MERCURY VAPOR AS AN ATMOSPHERIC

CONTAMINANT OF DENTAL OFFICES

B. BERCK1
Crop ProtectionSection, Agriculture Canada
Research Station. Winnipeg. Manitoba, Canada

G. CORTEand J. L. MONKMAN
Chemistry Division, Air Pollution Control Directorate
Environment Canada, Ottawa, Ontario. Canada
and

I. KLEINBERG2
Faculty of Dentistry, University of Manitoba
Winnipeg, Manitoba, Canada

Airborne mercury from dental offices was selectively trapped by silver gauze elements in
borosilicate glass absorbers, followed by heat-desorption and spectrophotometric measurement
at 2537A. As little as 0.4 ng of Hg could be accurately determined, which is equivalent to 49 ppt
in a one-L air sample on a v/v basis. Over 860 air samples were taken over a range of locations
and working conditions at 88 different dental offices, and at the Dental Training Clinic of the
University of Manitoba. The Hg vapor concentrations at the dental facilities ranged from 0.45
to 742 ~tg/m 3 of air; 29% of the samples were within 0.45 to 5 ~g; 37.8 were within 5.1 to 25 ,~g;
and 33.2% were above 25/zg. Mercury concentrations varied during the working day, depend-
ing on the time of sampling, the number of amalgams placed, and the interval between place-
ments. The lowest concentrations were obtained in the morning. Disturbance of residual merc-
ury droplets on floors or working areas by sweeping or dusting, or immediately after attempted
clean-up of a mercury spill, sharply increased the amount of airborne mercury.

This report deals with m e t h o d s and results of a s u r v e y c o n d u c t e d in the Winnipeg area

to d e t e r m i n e trace a m o u n t s of m e r c u r y (Hg) vapor as an e n v i r o n m e n t a l c o n t a m i n a n t of the
air of dental operating rooms. This particular project was u n d e r t a k e n to assist in estimating
possible toxic hazards associated with preparation and p l a c e m e n t of m e r c u r y - s i l v e r
amalgams as tooth fillings in restorative dentistry. Samples were collected at various diur-
nal periods of the room air of 88 dental offices, the Dental Training Clinic of the Faculty of
Dentistry, University of Manitoba and, for cross-reference, the laboratory o f one of us
(B.B.).

T h e selective, reproducible and highly sensitive m e t h o d of Corte and M o n k m a n (1971a,

1971b) and of Corte et aL (1971) was used. As little as 0.4 ng of Hg vapor could be ac-
curately d e t e r m i n e d with a reproducibility of _+ 10% b e t w e e n duplicate air samples. On a v / v

lContribution No. 610, Agriculture Canada, Research Station, Winnipeg, Canada

2present address: Department of Oral Biology and Pathology, Health Sciences Center, State University of New York
at Stony Brook, Stony Brook, New York 11790

Archives of Environmental Contamination 229

and Toxicology, Vol. 3, No. 2, 1975
9 1975 by Springer-Verlag New York Inc.
230 B. Berck et al.

basis at 25~ 0.4 ng of Hg present in one L of air corresponds to 49 ppt. Background

levels ranging from 1.2 to 2.8 ng of Hg/m 3 at breathing zone height in ambient outdoor at-
mospheres at the University of Manitoba were readily determined.

Research on toxic hazard potential of dental amalgam preparation. Frykholm (1957)

conducted extensive experiments on the toxic and allergenic effects of mercury from den-
tal amalgam. Stock and Cucuel (1934) showed that mercury was deposited in lungs and kid-
neys after inhalation of Hg vapor. Ashe et al. (1953) found 0.44, 0.067 and 0.019 mg of
Hg/100 g of kidney, liver and brain of dogs exposed to an atmosphere of 100/xg of Hg/m 3
for five 8-hour days per week for a period of 1.5 years. The normal amount of Hg was esti-
mated to be about 0.2 rag/100 g in kidneys and somewhat less in the liver.

In inhalation experiments on dogs, Fraser et al. (1934) found that about 12% of inhaled
vapor was periodically excreted in the urine. Milnor et al. (150) found that excretion of Hg
commences soon after administration, but that the commencement and percent of excre-
tion depend on the Hg compound and method of administration. According to Stock (1936,
1942), normal excretion of Hg in urine, from Hg in ingested food, is 0.1 to 1.0 ~g of Hg/24
hr. Frykholm and Odeblad (I955) showed that old amalgam fillings can generally be dis-
regarded as a source of Hg excretion in urine, but that freshly deposited fillings would be
conducive to high excretion levels within and up to seven days after placement. Similarly,
Hoover and Goldwater (1966) found that the absorption and excretion of Hg by patients
after one week following insertion of amalgam fillings is negligible and concluded that Hg
in tooth fillings is innocuous to the patients.

Mercury vapor inhaled from amalgam fillings may cause dermatitis including blisters
on tongue, lips and cheek in susceptible patients (Thomson and Russell 1970). Prior sen-
sitization through use of medicinals containing Hg was a precondition. Approximately 8%
of persons with skin ailments reacted positively to Hg, including amalgam restorations
(Frykholm 1957). Hg-copper amalgam restorations yielded intestinal and skin effects (der-
matitis) much more severe than Hg-silver amalgams. Elemental Hg administered
epicutaneously gave positive reactions, as did Hg-silver amalgam powder. Poisoning also
occurred among policemen who used mercury powder to develop fingerprints (Frykholm
1957). Gutenmann et aL (1973) were unable to correlate mercury concentration in the hair
of individual dentists as a function of the number of years each was in practice. The Hg
content ranged from 1 to 34.5 ppm, in contrast to 0.01 to 2.5 ppm regarded as the range in
humans exposed to 'normal' sources of Hg contamination.

Over 25 symptoms pertaining to both acute and chronic mercury poisoning were
catalogued by D'ltri (1972) and by Friberg and Vostal (1972). Chronic effects include psy-
chic disturbances, brain damage, loss of memory, and teratogenic effects on offspring. An
early symptom of chronic exposure is a slight muscular tremor, readily observed in hand-
writing and other fine hand movements. As poisoning progresses, the writing becomes il-
legible (Gronka et al. 1970). Differences in toxic effects are related to differences in the
nature of the Hg compound, and to differences in absorption, metabolism, distribution,
and excretion of the compounds. Requirements for further epidemiological and toxicologi-
cal investigations were discussed by Friberg and Vostal (1972).
 Hg Vapor in the Air of Dental Offices 231

In formation on uses of Hg and the many-sided ramifications of Hg as an environmental

pollutant was collated in the reviews of D'Itri (1972), Saha (1972), and Friberg and Vostal
(1972). Toxic hazards pertaining to preparation and use of dental amalgams, including ex-
tensive personal research, were reviewed by Frykholm (1957). Additional papers relevant
to chronic hazards to dental personnel from mercury usage include: Ashe et al. (1953),
Brooks and Holmes (1958), Chan and Svare (1972), Cook and Yates (1969), Fraser et al.
(1934), Grossman and Dannenberg (1949), Goldwater and Jeffers (1942), Hoover and Gold-
water (1966), Jacobs and Goldwater (1965), Joselow et aL (1968a; 1968b), Meyer (1962),
Nixon et aL (1965), Segreto et al. (1969), Stock (1942), Stewart and Stradling (1971), Suzuki et
aL (1970) and Thomson and Russell (1970).

Experimental
Analytieal. The method of Corte and Monkman (1971a; 1971b)and Corte et al. (1971)
used in this investigation is based on the formation of a Hg-Ag amalgam with silver gauze
which enables quantitative trapping of 0.4 to I00 ng of Hg vapor. Air was drawn through
borosilicate glass absorbers containing a 60-mesh silver gauze element (1.8 g, with an ac-
tive surface area of 2.45 cm 2) sealed into the borosilicate tube as a double cylinder. The
amalgamated mercury was quantitatively desorbed by heat applied to the tube.

Over 860 air samples were drawn in duplicate samplings through the absorbers with
portable, battery-operated CaseUa (London, England) air samplers (available from Carleton
Instruments Ltd., 2414 Holly Lane, Ottawa, Canada). The Casella samplers were placed in
pairs about 15 cm apart and were operated simultaneously at a flow rate of l.5 L per min,
which was set by prior calibration with a precision rotameter. Each sampler was operated
by chargeable nickle-cadmium batteries and had a built-in digital timer in 0.01-minute
units synchronized with a diaphragm pump. Figure 1 shows the dimensions of the merc-
ury vapor sampler, and Figure 2 shows a portable air sampling unit.

After sampling, the arms of the absorber were sealed with PVC tubing and the absor-
bers were shipped to the Central APCD Laboratory (Ottawa) for analysis. The trapped mer-
cury was heat-released and conveyed by Hg-free compressed air (palladium chloride-
scrubbed in the air exit line) to an optical cell with quartz windows and one-m pathlength,
as an integral part of a Du Pont Model 400 ultraviolet photometric split beam analyzer. Ab-
sorbance was measured at the maximum absorption line (2537A), and the photometer sig-
nal was fed into a GC area integrator and a strip chart recorder. Parallel measurements
were thus provided of peak heights from the recorder and peak areas from the integrator in
units of mV/sec.

Calibration curves were made by triplicate injections of known amounts of Hg vapor

into the absorption system. Appropriate amounts of saturated Hg vapor were taken from
the supernatant air of septum-sealed borosilicate glass bottles containing triple distilled
elemental Hg held at a constant temperature. Curves were made at seven temperatures to
traverse the working range of 22.0 ~ to 28.0 ~ +__ 0.1~
232 B. Berck et al.

~ 33

+S,
25
33.5

27.5

55

r
T
25 ~
120

70

28 25

- - T ~ g

I I
I I

10

Figure 1. Mercury vapor absorption tube with silver gauze as vapor trap specific for airborne Hg
(Dimensions in ram).

Air sample sources, Eighty-eight dentists in the Winnipeg area and the Dental Training
Clinic at the Faculty of Dentistry, University of Manitoba, cooperated in this project. Air
samples were taken at different times and locations in the various dental offices and opera-
tion areas. All amalgams used in this project were of the standard mercury-silver-tin type.
Results were the averages of duplicate air samplings, with the exception of four samples in
which absorbers were broken in transit. Each sample represented a specific area (e.g., ball-
way, near dental chair, waiting room) or function (grinding and polishing, amalgam pre-
paration, amalgam insertions, etc.).

Dentists whose premises were sampled were listed by "dentist n u m b e r " to maintain in-
terdentist anonymity. Each dentist who cooperated in this project received an interim re-
port of results obtained, with Hg vapor levels pertaining to his specific dentist n u m b e r en-
circled. To help translate/zg of Hg vapor/m 3 to degree of air contamination, the reports to
 Hg Vapor in the Air of Dental Offices 233

Figure 2. Mercury vapor absorption tube attached to Casella air sampler adjusted to preset flowrate.

each dentist also stated an arbitrary Hg contamination rating for each Hg level; namely,
low (L) ~- 0.5 to 5/~g; medium (M) ~- 5.1 to 25/~g; and high (H) - > 25/zg. Methods of
reducing Hg vapor levels were outlined. Plans were discussed with some dentists whose
premises showed high Hg vapor levels regarding possible follow-up tests on urine, nails,
and hair of dentists and dental assistants as indicators of chronic exposure to Hg.
 234 B. Berck et al.

Results and discussion

Analytical. Direct injection of Hg vapor standards in the range 0.4 to 100 ng into the
measuring cell gave immediate peak responses. Injection of the same amounts through the
silver gauze absorber completely prevented mercury vapor from reaching the cell. Recov-
eries of 97 to 100% of the trapped mercury were quickly and reproducibly obtained upon
Hg desorption by heat. Sensitivity could be extended by using the integrator output. The
calibration curve for Hg vapor, with concentration response and peak height
simultaneously recorded, was linear up to I00 ng of Hg. To accelerate processing large
amounts of data, the calibration curve equation was incorporated into a PDP-8 computer
program. After processing each batch of samples, information was provided to the com-
puter on sampling time (volume), temperature-barometric data and integrator output, and
the results were printed out automatically. The computer calculated the arithmetic mean
and percent mean difference of duplicate assays; percent mean difference greater than
10% was marked "rejected" by the computer, and called for repeat determinations. A 10%
difference in duplicate determinations was found to be due to small differences in air
volumes delivered by two different sampling pumps. By varying the sampling time and
thus the sample volume drawn through a silver gauze trap, Hg/air concentrations from 0.4
to 100 ng were accurately measured. The method was thus adaptable to almost any con-
centration likely to be encountered.

Table I indicates the sensitivity and reproducibility of Hg determination in the range 0.4
to 4.0 ng. Figure 3 shows the corresponding peak heights that were recorded. As was indi-
cated, the relationship between Hg vapor concentration and peak height or peak area was
linear in the range 0.4 to 100 ng. Similar results were obtained by a permeation tube techni-
que used as an optional method of calibration.

In the determination of mercury by the Corte-Monkman method, absorption at the

2537A resonance line in the UV region is measured. Gases and vapors, such as ozone,
smoke, oxides of sulphur and nitrogen and aromatic ring compounds (e.g., benzene,
toluene, dioxane) and straight-chain organic substances (acetone, ethyl acetate, etc.) do not
interfere because they are not collected by the silver gauze traps. Use of a charcoal filter as
a trap to collect airborne Hg is not sufficiently selective, since nonmercurial vapors such as
smoke, SO2, etc. can also be trapped by charcoal, and later released and measured as Hg at
2537A (Corte and Dubois 1973). Thus, the strong affinity of silver gauze for Hg vapor in air
and the ease of Hg release by flash heating greatly improve the specificity of the method.
While absorption of Hg on gold foil could also be used to selectively trap airborne Hg, the
considerably lower cost and greater availability of silver gauze was a practical influence on
choice.

Hg Vapor Data. Table II shows the ranges of Hg vapor levels ~ g of Hg/m 3) of air.sam-
ples taken at various locations in offices and dental working areas during a 3.5-month
period. The samples were taken at breathing zone height and approximately 60 cm from
the dental assistants, and encompassed diverse work areas and operations during an
average eight hr day (near dental chairs, in amalgam preparation and placement, polishing,
grinding, air and water aspiration, etc.). The overall aim was to obtain quantitative data on
 Hg Vapor in the Air of Dental Offices 235

T a b l e I. Sensitivity and reproducibility of measurement of rig vapora

Hg vapor Peak height Absorbance Hg

(co) (arbitrary units) Mean x 103 (ng)
0.02 2.6
2.8
3.3 2.9 • 0.2 1.3 0.40
0.04 6.2
5.8
5.8 5.9 • 0.2 2.7 0.79
0.05 7.8
7.9
8.2 8.0 • 0.2 3.6 1.00
0.06 9.5
9.2
9.3 9.3 • 0.2 4.2 1.19
0.08 12.1
11.8
12.0 12.0 • 0.2 5.4 1.59
0.10 15.5
15.5
15.5 15.5 • 0.0 6.6 1.99
0.20 30.0
30.4
31.3 30.6 • 0.7 14.2 3.94

aData of Corte and Monkman (1971a).

0.2

0.1

0.138
0.06
0.05

0.04

Figure 3. Peak heights recorded for triplicate determinations of Hg vapor standards (ref. Table I).
Values above peaks are ml of saturated Hg vapor at 25~
236 B. Berck et al.

Table II. Ranges and means o f rig vapor concentrations o f air samples taken at restorative dental
facilities o f 88 dentists in the Winnipeg area

Total
Time of no. of Hg vapor,/zg/m3air
Type of air sample sampling samples Range Mean
A. Samples at breathing zone height (1 m 8- 9:00 AM 6 0.45-1.41 0.81
approx.) inside dental office entrance door
B. Samples taken at breathing zone height 8- 9:55 AM 84 0.71-11.69 3.08
ca. 61 cm from dentists and dental 10-12:00 AM 98 2.44-25.80 14.66
assistants in operational area during 1- 2:55 PM 120 5.00-61.01 21.75
workdays 3- 5:00 PM 136 9.28-171.20 42.50
C. Same as B, but in 4 dental clinics with 3 8- 9:55 AM 24 3.48-17.05 6.90
to 4 dentists operating simultaneously in 10-12:00 AM 28 8.90-63.75 24.75
separate but adjoining offices i- 2:55 PM 34 9.54-122.8t 33.35
3- 5 PM 38 10.44-213.85 59.60
D. Accidental mercury spill, workbench 2- 3:00 PM 8 69.63-90.47 85.02
area, Dentist No. 88, sampled 6 hr after
spill and before attempted cleanup
E. Same as D, but shortly after attempted 3:15 PM 4 210.50-372.22 298.36
clean-up and recovery of spilled Hg using
aspiration and suction probe
F. Same as E, but sampled 17 hr after 8:30 AM 4 1.72-6.31 3.60
clean-up

the range of airborne Hg levels encountered in the dental offices, rather than to establish
interoffice differences in sampling areas, working conditions, frequency of restorations,
degree of ventilation, etc.

The Hg vapor concentrations at the dental facilities ranged from 0.45 to 742/zg/m 3 of
air (Table II). Of the samples collected, 29% contained 0.45 to 5/zg, 37.8% contained 5.1 to
25/zg, and 33.2% were above 25/zg/m 3.

Hg concentrations varied during the working day, in accord with the time of sampling,
the total n u m b e r of amalgams placed, and the interval between placements. The lowest Hg
concentrations were obtained in the morning between 8 and 10 AM and progressively in-
creased thereafter. Thus, low values (0.71-5/zg/m 3) were generally obtained between 8 and
9 A M in all instances, when daily work programs were getting started. M e d i u m a n d high
(5.1 to 25 p.g and > 25/xg, respectively) levels were attained as work progressed, depending
on the cumulative number of tooth fillings that were made. Hg levels near office entrance
doors were low (0.45-1.41 p.g)(Table II). "

The room atmosphere in four dental clinics (groups of 3 to 4 dentists working in sepa-
rate but adjoining offices) reached medium and high levels between I0 A M and 5 PM (Ta-
ble II). The levels were significantly higher than those of single-dentist offices, sampled
during similar diurnal periods. These and other differences were attributed to the in-
 Hg Vapor in the Air of Dental Offices 237

creased volume of dental work, which was generally offset by more intensive ventilation
and better hygiene in the disposal of amalgam scrap, using capped mechanical amalgama-
tors and frequent use of water jets as a coolant in grinding.

Dentist 88 (Table II) had an accidental Hg spill at his work-preparation desk. Approx-
imately six hr after the spill, Hg levels in the vicinity of the spill ranged from 69.6 to 90.5
/zg/m 3. After attempted clean-up of the spill with squeezed out wet paper towels to aggreg-
ate the Hg for collection in a suction flask with a water-aspirated air suction line, the Hg
levels rose to 210 to 372 ~zg (Table II). The considerable rise in Hg level was evidently due
to the stirring up of the residual Hg droplets. This was shown also in a confirmatory experi-
ment in which sweeping the floor, dry mopping, vacuum-cleaning, or dusting resulted in a
substantial but temporary increase from 1.2 to 41.7/zg in the amount of airborne Hg.

The operational area of dentist 46 was carpeted and a Hg vapor concentration of 35.44
/zg/m3 was obtained at 75 cm above the floor shortly after the office was opened at 8:30
AM. When the air conditioner was turned on, the Hg level was reduced to 6.25/~g within
one hr. On this aspect, carpeted reception rooms adjoining dental offices were found to be
reservoirs of Hg vapor from Hg droplets deposited by leather footwear (Joselow et aL
1968b). Evidence was found for the translocation of Hg particles by footwear from dental
offices to the homes of dentists and dental assistants; up to 30 /zg/m 3 Hg. vapor was
measured in a dentist's home from this source (Gronka et aL 1970).

The Dental Training Clinic consisted of a large room (36 x 14.4 x 4.9 m) with a total
volume of 2,550 m 3 and accommodated dental chairs for up to 60 student dentists. Table
III indicates the variable results that were obtained at breathing zone heights in the high
and well-ventilated room. On date "A", during the August summer vacation period when
the training clinic was not in operation, low levels of Hg vapor (0.55-5.18 t~g/m 3) were
found. On dates "B" and "C", during afternoons when restorations, drilling, etc., for 30 to
35 patients were under way simultaneously, high Hg levels, ranging from 31 to 742/zg/m 3,
were obtained. On date 'D', during the morning of a 'slow' day with eight patients being
treated at the time, Hg levels ranging from 5.92-33.14/zg/m 3 were obtained.

Table IV shows Hg vapor concentrations at the Dental Training Clinic at six periods
during a single workday in whicfi comparatively few dental restorations were placed. The
increase in Hg concentration in sample locations with advance in time during a work day is
clearly shown. It is worth noting that the clinic used an effective air conditioning system
that had been estimated to yield a complete change of room air within 45 seconds. The
possibility that the air conditioning system might either reintroduce some of the exhausted
mercury vapor or accelerate the volatilization of micronized mercury globules normally
found in cracks and on floor peripheries was not investigated.

The removal of old dental amalgams with high-speed rotary drills can contaminate
room air with mercury vapor (Rupp and Paffenbarger 1971). The micronized amalgam
powder that is generated by grinding and polishing is breathed by dentists and dental assis-
tants for longer periods than by patients, and must be regarded as a chronic health hazard.
Similarly, mechanical amalgamators, ultrasonic condensers, and high-speed rotary drills
 238 B. Berck et al.

Table III. Mean Hg vapor concentrations in restorative dental facilities of the Dental Training
Clinic, Faculty of Dentistry, Univ. of lklanitoba, Winnipeg

Sampling Sample Hg eone'n Sampling Sample ~ Hg eone'n

date No. ~gHg/m 3 category b date No. gg Hg/m 3 category b
Aug. 15/72 a 305 0.55 L Oct. 17/72 334 232.0 H
10-12AM 306 1.46 L 2-5 PM 335 580.0 H
307 2.89 L 336 353.0 H
308 3.44 L 337 386.0 H
309 1.01 L 338 352.0 H
310 2.56 L 339 41.9l H
311 3.13 L 340 31.04 H
312 5.18 M 341 27.85 H
342 713.0 H
343 742.0 H
344 40.49 H
Sept. 27/72 319 61.54 H Nov. 6/72 345 8.11 M
2-4 PM 320 122.37 H 10-12 AM 346 9.10 M
321 134.40 H 347 8.43 M
322 87.15 H 348 8.56 M
323 96.87 H 349 8.49 M
324 94.48 H 350 9.98 M
325 41.14 H 351 20.52 M
326 76.02 H 352 17.20 M
327 195.28 H 353 10.16 M
328 81.21 H 354 21.05 M
329 279.51 e H 355 9.84 M
330 137.76 H 356 33.14 H
331 129.77 H 357 8.88 M
332 228.93 H 358 7.24 M
333 303.61 c H 359 7.18 M
360 5.94 M
361 6.56 M
362 7.05 M
363 5.92 M

aSamples were taken when the Dental Training Clinic was not in operation during the 3-month period
June-September.
bThe "Hg concentration category" is tentatively designated as: Low (L) = 0-5/~g/m3; Medium (M) =
5.1-25/zg; and High(H) = 25A ~g and above.
c61 cm from patient, while amalgam was being inserted.

present hazards to dentists and dental assistants. T h u s , the c o m p a c t i o n of Hg a m a l g a m

f o r m e d with an ultrasonic c o n d e n s e r can produce spray dispersions to five microns or less
in diameter, and poses a serious potential hazard of possible inspiration in lungs (Chandler
et al. 1971). Air conditioning systems in dental offices may also be a m e a n s o f recycling
m e r c u r y vapor if the filters are not cleaned or replaced frequently (Gronka et al. 1970).

For cross-reference purposes, Hg vapor c o n c e n t r a t i o n s were d e t e r m i n e d in the c h e m i -

cal laboratory of one of us (B.B.). Table V s h o w s that the m e a n Hg levels f r o m various
laboratory locations were approximately 0.62 tzg/m 3. Two air samples ( n u m b e r s 22 and
 Hg Vapor in the Air of Dental Offices 239

Table IV. Hg vapor concentrations (Izg Hg/m 3 air) at Dental Training Clinic during a work day
with comparatively few dental restorations

9:15 10:15 12:15 2:15 4:15 5:15

AM AM PM PM PM PM
2.05 3.79 4.23 6.58 13.47 10.16
2.93 3.70 5.17 11.08 18.72 9.82
1.97 3.49 5.49 9.70 9.70 13.57
6.03 4.56 6.17 9.26 18.78 16.47
3.25 6.19 5.12 15.07 17.56 15.14
Mean 3.24 4.35 5.24 10.34 15.65 13.03

Table V. Hg vapor concentrations in a chemical laboratory

(B.B.)

Mean Hg level,
Sample No. ~tg/m3 air
13 1.52
14 0.53
23 0.89
93 0.19
94 1.05
255 0.47
275 0.52
303 0.I3
304 0.21
22 23.04a
287 32.40a

aSamples 22 and 287 were taken 6 weeks apart during seed-mixing

operations in which elemental Hg and organomercurial seed dress-
ings were experimentally applied to wheat to determine volatility
patterns.

287), taken six weeks apart in a seed-mixing experiment in which elemental Hg and
organomercurial formulations were applied to wheat to determine comparative Hg
volatility patterns (Berck et al. 1975) contained 23.04 and 32.40 p,g/m 3. respectively. The
results showed that even small-scale operations in which 0.2 to 0.4 g of Hg or volatile merc-
ury compounds were used contribute measurable amounts of Hg vapor for short periods.

Although in themselves the Hg vapor levels found in the dental office atmospheres ap-
pear to be small, there are at least two aspects to be considered: (1) The concentration level
that may be considered safe. The TLV (thresh'old limit value) for Hg adopted by the Amer#
can Conference of Governmental Industrial Hygienists, Third Edition, 1971, is 50 p,g of Hg/.m 3
for inorganic Hg vapors and solids and organic compounds other than alkyl mercury; for
alkyl mercury the TLV is 10 p,g/m 3. In this regard, the TLV is a median value based on
averages of toxicological data obtained from multiple sources. It is not the same as MAC
(maximum allowable concentration) used in most European countries; and, (2) the total
240 B. Berck et al.

volume of air breathed by individual dentists or dental assistants during an eight-hr work-
day. Based on two different information sources regarding volumes of air breathed by
mildly active adults, a volume between four and five m 3 air may be inspired during an
eight-hr exposure.

Although it would be of interest to relate TLV to the total eight-hr inhalation by an in-
dividual, we recognize that estimation of average daily Hg concentrations for each situa-
tion is difficult because of variables such as frequency of restorations, office layout, etc.

Additional data are needed to assess the possible chronic hazards from exposure to the
atmospheric mercury levels found under average working conditions of dentists and den-
tal assistants. The survey showed that greater attention should be given to good hygiene in
the handling of excess mercury and in the preparation of amalgams.

Conclusions
Airborne Hg levels in working areas and dental offices should be monitored
periodically. Radiation monitoring film may be used to monitor for continuous exposure in
an environment containing Hg vapor. The film becomes progressively opaque through the
formation of a silver amalgam and is a function of the Hg vapor content, the duration of
exposure and the ambient temperature (Stradling and Fletcher 1970).

Good housekeeping is the key to reducing toxic hazards from Hg vapor in the at-
mosphere of work areas. Spilled mercury should be cleaned up immediately with water-
aspirated suction apparatus. Droplets that cannot be reached can be dusted with powdered
sulfur or covered with a slurry of sulfur and calcium oxide (Rupp and Paffenbarger 1971).
Excess amalgam rinsed from the mouth or aspirated should be caught in a strainer or trap
located in the waste drain pipe. The scrap should be transferred to a capped wide-mouth jar
(plastic preferred, to avoid possible breakage) and covered with about a one-cm layer of
water to suppress and confine the fugacity of Hg vapor.

A plastic tray or equivalent container suitable for containing inadvertent spills should
be used in the working or handling area. The container should be kept from radiators or
other heating areas. Used dental napkins, contaminated paper towels and similar items
should be deposited in a closed waste basket lined with a removable polyethylene bag. Eat-
ing, smoking, drinking and the application of cosmetics must not be permitted in dental
operating areas.

Floor covering in dental offices should be seam-free and impervious, e.g., PVC. Tiled
floor covering should be avoided and carpeting should never be used. If hidden Hg glob-
ules are suspected on linoleum or tile flooring, brushing with a dry handbrush can reveal,
through increase in Hg vapor content, the presence of a mercury "reservoir".

Footwear is a possible source of transport and redistribution of Hg globules in a dental

office. Slip-on plastic shoe covers should be worn in the dental office and removed before
 Hg Vapor in the Air of Dental Offices 241

walking to other premises as a means of reducing translocation of Hg droplets via footwear

(Stewart and Stradling 1971).

High-speed rotary drilling to excavate old dental amalgams is a health hazard. A water
spray should be used to reduce development of excessive heat that can accelerate Hg
vaporization, with a high-volume evacuator, properly trapped. A water spray and suction
should be used when grinding dental amalgam. Heating of Hg or amalgam should be
avoided. The fine Hg amalgam dust generated by grinding is an additional hazard and can
contaminate the entire office. Such dust can be mopped with squeezed-out wet paper
towelling, to be de~)osited in a disposable polyethylene bag.

Acknowledgements

The authors acknowledge the financial assistance by the Manitoba Environmental

Research Committee (MERC) operating with a Local Initiatives Program (LIP) grant from
Canada Manpower, Ottawa, that enabled the employment of Mr. Perry Chochinov and Mr.
Lawrence Lee in the taking of multiple samples in this survey and in making useful obser-
vations on the toxic hazard potential of dental restorations. The assistance of the Dental
Training Clinic, Faculty of Dentistry, University of Manitoba, and of the Air Pollution
Control Directorate, Environment Canada, Ottawa, is greatly appreciated.

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Manuscript received March 25, i974; accepted June 1, 1974.