In the U.S., the number of women of child-bearing age practicing dentistry has dramatically increased over the last 15 years. Information is needed about the effects and mechanisms of known occupational toxins with regard to their manifestations in women's health and reproduction. Of particular concern in dentistry is the chronic low dose exposure to mercury vapor, occurring through the use of mercury in amalgam restorations. Mercury vapor is recognized to readily cross both the brain and placental barriers. Studies of the effect of mercury vapor exposure in animals have shown associations with a variety of serious adverse outcomes, suggesting the possibility of multiple mechanisms of effect. The purpose of this study is to determine if occupational mercury exposure affects the fecundability (time to pregnancy) or risk of spontaneous abortion for women dentists. The sampling frame for this mailed questionnaire will be women who graduated from dental school before 1987, of child bearing age, and are on the list of dentists maintained by the American Dental Association. This restriction enables the current study to relate estimated dental occupational exposures to outcome measures addressing several maternal and fetal consequences. The questionnaire is based on those used in other occupational and reproductive health studies. Some of the confounders an effect modifiers to be studies include; nitrous oxide, smoking, coffee, alcohol, reproductive history, age of the mother at pregnancy, other occupational exposures, and the occupation of the husband/partner. This study will help determine if dental practice patterns involving mercury exposure place the female dentist at increased risk for delay in conceiving or of adverse reproductive outcomes.
