Nephrotic syndrome of minimal change disease following exposure to mercury-containing skin lightening cream: A case report and literature review.

Long-term exposure to mercury-containing skin lightening cream can cause mercury-related nephropathy, among which, membranous nephropathy (MN) and minimal change disease (MCD) are the main pathological types. In contrast to these two conditions, MCD with IgA deposition is not a common disease. In the present study, we report a 65-year-old Asian woman who developed nephrotic syndrome following long-term use of mercury-containing skin lightening cream. The urine mercury level of the patient was significantly increased, and the results of the renal biopsy indicated diagnosis of MCD with IgA deposition. Following three courses of treatment with sodium dimercaptopropane sulfonate (DMPS) alone and discontinuation of the skin cream, the symptoms of the patient were relieved without use of glucocorticoids, with proteinuria turning negative and a significant reduction in urine mercury levels. During the 6-month follow-up period, routine urinalysis remained normal. By reviewing relevant published literature, we summarized the pathological characteristics, possible mechanism of action, and treatment strategies of mercury poisoning-related MCD. The possibility of mercury poisoning should be considered for patients with nephropathy and history of use of skin lightening cosmetics. In these patients, the urine mercury levels should be measured in time so that mercury removal therapy can be implemented early.

Mercury poisoning complicated by acquired neuromyotonia syndrome: A case report.

RATIONALE: Acquired neuromyotonia syndrome is a rare form of peripheral nerve hyperexcitability syndrome. It is characterized by spontaneous and continuous muscle contractions. Acquired neuromyotonia syndrome is mainly observed in patients with autoimmune diseases or tumors, but it is a rare neurological clinical manifestation in patients with mercury poisoning. PATIENT CONCERNS: A 56-year-old woman presented with continuous and involuntary muscle twitching in her legs for 2 months; it was accompanied by a burning sensation in the lower limbs, insomnia, fatigue, and night sweats. These symptoms did not disappear during sleep. DIAGNOSES: Toxicological blood analysis via atomic fluorescence spectrometry revealed that the level of mercury was 0.07 µmol/L (normal level: <0.05 µmol/L). Her urinary mercury level measured using the cold atomic absorption method was 217.50 µmol/mol creatinine, which was considerably higher than the reference range (0-2.25 µmol/mol creatinine for people not in contact with mercury, 0-20 µmol/mol creatinine following long-term exposure). Upon further testing, a high level of mercury (10,572 mg/kg) was detected in the patient's cream. Accordingly, this patient was diagnosed with mercury poisoning. INTERVENTIONS: Treatment with 2,3-dimercapto-1-propanesulfonic acid (DMPS) was initiated. Her urinary mercury level decreased to 9.67 µmol/mol creatinine, and her neuromyotonia syndrome and hyponatremia were relieved, with urine protein completely disappearing after 3 months of treatment. OUTCOMES: After DMPS treatment, the clinical manifestations of the nervous system disappeared and electrolyte parameters returned to normal levels. LESSONS: Acquired neuromyotonia syndrome is a rare disorder caused by the hyperexcitability of peripheral nerves, resulting in spontaneous and continuous muscle contraction. Mercury poisoning should be considered in patients with neuromyotonia syndrome. Early detection of mercury poisoning can prevent unnecessary examinations and treatments.

Palmoplantar eruption in a patient with mercury poisoning.

Mercury poisoning is a rare event that can present with a variety of nonspecific systemic symptoms, making it difficult to diagnose. Dermatologic manifestations of mercury exposure may be variable and include pink disease (acrodynia), mercury exanthem, contact dermatitis, and cutaneous granulomas. We present the case of an 18-year-old woman with a palmoplantar eruption associated with tachycardia, hyperhidrosis, myalgia, paresthesia, and muscle fasciculations. Physical examination demonstrated poorly demarcated pink macules coalescing into patches on the left palm, right wrist, and soles. A punch biopsy was nonspecific, showing acanthosis and orthokeratosis with mild inflammation. Elevated urine and serum mercury levels confirmed a diagnosis of mercury poisoning. This case highlights the importance of consideration of mercury poisoning in the differential diagnosis for acral eruptions, especially in the presence of systemic symptoms and known risk factors.

Effects of Chronic Exposure to Mercury on Angiotensin-Converting Enzyme Activity and Oxidative Stress in Normotensive and Hypertensive Rats / Efeitos da Exposição Crônica ao Mercúrio sobre a Atividade da Enzima Conversora de Angiotensina e Estresse Oxidativo em Ratos Normotensos e Hipertensos

Abstract Background: Mercury's deleterious effects are associated with increased cardiovascular risk. Objective: To determine whether chronic exposure to inorganic mercury increases the activity of angiotensin-converting enzyme and its relationship with oxidative stress in several organs and tissues. Methods: We studied male Wistar and spontaneously hypertensive rats (SHR) (3-month-old) exposed or not to HgCl2 for 30 days. At the end of treatment, we investigated the following: changes in body weight, hemodynamic parameters, angiotensin-converting enzyme (ACE) activity and oxidative stress in the heart, aorta, lung, brain and kidney in hypertensive compared to normotensive animals. A value of p < 0.05 was considered significant. Results: Chronic exposure to HgCl2 did not affect weight gain in either group. Systolic blood pressure, measured weekly, did not increase in Wistar rats but showed a small increase in SHR rats. We also observed increases in left ventricular end-diastolic pressure and ACE activity in the plasma and hearts of normotensive rats. In the SHR+Hg group, ACE activity increased in plasma but decreased in kidney, lung, heart, brain and aorta. Oxidative stress was assessed indirectly by malondialdehyde (MDA) production, which increased in Hg-treated rats in both plasma and heart. In the SHR+Hg group, MDA increased in heart and aorta and decreased in lungs and brain. Conclusion: These results suggest that chronic exposure to inorganic mercury aggravates hypertension and produces more expressive changes in ACE activity and oxidative stress in SHRs. Such exposure affects the cardiovascular system, representing a risk factor for the development of cardiovascular disorders in normotensive rats and worsening of pre-existing risks for hypertension.

Resumo Fundamento: Os efeitos deletérios do mercúrio estão associados ao risco cardiovascular aumentado. Objetivo: Determinar se a exposição crônica ao mercúrio inorgânico aumenta a atividade da enzima conversora de angiotensina e sua relação com o estresse oxidativo em vários órgãos e tecidos. Métodos: Estudamos ratos Wistar e ratos espontaneamente hipertensos (SHR) (3 meses de idade) expostos ou não a HgCl2 por 30 dias. Ao final do tratamento, investigamos: alterações de peso, parâmetros hemodinâmicos, atividade da enzima conversora de angiotensina (ECA) e estresse oxidativo no coração, aorta, pulmão, cérebro e rim de animais hipertensos comparados a animais normotensos. Um valor de p < 0,05 foi considerado significativo. Resultados: A exposição crônica ao HgCl2 não afetou o ganho de peso em nenhum dos grupos. A pressão arterial sistólica, medida semanalmente, não aumentou em ratos Wistar, mas mostrou um pequeno aumento nos ratos SHR. Também observamos aumentos na pressão diastólica final do ventrículo esquerdo e na atividade da ECA no plasma e no coração de ratos normotensos. No grupo SHR + Hg, a atividade da ECA aumentou no plasma, mas diminuiu no rim, pulmão, coração, cérebro e aorta. O estresse oxidativo foi avaliado indiretamente pela produção de MDA, que aumentou nos ratos tratados com Hg tanto no plasma quanto no coração. No grupo SHR + Hg, o MDA aumentou no coração e na aorta e diminuiu nos pulmões e no cérebro. Conclusão: Estes resultados sugerem que a exposição crônica ao mercúrio inorgânico agrava a hipertensão e produz mudanças mais expressivas na atividade da ECA e no estresse oxidativo em SHRs. Essa exposição afeta o sistema cardiovascular, representando um fator de risco para o desenvolvimento de distúrbios cardiovasculares em ratos normotensos e para piorar riscos pré-existentes para hipertensão.

Prenatal exposure to dental amalgam and risk of symptoms of attention-deficit and hyperactivity disorder (ADHD).

BACKGROUND: ADHD is multifactorial, including both genetic and environmental factors. The safety of amalgam used in dental treatment has been discussed due to its content of mercury and potential risks for negative neurodevelopmental consequences in the offspring. The aim of the study was to investigate possible associations between symptoms related to ADHD in children of three and five years of age and prenatal exposure to mercury from mothers' amalgam fillings. METHODS: Data from the Norwegian Mother and Child Cohort Study (MoBa) were used. Data were collected by questionnaires sent to participating women in week 17 (Q1) and 30 (Q3) of pregnancy and when the child was three (Q6) and five years of age (Q7). Information about exposure to amalgam during pregnancy was obtained from Q3. Information about symptoms related to ADHD was obtained from Q6 and Q7. Valid data were obtained for 42 163 children at three years of age and 23 392 children at five years of age. Logistic regression models, including mothers' age, education, body mass index, parity, smoking and alcohol consumption during pregnancy, were used to estimate the association between ADHD symptoms and prenatal exposure to amalgam fillings. RESULTS: No significant associations between number of teeth with amalgam filling, amalgam fillings placed or removed during pregnancy, and symptoms related to ADHD in children of three and five years of age were found. CONCLUSIONS: In a large, prospective cohort study, we found no indication of increased risk of ADHD-related symptoms in children prenatally exposed to mother's amalgam fillings.

Mercury Intoxication as a Rare Cause of Membranous Nephropathy in a Child.

In adults, membranous nephropathy is the second most common cause of nephrotic syndrome. In contrast, minimal change disease and focal segmental glomerulosclerosis constitute the most common forms of nephrotic syndrome in children, while membranous nephropathy accounts for <5% of cases. In adults, causes of membranous nephropathy include autoantibodies directed against phospholipase A2 receptor and thrombospondin type 1 containing 7A, various infections, environmental toxicities, autoimmune disorders, malignancies, and other secondary forms. The most common causes of secondary membranous nephropathy in children are infections, autoimmune diseases, and neoplasia. We discuss an unusual presentation of new-onset membranous nephropathy due to mercury toxicity in a 14-year-old male with reflux nephropathy. This case underscores the importance of a high index of suspicion for uncommon causes of nephrotic syndrome in pediatric patients with membranous nephropathy.

Full Atrioventricular Block Secondary to Acute Poisoning Mercury: A Case Report.

Background: The biological behaviour and clinical significance of mercury toxicity vary according to its chemical structure. Mercury differs in its degree of toxicity and in its effects on the nervous, digestive and immune systems as well as on organs such as the lungs, kidneys, skin, eyes and heart. Human exposure occurs mainly through inhalation of elemental mercury vapours during industrial and artisanal processes such as artisanal and small-scale gold mining. Case presentation: A 52-years-old female, housewife, with a body mass index of 25.3 kg/cm², without smoking or alcohol habits or any important clinical or chronic cardiovascular history, was admitted to the emergency room due to probable accidental poisoning by butane gas. Clinical manifestations with a headache, dizziness, cough, and dyspnoea of medium to small efforts. An initial physical exploration with Glasgow scored at 15, with arrhythmic heart sounds, pulmonary fields with bilateral subcrepitant rales and right basal predominance. Electrocardiographic findings were as follows: a cardiac frequency of 50 beats per minute and atrioventricular dissociation. Laboratory parameters were: white blood cells at 15.8 × 108/L; aspartate aminotransferase at 38 U/L; lactate dehydrogenase at 1288 U/L; creatine-kinase at 115 U/L; CK-MB fraction at 28 U/L; and other biochemical parameters were within the reference values. A radiographic evaluation showed flow cephalization, diffuse bilateral infiltrates with right basal predominance. In addition, the patient presented data of low secondary expenditure to third-degree atrioventricular (AV) block for which the placement of a transvenous pacemaker was decided, substantially improving the haemodynamic parameters. Subsequently, after a family interrogation, the diagnosis of mercury inhalation poisoning was established. An initial detection of mercury concentration (Hg(0)) was carried out, reporting 243.5 µg/L. In view of this new evidence, mercury chelation therapy with intravenous calcium disodium ethylenediamine tetraacetic acid (CaNa2·EDTA) was initiated. After 8-days of hospital stay, she presented a favourable evolution with both clinical and radiological improvements, so that the mechanical ventilation progressed to extubating. Subsequently, she was referred for cardiology because of her persistent 3rd-degree atrioventricular block, deciding to place a definitive bicameral pacemaker. The patient was discharged from the hospital 14 days after admission due to clinical improvements with mercury plasma levels at 5 µmol/L and a heart rhythm from the pacemaker. Conclusions: We show evidence that acute exposure to elemental mercury can affect the heart rhythm, including a complete atrioventricular blockage.

Clinicopathological features, diagnosis, and treatment of IgA nephropathy with minimal change disease related to exposure to mercury-containing cosmetics: a case report
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AIM: Membranous nephropathy and minimal change disease (MCD) have been involved in mercury-induced nephrotic syndrome. IgA nephropathy is not known to be a common pathological type. In the present article, we report a case of IgA nephropathy with MCD following exposure to mercury-containing skin lightening cream. MATERIAL AND METHODS: The patient was a 39-year-old woman who presented with nephrotic syndrome. She had a 6-month history of using as many as 8 kinds of skin-lightening creams, and urinary mercury excretion was high. Renal biopsy revealed IgA nephropathy with MCD. The use of cosmetics was stopped and chelation therapy was given. After 4 courses (1 month) of chelation therapy, there was a complete remission of proteinuria and hematuria, and urine tests remained normal during the 5-year follow-up period. RESULTS AND CONCLUSIONS: The unique clinical and pathological features of IgA nephropathy with MCD had raised the controversial question of whether MCD and IgA deposition are separate entities or a common pathophysiology. Repeated renal biopsy and similar cases were helpful and should be carried out as far as possible.
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Occupational mercury exposure in association with prevalence of multiple sclerosis and tremor among US dentists.

BACKGROUND: The effects of chronic occupational exposure to elemental mercury (Hg(0)) are largely unknown. The objective was to evaluate the association of occupational Hg(0) exposure with multiple sclerosis (MS) and tremor. METHODS: The study included 13,906 dentists who attended the American Dental Association's annual meeting over 24 years (1986-2007 and 2011-2012). Participants reported MS and tremor and provided urine specimens for Hg(0) analysis. The authors estimated mean Hg(0) exposures over time and used logistic regression to estimate the associations of 3 Hg(0) exposure measures with MS or tremor. RESULTS: Among participants, 0.18% reported MS and 1.24% reported tremor. Hg(0) exposure was not associated with MS (odds ratio [OR] per 191 micrograms per liter in cumulative Hg(0) exposure, 0.85; 95% confidence interval [CI], 0.39-1.85). Increased prevalent risk of tremor was found with exposure to both urinary Hg(0) exposure (OR, 1.10 [95% CI, 1.00-1.22]) and cumulative Hg(0) exposure among younger dentists (< 51 years; OR, 1.13 [95% CI, 1.05-1.22]). CONCLUSIONS: Occupational Hg(0) exposure in US dentists decreased over time and now is approaching that of the general population. Our results suggest a positive association between Hg(0) exposure and tremor. PRACTICAL IMPLICATIONS: Studies with more sophisticated outcome and exposure measures, and including more retired dentists, would provide critical information toward understanding the relation of Hg(0) exposures to MS and tremor risk.

Descripción del perfil neuropsicológico de cuatro casos con intoxicación por mercurio elemental / Description of the neuropsychological profile of four cases with elemental mercury poisoning

El mercurio elemental, es un metal tóxico líquido a temperatura ambiente; sus vapores son absorbidos por el organismo humano y atraviesa fácilmente la barrera hematonencefálica. Su exposición crónica genera una intoxicación que lleva al cuadro clínico llamado eretismo mercurial, caracterizado por cambios comportamentales, cognitivos y motores. Los efectos a largo plazo de la intoxicación por mercurio elemental no ha sido ampliamente documentada, razón por la cual el objetivo del presente estudio es describir el perfil neuropsicológico secundario a un cuadro de intoxicación por mercurio elemental, en un grupo familiar después de un tiempo de evolución de 20 años. Se realizó una evaluación neuropsicológica a cuatro sujetos intoxicados por mercurio elemental encontrando alteraciones en la atención ejecutiva, memoria operativa, memoria verbal a corto plazo, memoria visual, procesamiento viso construccional, fluidez semántica y fonológica, velocidad de procesamiento, altas implicaciones en las funciones ejecutivas, conductas comportamentales de predominio frontal y depresión. Se concluye que generalmente las alteraciones son permanentes en el tiempo de evolución de la patología y que no existe diferenciación en las funciones cognitivas afectadas, independientemente del ciclo vital por el cual atraviese la persona al momento de padecer la intoxicación...

Elemental mercury is a toxic metal liquid at room temperature. Whose vapours are absorbed by the human organism and readily crosses the blood-brain barrier. Its chronic exposition leads to erethismmercurialis, a neurological disorder characterized by behavioural, cognitive and motor changes. Long-term effects of mercurial poisoning are not widely documented; the aim of the present study is to describe the neuropsychological profile of a family, poisoned by elemental mercury 20 years ago. Cognitive deficits in executive attention, working memory, short-term verbal memory, visual memory, visuo constructional processing, semantic fluency, processing speed, elicited deficits in executive functions, frontal behavioural conducts and depression where found. It is concluded, that generally in chronic poisoning the deficits are permanent in time and that there are not differences on the cognitive deficits, independently of the cycle of life in which the person is at the moment when the poisoning occurs...

Acute mercury poisoning presenting as fever of unknown origin in an adult woman: a case report.

INTRODUCTION: Mercury intoxication may present in a wide range of clinical forms from a simple disease to fatal poisoning. This article presents a case of acute mercury poisoning, a rare condition that presents challenges for diagnosis with fever of unknown origin. CASE PRESENTATION: A 52-year-old Caucasian woman was admitted to the hospital with high fever, sore throat, a rash over her entire body, itching, nausea, and extensive muscle pain. She had cervical, bilateral axillary and mediastinal lymphadenopathies. We learned that her son and husband had similar symptoms. After excluding infectious pathologies, autoimmune diseases and malignancy were investigated. Multiple organs of our patient were involved and her fever persisted at the fourth week of admission. A repeat medical history elicited that her son had brought mercury home from school and put it on the hot stove, and the family had been exposed to the fumes for a long period of time. Our patient's serum and urine mercury levels were high. She was diagnosed with mercury poisoning and treated accordingly. CONCLUSIONS: Mercury vapor is a colourless and odorless substance. Therefore, patients with various unexplained symptoms and clinical conditions should be questioned about possible exposure to mercury.

Protective effect of pomegranate seed oil against mercuric chloride-induced nephrotoxicity in rat.

PURPOSE: Heavy metals such as mercury can induce the generation of free radicals and oxidative stress which are associated with tissue injury. The present study was designed to evaluate the protective effect of pomegranate seed oil against HgCl2-induced nephrotoxicity. METHODS: Twenty-four W/A adult rats were randomly divided into four groups. Group I received corn oil (1 mL/kg). Group II received HgCl2 (5 mg/kg) for 3 days. Group III and IV received PSO 0.4 mL/kg and 0.8 mL/kg, respectively one hour before HgCl2 administration for 3 days. Blood samples were taken by cardiac puncture and used for the measurement of urea and creatinine concentration. Twenty-hour-hour urine samples were collected to measure protein and glucose. The right kidney was fixed in formalin for histological examination and the left kidney was homogenized for measuring malondialdehyde (MDA) and total sulfhydryl groups. RESULTS: Significant elevation of serum creatinine and urea levels as well as urine glucose and protein concentrations, a significant decrease in total thiol content and a significant increase in MDA levels in kidney homogenate samples were observed after administration of HgCl2 as compared with control group. PSO pretreatment resulted in a significant decrease in serum creatinine and urea levels as well as urine glucose and protein concentrations when compared with HgCl2 treated (group II). PSO also significantly reversed the HgCl2-induced depletion in thiol content and elevation in MDA content. Histological studies revealed milder kidney lesions in PSO treated groups (groups III and IV) compared to HgCl2 treated group. CONCLUSION: Our results suggest that PSO has a protective effect against HgCl2-induced nephrotoxicity in rats.

Mercury-induced nephrotic syndrome: a case report and review of the literature.

A 42-year-old man was admitted to the Nephrology Department because of nephrotic syndrome. Eight months prior to admission he attempted suicide by intravenous self-injection of 2.5 ml of elemental mercury. Renal biopsy was performed. Light microscopy findings showed normal glomeruli and injury of proximal tubular cells. Immunofluorescence was negative, and electron microscopy study revealed diffuse effacement of podocyte foot processes and vacuolization of podocyte cytoplasm. Minimal change disease was diagnosed. The patient was treated with 2,3-dimercaptopropane-1-sulfonate, for mercury detoxification, and steroids. In one-year follow-up the 24-h urine protein excretion decreased from 30 γ to 0.186 g, and the renal function remain normal. The presented case indicates that mercury intoxication should be mentioned as a cause of secondary minimal change disease.

Health effects associated with long-term occupational exposure of employees of a chlor-alkali plant to mercury.

This study aimed to evaluate possible health effects associated with long-term occupational exposure to low levels of mercury vapors. Forty-six subjects exposed to mercury and 65 healthy unexposed employees were studied. The subjects were administered a questionnaire on experienced symptoms and underwent clinical examinations as well as routine biochemical tests. Atmospheric and urinary concentrations of mercury were measured, too. Environmental concentrations of mercury were estimated to be 3.97 ± 6.28 µg/m(3) and urinary concentrations of mercury in exposed and referent groups were 34.30 ± 26.77 and 10.15 ± 3.82 µg/dm(3), respectively. Additionally, symptoms such as somatic fatigue, anorexia, loss of memory, erethism, blurred vision and teeth problems were significantly more common among exposed individuals. These observations indicate that occupational exposure to mercury vapors, even at low levels, is likely to be associated with neurological and psychological symptoms.

Limiares auditivos em crianças expostas a mercúrio no período pré-natal / Hearing thresholds in children exposed to mercury in the prenatal period

OBJETIVO: Avaliar os limiares auditivos de crianças com histórico de exposição ao mercúrio durante o período pré-natal. MÉTODOS: Foram avaliadas 90 crianças com idades entre 8 e 10 anos, de ambos os gêneros, categorizadas em dois grupos de acordo com os níveis de exposição pré-natal ao mercúrio. O grupo de estudo foi composto por 57 crianças que apresentaram níveis de mercúrio no cordão umbilical iguais ou superiores a 8 µg/L, e o grupo de comparação por 33 crianças que apresentaram níveis de mercúrio no cordão umbilical inferiores a 8µg/L. Os procedimentos incluíram um questionário, audiometria tonal liminar, pesquisa do limiar de recepção de fala e análise das doses de mercúrio no cordão umbilical coletadas ao nascimento. RESULTADOS: O grupo de estudo apresentou mediana de mercúrio no cordão umbilical de 14,63 µg/L, e mediana dos limiares tonais das frequências de 500 Hz, 1 kHz e 2 kHz de 10 dB em ambas orelhas. O grupo de comparação apresentou mediana de mercúrio no cordão umbilical de 4,88 µg/L, e mediana dos limiares tonais das frequências de 500 Hz, 1 kHz e 2 kHz de 10 dB em ambas orelhas. Quando comparados os limiares auditivos, tanto pela média tritonal quanto para cada frequência isoladamente, não foram observadas diferenças significativas entre os grupos. CONCLUSÃO: As crianças apresentaram limiares auditivos dentro dos padrões de normalidade e não foi observada diferença significativa entre os limiares auditivos das crianças expostas e não-expostas ao mercúrio no período pré-natal.

PURPOSE: To evaluate hearing thresholds in children with a history of exposure to mercury during the prenatal period. METHODS: Participants were 90 children of both genders with ages from 8 to 10 years, divided into two groups according to prenatal mercury exposure levels. The study group was composed by 57 children who had mercury levels in the umbilical cord equal or above 8 µg/L, and the comparison group comprised 33 children who had mercury levels in the umbilical cord below 8 µg/L. Investigation procedures included the application of a questionnaire, pure-tone audiometry, speech reception threshold, and mercury level analysis in cord blood collected at birth. RESULTS: The study group showed a median mercury level in the umbilical cord of 14.63 µg/L, and the median threshold for 500 Hz, 1 kHz and 2 kHz in pure-tone audiometry was 10 dB for both ears. The comparison group had a median cord blood mercury level of 4.88 µg/L, and the median threshold for 500 Hz, 1 kHz and 2 kHz in pure-tone audiometry was 10 dB for both ears. When the hearing thresholds were compared, both by the tritonal mean and by each frequency separately, there were no significant differences between groups. CONCLUSION: The children had hearing thresholds within normal limits and there was no significant difference between the hearing thresholds of children exposed and not exposed prenatally to mercury.

Exposición ambiental al mercurio y valores en orina de los habitantes de la comunidad Boca de Yaracuy: ubicada en la costa centro-norte de Venezuela / Enviromental expossure to mercury and urine values in inhabitants from Boca de Yaracuy community in the Venezuela north central coast

El objetivo de esta investigación fue relacionar la concentración de mercurio urinario de 100 residentes de la comunidad Boca de Yaracuy (zona costera del Estado Carabobo-Venezuela) con los niveles mercuriales encontrados en pescado, agua y sedimento provenientes del Caño El Alpargatón. Durante el estudio fueron captados 4 peces, 2 muestras de agua y tres de sedimento y analizadas por absorción atómica. La media de los niveles de mercurio en la orina de los individuos analizados fue de 3,62 ± 1,09 µg/g creatinina, ubicandose por debajo del valor límites establecido por la Agencia para sustancias tóxicas y registro de enfermedades, Conferencia americana de higienistas industriales gubernamentales y la Organización Mundial de la Salud, además de las Gacetas oficiales venezolanas N° 5382 y 5021. En las muestras ambientales provenientes del Caño. El Alpargatón, no se encontraron niveles elevados de mercurio, así como ausencia de intoxicación por mercurio en sus habitantes. Se requieren de nuevas investigaciones que abarquen un mayor número de elementos que faciliten un mejor abordaje de la contaminación mercurial.

The aim study was to relate the concentration of urinary mercury than 100 residents of the Community Boca Yaracuy (Carabobo state coastal-Venezuela) with mercury levels found in fish, water and sediment from the Caño Alpargatón. During the study were caught 4 fish, 2 samples of water and three samples of sedimentand, analyzed by atomic absorption. The average mercury levels in urine of individuals analyzed was 3,62 ± 1.09 mg/g creatinine, ranking below the limits set by the Agency for toxic substance and disease registry, American conference of gubernamental industrial hygienists, the World Health Organization and the Venezuela Official Gazettes N°5382 and 5021. In environmental samples from the Caño Alpargaton not were found elevanted levels of mercury and mercury poisoning absence of its inhabitants. Further investigations are needed to cover a larger number of elements to be a better approach to mercury pollution.

Minimal-change nephrotic syndrome due to occupational mercury vapor inhalation.

A 25-year-old man developed nephrotic syndrome and severe hypertension following occupational exposure to mercury vapor whilst working at a fluorescent light factory. A renal biopsy confirmed minimal-change disease on light microscopy, immunofluorescence and electron microscopy. He was also noted to be polycythemic which was initially treated with venesection. His blood and urinary mercury levels were elevated and so he was given chelation therapy with 2,3-dimercaptopropane-1-sulfonate (DMPS), along with steroids for his minimal-change disease, resulting in full resolution of his nephrotic syndrome within 6 weeks. He remains well with normal renal function, blood pressure and normal blood and urine mercury concentrations.

Occurrence of cognitive symptoms in dental assistants with previous occupational exposure to metallic mercury.

Previous investigations have presented evidence for an increased prevalence of late cognitive effects in dental personnel exposed to metallic mercury. We wanted to examine if there was a correlation between mercury exposure and cognitive effects in a Norwegian population of dental workers, and if so, to quantify the occurrence. The study group consisted of 608 female dental assistants from central Norway and 425 female controls from the general population, all under the age of 70. They had responded to a standardized postal questionnaire (Euroquest) inquiring about seven symptoms in regard to neurology, psychosomatics, memory, concentration, mood, sleep disturbances, and fatigue. A score was calculated for each symptom based on 4-15 single questions graded on a scale from 1 (seldom or never) to 4 (very often). Dental assistants and controls had a participation rate of 56.4% and 42.9% respectively. Dental assistants reported more cognitive symptoms than the controls, but on average they reported having each of the symptoms "now and then" or less frequently. There were 4.4% of the dental assistants and 2.8% of the controls who reported having three or more of the seven symptoms "often" or more frequently. The corresponding figures for five or more of the seven symptoms were 1.0% and 0.5% respectively. The occurrence of cognitive malfunction may be moderately increased in dental assistants. For dental assistants there was a relative risk of 1.6 of having three or more symptoms "often" or more frequently, and a relative risk of 2.0 of having five or more symptoms as frequently. It can be assumed from our results that the prevalence of possibly work-related cognitive malfunction in dental assistants is between 0.4% and 2.8%, dependent on the applied severity.