From the Guidelines
Zinc oxide toxicity can cause severe adverse effects, including metal fume fever, gastrointestinal distress, and respiratory issues, and should be treated with supportive care and, in severe cases, chelation therapy or copper sulfate. The effects of zinc oxide toxicity can be acute or chronic, with acute toxicity secondary to oral ingestion treated by anti-emetics, fluids, as well as proton pump inhibitors or H-blockers 1. Whole bowel irrigation may be required, and chelation with calcium disodium edetate (CaNa2 EDTA) or DTPA has also been shown to decrease zinc levels in patients with toxicity 1. Chronic zinc toxicity is primarily treated with copper sulfate, and chelation may be required in severe cases 1. In addition to these treatments, oral zinc has been associated with headaches, nausea, vomiting, decreased appetite, diarrhea, and abdominal cramps, and in high doses with prolonged use, can have more severe adverse effects such as low copper, anemia, leukopenia, neutropenia, and gastrointestinal ulcers 1. Some key points to consider when treating zinc oxide toxicity include:
- Removing the person from exposure to prevent further toxicity
- Providing symptomatic relief with rest, hydration, and over-the-counter medications like acetaminophen or ibuprofen for fever and pain
- Using supplemental oxygen or bronchodilators for severe respiratory symptoms
- Considering chelation therapy or copper sulfate for severe cases
- Preventing exposure through proper ventilation and respiratory protection when working with heated zinc.
From the Research
Effects of Zinc Oxide Toxicity
- Zinc oxide toxicity can cause various health problems, including digestive, respiratory, and nerve system damage, as well as cancer 2.
- The ingestion of high amounts of zinc can produce emesis, and zinc compounds can cause irritation and corrosion of the gastrointestinal tract, acute renal tubular necrosis, and interstitial nephritis 3.
- Inhalation of high concentrations of zinc chloride can cause chemical pneumonitis and adult respiratory distress syndrome, while inhalation of zinc oxide fumes can cause metal fume fever, characterized by fatigue, chills, fever, myalgias, cough, dyspnea, leukocytosis, thirst, metallic taste, and salivation 3, 4.
- Long-term exposure to zinc oxide nanoparticles can cause reduced body weight, increased serum glutamic-pyruvic transaminase activity, and increased zinc concentrations in the serum, liver, and kidney 5.
- Zinc oxide nanoparticles have also been shown to have potential risks, including hepatotoxicity, pulmonary toxicity, neurotoxicity, and immunotoxicity, although they may also have benefits in the treatment of various diseases 6.
Health Hazards
- Occupational exposure to zinc and its inorganic compounds can cause health hazards, including impaired lung function and asthma symptoms 4.
- The effects of exposure to zinc and its compounds depend on the degree of dispersion of dusts/fumes suspended in the air and the particle size 4.
- Critical effects of acute exposure to respirable fraction include "fume fever", while chronic exposure can cause recurrent symptoms of acute poisoning 4.
Treatment and Prevention
- Treatment of zinc toxicity is supportive, and may include chelating agents, such as calcium disodium ethylenediaminetetraacetate (CaNa2EDTA), as well as protective lung ventilation, extracorporeal membrane oxygenation (ECMO), and supportive care 2, 3.
- Establishing occupational exposure limits for respirable and inhalable fractions of zinc and its compounds can help prevent health hazards 4.