Inhalational mercury toxicity from artisanal gold extraction reported to the Oregon poison center, 2002–2015

Noble, Matthew J.; Decker, Stewart L.; Horowitz, B. Zane

doi:10.1080/15563650.2016.1199029

Cited by 6 publications

(4 citation statements)

References 9 publications

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“…Elemental mercury toxicity is a rare condition which can occur after exposure to mercury‐containing devices including thermometers, barometers, batteries, and older sphygmomanometers 2 . Intoxication may also result from the use of elemental mercury in spiritual practices or rituals, including Santeria and Voodoo, as well as occupational endeavors such as gold mining and extraction 3,4 . The clinical presentation of elemental mercury intoxication is often nonspecific in nature and may be easily misdiagnosed.…”

Section: Introductionmentioning

confidence: 99%

“…as occupational endeavors such as gold mining and extraction. 3,4 The clinical presentation of elemental mercury intoxication is often nonspecific in nature and may be easily misdiagnosed. The signs and symptoms of elemental mercury intoxication are distinctly different from the clinical effects of other forms of mercury intoxication; inorganic mercury toxicity results in gastrointestinal and neurological symptoms, while organic dimethylmercury exposure is associated with delayed cerebellar damage which is often fatal.…”

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confidence: 99%

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Characteristics and treatment of elemental mercury intoxication: A case series

Johnson‐Arbor

Tefera

Farrell³

2021

Health Science Reports

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Background and aims Elemental mercury toxicity is a rare condition which can be difficult to diagnose due to its nonspecific signs and symptoms. The purpose of this investigation is to describe the presenting characteristics and treatment of adult and pediatric patients with elemental mercury poisoning. Methods A retrospective review was performed in six patients with elemental mercury exposure or intoxication who were treated in an outpatient medical toxicology clinic. Clinical signs and symptoms, laboratory assessments, and public health responses were reviewed. Results Headache, anorexia, rash, and personality changes were commonly reported symptoms in pediatric patients; the adult patients were asymptomatic or reported signs and symptoms included myalgias, tremors, and hypertension. Delays in diagnosis were common. Symptomatic patients had 24‐hour urine mercury concentrations greater than 20 mcg/L. Treatment, including removal from the exposure source as well as chelation with dimercaptosuccinic acid, resulted in resolution of signs and symptoms within 6 months of diagnosis. Conclusion The evaluation and treatment of patients with suspected elemental mercury poisoning frequently require a multidisciplinary approach including medical toxicologists and public health officials. A heightened awareness of the clinical presentations of this condition, as well as early identification and removal of patients from the source of exposure and consideration of chelation therapy, can result in accelerated patient recovery.

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Section: Introductionmentioning

confidence: 99%

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confidence: 99%

Characteristics and treatment of elemental mercury intoxication: A case series

Johnson‐Arbor

Tefera

Farrell³

2021

Health Science Reports

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“…A report from the Oregon Poison Center database from 2002 to 2015 identified 9 cases of mercury inhalation exposures, age range 32 to 81 years, 89% male, with 2 patients (29%) with severe pulmonary toxicity that required intubation. 17 The most recent report of acute mercury poisoning with associated ARDS, acute respiratory failure, and chemical pneumonitis after home gold and silver smelting was in a 59-year-old man in Iowa with a confirmed blood mercury level of 86 mg/L (reference value, <10 mg/L). 18 If inhalational mercury vapor exposure results in ARDS, early chelation treatment with penicillamine, dimercaprol (British Anti-Lewisite), 2,3-dimercapto-1propanesulfonic acid, or DMSA can accelerate the urinary excretion of mercury and decrease blood mercury concentrations.…”

Section: Clinical Discussionmentioning

confidence: 99%

An Unusual Cause of Severe Hypoxemia and Acute Respiratory Distress Syndrome

Hammerling

Kanters

Jacobs

et al. 2020

Chest

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Case Presentation A 50-year-old man with a medical history of coronary artery disease, polysubstance abuse, and a remote smoking history presented with a 3-day history of dyspnea and chest pain. Physical examination was notable for diffuse wheezing in all lung fields. Diagnostic laboratory testing revealed a white blood count of 16.1 Â 10 9 /L, with arterial blood gas pH 7.5, PaCO 2 29 mm Hg, and PaO 2 179 mm Hg (FIO 2 1.0 nonrebreather facemask). Initial chest radiograph demonstrated diffuse bilateral opacities in a pulmonary edema pattern without focal consolidation. There were no effusions, lobar/lung collapse, or nodules. He reported a recent history of attempts to purify gold with mercury on his porch with an electric pottery kiln. He was admitted to hospital and treated with supplemental oxygen and systemic steroids. He gradually improved, weaned off supplemental oxygen, and was discharged 5 days later.

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“…Occupational exposure to elemental Hg is common among workers that inappropriately handled the elemental mercury. Contaminated individuals presented symptoms such as skin rash, pruritus, myalgia, sleep disturbance fatigue, insomnia, nightmares, anxiety disorder and elevated hair, urine and blood Hg levels (Schuurs 1999;Mostafazadeh et al 2013;Noble et al 2016;Do et al 2017). In addition, there are cases of accidental or even intentional contamination with Hg 0 (Florentine and Sanfilippo 1991;Gul Oz et al 2012;Gao et al 2017).…”

Section: Inorganic Elemental Mercurymentioning

confidence: 99%

Neurodevelopmental Effects of Mercury

Oliveira

Nogara

Ardisson-Araújo

et al. 2018

Linking Environmental Exposure to Neurodevelopmental Disorders

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The toxicology of mercury (Hg) is of concern since this metal is ubiquitously distributed in the environment, and living organisms are routinely exposed to Hg at low to high levels. The toxic effects of Hg are well studied and it is known that they may differ depending on the Hg chemical species. In this chapter, we emphasize the neurotoxic effects of Hg during brain development. The immature brain is more susceptible to Hg exposure, since all the Hg chemical forms, not only the organic ones, can harm it. The possible consequences of Hg exposure during the early stages of development, the additive effects with other co-occurring neurotoxicants, and the known mechanisms of action and targets will be addressed in this chapter.

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Inhalational mercury toxicity from artisanal gold extraction reported to the Oregon poison center, 2002–2015

Abstract: Artisanal gold extraction may be associated with inhalational mercury toxicity, including elevated blood mercury concentrations and acute hypoxic lung injury requiring intubation.

Cited by 6 publications

References 9 publications

Characteristics and treatment of elemental mercury intoxication: A case series

Characteristics and treatment of elemental mercury intoxication: A case series

An Unusual Cause of Severe Hypoxemia and Acute Respiratory Distress Syndrome

Neurodevelopmental Effects of Mercury

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