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MERCURY EXPOSURE IN LARUE COUNTY - NOVEMBER 2004. ASHOKA INDUKURI Senior Epidemiologist Lincoln Trail District Health Department. NOVEMBER 10 TH 2004. 15yr old student brought a vial of mercury onto the school bus and into the Larue county high school.
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MERCURY EXPOSURE IN LARUE COUNTY- NOVEMBER 2004 ASHOKA INDUKURI Senior Epidemiologist Lincoln Trail District Health Department
NOVEMBER 10TH 2004 • 15yr old student brought a vial of mercury onto the school bus and into the Larue county high school. • School officials notice around 15 students playing with Liquid Mercury in the Cafeteria. • Mercury secured by school officials.
NOVEMBER 10TH 2004 • Cafeteria closed immediately. • Basic cleaning procedures performed on Exposed students. • Local Health Department, EPA and Emergency Management notified. • EPA officials secure the school and school closed for next 2 days for cleaning and to limit exposure.
NOVEMBER 10TH 2004 • Education material about Mercury exposure, health effects and treatment sent Local health director Joyce Walsh. • School officials notify the parents and advice them to seek medical attention if their child needs any testing for mercury exposure.
November 11-15th 2004 • US EPA, KDEP perform testing and cleaning of school, school buses and other facilities. • District health department contacts state for advice regarding testing the exposed students and family members. • Kentucky Regional Poison center informed about the spill.
NOVEMBER 11-15TH • Initial investigation of the 15yr old boy reveals that the Mercury has been stolen from a Dentist’s office on November 9th . • Blood and Urine samples has been ordered for all the family members living in a mobile home. • Close contacts include Three adults and 6 children (14yrs-5 yrs) • Family members relocated to a motel in Elizabethtown to facilitate clean up of the mobile home.
Mercury Spill Investigation • Further questioning of the boy reveals that he had mercury with him for more than an year( Taken from the Dentist’s office in August 2003 visit). • Several children in the family experienced headaches, itchy rashes and mild tremors.
Mercury Spill Investigation • One of the family members(13yr old girl) has experienced several months of mysterious illness (unexplained tachycardia, hypertension , rashes, muscle pain, tremors, insomnia desquamatization of soles and palms) in Late 2003 and admitted to hospital in Louisville for 30days. • Mercury exposure was not on differential diagnosis at that time.
Mercury Spill Investigation • Boy admits spilling some of the mercury in the family car of a close friend in October / November 2003 • Investigation of the “Close friend’s” family confirms the incident. Four family members potentially exposed. • All four contacts ordered testing for Blood and Urine samples. • Additional 12 people who spent substantial amount of time in the mobile home interviewed and advised to contact their health care provider.
Mercury Spill Investigation- Lab Results • The blood an urine samples reveal substantial mercury exposure in family members. • Blood mercury levels ranged from 32 – 72 micrograms/liter (normal:0-10ug/l) • 24hr Urine mercury concentrations ranged from 28-496 micrograms/liter (normal:0-19ug/l)
Mercury Spill Investigation- Lab Results • Lab tests reveal direct relation between Time spent in the mobile home and Mercury levels in blood and urine. • The 15yr old boy has highest Mercury concentrations in both blood(72ug/l) and urine (496ug/l). • All other contacts tested negative.
Mercury Spill Investigation- EPA Investigation Results • Family’s mobile home and possessions were destroyed(ambient mercury was >50,000ng/m3 initially and 11,550ng/m3 later) • NORMAL--<3,000NG/m3) • Family van and vehicle cleaned and returned to family. • Additional car (family of Boy’s friend) destroyed
Mercury Spill Investigation-Treatment • All children treated with chelation therapy with Succimer. • Three adults in the family treated by multiple chelation sessions. • All contacts are advised to take the advise of their healthcare provider if they develop any signs and symptoms.
Mercury Spill Investigation-Agencies involved • Larue county health department • Larue county Emergency Management • Lincoln Trail District Health Department • Kentucky Department of Public Health • Kentucky Regional Poison Center • US EPA and KDEP
CONCLUSION • Increase awareness of school and local public health officials (including ERRT members) about mercury exposure. • Continue to increase coordination and communication between all agencies.
This Article published in MMWR (Morbidity and Mortality Weekly Report) August 19, 2005 / Vol. 54 / No. 32 Link: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5432a2.htm Mercury information links: http://www.epa.gov/mercury/ Useful links