The first Environmental Protection Agency (EPA) mercury vapor concentration measurements were recorded 11 days after the inhalation. The maximal concentration in the home was 0.885 mg/m. We cannot explain the delay in measuring the ambient mercury vapor concentrations within the home after powder samples analyzed six days earlier showed evidence implicating mercury. Measurements may have been made in the interim but they were not reported.
The symptoms of mercury inhalation differ in regard to the duration and concentration of exposure. Acute exposure to high-level concentrations primarily involves the lung and results in symptoms of dyspnea, chest pain, and cough.2 Long-term low-level exposure affects the neurologic system with resultant symptoms of tremor, neuropathy, and changes in personality referred to as mercurial erethism. All four of our patients had symptoms compatible with acute exposure at presentation. Our patients followed a similar clinical course of progressive respiratory failure and subsequent death. Their chest roentgenograms paralleled their clinical course and demonstrated progressive difluse bilateral infiltrates consistent with the adult respiratory distress syndrome.