Heavy metal poisoning: management of intoxication and antidotes

  • Daniel E. Rusyniak
  • Anna Arroyo
  • Jennifer Acciani
  • Blake Froberg
  • Louise Kao
  • Brent Furbee
Part of the Experientia Supplementum book series (EXS, volume 100)


Of the known elements, nearly 80% are either metals or metalloids. The highly reactive nature of most metals result in their forming complexes with other compounds such oxygen, sulfide and chloride. Although this reactivity is the primary means by which they are toxic, many metals, in trace amounts, are vital to normal physiological processes; examples include iron in oxygen transport, manganese and selenium in antioxidant defense and zinc in metabolism. With these essential metals toxicity occurs when concentrations are either too low or too high. For some metals there are no physiological concentrations that are beneficial; as such these metals only have the potential to cause toxicity. This chapter focuses on four of these: arsenic, mercury, lead and thallium.


Prussian Blue Lead Exposure Lead Poisoning Elemental Mercury Lead Toxicity 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Hunt E, Hader SL, Files D, Corey GR (1999) Arsenic poisoning seen at Duke Hospital, 1965–1998. NC Med J 60: 70–74Google Scholar
  2. 2.
    Lynch E, Braithwaite R (2005) A review of the clinical and toxicological aspects of ‘traditional’ (herbal) medicines adulterated with heavy metals. Expert Opin Drug Saf 4: 769–778PubMedGoogle Scholar
  3. 3.
    Wong ST, Chan HL, Teo SK (1998) The spectrum of cutaneous and internal malignancies in chronic arsenic toxicity. Singapore Med J 39: 171–173PubMedGoogle Scholar
  4. 4.
    Klasco RK (2009) DRUGDEX® System. Thomson Reuters, Greenwood Village, CO (online available at: http://csi.micromedex.com/help/DKS/DKRefEntir.htm)Google Scholar
  5. 5.
    FDA (2001) Trisenox Consumer Information Sheet. U.S. Food and Drug Administration Center for Drug Evaluation and Research (http://www.fda.gov/)Google Scholar
  6. 6.
    Vahidnia A, van der Voet GB, de Wolff FA (2007) Arsenic neurotoxicity — A review. Hum Exp Toxicol 26: 823–832PubMedGoogle Scholar
  7. 7.
    Baselt RC (2002) Disposition of Toxic Drugs and Chemicals in Man. 6th edn., Biomedical Publications, Foster City, CAGoogle Scholar
  8. 8.
    Ford M (2006) Arsenic. In: NE Flomenbaum, LR Goldfrank, RS Hoffman, MA Howland, NA Lewin, LS Nelson (eds): Goldfrank’s Toxicologic Emergencies. 8th edn., McGraw-Hill, New York, 1251–1264Google Scholar
  9. 9.
    ATSDR (2007) Toxicological Profile for Arsenic. U.S. Department of Health and Human Services, Public Health Service, Agency for Toxic Substances and Disease Registry, Atlanta, GAGoogle Scholar
  10. 10.
    Peters GR, McCurdy RF, Hindmarsh JT (1996) Environmental aspects of arsenic toxicity. Crit Rev Clin Lab Sci 33: 457–493PubMedGoogle Scholar
  11. 11.
    Khan MM, Sakauchi F, Sonoda T, Washio M, Mori M (2003) Magnitude of arsenic toxicity in tube-well drinking water in Bangladesh and its adverse effects on human health including cancer: Evidence from a review of the literature. Asian Pac J Cancer Prev 4: 7–14PubMedGoogle Scholar
  12. 12.
    Jones H, Visoottiviseth P, Bux MK, Fodenyi R, Kovats N, Borbely G, Galbacs Z (2008) Case reports: Arsenic pollution in Thailand, Bangladesh, and Hungary. Rev Environ Contam Toxicol 197: 163–187PubMedGoogle Scholar
  13. 13.
    Ghosh P, Banerjee M, Giri AK, Ray K (2008) Toxicogenomics of arsenic: Classical ideas and recent advances. Mutat Res 659: 293–301PubMedGoogle Scholar
  14. 14.
    Vahter M, Concha G (2001) Role of metabolism in arsenic toxicity. Pharmacol Toxicol 89: 1–5PubMedGoogle Scholar
  15. 15.
    ter Welle HF, Slater EC (1967) Uncoupling of respiratory-chain phosphorylation by arsenate. Biochim Biophys Acta 143: 1–17PubMedGoogle Scholar
  16. 16.
    Pullen-James S, Woods SE (2006) Occupational arsine gas exposure. J Natl Med Assoc 98: 1998–2001PubMedGoogle Scholar
  17. 17.
    Vantroyen B, Heilier JF, Meulemans A, Michels A, Buchet JP, Vanderschueren S, Haufroid V, Sabbe M (2004) Survival after a lethal dose of arsenic trioxide. Clin Toxicol 42: 889–895Google Scholar
  18. 18.
    ATSDR (1990) Case Studies in Environmental Medicine. Arsenic Toxicity. U.S. Department of Health and Human Services, Public Health Service, Agency for Toxic Substances and Disease Registry, Atlanta, GAGoogle Scholar
  19. 19.
    Klaassen CD (2006) Heavy metals and heavy-metal antagonists. In: LL Brunton, JS Lazo, KL Parker (eds): Goodman & Gilman’s The Pharmacological Basis of Therapeutics. McGraw-Hill, New York, 1753–1775Google Scholar
  20. 20.
    Hall JC, Harruff R (1989) Fatal cardiac arrhythmia in a patient with interstitial myocarditis related to chronic arsenic poisoning. South Med J 82: 1557–1560PubMedGoogle Scholar
  21. 21.
    Beckman KJ, Bauman JL, Pimental PA, Garrard C, Hariman RJ (1991) Arsenic-induced torsade de pointes. Crit Care Med 19: 290–292PubMedGoogle Scholar
  22. 22.
    Little RE, Kay GN, Cavender JB, Epstein AE, Plumb VJ (1990) Torsade de pointes and T-U wave alternans associated with arsenic poisoning. Pacing Clin Electrophysiol 13: 164–170PubMedGoogle Scholar
  23. 23.
    Goldsmith S, From AH (1980) Arsenic-induced atypical ventricular tachycardia. N Engl J Med 303: 1096–1098PubMedGoogle Scholar
  24. 24.
    St Petery J, Gross C, Victorica BE (1970) Ventricular fibrillation caused by arsenic poisoning. Am J Dis Child 120: 367–371PubMedGoogle Scholar
  25. 25.
    Kishi Y, Sasaki H, Yamasaki H, Ogawa K, Nishi M, Nanjo K (2001) An epidemic of arsenic neuropathy from a spiked curry. Neurology 56: 1417–1418PubMedGoogle Scholar
  26. 26.
    Donofrio PD, Wilbourn AJ, Albers JW, Rogers L, Salanga V, Greenberg HS (1987) Acute arsenic intoxication presenting as Guillain-Barre-like syndrome. Muscle Nerve 10: 114–120PubMedGoogle Scholar
  27. 27.
    Heaven R, Duncan M, Vukelja SJ (1994) Arsenic intoxication presenting with macrocytosis and peripheral neuropathy, without anemia. Acta Haematol 92: 142–143PubMedGoogle Scholar
  28. 28.
    Alain G, Tousignant J, Rozenfarb E (1993) Chronic arsenic toxicity. Int J Dermatol 32: 899–901PubMedGoogle Scholar
  29. 29.
    Ferreccio C, Sancha AM (2006) Arsenic exposure and its impact on health in Chile. J Health Popul Nutr 24: 164–175PubMedGoogle Scholar
  30. 30.
    Rahman MM, Ng JC, Naidu R (2009) Chronic exposure of arsenic via drinking water and its adverse health impacts on humans Environ Geochem Health Google Scholar
  31. 31.
    Ferreccio C, Gonzalez C, Milosavjlevic V, Marshall G, Sancha AM, Smith AH (2000) Lung cancer and arsenic concentrations in drinking water in Chile. Epidemiology 11: 673–679PubMedGoogle Scholar
  32. 32.
    Mealey J Jr, Brownell GL, Sweet WH (1959) Radioarsenic in plasma, urine, normal tissues, and intracranial neoplasms; distribution and turnover after intravenous injection in man. AMA Arch Neurol Psychiatry 81: 310–320PubMedGoogle Scholar
  33. 33.
    Stenehjem AE, Vahter M, Nermell B, Aasen J, Lierhagen S, Morland J, Jacobsen D (2007) Slow recovery from severe inorganic arsenic poisoning despite treatment with DMSA (2.3-dimercapto-succinic acid). Clin Toxicol 45: 424–428Google Scholar
  34. 34.
    Vaziri ND, Upham T, Barton CH (1980) Hemodialysis clearance of arsenic. Clin Toxicol 17: 451–456PubMedGoogle Scholar
  35. 35.
    FDA (2007) Approved Drug Products. Label for CHEMET. NDA no. 019998 (http://www.fda.gov/)Google Scholar
  36. 36.
    Kreppel H, Reichl FX, Forth W, Fichtl B (1989) Lack of effectiveness of d-penicillamine in experimental arsenic poisoning. Vet Hum Toxicol 31: 1–5PubMedGoogle Scholar
  37. 37.
    Klimecki WT, Carter DE (1995) Arsine toxicity: Chemical and mechanistic implications. J Toxicol Environ Health 46: 399–409PubMedGoogle Scholar
  38. 38.
    Parish GG, Glass R, Kimbrough R (1979) Acute arsine posioning in two workers cleaning a clogged drain. Arch Environ Health 34: 224–227PubMedGoogle Scholar
  39. 39.
    Ibrahim D, Froberg B, Wolf A, Rusyniak DE (2006) Heavy metal poisoning: Clinical Presentations and pathophysiology. Clin Lab Med 26: 67–97PubMedGoogle Scholar
  40. 40.
    Fowler BA, Weissberg JB (1974) Arsine poisoning. N Engl J Med 291: 1171–1174PubMedGoogle Scholar
  41. 41.
    EPA Web Page — Chromated Copper Arsenate (CCA), U.S. Environmental Protection Agency (http://www.epa.gov/)Google Scholar
  42. 42.
    CPSC (U.S. Consumer Product Safety Commission) Fact Sheet, Chromated Copper Arsenate (CCA) — Treated Wood Used in Playground Equipment, http://www.cpsc.gov/phth/ccafact.htmlGoogle Scholar
  43. 43.
    Hall AH (2002) Chronic arsenic poisoning. Toxicol Lett 128: 69–72PubMedGoogle Scholar
  44. 44.
    O’Shea JG (1990) “Two minutes with Venus, two years with mercury” — Mercury as an anti-syphilitic chemotherapeutic agent. J R Soc Med 83: 392–395PubMedGoogle Scholar
  45. 45.
    Risher J, De Woskin R (1999) Toxicological Profile for Mercury Agency for Toxic Substances and Disease Registry (ATSDR), U.S. Department of Health and Human Services, Public Health Service, Atlanta, GAGoogle Scholar
  46. 46.
    Goldwater LJ (1955) Hat industry: Mercury; a History of Quicksilver. York Press, Baltimore, MDGoogle Scholar
  47. 47.
    Graeme KA, Pollack CV (1998) Heavy metal toxicity, Part I: Arsenic and mercury. J Emerg Med 16: 45–56PubMedGoogle Scholar
  48. 48.
    Caravati EM, Erdman AR, Christianson G, Nelson LS, Woolf AD, Booze LL, Cobaugh DJ, Chyka PA, Scharman EJ, Manoguerra AS, Troutman WG, American Association of Poison Control Centers (2008) Elemental mercury exposure: An evidence-based consensus guideline for out-of-hospital management. Clin Toxicol 46: 1–21Google Scholar
  49. 49.
    Bluhm RE, Breyer JA, Bobbitt RG, Welch LW, Wood AJ, Branch RA (1992) Elemental mercury vapour toxicity, treatment, and prognosis after acute, intensive exposure in chloralkali plant workers. Part II: Hyperchloraemia and genitourinary symptoms. Hum Exp Toxicol 11: 211–215PubMedGoogle Scholar
  50. 50.
    Song Y, Li A (2007) Massive elemental mercury ingestion. Clin Toxicol 45: 193Google Scholar
  51. 51.
    Rusyniak DE, Nanagas KA (2008) Conservative management of elemental mercury retained in the appendix. Clin Toxicol 46: 831–833Google Scholar
  52. 52.
    Bredfeldt JE, Moeller DD (1978) Systemic mercury intoxication following rupture of a Miller-Abbott tube. Am J Gastroenterol 69: 478–480PubMedGoogle Scholar
  53. 53.
    dell’Omo M, Muzi G, Bernard A, Lauwerys RR, Abbritti G (1996) Long-term toxicity of intravenous mercury injection. Lancet 348: 64PubMedGoogle Scholar
  54. 54.
    Kedziora A, Duflou J (1995) Attempted suicide by intravenous injection of mercury: A rare cause of cardiac granulomas. A case report. Am J Forensic Med Pathol 16: 172–176PubMedGoogle Scholar
  55. 55.
    Hursh JB, Clarkson TW, Miles EF, Goldsmith LA (1989) Percutaneous absorption of mercury vapor by man. Arch Environ Health 44: 120–127PubMedGoogle Scholar
  56. 56.
    Boyd AS, Seger D, Vannucci S, Langley M, Abraham JL, King LE Jr (2000) Mercury exposure and cutaneous disease. J Am Acad Dermatol 43: 81–90PubMedGoogle Scholar
  57. 57.
    Rishler JF, Amler SN (2005) Mercury exposure: Evaluation and intervention in the in appropriate use of chelation agents in the diagnosis and treatment of putative mercury poisoning. Neurotoxicology 26: 691–699Google Scholar
  58. 58.
    Chang LW, Verity MA (1995) Mercury neurotoxicity: Effects and mechanisms. In: LW Chang, RS Dyer (eds). Handbook of Neurotoxicology. Marcel Dekker, New York, 31–59Google Scholar
  59. 59.
    Henningsson C, Hoffmann S, McGonigle L (1993) Acute mercury poisoning (acrodynia) mimicking pheochromocytoma in an adolescent. J Pediatr 122: 252–253PubMedGoogle Scholar
  60. 60.
    Torres AD, Ashok NR, Hardiek ML (2000) Mercury intoxication and arterial hypertension: Report of two patients and review of the literature. Pediatrics 105: E34PubMedGoogle Scholar
  61. 61.
    Wossmann W, Kohl M, Gruning G, Bucsky P (1999) Mercury intoxication presenting with hypertension and tachycardia. Arch Dis Childhood 80: 556–557Google Scholar
  62. 62.
    Finkelstein Y, Vardi J, Kesten MM, Hod I (1996) The enigma of parkinsonism in chronic borderline mercury intoxication, resolved by challenge with penicillamine. Neurotoxicology 17: 291–295PubMedGoogle Scholar
  63. 63.
    Miller K, Ochudlo S, Opala G, Smolicha W, Siuda J (2003) Parkinsonism in chronic occupational metallic mercury intoxication. Neurol Neurochir Pol 37 Suppl 5: 31–38PubMedGoogle Scholar
  64. 64.
    Ngim CH, Devathasan G (1989) Epidemiologic study on the association between body burden mercury level and idiopathic parkinson’s disease. Neuro epidemiology 8: 128–141Google Scholar
  65. 65.
    Ohlson CG, Hogstedt C (1981) Parkinson’s disease and occupational exposure to organic solvents, agricultural chemicals and mercury — A case-referent study. Scand J Work Environ Health 7: 252–256PubMedGoogle Scholar
  66. 66.
    Cornelis R, Heinzow B, Herber R, Christensen J, Paulsen O, Sabbioni E, Templeton D, Thomassen Y, Vahter M, Vesterberg O (1995) Sample collection guidelines for trace elements in blood and urine. Pure Appl Chem 67: 1575–1608Google Scholar
  67. 67.
    Allain P, Mauras Y, Premel-Cabic A, Islam S, Herve JP, Cledes J (1991) Effects of an EDTA infusion on the urinary elimination of several elements in healthy subjects. Br J Clin Pharmacol 31: 347–349PubMedGoogle Scholar
  68. 68.
    Sata F, Araki S, Murata K, Aono H (1998) Behavior of heavy metals in human urine and blood following calcium disodium ethylenediamine tetraacetate injection: Observations in metal workers. J Toxicol Environ Health A 54: 167–178PubMedGoogle Scholar
  69. 69.
    Clarkson TW, Magos L, Myers GJ (2003) The toxicology of mercury — Current exposures and clinical manifestations. N Engl J Med 349: 1731–1737PubMedGoogle Scholar
  70. 70.
    Kosnett MJ (1992) Unanswered questions in metal chelation. Clin Toxicol 30: 529–547Google Scholar
  71. 71.
    Clarkson TW, Magos L (2006) The toxicology of mercury and its chemical compounds. Crit Rev Toxicol 36: 609–662PubMedGoogle Scholar
  72. 72.
    Vimy MJ, Takahashi Y, Lorscheider FL (1990) Maternal-fetal distribution of mercury (203Hg) released from dental amalgam fillings. Am J Physiol 258: R939–945PubMedGoogle Scholar
  73. 73.
    Mutter J, Naumann J, Guethlin C (2007) Comments on the article “The toxicology of mercury and its chemical compounds” by Clarkson and Magos (2006). Crit Rev Tixicol 37: 537–552Google Scholar
  74. 74.
    Bates MN, Fawcett J, Garrett N, Cutress T, Kjellstrom T (2004) Health effects of dental amalgam exposure: A retrospective cohort study. Int J Epidemiol 33: 894–902PubMedGoogle Scholar
  75. 75.
    Bjorkman L, Pedersen NL, Lichtenstein P (1996) Physical and mental health related to dental amalgam fillings in Swedish twins. Commun Dent Oral Epidemiol 24: 260–267Google Scholar
  76. 76.
    Factor-Litvak P, Hasselgren G, Jacobs D, Begg M, Kline J, Geier J, Mervish N, Schoenholtz S, Graziano J (2003) Mercury derived from dental amalgams and neuropsychologic function. Environ Health Perspect 111: 719–723PubMedGoogle Scholar
  77. 77.
    Fung YK, Meade AG, Rack EP, Blotcky AJ (1997) Brain mercury in neurodegenerative disorders. J Toxicol Clin Toxicol 35: 49–54PubMedGoogle Scholar
  78. 78.
    Fung YK, Meade AG, Rack EP, Blotcky AJ, Claassen JP, Beatty MW, Durham T (1996) Mercury determination in nursing home patients with Alzheimer’s disease. Gen Dent 44: 74–78PubMedGoogle Scholar
  79. 79.
    Nitschke I, Müller F, Smith J, Hopfenmüller W (2000) Amalgam fillings and cognitive abilities in a representative sample of the elderly population. Gerodontology 17: 39–44PubMedGoogle Scholar
  80. 80.
    Saxe SR, Snowdon DA, Wekstein MW, Henry RG, Grant FT, Donegan SJ, Wekstein DR (1995) Dental amalgam and cognitive function in older women: Findings from the Nun Study. J Am Dent Assoc 126: 1495–1501PubMedGoogle Scholar
  81. 81.
    Saxe SR, Wekstein MW, Kryscio RJ, Henry RG, Cornett CR, Snowdon DA, Grant FT, Schmitt FA, Donegan SJ, Wekstein DR, Ehmann WD, Markesbery WR (1999) Alzheimer’s disease, dental amalgam and mercury. J Am Dent Assoc 130: 191–199PubMedGoogle Scholar
  82. 82.
    Langworth S, Bjorkman L, Elinder CG, Jarup L, Savlin P (2002) Multidisciplinary examination of patients with illness attributed to dental fillings. J Oral Rehabil 29: 705–713PubMedGoogle Scholar
  83. 83.
    Lygre GB, Gjerdet NR, Bjorkman L (2005) A follow-up study of patients with subjective symptoms related to dental materials. Commun Dent Oral Epidemiol 33: 227–234Google Scholar
  84. 84.
    Berglund A, Molin M (1997) Mercury levels in plasma and urine after removal of all amalgam restorations: The effect of using rubber dams. Dent Mater 13: 297–304PubMedGoogle Scholar
  85. 85.
    Molin M, Bergman B, Marklund SL, Schutz A, Skerfving S (1990) Mercury, selenium, and glutathione peroxidase before and after amalgam removal in man. Acta Odontol Scand 48: 189–202PubMedGoogle Scholar
  86. 86.
    DeBont B, Lauwerys R, Govaerts H, Moulin D (1986) Yellow mercuric oxide ointment and mercury intoxication. Eur J Pediatr 145: 217–218Google Scholar
  87. 87.
    Yip L, Dart R, Sullivan JJ (2001) Mercury. In: JJ Sullivan, G Drieger (eds): Clinical Environmental Health and Toxic Exposures. Lippincott Williams & Wilkins, Philadelphia, PA, 867–879Google Scholar
  88. 88.
    Dargan P, Giles L, Wallace C, House I, Thomson A, Beale R, Jones A (2003) Case report: Severe mercuric sulphate poisoning treated with 2,3-dimercaptopropane-1-sulphonate and haemodiafiltration. Crit Care 7: R1–R6PubMedGoogle Scholar
  89. 89.
    Endo T, Nakaya S, Kimura R, Murata T (1984) Gastrointestinal absorption of in organic mercuric compounds in vivo and in situ. Toxicol Appl Pharmacol 74: 223–229PubMedGoogle Scholar
  90. 90.
    Martin-Gil J, Martin-Gil FJ, Delibes-de-Castro G, Zapatero-Magdaleno P, Sarabia-Herrero FJ (1995) The first known use of vermillion. Experientia 51: 759–761PubMedGoogle Scholar
  91. 91.
    Sanchez-Sicilia L, Seto D, Nakamoto S, Kolff W (1963) Acute mercurial intoxication treated by hemodialysis. Ann Intern Med 59: 692–706PubMedGoogle Scholar
  92. 92.
    Schreiner G, Maher J (1965) Toxic nephropathy. Am J Med 38: 409–449PubMedGoogle Scholar
  93. 93.
    Newton JA, House IM, Volans GN, Goodwin FJ (1983) Plasma mercury during prolonged acute renal failure after mercuric chloride ingestion. Hum Toxicol 2: 535–537PubMedGoogle Scholar
  94. 94.
    Lund A (1956) The effect various substances on the excretion and the toxicity of thallium in the rat. Acta Pharmacol Toxicol 12: 260–268Google Scholar
  95. 95.
    Longcope WT, Luetscher JA Jr (1949) The use of BAL in the treatment of the injurious effects of arsenic, mercury and other metallic poisons. Ann Intern Med 31: 545–554PubMedGoogle Scholar
  96. 96.
    Baker JP (2008) Mercury, vaccines, and autism: One controversy, three histories. Am J Pub Health 98: 244–253Google Scholar
  97. 97.
    Harada M (1995) Minamata disease: Methylmercury poisoning in Japan caused by environmental pollution. Crit Rev Toxicol 25: 1–24PubMedGoogle Scholar
  98. 98.
    Bakir F, Damluji SF, Amin-Zaki L, Murtadha M, Khalidi A, al-Rawi NY, Tikriti S, Dahahir HI, Clarkson TW, Smith JC, Doherty RA (1973) Methylmercury poisoning in Iraq. Science 181: 230–241PubMedGoogle Scholar
  99. 99.
    Aberg B, Ekman L, Falk R, Greitz U, Persson G, Snihs JO (1969) Metabolism of methyl mercury (203Hg) compounds in man. Arch Environ Health 19: 478–484PubMedGoogle Scholar
  100. 100.
    Berlin M, Carlson J, Norseth T (1975) Dose-dependence of methylmercury metabolism. A study of distribution: Biotransformation and excretion in the squirrel monkey. Arch Environ Health 30: 307–313PubMedGoogle Scholar
  101. 101.
    Eto K (2000) Minamata disease. Neuropathology 20: S14–19Google Scholar
  102. 102.
    Eto K, Tokunaga H, Nagashima K, Takeuchi T (2002) An autopsy case of minamata disease (methylmercury poisoning) — Pathological viewpoints of peripheral nerves. Toxicol Pathol 30: 714–722PubMedGoogle Scholar
  103. 103.
    Harada M (1978) Congenital Minamata disease: Intrauterine methylmercury poisoning. Teratology 18: 285–288PubMedGoogle Scholar
  104. 104.
    Kondo K (2000) Congenital Minamata disease: Warnings from Japan’s experience. J Child Neurol 15: 458–464PubMedGoogle Scholar
  105. 105.
    Bakir F, Rustam H, Tikriti S, Al-Damluji SF, Shihristani H (1980) Clinical and epidemiological aspects of methylmercury poisoning. Postgrad Med J 56: 1–10PubMedGoogle Scholar
  106. 106.
    Nierenberg DW, Nordgren RE, Chang MB, Siegler RW, Blayney MB, Hochberg F, Toribara TY, Cernichiari E, Clarkson T (1998) Delayed cerebellar disease and death after accidental exposure to dimethylmercury. N Engl J Med 338: 1672–1676PubMedGoogle Scholar
  107. 107.
    Aaseth J, Frieheim EA (1978) Treatment of methyl mercury poisoning in mice with 2,3-dimercaptosuccinic acid and other complexing thiols. Acta Pharmacol Toxicol 42: 248–252Google Scholar
  108. 108.
    Zimmer LJ, Carter DE (1978) The efficacy of 2,3-dimercaptopropanol and d-penicillamine on methyl mercury induced neurological signs and weight loss. Life Sci 23: 1025–1034PubMedGoogle Scholar
  109. 109.
    Axton JH (1972) Six cases of poisoning after a parenteral organic mercurial compound (Merthiolate). Postgrad Med J 48: 417–421PubMedGoogle Scholar
  110. 110.
    Fagan DG, Pritchard JS, Clarkson TW, Greenwood MR (1977) Organ mercury levels in infants with omphaloceles treated with organic mercurial antiseptic. Arch Dis Child 52: 962–964PubMedGoogle Scholar
  111. 111.
    Lowell JA, Burgess S, Shenoy S, Peters M, Howard TK (1996) Mercury poisoning associated with hepatitis-B immunoglobulin. Lancet 347: 480PubMedGoogle Scholar
  112. 112.
    Pfab R, Mückter H, Roider G, Zilker T (1996) Clinical course of severe poisoning with thiomersal. J Toxicol Clin Toxicol 34: 453–460PubMedGoogle Scholar
  113. 113.
    Rohyans J, Walson PD, Wood GA, MacDonald WA (1984) Mercury toxicity following merthiolate ear irrigations. J Pediatr 104: 311–313PubMedGoogle Scholar
  114. 114.
    Gibson S (1976) Memorandum from Assistant Diretor, Bureau of Biologics, FDA to Director, Bureau of Biologics, FDA entitled “Use of thimerosol in biologics production”. February 27, 1976Google Scholar
  115. 115.
    Ball LK, Ball R, Pratt RD (2001) An assessment of thimerosal use in childhood vaccines. Pediatrics 107: 1147–1154PubMedGoogle Scholar
  116. 116.
    Bigham M, Copes R (2005) Thiomersal in vaccines: Balancing the risk of adverse effects with the risk of vaccine-preventable disease. Drug Saf 28: 89–101PubMedGoogle Scholar
  117. 117.
    Hviid A, Stellfeld M, Wohlfahrt J, Melbye M (2003) Association between thimerosal-containing vaccine and autism. J Am Med Assoc 290: 1763–1766Google Scholar
  118. 118.
    Thompson WW, Price C, Goodson B, Shay DK, Benson P, Hinrichsen VL, Lewis E, Eriksen E, Ray P, Marcy SM, Dunn J, Jackson LA, Lieu TA, Black S, Stewart G, Weintraub ES, Davis RL, DeStefano F (2007) Early thimerosal exposure and neuropsychological outcomes at 7 to 10 years. N Engl J Med 357: 1281–1292PubMedGoogle Scholar
  119. 119.
    Verstraeten T, Davis RL, DeStefano F, Lieu TA, Rhodes PH, Black SB, Shinefield H, Chen RT (2003) Safety of thimerosal-containing vaccines: A two-phased study of computerized health maintenance organization databases. Pediatrics 112: 1039–1048PubMedGoogle Scholar
  120. 120.
    Immunization Safety Review Committee (2004) Vaccines and Autism. The National Academies Press, Institute of Medicine (online available at: http://www.nap.edu/openbook.php?isbn=030909237X)Google Scholar
  121. 121.
    Global Advisory Committee on Vaccine Safety (2003) Statement on Thimerosal. World Health Organization (online available at: http://www.who.int/vaccine_safety/topics/thiomersal/statment_jul2006/en/index.html)Google Scholar
  122. 122.
    Lyketsos CG (2003) Should pregnant women avoid eating fish? Lessons from the Seychelles. Lancet 361: 1667–1668PubMedGoogle Scholar
  123. 123.
    Myers GJ, Davidson PW, Cox C, Shamlaye CF, Palumbo D, Cernichiari E, Sloane-Reeves J, Wilding GE, Kost J, Huang LS, Clarkson TW (2003) Prenatal methylmercury exposure from ocean fish consumption in the Seychelles child development study. Lancet 361: 1686–1692PubMedGoogle Scholar
  124. 124.
    Davidson PW, Myers GJ, Cox C, Axtell C, Shamlaye C, Sloane-Reeves J, Cernichiari E, Needham L, Choi A, Wang Y, Berlin M, Clarkson TW (1998) Effects of prenatal and postnatal methylmercury exposure from fish consumption on neurodevelopment: Outcomes at 66 months of age in the Seychelles Child Development Study. J Am Med Assoc 280: 701–707Google Scholar
  125. 125.
    Grandjean P, Weihe P, White RF, Debes F, Araki S, Yokoyama K, Murata K, Sorensen N, Dahl R, Jorgensen PJ (1997) Cognitive deficit in 7-year-old children with prenatal exposure to methylmercury. Neurotoxicol Teratol 19: 417–428PubMedGoogle Scholar
  126. 126.
    Hernberg S (2000) Lead poisoning in a historical perspective. Am J Ind Med 38: 244–254PubMedGoogle Scholar
  127. 127.
    Waldron HA (1969) James Hardy and the Devonshire Colic. Med Hist 13: 74–81PubMedGoogle Scholar
  128. 128.
    Felton JS (1967) Man, medicine, and work in America: A historical series. 3. Benjamin Franklin and his awareness of lead poisoning. J Occup Med 9: 543–554PubMedGoogle Scholar
  129. 129.
    Jacobs DE, Clickner RP, Zhou JY, Viet SM, Marker DA, Rogers JW, Zeldin DC, Broene P, Friedman W (2002) The prevalence of lead-based paint hazards in U.S. housing. Environ Health Perspect 110: A599–606PubMedGoogle Scholar
  130. 130.
    CDC (2005) Blood lead levels — United States, 1999–2002. MMWR — Morb Mortal Wkly Rep 54: 513–516Google Scholar
  131. 131.
    Haley VB, Talbot TO (2004) Seasonality and trend in blood lead levels of New York State children. BMC Pediatr 4: 8PubMedGoogle Scholar
  132. 132.
    Goldstein GW (1992) Neurologic concepts of lead poisoning in children. Pediatr Ann 21: 384–388PubMedGoogle Scholar
  133. 133.
    CDC (2004) Lead poisoning from ingestion of a toy necklace — Oregon, 2003. MMWR — Morb Mortal Wkly Rep 53: 509–511Google Scholar
  134. 134.
    Sokolowski MJ, Sisson G Jr (2005) Systemic lead poisoning due to an intra-articular bullet. Orthopedics 28: 411–412PubMedGoogle Scholar
  135. 135.
    CDC (1992) Elevated blood lead levels associated with illicitly distilled alcohol — Alabama, 1990–1991. MMWR — Morb Mortal Wkly Rep 41: 294–295Google Scholar
  136. 136.
    Holstege CP, Ferguson JD, Wolf CE, Baer AB, Poklis A (2004) Analysis of moonshine for contaminants. J Toxicol Clin Toxicol 42: 597–601PubMedGoogle Scholar
  137. 137.
    Lidsky TI, Schneider JS (2003) Lead neurotoxicity in children: Basic mechanisms and clinical correlates. Brain 126: 5–19PubMedGoogle Scholar
  138. 138.
    Piomelli S (1981) Chemical toxicity of red cells. Environ Health Perspect 39: 65–70PubMedGoogle Scholar
  139. 139.
    Albahary C (1972) Lead and hemopoiesis. The mechanism and consequences of the erythropathy of occupational lead poisoning. Am J Med 52: 367–378PubMedGoogle Scholar
  140. 140.
    Cheson BD, Rom WN, Webber RC (1984) Basophilic stippling of red blood cells: A nonspecific finding of multiple etiology. Am J Ind Med 5: 327–334PubMedGoogle Scholar
  141. 141.
    Levander OA (1979) Lead toxicity and nutritional deficiencies. Environ Health Perspect 29: 115–125PubMedGoogle Scholar
  142. 142.
    Loghman-Adham M (1997) Renal effects of environmental and occupational lead exposure. Environ Health Perspect 105: 928–939PubMedGoogle Scholar
  143. 143.
    Rabinowitz MB (1991) Toxicokinetics of bone lead. Environ Health Perspect 91: 33–37PubMedGoogle Scholar
  144. 144.
    Rastogi S, Nandlike K, Fenster W (2007) Elevated blood lead levels in pregnant women: Identification of a high-risk population and interventions. J Perinat Med 35: 492–496PubMedGoogle Scholar
  145. 145.
    Sachs HK (1981) The evolution of the radiologic lead line. Radiology 139: 81–85PubMedGoogle Scholar
  146. 146.
    Prozialeck WC, Edwards JR, Nebert DW, Woods JM, Barchowsky A, Atchison WD (2008) The vascular system as a target of metal toxicity. Toxicol Sci 102: 207–218PubMedGoogle Scholar
  147. 147.
    Canfield RL, Henderson CR Jr, Cory-Slechta DA, Cox C, Jusko TA, Lanphear BP (2003) Intellectual impairment in children with blood lead concentrations below 10 microg per deciliter. N Engl J Med 348: 1517–1526PubMedGoogle Scholar
  148. 148.
    Pocock SJ, Smith M, Baghurst P (1994) Environmental lead and children’s intelligence: A systematic review of the epidemiological evidence. BMJ 309: 1189–1197PubMedGoogle Scholar
  149. 149.
    Koller K, Brown T, Spurgeon A, Levy L (2004) Recent developments in low-level lead exposure and intellectual impairment in children. Environ Health Perspect 112: 987–994PubMedGoogle Scholar
  150. 150.
    Henretig FM (2006) Lead. In: NE Flomenbaum, LR Goldfrank, RS Hoffman, MA Howland, NA Lewin, LS Nelson (eds): Goldfrank’s Toxicologic Emergencies. 8th edn., McGraw-Hill, New York, 1308–1334Google Scholar
  151. 151.
    Cullen MR, Robins JM, Eskenazi B (1983) Adult inorganic lead intoxication: Presentation of 31 new cases and a review of recent advances in the literature. Medicine (Baltimore) 62: 221–247Google Scholar
  152. 152.
    Baker EL, Feldman RG, White RA, Harley JP, Niles CA, Dinse GE, Berkey CS (1984) Occupational lead neurotoxicity: A behavioural and electrophysiological evaluation. Study design and year one results. Br J Ind Med 41: 352–361PubMedGoogle Scholar
  153. 153.
    Erenberg G, Rinsler SS, Fish BG (1974) Lead neuropathy and sickle cell disease. Pediatrics 54: 438–441PubMedGoogle Scholar
  154. 154.
    Nawrot TS, Thijs L, Den Hond EM, Roels HA, Staessen JA (2002) An epidemiological reappraisal of the association between blood pressure and blood lead: A meta-analysis. J Hum Hypertens 16: 123–131PubMedGoogle Scholar
  155. 155.
    Navas-Acien A, Schwartz BS, Rothenberg SJ, Hu H, Silbergeld EK, Guallar E (2008) Bone lead levels and blood pressure endpoints: A meta-analysis. Epidemiology 19: 496–504PubMedGoogle Scholar
  156. 156.
    Assennato G, Paci C, Baser ME, Molinini R, Candela RG, Altamura BM, Giorgino R (1987) Sperm count suppression without endocrine dysfunction in lead-exposed men. Arch Environ Health 42: 124–127PubMedGoogle Scholar
  157. 157.
    Counter SA, Buchanan LH, Ortega F (2004) Current pediatric and maternal lead levels in blood and breast milk in Andean inhabitants of a lead-glazing enclave. J Occup Environ Med 46: 967–973PubMedGoogle Scholar
  158. 158.
    IARC (1987) Overall Evaluation of Carcinogenicity: An Updating of IARC Monographs, Vols. 1 to 42. International Agency for Research on Cancer (IARC), Lyon, 230–232Google Scholar
  159. 159.
    Steenland K, Boffetta P (2000) Lead and cancer in humans: Where are we now? Am J Ind Med 38: 295–299PubMedGoogle Scholar
  160. 160.
    Boeckx RL, Postl B, Coodin FJ (1977) Gasoline sniffing and tetraethyl lead poisoning in children. Pediatrics 60: 140–145PubMedGoogle Scholar
  161. 161.
    Anderson MK, Amrich M, Decker KL, Mervis CA (2007) Using state lead poisoning surveillance system data to assess false positive results of capillary testing. Matern Child Health J 11: 603–610PubMedGoogle Scholar
  162. 162.
    Martin CJ, Werntz CL 3rd, Ducatman AM (2004) The interpretation of zinc protoporphyrin changes in lead intoxication: A case report and review of the literature. Occup Med 54: 587–591Google Scholar
  163. 163.
    Hu H, Shih R, Rothenberg S, Schwartz BS (2007) The epidemiology of lead toxicity in adults: Measuring dose and consideration of other methodologic issues. Environ Health Perspect 115: 455–462PubMedGoogle Scholar
  164. 164.
    American Academy of Pediatrics Committee on Environmental Health (2005) Lead exposure in children: Prevention, detection, and management. Pediatrics 116: 1036–1046Google Scholar
  165. 165.
    Yeoh B, Woolfenden S, Wheeler D, Alperstein G, Lanphear B (2008) Household interventions for prevention of domestic lead exposure in children. Cochrane Database Syst Rev: CD006047Google Scholar
  166. 166.
    Rogan WJ, Dietrich KN, Ware JH, Dockery DW, Salganik M, Radcliffe J, Jones RL, Ragan NB, Chisolm JJ Jr, Rhoads GG (2001) The effect of chelation therapy with succimer on neuropsychological development in children exposed to lead. N Engl J Med 344: 1421–1426PubMedGoogle Scholar
  167. 167.
    De Groot G, van Heijst AN, van Kesteren RG, Maes RA (1985) An evaluation of the efficacy of charcoal haemoperfusion in the treatment of three cases of acute thallium poisoning. Arch Toxicol 57: 61–66PubMedGoogle Scholar
  168. 168.
    Besunder JB, Super DM, Anderson RL (1997) Comparison of dimercaptosuccinic acid and calcium disodium ethylenediaminetetraacetic acid versus dimercaptopropanol and ethylenediaminetetraacetic acid in children with lead poisoning. J Pediatr 130: 966–971PubMedGoogle Scholar
  169. 169.
    Brown MJ, Willis T, Omalu B, Leiker R (2006) Deaths resulting from hypocalcemia after administration of edetate disodium: 2003–2005. Pediatrics 118: e534–536PubMedGoogle Scholar
  170. 170.
    Lehmann PA, Favari L (1984) Parameters for the adsorption of thallium ions by activated charcoal and Prussian blue. J Toxicol Clin Toxicol 22: 331–339PubMedGoogle Scholar
  171. 171.
    De Backer W, Zachee P, Verpooten GA, Majelyne W, Vanheule A, De Broe ME (1982) Thallium intoxication treated with combined hemoperfusion-hemodialysis. J Toxicol Clin Toxicol 19: 259–264PubMedGoogle Scholar
  172. 172.
    Hologgitas J, Ullucci P, Driscoll J, Grauerholz J, Martin H (1980) Thallium elimination kinetics in acute thallotoxicosis. J Anal Toxicol 4: 68–75PubMedGoogle Scholar
  173. 173.
    Clifton JC 2nd, Sigg T, Burda AM, Leikin JB, Smith CJ, Sandler RH (2002) Acute pediatric lead poisoning: Combined whole bowel irrigation, succimer therapy, and endoscopic removal of ingested lead pellets. Pediatr Emerg Care 18: 200–202PubMedGoogle Scholar
  174. 174.
    James FA (1984) Of ‘Medals and Muddles’ the context of the discovery of thallium: William Crookes’s early spectro-chemical work. Notes Rec R Soc Lond 39: 65–90Google Scholar
  175. 175.
    Douglas KT, Bunni MA, Baindur SR (1990) Thallium in biochemistry. Int J Biochem 22: 429–438PubMedGoogle Scholar
  176. 176.
    Gehring PJ, Hammond PB (1967) The interrelationship between thallium and potassium in animals. J Pharmacol Exp Ther 155: 187–201PubMedGoogle Scholar
  177. 177.
    Melnick RL, Monti LG, Motzkin SM (1976) Uncoupling of mitochondrial oxidative phosphorylation by thallium. Biochem Biophy Res Commun 69: 68–73Google Scholar
  178. 178.
    Mulkey JP, Oehme FW (1993) A review of thallium toxicity. Vet Hum Toxicol 35: 445–453PubMedGoogle Scholar
  179. 179.
    Lund A (1956) Distribution of thallium in the organism and its elimination. Acta Pharmacol Toxicol 12: 251–259Google Scholar
  180. 180.
    Malbrain ML, Lambrecht GL, Zandijk E, Demedts PA, Neels HM, Lambert W, De Leenheer AP, Lins RL, Daelemans R (1997) Treatment of severe thallium intoxication. J Toxicol Clin Toxicol 35: 97–100PubMedGoogle Scholar
  181. 181.
    Reed D, Crawley J, Faro SN, Pieper SJ, Kurland LT (1963) Thallotoxicosis. J Am Med Assoc 183Google Scholar
  182. 182.
    Rusyniak DE, Furbee RB, Kirk MS (2002) Thallium and arsenic poisoning in a small midwest town. Ann Emerg Med 39: 307–311PubMedGoogle Scholar
  183. 183.
    Meggs WJ, Hoffman RS, Shih RD, Weisman RS, Goldfrank LR (1994) Thallium poisoning from maliciously contaminated food. J Toxicol Clin Toxicol 32: 723–730PubMedGoogle Scholar
  184. 184.
    Misra UK, Kalita J, Yadav RK, Ranjan P (2003) Thallium poisoning: Emphasis on early diagnosis and response to haemodialysis. Postgrad Med J 79: 103–105PubMedGoogle Scholar
  185. 185.
    Chamberlain PH, Stavinoha WB, Davis H, Kniker WT, Panos TC (1958) Thallium poisoning. Pediatrics 22: 1170–1182PubMedGoogle Scholar
  186. 186.
    Desenclos JC, Wilder MH, Coppenger GW, Sherin K, Tiller R, van Hook RM (1992) Thallium poisoning: An outbreak in Florida, 1988. South Med J 85: 1203–1206PubMedGoogle Scholar
  187. 187.
    Prick JJG, Sillevis Smitt WG, Muller L (1955) Thallium Poisoning. Elsevier Publishing, AmsterdamGoogle Scholar
  188. 188.
    Cavanagh JB, Fuller NH, Johnson HRM (1974) The effects of thallium salts, with particular reference to the nervous system changes. A report of three cases. Q J Med 170: 293–319Google Scholar
  189. 189.
    Davis LE, Standefer JC, Kornfeld M, Abercrombie DM, Butler C (1980) Acute thallium poisoning: Toxicological and morphological studies of the nervous system. Ann Neurol 10: 38–44Google Scholar
  190. 190.
    Hoffman RS (2003) Thallium toxicity and the role of Prussian blue in therapy. Toxicol Rev 22: 29–40PubMedGoogle Scholar
  191. 191.
    Tabandeh H, Crowston JG, Thompson GM (1994) Ophthalmologic features of thallium poisoning. Am J Ophthal 117: 243–245PubMedGoogle Scholar
  192. 192.
    Feldman J, Levisohn DR (1993) Acute alopecia: Clue to thallium toxicity. Pediatr Dermatol 10: 29–31PubMedGoogle Scholar
  193. 193.
    Heyl T, Barlow RJ (1989) Thallium poisoning: A dermatological perspective. Br J Dermatol 121: 787–791PubMedGoogle Scholar
  194. 194.
    Moeschlin S (1980) Thallium poisoning. Clin Toxicol 17: 133–146PubMedGoogle Scholar
  195. 195.
    Koblenzer PJ, Weiner LB (1969) Alopecia secondary to thallium intoxication. Arch Dermatol 99: 777PubMedGoogle Scholar
  196. 196.
    Cavanagh JB, Gregson M (1978) Some effects of a thallium salt on the proliferation of hair follicle cells. J Pathol 125: 179–191PubMedGoogle Scholar
  197. 197.
    Tromme I, van Neste D, Dobbelaere F, Bouffioux B, Courtin C, Dugernier T, Pierre P, Dupuis M (1998) Skin signs in the diagnosis of thallium poisoning. Br J Dermatol 138: 321–325PubMedGoogle Scholar
  198. 198.
    Saha A, Sadhu HG, Karnik AB, Patel TS, Sinha SN, Saiyed HN (2004) Erosion of nails following thallium poisoning: A case report. Occup Environ Med 61: 640–642PubMedGoogle Scholar
  199. 199.
    Bank WJ, Pleasure DE, Suzuki K, Nigro M, Katz R (1972) Thallium poisoning. Arch Neurol 26: 456–464PubMedGoogle Scholar
  200. 200.
    Roby DS, Fein AM, Bennett RH, Morgan LS, Zatuchni J, Lippmann ML (1984) Cardiopulmonary effects of acute thallium poisoning. Chest 85: 236–240PubMedGoogle Scholar
  201. 201.
    Moore D, House I, Dixon A (1993) Thallium poisoning. Diagnosis may be elusive but alopecia is the clue. BMJ 306: 1527–1529PubMedGoogle Scholar
  202. 202.
    Cavanagh JB (1979) The ‘dying back’ process. A common denominator in many naturally occurring and toxic neuropathies. Arch Pathol Lab Med 103: 659–664PubMedGoogle Scholar
  203. 203.
    Cavanagh JB (1991) What have we learnt from Graham Frederick Young? Reflections on the mechanism of thallium neurotoxicity. Neuropathol Appl Neurobiol 17: 3–9PubMedGoogle Scholar
  204. 204.
    Metter D, Vock R (1984) [Structure of the hair in thallium poisoning]. Zeitschr Rechtsmed J Leg Med 91: 201–214Google Scholar
  205. 205.
    Wecht C, Saitz G (2007) Mortal Evidence: The Forensics Behind Nine Shocking Cases. Prometheus Books, New YorkGoogle Scholar
  206. 206.
    Barroso-Moguel R, Villeda-Hernandez J, Mendez-Armenta M, Rios C, Monroy-Noyola A (1994) Combinet d-penicillamine and Prussian blue as antidotal treatment against thallotoxicosis in rats: Evaluation of cerebellar lesions. Toxicology 89: 15–24PubMedGoogle Scholar
  207. 207.
    Heydlauf H (1969) Ferric-cyanoferrate (II): An effective antidote in thallium poisoning. Eur J Pharmacol 6: 340–344PubMedGoogle Scholar
  208. 208.
    Kamerbeek HH, Rauws AG, ten Ham M, van Heijst AN (1971) Dangerous redistribution of thallium by treatment with sodium diethyldithiocarbamate. Acta Med Scand 189: 149–154PubMedGoogle Scholar
  209. 209.
    Manninen V, Malkonen M, Skulskii IA (1976) Elimination of thallium in rats as influenced by Prussian blue and sodium chloride. Acta Pharmacol Toxicol 39: 256–261Google Scholar
  210. 210.
    Meggs WJ, Cahill-Morasco R, Shih RD, Goldfrank LR, Hoffman RS (1997) Effects of Prussian blue and N-acetylcysteine on thallium toxicity in mice. J Toxicol Clin Toxicol 35: 163–166PubMedGoogle Scholar
  211. 211.
    Rauws AG (1974) Thallium pharmacokinetics and its modification by Prussian blue. Naunyn Schmiedebergs Arch Pharmacol 284: 295–306Google Scholar
  212. 212.
    Rios C, Monroy-Noyola A (1992) d-Penicillamine and Prussian blue as antidotes against thallium intoxication in rats. Toxicology 74: 69–76PubMedGoogle Scholar
  213. 213.
    Rusyniak DE, Kao LW, Nanagas KA, Kirk MA, Furbee RB, Brizendine EJ, Wilmot PE (2003) Dimercaptosuccinic acid and Prussian blue in the treatment of acute thallium poisoning in rats. J Toxicol Clin Toxicol 41: 137–142PubMedGoogle Scholar
  214. 214.
    Pearce J (1994) Studies of any toxicological effects of Prussian blue compounds in mammals — A review. Food Chem Toxicol 32: 577–582PubMedGoogle Scholar
  215. 215.
    Lund A (1956) The effect various substances on the excretion and the toxicity of thallium in the rat. Acta Pharmacol Toxicol 12: 260–268Google Scholar
  216. 216.
    Mulkey JP, Oehme FW (2000) Are 2,3-dimercapto-1-propanesulfonic acid or Prussian blue beneficial in acute thallotoxicosis in rats? Vet Hum Toxicol 42: 325–329PubMedGoogle Scholar
  217. 217.
    Van der Stock J, Schepper J (1978) The effect of Prussian blue and sodium-ethylenediaminetetraacetic acid on the faecal and urinary elimination of thallium by the dog. Res, Vet Sci 25: 337–342Google Scholar
  218. 218.
    Hoffman RS, Stringer JA, Feinberg RS, Goldfrank LR (1999) Comparative efficacy of thallium adsorption by activated charcoal, Prussian blue, and sodium polystyrene sulfonate. J Toxicol Clin Toxicol 37: 833–837PubMedGoogle Scholar

Copyright information

© Birkhäuser Verlag/Switzerland 2010

Authors and Affiliations

  • Daniel E. Rusyniak
    • 1
  • Anna Arroyo
    • 1
  • Jennifer Acciani
    • 1
  • Blake Froberg
    • 2
  • Louise Kao
    • 1
  • Brent Furbee
    • 1
  1. 1.Department of Emergency Medicine, Division of Medical ToxicologyIndiana University School of MedicineIndianapolisUSA
  2. 2.Department of Pediatrics, Division of Medical ToxicologyIndiana University School of MedicineIndianapolisUSA

Personalised recommendations