Occupational and Environmental Medicine 1995;52:661-666 Platinum salt sensitivity in refinery workers: incidence and effects of smoking and exposure

Accepted 19 June 1995 Abstract Objective-To measure the incidence of platinum salt sensitivity (PSS) in refinery workers and examine the influence ofcigarette smoking and exposure to platinum salts on sensitisation. Design-A prospective cohort study with examination ofworkers at quarterly intervals for 18 months, and again at 24 months. Setting-A South African primary platinum refinery. Subjects-78 new recruits, selected by the refinery's usual procedure, without apparent atopy and in good respiratory health. Results-After 24 months 32 (41%) subjects had been diagnosed PSS and were subsequently medically separated. Twenty two (28%) cases were confirmed by positive skin prick test to platinum salts, 10 (13%) cases were symptomatic but skin prick negative. Incidence of cases per 100 person-months was 1 9 skin prick positive and 0-8 negative. Risk of sensitisation was about eight times greater for smokers than non-smokers, and six times greater for high exposure than low exposure. Conclusion-Smoking and intensity of exposure were definitely associated with development of PSS. Positive response to platinum salt skin prick test had a 100% positive predictive value for symptoms and signs ofPSS if exposure continued.