[Methods of diagnosis of thallium intoxication and its antidote therapy]. / Metody diagnostiki tallievykh intoksikatsii i antidotnaia terapiia tallotoksikozov.

Absence of early signs specific for thallium intoxication requires objective diagnostic methods. The studies covered 4 techniques: electroretinography (ERG), assessment of urine levels of thallium and delta-aminolevulinic acid, capillaroscopy. The authors supported their previous foundation concerning diagnostic value of ERG for early diagnosis of thallium effects (higher amplitude of b-wave in one and that of a-wave in 8 out of 10 examinees). Further experimental and clinical basis for grading the intoxication through amounts of urinary thallium were found promising. Capillaroscopy method appeared informative: 8 out of 12 examinees demonstrated spastic and atonic state of hand capillaries--that provided objective verification of vascular disorders in workers exposed to thallium and its derivatives.

Thallium as an industrial poison (review of literature).

The presented reports on cases of occupational thallium poisoning clearly demonstrate that the possibility of their occurrence in industrial plants is very real. The number of such intoxications is much higher than that of non-industrial poisonings, but this is predominantly due to the less pronounced clinical picture and to the fact that specific tests for thallium are not performed. As a result, these cases partly escape registration altogether and partly are wrongly diagnosed. Thallium and its compounds belong to the first class of poisons, their dangerousness being enhanced by their easy permeability through the skin. Industrial thallium poisoning can be either acute or chronic, but in all cases, it is characterized by a long duration and severity of its course. Strict hygienic demands on the organization of the technological process and the measures of protection of persons working with thallium are indispensable. Compulsory examination of the urine of those working with thallium for the presence of this substance should also be introduced.

Toxicity and character of the effect of some zinc compounds.

Investigation of the parameters of toxicity of 8 zinc compounds revealed some differences in the degree of their risk for persons working with them. The following TSELs (tentative safe exposure levels of harmful substances) have been determined: 0.5 mg/m3 for zinc nitrate and hydrogen and dihydrogen zinc phosphates, 2 mg/m3 for zinc carbonate and zinc selenide, as well as MAC (maximum allowable concentration) for zinc sulphide equal to 5 mg/m3. No TSEL have been set for zinc caprylate and zinc stearate, but intratracheal administration of 50 mg caprylate caused 100%, of stearate 50% death of experimental animals due to pulmonary edema. Maximum tolerable doses were 10 and 1 mg, respectively. Zinc nitrate shows an expressed irritative effect on the skin and a highly expressed effect on the conjunctiva. Zinc phosphates, zinc caprylate and zinc stearate are resorbed by the skin. In all cases, working persons must be protected from the effect of the compounds under study because even though the toxicity of a compound may be rather low, highly noxious compounds may develop in the course of the technological process, e.g., in mechanical treatment of zinc selenide and zinc sulphide monocrystals, hydrogen selenide and hydrogen sulphide, respectively, can be isolated.

Electroretinography in the diagnosis of thallium intoxication.

Appearance of dystrophic alterations in the retina was carried out by administering 0.2 ml 12 mM of tallium chloride solution into the vitreous humour of 9 rabbits. Electroretinographic examination revealed a decline in the b wave either decreasing 2-3 times or entirely disappearing as early as on day 2 after the administration of tallium chloride. Electron microscopic investigation suggested that photoreceptors of the retina were initial by involved in the pathological process. Namely, the external segments of the photoreceptors were found to be reduced, indicating impairment of the formation of photoreceptor disks, which is known to proceed continuously under normal conditions. In the absence of an electroretinogram (ERG), the photoreceptor layers were shown to have disappeared completely. An examination of 28 subjects who were exposed to tallium and its compound at work revealed impaired retinal electrogenesis, as evident from subnormal ERG responses. This was of a functional nature and became more pronounced as occupational exposure time increased. The fact that the internal retinal layers and the 3-rd neurone remained intact, as suggested by the electrical sensitivity of the eye and lability of the optic nerve as well as by static perimetry, correlated with the EM findings obtained in experiments. Ophthalmobiomicroscopic examination of 12 eyes yielded data on characteristic changes in the lens when visual functions remained intact. These findings suggest that changes in the ERG may be indicative of initial preclinical symptoms of tallium intoxication and as such can be used when persons exposed to it in industry receive check-ups.