We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Letters to the Editor |

Hearing Loss in US Adolescents and Exposure to Heavy Metals: Mercury in Perspective

James P. K. Rooney, BSc, MB, BAO, BCH, PGDIP; José G. Dórea, PhD
Arch Otolaryngol Head Neck Surg. 2012;138(6):608-609. doi:10.1001/archoto.2012.907.
Text Size: A A A
Published online


Shargorodsky et al1 investigated the association of heavy metals and hearing loss in adolescents; they reported no overall association between quartiles of blood mercury or urinary arsenic levels and hearing loss and found that urinary cadmium and blood lead levels were associated with substantially increased odds of high-frequency hearing loss. They state that the measurement of serum mercury levels is reflective of the “current body burden of the heavy metal as influenced by recent exposure.” As has been discussed previously,2 urine and serum mercury levels are reflective only of recent short-term exposure, not of historical, long-term, or low-dose mercury exposure. This limitation is in part attributable to the very long half-life of mercury in the brain. The authors go on to say, “Longer-term exposure would be better measured by mercury levels in hair.” Again, this statement is not strictly accurate: while hair mercury levels are known to be reflective of exposure to methyl-mercury from fish consumption, they are not reflective of elemental mercury exposure. It is also noteworthy that exposure to elemental, ethyl-mercury, and methyl-mercury (but, ironically, not inorganic mercury) can lead to deposition of inorganic mercury in the brain via the metabolism. However, the National Health and Nutrition Examination Survey collects data on diet, dental health, and vaccinations. Using these data, it should be possible to produce a mercury “exposure index” that might prove more valuable in analyzing the relationship between mercury exposure and hearing deficit.


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.