Abstract
Two maritime academy interns (X and Y) were exposed to mercury vapor after spilling a bottle of mercury on the floor in an enclosed storeroom while doing inventory aboard an ore boat. During a 3-day period, intern Y suffered transient clinical intoxication that resolved after he was removed from the environment and he showered and discarded all clothing. His initial serum mercury level dropped from 4 ng/mL to < 0.05 ng/mL. Intern X had an initial level of 11 ng/mL, which continued to rise to a maximum of 188.8 ng/mL. He complained of tremulousness, insomnia, and mild agitation and was hospitalized. He had showered and discarded all clothing except his footwear earlier than intern Y. Intern X's continued exposure due to mercury in the contaminated boots during the 2 weeks before hospitalization was presumed to be the cause. Removing his footwear led to resolution of his toxic symptoms and correlated with subsequent lowered serum mercury levels. Chelation was initiated as recommended, despite its uncertain benefit for neurologic intoxication. Mercury is used in the merchant marine industry in ballast monitors called king gauges. New engineering is recommended for ballast monitoring to eliminate this hazard.
Full Text
The Full Text of this article is available as a PDF (159.7 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Aaseth J., Jacobsen D., Andersen O., Wickstrøm E. Treatment of mercury and lead poisonings with dimercaptosuccinic acid and sodium dimercaptopropanesulfonate. A review. Analyst. 1995 Mar;120(3):853–854. doi: 10.1039/an9952000853. [DOI] [PubMed] [Google Scholar]
- Buchet J. P., Lauwerys R. R. Influence of 2,3-dimercaptopropane-1-sulfonate and dimercaptosuccinic acid on the mobilization of mercury from tissues of rats pretreated with mercuric chloride, phenylmercury acetate or mercury vapors. Toxicology. 1989 Mar;54(3):323–333. doi: 10.1016/0300-483x(89)90067-x. [DOI] [PubMed] [Google Scholar]
- Cherry Debra, Lowry Larry, Velez Larissa, Cotrell Cindy, Keyes D. Christopher. Elemental mercury poisoning in a family of seven. Fam Community Health. 2002 Jan;24(4):1–8. doi: 10.1097/00003727-200201000-00003. [DOI] [PubMed] [Google Scholar]
- Cikrt M., Lenger V. Distribution and excretion of 203Hg2+ in rats after unitiol, spironolactone and polythiol resin treatment. Toxicol Lett. 1980 Jan;5(1):51–54. doi: 10.1016/0378-4274(80)90147-2. [DOI] [PubMed] [Google Scholar]
- Frumkin H., Manning C. C., Williams P. L., Sanders A., Taylor B. B., Pierce M., Elon L., Hertzberg V. S. Diagnostic chelation challenge with DMSA: a biomarker of long-term mercury exposure? Environ Health Perspect. 2001 Feb;109(2):167–171. doi: 10.1289/ehp.01109167. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Goyer R. A., Cherian M. G., Jones M. M., Reigart J. R. Role of chelating agents for prevention, intervention, and treatment of exposures to toxic metals. Environ Health Perspect. 1995 Nov;103(11):1048–1052. doi: 10.1289/ehp.951031048. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kostial K., Restek-Samarzija N., Blanusa M., Piasek M., Jones M. M., Singh P. K. Combined oral treatment with racemic and meso-2,3-dimercaptosuccinic acid for removal of mercury in rats. Pharmacol Toxicol. 1997 Nov;81(5):242–244. doi: 10.1111/j.1600-0773.1997.tb00054.x. [DOI] [PubMed] [Google Scholar]
- Letz R., Gerr F., Cragle D., Green R. C., Watkins J., Fidler A. T. Residual neurologic deficits 30 years after occupational exposure to elemental mercury. Neurotoxicology. 2000 Aug;21(4):459–474. [PubMed] [Google Scholar]
- Litovitz Toby L., Klein-Schwartz Wendy, Rodgers George C., Jr, Cobaugh Daniel J., Youniss Jessica, Omslaer Judith C., May Mary E., Woolf Alan D., Benson Blaine E. 2001 Annual report of the American Association of Poison Control Centers Toxic Exposure Surveillance System. Am J Emerg Med. 2002 Sep;20(5):391–452. doi: 10.1053/ajem.2002.34955. [DOI] [PubMed] [Google Scholar]
- Louwerse E. S., Buchet J. P., Van Dijk M. A., de Jong V. J., Lauwerys R. R. Urinary excretion of lead and mercury after oral administration of meso-2,3-dimercaptosuccinic acid in patients with motor neurone disease. Int Arch Occup Environ Health. 1995;67(2):135–138. doi: 10.1007/BF00572238. [DOI] [PubMed] [Google Scholar]
- Maiorino R. M., Gonzalez-Ramirez D., Zuniga-Charles M., Xu Z., Hurlbut K. M., Aposhian M. M., Dart R. C., Woods J. S., Ostrosky-Wegman P., Gonsebatt M. E. Sodium 2,3-dimercaptopropane-1-sulfonate challenge test for mercury in humans. III. Urinary mercury after exposure to mercurous chloride. J Pharmacol Exp Ther. 1996 May;277(2):938–944. [PubMed] [Google Scholar]
- Mercury toxicity. Agency for Toxic Substance and Disease Registry. Am Fam Physician. 1992 Dec;46(6):1731–1741. [PubMed] [Google Scholar]
- Netterstrøm B., Guldager B., Heebøll J. Acute mercury intoxication examined with coordination ability and tremor. Neurotoxicol Teratol. 1996 Jul-Aug;18(4):505–509. doi: 10.1016/0892-0362(96)00025-6. [DOI] [PubMed] [Google Scholar]
- Nierenberg D. W., Nordgren R. E., Chang M. B., Siegler R. W., Blayney M. B., Hochberg F., Toribara T. Y., Cernichiari E., Clarkson T. Delayed cerebellar disease and death after accidental exposure to dimethylmercury. N Engl J Med. 1998 Jun 4;338(23):1672–1676. doi: 10.1056/NEJM199806043382305. [DOI] [PubMed] [Google Scholar]
- Ozuah P. O. Mercury poisoning. Curr Probl Pediatr. 2000 Mar;30(3):91–99. doi: 10.1067/mps.2000.104054. [DOI] [PubMed] [Google Scholar]
- Roels H. A., Boeckx M., Ceulemans E., Lauwerys R. R. Urinary excretion of mercury after occupational exposure to mercury vapour and influence of the chelating agent meso-2,3-dimercaptosuccinic acid (DMSA). Br J Ind Med. 1991 Apr;48(4):247–253. doi: 10.1136/oem.48.4.247. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Sandborgh Englund G., Dahlqvist R., Lindelöf B., Söderman E., Jonzon B., Vesterberg O., Larsson K. S. DMSA administration to patients with alleged mercury poisoning from dental amalgams: a placebo-controlled study. J Dent Res. 1994 Mar;73(3):620–628. doi: 10.1177/00220345940730030701. [DOI] [PubMed] [Google Scholar]
- Sunderman F. W. Perils of mercury. Ann Clin Lab Sci. 1988 Mar-Apr;18(2):89–101. [PubMed] [Google Scholar]
- Torres-Alanís O., Garza-Ocañas L., Pineyro-Lopez A. Evaluation of urinary mercury excretion after administration of 2,3-dimercapto-1-propane sulfonic acid to occupationally exposed men. J Toxicol Clin Toxicol. 1995;33(6):717–720. doi: 10.3109/15563659509010636. [DOI] [PubMed] [Google Scholar]
- Wendroff A. P. Magico-religious mercury use and cultural sensitivity. Am J Public Health. 1995 Mar;85(3):409–410. doi: 10.2105/ajph.85.3.409. [DOI] [PMC free article] [PubMed] [Google Scholar]