efsa-opinion-chromium-food-drinking-water

Chromium in food and bottled water
Appendix I: Observation in humans
I1. Six fatal outcomes accidental or intentional ingestion of hexavalent chromium
Cases of accidental or intentional ingestion of Cr(VI) that have resulted in death have been reported in
the past and continue to be reported even in more recent literature. A selection is listed below, even
when the amount of ingested Cr(VI) was unknown.
A 22-month-old boy died 18.5 hours after ingesting an unknown amount of a sodium dichromate
solution despite gastric lavage. Autopsy revealed generalized edema, pulmonary edema, severe
bronchitis, acute bronchopneumonia, early hypoxic changes in the myocardium, liver congestion, and
necrosis of the liver, renal tubules, and gastrointestinal tract (Ellis et al., 1982).
A 1-year-old girl died after ingesting an unknown amount of ammonium dichromate with severe
dehydration, caustic burns in the mouth and pharynx, blood in the vomitus, diarrhea, irregular
respiration, and labored breathing. The ultimate cause of death was shock and hemorrhage into the small
intestine (Reichelderfer, 1968).
A 17-year-old male died after ingesting 29 mg Cr(VI)/kg b.w. as potassium dichromate in a suicide. He
died 14 hours after ingestion from respiratory distress with severe hemorrhages. Caustic burns in the
stomach and duodenum and gastrointestinal hemorrhage were also found (Iserson et al., 1983;
Clochesy,1984).
A 35-year-old female died after ingesting approximately 357 mg Cr(VI)/kg b.w. as chromic acid in a
suicide (Loubières et al., 1999) and died of multiple organ failure. (metabolic acidosis, gastrointestinal
hemorrhage and necrosis, fatty degeneration of the liver, and acute renal failure and necrosis).
A 14-year-old boy died 8 days after admission to the hospital following ingestion of 7.5 mg Cr(VI)/kg
b.w. as potassium dichromate from his chemistry set. Death was preceded by gastro-intestinal ulceration
and severe liver and kidney damage (Kaufman et al., 1970).
A 44-year-old man died of severe gastrointestinal hemorrhage one month after ingesting 4.1 mg
Cr(VI)/kg b.w. as chromic acid (Saryan and Reedy, 1988).
I2. Haematological effects after accidental or intentional ingestion of Cr (VI)
A 18-year-old woman who ingested a few grams of potassium dichromate exhibited decreased
hemoglobin content and hematocrit, and increased total white blood cell counts, reticulocyte counts, and
plasma hemoglobin 4 days after ingestion. Intravascular hemolysis was suggested (Sharma et al., 1978).
A 25-year-old woman who drank a solution containing potassium dichromate had a clinically significant
increase in leukocytes due to a rise in polymorphonuclear cells (Goldman and Karotkin, 1935).
A 44-year-old man had decreased hemoglobin levels 9 days after ingestion of 4.1 mg Cr(VI)/kg b.w. as
chromic acid solution that probably resulted from gastrointestinal hemorrhage (Saryan and Reedy,
1988).
Blood coagulation was inhibited in a 17-year-old male who died after ingesting ~ 29 mg Cr(VI)/kg b.w.
as potassium dichromate (Iserson et al., 1983; Clochesy, 1984).
I3. Gastrouintestinal effects after accidental or intentional ingestion of Cr (VI)
A 25-year-old woman who drank a solution containing potassium dichromate experienced abdominal
pain and vomiting (Goldman and Karotkin, 1935).
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