{"version":1,"type":"rich","provider_name":"Libsyn","provider_url":"https:\/\/www.libsyn.com","height":90,"width":600,"title":"Episode 968: Heavy Metals","description":"Contributor: Megan Hurley MD Educational Pearls: Acute toxicity of heavy metals:  Gastrointestinal upset is the most common presentation  Chronic toxicity of heavy metals:  Symptoms depend on the metal ingested Increased risk of cancer Altered mentation Developmental delays (in children) Kidney failure  Four heavy metals that are tested for in a general panel and their sources:  Lead  Old paint (homes built before 1977) or some older toys Pipes of older homes or those with corrosive agents May obtain testing kits from home improvement stores to test water supply   Mercury  Previously in thermometers, although much less common now Compact fluorescent lightbulbs, LCD screens, and some batteries Large predatory fish like tuna, swordfish, dolphins, and shark   Arsenic sources  Most commonly found in pesticides Contaminated groundwater (especially private wells)   Cadmiun sources  Most commonly found in tobacco smoke Batteries Metal plating and welding   Additional heavy metals that require specific testing  Chromium, Nickel, &amp;amp; Thallium Thallium is found in rodenticides, pesticides, and fireworks    Management of heavy metal toxicity depends on the intoxicant  Generally, chelation therapy is used for acute and severe cases Arsenic: dimercaprol or DMSA Mercury: DMPS (chronic or mild) or DMSA (severe) Lead: succimer is first line, followed by dimercaprol or EDTA  References  Baker BA, Cassano VA, Murray C; ACOEM Task Force on Arsenic Exposure. Arsenic Exposure, Assessment, Toxicity, Diagnosis, and Management: Guidance for Occupational and Environmental Physicians. J Occup Environ Med. 2018;60(12):e634-e639. doi:10.1097\/JOM.0000000000001485 Balali-Mood M, Naseri K, Tahergorabi Z, Khazdair MR, Sadeghi M. Toxic Mechanisms of Five Heavy Metals: Mercury, Lead, Chromium, Cadmium, and Arsenic. Front Pharmacol. 2021;12:643972. Published 2021 Apr 13. doi:10.3389\/fphar.2021.643972 Kinally C, Fuller R, Larsen B, Hu H, Lanphear B. A review of lead exposure source attributional studies. Sci Total Environ. 2025;990:179838. doi:10.1016\/j.scitotenv.2025.179838 Jannetto PJ, Cowl CT. Elementary Overview of Heavy Metals. Clin Chem. 2023;69(4):336-349. doi:10.1093\/clinchem\/hvad022 J\u00e4rup L. Hazards of heavy metal contamination. Br Med Bull. 2003;68:167-182. doi:10.1093\/bmb\/ldg032 Zhang H, Reynolds M. Cadmium exposure in living organisms: A short review. Sci Total Environ. 2019;678:761-767. doi:10.1016\/j.scitotenv.2019.04.395  Summarized &amp;amp; Edited by Jorge Chalit, OMS4 Donate: https:\/\/emergencymedicalminute.org\/donate\/ ","author_name":"Emergency Medical Minute","author_url":"https:\/\/www.emergencymedicalminute.com","html":"<iframe title=\"Libsyn Player\" style=\"border: none\" src=\"\/\/html5-player.libsyn.com\/embed\/episode\/id\/37657090\/height\/90\/theme\/custom\/thumbnail\/yes\/direction\/forward\/render-playlist\/no\/custom-color\/fa102a\/\" height=\"90\" width=\"600\" scrolling=\"no\"  allowfullscreen webkitallowfullscreen mozallowfullscreen oallowfullscreen msallowfullscreen><\/iframe>","thumbnail_url":"https:\/\/assets.libsyn.com\/secure\/item\/37657090"}