ObjectiveConcern for children exposed to elemental mercury prompted the Agency for Toxic Substances and Disease Registry and the Centers for Disease Control and Prevention to review the sources of elemental mercury exposures in children, describe the location and proportion of children affected, and make recommendations on how to prevent these exposures. In this review, we excluded mercury exposures from coal-burning facilities, dental amalgams, fish consumption, medical waste incinerators, or thimerosal-containing vaccines.Data sourcesWe reviewed federal, state, and regional programs with information on mercury releases along with published reports of children exposed to elemental mercury in the United States. We selected all mercury-related events that were documented to expose (or potentially expose) children. We then explored event characteristics (i.e., the exposure source, location).Data synthesisPrimary exposure locations were at home, at school, and at other locations such as industrial property not adequately remediated or medical facilities. Exposure to small spills from broken thermometers was the most common scenario; however, reports of such exposures are declining.Discussion and conclusionsChildhood exposures to elemental mercury often result from inappropriate handling or cleanup of spilled mercury. The information reviewed suggests that most releases do not lead to demonstrable harm if the exposure period is short and the mercury is properly cleaned up.RecommendationsPrimary prevention should include health education and policy initiatives. For larger spills, better coordination among existing surveillance systems would assist in understanding the risk factors and in developing effective prevention efforts.
Concern for children exposed to elemental mercury prompted the Agency for Toxic Substances and Disease Registry and the Centers for Disease Control and Prevention to review the sources of elemental mercury exposures in children, describe the location and proportion of children affected, and make recommendations on how to prevent these exposures. In this review, we excluded mercury exposures from coal-burning facilities, dental amalgams, fish consumption, medical waste incinerators, or thimerosal-containing vaccines. We reviewed federal, state, and regional programs with data on mercury releases along with published reports of children exposed to elemental mercury in the United States. We selected all mercury-related events that were documented to expose (or potentially expose) children. Primary exposure locations were at home, at school, and at others such as industrial property not adequately remediated or medical facilities. Exposure to small spills from broken thermometers was the most common scenario; however, reports of such exposures are declining. The information reviewed suggests that most releases do not lead to demonstrable harm if the exposure period is short and the mercury is properly cleaned up. Primary prevention should include health education and policy initiatives.
The Division of Toxicology, Agency for Toxic Substances and Disease Registry (ATSDR) has a Congressional mandate to develop toxicological profiles for chemicals of greatest concern at hazardous waste sites. These chemical profiles provide a comprehensive evaluation and interpretation of the health effects, chemical and physical properties, production and use, potential for human exposure, analytical methodologies, and regulations and advisories for those chemicals. In addition, these profiles identify critical gaps in the knowledge base for these chemicals and identify levels of significant human exposure. Health assessors and other public health officials use this information to make critical decisions regarding the potential for adverse health effects at hazardous waste sites and other chemical-release events through such activities as public health assessments, chemical-specific and health-specific consultations, health-guidance-value derivations, database development, and emergency response actions. In a previous paper, we provided an overview of six specific public-health activities conducted by the ATSDR Division of Toxicology and examined how these activities have made unique impacts on public health policy and service. In this paper, we follow up on two of these, ATSDR polychlorinated biphenyls (PCBs) activities and ATSDR mercury activities, and examine their long-term, continually evolving impacts on public health policy and service.
The Agency for Toxic Substances and Disease Registry (ATSDR) is the lead agency within the U.S. Department of Health and Human Services (HHS) for providing support to the federal response to releases of hazardous substances in the environment. Since the Comprehensive Environmental Response Compensation and Liability Act was passed and amended, ATSDR has represented HHS on the National Response Team (NRT). The NRT role, and the subsequently established National Response System, are described in the National Contingency Plan for Oil and Hazardous Substances Releases (Title 40 Code of Federal Regulations, Section 300). As part of the National Response System, ATSDR can be called when a hazardous substance is released. Consistently, one of the most common substances ATSDR is called about is mercury, usually elemental mercury. This presentation will provide some background statistics on these calls and some general response options. Several specific cases that have occurred in the last few years will be reviewed. These reviews will deal less with remedial options than with describing common issues that arose, issues unique to the specific case, and the impact of that case on the community. A brief discussion of risk communication issues and ATSDR's response to those issues concludes the presentation.
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