What are the common symptoms of mercury poisoning. How does mercury enter the human body. What are the long-term health risks associated with mercury exposure. How can mercury poisoning be prevented.

Understanding Mercury and Its Toxic Nature

Mercury, a naturally occurring heavy metal, is highly toxic to humans even in small amounts. While limited exposure is generally considered safe, the accumulation of mercury in the body can lead to severe health complications. Mercury exists as a liquid at room temperature and readily vaporizes, making it easy to inhale or ingest unknowingly.

Industrial processes, such as coal burning for power generation, often release mercury as a by-product. This vaporized mercury can contaminate rain, soil, and water sources, posing risks to plants, animals, and humans. Understanding the sources and risks associated with mercury exposure is crucial for prevention and early detection of mercury poisoning.

What makes mercury so dangerous to human health?

Mercury’s toxicity stems from its ability to interfere with cellular processes and damage various organ systems, particularly the nervous system. It can cross the blood-brain barrier and accumulate in brain tissue, leading to neurological symptoms. Additionally, mercury can bind to proteins in the body, disrupting their normal functions and potentially causing long-term health effects.

Common Symptoms of Mercury Poisoning

Mercury poisoning can manifest in various ways, depending on the level and duration of exposure. Recognizing these symptoms is crucial for early diagnosis and treatment.

Neurological Symptoms

• Nervousness or anxiety
• Irritability or mood changes
• Numbness
• Memory problems
• Depression
• Physical tremors

Physical Symptoms in Adults

• Muscle weakness
• Metallic taste in the mouth
• Nausea and vomiting
• Lack of motor skills or feeling uncoordinated
• Inability to feel in the hands, face, or other areas
• Changes in vision, hearing, or speech
• Difficulty breathing
• Difficulty walking or standing straight

Symptoms in Children

Mercury poisoning can have particularly devastating effects on children’s development. Common symptoms in children include:

• Impaired motor skills
• Problems thinking or problem-solving
• Difficulties learning to speak or understanding language
• Issues with hand-eye coordination
• Being physically unaware of their surroundings

It’s important to note that mercury poisoning typically develops slowly over time with frequent exposure. However, in some cases, symptoms can appear suddenly, especially after a specific incident of high exposure.

Primary Sources of Mercury Exposure

Understanding the common sources of mercury exposure is essential for prevention. While seafood consumption is the most frequent cause, there are several other potential sources to be aware of.

Mercury in Seafood

Consuming seafood contaminated with methylmercury is the most common cause of mercury poisoning in humans. Methylmercury, a highly toxic form of mercury, forms when mercury dissolves in water and is absorbed by sea creatures. It bioaccumulates up the food chain, with larger predatory fish often containing higher levels of mercury.

Other Sources of Mercury Exposure

• Industrial processing
• Thermometers and blood pressure machines
• Dental work (amalgam fillings)
• Old paints
• Certain types of light bulbs
• Some traditional medicines and cosmetics

Long-Term Health Risks of Mercury Poisoning

Exposure to high levels of mercury can lead to severe long-term health complications, affecting various body systems.

Neurological Damage

Prolonged mercury exposure can cause significant neurological damage, with effects potentially more pronounced in developing children. A study in the Journal of Preventive Medicine and Public Health highlighted several long-term neurological effects of mercury poisoning:

• Intelligence disorders and low IQ
• Slow reflexes
• Damaged motor skills
• Paralysis
• Numbness
• Problems with memory and concentration
• Symptoms resembling ADHD

Reproductive Effects

Mercury poisoning can have serious implications for the reproductive system, affecting both males and females. Potential effects include:

• Reduced sperm count
• Decreased fertility
• Fetal deformities
• Decreased fetal survival rate
• Reduced growth and size of newborns

Cardiovascular Risks

Mercury promotes the accumulation of free radicals in the body, increasing the risk of cellular damage. This oxidative stress can lead to various cardiovascular problems, including:

• Increased risk of heart attack
• Higher likelihood of coronary heart disease
• Potential damage to blood vessels

Preventing Mercury Poisoning

While complete avoidance of mercury exposure is challenging in the modern world, there are several steps individuals can take to minimize their risk of mercury poisoning.

Dietary Considerations

1. Choose low-mercury seafood options: Opt for fish like salmon, tilapia, and cod, which typically have lower mercury levels.
2. Limit consumption of high-mercury fish: Reduce intake of large predatory fish such as shark, swordfish, king mackerel, and tilefish.
3. Stay informed about local fish advisories: Check for warnings about mercury levels in locally caught fish.
4. Diversify protein sources: Include a variety of protein sources in your diet beyond seafood.

Environmental Precautions

1. Proper disposal of mercury-containing products: Ensure proper disposal of items like old thermometers, fluorescent light bulbs, and batteries.
2. Avoid mercury in the workplace: If you work in an industry that uses mercury, follow safety protocols and wear protective equipment.
3. Be cautious with dental amalgams: Discuss alternatives to mercury-containing dental fillings with your dentist.
4. Check household items: Be aware of potential mercury sources in your home and replace them with safer alternatives when possible.

Stay Informed and Vigilant

Educate yourself about potential sources of mercury exposure in your environment and lifestyle. Regular health check-ups can help detect early signs of mercury poisoning, especially if you’re in a high-risk group or occupation.

Diagnosis and Treatment of Mercury Poisoning

Diagnosing mercury poisoning can be challenging due to the similarity of its symptoms to other conditions. However, early detection and treatment are crucial for preventing long-term health effects.

Diagnostic Methods

• Blood tests: Measure current mercury levels in the bloodstream
• Urine tests: Indicate mercury levels over time
• Hair analysis: Can show mercury exposure over several months
• Physical examination: Assess neurological function and other symptoms

Treatment Approaches

Treatment for mercury poisoning typically involves removing the source of exposure and supporting the body’s natural detoxification processes. In severe cases, chelation therapy may be used to remove mercury from the body.

1. Elimination of exposure: Identify and remove the source of mercury contamination
2. Supportive care: Treat symptoms and provide nutritional support
3. Chelation therapy: Administration of chelating agents to bind and remove mercury from the body
4. Monitoring: Regular testing to track mercury levels and assess treatment effectiveness

It’s important to note that treatment should be conducted under close medical supervision, as some treatments, like chelation therapy, can have side effects.

Global Efforts to Reduce Mercury Pollution

Recognizing the global threat of mercury pollution, international organizations and governments have initiated various programs and agreements to reduce mercury emissions and protect human health.

The Minamata Convention on Mercury

This global treaty, which entered into force in 2017, aims to protect human health and the environment from anthropogenic emissions and releases of mercury and mercury compounds. Key provisions include:

• Banning new mercury mines and phasing out existing ones
• Reducing or eliminating the use of mercury in various products and processes
• Controlling mercury emissions to air and releases to land and water
• Regulating the informal sector of artisanal and small-scale gold mining

National and Regional Initiatives

Many countries have implemented their own regulations and programs to reduce mercury use and emissions:

• Banning or phasing out mercury-containing products
• Implementing stricter emissions controls on coal-fired power plants
• Improving waste management practices for mercury-containing products
• Promoting public awareness about mercury risks and safe handling

These global and national efforts are crucial in reducing overall mercury pollution and protecting public health. However, individual awareness and action remain essential in minimizing personal exposure to this toxic metal.

Emerging Research and Future Directions

As our understanding of mercury toxicity grows, researchers continue to explore new aspects of its effects on human health and potential treatment strategies.

Genetic Susceptibility to Mercury Toxicity

Recent studies suggest that genetic factors may influence an individual’s susceptibility to mercury poisoning. Researchers are investigating genetic variations that affect mercury metabolism and detoxification, which could explain why some people are more sensitive to mercury exposure than others.

Novel Detoxification Methods

Scientists are exploring new approaches to mercury detoxification, including:

• Phytoremediation: Using plants to absorb and detoxify mercury from soil and water
• Nanotechnology: Developing nanoparticles that can selectively bind and remove mercury from the body
• Probiotic treatments: Investigating the potential of certain bacteria to aid in mercury detoxification

Long-term Health Impacts

Ongoing research is focusing on the long-term health impacts of chronic, low-level mercury exposure, which may be more common than acute poisoning. Areas of interest include:

• Neurodegenerative diseases: Potential links between mercury exposure and conditions like Alzheimer’s and Parkinson’s
• Autoimmune disorders: Investigating the role of mercury in triggering or exacerbating autoimmune responses
• Epigenetic effects: Studying how mercury exposure might affect gene expression across generations

These emerging areas of research hold promise for improving our ability to prevent, detect, and treat mercury poisoning, as well as understanding its broader impacts on public health.

The Role of Public Health Education in Mercury Poisoning Prevention

Effective public health education is crucial in preventing mercury poisoning and reducing overall exposure to this toxic metal. By raising awareness and providing practical guidelines, we can empower individuals to make informed decisions about their health and environment.

Key Components of Mercury Education Programs

1. Risk communication: Clearly explaining the sources and health risks of mercury exposure
2. Safe handling practices: Teaching proper methods for handling and disposing of mercury-containing products
3. Dietary guidance: Providing information on safe fish consumption and alternatives to high-mercury seafood
4. Environmental awareness: Educating about mercury pollution and its impact on ecosystems
5. Occupational safety: Offering specific guidance for workers in high-risk industries

Targeted Education Initiatives

Effective mercury education programs often target specific groups who may be at higher risk of exposure:

• Pregnant women and young children: Emphasizing the importance of avoiding mercury exposure during critical developmental periods
• Fishing communities: Providing guidance on safe fish consumption and local water body contamination levels
• Healthcare professionals: Ensuring they can recognize symptoms of mercury poisoning and provide appropriate care
• Industrial workers: Offering specialized training on occupational safety and proper handling of mercury-containing materials

By implementing comprehensive public health education programs, we can significantly reduce the incidence of mercury poisoning and promote overall environmental health. These efforts, combined with ongoing research and global initiatives, form a multi-faceted approach to addressing the challenges posed by mercury contamination in our modern world.

Mercury poisoning: Symptoms and early signs

Mercury poisoning is the result of being exposed to too much mercury, either through the diet or environment. Mercury is a heavy metal that is highly toxic to humans.

Consuming food that contains mercury is the most common cause of mercury poisoning. Mercury poisoning can cause severe symptoms and put the body at unnecessary risk.

A person can help prevent mercury poisoning by making changes to their diet and environment that limit exposure to the toxic metal.

Mercury is a naturally occurring metal that is in many everyday products, albeit in tiny amounts. While this limited exposure is usually considered safe, a buildup of mercury is highly dangerous.

Mercury is a liquid at room temperature and readily vaporizes into the air around it. It is often a by-product of industrial processes, such as burning coal for power. Vaporized mercury can make its way into the rain, soil, and water, where it poses a risk to plants, animals, and humans.

Ingesting or coming into contact with too much mercury can cause symptoms of mercury poisoning.

Mercury may affect the nervous system, leading to neurological symptoms such as:

• nervousness or anxiety
• irritability or mood changes
• numbness
• memory problems
• depression
• physical tremors

As the levels of mercury in the body rise, more symptoms will appear. These symptoms may vary depending on a person’s age and exposure levels. Adults with mercury poisoning may experience symptoms such as:

• muscle weakness
• metallic taste in the mouth
• nausea and vomiting
• lack of motor skills or feeling uncoordinated
• inability to feel in the hands, face, or other areas
• changes in vision, hearing, or speech
• difficulty breathing
• difficulty walking or standing straight

Mercury can also affect a child’s early development. Children with mercury poisoning may show symptoms such as:

• impaired motor skills
• problems thinking or problem-solving
• difficulties learning to speak or understanding language
• issues with hand-eye coordination
• being physically unaware of their surroundings

Mercury poisoning tends to develop slowly over time if a person comes into frequent contact with mercury. However, in some cases, mercury poisoning comes on quickly and is associated with a specific incident.

Anyone who experiences a sudden onset of mercury poisoning symptoms should call a doctor or poison control.

Exposure to high levels of mercury may also put a person at risk for long-term complications, including:

Neurological damage

Share on PinterestMercury poisoning may cause slow reflexes, damaged motor skills, and intelligence disorders.

High levels of mercury in the blood may put a person at risk for long-term neurological damage. These effects may be more pronounced in children who are still developing.

A study in the Journal of Preventive Medicine and Public Health noted that many incidents of mercury poisoning have led to long-term nerve damage, which can cause:

• intelligence disorders and low IQ
• slow reflexes
• damaged motor skills
• paralysis
• numbness
• problems with memory and concentration
• symptoms of ADHD

Reproductive effects

Mercury poisoning also poses a risk to the reproductive system. It may cause reduced sperm count or decreased fertility and may also cause problems with the fetus.

Possible effects of mercury poisoning include deformity and a decreased survival rate of the fetus, and reduced growth and size of the newborn at birth.

Cardiovascular risks

Mercury helps promote the accumulation of free radicals in the body, which puts the cells at risk for damage. This may lead to an increased risk of heart problems, including heart attack and coronary heart disease.

The most common cause of mercury poisoning is from eating seafood, but people can get mercury poisoning from industrial processing, thermometers and blood pressure machines, dental work, and old paints.

Mercury poisoning from seafood

Share on PinterestThe most common way for a human to have mercury poisoning is by eating seafood tainted with mercury.

Eating seafood that has been tainted with mercury is one of the most common ways humans accumulate mercury in their bodies. The mercury in seafood is a highly poisonous form of the metal called methylmercury, which forms when mercury dissolves into the water.

Methylmercury can be absorbed from the water by all sea creatures, but it also continues through the food chain.

Small sea creatures, such as shrimp, often ingest methylmercury and are then eaten by other fish. These fish will now have more methylmercury in them than the original shrimp.

This process continues all the way up the food chain, so that a large fish may contain much more mercury than the fish it has eaten. This does not necessarily make it better to eat smaller fish, however. It is always essential for a person to check the source of their seafood to avoid contaminated fish and shellfish.

People worried about their exposure to mercury may want to limit their seafood intake, particularly of fish that are high on the food chain, such as swordfish, shark, white tuna, pike, walleye, and bass.

Pregnant or breast-feeding women may want to avoid or restrict their intake of fish and shellfish, as any mercury they contain can pass to the fetus or infant through the umbilical cord or breast milk.

Dental fillings

Amalgam fillings, commonly called silver fillings, contain approximately 40 to 50 percent mercury. Amalgam fillings are not often used now, as there are newer and safer alternatives.

Old fillings may increase a person’s risk for mercury exposure. Some people choose to replace their amalgam fillings to reduce their long-term exposure to mercury.

Other causes

Mercury poisoning may also be due to direct or environmental exposure. Mercury exposure may come from one or more of the following sources:

• mining for gold
• exposure to some types of jewelry
• exposure to older paints
• some vaccinations
• contact with a broken fever thermometer or older house thermometer
• toxic air in areas near factories that produce mercury as a by-product, such as coal plants

Some skin care products may also be tainted with mercury, though this is uncommon.

Doctors can usually diagnose mercury poisoning through a physical exam and blood tests. Doctors may ask about any symptoms the person is having, as well as for a general breakdown of their diet.

They may also ask questions about the environment the person lives or works in, including whether they live near any factories or work in an industrial plant.

If the doctor suspects mercury poisoning, a blood and or urine mercury test can gauge the levels of mercury in the body.

Mercury is toxic to humans. There is no standard cure for mercury poisoning, so it is best to avoid exposure to high amounts of mercury when possible.

Eliminating risk factors by making changes in the diet and work or living environment may help reduce the levels of mercury in the body.

It is essential to consult a doctor at the first sign of mercury poisoning, as it can have long-lasting effects. Parents and caregivers should also be aware of the signs of mercury poisoning in children and call a doctor if a child or infant displays any symptoms.

Mercury Information | Mount Sinai

This article discusses poisoning from mercury.

This article is for information only. DO NOT use it to treat or manage an actual poison exposure. If you or someone you are with has an exposure, call the local emergency number (such as 911), or the local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States.

Poisonous Ingredient

There are three different forms of mercury that cause health problems. They are:

• Elemental mercury, also known as liquid mercury or quicksilver
• Inorganic mercury salts
• Organic mercury

Where Found

Elemental mercury can be found in:

• Glass thermometers
• Electrical switches
• Fluorescent light bulbs
• Dental fillings
• Some medical equipment

Inorganic mercury can be found in:

• Batteries
• Chemistry labs
• Some disinfectants
• Folk remedies
• Red cinnabar mineral

Organic mercury can be found in:

• Older germ-killers (antiseptics) such as red mercurochrome (merbromin) (this substance is now banned by the FDA)
• Fumes from burning coal
• Fish that have eaten a form of organic mercury called methylmercury

There may be other sources of these forms of mercury.

Symptoms

ELEMENTAL MERCURY

Elemental mercury is usually harmless if it is touched or swallowed. It is so thick and slippery that it usually falls off the skin or leaves the stomach and intestines without being absorbed.

A lot of damage can occur, though, if elemental mercury gets into the air in the form of small droplets that are breathed into the lungs. This often occurs by mistake when people try to vacuum up mercury that has spilled onto the ground.

Breathing in enough elemental mercury will cause symptoms right away. These are called acute symptoms. Long-term symptoms will occur if small amounts are inhaled over time. These are called chronic symptoms. Chronic symptoms may include:

• Metallic taste in the mouth
• Vomiting
• Difficulty breathing
• Bad cough
• Swollen, bleeding gums

Depending on how much mercury is inhaled, permanent lung damage and death may occur. Long-term brain damage from inhaled elemental mercury can also occur.

There have been cases of mercury being injected under the skin, which can cause fever and rash. Infection may develop, requiring surgical drainage and removal of the mercury.

INORGANIC MERCURY

Unlike elemental mercury, inorganic mercury is usually poisonous when swallowed. Depending on how much is swallowed, symptoms may include:

• Burning in the stomach and throat
• Bloody diarrhea and vomiting

If inorganic mercury enters your bloodstream, it can attack the kidneys and brain. Permanent kidney damage and kidney failure may occur. A large amount in the bloodstream may cause massive blood and fluid loss from diarrhea and kidney failure, leading to death.

ORGANIC MERCURY

Organic mercury can cause sickness if it is breathed in, eaten, or placed on the skin over long periods of time. Usually, organic mercury causes problems over years or decades, not right away. This means that being exposed to small amounts of organic mercury every day for years will likely cause symptoms to appear later. A single large exposure, however, can also cause problems.

Long-term exposure will likely cause symptoms in the nervous system, including:

• Numbness or pain in certain parts of your skin
• Uncontrollable shaking or tremor
• Inability to walk well
• Blindness and double vision
• Memory problems
• Seizures and death (with large exposures)

Being exposed to large amounts of the organic mercury called methylmercury while pregnant may cause permanent brain damage in the baby. Most health care providers recommend eating less fish, especially swordfish, while pregnant. Women should talk to their provider about what they should and should not eat while pregnant.

Before Calling Emergency

Have this information ready:

• Person’s age, weight, and condition (for example, is the person awake and alert?)
• Source of the mercury
• Time it was swallowed, inhaled, or touched
• Amount swallowed, inhaled, or touched

Do not delay calling for help if you do not know the above information.

Poison Control

Your local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. This national hotline number will let you talk to experts in poisoning. They will give you further instructions.

This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

What to Expect at the Emergency Room

General treatment for mercury exposure includes the steps just below. Treatment for exposure to different forms of mercury are given after this general information.

The person should be moved away from the source of exposure.

The health care provider will measure and monitor the person’s vital signs, including temperature, pulse, breathing rate, and blood pressure.

Tests that may be done include:

• Blood and urine tests
• Chest x-ray
• ECG (electrocardiogram) or heart tracing

Treatment may include:

• Activated charcoal by mouth or tube through the nose into the stomach, if mercury is swallowed (under limited circumstances)
• Dialysis (kidney machine)
• Fluids through a vein (by IV)
• Medicine to treat symptoms

The type of exposure will determine what other tests and treatments are needed.

ELEMENTAL MERCURY

Inhaled elemental mercury poisoning may be difficult to treat. The person may receive:

• Humidified oxygen or air
• Breathing tube through the mouth into the lungs and use of a breathing machine (ventilator)
• Suctioning of mercury out of the lungs
• Medicine to remove mercury and heavy metals from the body
• Surgical removal of the mercury if injected under the skin

INORGANIC MERCURY

For inorganic mercury poisoning, treatment often begins with supportive care. The person may receive:

• Fluids by IV (into a vein)
• Medicines to treat symptoms
• Activated charcoal, a medicine that soaks up many substances from the stomach
• Medicines called chelators to remove mercury from the blood

ORGANIC MERCURY

Treatment for exposure to organic mercury usually consists of medicines called chelators. These remove mercury from the blood and move it away from the brain and kidneys. Often, these medicines will have to be used for weeks to months.

Outlook (Prognosis)

Breathing in a small amount of elemental mercury will cause very few, if any, long-term side effects. However, breathing in larger amounts can lead to a long hospital stay. Permanent lung damage is likely. There may be brain damage. Very large exposures will likely cause death.

A large overdose of inorganic mercury may cause massive blood and fluid loss, kidney failure, and likely death.

Chronic brain damage from organic mercury poisoning is difficult to treat. Some people never recover, but there has been some success in people who receive chelation treatment.

Mahajan PV. Heavy metal intoxication. In: Kliegman RM, St Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 738.

Theobald JL, Mycyk MB. Iron and heavy metals. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 151.

Last reviewed on: 7/5/2021

Reviewed by: Jacob L. Heller, MD, MHA, Emergency Medicine, Emeritus, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Mercury poisoning. What is mercury poisoning?

IMPORTANT
The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.

Mercury poisoning is an acute or chronic intoxication with a metallic variety of a given substance or its compounds (chloride, amidochloride, chlormerodrine). The main symptoms are vomiting, nausea, abdominal pain, stomatitis, proteinuria, hematuria, lethargy, drowsiness, cough. In chronic forms, encephalopathy, impaired coordination is observed. When making a diagnosis, the clinical signs of the disease and the results of atomic absorption spectrometry are evaluated. Treatment includes antidotes, general antitoxic measures, and metabolic therapy.

ICD-10

T56.1 Toxic effects of mercury and its compounds

• Causes
• Pathogenesis
• Classification
• Symptoms of mercury poisoning
  • Acute poisoning
  • Mercurialize
  • Micromercurialism
• Complications
• Diagnostics
• Treatment for mercury poisoning
  • First aid
  • Scheduled treatment
  • Recovery
• Prognosis and prevention
• Prices for treatment

General

Mercury poisoning (Hg) is a relatively rare pathology that often occurs in a chronic form. Regular long-term consumption of poison leads to damage to the tissues of the central nervous system, kidneys, lungs, liver, heart, and oral mucosa. Acute varieties occur mainly during industrial accidents, when a large amount of toxicant is released into the environment. A dose of 2.5 g of metal vapor taken by inhalation is considered lethal. MPC for the working area is 0.005 mg/m3, for residential air – 0.0003 mg/m3.

mercury poisoning

Causes

The main cause of chronic mercury intoxication is working in rooms with a high content of heavy metal fumes. Similar situations arise in the schlicho-enrichment industry, plants involved in the production of chlorine, alkalis, and high-purity metals. Acute mercury poisoning is the result of oral ingestion of mercury salts. In its pure form, the metal taken by mouth is not too toxic. Other possible reasons:

• Vapor leakage during laboratory experiments. May occur during use of equipment containing mercury. A common option is a broken thermometer. The xenobiotic contained in it is able to increase the concentration of vapors in the air up to 100-150 MPC. The problem may also arise from the use of other demonstration equipment containing mercury.
• Insecticides. Some formulations used to kill insects and pests contain mercury salts as an active ingredient. Violation of safety precautions when using them causes acute (less often chronic) exotoxicosis. The substance also accumulates in vegetables and fruits, which contributes to the occurrence of food poisoning.
• Medicinal preparations. Outdated medical products intended for the treatment of syphilis and gonorrhea were made on the basis of liquid metal salts. In patients treated with merkurbenzoate, symptoms of mercurialism were determined. Today, such medicines are not used in official medicine.
• Sea fish. The tissues of marine animals living in chemically polluted areas of the oceans are capable of accumulating Hg. Eating such food, a person daily receives a small amount of a poisonous substance. Over time, he develops signs of chronic intoxication. The food path of defeat is common among the inhabitants of Japan.
• Dental fillings. The installation of fillings containing amalgam was practiced until the beginning of the 2000s. At the moment, such technologies are no longer used on the territory of the Russian Federation, the United States, and the European Union. Mercury-based fillers continue to be used in some developing countries.
• Crime and suicide. For the purpose of murder or suicide, hydrargium salts are used, the lethal dose of which does not exceed 1 gram. Such cases were widespread in the VX-IX centuries. Today they are recorded extremely rarely, as more effective, fast-acting and non-marking poisons have appeared.

Pathogenesis

Mercury, entering the body, binds to the sulfhydryl groups of blood enzymes, blocking their activity. In addition, there is a violation of the biosynthesis of proteins and cellular ribonucleic acids. Target organs include the central nervous system, kidneys and liver, in which necrotic and dystrophic processes occur, and functional disorders develop. The lungs, cardiovascular apparatus, and muscles suffer somewhat less.

Mercury poisoning causes congenital malformations of the fetus. After birth, he has symptoms of prenatal damage: functional immaturity, malformations of the brain, excretion systems. Possible antenatal or early postnatal death, musculoskeletal defects, mental retardation. The teratogenic effect of the poison is more pronounced with mercurialism.

Classification

The disease is subdivided according to severity (severe, moderate, mild), causes (domestic, criminal, professional), type of damaging agent (metal mercury or its salts), the presence of complications (liver, kidney failure, encephalopathy). The most common classification criterion is the nature of the pathology:

• Acute mercury poisoning. It occurs due to the simultaneous intake of a large amount of a toxic substance into the body. It occurs during criminal intoxication, industrial accidents, inhalation of high concentration vapors. A similar variety is diagnosed in 18-20% of victims.
• Mercurialism. Variant of the chronic course of the disease. Symptoms of pathology are determined in people receiving small doses of Hg for a long time. It is often diagnosed in workers in industries that operate liquid metal, even if the necessary precautions are observed. The share in the overall structure of the disease is 30-32%.
• Micromercurialism. Signs of exotoxicosis are detected in patients who have been in contact with mercury compounds for 5-15 years. The reason is the regular intake of a xenobiotic microdose, which leads to its accumulation. It is characterized by a less specific course. Micromercurialism accounts for about 40% of the total number of mercury exotoxicoses.

Symptoms of mercury poisoning

Acute poisoning

In the acute variant of the course, the pathology is accompanied by the occurrence of abdominalgia, vomiting, nausea, diarrhea mixed with blood. On the part of the nervous system, drowsiness, depression, periods of psychomotor agitation are noted. The consequences of inhalation of vapors are cough, chest pain, hyperthermia. Perhaps the development of pulmonary edema with the appearance of moist rales, foam from the mouth, orthopnea, diffuse cyanosis, sweating.

Later diuresis decreases, renal failure is formed. Patients complain of a metallic taste in the mouth. On examination, salivation, rhinorrhea, swelling of the lymph nodes in the neck, bleeding gums are revealed. A dark border is visible on the gums, which is a specific evidence of pathology. Perhaps a decrease in the number of red blood cells, hemodynamic instability.

Mercurialize

With mercurialism, signs of damage to the nervous system come to the fore. The patient is determined by the presence of neurosis, frequent mood swings, in which depression is replaced by outbursts of irritability, aggression. There are psychosomatic phenomena, arterial dystonia. Some patients complain of visual impairment caused by papillary edema or optic nerve atrophy. Anisocoria, swallowing disorder, may be present.

Mercury poisoning, provoked by the intake of its chemically related forms, is accompanied by limb ischemia. Patients note the appearance of dark pink spots on the tips of the toes and hands. Nails, hair, teeth begin to fall out, skin itching occurs. Additional symptoms are impaired coordination, tremor, and a drop in muscle tone. During specialized tests, a decrease in skin sensitivity is detected.

Micromercurialism

It manifests itself as a set of non-specific events that are rarely associated with mercury consumption at the stage of initial diagnosis. There are signs of inflammatory diseases of the respiratory tract, a small tremor of the fingers on the hands, and a decrease in working capacity. Irritability, intolerance to interfering factors is determined. The clinical picture is mild, but progresses with time.

Complications

Possible complications include multiple organ failure, which is diagnosed in 37% of patients with an acute form of pathology. In 48% of patients, it develops after 10-20 years of regular intake of metal or its salts in tissues. Another common consequence of mercurialism is neurological changes, which often make a person disabled. About 38% of the victims have similar symptoms.

Inhalation of mercury vapor is accompanied by the development of pneumonia in 15-17% of patients, manifestations of toxic pulmonary edema are found in 20%. Approximately 10% of patients complain of problems with vision, hearing, tactile sensitivity. Almost all people who have suffered mercury poisoning note their own irascibility, frequent conflicts with others, and partial desocialization. This leads to difficulties in communicating with family and friends, management at work.

Diagnostics

One-stage mercury poisoning is diagnosed by an ambulance paramedic. The diagnosis is confirmed in the hospital, where the patient is assigned a series of laboratory and instrumental examinations. Consultations of the neurologist, gastroenterologist, therapist are required. Mercurialism is detected during the patient’s visit to a polyclinic or a poison control center. The following diagnostic methods are used:

• Physical. The skin is of normal color or pale, there are periods of increase and decrease in blood pressure. Muscle tone is inadequate. Heart sounds are muffled, rales can be heard in the lungs. Possible tachycardia. There are dark spots on the distal phalanges of the fingers, sometimes trophic ulcers are formed. On the oral mucosa there is a border, areas of bleeding.
• Laboratory. The content of mercury in the blood exceeds 5.8 µg/l. This indicator is determined using adsorption atomic spectrometry. Indirect evidence of mercurialism is eosinophilia, leukopenia, anemia, agranulocytosis. An increase in the activity of liver enzymes, creatinine, urea is possible.
• Hardware. When metallic Hg is ingested, it can be seen on x-rays of the intestines, and when administered intravenously, it can be seen in the vessels of the lungs. Computed and magnetic resonance imaging can detect changes in the parenchyma of the kidneys, liver, and cerebral tissues. ECG shows evidence of rhythm disturbance.

Treatment of mercury poisoning

Primary measures are standard for most poisonings. The victim should be removed from the zone of chemical contamination, provide fresh air, unfasten tight clothing. If the toxicant was taken orally, it is necessary to induce vomiting, rinse the stomach with a tubeless method. An exception is damage by mercury nitrate, which causes chemical burns. Chronic varieties do not require emergency pre-medical measures.

First Aid

It is carried out only in acute conditions. Symptomatic therapy aimed at correcting existing disorders is shown. Pulmonary edema requires the infusion of loop diuretics, sanitation of the respiratory tract, intubation of the victim. Convulsions are eliminated with the help of benzodiazepines, anticonvulsants. Severe psychomotor agitation is eliminated by the introduction of antipsychotic medications. Unithiol is used as an antidote.

Gastric lavage is carried out with the introduction of a probe. The working solution is pure water with the addition of crushed activated carbon. After the end of the procedure, the victim is allowed to swallow the adsorbent tablets, the amount of which should correspond to body weight. It is permissible to use weak solutions of food acids or sodium chloride to cleanse the stomach. This increases the efficiency of manipulation.

Planned treatment

The main method of therapy is demercurialization with unitiol. The drug forms low-toxic soluble compounds with Hg, which are excreted in the urine. The agent is prescribed in courses, the duration is 3-4 days, the interval is 1-4 months. The duration of treatment can be up to 1 year. Patients also receive kacarboxylase, multivitamins, nootropics, glucocorticoids, folic acid, d-penicillamine as an additional antidote.

Posindromic therapy is indicated. Muscle relaxants are recommended for patients with central hypertonicity and a tendency to convulsions, anabolic steroids are recommended for children with a lack of muscle mass. For the purpose of sedation, sedative medications are given, including herbal ones. ATP is used to maintain the work of the heart, hepatoprotectors are used for the liver. Renal insufficiency is an indication for hemodialysis.

Recovery

It may run for several years. The convalescent is recommended to follow a diet with a restriction of spicy, salty, fatty, high-protein foods. Table salt should be excluded in order to avoid the development of edema. Diuresis is subject to careful control. With a decrease in the daily volume of urine, the amount of fluid consumed is limited; diuretics are used as prescribed by the doctor. Any contact with the toxicant is excluded.

Prognosis and prevention

The prognosis for life is favorable. About 95% of people suffering from moderate or mild mercuryism overcome the 20-year survival threshold. In acute intoxication, mortality is 13-18%. Some residual symptoms persist throughout life in 67% of patients, some of them become disabled. The severity of the consequences is directly proportional to the amount of metal taken and the time of contact with it.

To prevent mercury poisoning, sanitary and hygienic standards should be strictly observed. In areas where work is carried out that requires the use of liquid metal, it is necessary to make regular measurements. If the MPC is exceeded, people must be evacuated, the contaminated zone is subject to chemical demercurialization using 20% ​​ferric chloride. Broken thermometers and other mercury-containing products must be handed over to special services.

You can share your medical history, what helped you in the treatment of mercury poisoning.

Sources

1. Clinical toxicology of children and adolescents / Markova I. V., Afanasiev V.V., Tsybulkin E.K. – 1999.
2. Fundamentals of toxicology / Tarasov A.V., Smirnova T.V. – 2006.
3. Intoxication of the human body with metallic mercury / Moiseenko V.G., Radomskaya V.I. and others – 2004.
4. This article was prepared based on the site: https://www.krasotaimedicina.ru/

IMPORTANT
The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.

Mercury in the blood

The test measures mercury in the blood to detect acute or chronic poisoning after contact with this element. Mercury can be inhaled in the form of vapors, penetrate the skin, or be ingested with food. Small amounts of mercury usually do not harm the body. However, prolonged contact with it or its high concentrations can cause complications.

Synonyms Russian

Alchemical Mercury.

Synonyms English

Mercury, Hydrargyrum, Hg, quicksilver.

Research method

Atomic absorption spectrometry (AAS).

Units

µg/l (micrograms per litre).

What biomaterial can be used for research?

Venous blood.

How to properly prepare for an examination?

• Do not eat for 2-3 hours before the test (you can drink pure non-carbonated water).
• Do not smoke for 30 minutes prior to examination.

General information about the study

Mercury is an element that exists in three forms.

1. The metal mercury (in liquid or gaseous form) is often used in dental fillings and in thermometers and batteries.
2. Mercury can form inorganic compounds (mercury salts) with other elements such as oxygen or sulfur. In this form, it occurs in crystalline form and is sometimes used in topical preparations such as skin lighteners or antiseptic creams.
3. Combining with carbon, mercury forms organic substances, the most common of which is methylmercury. Such substances are produced by bacteria that live in soil and water. Elevated levels of this form of mercury are often found in large predatory, older fish such as sharks and king mackerels.

Blood mercury test to diagnose acute poisoning or chronic mercury exposure.

Mercury occurs in small amounts in the environment. It is released as a result of the breakdown of rock and soil minerals, as well as a by-product of fuel combustion and garbage burning.

Mercury can be ingested from the air we breathe, through the skin or through food. The meager concentrations of this metal that most people encounter in everyday life do not pose a threat to health. However, its high content, for example, in toxic waste storages, as well as regular long-term contact with moderate amounts of it, as when working with heavy metals, can lead to poisoning.

The amount of mercury absorbed by the body and its effect on health depends on its type, concentration and duration of exposure. Very little mercury (less than 0.1%) enters the body, even if swallowed. However, if the same amount is inhaled along with the vapors, then about 80% enters the bloodstream.

The most common source of methylmercury entering the human body is contaminated seafood and fish. Moreover, through the digestive tract, methylmercury is absorbed almost completely (about 95%).

What is research used for?

• To detect excess mercury in the body.
• For diagnosing acute or chronic mercury poisoning (for example, when examining patients who are exposed to mercury in the workplace).
• For the detection of methylmercury. Other forms (metal and inorganic) can also be detected from a blood test, but the mercury will decrease every three days as it passes into internal organs such as the brain and kidneys. Therefore, the analysis must be carried out as soon as poisoning is suspected.

When is the test ordered?

• If mercury poisoning is suspected, to diagnose and assess its severity. Acute symptoms include burning in the mouth and lungs, coughing, shortness of breath, heaviness in the chest, decreased urination, nausea, vomiting, diarrhea, and rapid heartbeat. In chronic poisoning, non-specific signs may appear that affect the function of the lungs, kidneys and nervous system. In addition, sometimes there are problems with hearing, taste and smell, blurred vision or narrowing of the field of vision, tingling and trembling in the hands and feet, difficulty walking, irritability.
• Regularly when screening patients who work in a mercury recycling facility, and in conjunction with testing for lead and other heavy metals in patients who work with hazardous materials.

What do the results mean?

Reference values: 0.