From: Charles Brown \[brownchas@erols.com\]

Sent: Monday, September 16, 2002 7:11 PM

To: fdadockets@oc.fda.gov

Cc: Mary Ann Newell; sandy duffy

Subject: BOTH Dkt #01-D-0064 AND Dkt #01-N-0067, Against FDA Proposal

that Covers Up Risks of Mercury Dental Fillings

To FDA dockets manager:

The brief is attached first, followed by attachments.

We are mailing, today (Sept 16) this brief and attachments, INCLUDING

several additional attachments, including those not contained with a

computer. The mailed copy thus will have the complete list of
attachments.

Charles G. Brown, counsel

From [Consumers for Dental Choice, Inc]{.underline}.

For both Dockets: Dkt #01-D-0064 AND Dkt #01-N-0067

## [Against FDA Proposal that]{.underline}

## [Covers Up Risks of Mercury Dental Fillings]{.underline}

We object to the FDA proposed rule on substantive and procedural
grounds. The rule needs to be retracted and re-written. A new Advisory
Panel must be created and hold public meetings.

Mercury, the most toxic non-radioactive element and volatile heavy
metal, is now being removed from every use in the human body[^1] (save
one, dental fillings). An intense debate now divides dentistry on
whether amalgam fillings are safe, but about the toxicity of mercury
there is no such debate. Mercury dental fillings are toxic when they go
into the body, and a hazardous waste when they come out! And when they
are in the body, vapors constantly emanate from the fillings, a
particular hazard for the developing brains of children.[^2]

The FDA has condemned mercury in other health uses, e.g., in fish, in
vaccines, in disinfectants, even in products or medicines for horses. It
has chosen, uniquely, to call mercury dental fillings safe. The FDA has
no basis to separate mercury in dental fillings from other uses, and in
fact can cite no peer-reviewed studies, aye not one, which says mercury
fillings are safe. The FDA's first rationale, as it recites in its
myriad letters to Members of Congress, is the scientifically
preposterous claim that it is safe because it has been used for 150
years.

The FDA chose to be highly selective in what it cites. It ignores
scientific studies that show the huge health risks of mercury fillings.
It ignores state statutes calling for consumer protection -- in
California, Arizona, and Maine as of February 2002, more since \-- and
ignores resolutions such as that by the National Black Caucus of State
Legislators. When the source has information adverse to the FDA
position, the FDA mischaracterizes, or even falsifies that information.
For example, the FDA claims, falsely, that Sweden opted for mercury-free
dentistry for environmental reasons, when in fact it was for health and
environmental reasons, as the record demonstrates. The FDA trivializes
the enormously important Health Canada and its recommendations that
children and pregnant women not receive mercury fillings, instead
relying upon a less important provincial report. The FDA even ignored
the highly salient at the largest mercury amalgam manufacturer,
Dentsply, put on its MSDS back in 1997 that mercury fillings are
[contraindicated]{.underline} for children, pregnant women, and persons
with kidney problems or braces. With the tiniest amount of due diligence
-- or by turning to sources other than those supplied by the American
Dental Association -- the FDA could have found these facts and put them
in its findings.

The FDA ignores the voluminous 1999 report of the Public Health Service
\-- Agency for Toxic Substances and Disease Registry, U.S. Public Health
Service, [Toxicological Profile in Mercury]{.underline}, (Update) (1999)
\-- which says that mercury from dental fillings can harm the brain, and
is of highest risk to children getting mercury fillings (because their
brains are just developing "children are not little adults," the report
notes). It further notes that the mercury goes through the placenta to
the developing fetus, and through the breast milk into the suckling
infant. The report states that mercury toxicity is a major health
problem, and that the two primary sources of mercury exposure (except
for exposed workers) are mercury dental fillings and fish. The FDA is
quite concerned about mercury in fish, but AWOL when it comes to the
other major source, dental fillings.

The FDA has chosen to side with organized dentistry, its lone supporter
in saying mercury fillings are safe, and against the children of
America.

A growing movement in both the scientific and dental communities now
condemns amalgam. The government of Canada advised in 1996 against its
use for (1) pregnant women, (2) children, and people with: (3) kidney
problems, (4) braces, or (5) mercury allergies. Indeed, the major
manufacturer of amalgam warned back in 1997 that amalgam is
[contraindicated]{.underline} for those five vulnerable population
categories (again, including children and pregnant women).

Peer reviewed studies continue to point to the risks of amalgam.[^3]

Dentistry is divided on the issue. The American Dental Association still
supports its use, but its scientific basis is specious. First, its main
basis is "we have done the procedure for over 150 years," an
anti-scientific statement if there ever was one. Second, dentistry can
point to no peer-reviewed studies showing mercury fillings are safe,
instead citing the platitudes of government agencies who have done no
research but relied on the ADA, who has done no research either on
amalgam's safety. Third, the ADA gets money from amalgam manufacturers
for endorsing the product, a position condemned as unethical by the
American MEDICAL Association. (For years, the ADA also held patents on
amalgam further evidence of its economic-based support for the product.)
Fourth, dentistry uses a deceptive word for the product, something
medicine also condemns. Fifth, dentistry gives no warnings about the
product (even for allergic patients), something that medicine, again,
always tried to do (e.g., penicillin).

Several national dental societies are adverse to the ADA, strenuously
opposing placing mercury into human bodies.[^4] The California Medical
Association adopted a resolution in 2000 urging the abandonment of all
mercury-based products. The American Pediatric Medical Association
adopted a similar, albeit less specific, position in an official paper
released in 2001.

Congresswoman Diane Watson (Calif.) and Congressman Dan Burton (Ind.)
have introduced legislation to phase out mercury-based dental fillings
over five years, and stop their use immediately for children, pregnant
women, and nursing mothers. The bill, H.R. 4163, would give health
warnings between now and the phase-out of the product. Co-sponsors
currently include five more Members of Congress: Conyers (Mich.) J.
Carson (Ind.), J. Davis (Va.), Ford Jr. (Tenn.), and Hinchey (NY).
Similar bills have been introduced in several states, including Alabama,
Arizona, California, Georgia, Illinois, and Ohio. Consumer disclosure
laws were recently adopted in Maine and New Hampshire, and earlier in
Arizona and California.

I. The Advisory Panel met too distantly in the past to consider the
emerging science about the health risks of amalgam.

Dusted off from old files, the rule was launched without regard to the
science of the past seven years. The FDA took an Advisory Panel report
from 1993-94 -- eight years is not just old in science, it is ancient.
The agency makes a stab at perusing some of the literature since 1993,
but misinterprets or misses entirely anything not to its liking.

Since 1994, an amalgam manufacturer, Dentsply, has said amalgam is
CONTRAINDICATED for children, pregnant women, and people with braces,
kidney problems, or mercury allergies. The government of Canada has
recommended that dentists in that country not place such fillings in any
of those categories -- children, pregnant women, and those with kidney
problems, braces, or mercury allergies. That such spectacular
developments would escape the attention of the FDA shows the need for a
new advisory panel.

An important federal report, to which the FDA gave short shrift, is by
the Agency for Toxic Substances and Disease Registry, U.S. Public Health
Service: [Toxicological Profile in Mercury]{.underline}, (Update)
(1999). The report addresses the extreme harm of mercury toxicity, and
says its two main causes are fish and mercury dental fillings, or
mercury dental fillings and fish (except for employees in a
mercury-intensive work environment). The chief victims, the report says,
are children, because their brains are still developing, and because the
vapors from mercury dental fillings go first to the brain. At extreme
risk, too, are children still in the womb, because the mercury goes
through the placenta, and also nursing children, because the mercury
goes through the mother's breast milk. Small wonder that the populations
needing immediate protection from having mercury dental fillings are
children, pregnant women, and nursing mothers.

Meanwhile, no peer reviewed studies -- none, zero, nada \-- since 1994
point to amalgam's safety.

To rely upon an Advisory Panel from the early 1990s is both negligent
and plain legal error.

II\. There is no record that the Advisory Panel membership meets
statutory requirements. Even if so, the Panel does not reflect today's
reality of (1) consumer groups opposed to mercury amalgam, (2) diversity
and dissension within dentistry, and (3) opposition in the scientific
community.

The record needs to note the members and background of the Advisory
Panel.

A panel should include representatives of consumers who have organized
to oppose mercury dental fillings. Over the past decade, two broad-based
consumer organizations have emerged who should be included in any
consideration of the issue : Consumers for Dental Choice, Inc.
(headquartered in Washington, DC), and Dental Amalgam Mercury Syndrome,
Inc. (Minneapolis). More recently, a new umbrella coalition has been
formed, the Coalition to Abolish Mercury Dental Fillings. The case law
requires that such organizations should be invited to nominate members.

An ongoing petition by consumers seeks to ban amalgam. We incorporate it
by reference. http://www.PetitionOnline.com/mercury/petition.html.

The Advisory Panel should be constituted recognizing that (according to
the Utah-based Christiansen Institute) 28% of dentists are mercury-free,
and which therefore includes dentists drawn from any of the following
organizations: International Academy of Oral Medicine and Toxicology
(headquartered in Orlando, Fla.); American Academy of Biological
Dentistry (Carmel, Calif.), and/or Holistic Dental Association
(Steamboat Springs, Colo.). The above report states that the growth of
mercury-free dentists has gone from 3% in 1985 to 9% in 1995 to 28% in
2001. Dentists (but not the ADA) are increasingly recognizing the health
risks TO THEM of using mercury fillings. One indication: dentists have
the highest suicide rate of any profession.

The ADA has even admitted to even more startling data -- fewer than 50%
of all fillings are now mercury fillings. That too argues for composing
a committee of more than zealots for mercury.

Scientists who have studied this issue -- e.g., Professor Haley,
Professor Aposhian, Professor Summers, Professor Lorscheider, Dr. Vimy,
Dr. Hanson -- should be included if the panel is to meet legal standards
and have scientific and public credibility.

III\. There is no record of public meetings or hearings of the Advisory
Panel.

The regulation should list the activities of this Advisory Panel. We
have no way of ascertaining its functions, particularly since it met in
the distant past. The public has a right to view these meetings. That
they were done in a distant past means, with the emerging and
overwhelming consumer interest today in this issue, new meetings should
be held.

IV\. The report ignores the emerging science.

The scientific developments against using mercury amalgam fillings have
been overwhelming in the past decade. We have attached some of the many
studies. In addition, we incorporate into the record by reference three
web sites that contain hundreds of sources:
www.altcorp.com/amalgmpage.htm; www.home.earthlink.net/\~berniew1;
and http://www.vimy-dentistry.com/.

Attached is a summary of 20 peer-reviewed studies. It is disappointing
that the FDA staff either failed to notice them or chose to ignore them
(we are not sure which would be more disappointing). We have also
attached many studies in notebooks. Finally, here is a listing of a few
of the many books covering the health risks of mercury dental fillings:
(1) Levenson, Dr. Jack, [Menace in the Mouth]{.underline}. Brompton
Health, London, Sweden: 2000; Stortebecker, M.D., Ph.D., Patrick.
[Mercury Poisoning from Dental Amalgam: A Hazard to Human
Brain.]{.underline} Bio-Probe, Orlando, Florida: 1985; (2) Hardy, Dr.
James E., [Mercury Free: The Wisdom Behind the Global Consumer Movement
to Ban "Silver" Dental Fillings]{.underline}. Gabriel Rose Press, Inc.,
U.S.A.: 1996; (3) Huggins, Dr. Hal A., [It's All in Your Head: The Link
Between Mercury Amalgams and Illness.]{.underline} Paragon Press,
Honesdale, Pennsylvania: 1993; (4) Queen, H.L. [Your Personal Health
Guide: The Secret to Gaining & Maintaining Health.]{.underline} Queen
and Company Health Communications, Inc., Colorado Springs, Colorado:
1997; (5) Queen, H.L., [Chronic Mercury Toxicity: New Hope Against an
Endemic Disease.]{.underline} Queen and Company health communication,
inc., Colorado Springs, Colorado: 1988; (6) Ziff, Sam and Dr. Michael F.
Ziff, D.D.S. [Dentistry Without Mercury]{.underline}. Bio-Probe, Inc.,
Orlando, Florida: 2001; (7) Ziff, Sam and Dr. Michael F. Ziff.
[Infertility & Birth Defects: Is Mercury from Silver Dental Fillings an
Unsuspected Cause?]{.underline} Bio-Probe, Inc., Orlando, Florida: 1987;
(8) Atkins, M.D., Robert C., [Dr. Atkins New Diet
Revolution]{.underline}. Avon Books Inc., New York, New York: 1992; (9)
Brown J.D., Ellen Hodgson and Richard T. Hansen, D.M.D., [The Key to
Ultimate Health.]{.underline} Advanced health Research Publishing,
Fullerton, California: 1998.

We have included in the record the following book of *case studies*:
Davis, Mary. [Solving the Puzzle of Mystery Syndromes: Are Your Amalgam
Fillings the Missing Piece?]{.underline} Hott Off The Press Printing
Co., Des Moines, Iowa: 2000. The regulation falsely asserts that all
that can happen when a person becomes mercury toxic from dental fillings
is an allergic reaction -- it is the least problem when we are
discussing a bioaccumulative neurotoxin like mercury. This report, of
real people with real life stories, belies the claim of the FDA / ADA
that all consumers have to worry about with mercury is skin rashes!

Basically, the FDA sets out to prove amalgam is safe. Such a
result-oriented approach to science is bound to fail

-   Amalgam is 43 to 54% mercury.

-   No peer-reviewed studies say it is safe

-   Numerous peer review studies say it has risks

-   Case studies -- a report is attached \-- say it is highly risky

-   Other governments have issued warnings or entire phase-outs of its
    product

-   No peer-reviewed studies say it is safe. To rely upon one government
    agency quoting another, which cites 150 years of use as a
    "scientific" basis, is outrageous, both in science and in public
    policy.

> V. The FDA proposal severely limits public input.

The FDA compounds the problem by doing all it can to rush through this
rule. It is conducting no public hearings. It has no period to respond
to the comments of other responders. It invited the public to comment
via e-mail -- the only sure way to get mail through to the government
after 9/11 -- then listed a *web site* instead of an e-mail address.
Only the most technically proficient (those under age 21) could get
through. Consumers and dentists had to find an e-mail address, at the
11^th^ hour, to make submissions. Clearly, many more submissions would
have been made with a proper e-mail listing.

Even the ADA admits the issue is now a public controversy. It asked such
a question in a poll it just published, and found that 60 percent of the
public is still unaware of the "health controversy" (the ADA's words)
over amalgam. The FDA pretends what even the ADA no longer does -- that
the matter is one of public controversy. It is time this rule-making was
done in the public domain and both sides were presented within the
Advisory Panel and in the proposed regulation. This one-sidedness defies
current science, public policy, and the emerging intense public debate.

We have requested a 60-day extension for public comment. That request is
pending.

> VI\. The FDA is rushing through this proposal.

The proposal came on the heels of an announcement by Congresswoman
Watson that she would introduce legislation seeking to ban amalgam.
After the rule was proposed, she introduced the bill, joined by
co-sponsors Congressmen Burton, Ford, Hinckley, and McGovern, and
Congresswomen Carson and Davis (H.R. 4163).

The proposal also came amidst a flurry of proposals at the state level
to provide consumers disclosures or to ban dentists from performing the
procedure on children.

The American Dental Association opposes all such bills, even those
advocating disclosure.

The FDA did nothing for a decade, despite repeated petitions. Then, it
acted based on old data and an outdated Advisory Panel, with no public
hearings, and no rebuttal opportunity. Since the proposal mirrors the
position of organized dentistry totally, it is fair to surmise that the
FDA is acting only in response to, and to counter, developments opposed
by the American Dental Association.

> VII\. The rule is a bailout for the American Dental Association.

The FDA rule so closely mirrors the economic agenda of the American
Dental Association that we are frankly concerned about the agency's
independence from this special interest organization.

The rule pretends that the agency "inadvertently" failed to classify the
amalgam mixture. Actually, the agency did so intentionally, in order to
"pass the buck" to dentists on the safety question. Now that dentists
are being sued for failure to warn patients, or for harming children and
pregnant women by putting mercury in their bodies, the FDA rule seeks to
exonerate the dentist by declaring, retroactively, that the FDA meant to
do things differently. The FDA doesn't even proffer an explanation of
its "inadvertence."

The ADA has a huge vested interest in protecting the marketing of
amalgam:

\-- Through its Seal of Acceptance program, the ADA quietly takes
thousands of dollars from amalgam manufacturers, then declares amalgam
to be safe and effective. In fact, the ADA has never determined amalgam
to be safe. It has never done a peer reviewed study that shows amalgam
to be safe. It trumpets the wonders of amalgam in its trade magazines,
the Journal of the American Dental Association and ADA News, but neither
is a peer-reviewed journal.

\-- For years, the ADA had patents on amalgam. The patents have now
expired.

\-- Both the money taken from amalgam manufacturers and the patents
constitute a brazen conflict of interest by the ADA. The American
Medical Association has a strict policy against taking money for product
endorsements, because the practice is unethical, according to the AMA.
The ADA has no such ethical qualms.

\-- The failure of the ADA to note its revenue from amalgam
manufacturers, and its patents before they expired, while endorsing
amalgam, constitutes a deception on the public.

\-- Using amalgam is great dental economics, as it allows the dentists
to place the maximum number of fillings per hour and thus make more
money that fillings that take time to mold in the mouth. The ADA
policies, and the FDA regulation, put in place a system of protective
dental economics instead of public protection.

\-- The ADA has been sued for such practices. The FDA rule attempts to
shield the ADA by declaring amalgam to be safe.

\-- It is increasingly likely that many dentists will be sued for
failing to disclose the risks of amalgam. This rule constitutes a shield
for them, rather than providing information to the public.

> VIII\. The FDA appears to be attempting to pre-empt state consumer
> protection laws.

Among the most disappointing aspects of this proposal is the term
"uniform disclosure," which would infer an FDA effort to pre-empt state
consumer protection laws and bills. Note that the FDA did not act when
there was an absence of state laws -- it acted amidst a flurry of bills.
California passed a law in 1992, but it was never implemented by the
state Dental Board. Arizona passed a law in 2000, but with the same
non-result. In 2001, state legislative activity heated up:

-   The California Legislature shut down the Dental Board for failing to
    implement the Watson law, requiring disclosures of the risks of
    mercury fillings.

-   The Maine Legislature passed a tough disclosure bill.

-   The Arizona Legislature, through its budget bill, demanded
    compliance with the law enacted in 2001.

The FDA proposal does not even note the existence of the laws in
California (1992), Arizona (2000), and Maine (2001). Surely the FDA
knows of these laws. Their passage was constantly referenced in ADA
materials, apparently the only literature the FDA appears interested in
reading. To ignore the existence of such laws, while calling for
"uniform" disclosures, is another attempt to hide important information
that belongs in the public record.

But it is this year, on the heels of the federal proposal by
Congresswoman Watson, that put the mercury-free movement on the
political map. Bills were introduced in several states to phase out its
use, or for consumer disclosures, including (sponsor name in
parentheses) California (Assemblyman Dickerson), Washington (Lieutenant
Governor Owen), Arizona (Representative Brimhall), Alabama
(Representative Rogers, et al.) Georgia (Representative Holmes, et al.),
Illinois (Representative Flowers), and New Hampshire (Representative
Lynde). The New Hampshire bill has been enacted into law. In addition,
the Maine Legislature enacted a law to implement the law it passed the
year before.

Predictably, the ADA (in *ADA News*) referenced this FDA regulation
(even though it is not enacted) as a basis to invalidate the Dickerson
bill in California, A.B. 2270. The ADA is obviously so confident that
the FDA will enact the mirror of its own position that it is touting the
regulation as being in force and effect.

Does the FDA plan to pre-empt? If so, it should say so, boldly, instead
of hiding the ball on its intentions.

> IX\. The regulation is punitive to lower-income and
>
> minority families.

As Americans wise up to the reality that "silver" fillings are really
"mercury" fillings, they are converting to alternatives. Unfortunately,
the "they" does not include families in Medicaid or families on limited
insurance plans. Most third-party payment systems have a policy of
"mercury fillings or no fillings." For low- and moderate-income
Americans, there is in reality no choice.

The origin of the system of paying only for mercury fillings lies with
the American Dental Association. Delta Dental Plan was created by the
ADA, and historically controlled by dentists in most states. Delta
Dental set the pace: insure for the ADA's favorite filling material:
mercury.

The FDA could lead the way to transitioning of third-party payment
systems (government and private), by issuing proper warnings. Payment
plans could evolve into paying for the slightly higher-priced filling
material, as the State of Maine is doing right now. A law on informed
consent is leading Maine toward paying for alternatives for Medicaid
patients. (*Bangor Daily News*, May 20, 2002).

> X. The proposal contains factual errors and is intellectually
> dishonest.

For example, the proposal says that mercury is classified as Class II
when it is currently Class I. The proposal says Sweden and other
countries adopted anti-amalgam policies for environmental reasons, when
health reasons were also important.

More important than its specific errors is the overall intellectual
dishonesty of the proposal. It pretends that the scientific literature
favors mercury fillings, when the only favorable reporting is by
agencies who make vague claims mirroring the ADA position, and when the
scientific literature is against mercury in all uses. It pretends state
laws do not exist. It ignores manufacturer warnings, Proposition 65
enforcement actions, legal actions, and any other material adverse to
the ADA. It is a Pollyannaish tribute to one of the most toxic elements
and the most volatile heavy metal.

> XI\. The Proposal Does Not Provide the Specific Warnings that Will
> Issue.

After its apology piece for mercury amalgam, the proposal fails to state
with specificity what warnings will issue on each product, and how.
Forcing the public to comment in May, then facing an October surprise on
a finalized rule, is unfair to all concern, and fails to provide the
specificity required in rule-making.

> XII\. Because of the widespread consumer deception, the FDA must be
> especially vigilant in its warnings.

Organized dentistry has a two-part strategy to keep consumers from
learning that mercury is the main component of amalgam, and that its use
is highly controversial. First, the ADA promotes the fillings as
"silver" fillings, a not surprising step considering that the term
"mercury" fillings would draw attention from most parents, and could
hurt the ADA's future payouts from amalgam manufacturers. The public
understandably believes the fillings are "silver." Indeed, the ADA
boasts about a recent survey that 60% of the public is unaware of the
mercury controversy.

Second is the ADA gag rule, as enforced by state dental boards. By
enjoining dentists from initiating warnings to their patients, the ADA
and the dental boards maintain a silence that keeps the public from
learning even that the fillings are mercury, and about health risks as
well. The American Civil Liberties Union challenged the Oregon gag rule,
successfully, as did the Goldwater Center in Arizona. In many other
states, however, the gag rule remains.

In this circumstance, the FDA must take extraordinary steps to override
a conspiracy of silence and get the health warnings out. Instead, the
FDA takes the opposite approach: disclose nothing, and override those
states who are trying to provide warnings!

> XIII\. Amalgam should be classified as Class III.

There is one category, and one alone, to which amalgam belongs: Class
III. The scientific literature we and others submit make that clear.

The FDA has no place in comforting or confirming a medical practice
simply because it has been used for a long time. Amalgam products are
constantly new and remade; there is no "grandfathering" issue here. It
is time the FDA abandons politics and economics, and returns to its
legislative mission of protecting American consumers.

Amalgam is a Class III product. The issue is not a close call.

# SUMMARY

We hereby request

-   A new Advisory Panel be empanelled, to review the science of the
    past seven years.

-   An extension period for public comment.

-   A right to reply to the comments of organized dentistry, who
    submitted platitudes from other government agencies instead of
    peer-reviewed science.

-   A public hearing.

We request a total re-writing of the rule, one that includes the
following:

-   A clarification of the preemption question concerning state laws and
    regulations.

-   A description of what the disclosure will actually say, so that we
    may comment specifically.

-   A proposal devoid of factual errors.

-   An explanation of the "inadvertent" failure to classify, an event of
    over a decade ago that was never addressed until now, and which is
    addressed without explanation.

-   A rule that contains scientific research negative to amalgam.

We request that any final rule which issue

-   Classify amalgam as a Class III substance, or

-   Prohibit amalgam for children, pregnant women, nursing mothers, and
    people with braces, and provide strong warnings for all others.

Respectfully submitted,

Charles G. Brown, counsel

Consumers for Dental Choice, Inc.

1616 H St., N.W., Suite 810

Washington, DC 20006

Phone 202.347-9112. Fax 202.347-9114

E: brownchas@erols.com

TOXICOLOGICAL PROFILE FOR MERCURY (UPDATE)

U.S. DEPT. OF HEALTH AND HUMAN SERVICES

PUBLIC HEALTH SERVICE

AGENCY FOR TOXIC SUBSTANCES AND DISEASE REGISTRY

1999

# *Selected quotations:*

MERCURY EXPOSURE

Page 7: "The mercury from dental amalgam may contribute 0 to more than
75% of your total daily mercury exposure, depending on the number of
amalgam fillings you have, the amount of \[and levels of mercury in
the\] fish you consume, ... and exposure from less common sources of
mercury."

MOTHER TO BRAIN OF FETUS

Page 12: "Methylmercury that is in the blood of a pregnant woman will
easily move into the blood of the developing child and then into the
child's brain and other tissues." Methylmercury will change into organic
mercury, and "remain \[in the brain' for a long time."

MOTHER TO NURSING INFANT

Page 12: "As with inorganic mercury, some of the methylmercury in a
nursing woman's body will pass into breast milk.

BRAIN DAMAGE

Page 13: "Permanent damage to the brain has also been shown to occur
through exposure to sufficiently high levels of metallic mercury."

AMALGAM AND MERCURY EXPOSURE

Page 29: "The general population is commonly exposed to mercury
primarily from two sources: (1) eating fish ... or (2) from the release
of elemental mercury from the dental amalgam used in fillings."

EFFECT ON DENTISTS

Page 63: "Dentists with an average of 5.5 years of exposure to low
levels of mercury showed impaired performance on several neurobehavioral
tests."

EFFECT ON WOMEN DENTAL PERSONNEL

Page 278: "Reproductive effects. ... Female dentists and dental
assistants exposed to metallic mercury vapors had increased reproductive
failures (spontaneous abortions, stillbirths, and congenital
malformations) and irregular, painful, or hemorrhagic menstrual
disorders. Correlations were observed between the incidence of these
effects and hair mercury levels."

RESPIRATORY EFFECTS

Page 264: "Inhalation of metallic mercury vapor may result in clinical
respiratory symptoms."

NEUROLOGICAL EFFECTS

Page 276: "The nervous system is the primary target organ for elemental
and methylmercury-induced toxicity."

DEVELOPMENTAL EFFECTS

Page 280: "Mercury is considered a developmental toxicant."

AMALGAM AND M.S.

Page 299: "Siblerud and Kienholz (1997) investigated whether mercury
from ... amalgam may be an etiological factor in multiple sclerosis."
(The report then goes through several data supporting such a
correlation.)

CORRELATION OF AMALGAM AND REDUCED IMMUNITY

Page 300-01: "Accumulation of heavy metals form dental amalgam, as well
as from other sources, may lower the threshold of an individual metal to
elicit immune aberrations, which could lead to overt autoimmunity

AMALGAM AS LARGEST POTENTIAL SOURCE OF MERCURY

Page 439: "Dental amalgams potentially represent the largest single
contributing factor of mercury exposure in some individuals with large
numbers (\>8) of amalgam fillings." The study then spends several pages
going through research indicating large exposure from amalgam fillings,
several such studies showing a larger exposure than fish.

CHILDREN

Page 455 : "Children are not small adults." The report shows how
children may have greater exposure and have greater risks from mercury.

Page 455: "Significant health risks, including numerous
neuropathological and neurobehavioral effects, are associated with
prenatal exposure to methylmercury."

CALIFORNIA MEDICAL ASSOCIATION HOUSE OF DELEGATES

Resolution 115-00 (2000)

Title: Preventing Human Mercury Exposure

Author: Robert M. Gould, MD

\> Whereas, mercury is a component of consumer and medical products
which,

when discarded, become a fuel for waste incinerators, ultimately
accounting for approximately 30% of the 158 tons of human-generated
mercury emissions released to the air annually in the U.S.;\[1\] and,

\> Whereas, it is understood that when inorganic mercury is released
into the environment, microbial biotransformation produces
methylmercury,

especially in aquatic environments, and that this organic compound
accumulates as one moves up the food chain;\[2\] and,

\> Whereas, methylmercury is known to adversely affect the nervous and
reproductive systems of humans, with particular danger posed to the
developing brain, manifested by neuro-developmental deficits such as
cerebral palsy and mental retardation, as well as developmental delays
such as delayed walking and speech, and other disabilities that may be
latent in infancy, and which may appear only later in childhood;\[3\]
and,

\> Whereas, avoiding incineration of mercury-containing wastes and
adopting mercury-free product alternatives is fundamental to a primary
prevention approach that reduces human and wildlife exposure to mercury;
and,

\> Whereas, it is known that appropriate alternative mercury-free
products are currently available for many mercury-containing consumer
and healthcare products;\[4\] and,

\> Whereas, the American Hospital Association has signed a Memorandum of
Understanding with the EPA to phase out mercury-contaminated waste in
hospitals by the year 2005, while highly-effective programs for the
virtual elimination of mercury from hospital waste through use of
mercury-free alternative products have been initiated in the
U.S.;\[5\]therefore be it

RESOLVED: That the California Medical Association encourages the reduced

use of mercury-containing products by urging medical product suppliers
to continue to develop, produce, and bring to market appropriate,
cost-competitive, environmentally protective, and effective mercury-free
replacements; and, be it further

RESOLVED: That the CMA calls upon health care professionals to encourage

the institutions with which they are associated to adopt policies that
will

lead toward the eventual elimination of mercury containing products
where feasible, effective alternatives are available, and to promptly
eliminate mercury from the waste-stream fed into incinerators.

References:

1\. US Environmental Protection Agency. *Mercury Study: Report to
Congress, Vol II, An Inventory of Anthropogenic Mercury Emissions in the
United States*, Washington DC: US Environmental Protection Agency,
Office of Air Quality Planning Standards and Office of Research and
Development; 1997. EPA/452/R-97-004; Northeast States and Eastern
Canadian Provinces. *Mercury Study: A Framework for Action*, 1998.

2\. Agency for Toxic Substances and Disease Registry. Mercury Fact
Sheet, U.S. Department of Health and Human Services, Public Health
Service, September 1995.

3\. US Environmental Protection Agency, *Mercury Study: Report to
Congress, Vol VII, Characterization of Human Health and Wildlife Risks
from Mercury Exposure in the United States*, Washington DC: US
Environmental Protection Agency, Office of Air Quality Planning
Standards and Office of Research and Development; 1997.
EPA/452/R-97-009; Watanabe C, Satoh H., *Evolution of Our Understanding
of Methylmercury as a Health Threat*. Environ Health Perspect. 1996,
104(Suppl 2): 367-379; Weiss B, Reuhl K., *Delayed Neurotoxicity: A
Silent Toxicity in Principles of Neurotoxicology*, Louis W. Chang, ed.
Marcel Dekker, New York: publisher, 1994.

4\. Michigan Mercury Pollution Prevention Task Force, *Mercury Pollution
Prevention in Michigan*, 1996; National Wildlife Federation, *Mercury
Pollution Prevention in Healthcare: A Prescription for Success*, 1997.

5\. American Hospital Association: Memorandum of Understanding between
the United States Environmental Protection Agency and the American
Hospital Association, June 24, 1998; Environmental Working Group and
Healthcare Without Harm. Greening Hospitals: An Analysis of Pollution
Prevention in America\'s Top Hospitals, 1998

RESOLUTION -- National Black Caucus of State Legislators

WHEREAS:

1)  The major ingredient of dental amalgam (43 to 54%) is mercury;

2)  Mercury is an acute neuro-toxin;

3)  Each mercury amalgam filling contains about one-half to
    three-fourths gram of mercury, the same amount of mercury as is in a
    mercury thermometer;

4)  The mercury in dental amalgam continually emits poisonous vapors
    while in the dental filling;

5)  The term "silver" to describe a product that has substantially more
    mercury than silver does not accurately convey needed information to
    consumers;

6)  Mercury is being removed from all other health care uses, such as
    vaccines, disinfectants, and contact lenses. Many health
    organizations, such as the American Public Health Association, the
    California Medical Association, and Health Care Without Harm,
    recommend removing mercury from all health products.

7)  Children under 18, pregnant women, and nursing mothers may be at
    particular risk to mercury exposure, because the mercury goes to the
    developing brain, through the placenta, and through the breast milk,
    according to the Agency for Toxic Substances and Disease Registry of
    the United States Public Health Service. Several authorities,
    including manufacturers who have issued contraindications and the
    Government of Canada, warn that children and pregnant women are at
    particularized risk for exposure to mercury amalgam;

8)  Consumers and parents have a right to know, in advance, that, in the
    words of the California Dental Board: *"There exists a diversity of
    various scientific opinions regarding the safety of mercury dental
    amalgam"*;

9)  Alternatives to mercury-based dental fillings exist, such as resin
    composite and porcelain;

10) Medicaid and many third-party payment health plans do not allow
    consumers to choose alternatives to mercury amalgam, so poor
    children's only options are mercury fillings or no fillings at all;
    and

11) The states of Arizona, California, and Maine have passed laws
    providing warnings to consumers about the risks of "silver"
    (mercury) dental amalgam, and Rhode Island has passed a law giving
    consumers on insurance plans full choice on the type of fillings
    they may have.

THEREFORE, the National Black Caucus of State Legislators recommends:

1\. States enacts laws providing warnings to all consumers that

(a) Silver fillings are about 50% mercury, a neuro-toxin and
    environmental hazard;

(b) There exists a diversity of various scientific opinions regarding
    the safety of mercury dental amalgam;

(c) Particularized concern has been expressed regarding the health
    effects on children, pregnant women, and nursing mothers;

2\. States enact laws to provide choices to all consumers, so that
Medicaid families and moderate-income consumers on insurance plans will
be able to choose alternatives to mercury amalgam.

*NAACP Delegates overwhelming voted for, on July 9, 2002*:

Mercury Dental Fillings

(From Alexandria, Virginia, Branch)

-   WHEREAS, Mercury is toxic; a human being with mercury toxicity can
    suffer grave health consequences; and

-   WHEREAS, Mercury is such a toxic element that it is being removed
    from all uses in or affecting the human body, such as vaccines,
    disinfectants, and thermometers, with the sole exception to date of
    mercury-based dental fillings; and

-   WHEREAS, the major ingredient of so-called "silver" fillings is
    mercury (43 to 54%); and

-   WHEREAS, many health organizations, such as the American Public
    Health Association, the California Medical Association, and Health
    Care Without Harm, recommend removing mercury from all health
    products; and

-   WHEREAS, children under 18, pregnant women, and nursing mothers are
    at particular risk to mercury exposure: and

    i.  according to the Agency for Toxic Substances and Disease
        Registry of the United States Public Health Service, they are at
        risk because the mercury goes to the still-developing brain of
        children, through the placenta of the pregnant women to the
        fetus, and through the breast milk of the nursing woman to the
        baby;

    ii. several authorities, including manufacturers who have issued
        contraindications and the Government of Canada, warn that
        children and pregnant women are at particularized risk for
        exposure to mercury amalgam; and

    iii. a health risk exists when mercury dental fillings are placed in
         human teeth, and, for children and pregnant women.

-   WHEREAS, alternatives to mercury-based dental fillings exist, such
    as resin composite and porcelain; and

-   WHEREAS, Medicaid and many third-party payment health plans do not
    allow consumers to choose alternatives to mercury amalgam, so poor
    children's only options are mercury fillings or no fillings at all;
    and

-   WHEREAS, low-income people are more likely to have larger numbers of
    mercury dental fillings; and

-   WHEREAS, the National Black Caucus of State Legislators has passed a
    resolution calling for

(a) full disclosure of the existence and risk of mercury dental
    fillings;

(b) special protections for children and pregnant women, and

(c) a choice of fillings for low- and moderate-income Americans.

-   WHEREAS, a bill sponsored by Congresswoman Diane Watson (D-Calif.)
    and Dan Burton (R-Ind.) would stop mercury dental fillings being
    placed in children and pregnant women, provide health warnings for
    all, and phase out all mercury in dental fillings in five years.

THEREFORE, BE IT RESOLVED that the National Association for the
Advancement of Colored People call for:

1.  disclosure be required to all dental patients (a) that the main
    material in so-called silver fillings is mercury (not "silver"), (b)
    that mercury is highly toxic, and (c) that such fillings constitute
    a hazardous waste when removed;

2.  a ban on mercury dental fillings being placed in young children,
    pregnant women, or nursing mothers;

3.  all Americans, including families on Medicaid and/or dental
    insurance plans be given a choice of dental fillings, including the
    right to choose alternatives to mercury fillings;

4.  The United States Congress give immediate consideration to the
    Watson-Burton bill to phase out all mercury in dentistry within five
    years; and

5.  State Legislatures to give immediate consideration to legislation
    comparable to the Watson-Burton Bill.

[^1]: \(1\) Mercurochrome and merthiolate, disinfectants, are banned.
    (2) The CDC has directed that a mercury-based preservative
    (thimerosal) be removed from childhood vaccines and over-the-counter
    cosmetics/drugs (ex. contact lens solution). (3) Mercury
    thermometers are now banned in many states, e.g., California. (4)
    The American Public Health Association, the California Medical
    Association, and Health Care Without Harm have all called for the
    elimination of putting any mercury-based products into the human
    body.

[^2]: Agency for Toxic Substances and Disease Registry, U.S. Public
    Health Service, [Toxicological Profile in Mercury]{.underline},
    (Update) (1999).

[^3]: For a listing of the many scientific studies, see
    www.altcorp.com/amalgmpage.htm, and
    www.home.earthlink.net/\~berniew1.

[^4]: The International Academy of Oral Medicine & Toxicology, the
    American Academy of Biological Dentistry, the Holistic Dental
    Association.