Heavy Metals, Hard Metal Disease, & Hair Testing

1. What is hard metal disease?

This is the description of Hard metal disease in Haz-Map.

2. What is heavy metal toxicity?

"Heavy metal" is a redundant phrase like "unexpected surprise" or "free gift." There is no ICD-9 code for heavy metal toxicity. The code 958.8 is for "Toxic effect of other specified metals." See ICD-9 codes for toxic effects of metals. In ICD-10, the toxic effects of metals are listed under T56.

In the 5th edition of Occupational & Environmental Medicine, edited by Joseph LaDou and Robert Harrison, there is a chapter on "Metals." Metals treated separately are arsenic, beryllium, cadmium, chromium, lead, manganese, mercury, and thallium. Metals treated under "Other Metals" are antimony, nickel, selenium & tellurium, and vanadium. [LaDou, p. 463-81]

"For example, evidence of exposure to heavy metals can be assessed directly by measuring levels in the blood or urine." [Rosenstock, p. 655]

ACGIH has established BEIs for arsenic (urine), chromium (urine), cobalt (urine), lead (blood), elemental mercury (urine), and uranium (urine). "The BEI generally indicates a concentration below which nearly all workers should not experience adverse health effects." [TLVs and BEIs, p. 101]

3. How is chelation therapy misused in the treatment of chronic symptoms incorrectly attributed to chronic metal toxicity?

See Current use of chelation in American health care.

See the Chelation Therapy statement of the Oregon Medical Board.

See Introduction to Special Issue: Use and Misuse of Metal Chelation Therapy.

4. What is the value of commercial hair analysis for multiple metals as used by some alternative care doctors?

See The pitfalls of hair analysis for toxicants in clinical practice: three case reports, an article written by two occupational medicine doctors at Johns Hopkins Bloomberg School of Public Health. Their first reference is Commercial Hair Analysis: A Cardinal Sign of Quackery.

"Hair is readily available and may be used to screen for heavy metals such as mercury. It has also been used as a research tool to assess exposure to persistent organic pollutants. Hair biomonitoring poses challenges as samples must be cleaned to reduce contamination from surface deposition and interpretation of hair biomonitoring results is complex. Furthermore, measurements do not readily distinguish ambient from internal exposure. Other, less readily available, analytic techniques must be used to provide this critical information." [LaDou, p. 712]

"Hair mercury level is often not correlated with blood mercury concentration or symptoms of mercury toxicity, and reports of hair contamination by exogenous mercury are not uncommon. Hair mercury level is notoriously prone to misinterpretation and should be used with an understanding of its limitations." [Abstract]

"Our findings suggest that while the idea of measuring trace elements in hair is attractive, hair is not an appropriate biomarker for evaluating Cu, Mn and Sr deficiency or Pb exposure." [Abstract]

"Hair mineral analysis from these laboratories was unreliable, and we recommend that health care practitioners refrain from using such analyses to assess individual nutritional status or suspected environmental exposures." [Abstract]

"Nevertheless, the analysis of these compounds in biological matrices other than blood and urine has not yet been accepted as a useful tool for biomonitoring." [Abstract]

"Hair Al analysis is of no value as an indicator of body Al accumulation." [Abstract]

5. Has it been established that mercury amalgams used in dentistry are harmful?

See Dental Amalgam FAQs published by the Canadian Dental Association. See Mercury in Haz-Map: Regarding dental amalgams as a source of mercury vapor, occupational exposures can be controlled and personal exposures from fillings are insignificant. [Goldfrank, p. 1302, 1304] "Exposure to metallic mercury, for example from amalgam teeth fillings and other dental exposure, may give rise to sensitization." [Nordberg, p. 1041] See The potential adverse health effects of dental amalgam.

6. Under what conditions Is copper an occupational hazard?

See Copper in Haz-Map.

"Systemic toxicity of copper or its salts is seen almost exclusively in association with ingestion." [Rosenstock, p. 982]

"Acute copper toxicity has been described after excessive oral intake and with absorption of copper salts applied to burned skin. Milder manifestations include nausea, vomiting, epigastric pain, and diarrhea; coma and hepatic necrosis may ensue in severe cases. Toxicity may be seen with doses as low as 70 ug/kg/day. Chronic toxicity is also described. Wilson's disease is a rare, inherited disease associated with abnormally low ceruloplasmin levels and accumulation of copper in the liver and brain, eventually leading to damage to these two organs." [Cecil, p. 1403]

7. How can copper enter and leave my body?

See the ATSDR Public Health Statement for Copper. "Copper then leaves your body in feces and urine, mostly in feces. It takes several days for copper to leave your body." Haz-Map shows the half life of copper in the body as 4 weeks. Therefore, if one had a toxic level of copper and the exposure ended, the level would be 1/2 of that level in 4 weeks and 1/4 of that level in 8 weeks.


Revised: March 10, 2017



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