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 the Florida 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 1 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 c
ommonly 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 mercur
y 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 a 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 1
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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in relation to exposure to amalgam
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Environ
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Leistevuo
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J, &
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(32) Department of Environment, Food and Rural
Affairs, UK, Oct 2005
(b)
Mercury
emissions from crematoria
, Defra/WAG/SE, July 2004,
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Agencys
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,
(33) EPA
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,
(35) Electric Power
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1993
*********************************
Technical contact
person: Bernard Windham
Research Coordinator, DAMS International
berniew1@embarqmail.com
ph
:
850-878-9024