Anglen Julia, Gruninger Stephen E, Chou Hwai-Nan, Weuve Jennifer, Turyk Mary Ellen, Freels Sally, Stayner Leslie Thomas
J Am Dent Assoc. 2015 Sep;146(9):659-668.e1. doi: 10.1016/j.adaj.2015.05.016.
The effects of chronic occupational exposure to elemental mercury (Hg(0)) are largely unknown. The objective was to evaluate the association of occupational Hg(0) exposure with multiple sclerosis (MS) and tremor.
The study included 13,906 dentists who attended the American Dental Association's annual meeting over 24 years (1986-2007 and 2011-2012). Participants reported MS and tremor and provided urine specimens for Hg(0) analysis. The authors estimated mean Hg(0) exposures over time and used logistic regression to estimate the associations of 3 Hg(0) exposure measures with MS or tremor.
Among participants, 0.18% reported MS and 1.24% reported tremor. Hg(0) exposure was not associated with MS (odds ratio [OR] per 191 micrograms per liter in cumulative Hg(0) exposure, 0.85; 95% confidence interval [CI], 0.39-1.85). Increased prevalent risk of tremor was found with exposure to both urinary Hg(0) exposure (OR, 1.10 [95% CI, 1.00-1.22]) and cumulative Hg(0) exposure among younger dentists (< 51 years; OR, 1.13 [95% CI, 1.05-1.22]).
Occupational Hg(0) exposure in US dentists decreased over time and now is approaching that of the general population. Our results suggest a positive association between Hg(0) exposure and tremor.
Studies with more sophisticated outcome and exposure measures, and including more retired dentists, would provide critical information toward understanding the relation of Hg(0) exposures to MS and tremor risk.
长期职业性接触元素汞（Hg(0)）的影响很大程度上尚不明确。目的是评估职业性Hg(0)接触与多发性硬化症（MS）及震颤之间的关联。
该研究纳入了13906名在24年期间（1986 - 2007年及2011 - 2012年）参加美国牙科协会年会的牙医。参与者报告了MS和震颤情况，并提供尿液样本用于Hg(0)分析。作者估算了随时间变化的平均Hg(0)接触量，并使用逻辑回归来估算3种Hg(0)接触量测量指标与MS或震颤之间的关联。
在参与者中，0.18%报告患有MS，1.24%报告有震颤。Hg(0)接触与MS无关联（累积Hg(0)接触量每升191微克时的比值比[OR]为0.85；95%置信区间[CI]为0.39 - 1.85）。在较年轻的牙医（<51岁）中，发现尿液Hg(0)接触（OR为1.10 [95% CI为1.00 - 1.22]）及累积Hg(0)接触均与震颤的患病风险增加有关（OR为1.13 [95% CI为1.05 - 1.22]）。
美国牙医的职业性Hg(0)接触随时间减少，目前已接近普通人群的接触水平。我们的结果表明Hg(0)接触与震颤之间存在正相关。
采用更精确的结局和接触量测量指标且纳入更多退休牙医的研究，将为理解Hg(0)接触与MS及震颤风险之间的关系提供关键信息。
