Mercury and Arsenic poisoning

1. Mercury and Arsenic poisoning Everyone reacts differently

2. Sources • Food • Air • Water

3. Food sources • Seafood – seawater has low conc of Hg • Seafood – up to 1 ppm • Grass – does not accumulate Hg • Grazing animals – low accumulation

4. Environment • Mercury(I), Hg22+ • Mercury(II), Hg2+ • Solubility, HgS • Organomercury • Mercury in the air • From Coal plants and waste incineration • Use of plants to detoxify soil

5. Other sources • Dental fillings • Calomel, Hg2Cl2 • Mercury spills in the laboratory • Medications

6. Medications • Mercury with sugar – laxative • Calomel – skin rash and laxative • Mercury with chalk (grey) – laxative, syphilis • Mercury(II) cyanide – eyes • Mercury(II) iodide – ringworm, disinfectant • Mercury (II) nitrate – remove warts • Mercury(II) oxide - eyes

7. Biochemistry • As liquid • Attaches to S of peptides • Attaches Na/K-ATPase – nerves, twitching • Kidneys, liver • Inhibits formation of myelin • Pink disease – coloring of fingers, toes, nose, cheeks

8. Mad hatters • Dentists • Detectives – use of grey dust for fingerprints • Mining of cinnabar (HgS) • Extract and purify gold (as an amalgam) • Lab equipment – thermometers, barometers, switches, explosives, batteries • Chlor-alkali plants

9. Organomercury • Frankland labs (1865) – 10 days, 1 year • Arthur H (1940) – survived • Two secretaries (1942) • Karen Wetterhahn (1997) - ~1 month • Autism and thimerosal • Fish – Minamata disease • Chelating agents

10. As a poison • Mercury cyanide • Calomel • Since all react differently, hard to determine the lethal dose

11. Berlin - Prosecutors in Berlin suspended investigations on Tuesday (Jan 4, 2011) into a suspected mercury poisoning attack on a Russian dissident couple staying in Germany. There were no signs that the couple were deliberately poisoned during their stay, investigators said, adding however that they could not be sure what had previously happened to the couple in Russia. Prosecutors also said they could not rule out 'accidental self- contamination.' The former KGB officer and his wife had been in hiding for several months in Berlin, German daily Bild was due to report in its Wednesday edition. The man, who worked as a journalist in Moscow, reportedly feared that former secret service colleagues wanted to poison him. Media reported that the couple, identified by Focus news magazine as Viktor and Marina Kalashnikov, were fierce critics of the government in Moscow. Tests on them conducted at Berlin's Charite hospital had revealed 53.7 micrograms of mercury per litre in Viktor's blood, and 56 in Marina's. The usual level is between 1-3 microgram per litre. The couple subsequently contacted the police, and an inquiry was launched in late December. Mercury poisoning can lead to kidney failure and speech impediments, among other things.

12. One rainy evening in the gold mining city of Segovia in northeastern Colombia, José Leonardo Atehortua was working late at the refinery — or entable — where miners bring their ores to be processed. Atehortua entered the cramped, concrete room and began his labor — roasting balls of amalgam composed of equal parts gold and mercury, an ancient process used to separate one of the world’s most valuable elements from one of the most toxic.The next thing Atehortua remembers it was morning. He wanted to rise to his feet, to say something, but when he tried to speak saliva poured uncontrollably over his lips and down his chin. He had tunnel vision. He was unable to move his eyes. His limbs were stiff as a plank. He was lying on a cot in the entable surrounded by men saying “José estáazogado” — Jose is mercuried. The mercury poisoning of Atehortua reflects a growing threat in Colombia and other parts of the world as small-scale gold mining expands in response to rising gold prices. Gold and mercury are interdependent commodities. When the price of gold increases — as it has since 2002 — so does mercury pollution. The source of this pollution is a little known but widely practiced variety of small-scale gold mining, found throughout rural districts of the developing world. To separate precious gold from common stones, small-scale miners cart their ore to town, where it is mixed with mercury in cylindrical mills filled with steel balls that grind the ore into a fine flour. Mercury and gold bind as one, until, sundered by fire, the more volatile mercury is vaporized from the elemental union. The result, in backwater towns like Segovia, can be the exposure of large numbers of people to high levels of mercury vapor, which, in extreme cases like Atehortua’s, can lead to life-threatening mercury poisoning.

13. Hilary Swank has revealed that she suffered mercury poisoning from eating too much fish whilst trying to bulk up for her role in Million Dollar Baby. The 36-year-old Oscar winner said that it took her 'years' to get her health back following her illness in 2004. She had to resort to a high-protein diet in a bid to gain weight and build strength for her role as a female boxer. She explained to You magazine, 'I put on 19 pounds of muscle: I was 29, I was a vegetarian and suddenly I was eating so much fish that I got elevated mercury problems. It plagued me for a couple of years after that movie.

14. Arsenic – first discovered about 1250 AD but had been used as a poison for centuries back to the Romans Was used as a green dye (Paris green), found in shellfish, seawater, When ingested – vomiting, diarrhea, Peppermint lozenges was mistaken for calcium sulfate which was being substituted for sugar (1858) Beer containing arsenic (1900) Baby powder (1952) substituted for zinc oxide Arsenic eaters (1800) in the Alps between Austria and Hungary Orpiment (As2S3) and realgar (As4S4)

15. As the symptoms of arsenic poisoning were somewhat ill-defined, it was frequently used for murder until the advent of the Marsh test, a sensitive chemical test for its presence. Its use by the ruling class to murder one another and its potency and discreetness, arsenic has been called the Poison of Kings and the King of Poisons. During the 18th, 19th, and 20th centuries, a number of arsenic compounds have been used as medicines, including arsphenamine (neosalvarsan) indicated for syphilis. Arsenic trioxide has been used in a variety of ways over the past 500 years, but most commonly in the treatment of cancer. The high affinity of arsenic(III) oxides for thiols is usually assigned as the cause of the high toxicity. Thiols, in the form of cysteine residues, are situated at the active sites of many important enzymes.

16. Arsenic and many of its compounds are especially potent poisons. Many water supplies close to mines are contaminated by these poisons. Arsenic disrupts ATP production through several mechanisms. At the level of the citric acid cycle, arsenic inhibits lipoic acid, which is a cofactor for pyruvatedehydrogenase; and by competing with phosphate it uncouples oxidative phosphorylation, thus inhibiting energy-linked reduction of NAD+, mitochondrial respiration and ATP synthesis.

17. Hyoscine (scopolamine) • Plant sources (an alkaloid) – deadly nightshade, henbane, jimsonweed, mandrake • Hamlet – ghost of Hamlet’s father tells of being poisoned by the uncle pouring henbane in his ear. • Christie – “Black Coffee” • Dr. Crippen and Belle Elmore (1910)

18. Heroin is mixed ("cut") frequently with other substances primarily to increase its weight for retail sale (e.g., mannitol and starch) and to add pharmacologic effects (e.g., dextromethorphan and lidocaine). During 1995 and 1996, health departments and poison-control centers in New York City (NYC); Newark, New Jersey; Philadelphia; and Baltimore reported at least 325 cases of drug overdoses requiring medical treatment in persons who had used "street drugs" sold as heroin that probably also contained scopolamine, an anticholinergic drug. This report summarizes the clinical and epidemiologic features of these cases, which represent a new type of drug overdose. New York City • On March 16, 1995, eight persons were treated in the emergency department (ED) of a Bronx hospital for acute onset of agitation and hallucinations approximately 1 hour after "snorting" heroin. On physical examination, all these persons had clinical manifestations of anticholinergic toxicity (i.e., tachycardia, mild hypertension, dilated pupils, dry skin and mucous membranes, and diminished or absent bowel sounds); five had urinary retention. All were initially lethargic and became agitated and combative after emergency medical service (EMS) personnel treated them with parenteralnaloxone, which is routinely used for suspected heroin overdose to reverse the toxic effects of opioids (e.g., coma and respiratory depression). All patients received diazepam or lorazepam for sedation, and signs and symptoms resolved during the next 12-24 hours.

19. LH, a 76-year-old Caucasian male, ingested 3 teaspoons (15 mL) of a homemade wine over a 1-h period and became ill. Approximately 1.5 h later, he was taken to the emergency room of a local hospital with symptoms of respiratory distress and weakness. The plant used in making the wine was Angel's trumpet (Daturasuaveolens), which reportedly contains varying amounts of scopolamine and atropine. A sample of the wine was collected and analyzed for these two compounds by reversed-phase HPLC chromatography using 97% methanol-3% deionized water. The filtered wine contained an estimated 29 mg scopolamine/mL, which produced a total ingested dose of 435 mg. No atropine was detected. The scopolamine was confirmed by TLC. An oral dose of 50 mg of atropine sulfate in humans has been reported fatal, but there is no reported fatal dose for scopolamine. The alcohol content and 3.8 pH of the homemade wine may have increased the extraction of this compound from the plant material, and the wine fermentation process may have concentrated the original extract

20. Ricin • Extracted from the castor bean (pulp from 8 beans is toxic) • LD50 of 22 mcg /kg injected or inhaled, 22 mg/kg if taken orally • Inhibits protein synthesis • Is a globular “protein” – 2 chains

21. Chemical warfare / poisonings • KGB – Markov, pellet “fired” from special umbrella – 3 days • Mettetal • Was found in the senate office building in Washington