Nickel Poisoning

Introduction

Introduction to nickel poisoning Nickel poisoning (nickel poisoning) is mainly caused by the inhalation of dust from nickel and its salts. The clinical manifestations are respiratory irritation and skin damage. In the industry, nickel is used to make various nickel alloys, utensils and materials. In addition to poisoning opportunities, long-term exposure to nickel workers increases the risk of cancer. According to the occupational history, production environment and occupational epidemiology survey, the data of urine nickel or blood nickel determination can be comprehensively analyzed to exclude other causes before diagnosis. basic knowledge The proportion of illness: 0.001% Susceptible people: long-term exposure to nickel workers Mode of infection: non-infectious Complications: pulmonary edema, coma, headache, insomnia, cough

Cause

Causes of nickel poisoning

Dermatitis lesions (35%):

Wear allergic dermatitis with nickel-plated watches, jewelry, eyeglass frames, nickel-plated appliances, and contact with metallic nickel powder and nickel sulfate at work. Its skin lesions are similar to general contact dermatitis, but often accompanied by itching, it is also known as "nickel itch".

Respiratory damage (30%):

Highly sensitive to nickel and its compounds, it can produce bronchial asthma or pulmonary eosinophilic infiltration. Foreign literature reported that people exposed to nickel powder developed pneumonia.

Prevention

Nickel poisoning prevention

1. Production workshop, strict implementation of rules and regulations and mechanical operation procedures, strengthening ventilation and personal protection.

2, wearing nickel-plated watches, jewelry, glasses frames, the use of nickel-plated equipment, and contact with metal nickel powder and nickel sulfate at work, should pay attention to the cleanliness of the skin, to prevent the formation of dermatitis.

3, the patient has cough, sputum, chest tightness, chest pain, asthma. If the chest radiograph shows abnormalities such as increased lung texture, flaky shadows, and widened hilar, it should be promptly examined and actively treated.

4. Reasonable dietary habits: Maintain a light diet. Eat more fresh vegetables and aquatic products. Such as green vegetables, radishes, kelp, seaweed and so on. Fasting fat meat and animal offal, do not eat spicy onions, peppers, coffee, etc. Eat less refined sugar, honey, fruit candy, cakes, etc.

Complication

Nickel poisoning complications Complications pulmonary edema coma headache insomnia cough

There may be complications such as infection, pulmonary edema, pulmonary edema in acute carbonyl nickel poisoning, resulting in hypoxia, blood gas analysis PaO2 determination can understand the degree of hypoxia. Symptoms such as convulsions and coma can be accompanied by fever. Chronic nickel carbonyl poisoning can cause dizziness, headache, fatigue, multiple dreams, insomnia, memory loss, and cough, chest tightness and other non-specific manifestations.

Symptom

Nickel poisoning symptoms common symptoms chest pain pimples chest tightness herpes wheezing

Determining respiratory symptoms and skin lesions caused by nickel in patients with cough, sputum, chest tightness, chest pain, asthma, increased lung texture in the chest radiograph, flaky shadows, widened hilar, rhinitis can occur in nickel electrolysis and plating workers, Loss of smell and perforation of the nasal septum, skin damage is more common in the exposed parts, the skin lesions are erythema, papules, herpes, often itchy.

Examine

Nickel poisoning inspection

Chronic skin lesions are lichen-like or hyperpigmented. After dissociation, the skin lesions heal itself within weeks or months. The normal value of urine nickel is 0.075mol/L (4.4g/L), the range is 00.187mol/L (011g/L); the normal value of blood nickel is 0.817mol/L (0.48g/dl), range, 0.049 ~0.119mol/L (0.29-0.7g/dl), nickel poisoning, urine nickel and blood nickel can be increased.

Diagnosis

Diagnosis and identification of nickel poisoning

diagnosis

To determine respiratory symptoms and skin lesions caused by nickel, it must be based on occupational history, production environment and occupational epidemiological investigation, with reference to urine nickel or blood nickel determination data, comprehensive analysis, to rule out other causes, in order to diagnose.

Differential diagnosis

The diseases that need to be differentiated from acute nickel poisoning are mainly respiratory diseases caused by upper respiratory tract infection, cardiogenic pulmonary edema and other acute poisoning of metal and irritating gases.

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