Gold
Classification:
Gold is a chemical element.
Cas:
7440-57-5
Synonyms/Trade Names:
Burnish Gold, Colloidal Gold, Gold Flake, Gold Leaf, Gold Powder, Shell Gold; Gold Miner ’s Phthisis, Rand Miner ’s Phthisis.
Chemistry/Composition:
Au. It can contain traces of Ag and Cu.
Structure:
Cubic face centered.
Crystallographic Constants:
4.079 4.079 4.079 90.000 90.000 90.000.
Crystal Group:
Cubic.
Color:
Metallic yellowish.
Optical Properties:
Opaque.
Pleochroism:
None.
Powder Diagram:
2.36 2.04 1.23 1.44 (4-784).
Natural Sources:
Mined in Australia, Canada, India, the RSA, Russia, and the USA.
Medical Importance:
Key Hazards:
Hypersensitivity reaction.
Involved Organs:
Lung.
Exposure/Epidemiology:
Exposure may occur during mining, smelting, in metallurgy and in therapeutic drug regimes. World production amounts to 1000 tons per year.
Thresholds:
In Germany, MAK 6 mg/m3.
Etiology/Pathophysiology:
Gold belongs to the so-called inert metals; however, during mining processes, the miners can be exposed to quartz and radioactive substances (e.g. radon), that can induce silicosis (see there), and lung cancer (see mining). In addition, gold may provoke a hypersensitivity reaction of the lung or induce an adult respiratory distress syndrome that may proceed to interstitial lung fibrosis.
Lung Diseases:
Hypersensitivity reaction, adult respiratory distress syndrome, usual interstitial pneumonia, fibrosis, and cancer.
Clinical Presentation:
The patients present with cough, shortness of breath, dyspnea, fever, chest pain, pleural or pericardial effusions.
Radiology:
Chest radiographs show diffuse interstitial patchy densities, consolidated nodules, diffuse markings, or circumscribed tumors.
Lung Function:
The Lung Function may be heavily disturbed including reduced vital capacity and global insufficiency.
Bronchoalveolar Lavage:
The lavage fluid contains numerous neutrophilic and eosinophilic granulocytes, and increased number of mononuclear inflammatory infiltrates in chronic stages.
Pathology:
Gross:
The lungs are heavy and wet; chronic stages may present with honeycombing.
Histology:
The adult respiratory distress syndrome is characterized by an edematous (exsudative) stage in the early beginning and an organizing stage after 3-7 days. The edematous fibrinous exsudate and debris are deposited along the interalveolar septae forming hyaline membranes. Proliferating type II pneumocytes and invading histiocytes alter the fibrinous exsudate into collagen fibers that are usually first seen in the interstitial lung parenchyma. Remnants of fibrin and debris are still detectable after several weeks; however, severe disturbance of the lung texture and progress into honeycombing can start as early as 14 days after exposure.
Prognosis:
Usually good; however, a few lethal cases have been reported.
Additional Diseases:
None.
References:
search Pubmed for Gold
Amandus H, Costello J: Silicosis and lung cancer in US metal miners. Arch Environ Health 46 (1991) 82-89
Aoshiba K, Fukuda I, Mochizuki M, Tamaoki J, Konno K, Takizawa T: case report and literature analysis of the clinical factors relating to the development of fibrotic changes in gold lung. Nippon Kyobu Shikkan Gakkai Zasshi 28 (1990) 336-343
Bando M, Takishita Y, Bando H, Hashimoto Y, Sano T: A case of gold-induced pneumonitis showing a positive reaction in the drug lymphocyte stimulation test (DLST) for gold. Nippon Kyobu Shikkan Gakkai Zasshi 30 (1992) 128-132
Cowie RL, Van Schalkmyk MG: The prevalence of silicosis in Orange Free State gold miners. J Occup Med 29 (1987) 44-46
Cowie RL, Mabena SK: Silicosis, chronic airflow limitation, and chronic bronchitis in South African gold miners. Am Rev Respir Dis 143 (1991) 80-84
Hnizdo E: Loss of Lung Function associated with exposure to silica dust and with smoking and its relation to disability and mortality in South African gold miners. Br J Ind Med 49 (1992) 472-479
Hnizdo E, Baskind E, Sluis-Cremer GK: Combined effect of silica dust exposure and tobacco smoking on the prevalence of respiratory impairments among gold miners. Scand J Work Environ Health 16 (1990) 411-422
Kayser K: Analytical Lung Pathology. Springer, Heidelberg, New York (1992)
Kusiak RA, Springer J, Ritchie AC, Muller J: Carcinoma of the lung in Ontario gold miners: possible aetiological factors. Br J Ind Med 48 (1991) 808-817
Kusiak RA, Ritchie AC, Springer J, Muller J: Mortality from stomach cancer in Ontario miners. Br J Ind Med 50 (1993) 117-126
Lewis RJ: Carcinogenically active chemicals. Van Nostrand Reinhold, New York (1991)
Musk AW, Rouse IL, Rivera B, De Klerk NH, McNulty JC: Respiratory disease in non-smoking Western Australian goldminers. Br J Ind Med 49 (1992) 750-754
Slingerland R, Hoggsteden HC, Adriaasen HJ, van der Kwast TH, Hilvering C: Gold-induced pneumonitis. Respiration 52 (1987) 232-236
Thurlbeck WM: Pathology of the lung. Thieme, Stuttgart, New York (1988)
Wiles FJ, Baskind E, Hessel PA, Bezuidenhout B, Hznido E: Lung Function in silicosis. Int Arch Occup Environ Health 63 (1992) 387-391