Ban or regulate? Costs of dental occupational safety from mercury

Occupational hazard from mercury (Hg) exposure in the dental practice is less well studied than patient and environmental hazard. Developing country evidence on all dimensions of the problem is sparse, as are analyses of cost tradeoffs from practices that can reduce Hg exposure. A survey was conducted on 99 dentists from Greater Beirut to investigate levels of exposure and factors affecting them. Twenty-five percent of the dentists had hair Hg concentrations above the initially accepted level of 5 microg/g, and 28 percent had levels exceeding 10 microg/g. Gloves and masks had the most significant effect on the reduction of Hg level. Given these results and drawing on previous literature, we estimate and compare the costs of a total ban on amalgam use versus regulatory interventions to reduce exposure. We conclude that regulation constitutes a significantly lower financial burden. This result is consistent with policy conclusions in most industrialized countries. In addition, it serves as a useful benchmark for developing countries with dental sector and socioeconomic characteristics similar to those of Lebanon, such as a range of countries in Latin America, Eastern Europe, Asia, and Africa.