The following Press Release From Germany has been translated by Mats
Hanson, Ph.D. of Sweden.
arie
BUND, Friends of the earth. The Association of Environment and
Environmental Protection, Germany. Dunanstrasse 16, D-79110 Freiburg
Freiburg/Bonn, 28 January 1997
Review/Background Information
Presentation of the results of the largest trial on mercury release
from dental amalgam fillings in world,
BUND demands: No respite for amalgam - Amalgam ban overdue.
Amalgam has been the dental filling material of choice since 150
years. The criticism of this debated material has now been further
strengthened after the current results of the Tubingen amalgam tests.
The largest test in the world on mercury release from amalgam fillings
into the saliva was initiated in summer 1995 by BUND and carried out
by the department of environmental analysis at the university of
Tubingen. After a few hundred tests at the BUND- Environmental
exhibition OKO-95 in Ulm had shown a mean of more than four times
higher mercury levels in the saliva than the Bundesgesundheitsamt had
reported, BUND decided to act because of apparent governmental
inactivity. Funded by the MOMO-Children Foundation, we engaged the
environmental analytical group at the university of Tubingen for the
scientific realization of the largest experiment in the world on
mercury release from dental amalgam fillings. The analysis of the data
have been completed and sent to the Bundesinstitut fur Arzneimittel
und Medizinprodukte for publication.
Part 1: Mercury concentration In saliva from amalgam fillings.
In the first part of the study mercury levels in the saliva were
measured in 20,000 persons and related to the number of amalgam
fillings. The aim was to evaluate whether and to what degree there was
an exposure to mercury from amalgam fillings. The second part of the
study examined the relation between the levels of mercury In saliva
and a special spectrum of symptoms.
Mercury levels strongly elevated.
The more than 4-5 times higher mercury levels in saliva compared to
the levels reported by the former Bundesgesundheitsamt in 1984 (now
Bundesinstitut fur Arzneimittels und Medizinalprodukte) caused alarm,
both among the public as well as among professionals. The continuation
of the analyses were increasingly made more and more difficult for the
scientists at the University of Tubingen, a sign of the alarming
nature of the results. In addition to a great deal of irrelevant
criticism, it was also reported that WHO had distanced itself from
interpretations of the Tubingen study, which also proved to be false.
Especially the exceeding of the established tolerable limits caused
worry: The total tolerable weekly uptake of mercury (including the
vapor phase) of WHO was exceeded. About 43 % of the test
persons had higher, often several fold, exposure than the permissible
intake.
Since it has already been demonstrated that the mercury in the saliva
is dissolved but not particulate, one has to calculate with a much
higher absorption and mercury load than previously supposed. Of
importance is that in the 20-39 year old group (including women in the
fertile ages) the tolerable levels were especially often exceeded.
This can be explained by the fact that the number of fillings in this
group is especially high with 9-11 fillings, compared to a mean of 8
in the general German population. The tolerable intake was also often
exceeded for children with fewer fillings because of their lower body
weight.
Mercury load from amalgam fillings.
As a further statistical result the study established that the mercury
concentration in saliva (before and after chewing) depends on the
number amalgam fillings. The exposure lo mercury from amalgam fillings
has been scientifically debated, The results from the Tubingen study
clearly show an increased mercury load from amalgam fillings.
Saliva test a method to establish the mercury load.
The criticism of the Tubingen amalgam study concentrated on the
question whether saliva was a better medium than for instance blood
and urine to evaluate mercury exposure, Recent research confirms the
advantages of the saliva test. The load on the oral cavity and the
gastrointestinal tract can be estimated better with the saliva test
than with any other available method. Hg can be present in both the
oral cavity and the gastrointestinal tract without being detectable In
blood or urine. It is clear that blood and urine do not reflect the
Hg-concentration in the oral cavity/upper airways and in the
gastrointestinal tract. In addition, it was not possible to obtain
a certification/standardization for either blood (Dtsch Ges fur
Arbeitsmed) or urine (Dtsch Ges fur Kiln Chem) in the exposure range
relevant for amalgam fillings. In contrast, a standardization test by
the State Medical Dept of Stuttgart confirmed the excellent
reproducibility for the saliva test; laboratories which processed the
samples with the same method obtained consistent results; the standard
error between the 10 laboratories was less than 15 %.
Part 2. Measured levels In saliva and disease symptoms.
Every saliva test was accompanied by a questionnaire In which the
persons were asked for 30 symptoms. The analytical group at Tubingen
university evaluated 17500 completely answered questionnaires. The
question was whether there was a significant relation between report
of a symptom and the measured level of Hg in the saliva after chewing.
It has to be stressed that the established relation has a direct
mathematical and statistical character and should not be casually
interpreted. A statistically significant difference does not
automatically mean a medical or biological relevance. Not even multi
variance analysis can decide which relations are caused by chance and
which by a casual relation.
Relation between symptoms and mercury concentrations in saliva after
chewing.
The Tubingen amalgam study could establish in the especially examined
group of 21-40 year old persons a statistically significant relation
between mercury levels in saliva and symptoms. Only symptoms which are
characteristic of subacute or chronic mercury exposure in the
low-level range were studied.
The set of symptoms are often called micromercurialism in the
literature,
There was a significant relation between the measured mercury
concentration and the following symptoms:
Mouth-oral cavity: Bleeding gingiva, metal taste, burning tongue.
Central nervous system: Concentration difficulties, impaired memory,
sleep disturbances, lack of initiative, nervousness.
Gastrointestinal tract: not specified; further research is needed to
establish the diseases which are covered by the non- specific label
gastrointestinal problems.
Plausibility and explainability of the demonstrated symptoms.
In addition to high levels of mercury in saliva there has also been
demonstrated high levels In gingiva, pulp, oral mucosa, dentine, roots
and jaw bone. Amalgam fillings, as described in the literature, lead
to increased inflammation of the gingiva. In addition the oral cavity
will be affected by the Hg-vapor released by the fillings. Experiments
with cell cultures demonstrated that the Hg-levels measured in the
oral tissues (up to 8000 ng/g in the mucosa) can lead to damage to
human cells. It has also been described that unpolished amalgam
fillings can damage nearby cells more than polished ones.
Also for the gastrointestinal tract it has been demonstrated that
there are high levels of mercury in the intestinal wall, intestinal
lymph nodes and in feces. The cause of this is that the mercury which
is swallowed with the saliva is only absorbed to 10% and the rest
remains in the gastrointestinal tract.
For both these body parts it has been established that blood and urine
levels are unsuitable to evaluate the mercury load. The symptoms from
the central nervous system show a remarkable similarity with the
classical mercury symptoms described in the literature. For instance,
effects of mercury on memory and concentration has been repeatedly
described in the literature.
The Tubingen group for environmental analysis stress that some aspects
of the study require further examination. For instance, the
relationships between mercury exposure to metal allergy, or loss of
hair, or the relationship to involuntary infertility. In each of these
considerations, tendencies were noted, however, extensive and
expensive further questionnaires are required. It should be stressed
that the results are statistical and do not establish a causal
relation for single cases for any symptom.
After the statistical relations found in the study, persons who
complain over problems with amalgam must not further be dismissed a
"Ecochondriacs" or "Hypochondriacs," and furthermore a possible
Hg-load must be take into account in the anamnesis, especially when
the patients exhibit the described symptomatology.
Amalgam is with certainty not the material for the future, the
Tubingen group stress, however they also warn for exaggerated panic
reactions. As in medicine In general, In every single case one must
together with the treating doctor evaluate whether an amalgam removal
is necessary and if yes, how rapidly a removal should take place.
The relations found, which as stated above, should not be causally
interpreted, however clearly prove that humans will be exposed to a
continuous load of mercury from amalgam fillings. The filling material
amalgam is thus suspected of being able to cause damage to health,
This should be sufficient for health policy measures and at last start
to end the amalgam era.
Demands by BUND as a consequence of the amalgam study:
BUND demands that minister of health, Seehofer, immediately acts on
the basis that: Amalgam, as an additional risk factor, does not belong
in the oral cavity.
The amalgam ban should not only be restricted to pregnant women and
children but should immediately be general for dentistry.
The university dental clinics must immediately remove the technique of
amalgam placement from their educational agenda, as has already
happened in renowned dental clinics in Switzerland.
Teaching and education on amalgam problems, safer removal techniques
for amalgam filling and on plastic alternatives for molar teeth.
Further studies are indicated by the amalgam study. The Minister of
Health Seehofer must not further burden environmental organizations
with the expenses,
BUND demands that the Minister of Health release funds for follow-up
studies at the Uuniversity of Tubingen.
After an overdue amalgam ban the costs for alternative materials must
be taken over by the insurance s stem
Dental metal test can be mediated by all pharmacies. BUND can, in
cooperation with the environmental analytical group at Tubingen, offer
under the name SALIVAGAM a dental metal test. This can be mediated by
all pharmacies. In addition to mercury levels in saliva all other
dental metal are analyzed. Further information in all pharmacies and
from BUND-Umweltlabor, Tel: 0781/9383-21, Fox-11
For answers to scientific matters please contact Dr E Roller, Dr. HD
Wolss, KH Maier, AK Umweltanalytik, Univ. of Tubingen, Postfach
210352, D-72026 Tubingen, tel 07071/2984802. Interested journalists
can obtain detailed information from BUND, Dunanstrasse 16. D-79110
Freiburg, Tel: 0761/885955-0, Fax-90
