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Biomedical subjects

L Barregård

Publications and source records attributed to L Barregård.

At least 37 records · Page 2Linked to original sources

Impact of nocturnal bruxism on mercury uptake from dental amalgams.

The mercury (Hg) release from dental amalgam fillings increases by mechanical stimulation. The aim of this study was to investigate the possible impact of nocturnal bruxism on Hg exposure from dental amalgams and to evaluate the effect of an occlusal appliance. 88 female patients from an orofacial pain clinic with a complete maxillary and mandibular dentition, a normal frontal vertical overbite with cuspid guidance, and at least 4 occlusal amalgam fillings in contact with antagonists in intercuspidal position, were examined with the Bruxcore bruxism monitoring device to measure the level of on-going nocturnal bruxism. Based on the degree of abrasion recorded, the subjects were divided into a group defined as bruxists, (n = 29), another group defined as non-bruxists, (n = 32), serving as controls, the intermediate group being discarded. The Hg exposure was assessed from the Hg concentration in plasma and urine, corrected for the creatinine content. In a regression model with bruxism as the only explanatory variable, no significant effect of bruxism was found, but when the number of amalgam fillings, chewing gum use, and other background variables were taken into account, there was a limited impact of bruxism on Hg in plasma. The nocturnal use of an occlusal appliance did not, however, significantly change the Hg levels. This study indicates that mechanical wear on amalgams from nocturnal bruxism may increase the Hg uptake, but the magnitude of this effect seems to be less than from the use of chewing gum.

Absorption↗

Exposure to mercury vapor and impact on health in the dental profession in Sweden.

Possible adverse effects of mercury exposure in dentistry have been discussed in several studies. The objective of the present study was to carry out detailed measurements of mercury exposure in the dental profession in Sweden, and to search for adverse health effects from such exposure. We examined 22 dentists and 22 dental nurses, working in teams, at six Swedish dental clinics. Measurements of air mercury, performed with personal, active air samplers, showed a median air Hg of 1.8 micrograms/m3 for the dentists, and 2.1 micrograms/m3 for the dental nurses. Spot measurements with a direct reading instrument displayed temporarily elevated air Hg, especially during the preparation and application of amalgam. The average concentration of mercury in whole blood (B-Hg) was 18 nmol/L, in plasma (P-Hg) 5.1 nmol/L, and in urine (U-Hg) 3.0 nmol/mmol creatinine. Possible effects on the central nervous system (CNS) were registered with three questionnaires: Q16, Eysenck Personality Inventory (EPI), and the Profile of Mood Scales (POMS). In the Q16, the number of symptoms was statistically significantly higher in the dentistry group compared with an age- and gender-matched control group (n = 44). The urinary excretion of albumin and urinary activity of the tubular enzyme N-acetyl-beta-glucose-aminidase (NAG) did not differ between the two groups. The results confirm that exposure to mercury in the dental profession in Sweden is low. The air Hg levels were mainly influenced by the method of amalgam preparation and inserting, and by the method of air evacuation during drilling and polishing.

Adult↗

Estimated exposure to static magnetic fields for the staffs of NMR-units.

Exposure of the staffs to static magnetic fields of NMR-units, was investigated at two departments for chemical analysis (static field strength of the systems 11.7 and 4.7 Tesla) and two for clinical imaging (0.5 and 0.02 Tesla). The exposure time was estimated by personal interviews. The magnetic flux density was highly dependent on distance to the magnet, and the magnetic fields in normal work with the NMR-units were, during most working time, lower than 1 milliTesla (mT), which is far below the whole-body limit recommended by the American Conference of Governmental and Industrial Hygienists (60 mT), the British National Radiation Protection Board (200 mT), or the international Commission on Non-Ionizing Radiation Protection (200 mT). During short periods, when changing samples or assisting anxious patients, the fields may be strong (100-150 mT). The recommended ceiling values (2-5 Tesla) are, however, not exceeded.

Electromagnetic Fields↗

Thromboxane metabolite excretion in patients with hand-arm vibration syndrome.

As chronic exposure to hand-held vibrating tools may cause endothelial injury, a subsequent sustained platelet activation with the increased release of vasoconstricting thromboxane A2 (TxA2) could be of pathophysiological importance in vibration-induced Raynaud's phenomenon. Therefore, the aim of this study was to elucidate whether or not hand-arm vibration syndrome is accompanied by increased endogenous TxA2 biosynthesis. The study involved 64 men, aged 23-61 years, stratified according to the exposure to vibrating tools, the presence of Raynaud's phenomenon, and smoking habit. Forty of them were car mechanics and 24 were age-matched healthy volunteers who served as controls. The assessment of platelet TxA2 formation in vivo was performed by quantification of the urinary excretion of its major metabolite, 2,3-dinorthromboxane B2 (2,3-dinor-TxB2), employing gas chromatography-mass spectrometry. The average urinary excretion rate of 2,3-dinor-TxB2 in patients with Raynaud's phenomenon was 296 +/- 42 pg/mg creatinine and did not differ significantly from the corresponding values in controls (328 +/- 62 pg/mg creatinine) or individuals exposed to vibrating tools, but without any signs of vasospastic disease (232 +/- 29 pg/mg creatinine). The only statistically significant difference was found between smokers and non-smokers (P < 0.001), a finding confirming the existence of chronic platelet dysfunction in cigarette smokers. The present data indicate that chronic exposure to vibrating tools, with or without Raynaud's phenomenon, is not associated with an enhanced platelet function as monitored by the urinary excretion of 2,3-dinor-TxB2. Hence, a possible vibration-induced vascular injury does not seem to provide a stimulus sufficient to induce a persistent platelet activation.

Adult↗

Long-term use of nicotine chewing gum and mercury exposure from dental amalgam fillings.

In experimental studies, chewing gum has been shown to increase the release rate of mercury vapor from dental amalgam fillings. The aim of the present study was to investigate the influence of long-term frequent chewing on mercury levels in plasma and urine. Mercury levels in plasma (P-Hg) and urine (U-Hg), and urinary cotinine were examined in 18 subjects who regularly used nicotine chewing gum, and in 19 referents. Age and number of amalgam surfaces were similar in the two groups. Total mercury concentrations in plasma and urine were determined by means of cold vapor atomic absorption spectrometry. Urinary cotinine was determined by gas chromatography-mass spectrometry. The chewers had been using 10 (median) pieces of gum per day for the past 27 (median) months. P-Hg and U-Hg levels were significantly higher in the chewers (27 nmol/L and 6.5 nmol/mmol creatinine) than in the referents (4.9 nmol/L and 1.2 nmol/mmol creatinine). In both groups, significant correlations were found between P-Hg or U-Hg on the one hand and the number of amalgam surfaces on the other. In the chewers, no correlations were found between P-Hg or U-Hg and chewing time per day or cotinine in urine. Cotinine in urine increased with the number of pieces of chewing gum used. The impact of excessive chewing on mercury levels was considerable.

Adult↗

Variability in the quantification of abrasion on the Bruxcore device.

The rate of abrasion of dental surfaces during short periods of time is difficult to measure clinically, but one quantifiable method is the use of the Bruxcore bruxism monitoring device. The aim of this study was to estimate the interobserver and intraobserver variation in the Bruxcore system using different reading methods. Fifteen volunteers used individually fabricated Bruxcore devices during 4 consecutive nights, and this procedure was repeated after 6 weeks. The abraded areas of the 30 Bruxcore devices were measured by two observers on two occasions and with three methods: microscope without a reference scale; microscope with a reference scale; and a computer-aided system. Intraobserver variation was small (5%), but interobserver variation was statistically significant for all three methods. The computer-aided system was superior to the other two methods. The interaction between Bruxcore values and observers was statistically significant for the microscope methods but not for the computer method. This was a desired property, indicating stability of the computer-aided method over the range of Bruxcore values observed. Small measurement errors, independent of the size of the measurements, can be expected using a trained observer and a computer-aided method for reading the Bruxcore bruxism monitoring device.

Adult↗

In vivo XRF analysis of mercury: the relation between concentrations in the kidney and the urine.

The objective of this study was to determine the concentrations of mercury in organs of occupationally exposed workers using in vivo x-ray fluorescence analysis. Twenty mercury exposed workers and twelve occupationally unexposed referents participated in the study. Their mercury levels in kidney, liver and thyroid were measured using a technique based on excitation with partly plane polarized photons. The mercury levels in blood and urine were determined using atomic absorption spectrophotometry. The detection limit for mercury in the kidney was exceeded in nine of the exposed workers, but in none of the referents. The mean kidney mercury concentration (including estimates below the detection limits) was 24 micrograms g-1 in the exposed workers, and 1 microgram g-1 in the referents. The association between mercury in the kidney and in urine was statistically significant, but it was unclear whether the relation was linear. The measurements on liver (n = 10) and thyroid (n = 8) in the exposed workers showed mercury levels below the detection limit. The study shows that it is now possible to measure the mercury concentrations in kidneys of occupationally exposed persons, using in vivo x-ray fluorescence. The estimated concentrations are in reasonable agreement with the limited human autopsy data, and the results of animal studies.

Adult↗

People with high mercury uptake from their own dental amalgam fillings.

OBJECTIVES: To describe people with high mercury (Hg) uptake from their amalgam fillings, and to estimate the possible fraction of the occupationally unexposed Swedish population with high excretion of urinary Hg. METHODS: Three case reports are presented. The distribution of excretion of urinary Hg in the general population was examined in pooled data from several sources. RESULTS: The three cases excreted 23-60 micrograms of Hg/day (25-54 micrograms/g creatinine), indicating daily uptake of Hg as high as 100 micrograms. Blood Hg was 12-23 micrograms/l, which is five to 10 times the average in the general population. No other sources of exposure were found, and removal of the amalgam fillings resulted in normal Hg concentrations. Chewing gum and bruxism were the probable reasons for the increased Hg uptake. Extrapolations from data on urinary Hg in the general population indicate that the number of people with urinary excretion of > or = 50 micrograms/g creatinine could in fact be larger than the number of workers with equivalent exposure from occupational sources. CONCLUSION: Although the average daily Hg uptake from dental amalgam fillings is low, there is a considerable variation between people; certain people have a high mercury uptake from their amalgam fillings.

Adult↗

Mercury and proteins in cerebrospinal fluid in subjects exposed to mercury vapor.

Mercury (Hg) and protein levels in cerebrospinal fluid (CSF), and mercury in plasma (P), erythrocytes (Ery), and urine (U), were determined in 10 workers exposed to mercury vapor for 2-28 (median 13) years and in 16 occupationally unexposed referents. CSF-Hg was analyzed using radiochemical neutron activation analysis and P-Hg, Ery-Hg, and U-Hg were analyzed using cold-vapor atomic absorption spectrometry. P-Hg and U-Hg were significantly higher, but Ery-Hg was similar in the exposed workers (37 nmole/liter, 16 nmole/mmole creatinine, and 56 nmole/liter, respectively) compared with the referents (7.1 nmole/liter, 1.9 nmole/mmole creatinine, and 52 nmole/liter, respectively). CSF-Hg was correlated to P-Hg, and in workers with current high exposure (P-Hg > 50 nmole/liter), the CSF-Hg was significantly higher than in the reference group (1.08 versus 0.35 nmole/liter; P = 0.002). In two individuals, studied after ceased occupational exposure, a decrease of CSF-Hg was seen. There were no indications of changes in the CSF protein pattern in the exposed workers.

Adult↗

No indication of in vivo methylation of inorganic mercury in chloralkali workers.

It has been shown in vitro that human oral and intestinal bacteria are able to methylate inorganic mercury (Hg) to methylmercury (MeHg). In vivo methylation has been reported for guinea pigs, and several studies have found higher levels of organic Hg in blood of workers exposed to inorganic Hg. In search for indications of in vivo methylation of Hg, we determined total Hg in urine (U), plasma (P), and erythrocytes (Ery), and MeHg in erythrocytes, in 22 chloralkali workers exposed to inorganic Hg, and in 22 age-matched referents. The subjects in both groups ate fish not more than once a week. MeHg was determined using ion exchange separation and cold vapor atomic absorption spectrometry. The mean concentrations of total mercury in chloralkali workers and referents were 26 vs 2.3 micrograms/g creatinine (U-Hg), 9.7 vs 1.8 ng/g (P-Hg), and 11.4 vs 5.6 ng/g (Ery-Hg). The mean Ery-MeHg concentrations were 3.0 vs 3.7 ng/g, and there were no correlations between Ery-MeHg on the one hand and U-Hg or P-Hg on the other. Our results indicate no significant in vivo methylation of inorganic Hg in man. Contradictory results from previous studies may be due either to bias owing to fish consumption or to analytical shortcomings.

Alkalies↗

Hand eczema in car mechanics.

To estimate the prevalence of hand eczema, a questionnaire was distributed to 901 male car mechanics. Of the 801 persons who responded, 15% reported hand eczema on some occasion in the previous 12 months, and 57% admitted dry skin on the hands. In a 2nd part of the study, those who reported hand eczema were examined and patch tested with a standard series and a special "car mechanics' series". The most common diagnosis was irritant contact dermatitis, 55%, and 2nd was allergic contact dermatitis, 19%. 35/105 (33%) had a total of 51 positive patch test reactions, all to substances in the standard series, except for 2 persons who reacted to oxidized d-limonene. The most frequent reactions were to thimerosal (9%), nickel (8%) and colophony (5%). One plausible explanation for the high prevalence of nickel allergy was the common use of nickel-plated tools. 5 individuals had a history of contact urticaria, but scratch tests were negative. It was concluded that car mechanics are at high risk for contact dermatitis on the hands, irritant as well as allergic.

Adolescent↗

Clearance half life of mercury in urine after the cessation of long term occupational exposure: influence of a chelating agent (DMPS) on excretion of mercury in urine.

The elimination of mercury (Hg) in urine was investigated in 12 former chloro-alkali workers exposed to metallic Hg vapour for two to 18 (median five) years. Morning urine samples were taken on several (median 9) occasions after change of employment or retirement. The median follow up time was 28 months. The decrease in concentration of Hg in urine (U-Hg) was well characterised by a one compartment model. Three different regression methods were used; non-linear least squares regression (NLSR), weighted non-linear least squares regression (WNLSR), and linear least squares regression (LLSR) after log transformation of the U-Hg data. The median half life from the WNLSR method was 55 days. There were no large differences in the half life estimates given by the WNLSR or the NLSR methods, but for five subjects the LLSR method gave poor fits. There was a non-significant tendency towards longer half lives with higher initial U-Hg. About three years after the cessation of occupational exposure a mobilisation test with 2,3-dimercaptopropane-1-sulphonate (DMPS) was performed on seven subjects. Excretion of Hg, copper (Cu), and zinc (Zn) in urine was estimated before and after the ingestion of 300 mg of DMPS. Treatment with DMPS increased 24 hour urinary excretion by a factor of 7.6 for Hg, 12 for Cu, and 1.5 for Zn. The relative increase in U-Hg was not significantly higher than that obtained in a previous study of an occupationally unexposed group. A major proportion (62%) of Hg excreted during 24 hours after DMPS appeared in the first six hours.

Adult↗

Endocrine function in mercury exposed chloralkali workers.

OBJECTIVE: The aim was to study whether functional impairment of the pituitary, thyroid, testes, and adrenal glands of humans occupationally exposed to mercury (Hg) vapour can be shown as a result of accumulation of Hg in these glands. METHODS: Basal concentrations of thyrotrophin (TSH), prolactin, free thyroxine (free T4), free 3,5,3'-triiodothyronine (free T3), antibodies against thyroperoxidase, and testosterone in serum, as well as cortisol in morning urine were measured in 41 chloralkali workers exposed (10 years on average) to Hg vapour, and in 41 age matched occupationally unexposed referents. The chloralkali workers had a mean urinary Hg concentration (U-Hg) of 15 nmol/mmol (27 micrograms/g) creatinine, and a mean blood Hg concentration (B-Hg) of 46 nmol/l. For the reference group U-Hg and B-Hg were 1.9 nmol/mmol (3.3 micrograms/g) creatinine and 17 nmol/l respectively. RESULTS: The serum free T4 concentration and the ratio free T4/free T3 were slightly, but significantly, higher in the subgroups with the highest exposure, and the serum free T3 was inversely associated with cumulative Hg exposure. This indicates a possible inhibitory effect of mercury on 5'-deiodinases, which are responsible for the conversion of T4 to the active hormone T3. Serum total testosterone, but not free testosterone, was positively correlated with cumulative Hg exposure. Prolactin, TSH and urinary cortisol concentrations were not significantly associated to exposure. CONCLUSION: Apart from inhibition of the deiodination of T4 to T3, the endocrine functions studied seem not to be affected by exposure to Hg vapour at the exposure levels of the present study. Growth hormone secretion was not studied.

Adrenal Glands↗

Assessment of renal dysfunction in workers previously exposed to mercury vapour at a chloralkali plant.

Urinary albumin concentration (U-alb) and N-acetyl-beta-D-glucosaminidase (U-NAG) and glomerular basement membrane antibodies (a-GBMs) in serum samples were measured in 77 chloralkali workers previously exposed to mercury (Hg) vapour and 53 age matched referents. The exposure ceased on average 12.3 (range 1-35) years before the study. The mean exposure time was 7.9 (range 1.1-36.2) years. The mean yearly urinary Hg concentration (U-Hg) was 531 nmol/l. The concentrations of the urinary isoenzymes NAG A (U-NAG A) and NAG B (U-NAG B) were determined in 30 highly exposed subjects and 30 referents. No differences in U-alb or U-NAG, U-NAG A, or U-NAG B were found between the groups. Higher concentrations of a-GBMs were found among subjects who stopped exposure a short time before the study, but there was no association between a-GBMs and U-alb. The U-NAG and U-NAG A were negatively correlated with storage time. The results may suggest that microalbuminuria and enzymuria reported in subjects with ongoing exposure to Hg vapour are reversible in most instances.

Acetylglucosaminidase↗

Biological monitoring of exposure to mercury vapor.

Biological monitoring of mercury in whole blood (B-Hg) or urine (U-Hg) can be used to assess exposure to mercury vapor if the kinetics and other sources of variation are taken into account. Its rapid rise postexposure makes B-Hg a good indicator of recent exposure peaks, while U-Hg (corrected for urinary flow rate) reflects average long-term exposure. However, high intraindividual variation sometimes requires the average of several U-Hg determinations. In the general population, methylmercury from fish and mercury from dental amalgam influence B-Hg and U-Hg, respectively, and must be considered if other exposures are being monitored. The quantitative relations between mercury in biological fluids and critical organs are poorly understood. Monitoring U-Hg is useful for assessing the risk of adverse effects and the need for preventive measures. At average U-Hg levels of about 50 micrograms.g creatinine-1 (28 nmol.mmol creatinine-1) the prevalence of symptoms and slight objective changes in the central nervous system and the excretion of certain urinary proteins are increased.

Air Pollutants↗

Decrease in mercury concentration in blood after long term exposure: a kinetic study of chloralkali workers.

The elimination of mercury (Hg) in blood was investigated in 14 chloralkali workers exposed to metallic Hg vapour for 1-24 (median 10) years. Blood and urine samples were collected on several (median eight) occasions during a period of 17-26 days. The initial Hg concentrations were about 80 nmol/l in whole blood (B-Hg) and 17 nmol/mmol creatinine in urine (U-Hg). The decrease in Hg in whole blood, plasma (P) and erythrocytes (Ery) was best characterised by a two compartment model. In a model with a common half life for all subjects, the best fit for B-Hg was obtained with half lives of 3.8 days for a fast phase and 45 days for a slow phase. The half life of the fast phase was shorter for P-Hg than for Ery-Hg, whereas the opposite was the case for the slow phase. The half lives of the slow phases in whole blood and plasma were longer, and the relative fractions of the slow phases were higher (about 50%) after long term exposure than those (about 20%) reported after brief exposure. Slower elimination indicates higher accumulation of Hg in organs with long half lives, and possibly the presence of at least one additional, even slower compartment. The U-Hg fluctuated substantially during the sampling period, and average concentrations decreased only slightly.

Adult↗