title: Mercury Toxicity and Contamination of Households from the Use of Skin Creams Adulterated with Mercurous Chloride (Calomel).
abstract: Inorganic mercury, in the form of mercurous chloride, or calomel, is intentionally added to some cosmetic products sold through informal channels in Mexico and the US for skin lightening and acne treatment. These products have led to multiple cases of mercury poisoning but few investigations have addressed the contamination of cream users' homes. We report on several cases of mercury poisoning among three Mexican-American families in California from use of mercury-containing skin creams. Each case resulted in widespread household contamination and secondary contamination of family members. Urine mercury levels in cream users ranged from 37 to 482 µg/g creatinine and in non-users from non-detectable to 107 µg/g creatinine. Air concentrations of up to 8 µg/m³ of mercury within homes exceeded the USEPA/ATSDR health-based guidance and action level of <1.0 μg/m³. Mercury contamination of cream users' homes presented a multi-pathway exposure environment to residents. Homes required extensive decontamination, including disposal of most household items, to achieve acceptable air levels. The acceptable air levels used were not designed to consider multi-pathway exposure scenarios. These findings support that the calomel is able to change valence form to elemental mercury and volatilize once exposed to the skin or surfaces in the indoor environment.
authors.affiliation: California Department of Public Health, Environmental Health Investigations Branch, Richmond, CA 94706, USA. lori.copan@cdph.ca.gov.
authors.forename: Lori
authors.initials: L
authors.lastname: Copan
authors.affiliation: California Department of Public Health, Environmental Health Investigations Branch, Richmond, CA 94706, USA. Jeff.Fowles@cdph.ca.gov.
authors.forename: Jeff
authors.initials: J
authors.lastname: Fowles
authors.affiliation: California Department of Public Health, Environmental Health Investigations Branch, Richmond, CA 94706, USA. Tracy.Barreau@cdph.ca.gov.
authors.forename: Tracy
authors.initials: T
authors.lastname: Barreau
authors.affiliation: California Department of Toxic Substances Control, Enforcement and Emergency Response Division, Sacramento, CA 95826-3200, USA. Nancy.McGee@dtsc.ca.gov.
authors.forename: Nancy
authors.initials: N
authors.lastname: McGee
mesh_terms: D000293:Adolescent; D002140:California; D003358:Cosmetics / Q000009:adverse effects*; D004340:Drug Contamination; D004781:Environmental Exposure / Q000032:analysis*; D005190:Family; D006801:Humans; D007223:Infant; D008297:Male; D017669:Mercury Compounds / Q000633:toxicity* / Q000652:urine; D008630:Mercury Poisoning / Q000175:diagnosis* / Q000453:epidemiology*; D008800:Mexico; D063465:Skin Cream / Q000633:toxicity*; D014481:United States; D014484:United States Environmental Protection Agency
chemical_list: D003358:Cosmetics; D017669:Mercury Compounds; C015728:calomel
keywords: calomel; inorganic mercury poisoning; mercurous chloride; mercury health-based guidance values; mercury toxicity children; residential mercury contamination; skin lightening cream