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BENTONITE

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Classification   |    Detailed evidence-based information

Substances Included Synonyms

Therapeutic Toxic Class

    A) Bentonite is a natural aluminum silicate clay containing appreciable amounts of the clay mineral montmorillonite. It is insoluble in water and common organic solvents, but swells with a little water forming a malleable mass.

Specific Substances

    1) Bentonitum
    2) Colloidal clay
    3) Mineral soap
    4) Montmorillonite
    5) Native colloidal hydrated aluminum silicate
    6) Otaylite
    7) Soap clay
    8) Tixoton
    9) Volclay
    10) Wilkinite
    11) CAS 1302-78-9
    12) ALBAGEL PREMIUM UPS 4444
    13) BENTONITE 2073
    14) BENTONITE MAGMA
    15) CAOLIN
    16) MAGBOND
    17) MONTMORILLONITE CLAY
    18) PANTHER CREEK BENTONITE
    19) SOUTHERN BENTONITE
    20) VOLCALY BENTONITE BC

Available Forms Sources

    A) FORMS
    1) Bentonite is a natural colloidal hydrated silicate. The major constituent of this clay is montmorillonite, Al2O3,4Si2,H2O. Minor constituents may include calcium carbonate, iron, and magnesium. Some free crystalline silica may be present. (S Sweetman , 2001; Budavari, 1996; Lewis & Sr, 1996).
    B) USES
    1) Bentonite is used in a gel or magma as a bulk laxative and is present as a binder or filler in some tablets or capsules. In the food industry it is used as an anticaking agent. Following paraquat poisoning, bentonite has been used as an oral adsorbent (S Sweetman , 2001).

Overview

Life Support

    A) This overview assumes that basic life support measures have been instituted.

Clinical Effects

    0.2.1) SUMMARY OF EXPOSURE
    A) Bentonite clay is physiologically inert. Upon ingestion, bentonite will swell into a homogenous mass up to 12 times the volume of the dry powder which may produce intestinal obstruction.
    0.2.4) HEENT
    A) Direct eye exposure resulted in severe anterior segment uveitis and retrocorneal abscess in a dental assistant.
    0.2.6) RESPIRATORY
    A) Chronic inhalation exposure to similar clays, such as Fuller's earth, has been shown to cause pneumoconiosis without pathological changes of silicosis. Symptoms usually appear after many years of exposure.
    B) Bronchospasm was reported in up to 25 percent of bentonite-exposed workers in one processing plant.
    0.2.8) GASTROINTESTINAL
    A) Bentonite has been used therapeutically as a bulk laxative, due to its ability to adsorb water and to swell into a homogenous mass. Ingestion without adequate liquids may result in intestinal obstruction.
    0.2.12) FLUID-ELECTROLYTE
    A) Hypokalemia and microcytic iron-deficiency anemia has been described in patients chronically ingesting clay.
    B) Hypokalemia was noted in a cat supposedly chronically ingesting bentonite from cat litter, although this etiology has been disputed.
    0.2.13) HEMATOLOGIC
    A) Microcytic iron-deficiency anemia may occur following chronic ingestion.
    0.2.15) MUSCULOSKELETAL
    A) Chronic ingestion has been reported to cause myositis.
    B) A cat supposedly chronically ingesting bentonite from cat litter developed lethargy and muscle weakness, although this etiology has been disputed.
    0.2.20) REPRODUCTIVE
    A) At the time of this review, no reproductive studies were found for bentonite in humans or experimental animals.

Laboratory Monitoring

    A) Laboratory measures are not usually useful. Monitor serum potassium levels in patients with significant exposure.
    B) If respiratory tract irritation is present, monitor chest x-ray.

Treatment Overview

    0.4.2) ORAL/PARENTERAL EXPOSURE
    A) DILUTION: If no respiratory compromise is present, administer milk or water as soon as possible after ingestion. Dilution may only be helpful if performed in the first seconds to minutes after ingestion. The ideal amount is unknown; no more than 8 ounces (240 mL) in adults and 4 ounces (120 mL) in children is recommended to minimize the risk of vomiting.
    B) Encourage fluid intake. Monitor for evidence of constipation and intestinal obstruction.
    0.4.3) INHALATION EXPOSURE
    A) ACUTE - Acute effects have not been described. Refer to the document on TALC for more information.
    0.4.4) EYE EXPOSURE
    A) DECONTAMINATION: Remove contact lenses and irrigate exposed eyes with copious amounts of room temperature 0.9% saline or water for at least 15 minutes. If irritation, pain, swelling, lacrimation, or photophobia persist after 15 minutes of irrigation, the patient should be seen in a healthcare facility.
    0.4.5) DERMAL EXPOSURE
    A) OVERVIEW
    1) DECONTAMINATION: Remove contaminated clothing and jewelry and place them in plastic bags. Wash exposed areas with soap and water for 10 to 15 minutes with gentle sponging to avoid skin breakdown. A physician may need to examine the area if irritation or pain persists (Burgess et al, 1999).

Range Of Toxicity

    A) Acute poisoning is more related to water intake than to dose. In chronic exposure experimental animal studies, bentonite at 1% to 2% of the diet did not effect calcium or phosphorus metabolism, but larger amounts caused decreased growth, muscle weakness, and death with marked changes in both calcium and phosphorus metabolism.

Clinical Effects

Summary Of Exposure

    A) Bentonite clay is physiologically inert. Upon ingestion, bentonite will swell into a homogenous mass up to 12 times the volume of the dry powder which may produce intestinal obstruction.

Heent

    3.4.1) SUMMARY
    A) Direct eye exposure resulted in severe anterior segment uveitis and retrocorneal abscess in a dental assistant.
    3.4.3) EYES
    A) UVEITIS - Direct eye exposure resulted in severe anterior segment uveitis and retrocorneal abscess in a dental assistant exposed to a paste containing bentonite while cleaning teeth (Grant & Schuman, 1993; Austin & Doughman, 1980).

Respiratory

    3.6.1) SUMMARY
    A) Chronic inhalation exposure to similar clays, such as Fuller's earth, has been shown to cause pneumoconiosis without pathological changes of silicosis. Symptoms usually appear after many years of exposure.
    B) Bronchospasm was reported in up to 25 percent of bentonite-exposed workers in one processing plant.
    3.6.2) CLINICAL EFFECTS
    A) RESPIRATORY FINDING
    1) LACK OF EFFECT
    a) Acute inhalation exposure has not been reported to result in respiratory effects, but this is theoretically possible.

Gastrointestinal

    3.8.1) SUMMARY
    A) Bentonite has been used therapeutically as a bulk laxative, due to its ability to adsorb water and to swell into a homogenous mass. Ingestion without adequate liquids may result in intestinal obstruction.
    3.8.2) CLINICAL EFFECTS
    A) INTESTINAL OBSTRUCTION
    1) Bentonite has been used therapeutically as a bulk laxative, due to its ability to adsorb water and swell into a homogeneous mass up to 12 times the volume of the dry powder. Ingestion without concomitant ingestion of fluids may result in intestinal obstruction.

Hematologic

    3.13.1) SUMMARY
    A) Microcytic iron-deficiency anemia may occur following chronic ingestion.
    3.13.2) CLINICAL EFFECTS
    A) ANEMIA
    1) Microcytic iron-deficiency anemia has been described in patients who chronically ingest clay (Gonzalez et al, 1982).

Dermatologic

    3.14.2) CLINICAL EFFECTS
    A) SKIN IRRITATION
    1) Skin contact can cause drying and minor irritation.

Musculoskeletal

    3.15.1) SUMMARY
    A) Chronic ingestion has been reported to cause myositis.
    B) A cat supposedly chronically ingesting bentonite from cat litter developed lethargy and muscle weakness, although this etiology has been disputed.
    3.15.2) CLINICAL EFFECTS
    A) MYOSITIS
    1) Muscular weakness, myositis, and hypokalemia have been reported following chronic ingestion of 1 to 2 cups of clay per day (Severance, 1988).
    2) A cat supposedly chronically ingesting bentonite from cat litter developed lethargy and muscle weakness, although this etiology has been disputed (Hornfeldt & Westfall, 1996; McDonough, 1997).

Reproductive

    3.20.1) SUMMARY
    A) At the time of this review, no reproductive studies were found for bentonite in humans or experimental animals.

Carcinogenicity

    3.21.1) IARC CATEGORY
    A) IARC Carcinogenicity Ratings for CAS1302-78-9 (International Agency for Research on Cancer (IARC), 2016; International Agency for Research on Cancer, 2015; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2010; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2010a; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2008; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2007; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2006; IARC, 2004):
    1) Not Listed
    3.21.4) ANIMAL STUDIES
    A) CARCINOMA
    1) Equivocal tumorigenic agent, with reported continuous lowest toxic oral dose (TDLo) in mice of 12,000 g/kg/28 weeks (RTECS , 2001).
    2) Mice fed a diet containing 50 percent bentonite developed liver tumors, possibly from choline deficiency (Wilson, 1953).

Genotoxicity

    A) At the time of this review, no genetic studies were found for bentonite.

Laboratory Monitoring

Monitoring Parameters Levels

    4.1.1) SUMMARY
    A) Laboratory measures are not usually useful. Monitor serum potassium levels in patients with significant exposure.
    B) If respiratory tract irritation is present, monitor chest x-ray.
    4.1.2) SERUM/BLOOD
    A) BLOOD/SERUM CHEMISTRY
    1) Measurement of serum potassium and iron levels may help establish a diagnosis of hypokalemia associated with chronic ingestion of clay.

Radiographic Studies

    A) CHEST RADIOGRAPH
    1) Chest x-ray may help to establish a diagnosis of bentonite induced-pneumoconiosis.

Treatment

Life Support

    A) Support respiratory and cardiovascular function.

Monitoring

    A) Laboratory measures are not usually useful. Monitor serum potassium levels in patients with significant exposure.
    B) If respiratory tract irritation is present, monitor chest x-ray.

Oral Exposure

    6.5.1) PREVENTION OF ABSORPTION/PREHOSPITAL
    A) DILUTION -
    1) DILUTION: If no respiratory compromise is present, administer milk or water as soon as possible after ingestion. Dilution may only be helpful if performed in the first seconds to minutes after ingestion. The ideal amount is unknown; no more than 8 ounces (240 mL) in adults and 4 ounces (120 mL) in children is recommended to minimize the risk of vomiting (Caravati, 2004).
    6.5.2) PREVENTION OF ABSORPTION
    A) DILUTION
    1) Treatment of ingestion of the dry powder consists of dilution and catharsis to prevent obstruction. Ingestion of magmas or gels is not likely to be hazardous and dilution will probably be sufficient.
    2) DILUTION: If no respiratory compromise is present, administer milk or water as soon as possible after ingestion. Dilution may only be helpful if performed in the first seconds to minutes after ingestion. The ideal amount is unknown; no more than 8 ounces (240 mL) in adults and 4 ounces (120 mL) in children is recommended to minimize the risk of vomiting (Caravati, 2004).
    B) OTHER
    1) Encourage fluid intake. Monitor for evidence of constipation and intestinal obstruction.
    6.5.3) TREATMENT
    A) SUPPORT
    1) Treatment is symptomatic and supportive. Monitor for evidence of constipation or intestinal obstruction.

Inhalation Exposure

    6.7.2) TREATMENT
    A) TOXIC INHALATION INJURY
    1) Acute effects have not been described. If respiratory distress develops, the treatment protocol for TALC ASPIRATION may be indicated.
    B) Treatment should include recommendations listed in the ORAL EXPOSURE section when appropriate.

Eye Exposure

    6.8.1) DECONTAMINATION
    A) EYE IRRIGATION, ROUTINE: Remove contact lenses and irrigate exposed eyes with copious amounts of room temperature 0.9% saline or water for at least 15 minutes. If irritation, pain, swelling, lacrimation, or photophobia persist after 15 minutes of irrigation, an ophthalmologic examination should be performed (Peate, 2007; Naradzay & Barish, 2006).

Dermal Exposure

    6.9.1) DECONTAMINATION
    A) DECONTAMINATION: Remove contaminated clothing and wash exposed area thoroughly with soap and water for 10 to 15 minutes. A physician may need to examine the area if irritation or pain persists (Burgess et al, 1999).

Range Of Toxicity

Summary

    A) Acute poisoning is more related to water intake than to dose. In chronic exposure experimental animal studies, bentonite at 1% to 2% of the diet did not effect calcium or phosphorus metabolism, but larger amounts caused decreased growth, muscle weakness, and death with marked changes in both calcium and phosphorus metabolism.

Minimum Lethal Exposure

    A) GENERAL/SUMMARY
    1) Bentonite is considered to be practically nontoxic with an estimated probable oral lethal dose in humans of more than 15 grams/kilogram (more than 1 quart or 2.2 kilograms for a 70 kilogram man) (HSDB , 2001; Gosselin et al, 1984).

Workplace Standards

    A) ACGIH TLV Values for CAS1302-78-9 (American Conference of Governmental Industrial Hygienists, 2010):
    1) Not Listed

    B) NIOSH REL and IDLH Values for CAS1302-78-9 (National Institute for Occupational Safety and Health, 2007):
    1) Not Listed

    C) Carcinogenicity Ratings for CAS1302-78-9 :
    1) ACGIH (American Conference of Governmental Industrial Hygienists, 2010): Not Listed
    2) EPA (U.S. Environmental Protection Agency, 2011): Not Listed
    3) IARC (International Agency for Research on Cancer (IARC), 2016; International Agency for Research on Cancer, 2015; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2010; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2010a; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2008; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2007; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2006; IARC, 2004): Not Listed
    4) NIOSH (National Institute for Occupational Safety and Health, 2007): Not Listed
    5) MAK (DFG, 2002): Not Listed
    6) NTP (U.S. Department of Health and Human Services, Public Health Service, National Toxicology Project ): Not Listed

    D) OSHA PEL Values for CAS1302-78-9 (U.S. Occupational Safety, and Health Administration (OSHA), 2010):
    1) Not Listed

Toxicity Information

    7.7.1) TOXICITY VALUES
    A) ANIMAL DATA

Pharmacology Toxicology

Pharmacologic Mechanism

    A) In vitro studies have shown bentonite to couple with free purines, pyrimidines, and breakdown products of RNA, DNA, ATP, ADP and, AMP (Sorenson et al, 1974).

Physicochemical

Physical Characteristics

    A) Bentonite is a native colloidal hydrated aluminum silicate. It is homogeneous, hygroscopic, odorless, tasteless, very fine grayish-white powder (S Sweetman , 2001).

Ph

    A) 9.5 to 10.5 (for a 2 percent suspension) (S Sweetman , 2001)

Molecular Weight

    A) Varies

References

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