DENTAL AMALGAM MERCURY SOLUTIONS www.flcv.com/dams.html
DAMS 12164 Whitehouse
Rd, Tallahassee, Fl 32317
THE ENVIRONMENTAL
EFFECTS OF AMALGAM FILLINGS AFFECT EVERYONE
THE FOLLOWING FINDINGS
ARE DOCUMENTED IN THIS Review Paper:
1. Human excretion
into sewers by those with amalgam dental fillings along with dental office
amalgam waste have been documented to be the largest source of mercury into sewers
and septic tanks in most areas. Much of the mercury is organic mercury, due to
bacterial actions that methylate inorganic mercury to organic.
2. All
sewer plants in the U.S. have high levels of mercury and all sewer
sludge has dangerous levels of mercury (generally 1 to
3 ppm).
3. Dental
amalgam fillings are a major source of mercury going into rivers,
lakes, and bays, both from dental offices and human wastes in home and
office sewers. Dentistry is the third largest use of mercury in
the U.S. using 45 tons per year most of which ends up in the environment.
4.
Mercury pollution is widespread in U.S. rivers, lakes, and bays;
with dangerous amounts of mercury commonly found in freshwater
and saltwater fish. Over 50% of Florida’s rivers and lakes have
warnings regarding eating the fish and most bays. Over 33% of
all U.S. lakes have fish consumption warnings, 15% of all U.S. river miles, 90%
of Atlantic coastal miles, and 100% of all Gulf coastal
miles. Most Gulf Coast salt water predator fish
species have high levels of mercury (above
EPA/FDA warning level)
5. Mercury is the most toxic substance commonly encountered, and
is adversely affecting the health of
millions of people in the U.S.
6. If
sewer sludge is incinerated, most of the mercury goes into
emissions.
7. Crops
grown on land using sewer sludge pick up high levels of
mercury. Soil bacteria in landfills and land spread
sludge areas methylate mercury to methyl mercury, which is released
in methane and landfill gas in high levels.
High levels of mercury are being found in
rain all over the U.S.
8. Dental Amalgam fillings are the largest
source of mercury in most people and levels
of mercury exposure from amalgam commonly exceeds Government Health
Guidelines, with high levels in human excretion wastes documented.
9. The
level of mercury in most sewer plants in the U.S. exceeds
the U.S. Environmental Protection Agency (EPA’s) proposed
mercury limit for mercury in water due to the large amount from amalgam in
sewers from dental offices, homes, and businesses.
10.
Crematoria emissions commonly violate mercury air emission standards and are a
significant source of mercury emissions due to mercury in amalgam
fillings. Amalgam related air emissions exceed coal plant emissions
in UK.
11. Due
to the high mercury releases from dental offices, most European countries
require amalgam separators in dental offices but
the U.S. still has no regulations on this source of
mercury. Due to the major environmental effects of mercury from
amalgam fillings, plus the additional known adverse health effects, most
Japanese Dental Schools no longer teach the use of mercury amalgam fillings and
several other countries have voted to ban amalgam use or issued warnings
regarding its use, as have several U.S. states.
Documentation:
Mercury is one of
the most toxic substances commonly encountered, and according to Government
agencies causes adverse health effects in large numbers of people in
the U.S. [1,20,34] Some of the mercury excreted by people and dental
offices is organic mercury since bacteria in people and sewers methylate
inorganic mercury to organic mercury (4,20). The extreme toxicity of mercury
can be seen from documented effects on wildlife by very low levels of mercury
exposure. The amount of mercury in the marine environment is increasing 4.8%
per year, doubling every 16 years (16). Some Florida panthers
that eat birds and animals that eat fish containing very low levels
of mercury (about 1 part per million) have died from chronic mercury
poisoning (17). Since mercury is an estrogenic chemical and
reproductive toxin, the majority of the rest cannot reproduce. The
average male Florida panther has higher estrogen levels than females, due
to the estrogenic properties of mercury (17). Similar is true of some other
animals at the top of the food chain like polar bears, beluga whales, and
alligators, which are affected by mercury and other hormone disrupting
chemicals (16,25,29,20). Mercury in whale meat has been
found to be high enough to cause acute toxicity from one meal. Several liver
samples contained over 1000 ppm mercury, over 2000 times the Japanese
health standard. Muscle samples contained 2.5 to 25 times the health standard
(25). The Japanese government's limit for mercury
contamination, 0.4 micrograms per gram (25). According to
the U.S. EPA, the maximum advisable concentration of methylmercury in
fish and shellfish tissue to protect consumers among the general population is
0.3 ppm(25b). Several European countries including Sweden have
banned use of amalgam fillings, with the environmental releases being a
major factor(5b,34).
Mercury has been found
to be so toxic that the drinking water standard for mercury is 2 parts
per billion(ppb). But U.S. EPA have found that because
mercury bioaccumulates in the environment and fish, in order to
protect from accumulation in fish and wildlife and human health even lower
standards appear to be needed and lower standards have been proposed or adopted
in many areas (14). The Great Lakes Initiative Wildlife Criteria
calculated needed to prevent accumulation in fish and wildlife is 1.3 nanagrams per Liter(ng/L) while the GLI Human Health
Criteria is 3.1 ng/L(parts per trillion). The EPA
Fish Tissue Methyl Mercury-based Criteria for rivers
is 7.8 ng/L and for lakes is 3.5 ng/L. The California
Toxics Rule Saltwater Criteria is 25 ng/L (14,33). The EEU limit on
mercury in sewers is 50 micrograms per liter (31).
The
average amalgam filling is 50% mercury and has more than ˝ gram of mercury; and
has been documented to continuously leak mercury into the body of those with
amalgam fillings due to the low mercury vapor pressure and galvanic current
induced by mixed metals in the mouth (2,19,20,34). Amalgam has been well
documented to be the number one source of mercury in most people (19,20)
and to commonly cause serious
adverse health effects (20, etc.). Amalgam has also been
documented to be the largest source of methyl mercury in most people with
several amalgam fillings, since mercury vapor and inorganic mercury have
been shown to be methylated to methyl mercury in the
mouth and intestines by bacteria, yeasts and other methyl donors (2,19,20). Mercury
has also been found to be methylated in dental office disposal and
sewer systems at levels orders of magnitude higher than in lakes
and rain(4d,19,27,29,34). The World Health Organization confirmed that mercury contained
in dental amalgam is the greatest source of mercury vapor in non-industrialized
settings, exposing the concerned population to mercury levels significantly
exceeding those set for food and for air (34,19). Mercury from dental amalgams
are discharged to the sewer, atmosphere or land, with another some sent for
recycling or disposed with the clinical waste stream (34). Together, mercury
contained in dental amalgam and in laboratory and medical devices, account for
about 53% of the total mercury emissions in the UK. (34)
Health-care facilities are one of
the main sources of mercury release into the atmosphere because
of emissions from the incineration of medical waste. The Environment
Minister of the Canadian province of Ontario declared on December 2002 that
emissions from incinerators were the fourth-largest source of mercury.
In the United States, according to US Environmental Protection Agency
(EPA) in a 1997 report, medical waste incinerators may have been responsible
for as much as 10% of all mercury air releases. (34)
Dental offices and health-care
facilities are also responsible for mercury pollution taking place in water
bodies from the release of untreated wastewater. According to a 1999
report, health-care facilities may also have been responsible for as much as 5%
of all mercury releases in wastewater. Environment Canada estimates that more
than one-third of the mercury load in sewage systems is due to dental
practice. (34)
The most common potential mode of occupational
exposure to mercury is via inhalation of metallic liquid mercury vapor. If
not cleaned up properly, spills of even small amounts of elemental mercury,
such as from breakage of thermometers or dental waste, can contaminate indoor
air above recommended limits and lead to serious health consequences. Since
mercury vapor is odorless and colorless, people can breathe mercury vapor and
not know it. For liquid metallic mercury such as in thermometers or as used for
dental amalgams, inhalation of vapor is the route of exposure that poses the
greatest health risk. (30,20)
Because of the extreme toxicity of mercury, only ˝
gram is required to contaminate the ecosystem and fish of a 10
acre lake to the extent that a health warning would be issued by the
government to not eat the fish [35]. Over half the rivers and
lakes along with most bays in Florida have such health warnings (3) banning
or limiting eating of fish, and most other states and 4 Canadian
provinces have similar health warnings (16,29). Wisconsin has
fish consumption warnings for over 250 lakes and rivers(5b) and Minnesota even
more, as part of the total of over 50,000 such lakes with warnings (16) (over
33% of all significant U.S. lakes) and 15% of all U.S. river miles.
All Great Lakes as well as most coastal bays and estuaries
and large numbers of salt water fish carry similar health warnings, with 90% of
Atlantic coastal miles and 100% of Gulf coastal miles covered by fish mercury
warnings.
Nationwide the dental industry is the
third largest user of mercury, using over 45 tons of mercury per year (26,14,34),
and most of this mercury eventually ends up in the
environment. Amalgam from dental offices is by far the largest
contributor of mercury (over 35% of total) into sewers and sewer
plants(4,13b,14,26,34), with mercury from replaced amalgam fillings and crown
bases the largest source. When amalgam fillings are removed by standard
practice methods using primary and secondary solids collectors, approximately
60% of the amalgam metals by weight end up in sewer effluent(28b). As much
as 10% of prepared new amalgam becomes waste. This mercury also accumulates in
building sewer pipes and septic tanks or drain fields where used, creating
toxic liabilities. Unlike Canada and most European
countries such as Germany, Sweden, Switzerland, and Denmark which have
much more stringent regulation of mercury that requires amalgam separators in
dental offices (26,28,22), the U.S. does not and most dental offices do not
have them, but new more stringent regulations are set to go into effect in
2020(33). The discharge into sewers at a dental office per
dentist using amalgam without amalgam separators is between 56 milligrams
per day (14) and 270 milligrams per day (2,4,14,26). (some studies
found much higher levels for some offices) For the U.S. with
approximately 170,000 dentists working with amalgam (26), this would
be from 2500 kg/yr to 12,000 kg/yr
(between 3 to 13 tons/year of mercury into sewers and thus into streams, lakes,
bays, and sewer sludge. In Canada the annual amount
discharged is about 2 tons per year (28), with portions ending up in
waters/fish, some in landfills and cropland, and in air emissions. The recently
enacted regulations on dental office waste in Canada are expected to reduce
emissions by at least 63% by 2005, compared to 2000(28).
Studies in Michigan, California, and Washington estimated
that dental mercury is responsible for approximately 12 to14 % of mercury
discharged to streams (5). An EPA study (13) found that dental office
waste were responsible for similar levels of mercury
in lakes, bays, and streams in other areas throughout
the U.S. A Canadian study found similar levels of mercury
contribution from dental offices into lakes and streams, and surveys of dental
office disposal practices found the majority violated disposal regulations, and
dangerous levels of mercury are accumulating in pipes and septic tanks from many offices
(14,21,26). Dental amalgam mercury has been documented to be
highly bioavailable in water (30).
The total discharge into sewers from
dental amalgam at individual homes and businesses
is second only to that from dental offices (2,14), since the
average person with amalgam fillings excretes in body waste approximately
40 micrograms per day of mercury(6,7,8,20,31a). This has also been
confirmed by medical labs(13c), such as Doctors Data Lab
in Chicago and Biospectron in Sweden,
which do thousands of stool tests per year and is consistent with studies
measuring levels in residential sewers by
municipalities(13b). In a Finnish study, over 20 % of those
with amalgam excrete so much to home sewers that the EEU standard for mercury in sewers
(50 ug/L) is exceeded (31). The amount of
mercury excreted on average doubled for each additional 10 amalgam
surfaces. The AMSA study adopted the conservative estimate of
28 micrograms per day for the average person with amalgam and 17 micrograms for
the average of all those with and without amalgam. In the U.S.
this would amount to approximately 2800 to 5500 kilograms per year into sewers
or from 3 to 6 tons per year. Over 3 tons of mercury flows into the Chesapeake
Bay annually from sewer plants, with numerous resulting fish consumption
advisories for that area and similar for other areas (16). Thus, the
amount of mercury being excreted from dental amalgam is more than enough to
cause dangerous levels of mercury in fish in most U.S. streams into which
sewers empty. Studies by Oak Ridge National Laboratory (U.S.
Dept. of Energy) (22,23) and other studies (14) have confirmed high levels of
mercury in sewers and sewer sludge (generally 1 to
3 ppm in biosolids). Public Owned Treatment Works
(POTWs) do not have equipment to remove mercury in sewers other than any
pretreatment requirements imposed by sewer districts. Mercury wastes
are incompatible and must be removed at the source. In general, POTWs are
not equipped to remove or treat toxic chemicals.
MCES found that dental offices were responsible
for over 40% of Mineapolis sewer mercury
and excretion from those with amalgam responsible for over 80% of domestic
mercury (4). According to an EPA study the majority
of U.S. sewerage plants cannot meet the new EPA guideline for mercury
discharge into waterways that was designed to prevent bioaccumulation in fish
and wildlife due to household sewer mercury levels(15,13).
The EPA discharge rule had been reduced due to a National Academy of Sciences
report of July 2000 that found that even small levels of mercury in fish result
in unacceptable risks of birth defects and developmental effects
in infants (18).
ORNL studies have found that crops
grown on land using land spread sewer sludge pick up high levels of mercury,
and soil bacteria methylate inorganic mercury into methyl mercury,
which is released into the air or landfill gas at high levels(22,23a).
Sixty percent of the 5.6 million tons of sewage sludge generated each year are
used for land application (27). The ORNL studies estimate that emissions
of mercury from sludge amended soil amounts to from 5 to 6 tons of mercury
per year(23a). Most dental amalgam waste from dental offices
either goes into landfills or is incinerated (26). Much
of the sewer sludge is also incinerated. Most of the mercury
in materials that are incinerated goes out in the emissions, as most
incinerators have no controls to remove
mercury. High levels of mercury including the very
toxic organic forms are being measured in rainfall throughout the U.S. (24). High
levels of the extremely
toxic dimethyl and methylmercury forms of mercury are being
found in landfill gas coming from landfills and appear to be a significant
source of some of this (22,24). Bacteria in landfills have been
found to be methylating elemental and
inorganic mercury to the organic forms(22a,23a). Dental amalgam
waste and mercury from human sewer sludge are major sources of mercury in some
landfills and sludge is also used in landspreading on
farms and other areas. Health Canada has also documented
similar information on mercury emissions from amalgam and sewer sludge to
waterways, crops, and air(28,29).
Additionally, cremation of those
with amalgam fillings adds to air emissions and deposition onto land and
lakes. A study in Switzerland found that in that small country,
cremation released over 65 kilograms of mercury per year as emissions, often
exceeding site air mercury standards (9), while another Swiss study found
mercury levels during cremation of a person with amalgam fillings as high as
200 micrograms per cubic meter (considerably higher than U.S. mercury
standards). The amount of mercury in the mouth of a person
with fillings was on average 2.5 grams, enough to contaminate 5 ten-acre lakes
to the extent there would be dangerous levels in fish (2,20). A
Japanese study estimated mercury emissions from a small crematorium there as 26
grams per day (10). A study in Sweden found significant
occupational and environmental exposures at crematoria, and since the
requirement to install selenium filters mercury emission levels in crematoria
have been reduced 85% (11). For the 70% of people in Britain who die and
end up with their bodies being cremated, the mercury escapes into the atmosphere and
contaminates waterways, soil, wildlife and food. Crematoria now contribute
16% of all the mercury released by industry and power plants in
Britain (32), with levels projected to soon exceed emissions by
power/industrial plants(32b). The 440,000 people cremated in Britain every year
are estimated to discharge 1300kg of mercury. (12) A study of
assessing hair mercury in a group of staff at some of the 238 British
crematoriums found that the groups hair mercury were
significantly greater than that of controls (12). Government guidance
calls on them to introduce new flue cleaning measures to help achieve a
statutory target of a 50 per cent reduction by 2012.
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(35) Electric
Power Research Institute. Mercury in the
Environment. Electric EPRI Journal 1990; April, p5; & EPRI
Technical Brief: "Mercury in the Environment",
1993
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Technical
contact person: Bernard Windham
Research
Coordinator, DAMS International
berniew1@embarqmail.com ph:
850-878-9024