Information Sources for Health Professionals
Video - "Choosing Wisely: Recognizing and Preventing Overexposure to Mercury in Fish"
This video provides information for health professionals to improve the diagnosis of methylmercury poisoning from seafood consumption. Two people describe their experiences with methylmercury poisoning and expert physician, Michael Gochfeld, MD, PhD, provides information on how to diagnose and treat this avoidable condition.
Resources and References Recognizing and Diagnosing MeHg Toxicity:
"Recognizing and Preventing Overexposure to Methylmercury: Information for Physicians" provides information on monitoring blood mercury levels in seafood consumers, symptoms of overexposure to methylmercury, and how to guide people to low mercury seafood choices to maximize health benefits. Silbernagel, S.M. et al., Journal of Toxicology,volume 2011 (2011), Article ID 983072, 7 pages, doi:10.1155/2011/983072
Powerpoint presentation, "Recognizing and Preventing Overexposure to Methylmercury: Information for Physicians" provides manuscript content, slightly updated from 2011 publication, in slide format. (9/2013)
Downloadable card with fish choice advice on one side and list of signs and symptoms of MeHg Poisoning on other side. Adjust print size to 4 x 5.5" for 'card'. This card was adapted from tables in the journal article above.
Healthy Fish Choices is an online Continuing Medical Education (CME) Course created at the University of Illinois that provides information on how to promote healthy fish consumption in women and children. It includes in-depth information on contaminants and nutrients and how to maximize benefits.
"Mercury Exposure: Medical and Public Health issues" provides an overview of human mercury exposure pathways but focuses on exposure to methylmercury from seafood consumption, identifies those at highest risk of overexposure in the US, describes appropriate laboratory diagnostic methods, and discusses health implications. Mahaffey, K.R., Transactions of the American Clinical and Climatological Association, Vol. 116, 2005.
"Mercury Exposure: Current Concepts, Controversies, and a Clinic's Experience" describes a chart review study of a clinic's experience with a variety of patients presenting with possible mercury toxicity and discusses how they evaluated their exposures. S.N. Kales, MD, MPH and R.H. Goldman, MD, MPH, "Mercury exposure: Current Concepts, Controversies, and a Clinic's Experience", JOEM, Vol. 44, 2, 2002.
References on Treatment Methods:
Journal of Medical Toxicology published a special issue on the Use and Misuse of Metal Chelation Therapy. December 2013, Volume 9, Issue 4, pp 298-300. There are several articles of relevance in this special issue.The special issue was compiled following a conference held Feb. 29, 2012.
"Mercury Toxicity and Treatment: A Review of the Literature" describes clinical presentation from toxicity from inorganic and organic mercury, laboratory assessment and use of DMPS to assess body burden of mercury. Robin A. Bernhoft, "Mercury Toxicity and Treatment: A Review of the Literature", Journal of Environmental and Public Health, Vol. 2012, Article ID 460508.
"Chelation: Harnessing and Enhancing Heavy Metal Detoxification-A Review" describes use of chelation for metal detoxification includes history of use, lessons learned and controversies surrounding it's use. Margaret E. Sears, "Chelation: Harnessing and Enhancing Heavy Metal Detoxification-A Review", The Scientific World Journal, Volume 2013, Article ID 219840.
"Environmental Determinants of Chronic Disease and Medical Approaches: Recognition, Avoidance, Supportive Therapy, and Detoxification" is a review article about recognzing environmental exposures; includes discussion of clinically relevant considerations. M.E.Sears and S. J. Genius, "Environmental Determinants of Chronic Disease and Medical Approaches: Recognition, Avoidance, Supportive Therapy, and Detoxification", Journal of Environmental and Public Health, Volume 2012, Article ID 356798.
Organizations with information:
Agency for Toxic Substances and Disease Registry
Provides information on all forms of mercury (elemental and inorganic as well as organic) and the medical management of exposures from the different forms.
American Association of Medical Colleges MedEdPortal
"MedEdPORTAL promotes educational scholarship and collaboration by facilitating the open exchange of peer-reviewed health education teaching and assessment resources. MedEdPORTAL is a free and open education resource and publication service provided by the Association of American Medical Colleges in partnership with the American Dental Education Association." "Eating Fish: Maximizing the Benefits and Minimizing the Risks" contains information to help guide patients to healthy seafood choices.
American College of Medical Toxicology
"ACMT is a professional, non-profit association of physicians with recognized expertise in medical toxicology. The College is dedicated to advancing the science and practice of medical toxicology through a variety of activities." A 2012 conference organized by this organization resulted in a special journal issue on metals and chelation therapy.
American Medical Association
Report 13 of the Council on Scientific Affairs "summarizes the key findings of the April 2004 Conference on Mercury: Medical and Public Health Issues, co-sponsored by the EPA and the U.S. Department of Health and Human Services."
Association of Reproductive Health Professionals
Created a “Quick reference guide for Clinicians: Fish Consumption to Promote Good Health and Minimize Contaminants” (2008).
Fish Facts for Health Professionals (2009) is an EPA-funded project that offers four 3-5 minute video modules that cover topics about methylmercury, including: (1) toxicology and epidemiology, (2) hazard identification and exposure assessment, (3) a clinical perspective, and (4) risk communication and fish advisories. A downloadable workbook provides more in depth information.
Health Care Provider Information on all forms of mercury.
New York City Department of Health and Mental Hygiene Guidelines
Conducted a study of blood mercury levels in NYC residents and found that almost 50% of Asians and 25% of adults were estimated to be over the EPA’s recommended blood mercury level. They produced guidelines for physicians and “Information for Health Care Providers on Mercury Poisoning.”
Physicians for Social Responsibility and Association for Reproductive Health Professionals
“Fish Consumption to Promote Good Health and Minimize Contaminants”(2004).