어린이의 구강 내 아말감 노출이 요중 수은농도에 미치는 영향

The Impact of Amalgam Exposure an Urinary Mercury Concentration in Children

  • 전은숙 (춘해보건대학교 치위생과) ;
  • 진혜정 (동의대학교 치위생학과) ;
  • 김은경 (경북대학교 치의학전문대학원 예방치과학교실) ;
  • 임상욱 (경북대학교 치의학전문대학원 예방치과학교실) ;
  • 송근배 (경북대학교 치의학전문대학원 예방치과학교실) ;
  • 최연희 (경북대학교 치의학전문대학원 예방치과학교실)
  • Jeon, Eun-Suk (Department of Dental Hygiene, Choonhae College of Health Sciences) ;
  • Jin, Hye-Jung (Department of Dental Hygiene, Dong-Eui University) ;
  • Kim, Eun-Kyong (Department of Preventive Dentistry, School of Dentistry, Kyungpook National University) ;
  • Im, Sang-Uk (Department of Preventive Dentistry, School of Dentistry, Kyungpook National University) ;
  • Song, Keun-Bae (Department of Preventive Dentistry, School of Dentistry, Kyungpook National University) ;
  • Choi, Youn Hee (Department of Preventive Dentistry, School of Dentistry, Kyungpook National University)
  • 투고 : 2013.12.19
  • 심사 : 2014.01.29
  • 발행 : 2014.03.31

초록

구강 내 아말감 충전물에 의해 인체에 유리되는 수은이 요중 수은농도에 미치는 영향에 대하여 관련성을 평가하고자 하였다. 이 연구는 대도시 일부지역의 2개 초등학교 1~4학년 학생 317명을 대상으로 6개월 간격으로 총 4번의 구강검진과 소변검사를 실시하였으며, 자료를 수합하여 분석한 결과 다음과 같은 결론을 얻었다. 각 조사 시점별 아말감 충전 여부에 따라 요중 수은농도를 비교한 결과, 모든 연구시기에서 아말감 충전한 대상자에서 아말감 비충전군에 비해 요중 수은농도가 높게 나타났으며, 2차 추적조사와 3차 추적조사는 통계적으로 유의한 차이가 있었다. 혼합모형 분석한 결과 아말감 한 치면이 증가할수록 현재 요중 수은농도에서 $0.028{\mu}g/g$ creatinine 증가하였다(p<0.001). 남학생에 비해 여학생에서 $0.065{\mu}g/g$ creatinine (p<0.001), 생선섭취 빈도에서 일주일에 3회 이상 섭취군에서 $0.099{\mu}g/g$ creatinine 증가하였다(p=0.001). 누적 요중 수은농도에서 아말감 한 치면이 증가 할수록 누적 요중 수은농도에서 $0.017{\mu}g/g$ creatinine 증가 하였다(p<0.001). 남학생에 비해 여학생에서 $0.071{\mu}g/g$ creatinine (p<0.001), 생선섭취 빈도에서 일주일에 3회 이상 섭취군에서 $0.110{\mu}g/g$ creatinine 증가하였다(p<0.001). 구강 내 아말감 충전물은 미량이라도 수은을 유리시켜 체내 요중 수은농도의 변화에 영향을 미치므로 이 연구결과를 토대로 구강 내 수은흡수를 최소화할 수 있는 기준이나 방안이 마련되어야 할 것이다.

This study aims to evaluate the impact of varying exposure to dental amalgam on urinary mercury levels in children by measuring the number of amalgam-filled teeth and the variance of mercury concentration in urine over a period of 2 years. A total of 317 (male 158, female 159) elementary school children (1st~4th graders) attending 2 schools in urban regions participated in this study. At 6-month intervals, 4 oral examinations were conducted to check any variance in the conditions of dental caries and the status of dental fillings. Also, urine tests were conducted followed by a questionnaire survey. To elucidate the factors potentially affecting the mercury concentration in urine, t-test, ANOVA, chi-square test and a mixed model were used for the analysis. Regarding the status of dental fillings in line with examination time periods, deciduous teeth had more amalgam-filled surfaces than those filled with resin, whereas permanent teeth had more resin-filled surfaces than those filled with amalgam. A significant relevance was found between the exposure to dental amalgam and urinary mercury levels. Specifically, subjects whose teeth surfaces had been filled with dental amalgam showed higher urinary mercury levels than those who had no dental amalgam fillings. Based on the analysis using the mixed model, the increase in the number of teeth surfaces filled with amalgam was found to be the factor affecting the increase in urinary mercury levels. The urinary mercury levels were found to be highly associated with the exposure to dental amalgam. The more the teeth surfaces filled with amalgam, the higher the urinary mercury levels. Hence, even a trace of dental amalgam fillings can liberate mercury, affecting the variance in the urinary mercury levels. These findings suggest that some criteria or measures should be developed to minimize the exposure to dental amalgam. Moreover, relevant further studies are warranted.

키워드

과제정보

연구 과제 주관 기관 : 한국연구재단

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