Heavy Metal Toxicity

 

Welcome to PT 635 Pathophysiology of Complex Patient Problems This is a wiki created by and for the students in the School of Physical Therapy at Bellarmine University in Louisville KY. Please do not edit unless you are involved in this project, but please come back in the near future to check out new information!!

Original Editors - Chase Almgren from Bellarmine University's Pathophysiology of Complex Patient Problems project.

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Definition/Description

Heavy metal toxicity is a generic term for an above average level of metal in the blood which may result in undesirable side-effects.  Authors argue what constitues a "heavy metal," but it's commonly referred to as any metal which could potentially cause human or environmental harm.  Common heavy metal toxicities humans are expose to are lead, arsenic, mercury, aluminum and cadmium.

Lead Toxicity

Common sources of lead which may be harmful to humans are in lead based paints, soldered around the rims of food cans (more common outside of the United States), plumbing, older bath tubs, and imported dishware.  Though it is generally safe to use older bath tubs and imported dishware, scratching and chipping can extract the lead from these products.  Imported dishware may also have lead extracted through repeated microwave or dishwasher use, as well as frequent juices which are highly acidic.  Lead particles may also travel through the air during older house renovation projects

Precautions with young infants and children

Young children should be especially careful around lead based products as the minimal level to declare lead toxicity (10mg/dl) is smaller than that for adults(24mg/dl).  Since the blood-brain barrier is unformed in infants, lead easily diffuses across.

Children and infants are commonly exposed to lead particles during floor activities, and through the hand-to-mouth stages of development.  Risk factors which may predispose children to lead toxicity are under age 6, low income, and urban dwelling.

Adults and lead exposure

Adults are more likely to be exposed to lead during the renovation of old houses, manufacturing of brass, bullets, solder, stained-glass/ pottery designs, and frequent use of metallic wick candles.

Arsenic Toxicity

Arsenic exposure may come from glass infiltrates, pesticides, wood preservatives.

Mercury Toxicity

Mercury exposure can be in the forms of inhalion, ingestion, or topically through the skin.  Common sources of mercury are fish (the number one cause of toxicity), emissions from coal burning plants, medical waste and from mines.  Another common source of mercury is through the food chain; one animal becomes exposed and passes it to the top of the food chain through ingestion.

Prevalence

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Characteristics/Clinical Presentation

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Associated Co-morbidities

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Medications

Penicillamine (Brand names; Cuprimine, Depen)

This medication is generally used for Wilson's disease (excess copper in the body), rheumatoid arthritis, and kidney stone prevention, but can also be used to treat heavy metal toxicity. 

Diagnostic Tests/Lab Tests/Lab Values

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Etiology/Causes

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Medical Management (current best evidence)

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Physical Therapy Management (current best evidence)

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Alternative/Holistic Management (current best evidence)

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Differential Diagnosis

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Case Reports/ Case Studies

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Resources

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Recent Related Research (from Pubmed)

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References

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