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

MERCURY 473
5. POTENTIAL FOR HUMAN EXPOSURE
reported in three amalgam studies. Patterson et al. (1985) measured elemental mercury in exhaled breath,
and levels of mercury ranging from 0.0001 to 62 ng/L (ppb) (mean, 0.0082 µg/L [ppb]) were detected in
167 persons with dental restorations, compared to 0.000008–0.0001 µg/L (ppb) (mean, 0.00006 µg/L [ppb])
in 5 persons with no amalgams; however, these values were measured after the people had brushed their
teeth. Jokstad et al. 1992 reported that mercury urine concentrations increased with increasing number of
amalgams. Individuals with 36 to 39 dental amalgams had mercury urine levels of 6 ppb compared to
1.2 ppb in individuals without amalgams. Mercury concentrations in whole blood were also higher in
persons who ate no fish, but had >6 dental amalgam fillings (mean, 1.047±0.797 µg/L [ppb] as compared to
persons who did not eat fish and had no dental amalgams (0.2±0.4 µg/L [ppb]) (Schweinberg 1994).
Individuals who have large numbers of dental amalgams installed or replaced at one time are likely to exhibit
transient elevated blood and urine mercury levels (PHS 1995).
Individuals Exposed to Consumer Products and Medicinal Products Containing Mercury.
Individual who use various consumer products containing mercury (i.e., medicinal herbal remedies, skin
lightening creams and soaps, laxatives, tattoo dyes, fingerpaints, and make-up paints) are also exposed to
higher mercury levels than the general population (Barr et al. 1973; Dyall-Smith and Scurry 1990; Espinoza
et al. 1995; Geffner and Sandler 1980; Lauwerys et al. 1987; Rastogi 1992; Wendroff 1990). Metallic
mercury has been used by Mexican American and Asian populations in traditional remedies for a variety of
medical conditions, including chronic stomach disorders. Several papers have been published related to the
use of metallic mercury as a folk remedy (ATSDR 1992, 1997; Department of Health 1997; Geffner and
Sandler 1980; Hartman 1995; Johnson [in press]; Trotter 1985; Wendroff 1990, 1991; Zayas and Ozuah
1996). Some Mexican-Americans believe that disorders of the alimentary tract may be caused by a bolus of
food adhering to the stomach wall, a condition known as empacho. Geffner and Sandler (1980) reported
cases of two young patients with acute gastroenteritis who received traditional remedies of oral
administration of metallic mercury, presumably to dislodge the bolus. Both patients were successfully
treated and released from the hospital after 2 and 10 days of treatment, respectively. Trotter (1985) reported
that metallic mercury known as azogue is in common use in New Mexico and the bordering areas for treating
this gastrointestinal condition, empacho. Metallic mercury was also implicated in two cases of mercury
poisoning caused by the dermal application of an over-the-counter antilice product (Bourgeois et al. 1986).
Wands et al. (1974) reported the deaths of two individuals due to the excessive use of a laxative