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Chromium toxicity may result from occupational exposure, environmental exposure, or a combination of both routes. Similar to the case with many metals, the clinical manifestations of chromium toxicity depend on whether the exposure is acute or chronic and on the chemical form of chromium. Whereas acute toxicity is more likely to involve multiple organ failure, chronic exposure may lead to cancer.

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Chromium (from the Greek word for color, chroma) is a naturally occurring element that may be found in oxidation states of −2 to +6 but primarily exists in the trivalent (Cr3+) and hexavalent (Cr6+) forms. It was first discovered in 1797 in the form of Siberian red lead (crocoite: PbCrO4) and occurs only in combination with other elements, primarily as halides, oxides, or sulfides (Table 91–1). Chromium is found most abundantly in chromite ore (FeCr2O4).9 Elemental chromium (Cr0) does not occur naturally but is extracted commercially from ore.

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Table 91–1. Common Forms of Chromium
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Elemental chromium is a blue-white metal that is hard and brittle. It can be polished to a fine, shiny surface; affords significant protection against corrosion; and can be added to steel to form stainless steel (an alloy of chromium, nickel, and iron). One of the most important uses of chrome plating is to apply a hard, smooth surface to machine parts such as crankshafts, printing rollers, ball bearings, and cutting tools. This is known as "hard" chrome plating. Elemental chromium is also used in armor plating safes and is used in forming brick molds because of its high melting point and moderate thermal expansion.

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The carcinogenic potential of hexavalent chromium was first recognized as a cause of nasal tumors in Scottish chrome pigment workers in the late 1800s. In the 1930s, the pulmonary carcinogenicity of hexavalent chromium was first described in German chromate workers.12

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Chromium is an essential element involved in glucose metabolism. This may be through facilitation of insulin ...

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