Overview
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Key numbers
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- biomonitoring campaigns conducted between 2007 and 2024. Median U-Hg levels declined from 0.76 ng mL−1
- SLO-HBM-II cohort, paralleling a decrease in the prevalence (from 65 to 3%) and the average number of dental
- However, its composition, of approximately 50% Hg⁰, Thus, U-Hg reflects not only inorganic and elemental Hg
- ally, of which 70–100 tons (20–30%) enter the waste used in about 30% of restorations in Slovenia, primarily
- major determinants, and to illustrate how such informa- each study are summarised in Table 1, additional details
- tion can support future assessments of amalgam phase- in the Supplementary Material Table S1.
- Table 1 Overview of Slovenian child cohorts included in the present analysis. More detailed information is available in the
- Study area(s) Urban (n = 1), rural (n = 1), Urban (n = 1), rural (n = 1) Urban (n = 1) Urban (n = 7), rural (n = 1), (potentially)
- Hg-contaminated (n = 1) Hg-contaminated (n = 3)
- numbers listed in Table S1). As these were observational consistently fell within assigned acceptance ranges.
- collected into nitric-acid solution pre-cleaned vessels (or by LOD/2. Differences between cohorts were evalu-
- evolved over the 17 years (Table 1). In the initial cohorts unmeasured local context shared by children residing in
- (LODs) were 0.10 ng mL−1 and 0.05 ng mL−1, respectively. The outcome variable was natural log-transformed
- – Model 1 (base model): sampling year as fixed effect cohorts (Kruskal–Wallis, p < 0.001; Table S3). The highest
- demographic and contextual covariates (age, sex, (Table 2; Table S4). When using creatinine-adjusted con-
- consumption). shifted (Table S4). These discrepancies likely reflect vari-
- mula: % reduction = (ꞵModel1—ꞵModel3)/ꞵModel1 × 100. (Fig. 1 and Figure S2; Table S5). Across the pooled data-
- whether the temporal trend differed by fish intake. time, from 65% in PHIME, 37% in DEMOCOPHES, 12%
- – Model 5: Model 4 with the addition of year × binary in CROME, to only 3% in SLO-HBM-II. Moreover, even
- difference between amalgam carriers and non- decreased across successive cohorts (Table 3; Fig. 1; Fig-
- recent cohorts from 19.7% in PHIME, 48.9% in CROME,
- Missing data and sensitivity analysis to 67.5% in SLO-HBM-II. Similar trends were observed
- The overall data missingness was low: 94.1% of chil- in Idrija and Ljubljana over the years (Fig. 1; Figure S2;
- (Table S2). As a sensitivity check, the same mixed-effects elling approach with random intercepts for town was
- the models are presented in Tables 4 and 5. In the base
- 1.46 was observed, with a geometric mean ratio (GMR) of
- ing an average annual decline of approximately 5.5%.
- The LODs for the PHIME, DEMOCOPHES, CROME, and SLO-HBM-II were: 0.1 ng mL−1, 0.05 ng mL−1, 0.06 ng mL−1, and 0.04 ng mL−1, respectively
- 12.4 effect, increasing the GMR to 0.977 (95% CI: 0.961,
- GM = geometric mean; Min = minimum; p25 = 25th percentile; p50 = 50th percentile (median); p75 = 75th percentile; Max = maximum
- Number of individuals with available urinary Hg concentration data. Missing data in µg g−1 creatinine: in 2007 (n = 1); in 2016 (n = 1)
- Table 2 Summary of U-Hg concentrations (in ng mL−1 and in µg g−1 creatinine) by study cohort and year
- < LOD high vs. low, all p < 0.001), indicating that, after adjust-
- 0.22 < LOD of dietary sources to U-Hg becomes more prominent.
- (ng mL.−1; median and interquartile range, left y-axis) and, on the right y-axis, the percentage of participants with at least one dental amalgam and the
- tion (Supplementary Material, Tables S6 − 7), indicating Slovenian children were low and comparable to those
- status (yes/no) was negative and borderline significant lations (6). The highest median U-Hg concentration was
- Table 3 Summary of basic participant characteristics by study cohort and year
- x ̄ = arithmetic mean; SD = standard deviation; BMI = body mass index; Amalgam Yes = indicator that child has dental amalgam filling(s); fish consumption: low = < 1
- Missing data on amalgam presence/number: in 2007 (n = 28)
- Table 4 Multilevel modelling of the temporal trend in urinary Hg concentrations (2007–2024). Year effect reduction (%) represents the
- Table 5 Multilevel mixed-effects models assessing effect modification of the temporal trend in urinary Hg (2007–2024). Models
Methods (brief)
- among children and shifts in the relative importance of sample. Most towns were sampled only once (within a
- established with school headmasters, followed by infor-
- Sample Spot morning urine Spot morning urine Spot random urine Spot morning urine
- Sample preparation Acid digestion (hot plate) Acid digestion (hot plate) Acid digestion (microwave) Acid digestion (microwave)
- THg determination CVAAS CVAAS ICP-MS ICP-MS
- LOD (ng mL−1) 0.10 0.05 0.06 0.04
- % samples < LOD 3.0 0.0 9.7 4.5
- Refers to the total number of recruited children. For SLO-HBM-II, a subsample consisting of children aged 6–9
- graphic data were collected consistently, whereas fish that required inclusion of at least one reference material
- assumed. Other key variables, including the number between the older CVAAS method and the newer ICP-
- of dental amalgam fillings, were collected comparably MS method. These procedures, along with continuous
- sample at their local primary school visit. Samples were Values below the limit of detection (LOD) were replaced
- collected into nitric-acid solution pre-cleaned vessels (or by LOD/2. Differences between cohorts were evalu-
- spot sample (not first-morning) at their appointed visit between the number of dental amalgam fillings and U-Hg
- to the Paediatric Clinic. All samples were transported to levels were investigated using Spearman’s correlation (ρ).
- cold vapor atomic absorption spectrometry (CVAAS) effect to estimate the overall temporal trend across the
- after acid digestion on a hot plate. The limits of detection entire dataset.
- (LODs) were 0.10 ng mL−1 and 0.05 ng mL−1, respectively. The outcome variable was natural log-transformed
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Update history
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