EXPOSURE TO CORROSIVE CHROMATES IN PREGNANCY

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(Date of issue: April 2012, Version: 1)

This is a UKTIS monograph for use by health care professionals. For case-specific advice please contact UKTIS on 0344 892 0909. To report an exposure please download and complete a pregnancy reporting form. Please encourage all women to complete an online reporting form.

Summary

Chromic acid, chromate and dichromate salts of ammonia, potassium and sodium exist as odourless, yellow to red crystalline solids.  They carry chromium in the hexavalent state (Cr VI) which is a confirmed mutagen, carcinogen and genotoxicant in animals, and a carcinogen in humans.  Chromates are highly corrosive and toxic, and are easily absorbed through the digestive and respiratory tracts and through skin.  Exposure is mainly occupational in industries that produce or use chromate compounds (e.g. metal, leather, paint, dye, welding industries).

A number of animal studies in diverse species have documented adverse reproductive and teratogenic effects of maternal Cr (VI) exposure.  Human data are very limited; an increased risk of maternal toxicosis*[sic], and postnatal haemorrhage have been reported following maternal occupational exposure, and a single study reported a slight increase in stillbirth rates following maternal environmental exposure.  No increased rate of congenital anomalies was detected in two studies where maternal exposure to environmental chromium occurred.  However, these data are highly confounded and suffer from a number of methodological limitations.

Paternal exposure to Cr (VI) has been shown to have adverse effects on male fertility and an increased risk of male mediated spontaneous abortion in a number of studies, however available data are inconsistent.

There are no published data regarding acute chromate exposure in human pregnancy, therefore it is not possible to provide an evidence-based assessment of the risk exposure poses to a developing fetus, although maternal toxicity is likely to be a major determinant of risk to the fetus. 

Due to their corrosive and toxic properties, acute exposure to chromates in pregnancy necessitates prompt treatment as for a non-pregnant patient.  Given the evidence of teratogenicity in animals and lack of robust data in humans, additional fetal monitoring should be considered on a case-by-case basis.  Discussion with UKTIS is advised in all cases.

Toxicosis* - it is unclear whether this term refers to symptoms of early pregnancy (e.g. nausea, vomiting) or preclamptic toxaemia.

Note: This document has been archived and will not be routinely updated. If up-to-date information is required please contact UKTIS.

This document is regularly reviewed and updated.  Only use UKTIS monographs downloaded directly from TOXBASE.org or UKTIS.org to be sure you are using the most up-to-date version.

This is a summary of the full UKTIS monograph for health care professionals and should not be used in isolation. The full UKTIS monograph and access to any hyperlinked related documents is available to health care professionals at www.toxbase.org.

If you have a patient with exposure to a drug or chemical and require assistance in making a patient-specific risk assessment, please telephone UKTIS on 0344 892 0909 to discuss the case with a teratology specialist.

If you would like to report a pregnancy to UKTIS please click here to download our pregnancy reporting form. Please encourage all women to complete an online reporting form.

Disclaimer: Every effort has been made to ensure that this monograph was accurate and up-to-date at the time of writing, however it cannot cover every eventuality and the information providers cannot be held responsible for any adverse outcomes of the measures recommended. The final decision regarding which treatment is used for an individual patient remains the clinical responsibility of the prescriber. This material may be freely reproduced for education and not for profit purposes within the UK National Health Service, however no linking to this website or reproduction by or for commercial organisations is permitted without the express written permission of this service. This document is regularly reviewed and updated. Only use UKTIS monographs downloaded directly from TOXBASE.org or UKTIS.org to ensure you are using the most up-to-date version.