1. A Small Dose of MercuryMercury Toxicology – 10/13/04 ELSI & Mercury The Ethical, Legal, and Social Implications of Mercury Steven G.Gilbert, PhD,DABT www.asmalldoseof.org

2. A Small Dose of MercuryMercury Toxicology – 10/13/04 Child Health

3. A Small Dose of MercuryMercury Toxicology – 10/13/04 “Conditions that ensure that all living things have the best opportunity to reach and maintain their full genetic potential.” Steven G. Gilbert, 1999 Environmental Health

4. A Small Dose of MercuryMercury Toxicology – 10/13/04 “The Commons” The Tragedy of the Commons By Garrett Hardin, Science, 1968

5. A Small Dose of MercuryMercury Toxicology – 10/13/04 Technical Solutions “It is our considered professional judgment that this dilemma has no technical solution.” The Tragedy of the Commons By Garrett Hardin, Science, 1968

6. A Small Dose of MercuryMercury Toxicology – 10/13/04 Problems – Solutions?  Lead and kids  Fetal alcohol syndrome  Nuclear disarmament  Bioterrorism  Ocean Fisheries  Persistent chemicals  The Commons

7. A Small Dose of MercuryMercury Toxicology – 10/13/04 Hg - Inorganic & Organic Hg CH 3 Inorganic – Quick Silver Hg Organic – Methyl Mercury

8. A Small Dose of MercuryMercury Toxicology – 10/13/04 Hg Facts & Uses Quicksilver 13.6 times the weight of water Evaporates at room temperature Bacteria change to Methylmercury Amalgam Many Industrial uses (thermometers, chemical reactions, gold mining)

9. A Small Dose of MercuryMercury Toxicology – 10/13/04 Hg – Like Water

10. A Small Dose of MercuryMercury Toxicology – 10/13/04 Hg – Solid Enough to Sit On

11. A Small Dose of MercuryMercury Toxicology – 10/13/04 Alchemy Medicine - cure syphilis? Egyptian tomb -1500 BC Ancient Awareness

12. A Small Dose of MercuryMercury Toxicology – 10/13/04 Greek God Mercury “For then she bare a son, of many shifts, blandly cunning, a robber, a cattle driver, a bringer of dreams, a watcher by night, a thief at the gates, one who was soon to show forth wonderful deeds among the deathless gods...” Description of the birth of the Greek God Mercury

13. A Small Dose of MercuryMercury Toxicology – 10/13/04 Occupational Exposure Gold mining. Hatters in the felt industry Magicoreligious & Ethnomedical Historical Events

14. A Small Dose of MercuryMercury Toxicology – 10/13/04 Historical Awareness

15. A Small Dose of MercuryMercury Toxicology – 10/13/04 Magicoreligious & Ethnomedical Esperitismo (spiritual belief Puerto Rico) Santeria (Cuban practice) Voodoo Carried in pouch, spread around house or bed, mixed in bath or burned in devotional candles Some consume orally for indigestion, constipation Injected to ward of evil (see Prasad, EHP 112(13), Sept 2004) Current Ethnic Exposures

16. A Small Dose of MercuryMercury Toxicology – 10/13/04 Polluting with HG Discharge in Minamata Bay

17. A Small Dose of MercuryMercury Toxicology – 10/13/04 Fetal Effects of MeHg

18. A Small Dose of MercuryMercury Toxicology – 10/13/04 Life-Long Effects of MeHg

19. A Small Dose of MercuryMercury Toxicology – 10/13/04 Planting Seed with Mercury

20. A Small Dose of MercuryMercury Toxicology – 10/13/04 Iraq Mothers with Bread

21. A Small Dose of MercuryMercury Toxicology – 10/13/04 Iraq Infant - Effects of Mercury

22. A Small Dose of MercuryMercury Toxicology – 10/13/04 Outbreaks of MeHg Poisoning PlaceYearCases Minamata1953-601000 Nigata1964-65646 Guatemala1963-6545 Ghana1967144 Pakistan1969100 Iraq1956100 Iraq19601,002 Iraq197140,000 On-going2001???

23. A Small Dose of MercuryMercury Toxicology – 10/13/04 Natural Degassing of the earth Combustion of fossil fuel Industrial Discharges and Wastes Incineration & Crematories Dental amalgams Hg 0 Hg 2+ CH 3 Hg + Environmental Sources of Mercury

24. A Small Dose of MercuryMercury Toxicology – 10/13/04 Coal Fired Plants – Hg Emissions

25. A Small Dose of MercuryMercury Toxicology – 10/13/04 Atmospheric Hg

26. A Small Dose of MercuryMercury Toxicology – 10/13/04 Mercury Release 50-75% mercury of released in the environment related to human activities

27. A Small Dose of MercuryMercury Toxicology – 10/13/04 Ambient Water Sediments Edible Fish Inorganic Mercury Methyl- Mercury In Humans Biomethylation Bioaccumulation Exposure Discharge Biotransformation of Mercury

28. A Small Dose of MercuryMercury Toxicology – 10/13/04 The Mercury Cycle

29. A Small Dose of MercuryMercury Toxicology – 10/13/04 Blindness - Deafness Cerebral Palsy - Seizures Abnormal reflexes & muscle tone Retarded motor development Visual and Auditory Deficits Delayed motor development Altered DRH performance Neurobehavioral Effects

30. A Small Dose of MercuryMercury Toxicology – 10/13/04 Decrease in Brain Size Cell loss Disorganization of cells Cell migration failures Effects On The Brain

31. A Small Dose of MercuryMercury Toxicology – 10/13/04  MONKEY - 25 µg/kg - LOAEL  RAT - 10 µg/kg - LOAEL  RAT - 50 µg/kg - replicated Animal - Risk Assessment

32. A Small Dose of MercuryMercury Toxicology – 10/13/04  2.5 µg/kg - NOAEL (animals)  0.25 µg/kg - Human  0.025 µg/kg - Sensitive populations Animal - Risk Assessment (the rule of dividing by 10)

33. A Small Dose of MercuryMercury Toxicology – 10/13/04 10-20 ppm hair - LOAEL 40-80 ppb blood - LOAEL 0.645 µg/kg 0.06 µg/kg - RfD Human - Risk Assessment

34. A Small Dose of MercuryMercury Toxicology – 10/13/04 MeHg Consumption Limits US EPA – RfD 0.1 ug/kg-day US FDA – 1 ppm (mg/kg) fish NAS – blood Hg <5.0 µg/L hair <1.0 µg/g

35. A Small Dose of MercuryMercury Toxicology – 10/13/04 Hg in Newborns “Based on the distribution of Blood Hg concentrations among the adult female participants in 1999-2000 NHANES and the number of U.S. births in 2000, > 300,000 newborns each year in the United States may have been exposed in utero to methyl mercury concentrations higher than those considered to be without increased risk of adverse neurodevelopmental effects associated with methyl mercury exposure.” Mahaffey et al. Environ Health Perspect 112:562-570 (2004).

36. A Small Dose of MercuryMercury Toxicology – 10/13/04 Environmental Pollutants and Disease in American Children: Estimates of Morbidity, and Costs for Lead Poisoning, Asthma, Cancer, and Developmental Disabilities, by Landrigan, P. et al. EHP, 110, July 2002, 721-728. Cost of Childhood Disorders Lead exposure$43.4 Billion Asthma$ 2.0 Billion Cancer$ 0.3 Billion Neurobehavioral$ 9.2 Billion Total costs$54.9 (48.8-64.8) Billion

37. A Small Dose of MercuryMercury Toxicology – 10/13/04 Mercury Fishing Advisories  In 2000, 41 States have over 2000 fish consumption advisories  An increase from 27 in 1993  Pregnant women, nursing mothers, women who intend to have children, and children under 15

38. A Small Dose of MercuryMercury Toxicology – 10/13/04 Limit the amount of canned tuna you eat, based on your bodyweight. Guidelines are: Women of childbearing age should limit the amount of canned tuna they eat to about one can per week (six ounces.) A woman who weighs less than 135 pounds should eat less than one can of tuna per week. Children under six should eat less than one half a can of tuna (three ounces) per week. Specific weekly limits for children under six range from one ounce for a twenty pound child, to three ounces for a child weighing about sixty pounds. WA State Advisory http://www.doh.wa.gov/fish/FishAdvMercury.htm

39. A Small Dose of MercuryMercury Toxicology – 10/13/04 WA State Mercury Chemical Action Plan Reduce Hg in fish Reduce Hg release into the environment 4-5 tons of Hg released in WA Educating consumers about Hg in home WA State Hg CAP http://www.ecy.wa.gov/biblio/0303001.html http://www.ecy.wa.gov/programs/eap/pbt/mercuryplan.html

40. A Small Dose of MercuryMercury Toxicology – 10/13/04 U.S. EPA Produced “First-Ever Rule to Reduce Mercury Emissions from Power Plants” Last 15 years no drop in Hg emissions from power plants Is Cap and Trade appropriate for a demonstrated neurotoxic compound? Hg CAP and Trade

41. A Small Dose of MercuryMercury Toxicology – 10/13/04 Precautionary Principle "When an activity raises threats of harm to the environment or human health, precautionary measures should be taken even if some cause and effect relationships are not fully established scientifically." - Wingspread Statement on the Precautionary Principle, Jan. 1998

42. A Small Dose of MercuryMercury Toxicology – 10/13/04  FDA regulations of Drugs (1938)  FDA regulations of Dietary Supplements (Dietary Supplement Health and Education Act of 1994 (DSHEA))  Ephedra present an unreasonable risk of illness or injury (Dec, 2003) Safety & Efficacy vs Harm

43. A Small Dose of MercuryMercury Toxicology – 10/13/04 Taking preventive action in the face of uncertainty Shifting the burden of proof / responsibility to the proponents of an activity Exploring a wide range of alternatives to possibly harmful actions Increasing public participation in decision making Wingspread Conference, 1998. Central components

44. A Small Dose of MercuryMercury Toxicology – 10/13/04 City Comprehensive Plans Every citizen of Seattle has an equal right to a healthy and safe environment. Seattle sees the Precautionary Principle approach as its policy framework to develop laws for a healthier and more just Seattle. Seattle Initiative

45. A Small Dose of MercuryMercury Toxicology – 10/13/04 Children have a right to a safe, fair and healthy environment Ethical Responsibility to share and use of knowledge Duty to promote health and well being of children Thoughtful public health advocate Knowledge - Responsibility

46. A Small Dose of MercuryMercury Toxicology – 10/13/04 Testifying Writing review papers K-12 class room teaching Adding expertise to community groups Education Mentoring Speakers Bureau Socially Responsible Actions

47. A Small Dose of MercuryMercury Toxicology – 10/13/04 Mercury A Global Issue Mercury distribution and exposure is a global problem

48. A Small Dose of MercuryMercury Toxicology – 10/13/04 Alice’s Adventures “Everything’s got a moral, if you can only find it” Lewis Carroll in Alice’s Adventures in Wonderland

49. A Small Dose of MercuryMercury Toxicology – 10/13/04 The Potential of Children

50. A Small Dose of MercuryMercury Toxicology – 10/13/04 A Small Dose of ™ Mercury

51. A Small Dose of MercuryMercury Toxicology – 10/13/04 Additional Information  Web Sites World Health Organization - global prospective on mercury health effects. http://www.who.int/water_sanitation_health/GDW Q/Chemicals/mercuryfull.htm US EPA - Main site on Mercury. http://www.epa.gov/mercury/ The Mercury Policy Project (MPP). - works to raise awareness about the threat of mercury contamination - http://www.mercurypolicy.org/

52. A Small Dose of MercuryMercury Toxicology – 10/13/04 Authorship Information For Additional Information Contact Steven G. Gilbert, PhD, DABT E-mail: smdose@asmalldoseof.org Web: www.asmalldoseof.org This presentation is supplement to “A Small Dose of Toxicology”