revised final - Agency for Toxic Substances and Disease Registry ...

MERCURY 158
Endocrine Effects
2. HEALTH EFFECTS
No studies were located regarding endocrine effects in humans or animals after dermal exposure to
inorganic or organic mercury.
Organic Mercury. No studies were located regarding endocrine effects in humans or animals after dermal
exposure to organic mercury.
Dermal Effects
Inorganic Mercury. Contact dermatitis caused by acute, longer-term, or occupational inorganic mercury
exposure has been described in a number of case reports (Bagley et al. 1987; Biro and Klein 1967; Faria
and Freitas 1992; Goh and Ng 1988; Handley et al. 1993; Kanerva et al. 1993; Nordlind and Liden 1992;
Pambor and Timmel 1989; Skoglund and Egelrud 1991; Veien 1990). Patch tests conducted in many of the
cases show some cross-reactivity between various inorganic and organic forms of mercury (Faria and
Freitas 1992; Handley et al. 1993; Kanerva et al. 1993; Pambor and Timmel 1989; Veien 1990). In these
studies, dermal exposure occurred as a result of the breakage of mercury-containing thermometers or
sphygmomanometers, dental amalgams containing elemental mercury, inoculation with vaccines containing
merthiolate preservatives, or mercuric sulfide in tattoos. One report of contact dermatitis caused by a
mercuric sulfide-containing tattoo suggested that the reaction was not to mercuric sulfide itself but to a
mercury derivative that was formed in the skin (Biro and Klein 1967).
Excluding reports of contact dermatitis, limited information was obtained regarding the dermal effects of
inorganic mercury. Application of an ammoniated mercury ointment to the skin of children or exposure to
diapers that had been rinsed in a mercuric chloride-containing solution resulted in itching, flushing,
swelling, and/or desquamation of the palms of the hands and soles of the feet (Warkany and Hubbard
1953). In addition, rashes, conjunctivitis, and/or excessive perspiration were observed. These dermal
reactions were not attributed to allergic-type reactions to the mercury. A 23-month-old boy who was
exposed to an unspecified form of mercury also developed a "diffuse, pinpoint, erythematous, papular rash"
and bright red finger tips "with large sheets of peeling skin" (Tunnessen et al. 1987).
Application of a 1% solution of ammoniated mercuric chloride to the skin resulted in only minor irritation
in 2 of 11 exposed subjects (Kawahara et al. 1993). After 18 years of using a mercury-containing cream, a