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

MERCURY 303
2. HEALTH EFFECTS
system damage once a nonpolar mercury compound gains access to the circulatory system and begins to
concentrate in tissues (Neirenberg et al. 1998, Taueg et al. 1992).
For similar routes and forms of mercury, the adverse health effects seen in children are similar to the effects
seen in adults. For example, a young child who was intoxicated with mercury vapor, died of pulmonary
edema and had a grayish, necrotic mucosa of the stomach and duodenum (Campbell 1948). These effects are
similar to those seen in adult populations occupationally exposures to inhaled metallic mercury vapors.
Respiratory effects in adults from inhalation of metallic mercury vapor include pulmonary edema, lobar
pneumonia, fibrosis, desquamation of the bronchiolar epithelium, and death in severe cases due to
respiratory failure (Gore and Harding 1987; Jaffe et al. 1983; Kanluen and Gottlieb 1991; Matthes et al.
1958; Taueg et al. 1992; Teng and Brennan 1959; Tennant et al. 1961).
The majority of the information regarding cardiovascular effects comes from reports of children who were
treated with mercurous chloride tablets for worms or mercurous chloride-containing powders for teething
discomfort (Warkany and Hubbard 1953). These authors described multiple cases in which tachycardia and
elevated blood pressure were observed in the affected children.
Electrocardiography in four family members who ate meat from a hog that had consumed seed treated with
ethylmercuric chloride showed abnormal heart rhythms (ST segment depression and T wave inversion)
(Cinca et al. 1979). Death of the two children in the family was attributed to cardiac arrest, and autopsy of
these boys showed myocarditis. Cardiovascular abnormalities were also observed in severe cases of
poisoning in the Iraqi epidemic of 1956, when widespread poisoning resulted from eating flour made from
seed grains treated with ethylmercury p-toluene sulfonanilide (Jalili and Abbasi 1961). These abnormalities
included irregular pulse, occasionally with bradycardia, and electrocardiograms showing ventricular ectopic
beats, prolongation of the Q-T interval, depression of the S-T segment, and T inversion.
Several children who were treated with mercurous chloride for constipation, worms, or teething discomfort
had swollen red gums, excessive salivation, anorexia, diarrhea, and/or abdominal pain (Warkany and
Hubbard 1953). They also experienced muscle twitching or cramping in the legs and/or arms, but these
muscular effects were probably secondary to changes in electrolyte balance (i.e., potassium imbalance due to
fluid loss or renal wasting).