1. Minamata Disease and The Photography of W Eugene Smith
Martin Donohoe

2. Outline Introduction Mercury and Methylmercury as pollutants
Minamata Disease
W Eugene Smith – bio and photos
Minamata Convention

3. Mercury
Mercury ore (cinnabar) used as pigment since Neolithic era (found in 10,000 yr old cave paintings)
Ancient Romans, Chinese used as rouge makeup
Pigment mixed with wax for document seals in Middle Ages

4. Mercury Syphilis Treatment - 15th Century onward
- abandoned 1940 for penicillin
Recognized as cause of disease in 19th Century (Hunter-Russell Syndrome)
- chemists, hatters (matted fur together with mercuric nitrate to make felt hats)

5. Mercury
Used in late-19th Century to extract silver from pulverized ore
Diuretic (used through mid-20th Century)
Used as a preservative in latex paints until banned by EPA in 1991

6. Mercury
Added by US government to industrial alcohol during Prohibition to make it more lethal and discourage moonshine production ( )
Led to more than 10,000 deaths

7. Mercury
Used in chlor-alkali plants to make chlorine and sodium hydroxide for industry
Used in production of vinyl chloride, an important ingredient in plastics and vinyl

8. Mercury Hg miners at high risk
Found today in Chinese medications, skin lightening creams, hair dyes

9. Mercury Half from volcanic eruptions and other geological processes
Released into air by coal combustion, industrial processes, mining, and waste disposal
4500 tons/yr

10. Mercury
Travels throughout atmosphere and settles in oceans and waterways
Bacteria convert it to toxic methyl-mercury
Levels in Great Lakes, Great Salt Lake rising

11. Mercury Travels up food chain via fish
Warmer temperatures increase metabolic rate and ability of fish to accumulate
Avoid top predators (tuna, shark, swordfish
Acadian redfish, aka dogfish – used in school lunch programs
1/3 of US exposure to methylmercury from canned tuna

12. Gold Mining Gold = Cyanide + Mercury
Mercury used to capture gold particles as an amalgam
Gold leached from ore using cyanide
Cyanide paralyzes cellular respiration
At least 18 tons of mine waste created to obtain the gold for a single 3 oz., 18k ring

13. Gold Mining and Mercury
Contaminated groundwater often sits in large toxic lakes held in place by tenuous dams
Release of cyanide and mercury into local waterways kills fish, harms fish-eating animals, and poisons drinking water

14. Mercury Other sources: Deforestation and runoff Industrial boilers
Tooth fillings
Car batteries
Cosmetics

15. Mercury Contaminant in high fructose corn syrup
Gluten-free diets may contain more mercury (and arsenic) due to higher intake of rice-/rice syrup-based products (rice absorbs metals from water and soil)

16. Mercury Dental amalgams:
50% mercury; 50% silver, copper, tin, zinc mixture
dental amalgam factory workers at high risk
Mercury dental amalgams pose health risks to pregnant women, unborn babies, and children (FDA Black Box Warning added 2009) – esp tooth grinders

17. Mercury Dental amalgams:
No link with nervous system toxicity and no benefit to removal in adults
However, human cremations (increasing) releases 2-4g Hg/body if amalgams present

18. Mercury 720,000 metric tons removed from ground since 1850
57% of mercury released since 1850 circulates in environment
43% locked away in sediments and landfills

19. Mercury Long biological half-life - 1-3 years in humans
Mercury costs U.S. economy $5 billion/yr
Regulation inadequate
Allows “cap and trade”

20. Mercury States pregnant women should not eat ANY tuna
16% of women of childbearing age exceed the EPA’s “safe” mercury level
75,000 newborns/yr in US have increased risk of learning disabilities associated with mercury exposure in the womb
Freshwater fish mercury levels too high for pregnant women to eat in 43 states
Consumers Union disagrees with FDA recommended limits on tuna consumption for pregnant women
States pregnant women should not eat ANY tuna

21. Minamata Bay Southern Japan Shiranui Sea Fishing village
Villagers: fisherman/Chisso Corporation employees and their families

24. Chisso Corporation Established 1918
Produced acetaldehyde for plastics, drugs, perfumes, photography
Mercury (Hg) catalyst
Byproduct = methylmercury, dumped into bay (150 tons over 4 decades)
Dumped over 60 deadly poisons, including vinyl chloride (cause of liver cancer)

26. Chronology of Chisso's Environmental Pollution
local fishing cooperative compensated for decreased catch
1950s - bizarre behavioral changes observed in birds, marine fish, land vertebrates; oysters vanish
1950s / 1960s - reports in Japanese medical journals about human cases

27. Chronology of Chisso's Environmental Pollution
cause (MeHg) of Minamata Disease elucidated
reports in English medical journals
Dr. Hosokawa's experiments
Cat #400
Other studies
1959 cyclator added
Removed Hg, but not MeHg

29. Chronology of Chisso's Environmental Pollution
fishing banned in Minamata Bay after similar events noted in Niigata, Japan
all acetaldehyde-producing plants ceased operating
Japan Water Pollution Control Act
Allowed no detectable Hg or MeHg in waste water

30. Chronology of Chisso's Environmental Pollution
1997 – Minamata Bay declared free of mercury
2004 – Japanese Supreme Court rules government shares responsibility for epidemic (government slow to react, cut off research funding in 1962)

31. Minamata Disease
3,000 official cases in Minamata Bay (almost 2,500 dead)
Tens of thousands of unofficial cases
Number of victims may be as high as 100,000
Social stigma / Poor health care

32. Congenital Minamata Disease: Signs and Symptoms
Congenital: high dose → infertility; medium dose → spontaneous abortions; low dose → congenital disease (including anencephaly and spina bifida)
S/S: poor physical growth, mental retardation, impaired speech/chewing/swallowing, muscle tone abnormalities, involuntary movements, constricted visual fields
- EDTA not effective

33. Signs and Symptoms Acute / Chronic Poisoning:
Numbness, slurred speech, ataxia, unsteady gait, deafness, poor vision, dysphagia, hypersalivation, confusion, drowsiness/stupor to irritability/restlessness
Linked to autism
Chronic liver disease, liver cancer
Nephropathy

34. Signs and Symptoms Acute / Chronic Poisoning: Hypertension
Autoimmune disorders
Rash - Acrodynia (“pink disease”, small children, swelling and irritation of palms and feet → desquamation, irritability, photophobia, fever, insomnia, profuse sweating
Death within a few months if severe

35. Diagnosis Mercury levels in air, blood, urine:
“Normal” level = 5 mcg/l
20 mcg/l – 100 mcg/l = subacute toxicity, consider treatment
>100 mcg/l in blood and/or urine = toxic, treat

36. Treatment Chelation with BAL, penicillamine, DMPS, DMSA (best)
May help with neurologic symptoms
Nephrotic syndrome resolves over several months
Follow levels to assess adequacy of treatment, need for additional doses
Consult occupational medicine/poison control

41. Civil suit vs. Chisso (1969-73)
Plaintiffs initially awarded $66,000 for deceased victims, $59,000 - $66,000 for survivors
Precedent - Niigata suit versus Showa Denko
$3.4 million paid out the first night, $80 million paid out by 1975
As of 2014, most victims have received financial compensation ($160,000 - $180,000; $26000 for those with lesser disabilities)

44. Civil suit vs. Chisso (1969-73)
Dr. Hosokawa key witness (from deathbed)
Identity - company employee vs. impartial physician with obligation to patients
Loyalty - company vs. to public

46. Reasons for Delayed Recognition and Action
Science slow, unfunded/underfunded, corrupt
Dissemination of knowledge slow
Social stigma of disease, fear of contagion
Pressure from fisheries cooperative, Chisso employees

47. Reasons for Delayed Recognition and Action
Lack of local/world awareness of health effects of pollution
Strong government-business links in Japan, employee loyalty strong

48. Decreasing Causes and Limiting Consequences of Mercury Pollution
Phase out coal burning power plants
Hospitals phasing out mercury thermometers
Stop buying gold (e.g., wedding rings)
Make healthy seafood purchases
Screen and treat when appropriate
Avoid tainted cosmetics

49. Minamata Convention
A set of legally binding measures to curb mercury pollution
As of October, 2017, 128 countries have signed and 6 (including the U.S.) have ratified
Took effect August, 2017

50. Minamata Convention
A set of legally binding measures to curb mercury pollution
As of 10/16/14, 128 countries have signed and 6 (including the U.S.) have ratified
Takes effect 90 days after 50 nations ratify

51. Minamata Convention
Best emission-control technologies requred for new power plants, boilers and smelters
Compact fluorescent lightbulbs containing over 5 mg Hg banned by 2020
Primary mercury mining banned (old mines get 15 yrs to close down)
Allows use of mercury in artisanal and small scale gold mining; encourages nations to phase out use altogether

52. Minamata Convention
Exempts dental fillings, but encourages alternatives
Vaccines with thimerosol (ethylmercury) exempt (very few, trace amounts)
Considered “safe” but best to avoid if possible
But benefits of vaccination great

53. Minamata Convention
Bans Hg-containing batteries by 2020 (button-cell batteries exempt)
Bans switches and relays with Hg by 2020
Limits Hg in soaps and some cosmetics

54. Minamata Convention Bans Hg in medical devices by 2020
Exempts religious and traditional uses of Hg
Bans use in certain types of manufacturing
Japan – Asia’s largest exporter of mercury
Japanese industry fighting treaty/trade ban

55. Minamata Disease Memorial

56. W Eugene Smith Born 1918, Wichita, KS
Local news photographer at age 15
Turned down scholarship to Notre Dame to study photography at NY Institute of Photography
Worked for Newsweek, then Life, then Magnum

57. W Eugene Smith Married to Aileen Smith, photojournalist
Minamata: Final Assignment
Beaten by Chisso employees
Died 1978

72. Role of the Media in Promoting Awareness of Environmental Health Issues
Books
Henrik Ibsen’s Enemy of the People
Upton Sinclair's The Jungle
Rachel Carson's Silent Spring
Photography
W. Eugene and Aileen Smith's Minamata photoessay
Jacob Riis, Dorothea Lange, Sebastiao Salgado, James Nachtwey, others
Film, TV

82. Contact Info, References
Martin Donohoe This slide show and others available at