Mercury has long been recognized by the public health community as an environmental and occupational health hazard. In October 2013, the U.S. signed and ratified the international Minamata Convention on Mercury. Once fully ratified, this global treaty will require countries to reduce emissions and releases of mercury from products, processes, and industries to protect human health and the environment (United Nations Environment Programme, 2014). While many public health policy efforts focus on methylmercury exposure from fish or airborne elemental mercury emissions from coal-powered plants, a recent Agency for Toxic Substances and Disease Registry (ATSDR) initiative, Don’t Mess With Mercury (DMWM) (Figures 1 and ​and2),2), is aimed at preventing exposure from elemental mercury spills. FIGURE 1 Agency for Toxic Substances and Disease Registry’s Don’t Mess With Mercury Initiative FIGURE 2 Agency for Toxic Substances and Disease Registry’s Don’t Mess With Mercury Initiative Elemental mercury is a dense, silvery metal that is liquid at room temperature. When spilled, its high surface tension causes tiny droplets to form. These unique physical characteristics appeal to children and adolescents who have been observed playing with mercury, sharing it with friends, decorating their hair with it, taking it on school buses and into school buildings, and smoking mercury-dipped cigarettes. Mercury can be found in a variety of household items including thermometers, fluorescent light bulbs, and electronic switches. People have kept jars and containers of mercury for refining metals, folk medicine, and some ritualistic practices (Agency for Toxic Substances and Disease Registry [ATSDR], 1999). Elemental mercury volatilizes at room temperature; the vapors are colorless, odorless, and heavier than air and accumulate in lower areas of a room. Heating mercury or dispersing mercury droplets by vacuuming or sweeping will increase concentrations of airborne mercury. The droplets can settle deep into cracks and crevices making the spill difficult to remediate and providing an ongoing exposure. Inhalation of mercury vapor is the major route of exposure and toxicity; minimal dermal or gastrointestinal absorption occurs. Once inhaled, mercury enters the bloodstream and distributes to all tissues but accumulates primarily in the kidneys and brain. Elemental mercury crosses the blood-brain and placental barriers (ATSDR, 1999). The human body has no known physiologic requirement for mercury. The nervous system and renal system are sensitive targets for both acute and chronic exposures to mercury vapors. Exposures may result in tremor, personality changes, irritability, memory loss, insomnia, mood swings, weakness, and sensory-motor peripheral neuropathy. Kidney effects range from transient proteinuria to acute tubular necrosis. High concentrations of vapor received acutely can cause cough, dyspnea, and pneumonitis. Dermal manifestations of mercury vapor exposure may include an erythematous, pruritic rash or acrodynia (a rare, nonallergic hypersensitivity reaction seen in some children). In general, children are more sensitive to health effects from mercury than adults (ATSDR, 1999). Unfortunately many people, especially children, are not aware of the dangers of mercury exposure, and mercury spills are common throughout the country. In 2008, Congress directed ATSDR to characterize elemental mercury exposures to children across the U.S. The report, “Children’s Exposure to Elemental Mercury,” summarized numerous mercury spill exposures and other sources of children’s exposure to mercury (ATSDR, 2009). While no comprehensive surveillance system exists for elemental mercury spills, numerous sources were used to document hundreds of spills ranging in size from broken thermometers reported to poison control centers (1,825 calls in 2012) to mercury spills of one pound or more (two tablespoons by volume) that must be report