In the United States, for example, 733 tonnes of bismuth were consumed in 2016, of which 70% went into chemicals (including pharmaceuticals, pigments, and cosmetics) and 11% into bismuth alloys.Some manufacturers use bismuth as a substitute in equipment for potable water systems such as valves to meet "lead-free" mandates in the U.S. (began in 2014). This is a fairly large application since it covers all residential and commercial building construction.In the early 1990s, researchers began to evaluate bismuth as a nontoxic replacement for lead in various applications. Medicines
Bismuth is an ingredient in some pharmaceuticals, although the use of some of these substances is declining. Bismuth subsalicylate is used as an antidiarrheal; it is the active ingredient in such "pink bismuth" preparations as Pepto-Bismol, as well as the 2004 reformulation of Kaopectate. It is also used to treat some other gastro-intestinal diseases like shigellosis and cadmium poisoning. The mechanism of action of this substance is still not well documented, although an oligodynamic effect (toxic effect of small doses of heavy metal ions on microbes) may be involved in at least some cases. Salicylic acid from hydrolysis of the compound is antimicrobial for toxogenic E. coli, an important pathogen in travelers diarrhea. A combination of bismuth subsalicylate and bismuth subcitrate is used to treat the bacteria causing peptic ulcers. Bibrocathol is an organic bismuth-containing compound used to treat eye infections. Bismuth subgallate, the active ingredient in Devrom, is used as an internal deodorant to treat malodor from flatulence and feces.
In oxidation state +3, bismuth forms trihalides with all of the halogens: BiF3, BiCl3, BiBr3, and BiI3. All of these except BiF3 are hydrolyzed by water.Bismuth(III) chloride reacts with hydrogen chloride in ether solution to produce the acid HBiCl4.The oxidation state +5 is less frequently encountered. One such compound is BiF5, a powerful oxidizing and fluorinating agent. It is also a strong fluoride acceptor, reacting with xenon tetrafluoride to form the XeF+3 cation:
BiF5 + XeF4 → XeF+3BiF−6

Aqueous species
In aqueous solution, the Bi3+ ion is solvated to form the aqua ion Bi(H2O)3+8 in strongly acidic conditions. At pH > 0 polynuclear species exist, the most important of which is believed to be the octahedral complex [Bi6O4(OH)4]6+. Occurrence and production
In the Earths crust, bismuth is about twice as abundant as gold. The most important ores of bismuth are bismuthinite and bismite. Native bismuth is known from Australia, Bolivia, and China. The difference between mining and refining production reflects bismuths status as a byproduct of extraction of other metals such as lead, copper, tin, molybdenum and tungsten. World bismuth production from refineries is a more complete and reliable statistic.Bismuth travels in crude lead bullion (which can contain up to 10% bismuth) through several stages of refining, until it is removed by the Kroll-Betterton process which separates the impurities as slag, or the electrolytic Betts process. Bismuth will behave similarly with another of its major metals, copper. The raw bismuth metal from both processes contains still considerable amounts of other metals, foremost lead.