Isolated outbreaks of acute zinc toxicity have occurred as a result of the consumption of food or beverages contaminated with zinc released from galvanized containers. Signs of acute zinc toxicity are abdominal pain, diarrhea, nausea and vomiting. Single doses of 225-450 mg of zinc usually induce vomiting.10 Milder gastrointestinal distress has been reported at doses of 50-150 mg/day of elemental zinc. Metal fume fever has been reported after the inhalation of zinc oxide fumes. Profuse sweating, weakness, and rapid breathing may develop within 8h of zinc oxide inhalation and persist 12-24 h after exposure is terminated.8 Total zinc intakes of 60 mg/day (50 mg/day supplemental and 10 mg/day dietary zinc) have been found to result in signs of copper defi-ciency.160 In 2001, the Food and Nutrition Board of the Institute of Medicine established tolerable upper intake levels (UL) for zinc based on the prevention of copper deficiency (Table 13.1). The UL for zinc in adults is 40mg/day.10 Intranasal zinc is known to cause a loss of the sense of smell (anosmia) in laboratory animals.161 Zinc sulfate nasal spray was reported to cause persistent anosmia in humans in the 1930s,162 and there have been several recent case

The Role of Zinc as a Metallotherapeutic Agent reports of individuals who developed anosmia after using intranasal zinc gluconate.82,83

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