Quantitative aspects of contact allergy to chromium and exposure to chrome-tanned leather

The potential of trivalent and hexavalent chromium to induce and elicit allergic contact dermatitis and the degree of chromium exposure from leather products are reviewed. Chromium dermatitis is often due to exposure in the occupational environment, with cement being one of the most common chromium sources. However, consumer products such as chromium(III)-tanned leather products are also an important source of chromium exposure. Apart from Cr(III), which is used for tanning, leather often also contains trace amounts of Cr(VI), which is formed by oxidation of Cr(III) during the tanning process. In a recent study of the Cr(VI) content of leather products bought on the Danish market, 35% of such articles had a Cr(VI) content above the detection limit of 3 p.p.m., ranging from 3.6 p.p.m. to 14.7 p.p.m. Leachable Cr(III) was detected at levels of 430-980 p.p.m. An examination of available dose-response studies showed that exposure to occluded patch test concentrations of 7-45 p.p.m. Cr(VI) elicits a reaction in 10% of the chromium-sensitive patients. When reviewing repeated open exposure studies, it is seen that either exposure to 5 p.p.m. Cr(VI) in the presence of 1% sodium lauryl sulfate (SLS) or exposure to 10 p.p.m. Cr(VI) alone both elicit eczema in chromium-sensitive patients. The eliciting capacity of Cr(III) has not been systematically investigated but, compared to Cr(VI), much higher concentrations are needed to elicit eczema.