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BRUSSELS, Belgium: A new study, conducted on behalf of the European Commission, recommends phasing out dental amalgam use over the next few years owing to mercury’s negative impact on the environment. According to the recently published study results, the ban should be combined with improved enforcement of the EU waste legislation regarding dental amalgam.
The report explains that mercury-free alternatives are still not used widely in many EU member states. The reasons are that alternative fillings are often believed to be more expensive than amalgam fillings, that many dentists are simply not trained to apply new methods and that many dentists think that composite materials have a lower durability than amalgam fillings. Some dentists are also “reluctant to change their current practice and invest in new equipment to handle mercury-free fillings,” according to the report. Additionally, many patients are not even aware that amalgam fillings contain mercury.
In 2007, mercury was used in more than 60 different applications in the EU, dental amalgam being the second largest mercury use (24 per cent) after chlor-alkali production (41 per cent). Once the use of mercury in chlor-alkali production has been phased out (target year 2020), according to the Euro Chlor’s voluntary agreement, dental mercury will become the main use of mercury. The EU consumption of dental amalgam is estimated to be between 55 and 95 tonnes of mercury (figures from 2010).
The study analysed the baseline scenario and three policy options to reduce the environmental impact of dental amalgam. The researchers stressed that there is currently no scientific consensus on the direct health effects of dental amalgam (except allergies) and that future policy actions concerning dental amalgam addressed in the study focus on the environmental aspect of the problem and indirect health effects.
The options suggested included improving enforcement of the EU waste legislation regarding dental amalgam, encouraging member states to take national measures to reduce dental amalgam use while promoting the use of mercury-free filling materials, and banning the use of mercury in dentistry entirely.
The researchers concluded that a combination of a ban and the improved enforcement of the EU waste legislation would be the most effective policy option. The European Commission would “ask member states to report on measures taken to manage dental amalgam waste in compliance with EU waste legislation and to provide evidence of the effectiveness of the measures in place. Usual steps taken to comply with these requirements are the presence of amalgam separators in dental practices, adequate maintenance of these separators in order to ensure a minimum 95 per cent efficiency and to have amalgam waste collected and treated by companies with the adequate authorisation to handle this type of hazardous waste”.
The ban of mercury could be implemented by adding the use of mercury in dentistry to Annex XVII of the REACH Regulation. REACH (Registration, Evaluation, Authorisation and Restriction of Chemicals) is the EU regulatory framework for chemicals that aims to enhance the protection of human health and the environment. REACH establishes European-wide uniform legal standards.
The report suggests the possibility of defining limited exemptions for medical conditions for which there is no substitute for dental amalgam at present. The study suggests that a decision to submit a REACH Restriction Dossier and effect a ban would probably be made in 2013, and become applicable five years later.
The researchers consider the combination of both policies necessary, as without the ban, mercury released from natural deterioration of amalgam fillings in people’s mouths, from cremation and burial, and from residual emissions into urban wastewater treatment plants would not be addressed. While the ban would eliminate the environmental impact in the longer term, the cessation of mercury would only be significant after about 15 years; therefore, both policies need to be employed to reduce mercury releases in the short term as well.
Amalgam’s environmental effects have been much discussed. Sweden has already phased out dental mercury, while Denmark, Finland, the Netherlands and Italy have all reduced amalgam use significantly. Other countries, including Germany, Spain, Italy and Austria, either have restrictions or guidelines on amalgam in place.
The complete “Study on the potential for reducing mercury pollution from dental amalgam and batteries”, conducted by BIO Intelligence Service, a Paris-based environment and sustainable development consultancy, can be downloaded athttp://ec.europa.eu/environment/chemicals/mercury/pdf/Final_report_11.07.12.pdf
