Death by cadmium poisioning is very rare

Pittsburgh toxicologist Dr. Charles Winek has seen people killed by arsenic, cyanide and thallium, but never by cadmium.

Until now.

After state police asked him to review the toxicology tests done on the remains of Russell Repine, of Indiana County, Winek agreed that someone had administered a lethal dose of the heavy metal to the 61-year-old Brush Valley man, who died last March of what his family thought was a heart attack.

"They asked me if I thought the death was due to cadmium poisoning, and I said it was," said Winek, a former toxicologist for the Allegheny County Coroner's Office and retired professor at Duquesne University.

Indiana County Coroner Tom Streams has ruled Repine was a victim of a homicide caused by cadmium poisoning. He is awaiting test results on a second body, Anna Nagg, 58, of Saltsburg, who also may have been poisoned.

"It's a strange situation with the results that I saw," Winek said. "I'm not aware of cadmium ever being used as a possible homicide drug."

Allegheny County Coroner Dr. Cyril Wecht agreed that cadmium poisoning is rare — whether accidental or intentional in nature.

"It would be fascinating if a serial poisoner is using something unexpected like this," Wecht said.

He added that, over the years, he's investigated "maybe a dozen poisoning cases of an individual nature" but nothing that compares to a series of related poisonings.

"Some of the cases involved very rare and bizarre compounds. If there are, in fact, things linking these people, they're doing the right thing," he said, referring to the exhumations.

Dr. Graham R. Jones, chief of toxicology for the Medical Examiners Office in Alberta, Canada, and president of the American Academy of Forensic Science, said murder by cadmium is "very rare, very, very uncommon."

"That's because toxic metals are not that readily available to the public," he added.

People are more likely to be poisoned by arsenic or cyanide, Jones and Winek agreed.

Winek said he investigated six homicide cases in which cyanide was used. When he was with the coroner's office, Winek investigated the death of an Allegheny County salt truck driver who kept a liquor bottle in his locker at work.

"Someone put cyanide in the liquid and we never solved the case," he said. "In these types of poisoning cases, it's difficult to show the cause-and-effect relationship."

So how did Repine ingest such a massive dose of cadmium?

Winek and Jones agree that Repine most likely ingested cadmium salts placed in his food or drink.

"If it's going to be administered, it's going to be administered through food and drink," continued Jones, who said cadmium salts dissolve in liquid.

He said cadmium — in metallic form — is converted into salt by dissolving it in sulfuric or nitric acids. Food laced with cadmium would have a salty taste.

Jones suspects pathologists calculated the level of cadmium in Repine's body by checking hair samples from the back of the neck as well as from lung, liver and kidney tissue and bone marrow. Because Repine and Nagg were buried without autopsies, Winek said blood samples would be difficult because the embalming process would reduce the levels of cadmium. That's why organs and hair make better samples, provided tissue portions are big enough.

Cadmium is a persistent poison.

Studies by the National Institutes of Health reveal cadmium levels can remain for as long as three decades in the kidneys and about seven years in the liver.

A person with acute levels of cadmium in his system would experience flu-like symptoms including weakness, fever, headache, muscle ache, chills and sweating. The victim would develop pulmonary swelling from an accumulation of fluid, followed by death.

Cadmium was once used in certain types of fertilizers. Jones said it is unlikely the cadmium that killed Repine was purchased in an agricultural product supply store because these stores cannot sell cadmium in metallic form, and cadmium salts are not sold over the counter.

"I would be very, very surprised if someone bought cadmium salts in an agricultural supply store," he added.

As a rule, forensic pathologists, coroners and medical examiners normally test for drugs and alcohol during an autopsy. They do not routinely test for heavy metals unless suspicious police officers request it, Jones said.

"Heavy-metal screening is not part of the routine screening of most laboratories," Jones said.

The public is exposed to cadmium daily through the ingestion of food and water from contaminated soil. Exposure also occurs through cigarette smoke, contaminated soil or dust, and certain manufacturing processes. Jones said most poisoning cases are caused by occupational or environmental exposure.

For example, coal-fired power plants burn coal to generate electricity. There are trace amounts of cadmium and other heavy metals found in coal. When coal is burned, it releases cadmium into the atmosphere.

Repine lived near the Homer City Generating Station. However, Jones said it's unlikely the facility caused such high levels of cadmium in his bloodstream.

Repine worked as a machinist for the FMC Corp. in Homer City, which manufactures conveyor systems. Streams said earlier the plant was checked and ruled out as a source for the poison.

Nagg was a housewife. If tests results indicate she died of cadmium poisoning, investigators will have to determine the source of cadmium in her system.