Nitrate Poisoning

2024 Author: Rachel Wainwright | [email protected]. Last modified: 2023-12-15 07:39

Nitrates (salts of nitric acid) are present in all living organisms, both plant and animal. They come inside with food, are formed as a result of their own chemical processes, in small quantities they serve as an indispensable component of metabolism. Excessive intake of nitric acid salts into the body from the outside, most often in the composition of vegetables, fruits, water and sausages, is pathological.

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Nitrates, also known under the outdated name "saltpeter", have become widespread in agriculture due to the intensification of production. The introduction of nitrogenous fertilizers into the soil can increase yields and accelerate the process of fruit ripening.

The commercially justified use of high and ultra-high doses of nitrate fertilizers leads to their excessive accumulation in agricultural products. In addition, nitrogen fertilizers enhance the mineralization of the soil in which the crop is planted, which results in an additional supply of nitrates to the plant from the soil.

Up to 70% of agricultural products have an overestimated level of nitrates; off-season vegetables and melons grown in an unnatural season for them are especially dangerous. When storing the crop, the amount of nitrates in plants is significantly reduced: in about six months, the concentration of nitric acid salts in potatoes decreases by 4 times, in table beets - by 1.5 times, in carrots and cabbage - by 3 times.

Of the cultivated plants, the most actively accumulate nitrates are peas, corn, potatoes, beets, watermelon, melon, zucchini, carrots, tomatoes, cucumbers, and greens.

In addition to agriculture, nitrates are widely used in the food industry, especially in the production of sausages. By interacting with the protein myoglobin contained in meat, they give the product an attractive pink color.

Large amounts of nitrates are harmful to the body, an even greater danger is the products of their reduction - salts of nitrous acid, or nitrites. The toxicity of nitrites is approximately 10 times higher than that of nitrates: a lethal dose for humans is 2–4 g and 10–15 g, respectively.

How does nitrate poisoning occur?

Poisoning most often occurs when eating agricultural products in which the permissible norm of nitrates is exceeded.

It is often possible to identify such vegetables and gourds without measuring the level of harmful substances with special equipment, in appearance. The risk of acute intoxication is especially high when eating foods with the following symptoms:

cucumbers saturated with nitrates do not have a light herbaceous peel, but a dark green;
tomatoes on a cut of a heterogeneous color, pink-red flesh is interspersed with dense light areas and veins, the peel around the stalk is light yellow or greenish;
unnaturally bright color of greens (parsley, dill, lettuce);
excessively large size (potatoes, beets) and a green top, bordering on the tops, part of the root crops (radishes, carrots);
dark green skin around the stalk of the squash.

Poisoning of a breastfed baby is possible when the mother eats foods high in nitrates, since nitric acid salts penetrate well into breast milk.

Poisoning symptoms

Once in the gastrointestinal tract, nitrates are rapidly absorbed into the systemic circulation. Upon contact with the respiratory protein hemoglobin, nitrites formed during the nitrate reduction reaction change the iron atom in hemoglobin and convert it into methemoglobin. The resulting substance is unable to bind and transport oxygen, which leads to a decrease in the oxygen capacity of the blood and the development of hypoxia of organs and tissues.

The destruction of methemoglobin occurs under the influence of an enzyme, the production of which begins at the age of three months, therefore, children of the first year of life are especially vulnerable to nitrates.

Against the background of tissue hypoxia, a number of systems and organs are involved in the pathological process, which causes the development of characteristic signs of acute nitrate intoxication. Poisoning symptoms appear 1-6 hours after consuming high-nitrate foods:

nausea, vomiting;
loose stools;
pain and heaviness in the right hypochondrium due to an enlarged liver;
lowering blood pressure;
frequent arrhythmic threadlike pulse;
cold snap and cyanosis of the extremities;
increased breathing;
noise, ringing in the ears;
headache, dizziness;
drowsiness, deterioration in general health;
in severe cases, loss of consciousness, coma.

In chronic nitrate poisoning, performance decreases, vitamin deficiency develops, metabolic processes, the functioning of organs and systems are disrupted. The victims have a depressed state, up to the development of depression.

When the content of methemoglobin in the blood is about 15-20%, symptoms of acute intoxication appear, with a content of 50% or more, the death of the victim occurs.

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First aid for nitrate poisoning

In case of acute nitrate poisoning, it is necessary:

rinse the stomach, for which it is necessary to drink 1–1.5 liters of warm water or a weak solution of potassium permanganate and induce vomiting by pressing on the root of the tongue;
take enterosorbent (Enterosgel, Polyphepan, Polysorb, activated carbon);
take a saline laxative (Magnesium sulfate) - only if there is no diarrhea;
organize an increased drinking regime to prevent dehydration.

To reduce the symptoms of intoxication, it is recommended to take 2-3 pills of vitamin C (ascorbic acid), since in its presence the conversion of nitrates into toxic nitrosoamines stops.

When is medical attention required?

Qualified assistance is needed if:

against the background of emergency measures, the condition of the victim remains stably severe or worsens;
developed neurological symptoms (impaired coordination, vision or speech, seizures);
there are traces of blood in the vomit or feces;
symptoms of dehydration have developed (dry mouth, decreased blood pressure, a sharp decrease in urination, urine has become concentrated, with a pungent odor);
vomiting or diarrhea becomes uncontrollable;
a child, elderly person or pregnant woman is injured.

In this case, the treatment of nitrate poisoning is carried out in stationary conditions. Detoxification therapy, measures aimed at maintaining the function of vital organs, symptomatic treatment are carried out.

Possible consequences

The consequences of nitrate poisoning can be:

reactive inflammation of the pancreas, organs of the hepatobiliary zone;
the development of allergic reactions;
exacerbation of chronic inflammatory processes;
violation of water and electrolyte balance;
violation of all types of metabolism.

The main danger of chronic intoxication with nitrates is that nitrites, which are reduced from them, combine with amines and amides of any protein products and form highly toxic nitrosamines and nitrosamides. These compounds have a pronounced carcinogenic effect, damaging primarily the hematopoietic, lymphoid and digestive systems.

Prevention

To avoid nitrate poisoning, you must:

limit the use of non-seasonal vegetables and fruits;
soak, wash and peel vegetables thoroughly before eating;
peel off the peel from vegetables, since it is in it that the maximum concentration of nitrates accumulates;
before using, cut off the upper part of the root crops (carrots, beets) at a distance of 1-2 cm from the tops;
do not eat melon and watermelon pulp in the immediate vicinity of the peel;
defrost vegetables just before cooking;
when cooking and stewing, do not cover zucchini, beets and cabbage;
use freshly prepared vegetable juices immediately or sterilize.

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Olesya Smolnyakova Therapy, clinical pharmacology and pharmacotherapy About the author

Education: higher, 2004 (GOU VPO "Kursk State Medical University"), specialty "General Medicine", qualification "Doctor". 2008-2012 - Postgraduate student of the Department of Clinical Pharmacology, KSMU, Candidate of Medical Sciences (2013, specialty "Pharmacology, Clinical Pharmacology"). 2014-2015 - professional retraining, specialty "Management in education", FSBEI HPE "KSU".

The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!