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Global Go To Think Tank Index (GGTTI) 2020 launched                    111,75 Think Tanks across the world ranked in different categories.                SDPI is ranked 90th among “Top Think Tanks Worldwide (non-US)”.           SDPI stands 11th among Top Think Tanks in South & South East Asia & the Pacific (excluding India).            SDPI notches 33rd position in “Best New Idea or Paradigm Developed by A Think Tank” category.                SDPI remains 42nd in “Best Quality Assurance and Integrity Policies and Procedure” category.              SDPI stands 49th in “Think Tank to Watch in 2020”.            SDPI gets 52nd position among “Best Independent Think Tanks”.                           SDPI becomes 63rd in “Best Advocacy Campaign” category.                   SDPI secures 60th position in “Best Institutional Collaboration Involving Two or More Think Tanks” category.                       SDPI obtains 64th position in “Best Use of Media (Print & Electronic)” category.               SDPI gains 66th position in “Top Environment Policy Tink Tanks” category.                SDPI achieves 76th position in “Think Tanks With Best External Relations/Public Engagement Program” category.                    SDPI notches 99th position in “Top Social Policy Think Tanks”.            SDPI wins 140th position among “Top Domestic Economic Policy Think Tanks”.               SDPI is placed among special non-ranked category of Think Tanks – “Best Policy and Institutional Response to COVID-19”.                                            Owing to COVID-19 outbreak, SDPI staff is working from home from 9am to 5pm five days a week. All our staff members are available on phone, email and/or any other digital/electronic modes of communication during our usual official hours. You can also find all our work related to COVID-19 in orange entries in our publications section below.    The Sustainable Development Policy Institute (SDPI) is pleased to announce its Twenty-third Sustainable Development Conference (SDC) from 14 – 17 December 2020 in Islamabad, Pakistan. The overarching theme of this year’s Conference is Sustainable Development in the Times of COVID-19. Read more…       FOOD SECIRITY DASHBOARD: On 4th Nov, SDPI has shared the first prototype of Food Security Dashboard with Dr Moeed Yousaf, the Special Assistant to Prime Minister on  National Security and Economic Outreach in the presence of stakeholders, including Ministry of National Food Security and Research. Provincial and district authorities attended the event in person or through zoom. The dashboard will help the government monitor and regulate the supply chain of essential food commodities.

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Published Date: Nov 6, 2015

Regulating Mercury Amalgam Use at Private Dental Clinics in Pakista (PB – 45)


Mercury, one of the most hazardous chemicals, has become a
growing issue of global concern because of its adverse environmental and health
impacts (ATSDR 2011). Despite its toxic properties, mercury is widely used in
dental amalgams for filling cavities caused by caries (SOU 2003). Dental
amalgam is typically composed of approximately 50% mercury, 34.5% silver, 9%
tin, 6% copper, and 0.5% zinc by weight (Alt Inc. 2005). The dentist’s
occupational exposure to mercury vaporus occurs to a large extent during direct
clinical work with preparation of dental amalgam restorative material, as well
as during cutting, filling and polishing operations (Morton et al. 2004; Ely,
1997). It is estimated that in human, 60 per cent of Mercury exposure results
from dental amalgam in the oral cavity via inhalation of mercury vapours and 40
per cent of mercury exposure is via ingestion (Spencer 2000). A person having
dental mercury amalgam filling on the average absorbs about 3-17micrograms of
mercury (Weinberg 2010). Mercury poisoning may damage the nervous system,
lungs, and kidneys. Exposure to mercury of vulnerable population (dental
professionals, healthcare workers, children, pregnant women, and elderly) is of
particular concern. The nervous system is most sensitive to mercury exposure
(OPH 2008). Children are more at risk from mercury poisoning, which affects
their neurological development and brain. According to the World Health
Organization, dentists are among the health professionals with higher
occupational exposure to mercury vapours (World Health Organization 1991;
Morton et al. 2004).

Very few investigations on mercury amalgam use in the
dentistry sector have been carried out in South Asia (including Pakistan) and
there is little data reported on mercury contamination of indoor/outdoor air at
dental healthcare sites, dental teaching institutions, hospitals & private
dental clinics. In Pakistan, mercury emission and transfer are mainly from
extraction and use of fuels, intentional use of mercury in industrial processes,
and in others, such as dental mercury-amalgam fillings, medical equipment’s,
waste deposition/land fillings and waste water-treatment (MoE 2000). Studies on
dental amalgam use and mercury contaminated waste disposal practices by dental
professionals in Pakistan have been reported by Rubina et al.  (2010) and Iqbal et al. (2011). SDPI studies
indicated alarmingly high mercury levels in the air (indoor as well as outdoor)
at 11 of the 34 visited dental sites (17 dental teaching institutions, 7
general hospitals & 10 dental clinics) in five main cities of Pakistan
(Khwaja & Maryum 2014; Khwaja et al. 
2014). Responses from dental professionals at 38 dental institutions in
Pakistan showed general unawareness among dental professionals regarding
mercury containing wastes and lack of awareness about health hazards of mercury
exposure to human health (Khwaja & Sadaf 2014). A recent study carried out
by Gul (2015) at Peshawar University, Pakistan 
on appropriate handling of mercury/mercury amalgam, environmentally unsound
management of biological samples (RBCs, plasma, urine, hair & nails) of
individuals with mercury dental amalgam (n=30) and controlled samples (n=30))
have shown mercury concentration 6 – 8 times higher than the controlled samples
(individuals without dental mercury amalgam). 

In view of the earlier SDPI studies mentioned
above, indicating high indoor air mercury levels within private dental clinics
and lack of awareness among dental professionals regarding mercury related
occupational health and safety issues, the present study was conducted to
assess the status of mercury amalgam use in private dental clinics. In the
light of the findings described and discussed in the following pages to
safeguard public health and for the protection of environment, it is strongly recommended that since
mercury amalgam use cannot be banned immediately in the country, its use may be
regularized and allowed subject to use of “Amalgam Separators,” “Capsulated
Mercury” and “Mechanized Mixing ban on use of mercury amalgam for children
(below 12 years age) and pregnant women. 
A review/revision of the curriculum currently being taught at medical
and dental colleges in the country should be conducted to ensure adequate
training towards minimizing mercury exposure, 
and mercury amalgam use in dentistry.