Brennpunkt: Amalgam poisoning and dentist assistants
http://www7.nrk.no/nrkplayer/?klipp_id=85139

NRK May 10th 2005 Norway http://nrk.no/

This report was aired on May 10th 2005 at the prime time, on the most widely available TV Chanell in Norway: NRK1
It will be again aired tomorrow.
After the report, evening news on NRK1 reported they received more then 1000 phone calls, thanking for the report, and many phonecalls from dentist assistants confirming that they are suffereing from the same symptoms.
It is about time for the truth about amalgam to come out in the open!

This is a report about more then 10 000 dentist assistants and dentists in Norway poisoned on their job, while working with Amalgam.

About governmental organizations and experts who failed to warn and protect dentists and their assistants about dangers of amalgam and mercury.

Health ministry has known about risks, but has not warned enough.

Norwegian Labor Inspection Authority has not prioritized inspection and has not estimated the risks.

Researchers have prioritized but have assumed that doses were too law.

About doctors who refuse to diagnose mercury poisoning and are rather giving "happiness pills" and pain killers and diagnoses like Parkinson's, Alzheimer's, Hypochondria.

Transcript of the report that was aired on may 10th on Norwegian channel NRK

Reporter: "It was dentist assistants that were making Amalgam, all the way to late nineties (90's) they worked under totally different standards of hygiene then today. They were daily in contact with Mercury (Hg).

Reporter: Gerd Irene Lyse started working as dentist assistant 1971.

She was assisting dentist, receiving patients and she was making Amalgam.

Amalgam was made inside "Amalgamator", blending machine, and that machine had to be filled before use.

Gerd Irene Lyse: To fill mercury into the Amalgamator without spilling some drops was next to impossible.

Reporter: Does it mean that you were spilling mercury on the floor?

Irene Lyse: Yes

Reporter: Did you collect it?

Irene Lyse: Yes, we had a special technique to collect drops of mercury. We would take rests of amalgam, and would collect mercury with amalgam as amalgam acted like absorbent for mercury.

Reporter: Mercury is constantly evaporating and mixing with air cause that's how mercury is. Gerd Irene Lyse worked for a dentist who was working with very soft Amalgam. It means the Amalgam contained far more then 50% Mercury. It was very easy to work with such soft Amalgam.

Irene Lyse: I gave him Amalgam, and he would take it with his hands, between his fingers, he was using a tissue, he would turn the tissue until small drops of mercury would appear at it's ends, and he would then shake it until drops of mercury would fall down on the carpet.

Reporter: Yesterday, in Telemark, we met Tordis Klausen. She began working as a dentist assistant 1969. And, like most of the other dentist assistants, she was daily kneading mercury with her bare hands to keep it soft.

Tordis Klausen: I would take it over in my hands, and knead it until it became a homogenous mass. There we were standing and kneading it. Then, we were holding it in our hands, and after a while when dentist would place amalgam into the patient's teeth, we would place it on a little spaltel.

Reporter: Did you wear glows while you were doing it?

Tordis Klausen: No, not 1969.

Reporter: Was is written that it could be dangerous?

Tordis Klausen: No.

Reporter: Did you get any information that it could be dangerous?

Tordis Klausen: No.

Reporter: This is the machine used for mixing Amalgam. Inside these 2 holes assistant would fill at least 50% Mercury, and rest alloy. Machine would mix materials until dentist assistant would take it with hands and knead it. Tordis Klausen too had problems filling machine without spilling drops of mercury.

Tordis Klausen: Everybody knows that some drops would be spilled. That is why we would add more mercury, and then some of it would spill down on the floor, and it would break into very many small drops over the whole floor.

Reporter: Did you collect it?

Tordis Klausen: We would never have time to do it.

Reporter: There are limits on how much mercury can be in the air, but those limits differ extremely.

Air limit for one 8 hours working day in Norway is today 50µg Hg per cubic meter (m3) of air. (µg = micro gram = 1/1,000,000 gram = one millionth part of a gram).

WHO (World Health Organization) has at the moment much lower limit: it is 20 µg Hg/m3 air.

One survey of 15 dentist offices performed by Norwegian Labour Inspection Authority 1973 shows average value to be 28µg Hg/m3 of air, but 3 offices have much higher values. One was kept outside this report with value that was 400 µg/m3 of air. This report confirms Tordis Klausen's and Irene Lyse's story.

They were spilling mercury in offices, there was no appropriate ventilation, and mercury was handled with bare hands.

No expert the Brennpunk was in contact with would have done that today!

Especially not here, at the " Statens Arbeidsmiljøinstitutt (STAMI)" (State Labor Environment Institute) where all most reputable Norwegian experts in this field are.

STAMI Expert: I believe that it is important to look at it in the context of the time they were doing it … but today … such situation would not be acceptable. That time we thought that mercury is far less poisonous then what later was discovered.

Reporter: But, it was actually much worst. After the Second World War, Scandinavia had a huge tooth-hole problem. Dental Caries was destroying the teeth of adults and children. Such teeth were not unusual. [Showing very poor teeth.] Something had to be done and the weapon was Copper-Amalgam. It was composed of 70% Mercury, and was ideal for use on milk teeth in kids. Copper was killing bacteria, and it was possible to place filling without that tooth had to be dry or clean.

But, Copper-Amalgam had one huge disadvantage: It had to be cooked first.

Tordis Klausen: It was in very small tablets, and we had to heat it over the open flame until pearls of mercury appear on the outside. Then, we would take it into another container, and it was crushed and mixed there, then we would take it into our hands, and would be standing and kneading it.

Reporter:That is what Tordis Klausen has done every half an hour, every day for many years… but at the end of seventies, she got sick. After a long time of being sick, she got Disability Pension.

Gard Irene Lyse was also working with Copper-Amalgam. She was doing it from 1971 until the end of eighties. She went to a high school to become Dentist Assistant, and Copper-Amalgam was a part of curriculum. But, they never told her that it could be dangerous.

Gerd Irene Lyse : No, it was never said anything about the danger. If I knew, I would have never done it.

Reporter: You have been lectured on this method (heating Copper-Amalgam tablets)

Gerd Irene Lyse : Yes, it was very common. It was used daily, and that was what we were working most with.

After a while, when Gerd Irene Lyse and urdis Klausen become sick, they got one message from doctors, researcher, social system and justice system: "Your health problems are not caused by mercury cause doses that you were exposed to were too low."

Arbeidstilsynet / Norwegian Labour Inspection Authority had responsibility to insure that working place is safe. They should have inspected dentist offices, but they did not discover that something was wrong.

Arbeidstilsynet Expert: As I said, we have done research 1973 and concluded that level of exposure was acceptable though possibly with few exceptions.

Reporter: Have you had any idea that something couldhave been wrong?

Arbeidstilsynet Expert: That time, as I said, we did not focus on that.

But, Tordis Klausen was sick at the end of seventies (70's).

After several years with mercury fumes, symptoms appeared crouching one after another.

Tordis Klausen : When dentist asked me to do most usual things, things I have done for many years, suddenly, I stopped: "What is that?" I needed several minutes to come to myself, and to remember what is it he is asking me to do. Loss of memory was getting worse, and in the end it was so extreme that I totally lost sense for orientation.

Reporter: But, after a while ... it was more. Much More! Tordis Klausen developed next problems: (on the screen, problems are listed: ) neurological problems, inability to concentrate, shaking, loss of memory and loss of orientation, pain, respiratory problems, cramps, …

Tordis Klausen : One day, I was getting so strong cramps all over my body. I was sitting inside bath, and cramps were strong and I totally lost concentration.

Reporter: Also Gerd Irene Lyse got sick while she was working. And, same like with Tordis Klausen, symptoms were appearing gradually.

Gerd Irene Lyse : I was loosing my memory, there were things I new, but I was totally blocked, … There was a doctor that said I was not sick. …. I got diagnosed with Parkinson's December 2000, just before Christmas.

Reporter: Do you think your problems are caused by mercury?

Gerd Irene Lyse: I am totally convinced.

Reporter: But, the problem was, nobody else believed that it was mercury. Through many years, answer from doctors was a prescription for "happines pill" Others that Brennpunkt contacted gave her directions to Hypochondriac Clinic.

Symptoms of mercury poisoning are extremely similar to psychological ailments.
And, women that need help are in their fifties and sixties.

In Stockholm we met Maths Berlin . He is the professor of Environmental Medicine at the Medical Faculty of Lund.
He specializes in Mercury toxicity, and was one of the people who were working on the Mercury Exposure Limits suggested by WHO.

Maths Berlin confirms that it is difficult to come up with clear diagnosis.

Maths Berlin: Doctors have very little knowledge about the risk of Mercury Poisoning. They have never learned about it and they never diagnose it. Maths Berlin believes that up to 500,000 Swedish citizens have problems caused by mercury.

Reporter: Berlin knows very well about dentist assistants. He said that they have been working daily and breathing too much mercury. His opinion is that even exposure limits sat today are too high.

Maths Berlin: Zero exposition to mercury is best. All biological organisms are affected by mercury.

Reporter is now in USA:

Washington, Seattle: Battelle Centers for Public Health Research and Evaluation
More Info: Neurobehavioral effects from exposure to dental amalgam Hg

Reporter: Seattle , here we can find some of the world leading experts on mercury poisoning research.
Nobody knows more about Dentists and Dentist assistants then the researchers here. They are connected to Battelle, a research organization with departments in many countries.
In USA they are doing a lot of work for the US Government.

Battelle Expert : Today, we are going to run through a battery of behavioral tests, so, what I'm gonna do is start the test right here …

Reporter: At Battelle, mercury researchers have examined over 6000 dentists and dentist assistants.

Battelle Expert (to persons being tested): Welcome to the Battelle. Today you will be taking a series of tests that evaluate your memory, coordination, response time, visual analysis and concentration.

Reporter: These are the tests that can show if someone is suffering neurological damage seen in people ho have been exposed to toxic amounts of mercury. Right here, they are testing memory: you have to remember yellow boxes and the order by what thye were arranged on the coputer screen. You have to arrange them as fast as you can.
Dental office personnel who has been examined here, has been exposed to a very low levels of mercury, 10 times lower then what was normal exposure of dental health workers in Norway up to seventies.

And, even at such small doses, they were able to detect the damages.

Diana Echeverria (Battelle Expert, Author of the behavioral study, is demonstarting different way how people are tested ): A person's capacity to move their finger from here to here as fast as possible, reaction time is slowed down.

A person's capacity to hold something steadily, very firmly in their fingers, and not jiggle, and not move this way or this way … is impaired when someone has a fair amount of exposure to mercury.

A person's ability to recall numbers is worse, so their attention is lower. We see increased symptomology mostly in complaints of memory loss, concentration and anxiety. We see some mood problems and some depression.

Reporter (explaining the test): This is one test for shaking. Every time the pin touches the edge of the circle, it gets registered.

Dentist assistants in Diana Echeverria's survey are able to work, but doses of mercury they were exposed to were very low.

At higher does, symptoms will increase.

Urine test taken while you are working can tell how much mercury is inside of you. In examination done here in USA , dentist assistants had 4µg of mercury in urine. Tordis Klausen has never got a chance to take urine test while she was working. But, one of her friends, dentist assistant, was tested and she has had 60 µg of mercury in urine. Tordis Klausen has applied for Work Related Injury Compensation but has not got it. Many years of court battle, a lot of research, and 2 million Norwegian Crowns ($ 320,000) out of the pocket, she spent to run the case to the top of the Norwegian Justice System, but she lost on all instances. As late as 1999, researchers from " Statens Arbeidsmiljøinstitutt (STAMI)" (State Labor Environment Institute) were testifying as expert witnesses in court and claiming that mercury exposure levels were too low to cause health problems.

STAMI Expert: I can't comment on this case as we are here going into individual cases and I don't wish to comment on it. That being said, I want to make clear that STAMI has many highly qualified people who testified in many court cases.
But, in court, they represent competence and they represent only themselves, they don't represent the official STAMI view on the subject.

Reporter: This is Nils Roar Gjerdet , Professor of Odontology at the University of Bergen. Inside of his storage, we find Copper-Amalgam.

We will now try to find out how much mercury is released when we do exactly what dentist assistants were doing several times a day.

The difference is: We have glows, and protective clothes. To measure, we have with us a labor hygiene professional. Remember that allowed dose in Norway is 50µg Hg per cubic meter of air (over 8 hours working day).

Nils Roar Gjerdet (while worming up 2 Copper-Amalgam tablets inside small container over the open flame): Now, drops of mercury are visible at the surface of tablets, so now we take them into other container and we crush them and mix them.

Labor hygiene professional is measuring the level of mercury in the air, she is holding instrument as far from heated tablest as the head of Nils Ove Gjerde is.

Labor hygiene professional: Now, we are over the limit of this measuring device that is over 1000 µg Hg per cubic meter of air.

Nils Roar Gjerdet : So, it is happening while we are mixing amalgam.

Labor hygiene professional: Yes.

Reporter: Every time we were measuring, the instrument was showing "HL", High Level… that means over 1000 µg Hg per cubic meter of air. How much over, we don't know … we don't have the instrument that can measure it.

Nils Roar Gjerdet : If this is happening repeatedly over a longer time, then it is of serious concern. The danger of getting exposed to extremely high levels of mercury is very, very high.

Reporter: Some of those dentist assistants we contacted said that they have been done it every half an hour, every day, Monday to Saturday, over many years. What do you think about that?

Nils Roar Gjerdet : Then, I believe that they have been exposed to extremely high mercury doses during the working day.

Diana Echeverria(USA): That is very high, especially in an uncontrolled environment, without any ventilation, or without being in a hood, or without heaving special controls. Yea, that's extremely high.

Reporter: Arbeidstilsynet (Norwegian Labour Inspection Authority) have responsibility to inspect working place. Last 3 weeks they have gone through everything they have of documents and it is clear now that there was no any Inspection.

Arbeidstilsynet Expert: As far as I have seen, there have never been any systematic control done. We had very few stick controls.

Reporter: That was the only form for control, because experts agreed that the work inside dentist office was not dangerous. And experts were the same, year after year.

Arbeidstilsynet Expert: If we go back to 60s, 70s, 80's , then we were still using as the bases of our opinion the same report provided by STAMI.

Reporter: And these were the expert consultants to Arbeidstilsynet (Norwegian Labour Inspection Authority).

Researchers at STAMI have previously claimed that doses are too low.

But now, they are changing their opinion.

STAMI expert: It is a very high dose. When we are talking about 1 milligram, then we are beginning to talk about a lot of mercury. We actually have some experience with similar doses. That is the level of mercury that was inside mercury mines where miners were poisoned almost without exception.

Reporter: Amalgam was used as tooth filling material of choice in over 150 years. And, all of that time, there were warnings. Also about Copper-Amalgam.

Already 1936 Karl Schmidt Fieseldeck at the University of Århus was warning against mercury: It was dangerous for dental personnel.

The warning was repeated 1957 at the dentist school in Stockholm. Copper Amalgam was classified as high risk material.

Last warning came from Nils Roar Gjerdet and his colleagues from the University of Bergen 1981.

Nils Roar Gjerdet : Our focus, 1981, at the beginning, was not working environment, but it was the alarming amount of mercury that was leaking from the amalgam fillings, so we decided to warn health authorities at the time, and they reacted.

Reporter: But, reaction from health minister was much nicer formulated then what the experts suggested. Copper-amalgam was not forbidden, instead, it has been said that it should be used with extreme caution.

The letter (1981) was supposedly sent to all dentist offices, but no one we have spoken with remembers that letter?!?

Tordis Klausen: No, I have never seen that letter.

Reporter: So, you have never seen this letter circulating?

Tordis Klausen: No, I so it first time in the hands of one of the people working in Arbeidstilsinet, early nineties.

Gerd Irene Lyse: We have not known anything about that. We know now, but if I have known about it before, I would have never worked with Copper-Amalgam.

Reporter: Gerd Irene Lyse began to work seriously with Copper-Amalgam 1981, the same year the warning from health minister went out about Copper-Amalgam. And, she was working with it until late 80's. Some palaces Copper-Amalgam was used until 1994.

STAMI experts are surprised about this.

STAMI expert: Warming-up mercury has never been considered very smart or safe practice. So, I am very surprised that it was practiced as late as you say.

Reporter: As Inspection Authority ,when you saw that people are warming-up the mercury, should have not you done something about that?

Arbeidstilsynet representative: Of course, but as I said, we have never seen it like that, we heard about it, but I don't think I can comment more about this, but it is possible that our procedures were not good enough that time.

Reporter: Tordis Klausen was fighting hopeless battle for herself and her peers.

Health ministry has known about risks, but has not warned enough.
Arbeidstilsynet have not prioritized inspection and have not estimated the risks.
Researchers have prioritized but have assumed that doses were too law.
Justice system have chosen not to believe to Tordis Klausen.
Very few were ever able to pass by the Doctors, General Practitioners who were convinced that they are mentally sick.

But, there is somebody who believes them.

Diana Echeverria (USA): I would be willing to state on record that those people should be evaluated, absolutely.

Reporter: Is it possible to say that those doses are definitively too low, that they could have not been affected?

Diana Echeverria (USA): NO! No!.

Also Maths Berlin in Stocholm means that there is absolutely no doubt that some of the dental personnel was exposed to the extremely high doses of mercury.

Maths Berlin: Without protection, without ventilation, no doubt some of them were exposed to too high doses. On the long run, it will cause health problems.

---------

Section for Labor Medicine at the University of Bergen has examined dentist assistants after the request from Brennpunkt, NRK1.

All of them were working during the same time span: 1960 – 1990.

25% of them reports that they often or very often have neurological problems.

They have been compared with a group of Nurses of same age.

Dentist assistants score sky high over Nurses on 4 points: (On the screen, graphs are shown, showung that Dentist assistants had from 2 to 10 times more symptoms when comapred with nurses. )

1. Tremor / shaking
2. Heart and lung problems.
3. Depression
4. Lack of memory / memory failure

Reporter: Extremely conservative estimation would be that 10,000 women were working as dentist assistants in Norway during the time span: 1960 – 1990

Not all of them were working under equally bad circumstances and some of them tolerate mercury better then the others. But there is a little doubt that many have inhaled too much toxic fumes.

STAMI has concluded the same in an interview with us.

But, there is now a new problem.

The lack of data and the lack of urine tests is why STAMI states: it is impossible for them to find out more about what has happened.

STAMI expert: The biggest part of the problem is that we have very bad documentation on the individual level: how much and how high exposure was on every single person, and that makes research difficult or impossible.

Reporter : But, others do not agree with STAMI.

Maths Berlin states that it is possible to do brain MRI examination of dental assistants. MRI will be sufficient enough to chart damages and injuries.

In USA, Diana Echeverria relieve that it is possible to do the research the way she has done it: with the help of survey forms and neurological tests.

Researchers of the In the University of Bergen states that results of the research that they have done is so alarming that they are ready to go further with it. But, in that case, someone must come with money.

If that doesn't happen, then the answer will not come before dentist assistants are dead. Under autopsy, mercury is found in brain.

Today, there are strict restrictions on the use of mercury and Environment Protection Minister is considering total ban on use of Mercury because it is so toxic.

Nobody said that to Tordis Klausen. She didn't know that job she is doing every day can lead to poisoning. She found that out alone. Today, she is angry with everyone who should have known.

Tordis Klausen : Norwegian Health Ministry, Social Health Department, Communal and Labor Department, STAMI, Norwegian Labour Inspection Authority, they are responsible! They have had responsibility to inform us, and to give us knowledge how to protect us.

No one of those women have received Work Related Injury Compensation.

Last years, Gerd Irene Lyse has gone from doctor to doctor, trying to find one that wants to listen to her.

Reporter: Irene Lyse, you re 50 years old, and you are on Disability Pension.

Irene Lyse: Yes, unfortunately, I am unable to work.

Reporter: 2 days after this interview, I went with Irene Lyse to a new doctor with hope that he will listen to her. Doctor offered one new pain killer. Later, we found out is an anti-depressant.

This report will be aired again on Thursday, May 12, at 10:30. If you need to talk with someone, you can call +47 55 27 57 96

End of Brennpunkt report.

NRK web site: http://nrk.no/

Transleted by Rune from a report aired in Norwegian Language.

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