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Amalgam ban demanded in germany

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The following Press Release From Germany has been translated by Mats Hanson,
Ph.D. of Sweden.

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 Tübingen 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 Tübingen. After a few hundred
tests at the BUND- Environmental exhibition ÖKO-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 Tübingen 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 für 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 für
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 Tübingen,
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 Tübingen 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 Tübingen study clearly show an
increased mercury load from amalgam fillings.

Saliva test a method to establish the mercury load.
The criticism of the Tübingen 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 für Arbeitsmed) or
urine (Dtsch Ges für 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 Tübingen 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 Tübingen 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 Tübingen 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 Tübingen 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 Tübingen.
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 Tübingen, 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 Tübingen, Postfach 210352, D-72026
Tübingen, tel 07071/2984802. Interested journalists can obtain detailed
information from BUND, Dunanstrasse 16. D-79110 Freiburg, Tel: 0761/885955-0,
Fax-90