Acute human toxicity and mortality after selenium ingestion: A review

Background: Although selenium is an essential element for humans, acute toxicity has been reported after high oral exposure. Methods: The published literature on the acute toxicity of oral selenium was gathered and reviewed. Results: Reported symptoms and signs include abdominal symptoms, such as vomiting, diarrhea, pain, and nausea, as well as garlic-like odor on the breath. In cases of severe toxicity, cardiac and pulmonary symptoms may develop and ultimately lead to mortality. Mortality has been described after the ingestion of gun bluing solutions, which often contain selenous acid among other potentially toxic substances. Mortality has also been reported after the ingestion of other forms of selenium. Ingested doses associated with mortality are in the range of 1-100 mg Se/kg body weight. Blood levels associated with mortality are above 300 mu g Se/L (normal level: 100 mu g/L), whereas urinary levels associated with the same endpoint are above170 mu g Se/L (normal level: 20-90 mu g/L). Conclusion: The acute toxicity associated with oral selenium ingestion and the blood and urinary levels of selenium in different cases of poisonings were reviewed. Mortality is a risk of acute selenium poisoning. Concentrations of selenium in blood and urine samples in non-fatal cases are close to those observed in fatal cases.