Estimation of mercury emission from dental amalgam removal in South Korea : retrospective cross-sectional study

Objectives: Dental amalgam, containing approximately 50% mercury, is removed during treatment and released into the environment via medical waste incineration or sewage.This study estimated the annual mercury emission from amalgam removal in South Korea.Methods: Data on simple restoration removal (2014-2018) were obtained from a dental hospital's insurance claims and the Health Insurance Review and Assessment Service (HIRA).Amalgam removal rates were calculated and applied to national data.The average amalgam weight was 0.2 g (50% mercury).Results: Over 5 years, 4,668,490 amalgam restorations were removed.The estimated mercury emission was 466.84 kg total (mean 93.411.0kg/year; 95% CI, 372.2-536.8kg).Conclusions: Approximately 93.4 kg of mercury is annually released from amalgam removal, equivalent to discarding 9-18 million mercury-containing fluorescent lamps.Despite declining amalgam use, systematic separation and disposal guidelines are urgently needed.