Vous êtes sur la page 1sur 10

bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb

aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa
aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa
bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb
aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa
bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb
aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa
bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb
aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa
bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb
aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa
bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb
aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa
bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb
aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa
bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb
aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa
bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb
aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa
bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb
aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa
bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb
aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa
bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb
aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa
bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb
aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa
bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb
aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa
bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb
aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa
bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb
aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa
bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb
aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa
bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb
aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa
bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb
aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa
bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb
aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa
bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb
aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa
bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb
aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa
bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb
aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa
bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb
aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa
bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb
aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa
bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb
aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa
bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb
aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa
bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb
aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa
bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb
aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa
bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb
aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa
bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb
aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa
bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb
aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa
bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb
aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa
bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb
aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa
bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb
aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa
bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb
aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa
bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb
aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa
bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb
aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa
bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb
aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa
bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb
bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb
aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa
bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb
aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa

Exposure or Absorption
and the Crucial Question
of Limits for Mercury
Derek W. Jones, PhD, FIM, CChem., FRSC(UK), FBSE

ABSTRACT
Health Canada recently lowered the recommended maximum daily exposure of mercury from all sources
for women of child-bearing age and for children less than 10 years. This new exposure guideline does not seem
to be based on any new scientific finding of human toxicity. The average daily intake of methylmercury (mainly from fish) that may cause demonstrable health effects in the most sensitive individual is 300 µg/day, or
4.3 µg Hg/day/kg body weight. The new, lower Health Canada limit is 95% below the level that may cause
health effects. A number of studies have looked at methylmercury in human breast milk (where maternal consumption of fish is high), but no strong evidence of toxicity has been reported. The amount of mercury
released from dental amalgam is minimal; a person would have to have 490 amalgam surfaces for there to be
enough mercury vapour and ionic mercury given off from amalgam fillings to meet the maximum exposure
guidelines. The uptake of food-related organic mercury is six times higher than the uptake of mercury from
amalgam; moreover, food-related mercury is significantly more toxic. Many studies of amalgam-related mercury are flawed by confusion between exposure and absorption for the various forms of mercury, a limited
selection of data, the ignoring of confounding variables or the misclassification of data.
MeSH Key Words: absorption; dental amalgam/adverse effects; environmental exposure; mercury/adverse
effects.
©

J Can Dent Assoc 1999; 65:42-6
This article has been peer reviewed.

Introduction

I
Journal
January
1999
Vol. 65
No. 1

42

n April 1998, Health Canada
lowered the maximum daily
exposure of mercury from all
sources for women of child-bearing
age and for children less than 10
years by 57% from 0.47 µg/kg/day
down to 0.2 µg/kg/day. This new
exposure guideline does not seem
to be based upon any new scientific finding of human toxicity. The
average daily intake of methylmercury (mainly from fish) that
may cause demonstrable health
effects in the most sensitive individual is 300 µg/day, or 4.3 µg
Hg/day/kg body weight.1 The new,
lower Health Canada limit is 95%

below the level that may cause
health effects. This recommended
lower mercury exposure has raised
questions about the dental amalgam issue once again.
It is extremely misleading to
look only at the exposure levels
without considering the absorption levels, particularly if we consider the different chemical forms
of mercury. Lipid soluble organic
mercury is much more bioavailable than metallic inorganic mercury, ionic mercury or mercury
vapour from dental amalgam. The
organic form in food is much more
insidious due to its ability to traverse lipid membranes and penetrate the central nervous system.2

Unlike inorganic or metallic mercury, organic mercury readily
crosses the blood-brain barrier.3
Health Canada and Environment Canada have stated that they
are concerned about industrial
pollution; however, it is important
to note that about 50% of environmental mercury comes from natural sources due to volatilization
from the ocean and erosion of
rocks. The atmosphere deposits
about 2 million kg/year of mercury into oceans, and the rivers are
estimated to contribute a further
200,000 kg/year.4 Regardless of
the source of environmental mercury, a major question that science has not yet answered is what
Canadian Dental Association

shorter periods of time such as the duration of breast-feeding are even more challenging.. high maternal consumption of pilot whale meat and blubber and other seafood had the potential to cause a considerable transfer of neurotoxicants during breast-feeding. The researchers followed 583 children from a birth cohort.e.10 In a community in the Faroe Islands. these are the Seychelles study and the Faroe Islands study. They reported that the exposure of the infant to mercury from breast milk ranged up to 0. Mercury in the Food Chain A 20-year retrospective analysis of methylmercury in fish involving over 38. - aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb Journal January 1999 Vol.effect mercury in the food chain has on human health. However. The study is double blind and uses maternal hair mercury as the index of fetal exposure. In light of these findings it is difficult to understand the recent change in the guidelines from Health Canada. the effect was compensated by the advantages associated with breastfeeding. Three developmental milestones that are usually reached between 5 and 12 months of age. Dose-response relationships are not clearly established for developmental neurotoxicity under conditions of chronic exposure (exposure for 365 days or more) to methylmercury. It was found that infants who reached the milestone criteria early had significantly higher mercury concentrations in the hair at 12 months of age. 65 No. Of the two studies. crawling and standing. In the milk. of which approximately 50% was inorganic. The Faroe Islands study. The researchers claimed that the exposure from amalgam fillings was the main source of mercury in milk. This led to public health concerns that prenatal low-dose exposure from fish consumption could also adversely affect the fetus. Thus. Controversy exists concerning the fetal risk associated with exposure to low-dose methylmercury from maternal fish consumption.3 µg/kg/day. sources of mercury exposure were identified through a questionnaire at the time of sampling. This association is contrary to what would be expected from possible neurotoxic effects of mercury. although a number of studies have looked at methylmercury in human breast milk. The extensive Seychelles Child Development Study that began in 1986 is examining the association between fetal methylmercury exposure from a maternal diet high in fish and subsequent child development. no strong evidence of toxicity has been reported. however. Human milk as a source of methylmercury Canadian Dental Association exposure in infants has been studied by Grandjean and others.9 The authors do say that more detailed studies in older children are needed to determine if there are adverse effects in fish-eating populations.5 No negative health effects from eating contaminated fish have been established. They concluded that efforts should be made to decrease mercury burden in fertile women. Concentrations of total and inorganic blood mercury were significantly higher in dentists. The authors found no significant correlation between the mercury levels in milk in any chemical form and the methylmercury intake. organo-mercury concentrations of the two groups were not statistically different (p ≥ . The study does not exclude the possibility that some degree of non-significant biotransformation may occur. 51% of the mercury was in the inorganic form. A study by Chang and others14 evaluated the blood mercury concentrations of dentists and non-dentists. A study by Oskarsson and others11 looked at the total and inorganic mercury content in breast milk that is related to fish consumption. a study by Smith and others12 reported that methylmercury in the U.S. Biotransformation of mercury. In addition. if methylmercury exposure from human milk had any adverse effect on milestone development in these infants.000 individuals in Canada did not find any identifiable health problems related to mercury. in the blood. 1 43 . The exposure was said to be one-half the tolerable daily intake for adults recommended by the World Health Organization (WHO). only 26% was present in the inorganic form. The results indicated that there was an efficient transfer of inorganic mercury from blood to milk. the double-blind study in the Seychelles has by far the best design and has the potential to yield the most valid scientific data. The Seychelles study. no clinical cases of methylmercury poisoning from fish have been found in Canada or Sweden. sitting. suggesting that biotransformation of inorganic mercury to organo-mercury does not occur in vivo. which suggests that. were examined. No definite effects have been detected through 29 months of age in the main study.6 Two important scientific studies that are currently under way aim to address the effect of mercury in the food chain. Since organic mercury presents a greater health hazard than metallic or inorganic mercury. a suggestion has been made that exposure to mercury vapour may result in metallic mercury (or perhaps ionic mercury) being transformed into highly toxic lipid soluble organomercury compounds by microorganisms in the oral cavity and gastrointestinal tract. In contrast.7 Previous studies of the effects of acute prenatal mercury exposure identified delays in achieving developmental milestones among exposed children. population is quite low.05). and that it is not likely that maternal hair methylmercury levels in the range found in their study would be associated with adverse health effects in children.8 Toddlers who had prenatal exposure to methylmercury are achieving the developmental milestones of walking and talking at normal ages. The authors point out that early milestone development is clearly associated with breast-feeding. a study by Drexler and Schaller13 concluded that the additional exposure to mercury of breast-fed babies from maternal amalgam fillings is of minor importance compared to maternal fish consumption. Other studies on mercury in breast milk. i.

most inorganic mercury released from amalgam is excreted.. about half of this 25% is exhaled and the other half is inhaled (12. of which about 90% is absorbed. Dental Amalgam An item of news causing some confusion recently was the announcement from the United Kingdom that pregnant women should avoid treatment involving amalgam fillings to limit the possibility of mercury reaching the fetus. About 25% is released as vapour from the saliva-covered amalgam.073 male subjects with a mean of 8. The British Dental Association issued a press release on April 29. pointing out that the use of amalgam. Mackert and Berglund17 point out that several publications misinterpret mercury in air by a factor of 16.4 µg Hg/day ÷ 24 hours = 0. UK Consumer Products and Environment] is issuing precautionary advice pending further research.1 µg/L. however.21 WHO’s maximum acceptable daily intake (ADI) for mercury is 40 µg/day. “The BDA accepts the Department of Health’s view that: • Pregnant women (or new mothers) should not be alarmed by this announcement. This 1997 WHO consensus statement does not suggest restrictions in the use of dental amalgam.22 and still keep within the limit of 40 µg/day: 44 µg/day ÷ 100 × 90 = 39. • There is no evidence that placement or removal of amalgam during pregnancy affects the fetus. higher rates occur during the eating of some foods and during tooth-brushing.534 µg Hg/day Many researchers studying the release of mercury from amalgam have made use of a Jerome 401 instrument for sampling mercury in air.6 µg/day An individual can be exposed to 262 µg/day of inorganic mercury from amalgam fillings with only 15.5%). 1998.25%) of the total mercury given off from dental amalgam is absorbed. this 262 µg/day of mercury vapour and ionic mercury given off from amalgam fillings would be equivalent to the mercury released from 490 amalgam surfaces.16 Berglund17 have reported that the rate of unstimulated mercury release from amalgam averages 0. An individual can be exposed to 44 µg/day of organic mercury in food.25% (10% + 5. Thus only 15.0167 × 4 = 0. an erroneous assumption.25% absorption and be within the same limit of 40 µg/day: 262 µg/day ÷ 100 × 15.5 seconds needed by the lungs produces a mercury-in-air value (40 ÷ 2. especially during placement and removal.34 µg Hg/day = 0. the U. it can be calculated that the 4-hour stimulated release during the day would be: 0.4 µg Hg/day ÷ 24 hours × 20 = 0.e. It takes the instrument 40 seconds to aspirate 500 mL of air. Only about 5.20 The mean total mercury level in urine for 1. but the lungs inhale that much air in just 2.aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb organo-mercury in blood was positively correlated with the frequency of fish consumption. The mercury vapour taken in by the instrument in 40 seconds compared with the 2. and of this latter amount 80% is absorbed through the lungs. This is. stating.4 µg per amalgam surface per day. these incorrect values compound inaccuracy.18. (A number of reports have assumed that meals and snacks affect mercury release to a degree similar to gum-chewing and tooth-brushing.067 × 3 = 0.25 = 39. when used to make further calculations.95 µg/day Assuming a combined stimulated and unstimulated release of 0. WHO standards for occupational exposure to inorganic mercury are currently 50 µg/m3 in air and 50 µg/g creatinine in urine. Having produced this new guideline. swallowed and converted to the ionic form. government then stated that it had no evidence that there was a risk from amalgam. COT [Committee on Toxicity of Chemicals in Food.19) If we assume that the stimulated condition occurs during a period of 4 hours and that it is three times higher than the unstimulated rate. The combined 24-hour stimulated and unstimulated rate would thus be: 0.5 seconds. It is further estimated that the other 75% of mercury vapour is dissolved in saliva.” Journal January 1999 Vol. only about 10% of mercury vapour released is absorbed (i.5) that is 16 times too high.5%). There is no evidence of harm to children whose mothers have undergone dental amalgam placement or removal during pregnancy. Release of mercury from restorations is time-dependent and proportional to the surface area of the Mackert and restorations. Mercury release is associated with the removal of an oxide layer from the surface of the amalgam alloy. 65 No.334 µg Hg/day. which leads to serious overestimations in calculating release of mercury from restorations. has not been shown to cause any adverse health effects. Thus.2 µg Hg/day + 3. 80% of 12.K. Studies show small amounts of mercury in fetuses but no adverse health effects have been shown and it is also not known whether the mercury found came from the diet or from amalgam fillings. How many patients do you know who have 490 amalgam surfaces? Canadian Dental Association .2 amalgam restorations has been reported as 3. Berglund18 developed a model based upon available literature that estimates the total mercury released from amalgam restorations. this amount of air (500 mL) is typical for an ordinary inhalation into the lungs. 1 44 A publication of WHO by Mjõr and Pakhomov15 recently endorsed the safety of amalgam.25% of this ionic mercury ends up being absorbed from the gastrointestinal tract (7% of 75%). Only inorganic and ionic forms of mercury are released from amalgam restorations.535 µg/day per amalgam surface.2 µg/day The unstimulated rate for 20 hours would be: 0.

Another study initiated by the NIDR.8 µg Hg ÷ 15. data indicate that each 10-fold increase in amalgam surfaces is associated with an increase of 1 µg/L of mercury in urine. as in the case of the Journal January 1999 Vol. prospective clinical trial in Portugal involves placement of amalgam and composite restorations in a group of 500 children aged 8 to 10 years. The ability to be absorbed is an essential prerequisite for systematic toxicity to occur. 65 No. if the mercury is all contributed from dental amalgam fillings. the design of the study limits its usefulness. The constantly repeated statement that most mercury is derived from amalgam fillings is puzzling. the ignoring of confounding variables or the misclassification of data. The database of these individuals contains comprehensive health data such as exposure to heavy metals and clinical measurements evaluating the central nervous and renal systems. exposure to organic mercury from food results in an absorption six times greater than the same amount of inorganic or ionic mercury. this study may finally provide solid data to confirm or disprove the potential for subtle and long-term effects from dental amalgam.24 It is too simplistic to lay blame on any one toxic element or compound in the absence of scientific proof. Additionally. In other words.A woman weighing 54 kg under the old Health Canada maximum exposure limit of 0. 1 45 . Assuming no mercury being contributed from food. That assumption holds even if. moreover. in 1992. However.S. because it will not be possible to infer cause and effect based simply on association. A major concern with neurobehavioural testing has to be the danger of measuring effects that are due to an activity or substance other than the one being evaluated. aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb Conclusions Recent announcements in Canada and the United Kingdom raise the question.6 µgHg/day. Ongoing Research A longitudinal. 9.2 µg/Hg/kg/day. When the public see an item reported in the media they assume that it is true.8 µg Hg/day The resultant absorbed dose differs greatly with the form of mercury. Exposure and Absorption The science of toxicity is complex. If all of the mercury is food-related.25% = 1. while inorganic ionic mercury is only very sparingly absorbed. The study was originally designed to evaluate the health effects attributable to exposure to Agent Orange. this 54-kg woman would have to have 47 amalgam surfaces (assuming an average mercury release per surface of 0. then the absorbed dose would be 10.7 µg. food-related mercury is significantly more toxic. Air Force personnel who served in Vietnam from 1962 to 1971. with the new Canadian exposure limit of 0.. The database also contains full dental records. i. a 54-kg woman would be permitted to be exposed to: 54 kg × 0. the number of amalgam surfaces would be reduced to 20. or about the different chemical forms in which it exists. Thus far. Should governments be developing limits and issuing precautionary advice for exposure to mercury from food or dental amalgam in the absence of new. Many studies suffer from a limited selection or choice of data. If governments change position statements or guidelines regarding health and safety. definitive scientific data? Do such announcements themselves create unease and stress that can affect the health of the population? The public should not be misled about the difference between exposure to mercury and the absorbed dose of mercury. this would be equal to an absorption of 1. The study design had a matching comparison group of non-exposed individuals. The resulting misinformation has been propagated and sensationalized by the media and by those with vested interests. is the so-called Ranch Hand study. Alternatively.47 µg/kg/day would be permitted to be exposed to 25.25 It is hoped that further data studying the possible linkages between mercury levels and health outcomes will become available as the study proceeds. including the type of restorations. the absorbed dosage is by far the most important critical factor in determining if a substance is an acute or chronic toxicant or if it has no toxic effect at all.e. the database should be able to provide some useful information. The lipid soluble organic mercury is readily Canadian Dental Association absorbed from the gastrointestinal tract.8.65 µg Hg/day Thus.2 µg/kg/day = 10.534 µg/day) to reach the maximum level of mercury permitted. based on U.127-man cohort cannot be said to represent a cross-section of the general population. the public assume that the situation has become worse.21 The test population selected had little or no exposure to mercury combined with a relatively high rate of caries.38 µg/day Hg. the uptake of food-related organic mercury is six times higher than the uptake of mercury from amalgam.23 We are faced with a constant stream of half-truths and anti-chemical alarms that ignore and undermine basic scientific principals. Supported by the National Institute of Dental and Craniofacial Research (NIDR). again assuming no mercury intake from other sources such as food. As demonstrated above. With the new lower Health Canada maximum exposure limit. Many well-meaning environmental activists subscribe to these scare stories that are often based on poorly designed experiments and epidemiological surveys. Confusion between exposure and absorption for the various forms of mercury and the overestimation of mercury vapour using the Jerome instrument are two of many areas of misinformation that have confused facts relating to dental amalgam. At least 750 toxicants have the potential to cause neurotoxic effects in humans after a shortterm or long-term exposure or latent period. randomized. This all-male (age 40 to 78 years) 1. However. then the absorbed dose would be 90% of 10.

104:56-63. Lakowicz JR. Leroux B. Estimation by a 24-hour study of the dose of intra-oral mercury vapour inhaled after release from dental amalgam. Weihe P. In: Nriagu JO. Environmental health criteria 118. 285-309. 1991. World Health Organization. Fate and transport of mercury in the environment: global aspects. it seems likely that humans may have evolved with a threshold level for mercury below which there is no response or observable adverse health effects. Environ Toxicol Chem 1990. Semiparametric modeling of age at achieving developmental milestones after prenatal exposure to methylmercury in the Seychelles Child Development Study. 1997. Permeability of lipid biolayers to methylmercuric chloride: quantification by fluorescence quenching of a carbazolelabeled phospholipid.W. Neurotoxicology 1995. Mercury. 18:819-29. Neurotoxicity of industrial and commercial chemicals. White RF. 17:241-50. Smith JC. 52:476-80. and others. Gruninger SE. Fax: (613) 523-6574. Axtell CD. 5981 University Ave. 14. 1994 Oct 30-Nov 2. 1991. Clarkson T. CDA members can borrow this book by contacting the CDA Resource Centre at: Tel.S. Oxford: Butterworth-Heinmann. Neurotoxicology 1997. Tanner MA. Inorganic mercury. Mjõr IA. E-mail: library@cda-adc. 8:410-36. 1979. editor. References Journal January 1999 Vol. 11. Environ Health Perspect 1998. Anger WK.26. NS B3H 3J5. Jones. 1985. 9. Department of Applied Oral Sciences. Myers GJ. Schultz A. Schaller KH. 15. 7. Arch Environ Health 1997. and others.: 1-800-267-6354 (ext. Dalhousie University. The biogeochemistry of mercury in the environment. Boca Raton (FL): CRC Press. Berglund A. Eur J Oral Sci 1996. Von Burg R. 26. 1984. In: O’Donoghue J. Hallen IP. Myers GJ.ca.Abst 2594):956. Shamlaye CF. 1997. 5. J Dent Res 1990. Dental amalgam and alternative direct restorative materials. The concept that an actual tolerance may exists for low levels of mercury in the human body can. be rationalized. Skerfving S. 650. aquatic and air environments. Mercury concentrations in urine and whole blood associated with amalgam exposure in a US military population. 19. suggests that living organisms have been in contact with mercury and mercury compounds throughout the long evolution of biological systems leading up to human development.North Holland Biomedical Press. The future of dental amalgam: a review of the literature. Oskarsson A. Davidson PW. Anderson CJ. Canadian Dental Association . Molin M. Halifax. What risk?. 51:234-41. Milestone development in infants exposed to methylmercury from human milk. Pakhomov GN. New York: Elsevier. Amdur MO. Choissy D. 18. R. Siew C. Berglund A. Allen PV. 1994 Oct 30-Nov 2. women. WHO. Neurotoxicology 1996. no level of mercury is acceptable in the human body. 27. Division of Noncommunicable Diseases. International Program on Chemical Safety. Arkansas. Davidson PW. coupled with the relative ease with which it can be chemically modified. Jones is professor of biomaterials at Dalhousie University. Sloane-Reeves J. Berglund A. The prevalence of naturally occurring mercury in the Earth’s crust. International Program on Chemical Safety. World Health Organization. Brown LJ. 8. Cernichiari E. Mercury from dental amalgam fillings: absorbed dose and the potential for adverse health effects. Derek W. p. Olsson S. Clarkson T. Halifax. Changing metal cycles and human health. Casa Pia study of the health effects of dental amalgam. Woods J. Mercury vapour release from dental amalgam in patients with symptoms allegedly caused by amalgam fillings. 1998. Vol. Choi AL. Hair methylmercury levels in U. Factors affecting blood mercury concentrations in practicing dentists. p. Crit Rev Oral Biol Med 1997. The mercury concentration in breast milk resulting from amalgam fillings and dietary habits. 77:124-9. Geneva.27 Given the epidemiological evidence we have. Arch Environ Health 1996. 23. and others. 1990. Marsh DO. 21. Cernichiari E. Kingman A. Summary of the Seychelles Child Development Study on the relationship of fetal methylmercury exposure to neurodevelopment. New York: Pergamon Press. Klassen CD. Doull J. Arkansas. Paradis S. 10. Geneva. Human exposure to methylmercury from fish: studies of fish eating populations. the new guidelines are introduced with the qualifying statement that there is no evidence on the health risk. Albertini T. Drexler H. Effects of prenatal methylmercury exposure from a high fish diet on developmental milestones in the Seychelles Child Development Study. Berglund A. Johnson BL. 4. 1 46 1. Martin M. Gloss SP. editor. 24. The Athenaeum Press. 65 No. Mackert JR Jr. 9:919-30. NEW ACQUISITION Eley. transported and exchanged among land. editor. Myers GJ. Chem Biol Inter 1980. Bate. Ohlin B. Reprint requests to: Dr. Paper presented at 12th International Neurotoxicology Conference. 25. Hot Springs. Cassaret and Doull’s Toxicology: The basic science of poisons. Methylmercury. 16:711-6. D. Neurotoxicology 1995. According to some people who view dental amalgam as causing a variety of health problems. Determination of the rate of release of intra-oral mercury vapour from amalgam. J Dent Res 1998. 106:559-63. 69:1646-51. and others. J Dent Res 1998. 77(Spec Iss B . 16:27-33. Derouen T. 3. editor.aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb British government and dental amalgam. Bergman M. Paper presented at 12th International Neurotoxicology Conference. Geneva. risk and reality: questions raised by the Canadian Aboriginal Methylmercury Program. Townes B. and others. 2223). 20. Lagerkvist BJ. however. 30:309-23. Davidson PW. 51-148. Hot Springs. 16. Cox C. Berlin: Springer-Verlag. 77:461-71. n Dr. p. Pohl L.. 6. Grandjean P. Barry M. J Dent Res 1988. Chang SB. 12. 67:1235-42. Total and inorganic mercury in breast milk in relation to fish consumption and amalgam in lactating women. 22. 13. Grieb TM. Shamlaye CF. I. Axtell CD. Balancing human exposure. Environmental health criteria 101. 71:66-74. Wheatley B. Factors affecting mercury accumulation in fish in the Upper Michigan Peninsula. Fitzgerald W. 17. Nriagu JO. Environ Res 1998. J Dent Res 1992. Chemicals affecting behaviour. Driscoll CT. 2.

47 µg/kg/day down to 0. The average daily intake of methylmercury (mainly from fish) that may cause demonstrable health effects in the most sensitive individual is 300 µg/day. 65 No 1 42 n April 1998. En moyenne. particularly if we consider the different chemical forms of mercury. La quantité de mercure organique qui provient des aliments est six fois plus élevée que l’apport provenant des amalgames. This recommended lower mercury exposure has raised questions about the dental amalgam issue once again. The atmosphere deposits about 2 million kg/year of mercury into oceans.3 µg de Hg par jour.3 µg Hg/day/kg body weight. Introduction I Journal Janvier 1999 Vol. It is extremely misleading to look only at the exposure levels without considering the absorption levels. par kilogramme de poids corporel. This new exposure guideline does not seem to be based upon any new scientific finding of human toxicity. mercury/adverse effects. dental amalgam/adverse effects.2 Unlike inorganic or metallic mercury. and the rivers are estimated to contribute a further 200. or 4. environmental exposure. © J Can Dent Assoc 1999. Lipid soluble organic mercury is much more bioavailable than metallic inorganic mercury. ou 4. Health Canada lowered the maximum daily exposure of mercury from all sources for women of child-bearing age and for children less than 10 years by 57% from 0.. ainsi qu’à l’erreur de classification des données ou à l’abstraction qui est faite des variables confusionnelles dans l’analyse. 65:42-6 Cet article a fait l’objet d’une révision par des pairs. il faudrait en effet qu’une personne ait 490 surfaces d’amalgame pour que la quantité de vapeurs de mercure et d’ions mercure libérés par les obturations à l’amalgame atteigne l’exposition maximale prescrite. Jones. CChem.000 kg/year. a major question that science has not yet answered is what L’Association dentaire canadienne . The organic form in food is much more insidious due to its ability to traverse lipid membranes and penetrate the central nervous system.1 The new. FRSC(UK).2 µg/kg/day. organic mercury readily crosses the blood-brain barrier. it is important to note that about 50% of environmental mercury comes from natural sources due to volatilization from the ocean and erosion of rocks. cette nouvelle directive ne semble s’appuyer sur aucune donnée scientifique nouvelle concernant la toxicité du mercure chez les humains.aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa Exposure or Absorption and the Crucial Question of Limits for Mercury (Différence entre exposition et absorption et la question cruciale des limites relatives au mercure) Derek W. however. pour les femmes en âge de procréer et les enfants de moins de 10 ans. FIM. PhD. Mots clés MeSH : absorption. La quantité de mercure qui se dégage des amalgames dentaires est minime. FBSE SOMMAIRE Santé Canada a récemment abaissé le taux maximal recommandé d’exposition quotidienne au mercure (toutes sources confondues).3 Health Canada and Environment Canada have stated that they are concerned about industrial pollution. Les études qui ont été faites sur le méthylmercure dans le lait maternel (chez les mères qui consomment beaucoup de poisson) n’ont révélé aucune preuve solide de toxicité.4 Regardless of the source of environmental mercury. ionic mercury or mercury vapour from dental amalgam. qui plus est. lower Health Canada limit is 95% below the level that may cause health effects. le mercure d’origine alimentaire est beaucoup plus toxique. Cependant. Or la nouvelle limite à la baisse établie par Santé Canada est de 95 % inférieure au seuil nuisible à la santé. l’ingestion quotidienne de méthylmercure (provenant essentiellement du poisson) qui peut causer des effets démontrables sur la santé des personnes les plus sensibles est de 300 µg par jour. à la sélection limitée de données. Un grand nombre d’études sur le mercure dans les amalgames dentaires présentent des lacunes dues à la confusion qui existe entre l’exposition aux diverses formes de mercure et l’absorption de ce dernier.

9 The authors do say that more detailed studies in older children are needed to determine if there are adverse effects in fish-eating populations.05). Since organic mercury presents a greater health hazard than metallic or inorganic mercury. were examined. only 26% was present in the inorganic form. This led to public health concerns that prenatal low-dose exposure from fish consumption could also adversely affect the fetus. if methylmercury exposure from human milk had any adverse effect on milestone development in these infants. They reported that the exposure of the infant to mercury from breast milk ranged up to 0. Thus. Of the two studies. A study by Chang and others14 evaluated the blood mercury concentrations of dentists and non-dentists. This association is contrary to what would be expected from possible neurotoxic effects of mercury. Human milk as a source of methylmercury L’Association dentaire canadienne exposure in infants has been studied by Grandjean and others.8 Toddlers who had prenatal exposure to methylmercury are achieving the developmental milestones of walking and talking at normal ages.10 In a community in the Faroe Islands. The study does not exclude the possibility that some degree of non-significant biotransformation may occur. However. A study by Oskarsson and others11 looked at the total and inorganic mercury content in breast milk that is related to fish consumption. although a number of studies have looked at methylmercury in human breast milk.6 Two important scientific studies that are currently under way aim to address the effect of mercury in the food chain. which suggests that. The Seychelles study. Controversy exists concerning the fetal risk associated with exposure to low-dose methylmercury from maternal fish consumption.7 Previous studies of the effects of acute prenatal mercury exposure identified delays in achieving developmental milestones among exposed children. The study is double blind and uses maternal hair mercury as the index of fetal exposure. sources of mercury exposure were identified through a questionnaire at the time of sampling. In light of these findings it is difficult to understand the recent change in the guidelines from Health Canada. The authors found no significant correlation between the mercury levels in milk in any chemical form and the methylmercury intake. sitting. a suggestion has been made that exposure to mercury vapour may result in metallic mercury (or perhaps ionic mercury) being transformed into highly toxic lipid soluble organomercury compounds by microorganisms in the oral cavity and gastrointestinal tract. the effect was compensated by the advantages associated with breastfeeding. - aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb Journal Janvier 1999 Vol.5 No negative health effects from eating contaminated fish have been established.000 individuals in Canada did not find any identifiable health problems related to mercury. in the blood. 65 No 1 43 . Biotransformation of mercury. shorter periods of time such as the duration of breast-feeding are even more challenging. a study by Smith and others12 reported that methylmercury in the U. In contrast. crawling and standing. The researchers claimed that the exposure from amalgam fillings was the main source of mercury in milk.S. The extensive Seychelles Child Development Study that began in 1986 is examining the association between fetal methylmercury exposure from a maternal diet high in fish and subsequent child development. It was found that infants who reached the milestone criteria early had significantly higher mercury concentrations in the hair at 12 months of age. The Faroe Islands study. suggesting that biotransformation of inorganic mercury to organo-mercury does not occur in vivo. 51% of the mercury was in the inorganic form. i. In addition. Dose-response relationships are not clearly established for developmental neurotoxicity under conditions of chronic exposure (exposure for 365 days or more) to methylmercury. however. They concluded that efforts should be made to decrease mercury burden in fertile women. the double-blind study in the Seychelles has by far the best design and has the potential to yield the most valid scientific data. The authors point out that early milestone development is clearly associated with breast-feeding. In the milk.. these are the Seychelles study and the Faroe Islands study. no strong evidence of toxicity has been reported. high maternal consumption of pilot whale meat and blubber and other seafood had the potential to cause a considerable transfer of neurotoxicants during breast-feeding. a study by Drexler and Schaller13 concluded that the additional exposure to mercury of breast-fed babies from maternal amalgam fillings is of minor importance compared to maternal fish consumption. The exposure was said to be one-half the tolerable daily intake for adults recommended by the World Health Organization (WHO). Mercury in the Food Chain A 20-year retrospective analysis of methylmercury in fish involving over 38. no clinical cases of methylmercury poisoning from fish have been found in Canada or Sweden.3 µg/kg/day.effect mercury in the food chain has on human health. and that it is not likely that maternal hair methylmercury levels in the range found in their study would be associated with adverse health effects in children. The researchers followed 583 children from a birth cohort. The results indicated that there was an efficient transfer of inorganic mercury from blood to milk. Concentrations of total and inorganic blood mercury were significantly higher in dentists. Three developmental milestones that are usually reached between 5 and 12 months of age. population is quite low. organo-mercury concentrations of the two groups were not statistically different (p ≥ . No definite effects have been detected through 29 months of age in the main study.e. Other studies on mercury in breast milk. of which approximately 50% was inorganic.

4 µg per amalgam surface per day.5%). only about 10% of mercury vapour released is absorbed (i. swallowed and converted to the ionic form.5) that is 16 times too high. has not been shown to cause any adverse health effects. The British Dental Association issued a press release on April 29.067 × 3 = 0.25%) of the total mercury given off from dental amalgam is absorbed.073 male subjects with a mean of 8.34 µg Hg/day = 0.25% (10% + 5. Dental Amalgam An item of news causing some confusion recently was the announcement from the United Kingdom that pregnant women should avoid treatment involving amalgam fillings to limit the possibility of mercury reaching the fetus.K. It takes the instrument 40 seconds to aspirate 500 mL of air.0167 × 4 = 0. How many patients do you know who have 490 amalgam surfaces? L’Association dentaire canadienne . Having produced this new guideline.5 seconds needed by the lungs produces a mercury-in-air value (40 ÷ 2.20 The mean total mercury level in urine for 1. pointing out that the use of amalgam.22 and still keep within the limit of 40 µg/day: 44 µg/day ÷ 100 × 90 = 39. Berglund18 developed a model based upon available literature that estimates the total mercury released from amalgam restorations. COT [Committee on Toxicity of Chemicals in Food. The mercury vapour taken in by the instrument in 40 seconds compared with the 2. 1998.21 WHO’s maximum acceptable daily intake (ADI) for mercury is 40 µg/day.19) If we assume that the stimulated condition occurs during a period of 4 hours and that it is three times higher than the unstimulated rate. “The BDA accepts the Department of Health’s view that: • Pregnant women (or new mothers) should not be alarmed by this announcement. of which about 90% is absorbed. most inorganic mercury released from amalgam is excreted.534 µg Hg/day Many researchers studying the release of mercury from amalgam have made use of a Jerome 401 instrument for sampling mercury in air. • There is no evidence that placement or removal of amalgam during pregnancy affects the fetus.5%).1 µg/L.25% of this ionic mercury ends up being absorbed from the gastrointestinal tract (7% of 75%). it can be calculated that the 4-hour stimulated release during the day would be: 0. This 1997 WHO consensus statement does not suggest restrictions in the use of dental amalgam. 80% of 12. Thus.5 seconds.4 µg Hg/day ÷ 24 hours × 20 = 0. There is no evidence of harm to children whose mothers have undergone dental amalgam placement or removal during pregnancy. Studies show small amounts of mercury in fetuses but no adverse health effects have been shown and it is also not known whether the mercury found came from the diet or from amalgam fillings. Thus only 15. government then stated that it had no evidence that there was a risk from amalgam. however.4 µg Hg/day ÷ 24 hours = 0.95 µg/day Assuming a combined stimulated and unstimulated release of 0.16 Berglund17 have reported that the rate of unstimulated mercury release from amalgam averages 0.” Journal Janvier 1999 Vol.2 amalgam restorations has been reported as 3.. Only inorganic and ionic forms of mercury are released from amalgam restorations. higher rates occur during the eating of some foods and during tooth-brushing. this amount of air (500 mL) is typical for an ordinary inhalation into the lungs. stating. 65 No 1 44 A publication of WHO by Mjõr and Pakhomov15 recently endorsed the safety of amalgam. About 25% is released as vapour from the saliva-covered amalgam.334 µg Hg/day.6 µg/day An individual can be exposed to 262 µg/day of inorganic mercury from amalgam fillings with only 15. The combined 24-hour stimulated and unstimulated rate would thus be: 0. especially during placement and removal. UK Consumer Products and Environment] is issuing precautionary advice pending further research. this 262 µg/day of mercury vapour and ionic mercury given off from amalgam fillings would be equivalent to the mercury released from 490 amalgam surfaces. but the lungs inhale that much air in just 2. Release of mercury from restorations is time-dependent and proportional to the surface area of the Mackert and restorations. these incorrect values compound inaccuracy. which leads to serious overestimations in calculating release of mercury from restorations.18.25 = 39.2 µg/day The unstimulated rate for 20 hours would be: 0.aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb organo-mercury in blood was positively correlated with the frequency of fish consumption. Only about 5.e. when used to make further calculations. and of this latter amount 80% is absorbed through the lungs. An individual can be exposed to 44 µg/day of organic mercury in food. the U. It is further estimated that the other 75% of mercury vapour is dissolved in saliva.2 µg Hg/day + 3. Mercury release is associated with the removal of an oxide layer from the surface of the amalgam alloy. (A number of reports have assumed that meals and snacks affect mercury release to a degree similar to gum-chewing and tooth-brushing.25% absorption and be within the same limit of 40 µg/day: 262 µg/day ÷ 100 × 15. This is. about half of this 25% is exhaled and the other half is inhaled (12. Mackert and Berglund17 point out that several publications misinterpret mercury in air by a factor of 16. an erroneous assumption. WHO standards for occupational exposure to inorganic mercury are currently 50 µg/m3 in air and 50 µg/g creatinine in urine.535 µg/day per amalgam surface.

is the so-called Ranch Hand study. However.25 It is hoped that further data studying the possible linkages between mercury levels and health outcomes will become available as the study proceeds. the database should be able to provide some useful information. the public assume that the situation has become worse. aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb Conclusions Recent announcements in Canada and the United Kingdom raise the question.8 µg Hg/day The resultant absorbed dose differs greatly with the form of mercury. The study design had a matching comparison group of non-exposed individuals.534 µg/day) to reach the maximum level of mercury permitted. again assuming no mercury intake from other sources such as food. The lipid soluble organic mercury is readily L’Association dentaire canadienne absorbed from the gastrointestinal tract. Ongoing Research A longitudinal. a 54-kg woman would be permitted to be exposed to: 54 kg × 0. the uptake of food-related organic mercury is six times higher than the uptake of mercury from amalgam. prospective clinical trial in Portugal involves placement of amalgam and composite restorations in a group of 500 children aged 8 to 10 years. then the absorbed dose would be 90% of 10. 9. then the absorbed dose would be 10.65 µg Hg/day Thus. That assumption holds even if.6 µgHg/day.127-man cohort cannot be said to represent a cross-section of the general population. The study was originally designed to evaluate the health effects attributable to exposure to Agent Orange. When the public see an item reported in the media they assume that it is true. This all-male (age 40 to 78 years) 1.8 µg Hg ÷ 15. definitive scientific data? Do such announcements themselves create unease and stress that can affect the health of the population? The public should not be misled about the difference between exposure to mercury and the absorbed dose of mercury. Many studies suffer from a limited selection or choice of data. The constantly repeated statement that most mercury is derived from amalgam fillings is puzzling. However.2 µg/Hg/kg/day. as in the case of the Journal Janvier 1999 Vol.24 It is too simplistic to lay blame on any one toxic element or compound in the absence of scientific proof.21 The test population selected had little or no exposure to mercury combined with a relatively high rate of caries. The ability to be absorbed is an essential prerequisite for systematic toxicity to occur.23 We are faced with a constant stream of half-truths and anti-chemical alarms that ignore and undermine basic scientific principals. i.25% = 1. If governments change position statements or guidelines regarding health and safety. or about the different chemical forms in which it exists. randomized. if the mercury is all contributed from dental amalgam fillings.S. because it will not be possible to infer cause and effect based simply on association. 65 No 1 45 . the design of the study limits its usefulness. The resulting misinformation has been propagated and sensationalized by the media and by those with vested interests. with the new Canadian exposure limit of 0. Another study initiated by the NIDR. this study may finally provide solid data to confirm or disprove the potential for subtle and long-term effects from dental amalgam. food-related mercury is significantly more toxic. Alternatively.A woman weighing 54 kg under the old Health Canada maximum exposure limit of 0. Supported by the National Institute of Dental and Craniofacial Research (NIDR). Confusion between exposure and absorption for the various forms of mercury and the overestimation of mercury vapour using the Jerome instrument are two of many areas of misinformation that have confused facts relating to dental amalgam. The database of these individuals contains comprehensive health data such as exposure to heavy metals and clinical measurements evaluating the central nervous and renal systems. Exposure and Absorption The science of toxicity is complex. With the new lower Health Canada maximum exposure limit.2 µg/kg/day = 10. exposure to organic mercury from food results in an absorption six times greater than the same amount of inorganic or ionic mercury. including the type of restorations. the number of amalgam surfaces would be reduced to 20.. The database also contains full dental records.7 µg.47 µg/kg/day would be permitted to be exposed to 25. Thus far. the absorbed dosage is by far the most important critical factor in determining if a substance is an acute or chronic toxicant or if it has no toxic effect at all. Should governments be developing limits and issuing precautionary advice for exposure to mercury from food or dental amalgam in the absence of new. the ignoring of confounding variables or the misclassification of data. At least 750 toxicants have the potential to cause neurotoxic effects in humans after a shortterm or long-term exposure or latent period. If all of the mercury is food-related. As demonstrated above. Assuming no mercury being contributed from food. A major concern with neurobehavioural testing has to be the danger of measuring effects that are due to an activity or substance other than the one being evaluated. Many well-meaning environmental activists subscribe to these scare stories that are often based on poorly designed experiments and epidemiological surveys.8. data indicate that each 10-fold increase in amalgam surfaces is associated with an increase of 1 µg/L of mercury in urine. while inorganic ionic mercury is only very sparingly absorbed. based on U. Air Force personnel who served in Vietnam from 1962 to 1971. this 54-kg woman would have to have 47 amalgam surfaces (assuming an average mercury release per surface of 0. Additionally. in 1992.e. moreover.38 µg/day Hg. this would be equal to an absorption of 1. In other words.

Lakowicz JR. 1984. Jones is professor of biomaterials at Dalhousie University. 18. Hallen IP. 16. J Dent Res 1998. Paradis S. Siew C. Neurotoxicology 1997. 5981 University Ave. Gloss SP. Sloane-Reeves J. 14. Reprint requests to: Dr. 650. 9:919-30. Axtell CD. Neurotoxicology 1995. 1997. it seems likely that humans may have evolved with a threshold level for mercury below which there is no response or observable adverse health effects. Permeability of lipid biolayers to methylmercuric chloride: quantification by fluorescence quenching of a carbazolelabeled phospholipid. Martin M. Von Burg R. Schaller KH. Fate and transport of mercury in the environment: global aspects. Paper presented at 12th International Neurotoxicology Conference. 69:1646-51. Chang SB. Shamlaye CF. Skerfving S. Neurotoxicology 1996. the new guidelines are introduced with the qualifying statement that there is no evidence on the health risk. Mercury concentrations in urine and whole blood associated with amalgam exposure in a US military population. 6. p. Molin M. 1994 Oct 30-Nov 2. D. aquatic and air environments. Inorganic mercury. Ohlin B. 30:309-23. Derouen T. Pakhomov GN. Shamlaye CF. risk and reality: questions raised by the Canadian Aboriginal Methylmercury Program. Gruninger SE. Oxford: Butterworth-Heinmann. WHO.aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa bbbbbbbbbbbbbbbbbbbbbbbbbbbbbb British government and dental amalgam. The prevalence of naturally occurring mercury in the Earth’s crust. Davidson PW. Nriagu JO. Mercury vapour release from dental amalgam in patients with symptoms allegedly caused by amalgam fillings. 1991. In: O’Donoghue J. Estimation by a 24-hour study of the dose of intra-oral mercury vapour inhaled after release from dental amalgam. Halifax. What risk?. New York: Elsevier. 1997. Eur J Oral Sci 1996. Geneva. 7. Paper presented at 12th International Neurotoxicology Conference. The biogeochemistry of mercury in the environment. Grandjean P. Cox C. 285-309.26. Klassen CD. Townes B. Arch Environ Health 1996. 1991. 1985. Geneva. 11. Casa Pia study of the health effects of dental amalgam. Pohl L. 24. Human exposure to methylmercury from fish: studies of fish eating populations. Mercury from dental amalgam fillings: absorbed dose and the potential for adverse health effects. New York: Pergamon Press. Factors affecting mercury accumulation in fish in the Upper Michigan Peninsula. International Program on Chemical Safety. Summary of the Seychelles Child Development Study on the relationship of fetal methylmercury exposure to neurodevelopment.. 8. editor. J Dent Res 1988. J Dent Res 1992. 22. Bate. 17. Clarkson T. 27. transported and exchanged among land. Environ Res 1998. Grieb TM. Halifax. L’Association dentaire canadienne . Environ Health Perspect 1998. and others. Mercury. 104:56-63. n Dr. Marsh DO. Davidson PW. Wheatley B. Clarkson T. Woods J. Determination of the rate of release of intra-oral mercury vapour from amalgam. 10. Myers GJ. however. Choissy D. In: Nriagu JO. 106:559-63. Milestone development in infants exposed to methylmercury from human milk. Effects of prenatal methylmercury exposure from a high fish diet on developmental milestones in the Seychelles Child Development Study. Axtell CD. Cernichiari E. Hot Springs. Arkansas. Drexler H. Department of Applied Oral Sciences. World Health Organization. 52:476-80. 71:66-74. 20. 25. 8:410-36. editor. Geneva. 9. J Dent Res 1990. Jones. and others. Factors affecting blood mercury concentrations in practicing dentists. Oskarsson A. 26. 51:234-41. Amdur MO. The future of dental amalgam: a review of the literature.North Holland Biomedical Press. Neurotoxicology 1995. 17:241-50. Barry M.W. Anger WK. Neurotoxicity of industrial and commercial chemicals. Arch Environ Health 1997. no level of mercury is acceptable in the human body. 1994 Oct 30-Nov 2. Davidson PW. I. Dalhousie University. Les membres de l’ADC peuvent emprunter ce livre en communiquant avec le Centre de documentation de l’ADC par téléphone au 1-800-267-6354 (poste 2223). editor. Methylmercury. Anderson CJ. The Athenaeum Press. 65 No 1 46 1. 1998. 51-148. Berglund A. Myers GJ. 3. Lagerkvist BJ. J Dent Res 1998. 18:819-29. Vol.Abst 2594):956. Bergman M. 67:1235-42. 16:27-33. Choi AL. Albertini T. White RF. 77:461-71. suggests that living organisms have been in contact with mercury and mercury compounds throughout the long evolution of biological systems leading up to human development. 2. Balancing human exposure. Total and inorganic mercury in breast milk in relation to fish consumption and amalgam in lactating women. Changing metal cycles and human health. 12. 23. and others. Dental amalgam and alternative direct restorative materials. 16:711-6. Driscoll CT. Berlin: Springer-Verlag. NS B3H 3J5. 1979. be rationalized. Environmental health criteria 118. Derek W. NOUVELLE ACQUISITION Eley. and others. 15. Berglund A. Crit Rev Oral Biol Med 1997. International Program on Chemical Safety. 5. Arkansas. Allen PV. Johnson BL. Olsson S. According to some people who view dental amalgam as causing a variety of health problems. Division of Noncommunicable Diseases. Smith JC. 21. Doull J. Kingman A.27 Given the epidemiological evidence we have. 19. Boca Raton (FL): CRC Press. editor. Semiparametric modeling of age at achieving developmental milestones after prenatal exposure to methylmercury in the Seychelles Child Development Study. 77:124-9. World Health Organization. par télécopieur au (613) 523-6574 ou par courrier électronique à library@cda-adc. women. The mercury concentration in breast milk resulting from amalgam fillings and dietary habits. Cassaret and Doull’s Toxicology: The basic science of poisons. Weihe P. Brown LJ. Environ Toxicol Chem 1990. Hair methylmercury levels in U. Environmental health criteria 101. Mackert JR Jr. Hot Springs. 4. Schultz A. p. 1990. 77(Spec Iss B . Chemicals affecting behaviour. The concept that an actual tolerance may exists for low levels of mercury in the human body can. Berglund A. Fitzgerald W. 13. Mjõr IA. Chem Biol Inter 1980. References Journal Janvier 1999 Vol. Leroux B. coupled with the relative ease with which it can be chemically modified. p. and others. Cernichiari E.S.ca. Tanner MA. Berglund A. Myers GJ. R.