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EPA Not Supportive of Ban on Mercury In Dental Fillings, Agency Official Testifies
While taking measures to prevent dental amalgams from getting into municipal water supplies can reduce the amount of mercury in wastewater, it is up to dentists whether to use mercury amalgam fillings, the head of the Environmental Protection Agency's science office told a House subcommittee Oct. 8.
Dental practices have come under fire from environmental advocates and others who want mandatory requirements for dental offices to reduce the effects of mercury pollution.
"Alternatives to mercury-containing dental amalgams exist. As fewer
mercury-containing dental amalgams are provided as treatment, they will become
less a source of mercury in the environment," Geoffrey Grubbs, director of EPA's
Office of Science and Technology, testified before the Government Reform
Subcommittee on Wellness and Human Rights. However, Grubbs said, "The choice of
dental treatment rests solely with dental professionals and their patients."
Mercury is a naturally occurring element present throughout the environment.
According to EPA, when mercury enters water, biological processes transform it
to a highly toxic form that builds up in fish and animals that eat fish.
Subcommittee Chairman Dan Burton (R-Ind.) said he has led a two-year
investigation into the dangers of using mercury in common dental and medical
procedures. At the hearing, he questioned why mercury amalgams continue to be
used in human dentistry and urged its use be stopped. Amalgams, which are used
by dentists to fill teeth, are metallic alloys consisting of mercury, silver,
copper, and tin.
"As the dangers of mercury have become more widely understood, federal, state,
and local agencies have acted to eliminate mercury from common items such as
thermometers, blood pressure gauges, light switches, cosmetics, and teething
powder," Burton said.
"Yet, despite all the evidence to the contrary, mercury amalgam fillings
continue to be routinely used in human dentistry," he said.
Burton cited an estimate by the Association of Metropolitan Sewerage Agencies
(AMSA) that it costs as much as $21 million per pound to safely remove mercury
once it becomes part of the waste stream.
'Staggering' Cost
If the American Dental Association's estimate is correct that approximately 6.5
tons of mercury enter public wastewater treatment facilities from dental offices
every year, Burton said, the cost to remove that amount of mercury would be
approximately $273 billion annually.
"That is a staggering amount of money," Burton said. "A more cost-effective
solution would be to simply stop the mercury contamination at the source, within
the dentists' offices."
Michael Bender, director of the Mercury Policy Project, criticized the American
Dental Association. "It is like pulling teeth to get ADA to support efforts to
reduce mercury pollution and unnecessary use, even though dentists are the
number one contributor to the nation's wastewater and still one of the largest
mercury users in the United States today," he said in a prepared statement.
Operators of public wastewater treatment plants want to help reduce mercury
releases to the environment, but the plants are not designed to remove toxics
like mercury, according to Norman LeBlanc, chairman of the AMSA Water Quality
Committee. Citing a 2002 AMSA study conducted under a cooperative agreement with
EPA, he said an average of 35 percent to 40 percent of the mercury entering
wastewater treatment plants is attributable to dental offices.
"While human waste and food products are significant sources of mercury, they
are not controllable," LeBlanc said. "Consequently, dental offices must be a
component of most pretreatment efforts to control mercury."
AMSA supports legislation that would create a national task force or another
type of interagency working group to evaluate issues surrounding mercury in the
environment, LeBlanc said.
Frederick C. Eichmiller, director of the American Dental Association
Foundation's Paffenbarger Research Center in Gaithersburg, Md., testified the
association's voluntary "best management practices" for amalgam waste has as its
goal 100 percent recycling of the amalgam waste captured by dental offices.
The dental association is proposing that EPA convene a working group composed of
representatives from the agency, ADA, state regulators, amalgam manufacturers
and recyclers, and dental disposal companies to identify and eliminate barriers
to recycling. Eichmiller said the association would work with EPA to implement
the most effective ways to educate members about the benefits of best management
practices.
Dentists also propose that EPA work with the dental association to develop
guidance that would recommend approaches for states to take to encourage the
reduction of amalgam discharges from dental offices to sewer systems. In
addition, the ADA supports the establishment of grants to install mercury
collection technology, Eichmiller said.
At its annual meeting Oct. 23-24 in San Francisco, the ADA plans to vote on
voluntary resolutions to reduce dental office mercury amalgam discharges into
wastewater.
Dispute Over Use of Amalgam Separators
Bender criticized an ADA document submitted to EPA arguing that reducing dental
mercury pollution through the installation of amalgam separators is not
cost-effective or necessary. The ADA document also attempts to persuade EPA not
to support the widespread installation of amalgam separators, as do laws and
policies in Connecticut, New Hampshire, and Maine, according to Bender.
David V. Galvin, a program manager for the King County Department of Natural
Resources and Parks, based in Seattle, described the results of a voluntary
program the county conducted with the local dental society to encourage the
purchase and installation of amalgam separator units, which research showed
would allow a dentist to meet the county's local mercury limits. After six
years, he said, 24 dental offices, out of approximately 900, installed amalgam
separators.
"A voluntary program did not result in significant change in King County," he
said. "Once separators were mandated, compliance happened quickly, dramatically,
and with little resistance."
By Linda Roeder