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.
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Revised: May 30, 2018