Thallium poisoning
Thallium is a toxic, silvery-white metal with a slight grayish tint. It is widely used as part of insecticidal preparations intended for the destruction of rodents. In the form of salts of nitrate, sulfate and iodine thallium is used as a contrast agent in radiological studies of myocardial contractile function, in the production of optical lenses and as a catalyst for fireworks.
Source: depositphotos.com
How does thallium poisoning occur?
Thallium is a highly toxic poison, poisoning with which is often fatal. Thallium poisoning can be either intentional, with the intent of murder or suicide, or accidental. When eating grain contaminated with thallium when processing crops, mass poisoning is possible.
Thallium and its compounds enter the body by inhalation, oral route, and also have the ability to be absorbed through intact skin and mucous membranes. The toxic substance accumulates in the brain, muscle tissue, lungs, liver, spleen, pancreas and kidneys, binding with sulfhydryl groups of mitochondrial membranes.
Thallium is excreted from the human body in the urine. During the day, the kidneys are able to remove no more than 3% of the received dose, therefore, its half-life is long, ranging from 3 to 15 days.
Thallium inhibits the activity of the enzyme ATP-ase by disrupting the process of oxidative phosphorylation. This causes degenerative changes in myocardial cells, fatty liver infiltration, loss of the myelin sheath by peripheral nerves and cerebral edema.
The lethal dose of thallium for an adult is 15 mg / kg of body weight. But even half of this dose, taken internally, can cause very severe poisoning.
Poisoning symptoms
The first symptoms of thallium poisoning appear 3-4 hours after the poison enters the body. These include:
- severe abdominal pain;
- nausea and vomiting;
- diarrhea, in which an admixture of blood is found in the stool.
After 7-10 days from the moment of thallium poisoning, the victim shows signs of damage to the central and peripheral nervous system. These include:
- psychosis;
- disturbances of consciousness;
- convulsions;
- choreoathetosis;
- paresthesia;
- muscle weakness;
- myalgia;
- ataxia;
- tremor;
- hypersalivation;
- increased blood pressure;
- tachycardia;
- optic neuritis;
- strabismus;
- ptosis of the eyelids;
- ophthalmoplegia;
- cranial nerve palsy;
- coma.
A late symptom of thallium poisoning, which occurs after 2-4 weeks, is the loss of hair on the head and part of the eyebrows, it is characteristic that pubic and body hair is preserved. After reducing the concentration of thallium in the victim's body, the hairline is restored.
Source: depositphotos.com
First aid for thallium poisoning
In case of oral poisoning with thallium, the victim should urgently rinse the stomach. To do this, he is given about a liter of warm water to drink, and then the root of the tongue is irritated, causing vomiting. If possible, gastric lavage should be performed several times in order to remove the maximum possible dose of the toxic substance. The criterion for a well-performed gastric lavage is clean washings without food particles.
Then the victim is given a saline (Magnesium sulfate) or osmotic (Mannitol, Sorbitol) laxative to drink, as well as diuretics (Furosemide, Hypothiazide). This will speed up the process of removing thallium from the body and, as a result, will reduce its toxic effect on tissues.
When is medical attention needed?
Medical assistance is necessary in all cases, since thallium poisoning requires long-term treatment in the toxicology department.
To accelerate the elimination of the toxin from the body, repeated hemodialysis sessions are performed.
In order to prevent thallium reabsorption in the renal tubules, the introduction of potassium chloride is indicated. Potassium displaces thallium from cells, after which the poison is excreted with feces.
For the treatment of neurological disorders, B vitamins are used, first of all, Thiamine hydrochloride.
For pathologies on the part of the cardiovascular system, cardiac drugs are prescribed, and for respiratory disorders, respiratory analeptics are used (Lobelina hydrochloride, Cititon, Cordiamin, Bemegrid).
Possible complications
Severe thallium poisoning is fatal. But even milder poisonings have an unfavorable prognosis, as they lead to numerous long-term consequences:
- tremor of the limbs;
- ataxia;
- memory impairment;
- stroke;
- myocardial infarction;
- hormonal disorders;
- chronic lung disease;
- chronic diseases of the digestive system;
- infertility;
- violations of potency in men and menstrual function in women;
- increased risk of congenital abnormalities in offspring.
Prevention
Thallium poisoning is most often observed in production workers in whose technological process this metal or its compounds is used. Therefore, in order to prevent them, it is necessary to establish careful monitoring of employees' compliance with safety rules.
When working in a hazardous area, it is necessary to use personal protective equipment (respirators, gloves, special shoes and overalls). After the end of the shift, employees must take off their work clothes and hand them over to the laundry, be sure to take a shower.
To prevent thallium poisoning, do not smoke, drink water or eat at the workplace.
All employees who come into contact with thallium must undergo regular medical examinations. If signs of poisoning are detected, they are subject to immediate hospitalization; in the future, they are prohibited from working in a harmful area.
Elena Minkina Doctor anesthesiologist-resuscitator About the author
Education: graduated from the Tashkent State Medical Institute, specializing in general medicine in 1991. Repeatedly passed refresher courses.
Work experience: anesthesiologist-resuscitator of the city maternity complex, resuscitator of the hemodialysis department.
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!
