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

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

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<strong>Agency</strong> <strong>for</strong> <strong>Toxic</strong> <strong>Substances</strong> <strong>and</strong> Disease Registry Chromium <strong><strong>Toxic</strong>ity</strong><br />

Case Studies in Environmental Medicine (<strong>CSEM</strong>)<br />

What Instructions Should Be Given to Patients Exposed to Chromium?<br />

Learning<br />

Objectives<br />

Upon completion of this section, you will be able to<br />

• describe patient self care, <strong>and</strong><br />

• describe clinical follow-up.<br />

Introduction <strong>Cr</strong>(VI) compounds are widely used in the chemical industry as ingredients<br />

<strong>and</strong> catalysts in pigments, metal plating <strong>and</strong> chemical synthesis. <strong>Cr</strong>(VI) can<br />

also be produced when welding on stainless steel or <strong>Cr</strong>(VI)-painted surfaces.<br />

The major health effects associated with exposure to <strong>Cr</strong>(VI) include lung<br />

cancer, nasal septum ulcerations <strong>and</strong> per<strong>for</strong>ations, skin ulcerations, <strong>and</strong><br />

allergic <strong>and</strong> irritant contact dermatitis.<br />

All patients exposed to chromium need some basic guidance on<br />

• self care, so they can minimize further risks <strong>and</strong> avoid complications to<br />

the extent possible <strong>and</strong><br />

• clinical follow up, so they underst<strong>and</strong> when <strong>and</strong> why to return <strong>for</strong><br />

further medical attention.<br />

Self Care Effective steps patients should be advised to take to prevent <strong>and</strong> eliminate<br />

exposure.<br />

Clinical Follow-<br />

Up<br />

• Wear proper personal protective equipment such as respiratory<br />

protection, protective clothing, eye protection, <strong>and</strong> gloves.<br />

• Maintain a clean work area free of dust.<br />

• Shower <strong>and</strong> change clothes immediately on completion of work.<br />

• Leave or dispose of contaminated clothing at the work site.<br />

• Do not track dust from the work area to the rest of the home.<br />

• Do not smoke, eat, or drink in the work area.<br />

• Wash h<strong>and</strong>s well be<strong>for</strong>e eating, drinking, or smoking.<br />

• Heed employer provided patient <strong>and</strong> worker education.<br />

• If a smoker, stop smoking.<br />

Patients should be advised to call if they develop any of the following<br />

symptoms:<br />

• symptoms of kidney dysfunction such as lower extremity swelling,<br />

reduced urine volume, changes in color of urine, etc.,<br />

• dyspnea, cough, wheezing,<br />

• nausea, vomiting, diarrhea,<br />

• yellowing of the teeth,<br />

• altered sense of smell, <strong>and</strong><br />

• if you suspect you have been exposed.<br />

Page 51 of 67

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