Testimony at the Maine Legislature
by Jon Hinck, NRCM toxics project director
Good afternoon Senator Cowger, Representative Koffman and members of the Natural Resources Committee. My name is Jon Hinck. I am Staff Attorney and Toxics Project Director with the Natural Resources Council of Maine (NRCM).
NRCM is neither for nor against LD 1327 and LD 1338 in current form but would support amendments to encourage reduction and phase out of dental mercury.
Dentistry remains a significant source of mercury to the environment. This despite important and commendable strides forward, including an overall trend of diminished use of mercury amalgam fillings and widespread installation throughout Maine of amalgam separators pursuant to a law passed by this Committee and the full legislature in 2003.
NRCM offers no opinions regarding the health effects of direct exposure to mercury from the presence of mercury fillings in the mouth. We also do not claim to have expertise on dentistry or the merits of each of the dental treatment options.
We have, however, reviewed relevant environmental data and recognize that mercury amalgam remains a significant source of dangerous mercury pollution that reaches the water and air via sewage treatment plants, crematoria and other mechanisms. Consequently, NRCM encourages a steady phase out of the use of mercury-containing amalgams to the extent compatible with good dental practices. Though we are not prepared to recommend a date certain for a ban on the use of dental amalgams, we encourage the legislature to make policy changes to provide incentives for the use of alternatives to dental mercury.
To this end, certain provisions in the bills before you should be strengthened. For example, the state could do more with respect to dental insurance. LD 1338 provides for consumer choice of filling materials, but continues an unfortunate aspect of the status quo. Currently, and under the bill, third party payors, like government dental plans and insurers, limit coverage for fillings to an amount equal to the cost of the lowest priced filling. The lowest priced filling typically is mercury amalgam. Therefore, covered patients must pay extra to avoid mercury. A government-appointed Mercury Task Force in New Jersey completed a thorough review of dental mercury issues and recommended that state insurance contracts not cover amalgam fillings at all.[1] Rhode Island law already requires that state dental insurance contracts negotiated after January 1, 2003 provide coverage for non-mercury fillings at no additional expense to the state employee.[2] Such measures should be implemented here, and similar regulation of the private sector dental insurance plans should also be evaluated.
NRCM supports the provision in LD 1338 of making mandatory “best practices” rules for limiting mercury releases to the environment. On the other hand, we see no reason why the bill includes a liability provision to limit the rights harm of those that can prove harm caused by dental mercury to seek redress in the courts.
There are important environmental reasons to encourage the rapid phase-out of mercury in dentistry. Policymakers in Maine are well aware of the unfortunate effects that the use of mercury has had on our environment. In recent years, this Committee has led efforts to reverse the problem. But the job is not finished. Due to unsafe mercury levels, Maine’s Bureau of Health maintains strict fish consumption advisories for most of the fresh water fish found in Maine’s lakes, rivers and streams.
Federal studies show that the dental sector is the third largest user of mercury in the United States.[3] In 2004, the Environmental Protection Agency (EPA) estimated that dental clinics use 34 tons of mercury annually, 14% of the total annual mercury consumption in the U.S.
Approximately 100 million amalgams are placed in patients’ teeth each year by 175,000 U.S. dentists.[4] This annual mercury input has added up over time. It is estimated that there are currently over 1,000 tons of mercury in the mouths of U.S. residents–more than half of all mercury currently in use in all products.[5] All portions of this giant reservoir that are not captured and managed end up in the environment.
Dental mercury takes many routes to the air, land and water. Until the recent installation of amalgam separators, one major route was simply down the drain. Direct
disposal into wastewater and septic systems should by now greatly reduced and we thank Maine dentists for their efforts to address this mechanism. But other pathways remain. These include:
These last two mechanisms, human waste and cremation, though somewhat uncomfortable subjects, will continue to be a problem so long as mercury is used in dental fillings. I would like to summarize each in turn.
Sewage treatment plants in turn discharge mercury from sewer users that passes through the treatment system. Therefore, to protect our rivers and streams and to meet strict water quality standards for mercury, it is critical for sewer users to reduce, and wherever possible eliminate, their use and discharge of mercury. This applies to dental amalgam just as much as to hospitals or industries that use mercury or mercury-added products.
In summation, the legislature, as it considers this issue, should be aware that mercury fillings can be a significant source of mercury to sewage treatment plants and the state’s waters as well as mercury air emissions. Supporting environmentally sound replacements for amalgam fillings should be a part of efforts to reduce mercury use and pollution overall. I would be happy to answer any questions you may have. ——————————————————————————– [1] NJ Mercury Task Force Report (December 2001) [2] Rhode Island Mercury Reduction and Ed. Act, Gen. Laws, 23 Health and Safety §§ 23-24.9-15. (“ State dental insurance contracts negotiated after January 1, 2003, shall provide coverage for non-mercury fillings at no additional expense to the state employee.”) [3] U.S. E.P.A., International Mercury Market Study and the Role and Impact of US Environmental Policy, 2004 (“Switches and Relays” = 42%; “Measuring Devices” = 28%; Dental Amalgam =14%; Thermostats = 8%.) [4] Water Environment Federation, “Controlling Dental Facility Discharges in Wastewater, Alexandria, VA,” 1999; King County Department of Natural Resources, “
[5]U.S. E.P.A, Int’l Mercury Market Study and the Role and Impact of US Environmental Policy, 2004. [6] O’Conner Environmental Assoc. Inc., “
[7] . American Metropolitan Sewerage Agencies, “
[8] amsa-cleanwater.org/pubs/mercury/mercury.htm [9] USEPA. 1997. Mercury Study Report to Congress. Volume II: An Inventory of Anthropogenic Mercury Emissions in the United States. PP. 4-28, 4-36.