![]() Other sources of organic mercury exposures include contaminated grain seeds (where the organic mercury compound can be used as a fungicide) and in the laboratory setting. Methylmercury, a short chain compound, is the most commonly encountered organic mercury and exposure is primarily through seafood consumption. Organic mercury exists as short chain alkyl-mercury compounds and long chain aryl-mercury compounds. Ingestion is the most common source of exposure and is typically intentional though they also can occur through herbal preparations and traditional medicines. In the past, these notorious inorganic mercury compounds were used as treatment for many ailments such as syphilis and even as teething medications. Inorganic mercury is typically encountered as mercuric oxide, mercuric sulfide (cinnabar), mercurous chloride (calomel), or mercuric chloride (corrosive sublimate). A similar but less deadly increase in volatilization of elemental mercury can occur if attempts are made to use a vacuum to clean up spills on floors or carpets. Frequently this involves heating the metallic mercury which dramatically increases the mercury vapor content in the air and is well reported to cause fatalities. Rarer, but potentially more deadly, are exposures that result from home metallurgy use of metallic mercury. Exposure to the amount of elemental mercury typically found in a broken thermometer is not usually medically significant. Exposures to elemental mercury are typically via inhalation and are most common in the occupational setting but children are frequently exposed via broken thermometers and thermostats. It is present in three distinct forms in the environment: elemental, inorganic, and organic.Įlemental or metallic mercury is unique among all metals in that it is a liquid (“quicksilver”) at room temperature. Mercury is a naturally occurring element. What role does laboratory evaluation play in mercury toxicity?.What toxicity does each form of mercury cause and by what route of exposure?.What are the different forms of mercury?. ![]() The treating physician is calling asking for recommendations for treatment and disposition of this patient. A chest x-ray was done and read as normal. Her laboratory values in the emergency department are normal, including kidney function. The patient complains of rash to her face and arms, generalized fatigue, and a dry cough for several weeks. The patient states she was exposed to mercury via a broken thermostat. Case presentationĪn emergency physician calls the Poison Control Center because a patient has been referred to the emergency department for the complaint of “mercury poisoning” and has a laboratory print out detailing a whole blood mercury level of 1208 mcg/L (normal 0-10 mcg/L). Chelation can be considered but its indications and benefits are not clear. The treatment of mercury toxicity relies on cessation of the exposure and good supportive care. The evaluation of mercury exposure and toxicity is equally confusing as the limitations of laboratory testing must be appreciated. ![]() Further complicating the picture is that mercury has deleterious effects on many organic systems, ranging from the brain to the kidney to the skin. ingestion), and distinctly different pathological effects (acute vs. The toxicology of mercury (Hg) is complex due to the presences of different states (elemental, inorganic, and organic), different routes of exposure (inhalation vs. Mercury remains a common heavy metal exposure as it can be found in both the home and industrial setting.
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