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Toxic Heavy Metals List Exposures, Disorders, Prevention

Aluminum

Exposures: Metal that has resistant properties to corrosion. It is used in foil, kitchenware and automobile and aircraft industries. Workers who are at risk for toxicity are those in refineries, foundries and also welders and grinders. Dialysis patients can also have toxicity.

Disorders: Conjunctivitis, eczema, upper airway irritation, pneumoconiosis, and especially with dialysis patients, neurotoxicity and osteomalacia.

Prevention: Using dialysis water aluminum concentration should be lower than 10-micrograms/ deciliter. Exposure limits are 15mg/m³ for dust and 5mg/m³ for respirable particles.

Antimony

Exposures: Used with lead for the production of semiconductors and thermoelectric devices. Other exposures include pharmaceuticals, mining, making pewter, solder, and storage battery plates.

Disorders: Cardiotoxicity occurs with antimony pharmaceuticals. Occupational exposure - irritation of mucus membranes, eczema, chemical burns, perforation of the nasal septum, antimony spots, benign pneumoconiosis and possible lung cancer risk. Antimony in combination with a strong acid leads to Stibine toxicity with hemolysis, shock, CNS symptoms and death due to anuria.

Prevention: Limit exposure levels to 0.5mg/m³ and stibine 0.1 ppm.

Arsenic

Exposures: Metal smelters and coal burning emit this. Contaminated well water is found in South America, West Bengal and Taiwan. Used in manufacture of semiconductors, pesticides, opal glass, pharmaceuticals, paint and coating, and leather tanning. Taxidermists use arsenic.

Disorders: Acute effects - vomiting, colic and diarrhea, fever, cardiotoxicity, shock, and death. Inhaled Arsine causes dizziness, headache, hemolysis, jaundice, kidney damage and death. Chronic effects - sensorimotor neuropathy, eczema, hyperkeratosis, hyperpigmentation, vascular effects including Raynaud's, acrocyanosis and necrosis. Associated with lung cancer.

Prevention:
Measure arsenic levels in the urine. Limit for airborne arsenic and inorganic form is 0.01 mg/m³, for organic form is 0.5 mg/m³ and for arsine is 0.05 ppm.

Barium

Exposures: Utilized in drilling muds, glass, ceramic glazes, paper, pesticides, and X-Ray contrast material.

Disorders: Inhalation with insoluble form causes benign pneumoconiosis (Baritosis) and soluble salts cause hypokalemia. Acute poisoning - smooth muscle stimulation, vomiting, colic, diarrhea and eventual paralysis.

Prevention: Occupational exposure limit for soluble form is 0.05 mg/m³.

Beryllium

Exposures: Manufacture of fluorescent lamps, cathode ray tubes and space and aircraft industry.

Disorders: Acute effects - allergic dermatitis and chemical pneumonia. Chronic effects - berylliosis - granulomatous lung disease.

Prevention: Occupational exposure limit is 0.002 mg/m³.

Cadmium

Exposures: Found in fertilizer and sewage sludge (contaminating agricultural soil). Cadmium is used for plating and corrosion treatment of iron and steel. Utilized in production of batteries, and in spray painting, and cutting cadmium and its ores.

Disorders: Acute effects - toxic pneumonitis. Chronic effects - renal dysfunction/nephropathy and osteomalacia. Long term exposure - emphysema and lung cancer.

Prevention: Monitor blood levels. Limit for exposure is 0.005 mg/m³.

Chromium

Exposures: Present in food and water especially in Northern Europe. It is an essential trace element. Used in the steel industry, welding, photographic emulsions and wood preservatives. Hexavalent Cr (VII) is more toxic then trivalent Cr (III).

Disorders: Cr (VI) - Corrosion of the nasal septum and circumscribed ulcers or chrome holes. Cr (III) - allergen, eczema and asthma. Lung cancer (hexavalent).

Prevention: Monitor hexavalent chromium levels in the urine. Levels for airborne chromate and chromic acid are 0.1 mg/m³, soluble chromium and salts are 0.05 mg/m³ and chromium metals are 1 mg/m³. Permissible exposure level for hexavalent chromium is 0.001 mg/m³.

Cobalt

Exposures: Production of hard metal, which is cemented by a cobalt binder. Cobalt compounds are in catalysts and in desiccators. It is also an essential trace element.

Disorders: Airway irritation, asthma and "hard metal pneumoconiosis." Eczema, especially in the hand. Cardiomyopathy has been reported among beer drinkers.

Prevention: Monitor cobalt in the urine. Exposure limit is 0.5 mg/m³.

Copper

Exposures: Production of electric equipment, alloys, plumbing and heating systems.

Disorders: Metal fume fever. Patients with Wilson's disease are at risk for toxicity.

Prevention: Monitor ceruloplasmin levels in the serum. Exposure limit for copper dust is 1 mg/m3 and copper fume is 0.1 mg/m³.

Iron

Exposures: It is an essential element. Toxic effects are manifested with overdose of Iron supplements. Foundry workers, grinders, welders are exposed to Iron Oxide fume.

Disorders:Overdose - GI upset/lesions, metabolic acidosis, toxic hepatitis and shock. Chronic overload - Hemachromatosis - hemasiderosis, liver cirrhosis and cancer. Inhalation - Pulmonary siderosis.

Prevention: Use childproof containers for supplements. Limit iron oxide fume to 10 mg/m³.

Lead

Exposures:
Environmental - gasoline additives (organolead is contained in gasoline as an octane booster), lead based paint, lead soldered cans and ceramic glazes. Occupational - Primary manufacture of lead, lead production from auto batteries and scrap metal. Production of batteries. Welding and cutting of lead alloys.

Disorders
Inorganic lead - encephalopathy, seizures, decreased intellectual performance of children, anemia and lead palsy in adults. Acute effects- nephro toxicity, GI upset anorexia, dysphagia, constipation, renal dysfunction and lead seams in gingiva. Organic lead - sleepiness, dizziness, fatigue, insomnia and psychosis.

Prevention:
Maintain blood lead levels for occupational exposure < 300 micrograms/liter. CDC recommends that blood lead in children be < 100 micrograms/liter. Occupational exposure limit for organolead is 0.075 mg/m³.

Magnesium

Exposure: Occupational exposure to magnesium oxide.

Disorders: Eye and upper airway irritation. Metal fume fever.

Prevention: Limit for exposure 15 mg/m³.

Manganese

Exposures: Production of metal alloys and welding rods, dry batteries and pigments for the glass and ceramic industry.

Disorders: Acute effect by inhalation - pneumonitis and metal fume fever. Chronic effects - Parkinson's like disease.

Prevention: Occupational exposure level 5 mg/m³.

Mercury

Exposures: Mercury is evaporated in the atmosphere. In organic mercury is methylated in the marine environment by microorganisms and then accumulates in fat deposits of fish. Marine carnivores are at high risk for toxicity. Used in the manufacture of thermometers, manometers, electric equipment, fluorescent light bulbs, pharmaceuticals and pesticides. Used in amalgam for dental filling.

Disorders: Acute exposure by inhalation - chemical pneumonitis and pulmonary edema. Ingestion of organic compounds - GI irritation, vomiting, bloody diarrhea and stomach pains. Dermal exposure - contact dermatitis. CNS effects - erethism (restlessness, insomnia, difficulty concentrating and memory deficits) and intention tremor with also gingivitis. Nephrotoxic effects. In children - pink disease (reddish scaly skin eruption). Methyl mercury (seen in the pollution of Minamata Bay) causes paraesthesias, ataxias, visual field defects and deafness. Congenital exposure may lead to cerebral palsy.

Prevention: Measure urine levels. Limit long-term exposure to mercury vapor 25 micrograms/meter³ as a TWA. Limit concentration in fish 0.5 mg or 1mg/kg. Occupational exposure limit is 0.1 mg/m³ and 0.01 mg/m³ for organic mercury.

Nickel

Exposures: Used in alloys, surface treatment of metals, catalysts in electronics and production of nickel-cadmium batteries.

Disorders: Cancer of the nasal sinuses and lung cancer. Contact eczema. Nickel carbonyl may cause shortness of breath, headache, dizziness, abdominal pain, vomiting, pulmonary symptoms, cerebral toxicity and death.

Prevention: Monitor nickel levels in the plasma and urine. Limits for occupational exposure are 1 mg/m³ for nickel metal and 0.001 ppm for nickel carbonyl.

Zinc

Exposures: Essential trace element. Used in soldering and welding.

Disorders: Zinc oxide is associated with metal fume fever. Symptoms of this syndrome in the first few hours are malaise, cough, sore throat and metallic taste in the mouth. Six to eight hours after onset, the patients' experience influenza-like symptoms with chills, muscle pains, headache and fever. It usually lasts less than a day. Laboratory findings are elevated erythrocyte sedimentation rate, leukocytosis, and elevated lactate dehydrogenase.

Prevention: Limit exposure of zinc oxide fumes to 5 mg/m³.

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