From the Guidelines
Worrisome chromium levels are typically considered to be above 1-2 μg/L in blood tests and above 5 μg/L in urine tests, as these levels may indicate excessive exposure and potential toxicity. Chromium toxicity is a concern due to its potential to cause skin irritation, respiratory problems, gastrointestinal issues, and liver or kidney damage, as well as its carcinogenic properties, particularly in the case of hexavalent chromium [ 1 ].
Key Considerations
- Normal total chromium levels in blood are typically below 0.5 μg/L [ 1 ]
- Hexavalent chromium is particularly dangerous, with even trace amounts being potentially harmful due to its carcinogenic properties [ 1 ]
- Occupational safety guidelines recommend keeping airborne hexavalent chromium below 5 μg/m³ in workplace environments
- Symptoms of chromium toxicity include skin irritation, respiratory problems, gastrointestinal issues, and liver or kidney damage [ 1 ]
Special Populations
- The elderly may be more vulnerable to chromium depletion than younger people, and may benefit from chromium supplementation [ 1 ]
- Pediatric patients may be at higher risk of chromium toxicity, and the ESPGHAN/ESPEN do not recommend chromium addition in PN in children [ 1 ]
- Patients with end-stage renal disease may accumulate chromium in their bones, and increased serum chromium levels have been found in patients undergoing maintenance hemodialysis [ 1 ]
Testing and Interpretation
- If you suspect chromium exposure, consult a healthcare provider for proper testing and interpretation of results
- Blood and urine tests can be used to measure chromium levels, but the results must be interpreted in the context of the individual's exposure history and medical condition [ 1 ]
From the Research
Worrisome Chromium Levels
Worrisome chromium levels are typically associated with exposure to chromium(VI) compounds, which are known to be carcinogenic and mutagenic. The following points highlight the levels of chromium that are considered worrisome:
- Chromium(VI) concentrations at 0.025 mg/m³ are associated with a high cancer risk, increasing the risk of lung cancer in 2-14 cases per 1000 exposed workers 2.
- Exposure to chromium(VI) compounds at 0.01 mg Cr(VI)/m³ is responsible for an increased number of lung cancer cases in 1-6 per 1000 people employed in this condition for their entire professional activity 2.
- Elevated levels of chromium have been found in workers exposed to leather tanning and metal plating units, with higher levels of chromium exposure enhancing oxidative stress and potentially causing cellular and molecular damage 3.
- Biological monitoring data have shown high urinary concentrations of chromium in the general population with no occupational exposure to these metals, resident in industrial areas 4.
- Urinary excretion of chromium has been closely related to the concentration of water-soluble chromium(VI) in the air, with values corresponding to 50 micrograms m-3 in the air being 29.8 and 12.2 micrograms g-1 of creatinine, respectively 5.
Health Effects of Chromium Exposure
The health effects of chromium exposure are varied and can include:
- Genetic alterations 6
- Respiratory alterations 6
- Cancer 6
- Dermatitis 6
- Male reproduction alterations 6 Hexavalent chromium is the agent most frequently associated with these health effects, highlighting the need for adequate control measures to minimize exposure and diminish the number of associated diseases 6.