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

MERCURY 272
2. HEALTH EFFECTS
Tunnessen et al. 1987; Veien 1990; Warkany and Hubbard 1953). In many of the dermal cases, a contact
dermatitis type of response was observed. However, a nonallergic pruritus is characteristic of acrodynia, a
hypersensitive reaction to mercury exposure observed primarily in children, and several of the above cases
may have been attributable to this syndrome (Aronow et al. 1990; Engleson and Herner 1952; Foulds et al.
1987; Jalili and Abbasi 1961; Karpathios et al. 1991; Tunnessen et al. 1987; Warkany and Hubbard 1953).
Other dermal reactions characteristic of acrodynia include heavy perspiration (Aronow et al. 1990; Fagala and
Wigg 1992; Karpathios et al. 1991; Sexton et al. 1976; Warkany and Hubbard 1953) and itching, reddened,
swollen and/or peeling skin on the palms of the hands and soles of the feet (Aronow et al. 1990; Fagala and
Wigg 1992; Jalili and Abbasi 1961; Karpathios et al. 1991; Tunnessen et al. 1987; Warkany and Hubbard
1953). No animal studies were located to support these findings. However, these results demonstrate that
two populations may experience dermal effects as a result of mercury exposure. One is those persons who
develop an allergic reaction to mercury. The other is those who are hypersensitive to mercury and who
develop acrodynia upon exposure. It is unknown whether sufficiently high concentrations of inorganic
mercury in soil or methylmercury in fish may exist at hazardous waste sites to trigger allergic dermatitis in
sensitive persons or acrodynia in those predisposed to develop this syndrome.
Ocular Effects. Ocular effects have been observed in persons exposed to high concentrations of metallic
mercury vapors. These effects are probably due to direct contact of the mercury vapor with the eyes. The
observed effects include red and burning eyes, conjunctivitis (Bluhm et al. 1992a; Foulds et al. 1987;
Karpathios et al. 1991; Schwartz et al. 1992; Sexton et al. 1976), and a yellow haze on the lenses of the eye
(Atkinson 1943; Bidstrup et al. 1951; Locket and Nazroo 1952). The yellow haze was associated with longterm
occupational exposures. Animal studies were not available to support these findings. However, the
evidence suggests that exposure to high levels of mercury vapor may result in ocular irritation.
Other Systemic Effects. Studies of workers exposed to mercury vapor found no effect on serum levels of
thyroid-stimulating hormone (Erfurth et al. 1990; McGregor and Mason 1991). However, an enlarged
thyroid, with elevated triiodothyronine and thyroxine, as well as reduced thyroid-stimulating hormone
developed in a 13-year-old boy exposed to mercury vapor for 2 weeks (Karpathios et al. 1991). Animal
studies generally support an effect of acute-duration high-level exposure on the thyroid, although the results
have been somewhat variable (Goldman and Blackburn 1979; Sin and The 1992; Sin et al. 1990). A single
intramuscular injection of 14.8 mg Hg/kg in rabbits resulted in increased thyroid peroxidase and triiodo­
thyronine and decreased thyroxine (Ghosh and Bhattacharya 1992). A study in which rats received three