Lars Björkman

Mercury in human brain, blood, muscle and toenails in relation to exposure: an autopsy study

BackgroundThe main forms of mercury (Hg) exposure in the general population are methylmercury (MeHg) from seafood, inorganic mercury (I-Hg) from food, and mercury vapor (Hg0) from dental amalgam restorations. While the distribution of MeHg in the body is described by a one compartment model, the distribution of I-Hg after exposure to elemental mercury is more complex, and there is no biomarker for I-Hg in the brain. The aim of this study was to elucidate the relationships between on the one hand MeHg and I-Hg in human brain and other tissues, including blood, and on the other Hg exposure via dental amalgam in a fish-eating population. In addition, the use of blood and toenails as biological indicator media for inorganic and organic mercury (MeHg) in the tissues was evaluated.MethodsSamples of blood, brain (occipital lobe cortex), pituitary, thyroid, abdominal muscle and toenails were collected at autopsy of 30 deceased individuals, age from 47 to 91 years of age. Concentrations of total-Hg and I-Hg in blood and brain cortex were determined by cold vapor atomic fluorescence spectrometry and total-Hg in other tissues by sector field inductively coupled plasma-mass spectrometry (ICP-SFMS).ResultsThe median concentrations of MeHg (total-Hg minus I-Hg) and I-Hg in blood were 2.2 and 1.0 μg/L, and in occipital lobe cortex 4 and 5 μg/kg, respectively. There was a significant correlation between MeHg in blood and occipital cortex. Also, total-Hg in toenails correlated with MeHg in both blood and occipital lobe. I-Hg in both blood and occipital cortex, as well as total-Hg in pituitary and thyroid were strongly associated with the number of dental amalgam surfaces at the time of death.ConclusionIn a fish-eating population, intake of MeHg via the diet has a marked impact on the MeHg concentration in the brain, while exposure to dental amalgam restorations increases the I-Hg concentrations in the brain. Discrimination between mercury species is necessary to evaluate the impact on Hg in the brain of various sources of exposure, in particular, dental amalgam exposure.

Environmental and Heritable Factors in the Etiology of Oral Diseases—A Population-based Study of Swedish Twins

A population-based twin study is a useful design for quantification of the effects of genes and environmental factors in disease etiology. We used data from 10,000 Swedish twin pairs to quantify genetic and environmental contributions to tooth loss and periodontal health. Oral health information was obtained from telephone interviews. Structural equation models measured the relative importance of genetic and environmental factors. Genetic factors contributed to 14% of variation in tooth loss among women, and 39% among men. Non-shared environmental factors accounted for one-quarter of risk; environmental factors shared by twins comprised the remainder. Heritability estimates of periodontal disease were 39% and 33% for women and men, respectively, while non-shared environmental factors accounted for the remaining variation. Heritability for both conditions varied as a function of age and smoking status. Analysis of data from this large, population-based study demonstrates a moderate role of genetic factors in oral diseases, and suggests potential gene-environment interactions.

Selenium concentrations in brain after exposure to methylmercury: relations between the inorganic mercury fraction and selenium.

Three groups of female monkeys (Macaca fascicularies) were exposed to methylmercury (MeHg, p.o. 50 μg Hg/kg body wt per day) for 6, 12, or 18 months. One group was exposed to MeHg for 12 months and kept unexposed for 6 months before sacrifice. Another group of three monkeys was exposed to HgCl2 i.v. for 3 months. Total and inorganic mercury concentrations in occipital pole and thalamus were determined by cold vapor atomic absorption spectroscopy. Selenium concentrations were analyzed by hydride generation atomic absorption spectroscopy. The results indicated an association between concentrations of inorganic mercury and selenium in both occipital pole and thalamus in the MeHg-exposed animals. A linear regression model using concentrations of inorganic mercury (nmol/g wet wt) as independent variable, and selenium concentrations (nmol/g wet wt) as the dependent variable showed significant correlations between the variables in both occipital pole and thalamus (r=0.85 and r=0.91, P<0.0001). The intercept of the regression line was slightly lower (about 2 nmol Se/g wet wt) than the selenium concentrations found in control monkeys (about 3 nmol Se/g wet wt). There was a tendency to a “hockey stick”-shaped relationship between concentrations of selenium and inorganic mercury in the thalamus of monkeys with ongoing exposure to MeHg. An important role for selenium in the retention of mercury in brain is indicated.

In vitro shear bond strength of orthodontic bondings without liquid resin.

This study aimed at evaluating the early shear bond strength of enamel-composite-bracket adhesion accomplished without the use of liquid resin. Orthodontic brackets were bonded to the buccal surfaces of healthy extracted premolars in the test group by Transbond XT (n = 8) and Phase II (n = 8) composites but not the enclosed liquid resins in these products. Brackets bonded with the same materials (n = 8 for each) along with their corresponding liquid resin served as controls. The specimens were tested for shear bond strength after 24-h storage in water at 37°C. The fractured surfaces were graded with Adhesive Remnant Index (ARI) under a 2x-dissection microscope. Enamel of the randomly selected test and control specimens was dissolved by 20% formic acid. Afterwards, the enamel side of the bonding materials in both groups (n = 4) was examined under the scanning electron microscope. ANOVA was used for statistical analyses. Our laboratory data suggest that the enamel adhesion produced by these two commercial materials without the use of liquid resin does not differ significantly in their early in vitro shear bond strength. Keywords:Enamel adhesion; orthodontic bondings; shear bond strength

Changes in health complaints after removal of amalgam fillings

The aim of the present study was to investigate whether removal of all amalgam fillings was associated with long-term changes in health complaints in a group of patients who attributed subjective health complaints to amalgam fillings. Patients previously examined at the Norwegian Dental Biomaterials Adverse Reaction Unit were included in the study and assigned to a treatment group (n = 20) and a reference group (n = 20). Participants in the treatment group had all amalgam fillings replaced with other restorative materials. Follow-ups took place 3 months, 1 and 3 years after removal of all amalgam fillings. There was no intervention in the reference group. Subjective health complaints were measured by numeric rating scales in both groups. Analysis of covariance was used to compare changes in health complaints over time in the two groups. In the treatment group, there were significant reductions in intra-oral and general health complaints from inclusion into study to the 3-year follow-up. In the reference group, changes in the same period were not significant. Comparisons between the groups showed that reductions in intra-oral and general health complaints in the treatment group were significantly different from the changes in the reference group. The mechanisms behind this remain to be identified. Reduced exposure to dental amalgam, patient-centred treatment and follow-ups, and elimination of worry are factors that may have influenced the results.

Mercury and selenium distribution in human kidney cortex

Concentration of mercury and selenium were analyzed in tissue fractions of human kidney cortex samples from seven autopsy cases. Total mercury content ranged between 0.3–9.0 nmol Hg/g wet wt. Between 27–61% of the total mercury was found in the 105,000g supernatant of the tissue homogenate from six cases. In kidney cortex from the seventh case, a deceased dentist with the highest concentration of mercury, only 3% of the total mercury was found in the 105,000g supernatant and about 88% in a SDS-insoluble fraction. In this fraction the molar ratio between mercury and selenium was close to 1∶1. This study supports results from previous animal studies and indicates that mercury in human kidney cortex could be deposited in forms with different solubility. It could be of importance to speciate different forms of mercury in tissues according to solubility and association to selenium when interpretations of mercury concentrations are made.

Blood levels of lead, cadmium and selenium in children from Bytom, Poland

A study was carried out on the concentration of cadmium, lead and selenium in blood from 140 school children, aged 8–9 years, living in Bytom in the Silesian Region, an industrialized area of Poland. Concentrations of lead in blood ranged from 0.17 to 1.67 μmol Pb 1‐1 with a median of 0.38 μmol Pb 1‐1. Levels of cadmium in blood ranged from 2 to 22 nmol Cd 1‐1 with a median of 4 nmol Cd 1‐1. The values obtained were relatively low and indicated only a moderate exposure to lead and cadmium in the majority of the study population. However, 20% of the children had blood lead levels exceeding 0.48 μmol Pb 1‐1, which is a level of concern issued by Centers for Disease Control (CDC), USA. Concentrations of selenium in blood were 0.63 to 1.40 μmol Se 1‐1 with a median of 0.91 μmol Se 1‐1. The activity of glutathione peroxidase (GSH‐px) was measured in whole blood in 70 of the children and correlated to selenium concentration.

Minor changes in serum levels of cytokines after removal of amalgam restorations

Dental amalgam restorations release mercury and silver which is absorbed and distributed in the body. Animal studies have shown that both elements may interfere with the host by activation of the immune system in genetically susceptible strains at exposure levels relevant to those from dental amalgam restorations. The aim of this study was to test the hypothesis of no change over time in concentrations of a number of immune mediators in serum after removal of all dental amalgam restorations in patients with health complaints attributed to their amalgam restorations and compare with a healthy reference group. Twenty patients previously examined at a specialty unit for health complaints attributed to dental materials were included in a clinical trial and had all amalgam restorations replaced with other dental restorative materials. Serum samples were collected before amalgam removal and 3 and 12 months after the removal was finished. Twenty blood donors matched for age and gender were used as comparison group. A fluorescent bead-based (Luminex) immunoassay kit was used to measure cytokines, chemokines and growth factors in serum. At baseline, the patient group had slightly higher values for GM-CSF, IL-6, IL-2R, IFN-alpha, IL-7, and IL-12p40/p70 compared with the reference group. After amalgam removal a decrease towards the median value of the reference group was found for GM-CSF, IL-8, and IL-7. In conclusion, removal of all dental amalgam restorations and replacement with other dental restorative materials was associated with decreased concentrations of Th1-type proinflammatory markers in serum.

Biological monitoring of metals in children and pregnant women in Poland

A pilot study was carried out on the concentration of cadmium, lead, mercury and selenium in blood and urine from 15 first grade school children, 7–8 years of age, living in Katowice‐Szopienice (Silesian Region), and eight pregnant women living in Krakow. The two Polish communities have high levels of pollution from the metallurgic and coal industry. The concentrations of lead in blood for the children ranged from 77 to 255 µg Pb 1−1 with a median (Md) of 163 µg Pb 1−1 and for the women from 32 to 64 µg Pb 1−1 with a Md of 38 µg Pb 1−1 The high lead levels in blood among the children were related to the distance from their home to a smelter. The analysis of lead in urine also identified the children with the highest levels of exposure. The median levels of cadmium in blood were for children 0.5 µg Cd 1−1 and for women 0.7 µg Cd 1−1 and in urine 0.4 µg Cd 1−1 for children and 0.5 µg Cd 1−1 for women. Mercury levels in blood were below 4 µg Hg 1−1 in both groups. The concentrations of selenium in plasma and...

Patients' choice of dental treatment following examination at a specialty unit for adverse reactions to dental materials.

The Dental Biomaterials Adverse Reaction Unit in Bergen, Norway, is a national unit for the examination of patients with suspected adverse reactions to dental materials. The aim of this study was to investigate whether patients with suspected adverse reactions to dental materials experienced improvement in health after dental restorations had been replaced, and whether they had acted according to the recommendations of the Unit. A questionnaire was sent to 358 patients who had been examined at the Unit 18 months to 7 years earlier. Of the 207 patients who completed the questionnaire, 85 had had restorative materials replaced with other types of materials. A majority had had amalgam fillings replaced. After replacement, 51 patients reported an improvement in health. Twelve patients reported that they felt worse after replacement. The Unit recommended replacement of materials in 31 patients, of whom 24 followed the recommendation. Among 176 patients who were not given specific recommendations as to replacement of dental materials, 67 had had their restorations replaced, and 40 had started to have them replaced. It appears that the examination at the Dental Biomaterials Adverse Reaction Unit is one of several inputs that influence a persons decision to replace dental materials.