Beer foam and artificial hips
Forty eight years ago there was an epidemic of heart failure in Quebec City. The clue was that the thirty men affected were all beer drinkers. In a round about way, the culprit was the introduction of a new dish washing detergent that left a residue on glasses. Detergent is the enemy of foam on beer and brewers countered the problem by adding a foam boosting agent, cobalt sulphate, to their product. It seems the potential toxicity of the cobalt compound was not considered. It should have been because cobalt affects the heart and causes heart failure. After the beer toxicity episode cobalt was of course banned as a food additive but now cobalt poisoning has made it into the headlines again. This time the problem is small amounts of the metal leaching out of cobalt-chromium artificial hips. In a case that has hit the headlines a German doctor made the diagnosis of cobalt poisoning thanks to having watched an episode of Dr. House on TV. That show’s producers dredged the medical literature for unusual ailments and came up with cobalt poisoning that was featured in an episode.
The German physician was confronted by a case in which a 55 year old patient presented with failing sight, hearing, thyroid problems and heart failure without any evidence of coronary disease. These were the symptoms depicted on the Dr. House episode which luckily the physician had watched. The cobalt hip was removed and the man’s blood levels of the metal plunged. The problem was actually traced to the fact that the patient originally had a ceramic hip which was replaced with the metal one. But bits of ceramic remained behind and acted like sandpaper on the new metal hip, dispersing cobalt into the bloodstream. The manufacturer of the cobalt artificial hip has paid out billions to patients who had hip replacement surgery with that particular brand of artificial hip.