Heavy metal poisoning

Heavy metals – what do we know about them? As a rule, most people associate this term with a school chemistry course. In fact, heavy metals surround us everywhere: they are present in household chemical solutions, in the soil, in water, in the atmosphere. It turns out that heavy metal poisoning can be obtained almost anywhere – both at home and at work. Such poisoning does not always become obvious – sometimes it becomes chronic, and harmful substances accumulate in human tissues for years and even decades. How to identify poisoning, and what measures should be taken to eliminate its consequences?

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Epidemiology

Poisoning with heavy metal compounds is actually quite common. The first records of such poisonings were made back in the 4th century – that was when corrosive sublimate poisoning was first described. In the old days, such inorganic toxins as corrosive sublimate and arsenic were widespread – they were used everywhere, including in everyday life.

According to statistics, in just one year (from 1924 to 1925) almost a thousand people died in Russia from corrosive sublimate poisoning.

Poisoning with such a heavy metal as copper is typical for regions where winemaking and gardening are actively practiced. The reason for this is the widespread use of copper sulfate in the fight against harmful insects and plant diseases.

Heavy metal poisoning also often occurred after using an anti-lice remedy such as grey mercury ointment.

Today, the number of fatalities from heavy metal poisoning has decreased significantly. Thus, in the last century, the mortality rate from such intoxications was approximately 65-85%, and in our time it barely reaches 15%.

The lethal amount of heavy metals when ingested is as follows:

• mercury compounds – 0.5 g;
• mercury chloride, calomel – 1 g;
• copper sulfate – 10 g;
• lead acetate – 50 g;
• white lead – 50 g;
• potassium dichromate – 3 g;
• arsenic – 0.1 g.

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Causes heavy metal poisoning

Heavy metals can easily penetrate the human body - through mucous tissues, skin, with inhaled air, with food products. After entering the stomach, heavy metals quickly end up in the blood, and then in almost all organs and tissues of the body. Heavy metals tend to accumulate in tissues, but this process is lengthy and can last for years.

Risk factors that predispose to heavy metal poisoning may include the following:

• industrial breakdowns with the release of toxic compounds into the environment;
• work in an inherently harmful production environment (presence of fumes, emissions);
• living near major highways, eating mushrooms or plants collected along highways;
• working with petroleum products;
• working with products containing herbicides, pesticides;
• use of insect and rodent repellents;
• use of drugs (accidental or overdose);
• long-term smoking, or smoking large amounts of tobacco daily, as well as passive smoking;
• use of unsuitable containers for food and beverages.

Heavy metals can accumulate in plant products, in animal meat, which we then eat. Heavy metals end up in our bodies when we inhale polluted air, swallow polluted water, etc.

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Pathogenesis

Heavy metals are a series of chemical elements that are highly toxic to all living things. Moreover, you can get poisoned even without living in a metropolis or near large enterprises, and without encountering industrial "harmful substances". According to statistics, most heavy metal poisonings are associated with careless use of household chemicals, ignoring safety precautions, and also with suicide attempts.

But that's not all: heavy metals can be found everywhere. Children are often poisoned - usually due to the fault of adults who do not pay due attention to safety. Many people store medicines, household chemicals, varnishes, solutions, and fertilizers in places accessible to children.

People who eat unwashed plant products, drink untreated water, and use containers not intended for storing food products can also suffer from poisoning. As a result, toxic components accumulate in human organs and tissues, and the immune defense is powerless against them. Gradually, the body's resources are depleted, and signs of intoxication are detected - at first mild (for example, unmotivated fatigue), and then - typical for each individual metal.

The most toxic heavy metals are lead, mercury, thallium, copper, antimony, zinc, cadmium, nickel, and bismuth.

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Symptoms heavy metal poisoning

Heavy metal poisoning has a number of typical symptoms. If the poisoning occurred through heavy metals entering the stomach, the digestive system suffers first. The following initial symptoms are observed:

• increased gas formation;
• severe and sharp spasmodic pain in the abdomen;
• increasing nausea, even to the point of vomiting;
• intestinal upset, severe diarrhea.

Chronic poisoning with heavy metals is characterized by the development of chronic renal failure, mental disorders (hallucinations and delirium may occur), and disorders of the nervous system. The patient loses sensitivity to tastes and aromas.

There are also other early signs that are typical for a certain nature of a toxic substance. For example, if mercury vapor enters the body, the following signs may be observed within a couple of hours:

• sensation of metallic taste in the mouth;
• a feeling of heat throughout the body;
• severe diarrhea, possibly with blood and mucus;
• loss of appetite, increasing nausea, vomiting;
• sharp pains in the temples, in the stomach;
• disorders of the cardiac and respiratory systems.

If lead poisoning has occurred, the following symptoms are predominantly found:

• sudden weakness, fatigue;
• joint pain;
• headaches;
• spastic contractions of the abdominal muscles, vomiting;
• Vestibular system disorders, dizziness.

If copper poisoning has occurred, the clinical symptoms may be as follows:

• a feeling of being hot and then cold;
• headaches;
• abdominal pain due to increased gas formation inside the intestines;
• muscle weakness.

Poisoning with thallium salts usually occurs accidentally and is manifested by the following symptoms:

• sudden and significant digestive upset - vomiting, profuse loose stools;
• headaches, impaired consciousness;
• convulsive attacks;
• sleep disturbance;
• sudden hypertension, tachycardia;
• dermatological problems, baldness.

If measures are not taken in a timely manner, the symptoms worsen and the victim's condition deteriorates sharply. In severe cases, resuscitation measures have to be used.

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Complications and consequences

With prolonged or severe intoxication, pathomorphological transformations are observed in the urinary system. The kidneys undergo necrosis, degenerative processes occur in the renal epithelium. Foci of calcification and interstitial inflammation develop. When macroscopically examined, the kidneys are enlarged and acquire a light shade (the so-called "corrosive sublimate kidney").

If hemolysis develops, then the clinical picture of acute toxic nephrosis is observed.

The liver suffers: ubiquitous centrilobular necrotic foci appear, bile stasis is noted. Hemolysis is characterized by pigmented hepatosis with necrotic foci.

In severe cases, failure to provide assistance results in the death of the victim.

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Diagnostics heavy metal poisoning

• The diagnosis of lead poisoning is based on the presence of high concentrations of lead in the bloodstream. Additional tests include: general blood analysis (detects anemia against the background of basophilic granularity), blood electrolyte analysis, liver function tests, and urine analysis. Instrumental diagnostics include radiography (long tubular bones are examined, and in pediatric patients, the ulna and fibula).
• The diagnosis of iron poisoning is established if a high concentration of iron is determined in the blood, in accordance with the severity of intoxication. Blood analysis indicates anemia, biochemistry determines hypoglycemia. Instrumental examination - X-ray of the abdominal cavity, can determine tablets containing iron.
• The diagnosis of arsenic poisoning is determined by the presence of more than 100 mcg in a daily urine analysis, or more than 50 mcg per liter in a single portion of urine. In chronic poisoning, arsenic can be determined by analyzing nails and hair. Blood analysis is characterized by anemia against the background of basophilic granularity. General urine analysis can detect cylinders, as well as a considerable number of erythrocytes and leukocytes.

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Differential diagnosis

Differential diagnostics are performed with acute digestive disorders, acute renal failure of non-toxic origin, acute cerebrovascular accident. In differential diagnostics, free hemoglobin in the blood, quantitative mercury content in the blood and urine (colorimetry), and quantitative copper content are determined.

Treatment heavy metal poisoning

The first step in heavy metal poisoning is to remove toxic substances from the body as quickly as possible. The victim should drink a lot of liquid, which should be vomited at the first stage, thus clearing the gastric mucosa.

Next, the patient is given sorbent agents - such as the well-known activated carbon, as well as other similar drugs - enterosgel, polysorb, magnesium sulfate, etc. Symptomatic therapy is also practiced - for example, when the temperature rises, antipyretic medications are offered.

In cases of heavy metal poisoning, the following medications are most often used:

• Use of activated carbon: adults are prescribed 20-30 g per dose with 200-400 ml of water. The course of therapy is 5-15 days, depending on the indications. With prolonged use, constipation may develop.
• Magnesium sulfate injections: administered intravenously, in an individually selected dosage. The maximum daily dose of the drug for an adult is 40 g. Shortness of breath, hypothermia, and hypermagnesemia may occur during treatment.
• Calcium gluconate tablets: used for liver detoxification (especially in cases of magnesium salt poisoning), 2-6 tablets up to 3 times a day. The course duration is one week. While taking calcium gluconate, you should increase the amount of liquid you drink.
• Atropine: in case of poisoning with salts of heavy metals, the drug is taken orally at 300 mcg every 5 hours. Side effects when taken may include thirst, constipation, photosensitivity, dizziness.

Antidotes for heavy metal poisoning are administered in hospital, against the background of complex medical measures and symptomatic therapy. For any type of heavy metal poisoning, an antidote such as unithiol is administered.

Gastric lavage is performed using 50-100 ml of 5% unitiol to bind toxins that have not yet entered the bloodstream. After using laxatives, a siphon enema is performed with the addition of unitiol.

Forced diuresis is connected simultaneously with intravenous infusion of up to 300 ml of 5% unithiol.

Additionally, glucocorticoids, analgesics, and antispasmodics are prescribed.

If there is toxic damage to the skin, then the therapeutic scheme includes injections of antibiotics, which are standardly used for burns of the skin. If necessary, vitamin preparations and hepatoprotectors are added.

Vitamins

In case of poisoning with heavy metals, the victim should add an increased dose of vitamin D to their food. In case of intoxication, it is recommended to consume fatty varieties of sea fish and dairy products.

Don't forget about ascorbic acid - this vitamin boosts the immune system, helping to quickly neutralize toxic substances. There is a lot of ascorbic acid in citrus fruits, kiwi, sauerkraut, berries.

After eliminating acute symptoms of intoxication, it is necessary to add rosehip infusion, tomatoes, cherries, and sweet cherries to the diet. The listed products are rich in vitamin P, which accelerates the purification of blood and tissues from heavy metals.

The need to prescribe additional vitamin and mineral complexes is determined by the doctor.

Physiotherapy treatment

Physiotherapy is not one of the main treatments used for heavy metal poisoning. In mild forms, hydrotherapy, balneotherapy, and long-term mineral water intake may be prescribed.

Folk remedies

Fresh egg whites help effectively neutralize the toxic effects of heavy metals. They are recommended for use in particularly complex cases of intoxication, when there is a need to block the absorption of toxic substances. To prepare the remedy, take a dozen fresh chicken eggs, separate the yolks and whites, and then mix the whites with 400 ml of milk. The resulting "cocktail" should be drunk little by little over the course of an hour - this will bind the toxic components and speed up their elimination in a natural way.

In addition to proteins, the following products accelerate the removal of heavy metals:

• Pectin. Increasing in the digestive tract, pectin adsorbs toxins and harmful substances. Pectin is found in large quantities in apples, apricots, root vegetables, berries, cabbage. It is also present in such sweets as marshmallows, marmalade, jam. Pectin can be introduced into the diet immediately after the attacks of nausea have passed.
• Peristaltic stimulants. The best natural stimulant of intestinal motility is considered to be fiber. A large amount of fiber is present in dried fruits, corn, cabbage, apples, bran. The listed products can be consumed after the acute symptoms of intoxication have been relieved.
• Calcium. Calcium copes well with the task of removing heavy metal salts from the musculoskeletal system. It is quite abundant in sesame seeds, nuts, and dairy products. In case of heavy metal poisoning, calcium has an irreplaceable effect on the body, so it must be included in the daily diet.
• Selenium. Selenium, which is present in garlic, vegetable oil, and eggs, helps neutralize the toxic effects of heavy metals. Therefore, doctors advise paying attention to these products, especially if the intoxication is chronic.

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Herbal treatment

Antitoxic action is also inherent in many medicinal herbs. However, they are recommended to be taken only in relatively mild cases of heavy metal poisoning, when toxic components do not impair organ function.

• Horsetail has a good effect in case of poisoning, especially lead poisoning. To prepare a decoction, you will need horsetail grass and boiling water in a ratio of 1:20. Pour boiling water over the grass and leave for about 20 minutes. Drink the remedy every three hours, 100 ml.
• A remedy based on knotweed will help neutralize intoxication. Two tablespoons of the herb are infused in half a liter of boiling water for 2 hours. Drink the remedy 100 ml every 3-4 hours.
• You can buy ready-made pink radiola tincture at the pharmacy - in case of poisoning with heavy metals, take 10 drops of the tincture three times a day, with half a glass of water.
• Sunflower leaves are considered a good detoxifier - you will need one full tablespoon. Pour a liter of boiling water over the leaves and let it brew. Take 100 ml with honey every three hours. This remedy is especially helpful in cases of poisoning with cobalt and strontium compounds.
• In case of copper or lead poisoning, prepare an equivalent collection of horsetail and clover. Mix five tablespoons of the collection with 2 tablespoons of oak bark, pour boiling water (1 l), and leave until cool. Drink 100 ml every 2-3 hours.
• Mercury poisoning can be neutralized with an infusion of horsetail and walnut. To prepare the medicine, mix 5 tablespoons of the herb and 3 tablespoons of walnut kernels. Pour 2 tablespoons of the mixture with 1 liter of boiling water, filter after an hour and drink 100 ml every three hours.
• After poisoning with heavy metals, it is necessary to restore the liver. To do this, take 20 g of elecampane rhizome, steam it with 250 ml of boiling water, filter it after 20 minutes. Take 1 tbsp. once every three hours, before meals.
• Dandelion has an antitoxic effect. To prepare the medicine, you will need 6 g of it. This amount is poured with 200 ml of boiling water, infused for about half an hour, filtered. Drink 1 tbsp. three times a day, before meals.
• Poisoning with heavy metal salts can be neutralized with anise seed decoction. You will need 400 ml of boiling water and 20 anise seeds - the remedy is steamed in a thermos and kept for at least half an hour. Then the infusion is filtered and given to the victim to drink - after this, vomiting is immediately induced. After cleansing the stomach, a second similar portion of the medicine is brewed: the patient must take it twice over six hours.

Homeopathy

Homeopathic treatment is prescribed only for mild forms of heavy metal poisoning, and only after a complete cleansing of the digestive system.

The following homeopathic remedies can be used in individual dosages:

• Nux vomica - relieves cramps and pain along the digestive tract, alleviates discomfort associated with nausea, vomiting and fever.
• Arsenicum album – alleviates the condition, relieves burning and pain in the abdomen, eliminates spasms of smooth muscles.
• Carbo vegetabilis – eliminates intestinal disorders, normalizes gas formation processes. Relieves severe weakness and fever.
• Pulsatilla – normalizes digestive processes, stops severe diarrhea, eliminates bloating.
• Hina – helps with severe flatulence, diarrhea, and alleviates chills and fever.

If the poisoning is severe, it is necessary to seek medical help at a hospital. Homeopathic remedies are not emergency medical care drugs.

Prevention

Preventive measures usually involve following these rules:

• we must not forget about industrial safety;
• The rules for disposal of batteries and depressurized thermometers must not be ignored;
• Copper and galvanized containers should not be used for storing and consuming food and drinks;
• any plant products should be washed immediately before consumption;
• You should not collect mushrooms, berries, medicinal plants, vegetables, or fruits if there are large industrial facilities or highways nearby;
• You should not drink water without knowing its quality.

Household chemical solutions and liquids, as well as medicines and paints and varnishes, should be stored in strictly designated places, inaccessible to children and mentally unstable people. When working with fertilizers and insecticides, special care should be taken, using all necessary personal protective equipment.

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Forecast

After acute poisoning with heavy metals in mild or moderate form, recovery can last up to 2 weeks. In case of severe poisoning, the victim can be hospitalized for up to 2 months, without a 100% guarantee of complete recovery of the body. Individual signs of intoxication can remain in a person for life.

Chronic heavy metal poisoning rarely results in a complete cure. Treatment usually eliminates most of the painful symptoms, but it is almost impossible to completely get rid of the consequences of long-term intoxication.

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