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Jonidi Jafari A, Esrafili A, Moradi Y, Mahmoudi N. Mercury level in biological samples of dentists in Iran: a systematic review and meta-analysis. JOURNAL OF ENVIRONMENTAL HEALTH SCIENCE & ENGINEERING 2020; 18:1655-1669. [PMID: 33312669 PMCID: PMC7721756 DOI: 10.1007/s40201-020-00558-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Accepted: 09/29/2020] [Indexed: 05/09/2023]
Abstract
Exposure to mercury is an important risk to dentists health. The aim of the present study was to assess the pooled mean mercury level (MML) in the urine, blood, nail, and hair of Iranian dentists (IDs) through the meta-analysis technique. Comprehensive and systematic searches were performed in main local databases including SID, Magiran, Iran medex, and ISC as well as internationally available databases including Embase, PubMed and Scopus for all the relevant studies up to 2018. In order to prevent bias in this study and identify eligible studies, various steps of the study was performed independently by two researchers. Out of 13 studies in the meta-analysis process which included 1499 IDs, the mean of the mercury level in the urine, nail, and blood was estimated to be 6.29 (95% CI: 2.61-9.97, I-square: 62.7%, P: 0.006), 3.54 (95% CI: 2.81-4.28, I-square: 0.0%, P: 0.968), 11.20 (95% CI: 2.28-20.13, I-square: 59.9%, P: 0.082), respectively. The mean mercury level (MML) in the biological samples of IDs was higher than the standard of World Health Organization (WHO). So, in accordance with Article 10 of the European Union Regulations (EUR), in the context of the Minamata Convention (MC) on Dental Amalgam (DA), in order to avoid the dangers of mercury exposure in dentists, it is necessary for Iran and other countries to approve laws and to implement a national plan to reduce mercury levels and replace the appropriate materials.
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Affiliation(s)
- Ahmad Jonidi Jafari
- Research Center for Environmental Health Technology, Iran University of Medical Sciences, Tehran, Iran
- Department of Environmental Health Engineering, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Esrafili
- Research Center for Environmental Health Technology, Iran University of Medical Sciences, Tehran, Iran
- Department of Environmental Health Engineering, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Yousef Moradi
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Norouz Mahmoudi
- Research Center for Environmental Health Technology, Iran University of Medical Sciences, Tehran, Iran
- Department of Environmental Health Engineering, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
- Health Research Center, Life style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
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Bjørklund G, Chirumbolo S, Dadar M, Pivina L, Lindh U, Butnariu M, Aaseth J. Mercury exposure and its effects on fertility and pregnancy outcome. Basic Clin Pharmacol Toxicol 2019; 125:317-327. [PMID: 31136080 DOI: 10.1111/bcpt.13264] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 05/22/2019] [Indexed: 12/11/2022]
Abstract
Mercury (Hg), a highly toxic environmental pollutant, shows harmfulness which still represents a big concern for human health, including hazards to fertility and pregnancy outcome. Research has shown that Hg could induce impairments in the reproductive function, cellular deformation of the Leydig cells and the seminiferous tubules, and testicular degeneration as well as abnormal menstrual cycles. Some studies investigated spontaneous abortion and complicated fertility outcome due to occupational Hg exposure. Moreover, there is a relation between inhaled Hg vapour and reproductive outcome. This MiniReview evaluates the hypothesis that exposure to Hg may increase the risk of reduced fertility, spontaneous abortion and congenital deficits or abnormalities.
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Affiliation(s)
- Geir Bjørklund
- Council for Nutritional and Environmental Medicine (CONEM), Mo i Rana, Norway
| | - Salvatore Chirumbolo
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.,CONEM Scientific Secretary, Verona, Italy
| | - Maryam Dadar
- Razi Vaccine and Serum Research Institute, Agricultural Research, Education and Extension Organization (AREEO), Karaj, Iran
| | - Lyudmila Pivina
- Semey Medical University, Semey, Kazakhstan.,CONEM Kazakhstan Environmental Health and Safety Research Group, Semey Medical University, Semey, Kazakhstan
| | - Ulf Lindh
- Biology Education Centre, Uppsala University, Uppsala, Sweden
| | - Monica Butnariu
- Banat's University of Agricultural Sciences and Veterinary Medicine "King Michael I of Romania" from Timisoara, Timisoara, Romania.,CONEM Romania Biotechnology and Environmental Sciences Group, Banat's University of Agricultural Sciences and Veterinary Medicine "King Michael I of Romania" from Timisoara, Timisoara, Romania
| | - Jan Aaseth
- Research Department, Innlandet Hospital Trust, Brumunddal, Norway.,Inland Norway University of Applied Sciences, Elverum, Norway
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Amir Sultan MM, Goh CT, Wan Puteh SE, Mokhtar M. Establishing mercury-free medical facilities: a Malaysian case study. Int J Health Care Qual Assur 2019; 32:34-44. [PMID: 30859864 DOI: 10.1108/ijhcqa-08-2017-0161] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE Mercury is widely used in medical and healthcare facilities as dental amalgam, mercury-added medical devices, thiomersal-containing vaccines, laboratory analysis and for other general applications despite the hazards. Various agencies consistently promote mercury-free medical facilities through mercury-free alternatives and better management practices, which are in line with the Minamata Convention on Mercury that aims to protect human health and environment from anthropogenic mercury release. The paper aims to discuss these issues. DESIGN/METHODOLOGY/APPROACH The authors conducted a gap analysis on recommended practices gathered from the literature and current practices gathered through semi-structured interviews with Malaysian medical personnel. A life cycle approach was adopted covering mercury use: input, storage, handling, accident, waste disposal and governance phases. FINDINGS The authors found that there are significant gaps between recommended and current mercury management practices. Analysis indicates improper mercury management as the main contributor to these gaps. The authors found from recommended practices that core components needing improvement include: mercury management action plan, mercury use identification team, purchasing policy, proper guidelines and monitoring systems. PRACTICAL IMPLICATIONS This study helps us to understand mercury management practices and suggests essential steps to establish a mercury-free medical facility. ORIGINALITY/VALUE This study explored the gaps between recommended and current mercury management practices in a medical facility and contributes to the Minamata Convention on Mercury aspirations.
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Affiliation(s)
| | - Choo Ta Goh
- Institute for Environment and Development (LESTARI), Universiti Kebangsaan Malaysia , Bangi, Malaysia
| | | | - Mazlin Mokhtar
- Institute for Environment and Development (LESTARI), Universiti Kebangsaan Malaysia , Bangi, Malaysia
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Bjørklund G, Lindh U, Aaseth J, Mutter J, Chirumbolo S. Mercury in dental amalgams: A great concern for clinical toxicology in developing countries? J Trace Elem Med Biol 2019; 51:9-11. [PMID: 30466944 DOI: 10.1016/j.jtemb.2018.09.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Revised: 09/02/2018] [Accepted: 09/05/2018] [Indexed: 12/25/2022]
Affiliation(s)
- Geir Bjørklund
- Council for Nutritional and Environmental Medicine, Mo i Rana, Norway.
| | - Ulf Lindh
- Biology Education Centre, Uppsala University, Uppsala, Sweden
| | - Jan Aaseth
- Research Department, Innlandet Hospital Trust, Brumunddal, Norway; Inland Norway University of Applied Sciences, Elverum, Norway
| | - Joachim Mutter
- Environmental Medicine, Konstanz, Germany and Paracelsus Clinica al Ronc, Castaneda, Switzerland
| | - Salvatore Chirumbolo
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
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Moreno-Quispe LA, Espinoza-Espinoza LA, Bedon-Pajuelo LS, Guzmán-Avalos M. Dental caries in the peruvian police population. J Clin Exp Dent 2018; 10:e134-e138. [PMID: 29670730 PMCID: PMC5899794 DOI: 10.4317/jced.54265] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2017] [Accepted: 01/03/2018] [Indexed: 11/17/2022] Open
Abstract
Background Dental caries is a multifactorial disease that affects the general population. After reviewing the scientific literature, no studies were found on the index of decayed, missing and filled teeth (DMFT) in the Peruvian police population. The objective was to evaluate the DMFT index and severity level of the disease in police personnel of the Ancash region, Peru. Material and Methods Cross-sectional prevalence study. The medical records of the police personnel in activity were reviewed and each subject was examined from May 2012 to May 2013. The study was authorized by the Director of the PNP-Huaraz Ancash Polyclinic as part of the activities of the civil SERUMS personnel in the area of odontology. The sample was census with 925 subjects. The data was systematized following the methodology recommended by the World Health Organization (WHO). The statistics were analyzed by Chi square test with significance p<0.05, Pearson test and ANOVA. Results The prevalence of caries in the police population was 73.4%. The DMFT index was 10.63 ± 4.96 (p<0.01). The severity of the disease in relation to age was 0.77 ± 0.41 with a high risk in this population. The DMFT index in females 128/925 and males 797/925 was 10.43 and 10.67 respectively. There is an inversely proportional relationship in the number of teeth filled with dental amalgam in policemen older than 35 years versus the number of teeth sealed with material other than dental amalgam in policemen under 35 years. Only 0.8% 7/925 had dental prostheses and 58.6% (542/925) of the subjects needed oral rehabilitation. Conclusions The severity of dental caries is high, strategies are required to improve intervention in this sector, developing effective programs in oral health in the short, medium and long term. Key words:Dental caries severity, oral health, dental caries prevalence, peruvian police.
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Affiliation(s)
- Luz A Moreno-Quispe
- MS, DDS, Researcher, Department of Research, Innovation and Development Peru SAC, Ancash Peru
| | | | - Loel S Bedon-Pajuelo
- MS, Ph.D, Professor, Social Policies Program, Graduate School, Santiago Antúnez de Mayolo University, Ancash Peru
| | - Magna Guzmán-Avalos
- MS, Ph.D, Professor, School of Health Sciences, Santiago Antúnez de Mayolo University, Ancash Peru
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Al-Zubaidi ES, Rabee AM. The risk of occupational exposure to mercury vapor in some public dental clinics of Baghdad city, Iraq. Inhal Toxicol 2017; 29:397-403. [PMID: 29043874 DOI: 10.1080/08958378.2017.1369601] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Dental workers are exposed to elevated levels of elemental mercury vapor substantially above the occupational exposure standards when placing or removing mercury/silver tooth restorations and disposing of mercury waste. This results in a significant increase in occupational exposure and risk of mercury intoxication. METHODS To evaluate the occupational exposure of dental workers to amalgam in four dental clinics in Baghdad city, the concentrations of mercury vapor were measured seasonally from February to November 2016. Samples of blood and urine were collected from 30 dental workers (exposed individuals) and five non-occupationally exposed individuals. Biochemical parameters such as cholesterol, liver enzymes (alanine aminotransferase, aspartate aminotransferase and alkaline phosphatase), renal enzymes (urea and creatinine), total protein and reduced glutathione (GSH) were observed. RESULTS The results indicated that mercury vapor levels varied from 84.7 ± 18.67 to 609.3 ± 238.90 µg/m3 and most concentrations were above the occupational exposure standards. The results of the biochemical parameters showed a significant increase in levels of cholesterol, aspartate aminotransferase (AST) and alanine aminotransferase (ALT) and no significant increase in blood urea and creatinine in dental workers in comparison with unexposed persons (control). Although the results showed a significant reduction in the levels of glutathione and total protein, there was no significant decrease in the levels of alkaline phosphatase (ALP) in exposed dental workers when compared with non-occupationally exposed individuals. CONCLUSIONS It is concluded that mercury vapor concentrations in the indoor air of some dental clinics in Baghdad city are high and exceed the OSHA STEL(Occupational Safety and Health Administration Short Term Exposure Limit). The present data showed that altered biochemical parameters can be used as efficient bioindicators for mercury toxicity.
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Affiliation(s)
| | - Adel Mashaan Rabee
- b Department of Biology, College of Science , University of Baghdad , Baghdad , Iraq
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Nagpal N, Bettiol SS, Isham A, Hoang H, Crocombe LA. A Review of Mercury Exposure and Health of Dental Personnel. Saf Health Work 2016; 8:1-10. [PMID: 28344835 PMCID: PMC5355537 DOI: 10.1016/j.shaw.2016.05.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Revised: 05/18/2016] [Accepted: 05/30/2016] [Indexed: 11/02/2022] Open
Abstract
Considerable effort has been made to address the issue of occupational health and environmental exposure to mercury. This review reports on the current literature of mercury exposure and health impacts on dental personnel. Citations were searched using four comprehensive electronic databases for articles published between 2002 and 2015. All original articles that evaluated an association between the use of dental amalgam and occupational mercury exposure in dental personnel were included. Fifteen publications from nine different countries met the selection criteria. The design and quality of the studies showed significant variation, particularly in the choice of biomarkers as an indicator of mercury exposure. In several countries, dental personnel had higher mercury levels in biological fluids and tissues than in control groups; some work practices increased mercury exposure but the exposure levels remained below recommended guidelines. Dental personnel reported more health conditions, often involving the central nervous system, than the control groups. Clinical symptoms reported by dental professionals may be associated with low-level, long-term exposure to occupational mercury, but may also be due to the effects of aging, occupational overuse, and stress. It is important that dental personnel, researchers, and educators continue to encourage and monitor good work practices by dental professionals.
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Affiliation(s)
- Natasha Nagpal
- Oxford Brookes University, School of Psychology, Social Work and Public Health, Oxford, UK
| | - Silvana S Bettiol
- School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Amy Isham
- University Department of Rural Health, University of Tasmania, Hobart, Tasmania, Australia
| | - Ha Hoang
- University Department of Rural Health, University of Tasmania, Hobart, Tasmania, Australia
| | - Leonard A Crocombe
- University Department of Rural Health, University of Tasmania, Hobart, Tasmania, Australia
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