![]() All cars screened negative therefore, screening of any of the children’s homes was deemed unnecessary.Ī case of day care center–associated mercury exposure was defined as a blood or urine mercury level >10 μg/L in a person exposed at the day care center and a diagnosis of mercury poisoning by a medical professional. To determine whether children might have tracked mercury out of the day care center on their shoes or clothes, parents’ cars were screened for mercury. Parents of day care attendees and persons who visited the day care home since July 2015 were informed about the exposure and advised to be screened for heavy metal exposure. ![]() Hillsborough County Child Care Licensing inspected the home on November 25, and the day care center resumed operation on November 30, after the Thanksgiving holiday. The remediation was completed within 2 days, and the home was cleared by EPA to reopen when mercury concentrations were 1.63 μg/m 3, a level consistent with the Agency for Toxic Substances and Disease Registry’s recommended action level for mercury vapors in schools (≤3 μg/m 3) ( 3). The floors were cleaned with an Epsom salt wash, followed by heating and ventilation of the home. The carpet, carpet pads, and other mercury-contaminated household items were removed beads of mercury were observed on the floor when the carpets were removed. EPA estimated that approximately 80 g (6 mL) of mercury were originally in the sphygmomanometer. A small bead of mercury was observed in the sphygmomanometer, which had been stored in the family’s unattached garage after its removal from the home. On November 19, an Environmental Protection Agency (EPA) response team coordinated with local contractors to complete the home remediation. The day care center was immediately closed, and the home’s residents were advised to relocate until remediation was completed. Mercury testing of the day care center was conducted on November 18, and revealed hazardous mercury vapor levels as high as 89 μg/m 3. The day care center owner was not aware that the sphygmomanometer contained mercury, and no loose mercury was observed. The device was removed 3 weeks later because the children had pulled off the two attached hoses. No similar illnesses were reported however, the owner reported purchasing a sphygmomanometer at an antique auction and placing it in the children’s play area in early July, with the intention of providing a realistic experience for learning. The day care center owner was interviewed to identify possible exposure sources and was asked about illnesses among other children and staff members ( 1). On November 19, the child began chelation therapy according to recommendations of the Southeast Pediatric Environmental Health Specialty Unit* and the Florida Poison Information Center Tampa.īecause the patient’s clinical signs and symptoms suggested chronic exposure to mercury vapors, investigators focused on a large family-run home day care center attended by the child ( 2). No apparent exposures were identified, and on November 13, the family’s rented home was tested by the Florida Department of Environmental Protection, which found no evidence of contamination. The patient’s father was interviewed to identify exposures to mercury, such as fish, employment industries or hobbies, or broken mercury-containing items, including thermometers, sphygmomanometers, and fluorescent light bulbs ( 1). Education and regulation of mercury containing items among home day care providers could prevent exposures leading to serious health effects. A home day care center serves as both a home and a business, and hobbies, collections, cultural practices, and occupational exposures of residents in the home might inadvertently expose day care attendees. What are the implications for public health practice?Īlthough the awareness of the dangers of mercury-containing items has increased over time, exposure to mercury can still occur. Exposure continued for nearly 6 months before detection during an epidemiologic investigation. ![]() The owners were unaware that the device was leaking elemental mercury without appearing to be broken. The source of the mercury was an antique sphygmomanometer that was placed in the day care center as an educational toy. ![]() In November 2015, 13 cases of mercury poisoning were detected among attendees and residents of a home day care center after identification of elevated urine mercury levels in a hospitalized child who attended the day care center. Thus, epidemiologic investigations rely on identification of sources of mercury and exposure locations. The relative rarity of mercury toxicity might make attributing clinical signs and symptoms to mercury poisoning difficult. When mercury is spilled indoors it can result in numerous health effects, particularly among young children with developing nervous systems. ![]()
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