1. WHAT TO TELL SPILL VICTIMS? If thermometer is cleaned up per instructions, within 24 hours, risk is extremely small. If residual mercury droplets or particles imbedded in carpet remain, the extent of risk is unknown and we cannot predict it. People with confirmed high levels had exposure more than one week. If anyone will be affected it will most likely be the youngest (or unborn) child.

2. TREATMENT Removal from further exposure Decontamination Chelation (drugs that eliminate Hg into urine) Hemodialysis Indications for chelation are controversial

3. TREATMENT: CHELATORS Dimercaprol (BAL): intramuscular DMPS: most effective for organic Hg N-Acetyl-D, L penicillamine: oral Succimer (DMSA): oral superior to penicillamine prevents mercury uptake by cells very safe Call PCC for treatment advice

4. TREATMENT May not be effective in reversing toxicity from chronic organic or chronic elemental mercury exposure

5. TAKE HOME POINTS Mercury is a potent neurotoxin Children are more susceptible Treatment is not always effective Blood mercury levels are most useful if spill was less than 1 week ago People or doctors with questions Call Poison Control Center – 1-800-222-1222

6. EXPOSURE LIMITS

7. EXPOSURE LIMITS MIOSHA TWA 50 µg/m 3 Urine Mercury 50 µg/L Blood Mercury 30 -35 µg/L Neurobehavioral effects (IQ) children blood >3.5 µg/L in pregnant women

8. NON-OCCUPATIONAL EXPOSURE MINIMAL RISK LEVEL (MRL) occupational LOAEL 26 µg/m 3 average 15 years of exposure adjusted to 24 hour exposure added 30- fold uncertainty factor 0.2 µg/m 3

9. MDCH REFERENCE LEVELS Mercury concentration in µg/m 3 Actions Less than 1After clean-up, re-occupy – residential Less than 3After clean-up, re-occupy – non-residential Greater than 10 Occupants to leave during remediation Discard bagged items Greater than 20 Occupants to immediately leave Enter to open windows but do not stay to characterize Greater than 50Evacuate & Do Not Enter

10. LAWS

11. NATURAL RESOURCES AND ENVIRONMENTAL PROTECTION ACT (EXCERPT) ACT 451 OF 1994 324.17202 MERCURY THERMOMETER; SALE,OFFER FOR SALE, OR OFFER FOR PROMOTIONAL PURPOSES (1) Except as provided in subsection (2), beginning on January 1, 2003, a person shall not sell, offer for sale, or offer for promotional purposes a mercury thermometer in this state or for use in this state. Except: A) required by statue, regulation or rule B) Pharmaceutical research purposes 2) After January 1, 2003 by prescription only.

12. FEVER THERMOMETER BREAKS REPORTED TO PCC’S IN US 2000 18,265 2001 17,457 2005 9,122 15,442 Other Mercury Exposures

13. BLOOD PRESSURE DEVICES MCL 324.17204 It is illegal: As of January 1, 2008 To offer a mercury containing BP device for sale As of January 1, 2009 To use this device outside of a private home Can only be used for calibrating other devices Must be stored in a locked cabinet

14. THERMOSTATS MCL 324.17205 As of January 1, 2009 “A person shall not sell, offer for sale, or distribute.. A thermostat for regulating room temperature that contains mercury…” Does not apply if it is a replacement for an existing thermostat containing mercury or is a component of an appliance.

15. REVISED SCHOOL CODE MCL 380.1274B After December 31, 2004 the school district …. does not purchase, store, or use free flowing elemental mercury …. Or use an instrument that contains mercury…” Exception if no alternative exists

16. MERCURY CONTAINING ITEMS

17. COMPACT FLUORESCENT LIGHTBULBS (CFLS) Far fewer calls than a couple years ago Internet still has some extreme misinformation 100 times less mercury than a fever thermometer 4 mg of mercury

18. FLUORESCENT TUBES Mercury Content Silver end 8 to 14 mg/bulb Older bulbs up to 40 mg/bulb Green end 3.5 to 4 mg/bulb New bulbs Most mercury is vapor Used/Burnt our bulbs Most mercury is bound to phosphor powder

19. GROW LIGHT-FACT SHEET Clandestine greenhouse operations Procedure for collection/storage Procedure for breaks For first responders – request Most switching to LEDs

20. THERMOMETERS MCL 324.17202 Home fever thermometers 0.5-1 grams of mercury Banned sale in MI in 2003 – except by prescription Laboratory thermometers Up to 3 grams of mercury Banned for sale in MI except for drug manufacturing

21. REPLACEMENTS FOR A MERCURY FEVER THERMOMETER Digital No shaking Alcohol Have to shake Usually red liquid

22. LIQUID METAL FROM A MERCURY-FREE THERMOMETER Galinstan Mix of gal lium, in dium, and stan num (tin) Smears on glass, paper No beads

23. THERMOSTATS AND OTHER MERCURY SWITCHES Tilt, pressure, or float switches (possibly others) 0.01 grams (10 mg ) to 200 grams – less than 0.4 lbs In Michigan mercury thermostat sales banned as of 2009 Some dial thermostats now mercury-free

24. BAROMETERS From 100 grams to 6 kilograms (0.2 to 13 lbs)