Authors: E Ratshikhopha, M Muvhali, T Singh, D Rees
Source: Current Allergy & Clinical Immunology. March 2019 Vol 32, No 1
Introduction: Cases of sensitisation to platinum salts within platinum-processing sectors (particularly platinum refineries and motor-vehicle, catalytic-convertor production) have been extensively described. However, the occurrence of platinum salt sensitisation outside of these sectors is less well known. We present a case of platinum-salt sensitisation in a chemical plant worker cleaning reactors from platinum refineries.
Methodology: A 32-year-old man working at a chemical plant presented at the National Institute for Occupational Health’s Occupational Medicine Clinic for evaluation of potential work-related asthma. A medical evaluation, including spirometry and a skin-prick test for sodium hexachloroplatinate and ammonium chloroplatinate salts (platinum salts), was performed.
Results: The worker had convincing evidence of occupational asthma induced by platinum salts: there was a temporal association between lower respiratory symptoms and workplace exposure; he had objective evidence of asthma; and he had exposure to a known cause of occupational asthma, namely, platinum salts. Positive skin-prick tests to two platinum salts – an 11 mm wheal average for sodium hexachloroplatinate and a 10 mm wheal average for ammonium chloroplatinate – provided support that platinum salts were the causative agent.
Conclusion: This case demonstrates that platinum-salt sensitisation and resultant allergic diseases can occur outside the traditional industries associated with exposure to platinum salts. Healthcare providers should be aware of this, and occupational health services need to prevent sensitisation through appropriate hazard control – in this case cleaning of reactors at the refinery – and to consider medical surveillance of exposed workers. Thorough workplace health-risk assessments are required to adequately identify potential exposures.