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  1. If test results indicate the patient has a high urinary mercury concentration, chelation therapy should be considered, and a physician experienced in chelation therapy should be consulted. It is also important to ensure that the patient is no longer exposed to the mercury source.

All family members should have their urinary mercury concentration measured. A common exposure is quite likely, particularly if the source is mercury vapor in the home. If the source is a product used in the home, other persons using the product may be at risk. The county or state health department should be contacted to identify and eliminate the mercury source and to evaluate the potential exposure to members of the community. Medical follow-up for mercury-exposed persons includes monitoring nervous system and renal function status.

Challenge

Challenge questions begin on page 4.

  1. In a patient so young, sources of chronic mercury exposure are most likely to be linked to the home. Within the home, the possible mercury sources include off-gassing of paint on interior walls and liquid mercury from a spill embedded in floors or carpets. Possible ingestion sources include contaminated drinking water, mercury-containing medicinals, or folk remedies.

  2. If the mercury source is in the home or diet, all members of the family could be exposed. Other persons in the community who ingest contaminated food or drink might also be affected. In addition, if paint is the source of exposure, consumers using the same paint brand may be exposed.

  3. Yes, if the source is elemental mercury vapor released from paint in the home, the mother, and subsequently, the fetus, are likely to be exposed. Although the adverse developmental effects of MeHg are known, the long-term neurologic consequences to the human fetus of chronic low-level exposure to mercury vapor have not been documented well.

  4. See pretest answer (a).

  5. See pretest answer (b).

  6. See pretest answer (c).

  7. See pretest answer (d).

  8. See pretest answer (d), paragraph 2.



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