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National Research Council (US) Committee on Copper in Drinking Water. Copper in Drinking Water. Washington (DC): National Academies Press (US); 2000.

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Copper in Drinking Water.

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TABLE 5-1Case Reports of Copper Toxicosis Following Oral Exposures of Humans to Copper Salts

ReferenceSex, Age, NumberExposuresClinical Sequelae and Comments
Percival 1784F, 17 yr, 1Ingestion of ≈ 100 to 130 g of a pickled vegetable, shown by analysis to be contaminated with CuAbdominal pain, generalized rash, flatulence, vomiting, diarrhea, cardiac arrhythmia, death on the 8th day post-exposure
Griffin 1951M, adults, 6Ingestion of coffee brewed with water from a Cu-contaminated, gas-heated boilerNausea, vomiting, malaise
Ross 1955M F, NS, 12Stewed apples, cooked in a Cu vessel, were served to 87 adults and 458 children; 3 adults and 9 children developed symptomsBitter taste, nausea, vomiting, and diarrhea
Roberts 1956M, 24 yr, 1≈ 400 g of CuSO4 in water over a 4-mo period (≈ 2 g Cu per day)Abdominal pain, hemolytic anemia
Sanghvi et al. 1957M, 18, 20 yr, 2Ingestion of CuSO4 (amounts unknown) with suicidal intentSulfhemoglobinemia, acute renal tubular necrosis, azotemia, anuria, coma, and death
Wyllie 1957F, NR, 15Contaminated alcohol lemon cocktails from cocktail shakers containing Cu; estimated Cu ingestion, 5–32 mgWeakness, abdominal cramps, headache, nausea, dizziness, vomiting in 10/13 nurses; possible causes, other than Cu, not excluded
Semple et al. 1960M, NR, 18Contaminated tea (≈ 250 mL) containing Cu at 44 mg/L; tea made with water from a Cu-lined, gas-heated boilerAbdominal pain, vomiting, diarrhea, dizziness, and headache developed in 18 of 150 workers within 10 min after drinking the tea
Le Van and Perry 1961M, NR, NRUnspecified number of men on ship drank Cu-contaminated soft drink (Cu content not stated) from a vending machineSeveral men developed mild nausea
Chowdhury et al. 1961M F, adults, 2012 women and 8 men attempted suicide by ingestion of unknown quantities of CuSO4 Epigastric pain, nausea, jaundice, hemolysis, hemoglobinuria, proteinuria, glucosuria, hypotension, tachycardia, stupor; no deaths
Ghosh and Aggarwal 1962M F, children, 3231 children accidentally ingested unknown amounts of CuSO4; one boy (age 11) given CuSO4 for attempted homicideVomiting was chief complaint; the victim of attempted homicide developed severe hemolysis
Bohré et al. 1965M, adults, 7Naval officers consumed coffee prepared with water from a Cu-contaminated electrically heated boilerNausea, vomiting, malaise, collapse, no deaths
Chuttani et al. 1965M F, 14– 60 yr, 53Oral ingestion with suicidal intent; estimated 1–30 g of CuSO4 Diarrhea (29%), hemoglobinuria and hematuria (29%), anuria (27%), jaundice (23%), hypotension (8%), coma (8%), death (15%)
Fairbanks 1967F, 22 yr, 1Accidental ingestion of unknown amount of CuSO4 solutionNausea, vomiting, diarrhea, abdominal pain, icterus, melena, hemoglobinuria, proteinuria, mild anemia
Wahal et al. 1965M F, 15– 58 yr, 100100 patients ingested CuSO4 (dose unknown, mostly suicidal)Hepatotoxicity (36%), renal toxicity (18%), cardiovascular toxicity (10%), neurotoxicity (10%), GI hemorrhage (6%), death (10%)
Nicholas 1968M, NR, 20Contaminated tea (≈ 250 mL) containing Cu at >30 mg/L; tea made with water from a Cu-lined boilerDiarrhea, nausea, vomiting
Singh and Singh 1968M F, 13– 85 yr, 4027 males and 13 females; accidental or suicidal ingestion of copper saltsVariable hypercupremia, transaminasemia, hyperbilirubinemia, and renal insufficiency; 4 deaths
Salmon and Wright 1971M, 1.25 hr, 1Oral ingestion of drinking water (Cu at 0.35–0.79 mg/L) over a 3-mo periodProstration, vomiting, red extremities, hypotonia, photophobia, peripheral edema, hypercupremia
McMullen 1971M, NR, ≥ 10Oral ingestion of Cu-contaminated orange- or lime-flavored soft drinks, dispensed through Cu-containing bottle pourers; drinks contained Cu at 190 and 220 mg/L.At least 10 members of a sports club vomited immediately after consuming the soft drinks
Mittal 1972M, 22 yr, 1Oral ingestion of ≈ 175 g of CuSO4 (≈ 70 g Cu)Severe abdominal pain, vomiting, diarrhea starting 1.5 hr post- ingestion; renal damage with hemoglobinuria; eventual recovery
Chugh et al. 1975M, 27 yr, 1Oral ingestion of ≥ 50 g of CuSO4 (≈ 20 g Cu)Cyanosis, oliguria, hemolysis, methemoglobinemia, death 16 hr post-ingestion
Agarwal et al. 1975F, 41 yr, 1Oral ingestion of CuSO4 with suicidal intent; patient treated by hemodialysis at 13 hr after ingestionVomiting, diarrhea, hepatorenal failure, coma; hemodialysis was ineffectual; death; autopsy showed Cu in brain, heart, liver, kidney
Stein et al. 1976F, 44 yr, 1After the patient had ingested ethanol and diazepam, CuSO4 (796 mg Cu) was administered as an emeticRespiratory collapse, massive GI hemorrhage, hemolytic anemia, renal and hepatic failure, death; autopsy showed renal tubular necrosis and increased hepatic Cu content
Chugh et al. 1977M F, 18– 35 yr, 11Report of 11 cases of acute renal failure in a series of 29 patients with acute CuSO4 poisoning with suicidal intent.Vomiting (100%), epigastric pain (45%), diarrhea (45%), oliguria or anuria (91%), jaundice (91%), coma (18%); death (45%); biopsy or autopsy showed renal tubular necrosis in 7 of 8 patients studied
Walsh et al. 1977M, 1.5 yr, 1Oral ingestion of 3 g of CuSO4 (≈ 1.2 g Cu)Hemolytic anemia was observed 2 days post-ingestion, with hematuria, glucosuria, proteinuria, cylindruria, hypercupremia, hypercupriuria; recovery period was ≈ 1 yr
Stenhammar 1979?, 1–2.5 yr, 3Oral ingestion for unknown duration of tap water containing Cu at 0.22–1 mg/LProlonged diarrhea with weight loss; symptoms disappeared with change of water source
Berg and Lundh 1981M F, < 3 yr, NRChildren at 7 Swedish kindergartens with Cu content in first-draw water from 0.35 to 6.5 mg/LAssociation noted between Cu content of drinking water and diarrhea, but other possible causes of diarrhea were not studied
Spitalny et al. 1984M F, 5, 7, 32 yr, 3Oral ingestion of drinking water (Cu at 2–8 mg/L; median 3 mg/L) for 1.5 yr by a family living at the end of a copper water mainEpisodic nausea, vomiting, abdominal pain occurred 5–20 min after drinking tap water in morning in 3 of 4 family members; the symptoms ceased with change of water source
Jantsch et al. 1985M, 42 yr, 1Ingestion of ≈ 250 g of CuSO4 (≈ 100 g Cu) in attempted suicideProtracted vomiting, hepatic failure, response to chelation therapy, eventual recovery
Müller-Höcker et al. 1988M F, 1 yr, 2Two infant siblings consumed for >9 mo Cu-containing tap water (Cu at 2.2–3.4 mg/L); the Cu was derived from Cu pipesMicronodular cirrhosis with hepatic Cu storage, hepatosplenomegaly, jaundice, and hypertransaminasemia; 1 death
Knobeloch et al. 1994M F, NRFive studies of GI upsets associated with ingestion of Cu-containing drinking waterHigher incidence of symptoms following ingestion of first-draw water compared with flushed water
NR, not recorded

From: 5, Health Effects of Excess Copper

Copyright 2000 by the National Academy of Sciences. All rights reserved.

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