<DOC>
[108th Congress House Hearings]
[From the U.S. Government Printing Office via GPO Access]
[DOCID: f:91841.wais]
THE ENVIRONMENTAL IMPACT OF MERCURY-CONTAINING DENTAL AMALGAMS
=======================================================================
HEARING
before the
SUBCOMMITTEE ON HUMAN RIGHTS AND WELLNESS
of the
COMMITTEE ON
GOVERNMENT REFORM
HOUSE OF REPRESENTATIVES
ONE HUNDRED EIGHTH CONGRESS
FIRST SESSION
__________
OCTOBER 8, 2003
__________
Serial No. 108-102
__________
Printed for the use of the Committee on Government Reform
Available via the World Wide Web: http://www.gpo.gov/congress/house
http://www.house.gov/reform
________
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COMMITTEE ON GOVERNMENT REFORM
TOM DAVIS, Virginia, Chairman
DAN BURTON, Indiana HENRY A. WAXMAN, California
CHRISTOPHER SHAYS, Connecticut TOM LANTOS, California
ILEANA ROS-LEHTINEN, Florida MAJOR R. OWENS, New York
JOHN M. McHUGH, New York EDOLPHUS TOWNS, New York
JOHN L. MICA, Florida PAUL E. KANJORSKI, Pennsylvania
MARK E. SOUDER, Indiana CAROLYN B. MALONEY, New York
STEVEN C. LaTOURETTE, Ohio ELIJAH E. CUMMINGS, Maryland
DOUG OSE, California DENNIS J. KUCINICH, Ohio
RON LEWIS, Kentucky DANNY K. DAVIS, Illinois
JO ANN DAVIS, Virginia JOHN F. TIERNEY, Massachusetts
TODD RUSSELL PLATTS, Pennsylvania WM. LACY CLAY, Missouri
CHRIS CANNON, Utah DIANE E. WATSON, California
ADAM H. PUTNAM, Florida STEPHEN F. LYNCH, Massachusetts
EDWARD L. SCHROCK, Virginia CHRIS VAN HOLLEN, Maryland
JOHN J. DUNCAN, Jr., Tennessee LINDA T. SANCHEZ, California
JOHN SULLIVAN, Oklahoma C.A. ``DUTCH'' RUPPERSBERGER,
NATHAN DEAL, Georgia Maryland
CANDICE S. MILLER, Michigan ELEANOR HOLMES NORTON, District of
TIM MURPHY, Pennsylvania Columbia
MICHAEL R. TURNER, Ohio JIM COOPER, Tennessee
JOHN R. CARTER, Texas CHRIS BELL, Texas
WILLIAM J. JANKLOW, South Dakota ------
MARSHA BLACKBURN, Tennessee BERNARD SANDERS, Vermont
(Independent)
Peter Sirh, Staff Director
Melissa Wojciak, Deputy Staff Director
Rob Borden, Parliamentarian
Teresa Austin, Chief Clerk
Philip M. Schiliro, Minority Staff Director
Subcommittee on Human Rights and Wellness
DAN BURTON, Indiana, Chairman
CHRIS CANNON, Utah DIANE E. WATSON, California
CHRISTOPHER SHAYS, Connecticut BERNARD SANDERS, Vermont
ILEANA ROS-LEHTINEN, Florida (Independent)
ELIJAH E. CUMMINGS, Maryland
Ex Officio
TOM DAVIS, Virginia HENRY A. WAXMAN, California
Mark Walker, Staff Director
John Rowe, Professional Staff Member
Danielle Perraut, Clerk
Richard Butcher, Minority Professional Staff Member
C O N T E N T S
----------
Page
Hearing held on October 8, 2003.................................. 1
Statement of:
Eichmiller, Dr. Fredrick, director, American Dental
Association Health Foundation, Paffenbarger Research
Center, National Bureau of Standards & Technology,
accompanied by Jerome Bowman, ADA staff attorney; Norman
LeBlanc, chief, technical services, Hampton Roads
Sanitation District; Peter Berglund, PE, principal
engineer, Metropolitan Council of Environmental Services,
Industrial Waste Section; and David Galvin, project
manager, Hazardous Waste Management Program, King County
Department of Natural Resources and Parks, Water and Land
Resources Division......................................... 37
Grubbs, Geoffrey, Director, Office of Science and Technology;
and Capt. James Ragain, Jr., Dental Corps, U.S. Navy,
accompanied by CDR. John Kuehne, U.S. Navy; and Dr. Mark
Stone, Program Manager for the NIDBR Mercury Abatement
Program.................................................... 7
Letters, statements, etc., submitted for the record by:
Berglund, Peter, PE, principal engineer, Metropolitan Council
of Environmental Services, Industrial Waste Section,
prepared statement of...................................... 53
Burton, Hon. Dan, a Representative in Congress from the State
of Indiana, article dated October 7, 2003.................. 2
Cummings, Hon. Elijah E., a Representative in Congress from
the State of Maryland, prepared statement of............... 27
Eichmiller, Dr. Fredrick, director, American Dental
Association Health Foundation, Paffenbarger Research
Center, National Bureau of Standards & Technology, prepared
statement of............................................... 40
Galvin, David, project manager, Hazardous Waste Management
Program, King County Department of Natural Resources and
Parks, Water and Land Resources Division, prepared
statement of............................................... 64
Grubbs, Geoffrey, Director, Office of Science and Technology,
prepared statement of...................................... 10
LeBlanc, Norman, chief, technical services, Hampton Roads
Sanitation District, prepared statement of................. 58
Ragain, Capt. James, Jr., Dental Corps, U.S. Navy, prepared
statement of............................................... 21
Watson, Hon. Diane E., a Representative in Congress from the
State of California, prepared statement of................. 79
THE ENVIRONMENTAL IMPACT OF MERCURY-CONTAINING DENTAL AMALGAMS
----------
WEDNESDAY, OCTOBER 8, 2003
House of Representatives,
Subcommittee on Human Rights and Wellness,
Committee on Government Reform,
Washington, DC.
The subcommittee met, pursuant to notice, at 4 p.m., in
room 2157, Rayburn House Office Building, Hon. Dan Burton
(chairman of the subcommittee) presiding.
Present: Representatives Burton and Cummings.
Staff present: Mark Walker, staff director; John Rowe and
Brian Fauls, professional staff member; Danielle Perraut,
clerk; Nick Mutton, press secretary; Richard Butcher, minority
professional staff member; and Cecelia Morton, minority office
manager.
Mr. Burton. A quorum being present, the Subcommittee on
Human Rights and Wellness will come to order. I ask unanimous
consent that all Members and witnesses' written and opening
statements be included in the record. Without objection, so
ordered. I ask unanimous consent that all articles, exhibits
and extraneous or tabular material referred to be included in
the record. Without objection, so ordered.
Recently, there was an incident at a local high school here
in D.C. that rightfully received front page news and that
dramatically illustrates the danger of mercury toxicity. Just
last week, several students walked into an unlocked chemistry
lab, stole a vial of mercury and decided to splash it all over
the floors and walls of the school. The result was an immediate
evacuation and closure of the building. The building could be
closed for as long as 4 months while authorities work to ensure
that all traces of the mercury have been eliminated. During the
extensive cleanup process, students will have to attend classes
in uncontaminated buildings and they have been instructed to
turn in the clothes that they were wearing and their shoes that
they wore that day of the incident to have them decontaminated.
[The information referred to follows:]
[GRAPHICS NOT AVAILABLE IN TIFF FORMAT]
Mr. Burton. I am sure that everyone here today would agree
that these precautions make perfect sense in order to safeguard
and protect the health of the students, teachers and staff. I
personally believe that there is no more important function of
government than doing everything in its power to protect the
health and well-being of its citizens. That is why as chairman
of the House Committee on Government Reform and now the
chairman of the Subcommittee on Human Rights and Wellness, I
have led a 2-year-long investigation into the dangers of using
highly toxic mercury in everyday medical and dental procedures.
Mercury is one of the most toxic elements found in nature,
second only to radioactive materials. While some minerals are
beneficial to human life, mercury is most assuredly not,
because the human body was not designed or ever meant to ingest
mercury. Consequently, the human body has no effective filter
or elimination system for it. The end result is that much of
the ingested mercury accumulates in the body's tissue,
including the nervous system and vital organs, such as the
brain.
Previous committee and subcommittee hearings have focused
on the dangers of mercury-containing thimerosal in vaccines and
mercury-containing dental amalgam fillings. In each case,
credible witnesses provided clear and convincing scientific
testimony that links mercury in the human body to a variety of
developmental and neurological disorders from modest declines
in intelligent quotient, to tremors, Alzheimer's disease and
autism.
As the dangers of mercury have become more widely
understood, government agencies on the Federal, State and local
level have acted to eliminate mercury from common items like
thermometers, blood pressure gauges, light switches, cosmetics
and teething powder. Yet despite all the evidence to the
contrary, mercury amalgam fillings continue to be routinely
used in human dentistry. Collectively Americans are walking
around today with 800 metric tons of mercury in their mouths
and tens of millions of mercury-containing fillings continue to
be put into Americans' teeth every single year. In spite of
overwhelming evidence that mercury is especially dangerous to
young children and women of child-bearing age, millions of
mercury amalgams continue to be placed in their mouths every
single year, and dentists cannot honestly say that they are not
aware of the dangers of mercury.
In fact, dentists take routine precautions against this
dangerous substance. Mercury-containing amalgam scraps and
extracted teeth with amalgam fillings according to protocol
must be stored in sealed jars under liquid until a special
hazardous materials recycler picks them up for special
disposal. Unfortunately, a lot of them get into the water
supply.
If dentists are aware of the dangers of mercury, why is
this toxic material still being used? The answer is that the
dental establishment continues to hold to the scientific
fiction that a material that is hazardous before it goes into
your mouth and hazardous after it comes out of your mouth is
somehow perfectly safe while it is in your mouth. This
disconnect in logic simply does not make sense and it flies in
the face of a growing body of credible scientific evidence.
The fact is that dentistry continues to dangerously expose
humans to mercury, both through direct implantation of amalgams
into patients' teeth and again during the disposal process by
increasing the amount of mercury in our wastewater treatment
plants.
The Association of Metropolitan Sewerage Agencies [AMSA],
estimates that on average dentists contribute 35 to 40 percent
of the influent mercury received by publicly owned sewerage
treatment plants. In many municipalities, dentists are the
highest, largest source of wastewater mercury.
And as an element, mercury remains always mercury.
Wastewater treatment plants cannot simply treat it. It must
be completely removed from the wastewater system and stream.
If the mercury is not removed, heavy particles of mercury
settle into treatment plant sludge. Eventually that sludge
either gets incinerated, releasing its mercury directly into
the atmosphere or it gets spread out on agricultural fields as
fertilizer. Over time, bacteria help recirculate that mercury
back into the environment. So mercury that ultimately escapes
into the environment inevitably ends up in the food we eat and
the air we breathe.
AMSA has estimated that it costs as much as $21 million per
pound to safely remove mercury once it becomes part of the
wastewater stream. If the American Dental Association's
estimate is correct that approximately 6\1/2\ tons of mercury
enter public wastewater treatment facilities from dental
offices every year at $21 million per pound, the cost to remove
that amount of mercury would be approximately $273 billion
annually. That is a staggering amount of money.
A more cost effective solution in my opinion would be to
simply stop the mercury contamination at its source within the
dentists' offices. The technology to do just that exists today.
The only thing standing in the way of using it is professional
inertia.
Today's hearing will examine the facts surrounding dental
amalgam's impact on the environment, discuss some cost
effective measures to mitigate that impact and to promote
improved mercury-safe communities for all Americans. I look
forward to hearing what our expert witnesses have to say today.
Many of my colleagues because of the lateness of the hour
had to catch planes, and so I apologize for them not being
here. We have some of their statements which we will include in
the record. I am told that Mr. Sanders and Mr. Cummings will be
here shortly.
In the meantime, I would like to bring our first witnesses
to the table and have them sworn. Mr. Geoffrey Grubbs, Director
of the Office of Science and Technology at the EPA, and Captain
James Ragain Jr. with the Dental Corps of the U.S. Navy.
Would you please stand and raise your right hands? We have
two other people with you. Would you identify them?
Captain Ragain. Yes, sir. On my immediate left is Commander
John Kuehne, U.S. Navy, and Dr. Mark Stone.
Mr. Burton. Very good. They might participate, so I will
have them raise their right hands, too.
[Witnesses sworn.]
Mr. Burton. Mr. Grubbs, would you want to start or Captain
Ragain?
STATEMENTS OF GEOFFREY GRUBBS, DIRECTOR, OFFICE OF SCIENCE AND
TECHNOLOGY; AND CAPT. JAMES RAGAIN, JR., DENTAL CORPS, U.S.
NAVY, ACCOMPANIED BY CDR. JOHN KUEHNE, U.S. NAVY; AND DR. MARK
STONE, PROGRAM MANAGER FOR THE NIDBR MERCURY ABATEMENT PROGRAM
Mr. Grubbs. I will be glad to start. With your permission,
I would like to submit the entire statement for the record and
just touch on a few quick highlights in the interest of time
here.
Mercury persists in the environment and under certain
conditions inorganic mercury in fresh and salt water is
transformed by microorganisms into organic methylmercury. This
transformation enables mercury to accumulate in the tissue of
fish and other organisms. Relatively higher concentrations can
be found in the top of the food chain in larger ocean going
predatory fish.
Moving to the next page of my testimony so you can follow
along in my skipping here, concentrations in water of mercury
from all sources are low and of little immediate health
concern, referring to acute toxicity problems. The greatest
mercury exposure and the greatest potential risk exists for
those persons who regularly eat fish containing elevated levels
of methylmercury over long periods of time. Approximately 8
percent of reproductive aged women in a recent study conducted
by the Centers for Disease Control within HHS had blood mercury
concentrations higher than a safe level based on EPA's
reference dose and that is the level that EPA has determined is
safe. Forty-four States, one territory and three tribes have
issued fish consumption advisories for mercury contaminated
fish, all of whom are based, or nearly all of them are based on
EPA's advice.
I am going to skip to the section marked Mercury in Dental
Waste on page 3. Dental amalgam contributes a small proportion
of all mercury released to the environment from human
activities. Virtually all releases of dental amalgam to water
are through municipal wastewater facilities. A recent study by
the American Metropolitan Sewerage Authorities found that
dental clinics account for an average of more than 35 percent
of the mercury influent to the sewerage treatment plants.
An American Dental Association survey indicates that in
1996 the dental industry used 31 metric tons of mercury. The
majority of waste dental mercury amalgam from chairside drains
is removed by traps and vacuum filters but according to several
reports, 25 to 40 percent of the mercury-containing amalgam
waste is discharged to sewer systems. The physical processes
used in sewerage treatment plants remove about 95 percent of
the mercury received in wastewater. The mercury removed from
wastewater then resides in the biosolids or it is sometimes
called sludges generated during primary and secondary treatment
processes. EPA estimates that sewage sludge nationally contains
about 15 tons of mercury per year and this is from all sources,
not just from dental amalgam. Sewerage treatment plants
discharge about a half a ton of mercury to surface waters per
year nationally, again from all sources.
We do not know exactly the proportion of mercury that is
found in fish originates in dental amalgam as compared to other
mercury sources. The mercury contained in amalgam is not
methylmercury and tends to stay bound in the amalgam. However,
dental amalgam can break down and at least one report has shown
that it can be released into the environment.
The amount of mercury from dental amalgams that is
methylated is not currently known. The American Dental
Association has identified numerous best management practices
for reducing mercury waste from dental amalgam, including
chairside screens and traps. Amalgam separators are available
at a relatively low cost to remove fine particles of waste
amalgam. The choice of dental treatment rests solely with
dental professionals and their patients and EPA does not intend
to second-guess those treatment decisions. However, over time
as fewer mercury-containing dental amalgams are used in favor
of composites, amalgam will become less of a source of mercury
in the environment.
Turning to EPA actions, EPA is working on a mercury action
plan to describe EPA's long-term goals and near-term priority
actions involving mercury in all media and under all of EPA's
statutory authorities. Under the Clean Air Act in the United
States, we have cut emissions by over 90 percent from two of
the largest categories of sources of airborne mercury,
municipal waste combustion and medical waste incineration.
These are through maximum achievable control technology
requirements.
The United States also has a goal under the Great Lakes
Binational Strategy which we executed with the country of
Canada to reduce mercury emissions and water releases by 50
percent from 1990 levels. That would be done by 2006.
The administration has proposed the clear skies legislation
that would create a mandatory program to reduce from power
plants emissions of mercury, sulfur dioxide and nitrogen
oxides, and in this proposal mercury emissions would be cut by
70 percent by the year 2018.
Under the Clean Water Act, which is primarily where I work,
through the NPDES discharge permit program, those are
regulatory permits issued to all dischargers and the national
pretreatment programs which sewerage treatment plants need to
deal with. EPA and authorized States encourage sewerage
treatment plants to develop and implement pollution prevention
strategies to reduce the amount of mercury received by the
wastewater treatment plant. There are several examples of that
we can provide to you.
The Clean Water Act requires EPA to develop scientific
information on safe levels of pollution and for States to adopt
water quality standards for open and ambient water that protect
human health and the environment. In January 2001, EPA
published a new ambient water quality criterion recommendation
for methylmercury which is expressed as a fish and shellfish
tissue value rather than as an ambient water column value.
States are now starting to adopt this new water quality
criterion into their water quality standards.
EPA has also promulgated water quality standards for the
Great Lakes and their tributaries which take into account the
effects of mercury on birds and mammals that consume
contaminated fish. The Clean Water Act also requires States to
assess their waters periodically to determine whether those
water bodies exceed ambient water quality standards and, if
they do exceed them, to establish total maximum daily loads for
those waters. Total maximum daily loads are basically a budget
which lays out who needs to do what, including regulatory
requirements, in order to meet the ambient goal of the water
quality standard.
States have so far identified 1,097 water bodies where the
levels of mercury exceed their water quality standards, and so
far States have completed 144 TMDLs for these water bodies. EPA
also has a research program that is primarily invested in the
fate and transport as well as other areas to address science
needs for mercury. We are funding that at the level of $5.5
million per year.
With that, I will end my statement. I would be glad to
expand on any of these quick highlights as we turn to questions
and to answer any questions you might have.
[The prepared statement of Mr. Grubbs follows:]
[GRAPHICS NOT AVAILABLE IN TIFF FORMAT]
Mr. Burton. Thank you. Before we go to Captain Ragain, do
you have an opening statement you would like to make, Mr.
Cummings?
Mr. Cummings. I do, Mr. Chairman, but why don't we go to
the next witness.
Mr. Burton. Captain Ragain.
Captain Ragain. Mr. Chairman, Honorable Representatives,
ladies and gentlemen, good afternoon. Thank you for inviting us
to testify before the Subcommittee on Human Rights and
Wellness. I am Captain James C. Ragain Jr., Dental Corps, U.S.
Navy, Commanding Officer of the Naval Institute for Dental and
Biomedical Research [NIDBR], located at the Naval Service
Training Center, Great Lakes, IL. Accompanying me this
afternoon are Commander John C. Kuehne, Dental Corps, head of
the Bioenvironmental Sciences Department, and Dr. Mark E.
Stone, program manager for the NIDBR Mercury Abatement Program.
NIDBR's research related to the control of mercury
emissions from dental amalgam began in 1991 as a collaboration
with the American Dental Association involving the evaluation
of commercial amalgam separators. NIDBR instituted a mercury
management program to coordinate and direct the research
efforts of a number of dental researchers and equipment
specialists. This program made great strides in the design and
installation of pretreatment systems at several Navy dental
treatment facilities. NIDBR was then designated by Navy
dentistry as the lead agent for development, evaluation and
guidance regarding Navy wide installation of pretreatment
systems to minimize the environmental impact of Navy dentistry.
The tasking required that pretreatment systems be able to
remove mercury in order to allow all Navy dental clinics to
comply with local wastewater discharge standards. NIDBR was
specifically tasked to assess current compliance of dental
treatment facilities [DTFs], in meeting local discharge
standards and to develop strategies to bring all DTFs in the
Navy into compliance. This includes ships, field and mobile
dental units.
In fiscal year 2001, NIDBR began the implementation of a
multiyear program to survey and install pretreatment systems in
every Navy DTF worldwide. To date, pretreatment systems of
various sizes have been successfully installed in 50 percent of
all Navy dental clinics located within the continental United
States. By the end of calendar year 2003, we expect to have
completed the installation of mercury abatement systems in 95
percent of the Navy's U.S. clinics. These systems meet local
discharge limits with anywhere from 95 to greater than 99
percent of total mercury removed from the wastewater.
Previously completed wastewater characterization studies by
NIDBR have enabled us to develop a pretreatment strategy that
allows for the removal of mercury to extremely low levels, thus
reducing mercury from grams per liter to micrograms per liter
in the waste stream.
NIDBR's strategy involves the phased treatment of the
dental-unit wastewater stream. Phase 1 is the removal of
amalgam particulate through filtration and/or settling. Removal
of particulate greater than 10 microns removes up to 95 percent
of the total mercury in the waste stream. However, a
significant amount of mercury is located in the dissolved or
soluble fraction and is high enough to violate some local
discharge limits. In phase 2, the remaining dissolved mercury
is driven to the ionic form by oxidation and removed by
sorbents. This phased treatment program has proved very
effective for both large and small dental treatment facilities.
An additional benefit of the phased pretreatment strategy is
the ability to deploy technology that can be scaled to meet
variable local water treatment facilities' discharge limits.
Navy dentistry's mercury abatement program is a proactive
effort intended to keep the Navy in compliance with local and
overseas environmental requirements, and the successful
implementation of these pretreatment systems will remove a
source of mercury contamination to the environment. Additional
studies at NIDBR have attempted to measure the concentrations
of various forms of mercury residing in the dental wastewater,
including ionic, organic and elemental mercury bound to
particulate.
This is an important endeavor because different mercury
species have different toxicity profiles and a meaningful
assessment of mercury in dental wastewater must address the
concentrations of all the different species present.
Determining total mercury alone is not adequate to give a
complete picture.
One of the questions you asked in your invitation to us was
information on whether mercury solids methylate in sewer
systems. In 1967, Swedish researchers demonstrated that
bacteria are capable of transforming inorganic mercury into
methylmercury, a more toxic and more readily absorbed form of
the element. Many microorganisms, including bacteria and fungi,
have been shown to possess the ability to methylate mercury.
NIDBR has been involved in the characterization of dental
wastewater since 1993. We have measured total mercury and
methylmercury levels in wastewater directly at the chair, from
holding tanks and from sewers both upstream and downstream from
dental treatment facilities. We found the percentage of
methylmercury relative to total mercury to be a relatively
small fraction. However, preliminary composite sampling of
wastewater upstream and downstream from a large dental
treatment facility showed a 12fold increase in total mercury
leaving the dental clinic and a 3.6fold increase in
methylmercury levels. One mile downstream from the clinic, the
total mercury level had returned to the same as those upstream.
However, the methylmercury level remains about 3.5fold higher
than those upstream. The filter systems that we are installing
in our dental clinics remove almost all of the total mercury
prior to discharge into the waste stream.
Results of NIDBR studies underscore the importance of
limiting the release of mercury into wastewater streams as the
potential exists for mercury to be transformed into more toxic
species.
That concludes my prepared remarks. We are ready for any
questions you might have.
[The prepared statement of Captain Ragain follows:]
[GRAPHICS NOT AVAILABLE IN TIFF FORMAT]
Mr. Burton. Thank you, Captain. Mr. Cummings.
Mr. Cummings. Thank you very much, Mr. Chairman. Mr.
Chairman, Diane Watson, who is the ranking member on the
committee, was not able to be here this afternoon because she
is in her district. I just wanted to read her statement if that
is OK with you, Mr. Chairman.
Thank you, Mr. Chairman. The Human Rights and Wellness
hearing today is very important for the American people. This
hearing will provide more information about the effects of
elemental mercury and its use in dental fillings. In previous
hearings we have discussed different aspects about the last
remaining use of mercury inside the human body, but the
environmental effects of mercury are equally disturbing.
Mercury is listed as the No. 1 environmental poison by the
World Health Organization. The Environmental Protection Agency
has listed mercury as No. 1 of the 19 most persistent and bio-
accumulative toxic metals. Last Thursday, October 2, 2003,
Ballou Senior High School was shut down in Southeast
Washington, DC, due to 250 milliliters, or approximately 450
fillings worth of mercury. I understand the public concern over
the mercury spill, but we should also be concerned with
approximately one-half gram of the same hazardous material
being placed in the mouths of our children and adults in each
amalgam filling.
In a recent report entitled ``Dentists the Menace,''
dentists were called the biggest mercury polluters in the
United States. Consider these facts. Dentistry is one of the
only unregulated major sources of mercury discharges to the
environment. Dental fillings constitute the largest source of
direct mercury pollution in wastewater. Dentistry is the fifth
largest consumer of mercury in the United States. And dentists
use toxic mercury in silver fillings which are made of 43 to 54
percent mercury.
Dentists improperly dispose of mercury dental fillings
every day. Mercury dental fillings are put in the trash that
eventually will be incinerated, releasing poisonous gases and
vapors into the air. Properly cremated loved ones release the
same mercury contaminants into the air through mercury
fillings. Dentists also discard mercury dental fillings by
putting them in landfills, contaminating the soil and
surrounding water sources. Mercury dental fillings pose too
much risk for not only the health of dental patients but
environmental and agricultural safety.
Mercury is constantly being discharged into our
environment, polluting our water sources. The body tissue of
fish easily absorbs mercury suspended in water. Ultimately we
eat this toxic mercury. Pregnant women are constantly being
warned not to eat shark, swordfish or mackerel due to their
extremely high accumulation of mercury. If they are warned not
to eat fish, why are they not constantly being warned to not
use mercury dental fillings?
That is the statement of Ms. Watson, Mr. Chairman. I thank
you for allowing me to put that into the record.
[The prepared statement of Hon. Elijah E. Cummings
follows:]
[GRAPHICS NOT AVAILABLE IN TIFF FORMAT]
Mr. Burton. No problem. Thank you.
First of all, I want to commend the Navy for its
constructive actions that they have taken to reduce dental
mercury in their facilities around the world. Captain, you
didn't mention in your testimony why the Navy first got
interested in mercury abatement. Wasn't there a particularly
alarming and costly incident involving the naval dental clinic
in the Virginia Beach-Hampton Roads area?
Captain Ragain. Yes, sir, there was.
Mr. Burton. Do you want to go into that in detail or do you
want me just to read what happened?
Captain Ragain. It is up to you, Mr. Chairman.
Mr. Burton. Well, the answer is the Hampton Roads sewage
treatment plant finally refused to accept the Navy's sewage
because it contained too much mercury. The Navy had to dump
their wastewater into 55-gallon drums and then have them hauled
away by a hazardous materials company that charged $900 per
barrel. Why did that happen?
Captain Ragain. Why did it? I don't understand your
question.
Mr. Burton. Why would that sewage treatment plant not
accept the refuse from your facility?
Captain Ragain. I wouldn't know, sir.
Mr. Burton. Well, they said it was because there was too
much mercury going in there, isn't that correct?
Captain Ragain. I haven't talked to that plant, sir. I
don't know.
Mr. Burton. Well, you do know that they wouldn't accept
that, don't you?
Captain Ragain. That was their statement, sir.
Mr. Burton. Captain, come on now. You don't know about
this? You don't know what happened?
Captain Ragain. I know that we were required to put our
dental wastewater in cans because the discharge limits exceeded
the local PWC limits.
Mr. Burton. And the reason for that was?
Captain Ragain. Because of the discharge of the water. Not
why they wouldn't accept the cans.
Mr. Burton. What was in the water? It was mercury, wasn't
it?
Captain Ragain. The mercury had spiked, yes, sir.
Mr. Burton. Yes. Now, the mercury is being removed because
of the amalgam separators and 95 to 90 percent of the mercury
is now being removed, is that right?
Captain Ragain. Yes, sir.
Mr. Burton. Let me ask you both a question. If mercury is
unsafe before it is put into your teeth and it is unsafe
afterwards because it has to be collected and handled very
carefully, why is it safe in your mouth? How about you, Mr.
Grubbs?
Mr. Grubbs. To be honest, I am not sure I can answer that
one either, sir. The jurisdiction for EPA deals with pollution
into the environment from sewage treatment plants, into the
air, and so forth. With regard to exposure to the body, my
understanding is that is Food and Drug Administration where
those decisions are made. So I have not looked at that specific
question.
Mr. Burton. The FDA. How about you, Captain?
Captain Ragain. When it is in the mouth, it is bound into
the amalgam and it is not released.
Mr. Burton. Let's followup on that. We had a scientist
here--we had scientists, more than one here, who said that they
had tested amalgams in a glass of water and checked them and
they were releasing mercury even though they were supposed to
be inert in that filling. They had done several tests to show
that was occurring. They also showed when heat was applied or
cold was applied that vapors were emitted from the fillings
that showed that the mercury was being released.
When a filling is taken out and it is put into the sewage
of the office, let's say a dentist flushes it down the drain
like a lot of them have been known to do, why is that a danger
if it is inert in the mouth? If it is hard in the mouth and it
is safe because it has that other residue with it, you know,
when they make the filling, why is it not safe when it leaves
the mouth?
Captain Ragain. Sir, I'm going to defer that question, if I
may, to Commander Kuehne. He is a materials expert in the
bioenvironmental area and he probably could have a better
answer there that you are looking for.
Mr. Burton. Sure.
Commander Kuehne. Thank you, sir.
First of all, I would say it is not really my decision to
rule definitively on what is or isn't safe. The scientific
panels that have met in the past to evaluate amalgam as a
material have deemed it to be a safe and effective material.
However, to answer your question, the real issue is that
when the amalgam is in the waste stream or in the environment,
for as long as it remains there, which is indefinite, it is
subject to bacterial conversion, bacterial organisms in the
environment that convert the source of mercury in the amalgam
to methylmercury.
Mr. Burton. You really believe that is how it happens? The
bacteria in your mouth doesn't have any effect?
Commander Kuehne. I don't know, sir. I wouldn't say that
it's impossible. All I can say is that the scientific evidence
to date that I am aware of have not shown any significant
release of free mercury or methylmercury from fillings in the
mouth.
Mr. Burton. Have you heard of Dr. Boyd Haley?
Commander Kuehne. No, sir.
Mr. Burton. You haven't had any conversations with him? Dr.
Haley testified before our committee, and Dr. Haley went into
great detail. He is a biological scientist.
Mr. Rowe. Yes, and he is Chair of the Department of
Chemistry.
Mr. Burton. He is the chairman of the Department of
Chemistry down there at the University of Kentucky.
He has done an enormous amount of research on this. He says
there is absolutely no doubt, no doubt whatsoever that the
mercury fillings in the mouth and afterwards does emit vapors
that get into the blood stream, mercury vapors, and can cause
neurological problems and that when you chew every once in a
while you might chew a hard substance and it breaks off and
gets into your system, it can also cause some damage. You
wouldn't argue with that, though?
Commander Kuehne. Sir, again, I wouldn't say that it is
impossible. I'm just saying that all of the scientific evidence
and the panels that have met in the past, NIH panels and other
panels that have come together to weigh all the scientific
evidence that is available, have so far concluded that there is
no significant release of toxic mercury from fillings that are
placed in the mouth.
Mr. Burton. When I was a little boy, we used to find old
thermometers, and we would break them, and we would do this
with the mercury. You know what I'm talking about, when you
were kids? I wonder why they don't do that anymore? Because we
found out that the mercury was toxic, and it could really cause
severe damage. In my district, we spilled a very small amount
of it, and they evacuated two neighborhoods, had people come
in, looked like they were from outer space to clean it up. That
happened in this school here in Washington, DC. Yet we continue
to put mercury in our mouths. Would you swallow a mercury
amalgam? You would swallow it? You wouldn't worry about it?
Commander Kuehne. Yes, sir. Honestly myself, because of
what I know about the differences between the absorption of
elemental mercury vapor through the lungs and solid amalgam
absorption through the gut, it personally wouldn't bother me. I
would much rather swallow a dental amalgam than to breathe in
the same amount of mercury vapor. I would be very worried about
breathing in the same amount.
Mr. Burton. If you knew it was being emitted from your
teeth? If you knew that vapor was being emitted----
Commander Kuehne. Yes, sir. Again, I'm not trying to defend
it. I'm not trying to say it is impossible. All I am trying to
say is, from what I know of the scientific evidence to date--I
have dental amalgams in my mouth. I am not worried about the
emission of mercury. I do know that elemental mercury vapor is
toxic and easily absorbed into the body. I do know that amalgam
has the potential to methylate in the environment. So both of
those issues I am concerned about, and we are taking action for
it.
Mr. Burton. I am going to yield to Mr. Cummings, but just
let me tell you that there is a machine that my dentist used to
show the amount of mercury vapor that was being emitted from
the amalgams I had in my mouth. It has been pretty much proved
that this machine is accurate. I don't know if you guys have
any mercury fillings in your mouth, but we happen to have one
of those machines over there if you would like to check it out
before you leave. It might be a very intellectually stimulating
experience for you.
Captain Ragain. I've got five in my mouth.
Mr. Burton. You have five in your mouth?
Captain Ragain. Yes, sir.
Mr. Burton. You might want to check that out before you
leave. It might make you want to get them out of there.
Mr. Cummings.
Mr. Cummings. Just a few questions, Mr. Chairman.
Commander Kuehne, you had said with regard to the amalgam
and the mercury in the filling that you did not believe a
significant amount of mercury was released. What do you
consider not significant, or significant?
Commander Kuehne. That is a good question. I guess that is
what it comes down to, I think, because almost everything could
have some trace mercury concentration if you could employ
methods fine enough to detect it. I would say for myself as a
standard compared to the amount I would get in a normal diet.
In other words, I think that whatever mercury would be released
from fillings in my mouth would be insignificant when you
compared it to a normal diet. If I would try to exclude the
same amount of mercury from my diet completely, I would
probably have to eliminate most if not all of the things I ate.
It is a naturally occurring element in the Earth's crust. It is
present in many foods, not just fish.
Mr. Cummings. A woman who is pregnant, is she more
susceptible to harm from mercury?
Commander Kuehne. Sir, with all due respect, I can
understand why you would be asking us this, but really I think
these are questions that the FDA and WHO and people like that
have--it is in their purview to rule on those things. WHO and
FDA, organizations like that.
Mr. Cummings. I understand that. Just based upon your
knowledge--and I understand and I am not trying to take you out
of your realm, but I am just asking you a general question. You
make decisions, you have to address these issues, and I am sure
you have some general knowledge of what you believe. If you do,
that is all I am asking you. I am not trying to put you in a
corner or anything like that. So you do believe that a woman--
in other words, you would not like to see a woman who is
pregnant absorbing mercury, swallowing it from her teeth or
anything, I take it?
Commander Kuehne. First of all, I would be concerned about,
or I would advise a pregnant woman to exercise some caution,
educate herself about the dangers of mercury consumption. I
think the place to begin with that personally would not be with
the fillings in her mouth if they are already there. I think
the place to begin would be looking at the diet, fish
consumption, to know where the fish comes from and the
concentration of mercury that would be in the fish, water, the
things that would be consumed on a regular basis daily. I would
never try to argue that absolutely zero amount--there may be
very small amounts of mercury that would be released from
whatever fillings she would have in her mouth, but, again, I
think that in terms of her total dietary consumption that would
not be my major concern.
Mr. Cummings. A filling--when a person--sometimes a doctor
will tell you, a dentist will say, we've got to give you
another filling. I am just wondering, is that--I mean,
something has happened to cause the filling that you had not to
be doing what it was doing before. There is some kind of
problem.
Captain Ragain. It depends on the clinical situation.
Mr. Cummings. So I guess what I am getting at is that if
there is--if something has happened to that filling, and that
is assuming there is some still there, would you assume that
there is a release of mercury that is higher than the
insignificant or amount that you just talked about? Are you
following what I am saying?
Commander Kuehne. Yes, sir.
Mr. Cummings. I mean, it happens all the time. People go to
the dentist. The dentist says, look, we've got to refill this.
I was just curious.
Commander Kuehne. Yes, sir. Again, we're getting into an
area that may be as much opinion or judgment call as anything
else, but, in my own judgment, it is not actually the amount of
mercury that would be released during normal chewing that would
be a concern. But when you either place or remove the mercury,
the patient exposure to mercury at that time would be higher
than once it is placed and set. So in the placement and the
removal process that is when proper practices should be
followed in order to minimize that risk exposure to the patient
and the dentist, their staff, as well as to the environment.
Dentists do and should follow certain procedures that we,
for instance, would use in a rubber dam which protects the
patient but provides a barrier between the patient and the
removal using high-speed suction. If the proper filters to
remove mercury are attached to that suction, you can do that
procedure safely or you can do that procedure where it
represents a larger risk to the patient and the environment.
Mr. Cummings. Finally, Mr. Chairman, from an environmental
standpoint, what is the safest way to get rid of, I guess it
would be, mercury waste? What is the safest way to do that? In
other words, so that you minimize any kind of harm to the
environment, what is the ideal way to do that?
Commander Kuehne. First of all, to remove all of it from
the wastewater before--again in my opinion, it would be to
first of all remove all of it from the wastewater before it is
sent to the treatment facility plant, to collect it and dry it
so that it is in a dry amalgam form. The dissolved portion of
the mercury, which would be ionic mercury, that would be
dissolved in water. We use a process that binds that ionic
mercury to a resin, and it is chemically bound at that point,
and at that point it won't be released from that chemical bond.
Then to collect that in those states, the dry particulate
amalgam and the chemical resin, all the forms of mercury that
you have used to remove it and to send that to a licensed
recycler or a company that is licensed and knows how to reclaim
that mercury or dispose of it properly.
Mr. Cummings. So a small amount of mercury can do some
serious damage? I mean, the chairman just talked about--we had
the school to close and then the chairman talked about a small
amount--were you talking about in your district?
Mr. Burton. Yes.
Mr. Cummings. It can do a lot. I assume this is something
that sends off a lot of red lights. I guess that is why we are
here.
Commander Kuehne. The risk, that is really a difficult
question to answer. When you say a small amount and a lot of
damage, those are terms that are difficult to quantify from a
scientific point of view. And it really represents what
somebody would consider small, what----
Mr. Cummings. I will let the chairman--because he knows
what happened in his district or wherever. I guess what I am
trying to do is make sure I get a real clear picture of exactly
how much of this substance would cause any reasonable health
official or provider to be alarmed.
Commander Kuehne. I wouldn't want to breathe mercury vapor
on a regular basis over a long period of time, because mercury
vapor is well absorbed across the lungs, it accumulates in the
body and it has long-term health effects. So I certainly--a
small amount of mercury vapor like that, what was released in
the school, especially if it is inhaled chronically over a long
period of time certainly represents a health risk. A consistent
ingestion of methylmercury from fish or organic tissue, once it
is taken up in the food chain, especially by more susceptible
people like pregnant women, again over a long period of time,
certainly represents a definite health risk. But in both of
those cases you have to consider the form that the mercury is
in, whether it is in elemental mercury, liquid, vapor state,
whether it is amalgam, whether it is methylmercury in the
organic tissue of fish. Each one of those things represents a
different situation. The way it is ingested represents--the
time of exposure, whether it is a one-time exposure.
It is like x-rays. Being out in the sun for 5 minutes
represents a different risk than being out in the sun for 3
hours. It depends on the angle of the sun.
To say absolutely mercury in every form, in every
condition, in every concentration is a huge risk, no, sir, I
couldn't go that far. But it definitely is a health risk.
Captain Ragain. It is like chlorine, chlorine gas. It is
very toxic, but we have all had sodium chloride today in salt.
Mr. Cummings. Thank you, Mr. Chairman.
Mr. Burton. Mercury is supposedly one of the most toxic if
not the most toxic substances around, isn't it? Is that not
correct, when it is ingested? Incidentally, where did you get
all this information? Commander, where did you get all this
information?
Commander Kuehne. All the information about mercury?
Mr. Burton. About mercury. Do you have a degree in that?
Have you studied it? Are you a chemist?
Commander Kuehne. Yes, sir. I'm a dentist. We studied it in
dental school. I have a master's degree in dental materials and
being involved with research for a number of years. I have read
research papers, and I guess that is where I get my information
from.
Mr. Burton. You have never read any research papers from
the University of Kentucky and the head of their chemistry
department down there that has worked on this?
Mr. Stone. I think most of the literature that we're
familiar with is related to the environmental exposure to it,
to the mercury. I think a lot of the issues you are talking
about are exposure to humans, related to human health effects.
We're sort of on the other side of that with the wastewater
issue.
Mr. Burton. Well, the fact of the matter is the wastewater
treatment people of this country say that the amalgams getting
into the wastewater treatment system has caused an awful lot of
problems, correct?
Commander Kuehne. Yes.
Mr. Burton. And it wouldn't be in the wastewater treatment
system if we didn't have mercury in our mouths in the first
place, would it? It wouldn't be getting in there from the
amalgams if it wasn't in our mouths, isn't that correct?
Commander Kuehne. Yes, sir.
Mr. Burton. What I can't understand is if there is a risk
to our health, either before it is in our mouths, after it is
in our mouths, while it is in our mouths, we know that once it
gets into the food chain it is a real problem and there is an
increasing number of items in our food chain, you mentioned
fish, that are becoming a real problem as far as human beings
consuming them.
One of the ways they are getting that is from the water
that goes through the wastewater treatment system into our
lakes and our streams around this country. It seems to me that
we would want to get that out of there, especially if there is
an alternative substance that can be used to fill teeth. Why
would you use something that you knew was toxic if you knew
there was something else? Because it is less expensive is the
answer. But the fact of the matter is there are ways to deal
with this without putting mercury in people's teeth.
The other thing that is very interesting is when they put
mercury fillings in your mouth, they aren't inert while they
are putting them in your mouth. They mix them up. The person
who is mixing them up has some exposure, I would imagine, from
mixing them on a regular basis. Then they put it into some kind
of a syringe-type thing and they jam it down into your tooth,
into the cavity that they have exposed by drilling. And when
they jam it down into your tooth, I know that parts of it fall
down into your mouth, parts of it, and it is not yet inert, it
is still liquid, because they say, oh, you've got to wait about
5 minutes before we take this brace off that holds it in place.
And that inert material, that material that is not yet inert,
is ingested into your body, because I have swallowed part of it
because I couldn't get it all out when I rinsed after they put
the filling in. Are you telling me that none of that is
dangerous? It is not yet inert. It is still in the syringe. He
puts it in your mouth. Are you saying there is no danger there?
Commander Kuehne. No, sir. I certainly don't say there is
no danger. I think--it is just--we recognize--I think what we
are here to agree to is that we recognize the long-term
consequences of putting amalgam waste into the environment and
that is why the Navy has taken steps to stop that. Beyond that,
what constitutes an acceptable risk----
Mr. Burton. So there is a risk.
Commander Kuehne. There is a risk in every activity that I
can think of. And certainly there is a risk of--there are many
risks associated with the practice of dentistry.
Mr. Burton. You don't need to go any further. The fact of
the matter is there is a risk, and you think it is an
acceptable risk to put an amalgam in people's mouths. There is
a divergence of opinion on that subject. We have had scientists
who say they have tested it very thoroughly over many years,
and there are vapors that escape into people's mouths. There
are also chips and so forth that fall into the body. If there
is a biological thing that takes place, you said that there is
some bacteria that might eat away at one of these amalgams and
cause a release of the mercury. It could happen in our bodies
as well. But the fact of the matter is there is a risk, and I
do appreciate that.
Do any of you have any final comments you would like to
make?
Captain Ragain. No, sir.
Mr. Grubbs. No, sir.
Mr. Burton. Thank you very much. We appreciate it.
Our next panel is Dr. Frederick Eichmiller, director,
American Dental Association Health Foundation; Mr. Norman
LeBlanc, chief, Technical Services at the Hampton Roads
Sanitation District; Mr. Peter Berglund, principal engineer at
the Metropolitan Council of Environmental Services; and Mr.
David Galvin, project manager, Hazardous Waste Management
Program at the King County Department of Natural Resources.
Would you all please stand?
I appreciate you sticking around to hear what they have to
say.
[Witnesses sworn.]
Mr. Burton. Since there are a large number of you and it is
getting a little late and I apologize for that, if we could
keep our comments to around 5 minutes, I would really
appreciate it. We will put the rest of your statements in the
record.
Dr. Eichmiller.
STATEMENTS OF DR. FREDRICK EICHMILLER, DIRECTOR, AMERICAN
DENTAL ASSOCIATION HEALTH FOUNDATION, PAFFENBARGER RESEARCH
CENTER, NATIONAL BUREAU OF STANDARDS & TECHNOLOGY, ACCOMPANIED
BY JEROME BOWMAN, ADA STAFF ATTORNEY; NORMAN LEBLANC, CHIEF,
TECHNICAL SERVICES, HAMPTON ROADS SANITATION DISTRICT; PETER
BERGLUND, PE, PRINCIPAL ENGINEER, METROPOLITAN COUNCIL OF
ENVIRONMENTAL SERVICES, INDUSTRIAL WASTE SECTION; AND DAVID
GALVIN, PROJECT MANAGER, HAZARDOUS WASTE MANAGEMENT PROGRAM,
KING COUNTY DEPARTMENT OF NATURAL RESOURCES AND PARKS, WATER
AND LAND RESOURCES DIVISION
Dr. Eichmiller. Mr. Chairman, members of the committee, my
name is Fred Eichmiller. I am a dentist and director of the
Paffenbarger Research Center, one of the world's premier dental
research facilities, an affiliate of the ADA Health Foundation
in Gaithersburg, MD. Scientists at the Paffenbarger Center
conduct basic and applied studies to improve the science and
art of dentistry and benefit the health of the American public.
With me today is Mr. Jerome Bowman, an ADA staff attorney
who has been involved in the Association's efforts to forge a
partnership with the EPA to further minimize the environmental
impact of waste dental amalgam.
I speak today on behalf of the ADA's members, 147,000
individual dentists and their families who live in the same
communities and consume the same water as everyone else.
The ADA bases its policy positions on the best available
scientific evidence, so in crafting its best management
practices and a national advocacy plan to reduce amalgam waste
discharge we sought first to expand and improve the scientific
data available on the amount of waste amalgam that dental
offices actually discharge and what happens to any amalgam that
is discharged. To that end, we commissioned ENVIRON to conduct
a scientific assessment. The author of that assessment, Mr. Jay
Vandeven, is with us here today and available to answer any
questions or any additional questions that Mr. Bowman and I
cannot answer.
I will note that because mercury in dental amalgam is bound
as a stable ally with other metals, the studies thus far
indicate that very little of it dissolves to become
bioavailable. In other words, even when amalgam enters the
wastewater, mercury from amalgam is unlikely to enter the food
chain.
Despite this, we asked that the ENVIRON assessment ignore
that premise. The data it reports and the conclusions it
reaches reflect a worst-case assumption that all of the mercury
in any waste amalgam could eventually become bioavailable.
The key findings of that study include the contribution of
mercury in surface waters and sludge that are attributed to
dental offices is far worse than those from other sources. The
chairside traps and vacuum pump filters capture approximately
77 percent of the amalgam discharged in wastewater by dental
offices. Amalgam separators when used in conjunction with best
management practices can capture up to 95 percent of the
amalgam not captured by the traps and filters. However, because
public water treatment facilities capture 95 percent or more of
that same material, the use of separators ultimately would have
little impact on the level of mercury in the surface water or
fish.
The ENVIRON report underwent prepublication review by
individuals from AMSA and the EPA.
Let me make it clear that the ADA does not see the ENVIRON
report as justification for inaction on amalgam waste. Rather,
the Association is using the report's findings to guide the
process of enhancing our longstanding commitment to foster an
environmentally sound dental practice.
Based on the ENVIRON findings, the Association this year
published best management practices for amalgam waste to
provide its members with comprehensive, easy-to-follow
recommendations for managing the waste and finding a recycler.
Our goal is 100 percent recycling of amalgam waste captured by
dental offices.
The ADA recognizes amalgam separators as a potentially
valuable adjunct to a dental office's waste management
procedures in situations where environmental concerns or local
law warrant them. However, the Association believes that the
decision about whether to use separators should be made on a
case-by-case basis in response to local needs and within the
context of comprehensive best management practices. In fact,
many State dental associations have reached or are currently
working on agreements with their State environmental
authorities, and many of these agreements involve the voluntary
use of amalgam separators.
The ADA has and will continue to publish and otherwise
disseminate useful information for dentists who want or need to
install separators, including seminars at major dental meetings
and articles in the peer-reviewed Journal of the American
Dental Association, which is sent to all of our members.
Finally, I will note that the ADA is actively engaged in
discussions with the EPA with the aim of establishing a
national partnership to help State and local authorities
develop sensible policies regarding dental amalgam waste. These
could include recycling, collection programs, best management
practices and other common-sense measures.
Mr. Chairman, that concludes my statement, but I
respectfully request just a moment more of your time to read
the text of the resolutions that are going before our House of
Delegates and will be considered in 2 weeks at that meeting. I
believe these actions give good testimony to the ADA's
commitment to environmentally sound dental practice.
The first resolution is, resolved that the Association
strongly encourages dentists to adhere to best management
practice and supports other voluntary efforts by dentists to
reduce amalgam discharges in dental office wastewater.
Be it further resolved that the Association encourages
constituent and component societies to enter into collaborative
arrangements with regional, State or local wastewater
authorities to address their concerns about amalgam in dental
office wastewater.
Be it further resolved that the appropriate agencies of the
Association continue to disseminate information to the
constituent and component societies to help them address
concerns of regional, State or local wastewater authorities
about amalgam in dental office wastewater.
Be it further resolved that the appropriate agencies of the
Association continue to investigate products and services that
will help dentists effectively reduce amalgam in dental office
wastewater and keep the profession advised.
Be it further resolved that the Association include in its
advocacy messages the importance of basing environmental
regulations or guidances affecting dental offices on sound
science.
And be it further resolved that the Association continue to
identify and urge the Environmental Protection Agency to fund
studies that accurately and appropriately identify whether
amalgam wastewater discharge affects the environment.
Thank you for allowing us to appear before this panel. We
will be glad to answer your questions.
Mr. Burton. That resolution you are talking about is not
mandatory, though, is it? It is voluntary?
Dr. Eichmiller. Yes, it is voluntary.
Mr. Burton. Thank you.
[The prepared statement of Dr. Eichmiller follows:]
[GRAPHICS NOT AVAILABLE IN TIFF FORMAT]
Mr. Burton. Mr. Berglund.
Mr. Berglund. Thank you, Mr. Chair.
My name is Peter Berglund. I'm with Metropolitan Council of
POTW in St. Paul, MN, which in layman's terms I like to call it
the sewer board.
We have completed two major research projects on dental
clinics' loadings to sanitary sewers and the effectiveness of
amalgam separators used to treat the clinic wastewater. The
good news is that our loading estimates agree well with the
ADA's ENVIRON report. We measured 234 milligrams of mercury per
dentist per operating day and we also measured a 29 to 44
percent reduction in mercury loads at two of our treatment
plants while amalgam separators were in place.
There is more good news. These reductions also agree well
with the ADA's ENVIRON report. The ENVIRON report had showed
dental contributions of approximately 50 percent to wastewater
treatment plants. The bad news is that I had to handle this
waste during my study.
We also studied and tested the separators in actual clinic
settings. The ADA tested separators in a laboratory setting,
so-called bench-top testing.
And there is more good news. Our results agree well with
the ADA's testing of the separators. So both projects show that
the separators perform well at removing amalgam from the
wastewater.
Given all of this work which--I should mention our research
projects were done in partnership with the Minnesota Dental
Association. They helped us enormously on studying the loadings
and studying the amalgam separators, so we continued that
partnership on what we have called a voluntary dental office
amalgam separator program to promote the installation of
separators that remove 99 percent of the amalgam present in the
wastewater. And we--in fact, we have--the results were so good
in ADA's testing on the separators that we set the bar higher
than the normal test criteria. We call for 99 percent removal
of the amalgam in the wastewater where the common criteria is
95 percent.
We launched our program for the promotion of separator
installation in January 2003, and we already have two-thirds of
our dentists committed to installing separators. These are
signed commitments sent in by the dentists. Two-thirds have
sent that in. And many countries in the world call for
separators, so this is not new.
I should mention that there've been reductions in mercury
levels at wastewater treatment plants in, Toronto, Canada, and
Wichita, KS, and the subcommittee may wish to get more
information from those two cities.
Separators are effective at reducing the amount of amalgam
discharged to treatment plants. The use of the separators in
our area will drastically cut back the amount of mercury
released via the burning of our sludge. And then for those
treatment plants that may land apply, the sludge separators
will obviously help reduce the amount of mercury present in
that land-applied sludge. Capturing amalgam at a dental office
will maximize the recycling of the mercury and the silver
present in the amalgam. If these metals end up in a wastewater
treatment plant sludge, they will not be recovered or reused.
One other little comment, the ADA environmental report had
mentioned the possibility of dental clinic wastewater being
discharged to septic tanks. We found in our early survey work
that, yes, some dental waste does go into septic tanks, which
is not allowed in Minnesota. The septic tank--septage from the
septic tanks may be hauled back to the wastewater treatment
plant, adding to the treatment plants' load, or it may be land
applied. That concludes my comment.
Thank you.
Mr. Burton. Thank you Mr. Berglund.
[The prepared statement of Mr. Berglund follows:]
[GRAPHICS NOT AVAILABLE IN TIFF FORMAT]
Mr. Burton. Mr. LeBlanc.
Mr. LeBlanc. Good afternoon, Chairman Burton, members of
the subcommittee. My name is Norm LeBlanc. I am chief of
Technical Services for the Hampton Roads Sanitation District in
Virginia Beach, VA, and Chair of the Association of
Metropolitan Sewage Agencies [AMSA's], Water Quality Committee.
AMSA represents the interests of nearly 300 of the Nation's
wastewater treatment agencies, also known as publicly owned
treatment works [POTWs].
AMSA members serve the majority of the sewer population of
the United States, and I would like to thank you for the
opportunity to present AMSA's position here at the subcommittee
this afternoon.
Mr. Chairman, mercury is a multimedia problem that AMSA
believes demands a multimedia, multifaceted solution. Only a
coordinated effort involving all levels of government, Federal,
State and local, will be able to address the mercury problem as
a whole and be able to ensure that the resources being applied
to control mercury across the Nation have a real impact on
improving the environment and public health. AMSA, therefore,
continues to support legislation that would create a national
task force or some other type of interagency working group to
evaluate the issues surrounding mercury in the environment and
coordinating efforts to control it.
With that said, AMSA strongly believes that each wastewater
treatment agency and the community they serve should have
ultimate control over the approach used to reduce mercury
discharges from dental offices. I hope my remarks today will
provide you with added insight into what the Nation's POTWs are
already doing to address the issue. The U.S. EPA's 1997 report
to Congress on mercury demonstrated that when compared to all
of the sources of mercury released to the environment,
wastewater treatment facilities are de minimis sources, or
minor sources. Despite their de minimis contributions,
wastewater treatment agencies continue to receive stringent
numeric limits for mercury in their wastewater discharge
permits, and many are experiencing difficulties in complying
with these new limits.
I want to be clear that POTWs want to do their part in
reducing mercury releases to the environment, but it is
important to recognize that wastewater treatment plants are not
designed to remove toxics like mercury. In fact, the Clean
Water Act, in requiring us to implement pretreatment programs,
recognizes that it's not only good public policy, but also good
engineering practice to remove toxins at the source and not at
the wastewater treatment plant.
A well-run pretreatment program is a POTW's first and,
primarily, its only line of defense against toxic discharges;
and it's critical for reducing mercury concentrations in
wastewater discharge to the environment. Although residential
sources of mercury, such as human waste and household products,
are significant, POTWs have absolutely no authority to control
these sources.
Dental office mercury, which makes up about 40 percent of
the mercury coming into the wastewater treatment plant,
according to a March 2002 AMSA study and a recent ADA report,
is controllable. Consequently, dental offices will almost
always be a component of pretreatment efforts to control
mercury in order to meet permit limits.
Pretreatment programs can approach the issue of dental
office mercury control in many ways, and AMSA believes that
each community will choose the approach that works best for it.
While some communities may have chosen the approach of issuing
voluntary best-management practices that dental offices are
asked to implement, other communities are requiring dental
offices to install equipment such as amalgam separators to
remove the mercury contained in amalgam fillings before it has
a chance to enter the sewer system.
There are success stories for each type of approach where
reductions have been made in the amount of mercury being
discharged to the wastewater treatment plant. In most
communities, it's too early to tell whether or not long-term
implementation of these programs will achieve the low levels of
mercury necessary to meet increasingly stringent permit limits,
but preliminary indications are that they will not.
More work is needed to evaluate the options available for
controlling the amount of mercury entering POTWs, and AMSA has
recently begun a new international study to evaluate the
effectiveness of amalgam separators at reducing mercury load
from dental offices. This project, however, will not be
completed until 2005.
AMSA's 2002 study on the effectiveness of pollution
prevention in our source control by reducing mercury discharged
to wastewater treatment plants does suggest that pollution
prevention efforts alone, without the use of amalgam
separators, for example, will not enable POTWs to meet
stringent permit limits.
AMSA had recently had the opportunity to peer review the
ADA assessment on the quantity of mercury nationwide that finds
its way into the environment from dental offices. While a
review on the final report is still ongoing, many of AMSA's
were addressed in the final document, nevertheless some broader
issues remain that we feel the report could have addressed
better, and AMSA will be providing additional comments to the
ADA on those issues.
The Nation's wastewater treatment agencies continue to do
their best to minimize the discharge of mercury to their plants
and, subsequently, to the environment from all potential
controllable sources, including dental offices. It is important
that we have the ability to control all commercial industrial
sources of mercury if we are to have any chance of meeting
current and future requirements. However, we do not want to
mislead the subcommittee into believing that controlling dental
offices alone will result in attainment of Clean Water Act
requirements at all POTWs.
AMSA looks forward to working with you and your colleagues,
as well as the national and State dental associations on
mercury issues, and appreciates the opportunity to provide our
expertise on mercury to the subcommittee. And I'll be happy to
answer any questions.
Mr. Burton. Thank you.
[The prepared statement of Mr. LeBlanc follows:]
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Mr. Burton. Mr. Galvin.
Mr. Galvin. Chairman Burton, my name is David Galvin. I'm a
program manager with King County's Department of Natural
Resources and Parks based in Seattle, WA.
King County operates the major wastewater treatment system
for the Metro Seattle area, including two large treatment
plants with total flows of about 200 million gallons per day.
We discharge treated effluent into Puget Sound, a sensitive
marine waterway.
One hundred percent of the residual solids from our
treatment plants, known as biosolids, is reused beneficially in
wheat and hop fields in eastern Washington and forestlands in
the Cascade Mountains and in the composted product available
for landscaping. We control sources of contaminants into our
system by means of a major industrial pretreatment program and
extensive work with small businesses and households.
Toxic metals, including mercury, don't go away or get
magically treated in wastewater treatment plants. Rather, they
either settle out in the solids or are discharged in the water
effluent. Most mercury that enters our system ends up in our
biosolids. Even though our biosolids currently meet Federal and
State regulations for mercury, our concerns for the future
marketability of these solids drives our efforts to
continuously make them cleaner. But potential for more
stringent mercury limits in the future is also a concern for
us.
Under an agreement with the Seattle-King County Dental
Society, we conducted an extensive collaborative program from
1995 through 2000 to promote voluntary compliance of the dental
offices in our area. We encouraged purchasing an installation
of amalgam separator units, which research showed would allow
dentists to meet King County's local mercury limit. The results
after 6 years of this collaborative voluntary approach were
that 24 dental offices, out of approximately 900, installed
amalgam separators.
In 2001, King County in consultation with the local dental
society decided that the voluntary program had failed and
notified local dentists that they would be required to meet our
local discharge limit. We gave them the choice of installing
separators or applying for a permit and proving that they can
meet our limits without a separator.
We gave them 2 years to meet compliance, until July 1,
2003. We provided extensive outreach to these dental offices,
including technical assistance, via visits from our public
health staff to every dental office in the county. We provided
monetary incentives via vouchers reimbursed at 50 percent of
the costs up to $500. We worked closely with the local dental
society as they held trade fairs and technical workshops.
Local dentists did not fight this new requirement, but
rather, sought practical information about purchasing
separators, and they got on with the task. Results in the 2
years since the requirement was announced are that
approximately 750 additional dental offices, that is, more than
80 percent, have installed amalgam separator units, with the
remaining offices quickly following suit during this last
quarter.
In conclusion, we believe that mercury is best controlled
at the dental office, not at the wastewater treatment plant.
Control at the source is the best way to manage such toxic
metals. A voluntary program did not result in significant
change in King County. Once separators were mandated,
compliance happened quickly, dramatically and with little
resistance.
Amalgam separator units are effective at removing at least
95 percent of the mercury. They are readily available, low
tech, reasonably priced and easily installed and maintained.
The attached graph that I included with my testimony shows
the results of our work, both in the voluntary phase and once
we made it a requirement.
Thank you for the opportunity to testify. I would be happy
to answer any questions.
Mr. Burton. Thank you, Mr. Galvin.
[The prepared statement of Mr. Galvin follows:]
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Mr. Burton. Dr. Eichmiller, you read that resolution that
you hope will be adopted at the ADA meeting, and it was
voluntary. Did you just get those figures that he cited from
the State of Washington?
Dr. Eichmiller. Yes, I did.
Mr. Burton. Twenty-four out of 900-some dentists complied
after 6 years?
Dr. Eichmiller. That's correct, sir.
Mr. Burton. What makes you think that a voluntary
resolution is going to bear fruit?
Dr. Eichmiller. Well, I should also say that where
separators are mandated, such as this, we have--and I think it
was a good example--we have worked directly with the regulator
to try to disseminate the information and to try to implement
that. So we definitely want to facilitate the use of those
separators when they are mandated on that local level.
What we're opposing is a mandate on a national scale.
Mr. Burton. Why?
Dr. Eichmiller. One is that there really is--and I think
from the EPA's testimony, too, they pointed out that there
wasn't a one-size-fits-all. The regulatory process here is one
that is done on a local and regional level, and what we found
to be most effective is when we work with those local and
regional regulators to come up with programs that perhaps will
include separators, but also include all the best management
practices and all the education and outreach that have to go
with it. And that, I think, attests to the success they had in
the second round. We have also seen that in other areas where
we have used this approach.
Mr. Burton. Mr. LeBlanc, you said that the safety
approaches that are being used by dentists, I guess on a
voluntary basis now, have not or you don't believe will
appreciably change the amount of mercury that is going into the
wastewater treatment plants.
Mr. LeBlanc. I'm sorry. I think you misunderstood what I
said.
Mr. Burton. Well, you said 40 percent of the----
Mr. LeBlanc. I said dentists contributed about 40 percent
of the total load of mercury to the POTWs. There are success
stories, I think, out there that deal with voluntary programs;
and there are stories, there are areas where mandatory
requirements are necessary.
The need to control mercury and to what level it needs to
be controlled is somewhat a function of the discharge
situation, the area of the country, the relative sources of
where you are in terms of meeting your regulatory requirements.
Mr. Burton. But you continued to have substantial amounts
of mercury in the wastewater treatments plants in your area?
Mr. LeBlanc. We have a voluntary program; we have seen
reductions in our area, in the Hampton Roads Sanitation
District area. And we do not mandate it as a requirement. We
currently meet all of our, exceed all of our regulatory--
``exceed'' is a bad word; we better our requirements, our
regulatory requirements, without mandating amalgam separators
with the exception of the naval facility that you talked about
earlier.
Mr. Burton. The problem that they had down there with the
inordinate amount of mercury coming into the sewage treatment
plant from that facility down there, that dental facility where
you had to put them in 90-gallon drums and haul them away, you
don't have that problem any longer?
Mr. LeBlanc. Yes, we do.
Mr. Burton. Oh, you do? Why?
Mr. LeBlanc. Well, first of all, let me put that in
perspective a little bit.
That is a unique situation where we have a relatively small
treatment facility that is designed to treat a population of
about 100,000 people, 18 million gallons a day. And it handles
the naval operations base, Norfolk, the world's largest naval
facility which houses, I understand, if not the largest, one of
the largest dental clinics in the United States. It has the
equivalent of 100 dentists' offices in--for a city the size of
100,000 people, which is a lot of dentists for a fairly small
area.
A local limit was established at that plant to protect the
biosolids for land application. Even though we incinerate
that--biosolids at that plant, our policy at Hampton Roads
Sanitation District is to have quality of our biosolids
sufficient to allow us to use all options to handle our
biosolids. So we set a fairly stringent limit to get the
mercury in the biosolids at that plant down.
The Navy had a great deal of difficulty meeting that local
limit. And while it's improved and they've tried numerous
technologies over the years and have gotten better, they still
cannot consistently meet the limit for that facility because it
is fairly--it is very stringent. It's probably one of the most
stringent in the Nation. And they are currently still barreling
it up right now.
Mr. Burton. Mr. Galvin, based upon your experience in the
State of Washington, do you think that any part of the country
would have better results on a voluntary program of having
dentists comply?
Mr. Galvin. I haven't had experience working with dentists
from other parts of the country. The dentists that we've worked
with in the Seattle-King County area are professionals, and
they've been fine to work with. Our experience has been, even
after years of a very collaborative process working with their
dental society and a lot of site visits, that proof of the
actual number of separators installed was still only about--
less than 3 percent of the total number of dental offices in
our system. And once we said that isn't working, we need to
make this a requirement, then the compliance has been very
good.
Mr. Burton. Well, if we didn't have mercury amalgams in our
teeth, you wouldn't have that problem with having to haul away,
in 98 gallon drums, that sludge, would you?
Mr. Galvin. You're correct.
Mr. Burton. So the mercury amalgams in those people's teeth
that are being put in the trash and the sewage treatment plant
is a problem. And if it wasn't there, it wouldn't be a problem.
And the thing that everybody keeps defending is that in our
mouths it's safe.
You know, I was always taught that if you're going to err,
you err on the side of caution. You don't continue to say,
well, you know, there's only a 5 percent chance that you're
going to die from this, or a 10 percent chance. If there's a
possibility of making it 100 percent safe, why would you keep
people in the situation where there's a 10 percent or 20
percent or 5 percent chance of having neurological problems
from the substance that you're putting into their bodies.
We see mercury in not only amalgams; we see it in vaccines
in the form of thimerosal, which is a preservative which has
never been tested, that's going into our children's bodies and
because the entire food chain that you're talking about and the
amount of mercury that's going into our streams not only from
amalgams, but from coal-fired generators and electrical plants
and so forth, we've got a serious problem.
We've gone from 1 in 10,000 children that are autistic in
this country to 1 in 150. Now, something's causing that. It's
not something that's just happened. They say, well, maybe it's
because we haven't been keeping accurate records in the past.
Well, let's say that was 1 in 5,000 before, or 1 in 2,000; now
it's 1 in 150. And we have senior citizens that more and more
are getting Alzheimer's disease. And the scientists that have
been before our committee say that one of the contributing
factors of Alzheimer's and autism is the amount of mercury
that's being ingested into people's bodies, either through
needles or through amalgams or other things. And I just can't
understand why everybody continues to defend this substance
saying, you know, it's something that's absolutely essential to
be used in the art of dentistry.
I mean, I know that it is more expensive to use other
substances. But if they were used in larger amounts, perhaps
the cost would come down. And in any event, it seems to me that
we ought to try to err on the side of safety, and we seem to be
hell-bent for leather not to do that.
Are there any other questions that I need to ask this
panel? Yes.
There was an article that was put out. It says, ``U.S.
Congressional Hearing on Dental Mercury Leaked Document Shows
ADA Undercuts Pollution Exposure Reduction,'' say advocates.
And I'd like to read you a little bit of this and then you can
make a comment, Dr. Eichmiller.
It says, ``As the American Dental Association prepares to
testify before a U.S. congressional committee today on dental
mercury, advocates released a confidential document showing the
association's continuing intent to undermine efforts to reduce
dental mercury pollution and human exposure from mercury
fillings.''
``It's like pulling teeth to get the ADA to support efforts
to reduce mercury pollution and unnecessary use even though
dentists are the No. 1 contributor of mercury to the Nation's
wastewater and still one of the largest mercury users in the
U.S. today,'' said Michael Bender, Director of the Mercury
Policy Project.
``Meanwhile, the latest Centers of Disease Control data
indicate that 8 percent of U.S. women of child-bearing age have
mercury levels so high that their developing babies are at risk
of neurological damage.''
ADA has submitted a confidential document to EPA that, in
essence, argues that reducing dental mercury pollution through
installation of amalgam separators, which can capture between
95 to 99 percent of the dental mercury particles is not cost
effective or necessary. In the document, ADA urges EPA to issue
guidance practically devoid of amalgam separators that would
recommend, ``only voluntary best-management practice,'' unless
the environmental conditions or State law mercury require
mercury reductions.
Is that true?
Dr. Eichmiller. I can speak probably to the, one of the
first points that was made there.
Mr. Burton. Well, before you go to the first point, let me
go to that last point.
Did the ADA submit a confidential document to the EPA that,
in essence, argues that reducing dental mercury pollution
through installation of amalgam separators is not cost
effective or necessary?
Dr. Eichmiller. I'm going to defer that to Jerome here, who
has been working directly with the EPA on this.
Mr. Burton. Well, it's a simple yes or no answer. Was that
sent to the EPA saying it was not cost effective?
Mr. Bowman. Mr. Chairman, we've made a proposal to partner
with the EPA on a nationwide basis to address a series of
issues relating to amalgam wastewater--amalgam discharges in
wastewater, including recycling, including separators,
including education.
It is the position of the ADA, and the position we have
taken to EPA, that there may well be environmental conditions,
local environmental conditions that warrant something over and
above voluntary BMPs. But absent those environmental
conditions, it is our position that voluntary best-management
practices are effective and suffice.
Mr. Burton. OK. Let me just stop you right there.
You know, if you were talking about something that was
contained in a very small area, like Indianapolis, IN, for
instance, where I live, or Crawfordsville, IN, it would be one
thing. But this mercury gets into the water streams, the
groundwater supply; it gets into the air when you burn this
wastewater product, and it goes everywhere. And it gets into
the fish we eat. And so, for the ADA to contact the EPA--and
evidently you're admitting that happened, that you submitted a
confidential document that argues that reducing dental mercury
pollution through installation of amalgam separators is not
cost effective or necessary--so the answer is yes, in effect,
that's what you sent to the EPA, right?
Mr. Bowman. Mr. Chairman, if I could just point out the
next clause in what you were just referring to, specific
environmental conditions.
Mr. Burton. OK. In the document, ADA urges EPA to issue
guidance practically devoid of amalgam separators that would
recommend only voluntary BMPs unless environmental conditions
or State law requires mercury reductions.
Mr. Bowman. Correct.
Mr. Burton. Yes. But the fact of the matter is, you did
send a document, or documents, that said to that effect what I
just read.
And so you're saying, unless the local people, like in the
State of Washington, say, you've got to do this, then it's
going to be on a voluntary basis? And the State of Washington
said, when it was voluntary, after 6 years, 24 out of 900
dentists complied. That's a very, very small number. And since
we know that 40 percent of the mercury that's going into our
environment from--through the wastewater treatment plants is
from dental amalgams, why in the world wouldn't you want to say
to your dentists around the country, this is something you must
do?
Mr. Bowman. Mr. Chairman, if local authorities mandate
separators, the American Dental Association will do everything
it can to assist our members in obtaining and installing the
correct separators.
Furthermore, there are in place regulatory schemes that
address surface water contaminant levels and sludge limits. If
those limits or those levels are exceeded, again the American
Dental Association is ready to assist our members to do what--
to do their fair share to help the environment. But where there
is no specific environmental problem, it is our position that
voluntary methods are sufficient and work well, yes.
Mr. Burton. You know, that--I don't want to make light of
what you said, but unless there's an environmental problem--any
amount of mercury in the environment's not good. Any amount of
mercury in your body's not good. It's just not.
Do we have anybody here from the EPA?
Mr. Kuzmack. Yes, my name is Arnold Kuzmack.
Mr. Burton. Did you get the document from the ADA about
this? Are you familiar with that?
Mr. Kuzmack. Yes, I am familiar with the document.
Mr. Burton. What is the EPA's response to that document?
Mr. Kuzmack. What we're doing is, we have had a meeting
with ADA and then we're continuing to have additional meetings
to develop areas where we can cooperate. We do continue to
support local and State agencies that want to either
voluntarily or on a mandatory basis require separators. We
would support that, and we would not----
Mr. Burton. On a voluntary basis?
Mr. Kuzmack. Or on a mandatory basis, depending on----
Mr. Burton. Oh, would EPA prefer mandatory?
Mr. Kuzmack. I think as long as it works, we don't care
which way they do it.
Mr. Burton. Well, when you just heard this figure that was
quoted by the gentleman from the State of Washington that--
let's see, how much was it; 24 out of 900 over a 6-year period
complied in a voluntary.
Does that sound to you like it's effective?
Mr. Kuzmack. In that case, obviously not. I believe there
are other situations where they have been relatively effective.
Mr. Burton. Really? Where?
Mr. Kuzmack. Duluth, MN, for example.
Mr. Burton. How many complied on a voluntary basis?
Mr. Kuzmack. I don't have the figures in my head right now.
Mr. Burton. Was it a high percentage?
Mr. Kuzmack. My understanding is, it was a high percentage.
Mr. Burton. Fifty percent?
Mr. Kuzmack. I really couldn't say.
Mr. Burton. Could you send me some statistical data on that
to show that?
Mr. Kuzmack. I'll try to find something, yes.
Mr. Burton. Would you do that?
Mr. Kuzmack. Yes, sir.
Mr. Burton. OK.
Dr. Eichmiller. We do have the information from the Duluth
group, and it was near 100 percent compliance.
Mr. Burton. On a voluntary basis up there?
Dr. Eichmiller. That's correct.
Mr. Burton. I wonder why it was only 24 out of 900 in the
State of Washington.
Dr. Eichmiller. I think that was an unfortunate situation
where there was a lot of misunderstanding on both the side of
the regulators and the regulated community.
We've learned an awful lot from that, and that's one of the
reasons why we have made such an effort to work with the
regulators since then to try to put our constituent societies
in touch with them, so they can come up together with a
collaborative scheme.
Mr. Burton. OK.
Do you know who paid for the Duluth separators? Were they
paid for by the individual dentists?
Mr. Berglund.
Dr. Eichmiller. I'm not sure.
Mr. Berglund. Mr. Chair, I'm not sure about each and every
single separator, but a good number of them were provided by
the Western Lake Superior Sanitary District, the sewer board in
Duluth.
Mr. Burton. So the government up there was paying for them?
Mr. Berglund. Right. Yeah, a good chunk of them. The person
working in Duluth acquired some grant money and funded the
acquisition. Some of the separators were given to Duluth by one
of the manufacturers on a trial basis and in Duluth.
Mr. Burton. Thank you.
The gentleman from EPA, did you know they were paid for in
large part by the government up there?
Mr. Kuzmack. I was not specifically aware.
I guess I'm not supporting--I'm not opposing mandatory
requirements, but we are not requiring that either. If it
works, it works.
Mr. Burton. Well, the point is--and I don't know what your
position is as far as authority over at the EPA is concerned,
but if the ADA is coming to you with a voluntary approach and
you see that in the State of Washington only a very small
percentage of them complied, and then they use, as an example,
another area where almost 100 percent complied, but the
government was paying for the separators, you'd say, well, wait
a minute. Of course, if somebody's buying me a car, I'd say,
gee, that's great; I'll drive more safely.
But the fact of the matter is, we're not going to be able
to pay for all the dentists in the country to have these
separators. It's going to have to be mandated by somebody;
otherwise, it's going to get into the wastewater treatment.
Now, let me just ask you one last question, and I'll let
you gentlemen go, because I don't want to prolong this. It's
getting rather late in the day.
If we didn't have mercury in our fillings, would this be a
problem? Of course not. That's the answer.
If there's any question about the safety of the mercury in
your mouth, why not get it out? If there's any question about
the safety as far as sewage treatment plants are concerned,
then why not get it out? If there's any question about the
burning of it and its getting into the environment where we
breathe it, then why not get it out? If there's any question
about its getting into the waterways, then why not get it out?
The only question is, and it's the same thing we found with
the pharmaceutical companies as far as thimerosal and the
vaccines; it's money. It's money. And it's unfortunate that the
safety and the health of the American people comes down to the
dollar because, you know, if there's any question about it, you
ought to get that substance out of there. That's the question.
You ought to get it out of there.
And with that, I really, really appreciate your being here.
This will not be the last hearing. We're going to have hearings
around the country on this subject, and I hope that some day
we'll see these things bear fruit.
We stand adjourned.
[Whereupon, at 5:36 p.m., the subcommittee was adjourned.]
[The prepared statement of Hon. Diane E. Watson follows:]
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