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

MERCURY
Gastrointestinal Effects
2. HEALTH EFFECTS
Metallic Mercury. Many instances of gastrointestinal effects have been reported in humans following acute
inhalation exposure to metallic mercury vapor. A classical sign of mercury intoxication is stomatitis
(inflammation of the oral mucosa). Accordingly, a number of case studies have reported stomatitis after
acute-duration exposure to high concentrations of metallic mercury vapors (Bluhm et al. 1992a; Garnier et
al. 1981; Haddad and Sternberg 1963; Snodgrass et al. 1981; Tennant et al. 1961). Occasionally, the
stomatitis was accompanied by excessive salivation (Hallee 1969; Karpathios et al. 1991) or difficulty
swallowing (Campbell 1948). Other gastrointestinal effects observed after acute-duration exposure to high
levels of mercury include abdominal pains (Bluhm et al. 1992a; Campbell 1948; Haddad and Sternberg
1963; Milne et al. 1970; Teng and Brennan 1959), nausea and/or vomiting (Haddad and Sternberg 1963;
Hallee 1969; Kanluen and Gottlieb 1991; Lilis et al. 1985; Milne et al. 1970; Rowens et al. 1991; Snodgrass
et al. 1981; Soni et al. 1992; Taueg et al. 1992), and diarrhea (Bluhm et al. 1992a; Kanluen and Gottlieb
1991; Rowens et al. 1991; Taueg et al. 1992; Teng and Brennan 1959). The autopsy of a young child who
was intoxicated with mercury vapor and died of pulmonary edema revealed a grayish, necrotic mucosa of the
stomach and duodenum (Campbell 1948).
Intermediate-duration exposures to mercury spills have also resulted in similar gastrointestinal effects. A
case study reported that teenage girls exhibited anorexia, intermittent abdominal cramps, mild diarrhea,
painful mouth, and bleeding gingiva 2 weeks after a spill of metallic mercury in their home (on carpet)
resulted in the release of metallic mercury vapor (Sexton et al. 1976). Air levels in the home were measured
6 months after the initial spill and ranged from 0.02 to 1 mg Hg/m 3 , depending upon the degree of ventilation
and proximity to the spill. Fagala and Wigg (1992) reported a case of colicky abdominal pain and diarrhea
in a 12-year-old girl exposed to mercury vapors for approximately 6 months after a spill in her home.
Limited information was located regarding gastrointestinal effects in persons who are chronically exposed to
elemental mercury vapors. Stomatitis was observed in 22 of 72 workers exposed to mercury vapors in the
manufacture of thermometers in the 1940s (Bucknell et al. 1993). Drooling, sore gums, ulcerations of the
oral mucosa, and/or diarrhea were observed in 5 of 9 workers in a thermometer-manufacturing plant (Vroom
and Greer 1972). A correlation was also observed between mercury exposure levels and unspecified
oropharyngeal symptoms in workers from a chloralkali plant (Smith et al. 1970).
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