Mercury Spill Responses - Five States, 2012-2015.

Despite measures to educate the public about the dangers of elemental mercury, spills continue to occur in homes, schools, health care facilities, and other settings, endangering the public's health and requiring costly cleanup. Mercury is most efficiently absorbed by the lungs, and exposure to high levels of mercury vapor after a release can cause cough, sore throat, shortness of breath, nausea, vomiting, diarrhea, headaches, and visual disturbances (1). Children and fetuses are most susceptible to the adverse effects of mercury vapor exposure. Because their organ systems are still developing, children have increased respiratory rates, and they are closer to the ground where mercury vapors are most highly concentrated (2). To summarize key features of recent mercury spills and lessons learned, five state health departments involved in the cleanup (Iowa, Michigan, Missouri, North Carolina, and Wisconsin) compiled data from various sources on nonthermometer mercury spills from 2012 to 2015. The most common sites of contamination were residences, schools and school buses, health care facilities, and commercial and industrial facilities. Children aged <18 years were present in about one third of the spills, with approximately one in seven incidents resulting in symptoms consistent with acute mercury exposure. To protect the public's health after a mercury spill, it is important that local, state, and federal agencies communicate and coordinate effectively to ensure a quick response, and to minimize the spread of contamination. To reduce the number of mercury spills that occur in the United States, public health officials should increase awareness about exchange programs for mercury-containing items and educate school and health care workers about sources of mercury and how to dispose of them properly.

Carbon Monoxide Poisonings from Forklift Use During Produce Packing Operations.

In August 2013, the North Carolina Division of Public Health investigated a carbon monoxide (CO) exposure on a farm. Two employees were overcome by CO and lost consciousness while using a propane-powered forklift to load produce into a refrigerated trailer backed up to a warehouse. One employee died, and the second employee was admitted to the hospital for hyperbaric oxygen treatment. Eighteen people, ranging in age from 18 to 69 years, were potentially exposed to CO, including the two employees, a family member who discovered the employees, two bystanders who stopped to offer assistance, and 13 first responders. Thirteen people who assisted in the emergency response experienced symptoms such as headache and dizziness, and all 16 who assisted were evaluated in a local hospital emergency department and released after receiving 100% oxygen. Blood tests showed five people (the two employees, family member, and two bystanders) had elevated blood carboxyhemoglobin levels, but all first responders had levels within normal range. Firefighters measured a peak CO concentration of 2214 parts per million in the warehouse. The North Carolina Division of Occupational Safety and Health investigated and determined that the forklift, operated inside the trailer with no ventilation, was the source of the CO. Public health investigation activities included interviewing responders, obtaining ambient CO concentration measurements from the fire department, advising the local health director, reviewing medical records, and developing a line listing of exposed persons. To prevent CO poisoning, employers should consider replacing gas-powered equipment with electric equipment, which does not produce CO.