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Direct observations: clinical cases, poisoning incidents and other

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direct observations: clinical cases, poisoning incidents and other
Type of information:
migrated information: read-across from supporting substance (structural analogue or surrogate)
Adequacy of study:
supporting study
Study period:
Not Reported
3 (not reliable)
Rationale for reliability incl. deficiencies:
other: Documentation insufficient for assessment (insufficient exposure data)
Cross-referenceopen allclose all
Reason / purpose for cross-reference:
reference to same study
Reason / purpose for cross-reference:
reference to other study

Data source

Reference Type:
Health hazards in the manufacture of alkaline accumulators with a special reference to chronic cadmium poisoning
Friberg L
Bibliographic source:
Acta Med Scand. 138 (Suppl): 240

Materials and methods

Study type:
other: case report
Endpoint addressed:
not applicable
Test guideline
no guideline available
Principles of method if other than guideline:
Case reports discussed for two of three workers that died during the course of surveillance.
GLP compliance:
not specified

Test material

Constituent 1
Reference substance name:
Nickel dihydroxide
EC Number:
EC Name:
Nickel dihydroxide
Cas Number:
nickel(2+) dihydroxide
Details on test material:
Workers were exposed to large quantities of dust in the air. The dust was derived from the raw material associated with the manufacture of electrodes. The dust was described as having a positive and negative mass. The negative mass consisted of 60% (by weight) cadmium, 25% iron, and ~3% kerosene. The positive mass consisted of 80% (by weight) nickel hydrate and about 20% graphite. In extremely small quantities, the negative mass also contained Si, Ni, Mn, Ca and Al, and the positive mass contained Si, Ca, Al, Mg, Fe, Cu and Co.

The amount of dust in the air was determined using the filter-paper method: air from the working premises was sucked with a vacuum-pump through a filter paper. The cadmium and nickel content was obtained by polarographic analysis. Samples were collected at three time points: Nov 1946, Nov 1947, and Nov 1948. The amount of Ni in the dust ranged from 0.2 mg/m3 to 150 mg/m3.


Type of population:
Author was studying male workes employed in the accumulator department of an alkaline accumulator manufacturing facility. During the period of evaluation, three workers died.
Ethical approval:
not specified
Route of exposure:
Reason of exposure:
unintentional, occupational
Exposure assessment:
not specified
Details on exposure:
Workers were reported to work in the accumulator department and thus were exposed to dust containing cadmium and nickel.
Case 1 (referred to as Case 14): died in hospital, post-mortem exam performed by physician on duty
Case 2 (referred to as Case 12): died in hospital, post-mortem exam performed by physician on duty, medico-legal post-mortem exam also performed
Case 3 - worker died at home, no exam conducted
Medical treatment:
Not Reported

Results and discussion

Clinical signs:
Case 1 (referred to as Case 14): shortness of breath, cough, symptoms typical for workers in the accumulator department, low physical working capacity, blood in faeces, reduced blood values
Case 2 (referred to as Case 12): bad cough, increasing dyspnea, typical symptoms for workers in the accumulator department, pronounced emphysema, low physical working capacity, heart trouble, edema in legs
Case 3 - Not Reported
Results of examinations:
Case 1 (referred to as Case 14): edema in lungs, hypertrophy of right ventricular chamber in heart
Case 2 (referred to as Case 12): thinned nasal mucous membrane, thickened right ventricular chamber, mucus in bronchi, copious amounts of thick mucus in respiratory passage, swollen and reddened mucous membranes in bronchi, larynx and trachea. Inflammatory changes in pericardium, main bronchi swollen in lungs, signs of congestion in the liver. Cadmium and nickel in organs was determined via spectrographic assessment; results showed the presence of cadmium in practically all organs while nickel did not occur in greater quantities. Summary of macroscopic and microscopic findings were indicative of chronic cadmium poisoning.
Case 3: Not Reported
Effectivity of medical treatment:
Not Applicable
Outcome of incidence:
Case 1 (referred to as Case 14): death, cause of death not provided on death certificate but the author reports it was likely due to cardiac insufficiency
Case 2 (referred to as Case 12): death, cause of death reported as combined circulation and respiratory insufficiency
Case 3: death, cause of death reported as coronary thrombosis

Any other information on results incl. tables

Not Applicable

Applicant's summary and conclusion

The author concluded that there was a great probability that the fatal cases were casued by the workers' exposure to dust