The association between serotonin transporter gene promoter polymorphism (5-HTTLPR), self-reported symptoms, and dental mercury exposure

J Toxicol Environ Health A. 2008;71(19):1318-26. doi: 10.1080/15287390802240850.


The associations between a polymorphism of the serotonin transporter gene (5-HTTLPR), dental mercury exposure, and self-reported symptoms were evaluated among 157 male dentists and 84 female dental assistants. Self-reported symptoms and detailed work histories were obtained by computerized questionnaire. Spot urine samples were collected and analyzed for mercury concentrations to evaluate recent exposures, whereas a chronic mercury exposure index was created from the work histories. 5-HTTLPR polymorphism status was determined using a polymerase chain reaction (PCR)-based assay. Scores for current, recent, and chronic self-reported symptom groups were evaluated with respect to recent and chronic mercury exposure and 5-HTTLPR polymorphism status. Multiple regression analysis controlled for age, socioeconomic status, tobacco and alcohol use, self-reported health problems, and medications. Analyses were restricted to Caucasian subjects due to the highly skewed distribution of the 5-HTTLPR polymorphism. Separate evaluations were conducted for dentists and dental assistants. In contrast to previous reports, no consistent associations were found between either urinary mercury concentration or the chronic index of mercury exposure and any category of symptoms. However, both significant and consistent associations were observed between increased symptoms and the 5-HTTLPR polymorphism involving two copies of the short or "s" allele (full mutation), but not with the polymorphism involving only one copy (heterozygous), demonstrating a gene-dose relationship for symptom reporting. These findings suggest that within this restricted population increased symptoms of depression, anxiety, and memory are associated with the 5-HTTLPR polymorphism among both males and females.

MeSH terms

  • Anxiety / genetics
  • Cohort Studies
  • Dental Amalgam / chemistry
  • Dental Amalgam / toxicity*
  • Dental Assistants
  • Dentists
  • Depression / genetics
  • Female
  • Genetic Predisposition to Disease / genetics*
  • Health Surveys
  • Humans
  • Male
  • Memory Disorders / genetics
  • Mercury / urine
  • Mercury Poisoning, Nervous System / genetics*
  • Occupational Diseases / genetics
  • Occupational Exposure / adverse effects*
  • Polymorphism, Single Nucleotide / genetics*
  • Serotonin Plasma Membrane Transport Proteins / genetics*
  • White People


  • SLC6A4 protein, human
  • Serotonin Plasma Membrane Transport Proteins
  • Dental Amalgam
  • Mercury