Mercury poisoning associated with beauty cream - Texas, New Mexico, and California, 1995-1996

Morbidity and Mortality Weekly Report, May 17, 1996

Reported by: JF Villanacci, PhD, R Beauchamp, MD, DM Perrotta, PhD, Bur of Epidemiology, K Hendricks, MD, Bur of Communicable Disease Control, M Rodriguez, MD, Office of Border Health, RJ Dutton, PhD, Environmental and Consumer Health; K Sutton, MS, Public Health Region 8; J Duran, Public Health Region 9110; DM Simpson, MD, State Epidemiologist, Texas Dept of Health. K Richards, Office of Border Health; D Nelson, Div of Epidemiology, Evaluation, and Planning, F Crespin, MD, Public Health Div; CM Sewell, DrPh, State Epidemiologist, New Mexico Dept of Health. M Bartzen, M Ginsberg, MD, San Diego County Health Dept, San Diego, L Senini, Office of Border Health, F Nava, S Richardson, S Waterman, MD, State Epidemiologist, California Dept of Health Svcs. MG Lombera, MD, MA Ruiz, MO, P Cravioto, MS, Director General of Epidemiology, Ministry of Health; O Saldate, National Laboratory of Public Health, Ministry of Health; G Flores, MD, Health Svcs of Tampaulipas, Mexico. Environmental Hazards Epidemiology Section, Health Studies Br Div of Environmental Hazards and Health Effects, National Center for Environmental Health; Div of Field Epidemiology, Epidemiology Program Office, CDC.

Editorial Note: Although the product associated with these three reported cases of mercury poisoning is sold primarily in Mexico, the ongoing investigation also is assessing reports that the product may be sold in the United States in some border-area shops. Furthermore, some U.S. residents residing in the border-area frequently travel to Mexico to purchase pharmaceuticals for use in the United States.

The product label is printed in Spanish and lists 'calomel' (i.e., mercurous chloride) as an ingredient, but does not indicate the concentration. Because mercury compounds are readily absorbed through the skin, Food and Drug Administration regulations restrict the use of these compounds as cosmetic ingredients: specifically, mercury can be used only as a preservative in eye-area cosmetics at concentrations not exceeding 65 ppm (0.0065%); no effective and safe nonmercurial substitute preservative is available for use in such cosmetics.

Urinary mercury concentrations >20 [mu]g/l or >25 [mu]g/g creatinine have been associated with signs and symptoms of mercury poisoning. Chronic exposure to mercury salts can result in central nervous system toxicity, including personality changes; nervousness; irritability; tremors; weakness; fatigue; loss of memory; changes in or loss of hearing, vision, or taste (1); gingivitis; stomatitis; and excessive salivation. In children, mercury poisoning can result in the syndrome of acrodynia, which is characterized by severe leg cramps, irritability, paresthesias, excessive perspiration, pruritus, and painful redness and peeling of the palms of the hands and soles of the feet. Acute poisoning with mercury salts can result in a metallic taste, nausea, vomiting, bloody diarrhea, severe abdominal pain, and tenesmus. Renal damage may include acute tubular necrosis and excessive protein, casts, and red blood cells in the urine. Additional information about mercury poisoning is available from local poison-control centers.