![]() Currently, all vaccines recommended for childhood immunizations are free of thimerosal as a preservative. Medical equipment (e.g., sphygmomanometers)Ĭommon organic sources of mercury, although not the subject of this article, include methyl mercury, most commonly found in fish caught in contaminated waters, and thimerosal, a mercury-based preservative that was, until recently, used in some vaccines 5 and that is metabolized to ethylmercury and thiosalicylate. TABLE 1 Where can children commonly find elemental mercury? 2 Elemental mercury is also used in dental amalgam, which is generally not considered a clinically significant source of exposure. Elemental mercury is commonly used in electrical switches, fluorescent and mercury vapor lamps, thermometers, barometers, indoor gas meter regulators, equipment gauges, and hospital equipment such as blood pressure monitors, esophageal dilators, and weighted feeding tubes. Today, the many uses of elemental mercury make it easy for children and teenagers to find (Table 1). It has also been used by Mexican-American and Asian populations in folk remedies, and by Latin-American and Caribbean natives in religious and cultural practices that still take place in certain communities in the United States. Mercury was used to embalm corpses because of its antimicrobial and antifungal properties. ![]() According to legend, the first Chinese emperor, Qin Shi Huang (259≢10), was entombed with his sarcophagus afloat in a pool of mercury. The expression "mad as a hatter" came from the exposure of 19th century hat makers to mercury that was used as a fixative. The term "quack" has its origin in the treatment of syphilis with quicksilver (mercury). 1 It has been used as a cathartic, diuretic, antipruritic, anti-inflammatory, antimicrobial, and antiparasitic agent. People have been fascinated by mercury for thousands of years, using it in medicine, industry, and cultural practices. This article was written to address questions most commonly asked by physicians about liquid mercury exposure, to raise awareness about this problem among pediatricians, and to provide information about initial management of spills. Their questions take on great urgency when a mercury spill occurs: In a recent event, for example, more than 1,000 people were evacuated from their homes, many for several days, and more than 100 area children were examined at local hospitals and clinics and an unknown number at physicians' offices. The ATSDR receives many inquiries from physicians who do not know how to evaluate exposed patients. Hazardous Substances Emergency Events Surveillance, an ongoing event-based survey conducted in 14 states by the Department of Health and Human Service's Agency for Toxic Substances and Disease Registry (ATSDR), received reports of 405 mercury spills in the six-year period 1993 to 1998. The precise number of incidents is unknown because reporting is not mandated by law. Sporadic reports of spills of elemental mercury to federal public health authorities have increased dramatically in recent years (Figure 1), reflecting greater access to expert assistance in such cases. The vast majority of those thermometers were believed to contain mercury. ![]() In 1999, the most recent year for which reporting statistics are available, poison control centers in the United States received more than 19,000 calls from Americans whose thermometers broke, according to the Georgia Poison Center. The fact remains, however, that mercury is a poison that can terminate human life.Īlthough no national statistics exist on the prevalence of mercury poisoning, what limited data are available suggest that mercury exposure occurs with considerable frequency among all age groups and in all geographic regions of the United States. Mercury is especially attractive to adolescents, who have been known to rub it on their skin and hair to take on the physical appearance of the silvery villain in the motion picture Terminator 2. Even adults amuse themselves with mercuryboiling it so that it jumps in the pan, throwing it against walls to see it dribble down, and coating it on cigarettes to revel in the colorful sparks created. Mercury is an amusing and attractive silvery liquid that appeals to children, who love to play with the shiny beads. Mercuryit's not hard to find Physical properties and toxicity Clinical manifestations and evaluation Responding to an exposure A deadly plaything By Sherlita Amler, MDįaced with a child who has been exposed to mercury, would you recognize the signs and symptoms? Would you know what questions to ask, which lab tests to draw, and what treatment to initiate? Would you know what to advise parents about a mercury spill at home?
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