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By Mike Penprase
News-Leader, Springfield, Missouri
September 14, 2004

A woman holds a vial of elemental mercury. Mercury has been linked to
developmental problems in children who were exposed in the womb.
Mark Randall / South Florida Sun-Sentinel

Environmental workers clean up mercury from the walkway of a Texas home after
some teenagers confessed to handling the toxic element. Mercury has become more
high-profile this year after Environmental Protection Agency warnings.
Associated Press File Photo
Basics of mercury: Types of compounds, what mercury can do to the body, testing
for it

Mercury is a naturally occurring element that is present throughout the
environment. It is a silver-white heavy metal that is liquid at room
temperature. In the U.S., coal-fired power plants are the biggest source of
mercury emissions in the air. Mercury takes various forms: pure element,
inorganic compounds and organic compounds.

• Elemental mercury is a liquid and gives off mercury vapor at room
temperature. This vapor can be inhaled into the lungs and passed into the
bloodstream. Elemental mercury, which is fat-soluble, can also pass through the
skin and into the blood stream. If it's swallowed, only a small amount is
absorbed through the gastrointestinal tract, making poisoning from swallowing
the element rare.

Once in the body, elemental mercury is eventually eliminated in urine and
feces. But it can accumulate in the kidneys, bone marrow, liver, spleen, lungs,
skin and hair. Acute exposure to mercury vapor leads to pulmonary and central
nervous system effects. Inhalation of high levels of vapor can lead to
coughing, chest pain, nausea, vomiting, diarrhea, fever and a metallic taste in
the mouth. Chronic exposure to lower levels of mercury vapor affects the
central nervous system.

Symptoms of chronic poisoning vary, but may include tremors, psychological
changes, insomnia, loss of appetite, irritability, headache and short-term
memory loss. Direct contact with the skin can lead to dermatitis. A rare
syndrome called acrodynia, or "pink's disease," can occur in children exposed
to vapor. Its symptoms include severe leg cramps, irritability and painful pink
fingers and peeling hands.

• Inorganic mercury compounds are created when mercury blends with nonliving
things. Inorganic mercury can be found in products such as batteries and
over-the-counter drugs. Many inorganic mercury compounds are irritating or
corrosive to the skin, eyes and mucous membranes.

• Organic mercury compounds, like methylmercury, are created when mercury is
converted in the environment by microorganisms. When the element becomes an
organic compound, it can be highly toxic to mammals, including people. Acute
exposure can also lead to blindness, deafness and impaired consciousness.

In extreme cases, oral ingestion of methylmercury by pregnant women has led to
developmental defects such as blindness and retardation.

• Health problems caused by mercury depend on how much has entered your body,
how it entered, how long you have been exposed and how your body responds.

There are two tests available to measure mercury in the body: A blood test
measures exposure to all three types of mercury, but because mercury remains in
the bloodstream for only a few days, the test must be done soon after exposure.
A urine test only measures exposure to elemental and inorganic mercury. Organic
mercury is not passed from the body in urine and thus cannot be measured this
way.
- Sources: Illinois Department of Public Health, U.S. Environmental Protection
Agency


The substance that made the Mad Hatter mad back in author Lewis Carroll's time
still poses enough environmental and health hazards to deserve the increasing
attention it's getting, Marie Steinwachs believes."We have just reached the
crisis level on mercury," Steinwachs, the environmental quality specialist with
the University of Missouri Extension, says. She has spent years trying to
reduce and recycle hazardous waste. "Now, we're finding it in our food, our
water, our soil, our babies, everywhere."Carroll's character of the Mad Hatter
in "Alice in Wonderland" was based on hat makers of the 1800s, who frequently
showed signs of nervous system degeneration due to the use of the element in
the process of making felt hats.In recent years, concern has arisen regarding
dental fillings made with amalgams containing mercury, the use of mercury-based
thimerosal as a preservative in vaccines for children, and mercury emissions
from coal-fired powerplants. And this summer, advisories were issued regarding
fish — eating the animals, the U.S. Environmental Protection Agency feared,
could lead to ingestion of methylmercury. Methylmercury is an organic compound
created when pure mercury enters the air, then gets into a water supply.
Bacteria in the water cause chemical changes that transform the mercury into
methylmercury. It is this type of mercury that can be harmful to unborn babies
and young children. Fish absorb the methylmercury as they feed, then the
substance builds up in their tissues.In a report on methylmercury contamination
in freshwater lakes and streams, the EPA estimated one of every three lakes and
one quarter of the nation's rivers are contaminated enough that some fish taken
from them shouldn't be eaten by pregnant women, women who are nursing, women
considering pregnancy or children under 12 years of age.Missouri had a jump on
the EPA: It has issued advisories on fish contaminated by methylmercury for
several years. Gale Carlson, whose job with the Missouri Department of Health
and Human Services includes supervising the department's mercury advisory
program, said the state's Department of Health issued its 2004 advisory just
for largemouth bass that are more than 12 inches long. Big largemouth bass are
the focus of concern because they have the highest concentrations of mercury,
he said.Other fish in this state aren't included in the mercury
advisory.Missourians can expect changes in the advisory system because it's
being refined to determine whether other fish should be included and to define
areas of concern, he said."Hopefully, we can get a regional advisory rather
than a statewide advisory," he said.Currently, the state is trying to reassure
people that fish not included in the advisory are a good source of protein and
can be eaten without concern, Carlson said.

Why single out large fish?
Mercury enters the environment from coal-fired power plants in Missouri (or
even from plants in other states, hundreds of miles away), chlorine plants
using mercury as part of the production process, and from products such as
mercury switches that aren't removed from junked cars before they're smelted to
make new steel products, Carlson said.And there are other, more unusual
sources, he said. One is cultural, with the area's increasing number of
Hispanic residents continuing a tradition of burning candles with
mercury-soaked wicks or sprinkling mercury on floors beneath beds, he said.Once
it's in vapor form, mercury can become part of a raindrop — and fall into
lakes and rivers, turning into a food source for plants and tiny critters that
make up the base of the aquatic food chain."All that stuff, no matter what form
it's in, when it gets into water ... small organisms actually use that chemical
to make energy," he said.And that mercury persists up the food chain, ending in
big predator fish such as largemouth bass. As the fish grow larger, they
concentrate higher levels of mercury in their flesh — and the methylmercury
can't be removed by cutting away fat or by cooking, Carlson said.Although older
children and adults can eat those fish on an occasional basis, the threat is
highest for fetuses because mercury can interrupt the formation of the nervous
system, he said.Determining whether a fetus has had too much exposure involves
trying to detect mercury levels in a baby's or small child's system, he said.
But he's never seen a physician report that mercury caused a child's
developmental problems, Carlson said."We'll never see that happen," he said.
"Those levels are so low we're not going to be able to determine the number of
people harmed. ... Even if in fact you had a young baby who had some kind of
developmental delay, you can't point to mercury and say because the child was
this way, it was caused by mercury."
Symptoms of poisoning
The situation is different when exposure to elemental mercury, the substance in
its purest form, is involved. Because long-term exposure to vapors from the
silver element is readily apparent, deciding that a person suffers from mercury
poisoning isn't difficult, Carlson said.But just how mercury in levels high
enough to require hospitalization affects the body — and why some people are
more susceptible to mercury contamination — isn't known, said Dr. Stephen
Adams, medical director of Cox Walnut Lawn Urgent Care Center."Once that
mercury molecule gets turned into something that's fat-soluble, it can enter
cells and start doing damage," he said. "The way mercury does its damage is
unclear at this point."Some researchers contend that mercury blocks the neural
transmitters that send signals from the brain, while other researchers
speculate that mercury changes how the body uses proteins, he said.Symptoms of
poisoning run a wide gamut, Adams said. They range from diarrhea and stomach
cramping to chronic fatigue, tremors, irritability, agitation or shyness and
memory loss.Treatment involves chelation therapy, which is also used to treat
people who have been exposed to lead and arsenic, Adams said. In the therapy,
chemicals attach to mercury molecules to draw them out of the body's cells and
into the bloodstream. The mercury returns to its elemental form and is
eliminated in urine, he said. The procedure can take weeks or months.

Cleaning it up
Springfield-Greene County Health Department environmental health services
administrator Ron Boyer said he's familiar with one case in Springfield in
which exposure led to chelation treatment. The exposure occurred when
acquaintances of a woman living in a Springfield apartment scattered elemental
mercury around without her knowledge, he said."She breathed enough mercury
fumes (that) she ended up in the hospital and was quite ill," he said."She had
acute poisoning. You have to have a pretty big dose for that."The woman
received medical treatment and her apartment had to undergo cleanup, Boyer
said.Mercury cleanups happen more often than people might think, said two
Environmental Protection Agency representatives from Region 7, which covers
Iowa, Kansas, Missouri, Nebraska, and 9 Tribal Nations. Their office currently
is working on two spills in Iowa and Nebraska, Eric Nold and Ken Rapplean
said.One incident in Council Bluff, Iowa, started when a man mailed three vials
of mercury to the apartment where he was moving, Rapplean said."For some reason
or other he had three small vials of mercury, and ... a cap got loose," he
said. "When the box was delivered, the (apartment) owner recognized it was
elemental mercury. It sort of mushroomed from there."The spill resulted in
cleanups not only at the apartment, but also at the local post office and in
the vehicle carrying the mail.The process of cleaning up after mercury can vary
according to the amount of the substance involved, how long it has been present
and whether it has been tracked into other areas, Nold said."In general, the
first thing we always do is go for the elemental mercury, pick up the source,"
he said. "Once we pick up all the elemental mercury, we do field
monitoring."That determines whether mercury has vaporized and if ventilating a
structure is necessary.Sometimes, the contamination is so serious that further
work has to be done, ranging from removing carpeting and stripping walls to
using special materials to absorb mercury. And when even that isn't enough,
sometimes buildings must be torn down.

Local recycling efforts
Since mercury exposure can result in a hospital visit, the public needs to be
educated about hazards posed by the substance and how to reduce its use,
Steinwachs said.She wants to convince legislators that Missouri should join
states that require removal of mercury switches from scrapped automobiles, and
that the state should provide more recycling options for products such as
thermometers, microwave ovens, televisions and over-the-counter drugs that
contain mercury.Raising awareness, she said, requires more public education and
government action — and it could lead to results similar to the removal of
lead from gasoline after it was discovered to pose a health hazard, she
said."People are still catching on," she said. "It's in the news right now.
People are beginning to understand mercury is dangerous. There's a lot of
headshaking; (people are saying) 'I used to play with it as a kid.' But there's
also awareness it's not good stuff, it's not good to have it in the
environment."Although the Household Chemical Collection Center in Springfield
accepts household items containing mercury such as light switches and
batteries, it can't take anything from businesses, Springfield Public Works
recycling coordinator Barbara Lucks said.That's why she and others are working
with Steinwachs to win grant money to start a mercury recycling program in the
Springfield area.Whether that happens depends on how a grant application fares,
but Steinwachs said if it becomes reality, the program could be
groundbreaking."It would be looking at best management practices for a number
of sources; small businesses, homes, schools," she said."It would be a good
test market here because people are environmentally aware and conscious and we
have a good response from the business community and government."