Current Pediatric Research

Mercury is a ubiquitous environmental pollutant with diverse adverse health effects that could result in death. Children are the most susceptible population of the world to mercury poisoning. Two earlier reviews by the author dealt with fatal mercury poisoning cases in the general population and mercury vapor exposure in dentistry. The objective of the present article is to review global studies on environmental mercury poisoning of children and get perspective on its impact on pediatric health by assessing the progress made in diagnosis, treatment, prevention and monitoring of the adverse effects. With the aid of several search platforms, studies of environmental mercury exposures in children published in the world literature were collected. With emphasis on clinical studies, details of the reported adverse health effects and treatments used were compiled along with prevention and monitoring aspects of mercury exposures. Mercury poisoning events were categorized based on exposure sites (at home or outside), its form (elemental, organic or inorganic), route (inhalation, oral ingestion, skin absorption or pre-and postnatal), duration (acute or chronic) and dose. The clinical signs, symptoms and treatments used in each category were separately enumerated for comparative purpose. Home is the most common site for children’s exposure to mercury attributable to breakage of fever thermometers, dental amalgam fillings, tainted cosmetics, toys and jewelry, and consumption of contaminated fish, OTC and herbal medicines, and dietary supplements. The main organs affected are brain, lungs, kidneys and immune systems. Clinical interpretation of blood and urine levels of mercury are unambiguous when they are high and become difficult as they approach normal range. While diagnosing mercury poisoning can be challenging, it can be made with reasonable reliability and promptly treated with chelation therapy. With the development of mercury-free products and manufacturing processes along with industrial pollution abatement measures, children’s exposure to mercury is currently being reduced. Parents, pediatricians, and school science teachers can play a major role in preventing mercury poisoning of children. This review should be of immediate interest to environmental scientists and regulators around the world.

Author(s): G. Subba Rao*

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