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Forensic Toxicology Jul 2023Poisoning with elemental metals and metallic compounds was much more frequent in the past, and was related, among other things, to lifestyle and the lack of appropriate...
PURPOSE
Poisoning with elemental metals and metallic compounds was much more frequent in the past, and was related, among other things, to lifestyle and the lack of appropriate toxicological diagnostics. One example is mercury, which is being gradually eliminated but still has many different applications as a pure metal or in the form of various compounds. The paper presents a case of suicidal poisoning with mercury chloride (corrosive sublimate).
METHODS
Forensic and toxicological tests including inductively coupled plasma mass spectrometry (ICP-MS) were at the Department of Forensic Medicine, PMU in Szczecin.
RESULTS
The patient before death had a range of symptoms such as epigastric pain, vomiting of the stomach contents, central cyanosis with tachycardia, tremors, severe shortness of breath with wheezing, difficulty swallowing, slurred speech, rales in the lungs, and diarrhea. The concentration of mercury measured by ICP-MS was 191 mg/L for a blood sample collected antemortem, and 147 mg/L for a blood sample collected at autopsy. Both concentrations of mercury are regarded as lethal. The post-mortem examination revealed signs of extensive thrombotic necrosis in some internal organs.
CONCLUSIONS
Mercuric chloride has an estimated human fatal dose of between 1 and 4 g. It can produce a range of toxic effects, including corrosive injury, severe gastrointestinal disturbances, acute renal failure, circulatory collapse, and eventual death. The presented case of fatal poisoning with mercury chloride, due to the type of agent used, is now interesting in toxicological practice.
Topics: Humans; Mercuric Chloride; Chlorides; Suicidal Ideation; Mercury Poisoning; Mercury
PubMed: 36564610
DOI: 10.1007/s11419-022-00653-7 -
Revista de NeurologiaMercury is a metal that is widely used in hundreds of applications nowadays. This metal has proved to be extremely toxic in humans, especially for the central nervous... (Review)
Review
INTRODUCTION AND AIMS
Mercury is a metal that is widely used in hundreds of applications nowadays. This metal has proved to be extremely toxic in humans, especially for the central nervous system, both in cases of exposure from everyday applications (e.g. dental fillings) and from environmental exposure. Unfortunately, most of the research carried out on this metal is relatively recent and many questions remain unanswered. The aim of this work is to review all the knowledge we have at the present time about the mechanisms of action of this metal.
DEVELOPMENT
To do so, we discuss the latest scientific findings about the toxic processes that are activated, as well as its effects on the cellular cytoskeleton, its genotoxicity or the production of compounds that have been linked to neurodegeneration.
CONCLUSIONS
Its prolonged period of latency, ambiguous symptoms and the activation of generalised toxic mechanisms call for urgent efforts to be made in basic research to help determine as clearly as possible the way this metal acts in the body. This knowledge will provide us not only with the way to obtain therapies but also with the hope of developing biomarkers that make it possible to carry out early and reliable diagnoses of the damage done and of individual susceptibility.
Topics: Apoptosis; Autoimmunity; Humans; Mercury; Mercury Poisoning, Nervous System; Microtubules; Oxidative Stress
PubMed: 15849680
DOI: No ID Found -
International Journal of Occupational... Mar 2017Gold miners use mercury to extract gold from ore adding liquid mercury to the milled gold-containing ore. This results in a mercury-gold compound, called amalgam. Miners...
OBJECTIVES
Gold miners use mercury to extract gold from ore adding liquid mercury to the milled gold-containing ore. This results in a mercury-gold compound, called amalgam. Miners smelt this amalgam to obtain gold, vaporizing it and finally inhaling the toxic mercury fumes. The objective was to merge and analyze data from different projects, to identify typical signs and symptoms of chronic inorganic mercury exposure.
MATERIAL AND METHODS
Miners and community members from various artisanal small-scale gold mining areas had been examined (Philippines, Mongolia, Tanzania, Zimbabwe, Indonesia). Data of several health assessments were pooled. Urine, blood and hair samples were analyzed for mercury (N = 1252). Questionnaires, standardized medical examinations and neuropsychological tests were used. Participants were grouped into: Controls (N = 209), living in an exposed area (N = 408), working with mercury as panners (N = 181), working with mercury as amalgam burners (N = 454). Chi test, linear trend test, Mann-Whitney test, Kruskal-Wallis test, correlation coefficient, Spearman's rho, and analysis of variance tests were used. An algorithm was used to define participants with chronic mercury intoxication.
RESULTS
Mean mercury concentrations in all exposed subgroups were elevated and above threshold limits, with amalgam burners showing highest levels. Typical symptoms of chronic metallic mercury intoxication were tremor, ataxia, coordination problems, excessive salivation and metallic taste. Participants from the exposed groups showed poorer results in different neuropsychological tests in comparison to the control group. Fifty-four percent of the high-exposed group (amalgam burners) were diagnosed as being mercury-intoxicated, compared to 0% within the control group (Chi p < 0.001).
CONCLUSIONS
Chronic mercury intoxication, with tremor, ataxia and other neurological symptoms together with a raised body burden of mercury was clinically diagnosed in exposed people in artisanal small-scale mining areas. The mercury exposure needs to be urgently reduced. Health care systems need to be prepared for this emerging problem of chronic mercury intoxication among exposed people. Int J Occup Med Environ Health 2017;30(2):249-269.
Topics: Ataxia; Body Burden; Female; Gold; Hair; Humans; Male; Mercury; Mercury Poisoning, Nervous System; Metallurgy; Miners; Neuropsychological Tests; Occupational Exposure; Tremor
PubMed: 28366955
DOI: 10.13075/ijomeh.1896.00715 -
Basic & Clinical Pharmacology &... May 2019Numerous studies have reported neurobehavioural effects in dental personnel occupationally exposed to chronic low levels of mercury (Hg). Hg exposure from dental work... (Review)
Review
Numerous studies have reported neurobehavioural effects in dental personnel occupationally exposed to chronic low levels of mercury (Hg). Hg exposure from dental work may also induce various chronic conditions such as elevation of amyloid protein expression, deterioration of microtubules and increase or inhibition of transmitter release at motor nerve terminal endings. Therefore, clinical studies of Hg toxicity in dentistry may provide new knowledge about disturbed metal homeostasis in neurodegenerative diseases such as Alzheimer's disease, multiple sclerosis and mood disorders. The purpose of this MiniReview is to evaluate the evidence of possible relevance between Hg exposure in dentistry and idiopathic disturbances in motor functions, cognitive skills and affective reactions, as well as dose-response relationships.
Topics: Dental Assistants; Dentistry; Dentists; Humans; Mercury; Mercury Poisoning; Mood Disorders; Neuropsychological Tests; Neurotoxicity Syndromes; Occupational Diseases; Occupational Exposure
PubMed: 30589214
DOI: 10.1111/bcpt.13199 -
MMWR. Morbidity and Mortality Weekly... Aug 2005In November 2004, a student aged 15 years brought a small vial of liquid mercury onto a school bus and into a high school in Kentucky. A subsequent investigation...
In November 2004, a student aged 15 years brought a small vial of liquid mercury onto a school bus and into a high school in Kentucky. A subsequent investigation revealed that mercury had been in the student's possession for more than a year and that substantial amounts had been spilled in multiple locations. This report describes the results of that investigation, which indicated that 1) duration of exposure was associated with the amount of mercury absorbed by exposed persons and 2) extensive multiagency collaboration facilitated an efficient response. The investigation further revealed that, although mercury exposure is common, clinicians might not be aware of how to evaluate and treat patients with mercury exposure. State and federal health agencies should provide schools, clinicians, and local health department staff with readily accessible guidelines for use in mercury spills and exposures.
Topics: Adolescent; Environmental Exposure; Humans; Kentucky; Mercury; Mercury Poisoning; Schools
PubMed: 16107784
DOI: No ID Found -
International Journal of Environmental... Dec 2019Mercury is one of the most toxic elements and causes a multitude of health problems. It is ten times more toxic to neurons than lead. This study was created to determine...
Mercury is one of the most toxic elements and causes a multitude of health problems. It is ten times more toxic to neurons than lead. This study was created to determine if mercury could be causing Alzheimer's disease (AD) by cross referencing the effects of mercury with 70 factors associated with AD. The results found that all these factors could be attributed to mercury. The hallmark changes in AD include plaques, beta amyloid protein, neurofibrillary tangles, phosphorylated tau protein, and memory loss-all changes that can be caused by mercury. Neurotransmitters such as acetylcholine, serotonin, dopamine, glutamate, and norepinephrine are inhibited in patients with Alzheimer's disease, with the same inhibition occurring in mercury toxicity. Enzyme dysfunction in patients with Alzheimer's disease include BACE 1, gamma secretase, cyclooxygenase-2, cytochrome-c-oxidase, protein kinases, monoamine oxidase, nitric oxide synthetase, acetyl choline transferase, and caspases, all which can be explained by mercury toxicity. Immune and inflammatory responses seen in patients with Alzheimer's disease also occur when cells are exposed to mercury, including complement activation, cytokine expression, production of glial fibrillary acid protein antibodies and interleukin-1, transforming growth factor, beta 2 microglobulins, and phosphodiesterase 4 stimulation. Genetic factors in patients with Alzheimer's disease are also associated with mercury. Apolipoprotein E 4 allele increases the toxicity of mercury. Mercury can inhibit DNA synthesis in the hippocampus, and has been associated with genetic mutations of presenilin 1 and 2, found in AD. The abnormalities of minerals and vitamins, specifically aluminum, calcium, copper, iron, magnesium, selenium, zinc, and vitamins B1, B12, E, and C, that occur in patients with Alzheimer's disease, also occur in mercury toxicity. Aluminum has been found to increase mercury's toxicity. Likewise, similar biochemical factors in AD are affected by mercury, including changes in blood levels of homocysteine, arachidonic acid, DHEA sulfate, glutathione, hydrogen peroxide, glycosamine glycans, acetyl-L carnitine, melatonin, and HDL. Other factors seen in Alzheimer's disease, such as increased platelet activation, poor odor identification, hypertension, depression, increased incidences of herpes virus and chlamydia infections, also occur in mercury exposure. In addition, patients diagnosed with Alzheimer's disease exhibit higher levels of brain mercury, blood mercury, and tissue mercury in some studies. The greatest exogenous sources of brain mercury come from dental amalgams. Conclusion: This review of the literature strongly suggests that mercury can be a cause of Alzheimer's Disease.
Topics: Alzheimer Disease; Brain; Dental Amalgam; Humans; Mercury; Mercury Poisoning; Neurons
PubMed: 31861093
DOI: 10.3390/ijerph16245152 -
Science Progress 2012There is a long history and an overwhelming amount of data on the toxicity of heavy metal compounds. Here a brief look is taken of some aspects of the toxicity of lead,... (Review)
Review
There is a long history and an overwhelming amount of data on the toxicity of heavy metal compounds. Here a brief look is taken of some aspects of the toxicity of lead, cadmium, mercury and arsenic, chosen for their historical importance and environmental significance, highlighting especially the contrast between the acute and chronic toxicity of purely inorganic species and their organic derivatives. For further details of other toxic metal compounds, the reader might like to consult "Elements of murder: a history of poison" by John Emsley (2005, Oxford University Press).
Topics: Animals; Cadmium Poisoning; Environmental Exposure; Humans; Lead Poisoning; Mercury Poisoning; Metalloids; Metals, Heavy; Methylmercury Compounds; Public Health; Toxicity Tests, Acute
PubMed: 22574386
DOI: 10.3184/003685012X13286247093244 -
Journal of Environmental and Public... 2012Today's environment has different impacts on our body than previous generations. Heavy metals are a growing concern in medicine. Doctors and individuals request the... (Review)
Review
Today's environment has different impacts on our body than previous generations. Heavy metals are a growing concern in medicine. Doctors and individuals request the removal of their amalgam (silver mercury) restorations due to the high mercury content. A safe protocol to replace the silver mercury filling will ensure that there is minimal if any absorption of materials while being removed. Strong alternative white composite and lab-processed materials are available today to create a healthy and functioning mouth. Preparation of the patient prior to the procedure and after treatment is vital to establish the excretion of the mercury from the body.
Topics: Dental Amalgam; Dental Restoration, Permanent; Humans; Mercury Poisoning; Root Canal Filling Materials
PubMed: 22315627
DOI: 10.1155/2012/517391 -
Anatolian Journal of Cardiology Jan 2016
Topics: Arrhythmias, Cardiac; Female; Humans; Mercury Poisoning
PubMed: 26854675
DOI: 10.14744/AnatolJCardiol.2015.6766 -
Scandinavian Journal of Work,... Feb 1993Mercury and mercury compounds are widely used in modern society, but only sparse data are available on their carcinogenicity. Methylmercury chloride causes kidney tumors... (Review)
Review
Mercury and mercury compounds are widely used in modern society, but only sparse data are available on their carcinogenicity. Methylmercury chloride causes kidney tumors in male mice. Mercury chloride has shown some carcinogenic activity in male rats, but the evidence for female rats and male mice is equivocal. Other mercury compounds and metallic mercury have not been tested adequately in experimental animals. Epidemiologic data are available for chloralkali workers, dentists and dental nurses, and nuclear weapons workers, three groups occupationally exposed to low levels of mercury and its compounds, but those highly exposed in the past, such as miners, or populations which have suffered massive environmental exposure have not been adequately studied. However, the sparse epidemiologic data point toward the possibility of a risk of lung, kidney, and central nervous system tumors. Better data are needed on the carcinogenicity of mercury and mercury compounds in humans and experimental animals.
Topics: Animals; Carcinogenicity Tests; Humans; Mercury; Mercury Poisoning; Neoplasms; Neoplasms, Experimental; Occupational Diseases; Occupational Exposure; Organomercury Compounds; Risk Factors
PubMed: 8465166
DOI: 10.5271/sjweh.1510