Mercury level in biological samples of dentists in Iran: a systematic review and meta-analysis
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REVIEW ARTICLE
Mercury level in biological samples of dentists in Iran: a systematic review and meta-analysis Ahmad Jonidi Jafari 1,2 & Ali Esrafili 1,2 & Yousef Moradi 3 & Norouz Mahmoudi 1,2,4 Received: 26 July 2020 / Accepted: 29 September 2020 # Springer Nature Switzerland AG 2020
Abstract Exposure to mercury is an important risk to dentists health. The aim of the present study was to assess the pooled mean mercury level (MML) in the urine, blood, nail, and hair of Iranian dentists (IDs) through the meta-analysis technique. Comprehensive and systematic searches were performed in main local databases including SID, Magiran, Iran medex, and ISC as well as internationally available databases including Embase, PubMed and Scopus for all the relevant studies up to 2018. In order to prevent bias in this study and identify eligible studies, various steps of the study was performed independently by two researchers. Out of 13 studies in the meta-analysis process which included 1499 IDs, the mean of the mercury level in the urine, nail, and blood was estimated to be 6.29 (95% CI: 2.61–9.97, I-square: 62.7%, P: 0.006), 3.54 (95% CI: 2.81–4.28, I-square: 0.0%, P: 0.968), 11.20 (95% CI: 2.28–20.13, I-square: 59.9%, P: 0.082), respectively. The mean mercury level (MML) in the biological samples of IDs was higher than the standard of World Health Organization (WHO). So, in accordance with Article 10 of the European Union Regulations (EUR), in the context of the Minamata Convention (MC) on Dental Amalgam (DA), in order to avoid the dangers of mercury exposure in dentists, it is necessary for Iran and other countries to approve laws and to implement a national plan to reduce mercury levels and replace the appropriate materials. Keywords Occupational exposure . Mercury . Dentists . Iran
Abbreviations BML Blood Mercury Level UML Urine Mercury Level HML Hair Mercury Level IDs Iranian Dentists MML Mean Mercury Level MC Minamata Convention SD Standard Deviation EMVs Elemental Mercury Vapors DA Dental Amalgam
* Norouz Mahmoudi [email protected] 1
Research Center for Environmental Health Technology, Iran University of Medical Sciences, Tehran, Iran
2
Department of Environmental Health Engineering, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
3
Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
4
Health Research Center, Life style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
Introduction Metals are found in the crust of the Earth [1]. Out of the 35 natural metals available, 23 have specific density above 5 g/cm3 with the atomic weight more than Forty, which are commonly referred to as heavy metals [2–4]. Exposure to some of these metals such as mercury is extremely dangerous in very small amounts and can cause acute and chronic toxicity in humans [5]. Among the heavy metals, mercury has unique physicochemical properties, according to which human exposure to its various compounds has caused a great deal of environmental
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