Consumption of food containing mercury has been identified as a health risk. The U.S. Environmental Protection Agency (U.S. EPA) and the National Academy of Sciences recommend keeping the whole blood mercury level < 5.0 microg/L or the hair level < 1.0 microg/g. This corresponds to a reference dose (RfD) of 0.1 microg/kg body weight per day. All patients in a 1-year period (n = 720) who came for an office visit in a private internal medicine practice in San Francisco, California, were evaluated for mercury excess using the current RfD. One hundred twenty-three patients were tested (93 females, 30 males). Of these, data were statistically analyzed for 89 subjects. Mercury levels ranged from 2.0 to 89.5 microg/L for the 89 subjects. The mean for 66 women was 15 microg/L [standard deviation (SD) = 15], and for 23 men was 13 microg/L (SD = 5); 89% had levels exceeding the RfD. Subjects consumed 30 different forms or types of fish. Swordfish had the highest correlation with mercury level. Sixty-seven patients with serial blood levels over time after stopping fish showed a decline in mercury levels; reduction was significant (p < 0.0001). A substantial fraction of patients had diets high in fish consumption; of these, a high proportion had blood mercury levels exceeding the maximum level recommended by the U.S. EPA and National Academy of Sciences. The mean level for women in this survey was 10 times that of mercury levels found in a recent population survey by the U.S. Centers for Disease Control and Prevention. Some children were > 40 times the national mean.

IntroductionAsians, Pacific Islanders, and Native Americans are a potentially high-risk group for dietary exposure to methylmercury through fish consumption. However, blood mercury levels in this group have not been identified in recent reports of the National Health and Nutrition Examination Survey (NHANES) for the years 1999–2002.MethodsWe used NHANES data from 1999–2002 to obtain population estimates of blood mercury levels among women of childbearing age classified as belonging to the “other” racial/ethnic group (Asian, Pacific Islander, Native American, and multiracial; n = 140). Blood mercury levels in this group were compared with those among all other women participants, classified as Mexican American, non-Hispanic black, non-Hispanic white, and “other” Hispanic.ResultsAn estimated 16.59 ± 4.0% (mean ± SE) of adult female participants who self-identified as Asian, Pacific Islander, Native American, or multiracial (n = 140) had blood mercury levels ≥5.8 μg/L, and 27.26 ± 4.22% had levels ≥3.5 μg/L. Among remaining survey participants (n = 3,497), 5.08 ± 0.90% had blood mercury levels ≥5.8 μg/L, and 10.86 ± 1.45% had levels ≥3.5 μg/L.ConclusionsStudy subjects in NHANES who self-identified as Asian, Pacific Islander, Native American, or multiracial had a higher prevalence of elevated blood mercury than all other racial/ethnic participants in the survey. Future studies should address reasons for the high mercury levels in this group and explore possible interventions for lowering risk of methylmercury exposure in this population.

Fish is a valuable source of nutrition, and many people would benefit from eating fish regularly. But some people eat a lot of fish, every day or several meals per week, and thus can run a significant risk of overexposure to methylmercury. Current advice regarding methylmercury from fish consumption is targeted to protect the developing brain and nervous system but adverse health effects are increasingly associated with adult chronic low-level methylmercury exposure. Manifestations of methylmercury poisoning are variable and may be difficult to detect unless one considers this specific diagnosis and does an appropriate test (blood or hair analysis). We provide information to physicians to recognize and prevent overexposure to methylmercury from fish and seafood consumption. Physicians are urged to ask patients if they eat fish: how often, how much, and what kinds. People who eat fish frequently (once a week or more often) and pregnant women are advised to choose low mercury fish.

Mercury cell chlor-alkali products are used to produce thousands of other products including food ingredients such as citric acid, sodium benzoate, and high fructose corn syrup. High fructose corn syrup is used in food products to enhance shelf life. A pilot study was conducted to determine if high fructose corn syrup contains mercury, a toxic metal historically used as an anti-microbial. High fructose corn syrup samples were collected from three different manufacturers and analyzed for total mercury. The samples were found to contain levels of mercury ranging from below a detection limit of 0.005 to 0.570 micrograms mercury per gram of high fructose corn syrup. Average daily consumption of high fructose corn syrup is about 50 grams per person in the United States. With respect to total mercury exposure, it may be necessary to account for this source of mercury in the diet of children and sensitive populations.

Myofascial pain as assessed by tender trigger points and 25(OH)D deficiency showed a significant association with cancer, adenomatous colon polyps, and tendon rupture. Further studies to verify these results are needed, especially in areas where there is low magnesium in the drinking water.