The symptoms of heavy metal poisoning vary according to which type of metal overexposure is involved. Some specific examples are:

ARSENIC POISONING

Arsenic is used in the manufacture of pesticides. The gas from arsenic also has some industrial uses. Overexposure may cause headaches, drowsiness, confusion, seizures, and life-threatening complications. Neurological symptoms include brain damage (encephalopathy), nerve disease of the extremities (peripheral neuropathy), pericapillary hemorrhages within the white matter, and loss or deficiency of the fatty coverings (myelin) around these nerve fibers (demyelination). Skin problems include transverse white bands on the fingernails (mees’ lines) and excessive accumulation of fluid in the soft layers of tissue below the skin (edema). Gastrointestinal symptoms include a flu-like illness (gastroenteritis) that is characterized by vomiting; abdominal pain; fever; and diarrhea, which, in some cases, may be bloody. Other symptoms include breakdown of the hemoglobin of red blood cells (hemolysis), a low level of iron in the red blood cells (anemia), and low blood pressure (hypotension). Some individuals may experience a garlic-like odor that may be detectable on the breath.

In cases of chronic poisoning, weakness, muscle aches, chills, and fever may develop. The onset of symptoms in chronic arsenic poisoning is about two to eight weeks after exposure. Skin and nail symptoms include hardened patches of skin (hyperkeratosis) with unusually deep creases on the palms of the hands and the soles of the feet, unusual darkening of certain areas of the skin (hyperpigmentation), transverse white bands on the fingernails (mees’ lines), and a scale like inflammation of the skin (exfoliative dermatitis). Other symptoms include inflammation of sensory and motor nerves (polyneuritis) and the mucose membrane lining the throat.

Inorganic arsenic accumulates in the liver, spleen, kidneys, lungs, and gastrointestinal tract. It then passes through these sites but leaves a residue in tissues such as skin, hair, and nails. Symptoms of acute inorganic arsenic poisoning include severe burning of the mouth and throat, abdominal pain, nausea, vomiting, diarrhea, low blood pressure (hypotension), and muscle spasms. Individuals with severe inorganic arsenic poisoning may experience heart problems (cardiomyopathy); accumulation of acid in the tubes of the kidneys (renal tubular acidosis); breakdown of the hemoglobin of red blood cells (hemolysis); irregular heart rhythms (ventricular arrhythmias); coma; seizures; bleeding within the intestines (intestinal hemorrhage); and yellowing of the skin, mucous membranes, and whites of the eyes (jaundice).

CADMIUM POISONING

Cadmium is used for many items, including electroplating, storage batteries, vapor lamps and in some solders. The onset of symptoms may be delayed for two to four hours after exposure. Overexposure may cause fatigue, headaches, nausea, vomiting, abdominal cramps, diarrhea, and fever. In addition, progressive loss of lung function (emphysema), abnormal buildup of fluid within the lungs (pulmonary edema), and breathlessness (dyspnea) may also be present. In some cases, affected individuals may exhibit increased salivation; yellowing of the teeth; an unusually rapid heart beat (tachycardia); low levels of iron within the red blood cells (anemia); bluish discoloration (cyanosis) of the skin and mucous membranes due to insufficient oxygen supply to these tissues; and/or an impaired sense of smell (anosmia). Individuals with cadmium poisoning may also experience improper functioning of the canals with the kidney (renal tubular dysfunction) characterized by excretion of abnormally high levels of protein in the urine (proteinuria), minor changes in liver function, and/or softening of certain bones (osteomalacia).

CHROMIUM POISONING

Chromium is used in the manufacture of cars, glass, pottery and linoleum. Exposure to too much chromium may cause lung and respiratory tract cancer as well as kidney diseases. In addition, overexposure to chromium may also cause gastrointestinal symptoms, such as diarrhea and vomiting, often with blood. Symptoms may lead to severe water-electrolyte disorders, increased mild acidity of blood and body tissues (acidosis), and/or inadequate blood flow to its tissues resulting in shock. Lesions on the kidneys, liver, and muscular layer of the heart (myocardium) may also develop.

COBALT POISONING

Cobalt, used in making jet engines, may cause nausea, vomiting, lack of appetite (anorexia), ear ringing (tinnitus), nerve damage, respiratory diseases, an unusually large thyroid gland (goiter), and/or heart and/or kidney damage.

LEAD POISONING

Lead production workers, battery plant workers, welders and solders may be overexposed to lead if proper precautions are not taken. Lead is stored in the bone but may affect any organ system. The effects of lead poisoning varies depending on the age of the individual and the amount of exposure.

In children, symptoms vary depending upon the degree of exposure to lead. Some affected individuals may not have any noticeable symptoms. Symptoms usually develop over a three to six week time period. Lead overexposure may cause children to be less playful, clumsier, irritable, and sluggish (lethargic). In some cases, symptoms include headaches, vomiting, abdominal pain, lack of appetite (anorexia), constipation, slurred speech (dysarthria), changes in kidney function, unusually high amounts of protein in the blood (hyperproteinemia), and unusually pale skin (pallor) resulting from a low level of iron in the red blood cells (anemia). Neurological symptoms associated with lead overexposure include an impaired ability to coordinate voluntary movements (ataxia), brain damage (encephalopathy), seizures, convulsions, swelling of the optic nerve (papilledema), and/or impaired consciousness. Some affected children experience learning or behavioral problems such as mental retardation and selective deficits in language, cognitive function, balance, behavior, and school performance. In some cases, symptoms may be life-threatening.

In adults, overexposure to lead may cause high blood pressure and damage to the reproductive organs. Additional symptoms may include fever, headaches, fatigue, sluggishness (letheragy), vomiting, loss of appetite (anorexia), abdominal pain, constipation, joint pain, loss of recently acquired skills, incoordination, listlessness, difficulty sleeping (insomnia), irritability, altered consciousness, hallucinations, and/or seizures. In addition, affected individuals may experience low levels of iron in the red blood cells (anemia), peripheral neuropathy, and, in some cases, brain damage (encephalopathy). Some affected individuals experience decreased muscle strength and endurance; kidney disease; wrist drop; and behavioral changes such as hostility, depression, and/or anxiety. In some cases, symptoms may be life-threatening.

Lead is excreted in urine and feces. However, it may also appear in hair, nails, sweat, saliva, and breast milk.

MANGANESE POISONING

Manganese is used as a purifying agent in the production of several metals. Symptoms associated with overexposure to manganese may include damage to the central nervous system and pneumonia. Additional symptoms and physical findings include weakness, fatigue, confusion, hallucinations, odd or awkward manner of walking (gait), muscle spasms (dystonia), rigidity of the trunk, stiffness, awkwardness of the limbs, tremors of the hands, and psychiatric abnormalities.

MERCURY POISONING

Mercury is used by dental assistants and hygienists, and chemical workers. Mercury can affect the lungs, kidneys, brain, and/or skin. Symptoms of mercury poisoning include fatigue, depression, sluggishness (letheragy), irritability, and headaches.

Respiratory symptoms associated with inhalation to mercury vapors include coughing, breathlessness (dyspnea), tightness or burning pain in the chest, and/or respiratory distress. Some affected individuals may experience abnormal buildup of fluid in the lungs (pulmonary edema); pneumonia; and/or abnormal formation of fibrous tissue (fibrosis).

There may be behavioral and neurological changes associated with overexposure to mercury poisoning, such as excitability and quick-tempered behavior, lack of concentration, and loss of memory. Shock and permanent brain damage may also be result from mercury poisoning. Some affected individuals experience mental confusion. A progressive cerebellar syndrome with impaired ability to coordinate voluntary movements (ataxia) of the arms may also be present. Abnormal involuntary movements of the body such as uncontrolled jerky movements combined with slow, writhing movements (choreoathetosis) are common. Additional symptoms include non-inflammatory degenerative disease of the nerves (polyneuropathy); impaired ability to coordinate voluntary movements (cerebellar ataxia); tremors of the legs and arms and, in some cases, of the tongue and lips; seizures; and/or slurred speech (dysarthria). Changes in mood, behavior, and consciousness may also occur.

In some cases of chronic exposure to inorganic mercury a personality disorder known as erethism or mad hatter syndrome may occur. Symptoms associated with mad hatter syndrome include memory loss, excessive shyness, abnormal excitability, and/or insomnia. This syndrome was described in workers with occupational exposure to mercury in the felt-hat industry.

Many affected individual experience sensory impairments such as visual problems (e.g. constriction of visual fields, tunnel vision, and blindness) as well as hearing loss.

Some individuals may experience skin changes such as painful swelling and pink coloration of the fingers and toes (acrodynia); persistent redness or inflammation of the skin (erythema); extreme sensitivity (hyperesthesia) of the affected areas; and tingling and sensory disturbances.

In some cases, other affected individuals may experience stomach and intestinal disturbances; kidney damage; dehydration; acute renal failure; inflammation of the gums (gingivitis); severe local irritation of the mouth and pharynx, accompanied by vomiting; and/or abdominal cramps with bloody diarrhea.

Mercury is mainly excreted through the urine and feces.

PHOSPHORUS POISONING

Symptoms associated with phosphorus poisoning include weakness, headaches, vomiting, sweating, abdominal cramps, salivation, wheezing secondary to bronchial spasm, drooping of the upper eyelids (ptosis), contraction of the pupil (miosis), and/or muscular weakness and twitching. In addition, non-inflammatory degenerative disease of the sensorimotor nerves (sensorimotor polyneuropathy) may advance to progressive deterioration (atrophy). In some cases, respiratory paralysis may also occur.

THALLIUM POISONING

Symptoms associated with thallium poisoning include extreme drowsiness (somnolence), nausea, vomiting, abdominal pain, and bloody vomiting (hematemesis). Some affected individuals may experience the loss of most or all of their scalp hair (alopecia); rapidly progressive and painful sensory polyneuropathy; motor neuropathy; cranial nerve palsies; seizures; impaired ability to coordinate voluntary movements (cerebellar ataxia); and/or mental retardation. Some individuals may experience eye symptoms including wasting away (atrophy) of the optic nerve (optic atrophy), inflammation of the optic nerve (retrobulbar neuritis), and impaired functioning of the muscles of the eyes (ophthalmoplegia). In some cases, thallium poisoning may progress to include renal and cardiac failure, confusion, psychosis, organic brain syndrome, and/or coma.

ADDITIONAL METAL POISONINGS

Additional metals that may cause poisoning include antimony, aluminum, barium, bismuth, copper, gold, iron, lithium, platinum, silver, tin, and zinc. Common symptoms of poisoning from these metals may include gastrointestinal, renal, and neurological symptoms, such as headaches, irritability, psychosis, stupor, coma, and convulsions.

Antimony is used for hardening lead, and in the manufacture of batteries and cables. It may possibly cause lung disease and skin cancer, especially in those who smoke.

Copper is used in the manufacture of electrical wires. It may cause a flu-like reaction called metal fume disease and disturbances in the blood.

Lithium is used to make glasses and pharmaceuticals. Lithium may cause diseases of the stomach, intestinal tract, central nervous system, and kidneys.

Overexposure to silver may cause a gray discoloration of the skin, hair and internal organs. Additional symptoms may include nausea, vomiting, and diarrhea.

Zinc overexposure may cause the flu-like symptoms of metal fume fever; stomach and intestinal disturbances; and/or liver dysfunction.

Overexposure to bismuth may cause extreme drowsiness (somnolence) and neurologic disturbances such as confusion, difficulty in concentration, hallucinations, delusions, myoclonic jerks, tremors, seizures, an impaired ability to coordinate voluntary movements (ataxia), and/or inability to stand or walk.

Overexposure to gold (as in treatment of rheumatoid arthritis) may cause skin rashes; bone marrow depression; stomach and intestinal bleeding; headaches; vomiting; focal or generalized continuous fine vibrating muscle movements (myokymia); and yellowing of the skin, mucous membranes, and whites of the eyes (jaundice).

Some cases of overexposure to nickel have been associated an increased risk of lung cancer.

Overexposure to selenium may cause irritation of the respiratory system, gastrointestinal tract, and eyes; inflammation of the liver; loss of hair (alopecia); loss of skin color (depigmentation); and peripheral nerve damage.

Overexposure to tin may damage the nervous system and cause psychomotor disturbances including tremor, convulsions, hallucinations, and psychotic behavior.

Aluminum containers used in the manufacture and processing of some foods, cosmetics and medicines, and also for water purification. Overexposure to aluminum may cause brain damage (encephalopathy).