Population-Based Inorganic Mercury Biomonitoring and the Identification of Skin Care Products as a Source of Exposure in New York City

BACKGROUND Mercury is a toxic metal that has been used for centuries as a constituent of medicines and other items. OBJECTIVE We assessed exposure to inorganic mercury in the adult population of New York City (NYC). METHODS 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. RESULTS 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. CONCLUSION 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.