Efficacy of Succimer Chelation of Mercury at Background Exposures in Toddlers: A Randomized Trial

Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC 27709, USA.
The Journal of pediatrics (Impact Factor: 3.79). 10/2010; 158(3):480-485.e1. DOI: 10.1016/j.jpeds.2010.08.036
Source: PubMed


To examine whether succimer, a mercaptan compound known to reduce blood lead concentration in children, reduces blood mercury concentration.
We used samples from a randomized clinical trial of succimer chelation for lead-exposed children. We measured mercury levels in pre-treatment samples from 767 children. We also measured mercury levels in blood samples drawn 1 week after treatment began (n = 768) and in a 20% random sample of the children who received the maximum 3 courses of treatment (n = 67). A bootstrap-based isotonic regression method was used to compare the trend with time in the difference between the adjusted mean mercury concentrations in the succimer group and that in the placebo group.
The adjusted mean organic mercury concentration in the succimer group relative to the placebo group fell from 99% at baseline to 82% after 3 courses of treatment (P for trend = .048), but this resulted from the prevention of the age-related increase in the succimer group.
Succimer chelation for low level organic mercury exposure in children has limited efficacy.

Download full-text


Available from: Jerilynn Radcliffe
  • [Show abstract] [Hide abstract]
    ABSTRACT: Pediatric healthcare providers are confronted with environmental health problems frequently: the child with asthma exacerbated by the odor of paint in school or mouse antigen at home, the family who wants to know the risks and benefits of using different types of sunblock, or the community that asks the provider for advice on the potential health impacts of building the new elementary school next to the on-ramp to the interstate highway. Pediatric providers have not been well trained to deal with these questions in medical or nursing schools, residency training, or continuing-education settings. This article provides guidance on history taking, the physical examination, laboratory evaluations of patients and the environment, and making an assessment about and managing environmental health problems. Pediatric Environmental Health Specialty Units are discussed as a source of consultation and referral. The identification and utilization of evidence-based resources are stressed and clinicians are cautioned about non-evidence-based assessments such as clinical ecology and hair analysis and non-evidence-based management strategies such as chelation for autism.
    No preview · Article · Jan 2011 · Mount Sinai Journal of Medicine A Journal of Translational and Personalized Medicine
  • [Show abstract] [Hide abstract]
    ABSTRACT: Mercury has long been an object of fascination and fear. There have been increasing reports in the media on various mercury exposures, raising concern and confusion in both the public and medical field about its toxicity and need for specific treatment. There has also been increasing concern from national environmental and public health agencies over low-level mercury exposure, especially in children. In its most familiar, elemental form, mercury presents an inhalational hazard. Less familiar are the other species: inorganic mercury, a potential threat to the gastrointestinal and renal systems; and various organic forms that include the neurotoxic methylmercury, associated historically with seafood contamination in Minamata Bay, Japan. The consequences to exposed children depend on the specific form of mercury and the circumstances of the exposure. The practitioner must be able to distinguish among these forms and their routes of exposure, to assess for toxicity, and to formulate a plan for mitigation and treatment.
    No preview · Article · Dec 2012 · Clinical Pediatric Emergency Medicine
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Succimer lowers blood lead concentrations in children, and the structure of succimer chelates of lead and cadmium are similar. Using blood samples from a randomized trial of succimer for lead poisoning, however, we found that succimer did not lower blood cadmium in children with background exposure.
    Full-text · Article · Apr 2013 · The Journal of pediatrics
Show more