Allergic metals

Eye and Skin Contact. Some nickel salts and aqueous solutions of these salts, eg, the sulfate and chloride, may cause a primary irritant reaction of the eye and skin. The most common effect of dermal exposure to nickel is allergic contact dermatitis. Nickel dermatitis may occur in sensitized individuals following close and prolonged contact with nickel-containing solutions or metallic objects such as jewelry, particularly pierced earrings. It is estimated that 8—15% of the female human population and 0.2—2% of the male human population is nickel-sensitized (125). 

Mean arterial pressure and cardiac output, an expression of the amount of blood that the heart pumps each minute, are the key Indicators of the normal functioning of the cardiovascular system. Mean arterial pressure is strictly controlled, but by changing the cardiac output, a person can adapt, e.g., to increased oxygen requirement due to increased workload. Blood flow in vital organs may vary for many reasons, but is usually due to decreased cardiac output. However, there can be very dramatic changes in blood pressure, e.g., blood pressure plummets during an anaphylactic allergic reaction. Also cytotoxic chemicals, such as heavy metals, may decrease the blood pressure. 

There have been numerous reports of possible allergic reactions to mercury and mercury salts and to the mercury, silver and copper in dental amalgam as well as to amalgam corrosion products Studies of the release of mercury by amalgams into distilled water, saline and artificial saliva tend to be conflicting and contradictory but, overall, the data indicate that mercury release drops with time due to film formation and is less than the acceptable daily intake for mercury in food . Further, while metallic mercury can sensitise, sensitisation of patients to mercury by dental amalgam appears to be a rare occurrence. Nevertheless, there is a growing trend to develop polymer-based posterior restorative materials in order to eliminate the use of mercury in dentistry. 

Oral corrosion of metallic restorations does not, per se, generally result in serious damage to the structure. Corrosion can result, however, in various local and systemic effects, notably the hypersensitivity and allergic reactions reported by many workers. Galvanic cells created by mixed metal couples can delay fracture healing and induce oral lesions and cancer. 

Rash, swelling of salivary glands, "iodism (metallic taste, burning mouth and throat, sore teeth and gums, symptoms of a head cold, diarrhea, nausea), allergic reactions (fever, joint pains, swelling of parts of face and body)... 

Platinum is used as a catalyst for nitric and sulphuric acid production, in petroleum refining and in catalytic mufflers to control air pollution. Platinum salts can cause respiratory complaints, asthma, and platinosis , an allergic response. Allergic dermatitis may also result from exposure to soluble platinum salts and once subjects have been sensitized it generally precludes continued occupational exposure at any level. The 8 hr TWA OEL for platinum metal is 5 mg/m but for soluble platinum salts it is only 0.002 mg/m. Handling precautions must include containment where possible, ventilation, personal protection, and the screening out of individuals who have become sensitized. 

Irritant contact dermatitis results from first-time exposures to irritating substances such as soaps, plants, cleaning solutions, or solvents. Allergic contact dermatitis occurs after an initial sensitivity and further exposure to allergenic substances, including poison ivy, latex, and certain types of metals. 

A dietary supplement may be safe when taken in the recommended doses but may become dangerous in higher doses. However, patients may develop side effects even when ingesting recommended doses. Adverse reactions may be due to allergic reactions, dietary supplements containing toxic substances, mis-identification of plant, mislabeling of plant, natural toxic substances such as pyrrolizidine alkaloids in comfrey, unnatural toxic substances such as heavy metals, or pesticides. 

Lambert, A.L., et al., Enhanced allergic sensitization by residual oil fly ash particles is mediated by soluble metal constituents, Toxicol. Appl. Pharmacol. 165, 1, 84, 2000. 

The most frequent causes of allergic contact dermatitis in the United States include plants (poison ivy, poison oak, and poison sumac), metallic salts, organic dyes, plastic resins, rubber additives, and germicides.74 The most common skin patch test allergens found to be positive in patients along with potential sources of exposure are shown in Table 32.1.75 In patients with occupational contact dermatitis who were skin patch tested, the common allergens included carba mix, thiuram mix, formaldehyde, epoxy resin, and nickel.76... 

There is disagreement relative to the dangers of the elemental form of zirconium. Some say that the metal and gemstone forms are harmless, but there is some evidence that the vapors and powder forms of the metal may be carcinogenic. Also, several zirconium compounds can produce allergic reactions in humans and have proven to be toxic to the skin or lungs if inhaled. 

Unlike nickel, chromium metal does not produce allergic contact dermatitis. Some patients exhibit positive patch tests to divalent chromium compounds, but these compounds are considerably less potent as sensitizers than hexavalent chromium compounds. A case of chromium (chromic) sulfate-induced asthma in a plating worker, confirmed by specific challenge testing and the presence of IgE antibodies, has been reported. ... 

Toxicology. Cobalt causes skin irritation, allergic contact dermatitis, and occupational asthma interstitial pulmonary fibrosis is associated with exposure to hard metal dust (tungsten and cobalt). 

No allergic reactions to tungstate were observed in patch testing of 853 individuals who were working or had worked with tungsten carbide in hard metal manufacture. Irritant pustular reactions appeared in 2% of the patch tests. ... 

Carbon fiber composites are replacing screws for bone fracture repair and joint replacements. These fiber composites are equally strong and chemically inert. By comparison, the metals they replace are often alloys, which may contain metals that the patient may be allergic to. 

Adverse reactions may include acneiform eruptions allergic dermatitis arthropathy multiple cases of cholestatic and fulminant hepatitis drowsiness fatigue headache hepatotoxicity resembling viral or alcoholic hepatitis impotence metallic or garlic-like aftertaste peripheral neuropathy polyneuritis optic or retrobulbar neuritis restlessness occasional skin eruptions. 

The most common adverse health effect of nickel in humans is an allergic reaction to nickel. People can become sensitive to nickel when jewelry or other things containing nickel are in direct contact with the skin. Wearing earrings containing nickel in pierced ears may also sensitize people to nickel. Once a person is sensitized to nickel, further contact with the metal will produce a reaction. The most common reaction is a skin rash at the site of contact. In... 

Allergic reaction (such as rash and itching), backache, myalgia, chills, dizziness, headache, fever, nausea, vomiting, flushed skin, pain or redness at injection site, brown discoloration of skin, metallic taste... 

Adverse effects include metallic or bitter after-taste, nausea, vomiting, allergic skin reaction, irritability, hallucinations, depression, amnesia and confusion. 

Adverse effects include urticaria, allergic dermatitis, restlessness, tremor, dizziness, metallic taste, fatigue, decrease in sexual potency and lassitude. 

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