[House Hearing, 110 Congress]
[From the U.S. Government Publishing Office]
ASSESSING STATE AND LOCAL REGULATIONS TO REDUCE DENTAL MERCURY
EMISSIONS
=======================================================================
HEARING
before the
SUBCOMMITTEE ON DOMESTIC POLICY
of the
COMMITTEE ON OVERSIGHT
AND GOVERNMENT REFORM
HOUSE OF REPRESENTATIVES
ONE HUNDRED TENTH CONGRESS
SECOND SESSION
__________
JULY 8, 2008
__________
Serial No. 110-167
__________
Printed for the use of the Committee on Oversight and Government Reform
Available via the World Wide Web: http://www.gpoaccess.gov/congress/
index.html
http://www.oversight.house.gov
----------
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COMMITTEE ON OVERSIGHT AND GOVERNMENT REFORM
HENRY A. WAXMAN, California, Chairman
EDOLPHUS TOWNS, New York TOM DAVIS, Virginia
PAUL E. KANJORSKI, Pennsylvania DAN BURTON, Indiana
CAROLYN B. MALONEY, New York CHRISTOPHER SHAYS, Connecticut
ELIJAH E. CUMMINGS, Maryland JOHN M. McHUGH, New York
DENNIS J. KUCINICH, Ohio JOHN L. MICA, Florida
DANNY K. DAVIS, Illinois MARK E. SOUDER, Indiana
JOHN F. TIERNEY, Massachusetts TODD RUSSELL PLATTS, Pennsylvania
WM. LACY CLAY, Missouri CHRIS CANNON, Utah
DIANE E. WATSON, California JOHN J. DUNCAN, Jr., Tennessee
STEPHEN F. LYNCH, Massachusetts MICHAEL R. TURNER, Ohio
BRIAN HIGGINS, New York DARRELL E. ISSA, California
JOHN A. YARMUTH, Kentucky KENNY MARCHANT, Texas
BRUCE L. BRALEY, Iowa LYNN A. WESTMORELAND, Georgia
ELEANOR HOLMES NORTON, District of PATRICK T. McHENRY, North Carolina
Columbia VIRGINIA FOXX, North Carolina
BETTY McCOLLUM, Minnesota BRIAN P. BILBRAY, California
JIM COOPER, Tennessee BILL SALI, Idaho
CHRIS VAN HOLLEN, Maryland JIM JORDAN, Ohio
PAUL W. HODES, New Hampshire
CHRISTOPHER S. MURPHY, Connecticut
JOHN P. SARBANES, Maryland
PETER WELCH, Vermont
------ ------
Phil Barnett, Staff Director
Earley Green, Chief Clerk
Lawrence Halloran, Minority Staff Director
Subcommittee on Domestic Policy
DENNIS J. KUCINICH, Ohio, Chairman
TOM LANTOS, California DARRELL E. ISSA, California
ELIJAH E. CUMMINGS, Maryland DAN BURTON, Indiana
DIANE E. WATSON, California CHRISTOPHER SHAYS, Connecticut
CHRISTOPHER S. MURPHY, Connecticut JOHN L. MICA, Florida
DANNY K. DAVIS, Illinois MARK E. SOUDER, Indiana
JOHN F. TIERNEY, Massachusetts CHRIS CANNON, Utah
BRIAN HIGGINS, New York BRIAN P. BILBRAY, California
BRUCE L. BRALEY, Iowa
Jaron R. Bourke, Staff Director
C O N T E N T S
----------
Page
Hearing held on July 8, 2008..................................... 1
Statement of:
Bender, Michael, director, Mercury Policy Project; Richard D.
Fischer, former president, International Academy of Oral
Medicine and Toxicology; Curt McCormick, former
Administrator, Environmental Protection Agency Region 8;
and William Walsh, counsel, American Dental Association.... 12
Bender, Michael.......................................... 12
Fischer, Richard D....................................... 41
McCormick, Curt.......................................... 49
Walsh, William........................................... 58
Magnuson, Patricia, industrial waste investigator, King
County, Seattle, WA; Ann Farrell, director, Engineering
Department, Central Contra Costa County Sanitary District;
Dr. C. Mark Smith, deputy director and co-chair,
Massachusetts Department of EPA, New England Governors and
Eastern Canadian Premiers Task Force; and Owen Boyd, CEO,
Solmetex................................................... 97
Boyd, Owen............................................... 152
Farrell, Ann............................................. 115
Magnuson, Patricia....................................... 97
Smith, Dr. C. Mark....................................... 133
Letters, statements, etc., submitted for the record by:
Bender, Michael, director, Mercury Policy Project, prepared
statement of............................................... 18
Boyd, Owen, CEO, Solmetex, prepared statement of............. 155
Farrell, Ann, director, Engineering Department, Central
Contra Costa County Sanitary District, prepared statement
of......................................................... 118
Fischer, Richard D., former president, International Academy
of Oral Medicine and Toxicology, prepared statement of..... 43
Kucinich, Hon. Dennis J., a Representative in Congress from
the State of Ohio, prepared statement of................... 4
Magnuson, Patricia, industrial waste investigator, King
County, Seattle, WA, prepared statement of................. 100
McCormick, Curt, former Administrator, Environmental
Protection Agency Region 8, prepared statement of.......... 52
Smith, Dr. C. Mark, deputy director and co-chair,
Massachusetts Department of EPA, New England Governors and
Eastern Canadian Premiers Task Force....................... 136
Walsh, William, counsel, American Dental Association,
prepared statement of...................................... 60
Watson, Hon. Diane E., a Representative in Congress from the
State of California, letter dated December 17, 2004........ 77
ASSESSING STATE AND LOCAL REGULATIONS TO REDUCE DENTAL MERCURY
EMISSIONS
----------
TUESDAY, JULY 8, 2008
House of Representatives,
Subcommittee on Domestic Policy,
Committee on Oversight and Government Reform,
Washington, DC.
The subcommittee met, pursuant to notice, at 2:35 p.m., in
room 2154, Rayburn House Office Building, Hon. Dennis J.
Kucinich (chairman of the subcommittee) presiding.
Present: Representatives Kucinich, Watson, and Burton.
Staff present: Jaron R. Bourke, staff director; Noura
Erakat, counsel; Jean Gosa, clerk; Leneal Scott, information
systems manager; and Jill Schmalz, minority professional staff
member.
Mr. Kucinich. Good afternoon to our witnesses and to all
those in attendance. I am Congressman Dennis Kucinich, chairman
of the Domestic Policy Subcommittee of the Oversight and
Government Reform Committee.
Our hearing today is going to be on assessing State and
local regulations to reduce dental mercury emissions.
I am pleased to be joined today by the distinguished
Congressman from the State of Indiana, Representative Dan
Burton, who I had the privilege of serving with in many
different capacities over the last 12 years.
Congressman Burton, thank you for joining us, sitting in as
the ranking member today for Congressman Issa.
This hearing today continues an examination that this
subcommittee began last November into the detrimental impact of
mercury on the environment. In particular, we are taking a
closer look at mercury released from the dental industry and
how State and local governments have worked to reduce those
emissions.
Elemental mercury and most of its compounds are extremely
toxic substances that can cause chronic and acute poisoning in
human beings who come into contact with them. Young children
and unborn fetuses are particularly susceptible to mercury
poisoning. Today, improper disposal of mercury into wastewater
by industries and persons who use it has caused dangerously
high contamination levels in many of the country's water
bodies.
The dental industry contributes substantially to the amount
of mercury that ends up in wastewater and eventually in fresh
water. In places where the disposal of dental amalgam is not
subject to regulation, amalgam is frequently discarded by
simply washing it down the drain.
Last November, the subcommittee held its first hearing on
this matter, where it heard testimony from the EPA, as well as
the Food and Drug Administration. In the aftermath of the
hearing, the FDA set a deadline to issue a final regulation on
the reclassification of dental amalgam and its components,
which would increase FDA oversight of dental amalgam. We are
pleased with the FDA's decision to issue this proposed
rulemaking.
During our first hearing, we learned that dental offices
constitute the largest source of mercury in wastewater
influent. Once in the wastewater, mercury contaminates the
environment in several ways. Most of the mercury entering the
wastewater stream concentrates in the sewage sludge, 60 percent
of which is spread over land as fertilizer; 20 percent is
incinerated, resulting in the atmospheric release of mercury;
and 15 percent is land-filled.
The mercury that does not concentrate in sludge is
discharged to downstream surface waters along with the treated
effluent, namely into lakes, oceans, streams and land. We have
also learned that a number of States and municipalities have
made attempts at preventing the release of dental mercury from
dental offices.
Subsequently, the subcommittee took a closer look at State
and local efforts aimed at reducing dental mercury emissions.
The subcommittee surveyed nine States and eight local
governments that have attempted to do so and found that when
States evaluated the cost and benefits of choosing how to
prevent environmental emissions of mercury, they all found that
the most economical means for doing so was to prevent the
dental mercury from entering their wastewater, as opposed to
removing mercury from the wastewater.
The technology used to capture mercury in the dentists'
offices before it enters the wastewater stream is the mercury
amalgam separator. Our survey revealed that to prevent dental
mercury from entering municipal wastewaters, State and local
governments have either encouraged voluntary use or mandated
the use of separators.
Our findings indicate that successful voluntary programs
were incentivized programs that offered less cumbersome
compliance requirements and were underpinned with the threat of
a mandatory program. Moreover, most of the State and local
governments that we surveyed initiated a voluntary program
before enacting provisions in the form of a regulation,
ordinance or statue mandating the installation of separators
and a recycling program. Only after the failure of their
voluntary programs to achieve their desired compliance goals
did these governments switch to a mandatory program.
Today we are going to hear from several of those States and
local government representatives about how they grappled with
these challenges, what were their lessons learned and how their
regulatory experience can help States and local governments
seeking to reduce dental mercury discharges to their
wastewater.
We will also hear from the American Dental Association. The
ADA constitutes one of the most significant stakeholders in the
effort to reduce dental mercury emissions. As we will hear
today, among the most valuable lessons learned in the effort to
achieve compliance is the importance of the cooperation and
leadership of local and State dental societies.
The ADA has already made significant strides in leading the
effort to reduce dental mercury emissions. Most recently, it
amended its best management practices to reflect its
endorsement of amalgam separators as an effective tool to
reducing mercury contamination from the dental industry. The
ADA writes that ``the use of separators will allow greater
recycling and reduce the amount of amalgam which contains
mercury entering wastewater treatment plants.''
Some of the questions we hope to address in today's
hearings are: First, what is the impact of dental mercury on
the environment? Second, what is the efficacy of amalgam
separator units? Third, what is the cost-benefit analysis of
amalgam separators made by State and local governments? And,
fourth, what are the considerations to make when deciding
between a voluntary and a mandatory dental mercury reduction
program?
The subcommittee looks forward to hearing the testimony of
witnesses today, and we will continue our investigation of how
State and local governments can effectively reduce dental
mercury emissions.
At this time I would like to introduce the gentleman from
Indiana, Congressman Burton, for his opening statement thank,
Mr. Burton.
[The prepared statement of Hon. Dennis J. Kucinich
follows:]
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
Mr. Burton. Thank you, Mr. Kucinich.
Dr. Fischer, it's good seeing you again. Haven't seen you
for a while.
I will tell you a little story. This weekend I had a cap
come off of one of my teeth, and I had to call my dentist for
an emergency so he could put that cap back on. But when I got
there, I asked him, I said, ``What kind of a filling do I have
in that tooth that was under that cap?'' He says, ``Well, it's
an amalgam.'' I said, ``Well, that's partially mercury, isn't
it?'' He says, ``Yeah, but it's inert, and it can't cause you
any problem.''
I just want you to know that it split, and a lot of that
came into little bitty chunks and it got in my mouth, and I had
to rinse it out. I was thinking, as I was rinsing it out, I
wonder how much of this I am going to swallow and what kind of
an impact it might have on me later in life.
And I had to have him go ahead and put the cap on it, so it
is still there. So, Dr. Fischer, I may be coming to you to have
to get that out of there, because I had to have my tooth fixed
over the weekend.
But that's an example of--and he is a very good dentist;
don't misunderstand. He is trying to do what he thinks is
right, and he gets his direction from the ADA, who doesn't like
me very much. You guys worked hard to beat me in the primary. I
just want you to know you didn't win.
But, anyhow, the thing about mercury is it is toxic, and it
shouldn't be in our drinking water, it shouldn't be in our
teeth, it shouldn't be in our vaccines, it shouldn't be in
anything that goes into the human body. There's just no
question, it shouldn't be in anything that goes into the human
body.
And even the FDA--I guess it was the FDA--the U.S. Food and
Drug Administration just recently said they no longer ignored
the science after dodging its duty to classify mercury fillings
for decades. The U.S. Food and Drug Administration recently
settled a lawsuit with several consumer groups promising to
complete its end of the settlement within a year. As part of
the settlement, the FDA has even publicly withdrawn its claims
that amalgam is safe for all. And now it warns, ``Dental
amalgams contain mercury, which may have neurotoxic effects on
the nervous systems of developing children and fetuses.'' Well,
what about the person who has it in their mouth?
You know, we had hearings on this for 2 years, Mr.
Chairman. When I was chairman of the Government Reform
Committee, my grandson became autistic. And I started looking
into the mercury that was going into the human body, and I
found that the vaccinations that children were getting
contained 50 percent ethyl mercury and what was called the
thimerosal preservative.
And it used to be kids would get, you know, two or three
vaccinations and then go to school. When I was a kid, if you
had measles, it was a quarantine, or chicken pox or anything.
Today, they give you vaccinations for all of that. And, as a
result, children get as many as 28 to 30 vaccinations before
they start to school.
And, as a result, we have gone from one in 10,000 children
that are autistic to one in 150. It is an absolute epidemic in
America. And those kids are going to grow up, and they are
going to get older, live to maybe 70 or 75, and be a burden not
only to their families but on society and the taxpayers,
because they are going to need help.
And we still have mercury in adult vaccinations, and we
have been able to get it out of almost all of the children's
vaccinations except three or four. But a lot more needs to be
done, and that's why I congratulate you on having this hearing.
Representative Watson, your colleague on the Democrat side,
who unfortunately couldn't be here today, she worked on this
very hard in California. And she was able to get legislation
passed out there that dealt with the mercury in dentistry, so
that California is way ahead of the Federal Government and the
ADA on this issue.
I understand that other substances that they have put into
our teeth may have some side effects. I have heard the ADA
before, when we have had these hearings before, and there are
some things that people should be concerned about. But mercury
is the most toxic substance aside from radioactive material in
the world. If you spill it on this floor, they are going to
evacuate the building. They did that in high school in a
science class here in Washington, DC. They spilled some on
floor, they cleared the room, they evacuated the school, and
they took the kids who had the mercury spilled on the floor
near them and burned their clothes and had them watched by
doctors for a long period of time.
I am anxious to hear from our witnesses today. I have heard
most of you before, and I am sure I am going to hear pretty
much the same kind of testimony I have heard before.
But I really do appreciate Dennis Kucinich, the chairman of
this committee, who ran unsuccessfully for President but
nevertheless he has a national following now. And even though
Dennis is in the other party, him holding a hearing on this, I
think, will bring far more attention on the subject. And I
really appreciate him holding the hearing.
Mercury should not be ingested in the human body in any
way.
One more thing, in Newport News, Virginia, when we were
holding these hearings, the dentist down there, when they did
the dental work on the naval personnel, they evidently were
letting a lot of the mercury get into the wastewater system.
And so the wastewater treatment system down there, the people
that were head of the Newport News, Virginia, went to the naval
leaders at Newport News and said, those all have to be put in
containers, they can't allow any of the amalgams to leach into
the water system because it was getting into the recycling
system and it was getting into the water and causing problems.
And so they started making sure it was put into lead-covered
containers so it couldn't get into the system down there.
That tells you pretty clearly that the residual impact of
mercury fillings, even if you could keep them inert and
wouldn't hurt you in your mouth, certainly hurt when they get
into the ecological system, the water systems. And if you burn
them in an incinerator, they get into the air. And so mercury
should be not allowed to be put into amalgams or into the human
body in any way.
I am sorry if I droned on a little bit too long, Mr.
Chairman, but when you have a grandson----
Mr. Kucinich. The gentleman is entitled to take whatever
time he thinks is necessary.
Mr. Burton. Well, thank you.
But when you have a child who is a normal child, and he is
your grandson, and he gets nine shots in 1 day, seven of which
have mercury in it, and he becomes autistic within just a short
period of time, and you have hearings on it for 2 or 3 years,
and you find out from leading scientists and doctors from all
over the world that the mercury in the vaccinations was a
contributing cause, they believe--and there have been studies
that show it does--that it's a contributing factor to autism,
mercury in the amalgams.
We had scientists from all over the country and the world
come in and talk about the leaching effect of the vapors from
hot and cold water getting into the mouth that could cause
neurological problems from the mercury amalgams that are in
people's teeth.
And so this is a very big issue. It's one that is not
focused on very often. And I really appreciate, Mr. Chairman,
you taking the lead on this today. And I want you to know that,
as long as you do this and as long as I am in Congress, I will
do everything I can to get mercury out of everything that goes
into the human body.
Thank you, Mr. Chairman.
Mr. Kucinich. I want to thank the gentleman for his
passionate opening statement and also to indicate to you that
this subcommittee is going to have an ongoing interest in this.
The gentleman from Indiana and I have had other
conversations about exploring the research and the causative
effects of autism.
I want to thank you very much, Mr. Burton, for the heart
that you put into this. Thank you.
Mr. Burton. Thank you, Mr. Chairman.
Mr. Kucinich. Without objection, Members and witnesses may
have 5 legislative days to submit a written statement or
extraneous materials for the record.
Since there is no other Member seeking recognition, we are
going to go to the witnesses' testimony. I want to begin by
introducing our first panel.
Mr. Michael Bender is the director and cofounder of the
Mercury Policy Project. Over the past 12 years, Mr. Bender has
worked extensively on reducing mercury uses, reduce trade and
exposure at the State, national and international levels. He
serves as cochair of the State of Vermont Advisory Committee on
Mercury Pollution, where he has represented the Abenaki, a
local indigenous tribe, since 1998.
Dr. Rich Fischer is the former president of the
International Academy of Oral Medicine and Toxicology. He has
published scientific papers internationally, and in 1998 he
authored a chapter in the British dental textbook entitled,
``Complementary Therapies in Dental Practice.'' Dr. Fischer is
also a member of several professional organizations, including
the Academy of General Dentistry, the American Academy of
Biological Dentistry, and the National Academy of Research
Biochemists.
Mr. Curt McCormick is the former administrator of the
Environmental Protection Agency's Clean Water Act Industrial
Pretreatment Program in Region 8. He worked for the EPA as an
environmental scientist from 1987 to 2007, during which time he
conducted hundreds of inspections of local government
pretreatment programs and industrial facilities. Mr. McCormick
is currently the owner of CWA Consulting Services and a board
member for the Consortium for Research and Education on
Emerging Contaminates.
Mr. William Walsh--welcome--is legal counsel for the
American Dental Association. He is of counsel in the Washington
office of Pepper Hamilton LLP, where he heads the office's
environmental practice group. He is also a member of the firm's
sustainability and climate change team. His experience
encompasses all major Federal environmental statutes and many
State and local environmental laws, as well.
I want to welcome all of our witnesses and thank you for
appearing before the subcommittee today.
It's the policy of the Committee on Oversight and
Government Reform to swear in all the witnesses before they
testify. I would ask that all the witnesses please rise and
raise your right hands.
[Witnesses sworn.]
Mr. Kucinich. Let the record reflect that the witnesses
answered in the affirmative.
I will ask that each of the witnesses now give a brief
summary of the testimony. Please keep this summary under 5
minutes in duration. And I want you to keep in mind that your
presentation is very important. We want to be able to have it
on the record, and we will, because your written statement is
going to be included in the hearing record. So if you can
present for 5 minutes, everything else in the record.
Let's start with Mr. Bender. You are our first witness.
Please proceed.
STATEMENTS OF MICHAEL BENDER, DIRECTOR, MERCURY POLICY PROJECT;
RICHARD D. FISCHER, FORMER PRESIDENT, INTERNATIONAL ACADEMY OF
ORAL MEDICINE AND TOXICOLOGY; CURT MCCORMICK, FORMER
ADMINISTRATOR, ENVIRONMENTAL PROTECTION AGENCY REGION 8; AND
WILLIAM WALSH, COUNSEL, AMERICAN DENTAL ASSOCIATION
STATEMENT OF MICHAEL BENDER
Mr. Bender. Thank you, Mr. Chairman, members of the
committee. My name is Michael Bender.
Mr. Kucinich. You know what? I am sorry. Before we begin, I
want to ask if--Congresswoman Watson just entered the room, and
she has done so much on this.
Did you want an opening statement, Congresswoman?
Ms. Watson. Yes.
Mr. Kucinich. OK. The Chair is going to use his prerogative
to go to Congresswoman Watson, who has done a lot of work on
this issue in the State of California, as Mr. Burton noted.
And so, Ms. Watson, when you are ready, you may proceed.
Just take your time. Thank you.
And then we will return to you, Mr. Bender.
Ms. Watson. Mr. Chairman, thank you so much for your
leadership and your hard work on this issue and for holding
this hearing.
And I want to thank all of the witnesses for being here
today.
Mercury is a toxin. And we all are concerned about the
welfare of the patients, but I am also worried about the long-
term effects of exposure to mercury to dentists and to the
staff. For many years, there has been a research study on this
very topic, and it was discovered that all dentists and staff
who either replace or remove mercury fillings have extremely
high levels of mercury in their systems.
Some of the dental offices do not insert mercury fillings;
they only remove them. Therefore, they are breathing in the
mercury vapors and dust, and a regular mask does not help. One
needs to wear a respirator. And this toxic material enters
their systems via the respiratory tract. Absorption through the
skin is another mode of transport.
Dentists and staff, when compared to the general
population, have a large mercury content difference. And it is
not because they eat a lot of fish. Forget about the aesthetic
component; the need of the dentists and staff, the health
aspect, should be also a major concern.
It's amazing to me that the EPA has not gotten involved
with this. The long-term danger of mercury inhalation is as
detrimental as dental mercury fillings in one's mouth. It makes
you think we might be hiding something, doesn't it?
And allow me to ask this question: Why is it that dentists
have the highest suicide rate among any other health
professional?
Did you know that one of the side effects of mercury
toxicity is depression and suicidal tendencies, known years ago
as the Mad Hatter's Disease?
I, myself, Mr. Chairman--and I am so pleased to see
Congressman Burton here. We have been on this issue for years
together, and I appreciate your interest and your focus and
your being here. Look at the vacant seats.
I, myself, did not know I was being poisoned for decades. I
got my mercury fillings when I was 9 years old. And I noticed
that I had these allergies to everything, that I was getting
headaches, I was getting splotches in my skin. My skin was
much, much darker.
And so a group of researchers came into my office. They had
been doing research in Europe. And they said, you know, have
you ever been tested for mercury poison or vapors? They brought
in the tester. It's a metal tube that goes down. And mine hit
almost off the charts.
I had to go to Mexico. I asked my own dentist about it, and
he stuck something in my mouth and wouldn't even discuss it.
And I have been going to him for 30 years.
I went down to Mexico, and the dentist down there said he
had to go to Mexico because he was to do 40 mercury fillings,
amalgam fillings, he refused, and he couldn't pass his boards.
So he went to the University of Mexico, passed his boards,
lives in California but goes down to work there. So he
explained to me. It took 6 weeks. I went from Washington, down
to Mexico, to LA. That was my route, until the work was done.
I looked like a different person. I went to the
dermatologist. He said, I am going to pull out the poison
through your skin. So, along with getting the mercury fillings
out, they were going, the fumes were going up through my T-
zone. I was having trouble remembering names. I said, what's
wrong with me? I was being poisoned.
I called in the National Dental Association, and they told
me that black people didn't like to go the dentist, and so
certainly they are going to continue to use amalgam fillings
because they were cheaper. And I tried to explain to them what
I knew scientifically; did no good. They were looking at cost.
And I was just amazed. I said, you are going to put young
people under risk? And they didn't seem to care.
So I said, you take my bill. You take it home with you,
look at it, and then you tell me how I can amend that bill to
suit your needs. I got the same letter back from them that they
sent in the beginning.
So I see that profit for dentists--you know, don't make a
wave. People won't know. We are dulling down our children's
brains. And I think pregnant women, you know, whatever goes in
here seeps through the placenta and has an effect on that
fetus.
And I think it's high time that any professional start
looking at this. And I am surprised. The Environmental
Protection Agency wouldn't really want to look at it seriously
without our prompting?
Senator--Congressman Burton--I just promoted you to
Senator.
And we were told in southern California, do not eat the
tuna along the coast; it's infested with mercury. Do not eat
it. Why? Because, as you know, the waste from dental offices go
into the sewage plant and then out into the ocean.
And so I am really, really concerned. We need to wake up to
this new threat.
And, again, Mr. Chairman, I wish to thank you for your
leadership, your hard work. Mercury is an environmental
disaster. It's the number-one toxic substance in terms of the
WHO. And dentists have alternatives. They might be a little
more expensive, but why would you want to take the risk and put
a toxic substance in, particularly, a young person's mouth?
Because you say it's well-sealed. Well, I haven't seen a child
who hasn't fallen, cracked a tooth, or tooth is pulled, or
whatever. And that mercury goes right up into your T-zone.
So, Mr. Chairman, I know that we are going to be
enlightened today, and I want to thank you. And I want to thank
my partner over there, Representative Burton, for his interest,
his focus, in setting this as a priority.
Thank you very much. I look forward to hearing from the
witnesses.
Mr. Kucinich. I thank the gentlelady for her comments.
Let's proceed with Mr. Bender. Thank you.
Mr. Bender. Thank you, Mr. Chairman, members of the
committee. My name is Michael Bender. I am the director of the
Mercury Policy Project. We work locally, nationally and
globally to eliminate mercury releases and the use of mercury
and exposures to mercury.
Next slide, please.
In my brief presentation today, I am just going to recap
some of the information that we have heard from the last
hearing.
First of all, that there's over 1,000 tons of mercury tooth
fillings in Americans today that, when released, will pollute
our environment. And mercury use is continuing.
Second, nine States require dentists to have amalgam
separators to reduce mercury into wastewater. That's one good
step forward, and we will talk about others.
Third, that the voluntary efforts are not effective at
convincing dentists to install separators. They need some kind
of an incentive.
Fourthly, that the ADA and the State associations are
reportedly blocking State and local amalgam separator
initiatives, even though they voluntarily say they promote
them.
And then finally, we will summarize the discussion that the
amalgam separators is the most cost-effective at controlling
dental mercury pollution.
We will also want to draw the committee's attention to a
report we provided to the committee where we do a cost
analysis. Representative Watson mentioned the higher cost of
the amalgam separator. When you factor in the externalities,
the cost of keeping mercury out of wastewater and keeping
mercury out of the airstream from cremations and the costs of
the amalgams aren't cheaper. In fact, they are comparable, or
the composites are actually more cost-effective.
So, next slide, please.
This is a pie chart from the U.S. EPA where they have
alerted us that there's over 1,000 tons of mercury walking
around in Americans' mouths. It's the largest single current
use of mercury in the United States today.
Next slide, please.
That dental mercury, on average, accounts for over 50
percent of the load of mercury into wastewater. And we see some
examples there. And, again, this was background.
I would like to move to the next slide, which is some new
information that we just got from the Northeast Waste
Management Officials' Association, the interstate mercury
education and reduction clearinghouse. They just released the
2004 data on mercury uses from the amalgam manufacturers.
Unfortunately, we are saddened to hear that the U.S.
dentists are still using 30 tons of mercury annually in 2004,
just as they were in 2001. This is significant because,
contrary to what we have heard from the dental sector, their
mercury pollution will continue unabated without controls.
Next slide, please.
Although you can't see this on this screen very well, you
can see the actual numbers and that the dental mercury use is
about 25 percent of all the use in the United States today. And
it indicates the numbers from 2001 to 2004.
Mr. Chair, these are actual numbers that were reported by
State law from the amalgam manufacturers to the NEWMOA group.
And so, unfortunately, we keep hearing from the dentists that
they are reducing the use of mercury; we are not seeing it in
the hard numbers. We have heard it anecdotally, and
unfortunately we are not seeing it.
Next slide, please.
As I indicated earlier, there are State mandates for
amalgam separators. Nine States require mandatory separator
installation. Why? Because the voluntary programs aren't
effective at convincing dentists to install separators. And
there are numerous examples of this, and we will hear more of
those today.
Data from the Boston area showed a 48 percent reduction in
mercury concentration and sludge as amalgam separator use
increased from less than 20 percent to over 80 percent due to
mandates.
Next slide, please.
The ADA unfortunately and apparently is continuing--even
though they are now supporting these amalgam separator
initiatives as a voluntary BMP, what we are hearing from their
own news reports is that they are reportedly training their
trainers to support these BMPs, best management practices, and,
along the way, use this argument as a way to oppose the amalgam
separator initiatives.
The ADA and the State dental associations appear to have
blocked amalgam separator initiatives in California, Wyoming,
Michigan, Ohio, Montana and likely elsewhere, and they have
slowed the requirements for installation in Oregon. They are
also blocking local separator initiatives as well, as we know
from their recent work in the city of Philadelphia.
Next slide, please.
In summary--I am sorry, I am jumping ahead of myself. I
just wanted to emphasize Chairman Kucinich's statement about
amalgam separators being very cost-effective. We had
consultants do an analysis over a certain period of time, using
2005 numbers. The cost per filling for amalgam separators is an
add-on cost of about $2 a filling. As I indicated earlier, we
also did an economic analysis of the cost of putting the
controls on the cremation. That will be $18 more a filling. So
that's where the numbers add up, that, in fact, the amalgam is
not cheaper.
Then, finally, I would like to conclude with some
information that's in our longer-term and our larger report
that's available for the record, and it sort of reiterates a
little bit of what Representative Watson was saying.
In summary, the encapsulated dental amalgam is shipped from
manufacturers to a dentist's office with a skull and crossbones
affixed next to the word, ``Poison, Contains Metallic
Mercury,'' MSDS 2007, from Dentsply. Amalgam manufacturers--
Kerr, Vivadent and Dentsply, among others--advise dentists
against placing amalgam in the teeth of pregnant women, nursing
mothers, children under 6, and anyone with kidney disease.
Dentsply, for example, warns, ``Contraindication
(`contraindication' is a directive to forbid, not just a
`warning'): in children 6 and under and in expectant mothers.''
Dentsply also supplies a warning on their MSDS to dentists that
amalgam is dangerous for the environment. And you can see a
copy of their MSDS on a report that's on the table.
But then that information apparently gets stuck at the
dentist's office. We did a national poll. We hired Zogby
International, and what we found is that most Americans, 76
percent, don't know mercury is a primary component of amalgam
fillings; that 92 percent of Americans overwhelmingly want to
be informed of their options with respect to mercury and
nonmercury dental filling materials prior to treatment; and,
finally, once they are aware that there is mercury in the
amalgam, 77 percent of those surveyed would choose higher-cost
fillings that did not contain mercury if given the choice.
Mr. Chairman, I would like to join others and express my
appreciation to you for holding this hearing. It's a very
important topic area. I was joking that this dental sector
seems to be one of the last sacred cows in the continued use of
their justification for mercury.
We know, from a ruling in Norway and Sweden just having
banned amalgam in January 2008, that there is no reason to
continue using amalgam. Those societies are just doing fine.
They aren't having any kind of a health epidemic over there.
They are doing very well. And they worked cooperatively with
their dental association over a number of years to put controls
on in their facilities and also to recognize that dental
mercury is not appropriate in the human mouth.
So what concerns me about the 30 tons of mercury that is
still being used, which is 60 million mercury dental placements
a year, is that I think that this dental sector is stuck in
complacency, and it needs some kind of a regulatory incentive
to move forward.
Thank you, Mr. Chairman.
[The prepared statement of Mr. Bender follows:]
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Mr. Kucinich. Dr. Fischer.
STATEMENT OF RICHARD FISCHER
Mr. Fischer. Thank you, Mr. Chairman, Ms. Watson and Mr.
Burton.
Current estimates indicate that the dental profession uses
about 40 tons of mercury per year in the fabrication of amalgam
fillings. These mixtures emit mercury vapor continuously for
decades and are the major contributor of mercury to human body
burden. EPA requires that the excess unused newly mixed amalgam
be handled as a toxic waste disposal hazard, just as it does
the amalgam particles from removing old mercury fillings.
There are four major routes by which dental mercury may
come into contact with the environment.
The first is dental clinic wastewater. The process of
either placing or removing mercury fillings generates a slurry
of mercury-rich amalgam waste, which is vacuumed into the
chair-side suction unit. According to a recent study
commissioned by the ADA, 6\1/2\ tons of mercury are released to
wastewater treatment plants annually by dentists in the United
States. This represents more than 50 percent of the total
mercury entering wastewater treatment facilities.
The IAOMT, recognizing that the dental profession has the
opportunity and the obligation to eliminate or reduce this
environmental hazard, urges all general dentists to install
effective mercury separator equipment. We support efforts to
make this a regulatory requirement, since efforts toward
voluntary compliance by dental associations have failed.
No. 2, air discharge. Mercury vapor has also been measured
in air vented from the central vacuum systems to the outside of
the dental office. An estimated one ton of mercury vapor per
year finds its way into the atmosphere through this route in
the United States. There is currently no known technology to
prevent this form of pollution.
No. 3, amalgam in human cadavers. The EPA estimated that in
2005 over 3 tons of mercury were released to the environment in
the United States from crematoria.
Four, human waste. Published studies have concluded that
each and every amalgam bearer excretes an average of 100
micrograms of mercury per day in his or her urine and feces.
Assuming two-thirds of this mercury is derived from dental
fillings, then 5.7 tons of dental mercury annually are flushed
directly into our wastewater. Again, there is no known
technology to prevent this form of pollution, nor are there any
regulations over this form of domestic waste.
The above four routes of mercury entering the environment
combined for at least 16 tons of mercury annually from dental
fillings. Less than half of that total, the 6\1/2\ tons from
dental wastewater, can be captured by best management practices
and amalgam separators in dental offices, but then only if
mandatory.
Over 1,000 tons of mercury are implanted in the teeth of
Americans nationwide. Assuming a 10- to 15-year average
durability of these mercury fillings in patients' mouths, this
enormous reservoir of mercury will be continuously flushed into
the environment for decades to come.
Organized dentistry has established best management
practices for managing hazardous waste. These practices have
had disappointing participation by dentists when purely
voluntary.
For example, in the Seattle/King County area of Washington
State, after 5 years of promises from local dental societies,
2.5 percent of offices had complied. Currently, 11 States in
various municipalities have replaced their voluntary programs
with mandatory regulations, resulting in nearly 100 percent
compliance.
In those States and municipalities where amalgam separators
are required, there has been a 50 percent reduction in the
amount of total mercury from all sources entering wastewater
treatment plants.
When considering whether or not an amalgam separator
installation should be voluntary or mandatory, we should
consider information published in the fall edition of the ADA
Professional Product Review. There it was reported that, ``A
survey of members showed that relatively few panel members own
an amalgam separator or plan to purchase one.''
I have been practicing dentistry for 35 years, the last 26
without using mercury fillings. I stopped using them when I
discovered that the mercury was not locked in the fillings, as
I had been told in dental school. I purchased an amalgam
separator approximately 15 years ago when I discovered that
this technology was commercially available.
As a health professional, I am ethically bound to err on
the side of caution for my patients, my staff, my colleagues
and my environment. To place a mixture containing 50 percent
mercury, the most neurotoxic element known on Earth, within
inches of a child's brain stem and assume it's harmless is, at
best, counterintuitive.
To release the same pollutant into the wastewater is
irresponsible when simple and available technology exists to
reduce that release by over 95 percent. But that still leaves
more than half of the dental-derived mercury that is dumped
into the environment that remains beyond our ability to
capture.
We all remember the character The Mad Hatter from ``Alice
in Wonderland.'' The character was based on the historical
observation of workers who made felt hats in Connecticut in the
1800's. The workers, or hatters, used mercury nitrate to shape
the hats. The hatters frequently suffered from shakes,
hallucination and dementia or madness due to that mercury
exposure.
The hatmakers stopped using mercury in 1943. It's now 2008.
It's time for dentistry to stop the madness. Until dentistry
joins the rest of the 21st-century health-care profession and
abandons its use of mercury, there can be no effective
environmental solution to the dental mercury crisis.
Thank you.
[The prepared statement of Dr. Fischer follows:]
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Mr. Kucinich. Thank you.
Mr. McCormick, you may proceed.
STATEMENT OF CURT MCCORMICK
Mr. McCormick. Good afternoon, Mr. Chairman, Mr. Burton,
Ms. Watson and members of the subcommittee.
I am Curt McCormick. I currently own a small business. But
I think I was asked to show up today because I just recently
retired or left the Environmental Protection Agency, the Denver
office of the EPA.
For 17 years, I was regional pretreatment coordinator
there, which is a program which regulates local governments and
requires that discharges to their sewer systems are controlled
for pollutants.
I also worked on a mercury-control strategy for the region.
EPA in Colorado, Wyoming and Montana was the primary pollution
control authority on municipalities, as the States do not have
authority or do not authorize that program.
I want to preface my comments today that, while I probably
will be mentioning the ADA in some parts of this, I don't
believe the ADA did anything inappropriate in their lobbying of
Region 8 or EPA headquarters. I think most of my comments are
directed toward the internal EPA process of developing guidance
and providing technical assistance.
I have to admit that the ADA was fairly tenacious in its
efforts. And the outcome of their lobbying was fairly
surprising in some areas, which I will go into.
Your subcommittee has heard the testimony of EPA and others
in the past about the importance of reducing mercury in the
environment and contribution of dental waste amalgam. One EPA
senior manager referred to the Clean Water Act pretreatment
program, and that is the program I oversaw for much of my
career. This federally mandated program makes controlling the
discharge of mercury and other pollutants into a sanitary sewer
system a regulated and local responsibility.
While EPA Region 5, which was the Chicago office, the Great
Lakes initiative, had acquiesced to the ADA's position that
treatment not be a requirement for controlling dental
discharges, EPA Region 8, which is the Denver office, we did
not opt to adopt that voluntary approach to controlling
mercury. We had a more mandatory requirement in the guidance
that we developed. Our premise was that where a problem exists
with a specific pollutant, local government pretreatment
programs were required to control discharges of this pollutant
into the sewer system. This approach is clearly reflected in
the regulatory objectives of the pretreatment program that
implement the Clean Water Act.
As mentioned earlier, the ADA focused its efforts on all
levels of government. And Jerry Bowman, assistant general
counsel for the ADA, attended and spoke at a public hearing at
a city council meeting in Laramie, Wyoming. The city intended
to adopt mercury controls to address problems at their
wastewater plant. Presentations by myself and the city
pretreatment staff, in addition to local support by other
locally regulated industries, was enough to assure that Laramie
City Council that the Region 8 approach was consistent with
their local regulations and a fair approach that included
dental offices as part of a solution to an identified mercury
problem.
This outcome intensified the ADA efforts to work through
the EPA Office of Water. In a letter to Ben Grumbles dated
February 16, 2005, the ADA made it clear that they were very
unhappy with the lack of progress that EPA headquarters had
made in stopping my program's efforts.
The ADA opens the letter stating, ``We appreciate the
opportunities you have afforded us in the past. On December 15,
2004, representatives of the American Dental Association were
able to spend approximately an hour with you discussing, among
other things, the association's deep concern with the
contemplated approach of EPA Region 8 to dental wastewater. As
we discussed, the region's draft guidance, on which the ADA
submitted extensive comments, prohibits the very type of
voluntary partnership which the administration otherwise
supports. Moreover, the draft guidance requires amalgam
separators whenever a POTW has a need to address mercury. At
the end of our meeting, you indicated that you would speak to
the Region 8 administrator on these topics. We have not heard
back from you.''
The letter continues with references to Region 8, its
proposed mercury control efforts, and a concern that Region 8's
approach will influence the rest of the country. EPA Region 8
senior management responded directly and independently to the
ADA in an April 22, 2005, letter stating that the Region 8
supported the approach by my program and that the final
document would continue to be consistent with the Clean Water
Act and its implementing regulations.
I have not seen copies of any responses by the Office of
Water on the February 16, 2005, ADA letter. However, after the
Region 8 letter of April 22nd, I was informed by my Region 8
senior management team that my program strategy document would
not be issued final. The message was that the Office of Water
did not want it published final. Region 8 senior management
told me that the draft version of the document would be made
available to anybody requesting a copy and would be posted for
download on the Internet. And it currently is still available,
the draft, for download on the Internet.
Regardless of the status of that document, my program, I
continued to approve local programs, mercury-control
regulations so that they would fully implement amalgam
separator requirements where necessary. But the stoppage of
this document put a dampening effect on some of the POTWs or on
some of the cities adopting it.
I will wrap up here quickly.
I left the EPA in October 2007. I have written newsletters
on interest groups and the regulation of mercury. A current one
discusses a State of Michigan bill that allows for self-
regulation of dental dischargers. This bill specifically
prohibits the State-mandated pretreatment programs from
requiring any more stringent than what the State dental
association deems necessary. EPA has been notified of this
legislation and has taken no identified action to ensure that
this bill will be consistent with the Clean Water Act.
In conclusion, I believe that many scientists and
regulators at EPA are perplexed at the evolving level of
influence at the decisionmaking levels within EPA. As with
other EPA staff, I took seriously the oath to uphold the law
and believe in the mission of the EPA, even now having left the
agency. However, I believe that there's a reinterpretation of
that mission which has and will continue to result in the
eroding of credibility and the loss of experts from the agency.
Mr. Chairman, this concludes my statement, and I will be
happy to answer any questions you or your colleagues have.
[The prepared statement of Mr. McCormick follows:]
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
Mr. Kucinich. I thank the gentleman.
Mr. Walsh, you may proceed.
STATEMENT OF WILLIAM WALSH
Mr. Walsh. Thank you, Mr. Chairman, Mr. Burton and Ms.
Watson. Thank you for the opportunity to speak today.
I am William Walsh from Pepper Hamilton LLP, outside
counsel for the American Dental Association on amalgam
wastewater issues. I have represented the ADA on these issues
since 2001.
The ADA is the world's largest and oldest dental
association, representing more than 155,000 dentists
nationwide. The ADA has issued and continually updates, as
appropriate, its best management practices for handling waste
amalgam. These BMP call for the use of standard control
methods, recycling of collected amalgam and, since last fall,
the use of amalgam separators.
Even without separators, dentists capture in their office
approximately 80 percent of the waste amalgam, with almost all
of the remaining 20 percent being captured by wastewater
treatment plants before the wastewater is discharged to surface
water. In other words, 99 percent of the amalgam is already
captured prior to discharge from the POTW. Adding a separator
allows the capture of that additional waste in the dental
office instead of at the wastewater treatment plant.
The ADA has devoted substantial time and resources to
promoting its best management practices. For example, in 2001,
the ADA commissioned an independent study to determine how much
mercury might be entering the surface waters from amalgam
wastewater discharges. The ADA evaluated the effectiveness and
the cost of amalgam separators, including contributing to the
development of standards for testing separators that were being
developed by the International Standards Organization.
In 2003, ADA proposed to the Office of Water to initiate a
voluntary amalgam wastewater reduction program in partnership
with EPA, and has continued those discussions. The ADA proposed
to EPA and participated in developing a standard for recycling
amalgam waste that is collected in the offices.
The ADA has conducted a comprehensive outreach and
education program for dentists and dental societies, including
numerous seminars for dentist and dental societies, articles in
the ADA News, the peer-reviewed journal of the American Dental
Association, and the ADA Professional Product Review,
partnering with EPA to produce and distribute BMP brochures and
videos to 43,000 dentists in the Great Lakes region in 2005.
Several factors favor ongoing efforts.
First, the dentist industry's goals as of last fall comport
exactly with those of the government to minimize dentistry's
discharge of amalgam waste.
Second, dentists, as health professionals, would respond to
scientific evidence and cooperative approaches. Some of the
early efforts were not successful because of the lack of
understanding on both sides. But the ADA and dentistry have
learned from this past experience, they have calibrated their
approach, and voluntary and cooperative partnerships have
succeeded in some of the subsequent efforts.
Third, according to the 1997 report to Congress by EPA,
dentistry contributes to less than 1 percent of the total
mercury found in our lakes and streams--0.4 percent mercury in
surface waters.
Fourth, mandating separators would require a costly
inspection and enforcement apparatus, given that there are some
100,000 dental offices that would need to be regulated.
Fifth, nothing precludes in the proposals that the ADA has
made the State or local agencies for enacting mandatory
programs, should voluntary efforts fail. As the testimony
submitted by some of the other witnesses indicate, many of them
encourage cooperative efforts between the regulators and the
local dental associations to determine whether mandating
separators in a dental office is appropriate. And we think that
decision is best left to the local authorities.
Dentists drink and fish and swim in the same waters as
everyone else in their communities, and they believe that
ongoing efforts to encourage the use of BMPs, which includes
separators, are succeeding and will continue to increasingly
succeed.
In closing, dentists have steadily reduced their already-
minimal contribution to metal mercury discharges to surface
waters over the past decade. They bring to these efforts the
same commitment they bring to providing the best possible oral
health care to the American people.
I will be pleased to answer any questions you might have.
[The prepared statement of Mr. Walsh follows:]
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Mr. Kucinich. I thank the gentleman.
I just want to remind all the witnesses that this Chair
takes it very seriously when witnesses rise and take an oath to
tell the truth. I just want you to understand that.
I also want to ask the members of the committee, without
objection, if each of us may proceed for a period of 10 minutes
for the questioning of the witnesses.
Without objection, so ordered.
I am going to begin here and ask some questions of Mr.
Walsh.
I want to say that the subcommittee appreciates your
participation on behalf of the ADA, because we are dealing with
a matter that cannot be addressed without the participation and
cooperation of the dental community.
After listening to your testimony, I am somewhat confounded
by the substance of it, because it seems that the ADA is at
odds not only with the witnesses on this panel and the next
panel but also with its best management practices, which
recommend the use of amalgam separators. And this committee is
going to ask you to help us understand.
I want to begin with the impact of dental mercury emissions
on the environment. Now, in your testimony--and you said it
twice in the last minute--you said that dentistry plays a very
small role in the overall issue of mercury in surface waters.
Today, we have been discussing the impact of dental mercury
emissions into the environment from wastewater, not surface
water.
Testimony for today's hearing indicates that dental mercury
emissions constitute about 40 to 50 percent of the mercury
found in wastewater, far exceeding the level of mercury
discharge from all other commercial and residential sources.
Mr. Walsh, do you agree with this finding, that dentistry
is the largest contributor of mercury to municipal wastewater?
Mr. Walsh. Yes, we do. The study we commissioned that I
mentioned in my testimony determined that between 40 and 50
percent of the mercury from amalgam discharged into wastewater
treatment plants----
Mr. Kucinich. OK, I am glad that you agree, because I have
here a statement that agrees with your position. The World
Health Organization that says that one-third of the mercury in
the sewage system comes from dental amalgam flushed down the
drain. And, more discretely, the Association of Metropolitan
Sewage Agencies found that dentistry contributed 40 percent of
mercury into wastewater, over three times the next greatest
contributor.
And so, in your opinion, Mr. Walsh, does dentistry play a
significant role in mercury contamination into the environment?
Yes or no?
Mr. Walsh. No, because the wastewater treatment plant
removes 95 percent of that mercury that goes into the
wastewater treatment plant. You are looking at influent
numbers, also the amount that may be collected in the sludge.
The reason it is being collected in the sludge is it is not
being discharged through.
The study I mentioned looked at both the effect of
incineration of the sludge for the 20 percent of the sludge
that is incinerated, as well as the direct discharges.
Mr. Kucinich. Thank you.
To the other panelists, I would like you to respond to
that, starting with Mr. Bender. Keep it brief, please.
Mr. Bender. Wastewater treatment plants aren't set up to
treat hazardous waste. It's very clear that most of the mercury
ends up in the sludge, and the sludge gets incinerated or it
gets land-applied or it gets used as a soil amendment.
And there are a number of studies out there, which are in
my previous testimony, I can provide to the committee, which
indicate that mercury gets released into the environment; it
does not get captured.
Mr. Kucinich. Dr. Fischer.
Pull that mic closer, please.
Dr. Fischer. I would agree that 95 percent of the mercury
in the wastewater from the amalgam does settle, but then it
just goes from one pocket to another. I mean, I mean it's not
reclaimed, recycled or captured in any way that's effective.
It's been just put back into the environment in some other
manner. The wastewater treatment plants aren't alchemists. I
mean, mercury comes in; mercury's got to go out somewhere.
Mr. Kucinich. Mr. McCormick.
Mr. McCormick. Now, from a regulatory standpoint, all
you're doing is disposing it from one media to the next. You're
not actually reducing discharges to the environment. You are
just sending them out either through the solids, through land
application, incineration, generally through biosolids, so----
Mr. Kucinich. Mr. Walsh, I want to ask you again,
considering that dentistry is the largest contributor to
mercury in wastewater and in light of the fact that once in
wastewater mercury becomes part the sludge that is incinerated,
landfilled or sprayed over the land, volatilized in some way,
would you agree that dentistry does in fact play a significant
role in mercury contamination into the environment?
Mr. Walsh. No, because when we looked at various studies
that had been done----
Mr. Kucinich. OK. I'm going to go on. I'm going to go on
with my questioning.
In your testimony, you also say that, ``even if a dentist
installed a separator, it would have little effect on the
environment because amalgam is ultimately captured at the
treatment plant.''
I want to ask you a few questions about this. Are you
suggesting that mercury discharged into wastewater is not an
issue because it can be treated before the water is released
into the effluent?
Mr. Walsh. I'm suggesting that if the impact is surface
water, which is what the impact----
Mr. Kucinich. The question is----
Mr. Walsh. If you prevent that----
Mr. Kucinich. You keep on drawing a distinction between
wastewater and surface water, but you're talking about surface
water. This hearing is about the effect on wastewater. This is
the point that I'm asking you; I'm asking you again, are you
suggesting that mercury discharged in the wastewater is not an
issue? Wastewater, you know the difference. Can you answer the
question, yes or no?
Mr. Walsh. I know the difference between wastewater and the
surface water.
Mr. Kucinich. Can you answer the question, yes or no, sir?
Mr. Walsh. The wastewater is what is going into the POTW.
It is captured. It is not discharged. The limits and the
regulatory requirements are based on protecting the surface
water and protecting the fish that are in the surface water. So
it's relevant that the wastewater is in fact captured, whether
it was originally designed, POTWs do in fact, and there is data
that NACWA has done, many studies looking at many different
treatment plants----
Mr. Kucinich. This is one chairman who isn't going to let
you run out the clock.
Mr. McCormick, what about the wastewater and mercury
capture at the publicly owned treatment works?
Mr. McCormick. Well, as I indicated before, it is
partitioned primarily--or it settles--it absorbs primarily to
the sludge. I would have to take a little bit of an issue in
that water quality, surface water quality, is one criteria that
drives limits. However, I think what isn't being talked about
is there are also standards for biosolids for mercury. There
is--there are various standards that have to be met. And while
surface water quality is one standard that has to be
considered, I think biosolids or sewage----
Mr. Kucinich. I want to go back to Mr. Walsh.
Mr. Walsh, is it true or not that the International Academy
of Oral Medicine and Toxicology has said that wastewater
treatment facilities are not designed to process or handle
heavy metals?
Mr. Walsh. I don't know that particular reference, but I
think the statement is correct that they were originally
designed in the turn of the century to treat wastewater. The
physics of the amalgam particles and the data that has been
looked at across the board by the National Association of Clean
Water Agencies show that in fact because of that physics 95
percent plus of the amalgam particles are captured in the
sludge, as was indicated. And in fact NACWA has said, looking
at the mercury levels in biosolids across the country, that
there are today, as a result of a number of mercury reduction
programs, the levels are well below EPA's standards for
biosolids.
Mr. Kucinich. Well, we've received--as members of this
committee, we've received testimony from several
representatives of municipal wastewater plants. And in that
testimony, we are told that precisely because wastewater plants
cannot adequately remove mercury, the respective sewage
district adopted a prevention policy and began with its dental
community, who constitute the largest contributors of mercury
to wastewater.
Does everyone have this wrong, Mr. Walsh, or are we not
understanding something about your presentation here? Could you
help us a little bit?
Mr. Walsh. The, particularly in the Great Lakes, which
have----
Mr. Kucinich. Can you be close to the mic?
Mr. Walsh. Yes. Particularly in the Great Lakes, there is a
very low water quality standard; I believe it is 1.3 parts per
trillion. The level of mercury in rain, mainly from combustion
sources, some of them outside the United States and some in,
exceed that level. So the municipalities were faced with a
tough problem; the level cannot be reached no matter what the
discharge is. And in those areas, many of the municipalities
are using a variety of techniques to try to get their sources
to reduce the levels. And so--but there are other areas where
there are aren't such low water quality standards, and there
are no biosolids limits being exceeded, and there are no
discharge surface water quality levels being exceeded. And in
fact, the fish are not being--containing levels that are above
the level.
But remember, the ADA has taken the position that we
should--every dentist in the country should in fact install a
separator; that, as has been said, it is better to recycle this
material; and that the preferable way is using the good offices
and resources of the ADA to help communicate these requirements
to the thousands of health and dental professionals to work
cooperatively with government for the mutual goal.
The goal here now is the same now. Admittedly when we
started our discussions and were educating ourselves as to what
was happening, the goal wasn't the same. But the goal is now
the same: Gather as much of this as possible in the dental
offices, get it recycled. There is a difference as to whether a
voluntary program initially, as is always true in a voluntary
program, the potential of it becoming mandatory is the
preferable way. And we have to think for a number of reasons
that it is preferable, but I think there is more agreement now
than there has been historically on what to do.
Mr. Kucinich. I thank the gentleman.
I just want to conclude this round of questioning for
myself by making this observation, and that is that you've said
that the ADA supports the use of separators because they
prevent, and this is a quote, a significant amount of waste
amalgam from being deposited in wastewater treatment biosolids.
And if the plants will treat the water in any case, then, you
know, it is obvious, why would the ADA support the use of
separators?
What's happening here is that, while your best management
practices say that, you focus on the word ``voluntary.'' That's
where you're holding on to that for dear life, voluntary as
opposed to mandatory. But we're talking about a neurotoxin
here.
Now I can understand and I've had debates with my
Republican colleagues on the whole issue of regulation. And you
know, there are some honest debates about it. How far do you go
with regulation? But this is a particular area that has to do
with a substance that has been found to not just be a
neurotoxin, but that particular neurotoxin is associated with a
whole other range of serious health implications.
And so the questions of this subcommittee are going to
challenge your position on the--I'm assuming will challenge
your position on the difference between voluntary participation
and mandatory. And it becomes particularly important since the
ADA itself has taken a position that you support the use of
separators.
So the Chair recognizes Mr. Burton. I took 13 minutes. You
can have the like amount.
Mr. Burton. Thank you very much.
The Association of Metropolitan Sewage Agencies estimates
it costs as much as $21 million per pound to safely remove
mercury once it becomes part of the wastewater stream.
The Environmental Protection Agency estimates that sewage
sludge nationally contains about 15 tons of mercury per year
from all sources, not just dental amalgam. However, the
Association of Metropolitan Sewage Agencies estimates that 35
to 40 percent of the mercury load comes from dentists. That's
roughly 6 tons of mercury. At 2,000 pounds per ton, that means
it costs taxpayers roughly $252 billion per year to remove
dental mercury from sewage sludge.
In contrast, the company Solmetex sells amalgam separators
priced from a low of $715 to $2,490. If every one of the
155,000 members of the American Dental Association purchased an
amalgam separator, it would cost anywhere from a low of
$110.835 million to a high of $38--385.95 million one time
only. Wouldn't you agree the most cost effective solution is to
simply stop mercury contamination at its source within a
dentist's office?
Mr. Walsh. We looked at the cost effectiveness, but I
believe the numbers you are quoting is if a POTW had to do
additional reduction to meet numbers like the Great Lakes water
quality standard of 1.3. The existing cost to POTWs, since
their sludge levels are not exceeding the regulatory levels
that were based on risk, as I understand it, is nothing. The
plants, as designed, although that wasn't the purpose of the
design, in fact collect the numbers we are talking about.
Separators collect slightly more; it is an additional amount of
collection.
When you look at using the same kind of methodology that
EPA uses, and you have to include the cost of recycling all of
the amalgam that's collected because that's part of the cost,
it is actually higher than it would cost to reduce mercury
emissions from coal-fired plants. Despite that, the ADA has
taken the position----
Mr. Burton. Do you have any amalgams in your mouth? .
Mr. Walsh. Yes, I do.
Mr. Burton. Do you? Do you remember when they put those
amalgams in your mouth?
Mr. Walsh. I remember generally. It started when I was a
child, and I have quite a few.
Mr. Burton. Do you remember when they mixed it up, they put
the mercury in and they mixed it up with this little machine;
do you remember that?
Mr. Walsh. I actually don't remember that. I know that was
the practice until recently.
Mr. Burton. I remember how they did it. They mix it up, and
the dental assistant mixes it, and they put it in this thing,
and then they put it into a device that inserts it into your
cavity. And when put that into your cavity, they say, well, it
is going to be inert; it is not going to cause any problems.
But every time I every had an amalgam put my mouth, there was a
lot of it that squished out and went into my mouth. And then I
would rinse it out after they--while they were doing it, and we
would spit it into the water container. And you know where that
mercury goes then, don't you?
Mr. Walsh. Yes, it goes down into the sewer system.
Mr. Kucinich. It goes down the sewer system.
Mr. Burton. The sewer system. What about the mercury that
doesn't go down the sewer system that you swallow, because you
can't get it all out? Does that have any impact on a human
being?
Mr. Walsh. Well, my testimony is focused on the
environmental. I am an attorney. I think it would be beyond my
capacity to testify on----
Mr. Burton. Well, let me just tell you, it is my belief
that if you consume mercury in any form or have it injected
into your body, it is a contaminant that can cause neurological
problems. And that's why I believe that they shouldn't be
putting amalgams in a person's mouth in the first place.
Separators are a plus. They are going in the right direction.
But why in the world even put amalgams into a person's mouth?
It doesn't make any sense to me.
I know that, I've talked to some dentists who say, well, it
costs more to put another kind of filling into a person's mouth
and it may not be as durable as the amalgam, but nevertheless,
you can do it. And for the additional cost, I think most
people, if they are made aware that the amalgam is about half
mercury, that they would opt not to have the mercury put into
their bodies in the first place. And I just think there is an
educational process that should take place in the dentist's
office saying, the side effects of having mercury ingested into
the human being either in the form of a vaccination or in the
form of an amalgam.
We were talking about the sludge that goes into the
wastewater treatment system. Where does that sludge go when it
leaves the treatment center?
Mr. Walsh. About 20 percent of it nationwide is
incinerated.
Mr. Burton. Wait, let's stop right there. It is
incinerated.
Mr. Walsh. Correct.
Mr. Burton. When it is incinerated, where do the particles
go?
Mr. Walsh. You mean the mercury?
Mr. Burton. Well, anything that's incinerated, doesn't it
go up in the air?
Mr. Walsh. Some of it becomes ash. Some of the mercury is
emitted. About 95 percent, 96 percent, I forget the exact
figure, is captured in the pollution control device of the
incinerator.
Mr. Burton. OK, where does it go then?
Mr. Walsh. I don't remember off the top of my head where it
goes then.
Mr. Burton. Well, it doesn't just disappear.
Mr. Walsh. No, I assume it is disposed of.
Mr. Burton. Is it recycled in some form into another
mercury product?
Mr. Walsh. I'm afraid I don't know what the----
Mr. Burton. But you know it does exist; it is there.
Mr. Walsh. Oh, no question, it's an element.
Mr. Burton. So the mercury is in the environment after it
comes out of an amalgam and goes through the system, right?
Mr. Walsh. Could you repeat the question?
Mr. Burton. The mercury that's in the amalgam, when goes
through the system, the sludge or whatever it is, it is back in
the environment some place.
Mr. Walsh. It is in the sludge, which is either landfilled,
and we've looked at the studies that have been done
historically on the emissions from landfills and looked at the
percentage of mercury that would be from sludge; it is a very
small amount, but----
Mr. Burton. Wait a minute. It says that 30 tons of mercury
is going into the amalgams a year. That's the estimate.
Mr. Walsh. Yes.
Mr. Burton. Excuse me, 6 tons of mercury, excuse me, 6 tons
of mercury is going into the amalgams per year. That 6 tons is
going to go some place. It is either going to stay in a
person's mouth or into the wastewater treatment system, and it
is either going to be incinerated, in the sludge, or it is
going to be sent someplace else, or it is going to be put into
a landfill. If it is put into a landfill, it's going to leach
down into the ground and into the groundwater.
We've had tests of water in Indiana that's found mercury in
the groundwater.
Now, why in the world--I'm not talking about the separators
now--why in the world wouldn't dentists or anybody that deals
with mercury say, hey, it is a toxic substance, we ought to get
it out of the environment in any way possible? And a dentist,
knowing that they are working with it on a daily basis, why
wouldn't they want to get it out of system?
Mr. Walsh. Well, we looked at EPA's regulation, and these
are long standing regulations from the 90's. They looked at all
of those issues when they issued the regs. The National Academy
of Science reviewed the biosolids limits, and the, I believe
NACWA has said that all the evidence suggests that those
metals, mercury included, are not causing health hazards when
they are disposed of in compliance with those regs.
Mr. Burton. Recently, the U.S. Food and Drug Administration
settled a lawsuit with several consumer groups promising to
classify dental amalgam and list the possible hazards involved
with mercury-based fillings within a year. As part of the
settlement, the FDA has even publicly withdrawn its claims that
amalgam is safe for all and now warns--this is the FDA now--
dental amalgams contain mercury which may have neurotoxic
effects on the nervous systems of developing children and
fetuses.
Why--does the American Dental Association agree with that
warning?
Mr. Walsh. Again, the purpose of my testimony and the focus
is on the environmental impacts, and I am an attorney. I'm sure
if you want to submit a question to the American Dental
Association, they will provide an answer. But you're asking the
wrong--you're just asking the wrong person.
Mr. Burton. You don't have the answer to that.
But the FDA has publicly withdrawn its claims that amalgam
is safe for all and now dental warns dental amalgams contain
mercury which may have neurotoxic effects on the nervous
systems of developing children and fetuses. And that being the
case, why would they put them in an adult's mouth in the first
place, because obviously it could have an adverse impact on the
adult as well? I just don't understand the ADA. I just do not
understand it.
When I had the amalgams put in any mouth, I can remember
vividly, because I had some pretty bad teeth at one time, and I
remember vividly them mixing it up and squirting it into my
mouth. And I can remember, remember them sucking it out with a
vacuum cleaner and it going down into the water system, going
through the system. And when I'd spit it out, it was going into
the water and down into the sewage system. And when I--and the
part that went flushed out or vacuumed out went into my body.
And I just can't understand why people don't realize that
mercury is toxic, and it shouldn't be inserted into a human
being in any form. And no matter how much you say--and I won't
take any more time, Mr. Chairman--but no matter how much you
say all the science and research----
Mr. Kucinich. The gentleman has another 2\1/2\ minutes
actually.
Mr. Burton. Thank you.
No matter what is said by scientific research or anything
else, common sense would dictate to me and to any human being
that's made aware of the dangers of mercury that it shouldn't
be in your mouth. They took it out of thermometers. They took
it out of Merthiolate, Mercurochrome. They took it out of
ophthalmologic liquids. They take it out most of the children's
vaccinations. It is still in--it is in almost all of the adult
vaccinations. And I just cannot understand, it just alludes me
why a substance that is as toxic to the neuro--neuro system
would be put into the human body. I just can't understand it.
With that, Mr. Chairman, I don't--I have a sense of
frustration that goes on every time we have one of these
hearings.
I will just yield back the balance of my time.
Mr. Kucinich. I thank the gentleman.
Congresswoman Watson you may proceed for 13 minutes.
Ms. Watson. I just want to let Representative Burton know I
am sitting here so frustrated.
And I really want to know, Mr. Chairman, why the American
Dental Association would send their attorney and not a health
professional for this hearing. Since the counsel for the ADA is
here, we ought to have someone from the opposing side, some
attorney come, because I've been listening to the responses.
And these are truly the responses from a defense attorney and
not the responses from a health professional who is interested
in the health of every single human being here in the United
States.
So I'm going to address my questions to you, Mr. Walsh.
Does the ADA support local and State government efforts to
reduce mercury? And how does it encourage its members to
cooperate in these programs?
I want to go further to say, you said many minutes ago that
it should be a local and State, but Mr. Burton is from a
different state; I'm from a different state, and Mr. Kucinich
is from a different state. We ought to have some kind of
Federal regulation because the risk is the same regardless. I'm
from California, and the risk is high, and you keep talking
about the surface water. I want to tell you about the water
that is waste that apparently is not being processed, because I
have evidence.
And I'm sure, Mr. McCormick, when I direct some questions,
knows that there is evidence showing that the mercury comes
from the waste that comes from dental offices mainly.
And I also understand that Mr. McCormick's report in some
way has been curtailed when it was completed, but I will
address this to him.
So will you please deal with what the ADA is thinking in
terms of local and government efforts to reduce mercury? And
then if it encourages its members to cooperate in these
programs? Would you please respond?
Mr. Walsh. Well, the ADA has been supporting, since at
least 2002, efforts to reduce the discharge of amalgam into
wastewater treatment plants, initially through what was then
the use of best management practices that were limited to
chair-side traps.
Ms. Watson. Period, period. These were voluntary efforts,
yes, no?
Mr. Walsh. The ADA best management practices are voluntary
recommendations of the ADA. We have no----
Ms. Watson. OK, they are voluntary?
Mr. Walsh. Yes.
Ms. Watson. Thank you very much.
Mr. Walsh. We also have worked cooperatively with
regulatory agencies and various State agencies--State
associations.
Ms. Watson. OK, put a period there, because I'm going to
use my time----
Mr. Walsh. Yes.
Ms. Watson [continuing]. Very thoroughly and wisely.
How does the ADA encourage its members to cooperate with
these programs? And what is the percentage of cooperation,
voluntary cooperation?
Mr. Walsh. The answer to that, you need to understand----
Ms. Watson. Wait a minute. How does it encourage its
members? Can you get right on point?
Mr. Walsh. Well, they have developed their understanding.
Dentists were not familiar with the regulatory system. They
were being faced----
Ms. Watson. So you're talking about enlightenment----
Mr. Walsh. Well, first you have to educate anyone----
Ms. Watson. I am an educator so I like that response.
Mr. Walsh. Whatever it is, whether it is an enforcement
action or a voluntary program, first, you've got to inform the
regulated community----
Ms. Watson. Good. Period on that, period, period, on that.
Should we educate the patients as well when they walk
through that door? Should we educate them about what the
amalgam contains?
Mr. Walsh. Again, that is not the subject of my testimony.
Ms. Watson. Yes or no?
Mr. Walsh. It's just not within my area of expertise.
Ms. Watson. So you don't know. You don't know. You don't
know if we should educate the patient?
Mr. Walsh. I am----
Ms. Watson. You know, that's why I want a health
professional here, not you the counsel, because you represent
just one side of this. And you're going to give me the legal
jargon, and that's not getting to the problem.
I'm going to have my staff give you the bills that I have
introduced, 7 years. And we're trying to get them moving
because my interest, my interest personally is protecting the
health of the public. That's my interest. My interest is
letting them know the risk they undertake when they have--I'm
passionate about this because it happened to me. And they would
send you the counsel and not the health professional.
OK, you didn't tell me what percentage of the dentists are
cooperating. Do you know that? Do you know that?
Mr. Walsh. There are no hard figures. EPA----
Ms. Watson. OK, you don't know it.
Mr. Walsh [continuing]. Estimated----
Ms. Watson. Don't give me the jargon, please. My time is
limited. You don't know it. You don't have those figures; yes,
no?
Mr. Walsh. There----
Ms. Watson. You don't have those figures----
Mr. Walsh. We do not have any figures, correct.
Ms. Watson. Yes, no?
Mr. Walsh. We do not have any figures,
Ms. Watson. OK, thank you.
What was the difference about the experience in EPA Region
8? And according to Mr. McCormick, you were strongly opposed to
the EPA's guidance on setting and meeting local limits for
toxic metal discharge.
Mr. Walsh. We started voluntarily coming to EPA, over a
year and a half before Mr. McCormick ever issued his guidance,
seeking to put a voluntary program together to reduce the
amount of amalgam. In the midst of that, we found out that the
city of Laramie was being told that they would be enforced
against if they didn't meet a number in a draft guidance.
We asked to see the draft, so we could comment on it. Mr.
McCormick mentioned a Region 5 draft. We had commented earlier
in the year on a Region 5 draft, which in fact does not say
``use only voluntary.'' It says, ``you may use a voluntary; you
may use a mandatory.'' And it says you can use what was then
just chair-side traps and vacuum filters or you could require
separators----
Ms. Watson. Period, period. Did you try to influence the
outcome of the EPA policy in Region 8?
Mr. Walsh. We filed public comments with Region 5, with
Region 8, with EPA headquarters. We continue to fill comments
in regulatory proceedings. Those comments are public record.
Those comments have been given and are on the Internet. In
fact, we file and attach all those comments.
Ms. Watson. Let me read this. subcommittee staff spoke to
the ADA and asked your representatives about the case. Jerry
Bowman, the ADA's general counsel told my staffer or this staff
of the committee that the ADA has no control over an EPA
representative. However a letter written by Mr. Bowman to
Benjamin Grumbles, the assistant administrator in February
2005, reveals that the ADA tried to interfere with Mr.
McCormick's initiative. Now I'm going to give you a relevant
quote from that letter: Region 8 has clearly not shifted its
position one inch since our meeting with you. As we stated
then, this is a very damaging position. Through its proposed
guidance, Region 8 will wipe away EPA's effort to reach
consensus to work with small businesses and to encourage
voluntary efforts and replace those goals with a command and
control strategy.
Mr. Walsh, please help me understand this, the ADA supports
the use of amalgam separators, and you conceded the
environmental impact of dental mercury on the environment was
great. So why was the ADA so strongly opposed to EPA's efforts
in Region 8? Do other State or local governments who try to
initiate similar policies have the same to look forward to from
the ADA? Do you have any idea? You're representing them. You're
the counsel.
Mr. Walsh. These decisions are made on a case-by-case
basis. The Michigan Dental Association is supporting, contrary
to what was said earlier, a statute that would require amalgam
separators in Michigan. What we were doing then, this was
before the recent amendment to the BMPs that required amalgam
separators, is we're taking the position that the local
governments, the State and local entities should be free to
choose a voluntary program or a mandatory program.
What Mr. McCormick, and he is trying to fulfill his duties,
he precluded any voluntary program. We believe, given the
number of sources, given the nature of the sources,
professional people who were not familiar with the environment,
that the preferable way and the more effective way to use the
limited resources that the agency has on enforcement is to use
a voluntary program always backed up, and we would be remiss if
we didn't tell our members that this they don't fulfilling
voluntary program, if it is not effective, a mandatory program
would follow. But this has been done----
Ms. Watson. OK, period, period, period, please.
Mr. Walsh. Done by a number of----
Ms. Watson. Period, period, when I say that, please cease,
because I'm on time. They are keeping time on me.
Mr. Kucinich. The gentle lady has another minute.
Mr. Walsh. I apologize.
Ms. Watson. The ADA supported a lawsuit filed by Laramie
dentists opposing the Region 8 guidance; is that correct?
Mr. Walsh. No, that's not correct. We filed comments
publicly and appeared at the council meeting, and we explained
the reasons we thought a more cooperative voluntary approach
was appropriate----
Ms. Watson. I got it, I got it.
Mr. Walsh [continuing]. As was pointed out.
Ms. Watson. Mr. McCormick, can you tell me about the--give
me a summary of what your report showed for Region 8.
Mr. McCormick. The strategy?
Ms. Watson. Yes, and what your recommendations would be.
Mr. McCormick. The chairman asked a really good question
earlier. It was rhetorical, unfortunately, and deals with what
exactly you're asking, is how far do you go with regulation? I
kind of want to make it clear because everything seems to get
spun here, and that's a frustration, when I was a regulator,
that I always had. The law already exists, the Clean Water Act
exists, and the regulation exists, and they clearly say,
although the ADA probably wouldn't accept this, that we have a
problem with the pollutant; it's mandatory to implement
controls. It is not a voluntary reaction to a pollutant
problem.
The regulations already exist. They are black and white.
There isn't a gray area there. And that's where--that's sadly
where the influence is kind of coming in twisted. There is no
leadership to make sure that these regulations are implemented
and enforced. The regulations are there: If mercury is causing
a problem, you must control it being discharged into a sanitary
sewer system. There is no gray area in the regulations. That's
what my strategy said. It said, like we do with every other
pollutant that's causing a problem with an environmental
criteria standard, you shall control discharges from
nondomestic sources, which include dentists----
Ms. Watson. A question to the Chair, ``shall'' and ``may''
are two different legal terms.
Mr. McCormick. Absolutely.
Ms. Watson. ``Shall'' was used, making it mandatory,
correct?
Mr. McCormick. In the regulations, it's ``shall.''
Ms. Watson. The attorney is moving his head, because these
are legal terms, ``shall'' and ``may.'' ``May'' is permissive;
you do it if you want. ``Shall'' is mandatory.
Mr. McCormick. I would just direct the ADA to the
objective----
Ms. Watson. OK. I just asked my staff to get me the
language.
Mr. Walsh. You should also look at the Court of Appeals
opinion----
Ms. Watson. Mr. Walsh, I was addressing----
Mr. Walsh. Oh, I'm sorry.
Ms. Watson [continuing]. Mr. McCormick. Thank you.
Mr. Walsh, are you a member of Pepper Hamilton, L.L.P.
Mr. Walsh. Yes, I am.
Ms. Watson. Is that your firm? OK, the lawsuit I believe
was filed--I'm not sure of this date--December 17, 2004.
Mr. Walsh. That's the date----
Ms. Watson. Somewhere in there.
Mr. Walsh. That's the date we filed comments with the city.
Ms. Watson. And you have--you wrote this letter, if I'm
correct. This is the city of Laramie Public Works, you wrote it
to the mayor and the city council member.
Mr. Walsh. Correct.
Ms. Watson. If there is anything I say, then you can
intervene, and say, it is not correct or just not a factoid.
Mr. Walsh. OK.
Ms. Watson. And remember, you're sworn in, so that is why I
say that disclaimer.
You say: I have been retained by the Laramie Dental
Association, which represents all 12 dentists in Laramie, WY,
and the Wyoming Dental Association, and the American Dental
Association to provide their comments on the city of Laramie's
proposed local limit of two-millionths of an ounce of mercury
per liter, that's 2 parts per billion, for wastewater
discharged into the city of Laramie's sewage treatment plant.
The ADA has also submitted comments on the EPA Region 8 draft
guidance. That is the motivating force behind the enactment of
this poorly--poorly--thought out ordinance and has met with the
EPA assistant administration--administrator of water and his
staff to address this draft document and as a part of its
ongoing effort to develop a national guidance for reducing
mercury releases from dental offices. And the Laramie dental
community strongly opposes this specific ordinance.
And then you go on to state the reasons. Is this letter
authentic?
Mr. Walsh. Yes.
Ms. Watson. And you still believe those reasons that you
state in your letter of December 17, 2004, are relevant to
today?
Mr. Walsh. Yes.
Ms. Watson. OK. And you say there is no need to rush to
judgment; the EPA guidance is still draft and is inconsistent
with national policy.
The intent and my intent is to change national policy.
So I'm going to have your letter a matter of record, Mr.
Chairman.
Mr. Kucinich. Without objection the letter will be included
in the record hearing.
[The information referred to follows:]
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
Ms. Watson. And I want you to look at my proposed
legislation, and I want to you respond to me and to the other
members of this subcommittee as to how my proposed legislation
would be opposed by the ADA and why.
Do I have your commitment to do that, to look at my
legislation and tell me if it's inconsistent with this letter
that you wrote opposing the draft coming from Region 8?
Mr. Walsh. We will look at it and respond.
Ms. Watson. And get back to me.
Mr. Walsh. As positively as possible.
Ms. Watson. If you would respond, which I would appreciate
it, I'm going to look at your letter, and I will read your
response. And I will share it with the subcommittee and the
Chair.
Mr. Kucinich. I thank the gentle lady.
Without objection, the Chair is going to continue with one
more 5-minute round of each of the witnesses or of this next--
of this panel.
I would like to begin with a question for Mr. Walsh.
I want to ask you a question about what you term as your
voluntary success stories in the ADA's comments to the EPA
concerning its dental office scoping study. You reference five
examples of voluntary success stories in Massachusetts, Duluth,
Washington, Madison--and Madison, WI, and the Minnesota
Metropolitan Council for Environmental Services. We have looked
at these carefully, and this is what we found: With the
exception of the Minnesota case studies, all were a
combination--a combination--of voluntary and mandatory
provisions. Even the exception proves the rule. In Duluth, MN,
there are only 55 dental offices, and the lead chemists in the
Western Lake Superior Sanitary District obtained a grant for
all the separators acquired.
Moreover, the sanitary district had a very hands-on
approach and worked with every office to install the
separators. Even the sanitary district told us that this model
could not be replicated in a larger city.
Duluth, MN, has submitted testimony to be entered into our
hearing record.
If we have a slide ready, can staff put up slide 3? Do you
have that available? OK, between--is that the right chart?
We're looking at the slide that has to do with the
Massachusetts Dental Society.
I'm just going to--do you have it? OK. Yeah, that looks
like the right one.
Is that OK?
Between 2001 and 2004, a memorandum of understanding
between the Massachusetts Dental Society and the State, and by
2003, there was only a modest increase in the installation
separators. In 2004, the Massachusetts Department of
Environmental Protection initiated a followup program to speed
up the process. It did two things. One, it offered incentives
for voluntary compliance; and two, announced that mandatory
regulations would be adopted in 2006. So that, by 2006, the
compliance rate in Massachusetts was about 75 percent, and
after the implementation of the mandatory program, compliance
had jumped to 95 percent.
Mr. Walsh, despite your testimony that deems Massachusetts
a model for voluntary compliance, it should be noted that when
it was strictly voluntary, between 2001 and 2004, it wasn't
very successful at all.
We also have testimony from Washington State; Madison,
Wisconsin; and they tell a different story than the one that
you've told. Like Massachusetts, their purely voluntary
approach had no impact until there were incentives to install
the separators and the government announced a looming mandatory
program.
In view of a full reading of the history of these case
studies, wouldn't it be more accurate to describe these cases
as models of government-dental collaboration as opposed to
voluntary success stories?
Mr. Walsh. I think my testimony, my opening statement,
indicated that we had learned a lot in the dental community. We
were talking about a problem that really wasn't on the horizon,
certainly regulatorily, before 2001. And the dental community
is 155,000 different people. They had to be educated as to the
law. They had to be assured that, in fact, the separators--and
they went out and did it themselves--could be tested, were
effective, that we did surveys of the costs.
I've mentioned a number of times the amendment of the best
management practices last year to include separators; that--
dentistry makes many of the big decisions by vote of the House
of Delegates. These are people elected by dentists
geographically, and they vote. It was an overwhelming vote.
There is no question that understanding and cooperation was not
there initially, has grown over time. We believe that dentistry
and the fact that we have a common goal now of 100 percent of
all dentists should follow the best management practices, that
this is still more like other examples. In 1999, EPA went to
the laundries and said, there are so many little laundries, we
want a voluntary program. It has been done with a number of
different industries, including mercury in laundries; a lot of
laundry detergents have mercury. The kind of----
Mr. Kucinich. But we are not drinking the dirty water out
of the laundry.
I just want to point something out to you, and that is
that, you know, you're suggesting that dentists now install
separators because they are better educated, which is, you
know, good, obviously. I mean, you're also suggesting, we've
learned; we're trying to move in the right direction; and here
is what we're doing; and this is the progress that we're having
voluntarily. But in your testimony, you write that voluntary
programs are just as effective as a mandatory approach. But
according to the subcommittee's national survey, that doesn't
seem to be the case.
Can we put that next slide up there?
Now, if you look at these figures and understand them, it
shows that voluntary programs don't exact the same results as
mandatory ones. That's what the record suggests.
Would you like to respond to that, Mr. Walsh?
I mean, what are your thoughts about this? Your whole
presence here is trying to defend voluntary as opposed to
mandatory, but here we've got some actual survey data that
seems to contradict.
We're informed that we have an up-to-date slide. Do you
want to get it up there? Have you got it now?
I'll give Mr. Walsh a moment to take a look at it.
Mr. Walsh, do you have--does the committee staff have a
copy of this?
Can you see that, Mr. Walsh?
Mr. Walsh. The slide that's up on the screen? I can see it.
Mr. Kucinich. The name of the State, county municipality
offices with separators installed; voluntary separators
installed; mandatory.
Mr. Walsh. And the question is?
Mr. Kucinich. Well, the question is, voluntary or
mandatory? I mean, you're defending a voluntary approach, and
it seems that the compliance level just isn't there. And if you
are recommending these amalgam separators on a voluntary basis,
but it doesn't appear to work, why wouldn't the ADA change its
position and tell people they have to have them in there? Why
wouldn't you do that?
Mr. Walsh. Well, what I think we would be doing, and this,
again, the BMPs, we added the separators last October. The
separator pieces are being put into the education requirements.
What we have now is the leadership overwhelming voting for
separators. That didn't exist, and there is no question, when
this first came up, they first asked how can we be regulated;
we're dentists? There is an education process, information
process. Dentists like science. We went out and did the
science. Many of these things the ADA has done on, you know,
its own expense to help set the pieces that would allow for
putting in separators, and we are willing to do other things to
keep track of the information rather than a lot of paperwork
going around, keeping track of actually how much dentists send
amalgam to either recyclers or the amalgam separator
manufacturers so we have hard figures, rather than pieces of
paper that say this is what is being done.
Mr. Kucinich. I just have to say that anyone who is
watching this, just I would assume, as the unbiased observers
that are out there, it seems that the ADA has a resistance to
mandatory regulations with respect to dental mercury. It seems
that your resistance to it is almost theological. Faced with a
tremendous amount of evidence, you just don't want to get off
that position of saying it is voluntary instead of mandatory.
I'm wondering--it seems to me, and I don't know how my
colleagues feel about this, but in listening to Mr. Walsh, he's
very well spoken and obviously a very effective witness from
the ADA's standpoint, albeit that there are some concerns that
there are questions you couldn't answer, and we are going to
submit followup questions to the ADA to give them a chance to
go on record. But are there product liability concerns here? Is
there something deeper here that you're--that a class action
could be in the offing if all of a sudden, you take this, you
feel that it would be fortifying a position and would undermine
your position? Did you ever have any discussions about that?
Mr. Walsh. Well, that would be attorney-client if I had
discussions.
But frankly, our concern is, it has to do with the nature
of, I think, dentistry and what we think is the more effective
way; 100,000 different dental offices is larger than most
point-source dischargers in the country.
Mr. Kucinich. Indeed, I mean that's why this has some
consequences.
Mr. Walsh. It also makes it difficult to enforce. We think
that whatever the final decisions of either Congress or the
agency, there should be cooperation between the government and
dentistry.
I understand that one can say it should have been done
quicker, but there is a process that the American Dental
Association goes through in terms of getting the science behind
things, getting educated. And because they elect their
leadership and some of these discussions are made by the House
of Delegates, it is done with deliberate process, and we are
now at a stage that's different from when we were in these
other things.
I mentioned a few minutes ago, the Michigan Dental
Association is supporting now a statute making separators
mandatory. Each State differs. There are different
circumstances, and we think----
Mr. Kucinich. I just want to say, this is very interesting,
this assertion, because here we are, mandatory or voluntary,
case-by-case basis, as if the science should be applied on a
case-by-case basis. We either have scientific facts here that
underlie the concerns that bring this subcommittee to this
moment and health concerns, or it is just a case-by-case basis.
You're an attorney. Surely, as an attorney, you are--bodies
of law, it's understood, are--you know, the basis of them are
not voluntary; they are mandatory. And when we're talking about
regulation, the entire structure of regulation in this country
is based on certain things you can't do.
When Moses came down from the Mount, he didn't say, these
are 10 voluntary ideas here, commandments; thou shalt not, thou
shalt not pollute, perhaps. Or maybe, whether you like it or
not, if you like to you could pollute, if you don't--this is
where this whole meeting turns today. I would suggest to you
respectfully as someone who has a great deal of admiration for
the kind of effort that goes into a dental practice, into the
life of a dentist, who understands the commitment that dentists
have to their patients, the ADA, it seems to me, for whatever
reason, whether it is product liability, class-action exposure,
or what, the ADA is really behind the curve on this, and I
don't understand why that is----
Ms. Watson. Mr. Chairman, would you yield for a question?
Isn't the Hippocratic Oath that you do no harm?
Mr. Kucinich. I'm not a doctor, but I know that to be so.
Ms. Watson. Well, next time we hold a hearing like this,
would you bring me someone from the association who is involved
with taking that oath rather than an attorney who doesn't take
that oath?
Mr. Kucinich. Well, we asked--in fairness to Mr. Walsh, I
mean, we asked the ADA. First, we invited the president. The
president wasn't available. We agreed that Mr. Walsh would be
an effective witness on the question of regulation. Now, I will
give you that much.
Ms. Watson. He is.
Mr. Walsh. Thank you.
Ms. Watson. But not being a health professional who----
Mr. Kucinich. But we have to set the ADA on record----
Ms. Watson. Thank you so much.
Mr. Kucinich. To say that mercury contamination to
wastewater is environmentally hazardous. We still don't have
that out of you Mr. Walsh, but I think that--I think we'll
somehow be able to establish that with or without you.
Mr. Burton, your time.
Mr. Burton. I won't take much time----
Mr. Kucinich. I just want to say, why else would they
support separators if they don't believe that mercury
contamination to wastewater is environmentally hazardous?
Mr. Burton. I think, Mr. Chairman, a high school student
studying science would know that mercury is not the sort of
thing you would stick into a human being in any form. I mean, I
don't think this is rocket science. I think anybody with any
common sense knows that.
And no matter how much you talk about it, mercury is a
toxic substance, it shouldn't be injected into the human body
in any form, period. It's just crazy.
Now, I'm a conservative, and I don't believe in government
regulation unless it is absolutely necessary. But when an
organization doesn't voluntarily comply with something that's a
public health hazard, dealing with public health hazards, then
the government has no alternative than to do something about
it.
You know, in your testimony, you highlighted two programs
to encourage dentists to voluntarily install separators as
examples of why voluntary problems are better than mandates.
The first program you talked about was by your ADA counterpart
in 2003, involved dentists in Duluth, MN, where a voluntary
program achieved a 100 percent remarkable compliance rate. Are
you familiar with that?
Mr. Walsh. I am, yes.
Mr. Burton. Do you know that was paid for by the
government, all those separators?
Mr. Walsh. I know the dentists and the local POTW applied
for a grant.
Mr. Burton. But you didn't say that in your testimony. I
mean, this was a voluntary program? I mean, the dentists didn't
pay for any of it. It was paid for by the sewage treatment
organization there.
Mr. Walsh. The biggest cost of amalgam separators is not
the purchase of the separator, but it is the recycling of all
the amalgam. That cost is borne by----
Mr. Burton. In any event, when you say it was a voluntary
program, it was not a voluntary program. They voluntarily let
them put them in their offices, but they didn't pay for them.
And so I think there is a little bit of misleading of the
committee there.
Let me just say that I don't understand why we don't have
somebody from the ADA here who is on the Board of Governors,
whatever it is. You are a competent attorney, obviously, but a
lot of these questions we have had and a lot of these
statements that we have had that we wanted to make today was to
the ADA itself. I think it is unfortunate that we don't have
somebody from the ADA here to testify.
Do we have anybody? Hold up your hand if you are a member
of the ADA here. I would just like to know. You are a member of
the ADA. Anybody else? But you are on the other side. I mean,
is there anybody here with the ADA--no, nobody except you.
Do you practice dentistry?
Mr. Walsh. No.
Mr. Burton. I just wanted to check.
Mr. Walsh. I was a research physicist. If that helps.
Mr. Burton. You were a research physicist.
Mr. Walsh. Before I became a lawyer.
Mr. Burton. Really.
Mr. Walsh. Went to work for EPA.
Mr. Burton. Did you ever put an amalgam in somebody's
mouth?
Mr. Walsh. No.
Mr. Burton. I didn't think so. I tell you what. We have
three other witnesses here who might have some things they
might like to say on my time. So if any of you have anything
you would like to comment on--you have heard all this testimony
and the questioning.
Mr. Walsh has been pretty kind to sit there and take all
the punishment we have been giving him today, so I admire you
for that. But I would like to hear from the three of you.
Dr. Fischer, go ahead.
Dr. Fischer. I am a member of the ADA, and have been for
many years. I think one of my big disappointments
professionally over the years has been the lack of leadership
from the ADA on this issue.
It is been a quarter of a century or longer now since I
have stopped using amalgam, not because of anything I learned
at an ADA meeting, but the ADA has sort of gotten in the way of
a lot of informed consent legislation, as Congresswoman Watson
knows, in California. They are not really trying to be
responsible stewards. If they are putting 40 tons or 30 tons,
whatever figure you want to use, into people's mouths every
year, and there is 1,000 tons out there in people's mouths, you
know, the only way to fix this is to put an amalgam separator
on everybody's bathroom toilet or else stop putting it in.
Mr. Burton. Mr. Bender.
Mr. Bender. Thank you. First, thanks for the opportunity. I
would like to correct for the record a statement Mr. Walsh
made. I don't believe that sewage sludge incinerators have any
kind of pollution control equipment, so they certainly aren't
capturing 95 percent of the mercury without any kind of
capture.
Mr. Burton. While you are talking about that, you might
elaborate and tell us where all that mercury goes and how it is
distributed in the environment.
Mr. Bender. Sure, thank you. Once the mercury gets
volatilized it goes into the atmosphere and some of it, a
certain percentage of it, rains down or dried up in a position
locally, some of it regionally, and some of it goes into this
global pool.
Part of the concern about any dental mercury that goes into
the air is that it will methylate, and when it methylates, it
will get into the fish, and we know that is a problem.
So, you know, a big area that hasn't been discussed today,
which is in my written report, has to do with the cremation and
the other air sources.
During my last testimony in the fall, I presented
information that there was between 7 and 9 tons of mercury air
emissions from dental mercury releases each year. And I believe
that Chairman Kucinich wrote a letter to the EPA asking
questions about that number compared to the EPA's number of
something like 1.5 tons, and I don't know whether or not the
EPA has ever responded.
But, you know, again, in Washington there seems to be a
great concern over air releases, and we have had this--rightly
so--a major focus on coal-fired plants which are estimated to
emit 48 tons a year. Well, here you have another sector out
there that is maybe emitting 10 tons per year.
So, again, the concern there has to do with the
methylization of the mercury and it gets in the fish, and we
all know about the tuna and all the rest.
But there are many different places, and Dr. Fischer did a
great job in his testimony of laying out all the different
places, where mercury gets released into the environment, and
if there is the--the U.S. dental sector is still using 30 tons
per year, 60 million mercury filling placements each year in 10
years or however many years the life of those fillings, that
mercury is going to get released into the environment, and it
is a perpetual cycle. As much as you use the mercury, it is
going to get released into the environment.
One area that we focused on with State legislation is the
manufacturers, and I have actually been thinking, in putting
this report together the last few days, that maybe it is time
to hear from the amalgam manufacturers, because there is about
five or six of them in the United States, and I think most of
them made both the mercury free so-called composites and the
mercury fillings.
So maybe we are--some of the focus we haven't had today is
on all of these individuals dentists who are really trying to
do the best job with misguided information, unfortunately, from
the ADA, that we need to hear from these five amalgam
manufacturers. Because their numbers don't--you know, they have
to report by State law.
We lost the Federal arm to be able to track this mercury-
use category with the U.S. Bureau of Mines stopping this
tracking mechanism in 1999.
Mr. Burton. I just want to make sure I get a chance to hear
from Mr. McCormick, too. Go ahead.
Mr. Bender. Sure. But the other thing I wanted to mention
is there is a sort of a difference between sort of a laissez
faire like voluntary installation of amalgam separators and the
facts on the record. And the facts are on the record, and I
have it in my written testimony, in California in 2005 the CDA
single-handedly--sole opponent of assembly bill 996--defeated
the legislation. In Michigan, ADA lawyers, helping with the
separator issue, told a colleague that they would not have to
deal with the issue in 2011.
In Montana, in the ADA's own newsletter they talk about
their one-two knockout punch. So, essentially at this point--
and it goes on and on, Oregon, Philadelphia, where have you,
that we can't move this issue any more on the State and local
level because they made it their business to stop us. So at
this point we are coming to you because this State strategy is
not working for us any more.
Mr. Burton. So the point you are making very vividly is
that they have a concerted effort to block anything but a
voluntary program and the voluntary program simply is not
working?
Mr. Bender. Absolutely. Thank you.
Mr. Burton. Let me followup with just one thing that you
said and then I will just yield the rest of my time to Mr.
McCormick, and that is that I, like you, believe that most of
the dentists, probably 99 percent of them, are very honorable
people trying to do a job, just like the doctors. But they are
getting their information from the ADA just like the doctors
are getting theirs from the AMA. I have talked to doctors and
dentists, and unless it is coming from the gospel, which is the
ADA, they don't believe it.
Mr. Bender. Right.
Mr. Burton. When you talk to them, and I have talked to a
number of them about mercury, they say, hey, that is scientific
research and the ADA says that, and that is gospel. So until
the ADA changes and starts giving them facts as we see them, I
don't think they are ever going to accept that. It is not
because they are not good people, it is just that is what they
are getting.
Mr. Bender. Well, the only other pressure point we had,
Representative Burton, I was a party in the lawsuit against the
FDA to classify mercury as a medical device, and that is where
we are starting to see a chink in the armor where the FDA, as
you quoted, from their new information on their Web site, is
now saying, admitting it is a neurotoxin. So I think we can
also push on the FDA.
Thank you.
Mr. Burton. Mr. McCormick.
Mr. McCormick. Yes, I was 17 years--among my other job
duties--I was a credentialed enforcement officer with the
Agency. I worked a lot of criminal cases as well as civil
cases, and I have been cross-examined by some of the best
environmental attorneys out there.
I am an expert on the pretreatment regulations that cities
have to comply with and that part of the Clean Water Act. If
you want to keep it out of the sewer, the regulations are in
place.
The ADA can disagree, but 40 C.F.R. 403.2 says here are the
objectives of the pollution pretreatment program, and it very
clearly establishes that you can't cause problems with surface
waters or any other environmental criteria.
You know, again, my frustration is all we have to do is say
let's enforce the regulations. That is what Region 8 strategy
said, said where there is a problem you have to control it, and
this is what it says in the pretreatment regulations
implementing the Clean Water Act.
It is not a gray area. OK, I have been on the stand. I have
been grilled on pretreatment regulations. I am very well aware
of the preambles to them, so I guess that is all I have to say.
The tools are there.
Mr. Burton. In 40 C.F.R. What?
Mr. McCormick. 403.2--it is the objectives of the general
pretreatment regulations. The tools are there. The regulations
are there. What I was trying to do was take a document and
provide technical guidance to State and local governments that
said, and it is guidance, OK, it is not even rules. It said,
here is a good way of doing it. OK. Here is a way to approach
reducing mercury discharges to a sanitary sewer system when you
have a problem with mercury.
Very simple. I mean, it was very clear, and the ADA doesn't
disagree with that, that is exactly what they admit it says.
Mr. Burton. OK.
Mr. McCormick. But it is mandatory at that point.
Mr. Burton. Thank you, Mr. McCormick. Thank you all. Mr.
Chairman, I yield back to you.
Mr. Kucinich. Will the gentlelady yield?
Ms. Watson. Certainly, and would you also ask the question
of Mr. McCormick why did WHO ban mercury in thermometers.
I will yield.
Mr. Kucinich. I am still wondering, Mr. Walsh, before we
wrap up work on this panel, the ADA supports separation, right,
of the amalgams?
Mr. Walsh. Correct.
Mr. Kucinich. Why?
Mr. Walsh. We believe that the best environmental result is
to recycle the amalgam----
Mr. Kucinich. You don't do it because it is about
recycling, it is not about contamination to wastewater being
environmentally hazardous?
Mr. Walsh. Every study that has been done by NACWA, by EPA
and our own studies show there is a contribution, but it is a
very small, less than 1 percent contribution. We are willing to
do our fair share.
Mr. Kucinich. You then would agree that mercury
contamination to wastewater is environmentally hazardous? You
are just saying it is a question of the degree; is that right?
Mr. Walsh. We have never attacked the water quality
standard, which is a fish tissue number or the biosolids
numbers. There are a number of plants across the country where
the biosolids numbers are, in fact, on average, about 3, the
limit is 57. And, in many places, the water quality standard is
50 parts per trillion and the level, for example in Laramie, is
8. And the fish levels are not exceeding 0.3. Even there we
think the mercury ought to be recycled, because that is the
best beneficial use.
Mr. Kucinich. Is it environmentally hazardous? That is the
bottom line. You basically say yes, but you are saying the
degree to which the effluent exists from dental offices isn't
significant, is that your testimony?
Mr. Walsh. Yes.
Mr. Kucinich. Why do you support recycling? Is it just
because you are for recycling everything or because you think
that mercury ought to be recycled?
Mr. Walsh. We think mercury--well.
Mr. Kucinich. Why?
Mr. Walsh. The ADA hasn't taken a position on recycling in
general. I personally think many more things ought to be
recycled. But the mercury ought to be recycled because it is
the way you can ensure that the mercury is reused. You don't
have new mercury being created, and it doesn't--even the small
amount of mercury that is incinerated or otherwise gets into
the environment would be lessened.
Mr. Kucinich. You know, I was struck by your candid
admission that you are not a dentist, but you are a physicist.
That is very interesting.
When a piece of mercury metal is heated in air, it comes
together with oxygen in the air, and then if it is weighed it
is found to have a greater mass that the original piece of
metal had. If, however, the mass of the oxygen of the air that
combines with the metal is taken into consideration, it would
be shown that the mass of the product is within the limits of
accuracy of any one instrument equal to the sum of the masses
of mercury and oxygen that combine.
Are you familiar with that principle?
Mr. Walsh. I am afraid, just the way----
Mr. Kucinich. As a physicist?
Mr. Walsh. You just read something that is very complex.
Mr. Kucinich. Are you familiar with the law of conservation
matter?
Mr. Walsh. Yes, I am.
Mr. Kucinich. As a physicist.
Mr. Walsh. Yes, I am.
Mr. Kucinich. As a physicist, do you see any relationship
between mercury deposits in land and air as a function of the
law of conservation and matter, of matter?
Mr. Walsh. All the studies I have seen show that the levels
in the environment are related primarily to air emission
levels. The Everglades study, the Metallica study, various
other studies. It is emissions in an oxidized form that ends up
creating the methylated mercury that is accumulating in fish.
Mr. Kucinich. Does the law of conservation matter, or does
it not say that during an ordinary chemical change there is no
detectable increase or decrease in the quantity of matter?
Mr. Walsh. Mercury is an element. It is the same amount no
matter what happens----
Mr. Kucinich. So what happens to the mercury when it goes
down the drain?
Thank you. You are a physicist, and I am glad you showed
up.
This panel is appreciated, and dismissed.
Mr. Kucinich. I will ask the individuals who are here from
the second panel to come forward. Are there any physicists on
this panel? Anybody? Do we have a physicist? Is there a
physicist in the house? Let's get started.
Well, since you are all standing.
[Witnesses sworn.]
Mr. Kucinich. Thank you. The witnesses have been sworn. Let
the record reflect that the witnesses have answered in the
affirmative.
I am going to introduce them now, and we will proceed with
our second panel.
Ms. Pat Magnuson is an industrial waste compliance
investigator for King County in the State of Washington, and
which, of course, includes Seattle.
She was responsible for coordinating the implementation of
the county's plan to control dental office wastewater
discharges. She also issues permits for and conducts
inspections of a wide range of industrial dischargers to the
county's sewage treatment plants.
Ms. Ann Farrell is a Director of the Central Contra Costa
County Sanitary District Engineering Department. Recently she
has been heading up pollution prevention activities aimed at
reducing the amount of mercury entering the wastewater
treatment facility and eliminating the need for costly mercury
removal projects.
This source control program recently completed the
implementation of a very successful mandatory amalgam separator
program for the dental community.
Dr. Mark Smith, Deputy Director of the Massachusetts
Department of Environmental Protections, Office of Research and
Standards. Dr. Smith is the cochair of the New England
Governors and Eastern Canadian Premiers Task Force. Dr. Smith
has been published numerous times in the areas of environmental
policy, molecular epidemiology, genetic markers of
susceptibility and risk assessment. He has been involved in
mercury as well as environmental research for over 15 years.
Mr. Owen Boyd is the CEO and principal founder of Solmetex.
Under his direction Solmetex became the first water treatment
company to migrate biopharmaceutical separation science to
wastewater applications, and is also the first company to
launch nanotechnology into water treatment fields. Mr. Boyd
also coauthored a 2003 paper entitled Environmental Concerns of
Dental Mercury. He has received numerous awards for his work,
including the EPA's Environmental Technology Innovator Award.
The witnesses have been sworn. We will go to Ms. Magnuson
for an opening statement.
As I indicated to the last panel, please keep your
statements under 5 minutes in length. Your entire written
testimony will be included in the record of the hearing, and
you may proceed. Thank you.
STATEMENTS OF PATRICIA MAGNUSON, INDUSTRIAL WASTE INVESTIGATOR,
KING COUNTY, SEATTLE, WA; ANN FARRELL, DIRECTOR, ENGINEERING
DEPARTMENT, CENTRAL CONTRA COSTA COUNTY SANITARY DISTRICT; DR.
C. MARK SMITH, DEPUTY DIRECTOR AND CO-CHAIR, MASSACHUSETTS
DEPARTMENT OF EPA, NEW ENGLAND GOVERNORS AND EASTERN CANADIAN
PREMIERS TASK FORCE; AND OWEN BOYD, CEO, SOLMETEX
STATEMENT OF PATRICIA MAGNUSON
Ms. Magnuson. Mr. Chairman and members of the subcommittee,
thanks for this opportunity to tell our story.
King County operates the major wastewater treatment system
for the metropolitan Seattle area, including two large
treatment plants with average flows of over 200 million gallons
per day. We discharge treated effluent in the Puget Sound, a
sensitive marine waterway. One hundred percent of the residual
solids from our treatment plants, known as biosolids, are
reused beneficially in wheat and hop fields in Washington, on
forest lands in the Cascade Mountains, and in a composted
product available for landscaping. We control the source of
contaminants into our system by means of our industrial waste
pretreatment program and extensive work with small businesses
and households.
Most mercury that enters our system ends up in the
biosolids, even though our marketability. Even though our
biosolids currently meet all Federal and State regulations for
mercury, our concerns for future marketability of these solids
drives our efforts to continuously make them cleaner. And,
also, the potential for stringent mercury limits in the future
is also a concern.
Under an agreement with the Seattle-King County Dental
Society we conducted an extensive collaborative program from
1995 through 2000 to promote voluntary compliance. We
encouraged purchase and installation of amalgam separator
units, which showed they could meet our limit for mercury. And
the results, after 6 years, were that 24 dental offices out of
approximately 900 had installed the amalgam separators.
In 2001, in consultation with the local dental society, we
decided that the voluntary program had failed and notified the
local dentists that they would be required to meet our local
discharge limits of 0.2 milligrams per liter total mercury.
Using our existing authority we gave them the choice of
installing separators or applying for a permit and proving they
meet our limits without a separator, and we gave them 2 years
to meet compliance.
During that time, we provided extensive outreach to the
dental offices, including technical assistance site visits by
staff from the Public Health Seattle-King County to every
office in the county. Local dentists did not fight this
requirement but rather sought practical information about
purchasing the separators and got on with the task.
After the compliance date, approximately 750 additional
dental offices had installed the amalgam separator units with
the remaining offices quickly following suit by the end of
2003.
Since 2003, we continued to perform outreach to the dental
community through letters and the dental office Web pages.
Compliance rates are determined through ongoing compliance
inspections and by monitoring the amount of mercury in the
biosolids.
In conclusion, the voluntary program did not result in a
significant change in King County. When separators were
mandated, compliance happened quickly, dramatically and with
little resistance.
Partially as a result of this initiative, mercury levels in
King County biosolids have dropped by about 50 percent, and
this represents about 75 pounds of mercury that are kept out of
our biosolids each year.
Then I am going to go to the attached slides, and the first
one graphically demonstrates the number of amalgam separator
units sold in our county during the voluntary phase from 1995
through 2000 and the 2-year transition period from 2001 to
2003, during which they were required to be in compliance.
Slide 2, and this provides an interesting look at two
different areas within King County that received technical
assistance visits from the public health inspectors, and the
chart on the left is the number of amalgam separator units
installed within our source service area, which is only a
portion of King County. And this is where our pretreatment
regulations apply and compliance was mandatory.
The chart on the right includes all other dentists in King
County, and there are areas served by other sewer districts or
on septic systems, and our regulations did not apply to those
dentists.
All dentists received the same visits and information
packets by public health inspectors, but the dentists outside
our service area didn't receive our mailing and were told it is
not mandatory.
Slide 3, that just presents the annual median concentration
of mercury in our biosolids from 2000, the last year before we
introduced our mandatory program, till now. And that shows
about the 50 percent decline, and that remained there.
Finally, I would like to close by saying that we were able
to work with the local dental community and citizens of our
county using existing regulations, and to develop a relatively
low-cost method of achieving measurable reductions of mercury
in our biosolids. Other communities have found different
approaches that better met their particular needs, and local
communities need to have the flexibility to address this issue
in the manner that will work with them.
[The prepared statement of Ms. Magnuson follows:]
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
Mr. Kucinich. Thank you very much.
Ms. Farrell.
STATEMENT OF ANN FARRELL
Ms. Farrell. Good afternoon, Mr. Chairman, Ms. Watson and
Mr. Burton. I am Ann Farrell, Director of Engineering for
Contra Costa Sanitary District, a special discharge district in
Martinez, California. We are responsible for the collection and
treatment of wastewater for approximately 450,000 residents and
more than 10,000 businesses in central Contra Costa County,
which is directly east of Oakland and San Francisco.
I appreciate this opportunity to discuss our successful
program to require dentists in our service area to install
amalgam separators and reduce the mercury entering the San
Francisco Bay.
The San Francisco Bay is impaired for mercury. As the
development of the total maximum daily load of allowable
mercury for the San Francisco Bay was occurring, it became
clear to us in late 2003 that significant reductions in our
mercury load to the bay would be required.
We knew from previous studies that 50 percent of our
influent mercury was coming to us from dental offices. We had
tried in the past to implement mandatory programs, but the
dental community had approached our elected board, and we did
not obtain board support.
This time we wanted to try a different approach and enlist
the support and cooperation of the dental community so that we
could be successful in implementing an amalgam separator
program. We developed outreach materials, and we were basically
trying to acquire informed consent, which was mentioned
earlier. We wanted to document the changes in the regulatory
climate and our potential regulatory risk, as well as our legal
authority, to regulate the dental community. And we began
meeting with the local and State dental societies.
Once we began educating the societies themselves we
received a great deal of cooperation from the Contra Costa
Dental Society and the California Dental Association and
particularly from Patricia Conley, Roseanne Harding and Theresa
Pichay, who worked with us hand-in-hand throughout this
process.
In 2004, we began with a survey of the dental practices in
our service area to obtain accurate inventory of the best
management practices they were utilizing. The best management
practices were voluntary, but the survey was required so that
we could get accurate information.
After analyzing the information we obtained, we observed
that while many BMPs were being used, which accounted for
basically general and good housekeeping, very few of the
dentists had installed amalgam separators, less than 15
percent. During that time, as we monitored our influent
mercury, we found that the mercury had stayed about the same.
We continued our outreach efforts to the dental community
and shared the results of our inventory.
At each of our meetings, the majority of the dentists were
very supportive. They acknowledged that it was relatively
inexpensive for them to install the amalgam separator
equipment, and they understood that it would significantly
reduce their mercury discharge to the environment, but they
further suggested that it could be a competitive disadvantage
and that they--it was not likely they would make the investment
unless a program that was mandatory was implemented.
During this same time period we continued with the carrot,
not the stick approach. We took the opportunity to recognize
any dental practice that voluntarily installed an amalgam
separator through our annual pollution prevention awards
program. However, during this time, this recognition was only
conferred upon 13 dentists of the approximately 300 to 400
dentists in our service area.
Based on the continued series of meetings and discussions
with the local and State associations, we determined that it
was necessary to go back to our board and recommend a formal
and mandatory dental amalgam program.
At that time, because we had the endorsement of the local
and State dental societies, our elected board adopted an
enforcement program in April 2006. We then began the
implementation of the program and the actual permitting of
materials, and we continued to partner with the local and State
dental societies. We allowed them to review the draft copies of
our permits and provide input.
The permit requires self-certification. In other words, the
dentist certifies that he has installed an amalgam permit--an
amalgam separator.
We mailed the permits in three batches, and the compliance
dates were staggered because we had learned from other
municipalities and States that the dentists had been charged
outrageous sums to comply with the deadlines by some of the
plumbers. And so we wanted to give them plenty of time and
stagger deadlines so that they could negotiate with their
plumbers, with their amalgam separator suppliers and have
reasonable costs.
The mandatory permit and certification process was
completed in about 10 months. After the final deadline of
December 31, 2007, had passed, only a few dentists had not
submitted the required forms. Today a total of 318 dental
practices have been issued a BMP permit and 314 of them have
submitted the required self-certification form, for a 98
percent compliance rate.
But we also need to look at the effectiveness of the
program with respect to the mercury and our influent, and I
believe there is a slide that shows our influent, which you
can't read, so I will explain it. And, actually, I wanted to
point out an error in the slide. Where it says parts per
million, it should actually be parts per billion.
But what we found is that our influent mercury
concentration was reduced by over 70 percent, from 0.27 parts
per billion in 2002 to 0.08 parts per billion in 2008. That is
an annual average. Then our effluent, which is the mercury
going into the San Francisco Bay, was reduced by 50 percent
from 0.029 parts per billion in 2002 to 0.0149 parts per
billion for 2008.
I also wanted to point out, if you have the written
testimony, there were some discussions earlier about the
removal through a treatment plant. Our treatment plant is
somewhat unique in that we have incineration, and we have wet
scrubbers. So the mercury is removed from the air and goes into
the wet--basically the treatment plant influent.
Because it is in the scrubber water it is dissolved. So it
is more difficult to remove it because it is not a solid that
settles out. So if you study the chart, you will see that we
only actually got about 27 percent removal of mercury in 2002,
and with our reduced numbers we have about 29 percent removal
of mercury.
So the claim that you can get 90 percent removal of mercury
through a wastewater plant is completely dependent on how much
mercury is in the solids, because the solids are what is
removed. If you have a lot of dissolved mercury, which may
occur if you have an incineration process, then the mercury
removal through the treatment plant is much less, and therefore
the value to the environment of the mandatory amalgam separator
program is that much greater because we are removing the
mercury upstream before it can come in, be volatilized, be
captured in the scrubber water and go out into the bay.
So, in summary, the staff and our board are very pleased
with the cooperation we received from the dental community, and
we feel it is a very successful program, and we are going to
continue to monitor it each year, to meet them, make sure the
maintenance is occurring.
And I welcome any questions when we get to the question
period.
[The prepared statement of Ms. Farrell follows:]
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
Mr. Kucinich. Thank you very much, Ms. Farrell.
Dr. Smith.
STATEMENT OF DR. C. MARK SMITH
Mr. Smith. Thank you, Chairman Kucinich, Mr. Burton, and
Ms. Watson, for inviting me today to testify about our efforts
in Massachusetts and in the New England region to reduce
mercury from the dental sector. I would also like to thank you
all for summarizing, excellently, most of what I am about to
say, and bearing with me to say it again.
As a scientist, a fisherman and a father of children who
love to fish and occasionally eat fish, I have been very
concerned about the effects of mercury on our environment and
on our children's health. To address the problem, I have been
working in the mercury field in policy and research for the
past 15 years.
As we have heard today, many reports have concluded, I
think appropriately so, that the dental sector is a significant
contributor of mercury releases to wastewater, accounting for
50 percent or more of the mercury found there.
Mercury wastewater can be released to the environment
through sludge incineration, through sludge reuse and from
wastewater. I would also like to note that sewage sludge
incinerators typically do not contain or have mercury specific
control technologies, and a substantial fraction of the mercury
will be remitted to the atmosphere. What is captured is
typically captured by scrubbers, as Ms. Farrell mentioned, and
then can be recirculated back to wastewater treatment plants,
contributing to wastewater discharge releases as well.
Mercury can also be released from sludge reuse. And in New
England we estimate that about 12 percent of our air emissions
are attributable to sewage and sludge incineration, which is a
significant amount.
Eleven States now, as well as numerous municipalities, have
adopted mandatory programs requiring the use of amalgam
separators. This is based on recent results from a survey of
the States conducted by the Quicksilver Caucus.
In New England, mercury from the dental sector is being
addressed through the New England Governors and Eastern
Canadian Premiers Mercury Action Plan, which was adopted in
1998 and set a long-term goal of virtually eliminating
anthropogenic sources of mercury in our region. We also adopted
long-term goals of 50 percent reduction by 2003 and 75 percent
by 2010.
We have met and exceeded the plan's first goal, and we are
well on the way to the 2010 target. We have done that by
adopting State regulations that exceed EPA requirements in
essentially all areas, focused on trash incinerators, coal-
fired power plants, mercury products and also the dental
sector.
I would also like to note that we recently completed a
regional total maximum daily load assessment for mercury,
indicating that mercury inputs to our water bodies will need to
be reduced by 98 percent to restore those water bodies to a
fishable condition where the fish will be safe to eat. Yes, 98
percent is pretty high. In order to get there, you have to
address all the sources, even ones that you might traditionally
think are not significant.
As I mentioned before, just looking at sewage sludge
incineration emissions and the dental contribution to that,
that is a source that we really do need to address in order to
get our fish back to a situation where they will be edible.
In 2005, we specifically adopted goals for amalgam
separator use under our regional action plan. These goals were
that 75 percent of dentists in our entire New England region
would have amalgam separators installed by 2007 and 95 percent
by 2010. In order to get there, all New England States have now
adopted requirements for amalgam separators, and we currently
estimate that over 91 percent of dentists who generate amalgam
wastewater in New England are now using these pollution
controls, reducing mercury entering the region's sewage by many
hundreds of pounds each year and, of course, reducing emission
from incinerators and the reuse of the sludge where the mercury
concentrates.
In Massachusetts, State regulatory agencies and the dental
society of--Massachusetts Dental Society, signed a memorandum
of understanding in 2001 to increase the voluntary use of
amalgam separators in best management practices. Under this
agreement, we did substantial outreach to dentists to educate
them and had discount pricing on select amalgam separators.
Although the MOU certainly helped to raise awareness, by
2003 we only saw a modest increase in the sales of separators
in our State. In 2004, Mass DEP, my agency, implemented a
followup program to speed up the process. At the start of this
initiative we announced that we would be adopting regulations
in 2006 which would require the installation of amalgam
separators to achieve faster reductions, because it typically
takes us about that 2-year period to develop and implement new
regulations.
We instituted an incentive-based voluntary early compliance
program. Dentists participating in this program were required
to certify that they used an approved amalgam separator,
followed best management practices and recycled all of their
waste mercury. As an incentive, the participants in the first
year were exempted from permit fees, saving them a few hundred
dollars, and the installed units were grandfathered into 2010.
Our local Massachusetts dental society was very helpful in
getting the word out about this program, and 75 percent of our
dentists participated in that early compliance program with the
backdrop of the mandatory regulations coming down the road.
Regulations requiring separators were adopted in 2006 pretty
much on schedule.
To date, over 98 percent of facilities that were randomly
expected have been found to have appropriate amalgam separators
installed. Despite some compliance issues that we found in our
audits relating to record keeping and recycling, our initiative
has been very successful, and over the 2-year period of 2004 to
2006, when amalgam separator use increased to 75 percent in our
State, mercury levels in sludge from the greater Boston area
decreased by close to 50 percent.
In conclusion, without appropriate pollution controls, the
dental sector can be a significant source of mercury pollution
to the environment. Amalgam separators can substantially reduce
these releases. The successful experiences in Massachusetts and
other States in reducing pollution from the dental sector will
only support further national action in this area.
Programs that include outreach through collaboration with
State dental societies and that also include quantifiable goals
and mandatory deadlines for the use of amalgam separators and
other best management practices are both effective and
achievable.
Again, I would like to thank you all for the opportunity to
testify today, and I am willing to answer any questions that
you may have.
Thank you.
[The prepared statement of Mr. Smith follows:]
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
Mr. Kucinich. Thank you, Dr. Smith.
Mr. Boyd.
STATEMENT OF OWEN BOYD
Mr. Boyd. Good afternoon, Mr. Chairman, Ms. Watson, Mr.
Burton. I am Owen Boyd, founder of Solmetex. We founded
Solmetex on the principle that we wanted to increase
efficiencies in water technologies that were being deployed
within the United States. So we took efficiencies that were
being used in biopharmaceutical separations; namely, called
advanced affinity chromatography, and we were able to migrate
it into, at first, a resin that would remove mercury from
water.
We put systems into hospitals, we treat incinerator wet
scrubber waste to remove mercury down to below a part per
billion in water discharges. We do commercial installations to
keep mercury out of wastewater. And we were asked to approach
the dental industry to see if we could take mercury out of
dental waste.
After examining the profile of dental waste, we developed
an amalgam separator. We call them amalgam separators because,
in any other industry, they would have been called simply a
filtration device. Most amalgam separators use, you know, one
of four principles of filtration, which is centrifugal,
mechanical, chemical or sedimentation. All of them have been
used for well over a century. There is nothing novel about an
amalgam separator. It shouldn't be viewed as a new technology.
It is a simple filtration device held at point of source
generation.
We developed the device to make sure that we could not only
take the mercury out but recycle the mercury so it didn't end
up back in a landfill and just be a transfer waste.
I am going to cover three areas. One is do amalgam
separators work, do they have an impact on a sewage treatment
plant, the cost and use of amalgam separators and a little bit
of our sales history to show the impact of a regulation versus
a voluntary approach.
As I said, amalgam separators are filtration devices that
have been used in a lot of dental clinics. In the European
Union they have been used for well over a decade. The Paris
Commission, PARCOM, in their Recommendation 93/2, they cited
information received from Belgium, Finland, France, Germany,
Iceland, Netherlands, Norway, Spain, Sweden, Switzerland and
the U.K. That now will have mandatory regulations that the
discharge of dental amalgam in the municipal systems has been
significantly reduced by the use of separation equipment in
recent years, in most cases by at least 95 percent.
In Toronto, Ontario, the fifth largest city in North
America, a 58 percent reduction of mercury in biosolids was
recognized when an estimated 73 percent of dental clinics had
complied with separator regulations. Their biosolid mercury
concentrations were reduced from 17 kilograms a month, or 37
pounds, to 7 kilograms a month. Additionally, a 13 percent
reduction of mercury in their final wastewater was measured.
Minnesota, two particular POTWs; that is, a publicly owned
treatment work or sewage treatment plant, Hastings and Cottage
Grove, their mercury in biosolids were reduced 24 and 49
percent.
U.S. Navy had 53 notices of violations from regulatory
folks. That is now down to 3, 52 percent decrease in POTW
biosolids.
Duluth, MN, has had the same type of experience. Seattle-
King County, they have reduced their amount from 74 pounds per
year in 2000 to 38 pounds in 2004.
The Strategic Envirotech Partnership from the Executive
Office of Environmental Affairs in Boston, MA, tested amalgam
separators in dental settings, and they measured 99.85 percent,
98.94 percent and 99.74 percent reduction in the three amalgam
separator sites that they tested.
The cost of an amalgam separator. There is a lot of
different, varying costs, I can tell you. With about 120,000
clinics that deal with amalgam, our cost of $750 per system,
that would run about $90 million to install at all of those
clinics, and it would cost an additional $34 to $34.5 million a
year to maintain those systems so they continue to be
operational. That would be the cost of the removal at all
dental clinics across the United States.
If you can bring up slide 1 for me, these are actual
numbers, and what that shows you is our units sold in what we
refer to as States with regulations, States with partial
regulations, and States with no regulations whatsoever.
Partial regulations, these are States, you know, like
California, where you have individuals POTWs or cities that
take action, but not the whole State is regulated, and there
were a number of States that do that, and it is in my written
testimony.
But you can see that, you know, what this chart shows you
is that the States with the legislation, our sales are sky
high. Those without, which are the yellow bars, are essentially
unaffected. Those with partial regulations, we had very good
results.
As a matter of fact, if you looked at the results in total,
that would show you that within the United States we have 93
percent of our sales are in regulated or nonregulated or
partially regulated States. If you took all of our sales
internationally and domestic, 99 percent of our sales are in
regulated areas or partially regulated areas.
If you look at the next slide, this will give you an
impact, because we track our sales month-by-month in every area
that is regulated. And what you can see is that the left side
of that scale, that is a percent of sales, you can see that as
a regulation comes into effect, the first 24 months we see very
little activity. As the deadline approaches, you can see,
literally, between 8 to 2 months before the deadline, the
majority of our sales occur. You can also see--if you notice on
the blue line, that is where you can give a lot of credit to
the Massachusetts Dental Society for putting extraordinary
effort into a voluntary approach. And we tracked that 24 months
as a period of voluntary approach with a threat of regulated
approach, but they got an awful lot accomplished in a short
period of time.
But what all that data shows you, in summary, first off
amalgam separators do, in fact, work, if maintained properly.
You can see the impact on regulations. If there were no
regulations in the United States, we wouldn't be marketing
here, we would be marketing elsewhere. And the cost for
Solmetex systems is about $120 million to acquire the equipment
and another $34.5 million to maintain that equipment.
That number is not an estimate, it is reality, because we
keep track of how many replacement cylinders are sent to each
dentist every year, and the average is they change a little
less than one replacement filter per year.
I am going to go back to that graph just for 1 second.
There is an interesting little note on followup. The yellow
line you will see after the regulation, the deadline date, you
will see another bump in sales. That bump in sales actually
correlates to a letter that the Connecticut DEP wrote to
dentists after regulations had passed. They had an indication
that a lot of dentists had not complied. So they asked for a
serial number, manufacturer number, installation date and the
installer. And we saw another bump in sales as the enforcement
arm of the regulation took place.
Thank you.
[The prepared statement of Mr. Boyd follows:]
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
Mr. Kucinich. I thank all the witnesses. I would like to
begin with a 5-minute round of questioning, begin with Ms.
Magnuson.
As an alternative to installing separators, King County
could have chosen to treat its wastewater mercury. Why did you
decide against that option instead of treating it and
installing the separators?
Ms. Magnuson. Instead of treating it at the treatment
plant?
Mr. Kucinich. Yes, yes.
Ms. Magnuson. I don't think--it is costly to treat it at
the treatment plant. Is that the question?
Mr. Kucinich. Yes, you had a choice. Why did you do the one
instead of the other?
Ms. Magnuson. We had the choice? No, actually, King
County--our treatment plant effluent limits and even the
biosolids mercury levels were within our limits for our MPDS
permit.
Mr. Kucinich. What about the cost of treating it at the
treatment plant? Is there a cost involved there? Is it a high
cost?
Ms. Magnuson. If the technology, yes, is there, it is a
high cost. I don't have the costs for treating it at the
treatment plant right now. NACWA did some studies, so I don't--
--
Mr. Kucinich. Do you have any information about the cost as
far as the breakdown?
Ms. Magnuson. For the treatment plant, to treat it at the
treatment plant?
Mr. Kucinich. Yes. You said it would be prohibitive?
Ms. Magnuson. It is prohibitive, and it runs in the
millions of dollars, like tens of millions of dollars, if it
exists, you know, if the technology would be viable.
Mr. Kucinich. So you are saying then that the separators
are preferred to trying to----
Ms. Magnuson. Treating it at the source. Any of the
pretreatment for metals, it is always preferable to treat it at
the source.
Mr. Kucinich. Ms. Farrell, I understand the first time you
considered installing separators in dental offices you
experienced strong resistance. What was different about your
second attempt and what can you recommend to other counties
considering policies to reduce dental mercury emissions?
Ms. Farrell. Well, the first time we just kind of rolled
out the program, and we didn't go work--do the prework with the
dental societies. And so they immediately came to our board
meeting and complained to our board, who is an elected board,
and that was kind of the end of that.
So the second time we got a little bit smarter, and we
approached them. I think, also, times had changed where they
were beginning to understand that this was coming down the
road.
We had a real regulatory requirement that we were going to
have to meet that was going to cost us in the tens of millions
of dollars, so we basically need to educate them that this was
the least expensive way to meet our requirements for the
community at large.
Mr. Kucinich. Thank you. During your outreach meetings to
dentists, you have said that dentists actually requested that
the central Contra Costa County make separators a mandatory
policy. Why was that?
Ms. Farrell. I am not sure I said they requested. I think
they acknowledged that it was unlikely we would get a high rate
of participation without a mandatory program.
Mr. Kucinich. Thank you.
Dr. Smith, do you think it is accurate to describe the
Massachusetts program as a voluntary one? Why or why not?
Mr. Smith. I would say that the overall program was not
strictly a voluntary program.
Mr. Kucinich. Meaning what?
Mr. Smith. Meaning the voluntary component was really
applicable only to the incentivized early compliance part of
our program, which was backstopped with a mandatory regulation.
Mr. Kucinich. Did you offer incentives? What incentives did
you offer to dentists who voluntarily installed separators
before the program became mandatory?
Mr. Smith. The two incentives that we offered, one was that
we waived the permit fee so they did not have to pay permit
fees if they came in early in the process. And the second
incentive was that the units they installed were grandfathered.
And in the voluntary compliance program, that early
compliance component, we only required separators to achieve a
95 percent removal efficiency. The regulation specifies 98
percent, so it is modeled on regulatory certainty.
Mr. Kucinich. So based on your experience, have you or
would you recommend other States offer similar incentives?
Mr. Smith. Yes, I think the incentives worked extremely
well and were highly supported by the Massachusetts Dental
Society. I think it really galvanized attention to dentists who
really wanted to do the right thing, who realize that they
needed or should be putting on the amalgam separators. And here
is the shot in the arm to actually get them to take the step to
do it.
Mr. Kucinich. So you have established that a beneficial
effect can be made on the environment if every dentist
installed a mercury separator; do you believe that?
Mr. Smith. Yes, absolutely.
Mr. Kucinich. What have been the costs in terms of time and
money associated with maintaining the dental mercury program?
Mr. Smith. For the State?
Mr. Kucinich. Yes.
Mr. Smith. We haven't broken it down that way, but in order
to minimize the expense in terms of staff resources to the
Agency, and also to make it easy for the dentists to basically
submit, we have been using a self-certification process. And we
developed an electronic e-form that the dentist can basically
fill out and submit to the Agency, which makes it very easy
once the form was developed. Getting the form developed was
difficult. So the cost to the Agency has been relatively
modest.
Mr. Kucinich. I would just like to say that the staff will
submit some questions so that we can better quantify this as we
prepare our report on this committee.
Mr. Smith. If I could just add one more thing because it
was brought up earlier.
Mr. Kucinich. Sure.
Mr. Smith. On the compliance and enforcement end, you don't
have to go visit every single dentist to verify compliance and
enforcement. We are using statistically based sampling to do
that, which really minimizes the expense and gives you good
data.
Mr. Kucinich. That is noteworthy. I appreciate that. Thank
you.
Mr. Burton.
Mr. Burton. Thank you, Mr. Chairman. Dr. Smith, you said
that the amount of mercury in the fish up there really hasn't
improved all that much.
Mr. Smith. We actually have been seeing some improvements
over the past--well, since 2000 to 2007, mercury levels in fish
in Massachusetts have decreased by approximately 20 percent,
depending on where you look.
Mr. Burton. Are you eating fish up there that comes out of
that area?
Mr. Smith. Some of the fish are edible, are safe to eat.
Many of them are still not safe to eat. I think we have a long
way to go before they are.
Mr. Burton. How do you decide when you go to the
supermarket which fish to buy?
Mr. Smith. Well, the smaller fish. Stay away from the tuna,
the swordfish. Stick to the cod, the flounder and fish like
that. Farm-raised salmon tend to have lower levels.
Mr. Burton. Isn't that a heck of a thing you have to go
through?
Mr. Smith. It is.
Mr. Burton. I don't eat much meat. I eat fish and chicken.
It just bugs me to death to think that there is a lot of
mercury in there.
Mr. Smith. Yes.
Mr. Burton. Ms. Farrell, without the separators the percent
of mercury remains fairly consistent; is that correct?
Ms. Farrell. That is correct. We saw very little reduction
until we had the mandatory program.
Mr. Burton. And, Mr. Boyd, you said that in Europe the
compliance was almost 100 percent because it was mandatory; is
that right?
Mr. Boyd. That is correct.
Mr. Burton. So I deduce from all of your testimony what the
lawyer for the ADA was saying wasn't quite correct in that he
thought that the voluntary program was going to be effective. I
mean, all of you can answer once, if you want to. You don't
think the voluntary programs work that well?
Mr. Smith. I would say there is no good evidence that would
support that.
Mr. Burton. Well, there you go. As Ronald Reagan would say,
there you go.
I just wish they were still here so they could hear your
testimony. I am sorry, but I think they already know it. It is
just a matter of making sure that the message gets through to
them. I know you don't have anything to do with this, but I
just wish you guys didn't have to worry about this. I wish we
weren't putting amalgams in people's mouths in the first place.
But anyhow I really appreciate your testimony.
Mr. Chairman, again, I want to thank you for having this
hearing. I yield back.
Mr. Kucinich. I thank the gentleman. The Chair recognizes
Ms. Watson from California.
Ms. Watson. I want to thank all of our witnesses for
providing us with the empirical evidence, and I will join with
my colleague and say I wish the attorney were still here. You
know, we sit through a lot of these hearings, and these
attorneys come in and they tend to get you all tied up in
legalese so that we miss the point. Thank you for coming and
giving us the specific evidence from what you are doing in your
respective locations.
I want to thank Dr. Smith in particular. I found your
information to be very helpful. And Mr. Boyd, you have had some
experience from the commercial, retail end. So I would like to
have you tell about one experience where you provided free
separators to dental offices, dental offices in Highland Ranch,
Colorado, to encourage them to install separators in their
clinics, and what was the outcome from this pilot project. Do
you remember that one?
Mr. Boyd. Yes, that pilot project was actually an
opportunity for us to put in a very scientific setting the
impact of an amalgam separator. It is unusual to have an
opportunity to treat just the mercury influent with no other
mercury initiative going on and measure quantitatively the
reduction of mercury and solids and the production of mercury
in their liquid wastes as well.
So we, in a voluntary effort with the local sewer district
out there, have provided free separators and we are doing free
analyticals as well, which are being backed up by the local
agency.
The results aren't all in yet. It is probably going to be
about another 6 months before we have definitive results.
We had a similar opportunity in the city of Toronto, where
there were no initiatives, but I can't say the science that was
behind it was rock solid that showed that the impact of amalgam
separators up there was incredibly dramatic. And, rather than
argue the point, you know, we sort of go about it in a very
scientific fashion saying we will provide the data.
Ms. Watson. Thank you.
In light of the information reflected in your second graph
regarding the deadline dates, what kind of deadline would you
recommend to State and local governments considering mandating
the use of separators in their State, city or counties?
Mr. Boyd. The experience that we've had is that a, you
know, a mandated regulation, again, you will have some plumbers
that if you give them a 3- or 4-month mandate, you know,
plumbers will wreak havoc on the dental community. However,
even with a 2-year, we have found most of the dentists buy in 4
months before the deadline anyway and set their own trap. So,
you know, somewhere in between is probably the proper
timeframe.
Ms. Watson. Very good. Thank you.
And can you tell us about your previous experience,
specifically in Maine, and what was significant about your
participation, and what was the result of the Maine hearings
that you had?
Mr. Boyd. Well, in Maine, I probably found myself in a very
unusual situation in that I was testifying for folks that
wanted amalgam separators and for the Maine Dental Association
simultaneously. And what we were trying to do was to provide
reality, because a lot of the regulation was being passed with
what is called an ISO standard of performance, which is a
static test run by an international--under an international
standards organization protocol that determines the efficiency
of a unit in that static test.
And the efficiency of that unit, if you looked at the
volume of mercury that you have to remove, whether something is
95 percent or 99 percent efficient, those efficiency numbers
are almost invalid in terms of making much of a difference. The
standard says you have to meet a 95 percent criteria, and my
argument to the folks that wanted amalgam separators was, stay
at 95 percent; if you go to 99, you'll limit the market choices
the dental community will have, and then people like me could
take advantage.
So I argued against my own company's separators on that
particular regard and argued for the Maine Dental Association
that the 95 percent number would get the folks that wanted
mercury reduction, it would get them the same equivalent
reduction because the static test was not that representative
of what actually occurred in a dental setting. So whether it
was 95 or 99 percent statically, you know, when those systems
are put into actual use, they still run about 98, 98 to 99
percent efficient.
Ms. Watson. And I will just close with this.
Mr. Chairman, you have been very kind to give us this time.
As we try to look nationally and make policy, I would like
you to take a look from the retail commercial end at my
proposed measure, and we'll get you a copy, and suggest what
policymakers should really do.
I'd like Dr. Smith to do the same thing, and maybe all four
of you, you know, what we should set as a national policy. You
heard the attorney before, and rather than go down the wrong
path because we're not considering both ends of this, I would
like to get some feedback from you who have put what we're
trying to do in practicality as pilot projects how we as a
Federal Government can design the policy so it will be
effective.
Mr. Boyd. It would be my pleasure.
Ms. Watson. Thank you very much.
And, thank you, Mr. Chairman.
And thank you, Mr. Burton.
Mr. Kucinich. I thank the gentle lady from California.
This has been a hearing of the Domestic Policy Subcommittee
of the Oversight and Government Reform Committee. The title of
today's hearing has been, ``Assessing State and Local
Regulations to Reduce Dental Mercury Emissions.'' We have had a
distinguished group of people here to testify. Panelists have
included Michael Bender, the director of the Mercury Policy
Project; Dr. Richard Fischer, the former president of the
International Academy of Oral Medicine and Toxicology, Dr.
Fischer is a dentist; Mr. Curt McCormick, former administrator,
EPA Region 8; Mr. William Walsh of counsel to the American
Dental Association.
Our second panel, we've had Ms. Patricia Magnuson, the
Industrial Waste investigator, King County, Seattle, WA; and
Ms. Ann Farrell, the director of the engineering department
Central Contra Costa County Sanitary District; Dr. C. Mark
Smith, the deputy director and cochair of the Massachusetts
Department of EPA and New England Governors and Eastern
Canadian Premiers Task Force; and Mr. Owen Boyd, CEO of
Solmetex.
I want to thank these witnesses.
I want to thank my colleagues, Representative Burton and
Representative Watson, for their participation in this hearing
which has taken over 3 hours, and members of our staff, who
have well prepared us for this hearing.
This subcommittee will continue its look at the
implications of mercury as an environmental contaminant, the
health effects of it, whatever the point source happens to be
of that.
I want to, again, thank everyone for their attendance, and
this committee stands adjourned. Thank you.
[Whereupon, at 5:44 p.m., the subcommittee was adjourned.]
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