Heavy Metal Contributions on Human Skin Disease near Cement Plant: A Systematic Review


  • Annisa Utami Rauf Department of Environmental Health, Faculty of Public Health, Hasanuddin University, Indonesia
  • Anwar Mallongi Department of Environmental Health, Faculty of Public Health, Hasanuddin University, Indonesia
  • Ratna Dwi Puji Astuti Department of Environmental Health, Faculty of Public Health, Hasanuddin University, Indonesia




heavy metal, skin disease, cement plant, industry


AIM: The aim of this systematic review was to investigate heavy metal roles at skin disease of humans in the cement industrial area.

METHODS: All research reporting a specific heavy metal, which could be increasing the risk of the disease, cause cement induced to skin. Fourteen selected articles from our inclusion criteria rated using eight quality-appraisal criteria derived from Strengthening the Reporting of Observational Studies in Epidemiology checklist and following preferred reporting items for systematic reviews and meta-analyses methodology.

RESULTS: We performed a systematic review of published articles between 2009 and 2019 from ten case–control, two cohort, one ecological study, and one cross-sectional study showed the heterogeneity of the study design. The studies are focusing on the relationship between heavy metal and skin disease that appeared in cement plant areas such as dermatitis, skin cancer, eczema, and other allergies. Chromium, nickel, cobalt, zinc, cadmium, mercury may present and play an important role for human skin disease.

CONCLUSION: Heavy metals have been found in the skin of human living and work around the cement industry. Chromium, cobalt, and nickel are almost certainly present in every case of dermatitis and eczema. Signs and mild symptoms of skin disease include redness, itching, starch, and dryness. Elements such as cadmium, lead, and mercury usually are found in chronic skin disease (psoriasis and skin cancer) on a biologic test. These findings should raise an important concern and recommendation policy for controlling raw materials contains heavy metal in cement industrial areas and proper protection for workers and non-worker.


Download data is not yet available.


Metrics Loading ...

Plum Analytics Artifact Widget Block


Amer MM, Sabry BA, Marrez DA, Hathout AS, Fouzy AS. Exposure assessment of heavy metal residues in some Egyptian fruits. Toxicol Rep. 2019;6:538-43. https://doi.org/10.1016/j. toxrep.2019.06.007

ACGIH. Threshold Limit Values for Chemical Substances and Physical Agents and Biological Exposure Indices. Cincinnati: ACGIH Worldwide, Signature Publications; 2004. p. 109-28.

Bai L, Wang Y, Guo Y, Zhou Y, Xie X. Health risk assessment research on heavy metals ingestion through groundwater drinking pathway for the residents in Baotou, China. J Environ Health. 2016;78(6):84-91. PMid:26867296

Taner S, Pekey B, Pekey H. Fine particulate matter in the indoor air of barbeque restaurants: Elemental compositions, sources and health risks. Sci Total Environ. 2013;454-455:79-87. https:// doi.org/10.1016/j.scitotenv.2013.03.018 PMid:23542481

Wang X, Mukherjee B, Park SK. Associations of cumulative exposure to heavy metal mixtures with obesity and its comorbidities among U.S. adults in NHANES 2003-2014. Environ Int. 2018;121:683-94. https://doi.org/10.1016/j. envint.2018.09.035 PMid:30316184

Geng HX, Wang L. Cadmium: Toxic effects on placental and embryonic development. Environ Toxicol Pharmacol. 2019;67:102-7. PMid:30797179

Chou TC, Wang PC, Wu J De, Sheu SC. Chromiuminduced skin damage among Taiwanese cement workers. Toxicol Ind Health. 2016;32(10):1745-51. https://doi. org/10.1177/0748233715584699 PMid:25964241

Frías M, De Rojas MI. Total and soluble chromium, nickel and cobalt content in the main materials used in the manufacturing of Spanish commercial cements. Cem Concr Res. 2002;32(3):435- 40. https://doi.org/10.1016/s0008-8846(01)00701-3

Afridi HI, Kazi TG, Kazi N, Kandhro GA, Baig JA, Shah AQ, et al. Evaluation of cadmium, chromium, nickel, and zinc in biological samples of psoriasis patients living in Pakistani cement factory area. Biol Trace Elem Res. 2011;142(3):284-301. https://doi. org/10.1007/s12011-010-8778-y PMid:20665125

Koh DH, Kim TW, Jang SH, Ryu HW. Cancer mortality and incidence in cement industry workers in Korea. Saf Health Work. 2011;2(3):243-9. https://doi.org/10.5491/shaw.2011.2.3.243 PMid:22953208

Lushniak BD. Occupational contact dermatitis. Dermatol Ther. 2004;17(3):272-7. PMid:15186373

Cha KT, Oh SS, Yoon JH, Lee KH, Kim SK, Cha BS, et al. Adverse health outcomes in residents exposed to cement dust. Toxicol Environ Health Sci. 2011;3(4):239-44. https://doi. org/10.1007/s13530-011-0101-6

Thyssen JP, Jensen P, Carlsen BC, Engkilde K, Menné T, Johansen JD. The prevalence of chromium allergy in Denmark is currently increasing as a result of leather exposure. Br J Dermatol. 2009;161(6):1288-93. https://doi. org/10.1111/j.1365-2133.2009.09405.x PMid:19673874

Sigvardsen NM, Ottosen LM. Characterization of coal bio ash from wood pellets and low-alkali coal fly ash and use as partial cement replacement in mortar. Cem Concr Compos. 2019;95:25- 32. https://doi.org/10.1016/j.cemconcomp.2018.10.005

Aljeesh Y, Al Madhoun W, El Jabaly S. Effect of exposure to cement dust on pulmonary function among cement plants workers in the Middle Governorate, Gaza, Palestine. Public Health Res. 2015;5(5):129-34.

Spiro J. Occupational skin diseases. Princ Pract Ski Toxicol. 2008;27(4):259-77.

Normohammadi M, Kakooei H, Omidi L, Yari S, Alimi R. Risk assessment of exposure to silica dust in building demolition sites. Saf Health Work. 2016;7(3):251-5. https://doi.org/10.1016/j. shaw.2015.12.006 PMid:27630796

Mallongi A, Stang, Syamsuar M, Fajar MN, Pujiastuti RD, Rauf AU. Risks assessment of silica contamination on the communities living surround the cement industry, pangkep Indonesia. Indian J Public Health Med Res. 2019;10(10):1619. https://doi.org/10.5958/0976-5506.2019.03072.9

Omrani MA, Modarres A. Emulsified cold recycled mixtures using cement kiln dust and coal waste ash-mechanicalenvironmental impacts. J Clean Prod. 2018;199:101-11. https:// doi.org/10.1016/j.jclepro.2018.07.155

Thomas B, Kulichova D, Wolf R, Summer B, Mahler V, Thomas P. High frequency of contact allergy to implant and bone cement components, in particular gentamicin, in cemented arthroplasty with complications: Usefulness of late patch test reading. Contact Dermatitis. 2015;73(6):343-9. https://doi. org/10.1111/cod.12465 PMid:26329644

Stern AH, Bagdon RE, Hazen RE, Marzulli FN. Risk assessment of the allergic dermatitis potential of environmental exposure to hexavalent chromium. J Toxicol Environ Health. 1993;40(4):613- 41. https://doi.org/10.1080/15287399309531822 PMid:8277522

Hedberg YS, Lidén C, Lindberg M. Chromium dermatitis in a metal worker due to leather gloves and alkaline coolant. Acta Derm Venereol. 2016;96(1):104-5. https://doi. org/10.2340/00015555-2160 PMid:26062867

Nijhawan RI, Molenda M, Zirwas MJ, Jacob SE. Systemic contact dermatitis. Dermatol Clin. 2009;27(3):355-64. https:// doi.org/10.1016/j.det.2009.05.005 PMid:19580929

Achmad RT, Auerkari EI. Effects of chromium on human body. Annu Res Rev Biol. 2017;13(3):1-8.

Wong CC, Gamboni SE, Palmer AM, Nixon RL. Occupational allergic contact dermatitis to chromium from cement: Estimating the size of the problem in Australia. Australas J Dermatol. 2015;56(4):290-3. https://doi.org/10.1111/ajd.12238 PMid:25367657

Lison D. Cobalt. Handb Toxicol Met Fourth Ed. 2015;1:743-63.

Hon KL, Wang SS, Hung EC, Lam HS, Lui HH, Chow CM, et al. Serum levels of heavy metals in childhood eczema and skin diseases: Friends or foes. Pediatr Allergy Immunol. 2010;21(5):831-6. https://doi.org/10.1111/j.1399-3038.2010.01022.x

Darmono. Lingkungan Hidup dan Pencemaran: Hubungannya Dengan Toksikologi Senyawa Logam. Jakarta: Penerbiit Universitas Indonesia; 2010.

Wang BJ, De Wu J, Sheu SC, Shih TS, Chang HY, Guo YL, et al. Occupational hand dermatitis among cement workers in Taiwan. J Formos Med Assoc. 2011;110(12):775-9. https://doi. org/10.1016/j.jfma.2011.11.008 PMid:22248832

Schwensen JF, Menné T, Veien NK, Funding AT, Avnstorp C, Østerballe M, et al. Occupational contact dermatitis in bluecollar workers: Results from a multicentre study from the Danish contact dermatitis group (2003-2012). Contact Dermatitis. 2014;71(6):348-55. https://doi.org/10.1111/cod.12277 PMid:25041423

García-Pérez J, López-Abente G, Castelló A, GonzálezSánchez M, Fernández-Navarro P. Cancer mortality in towns in the vicinity of installations for the production of cement, lime, plaster, and magnesium oxide. Chemosphere. 2015;128:103- 10. https://doi.org/10.1016/j.chemosphere.2015.01.020 PMid:25681568

Bermudez GM, Moreno M, Invernizzi R, Plá R, Pignata ML. Heavy metal pollution in topsoils near a cement plant: The role of organic matter and distance to the source to predict total and HCl-extracted heavy metal concentrations. Chemosphere. 2010;78(4):375-81. https://doi.org/10.1016/j.chemosphere.2009.11.012 PMid:19962174

Elhosary N, Maklad A, Soliman E, El-Ashmawy N, Oreby M. Evaluation of oxidative stress and DNA damage in cement and tannery workers in Egypt. Inhal Toxicol. 2014;26(5):289-98. https://doi.org/10.3109/08958378.2014.885100 PMid:24617565

Khatami A, Nassiri-Kashani M, Gorouhi F, Babakoohi S, Kazerouni-Timsar A, Davari P, et al. Allergic contact dermatitis to metal allergens in Iran. Int J Dermatol. 2013;52(12):1513-8. https://doi.org/10.1111/j.1365-4632.2012.05623.x PMid:23488935

Rycroft RJ. Textbook of Contact Dermatitis. Berlin, Germany: Springer; 2001.

Thyssen JP, Ross-Hansen K, Menné T, Johansen JD. Patch test reactivity to metal allergens following regulatory interventions: A 33-year retrospective study. Contact Dermatitis. 2010;63(2):102- 6. https://doi.org/10.1111/j.1600-0536.2010.01751.x PMid:20629675




How to Cite

Rauf AU, Mallongi A, Astuti RDP. Heavy Metal Contributions on Human Skin Disease near Cement Plant: A Systematic Review. Open Access Maced J Med Sci [Internet]. 2020 Jul. 25 [cited 2021 Oct. 19];8(F):117-22. Available from: https://oamjms.eu/index.php/mjms/article/view/4396



Systematic Review Article


Most read articles by the same author(s)

1 2 3 > >>