Cadmium poisoning
| Classification according to ICD-10 | |
|---|---|
| T56.3 | Toxic effect: cadmium and its compounds |
| ICD-10 online (WHO version 2019) | |
Cadmium occurs naturally in the human body, which also has tools to bind it. Since no physiological significance is known to date and it has a toxic effect, excessive ingestion is referred to as cadmium poisoning . However, a cadmium deficiency is unknown. Cadmium often occurs in nature together with zinc, is absorbed into the human body through the mouth (orally) in the form of water-soluble cadmium salts or in elemental form through the breath (inhalation) and then remains in it for a long time.
Acute cadmium poisoning was first described in 1858 after it had previously been assumed that a person could not poison himself with cadmium.
The " chronic cadmium poisoning with often fatal outcome" is also referred to as Itai-Itai disease ( Japanese イ タ イ イ タ イ 病 , Itai-Itai-byō , literally: "Ouch-ouch disease" because of the severe pain). It was first described in Toyama Prefecture , Japan in the 1950s .
While acute poisoning is associated with chemical burns, including the gastric mucosa, as well as violent vomiting, the chronic form is more manifest in pain, particularly in the back and legs, bone softening with spontaneous fractures , liver and kidney damage and anemia .
Absorption of cadmium
Cadmium occurs naturally in the environment together with zinc spar , silica zinc ore and zinc blende , which can be traced back to natural processes and sources such as volcanism or the weathering of rocks . Occurrences of civilizational origin can be traced back to the side effects of (metal) industry and agriculture. Cadmium is also an unavoidable by-product in the extraction and processing of metals. It can also be found in fertilizers and pesticides . Cadmium, especially from soils and water, can accumulate in both plants and animals. It is absorbed into the body in particular via water-soluble compounds (salts), but also via its vapors, which arise at temperatures above its boiling point, such as those during combustion processes.
The Itai-Itai disease was caused by contamination that was associated with industrial mining: when silver , lead , copper and zinc were extracted, large amounts of cadmium from the mines were released into the environment, and especially into the Jinzū River . The river water was used to irrigate the rice fields and as drinking and washing water, and the river was also heavily fished. About the food chain, v. a. the cadmium-contaminated rice and fish, it finally got into the human body and continued to accumulate there over a longer period of time.
Even under normal circumstances, cadmium is mainly absorbed through food. Cadmium contains grains, vegetables, legumes, potatoes, nuts and chocolate, meat, fish and seafood, seaweed and seaweed, dietary supplements and mushrooms. Vegetarians who consume large quantities of grains, nuts, oilseed products and legumes thus take in twice as much cadmium as the normal population. It is also absorbed through tobacco smoke and house dust .
The temporarily tolerable monthly intake ( PTMI ) is currently assumed by the WHO at 25 micrograms of cadmium per kilogram of body weight per month. It is assumed that average adults ingest about 2.2 to 12 micrograms of cadmium per kilogram of body weight every month. The intake is above average among children up to the age of 12, which is attributed to their increased consumption of cocoa , and among vegetarians . Both groups are still below the limit value set by the WHO.
Similar to the WHO, the EFSA assumes an average cadmium intake in adult Europeans of between 2.3 and 3.0 micrograms per kilogram of body weight per week, but has now also reduced the specified tolerable weekly intake (TWI) to 2.5 micrograms per kilogram of body weight . For example, vegetarians, children, smokers and people who live in highly polluted areas exceed the EFSA limit values by up to two times (although the assumed pollution correlates with that given by the WHO). According to EFSA, the risk of adverse effects remains very low.
Guideline and limit values for food and fertilizers were and are set politically. In the European Union, for example, there has long been a ban on the transport of foods that exceed a certain limit value for this contaminant , not only for the food of sensitive groups such as children : there are maximum limits for liver of 0.5, for mussels and many mushrooms of 1, 3 for seaweed, 0.2 for wheat grains and, since January 2019, 0.6 mg / kg fresh weight for cocoa powder.
physiology
Cadmium is found in the human body in a small amount totaling around 30 milligrams. It can get into the body through inhalation of cadmium vapors or orally through ingestion of soluble cadmium salts. If this amount is exceeded in the body, the signs of poisoning appear. A basic distinction must be made between acute and chronic intoxication .
The human body has a metallothionein that can bind excess cadmium. Its formation is stimulated by cadmium.
Clinical appearance
Glucose and proteinuria , metabolic acidosis , an increase in phosphatases and a decrease in serum phosphates are typical .
Chronic poisoning (Itai-Itai disease)
A long-term increased intake of cadmium leads to kidney damage, is a risk factor for tumor diseases and hinders the absorption of calcium from food, which causes a thinning of the bone substance ( osteopenia ). Those suffering from Itai-Itai showed kidney damage, deformation of the skeleton and broken bones.
Effects
Cadmium accumulates in the kidneys and damages them, so that glomerularly filtered proteins are not reabsorbed tubularly and are therefore excreted with the urine . Calcium is also not reabsorbed tubularly to a sufficient extent and is therefore increasingly excreted renally. At the same time, cadmium in the intestine causes the reduced absorption of calcium , which is essential for bone structure . In order to compensate for these losses, more calcium is now mobilized from the bones, which leads to brittle bones and thus to osteoporosis .
(→ main article cadmium, section toxicology )
Similar diseases
Chronic mercury poisoning triggers Minamata disease ; lead can lead to lead poisoning .
See also
- Gressenich disease in grazing cattle
Individual evidence
- ↑ www.duden.de: Itai-Itai Disease, here online , last viewed on Jan. 10, 2017
- ↑ http://www.spektrum.de:/ Itai-Itai disease, [1] , last viewed on Jan. 10, 2017.
- ↑ a b v. Neureiter F., ea: Concise dictionary of forensic medicine and natural scientific criminalistics: In association with numerous specialists from home and abroad , Springer-Verlag, 2013, p. 121, ISBN 3-642-51321-2 , here online .
- ↑ www.wasser-wissen.de: Itai-Itai disease, here online ; last viewed on Jan. 10, 2017.
- ↑ a b www.efsa.europa.eu/de: EFSA sets a lower value for the tolerable intake of cadmium contained in food , here online , last viewed on January 8, 2020.
- ^ World Health Organization .: Guidelines for drinking-water quality. 4th ed. World Health Organization, Geneva 2011, ISBN 978-92-4154815-1 .
- ↑ WHO: CADMIUM : online here ; last accessed on January 22, 2017.
- ↑ bmub.bund.de: Interim report of the federal government on the implementation ... Reduction of the cadmium content in food , pdf ( Memento of the original from January 22, 2017 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. ; last accessed on January 22, 2017.
- ↑ Article 1 of Regulation (EC) No. 1881/2006 of the Commission of December 19, 2006 setting the maximum levels for certain contaminants in food, there Annex No. 3.2 .. bmub.bund.de: REGULATION (EU) No. 488 / 2014 OF THE COMMISSION , pdf (PDF) ; last accessed on January 22, 2017.
- ↑ deutschlandfunk.de: Cadmium in cocoa - dark chocolate particularly affected by heavy metals , here online ; last accessed on January 22, 2017
- ↑ Chocolate: Enjoyment without regrets. Federal Institute for Materials Research and Testing, February 26, 2019, accessed on January 8, 2020 . Dr. Christine Hupfer: Cadmium in cocoa products, test results 2018 , Bayer. State Office for Health and Food Safety
- ↑ a b Harold A. Harper, Georg Löffler et al .: Physiological chemistry: An introduction to medical biochemistry for students of medicine and doctors , Springer-Verlag, 2013, p. 563, ISBN 3-662-09766-4 , here online .
