Evaluation of the mercury exposure of dental amalgam patients by the Mercury Triple Test
Evaluation of the mercury exposure of dental amalgam patients by the Mercury Triple Test
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DOI：
10.1136/oem.2003.009555
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发表时间：
2004-06-01
影响因子：
4.9
通讯作者：
Schweitzer, C
中科院分区：
文献类型：
--
作者：
Hansen, G;Victor, R;Schweitzer, C
目的：建立和分析汞合金充填和未充填汞合金充填患者汞负荷的参考数据。方法：采用原子吸收光谱法测定头皮、头发和尿液中汞浓度（应用二巯基丙烷磺酸盐前后）和牙科汞合金中汞的释放（使用新开发的汞合金咀嚼试验）。结果：第50百分位数为基础尿中1.3 mug Hg/g肌酐，DMPS应用后32 mug Hg/g肌酐，头发中454 ng Hg/g，口香糖中27 mug Hg/g，这相当于咀嚼每分钟释放约1毫克汞。大多数患者的汞总摄入量（来自环境空气、饮用水、食物和汞合金）远低于世卫组织规定的每周可耐受摄入量（PTWI），除非定期食用汞含量极高的食物。然而，对于咀嚼试验中超过第75百分位数的患者，即使在食物摄入量的下限，总汞摄入量也超过PTWI约50%。在没有职业接触的情况下，牙科汞合金释放大量汞是获得长期高身体负担的必要条件，但这还不充分。去除汞合金后，咀嚼试验不再显示口腔汞暴露，而基础尿汞含量和DMPS诱导的排泄显示指数下降（两种情况下的半衰期约为2个月）。已经制定了一个标准化程序，用于评估个人汞负担的程度和来源，通过与本文首次提供的数据库进行比较，可以作为诊断工具。
Aims: To establish and analyse reference data for the mercury burden of patients with and without amalgam fillings.Methods: Atomic absorption spectroscopy was used to quantify Hg concentrations in the scalp hair and urine ( before and after application of dimercaptopropane sulphonate), and Hg release from dental amalgams (using a newly developed, amalgam specific chew test), in 2223 subjects.Results: 50th centiles were 1.3 mug Hg/g creatinine in basal urine, 32 mug Hg/g creatinine after DMPS application, 454 ng Hg/g in hair, and 27 mug Hg per g of chewing gum, which corresponds to about 1 mg Hg released per minute of chewing. Total Hg intake (from ambient air, drinking water, food, and amalgams) of most patients is well below the provisioned tolerable weekly intake (PTWI) defined by the WHO, unless extremely Hg rich food is consumed on a regular basis. However, for patients exceeding the 75th centile in chew tests, total Hg intake exceeds the PTWI by about 50%, even at the low limit of intake from food. In the absence of occupational exposure, significant Hg release from dental amalgams is a necessary but insufficient condition to obtain a high long term body burden. After removal of dental amalgams, chew tests no longer exhibit oral Hg exposure, while basal urine Hg content and DMPS induced excretion display a exponential decrease (half life about 2 months in both cases).Conclusions: A standardised procedure for evaluation of the magnitude and origin of the Hg burden of individuals has been developed, which, by comparison with the database presented here for the first time, can serve as a diagnostic tool.