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HISTORICAL NEUROLOGY: Michael J. Doherty The quicksilver prize: Mercury vapor poisoning aboard HMS Triumph and HMS Phipps Neurology 2004; 62: 963-966 [Abstract] [Full text] [PDF]

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The quicksilver prize: Mercury vapor poisoning aboard HMS Triumph and HMS Phipps

Gianpaolo Guzzi   (5 May 2004)

Reply to Guzzi

Michael J Doherty   (5 May 2004)

The quicksilver prize: Mercury vapor poisoning aboard HMS Triumph and HMS Phipps 5 May 2004
Gianpaolo Guzzi, Italian Association for Metal and Biocompatibility Research Via F. Sforza,15 20122 Milan Italy Send Correspondence to journal: Re: The quicksilver prize: Mercury vapor poisoning aboard HMS Triumph and HMS Phipps gianpaolo_guzzi{at}fastwebnet.it Gianpaolo Guzzi	I was interested in the excellent report by Doherty that describes links between mercury vapor exposure and neurologic symptoms among the HMS Triumph’s and HMS Phipps’s sailors. [1] He concludes that elemental mercury vapor is difficult to detect and discusses the symptoms associated with mercury vapor poisoning. I am perplexed by three aspects of Doherty’s article. First, for approximately two decades instruments have been able to detect directly and instantly the mercury vapor as monatomic gas generated from different sources. This is termed mercury vapor monitored onsite. Buildings, ships, and other workplaces can be assayed with these instruments. Second, both whole-blood and plasma mercury levels are believed to be a reliable marker for recent exposure to mercury vapor. This is due to the half-life of mercury vapor in the bloodstream for about two days. [2] Third and somewhat surprisingly, the author does not mention some of the most important neurologic signs and symptoms that affect individuals who have been exposed to mercury vapor during a prolonged period of time. Notably, typical symptoms of individuals who had been exposed chronically to mercury vapor are as follows: erethism, metallic taste in the mouth, asthenic-vegetative syndrome, constricted visual fields, depression, and paresthesias. [3] Neurologically, the early preclinical effects from elemental mercury vapor may be measured by peripheral nerve conduction velocity (NCV) testing. In many cases, there is direct evidence of abnormalities of the NCV. [4] Combined knowledge from neurology and toxicology should provide the diagnostic procedures that would facilitate the diagnosis of neurotoxicity from elemental mercury vapor. References 1) Doherty MJ. The quicksilver prize. Mercury vapor poisoning aboard HMS Triumph and HMS Phipps. Neurology 2004; 23: 963-966. 2) Clarkson TW. The three modern faces of mercury. Environ Health Perspect 2002; 110(suppl 1):11-23. 3) Goyer RA, Clarkson TW. Toxic effects of metals. In: Klaassen CD. Casarett & Doull’s Toxicology: The basic science of poisons. 6th ed. McGraw Hill, 2001. 4) Urban P, Lukas E, Benicky L, Moscovicova E. Neurological and electrophysiological examination on workers exposed to mercury vapors. Neurotoxicology 1996;17:191-6. I have no conflicts of interest connected with this work.
Reply to Guzzi 5 May 2004
Michael J Doherty, Swedish Epilepsy Center 801 Broadway Suite 901, Seattle, WA 98122 Send Correspondence to journal: Re: Reply to Guzzi michael.doherty{at}swedish.org Michael J Doherty	I thank Dr. Guzzi for his comments regarding current strategies of evaluating for mercury toxicity. I've come across two other references worth accessing, the first is a straightforward review, the second an older article addressing the Triumph disaster that I had not previously seen.(5,6) The second piece details signs of mercury vapor overexposure that differ from Guzzi's, but are no less important. Swelling of the head and tongue for instance, or gangrene of the tongue and cheeks are some of the findings. Earles had access to the Ship and Captain's logs. Interestingly, these records add little information. They barely discuss the poisoning, perhaps lending creedence to the Eyewitness account that suggested officers were complicit in disrupting the mercury stores.[1] References 5.)Clarkson TW, Magos L, Myers GJ.The toxicology of mercury--current exposures and clinical manifestations.N Engl J Med. 2003;349:1731-1737. 6.) Earles, MP. J R Nav Med Serv. 1965;51:281-286.