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ACUTE EXPOSURE INFORMATION
- The classic toxidrome of chronic soluble cobalt poisoning is the tetrad of goiter, polycythemia, cardiomyopathy, and metabolic acidosis.
- INHALATION: Occupational inhalation exposure to metallic cobalt or cobalt alloys, usually produces cough, dyspnea, wheezing, asthma, or interstitial fibrosis ("hard metal disease"). Fume exposure can cause conjunctivitis and rhinitis.
- DERMAL: "Cobalt itch" or "carboloy-itch" (an allergic erythematous papular eruption) may occur.
- ORAL: "Beer drinker's cardiomyopathy" with frequent pericardial effusions have been described. Ingestion of cobalt can cause nausea, vomiting, and diarrhea. Ingestion of cobalt causes stimulation of the bone marrow and blood-forming components, resulting in polycythemia.
- PARENTERAL: Rhabdomyosarcomas have been found in rats following intramuscular injections.
- This management does not deal with potential clinical effects or treatment of radiation injury from radioactive cobalt isotopes. IF EXPOSURE TO RADIOACTIVE ISOTOPES OF COBALT HAS OCCURRED - refer to RADIATION MANAGEMENT for further information.
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