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    TELLURIUM




    WN Harrison PhD CChem MRSC
    SM Bradberry BSc MB MRCP
    JA Vale MD FRCP FRCPE FRCPG FFOM

    National Poisons Information Service
    (Birmingham Centre),
    West Midlands Poisons Unit,
    City Hospital NHS Trust,
    Dudley Road,
    Birmingham
    B18 7QH


    This monograph has been produced by staff of a National Poisons
    Information Service Centre in the United Kingdom.  The work was
    commissioned and funded by the UK Departments of Health, and was
    designed as a source of detailed information for use by poisons
    information centres.

    Peer review group: Directors of the UK National Poisons Information
    Service.


    TELLURIUM

    Toxbase summary

    Type of product

    Tellurium and its compounds are industrial chemicals used in metal
    alloys, "daylight lamps" and the electronics industry.

    Toxicity

    Acute poisoning is rare. Two men died after 2g sodium tellurite was
    mistakenly injected during retrograde pyelography (Keall et al, 1946).
    Exposure may occur occupationally, particularly during the production
    of metal alloys and electrolytic copper refining.

    Features

    Topical

         -    Irritant to skin and eyes.
         -    May cause dermal discolouration.

    Inhalation

         -    A garlic odour to the breath, sweat and urine is
              characteristic of tellurium exposure.
         -    A metallic taste, nausea, loss of appetite, tiredness,
              reduced sweating and unspecified ECG changes have been
              reported.
         -    May cause respiratory tract irritation, although reports of
              significant pulmonary toxicity are rare.

    Ingestion

         -    A garlic odour of the breath, sweat, urine and faeces is
              characteristic of tellurium exposure.
         -    Initial symptoms of nausea, vomiting and a metallic taste
              develop within hours.
         -    Fever, hair loss, weight loss and fatigue may occur days to
              weeks after substantial ingestion.

    Injection

         -    A garlic odour of the breath and body secretions is
              characteristic after systemic administration of tellurium.
         -    Loin pain, nausea, vomiting, confusion, dyspnoea and
              cyanosis occurred in two patients following accidental
              intraureteric injection of 2g sodium tellurite; both died
              (Keall et al, 1946).

    Management

    Dermal

    1.   If possible the patient should remove soiled clothing and wash
         him/herself.
    2.   Wash contaminated hair and skin with soap and copious amounts of
         water.
    3.   Pay special attention to skin folds, fingernails and ears.

    Ocular

    1.   Immediately irrigate the affected eye thoroughly with tepid water
         or 0.9% saline for at least 10-15 minutes.
    2.   Any particles lodged in the conjunctival recesses should be
         removed.
    3.   Continue irrigation with saline infusion using drip tubing.
    4.   Repeated instillation of local anaesthetic may reduce discomfort
         and help more thorough decontamination.
    5.   Corneal damage may be detected by instillation of fluorescein.
    6.   Patients with corneal damage and those whose symptoms do not
         resolve rapidly should be referred for ophthalmological
         assessment.

    Ingestion

    Minor ingestions (very mild or no symptoms):
    1.   Gastrointestinal decontamination is unnecessary.
    2.   Symptomatic and supportive measures only.

    Moderate/substantial ingestions:
    1.   Gastric lavage should be considered only if the patient presents
         within one hour; its value is unproven.
    2.   Symptomatic and supportive measures as dictated by the patient's
         condition.
    3.   Monitor the ECG, biochemical and haematological profiles.
    4.   Collect urine and blood for tellurium concentration measurements
         to confirm diagnosis although these assays are not widely
         available. Check with NPIS.
    5.   It has been suggested that ascorbic acid may reduce the garlic
         odour from tellurium intoxication (De Meio, 1947) but this has
         not been confirmed.
    6.   Dimercaprol increases tellurium toxicity and should not be used.

    Inhalation

    1.   Remove from exposure
    2.   Treat symptomatically and supportively.
    3.   If symptoms occur perform a chest X-ray, ECG, biochemical and
         haematological profiles.

    4.   Collect urine and blood for tellurium concentration measurements
         to confirm diagnosis although these assays are not widely
         available. Check with NPIS.
    5.   It has been suggested that ascorbic acid may reduce the garlic
         odour from tellurium intoxication (De Meio, 1947) but this has
         not been confirmed.
    6.   Dimercaprol increases tellurium toxicity and should not be used.

    Injection

    1.   Symptomatic and supportive care as dictated by the patients
         condition.
    2.   Monitor the ECG, biochemical and haematological profiles.
    3.   Collect urine and blood for tellurium concentration measurements
         to confirm diagnosis although these assays are not widely
         available. Check with NPIS.
    4.   It has been suggested that ascorbic acid may reduce the garlic
         odour from tellurium intoxication (De Meio, 1947) but this has
         not been confirmed.
    5.   Dimercaprol increases tellurium toxicity and should not be used.

    REFERENCES

    Blackadder ES, Manderson WG.
    Occupational absorption of tellurium: a report of two cases.
    Br J Ind Med 1975; 32: 59-61.

    De Meio RH.
    Tellurium. II. Effect of ascorbic acid on the tellurium breath.
    J Ind Hyg Toxicol 1947; 29: 393-5.

    Keall JHH, Martin NH, Tunbridge RE.
    A report of three cases of accidental poisoning by sodium tellurite.
    Br J Ind Med 1946; 3: 175-6.

    Kron T, Hansen C, Werner E.
    Renal excretion of tellurium after peroral administration of tellurium
    in different forms to healthy human volunteers.
    J Trace Elem Electrolytes Health Dis 1991; 5: 239-44.

    Müller R, Zschiesche W, Steffen HM, Schaller KH.
    Tellurium-intoxication.
    Klin Wochenschr 1989; 67: 1152-5.

    Substance name

         Tellurium

    Origin of substance

         Usually found naturally as the telluride of gold (calverite). It
         is produced as a by-product of the smelting of copper and other
         metals.                               (Gerhardsson et al, 1986)

    Synonyms

         Aurum paradoxum
         Metalum problematum                     (DOSE, 1994)

    Chemical group

         A group VIA element

    Reference numbers

         CAS           13494-80-9                (DOSE, 1994)
         RTECS         WY 2625000                (RTECS, 1997)
         UN            3284                      (HAZARD TEXT, 1997)
         HAZCHEM CODE  NIF

    Physicochemical properties

    Chemical structure
         Te                                      (DOSE, 1994)

    Molecular weight
         127.60                                  (DOSE, 1994)

    Physical state at room temperature
         Crystalline solid or amorphous powder.
                                                 (Gerhardsson et al, 1986)

    Colour
         Crystals are silvery white, powder is black.
                                                 (Gerhardsson et al, 1986)

    Odour
         Odourless                               (HSDB, 1997)

    Viscosity
         NIF

    pH
         NIF

    Solubility
         Elemental tellurium is insoluble in water.
                                                 (Gerhardsson et al, 1986)

    Autoignition temperature
         NIF

    Chemical interactions
         Tellurium is not attacked by hydrochloric acid. It reacts with
         nitric acid and with concentrated or fuming sulphuric acid. In
         the presence of air, it dissolves in potassium hydroxide with
         formation of a deep-red solution.       (HSDB, 1997)

    Major products of combustion
         Tellurium dioxide.                      (HSDB, 1997)

    Explosive limits
         NIF

    Flammability
         Burns slowly in air.                    (HSDB, 1997)

    Boiling point
         990°C.                                  (DOSE, 1994)

    Density
         6.2                                     (Gerhardsson et al, 1986)

    Vapour pressure
         133.3 Pa at 520°C                       (DOSE, 1994)

    Relative vapour density
         NIF

    Flash point
         NIF

    Reactivity
         A finely divided suspension of elemental tellurium in air can be
         exploded.
         The fire hazard of tellurium is moderate in the form of dust when
         exposed to heat or flame or by chemical reaction with oxidizing
         agents.
         Reactions with zinc, chlorine, fluorine, and solid sodium are
         vigorous and have a potential to cause fires (HSDB, 1997).

    Uses

         Additive to metal alloys.
         Vulcanization of rubber.
         Semiconductors and electronic devices.
         Catalyst.
         Tellurium vapour is used in "daylight lamps".
         Used in blast caps.
         Limited use in pottery glazes.          (PATTY, 1993)

    Hazard/Risk Classification

         NIF

    INTRODUCTION

    Tellurium has the appearance and physical properties of a metal yet
    has the chemical properties of a non-metal. It forms compounds in
    oxidation states -2, +2, +4 and +6. Of toxicological interest are
    elemental tellurium, tellurium dioxide, the gases hydrogen telluride
    and tellurium hexafluoride, and the water soluble salts of tellurous
    and telluric acid. It also forms a number of organometallic complexes
    (Gerhardsson et al, 1986). There is no evidence that tellurium is an
    essential trace element.

    Tellurium exposure is characterized by a distinctive garlic odour
    which is due to formation of the hepatic metabolite dimethyl
    telluride.

    EPIDEMIOLOGY

    Tellurium is used as an additive in many metallurgical processes such
    that it is often involved in multiple metal exposures, notably with
    lead, zinc, arsenic, selenium, cadmium and thallium. Tellurium
    exposure also occurs during electrolytic copper refining where
    tellurium is formed in the anode slime. Tellurium intoxication is
    rare, though acute (Gerhardsson et al, 1986; Blackadder and Manderson,
    1975) and chronic (Keall et al, 1946; Shie and Deeds, 1920)
    occupational exposure has been reported.

    An isolated case of poisoning from tellurium-contaminated meat has
    been reported (Müller et al, 1989). The source of contamination is
    unknown.

    The only reported deaths from tellurium intoxication occurred when two
    men were mistakenly injected with some 2 g sodium tellurite during
    retrograde pyelography (Keall et al, 1946).

    MECHANISMS OF TOXICITY

    There are few data on the mechanism of toxicity of tellurium or its
    compounds. Animal studies suggest tellurium may affect the conversion
    of squalene to cholesterol so interfering with neurotransmission via
    demyelination (Gerhardsson et al, 1986).

    Impaired secretory nerve neurotransmission is the proposed mechanism
    of impaired saliva and sweat secretion in humans and of reduced
    gastric acid secretion in animals poisoned with tellurium (Shie and
    Deeds, 1920).

    There is some evidence that the aroma of fresh garlic is caused by a
    high tellurium content. This may contribute to garlic's cholesterol-
    lowering properties (Larner, 1995).

     In vitro studies demonstrate that tellurite (Te4+) ions can
    penetrate the erythrocyte membrane and, in the presence of reduced
    glutathione, form telluride (Te2+) which causes irreversible membrane
    damage and hence haemolysis (De Meio and O'Leary, 1975; Kurantsin-
    Mills et al, 1988). Tellurate (Te6+) ions do not penetrate the
    erythrocyte membrane. Haemolysis has been observed in animals poisoned
    with tellurium (Shie and Deeds, 1920), but not as a feature of
    tellurium intoxication in man.

    TOXICOKINETICS

    Absorption

    The mean (± SD) gastrointestinal absorption in healthy volunteers
    ingesting between 15 and 57 µg has been estimated as ten per cent (± 4
    per cent) for elemental tellurium, 23 per cent (± 9 per cent) for
    tellurate and 21.5 per cent (no SD given) for tellurite (Kron et al,
    1991).

    Ingestion of 0.5 µg tellurium oxide produced a garlic breath odour
    within 75 minutes which lasted for 30 hours (Reisert, 1884).

    Tellurium dusts and fumes can be absorbed via the lung. Workers
    exposed to tellurium concentrations up to 0.1 mg/m3 had urine
    tellurium concentrations of up to 0.06 mg/L (Steinberg et al, 1942).

    Organometallic complexes of tellurium and soluble tellurium salts can
    be absorbed through the skin (Blackadder and Manderson, 1975).

    Distribution

    Tellurium is distributed widely with high concentrations particularly
    in kidneys, liver, bone, brain and testes (Meditext, 1997).

    Excretion

    Excretion is mainly renal although small amounts of tellurium are
    exhaled as dimethyl telluride which has a distinctive garlic odour
    which may persist for many days; Reisert (1884) reported garlic breath
    odour for 237 days following ingestion of 15 mg tellurium oxide. The
    susceptibility to this effect varies considerably between individuals
    and is exacerbated by alcohol consumption (Cerwenka and Cooper, 1961).

    The whole body retention time of tetravalent tellurium has been
    estimated as more than two months (Kron et al, 1991).

    CLINICAL FEATURES: ACUTE EXPOSURE

    Dermal exposure

    Although it has been claimed that some tellurium compounds give rise
    to skin burns or rashes following dermal contact (Gerhardsson et al,
    1986), no original case data were cited in support.

    Blue-black patches in the webs of the fingers and streaks on the neck
    were observed in two postgraduate chemists who handled volatile
    tellurium esters. The discolouration was believed to be due to
    deposition of elemental tellurium in the dermis and subcutaneous
    tissue (Blackadder and Manderson, 1975).

    Ocular exposure

    Some tellurium compounds are irritant although there are no reports of
    ocular exposure to tellurium or its compounds producing adverse
    effects.

    Exposure to either hydrogen telluride or to shampoo containing
    tellurium oxide has not caused eye problems (Grant and Schuman, 1993).

    Inhalation

    Reports from the Russian literature state that tellurium dust or fumes
    and hydrogen telluride are irritant to the respiratory tract
    (Gerhardsson et al, 1986).

    No pulmonary features were reported when two postgraduate chemists
    were exposed to some 50 g tellurium hexafluoride gas which leaked from
    a cylinder into a small laboratory. The first individual developed a
    metallic taste, anorexia and tiredness and, after two days, an
    erythematous papular vesicular rash on the hands, arms and neck. This
    was diagnosed as contact dermatitis, possibly from wearing rubber
    gloves, although the ability of tellurium to inhibit sweating may have
    contributed. The second person affected experienced only a metallic
    taste and somnolence. Both patients developed a garlic odour to the
    breath, sweat and urine which persisted for several weeks (Blackadder
    and Manderson, 1975). Haematological and biochemical profiles and
    chest X-ray were normal.

    Three workers exposed to tellurium fumes for ten minutes developed a
    garlic breath odour and experienced a metallic taste, headache and
    "epigastric distress" within 24 hours. Twenty-four hour urine
    tellurium concentrations in collections commenced some 48 hours post
    exposure varied between 7.7 µg/L and 12.0 µg/L. The full blood count
    in each case showed a mild lymphocytosis (40-51 per cent of the total
    white cells). All recovered fully without treatment but were given an
    eight day course of dimercaprol in an attempt to clear the garlic
    odour, which disappeared one to four days after cessation of treatment
    (Amdur, 1947). No tellurium was detectable in the urine 17 days after
    presentation.

    Two cases of occupational exposure to tellurium vapour have been
    reported in the Russian literature (Gerhardsson et al, 1986). Features
    included a garlic breath odour with general weakness, pallor, cough,
    shivering, fever, sinus tachycardia, amnesia and black-green
    discolouration of the mucosa of the tongue and the nasopharynx.

    Ingestion

    A 37 year-old woman developed characteristic symptoms of tellurium
    exposure "only hours" after eating a small piece of meat containing
    800-1000 µg/kg tellurium of unknown origin. Initially she experienced
    nausea, vomiting, a metallic taste and a garlic odour of the breath,
    sweat, urine and faeces. The next day she developed a fever which
    resolved over some five days as the gastrointestinal features
    subsided. The patient noticed hair loss two weeks after intoxication
    and was referred to hospital after four weeks with weight loss,
    fatigue and a persistent garlic breath odour. Examination was normal
    except for the strong garlic odour. Gastroscopy showed petechial
    bleeding in the gastric fundus. Serum and urine tellurium
    concentrations were 27.6 µg/L (normal = 1.0 µg/L) and 3.1-3.2 µg/L
    (normal = 1.0 µg/L) respectively. The patient was given ascorbic acid
    200 mg per day and discharged. Hair loss ceased eight weeks after
    intoxication with a "bright colour" to new grown hair. The garlic
    odour persisted for some ten months, intensifying after alcohol
    intake. No persistent health effects were reported. (Müller et al,
    1989).

    Injection

    Three patients were accidentally poisoned when sodium tellurite was
    administered instead of sodium iodide during retrograde pyelography
    (Keall et al, 1946). Two of these patients who each received an
    estimated 2 g tellurite died.

    A garlic odour was observed around the first patient, a 40 year old
    male, some 90 minutes after sodium tellurite was injected into the
    left ureter. After a further 75 minutes the patient complained of
    severe discomfort in the left loin and subsequently vomited. Four
    hours after the procedure he became deeply cyanosed and dyspnoeic and
    died twenty minutes later (Keall et al, 1946).

    The second patient, a 31 year old male, developed a garlic odour
    within an hour of undergoing pyelography. He became confused and
    progressively cyanosed with only partial relief from oxygen therapy.
    Spectroscopy of the patient's blood revealed an abnormal pigment which
    was not methaemoglobin and could not be identified. The patient died
    six hours after sodium tellurite injection (Keall et al, 1946).

    At autopsy both patients showed marked cyanosis of the head and neck.
    An intense yellow colour was observed in body fat and a deep brown
    colour in muscles. Black deposits were found in the mucosa of the
    bladder and in the injected ureter. Congestion was noted in the lungs,
    liver, spleen and kidneys with marked fatty degeneration and oedema in
    the liver. A garlic odour was emitted from all tissues (Keall et al,
    1946).

    The third patient, a 21 year old male, received a smaller (unknown)
    dose of sodium tellurite due to a blocked catheter. After four days a
    garlic odour was noticed and the patient became slightly cyanosed,
    complained of a "nasty taste" in the mouth and was administered
    intravenous fluids. He vomited the following day but recovered fully
    by day seven. The garlic odour disappeared after 12 days (Keall et al,
    1946).

    CLINICAL FEATURES: CHRONIC EXPOSURE

    Exposure to tellurium compounds is most likely to occur in the form of
    dusts and fumes in industry. Only hydrogen telluride, tellurium
    dioxide and potassium tellurite are of occupational significance
    (Glover, 1983). No deaths or permanent health effects have been
    reported following exposure.

    Inhalation

    Thirteen individuals working near the blast furnaces in a lead
    refinery were examined for signs of tellurium exposure (Shie and
    Deeds, 1920). The workers were believed to have been exposed to
    hydrogen telluride though no exposure data were given. Seven had a
    garlic odour to the breath, sweat and urine, and dryness and a
    metallic taste in the mouth. Five had "considerable inhibition of the
    sweat function" and three developed dry and itchy skin, anorexia,
    nausea, vomiting, depression and somnolence.

    A survey of ninety-eight workers exposed to 0.01-0.1 mg/m3 tellurium
    for 22 months revealed similar effects. The most common findings were
    a garlic odour of the breath (84 individuals), dryness of the mouth
    (32), a metallic taste (27) and garlic odour of the sweat (20). Other
    symptoms included somnolence (16), loss of appetite (9) and nausea
    (3). No evidence of sweat suppression was found. Urinalysis revealed
    increased tellurium concentrations (0.01 to greater than 0.06 mg/L) in
    the exposed group compared to controls. Symptoms occurred even in
    those with urine tellurium concentrations less than 0.01 mg/L, though
    the frequency increased at higher tellurium concentrations with
    somnolence and a garlic sweat odour occurring only in workers with a
    urine tellurium concentration greater than 0.01 mg/L (Steinberg et al,
    1942).

    MANAGEMENT

    Dermal exposure

    If possible the patient should remove any contaminated clothing
    him/herself. Affected areas of skin should be washed with copious
    quantities of water. Pay special attention to skin folds, fingernails
    and ears. Burns should be treated conventionally as for thermal burns
    (e.g. silver sulphadiazine dressing).

    Ocular exposure

    Irrigate immediately with lukewarm water or preferably saline for at
    least 10-15 minutes. Specialist ophthalmological advice should be
    sought if any abnormality is detected or suspected on examination and
    in those whose symptoms do not resolved rapidly.

    Inhalation

    Immediate management involves removal from exposure, establishment of
    a clear airway and administration of supplemental oxygen if necessary.
    Mechanical ventilation may be required. Other symptomatic and
    supportive measures should be dictated by the patients condition.

    Ingestion

    Gastric lavage may be considered if presentation is within the first
    hour, though there are no clinical data regarding its value. It is not
    known whether activated charcoal will adsorb tellurium. Symptomatic
    and supportive measures should be employed. An ECG should be performed
    and biochemical and haematological profiles undertaken. Blood and
    urine tellurium concentrations are not widely available but may be of
    interest retrospectively to confirm systemic uptake.

    Injection

    The management of a patient following injection of tellurium is
    symptomatic and supportive as dictated by the patient's condition.
    Monitoring and investigations are as for tellurium ingestion.

    Antidotes

    Animal studies

    Four guinea pigs were administered 5 mg intramuscular dimercaprol
    eight hours prior to the intramuscular injection of 75 mg tellurium
    oxide. A second group of four similarly poisoned guinea pigs received
    dimercaprol eight hours after tellurium oxide injection. Both groups
    then received dimercaprol 5 mg tds for 24 hours and 5 mg bd for a
    further 24 hours. There was 100 per cent mortality in the two
    dimercaprol administered groups (n=8) within 48 hours (and all animals
    showed pronounced haematuria) whereas the 48 hour survival rate in
    control animals (n=4) administered tellurium oxide alone was 75 per
    cent. A single guinea pig administered only intramuscular dimercaprol
    5 mg every eight hours for 24 hours remained healthy. The weights of
    the animals were not stated (Armdur, 1958).

    Clinical studies

    Three men exposed to tellurium fumes developed a strong garlic breath
    odour and were treated with 2.5 mg/kg dimercaprol intramuscularly
    every four hours for 24 hours, every six hours for a further 24 hours
    and then daily for six days. Each patient reported accentuation of the

    garlic odour following the injection and the odour disappeared one to
    four days after the cessation of treatment. There was no evidence of
    enhanced tellurium elimination with therapy (Amdur, 1947).

    Ascorbic acid

    Animal studies

    The reduction in garlic odour from rabbits and guinea pigs intoxicated
    with tellurium following administration of ascorbic acid (route not
    described) has been reported. The proposed mechanism is reduction of
    ionized to elemental tellurium with decreased dimethyl telluride
    formation (De Meio, 1947).

    Intramuscular ascorbic acid 25 mg tds for 24 hours then 25 mg bd for a
    further 24 hours did not increase the one week survival of guinea pigs
    injected intramuscularly with 75 mg tellurium oxide compared to
    controls (Amdur, 1958).

    Clinical studies

    Workers exposed to tellurium dust were treated with 8-10 mg/kg
    ascorbic acid (route not stated) one to three times daily. A reduction
    in the garlic odour of the breath was noted which recurred on
    cessation of treatment (De Meio, 1947).

    A 37 year old woman who ingested an unknown amount of tellurium was
    treated with ascorbic acid 200 mg daily (route not stated). She
    recovered fully though a garlic odour of the breath persisted from
    some ten months (Müller et al, 1989).

    Antidotes: Conclusions and recommendations

    1.   Animal studies suggest dimercaprol increases tellurium toxicity
         and, as there is no evidence that it enhances tellurium
         elimination, it should not be employed.

    2.   Ascorbic acid may decrease the extent of garlic odour in persons
         with tellurium intoxication although this has not been confirmed
         in controlled studies.

    MEDICAL SURVEILLANCE

    The most obvious indication of tellurium exposure is a garlic odour to
    the breath, which occurs in association with urine tellurium
    concentrations greater than 1 µg/L (Gerhardsson et al, 1986). This
    clinical indication of tellurium exposure may be masked in those with
    badly smelling breath (i.e. bronchiectasis, grossly carious teeth,
    severe gingivitis) (Gerhardsson et al, 1986).

    Normal concentrations in biological fluids

    The "upper normal limits" for tellurium in non-occupationally exposed
    individuals have been reported as 1.0 µg/L in serum and 1.0 µg/L in
    urine (Müller et al, 1989).

    OCCUPATIONAL DATA

    Occupational exposure standard

    Tellurium and compounds, except hydrogen telluride. Long-term exposure
    limit 0.1 µg/m3 (as Te) (Health and Safety Executive, 1997).

    OTHER TOXICOLOGICAL DATA

    Carcinogenicity

    There are no reports associating tellurium or its compounds with the
    development of cancer in humans.

    Reprotoxicity

    There are no reports of exposure to tellurium or its compounds causing
    reproductive effects in humans although pregnant rats fed diets
    containing 500 to 3500 ppm tellurium gave birth to hydrocephalic (non-
    obstructive) offspring, the incidence of hydrocephalus being
    proportional to the tellurium dose (Duckett, 1970). The mechanism of
    this effect is not known.

    Genotoxicity

    An increase in the incidence of chromosome breakage was found when 
     in vitro human leukocytes were treated for 48 hours with 1.2 x 10-8
    mol/L sodium tellurite and 2.4 x 10-7 mol/L ammonium tellurite (Paton
    and Allison, 1972).

    Fish toxicity

    NIF

    EC Directive on Drinking Water Quality 80/778/EEC

    NIF

    WHO Guidelines for Drinking Water Quality

    NIF

    AUTHORS

    WN Harrison PhD CChem MRSC
    SM Bradberry BSc MB MRCP
    JA Vale MD FRCP FRCPE FRCPG FFOM

    National Poisons Information Service (Birmingham Centre),
    West Midlands Poisons Unit,
    City Hospital NHS Trust,
    Dudley Road,
    Birmingham
    B18 7QH
    UK

    This monograph was produced by the staff of the Birmingham Centre of
    the National Poisons Information Service in the United Kingdom. The
    work was commissioned and funded by the UK Departments of Health, and
    was designed as a source of detailed information for use by poisons
    information centres.

    Date of last revision
    28/1/98

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    EH40/97: Occupational exposure limits 1997.
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