Cadmium toxicity

Background

• Used in electroplating, soldering, pigments, and plastics

Mechanism of Toxicity

• Inhaled form is 60 times more toxic than ingested form
• Chemical pneumonitis
• Pulmonary edema/hemorrhage
• GI irritation
• Renal tubule damage

Clinical Features

• Local skin and eye irritation
• Cough, wheezing, pulmonary edema
• Nausea, vomiting, diarrhea
• Chronic exposure can lead to bone deposition and "itai-itai" disease

Evaluation

• History of exposure and respiratory / gastrointestinal complaints

Management

Inhalation

• Supplemental oxygen
• Monitor ABG, check CXR
• Treat wheezing and pulmonary edema

Ingestion

• Activated charcoal or lavage
• Volume resuscitation to counter fluid losses
• No role for hemodialysis

References

Olson, K. Poisoning and Drug Overdose, 1999.