Thallium (Tl) is a highly toxic element which, like lead and mercury, accumulates in many body tissues. Hair levels reflect chronic accumulation of Tl, but alopecia occurs about two weeks after ACUTE Tl poisoning. Thallium occurs naturally in some minerals, and magmatic and sedimentary rock, consequently in soil, water, and air. Industrially, Tl is used in lenses and prisms, as an alloy with mercury in low temperature thermometers, and in the preparation of high density liquids.
Rodenticides and pesticides (thallium sulfate) are a major source of exposure to Tl. Other sources of Tl are: foods (marine organisms concentrate Tl up to 700 times), tobacco, contaminated water, electronic components, fly ash, cement dust, and some fertilizers. Tl is rapidly and completely absorbed when ingested, inhaled or brought into contact with skin. Symptoms of Tl excess include: sleep disturbances, and cardiac, optical, dermatatological, liver, GI, and kidney dysfunctions.
Albuminuria and alopecia are consistent with Tl excess. Potassium, selenium and sulfhydryl compounds (e.g. glutathione) diminish Tl retention and toxicity. Tl toxicity can have a long latency period before clinical symptoms become apparent. Tl inhibits Na/K ATPase and thereby disrupts intracellular K homeostasis. Tl is primarily excreted in the urine and feces. Fecal Tl and cesium excretion appear to be enhanced by DMSA and oral Prussian blue (potassium ferric cyanoferrate II) as a results of inhibition of enterohepatic resorption (Toxicology of Metals, ed. Chang, 1996). EDTA and BAL have been reported to be ineffective for chelation of Tl.
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