{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T11:40:06Z","timestamp":1793878806933,"version":"4.7.0"},"reference-count":62,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2023,3,22]],"date-time":"2023-03-22T00:00:00Z","timestamp":1679443200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,4,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Exposure to heavy metals is common as a result of environmental contamination of air, water, and soil as well as accumulation in food, tobacco, herbal medicines, and occupational contact. However, clinically relevant toxicity is much less prevalent. Toxic effects, when they occur, may present with non-specific symptoms, resulting in a very large differential for clinicians to consider.<\/jats:p><\/jats:sec><jats:sec><jats:title>Content<\/jats:title><jats:p>Arsenic, cadmium, lead, and mercury are four heavy metals with no biological role in humans. However, these metals are commonly used in industrial applications and consumer products. Since these elements are not biodegradeable, their potential toxic effects may be long-lasting within the environment. These heavy metals have the potential to accumulate in vital organs such as the brain, heart, and kidney where they may disrupt normal cellular functioning and if exposures are repetitive or of high concentration, toxicity may result.<\/jats:p><\/jats:sec><jats:sec><jats:title>Summary<\/jats:title><jats:p>The objective of this review is to provide an overview of arsenic, cadmium, lead, and mercury physical properties, common sources of exposure, basic toxicokinetics and health effects, and to review clinical guidelines and treatment strategies. Acute and chronic symptoms and recommended laboratory biomarker testing are also discussed.<\/jats:p><\/jats:sec>","DOI":"10.1093\/clinchem\/hvad022","type":"journal-article","created":{"date-parts":[[2023,3,22]],"date-time":"2023-03-22T05:07:06Z","timestamp":1679461626000},"page":"336-349","source":"Crossref","is-referenced-by-count":114,"title":["Elementary Overview of Heavy Metals"],"prefix":"10.1093","volume":"69","author":[{"given":"Paul J","family":"Jannetto","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine & Pathology, Mayo Clinic , Rochester, MN , United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clayton T","family":"Cowl","sequence":"additional","affiliation":[{"name":"Division of Public Health, Infectious Diseases and Occupational Medicine, Mayo Clinic , Rochester, MN , United States"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,3,22]]},"reference":[{"key":"2023040316224036600_","doi-asserted-by":"crossref","first-page":"8513","DOI":"10.1021\/acs.jafc.2c01437","article-title":"Research progress of soil microorganisms in response to heavy metals in rice","volume":"70","author":"Mao","year":"2022","journal-title":"J Agric Food Chem"},{"key":"2023040316224036600_","author":"Agency for Toxic Substance and Disease Registry"},{"key":"2023040316224036600_","doi-asserted-by":"crossref","first-page":"2198","DOI":"10.2174\/0929867325666171129124616","article-title":"Metals and Parkinson's disease: mechanisms and biochemical processes","volume":"25","author":"Bjorklund","year":"2018","journal-title":"Curr Med Chem"},{"key":"2023040316224036600_","first-page":"403","article-title":"Cadmium polyneuropathy: a rare, but not less important, cause of peripheral neuropathy","volume":"74","author":"Leon-Ruiz","year":"2022","journal-title":"Rev Neurol"},{"key":"2023040316224036600_","doi-asserted-by":"crossref","first-page":"134625","DOI":"10.1016\/j.chemosphere.2022.134625","article-title":"Role of heavy metals (copper (Cu), arsenic (As), cadmium (Cd), iron (Fe) and lithium (Li)) induced neurotoxicity","volume":"301","author":"Vellingiri","year":"2022","journal-title":"Chemosphere"},{"key":"2023040316224036600_","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1002\/jcb.26234","article-title":"Prevalence of exposure of heavy metals and their impact on health consequences","volume":"119","author":"Rehman","year":"2018","journal-title":"J Cell Biochem"},{"key":"2023040316224036600_","first-page":"627","article-title":"The effects of toxic heavy metals lead, cadmium and copper on the epidemiology of male and female infertility","volume":"26","author":"Manouchehri","year":"2022","journal-title":"JBRA Assist Reprod"},{"key":"2023040316224036600_","first-page":"4","volume-title":"Lead. 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