Toxic Elements

Where does aluminum concentrate?

50% in bone and 25% in lungs

How is aluminum transported?

Bound to proteins (transferrin)

What accounts for the most excretion of aluminum?

Urine (95%);

What does aluinum do?

What does aluminum toxicity cause?

Encephalopathy, anemia, bone disease, progressive dementia

How is aluminum evaluated in the lab?

ICP-MS and GFAAS with urine and serum samples

Reference range for aluminum

0-6 ng/mL

What does arsenic toxicity affect?

GI, cardiovascular, hepatic, dermatologic, and renal involvement

What are the health effects of arsenic?

Acute and chronic states. fatal at low doses

How is arsenic absorbed?

Ingestion and inhalation

How is arsenic transported?

Hepatic metabolism

How is arsenic excreted?

Organic arsenic is cleared rapidly; inorganic and methylated are more toxic

How is arsenic evaluated in the lab?

ICP-MS and GFAAS; urine is best specimen (hair, nails, serum also suitable)

Reference ranges for arsenic

Blood = < 13 ng/mL

Urine = < 35 µg/L

How is cadmium absorbed?

Ingestion (5%) and inhalation (50%)

Absorption of cadmium is higher in what populations?

Higher in females and smokers

Where is cadmium excreted the most?

Urine (95%); 2% in bile

What does cadmium affect?

Liver, bone, immune, blood, pulmonary, and nervous systems

Does cadmium have an effect on human physiology?

No

How is cadmium evaluated in the lab?

ICP-MS and GFAAS; found in RBCs (80%) or urine

Reference range for cadmium?

< 5 ng/dL

How is chromium absorbed?

Ingestion, inhalation, and dermal absorption

What form of chromium is easier to absorb and more toxic than Cr3+?

Cr6+

How is chromium transported?

Bound to albumin and transferrin

What are the health effects of chromium?

Cr3+ is an essential element for insulin action; Cr6+ is an oxidizing agent

Chromium toxicity

Lung irritation and dermatitis are common; liver, kidney and immune system affected

How is chromium evaluated in the lab?

ICP-MS and GFAAS; serum/plasma or urine

Reference range of chromium

< 6 ng/mL

How is copper absorbed?

Ingestion, inhalation, and dermal

How is copper transported?

Bound to proteins (albumin)

How is copper excreted?

Bile (98%) and <3% in urine/sweat

What is copper important for?

Metalloenzymes

What does copper toxicity affect?

Hepatic and renal damage, neurologic symptoms, mucous membrane irritation

How is copper evaluated in the lab?

ICP-MS, FAAS, ICP-AES, ASV; serum and urine samples

Reference range for copper

75-145 µg/dL

How is lead absorbed?

Ingestion and inhalation

How is lead absorbed?

99% absorbed by RBCs; liver, kidney, brain, highest in bone (90%)

How is lead excreted?

Urine (76%), feces (16%), remainder in hair, sweat, nails

Does lead have a role in human physiology?

No

What does lead toxicity affect?

Higher absorption in children, leads to neurologic symptoms and low IQ, anemia

How is lead evaluated in the lab?

ICP-MS, GFAAS, ASV; whole blood preferred

Reference range for lead

< 3.5 µg/dL

How is mercury absorbed?

Inhalation = most common

Ingestion, cutaneous, injection, dental

What organ is the major storage organ for mercury?

Kidney = major

Liver, spleen, brain

How is mercury excreted?

Feces and urine

Does mercury have a role in physiology?

No

What does mercury toxicity affect?

CNS and PNS toxicity; can damage most organs/tissues before symptoms appear

How is mercury evaluted in the lab?

ICP-MS, CV-AAS; serum and urine samples (hair can be used, but challenging)

Reference range for mercury

< 10 ng/mL