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Systematic review and quantification of respiratory cancer risk for occupational exposure to hexavalent chromium

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A Letter to the Editor to this article was published on 28 May 2013



To investigate the exposure-risk relationship for occupational chromium (VI) exposure and lung cancer in order to establish exposure limits.


We systematically searched for studies reporting on occupational Cr(VI) exposure and cancers of the respiratory tract. To be included, studies needed to provide data for more than one level of occupational Cr(VI) exposure, adequately consider the confounder smoking and be of adequate methodological quality. Because direct genotoxicity was considered the predominant mechanism of carcinogenesis of Cr(VI), linear models were applied in order to fit risk data. Relative risks were calculated based on these linear regression models and then used to estimate excess absolute risks.


Five studies of two cohorts of chromium production workers in Baltimore, Maryland, and Painesville, Ohio, were included. Based on different estimates for the exposure effect, the absolute excess risk was found to be “acceptable” (less than 4 per 10,000 according to the German Committee on Hazardous Substances, “AGS”) at a Cr(VI) concentration of 0.1 μg/m3, and became “intolerable” (more than 4 per 1,000) beyond a Cr(VI) concentration of 1 μg/m3.


Occupational exposure limits for Cr(VI) based on excess absolute risks can be derived from published data identified by a systematic literature review.

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  • ACGIH (American Conference of Industrial Hygienists) (2004) Chromium and inorganic compounds; Chromium(VI), water-soluble fume

  • AGS (2008) Announcement 910 June 2008. Announcement on hazardous substances, risk figures and exposure-risk relationships in activities involving carcinogenic hazardous substances. URL Accessed 14 Aug 2011

  • Alderson M, Rattan N, Bidstrup L (1981) Health of workmen in the chromate-producing industry in Britain. Br J Ind Med 38:117–124

    CAS  Google Scholar 

  • ATSDR (Agency for Toxic Substances & Diseases Registry) (2000) URL Accessed 14 Apr 2011

  • Birk T, Mundt KA, Dell LD, Luippold RS, Miksche L, Steinmann-Steiner-Haldenstaett W, Mundt DJ (2006) Lung cancer mortality in the German chromate industry, 1958–1998. J Occup Environ Med 48:426–433

    Article  CAS  Google Scholar 

  • Bukowski JA, Goldstein MD, Johnson BB (1991) Biological markers in chromium exposure assessment confounding variables. Arch Environ Health 46:230–236

    Article  CAS  Google Scholar 

  • CASP (Critical Appraisal Skills Programme of the British NHS Appraisal Tools) (2008) URL Accessed 14 Apr 2011)

  • Crispo A, Brennan P, Jöckel KH, Schaffrath-Rosario A, Wichmann HE, Nyberg F, Simonato L, Merletti F, Forastiere F, Boffetta P, Darby S (2004) The cumulative risk of lung cancer among current, ex- and never-smokers in European men. Br J Cancer 91:1280–1286

    Article  CAS  Google Scholar 

  • Crump C, Crump K, Hack E, Luippold R, Mundt K, Liebig E, Panko J, Paustenbach D, Proctor D (2003) Dose-response and risk assessment of airborne hexavalent chromium and lung cancer mortality. Risk Anal 23:1147–1163

    Article  Google Scholar 

  • De Flora S, Bagnasco M, Serra D, Zanacchi P (1990) Genotoxicity of chromium compounds. A review. Mutat Res 238:99–172

    Article  Google Scholar 

  • Deutsche Forschungsgemeinschaft (DFG) (ed) (2012) MAK- und BAT-Werte-Liste 2012: maximale Arbeitsplatzkonzentrationen und Biologische Arbeitsstofftoleranzwerte, vol 48. Wiley-VCH, Weinheim

    Google Scholar 

  • Gerin M, Fletcher AC, Gray C, Winkelmann R, Boffetta P, Simonato L (1993) Development and use of a welding process exposure matrix in a historical prospective study of lung cancer risk in European welders. Int J Epidemiol 22(Suppl 2):S22–S28

    Article  Google Scholar 

  • Gibb HJ, Lees PS, Pinsky PF, Rooney BC (2000) Lung cancer among workers in chromium chemical production. Am J Ind Med 38(2):115–126

    Article  CAS  Google Scholar 

  • Globocan (2008) Cancer incidence, mortality and prevalence worldwide in 2008. URL Accessed 19 Mar 2012

  • Goldbohm RA, Thielemans LJP, Heederik D, Rubingh CM, Dekkers S, Willems MI, Kroese ED (2006) Risk estimation for carcinogens based on epidemiological data: a structured approach, illustrated by an example on chromium. Reg Tox Pharm 44:294–310

    Article  CAS  Google Scholar 

  • International Agency on Research on Cancer (IARC) (1990) IARC monographs on the evaluation of carcinogenic risks to humans, chromium, nickel and welding, 49, Lyon

  • Jones ME, Swerdlow AJ (1998) Bias in the standardized mortality ratio when using general population rates to estimate expected number of deaths. Am J Epidemiol 148:1012–1017

    Article  CAS  Google Scholar 

  • Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP, Clarke M, Devereaux PJ, Kleijnen J, Moher D (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLOS 6:1–28

    Google Scholar 

  • Luippold RS, Mundt KA, Austin RP, Liebig E, Crump C, Crump K, Proctor D (2003) Lung cancer mortality among chromate production workers. Occup Environm Med 60:451–457

    Article  CAS  Google Scholar 

  • Manusco TF (1997a) Chromium as an industrial carcinogen: part I. Am J Ind Med 31:129–139

    Article  Google Scholar 

  • Manusco TF (1997b) Chromium as an industrial carcinogen: part II. Chromium in human tissues. Am J Ind Med 31:140–147

    Article  Google Scholar 

  • Mattioli S, Zanardi F, Baldasseroni A, Schaafsma F, Cooke RMT, Mancini G, Fierro M, Santangelo C, Farioli A, Fucksia S, Curti S, Violante FS, Verbeek J (2010) Search strings for the study of putative occupational determinants of disease. Occup Environ Med 67:436–443

    Article  CAS  Google Scholar 

  • Morfeld P, McCunney RJ (2010) Bayesian bias adjustment of the lung cancer SMR in a cohort of German carbon black production workers. J Occup Med Tox 5:23

    Article  Google Scholar 

  • SIGN (Scottish Intercollegiate Guidelines Network) (2008) URL Accessed 14 Apr 2011

  • Park RM, Stayner LT (2006) A search for thresholds and other nonlinearities in the relationship between hexavalent chromium and lung cancer. Risk Anal 26:79–88

    Article  Google Scholar 

  • Park RM, Bena JF, Stayner LT, Smith RJ, Gibb HJ, Lees PS (2004) Hexavalent chromium and lung cancer in the chromate industry: a quantitative risk assessment. Risk Anal 24:1099–1108

    Article  Google Scholar 

  • Robert Koch Institut (RKI) (2012) Krebs in Deutschland 2007/2008. Gesundheitsberichterstattung des Bundes. RKI 2012. Accessed 19 Mar 2012

  • SCOEL (2004) Recommendation from the scientific committee on occupational exposure limits: risk assessment for hexavalent chromium, SCOEL/SUM/86, December 2004

  • Steenland K, Deddens JA (2004) A practical guide to dose-response analyses and risk assessment in occupational epidemiology. Epidemiology 15:63–70

    Article  Google Scholar 

  • Steenland K, Loomis D, Shy S, Simonsen N (1996) Review of occupational lung carcinogens. Am J Ind Med 29:317–324

    Google Scholar 

  • Takahashi K, Okubo T (1990) A prospective study of chromium plating workers in Japan. Arch Environm Health 45:107–111

    Article  CAS  Google Scholar 

  • R Development Core Team (2011) R: a language and environment for statistical computing. R foundation for statistical computing, Vienna, Austria. URL

  • US EPA (1998) Toxicological Review of hexavalent chromium (CAS No. 18540-29-9) in support of summary information on the Integrated Risk Information System (IRIS). US Environmental Protection Agency. URL Accessed 9 Oct 2012

  • WHO (2000) Air quality guidelines, 2nd edn. WHO Regional Office for Europe, Copenhagen

    Google Scholar 

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The authors thank the German Federal Institute for Occupational Safety and Health for funding.

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The authors declare that they have no conflict of interest.

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Correspondence to Andreas Seidler.

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Seidler, A., Jähnichen, S., Hegewald, J. et al. Systematic review and quantification of respiratory cancer risk for occupational exposure to hexavalent chromium. Int Arch Occup Environ Health 86, 943–955 (2013).

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