Mercury%20Poisoning%20Presentation

8/8/2019 Mercury%20Poisoning%20Presentation

http://slidepdf.com/reader/full/mercury20poisoning20presentation 1/55

9/25/2010

GeraldDENTAL FILLINGS / MercuryPoisoning / UCSF School Of

Medicine-Winter 1989

Mercury is a Global NeurotoxinThat Decreases Think, Commandand Control Think- Higher Cognitive (Mental) Functions



9/25/2010

Steps in finding

Poison? Gradual Onset of fine tremor

(intention) led me to suspect

poison. This led to the approach of two

UCSF medical professors, MichaelDae M.D. and Dorthlee Perloff M.D.



9/25/2010

Medical Evaluation Student Health Service/Toxicology-SFGH Charles

Becker M.D.

Objective Findings: Fine tremor Low Blood Pressure Normal White Blood Cell Count Normal Red Cell Sedimentation Rate Urine Hg: High Normal range [normal=<10 ug Hg/L] Blood Hg: High Normal range [normal= (2-20ug) Hg/L] (See The Heavy Metal Paradigm: No Safe Lower

Limit even at levels found in the U.S. Population. )Urine= 3.1 ug Hg/L avg. ;range (0-34 ug Hg/L);Kingman (1994)



9/25/2010

Medical Evaluation Subjective Complaints Headaches

Stags and Sways (Balance/Ataxia) Hazy Vision (slight) Decreased Higher Mental Functions or

Decreased Cognition. Speech

Insomnia



9/25/2010

Medical Evaluation Diagnosis/Treatment

Winter 1989 NeuropsychiatricEvaluation ± Michael Shore PhD



9/25/2010

Medical Evaluation Diagnosis/Treatment

Cecil¶s Textbook Of Internal Medicine



9/25/2010

Medical Evaluation . Revealed Decreased Global Cognitive

Function-I.Q. drop of 22 pts. (1.5Standard Deviations) From Age 9 yrs./4th

grade- Jackson Mental Health Clinic 1) Anxiety Neurosis -( Pt. Believed

Falsely to the point of Mental Illness thatHe was being poisoned by Hg from

dentalf illings)



9/25/2010

Medical Evaluation 2)Depression- Medications

Antitremor- Inderal (Beta-Blocker)/(Marc Gropper M.D.) -SHS

Antidepressants- Prozac, Trazedone,Elavil

Antianxiety- Valium (Mindy Fullilove

M.D.); Xanax (Tim Summers M.D.);I nsomnia-Restoril; Dalmane.



9/25/2010

Apples vs. Oranges



9/25/2010

Apples vs. Oranges



9/25/2010

Apples vs. Oranges



9/25/2010

Apples vs. Oranges



9/25/2010

Apples vs. Oranges

21218

Peak to Trough Dose 30

min @ 3-4 times/day15 min @ 3-4 times/day

Peak toTrough

Dose

Occupational

Exposure -8 hrs.

JackieCarter Ultramarathon Length

Jeneat Burist HIV Positive Quick DrawMcGraw

UT-Tyler Toxicology Apple to Orange



9/25/2010

Apples vs. Oranges

Hg Vapor Occupational Exp.

(Known Toxic Doses)

HIV Positive QuickDraw Mc Graw ±

Jeneat Burist Dose

Jackie Carter UltraMarathon LengthDose

Duration/AreaUnder The Curve

8 hrs Blue Line 1 hr 2hrs



9/25/2010

Medical EvaluationDental Amalgam:A Scientific Review and Recommended Public Health Service Strategy for Research, Education and RegulationFinal Report of the Subcommittee on Risk Management of the Committee to Coordinate Environmental Health and Related ProgramsPublic Health ServiceJanuary 1993

Department of Health and Human ServicesPublic Health Service

Table of Contents III: Evaluation of Risks Associated With Mercury Vapor from Dental

Amalgam

FDA Position Statement on Dental Amalgams (Mainstream Position)



9/25/2010

Standard Of Care

E arly detection of subclinical inorganic and organic mercury intoxication This is the USPHS own (Peer reviewed) PositionStatement on Dental Fillings!

E valuation of Risks Associated With Mercury Vapor from

Dental Amalgam M ercury is a toxic substance. For high exposures, observed

mostly in occupational settings, the severity of responsecorrelates with the duration and intensity of the exposure.The relationship between the severity of response and theduration of exposure has, however, not been quanti f ied at levels of exposure associated with dental amalgam

restorations.I n addition, subtle signs and symptoms o

f chronic mercury intoxication may not be f ound through

routine physical examinations. The subtle changes previously described require special tests not commonly used in routine examinations²that is, nerve conductionstudies, measurement of alterations in EEG , and measures of psychomotor functioning



9/25/2010

Standard Of Care

The official recommendation by their own (UT-Tyler Public Health Library)Medical Toxicology Textbook- TheClinical Basis of Medical Toxicology.P. 1328.

"I n addition to mercury assays,neuropsychiatric testing, nerve

conduction studies and urine assaysf or N-acetyl B-D-glucosaminidase and beta-

2-microglobulin are advocated f or early detection of subclinical inorganic and organic mercury intoxication. (20, 28,

50)"



9/25/2010

Dose response

curve Does Hg vapor have a dose

response curve in biological

systems (i.e. Humans) ?

Find the Answers below



9/25/2010

Dose response

curve 1) Just what part of the dose response curve is a

person on with dental fillings (40 Dental fillings) ? 2) What part of the dose response curve causes a

blue line on gums/gingivitis? 3) What is the standard of care for anoccupational environment/ setting where Hg vapor is a hazard? (For example, a Fluorescent lampfactory, Chloralkali factory, Thermometer factory,Dental office/workers)

4) What is the standard of care for a person withdental fillings?

5) How was the standard of care/response curvesestablished ?



9/25/2010

Dose response

curve The toxicity of mercury and its compounds,

recognized since antiquity and widely acknowledged in industry, has recently beenreviewed (7-12).

Clinically significant effects (erethism,intention tremor, gingivitis ) have not beenreported below air concentrations of 100 µg Hg/m3. [The OSHA limit = 50 ug Hg/m3 x 8hr/day: not to exceed 50 hrs/wk] . Most effects observed in persons exposed to

mercury in air concentrations below 100 ug Hg/m3 are preclinical e.g., slowed nerveconduction, short term memory loss, special instrumental tests for tremor



9/25/2010

Dose response

curve However The prideful and Pathetically

Incompetent BIG GOOFS AND FUCK-UPS ANDRUDY POOTS AND COUNTRY BUMPKINS AND

MEDICALLY IRRESPONSIBLE LOOSECANNONS ON DECK and refuse to Back DownUT-Tyler Toxicology Attendings try to go aroundthis with the statement "The vast majority of descriptions in our limited understanding of thedetailed literature of mercury poisoning contain a

BLU E LI N E . Theref ore we think that you should have one as well " .

What is wrong with the statement above?



9/25/2010

The Heavy Metal

Paradigm The Heavy Metal Paradigm

(There is no saf e lower limit f or Lead and M ercury

at the dosesf ound either in the occupational environment or f rom Dental Amalgams)

Normal Values Urine= <10 ug Hg/L; Blood= (0.2-2 ug) Hg/100 ml [2-20 ug Hg/L]

There is considerable overlap amongconcentrations of mercury found in the normal

population, asymptomatic exposed individuals, and patients with clinical evidenceof poisoning . There is no definitive correlationbetween blood and urine mercury levels withmercury toxicity. 9,23



9/25/2010

The Heavy Metal

Paradigm U.S. Population Hg Levels (Kingman

1994) Urine= 3.1 ug Hg/L avg. ;(0-34 ug Hg/L)

These levels are mainly due to either dental amalgams or methyl mercury

from seafood/fish consumption. These

overlap with the doses in several studies (see above; Aphoshian-1998)which have produced Hg toxicity .



9/25/2010

The Heavy Metal

ParadigmF

DA n=550 Reports Adverse effects information²collected from

FDA's Medical Device Reporting (MDR) andProblem Reporting Programs (PRP) n=550

Reports concerning Dental Amalgams

Not Measured (expected to be in normal range)

A plethora of reports (n=550) have been filed(FDA) with chief complaints that were claimed to

be resolved with the removal of amalgam/mercuryrestorations A Blue Line nor G ingivitis was not reported, even during the process of removal.( See Below-Bjorkman:1997)



9/25/2010

Dose response

curve Study/Conc. Hg ug/m3 (air)

Effects (gingivitis) Yang (1994)-

Taiwanese Lamp socket Factoryworker 945 ug Hg/m3; (Urine= 610ug

Hg/L); (Blood=237ug Hg/L)

Prominent gingivitis, ataxia, blurredvision, dysarthria, tremors (usuallypostural and intentional), unsteadygait, and slow mental response



9/25/2010

PEL (MaximumPermissible Exposure

Limit) OSHA, WHO,ACGIH 100 ug Hg/m3 and above

See Below; Only brief exposures are advised w/orespiratory protection



9/25/2010

Dose response

curve Scientific Literature100 ug Hg/m3 and

below Clinically significant effects(erethism, intention tremor, gingivitis )have not been reported below air concentrations of 100 µg Hg/m3. [TheOSHA limit = 50 ug Hg/m3 x 8hr/day: notto exceed 50 hrs/wk] . Most effects

observed in persons exposed to mercuryin air concentrations below 100 ugHg/m3 are preclinical e.g., slowed nerveconduction, short term memory loss,special instrumental tests for tremor



9/25/2010

Dose response

curve Ehrenberg et al. (1991):

Thermometer plant workers

76 ug Hg/m3 Difficulty with heel-to-toe gait wasobserved in thermometer plantworkers.



9/25/2010

OS

HA Limit OSHA Limit

50 ug Hg/m3 x 8hr/day: not toexceed 50 hrs/wk

See Above (mostly preclinical)



9/25/2010

Dose response

curve Fawer,. et al. (1983): Mercury-exposed workers

in 3 industries (n=26) 26 ug Hg/m3

Hand tremor induced by industrial exposure tometallic mercury. a study of workers exposed to atime weighted average of 26 ug/m3 for anaverage of 15.3 years with an increase inintentional tremor compared to the control groupThese results clearly indicate that metallic

mercury, even at concentrations below thecurrent OSHA TLV-TWA of 50 ug Hg/m3, canlead to neurological disorders.



9/25/2010

WHO Limit WHO Limit 25 ug Hg/m3 x 8hr/day: not to exceed

50 hrs/wk

The World Health Organization (WHO)adopted a health-based recommendedlimit for occupational exposure of 25ug/m3 . The WHO Study Group selected

this value to ensure a reasonable degreeof protection not only against tremor butagainst mercury-induced nonspecificsymptoms (17). Effects induced byexposures that exceed these levels have

been well documented (7,9,10,16)



9/25/2010

ACGIH Limit ACGIH Limit ACGIH - American

Congress of Governmental IndustrialHygienists

25 ug Hg/m3 x 8hr/day: not to exceed50 hrs/wk

The American Congress of Governmental Industrial Hygienists

(ACGIH) adopted a health-basedrecommended limit for occupationalexposure of 25 ug/m3 See WHO study.



9/25/2010

Dose response

curve Piikivi, L., Tolonen, U. (1989):

Chloralkali workers (n=41) 15-25 ug Hg/m3

Comparison of computer-supportedevaluation of EEGs obtained frommercury exposed and control workers

showed those from the exposed groupwere significantly slower and moreattenuated. This difference was mostprominent in the occipital region,became milder parietally, and was

almost absent frontally



9/25/2010

Dose response

curve Ngim (1992) Dentists (n=98) 14 ug Hg/m3 Dentists (n=98, mean age 32, range 24±49) with

an average of 5.5 years of exposure to low levels

of mercury showed impaired performance onseveral neurobehavioral tests. The dentistsshowed significantly poorer performance on finger tapping (measures motor speed), trail making(measures visual scanning), digit symbol(measures visuomotor coordination and

concentration), digit span, logical memory delayedrecall (measures visual memory), and Bender-Gestalt time (measures visuomotor coordination).The dentists had a higher aggression score thanthe controls..



9/25/2010

Dose response curve

The Double-DoubleEffect Echeverria, Aposhian (1998) Dentists (n=49)

(Urine pre= 0.94 ug Hg/L avg.; 9.1post ug Hg/L)

By using an approach ( pre and post chelation Urine Hg levels)that distinguishes recent Hg exposure from Hg body burden,

subtle associations were observed between Hg and symptoms,mood, motor function, and nonspecific cognitive alterations in

task performance in an occupationally exposed group (dentists)with Hg Urine levels comparable to the general U.S. population.(0-4 ug Hg/L ). Some of the subclinical findings were due only to

the Hg source derived from their own dental amalgams. Thisstudy is evidence that Hg toxicity (CNS is Target) can occur from the low-levels emitted by dental fillings, By using the

pre/post chelation technique of course some had toxicity due toboth sources, occupational (DE NTAL O FFI C E S AV G . 20-40 ug Hg/m3 8 hrs/day x 40hrs/wk) and dental amalgams, Y E T NON E HAD A BLU E LI N E ON G UMS . Application of this approach maybe particularly useful in defining thresholds of Hg toxicity andfor establishing safe limits of exposure to mercury from dental

amalgam material, the restoration itself, diet, and other sources.



9/25/2010

Dose response

curve Dental Amalgams (Björkman et

al. 1997; Lorscheider et al. 1995).

1-100ug Hg/day (weight) dependson no. and (highest to lowest peaklevels during) drilling , installation,chewing, acidic, tooth brushing, hot

liquids etc«Gingivitis or Blue Lineon gums has not been reported per FDA¶S own review of literature.(175 STUDIE S) & 550 case reports



9/25/2010

Dose response

curve What this means is that the mercury released

from dental amalgams has a definite doseresponse curve in the human body just like

food or a drug like Bayer Aspirin. The highest Hg vapor/plasma/urine peaks ever measured are during removal (requires drilling one by one ), the next highest, during installation, the next during heavy chewing esp. w/ acidic f oods, toothbrushing w/abrasive grit toothpaste, then hot

liquids but yet a Blue Line on G ums was never seen/observed or reported. R emoval of dental amalgams in people who have

no indication of adverse eff ects is not recommended and can put the person at greater risk, i f per f ormed improperly. (ATSDR -1999)



9/25/2010

MRL (Minimum Risk

Level) 0.2 ug Hg/m3 = MRL continuous (26 ug Hg/m3) x (8/24 hrs/day) x (5/7 days/wk)

/10 variability /3 minimal effect

Dose and end point used for MRL derivation:0.026 mg/m3; increased frequency of tremors. Since the duration of exposure does influence the

level of mercury in the body, the exposure level reported in the F awer et al. (1983)occupational study was extrapolated from an

8-hour/day, 40-hour/workweek exposure to a levelequivalent to a continuous 24 hour/day, 7 days/week exposure as might be encountered near a hazardous waste site containing metallic mercury.



9/25/2010

MRL (Minimum Risk

Level) During the development of toxicological profiles, Minimal Risk Levels (MRLs) are derived

when reliable and sufficient data exist to identify the target organ(s) of effect or the mostsensitive health effect(s) for a specific duration for a given route of exposure. For Hg(inorganic/ organic) the target organ is the CNS.

An MRL is an estimate of the daily human exposure to a hazardous substance that is likely tobe without appreciable risk of adverse noncancer health effects over a specified duration of exposure.

MRLs are based on noncancer health effects only and are not based on a consideration of cancer effects. These substance-specific estimates, which are intended to serve as screeninglevels, are used by ATSDR health assessors to identify contaminants and potential healtheffects that may be of concern at hazardous waste sites.

Additional studies or pertinent information which lend support to this MRL: The ability of long-term, low level exposure to metallic mercury to produce a degradation in neurologicalperformance was also demonstrated in other studies.

(Ngim et al. 1992); (Ehrenberg et al. 1991) See Above.

Abnormal nerve conduction velocities have also been observed in chloralkali plant workers ata mean urine concentration of 450 µg/L (Levine et al.1982). These workers also experienced

weakness, paresthesias, and muscle cramps.

Tremors have also been reported in occupationally exposed workers with urinary mercuryconcentrations of 50±100 µg/g creatinine, and blood levels of 10±20 µg/L (Roels et al. 1982).

(Piikivi et al. 1984), decreases in performance on tests that measured intelligence(similarities) and memory (digit span and visual reproduction) were observed in chloralkaliworkers exposed for an average of 16.9 years (range, 10±37 years) to low levels of mercurywhen compared to an age-matched control group..



9/25/2010

References REFERENCES

. DHHS. 1993. Dental amalgam: A scientific review and recommended public health service strategyfor research, education and regulation. Department of Health and Human Services, Public HealthService, Washington, D.C

Björkman L, Sandborgh-Englund G, Ekstrand J. 1997. Mercury in salvia and feces after removal of amalgam fillings. Toxicol Appl Pharmacol 144:156-162

Ehrenberg RL, Vogt RL, Smith AB, et al. 1991. Effects of elemental mercury exposure at a

thermometer plant. Am J Ind Med 19(4):495-507 Fawer, R.F., DeRibaupiere, Y., Guillemin, M. et al. (1983): Measurement of hand tremor induced byindustrial exposure to metallic mercury. Br J Ind Med 40:204-208

Levine SP, Cavender GD, Langolf GD, et al: Elemental mercury exposure: peripheral neurotoxicity.Br J Ind Med 1982 May; 39(2): 136-9[Medline]

Ngim CH, Foo SC, Boey KW, et al. 1992. Chronic neurobehavioural effects of elemental mercury indentists. Br J Ind Med 49(11):782-790

Piikivi L, Hanninen H, Martelin T, et al. 1984. Psychological performance and long term exposure to mercury vapors. Scand J Work Environ Health 10:35-41. Piikivi L, Hanninen H. 1989. Subjective symptoms and psychological performance of chlor-alkali

workers. Scand J Work Environ Health 15(1):69-74. Piikivi, L., Tolonen, U. (1989): EEG findings in chlor-alkali workers subjected to low long term

exposure to mercury vapour. Br J Ind Med 46:30-35 Roels HA, Lauwerys R, Buchet JP, et al. 1982. Comparison of renal function and psychomotor performance in workers exposed. Int Arch Occup Environ Health 50:77-93. Yang Y-J, Huang C-C, Shih T-S, et al. 1994. Chronic elemental mercury intoxication:clinical and field

studies in lampsocket manufactures. Occup Environ Med 51(4):267-270



9/25/2010

Dose response

curve Translation: There are no published reports of a

blue line on gums (gingivitis) from either occupational exposure below 100 ug Hg/m3

or Dental Fillings This is what is wrong with it! There are no applications of the dose response

curve of Hg Vapor to this approach. Like any drug or just like food, Hg vapor has a

dose response curve just like Bayer Aspirin. You are pathetic failures in Pharmacology! This Evidence cannot be scientifically refuted by

any trained PhD. or M.D. in Medical Toxicology



9/25/2010

SUMMARY

Of course the UT-Tyler Attendings can try to get apublication In the Journal of Toxicology

As to how the Blue Line on Gums can be used totrack low-term, low-dose

Effects of Exposure to HG vapor,However no peer reviewed Toxicology Journal would

let you Publish,Because, I almost forgot The Studies have already

been done.

Is that what they meant by ³got´? A small child can see that you don¶t have (ain¶t got) alick

Of sense.

O i St di f



9/25/2010

Ongoing Studies of Long-Term Low Dose

Exposure toHg Vapor Echeverria, D

Battlle Centers, Public Health and

Evaluation, Seattle, WA Neurologic Effects of MetallicMercury Exposure In DentalPersonnel

National Institute Of DentalResearch

O i St di f



9/25/2010


Exposure toHg Vapor Factor-Litvak, P

Columbia University, New York,

New York Dental Amalgams andNeuropsychological Function

National Institute Of DentalResearch

Ongoing St dies of



9/25/2010


Exposure toHg Vapor Crawford, S. New England Research Institute

Health Effects of Dental Amalgam in Childrenhttp://www.neri.org/html/research/clinical/cat.asp

Children's Amalgam Trial - CAT Funding: National Institute of Dental and Craniofacial

Research

Safety will be measured in two ways Cognitive function (IQ) is theprimary outcome, given the hypothesis that mercury vapor ,released from amalgam may affect neuropsychologicaldevelopment in children. Dr. David Bellinger (Children's Hospital,Harvard Medical School and Dr. David Daniel (University of Maine,Farmington) are providing leadership in these measurements.

Kidney (renal) function, the other important system likely to beadversely affected by mercury, is being measured in the laboratoriesof Dr. Tom Clarkson (U. Rochester, NY) and Dr. Lars Barregard (U.Goteborg, Sweden)

Originally funded by the National Institute of Dental and CraniofacialResearch in 1996, this trial has been funded for another 5 years inorder to complete the planned 5 years of dental treatment and follow-up measurement originally planned. A sister trial " Casa Pia", is

also funded by the same I nstitute, to complete similar treatment and measurement on children in Portugal

Ongoing Studies of



9/25/2010


Exposure toHg Vapor DeRuen, T.

University of Washington

The Casa Pia Study [ Portugal ] of DentalAmalgam in Children (See Above)

National Institute Of Dental Research

The target organs of mercury exposure are

renal and neurological . Baseline and annualrepeated measures are taken on all subjects for renal function, nerve conduction velocity and alarge battery of neurobehavioral tests. Follow-up is planned for a period of 7 years



9/25/2010

ConclusionsYour Gimp Asses Would Kill themwaiting on a Blue Line to show up.

UT-Tyler Attendings in Toxicology.Orange Peels for Brains



9/25/2010

Medical MalpracticeThis fact is so obvious, GIMP UT-Tyler Attendings in

Toxicology that it is Surreal.You Truly are the Fuck-Ups, Big Goofs and Rudy

Poots of TheEntire Country-Country Bumpkins.

Incompetent, Bumbling, Inept, UT Tyler Toxicology Attendings, Big Goofs, Big Fuck-Ups, Rudy Poots and

Country Bumpkins whose approach to the detailedliterature of HG poisoning is Causal ,Shallow,

Lackadaisical, Lassie-Faire, Misapplied as an Appleis to an Orange, Non- Committal ,Half-Ass, NotTolerated , grossly medically incompetent and gets a

grade of "F"





9/25/2010

Medical Malpractice When asked these questions in a

court of law in a scientific,

medical and/or medical-legal context there is one answer that can be given by experts in Hg poisoning and any medically trained professional inc. UT-

Tyler Attendings w/o BLATANT

LY I N G UNDE R OATH.



9/25/2010

Medical MalpracticeThe Double-Double

Effect Did some of these persons

Diagnosed with and/or E xperiencing Mercury Poisoning I n Occupational E nvironments(The Double-Double Effect)

ALSO HAV E DE NTAL

AMALG AMS/ FI LLI N G S?



9/25/2010

Medical Malpractice1. What is the definition of Subclinical? The subclinical onset of chronic metallic mercury

poisoning as also described in the Textbook reference at UT-Tyler Public Health Library [TheClinical Basis of Medical Toxicology p. 1328 with

several references (20, 28, 50) from their ownPublic health Library .

" I n addition to mercury assays, neuropsychiatric

testing, nerve conduction studies and urine assaysfor N-acetyl B-D-glucosaminidase and beta-2-

microglobulin are advocated for early detection of subclinical inorganic and organic mercury

intoxication. (20, 28, 50)"



9/25/2010

Medical Malpractice What is the definition of Normal

Physical E xamination and

manifestations of toxicity? These manifestations of toxicity were not apparent throughstandard physical examinations.I n workers from a chloralkali plant (Levine et al. 1982). Metalsand Metalloids p.90 Levine(1982)



9/25/2010

Medical Malpractice1. Does Mercury have a dose response curve in the body or

biological systems?

Mosby's Occupational Medicine-1994 p. 552

" Chronic mercury poisoning is the mercurial poisoning found most commonly

in the occupational setting.(45,78) The symptoms may first occur after a very few weeks of exposure, or they may not become apparent for several years.The more intense the exposure has been, the more the symptoms will relate tothe mouth, the kidney, and the respiratory systems and gastrointestinal systems. The more prolonged and the lower the level of exposure, the morelikely the symptoms and signs will be pathoneurologic in nature. Most caseshave a blending of both. "

Recently, controversy has surrounded the use of mercury amalgams indentistry and the potential for adverse for adverse effects in both dental

personnel and patients. Studies have shown that amalgam fillings have

significantly contributed to plasma and urinary mercury levels; There is adefinite relationship between plasma mercury levels and the number and surface area of amalgam dental fillings. (54,55) Removal of fillings resulted ininitially higher plasma mercury levels, followed by eventual significant decreased levels compared to preremoval. (17,70) However, there is as yet noconclusive evidence of significant adverse health effects from exposure todental amalgams, except in cases of allergic sensitivity.(53,74)



9/25/2010

Medical Malpractice

What is the standard for care for occupational exposureand/or dental fillings?

The subclinical onset of chronic metallic mercury poisoning as also described in theTextbook ref erence at UT-Tyler Public Health Library [The Clinical Basis of Medical Toxicology p. 1328 with several references (20, 28, 50) from their ownPublic health Library.

" I n addition to mercury assays, neuropsychiatric testing, nerve conductionstudies and urine assays for N-acetyl B-D-glucosaminidase and beta-2- microglobulin are advocated for early detection of subclinical inorganic and organic mercury intoxication. (20, 28, 50)³

III : E valuation of Risks Associated With Mercury Vapor from Dental Amalgamo M ercury is a toxic substance. For high exposures, observed mostly in occupational

settings, the severity of response correlates with the duration and intensity of the

exposure. The relationship between the severity of response and the duration of exposure has, however, not been quantified at levels of exposure associated with dental amalgam restorations. I n addition, subtle signs and symptoms of chronic mercury intoxication may not be found through routine physical examinations. The subtle changes previously described require special testsnot commonly used in routine examinations²that is, nerve conduction studies,

measurement of alterations in EEG , and measures of psychomotor functioning.

Date post:	09-Apr-2018
Category:	Documents
Upload:	gerald-russell
View:	217 times
Download:	0 times

Mercury%20Poisoning%20Presentation

Documents