Skip to content
Licensed Unlicensed Requires Authentication Published by De Gruyter February 19, 2014

Mercury poisoning dentistry: high-level indoor air mercury contamination at selected dental sites

  • Mahmood A. Khwaja EMAIL logo and Maryam Shabbir Abbasi


Mercury (Hg), also known as quick silver, is an essential constituent of dental amalgam. It is a toxic substance of global concern. Children are more at risk from mercury poisoning which affects their neurological development and brain. In the past, a number of studies at dental sites in many countries have been carried out and reported. The present report briefly describes and discusses our recent investigations carried out at 34 dental sites (teaching institutions, hospitals and private clinics) in Pakistan. It is evident from the data that at many sites the indoor mercury vapor levels exceed far above the permissible limit recommended for safe physical and mental health. At these sites, public in general and the medical, paramedical staff and vulnerable population in particular, are at most serious risk to health resulting from exposure to toxic and hazardous mercury. To minimize such risk, some of the recommendations are, best in-house environmental practices for occupational health and safety, mercury contaminated waste reduction at source, mercury specific legislation and ratification of Minamata convention on mercury by Pakistan and other world governments at the earliest time possible

Corresponding author: Mahmood A. Khwaja, Sustainable Development Policy Institute (SDPI), 38, Main Embassy Road, G-6/3, Islamabad, Pakistan, E-mail:


We gratefully acknowledge the collaboration of the Zero Mercury Working Group (ZMWG) and the Institute of Chemical Sciences (ICS), Peshawar University, as well as the financial support of the Sigrid Rausing Trust and the European Commission via the European Environmental Bureau (EEB). We are also thankful to our SDPI colleagues, Fareeha Mehmood and Sehrish Jahangir, for their valuable contributions towards this study.


1. The Vermont Advisory Committee on Mercury Pollution. 1998. Available at: Accessed on November 2013.Search in Google Scholar

2. Intelligence Service. Study on the potential for reducing mercury pollution from dental amalgam and batteries, Final report prepared for the European Commission- DG ENV, 2012:45.Search in Google Scholar

3. IUCN GCC. Legally binding global mercury treaty to protect wildlife, ecosystems and health, 2012. Available at: < _2012.pdf>. Accessed on November 2013.Search in Google Scholar

4. United Nations Environment Program. Advance version of the Minamata Convention on mercury, 2013. (DTTE)/Hg/INC.5/7.Search in Google Scholar

5. Stortebecker P. Mercury poisoning from dental amalgam through a direct nose-brain transport. Lancet 1989;333:1207.10.1016/S0140-6736(89)92789-XSearch in Google Scholar

6. United Nations Environment Program Chemicals. Global Mercury Report. Geneva, Switzerland, 2002.Search in Google Scholar

7. Pamphlett R, Coote P. Entry of low doses of mercury vapors into the nervous system, Neurotoxicol 1998;19:39–48.Search in Google Scholar

8. Kirby A, Rucevska I, YemelinV, Cooke C, Simonett O, et al. Mercury – Time to Act. United Nations Environment Program 2013;23.Search in Google Scholar

9. MERC Vermont. Advisory Committee on Mercury Pollution. Dental amalgam fillings. 1999. Available at: <>. Accessed on November 2013.Search in Google Scholar

10. Khwaja MA, Umer F, Shaheen N, Sherazi A, Shaheen FH. Air pollution reduction and control in south – need for regional agreement. Sci Technol Dev 2012;31:51–68.Search in Google Scholar

11. Khwaja MA, Khan SR. Air pollution: Key environmental issues in Pakistan, working paper series No.99. Sustainable Development policy Institute, Islamabad, Pakistan, 2005.Search in Google Scholar

12. United Nations Environment Program. Preliminary report on Mercury Inventory in Pakistan. Chemical Branch, Ministry of Environment, Islamabad. 2000. Available at: Accessed on November 2013.Search in Google Scholar

13. Mumtaz R, Khan AA, Noor N, Humayun S. Amalgam use and waste management by Pak. dentist. EMHU 2010;16:334–9.Search in Google Scholar

14. Kefi I, Maria A, Majid Z, Sana J, Afreen M, et al. Dental amalgam: effects of alloy/mercury mixing ratio, uses and waste management. J Ayub Med Coll Abbottabad 2011;23:43–5.Search in Google Scholar

15. Lumex Ltd. User Manual, Mercury Analyzer RA915+. Available at: Accessed on November 2013.Search in Google Scholar

16. Agency for Toxic Substances and Disease Registry (ASTDR). Action Levels for Elementary Mercury Spills, Chemical-Specific Health consultation, 2012.Search in Google Scholar

Received: 2014-1-16
Accepted: 2014-1-16
Published Online: 2014-2-19
Published in Print: 2014-4-1

©2014 by Walter de Gruyter Berlin/Boston

Downloaded on 23.3.2023 from
Scroll Up Arrow