Toxic Heavy Metal Exposure

Metal poisoning occurs when toxic metals accumulate in the body, causing a range of symptoms and health effects that depend on the specific metal, quantity, and exposure duration. This article provides an overview of various metal poisonings, their causes, symptoms, and treatments.

Aluminum

Causes: Occupational exposure in manufacturing, ingestion of contaminated water/food.
Symptoms: Possibly linked to neurological effects like Alzheimer’s disease (not confirmed).
Treatment: Mainly supportive; remove exposure.

Antimony

Causes: Industrial exposure, mining, or ingestion of contaminated substances.
Symptoms: Respiratory irritation, vomiting, diarrhea, cardiac toxicity.
Treatment: Stop exposure, supportive care, chelation if severe.

Arsenic

Causes: Contaminated water, industrial exposure, pesticides.
Symptoms: Acute: nausea, vomiting, watery diarrhea, abdominal pain; chronic: skin changes (melanosis, hyperkeratosis), Mees lines (white lines on nails), peripheral neuropathy, cancers (skin, lung, bladder).
Treatment: Remove exposure, chelation therapy, supportive care[1][3].

Barium

Causes: Industrial exposure, contaminated water or soil.
Symptoms: Gastrointestinal distress, muscle weakness, cardiac arrhythmias.
Treatment: Supportive care, potassium administration, avoid further exposure.

Bismuth

Causes: Medication (bismuth compounds), industrial exposure.
Symptoms: Neurotoxicity with high doses, kidney damage.
Treatment: Discontinue source, supportive treatment, chelation if indicated.

Cadmium

Causes: Battery manufacturing, pigments, cigarette smoke.
Symptoms: Acute: pulmonary edema; chronic: kidney damage, bone disease.
Treatment: Stop exposure, supportive care; no effective chelation established[1].

Chromium

Causes: Galvanization, paint/glass manufacture, leather tanning, cement exposure.
Symptoms: Acute: dermatitis, allergic asthma, hemorrhagic gastroenteritis; chronic: nasal septum ulceration/perforation, lung cancer, welder’s lung.
Treatment: Remove exposure, wash skin contamination, supportive care[1].

Cobalt

Causes: Occupational exposure, cobalt-containing alloys.
Symptoms: Asthma, cardiomyopathy, skin rash.
Treatment: Remove exposure, supportive treatment.

Copper

Causes: Contaminated water, occupational exposure.
Symptoms: Acute: gastrointestinal symptoms, hemolysis; chronic: liver damage, neurological symptoms.
Treatment: Chelation therapy (e.g., penicillamine), supportive care.

Gold

Causes: Medical use (arthritis treatment), occupational exposure.
Symptoms: Dermatitis, kidney damage, hematologic abnormalities.
Treatment: Withdraw gold, supportive therapy.

Iron

Causes: Overdose of supplements, accidental ingestion by children.
Symptoms: Gastrointestinal symptoms, metabolic acidosis, liver failure.
Treatment: Deferoxamine chelation, supportive care[1][5].

Lithium

Causes: Overdose in psychiatric treatment, accumulation in renal impairment.
Symptoms: Tremor, ataxia, confusion, seizures.
Treatment: Discontinue lithium, hydration, hemodialysis in severe cases.

Manganese

Causes: Occupational inhalation (welding, mining).
Symptoms: Neurological symptoms resembling Parkinson’s disease.
Treatment: Remove exposure, supportive care.

Mercury

Causes: Occupational inhalation, ingestion of organic/inorganic mercury.
Symptoms: Acute: severe gastrointestinal inflammation, abdominal cramps, bloody diarrhea; chronic: metallic taste, excessive saliva, gingival changes (blue line), tremors, neuropsychiatric changes, acrodynia in children.
Treatment: Remove exposure, chelation therapy (e.g., dimercaprol), supportive care[1][2].

Nickel

Causes: Industrial exposure, jewelry, batteries.
Symptoms: Dermatitis, allergic reactions, respiratory issues.
Treatment: Remove exposure, symptomatic treatment.

Phosphorus

Causes: Exposure to white phosphorus in industry or rodenticides.
Symptoms: Gastrointestinal symptoms, hepatic failure, bone necrosis ("phossy jaw").
Treatment: Supportive care, avoid exposure.

Platinum

Causes: Occupational exposure during refining.
Symptoms: Allergic reactions, asthma, dermatitis.
Treatment: Avoid exposure, symptomatic therapy.

Selenium

Causes: Dietary excess, industrial exposure.
Symptoms: Hair/nail loss, gastrointestinal upset, garlic odor of breath.
Treatment: Remove exposure, supportive treatment.

Silver

Causes: Medical products, workers in silver mining/refining.
Symptoms: Argyria (blue-gray skin discoloration), gastrointestinal symptoms.
Treatment: Avoid exposure; argyria is typically permanent.

Thallium

Causes: Industrial exposure, rodenticides.
Symptoms: Gastrointestinal symptoms, peripheral neuropathy, alopecia.
Treatment: Chelation therapy (prussian blue), supportive care.

Tin

Causes: Industrial exposure in tin mining/processes.
Symptoms: Respiratory issues, gastrointestinal upset.
Treatment: Remove exposure, symptomatic care.

Zinc

Causes: Excess supplementation, inhalation of fumes.
Symptoms: Gastrointestinal symptoms, anemia, copper deficiency with chronic exposure.
Treatment: Remove exposure, supportive care.

General Principles of Diagnosis and Treatment

Diagnosis is based on clinical history, exposure, and confirming elevated metal levels in blood, urine, or tissues.
Chelation therapy is central, using agents specific to metals (e.g., dimercaprol for arsenic or mercury, deferoxamine for iron, penicillamine for copper).
Supportive care addresses symptoms such as gastrointestinal distress, neurological effects, or organ damage.
Avoidance of further exposure is critical.
Nutritional and mineral replenishment may be needed during recovery[1][4][5].

This overview synthesizes current knowledge mainly drawn from the Amboss 2025 metal poisoning summary, recent Britannica mercury poisoning article, and clinical treatment guidelines[1][2][5]. If you suspect you have heavy metal poisoning, seek medical attention immediately.

The field of forensic toxicology, a sub-discipline of science, plays a crucial role in diagnosing and treating metal poisoning cases.
Understanding various metal poisonings and their connections to medical-conditions like cancer, neurological effects, and kidney damage is essential for health-and-wellness professionals and environmental-science researchers.
Climate-change and environmental-science studies can also benefit from this knowledge as toxic metals are often linked to industrial activities and pollution sources.

Toxic Heavy Metal Exposure