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Elevated chromium levels and prosthetic joint implants.

James William Price1

  • 1Medical Director, St Mary's Occupational Medicine Clinic, St Mary's Medical Center, 2330 Lynch Rd, Evansville, IN 47711-2998, USA. james.price@stmarys.org

The Journal of the American Osteopathic Association
|September 30, 2011
PubMed
Summary

Elevated urinary chromium levels in a patient were caused by cobalt-chromium knee prostheses, not occupational exposure. This highlights the importance of considering implants in chromium level assessments.

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Area of Science:

  • Toxicology
  • Biomaterials Science
  • Occupational Health

Background:

  • Chromium is a toxic heavy metal with established occupational exposure limits.
  • Medical surveillance guidelines exist for chromium-exposed individuals.
  • Occupational Safety and Health Administration (OSHA) sets chromium exposure standards.

Observation:

  • A 54-year-old man with a history of chromium work showed persistent high urinary chromium levels post-exposure.
  • Standard occupational exposure screening did not explain the elevated levels.

Findings:

  • The persistent chromium elevation was definitively linked to the patient's cobalt-chromium alloy knee prostheses.
  • The prosthetic implants served as a chronic source of chromium release.

Implications:

  • Medical evaluations for elevated chromium should consider prosthetic joint implants.
  • Biocompatibility and long-term leaching of metal-on-metal implants warrant further investigation.
  • Clinical guidelines for chromium exposure may need revision to include implant-related sources.