Mercury level in biological samples of dentists in Iran: a systematic review and meta-analysis

Exposure to mercury is an important risk to dentists health. The aim of the present study was to assess the pooled mean mercury level (MML) in the urine, blood, nail, and hair of Iranian dentists (IDs) through the meta-analysis technique. Comprehensive and systematic searches were performed in main local databases including SID, Magiran, Iran medex, and ISC as well as internationally available databases including Embase, PubMed and Scopus for all the relevant studies up to 2018. In order to prevent bias in this study and identify eligible studies, various steps of the study was performed independently by two researchers. Out of 13 studies in the meta-analysis process which included 1499 IDs, the mean of the mercury level in the urine, nail, and blood was estimated to be 6.29 (95% CI: 2.61-9.97, I-square: 62.7%, P: 0.006), 3.54 (95% CI: 2.81-4.28, I-square: 0.0%, P: 0.968), 11.20 (95% CI: 2.28-20.13, I-square: 59.9%, P: 0.082), respectively. The mean mercury level (MML) in the biological samples of IDs was higher than the standard of World Health Organization (WHO). So, in accordance with Article 10 of the European Union Regulations (EUR), in the context of the Minamata Convention (MC) on Dental Amalgam (DA), in order to avoid the dangers of mercury exposure in dentists, it is necessary for Iran and other countries to approve laws and to implement a national plan to reduce mercury levels and replace the appropriate materials.