COPPER POISONING
INTRODUCTION
TOXIC COMPOUNDS
ACTION
ACUTE POISONING
CHRONIC POISONING
TREATMENT
MEDICO LEGAL ASPECTS
INTRODUCTION
• Copper is a chemical element with the symbol Cu and
atomic number 29.
• It is a soft, malleable, and ductile metal with very
high thermal and electrical conductivity.
• A freshly exposed surface of pure copper has a
pinkish-orange color.
• Copper as a metal is non poisonous. It is important
for functioning of protein and enzyme systems like
catalase, cytrochrome c oxidase, ceruloplasmin.
• Body cannot synthesize copper on its own.
TOXIC COMPOUNDS OF COPPER
Compound Uses
Copper sulphate (CuSO4, blue Fungicide, algicide, molluscicide.
vitiol, blue stone) It is both a poison as well as an
antidote.
Copper subacetate (verdigris) Frequently used in field of arts
and external medicine.
Copper carbonate Used as a fungicide.
.
ACTION
• Affects the enzymes whose activity
depends on sulfhydryl and amino groups
like in other heavy metals.
• Nucleic acid may also be the target of
copper toxicity.
• Copper iron oxidise heme iron into
methemoglobin causing cyanosis and
chocolate brown color of blood.
ACUTE POISONING
• Metallic taste
• Metal fume fever
• Hemolysis
• Hemoglobinuria
• Vomit matter is blue or green in color
• Nausea, gastric pain and diarrheae
Fatal dose: Copper subacetate- 15 grams, Copper
sulphate- 20 grams
POST MORTEM FINDINGS OF ACUTE
POISONING
• Skin yellow due to jaundice.
• Blue green froth seen around the mouth.
• Mucous membrane of the mouth and tongue may
have bluish green tinge.
• Internally, some discoloration in the mucous
membrane of esophagus and stomach.
• Burns in esophagus, superficial and deep ulcers in
stomach and small intestine.
• Liver is soft and fatty.
CHRONIC POISONING
• Green or purple lines seen around the gums.
• Metallic taste, nausea, vomit, diarrhea.
• Bronzed diabetes
• Renal damage
• Copper dust may cause inflammation of conjuctiva
and ulceration of cornea
• Skin become jaundiced PM FINDINGS:
Liver is fatty
Degeneration of epithelial cells in
kidneys.
.
● Chalcosis oculi
● The deposition of copper in the tissues of the eye, usually
resulting from the presence of a copper foreign body within
the eye.
● Chalcosis corneae: In the cornea a deposit forms near
Descemet's membrane adjacent to the limbus. It appears as
golden brown ring called Kaser fleisher ring.
● Chalcosis lentis: A cataract caused by excessive amount of
copper in the eye. It appears as small yellowish-brown
opacities in the subcapsular cortex of the lens
● Vineyard sprayer’s lung
● The mildew of the vineyards is prevented by the use of sprays
with a solution of copper sulphate neutralized with hydrated
lime. The inhalation of this solution while spraying may give
rise to copper poisoning. The patients develop interstitial
pulmonary fibrosis and granulomas containing copper.
TREATMENT
• Remove from source of exposure.
• Gastric lavage with 1% potassium ferrocyanide.
• No need for emetics.
• Egg white or milk can be given as demulcents.
• BAL (dimercaprol), EDTA, ~DMPS, DMSA are good
chelating agents.
• Maintain electrolyte and water balance.
• Symptomatic treatments.
MEDICO LEGAL ASPECTS
1. Suicidal cases are rare.
2. Accidental chronic toxicity may occur from eating
food or drinking water contaminated with verdigris. It
may also occur among workers working in copper
product related factory.
3. It may also develop from intra uterine contraceptive
wires.
4. Rarely it is used for homicide because of its color and
taste.
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