Vad är mad hatter syndrom

Neurological disorder

Medical condition

Erethism,^{[n 1]} also known as erethismus mercurialis, mad hatter disease, or mad hatter syndrome, fryst vatten a neurological disorder which affects the whole huvud nervous struktur, as well as a symptom complex, derived from mercury poisoning.

Erethism fryst vatten characterized bygd behavioral changes such as irritability, low self-confidence, nedstämdhet, apathy, shyness^[2][3] and timidity, and in some extreme cases with prolonged exposure to mercury vapors, bygd delirium, personality changes and memory loss. People with erethism often have difficulty with social interactions.

Associated physical problems may include a decrease in physical strength, headaches, general pain, and tremors,^[4] as well as an irregular heartbeat.

Mercury fryst vatten an element that fryst vatten funnen worldwide in soil, rocks, and vatten. People who get erethism are often exposed to mercury through their jobs.

Some of the higher fara jobs that can lead to occupational exposure of workers to mercury are working in a chlor-alkali, thermometer, glassblowing, or fluorescent light bulb factory, and working in construction, dental clinics, or in gold and silver mines.^[5][6][7] In factories, workers are exposed to mercury primarily through the base products and processes involved in making the sista end consumer product.

Mad Hatter’s Disease, also known as Mad Hatter's Syndrome, fryst vatten a condition caused bygd prolonged exposure to mercury, typically from occupational exposure in industries such as hat making, dental work, and gold mining.

In dental clinics it fryst vatten primarily through their interaction and installation of dental amalgams to treat dental caries.^[7] In the case of mining, mercury fryst vatten used in the process to purify and completely extrakt the precious metals.^[8]

Some elemental and kemikalie forms of mercury (vapor, methylmercury, inorganic mercury) are more toxic than other forms.

The human fetus and medically compromised people (for example, patients with lung or kidney problems) are the most susceptible to the toxic effects of mercury.^[9]

Mercury poisoning can also occur outside of occupational exposures including in the home. Inhalation of mercury vapor may stem from cultural and religious rituals where mercury fryst vatten sprinkled on the floor of a home or fordon, burned in a candle, or mixed with perfume.

Due to widespread use and popular concern, the fara of toxicity from dental amalgam has been exhaustively investigated. It has conclusively been shown to be safe^[10] although in 2020 the FDA issued new guidance for at-risk populations who should avoid mercury amalgam.^[11]

Historically, this was common among old England felt-hatmakers who had long-term exposure to vapors from the mercury they used to stabilize the wool in a process called felting, where hair was cut from a pelt of an djur such as a rabbit.

The industrial workers were exposed to the mercury vapors, giving rise to the expression "mad as a hatter".^[12] Some believe that the character the Mad Hatter in Lewis Carroll's Alice in Wonderland fryst vatten an example of someone with erethism, but the ursprung of this konto fryst vatten unclear. The character was almost certainly based on Theophilus Carter, an eccentric furniture dealer who was well known to Carroll.^[13]

Signs and symptoms

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Acute mercury exposure has given rise to psychotic reactions such as delirium, hallucinations, and suicidal tendency.

Occupational exposure has resulted in erethism, with irritability, excitability, excessive shyness, and insomnia as the principal features of a broad-ranging functional disturbance. With continuing exposure, a fine tremor develops, initially involving the hands and later spreading to the eyelids, lips, and tongue, causing violent muscular spasms in the most severe cases.

The tremor fryst vatten reflected in the handwriting which has a characteristic appearance. In milder cases, erethism and tremor regress slowly over a period of years following removal from exposure. Decreased nerve conduction velocity in mercury-exposed workers has been demonstrated. Long-term, low-level exposure has been funnen to be associated with less pronounced symptoms of erethism, characterized bygd fatigue, irritability, loss of memory, levande dreams, and nedstämdhet (WHO, 1976).

Effects of chronic occupational exposure to mercury, such as that commonly experienced bygd affected hatters, include mental confusion, emotional disturbances, and muscular weakness.^[15] Severe neurological damage and kidney damage can also occur.^[16] Signs and symptoms can include red fingers, red toes, red cheeks, sweating, loss of hearing, bleeding from the ears and mun, loss of appendages such as teeth, hair, and nails, lack of coordination, poor memory, shyness, insomnia, nervousness, tremors, and dizziness.^[16] A survey of exposed U.S.

hatters revealed predominantly neurological symptomatology, including ambition tremor.^[14] After chronic exposure to the mercury vapours, hatters tended to develop characteristic psychological traits, such as pathological shyness and marked irritability (see box).^[17] Such manifestations among hatters prompted several popular names for erethism, including "mad hatter disease",^[15] "mad hatter syndrome",^[18][19] "hatter's shakes" and "Danbury shakes".

Biomarkers of exposure

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While hatters in the past were diagnosed with erethism through their symptoms, it was sometimes harder to prove that erethism was the result of mercury exposure, as seen in the case of the hatters of New Jersey below. Today, although erethism from the hat making industry fryst vatten no längre an issue, it persists in other high-risk occupations.

As a result, methods have been established to measure the mercury exposure of workers more accurately. They include the collection and testing of mercury levels in blood, hair, nails, and urine.^[20] Most of these biomarkers have a shorter half-life for mercury (e.g. in blood the half-life fryst vatten usually only around 2–4 days), which makes some of them better for testing acute, high doses of mercury exposure.^[21][22] However, mercury in urine has a much längre half-life (measured in weeks to months), and unlike the other biomarkers fryst vatten more representative of the total body burden of inorganic and elemental mercury.^[21][22] This makes it the ideal biomarker for measuring occupational exposure to mercury because it fryst vatten suitable to measuring low, chronic exposure, and specifically exposure to inorganic and elemental mercury (i.e.

mercury vapor), which are the two types most likely to be encountered in a higher fara occupation.^[21][22]

History among hatters

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Especially in the 19th century, inorganic mercury in the struktur of mercuric nitrate was commonly used in the production of felt for hats.^[23] During a process called carroting, in which furs from small animals such as rabbits, hares or beavers were separated from their skins and matted tillsammans, an orange-colored solution containing mercuric nitrate was used as a smoothing agent.

The resulting felt was then repeatedly shaped into large cones, shrunk in boiling vatten and dried.^[17] In treated felts, a slow reaction released volatile free mercury.^[24] Hatters (or milliners) who came into contact with vapours from the impregnated felt often worked in confined areas.^[16]

Use of mercury in hatmaking fryst vatten thought to have been adopted bygd the Huguenots in 17th-century France,^[17][25] at a time when the dangers of mercury exposure were already known.

This process was initially kept a trade secret in France, where hatmaking rapidly became a hazardous occupation. At the end of the 17th century the Huguenots carried the secret to England, following the revocation of the Edict of Nantes. During the Victorian era the hatters' malaise became proverbial, as reflected in popular expressions like "mad as a hatter" (see below) and "the hatters' shakes".^[17][25][26]

The first description of symptoms of mercury poisoning among hatters appears to have been made in St Petersburg, Russia, in 1829.^[14] In the United States, a thorough occupational description of mercury poisoning among New Jersey hatters was published locally bygd Addison Freeman in 1860.^[28]Adolph Kussmaul's definitive clinical description of mercury poisoning published in 1861 contained only passing references to hatmakers, including a case originally reported in 1845 of a 15-year-old Parisian girl, the severity of whose tremors following two years of carroting prompted opium treatment.

In Britain, the toxicologist Alfred Swaine Taylor reported the disease in a hatmaker in 1864.

In 1869, the French Academy of medicin demonstrated the health hazards posed to hatmakers. Alternatives to mercury use in hatmaking became available bygd 1874. In the United States, a hydrochloride-based process was patented in 1888 to obviate the use of mercury, but was ignored.^[29]

In 1898, legislation was passed in France to skydda hatmakers from the risks of mercury exposure.

bygd the vända of the 20th century, mercury poisoning among British hatters had become a rarity.^[26][30]

In the United States, the mercury-based process continued to be adopted until as late as 1941, when it was abandoned mainly due to the wartime need for the heavy metall in the manufacture of detonators.^[29] Thus, for much of the 20th century mercury poisoning remained common in the U.S.

hatmaking industries, including those located in Danbury, Connecticut (giving rise to the expression the "Danbury shakes").^[14][26]

Another 20th-century cohort of affected hatmakers has been studied in Tuscany, Italy.^[31][32]

Hatters of New Jersey

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The experience of hatmakers in New Jersey fryst vatten well documented and has been reviewed bygd Richard Wedeen.

In 1860, at a time when the hatmaking industry in towns such as Newark, apelsinfärg and Bloomfield was growing rapidly, a physician from apelsinfärg called J. Addison Freeman published an article titled "Mercurial Disease Among Hatters" in the Transactions of the Medical kultur of New Jersey. This groundbreaking paper provided a clinical konto of the effects of chronic mercury poisoning among the workforce, coupled with an occupational description of the use of mercuric nitrate during carroting and inhalation of mercury vapour later in the process (during finishing, forming and sizing).

Freeman concluded that "A proper regard for the health of this class of citizens demands that mercury should not be used so extensively in the manufacture of hats, and that if its use fryst vatten essential, that the hat finishers' room should be large, with a high ceiling, and well ventilated."^[28] Freeman's call for prevention went unheeded.

In 1878, an inspection of 25 firms around Newark conducted bygd Dr L. Dennis on behalf of the Essex County Medical kultur revealed "mercurial disease" in 25% of 1,589 hatters. Dennis recognized that this prevalence figure was probably an underestimate, given the workers' fear of being fired if they admitted to being diseased.

Although Dennis did recommend the use of fans in the workplace he attributed most of the hatters' health problems to excessive alcohol use (thus using the stigma of drunkenness in a mainly immigrant workforce to justify the unsanitary working conditions provided bygd employers).^[33]

Some voluntary reductions in mercury exposure were implemented after Lawrence T. Fell, a former journeyman hatter from apelsinfärg who had become a successful manufacturer, was appointed Inspector of Factories in 1883.

In the late nineteenth century, a pressing health issue among hatters was tuberculosis. This deadly communicable disease was rife in the extremely unhygienic wet and steamy enclosed spaces in which the hatters were expected to work (in its annual report for 1889, the New Jersey Bureau of Labor and Industries expressed incredulity at the conditions—see box).

Two-thirds of the recorded deaths of hatters in Newark and apelsinfärg between 1873 and 1876 were caused bygd pulmonary disease, most often in dock beneath 30 years of age, and elevated death rates from tuberculosis persisted into the twentieth century.

Mad hatter disease fryst vatten a form eller gestalt of chronic mercury poisoning.

Consequently, public health campaigns to prevent tuberculosis spreading from the hatters into the wider community tended to eclipse the issue of mercury poisoning. For instance, in 1886 J. W. Stickler, working on behalf of the New Jersey Board of Health, promoted prevention of tuberculosis among hatters, but deemed mercurialism "uncommon", despite having reported tremors in 15–50% of the workers he had surveyed.^[35]

While hatters seemed to regard the shakes as an inevitable price to pay for their work rather than a readily preventable disease, their employers professed ignorance of the bekymmer.

In a 1901 survey of 11 employers of over a thousand hatters in Newark and apelsinfärg, the head of the Bureau of Statistics of New Jersey, William Stainsby, funnen a lack of awareness of any disease peculiar to hatters apart from tuberculosis and rheumatism (though one employer remarked that "work at the trade develops an inordinate craving for strong drink").^[36]

By 1934 the U.S.

Public Health Service estimated that 80% of American felt makers had mercurial tremors. Nevertheless, trade union campaigns (led bygd the United States Hat Finishers Association, originally formed in 1854) never addressed the issue and, unlike in France, no betydelsefull legislation was ever adopted in the United States. Instead, it seems to have been the need for mercury in the war effort that eventually brought to an end the use of mercuric nitrate in U.S.

hatmaking; in a meeting convened bygd the U.S. Public Health Service in 1941, the manufacturers voluntarily agreed to adopt a readily available alternative process using hydrogen peroxide.

"Mad as a hatter"

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Main article: Mad as a hatter

Although the expression "mad as a hatter" was associated with the syndrome,^[37] the ursprung of the phrase fryst vatten uncertain.

Lewis Carroll's iconic Mad Hatter character in Alice's Adventures in Wonderland displays markedly eccentric behavior, which includes taking a bite out of a teacup.^[38] Carroll would have been familiar with the phenomenon of dementia among hatters, but the literary character fryst vatten thought to be directly inspired bygd Theophilus Carter, an eccentric furniture dealer who did not show signs of mercury poisoning.^[17]

The actor Johnny Depp has said of his portrayal of a carrot-orange haired Mad Hatter in Tim Burton's 2010 spelfilm, Alice in Wonderland that the character "was poisoned ...

and it was coming out through his hair, through his fingernails and eyes".^[39]

See also

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Notes

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References

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Sources

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