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==Overview==
==Overview==
''Heavy metal poisoning'' is the toxic accumulation of heavy metals in the soft tissues of the body.
''Heavy metal poisoning'' is the toxic accumulation of heavy metals in the soft tissues of the body. Heavy metals are chemical elements that have a specific gravity (a measure of density) at least five times that of water. The heavy metals most often implicated in accidental human poisoning are lead, mercury, arsenic, and cadmium. More recently, thallium has gained some attention in the media as the poison used in several murder cases in the 1990s. Some heavy metals, such as zinc, copper, chromium, iron, and manganese, are required by the body in small amounts, but these same elements can be toxic in larger quantities.
 
==Natural History, Complications and Prognosis==
Heavy metals are chemical elements that have a specific gravity (a measure of density) at least five times that of water. The heavy metals most often implicated in accidental human poisoning are lead, mercury, arsenic, and cadmium. More recently, thallium has gained some attention in the media as the poison used in several murder cases in the 1990s. Some heavy metals, such as zinc, copper, chromium, iron, and manganese, are required by the body in small amounts, but these same elements can be toxic in larger quantities.
The chelation process can only halt further effects of the poisoning; it cannot reverse neurological damage already sustained.
 
A ''heavy metal'' is any of a number of higher atomic weight elements, which has the properties of a metallic substance at room temperature. There are several different definitions concerning which elements fall in this class designation. Alternative terms are 'metal' or 'semi-metal' (according to the element in view). Some of the nearly 40 known definitions are:
 
*According to one definition, heavy metals are a group of elements between [[copper]] and [[bismuth]] on the [[periodic table]] of the elements—having [[Specific gravity|specific gravities]] greater than 4.0.
 
*A more strict definition increases specificity to metals heavier than the rare earth metals, which are at the bottom of the periodic table. None of these are essential elements in biological systems and additionally, most of the better known elements are toxic in fairly low concentrations. [[Thorium]] and [[uranium]] are occasionally included in this classification as well, but they are more often referred to as "[[radioactive]] metals". See [[actinides in the environment]] for further details of these radioactive metals.
 
*Also, often the elements beyond mercury, e.g., the [[actinides]] such as [[uranium]] and [[plutonium]], are not excluded from the heavy metals. In the context of [[nuclear power plant]]s, tHM means tons of heavy metal.
 
*In astronomy, which defines any element heavier than [[helium]] a metal, a heavy metal or heavy element includes all elements that were not formed in the big bang; all but [[hydrogen]] (and [[deuterium]]), helium, and [[lithium]].
 
*Any [[toxic metal]]s may be called "heavy metals", whether or not they are heavy.
 
Living organisms require trace amounts of some heavy metals, including [[iron]], [[cobalt]], [[copper]], [[manganese]], [[molybdenum]], [[vanadium]], [[strontium]], and [[zinc]], but excessive levels can be detrimental to the organism. Other heavy metals such as [[mercury (element)|mercury]], [[lead]] and [[cadmium]] ([http://www-ssrl.slac.stanford.edu/research/highlights_archive/cd-ca.html with one exception for the latter]) are [[toxic metal]]s — they have no known vital or beneficial effect on organisms, and their accumulation over time in the bodies of [[mammal]]s can cause serious illness.  The pathway for toxic effects on humans is normally:
*for the entry of heavy metals into the atmosphere as industrial stack gas
*to enter the soil as a [[soil contaminant]]
*to enter groundwater as a water pollutant
*to be deposited in ocean bottoms or bay mud, which materials at a later time be dredged to the surface
 
In medical usage, the definition is considerably looser and includes all [[toxic metal]]s irrespective of their atomic weight: "heavy metal poisoning" can include excessive amounts of [[iron]], [[manganese]], [[aluminium]], or [[beryllium]] (the seventh-lightest metal) as well as the true heavy metals.
 
Heavy metals in a [[hazardous materials]] (or "hazmat") setting are for the most part classified in Misc. on the UN model hazard class but, they are sometimes labeled as a poison when being transported.
Heavy metals may enter the body in food, water, or air, or by absorption through the skin. Once in the body, they compete with and displace essential minerals such as zinc, copper, magnesium, and calcium, and interfere with organ system function. People may come in contact with heavy metals in industrial work, pharmaceutical manufacturing, and agriculture. Children may be poisoned as a result of playing in contaminated soil. Lead poisoning in adults has been traced to the use of lead-based glazes on pottery vessels intended for use with food, and contamination of Ayurvedic and other imported herbal remedies. Arsenic and thallium have been mixed with food or beverages to attempt suicide or poison others.
 
Another form of mercury poisoning that is seen more and more frequently in the United States is self-injected mercury under the skin. Some boxers inject themselves with mercury in the belief that it adds muscle bulk. Metallic mercury is also used in folk medicine or religious rituals in various cultures. These practices increase the risk of mercury poisoning of children in these ethnic groups or subcultures.


==Diagnosis==
===Physical Examination===
Depending on the metal, there may be blue-black lines in the gum tissues. In severe cases, patients exhibit obvious impairment of cognitive, motor, and language skills. The expression "mad as a hatter" comes from the [[mercury poisoning]] prevalent in 17th-century France among hatmakers who soaked animal hides in a solution of mercuric nitrate to soften the hair.
==References==
==References==
{{reflist|2}}
{{reflist|2}}

Latest revision as of 18:07, 8 February 2013

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Heavy metal poisoning is the toxic accumulation of heavy metals in the soft tissues of the body. Heavy metals are chemical elements that have a specific gravity (a measure of density) at least five times that of water. The heavy metals most often implicated in accidental human poisoning are lead, mercury, arsenic, and cadmium. More recently, thallium has gained some attention in the media as the poison used in several murder cases in the 1990s. Some heavy metals, such as zinc, copper, chromium, iron, and manganese, are required by the body in small amounts, but these same elements can be toxic in larger quantities.

Natural History, Complications and Prognosis

The chelation process can only halt further effects of the poisoning; it cannot reverse neurological damage already sustained.

Diagnosis

Physical Examination

Depending on the metal, there may be blue-black lines in the gum tissues. In severe cases, patients exhibit obvious impairment of cognitive, motor, and language skills. The expression "mad as a hatter" comes from the mercury poisoning prevalent in 17th-century France among hatmakers who soaked animal hides in a solution of mercuric nitrate to soften the hair.

References

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