Evaluation of Skin and Respiratory Symptoms Among Employees with Occupational Exposures to Cobalt and Chromium at an Orthopedic Implant Manufacturer

Details

• Personal Author:
  Beaucham, Catherine C. ; Mueller, Charles A. ; Tapp, Loren C.
• Description:
  The National Institute for Occupational Safety and Health (NIOSH) Health Hazard Evaluation Program received a request from employees at an orthopedic implant manufacturer. Employees were concerned about respiratory symptoms thought to be caused by occupational exposures to metals and metalworking fluids. The company manufactured surgical instrumentation and medical devices including cobalt-chromium femoral implants for use in joint replacement surgeries. At the time of the evaluation, the company employed 400 employees spread across nine buildings, working two 8-hour shifts per day, 5 or 6 days per week. Twenty-six employees worked in the building where the implants were machined. Although cobalt is an essential element and is present in the human diet in tiny amounts, occupational exposure has been associated with the development of occupational asthma and allergic contact dermatitis. In addition, some studies have shown that low levels of cobalt can lead to a decrease in lung function, in addition to irritation of the mucous membranes in the respiratory tract. There is also evidence that skin exposure to cobalt and other sensitizing chemicals may lead to an asthma-like response. Hexavalent chromium is carcinogenic to humans and is associated with cancer of the lung, nose, and nasal sinuses. A 2015 study suggests that hexavalent chromium is associated with an increased risk for stomach cancer. Occupational hexavalent chromium exposure has also been associated with irritation or damage to the nose, throat, lungs, eyes, and skin, including allergic contact dermatitis. NIOSH investigators collected personal air samples for aluminum, chromium, cobalt, hexavalent chromium, and titanium, and surface wipe samples for cobalt and chromium in the implant machining building. Personal air samples were also collected for metalworking fluids (MWF) and particulates. Because MWFs were detected in only one of the three personal air samples at less than 10% of the NIOSH REL and the highest particulate concentrations was approximately 13% of the NIOSH REL, this case study focuses on the cobalt and chromium exposures. [Description provided by NIOSH]
• Subjects:
  Chromium Environmental Monitoring Health Care Facilities Workforce And Services Manufacturing And Industrial Facilities Occupational Exposure Occupational Health Particulate Matter Respiratory System Safety
• Keywords:
  Air Sampling Aluminum Author Keywords: Surgical Appliances And Supplies Manufacturing Chromium Cobalt Hexavalent Chromium HHE 2013-0033-3238 Manufacturing Medical Equipment Metalworking Fluids Metal Working Fluids MWF MWFs Noise Occupational Exposure Particulates Respiratory Respiratory Irritants Sinus Skin Surgical Device Manufacturer Surgical Implants

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• ISSN:
  1076-2752
• Document Type:
  Text
• Genre:
  Journal Article
• Place as Subject:
  Ohio ; OSHA Region 5
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  DSHEFS - Division of Surveillance, Hazard Evaluations, and Field Studies
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  60
• Issue:
  11
• NIOSHTIC Number:
  nn:20053223
• Citation:
  J Occup Environ Med 2018 Nov; 60(11):e626-e632
• Contact Point Address:
  Catherine Beaucham, MPH, Hazard Evaluations and Technical Assistance Branch, Division of Surveillance, Hazard Evaluations, and Field Studies, National Institute for Occupational Safety and Health, 1090 Tusculum Avenue, Mailstop R-11, Cincinnati, OH 45226
• Email:
  htn9@cdc.gov
• CAS Registry Number:
  Chromium (CAS RN 7440-47-3) ; Chromium(6+) (CAS RN 18540-29-9) ; Cobalt (CAS RN 7440-48-4)
• Federal Fiscal Year:
  2019
• NORA Priority Area:
  Services
• Peer Reviewed:
  False
• NAICS and SIC Codes:
  339113 - Surgical Appliance and Supplies Manufacturing - (NAICS)
• Source Full Name:
  Journal of Occupational and Environmental Medicine
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:61fb88ad205dc5477643b38031f137131df2519e7776ca465ee2ae25a81e4f6605d5dcde69090355d38a7fb1a4ba46c5438bdf122a0bac8dbc65a67d00bea12b
• Download URL:
  https://stacks.cdc.gov/view/cdc/216023/cdc_216023_DS1.pdf
• File Type:
  [PDF - 385.03 KB ]