Cadmium toxicity: Difference between revisions

 
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==Background==
==Background==
*Used in electroplating, soldering, pigments, and plastics
*Used in electroplating, soldering, pigments, and plastics
*Routes of exposure:
*Once absorbed, cadmium distributes to most major organs, however it has a predilection for the liver and kidneys
**Inahlation (up to 25%)
 
***Cigarette smoking, occupational exposure
===Routes of exposure===
***Particle size influences the amount absorbed
*Inahlation (up to 25%)
****Smaller particles are more likely to penetrate the alveolar-capillary membrane
**Cigarette smoking, occupational exposure
**Gastrointestinal (1-10%)
**Particle size influences the amount absorbed
***Cadmium is ubiquitous in food systems
***Smaller particles are more likely to penetrate the alveolar-capillary membrane
***Total daily amount ingested is influenced by a variety of factors
*Gastrointestinal (1-10%)
****Reduced total body iron stores leads to upregulation of the gene that encodes for DMT1, a heavy metal transporter located on the luminal side of enterocytes. Consequently, more cadmium is absorbed from the gastrointestinal tract. <ref> Traub, S., & Elinder, C. (2017). Epidemiology and toxicity of cadmium. In G. Curhan (Ed.), UpToDate. UpToDate, Waltham, MA, (Accessed on February 22, 2018). </ref>
**Cadmium is ubiquitous in food systems
****In certain parts of Japan, consumption of cadmium ranges from 59 to 113 mcg per day, which is more than twice the daily average of individuals in Europe. This is in large part due to rice irrigated with cadmium-contaminated water. <ref> Traub, S., & Elinder, C. (2017). Epidemiology and toxicity of cadmium. In G. Curhan (Ed.), UpToDate. UpToDate, Waltham, MA, (Accessed on February 22, 2018). </ref>
**Total daily amount ingested is influenced by a variety of factors
**Dermal (less than 1%)
***Reduced total body iron stores leads to upregulation of the gene that encodes for DMT1, a heavy metal transporter located on the luminal side of enterocytes. Consequently, more cadmium is absorbed from the gastrointestinal tract. <ref> Traub, S., & Elinder, C. (2017). Epidemiology and toxicity of cadmium. In G. Curhan (Ed.), UpToDate. UpToDate, Waltham, MA, (Accessed on February 22, 2018). </ref>
*Distribution
***In certain parts of Japan, consumption of cadmium ranges from 59 to 113 mcg per day, which is more than twice the daily average of individuals in Europe. This is in large part due to rice irrigated with cadmium-contaminated water. <ref> Traub, S., & Elinder, C. (2017). Epidemiology and toxicity of cadmium. In G. Curhan (Ed.), UpToDate. UpToDate, Waltham, MA, (Accessed on February 22, 2018). </ref>
**Once absorbed, cadmium distributes to most major organs, however it has a predilection for the liver and kidneys
*Dermal (less than 1%)


===Mechanism of Toxicity===
===Mechanism of Toxicity===
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==Differential Diagnosis==
==Differential Diagnosis==
{{Heavy metals list}}


==Evaluation==
==Evaluation==
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*Supplemental oxygen
*Supplemental oxygen
*Monitor [[ABG]], check [[CXR]]
*Monitor [[ABG]], check [[CXR]]
*Treat wheezing and pulmonary edema
*Treat wheezing and [[pulmonary edema]]


===Ingestion===
===Ingestion===
*[[Activated charcoal]] or lavage
*[[Activated charcoal]] or [[gastric lavage]]
*Volume resuscitation to counter fluid losses
*[[IVF|Volume resuscitation]] to counter fluid losses
*No role for hemodialysis
*No role for [[hemodialysis]]


==Disposition==
==Disposition==


==See Also==
==See Also==
[[Heavy Metals]]
*[[Toxicology (main)]]
*[[Heavy Metals]]


==References==
==References==
*Olson, K. Poisoning--[[User:Hkm91450|Melody Ong]] ([[User talk:Hkm91450|talk]]) 22:34, 2 March 2018 (UTC) and Drug Overdose, 1999.
<references/>
*Traub, S., & Elinder, C. (2017). Epidemiology and toxicity of cadmium. In G. Curhan (Ed.), UpToDate. UpToDate, Waltham, MA, (Accessed on February 22, 2018).
*Olson, K. Poisoning and Drug Overdose, 1999.
 
[[Category:Toxicology]]
[[Category:Toxicology]]

Latest revision as of 01:09, 9 March 2021

Background

  • Used in electroplating, soldering, pigments, and plastics
  • Once absorbed, cadmium distributes to most major organs, however it has a predilection for the liver and kidneys

Routes of exposure

  • Inahlation (up to 25%)
    • Cigarette smoking, occupational exposure
    • Particle size influences the amount absorbed
      • Smaller particles are more likely to penetrate the alveolar-capillary membrane
  • Gastrointestinal (1-10%)
    • Cadmium is ubiquitous in food systems
    • Total daily amount ingested is influenced by a variety of factors
      • Reduced total body iron stores leads to upregulation of the gene that encodes for DMT1, a heavy metal transporter located on the luminal side of enterocytes. Consequently, more cadmium is absorbed from the gastrointestinal tract. [1]
      • In certain parts of Japan, consumption of cadmium ranges from 59 to 113 mcg per day, which is more than twice the daily average of individuals in Europe. This is in large part due to rice irrigated with cadmium-contaminated water. [2]
  • Dermal (less than 1%)

Mechanism of Toxicity

  • Inhaled form is 60 times more toxic than ingested form
  • Chemical pneumonitis
  • Pulmonary edema/hemorrhage
  • GI irritation
  • Renal tubule damage

Clinical Features

Differential Diagnosis

Heavy metal toxicity

Evaluation

  • History of exposure and respiratory / gastrointestinal complaints

Management

Inhalation

Ingestion

Disposition

See Also

References

  1. Traub, S., & Elinder, C. (2017). Epidemiology and toxicity of cadmium. In G. Curhan (Ed.), UpToDate. UpToDate, Waltham, MA, (Accessed on February 22, 2018).
  2. Traub, S., & Elinder, C. (2017). Epidemiology and toxicity of cadmium. In G. Curhan (Ed.), UpToDate. UpToDate, Waltham, MA, (Accessed on February 22, 2018).
  • Olson, K. Poisoning and Drug Overdose, 1999.