Biomonitoring Summary

Antimony

CAS No. 7440-36-0

General Information

Antimony is found in ores or other minerals, often combined with oxygen to form antimony trioxide or with sulfur to form stibnite. Antimony can exist in one of four valences in its various chemical and physical forms: -3, 0, +3, and +5. It is used in metal alloys, storage batteries, solder, sheet and pipe metal, ammunition, metal bearings, castings, and pewter. It is also used in paints, ceramics, fireworks, enamels, and glass, and as a fire-retardant in textiles and plastics. Stibine is a metal hydride form of antimony used in the semiconductor industry. Two antimony compounds (sodium stibogluconate and antimony potassium tartrate) have been used as antiparasitic medications.

Antimony enters the environment from natural sources and from its use in industry. People are exposed to antimony primarily through food and, to a lesser extent, from air and drinking water. Workplace exposures can occur at smelters, coal-fired plants, and refuse incinerators that process or release antimony. Dermal contact with soil, water, or other substances containing antimony is another means of exposure. The absorption, distribution, and excretion of antimony vary depending on its oxidation state. Urinary excretion appears to be greater for pentavalent antimony than for trivalent compounds (Elinder and Friberg, 1986). An elimination half-life of approximately 95 hours has been estimated after occupational exposures (Kentner et al., 1995).

Human health effects from antimony at low environmental doses or at biomonitored levels from low environmental exposures are unknown. Inorganic antimony salts irritate the mucous membranes, skin, and eyes. Acute inhalation of antimony has been associated with irritation of the respiratory tract and impaired pulmonary function (Renes, 1953). Pulmonary edema may occur in severe cases of inhalation exposure (Cordasco et al., 1973). Dysrhythmias and T-wave changes on electrocardiogram have also been noted after both therapeutic (Berman, 1988; Ming-Hsin et al., 1958) and occupational exposures (Briegner et al., 1954). Histopathologic inflammatory and degenerative changes in the lung, myocardium, liver, and kidney have been demonstrated in high dose animal studies depending on the dose, species, and route of exposure (Elinder and Friberg, 1986). Acute antimony poisoning may cause a metallic taste, and gastrointestinal symptoms such as vomiting, diarrhea, abdominal pain, and ulcers (Werrin, 1962). The toxicity of stibine after acute inhalational exposure is similar to that of arsine, resulting in hemolysis with abdominal and back pain (Dernehl et al., 1944).

Workplace standards and recommendations for air exposure to antimony have been established by OSHA and ACGIH, respectively, and a drinking water standard has been established by the U.S. EPA. Antimony trioxide is rated by IARC as a possible human carcinogen. Information about external exposure (i.e., environmental levels) and health effects is available from ATSDR at https://www.atsdr.cdc.gov/toxprofiles/index.asp.

Biomonitoring Information

Levels of urinary antimony reflect recent exposure. Earlier measurements in general populations (Minoia et al., 1990; Paschal et al., 1998) or compiled reference ranges (Hamilton et al., 1994) have reported values slightly higher than those reported in the National Report on Human Exposure to Environmental Chemicals, which may be due to methodologic, population, or exposure differences (CDC, 2012). Levels of urinary antimony in infants appeared to be similar to those reported by CDC (2012) for young children (Cullen et al., 1998; Dezateux et al., 1997). Urinary antimony was not associated with locally elevated soil levels in a study of more than 200 German residents (Gebel et al., 1998). Several investigations of airborne antimony exposures in workers have found urinary levels that are many times higher than those seen in NHANES 1999-2000, 2001-2002, and 2003-2004, even when exposure levels were below workplace air standards (Bailly et al., 1991; Iavicoli et al., 2002; Kentner et al., 1995; Liao Y-H et al., 2004; Ludersdorf et al., 1987).

Finding a measurable amount of antimony in urine does not imply that the level of antimony causes an adverse health effect. Biomonitoring studies on levels of urinary antimony can provide physicians and public health officials with reference values so that they can determine whether people have been exposed to higher levels of antimony than are found in the general population. Biomonitoring data can also help scientists plan and conduct research on exposure and health effects.

References

Berman JD. Chemotherapy for leishmaniasis: Biochemical mechanisms, clinical efficacy, and future strategies. Rev Infect Dis 1988;10(3):560-586.

Bailly R, Lauwerys R, Buchet JP, Mahieu P, Konings J. Experimental and human studies on antimony metabolism: their relevance for the biological monitoring of workers exposed to inorganic antimony. Br J Ind Med 1991;48:93-97.

Briegner H, Semisch CW, Stasney J, Piatnek DA. Industrial antimony poisoning. Industrial Medicine and Surgery (Dec.)1954;521-523.

Centers for Disease Control and Prevention (CDC). Fourth National Report on Human Exposure to Environmental Chemicals. Updated Tables, 2012. [online] Available at URL: https://www.cdc.gov/exposurereport/. 10/1512

Cordasco EM, Stone FD. Pulmonary edema of environmental origin. Chest 1973;64(2):182-185.

Cullen A, Kiberd B, Matthews T, Mayne P, Delves HT, O'Regan M. Antimony in blood and urine of infants. J Clin Pathol 1998;51:238-240.

Dernehl CU, Stead FM, Nau CA. Arsine, stibine, and hydrogen sulfide. Industrial Medicine 1944;13:361-362.

Dezateux C, Delves HT, Stocks J, Wade A, Pilgrim L, Costeloe K. Urinary antimony in infancy. Arch Dis Child 1997;76:432-436.

Elinder CG, Friberg L. Antimony. In: Friberg L, Nordberg GF, Vouk VB, eds. Handbook on the toxicology of metals. 2nd ed. New York: Elsevier; 1986. pp. 26-42.

Gebel TW, Roland H, Suchenwirth R, Bolten C, Dunkelberg, HH. Human biomonitoring of arsenic and antimony in case of an elevated geogenic exposure. Environ Health Perspect 1998;106:33-39.

Hamilton EI, Sabbioni E, Van der Venne MT. Element reference values in tissues from inhabitants of the European community. VI. Review of elements in blood, plasma and urine and a critical evaluation of reference values for the United Kingdom population. Sci Total Environ 1994;158:165-190.

Iavicoli I, Caroli S, Alimonti A, Petrucci F, Carelli G. Biomonitoring of a worker population exposed to low antimony trioxide levels. J Trace Elem Med Biol 2002;16: 33-39.

Kentner M, Leinemann M, Schaller KH, Weltle D, Lenert G. External and internal antimony exposure in starter battery production. Int Arch Occup Environ Health 1995;67:119-123.

Liao Y-H, Yu H-S, Ho C-K, Wu M-T, Yang C-Y, Chen J-R, et al. Biological monitoring of exposures to aluminum, gallium, indium, arsenic, and antimony in optoelectronic industry workers. J Occup Environ Med 2004;46:931-936.

Luedersdorf R, Fuchs A, Mayer P, Skulsukai G, Schacke G. Biological assessment of exposure to antimony and lead in the glass-producing industry. Int Arch Occup Environ Health 1987;59:469-474.

Ming-Hsin H, Shao-Chi C, Ju-Sun P, Kuo-Juie Y, Cheng-Wei L, Chia-Yu H, et al. Mechanism and treatment of cardiac arrhythmias in tartar emetic intoxication. Chin Med J 1958;76(2):103-115.

Minoia C, Sabbioni E, Apostoli P, Pietra R, Pozzoli L, Gallorini M, et al. Trace element reference values in tissues from inhabitants of the European community I. A study of 46 elements in urine, blood, and serum of Italian subjects. Sci Total Environ 1990;95:89-105.

Paschal DC, Ting BG, Morrow JC, Pirkle JL, Jackson RJ, Sampson EJ, et al. Trace metals in urine of United States residents: reference range concentrations. Environ Res 1998;76(1):53-59.

Renes LE. Antimony poisoning in industry. Industrial Hygiene and Occupational Medicine 1953;99-108.

Werrin M. Chemical food poisoning. Quarterly Bulletin of the Association of Food and Drug Officials 1962; 27:38-45.