Implications for Public Policy Environmental Justice and Public Health Education By Mark Mitchell MD MPH Minamata Treaty Goal Why is Mercury Exposure a Problem Minamata Treaty Requirements ID: 799485
Download The PPT/PDF document "Implementation of the Minamata Treaty on..." is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
Slide1
Implementation of the Minamata Treaty on Mercury in the U.S.
Implications for Public Policy, Environmental Justice, and Public Health Education
-By Mark Mitchell M.D., MPH
Slide2Slide3Minamata Treaty Goal
Why is Mercury Exposure a Problem?
Minamata Treaty Requirements
Sources of Mercury in the U.S.Why Focus on Mercury Products?Exposures in Vulnerable PopulationsPolicies Needed to Reduce Mercury Exposure
Overview
Slide4Minamata Convention on Mercury
Mercury Treaty Negotiations
Objective:
“…to protect the human health and the environmental from anthropogenic emissions and releases of mercury and mercury compounds.”
Slide5Mercury is an elementCannot be created or destroyed by humans
Can change in form to become more or less
Toxic
Biologically availableMercury is persistent, bioaccumulative and toxicWhy is Mercury a Problem?
Slide6Fish consumption is largest source
Fish consumption advisories in all 50 states
Mercury in commercial fish varies considerably
High mercury commercial fish:SwordfishKing Mackerel (not canned, Atlantic, or Pacific Mackerel)SharkTilefishTuna (especially albacore [white] tuna)Mercury amalgam tooth fillingsHave not been shown to cause direct harm in adultsSome medications and multi-dose vaccines
Particularly eye, ear, and nose antibioticsHave not been shown to cause direct harm to humans
Human Exposure to Mercury
Slide7To protect public health we must reverse the bioaccumulation in fish
To reverse bioaccumulation of mercury in fish, we must eliminate as much mercury released into air and water as possible on a global scale
The Minamata Convention on
Mercury attempts to do thisReversing Bioaccumulation in Fish
Slide8Reduce or eliminate mercury
from
artisanal and small-scale gold mining
.Control mercury air emissions from coal-fired power plants, coal-fired industrial boilers, certain non-ferrous metals production operations, waste
incineration and cement production.
Phase
out or reduce
mercury
in
manufacturing processes
chlor
-alkali
production,
vinyl
chloride monomer production, and
acetaldehyde
production.
Source:
www.epa.gov/mercury
Minamata Convention on Mercury Requirements
Slide9Phase-out or reduce mercury use in mercury containing products
batteries, switches, lights,
cosmetics, pesticides and measuring devices, reduce the use of (phase down) mercury in dental amalgamIn addition, the Convention addresses the supply and trade of mercury; safer storage and disposal, and strategies to address contaminated sites.
Minamata Convention on Mercury Requirements (cont’d)
Slide10Mercury Releases in the United
States—2000
(tons)*
Releases to Air
Releases to Water
Releases to Land
Intentional Use in Products
41
0.8
106
Combustion of Coal and
Other Fuels
60
0.2
33
Mining (mercury in
ore)
15
45
2585
Other
10
0.1
2
Total
126
46.1
2726
* Source: Cain, et al, Substance Flow Analysis of Mercury Intentionally Used in Products in the United States.
Journal of Industrial Ecology 2007
Vol
: 11(3):61-75. DOI: 10.1162/jiec.2007.1214
Slide11Mercury in products is (arguable) easiest source to eliminate in the U.S.
Mercury in
non-dental products has dropped 97% since 1980
(Source: EPA Strategy to Address Mercury Containing Products, Sept. 2014)Why Focus on Mercury Products?
Slide12Mercury in Products
Tons Released Per Year
Slide13Mercury Use in Dentistry is Declining
Eleven Low Amalgam Countries
Use of
mercury in dentistry is declining more slowly than in other products in U.S.
There are safe substitutesEven though only about 48-68% of dentists in the U.S. use dental amalgam,[1] dental amalgam still represents one of the leading uses of mercury in the United States at about 18 to 30 tons
annually (35 to 57% of use in products).[
2
][3]
Many other countries have virtually eliminated dental amalgam
Slide14Pregnant women and developing fetusWomen who might become pregnant
Nursing mothers
Young children
Subsistence fishers who fish from local watersPeople who engage in cultural practices using azogueThose who eat more than one or two tuna meals per weekThose from developing countries who live near mining or mercury storage or disposal sitesVulnerable Populations for Mercury Poisoning
Slide15People of Color are more likely to have high mercury levels
(Source:
Schober
, S et al: JAMA. 2003;289(13):1667-1674)From subsistence fishing or eating more local fishFrom eating more canned tunaFrom cultural practices using azogueLow Income people get amalgam fillings placed more oftenAmalgam is more likely to be used for American Indians, Alaska Native, Asians, and Pacific Islander patients while composite is more likely to be used in
other patients.[4
]
Medicaid often only covers cost of amalgam fillings
Patients often are not given a choice of fillings
Dental students are often required to place amalgam fillings in dental clinics
Environmental Justice Concerns
Slide16INCREASE fish consumption in pregnant women and children while REDUCING canned tuna and other higher mercury fish
Eliminate added mercury from products, as much as possible
Increase public awareness of
mercury in foods and products, and the availability of low mercury alternativesResearch alternatives to mercury in products where no good alternative currently exists Modify insurance to cover non-mercury dental products
Mercury Policies Needed in U.S.
Slide17[1]Haj-Ali R
,
Walker MP
, Williams K., Survey of general dentists regarding posterior restorations, selection criteria, and associated clinical problems, Gen Dent. 2005 Sep-Oct;53(5):369-75 (“A total of 714 dentists (26.3%) responded. Direct composite was the material used most commonly for posterior intracoronal restorations. Dentists in amalgam-free practices (31.6%) were significantly more likely (p = 0.001) to use direct composite than dentists whose practices used amalgam.”); U.S. EPA, Health services industry detailed study (August 2008), http://water.epa.gov/scitech/wastetech/guide/304m/upload/2008_09_08_guide_304m_2008_hsi-dental-200809.pdf, p.3-1 (“The survey found that 52 percent of dentists do not place amalgam fillings”).
[2] U.S. Geological Survey, Changing Patterns in the Use, Recycling, and Material Substitution of Mercury in the United States
(2013), p.26 (“Dental amalgam represents one of the leading uses of mercury in the United States at about 18 to 30 t annually and constitutes the largest amount of mercury in use in the United States
.”)
[3]
U.S
. Geological Survey,
Changing Patterns in the Use, Recycling, and Material Substitution of Mercury in the United States
(2013),
http://pubs.usgs.gov/sir/2013/5137/pdf/sir2013-5137.pdf
, p.1
[
4
]
Sonia K.
Makhija
, Valeria V.
Gordan
, Gregg H. Gilbert, Mark S. Litaker
, D. Brad Rindal, Daniel J. Pihlstrom and Vibeke
Qvist,
Practitioner
, patient and carious lesion characteristics associated with type
ofrestorative
material : Findings from The Dental Practice-Based Research Network
,
J Am Dent Assoc
2011;142;622-632,
http://jada.ada.org/content/142/6/622.long
References
Slide18Thank You
Questions?
mmitchell@enviro-md.com