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

MERCURY 268
2. HEALTH EFFECTS
and decreased δ-aminolevulinic acid dehydratase activity in erythrocytes or increased serum proteins involved
in the storage and transport of copper in workers exposed to mercury vapor (Bencko et al. 1990; Wada et al.
1969). Anemia was found in a man who ingested a lethal amount of mercuric chloride (Murphy et al. 1979).
However, the anemia was most likely the result of massive gastrointestinal hemorrhaging. No reports of
effects on blood parameters in humans were located after oral exposure to organic mercury. A decrease in red
cell count, hemoglobin, and hematocrit and rupture of erythrocytes were observed after intraperitoneal
injection of mice with 19.2 mg Hg/kg as methylmercuric chloride (Shaw et al. 1991). A decrease in
hemoglobin, hematocrit, and red blood cell count was observed in rats that received phenylmercuric acetate in
their drinking water for 2 years (Solecki et al. 1991). However, this effect was probably due to blood loss
associated with intestinal ulcers. Thus, there is limited information that suggests that prolonged exposure of
humans to high levels of mercury, possibly from living in the vicinity of hazardous waste sites, may result in
hematological changes.
Musculoskeletal Effects. Increases in tremors, muscle fasciculations, myoclonus, or muscle pains have been
reported in persons exposed to unspecified concentrations of elemental mercury vapor (Adams et al. 1983;
Albers et al. 1982, 1988; Aronow et al. 1990; Barber 1978; Bidstrup et al. 1951; Bluhm et al. 1992a; Chaffin
et al. 1973; Chapman et al. 1990; Fawer et al. 1983; Karpathios et al. 1991; McFarland and Reigel 1978;
Sexton et al. 1976; Smith et al. 1970; Taueg et al. 1992; Verberk et al. 1986; Vroom and Greer 1972;
Williamson et al. 1982), in individuals inhaling alkyl mercury compounds (Brown 1954; Hook et al. 1954;
Hunter et al. 1940), and in persons ingesting mercurous chloride (Warkany and Hubbard 1953) or ethylmercury
compounds (Jalili and Abbasi 1961). These muscular effects are probably the result of peripheral
nervous system dysfunction. It is probable that persons exposed to sufficiently high concentrations of
mercury in the air or in foodstuffs (e.g., contaminated fish) at hazardous waste sites may also experience
symptoms of tremors, myoclonus, muscle fasciculations, or muscle pains. A single report was identified that
found evidence of rhabdomyolysis (destruction of the skeletal muscle) in a 22-year-old man who attempted
suicide by ingesting 2 g of mercuric chloride (Chugh et al. 1978). It is extremely unlikely that persons at
hazardous waste sites would be exposed to similarly high concentrations of mercuric chloride.
Hepatic Effects. Elevated serum glutamic pyruvic transaminase (SGPT), ornithine carbamyl transferase,
and serum bilirubin, as well as evidence of decreased synthesis of hepatic coagulation factors, were
reported in a case study of a child who inhaled an unspecified concentration of metallic mercury vapor
(Jaffe et al. 1983). Similarly, hepatomegaly and hepatocellular vacuolation were observed in a man who