Article

Potential health consequences of applying mercury-containing skin-lightening creams during pregnancy and lactation periods

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Abstract

Many studies have highlighted the widespread use of skin-lightening creams containing mercury by women during and after pregnancy to remove dark spots. Women, especially pregnant and lactating mothers using these products are at risk of mercury poisoning because sometimes it has no clinical symptoms, particularly during early exposure. Studies have shown that prenatal and postnatal mercury exposure can cause permanent neurological damage in children. Furthermore, mercury can cause women infertility and birth defects. Even though several studies have examined the reproductive and/or developmental consequences of gestational and lactational mercury exposure from fish consumption and/or dental amalgam, no studies have assessed the possible effects of the long-term use of mercury-containing skin- lightening products by women of childbearing age on their pregnancy outcome and children’s health. This commentary aims to collate information on the popular use of mercury-containing skin-lightening creams and sheds the light to the readers about the limitations of the available data on its impact during a prenatal and/or postnatal period. There is an urgent need to assess the adverse health effects of applying these products during pregnancy or lactation on child growth and development through birth cohort studies. Until data from these studies are available, women should be advised not to use topical skin-lightening creams during pregnancy and lactation.

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... 11 Some previous reviews have been conducted on the skin bleaching literature. [4][5][6][7][8][9][12][13][14][15] However, with one exception, 8 past reviews have been merely narrative and unsystematic. Further, although several epidemiological investigations have been conducted on skin bleaching practice in various parts of the world, 4,5,8,9,12,14 to our knowledge, no previous review has quantified through a systematic and meta-analytic approach the global prevalence of skin bleaching. ...
... [4][5][6][7][8][9][12][13][14][15] However, with one exception, 8 past reviews have been merely narrative and unsystematic. Further, although several epidemiological investigations have been conducted on skin bleaching practice in various parts of the world, 4,5,8,9,12,14 to our knowledge, no previous review has quantified through a systematic and meta-analytic approach the global prevalence of skin bleaching. ...
... 5,6,9,56 As previously noted, prolonged skin bleaching and the use of toxic and highly potent agents has been associated with various adverse consequences. 4,5,8,12 In line with the above, the high prevalence estimate for patients (21.3%) is reasonable. On the other hand, this cohort may be more likely to suffer from preexisting dermatoses for which skin bleaching agents may be required. ...
Article
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Purpose: To estimate and investigate the global lifetime prevalence and correlates of skin bleaching. Methods: A meta-analysis and meta-regression analysis was performed based on a systematic and comprehensive literature search conducted in Google Scholar, ISI Web of Science, ProQuest, PsycNET, PubMed, other relevant websites and reference lists. A total of 68 studies (67,665 participants) providing original data on the lifetime prevalence of skin bleaching were included. Publication bias was corrected using the trim and fill procedure. Results: The pooled (imputed) lifetime prevalence of skin bleaching was 27.7% (95% CI: 19.6–37.5, I2 = 99.6, p < .01). The highest significant prevalences were associated with: males (28.0%), topical corticosteroid use (51.8%), Africa (27.1%), persons aged ≤ 30 years (55.9%), individuals with only primary school education (31.6%), urban or semi-urban residents (74.9%), patients (21.3%), data from 2010–2017 (26.8%), dermatological evaluation and testing-based assessment (24.9%), random sampling methods (29.2%), and moderate quality studies (32.3%). The proportion of females in study samples was significantly related to skin bleaching prevalence. Conclusion: Despite some limitations, our results indicate that the practice of skin bleaching is a serious global public health issue that should be addressed through appropriate public health interventions.
... The bacterial growth occurring in skin whitening creams could deteriorate the quality of creams and this could happen due to various reasons. The components of creams are the major reason behind the occurrence of bacterial growth [14][15][16]. Among them, water is the main component of skin-whitening creams and inclusion of contaminated water results in the bacterial growth as it provides medium for the growth of bacteria in creams. ...
... Among them, water is the main component of skin-whitening creams and inclusion of contaminated water results in the bacterial growth as it provides medium for the growth of bacteria in creams. Use of contaminated creams on the skin results in various kinds of skin diseases [15]. Thus, it is imperative to determine the microbial count of skin-whitening creams. ...
... The sample cream with the highest mercury concentration was manufactured in India and was the most popular skin-whitening cream among the population of Pakistan. A higher concentration of mercury in SLC obtained from Middle East Asia and Saudi Arabia and was also reported in another study [15]. A high concentration (0.16 to 25.30 mg/kg) of mercury (>standard limit) was estimated in skin-lightening cream samples obtained from the Dar es Salaam market of Tanzania [27]. ...
Article
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Generally white color of the skin is regarded as a feature of superiority and prettiness around the world. Both the males and females in Pakistan apply skin-lightening creams (SLC) but they do not know about the side-effects of their constituents. Skin-lightening products include SLC and related ointments. The SLC are made by mixing fates and water in standard procedure. Here, 20 SLC specimens were obtained and subjected to mercury, hydroquinone and the total plate count (TPC). The hydroquinone in SLC was determined using HPLC, mercury level was assessed by ICP OES and finally TPC were computing by utilizing nutrient media (Agar). The hydroquinone in SLC ranged from 0 to 7.14 ± 0.18% with a median value of 0.33%. In 25% of the studied samples, hydroquinone was not detected, 70% of the samples showed values within the limit and 5% of the samples (1 sample) had a hydroquinone concentration above the permissible limit defined by Pakistan (5%). The mercury ranged 0-7.7 ppm, with a median value of 2.5 ppm. Mercury was detected in 95% of the samples; thus, only 5% of the samples had no mercury. In turn, 20% had mercury within the limit value while 75% of the samples had concentration above the Pakistan standard limit (1 ppm). Moreover, TPC obtained in this study was less than the allowable value set according to European Union (EU). Hence, the SLC samples showed high concentration of toxic constituents which could cause deleterious skin diseases. Government must monitor such kind of cosmetic products regularly in order to reduce the danger.
... Leurs complications sont cutanées (atrophie, infections, irritation, vergetures, retards de cicatrisation, taches indélébiles…) mais aussi générales, en raison du passage des molécules dans la circulation sanguine à travers la peau (augmentation de l'hypertension, du diabète, des risques d'infection, d'ostéoporose, de glaucome ou de cataracte…). La dépigmentation pendant la grossesse peut provoquer des pathologies foetales (Mahé et al., 2007 ;Al-Saleh et al., 2016). Des cas de cancers de la peau ont même été décrits récemment chez des femmes se dépigmentant depuis longtemps en Afrique (Ly et al., 2018). ...
... Des cas de cancers de la peau ont même été décrits récemment chez des femmes se dépigmentant depuis longtemps en Afrique (Ly et al., 2018). Les produits à base de mercure sont potentiellement très dangereux aussi, pouvant induire des complications viscérales, en particulier neurologiques, chez certaines personnes (Al-Saleh et al., 2016 ;Sun et al., 2017). On rencontre plus rarement de telles complications en France. ...
... In fact, mercury's use and marketing in the developing countries is unhindered, and people are frequently unaware of the potential side effects stemming from misuse or abuse. 10 Moreover, hydroquinone is a standard skin-lightening compound found in high-quality SLPs and is also associated with dermatological side effects following misuse and abuse. 11 Among these side effects is exogenous ochronosis, where the application site of hydroquinone cream becomes progressively darker, leaving a perplexing paradoxical result of the intended desire. ...
... In fact, high mercury concentrations well above the (FDA's) limits were found in about 45% of the examined SLPs sold in Saudi markets for more than a decade. 10 Moreover, coupled with our finding, 23% (88) of the participants used a product containing mercury as an active ingredient. ...
Article
Background Women are adopting skin‐lightening practices worldwide in an attempt to enhance their skin tone. The reasons and beliefs behind such practices vary from culture to culture. Scarce data are available for this phenomenon among Saudi women. We carried out this study to determine the practices, reasons, and correlates of skin‐lightening practices among women in the northern region of Saudi Arabia. Method Using nonprobability convenient sampling, an analytical cross‐sectional study was carried out among women attending two multispecialty hospitals in the Al‐Jouf region. A prevalidated, self‐administered questionnaire containing 35 items about demographic characteristics, skin‐lightening practices, knowledge of skin‐lightening products (SLPs), reasons, and perceptions about lighter skin tone was used to collect data. Results Among 605 sampled women, usage of skin‐lightening practices was found in 382 participants (63.1%). All participants had relatively lighter skin. Skin type and education affected skin‐lightening practices significantly (P values = 0.002 and 0.012, respectively). The prevalent reason for using SLPs was cosmetic (66%). One‐third of users faced side effects from these products. The SLP users believed that lighter skin tone plays a role in self‐esteem, perception of beauty, social class, marriage, and employment opportunities (P values < 0.01) as compared to nonusers. Media was found to influence the use of SLPs (P values < 0.001). Conclusion Skin‐lightening practices are prevalent among Saudi women. Such practices are reinforced by a belief that fairer skin is associated with beauty, self‐esteem, and financial and social advantages. A public health educational campaign is needed to decrease the usage of SLPs.
... Mercury has historically been used as a key ingredient in skin-lightening products. However, the health hazards of mercury resulted in its elimination from skin-lightening products in many countries in recent decades (12)(13)(14). The use of other hazardous chemicals, such as hydroquinone in skinlightening products, have also raised public concern about their dangers to health and emphasizes the importance of government regulations (15,16). ...
Article
Background/aim: Natural skin whiteners have been investigated for centuries. The development of preparations that safely achieve whitening of hyper-pigmented skin lesions is a challenge for the cosmetics industry. Furthermore, promoting rapid wound healing and minimizing inflammation in injured skin are key to prevent from abnormal pigmentation in scar tissue. Natural products, including the fungus Tremella fuciformis (TF), are attracting attention as potential sources of lead compounds for these applications. Materials and methods: We investigated the in vitro effects of TF on melanogenesis in murine B16F10 cells. Melanin and tyrosinase levels were measured after treatment with TF. Wound healing in human keratinocytes (HaCaT) and fibroblasts (Detroit 551) was also determined via cell migration assay prior to TF exposure. Results: TF significantly decreased melanin content and tyrosinase expression in a concentration-dependent manner in B16F10 cells. Furthermore, TF promoted wound healing in human HaCaT keratinocytes and Detroit 551 fibroblasts. Conclusion: TF proved effectively on inhibiting melanogenesis and promoting wound healing in vitro, demonstrating its potential as a novel skin-whitening agent. However, further clinical studies of safety and efficacy are required.
... Exposure to Hg occurs by inhalation (metallic Hg vapor/ionized Hg), ingestion (methylmercury-MeHg), through the skin in cosmetic products (skin-lightening creams), and injection (ethylmercury-EtHg ). Skin-lightening creams are used by pregnant and lactating mothers (Al-Saleh, 2016) and thimerosal-containing vaccines are given to pregnant mothers, newborns, neonates, and children (Marques et al., 2016) in less developed countries. We do not have established criteria for neurologic diagnosis due to low doses of these types of Hg exposure. ...
... As sustained by Woods and coworkers, Hg is a serious toxic pollutant for the pathogenesis of neurodevelopmental disorders and in this sense, at-risk subjects are mainly pregnant women, particularly if bearing a genetic predisposition and their newborns/children. Several industrialized countries have fundamental guidelines for preventing subjects in pregnancy to be treated with Hg-containing dental filling during the gestational period, but these guidelines are rarely observed in developing countries and therefore represent a major concern (Hujoel et al., 2005;Al-Saleh, 2016;Dórea, 2016). Also, previous research has already revealed a dose-response relationship between increasing prenatal exposure to Hg from maternal dental amalgams and autism severity (Geier et al., 2009b). ...
Article
Cite as Bjørklund G, Bengtsson U, Chirumbolo S, Kern JK. Concerns about environmental mercury toxicity: do we forget something else? Environ Res. 2016 Sep 8. pii: S0013-9351(16)30398-X. doi: 10.1016/j.envres.2016.08.038. [Epub ahead of print] PubMed PMID: 27616662.
... In children, it has been ACCEPTED MANUSCRIPT ACCEPTED MANUSCRIPT 6 observed that the most popular symptoms of toxicity are pruritic rash and skin itching with dermatitis [18,19]. Even during pregnancy, toxic effects of Hg have been proved, when some women use creams on their body [20]. This condition causes development of poorly identifiable erythematous eruption and thus induce edema, in addition to that face skin eruptions, palms and soles take place. ...
Article
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Mercury (Hg) is toxic and hazardous metal that causes natural disasters in the earth's crust. Exposure to Hg occurs via various routes; like oral (fish), inhalation, dental amalgams, and skin from cosmetics. In this review, we have discussed the sources of Hg and its potential for causing toxicity in humans. In addition, it's bio-chemical cycling in the environment; its systemic, immunotoxic, genotoxic/carcinogenic and teratogenic health effects; and the dietary influences; as well as the important considerations in risk assessment and management of Hg poisoning have been discussed in detail. Many harmful outcomes have been reported which will provide more awareness.
... Moreover, the aforementioned metals penetrate the blood-brain barrier, which can negatively impact critical neurological functions (Karri et al., 2016;Xu et al., 2018). Furthermore, there is a significant risk of metals passing through the placental barrier or into breast milk, which may have serious health consequences for the offspring of women using skin lightening products (Al-Saleh, 2016;Caito and Aschner, 2017;Hon et al., 2017;Milton et al., 2017;Rebelo and Caldas, 2016;Rzymski et al., 2015;Sanders et al., 2015). ...
Article
Background: There is an urgent need to address the safety problems caused by the use of skin lightening cosmetics. Evidence suggests that some of them may contain heavy metals. Objectives: We conducted a systematic review of global legal regulations regarding the permissible level of mercury, lead, arsenic, and cadmium in cosmetic products, with particular emphasis on skin lightening preparations. Methods: The systematic search of documents was a two-stage process. First, official websites of 17 regional organizations and subsequently regulations for countries with a population over 100 million were searched. Results: Fifteen legislative acts, encompassing more than 67·2% of the global population were reviewed. Regulations were identified for 44/59 high income countries, 16/55 upper middle income countries, 9/45 lower income countries, 0/34 low income countries. The median adult literacy rate was 91·4% and 64·2% in countries with and without regulations, respectively. The use of mercury, lead, arsenic, and cadmium has been banned in 67, 67, 65, and 65 out of 69 countries, respectively. Conclusions: While regulations exist in most of the high income countries, in low income countries there is a lack of similar standards. In most countries for which these legal regulations have been identified, restrictions on the permissible level of heavy metals are strict. There is a need for enforcement of existing rules, and rigorous assessment of the effectiveness of these regulations.
... Of primary concern is the fact that 13% of our participants used skin bleaching products while pregnant and/or possibly breastfeeding. This finding is consistent with prior studies [6,45,46] and highlights the existence of prenatal and postnatal exposure to Hg, HQ, and other potentially harmful chemicals in skin bleaching products [27,31,32,[47][48][49], for which the neurodevelopmental and other effects on offspring remain understudied. The vulnerability of the fetus and young offspring to the adverse health effects of skin bleaching during such a sensitive period of their growth and development deserves urgent attention from the public health community, especially given the rising global incidence and prevalence of this practice. ...
Article
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Introduction The application of skin bleaching products to inhibit melanogenesis is a common practice within the African diaspora. Despite the adverse health effects of skin bleaching, rigorous studies investigating skin bleaching behavior among these populations in the United States are limited. In our P30 pilot study, we explored predictors of skin bleaching practice intensity among African and Afro-Caribbean women. Methods In collaboration with our Community Engagement Core, we conducted a cross-sectional study to investigate the relationship between demographic and psychosocial predictors and skin-bleaching-related practice patterns among African and Afro-Caribbean women in New York City. Results Among the 76 participants recruited, the median age at the initiation of skin bleaching was 19.5 (16–25) years, yielding a median duration of 13.5 (6–23) years. Although pregnant women were not actively recruited for the study, 13.2% (n = 10) of the participants used skin bleaching products while pregnant or possibly breastfeeding. Nativeness and education were associated with various components of skin bleaching practice intensity, including duration of skin bleaching, daily use of products, and bleaching of the entire body. Participants’ perceived skin-color-related quality of life was not associated with skin bleaching practice intensity. Conclusion Skin bleaching is a habitual practice that likely requires culturally sensitive interventions to promote behavioral change. The existence of prenatal and postnatal exposure to mercury, hydroquinone, and other potentially harmful chemicals in skin bleaching products highlights an urgent need to explore the adverse effects of skin bleaching practices on birth outcomes and the growth and neurodevelopment of young babies.
... Mercury is a ubiquitous toxic heavy metal, and people are exposed to mercury by contact with contaminated food, water, air [6], skinlightening creams [7], and amalgam dental fillings [8]. The U.S. Agency for Toxic Substances and Disease Registry has ranked it in the top three priority pollutants that have a great impact on human health [9][10][11]. ...
Article
Mercury is a ubiquitous toxic heavy metal associated with an increased risk of female infertility; however, the evidence supporting this is limited and controversial. We aimed to explore the relationship between the total blood mercury and infertility in 1796 selected participants from the National Health and Nutrition Examination Survey (NHANES) (2013-2016). We found no significant association between mercury and infertility based on a fully-adjusted model (OR 1.04; 95% CI 0.91, 1.19), and the results remained robust in a series of sensitive analysis. However, a non-linear relationship was detected. By a two-piecewise linear regression model and recursive algorithm, we identified an inflection point of 5.278 μg/L, when blood mercury was >5.278 μg/L, a 1-unit increase in mercury (log2) was associated with 157% greater adjusted odds of infertility (OR 2.57; 95% CI 1.12, 5.87). Our findings provide new insights to advance the research of the link between mercury and infertility.
... It is well known that heavy metals are very harmful to the human body. Among such metals, mercury is the most widely used heavy metal, and it is used in the manufacture of compact fluorescent-lamp light bulbs, jewelry, thermometers, blood pressure monitors, and silver dental fillings [1]. Mercury ions (Hg 2+ ) are the general form of mercury and these can cause various diseases, such as hypertension, enteritis, bronchitis, and pulmonary edema [2]. ...
Article
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A highly sensitive self-powered photoelectrochemical (spPEC) sensing platform was constructed for Hg2+ determination based on the g-C3N4-CdS-CuO co-sensitized photoelectrode and a visible light-induced redox cycle for signal amplification. Through successively coating the single-layer g-C3N4, CdS, and CuO onto the surface of an electrode, the modified electrode exhibited significantly enhanced PEC activity. The microstructure of the material was characterized by scanning electron microscopy (SEM), X-ray diffraction (XRD) and Fourier transform infrared spectroscopy (FT-IR). However, the boost in photocurrent could be noticeably suppressed due to the consumption of hole-scavenging agents (reduced glutathione) by the added Hg2+. Under optimal conditions, we discovered that the photocurrent was linearly related to the Hg2+ concentration in the range of 5 pM–100 nM. The detection limit for Hg2+ was 0.84 pM. Moreover, the spPEC sensor demonstrated good performance for the detection of mercury ions in human urine and artificial saliva.
... More specifically, the use of skin-lightening products containing inorganic mercury may lead to central nervous system, gastrointestinal and renal toxicity (Chan, 2011). For this reason, the sale of skin-lightening products containing inorganic mercury was prohibited in many countries (Al-Saleh, 2016). Despite repeated warnings of mercury poisoning by health authorities and the ban against the sale of skin-lightening products containing inorganic mercury, these products are widely available for sale in pharmacies, beauty aid stores and on the internet (Hamann et al., 2014). ...
Article
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Inorganic mercury compounds have been used in skin-lightening products since ancient times. Although a previous study demonstrated that mercury impeded the transfer of Cu2+ to the apotyrosinase, the effect of mercury on tyrosinase is still unclear. In the present study, the mechanism of mercury chloride (HgCl2) induced inactivation of tyrosinase was investigated for the first time. The IC50 values were 29.97 and 77.93 μmol/L for monophenolase and diphenolase, respectively. A kinetic analysis revealed that HgCl2 inhibited tyrosinase activity in an irreversible non-competitive manner. The strong intrinsic fluorescence quenching suggested that the formation of the HgCl2-tyrosinase complex induced conformational changes of the enzyme, and HgCl2 had only one single binding site or a single class of binding site on tyrosinase. The molecular docking and further experiments demonstrated that HgCl2 bound to the amino residuals (His) in the catalytic center of tyrosinase. To our knowledge, these findings presented in this paper were the first evidence of the direct interactions between HgCl2 and tyrosinase, which provided a deep understanding of the inhibition mechanism of mercury on tyrosinase.
... The harmful effects of active ingredients in these products have been scientifically proven to result in cutaneous complications as well as conditions such as skin cancer, liver damage, kidney failure, hypertension, diabetes, depression, and blindness [49]. In cases of pregnant users of skin-bleaching products, outcomes such as stillbirth, low birth weight, and neonatal infections may be experienced [50][51][52]. Skin bleaching is a public health menace in Africa given both its prevalence and its impact on women and children. The economic impact of treating users of skin-bleaching cosmetics on individual patients, communities, and the government is enormous. ...
Article
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Focusing on black communities in Africa, in this paper, I attempt an African bioethico-aesthetic deconstruction of the falsehood in colorist definitions of beauty purveyed by the migration of non-surgical cosmetics to Africa. I provide a novel ethical evaluation of the act of skin bleaching using principles of the African ethic of communion. I argue that skin bleaching is morally wrong to the extent that it promotes disharmonious relations and false identity in the beauty industry in Africa. Drawing on scientific studies that link toxic ingredients in many skin-bleaching products to adverse health effects, I discuss the public health impact of bleaching cosmetics and other problems occasioned by their strategic expansion into African markets. I propose that there is an urgent need for a relational ethic of polycentric governance that would harmoniously regulate the production and distribution of cosmetic products across regions in order to avoid the exploitation of consumers in black African societies, while also protecting consumers' right to make informed choices through education.
... Individuals exposed to 1000 ppm to 38,000 ppm of mercury displayed symptoms of mercury poisoning and ultimately kidney damage, while persons exposed to mercury less than 25 ppm did not display any critical symptoms. 9 Although there were some products in Jamaica containing more than 1000 ppm of mercury, to our knowledge, there have been no reported cases of mercury poisoning as a result of using skin lightening products. The main reported side effects were itchiness and irritability. ...
Article
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Background. Skin bleaching is a major health concern among Jamaicans. A common ingredient in skin lightening products is mercury. Mercury is a toxic substance that can cause damage to the gastrointestinal tract, nervous system and kidneys. Objective. The objectives of this study were to use different analytical techniques to measure mercury concentrations in popular skin lightening products used in Jamaica and to assess individual levels of mercury exposure based on product usage. Methods. Sixty skin lightening products were purchased from different vendors across various locations in Jamaica. Each product was initially screened for mercury using a portable handheld energy dispersive X-ray fluorescence (XRF) analyzer. In addition, 25 out of 60 products were further measured using cold vapor atomic absorption spectroscopy (CVAAS). Questionnaires were distributed to users of skin lightening products to determine their usage patterns. Results. Six products had mercury concentrations above the United States Food and Drug Administration (FDA) allowable limit of 1 ppm, of which three products contained alarmingly high concentrations (i.e. > 400 ppm). The majority of products (57 out of 60) had mercury concentrations below 10 ppm. The mercury concentrations in skin lightening products ranged from 0.05 ppm to 17,547 ppm. In our sample, 51% of women and 49% of men used skin products more than once per day. Conclusions. On average, creams contained more mercury than lotions and soaps. Individuals who use skin lightening products in Jamaica may be at risk for high mercury exposure, as some popular products were found to have mercury concentrations above the allowable limit. Competing Interests. The authors declare no competing financial interests.
... There were frequent reports on cosmetic product violations related to the prohibited ingredients found in the cosmetic that impacted safety; thus, there is the need to obtain information from the regulation and manufacturers' compliance perspectives. This situation indicates that sometimes the halal status of products is questionable because of the use of ingredients such as hydroquinone and steroids as active ingredients which are highly toxic, especially after prolonged applications (21)(22)(23)(24)(25)(26)(27). ...
... A Belgian woman who has been known to use a 1% mercury product for more than ten years (including during pregnancy and lactation) has elevated levels of mercury in her blood (91 g/l) and urine (784 g/g creatinine), and similar levels have been detected in her 3-month-old daughter. Similar systemic mercury toxicity can occur in fetuses and infants as mercury can pass through the placenta and breast milk (Al-saleh, 2016). ...
Article
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Cosmetics can be defined as serving to beautify by imparting or improving the beauty of the human. Men and women use cosmetics products to affect impressions of attractiveness and morality significantly. This review paper discusses the issues faced by the cosmetic industry and consumers in Malaysia. The halal dimensions of cosmetics and personal care products include materials and all manufacturing procedures right up to customer distribution, protection, and product effectiveness tests. Lighter and fairer skin is something that everyone craves. However, some cosmetic products can affect health and affect the economy and research development. Due to increasing local awareness regarding cosmetic products, the government has enforced a law that states all cosmetic sellers must register all cosmetic products before sell in the current market to ensure the consumer can use the quality product. There are also several ways to overcome the challenges and improvements in cosmetic industries implemented by different sectors.
... Other researchers also reported that all tested samples were containing suspected whitening agent such as mercury, hydroquinone or tretenoin in high concentration and without any clear indication on the label (Jose & Ray, 2018;Shams, Khan & Iqbal, 2016& Al Saleh et al, 2012 This situation indicate that the halal status of the products maybe doubted due to the used of mercury, hydroquinone, and steroids as active ingredients which are highly toxic, especially after prolonged applications (Hamann et al., 2014;Ho et. al., 2017;Al-Saleh, 2016& WHO, 2011. Besides, used of additive chemicals are sometimes hazardous and prohibited due to the health risk it possesses (Al-Saleh et. ...
Conference Paper
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Increasingly, nutritious halal products are expected to be extremely favourable for worldwide consumption, but the procedure of halal processed food is considered as prime concern for successful marketing. Jam processing is an ancient food preservation technique that is used to extend and in the meantime, maintain the nutritious quality beyond its storage capacity, as well as, reduce post-harvest losses through ripening. In this work, the raw ingredients utilized in jam processing are from known sources, with no addition of synthetic preservatives, which are of halal derivatives and safe for consumption. This complies with halal standards with hygienic conditions to make the jam confections safe for consumption. Along the above guidelines, the current study focuses on developing and characterising local exotic fruits for jam confections derived from Tarap (Artocarpus odoratissimus), Mata kucing (Dimocarpus longan) and Langsat (Lansium parasiticum). This includes the evaluation of their nutritional composition, sensory, shelf life stability, and quality attributes for the purpose of good manufacturing requirements. Our initial analysis shows that Artocarpus odoratissimus, Dimocarpus longan and Lansium parasiticum possess good characteristics as fruit jam confections. In conclusion, this could represent growth opportunities in the regional/global halal food market.
Article
We previously assessed the exposure of Saudi women to mercury, cadmium and lead based on reference values (RVs) established for other populations experiencing differences in environmental exposure, diet and lifestyle as an indicator of background exposure to pollutants. The present study aimed to (1) calculate RV95 for mercury, cadmium and lead in blood and urine from Saudi women based on the 95th percentile of the metal and its corresponding 95% confidence interval (95%CI) as defined by the German Human Biomonitoring Commission, and (2) compare with RV95s established in other countries. RV95s were derived using data from two different human biomonitoring studies measured three metals in the blood (2005-2006), and both urine and blood (2011-2013) from healthy non-smokers and non-occupationally exposed women living in Al-Kharj and Riyadh. RV95s for mercury, cadmium and lead in Al-Kharj (Riyadh) blood were 5.9 (1.6) μg/l, 1.4 (1.9) μg/l and 4.3 (4.8) μg/dl, respectively. RV95s for urinary mercury, cadmium and lead in Riyadh samples expressed in μg/l (μg/g creatinine) were 2.5 (1.9), 1.2 (0.96) and 14 (10.8), respectively. Values in both matrices remained high even when potential factors such as secondhand smoking, dental amalgam, and/or fish consumption excluded. RV95s for metals in blood were generally higher than in other countries, except for mercury in Riyadh samples, which was also 4-fold lower than in Al-Kharj. However, due to the time lag between the two studies, and since the Al-Kharj study was conducted 13 years ago, the most recent RV95s derived from the Riyadh study are recommended for Saudi women living in the Central region. The RV95s for urinary mercury and cadmium were comparable to other countries, but lead requires closer attention. To our knowledge, this study is the first to propose RV95s for mercury, cadmium, and lead in blood and urine of Saudi women of childbearing age, a population that is highly susceptible to the adverse health effects of these metals.
Article
Background Skin lightening products containing dangerous levels of chemicals pose a serious health concern for consumers. However, to date, the extent of these products in Europe has not been extensively studied. The aim of this study was to determine whether harmful skin lightening products are available for sale in Europe and what violations exist regarding their composition. Materials and methods We queried the Rapex database, which is the rapid alert system for dangerous non-food products among 31 European countries, to identify skin lightening cosmetics reported between 2005 and 2018, and presented a detailed summary of these notifications. Results In the years 2005–2018, of all violations regarding cosmetics, 26.3% concerned skin lightening products. In the database, 266 reports on skin lightening products were identified. Most of the notifications came from Germany (17.29%), France (17.29%), Portugal (15.41%), and the United Kingdom (11.65%). The majority of the registered products originated from non-European countries, mainly the Côte d’Ivoire (29.70%). The major reason for the violation was the content of hydroquinone, mercury, or clobetasol propionate. Conclusions Hazardous skin lightening products that are not in line with European cosmetics legislation are available on the European market. Most of the products are imported. The main risk associated with these products is the content of hydroquinone, mercury, and clobetasol propionate. It is important to bear in mind that this study focuses on the Rapex system and other sources of information may exist. Based on our findings, a more comprehensive evaluation by international authorities is justified.
Article
This follow-up study of 82 children investigated the potential impact of early and recent exposure to mercury and lead on their neurodevelopmental performance at 5-8 years of age (2017-2018). Early exposure of these children to mercury, methylmercury, and lead was assessed during lactation at 3-12 months old, as well as their mother's exposure using measurements from a cross-sectional study (2011-2013). Only infants who failed to pass the neurodevelopment screening tools and/or had elevated mercury were included in this study. Urine and hair were sampled during the follow-up study to assess the children's recent exposure to mercury, methylmercury, and lead. Their cognitive performance and visual-motor integration were also measured using the Test of Non-Verbal Intelligence (TONI) and the Beery-Visual-Motor Integration (Beery VMI), respectively. The association between alterations in urinary porphyrins excretion and exposure to metals was analyzed and their influence on the children's neurodevelopment was explored. Linear regression models revealed a significant negative association between the infants' mercury exposure during lactation and the TONI Quotient (β = -0.298, 95%CI = -4.677, -0.414) and Beery VMI Age Equivalent scores at age 5-8 (β = -0.437, 95%CI = -6.383, -1.844). The mothers' blood methylmercury was inversely and significantly associated with their children's TONI Quotient (β = -0.231, 95%CI = -8.184, -0.331). In contrast, the children's Beery VMI Age Equivalent scores were positively and significantly associated with the hair methylmercury of the mothers (β = 0.214, 95%CI = 0.088, 3.899) and their infants (β = 0.256, 95%CI = 0.396, 4.488). These relationships suggest the presence of negative confounding that we did not take into account. Unlike mercury, there was some evidence that lead in breast milk had an inverse relationship with the children's visual-motor coordination skills. Our study did not show a clear association between children's recent exposure to metals and neurodevelopment. However, a significant inverse association was observed between the TONI Quotient and the interaction of hair methylmercury × ∑porphyrins (ß = -0.224, 95%CI = -0.86, -0.049), implying that porphyrins are a sensitive measure of low body-mercury burden. Although lead induced higher ∑porphyrins excretion in urine (β = 0.347, 95%CI = 0.107, 0.525), their interaction did not influence children's neurodevelopmental scores. The interactions between metals and porphyrins might provide insights into their potential contributory role in the pathogenesis associated with neurological disorders or other diseases. Despite the small sample size of the present study, its findings about the association between toxic metal exposure and the high risk of poor neurodevelopmental performance are worrying, particularly at an early age, and additional research is needed using larger sample sizes.
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Konsep cantik di masyarakat salah satunya memiliki kulit putih dengan cara menggunakan produk pemutih dan pencerah kulit. Namun terdapat sejumlah produk pemutih yang mengandung bahan berbahaya. Pemilihan produk pemutih harus diperhatikan dengan baik dan benar. Tujuan penelitian ini adalah untuk mengetahui pengetahuan dan penggunaan masyarakat mengenai produk pemutih dan pencerah, serta hubungan antara tingkat pendidikan dan pengetahuan masyarakat mengenai produk pemutih dan pencerah. Penelitian dilakukan pada bulan September 2019 menggunakan metode survei, rancangan studi cross sectional dengan teknik purposive random sampling. Responden dalam penelitian adalah wanita berusia 16–35 tahun (n=130). Dari hasil penelitian diperoleh bahwa produk pemutih dan pencerah yang paling banyak digunakan adalah produk komersil teregistrasi BPOM dengan persentase 69,2% (92 responden). Tingkat pendidikan pengguna produk pemutih dan pencerah tertinggi adalah tingkat sarjana dan pascasarjana yaitu dengan persentase 64,6% (84 responden). Rata-rata skor yang didapatkan dari 130 responden adalah 3,8. Sebanyak 87 responden (67%) memiliki skor di bawah 4,6 yang dikategorikan memiliki pengetahuan rendah mengenai produk pemutih dan pencerah. Uji korelasi Spearman menujukkan terdapat hubungan antara tingkat pendidikan dengan pengetahuan responden mengenai produk pemutih dan pencerah (p=0,016). Responden dalam penelitian memiliki tingkat pengetahuan rendah mengenai produk pemutih dan pencerah serta terdapat hubungan antara tingkat pendidikan dengan pengetahuan tentang produk pemutih dan pencerah.
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Whitening cream containing mercury exposure can leads high levels mercury in urine and skin health complained. The aim of this study was to analyze correlation between whitening mercury levels and urine mercury levels among student users whitening cream in FKM Unair. This was a observasional study with cross sectional approach. This study was conducted in 11 undergraduated students of FKM Unair as sample from 12 students who are population by using simple random sampling. Moreover, facial whitening cream measurement used by respondents. Results showed that facial whitening cream as a whole containing mercury with an average 16,325 ppm. Levels mercury in urine of respondents an average 22,455 µg/g creatinin urine. Then the correlated between levels mercury in urine and levels mercury in cream has a value of 0,119. The conclusion of this study is not correlation whitening cream mercury levels with mercury levels in creatinin urine. Users of facial whitening cream is recomended to stop use facial whitening cream containing mercury and replace with natural produk like a mask of the fruit.
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Skin-bleaching practices, such as using skin creams and soaps to achieve a lighter skin tone, are common throughout the world and are triggered by cosmetic reasons that oftentimes have deep historical, economic, sociocultural, and psychosocial roots. Exposure to chemicals in the bleaching products, notably, mercury (Hg), hydroquinone, and steroids, has been associated with a variety of adverse health effects, such as Hg poisoning and exogenous ochronosis. In New York City (NYC), skin care product use has been identified as an important route of Hg exposure, especially among Caribbean-born blacks and Dominicans. However, surprisingly sparse information is available on the epidemiology of the health impacts of skin-bleaching practices among these populations. We highlight the dearth of large-scale, comprehensive, community-based, clinical, and translational research in this area, especially the limited skin-bleaching-related research among non-White populations in the US. We offer five new research directions, including investigating the known and under-studied health consequences among populations for which the skin bleach practice is newly emerging at an alarming rate using innovative laboratory and statistical methods. We call for conducting methodologically rigorous, multidisciplinary, and culturally sensitive research in order to provide insights into the root and the epidemiological status of the practice and provide evidence of exposure-outcome associations, with an ultimate goal of developing potential intervention strategies to reduce the health burdens of skin-bleaching practice.
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Freshwater is a basic essential element necessary to maintain human health. Of the total available water on Earth, only 2.5% constitute as freshwater. This small fraction is rapidly deteriorating due to uncontrolled population, urbanization, industrialization, deforestation, climatic change, and other factors. In the present scenario, over 1 billion inhabitants lack access to freshwater. Heavy metal contamination is one of the emerging causes that have had an adverse impact on human health. Several heavy metals at high doses impose harmful effects to human bodies, while others such as mercury, arsenic, lead, cadmium, and chromium, even in trace amounts, cause delirious effects on the human metabolism, leading to undesirable synergistic consequences. They directly or indirectly cause acute and chronic diseases. Here we intend to describe the causes of water contamination and intoxication mechanism of a few heavy metals along with possible associated health risks by focusing on the heavy metals that induce adverse effects of free radicals on public health and its remediation.
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Exposure through human skin from application of skin lightening creams and soaps (SLCS) based on mercury salts has often escaped attention of environmental scientists. The skin absorption of Hg from an adult on a daily basis in this type of exposure, depending on the product used, can be higher than Hg originated from dental amalgam filling, Thimerosal-containing flu vaccine, and fish-methylmercury. Hg from SLCS is retained more in brain of albino than pigmented animals. Therefore, environmental Hg scientists should be aware of this important but often neglected source of low-dose Hg exposure during pregnancy and lactation when measuring adverse health effects on child growth and development.
Research
This is a monthly list of new papers on key topics: Air Pollution, Bed Bugs, Biosolids, Climate Change, Drinking Water, Food Safety, Health Impact Assessment, Indoor Air, Noise Pollution, Pesticides, Plastics, Shale Gas, Urban Agriculture, WiFi, Wildfire Smoke, Zoonoses. This resource is produced through the National Collaborating Centre for Environmental Health (NCCEH.ca).
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Inorganic mercury, in the form of mercurous chloride, or calomel, is intentionally added to some cosmetic products sold through informal channels in Mexico and the US for skin lightening and acne treatment. These products have led to multiple cases of mercury poisoning but few investigations have addressed the contamination of cream users' homes. We report on several cases of mercury poisoning among three Mexican-American families in California from use of mercury-containing skin creams. Each case resulted in widespread household contamination and secondary contamination of family members. Urine mercury levels in cream users ranged from 37 to 482 µg/g creatinine and in non-users from non-detectable to 107 µg/g creatinine. Air concentrations of up to 8 µg/m 3 of mercury within homes exceeded the USEPA/ATSDR health-based guidance and action level of <1.0 μg/m 3. Mercury contamination of cream users' homes presented a multi-pathway exposure environment to residents. Homes required extensive decontamination, including disposal of most household items, to achieve acceptable air levels. The acceptable air levels used were not designed to consider multi-pathway exposure scenarios. These findings support that the OPEN ACCESS Int. J. Environ. Res. Public Health 2015, 12 10944 calomel is able to change valence form to elemental mercury and volatilize once exposed to the skin or surfaces in the indoor environment.
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A data-driven, high-order vector auto-regressive (VAR) model is evaluated for predicting the Northern Hemisphere summer time (May through September) low frequency (>10 days or so) variability. The VAR model is suitable for linear stationary time series, similar to the commonly used linear inverse model (LIM), with additional temporal information incorporated to improve forecast skill. The intraseasonal forecast skill of the 250/750 hPa streamfunction is investigated using observational data since 1979, which shows significant improvements in high-order VAR models than the first-order model LIM. Furthermore, the tropical diabatic heating is found to significantly improve the forecast skill of the atmospheric low frequency circulation when included in the VAR model. The forecast skill of 250 hPa streamfunction at Arabian Peninsula is particularly enhanced for up to 5 weeks lead-time through circumglobal wave propagation associated with the persistent tropical eastern Pacific and equatorial Atlantic heating anomalies and the intraseasonal evolution of the tropical Indian Ocean and western Pacific heating anomalies.
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A 28-year-old female suffered from nephrotic syndrome after a long-term use of mercury-containing, skin-lightening cream. The blood and urinary mercury content of this patient increased with use. Renal biopsy showed minimal change disease. Her symptoms were relieved 6 months after discontinuing use of the cream and receiving sodium dimercaptosulfonate and glucocorticosteroid treatments. Proteinuria disappeared, and blood and urinary mercury levels returned to normal. Previous reports of nephrotic syndrome caused by mercury-containing, skin-lightening creams have mostly been identified as be.ing due to membranous nephropathy. Minimal change disease has been reported in a few case reports published in the English language. Here we report a case of nephrotic syndrome with minimal change disease following exposure to a mercury-containing, skin-lightening cream. We also reviewed relevant published reports to summarize clinical features and treatments and to explore the possible mechanisms involved.
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Background: Skin-lightening products are increasingly common in European cities. These products may contain substances that are banned under EU regulations as they can induce adverse effects, including cutaneous and systemic reactions (e.g., mercury, hydroquinone and topical corticosteroids). Objectives: To assess the knowledge, attitudes and practices of women regarding skin-lightening products and to quantify the potentially harmful substances in the products used. Methods: We performed a cross-sectional study among 82 non-Italian women visiting an outpatient facility in Rome, Italy. The women completed a questionnaire on product use, side effects and risk awareness. We performed patch tests among a subgroup of 48 women who presented with contact dermatitis. We also quantified the allergenic and toxic substances in the 14 products reported, using dynamic reaction cell inductively coupled plasma mass spectrometry for metals and high-performance liquid chromatography for hydroquinone and topical corticosteroids. Results: Out of the 82 women, 33 used skin-lightening products; about one fourth of these women were aware of potential risks. Three cosmetic creams and two soaps contained high concentrations of metals (Cr, Ni and Pb); hydroquinone was found in three creams and one oil. The only topical corticosteroid detected was dexamethasone, in one product. More than half of the women in the clinical evaluation had irritant contact dermatitis (i.e., negative response to patch test). Conclusions: Among immigrant women in Rome, the use of skin-lightening products seems to be fairly common, and some of these products contain potentially hazardous substances. Consumers must be informed of the potential risks, and EU regulations must be more strictly enforced.
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Fish and other aquatic organisms are important source of dietary proteins for the human population. Fish meat, however, is contaminated with methyl mercury (MeHg), a potent neurotoxin. The well known Minamata and Niigata epidemic outcomes in Japan have raised the awareness of the health risk resulting from consumption of fish (and shellfish) from water basins polluted with industrial wastes containing mercury. In the present study, pregnant rat dams were exposed to environmental toxic elements--methyl mercury, 1000-1200 h, daily from the fifth gestation day (GD5) till parturition. Three groups of animals were given, by gavages, MeHg (0.5, 1.0 and 2.0 mg/kg/day) and control group received 0.9% saline at the same time. All animals were allowed to deliver and wean their offspring. Pups were evaluated for early development effects. There was a significant effect of treatment on somatic growth such as reduction in percentage of maternal weight gain (20.62%) at higher dose level whereas there was no change in percentage of live birth (100.00%) with 0.5 and 1.0 mg/kg dose treatment groups. There was a significant increase in the percentage of resorption (100.00%) per litter with 2.0 mg/kg/day MeHg dose. Average gestation length (days) and percentage resorption per litter or percentage foetuses/malformations per litter were not affected at 0.5 and 1.0 mg/kg/day dose level. The results of the study confirmed the high-teratogenic potential of MeHg and the need of payng increased attention to MeHg concerning its exogenous use during pregnancy.
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A novel and highly sensitive method for the determination of some heavy metals in skin whitening cosmetics creams using multiwalled carbon nanotubes MWCNTs as solid phase extraction sorbent for the preconcentration of these heavy metals prior to their determination by inductively coupled plasma atomic emission spectrometry is described. Different practical parameters have been thoroughly investigated and the optimum experimental conditions were employed. The developed method was then applied for the determination of arsenic, bismuth, cadmium, mercury, lead and titanium in samples of skin whitening cosmetics. The detection limits under these conditions for As, Bi, Cd, Pb, Hg and Ti were 2.4, 4.08, 0.3, 2.1, 1.8, and 1.8 ng·mL-1, respectively. The relative standard deviations (RSDs) were found to be less than 2.0%. For validation, a certified reference material of NIST SRM 1570a spinach leaves was analyzed and the determined values were in good agreement with the certified values. The recoveries for spiked samples were found to be in the range of 89.6-104.4%.
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Mercury is considered one of the most toxic elements for plants and animals. Nevertheless, in the Middle East, Asia and Latin America, whitening creams containing mercury are being manufactured and purchased, despite their obvious health risks. Due to the mass distribution of these products, this can be considered a global public health issue. In Mexico, these products are widely available in pharmacies, beauty aid and health stores. They are used for their skin lightening effects. The aim of this work was to analyze the mercury content in some cosmetic whitening creams using the cold vapor technique coupled with atomic absorption spectrometry (CV-AAS). A total of 16 skin-lightening creams from the local market were investigated. No warning information was noted on the packaging. In 10 of the samples, no mercury was detected. The mercury content in six of the samples varied between 878 and 36,000 ppm, despite the fact that the U.S. Food and Drug Administration (FDA) has determined that the limit for mercury in creams should be less than 1 ppm. Skin creams containing mercury are still available and commonly used in Mexico and many developing countries, and their contents are poorly controlled.
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The most common exposure to mercury is from organic methylmercury found in fish. People with no workplace exposure to mercury typically have low levels of exposure to inorganic or elemental mercury, although nonoccupational exposure can occur from dental amalgams, some herbal medicine products, and cosmetics that contain mercury. When a New York City (NYC) biomonitoring study revealed that thousands of women in that city may have been exposed to dangerous levels of inorganic mercury from imported skin-lightening creams, city health officials enlisted the help of U.S. and international health agencies in getting the creams off local store shelves [EHP 119(2):203–209; McKelvey et al.]. In 2004 the NYC Department of Health and Mental Hygiene (DOHMH) conducted the nation’s first local Health and Nutrition Examination Survey. Analysis of urine specimens from 1,840 adult New Yorkers collected during the survey yielded a geometric mean mercury concentration of 0.73 μg/L, slightly higher than the national average of 0.5 μg/L. The authors took note when 13 women were found to have urine mercury concentrations exceeding the state’s reportable level of 20 μg/L; 4 women had levels exceeding 50 μg/L. All 13 highly exposed women were Hispanic or black, and 10 had been born in the Dominican Republic. Each of the 9 women interviewed on followup had used mercury-containing skin-lightening cream. One such product sampled by DOHMH workers contained 6,190 ppm mercury. The U.S. Food and Drug Administration (FDA) limit for mercury in skin-care products is 1 ppm. Extrapolating from the population sampled, the authors estimate nearly 27,000 New Yorkers may have urine mercury levels exceeding 20 μg/L. Although the researchers did not assess potential health effects among the highly exposed women, occupational studies indicate kidney and neurologic toxicity may occur when urine mercury levels exceed 20 μg/L. City health officials responded to the survey results by seizing 12 brands of illegally imported cosmetics from store shelves. All the products listed mercury as an active ingredient. Press releases issued by the DOHMH urged residents to report mercury-tainted cosmetics and the shops selling them, and New Jersey investigators were enlisted to plug the pipeline to importers in that state. The Pan American Health Organization called on the Dominican Republic to stop manufacturing the dangerous products. The Dominican Secretary of Health reportedly has notified all laboratories to stop manufacturing mercury-containing skin-care products. The authors realize some tainted products may still cross the border, as they have for years despite FDA prohibitions. But they believe their efforts, coupled with evidence of mercury’s toxicity and continued vigilance, will substantially reduce the availability and use of these products.
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Membranous glomerulonephritis (MGN) is the commonest cause of the nephrotic syndrome in adults.1,2 The majority of cases are idiopathic (primary MGN), however ∼30% are secondary to systemic diseases such as SLE, epithelial malignancies, medications or exposure to heavy metals.3 Recently, an autoantibody has been identified in >70% of cases of idiopathic MGN with specificity for the M-type phospholipase A2 receptor (PLA2R).4 Skin-lightening creams, which may contain mercury salts, are widely used in ethnic subgroups where paler skin is seen as a desirable attribute.5 With prolonged use, mercury toxicity can occur, leading to the development of autoimmune phenomena and renal dysfunction.6 We describe two cases of biopsy-proven MGN associated with elevated serum and urine mercury levels in females who used skin-lightening creams containing mercury that had been manufactured in the UK. Neither patient had antibodies against the PLA2R providing further evidence for the specificity of this antibody for primary MGN. ### Case 1 A 44-year-old woman originally from Pakistan was referred for investigation of the nephrotic syndrome. She had peripheral oedema, an albumin of 32 g/l, a plasma creatinine of 95 µmol/l (eGFR59 ml/min/1.73 m2) and a urine protein–creatinine ratio of 1419 mg/mmol (normal <30). Her history included peptic ulcer disease and vitamin D deficiency, which had been diagnosed 4 months before the …
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Mercury is a toxic metal that has been used for centuries as a constituent of medicines and other items. We assessed exposure to inorganic mercury in the adult population of New York City (NYC). We measured mercury concentrations in spot urine specimens from a representative sample of 1,840 adult New Yorkers in the 2004 NYC Health and Nutrition Examination Survey. Cases with urine concentrations ≥ 20 µg/L were followed up with a telephone or in-person interview that asked about potential sources of exposure, including ritualistic/cultural practices, skin care products, mercury spills, herbal medicine products, and fish. Geometric mean urine mercury concentration in NYC was higher for Caribbean-born blacks [1.39 µg/L; 95% confidence interval (CI), 1.14-1.70] and Dominicans (1.04 µg/L; 95% CI, 0.82-1.33) than for non-Hispanic whites (0.67 µg/L; 95% CI, 0.60-0.75) or other racial/ethnic groups. It was also higher among those who reported at least 20 fish meals in the past 30 days (1.02 µg/L; 95% CI, 0.83-1.25) than among those who reported no fish meals (0.50 µg/L; 95% CI, 0.41-0.61). We observed the highest 95th percentile of exposure (21.18 µg/L; 95% CI, 7.25-51.29) among Dominican women. Mercury-containing skin-lightening creams were a source of exposure among those most highly exposed, and we subsequently identified 12 imported products containing illegal levels of mercury in NYC stores. Population-based biomonitoring identified a previously unrecognized source of exposure to inorganic mercury among NYC residents. In response, the NYC Health Department embargoed products and notified store owners and the public that skin-lightening creams and other skin care products that contain mercury are dangerous and illegal. Although exposure to inorganic mercury is not a widespread problem in NYC, users of these products may be at risk of health effects from exposure.
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Although the practice of bleaching is common worldwide, there are few studies that discuss knowledge, attitudes and practices towards bleaching. The aim of this study was to explore the knowledge, attitudes and practices towards the usage of topical bleaching agents among women. A self-administered questionnaire on the use of bleaching creams was distributed randomly to women attending the outpatient clinics at a university hospital in Saudi Arabia during 2008. Five hundred and nine of 620 women responded (82% response rate). All the participants had dark skin (skin type 4-5). The mean age was 29.22 ± 9 years. Of the participants, 38.9% (197/506) were current users of bleaching agents. Only 26.7% (106/397) of the respondents used bleaching agents for medical purposes to treat localized abnormal skin hyper-pigmentation; 20.8% (101/485) were ready to use any bleaching cream that gives fast results, even if the components were unknown. Of the respondents, 30% (152/509) used more than 100 g of bleaching creams monthly. These products were applied to the whole body in 7.3% of the cases. While 10.3% (28/271) continued applying the bleaching products during pregnancy, 20.8% (54/260) did so during lactation. No associations could be found between the various sociodemographic variables and differences in the attitude towards and practice of using bleaching creams. A major proportion of our sample respondents have overused and/or misused bleaching agents. This was regardless of age, income, education or marital status. There is a need to educate women about the possible risks.
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This study deals with the nephrotic syndrome in 34 Malawian Blacks, Plasmodium malariae infection and the use of mercury-containing skin lightening creams (Butone 3) must be included among the usual causes of nephrotic syndrome in the Malawian Black.
Article
The topical steroids betamethasone (BM) and clobetasol propionate (CP) are illegal in cosmetics. Hydroquinone (HQ) and mercury (Hg) are either illegal or allowed only in limited concentrations (2% and 1 ppm, respectively). To investigate active ingredients and countries of origin of popular skin-lightening products available in Cape Town, South Africa. In total, 29 products were examined; of these, 22 products were purchased from informal vendors, and 2 products (out of a total of 29) were purchased over the counter. HQ, Hg(2+) and steroids were quantified by high-performance liquid chromatography-ultraviolet spectrophotometry, inductively coupled plasma-mass spectrometry and liquid chromatography-mass spectrometry, respectively. Of the 29 products, 22 (75.9%), all imported and bought from informal vendors, contained illegal or banned ingredients: 13 (44.8%) contained steroids (9 CP, 4 BM), 12 (41.4%) contained Hg (30-2300 ppm), and 11 (37.9%) contained HQ. Sequentially, the products originated from Italy (27.3%, n = 6), India (22.7%, n = 5), the Democratic Republic of Congo (DRC) (22.7%, n = 5), Cote d'Ivoire (9.1%, n = 2), USA (9.1%, n = 2), UK (4.5%, n = 1) and France (4.5%, n = 1). Two products, one from India and one from the DRC, contained all four ingredients (HQ, Hg, BM, CP). Of the 12 products containing Hg, 10 also contained HQ and/or a steroid, yet none listed Hg as an ingredient. A significant proportion of the steroid-containing products (76.9%) also contained at least one other skin-lightening agent. Not all internationally available products were tested, which is a limitation of the study. In spite of a European Union ban on skin lighteners, a third of the products tested were from Europe. Combinations of Hg and ultrapotent steroids were prominent. International law enforcement and random testing is needed to encourage industry compliance and help protect consumers. © 2015 British Association of Dermatologists.
Article
Cutaneous adverse sequelae of skin lightening creams present with myriad skin complications and affect dermatology practice, particularly in sub-Saharan Africa where such products are widely used, with a prevalence of 25-67%. To examine the skin lightening practices of both African and Indian women living in South Africa. A cross-sectional survey was undertaken in the general outpatient departments of two regional university hospitals in Durban, South Africa. All consenting African and Indian women aged 18-70 years were recruited and asked to complete a questionnaire. Six hundred women completed the questionnaire, of whom 32·7% reported using skin lightening products. The main reasons cited were treatment of skin problems (66·7%) and skin lightening (33·3%). Products were purchased from a variety of sources. Twenty-five percent reported using sunscreen. The use of skin lightening cosmetics is common among darkly pigmented South African women, including those of both African and Indian ancestries. Despite more than 20 years of governmental regulations aimed at prohibiting both the sale of cosmetics containing mercury, hydroquinone and corticosteroids, and the advertising of any kind of skin lightener, they are far from having disappeared. The main motivations for using these products are the desire to treat skin disorders and to achieve a lighter skin colour. Television and magazine advertisements seem to influence womens' choice of these products and, thus, would be efficient channels for raising public awareness about the dangers of using uncontrolled skin lighteners. © 2015 The Authors BJD © 2015 British Association of Dermatologists.
Article
Epidemiological studies finding menstrual cycle abnormalities among women occupationally exposed to Hg° prompted us to investigate the mechanisms of reproductive toxicity of Hg° in the female rat. Nose-only Hg° vapor inhalation exposures were conducted on regularly cycling rats 80-90 days of age in dose-response and acute time-course studies, which have previously proven useful as a model to identify ovarian toxicants. Vaginal smears were evaluated daily and serum hormone levels were correlated with cycle and with ovarian morphology at necropsy. Exposure concentration-related effects of Hg° were evaluated by exposing rats to 0, 1, 2, or 4 mg/m 3 Hg° vapor 2 h/day for 11 consecutive days. Tissue Hg levels correlated with exposure concentration and duration. Exposure of rats to 4 mg/m 3 (but not 1 or 2 mg/m 3 ) Hg vapor for 11 days resulted in significant decreases in body weights relative to controls. Estrous cycles were slightly prolonged in the 2 and 4 mg/m 3 dose groups, and serum estradiol and progesterone levels were significantly different in the 4 mg/m 3 group compared to controls. The alterations in cycle and hormones at the 4 mg/m 3 exposure concentration were attributed to body weight loss and generalized toxicity. In the time-course study, rats were exposed to 2 mg/m 3 Hg° or air beginning in metestrus and evaluated daily for 8 days. A lengthening of the cycle was detected and morphological changes were observed in the corpora lutea (CL) after exposure for 6 days. To determine if changes in the CL and cyclicity correlated with a functional defect, rats were exposed to Hg° vapor and evaluated for pregnancy outcome. There were no significant effects on pregnancy rate or numbers of implantation sites when rats were exposed to 1 or 2 mg/m 3 Hg° for 8 days prior to breeding, or when exposed for 8 days after breeding. These studies indicate that exposure to Hg° vapor altered estrous cyclicity, but had no significant effect on ovulation, implantation, or maintenance of first pregnancy during exposure of short duration in female rats.
Article
Objectives To describe demographic characteristics, patterns of use, and symptoms associated with mercury poisoning among persons who used aMexican beauty cream containing mercurous chloride and to estimate the prevalence of cream use in Texas near the Mexico border. Design Case series and cross-sectional survey. Setting Border communities ofArizona, California, New Mexico, and Texas. Participants Persons who used the cream and contacted a health department in response to announcements about the cream and households that participated in the Survey of Health andEnvironmental Conditions in Texas Border Counties and Colonias, 1997. Mainoutcome measures Urine mercury concentrations, self-reported symptoms, and prevalence of cream use among households. Results Of 330 cream users who contacted their health department, 96% were women, and 95% were Hispanic.The mean urine mercury concentration was 146.7 μg/L (reference range : 0-20μg/L). In 5% of 2,194 randomly selected Texas households near the Mexico border, at least 1 person had used “Crema de Belleza-Manning”(Laboratorios Vida Natural, S.A., Tampico, Tamaulipas, Mexico) in the previous year. Conclusions Most cream users had increased urine mercury concentrations. Cream use was common in Texas near the Mexico border.Physicians should consider toxicity in patients with neurologic symptoms of unclear cause and use public health departments when investigating unusual illnesses.
Article
Total mercury (T-Hg) concentrations were analysed in human hairs and cosmetic products sold in Dar es Salaam Tanzania. The average total mercury (T-Hg) concentrations in the scalp hair of females using mercury based cosmetic creams and soaps ranged from 7.0 ± 0.4 to 880 ± 12 ppm. Highest T-Hg concentrations were found in females who work in beauty hair salons and the lowest concentrations were found among students. The average values in non-cosmetic users were found to be lower, with mercury ranging from 0.57 ± 0.07 to 8.29 ± 1.22 ppm. Analysis of cosmetic products indicated high values, ranging from 0.11 ± 0.03 to 8665 ± 15 ppm in soaps and 0.16 ± 0.02 to 25.30 ± 4.2 ppm in cosmetic creams. Mercury being a cumulative toxin, the findings suggests that women who use mercurial crèmes and soaps are likely to be poisoned as the compounds can enter the body through various pathways, including inhalation of vapor, ingestion, and skin contact. Tanzania Journal of Science Vol. 31 (1) 2005: pp. 83-90
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Women's & Gender Studies. Her research interests include African cultural aesthetics and aesthetic practices, the politics of embodiment and Black identities, transnational skin bleaching, African feminist theory, and critical media literacy. Dr. Blay is the recipient of a 2010 Leeway Foundation Art and Change Grant through which she will publish The Other Side of Blackness, a portrait documentary exploring the intersection of skin color politics and negotiations of Black identity. Abstract The cosmetic use of chemical agents to lighten the complexion of one's skin, also referred to as skin whitening, skin lightening, and/or skin bleaching, is currently a widespread global phenomenon. While the history of skin bleaching can be traced to the Elizabethan age of powder and paint, in its current manifestations, skin bleaching is practiced disproportionately within communities "of color" and exceedingly among people of African descent. While it is true that skin bleaching represents a multifaceted phenomenon, with a complexity of historical, cultural, sociopolitical, and psychological forces motivating the practice, the large majority of scholars who examine skin bleaching at the very least acknowledge the institutions of colonialism and enslavement historically, and global White supremacy contemporarily, as dominant and culpable instigators of the penchant for skin bleaching. As an introduction to this Special Issue of the Journal of Pan African Studies focusing on skin bleaching and global White supremacy, the purpose of this paper is to critically examine the symbolic significance of whiteness, particularly for and among African people, by outlining the history of global White supremacy, both politically and ideologically, discussing its subsequent promulgation, and further investigating its relationship to the historical and contemporary skin bleaching phenomenon.
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Objective: This report examines the source and outcome of four Barbadian women with extremely high hair mercury concentrations (361-5617 µg/g inorganic mercury) due to topical application of mercury containing skin-lightening cosmetics. Methods: Inorganic hair and urine mercury analysis was done at the toxicological centre laboratory of the Institut National de Santé Publique du Québec (Standard Council of Canada accredited). The clinical examinations were performed on location at the Queen Elizabeth Hospital of Barbados. Results: Urine samples [7-135 µg/L, normal < 2 µg/L] revealed elevated mercury concentrations signifying systemic exposure. Reported symptoms during the clinical examination were consistent but nonspecific to chronic mercury exposure. Conclusion: Evidently, cosmetics containing dangerous levels of mercury are still available for purchase in Barbados and should be entirely banned.
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Cosmetic skin lightening is practiced worldwide. Mercury is a well-documented melanotoxin added to some lightening products. However, mercury can cause many dermatologic, renal, and neurologic problems. The Food and Drug Administration limits the amount of mercury in cosmetic products to trace amounts, 1 ppm. The objective of this study was to quantitatively evaluate a large international sample of lightening products for mercury content, focusing on products available to US consumers either online or in stores. A total of 549 skin-lightening products, manufactured in 32 countries, were purchased online in the United States, Taiwan, and Japan and in stores in the United States, China, Taiwan, Thailand, Japan, and Sri Lanka. Cosmetics were screened for mercury content above 200 ppm using a low-cost portable x-ray fluorescence spectrometer. Of the 549 tested products, 6.0% (n = 33) contained mercury above 1000 ppm. In all, 45% of mercury-containing samples contained mercury in excess of 10,000 ppm. Of lightening products purchased in the United States, 3.3% were found to contain mercury in excess of 1000 ppm. Our study did not evaluate creams for other melanosuppressive ingredients. Only 1 sample of each product was tested. Our study confirms the national and global presence of mercury in skin-lightening products.
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Somali women often use creams and soaps to lighten skin tone, fade freckles or get rid of age spots. Use of these products raises a health concern, as some have been found to contain mercury. This article describes an investigation that involved interviewing Somali women about skin-lightening practices and the products they use and then testing those products for mercury. Twenty-seven samples of products purchased at markets in Minneapolis and St. Paul were analyzed bythe Minnesota Department of Health for specific mercury levels. Eleven of the 27 (47%) were found to contain mercury. Some exceeded the current FDA threshold of 1 part per million. This has prompted both state and federal health officials to issue warnings about the use of these products.
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In two female patients chronic mercurialism following topical application of skin bleachers for the treatment of freckles was diagnosed. Over 20 to 25 years 3 to 10% mercurial ointments were applied twice daily. Recurrent attacks of headache, dyspnoea and abdominal colic-like cramps had lead repeatedly to emergency hospitalisations, multiple medical check-ups and surgical exploratory procedures. The diagnosis of mercurialism was made clinically because of a slate-grayish skin hyperpigmentation in the presence of freckles, and the drug-history. Metallic deposits in facial biopsies were demonstrated by electron microscopy. On admission 15.4 µg% and 5.0 µg% total Hg respectively were found in the two patients (normal values up to 2.0 µg%). Following D-penicillamine treatment the mercury excretion via the urine could be elevated up to 25 µg%. Neither the slate-gray facial discoloration nor the neurasthenic complaints were affected by this therapeutic trial. In one patient, a maculo-papular drug-induced skin rash to D-penicillamine developed. Persistent unsolved neurological complaints and cramp-like abdominal pains should remind that percutaneous mercury intoxication through intact skin following skin bleachers is still possible today.
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Mercury exposure during pregnancy can have serious health effects for a developing fetus including impacting the child's neurological and cognitive development. Through biomonitoring in a low-income Latina population, we identified a patient with high levels of mercury and traced the source to face creams purchased in a pharmacy in Mexico.
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The objective of this work was to assess exposure to mercury (Hg) and its induction of oxidative stress in 155 healthy lactating Saudi mothers and their infants. Samples of breast milk and blood were collected from the mothers, while urine was taken from both infants and mothers. Both urinary 8-hydroxy-2′-deoxyguanosine (8-OHdG) and malondialdehyde (MDA) were measured in mothers and infants as biomarkers of oxidative stress. The mean concentration of Hg in breast milk was 1.19 μg/L (range 0.012–6.44 μg/L) with only one mother having Hg >4 μg/L, the upper limit established by the US Agency for Toxic Substance and Disease Registry. However, 57.4 % had Hg ≥1 μg/L, the background level for Hg in human milk. The mean urinary Hg corrected for creatinine (Hg-C) in mothers and infants was 1.47 and 7.90 μg/g creatinine, respectively, with a significant correlation between the two (p p > 0.05). Hg in breast milk, though, was associated with Hg in blood (p 8-OHdG, respectively, in a dose-related manner. These findings reveal for the first time lactational exposure to Hg-induced oxidative stress in breast-fed infants, which may play a role in pathogenesis, particularly during neurodevelopment. This will also contribute to the debate over the benefits of breast milk versus the adverse effects of exposure to pollutants. Nevertheless, breastfeeding should not be discouraged, but efforts should be made to identify and eliminate the source of Hg exposure in the population.
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Unlabelled: Dental amalgam is the most common restorative material used in dentistry. It was reported that amalgam might constitute potential toxic hazards to pregnant patients and foetuses through mercury release and absorption. The present study aimed to investigate the vital tissue response in contact to dental amalgam plus determination of blood mercury levels in mother and offspring Wistar strain albino rats. Pregnant mothers were divided into two main groups each had dental amalgam implanted into either an oral mucosa incision or a bony socket following extraction. Third and fourth groups included the offspring rats of mothers from the first and second groups, respectively. The blood mercury levels and histopathology of oral tissues were analyzed in mothers at one and six months post-implantation and in offspring rats one day after birth. The blood mercury levels of mothers increased significantly at six months (P<0.01) as compared to levels at one month. However, blood mercury levels were not significant (P>0.05) when the two offspring (third and fourth) groups were compared. Histopathology results from mothers showed inflammatory response at the bottom of the socket, one month after amalgam implantation. At six months, teeth germs showed vacuolation of the abnormal odontoblasts with globular dentine formation. Degenerated periodontal fibres and thin trabeculae forming the bony sockets with large marrow spaces were evident. A fibrous connective tissue capsule surrounded the amalgam mass inside the mucosa of mothers at one month and was evident also at 6 months with a huge inflammatory cell infiltrate. Teeth germs showed elongated odontoblasts with intercellular oedema, thinner dentine and bony trabeculae with wider marrow spaces. Offspring rats showed comparable oral tissue response. Conclusions: There is a positive correlation between blood mercury levels and oral tissue response in mothers, however, the negative impact of mercury on oral tissues of offspring rats was due to high mercury levels in their mothers' blood during pregnancy. We would recommend that women should - as far as possible - postpone having dental amalgam filling placed or removed during pregnancy to avoid its harmful effect on the foetus. Further clinical studies are recommended to test our findings in man.
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Mercury is a known cause of nephrotic syndrome and the underlying renal pathology in most of the reported cases was membranous nephropathy. We describe here 4 cases of minimal change disease following exposure to mercury-containing skin lightening cream for 2 - 6 months. The mercury content of the facial creams was very high (7,420 - 30,000 parts per million). All patients were female and presented with nephrotic syndrome and heavy proteinuria (8.35 - 20.69 g/d). The blood and urine mercury levels were 26 - 129 nmol/l and 316 - 2,521 nmol/d, respectively. Renal biopsy revealed minimal change disease (MCD) in all patients. The use of cosmetic cream was stopped and chelation therapy with D-penicillamine was given. Two patients were also given steroids. The time for blood mercury level to normalize was 1 - 7 months, whereas it took longer for urine mercury level to normalize (9 - 16 months). All patients had complete remission of proteinuria and the time to normalization of proteinuria was 1 - 9 months. Mercury-containing skin lightening cream is hazardous because skin absorption of mercury can cause minimal change disease. The public should be warned of the danger of using such products. In patients presenting with nephrotic syndrome, a detailed history should be taken, including the use of skin lightening cream. With regard to renal pathology, apart from membranous nephropathy, minimal change disease should be included as another pathological entity caused by mercury exposure or intoxication.
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In 2009 the Health Protection Agency was notified of two cases of nephrotic syndrome and one case of chronic back pain potentially associated with chronic mercury poisoning from the use of illegal skin lightening creams.1 These women, all of …
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Mercury and mercury salts, including mercurous chloride and mercurous oxide, are prohibited for use in cosmetic products as skin-lightening agents because of their high toxicity. Yet, the public continue to have access to these products. Reports of skin-lightening cosmetic products containing mercury and cases of mercury poisoning following the use of such products were identified using Medline (1950 - 28 March 2011) with mercury, mercury compounds, mercury poisoning, cosmetics and skin absorption as the subject headings. These searches identified 118 citations of which 31 were relevant. TOXICOKINETICS: The rate of dermal absorption increases with the concentration of mercury and prior hydration of the skin. The degree of dermal absorption varies with the skin integrity and lipid solubility of the vehicle in the cosmetic products. Ingestion may occur after topical application around the mouth and hand-to-mouth contact. After absorption, inorganic mercury is distributed widely and elimination occurs primarily through the urine and feces. With long-term exposure, urinary excretion is the major route of elimination. The half-life is approximately 1-2 months. The kidneys are the major site of inorganic mercury deposition; renal damage includes reversible proteinuria, acute tubular necrosis and nephrotic syndrome. Gastrointestinal symptoms include a metallic taste, gingivostomatitis, nausea and hypersalivation. Although penetration of the blood-brain barrier by inorganic mercury is poor, prolonged exposure can result in central nervous system (CNS) accumulation and neurotoxicity. Inorganic mercury poisoning following the use of skin-lightening creams has been reported from Africa, Europe, USA, Mexico, Australia and Hong Kong. Nephrotic syndrome (mainly due to minimal change or membranous nephropathy) and neurotoxicity were the most common presenting features. As mercury-containing cosmetic products can contaminate the home, some close household contacts were also reported to have elevated urine mercury concentrations. Prevention from further exposure is the first step. Cream users and their close contacts should be evaluated for evidence of mercury exposure, the presence of target organ damage and the need for chelation treatment. Laboratory evaluation of affected subjects should include a complete blood count, serum electrolytes, liver and renal function tests, urinalysis, urine and blood mercury concentrations. Since blood mercury concentrations tend to return to normal within days of exposure, blood samples are useful primarily in short-term, higher-level exposures. Estimation of the urine mercury concentration is the best marker of exposure to inorganic mercury and indicator of body burden. A 24-hour urine for measurement of mercury excretion is preferred; a spot urine mercury concentration should be corrected for creatinine output. Chelation therapy is indicated in patients with features of mercury poisoning and elevated blood and/or urine mercury concentrations. Unithiol (2,3-dimercapto-1-propanesulfonic acid, DMPS) is the preferred antidote though succimer (dimercaptosuccinic acid, DMSA) has also been employed. The use of mercury in cosmetic products should be strictly prohibited. The public should be warned not to use such products as their use can result in systemic absorption and accumulation of mercury causing renal, gastrointestinal and CNS toxicity.
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Hyperpigmentation disorders and skin lightening treatments have a significant impact on the dermatologic, physiologic, psychologic, economic, social, and cultural aspects of life. Skin lightening compounds, such as hydroquinone and topical corticosteroids, are often used to treat hyperpigmentation disorders, such as melasma, or lighten skin for cosmetic purposes. Despite their established effectiveness, a multitude of dermatologic and systemic complications have been associated with these agents. Regulatory agencies have also recognized the adverse effects of skin lighteners and many countries around the world now forbid the production and sale of these compounds, although this prohibition has not significantly curtailed distribution. Dermatologists and users of cosmetic products should be aware of the various components in bleaching compounds, their potential adverse effects, and alternative options for skin lightening.
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Lead, cadmium and mercury were measured in placental tissue, umbilical cord and maternal blood samples of 1578 women who delivered at the Al-Kharj King Khalid Hospital between 2005 and 2006. The aim of this study was to evaluate the status of heavy metal exposure in mothers and their newborns and to identify predictors of maternal exposure. Lead was detected in all cord and maternal blood and in 96% of placental tissues. Only in 0.89% and 0.83% of cord and maternal blood samples were the levels of lead above the CDC threshold limit of 10 μg/dl. Maternal blood lead was also higher (2.3%) than the German Reference value in women of 7 μg/dl. Approximately 9.3% of women had a placental lead above the 95th percentile in the range of 0.83-78 μg/g dry wt., a level of possible developmental toxicity. Cadmium was detected in 94.8% and 97.9% of cord and maternal blood samples respectively, though only five newborns had a cadmium level above the OSHA threshold limit of 5 μg/l. Comparing our results to the newly revised German Reference value for nonsmokers, 48.6% of mothers had blood cadmium levels >1.0 μg/l. We found as well that 25% of women had placental cadmium in the >75th percentile, in the range of 0.048-4.36 μg/g dry wt., which is likely to affect fetal growth and development. Of the maternal and cord blood samples, 11.2% and 13%, respectively, had mercury levels >5.8 μg/l, which is the EPA reference dose. Nearly 49% of women had mercury levels >2.0 μg/l, the German Reference value for those who consume fish ≤3 times a month. Around 50% of the mothers had placental mercury in the range of 0.031-13.0 μg/g dry wt. Regression analyses indicated that the levels of metals in the blood and placenta were influenced by several factors. This study provides informative baseline biomonitoring data and reveals a substantial exposure to heavy metals in non-occupationally exposed Saudi mothers and their newborns that might jeopardize the health of both. Additional research is also urgently needed to explore factors such as environment, diet, lifestyle and/or cultural habits contributing to maternal and fetal exposures. Preventive measures to eliminate or minimize the unnecessary risk of fetus exposure to heavy metals or other pollutants during pregnancy should be initiated once these factors are identified.
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Acute or chronic mercury exposure can cause adverse effects during any period of development. Mercury is a highly toxic element; there is no known safe level of exposure. Ideally, neither children nor adults should have any mercury in their bodies because it provides no physiological benefit. Prenatal and postnatal mercury exposures occur frequently in many different ways. Pediatricians, nurses, and other health care providers should understand the scope of mercury exposures and health problems among children and be prepared to handle mercury exposures in medical practice. Prevention is the key to reducing mercury poisoning. Mercury exists in different chemical forms: elemental (or metallic), inorganic, and organic (methylmercury and ethyl mercury). Mercury exposure can cause acute and chronic intoxication at low levels of exposure. Mercury is neuro-, nephro-, and immunotoxic. The development of the child in utero and early in life is at particular risk. Mercury is ubiquitous and persistent. Mercury is a global pollutant, bio-accumulating, mainly through the aquatic food chain, resulting in a serious health hazard for children. This article provides an extensive review of mercury exposure and children's health.
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Long-term contact with mercury may induce membranous nephropathy (MN); however, the clinical pathologic features and pathogenesis of mercury-induced MN have not been investigated. The present study retrospectively evaluated 11 cases of mercury-induced MN to analyze its causes and its clinical and pathologic features. A total of 10 women and 1 man ages 15 to 45 years were enrolled in the present study. Mercury exposure was caused by mercury-containing pills (five patients), skin lightening cream (four patients), hair-dyeing agents (one patient), and mercury vapor (one patient). The duration of contact with mercury ranged from 2 to 60 months, and the urinary mercury concentrations were 1.5 to 50 times higher than reference values. All patients presented with proteinuria and normal renal function; three had nephrotic syndrome. Light microscopy revealed thickened glomerular basement membrane and mildly proliferative mesangial cells. Acute tubulointerstitial injury occurred in three patients. The immunofluorescence findings showed granular deposits of IgG and C3 along the glomerular capillary wall, mostly accompanied by deposits of C4 and C1q. IgG1 and IgG4 (predominantly IgG1) deposits were observed along the glomerular capillary loops. Nine patients reached complete remission in follow-up after withdrawal from mercury exposure. Deposits of IgG1 subclasses in renal tissues indicated that the pathogenesis of mercury-induced MN differs from that of idiopathic MN. It is important that clinicians are aware that mercury exposure should be considered a possible cause of membranous nephropathy.
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Skin-lightening creams are being increasingly used by women in particular, worldwide in an attempt to whiten their skin. Men and older people use these creams to remove age spots or other pigmentation disorders. Several studies have reported the presence of high mercury levels in skin-lightening cream. Women, especially pregnant and nursing mothers, who use these creams are at risk of mercury toxicity because long-term exposure can cause permanent neurological damage, nephrological disorders, fertility problems, and birth defects. Early exposure usually has no clinical symptoms. Mercury levels were measured in a total of 49 ovary tissue samples. The mean mercury contents in the ovaries of non-treated mice (11.70 +/- 13.38 ng/g) were compared to mice treated with Rose skin-lightening cream samples (2,471.92 +/- 1,336.31 ng/g) and those treated with Fair & Lovely skin-lightening creams (58.47 +/- 39.51 ng/g). The mercury content in the ovary tissues increased with number of cream applications and were highest in the ovaries of mice treated twice a day with Fair & Lovely (87.79 +/- 26.20 ng/g) and once a day with Rose (3,515.61 +/- 1,099.78 ng/g). Our data indicate that dermal exposure to mercury can result in a significant accumulation in the ovaries of mice following the application of skin-lightening cream. This may cause alterations in reproductive behavior and contribute to infertility or ovarian failure. Of course, these results need to be confirmed by further research. Imported or locally made skin-lightening creams are widely available in Saudi market. It would be ideal to ban the sale of these creams but unfortunately, advertisements in the mass media presenting celebrities and beauty specialists make these products more popular. Alternatively, public health authorities should encourage more reliance on prescribed creams for the treatment of skin pigmentation problems.
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A nine year old patient developed the nephrotic syndrome as a result of the use of topical medication containing mercury. The relationship of this entity to other forms of mercury toxicity is discussed.
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A 72-year-old Caucasian man with widespread psoriasis presented with a sensory-motor peripheral neuropathy following 40 years' use of an ammoniated mercury ointment. No clinical involvement of his central nervous system was noted and no other possible causative factors for his peripheral nerve disease were found. D-Penicillamine treatment induced mercuriuresis and blood levels of mercury fell to normal. His peripheral neuropathy improved slowly after normalisation of the serum mercury. It is believed that his condition was caused by percutaneous absorption of mercury. Ammoniated mercury ointments should have no role in the current management of skin disorders.
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Two cases of mercury poisoning with predominantly dermatological symptoms are reported. The mercury intoxication was caused by the application of an over-the-counter metallic mercury ointment. The calculations of mercury excretion suggest strongly that cutaneous absorption could have been a significant route of entry.
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A total of 507 (M 121, F 386) cases of facial dermatitis were investigated, of whom 308 (M 49, F 259) had eczema confined to the face. The prevalence of positive patch tests was 45% (229/507). Among all the patients, the 2 most frequent allergens were nickel (15.2%) and ammoniated mercury (6.1%), with the incidence of nickel sensitivity in men (20%) being greater than in women (13.7%). 56% of the nickel-positive cases were caused by metal spectacle frames. Taiwan's high number of spectacle-wearers, its subtropical climate and the characteristic oriental facial structure are possibly major contributing factors. Most ammoniated mercury (AM)-sensitive cases resulted from cosmetics. Skin-lightening creams are widely used in Taiwan, but their content is poorly controlled. According to consumer reports, 14.9% (48/322) had applied AM-containing cosmetics. Of all the cosmetics tested for mercury, 2.2% (60/2711) were positive.
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A case of slight renal tubular dysfunction associated with cataract and anaemia was diagnosed in a 3-month-old black boy in whom high levels of mercury were found in blood and urine. Several arguments suggest that the renal, ocular and haematological defects may have resulted from exposure to mercury during foetal life and the 1-month lactation period due to the extensive use of inorganic mercury containing cosmetics by the mother.
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Proteinuria in a woman treated for psoriasis with ammoniated mercury lead to the discovery of membranous glomerulonephritis. This report reviews the literature and experimental models of mercury nephropathy.
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The adult nephrotic syndrome as met with in Nairobi is predominantly encountered in young sophisticated African women, most of whom began to use skin-lightening creams containing mercury before the symptomatic onset of their illness. The particular form of mercury involved is well known to cause the nephrotic syndrome in other circumstances-for example, when applied to the skin in the treatment of psoriasis. In these circumstances the pathogenetic mechanism is thought to be of an idiosyncratic type. The use of mercury-containing skin-lightening creams in the patients studied seemed to be particularly associated with a "minimal-change" ("light-negative") renal glomerular lesion, this lesion being present in half of the patients. The prognosis in this group of patients seems remarkably good, with 50% entering remission, 77% of these doing so spontaneously on discontinuing the use of the creams.
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The pattern of use of mercury-containing skin lightening creams in a group of young healthy African women was strikingly reflected by the excretion of mercury in urine. Although the levels of mercury in urine frequently associated with manifestations of systemic toxicity were not observed, the mean concentration of mercury in urine, at random sampling, was significantly more than the acceptable upper limit of normal in the group of subjects using mercury-containing skin lightening creams at the time of study. When use of these preparations was discontinued, progressive reduction in mercury concentration in urine Was manifest. Continued use, however, resulted in a variable pattern of subsequent excretion of mercury in urine for which a probable explanation is presented. No definite evidence o of renal damage was obtained, and in particular there were no stigmata of the nephrotic syndrome. The previously published data concerning the association of the nephrotic syndrome with exposure to mercury is reviewed. It is felt that in this respect the subjects of this study constitute a vulnerable population.
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The use of skin-lightening preparations appears to be a problem for the coloured women in Africa as well as for the Black People in general. The mercurial creams occupy a place of choice into the most useful products for the skin depigmentation. An epidemiological study from twenty senegalese women using mercurials cosmetics has permitted to determine a mean value of 155,75 +/- 75,38 ppm Hg in scalp hair while the normal level is less than 10 ppm. An experimental study was realised with monkeys (Papio papio) treated with a soap containing mercuric biiodide. This study has shown, after only three months of experimentation, a significative augmentation of mercury levels in all the organs and specially in the kidneys and the hair.
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It seems evident from a wealth of scientific research that mercury is toxic. Because of the nature of the Saudi markets, different brands of skin-lightening creams are widely available. In this study, 38 skin-lightening cream samples were collected and analyzed for mercury by inductively coupled plasma spectrometry after an acid digestion procedure. About 45% of the tested skin-lightening cream samples contained mercury at levels well above the FDA's acceptable limit of 1 ppm. These findings are alarming and have wide legal and educational implications for Saudi Arabia in particular and developing countries in general. Further investigation for possible adverse health effects is also needed.