Reproductive toxicity of occupational mercury. A review of the literature

Objectives: This paper aims to give the dental practitioner insight into the potential reproductive effects of handling dental silver amalgam, c.q. mercury. Data sources: Experimental studies on animals, case reports and epidemiologic studies. Study selection: Experimental animal studies show high doses/concentrations of mercury to increase the risk of reproductive disorders, e.g. infertility, spontaneous abortion, stillbirth and congenital malformations. Some case reports suggest an association between the disorders in humans and high levels of mercury. Therefore, the present article reviews epidemiological studies on the relationship between occupational exposure to mercury, mainly as vapour in the dental practice, and femalesʹ procreative ability. Studies concerning the reproductive effects of malesʹ occupational mercury body burden are scarce. The reproductive risk of patientsʹ mercury uptake from silver amalgam fillings is assessed. Conclusions: It seems warranted to conclude that negative reproductive effects from exposure to mercury in the dental office are unproven, but safe levels have not been established. Seemingly problems are unlikely to occur, unless a poor hygiene causes the mercury concentration in the air to exceed femalesʹ time-weighted long-term Threshold Limit Value (TLV). Consequently, in view of the in general low amounts of mercury stemming from dental amalgam fillings, the population at large is at even less risk than dental staff. The effects of occupational elemental mercury concentrations lower than the TLV on the menstrual cycle, conception, male fertility and childrenʹs behaviour need, however, more research.