1
|
Koshy P, Seram RD, Pundkar A. From Sphygmomanometer to Lungs: Unveiling Mercury Poisoning in Emergency Department. Cureus 2024; 16:e65699. [PMID: 39211678 PMCID: PMC11358336 DOI: 10.7759/cureus.65699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2024] [Accepted: 07/29/2024] [Indexed: 09/04/2024] Open
Abstract
Mercury, a ubiquitous heavy metal, poses a significant threat to human health. Intravenous mercury poisoning is an uncommon but critical medical emergency. The nature and severity of its toxic effects depend on the form of mercury encountered: elemental, inorganic, or organic. It can affect almost all organ systems in the body. Chelating agents are the primary treatment for symptomatic mercury poisoning. This case report is about a 27-year-old male patient who presented to the emergency department with an alleged history of intravenous injection of mercury as an attempt at suicide, followed by breathlessness, chest pain, vomiting, and high-grade fever. He was managed with chelating therapy, non-invasive ventilation, and other supportive measures and was discharged home. After five days of discharge, he presented with fever and rashes and was diagnosed with toxic epidermal necrolysis (TEN). In spite of all aggressive management, he succumbed to death after four days of re-admission. Early intervention can significantly improve the chances of recovery. However, even with successful treatment, some individuals may experience long-term complications.
Collapse
Affiliation(s)
- Preethy Koshy
- Emergency Medicine, Datta Meghe Institute of Higher Education and Research, Jawaharlal Nehru Medical College, Wardha, IND
| | - Rajshree Devi Seram
- Emergency Medicine, Datta Meghe Institute of Higher Education and Research, Jawaharlal Nehru Medical College, Wardha, IND
| | - Aditya Pundkar
- Orthopedics, Datta Meghe Institute of Higher Education and Research, Jawaharlal Nehru Medical College, Wardha, IND
| |
Collapse
|
2
|
Magdalan J, Sozański T, Nowak K, Zawadzki M. Acute intranasal intoxication with mercuric chloride taken accidently instead of cocaine - A case report. J Forensic Leg Med 2021; 78:102129. [PMID: 33581407 DOI: 10.1016/j.jflm.2021.102129] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 01/22/2021] [Accepted: 01/31/2021] [Indexed: 11/26/2022]
Abstract
CONTEXT Mercuric chloride (mercury (II) chloride) belongs to inorganic mercury compounds characterized by good water solubility and associated high toxicity. The paper describes an unusual case of intranasal intoxication with corrosive sublimate confused with cocaine by a young male. CASE REPORT Intranasal administration of corrosive sublimate caused severe local symptoms of chemical burn within the nasal cavity. From the 2nd day the patient developed symptoms of renal dysfunction with transient polyuria and serum retention of nitrogen metabolites. The patient was undergoing chelation therapy with DMPS, N-acetylcysteine and d-penicyllamine. Four procedures of haemodialysis were performed with simultaneous DMPS and N-acetylcysteine treatment. The urine mercury level on the first day of hospitalization was 1989 μg/L, and after 26 days of treatment returned to the physiological level. During treatment renal function was normalized, the patient was discharged in general good condition. DISCUSSION Mercuric chloride is readily absorbed from the nasal cavity. Its administration may cause intoxication manifested by both chemical burn at the exposure site and systemic symptoms, particularly renal impairment. Even in case of renal dysfunction the use of DMPS seems safe, if haemodialysis is performed at the same time. Simultaneous haemodialysis and chelation therapy may accelerate elimination of mercury from the organism.
Collapse
Affiliation(s)
- Jan Magdalan
- Department of Toxicology and Internal Medicine, Lower Silesia Specialist Hospital T. Marciniak in Wrocław, Fieldorfa 2, Wrocław, PL 54-049, Poland; Department of Pharmacology, Wroclaw Medical University, Jana Mikulicza-Radeckiego 2, Wrocław, PL 50-345, Poland
| | - Tomasz Sozański
- Department of Pharmacology, Wroclaw Medical University, Jana Mikulicza-Radeckiego 2, Wrocław, PL 50-345, Poland
| | - Karolina Nowak
- Institute of Toxicology Research, Kasztanowa 45, Borowa, PL 55-093, Poland
| | - Marcin Zawadzki
- Department of Forensic Medicine, Wroclaw Medical University, Mikulicza-Radeckiego 4, Wroclaw, PL 50-345, Poland.
| |
Collapse
|
3
|
Vianna ADS, Matos EPD, Jesus IMD, Asmus CIRF, Câmara VDM. Human exposure to mercury and its hematological effects: a systematic review. CAD SAUDE PUBLICA 2019; 35:e00091618. [PMID: 30758455 DOI: 10.1590/0102-311x00091618] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 10/25/2018] [Indexed: 02/06/2023] Open
Abstract
Mercury is a metal found in the environment from natural and anthropogenic sources. It is highly toxic to ecosystems and living beings. Most human exposures come from ingestion of contaminated seafood, outgassing from dental amalgam or occupational exposure (e.g. gold mining), among other cases. Large populations are exposed to mercury, making it a very important issue from the public health perspective. Adverse health effects are commonly seen in the nervous system, but every organ is a potential target, such as the bone marrow. The main goal of this study was to assess the available evidence on human exposure to mercury and its hematological effects. A search strategy was constructed, including key terms (MeSH, text word and equivalents) for querying 2 repositories of master dissertation and PhD thesis (Fiocruz/ARCA and University of São Paulo) and 4 different electronic databases: BVS/LILACS, MEDLINE/PubMed, Scopus and TOXLINE/NIH, for articles published from 1950 to February 2018. There was no language restriction and a tool (EPHPP) was used to assess the quality of included studies. According to pre-established criteria, 80 studies were retrieved, all of them observational (48 case reports, 24 cross-sectional, 6 case series and 2 cohorts), comprising 9,284 people. Despite the fact that most exposed ones (6,012) had normal blood cell count and mercury hematological effects did not seem very usual (1,914 cases: 14 severe and 29 deaths), three studies reported association (β) for anemia, lymphopenia, neutrophilia and basophilia. We concluded that the gathered information pointed to mercury hematotoxic effects, some of them may be serious and even fatal.
Collapse
Affiliation(s)
| | | | | | - Carmen Ildes Rodrigues Fróes Asmus
- Instituto de Estudos de Saúde Coletiva, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil.,Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Volney de Magalhães Câmara
- Instituto de Estudos de Saúde Coletiva, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil.,Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| |
Collapse
|
4
|
Abstract
RATIONALE Metallic mercury poisoning through intravenous injection is rare, especially for a homicide attempt. Diagnosis and treatment of the disease are challenging. PATIENT CONCERNS A 34-year-old male presented with pyrexia, chill, fatigue, body aches, and pain of the dorsal aspect of right foot. Another case is that of a 29-year-old male who committed suicide by injecting himself metallic mercury 15 g intravenously and presented with dizzy, dyspnea, fatigue, sweatiness, and waist soreness. DIAGNOSIS The patient's condition in case 1 was deteriorated after initial treatment. Imaging studies revealed multiple high-density spots throughout the body especially in the lungs. On further questioning, the patient's girlfriend acknowledged that she injected him about 40 g mercury intravenously 11 days ago. The diagnosis was then confirmed with a urinary mercury concentration of 4828 mg/L. INTERVENTIONS Surgical excision, continuous blood purification, plasma exchange, alveolar lavage, and chelation were performed successively in case 1. Blood irrigation and chelation therapy were performed in case 2. OUTCOMES The laboratory test results and organ function of the patient in case 1 gradually returned to normal. However, in case 2, the patient's dyspnea was getting worse and he finally died due to toxic encephalopathy and respiratory failure. LESSONS Early diagnosis and appropriate treatment are critical for intravenous mercury poisoning. It should be concerned about the combined use of chelation agents and other treatments, such as surgical excision, hemodialysis and plasma exchange in clinical settings.
Collapse
|
5
|
Medico legal aspects of self-injection of metallic mercury in cases of suicide or self-harming. J Forensic Leg Med 2017; 50:12-19. [DOI: 10.1016/j.jflm.2017.06.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 05/28/2017] [Accepted: 06/18/2017] [Indexed: 11/19/2022]
|
6
|
Pelclova D, Vlckova S, Bezdicek O, Vaneckova M, Urban P, Ridzon P, Diblik P, Navratil T, Klusackova P, Vlcek K, Benesova O, Trestik P, Homolka J, Zakharov S. Is Chelation Therapy Efficient for the Treatment of Intravenous Metallic Mercury Intoxication? Basic Clin Pharmacol Toxicol 2017; 120:628-633. [DOI: 10.1111/bcpt.12725] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2016] [Accepted: 11/28/2016] [Indexed: 12/28/2022]
Affiliation(s)
- Daniela Pelclova
- Department of Occupational Medicine; Charles University; First Medical Faculty and General University Hospital in Prague; Prague Czech Republic
| | - Stepanka Vlckova
- Department of Occupational Medicine; Charles University; First Medical Faculty and General University Hospital in Prague; Prague Czech Republic
| | - Ondrej Bezdicek
- Department of Neurology Charles University; First Medical Faculty and General University Hospital in Prague; Prague Czech Republic
| | - Manuela Vaneckova
- MR Unit; Department of Radiodiagnostics; Charles University; First Medical Faculty and General University Hospital in Prague; Prague Czech Republic
| | - Pavel Urban
- Department of Occupational Medicine; Charles University; First Medical Faculty and General University Hospital in Prague; Prague Czech Republic
- National Institute of Public Health; Centre for Industrial Hygiene and Occupational Medicine; Prague Czech Republic
| | - Petr Ridzon
- Department of Occupational Medicine; Charles University; First Medical Faculty and General University Hospital in Prague; Prague Czech Republic
| | - Pavel Diblik
- Department of Ophthalmology; Charles University; First Medical Faculty and General University Hospital in Prague; Prague Czech Republic
| | - Tomas Navratil
- J. Heyrovský Institute of Physical Chemistry of the CAS, CR v.v.i.; Prague Czech Republic
| | - Pavlina Klusackova
- Department of Occupational Medicine; Charles University; First Medical Faculty and General University Hospital in Prague; Prague Czech Republic
| | - Kamil Vlcek
- Department of Occupational Medicine; Charles University; First Medical Faculty and General University Hospital in Prague; Prague Czech Republic
| | - Olga Benesova
- Department of Internal Medicine; Hospital Kromeriz; Kromeriz Czech Republic
| | - Pavel Trestik
- Department of Internal Medicine; Hospital Kromeriz; Kromeriz Czech Republic
| | - Jiri Homolka
- 1st Department of Tuberculosis and Respiratory Diseases; First Faculty of Medicine; Charles University and General University Hospital in Prague; Prague Czech Republic
| | - Sergey Zakharov
- Department of Occupational Medicine; Charles University; First Medical Faculty and General University Hospital in Prague; Prague Czech Republic
| |
Collapse
|
7
|
Mercury: What's In It For Kids? CLINICAL PEDIATRIC EMERGENCY MEDICINE 2012. [DOI: 10.1016/j.cpem.2012.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
8
|
Malkani R, Weinstein JM, Kumar N, Victor TA, Bernstein L. Ataxia and cranial neuropathies from subcutaneously injected elemental mercury. Clin Toxicol (Phila) 2011; 49:334-6. [DOI: 10.3109/15563650.2011.566881] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
9
|
Jindal M, Garg GR, Mediratta PK, Fahim M. Protective role of melatonin in myocardial oxidative damage induced by mercury in murine model. Hum Exp Toxicol 2010; 30:1489-500. [DOI: 10.1177/0960327110391685] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study was designed to investigate the electrophysiological, hemodynamic and biochemical parameters of mercuric chloride and methylmercury exposure on cardiovascular functions and its modulation by melatonin in vivo. Wistar albino rats were divided into six group containing 10 animals each. Mercuric chloride (3.75 µM/L) in drinking water and methylmercury (0.5 mg/kg/day) through gavage, given for 1 month, induced a statistically significant increase ( p < 0.001) in left ventricular end diastolic pressure, blood and cardiac tissue mercury content and myocardial lipid peroxides compared to control. Significant attenuation ( p < 0.05) of baroreflex sensitivity and depletion of myocardial endogenous antioxidants ( p < 0.001) viz. Reduced glutathione (GSH) and superoxide dismutase (SOD) were also found in the mercury-exposed groups as compared to control group. Mercury exposure followed by subacute treatment with melatonin (4 µg/mL/day) in drinking water for 1 month significantly lowered ( p < 0.01) left ventricular end diastolic pressure and lipid peroxide levels and increased baroreceptor sensitivity ( p < 0.001) and also levels of GSH and SOD ( p < 0.001) as compared to mercury-exposed rats. The results of our study provide clear evidence that elevated oxidative stress and altered baroreflex mechanisms caused by mercury intoxication may be the contributing factors responsible for impairment of cardiovascular functions and melatonin may exhibit cardioprotective property against subacute heavy metal intoxication and enhance the antioxidant defense against mercury-induced oxidative myocardial injury in rats.
Collapse
Affiliation(s)
- Mitali Jindal
- Department of Pharmacology, University College of Medical Sciences & GTB Hospital, Delhi, India
| | - Gobind Rai Garg
- Department of Pharmacology, University College of Medical Sciences & GTB Hospital, Delhi, India
| | - Pramod Kumari Mediratta
- Department of Pharmacology, University College of Medical Sciences & GTB Hospital, Delhi, India
| | - Mohammad Fahim
- Department of Physiology, VP Chest Institute, Delhi, India
| |
Collapse
|
10
|
Tan A, Neo WT, Phua J. Images in radiology. An element of surprise. Mercury poisoning. Am J Med 2010; 123:910-2. [PMID: 20920692 DOI: 10.1016/j.amjmed.2010.06.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2009] [Revised: 06/09/2010] [Accepted: 06/09/2010] [Indexed: 11/25/2022]
Affiliation(s)
- Adeline Tan
- Department of Respiratory Medicine and Critical Care, National University Hospital, Singapore, Singapore.
| | | | | |
Collapse
|
11
|
Singh M, Patel M, Pepper T. Fine needle aspiration of a neck lump: a mercurial mystery. Br J Oral Maxillofac Surg 2010; 48:147-8. [DOI: 10.1016/j.bjoms.2009.05.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2009] [Indexed: 10/20/2022]
|
12
|
Pugach S, Clarkson T. Prenatal mercury exposure and postnatal outcome: clinical case report and analysis. Clin Toxicol (Phila) 2009; 47:366-70. [DOI: 10.1080/15563650902866911] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
13
|
Vallant B, Deutsch J, Muntean M, Goessler W. Intravenous injection of metallic mercury: case report and course of mercury during chelation therapy with DMPS. Clin Toxicol (Phila) 2009; 46:566-9. [DOI: 10.1080/15563650701725102] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
14
|
De Palma G, Mariotti O, Lonati D, Goldoni M, Catalani S, Mutti A, Locatelli C, Apostoli P. Toxicokinetics and toxicodynamics of elemental mercury following self-administration. Clin Toxicol (Phila) 2008; 46:869-76. [PMID: 18787993 DOI: 10.1080/15563650802136241] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Intravenous injection of mercury has seldom been reported, especially in cases of attempted suicide, and is associated with variable clinical outcomes. CASE REPORT A young woman came to our attention after self-injecting and ingesting mercury drawn from 37 thermometers. The patient suffered lung embolization complicated by adult respiratory distress syndrome (ARDS), toxic dermatitis, anemia, mild hepato-renal impairment, and died after 30 days. Mercury was monitored in biological fluids (blood, plasma, urine, and bronchoalveolar fluid) to study its toxicokinetics and to evaluate dose-effect relationships. Its urinary clearance significantly increased after a chelation challenge test with meso-2,3-dimercaptosuccinic acid (DMSA) (median values of 2.48 and 8.85 before and after the test, respectively, p < 0.05). CONCLUSIONS Mercury poisoning by intravenous injection is a clinical emergency, potentially leading to death. When injected, the element has a very slow clearance, mainly renal. Our data do not allow any conclusion about the effectiveness of chelation therapy.
Collapse
Affiliation(s)
- Giuseppe De Palma
- Department of Experimental and Applied Medicine, Section of Industrial Hygiene, University of Brescia, Brescia, Italy.
| | | | | | | | | | | | | | | |
Collapse
|
15
|
Eyer F, Felgenhauer N, Pfab R, Drasch G, Zilker T. Neither DMPS nor DMSA is Effective in Quantitative Elimination of Elemental Mercury After Intentional IV Injection. Clin Toxicol (Phila) 2008; 44:395-7. [PMID: 16809143 DOI: 10.1080/15563650600671795] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Intravenous injection of elemental mercury (Hg) is rare and considered relatively harmless. Treatment recommendations vary and the effectiveness of chelation therapy is controversial. CASE REPORT A 27-year-old man intravenously injected 1.5 mL of elemental Hg. Within 12 hours he became febrile, tachycardic and dyspneic. Physical examination was unremarkable. X-rays showed scattered radiodense deposits in the lung, heart, intestinal wall, liver and kidney. The serum Hg level on admission was 172 microg/L and peaked on day 6 at 274 microg/L. Cumulative renal elimination during a five day oral treatment period with 2,3-dimercaptopropane-1-sulfonate (DMPS) and meso-2,3-dimercaptosuccinic acid (DMSA) was 8 mg and 3 mg, respectively. CONCLUSION Although urinary excretion could be enhanced during chelation therapy, Hg deposits in organs resulted in negligible elimination of mercury compared to the exposed dose.
Collapse
Affiliation(s)
- Florian Eyer
- Department of Toxicology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.
| | | | | | | | | |
Collapse
|
16
|
Gopalakrishna A, Pavan Kumar TV. Intravenous injection of elemental mercury: A report of two cases. Indian J Plast Surg 2008; 41:214-8. [PMID: 19753268 PMCID: PMC2740532 DOI: 10.4103/0970-0358.44942] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Two cases of intravenous injection of elemental mercury are described in this report. One patient succumbed and the other remains asymptomatic two years after the surgical removal of all the injected mercury. Management of intravenous injection of elemental mercury (intended to be an aphrodisiac in these two cases) is discussed here and the need for surgical removal of all accessible mercury has been emphasized.
Collapse
|
17
|
Intravenous and subcutaneous injection of mercury: an unusual self-injury. THE JOURNAL OF TRAUMA 2008; 66:E32-3. [PMID: 18277286 DOI: 10.1097/01.ta.0000219909.03256.64] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
18
|
Ragothaman M, Kulkarni G, Ashraf VV, Pal PK, Chickabasavaiah Y, Shankar SK, Govindappa SS, Satishchandra P, Muthane UB. Elemental mercury poisoning probably causes cortical myoclonus. Mov Disord 2007; 22:1964-8. [PMID: 17708573 DOI: 10.1002/mds.21641] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Mercury toxicity causes postural tremors, commonly referred to as "mercurial tremors," and cerebellar dysfunction. A 23-year woman, 2 years after injecting herself with elemental mercury developed disabling generalized myoclonus and ataxia. Electrophysiological studies confirmed the myoclonus was probably of cortical origin. Her deficits progressed over 2 years and improved after subcutaneous mercury deposits at the injection site were surgically cleared. Myoclonus of cortical origin has never been described in mercury poisoning. It is important to ask patients presenting with jerks about exposure to elemental mercury even if they have a progressive illness, as it is a potentially reversible condition as in our patient.
Collapse
Affiliation(s)
- Mona Ragothaman
- Department of Neurology, National Institute of Mental Health & Neurosciences, Bangalore, India
| | | | | | | | | | | | | | | | | |
Collapse
|
19
|
Abstract
A 14-year-old male milked the venom from a rattlesnake and injected it with a syringe into his right antecubital vein in a suicide attempt. He immediately developed severe pain and vomiting, then hypotension, swollen lips and tongue, and coma. The injection site did not have the considerable tissue damage seen with severe rattlesnake envenomation. Critical hematological abnormalities, gastrointestinal bleeding, and hematuria developed over 24 hours. He received crotalidae polyvalent immune fab (ovine) anti-venom and was discharged after 5 days without sequela. This patient's clinical findings were similar to those seen in patients bitten by rattlesnakes with rare intravenous envenomation.
Collapse
Affiliation(s)
- David L Morgan
- Central Texas Poison Center, and the Department of Emergency Medicine, Texas A&M University Health Sciences Center, Temple, TX 76508, USA.
| | | | | |
Collapse
|
20
|
Bhan A, Sarkar NN. Mercury in the environment: effect on health and reproduction. REVIEWS ON ENVIRONMENTAL HEALTH 2005; 20:39-56. [PMID: 15835497 DOI: 10.1515/reveh.2005.20.1.39] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Mercury is a heavy metal that is found naturally in the environment in various forms. Human activity can release mercury into the air, water, and soil. Mercury is also released into the environment after its conversion to methylmercury by bacteria. Mercury was once used in medicine, but the medicinal aspect changed because of its devastating poisoning effect on humans and animals. Today, mercury is one of the most potent neurotoxins known, having a number of adverse health effects in animals and humans. As the sources of mercury are many, the general population is exposed to mercury in day-to-day life, in occupational settings, and in cases of accidental exposure. In addition, ignorance about the use of mercury in cosmetics and religious materials has opened an additional source of exposure. Therefore, making people aware of mercury's effects on health, its sources of entry into the environment, and its chelating remedies becomes a necessity so that strategies can be adopted to minimize use and exposure.
Collapse
Affiliation(s)
- Ashima Bhan
- Department of Reproductive Biology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi-110029, India
| | | |
Collapse
|
21
|
Gordon AT. Short‐Term Elemental Mercury Exposures at Three Arizona Schools: Public Health Lessons Learned. ACTA ACUST UNITED AC 2004; 42:179-87. [PMID: 15214623 DOI: 10.1081/clt-120030944] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Acute exposure of schoolchildren to elemental mercury continues to produce public health crises that drain available health and environmental resources. In this retrospective study, we report three incidents of limited exposure to elemental mercury in Arizona schoolchildren. Health workers screened 347 students, family, and staff by history and physical exam for exposure level and symptomatology. Urine and blood mercury testing further evaluated at-risk individuals. Environmental contamination was also assessed. Despite up to 28% of patients reporting symptoms, no individual was found to have elevated serum or urinary mercury levels requiring treatment. Elevated airborne mercury levels were demonstrated in the classrooms, dormitories, buses, and student homes and appropriate clean-up measures were instituted. Previous studies of multiple exposures to elemental mercury either focus on significant patient morbidity or lack biological data. In contrast, this study reports biological and environmental data demonstrating no clinical toxicity following acute exposure in a large sample. Confirmatory studies are necessary to develop cost-effective guidelines for the appropriate management of these public health crises.
Collapse
Affiliation(s)
- Assaf T Gordon
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
| |
Collapse
|