Toxicity of Mercury in Human: a Review
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10Neurodevelopmental Effects of Childhood Exposure to Heavy
Neurodevelopmental E¤ects of Childhood Exposure to Heavy Metals: 10 Lessons from Pediatric Lead Poisoning Theodore I. Lidsky, Agnes T. Heaney, Jay S. Schneider, and John F. Rosen Increasing industrialization has led to increased exposure to neurotoxic metals. By far the most heavily studied of these metals is lead, a neurotoxin that is particularly dangerous to the developing nervous system of children. Awareness that lead poison- ing poses a special risk for children dates back over 100 years, and there has been increasing research on the developmental e¤ects of this poison over the past 60 years. Despite this research and growing public awareness of the dangers of lead to chil- dren, government regulation has lagged scientific knowledge; legislation has been in- e¤ectual in critical areas, and many new cases of poisoning occur each year. Lead, however, is not the only neurotoxic metal that presents a danger to children. Several other heavy metals, such as mercury and manganese, are also neurotoxic, have adverse e¤ects on the developing brain, and can be encountered by children. Al- though these other neurotoxic metals have not been as heavily studied as lead, there has been important research describing their e¤ects on the brain. The purpose of the present chapter is to review the neurotoxicology of lead poisoning as well as what is known concerning the neurtoxicology of mercury and manganese. The purpose of this review is to provide information that might be of some help in avoiding repeti- tion of the mistakes that were made in attempting to protect children from the dan- gers of lead poisoning. -
HISTORY of LEAD POISONING in the WORLD Dr. Herbert L. Needleman Introduction the Center for Disease Control Classified the Cause
HISTORY OF LEAD POISONING IN THE WORLD Dr. Herbert L. Needleman Introduction The Center for Disease Control classified the causes of disease and death as follows: 50 % due to unhealthy life styles 25 % due to environment 25% due to innate biology and 25% due to inadequate health care. Lead poisoning is an environmental disease, but it is also a disease of life style. Lead is one of the best-studied toxic substances, and as a result we know more about the adverse health effects of lead than virtually any other chemical. The health problems caused by lead have been well documented over a wide range of exposures on every continent. The advancements in technology have made it possible to research lead exposure down to very low levels approaching the limits of detection. We clearly know how it gets into the body and the harm it causes once it is ingested, and most importantly, how to prevent it! Using advanced technology, we can trace the evolution of lead into our environment and discover the health damage resulting from its exposure. Early History Lead is a normal constituent of the earth’s crust, with trace amounts found naturally in soil, plants, and water. If left undisturbed, lead is practically immobile. However, once mined and transformed into man-made products, which are dispersed throughout the environment, lead becomes highly toxic. Solely as a result of man’s actions, lead has become the most widely scattered toxic metal in the world. Unfortunately for people, lead has a long environmental persistence and never looses its toxic potential, if ingested. -
Approach to the Poisoned Patient
PED-1407 Chocolate to Crystal Methamphetamine to the Cinnamon Challenge - Emergency Approach to the Intoxicated Child BLS 08 / ALS 75 / 1.5 CEU Target Audience: All Pediatric and adolescent ingestions are common reasons for 911 dispatches and emergency department visits. With greater availability of medications and drugs, healthcare professionals need to stay sharp on current trends in medical toxicology. This lecture examines mind altering substances, initial prehospital approach to toxicology and stabilization for transport, poison control center resources, and ultimate emergency department and intensive care management. Pediatric Toxicology Dr. James Burhop Pediatric Emergency Medicine Children’s Hospital of the Kings Daughters Objectives • Epidemiology • History of Poisoning • Review initial assessment of the child with a possible ingestion • General management principles for toxic exposures • Case Based (12 common pediatric cases) • Emerging drugs of abuse • Cathinones, Synthetics, Salvia, Maxy/MCAT, 25I, Kratom Epidemiology • 55 Poison Centers serving 295 million people • 2.3 million exposures in 2011 – 39% are children younger than 3 years – 52% in children younger than 6 years • 1-800-222-1222 2011 Annual report of the American Association of Poison Control Centers Toxic Exposure Surveillance System Introduction • 95% decline in the number of pediatric poisoning deaths since 1960 – child resistant packaging – heightened parental awareness – more sophisticated interventions – poison control centers Epidemiology • Unintentional (1-2 -
Acute Poisoning: Understanding 90% of Cases in a Nutshell S L Greene, P I Dargan, a L Jones
204 REVIEW Postgrad Med J: first published as 10.1136/pgmj.2004.027813 on 5 April 2005. Downloaded from Acute poisoning: understanding 90% of cases in a nutshell S L Greene, P I Dargan, A L Jones ............................................................................................................................... Postgrad Med J 2005;81:204–216. doi: 10.1136/pgmj.2004.024794 The acutely poisoned patient remains a common problem Paracetamol remains the most common drug taken in overdose in the UK (50% of intentional facing doctors working in acute medicine in the United self poisoning presentations).19 Non-steroidal Kingdom and worldwide. This review examines the initial anti-inflammatory drugs (NSAIDs), benzodiaze- management of the acutely poisoned patient. Aspects of pines/zopiclone, aspirin, compound analgesics, drugs of misuse including opioids, tricyclic general management are reviewed including immediate antidepressants (TCAs), and selective serotonin interventions, investigations, gastrointestinal reuptake inhibitors (SSRIs) comprise most of the decontamination techniques, use of antidotes, methods to remaining 50% (box 1). Reductions in the price of drugs of misuse have led to increased cocaine, increase poison elimination, and psychological MDMA (ecstasy), and c-hydroxybutyrate (GHB) assessment. More common and serious poisonings caused toxicity related ED attendances.10 Clinicians by paracetamol, salicylates, opioids, tricyclic should also be aware that severe toxicity can result from exposure to non-licensed pharmaco- -
Toxicity Forecaster (Toxcasttm)
science in ACTION www.epa.gov/research INNOVATIVE RESEARCH FOR A SUSTAINABLE FUTURE Toxicity Forecaster (ToxCastTM) ADVANCING THE NEXT GENERATION OF CHEMICAL SAFETY EVALUATION Tens of thousands of chemicals are currently in commerce, and hundreds more are introduced every year. Because current chemical testing is expensive and time consuming, only a small fraction of chemicals have been fully evaluated for potential human health effects. Through its computational toxicology research (CompTox), the U.S. Environmental Protection Agency (EPA) is working to figure out how to change the current approach used to evaluate the safety of chemicals. CompTox research integrates advances in biology, biotechnology, chemistry, and computer science to identify important biological processes that may be disrupted by the chemicals and tracing those biological the potential to limit the number of of sources; including industrial and disruptions to a related dose and required laboratory animal-based consumer products, food additives, human exposure. The combined toxicity tests while quickly and and potentially “green” chemicals information helps prioritize efficiently screening large numbers that could be safer alternatives to chemicals based on potential human of chemicals. existing chemicals. These 2,000 health risks. Using CompTox, chemicals were evaluated in over thousands of chemicals can be The first phase of ToxCast, 700 high-throughput assays that evaluated for potential risk at a small appropriately called “Proof of cover a range of high-level cell cost in a very short amount of time. Concept”, was completed in responses and approximately 2009 and it evaluated over 300 300 signaling pathways. ToxCast A major part of EPA’s CompTox well studied chemicals (primarily research is the Toxicity Forecaster research is ongoing to determine pesticides) in over 500 high- which assays under what conditions (ToxCast™). -
Sound Management of Pesticides and Diagnosis and Treatment Of
* Revision of the“IPCS - Multilevel Course on the Safe Use of Pesticides and on the Diagnosis and Treatment of Presticide Poisoning, 1994” © World Health Organization 2006 All rights reserved. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use. CONTENTS Preface Acknowledgement Part I. Overview 1. Introduction 1.1 Background 1.2 Objectives 2. Overview of the resource tool 2.1 Moduledescription 2.2 Training levels 2.3 Visual aids 2.4 Informationsources 3. Using the resource tool 3.1 Introduction 3.2 Training trainers 3.2.1 Organizational aspects 3.2.2 Coordinator’s preparation 3.2.3 Selection of participants 3.2.4 Before training trainers 3.2.5 Specimen module 3.3 Trainers 3.3.1 Trainer preparation 3.3.2 Selection of participants 3.3.3 Organizational aspects 3.3.4 Before a course 4. -
TOXICOLOGY and EXPOSURE GUIDELINES ______(For Assistance, Please Contact EHS at (402) 472-4925, Or Visit Our Web Site At
(Revised 1/03) TOXICOLOGY AND EXPOSURE GUIDELINES ______________________________________________________________________ (For assistance, please contact EHS at (402) 472-4925, or visit our web site at http://ehs.unl.edu/) "All substances are poisons; there is none which is not a poison. The right dose differentiates a poison and a remedy." This early observation concerning the toxicity of chemicals was made by Paracelsus (1493- 1541). The classic connotation of toxicology was "the science of poisons." Since that time, the science has expanded to encompass several disciplines. Toxicology is the study of the interaction between chemical agents and biological systems. While the subject of toxicology is quite complex, it is necessary to understand the basic concepts in order to make logical decisions concerning the protection of personnel from toxic injuries. Toxicity can be defined as the relative ability of a substance to cause adverse effects in living organisms. This "relative ability is dependent upon several conditions. As Paracelsus suggests, the quantity or the dose of the substance determines whether the effects of the chemical are toxic, nontoxic or beneficial. In addition to dose, other factors may also influence the toxicity of the compound such as the route of entry, duration and frequency of exposure, variations between different species (interspecies) and variations among members of the same species (intraspecies). To apply these principles to hazardous materials response, the routes by which chemicals enter the human body will be considered first. Knowledge of these routes will support the selection of personal protective equipment and the development of safety plans. The second section deals with dose-response relationships. -
Ethylene Glycol Ingestion Reviewer: Adam Pomerlau, MD Authors: Jeff Holmes, MD / Tammi Schaeffer, DO
Pediatric Ethylene Glycol Ingestion Reviewer: Adam Pomerlau, MD Authors: Jeff Holmes, MD / Tammi Schaeffer, DO Target Audience: Emergency Medicine Residents, Medical Students Primary Learning Objectives: 1. Recognize signs and symptoms of ethylene glycol toxicity 2. Order appropriate laboratory and radiology studies in ethylene glycol toxicity 3. Recognize and interpret blood gas, anion gap, and osmolal gap in setting of TA ingestion 4. Differentiate the symptoms and signs of ethylene glycol toxicity from those associated with other toxic alcohols e.g. ethanol, methanol, and isopropyl alcohol Secondary Learning Objectives: detailed technical/behavioral goals, didactic points 1. Perform a mental status evaluation of the altered patient 2. Formulate independent differential diagnosis in setting of leading information from RN 3. Describe the role of bicarbonate for severe acidosis Critical actions checklist: 1. Obtain appropriate diagnostics 2. Protect the patient’s airway 3. Start intravenous fluid resuscitation 4. Initiate serum alkalinization 5. Initiate alcohol dehydrogenase blockade 6. Consult Poison Center/Toxicology 7. Get Nephrology Consultation for hemodialysis Environment: 1. Room Set Up – ED acute care area a. Manikin Set Up – Mid or high fidelity simulator, simulated sweat if available b. Airway equipment, Sodium Bicarbonate, Nasogastric tube, Activated charcoal, IV fluid, norepinephrine, Simulated naloxone, Simulate RSI medications (etomidate, succinylcholine) 2. Distractors – ED noise For Examiner Only CASE SUMMARY SYNOPSIS OF HISTORY/ Scenario Background The setting is an urban emergency department. This is the case of a 2.5-year-old male toddler who presents to the ED with an accidental ingestion of ethylene glycol. The child was home as the father was watching him. The father was changing the oil on his car. -
Indoor Air Mercury May 2003
Indoor Air Mercury May 2003 Why is Mercury a Problem in Indoor Air? Mercury is a potent neurotoxin found in a variety of products. It affects the brain, liver and kidneys and can cause developmental disorders in children. Young children and developing fetuses are especially at risk. Metallic, or elemental mercury, is a liquid at room temperature and like any other liquid it evaporates into the air, where it can be inhaled. Exposures can occur in the home when a mercury-containing item, such as a thermometer, breaks and is not properly cleaned up. They can occur in the workplace when mercury or mercury-containing device/materials are not carefully handled and safely managed or when workplace or storage areas are not properly ventilated. Exposures can also occur when children find and play with improperly stored mercury; many cases of mercury poisoning result for this reason.1 When spilled in a small, poorly-ventilated room, mercury can pose significant health threats. Very small amounts of metallic mercury, released into an enclosed space, (i.e., a few drops) can raise air concentrations of mercury to levels that may be harmful to health. The longer people breathe the contaminated air, the greater the risk to their health. In addition, metallic mercury and its vapors are extremely difficult to remove from clothes, furniture, carpet, and other porous items. If these items are not properly disposed or cleaned, the mercury can linger for months or years, continuing to pose a health threat. The risk of exposure to mercury from indoor air is not insignificant. -
Small Dose... Big Poison
Traps for the unwary George Braitberg Ed Oakley Small dose... Big poison All substances are poisons; Background There is none which is not a poison. It is not possible to identify all toxic substances in a single The right dose differentiates a poison from a remedy. journal article. However, there are some exposures that in Paracelsus (1493–1541)1 small doses are potentially fatal. Many of these exposures are particularly toxic to children. Using data from poison control centres, it is possible to recognise this group of Poisoning is a frequent occurrence with a low fatality rate. exposures. In 2008, almost 2.5 million human exposures were reported to the National Poison Data System (NPDS) in the United Objective States, of which only 1315 were thought to contribute This article provides information to assist the general to fatality.2 The most common poisons associated with practitioner to identify potential toxic substance exposures in children. fatalities are shown in Figure 1. Polypharmacy (the ingestion of more than one drug) is far more common. Discussion In this article the authors report the signs and symptoms Substances most frequently involved in human exposure are shown of toxic exposures and identify the time of onset. Where in Figure 2. In paediatric exposures there is an over-representation clear recommendations on the period of observation and of personal care products, cleaning solutions and other household known fatal dose are available, these are provided. We do not discuss management or disposition, and advise readers products, with ingestions peaking in the toddler age group. This to contact the Poison Information Service or a toxicologist reflects the acquisition of developmental milestones and subsequent for this advice. -
Effects of Temperature and Storage Conditions on the Electrophoretic, Toxic and Enzymatic Stability of Venom Components Sean M
Comp. Biochem. Physiol. Vol. 119B, No. 1, pp. 119±127, 1998 ISSN 0305-0491/98/$19.00 Copyright 1998 Elsevier Science Inc. All rights reserved. PII S0305-0491(97)00294-0 Effects of Temperature and Storage Conditions on the Electrophoretic, Toxic and Enzymatic Stability of Venom Components Sean M. Munekiyo and Stephen P. Mackessy Department of Biological Sciences, 501 20th St., University of Northern Colorado, Greeley, CO 80639, U.S.A. ABSTRACT. Rattlesnake venoms are complex biological products containing potentially autolytic compo- nents, and they provide a useful tool for the study of long-term maintenance of enzymes in a competent state, both in vivo and in vitro. To evaluate the stability of venom components, 15 aliquots of freshly extracted venom (from Crotalus molossus molossus) were subjected to 15 different temperature and storage conditions for 1 week and then lyophilized; conditions varied from storage at 280°C (optimal preservation of activities) to dilution (1:24) and storage at 37°C (maximal degradation potential). Effects of different storage conditions were evalu- ated using SDS-PAGE, metalloprotease zymogram gels, a cricket LD50 assay and enzyme assays (metalloprotease, serine proteases, phosphodiesterase, l-amino acid oxidase and phospholipase A2). Venom samples were remark- ably refractive to widely varying conditions; enzyme activities of some samples were variable, particularly l- amino acid oxidase, and one sample treatment showed higher toxicity, but electrophoretic results indicated very little effect on venom proteins. This study suggests that most venom activities should remain stable even if stored or collected under potentially adverse conditions, and freezing samples is not necessarily advantageous. -
From Murder to Mechanisms 7000 Years of Toxicology's Evolution
From Murder to Mechanisms 7000 Years of Toxicology’s Evolution 7000 Years of Toxicology’s Evolution Michael A. Gallo, PhD, DABT (ret), Emeritus Fellow ATS Professor Emeritus Environmental and Occupational Health Sciences Institute Rutgers-Robert Wood Johnson Medical School Piscataway, New Jersey Toxicants: Friends or Foes? “The dose makes the poison” Paracelsus 1493-1541 Objectives This presentation provides a history of toxicology with a few classic examples. The Family of Toxicology Poisons Signs, Symptoms, Adverse Reactions & Antidotes Drugs Patent Medicines and Chemotherapeutics Food Natural toxicants Industrial Chemicals Occupational and Environmental Toxicity Safety Evaluation Hazard Identification Tools to Elucidate Biology Toxicology the Borrowing Science • Pharmacology • Pathology • Physiology • Biochemistry • Synthetic Chemistry • Analytical Chemistry • Molecular and Cellular Biology • High Resolution Imaging Earliest Humans* • Use of natural toxins • Oral history evolved • Animal venoms • Toxic metals • Plant extracts – Hunting* – Warfare – Assassination * still used by indigenous people in S. America, Borneo, Pacific Islanders Ebers Papyrus ~1500 BCE • Hemlock • Aconite (buttercup family) • Opium • Lead • Copper • Antimony • Venoms Hippocrates and Friends • Defined effective dosages of toxin • Described bioavailability • Theophastus (370-286 BCE) – De Historia Plantanum • Socrates- Hemlock • Dioscorides (Nero)poison classes through 19th • Discovery of BellaDonna (scopolamine) • Discovery of Digitalis (foxglove)Dioscorides