Concentrations of antimony in infants dying from SIDS and infants dying from other causes

Abstract

Objectives-Raised concentrations of antimony have been found in infants dying of sudden infant death syndrome (SIDS). The presumed source of this antimony is toxic gases generated from fire retardants that are present in cot mattresses. The aim of this study was to determine the role of antimony in SIDS. Design-Samples of liver, brain, serum, and urine were collected from all patients dying from SIDS and a group of aged matched control infants who had died of other causes. Setting-Nationwide study in Ireland. Subjects-52 infants dying from SIDS and 19 control infants aged > 7 days and < 1 year. Results-The median concentration of antimony in the liver and brain of infants dying of SIDS was < 1 ng/g, with no diVerence detected between the infants dying from SIDS and the control infants. The range of antimony in the serum of infants dying of SIDS was 0.09-0.71 µg/ litre (median, 0.26). Although no diVerence was found between infants dying from SIDS and control infants, SIDS infants were found to have higher concentrations when compared with healthy infants in the 1st year of life, probably as a result of release of antimony into serum after death. Urine antimony concentrations in infants dying from SIDS were < 3.91 ng/mg (corrected for creatinine) and similar to values found both in control infants and healthy infants. Conclusion-There is no evidence to support a causal role for antimony in SIDS.

Antimony Toxicity

“…In vitro experiments appeared to demonstrate the release of stibine and phosphine, hydrides of antimony oxide fire retardant and phosphorus plasticisers from polyvinyl chloride mattress covers which had been treated with these substances and it was claimed that they had caused deaths from their toxicity. However, urine antimony concentration of antimony in infants dying from SIDS were similar to values found in control infants and healthy infants [24]. This causal role of antimony in SIDS was ultimately refuted due to lack of evidence.…”

Antimony and Nickel

“…The hallmark of arsine poisoning is intravascular hemolysis secondary to binding of arsine with oxidized hemoglobin. In a case report of acute arsine poisoning, antimony was detected in the urine of one patient, suggesting the co-formation of stibine through the same mechanism as arsine formation [87]. Although studies of pesticide workers exposed to phosphine demonstrated decreased RBC and pseudocholinesterase activity, suggesting a possible mechanism for stibine toxicity [88], subsequent studies found this to be incorrect [89].…”

“…Several cases of poisoning from a mixture of gases including stibine (others being arsine and hydrogen sulfide) have been reported [87]. The hallmark of arsine poisoning is intravascular hemolysis secondary to binding of arsine with oxidized hemoglobin.…”

Poisoning: Fact or Fiction?

“…If the outliers are excluded the results are similar to those seen in non-SIDS deaths. 32,33 Given that the samples had not been collected with the analysis in mind, sample contamination was the obvious likely explanation for the outliers even in 1996.…”