MERCURY POISONING IN THE AMAZON: THE TIP OF THE ICEBERG

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In *+e (+#r* *er%! *+e &#',( "( #n 3"e*. F#r*,na*e ) &#r *+e #'a pe#p e! 6+# 3er"-e %,'+ #& *+e"r pr#*e"n &r#% &"(+! re3,'"n$ e8p#(,re *# %er',r) 3#e( n#* %ean $"-"n$ ,p &"(+. T+ere are %#re *+an @C &"(+ (pe'"e( "n *+e r"-er! ea'+ 6"*+ -ar)"n$ a%#,n*( #& %er',r) '#n*a%"na*"#n. S# &ar! *+e *ea% +a( '# e'*e3 an3 e8a%"ne3 (#%e ECC &"(+ (a%p e(! *aken &r#% *+e (a%e ("*e( *+a* #'a &"(+er%en &reD,en*. In *+e pr#'e(( *+e) +"$+ "$+*e3 *+a* +erb"-#r#,( #r p an*0ea*"n$ &"(+ '#n*a"n -er) "** e %er',r)! 6+" e pre3a*#r) &"(+ '#n*a"n *+e %#(* an3 #%n"-#r#,( &"(+ &a "n be*6een. L"ke6"(e! pe#p e 6+# pre3#%"nan* ) ea* +erb"-#r#,( &"(+ 6ere &#,n3 *# +a-e e(( %er',r) *+an *+#(e 6+# ea* %#re pre3a*#r) &"(+. S,rpr"("n$ )! *+e 1,-en" e( #& (#%e (pe'"e( '#n*a"ne3 %#re %er',r) *+an *+e a3, *(. T+e re(ear'+er( a (# 3"('#-ere3 (ea(#na -ar"a*"#n( "n +a"r %er',r) e-e (! re& e'*"n$ *+e 3"&&eren* a-a" ab" "*) #& &"(+ (pe'"e( 3,r"n$ *+e ra"n) an3 3r) (ea(#n(. Ba(e3 #n *+"( ne6 kn#6 e3$e! *+e *ea% +a( been 6#rk"n$ 6"*+ '#%%,n"*) %e%ber( *# pr#p#(e &"(+ 3"e*( 6+"'+ '#n*a"n a $rea*er pr#p#r*"#n #& &"(+ 6"*+ #6 %er',r) e-e (. 4#%en "n *+e -" a$e (,$$e(*e3 *+e) '#, 3 ,(e a p#(*er " ,(*ra*"n$ ea'+ (pe'"e( an3 6+ere "* &a ( "n *+e ran$e #& %er',r) '#n*a%"na*"#n. In *+e %e3",% *er%! ('"en*"(*( are a (# 6#rk"n$ 6"*+ &"(+er( *# "3en*"&) G+#*(p#*(G 0 area( "n *+e r"-er 6"*+ '#n3"*"#n( *+a* +"$+ ) &a-#,r *+e *ran(&#r%a*"#n #& %er',r) "n*# *#8"' %e*+) %er',r) .%e*+) a*"#n/. A *+"r3! #n$er *er% area &#r "n*er-en*"#n "( *# re3,'e *+e #-era e-e #& %er',r) "n *+e en-"r#n%en*. One (# ,*"#n be"n$ e8p #re3 "( re&#re(*a*"#n an3 a$r"', *,re. In '# ab#ra*"#n 6"*+ #'a &ar%er(! *+e *ea% p an( *# *e(* 6+"'+ *)pe #& *ree( are be(* ab e *# re3,'e *+e ea'+"n$ #& na*,ra %er',r) "n*# *+e r"-er. I& *+e) 'an &"n3 &r,"* *ree( *+a* 3# *+e 1#b! a *+e be**er! ("n'e *+e) 6#, 3 pr#-"3e an#*+er (#,r'e #& &##3. A ne6 ne*6#rk &#r %er',r) re(ear'+ B," 3"n$ #n *+"( re(ear'+! IDRC re'en* ) pr#-"3e3 ne6 &,n3"n$ &#r *+e e(*ab "(+%en* #& an "n*er3"('"p "nar) ne*6#rk #& re(ear'+er( an3 a re&eren'e 'en*re re a*e3 *# %er',r) '#n*a%"na*"#n "n *+e A%a7#n. T+e %a"n $#a "( *# $a*+er e8"(*"n$ ('"en*"&"' kn#6 e3$e ab#,* *+e be+a-"#,r #& %er',r) "n *+e A%a7#n! "*( *ran(%"(("#n "n *+e &##3 '+a"n! an3 "*( ne,r#*#8"' an3 +ea *+ "%pa'*(. T+"( kn#6 e3$e 6" *+en be ,(e3 *# 3e-e #p '#n're*e (# ,*"#n( *# 3e'rea(e %er',r) "n*ake b) #'a p#p, a*"#n(! *# "%pr#-e *+e"r $enera +ea *+ '#n3"*"#n(! an3 *# re3,'e *+e e-e #& %e*+) %er',r) "n *+e e'#()(*e%. T+e re&eren'e 'en*er 6" be *+e &"r(* bank #& (*an3ar3"7e3 3a*a #n %er',r) "n *+e A%a7#n 0 "*( (#,r'e( an3 "*( "%pa'* #n *+e &##3 '+a"n an3 +,%an +ea *+. E-en*,a )! *+"( "n&#r%a*"#n 6" be %a3e a-a" ab e *# an)#ne *+r#,$+ a 6eb ("*e. H,%an +ea *+ an3 *+e en-"r#n%en*: IDRC9( %, *"03"('"p "nar) appr#a'+ T+e "n-e(*"$a*"#n "n*# *+e 'a,(e #& %er',r) '#n*a%"na*"#n "n *+e A%a7#n "( #ne #& %an) pr#1e'*( be"n$ &,n3e3 ,n3er *+e ,%bre a #& IDRC9( pr#$ra% "n"*"a*"-e #n GE'#()(*e% Appr#a'+e( *# H,%an Hea *+.G T+e $#a #& *+"( "n"*"a*"-e "( *# "%pr#-e +,%an +ea *+ b) (,pp#r*"n$ *ran(03"('"p "nar) re(ear'+ #n *+e (*r,'*,re an3 &,n'*"#n #& (*re((e3 e'#()(*e%( #n 6+"'+ pe#p e 3epen3 &#r *+e"r "-e( an3 "-e "+##3(. T+"( kn#6 e3$e 'an *+en be ,(e3 *# 3e-e #p "n*er-en*"#n( an3 p# "'"e( *#6ar3 *+e be**er %ana$e%en* #& e'#()(*e%( "n #r3er *# "%pr#-e +,%an +ea *+ an3 6e 0be"n$ 6+" e ("%, *ane#,( ) %a"n*a"n"n$ #r "%pr#-"n$ *+e +ea *+ #& e'#()(*e%( a( a 6+# e. Tran(03"('"p "nar) re(ear'+ #&&er( a %#re +# "(*"' appr#a'+ *# ,n3er(*an3"n$ en-"r#n%en*a pr#b e%( an3 r"(k(! an3 &"n3"n$ (,(*a"nab e! '#(*0e&&e'*"-e (# ,*"#n(. T#3a)! *+e *ea% *+a* "( e8p #r"n$ %er',r) '#n*a%"na*"#n "n *+e A%a7#n "n' ,3e( a ne,r#*#8"'# #$"(*! an3 (pe'"a "(*( "n e*+n#b#*an)! ')*#$ene*"'(!(#'"# #$)! b"#$e#'+e%"(*r)! *+e en-"r#n%en*! an3 &#re(*r) &r#% *+e A%a7#n"an Fe3era Un"-er("*) #& Para .UFPa/ "n Be ;%! *+e UFPa #,*rea'+ 'a%p,( "n San*ar;%! *+e Fe3era Un"-er("*) #& R"# 3e Jane"r#! *+e Un"-er("*) #& <,ebe' a* M#n*r;a .U<AM/! *+e M#n*r;a B"#3#%e! an3 *+e Gr,p# 3# De&en'"a 3# A%a7#na "n San*ar;%. An#*+er "%p#r*an* e e%en* #& *+"( pr#1e'* "( '#%%,n"*) "n-# -e%en*! "n b#*+ *+e re(ear'+ an3 *+e 3e-e #p%en* #& (# ,*"#n(. C#p)r"$+* >??? M In*erna*"#na De-e #p%en* Re(ear'+ Cen*re! O**a6a! Cana3a %e3"a2"3r'.'a N >C J,ne >??? 00000000000000000000000000000000000000000000000000000000000000000000000000000000

MERCURY AND ITS MANY FORMS

T#p"'( #n *+"( pa$e "n' ,3e: E e%en*a Mer',r) 4+a* are (#,r'e( #& e8p#(,re *# e e%en*a %er',r)5 H#6 *#8"' "( e e%en*a %er',r)5 Can e e%en*a %er',r) be 3an$er#,(5 In#r$an"' Mer',r) 4+a* are *+e ()%p*#%( #& "n#r$an"' %er',r) p#"(#n"n$5 Or$an"' Mer',r) 4+a* "( *+e %#(* '#%%#n (#,r'e #& #r$an"' %er',r) p#"(#n"n$5

4+a* are *+e ("$n( an3 ()%p*#%( #& #r$an"' %er',r) p#"(#n"n$5 H#6 "( %er',r) p#"(#n"n$ 3"a$n#(e3 an3 *rea*e35 H#6 3# I ' ean ,p a (%a (p" #& e e%en*a %er',r)5 H#6 *# (a&e ) an3 '#rre'* ) ' ean ,p a (%a (p" "( %#re '#%p "'a*e3 Br#ken *+er%#%e*er( are *+e 'a,(e #& n,%er#,( 'a ( *# *+e P#"(#n Cen*er. T+er%#%e*er( 6"*+ a (" -er "ne '#n*a"n e e%en*a %er',r). T+er%#%e*er( 6"*+ a re3 #r b ,e "D,"3 3# NOT '#n*a"n %er',r). T+ere "( %,'+ %"("n&#r%a*"#n ab#,* %er',r)! "*( -ar"#,( &#r%( an3 "*( 3an$er(. T+ree 3"&&eren* *)pe( #& %er',r) e8"(*! -ar)"n$ "n *+e"r e-e ( #& *#8"'"*). T+e) are e e%en*a %er',r)! "n#r$an"' %er',r) an3 #r$an"' %er',r). E e%en*a %er',r) Mer',r) "( an e8*re%e ) +ea-)! #3#r e((! (" -er '# #re3 "D,"3. Mer',r) e8"(*( a( a na*,ra e e%en* "n *+e ear*+9( 'r,(*. E e%en*a %er',r) "( a (# kn#6n a( %e*a "' %er',r)! "D,"3 %er',r)! "D,"3 (" -er an3 D,"'k(" -er. 4+a* are (#,r'e( #& e8p#(,re *# e e%en*a %er',r)5 S#,r'e( #& e e%en*a %er',r) "n *+e +#%e "n' ,3e br#ken %er',r) *+er%#%e*er(! br#ken & ,#re('en* "$+* b, b(! 3en*a a%a $a% &" "n$(! %er',r) '#n*a"n"n$ a*e8 pa"n*(! e8*ra'*"#n #& $# 3 &r#% #re ,("n$ %er',r)! an3 '#n*a%"na*e3 ' #*+"n$ &r#% 6#rker( "n *+er%#%e*er %ak"n$ p an*(. E e%en*a %er',r) "( a (# ,(e3 a( a Me8"'an &# k %e3"'"ne *# *rea* Ge%pa'+#!G a '+r#n"' (*#%a'+ 3"(#r3er. H#6 *#8"' "( e e%en*a %er',r)5 O& a *+e &#r%( #& %er',r)! e e%en*a %er',r) "( *+e %#(* '#%%#n ) (6a #6e3 &#r% #& %er',r)! ,(,a ) &r#% a br#ken *+er%#%e*er. F#r*,na*e )! e e%en*a %er',r) &r#% a *+er%#%e*er "( n#* ab(#rbe3 &r#% *+e (*#%a'+ an3 6" n#* 'a,(e an) p#"(#n"n$ "n a +ea *+) per(#n. In a +ea *+) per(#n! *+e ( "pper) (6a #6e3 %er',r) 6" r# "n*# *+e (*#%a'+! #,* "n *# *+e b#6e ( an3 6" be D,"'k ) e "%"na*e3 6"*+#,* 'a,("n$ an) ()%p*#%(. A per(#n 6"*+ (e-ere "n& a%%a*#r) b#6e 3"(ea(e #r *+#(e 6"*+ a &"(*, a .+# e #r #pen"n$/ "n *+e"r $,* %a) +a-e pr#b e%( 6"*+ %er',r) "& "* "( n#* a ' eare3 #,*! re(, *"n$ "n pr# #n$e3 e8p#(,re. Han3 "n$ "D,"3 %er',r) &#r a -er) (+#r* per"#3 #& *"%e ,(,a ) 3#e( n#* re(, * "n an) pr#b e%(. An a er$"' ra(+ "( p#(("b e! *+#,$+. Mer',r) "( n#* 6e ab(#rbe3 a'r#(( *+e (k"n (# (k"n '#n*a'* "( n#* "ke ) *# 'a,(e %er',r) p#"(#n"n$! e(pe'"a ) 6"*+ a br"e& #ne0*"%e e8p#(,re. E-en "& a per(#n +a( ',*( "n *+e"r (k"n! %er',r) "( *## +ea-) *# be '#n*a"ne3 b) a ',*. Mere ) 6a(+"n$ *+e 6#,n3 6e 6" 6a(+ *+e %er',r) #,* #& *+e 6#,n3. Can e e%en*a %er',r) be 3an$er#,(5 In+a a*"#n #& e e%en*a %er',r) -ap#r( "( *+e %a"n 'a,(e #& *#8"'"*)! a( %er',r) "( 6e ab(#rbe3 b) *+e ,n$(. T# 3e-e #p pr#b e%( b) "n+a a*"#n )#, nee3 e"*+er a ar$e #ne0*"%e e8p#(,re #r a #n$0*er% e8p#(,re. A (%a ! #ne0*"%e e8p#(,re "( n#* "ke ) *# 'a,(e pr#b e%(. 4+a* are *+e ()%p*#%(5 A&*er a ar$e! #ne0*"%e "n+a a*"#n e8p#(,re #& %er',r) -ap#r! *+e ,n$( are *+e %a"n *ar$e* #& %er',r) p#"(#n"n$! a *+#,$+ #*+er ()%p*#%( 3e-e #p a( 6e . S)%p*#%( %a) 3e-e #p 6"*+"n a &e6 +#,r( an3 "n' ,3e '+" (! %e*a "' *a(*e! %#,*+ (#re(! (6# en $,%(! na,(ea! -#%"*"n$! ab3#%"na pa"n! 3"arr+ea! +ea3a'+e! 6eakne((! '#n&,("#n! (+#r*ne(( #& brea*+! '#,$+! '+e(* *"$+*ne((! br#n'+"*"(! pne,%#n"a an3 k"3ne) 3a%a$e. H#6 3#e( #n$0*er% e8p#(,re 3"&&er &r#% a (+#r*0*er% e8p#(,re5 L#n$0*er% e8p#(,re .,(,a ) 6#rk0re a*e3/ #& "n+a e3 -ap#r( "( $enera ) %#re 3an$er#,( *+an a #ne0*"%e (+#r* e8p#(,re. A&*er #n$0*er% "n+a a*"#n e8p#(,re! *+e ner-#,( ()(*e% "( *+e %a"n *ar$e* #& *#8"'"*). S)%p*#%( %a) #'',r 6"*+"n 6eek( b,* ,(,a ) 3e-e #p "n("3"#,( ) #-er a per"#3 #& )ear(. Ne,r# #$"' ()%p*#%( "n' ,3e *re%#r(! +ea3a'+e(! (+#r*0*er% %e%#r) #((! "n'##r3"na*"#n! 6eakne((! #(( #& appe*"*e! a *ere3 (en(e #& *a(*e an3 (%e ! n,%bne(( an3 *"n$ "n$ "n *+e +an3( an3 &ee*! "n(#%n"a! an3 e8'e(("-e (6ea*"n$. P()'+"a*r"' e&&e'*( are a (# (een a&*er #n$0*er% e8p#(,re. A'r#3)n"a 'an re(, * &r#% repea*e3 e8p#(,re( *# %er',r)0'#n*a"n"n$ a*e8 pa"n* &,%e(. A'r#3)n"a "( ,(,a ) (een "n )#,n$er '+" 3ren. T+e ()%p*#%( "n' ,3e '+" (! (6ea*"n$! b#3) ra(+! "rr"*ab" "*)! ( eep e((ne((! e$ 'ra%p(! (6e "n$ #& *+e '+eek(! n#(e! +an3( an3 &ee*! "$+*0(en("*"-"*) *# *+e e)e( an3 pee "n$ (k"n a)er( #n *+e pa %( #& *+e +an3( an3 (# e( #& *+e &ee*.

In#r$an"' Mer',r)
In#r$an"' %er',r) '#%p#,n3( are kn#6n a( G%er',r"' (a *(.G S#%e #& *+e %er',r"' (a *( "n' ,3e: %er',r"' '+ #r"3e! %er',r"' "#3"3e! %er',r"' n"*ra*e! %er',r"' (, &"3e! )e #6 %er',r"' #8"3e! re3 %er',r"' #8"3e! a%%#n"a*e3 %er',r)! %er',r#,( '+ #r"3e an3 %er',r#,( a'e*a*e. 4+a* are (#,r'e( #& "n#r$an"' %er',r) '#%p#,n3(5 S#%e &# k %e3"'"ne( &r#% #,*("3e *+e Un"*e3 S*a*e( '#n*a"n +"$+ a%#,n*( #& %er',r) *+a* 'an 'a,(e %er',r) p#"(#n"n$. T6# '#%%#n %er',r) '#%p#,n3( are 'a #%e an3 '"nnabar. C+"ne(e +erba 3r,$( 6"*+ %ea(,rab e a%#,n*( #& %er',r) "n' ,3e: T(e O## C+#) <"n$ Fen Z+,0S+a C+en0Fen C+"ne(e +erba ba prepara*"#n( '#n*a"n"n$ b#*+ %er',r) an3 ar(en"' "n' ,3e: An G#n$ N", H,an$ 4an Da H,# L,# 4an Den3r#b",% M#n" "&#r%e N"$+* S"$+* p" ( N", H,an$ C+"an$ Ya 4an N", H,an$ C+"an$ H("n 4an Ta H,# L# Tan T(a" T(a# 4an In3"an an3 Me8"'an &# k %e3"'a*"#n( '#n*a"n"n$ %er',r) "n' ,3e: Cre%e 3e Be e7a0Mann"n$ Ta"nan P"n$0*#n$ S"n0'+, 4+a* are *+e ()%p*#%( #& "n#r$an"' %er',r) p#"(#n"n$5 In#r$an"' %er',r"' (a *( are '#rr#("-e an3 *+e) 3a%a$e *+e k"3ne)(. F# #6"n$ "n$e(*"#n! ()%p*#%( "n' ,3e na,(ea! -#%"*"n$ b ##3! b,rn( an3 *"((,e 3ea*+ "n *+e *+r#a* an3 (*#%a'+! ab3#%"na pa"n! b ##3) 3"arr+ea! 3e'rea(e3 ,r"na*"#n an3 k"3ne) &a" ,re. L#n$0*er% app "'a*"#n #& %er',r)0'#n*a"n"n$ (,b(*an'e( 'a,(e( (k"n re3ne(( an3 (*a"n"n$ #& *+e (k"n. M#re (e-ere ()%p*#%( "n' ,3e ner-e 3a%a$e re(, *"n$ "n 6eakne((! n,%bne(( an3 *"n$ "n$.

Or$an"' Mer',r)
4+a* are (#,r'e( #& #r$an"' %er',r)5 Or$an"' %er',r) '#%p#,n3( are &#,n3 "n a -ar"e*) #& pr#3,'*(. T+e) are ,(e3 %e3"'a ) a( &,n$"'"3e( an3 an*"ba'*er"a (. T+e %#(* '#%%#n #r$an"' %er',r) '#%p#,n3( "n *+e +#%e %a) 6e be %er',r#'+r#%e .%erbr#%"n/ an3 %er*+"# a*e .*+"%er#(a /! *6# '#%%#n an*"(ep*"'(. F#r*,na*e )! (%a "n$e(*"#n( b) '+" 3ren rare ) 'a,(e %a1#r pr#b e%(. 4+a* "( *+e %#(* '#%%#n (#,r'e #& #r$an"' %er',r) p#"(#n"n$5 In *+e $enera p#p, a*"#n! *+e %a"n (#,r'e #& %er',r) p#"(#n"n$ "( *+e "n$e(*"#n #& %er',r)0 '#n*a%"na*e3 &##3! ,(,a ) &"(+. 4+en ake! r"-er #r #'ean 6a*er "( '#n*a%"na*e3 6"*+ %e*+) 0%er',r) '#%p#,n3(! *+e %er',r) a'',%, a*e( an3 %a$n"&"e( "n *+e & e(+ #& *+e &"(+. Or$an"' %er',r) '#n'en*ra*"#n( 'an be %#re *+an >!CCC *"%e( $rea*er "n *+e &"(+ *+an "n *+e (,rr#,n3"n$ 6a*er. Pe#p e 6+# ea* &"(+ a( a %a"n '#%p#nen* #& *+e"r 3"e* %a) be a* r"(k. I& a r"-er #r ake "( kn#6n *# be p# ,*e3 6"*+ %er',r)! &"(+ ea*er( are 6arne3 *# 3e'rea(e *+e"r 6eek ) "n*ake #& &"(+. 4+a* are *+e ("$n( an3 ()%p*#%( #& #r$an"' %er',r) p#"(#n"n$5 Or$an"' %er',r) '#%p#,n3( are -er) 3a%a$"n$. T+e) are *#8"' b) "n$e(*"#n! "n+a a*"#n! an3 (k"n an3 e)e '#n*a'*. T+e(e %er',r) '#%p#,n3( 'an a**a'k a b#3) ()(*e%(. T+e) 'an 'a,(e na,(ea! -#%"*"n$! a'k #& appe*"*e! 6e"$+* #((! ab3#%"na pa"n! 3"arr+ea! k"3ne) &a" ,re! (k"n b,rn( an3 "rr"*a*"#n! re(p"ra*#r) 3"(*re((! (6# en $,%( an3 %#,*+ (#re(! 3r## "n$! n,%bne(( an3 *"n$ "n$ "n *+e "p(! %#,*+! *#n$,e! +an3( an3 &ee*! *re%#r( an3 "n'##r3"na*"#n! -"("#n an3 +ear"n$ #((! %e%#r) #((! per(#na "*) '+an$e( an3 +ea3a'+e. A er$"' rea'*"#n( 'an a (# #'',r.

Me*+) 0%er',r)! ,(,a ) &r#% '#n*a%"na*e3 &##3! "( -er) 3an$er#,( *# pre$nan* 6#%en. Me*+) 0%er',r) 'a,(e( pr#&#,n3 %en*a re*ar3a*"#n! 'erebra pa ()! (e"7,re(! (pa(*"'"*)! *re%#r(! an3 "n'##r3"na*"#n! a #n$ 6"*+ e)e an3 +ear"n$ 3a%a$e "n *+e ,nb#rn bab) a( a re(, * #& *+e %#*+er9( e8p#(,re. Or$an"' %er',r) pa((e( "n*# *+e brea(* %" k a( 6e . H#6 "( %er',r) p#"(#n"n$ 3"a$n#(e3 an3 *rea*e35 Be'a,(e *+e n,%ber #& ()%p*#%( "( (# $rea* an3 *+e -ar"e*) #& ()%p*#%( "( (# 6"3e! an)#ne '#, 3 p"'k #,* a* ea(* H #r B ()%p*#%( a* an) $"-en *"%e. I& )#, +a-e an) 3#,b* an3 "& )#, +a-e been #r are e8p#(e3 *# %er',r) '#%p#,n3(! (ee a p+)("'"an an3 $e* *e(*e3. Te(*"n$ "( *+e #n ) 3e&"n"*e 6a) *# 3e*er%"ne "& %er',r) "( *+e 'a,(e #& *+e ()%p*#%(. Mer',r) p#"(#n"n$ 'an be 3"a$n#(e3 b) (pe'"a b ##3 an3 ,r"ne '# e'*"#n *e(*(. I& e-e ( are +"$+! *+ere "( *rea*%en*. Me3"'a*"#n 'an be a3%"n"(*ere3 *# +e p b"n3 *+e %er',r) an3 "n'rea(e e "%"na*"#n. S)%p*#%( 3# n#* a 6a)( '#rre(p#n3 *# b ##3 %er',r) e-e (: Man) pa*"en*( 6"*+ +"$+ e-e ( 3# n#* +a-e (e-ere ()%p*#%(. I& %er',r) b ##3 e-e ( are $#"n$ *# be *e(*e3! "* "( "%p#r*an* NOT *# ea* an) (ea&##3 pr#3,'*( &#r a* ea(* BC +#,r( be&#re *e(*"n$. E-en a ("n$ e %ea #& (ea&##3 'an e e-a*e %er',r) b ##3 e-e ( &#r a( #n$ a( HC *# BC +#,r( a&*er ea*"n$. Ea*"n$ (ea&##3 6" 'a,(e %"( ea3"n$ +"$+ e-e (. H#6 3# I ' ean ,p a (%a (p" #& e e%en*a %er',r)5 Man) pe#p e +a-e 'a e3 *+e P#"(#n Cen*er a(k"n$ +#6 *# ' ean ,p *+e %er',r) &r#% a br#ken *+er%#0%e*er. T+ere are (e-era 3"&&eren* "3ea( #n +#6 an3 +#6 n#* *# ' ean ,p *+e %er',r) bea3(. E8per*( a$ree #n *+e 6a)( NOT *# ' ean ,p a (p" : D# n#* (6eep *+e area 6"*+ a br##%. S6eep"n$ break( *+e %er',r) "n*# (%a er 3r#p e*(! &,r*+er '#n*a%"na*"n$ *+e r##% an3 *+e br##%. Pa',,%"n$ -ap#r"7e( *+e %er',r) an3 "n'rea(e( *+e '#n'en*ra*"#n #& %er',r) "n *+e a"r. NOTE: I& )#, are 6ear"n$ $# 3 1e6e r)! e"*+er re%#-e *+e 1e6e r) #r 6ear $##3 pr#*e'*"-e $ #-e(. I& *+e "D,"3 %er',r) '#n*a'*( *+e $# 3 1e6e r)! *+e %er',r) b#n3( per%anen* ) *# *+e $# 3 an3 r,"n( "*. H#6 *# (a&e ) an3 '#rre'* ) ' ean ,p a (%a (p" "( %#re '#%p "'a*e3 S*ep One: U("n$ a p a)"n$ 'ar3! 're3"* 'ar3 #r (*"&& p"e'e #& paper! $a*+er ,p! ('rape ,p #r r# ,p *+e bea3( #& %er',r) "n*# #ne b"$ bea3 #r ba . T+en! (e-era ' ean,p #p*"#n( are a-a" ab e: Op*"#n A: U("n$ an e)e3r#pper #r #*+er (D,ee7e0b, b 3r#pper! 'are&, ) (,'k *+e %er',r) 3r#p e*( ,p. Op*"#n B: U("n$ a '#%%#n penn)! 3"p *+e penn) "n*# *+e %er',r) an3 e* *+e %er',r) a3+ere #r b#n3 *# *+e penn). T+"( %a) reD,"re %#re *+an #ne penn). Op*"#n C: U("n$ 3,'* .3,'k/ *ape! p a'e *+e *ape #-er *+e %er',r) ba #r bea3( an3 "&* *+e %er',r) #&& *+e (,r&a'e. S*ep T6#: P a'e *+e %er',r) bea3(! %er',r)0'#a*e3 penn"e(! #r *ape 6"*+ *+e %er',r) bea3( "n*# a 7"p0 #'k p a(*"' ba$. Sea *+e ba$ (e',re )! *ape "* (+,*! 6rap "* "n ne6(paper an3 3"(p#(e pr#per ). T6# #*+er! %#re '#%p "'a*e3 6a)( &#r ' ean"n$ ,p (%a (p" ( reD,"re *+e ,(e #& $ran, ar 7"n' #r (, &,r p#63er. Gran, ar 7"n' 'an be #b*a"ne3 &r#% ('"en*"&"' (,pp ) +#,(e( an3 (, &,r p#63er 'an be #b*a"ne3 a* $ar3en (,pp ) (+#p(. NOTE: I* "( "%p#r*an* *# kn#6 *+a* ,("n$ 7"n' $ran, e( 6" per%anen* ) (*a"n 'arpe*( a 3ark $ra) *+a* 'ann#* be re%#-e3. S, &,r %a) (*a"n 'arpe*( b a'k! b,* *+"( 'an #&*en .b,* n#* a 6a)(/ be re%#-e3 6"*+ 'arpe* (*a"n ' eaner(. S*ep One: D,(* #n *+e 7"n' #r (, &,r p#63er an3 r,b "n 6e 6"*+ a 3"(p#(ab e 6+"(k br##%. S*ep T6#: S6eep ,p a( %,'+ #& *+e %"8*,re a( p#(("b e 6"*+ *+e 6+"(k br##%. S*ep T+ree: Pa',,% ,p *+e re("3,a %a**er 6"*+ a -a',,% ' eaner an3 "%%e3"a*e ) 3"('ar3 *+e -a',,% ' eaner ba$. S*ep F#,r: I& an) %er',r) bea3( re%a"n! repea* *+e pr#'e(( ,n*" n#ne "( pre(en*. S*ep F"-e: D"('ar3 *+e 6+"(k br##% a&*er ,(e.

Re$ar3 e(( #& *+e %e*+#3 ,(e3 &#r ' ean,p! *+ere "( -er) "** e r"(k #& 3an$er "& *+e area "( 6e -en*" a*e3. A (p" #& a ar$e a%#,n* #& %er',r) *+a* "( n#* "%%e3"a*e ) ' eane3 ,p 'an pre(en* a pr#b e% a( *+e %er',r) -ap#r"7e( an3 "( brea*+e3 "n b) &a%" ) %e%ber(. Ca : >0QCC0QRF0@RFF an)*"%e! an)p a'e "n Ca "&#rn"a Ca "&#rn"a P#"(#n C#n*r# S)(*e%

Mercury poisoning case being investigated

A 6#%an! 6+# +a( been ,("n$ *+"( pr#3,'* &#r %#re *+an HC )ear(! pre(en*e3 6"*+ ("$n( #& %er',r) p#"(#n"n$. S,b(eD,en* "n-e(*"$a*"#n '#n&"r%e3 *+a* *+e (a%p e( #& #"n*%en* '#n*a"ne3 ("$n"&"'an* a%#,n*( #& %er',r). I* "( be "e-e3 *+a* *+e pr#3,'* 6a( pre('r"be3! &#r *rea*%en* #& -"*" "$#! b) a C+"ne(e %e3"'"ne pra'*"*"#ner ST UV WX 6+# "( pra'*"("n$ "n Ca,(e6a) Ba). Mer',r) '#%p#,n3( %a"n ) a&&e'* *+e ner-#,( ()(*e% an3 k"3ne)(. S)%p*#%( %a) "n' ,3e +an3 *re%#r(! -"(,a #r +ear"n$ #((! %e%#r) 3e*er"#ra*"#n! "rr"*ab" "*)! an3 3"&&"', *) 6"*+ ( eep"n$. O"3ne) 3a%a$e 'an re(, * "n #e3e%a! par*"', ar ) "n *+e ank e( an3 e$(. Ga(*r#"n*e(*"na ()%p*#%( (,'+ a( na,(ea! -#%"*"n$! an3 ab3#%"na 3"('#%&#r* %a) a (# #'',r. Mer',r) 'an a (# pa(( &r#% *+e %#*+er *# *+e &#e*,( re(, *"n$ "n "%pa"re3 bra"n 3e-e #p%en*. S#%e ne,r# #$"'a e&&e'*( 'an be #n$0 a(*"n$! 6+" e #*+er +ea *+ e&&e'*( are ,(,a ) re-er("b e. I& )#, +a-e n#* ,(e3 *+e #"n*%en* &#r %#re *+an F %#n*+(! )#,r b#3) 6#, 3 +a-e e8're*e3 %#(* #& *+e %er',r). I& )#, are '#n'erne3 ab#,* )#,r +ea *+! )#, %a) a (# (eek %e3"'a a3-"'e &r#% 3#'*#r.

MERCURY:
A FACT SHEET FOR HEALTH PROFESSIONALS
Mer',r) "( pr#bab ) be(* kn#6 a( *+e (" -er "D,"3 "n *+er%#%e*er(. H#6e-er! "* +a( #-er BCCC "n3,(*r"a ,(e(. Mer',r) an3 "*( '#%p#,n3( are 6"3e ) 3"(*r"b,*e3 "n *+e en-"r#n%en* a( a re(, * #& b#*+ na*,ra an3 %an0%a3e a'*"-"*"e(. T+e ,*" "*)! an3 *+e *#8"'"*)! #& %er',r) +a-e been kn#6n &#r 'en*,r"e(. Ne6 e-"3en'e 3e%#n(*ra*e( *+a* e-en #6 e-e ( #& %er',r) e8p#(,re %a) be +a7ar3#,(. T+e p,rp#(e #& *+"( 3#',%en* "( *# pr#-"3e +ea *+ pr#&e(("#na ( 6"*+ ,p3a*e3 "n&#r%a*"#n #n %er',r) an3 $,"3an'e #n pre-en*"n$ *#8"' e8p#(,re( "n +ea *+ 'are 6#rker( an3 *+e"r ' "en*(.

HISTORY Y REGULATIONS
Mer',r) #'',r( na*,ra ) "n *+e en-"r#n%en* a( %er',r"' (, &"3e! a (# kn#6n a( '"nnabar. I* "( a (# pre(en* "n (#%e &#((" &,e (. C"nnabar +a( been re&"ne3 &#r "*( %er',r) '#n*en* ("n'e *+e >E*+ #r >F*+ 'en*,r) B.C. I*( +ea *+ +a7ar3( +a-e been kn#6n a* ea(* ("n'e *+e r#%an '#nD,e(* #& Spa"n. D,e *# *+e *#8"'"*) #& %er',r) "n '"nnabar! 'r"%"na ( (en*en'e3 *# 6#rk "n D,"'k(" -er %"ne( b) *+e R#%an( +a3 a "&e e8pe'*an') #& #n ) B )ear(. Mer',r) "( pre(en* "n n,%er#,( '+e%"'a &#r%(. E e%en*a %er',r) "*(e & "( *#8"' an3 'ann#* be br#ken 3#6n "n*# e(( +a7ar3#,( '#%p#,n3(. E e%en*a #r "n#r$an"' &#r%( 'an be *ran(&#r%e3 "n*# #r$an"' .e(pe'"a ) %e*+) a*e3/ &#r%( b) b"# #$"'a ()(*e%(. N#* #n ) are *+e(e %e*+) a*e3 %er',r) '#%p#,n3( *#8"'! b,* +"$+ ) b"#a'',%, a*"-e a( 6e . T+e "n'rea(e "n %er',r) a( "* r"(e( "n *+e aD,a*"' &##3 '+a"n re(, *( "n re a*"-e ) +"$+ e-e ( #& %er',r) "n &"(+ '#n(,%e3 b) +,%an(. 4"3e(prea3 p#"(#n"n$ #& Japane(e &"(+er%an an3 *+e"r &a%" "e( #'',rre3 "n M"na%a*a! Japan "n *+e >?EC9( a( a re(, * #& '#n(,%p*"#n #& %e*+) %er',r) '#n*a%"na*e3 &"(+. T#3a)! 6e '#n*"n,e *# be e8p#(e3 *# %er',r) "n #,r 3"e*(! pr"%ar" ) &r#% &"(+ an3 (+e &"(+. A( a re(, *! *+e U.S. F##3 an3 Dr,$ A3%"n"(*ra*"#n .FDA/ +a( an a'*"#n e-e &#r %er',r) #& > par* per %" "#n .pp%/ "n &"(+ an3 *+e M"'+"$an Depar*%en* #& P,b "' Hea *+ "((,e( &"(+ '#n(,%p*"#n a3-"(#r"e( *# an$ er( 6+en %er',r) e-e ( e8'ee3 C.E pp% "n &"(+ *"((,e.

4"3e(prea3 "n3,(*r"a pr#3,'*"#n #& %er',r)! a #n$ 6"*+ a'k #& 'are&, +an3 "n$ an3 3"(p#(a pra'*"'e(! +a( '#n*r"b,*e3 *# en-"r#n%en*a '#n*a%"na*"#n. T+e U.S. En-"r#n%en*a Pr#*e'*"#n A$en') .EPA/ +a( %a3e e&&#r*( *# re$, a*e *+e '#n*"n,e3 re ea(e #& %er',r) "n*# *+e en-"r#n%en*. EPA re$, a*e( "n3,(*r"a 3"('+ar$e( *# a"r an3 6a*er! a( 6e a( re$, a*"n$ (#%e a(pe'*( #& %er',r) 6a(*e 3"(p#(a . In >?RF! EPA banne3 %#(* pe(*"'"3e ,(e( #& %er',r) 0 6"*+ *+e e8'ep*"#n( #& &,n$"'"3a ,(e( "n pa"n*( an3 #,*3##r &abr"'(! an3 &#r '#n*r# #& D,*'+ E % 3"(ea(e. In >??C! %er',r) ,(e a( a &,n$"'"3e "n "n*er"#r a*e8 pa"n* 6a( +a *e3 b) *+e EPA. T+"( a'*"#n (*e%%e3 &r#% reD,e(*( b) M"'+"$an #&&"'"a ( a&*er a '+" 3 6a( p#"(#ne3 &r#% #-er &#r%, a*e3 %er',r)0'#n*a"n"n$ pa"n* ,(e3 "n +"( +#%e. M#re re'en* )! *+e ,(e #& %er',r) '#%p#,n3( "n e8*er"#r a*e8 pa"n* +a( a (# been +a *e3. In a33"*"#n *# *+e ear ) 6#rker( "n *+e '"nnabar %"ne(! %#3ern 6#rker( "n "n3,(*r"e( ,("n$ %er',r) are a* r"(k &r#% #-ere8p#(,re. T+e O'',pa*"#na Sa&e*) an3 Hea *+ A3%"n"(*ra*"#n .OSHA/ +a( been re-"e6"n$ *+e ',rren* #'',pa*"#na e8p#(,re (*an3ar3 #& C.> %$Z%B .%" "$ra%( per ',b"' %e*er #& a"r/ *# 3e*er%"ne "& *+e) (+#, 3 re3,'e *+e Q +#,r a''ep*ab e e8p#(,re "%"* *# C.CE %$Z%B. A *+#,$+ n# re$, a*#r) "%"* e8"(*( &#r a"rb#rne e8p#(,re *# %er',r) #,*("3e #& an #'',pa*"#na (e**"n$! *+e EPA (,$$e(*( *+a* C.B ,$Z%B .%"'r#0$ra%( per ',b"' %e*er #& a"r/ #& %er',r) "( a n#0e&&e'* e-e .#r re&eren'e 3#(e [ R&3/ &#r '+r#n"' "n+a a*"#n e8p#(,re.

USES
De("rab e pr#per*"e( (,'+ a( *+e ab" "*) *# a #) 6"*+ %#(* %e*a (! "D,"3"*) a* r##% *e%pera*,re! ea(e #& -ap#r"7"n$ an3 &ree7"n$! an3 e e'*r"'a '#n3,'*"-"*) %ake %er',r) an "%p#r*an* "n3,(*r"a %e*a . In >?RB! U.S. '#n(,%p*"#n #& %er',r) 6a( >?CC %e*r"' *#n(. Pr"%ar) a%#n$ "*( #-er BCCC "n3,(*r"a ,(e( are ba**er) %an,&a'*,r"n$ an3 '+ #r"ne0a ka " pr#3,'*"#n. Pa"n*( an3 "n3,(*r"a "n(*r,%en*( +a-e a (# been a%#n$ *+e %a1#r ,(e(. Un*" pa"n* %an,&a'*,rer( a$ree3 *# e "%"na*e *+e ,(e #& %er',r) "n "n*er"#r pa"n*(! @QC!CCC p#,n3( #& %er',r) "n pa"n*( an3 '#a*"n$( 6ere pr#3,'e3 ea'+ )ear. Tab e > pr#-"3e( a "(* #& %er',r) ,(e(.

E\POSURE SCENARIOS
H,%an( '#%e "n '#n*a'* 6"*+ %er',r) *+r#,$+ en-"r#n%en*a ! #'',pa*"#na #r a''"3en*a e8p#(,re ('enar"#(. An e(*"%a*e3 QCI #& ,*" "7e3 %er',r) "( e-en*,a ) re ea(e3 ba'k "n*# *+e en-"r#n%en*. Be'a,(e "* "( ea(" ) -ap#r"7e3! a"r ar#,n3 '+ #r"ne0a ka " p an*(! (%e *er(! %,n"'"pa "n'"nera*#r(! (e6a$e *rea*%en* p an*( an3 e-en '#n*a%"na*e3 (#" ( %a) '#n*a"n "n'rea(e3 e-e ( #& %er',r). A pr"%ar) r#,*e #& e8p#(,re "( *+r#,$+ *ran(p#r* "n*# (,r&a'e 6a*er(! 6+ere %er',r) be'#%e( b"#%a$n"&"e3 "n &"(+ *"((,e(. 4#rkp a'e e8p#(,re *# %er',r) #'',r( *+r#,$+ "n+a a*"#n #& '#n*a%"na*e3 a"r! 3"re'* (k"n '#n*a'* 6"*+ "D,"3 %er',r)! #r #ra e8p#(,re *+r#,$+ '#n*a%"na*e3 +an3(! &##3! e*'. A re'en* e3"*"#n #& *+e *e e-"("#n (+#6 FC M"n,*e( +"$+ "$+*e3 '#n'ern( ab#,* %er',r) e8p#(,re "n pa*"en*( re'e"-"n$ (" -er 3en*a &" "n$( 6"*+ %er',r)0'#n*a"n"n$ a%a $a%. In(,&&"'"en* ('"en*"&"' e-"3en'e e8"(*( a* *+"( *"%e *# e"*+er (,pp#r* #r re&,*e *+e ' a"%( *+a* 3en*a &" "n$( %a) re(, * "n +ar%&, e8p#(,re *# %er',r). A''"3en*( +a-e re(, *e3 "n (e-era 'a(e( #& %er',r) p#"(#n"n$ "n M"'+"$an "n *+e pa(* *6# )ear(. F#,r %e%ber( #& a L"n'# n Park &a%" ) 6ere k" e3 a&*er #ne %e%ber a**e%p*e3 *# re&"ne 3en*a a%a $a% "n +"( +#%e 6+" e a**e%p*"n$ *# re'#-er (" -er. H"$+ e-e ( #& %er',r) 6ere &#,n3 *+r#,$+#,* *+e +#,(e! "n' ,3"n$ 6rappe3 &##3 "n("3e *+e &ree7er. T+e en*"re +#,(e +a3 *# be 3e%# "(+e3 an3 3"(p#(e3 #& "n a +a7ar3#,( 6a(*e an3&" . A n,%ber #& '+" 3ren +a-e 3e-e #pe3 %er',r) p#"(#n"n$ a&*er p a)"n$ 6"*+ (%a -"a ( #& %er',r) 6+"'+ *+e) &#,n3 a* +#%e #r ('+## . T+e(e '+" 3ren 6ere +#(p"*a "7e3 6+en ()%p*#%( be'a%e (# (e-ere *+a* *+e) '#, 3 n#* #n$er 6a k. One '#n*a%"na*"#n "n'"3en* "n-# -e3 ' #("n$ a ('+## &#r 6eek( an3 en*a" e3 en-"r#n%en*a "n-e(*"$a*"#n #& re("3en'e(! 'ar(! ('+## b,(e( an3 3a) 'are 'en*er(.

METABOLISM Y TO\ICITY
E8p#(,re *# %er',r) 'an #'',r *+r#,$+ "n+a a*"#n! "n$e(*"#n #r 3er%a ab(#rp*"#n. *+e a%#,n* #& %er',r) ab(#rbe3 b) *+e b#3) 0an3 *+,( *+e 3e$ree #& *#8"'"*) 0 "( 3epen3en* ,p#n *+e '+e%"'a &#r% #& %er',r). F#r "n(*an'e! "n$e(*e3 e e%en*a %er',r) "( #n ) C.C>I ab(#rbe3! b,* %e*+) %er',r) "( near ) >CCI ab(#rbe3 &r#% *+e $a(*r#"n*e(*"na *ra'*. T+e b"# #$"'a +a &0 "&e #& %er',r) "( FC 3a)(. T+,(! e-en *+#,$+ e8p#(,re "( re3,'e3! *+e b#3) b,r3en 6" re%a"n &#r a* ea(* a &e6 %#n*+(. E e%en*a %er',r) "( %#(* +a7ar3#,( 6+en "n+a e3. On ) ab#,* HEI #& an "n+a e3 3#(e "( e8+a e3. Sk"n ab(#rp*"#n #& %er',r) -ap#r #'',r(! b,* a* #6 e-e ( .e8. H.HI #& *+e *#*a 3#(e/. Der%a '#n*a'* 6"*+ "D,"3 %er',r) 'an ("$n"&"'an* ) "n'rea(e b"# #$"'a e-e (. T+e pr"%ar) &#',( #& *+"( ar*"' e "( e e%en*a %er',r)! ("n'e *+a* "( *+e &#r% #& e8p#(,re *# +ea *+ 'are 6#rker( "n-# -e3 6"*+ %er',r)0'#n*a"n"n$ "n(*r,%en* a''"3en*(.

In *+e +,%an b#3)! %er',r) a'',%, a*e( "n *+e "-er! k"3ne)! bra"n! an3 b ##3. Mer',r) %a) 'a,(e a',*e #r '+r#n"' +ea *+ e&&e'*(. A',*e e8p#(,re .".e.! (+#r* *er%! +"$+ 3#(e/ "( n#* a( '#%%#n *#3a) 3,e *# $rea*er pre'a,*"#n( an3 3e'rea(e3 +an3 "n$. H#6e-er! (e-ere a',*e e&&e'*( %a) "n' ,3e (e-ere $a(*r#"n*e(*"na 3a%a$e! 'ar3"#-a(', ar '# ap(e! #r k"3ne) &a" ,re! a #& 6+"'+ '#, 3 be &a*a . In+a a*"#n #& >0B %$Z%B &#r H0E +#,r( %a) 'a,(e +ea3a'+e(! (a "-a*"#n! %e*a "' *a(*e "n *+e %#,*+! '+" (! '#,$+! &e-er! *re%#r(! ab3#%"na 'ra%p(! 3"arr+ea! na,(ea! -#%"*"n$! *"$+*ne(( "n *+e '+e(*! 3"&&"', *) brea*+"n$! &a*"$,e! #r ,n$ "rr"*a*"#n. S)%p*#%( %a) be 3e a)e3 "n #n(e* &#r a n,%ber #& +#,r(. C+r#n"' e&&e'*( "n' ,3e 'en*ra ner-#,( ()(*e% e&&e'*(! k"3ne) 3a%a$e an3 b"r*+ 3e&e'*(. Gene*"' 3a%a$e "( a (# (,(pe'*e3. Ner-#,( ()(*e% e&&e'*(. T+e(e are *+e %#(* 'r"*"'a e&&e'*( #& '+r#n"' %er',r) e8p#(,re &r#% a3, * e8p#(,re a( *+e) are '#n("(*en* an3 pr#n#,n'e3. (#%e e e%en*a %er',r) "( 3"((# -e3 "n *+e b ##3 an3 %a) be *ran(p#r*e3 a'r#(( *+e b ##3Zbra"n barr"er! #8"3"7e3 an3 re*a"ne3 "n bra"n *"((,e. E "%"na*"#n &r#% *+e bra"n "( ( #6! re(, *"n$ "n ner-e *"((,e a'',%, a*"#n. S)%p*#%( #& '+r#n"' %er',r) e8p#(,re #n *+e ner-#,( ()(*e% "n' ,3e: In'rea(e3 e8'"*ab" "*)! %en*a "n(*ab" "*)! *en3en') *# 6eep! &"ne *re%#r( #& *+e +an3( an3 &ee*! an3 per(#na "*) '+an$e(. T+e *er% GMa3 a( a Ha**erG 'a%e &r#% *+e(e ()%p*#%( 6+"'+ 6ere a re(, * #& %er',r) e8p#(,re "n 6#rker( %an,&a'*,r"n$ &e * +a*( ,("n$ a %er',r)0 '#n*a"n"n$ pr#'e((. O"3ne) e&&e'*(: O"3ne) 3a%a$e "n' ,3e( "n'rea(e3 pr#*e"n "n *+e ,r"ne an3 %a) re(, * "n k"3ne) &a" ,re a* +"$+ 3#(e e8p#(,re. B"r*+ 3e&e'*(: Ne,r# #$"' 3a%a$e &r#% %e*+) %er',r). T+e %an"&e(*a*"#n( #& %" 3 e8p#(,re "n' ,3e 3e a)e3 3e-e #p%en*a %" e(*#ne(! a *ere3 %,(' e *#ne an3 *en3#n re& e8e(! an3 3epre((e3 "n*e "$en'e. Mer',r) e8p#(,re "n '+" 3ren 'an 'a,(e a (e-ere &#r% #& p#"(#n"n$ *er%e3 a'r#3)n"a. A'r#3)n"a "( e-"3en'e3 b) pa"n "n *+e e8*re%"*"e(! p"nkne(( an3 pee "n$ #& *+e +an3(! &ee* an3 n#(e! "rr"*ab" "*)! (6ea*"n$! rap"3 +ear*bea* an3 #(( #& %#b" "*).

PRECAUTIONS FOR HEALTH CARE 4OROERS

S,b(*"*,*e( &#r %er',r)0'#n*a"n"n$ %e3"'a 3e-"'e( (+#, 3 be ,(e3 6+ene-er p#(("b e! e.$. *+er%#%e*er( an3 (p+)$%#%an#%e*er(. 4+en %er',r) 3e-"'e( %,(* be ,(e3! (pe'"a pre'a,*"#n( (+#, 3 be *aken. T+e(e 3e-"'e( (+#, 3 ne-er be ,(e3 #n a ' #*+ (,r&a'e! (,'+ a( ,p+# (*ere3 '+a"r #r "n a r##% 6"*+ a 'arpe*e3 & ##r. I& a (p" #'',rre3 "n (,'+ an area! *+e ,p+# (*er) #r 'arpe*"n$ 6#, 3 nee3 *# be 3"('ar3e3 a( "* '#, 3 n#* be e&&e'*"-e ) 3e'#n*a%"na*e3. C+" 3ren (+#, 3 ne-er be e&* ,na**en3e3 near *+e(e 3e-"'e(. I& %er',r) *+er%#%e*er( are ,(e3! a %er',r) (p" k"* (+#, 3 be kep* rea3" ) a''e(("b e. T+e k"* (+#, 3 '#n*a"n a (, &,r p#63er *# (,ppre(( -# a*" "7a*"#n an3 a '# e'*"#n 3e-"'e.

SPILL RESPONSE
I& a (p" #'',r(! e-a',a*e *+e "%%e3"a*e area an3 -en*" a*e a( 6e a( p#(("b e. An en-"r#n%en*a '#n(, *an* 6" nee3 *# be '#n*a'*e3 &#r ' ean0,p an3 3"(p#(a . DO NOT a**e%p* *# ' ean0,p a %er',r) (p" ,("n$ ra$( #r an #r3"nar) -a',,%. T+"( 6" #n ) (er-e *# 3"(per(e *+e %er',r) an3 en'#,ra$e -# a*" "7a*"#n. F#r &,r*+er a(("(*an'e! '#n*a'* )#,r #'a +ea *+ 3epar*%en* an3Z#r *+e M"'+"$an Depar*%en* #& P,b "' Hea *+! D"-"("#n #& Hea *+ R"(k A((e((%en*. F#r a(("(*an'e 6"*+ a ar$e (p" ! 'a *+e F"re Depar*%en* &#r a(("(*an'e. F#r a(("(*an'e 6"*+ ' ean0,p! )#, %a) ##k "n )#,r #'a p+#ne b##k &#r en-"r#n%en*a '#n(, *an*(. Tab e H '#n*a"n( a "(* #& '#n(, *an*( kn#6n *# re(p#n3 *# %er',r) (p" (.

DISPOSAL
T+e be(* %e*+#3 #& %er',r) 3"(p#(a "( re' a%a*"#n. A**a'+e3 "( a "(* #& a$en'"e( "n M"'+"$an *+a* 6" *ake ,(e3 %er',r). B,**#n ba**er"e( 'an be re')' e3 a* %an) 1e6e r) (*#re( an3 #*+er re*a" #,* e*( *+a* (e ba**er"e(. Lar$er D,an*"*"e( #& %er',r) 6" nee3 *# be 3"(p#(e3 #& b) a "'en(e3 +a7ar3#,( 6a(*e +a, er. C#n*a'* *+e M"'+"$an Depar*%en* #& Na*,ra Re(#,r'e(! 4a(*e Mana$e%en* D"-"("#n &#r a(("(*an'e 6"*+ %er',r) 3"(p#(a .

Hg
Mercury
at. no. 80, at. wt. 200.61, metal, row 7, col. 2B, val. 1-2, orbits 2-8-18-32-18-2 !e "roblem #it! Mercury $Merc% &n'e( - ) 1*+2 by Merc% , -o., &nc..

Mercury, /uic%silver0 Hg1 at. wt. 200.611 at. no. 801 valence 1-2. 2ilver-w!ite, !eavy, mobile, li3ui'
metal1 slig!tly volatile at or'inary tem4. '. 13.5+6. 2oli'i6. at - 3*7 6orming a tin-w!ite, 'uctile, malleable mass w!ic! may be cut wit! a %ni6e. b. 3+6.*7. #!en 4ure 'oes not tarnis! on e(4osure to air at or'inary tem4., but w!en !eate' to near t!e boil. 4oint slowly o(i'i8es to Hg9. :orms alloys wit! most metals e(ce4t iron an' combines wit! sul6ur at or'inary tem4. &nsoluble in an' not attac%e' by H 291 soluble in 'ill. H;931 not attac%e' by H-l or col' H22951 converte' by !eating wit! concentrate'. H 2295 into mercurous or mercuric sul6ate, 'e4en'ing on t!e e(cess o6 t!e aci' an' time o6 !eating. "oisonous< Mercury salts w!en !eate' wit! ;a2-93 yiel' metallic Hg an' are re'uce' to metal by H 292 in 4resence o6 an al%ali !y'ro(i'e. -u, :e, =n an' many ot!er metals 44t. metallic Hg 6rom neutral or slig!tly aci' solns. o6 mercury salts. 2oluble ioni8e' Mercuric salts give a yellow 44t. o6 Hg9 wit! ;a9H an' a re' 44t. o6 Hg& 2 wit! al%ali io'i'e. Mercurous salts give a blac% 44t. wit! al%ali !y'ro(i'es an' a w!ite 44t. o6 calomel wit! H-l or soluble c!lori'es. !ey are slowly 'ecom4ose' by sunlig!t. >se0 &n barometers, t!ermometers, t!ermostats, !y'rometers, 4yrometers1 in mercury arc lam4s 4ro'ucing ultraviolet rays, 6luorescent lam4s, mercury va4or lam4s1 manu6. all mercury salts, mirrors1 as catalyst in o(i'ation o6 organic com4oun's1 e(tracting gol' an' silver 6rom ores1 ma%ing amalgams, electric recti6iers, mercury 6ulminate, ammunition1 &n 'ental amalgams 6or 6illing teet!1 in 'etermining ; by ?@el'a!l met!o', 6or MillonAs reagent1 as cat!o'e in electrolysis, electro analysis, e(terior !ouse 4aint, ceramics, an' many ot!er uses. Bra'es available0 Ceagent, ;.:., tec!nical. o(icity0 Cea'ily absorbe' via res4iratory tract Delemental mercury va4or, mercury com4oun' 'ustsE, intact s%in, an' B.&. tract. 24ille' an' !eate' elemental mercury is 4articularly !a8ar'ous. Fcute0 2oluble salts !ave violent corrosive e66ects on s%in an' mucous membranes1 severe nausea, vomiting, ab'ominal 4ain, bloo'y 'iarr!ea1 %i'ney 'amage1 'eat! usually wit!in 10 'ays. -!ronic0 &n6lammation o6 mout! an' gums, swelling o6 salivary glan's, e(cessive 6low o6 saliva, loosening o6 teet!1 %i'ney 'amage1 muscle tremors, @er%y gait, s4asms o6 e(tremities1 4ersonality c!anges, 'iscouragement, 'e4ression, irritability, nervousness, 'ementia, loss o6 motor coor'ination. $'ementia - loss or im4airment o6 mental 4owers 'ue to organic causes.. Mercury !as been 6oun' to accumulate in vital organs an' tissues, suc! as t!e liver, brain, an' !eart muscle. Ma@or sym4toms o6 mercury to(icity inclu'e Gmotional &nstability, tremors, gingivitis, an' %i'ney 6ailure. 2ome also believe mercury may be lin%e' to multi4le sclerosis an' e4ile4tic sei8ures. :urt!er, its a66ect on t!e bo'yAs immune system is 4otentially 'evastating, 4ossibly contributing to 'iseases suc! as leu%emia an' !emato4oietic 'ycrasias. Cecent stu'ies !ave 6oun' t!at substantial amounts o6 mercury va4or are release' 6rom 'ental amalgam a6ter c!ewing gum 6or @ust ten minutes. ;o governmental agency !as establis!e' sa6e stan'ar's 6or mercury inta%e 6rom 'ental amalgams. 2ome e(4erts believe Ht!ere is ;o 2a6e Ievel o6 mercury e(4osure.H Mercury e(4osure is o6 4articular concern in t!e 'evelo4ing 6etus an' in c!il'ren 'ue to t!eir low bo'y weig!t. J 2ource J !e "roblem wit! Mercury

Mercury -!emicals an' !eir >ses

Meragi'one 2o'ium >se' as 'iuretic Meralluri'e 2o'ium 2olution DMercu!y'rinE Me'. >se0 Kiuretic Merba%L -- see Fcetomeroctol Me'. >se0 101000 soln. as to4ical antise4tic Caution0 May cause irritation i6 a44lie' to mucous membranes or e(tensive woun's. Merba4!en D;ovasurolE Me'. >se0 Has been use' as a 'iuretic Merbromin Me'. >se0 Fntise4tic 6or t!e s%in as a 2 to +M soln. an' mucous membranes as a 1M soln. Merea4toacetic Fci' -- see !ioglycollic Fci' N- Merca4toalanine - -ysteine 2- Merca4toben8oic Fci' -- see !iosalicylic Fci' 2- Merca4to- 5-!y'ro(y4yrimi'ine -- see 2- !iouracil Me'. >se0 Hy4ert!yroi'ism, t!yroto(icosis an' t!yroi'itis. Toxicity0 Ieu%o4enia, granulocyto4enia, 'rug 6ever, s%in eru4tions.

Merca4tomerin 2o'ium Me'. >se0 Kiuretic 2- Merca4to- 5-4yrimi'one -- see 2- !iouracil Me'. >se0 Hy4ert!yroi'ism, t!yroto(icosis an' t!yroi'itis. Toxicity0 Ieu%o4enia, granulocyto4enia, 'rug 6ever, s%in eru4tions. Merca8ole - "ro4ose' as antit!yroi' Mercocresols DMercresinE Me'. >se0 Fntise4tic 6or minor su4er6icial woun's an' in6ections, 4reo4erative 4re4aration, mucous membranes an' irrigation. MercresinL -- see Mercocresols Me'. >se0 Fntise4tic 6or minor su4er6icial woun's an' in6ections, 4reo4erative 4re4aration, mucous membranes an' irrigation. Mercu!y'rinL -- see Meralluri'e 2o'ium 2olution Mercumatillin 2o'ium D-umertilin 2o'iumE Mercu4urinL -- see Mercuro4!ylline &n@ection Mercuranine -- see Merbromin Me'. >se0 Fntise4tic 6or t!e s%in as a 2 to +M soln. an' mucous membranes as a 1M soln. Mercurial 9intment, Mil' Me'. >se0 Has been use' 6or 4e'iculosis DKoes not %ill nitsE Mercurial 9intment, 2trong Me'. >se0 Has been use' in sy4!ilis Mercuric Fcetate >se0 -!ie6ly 6or mercuration o6 organic com4oun's. Mercuric Fminoacetate DMercuris glycocollateE Mercuric O-Fmino4ro4ionate DMercury-alanineE Mercuric Fmmonium -!lori'e Pet. >se0 Fs ointment in c!ronic ec8ema, 4arasitic s%in 'iseases. Mercuric Frsenate Mercuric Fs4araginate DFs4aragin-mercuryE Mercuric Fto(ylate DMercury arsanilateE Me'. >se0 :ormerly in sy4!ilis Mercuric Barium Bromi'e Mercuric Barium &o'i'e >se0 Fs an a3. soln., %nown as Co!rbac!As 2oln., 6or se4arating minerals o6 'i66erent 'ensities1 also 6or microc!emical 'etection o6 al%aloi's. Mercuric Ben8oate Mercuric Bromi'e Mercuric -aco'ylate Mercuric -!lori'e DMercury bic!lori'eE >se0 "reserving D%yani8ingE wool an' anatomical s4ecimens1 also embalming1 'isin6ecting1 browning an' etc!ing steel an' iron1 intensi6ier in 4!otogra4!y1 w!ite reserve in 6abric 4rinting1 tanning leat!er1 electro4lating aluminum1 'e4olari8er 6or 'ry batteries1 6reeing gol' 6rom lea'1 magic 4!otograms1 mor'ant 6or rabbit an' beaver 6urs1 staining woo' an' vegetable ivory 4in%1 Manu6. o6 in% 6or mercurogra4!y1 treating see' 4otatoes1 manu6. ot!er mercury com4oun's. Fs an im4ortant reagent in anal. c!emistry. Me'. >se0 Kisin6ectant 6or unabra'e' s%in as a 101000 to 102000 soln. Toxicity0 -orrosive to mucous membranes. 2evere nausea, vomiting, ab'ominal 4ain, 'iarr!ea, %i'ney 'amage, 4rostration. 1 g. is 6atal in +0M o6 cases. Pet. >se0 -austic, antise4tic, general 'isin6ectant1 irritant in bony growt!, s4avin, etc. Caution0 >n'ue absor4tion t!roug! s%in or by lic%ing may cause 4oisoning. KF;BGC< May Be :atal &6 2wallowe'. Ko not breat!e 'ust. ?ee4 away 6rom 6ee' or 6oo' 4ro'ucts. #as! t!oroug!ly be6ore eating or smo%ing. Mercuric -!lori'e Fmmoniate' DFmmoniate' mercuryE Me'. >se0 Has been use' as a s%in antise4tic 4articularly 6or im4etigo contagiosa an' 4arasitic s%in 'iseases. Pet. >se0 2%in antise4tic. Mercuric -!lori'e->rea, 2olution Mercuric -u4rous &o'i'e >se0 :or 'etecting over!eating o6 mac!ine bearings, etc., t!e re' color c!anges to brownis!-blac% at 60-70Q an' again becomes re' on cooling. Mercuric -yani'e Me'. >se0 Fntise4tic 6or use on s%in as a 102000 soln. an' mucous membranes as a 1010,000 soln. Has been use' in sy4!ilis. Toxicity0 -a4able o6 causing mercury an' cyani'e 4oisoning. Mercuric Kic!romate

Mercuric Kiio'osalicylate Mercuric :ormami'e, 2olution Mercuric Ballate Mercuric Blycocollate Mercuric Buaiacolsul6onate Mercuric &mi'osuccinate -- see Mercuric 2uccinimi'e Me'. >se0 Has been use' in sy4!ilis. Mercuric &o'ate Mercuic &o'i'e Ce' >se0 &n anal. c!emistry 6or 4re4aration o6 ;esslerAs Ceagent. Me'. >se0 :ormerly in sy4!ilis Pet. >se0 Blister ointment in e(ostoses bursal enlargement, etc. Caution0 Fvoi' contact wit! !an's. Mercuric Iactate Me'. >se0 :ormerly in sy4!ilis. Mercuric ;a4!t!olate Mercuric ;itrate >se0 Manu6. 6elt1 mercury 6ulminate1 'estroying 4!yllo(era. Mercuric ;itrate 9intment. Me'. >se0 Has been use' in im4etigo an' 4arasitic s%in 'iseases. Pet. >se0 2timulant in ulcers, ringworm, ec8ema, 6oot rot, c!ronic eye 'iseases. Caution0 >n'ue absor4tion t!roug! s%in or by lic%ing may cause 4oisoning. Mercuric 9leate Me'. >se0 Has been use' in 4arasitic s%in 'iseases. Mercuric 9(i'e Ce' >se0 &n 4aints 6or s!i4As bottoms, 'iluting 4igments 6or 4ainting on 4orcelain, wit! gra4!ite as 'e4olari8er in 'ry batteries. &n ?@el'a!l nitrogen 'etermination1 an' as reagent 6or citric aci', t!io4!ene, glucose, al'e!y'e, urea, acetone. Me'. >se0 Has been use' to4ically as a stimulant an' antise4tic 6or c!ancres1 c!ronic ulcers an' 6ungus in6ections o6 t!e s%in. Pet. >se0 Fs Me'. >se in 6issure' !eels. Mercuric 9(i'e Rellow >se0 2imilar to t!at o6 t!e re' o(i'e1 in t!e manu6. o6 organic mercurials. &n anal. c!emistry 6or 'etermining =n or H-;1 'etecting acetic aci' in 6ormic aci', -9 in gas mi(tures. Me'. >se0 Fntise4tic use' c!ie6ly 6or in6lammation o6 t!e eyeli's an' con@unctiva as 1M D10,000 44mE ointment. Pet. >se0 Fs Me'. >se. &n ringworm, ec8ema, in'olent ulcers, c!ronic glan'ular enlargement. Mercuric 9(ycyani'e Violent poison! &t e(4lo'es w!en touc!e' wit! a 6lame or by 4ercussion1 !ence 6or commerce it is ma'e wit! an e(cess o6 mercuric cyani'e w!ic! eliminates t!e 'anger o6 e(4losion. >se0 Fs a 0.1M soln. D1,000 44mE 6or sterili8ing surgical instruments. Me'. >se0 10+000 soln. D200 44mE as an antise4tic. :ormerly in sy4!ilis. Toxicity0 -a4able o6 causing mercury an' cyani'e 4oisoning. Mercuric "!enate Mercuric "!os4!ate Mercuric "otassium -yani'e >se0 &n manu6. o6 mirrors to 4revent t!e silver coating 6rom becoming yellow1 as reagent in testing 6or 6ree aci's. Mercuric "otassium &o'i'e Me'. >se0 10100 to 1010,000 soln. as a 'isin6ectant. Mercuric Cesorcinol-acetate DCesorcinol-mercury acetateE Mercuric 2alicylate DMercury subsalicylateE Me'. >se0 G(tern. 6or 4arasitic an' 6ungous s%in 'iseases. Has been use' in sy4!ilis. Mercuric 2ilver &o'i'e >se0 o 'etect over!eating in @ournal bearings, etc., becoming bloo'-re' at 50-+0Q an' yellow again on cooling. Mercuric 2tearate Mercuric 2ubsul6ate D ur4et! mineralE Mercuric 2uccinate Mercuric 2uccinimi'e Me'. >se0 Has been use' in sy4!ilis. Mercuric 2ul6ate DMercury bisul6ateE >se0 :illing 6or galvanic batteries1 wit! ;a-l 6or e(tracting gol' an' silver 6rom roaste' 4yrites1 as a reagent 6or wine coloring, barbital, an' cystine.

Mercuric 2ul6ate Gt!ylene'iamine -- see 2ublamineL Mercuric 2ul6i'e, Blac% DGt!io4s mineralE >se0 Fs 4igment 6or !orn, rubber, etc. Mercuric 2ul6i'e, Ce' DPermilionE 9ccurs in nature as t!e mineral cinnabar. $Brig!t scarlet-re'1 consi'ere' as a royal color in some cultures.. >se0 :or coloring 4lastics, sealing wa(, an' wit! :e29 5 6or mar%ing linen1 also manu6. o6 6ancy colore' 4a4ers1 as a 4igment. Mercuric 2ul6ocyanate -- see Mercuric !iocyanate Mercuric 2ul6ocyani'e -- see Mercuric !iocyanate. Mercuric !iocyanate DMercuric sul6ocyanate or sul6ocyani'eE >se0 :or "!arao!As ser4ents1 intensi6ier in 4!otogra4!y. Mercuric ribromo4!enylacetate Me'. >se0 :ormerly in sy4!ilis an' B. Mercuric =inc -yani'e MercurinL DMercu8anE Me'. >se0 Kiuretic Mercuroc!romeL -- see Merbromin Mercuroc!rome-220 2olubleL -- see Merbromin. Mercurocol -- see Merbromin. Mercuro-io'o!emol Me'. >se0 :ormerly in sy4!ilis. Mercurol DMercury H;ucleateHE Me'. >se0 :ormerly in sy4!ilis an' as an antise4tic. Mercurome -- see Merbromin Mercuro4!age -- see Merbromin Mercuro4!en D2o'ium !y'ro(ymercuri-o-nitro4!enolateE Me'. >se0 102000 to 101+,000 soln. as an antise4tic 6or s%in an' mucous membranes. Caution0 2trong solns. to be a44lie' 6or 1 min. only. ;ot e66ective 6or s4orulating 4at!ogens. Mercuro4!ylline &n@ection DMercu8ant!in, :ormerly %nown as Mercu4urinE Me'. >se0 Kiuretic MercurosalL DKiso'ium !y'ro(ymercuri-salicylo(yacetateE Mercurous Fcetate Me'. >se0 :ormerly 6or s%in lesions o6 sy4!ilis. Mercurous Ben8oate Mercurous Bromi'e Mercurous -!lorate Mercurous -!lori'e >se0 Kar%-green Bengal lig!ts1 calomel 4a4er1 mi(e' wit! gol' in 4ainting on 4orcelain1 6or calomel electro'es. Me'. >se0 Has been use' as a la(ative, 'iuretic, an' antise4tic. Pet. >se0 Iocally antise4tic, 'esiccant in moist ec8ema, can%er, t!rus!, 6oot rot. &n corneal ulcers, 4!lyctenular con@unctivitis. 9rally, cat!artic in !orses, 'ogs, cats. Kiuretic in car'iac !e4atic 'iseases. Mercurous -!romate >se0 -oloring 4orcelain an' c!inaware green. Mercurous -itrate Mercurous &o'i'e DRellow mercury io'i'e1 mercury 4rotoio'i'eE Me'. >se0 G(tern. as ointment in eye 'iseases. :ormerly in sy4!ilis. Mercurous &sovalerate Mercurous Iactate Mercurous ;itrate DMercury 4rotonitrateE >se0 :ire gil'ing, blac%ening brass. $gil'ing - t!e art or 4rocess o6 a44lying gol' lea6 or a substance li%e gol' to a sur6ace.. Mercurus ;itrate Fmmoniate' DHa!nemannAs soluble mercuryE Mercurous 9(i'e DMercury o(i'e blac%E Mercurous "!os4!ate D2c!ae66erAs 4!os4!orate' mercuryE Me'. >se0 :ormerly in sy4!ilis Mercurous 2ul6ate >se0 :or ma%ing electric batteries1 wit! 8inc sul6ate in t!e -lar% stan'ar' cell an' wit! ca'mium sul6ate in t!e stan'ar' #eston cell. Mercurous annate DHy'rargotinE Me'. >se0 :ormerly in sy4!ilis Mercurous artrate Mercury-Flanine -- see Mercuric O-Fmino4ro4ionate Mercury Frsanilate -- see Mercuric Fto(ylate

Mercury Betana4!t!ol -- see Mercuric ;a4!t!olate Mercury Bic!lori'e -- see Mercuric -!lori'e Mercury Bic!romate -- see Mercuric Kic!romate Mercury Binio'i'e -- see Mercuric &o'i'e Ce' Mercury Bisul6ate -- see Mercuric 2ul6ate Mercury -arbolate -- see Mercuric "!enate Mercury wit! -!al% DBray 4owerE Me'. >se0 Has been use' as a la(ative an' antisy4!ilitic. Pet. >se0 Has been use' as a la(ative 6or 6oals, caves, 4u44ies. Mercury -olloi'al Mercury Mass DBlue 4ill1 blue massE Me'. >se0 -at!artic $-at!artic - a me'ication 6or stimulating evacuation o6 t!e bowels.. Toxicity0 -an cause systemic mercury 4oisoning. Pet. >se0 Has been use' as a la(ative. Mercury Monoc!lori'e -- see Mercurous -!lori'e Mercury H;ucleateH -- see Mercurol Mercury 9(i'e Blac% -- see Mercurous 9(i'e Mercury "erc!lori'e -- see Mercuric -!lori'e Mercury "ernitrate -- see Mercuric ;itrate Mercury "!enolate -- see Mercuric "!enate Mercury "otassium &o'i'e 2olution D-!anningAs solution1 solution 4otassium io'o!y'rargyrateE Me'. >se0 10100 to 1010,000 soln. as an antise4tic. Mercury "rotoc!lori'e -- see Mercurous -!lori'e Mercury "rotoio'i'e -- see Mercurous &o'i'e Mercury "rotonitrate -- see Mercurous ;itrate Mercury 2o8oio'olate -- see 2o8oio'ole-Mercury Me'. >se0 Has been use' in sy4!ilis. Mercury 2ubc!lori'e -- see Mercurous -!lori'e Mercury 2ubsalicylate -- see Mercuric 2alicylate Mercu8anL -- see Mercurin Mercu8ant!inL -- see Mercuro4!ylline &n@ection Mer'ro(one 2o'ium -- Meragi'one 2o'ium Meret!o(ylline 2o'ium DKicurin 2o'iumE Me'. >se0 as a 'iuretic Mero(yl Me'. >se0 10200 to 101000 soln. as an antise4tic. Mer4!ene -- see "!enylmercuric ;itrate, Basic >se0 Fntise4tic, germici'e, 6ungici'e. "!enol coe66icient state' to be about 600 an' relatively una66ecte' by organic matter. Me'. >se0 101+00 to 1025,000 soln. as an antise4tic 6or e(tern. use. Mer4!enylL ;itrate -- see "!enylmercuric ;itrate, Basic Mersalyl D2alyrganE Me'. >se0 Mersalyl D2 4artsE an' t!eo4!ylline D1 4artE as a 'iuretic. Mert!iolateL DMert!iolate 2o'ium1 so'ium et!ylmercurit!iosalicylate1 !imerosal1 !iomersalateE Me'. >se0 Fntise4tic 6or sur6ace tissues as a 101000 to 1030,000 soln. or 101000 tincture. Caution0 ;ot e66ective against s4orulating organisms.

!e "roblem #it! Mercury

!e 4roblem is Mercury sim4ly HIoves 2ul6urH too muc!. 2o muc! so, t!at it will com4ete wit! ot!er molecules 6or 2ul6ur an' can usually HstealH 2ul6ur out o6 ot!er molecular structures, in e66ect %illing t!em. Mercury DHgE interacts wit! brain tubulin an' 'isassembles microtubules t!at maintain neurite structure. -re6erence&6 it canAt steal 2ul6ur, Mercury will bon' to t!e 2ul6ur atom t!e best it can. !is usually 4revents t!e molecule 6rom 4er6orming its 6unction. 2ul6ur is 4art o6 our bloo' cells as well as many ot!er 4roteins an' en8ymes. Many systems in our bo'ies are very muc! li%e to'ayAs &n'ustrial Fssembly Iines. &6 one wor% station sto4s 6unctioning t!e w!ole system can bac%u4 or get very cra8y. Hemoglobin
D !e o(ygen carrying 4rotein in re' bloo' cells.E

D-738 H1,166 :e ;203 9208 22E5 Gn8ymes 4er6orm very s4eciali8e' 6unctions wit!in our bo'yAs c!emical assembly line. &t s!oul'nAt be very !ar' to visuali8e t!e w!ole 4rocess going out o6 w!ac% i6 someone 'oesnAt s!ow u4 6or wor%. &magine cars coming o66 t!e assembly line wit!out tires, or !ea'lig!ts, or oil lig!t sensors, or 6uses J you get t!e i'ea. :rom our view4oint, Gn8ymes are really HHy4erH little 6ellows. &n t!e lab, t!ey !ave been cloc%e' 'oing wo Million Ceactions "er Minute < D2,000,000 Smin.E !at means in a 25-!our 4erio', t!ey can 'o t!eir @ob 2,880,000,000 times. D wo Billion, Gig!t Hun're' Gig!ty Million Ceactions 4er KayE Ft t!at s4ee', t!ese guys coul' count our national 'ebt in only 1,87+ 'ays. D+.1 yearsE o'ay a ty4ical a'ult carries ten amalgams weig!ing a total o6 about ten grams, o6 w!ic! 6ive grams is mercury. #!at little researc! t!ere is on t!e rate at w!ic! mercury esca4es amalgam suggests about !al6 a gram o6 mercury will esca4e 6rom t!ese ten 6illings over t!e ten-year li6e o6 t!ese 6illings, an' most o6 t!is mercury will be absorbe' by t!e bearer o6 t!e amalgams. o 4ut a !al6-gram in conte(t, consi'er t!ese 6acts0 Hal6 a gram o6 mercury 'ro44e' into a ten-acre la%e warrants t!e 4romulgation o6 a 6is! a'visory 6or t!e la%e in Minnesota1 t!e tennis s!oes wit! mercury in t!em t!at were banne' by t!e Minnesota legislature in 1**5 containe' !al6 a gram o6 mercury 4er s!oe. -re6erenceD0.+ gram in a 180 lb. bo'y 4ro'uces a concentration o6 6.168 ""M. -om4are t!is level, to t!e elements in t!e H #ater o6 Ii6eH. J C-JE !ere are about 1,+01,530,636,++8,5*6,+8+,515 atoms in 0.+ grams o6 mercury. Gac! an' every atom o6 mercury is able to 'isable an en8yme or ot!er critical 4rotein in your bo'y. 9ver ten years, i6 t!e bo'y 6ails to remove t!is mercury, a lot o6 'amage can be 'one. >n6ortunately, mercury !as ways o6 H!i'ing in t!e bo'yH an' can be 3uite !ar' to remove. !is 0.+ grams o6 mercury can 4ro'uce a 4otential loss o6 5,325,120,233,288,570,16+,**3,71*,1+6,+72 c!emical reactions in your bo'y. DBase' on our lab e(am4le S over 10 yearsE !at number o6 secon's e3uals 137,023,101,670,865,3*2,*1*,515.6 years < Fs you can see, it is 3uite 'i66icult to gras4 t!e scale on w!ic! all t!ese c!emical reactions are occurring, an' we are only consi'ering one source o6 mercury an' t!is one to(ic atom. Mercury into(ication o6ten 4ro'uces a 4syc!otic state resulting in !y4er-e(citability. !e e(4ression AMa' as a HatterA originates 6rom t!e !at-ma%ers o6 t!e 1*t! century w!o were c!ronically e(4ose' to mercury com4oun's use' in ma%ing 6elt an' beaver !ats. Mercury was also use' to 4reserve leat!er an' t!e 6urs 6or coats. J MFK F2 F HF GC J

:ew 4eo4le w!o use t!e 4!rase to'ay reali8e t!at t!ereAs a story o6 !uman su66ering be!in' it1 t!e term actually 'erives 6rom an early in'ustrial occu4ational 'isease. :elt !ats were once very 4o4ular in ;ort! Fmerica an' Guro4e1 an e(am4le is t!e to4 !at. !e best sorts were ma'e 6rom beaver 6ur, but c!ea4er ones use' 6urs suc! as rabbit instea'. F com4licate' set o6 4rocesses was nee'e' to turn t!e 6ur into a 6inis!e' !at. #it! t!e c!ea4er sorts o6 6ur, an early ste4 was to brus! a solution o6 a mercury com4oun' - usually mercurous nitrate - on to t!e 6ur to roug!en t!e 6ibers an' ma%e t!em mat more easily, a 4rocess calle' carroting because it ma'e t!e 6ur turn orange. Beaver 6ur !a' natural serrate' e'ges t!at ma'e t!is unnecessary, one reason w!y it was 4re6erre', but t!e cost an' scarcity o6 beaver meant t!at ot!er 6urs !a' to be use'. #!atever t!e source o6 t!e 6ur, t!e 6ibers were t!en s!ave' o66 t!e s%in an' turne' into 6elt1 t!is was later immerse' in a boiling aci' solution to t!ic%en an' !ar'en it. :inis!ing 4rocesses inclu'e' steaming t!e !at to s!a4e an' ironing it. &n all t!ese ste4s, !atters wor%ing in 4oorly ventilate' wor%s!o4s woul' breat!e in t!e mercury com4oun's an' accumulate t!e metal in t!eir bo'ies. #e now %now t!at mercury is a cumulative 4oison t!at causes %i'ney an' brain 'amage. "!ysical sym4toms inclu'e trembling D%nown at t!e time as !atterAs s!a%esE, loosening o6 teet!, loss o6 coor'ination, an' slurre' s4eec!1 mental ones inclu'e irritability, loss o6 memory, 'e4ression, an(iety, an' ot!er 4ersonality c!anges. !is was calle' ma' !atter syn'rome. J 2ource J !e 4eo4le w!o t!en wore t!ese H:ur "ro'uctsH were also "oisone' <<< Mercury is a''e' to 4ro'ucts to sto4 t!ings 6rom growing. Mercury was commonly a''e' to e(terior !ouse 4aint until t!e late 1**0As to %ee4 mol' 6rom growing on t!e 4aint. G(terior 4aint is 'esigne' to H4ow'er-o66H instea' o6 crac%ing an' 4eeling, so t!e mercury enters t!e environment as a 6ine 4ow'er. D& !ig!ly recommen' t!at you 6ilter t!e air coming into your environment.E

Mercury is a''e' at even !ig!er levels to marine 4aint 6or s!i4s. !e ob@ect !ere is to %ee4 barnacles o66 t!e !ull. !e solvents use' in t!ese 4aints continues to Hout-gasH 6or many mont!s, an' are very goo' at carrying mercury into t!e bo'y via t!e res4iratory tract. Mercury is also use' in ammunition an' many e(4losives, es4ecially military ty4es. 2tu'ies !ave s!own t!at to(ic levels o6 lea' can be 'etecte' in bloo' sam4les, a6ter only a cou4le o6 !ours o6 in'oor target 4ractice, in a 4oorly ventilate' room. !is stu'y 6aile' to measure mercury levels, but t!ere is a 'irect relations!i4 between t!e amount o6 lea' absorbe' an' t!e amount o6 mercury absorbe' by !uman bo'ies.

-ellular &mmunity
Fntibo'iesT contain sul6ur an' are t!ere6ore attac%e' by mercury J t!ereby 'estroying t!e bo'yAs natural 'isease 'e6ense system. U T anVtiVbo'Vy n. F 4rotein substance 4ro'uce' in t!e bloo' or tissues in res4onse to a s4eci6ic antigen, suc! as a bacterium or a to(in. Fntibo'ies 'estroy or wea%en bacteria an' neutrali8e organic 4oisons, t!us 6orming t!e basis o6 immunity. W Ma@or &mmunoglobulin -lasses Ma@or 2ubclasses o6 Human &gB Fn antibo'y is about 1S700 t!e si8e o6 a re' cell. !e immune system nee's to be able to create an enormous number o6 antibo'ies, e.g., 4er!a4s 10 billion B lym4!ocytes, eac! able to 4ro'uce more t!an 100 million 'i66erent antibo'y 4roteins. 2ince !umans !ave only about 100,000 genes, it becomes im4ossible 6or our genes to s4eci6y eac! one o6 t!ese 4roteins. ;ewborn c!il'ren receive s4eci6ic environmental antibo'ies t!roug! nursing. DMot!erAs mil%E 9ur bo'ies are constantly creating new antibo'ies in res4onse to t!e many 'i66erent li6e 6orms attac%ing our bo'ies. &n cellular immunity, cells 4lay t!e most im4ortant role in 'estroying 6oreign inva'ers. !e cells involve' are macro4!ages an' t!e various subsets o6 cells0 !el4er -K5X cells, su44ressor -K8X cells, cytoto(ic %iller cells, an' natural D;?E %iller cells. Mono%ines an' lym4!o%ines secrete' by macro4!ages an' -K5X !el4er cells, res4ectively, 4lay an im4ortant role in 'irecting an' augmenting bot! cellular an' !umoral immune res4onses. J Ce6erence J

&t 2!oul' Be 9bvious ;o Fmount o6 Mercury -an Be -onsi'ere' 2a6e <

!e 6ollowing in6ormation was co4ie' 6rom t!is web 4age able &0 2ummary -om4arison o6 raits o6 Futism , Mercury "oisoning D F2K re6erences in bol'1 Mercury "oisoning re6erences in italics E "syc!iatric Kisturbances 2ocial 'e6icits, s!yness, social wit!'rawal D1,2,130,1311 21,31,45,53,132 Ce4etitive, 4reservative, stereoty4ic be!aviors1 obsessive-com4ulsive ten'encies D1,2,53,58,1331 20,33-35,132E Ke4ressionS'e4ressive traits, moo' swings, 6lat a66ect1 im4aire' 6ace recognition D15,1+,17,103, 135,13+1 19,21,24,26,31E Fn(iety1 sc!i8oi' ten'encies1 irrational 6ears D2,1+,161 21,27,29,31E &rritability, aggression, tem4er tantrums D12,13,531 18,21,22,25E Iac%s eye contact1 im4aire' visual 6i(ation DHg"ES 4roblems in @oint attention DF2KE D3,36,136,1371 18,19,34E Speec an! "an#ua#e $e%icits Ioss o6 s4eec!, 'elaye' language, 6ailure to 'evelo4 s4eec! D1-3,138,13*1 11,23,24,27,30,37E Kysart!ria1 articulation 4roblems D31 21,25,27,39E 24eec! com4re!ension 'e6icits D3,5,1501 9,25,34,38E Perbali8ing an' wor' retrieval 4roblems DHg"E1 ec!olalia, wor' use an' 4ragmatic errors DF2KE D1,3,361 21,27,70E

Senso&y '(no&)alities Fbnormal sensation in mout! an' e(tremities D2,5*1 25,28,34,39E 2oun' sensitivity1 mil' to 4ro6oun' !earing loss D2,57,581 19,23-25,39,40E Fbnormal touc! sensations1 touc! aversion D2,5*1 23,24,45,53E 9ver-sensitivity to lig!t1 blurre' vision D2,+0,+11 18,23,31,34,45E *oto& $iso&!e&s :la44ing, myoclonal @er%s, c!orei6orm movements, circling, roc%ing, toe wal%ing, unusual 4ostures D2,3,53,551 11,19,27,30,31,34,39E Ke6icits in eye-!an' coor'ination1 limb a4ra(ia1 intention tremors DHg"ES4roblems wit! intentional movement or imitation DF2KE D2,3,36,1811 25,29,32,38,70,87E Fbnormal gait an' 4osture, clumsiness an' incoor'ination1 'i66iculties sitting, lying, crawling, an' wal%ing1 4roblem on one si'e o6 bo'y D5,51,52,1231 18,25,31,34,39,45E Co#niti+e ,)pai&)ents Bor'erline intelligence, mental retar'ation - some cases reversible D2,3,1+1,1+21 19,25,31,39,70E "oor concentration, attention, res4onse in!ibition DHg"ESs!i6ting attention DF2KE D5,36,1+31 21,25,31,38,141E >neven 4er6ormance on &/ subtests1 verbal &/ !ig!er t!an 4er6ormance &/ D3,5,361 31,38E "oor s!ort term, verbal, an' au'itory memory D36,1501 21,29,31,35,38,87,141E "oor visual an' 4erce4tual motor s%ills1 im4airment in sim4le reaction time DHg"ES lower 4er6ormance on time' tests DF2KE D5,150,1811 21,29,142E Ke6icits in un'erstan'ing abstract i'eas , symbolism1 'egeneration o6 !ig!er mental 4owers DHg"ESse3uencing, 4lanning , organi8ing DF2KE1 'i66iculty carrying out com4le( comman's D3,5,36,1+31 9,18,37,57,142E -nusual .e a+io&s 2el6 in@urious be!avior, e.g. !ea' banging D3,1+51 11,18,53E FKHK traits D2,36,1++1 35,70E Fgitation, un4rovo%e' crying, grimacing, staring s4ells 3,1+51 11,23,37,88E 2lee4 'i66iculties D2,1+6,1+71 11,22,31E / ysical $istu&(ances Hy4er- or !y4otonia1 abnormal re6le(es1 'ecrease' muscle strengt!, es4ecially u44er bo'y1 incontinence1 4roblems c!ewing, swallowing D3,52,15+,1811 19,27,31,32,39E Cas!es, 'ermatitis, ec8ema, itc!ing D107,1561 22,26,143E Kiarr!ea1 ab'ominal 4ainS'iscom6ort, consti4ation, HcolitisH D107,157-15*1 18,23,26,27,31,32E Fnore(ia1 nausea DHg"ESvomiting DF2KE1 4oor a44etite DHg"ESrestricte' 'iet DF2KE D2,1231 18,22E Iesions o6 ileum an' colon1 increase' gut 4ermeability D157,1+01 57,144E able &&0 2ummary -om4arison o6 Biological Fbnormalities in Futism , Mercury G(4osure Futism Iow sul6ate levels D*1,*2E Iow levels o6 glutat!ione1 'ecrease' ability o6 liver to 'eto(i6y (enobiotics1 abnormal glutat!ione 4ero(i'ase activity in eryt!rocytes D*1,*5,*+E "urine an' 4yrimi'ine metabolism errors lea' to autistic 6eatures D2,101,102E Mitoc!on'rial 'ys6unction, es4ecially in brain D76,172E More li%ely to !ave allergies an' ast!ma1 6amilial 4resence o6 autoimmune 'iseases, es4ecially r!eumatoi' art!ritis1 &gF 'e6iciencies D103,10610*,11+E 9n-going immune res4onse in -;21 brainSMB" autoantibo'ies 4resent D105,10+,10*,110E

Mercury G(4osure .ioc e)ist&y Bin's -2H grou4s1 bloc%s sul6ate trans4orter in intestines, %i'neys D50,*3E Ce'uces glutat!ione availability1 in!ibits en8ymes o6 glutat!ione metabolism1 glutat!ione nee'e' in neurons, cells, an' liver to 'eto(i6y !eavy metals1 re'uces glutat!ione 4ero(i'ase an' re'uctase D*7,100,161,162E Kisru4ts 4urine an' 4yrimi'ine metabolism D10,*7,1+8,1+*E Kisru4ts mitoc!on'rial activities, es4ecially in brain D160,163,165E ,))une Syste) 2ensitive in'ivi'uals more li%ely to !ave allergies, ast!ma, autoimmune-li%e sym4toms, es4ecially r!eumatoi'-li%e ones D8,11,18,25,28,31,111,113E

-an 4ro'uce an immune res4onse in -;21 causes brainSMB" autoantibo'ies D18,111,16+E

-auses over4ro'uction o6 !2 subset1 %illsSin!ibits lym4!ocytes, -cells, an' monocytes1 'ecreases ;? -cell activity1 in'uces or su44resses &:;g , &I2 D100,112,117-120,166E C0S St&uctu&e 2electively targets brain areas unable to 'eto(i6y or re'uce Hg-in'uce' o(i'ative stress D50,+6,161E Fccumulates in amyg'ala, !i44ocam4us, basal ganglia, cerebral corte(1 'amages "ur%in@e an' granule cells in cerebellum1 brain stem 'e6ects in some cases D10,35,50,70-73E -auses abnormal neuronal cytoarc!itecture1 'isru4ts neuronal migration, microtubules, an' cell 'ivision1 re'uces ;-FMs D10,28,+7-+*,161E "rogressive microce4!aly D25E 0eu&o-c e)ist&y "revents 4resyna4tic serotonin release an' in!ibits serotonin trans4ort1 causes calcium 'isru4tions D78,7*,163,167,168E Flters 'o4amine systems1 4ero(i'ine 'e6iciency in rats resembles mercurialism in !umans D8,80E Glevates e4ine4!rine an' nore4ine4!rine levels by bloc%ing en8yme t!at 'egra'es e4ine4!rine D81,160E Glevates glutamate D21,171E Iea's to cortical acetylc!oline 'e6iciency1 increases muscarinic rece4tor 'ensity in !i44ocam4us an' cerebellum D+7,170E -auses 'emyelinating neuro4at!y D22,16*E 0eu&op ysiolo#y -auses abnormal GGBs, e4ile4ti6orm activity, variable 4atterns, e.g., subtle, low am4litu'e sei8ure activities D27,31,35,86-8*E -auses abnormal vestibular nystagmus res4onses1 loss o6 sense o6 4osition in s4ace D*,1*,35,70E Cesults in autonomic 'isturbance0 e(cessive sweating, 4oor circulation, elevate' !eart rate D11,18,31,5+E

2%ewe' immune-cell subset in t!e !2 'irection1 'ecrease' res4onses to -cell mitogens1 re'uce' ;? -cell 6unction1 increase' &:;g , &I12 D103,108,115-116,173,175E 24eci6ic areas o6 brain 4at!ology1 many 6unctions s4are' D36E "at!ology in amyg'ala, !i44ocam4us, basal ganglia, cerebral corte(1 'amage to "ur%in@e an' granule cells in cerebellum1 brain stem 'e6ects in some cases D36,60-6*E ;euronal 'isorgani8ation1 increase' neuronal cell re4lication, increase' glial cells1 'e4resse' e(4ression o6 ;-FMs D5,+5,++E "rogressive microce4!aly an' macroce4!aly D17+E Kecrease' serotonin synt!esis in c!il'ren1 abnormal calcium metabolism D76,77,103,17*E Git!er !ig! or low 'o4amine levels1 4ositive res4onse to 4ero(i'ine, w!ic! lowers 'o4amine levels D2,177,178E Glevate' nore4ine4!rine an' e4ine4!rine D2E Glevate' glutamate an' as4artate D82,176E -ortical acetylc!oline 'e6iciency1 re'uce' muscarinic rece4tor bin'ing in !i44ocam4us D83E Kemyelination in brain D10+E Fbnormal GGBs, e4ile4ti6orm activity, variable 4atterns, inclu'ing subtle, low am4litu'e sei8ure activities D2,5,85,8+E Fbnormal vestibular nystagmus res4onses1 loss o6 sense o6 4osition in s4ace D27,180E Futonomic 'isturbance0 unusual sweating, 4oor circulation, elevate' !eart rate D17,180E

Ce6erences 1 Fmerican "syc!iatric Fssociation. $ia#nostic an! Statistical *anual o% *ental $iso&!e&s, 5t! e'n. #as!ington K.-.0 Fmerican "syc!iatric Fssociation, 1**5. 2 Billberg -., -oleman M. T e .iolo#y o% t e 'utistic Syn!&o)es, 2n' e'n. Ion'on0 Mac ?eit! "ress, 1**2. 3 :ili4e% "., Fccar'o "., Barane% B., et al. !e screening an' 'iagnosis o6 autistic s4ectrum 'isor'ers. 1 'utis) $e+ $iso&! 1***1 2*D6E0 53*-585. 5 Bailey F., "!illi4s #., Cutter M. Futism0 towar's an integration o6 clinical, genetic, neuro-4syc!ological, an' neurobiological 4ers4ectives. 1 C il! /syc ol /syc iat&y 1**61 37D1E0 8*-126. + 2u8u%i ., a%emoto . &., ?as!iwa8a%i H., Miyama ., Metabolic 6ate o6 et!ylmercury salts in man an' animal. *e&cu&y, *e&cu&ials, an! *e&captans ,-! 121 20*-233. Miller M. #., -lar%son . #., e's. 24ring6iel'0 -!arles -. !omas, 1*73. 6 Halsey ;. F. /e&specti+e on t e use o% t i)e&osal-containin# +accines2 "resentation at t!e ;ational Paccine F'visory -ommittee #or%s!o4 on !imerosal an' Paccines, Fugust 1112, 1***. &nstitute o6 Paccine 2a6ety website1. 7 Ggan, #. M. T i)e&osal in Vaccines2 "resentation to t!e :KF, 2e4tember 15, 1***. 8 Bosselin C. G., 2mit! C. "., Ho'ge H. -. *e&cu&y2 Clinical Toxicolo#y o% Co))e&cial /&o!ucts, 2ection &&&, !era4eutic &n'e(,+t! e'n. Baltimore0 #illiams , #il%ins, 1*850 262-271. * Kales I. K. !e neuroto(icity o6 al%yl mercury com4oun's. ') 1 *e! 1*721 +30 21*-232. 10 ?oos B. Y., Iongo I. K., Mercury to(icity in t!e 4regnant woman, 6etus, an' newborn in6ant. ') 1 3(stet 4ynecol 1*760 126D3E0 3*0-506. 11 #ar%any Y., Hubbar' K. H. Fcro'ynia an' mercury. 1 /e!iat&ics 1*+30 521 36+-386.

12 McKougle -. Y., Bro'%in G. 2., Reung ". "., ;aylor 2. ., -o!en K. Y., "rice I. H. Cis4eri'one in a'ults wit! autism or 4ervasive 'evelo4mental 'isor'er. 1 C il! '!olesc /syc op a&)acol 1**+1 +D5E0 273-282. 13 Yasels%is -., -oo% G., :letc!er ?., Bennett I. -loni'ine treatment o6 !y4eractive an' im4ulsive c!il'ren wit! autistic 'isor'er. 1 Clin / a&)acol 1**2. 15 "iven Y., "almer ". "syc!iatric 'isor'er an' t!e broa' autism 4!enoty4e0 evi'ence 6rom a 6amily stu'y o6 multi4le-inci'ence autism 6amilies. ') 1 /syc iat&y 1***1 1+6D5E0 ++7-+63. 1+ -lar%e K., Ba(ter M., "erry K., "ras!er P. !e 'iagnosis o6 a66ective an' 4syc!otic 'isor'ers in a'ults wit! autism0 seven case re4orts. 'utis) 1***1 3D2E0 15*-165. 16 Muris "., 2teerneman "., Merc%elbac! H., Hol'rinet &., Meesters -. -omorbi' an(iety sym4toms in c!il'ren wit! 4ervasive 'evelo4mental 'isor'ers. 1 'nxiety $iso&! 1**81 12D5E0 387-3*3. 17 #ing I., Fttwoo' F. 2yn'romes o6 autism an' aty4ical 'evelo4ment. 5an!(oo6 o% 'utis) an! /e&+asi+e $e+elop)ental $iso&!e&s2 Yo!n #iley , 2ons, &nc. 1*870 3-1*. 18 :agala B. G.,#igg -. I. "syc!iatric mani6estations o6 mercury 4oisoning. 1 ') 'ca! C il! '!olesc /syc iat&y 1**21 31D2E0 306-311. 1* ?ar% C. F., "os%an8er K .-., Bulloc% Y. K., Boylen B. Mercury 4oisoning an' its treatment wit! ;-acetyl-K., I-4enicillamine. 0 7n#l 1 *e! 1*711 28+0 10-16. 20 #!ite C. :., :el'man C. B., Moss M. B., "roctor 2. ". Magnetic resonance imaging DMC&E, neurobe!avioral testing, an' to(ic ence4!alo4at!y0 two cases. 7n+i&on 8es 1**31 610 117-123. 21 9A-arroll C. G., Masterton B., Kougnall ;., Gbmeier ?. ". !e neuro4syc!iatric se3uelae o6 mercury 4oisoning0 !e Ma' Hatters 'isease revisite'. .& 1 /syc iat&y 1**+1 167D1E0 *+-*8. 22 :lorentine M. Y., 2an6ili44o && K. Y. Bran' roun's0 elemental mercury 4oisoning. Clin / a&) 1**11 100 213221. 23 Fmin-=a%i, I., Gl!assani 2., Ma@ee' M. F., -lar%son . #., Ko!erty C. F., Breenwoo' M., &ntra-uterine met!ylmercury 4oisoning in &ra3. /e!iat&ics 1*751 +5D+E +87-+*+. 25 Fmin-=a%i I., Ma@ee' M. F., Gl!assani 2. B., -lar%son . #., Breenwoo' M. C., Ko!erty C. F., "renatal met!ylmercury 4oisoning. ') 1 $isa(le! C il! 1*7*1 1330 172-177. 2+ Yoselow M. M., Iouria K. B., Brow'er F. F., Mercurialism0 environmental an' occu4ational as4ects. 'nn ,nte&n *e! 1*721 760 11*-130. 26 2mit! K. *ental 7%%ects o% *e&cu&y /oisonin#2 "resentation be6ore t!e 2ection on :amily "ractice, 2out!ern Me'ical Fssociation, 71st Fnnual 2cienti6ic Fssembly, ;ovember 6-*, 1*77. 27 Iowell Y. F., Burgess 2., 2!enoy 2., -urci Y. F., "eters M., Howar' . ?. Mercury 4oisoning associate' wit! !ig!-'ose !e4atitis-B immune globulin a'ministration a6ter liver trans4lantation 6or c!ronic !e4atitis B. "i+e& T&anspl Su&# 1**61 2D6E0 57+-578. 28 -lar%son, . !e to(icology o6 mercury. C&it 8e+ Clin "a( Sci 1**71 35D3E0 36*-503. 2* -amerino K., -assito M.B., Kesi'eri G., Fngot8i B. Be!avior o6 some 4syc!ological 4arameters o6 a 4o4ulation o6 a Hg e(traction 4lant. Clin Toxicol 1*811 18D11E0 12**-130*. 30 2ny'er C. K. !e involuntary movements o6 c!ronic mercury 4oisoning. '&c 0eu&ol 1*721 260 37*-381. 31 Proom :. /., Breer M. Mercury va4or into(ication. .&ain 1*721 *+0 30+-318. 32 F'ams -. C., =iegler K. ?., Iin Y. . Mercury into(ication simulating amyotro4!ic lateral sclerosis. 1'*' 1*831 2+00 652-653. 33 -uomo P., Fmbrosi I., Fnnau =., -agiano C., Brunello ;., Cacagni B. Be!avioural an' neuroc!emical c!anges in o66s4ring o6 rats e(4ose' to met!ylmercury 'uring gestation. 0euo(e a+ Toxicol Te&atol 1*851 6D3E0 25*-2+5. 35 suba%i ., &ru%ayama ?., e's. *ina)ata $isease2 Glsevier 2cienti6ic "ublis!ing -o., 1*77. 3+ Glsner Y. esting strategies in be!avioral teratology. &&&. Microanalysis o6 be!avior. 0eu&o(e a+ Toxicol Te&atol 1*861 80 +73-+85. 36 Kawson B. Brie6 re4ort0 neuro4syc!ology o6 autism0 a re4ort on t!e state o6 t!e science. 1 'utis) $e+ $iso&! 1**61 26D2E0 17*-185. 37 "ierce ". G., !om4son Y. :. M"H, Ii%os%y #. H. MK, ;ic%ey I. ;. MK, Bar!tel #. :., Hinman F. C. MK M"H. Fl%yl mercury 4oisoning in !umans. 1'*' 1*721 220D11E0 153*-1552. 38 Bran'@ean "., #ei!e "., #!ite C. :., Kebes :. -ognitive 4er6ormance o6 c!il'ren 4renatally e(4ose' to Hsa6eH levels o6 met!ylmercury. 7n+i&on 8es 1**81 77D2E0 16+-172. 3* Fmin-=a%i I., Ma@ee' M. F., -lar%son . #., Breenwoo' M. C. Met!ylmercury 4oisoning in &ra3i c!il'ren0 clinical observations over two years. .&itis *e!ical 1ou&nal 1*781 Marc! 10 613-616. 50 -lar%son . #. Mercury0 ma@or issues in environmental !ealt!. 7n+i&on 5ealt /e&spect 1**21 1000 31-38. 51 ?ugler B. !e 'i66erentiation between autism an' Fs4erger syn'rome. 'utis) 1**81 2D1E0 11-32. 52 eitelbaum "., eitelbaum 9., ;ye Y., :ryman Y., Maurer C. B. Movement analysis in in6ancy may be use6ul 6or early 'iagnosis o6 autism. /&oc 0atl 'ca! Sci > 2 F 1**81 *+0 13*82-13*87. 53 sai I. R. Brie6 re4ort0 comorbi' 4syc!iatric 'isor'ers o6 autistic 'isor'er. 1 'utis) $e+ $iso&! 1**61 26D2E0 1+*-165. 55 -esaroni I., Barber M. G(4loring t!e e(4erience o6 autism t!roug! 6irst!an' accounts. 1 'utis) $e+ $iso&! 1**11 21D3E0 303-313. 5+ :arnswort! K. "in% Kisease 2urvey Cesults. "in% Kisease 2u44ort Brou4 2ite, 1**71

56 Brasic Y. C. Movements in autistic 'isor'er. *e! 5ypot 1***1 +30 58-5*. 57 Cosen!all >., ;or'in P., 2an'strom M., F!lsen B., Billberg -. Futism an' !earing loss. 1 'utis) $e+ $iso&! 1***1 2*D+E0 35*-3+8. 58 Cou( 2., F'rien Y-I., Bruneau ;., Malvy Y., Bart!elemy -. Be!avior 4ro6iles wit!in a 4o4ulation o6 15+ c!il'ren wit! autism using t!e Be!aviour 2ummari8e' Gvaluation scale0 in6luence o6 'evelo4mental age. 'utis) 1**81 2D5E0 35+-366. 5* Barane% B. Futism 'uring in6ancy0 a retros4ective vi'eo analysis o6 sensory-motor an' social be!aviors an' *-12 mont!s o6 age. 1 'utis) $e+ $iso&! 1***1 2*D3E0 213-225. +0 9;eill M., Yones C. 2. ". 2ensory-4erce4tual abnormalities in autism0 a case 6or more researc!Z 1 'utis) $e+ $iso&! 1**71 27D3E0 283-2*3. +1 24erry P. #. :amily an' 4ersonal section0 6rom t!e insi'e out - a view o6 t!e worl' as seen by one wit! Fs4erger syn'rome. 'utis) 1**81 2D1E0 81-86 +2 -ass H. Pisual im4airment an' autism0 current 3uestions an' 6uture researc!. 'utis) 1**81 2D2E0 117-138. +3 Manser ;. ;evilleAs 9a /in6ie: 8ecollection o% /in6 $isease2 "in% Kisease 2u44ort Brou41 www.users.big4on'.comS'i6arnswort!. +5 Mins!ew ;. Y. Brie6 re4ort0 brain mec!anisms in autism0 6unctional an' structural abnormalities. 1 'utis) $e+ $iso&! 1**61 26D2E0 20+-20*. ++ "lio4lys F. P., Hemmens 2. G., Cegan -. M. G(4ression o6 a neural cell a'!esion molecule serum 6ragment is 'e4resse' in autism. 1 0eu&opsyc iat&y Clin 0eu&osci 1**01 2D5E0 513-517. +6 2ara6ian . F., Bre'esen K. G., Perity M. F. -ellular resistance to met!ylmercury. 0eu&otoxicolo#y 1**6 24ring Fbstract1 17D1E0 27-36. +7 Hassett-2i44le B., 2wartout Y., 2c!oeny C. Pol. P. Healt! e66ects o6 mercury an' mercury com4oun's. *e&cu&y Stu!y 8epo&t to Con#&ess2 Gnvironmental "rotection Fgency DG"FE, Kecember 1**7. +8 "en'ergrass Y. -., Haley B. G., Pimy M. Y., #in6iel' 2. F., Iorsc!ei'er :. I. Mercury va4or in!alation in!ibits bin'ing o6 B " to tubulin in rat brain0 similarity to a molecular lesion in Fl8!eimer 'isease' brain. 0eu&otoxicolo#y 1**71 18D2E0 31+-325. +* Key ". M., Boc!6el' M., Ceu!l ?. C. Kevelo4mental met!ylmercury a'ministration alters cerebellar "2F;-FM e(4ression an' Bolgi sialyltrans6erase activity. .&ain 8es 1***1 85+D2E0 13*-1+1. 60 -ourc!esne G., et al. More evi'ence lin%s autism, cerebellar 'e6ects. reviewe' in 'utis) 8esea&c 8e+ie; ,nte&national 1**51 8D2E0 1,7. 61 Citvo G. C., :reeman B. Y., 2c!eibel F. B., et al. Iower "ur%in@e cell counts in t!e cerebella o6 6our autistic sub@ects0 initial 6in'ings o6 t!e >-IF-;2F- Futo4sy Cesearc! Ce4ort. ') 1 /syc iat&y 1*861 1530 862-866. 62 Hoon F. H., Ciess F. I. !e mesial-tem4oral lobe an' autism0 case re4ort an' review. $e+ *e! C il! 0eu&ol 1**21 350 2+2-26+. 63 "iven Y., Bert!ier M., 2tar%stein 2., ;e!me G., "earlson B., :olstein 2. Magnetic resonance imaging evi'ence 6or a 'e6ect o6 cerebral cortical 'evelo4ment in autism. ') 1 /syc iat&y 1**01 157D6E0 735-73*. 65 Fbell :., ?rams M., Fs!burner Y., et al. !e neuroanatomy o6 autism0 a vo(el-base' w!ole brain analysis o6 structural scans. 0eu&o&epo&t 1***1 10D8E0 1657-16+1. 6+ Fylwar' G. H., Mins!ew ;. Y., Bol'stein B., et al. MC& volumes o6 amyg'ala an' !i44ocam4us in nonmentally retar'e' autistic a'olescents an' a'ults. 0eu&olo#y 1***1 +3D*E0 215+-21+0. 66 9tsu%a H. Brain metabolites in t!e !i44ocam4us-amyg'ala region an' cerebellum in autism0 an 1H-MC s4ectrosco4y stu'y. 0eu&o&a!iolo#y 1***1 Yuly. 67 2ears I. I. Fn MC& stu'y o6 t!e basal ganglia in autism. /&o# 0eu&opsyc op a&)acol .iol /syc iat&y 1***1 May. 68 Has!imoto ., ayama M., Mura%awa ?., et al. Kevelo4ment o6 t!e brainstem an' cerebellum in autistic 4atients. 1 'utis) $e+ $iso&! 1**+1 2+D1E0 1-18. 6* Mc-lellan' C. Y., Gyre K., #atson K., -alvert Y. F neuro4!ysiological stu'y o6 autistic c!il'ren. 7lect&oencep alo#& Clin 0eu&op ysiol 1*8+1 610 16. 70 Kavis I. G., ?orn6el' M., Mooney H. 2., et al. Met!ylmercury 4oisoning0 long term clinical, ra'iological, to(icological, an' 4at!ological stu'ies o6 an a66ecte' 6amily. 'nn 0eu&ol 1**50 3+D6E0 680-688. 71 Iar%6ors I., 9s%arsson F., 2un'berg Y., Gben'al . Met!ylmercury in'uce' alterations in t!e nerve growt! 6actor level in t!e 'evelo4ing brain. .&ain 8es $e+ .&ain 8es 1**11 62D2E0 287-2*1. 72 Iorsc!ei'er :. I., Pimy M. Y., 2ummers F. 9. Mercury e(4osure 6rom HsilverH toot! 6illings0 emerging evi'ence 3uestions a tra'itional 'ental 4ara'igm. <'S7. 1 1**+1 *0 +05-+08. 73 Magos I., Brown F. #., 24arrow 2., Bailey G., 2now'en C. ., 2%i44 #. C. !e com4arative to(icology o6 et!yl- an' met!ylmercury. '&c Toxicol 1*8+1 +7D5E0 260-267. 75 Colls G. . Memory systems in t!e brain. 'nn 8e+ /syc ol 20001 +10 +**-630. 7+ Bac!evalier Y. Me'ial tem4oral lobe structures0 a review o6 clinical an' e(4erimental 6in'ings. 0eu&opsyc olo#ia 1**51 320 627-658. 76 -!ugani K. -., Mu8i% 9., Be!en M., et al. Kevelo4mental c!anges in brain serotonin synt!esis ca4acity in autistic an' nonautistic c!il'ren. 'nn 0eu&ol 1***1 5+. 77 -oo% G. H. Futism0 review o6 neuroc!emical investigation. Synapse 1**01 60 2*2-308.

78 9 ?us%y Y. C., Boyes B. G., McBeer G. B. Met!ylmercury-in'uce' movement an' 4ostural 'isor'ers in 'evelo4ing rat0 regional analysis o6 brain catec!olamines an' in'oleamines. .&ain 8es 1*881 53*D1-2E0 138156. 7* ;is!io H., ;e8asa ?., Hirano Y., ;a%ata R. G66ects o6 t!imerosal, an organic sul6!y'ryl mo'i6ying agent, on serotonin trans4ort activity into rabbit bloo' 4latelets. 0eu&oc e) ,nt 1**61 2*D5E0 3*1-3*6. 80 Mc?ay 2. Y., Ceynol's Y. ;., Cac8 #. Y. G66ects o6 mercury com4oun's on t!e s4ontaneous an' 4otassiumevo%e' release o6 U3HW'o4amine 6rom mouse striatal slices. Can 1 / ysiol / a&)acol 1*861 65D12E0 1+07-1+15. 81 Hr'ina ". K., "eters K. F., 2ing!al C. I. G66ects o6 c!ronic e(4osure to ca'mium, lea' an' mercury o6 brain biogenic amines in t!e rat. 8esea&c Co))unications in C e)ist&y, /at olo#y an! / a&)acolo#y 1*761 1+D3E0 583-5*3. 82 Moreno H., Bor@as I., Frrieta F., et al. -linical !eterogeneity o6 t!e autistic syn'rome0 a stu'y o6 60 6amilies D24anis!E. ,n+est Clin 1**21 33D1E0 13-31. 83 "erry G., Iee M., -ourt Y., "erry C. C oline&#ic 'cti+ities in 'utis)= 0icotinic an! *usca&inic 8ecepto& '(no&)alities in t e Ce&e(&al Co&tex2 "resentation to -ure Futism ;ow, 2000. 85 Iewine magnetoenc!alogra4!y in c!il'ren wit! an autistic e4ile4ti6orm regression. 1 /e!iat&ics 1***1 50+518. 8+ ;ass C., Bross F., Kevins%y 9. Futism an' autistic e4ile4ti6orm regression wit! occi4ital s4i%es. $e+ *e! C il! 0eu&ol 1**81 50D7E0 5+3-8. 86 Brenner C. ", 2ny'er C. K. Iate GGB 6in'ing an' clinical status a6ter organic mercury 4oisoning. '&c 0eu&ol 1*801 37D+E0 282-285. 87 "ii%ivi I., olonen >. GGB 6in'ings in c!lor-al%ali wor%ers sub@ect to low long term e(4osure to mercury va4or. .& 1 ,n! *e! 1*8*1 56D6E0 370-37+. 88 Co!yans Y., #alson ". K., #oo' B. F., MacKonal' #. F. Mercury to(icity 6ollowing mert!iolate ear irrigations. 1 /e!iat& 1*850 311-313. 8* 28as8 F., Barna B., 28u4era =., et al. -!ronic low-'ose maternal e(4osure to met!ylmercury en!ances e4ile4togenicity in 'evelo4ing rats. ,nt 1 $e+l 0eu&osci 1***1 17D7E0 733-752. *0 2c!eyer C. K. &nvolvement o6 glutamate in !uman e4ile4tic activities. /&o# .&ain 8es 1**81 116, 3+*-36*. *1 9 Ceilly B. F., #aring, C. Gn8yme an' sul6ur o(i'ation 'e6iciencies in autistic c!il'ren wit! %nown 6oo'Sc!emical intolerances. 1ou&nal o% 3&t o)olecula& *e!icine 1**31 50 1*8-200. *2 Flberti F., "irrone "., Glia M., #aring C. H., Comano -. 2ul4!ation 'e6icit in Hlow-6unctioningH autistic c!il'ren0 a 4ilot stu'y. .iol /syc iat&y 1***1 56D3E0 520-5. *3 Mar%ovic! K., ?nig!t K., Cenal ;a-2i cotrans4orter ;a2i-1 is in!ibite' by !eavy metals. ')e&ican 1ou&nal o% 8enal / ysiolo#y 1**81 275D2E0 283-28*. *5 Bolse B., Kebray-Cit8en "., Kurosay "., "uget ?., Mic!elson F. M. Flterations in two en8ymes0 su4ero(i'e 'ismutase an' glutat!ion 4ero(i'ase in 'evelo4mental in6antile 4syc!osis. 8e+ 0eu&ol D"arisE 1*781 135D11E0 6**-70+. *+ G'elson 2. B., -antor K. 2. Futism0 (enobiotic in6luences. Toxicol ,n! 5ealt 1**81 15D5E0 ++3-+63. *6 :uc!s Y., "ac%er I., =immer B. "ipoic 'ci! in 5ealt an! $isease . Marcel Ke%%er, &nc., 1**7 *7 #illiams M. P., #inters ., #a''ell ?. 2. &n vivo e66ects o6 Mercury D&&E on 'eo(yuri'ine tri4!os4!ate nucleoti'o!y'rolase, K;F 4olymerase Da,bE, uracil-K;F glycosylase activities in culture' !uman cells0 relations!i4 to K;F 'amage, K;F re4air, an' cytoto(icity. *ol / a&)acol 1*871 31D2E0 200-207. *8 Fu%rust "., et al. Kecrease' levels o6 total an' re'uce' glutat!ione in -K5X lym4!ocytes in common variable immuno'e6iciency are associate' wit! activation o6 t!e tumor necrosis 6actor system0 4ossible immuno4at!ogenic role o6 o(i'ative stress. .loo! 1**+186D5E0 1383-13*1. ** Ya66e Y. 2., et al. :unctional abnormalities o6 -K8X t cells 'e6ine a uni3ue subset o6 4atients wit! common variable immuno'e6iciency. .loo! 1**31 82D1E0 1*2-201. 100 2!en%er B. Y., Buo . I., 2!a4iro &. M. Iow-level met!ylmercury e(4osure causes !uman -cells to un'ergo a4o4tosis0 evi'ence o6 mitoc!on'rial 'ys6unction. 7n+i&on 8es 1**81 2ection F 77D2E0 15*-1+*. 101 "age ., Ru F., :ontanesi Y., ;y!an #. I. Kevelo4mental 'isor'er associate' wit! increase' cellular nucleoti'ase activity. /&oc 0atl 'ca! Sci - S ' 1**71 *50 11601-11606. 102 "age ., -oleman M. "urine metabolism abnormalities in a !y4eruricosuric subclass o6 autism. .ioc i) .iop ys 'cta 20001 1+00D3E0 2*1-2*6. 103 "lio4lys F. 'utis)= .io)e!ical /e&specti+es2 "resentation 6or t!e Futism 2ociety o6 Fmerica meeting, Yuly 1*8*. 105 -onnolly F. M., et al. 2erum autoantibo'ies to brain in Ian'au-?le66ner variant, autism, an' ot!er neurologic 'isor'ers. 1 /e!iat& 1***1 135D+E0 607-613. 10+ 2ing! P., #arren C., 9'ell Y., #arren #., -ole ". Fntibo'ies to myelin basic 4rotein in c!il'ren wit! autistic be!avior. .&ain .e a+ ,))un 1**31 7D1E0 *7-103. 106 -omi F. M., =immerman F., et al. :amilial clustering o6 autoimmune 'isor'ers an' evaluation o6 me'ical ris% 6actors in autism. 1 C il! 0eu&ol 1***1 150 388-3*5. 107 #!iteley "., Cogers Y., 2!attoc% ". -linical 6eatures associate' wit! autism0 observations o6 sym4toms outsi'e t!e 'iagnostic boun'aries o6 autistic s4ectrum 'isor'ers. 'utis) 1**812D5E0 51+-522.

108 #arren C. "., Margaretten ;. -., "ace ;. -., :oster F. &mmune abnormalities in 4atients wit! autism. 1 'utis) $e+ $iso&! 1*861 16D2E0 18*-1*7. 10* =immerman F., :rye P. H., "otter ;. . &mmunological as4ects o6 autism. ,nte&national 1ou&nal o% /e!iat&ics 1**31 80 1**-205. 110 #eit8man F., #eisman C., 28e%ely B. F., #i@senbee% H., Iivni G. Fbnormal immune res4onse to brain tissue antigen in t!e syn'rome o6 autism. ') 1 /syc iat&y 1*821 13*D11E0 1562-156+. 111 ;ielsen Y. B., Hultman ". G(4erimental stu'ies on genetically 'etermine' susce4tibility to mercury-in'uce' autoimmune res4onse. 8en <ail 1***1 21D3,5E0 353-358. 112 Hu H., Fbe'i-Paluger'i M., Moller B. "retreatment o6 lym4!ocytes wit! mercury in vitro in'uces a res4onse in cells 6rom genetically 'etermine' low-res4on'ers an' a s!i6t o6 t!e interleu%in 4ro6ile. ,))unolo#y 1**71 *00 1*8-205. 113 Fl-Balag!i 2., M[ller G., M[ller B., Fbe'i-Paluger'i M. Mercury in'uces 4olyclonal B cell activation, autoantibo'y 4ro'uction an' renal immune com4le( 'e4osits in young D;=B ( ;=#E :1 !ybri's. 7u& 1 ,))unol 1**61 26D7E0 1+1*-1+26. 115 #arren C. "., Margaretten ;. -., :oster F., Ce'uce' natural %iller cell activity in autism. 1 ') 'ca! C il! '!olesc /syc iat&y 1*871 26D3E0 333-33+. 11+ Bu4ta 2., Fggarwal 2., Hea's -., Brie6 re4ort0 'ysregulate' immune system in c!il'ren wit! autism0 bene6icial e66ects o6 intravenous immune globulin on autistic c!aracteristics, 1 'utis) $e+ $iso&! 1**61 26D5E0 53*-5+2. 116 Messa!el 2., "!easant F. G., "all H., F!me'--!ou'!ury Y., 2ungum-"aliwal C. 2., Postanis ". >rinary levels o6 neo4terin an' bio4terin in autism. 0eu&osci "ett 1**81 251D1E0 17-20. 117 Yo!ansson >., Hansson-Beorgia'is H., Hultman ". !e genoty4e 'etermines t!e B cell res4onse in mercury-treate' mice. ,nt '&c 'lle&#y ,))unol 1**81 116D5E0 2*+-30+. 118 Bagenstose I. M., 2algame "., Monestier M. Murine mercury-in'uce' autoimmunity0 a mo'el o6 c!emically relate' autoimmunity in !umans. ,))unol 8es 1***1 20D1E0 67-78. 11* Hu H., Moller B., Fbe'i-Paluger'i M. Mec!anism o6 mercury-in'uce' autoimmunity0 bot! !el4er 1- an' !el4er 2-ty4e res4onses are involve'. ,))unolo#y 1***1 *6D3E0 358-3+7. 120 &lbac% ;. B. G66ects o6 met!yl mercury e(4osure on s4leen an' bloo' natural-%iller D;?E cell-activity in t!e mouse. Toxicolo#y 1**11 67D1E0 117-125. 121 Mattsson Y. C., Miller G., Flligoo' Y. "., ?oering Y. G., Ievin 2. B. Garly e66ects o6 met!ylmercury on t!e visual evo%e' res4onse o6 t!e 'og. 0eu&otoxicolo#y 1*811 2D3E0 5**-+15. 122 Ce'woo', I. C elation case isto&ies2 Htt40SStlre'woo'.!ome.min's4ring.comScase\stu'ies.!tm. 125 Bilberg -., #ing I. Futism0 not an e(tremely rare 'isor'er. 'cta /syc iat& Scan! 1***1 **D6E1 3**-506. 123 ?anner I. Futistic 'isturbances o6 a66ective contact. T e 0e&+ous C il! 1*52-1*531 2D3E0 217-2+0. 12+ Bristol M., -o!en K., -ostello G., et al. 2tate o6 t!e science in autism0 re4ort to t!e ;ational &nstitutes o6 Healt!. 1 'utis) $e+ $iso&! 1**61 26D2E0 121-1+7. 126 /&e+alence o% 'utis) in .&ic6 To;ns ip, 0e; 1e&sey, 1998= Co))unity 8epo&t2 -enters 6or Kisease -ontrol an' "revention, F4ril 20001 www.c'c.govSnce!Sc''!S''Sr4ttoc. 127 2ager. ". C., Fsc!ner, M., Co'ier, ". M. "ersistent 'i66erential alteration in 'evelo4ing cerebellar corte( o6 male an' 6emale mice a6ter met!ylmercury e(4osure. $e+ .&ain 8es 1*851 120 1-11. 128 Cossi F. K., F!lbom G., 9gren 2. 9., ;icotera "., -eccatelli 2. "renatal e(4osure to met!ylmercury alters locomotor activity o6 male but not 6emale rats. 7xp .&ain 8es 1**71 117D3E0 528-536. 12* >4roar over a little-%nown 4reservative, t!imerosal, @ostles >.2. !e4atitis B vaccination 4olicy. 1*** 2ummer1 5D2E. 130 -a44s I., ?e!res Y., 2igman M. -onversational abilities among c!il'ren wit! autism an' c!il'ren wit! 'evelo4mental 'elays. 'utis) 1**81 2D5E0 32+-55. 131 onge B. Y., Brereton F. P., Bray ?. M., Gin6el' 2. I., Be!avioural an' emotional 'isturbance in !ig!6unctioning autism an' Fs4ergers syn'rome. 'utis) 1***1 3D2E0 117-130. 132 Coss #. Konal', Bec!man F., 2!oliton M., "aul H. Flertness to neuro4syc!iatric mani6estations. Co)p& /syc iat&y 1*771 18D6E0 +*+-+*8. 133 Howlin ". 9utcome in a'ult li6e 6or more able in'ivi'uals wit! autism or Fs4erger syn'rome. 'utis) 20001 5D1E0 63-85. 135 ?lin F., 24arrow 2. 2., 'e Bilt F., et al. F norme' stu'y o6 6ace recognition in autism an' relate' 'isor'ers. 1 'ut $e+ $iso&!e&s 1***1 2*D6E0 5**-+08. 13+ KeIong B. C. Futism0 new 'ata suggest a new !y4ot!esis. 0eu&olo#y 1***1 +2D+E0 *11-*16. 136 Bernabei "., -amaioni I., Ievi B. Fn evaluation o6 early 'evelo4ment in c!il'ren wit! autism an' 4ervasive 'evelo4mental 'isor'ers 6rom !ome movies0 4reliminary 6in'ings. 'utis) 1**81 2D3E0 253-2+8. 137 Baron--o!en 2., Fllen Y., Billberg -. -an autism be 'etecte' at 18 mont!s0 t!e nee'le, t!e !aystac%, an' t!e -HF . .& 1 /syc iat&y 1**21 1610 83*-853. 138 Gisenmayer C., et al. Kelaye' language onset as a 4re'ictor o6 clinical sym4toms in 4ervasive 'evelo4mental 'isor'ers. 1 'utis) $e+ $iso&! 1**81 28D6E0 +27-+33. 13* "ri8ant B. M. Brie6 re4ort0 communication, language, social, an' emotional 'evelo4ment. 1 'utis) $e+ $iso&! 1**61 26D2E0 173-178.

150 Bran'in . !e learning style o6 4eo4le wit! autism0 an autobiogra4!y. Teac in# C il!&en ;it 'utis)2 ?at!leen Fnn /uill, e'., 1**+0 33-+2. 151 Hua M. 2., Huang -. -., Rang R. Y. -!ronic elemental mercury into(ication0 neuro4syc!ological 6ollow u4 case stu'y. .&ain ,n> 1**61 10D+E0 377-385. 152 Reates ?. 9., Mortensen M. G. Fcute an' c!ronic neuro4syc!ological conse3uences o6 mercury va4or 4oisoning in two early a'olescents. 1 Clin 7xp 0eu&opsyc ol 153 Fronow C., :leisc!mann I. Mercury 4oisoning in c!il'ren. Clin /e!iat& 1*761 1+D10E0 *36-*5+. 155 #at8l B., Fbra!amse 2I., re4tow-van Iis!aut 2., et al. Gn!ancement o6 ovalbumin-in'uce' antibo'y 4ro'uction an' mucosal mast cell res4onse by mercury. <oo! C e) Toxicol 1***1 37D6E0 627-637. 15+ -!urc! -., -o4lan Y. !e !ig! 6unctioning autistic e(4erience0 birt! to 4reteen years. 1 /e!iat& 5ealt Ca&e 1**+1 *0 22-2*. 156 9;eill Y. I. T &ou# t e 7yes o% 'liens2 Yessica ?ingsley "ublis!ers It'., 1***. 157 Keu6emia "., -elli M., :inocc!iaro C., et al. Fbnormal intestinal 4ermeability in c!il'ren wit! autism. 'cta /?!iat& 1**61 8+0 1076-107*. 158 Horvat! ?., "a4a'imitriou Y. -., Cabs8tyn F., Krac!enberg -., il'on Y. . Bastrointestinal abnormalities in c!il'ren wit! autistic 'isor'er. 1 /e!iat& 1***1 13+D+E0 ++*-+63. 15* #a%e6iel' F. Y., Murc! 2. H., Fnt!ony F., et al. &leal-lym4!oi'-no'ular !y4er4lasia, non-s4eci6ic colitis, an' 4ervasive 'evelo4mental 'isor'er in c!il'ren. "ancet 1**81 3+10 637-651. 1+0 2!attoc% "., 2avery K. 'utis) as a *eta(olic $iso&!e&2 2un'erlan', >?0 Futism Cesearc! >nit, >niversity o6 2un'erlan', 1**7. 1+1 G'elson M. B., 2c!ubert K. ., G'elson 2. M. :actors 4re'icting intelligence cores on t!e 9;& in in'ivi'uals wit! autism. <ocus on 'utis) an! 3t e& $e+elop)ental $isa(ilities 1**81 13D1E0 17-26. 1+2 Iong term 6ollow-u40 early intervention e66ects lasting. '8, 0e;slette&, review 1**31 7D1E0 1,6 1+3 Cumsey Y. -once4tual 4roblem-solving in !ig!ly verbal, nonretar'e' autistic men. 1 'utis) $e+ $iso&! 1*8+1 1+D1E0 23-36. 1+5 Be'ye F. Fnatomy o6 sel6-in@urious, stereoty4ic, an' aggressive movements0 evi'ence 6or involuntary e(4lanation. 1 Clin /syc ol 1**21 58D6E0 766-778. 1++ ?im Y. F., 28atmari "., Bryson 2. G., 2treiner K. I., #ilson :. Y. !e 4revalence o6 an(iety an' moo' 4roblems among c!il'ren wit! autism an' Fs4erger syn'rome. ]^20001 5D2E1 117-133. 1+6 Cic!'ale F. I. 2lee4 4roblems in autism0 4revalence, cause, an' intervention. $e+ *e! C il! 0eu&ol 1***1 51D1E0 60-66. 1+7 2tores B., #iggs I. Fbnormal slee4ing 4atterns associate' wit! autism0 a brie6 review o6 researc! 6in'ings, assessment met!o's an' treatment strategies. 'utis) 1**81 2D2E0 1+7-170. 1+8 2ara6ian ., Perity M..F. Fltere' 4atterns o6 4rotein 4!os4!orylation an' synt!esis cause' by met!yl mercury in cerebellar granule cell culture. 1 0eu&oc e) 1**01 ++D3E0 *22-*2*. 1+* Cosens4ire F. Y., Bo'e4u'i 2., Mat!ews M., Mc-abe M. Y. Yr. Iow levels o6 ionic mercury mo'ulate 4rotein tyrosine 4!os4!orylation in lym4!ocytes. ,nt 1 ,))unop a&)acol 1**81 20D12E0 6*7-707. 160 Ca@anna B., Hobson M. &n6luence o6 mercury on u4ta%e o6 U3HW'o4amine an' U3HWnore4ine4!rine by rat braisyna4tosomes. Toxicol "ett 1*8+1 27D1-3E0 7-15. 161 Fsc!ner M., Mullaney ?Y., #agoner K., Ias! IH., ?imelberg H?. &ntracellular glutat!ione DB2HE levels mo'ulate mercuric c!lori'e DM-E- an' met!ylmercuric c!lori'e DMeHg-lE-in'uce' amino aci' release 6rom neonatal rat 4rimary astrocytes cultures. .&ain 8es 1**51 D665E1 133-150. 162 Fs!our H., Fb'el-Ca!man M., ?!o'air F. !e mec!anism o6 met!yl mercury to(icity in isolate' rat !e4atocytes. Toxicol "ett 1**31 6*D1E0 87-*6. 163 Ftc!ison #. K., Hare M. :. Mec!anisms o6 met!ylmercury-in'uce' neuroto(icity, <'S7. 1 1**51 8D*E0 622-62*. 165 :aro I. C. :., ;ascimento Y. I. M., Fl6onso M., Kuran C., Fcute a'ministration o6 met!ylmercury c!anges in vivo 'o4amine release 6rom rat striatum. .ull 7n+i&on Conta) Toxicol 1**81 600 632-638. 16+ Gl-:awal H. F., #aterman 2. Y., Ke :eo F., 2!amy M. R. ;euroimmunoto(icology0 !umoral assessment o6 neuroto(icity an' autoimmune mec!anisms. 7n+i&on 5ealt /e&spect 1***1 107D2u44l +E0 767-77+. 166 an _. _., ang -., -astol'i F. :., Man8o I., -osta I. B. G66ects o6 inorganic an' organic mercury on intracellular calcium levels in rat lym4!ocytes. 1 Toxicol 7n+i&on 5ealt 1**31 38D2E0 1+*-170. 167 Gl6erin% Y. B. !imerosal0 a versatile sul6!y'ryl reagent, calcium mobili8er, an' cell 6unction-mo'ulating agent. 4en / a&)acol 1***1 33D1E0 1-6. 168 Ftc!ison #. K., Yos!i >., !ornburg Y. G. &rreversible su44ression o6 calcium entry into nerve terminals by met!ylmercury. 1 / a&)acol 7xp T e& 1*861 238D2E0 618-625. 16* -!u -. -., Huang -. -., Cyu 2. Y., #u . ;. -!ronic inorganic mercury in'uce' 4eri4!eral neuro4at!y. 'cta 0eu&ol Scan! 1**81 *8D6E0 561-56+. 170 -occini ., Can'ine B., -an'ura 2. M., ;a44i C. G., "roc%o4 I. K., Man8o I. Iow-level e(4osure to met!ylmercury mo'i6ies muscarinic c!olinergic rece4tor bin'ing c!aracteristics in rat brain an' lym4!ocytes0 4!ysiologic im4lications an' new o44ortunities in biologic monitoring. 7n+i&on 5ealt /e&spect 20001 108D1E0 2*-33.

171 Polterra F., rotti K., -assutti "., et al. Hig! sensitivity o6 glutamate u4ta%e to e(tracellular 6ree arac!i'onic aci' levels in rat cortical syna4tosomes an' astrocytes. 1 0eu&oc e) 1**20 +*D2E0 600-606. 172 Iombar' Y. Futism0 a mitoc!on'rial 'isor'erZ *e! 5ypot eses 1**81 +0D6E0 5*7-+00. 173 Bu4ta 2., Fggarwal 2., Cas!anravan B., Iee . !1- an' !2-li%e cyto%ines in -K5X an' -K8X cells in autism. 1 0eu&oi))unol 1**81 8+D1E0 106-10*. 175 2ing! P. ?. "lasma increase o6 &nterleu%en-12 an' &nter6eron-gamma. "at!ological signi6icance in autism. 1 0eu&oi))unolo#y 1**61 660 153-15+. 17+ :ombonne G., Cog` B., -laverie Y., -ourty 2., :r`molle Y. Microce4!aly an' macroce4!aly in autism. 1 'utis) $e+ $iso&! 1***1 2*D2E0 113-11*. 176 -arlson M. I. Hy4ot!esis0 is in6antile autism a !y4oglutamatergic 'isor'erZ Celevance o6 glutamate serotonin interactions 6or 4!armacot!era4y. 1 0eu&al T&ans) 1**81 10+D5-+E0 +2+-+3+. 177 Billberg -., 2venner!olm I. -2: monoamines in autistic syn'romes an' ot!er 4ervasive 'ev. 'isor'ers o6 early c!il'!oo'. .& 1 /syc iat&y 1*871 D1+1E0 8*-*5. 178 Grnst M., =amet%in F. Y., Matoc!i% Y. F., "ascualvaca K., -o!en C. M. Iow me'ial 4re6rontal 'o4aminergic activity in autistic c!il'ren. "ancet 1**71 3+0D*078E0 638. 17* Ieboyer M., "!ili44e F., Bouvar' M., et al. #!ole bloo' serotonin an' 4lasma beta-en'or4!in in autistic 4roban's an' t!eir 6irst-'egree relatives. .iol /sycat&y 1***1 5+D2E0 1+8-163. 180 9rnit8 G. M. ;euro4!ysiologic stu'ies o6 in6antile autism. 5an!(oo6 o% 'utis) an! /e&+asi+e $e+elop)ental $iso&!e&s2 Yo!n #iley , 2ons, &nc., 1*870 158-16+. 181 2c!uler F. I. !in%ing in autism0 'i66erences in learning an' 'evelo4ment. Teac in# C il!&en ;it 'utis)2 ?at!leen Fnn /uill, e'., 1**+0 11-32

:rom !e #eb ...

!tt40SSwww.44.o%state.e'uSe!sStrainingSmercury.!tm G(4osure to any 6orm o6 mercury on a re4eate' basis, or even 6rom a single, very !ig! e(4osure can lea' to t!e 'isease o6 c!ronic mercury 4oisoning. !ere are t!ree main sym4toms0 1. Bum 4roblems. !e gums become so6t an' s4ongy, t!e teet! get loose, sores may 'evelo4, an' t!ere may be increase' saliva. 2. Moo' an' mental c!anges. "eo4le wit! c!ronic mercury 4oisoning o6ten !ave wi'e swings o6 moo', becoming irritable, 6rig!tene', 'e4resse' or e(cite' very 3uic%ly 6or no a44arent reason. 2uc! 4eo4le may become e(tremely u4set at any criticism, lose all sel6-con6i'ence, an' become a4at!etic. Hallucinations, memory loss an' inability to concentrate can occur. 3. ;ervous system. !e earliest an' most 6re3uent sym4tom is a 6ine tremor Ds!a%ingE o6 t!e !an'. F tremor may also occur in t!e tongue an' eyeli's. Gventually t!is can 4rogress to trouble balancing an' wal%ing. !tt40SSwww.town!all.westwoo'.ma.usS!umanSbo!Sin'e(\bo!.!tml Mercury is a neuroto(in. G(4osure to !ig! levels can cause 4ermanent 'amage to t!e brain an' %i'neys, as well as causing !arm to t!e 'evelo4ing 6etus. Mercury accumulates in t!e brain an' %i'neys. G(4osure to mercury can cause 4ersonality c!anges, tremors, c!anges in vision, loss o6 sensation an' memory. 2mall amounts o6 mercury can !ave serious im4act on t!e environment. Mercury eva4orates easily an' travels in t!e atmos4!ere, an' is 'e4osite' into soil an' water. !e mercury t!at enters la%es, 4on's rivers an' oceans accumulates in 6is! tissue an' concentrates as larger 6is! eat smaller 6is!. !tt40SSwww.algonet.seSalei6S6ummwr1*.!tml Pillanacci Y: et al. Mercury "oisoning Fssociate' wit! Beauty -ream - e(as, ;ew Me(ico, an' -ali6ornia, 1**+ - 1**6 MM#C 5+D1*E0500-503 D1**6E Mercury "oisoning J -ontinue' !e e(as Ke4artment o6 Healt! D KHE, ;ew Me(ico Ke4artment o6 Healt! D;MKHE, an' 2an Kiego -ounty Healt! Ke4artment D2K-HKE recently investigate' t!ree cases o6 mercury 4oisoning among 4ersons w!o !a' use' a beauty cream 4ro'uce' in Me(ico. !e investigations im4licate' t!e beauty cream as t!e source o6 t!e mercury. !e cream, mar%ete' as H-rema 'e Belle8a - Manning,H lists HcalomelH Dmercurous c!lori'eE as an ingre'ient an' was 6oun' to contain 6M-8M mercury by weig!t. !is re4ort summari8es t!e ongoing investigation o6 t!ese an' ot!er 4ossible cases. -ase 10 &n 2e4tember 1**+, a 4reviously !ealt!y 1+-year-ol' boy w!o resi'e' in e(as near t!e Me(ico bor'er !a' onset o6 6atigue, wea%ness, insomnia, myalgias o6 !is e(tremities, severe !ea'ac!e, sore t!roat, coug!, consti4ation, an' 4arest!esias o6 !is 6eet an' !an's. 9n 2e4tember 16, a 4!ysician in "ie'ras ;egras, Me(ico, 4rescribe' sym4tomatic treatment 6or t!e 4arest!esia an' coug!. 2ubse3uent 4roblems inclu'e' loss o6 taste, weig!t loss o6 a44ro(imately 1+ 4oun's, an' 4rogressive wea%ness in !is arms an' legs. F neurologist in "ie'ras ;egras 4er6orme' an electromyogram an' measure' nerve-con'uction velocities t!at were consistent

wit! a 'emyelinating 4olyneuro4at!y. &n early ;ovember 1**+, t!e 4atient was evaluate' at a !os4ital in 2an Fntonio, e(as, w!ere a magnetic resonance imaging DMC&E scan o6 !is brain was normal. :in'ings on e(amination by a 4e'iatric neurologist inclu'e' intact cranial nerve 6unction, 'i66usely 'ecrease' 'ee4 ten'on re6le(es, an' mil' wea%ness o6 t!e lower e(tremities. 9n ;ovember 3, !is bloo' lea' an' urine arsenic levels were normal1 !owever, a urine mercury level was 178 mgSI Dnormal range0 0-20 mgSIE, an' c!elation t!era4y was initiate' on Kecember 7. KH con'ucte' an environmental assessment o6 t!e 4atientAs !ome in mi'Kecember an' 'i' not 'etect mercury in in'oor air, in'oor 4aint, or soil. :amily members re4orte' t!at t!ey ate 6is! 6rom Me(ico once or twice 4er year an' 'enie' !obbies at !ome or sc!ool %nown to be associate' wit! mercury e(4osure. However, a container o6 cream DH-rema 'e Belle8a-ManningHE t!at was use' regularly by t!e 4atient 6or treatment o6 acne !a' HcalomelH liste' as an ingre'ient. Glevate' mercury levels Da44ro(imately 6M by weig!tE were con6irme' in t!at container an' in a secon' 4reviously uno4ene' container o6 t!e cream. !e 4atient !a' been using t!e cream 'aily since Yune an' was a'vise' to 'iscontinue use. -ase 20 &n F4ril 1**6, a neurologist in Gl "aso, e(as, 'iagnose' mercury 4oisoning in a 3+-year-ol' woman w!o resi'e' in ;ew Me(ico1 urinary mercury levels were 3++ mgSg creatinine Dnormal0 0-2+ mgSg creatinineE. Beginning in 2e4tember 1**+, t!e 4atient !a' onset o6 sym4toms 4rogressing to 4arest!esias Dle6t 6orearm, rig!t leg, an' earE, irritability, an' insomnia by Marc! 1**6. F collaborative investigation by t!e ;MKH an' KH in'icate' t!at t!e woman !a' use' H-rema 'e Belle8a-ManningH 6or a44ro(imately 10 years an' !a' no ot!er %nown e(4osures to mercury. 2!e was imme'iately a'vise' to 'iscontinue use o6 t!e cream. -ase 30 9n May 7, 1**6, 2K-HK i'enti6ie' mercury 4oisoning in a 33-year-ol' woman w!o resi'e' in 2an Kiego, -ali6ornia1 urinary mercury levels were 153 mgSg creatinine. Kuring 1**2-1**6, t!e woman !a' !a' wee%ly severe migraine !ea'ac!es o6 3-5 'ays 'uration, irritability, 6atigue, s!ort-term memory loss, nig!t blin'ness, an' inability to eat 4ro'ucts 6rom tin cans because o6 overt metal taste. 2ince 1**0, t!e 4atient !a' been using H-reme 'e Belle8a-ManningH 'aily on !er 6ace, !an's, an' c!est an' !a' no ot!er %nown e(4osures to mercury. 2!e was imme'iately a'vise' to 'iscontinue use o6 t!e cream. :ollow->4 &nvestigation an' -ontrol Measures KH an' t!e -ali6ornia Ke4artment o6 Healt! 2ervices D-KH2E are investigating a''itional cases o6 4ossible mercury 4oisoning relate' to t!e use o6 H-rema 'e Belle8aManning.H 9n F4ril 1*, KH issue' 4ress releases recommen'ing t!at 4ersons 'iscontinue use o6 H-rema 'e Belle8aManningH an' t!at 4ersons wit! 4otential mani6estations o6 mercury 4oisoning or w!o were e(4ose' to t!e 4ro'uct consult t!eir 4!ysicians. "!ysicians were a'vise' to contact local 4oison-control centers regar'ing t!e me'ical management o6 4atients e(4ose' to mercury. &n a''ition, because t!e cream is consi'ere' !a8ar'ous waste, KH recommen's t!at cream be 'is4ose' o6 in a manner consistent wit! t!e 4ro4er 'is4osal o6 !a8ar'ous !ouse!ol' waste suc! as batteries or 4aint. -KH2 will issue similar recommen'ations. :or 'is4osal instructions, commercial retailers wit! remaining stoc% can contact "aul !omas, >.2. Gnvironmental "rotection Fgency, tele4!one D215E 66+-6707. Kuring F4ril 22-30, 1**6, t!e Me(ican 2ecretary o6 Healt! sei8e' 3+,000 containers o6 H-rema 'e Belle8aManningH in t!e 2tate o6 am4auli4as, Me(ico, 6or testing at t!e ;ational "ublic Healt! Iaboratory. Iaboratory analyses con6irme' !ig! levels o6 mercury Da44ro(imately 8M by weig!tE in t!e cream. Fs a result, t!e Me(ican 2ecretary o6 Healt! issue' an e4i'emiologic alert to all nort!ern bor'er states o6 Me(ico to en!ance surveillance 6or cases o6 acute or c!ronic mercury into(ication. Ce4orte' by0 Y: Pillanacci, "!K, C Beauc!am4, MK, KM "errotta, "!K, Bur o6 G4i'emiology1 ? Hen'ric%s, MK, Bur o6 -ommunicable Kisease -ontrol1 M Co'rigue8, MK, 966ice o6 Bor'er Healt!1 CY Kutton, "!K, Gnvironmental an' -onsumer Healt!1 ? 2utton, M2, "ublic Healt! Cegion 81 Y Kuran, "ublic Healt! Cegion *S101 KM 2im4son, MK, 2tate G4i'emiologist, e(as Ke4t o6 Healt!. ? Cic!ar's, 966ice o6 Bor'er Healt!1 K ;elson, Kiv o6 G4i'emiology, Gvaluation, an' "lanning1 : -res4in, MK, "ublic Healt! Kiv1 -M 2ewell, Kr"!, 2tate G4i'emiologist, ;ew Me(ico Ke4t o6 Healt!. M Bart8en, M Binsberg, MK, 2an Kiego -ounty Healt! Ke4t, 2an Kiego1 I 2enini, 966ice o6 Bor'er Healt!, : ;ava, 2 Cic!ar'son, 2 #aterman, MK, 2tate G4i'emiologist, -ali6ornia Ke4t o6 Healt! 2vcs. MB Iombera, MK, MF Cub8, MK, " -ravioto, M2, Kirector Beneral o6 G4i'emiology, Ministry o6 Healt!1 9 2al'ate, ;ational Iaboratory o6 "ublic Healt!, Ministry o6 Healt!1 B :lores, MK, Healt! 2vcs o6 am4auli4as, Me(ico. Gnvironmental Ha8ar's G4i'emiology 2ection, Healt! 2tu'ies Br, Kiv o6 Gnvironmental Ha8ar's an' Healt! G66ects, ;ational -enter 6or Gnvironmental Healt!1 Kiv o6 :iel' G4i'emiology, G4i'emiology "rogram 966ice, -K-. G'itorial ;ote0 Flt!oug! t!e 4ro'uct associate' wit! t!ese t!ree re4orte' cases o6 mercury 4oisoning is sol' 4rimarily in Me(ico, t!e ongoing investigation also is assessing re4orts t!at t!e 4ro'uct may be sol' in t!e >nite' 2tates in

some bor'er-area s!o4s. :urt!ermore, some >.2. resi'ents resi'ing in t!e bor'er-area 6re3uently travel to Me(ico to 4urc!ase 4!armaceuticals 6or use in t!e >nite' 2tates. !e 4ro'uct label is 4rinte' in 24anis! an' lists HcalomelH Di.e., mercurous c!lori'eE as an ingre'ient, but 'oes not in'icate t!e concentration. Because mercury com4oun's are rea'ily absorbe' t!roug! t!e s%in, :oo' an' Krug F'ministration regulations restrict t!e use o6 t!ese com4oun's as cosmetic ingre'ients0 s4eci6ically, mercury can be use' only as a 4reservative in eye-area cosmetics at concentrations not e(cee'ing 6+ 44m D0.006+ME1 no e66ective an' sa6e nonmercurial substitute 4reservative is available 6or use in suc! cosmetics. >rinary mercury concentrations over 20 mgSI or over 2+ mgSg creatinine !ave been associate' wit! signs an' sym4toms o6 mercury 4oisoning. -!ronic e(4osure to mercury salts can result in central nervous system to(icity, inclu'ing 4ersonality c!anges1 nervousness1 irritability1 tremors1 wea%ness1 6atigue1 loss o6 memory1 c!anges in or loss o6 !earing, vision, or taste D 1 E1 gingivitis1 stomatitis1 an' e(cessive salivation. &n c!il'ren, mercury 4oisoning can result in t!e syn'rome o6 acro'ynia, w!ic! is c!aracteri8e' by severe leg cram4s, irritability, 4arest!esias, e(cessive 4ers4iration, 4ruritus, an' 4ain6ul re'ness an' 4eeling o6 t!e 4alms o6 t!e !an's an' soles o6 t!e 6eet. Fcute 4oisoning wit! mercury salts can result in a metallic taste, nausea, vomiting, bloo'y 'iarr!ea, severe ab'ominal 4ain, an' tenesmus. Cenal 'amage may inclu'e acute tubular necrosis an' e(cessive 4rotein, casts, an' re' bloo' cells in t!e urine. F''itional in6ormation about mercury 4oisoning is available 6rom local 4oison-control centers. Ce6erence 1. Fgency 6or o(ic 2ubstances an' Kisease Cegistry. o(icological 4ro6ile 6or mercury. Ftlanta, Beorgia0 >2 Ke4artment o6 Healt! an' Human 2ervices, "ublic Healt! 2ervice, Fgency 6or o(ic 2ubstances an' Kiseases Cegistry, May 1**3. !tt40SSwww.cal4oison.orgS4ublicSmercury.!tml #!at are t!e signs an' sym4toms o6 organic mercury 4oisoningZ 9rganic mercury com4oun's are very 'amaging. !ey are to(ic by ingestion, in!alation, an' s%in an' eye contact. !ese mercury com4oun's can attac% all bo'y systems. !ey can cause nausea, vomiting, lac% o6 a44etite, weig!t loss, ab'ominal 4ain, 'iarr!ea, %i'ney 6ailure, s%in burns an' irritation, res4iratory 'istress, swollen gums an' mout! sores, 'rooling, numbness an' tingling in t!e li4s, mout!, tongue, !an's an' 6eet, tremors an' incoor'ination, vision an' !earing loss, memory loss, 4ersonality c!anges an' !ea'ac!e. Fllergic reactions can also occur. How 'oes long-term e(4osure 'i66er 6rom a s!ort-term e(4osureZ Iong-term e(4osure Dusually wor%-relate'E o6 in!ale' va4ors is generally more 'angerous t!an a one-time s!ort e(4osure. F6ter long-term in!alation e(4osure, t!e nervous system is t!e main target o6 to(icity. 2ym4toms may occur wit!in wee%s but usually 'evelo4 insi'iously over a 4erio' o6 years. ;eurologic sym4toms inclu'e tremors, !ea'ac!es, s!ort-term memory loss, incoor'ination, wea%ness, loss o6 a44etite, altere' sense o6 taste an' smell, numbness an' tingling in t!e !an's an' 6eet, insomnia, an' e(cessive sweating. "syc!iatric e66ects are also seen a6ter long-term e(4osure. Fcro'ynia can result 6rom re4eate' e(4osures to mercury-containing late( 4aint 6umes. Fcro'ynia is usually seen in younger c!il'ren. !e sym4toms inclu'e c!ills, sweating, bo'y ras!, irritability, slee4lessness, leg cram4s, swelling o6 t!e c!ee%s, nose, !an's an' 6eet, lig!t-sensitivity to t!e eyes an' 4eeling s%in layers on t!e 4alms o6 t!e !an's an' soles o6 t!e 6eet. Met!yl-mercury, usually 6rom contaminate' 6oo', is very 'angerous to 4regnant women. Met!yl-mercury causes 4ro6oun' mental retar'ation, cerebral 4alsy, sei8ures, s4asticity, tremors, an' incoor'ination, along wit! eye an' !earing 'amage in t!e unborn baby as a result o6 t!e mot!erAs e(4osure. 9rganic mercury 4asses into t!e breast mil% as well. How 'o & clean u4 a small s4ill o6 elemental mercuryZ Many 4eo4le !ave calle' t!e "oison -enter as%ing !ow to clean u4 t!e mercury 6rom a bro%en t!ermometer. !ere are several 'i66erent i'eas on !ow an' !ow not to clean u4 t!e mercury bea's. G(4erts agree on t!e ways ;9 to clean u4 a s4ill0 Ko not swee4 t!e area wit! a broom. 2wee4ing brea%s t!e mercury into smaller 'ro4lets, 6urt!er contaminating t!e room an' t!e broom. Pacuuming va4ori8es t!e mercury an' increases t!e concentration o6 mercury in t!e air. ;9 G0 &6 you are wearing gol' @ewelry, eit!er remove t!e @ewelry or wear goo' 4rotective gloves. &6 t!e li3ui' mercury contacts t!e gol' @ewelry, t!e mercury bon's 4ermanently to t!e gol' an' ruins it.

Mercury occurs naturally in t!e environment as mercuric sul6i'e, also %nown as cinnabar. &t is also 4resent in some 6ossil 6uels. -innabar !as been re6ine' 6or its mercury content since t!e 1+t! or 16t! century B.-. &ts !ealt! !a8ar's !ave been %nown at least since t!e roman con3uest o6 24ain. Kue to t!e to(icity o6 mercury in cinnabar, criminals sentence' to wor% in 3uic%silver mines by t!e Comans !a' a li6e e(4ectancy o6 only 3 years. Mercury is 4resent in numerous c!emical 6orms. Glemental mercury itsel6 is to(ic an' cannot be bro%en 'own into less !a8ar'ous com4oun's. Glemental or inorganic 6orms can be trans6orme' into organic Des4ecially met!ylate'E 6orms by biological systems. ;ot only are t!ese met!ylate' mercury com4oun's to(ic, but !ig!ly bioaccumulative as well. !e increase in mercury as it rises in t!e a3uatic 6oo' c!ain results in relatively !ig! levels o6 mercury in 6is! consume' by !umans. #i'es4rea' 4oisoning o6 Ya4anese 6is!erman an' t!eir 6amilies occurre' in Minamata, Ya4an in t!e 1*+0As as a result o6 consum4tion o6 met!yl mercury contaminate' 6is!. o'ay, we continue to be e(4ose' to mercury in our 'iets, 4rimarily 6rom 6is! an' s!ell6is!. Fs a result, t!e >.2. :oo' an' Krug F'ministration D:KFE !as an action level 6or mercury o6 1 4art 4er million D44mE in 6is! an' t!e Mic!igan Ke4artment o6 "ublic Healt! issues 6is! consum4tion a'visories to anglers w!en mercury levels e(cee' 0.+ 44m in 6is! tissue. #i'es4rea' in'ustrial 4ro'uction o6 mercury, along wit! lac% o6 care6ul !an'ling an' 'is4osal 4ractices, !as contribute' to environmental contamination. !e >.2. Gnvironmental "rotection Fgency DG"FE !as ma'e e66orts to regulate t!e continue' release o6 mercury into t!e environment. G"F regulates in'ustrial 'isc!arges to air an' water, as well as regulating some as4ects o6 mercury waste 'is4osal. &n 1*76, G"F banne' most 4estici'e uses o6 mercury - wit! t!e e(ce4tions o6 6ungici'al uses in 4aints an' out'oor 6abrics, an' 6or control o6 Kutc! Glm 'isease. &n 1**0, mercury use as a 6ungici'e in interior late( 4aint was !alte' by t!e G"F. !is action stemme' 6rom re3uests by Mic!igan o66icials a6ter a c!il' was 4oisone' 6rom over 6ormulate' mercurycontaining 4aint use' in !is !ome. More recently, t!e use o6 mercury com4oun's in e(terior late( 4aint !as also been !alte'. &n a''ition to t!e early wor%ers in t!e cinnabar mines, mo'ern wor%ers in in'ustries using mercury are at ris% 6rom overe(4osure. More t!an 0.+ 4arts 4er million o6 mercury in eggs is consi'ere' su66icient to 4revent !atc!ing. 2mall mammal stu'ies in t!e laboratory an' in 6iel' situations 'emonstrate t!at mammals are 4articularly vulnerable to mercury, 4robably 'ue to its neuroto(ic e66ects an' t!e !ig! tro4!ic 4osition o6 mammals in t!e 6oo' c!ain. Min% s!ow sublet!al e66ects on a 'iet containing + to 10 44m mercury, inclu'ing loss o6 balance an' coor'ination, anore(ia, an' weig!t loss D#ren et. al., 1*87E. 2ome o6 t!e test animals 'ie'. 2mall mammals sam4le' 6rom 6iel's sown wit! mercuryctreate' grain also 'ie'. "lants !ave also been stu'ie' 6or mercury accumulation. 2ensitivities were s4eciescs4eci6ic, but in general, 4lants accumulate mercury as rea'ily as ot!er organisms. F3uatic 4lants are more e66icient accumulators t!an terrestrial 4lants DYo!n, 1*721 #H9, 1*8*E.

Mercury in bloo' may also be trans6erre' to breast mil%.

Because o6 t!e retention in re' bloo' cells, met!yl mercury in bloo' is slowly trans6erre' to ot!er organs1 t!is trans6er continues even a6ter ingestion o6 contaminate' 6oo' en's.

Met!yl mercury in t!e bloo'stream can enter t!e brain an' cross t!e 4lacenta.
9nce in t!ese an' ot!er organs, met!yl mercury can be metaboli8e' to ot!er inorganic 6orms t!at become concentrate' in t!e brain or 6etus. !us, even w!en bloo' mercury levels are 'ecreasing, concentrations in t!e brain an' 6etus may still be !ig! or even be increasing. Met!yl mercury also 4ersists in muscle tissue1 because o6 t!is, ingestion o6 animals, w!ic! !ave ta%en in met!yl mercury, can result in met!yl mercury 4oisoning.