This review discusses different aspects of the use of metal chelators, alone or in combination, in the treatment of As poisoning.

One effective strategy in reducing the toxic effects of As is the usage of chelating agents, which provide the formation of inert chelator–metal complexes with their further excretion from the body. The complex mechanism of As toxicity in the human body is associated with the generation of free radicals and the induction of oxidative damage in the cell. The sources of As such as contaminated water, air, soil, but also food, can cause serious human diseases. Relevant toxicological research output on lead, arsenic, mercury, and cadmium were included in this review.Arsenic (As) is widely used in the modern industry, especially in the production of pesticides, herbicides, wood preservatives, and semiconductors. Inclusion and exclusion criteria used were as follows: peer-reviewed papers in English were included if they had primaryĭata on lead, mercury, arsenic, and cadmium concentration in cocoa, cocoa products, or chocolate ĭata on lead, mercury, arsenic, and cadmium human exposure or dietary intake in cocoa, cocoa products, or chocolate ĭata on risk characterization, including hazard quotient or hazard index, of lead, arsenic, mercury, and cadmium in cocoa, cocoa products, or chocolate and The search was scoped to works from 1 January 2000 to in order to describe the current body of knowledge required to achieve the objective of the review. To ensure efficiency, the PubMed repository was searched using the Boolean script in Table 1. These selected keywords were used because the authors considered them adequate to pull out all the relevant and essential data available in order to achieve the objective of the study. ((“cadmium” OR “cadmium”) AND (“chocolate” OR “chocolate” OR “cocoa” OR “cacao” OR “cacao”)) AND (“”: “”) ((“cadmium” OR “cadmium”) AND (“chocolate” OR “chocolate”)) AND (“”: “”) ((“mercury” OR “mercury”) AND (“chocolate” OR “chocolate”)) AND (“”: “”) ((“mercury” OR “mercury”) AND (“chocolate” OR “chocolate” OR “cocoa” OR “cacao” OR “cacao”)) AND (“”: “”) ((“lead” OR “lead”) AND (“chocolate” OR “chocolate” OR “cocoa” OR “cacao” OR “cacao”)) AND (“”: “”)

((“arsenic” OR “arsenic”) AND (“chocolate” OR “chocolate”)) AND (“”: “”) ((“chocolate” OR “chocolate” OR “cocoa” OR “cacao” OR “cacao”) AND (“arsenic” OR “arsenic”)) AND (“”: “”) The key words searched were lead, arsenic, mercury, and cadmium each with cocoa and chocolate ( Table 1). However, Google Scholar database was also reviewed to capture additional published papers. PubMed database was preferred for the key words search because it is a more comprehensive research database with toxicological data, including food toxicological data. Literature search of PubMed database was conducted. The authors adopted European Food Safety Authority (2010) guide and the PRISMA protocol ( Moher et al., 2009) for reporting this review ( Figure 1). Does manufacturing concentrate or dilute the levels of these metals? Are exposures exceeding critical regulatory levels? What are the risks associated with current levels of exposure? What can be done about mitigation? This paper is a synthesis of the latest relevant available peer-reviewed literature on arsenic, cadmium, lead, and mercury levels, exposure and risk in cocoa and cocoa derivative foods with a view to highlight the gaps, to encourage further research and to inform industry. In response to these developments, the EU has enacted new guidelines for cadmium in cocoa products and cocoa derivatives, to be enforced from 2019 ( EU Law and Publications Office, 2006). Furthermore, according to the International Cocoa Organization (ICCO), per capita consumption of chocolate, a cocoa product, is on the rise in several countries including the UK, Germany, and France ( ICCO, 2010). A cursory search in the literature indicates that arsenic, cadmium, lead, and mercury have been well characterized in terms of their respective toxicities by transnational bodies such as the International Agency for Research on Cancer ( IARC, 1993, 2012a, 2012b). To this end, food regulatory bodies including the European Food Safety Authority ( EFSA, 2018), the Food Standards Agency ( FSA, 2018), and the Food and Drug Administration of the United States (US FDA, 2018) are monitoring the levels in foods. As such, the world body has called for appropriate preventive and interventionary measures in addition to consumption data. The World Health Organization ( WHO, 2018a) has expressed concern about arsenic, cadmium, lead, and mercury as potentially harmful to human health. Toxic heavy metals, risks, exposures, hazards, cocoa-based products Introduction

2017 arsenic and mercury poisoning