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

MERCURY 474
5. POTENTIAL FOR HUMAN EXPOSURE
preparation containing mercurous chloride (calomel). Espinoza et al. (1995) reported that while examining
imported Chinese herbal balls for the presence of products from endangered species, the authors detected
potentially toxic levels of mercury and arsenic in certain herbal ball preparations. Herbal balls are aromatic,
malleable, earth-toned, roughly spherical, hand-rolled mixtures of primarily herbs and honey. These herbal
balls are used as a self-medication for a wide variety of conditions, including fever, rheumatism, apoplexy,
and cataracts. Herbal balls similar to those analyzed are readily available in specialty markets throughout the
United States. Mercury (probably mercury sulfide) was detected in 8 of the 9 herbal balls tested. The
recommended adult dose for the herbal balls is two per day. Ingesting two herbal balls could theoretically
provide a dose of up to 1,200 mg of mercury. Perharic et al. (1994) reported poisonings resulting from
exposure to traditional remedies and food supplements reported to the National Poisons Unit in London,
England. From 1989 to 1991, metallic mercury was implicated in several poisonings following exposure to
Asian medicines. The issuance of informational notices by health departments cautioning members of these
subpopulation about the toxic properties of mercury may be appropriate.
Mercuric sulfide, or cinnabar, was reported to be used in tattooing dyes to produce a red pigmentation
(Bagley et al. 1987; Biro and Klein 1967). An analysis of finger paints and make-up paints manufactured in
Europe showed that they all contained less than 1 ppm mercury (Rastogi 1992). The author did not discuss
whether these products are available in the United States. While some of medicinal and pharmaceutical uses
of mercury compounds have been replaced in recent years, individuals in some ethnic or religious groups
may still use mercury in various traditional remedies, ceremonies, and rituals.
Individuals that Use Mercury in Religious Ceremonies and/or Ethnic Practices or Live in
Dwellings where Intentional or Unintentional Elemental Mercury Spills have Occurred.
Metallic mercury has been used in Latin American and Caribbean communities as part of certain religious
practices (e.g., Voodoo, Santeria, and Espiritismo) predominantly in domestic settings (Wendroff 1990).
Metallic mercury is sold in shops called botanicas (sometimes under the name azogue) which stock
medicinal plants, magical medicines, incense, candles, and perfumes. Botanicas typically dispense mercury
in gelatin capsules or, sometimes, in small glass vials. Some practices involve sprinkling metallic mercury
on the floor of the dwelling or of a car, mixing elemental mercury with soap and water to wash the floor, or
placing it in an open container to rid the house of evil spirits. Other practices involve carrying a small
amount of mercury in a vial on the person or mixing mercury in bath water or perfumed soaps, devotional