From the Department of Pediatrics, University of Health Sciences, Ankara Atatürk Sanatorium Training and Research Hospital, Ankara, Turkey.
Department of Pediatrics, Ankara Gazi Mustafa Kemal Occupational and Environmental Diseases Hospital, Ankara, Turkey.
Pediatr Emerg Care. 2022 Oct 1;38(10):481-488. doi: 10.1097/PEC.0000000000002834. Epub 2022 Sep 2.
Mercury exposure is common and can be toxic, especially in children. Children are often drawn to elemental mercury because of its density, color, and proclivity to form beads.
We present data on 49 children with mercury intoxication (MI) and 60 children with mercury exposure from Turkey.
The most common source of mercury was broken thermometer in schools. Inhaling mercury vapor was the most common route of exposure. The median exposure time was 6 (6-16) hours in the MI group, and the time to 1st symptoms was 10 (0-24) hours. In the MI group, the median blood mercury level was 21 μg/L (13-32.3), the median spot urine mercury level was 40 μg/L (7.66-78), and the median 24-hour urine mercury level was 25.8 μg/L (11-64). The most common symptoms in patients with MI were malaise, muscle pain, muscle cramps, abdominal pain, nausea, headache, and decreased appetite. The patients were treated with n-acetyl cysteine, 2,3-dimercaptopropane sulfonic acid, D-penicillamine, and meso 2,3-dimercaptosuccinic acid. A positive correlation was found between exposure time and urinary mercury level in the MI group (r = 0.793, P < 0.001). A positive moderate correlation was found between exposure time and blood level in the mercury exposure group (r = 0.535, P < 0.00). The neurological and systemic examinations of patients were all normal at the 1st follow-up visit 1 month after discharge.
Diagnosis, removal of the exposure source, and use of chelation therapy can result in complete resolution of the signs and symptoms of MI.
汞暴露很常见，且可能具有毒性，尤其是对儿童而言。儿童通常会因汞的密度、颜色和易于形成珠状而接触元素汞。
我们提供了来自土耳其的 49 例汞中毒（MI）儿童和 60 例汞暴露儿童的数据。
最常见的汞源是学校内破裂的温度计。吸入汞蒸气是最常见的暴露途径。MI 组的中位暴露时间为 6（6-16）小时，出现首个症状的时间为 10（0-24）小时。在 MI 组中，中位血汞水平为 21μg/L（13-32.3），中位尿汞水平为 40μg/L（7.66-78），中位 24 小时尿汞水平为 25.8μg/L（11-64）。MI 组患者最常见的症状为不适、肌肉疼痛、肌肉痉挛、腹痛、恶心、头痛和食欲减退。患者接受了 N-乙酰半胱氨酸、2,3-二巯基丙磺酸、D-青霉胺和 meso-2,3-二巯基丁二酸治疗。在 MI 组中，发现暴露时间与尿汞水平之间存在正相关（r = 0.793，P < 0.001）。在汞暴露组中，发现暴露时间与血汞水平之间存在正相关（r = 0.535，P < 0.00）。出院后 1 个月的首次随访时，患者的神经和系统检查均正常。
诊断、去除暴露源和使用螯合疗法可导致 MI 的体征和症状完全消退。
