Platinum in the environment: frequency of reactions to platinum-group elements in patients with dermatitis and urticaria

The aim of the present paper is to evaluate whether increasing environmental exposure increases the frequency of the positive prick and patch test reactions to certain chlorinated platinum salts in patients with dermatitis and urticaria. 800 consecutive subjects with contact dermatitis (n=749) and urticaria (n=51) were variously patch and prick tested with 30 haptens of a standard series, with aqueous solutions of, respectively, hexachloroplatinic acid (H-2[PtCl6]), potassium tetrachloro-platinate (K-2[PtCl4]), sodium hexachloroplatinate (Na-2[PtCl6]), iridium chloride (IrCl3), rhodium chloride (RhCl3) and palladium chloride (PdCl2), and with 16 common inhalants. 153 workers, variably exposed in a platinum refinery, were patch and prick tested only with solutions containing platinum-group elements at various concentrations and with 16 common inhalants. Platinum-group elements did not elicit positive patch or prick test reactions in non-occupationally exposed subjects. In contrast, in exposed workers, positive patch test reactions at day 2 and at 25 min, respectively, were found in 2 subjects with hand dermatitis and in 2 with urticaria and asthma. 22 out of the 153 workers, 18 of whom had rhinitis, asthma, and urticaria, gave positive prick test reactions to 1 or more salts. Furthermore, on patch and prick testing, 4 cross-reactions between platinum, palladium, iridium and rhodium were demonstrated. In conclusion, the test results demonstrate that the present concentration in the environment does not increase the incidence of reactions to platinum salts in patients with dermatitis and/or urticaria. However, if the average level of environmental platinum exposure approaches those existing in industrial settings in the future, we are going to observe more frequent health effects.