CDC/Barbara Jenkins, NIOSH

First Aid for Cobalt Poisoning

Article
Ear, Nose, & Throat (ENT)
Eye & Vision
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Contributed byKrish Tangella MD, MBAMar 05, 2018

What is Cobalt Poisoning?

  • Cobalt (Co) is a hard bluish-gray metal that is obtained naturally from the earth. It is necessary in trace amounts by the human body (generally found in vitamin B12)
  • Cobalt is used in the manufacture of magnetic alloys, lithium batteries, commercial radioisotopes, as a pigment in paints and inks, and a variety of other products
  • Cobalt Poisoning is the accidental or intentional intake of cobalt containing compounds or cobalt salts
  • The condition is diagnosed based upon the clinical history, combination of signs and symptoms, and additional tests (that may include, in some cases, radiological studies and laboratory tests)

Cobalt Poisoning may be variously referred to as the following:

  • Co Poisoning
  • Cobalt Chloride
  • Cobalt Oxide
  • Cobalt Sulfate
  • Cobalt Toxicity

What are the Causes of Cobalt Poisoning?

  • Cobalt Poisoning is caused by the ingestion (or inhalation of fumes, vapors, or fine dust) of cobalt compounds. Salts containing the element may also get into one’s eyes (or the skin may be exposed) and cause irritation and pain
  • This intake could be accidental, or in some cases intentional, to bring self-harm
  • Apart from forming an essential component of vitamin B12 (called cobalamin), cobalt may be found in school/college chemistry labs, in the form of cobalt salts of chloride, oxide, and sulfate. Cobalt is also used as a coloring agent in ceramics, glass, and inks, in metal hip implants, dry cells, etc.

Note: The compound can interact with other prescribed or non-prescribed medications in the body. Such interactions may enhance the therapeutic effects of other medications being taken, resulting in undesired side effects.

What are the Signs and Symptoms of Cobalt Poisoning?

The signs and symptoms of acute Cobalt Poisoning can vary from one individual to another. It may be mild in some and severe in others. The signs and symptoms may include:

  • Nausea and vomiting from ingesting large amounts of cobalt compounds
  • Abdominal pain
  • Exposure of the compound to the eye may result in pain, irritation, redness, and watery eyes
  • Contact dermatitis from direct contact of skin including irritation and skin rashes
  • Allergic reactions in some individuals
  • Individuals with preexisting lung conditions, such as asthma, have a higher risk of symptoms on acute exposure

Usually, exposure to a high-level of cobalt compounds may result in symptoms. This may be following the intake of a substantial quantity of cobalt compounds, or being occupationally exposed to cobalt dust in an industrial setting (via inhalation). Chronic exposure to cobalt can result in lung and heart complications including lung fibrosis and cardiomyopathy respectively.

How is First Aid administered for Cobalt Poisoning?

First Aid tips for Cobalt Poisoning:

  • Call 911 or your local emergency help number, for emergency assistance
  • Call the Poison Control Center at 1-800-222-1222 (or your local poison control center) for further instructions
  • Provide them with information such as the compound taken, quantity and time of ingestion, age, weight and general health status of affected individual
  • Carefully remove the individual from the exposure area; move them to region of fresh air immediately
  • Confirm that the airways are protected; also, ensure breathing and the presence of pulse
  • If exposure of the eye or skin has occurred, then wash thoroughly with copious amounts of water
  • Take individual to emergency room (ER) for further treatment
  • Always try to take the compound bottle/container to the ER

In case of any emergencies, the emergency medical health professional may take the following steps towards treating the condition:

  • Monitor vital signs
  • Medically manage symptoms and provide breathing support, if necessary
  • Administration of medication to counter the effects of the ingested substance
  • Wash eyes and skin repeatedly and thoroughly (irrigation), to eliminate any remaining compound
  • Topical applications for skin exposure may be administered
  • Administer fluids by an intravenous drip line, if necessary
  • Renal dialysis, if blood is affected by Cobalt Poisoning

Who should administer First Aid for Cobalt Poisoning?

First aid for Cobalt Poisoning is administered by healthcare professionals.

  • The individual who is affected, or someone near, should call 911 for emergency assistance (or the local emergency number)
  • They should also call the poison control center at 1-800-222-1222 (or the local poison control center) and follow instructions

What is the Prognosis of Cobalt Poisoning?

  • The prognosis of Cobalt Poisoning is dependent on the amount of substance consumed, time between consumption and treatment, severity of the symptoms, as well as general health status of the patient. It is also dependent on whether the toxic effects of cobalt are from an acute or chronic exposure
  • If the individual can recover from the symptoms, with appropriate medication and early support, the outcome is generally good. In most cases of acute poisoning, the outcome is generally good, since cobalt is considered as a mildly toxic substance. Symptoms due to skin exposure also tends to resolve on its own
  • However, chronic exposure to the substance can lead to several complications and irreversible damage. It may affect the heart, lungs, and nervous system, resulting in an adverse prognosis 

In general, toxicities are common situations in the emergency departments. A majority of the cases are often not fatal, when appropriate treatment is given.

How can Cobalt Poisoning be Prevented?

Cobalt Poisoning can be prevented by:

  • Always following instructions for usage of any household products
  • Keeping any poisonous/hazardous chemicals and other materials out of children’s reach
  • Keep all poisons correctly labeled and in suitable storage locations
  • Using appropriate protective wear when working with such chemicals (such as face masks and hand gloves)
  • Those who work in industries using cobalt should be aware of and comply with safe industrial practices
  • Working in well-ventilated spaces, when risk of exposure to cobalt dust is present
  • Being aware of basic first aid steps in case of an emergency (such as inadvertent poisoning)

What are certain Crucial Steps to be followed?

  • Call 911 (or your local emergency number) for emergency assistance, if symptoms are life-threatening
  • Call Poison Control Center at 1-800-222-1222 (or the local poison control center) and follow the recommend steps
  • It would be helpful if the following information is readily available:
    • Type, amount and time of consumption of the substance
    • Age and weight of the individual
    • And, the overall health status of the individual
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Krish Tangella MD, MBA

Pathology, Medical Editorial Board, DoveMed Team

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