Cases reported "mercury poisoning"

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1/166. Mercury toxicity due to the smelting of placer gold recovered by mercury amalgam.

    A 19-year-old man developed tremor in both hands and fatigue after starting work at a placer gold mine where he was exposed to mercury-gold amalgam. Examination revealed an intention tremor, dysdiadochokinesis and mild rigidity. The 24-h urinary mercury concentration reached a peak of 715 nmol/l (143 ug/l) shortly before the clinical examination, after which he was removed from working in the gold room [Mercury No. Adverse Effect Level: 250 nmol/l (50 ug/l)]. On review 7 weeks later his tremor had almost resolved and the dysdiadochokinesis and rigidity had gone. The 24-h urinary mercury concentration had fallen to 160 nmol/l (32 ug/l). The principal exposure to mercury was considered to be the smelting of retorted gold with previously unrecognized residual mercury in it. The peak air concentration of mercury vapour during gold smelting was 0.533 mg/m3 (Mercury Vapour ACGIH TLV: 0.05 mg/m3 TWA). Several engineering and procedural controls were instituted. This episode occurred at another mine site, unrelated to Mount Isa Mines Limited. ( info)

2/166. Lessons to be learned: a case study approach. An unusual case of alveolar deposition from swallowing metallic mercury in an attempt at self-poisoning.

    The authors report a case of deliberate self-poisoning in a drug addict who swallowed elemental mercury: in so doing he inadvertently acquired a permanent diffuse deposition of mercury particles throughout both lung fields. Swallowed mercury should be relatively harmless in small quantity but the high specific gravity and free flowing properties of elemental mercury allowed it to overcome the normal swallowing pathways--such that some of it passed into the bronchial tree instead of passing harmlessly through the gut. In that site its significant vapour pressure, together with its potential for oxidation to inorganic mercury--which may, in turn, be absorbed across the alveolar membrane, gives high potential for mercury poisoning. ( info)

3/166. Mercury intoxication presenting with hypertension and tachycardia.

    An 11 year old girl presented with hypertension and tachycardia. Excess urinary catecholamine excretion suggested phaeochromocytoma but imaging studies failed to demonstrate a tumour. Other symptoms included insomnia and weight loss, and she was found to have a raised concentration of mercury in blood and urine. Mercury intoxication should be considered in the differential diagnosis of hypertension with tachycardia even in patients presenting without the skin lesions typical of mercury intoxication and without a history of exposure. ( info)

4/166. An assessment of exposure to mercury and mercuric chloride from handling treated herbarium plants.

    A curator at a university herbarium reported headache, nausea and mucosal irritation after initiating a project to remount plant specimens treated with mercuric chloride. workplace exposure assessment indicated potential for mercury compound ingestion through hand-to-mouth contact. blood, hair and urine assays were negative. ( info)

5/166. Perimortem fixation of the gastric and duodenal mucosa: a diagnostic indication for oral poisoning.

    Two cases of fatal oral poisoning are presented. In the first case, a 40-year-old man died due to a lethal dose of mercury (blood concentration 113.8 microg/ml) and in the second, a 34-year-old man died of chloralhydrate overdose with a lethal blood concentration of trichloroethanol (52 microg/ml), the active metabolite of chloralhydrate. In both cases gross examination and histology showed an unusually well preserved gastrointestinal mucosa in addition to unspecific signs of intoxication. The two cases demonstrate that the phenomenon of perimortal fixation is a useful indication for the forensic pathologist and should direct the suspicion to oral poisoning. The detection of fixation facilitates toxicology screening by indicating that the relevant substance must have the capability to precipitate proteins. ( info)

6/166. Acute mercury vapour poisoning in a shipyard worker--a case report.

    Acute mercury vapour poisoning is a serious, potentially fatal but fortunately rarely encountered problem. It is most commonly due to industrial accidents. The vapour is a direct respiratory tract irritant as well as a cell poison, exerting its greatest effects in the lungs, nervous system, kidneys and liver. We present a case of mercury vapour poisoning in a shipyard workers presenting as an acute chemical pneumonitis, which resolved with aggressive supportive therapy. Further investigations later revealed transient mild neuropsychiatric symptoms, and residual peripheral neuropathy. No chelation therapy was instituted. The detailed investigative work that led to the discovery of the source of mercury is also presented. This case alerts us to the potential hazard to shipyard workers who may work in ships previously carrying oil contaminated with mercury. There have been no previous reports of mercury poisoning in shipyard workers. A high index of suspicion leading to early diagnosis and institution of appropriate supportive measures in suspected cases can be life-saving. ( info)

7/166. A young man with a heavy heart.

    A 34 year old man presented with acute chest pain. His ECG was very abnormal but stable and he was treated with opiate analgesia. When his condition did not improve, chest radiography and cardiac ultrasound were performed. Both revealed metal dense deposits in the heart. On questioning, the patient revealed that he had self injected with mercury 15 years before. Self injection of elemental mercury is rare but well described and normally used by those who are suicidally depressed or who seek to improve sexual or athletic performance. Intravenous mercury may be deposited in the right heart and can result in ECG abnormalities, which may later be mistaken for changes due to coronary or other cardiac disease and result in inappropriate medication and hospitalisation. ( info)

8/166. Membranous fat necrosis due to subcutaneous elemental mercury injections.

    Membranous fat necrosis (MFN) is a distinct abnormality in systemic and subcutaneous fatty tissue. Although ischemia and trauma have been implicated in its causation, the exact pathogenesis of MFN remains unknown. The deposition of metallic mercury in subcutaneous tissue due to accidental penetration or deliberate injection of mercury is unusual. Depending on the duration of the deposition, localized necrosis, suppuration, and granuloma formation have been described at mercury injection sites. We report subcutaneous MFN, a hitherto unrecognized histopathologic phenomenon at sites of mercury deposition, in a 21-year-old soccer player who had deliberate subcutaneous and intramuscular elemental mercury injections to improve his sporting performance. ( info)

9/166. Mercury toxicity in the dental office: a neglected problem.

    Amalgam has proved to be among the most versatile and durable of all restorative materials used in the treatment of dental disease. If it is handled and controlled properly, problems with its use should not develop. Safe mercury vapor levels can be maintained if good mercury hygiene practices are exercised. Materials and devices are available for aiding the dentist in adequate mercury control procedures. With the cooperation of each member of the dental team, compliance with all the criteria imposed by governmental regulatory agencies can be accomplished. These criteria have been established for the health protection of the dentist and his auxiliary personnel. Each practioner and office staff member should realize the potential hazards associated with mercury, and effect good mercury hygienic measures and control procedures. ( info)

10/166. public health response to metallic mercury spills in kansas.

    Local and state public health officials are called on to respond to environmental public health hazards just as they historically have been called on to respond to communicable disease outbreaks. Recent experience with metallic mercury spills in kansas suggests that neither the legal authority nor the scientific knowledgebase is as well developed for response to environmental hazards as for communicable disease threats. ( info)
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