Mercury use in dental amalgam at the EU Print
Sunday, 18 September 2011 15:45

Mercury use in dental amalgam at the EU

Developments 2011 - ongoing

The EU has launched a study in spring 2011, under the revised EU Mercury Strategy,  to carry out a full life-cycle assessment of the mercury use in dentistry.

The report will be mainly focusing on the environmental aspects of the use of mercury in dentistry. Then a small update will be included on health related issues.

The consultant BIO Intelligent Services (BIOS) (France) were awarded the contract to carry out the report. Input had been requested over the summer until September 2011.

The EEB has sent initial input to the study in September 2011. 

The report from BIOS is expected to finish the report around Easter 2012.

A draft report is expected to be published soon. A stakeholder meeting is also expected to take place in March 2012 - the draft report will be presented, stakeholders will give input, and after that the consultant will have to put together the final report.


Developments 2005 - 2008

Political process

 The EU adopted in January 2005 a mercury strategy that identified dental amalgam as an area for concern. In relation to that two actions were proposed:

Action 4. The Commission will review in 2005 Member States’ implementation of Community requirements on the treatment of dental amalgam waste, and will take appropriate steps thereafter to ensure correct application.

Action 6. In the short term the Commission will ask the Medical Devices Expert Group to consider the use of mercury in dental amalgam, and will seek an opinion from the Scientific Committee on Health and Environmental Risks, with a view to considering whether additional regulatory measures are appropriate.

Dental amalgam is considered hazardous waste in EU Directive 91/689/EEC. Therefore, mercury-containing dental amalgam waste should be collected separately and not left to end up in the wastewater. In 2006 DG Environment sent questionnaires to the Member States to verify how they were complying with the hazardous waste directive by using amalgam separators at dental clinics. Some Member states sent responses, found here.

In March 2006, the European Parliament called on the Commission to bring forward a proposal to restrict the use of mercury in dental amalgam by the end of 2007.

The European Commission consequently prepared questions in spring 2007 - DG Environment prepared questions on the environmental impact of the mercury dental amalgam use. DG Enterprise prepared questions on the health impacts of the mercury dental amalgam and their alternatives.

In autumn 2007, both sets of questions prepared by the respective DGs (ENV, ENTR) were sent to DG SANCO (Health and consumer protection).

DG SANCO then sent these questions to the relevant Scientific Committees. http://www.ec.europa.eu/health/ph_risk/committees/committees_en.html
The questions on environment (DG ENV) were sent to the Scientific Committee on Health and Environment Risks (SCHER);

http://www.ec.europa.eu/health/ph_risk/committees/04_scher/docs/scher_q_050.pdf

The questions on health (DG ENTR) were sent to the Scientific Committee on Emerging and Newly Identified Health Risks (SCENIHR). http://www.ec.europa.eu/health/ph_risk/committees/04_scenihr/docs/scenihr_q_009.pdf

The preliminary opinions of the two committees were published in January 2008 and a public consultation was launched. NGOs and others commented and expressed their concerns on the analysis presented in the two reports.

The EEB/ZMWG response to the SCHER consultation was submitted on 22 February 2008 in the electronic forms provided by the Commission. The full response can be found here.

 

The NGOs's reaction to the SCENIHR preliminary report can be found here.

In May 2008, the scientific committees published their final opinion. (SCHER opinion, SCHENIHR opinion - Corrigendum: Please note that in the footnote of table 2 (page 27), the MAK-value "0.1μg/m3" has been replaced by "0.1mg/m3" )
 

No major changes were made in the final reports by SCHER and SCHENIR- regarding the opinion on health and environmental effects by mercury dental amalgams and their alternatives- after the consultation, which led to the NGOs asking for a meeting with the European Commission, DG SANCO. A Stakeholder Dialogue Meeting on Health and Environmental Risk Assessment of Dental Amalgams was held on January 20, 2009.

Several NGOs were represented, including environmental NGOs (EEB), health NGOs (HEAL) and patients’ NGOs - representing patients suffering from mercury from dental amalgam (Mercuriados (ES),"Non au mercure dentaire” (FR)). Representatives from environmental medical academies (EuropeanAcademyfor Environmental Medicine) and scientists of metal allergies (Melisa Medica Foundation) also joined the meeting. From the EC side there were representatives from DG Health and Consumer Protection (SANCO) and DG Environment as well as from the two committees - SCENIHR and SCHER who were involved in the assessment process.

 At the Stakeholder Dialogue Meeting, SCENIHR and SCHER representatives provided stakeholders with information on how they reached their conclusions on the two opinions on dental amalgam (health and environmental aspects). Representatives from the NGOs were concerned that the message that seemed to be conveyed in the two reports is that there is no or very low health and environmental risks associated with mercury dental amalgam overall. SCHENIR and SCHER stated during the meeting that it was never concluded in the assessment that there is no risk for health or the environment from the use of mercury dental amalgams and emphasised that only a screening level risk assessment had been done and not a comprehensive risk assessment. Therefore the conclusions should be seen only within the framework of the limited available data and not as an overall conclusion.

 DG SANCO would write a report from the Stakeholder Dialogue Meeting and pass the report and comments to the newly formed Scientific Committees (around March 2009). The Scientific Committees would consider this report and give comments back to DG SANCO who would pass it to the stakeholders – the NGOs involved in that meeting. This new report was never developed.

For the environment side, whether a more comprehensive risk assessment is to be carried out, this would be a decision for DG ENV to make and they will have to put the resources to it. 

 

 Other relevant developments

 Given the developments in scientific assessments and policy demands on the widespread use of mercury used in dental amalgam, the EEB, together with HEAL and the Zero Mercury Working Group, organized the conference "Dental Sector as a source of mercury contamination" on the 25 May 2007 in Brussels, as a contribution to engaging more stakeholders in this important debate.

The report from the conference, the presentations and the participant list can be found here

Furthermore Members of the European Parliament asked questions related to the use of mercury in dental amalgam in 2008 to the Commission on mercury dental amalgam. The questions were from Hiltrud Breyer, German Greens which can be found on:

http://www.europarl.europa.eu/sides/getDoc.do?pubRef=-//EP//TEXT+WQ+E-2008-2444+0+DOC+XML+V0//EN

 and from Claude Thurmes, Luxemburg, Greens on:

http://www.europarl.europa.eu/sides/getDoc.do?pubRef=-//EP//TEXT+WQ+E-2008-4162+0+DOC+XML+V0//EN&language=EN

and from Kathy Sinnott (IND/DEM) to the Commission on:

http://www.europarl.europa.eu/sides/getDoc.do?pubRef=-//EP//TEXT+WQ+E-2008-3980+0+DOC+XML+V0//EN&language=EN
 

  A success story is that Mercuriados- ES, made a letter explaining that mercury may have adverse effects, they circulated this letter, it was signed by dentists, and was sent as official statement to authorities, and adopted at regional level (Barcelona, Catalonia). The Official web of the Spanish dentists from one autonomous region of Spain (Catalonia) now says that they recommend not to use dental amalgams, specially (therefore, not only) in pregnant women and children under 14 , due to the mercury they have and that may release and cause a variety of health and environmental hazards. See (although it is in Spanish): http://www.mercuriados.org/index.php?pagina=19  This could be a way to go also in other regions/MS.

Mercury is on the List of Priority substances which should be phased out from EU waters by 2020 under the Water Framework Directive 2000/60/EC and its daughter directive providing quality standards for water.

http://ec.europa.eu/environment/water/water-framework/index_en.html

 The EC is also addressing the issue under the implementation of the Water Framework Directive . Also under the Water Framework directive, the Member States should submit plans of how they are planning to reach the cessation target for different substances, including mercury.