Chronic Effects of Mercury on Organisms:

Basic principles of preventing effects of mercury on the organism


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BASIC PRINCIPLES OF PREVENTING EFFECTS OF MERCURY ON THE ORGANISM The prophylaxis of mercury vapor poisoning continues to be a major concern of public health agencies. Mercury and its compounds are known to be in daily large scale use and constitute a danger of intoxication, especially under conditions in which, previously, hygienists have never encountered it. Special hygienic investigations, experimental prevention of micromercurialism, and practical supervision where mercury and its compounds and mercury instruments are used, have determined basic principles for the prophylaxis of mercury poisoning: • Prevent the penetration of mercury vapor into the air of the work zone; • Protect structural elements of buildings, industrial equipment, and operating furniture from the possibility of mercury contamination; • Differentiated approach to evaluation of results of studying the mercury content of the environment, and correspondingly, to the development of health improvements not only under industrial but "non-industrial" conditions. In connection with the latter, it must be stressed that the adoption of 0.01 mg/m3 as the maximum permissible mercury content cannot be a criterion for the hygienic evaluation of the state of the external air at such facilities as academic (physics and chemistry classrooms of general and technical preparatory schools), medical (clinics, hospitals, dental offices, physical therapy rooms), and laboratories of higher educational institutes, etc.). Currently, the most widely distributed chemical demercurializing agents are ferric chloride and potassium permangenate. Medical-prophylactic surveillance of industrial workers possibly adversely affected my mercury vapor is done by medical departments of the enterprises themselves. It involves preventive, before beginning work, and periodic medical check-ups, once or twice a year depending on amount of exposure. The goal of the survey is to maintain good health and to determine those in which the initial symptoms of mercury effects. It is especially important to determine these initial pathological effects of micromercurialism so that they can be medically reversed. Also, the presence of such persons signal that sanitary-hygienic improvement measures are needed. Laboratory analyses recommended are: hemoglobin content, ESR, leucocyte content, urinary mercury and urobilin, general urinalysis, erythrocyte and reticulocyte count. The first five of these are obligatory. In doubtful cases there is diagnostic use of unithiol perorally (5g twice a day) until analysis is made. Medical contraindications to embarking upon work with mercury and its compounds include: epilepsy, obvious neurosis (neurasthenia, hysteria, psychasthenia) and also neurotic states of different etiology, organic CNS disease, psychic distress, evident endocrine-vegetative disease, chronic or recividistic gingivitis, stomatitis, alveolar pyorrhea, chronic colitis, obvious liver disease, nephrosis, nephritis, nephrosclerosis. These diseases are severely aggravated by mercury intoxication and leads more rapidly to more severe micromercurialism. Periodic medical examinations should include persons who have only intermittent, or who have long ceased to have, contact with mercury. Temporary absence from work with mercury is required when the initial symptoms of micromercurialism appear. Such a person can be treated as outpatients and given unithiol (0.5g twice a day for thee days with a three-day interval), diathermy of the liver and kidney region, Shcherbaks' galvanic collar and vitamin therapy with subsequent improvement in a sanitarium if needed. Upon the development of a functional stage of more pronounced chronic mercury effect (micromercurialism) the temporary removal from all contact with mercury, and hospitalization of the patient in a special occupational pathology ward, a full course of therapy (antidotes, physical therapy and vitamin therapy) and rest under sanitarium conditions is required. When the organic stage is reached (onset of tremors) the patient must be completely removed from all contact with mercury and hospitalized far from any mercury source for recovery. Permanent cessation of all contact with mercury is indicated for those persons who upon contact with mercury, have developed the above described diseases and pathological states which would be medically contraindicated for initiating work with mercury. An important place in medical service is the therapeutic-prophylactic diet of person likely to be exposed to mercury vapor. Diets should include large quantities of lecithin and complete protein with added thiamine and vitamin C. According to recommended guidelines, a six-day menu of hot breakfasts, and also pointed out the necessity of including lipotropic substances in the diet which exert a beneficial influence on the state of the liver and CNS - lecithin and others as noted above. Currently, experimental data points out the importance of using pectin substances, which increase mercury build-up in the system. (O. G. Arkhipova, 1961, 1966). It is known that carboxyl groups of galacturonic acid, anhydrides of which form the basic structure of pectins, can unite with metal ions. Pectins occur in many food products of plant origin, composing from 0.5 -39% of them. There is much pectin in fruit juices, berries and tubers.