A scoping review of systematic reviews on human exposure to mercury

Abstract: Introduction: in 2018, the promulgation of the Minamata Convention in Brazil encouraged compliance with its goals of reducing mercury use and pollution. Objective: to characterize the scientific production and identify the knowledge gaps to subsidize decision-making in healthcare on human exposure to mercury. Methods: a scoping review was carried out of systematic reviews and metanalysis, without language and publication date restriction, retrieved from the PubMed, BVS, and Cochrane Library databases. Results: a total of 71 studies met the eligibility criteria, of which 40 were systematic reviews, 30 meta-analyses, and one overview. Dental amalgam as well as food and environmental contamination by mercury-based activities were the most cited sources of exposure. Most studies focused on mental and behavioral disorders, as well as the use of biomarkers and neurobehavioral tests related to mercury exposure. Discussion: knowledge gaps on occupational exposure to mercury, mercury use in both traditional practices and cosmetics point to the need for further studies. The reviews identified could provide data for evidence synthesis and healthcare protocols for affected populations, as well as for elaborating public policies aimed at controlling mercury use and exposure.

摘要：引言：2018年巴西正式颁布《水俣公约（Minamata Convention）》，推动各方落实减少汞使用与汞污染的相关目标。研究目的：系统梳理现有科学研究产出情况，并识别相关知识缺口，以期为人类汞暴露相关医疗卫生领域的决策提供支撑。研究方法：本研究为范围综述，检索了PubMed数据库、卫生虚拟图书馆（BVS）、考克兰图书馆（Cochrane Library）收录的系统综述与荟萃分析文献，未对语言及发表时间设置限制。研究结果：共计71项研究符合纳入标准，其中40项为系统综述、30项为荟萃分析，另有1项概述性综述。牙科汞合金、涉汞活动引发的食品与环境污染是被引用频次最高的汞暴露来源。绝大多数研究聚焦于精神与行为障碍，以及与汞暴露相关的生物标志物检测与神经行为测试。讨论：现有研究在汞职业暴露、传统习俗与化妆品中汞使用相关领域存在明显知识缺口，亟需开展进一步研究。本研究纳入的综述类文献可为受影响人群的证据综合与医疗卫生诊疗方案制定提供数据支持，同时也可为制定旨在管控汞使用与汞暴露的公共政策提供参考。