The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #71945

Jane M Hightower, MD, California Pacific Medical Center, 2100 Webster Street suite 418, San Francisco, CA 94115, (415) 923-3025, Jhightowermd@aol.com

Consumption of food containing mercury has been identified as a health risk. The Environmental Protection Agency (EPA) and the National Academy of Sciences recommend keeping the whole blood mercury level < 5.0 µg/L or a hair level <1.0 µg/g. This corresponds to a reference dose of 0.1µg/Kg body weight/day. In a one-year survey of an Internal Medicine practice (n=720) in San Francisco, California, a substantial fraction of patients had diets high in fish consumption; of these, a high proportion had blood mercury levels exceeding the maximum level recommended by the US EPA and National Academy of Sciences. 123 were tested, 93 females and 30 males. Of these, 89 had data that were statistically analyzed. The level ranged from 2.0 to 89.5 µg/L for the 89 subjects. The mean for 66 women was 15 µg/L (sd=15) and for 23 men was 13 µg/L (sd=5). 89% had levels exceeding the Rfd. Some children were >40 times the national mean. Subjects consumed 30 different forms/types of fish. Swordfish had the highest correlation with mercury level. 67 patients with serial blood levels over time after stopping fish showed a decline in mercury. Reduction was significant (p-value <0.0001).

Learning Objectives:

Participants will be able to:
• Describe the impact of mercury exposure, in particular for adults;
• Recognize subtle clinical signs of mercury overexposure in high end consumers of fish; and
• Counsel patients to minimize mercury exposure from fish consumption.

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.