title: Case series of mercury toxicity among children in a hot, closed environment.
abstract: Mercury poisoning is much more prevalent in the general population than possibly many physicians realize. We present data on 26 pediatric cases with mercury intoxication from exposure to mercury by inhalation or skin contact as a result of a broken thermometer in a school laboratory. This is the largest pediatric series in Turkey. During a 3-month period, the study team observed the children for clinical symptoms, physical findings, and blood and mercury levels. Of all patients, 21 inhaled, 3 inhaled and touched the element, and 2 took the mercury home. Sixteen children were symptomatic at admission, although blood mercury levels in the symptomatic children were higher than those in asymptomatic children (P = 0.003). The urine mercury levels were not statistically different between the groups at the admission (P > 0.05). The exposure times were 3.5 and 2 hours for symptomatic and asymptomatic children, respectively (P = 0.003). The 2 children who took the mercury home had the highest blood mercury levels and the most prolonged exposure time. N-acetylcysteine and chelation treatments were started in 21 children who had symptoms of mercury intoxication and high mercury levels in their blood or urine. No adverse effects were observed during chelation therapy. Prompt removal of children from contaminated environments and proper decontamination or elimination of devices containing large amounts of mercury from schools are necessary to prevent serious complications caused by exposure to mercury.
authors.affiliation: Department of Pediatric Intensive Care, Faculty of Medicine, Erciyes University, Kayseri, Turkey. basaknurbesra@gmail.com
authors.forename: Basak Nur
authors.initials: BN
authors.lastname: Akyildiz
authors.forename: Meda
authors.initials: M
authors.lastname: Kondolot
authors.forename: Selim
authors.initials: S
authors.lastname: Kurtoğlu
authors.forename: Bahadir
authors.initials: B
authors.lastname: Konuşkan
mesh_terms: D000059:Accidents; D000111:Acetylcysteine / Q000627:therapeutic use; D000293:Adolescent; D002614:Chelating Agents / Q000627:therapeutic use*; D002648:Child; D003666:Decontamination; D004777:Environment; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D016166:Free Radical Scavengers / Q000627:therapeutic use*; D006358:Hot Temperature; D006801:Humans; D008297:Male; D008628:Mercury / Q000097:blood / Q000652:urine; D008630:Mercury Poisoning / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D010396:Penicillamine / Q000627:therapeutic use; D012574:Schools; D013821:Thermometers / Q000009:adverse effects; D014421:Turkey
chemical_list: D002614:Chelating Agents; D016166:Free Radical Scavengers; D008628:Mercury; D010396:Penicillamine; D000111:Acetylcysteine