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Mercury Toxicity

from www.drcranton.com

THE MAJOR CLINICAL TOXICOLOGY OF MERCURY*

Variable

Mercury Vapor

Inorganic Divalent Mercury

Methyl Mercury

Ethyl Mercury

Common Route of exposure

Inhalation

Oral

Oral (eating fish)

Parenteral (preservative in vaccines)

Principal Target Organ

Brain, peripheral nerves, kidneys

Kidney

Brain

Brain, kidney

LOCAL SYMPTOMS

6

6

6

6

Lung

Bronchitis, pneumonitis (>1,000 mcg/M3 air)

Digestive

tract

Metallic taste, stomatitis, gingivitis, increased salivation (>1,000 mcg/M3 air)

Metallic taste, stomatitis, gastroenteritis

Skin

Hives, blisters

SYSTEMIC SYMPTOMS

6

6

6

6

Kidney

Proteinuria

Proteinuria, tubular necrosis

Proteinuria

Nervous system

Peripheral neuropathy (>500 mcg/M3 air)

Painful, pink extremities (Acrodynia)

Painful, pink extremities (Acrodynia)

Brain

Irritability, tremor (>500 mcg/M3 air)

Abnormal sensations, Loss of balance, visual and hearing loss  (>200 mcg/L blood)

Abnormal sensations, Loss of balance, visual and hearing loss

Half-time in the body without  treatment

60 days

40 days

70 days

20 days†

Treatment§

DMSA by mouth

DMSA by mouth

DMSA by mouth, but chelators do not reverse damage§

DMSA by mouth, but chelators do not reverse damage§

* Data were adapted from Gossel and Bricker.(4)

Clinical manifestations vary with the degree and length of exposure. The values in parentheses are the approximate range of mercury concentration in air (expressed as micrograms per cubic meter) and in blood (expressed as micrograms per liter) associated with the onset of clinical signs and symptoms. Epidemiologic studies that did not use specific end points such as IQ score indicate a risk of adverse effects (approximately 5 percent) at lower concentrations (e.g., 25 to 50 µg of mercury vapor per cubic meter and 40 µg of methyl mercury per liter of blood are associated with an increased risk of prenatal damage to the developing central nervous system).(3,5) In general, the atmospheric concentration of mercury vapor equals the urinary concentration. The mean urinary concentration in the U.S. general population is 0.72 µg per liter (95 percent confidence interval, 0.6 to 0.8), and the mean blood concentration is 0.34 µg per liter (95 percent confidence interval, 0.3 to 0.4).(6)  In Europe (7) and other parts of the world,(8) blood concentrations appear to be somewhat higher. The mean urinary concentrations increase according to the number of dental amalgam surfaces, and blood concentrations increase according to the level of fish consumption.(6) No reliable data are available on the concentration of inorganic divalent mercury associated with adverse effects.

† The half-life of ethyl mercury in blood is about 20 days in adults, but may be as short as 7 days in infants.

‡ Details of meso-2,3-dimercaptosuccinic acid (DMSA) treatment have been published. (9-11)

§ Chelators can remove methyl and ethyl mercury from the body; they cannot reverse damage that has already occured to the brain and central nervous system. They may, however, prevent further deterioration. (12)

references

1. Toxicological profile for mercury. Atlanta: Agency for Toxic Substances DiseaseRegistry, 1999.

2. Evaluation of certain food additives and contaminants: twenty-second report of the Joint FAO/WHO Expert Committee on Food Additives. World Health Organ Tech Rep Ser 1978;631:1-39.

3. Environmental Protection Agency. Reference dose for chronic oral exposure to methylmercury. Greenbelt, Md.: Integrated Risk Information System, 2001.

4. Gossel TA, Bricker JD. Principles of clinical toxicology. 2nd ed. New York: Raven Press, 1990.

5. Inorganic mercury. Vol. 118 of Environmental health criteria. Geneva: World Health Organization, 1991.

6. Second national report on human exposure to environmental chemicals. Atlanta: Centers for Disease Control and Prevention, 2003. (Accessed October 6, 2003, at http://www.cdc.gov/exposurereport/ )

7. Brune D, Nordberg GF, Vesterberg O, Gerhardsson L, Wester PO. A review of normal concentrations of mercury in human blood. Sci Total Environ 1991;100:235-82.

8. Methylmercury. Vol. 101 of Environmental health criteria. Geneva: World Health Organization, 1990.

9. Forman J, Moline J, Cernichiari E, et al. A cluster of pediatric metallic mercury exposure cases treated with meso-2,3-dimercaptosuccinic acid (DMSA). Environ Health Perspect 2000;108:575-7.

10. Bluhm RE, Bobbitt RG, Welch LW, et al. Elemental mercury vapour toxicity, treatment, and prognosis after acute, intensive exposure in chloralkali plant workers. I. History, neuropsychological findings and chelator effects. Hum Exp Toxicol 1992;11:201-10.

11. Nierenberg DW, Nordgren RE, Chang MB, et al. Delayed cerebellar disease and death after accidental exposure to dimethylmercury. N Engl J Med 1998;338:1672-6.

12. Pfab R, Muckter H, Roider G, Zilker T. Clinical course of severe poisoning with thiomersal. J Toxicol Clin Toxicol 1996;34:453- 60.

Click here for a more complete list of references

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Sand Rocks Pebbles

A philosophy professor stood before his class and had some items in front of him. When class began, wordlessly he picked up a large empty mayonnaise jar and proceeded to fill it with rocks right to the top, rocks about 2″ diameter. He then asked the students if the jar was full? They agreed that it was. So the professor then picked up a box of pebbles and poured them in to the jar. He shook the jar lightly.

The pebbles, of course, rolled into the open areas between the rocks. The students laughed

He asked his students again if the jar was full?

They agreed that yes, it was.The professor then picked up a box of sand and poured it into the jar. Of course, the sand filled up everything else.

“Now,” said the professor, “I want you to recognize that this is your life. The rocks are the

important things – your family, your partner, your health, your children – anything that is so important to you that if it were lost, you would be nearly destroyed.

The pebbles are the other things in life that matter, but on a smaller scale. The pebbles represent things like your job, your house and your car.

The sand is everything else. The small stuff. If you put the sand or the pebbles into the jar first, there is no room for the rocks. The same goes for your life. If you spend all your energy and time on the small stuff, material things, you will never have room for the things that are truly most important.

Pay attention to the things that are critical in your life. Play with your children. Take your partner out dancing. There will always be time to go to work, clean the house, give a dinner party and fix the disposal.”

Take care of the rocks first – the things that really matter.

Set your priorities. The rest is just pebbles and sand.

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A Hill Side Thaw

A Hillside Thaw

To think to know the country and now know
The hillside on the day the sun lets go
Ten million silver lizards out of snow!
As often as I’ve seen it done before
I can’t pretend to tell the way it’s done.
It looks as if some magic of the sun
Lifted the rug that bred them on the floor
And the light breaking on them made them run.
But if I though to stop the wet stampede,
And caught one silver lizard by the tail,
And put my foot on one without avail,
And threw myself wet-elbowed and wet-kneed
In front of twenty others’ wriggling speed,–
In the confusion of them all aglitter,
And birds that joined in the excited fun
By doubling and redoubling song and twitter,
I have no doubt I’d end by holding none.

It takes the moon for this. The sun’s a wizard
By all I tell; but so’s the moon a witch.
From the high west she makes a gentle cast
And suddenly, without a jerk or twitch,
She has her speel on every single lizard.
I fancied when I looked at six o’clock
The swarm still ran and scuttled just as fast.
The moon was waiting for her chill effect.
I looked at nine: the swarm was turned to rock
In every lifelike posture of the swarm,
Transfixed on mountain slopes almost erect.
Across each other and side by side they lay.
The spell that so could hold them as they were
Was wrought through trees without a breath of storm
To make a leaf, if there had been one, stir.
One lizard at the end of every ray.
The thought of my attempting such a stray!

Robert Frost

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The Younger Son

The Younger Son

by Robert Service

If you leave the gloom of London and you seek a glowing land,
Where all except the flag is strange and new,
There’s a bronzed and stalwart fellow who will grip you by the hand,
And greet you with a welcome warm and true;
For he’s your younger brother, the one you sent away
Because there wasn’t room for him at home;
And now he’s quite contented, and he’s glad he didn’t stay,
And he’s building Britain’s greatness o’er the foam.

When the giant herd is moving at the rising of the sun,
And the prairie is lit with rose and gold,
And the camp is all a busstle, and the busy day’s begun,
He leaps into the saddle sure and bold.
Through the round of heat and hurry, through the racket and the rout,
He rattles at a pace that nothing mars;
And when the night-winds whisper and camp-fires flicker out,
He is sleeping like a child beneath the stars.

When the wattle-blooms are drooping in the somber shed-oak glade,
And the breathless land is lying in a swoon,
He leaves his work a moment, leaning lightly on his spade,
And he hears the bell-bird chime the Austral noon.
The parakeets are silent in the gum-tree by the creek;
The ferny grove is sunshine-steeped and still;
But the dew will gem the myrtle in the twilight ere he seek
His little lonely cabin on the hill.

Around the purple, vine-clad slope the argent river dreams;
The roses almost hide the house from view;
A snow-peak of the Winterberg in crimson splendor gleams;
The shadow deepens down on the karroo.
He seeks the lily-scented dusk beneath the orange tree;
His pipe in silence glows and fades and glows;
And then two little maids come out and climb upon his knee,
And one is like the lily, one the rose.
He sees his white sheep dapple o’er the green New Zealand plain,
And where Vancouver’s shaggy ramparts frown,
When the sunlight threads the pine-gloom he is fighting might and main
To clinch the rivets of an Empire down.
You will find him toiling, toiling, in the south or in the west,
A child of nature, fearless, frank, and free;
And the warmest heart that beats for you is beating in his breast,
And he sends you loyal greeting o’er the sea.

You’ve a brother in the army, you’ve another in the Church;
One of you is a diplomatic swell;
You’ve had the pick of everything and left him in the lurch,
And yet I think he’s doing very well.
I’m sure his life is happy, and he doesn’t envy yours;
I know he loves the land his pluck has won;
And I fancy in the years unborn, while England’s fame endures,
She will come to bless with pride — The Younger Son.

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