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Previous by Date: Subject: Re: Mercury from thermometers (again) Date: Tue, 1 Jun 2010 13:35:41 -0400 Author: McGrath Edward J |
Next by Date: Subject: Re: Mercury from thermometers (again) Date: Tue, 1 Jun 2010 14:22:11 -0400 Author: Secretary ACS DCHAS |
All (and especially Brad),
I cannot concieve as a Board Ce
rtified Medical Toxicologist, a former 20-year Board Certified Emegency P
hysician, a former Occupational/Environmental Medicine Physician,
;a Verified Advanced Hazmat Life Support Provider and Instructor
, and once a volunteer firefighter, ANY circumstance when students in a
school broke some thermometers (most current ones don't even contain mercu
ry but these might have contained small amounts) in which decontamin
ation in a decontamination trailer would be appropriate. OVERKILL a
nd HYPE never helped anybody. Jeez, there was a big chlorine gas
release in the southeast not too long ago when insistance on field water sk
in decontamination of what was a gas/vaper exposure requiring no decontamin
ation other than evacuation to fresh air and supply of supplemental oxygen
KILLED a number of exposed persons for no reason when they should have been
disrobed (yes, you can trap gas/vapors in clothing) and immediately tran
sported for definitive respiratory/oxygenation care. Dumb and dumbe
r. As I previously posted, most Regional Poison Centers (just cal
l 1-800-222-1222 and you'll autramtically be referred to the Regional Poiso
n Center for your area code) already have in place reasonable protocols for
such instances. The ones I've reviewed certainly don't go to such
extremes.
You can get rid of liquid mercury on the skin by dry-wiping or even wet wip
ing, and it's ability to penetrate through the skin in such circumstances
is so neglible as to be non-existent. You'd have to swallow
the blasted stuff in large quantities and have it pool in the veriform app
endix or in a rare congential defect called a Meckel's diverticulum (both h
ave occurred, but rare is rare and we aren't talking about this extremely
rare ingestion exposure scenario). Sure, you can inject it IV (h
as happened, I've had cases) or inject it subcutaneously as some South Am
erican boxers did into their hands thinking in would increase their "punch"
(it didn't). But really, let's get real about some kids do somet
hing with thermometers in schools; where is Thomas Pain ("Common Sense")
when you really need him?
Now, when the circumstance are with organomercurials or a reasonable expo
sure to mercury vapor (if anyone is aware of a single incidence of clinical
illness in schools -- leaving out the fluorescent lights ballast stuff of
which I'll well aware -- then post it). I think most of these thing
s are diddly-squat hysteria and in all cases that don't involve organomercu
rials, it is completely inappropriate to decontaminate anybody for minisc
ule potential skin exposures.
This is becoming an "urban legend" and getting out of hand. Should
we, as D-CHAS, have an outreach program to Local and State Health Depar
tments, School Districts, HAZMAT Teams, etc. so that we can have reas
onable responses to local circumstances? As SOT does for its K-12 o
utreach program, could we have something similar based on the "Ask Dr. Sa
fety" paradigm? Might be an issue for the next EC teleconference?
This might be a topic for a workshop in Baltimore or in San Fran next time
around.
Of course, we always want to err on the side of caution, but the expens
e in inappropriate responses in terms of time, money, and taking HAZMAT
teams out of service for more serious issues must be considered.
Let's continue the debate. No one will ever doubt that mercury can
be a very bad toxicant, but as our Patron Saint, Paracelsus, noted a
long time ago: "All substances are toxic. There are none wh
ich are not. The difference between a poison and a rememdy is the d
ose." I'll remind our members that injectable or oral antmony, ar
senic and mercurial compounds were used as treatments (actually quit
e effecitive) for syphilis and other disease in times past, efficacious
, but the therapeutic index (effective dose/toxic dose) was not such as t
o continue their use after other means became avaliable. There's ev
en a trivalent arsenic compound called Trisenox(R) on the market today and
FDA approved for treatment of a rere leukemia variation.
Please, folks, this is just like like some of the CCA (Chromated Copper
Arsenate) urban legend hysteria of a number of years past.
Let's simply go back to the Sir Bradford Hill Criteria (which can be summar
ized very simply as):
-- Can it?
-- Did it?
(Can mercury expoure be bad? Yes)
(Was mercury exposure in these circumstances bad? No).
Alan
Alan H. Hall, M.D.
Medical Toxicologist
Toxicology Consulting and Medical Translating Services, Inc. (TMCTS, In
c.)
Laramie, WY
Colorado School of Public Health
Denver, CO
us_md: Students, School Staff Isolated After Therm ometers Break < /P>
BALTIMORE -- A group of elementary schools playing w ith thermometers caused a hazmat situation Friday in Baltimore.
Fire department spokesman Kevin Cartwright said more than a dozen people were isolated after broken thermometers prompted conce rns about the mercury inside. ;
The incident occurred at Rodman Elementary School on West Mulberry Street.
The students and staffers affected wer e to be showered in a decontamination trailer.
There were no injuries reported.
Cartwright said the students were playing with therm ometers that broke and released mercury.
Y=92all knew this was coming, rig ht?
Once again, the absence of someon e (anyone) with a cool head and a mere modicum of common sense has caused a heinous over-reaction to a non-situation.
Before several amongst you inundate me with claims of how this really is a serious event, let me pre-empt yo ur knee-jerk reactions to my statement:
1) Unquestionably, mercur y is hazardous, and represents a severe chronic threat, particularly wh en exposures occur over an extended period of time.
2) Proper remediation of the spill must be performed any time mercury is spilled.
3) As noted in the earlier discussion, EPA must be notified if more than 454g are released.
But folks, seriously? Decontamination of the staff and students? This is patently and demonstrably asinine. There is NO conceivable scenario, dealing with elemental mercury from a thermometer or two, in a room of moderate s ize and with normal ventilation, by which these folks were exposed to anything remotely warranting bringing in a =93decontamination trailer =94. If there were an acute danger from playing with mercury from t hermometers, I and most every science major in my generation would alread y be brain-damaged and/or dead.
Again, my main focus here is the fact that we are reinforcing MINDLESS FEAR instead of understanding and respect for chemicals. If we, the =91experts=92 in res ponse, don=92t exercise wisdom and judgment, if we make every call to u s a local disaster response, eventually someone will not report something because they don=92t want to cause a scene - and that=92ll be the one we will have really wanted them to bring us in on.
Okay, I=92ll take your flames now .
Brad
Dr. Bradley K. Norwood
8302 Shady Ridge Lane
Mechanicsville, VA 23116< /SPAN>
(804) 559-7212 (H)
(804) 271-5572 ext. 307 (O)< /P>
(804) 641-4641 (cell)
brad.norwood**At_Symbol_Here**aristalabs.com< /A>
You cannot help the poor by destroy
ing the rich.
You cannot strengthen the weak by weakening the strong.
You cannot bring about prosperity by discouraging thrift.
You cannot li
ft the wage earner up by pulling the wage payer down.
You cannot further
the brotherhood of man by inciting class hatred.
You cannot build chara
cter and courage by taking away people's initiative and independence.
Yo
u cannot help people permanently by doing for them what they could and shou
ld do for themselves.
.....Abraham Lincoln
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