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Favero V, Bacci C, Volpato A, Bandiera M, Favero L, Zanette G. Pregnancy and Dentistry: A Literature Review on Risk Management during Dental Surgical Procedures. Dent J (Basel) 2021; 9:dj9040046. [PMID: 33921608 PMCID: PMC8072957 DOI: 10.3390/dj9040046] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 04/02/2021] [Accepted: 04/15/2021] [Indexed: 11/16/2022] Open
Abstract
Background: Pregnancy is a unique moment in a woman’s life, accompanied with several physiologic changes that have an impact on oral health. Aim of the study: The purpose of the present study was to conduct a critical review of published literature regarding pregnancy and dentistry, the most frequent oral diseases that are encountered during pregnancy, their correlation to adverse pregnancy events, and safe dental treatments that can be performed during pregnancy. Methods: A Medline/COCHRANE search was carried using specific keywords and MeSH terms, combined with the boolean operators “OR” and “AND”. Results: The search led to 146 publications including guidelines, meta-analyses, systematic and non-systematic reviews, published between 2000 and 2021. Discussion and conclusions: Due to the increased inflammatory and immune body response that characterizes pregnancy, periodontal conditions are often aggravated during pregnancy and periodontal disease encountered frequently in pregnant patients. There are conflicting study results in the literature regarding the association between periodontitis and adverse pregnancy outcomes. Periodontal treatment did not show a significant reduction in the adverse outcomes. Many dentists, often due to lack of information, are reluctant to provide dental treatment to pregnant women. However, preventive and restorative dental treatment is safe during pregnancy. Diagnostic radiographs may be performed after the first trimester if absolutely necessary. Analgesics (such as paracetamol) and anesthetics (such as lidocaine) are also considered safe. In case of infection, antibacterial drugs such as amoxicillin, ampicillin, and some cephalosporines and macrolides can also be prescribed. Organogenesis takes place in the first trimester, the time during which the fetus is susceptible to severe malformations (teratogenesis). The ideal time to perform dental treatment is the second trimester (week 17 to 28). However, acute pain or infections make the intervention of the dentist absolutely necessary and emergency treatment can be performed during the whole pregnancy period.
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Affiliation(s)
- Vittorio Favero
- Unit of Maxillofacial Surgery and Dentistry, University of Verona, 37129 Verona, Italy;
| | - Christian Bacci
- Dental Clinic, Department of Neuroscience, University of Padua, 35129 Padua, Italy; (C.B.); (M.B.); (L.F.); (G.Z.)
| | - Andrea Volpato
- Dental Clinic, Department of Neuroscience, University of Padua, 35129 Padua, Italy; (C.B.); (M.B.); (L.F.); (G.Z.)
- Correspondence: or
| | - Michela Bandiera
- Dental Clinic, Department of Neuroscience, University of Padua, 35129 Padua, Italy; (C.B.); (M.B.); (L.F.); (G.Z.)
| | - Lorenzo Favero
- Dental Clinic, Department of Neuroscience, University of Padua, 35129 Padua, Italy; (C.B.); (M.B.); (L.F.); (G.Z.)
| | - Gastone Zanette
- Dental Clinic, Department of Neuroscience, University of Padua, 35129 Padua, Italy; (C.B.); (M.B.); (L.F.); (G.Z.)
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Jennrich P. Diagnostic Use of Chelating Agents. DEUTSCHES ARZTEBLATT INTERNATIONAL 2017; 114:252-253. [PMID: 28446358 PMCID: PMC5415916 DOI: 10.3238/arztebl.2017.0252c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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Gump BB, Gabrikova E, Bendinskas K, Dumas AK, Palmer CD, Parsons PJ, MacKenzie JA. Low-level mercury in children: associations with sleep duration and cytokines TNF-α and IL-6. ENVIRONMENTAL RESEARCH 2014; 134:228-32. [PMID: 25173056 PMCID: PMC4262607 DOI: 10.1016/j.envres.2014.07.026] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Revised: 07/21/2014] [Accepted: 07/31/2014] [Indexed: 05/23/2023]
Abstract
There is a sizeable literature suggesting that mercury (Hg) exposure affects cytokine levels in humans. In addition to their signaling role in the immune system, some cytokines are also integrally associated with sleep behavior. In this cross-sectional study of 9-11 year old children (N=100), we measured total blood Hg in whole blood, serum levels of tumor necrosis factor α (TNF-α) and interleukin 6 (IL-6), and objectively measured sleep and activity using actigraphy. Increasing blood Hg was associated with significantly shorter sleep duration and lower levels of TNF-α. IL-6 was not associated with sleep or blood Hg. This study is the first to document an association between total blood Hg and sleep (albeit a small effect), and the first to consider the associations of total blood Hg with cytokines TNF-α and IL-6 in a pediatric sample. Further research using alternative designs (e.g., time-series) is necessary to determine if there is a causal pathway linking low-level Hg exposure to sleep restriction and reduced cytokines.
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Affiliation(s)
- Brooks B Gump
- Department of Public Health, Food Studies, and Nutrition, Syracuse University, United States.
| | - Elena Gabrikova
- Departments of Biological Sciences, State University of New York College at Oswego, United States
| | - Kestutis Bendinskas
- Departments of Chemistry, State University of New York College at Oswego, United States
| | - Amy K Dumas
- Department of Public Health, Food Studies, and Nutrition, Syracuse University, United States
| | - Christopher D Palmer
- Laboratory of Inorganic and Nuclear Chemistry, Wadsworth Center, New York State Department of Health, United States; Department of Environmental Health Sciences, School of Public Health, The University at Albany, United States
| | - Patrick J Parsons
- Laboratory of Inorganic and Nuclear Chemistry, Wadsworth Center, New York State Department of Health, United States; Department of Environmental Health Sciences, School of Public Health, The University at Albany, United States
| | - James A MacKenzie
- Departments of Biological Sciences, State University of New York College at Oswego, United States
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Pirard C, Koppen G, De Cremer K, Van Overmeire I, Govarts E, Dewolf MC, Van De Mieroop E, Aerts D, Biot P, Casteleyn L, Kolossa-Gehring M, Schwedler G, Angerer J, Koch HM, Schindler BK, Castaño A, Esteban M, Schoeters G, Den Hond E, Sepai O, Exley K, Horvat M, Bloemen L, Knudsen LE, Joas R, Joas A, Van Loco J, Charlier C. Hair mercury and urinary cadmium levels in Belgian children and their mothers within the framework of the COPHES/DEMOCOPHES projects. THE SCIENCE OF THE TOTAL ENVIRONMENT 2014; 472:730-740. [PMID: 24333995 DOI: 10.1016/j.scitotenv.2013.11.028] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Revised: 11/05/2013] [Accepted: 11/05/2013] [Indexed: 06/03/2023]
Abstract
A harmonized human biomonitoring pilot study was set up within the frame of the European projects DEMOCOPHES and COPHES. In 17 European countries, biomarkers of some environmental pollutants, including urinary cadmium and hair mercury, were measured in children and their mothers in order to obtain European-wide comparison values on these chemicals. The Belgian participant population consisted in 129 school children (6-11 years) and their mothers (≤ 45 years) living in urban or rural areas of Belgium. The geometric mean levels for mercury in hair were 0.383 μg/g and 0.204 μg/g for respectively mothers and children. Cadmium in mother's and children's urine was detected at a geometric mean concentration of respectively 0.21 and 0.04 μg/l. For both biomarkers, levels measured in the mothers and their child were correlated. While the urinary cadmium levels increased with age, no trend was found for hair mercury content, except the fact that mothers hold higher levels than children. The hair mercury content increased significantly with the number of dental amalgam fillings, explaining partially the higher levels in the mothers by their higher presence rate of these amalgams compared to children. Fish or seafood consumption was the other main parameter determining the mercury levels in hair. No relationship was found between smoking status and cadmium or mercury levels, but the studied population included very few smokers. Urinary cadmium levels were higher in both mothers and children living in urban areas, while for mercury this difference was only significant for children. Our small population showed urinary cadmium and hair mercury levels lower than the health based guidelines suggested by the WHO or the JECFA (Joint FAO/WHO Expert Committee on Food Additives). Only 1% had cadmium level slightly higher than the German HBM-I value (1 μg/l for adults), and 9% exceeded the 1 μg mercury/g hair suggested by the US EPA.
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Affiliation(s)
- Catherine Pirard
- CHU of Liege, Laboratory of Clinical, Forensic and Environmental Toxicology, CHU (B35), 4000 Liege, Belgium.
| | - Gudrun Koppen
- Flemish Institute of Technological Research, Environmental Risk and Health Unit, Boeretang 200, 2400 Mol, Belgium.
| | - Koen De Cremer
- Scientific Institute of Public Health, Juliette Wytsmanstraat 14, 1050 Brussels, Belgium.
| | - Ilse Van Overmeire
- Scientific Institute of Public Health, Juliette Wytsmanstraat 14, 1050 Brussels, Belgium.
| | - Eva Govarts
- Flemish Institute of Technological Research, Environmental Risk and Health Unit, Boeretang 200, 2400 Mol, Belgium.
| | - Marie-Christine Dewolf
- Provincial Institute Hainaut Vigilance Sanitaire - Hainaut Hygiène Publique en (HVS-HPH), Boulevard Sainctelette, 55, 7000 Mons, Belgium.
| | - Els Van De Mieroop
- Provincial Institute for Hygiene (PIH), Boomgaardstraat 22 bus 1, 2600 Antwerpen, Belgium.
| | - Dominique Aerts
- Federal Public Service Health, Food Chain Safety and Environment, Place Victor Horta 40/10, 1060 Brussels, Belgium.
| | - Pierre Biot
- Federal Public Service Health, Food Chain Safety and Environment, Place Victor Horta 40/10, 1060 Brussels, Belgium.
| | - Ludwine Casteleyn
- University of Leuven, Center for Human Genetics, Herestraat 49, 3000 Leuven, Belgium.
| | | | - Gerda Schwedler
- Federal Environment Agency, Corrensplatz 1, 14195 Berlin, Germany.
| | - Jürgen Angerer
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-Universität Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany.
| | - Holger M Koch
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-Universität Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany.
| | - Birgit K Schindler
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-Universität Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany.
| | - Argelia Castaño
- Instituto de Salud Carlos III (ISCIII), Ctra. Majadahonda - Pozuelo, Km. 2, 28220, Madrid, Spain.
| | - Marta Esteban
- Instituto de Salud Carlos III (ISCIII), Ctra. Majadahonda - Pozuelo, Km. 2, 28220, Madrid, Spain.
| | - Greet Schoeters
- Flemish Institute of Technological Research, Environmental Risk and Health Unit, Boeretang 200, 2400 Mol, Belgium.
| | - Elly Den Hond
- Flemish Institute of Technological Research, Environmental Risk and Health Unit, Boeretang 200, 2400 Mol, Belgium.
| | - Ovnair Sepai
- Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton, Oxfordshire OX11 0RQ, United Kingdom.
| | - Karen Exley
- Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton, Oxfordshire OX11 0RQ, United Kingdom.
| | - Milena Horvat
- Jožef Stefan Institute, Jamova cesta 39, 1000 Ljubljana, Slovenia.
| | - Louis Bloemen
- Environmental Health Science International, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands.
| | - Lisbeth E Knudsen
- University of Copenhagen, Department of Public Health, Øster Farimagsgade 5, 1353 København, Denmark.
| | - Reinhard Joas
- BiPRO GmbH, Grauertstrasse 12, 81545 Munich, Germany.
| | - Anke Joas
- BiPRO GmbH, Grauertstrasse 12, 81545 Munich, Germany.
| | - Joris Van Loco
- Scientific Institute of Public Health, Juliette Wytsmanstraat 14, 1050 Brussels, Belgium.
| | - Corinne Charlier
- CHU of Liege, Laboratory of Clinical, Forensic and Environmental Toxicology, CHU (B35), 4000 Liege, Belgium.
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Allergological and toxicological aspects in a multiple chemical sensitivity cohort. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2013; 2013:356235. [PMID: 24367721 PMCID: PMC3866722 DOI: 10.1155/2013/356235] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Accepted: 05/11/2013] [Indexed: 11/30/2022]
Abstract
Background. Multiple chemical sensitivity (MCS) is a chronic condition characterized by an exaggerated response to toxicants. We ascertained the prevalence of allergy to metals and toxicological aspects in MCS patients. Methods. We conducted a retrospective review of medical records of 41 patients with MCS. We performed patch testing (n = 21) for dental series and did lymphocyte transformation test (n = 18) for metals. We measured mercury in samples of blood (n = 19), urine (n = 19), saliva (n = 20), and scalp hair (n = 17) to investigate the association between mercury levels and cases of MCS. Results. The prevalence of metal immune hypersensitivity in a subset of 26 patients was 92.3 percent. Elevations of mercury occurred in 81.2 percent (26 of 32). The mean (±SD) in blood concentrations of mercury was 7.6 ± 13.6 μg/L; mean in urine was 1.9 ± 2.5 μg/L; mean in scalp hair was 2.2 ± 2.5 μg/g; mean in saliva was 38.1 ± 52.1 μg/L. Subgroup analyses showed that elevation of mercury levels in biological matrices were associated with mercury amalgams in patients with MCS (22 patients), compared with controls (8 patients) (odds ratio 11 : 95 percent confidence interval 1.5 to 81.6; P = 0.023). Conclusions. Our data show an increased prevalence of metal allergy and elevation of mercury levels in bioindicators among patients with MCS.
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Sears ME. Chelation: harnessing and enhancing heavy metal detoxification--a review. ScientificWorldJournal 2013; 2013:219840. [PMID: 23690738 PMCID: PMC3654245 DOI: 10.1155/2013/219840] [Citation(s) in RCA: 135] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2013] [Accepted: 03/14/2013] [Indexed: 01/21/2023] Open
Abstract
Toxic metals such as arsenic, cadmium, lead, and mercury are ubiquitous, have no beneficial role in human homeostasis, and contribute to noncommunicable chronic diseases. While novel drug targets for chronic disease are eagerly sought, potentially helpful agents that aid in detoxification of toxic elements, chelators, have largely been restricted to overt acute poisoning. Chelation, that is multiple coordination bonds between organic molecules and metals, is very common in the body and at the heart of enzymes with a metal cofactor such as copper or zinc. Peptides glutathione and metallothionein chelate both essential and toxic elements as they are sequestered, transported, and excreted. Enhancing natural chelation detoxification pathways, as well as use of pharmaceutical chelators against heavy metals are reviewed. Historical adverse outcomes with chelators, lessons learned in the art of using them, and successes using chelation to ameliorate renal, cardiovascular, and neurological conditions highlight the need for renewed attention to simple, safe, inexpensive interventions that offer potential to stem the tide of debilitating, expensive chronic disease.
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Affiliation(s)
- Margaret E Sears
- Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON, Canada.
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Tsuchiya A, Duff R, Stern AH, White JW, Krogstad F, Burbacher TM, Faustman EM, Mariën K. Single blood-Hg samples can result in exposure misclassification: temporal monitoring within the Japanese community (United States). Environ Health 2012; 11:37. [PMID: 22676231 PMCID: PMC3410813 DOI: 10.1186/1476-069x-11-37] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2011] [Accepted: 06/07/2012] [Indexed: 05/04/2023]
Abstract
BACKGROUND The most prominent non-occupational source of exposure to methylmercury is the consumption of fish. In this study we examine a fish consuming population to determine the extent of temporal exposure and investigate the extent to which single time estimates of methylmercury exposure based on blood-Hg concentration can provide reliable estimates of longer-term average exposure. METHODS Blood-mercury levels were obtained from a portion of the Arsenic Mercury Intake Biometric Study (AMIBS) cohort. Specifically, 56 Japanese women residing in the Puget Sound area of Washington State, US were sampled on three occasions across a one-year period. RESULTS An average of 135 days separated samples, with mean blood-mercury levels for the visits being 5.1, 6.6 and 5.0 μg/l and geometric means being 2.7, 4.5 and 3.1 μg/l. The blood-mercury levels in this group exceed national averages with geometric means for two of the visits being between the 90th and 95th percentiles of nationally observed levels and the lowest geometric mean being between the 75th and 90th percentile. Group means were not significantly different across sampling periods suggesting that exposure of combined subjects remained relatively constant. Comparing intra-individual results over time did not reveal a strong correlation among visits (r = 0.19, 0.50, 0.63 between 1st and 2nd, 2nd and 3rd, and 1st and 3rd sample results, respectively). In comparing blood-mercury levels across two sampling interval combinations (1st and 2nd, 2nd and 3rd, and 1st and 3rd visits, respectively), 58% (n = 34), 53% (n = 31) and 29% (n = 17) of the individuals had at least a 100% difference in blood-Hg levels. CONCLUSIONS Point estimates of blood-mercury, when compared with three sample averages, may not reflect temporal variability and individual exposures estimated on the basis of single blood samples should be treated with caution as indicators of long-term exposure. Reliance on single blood samples can make predicting ongoing methylmercury exposure highly speculative due to the large intra-individual variability.
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Affiliation(s)
- Ami Tsuchiya
- Department of Environmental and Occupational Health Services, University of Washington, Seattle, WA, USA
| | - Rob Duff
- Washington State Department of Ecology, Olympia, WA, USA
| | - Alan H Stern
- New Jersey Department of Environmental Protection, Trenton, NJ, USA
| | - Jim W White
- Washington State Department of Health, Olympia, WA, USA
| | - Finn Krogstad
- Department of Environmental and Occupational Health Services, University of Washington, Seattle, WA, USA
| | - Thomas M Burbacher
- Department of Environmental and Occupational Health Services, University of Washington, Seattle, WA, USA
| | - Elaine M Faustman
- Department of Environmental and Occupational Health Services, University of Washington, Seattle, WA, USA
- Institute for Risk Analysis and Risk Communication, University of Washington, Seattle, WA, USA
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Gump BB, MacKenzie JA, Dumas AK, Palmer CD, Parsons PJ, Segu ZM, Mechref YS, Bendinskas KG. Fish consumption, low-level mercury, lipids, and inflammatory markers in children. ENVIRONMENTAL RESEARCH 2012; 112:204-211. [PMID: 22030286 PMCID: PMC3267839 DOI: 10.1016/j.envres.2011.10.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2011] [Revised: 10/01/2011] [Accepted: 10/05/2011] [Indexed: 05/29/2023]
Abstract
There is considerable evidence that consuming fish has numerous health benefits, including a reduced risk of cardiovascular disease. However, fish is also the primary source of human exposure to mercury (Hg). In a cross-sectional study of 9-11 year old children (N=100), we measured fish consumption, blood lipids, total blood Hg, diurnal salivary cortisol (4 samples collected throughout the day), and performed a proteomic analysis of serum proteins using spectral count shotgun proteomics. Children who consumed fish had a significantly more atheroprotective lipid profile but higher levels of blood Hg relative to children that did not consume fish. Although the levels of blood Hg were very low in these children (M=0.77 μg/L; all but 1 participant had levels below 3.27 μg/L), increasing blood Hg was significantly associated with blunted diurnal cortisol levels. Blood Hg was also significantly associated with acute-phase proteins suggesting systemic inflammation, and several of these proteins were found to significantly reduce the association between Hg and diminished cortisol when included in the model. This study of a pediatric population is the first to document an association between blood Hg, systemic inflammation, and endocrine disruption in humans. Without a better understanding of the long-term consequences of an atheroprotective lipid profile relative to blunted diurnal cortisol and systemic inflammation, a determination of the risk-benefit ratio for fish consumption by children is not possible.
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Affiliation(s)
- Brooks B Gump
- Department of Public Health, Food Studies, and Nutrition, Syracuse University, Syracuse, NY 13244, USA.
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Kim BM, Lee BE, Hong YC, Park H, Ha M, Kim YJ, Kim Y, Chang N, Kim BN, Oh SY, Yoo M, Ha EH. Mercury levels in maternal and cord blood and attained weight through the 24 months of life. THE SCIENCE OF THE TOTAL ENVIRONMENT 2011; 410-411:26-33. [PMID: 22000783 DOI: 10.1016/j.scitotenv.2011.08.060] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2011] [Revised: 08/24/2011] [Accepted: 08/25/2011] [Indexed: 05/31/2023]
Abstract
Birth weight is a strong determinant of attained weight at early ages. Until now, many studies have reported that low birth weight corresponds with high mercury levels. However, the relationship between mercury exposure and attained weight of infant has not been well studied. Therefore, the aim of the present study was to assess the degree of prenatal exposure to mercury by measuring the total mercury levels in maternal and cord blood, and examine the relationship between the mercury level during pregnancy and the attained weight of infant during the first 24 months of life. The prospective cohort study of Mothers and Children's Environmental Health (MOCEH) was built up in 2006, and 921 mother-infant pairs were recruited. Information on the socio-demographic characteristics, health behavior and environmental exposure were collected from an interview with trained nurses. After delivery, infants and mothers were followed up at 6, 12 and 24 months and the weights of the infants were measured. The mercury concentrations in the late maternal blood (β=-0.19. p=0.05) and cord blood (β=-0.36. p=0.01) were negatively associated with the infants' attained weight over the first 24 months of age. The infants' attained weight in the small for their gestational age (SGA) group was lower than the normal birth weight group at the highest quartile of the mercury level. Therefore, efforts should be made to reduce the mercury level in the maternal blood at late pregnancy and cord blood. Further research on the possible harmful effects of prenatal mercury exposure on postnatal growth is recommended.
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Affiliation(s)
- Byung-Mi Kim
- Department of Preventive Medicine, School of Medicine, Ewha Medical Research Center, Ewha Womans University, Seoul, Republic of Korea
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Richardson GM, Wilson R, Allard D, Purtill C, Douma S, Gravière J. Mercury exposure and risks from dental amalgam in the US population, post-2000. THE SCIENCE OF THE TOTAL ENVIRONMENT 2011; 409:4257-68. [PMID: 21782213 DOI: 10.1016/j.scitotenv.2011.06.035] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2011] [Revised: 06/08/2011] [Accepted: 06/15/2011] [Indexed: 05/24/2023]
Abstract
Dental amalgam is 50% metallic mercury (Hg) by weight and Hg vapour continuously evolves from in-place dental amalgam, causing increased Hg content with increasing amalgam load in urine, faeces, exhaled breath, saliva, blood, and various organs and tissues including the kidney, pituitary gland, liver, and brain. The Hg content also increases with maternal amalgam load in amniotic fluid, placenta, cord blood, meconium, various foetal tissues including liver, kidney and brain, in colostrum and breast milk. Based on 2001 to 2004 population statistics, 181.1 million Americans carry a grand total of 1.46 billion restored teeth. Children as young as 26 months were recorded as having restored teeth. Past dental practice and recently available data indicate that the majority of these restorations are composed of dental amalgam. Employing recent US population-based statistics on body weight and the frequency of dentally restored tooth surfaces, and recent research on the incremental increase in urinary Hg concentration per amalgam-filled tooth surface, estimates of Hg exposure from amalgam fillings were determined for 5 age groups of the US population. Three specific exposure scenarios were considered, each scenario incrementally reducing the number of tooth surfaces assumed to be restored with amalgam. Based on the least conservative of the scenarios evaluated, it was estimated that some 67.2 million Americans would exceed the Hg dose associated with the reference exposure level (REL) of 0.3 μg/m(3) established by the US Environmental Protection Agency; and 122.3 million Americans would exceed the dose associated with the REL of 0.03 μg/m(3) established by the California Environmental Protection Agency. Exposure estimates are consistent with previous estimates presented by Health Canada in 1995, and amount to 0.2 to 0.4 μg/day per amalgam-filled tooth surface, or 0.5 to 1 μg/day/amalgam-filled tooth, depending on age and other factors.
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Affiliation(s)
- G M Richardson
- SNC-Lavalin Environment, Suite 110, 20 Colonnade Road, Ottawa, ON Canada.
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Hertz-Picciotto I, Green PG, Delwiche L, Hansen R, Walker C, Pessah IN. Blood mercury concentrations in CHARGE Study children with and without autism. ENVIRONMENTAL HEALTH PERSPECTIVES 2010; 118:161-6. [PMID: 20056569 PMCID: PMC2831962 DOI: 10.1289/ehp.0900736] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2009] [Accepted: 09/25/2009] [Indexed: 05/03/2023]
Abstract
BACKGROUND Some authors have reported higher blood mercury (Hg) levels in persons with autism, relative to unaffected controls. OBJECTIVES We compared blood total Hg concentrations in children with autism or autism spectrum disorder (AU/ASD) and typically developing (TD) controls in population-based samples, and determined the role of fish consumption in differences observed. METHODS The Childhood Autism Risk from Genetics and the Environment (CHARGE) Study enrolled children 2-5 years of age. After diagnostic evaluation, we analyzed three groups: AU/ASD, non-AU/ASD with developmental delay (DD), and population-based TD controls. Mothers were interviewed about household, medical, and dietary exposures. Blood Hg was measured by inductively coupled plasma mass spectrometry. Multiple linear regression analysis was conducted (n = 452) to predict blood Hg from diagnostic status controlling for Hg sources. RESULTS Fish consumption strongly predicted total Hg concentration. AU/ASD children ate less fish. After adjustment for fish and other Hg sources, blood Hg levels in AU/ASD children were similar to those of TD children (p = 0.75); this was also true among non-fish eaters (p = 0.73). The direct effect of AU/ASD diagnosis on blood Hg not through the indirect pathway of altered fish consumption was a 12% reduction. DD children had lower blood Hg concentrations in all analyses. Dental amalgams in children with gum-chewing or teeth-grinding habits predicted higher levels. CONCLUSIONS After accounting for dietary and other differences in Hg exposures, total Hg in blood was neither elevated nor reduced in CHARGE Study preschoolers with AU/ASD compared with unaffected controls, and resembled those of nationally representative samples.
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Affiliation(s)
- Irva Hertz-Picciotto
- Department of Public Health Sciences, University of California-Davis, Davis, California 95616-8638, USA.
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L’imprégnation mercurielle des dentistes et de leurs assistants dans la ville de Monastir, Tunisie. ACTA ACUST UNITED AC 2009; 110:139-44. [DOI: 10.1016/j.stomax.2009.01.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2008] [Revised: 01/15/2009] [Accepted: 01/22/2009] [Indexed: 11/20/2022]
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Díez S. Human health effects of methylmercury exposure. REVIEWS OF ENVIRONMENTAL CONTAMINATION AND TOXICOLOGY 2009; 198:111-132. [PMID: 19253038 DOI: 10.1007/978-0-387-09647-6_3] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Mercury (Hg), and the organometallic compounds formed from it, are among the most toxic of substances to the global environment. Mercury is environmentally ubiquitous, and both wildlife and humans are exposed to the toxic effects of its environmental residues, primarily elemental mercury (Hg0), divalent mercury (Hg2+) and methylmercury (MeHg). Humans are exposed to different forms of Hg, and potential health risks have been reported from such exposures; examples of Hg exposure include mercury vapor from dental amalgams, occupational exposures and exposures during artisan and small-scale gold mining operations. Despite the significance of those foregoing Hg exposures, of particular concern is human and wildlife exposure to MeHg, a potent neurotoxicant. Once incorporated into the body, MeHg easily penetrates the blood-brain barrier and causes damage to the central nervous system, particularly in fetuses. It bioaacumulates and biomagnifies in the aquatic food chain; consequently, fish and seafood consumption is the major pathway by which humans are exposed to MeHg. MeHg is the focus of this review. It adversely affects humans and is currently the subject of intense public health interest and worldwide concern. In this review, I summarize the sources and cycling of global mercury in the environment, pathways of exposure, toxicity and exposure evaluation, toxicokinetics, the common biomarkers to evaluate exposure and effects in populations, and finally review the nutritional risks and benefits from fish consumption.
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Affiliation(s)
- Sergi Díez
- Environmental Chemistry Department, IDAEA-CSIC, Jordi Girona, 18-26, E-08034, Barcelona, Spain
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Maserejian NN, Trachtenberg FL, Assmann SF, Barregard L. Dental amalgam exposure and urinary mercury levels in children: the New England Children's Amalgam Trial. ENVIRONMENTAL HEALTH PERSPECTIVES 2008; 116:256-62. [PMID: 18288327 PMCID: PMC2235235 DOI: 10.1289/ehp.10440] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2007] [Accepted: 11/11/2007] [Indexed: 05/03/2023]
Abstract
BACKGROUND Urinary mercury (U-Hg) excretion is a commonly used biomarker for mercury exposure from dental amalgam restorations. OBJECTIVES Our goal was to determine the most efficient measure of dental amalgam exposure for use in analyses concerning U-Hg in children. METHODS We analyzed time-sensitive longitudinal amalgam exposure data in children randomized to amalgam restorations (n = 267) during the 5-year New England Children's Amalgam Trial. We calculated 8 measures of amalgam, evaluating current versus cumulative exposure, teeth versus surfaces, and total versus posterior occlusal amalgams. Urine samples collected during follow-up years 3-5 were analyzed for mercury excretion. Multivariate models for current and cumulative U-Hg excretion estimated associations between exposures and U-Hg. RESULTS At the end of follow-up, the average (+/- SD) cumulative exposure was 10.3 +/- 6.1 surfaces and 5.7 +/- 2.9 teeth ever filled with amalgam, corresponding to 30 +/- 21 surface-years. Amalgam measures and U-Hg were moderately correlated. Of amalgam exposure measures, the current total of amalgam surfaces was the most robust predictor of current U-Hg, whereas posterior occlusal surface-years was best for cumulative U-Hg. In multivariate models, each additional amalgam surface present was associated with a 9% increase in current U-Hg, and each additional posterior occlusal surface-year was associated with a 3% increase in cumulative U-Hg excretion (p < 0.001). CONCLUSIONS One single measure of amalgam exposure is insufficient. Studies of cumulative effects of mercury from amalgam exposure in children are likely to have improved validity and precision if time-sensitive amalgam exposure measures are used. In contrast, simple counts of current amalgam fillings are adequate to capture amalgam-related current U-Hg.
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Xue F, Holzman C, Rahbar MH, Trosko K, Fischer L. Maternal fish consumption, mercury levels, and risk of preterm delivery. ENVIRONMENTAL HEALTH PERSPECTIVES 2007; 115:42-7. [PMID: 17366817 PMCID: PMC1797831 DOI: 10.1289/ehp.9329] [Citation(s) in RCA: 107] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2006] [Accepted: 09/25/2006] [Indexed: 05/03/2023]
Abstract
BACKGROUND Pregnant women receive mixed messages about fish consumption in pregnancy because unsaturated fatty acids and protein in fish are thought to be beneficial, but contaminants such as methylmercury may pose a hazard. METHODS In the Pregnancy Outcomes and Community Health (POUCH) study, women were enrolled in the 15th to 27th week of pregnancy from 52 prenatal clinics in five Michigan communities. At enrollment, information was gathered on amount and category of fish consumed during the current pregnancy, and a hair sample was obtained. A segment of hair closest to the scalp, approximating exposure during pregnancy, was assessed for total mercury levels (70-90% methylmercury) in 1,024 POUCH cohort women. RESULTS Mercury levels ranged from 0.01 to 2.50 pg/g (mean = 0.29 microg/g; median = 0.23 microg/g). Total fish consumption and consumption of canned fish, bought fish, and sport-caught fish were positively associated with mercury levels in hair. The greatest fish source for mercury exposure appeared to be canned fish. Compared with women delivering at term, women who delivered before 35 weeks' gestation were more likely to have hair mercury levels at or above the 90th percentile (> or = 0.55 microg/g), even after adjusting for maternal characteristics and fish consumption (adjusted odds ratio = 3.0; 95% confidence interval, 1.3-6.7). CONCLUSION This is the first large, community-based study to examine risk of very preterm birth in relation to mercury levels among women with low to moderate exposure. Additional studies are needed to see whether these findings will be replicated in other settings.
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Affiliation(s)
- Fei Xue
- Harvard School of Public Health, Harvard University, Boston, Massachusetts, USA
| | | | | | - Kay Trosko
- Integrative Toxicology, Michigan State University, East Lansing, Michigan, USA
| | - Lawrence Fischer
- Integrative Toxicology, Michigan State University, East Lansing, Michigan, USA
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