Letters to the Editor
Cadmium toxicity in silversmith: Safety is never too much! Dear Sir, The article by Parikh et al.[1] is indeed interesting and a timely reminder for the systematic surveillance of health status among silversmiths and enforcement of adequate use of personal protective equipments/measures. In developing countries such as India, silver jewelry manufacturing is an important cottage industry and this business is run traditionally from father to son, and carried out by the family members at home. Occupational health and safety research in developing countries are mainly focused on large‑scale industries. There are no strict enforcement of rules and regulations for family‑run cottage industries. Silver is usually mixed with 20%–30% cadmium and then it is used to make silver jewelry. During this process, there is a formation of cadmium fumes, which are inhaled by the workers. Subacute to chronic cadmium exposure from “silver solder” has been well recognized in the fabrication of jewels and in other industrial brazing applications. Cadmium is highly toxic to various biological systems of which the respiratory tract is a key target organ. Acute cadmium inhalation is associated with acute lung injury and diffuse alveolar damage.[2] In animal models, repeated exposure to cadmium fumes has lead to emphysema. [3] A recent Indian study by Moitra et al.[4] had documented decrements in lung function among those involved in jewellery works due to chronic exposure to cadmium fumes. Sethi et al., [5] had reported a case of cadmium‑induced peripheral neuropathy, nephropathy, and decreased bone density. Both reports warrants for comprehensive health and safety management program to prevent the organ toxicity. Prevention programs shall include technological improvements, development of safer substitutes, appropriate ventilation of the
work place, education of training of workers on the hazards of cadmium exposure, and adoption of suitable precautions. Long‑term exposure to lower cadmium concentrations should be considered a future occupational health issue, as cadmium confounds many physiological processes. Occupational health issues are often given less attention in medical education and training. As a result, occupational illnesses are not considered in clinical teaching or rounds.
REFERENCES 1.
2.
3.
4.
5.
Parikh JM, Dhareshwar S, Sharma A, Karanth R, Ramkumar VS, Ramaiah I. Acute respiratory distress in a silversmith. Indian J Occup Environ Med 2014;18:27‑8. Panchal L, Vaideeswar P. Acute lung injury due to cadmium inhalation‑a case report. Indian J Pathol Microbiol 2006;49:265‑6. Kirschvink N, Martin N, Fievez L, Smith N, Marlin D, Gustin P. Airway inflammation in cadmium‑exposed rats is associated with pulmonary oxidative stress and emphysema. Free Radic Res 2006;40:241‑50. Moitra S, Blanc PD, Sahu S. Adverse respiratory effects associated with cadmium exposure in small‑scale jewellery workshops in India. Thorax 2013;68:565‑70. Sethi PK, Khandelwal D, Sethi N. Cadmium exposure: Health hazards of silver cottage industry in developing countries. J Med Toxicol 2006;2:14‑5.
Indian Journal of Occupational and Environmental Medicine - December 2014 - Volume 18 - Issue 3
Subramanian Senthilkumaran, Chidambaram Ananth1, Sandeep B Gore2, Ponniah Thirumal koundusubramanian3 Department of Emergency and Critical Care Medicine, Sri Gokulam Hospitals and Research Institute, Salem, Tamil Nadu, 1Department of Anaesthesiology, 3 Department of Internal Medicine, Chennai Medical College and Research Center, Irungalur, Trichy, 2 Department of Accident and Emergency Medicine, Fortis Hospital, Mulund, Mumbai, Maharashtra, India For correspondence: Dr. Subramanian Senthilkumaran Department of Emergency and Critical Care Medicine, Sri Gokulam Hospital, Salem, Tamil Nadu, India. E-mail: maniansenthil @ yahoo.co.in Access this article online Website: www.ijoem.com DOI: 10.4103/0019-5278.146919 Quick Response Code:
163
Copyright of Indian Journal of Occupational & Environmental Medicine is the property of Medknow Publications & Media Pvt. Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
Cadmium toxicity in silversmith: Safety is never too much! Dear Sir, The article by Parikh et al.[1] is indeed interesting and a timely reminder for the systematic surveillance of health status among silversmiths and enforcement of adequate use of personal protective equipments/measures. In developing countries such as India, silver jewelry manufacturing is an important cottage industry and this business is run traditionally from father to son, and carried out by the family members at home. Occupational health and safety research in developing countries are mainly focused on large‑scale industries. There are no strict enforcement of rules and regulations for family‑run cottage industries. Silver is usually mixed with 20%–30% cadmium and then it is used to make silver jewelry. During this process, there is a formation of cadmium fumes, which are inhaled by the workers. Subacute to chronic cadmium exposure from “silver solder” has been well recognized in the fabrication of jewels and in other industrial brazing applications. Cadmium is highly toxic to various biological systems of which the respiratory tract is a key target organ. Acute cadmium inhalation is associated with acute lung injury and diffuse alveolar damage.[2] In animal models, repeated exposure to cadmium fumes has lead to emphysema. [3] A recent Indian study by Moitra et al.[4] had documented decrements in lung function among those involved in jewellery works due to chronic exposure to cadmium fumes. Sethi et al., [5] had reported a case of cadmium‑induced peripheral neuropathy, nephropathy, and decreased bone density. Both reports warrants for comprehensive health and safety management program to prevent the organ toxicity. Prevention programs shall include technological improvements, development of safer substitutes, appropriate ventilation of the
work place, education of training of workers on the hazards of cadmium exposure, and adoption of suitable precautions. Long‑term exposure to lower cadmium concentrations should be considered a future occupational health issue, as cadmium confounds many physiological processes. Occupational health issues are often given less attention in medical education and training. As a result, occupational illnesses are not considered in clinical teaching or rounds.
REFERENCES 1.
2.
3.
4.
5.
Parikh JM, Dhareshwar S, Sharma A, Karanth R, Ramkumar VS, Ramaiah I. Acute respiratory distress in a silversmith. Indian J Occup Environ Med 2014;18:27‑8. Panchal L, Vaideeswar P. Acute lung injury due to cadmium inhalation‑a case report. Indian J Pathol Microbiol 2006;49:265‑6. Kirschvink N, Martin N, Fievez L, Smith N, Marlin D, Gustin P. Airway inflammation in cadmium‑exposed rats is associated with pulmonary oxidative stress and emphysema. Free Radic Res 2006;40:241‑50. Moitra S, Blanc PD, Sahu S. Adverse respiratory effects associated with cadmium exposure in small‑scale jewellery workshops in India. Thorax 2013;68:565‑70. Sethi PK, Khandelwal D, Sethi N. Cadmium exposure: Health hazards of silver cottage industry in developing countries. J Med Toxicol 2006;2:14‑5.
Indian Journal of Occupational and Environmental Medicine - December 2014 - Volume 18 - Issue 3
Subramanian Senthilkumaran, Chidambaram Ananth1, Sandeep B Gore2, Ponniah Thirumal koundusubramanian3 Department of Emergency and Critical Care Medicine, Sri Gokulam Hospitals and Research Institute, Salem, Tamil Nadu, 1Department of Anaesthesiology, 3 Department of Internal Medicine, Chennai Medical College and Research Center, Irungalur, Trichy, 2 Department of Accident and Emergency Medicine, Fortis Hospital, Mulund, Mumbai, Maharashtra, India For correspondence: Dr. Subramanian Senthilkumaran Department of Emergency and Critical Care Medicine, Sri Gokulam Hospital, Salem, Tamil Nadu, India. E-mail: maniansenthil @ yahoo.co.in Access this article online Website: www.ijoem.com DOI: 10.4103/0019-5278.146919 Quick Response Code:
163
Copyright of Indian Journal of Occupational & Environmental Medicine is the property of Medknow Publications & Media Pvt. Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
