FOR IMMEDIATE RELEASE October 25 2000 New Studies Find Dental Amalgam Fillings to be the No.1 Source of Mercury in Most People and Daily Exposure Exceeds Government Health Standards for Inorganic Mercury(vapor). Studies also found adverse health effects in adults and that mercury from amalgam is passed on to infants through mother's blood and milk and that developmental effects on infants occur at low levels of mercury exposure. A large National Institute of Dental Research Study has confirmed other previous study results that found that the current type of amalgam dental fillings being used in the U.S. leak significant amounts of the extremely toxic substance mercury into the body and are the number one source of mercury in people. The study measured mercury levels in the blood and urine of over 1000 military personnel and found a high significant correlation to the number of amalgam filling surfaces in the mouth. Like several other recent studies the study found that amalgam fillings are not stable because of mercury's low vapor pressure and galvanic action between the different metals in the mouth. For this large military population that had a range of from 0 to 66 amalgam filling surfaces and an average of 20 surfaces each 10 surfaces added approximately 1 microgram of mercury per liter of urine excreted meaning total mercury excreted in urine averaged about 4.5 micrograms per day with soldiers levels with over 49 amalgam surfaces averaging over 8.7 micrograms. The average level for those with fillings was 4.5 times that of the controls without amalgam and those with over 49 surfaces averaged over 8 times controls. Together with the considerably larger amount of mercury excreted daily through the digestive tract and sweat the daily mercury excretion would amount to well over 10 micrograms per day on average and much more for some individuals. Over 90 % of the mercury in the urine was inorganic mercury the kind that comes from fillings as opposed to organic mercury which comes from fish. For this population it was determined that the exposure from amalgam fillings was the primary source of mercury exposure and on average exceeded the levels that would be consistent with U.S. Government Standards(MRL) for daily mercury exposure. The study's findings were consistent with the findings of many other recent such studies including a similar study testing 20000 people at a University Health Clinic in Germany as well as the findings of the World Health Organization Scientific Panel on mercury. The U.S.EPA mercury health guideline for elemental mercury exposure(vapor) is 0.3 micrograms per cubic meter of air(0.3 ug/M3). For the average adult breathing 20 M3 of air per day this amounts to an exposure of 6 micrograms(ug) per day. The U.S. Department of Health Agency for Toxic Substances and Disease Registry (ASTDR) standard (MRL) -for acute inhalation exposure to mercury vapor is 0.2 micrograms Hg/M3 which translates to approx. 4 ug/day for the average adult(5). The corresponding tolerable daily exposure developed in a report for the Canadian Health Agency Health Canada is .014 ug/kg body weight or 1 ug/day for average adult(6). The permissible level for a child would be less. But the levels of the average daily exposures found in the study were above all of these health guidelines for mercury exposure. Other studies that the Government Health Standards were based on have found adverse health effects at very low levels and developmental effects on infants and children at very low levels of exposure along with finding that mercury vapor from a mother's fillings is readily transferred through the mother's blood across the placenta to a fetus and also through mother's milk. These findings increase the urgency to advise the public of the clear danger in the use of mercury in fillings and to reconsider the policy of using mercury in dental fillings. Based on such studies several other countries such as Sweden Australia Japan and Canada have already adopted restrictions or warnings on the use of mercury in fillings such as for children pregnant women women of child bearing age people with damaged kidneys or immune systems and in the mouth adjacent to other metals. Amalgam manufacturers have also warned against some of the uses currently made of amalgam in dentistry in the U.S. Studies are also available that confirm adverse health effects from amalgam fillings and clinically document that many thousands of people have recovered or had significant improvement in many health conditions including very serious conditions after replacement of amalgam fillings. Fact sheets are available from DAMS with medical study references covering the statements and issues in this press release. DAMS is currently working with very many people in the U.S. dealing with serious health effects caused by exposure to mercury from amalgam and urges everyone to find out more about this major problem and to get involved in resolving these health safety issues. DAMS can provide information and help to anyone who is interested or who thinks they might have health problems related to their amalgam fillings. Available fact sheets with medical study references include: 1. Common Exposure Levels from Amalgam Fillings and Government Health Standards 2. Transfer of Mercury from Mother's Amalgams and Breast Milk to the Fetus and developmental effects of mercury on infants. 3. Documentation of recovery from 60000 clinical cases of serious adverse health effects after replacement of amalgam fillings. 4. Adverse oral health problems related to amalgam fillings. 5. Effect of mercury and other toxic metal exposure on cognitive and behavioral problems of children- including ADD dyslexia juvenile delinquency and crime. 6 Autoimmune conditions: the connection to mercury immune reactivity and amalgam fillings. 7. The battery in your mouth: oral galvanic currents and metals in the mouth and interactions with EMF 8. Health Effects of amalgam fillings and results of replacement of amalgam filings. Over 600 medical study references(most in Medline) and approx. 60000 clinical cases of amalgam replacement followed by doctors. Local contact person: (I suggest reference #1 and Kingman's abstract be attached to all PRs National contact person: ( issue paper requests- perhaps free with membership or $2 each perhaps free with membership free to media by E-mail or $2 each for handling cost by mail. this can also be distributed to media or non media through other mechanisms and additional distribution as a fact sheet or brochure to spread the message increase contacts and membership. You already have # 1 and also have likely seen all the other fact sheets. Each local coordinator who has E-mail should list their E-mail address on the PR and have access to the Fact sheets/papers for distribution as well as who to contact for technical questions probably me at home or someone else with me as backup if needed. (as an alternative the papers are available on a web page that will be noted on PR) Abstract: Kingman A Albertini T Brown LJ J Dent Res 1998 Mar;77(3):461-71 Mercury concentrations in urine and whole blood associated with amalgam exposure in a US military population. Oral Health Promotion Risk Factors and Molecular Epidemiology Branch National Institute of Dental Research Bethesda Maryland 20892 USA. Minute amounts of mercury vapor are released from dental amalgams. Since mercury vapor is known to be associated with adverse health effects from occupationally exposed persons questions regarding the margin of safety for exposure to mercury vapor in the general population continue to be raised. To address this issue one needs information regarding exposure to mercury vapor from dental amalgam fillings and its possible consequences for health in the general population. The NIDR Amalgam Study is designed to obtain precise information on amalgam exposure and health outcomes for a non-occupationally-exposed population of US adults. One hypothesis was that in a generally healthy population a significant association between amalgam exposure and Hg levels in urine and/or whole blood could be detected. The cohort investigated was an adult military population of 1127 healthy males. Their average age was 52.8 years and their ages varied from 40 to 78 years. Ninety-five percent of the study participants were white males and slightly over 50% had some college education. Five percent were edentulous. The dentate participants on average had 25 natural teeth 36.9 decayed or filled surfaces (DFS) and 19.9 surfaces exposed to amalgam with amalgam exposure varying from 0 to 66 surfaces. Their average total and inorganic urinary mercury concentrations were 3.09 microg/L and 2.88 microg/L. The average whole-blood total and inorganic mercury concentrations were 2.55 microg/L and 0.54 microg/L. Significant correlations were detected between amalgam exposure and the total (r = 0.34 p < 0.001) and inorganic 0.34 (r = 0.34 p < 0.001) urinary mercury concentrations on the original scale. Stronger correlations were found for total (r = 0.44 p < 0.001) and inorganic (r = 0.41 p < 0.001) urinary Hg on the log scale as well as for creatinine-corrected total (r = 0.43 p < 0.001) and inorganic (r = 0.43 p < 0.001) urine concentrations. In whole blood statistically significant but biologically weak correlations were detected for total (r = 0.09 p = 0.005) and inorganic (r = 0.15 p < 0.001) Hg concentrations respectively. Based on these cross-sectional data it is estimated that on average each ten-surface increase in amalgam exposure is associated with an increase of 1 microg/L mercury in urine concentration. PMID: 9496919 UI: 98156633 Ref. Paper #1 (You've seen this before) "Dental Amalgam Fillings" is the Number One Source of Mercury in People and Exposure Exceeds Government Health Standards for Inorganic mercury(vapor) Government agencies and medical studies have found that the number one source of mercury in people is from dental amalgam fillings(ref 2-20). Exposure from fillings amounts to from 50 to 90 percent of exposure with the average being about 80 % of total exposure(5-912-151920). The studies found that mercury amalgams are unstable due to mercury's low vapor pressure and galvanic action leaking mercury vapor continuously into the lungs and saliva at levels exceeding health standards. Mercury exposure of most people with fillings was found to exceed government health standards and levels found to cause adverse health effects(see below). The tolerable daily exposure level for mercury developed in a report for Health Canada is .014 micrograms/kilogram body weight(ug/kg) or approximately 1 ug/day for average adult(2). The U.S. EPA Health Standard for elemental mercury exposure(vapor) is 0.3 micrograms per cubic meter of air(1). The U.S. ATSDR health standard(MRL) for mercury vapor is 0.2 ug/ M3 of air and the MRL for methyl mercury is 0.3 ug/kg body weight/day(4). For the average adult breathing 20 M3 of air per day this amounts to an exposure of 4 or 6 ug/day for the 2 elemental mercury standards. The EPA health guideline for methyl mercury is 0.1 ug/kg body weight per day or 7 ug for the average adult(1). The range of mercury exposure levels found in people with amalgam fillings by the World Health Organization Scientific Panel on Mercury was 3 to 70 micrograms per day(3) with other medical studies finding up to 500 ug/day in gum chewers or people who grind their teeth(611161718). The average exposure was above 10 ug/day (ref. 3-18). The average mercury exposure for a Canadian adult with amalgam fillings was found in the Health Canada study to be 9 ug/day(2). In a large German study with 20000 tested subjects at a University Medical Clinic the average exposure from fillings was over 10 ug/day and over 50 % of all those with 6 or more amalgam fillings had daily exposure exceeding the EPA health guideline(6). Studies have consistently found modern high copper non gamma-two amalgams have greater release of mercury vapor than conventional silver amalgams (212223). Recent studies have concluded that because of the high mercury release levels of modern amalgams mercury poisoning from amalgam fillings is widespread throughout the population"(1722186). Common levels found in persons with amalgam fillings are over 10 times the Health Canada TDE and more than the EPA health standard for mercury vapor. Thus persons with amalgam fillings have levels of intraoral mercury vapor and body exposure levels higher than the level considered to have significant health risk. The studies found that Total mercury intake is proportional to the number and extent of amalgam surfaces but other factors such as chewing gum and drinking hot liquids influence the intake significantly increasing exposure as much as 500%. ). A World Health Organzation Scientific Panel concluded that a safe level of mercury exposure below which no adverse effects occur has never been established(3) References (1) U.S. Environmental Protection Agency(EPA) 1996 "Integrated Risk Information System National Center for Invironmental AssessmentCincinnati Ohio(& web). (2) Mark Richardson Environmental Health DirectorateHealth Canada Assessment of Mercury Exposure and Risks from Dental Amalgam 1995 Final Report. (3) World Health Organization(WHO)1991 Environmental Health criteria 118 Inorganic Mercury WHO Geneva; (4)Agency for Toxic Substances and Disease Registry U.S. Public Health Service "Toxicological Profile for Mercury"March 1999; & Apr 191999 Media Advisory New MRLs for toxic substances MRL:elemental mercury vapor/inhalation/ chronic & MRL: methy mercury/ oral/acute; & http://atsdr1.atsdr.cdc.gov:8080/97list.html. (5) A.Kingman et al National Institute of Dental Research "Mercury concentrations in urine and blood associated with amalgam exposure in the U.S. military population" Dent Res 1998 77(3):461-71. (6) Dr. P.Kraub & M.Deyhle Universitat Tubingen- Institut fur Organische Chemie "Field Study on the Mercury Content of Saliva" 1997 (20000 people tested for mercury level in saliva and health status/symptoms compiled) http://www.uni-tuebingen.de/KRAUSS/amalgam.html; (7) A. Engqvist et al "Speciation of mercury excreted in feces from individuals with amalgam fillings" Arch Environ Health 1998 53(3):205-13; & Dept. of Toxicology & Chemistry Stockholm Univ. National Institute for Working Life 1998.(www.niwl.se/ah/1998-02.html) (8) J.A.Weiner et al"The relationship between mercury concentration in human organs and predictor variables"138(1-3):101-1151993; & "An estimation of the uptake of mercury from amalgam fillings" Sci Total Environmetv168n31995. (9) M.J.Vimy and F.L. Lorscheider Faculty of Medicine Univ. Of Calgary July 1991. (Study findings) & J. Trace Elem. Exper. Med. 19903 111-123. (10) B.Arnold Eigenschaften und Einsatzgebiete des Chelatbildners:DMPS" Z.Umweltmedizin 19975(1):38-; & Diagnostik un Monitorung von SchwermetallbelastungenIIIZWR 1996105(10):586-569 & (11):665- (11) L.Barregard et al "People with high mercury uptake from their own dental amalgam fillings" Occup Envir Med 1995 52:124-128. (12) L.Bjorkman et al "Mercury in saliva and feces after removal of amalgam fillings" Toxicol Appl Pharmacol 1997 144(1): 156-162. (13) M.Molin et al "kinetics of mercury in blood and urine after mercury removal" J Dent Research 1995 74:420- (15) J.Begerow et al "Long Term Mercury Excretion in Urine after Removal of Amalgam Fillings" Int Arch Occup Health 66: 209-212. (16) G.Sallsten et al "long term use of chewing gum and mercury exposure from dental amalgam" J Dental Research 1996 75(1):594-598. (17) I.Skare "Mass Balance and Systemic Uptake of Mercury Released from Dental Fillings" Water Air and Soil Pollution 80(1-4):59-67 1995. (18) B.Windham Anotated Bibliography of Exposure and Health Effects from Amalgam Fillings 1997(over 500 references). (19) Halbach 1995"Estimation of mercury dose .." Int.Archieves of Occupational & Environmental Health 67:295-300; & G. Sandborgh-Englund "Pharmacokinetics of mercury from dental amalgam" Gotab(Stockholm) 1998 1-49. (20) H.V.Aposhian Envir.Health Perspectives Vol 106Supp 4 Aug 1998; & H.V. Aposhian et al FASEB J 6: 2472-2476 1992. (21) J Pleva "Mercury- A Public Health Hazard" Reviews on Environmental Health 1994 10:1-27. (22) C. Toomvali "Studies of mercury vapor emission from different dental amalgam alloys" LIU-IFM-Kemi-EX 1501988; & A.Berglund"A study of the release of mercury vapor from different types of amalgam alloys" J Dent Res 1993 72: 939-946; & D.B.Boyer "Mercury vaporization from corroded dental amalgam" Dental Materials 1988 4:89-93; & V.Psarras et al " Mercury vapour releases from dental amalgams" Swed Dent J1994 18:15-23; & L.E.Moberg "Long term corrosion studies of amalgams and Casting alloys in contact" Acta Odontal Scand 1985 43:163-177; (23) H. Lichtenberg "Mercury vapor in the oral cavity in relation to the number of amalgam fillings and chronic mercury poisoning" Journal of Orthomolecular Medicine 1996 11:2 87-94.