Mercury Poisoning

Mercury Poisoning 04.09.2019
 Mercury Poisoning Essay

Mercury poisoning

Mercury poisoning

• There are three or more different kinds of mercury

- elemental

-- inorganic

- organic

• Each includes a different toxicological profile

Sources of mercury

• Elemental mercury:

• Sphygmomanometers, thermometers, barometers

• Liquefied at space temp – volatilises conveniently

• Inorganic mercury:

• Traditional remedies (ayurvedic, chinese)

• Employed in gold removal, caustic soft drinks manufacturing

• Rodenticides

• Organic mercury:

• Fungicides, seed dressings

• Methylmercury in seafood …

Mercury - Absorption

• Breathing:

• Dermal:

60-80%

3-15%

• GI Tract: Steel Inorganic 15%

Organic 90+%

Organic mercury poisoning:

Unusual … yet severe

• Exposure: consumption, topical or inhalation

• CNS Toxicity:

•poor attention, fatigue, ataxia, tremor, narrowed

visual domains,

•coma & convulsions

• BM reductions

• Reniforme toxicity - dealkylation to inorganic contact form

• Lesser response to treatment

Inorganic mercury poisoning

• Gastrointestinal phase: Hg2+ can be described as potent GI irritant

• gingivitis, stomatitis

- oesophageal, gastric, large and small bowel erosions

- haematemesis, bloody diarrhoea, CVS collapse

• Systemic toxicity: Hg2+ inhibits sulphydryl enzymes

• hypotension, lactic acidosis

• Nephrotoxicity: Hg2+ deposits inside the tubules  ATN

• acute reniforme failure

-- potentially causes CRF in survivors

Much needed Mercury

Circumstance 1: A 4 year old son has bitten the top of a

mercury thermometer and his mother thinks

he may have ingested it.

What would the advice become?

Little or no risk of toxicity by oral important mercury:

--

Faecal removal precedes gradual oxidation

Case 2: A male rings A& E because he has

decreased a mercury thermometer in the son's

bedroom.

• What is the risk of toxicity?

• essential mercury can be volatile

• if on a heated area it may volatalise & end up being inhaled

• once inhaled ~ 80% absorption

Circumstance 2: Mercury thermometer broken in a

room

• How would you guide him to wash up the mercury?

1 . Leak on a non-porous surface:

• lift the mercury with card or paper (remove gold jewelry and put on gloves)

• place in a sealed container & remove in general squander

2 . Drip on a floor covering:

• DON'T USE a whirlpool!

• Make use of a sulphur primarily based (calcium polysulfide) powder  mercuric sulphide & then simply can cleaner up …

• Significant spills: involve environmental health

Inhaled Much needed Mercury (1)

ACUTE

• Irritant respiratory system effects:

- cough, dyspnoea

- pulmonary oedema, ARDS

• Metallic fume fever:

- pyrexia, cough, discomfort, uncomfortableness, flu-like symptoms

• CNS features:

- confusion, emotional lability, delire

- provocation, CNS depression & coma

• Renal effects:

-- rarely ARF (oxidation to Hg2+)

Inhaled Elemental Mercury (2)

SERIOUS

• ‘Erethism'

- TREMOR, dysarthria

-- peripheral neuropathy, sweating

-- personality change

• Stomatitis, gingivitis

• Chronic reniforme impairment

Acrodynia

• Mercury syndrome in children

• Usually related to elemental mercury exposure, 2 reports second to inorganic exposure

• 6 P's hands & feet: puffy, pink, agonizing, peeling,

paraesthetic, perspiring

• Associated with weight loss, anorexia, frustration,

behavioural adjustments

• Hypertension – may mimic phaeochromocytoma

• Mercury inhibits COMT (catecholamine-o-methyltransferase) … NAdr as well as Adr gather

Torres ADVERTISEMENT Pediatrics 2000

IV/IM Much needed Mercury

• Results in:

-- local issues

- embolic complications

- mercuralism

IV/IM Elemental Mercury

Local Complications

• Thrombophlebitis

• Infection

• Granuloma formation

 Excise huge s/c deposits

? helps prevent local & systemic effects

IV/IM Important Mercury

Embolic Complications

• Pulmonary

-- usually asymptomatic

- could potentially cause chest pain, SOB

- usual spirometry, decreased transfer element

• Systemic

-? mercury through pulmonary capillary bed

- popular eg. abdomen, intracerebral

- asymptomatic

IV/IM Elemental Mercury...

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