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Advisory Committee on Mercury Pollution
Meeting #53: Friday, June 4, 2004
Time: 9:00 am to 11:30 am
Location: Conference Room, Environmental Assistance Office
Laundry Building, Waterbury State Complex, Waterbury, Vermont
MINUTES
Members Present:
Michael Bender, Abenaki Self-Help Association, Inc.
Bill Bress, Vermont Department of Health
Mary Canales, Department of Nursing, University of Vermont
Neil Kamman, Agency of Natural Resources, Water Quality Division
Ruma Kohli, chemical Management Program Manager, IBM, Burlington
Guests Present:
Dan Ferraris, DMD
Peter Taylor, Vermont State Dental Society
Gary Gulka, Vermont Agency of Natural Resources, Environmental Assistance
Karen Knaebel, Vermont Agency of Natural Resources, Environmental Assistance
The Committee members and interested parties gathered in the Conference Room of the Environmental Assistance Office, Waterbury State Complex. Karen
Knaebel called the meeting to order.
Agenda Item 1-
Accept minutes of the May meeting and possible changes to today's agenda.
May minutes were approved with changes as to the correction of the location where the meeting was called to order as well as a change in Agenda
Item 2 that the Dental Society will be have a display at their annual meeting rather than it being a suggestion.
Agenda Item 2-
Review dental office brochures.
Bill Bress advised the Committee that he had made attempts to obtain information from the Vermont Department of Health Dental representatives.
He reported that the Department of Health currently has no Dental Director. He contacted Dr. Donald Swartz, VDH who he believed may be the temporary
contact and provided copies of the dental brochures as well as the Norwegian study. The response he received was that Dr. Swartz was not a dentist
and had not read the study and therefore could make no comment. Dr. Bress suggested that the topic should be set aside until the Committee could
obtain more definitive answers.
- Suggestion that the ACMP write a letter to the VDH to obtain their views on the issue.
- Concern that the ACMP should not determine such matters and use of dental brochures and amalgam.
- Suggestion that it is the Committee's charge to articulate the exposure message such as mercury is toxic and is harmful to humans and suggest
such methods to reduce that exposure by making recommendations for such items as amalgam separators, but beyond that there is question as to the
Committee's role in making recommendations to dentists and their patients.
- Concern that the only information that the Committee should be relaying is that mercury has health affects- there are choices and that mercury
that is released to the environment has an impact. Beyond that, the ACMP does not have the expertise to make recommendations. Suggestion to draft
these two points that could be included into a brochure and provide this information to the Dental Society as a recommendation for information
in a brochure.
- From the previous meetings the Committee had made a determination to ask the VDH to give their opinion on the amalgam issue. Concern that going
forward before the VDH determination would be premature.
- Concern that there was no opportunity to provide opposing views and the information is deficient to make informed decisions. Criticism as to
why the Committee obtained information from Norway that discredits amalgam.
- Comment that inclusion from Norway was intended to be an information piece for the Committee.
- Bill Bress suggested that the Committee was charged with reducing exposure to environment and people - mercury in amalgam is the largest human
exposure to mercury other than fish consumption. The Committee can address the situation in a practical way to collect through amalgam separators,
but is it a health threat to have this in people's mouths? That is up to the Dental Department. From a toxicologist's standpoint, there may be
other questions, such as what is leaching from things other than amalgams, such as composites.
- Peter Taylor supplied many handouts to the Committee for their consideration and review:
- Information regarding continuing dental education courses and an article by FDA - "Consumer Update: Dental Amalgams"
- An article in National Wildlife, Your Health by Sharon Levey "Protecting Yourself from Unsafe Plastics"
- An article written by Berglund & Molin titled "Mercury vapor release from dental amalgam in patients with symptoms allegedly caused
by amalgam fillings"
- Suggestion that the dentists in the country and the ADA are already doing a lot and there is no proof that amalgam is harming people.
- Dan Ferraris responded to the health hazards regarding composite fillings. He stated that there were ingredients (Bisphenel "A") that
are considered hormone disrupters and there are studies being conducted by many companies of their own composite products. He believed that the
Bisphenel "A", can probably be found in all composites but believes it to be a non-issue. There are composites without Bisphenel "A",
but may be totally inappropriate for large surfaces. There are many other options for fillings such as glass ionomer, combinations including glass
ionomer, gold, all porcelain; but, there are toxins in almost anything used.
- ADA has brochures that can be purchased by dentists. Concern as to what is the intent of the Committee - to mandate, to encourage - the use
of some brochure?
- Dan Ferraris suggested that people know that amalgam contains mercury and the health effects. The Committee suggested that they felt many people
were not aware.
- Motion that Committee write a letter to VDH to ask specific questions as to their views. This motion was seconded depending on what the letter
would include. The following information was agreed upon to be placed in a letter from the Committee to the VDH dental department:
- Ask for their review of the three brochures (2 ADA and 1 Maine).
- Ask them to review the Norwegian study.
- Ask for their opinion on the science.
- Ask for their opinion on the two major exposures (dental and cremation).
- Should this issue be further reviewed?
- Concern as to what the information requested from the VDH has to do with information that may appear on the dentist's racks? Suggestion that
if the VDH says the Committee should not go forward with further evaluation, then the Committee will not go forward.
- Bill Bress suggested that the important issue is exposure and proof of that exposure; and the only proof would be through mercury biomonitoring
that is currently being conducted by the New England states. The fish studies are based on epidemiological studies; the only substantial proof
would be to monitor women including other exposures. Not unlike lead, there has been little mercury exposure data for a long while and the symptoms
to exposure are not as easy to detect. An 80-year-old woman may not be an issue but exposure of a 21-year-old woman of childbearing age is another
issue altogether.
- Information from Norwegian study indicates that no dental work is conducted on pregnant woman. Dan Ferraris advised that this is a non-issue
as it is common that there is no work done on women who are pregnant.
- Concern is the half-life of mercury in the body, which is from 30-90 days and makes the mercury exposure an issue even before pregnancy.
- Rich will draft the letter to VDH with review by Bill Bress.
- Question as to the status of the amalgam separator draft report. Report will be available prior to the next ACMP meeting for the Committee to
review. As a side note, Dan Ferraris' office has installed an amalgam separator through the pilot project and will provide information on a large
practice installation.
Agenda Item 3-
Updates on current progress of outreach projects.
UPDATE ON OUTREACH TO SENSITIVE POPULATIONS
A handout was distributed to the Committee as follows:
Work in Process-
- Behavioral Risk Factor Surveillance System (BRFSS) Survey - Question for survey in Aug/Sept. (women of childbearing age)
Two potential questions:
- How many cans of tuna do you eat per (week?)(month?)
- 0-1 can
- 2-4 cans
- 5-7 cans
- Did you know that the Vermont Department of Health advises pregnant women and children to limit the amount of canned tuna they eat due to mercury?
- Finalizing general mercury brochure (card)
- Video
- Putting together RFP for bid on project
- Have volunteer producer that will help with content and potential programs including students
- Printing
- 30,000 Mercury in fish brochures
- 3,000 additional fish posters
- 200 literature stands
- Will be ordering 12,500 general brochures
- Survey and mailing for newlyweds
- Putting together survey questions for first draft review
- Set up evaluation by VDH survey committee
- Obtained database information on newlywed names- DEC staff will add addresses.
- Distribution for general practice, OB/GYN and pediatric offices
- Arrangements made through separate contract for outreach to physicians' offices.
- Fish & Wildlife updating list of fishing clubs for direct mailing
- Putting together letterhead for joint (DEC/F&W/VDH) mailing to 500+ libraries
Completed work:
- Mailing of poster to 600 stores that sell fishing licenses.
- Mailing of poster & advisory to 320 Town Health Officers and Deputy Officers.
- Mailing of poster & advisory to 327 School Nurses.
- Mailing of pregnant women poster and mercury in fish brochure to approx. 2,000 childcare providers.
- 30 posters and 1,000 brochures distributed to WIC clinics.
- 70+ posters distributed through Hazardous Waste Network staff of SWDs.
- 75 posters distributed at the legislature.
- Approx. 50 additional posters distributed by request.
The Committee reviewed the two proposed questions for the BRFSS survey and agreed the first potential question regarding the number of cans of
tuna that are consumed each week would be the best choice for the survey.
The draft brochure was also reviewed regarding concern as to how the "fish you buy" advisories were written and their coordination with
existing Vermont advisories. Bill Bress advised the Committee that the calculations for the advisories were based on the weight of the fetus and
since those calculations were not based on the mother's body weight, the same calculations could be used for a young child. There were still some
unresolved issues regarding fresh tuna steaks. Based on the evaluation by Bill Bress, the advisories on the proposed brochure were finalized.
UPDATE ON LAMP RECYCLING OUTREACH PROJECT
A handout was distributed to the Committee as follows:
- Direct mailing of lamp brochures to 16,000+ businesses
- Developed and placed newspaper ads in all daily and weekly papers in May
- Set up for newspaper inserts of lamp brochures in nine daily newspapers for June
- Recorded radio ads to be distributed for airing starting in June
- Developed poster to be distributed to 175 Solid Waste District/transfer stations and 25 town clerks for towns not in districts - in June.
- Distributed nearly 2,000 additional lamp brochures upon request.
- Direct mailing to 3,500 electrical and plumbing contractors of lamp brochure, list of electrical wholesalers that are collecting lamps and list
of TRC locations for free thermostat disposal.
- Set up meetings to organize placement of dumpster stickers and other promotional materials to be distributed by Casella to their customers.
As an addition to this outreach, DEC has had discussions with True Value Hardware stores to facilitate potential fluorescent bulb collection sites
in all True Value Hardware store across the state. A grant proposal has been submitted to fund a one-year pilot project to assist them in establishing
the collection and methods to further the program past the grant funding. This project would provide free lamp disposal for households and potentially
small businesses.
UPDATE ON MERCURY PRODUCT LEGISLATION
The Committee was advised that the product legislation that was passed out of the Senate Natural Resources and Energy Committee was not taken up
for consideration by the House Natural Resources and Energy Committee.
UPDATE ON NEW ENGLAND FISH ADVISORY FORUM
Michael Bender advised that he and Karen Knaebel attended this meeting that was sponsored by the New England Zero Mercury Campaign and held at
Northeastern University in Boston, Massachusetts. Approximately 50 people attended from the region including state agency representatives (mostly
Health Department), scientists, environmental advocates as well as students.
Mr. Bender gave a brief explanation of topics addressed as follows:
- Phillippe Grandjean, DMSc, MD, Professor and Chair, Environmental Medicine at the University of Southern Denmark spoke about the adverse health
effects of methyl mercury in relationship to the Farroe Islands study. He responded and defended criticism as to why the study was not valid.
This study was endorsed by the National Academy of Science as the primary study used to establish advisory reference doses.
- Dr. Richard Deth, Professor of Pharmacology, Department of Pharmaceutical Science, Northeastern University addressed the topic of molecular
mechanisms in relationship to autism as well as thimerosol use in infant and adult vaccines.
- Margaret Round spoke in reference to the New England states' study responding to concerns regarding air release inventories for the six New
England states.
- Larry Block, a physician on the Board of Health for the town of Swampscott, Massachusetts spoke of a requirement in the town to post the California
consumption warnings in stores that sell fish with a specific warning for pregnant women to avoid albacore tuna.
- Karen Knaebel, mercury education and reduction coordinator from Vermont DEC spoke to the group regarding the state's outreach efforts to sensitive
populations.
- Findings from a New England survey conducted by the Zero Mercury Campaign were heard. The survey focused on the awareness of New Englanders
to fish advisories.
- Wild Oats, a health based market (not located in Vermont), spoke about their efforts to voluntarily post fish warnings in their stores. The
representative indicated that fish sales had increased 20% after the postings. She felt that it created an atmosphere of trust of which the customers
responded.
- A panel of state representatives determined that there needed to be a unification of the advisory message between the states.
- Michael and Karen felt after attending this meeting that it may prove useful to provide advisory information to the grocers in the state of
Vermont so that they would have this information for their customers, if asked. Bill Bress advised that Beth Sisco, VDH had worked with grocers'
representatives and the committee could potentially contact those same representatives to determine if they may be amenable to pass on the information
to their customers. Karen will follow up.
UPDATE ON NESCAUM MEETING - Neil Kamman
Due to time constraints, this topic will be included in the August agenda.
Agenda Item 4-
Updates and other topics not on agenda.
No additional topics were addressed.
Agenda Item 5-
Set date and agenda for next meeting.
There will not be a meeting date set for July. The next meeting date will be set for mid-August via e-mail.
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