[{"@context":"https:\/\/schema.org\/","@type":"Article","@id":"https:\/\/iaomt.org\/dentists-health-evaluating-occupational-risks-amalgam\/#Article","mainEntityOfPage":"https:\/\/iaomt.org\/dentists-health-evaluating-occupational-risks-amalgam\/","headline":"The Dentist\u2019s Health: Evaluating Occupational Risks From The Use Of Amalgam","name":"The Dentist\u2019s Health: Evaluating Occupational Risks From The Use Of Amalgam","description":"Many dentists, dental staff, and dental students do not realize that a variety of procedures involving manipulation of an old or new amalgam will expose them to levels of mercury that pose an immediate threat to their health unless they take precautions such as instituting work practices and engineering controls to minimize exposure. ","datePublished":"2013-03-08","dateModified":"2019-01-26","author":{"@type":"Person","@id":"https:\/\/iaomt.org\/author\/jessica\/#Person","name":"Webmaster","url":"https:\/\/iaomt.org\/author\/jessica\/","identifier":3,"image":{"@type":"ImageObject","@id":"https:\/\/iaomt.org\/wp-content\/litespeed\/avatar\/6aa2b98c8dd5e8c8b24956bfacd0d2ed.jpg?ver=1776197309","url":"https:\/\/iaomt.org\/wp-content\/litespeed\/avatar\/6aa2b98c8dd5e8c8b24956bfacd0d2ed.jpg?ver=1776197309","height":96,"width":96}},"publisher":{"@type":"Organization","name":"The International Academy of Oral Medicine & Toxicology","logo":{"@type":"ImageObject","@id":"https:\/\/iaomt.org\/wp-content\/uploads\/IAOMT-Schema-app-logo.jpg","url":"https:\/\/iaomt.org\/wp-content\/uploads\/IAOMT-Schema-app-logo.jpg","width":120,"height":60}},"image":{"@type":"ImageObject","@id":"https:\/\/iaomt.org\/wp-content\/uploads\/visual-demonstration-mercury-vapor-01.jpg","url":"https:\/\/iaomt.org\/wp-content\/uploads\/visual-demonstration-mercury-vapor-01.jpg","height":1080,"width":1920},"url":"https:\/\/iaomt.org\/dentists-health-evaluating-occupational-risks-amalgam\/","about":["Articles"],"wordCount":3439,"keywords":["Dental Mercury Occupational"],"articleBody":"By David Kennedy, DDS, and Amanda Just; 2013Every occupation exposes workers to chronic conditions and situations that have an impact on overall health. For example, violin players and other musicians are known to suffer high rates of carpal tunnel syndrome (a musculoskeletal injury) due to the repetitive hand movements and positioning often used when playing their instruments. Obviously, dentistry also involves routine techniques and materials that can result in health issues. Fortunately, in the same way musicians can change their practices to protect themselves from some of the adverse effects of carpal tunnel, dentists can also change their practices to protect themselves from certain occupational health risks.Specifically, among the materials regularly handled in dental offices, mercury stands out as a notoriously harmful substance. In fact, a report from the World Health Organization warns, \u201cIt may cause harmful effects to the nervous, digestive, respiratory, immune systems and to the kidneys, besides causing lung damage\u2026Recent studies suggest that mercury may have no threshold below which some adverse effects do not occur.\u201dMany dentists, dental staff, and dental students do not realize that a variety of procedures involving manipulation of an old or new amalgam will expose them to levels of mercury that pose an immediate threat to their health unless they take precautions such as instituting work practices and engineering controls to minimize exposure. Research has confirmed adverse outcomes in dentists and dental personnel attributed to occupational mercury vapor and amalgam particulate exposure. This is largely because dangerous levels of mercury are generated in the dental workplace by numerous everyday procedures.Scientific evidence has associated mercury with a variety of human health problems, including loss of IQ with prenatal exposure, and likewise, research on dentists, dental students, and dental workers has established that toxic harm can occur. To illustrate this point, a 2012 study from Yale University School of Medicine\u2019s Dr. Thomas G. Duplinsky and Dr. Domenic V. Cicchetti reports a high rate of the use of prescription medication in male dentists and relates it to occupational mercury exposure:Dentists demonstrated significantly more prescription utilization of specific illness medications than did Controls, for the following disease categories: Neuropsychological, Neurological, Respiratory, and Cardiovascular. The greater majority of pediatric and general practice dentists still use mercury amalgam restorations. This places them at greater risk than the general population for those disorders, as well as threatening the future health of America\u2019s children and adults who continue to receive silver amalgam restorations.A series of other studies have validated this concern, as data has shown that exposure to mercury can cause behavioral, psychological, and cognitive impacts on dental workers.Moreover, genetic variables have been linked to dental workers, mercury levels, and neurobehavioral factors. A common genetic trait known as the CPOX4 polymorphism has been identified as a factor in neurological damage from extremely low mercury exposure in dentists and dental personnel, as well as in children with amalgam fillings. Another study conducted on dental workers even explains that \u201cchronic sub toxic levels of inorganic mercury appear to produce mild changes in short-term nonverbal recall and heightened distress generally, and particularly in categories of obsessive compulsion, anxiety and psychoticism.\u201dFurthermore, mercury is also known for being toxic to the kidney, and Germany, Finland, Austria, and Canada have worked to reduce the use of dental mercury amalgam fillings for patients with kidney problems and other populations. To relate this issue to dental workers, consider the results of a 1988 study which evaluated kidney function in dental personnel exposed to mercury compared to workers exposed to lead, cadmium, and chromium. The study concluded that the dentists and dental assistants appeared to have a higher risk of kidney function disturbance than the other industrial workers. A study using sheep found a remarkable decline in kidney function within just two months of receiving multiple amalgam fillings. More recently, loss of kidney function has also been linked to the number and size of amalgam fillings.Another area that has received much attention is the possible reproductive hazards to female dental personnel. It is known that mercury can have a damaging influence on the developing brain and neurological system, which impacts children, pregnant women, and women of childbearing age. Thus, the dangers of exposure to mercury for pregnant dental workers have been recognized, as well as fertility issues and menstrual cycle disorders.Other research confirms reproductive dangers caused by occupational use of mercury. The Illinois Teratogen Information Service has reported that pregnant women should avoid all significant mercury exposure and recommended greater caution for women of childbearing age. A 1999 study from Canada noted, \u201cPregnant women should not work in areas with high levels of mercury vapor. The recommended threshold limit value of 0.05 ug\/m3 for mercury vapor may not provide sufficient protection for fetuses. Therefore, women of childbearing age should not be exposed to mercury vapor concentrations of 0.01mg\/m3 or greater.\u201dDental workers and risks of reactions to mercury or mercury allergies have also been studied. It is estimated that approximately 21 million Americans are allergic to mercury, and studies establish that exposure to dental mercury amalgam correlates with higher prevalence of mercury allergies. Not surprisingly, reactions to mercury have been related to dental personnel for dermatitis, melanoma, and skin diseases. One study even specifies hazards of mercury allergies for dental students: \u201cThe fact that the dental students who were the volunteers in this study received only a small fraction of the exposure to mercury that the practicing dentist receives does emphasize the potential of this allergen in actual dental practice.\u201dIn addition to the concerns about mercury levels in the dental office and the exposure of workers there, a variety of studies have called for protective measures to be taken in the dental office as a means of limiting mercury releases. A 2013 study led by Robin Warwick states, \u201cTo maximize safety, dental schools should train students to remove amalgam only while using water spray and high volume suction. Alternatively, students should use appropriate occupational hygiene personal protective equipment during amalgam removals.\u201d Unfortunately, many dental students cannot comply with these work practices and engineering controls in their operative technique laboratories.Taken together, scientific data clearly indicates that the use of mercury in dentistry can be detrimental to dentists and their staff. Many factors contribute to increased incidences of disease and health conditions among dentists, but mercury poisoning is a threat that can be easily avoided by the use of current alternatives to amalgam filling materials.Perhaps a 2003 study by risk assessment expert Dr. G. Mark Richardson summarizes this issue perfectly: \u201cVarious countries are moving to limit the use of amalgam as a dental restorative material in order to protect dental patients from Hg [mercury] exposure. However, dentists\u2019 occupational exposure should also be considered as a justification for reduced amalgam use.\u201dMany of the key references cited in this article are available upon request to the author. davidkennedydds@gmail.comREFERENCESHand and arm injuries: Carpal tunnel syndrome.\u00a0\u00a0Part 4: Musculoskeletal injuries (MSIs) prevalent in performers.http:\/\/www.mesacc.edu\/~juafj03991\/cis105\/lectures\/carpal_tunnel.pdfWorld Health Organization.\u00a0 Mercury in Health Care: Policy Paper.\u00a0 Geneva, Switzerland; August 2005.\u00a0http:\/\/www.who.int\/water_sanitation_health\/medicalwaste\/mercurypolpaper.pdf.\u00a0 Accessed February 17, 2013.Richardson GM.\u00a0 Inhalation of mercury-contaminated particulate matter by dentists: an overlooked occupational risk.\u00a0Human and Ecological Risk Assessment.\u00a02003; 9(6): 1519-1531.Stonehouse CA, Newman AP.\u00a0 Mercury vapour release from a dental aspirator.\u00a0Br Dent J.2001; 190(10): 558-560.Windham B.\u00a0 Research: occupational mercury poisoning in dentistry.\u00a0The Natural Recovery Plan.\u00a0\u00a0http:\/\/www.thenaturalrecoveryplan.com\/articles\/research-mercury-dentistry.html. Accessed February 18, 2013.White RR, Brandt RL. Development of mercury hypersensitivity among dental students.JADA. 1976; 92(6):1204-7.Nimmo A, Werley MS, Martin JS, Tansy MF. Particulate inhalation during the removal of amalgam restorations.\u00a0J Prosth Dent. 1990; 63(2):228-33.Fabrizio E, Vanacore N, Valente M, Rubino A, Meco G. High prevalence of extrapyramidal signs and symptoms in a group of Italian dental technicians.\u00a0\u00a0BMC Neurol.\u00a0\u00a02007; 7(1): 24.Iano FG, Sobrinho S, Silva TLD, Pereira MA, Figueiredo PJM, Alberguini LBA, Granjeiro JM. Optimizing the procedure for mercury recovery from dental amalgam.\u00a0Braz Oral Res.\u00a0 2008; 22(2): 119-124.Johnson KF. Mercury hygiene.\u00a0Dent Clin North Am.\u00a0 1978; 22(3): 477.L\u00f6nnroth EC, Shahnavaz H. Amalgam in dentistry. A survey of methods used at dental clinics in Norrbotten to decrease exposure to mercury vapour.\u00a0Swed Dent J.\u00a0\u00a01995; 19(1-2): 55.L\u00f6nnroth EC, Shahnavaz H. Dental clinics\u2013a burden to environment?\u00a0\u00a0Swed Dent J.\u00a0 1996; 20(5): 173.Martin MD, Naleway C, Chou HN. Factors contributing to mercury exposure in dentists.\u00a0J Am Dent Assoc.\u00a0 1995; 126(11): 1502-1511.Mumtaz R, Khan AA, Noor N, Humayun S. Amalgam use and waste management by Pakistani dentists: an environmental perspective.\u00a0East Mediterr Health J.\u00a0 2010; 16(3).Parsell DE, Karns L, Buchanan WT, Johnson RB. Mercury release during autoclave sterilization of amalgam.\u00a0J Dent Educ.\u00a0 1996; 60(5): 453-458.Roberts HW, Leonard D, Osborne J. Potential health and environmental issues of mercury-contaminated amalgamators.\u00a0J Am Dent Assoc.\u00a0 2001; 132(1): 58-64.Rowe NH, Sidhu KS, Chadzynski L, Babcock RF. Potential public health risks related to mercury\/amalgam discharge from dental offices.\u00a0\u00a0J Mich Dent Assoc.\u00a0 1996; 78(2): 32.Votaw AL, Zey J. Vacuuming a mercury-contaminated dental office may be hazardous to your health.\u00a0Dent Assist.\u00a0 1991; 60(1): 27.Zahir F, Rizwi SJ, Haq SK, Khan RH. Low dose mercury toxicity and human health.\u00a0Environ Toxicol Pharmacol.\u00a0 2005; 20(2): 351-360.Trasande L, Landrigan P, and Schechter C.\u00a0 Public health and economic consequences of methyl mercury toxicity to the developing brain.\u00a0 \u00a0Environmental Health Perspectives.\u00a0 2005; 113(5).Duplinsky TG, Cicchetti DV. The health status of dentists exposed to mercury from silver amalgam tooth restorations.\u00a0International Journal of Statistics in Medical Research.\u00a02012; 1(1):1-15.Echeverria D, Heyer N, Martin MD, Naleway CA, Woods JS, Bittner AC. Behavioral effects of low-level exposure to Hg0 among dentists.\u00a0Neurotoxicol Teratol.\u00a01995; 17(2):161-8.Ngim CH, Foo SC, Boey KW, Jeyaratnem J. Chronic neurobehavioural effects of elemental mercury in dentists.\u00a0Br J Ind Med.\u00a01992; 49(11):782-790.Echeverria D, Aposhian HV, Woods JS, Heyer NJ, Aposhian MM, Bittner AC, Mahurin RK, Cianciola M. Neurobehavioral effects from exposure to dental amalgam Hgo: new distinctions between recent exposure and body burden.\u00a0\u00a0FASEBJ.\u00a01998; 12(11):971-980.Shapiro IM, Cornblath DR, Sumner AJ, Sptiz LK, Uzzell B, Ship II, Bloch P.\u00a0 Neurophysiological and neuropsychological function in mercury-exposed dentists.\u00a0\u00a0Lancet.\u00a01982; 319(8282):1447-1150.Hilt B, Svendsen K, Syversen T, Aas O, Qvenild T, Sletvold H, Mel\u00f8 I. Occurrence of cognitive symptoms in dental assistants with previous occupational exposure to metallic mercury.Neurotoxicology.\u00a02009; 30(6):1202-1206.Gonzalez-Ramirez D, Maiorino RM, Zuniga-Charles M, Xu Z, Hurlbut KM, Junco-Munoz P, Aposhian MM, Dart RC, Diaz Gama JH, Echeverria D. Sodium 2, 3-dimercaptopropane-1-sulfonate challenge test for mercury in humans: II. Urinary mercury, porphyrins and neurobehavioral changes of dental workers in Monterrey, Mexico.\u00a0Journal of Pharmacology and Experimental Therapeutics.\u00a01995; 272(1):264-274.Echeverria D, Woods JS, Heyer NJ, Rohlman D, Farin F, Li T, Garabedian CE.\u00a0 The association between a genetic polymorphism of coproporphyrinogen oxidase, dental mercury exposure and neurobehavioral response in humans.\u00a0Neurotoxicol Teratol.\u00a02006; 28(1):39-48.Woods\u00a0JS, Heyer NJ, Echeverria D, Russo JE, Martin MD, Bernardo MF, Luis HS, Vaz L, Farin FM.\u00a0 Modification of neurobehavioral effects of mercury by a\u00a0genetic\u00a0polymorphism of coproporphyrinogen oxidase in children.\u00a0Neurotoxicol Teratol. 2012; 34(5):513-21.Uzzell BP, Oler J. Chronic low-level mercury exposure and neuropsychological functioning.\u00a0J Clin Exp Neuropsychol. 1986; 8(5):581-593.Health and Environment Alliance.\u00a0 Mercury and Dental Amalgams [fact sheet]. Brussels, Belgium: Health and Environment Alliance and Health Care without Harm; May 2007: 3.http:\/\/www.env-health.org\/IMG\/pdf\/HEA_009-07.pdfVerschoor MA, Herber RF, Zielhuis RL. (1988). Urinary mercury levels and early changes in kidney function in dentists and dental assistants.\u00a0Community dentistry and oral epidemiology. 1988; 16(3):148-152.Boyd, N.D.;Benediktsson, H.;Vimy, M.J.; Hooper, D.E.;Lorscheider, F.L.\u00a0 Mercury from dental \u201csilver\u201d tooth fillings impairs sheep kidney function Am J Physiol. 1991 Oct;261(4 Pt 2):R1010-4.Al-Saleh I, et al. Effect of mercury (Hg) dental amalgam fillings on renal and oxidative stress biomarkers in children. Sci Total Environ. 2012 Jun 7;431C:188-196.Geier DA, et al., A significant dose-dependent relationship between mercury exposure from dental amalgams and kidney integrity biomarkers: a further assessment of the Casa Pia children\u2019s dental amalgam trial. Human and Experimental toxicology 1-7 (2012)Watson, Diane, and 18 other members of Congress.\u00a0 Dear Acting Commissioner Dr. Joshua Sharfstein\u2026 [Congressional letter].\u00a0 Washington, D.C.: May 14, 2009.\u00a0 Copy of letter available upon request to john.donnelly@mail.house.gov.Watson, Diane (Congresswoman). Mercury in Dental Filling Disclosure and Prohibition Act. Los Angeles, CA: November 5, 2001. Copy of Act available at http:\/\/amalgamillness.com\/Text_DCAct.html.Rowland AS, Baird DD, Weinberg CR, Shore DL, Shy CM, Wilcox AJ. The effect of occupational exposure to mercury vapour on the fertility of female dental assistants.\u00a0Occupat Environ Med. 1994; 51:28-34.Geier DA, Kern JK, Geier MR.\u00a0 A prospective study of prenatal mercury exposure from dental amalgams and autism severity.\u00a0Neurobiolgiae Experimentals Polish Neuroscience Society.\u00a0 2009;\u00a069(2): 189-197.London S. Amalgam fillings during pregnancy linked to infant cleft palate.\u00a0\u00a0Elsevier Global Medical News.\u00a0 July 21, 2010.\u00a0\u00a0http:\/\/www.medconnect.com.sg\/tabid\/92\/s4\/Obstetrics-Gynecology\/p21\/Pregnancy-Lactation\/ct1\/c37751\/Amalgam-Fillings-During-Pregnancy-Linked-to-Infant-Cleft-Palate\/Default.aspx. Accessed February 18, 2013.Laks DR.\u00a0 Environmental Mercury Exposure and the Risk of Autism.\u00a0\u00a0White Paper for Safe Minds.\u00a0 August 27, 2008.\u00a0http:\/\/www.safeminds.org\/about\/documents\/SM%20Env%20Mercury%20Exposure%20and%20Risk%20of%20Autism.pdf. Accessed February 18, 2013.Ask K, Akesson A, Berglund M, Vahter M. Inorganic mercury and methylmercury in placentas of Swedish women.\u00a0Environ Health Perspect.\u00a02002; 110(5):523-6.\u00a0http:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC1240842\/pdf\/ehp0110-000523.pdf. Accessed February 18, 2013.Vahter M, Akesson A, Lind B, Bjors U, Schutz A, Berglund M.\u00a0 Longitudinal study of methylmercury and inorganic mercury in blood and urine of pregnant and lactating women, as well as in umbilical cord blood.\u00a0Environ Res. 2000; 84(2):186-94.Nourouzi E, Bahramifar N, Ghasempouri SM.\u00a0 Effect of teeth amalgam on mercury levels in the colostrums human milk in Lenjan.\u00a0Environ Monit Access.\u00a0 2012; 184(1):375-380.Al-Saleh I, Al-Sedairi A. Mercury (Hg) burden in children: The impact of dental amalgam.\u00a0Sci Total Environ. 2011; 409(16):3003-3015.Vimy MJ, Hooper DE, King WW, Lorscheider FL. Mercury from maternal \u201csilver\u201d tooth fillings in sheep and human breast milk.\u00a0Biological Trace Element Research. 1997; 56(2): 143-152.Richardson GM, Wilson R, Allard D, Purtill C, Douma S, Gravi\u00e8re J. Mercury exposure and risks from dental amalgam in the US population, post-2000.\u00a0Science of the Total Environment.\u00a02011; 409(20): 4257-4268.Vimy MJ, Takahashi Y, Lorscheider FL.\u00a0 Maternal-fetal distribution of mercury (203 Hg) released from dental amalgam fillings.\u00a0American Physiology Society.\u00a01990; 258(4): R939-945.Haley BE. Mercury toxicity: genetic susceptibility and synergistic effects.\u00a0Medical Vertias.2005;\u00a02(2): 535-542.Sikorski R, Juszkiewicz T, Paszkowski T, Szprengier-Juszkiewicz T. Women in dental surgeries: reproductive hazards in exposure to metallic mercury. International Archives of Occupational and Environmental Health. 1987; 59(6): 551-557.Oskarsson A, Schutz A, Schkerving S, Hallen IP, Ohlin B, Lagerkvist BJ. Total and inorganic mercury in breast milk in relation to fish consumption and amalgam in lactating women.\u00a0Arch Environ Health. 1996; 51(3):234-51.Dunn JE, Trachtenberg FL, Barregard L, Bellinger D, McKinlay S. Scalp hair and urine mercury content of children in the northeast United States: the New England children\u2019s amalgam trial.\u00a0Environ Res. 2008;107(1):79\u201388.Woods\u00a0JS, Heyer NJ, Echeverria D, Russo JE, Martin MD, Bernardo MF, Luis HS, Vaz L, Farin FM.\u00a0 Modification of neurobehavioral effects of mercury by a\u00a0genetic\u00a0polymorphism of coproporphyrinogen oxidase in children.\u00a0Neurotoxicol Teratol. 2012; 34(5):513-21.Palkovicova L, Ursinyova M, Masanova V, Yu Z, Hertz-Picciotto I. Maternal amalgam dental fillings as the source of mercury exposure in developing fetus and newborn.\u00a0J Expo Sci Environ Epidemiol. 2008; 18(3):326\u201331.Lindow SW, Knight R, Batty J, Haswell SJ. Maternal and neonatal hair mercury concentrations: the effect of dental amalgam.\u00a0Journal of Obstetrics and Gynecology. 2003; 23(S1):S48-S49.Lutz E, Lind B, Herin P, Krakau I, Bui TH, Vahter M. Concentrations of mercury, cadmium and lead in brain and kidney of second trimester fetuses and infants.\u00a0J Trace Elem Med Biol.1996; 10(2):61\u20137.Ask-Bj\u00f6rnberg K, Vahter M, Petersson-Graw\u00e9 K, Glynn A, Cnattingius S, Darnerud PO, et al. Methyl mercury and inorganic mercury in Swedish pregnant women and in cord blood: influence of fish consumption.\u00a0Environ Health Perspect.\u00a02003; 111(4): 637\u201341.da Costa SL, Malm O, Dorea JG. Breast-milk mercury concentrations and amalgam surface in mothers from Brasilia, Brasil.\u00a0Biol Trace Elem Res.\u00a02005; 106(2): 145\u201351.Woods\u00a0JS, Heyer NJ, Echeverria D, Russo JE, Martin MD, Bernardo MF, Luis HS, Vaz L, Farin FM.\u00a0 Modification of neurobehavioral effects of mercury by a\u00a0genetic\u00a0polymorphism of coproporphyrinogen oxidase in children.\u00a0Neurotoxicol Teratol. 2012; 34(5):513-21.Watson GE, Evans K, Thurston SW, van Wijngaarden E, Wallace JM, McSorley EM, Bonham MP, Mulhern MS, McAfee AJ, Davidson PW, Shamlaye CF, Strain JJ, Love T, Zareba G, Myers GJ.\u00a0 Prenatal exposure to dental amalgam in the Seychelles Child Development Nutrition Study: Associations with neurodevelopmental outcomes at 9 and 30 months.\u00a0Neurotoxicology.\u00a0\u00a02012.Wasylko L, Matsui D, Dykxhoorn SM, Rieder MJ, Weinberg S. A review of common dental treatments during pregnancy: implications for patients and dental personnel.\u00a0J Can Dent Assoc. 1998; 64(6):434-9.Gelbier S, Ingram J.\u00a0 Possible fetotoxic effects of mercury vapor: a case report.\u00a0Public Health.1989; 103(1):35-40.Rowland AS, Baird DD, Weinberg CR, Shore DL, Shy CM, Wilcox AJ. The effect of occupational exposure to mercury vapour on the fertility of female dental assistants.\u00a0Occupat Environ Med.\u00a01994; 51:28-34.Sikorski R, Juszkiewicz T, Paszkowski T, Szprengier-Juszkiewicz T. Women in dental surgeries: reproductive hazards in exposure to metallic mercury.\u00a0International Archives of Occupational and Environmental Health.\u00a01987; 59(6):551-557.McMahon C, Pergament E. Illinois Teratogen Information Service. Mercury exposure and Pregnancy. 2001;\u00a0 8(3).Moienafshari R, Bar-Oz B, Koren G.\u00a0 Occupational exposure to mercury.\u00a0 What level is safe?\u00a0 Canadian Family Physician. 1999; 46: 43-45.Amalgam-Mercury Fact Sheet. IAOMT Web site: http:\/\/iaomt.guiadmin.com\/wp-content\/uploads\/IAOMT-Fact-Sheet.pdf.\u00a0 Published August 5, 2011.https:\/\/iaomt.wpengine.com\/wp-content\/uploads\/IAOMT-Fact-Sheet.pdfMiller EG, Perry WL, Wagner MJ. Prevalence of mercury hypersensitivity in dental students.\u00a0J Dent Res. 1985; 64: Special Issue, p. 338, Abstract #1472.White RR, Brandt RL. Development of mercury hypersensitivity among dental students. JADA. 1976; 92(6):1204-7.Finne KAJ, G\u00f6ransson K, Winckler L. Oral lichen planus and contact allergy to mercury.International Journal of Oral Surgery.\u00a0 1982; 11(4):236-239.Lee JY, Yoo JM, Cho BK, Kim HO. Contact dermatitis in Korean dental technicians.\u00a0Contact Dermatitis.\u00a02001; 45(1):13-16.P\u00e9rez-G\u00f3mez B, Aragon\u00e9s N, Gustavsson P, Plato N, L\u00f3pez-Abente G, Poll\u00e1n, M. Cutaneous melanoma in Swedish women: occupational risks by anatomic site.\u00a0Am J Ind Med.\u00a02005; 48(4):270-281.Kanerva L, Lahtinen A, Toikkanen J, Forss H, Estlander T, Susitaival P, Jolanki R. Increase in occupational skin diseases of dental personnel.\u00a0Contact Dermatitis.\u00a01999; 40(2):104-108.White RR, Brandt RL. Development of mercury hypersensitivity among dental students.JADA.\u00a01976; 92(6):1204-7.Rojas M, Seijas D, Agreda O, Rodr\u00edguez M. Biological monitoring of mercury exposure in individuals referred to a toxicological center in Venezuela.\u00a0Sci Total Environ. 2006; 354(2):278-285.de Oliveira MT, Pereira JR, Ghizoni JS, Bittencourt ST, Molina GO. Effects from exposure to dental amalgam on systemic mercury levels in patients and dental school students.\u00a0Photomed Laser Surg.\u00a0 2010; 28(S2):S-111.Karahalil B, Rahravi H, Ertas N. Examination of urinary mercury levels in dentists in Turkey.Hum Exp Toxicol.\u00a02005; 24(8):383-388.Martin MD, Naleway C, Chou HN. Factors contributing to mercury exposure in dentists.\u00a0J Am Dent Assoc. 1995; 126(11):1502-1511.Fabrizio E, Vanacore N, Valente M, Rubino A, Meco G. High prevalence of extrapyramidal signs and symptoms in a group of Italian dental technicians.\u00a0BMC Neurol.\u00a02007; 7(1):24.Richardson GM.\u00a0 Inhalation of mercury-contaminated particulate matter by dentists: an overlooked occupational risk.\u00a0Human and Ecological Risk Assessment.\u00a02003; 9(6):1519-1531.Zahir F, Rizwi SJ, Haq SK, Khan RH. Low dose mercury toxicity and human health.\u00a0Environ Toxicol Pharmacol.\u00a02005; 20(2):351-360.Richardson GM, Brecher RW, Scobie H, Hamblen J, Samuelian J, Smith C. Mercury vapour (Hg(0)): Continuing toxicological uncertainties, and establishing a Canadian reference exposure level.\u00a0Regul Toxicol Pharmacol.\u00a02009; 53(1):32-38.Shapiro IM, Cornblath DR, Sumner AJ, Sptiz LK, Uzzell B, Ship II, Bloch P.\u00a0 Neurophysiological and neuropsychological function in mercury-exposed dentists.\u00a0\u00a0Lancet.\u00a01982; 319(8282):1447-1150.Windham, B.\u00a0 Research: occupational mercury poisoning in dentistry. The Natural Recovery Plan.\u00a0 http:\/\/www.thenaturalrecoveryplan.com\/articles\/research-mercury-dentistry.htmlL\u00f6nnroth EC, Shahnavaz H. Amalgam in dentistry. A survey of methods used at dental clinics in Norrbotten to decrease exposure to mercury vapour.\u00a0Swed Dent J.\u00a01995; 19(1-2):55.L\u00f6nnroth EC, Shahnavaz H. Dental clinics\u2013a burden to environment?\u00a0\u00a0Swed Dent J.\u00a01996; 20(5):173.Buchwald H.\u00a0 Exposure of dental workers to mercury.\u00a0Am Ind Hyg Assoc J.\u00a01972; 33(7):492-502.Parsell DE, Karns L, Buchanan WT, Johnson RB. Mercury release during autoclave sterilization of amalgam.\u00a0J Dent Educ.\u00a01996; 60(5):453-458.Stonehouse CA, Newman AP. Mercury vapour release from a dental aspirator.\u00a0Br Dent J.2001; 190(10):558-60.Nimmo A, Werley MS, Martin JS, Tansy MF. Particulate inhalation during the removal of amalgam restorations.\u00a0J Prosth Dent.\u00a01990; 63(2):228-33.Roberts HW, Leonard D, Osborne J. Potential health and environmental issues of mercury-contaminated amalgamators.\u00a0J Am Dent Assoc. 2001; 132(1): 58-64.Warwick R, O Connor A, Lamey B. Sample size = 25 for each mercury vapor exposure during dental student training in amalgam removal.\u00a0J Occup Med Toxicol.\u00a02013; 8(1):27.Richardson GM.\u00a0 Inhalation of mercury-contaminated particulate matter by dentists: an overlooked occupational risk.\u00a0Human and Ecological Risk Assessment.\u00a02003; 9(6):1519-1531."},{"@context":"https:\/\/schema.org\/","@type":"BreadcrumbList","itemListElement":[{"@type":"ListItem","position":1,"name":"The Dentist\u2019s Health: Evaluating Occupational Risks From The Use Of Amalgam","item":"https:\/\/iaomt.org\/dentists-health-evaluating-occupational-risks-amalgam\/#breadcrumbitem"}]}]