Unanswered Questions in Metal Chelation

Details

• Personal Author:
  Kosnett MJ
• Description:
  Chelation has been shown to increase the urinary excretion of metals, particularly demonstrated with lead (7439921) intoxicated patients. However, the author noted that while increased excretion has been well documented, whether or not the clinical outcome of the patient is improved has not been delineated. Animal studies reveal a very important time dependence to the efficacy of British-Anti- Lewisite (BAL) in averting the lethality of arsenic (7440382). The first clinical use of BAL in humans occurred in individuals suffering from a side effect known as arsenical dermatitis. Patients had a short length of hospital stay when treated with BAL; however, there is no evidence that established neuropathy is improved by the use of BAL. Studies also indicated that chelation therapy increased the urinary excretion of lead (7439921). However, in some studies BAL actually increased the toxicity of lead as well. Use of BAL plus EDTA saw a fall in mortality from lead encephalopathy to less than 5%, but at the same time there were major advances in supportive medical care and the decline in mortality cannot be attributed necessarily to the use of chelation therapy alone. As regards the effect of lead chelation on neurological endpoints in adults, there have been no randomized, placebo controlled, trials. A significant finding is that chelatable lead is not necessarily an indication of a subject's long term lead exposure. The authors ends with a concern about choosing the correct candidates for chelation. [Description provided by NIOSH]
• Subjects:
  Arsenic Cardiovascular Diseases Cardiovascular System Chelating Agents Dust Lead Lead Poisoning Metals Metals, Heavy Occupational Health Poisoning Safety Toxicology

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• Keywords:
  Arsenic-poisoning Cardiovascular-system-disorders Chelating-agents Heavy-metal-poisoning Lead-poisoning Medical-treatment Metal-dusts Metal-poisoning NIOSH-Grant NIOSH-Publication
• ISSN:
  0731-3810
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  California ; OSHA Region 9
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  30
• Issue:
  4
• NIOSHTIC Number:
  nn:00236991
• Citation:
  J Toxicol Clin Toxicol 1992 Oct; 30(4):529-547
• Contact Point Address:
  Medicine University of California, SF Sfgh Bldg 30 5Th Floor San Francisco, CA 94110
• CAS Registry Number:
  Arsenic (CAS RN 7440-38-2) ; Lead (CAS RN 7439-92-1)
• Federal Fiscal Year:
  1993
• Performing Organization:
  University of California San Francisco, San Francisco, California
• Peer Reviewed:
  True
• Start Date:
  19910930
• Source Full Name:
  Journal of Toxicology: Clinical Toxicology
• End Date:
  19950330
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:0fd8c26d2e2c43c2b0ef85001a9ff71f02a501b3ea2843b576a3e6a739312e1beded1f1ee6050cb299fef07a60b9d7b2dcf934e4770549da801d6db8bc59d4e2
• Download URL:
  https://stacks.cdc.gov/view/cdc/197860/cdc_197860_DS1.pdf
• File Type:
  [PDF - 1.04 MB ]