Elemental Mercury Vapour Toxicity, Treatment, and Prognosis After Acute, Intensive Exposure in Chloralkali Plant Workers. Part II: Hyperchloraemia and Genitourinary Symptoms

Abstract

<jats:p> Exposure to elemental mercury vapour is known to influence renal function; however, severe renal disease has not been consistently identified. Eleven men were evaluated for renal disease after acute, massive mercury poisoning. Significant hyperchloraemia was identified in this group of patients and a reversible renal tubular defect was suggested by low normal serum bicarbonate, a normal serum anion gap and a positive urinary anion gap. The only other evidence of renal dysfunction was transient, mild proteinuria in one of the 11 patients. During this same time period, neuropsychological impairment was identified on a test of cognitive and visual-motor function, 'Trailmaking B', in seven of the 11 patients. Additionally, dysuria and ejaculatory pain occurred without evidence of urological disease. These complaints were more frequent in those patients with impairement on 'Trailmaking B' suggesting a neurological basis for these symptoms. The findings of this study support earlier observations that the brain rather than the kidney is the critical target organ after elemental mercury vapour exposure. </jats:p>

Heavy metal poisoning: management of intoxication and antidotes

“…A small amount of non-oxidized mercury vapor can penetrate the blood-brain barrier leading to central nervous system (CNS) toxicity in highdose exposures [48]. Inhaled vapor is largely eliminated in the urine with an elimination half-life of about 60 days [49]. Compared to the respiratory tract, GI absorption is negligible [50] and represents little risk for patients with intact GI mucosa [51].…”

Mechanisms involved in the transport of mercuric ions in target tissues

“…These include, but are not limited to, the cardiovascular (Carmignani et al 1992; Soni et al 1992; Wakita 1987; Wang et al 2000; Warkany and Hubbard 1953), gastrointestinal (Afonso and De Alvarez 1960; Bluhm et al 1992; Lundgren and Swensson 1949; Murphy et al 1979), neurological (Jaffe et al 1983; Lin and Lim 1993), hepatobiliary (Jaffe et al 1983; Murphy et al 1979; Samuels et al 1982), and renal (Murphy et al 1979; Rowens et al 1991; Samuels et al 1982) systems.…”

Safety of Dental Amalgam

“…When it does occur, the large dose of mercury vapor can cause acute pneumonitis, renal failure, seizures, and neurologic dysfunction. 34,69 The classic cases of mercury intoxication occur when mercury is spilled in a house or other enclosed area. [70][71][72][73] Typically, an aerosol of mercury vapor is created when vacuum cleaners are used to clean up the spill.…”

“…Chronic mercury toxicity commonly occurs in poorly ventilated areas where mercury is used in manufacturing. 6,69 Items such as electric relay switches, pesticides, furniture polish, bleaches, and vinyl chloride materials are potential sources for mercury contamination. Dental offices have the potential for chronic mercury vapor exposure.…”