Nickel

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Latest Edit: Hector 2014-02-18 (EDT)

Nickel is a heavy metal commonly used as a catalyst in petroleum, plastic, and rubber production. It is also used widely in rechargeable batteries, magnetic tape, and stainless steel. Nickel has been associated with contact dermatitis, asthma, conjunctivitis, sinusitis, nasal polyps, and hepatic injury.

Background

  • Nickel is found in three forms, elemental, inorganic, and organic.
  • An organic form of nickel, nickel carbonyl, is a toxic gas and is the form most associated with acute toxic exposure.
  • Other common sources of exposure include nickel plating in jewelry and contaminated drinking water.
  • The most impactful public health cases of nickel exposure date back to the early 1900s and the nickel mining industry. Miners and individuals living in close proximity to mines demonstrated an increased risk of lung and nasal cancers. This risk began to decrease with tighter environmental control in the 1930s, but were noted once again in the mining industry in Norway in the 1950s. [1] [2]

Associated Conditions

Conditions associated with nickel exposure include: [1]

Symptoms

Common symptoms of nickel exposure include:[1]

Sources

  • Nickel is present in drinking water in low levels, but may reach toxic levels due to industrial contamination.[1], [3]
  • Industry
  • Nickel is used in batteries, metal alloys, electroplating, and coins.[3]
  • Clothing and Jewelry
  • Nickel is commonly used in inexpensive jewelry and is a major cause of nickel related contact dermatitis.[3]
  • Electronics
  • Many cell phones have been shown to release nickels at levels high enough to cause contact dermatitis.[4]
  • Medical Interventions
  • Some surgical instruments and prosthetics may contain nickel.[3]

Diagnostic Testing

  • Urinary Testing
  • An 8 hr urinary elimination test is used to assess nickel levels.[1]
  • Blood Chemistry
  • Serum nickel may be used to determine nickel exposure.[1]

Treatment

  • Diethyldithiocarbonate can chelate nickel, although it has been shown to increase cerebral uptake of nickel.[1]
  • Other Therapy
  • Acute ingestion of nickel is treated with activated charcoal if the source of nickel is organic. If inorganic or elemental nickel is ingested gastric emptying is performed.[1]

References

  1. 1.0 1.1 1.2 1.3 1.4 1.5 1.6 1.7 Shannon MW (2007) Shannon: Haddad and Winchester’s Clinical Management of Poisoning and Drug Overdose, 4th ed Chap 73 Lead Saunders
  2. Strickland PT, Kensler TW (2008) Abeloff: Abeloff’s Clinical Oncology 4th ed Chap 9 Environmental Factors Churchill Livingstone
  3. 3.0 3.1 3.2 3.3 Mcguigan MA (2011) Goldman: Goldman’s Cecil Medicine 24th ed Chap 21 Chronic Poisoning Trace Metals and Others Saunders
  4. Jensen P (2011) Excessive nickel release from mobile phones- a persistent cause of nickel allergy and dermatitis. Contact Dermatitis 65(6):354-8