Academic journal article Environmental Health Perspectives

A Review of Events That Expose Children to Elemental Mercury in the United States

Academic journal article Environmental Health Perspectives

A Review of Events That Expose Children to Elemental Mercury in the United States

Article excerpt

OBJECTIVE: Concern for children exposed to elemental mercury prompted the Agency for Toxic Substances and Disease Registry and the Centers for Disease Control and Prevention to review the sources of elemental mercury exposures in children, describe the location and proportion of children affected, and make recommendations on how to prevent these exposures. In this review, we excluded mercury exposures from coal-burning facilities, dental amalgams, fish consumption, medical waste incinerators, or thimerosal-containing vaccines.

DATA SOURCES: We reviewed federal, state, and regional programs with information on mercury releases along with published reports of children exposed to elemental mercury in the United States. We selected all mercury-related events that were documented to expose (or potentially expose) children. We then explored event characteristics (i.e., the exposure source, location).

DATA SYNTHESIS: Primary exposure locations were at home, at school, and at other locations such as industrial property not adequately remediated or medical facilities. Exposure to small spills from broken thermometers was the most common scenario; however, reports of such exposures are declining.

DISCUSSION AND CONCLUSIONS: Childhood exposures to elemental mercury often result from inappropriate handling or cleanup of spilled mercury. The information reviewed suggests that most releases do not lead to demonstrable harm if the exposure period is short and the mercury is properly cleaned up.

RECOMMENDATIONS: Primary prevention should include health education and policy initiatives. For larger spills, better coordination among existing surveillance systems would assist in understanding the risk factors and in developing effective prevention efforts.

KEY WORDS: children, elemental mercury, environmental health, exposure, United States. Environ Health Perspect 117:871-878 (2009). doi:10.1289/ehp.0800337 available via http://dx.doi.org/ [Online 12 January 2009]

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Mercury occurs naturally in the earth's crust. It exists in the environment as the result of natural processes and human activities. Mercury forms a dense, silvery liquid at room temperature (density = 13.534 g/[cm.sup.3]). Liquid mercury has a relatively low vapor pressure (0.0085 mmHg at 25[degrees]C) and volatilizes slowly at room temperature. If not managed properly, indoor mercury spills can release mercury into the air over weeks or even years [Agency for Toxic Substances and Disease Registry (ATSDR) 1999]. Heating mercury results in much higher, potentially lethal airborne mercury concentrations, especially in indoor spaces (Putman and Madden 1972; Solis et al. 2000; Taueg et al. 1992).

Although mercury may be ingested, it is poorly absorbed in the normal gastrointestinal tract [World Health Organization (WHO) 1991]. Dermal absorption of mercury is also a minor exposure pathway (Hursh et al. 1989). However, mercury vapor is readily absorbed by the lungs, making inhalation the exposure route of greatest concern. The ATSDR minimal risk level for chronic mercury inhalation is 0.2 [micro]g/[m.sup.3] (ATSDR 1999).

Health concerns. The health effects associated with acute elemental mercury exposure vary with the magnitude and duration of exposure. The potential health effects from inhaling high mercury concentrations (e.g., - 10,000 [micro]g/[m.sup.3]) are primarily respiratory [ATSDR 1999; U.S. Environmental Protection Agency (EPA) 2002] and include pneumonitis, bronchiolitis, pulmonary edema, and in some instances death. Exposure to mercury vapor (e.g., 10-100 [mirco]g/[m.sup.3]) over prolonged time periods can cause neurobehavioral effects, mood changes, and tremors. Chronic exposures are associated with hypertension and autonomic nervous system dysfunction (WHO 2003). Mercury exposure is also associated with acrodynia (painful extremities), a rare hypersensitivity reaction to mercury (Caravati et al. …

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