(Cr) Toxicity | ATSDR - CSEM - Agency for Toxic Substances and ...

Agency for Toxic Substances and Disease Registry Chromium Toxicity
Case Studies in Environmental Medicine (CSEM)
Clinical Assessment - Laboratory Tests
Learning
Objectives
Upon completion of this section, you will be able to
• identify laboratory tests that can assist with diagnosis of chromium
exposure.
Introduction With excessive exposure, there will be evidence of renal and hepatic
damage. Proteinuria and hematuria precede anuria and uremia.
Initial Lab
Exams
Specialized
Tests
A reduction in the FEV1: FVC ratio on spirometry may be seen after acute
irritant exposure or in workers with chromium-induced asthma.
Skin allergy can be confirmed by patch testing.
Persistent cough, hemoptysis, or a mass lesion on chest radiograph in a
chromium worker should prompt a thorough evaluation for possible lung
cancer [Lewis 2004].
The following tests should be considered in the evaluation of Cr(VI) exposure
[HSDB 2000]
• complete blood count,
• liver function tests (aspartate aminotransferase (AST) or serum
glutamic-oxaloacetic transaminase (SGOT), ALT or serum glutamicpyruvic
transaminase (SGPT), and bilirubin),
• blood urea nitrogen (BUN) and creatinine, and
• urinalysis.
When obtaining biologic specimens for chromium analysis, care must be
taken to avoid sample contamination and chromium loss during collection,
transportation, and storage. For example, use of stainless steel utensils to
collect tissue samples might raise tissue chromium levels, as will stainless
steel grinding and homogenizing equipment. Some plastic containers contain
significant amounts of leachable chromium; therefore, specially prepared
acid-washed containers should be obtained from the laboratory.
Considerable care also must be taken in the analysis to minimize chromium
volatilization during sample washing [EPA 1984a].
Blood Or Serum Chromium Levels
Several methods are available for the analysis of chromium in different
biological media [ATSDR 2000]. For example, Cr(VI) and complexes of
Cr(III) can be rapidly determined in plasma and other biological specimens
via a high performance anion-exchange liquid chromatograph technique
[Suzuki 1987].
Blood distribution of chromium appears to be divided evenly between plasma
and erythrocytes. In the absence of known exposure, whole blood chromium
concentrations are in the range of 2.0 μg/100 mL to 3.0 μg/100 mL; lower
levels occur in rural areas, and higher levels occur in large urban centers.
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