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Cobalt poisoning

Definition:

Cobalt is a naturally occurring element in the earth’s crust. It is a very small part of our environment and very small amounts are needed for many animals and humans to stay healthy.

Cobalt poisoning can occur when you are exposed to large amounts of cobalt. There are three basic ways that cobalt can cause poisoning. You can swallow too much of it, breathe too much into your lungs, or have it come in constant contact with your skin.

Recently, cobalt poisoning has been seen from the wear and tear of some cobalt/chromium metal-on-metal hip implants. This type of implant is an artificial hip socket that is created by fitting a metal ball into a metal cup. Sometimes metal particles (cobalt) are released as the metal ball grinds against the metal cup when you walk. These metal particles (ions) can get released into the hip socket and sometimes the bloodstream, causing cobalt toxicity.

This is for information only and not for use in the treatment or management of an actual poison exposure. If you have an exposure, you should call your local emergency number (such as 911) or a local poison control center at 1-800-222-1222.



Alternative Names:

Cobalt chloride; Cobalt oxide; Cobalt sulfate



Poisonous Ingredient:

Cobalt



Where Found:

Cobalt is a component of vitamin B12, an essential vitamin.

Cobalt may also be found in:

  • Alloys
  • Batteries
  • Chemistry/crystal sets
  • Drill bits and machine tools
  • Dyes and pigments (Cobalt Blue)
  • Magnets
  • Some metal-on-metal hip implants
  • Tires

This list may not be all-inclusive.



Symptoms:

Usually you have to be exposed to high levels of cobalt for weeks to months to have symptoms. However, it is possible to have some symptoms if you swallow a large amount of cobalt at once.

The most worrisome form of cobalt poisoning occurs when you breathe too much into your lungs. This usually will only happen in industrial settings where large amounts of drilling, polishing, or other processes release fine particles containing cobalt into the air. Breathing in this cobalt dust can cause a lot of chronic lung problems. If you breathe in this substance for long periods, you will likely develop problems breathing similar to asthma or more permanent problems, such as pulmonary fibrosis.

Cobalt poisoning that occurs from constant contact with your skin will likely cause irritation and rashes that will go away slowly.

Swallowing a large amount of absorbable cobalt at one time is very rare and likely not too dangerous. This may cause nausea and vomiting. However, absorbing a large amount of cobalt over longer periods of time can lead to serious health problems such as:

  • Cardiomyopathy (a problem where your heart becomes big and floppy and has problems pumping blood)
  • Possible nerve problems
  • Thickening of your blood
  • Thyroid problems


Home Treatment:

If you or someone you know has been exposed to cobalt, the first step is to leave the area and get fresh air. If cobalt came in contact with the skin, wash the area thoroughly.



Before Calling Emergency:

If possible, determine the following information:

  • Patient's age, weight, and condition (for example, is the person awake or alert?)
  • Name of the product (ingredients and strengths, if known)
  • Time it was swallowed
  • Amount swallowed

However, DO NOT delay calling for help if this information is not immediately available.



Poison Control, or a local emergency number:

In the United States, call 1-800-222-1222 to speak with a local poison control center. This hotline number will let you talk to experts in poisoning. They will give you further instructions.

This is a free and confidential service. You should call if you have any questions about poisoning or poison prevention. You can call 24 hours a day, 7 days a week.



What to expect at the emergency room:

If you are brought to the emergency room, it is likely because you either swallowed a large amount of cobalt or because you are starting to feel sick from long-term exposure.

Treatment for skin contact: Since these rashes are rarely serious, very little will be done. The area may be washed and a skin cream may be prescribed.

Treatment for lung involvement: Breathing problems will be treated based on your symptoms. Breathing treatments and medications to treat swelling and inflammation in your lungs may be prescribed. X-rays may be taken.

Treatment for swallowed cobalt: The health care team will treat your symptoms and order some blood tests. In the rare cases where you have large levels of cobalt in your blood, hemodialysis is performed and medications (antidotes) to reverse the effects of the poison may be given.

Treatment for signs of cobalt toxicity from a metal on metal hip implant may include removing the implant and replacing it with a traditional hip implant.



Expectations (prognosis):

Persons who become sick from being exposed to large amounts of cobalt on one single occasion usually recover and have no long-term complications.

The symptoms and problems associated with long-term cobalt poisoning are rarely reversible. Persons who have such poisoning will likely have to take medicine for the rest of their life to control the symptoms.



References:

Goldfrank LR, ed. Goldfrank's Toxicologic Emergencies. 9th ed. New York, NY: McGraw Hill; 2011.




Review Date: 1/30/2013
Reviewed By: Eric Perez, MD, St. Luke's / Roosevelt Hospital Center, NY, NY, and Pegasus Emergency Group (Meadowlands and Hunterdon Medical Centers), NJ. Review provided by VeriMed Healthcare Network. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, Bethanne Black, Stephanie Slon, and Nissi Wang.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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