Public Health Department Response to Mercury Poisoning: The Importance of Biomarkers and Risks and Benefits Analysis for Chelation Therapy

Abstract

Chelation therapy is often used to treat mercury poisoning. Public health personnel are often asked about mercury toxicity and its treatment. This paper provides a public health department response to use of a mercurycontaining cosmetic in Minnesota, a perspective on two unpublished cases of chelation treatment for postulated mercury toxicity, and comments on the use of a nonsystemic treatment for removal of mercury following the Iraqi seed coat poisoning incident. Physicians should evaluate sources of exposure, biomarkers, and risks and benefits before recommending chelation therapy for their patients. Potential risks to chelation therapy and its little understood subtle or latent effects are areas of public health concern.

Medical Toxicology Case Presentations: to Chelate or Not to Chelate, Is that the Question?

“…As detailed in the first case above, and elsewhere in this issue [11], metal toxicity occurs in the setting of extraordinary exposure. Dr. Jeffrey Brent, one of the panelists, stated that although this woman initially had concerns about her health condition, that concern "has been inappropriately changed to being concerned about mercury toxicity, The job of the practitioner is to redirect her away from that and to go back to addressing her initial concerns, assuming her belief systems have not become fixed…" & The role of testing for heavy metals:…”

Clinical management of chronic mercury intoxication secondary to skin lightening products: A proposed algorithm

“…However, chelation therapy should not be used as a universal treatment in chronic mercury intoxication as harmful adverse reaction may occur due to reactivation of toxic metals and removal of essential elements because chelators are not metal-specific [ 42 , 43 ]. Furthermore, the precise and latent effects due to chelation therapy are not yet established [ 42 ]. The clinical benefit of chelating agents is uncertain according to some studies [ 42 , 44 ].…”

“…Furthermore, the precise and latent effects due to chelation therapy are not yet established [ 42 ]. The clinical benefit of chelating agents is uncertain according to some studies [ 42 , 44 ]. Proper assessments in terms of sources of mercury exposure, symptoms and signs, lab investigations, and risks and benefits of chelation are crucial before the commencement of chelation therapy [ 42 , 43 ].…”