Ua hoʻohana ʻia ka amalgam kahua niho e hoʻihoʻi i nā niho no ʻaneʻane ʻelua haneli mau makahiki, a me nā kānalua e pili ana i ka contradict o ka hāʻawi ʻana i kahi lawelawe mālama ola me kahi mea i loaʻa ka mercury i hoʻomau mau i ka manawa holoʻokoʻa. Ua loaʻa kekahi undercurrent ma lalo o ka ʻoihana niho o ka anti-amalgam manaʻo, kahi "mercury-free" neʻe. ʻOiai ua ulu aʻe nā manaʻo o kēlā manaʻo i loko o nā makahiki i hala aku nei i ka maʻalahi o ka hoʻokō ʻana i ka niho niho maikaʻi me nā mea i hoʻohui ʻia, e hōʻuluʻulu ʻia ke ʻano maʻamau o nā kauka niho i ka amalgam ma ke ʻano "ʻaʻohe mea hewa me ka ʻepekema, ʻaʻole wale mākou e hoʻohana nui. hou. "

No ka nīnau inā ʻaʻole hewa a ʻepekema paha kekahi me ka amalgam, pono ka nānā ʻana i nā puke ākea e pili ana i ka hōʻike ʻana, mea ʻona a me ka loiloi o ka mercury. Aia ka hapa nui o waho ma waho o nā kumuwaiwai o ka ʻike ʻike pinepine ʻia nā kauka niho. ʻOiai ka hapa nui o nā puke e pili ana i ka hōʻike mercury mai ka amalgam aia ma waho o nā puke pai niho. Hiki i ka ninaninau ʻana i kēia palapala hoʻonui ke hoʻomālamalama i nā manaʻo i hana ʻia e ka dentist e pili ana i ka palekana amalgam, a hiki ke kōkua i ka wehewehe ʻana i ke kumu o ka kūpaʻa mau ʻana o kekahi mau kauka niho i ka hoʻohana ʻana o amalgam i ka dentist restorative.

ʻAʻohe mea i kēia manawa e hoʻopaʻapaʻa i ka amalgam niho e hoʻokuʻu i ka mercury metallic i loko o kona kaiapuni ma kahi uku, a he mea hoihoi e hōʻuluʻulu pōkole i kekahi o nā hōʻike no kēlā hōʻike. He ākea loa ke kumuwaiwai o ka mercury i kumuhana no kahi ʻatikala pōkole, a nānā pono ʻia ma kahi ʻē. ʻO ke kumuhana o ka loiloi weliweli, akā, hele pololei i ka puʻuwai o ka hoʻopaʻapaʻa no ka palekana o amalgam, a i ʻole, no ka hoʻohana palena ʻole ʻia i ka heluna lehulehu i ka nui.

He aha ke ʻano o ka hao ma Amalgam kahua niho?

No ka mea he hui huʻihuʻi ia, ʻaʻole hiki i ka amalgam ke hoʻokō i ka wehewehe o ke kinikini, a he ʻano hoʻohui o nā metala i hana ʻia i kahi moku i hoʻoheheʻe ʻia. ʻAʻole nō hoʻi e hiki ke hoʻokō i ka wehewehe ʻana o kahi hui ionic e like me ka paʻakai, a pono e loaʻa kahi pānaʻi o nā electrons e hopena ana i ka lattice o nā ion i hoʻopiʻi ʻia. Kūpono ia i ka wehewehe ʻana o ka colloid inter-metallic, a i ʻole emulsion paʻa, kahi i hana ʻole ʻole ʻia ai ka matrix a loaʻa hou. Hōʻike ka helu 1 i kahi micrograph o kahi laʻana metallurgical polia o ka amalgam niho i hoʻopūʻiwa ʻia e ka hulina microscopic. I kēlā me kēia kiko o ke kaomi, kaomi ʻia nā droplets o ka wai mercury. ¹

Haley (2007)² ana ʻia i ka-in vitro o ka mercury mai nā laʻana hoʻokahi-ninini o Tytin®, Dispersalloy®, a me Valiant®, ʻo kēlā me kēia me kahi ʻāpana o 1 cm2. Ma hope o kanaiwa mau lā e waiho ana e ʻae i nā hopena hoʻonohonoho mua e hoʻopiha, ua kau ʻia nā mea i loko o ka wai pulu i ka mahana o ka lumi, 23˚C, a ʻaʻole i hoʻonāukiuki. Ua hoʻololi a ua kālailai ʻia ka wai maʻemaʻe i kēlā me kēia lā no 25 mau lā, e hoʻohana ana i kahi Nippon Direct Mercury Analyzer. Hoʻokuʻu ʻia ʻo Mercury ma lalo o kēia mau ʻano ma ke kaha o 4.5-22 microgram i kēlā me kēia lā, i kēlā me kēia kenimika. Chew (1991)³ ua hōʻike ʻia ua hoʻohemo ʻia ka mercury mai ka amalgam i loko o ka wai i hoʻokahe ʻia ma 37˚C ma ke ana o 43 micrograms i kēlā me kēia lā, ʻo Gross and Harrison (1989)⁴ ua hōʻike ʻia he 37.5 micrograms i kēlā me kēia lā i kā Ringer solution.

Ka hoʻokaʻawale ʻana o Duryury Mercury a puni ke Kino

ʻO nā haʻawina he nui, e like me nā hoʻopaʻa autopsy, ua hōʻike i nā kiʻekiʻe kiʻekiʻe o ka mercury i nāʻiʻo o nā kānaka me nā hoʻopiha amalgam, i kūʻē i ka poʻe i hōʻike ʻole ʻia. Hoʻopili ka hoʻonui ʻana i ka ukana amalgam me ka hoʻonui ʻana o ka mercury i ka ea i hoʻopau ʻia; ʻūhā; koko; palaoa; mimi; nāʻaʻaʻa like ʻole me ke akepaʻa, nā konāhua, ka pituitary gland, ka lolo, a pēlā aku. ka wai amniotic, ke kaula o ke kaula, ka placenta a me nā aʻa fetal; colostrum a me ka waiū umauma.⁵

ʻO nā hoʻokolohua kiʻi nui loa, e hōʻike ana i ka hoʻokaʻawale in-vivo o ka mercury mai nā hoʻopiha amalgam, ʻo ia nā "ʻimi hipa a me nā mōneka" ʻo Hahn, et. al. (1989 a me 1990).^6,7 Hāʻawi ʻia kahi hipa hāpai i ʻumikūmālua mau huila amalgam hoʻopiha i kau ʻia me ka radioactive ²⁰³Hg, kahi mea i ʻole i ke kūlohelohe, a he hapalua kona ola o 46 mau lā. Kālai ʻia nā mea hoʻopihapiha i waho o ka occlud, a mālama ʻia ka waha o ka holoholona a holoi ʻia e pale i ka ale ʻana i nā mea i ka wā o ka hana. Ma hope o kanakolu lā, ua mōhai ʻia. Hoʻokomo ʻia ka radioury mercury i ke akepaʻa, nā puʻupaʻa, nā ʻōnaehana digestive a me nā iwi ā, akā ʻo nāʻiʻo āpau, me nā pūpū o ka fetal, i loaʻa ke ana ʻia. ʻO ka autoradiogram o ka holoholona holoʻokoʻa, ma hope o ka hemo ʻana o nā niho, hōʻike ʻia i ke kiʻi 2.

Ua hoʻohewa ʻia ka hoʻokolohua hipa no ka hoʻohana ʻana i kahi holoholona i ʻai a nau i ke ʻano ʻokoʻa ma mua o nā kānaka, no laila ua hana hou ka hui i ka hoʻokolohua me ka mōneka, me nā hopena like.

25 Skare I, Engqvist A. Hōʻikeʻike kanaka i ka mercury a me ke kālā i hoʻokuʻu ʻia mai nā hoʻolauna hoʻohui mele niho. ʻO Arch Environ Health 1994; 49 (5): 384-94.

Ke kuleana o ka nānā loiloi 

ʻO ka hōʻike o ka hōʻike kahi mea hoʻokahi, akā inā "hana ka lāʻau i ka lāʻau make," e like me kā mākou i lohe pinepine ai e pili ana i ka hōʻike mercury mai ka amalgam niho, kahi hoʻoholo o ka pae o ka hōʻike he mea ʻawaʻawa a no wai ka panalāʻau o ka makaʻu loiloi. Ka helu hoʻolālā kahi hoʻonohonoho o nā kaʻina hana i hoʻohana ʻia i ka ʻikepili i loaʻa i nā puke ʻepekema, e noi ai i nā pae o ka hōʻike ʻana e ʻae ʻia ma lalo o nā kūlana i hāʻawi ʻia, i nā luna kuleana ka hoʻoweliweli koʻikoʻi. He hana ia e hoʻohana mau ʻia i ka ʻenehana, ʻoiai, no ka laʻana, pono i ka ʻoihana hana lehulehu e ʻike i ka likelika o kahi alahaka i hāʻule ma lalo o ka ukana ma mua o ke kau ʻana i ka palena kaupaona ma luna.

Aia kekahi mau ʻoihana i kuleana no ka hoʻoponopono ʻana i ka hōʻike kanaka i nā lāʻau ʻona, FDA, EPA, a me OSHA, i waena o lākou. Hilinaʻi lākou āpau i nā kaʻina hana loiloi no ka hoʻonohonoho ʻana i nā palena koena no nā kemika, e like me ka mercury, i nā iʻa a me nā meaʻai ʻē aʻe a mākou e ʻai ai, ka wai a mākou e inu ai a me ka ea a mākou e hanu nei. Hoʻonohonoho kēia mau ʻoihana i nā palena i hoʻokō ʻia ma ke kānāwai e pili ana i nā hōʻike kanaka i hōʻike ʻia e nā ʻano inoa like ʻole, e like me ka palena o ke kaohi (REL), ka lāʻau kuhikuhi (RfD), ka noʻonoʻo kūmole (RfC), ka palena hoʻomanawanui i kēlā me kēia lā (TDL), etc. like ka manaʻo o ia mau mea āpau: ka nui o ka hōʻike ʻana e ʻae ma lalo o nā kūlana a ke keʻena i kuleana ai. Pono kēia pae ʻae ʻia i hoʻokahi kahi e manaʻo ʻia ai ʻaʻohe hopena olakino maikaʻi ʻole i loko o ka heluna kanaka i uhi ʻia ma lalo o ke kānāwai.

Ke hoʻokumu nei i nā REL

I mea e hoʻopili ai i nā ʻano loiloi no ka hiki ke loaʻa ka mercury mai ka amalgam niho, pono mākou e hoʻoholo i ka hopena o ka mercury i hōʻike ʻia i ka poʻe mai kā lākou hoʻopihapiha, a hoʻohālikelike i nā pae palekana i hoʻokumu ʻia no kēlā ʻano hōʻike. Hoʻomaopopo ka lāʻau ʻona o ka mercury i ka hopena o ka hopena o ke kino i nā ʻano kemika i pili, a me ke ala o ka hōʻike. Ma kahi kokoke i nā hana āpau e pili ana i ka hoʻoweliweli amalgam kuhi ka mea nui ʻona e pili ana i ka mahu metallic mercury (Hg˚) i hoʻopuka ʻia e nā hoʻopihapiha, hanu ʻia i loko o nā akemāmā a lawe ʻia i kahi 80%. ʻO nā ʻano ʻē aʻe a me nā ala e ʻike ʻia e pili pū ana, me ka metallic mercury i hoʻoheheʻe ʻia i ka lawai, nā mea i hoʻoheheʻe ʻia a me nā huahana corrosion i ale ʻia, a methyl mercury paha i hana ʻia mai Hg˚ e nā koʻohune ʻōpū. ʻO nā ala exotic hou aku i ʻike ʻia, e like me ka omo ʻana o Hg˚ i loko o ka lolo ma o ka olfactory epithelium, a i ʻole retrograde axonal lawe ʻia o ka mercury mai nā iwi ā i loko o ka lolo. ʻAʻole ʻike ʻia kēia mau hōʻike i ka nui i ʻike ʻole ʻia, a i ʻole manaʻo ʻia ʻoi aku ka nui o ka nui ma mua o ka inhalation waha, no laila ʻo ka nui o ka noiʻi e pili ana i ka amalgam mercury i hoʻokumu ʻia ma laila.

Kuhi ʻia ka ʻōnaehana nīnūnē e lilo i ʻōpala pahuhopu ʻoi loa no ka hōʻike ʻana o ka mahu. Ua hoʻokumu maikaʻi ʻia nā hopena ʻawahia ma nā puʻupaʻa a me nā akemāmā i nā paepae hōʻike kiʻekiʻe. ʻO nā hopena ma muli o ka hypersensitivity, autoimmunity a me nā ʻano ʻano maʻi ʻē aʻe ʻaʻole hiki ke helu ʻia e nā hiʻohiʻona pane pane, (ʻo ia ka nīnau, pehea ka liʻiliʻi o ka allergy i ka mercury, ʻoiaʻiʻo?) No laila, ʻimi nā mea noiʻi a me nā keʻena e hoʻokumu i RELs no ka haʻahaʻa. ka nānā ʻana i ka Hg˚ maʻi mau i nā ana like ʻole o nā hopena CNS. Ua paʻi ʻia kekahi mau noiʻi nui (i hōʻuluʻulu ʻia i ka papa 1) i loko o nā makahiki e hoʻopili ana i ka nui o ka wai māla o ke mercury me nā hōʻailona hiki ke ana ʻia o ka hana ʻole o CNS. ʻO kēia nā haʻawina i hilinaʻi ʻia e nā ʻepekema loiloi weliweli.

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Pākaukau 1. Nā noiʻi koʻikoʻi i hoʻohana ʻia e hoʻomaulia i nā hoʻopili kūmole no ka mahu metala Mercury, i hōʻike ʻia ma ke ʻano he micrograms no ka mika cubic o ka ea. ʻO kahi asterix * e hōʻike ana i nā ʻano ea i loaʻa mai i ka hoʻohuli ʻana i ke koko a i ʻole ka mimi i kahi like o ke ea e like me nā mea hoʻololi mai Roels et al (1987).

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Hoʻomaopopo ka hana o ka loiloi weliweli i ka hōʻike a me ka hopena o ka ʻike i hōʻiliʻili ʻia no nā mākua, nā kāne nui, nā limahana i nā ʻoihana hana ʻaʻole hiki ke hoʻohana ʻia i kā lākou ʻano maka e hōʻike ana i nā pae palekana no kēlā me kēia. Nui a hewahewa ke ʻano o ka kānalua i ka ʻikepili.

• LOAEL vs. NOAEL. ʻAʻole i hōʻike ʻia kahi ʻikepili hōʻike i hōʻiliʻili ʻia i loko o nā noiʻi nui i kahi ʻano e hōʻike ana i ka pākana pane pane pane no nā hopena CNS i ana ʻia. E like me ia, ʻaʻole lākou e hōʻike i kahi mahele lāʻau palena palena no ka hoʻomaka ʻana o nā hopena. I nā huaʻōlelo ʻē aʻe, ʻaʻohe hoʻoholo o kahi "No-Observe-Adverse-Effect-Level" (NOAEL). Kuhi nā haʻawina i kēlā me kēia i kahi "Lowest-Observe-Adverse-Effect-Level" (LOAEL), ka mea i manaʻo ʻole ʻia he definitive.
• Ke ʻano kanaka. Nui a hewahewa nā pūʻulu o ka poʻe i ka heluna lehulehu: nā pēpē a me nā keiki me nā ʻōnaehana ʻoi aku ka maʻalahi e hoʻomohala i nā ʻōnaehana a me ke kaumaha o ke kino o lalo nā kānaka me nā kuʻikahi kuikahi; ka poʻe me ka genetically hoʻoholo e hoʻonui i ka ʻike; nā wahine o ka wā hānau keiki a me nā ʻokoʻa ʻē aʻe e pili ana i ke kāne; ʻelemakule, e inoa i kekahi. ʻAʻole i helu ʻia nā ʻokoʻa kanaka i ka ʻikepili no ka maopopo ʻole.
• ʻIkepili hoʻoulu a me ka hoʻomohala. ʻO kekahi mau ʻoihana, e like me Kaleponi EPA, ke kau nei i ka manaʻo nui i ka ʻike hānau a me ka hoʻomohala ʻana, a hoʻopili i kahi pae hou o ka maopopo ʻole i kā lākou helu ʻana ke nele.
• ʻIkepili waena ʻōiwi. ʻO ka hoʻohuli ʻana i ka ʻikepili noiʻi holoholona i ka ʻike kanaka ʻaʻole maʻalahi ia, akā ʻaʻole pili ka noʻonoʻo ʻana i kēia mea i kēia hanana, ʻoiai nā loiloi nui i hōʻike ʻia ma aneʻi e pili ana i nā kumuhana kanaka.

Hoʻopili ʻia nā REL no ka hōʻike ʻana o ka mahu o ka mercury i ka lehulehu i hōʻuluʻulu ʻia i ka Papa 2. Hoʻohālikelike ʻia nā REL e pili ana i ka mālama ʻana i ka lehulehu no ka mea ʻaʻole hiki ke manaʻo ʻia no nā hopena olakino maikaʻi ʻole no kēlā me kēia, no laila e hoʻoliʻiliʻi ʻia nā hōʻike ʻae ʻia mai nā pae hopena haʻahaʻa i ʻike ʻia e ka helu "maopopo ʻole" (UF). ʻAʻole hoʻoholo ʻia nā mea kānalua e nā kānāwai paʻakikī a wikiwiki, akā ma ke kulekele - pehea e akahele ai ka ʻoihana hoʻokele, a pehea ko lākou hilinaʻi i ka ʻike.

I ka hihia o ka US EPA, no ka laʻana, hoʻemi ʻia ka pae hopena (9 µg-Hg / cubic mika ea) e kahi mea o 3 ma muli o ka hilinaʻi ʻana i kahi LOAEL, a ma kahi helu o 10 e hōʻike ai i ka loli o ke kanaka, no ka huina UF o 30. Loaʻa kēia i kahi palena i ʻae ʻia o 0.3 µg-Hg / cubic mika ea. ⁸

Ua hoʻohui ka California EPA i kahi UF hou aʻe o 10 no ka nele o ka ʻike hānau a me ka hoʻomohala ʻana no Hg0, e hana ana i ko lākou palena he ʻumi mau manawa ke ʻoi loa, 0.03 Hg Hg / cubic mika ea. ⁹

Ua ʻike ʻo Richardson (2009) i ka noi Ngim et al¹⁰ ʻoiai ka mea kūpono loa no ka hoʻomohala ʻana i kahi REL, ʻoiai ua hōʻike ʻia nā kauka niho kāne a me nā wahine ma Singapore, hōʻike pinepine ʻia i nā haʻahaʻa haʻahaʻa o ka mahu mercury me ka ʻole o ke kinoea chlorine (ʻike ma lalo). Ua hoʻohana ʻo ia i kahi UF o 10 ma mua o 3 no ka LOAEL, me ka hoʻopaʻapaʻa ʻoi aku ka maʻalahi o nā pēpē a me nā keiki ma mua o ka helu o 3 e hiki ai ke helu. Ke noi nei i kahi UF o 10 no ka loli o ke kanaka, no ka nui o ka UF o 100, ua ʻōlelo ʻo ia e hoʻonohonoho ʻo Health Canada i ko lākou REL no ka mahu mercury ma 0.06 Hg Hg / cubic mika ea.¹¹

Ua loaʻa ʻo Lettmeier et al (2010) i nā pahuhopu nui loa (ataxia o ka puka) a me nā hopena (kaumaha) i nā mea minina gula liʻiliʻi ma ʻApelika, e hoʻohana nei i ka mercury e hoʻokaʻawale i ke gula mai nā ore i ulupa ʻia, ma nā pae hōʻike haʻahaʻa, 3 Hg Hg / ea mika cubic. Ma hope o ka US EPA, ua noi lākou i kahi pae UF o 30-50, a ua ʻōlelo ʻia kahi REL ma waena o 0.1 a me 0.07 Hg Hg / cubic mika ea.¹²

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Papa 2. Paʻi ʻia ʻo RELs no ka hōʻike ʻana i ka pae haʻahaʻa, ʻo ka mahu Hg0 maʻi maʻamau i ka heluna lehulehu, me ka ʻole o ka ʻoihana hana. * Ka hoʻohuli ʻana i ka mahele komo, Hg Hg / kg-lā, mai Richardson (2011).

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Nā pilikia me RELs

Ua hoʻoponopono hou ka US EPA i ko lākou mercury vapor REL (0.3 Hg Hg / cubic meter air) i ka makahiki 1995, a ʻoiai ua hōʻoia hou lākou ia i ka makahiki 2007, ua ʻae lākou ua paʻi ʻia nā pepa hou i hiki ke hōʻoia iā lākou e hoʻoponopono hou i ka REL i lalo. ʻO nā pepa kahiko o Fawer et al (1983) ¹³ and Piikivi, et al (1989 a, b, c)^{14, 15, 16}, i hilinaʻi nui ʻia i nā ana o ka loaʻa ʻana o ka mercury a me nā hopena CNS i nā limahana chloralkali. ʻO Chloralkali kahi ʻenehana ʻumikūmāiwa mau makahiki i hana ʻia kahi paʻakai paʻakai ma luna o kahi papa lahilahi o ka wai mercury, a hydrolyzed me ka uila i kēia manawa e hana i ka sodium hypochlorite, sodium hydroxide, sodium chlorate, chlorine gas, a me nā huahana ʻē aʻe. Hana ka mercury ma ke ʻano he electrode. Hōʻike ka poʻe hana ma ia mau mea kanu ʻaʻole wale i ka mercury i ka lewa, akā ʻo ka gasolina pū kekahi.

Hoʻololi ka hōʻike kūlohelohe o ka mahu mercury a me ka gas chlorine i ka ikaika o ka hōʻike ʻana o ke kanaka. ʻO ka Hg˚ e ʻokiʻoki hapa ʻia e ka chlorine i ka lewa iā Hg²⁺, a i ʻole HgCl₂, ka mea e hoʻēmi ai i kona permeability i loko o nā akemāmā, a hoʻololi nui i kāna hāʻawi i ke kino. Ma kahi kikoʻī, HgCl₂ omo ʻia mai ka lewa ma o nā akemāmā ʻaʻole komo i loko o nā hunaola, a i ʻole ma o ka pale lolo-lolo, maʻalahi e like me Hg˚. ʻO kahi laʻana, Suzuki et al (1976)¹⁷ hōʻike i nā limahana i hōʻike ʻia iā Hg˚ wale nō i ka lakio o Hg i nā hunaola ʻulaʻula i ka plasma o 1.5 -2.0 a 1, ʻoiai ʻo nā limahana chloralkali i hōʻike ʻia i ka mercury a me ka māʻamaʻama he māka Hg ma RBCs i ka plasma o 0.02 a 1, hoʻokahi haneli manawa ka liʻiliʻi ma loko o nā hunaola. ʻO kēia hanana ke kumu o ka mercury e hoʻokaʻawale hou aku i nā puʻupaʻa ma mua o ka lolo. ʻO ka mea hōʻike hōʻike, ka mimi mercury, like ia no nā ʻano hana ʻelua, akā ʻoi aku ka liʻiliʻi o ka hopena o ka CNS ma ka poʻe paʻahana. Ma ka nānā ʻana i ka hapanui o nā limahana limahana chloralkali, e hoʻowahāwahā ʻia ka ʻike o ka CNS i ka loaʻa ʻana o ka mercury, a e hoʻokahuli ʻia nā REL e pili ana i kēia mau noiʻi.

Aia ma waena o nā pepa hou ka hana a Echeverria, et al, (2006)¹⁸ ka mea e loaʻa nā hopena neurobeh behavioral a me neuropsychological koʻikoʻi i nā kauka niho a me nā limahana, ma lalo pono o ka 25 µg Hg / cubic mika pae pae, e hoʻohana ana i nā hoʻokolohua kūlana kiʻekiʻe. Eia hou, ʻaʻole i ʻike ʻia kahi paepae.

Ke noi nei iā Mercury RELs iā Dental Amalgam

Aia ka like ʻole i loko o nā puke e pili ana i ka mahele o ke kala i hōʻike ʻia mai amalgam, akā aia ka ʻae ākea e pili ana i kekahi o nā helu e pili ana, i hōʻuluʻulu ʻia ma ka Pakuhi 3. Kōkua ia i ka mālama ʻana i kēia mau kiʻi maʻamau, e like me ka hoʻohana ʻana o nā mea kākau āpau i kā lākou helu. . Kōkua pū kekahi ia e hoʻomanaʻo i ka ʻoiaʻiʻo o kēia hōʻike ʻike ʻano analogs o ka hōʻike ʻana i ka lolo. Aia kahi ʻikepili holoholona a me nā ʻike kanaka ma hope o ka make, akā ʻaʻohe mea ma ka neʻe maoli o ka mercury i loko o ka lolo o nā limahana e pili ana i kēia mau aʻo.

———————————————————————————————————————————————————— ——————

Papa 3. kuhikuhi:

• a- Mackert lāua ʻo Berglund (1997)
• b- Skare a me Engkvist (1994)
• c- loiloi ʻia ma Richardson (2011)
• d- Roels, et al (1987)

———————————————————————————————————————————————————— —————–

Ma ka waena o 1990 ua ʻike ʻia ka paʻi ʻia o nā loiloi ʻelua o ka hōʻike amalgam a me ka palekana. ʻO ka mea i loaʻa ka mana nui loa i nā kūkā kamaʻilio ʻana i loko o ke kaiāulu niho na H. Rodway Mackert lāua ʻo Anders Berglund (1997)¹⁹, nā polofesa niho ma ke Kulanui Lapaʻau o Georgia, a me ke Kulanui ʻo Umea ma Suedena. ʻO kēia ka pepa kahi e koi ai e lawe ʻia i 450 mau ʻāpana o amalgam e hoʻokokoke i kahi lāʻau ʻona. Ua kuhikuhi kēia mau mea kākau i nā pepa i hoʻoliʻiliʻi i ka hopena o ka chlorine i ka lawe ʻia ʻana o ka mercury lewa, a ua hoʻohana lākou i ka palena papaha hana, (i loaʻa no nā kāne makua i hōʻike ʻia he ʻewalu mau hola i kēlā me kēia lā, ʻelima mau lā i kēlā me kēia pule), o 25 µg-Hg / cubic mika ea e like me kā lākou de-facto REL. ʻAʻole lākou i noʻonoʻo i ka maopopo ʻole i kēlā helu no ka mea pili i ka heluna kanaka āpau, me nā keiki, e hōʻike ʻia ana he 24 mau hola, ʻehiku mau lā o ka pule.

Penei ka helu ʻana: ʻo ka pae hopena haʻahaʻa i ʻike ʻia no ka haʻalulu i hana ʻia ma waena o nā kāne hana makua, ʻo nā limahana limahana nui, he 25 µg-Hg / cubic mika ea e like ana me ka pae mimi ma kahi o 30 µg-Hg / gr-creatinine. ʻO ka helu ʻana no kahi pae liʻiliʻi o ka mikiury mercury i loaʻa i ka poʻe me ka ʻole o ka hoʻopihapiha, a me ka hoʻokaʻawale ʻana i ka 30 µg e ka hāʻawi pākahi ma ka mimi mercury, 0.06 µg-Hg / gr-creatinine, ʻo ka hopena ma kahi o 450 mau ʻili e pono ai e piʻi i kēlā pae. .

I kēia manawa, ʻo G. Mark Richardson, kahi loea loiloi loiloi i hoʻohana ʻia e Health Canada, a me Margaret Allan, he ʻenekele kūkā kamaʻilio, ʻaʻohe o lāua maʻa mua me ka kauka niho, ua kauoha ʻia e ua ʻoihana nei e hana i kahi loiloi no ka amalgam ma 1995. Ua hiki lākou i he hopena ʻokoʻa loa ma mua o Mackert lāua ʻo Berglund. Ke hoʻohana nei i nā ʻike kūpilikiʻi a me nā mea kānalua ʻole i ka laina me nā mea i kūkākūkā ʻia ma luna, ua noi lākou no Kanada kahi REL no ka mahu mercury o 0.014 Hg Hg / kg-lā. Ke manaʻo nei he 2.5 mau ʻāpana no ka hoʻopihapiha ʻana, ua helu lākou i kahi pae no ka nui o nā hoʻopihapiha ʻaʻole i ʻoi aku ma mua o ka pae o ka hōʻike no ʻelima mau makahiki like ʻole, e pili ana i ke kaupaona o ke kino: keiki, 0-1; ʻōpio, 0-1; makua, 1-3; 'elemakule, 2-4. Ma muli o kēia mau helu, ua hoʻopuka ʻo Health Canada i nā moʻo'ōlelo no ke kaohi ʻana i ka hoʻohana amalgam, a ua nānā nui ʻole ʻia i ka hana.^{20, 21}

I ka makahiki 2009, ka US Food and Drug Administration, ma lalo o ke kaomi a ka hoʻokolokolo a kahi kamaʻāina, ua hoʻopau i kāna papa inoa o ka amalgam niho mua, kahi hana i kauoha mua ʻia e ka ʻAhaʻōlelo i 1976.²² Ua hoʻokaʻawale lākou i ka amalgam ma ke ʻano he papa II me nā mana lepili, ʻo ia hoʻi ua palekana lākou no ka hoʻohana palena ʻole ʻia no nā mea āpau. ʻO nā kaohi lepili ka mea e hoʻomanaʻo ai i nā kauka niho e mālama lākou i kahi hāmeʻa i loaʻa ka mercury, akā ʻaʻohe kauoha e hāʻawi i kēlā ʻike i nā mea maʻi.

ʻO ka palapala hoʻolaha FDA kahi pepa ʻaoʻao kikoʻī 120 nona nā paio i hilinaʻi nui ʻia i ka loiloi weliweli, e hoʻohālikelike ana i ka amalgam mercury i ka EPA 0.3 µg-Hg / cubic meter air standard. Eia naʻe, ua hoʻohana wale ʻia ka hoʻopili ʻana a FDA ma ke kumu wale nō o ka heluna lehulehu o ka US i amalgam, ʻaʻole ka laulā piha, a, ʻo ka mea kupanaha, ʻaʻole i pololei no ka mahele lāʻau no ke kaupaona o ke kino. Ua mālama ʻia nā keiki me he mea makua lā. Ua hakakā ikaika ʻia kēia mau kiko i kekahi mau “palapala noi e noʻonoʻo hou” i waiho ʻia e nā kamaʻāina ʻelua a me nā hui ʻoihana i ka FDA ma hope o ka paʻi ʻia ʻana o ka hoʻohālikelike. Ua noʻonoʻo ʻia nā palapala noi e nā luna o ka FDA i hana i ka ʻanuʻu kakaʻikahi o ke kāhea ʻana i kahi papa loea e noʻonoʻo hou i nā ʻoiaʻiʻo o ka loiloi weliweli.

ʻO Richardson, he kūkākūkā kūʻokoʻa i kēia manawa, ua noi ʻia e kekahi o nā mea noi e hōʻano hou i kāna loiloi pilikino mua. ʻO ka hōʻuluʻulu hou, e hoʻohana ana i ka ʻike kikoʻī e pili ana i ka helu o nā niho piha i ka heluna kanaka o US, ʻo ia ke kikowaena o ke kūkā kamaʻilio ʻana ma ka hālāwai kūkā loea o ka FDA o Kekemapa, 2010. (E nānā iā Richardson et al 2011⁵).

ʻO ka ʻikepili e pili ana i ka nui o nā niho i hoʻopiha ʻia i ka heluna kanaka ʻAmelika mai ka National Health and Nutr Examination Survey, kahi noiʻi aupuni a puni ma kahi o 12,000 mau makahiki he 24 mau makahiki a ʻoi, i hoʻopau hope ʻia ma 2001-2004 e ka National Center for Health Statistics, kahi mahele. o nā kikowaena no ka mālama ʻana i ka maʻi a me ka pale ʻana. He ana helu helu kūpono ia e hōʻike ana i ka heluna kanaka holoʻokoʻa o US.

Ua hōʻiliʻili ka loiloi i ka ʻikepili ma ka helu o nā papa niho i hoʻopiha ʻia, akā ʻaʻole naʻe ma ka hoʻopihapiha. I mea e hoʻoponopono ai no kēia hemahema a kā Richardson hui i hoʻonohonoho ai i ʻekolu mau hanana, nā manaʻo āpau e nā puke i koe: 1) ua hui pū ʻia nā ʻāpana piha āpau. 2) 50% o nā papa i hoʻopihapiha i hoʻohui ʻia; 3) 30% o nā kumuhana ʻaʻohe o ka amalgam, a ʻo 50% o ke koena he amalgam. Ma lalo o ke kūlana 3, e kuhi ana i ka helu liʻiliʻi o nā hoʻopiha amalgam, ke ʻano helu o ke ana maoli o ka mercury i kēlā me kēia lā.

Nā kamaliʻi 0.06 µg-Hg / kg-lā
Nā keiki 0.04
Nā ʻōpio 0.04
Nā mākua 0.06
Nā mea kiʻekiʻe 0.07

ʻO kēia mau pae i loaʻa i kēlā me kēia lā i ka hopena i loaʻa i kēlā me kēia lā a i ʻoi aku paha ma mua o ka hopena o ka Hg0 i hoʻopili ʻia me nā REL i paʻi ʻia, e like me ka mea i ʻike ʻia ma ka Papa 2.

Ua helu ʻia ka helu o nā ʻāpana amalgam ʻaʻole i ʻoi aku i ka REL o ka US EPA o 0.048 µg-Hg / kg-lā, no nā kamaliʻi, nā keiki a me nā ʻōpio ʻōpio i 6 mau papa. No nā ʻōpio makua, nā mākua a me nā ʻelemakule, he 8 mau ʻāpana. I ʻole ma luna o ka REL o EPA Kaleponi, ʻo kēlā mau helu he 0.6 a me 0.8 mau ʻāpana.

Eia nō naʻe, ʻaʻole hōʻike kēia mau hōʻike awelika i ka moʻolelo holoʻokoʻa, a ʻaʻole hōʻike i ka nui o ka poʻe i ʻoi aku i kahi lāʻau "palekana". Ke nānā nei i ka nui o nā helu o nā niho piha i ka heluna kanaka, ua helu ʻo Richardson e loaʻa ana he 67 miliona mau ʻAmelika i kēia manawa nona ka hōʻike amalgam mercury ma mua o ka REL i hoʻokau ʻia e ka US EPA. Inā noi ʻia ka mea ʻoi loa ʻo California REL, ʻo 122 miliona ka helu. Hoʻohālikelike kēia me ka anamanaʻo a ka FDA ma 2009, ka mea i manaʻo wale i ka helu maʻamau o nā niho piha, no laila e ʻae nei i ka heluna lehulehu e kūpono ma lalo o ka EPA REL o kēia manawa.

No ka hoʻonui ʻana i kēia kiko, ua ʻike ʻo Richardson (2003) he ʻumikūmāhiku pepa i loko o nā puke i hōʻike ʻia i nā koho o ke ana o ka mercury mai nā hoʻopiha amalgam. ²³ Hōʻike ke kiʻi 3 iā lākou, a me nā ʻikepili mai kāna pepa 2011, e hōʻike ana i ka palapala kiʻi ke kaupaona o nā hōʻike. Kuhi nā laina ʻulaʻula kū i nā kaulike o ka Kaleponi EPA's REL, ka mea ʻoi loa o nā palena hoʻokele i paʻi ʻia no ka hōʻike ʻana o ka mahu mercury, a me ka REL o ka US EPA, ka mea maʻalahi loa. ʻIke ʻia ka hapanui o nā mea noiʻi nāna nā pepa i hōʻike ʻia ma ke kiʻi 3 e hoʻoholo i ka hoʻohana palena ʻole ʻia ʻana o ka amalgam e hopena i ka hōʻike i ka mercury.

ʻO ka wā e hiki mai ana o Dental Amalgam

E like me kēia kākau ʻana, Iune, 2012, ʻaʻole hoʻolaha ka FDA i kahi hopena i kāna mau kūkākūkā ʻana e pili ana i ke kūlana hoʻokele o ka amalgam niho. He paʻakikī e ʻike pehea e hiki ai i ka ʻoihana ke hāʻawi i ka amalgam i ke kukui ʻōmaʻomaʻo no ka hoʻohana palena ʻole ʻia. Maopopo he hiki i ka hoʻohana palena ʻole ke hōʻike aku i ka poʻe i ka mercury ma mua o ka EPA REL, ka palena like i koi ʻia ai ka hana ʻana o ka mana lanahu e hoʻokō, a hoʻolilo i mau piliona kālā e hana ai. Wahi a ka EPA ma ka makahiki 2016, e hoʻoliʻiliʻi ana i nā mea i hoʻokuʻu ʻia o ka mercury, me nā soot a me nā kinoea ʻakika, e mālama ʻia he $ 59 biliona a $ 140 biliona i nā kumukūʻai olakino makahiki, e pale ana i nā make make he 17,000 i kēlā me kēia makahiki, me nā maʻi a me nā lā hana nalowale.

Eia kekahi, ʻo ka ʻokoʻa ma waena o ka Mackert a me Berglund e hoʻokokoke nei i ka palekana amalgam a me ke ala ʻo Richardson e hōʻike ana i ka polarization i hōʻike ʻia i nā "amalgam kaua." ʻ saylelo paha mākou "ʻaʻole hiki iā ia ke hōʻeha iā haʻi," a i ʻole "hiki ke hōʻeha iā haʻi." I kēia makahiki o ka dentist hoʻihoʻi resinative maikaʻi, ke hana nei ka nui o nā kauka niho me ka ʻole o ka amalgam, loaʻa iā mākou kahi manawa maʻalahi e noho ai i ke kumu hoʻomalu. Ua kūpono ka manawa e hoʻouna i ka amalgam niho i kona wahi hanohano i ka mōʻaukala niho, a hoʻokuʻu iā ia e hele. Pono mākou e hele i mua me kāna denouement - e hoʻomohala i nā ʻano hana e pale ai i nā mea maʻi a me nā limahana niho mai ka hōʻike ākea ke lawe ʻia nā hoʻopihapiha; pale i nā limahana mai nā hōʻike manawa kiʻekiʻe, e like me ka wā e hemo ai nā pahele partulate.

Mercury kahua niho he ʻāpana liʻiliʻi wale nō paha ia o ka pilikia honua o haumia mercury, akā ʻo ia ka ʻāpana no ke kuleana pololei o mākou nā kauka niho. Pono mākou e hoʻomau i kā mākou hana hoʻomalu i ke kaiapuni, e hoʻokaʻawale i ka wai wai lawe wai i loaʻa i ka mercury mai ke kahawai wai, ʻoiai mākou e hoʻōki nei i kāna hoʻohana no nā hopohopo no ke olakino kanaka.

ʻO Stephen M. Koral, DMD, FIAOMT

_________

No nā kikoʻī piha aʻe e pili ana i kēia kumuhana, ʻike "Nā Helu Kuhi ʻImi Amalgam 2010" a "Nā Helu Kuhi ʻImi Amalgam 2005. "

Ma kāna ʻano hope loa, ua paʻi ʻia kēia ʻatikala ma ka puke Pepeluali, 2013 o ka “Hoʻohui o ka Hoʻomau Hoʻomau ma Dentistry." 

Hiki ke heluhelu ʻia i ke kūkā kamaʻilio e pili ana i ka loiloi i ka pilikia e pili ana i ka amalgam niho ma ka “ʻO ka pepa hoʻonohonoho IAOMT e kūʻē iā Dental Amalgam. "

E hoʻomaopopo '

1 Masi, JV. Ka palaʻino o nā pono hana hoʻihoʻi: ka pilikia a me ka hoʻohiki. Symposium: Kūlana Quo a me nā ʻike o Amalgam a me nā mea hana niho ʻē aʻe, ʻApelila 29-Mei 1, (1994).

2 Haley BE 2007. ʻO ka pilina o nā hopena ʻona o ka mercury i ka exacerbation o ke kūlana olakino i hoʻokaʻawale ʻia e like me ka maʻi Alzheimer. Kauka Veritas, 4: 1510-1524.

3 Chew CL, Soh G, Lee AS, Yeoh TS. 1991. Ka hoʻopau loa ʻana o ka mercury mai kahi amalgam e hoʻokuʻu nei i kahi mercury ʻole. ʻO Clin Prev Dent, 13 (3): 5-7.

4 Gross, MJ, Harrison, JA 1989. Kekahi electrochemical hiʻona o ka in vivo ka popopo o nā niho amalgams. ʻO J. Appl. Electrochem., 19: 301-310.

5 Richardson GM, R Wilson, D Allard, C Purtill, S Douma a me J Gravière. 2011. Loaʻa ka Mercury a me nā pilikia mai ka amalgam niho i ka heluna US, ma hope o 2000. ʻEpekema o ka Huina Kaiapuni, 409: 4257-4268.

6 Hahn LJ, Kloiber R, Vimy MJ, Takahashi Y, Lorscheider FL. 1989. Niho "kālā" hoʻopihapiha niho: kahi kumu o ka loaʻa ʻana o ka mercury i hōʻike ʻia e ka ʻimi ʻana o ke kino holoʻokoʻa a me ka ʻimi ʻana i nā kiko. FASEB J, 3 (14): 2641-6.

7 Hahn LJ, Kloiber R, Leininger RW, Vimy MJ, Lorscheider FL. 1990. Ke kiʻi holoʻokoʻa o ke kino o ka hoʻokaʻawale ʻana o ka mercury i hoʻokuʻu ʻia mai ka hoʻopiha niho ʻana i loko o nā kiko o ka mōneka. FASEB J, 4 (14): 3256-60.

8 USEPA (ʻAmelika Hui Pū ʻIa ʻĀina Hui Pū ʻIa). 1995. Mercury, kumumea (CASRN 7439-97-6). ʻŌnaehana ʻike kamepiula i hoʻohui ʻia. Hoʻohou hope loa ʻia Iune 1, 1995. Ma ka laina ma:  http://www.epa.gov/ncea/iris/subst/0370.htm

9 CalEPA (Kaleponi Mālama ʻĀina Koʻolau). 2008. Mercury, Inorganic - Nānā Hōʻike Hōʻikeʻike Kānāwau a me ka Hōʻuluʻulu Manaʻo Kūlohelohe. Keʻena o ka Hoʻolālā Haʻalulu ʻĀina Ola, California EPA. Ma ka lā Kēkēmapa 2008. Hōʻuluʻulu manaʻo ma ka laina ma: http://www.oehha.ca.gov/air/allrels.html; Loaʻa nā kikoʻī ma: http://www.oehha.ca.gov/air/hot_spots/2008/AppendixD1_final.pdf#page=2

10 Ngim, CH., Foo, SC, Boey, KW et al. 1992. Nā hopena neurobeh behavioral mau o ka mercury elemental i nā kauka niho. ʻO Br. J. Ind. Med., 49 (11): 782-790

11 Richardson, GM, R Brecher, H Scobie, J Hamblen, K Phillips, J Samuelian a me C Smith. 2009. Mercury vapor (Hg0): Ke hoʻomau nei i ka maopopo ʻole o ka hopena o ka lāʻau, a me ka hoʻokumu ʻana i kahi pae hōʻike kū Kanada. Hoʻoponopono Toxicology a me Pharmacology, 53: 32-38

12 Lettmeier B, Boese-O'Reilly S, Drasch G. 2010. Noi no ka hoʻopiʻi kūmole i hoʻoponopono hou ʻia (RfC) no ka mahu mercury i nā mākua. ʻO Sci Total En environment, 408: 3530-3535

13 Fawer, RF, de Ribaupeirre, Y., Buillemin, MP et al. 1983. Ka ana ʻana o ka haʻalulu lima i hoʻokomo ʻia e ka ʻoihana hanahana i ka mekala hao. ʻO Br. J. Ind. Med., 40: 204-208

14 Piikivi, L., 1989a. ʻO nā reflexes Cardiovascular a me ka hōʻike lōʻihi lōʻihi i ka mahu mercury. Int. Arch. Lanakila. ʻĀina. Ola 61, 391–395.

15 Piikivi, L., Hanninen, H., 1989b. Nā ʻōuli kumuhana a me ka hana psychological o nā limahana chlorine-alkali. Scand. J. Kahua Hana. Ola 15, 69-74.

16 Piikivi, L., Tolonen, U., 1989c. Loaʻa nā ʻike EEG i nā limahana kloral alkali i ka hōʻike haʻahaʻa lōʻihi i ka mahu mercury. ʻO Br. J. Ind. Med. 46, 370-375.

17 Suzuki, T., Shishido, S., Ishihara, N., 1976. Ka launa pū ʻana o ka mea ʻole i ka mercury meaola i loko o kā lākou metabolism i ke kino o ke kanaka. Int. Arch. Lanakila. Kaiapuni. ʻOihana 38, 103-113.

18 Echeverria, D., Woods, JS, Heyer, NJ, Rohlman, D., Farin, FM, Li, T., Garabedian, CE, 2006. ʻO ka hui ma waena o kahi polymorphism genetical o coproporphyrinogen oxidase, hōʻike ʻana i ka mercury niho a me ka pane neurobeh behavioral i loko o kānaka. ʻO Neurotoxicol. ʻO Teratol. 28, 39-48.

19 Mackert JR Jr. a me Berglund A. 1997. Hōʻike Mercury mai ka hoʻopiha ʻana i ka amalgam niho: ka hopena i lawe ʻia a me ka hiki no nā hopena olakino maikaʻi ʻole. ʻO Crit Rev Oral Biol Med 8 (4): 410-36

20 Richardson, GM 1995. Nānā i ka hōʻike ʻana o ka mercury a me nā pilikia mai ka amalgam niho. Hoʻomākaukau ʻia ma ka ʻaoʻao o ka Bureau of Medical Devices, Health Protection Branch, Health Canada. 109p. Nā lā 18 ʻAukake 1995. Ma ka laina ma: http://dsp-psd.communication.gc.ca/Collection/H46-1-36-1995E.pdf   or http://publications.gc.ca/collections/Collection/H46-1-36-1995E.pdf

21 Richardson, GM a me M. Allan. 1996. ʻO kahi loiloi ʻo Monte Carlo no Mercury Exposure a me nā Pilikia mai ka Dental Amalgam. Nānā ʻImi Pilikino kanaka a me nā Ecological, 2 (4): 709-761.

22 US FDA. 2009. Rula Hope No ka Amalgam kahua niho. Ma ka laina ma: http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/DentalProducts/DentalAmalgam/ucm171115.htm.

23 Hoʻonui ʻia mai: Richardson, GM 2003. ʻO ka inhalation o ka mercury-mea hoʻowahāwahā ʻia e nā kauka niho: kahi pilikia ʻoihana e nānā ʻole ʻia. Nānā ʻIlikia Pilikino Kanaka, 9 (6): 1519 - 1531. ʻO ke kiʻi i hāʻawi ʻia e ka mea kākau ma o ka kamaʻilio pilikino ʻana.

24 Roels, H., Abdeladim, S., Ceulemans, E. et al. 1987. Ka pilina ma waena o nā concentrations o ka mercury i ka lewa a me ke koko a i ʻole ka mimi o nā limahana i hōʻike ʻia i ka mahu mercury. ʻO Ann Lanakila. Hyg., 31 (2): 135-145.

25 Skare I, Engqvist A. Hōʻikeʻike kanaka i ka mercury a me ke kālā i hoʻokuʻu ʻia mai nā hoʻolauna hoʻohui mele niho. ʻO Arch Environ Health 1994; 49 (5): 384-94.