What is Mercury Poisoning?

• Mercury (Hg) is a heavy silver-grey liquid metal that exists in elemental, organic, and inorganic forms. Hg is grouped under heavy metals and is the only ‘liquid’ metal available at room temperature
• The source of mercury exposure may be wide-ranging and includes exposure to volcanic ashes, coal-based power station fumes, consumption of contaminated fish, use of various medications (such as laxatives and antimicrobial drugs), thermometers and batteries, etc.
• Mercury Poisoning is the accidental or intentional intake of compounds containing mercury and/or its organic and inorganic salts
• The condition is diagnosed based upon the clinical history, combination of signs and symptoms, and additional tests (that may include, in some cases, radiological studies and laboratory tests)

Mercury Poisoning may be also referred to as the following:

• Hg Poisoning
• Mercury Toxicity

What are the Causes of Mercury Poisoning?

• Mercury Poisoning is caused by the ingestion/swallowing of compounds containing mercury. Exposure may also occur following inhalation of vapors or dust particles, or via skin/eye
• This intake could be accidental, or in some cases intentional, to bring self-harm
• All forms of mercury are considered to be highly-toxic and exposure to mercury compounds are known to present severe symptoms and complications

Note: The compound can interact with other prescribed or non-prescribed medications in the body. Such interactions may enhance the therapeutic effects of other medications being taken, resulting in undesired side effects.

What are the Signs and Symptoms of Mercury Poisoning?

The signs and symptoms of Mercury Poisoning can vary from one individual to another. It may be mild in some and severe in others. Several systems of the body may be affected. The poisoning may occur due to swallowing or inhalation of the compound. Children are severely affected from than adults, especially if the element is inhaled.

The common signs and symptoms of Mercury Poisoning may include:

• Nausea and vomiting
• Diarrhea (blood in stool)
• Cough, sore throat, and chest pain
• Abdominal pain
• Visual disturbances
• Skin and eye exposure may result in dermatitis (inflammation of the skin) and itching of eyes respectively
• Breathing difficulties from inhaling mercury compound dust or vapors
• Swallowing difficulties

Additionally, the signs and symptoms of Elemental Mercury Poisoning may include:

• Fever and chills
• Headache
• Breathing difficulties from inhaling tiny mercury droplets that may include coughing and respiratory distress
• Long-term inhalation (over a period of time) may lead to chronic symptoms, severe lung damage, and even present neurological symptoms
• Chronic symptoms may include the following:
  • Taste of metal in the mouth
  • Severe coughing and breathing difficulties
  • Mouth ulcers and bleeding gums
  • Vomiting

Additionally, the signs and symptoms of Organic Mercury Poisoning may include:

• Burning pain in the mouth, throat, food-pipe, and stomach
• Chronic symptoms from exposure over many years may include the following:
  • Uncoordinated movements, staggering walk
  • Trembling and shaking
  • Feeling of numbness in certain areas of the body and skin
  • Vision abnormalities including double vision and partial/complete loss of vision
  • Seizures
• In pregnant women, toxicity through eating mercury contaminated fish, can be fatal for the developing fetus

Additionally, the signs and symptoms of Inorganic Mercury Poisoning may include:

• Severe poisoning may lead to severe diarrhea consequently resulting in massive blood and fluid loss from the body
• When the toxic compound affects blood, it can result in malfunctioning of several internal organs and result in permanent renal injury

How is First Aid administered for Mercury Poisoning?

First Aid tips for Mercury Poisoning:

• Call 911 or your local emergency help number immediately, for emergency assistance
• Call the Poison Control Center at 1-800-222-1222 (or your local poison control center) for further instructions
• Provide them with information such as the compound taken, quantity and time of ingestion, age, weight and general health status of affected individual
• Carefully remove the individual from the exposure area; move them to region of fresh air immediately
• Confirm that the airways are protected; also, ensure breathing and the presence of pulse
• Unless instructed by a healthcare professional, DO NOT induce vomiting in the affected individual
• Take individual to emergency room (ER) for further treatment
• Always try to take the compound bottle/container to the ER

The emergency medical health professional might perform the following steps towards treating the condition:

• Monitoring of vital signs
• Medically manage symptoms and provide breathing support, if necessary
• Administer fluids by an intravenous drip line
• Undertake kidney dialysis, if necessary
• In case of inhalation of elemental mercury presenting symptoms, the following treatment measures may be undertaken:
  • Administer suitable medication to remove the toxic element from the body
  • Use of suction to remove mercury from the lungs
  • Provide breathing support via humidified oxygen/air
  • In case the individual is unable to breathe, then breathing tubes may be placed into the lungs
• Additionally, in the case of Organic Mercury Poisoning, the following treatment is provided:
  • Administer suitable medication (chelators) to counter the effects of the toxin
  • Treatment using chelators may be long-term (for several months)
• Additionally, in the case of Inorganic Mercury Poisoning, the following treatment is provided:
  • Administer activated charcoal to avoid absorbance of the substance in the body
  • Administer suitable medication (chelators) to counter the effects of the toxin

Who should administer First Aid for Mercury Poisoning?

First aid for Mercury Poisoning is administered by healthcare professionals.

• The individual who is affected, or someone near, should call 911 for emergency assistance (or the local emergency number)
• They should also call the poison control center at 1-800-222-1222 (or the local poison control center) and follow instructions

What is the Prognosis of Mercury Poisoning?

• The prognosis of Mercury Poisoning is dependent on the amount and form of mercury consumed, time between consumption and treatment, severity of the symptoms, as well as general health status of the patient
• Severity of the poisoning and timely medical assistance are the key prognostic indicators. If early treatment is provided and suitable medication and support provided, the prognosis may be improved
• Inhalation of large amounts of elemental mercury can lead to permanent injury to the lungs and central nervous system. In such cases, deaths have been reported
• Since most cases of toxicity from mercury in its organic form are the result of long-term ingestions, providing adequate and appropriate treatment may not be sufficient enough to prevent permanent injury to the body, especially if the brain and/or kidneys are damaged
• Severe poisoning from ingestion of large amounts of inorganic mercury compounds and salts may seriously affect internal organs and result in renal failure, substantial loss of blood/fluids from the body, and permanent brain damage. In such cases, death is a high possibility

In general, toxicities are common situations in the emergency departments. A majority of the cases are often not fatal, when appropriate treatment is given.

How can Mercury Poisoning be Prevented?

Mercury Poisoning can be prevented by:

• Suitably disposing any material or equipment that contains mercury and its compounds/salts
• Keeping any poisonous/hazardous chemicals and other materials out of children’s reach
• Keep all poisons correctly labeled and in suitable storage locations
• Being aware of basic first aid steps in case of an emergency (such as inadvertent poisoning)

What are certain Crucial Steps to be followed?

• Call 911 (or your local emergency number) for emergency assistance, if symptoms are life-threatening
• Call Poison Control Center at 1-800-222-1222 (or the local poison control center) and follow the recommend steps
• It would be helpful if the following information is readily available:
  • Type, amount and time of consumption of the substance
  • Age and weight of the individual
  • And, the overall health status of the individual