Mercury

“In the present work we have investigated the actions of the oxidizing sulfhydryl reagent thimerosal on different mechanisms which regulate intracellular free Ca2+ concentration ([Ca2+]i) in GH4C1 pituitary cells. In intact Fura-2 loaded cells, low concentrations of thimerosal potentiated the spike phase of the TRH-induced (thyrotropin-releasing hormone) rise in [Ca2+]i, whereas high thimerosal concentrations inhibited it. The effect of thimerosal on the plateau phase was always inhibitory. The effect of thimerosal on the IP3-induced calcium release (IICR) was studied in permeabilized cells using the Ca2+ indicator Fluo-3. A low concentration of thimerosal (10 microM) stimulated IICR: the Ca2+ release induced by 300 nM inositol-1,4,5-trisphosphate (IP3) was enhanced in cells treated with thimerosal for 1 or 6 min (67 +/- 11 nM and 34 +/- 5 nM, respectively) as compared to control cells (17 +/- 2 nM). On the other hand, a high concentration of thimerosal (100 microM) inhibited IICR: when IP3 (10 microM) was added after a 5 min preincubation with thimerosal, the IP3-induced rise in [Ca2+]i (46 +/- 14 nM) was 57% smaller as compared with that seen in control cells (106 +/- 10 nM). The effect of thimerosal on the voltage-operated Ca2+ channels (VOCCs) was studied by depolarizing intact Fura-2 loaded cells by addition of 20 mM K+ to the cuvette. The depolarization-evoked increase in [Ca2+]i was inhibited in a dose-dependent manner by thimerosal. Direct evidence for an inhibitory effect of thimerosal on VOCCs was obtained by using the whole-cell configuration of the patch-clamp technique: thimerosal (100 microM) potently inhibited the Ba2+ currents through VOCCs. In addition, our results indicated that thimerosal inhibited the caffeine-induced increase in [Ca2+]i, and activated a capacitative Ca2+ entry pathway. The actions of thimerosal were apparently due to its oxidizing activity because the effects were mostly reversed by the thiol-reducing agent dithiothreitol (DTT). We conclude that, in GH4C1 pituitary cells, the mobilization of intracellular calcium and the different Ca2+ entry pathways are sensitive to redox modulation.”

“The local magnetic fields from computer monitors are well known. Recently a hypothesis was published that these magnetic fields may lead to a 400% increase of mercury dissolution from dental amalgam fillings. In MRI the exposure to the magnetic field exceeds by far the exposure from computer monitors. Therefore, this study examined the amalgam-related mercury release for typical MRI conditions, separated for both the static and the variable magnetic fields in a 1.5 T MR-unit. First, 20 dental cavities were filled with a non-gamma-2 amalgam, and the mercury release was measured for 14 days in a non-magnetic environment. Second, one half of the specimens were exposed to a static magnetic field for 24 hours (group A), while the other specimens were exposed to a repetitive gradient echo sequence for 60 minutes (group B). In both experiments there was no significant increase in mercury release due to MRI. This in vitro study demonstrated no evidence of an elevated mercury dissolution from a non-gamma-2 amalgam during magnetic field exposure by MRI; therefore, there is no increased risk to health.”

“In this study we examined the prevalence of mercury hypersensitivity in patients with oral lichenoid reactions (OLR) and the effect of amalgam replacement in subjects with amalgams adjacent to OLR irrespective of their mercury sensitivity status. One hundred and ninety-seven patients with oral problems were examined: 109 with OLR, 22 with oral and generalized lichen planus, and 66 with other oral diagnoses, including aphthous ulcers and orofacial granulomatosis. Nineteen per cent of patients with OLR reacted to mercury on patch testing, significantly more than in those with generalized lichen planus (0%) and in those with other oral diagnoses (3%). Twenty-two patients with OLR and adjacent amalgams had amalgam replacement and, in 16 of 17 mercury-positive subjects and three of four mercury-negative subjects, the OLR resolved after amalgam removal. In conclusion, we found a significantly increased prevalence of mercury hypersensitivity in patients with localized OLR in comparison to subjects with other oral problems. Amalgam replacement resulted in resolution of OLR in the majority of patients with amalgams adjacent to OLR irrespective of their mercury sensitivity status.”

“The ubiquitous nature of mercury in the environment, its global atmospheric cycling, and its toxicity to humans at levels that are uncomfortably close to exposures experienced by a proportion of the population are some of the current concerns associated with this pollutant. The purpose of this review is to critically evaluate the scientific quality of published reports involving human exposures to mercury and associated health outcomes as an aid in the risk evaluation of this chemical. A comprehensive review of the scientific literature involving human exposures to mercury was performed and each publication evaluated using a defined set of criteria that are considered standards in epidemiologic and toxicologic research. Severe, sometimes fatal, effects of mercury exposure at high levels were primarily reported as case studies. The disasters in Minamata, Japan, in the 1950s and in Iraq in 1971-1972 clearly demonstrated neurologic effects associated with ingestion of methylmercury both in adults and in infants exposed in utero. The effects were convincingly associated with methylmercury ingestion, despite limitations of the study design. Several well-conducted studies have investigated the effects of methylmercury at levels below those in the Iraq incident but have not provided clear evidence of an effect. The lower end of the dose-response curve constructed from the Iraq data therefore still needs to be confirmed. The studies of mercury exposure in the workplace were mainly of elemental or inorganic mercury, and effects that were observed at relatively low exposure levels were primarily neurologic and renal. Several studies have investigated effects associated with dental amalgam but have been rated as inconclusive because of methodologic deficiencies. In our overall evaluation, 29 of 110 occupational studies and 20 of 54 studies where exposure occurred in the natural environment provided at least suggestive evidence of an exposure-related effect.”

This report describes a patient who suffered from several complaints, which by herself were attributed to her amalgam fillings. Analysis of mercury in plasma and urine showed unexpectedly high concentrations, 63 and 223 nmol/l, respectively. Following removal of the amalgam fillings, the urinary excretion of mercury became gradually normalized, and her symptoms declined.

“Dental amalgam is approximately 50% mercury (Hg) by weight, and persons bearing amalgam fillings are exposed to this element, primarily as Hg vapor. For Canadians with amalgam-filled teeth, it was estimated, based on two independent models, that Hg exposure from amalgam averaged: 0.045 to 0.082 Jlglkg bw/day in toddlers (aged 3 to 4 years); 0.044 to 0.069 flg/kg bw/day in children (aged 5 to 11 years); 0.034 to 0.044 flg/kg bw/day in teens (aged 12 to 19 years); 0.050 to 0.055 flg/kg bw/day in adults (aged 20 to 59 years); and 0.031 to 0.041 flg/kg bw/day in seniors (aged 60+ years). Amalgam was estimated to contribute, on average, 50% of total Hg exposure from all sources (amalgam, air, water, food, soil) in adults, and 32 to 42% for other age groups. Numerous studies have consistently reported effects on the central nervous system (CNS) in persons occupationally exposed to Hg vapor. Most such studies have failed to detect a threshold for the CNS effects measured. A tolerable daily intake (TDI) of 0.014 flg Hg/kg body weight/day (as an absorbed dose) was proposed for inhalation of mercury vapor, the principal form ofHg to which bearers of amalgam fillings are exposed. This TDI was based on a published account of subclinical (i.e., not resulting in overt symptoms or medical care) CNS effects in occupationally-exposed men, expressed as slight tremor of the forearm, and should also protect against cognitive function impairment. Based on the least conservative exposure model of the two independent models developed, the average numbers of amalgam-filled teeth estimated nor to compromise the TDI were: 1 filling in toddlers; 1 filling in children; 3 fillings in teens; and 4 fillings in adults and seniors.”

“It had been shown previously by various authors that contact of amalgam fillings to metal fillings of different type can increase the electrochemically caused amalgam corrosion in vitro thus leading to an elevated release of mercury. So it was recommended to renounce of a dental contact of amalgam to metal fillings of other type. One aim of the present study was to evaluate possible influences of this contact in vivo on the urinary mercury contents in human volunteers. Neither approximal nor occlusal contacts had any influence on the urinary mercury excretion in comparison to a reference group with similar amalgam status. Furthermore, the influence of gum chewing on urinary mercury levels was taken into account. It could be shown that the consumption of chewing gum resulted in a significantly higher mean urinary mercury content in probands with amalgam fillings in comparison to people with similar amalgam status (gum chewers: 1.36 Hg/24 h vs. non-chewers 0.70 microgram Hg/24 h). Thus, gum chewing has to be considered as important parameter of influence on the urinary mercury levels of people with amalgam fillings.”

“Natural teeth are an invaluable teaching tool for preclinical instruction in operative dentistry and endodontic techniques. Cavity preparation in teeth containing amalgam restorations is a realistic simulation of an often experienced clinical situation. As various pathogens are contained in saliva, teeth must be disinfected before use by students. The purpose of this study is to indirectly evaluate whether mercury vapor is released from amalgam restorations in such teeth during steam autoclave sterilization. Mercury vapor detection, sample mass changes and x-ray fluorescence data were collected from experimental steam autoclave sterilization of amalgam samples sealed in autoclave bags. All of the data showed evidence of mercury vapor generation coincident to steam autoclave sterilization. Mercury vapor levels within the room where amalgam was exposed to steam autoclave sterilization reached levels that constitute an unnecessary health risk to dental personnel. The volume of amalgam tested simulated that contained in 175 amalgam restored teeth. Initial venting of the autoclave chamber produced mercury vapor concentrations significantly in excess of OSHA vapor concentration ceiling levels. Thus, the use of a steam autoclave for sterilization of amalgam containing teeth for use in preclinical laboratory exercises may be harmful to personnel involved.”

“Total mercury concentrations (mean +/- standard deviation) in breast milk, blood, and hair samples collected 6 wk after delivery from 30 women who lived in the north of Sweden were 0.6 +/- 0.4 ng/g (3.0 +/- 2.0 nmol/kg), 2.3 +/- 1.0 ng/g (11.5 +/- 5.0 nmol/kg), and 0.28 +/- 0.16 microg/g (1.40 +/- 0.80 micromol/kg), respectively. In milk, an average of 51% of total mercury was in the form of inorganic mercury, whereas in blood an average of only 26% was present in the inorganic form. Total and inorganic mercury levels in blood (r = .55, p = .003; and r = .46, p = .01 6; respectively) and milk (r = .47, p = .01; and r = .45, p = .018; respectively) were correlated with the number of amalgam fillings. The concentrations of total mercury and organic mercury (calculated by subtraction of inorganic mercury from total mercury) in blood (r = .59, p = .0006, and r = .56, p = .001; respectively) and total mercury in hair (r = .52, p = .006) were correlated with the estimated recent exposure to methylmercury via intake of fish. There was no significant between the milk levels of mercury in any chemical form and the estimated methylmercury intake. A significant correlation was found between levels of total mercury in blood and in milk (r = .66, p = .0001), with milk levels being an average of 27% of the blood levels. There was an association between inorganic mercury in blood and milk (r = .96, p < .0001); the average level of inorganic mercury in milk was 55% of the level of inorganic mercury in blood. No significant correlations were found between the levels of any form of mercury in milk and the levels of organic mercury in blood. The results indicated that there was an efficient transfer of inorganic mercury from blood to milk and that, in this population, mercury from amalgam fillings was the main source of mercury in milk. Exposure of the infant to mercury from breast milk was calculated to range up to 0.3 microg/kg x d, of which approximately one-half was inorganic mercury. This exposure, however, corresponds to approximately one-half the tolerable daily intake for adults recommended by the World Health Organization. We concluded that efforts should be made to decrease mercury burden in fertile women.”

“The issue of adverse health effects from dental amalgam and the concurrent low-dose exposure to inorganic mercury have been scrutinized by several Swedish expert groups during the past years. Only rarely have amalgam fillings in children been related to health effects. Experimental studies in genetically disposed animals have shown that low doses of inorganic mercury can induce autoimmune glomerulonephritis. The present case-control study included 31 children with acute glomerulonephritis and 33 with Henoch-Schönlein purpura retrieved from an in-patient register for the period 1973-1992 at the county hospital in Halmstad, Sweden. The median age was 10 and 9 years, respectively, for the two diagnostic groups. Dental clinics reported amalgam burden of the patients during the year before the date of diagnosis. Corresponding data were obtained for three randomly selected controls for each case, drawn from the case records of the same dental clinics, with matching for age and sex. Odds ratios (95% confidence interval) were 1.42 (0.49, 4.11) for Henoch-Schönlein purpura, 0.59 (0.25, 1.38) for acute glomerulonephritis and 0.84 (0.40, 1.75) for both diseases combined. The results of this study did not indicate increased disease risk in relation to amalgam burden.”