Mercury Toxicity and Contamination of Households from the Use of Skin Creams Adulterated with Mercurous Chloride (Calomel).

Lori Copan,Tracy Barreau,Jeff Fowles,Nancy McGee

doi:10.3390/ijerph120910943

Abstract

Inorganic mercury, in the form of mercurous chloride, or calomel, is intentionally added to some cosmetic products sold through informal channels in Mexico and the US for skin lightening and acne treatment. These products have led to multiple cases of mercury poisoning but few investigations have addressed the contamination of cream users’ homes. We report on several cases of mercury poisoning among three Mexican-American families in California from use of mercury-containing skin creams. Each case resulted in widespread household contamination and secondary contamination of family members. Urine mercury levels in cream users ranged from 37 to 482 µg/g creatinine and in non-users from non-detectable to 107 µg/g creatinine. Air concentrations of up to 8 µg/m3 of mercury within homes exceeded the USEPA/ATSDR health-based guidance and action level of <1.0 μg/m3. Mercury contamination of cream users’ homes presented a multi-pathway exposure environment to residents. Homes required extensive decontamination, including disposal of most household items, to achieve acceptable air levels. The acceptable air levels used were not designed to consider multi-pathway exposure scenarios. These findings support that the calomel is able to change valence form to elemental mercury and volatilize once exposed to the skin or surfaces in the indoor environment.

Highlights

Inorganic mercury salts, such as mercurous chloride, mercuric chloride, and mercuric oxide, have been found in skin-lightening and anti-acne cosmetic products imported into the US internationally from small scale, unregulated suppliers and through the Internet
Decontamination standards for elemental mercury, first established in 2000 [12], are based on health endpoints from exposure to mercury vapor. These action levels may not be suitable in cases of household contamination from inorganic mercury salts where exposure to mercury is through both elevated mercury vapor levels and dermal absorption from contaminated surfaces
The baby’s mercury urine level was 52 μg/g creatinine and the most likely exposure route was through physical contact with the mother or from contact with contaminated household items

Summary

Introduction

Inorganic mercury salts, such as mercurous chloride, mercuric chloride, and mercuric oxide, have been found in skin-lightening and anti-acne cosmetic products imported into the US internationally from small scale, unregulated suppliers and through the Internet. The use of these mercury-adulterated skin and face creams for the purposes of skin lightening has been described and reviewed, with case reports from Africa, Europe, Mexico, Asia, and the US [1]. These action levels may not be suitable in cases of household contamination from inorganic mercury salts where exposure to mercury is through both elevated mercury vapor levels and dermal absorption from contaminated surfaces

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