Pediatrics -- A report from the American Academy of Pediatrics addresses the hazards of mercury, and the measures pediatricians can take to reduce children's exposure. One of the chief conclusions is that pediatricians should stop using all mercury-containing devices, including thermometers, and encourage parents to do the same.
According to the report, everyone is exposed to mercury, an environmental toxin. It comes in several forms, and can be found in air, water and food. Significant exposure, whether brief or extended, can produce a broad range of effects on the central nervous system, kidneys, skin and lungs. In children, significant exposure to the central nervous system can result in effects ranging from learning disabilities to devastating neurologic problems including mental retardation, blindness and spasticity.
Because recent research has led to greater appreciation of mercury's toxicity, there have been growing efforts to limit exposure from all sources. For children, these efforts have centered on reducing mercury exposure in its organic form by limiting consumption of contaminated fish such as tuna and swordfish, and fish caught from mercury-contaminated waters. The AAP has also joined with the Public Health Service to reduce the use of thimerosal, a mercury-containing preservative, from vaccines.
Conclusions from the report include:
- Although the amount of mercury in a single thermometer is usually insufficient to produce clinically significant exposure when ingested, if the thermometer breaks, the mercury vaporizes and can be inhaled, causing toxicity. As a result the statement calls for an end to the use of all mercury-containing thermometers.
- Elemental mercury (mercury that is liquid and vaporizes at room temperature) should not be present in places where children live and play. Pediatricians need to be aware of traditional folk uses of mercury such as those practiced by some immigrants from Caribbean cultures, and be sensitive to families that use them. Public health agencies, community organizations, pediatricians and other child health providers should work together to identify the diverse cultural practices that may lead to mercury exposure.
- Parents can reduce children's exposure to methylmercury (mercury in the air which has been deposited in the water) by limiting consumption of fish with high mercury content consumed during pregnancy and lactation, and amounts eaten by children.
- In response to the FDA Modernization Act of 1997, the FDA is reviewing the use of mercury in biologic and pharmaceutical products.
As a precautionary measure, thimerosal, a mercury-containing preservative is being eliminated from vaccines as quickly as manufacturers can alter their production processes and obtain FDA approval. Currently, none of the vaccines in the recommended childhood immunization schedule contain thimerosal as a preservative.
The American Academy of Pediatrics is an organization of 55,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults.
