Mercury amalgam dental fillings: An epidemiologic assessment
Mercury amalgam dental fillings: An epidemiologic assessment
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DOI：
10.1016/j.ijheh.2005.11.006
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发表时间：
2006-07-01
影响因子：
6
通讯作者：
Bates, Michael N.
中科院分区：
文献类型：
--
作者：
Bates, Michael N.
含汞量约为50%的牙科汞合金填充物已经使用了近200年，几乎在同一时间一直存在争议。关于汞合金影响的指控涉及许多疾病。最近有证据表明，汞合金填充物不断释放出少量汞，这加剧了争议。这是一个全面的审查的流行病学证据的安全性牙科汞合金填充，重点是方法问题，并确定在文献中的差距。研究表明，几乎没有证据表明对一般慢性病发病率或死亡率的影响。与多发性硬化症相关的证据有限，但对阿尔茨海默病或帕金森病的研究很少。绝大多数证据表明，汞合金不会对肾脏产生影响，并且包括慢性疲劳综合征在内的不明确的综合症状也不是由汞合金引起的。几乎没有直接证据可用于评估生殖危害。总体而言，相关的流行病学研究很少。以往对汞合金可能对健康产生的影响的评估大多是基于对牙科汞暴露与职业汞暴露造成的危害进行比较。然而，接触汞齐的人群包括范围更广、可能更易受影响的人群。牙科汞合金影响的基于人群的研究的常见局限性包括纵向暴露评估不足和较高社会经济群体更好地获得牙科护理的负面混杂。需要设计更好的研究，特别是在神经退行性疾病及其对婴儿和儿童影响的研究方面。(c)2006年Elsevier GmbH。All rights reserved.
Dental amalgam fillings containing approximately 50% mercury have been used for almost 200 years and have been controversial for almost the same time. Allegations of effects caused by amalgams have involved many diseases. Recent evidence that small amounts of mercury are continuously released from amalgam fillings has fuelled the controversy. This is a comprehensive review of the epidemiologic evidence for the safety of dental amalgam fillings, with an emphasis on methodological issues and identifying gaps in the literature. Studies show little evidence of effects on general chronic disease incidence or mortality. Limited evidence exists for an association with multiple sclerosis, but few studies on either Alzheimer's or Parkinson's diseases. The preponderance of evidence suggests no renal effects and that ill-defined symptom complexes, including chronic fatigue syndrome, are not caused by amalgams. There is little direct evidence that can be used to assess reproductive hazards. Overall, few relevant epidemiologic studies are available. Most prior assessments of possible amalgam health effects have been based on comparisons of dental mercury exposures with occupational exposures causing harm. However, the amalgam-exposed population contains a broader, possibly more susceptible, spectrum of people. Common limitations of population-based studies of dental amalgam effects include inadequate longitudinal exposure assessment and negative confounding by better access to dental care in higher socioeconomic groups. Better designed studies are needed, particularly for investigation of neurodegenerative diseases and effects on infants and children. (c) 2006 Elsevier GmbH. All rights reserved.