Poisoning with compounds of mercury

Description:

Poisonings with mercury — the disorders of health connected with excess intake of vapors or compounds of mercury in an organism.

Symptoms of Poisoning with compounds of mercury:

Distinguish acute and chronic intoxications mercury. The last depending on degree of manifestation of clinical manifestations differentiate on poisonings easy (a functional stage), average (an organic, psychoorganic stage) and heavy (toxic encephalopathy) degrees.

Acute poisonings with vapors of mercury and its connections arise, as a rule, under production conditions at emergencies or gross violation of safety measures or in life in case of accidents. Acute poisonings are possible at concentration of vapors of mercury in air of 0,1-0,5 mg/m3, and influence of concentration of vapors in number of 0,5–8 mg/m3 leads to a lethal outcome or development of extremely severe forms of poisoning.

Acute poisonings are shown in 8–24 h and characterized by symptoms of an acute inflammation of upper respiratory tracts (rhinitis, tracheitis, bronchitis), the stomatitis which is quite often accompanied with ulcer processes, an ulitis, disturbances of a nervous system which severe damages of kidneys and intestines join afterwards. Characteristic symptoms of acute poisoning are also copper-colored coloring of a mucous mouth and throat, metal taste in a mouth, weakness, a headache, pains on the digestive tract course, vomiting with blood, the complicated swallowing and sensation of fear. Activity of kidneys up to an oliguria is broken, in blood the content of residual nitrogen increases. The renal failure can lead to death in the first days, but more often the victim perishes for the 10-30th days. Also fulminant forms of poisoning at which death comes later 0,5–1 h after hit of poison in an organism are possible.

Depending on weight of poisoning the following symptomatology differs:

    * at easy degree of poisoning with the leading signs nausea, hypersalivation, a loss of appetite against the background of the general weakness at working capacity preservation are;
    * at average degree – vomiting, single eases of a chair, dull aches in an anticardium;
    * at heavy degree – sharp colicy pains in a stomach, repeated vomiting, the expressed renal and hepatic pains, uneasy behavior of the patient.

Chronic poisoning with mercury (mercurialism) is shown generally by defeat of a nervous system.

The functional stage of intoxication (stage of a "mercury" neurasthenia) is characterized by the adynamy which is combined with neurologic frustration and the accruing phenomena of a psychoorganic syndrome. Vegetative disturbances (perspiration, tachycardia, arterial hypertension) are characteristic, subfebrile condition is possible. Feature of an adynamy are persistent headaches, dizzinesses, persistent sleep disorders (sleeplessness, a superficial dream with dreadful dreams, drowsiness in the afternoon). Extreme irritability, irascibility, tearfulness, emotional instability, fearfulness and a konfuzlivost (a mercury eretizm) are noted. At appearance of strangers the painful phenomena amplify, the patient is not capable to perform simple operations. In some cases the changeable mood, especially is noted in the evening, when strengthening an adynamy – with attacks of the alarming affect accompanied with perspiration, a shiver, blanching of the person. The thyroid gland is quite often increased, with hyperfunction signs. Trophic disturbances – fragility of nails, a hair loss are characteristic. Functional disturbances of action of the heart are shown by a myocardial dystrophy, and digestive tract – pains in epigastriums, nausea, sometimes vomiting with blood, watery excrements with blood and slime.

When progressing mercury intoxication process passes into a psychoorganic stage at which the small intensive tremor (a "mercury" tremor) of fingers of outstretched arms, the raised legs, a century, language, and then and all body comes to light. When progressing process amplitude of trembling movements increases. At rest this state reminds trembling paralysis, and at movement – the phenomena arising at multiple sclerosis. Gait becomes atactic, the speech – dizartrichny, handwriting changes. Development of weak-mindedness is possible. Mental disorders in this stage can become constants.

Toxic encephalopathy meets seldom. Its characteristic symptoms are: large wide trembling of extremities (hyperkinesia), strengthening of disturbances of mentality, the expressed astenisation, periodontosis, chronic stomatitis, a glomerulonephritis. Manifestations of a polyneuritis are possible.

At chronic poisoning with mercury patients note metal smack in a mouth, the strengthened hypersalivation, bleeding of gums is characteristic. In blood, as a rule, a lymphocytosis, a monocytosis, anemia, a leukopenia is more rare. In urine – protein traces, single erythrocytes. Content of mercury in urine in quantities more than 0,01-0,05 mg/l is raised and at the relevant clinical data confirms the diagnosis of mercury intoxication. In the absence of clinical data the mercury carriage is diagnosed.

Impact on an organism of small concentration of mercury can lead to development of a micromercurialism which symptoms are shown most often for the 2-4th year of work in contact with small concentration of mercury and are characterized by a hyperexcitability of sympathetic department of the autonomic nervous system with disturbances in the emotional sphere and with shifts in a morphological picture of blood.

Reasons of Poisoning with compounds of mercury:

Technogenic sources of mercury.
They are considered as the major factor in its distribution.

    * The mercury thermometer may contain about 2 grams of mercury.
    * Mercury-zinc galvanic cells (batteries)
    * Mercury lamps (DRL, DRSh, etc.)
    * Energy saving gas-discharge cold light lamps
    * Daguerreotype — the first practical way of photography, is now used seldom
    * Combustion of coal and gas in the industry and life (contain insignificant, but significant when burning large volumes, amounts of mercury)
    * Industrial sources — losses in mercury pumps, manometers, thermometers, electric switches, the relay. The most part of such equipment became outdated, and now is replaced with the equipment which is not containing mercury.
    * Processes of amalgamation, gilding, etc. Now are practically not used.
    * Explosions of mercury gates in power supply networks (to 50 kg of the mercury (warmed) in one powerful mercury ignitron).
    * Decomposition of rtutnosoderzhashchy pigments when heating or lighting (cinnabar decomposition).

Medical and food sources:

    * Vaccines, the antidotes and some other medical supplies containing preservatives on the basis of a mertiolyat.
    * Fillings with amalgam. In the CIS countries amalgamny seals are practically not applied today.
    * Rtutnoorganichesky connections in sea fish (for pregnant women maximum it is recommended - an admissible week dose of meat of a pike or tuna — no more than 100 g).

Treatment of Poisoning with compounds of mercury:

At acute poisoning with mercury of the victim it is necessary to bring (to take out) to fresh air and to provide rest. At hit of mercury in a stomach – to cause vomiting, to wash out a stomach a large amount of water in which it is desirable to add absorbent carbon ovalbumin or compounds of sulfur (sulfur transfers mercury to the insoluble and almost non-toxic sulfides removed from an organism with a stake). After completion of washing the victim needs to allow to drink milk.

Treatment is performed in the conditions of a hospital. At initial stages of chronic intoxication appoint intravenously 40% glucose solution on 20–40 ml with ascorbic acid, intramuscular injections of a gluconate of calcium, B1, B6 vitamins. Balneotherapy, a galvanic collar with calcium are desirable, a diathermy on area of a liver, galvanic bathtubs with sodium hyposulphite or are gray, Ural federal district in combination with heat pine needle baths, a milk diet.

At more expressed intoxication forms removal of mercury from an organism is promoted by intramuscular injections of 5% of solution of Unithiolum on 5 ml 2 times a day within 10 days or for 5 days with a break in 3–4 days, and also inhalations of an aerosol of Unithiolum. Succimerum (mesodimercaptosuccinic acid) after food on 0,5 g in 6 h during the first 3 days, in the next 4 days – on 0,5 g 3 times a day is appointed; in total on a course of 12 g. Drug is recommended to be washed down with alkaline mineral waters.

At stomatitis and an ulitis of an ulcer grease with tincture of iodine or 10% solution of chromic acid, or cauterize 10–25% solution of nitrate silver.

Symptomatic therapy – according to indications. The resort therapy (Matsesta, Pyatigorsk) is shown at all stages of intoxication.