When I was a kid, mercury was fun. I can recall going to the dentist and being given a thimble-sized blob of mercury in a cup, which I could pick up, push around, spill onto the floor, split into several smaller blobs and watch merge with each other. It was unusual stuff, with a consistency half-way between liquid and solid, and unlike anything else in my experience. It easily kept me occupied until it was my turn to see the dentist. Perhaps my dentist and my mother were unaware of the hazards of mercury at the time. Fortunately, it seems to have caused me no harm.
The toxic effects of mercury have become well-known over the last several decades. It would (and should) never be used as a toy for kids now. Mercury poisoning can cause irreversible nerve damage to a developing baby's vulnerable brain and nerve damage leading to numbness, tingling, imbalance, hearing loss and poor vision in adults.
But we are still exposed to mercury from a number of sources as the table below shows.
But just how much exposure to mercury is too much and how far should you go to avoid mercury exposure? These are controversial issues that I'll sort out here.
Consider the following statements:
Each of these may sound reasonable considering that mercury is a known toxin. But how much of a threat to your health do they really pose? Consider what the available research says.
Multiple studies with negative results do not prove that fillings or other sources of mercury are harmless, but at some point it's difficult to ignore the evidence. Perhaps the effect is so small that it's difficult to detect the evidence of harm. Maybe definitive studies on these issues will never be done because of the difficulty and the expense of designing them. Even if you design a study with thousands of people and detect nerve damage or other health problems in people who eat fish compared with people who don't, it might be impossible to link the problems directly to the mercury. Other differences in diet between the two groups could be responsible.
For now it's unclear whether mercury exposure should be on your short list of major health concerns. It's hard to avoid mercury completely, but it's unlikely that you're being exposed to harmful levels unless you eat three or more servings of white tuna a week or you're exposed to mercury regularly at work. One thing is for sure: my kids won't be playing with mercury at the dentist's office.
Robert H. Shmerling, M.D. is associate physician at Beth Israel Deaconess Medical Center and associate professor at Harvard Medical School. He has been a practicing rheumatologist for over 20 years at Beth Israel Deaconess Medical Center. He is an active teacher in the Internal Medicine Residency Program, serving as the Robinson Firm Chief. He is also a teacher in the Rheumatology Fellowship Program.
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