WHO Food Additives Series, 1972, No. 4 EVALUATION OF MERCURY, LEAD, CADMIUM AND THE FOOD ADDITIVES AMARANTH, DIETHYLPYROCARBONATE, AND OCTYL GALLATE The evaluations contained in this publication were prepared by the Joint FAO/WHO Expert Committee on Food Additives which met in Geneva, 4-12 April 19721 World Health Organization Geneva 1972 1 Sixteenth Report of the Joint FAO/WHO Expert Committee on Food Additives, Wld Hlth Org. techn. Rep. Ser., 1972, No. 505; FAO Nutrition Meetings Report Series, 1972, No. 51. MERCURY Mercury occurs naturally in the environment and is contributed to by human industrial activity. Because the natural background levels of mercury vary it is difficult to distinguish natural from artificial levels in any part of the environment. Annual natural erosion and weathering is estimated to contribute some 5000 tons to the sea. Another 4000-5000 tons of mined mercury (about half the annual world production of 9000 tons) are lost to sea, soil and the atmosphere. Following absorption mercury accumulates in most living organisms. It fulfils no known essential function in man or animals. There is much concern about the potential for human intoxication due to mercury in foodstuffs particularly fish. The most serious toxic hazard arises from methylmercury residues in food (Lu et al., 1972). Sources (a) Environmental sources Air. Mercury has a relatively high vapour pressure so that the air over mercury and its ore deposits generally contains elevated levels of mercury (0.2-20 µg Hg/m3). Small amounts are also found over non-mineralized land areas (0.003-0.009 µg Hg/m3), while insignificant amounts occur over the oceans (0.001 µg Hg/m3) (Fleischer, 1970; Wallace et al., 1971). If it is assumed that the average intake of air is 10m3 per day and that the maximum amount of mercury found over non-mineralized land areas is inhaled this would amount to 0.1 µg of mercury from this source, probably as elemental or inorganic mercury. Only limited information is available regarding tobacco; this suggests that for cigarettes most of the trace mercury present is retained in the butt and that (on average) not more than 0.1 µg of mercury per cigarette is inhaled. The combustion of fossil fuels will also liberate traces of mercury into the atmosphere: these add to the much larger quantities present in the atmosphere arising from natural vaporization processes from the earth's surface (Weiss et al., 1971) and may be significant locally. Water. Although there is considerable evidence that the manmade pollution of rivers, lakes and estuaries has often increased the mercury levels in fish, such pollution has not contributed significantly to the mercury levels found in wide-ranging ocean fish. Since the mercury content of the ocean has been estimated to be of the order of 108 tons and the annual industrial output of mercury is only of the order of 104 tons, the pollution due to man can have had only local effects, e.g. in lakes, rivers, estuaries and coastal areas (Miettinen, 1971). On the other hand, the present degassing of mercury from the earth's crust is estimated to range between 2.5 x 105 and 1.5 X 105 tons per year. Increased flux over the last few decades may be due to alteration of terrestrial surfaces through the variety of activities of man. The mercury content in ocean surface waters may have been augmented by a factor of 0.75 (Weiss et al, 1971). There is also natural geological contamination of individual lakes or watercourses due to underlying mineral deposits containing mercury, which leach into the water under natural circumstances. The mercury content of streams, lakes and rivers does not normally exceed 0.1 µg per litre although some water sources located near mercury ore deposits may contain amounts up to 80 µg/litre (Wershaw, 1970). WHO has recommended that the tentative upper limit for mercury in drinking water should be 1 µg per litre, this figure being related to levels found in natural waters used for drinking purposes (WHO, 1971). At the ingestion rate of 2.5 litres of water per day used in the calculations for the International standards, the upper limit of mercury intake would be 2.5 µg per person per day, mainly in the inorganic form. The levels of mercury found in treated water are lower than those found in food. Moreover, mercury in water is found in inorganic form. In terms of methylmercury, therefore, the contribution to the body load in man from water and air is unlikely to be significant. (b) Industrial sources The direct pollution of water by industrial sources is likely to affect fish more than other foods. Similar pollution will be caused by dumps of industrial wastes which will transfer mercury into the soil and, eventually, into water. The transfer into the atmosphere may form a significant addition locally due to the large amounts evolved by natural outgassing of surface materials. Mercury or mercury salts entering water may eventually result (primarily through microbial but also through other biological and chemical processes) in the formation of methylmercury compounds which can be absorbed and accumulated by aquatic organisms. The industrial sources that cause the transfer of mercury-containing wastes to water or mud in fishery areas constitute sources of most direct concern. Furthermore, once mercury has been deposited in watercourses and estuaries it may remain and give rise to the formation of methylmercury compounds by bacterial action over a period of many years (Wood et al., 1968). Thus, both past and present sources of contamination must be considered. Measures to control industrial sources can bring about a considerable reduction of new pollution. However, the problem presented by levels of mercury in fish taken from already polluted watercourses and estuaries will continue for a long time. The industrial processes which are likely to introduce significant quantities of mercury into the environment have been examined in a number of countries and control measures have been suggested (Env. Res. 1971). The principal sources are the chlor-alkali industry using the mercury process, the pulp and paper industry and other industries using mercury. Effluent from these industries in watercourses and estuaries has been the cause of much local pollution in fish. Indeterminate but significant quantities of mercury originate from mining, smelting and refining of ores, but the effects are usually localized. Industrial control equipment, hospital and laboratory instrumentation containing elemental mercury, such as relays, mercury arc rectifiers and thermometers represent minor sources when there are losses due to breakages. Laboratory and hospital wastes, discarded electrical apparatus, fluorescent lamps, paints, catalysts and other sources of mercury in dumps and sewage water, through seepage into watercourses, may also cause contamination of fish. (c) Agricultural sources Alkyl, alkoxyalkyl, aryl, and inorganic mercurial fungicides have been used for seed dressing, as turf fungicides, and in orchards. The amount of mercury entering the food supply from normal agricultural use has been usually small compared with that from other sources. On occasions, the use of alkyl mercury has resulted in the fortuitous accumulation of mercury by game birds feeding on mercury-treated seeds in the fields. Although the use of alkyl and aryl mercurial fungicides has been restricted or prohibited in a number of countries in recent years, accidents have occurred from the misuse of seeds treated with alkyl mercury compounds. (d) Other sources Additional intake sources are pharmaceuticals containing either inorganic or organic mercury compounds, and mercurials used as preservatives in cosmetics and toiletries. Care should therefore be taken in epidemiological surveys to consider these sources of exposure, as well. Transformation of mercury from inorganic to organic The geochemistry of metallic and inorganic mercury involves numerous interconversions and transformations. Mercury is present in both humic complexes and in the relatively unionized and stabilized form of mercuric sulfide (Wallace et al., 1971). Under oxidizing conditions, mercuric sulfide is gradually converted to mercuric sulfate, which is more readily dissociated, releasing ionic mercury in solution. Conditions of oxidation also promote the conversion of metallic mercury to ionic mercury. Mercuric compounds located on the earth's surface will usually degrade to metallic mercury and subsequently volatilize due to the action of sunlight. On the other hand, most of the mercury compounds which are carried down into river beds and lake bottoms will, in the presence of hydrogen sulfide, ultimately be converted to insoluble mercuric sulfide, which may be, in turn, converted into methylmercury compounds. The principal forms of mercury commercially discharged into the environment are metallic mercury, inorganic mercury, aryl-mercury, alkyl-mercury and alkoxyalkyl-mercury compounds. The transformation of inorganic mercury into the organic methylmercury form is promoted by micro-organisms or other biologically derived alkylating systems present in the sediments of lakes, rivers and estuaries. These systems are capable of forming methylmercury and dimethylmercury from inorganic mercury, both under aerobic and anaerobic conditions (Jensen & Jernelöv, 1969; Wood et al., 1968). Both methyl and dimethylmercury compounds appear as initial products of methylation. High mercury concentrations favour the monomethyl form while alkaline pH favours the highly volatile dimethyl form, which decomposes to monomethylmercury at acidic pH. The formation of methylmercury in bottom sediment under aerobic and anaerobic conditions was studied using 203Hg labelled mercury. The reaction proceeds under both conditions, but the rate of reaction depends upon the number of micro-organisms. No methylation occurs when the bottom mud is sterilized. The possibility of spontaneous chemical transformation to methylmercury has also been reported. The mechanisms of the methylation reaction are not yet fully understood, although several hypotheses have been advanced. Methods of analysis In the estimation of trace quantities of mercury a method is generally employed which determines the total mercury content. If necessary, separate analysis for alkyl-mercury compounds should follow. Total mercury and any mercury compounds are calculated as mercury, and may be expressed as µg Hg/kg, µg Hg/litre, mg Hg/kg, etc., according to the substrate examined. In the basic method for total mercury estimation, the sample is oxidized with a mixture of sulfuric and nitric acids, converting all the mercury present into inorganic form. Care is necessary to avoid losses of mercury by volatilization in this process, and specially designed apparatus should be utilized. After oxidation, the mercury is reduced to metallic state and the amount present estimated in the form of vapour released from the solution in a stream of nitrogen by flameless atomic absorption spectrophotometry, using the 253.7 nm line. Due regard should be given to the proportion of mercury recovered in control experiments. Similarly, in the determination of methylmercury compounds, these are extracted with organic solvents (usually benzene), re-extracted into aqueous cysteine solution and extracted back into solvent after acidification. Mercury in this solvent is then estimated by gas chromatography. Thin layer chromatography of the extract may also be useful as a confirmatory test for establishing the identity of unknown compounds. Due regard should be given to the proportion of methylmercury compounds recovered in control experiments. Neutron activation analysis requiring expensive and highly specialized equipment has been employed successfully as an alternative technique. Low temperature combustion has also been used in place of wet oxidation. When using either of these methods, particular attention should be exerted to possible losses of mercury, to contamination from outside sources and to recovery percentages. The method of the International Union of Pure and Applied Chemistry for the analysis of traces of mercury in food (IUPAC, 1965) is under revision and a further study of the Official Method of Analysis (AOAC, 1972) is currently in progress. A basic technique for estimating methylmercury compounds is described in the method of the Nordic Committee on Food Analysis (Nordic Committee, 1972). Levels in food The amount of mercury compounds found in plant produce is very small or zero. Although the use of alkyl mercury fungicides (particularly as seed dressings) is being discouraged, there may still be possibilities, in the absence of appropriate regulatory measures, that traces of such fungicides will get into cereals by accident. Low levels of total mercury can also occur in meat and dairy produce and may include some methylmercury compounds, derived presumably from residues in feeds containing fish-meal or treated cereal grains. Fish constitute a special problem. Since the tragic accidents at Minamata and Niigata in Japan, aquatic pollution with mercury and its resulting uptake and accumulation by edible fish has been given special attention in many parts of the world. In recent years thousands of analyses have been performed and comprehensive studies have been reported. The results show that increased levels are consistently found in places where the water is contaminated with mercury from industrial and mining processes. In fish from unpolluted water, comprising most of the world's total catch of food fish, low values are generally found. Some of the larger specimens of predatory species may contain high levels, apparently derived from natural sources since the same levels are found in museum specimens caught 50-100 years ago. There is evidence that the level of methylmercury in fish increases with the age of the fish, e.g., data on swordfish show levels of mercury clearly increasing with size (age) of the fish. The ratio of methylmercury to total mercury in edible fish muscle is usually high (approaching 100%). In shellfish, the proportion is only 50% or less when mercury is high. However, the high level of inorganic mercury may be due to the inclusion of viscera in the material analysed. Information available shows that 99% of the world's commercial catch has a total mercury content not exceeding 0.5 mg/kg, and 95% probably contains less than 0.3 mg/kg. In 1971 the United States Food and Drug Administration conducted a nationwide survey and found less than 3% of 1400 random samples of market fish (mainly deep ocean species) to contain mercury in excess of 0.5 mg/kg. Tuna species make up only about 2% of the total world catch of fish, and almost all of this goes for human consumption. The average mercury concentrations are below 0.5 mg/kg but old and large specimens may contain levels above 1 mg/kg. A United States study showed that 95% of the canned tuna contained less than 0.5 mg/kg (U.S., FDA, 1971). Larger specimens of halibut and shark may contain increased levels of total mercury, up to and exceeding 1 mg/kg (Bligh, 1971; Faile, 1971; Westöö & Rydälv, 1971). In some communities in countries where total diet surveys based on fish consumption of the edible portion of 20 g or less per day have shown an average daily intake of total mercury of 10 µg per person, the average amount of methylmercury present has been estimated to be not greater than 2 µg, depending on the amount and type of fish consumed (United Kingdom Report). Freshwater fish in unpolluted waters seem to have total mercury contents less than 0.2 mg/kg. In some cases, however, fish have been found to contain values up to 0.5-1 mg/kg in apparently uncontaminated lakes (Hasanen a Sjöblom; Westöö & Rydälv, 1969; 1971). Unusually elevated natural mercury concentrations in underlying geological structures may be responsible for the high levels of methylmercury in fish from these lakes. Freshwater fish in mercury-polluted environments has been extensively studied in some countries. Some larger species, such as pike, perch, pickerell, bass and burbot have in many lakes been found to contain 1-5 mg/kg of mercury; and in some cases even more. Freshwater fish in unpolluted waters seem to have total mercury contents less than 0.2 mg/kg. In some cases, however, fish have been found to contain values up to 0.5-1 mg/kg in apparently uncontaminated lakes (Hasanen & Sjöblom, 1969; Westöö & Rydälv, 1969; 1971). In some cases, sources of pollution have been revealed later on (Westöö, 1972) e.g. hospital sewage or mercury airborne by prevailing winds from industrial sources. However, in a large number of cases of bodies of water in isolated areas, there can be no man-made source of mercury pollution and in perhaps one half or more of these areas, there is reason to believe there may be natural occurrences of mercury often associated with methyl sulfide ore deposits (Tam & Armstrong, 1972). Other significant factors influencing the mercury content found in fish are shallow lakes, oligotrophic conditions (organisms other than fish "competing" for the mercury), pH of the water (low pH favours formation of methylmercury). Fish, as well as shellfish and crustacean and eels (anguila species), that constitute the local population in polluted estuaries may contain high values of mercury and as they may represent a valuable local fish supply, they should be more extensively surveyed. Levels in oysters and shellfish can be controlled by antipollution measures. Mercury levels in fish from certain lakes in Sweden and certain rivers in Japan have also fallen after the elimination of contamination sources. Fish caught elsewhere have not shown such a response with respect to mercury levels, but the period of observation was relatively short. BIOLOGICAL DATA Effects of mercury The chemical form of mercury determines the biological effects which occur. Mercurials fall into a number of well defined classes, distinguished by differences in absorption, biotransformation, deposition, retention and excretion. These metabolic features largely determine the toxic effects produced. Mercurials can be divided into the following groups: (a) elemental mercury, (b) inorganic mercury compounds, (c) aryl and alkoxyalkyl mercury compounds, (d) alkyl mercury compounds. (a) Elemental mercury The major route of human exposure is by inhalation of mercury vapour. The vapour diffuses rapidly (75-85%) across the alveolar membrane as shown by studies on four volunteers exposed to 50-350 µg/m3 metallic mercury. This absorption is reduced by the ingestion of alcohol (Kudsk, 1965). Occasional instances of acute poisoning from vapours have been reported. Major symptoms are acute pneumenitis ("metal fume fever"), gastrointestinal disturbances, bloody diarrhoea and severe kidney injury with uraemia and anuria. Chronic exposure produced tremor and psychological disturbances, (erethismus mercurialis) and occasional proteinuria which may progress to nephrotic syndrome (Kazantzis et al., 1962; Joselow & Goldwater, 1967). Gingivitis, stomatitis, excessive salivation, occasional dermatitis, mercurialentis, non-specific fatigue, weight-loss and pallor have been reported (Bidstrup, 1964). (b) Inorganic mercury compounds Following the absorption of a soluble inorganic mercury salt the mercuric ion is transported in approximately equal proportions bound to plasma proteins and haemoglobin in the red cell. The biological half-life in man has been determined at 42 ± 3 days for the whole body and 16 days for the RBC. Only 0.2-0.4% of the initial dose appeared in the whole blood. The RBC/plasma activity ratio was 0.4. Ionic (in water) or protein bound mercury (calf liver) was handled metabolically the same way (Rahola et al., 1971). The immediate effects of acute poisoning are due to irritation, coagulation and superficial corrosion of exposed tissues. Chronic effects include kidney damage and intestinal ulceration with haemorrhage (Bidstrup, 1964). (c) Organomercurials The biological effects of organomercurials are much influenced by the particular organic group present. They enter the body by inhalation, by skin absorption though only slowly, or by oral ingestion. They are volatile to a variable degree. Aerosol inhalation leads quickly to solution of the unchanged compound in body fluids and distribution to the blood. The compounds at present in use have the general formula R-Hg+-X(-) and biotransformation follows two general pathways: (a) splitting of the C-Hg bond to liberate Hg++ or (b) modification to R'-Hg+. (i) Aryl mercury compounds Man rapidly metabolises phenylmercury compounds to inorganic mercuric ions which are excreted in the urine. The RBC/Plasma ratio is about 1. Urine levels of mercury could be used to indicate the degree of exposure. Human chronic exposure by inhalation at air levels of up to 5.1 mg Hg/m3 had not produced clinical manifestations: blood levels reached 0.52 µg/ml and urinary excretion 2.8 µg/ml (Ladd et al., 1964; Goldwater et al., 1964). No systemic injury was noted by exposure from 0.2-3.2 mg/m3 With urinary excretion of 0-6 µg/ml. However, chronic exposure increases urinary protein level (Joselow & Goldwater, 1967). In exposed groups of seed dressers mercury levels in urine were 0.035 µg/ml, blood levels O-0.21 µg/ml and urinary protein was 166 mg/24 hours compared with 70 mg/24 hours in matched controls. No correlation was established between exposure and urinary mercury excretion. Serum glutathione reductase was unaffected but serum phosphoglucoseisomerase was low in the exposed group. The biological half-life of diphenylmercury in an individual accidentally exposed to this compound was found to be 14 days (Morsy & El-Assaly, 1970). There is some evidence that phenylmercury compounds produce chromosomal abnormalities in Drosophila melanogaster and possibly teratogenic effects in mice. However, studies with 203Hg phenyl acetate in pregnant mice showed that although the placenta takes up large amounts of mercury, only traces were present in the foetus (Berlin & Ullberg, 1963; Suzuki at al., 1967). (ii) Alkoxyalkyl mercury compounds Methoxyethyl mercury compounds are rapidly metabolized to inorganic mercuric ions and excreted in the urine. The RBC/Plasma ratio is about 1. In acute poisoning the organs most affected are the kidneys. There may be intestinal symptoms, headache and weight loss. Exposure may result in mercury blood levels of 0.3-1.1 µg/ml and mercury levels in urine of 0.2-1.2 µg/ml without clinical injury (Berlin, 1970). (d) Alkyl mercury compounds The distribution of alkyl mercury in the body tissues is very different from aryl and inorganic mercury. However, absorption, distribution and excretion are closely similar for the hydroxide, cyanide, dicyandiamide and propanediol mercaptide. Distribution and elimination after subcutaneous injection are similar for the hydroxide and dicyandiamide (Ulfvarson, 1962). MethyImercury compounds are absorbed via the skin, the respiratory tract in rat, mouse and monkey (Hunter et al., 1940; Swensson, 1952) and there is almost complete absorption from the digestive tract (Berglund, 1969; Ekman et al., 1968a; Clarkson, 1971). Elimination is very slow especially in primates, with consequent risk of considerable accumulation. It seems likely that the compounds dissociate in the body: the methylmercury group attaches to the functional groups of other substrates, e.g. proteins, being then similarly metabolized. The methylmercury group distributes rather evenly in the body but it accumulates in the erythrocytes; the distribution between plasma and erythrocytes varies with species. In man, 90% of the total blood mercury appears in the cellular elements. Blood/brain ratios differ from species to species. Methylmercury easily penetrates the placenta in animals. It also accumulates in hair. The most part is excreted in the faeces and some in the urine. Forty to fifty per cent. of the faecal excretion is in the inorganic form. The stability of alkyl mercury compounds favours their accumulation in the CNS. Observations in man Orally administered CH3203HgNO3 in three male volunteers was almost completely absorbed (over 90%). Erythrocytes took up the 203Hg within 15 minutes, the RBC/plasma ratio being 10. Maximum blood levels occurred three to six hours after ingestion. Fifty-five per cent. of the total 203Hg-activity was found localized in the liver, 12% in the head. Less than 1% of mercury passed through the gut unabsorbed. Faecal excretion totalled 34% in 49 days (initial 3% of body burden falling to 1% of body burden/day). Urinary excretion amounted to 3.3% in 49 days. No mercury was found in sperm, but some appeared in hair (0.12% of the dose at 50 days). The epidermis was not considered a significant route of excretion. The biological half-life was 70-74 days. At steady state equilibrium one unit dose CH3203HgNO3 per week was calculated to give a total body burden of 15.2 unit doses (Ekman et al., 1968a; 1968b; Åberg et al., 1969; Falk et al., 1971). Nine male and six female volunteers were given orally about 2 µg of methyl-203Hg which had been incorporated into fish muscle protein by feeding the fish 10 days earlier with labelled methylmercury proteinate. Most of the activity was excreted in the faeces (6% of body burden in three to four days, then 1.9% of body burden/day); very little was excreted in the urine (no activity until the one hundredth day). Activity in RBC's decreased rapidly, the RBC/plasma ratio being 10. The biological half-life was 50 ± 7 days for RBC and 76 ± 3 days for whole body activity (Miettinen et al., 1971). When a methylmercury-free diet followed a high methylmercury-fish diet the biological half-life for RBC activity was 70 days and for plasma activity 80 days (Birke et al., 1972). Urinary excretion of mercury cannot be used to evaluate exposure to alkyl mercury compounds (Lundgren et al., 1967). Alkyl mercury poisoning causes sensory nerve damage (paraesthesia of face and extremities), cerebellar damage (ataxia, incoordination, dysarthria), calcarine cortical damage (concentric visual field constriction), temporal lobe damage (hearing defects). All are associated with raised mercury levels in certain brain areas, liver and kidney. Patient response is very variable, the Hunter-Russel syndrome having been defined after industrial exposure (Hunter et al., 1940; Edwards, 1865; Hill, 1943). Diffuse encephalopathy in 168 cases with 52 deaths with concentric visual field loss, ataxia and peripheral neuropathy secondary to ingestion of mercury contaminated fish and shellfish has now been reported in Minamata and Niigata. The works of Irukayama (1968), Takeuchi (1968, 1970) and others (Study Group of Minamata disease) have established the etiologic role of methylmercury in Minamata disease. The mercury content of organs of human autopsy cases of Minamata disease (12 victims, age five to 62 years), in which the course of the disease was 100 days or less was liver 22-70 µg/g, kidney 22-144 µg/g, brain 2.6-25 µg/g. The brain/iiver ratio was 12:50, and brain/kidney 7:37 (Takeuchi, 1970). Similar symptoms have been reported in numerous instances following accidental ingestion of food treated with alkyl mercuric compounds (ethylmercury and methylmercury derivatives), e.g. ingestion of treated seeds or of meat from animals fed treated grain (Engleson & Herner, 1952; Haq, 1963; Ordoñez et al., 1966; Jalili & Abbasi, 1961; Dahhan & Orfaly, 1964; Mukhtarova, 1970; Gis'IU & Pozner, 1970; Snyder, 1971; Storrs et al., 1970; Curley et al., 1971; Mnatsakonov et al., 1968; Slatov & Zimnikova, 1968; Sandi, 1970; Okinaka et al., 1964). In the Minamata accident 23 infants with cerebral involvement (palsy and retardation) were born to mothers who had ingested mercury contaminated fish and shellfish indicating transplacental foetal damage. The mothers of these patients had shown no manifestations of the disease or had only slight complaints such as numbness of fingers and fatigue. In both adult and foetal cases there were degenerative and regressive alterations of the cerebral cortical nerve cells. In addition, hypoplasia was observed in the foetal cases. Cerebral cortical cell involvement was more diffuse in foetuses than in adults (Matsumoto et al., 1965). Methylmercury crosses the placental barrier and achieves a higher concentration in foetal RBC than in maternal RBC. The foetal plasma, however, has a lower concentration than does maternal plasma. The difference may be due to differences in the binding of methylmercury by maternal and foetal haemoglobin. The mercury content of blood of mothers and newborn infants in Sweden was reported as (average values ng/g): Infants RBC 11.5 Plasma 1.9 Mothers RBC 8.6 Plasma 2.5 (Tejning, 1970) Mercury levels in maternal blood, umbilical cord blood and placental tissue in Tokyo were reported as: (ng/ml) Umbilical cord RBC 30.8 Plasma 11.2 Maternal blood RBC 22.9 Plasma 12.4 Placenta 71.5 ng/g (Suzuki et al., 1971) It has been reported that accidental exposure of women to ethylmercuric chloride resulted in the accumulation of mercury in newborn infants because of the presence of mercury in the mother's milk but the analytical method was not stated (Bakulina, 1968). Chromosome analysis of cultured lymphocytes from normal controls (0.004-0.011 µg/g RBC) and individuals with high RBC mercury levels 0.03-0.23 µg/g (from contaminated fish containing 1.7 mg Hg/kg indicated increased chromosome breakage, dose related to mercury levels. The significance for man is unknown (Skerfving et al., 1970; Sumari et al., 1971). Animal studies Biotransformation of methylmercury in the rat was studied using detection of cleavage of the C-Hg bond as indicator. After exposure to single intravenous dose of 1 mg/kg methylmercury chloride, 80% of the total mercury excretion was in the faeces. Forty per cent. of the total mercury excreted was found to be inorganic mercury. Fifty per cent. of the faecal excretion and 5.20% of the urinary excretion was inorganic mercury. Most of the faecal inorganic mercury was derived from faecal bacterial processes. Ten per cent. of the methylmercury chloride was excreted in the bile within 24 hours, falling to 5% on day 10. Only 3% was excreted daily in the faeces. Methylmercury cysteine, or more probably a complex with a sulfydryl-containing dipeptide molecule, was the major biliary metabolite together with protein-bound mercury. Methylmercury cysteine was rapidly and nearly completely absorbed in the small gut, the methylmercury protein representing 15% of the total faecal mercury and the mercury protein complex representing another 15%. Seventy per cent. of the total mercury was in the intestinal cell, 95% as methylmercury. Methylmercury cysteine accumulated in the kidneys more than methylmercury chloride; and this could be inhibited by bile duct ligation despite rising blood and plasma levels (Norseth. 1969, 1971; Norseth & Clarkson, 1971). When polystyrene with thiol ligands was fed at 1% of the diet to groups of five mice, given intraperitoneally CH3203Hg, the mercury faecal excretion was three times that of controls, whole body count was reduced, tissue levels after 22 days treatment were lower, brain levels were 1/5 of controls, kidney levels 1/10 and the blood was free from methylmercury (Clarkson et al., 1972). Methylmercury chloride was mixed with soluble swine brain protein to form methylmercury proteinate. On dialysis against a variety of thiocompounds much mercury was removed. Similarly, thioclycollate-treated hair powder reduced mercury content. If mice were given intramuscularly 200 or 400 µg methylmercury chloride and fed either normal diet or diet with 3% treated hair powder for 10 or 20 days then the total body mercury of treated mice was lower than untreated controls (Hirayama & Takahashi, 1971a; 1971b). CH3203Hg was injected intraperitoneally into a guinea-pig two days before and three days after parturition. Milk levels were 5-10% of blood concentration. The blood levels of young mothers (given two days before parturition) were the same. Rapid transplacental transfer but difficult transfer to milk was the conclusion (Trenholm et al., 1971). Rats were maintained on diets containing 2 mg/kg methylmercury for 12 weeks. Examination of kidney tissue by electron microscopy indicated extrusion of numerous cytoplasmic masses from the proximal tubular cells of the pars recta segment in the kidney. Effects were more prominent in females than in males (Fowler, 1972). Rats were administered per os 1 mg methylmercuric sulfide per day for 20 days. Peripheral nerves were examined on the seventh and two hundred and fiftieth day after withdrawal of the test compound. On day 7 mitosis of Schwann cells were observed and on day 250 myelinated fibres were noticeably decreased in numbers, with regeneration of nerve fibres and an increase in collagen in the intercellular spaces. Posterior nerve root ganglion cells were, however, intact. Regeneration of peripheral nerve cells was not a very marked feature (Miyakawa et al., 1970). In another study, rats were administered per os 1 mg methylmercuric sulfide per day for 20 days. Examination of heart muscle by light microscopy, indicated a few degenerated muscle fibres. Electron microscopy indicated that Z-band and every other band were indistinct, and that the myofilaments and the sarcoplasmic reticulum were disorganized, degenerated or disappeared (Miyakawa or al., 1970). Japanese quail given 20 mg/kg of mercury as methylmercury in diets containing 17% (by weight) tuna, survived longer than quail given this concentration of methylmercury in a corn-soya diet. When rats were maintained on a purified basal diet containing 20% casein or the same diet supplemented with 0.5 mg/kg selenium, with various concentrations of methylmercury in the drinking water all rats fed 10 mg/kg mercury without selenium died, but those fed diet with selenium were still alive at the end of week 6 (Ganther et al., 1972). Squirrel monkeys were given 0.5-1 mg/CH3203Hg/kg body-weight via the diet. Pairs of monkeys were fed for 21 days (followed by 85 days withdrawal), 28 days (one having a 37 day withdrawal period prior to sacrifice) and 36 days (one having a 6 day withdrawal period prior to sacrifice). After 121 days feeding, the total body burden of mercury was 2.8 and 3.6 mg Hg/kg. Neither animal showed symptoms, but at sacrifice the animal with the greater body burden showed slight changes in the calcarine cortex. After 28 days feeding, body burdens were 4.3 and 5.5 mg Hg/kg. The animal with the lower body burden of mercury showed slowly progressing visual disturbance, and possibly ataxia. At sacrifice, severe damage to the entire occipital cortex was observed. The animal with the higher body burden was blind, and possibly ataxic at termination of dosing when it was sacrificed. Severe calcarine cortex damage was noted. After 36 days feeding, monkeys showed 5.0 and 5.5 mg Hg/kg body burden. Both animals were blind, and, at autopsy, damage to the calcarine cortex was noted. The severity was greatest in the animal permitted a six day withdrawal period. Blood brain ratio was 0.2 (Nordberg et al., 1969). Groups each of five male monkeys (3 Macaca mulatta, 2 Macacus irus) were administered dietary methylmercury chloride, which had previously been mixed with egg and the freeze dried product added to the normal diet. Dose levels were 0, 0.01, 0.03, 0.1 and 0.3 mg Hg/kg body-weight/day. At the highest dose level, onset of neurologic symptoms were observed at days 50-73 of test, i.e. after a total intake of mercury of approximately 60-145 mg. Other groups appear normal after 140 days of test although a light depression in body-weight has been observed. Mercury content of hair of test groups after two months averaged 0.3, 4.8, 19, 44 and 202 µg/g, for control and respective test groups in order of dose level. The animals continue on study (Ikeda & Tobe, 1972). Reproduction studies Oral administration of 0.1, 1, 2.5 or 5 mg/kg methylmercury chloride from pregnancy day 6-17 to mice, reduced litter size at the highest level. All pups died at 2.5 mg/kg with retarded cerebellar development on seventh to fourteenth day post-partum. 0.1 mg/kg was the no effect level (Clegg, 1971). Methylmercuric sulfide labelled at the mercury and the sulfur atoms was given to pregnant rats in daily oral doses of 0.1 mg/kg body-weight. Autoradiographs demonstrated that the sulfur and the mercury were present inside the placenta and in the maternal milk. Neurological symptoms in the young gave evidence of the transfer to the foetus. Evidence is presented to show that the mercury-sulfur bond is dissociated in the animal's body soon after oral ingestion and that a mercury compound without sulfur is transferred to the young (Fujita, 1969). Mutagenic studies In a dominant lethal test performed in mice there was no effect 24 hours after exposure but this may have been too late as regards mating. When 0.1 mg Hg/kg was injected intraperitoneally prior to mating reduced pregnancy incidence was noted but no litter size reduction. In another experiment, male rats received by injection for seven days, 1, 2.5 or 5 mg Hg/kg and were then mated with untreated females over a period of four weeks. In matings 10-15 days after injection there was reduced litter size at all dose levels, the severity being dose related. Thus a positive response at all levels was noted (Clegg, 1971). ASSESSMENT OF HAZARD TO MAN In view of the large differences in metabolism of methylmercury compounds in various species of animals, toxicological evaluation based on animal data was not attempted and only human data were used. Data were of three types: (1) levels of mercury in hair and whole blood of patients with methylmercury poisoning in Niigata; (2) levels of mercury in hair, whole blood and blood cells in subjects without any symptoms of methylmercury poisoning in Japan, Sweden and Finland; (3) calculated relationships between intake of methylmercury from the diet and levels of mercury in hair, whole blood and bLood cells in subjects in Japan and Sweden. From these data a minimum toxic dose of methylmercury compounds in fish was calculated, and a proposal was made for a provisional tolerable weekly intake of mercury from food. Theoretically, a more direct approach to the establishment of the minimum toxic dose would have involved the precise estimation of the dietary intake of fish by the cases of poisoning in Niigata or Minamata coupled with accurate analyses of the mercury levels in the fish of Niigata or Minamata consumed at the time of poisoning, but available data did not permit this approach. It should be realised therefore that with the alternative procedure used, each of the above steps embodied factors of uncertainty, one common factor being the accuracy of the analysis of the mercury. For these reasons, the proposed tolerable weekly intake must be considered as provisional for the time being. Indices in man of exposure to methylmercury compounds. Methylmercury and other short chain alkylmercury compounds exert their main toxicological effects on the nervous system and the most relevant index of exposure would therefore be the concentration of mercury in relevant areas of the central nervous system. In man, methylmercury levels in blood cells and in hair provide the best indices of exposure of the nervous system to methylmercury compounds. If exposure to other mercury compounds is minor compared with exposure to methylmercury, analysis of total mercury may be used instead. A strict correlation between levels in the nervous system, blood and hair can only be expected when a steady state has been reached, i.e. during long-term exposure to constant levels of methylmercury compounds. Blood levels of mercury reflect more accurately the intake from recent exposure to methylmercury, while hair levels of mercury reflect the average intake over a more prolonged period. Since mercury combines with protein components in hair over the period of its formation, the mercury content in successive segments of hair gives an indication of the levels of past absorption of mercury compounds. The estimation of mercury in hair, provided external contamination can be excluded, may therefore be of value in epidemiological investigations. Levels of mercury in whole blood, blood cells and hair. The relation between mercury levels in blood and hair has been studied in Sweden, Finland and Japan in persons exposed to different amounts of mercury through the consumption of contaminated fish. The results are summarized in the following table: No. of Blood (x) Hair (y) Linear References subjects Hg )19/9 Hg µg/g regression 12 .004-.65 1-180 y = 280X - 1.3 Birke et al., 1967 (Sweden) 51 .004-.11 1- 30 y = 230X + 0.6 Tejning, 1967 (Sweden) 30 .005-.27 0 - 56 y = 140X + 1.5 Sumari et al., (1969 (Finland) 45 .002-.80 20-325 y = 260 x + 0 Tsubeky, 1972 (Japan) The data presented by Tsubaki included 45 persons from the Niigata area with more subjects in the very high range (seven subjects above 180 µg/g hair). Hair levels at a steady state were approximately 250 times as high as levels in whole blood. Levels of mercury in hair and whole blood of patients with methylmercury poisoning in Niigata were determined in a follow-up investigation extending over many months after the onset of clinically overt poisoning (Tsubaki, 1972). The decrease of mercury levels in hair of eight patients studied corresponded to a biological half-life of 50-108 days (median 66 days), and in the blood of seven patients studied of 35-137 days (median 55 days). These figures are of the same order of magnitude as those reported from experiments with CH3Hg203 in man in healthy subjects Ekman et al., 1968a, 1968b; Miettinen et al., 1971; Birke et al., 1967; Tejning, 1969a, 1969b, 1969c) and from data on persons in Sweden who stopped eating methylmercury-contaminated fish (Berglund et al., 1971). Extrapolation of the mercury levels in the Niigata patients to the time of onset of symptoms indicated that poisoning occurred at mercury levels in the hair between 200 and 1000 µg/g but in one case the hair level was as low as 50 µg/g. Similar extrapolation of the blood data indicated that poisoning occurred at mercury levels in whole blood between 0.2-2.0 µg/g. More than 100 persons with hair levels of 50 µg/g have been found in Japan, in areas where fish was contaminated by methylmercury. Of these persons, six in Minamata and 17 in Niigata had blood levels above 0.2 µg/g. In Sweden and Finland mercury levels in blood above 0.2 µg/g were found in five persons, two of which had O.6-0.7 µg/g. None of these persons had any detectable evidence of methyl-mercury poisoning. Relationship to intake of mercury from fish The intake of mercury through the consumption of fish and levels of mercury in blood cells or hair has been studied in subjects without clinical evidence of poisoning and the following relationships established. No. of Hg intake Hg in blood Hg in hair Reference subjects mg/day (x) Cells µg/g (y2) µg/g (y1) 6 + 26* 0-0.8 Y1 = 1.4X + - Birke et al., 0.003 1967 139 + 26* 0-0.4 y1 = 0.6x + - Tejning, 1967; 0.011 1969a, b, c 735 0-0.8 - Y2 = 150X + Kojima & Araki, 1.66 1972 * 26 cases from Tejning's non-fish consumers (1969a, b, c; 1970). Since mercury in fish is largely in the form of methylmercury, the proportion of the total body burden of mercury present as methylmercury also increases with the degree of exposure. Conclusions The most reliable data for the toxicological evaluation of mercury in fish derive from adults with neurological involvement. The lowest mercury levels associated with the onset of clinical disease have been reported to be 50 µg/g in hair and 0.2 µg/g in whole blood, corresponding to 0.4 µg/g in blood cells. These levels would seem to represent individuals on the lower end of a distribution curve of methylmercury levels in blood and hair in the population exposed in Niigata. These individuals were considered to be more sensitive to the action of methylmercury and this assumption is supported by the observation of a number of persons in Japan and other countries with higher mercury levels in hair or blood but without clinical features of intoxication. On the other hand, the presence of methylmercury poisoning can only be diagnosed clinically because there are no specific laboratory tests for its early detection. The occurrence of prenatal intoxication also calls for caution. Clinical data from Japan indicate that the foetus is more sensitive than the mother. The significance of the morphological changes seen in chromosomes of circulating lymphocytes in a few individuals with a high methylmercury blood level is not known at present. Due to the uncertainty and indirect nature of relationships calculated between intake of mercury through fish, levels of mercury in "indicator organs" and mercury levels when poisoning develops, any evaluation must be provisional at present. EVALUATION Lowest Hg levels at onset of poisoning in adults with neurological involvement: 50 µg/g hair and 0.4 µg/g blood cells. Estimated intake of mercury, mainly as methylmercury compounds, causing poisoning; 0.3 mg/day over prolonged periods. PROVISIONAL TOLERABLE WEEKLY INTAKE: 0.3 mg total mercury, of which no more than 0.2 mg should be present as methylmercury, CH3Hg+, (expressed as mercury). This corresponds to a provisional tolerable weekly intake of 5 µg/kg body-weight of total mercury, of which no more than 3.3 µg/kg body-weight should be methylmercury compounds (expressed as Hg). This evaluation is based on a high total mercury intake in the diet, due to the consumption of fish containing high levels of methylmercury compounds. Where high total mercury intakes occur for other reasons, (for example due to inorganic mercury as a consequence of local natural conditions) the evaluation does not necessarily apply and the whole situation has to be reconsidered on its merits. When the total mercury intake in the diet is found to exceed 0.3 mg per week it would be advisable to undertake analyses for methylmercury. Other suitable investigations should be instituted and all possible steps taken to keep the levels of methylmercury as low as possible. 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See Also: Toxicological Abbreviations Mercury (EHC 1, 1976) Mercury (ICSC) Mercury (WHO Food Additives Series 13) MERCURY (JECFA Evaluation) Mercury (UKPID)