Vermont Agency of Natural Resources
Advisory Committee on Mercury Pollution

Advisory Committee on Mercury Pollution

Meeting #76: Wednesday, October 17, 2007

Time: 9:00 am to 12:00 noon

Location: Conference Room, Old Pantry Building, Waterbury State Complex,

Waterbury Vermont

MINUTES

Members Present:

              Michael Bender, Abenaki Self-Help Association, Inc.

              Gary Gulka, Vermont Agency of Natural Resources, Environmental Assistance

              Jennifer Holiday, Chittenden Solid Waste Management District, via telephone

              Neil Kamman, Vermont Agency of Natural Resources, Water Quality Division

              Ruma Kohli, Chemical Management Program Manager, IBM

              Senator Richard McCormack, Vermont State Senate

              Jeff Merrill, Vermont Agency of Natural Resources, Air Division

              Mary Jean Rajda, Porter Hospital

Guests Present:
             

              Matt Levin, Vermonters for Clean Environment

              Mark Smith, Massachusetts Department of Environmental Protection, via telephone

              Peter Taylor, Vermont State Dental Society

              Karen Knaebel, Vermont Agency of Natural Resources, Environmental Assistance

The Committee members and interested parties gathered at the Waterbury State Office Complex Laundry Building Conference room and by phone.  Michael Bender called the meeting to order.

Agenda Item 1
Review draft minutes from April 9 and June 19 meetings

Neil Kamman recommended a change to item 6 of the April 9 minutes to clarify that he briefed Agency of Natural Resources Secretary George Crombie on the mercury (total maximum daily limit) TMDL and suggested to that the advisory committee brief the Secretary on the work of the committee at some point.

The minutes of April 9 were approved with this change.

The draft minutes of the June 19 meeting were discussed. A quorum was not attained at this meeting and the Committee agreed by consensus that this was not a formal meeting of the Committee. The Committee also agreed by consensus to entitle the draft minutes “Meeting Notes” and include this document as a part of the public record, including posting on the web page of the Advisory Committee.

Agenda Item 2

Committee member concerns as a standing committee item

• Neil Kamman updated the Committee on the final draft mercury total maximum daily load (TMDL) which was expected to be issued this week. This mercury TMDL is a regional pollution control plan across all waters impaired by mercury pollution in the New England states and New York. The mercury TMDL was released for public comment and the vast majority of public comment supported it. There were also several meetings with EPA. In general, the TMDL says that the parties to the TMDL are addressing mercury reduction and controls in the region and the federal Clean Air Mercury Rule will only get us so far in addressing impaired waters; and that the burden is on EPA to make this happen. EPA will have 30 days to approve the TMDL when it is released.
• Neil Kamman also mentioned that new fish sampling from inland lakes has been accomplished, but the samples have not yet been processed.
• Michael Bender mentioned that the fourth and final meeting of the federal stakeholder process on surplus mercury was held. Industry (chloralkali plants and the mining sector) has been at the table as well as mercury traders. Mining members are committed to no primary mining, with the world’s largest mercury mines closed or closing, outside of China. The stakeholder group reached consensus on mercury export bans and the need for long-term storage of surplus mercury. Federal legislation has been introduced into the House (Tom Allen – Maine) and is working its way through the House Energy and Commerce Committee (currently in subcommittee) and appears that it may have bipartisan support.
• Michael Bender reported that the American Dental Association has come out in support of dental amalgam separator installation as a best management practice. The ADA Board of Delegates has also endorsed improvements to patient information on dental restorative material choices and will consider revising their current brochure. The press release was circulated.
• Michael Bender mentioned that the Great Lake states have issued a Draft Mercury Action Plan with a comment period that ends October 27. He indicated that this plan is a welcomed development that has aggressive action steps similar to what has been achieved in the Northeast through mercury legislation.
• Gary Gulka mentioned that DEC has initiated a residential mercury thermostat collection program for the months of October and November at over 80 hardware stores. Customers returning thermostats will receive $5 off the purchase of anything in the store (up to three thermostats per customer). The pilot is being funded through the Fifteen Mile Falls mercury reduction fund established in the re-licensing process for the hydroelectric dams on the Connecticut River. Information from this pilot will be used in as part of a legislative report that the Agency is responsible for submitting this January on thermostat collection recommendations and financial incentives. Newspaper and radio ads will be run in the coming weeks. (Some television coverage has occurred to date.) Jen Holliday was concerned that the public may not hear about the project and the Agency should be cautious on how it uses the results in evaluating the effectiveness of financial incentives. Michael Bender suggested that the Agency consider extending the pilot beyond two months and recommended that the Advisory Committee issue a press release in conjunction with Efficiency Vermont to further promote the program. The Committee agreed that Michael Bender would use the Agency press release to develop an ACMP press release, and perhaps partner with Efficiency Vermont, within the next two weeks. The ACMP press release would be circulated to Committee members before release.
• Karen Knaebel reported that Mary Jean Rajda and Neil Kamman have been re-appointed to the Advisory Committee.

The Committee agreed to reverse the order of agenda item 3 and 4.

Agenda Item 4
Mark Smith (Massachusetts Dept. of Environmental Protection) update on status of New England Governors’ and Eastern Canadian Premiers (NEGECP) Mercury Action Plan Updated and Status (via phone)

• MercuConcerns regarding information gathering studies that the ACMP is suggesting which is not seen in the CO report. Reindl commented that Colorado is remaining focused on in-state human cremation, and suggested contacting Mark McMillan regarding the Colorado report; study is continuing although nearing completion.ry Action Plan established and endorsed in 1998 by the New England Governors and Eastern Canadian Premiers (NEGECP). It was an adaptive implementation approach with a goal of 50% reduction in anthropogenic releases of mercury in the region by 2003 and 75% reduction by 2010. The 2003 goal has been met. The group is on target for 2010. The ultimate goal is the virtual elimination of anthropogenic mercury releases. The Mercury Task Force (comprised of state and Canadian province representatives) is on a two-year reporting cycle to the Environment Committee of the NEGECP and this year was a reporting year. The Mercury Task Force briefed the Environment Committee on May 1 and reported to the New England Governors and Eastern Canadian Premiers at their June meeting – this included a summary document, progress report, and proposed 2007-2009 work plan. Detailed reports were provided on amalgam separators, school cleanouts, outreach and education, pollution prevention and source reduction efforts, activities of interstate organizations, and updates on research and monitoring efforts. The work plan and documents were accepted by the Environment Committee.
• Dental Amalgam Separators – The goal in the plan was that amalgam separators would be installed in 75% of dental offices in the region by the end of 2005. The New England states reported 78% installation, although it is probably higher due to more recent installations mandated by various state laws. The Eastern Canadian Provinces reported 53% of dentists have installed separators, but the percentage is expected to be higher at the present time. There is a Canada-wide standard of 95% installation that is to be achieved either voluntarily, or if not achieved voluntarily, will become mandatory in the provinces. The Massachusetts Water Resources Authority (MWRA), the largest municipal wastewater treatment facility in Massachusetts (serving half of the state’s population), reported a 45-50% reduction in mercury concentrations in the municipal sludge, which is likely attributable to mercury release reductions in the dental sector (due to the timing of the reductions coinciding with the voluntary installation of separators in Massachusetts). In Toronto and Montreal, mercury reduction in sludge has been reported as 70% or higher, and also attributable to the installation of amalgam separators.
• Michael Bender asked Mark Smith if the Mercury Task Force is going to communicate amalgam success stories in the region to the Great Lakes states (prior to the close of comments on their Draft Mercury Action Plan) and the Environmental Council of States (ECOS) so that they can be informed and consider this information where there are gaps in the rest of the country for amalgam separator requirements. Mark Smith indicated that information has been shared on an ongoing basis with ECOS and the Quicksilver Caucus, and the information can certainly be shared with the Great Lakes states.
• Mark Smith reported that the Interstate Mercury Education and Reduction Clearinghouse will be coming out with a report in the next few weeks that describes and estimates the impact of regional mercury legislation on the reduction of mercury in products sold in the United States for between 2001 and 2004 reporting years. Data show that thousands of pounds per year of mercury have been eliminated from products that are sold.
• Mercury in Schools – Over 5000 pounds of mercury has been removed from schools in New England, including Vermont. About 85% of Massachusetts high schools have been cleaned out. Massachusetts is beginning work with community colleges – it is believed that there are significant quantities of mercury in colleges and they plan to expand this effort, including educating college students about the mercury problem. There is always some recalcitrance in the science teacher community to eliminate mercury, but the liability argument is compelling, and this helps to achieve a high degree of cooperation in the schools.
• Michael Bender stated that there may be large amounts of mercury in the industrial sector and suggested that the Mercury Task Force consider a way to address this issue at the time of sale or property transfer and through education and outreach. Comment that there are laws in place such as disposal bans that discourage improper management. Mark Smith indicated that he would bring this idea to the Mercury Task Force.
• Mercury Monitoring – Mark Smith indicated that fish contamination and hot spots of mercury contamination are of great interest in the region. Reduction in fish mercury levels has been reported in northeastern Massachusetts and some reductions in New Hampshire due to controls on municipal waste incineration. There are possibly some reductions of mercury in New Hampshire loons. Although there are some indications of improvements in environmental conditions, mercury levels still exceed levels of concern.
• 2007-2009 Work Plan – The Mercury Task Force estimated that 55% reduction of mercury releases was achieved by the end of 2005 and that the region is now over 60% reduction. He stated that good progress is being made towards the 75% reduction goal in 2010. The focal points of the work plan for 2007-2009 include the continuation of strategies underway such as coal-fired utility mercury reductions through regulatory controls in CT, MA, and NH, as well as keeping on course with mercury reductions in the dental sector. It is important to continue efforts on mercury reduction in sludges that are incinerated.. In 2009, there will be another evaluation of the major source categories of mercury releases in the region. In the area of research and monitoring, there will be continued work on environmental indicators of mercury levels in the biota. Hopefully monitoring programs will continue in the states. In the area of source reduction and safe management, there is considerable interest in the region in addressing the cleanup of broken fluorescent bulbs and developing more consistent guidance and education and outreach on cleanup. Maine is completing a study on mercury levels when bulbs are broken under controlled conditions. A regional meeting will be held in November for sharing of information among the states on broken lamp cleanup procedures. This will also hopefully build support for improved infrastructure for recycling of compact fluorescent bulbs. The Maine report will be completed in November.
• Michael Bender asked if retail collection of fluorescent lamps is being discussed. Mark Smith indicated that retail collection is on the table but nothing specific has been discussed.
• There was discussion that both the general public and state legislators are confused about the issue of mercury in fluorescent bulbs and there is a need for objective information from reliable or trusted sources about the health and safety implications. Mark Smith indicated that the upcoming state regional meeting in November on fluorescent lamp breakage and cleanup is an attempt at harmonized guidance which may help address this.
• Karen Knaebel indicated that various state agencies and organizations in Vermont became aware of the hysteria and confusion and has been coordinating to develop uniform guidance on cleaning up broken lamps – the Departments of Environmental Conservation and Health, as well as Efficiency Vermont, has been collaborating in this effort. There is also ongoing work to modify collection containers for CFLs to avoid breakage during collection and transport. There was discussion of the broken bulb situation in a household in Maine and the hysteria caused through media coverage. Michael Bender indicated that health and safety must be addressed but the issue is bigger. He felt that the Advisory Committee should become involved in this area and that strong guidance to legislature is needed. He stated that this issue should be discussed at the next meeting and that Vermont should take a leadership role.
• Mark Smith stated that mercury thermostat collection and recycling improvements are needed. This is also a priority for the Environmental Council of States (ECOS).
• Mark Smith indicated that there is a goal of 90% amalgam separator installation by 2010.
• Mark Smith indicated that there is increasing recognition about upwind national and international sources of mercury. One of areas of the work plan is capacity building and outreach – taking the northeast region’s mercury reduction success stories outside of region. As an example, he stated that he will be going to Taiwan to discuss mercury reduction efforts.
• Senator McCormack asked about increased mercury releases in hydroelectric dam impoundments. Mark Smith indicated that mobilization of methyl mercury in sediments and into the food chain occurs. Neil Kamman indicated that there are numerous studies that he can provide.
• Michael Bender asked about the information from IMERC on mercury reduction in products and when the data will be available, including the dental amalgam use data. Mark Smith stated that he believed the information would be available in a few weeks. Gary Gulka indicated that he would find out information on the availability of the report.
• Michael Bender mentioned that the article in Waste Management World on global mercury (authored by Michael Bender and Peter Maxson) is now available and suggested that it be shared as part of the outreach effort that Mark Smith mentioned.

Agenda Item 3
Election of Committee Chair

• The Committee discussed the pros and cons of a chair and vice chair rather than co-chairs. Recommendation that that if the chair is from the Agency of Natural Resources that the vice chair or co-chair be a non-state agency person. Some members expressed that they have no preference of co-chair or vice chair. The Advisory Committee members then reached consensus for having a chair and vice chair.
• Neil Kamman was nominated and seconded for committee chair. Neil Kamman indicated that regardless of who is chair, he will be relying on the international perspective of Michael Bender on mercury issues. Neil Kamman was elected as committee chair.
• Jen Holiday was nominated, seconded and elected as vice chair.
• Neil Kamman chaired the remainder of the meeting.

Agenda Item 5
Dental amalgam survey results

Gary Gulka explained the statutory requirement of dental amalgam use survey once every five years by the Agency of Natural Resources in collaboration with the Vermont State Dental Society (VSDS). The collaborative survey included questions related to whether amalgam is used, relative number of amalgam restorations placed, and trends in usage over time (increase or decrease). The Agency also obtained information on amalgam use by practice in the Dental BMP self-certification forms submitted by nearly every practice in the state.

Peter Taylor described survey results:

• 326 surveys mailed to individual dentists.
• There are about 236 practices.
• The survey was sent directly to dentists and not to the practice. The responses were individual responses, not responses by practice.

Summary of Survey Results

Surveys mailed   326
Responses         200
Response Rate   61%
167 responding dentists place restorations.

Of these, 33 responding dentists (20%) place only non-amalgam restoration and 134 (80%) use amalgam.

58% of dentists who use amalgam reported a decrease in use of amalgam over the last two years.

40% of dentists who use amalgam reported about the same amount of use over the last two years.

2% of dentists who use amalgam reported an increase in use over the last two years.

Of the dentists reporting that they use amalgam the following table is a breakdown of number of restorations placed weekly.

Of dentists using dental amalgam:

34% use amalgam 0-1 time per week

66% use it 10 times per week or less

86% use it 20 times per week or less

Dental Amalgam Use Results from Dental BMP Certification Filings

• 145 of 201 (71%) general dentistry practices use dental amalgam
• 29% of general dentistry practices do not use dental amalgam
• No information is available from these filings on relative amounts of amalgam used or whether or not there has been a change in use over time.
• Peter Taylor indicated that he firmly believes that there has been a continuing decline in amalgam use.
• Mary Jean Rajda had concern that dental insurance coverage of amalgam versus composite restorations is going to affect the amount of amalgam used. For example, some insurance providers will not pay for composites in molars. Peter Taylor stated that it is more common that insurance will cover a portion of the composite filling, equivalent to the cost of an amalgam filling.
• Michael Bender stated that the Advisory Committee might want to look into dental insurance and whether this is driving more or less use of amalgam.
• Michael Bender stated that the IMERC data on mercury use is an important piece. Use of amalgam from sales data shows a very small reduction. It was noted that although the IMERC data are for U.S. totals, he would like to see 2007 IMERC data as part of report to the legislature. He indicated that he wished there were more concrete and more frequent scientific information on amalgam use in Vermont. He is interested in seeing significant reduction in dental mercury use as in other sectors. He would like to have VSDS to take part in a collaborative effort to reduce dental mercury use.
• Mary Jean Rajda stated that she would like to know the reasons why one restoration was chosen over another. Matt Levine indicated that there are a variety of reasons why dentists make the decisions they do
• Peter Taylor stated that VSDS does not dictate what dentists use and the position of the VSDS is that the choice should be left up to the individual dentist.
• Jen Holliday stated that, more importantly, each patient needs information to make appropriate choices.
• Michael Bender asked if the Committee can obtain IMERC data on amalgam sales.
• Gary Gulka indicated that the data on amalgam sales will reflect national usage figures and would not help inform on amalgam use in Vermont. He stated that H.121 would require amalgam manufacturers or distributors provide Vermont-specific data on amalgam sold into the state on an annual basis and that the Committee may want make a recommendation in its report in support of this type of data.
• Peter Taylor stated that some data can be obtained from insurance companies on amalgam versus composite use, but insurers are hesitant to provide this proprietary information.
• Peter Taylor stated that about 50 percent of Vermonters have dental insurance and another question that comes into play is how this affects the choice of restorative materials. Mr. Taylor stated that it is the hope of VSDS that decline in amalgam use will continue, however, a mandate or ban on amalgam use is not acceptable to VSDS. He felt that the addition by ADA of amalgam separators to dental best management practices is a very positive thing and added that ADA does not take a position on mandates. Michael Bender requested a copy of the ADA delegates’ resolution. The ADA House of Delegates voted to have ADA revise its brochure and be more explanatory of the choices of filling materials. VSDS directed Peter Taylor to come up with a brochure. Peter Taylor stated that VSDS will wait and see what ADA develops. The ADA brochure will be developed before January. Peter Taylor stated that when the brochure is available, it should be available on line so dentists can print it out with minimal cost.
• Senator McCormack asked what is being done to improve alternatives to dental amalgam. Peter Taylor indicated that active research is ongoing. In any dental journal – all ads are directed toward composites. Mr. Taylor believes that dental materials manufacturers see the future in non-amalgam composites.
• Matt Levine with Vermonters for a Clean Environment stated the best person to write a patient brochure is the Commissioner of Health and stated that patients need more information on dental restorative materials. He indicated that his organization supports patient informed consent on the issue of dental amalgam use.
• Matt Levine provided the Committee with an update on legislation regarding dental amalgam. House bill (H.121) has gone from Fish, Wildlife and Natural Resources to Human Services. Neil Kamman suggested that the Committee should put H.121 and the Committee’s recommendation on the agenda for next meeting.
• Michael Bender indicated that it is really important to get the opinion of Bill Bress and the Health Department. He had an informal discussion with the Health Department about approaching the VSDS about potential voluntary pledges for amalgam use reduction by dentists. The amalgam use survey is a useful survey but there were questions that he would have liked to see that were not in the survey. Michael Bender stated that we need to know whether amalgam use is going down and we need more information about the dental insurance issue. He suggested a subcommittee on the insurance issue. He stated that it is a little premature to have a discussion on recommendations and that other information is needed first.
• Neil Kamman felt it is the Advisory Committee’s role to make recommendations in its report regarding H. 121. Jen Holliday stated that that the Committee got too bogged down on the health issue. Senator McCormack stated that he felt the Committee should go thru the bill line-by-line and see what it likes and does not like.
• Peter Taylor stated that oral health has not been considered in discussions. Both bills were sent to health and welfare committees because of health implications.
• Neil Kamman requested that the Committee members read the bill and be prepared at the next meeting to discuss what they like and did not like about the bill.

Agenda Item 6
Thimerosal in vaccines

• Matt Levin discussed S.81, Senator Snelling’s bill and H.114, the bill on thimerosal. He indicated that this issue is barely on the radar screen of legislators. Unless there is a lot of push and interest, it may fall by the wayside. If this committee wants to see something happen with this bill, it will have to make noise. The American Academy of Pediatrician’s opposes this bill. Informed consent rather than an outright ban may be the approach that is more logical. Jen Holiday asked if there is still concern that this state would become a dumping gound for mercury-containing vaccines. Matt Levine indicated that this is still a concern. Michael Bender posed the question of how the Committee wants to spend its limited amount of time.
• Neil Kamman stated that the Committee should look at language of the Committee’s recommendations last year and that the Committee might not need to spend a lot of time on the thimerosal issue.

Agenda Item 7
Set date and agenda for next meeting

Neil Kamman proposed the following agenda items for the next meeting:

• Compact fluorescent lamps and cleanup procedures
• College cleanouts
• Update on thermostat press release
• H.121 support or lack of support on dental amalgam
• H.114 on thimerosal

Michael suggested that Gary Gulka prepare an outline for the Committee report to the Legislature for the next meeting.

Gary Gulka stated that the Committee may want to discuss thermostats in December after the Department completes its thermostat pilot collection program.

Next meetings:

November 1 - 12:30 – 3:30 Chittenden Solid Waste District Offices, Williston

November 27 - 8:30 – noon Waterbury