[House Hearing, 111 Congress]
[From the U.S. Government Publishing Office]
ASSESSING EPA'S EFFORTS TO MEASURE AND REDUCE MERCURY POLLUTION FROM
DENTIST OFFICES
=======================================================================
HEARING
before the
SUBCOMMITTEE ON DOMESTIC POLICY
of the
COMMITTEE ON OVERSIGHT
AND GOVERNMENT REFORM
HOUSE OF REPRESENTATIVES
ONE HUNDRED ELEVENTH CONGRESS
SECOND SESSION
__________
MAY 26, 2010
__________
Serial No. 111-139
__________
Printed for the use of the Committee on Oversight and Government Reform
Available via the World Wide Web:http://www.fdsys.gov
http://www.oversight.house.gov
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COMMITTEE ON OVERSIGHT AND GOVERNMENT REFORM
EDOLPHUS TOWNS, New York, Chairman
PAUL E. KANJORSKI, Pennsylvania DARRELL E. ISSA, California
CAROLYN B. MALONEY, New York DAN BURTON, Indiana
ELIJAH E. CUMMINGS, Maryland JOHN L. MICA, Florida
DENNIS J. KUCINICH, Ohio JOHN J. DUNCAN, Jr., Tennessee
JOHN F. TIERNEY, Massachusetts MICHAEL R. TURNER, Ohio
WM. LACY CLAY, Missouri LYNN A. WESTMORELAND, Georgia
DIANE E. WATSON, California PATRICK T. McHENRY, North Carolina
STEPHEN F. LYNCH, Massachusetts BRIAN P. BILBRAY, California
JIM COOPER, Tennessee JIM JORDAN, Ohio
GERALD E. CONNOLLY, Virginia JEFF FLAKE, Arizona
MIKE QUIGLEY, Illinois JEFF FORTENBERRY, Nebraska
MARCY KAPTUR, Ohio JASON CHAFFETZ, Utah
ELEANOR HOLMES NORTON, District of AARON SCHOCK, Illinois
Columbia BLAINE LUETKEMEYER, Missouri
PATRICK J. KENNEDY, Rhode Island ANH ``JOSEPH'' CAO, Louisiana
DANNY K. DAVIS, Illinois ------ ------
CHRIS VAN HOLLEN, Maryland
HENRY CUELLAR, Texas
PAUL W. HODES, New Hampshire
CHRISTOPHER S. MURPHY, Connecticut
PETER WELCH, Vermont
BILL FOSTER, Illinois
JACKIE SPEIER, California
STEVE DRIEHAUS, Ohio
JUDY CHU, California
Ron Stroman, Staff Director
Michael McCarthy, Deputy Staff Director
Carla Hultberg, Chief Clerk
Larry Brady, Minority Staff Director
Subcommittee on Domestic Policy
DENNIS J. KUCINICH, Ohio, Chairman
ELIJAH E. CUMMINGS, Maryland JIM JORDAN, Ohio
JOHN F. TIERNEY, Massachusetts DAN BURTON, Indiana
DIANE E. WATSON, California MICHAEL R. TURNER, Ohio
JIM COOPER, Tennessee JEFF FORTENBERRY, Nebraska
PATRICK J. KENNEDY, Rhode Island AARON SCHOCK, Illinois
PETER WELCH, Vermont ------ ------
BILL FOSTER, Illinois
MARCY KAPTUR, Ohio
Jaron R. Bourke, Staff Director
C O N T E N T S
----------
Page
Hearing held on May 26, 2010..................................... 1
Statement of:
Stoner, Nancy, Deputy Assistant Administrator for Water, U.S.
Environmental Protection Agency, Office of Water........... 10
Walsh, William, of counsel, Pepper Hamilton, LLP,
representing American Dental Association; Steven Brown,
executive director, the Environmental Council of the
States; Alexis Cain, scientist, U.S. Environmental
Protection Agency, Region 5; and John Reindl, Mercury
Policy Project............................................. 74
Brown, Steven............................................ 82
Cain, Alexis............................................. 92
Reindl, John............................................. 98
Walsh, William........................................... 74
Letters, statements, etc., submitted for the record by:
Brown, Steven, executive director, the Environmental Council
of the States, prepared statement of....................... 84
Burton, Hon. Dan, a Representative in Congress from the State
of Indiana, prepared statement of.......................... 28
Cain, Alexis, scientist, U.S. Environmental Protection
Agency, Region 5, prepared statement of.................... 94
Kucinich, Hon. Dennis J., a Representative in Congress from
the State of Ohio:
Information concerning regulation sales trend............ 53
Letter dated May 26, 2010................................ 110
Letter dated May 28, 2010................................ 38
Letter dated May 28, 2010................................ 116
Prepared statement of.................................... 4
Prepared statement of Alfred Dube........................ 68
Reindl, John, Mercury Policy Project, prepared statement of.. 100
Stoner, Nancy, Deputy Assistant Administrator for Water, U.S.
Environmental Protection Agency, Office of Water, prepared
statement of............................................... 13
Walsh, William, of counsel, Pepper Hamilton, LLP,
representing American Dental Association, prepared
statement of............................................... 77
Watson, Hon. Diane E., a Representative in Congress from the
State of California, prepared statement of................. 62
ASSESSING EPA'S EFFORTS TO MEASURE AND REDUCE MERCURY POLLUTION FROM
DENTIST OFFICES
----------
WEDNESDAY, MAY 26, 2010
House of Representatives,
Subcommittee on Domestic Policy,
Committee on Oversight and Government Reform,
Washington, DC.
The subcommittee met, pursuant to notice, at 2:10 p.m. in
room 2154, Rayburn House Office Building, the Honorable Dennis
J. Kucinich (chairman of the subcommittee) presiding.
Present: Representatives Kucinich, Cummings, Watson,
Jordan, and Burton.
Staff present: Jaron R. Bourke, staff director; Charisma
Williams, staff assistant; Leneal Scott, IT specialist, full
committee; Ashley Callen, minority counsel; and Molly Boyl,
minority professional staff member.
Mr. Kucinich. We are going to call the meeting to order.
The Subcommittee on Domestic Policy of the Committee of
Oversight and Government Reform will now come to order.
We are joined by our ranking member, Mr. Jordan. Thank you.
Today's hearing is the third held by our subcommittee on
the subject of the pollution from mercury used in dentistry.
This hearing, the first to be held during the Obama
administration, will examine actions undertaken by the EPA and
other stakeholders to improve measurement of and limit mercury
pollution from dental sources.
Without objection, the Chair and ranking minority member
will have 5 minutes to make opening statements, followed by
opening statements not to exceed 3 minutes by any other Member
who seeks recognition.
Without objection, Members and witnesses may have 5
legislative days to submit a written statement or extraneous
materials for the record.
Mercury, especially methylmercury, is a very serious
environmental and public health threat. It is persistent and
bio-accumulative in nature and can cause birth defects, chronic
illnesses, mental disorders, autoimmune disorders, and
neurodegenerative diseases in human beings. Young children and
unborn fetuses are particularly susceptible to mercury
toxicity.
The largest source of mercury air emissions is smoke from
coal-burning power plants, about 50 tons per year. The next
tier of major mercury air emissions is attributable to
incineration of automobiles and mercury switches and pollution
from industrial and commercial boilers. Each of these emissions
is about 7\1/2\ tons per year.
Today's hearing addresses what scientific evidence suggests
may be an unrecognized member of that second tier of major
source of mercury pollution. Currently, dentists use more than
20 tons of mercury per year in dental fillings, replacing or
repairing current fillings or putting new fillings in. Where
does all that waste mercury go? Often it goes down the drain,
and if there isn't a major storm causing the sewers to
overflow, the waste mercury ends up in a public water treatment
works where it settles into biosolid sludge.
Many municipalities burn this sludge in incinerators. The
mercury in incinerated sludge is vaporized and goes into the
air. Over 1,000 tons of mercury are currently in the teeth of
Americans. Millions of Americans opt for cremation at death.
When corpses are cremated, the mercury in their teeth goes up
in the air.
How much dental mercury ends up in the air? According to
official estimates from EPA, the amount of mercury released
into the air when sewage sludge is incinerated is small, about
0.6 tons per year. According to EPA, the amount of mercury
emitted into the air from cremation is also insignificant,
about 0.3 tons per year. But actual mercury emissions from
crematoria and sludge incinerators may be more than five times
greater than EPA's official estimates.
EPA, itself, admits its estimates of air emissions from
sewer sludge incinerators are poor and unreliable. EPA's
estimate for emissions from crematoria is also suspect because
it is based entirely on tests conducted more than 10 years ago
on a single crematorium. No effort was made at the time to
determine whether or not the test was conducted as a
representative sample.
In spite of these deficiencies, EPA never changed its air
emission estimates for sludge incinerators and crematoria, and
they are repeated in EPA's written testimony today. But we have
found one EPA scientist whose scientific research disputes the
official estimates. He will testify today on his own behalf,
because his scientific work has never been fully or officially
adopted by EPA, but EPA has had plenty of time to consider his
findings and revise the official estimates. He has been
presenting at conferences since 2005, and in 2007 published his
findings that EPA's official estimates significantly under-
counted mercury air emissions.
In a previous hearing, this subcommittee received testimony
establishing that the true range of mercury air emissions
attributable to dental mercury could be as high as seven to
nine tons per year. That would put dental mercury emissions on
par with major source of mercury air emissions.
If EPA under-estimated the extent of the environmental
problem caused by dental mercury, it has also over-estimated
the amount of cooperation dentists have voluntarily given
toward preventing amalgam from leaving dental offices in
wastewater. The technology for capturing mercury is known as
the amalgam separator.
In 2008, EPA effectively agreed with comments submitted by
the American Dental Association, which asserted, in part, that
significant numbers of dentists are voluntarily purchasing
amalgam separators and are thereby reducing the amount of
mercury their offices use and wash down the drain. Thus, EPA
granted an exception for dental offices from mandatory effluent
guidelines in 2008; instead, EPA entered into a voluntary
memorandum of understanding in the last days of the previous
administration to encourage dentists to adapt amalgam
separators to prevent the mercury that they use every day from
going down the drain to the publicly owned water treatment
facilities.
But what happens in practice is far different from the
assumptions that justified the exception and a memorandum of
understanding. Unfortunately, in State after State dentists
have, by and large, been slow to adopt mercury separators
unless they were facing mandatory regulations. According to
testimony received today from the Environmental Council of the
States, a national association of State environmental
protection agencies, ``in many jurisdictions dental amalgam
separator installation rates were low unless there was a
mandatory component.''
That conclusion is consistent with our staff report
published in September 2008 and it is consistent with the sales
data trends from the largest manufacturer of mercury
separators. Dentists do not respond in large numbers to a
purely voluntary program to encourage mercury separator use.
Indeed, the American Dental Association promulgated voluntary
best management practices for disposing of amalgam waste in
2007, but the majority of dentists who installed separators at
this time reside in States or local jurisdictions where
separator use is a requirement.
Today's hearing will focus primarily on whether or not the
EPA's memorandum of understanding can achieve its purpose in
its current form. In preparation for this hearing, my staff has
assessed progress made under the memorandum of understanding.
What we found is that every milestone established by it has
been missed in the nearly 1\1/2\ years since it was signed.
Serious questions arise about whether the memorandum of
understanding has some inherent deficiencies such as: can the
parties to the memorandum deliver a high rate of dentist
compliance with best management practices for amalgam pollution
prevention? Would the MOU's chance of success increase if
additional parties were allowed to become signatories? What
measure is EPA prepared to take to ensure that the failures to
date of the memorandum of understanding practice do not predict
the ultimate failure of the EPA's efforts to encourage dentists
to remove mercury waste from wastewater before it leaves the
dentists' offices?
We hope to get the answers to these and other questions
today.
[The prepared statement of Hon. Dennis J. Kucinich
follows:]
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Mr. Kucinich. Thank you for being here.
I recognize Mr. Jordan.
Mr. Jordan. Thank you, Mr. Chairman, for holding this
hearing to examine the Environmental Protection Agency's role
in the use and disposal of dental amalgam by the dental
industry.
I just have a short statement.
Dental amalgam, or the silver fillings that many of us
have, are a compilation of metals, mainly mercury. According to
the Centers for Disease Control and Prevention, there is little
scientific evidence that dental amalgam poses a health threat;
however, I know this is a controversial area.
Today we are focusing on the EPA's role in the disposal of
dental amalgam. My understanding is that the industry and the
regulators are conversant on this topic and have executed a
memorandum of understanding. I am interested in learning how
that MOU is working, how it was developed, etc.
I would like to point out that traditionally regulation of
the dental industry is a matter reserved to the States, a very
important principle I think we need to keep in mind as we think
about our Federalist system as we move through this hearing and
look at this issue; therefore, I hope to hear more about what
States are doing to assist in this concern.
Mr. Chairman, thank you again for putting this together. I
appreciate the working relationship that we have, and I want to
thank the witnesses who are here today for their participation.
With that, I yield back.
Mr. Kucinich. Thank you very much, Mr. Jordan.
If there are no additional opening statements, the
subcommittee will now receive testimony from the witness before
us.
I want to start by introducing Ms. Nancy Stoner. Ms. Stoner
joined the U.S. Environmental Protection Agency as the Deputy
Assistant Administrator for the Office of Water on February 1st
of this year. This is Ms. Stoner's second tenure with EPA, as
she directed the Office of Planning and Policy Analysis and the
Office of Enforcement and Compliance Assurance from 1997 to
1999. More recently she was co-director of the Natural
Resources Defense Council's Water Program. Prior to that, she
served as project director and attorney for the Clean Water
Project for nearly 10 years.
Deputy Assistant Administrator Stoner, thank you for
appearing before the subcommittee today.
In view of the division of responsibilities at EPA, Ms.
Stoner is able to speak authoritatively on issues pertaining to
water and to the memorandum of understanding on reducing dental
amalgam discharges. We will send questions in writing to EPA
concerning EPA's efforts to measure mercury air emissions.
Now, Ms. Stoner, as you know, it is the policy of the
Committee on Oversight and Government Reform to swear in all
witnesses before they testify. I would ask that you rise and
raise your right hand.
[Witness sworn.]
Mr. Kucinich. I thank you. Let the record reflect that the
witness has answered in the affirmative.
I ask, Ms. Stoner, that you now give a brief summary of
your testimony, and to keep this summary under 5 minutes in
duration. Your entire written statement will be included in the
hearing record. I ask that you begin. Thank you.
STATEMENT OF NANCY STONER, DEPUTY ASSISTANT ADMINISTRATOR FOR
WATER, U.S. ENVIRONMENTAL PROTECTION AGENCY, OFFICE OF WATER
Ms. Stoner. Thank you. Thank you very much, Mr. Chairman,
for that lovely introduction. I appreciate the opportunity to
testify today before you and Ranking Member Jordan about the
Agency's policies on mercury and, in particular, dental
amalgam.
Mercury is widespread and persistent in the environment,
and under certain conditions can be transformed by
microorganisms into methylmercury, the form of mercury of
greatest concern in the United States, where exposures occur
primarily through fish consumption.
EPA is using its legislative mandates under the Clean Air
Act and the Clean Water Act to reduce the U.S. contribution to
the worldwide environmental mercury burden. Under the Clean Air
Act, EPA has substantially limited U.S. emissions of mercury to
the atmosphere through maximum achievable control technology,
MACT, and solid waste combustion incineration regulations. As a
result, the United States has cut its emissions by more than 90
percent from two of the three largest categories of sources,
municipal waste combustion and medical waste incineration,
since 1990.
For the other largest category, coal-fired power plants,
EPA is now in the process of developing a MACT standard that
will address mercury and other hazardous air pollutants.
Just last month, EPA proposed MACT regulations to
significantly reduce mercury air emissions from another large
source category: industrial, institutional, and commercial
boilers. EPA also plans to finalize air emission standards in
December of this year to address mercury and other air
pollutant emissions from both new and existing sewage sludge
incinerators.
EPA is committed to reducing mercury discharges to our
Nation's waters. In April EPA published final guidance for
implementing the January 2001 ambient methylmercury water
quality criterion for the protection of public health. This
document will help protect waters and human health by giving
guidance to States, territories, and authorized tribes for
adopting a fish-tissue-based methylmercury water quality
criterion into their water quality standards.
Last fall EPA also initiated effluent guideline rulemaking
under the Clean Water Act to address mercury and other
wastewater discharges from power plants.
Dental amalgam contributes a small portion of all mercury
released globally to the environment from human activities;
however, at the local level data indicate that discharges from
dental facilities can be a significant contributor to mercury
in the environment. Mercury containing amalgam wastes may find
their way into the environment when old mercury-containing
fillings are drilled out and waste amalgam materials are
flushed into chair-side drains entering the sewer system.
Dental facilities may employ a variety of controls and
management practices to reduce the discharge of mercury amalgam
in wastewater. Application of these practices, in conjunction
with traps and vacuum pump filters, can reduce discharges of
mercury containing amalgam and wastewater by more than 75
percent. Amalgam separators remove particulate mercury amalgam
and, in combination with traps and vacuum pump filters, achieve
better than 95 percent removal.
Some of the waste amalgam particles that reach the sewer
system settle out in the sewers and some are carried to sewage
treatment plants. The processes used at sewage treatment plants
remove 90 to 95 percent of the mercury present in wastewater on
average. The mercury removed from wastewater then resides in
the biosolids, or sewage sludge, generated during wastewater
treatment.
Preventing dental amalgam from getting into the sewer in
the first place reduces the amount of dental amalgam, and thus
mercury, in wastewater. Amalgam separators are also available
at relatively low cost to remove fine particles of waste
amalgam. Several studies, including one conducted by EPA's
Environmental Technology Verification Program, show separators
are highly effective.
Another way to reduce the amount of amalgam entering the
sewers is for dentists to use mercury-free fillings.
Alternatives to mercury-containing dental amalgams exist. As
fewer mercury-containing dental amalgams are used, the amount
of mercury in the environment will decline.
Every other year EPA publishes a final Effluent Guidelines
Program Plan. The plan addresses both categories of direct and
indirect discharges. As part of its 2008 Effluent Guidelines
Program Plan, EPA received comments from the American Dental
Association and the National Association of Clean Water
Agencies on dental amalgam. These comments led to discussions
of voluntary efforts and ultimately served as the basis for the
memorandum of understanding on reducing dental amalgam signed
in December 2008.
The purpose of the agreement between EPA, ADA, and NACWA is
to have dental offices follow the ADA's best management
practices, which include the installation of an amalgam
separator, proper maintenance of such separators, and recycling
of all amalgam waste collected in dental offices.
In our 2008 Effluent Guidelines Program Plan, we committed
to continue to examine the use of amalgam separators by
dentists. As part of our 2010 effluent guidelines planning
process, EPA intends to reevaluate whether a rulemaking is
appropriate. EPA will be issuing its 2010 Program Plan late
this calendar year, and will specifically address this issue.
In closing, let me assure this subcommittee that EPA is
committed to reducing mercury-related risks to citizens and the
environment. In this regard, EPA and State representatives have
scheduled a June 24th meeting to kick off an EPA/State dialog
on mercury. The purpose of this dialog is to identify gaps, set
priorities, enhance EPA/State collaboration, and identify
future areas of work.
Mr. Chairman, this concludes my testimony. I would be happy
to answer any questions you or your colleagues may have.
[The prepared statement of Ms. Stoner follows:]
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Mr. Kucinich. Thank you very much.
We have been joined by Mr. Burton. Welcome.
Mr. Burton. Thank you.
Mr. Kucinich. We are going to move to a question period
here of the witness, Ms. Stoner.
At the end of the Bush administration, EPA signed a
memorandum of understanding establishing a voluntary framework
to encourage dentists to adopt amalgam separators to reduce
dental mercury discharge into the environment. Can you tell us
how and why that happened?
Ms. Stoner. Mr. Chairman, I was actually not involved in it
directly, myself.
Mr. Kucinich. Do you know anything about it?
Ms. Stoner. I know that we were approached in the comment
process of the effluent guidelines plan with a suggestion that
we consider an agreement with ADA to encourage the use of a
technology that we thought would be effective in helping to
reduce mercury emissions.
Mr. Kucinich. OK. Well, in their written testimony the
State EPAs have testified that they had asked EPA to establish
``a nationwide program with a goal of substantially reducing
release of mercury to the environment from dental amalgam
mercury, and the stakeholders would include but certainly not
be limited to the American Dental Association, U.S. EPA,
States, publicly operated treatment works, and dental supply
manufacturers.''
Only 13 days later, the EPA signed a voluntary memorandum
of understanding with the American Dental Association and the
publicly operated treatment works, but excluded the other
suggested parties such as the States. Indeed, the States
testify, ``neither ECOS nor the Quicksilver Caucus were
involved with the development of the memorandum of
understanding. ECOS and Quicksilver Caucus members were not
aware that the EPA was working to develop such an agreement.
States were not asked to be a party to the memorandum of
understanding.''
So could you tell us why the EPA excluded the States from
the memorandum of understanding when enforcement of the Clean
Water Act and the Clean Air Act is shared responsibility with
State offices?
Ms. Stoner. I am less able to tell you what happened in the
past, but I can tell you where we are going moving forward.
Mr. Kucinich. OK.
Ms. Stoner. We do have a meeting with the States on June
24th which will look at mercury in a variety of media. It is
actually a multi-office EPA meeting. We are looking to work
collaboratively with our State partners, as well as the
manufacturers and other interested parties in moving forward to
build on the MOU.
Mr. Kucinich. So let me ask you then, as a logical followup
to your answer, if you are moving forward, does moving forward
mean that you want to incorporate the State EPAs as co-
signatories on the agreements?
Ms. Stoner. I am not sure that we will actually move
forward by revising the MOU. We see the MOU as a base to build
on, and so there are other things that we are considering.
Mr. Kucinich. If you want to build on it, though, wouldn't
you want them to sign it?
Ms. Stoner. I have not engaged in the discussion with them
about it. I don't have a view on that, but I do have a view
that we would like to work closely with our State partners. We
would like to gather information from them, from the dental
amalgam manufacturers, from others to improve the information
we have and consider whether additional efforts can be made.
Mr. Kucinich. OK. Here is the thing: you want to move
forward. Fine. I'm with you. Except I need an answer to this.
You really have not given me the answer I was hoping for with
respect to getting the States right there with you, and I am
wondering why the EPA didn't involve the States in the
development of the memorandum of understanding or even notify
them that a memorandum of understanding was under development.
Ms. Stoner. Well, let me suggest on that particular point--
--
Mr. Kucinich. That is a fact. I mean, you can check on it,
but, look, I don't need you to validate a fact. What I need you
to do is to tell me if there is any change in your policies,
because Mr. Jordan and I may come to some different conclusions
about what States will do, but we both agree that the States
ought to be involved here. Am I hearing from you that EPA is
taking a different posture with respect to involvement of the
States?
Ms. Stoner. I would suggest two things. One is that we
would be happy to get back to you with a written answer as to
what happened in 2008, December 2008.
Mr. Kucinich. But let's go forward. What are you going to
do?
Ms. Stoner. Well, we are going to involve the States and we
are going to have a discussion about what is the most
productive thing for us to work with the States on moving
forward, and we are starting to do that next month.
Mr. Kucinich. When you are crafting that written answer,
juxtapose it with what you are going to do differently.
Ms. Stoner. I will. Thank you.
Mr. Kucinich. Mr. Jordan.
Mr. Jordan. Thank you.
Ms. Stoner, thank you for being here.
You said several times in your response to the chairman
about building on the MOU. Tell me, just kind of refresh my
memory, how is the MOU working? I mean, we talk about building.
What does that mean? What additional costs does that mean? What
do you mean by building on it?
Ms. Stoner. Well, one thing is setting goals under the MOU.
That is one thing that we would like to do is to set and,
frankly, achieve some goals in terms of greater use of mercury
amalgam separators. That is something we would like to do. We
would actually like to get better information than we have
right now about the use of amalgam separators. We did get some
information. ADA did some surveys. We would like to actually
get more information.
Mr. Jordan. OK.
Ms. Stoner. One of the things we would like to do is go to
the manufacturers and get information from them and have a
better baseline.
Mr. Jordan. A couple of questions. What do these separators
cost, typically?
Ms. Stoner. They range in cost. I would say one to two
thousand dollars, I would say would be approximately. I could
get more specific information on that for you.
Mr. Jordan. Let's say a dental office has several chairs. I
don't know how the technology works, exactly, but do you have
to have it at each and every room where the dentists or
assistants are doing work on the patient?
Ms. Stoner. I believe that is correct, that you need to
have it with every chair.
Mr. Jordan. So it could be several thousand dollars?
Ms. Stoner. Could be.
Mr. Jordan. OK. And how many dentists are currently using
this separator, percentage-wise.
Ms. Stoner. Let me just clarify on the previous point. You
can hook up multiple chairs to one separator, so you do need a
separator that hooks up to each chair, but you can attach
multiple chairs.
Mr. Jordan. OK.
Ms. Stoner. I am sorry. I forgot the second question.
Mr. Jordan. How many dentists across the country right now
do you think are using this?
Ms. Stoner. As I said, we don't have really good
information on that. We would like to get better information,
including by getting information from the manufacturers.
Mr. Jordan. Are there States that mandate right now?
Ms. Stoner. Yes, there are.
Mr. Jordan. How many?
Ms. Stoner. It is twelve States.
Mr. Jordan. Twelve States mandate. And are the results such
that you see less mercury in the water supplies of those areas
than you do in States that don't mandate?
Ms. Stoner. You certainly see more use of dental amalgam
separators in those States.
Mr. Jordan. Significant?
Ms. Stoner. Yes. The rates are significantly better in
States that mandate the use of the separators. That is right.
So you would have less mercury going into the sewage treatment
plants and you would have less coming out. A lot of the mercury
is removed in the sewage treatment plant.
Mr. Jordan. Refresh my memory. How long has the MOU been in
place now? A couple of years?
Ms. Stoner. Since December 2008.
Mr. Jordan. So a couple years. All right. And I assume you
and the ADA have undertaken, as part of the memorandum, some
kind of educational program? You are telling dentists across
the country why this is important, etc.?
Ms. Stoner. That is right. For EPA's part, we have done
Webinars. We have provided information at conferences. We have
information on our Web. We are trying to get the word out.
Mr. Jordan. OK. Mr. Chairman, I am fine right now. I will
yield back.
Mr. Kucinich. Mr. Burton.
Mr. Burton. First of all, let me say that Mr. Jordan is one
of the finest Congressmen we have, and I really like this guy,
but I disagree with him. Mercury is probably one of the most
toxic substances on the face of the earth, and it is toxic
before it goes into a person's mouth and it is toxic when it
comes out, but it is not toxic when it is in their mouth. That
is the most ridiculous thing I have ever heard.
I am absolutely convinced, after having hearings for 4
years on this when I was chairman, that mercury is toxic and it
should not be put in the human body in any way.
Can I take my 5 minutes after this, Mr. Chairman, so I can
go ahead after I finish this, if you don't mind?
Mr. Kucinich. Without objection.
Mr. Burton. The thing I want to get across, my grandson got
nine shots in 1 day, seven had mercury in them. He became
autistic. We used to have one in 10,000 children that are
autistic; now it is one in under 100. It is an absolute
epidemic, and yet the FDA and CDC and others continue to deny
that mercury, a toxic substance put into the human body, is
going to affect the neurological system. There is no question
that it does. None whatsoever.
I had scientists for 4 years from all over the world come
in and testify. And mercury amalgams, when they are taken out
of the tooth and flushed down the drain--now my 5 minutes
start--they go into our water supply and the sludge and all the
other things that you enumerated. That should not happen.
Women who are pregnant are told not to eat fish in certain
areas of the country because it has mercury in them. How does
it get in there? It is getting in there because we are flushing
mercury down the drain. It should not be there.
I know $2,000 is a lot of money, but a dentist can afford
it if he is doing his job right and he should have separators.
We should not allow mercury into the system whatsoever.
I am not an environmental nut case. I mean, I think the
environmental nut cases drive this country and this Congress
nuts. But this is one area where I feel very strongly about.
Mercury is toxic. It should not be put in a human being in any
way at all. And we had scientists come in. I know the ADA
doesn't agree with me and they tried to get me defeated in the
last election again. That is OK.
But the ADA says that the mercury in an inner substance
like a filling doesn't cause any problems, and yet we had
scientists from all over the world testify at that table that
when you have hot and cold in the mouth it releases a vapor,
and the mercury vapor does go into the blood stream and does
get into the brain.
We have a huge increase in neurological problems among
children that get all these shots. We have an increase in
people who have Alzheimer's. I believe that part of that is
caused by the mercury that is injected into people in shots and
in the mercury amalgams, and it seems to me that we ought to
get that out of anything that goes into the human being.
Anything. And we certainly shouldn't be flushing it down the
drains.
My God, down at Newport News, Virginia, the Navy got so
upset about the amount of mercury that was going from military
personnel's fillings into the water system that they mandated
that they had huge barrels of it to catch the mercury fillings
so it wouldn't contaminate the water supply down there.
There is no question, none, whatsoever. This isn't nut case
stuff. There is no question that mercury should not be in the
water supply and we should do everything we can to keep it out
of there, and that is why the biggest contaminator are the
dentists who are flushing this stuff down the drains, and so we
need to have these separators. That is important.
The other thing is, we need to inform people who are going
into a dentist's office or who are getting a shot or whatever
it is that there is mercury in that substance. If you are going
in to get a shot and you know there is mercury in that shot,
like thimerosal, which is a preservative in shots that we get,
and if you get a shot where they have the rubber top on it and
you stick the needle in, it has thimerosal in it, and
thimerosal has mercury in it. Over a long period of time,
mercury accumulates in the brain. If you keep getting these
shots over and over, it is going to have some kind of an
adverse impact in most people, or in many people, so it
shouldn't be in there.
But if it is there, and if it is in amalgams, the people
have a right to know. It is their life. Now, we are telling
people that eat fish, Be careful, because there is mercury in
that fish, and if you are pregnant it might cause a
neurological problem in your baby so don't eat those fish if
they have mercury in them, and yet we are putting mercury into
the water supply, we are putting it into our mouths, we are
putting it into our shots, and the FDA and HHS aren't doing
anything about it.
Like I said, I don't like the Government to stick its nose
into States' rights. I don't like the Federal Government taking
over anything. But this is one area where the entire society is
at risk as long as mercury is being injected into human beings.
I feel so strongly about it.
Do you know what it is like to have a 2-year old child
getting nine shots in 1 day, a perfect child, starting to talk,
walk, and everything else, and all of the sudden he is banging
his head against the wall running around? And I talked to
people at that table who are losing their homes, going bankrupt
because they have kids who have autism and they can't afford to
take care of them, and yet the fund that we have created to
take care of these people that are contaminated by this isn't
doing a thing to solve the problem.
So you can tell I am pretty upset about it, because I have
watched it. I have watched thousands of mothers come out here
and show us their kids who are mentally retarded because of
this. I have talked to people who can't eat fish when they are
pregnant because they are afraid their child will be hurt by
the mercury in the drinking water. And yet we continue to pour
it into our system, pour it into our drinking water, and the
Federal Government doesn't do anything about it.
And yet I could read to you what the FDA says. For the
first time ever, the FDA publicly admitted that dental amalgam
contains highly toxic mercury and they did put warnings on the
labels. So if they put warnings on the labels, why don't they
put it in the dentist's office so people know when they go in
there? Why don't they tell us. That is not that expensive, a
little cardboard saying there is mercury in these things.
And so I think the FDI challenged the FDA after me being
chairman here for 6 years and being on this committee now for
over 25 years, tell the people. Let the people know the facts
and the country will be safe. I think somebody important said
that. I think it was Abraham Lincoln. Let the people know the
facts and the country will be saved, and, not only that, their
lives might be saved.
[The prepared statement of Hon. Dan Burton follows:]
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Mr. Kucinich. Thank you, Mr. Burton.
Mr. Burton. Thank you, sir.
Mr. Kucinich. The Chair recognizes Mr. Cummings.
Mr. Cummings. Good afternoon.
Ms. Stoner. Good afternoon.
Mr. Cummings. I was listening to my friend, Mr. Burton, and
on the one hand he says Government needs to stay out of the
business, to keep a certain distance; on the other hand, he
says we do need to have some regulation here, and I agree that
we do. That leads me to these questions.
As part of the 2002 effluent guidelines planning process,
EPA is committed to examining the use of amalgam separators by
dentists; is that right?
Ms. Stoner. Yes, sir.
Mr. Cummings. In the 2008 guidelines for new and existing
industrial pollution discharges into surface waters into
publicly owned treatment works, the EPA decided to exclude
dental offices from the scope of the guidelines; is that
correct?
Ms. Stoner. Well, EPA decided not to move forward with the
effluent guidelines at that time. Yes, Congressman.
Mr. Cummings. And so, in other words, dental offices were
excluded? I mean, I am not trying to put words in your mouth. I
am going somewhere, but I want to make sure you are going with
me.
Ms. Stoner. The only thing I am trying to say is that a
permanent exemption, nothing like that was done. What we
decided was not to move forwards with a rulemaking at that
time, and that is the issue that we are examining again this
year in our Effluent Guidelines Plan.
Mr. Cummings. So what would be the criterion needed for
dental offices to be included, say, in the 2010 guidelines?
Ms. Stoner. Well, I think what we would do is look at the
various different sectors that need either new or revised
technology-based standards and compare this to others in terms
of the importance of the agency moving forward with a
technology-based standard.
Mr. Cummings. And what would be the methodology for getting
there? I mean, in lay terms.
Ms. Stoner. Well, I think that what the Agency does is look
at the size of the problem. Obviously, we have been talking
about methylmercury and the health issues associated with that,
which are very significant and serious. We have been looking at
the contribution that comes from this source versus other
sources.
We would be looking at, for example, how the problem is
developing over time, what the trend analysis is in terms of
either the substitutes for dental amalgam or the use of
separators. We would be figuring out whether this is the best
thing to put the Agency's resources on in terms of protecting
human health and the environment. That is the decision that we
need to make in that plan.
Mr. Cummings. So right now I guess you are telling me you
don't have enough information? Is that it, in spite of what Mr.
Burton just said?
Ms. Stoner. Well, we have done some initial work on it, but
I would say that we need to gather additional information. That
is right, Congressman.
Mr. Cummings. And, assuming that what Mr. Burton said was
true, let's just assume that hypothetical, do you think dental
offices would be excluded or included at that juncture,
assuming what he just said is true?
Ms. Stoner. Again, I think it depends on how many effluent
guidelines we are able to do and how this compares to other
risks.
Mr. Cummings. Now, in implementing the 2001 guidance; are
you familiar with that?
Ms. Stoner. Yes, sir, I am.
Mr. Cummings. Who had input into that document, and what do
you hope it will accomplish?
Ms. Stoner. Let me check on the first question.
Mr. Cummings. OK.
Ms. Stoner. [Consults with audience member.] That document,
it is guidance for how to use the water quality criteria that
we developed for methylmercury. It helps States to set
standards, water quality standards for methylmercury to protect
the public. It did go through a public comment process, so we
got comments from a wide range of stakeholders on that
document.
That is what it is for, so what we are trying to do through
that document is to help States through the technical issues
associated with setting a water quality standard. They can then
use those standards also to set limits for sewage treatment
plants, and the sewage treatment plants can use that to set
limits for the dentists that discharge into those sewage
treatment plants. So it is another method under the Clean Water
Act to protect the public by reducing pollution.
Mr. Cummings. I see my time is up. Thank you, Mr. Chairman.
Mr. Kucinich. I thank the gentleman. We are going to go to
a second round of questions to Ms. Stoner.
Prior to signing the memorandum of understanding with the
American Dental Association and the Organization for Publicly
Owned Water Treatment Facilities, the EPA made a finding that
dentists were voluntarily moving toward adopting amalgam
separators. On the basis of that finding, EPA exempted
dentists' offices from mandatory effluent guidelines. I would
like to ask about the EPA's basis for excluding dentists'
offices from its mandatory effluent guidelines.
The ADA submitted a letter to the water docket in 2007--
that is comments on the EPA's study of a pre-treatment
requirement for dental offices--which made eight arguments in
favor of excluding dentists' offices from mandatory
requirements. In essence, that letter states, as ADA's
testimony today repeats, ``dentists can and will act on their
own.''
Did EPA take into account contrary evidence that dentists
are slow to voluntarily act on their own? For instance, did EPA
consider the Quicksilver Caucus's April 2008 report on mercury
separator usage, which noted that nearly all jurisdictions that
started with purely voluntary regulations ended with mandatory
regulations because the voluntary ones don't work? That finding
was similar to the conclusion of a report published by this
subcommittee in September 2008. So what do you say to that?
Ms. Stoner. I wasn't involved in that particular decision,
but----
Mr. Kucinich. But what do you think?
Ms. Stoner. I am confident that the Agency is aware that
mandatory requirements--as a matter of fact, the information is
available today that shows that in States where there are
mandatory requirements there is more use of amalgam separators
than there is in States where the programs are voluntary, and
that is consistent with the Agency's experience in a lot of
different areas. You will have more widespread compliance if
you actually have a mandate. I think that is pretty well
demonstrated.
Mr. Kucinich. Well, it might be pretty well demonstrated,
but that is not where the EPA was, because they exempted
dentists' offices from mandatory effluent programs, so, using
your logic, of course mandatory, but that is not what EPA did.
Ms. Stoner. EPA did not grant a permanent exemption to----
Mr. Kucinich. What was their basis for excluding dentists'
offices from mandatory effluent guidelines in the first place?
Ms. Stoner. I would prefer to get back to you in writing on
that.
Mr. Kucinich. OK. That would be fine.
Ms. Stoner. Because it was a decision I was not involved
in.
Mr. Kucinich. I will look forward to reading it.
[The information referred to follows:]
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Mr. Kucinich. Now will you look at the screen please? Ms.
Stoner, this graph depicts the actual sales trends of mercury
separators to dentists by the largest manufacturer in the
Nation. Sales pick up dramatically just prior to mandatory
regulations kicking in, which is depicted by the shaded column.
Is not this evidence that dentists respond to mandatory
regulations requiring adoption of mercury separators?
Ms. Stoner. I would agree that appears to show that. Yes,
sir.
Mr. Kucinich. Well, I would like you to look at the trend
lines to the left of the shaded bar there. I would like you to
look at it closely.
Ms. Stoner. OK.
Mr. Kucinich. I would like you to look at the trend lines
to the left of the shaded box.
Ms. Stoner. OK.
Mr. Kucinich. See how the purchase rate is? See how the
purchase rate decreases the further away you go from the shaded
bar? That is the voluntary period that preceded the mandatory
requirements. So there is evidence here that dentists don't
generally adopt mandatory separators on a voluntary basis.
Ms. Stoner. There is some----
Mr. Kucinich. Would you agree?
Ms. Stoner. There is certainly some variation, but in
general the sales certainly go up after the regulation date,
effective date. That is correct.
Mr. Kucinich. And if you look at the voluntary period, you
have mandatory regulations, compliance goes up; voluntary
regulations don't appear to go, appear to be low compliance,
right?
Ms. Stoner. I can't really tell what the voluntary program
is that precedes the bar, but it certainly looks like the
regulation makes the sales go up. That I can tell.
Mr. Kucinich. So don't you think that this shows voluntary
efforts by dentist trade associations since the signing of the
memorandum of understanding--excuse me. I am going to go to Mr.
Jordan.
[The information referred to follows:]
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Mr. Jordan. Thank you, Mr. Chairman.
Ms. Stoner, did you agree with my good friend and
colleague, Mr. Burton, his analysis of the situation, his
conclusion on the situation?
Ms. Stoner. I thought he made a number of excellent points.
Certainly his points about the dangers associated with
methylmercury are well taken. I also thought his point about
people being probably less likely to get amalgam fillings if
they had better information about the mercury in amalgam
fillings was also a compelling point.
Mr. Jordan. Then I think the chairman's question is the
$64,000 question. If, in fact, EPA thinks it is that bad--and I
don't know. I think the EPA over-reaches on a lot of things--
if, in fact, you think Mr. Burton's analysis is correct, why
the decision on the memorandum of understanding, why was that
made?
Ms. Stoner. Again, I----
Mr. Jordan. I mean, if this is as terrible as my good
friend points it out to be, it seems to me you would be making
the rules, doing the things that you think are going to protect
us. I mean, that is the big question. We would like an answer.
Ms. Stoner. Right. There is----
Mr. Jordan. I don't know if it is right or wrong. Look,
based on what you just said in response to Mr. Burton's
statements, it seems to me we need that answer.
Ms. Stoner. I think there are two different things we are
talking about, one of which is the use of dental amalgam by
patients, and that is a decision that is partly environmental
and partly medical, and we think that the FDA is better
situated to make that decision.
Mr. Jordan. Let me clarify. So you think mercury in some
other forms, what Mr. Burton had to say is right on target, but
specifically to the filling put in the patient's teeth while
they are in the dental office doesn't rise to that, maybe not
as bad as Mr. Burton might have said. Is that your conclusion?
Ms. Stoner. No.
Mr. Jordan. It would seem to be so, based on what the EPA's
decision has been.
Ms. Stoner. OK. Well, I may not be making myself clear, so
let me try to do better. What I am saying is that the EPA is
not in the lead role in deciding what dentists use in the
dentistry that they practice. There are other agencies that are
better situated to make decisions about those medical issues.
EPA is looking at the issues of mercury emissions, air
emissions, and mercury in wastewater discharges, and what I am
saying is that it is a concern. Mercury in wastewater discharge
is a concern, and that is one that we are evaluating at the
Agency, along with other pollutants of concern that cause human
health or environmental impact.
Mr. Jordan. But I just want to be clear. The memorandum of
understanding is between the EPA and the ADA, correct?
Ms. Stoner. Yes, sir, but it is not about the use of dental
amalgams. It is about use of amalgam separators. That doesn't,
either way, whether the patient uses dental amalgam or some
other kind of cavity, I am not a dentist, but some other kind
of filling, then the mercury would be captured in the amalgam
and it would then stay out of the sewage treatment plant and
stay out of the wastewater of the sewage treatment plant. That
is what our agreement is about.
Mr. Jordan. OK. Thank you, Mr. Chairman.
Mr. Kucinich. Mr. Burton.
Mr. Burton. First of all, I appreciate your acknowledging
some of the things that we talked about. I appreciate that, Ms.
Stoner.
The one thing that kind of bothers me is one agency kind of
passing the buck to another agency and back and forth and back
and forth. I had people from the HHS and FDA before the
committee, and when my grandson became autistic I said, would
you mind if I injected you with the amount of thimerosal with
mercury in it that my grandson got in 1 day, and they said it
wouldn't affect them but they wouldn't want it injected it into
them. It was kind of an interesting answer they had.
But here is the position the FDA has taken. For the first
time ever, the FDA publicly admitted that dental amalgam
contains highly toxic mercury and therefore requires a variety
of warnings on the product label. That is clearly a significant
improvement over the FDA's former position that mercury
amalgams are 100 percent safe. That was their previous
position.
Unfortunately and inexplicably, new warning requirements
have nothing to do with patient safety. It is just putting it
on the label on the product. And the FDA still does not require
dentists to warn patients in any way about the harmful
neurotoxins in the dental amalgam.
Considering the fact that in 2006 the FDA's own panel of
outside experts concluded that it is ``not reasonable for the
FDA to have the position that mercury amalgam fillings are
safe.'' How can the FDA not insist that dentists warn patients
about the dangers? They had this outside group come in and look
at it, and they said, well, we can't take the position that it
is safe, which means there is a real question about whether or
not it is safe.
Now, if dentists want to go ahead and continue to use that,
then I think the obligation is clear: let the patients know
that it is in there. And 90 percent of the people who have
dental fillings that are amalgams do not know that it has
mercury in them, and so they are being exposed without their
knowledge.
I think the thing that has bothered me the most is that we
are having such opposition from the dentists, because they are
getting information from the FDA and HHS that says this is not
harmful, and yet they are not supposed to flush it down the
drain, and they know that it is toxic if they get it on them
before they put it in the mouth and they mix it all up, but
they have been told that it is not harmful. And so the dentists
I think rightfully say, Why are you telling us what to do when
the FDA and HHS says there is no problem?
And so the dentists say guys like me are nuts. Maybe that
is true. I don't know. But the fact of the matter is they are
now starting to admit that there is a serious problem.
So what I can't understand is why the FDA and HHS and the
EPA don't get together in a panel and sit down and say, How do
we make sure that this is properly regulated and properly
brought to the attention of the American public? I would
suggest that is something that should be done. EPA has the
authority, FDA has the authority to do a lot of these things.
The other thing I would like to say before my time is up. I
talk to the pharmaceutical companies, the presidents of these
companies, major companies, Merck, Eli Lilly, a whole bunch of
them, and I said, If you will put more money into the vaccine
injury compensation fund to help people who have been damaged,
if you will get mercury out of all the vaccines, adult and
children, and they can do that in an economical, satisfactory
way, then I will introduce legislation that will protect you
from class action lawsuits. I will do everything I can to make
sure that you are not going to face any harmful financial
problems because of past experiences.
Now, when I said that one out of 10,000 people used to have
autism, kids, now it is one in less than 100, we know there is
a big problem. So if we protect the pharmaceutical companies by
giving them protection from class action lawsuits if they will
do these things, get the mercury out and put more money into
the vaccine injury compensation fund, I don't know why they
won't do it.
And I will do the same thing for the dentists. If dentists
are afraid that they are going to be sued by people that have
neurological problems that they allege came from amalgams that
they used in filling their teeth, I will do everything I can to
protect them, as long as we get the mercury out of the product
and get it out of people's mouths. Until that time, I hope that
the EPA, the FDA, and HHS will get together and come up with
some way to make sure the public is aware of what is going on.
OK?
Ms. Stoner. Thank you.
Mr. Burton. Would you carry that message back?
Ms. Stoner. Yes, sir, I will.
Mr. Burton. Thank you very much.
Mr. Kucinich. We are going to begin the third round of
questioning. There will be a final round of questioning of this
witness.
Before I begin, I just want to say to my colleague, Mr.
Burton, I just want to say before we begin the third round of
questions that I have watched for years your advocacy on this
and other health issues, and I am proud to serve with you in
this Congress.
Mr. Burton. Thank you, Mr. Chairman. I really appreciate
it.
Mr. Kucinich. You have really been outstanding and
courageous in your pursuit of the questions underlying the
effects of mercury in vaccines and a whole range of areas, and
I really appreciate it.
Mr. Burton. Thank you very much. I wish you would call my
wife and tell her that. She doesn't appreciate it. [Laughter.]
A little levity won't hurt.
Mr. Kucinich. Anything I can do to help you, Mr. Burton, I
will be glad to.
Now I am going to go to a final round of questions of this
witness.
I am concerned that EPA signed a memorandum of
understanding with someone who can't make the change the
memorandum of understanding seeks. When my staff spoke with a
top official at the ADA about steps ADA has taken to measure
the effectiveness of its outreach campaign such as tracking if
dentists are using best management practices or even viewing
the brochure produced, we learned that the ADA is not even
tracking that.
How can ADA optimize its efficacy in promoting compliance
with its best management practices if it doesn't track
dentists' compliance with its best management practices, or
even whether they look at its brochure?
Ms. Stoner. I agree with you, Congressman. It would be
better to have more outreach and more installation of those
amalgam separators.
Mr. Kucinich. What we are seeing is a perfunctory
performance here. We have learned that just this month ADA held
a conference in Chicago for Illinois dentists on the topic of
limiting mercury pollution from dental offices. The results
weren't particularly impressive. Of the 8,500 dentists in the
State of which 6,600 are members of the State Dental Society,
only 21 came to the conference.
Now, Ms. Stoner, I am calling this to your attention
because I think it is worth you looking at the ADA's outreach
efforts and to see if they can be more encouraging.
You have a report from the Quicksilver Caucus of the State
EPA offices, a report from this subcommittee, and the most
recent sales data of the largest seller of mercury separators
all showing that dentists are not, in fact, voluntarily
adopting mercury separators in significant numbers, yet the
memorandum of understanding depends upon their doing so.
Can they demonstrate the importance of a realistic prospect
for mandatory requirements for obtaining dentists' adoption of
amalgam separators? I am wondering what procedure EPA would
follow to reconsider its exemption of dentists' offices from
effluent guidelines?
Ms. Stoner. We will be gathering additional information. We
agree with you about the need to get additional information in
order to make a determination, and we have committed to doing
that, including from the manufacturers.
Mr. Kucinich. I am wondering why you wouldn't strongly say
right now that you intend to rescind the dentist office
exception as of, say, the 2012 effluent guidelines unless you
see verifiable compliance with the memorandum of understanding
goals in 2010 and 2011?
Ms. Stoner. We have a process we have to go through on the
effluent guidelines planning, and I don't want to get ahead of
that process, so we are committing to you that we will look at
it in that process and make a determination.
Mr. Kucinich. Ms. Stoner, we have a process here, too, and
what is noteworthy is that there is nothing that is separating
individuals from both political parties who are determined to
get to the truth of exactly what is happening here. So I
understand about your process. Our process here is going to
continue to go deeply into what I personally feel are the
shortcomings of the EPA's responsibility in this regard. And I
come to this not as someone who is a consistent foe of the
Environmental Protection Agency. I am a friend. And I am such a
good friend that if I see something wrong I am going to tell
you.
The Chair recognizes Mr. Jordan.
Mr. Jordan. Thank you, Mr. Chairman. I will just be real
brief and we will get to the second panel. I want to talk with
the witness from the ADA.
The chairman, in his comments, talked about the fact that
only 21 dentists I believe showed up at a conference in
Illinois. While the conference obviously was important to talk
about mercury, I would just remind members of the committee
that these guys are small business owners. They have to attend
to their practice. They have to attend to meeting the needs of
their patients in their communities. It is not always easy just
to pack up and go. So I think there is a balance we have to
keep in mind as we look at this whole issue and evaluate what
is the best means and best process as we move forward.
As I said, Mr. Chairman, I will yield back and wait for the
second panel.
Mr. Kucinich. I thank the gentleman.
The Chair recognizes Ms. Watson.
Ms. Watson. Mr. Chairman, I want to thank you. I also want
to thank Member Burton, who is not in the room at the moment.
We have been working on this issue ever since I have been here,
and I am completing my 10th year and I will be retiring after
this year. I worked on this same issue on mercury pollution
when I was chairing the Health and Human Services Committee in
California for 17 years. I finally had a Governor that
appointed a dental board who looked at the dental amalgams and
said we see some problems here. That particular Governor was
recalled and this has been hidden again.
So what I want to do, I will wait until the second panel
comes up, and I would like to read my opening statement if I
may.
I yield back my time.
Mr. Kucinich. And I would just say to the gentlelady, if
she would like to read her opening statement now, so that Ms.
Stoner will have the benefit of hearing it, and then when you
conclude I will call the second panel.
Ms. Watson. Thank you so very much.
Mr. Kucinich. Without objection.
Ms. Watson. I have been a staunch opponent of mercury
amalgams. For those of you that do not know what an amalgam is,
it is a substance that you put into a cavity to fill it, and it
is what is in that amalgam. The amalgam looks like silver, it
is 50 percent mercury. SB 65 in California of about 20 years
ago rates mercury as the most toxic substance in the
environment. So I have been an opponent of mercury amalgams
since my days in the California State Senate, where I helped
pass a law that requires a fact sheet about dental fillings
being given to consumers without any information about what is
being put into their mouth.
I believe that it is very important, it is essential for
consumers to know about the toxins they are putting into their
bodies, especially when it is one that implanted into their
mouths and helpless children's mouths and senior citizens, and
could possibly affect them for the rest of their lives.
For this reason, this Congress I introduced the CHOMP Act,
H.R. 4615, CHOMP. This bill will require dentists to give
consumers a fact sheet prepared by the Food and Drug
Administration outlining the dangers of each type of filling.
Now, you know in California, and I would hope in the rest
of the country, we are concerned about the atmosphere. We were
the first State to outlaw and ban smoking on airplanes in
California air space. It took us 14 years to do that, and then
the rest of the country followed, and now it is global.
Now, I am sure that we all know that mercury is one of the
most toxic substances. If you don't know, we are going to tell
you. Third on the CERCLA list of toxic chemicals. We also know
that amalgam releases sufficient amounts of mercury that can be
absorbed by our bodies.
That is the reason why, if you are in California, you are
warned not to eat tuna along the western coast of southern
California, because in a dental office what do you do with the
waste? You put it into a tube. It goes right out into the plant
and into the ocean and gets into the sea life and gets into the
shell life and so on. That is a fact.
Mercury poisoning has been shown to cause mental disorders,
autoimmune disorders, and other chronic illnesses. It is
thought that mercury also plays a role in Alzheimer's disease
and in MS. It is a documented fact that mercury can also
transfer from pregnant women through the placenta to the
developing fetus. Children and fetuses are especially at risk
because of the developmental risk posed by mercury, yet women
who are pregnant or plan on becoming pregnant are not told of
the risk associated with their new mercury fillings. Everyone
likes to show their new fillings. Look at this silver I have in
my mouth.
So informing the consumer is the right thing to do. I think
everyone needs to know what is added to whatever they put in
their body, because you know if you look at cigarettes and
tobacco, it tells you what it can do to your health, and I
think you make the choice. You suffer the consequences.
I know that many of these ill effects are real. In my time
fighting for this issue I have met so many people who have told
me their health histories, of being constantly fatigued after
getting their mercury amalgam fillings, of their lives being
crippled by chronic headaches, of being told that they have an
unknown autoimmune disorder only to be relieved of their
troubles after they removed their mercury amalgam fillings.
I sit in front of you as a witness and a victim. I had my
mercury amalgams, Mr. Chair, put into my mouth when I was 9
years old. My father was a police officer, so he could
practically get it done free. I have suffered from allergies
all of my life until an investigating team from abroad came in
and they said, my God, you are suffering from mercury
poisoning.
I went to my dentist, asked him to remove, and he would
not. Very few people know how to do it. I had to go to Mexico,
Ms. Stoner, and it took me 6 weeks and was very expensive. It
has changed my life. It has changed my looks. And it changes
the aging process, I can tell you that. I can tell you that.
And the doctor who did it was educated here, and he would not
do the mercury fillings that were required at his university,
so he left and went to the University of Mexico, and he lives
here in the States and goes over the border to practice,
because dentists will tell me now. I didn't get the backing of
the EPA, so that is the situation. It really made a difference.
He didn't give me medication, he gave me herbs. He told me
take these herbs until you clean your system. I tell you, it
has made a difference. People have accused me of having a face
lift. No. I took the mercury out, and I tell everyone I can,
remove your mercury amalgams.
So in response to the CHOMP Act the American Dental
Association, quoting the FDA, issued a statement saying that
mercury amalgams are safe. That is a lie. Quote me. And if
there is any press in this room, quote me, please. I have the
facts. You can come to my office. I will share this with you.
We have done research nationally and internationally. We
are killing ourselves because, as one group of dentists said to
me, people of color don't like to go to the dentist. So that is
the reason why we continue to use amalgams, because they are
safely combined and well filled. I said, do you ever consider
that kids go skating or biking and they fall and crack their
teeth? Happens every day. Do you ever consider that they get
teeth pulled out? Happens every day.
If you want a test, there is a probe you can put in your
mouth and you can see the vapors from the mercury going to your
T-zone. What is at the top of your T-zone? Yes. I see a lady in
the back. She says, What's at the top of your T-zone? Your
brain. And what is covering your brain? A thin skin called the
meninges. And guess what? Mercury affects the meninges of the
brain.
So why do so many of our children do poorly in school?
Because they chew on paint on their cribs that have lead in it,
and the mercury that they put in 9 years old in their teeth
also goes up.
So just think about that. We are going to find why so many
women are having cancer and breast cancer now. It is something
we add in or something in that can and so on. We are going to
continue to do the research until we can convince that mercury
has no place in the human body.
Now, if you read FDA's rule, FDA, itself, admits that the
report that was published by the Trans-Agency Working Group on
the Health Effects of Dental Amalgam in 2004 concluded that
there were ``important data gaps, including whether low-level
mercury vapor results in neurotoxicity.'' I am a witness and I
will testify on any stand to it. Also, studies that have been
performed do not account for mercury from other sources, nor
are they sufficiently long term. That is why we need to inform
people so they can make their own choices.
We have for years informed and warned consumers about the
risks of consuming fish with a high mercury content. Now we are
learning that dentists' offices contribute approximately--get
this--50 percent of mercury in wastewater, much of which makes
it into the environment. In 2002 a report from the University
of Chicago concludes this number could be as high as 70
percent.
After the passage of the mercury ban by then-Senator Obama,
it is baffling that we still allow dentists to pollute our
water and air with mercury. Mercury has vapors that are always
being emitted, always being emitted, especially when they can
install a $500 mercury separator that has the ability to
capture more than 90 percent of the mercury waste. I have been
thinking so much about how our sea waters now are polluted down
in the Gulf because of the escaping oil, and they are trying to
break it up, and whatever they are putting in to break up the
modules, killing the fish and the birds and so on. We need to
be more proactive and wiser.
Additionally, dental mercury amalgams contribute to the
mercury burden in the environment through a very unlikely
source, and that is crematoriums. As dentists continue to
install mercury amalgams into mouths, these installations
release mercury into the air during the cremation. Is there no
end to the ill effects of mercury, right to the end of the life
process and the disposal of the bodies?
So in conclusion, Mr. Chairman, I want to say that I firmly
believe that mercury amalgams should not be used. If the ADA is
going to insist on their continued use, then dentists have the
obligation to inform their patients in advance, and dentists
also have the obligation to prevent environmental harm,
remember, you take that Hippocratic Oath, by installing mercury
separators as a voluntary program has not worked. It is time
the EPA takes the initiative to regulate mercury in water and
air, and one very important aspect of that air is the pollution
of mercury amalgam.
Mr. Chairman, I really want to thank you and the minority
Member again for holding this hearing. As you can hear, I am
very emotional about this issue. Thank you.
[The prepared statement of Hon. Diane E. Watson follows:]
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Mr. Kucinich. I thank the gentlelady for her testimony.
Thank you, Ms. Stoner, for your presence and joining us and
listening to Ms. Watson's statement.
I want to thank Mr. Jordan for being here. You are welcome
to come back, if you are able to, from your busy schedule.
Ms. Stoner, you are dismissed as a witness.
Ms. Stoner. Thank you.
Mr. Kucinich. We want to invite the other witnesses to come
forward.
While the witnesses are coming forward, I would like to
make the introduction of our second panel.
Mr. William Walsh is of counsel, Pepper Hamilton, LLP,
where he heads that office's environmental practice group, and
he is representing the American Dental Association. Before
1986, when he joined Pepper, Mr. Walsh served as Section Chief
of the U.S. EPA Office of Enforcement as lead EPA counsel on a
precedent-setting hazardous waste lawsuit brought against
Occidental Chemical Corp. concerning Love Canal and related
landfills.
Next will be Mr. R. Steven Brown, the executive director of
the Environmental Council of the States, the national
nonpartisan association of the States' environmental agency
leaders. Mr. Brown helped form the Environmental Council of
States in 1993. Previously he worked with the Council of State
Governments as its chief environmental staff and with private
engineering firms in the Kentucky Environmental Agency. He has
34 years of experience in State environmental matters. As the
chief executive of ECOS, Mr. Brown has been closely involved in
its mercury policy matters for the last 10 years, including the
work of the Quicksilver Caucus and mercury policies of the
association.
Another witness that we were anticipating, Mr. Alfred Dube,
who is National Sales Manager of SolmeteX, had to cancel his
appearance here today due to death in the family. Without
objection, I ask unanimous consent to include Mr. Dube's
statement in the record of hearing, and this committee sends
its condolence to him on the death in the family.
[The prepared statement of Mr. Dube follows:]
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Mr. Kucinich. Mr. Alexis Cain is an environmental scientist
with the U.S. EPA Region 5 Air and Radiation Division. Mr. Cain
holds a Master's in International Affairs from American
University, Master's in Environmental Studies from Yale. He has
been with the U.S. EPA for 15 years. He works on mercury
control efforts including as the U.S. co-lead from the Great
Lakes Bi-National Toxic Strategy and on the development of
mercury reduction strategies under the Great Lakes Regional
Collaboration. He is testifying before this subcommittee on his
own behalf and his testimony is not in his official capacity
and he does not represent the positions of the EPA. I wanted to
make sure that disclaimer is put out there.
Mr. John Reindl is a retired professional engineer who
worked for Dane County, Wisconsin, as their recycling manager
for many years, including on programs to reduce the flow of
mercury to the environment from products. He has researched and
written on mercury air emissions from crematoria. His reference
paper on crematoria, which is updated on an ongoing basis, has
over 130 references to both literature and discussions with
people everywhere. The Mercury Policy Project was formed in
1998 and works to promote policies to eliminate mercury uses,
reduce the export and trafficking of mercury, and significantly
reduce mercury exposures at the local, national, and
international levels. That is certainly due, in great part, to
the initiation work of Mr. John Reindl.
It is the policy of the Committee on Oversight and
Government Reform to swear in all witnesses before they
testify. I would ask that you rise and raise your right hands.
[Witnesses sworn.]
Mr. Kucinich. Thank you. Let the record reflect that each
of the witnesses has answered in the affirmative.
I would ask that each witness give an oral summary of your
testimony. Keep this summary, if you would, to 5 minutes in
duration. Your complete written statement will be included in
the hearing record.
Mr. Walsh, you are our first witness on this panel. I ask
that you proceed, and thank you for being here.
STATEMENTS OF WILLIAM WALSH, OF COUNSEL, PEPPER HAMILTON, LLP,
REPRESENTING AMERICAN DENTAL ASSOCIATION; STEVEN BROWN,
EXECUTIVE DIRECTOR, THE ENVIRONMENTAL COUNCIL OF THE STATES;
ALEXIS CAIN, SCIENTIST, U.S. ENVIRONMENTAL PROTECTION AGENCY,
REGION 5; AND JOHN REINDL, MERCURY POLICY PROJECT
STATEMENT OF WILLIAM WALSH
Mr. Walsh. I am William Walsh, outside counsel for the
American Dental Association on amalgam wastewater issues. On
behalf of the ADA's more than 157,000 member dentists, thank
you, Mr. Chairman, and committee members for the opportunity to
discuss the memorandum of understanding with EPA.
Prior to that MOU, the ADA met periodically with EPA urging
a national voluntary program to reduce dental amalgam in
wastewater and implement educational programs and take other
actions. Even without amalgam separators, approximately 99
percent of the amalgam is captured either in the office by
other parts of the plumbing system or in the sewage treatment
plant, which captures prior to discharge into the rivers, a
substantial amount, 95 percent of the mercury that enters that
is related to amalgam.
Now, let me make it clear, because my earlier testimony in
the last hearing I was less clear. There is a large amount of
mercury that goes into the sewage treatment plant. The ADA has
done studies: 50 percent, and maybe more in some places, less
in others, but because the POTW captures in the biosolids, what
goes out into the streams is less than that. But separators
will reduce that somewhat if implemented.
In 2007 EPA was studying whether the release of dental
office wastewater into sewers warranted the issuance of an
enforceable pre-treatment standard. The ADA filed public
comments consistent with its earlier comments explaining why no
such standard was necessary, in part because the dentists can
and will act on their own. For example, the ADA had added
separators to its best management practices in 2007. We asked,
as we had in the past, to work with EPA on this issue. In
response, EPA contacted us in early 2008 and proposed an MOU to
promote the use of separators.
EPA's consultant had estimated that approximately 40
percent of the dentists in the United States were using
separators, but I think the report made it clear that was an
estimate for the purposes of the regulation and the information
was uncertain.
The MOU required ADA to prepare a baseline report on the
number of separators in use. Based on numerous data sources,
including surveys of ADA members, we determined information
concerning the number of separators and the percentage of
separators being used, in essence tracking as of 2009 what the
compliance of dentists were with separators. We looked both at
States where there are mandatory requirements as well as
voluntary requirements.
Unfortunately, as we pointed out to EPA and the National
Association of Clean Water Agencies, the data is somewhat
contradictory and incomplete, and there wasn't a clear answer
from the various surveys and various sources of information,
and that more information may be necessary from the
manufacturers, and EPA decided to seek additional data from
manufacturers.
Without a baseline, developing a progress goal has been
difficult. Nevertheless, the parties have agreed upon, and I
should say this agreement has come after some of the other
testimony that has been submitted here today, so the testimony
of ECOS, for example, talks about a goal not being set.
We have reached a goal that in the first 12 months after
setting the goal, that 20 percent of the dentists in
jurisdictions where there is no mandatory requirement would
have separators. The next 12 months after that, an additional
25 percent would have to meet, be shown through surveys with
the separator manufacturers, to meet the requirement of having
a separator, and every 12-month period after that another 25
percent, until 100 percent is met or some plateau is reached.
These are absolute numbers. If the baseline is determined
to be 20 percent, our goal is 40 percent in 12 months and 65
percent in 2 years.
We are only counting for the purpose of compliance those
dentists in voluntary areas, although obviously a number of
dentists in the States where there are mandatory requirements
would be additional number of separators.
This voluntary approach should be successful, in our
opinion, because it is directed at dentists as health
professionals. We think that is important in communicating a
voluntary program from a familiar source, the ADA, using all of
its communication outlets, and the same communication from EPA
and from the Sewer Authority Association. It is based on the
lessons learned from previous unsuccessful voluntary efforts,
and there is no question that some of the earlier efforts were
not successful.
It recognizes that if voluntary efforts fail, nothing in
the MOU, in fact, the MOU specifically provides EPA, the
States, or the local agencies the authority now to continue to
go ahead, regardless of what is happening with the MOU, with
any mandatory program that they so decide. That was
deliberately put in there and agreed upon by all the parties
from the beginning so we would not compromise the authority of
the States or local authorities or EPA, if EPA in its
discretion decided that it was insufficient.
Mr. Kucinich. Mr. Walsh, I am going to ask you if you could
summarize, because I asked the witnesses to go for five. I have
let you go for a little bit more than that.
Mr. Walsh. I have concluded. We have sought to do our fair
share, and that is what we are trying to do.
Thank you, sir.
[The prepared statement of Mr. Walsh follows:]
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Mr. Kucinich. Thank you.
Mr. Brown.
STATEMENT OF STEVEN BROWN
Mr. Brown. I am here representing the Environmental Council
of States, you have already explained what that is, and also
the Quicksilver Caucus, which is a group of associations of
State environmental officials that are interested in mercury.
There are three primary things I want to talk with you
today, and fortunately the committee has already added several
of them extensively, so I am going to cut my remarks somewhat
shorter.
First is I want to outline some of the State experiences
with voluntary and mandatory programs in States on this topic.
Second, I want to discuss the MOU, which we have been
discussing extensively today. And third, I want to tell you
something about the approach that ECOS and the Quicksilver
Caucus are recommending to EPA to address this topic.
As you know, Quicksilver Caucus research has looked at five
State programs, and the short version of that is that we found
in every case, when it became mandatory, as the graph you
showed earlier demonstrated, the results went up considerably.
And consequently also, I might add, the amount of mercury in
the sewage treatment sludge went down.
Now, I want to say something about the testimony Mr. Walsh
made regarding the fate of mercury in sewage treatment systems
when it leaves a dental office or any other source, for that
matter. It doesn't mysteriously disappear. That mercury that is
not in the water effluent is in the biosolids, and from there
it is either applied to land, it is incinerated and goes out
the stack, or it is buried in a landfill. Landfills have a
lifetime, but they don't last forever. And so the fate of that
mercury is to be put back into the environment, regardless,
sooner or later, when it goes into the POTW.
Coming back to my second point, the MOU, as you have
already stated, we were not involved in the development of the
MOU. It was a surprise to us when it came out. If we were asked
to be on it, we would say yes immediately, and we hope that
happens because we think the States obviously have a lot to
contribute on this subject matter. States are ahead of EPA on
removing mercury from dental facilities.
I would say, though, lest I leave a bad impression about
our relationship with EPA, we do have a good relationship with
EPA on other mercury issues, for example, the State/EPA mercury
dialog kick-off meeting that is going to happen in June. Ms.
Stoner mentioned that. It is just that we can't say we had the
same relationship on this particular topic.
The third point I wanted to make is a resolution that ECOS
passed at its spring meeting only a couple of months ago. I
think that one is significant because the States recognize that
amalgam can be the single largest source of mercury for a POTW,
and that it is a water discharge concern and a source of
pollution when sludge is incinerated or land applied. And this
is the significant part, because in these days when State
budgets are down and we are concerned about the cost to
implement EPA rules, that issue was not brought up on this
topic. In fact, our members agreed that EPA needs to include
dental facilities under the health care sector for rulemaking
in its effluent guidelines program plan and require the use of
best management practices to comply with that rule.
In March just recently the Quicksilver Caucus sent a letter
to EPA with the same recommendations, and we pointed out that
the BMP's recommendations included the installation and use of
separators. There doesn't seem to be much dispute about that as
a best management practice. Even ADA, as they have said, have
recommended that.
So our two-pronged strategy acknowledges the value of
voluntary programs. They do have some value, and that is that
EPA should amend the MOU to include the role of a
decisionmaking to include the States, and EPA should set and
implement ambitious voluntary reduction goals throughout the
MOU, and perhaps they have done that now. That will hold us to
some results during the period of time in which a rule becomes
final, and that can take quite a long time, as you probably
know.
But eventually EPA should require the dental facilities to
implement BMPs, and they should install that and use
separators, and that rulemaking should come out this year, in
our opinion.
Thank you very much.
[The prepared statement of Mr. Brown follows:]
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Mr. Kucinich. Mr. Cain, you may proceed.
STATEMENT OF ALEXIS CAIN
Mr. Cain. I appreciate the opportunity to speak to the
subcommittee today about releases of mercury resulting from the
use of dental amalgam. In 2007, some colleagues and I published
an article in the Journal of Industrial Ecology on the life
cycle environmental releases resulting from the use of a
variety of mercury-containing products including dental
amalgam. This paper was based on a mass balance model developed
by Barr Engineering, with help from the environmental agencies
of Minnesota, Wisconsin, and Dane County, Wisconsin, along with
the U.S. EPA.
The model estimated the life cycle flow of mercury and
products from production through use and disposal, using
distribution factors to estimate how much mercury would enter
various disposal pathways, and using release factors to
estimate how much of this mercury would be released to air,
land, and water at each of these stages. I will focus my
testimony on the air and water releases.
We estimated, based on the model, that use of dental
amalgam was responsible for approximately 4\1/2\ metric tons of
mercury release to the atmosphere in 2005. There is
considerable uncertainty around this estimate, and all of the
estimates that I will discuss today.
Based on our estimates, dental amalgam is certainly not the
largest source of mercury to the atmosphere, but it is,
nonetheless, a significant source, accounting for roughly 4 to
5 percent of total emissions.
Emissions from human cremation that is the result of the
presence of dental amalgam fillings in corpses accounted for
approximately half of the emissions related to dental mercury.
Other significant air emissions pathways included
volatilization of mercury within the dental office, itself, and
disposal of sewage sludge, both from incineration and land
application. Dental office mercury enters sewage sludge because
of discharges to sanitary sewers from dental wastewater
systems.
We also estimated that dental amalgam was responsible for
approximately 0.4 metric tons of mercury releases to water in
2005. We estimated using the model that implementation of best
practices, including amalgam separators, at all dental offices
would reduce water discharges by approximately 0.3 metric tons,
and air emissions by approximately one metric ton through
reducing the mercury content of sewage sludge which is
incinerated or land applied.
You may wonder what the value of this type of modeling is.
Why use a model to estimate releases instead of measuring these
releases directly? I think that there are several reasons that
a model can be useful. First, a model can provide estimates,
however rough, of sources that are difficult to measure
directly, such as releases from the land application of sewage
sludge.
Second, a model can generate estimates of releases caused
by particular products. Direct measurement, for instance, can
give us an estimate of how much mercury is emitted by
incinerators, but it requires a model to estimate how much of
those emissions result from the disposal of a particular type
of product.
Third, a model allows us to predict the impact of various
management options. For instance, to estimate the potential
decline in mercury releases resulting from installation of
amalgam separators.
Finally, a model provides a check on emissions measurements
and indicates where additional measurement may be warranted.
I would like to focus now on mercury emissions from
crematories. In the case of these releases, EPA's estimate is
that total nationwide emissions were 0.3 tons in 2005, based on
extrapolating from emissions measurements. The model, however,
estimates that these emissions are more than two tons per year,
based on data on the average mercury content of fillings, the
number of fillings that an average person has at the end of
life, and the number of corpses that are cremated.
As a general rule, there are good reasons to prioritize
measured results over an output from a model; however, I
believe that in this case the model's results are more
reliable. U.S. EPA's estimates are extrapolated from a small
number of emissions tests at a single facility, which could
generate a misleading result, given that we would expect
releases per cremation to vary greatly, depending on the number
of dental amalgam fillings in the particular corpse being
cremated at the time that the measurements were being made.
The hypothesis that emissions inventories may under-state
the significance of mercury emissions from crematories is
supported by evidence from emissions testing in Europe, where
there has been more testing done than has been the case in the
United States. For instance, the National Emissions Inventory
in the United Kingdom uses an emissions factor of three grams
per cremation, while Norway and Sweden each use an emissions
factor of five grams per cremation. U.S. EPA's emissions
inventory implies emissions of 0.4 grams per cremation, far
lower than the likely range suggested by the European evidence.
The life cycle flow model implies emissions of 2.7 grams per
cremation, which is more consistent with the European evidence.
Given all the uncertainties, I certainly do not claim that
the mercury flow model has produced a correct estimate of
mercury emissions from human cremation; however, I believe that
the evidence is strong that EPA's estimate understates
emissions from this source category. I believe that an
appropriate evaluation of all the available evidence would lead
to an increase in EPA's estimate of mercury emissions from
crematoria.
[The prepared statement of Mr. Cain follows:]
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Mr. Kucinich. I thank the gentleman.
Mr. Reindl? Thank you.
STATEMENT OF JOHN REINDL
Mr. Reindl. Thank you, Mr. Chairman and Congresswoman
Watson. My name is John Reindl. I am a volunteer for the
Mercury Policy Project, because, unfortunately, Mr. Bender
became ill and has been unable to attend. I do have 13 slides
that I would go through very quickly, since a lot of these
topics have been covered already.
This chart, and it is repeated in the written testimony,
shows the quantity of mercury used in 2004 and the quantity of
mercury that is currently in products. As noted in the chart on
the left, about 25 percent of all the mercury used in 2004 was,
in fact, for dental amalgams. As stated before by your Chair,
about 1,000 tons of mercury are currently in the teeth of
people in the United States, by far the largest source of
mercury in any products in the United States.
We believe that mercury from tooth fillings is one of the
largest sources of mercury that is discharged from various
sources to wastewater treatment plants. Since a typical amalgam
has a lifetime of 10 to 20 years, we have to look not only to
mercury that is currently being used, but the mercury that was
used, because those fillings will come out approximately 15
years later, and, as has been noted before, mercury that
escapes into the environment, regardless of what form it is, is
going to be converted to methylmercury, which is going to
buildup into fish and enter the human body.
We have gone over the memorandum of understanding several
times before, so I will skip this slide and, in fact, the next
slide talks about the memorandum of understanding even more, so
I will skip that one, as well.
EPA testified that there were 12 States that have mandatory
agreements. We were aware of 11 of them. Obviously, if 11
States or 12 States have agreements, 38 or 39 do not have
agreements.
What we find is that, for a suitable best management
practices program, these are the elements that need to be
included. It needs to include the installation and proper
management of amalgam separators, requiring the dentists to
recycle their mercury and requiring reporting to verify
compliance.
This chart will show the partial estimate of sales of
mercury amalgam separators. The States in the white, which are
the far right of those bar charts, shows those States without
legislation or requirements, and the tall ones represent those
States with legislation. Only 13 percent of amalgam separators
have been sold in the non-regulated States, even though those
are 38 to 39 States, three times the number of regulated
States, the amount of amalgam separators is less than one-
seventh of those otherwise sold.
Here is a comparison of the EPA's estimate of mercury
releases from dental sources to the atmosphere compared to
those represented by the Mercury Policy Project. As your Chair
mentioned before, the estimates of the Mercury Policy Project
are five to seven times larger than those estimates of EPA.
And, as you can see from the slide, there are several areas
that EPA did not include any estimates whatsoever.
This shows a flow diagram that was originally developed by
a Swedish chemical agency and was used actually as the basis
for our mercury flow models throughout the United States.
My big focus, though, is going to be on cremation. This is
the area that I have specialized in. As we see from this chart,
and, again, it is in the written testimony, the number of
cremations is expected to dramatically increase in the future.
We believe that this is going to increase the amount of mercury
that is emitted to the environment.
Additionally, what is happening is, because of improved
dental care in this country, the dental community has really
done a super job, and more people are having more of their
teeth when they pass away, but in those teeth there are more
dental restorations; that is, mercury fillings. Therefore, we
are going to have an increase in mercury emissions for two
reasons: one is increased number of cremations, and the second
is more dental restorations.
This shows a bunch of numbers, which is kind of hard to see
on the wall, but if you look in your testimony you will see
that our estimate is that the amount of mercury will over
double within the next 10 years as air emissions from
cremations, because of the combined impact of more cremations
and more dental restorations.
The last slide is a summary. There are seven to nine metric
tons of mercury released to the environment per year. That is
growing rapidly. We don't feel that the premise of the MOU was
based on true facts. We believe EPA should establish effluent
guidelines for dental offices. We believe that the dental air
emissions data should be updated, especially for cremation. We
believe that EPA should regulate mercury emissions from
crematoria, and we believe that EPA should maintain a
transparent, open process to include the non-governmental
organizations.
Thank you.
[The prepared statement of Mr. Reindl follows:]
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Mr. Kucinich. Thank you very much, Mr. Reindl.
Mr. Walsh, we are going to go to questions now. You
testified that the ADA filed public comment in 2007 against
bringing dentist offices under mandatory effluent guidelines.
The reason you exempt dentists was, as you state, because
dentists can and will act on their own. But isn't it true that
nearly every State or local jurisdiction that has tried to get
dentists to voluntarily adopt mercury separators has then
chosen to mandate or threatened to mandate a separator
requirement because dentists were not, in fact, acting in large
numbers on their own?
Mr. Walsh. Well, I think it is inherent in any voluntary
program that I am aware of that there is the implicit or
explicit consideration that the next step is regulation. In the
MOU, we specifically say that EPA and the States reserve that
right. In fact, in the communications that the ADA uses to its
members, it points out, as it must, to be honest and forthright
with its members, that if they do not do a voluntary compliance
the likely next step is enforcement.
Mr. Kucinich. So are just some members waiting for
mandatory?
Mr. Walsh. There has been, I think, a very long education
road to educate the dental professionals about this issue. When
I was first retained by the ADA back in 2001, there was very
little knowledge of what the regulatory regime was. They were
dentists. They had not been involved in many environmental
issues.
They also had some scientific issues about what was being
said. A lot of people took the 50 percent numbers of what was
going into the plant, POTW plants, and said that was what was
coming out. We built a factual basis that showed that it was a
problem that was significant in terms of the effluent, the
benefits of recycling, and on a science basis, which
professionals like the Dental Association and its members are
understanding more, and we look at the data and there were
early failures, and the dental community was part of the reason
for the failures.
But if you look at the pattern not only in the voluntary
programs involving dentists, but other voluntary programs,
because for 20 years the Water Office has used voluntary
programs. In situations like this where there is a large number
of small entities that have to be regulated and it has mainly
to do with their own resources and their own priorities, we
thought that if we have a consistent message from the ADA, from
the regulators, and those States or localities where there are
either local conditions that are required more stringent, they
should go ahead and do what they think is appropriate. We
reserved all the rights to do that, but we think that it
actually will be quicker to do this on a voluntary basis, and
we understand that if we are not successful that a likely
outcome is that EPA will issue a regulation.
Mr. Kucinich. Mr. Brown, would you like to respond to what
Mr. Walsh said?
Mr. Brown. Voluntary programs have a purpose and a place,
but our position is that their time as the solution has passed.
We need to have EPA, under the Clean Water Act, assert its
authority to issue a rule on this matter, and during the
process when that rule is developed, before it is finalized, it
takes years, typically, that the voluntary programs can help
educate dentists about their obligations and get some results
before the rule actually comes into place.
Mr. Kucinich. Mr. Walsh, you saw that chart on the wall,
right?
Mr. Walsh. I did, yes.
Mr. Kucinich. The one that deals with dentists seemingly
responding when mandatory regulations are requiring adoption of
mercury separators. I mean, I just wanted to ask you, because
you have seen it, isn't that evidence that dentists respond
when you have mandatory regulations?
Mr. Walsh. I think you need to look at the individual
cases.
Mr. Kucinich. I am asking what you saw, not what I saw.
Mr. Walsh. Well, what I saw is a number of different
factual backgrounds. One of the charts shows, I believe, either
Minnesota or Minneapolis in its voluntary program. That was a
relatively successful voluntary program, and it was followed by
agreement of the local dental association to go to a----
Mr. Kucinich. Are you talking about Massachusetts?
Mr. Walsh. No, I am talking about----
Mr. Kucinich. Take a look at that chart. I just want to
make sure we are talking about the same thing, because if you
are talking about Massachusetts, they had a different reason
for their compliance in Massachusetts. This letter from the
Commonwealth of Massachusetts, which I will put into the
record, says a big jump in SolmeteX, Inc. separator sales
apparent in Mr. Dube's exhibits starting 24 months prior to the
effective date of Massachusetts' regulations, which were
adopted in 2006, this sales increase started in 2004 was
concurrent with an innovative incentivized early compliance
effort implemented by MassDep in concert with the development
of State regulations requiring separator use.
We will put that in the record, without objection.
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Mr. Kucinich. Do you have any comment on that?
Mr. Walsh. Without having read the details----
Mr. Kucinich. I am going to ask my staff to take----
Mr. Walsh. As a general matter, as I said a few seconds
ago, many of these programs, voluntary programs, some of them
were do it voluntary within X number of years or we are going
to make it mandatory. In a couple of cases they decided they
didn't need to go to the mandatory case. Part and parcel of any
of these voluntary kinds of programs is the implicit or
explicit threat of there being a mandatory requirement.
Mr. Kucinich. But if there is no mandatory requirement in
the offing----
Mr. Walsh. If there is no mandatory----
Mr. Kucinich [continuing]. The voluntary compliance is
going to be low, right?
Mr. Walsh. That is true, but----
Mr. Kucinich. OK. I am done. That is my question.
Mr. Walsh. Fine.
Mr. Kucinich. That is what I wanted to hear.
Now, Ms. Watson is going to have 5 minutes, and then we
will be back. Thanks.
The Chair recognizes Ms. Watson.
Ms. Watson. Thank you very much.
I mentioned a bill that I have called the CHOMP Act, and it
stands for Consumers Have Options for Molar Protection. First
letter of each word spells CHOMP, and we chomp on food.
Your organization came out in opposition to my bill, the
CHOMP act, because the ADA believes that mercury amalgam is
safe. However, the CHOMP Act addresses important consumer
knowledge.
Do you believe dentists should tell every patient that
amalgam is mainly mercury?
Mr. Walsh. Testimony that I have prepared and what I have
been prepared to talk about----
Ms. Watson. Yes? No?
Mr. Walsh [continuing]. Has to do with the----
Mr. Walsh. Can you answer my----
Mr. Walsh [continuing]. MOU and----
Ms. Watson [continuing]. Question very specifically?
Mr. Walsh. No, I can't answer your question because I am
not the person at the ADA who has responded to you. We can
respond in writing.
Ms. Watson. Let me ask it again, and listen to it very
carefully. If I am not speaking clearly, just let me know.
Do you believe dentists should tell every patient that
amalgam is mainly mercury? Yes? No?
Mr. Walsh. You mean me personally, you are asking?
Ms. Watson. Do you, Mr. Walsh?
Mr. Walsh. Just as Mr. Walsh?
Ms. Watson. Do you believe that dentists should ask that
question or tell the patients that amalgam is mainly mercury?
Mr. Walsh. I think I would have to know more about the
issue than I do, because----
Ms. Watson. All right. If not, state in what circumstances
should dentists withhold from patients that amalgam is mainly
mercury?
Mr. Walsh. I am not aware of any circumstance in which
dentists withhold that information.
Ms. Watson. Can you think of a time when they should tell
their patients what amalgam is composed of and what percentages
of mercury is in amalgam?
Mr. Walsh. This is not something I am either qualified to--
--
Ms. Watson. You are not aware?
Mr. Walsh [continuing]. Or prepared to respond.
Ms. Watson. You are not aware? Yes? No?
Mr. Walsh. It is not a question I am capable or qualified
to answer.
Ms. Watson. Or are you capable or qualified to know what is
amalgam? What is an amalgam?
Mr. Walsh. I do know what an amalgam is, yes.
Ms. Watson. OK. Do you know the percentages of what makes
up the amalgam?
Mr. Walsh. Yes.
Ms. Watson. OK. Is amalgam 50 percent mercury?
Mr. Walsh. On average, yes.
Ms. Watson. OK. Do you think a person should know that
amalgam is 50 percent mercury?
Mr. Walsh. It is beyond my preparation for this meeting and
I have to think----
Ms. Watson. Is mercury safe?
Mr. Walsh. The FDA has said mercury in amalgam use is safe.
Ms. Watson. Is mercury safe?
Mr. Walsh. Well, you have to look at the use, the exposure
to determine it. In certain uses it is not safe, in other uses,
at least government agencies have found it to be safe.
Ms. Watson. Let me see. Maybe I don't really speak clearly,
so let me speak real clearly. You have a 9-year old child in
the dental chair and you are going to fill that cavity in that
child's mouth, the mother is sitting right outside the door or
maybe inside because no one likes to go to the dentist. If the
mother would ask the dentist, what are you putting into my
child's mouth, do you think the dentist should tell that mother
what is going in the mouth?
Mr. Walsh. If I were----
Ms. Watson. We are talking about professionals.
Mr. Walsh. If I were asked the question I would answer the
question, but you are asking in a policy context.
Ms. Watson. We are talking about a professional dentist,
DDS, and the mother wants to know what is going in the child's
mouth. What do you think? Who do you represent?
Mr. Walsh. I represent the American Dental Association on
amalgam wastewater issues.
Ms. Watson. OK. I will accept that. OK. Now, something goes
in that amalgam, and when they finish they usually give you
some water and you spit it out. It becomes wastewater. It goes
out into the sewage plant and then it goes into the ocean.
Now, if you were asked by a parent, is there anything in
there that will put my child at risk, do you think a dentist
should say yes, no?
Mr. Walsh. [No audible response.]
Ms. Watson. Apparently you are having trouble with my
questions. Let me go on.
Mr. Walsh. OK. Go on.
Ms. Watson. I do understand that historically----
Mr. Kucinich. The gentlelady's time is expired, but you can
ask your question.
Ms. Watson. OK. I will just ask this one and then I will
leave it alone, but I think we are getting the picture. I think
we are getting the picture here, and we are talking about a
toxic substance. I do understand that historically mercury
fillings have been labeled silver fillings because of their
color. Is that something you understand?
Mr. Walsh. I have heard and used that phrase. Yes.
Ms. Watson. OK. However, that title is no longer relevant
and it no longer fits and is desperately in need of a
scientific update. Why does the ADA insist on using the term
silver fillings to describe amalgam rather than more
appropriately referring to mercury fillings? And why doesn't
the ADA advocate for implementation of the recognized best
practice of calling these fillings mercury fillings? Now, you
represent the ADA. Can you tell us?
Mr. Kucinich. The witness can answer the question and then
we are going to complete this round.
Ms. Watson. Yes.
Mr. Walsh. I think the ADA can answer that question in
writing. Again, that is not within the area in which I
represent them.
Ms. Watson. Are you refusing to answer verbally?
Mr. Walsh. I am saying I am not the one that knows the
answer, so I----
Ms. Watson. But you are representing the ADA.
Mr. Walsh. I am representing them, as I said in my opening
statement----
Ms. Watson. I yield back.
Mr. Walsh [continuing]. Based on amalgam wastewater issues.
Ms. Watson. I yield back.
Mr. Kucinich. Well, let me pick up where the gentlelady
left off, and that is that you heard the question or asked, and
I would like to see an answer in writing.
Mr. Walsh. We will.
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Mr. Kucinich. I appreciate your being here. Until myself
and my colleagues get answers, definitive answers to these
questions, we are not going to be able to put this issue to
rest and we will be coming back and back and back.
Mr. Walsh. We will be happy to answer all of those
questions.
Mr. Kucinich. That is why we are hoping these hearings
are----
Ms. Watson. Mr. Chairman, could you yield so I can ask you
a question?
Mr. Kucinich. All right.
Ms. Watson. I would hope that if we do another hearing, we
will require someone who is a professional dentist from the ADA
rather than the attorney, because the questions I am asking
really should be responded to by a professional----
Mr. Kucinich. Well, I will ask staff to be mindful of your
request.
Ms. Watson. Maybe we can put it in writing and see if we
can get somebody, not the attorney.
Mr. Kucinich. Mr. Walsh is aware of the rules that this
committee has to produce witnesses, so you can facilitate that
working with the committee, I am sure. Thank you.
Ms. Watson. Thank you.
Mr. Kucinich. Mr. Cain, in your testimony you conclude that
``EPA's estimate under-states emissions of mercury from human
cremation.'' Your own scientific work estimates the true
emissions to be about at least seven times the estimate from
EPA; isn't that right?
Mr. Cain. That is right.
Mr. Kucinich. The problem of mercury air emissions by
crematoria likely to increase, decrease, or stay the same, in
your opinion?
Mr. Cain. In my opinion I agree with Mr. Reindl that over
the next 10 years it will increase. I think over the much
longer term it will decrease as a result of better dental care
and the reduced need for dental amalgam fillings. But for the
next decade, it will certainly increase.
Mr. Kucinich. Mr. Reindl, what is the European research
about mercury air emissions from crematoria showing?
Mr. Reindl. I would agree with what Mr. Cain had said. The
peak appears to be forecast to occur about 2020, and after that
period of time it will start to decrease.
Mr. Kucinich. So does mercury in the teeth of deceased
persons amount to a significant source of air emissions from
crematoria?
Mr. Reindl. In my opinion, yes, a very significant source.
Mr. Kucinich. Going back to Mr. Cain, your paper in the
Journal of Industrial Ecology was published in 2007, but you
have been presenting your work since 2005 at scientific
conferences; isn't that right?
Mr. Cain. That is correct.
Mr. Kucinich. And in those years did your work ever have an
impact on EPA's official air emissions inventory?
Mr. Cain. No, it did not.
Mr. Kucinich. Now EPA has informed us that they are in the
process--that was the word that Ms. Stoner used--process of
developing an automated, internet-based procedure of receiving
actual emission measurements and calculating with them by
algorithm emissions factors in a dynamic way. Before my staff
spoke with you about that, have you ever heard from anyone in
the EPA that the agency was revamping its emissions inventory
in this way?
Mr. Cain. No, I had not.
Mr. Kucinich. And do you think, based on what you know so
far, that this new procedure is assured of getting the air
emissions of mercury from crematoria right, or are there
possible complications that could compromise the new inventory
system?
Mr. Cain. I think there are complications. I mean,
certainly to have additional stack testing would be a
beneficial thing. I think, for some of the reasons I stated in
my testimony, you need to be careful that the stack testing is
representative and that it is probably a good idea to not rely
entirely on stack tests but also to look at techniques such as
looking at how much mercury is actually going into the
crematoria, which is easier to do than to measure the mercury
coming out.
Mr. Kucinich. So what are some of the difficulties that
could get in the way of the EPA's new system of emission
factors accurately determining emission factors for mercury air
emissions from crematoria and sludge incinerators?
Mr. Cain. I think the biggest problem is getting
representative samples for emissions tests. The other problem
is that mercury air emissions testing is difficult to do. It is
easier to make mistakes. I mean, it is fairly easy to count
fillings in a person's mouth, but more difficult to measure
micrograms of mercury per cubic meter of air. So I think it
would require a lot of air emissions testing.
Mr. Kucinich. So what questions do you think Congress
should be pursuing with EPA to ensure that their new air
mercury emissions aren't as mistaken as the old estimates?
Mr. Cain. I would think that asking EPA to consider all the
available evidence, both stack testing and other types of
evidence, would be appropriate.
Mr. Kucinich. Mr. Reindl, do you have any comment on that?
Mr. Reindl. Besides the comments that Mr. Cain made about
the difficulty measuring the stack emissions, what we have
found through our literature review is actually much of the
mercury doesn't go through the stack, and that they have found
that the mercury emissions actually in the office of the
crematoria are higher than the emissions outside, suggesting
that the emissions are not going necessarily up the stack but
are going through leaks, if you will, in the actual cremation
unit, and so measuring the emissions from the stack is going to
be very, very difficult.
Another point to note is that there is no crematorium in
the country that is required to have any air emission controls
whatsoever. We have almost no data on an ongoing basis from any
crematorium. The one crematory that was used 10 years ago had
mainly just a water spray system to reduce some of the dust,
but there is no other emissions control on any crematorium in
the country otherwise.
Mr. Kucinich. To staff, one of the things that occurs to me
is that as the EPA is going through this process we should call
to the EPA's attention experts who are available who have done
research that might enable their process to be enriched by that
research. Especially ones who work there. Just a thought.
The Chair recognizes Ms. Watson.
Ms. Watson. Mr. Brown, you have heard my line of
questioning, and you heard the responses that have come from
Mr. Walsh. Can you help us understand the position of the ADA?
Do you know anything about the American Dental Association and
their opposition to the amalgam fillings, the silver fillings?
Mr. Brown. I don't. In fact, it pains me to have to say I
have sort of the same answer that Mr. Walsh did. I can talk to
you about the environmental disposition of the mercury once it
leaves the dental office, but not the rest.
Ms. Watson. OK. Well, can you? Maybe that is something that
might be compelling as we try to gather more evidence and try
to change the ADA's position about amalgams.
Mr. Brown. Yes, ma'am.
Ms. Watson. The environmental impact, because we all know
that the waste goes to the sewer management and then out into
the ocean, and we just heard the emissions. There is no way or
they have not come up with a way to capture and to change the
particles in the emissions. They go out into the environment.
Can you help us?
Mr. Brown. Well, one of the things that in preparation for
this hearing and listening to the testimony is it occurs to me
that I need to go back and ask the Quicksilver Caucus if it has
any recommendations to ECOS about incinerators and mercury
emissions from crematoria, because that is not an issue that, I
mean, we are aware of it and we have looked at it, but we don't
have a position on it, and it strikes me that we need to have
one.
Ms. Watson. All right. Mr. Cain, can you help us?
Mr. Cain. I can note on the question of controlling mercury
emissions from incinerators that one of the States in Region 5,
Minnesota, has worked on a voluntary basis with the mortuary
association in the State and the University of Minnesota, and
they have come up with a goal of reducing mercury emissions
from crematoria by 75 percent.
Ms. Watson. Yes.
Mr. Cain. There is a variety of alternatives that they are
going to look at, including alkaline hydrolysis or
dechlorinating teeth prior to cremation.
Ms. Watson. I am aware of many substances, Mr. Brown, that
can be used in place of the mercury in the amalgam, and I was
told by the National Dental Association that they are too
expensive and people will stop coming and bringing their
children or coming in for fillings because of the cost.
Does anyone at the table here know of any of the
substitutes? Mr. Walsh, you can't speak professionally. You
just told me that, so I will refer this to other panelists,
maybe Mr. Reindl. The separators, yes, and, Mr. Reindl, can you
tell us how we can protect from further pollution of our
environment because of the mercury switch?
Mr. Reindl. Well, speaking on the cremation issue,
obviously there are two ways to deal with it. One is to remove
the teeth prior to cremation, and the other is to control the
mercury emissions during the process or use an alternative
process such as the alkaline hydrolysis process. One of the
challenges that Minnesota is facing is that they are not sure
of what technology can help them meet their goal for stack
emissions and, as I mentioned before, not all the emissions to
through the stack, so that is a very big challenge.
Ms. Watson. So we still need more research is what you are
saying?
Mr. Reindl. We still need more research. When your Chair
noted to staff that EPA ought to involve experts on the
cremation issue, I raised my hand to make a note that
unfortunately we don't have many experts on this. When I have
been doing this literature and survey and contacting people in
the field for over 10 years, I have never found anybody at a
university in North America that has worked on this. I have
never found anybody in the entire world that has done such a
survey of references on cremation. In fact, some of the people
that I was in contact with in Germany and Norway are no longer
involved in it. There simply aren't any experts in this field.
Ms. Watson. I hear you loud and clear. I think that is one
of the reasons why we are having this hearing, and I just
appreciate the Chair for allowing me to take part in this
hearing. I am on the subcommittee, too. Mercury is a toxic
substance that can do harm. I am just shocked that
professionals don't understand the harm that mercury can do in
a filling, and they are still calling these silver filings. You
know, people like gold fillings and silver and so on. I think
these mis-statements and holding back this information is very
harmful to the health.
Mr. Chairman, I will just end by saying this: I am about
this for improving our environment and keeping Americans
healthy, and people who only consider the money that comes out
of this profession from doing this I think are an abomination
to society. I am concerned about the health of young people. I
am a victim. And when we come and we bring professionals to
this panel and they are not straightforward and honest to us
and do not want to share with the public, the public has a
right to know about anything that is inserted in their bodies.
It is a proven fact that mercury is a very toxic substance,
and I would hope that the dentists would understand and would
have the knowledge, Mr. Reindl, of how they are polluting the
wastewater. And I would hope that they would not send an
attorney who really doesn't understand the chemicals and the
ingredients and what makes up an amalgam here to testify in
front of this committee, and particularly when I am on it,
because I don't buy it.
We have been studying this, Mr. Chairman, for years, and so
I would like a professional in front of me that can tell me
what they put into a person's mouth and will share that
information. We fought for years to get the warnings on
smoking, and now almost on everything you buy in a market you
can find out the ingredients in there. If you have allergies to
peanuts, you had better know there are peanuts in that candy
bar you give to a kid, because they can kill you. And if you
are a professional medical person and you don't know, you are
just as guilty as somebody who put a gun to their head.
With that, I yield back.
Mr. Kucinich. I thank the gentlelady from California for
her participation in this hearing, and all the other Members
who participated.
This is the Domestic Policy Subcommittee of Oversight and
Government Reform. Today's hearing, Assessing EPA's Efforts to
Measure and Reduce Mercury Pollution from Dentists' Offices. We
have had two panels of witnesses. I want to thank the panel in
front of us for their participation.
This committee will continue to retain jurisdiction over
this matter related to various types of mercury toxicity and
their circulation in the broader society.
As you can see, there are members of this subcommittee,
myself included, who have very strong feelings on this. It is
noteworthy because, as chairman, I rely very closely on how the
members of my committee feel about what we should pay attention
to.
That having been said, to the best of your ability to help
us move this along to compliance and to protect the public
health would be much appreciated.
With that, this subcommittee stands adjourned. Thank you.
[Whereupon, at 4:22 p.m., the subcommittee was adjourned.]
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