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HISTORY AND EPIDEMIOLOGY

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Although barium is utilized in various forms in developed nations, exposure to barium salts is uncommon and clinically significant poisoning is rare. Acute, clinically relevant exposures occur most commonly following the intentional ingestion of the soluble salts found in rodenticides,9 insecticides, or depilatories.10 Barium carbonate has an appearance similar to flour and has been responsible for most unintentional barium poisonings.8,12

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Barium salts and barium hydroxide are extensively employed in industry particularly in thermoplastics and the manufacture of synthetic fibers, soap manufacture, and in lubricants (Table 110–1). Toxicity occurs following occupational exposure to barium salts through ingestion, inhalation,32 or explosion of the propellant barium styphnate.14 Despite the fact that barium sulfate is insoluble, rare cases of unintentional toxicity are reported during radiographic procedures and include complications associated with oral22 and rectal administration.13,18,20,25 Toxicity and death occurred when soluble barium salts were unintentionally permitted to contaminate contrast solutions.27

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TABLE 110–1.Barium Salts: Solubility and Common Usages
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CHEMISTRY

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Barium is a soft metallic element that was first isolated by Sir Humphry Davey in 1808. With an atomic weight of 137.3 Da, barium is located at number 56 in the periodic table (between cesium and lanthanum). The metal oxidizes easily when exposed to water or alcohol, has a melting point of 1341°F (727°C) and a boiling point of 3398°F (1870°C). Elemental barium is not found in nature; it normally occurs as an oxide, dioxide, sulfate (barite), or carbonate (witherite). Chemically, barium resembles calcium more than it resembles any other element. While some barium salts are naturally occurring, most used commercially are produced from the more commonly found carbonates or oxides. Barium salts are typically classified as either water soluble or insoluble, but the solubility ...

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