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ASSESSING EPA’S EFFORTS TO MEASURE AND REDUCE MERCURY POLLUTION FROM DENTIST OFFICES

HEARING

BEFORE THE

SUBCOMMITTEE ON DOMESTIC POLICY

OF THE

COMMITTEE ON OVERSIGHT

AND GOVERNMENT REFORM

HOUSE OF REPRESENTATIVES

ONE HUNDRED ELEVENTH CONGRESS

SECOND SESSION

MAY 26, 2010

Serial No. 111–139

Printed for the use of the Committee on Oversight and Government Reform

(

Available via the World Wide Web:http://www.fdsys.gov

http://www.oversight.house.gov

(II)

COMMITTEE ON OVERSIGHT AND GOVERNMENT REFORM

EDOLPHUS TOWNS, New York, Chairman

PAUL E. KANJORSKI, Pennsylvania

CAROLYN B. MALONEY, New York

ELIJAH E. CUMMINGS, Maryland

DENNIS J. KUCINICH, Ohio

JOHN F. TIERNEY, Massachusetts

WM. LACY CLAY, Missouri

DIANE E. WATSON, California

STEPHEN F. LYNCH, Massachusetts

JIM COOPER, Tennessee

GERALD E. CONNOLLY, Virginia

MIKE QUIGLEY, Illinois

MARCY KAPTUR, Ohio

ELEANOR HOLMES NORTON, District of

Columbia

PATRICK J. KENNEDY, Rhode Island

DANNY K. DAVIS, Illinois

CHRIS VAN HOLLEN, Maryland

HENRY CUELLAR, Texas

PAUL W. HODES, New Hampshire

CHRISTOPHER S. MURPHY, Connecticut

PETER WELCH, Vermont

BILL FOSTER, Illinois

JACKIE SPEIER, California

STEVE DRIEHAUS, Ohio

JUDY CHU, California

DARRELL E. ISSA, California

DAN BURTON, Indiana

JOHN L. MICA, Florida

JOHN J. DUNCAN, JR., Tennessee

MICHAEL R. TURNER, Ohio

LYNN A. WESTMORELAND, Georgia

PATRICK T. MCHENRY, North Carolina

BRIAN P. BILBRAY, California

JIM JORDAN, Ohio

JEFF FLAKE, Arizona

JEFF FORTENBERRY, Nebraska

JASON CHAFFETZ, Utah

AARON SCHOCK, Illinois

BLAINE LUETKEMEYER, Missouri

ANH ‘‘JOSEPH’’ CAO, Louisiana

——— ———

RON STROMAN, Staff Director

MICHAEL MCCARTHY, Deputy Staff Director

CARLA HULTBERG, Chief Clerk

LARRY BRADY, Minority Staff Director

SUBCOMMITTEE ON DOMESTIC POLICY

DENNIS J. KUCINICH, Ohio, Chairman

ELIJAH E. CUMMINGS, Maryland

JOHN F. TIERNEY, Massachusetts

DIANE E. WATSON, California

JIM COOPER, Tennessee

PATRICK J. KENNEDY, Rhode Island

PETER WELCH, Vermont

BILL FOSTER, Illinois

MARCY KAPTUR, Ohio

JIM JORDAN, Ohio

DAN BURTON, Indiana

MICHAEL R. TURNER, Ohio

JEFF FORTENBERRY, Nebraska

AARON SCHOCK, Illinois

——— ———

JARON R. BOURKE, Staff Director

(III)

C O N T E N T S

Page

Hearing held on May 26, 2010 ............................................................................... 1

Statement of:

Stoner, Nancy, Deputy Assistant Administrator for Water, U.S. Environmental Protection Agency, Office of Water ................................................. 10

Walsh, William, of counsel, Pepper Hamilton, LLP, representing American Dental Association; Steven Brown, executive director, the Environmental Council of the States; Alexis Cain, scientist, U.S. Environmental Protection Agency, Region 5; and John Reindl, Mercury Policy

Project ............................................................................................................ 74

Brown, Steven ............................................................................................ 82

Cain, Alexis ................................................................................................ 92

Reindl, John ............................................................................................... 98

Walsh, William .......................................................................................... 74

Letters, statements, etc., submitted for the record by:

Brown, Steven, executive director, the Environmental Council of the

States, prepared statement of ...................................................................... 84

Burton, Hon. Dan, a Representative in Congress from the State of Indiana, prepared statement of .......................................................................... 28

Cain, Alexis, scientist, U.S. Environmental Protection Agency, Region

5, prepared statement of .............................................................................. 94

Kucinich, Hon. Dennis J., a Representative in Congress from the State

of Ohio:

Information concerning regulation sales trend ....................................... 53

Letter dated May 26, 2010 ....................................................................... 110

Letter dated May 28, 2010 ....................................................................... 38

Letter dated May 28, 2010 ....................................................................... 116

Prepared statement of ............................................................................... 4

Prepared statement of Alfred Dube ......................................................... 68

Reindl, John, Mercury Policy Project, prepared statement of ...................... 100

Stoner, Nancy, Deputy Assistant Administrator for Water, U.S. Environmental Protection Agency, Office of Water, prepared statement of ......... 13

Walsh, William, of counsel, Pepper Hamilton, LLP, representing American Dental Association, prepared statement of ......................................... 77

Watson, Hon. Diane E., a Representative in Congress from the State

of California, prepared statement of ........................................................... 62

(1)

ASSESSING EPA’S EFFORTS TO MEASURE AND

REDUCE MERCURY POLLUTION FROM DENTIST OFFICES

WEDNESDAY, MAY 26, 2010

HOUSE OF REPRESENTATIVES,

SUBCOMMITTEE ON DOMESTIC POLICY,

COMMITTEE ON OVERSIGHT AND GOVERNMENT REFORM,

Washington, DC.

The subcommittee met, pursuant to notice, at 2:10 p.m. in room

2154, Rayburn House Office Building, the Honorable Dennis J.

Kucinich (chairman of the subcommittee) presiding.

Present: Representatives Kucinich, Cummings, Watson, Jordan,

and Burton.

Staff present: Jaron R. Bourke, staff director; Charisma Williams, staff assistant; Leneal Scott, IT specialist, full committee;

Ashley Callen, minority counsel; and Molly Boyl, minority professional staff member.

Mr. KUCINICH. We are going to call the meeting to order. The

Subcommittee on Domestic Policy of the Committee of Oversight

and Government Reform will now come to order.

We are joined by our ranking member, Mr. Jordan. Thank you.

Today’s hearing is the third held by our subcommittee on the

subject of the pollution from mercury used in dentistry. This hearing, the first to be held during the Obama administration, will examine actions undertaken by the EPA and other stakeholders to

improve measurement of and limit mercury pollution from dental

sources.

Without objection, the Chair and ranking minority member will

have 5 minutes to make opening statements, followed by opening

statements not to exceed 3 minutes by any other Member who

seeks recognition.

Without objection, Members and witnesses may have 5 legislative days to submit a written statement or extraneous materials for

the record.

Mercury, especially methylmercury, is a very serious environmental and public health threat. It is persistent and bio-accumulative in nature and can cause birth defects, chronic illnesses, mental

disorders, autoimmune disorders, and neurodegenerative diseases

in human beings. Young children and unborn fetuses are particularly susceptible to mercury toxicity.

The largest source of mercury air emissions is smoke from coalburning power plants, about 50 tons per year. The next tier of

major mercury air emissions is attributable to incineration of autoVerDate 11-MAY-2000 14:34 Jun 09, 2011 Jkt 000000 PO 00000 Frm 00005 Fmt 6633 Sfmt 6633 C:\KATIES\DOCS\65133.TXT KATIE PsN: KATIE
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mobiles and mercury switches and pollution from industrial and

commercial boilers. Each of these emissions is about 71⁄2 tons per

year.

Today’s hearing addresses what scientific evidence suggests may

be an unrecognized member of that second tier of major source of

mercury pollution. Currently, dentists use more than 20 tons of

mercury per year in dental fillings, replacing or repairing current

fillings or putting new fillings in. Where does all that waste mercury go? Often it goes down the drain, and if there isn’t a major

storm causing the sewers to overflow, the waste mercury ends up

in a public water treatment works where it settles into biosolid

sludge.

Many municipalities burn this sludge in incinerators. The mercury in incinerated sludge is vaporized and goes into the air. Over

1,000 tons of mercury are currently in the teeth of Americans. Millions of Americans opt for cremation at death. When corpses are

cremated, the mercury in their teeth goes up in the air.

How much dental mercury ends up in the air? According to official estimates from EPA, the amount of mercury released into the

air when sewage sludge is incinerated is small, about 0.6 tons per

year. According to EPA, the amount of mercury emitted into the air

from cremation is also insignificant, about 0.3 tons per year. But

actual mercury emissions from crematoria and sludge incinerators

may be more than five times greater than EPA’s official estimates.

EPA, itself, admits its estimates of air emissions from sewer

sludge incinerators are poor and unreliable. EPA’s estimate for

emissions from crematoria is also suspect because it is based entirely on tests conducted more than 10 years ago on a single crematorium. No effort was made at the time to determine whether or

not the test was conducted as a representative sample.

In spite of these deficiencies, EPA never changed its air emission

estimates for sludge incinerators and crematoria, and they are repeated in EPA’s written testimony today. But we have found one

EPA scientist whose scientific research disputes the official estimates. He will testify today on his own behalf, because his scientific work has never been fully or officially adopted by EPA, but

EPA has had plenty of time to consider his findings and revise the

official estimates. He has been presenting at conferences since

2005, and in 2007 published his findings that EPA’s official estimates significantly under-counted mercury air emissions.

In a previous hearing, this subcommittee received testimony establishing that the true range of mercury air emissions attributable

to dental mercury could be as high as seven to nine tons per year.

That would put dental mercury emissions on par with major source

of mercury air emissions.

If EPA under-estimated the extent of the environmental problem

caused by dental mercury, it has also over-estimated the amount

of cooperation dentists have voluntarily given toward preventing

amalgam from leaving dental offices in wastewater. The technology

for capturing mercury is known as the amalgam separator.

In 2008, EPA effectively agreed with comments submitted by the

American Dental Association, which asserted, in part, that significant numbers of dentists are voluntarily purchasing amalgam separators and are thereby reducing the amount of mercury their ofVerDate 11-MAY-2000 14:34 Jun 09, 2011 Jkt 000000 PO 00000 Frm 00006 Fmt 6633 Sfmt 6633 C:\KATIES\DOCS\65133.TXT KATIE PsN: KATIE
3

fices use and wash down the drain. Thus, EPA granted an exception for dental offices from mandatory effluent guidelines in 2008;

instead, EPA entered into a voluntary memorandum of understanding in the last days of the previous administration to encourage

dentists to adapt amalgam separators to prevent the mercury that

they use every day from going down the drain to the publicly

owned water treatment facilities.

But what happens in practice is far different from the assumptions that justified the exception and a memorandum of understanding. Unfortunately, in State after State dentists have, by and

large, been slow to adopt mercury separators unless they were facing mandatory regulations. According to testimony received today

from the Environmental Council of the States, a national association of State environmental protection agencies, ‘‘in many jurisdictions dental amalgam separator installation rates were low unless

there was a mandatory component.’’

That conclusion is consistent with our staff report published in

September 2008 and it is consistent with the sales data trends

from the largest manufacturer of mercury separators. Dentists do

not respond in large numbers to a purely voluntary program to encourage mercury separator use. Indeed, the American Dental Association promulgated voluntary best management practices for disposing of amalgam waste in 2007, but the majority of dentists who

installed separators at this time reside in States or local jurisdictions where separator use is a requirement.

Today’s hearing will focus primarily on whether or not the EPA’s

memorandum of understanding can achieve its purpose in its current form. In preparation for this hearing, my staff has assessed

progress made under the memorandum of understanding. What we

found is that every milestone established by it has been missed in

the nearly 11⁄2 years since it was signed. Serious questions arise

about whether the memorandum of understanding has some inherent deficiencies such as: can the parties to the memorandum deliver a high rate of dentist compliance with best management practices for amalgam pollution prevention? Would the MOU’s chance

of success increase if additional parties were allowed to become signatories? What measure is EPA prepared to take to ensure that the

failures to date of the memorandum of understanding practice do

not predict the ultimate failure of the EPA’s efforts to encourage

dentists to remove mercury waste from wastewater before it leaves

the dentists’ offices?

We hope to get the answers to these and other questions today.

[The prepared statement of Hon. Dennis J. Kucinich follows:]

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Mr. KUCINICH. Thank you for being here.

I recognize Mr. Jordan.

Mr. JORDAN. Thank you, Mr. Chairman, for holding this hearing

to examine the Environmental Protection Agency’s role in the use

and disposal of dental amalgam by the dental industry.

I just have a short statement.

Dental amalgam, or the silver fillings that many of us have, are

a compilation of metals, mainly mercury. According to the Centers

for Disease Control and Prevention, there is little scientific evidence that dental amalgam poses a health threat; however, I know

this is a controversial area.

Today we are focusing on the EPA’s role in the disposal of dental

amalgam. My understanding is that the industry and the regulators are conversant on this topic and have executed a memorandum of understanding. I am interested in learning how that MOU

is working, how it was developed, etc.

I would like to point out that traditionally regulation of the dental industry is a matter reserved to the States, a very important

principle I think we need to keep in mind as we think about our

Federalist system as we move through this hearing and look at this

issue; therefore, I hope to hear more about what States are doing

to assist in this concern.

Mr. Chairman, thank you again for putting this together. I appreciate the working relationship that we have, and I want to

thank the witnesses who are here today for their participation.

With that, I yield back.

Mr. KUCINICH. Thank you very much, Mr. Jordan.

If there are no additional opening statements, the subcommittee

will now receive testimony from the witness before us.

I want to start by introducing Ms. Nancy Stoner. Ms. Stoner

joined the U.S. Environmental Protection Agency as the Deputy Assistant Administrator for the Office of Water on February 1st of

this year. This is Ms. Stoner’s second tenure with EPA, as she directed the Office of Planning and Policy Analysis and the Office of

Enforcement and Compliance Assurance from 1997 to 1999. More

recently she was co-director of the Natural Resources Defense

Council’s Water Program. Prior to that, she served as project director and attorney for the Clean Water Project for nearly 10 years.

Deputy Assistant Administrator Stoner, thank you for appearing

before the subcommittee today.

In view of the division of responsibilities at EPA, Ms. Stoner is

able to speak authoritatively on issues pertaining to water and to

the memorandum of understanding on reducing dental amalgam

discharges. We will send questions in writing to EPA concerning

EPA’s efforts to measure mercury air emissions.

Now, Ms. Stoner, as you know, it is the policy of the Committee

on Oversight and Government Reform to swear in all witnesses before they testify. I would ask that you rise and raise your right

hand.

[Witness sworn.]

Mr. KUCINICH. I thank you. Let the record reflect that the witness has answered in the affirmative.

I ask, Ms. Stoner, that you now give a brief summary of your testimony, and to keep this summary under 5 minutes in duration.

10

Your entire written statement will be included in the hearing

record. I ask that you begin. Thank you.

STATEMENT OF NANCY STONER, DEPUTY ASSISTANT ADMINISTRATOR FOR WATER, U.S. ENVIRONMENTAL PROTECTION

AGENCY, OFFICE OF WATER

Ms. STONER. Thank you. Thank you very much, Mr. Chairman,

for that lovely introduction. I appreciate the opportunity to testify

today before you and Ranking Member Jordan about the Agency’s

policies on mercury and, in particular, dental amalgam.

Mercury is widespread and persistent in the environment, and

under certain conditions can be transformed by microorganisms

into methylmercury, the form of mercury of greatest concern in the

United States, where exposures occur primarily through fish consumption.

EPA is using its legislative mandates under the Clean Air Act

and the Clean Water Act to reduce the U.S. contribution to the

worldwide environmental mercury burden. Under the Clean Air

Act, EPA has substantially limited U.S. emissions of mercury to

the atmosphere through maximum achievable control technology,

MACT, and solid waste combustion incineration regulations. As a

result, the United States has cut its emissions by more than 90

percent from two of the three largest categories of sources, municipal waste combustion and medical waste incineration, since 1990.

For the other largest category, coal-fired power plants, EPA is

now in the process of developing a MACT standard that will address mercury and other hazardous air pollutants.

Just last month, EPA proposed MACT regulations to significantly reduce mercury air emissions from another large source category: industrial, institutional, and commercial boilers. EPA also

plans to finalize air emission standards in December of this year

to address mercury and other air pollutant emissions from both

new and existing sewage sludge incinerators.

EPA is committed to reducing mercury discharges to our Nation’s

waters. In April EPA published final guidance for implementing

the January 2001 ambient methylmercury water quality criterion

for the protection of public health. This document will help protect

waters and human health by giving guidance to States, territories,

and authorized tribes for adopting a fish-tissue-based

methylmercury water quality criterion into their water quality

standards.

Last fall EPA also initiated effluent guideline rulemaking under

the Clean Water Act to address mercury and other wastewater discharges from power plants.

Dental amalgam contributes a small portion of all mercury released globally to the environment from human activities; however,

at the local level data indicate that discharges from dental facilities

can be a significant contributor to mercury in the environment.

Mercury containing amalgam wastes may find their way into the

environment when old mercury-containing fillings are drilled out

and waste amalgam materials are flushed into chair-side drains entering the sewer system.

Dental facilities may employ a variety of controls and management practices to reduce the discharge of mercury amalgam in

11

wastewater. Application of these practices, in conjunction with

traps and vacuum pump filters, can reduce discharges of mercury

containing amalgam and wastewater by more than 75 percent.

Amalgam separators remove particulate mercury amalgam and, in

combination with traps and vacuum pump filters, achieve better

than 95 percent removal.

Some of the waste amalgam particles that reach the sewer system settle out in the sewers and some are carried to sewage treatment plants. The processes used at sewage treatment plants remove 90 to 95 percent of the mercury present in wastewater on average. The mercury removed from wastewater then resides in the

biosolids, or sewage sludge, generated during wastewater treatment.

Preventing dental amalgam from getting into the sewer in the

first place reduces the amount of dental amalgam, and thus mercury, in wastewater. Amalgam separators are also available at relatively low cost to remove fine particles of waste amalgam. Several

studies, including one conducted by EPA’s Environmental Technology Verification Program, show separators are highly effective.

Another way to reduce the amount of amalgam entering the sewers is for dentists to use mercury-free fillings. Alternatives to mercury-containing dental amalgams exist. As fewer mercury-containing dental amalgams are used, the amount of mercury in the environment will decline.

Every other year EPA publishes a final Effluent Guidelines Program Plan. The plan addresses both categories of direct and indirect discharges. As part of its 2008 Effluent Guidelines Program

Plan, EPA received comments from the American Dental Association and the National Association of Clean Water Agencies on dental amalgam. These comments led to discussions of voluntary efforts and ultimately served as the basis for the memorandum of

understanding on reducing dental amalgam signed in December

2008.

The purpose of the agreement between EPA, ADA, and NACWA

is to have dental offices follow the ADA’s best management practices, which include the installation of an amalgam separator, proper maintenance of such separators, and recycling of all amalgam

waste collected in dental offices.

In our 2008 Effluent Guidelines Program Plan, we committed to

continue to examine the use of amalgam separators by dentists. As

part of our 2010 effluent guidelines planning process, EPA intends

to reevaluate whether a rulemaking is appropriate. EPA will be

issuing its 2010 Program Plan late this calendar year, and will specifically address this issue.

In closing, let me assure this subcommittee that EPA is committed to reducing mercury-related risks to citizens and the environment. In this regard, EPA and State representatives have scheduled a June 24th meeting to kick off an EPA/State dialog on mercury. The purpose of this dialog is to identify gaps, set priorities,

enhance EPA/State collaboration, and identify future areas of work.

12

Mr. Chairman, this concludes my testimony. I would be happy to

answer any questions you or your colleagues may have.

[The prepared statement of Ms. Stoner follows:]

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Mr. KUCINICH. Thank you very much.

We have been joined by Mr. Burton. Welcome.

Mr. BURTON. Thank you.

Mr. KUCINICH. We are going to move to a question period here

of the witness, Ms. Stoner.

At the end of the Bush administration, EPA signed a memorandum of understanding establishing a voluntary framework to encourage dentists to adopt amalgam separators to reduce dental

mercury discharge into the environment. Can you tell us how and

why that happened?

Ms. STONER. Mr. Chairman, I was actually not involved in it directly, myself.

Mr. KUCINICH. Do you know anything about it?

Ms. STONER. I know that we were approached in the comment

process of the effluent guidelines plan with a suggestion that we

consider an agreement with ADA to encourage the use of a technology that we thought would be effective in helping to reduce mercury emissions.

Mr. KUCINICH. OK. Well, in their written testimony the State

EPAs have testified that they had asked EPA to establish ‘‘a nationwide program with a goal of substantially reducing release of

mercury to the environment from dental amalgam mercury, and

the stakeholders would include but certainly not be limited to the

American Dental Association, U.S. EPA, States, publicly operated

treatment works, and dental supply manufacturers.’’

Only 13 days later, the EPA signed a voluntary memorandum of

understanding with the American Dental Association and the publicly operated treatment works, but excluded the other suggested

parties such as the States. Indeed, the States testify, ‘‘neither

ECOS nor the Quicksilver Caucus were involved with the development of the memorandum of understanding. ECOS and Quicksilver

Caucus members were not aware that the EPA was working to develop such an agreement. States were not asked to be a party to

the memorandum of understanding.’’

So could you tell us why the EPA excluded the States from the

memorandum of understanding when enforcement of the Clean

Water Act and the Clean Air Act is shared responsibility with

State offices?

Ms. STONER. I am less able to tell you what happened in the

past, but I can tell you where we are going moving forward.

Mr. KUCINICH. OK.

Ms. STONER. We do have a meeting with the States on June 24th

which will look at mercury in a variety of media. It is actually a

multi-office EPA meeting. We are looking to work collaboratively

with our State partners, as well as the manufacturers and other interested parties in moving forward to build on the MOU.

Mr. KUCINICH. So let me ask you then, as a logical followup to

your answer, if you are moving forward, does moving forward mean

that you want to incorporate the State EPAs as co-signatories on

the agreements?

Ms. STONER. I am not sure that we will actually move forward

by revising the MOU. We see the MOU as a base to build on, and

so there are other things that we are considering.

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Mr. KUCINICH. If you want to build on it, though, wouldn’t you

want them to sign it?

Ms. STONER. I have not engaged in the discussion with them

about it. I don’t have a view on that, but I do have a view that we

would like to work closely with our State partners. We would like

to gather information from them, from the dental amalgam manufacturers, from others to improve the information we have and consider whether additional efforts can be made.

Mr. KUCINICH. OK. Here is the thing: you want to move forward.

Fine. I’m with you. Except I need an answer to this. You really

have not given me the answer I was hoping for with respect to getting the States right there with you, and I am wondering why the

EPA didn’t involve the States in the development of the memorandum of understanding or even notify them that a memorandum of

understanding was under development.

Ms. STONER. Well, let me suggest on that particular point——

Mr. KUCINICH. That is a fact. I mean, you can check on it, but,

look, I don’t need you to validate a fact. What I need you to do is

to tell me if there is any change in your policies, because Mr. Jordan and I may come to some different conclusions about what

States will do, but we both agree that the States ought to be involved here. Am I hearing from you that EPA is taking a different

posture with respect to involvement of the States?

Ms. STONER. I would suggest two things. One is that we would

be happy to get back to you with a written answer as to what happened in 2008, December 2008.

Mr. KUCINICH. But let’s go forward. What are you going to do?

Ms. STONER. Well, we are going to involve the States and we are

going to have a discussion about what is the most productive thing

for us to work with the States on moving forward, and we are

starting to do that next month.

Mr. KUCINICH. When you are crafting that written answer, juxtapose it with what you are going to do differently.

Ms. STONER. I will. Thank you.

Mr. KUCINICH. Mr. Jordan.

Mr. JORDAN. Thank you.

Ms. Stoner, thank you for being here.

You said several times in your response to the chairman about

building on the MOU. Tell me, just kind of refresh my memory,

how is the MOU working? I mean, we talk about building. What

does that mean? What additional costs does that mean? What do

you mean by building on it?

Ms. STONER. Well, one thing is setting goals under the MOU.

That is one thing that we would like to do is to set and, frankly,

achieve some goals in terms of greater use of mercury amalgam

separators. That is something we would like to do. We would actually like to get better information than we have right now about

the use of amalgam separators. We did get some information. ADA

did some surveys. We would like to actually get more information.

Mr. JORDAN. OK.

Ms. STONER. One of the things we would like to do is go to the

manufacturers and get information from them and have a better

baseline.

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Mr. JORDAN. A couple of questions. What do these separators

cost, typically?

Ms. STONER. They range in cost. I would say one to two thousand

dollars, I would say would be approximately. I could get more specific information on that for you.

Mr. JORDAN. Let’s say a dental office has several chairs. I don’t

know how the technology works, exactly, but do you have to have

it at each and every room where the dentists or assistants are

doing work on the patient?

Ms. STONER. I believe that is correct, that you need to have it

with every chair.

Mr. JORDAN. So it could be several thousand dollars?

Ms. STONER. Could be.

Mr. JORDAN. OK. And how many dentists are currently using

this separator, percentage-wise.

Ms. STONER. Let me just clarify on the previous point. You can

hook up multiple chairs to one separator, so you do need a separator that hooks up to each chair, but you can attach multiple

chairs.

Mr. JORDAN. OK.

Ms. STONER. I am sorry. I forgot the second question.

Mr. JORDAN. How many dentists across the country right now do

you think are using this?

Ms. STONER. As I said, we don’t have really good information on

that. We would like to get better information, including by getting

information from the manufacturers.

Mr. JORDAN. Are there States that mandate right now?

Ms. STONER. Yes, there are.

Mr. JORDAN. How many?

Ms. STONER. It is twelve States.

Mr. JORDAN. Twelve States mandate. And are the results such

that you see less mercury in the water supplies of those areas than

you do in States that don’t mandate?

Ms. STONER. You certainly see more use of dental amalgam separators in those States.

Mr. JORDAN. Significant?

Ms. STONER. Yes. The rates are significantly better in States that

mandate the use of the separators. That is right. So you would

have less mercury going into the sewage treatment plants and you

would have less coming out. A lot of the mercury is removed in the

sewage treatment plant.

Mr. JORDAN. Refresh my memory. How long has the MOU been

in place now? A couple of years?

Ms. STONER. Since December 2008.

Mr. JORDAN. So a couple years. All right. And I assume you and

the ADA have undertaken, as part of the memorandum, some kind

of educational program? You are telling dentists across the country

why this is important, etc.?

Ms. STONER. That is right. For EPA’s part, we have done

Webinars. We have provided information at conferences. We have

information on our Web. We are trying to get the word out.

Mr. JORDAN. OK. Mr. Chairman, I am fine right now. I will yield

back.

Mr. KUCINICH. Mr. Burton.

25

Mr. BURTON. First of all, let me say that Mr. Jordan is one of

the finest Congressmen we have, and I really like this guy, but I

disagree with him. Mercury is probably one of the most toxic substances on the face of the earth, and it is toxic before it goes into

a person’s mouth and it is toxic when it comes out, but it is not

toxic when it is in their mouth. That is the most ridiculous thing

I have ever heard.

I am absolutely convinced, after having hearings for 4 years on

this when I was chairman, that mercury is toxic and it should not

be put in the human body in any way.

Can I take my 5 minutes after this, Mr. Chairman, so I can go

ahead after I finish this, if you don’t mind?

Mr. KUCINICH. Without objection.

Mr. BURTON. The thing I want to get across, my grandson got

nine shots in 1 day, seven had mercury in them. He became autistic. We used to have one in 10,000 children that are autistic; now

it is one in under 100. It is an absolute epidemic, and yet the FDA

and CDC and others continue to deny that mercury, a toxic substance put into the human body, is going to affect the neurological

system. There is no question that it does. None whatsoever.

I had scientists for 4 years from all over the world come in and

testify. And mercury amalgams, when they are taken out of the

tooth and flushed down the drain—now my 5 minutes start—they

go into our water supply and the sludge and all the other things

that you enumerated. That should not happen.

Women who are pregnant are told not to eat fish in certain areas

of the country because it has mercury in them. How does it get in

there? It is getting in there because we are flushing mercury down

the drain. It should not be there.

I know $2,000 is a lot of money, but a dentist can afford it if he

is doing his job right and he should have separators. We should not

allow mercury into the system whatsoever.

I am not an environmental nut case. I mean, I think the environmental nut cases drive this country and this Congress nuts. But

this is one area where I feel very strongly about. Mercury is toxic.

It should not be put in a human being in any way at all. And we

had scientists come in. I know the ADA doesn’t agree with me and

they tried to get me defeated in the last election again. That is OK.

But the ADA says that the mercury in an inner substance like

a filling doesn’t cause any problems, and yet we had scientists from

all over the world testify at that table that when you have hot and

cold in the mouth it releases a vapor, and the mercury vapor does

go into the blood stream and does get into the brain.

We have a huge increase in neurological problems among children that get all these shots. We have an increase in people who

have Alzheimer’s. I believe that part of that is caused by the mercury that is injected into people in shots and in the mercury amalgams, and it seems to me that we ought to get that out of anything

that goes into the human being. Anything. And we certainly

shouldn’t be flushing it down the drains.

My God, down at Newport News, Virginia, the Navy got so upset

about the amount of mercury that was going from military personnel’s fillings into the water system that they mandated that they

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had huge barrels of it to catch the mercury fillings so it wouldn’t

contaminate the water supply down there.

There is no question, none, whatsoever. This isn’t nut case stuff.

There is no question that mercury should not be in the water supply and we should do everything we can to keep it out of there, and

that is why the biggest contaminator are the dentists who are

flushing this stuff down the drains, and so we need to have these

separators. That is important.

The other thing is, we need to inform people who are going into

a dentist’s office or who are getting a shot or whatever it is that

there is mercury in that substance. If you are going in to get a shot

and you know there is mercury in that shot, like thimerosal, which

is a preservative in shots that we get, and if you get a shot where

they have the rubber top on it and you stick the needle in, it has

thimerosal in it, and thimerosal has mercury in it. Over a long period of time, mercury accumulates in the brain. If you keep getting

these shots over and over, it is going to have some kind of an adverse impact in most people, or in many people, so it shouldn’t be

in there.

But if it is there, and if it is in amalgams, the people have a

right to know. It is their life. Now, we are telling people that eat

fish, Be careful, because there is mercury in that fish, and if you

are pregnant it might cause a neurological problem in your baby

so don’t eat those fish if they have mercury in them, and yet we

are putting mercury into the water supply, we are putting it into

our mouths, we are putting it into our shots, and the FDA and

HHS aren’t doing anything about it.

Like I said, I don’t like the Government to stick its nose into

States’ rights. I don’t like the Federal Government taking over anything. But this is one area where the entire society is at risk as

long as mercury is being injected into human beings. I feel so

strongly about it.

Do you know what it is like to have a 2-year old child getting

nine shots in 1 day, a perfect child, starting to talk, walk, and everything else, and all of the sudden he is banging his head against

the wall running around? And I talked to people at that table who

are losing their homes, going bankrupt because they have kids who

have autism and they can’t afford to take care of them, and yet the

fund that we have created to take care of these people that are contaminated by this isn’t doing a thing to solve the problem.

So you can tell I am pretty upset about it, because I have

watched it. I have watched thousands of mothers come out here

and show us their kids who are mentally retarded because of this.

I have talked to people who can’t eat fish when they are pregnant

because they are afraid their child will be hurt by the mercury in

the drinking water. And yet we continue to pour it into our system,

pour it into our drinking water, and the Federal Government

doesn’t do anything about it.

And yet I could read to you what the FDA says. For the first

time ever, the FDA publicly admitted that dental amalgam contains highly toxic mercury and they did put warnings on the labels.

So if they put warnings on the labels, why don’t they put it in the

dentist’s office so people know when they go in there? Why don’t

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they tell us. That is not that expensive, a little cardboard saying

there is mercury in these things.

And so I think the FDI challenged the FDA after me being chairman here for 6 years and being on this committee now for over 25

years, tell the people. Let the people know the facts and the country will be safe. I think somebody important said that. I think it

was Abraham Lincoln. Let the people know the facts and the country will be saved, and, not only that, their lives might be saved.

[The prepared statement of Hon. Dan Burton follows:]

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Mr. KUCINICH. Thank you, Mr. Burton.

Mr. BURTON. Thank you, sir.

Mr. KUCINICH. The Chair recognizes Mr. Cummings.

Mr. CUMMINGS. Good afternoon.

Ms. STONER. Good afternoon.

Mr. CUMMINGS. I was listening to my friend, Mr. Burton, and on

the one hand he says Government needs to stay out of the business, to keep a certain distance; on the other hand, he says we do

need to have some regulation here, and I agree that we do. That

leads me to these questions.

As part of the 2002 effluent guidelines planning process, EPA is

committed to examining the use of amalgam separators by dentists;

is that right?

Ms. STONER. Yes, sir.

Mr. CUMMINGS. In the 2008 guidelines for new and existing industrial pollution discharges into surface waters into publicly

owned treatment works, the EPA decided to exclude dental offices

from the scope of the guidelines; is that correct?

Ms. STONER. Well, EPA decided not to move forward with the effluent guidelines at that time. Yes, Congressman.

Mr. CUMMINGS. And so, in other words, dental offices were excluded? I mean, I am not trying to put words in your mouth. I am

going somewhere, but I want to make sure you are going with me.

Ms. STONER. The only thing I am trying to say is that a permanent exemption, nothing like that was done. What we decided was

not to move forwards with a rulemaking at that time, and that is

the issue that we are examining again this year in our Effluent

Guidelines Plan.

Mr. CUMMINGS. So what would be the criterion needed for dental

offices to be included, say, in the 2010 guidelines?

Ms. STONER. Well, I think what we would do is look at the various different sectors that need either new or revised technologybased standards and compare this to others in terms of the importance of the agency moving forward with a technology-based standard.

Mr. CUMMINGS. And what would be the methodology for getting

there? I mean, in lay terms.

Ms. STONER. Well, I think that what the Agency does is look at

the size of the problem. Obviously, we have been talking about

methylmercury and the health issues associated with that, which

are very significant and serious. We have been looking at the contribution that comes from this source versus other sources.

We would be looking at, for example, how the problem is developing over time, what the trend analysis is in terms of either the substitutes for dental amalgam or the use of separators. We would be

figuring out whether this is the best thing to put the Agency’s resources on in terms of protecting human health and the environment. That is the decision that we need to make in that plan.

Mr. CUMMINGS. So right now I guess you are telling me you don’t

have enough information? Is that it, in spite of what Mr. Burton

just said?

Ms. STONER. Well, we have done some initial work on it, but I

would say that we need to gather additional information. That is

right, Congressman.

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Mr. CUMMINGS. And, assuming that what Mr. Burton said was

true, let’s just assume that hypothetical, do you think dental offices

would be excluded or included at that juncture, assuming what he

just said is true?

Ms. STONER. Again, I think it depends on how many effluent

guidelines we are able to do and how this compares to other risks.

Mr. CUMMINGS. Now, in implementing the 2001 guidance; are

you familiar with that?

Ms. STONER. Yes, sir, I am.

Mr. CUMMINGS. Who had input into that document, and what do

you hope it will accomplish?

Ms. STONER. Let me check on the first question.

Mr. CUMMINGS. OK.

Ms. STONER. [Consults with audience member.] That document,

it is guidance for how to use the water quality criteria that we developed for methylmercury. It helps States to set standards, water

quality standards for methylmercury to protect the public. It did go

through a public comment process, so we got comments from a

wide range of stakeholders on that document.

That is what it is for, so what we are trying to do through that

document is to help States through the technical issues associated

with setting a water quality standard. They can then use those

standards also to set limits for sewage treatment plants, and the

sewage treatment plants can use that to set limits for the dentists

that discharge into those sewage treatment plants. So it is another

method under the Clean Water Act to protect the public by reducing pollution.

Mr. CUMMINGS. I see my time is up. Thank you, Mr. Chairman.

Mr. KUCINICH. I thank the gentleman. We are going to go to a

second round of questions to Ms. Stoner.

Prior to signing the memorandum of understanding with the

American Dental Association and the Organization for Publicly

Owned Water Treatment Facilities, the EPA made a finding that

dentists were voluntarily moving toward adopting amalgam separators. On the basis of that finding, EPA exempted dentists’ offices

from mandatory effluent guidelines. I would like to ask about the

EPA’s basis for excluding dentists’ offices from its mandatory effluent guidelines.

The ADA submitted a letter to the water docket in 2007—that

is comments on the EPA’s study of a pre-treatment requirement for

dental offices—which made eight arguments in favor of excluding

dentists’ offices from mandatory requirements. In essence, that letter states, as ADA’s testimony today repeats, ‘‘dentists can and will

act on their own.’’

Did EPA take into account contrary evidence that dentists are

slow to voluntarily act on their own? For instance, did EPA consider the Quicksilver Caucus’s April 2008 report on mercury separator usage, which noted that nearly all jurisdictions that started

with purely voluntary regulations ended with mandatory regulations because the voluntary ones don’t work? That finding was

similar to the conclusion of a report published by this subcommittee in September 2008. So what do you say to that?

Ms. STONER. I wasn’t involved in that particular decision,

but——

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Mr. KUCINICH. But what do you think?

Ms. STONER. I am confident that the Agency is aware that mandatory requirements—as a matter of fact, the information is available today that shows that in States where there are mandatory

requirements there is more use of amalgam separators than there

is in States where the programs are voluntary, and that is consistent with the Agency’s experience in a lot of different areas. You

will have more widespread compliance if you actually have a mandate. I think that is pretty well demonstrated.

Mr. KUCINICH. Well, it might be pretty well demonstrated, but

that is not where the EPA was, because they exempted dentists’ offices from mandatory effluent programs, so, using your logic, of

course mandatory, but that is not what EPA did.

Ms. STONER. EPA did not grant a permanent exemption to——

Mr. KUCINICH. What was their basis for excluding dentists’ offices from mandatory effluent guidelines in the first place?

Ms. STONER. I would prefer to get back to you in writing on that.

Mr. KUCINICH. OK. That would be fine.

Ms. STONER. Because it was a decision I was not involved in.

Mr. KUCINICH. I will look forward to reading it.

[The information referred to follows:]

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Mr. KUCINICH. Now will you look at the screen please? Ms. Stoner, this graph depicts the actual sales trends of mercury separators

to dentists by the largest manufacturer in the Nation. Sales pick

up dramatically just prior to mandatory regulations kicking in,

which is depicted by the shaded column. Is not this evidence that

dentists respond to mandatory regulations requiring adoption of

mercury separators?

Ms. STONER. I would agree that appears to show that. Yes, sir.

Mr. KUCINICH. Well, I would like you to look at the trend lines

to the left of the shaded bar there. I would like you to look at it

closely.

Ms. STONER. OK.

Mr. KUCINICH. I would like you to look at the trend lines to the

left of the shaded box.

Ms. STONER. OK.

Mr. KUCINICH. See how the purchase rate is? See how the purchase rate decreases the further away you go from the shaded bar?

That is the voluntary period that preceded the mandatory requirements. So there is evidence here that dentists don’t generally adopt

mandatory separators on a voluntary basis.

Ms. STONER. There is some——

Mr. KUCINICH. Would you agree?

Ms. STONER. There is certainly some variation, but in general the

sales certainly go up after the regulation date, effective date. That

is correct.

Mr. KUCINICH. And if you look at the voluntary period, you have

mandatory regulations, compliance goes up; voluntary regulations

don’t appear to go, appear to be low compliance, right?

Ms. STONER. I can’t really tell what the voluntary program is

that precedes the bar, but it certainly looks like the regulation

makes the sales go up. That I can tell.

Mr. KUCINICH. So don’t you think that this shows voluntary efforts by dentist trade associations since the signing of the memorandum of understanding—excuse me. I am going to go to Mr. Jordan.

[The information referred to follows:]

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Mr. JORDAN. Thank you, Mr. Chairman.

Ms. Stoner, did you agree with my good friend and colleague, Mr.

Burton, his analysis of the situation, his conclusion on the situation?

Ms. STONER. I thought he made a number of excellent points.

Certainly his points about the dangers associated with

methylmercury are well taken. I also thought his point about people being probably less likely to get amalgam fillings if they had

better information about the mercury in amalgam fillings was also

a compelling point.

Mr. JORDAN. Then I think the chairman’s question is the $64,000

question. If, in fact, EPA thinks it is that bad—and I don’t know.

I think the EPA over-reaches on a lot of things—if, in fact, you

think Mr. Burton’s analysis is correct, why the decision on the

memorandum of understanding, why was that made?

Ms. STONER. Again, I——

Mr. JORDAN. I mean, if this is as terrible as my good friend

points it out to be, it seems to me you would be making the rules,

doing the things that you think are going to protect us. I mean,

that is the big question. We would like an answer.

Ms. STONER. Right. There is——

Mr. JORDAN. I don’t know if it is right or wrong. Look, based on

what you just said in response to Mr. Burton’s statements, it seems

to me we need that answer.

Ms. STONER. I think there are two different things we are talking

about, one of which is the use of dental amalgam by patients, and

that is a decision that is partly environmental and partly medical,

and we think that the FDA is better situated to make that decision.

Mr. JORDAN. Let me clarify. So you think mercury in some other

forms, what Mr. Burton had to say is right on target, but specifically to the filling put in the patient’s teeth while they are in the

dental office doesn’t rise to that, maybe not as bad as Mr. Burton

might have said. Is that your conclusion?

Ms. STONER. No.

Mr. JORDAN. It would seem to be so, based on what the EPA’s

decision has been.

Ms. STONER. OK. Well, I may not be making myself clear, so let

me try to do better. What I am saying is that the EPA is not in

the lead role in deciding what dentists use in the dentistry that

they practice. There are other agencies that are better situated to

make decisions about those medical issues. EPA is looking at the

issues of mercury emissions, air emissions, and mercury in wastewater discharges, and what I am saying is that it is a concern.

Mercury in wastewater discharge is a concern, and that is one that

we are evaluating at the Agency, along with other pollutants of

concern that cause human health or environmental impact.

Mr. JORDAN. But I just want to be clear. The memorandum of

understanding is between the EPA and the ADA, correct?

Ms. STONER. Yes, sir, but it is not about the use of dental amalgams. It is about use of amalgam separators. That doesn’t, either

way, whether the patient uses dental amalgam or some other kind

of cavity, I am not a dentist, but some other kind of filling, then

the mercury would be captured in the amalgam and it would then

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stay out of the sewage treatment plant and stay out of the wastewater of the sewage treatment plant. That is what our agreement

is about.

Mr. JORDAN. OK. Thank you, Mr. Chairman.

Mr. KUCINICH. Mr. Burton.

Mr. BURTON. First of all, I appreciate your acknowledging some

of the things that we talked about. I appreciate that, Ms. Stoner.

The one thing that kind of bothers me is one agency kind of passing the buck to another agency and back and forth and back and

forth. I had people from the HHS and FDA before the committee,

and when my grandson became autistic I said, would you mind if

I injected you with the amount of thimerosal with mercury in it

that my grandson got in 1 day, and they said it wouldn’t affect

them but they wouldn’t want it injected it into them. It was kind

of an interesting answer they had.

But here is the position the FDA has taken. For the first time

ever, the FDA publicly admitted that dental amalgam contains

highly toxic mercury and therefore requires a variety of warnings

on the product label. That is clearly a significant improvement over

the FDA’s former position that mercury amalgams are 100 percent

safe. That was their previous position.

Unfortunately and inexplicably, new warning requirements have

nothing to do with patient safety. It is just putting it on the label

on the product. And the FDA still does not require dentists to warn

patients in any way about the harmful neurotoxins in the dental

amalgam.

Considering the fact that in 2006 the FDA’s own panel of outside

experts concluded that it is ‘‘not reasonable for the FDA to have

the position that mercury amalgam fillings are safe.’’ How can the

FDA not insist that dentists warn patients about the dangers?

They had this outside group come in and look at it, and they said,

well, we can’t take the position that it is safe, which means there

is a real question about whether or not it is safe.

Now, if dentists want to go ahead and continue to use that, then

I think the obligation is clear: let the patients know that it is in

there. And 90 percent of the people who have dental fillings that

are amalgams do not know that it has mercury in them, and so

they are being exposed without their knowledge.

I think the thing that has bothered me the most is that we are

having such opposition from the dentists, because they are getting

information from the FDA and HHS that says this is not harmful,

and yet they are not supposed to flush it down the drain, and they

know that it is toxic if they get it on them before they put it in

the mouth and they mix it all up, but they have been told that it

is not harmful. And so the dentists I think rightfully say, Why are

you telling us what to do when the FDA and HHS says there is

no problem?

And so the dentists say guys like me are nuts. Maybe that is

true. I don’t know. But the fact of the matter is they are now starting to admit that there is a serious problem.

So what I can’t understand is why the FDA and HHS and the

EPA don’t get together in a panel and sit down and say, How do

we make sure that this is properly regulated and properly brought

to the attention of the American public? I would suggest that is

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something that should be done. EPA has the authority, FDA has

the authority to do a lot of these things.

The other thing I would like to say before my time is up. I talk

to the pharmaceutical companies, the presidents of these companies, major companies, Merck, Eli Lilly, a whole bunch of them,

and I said, If you will put more money into the vaccine injury compensation fund to help people who have been damaged, if you will

get mercury out of all the vaccines, adult and children, and they

can do that in an economical, satisfactory way, then I will introduce legislation that will protect you from class action lawsuits. I

will do everything I can to make sure that you are not going to face

any harmful financial problems because of past experiences.

Now, when I said that one out of 10,000 people used to have autism, kids, now it is one in less than 100, we know there is a big

problem. So if we protect the pharmaceutical companies by giving

them protection from class action lawsuits if they will do these

things, get the mercury out and put more money into the vaccine

injury compensation fund, I don’t know why they won’t do it.

And I will do the same thing for the dentists. If dentists are

afraid that they are going to be sued by people that have neurological problems that they allege came from amalgams that they

used in filling their teeth, I will do everything I can to protect

them, as long as we get the mercury out of the product and get it

out of people’s mouths. Until that time, I hope that the EPA, the

FDA, and HHS will get together and come up with some way to

make sure the public is aware of what is going on. OK?

Ms. STONER. Thank you.

Mr. BURTON. Would you carry that message back?

Ms. STONER. Yes, sir, I will.

Mr. BURTON. Thank you very much.

Mr. KUCINICH. We are going to begin the third round of questioning. There will be a final round of questioning of this witness.

Before I begin, I just want to say to my colleague, Mr. Burton,

I just want to say before we begin the third round of questions that

I have watched for years your advocacy on this and other health

issues, and I am proud to serve with you in this Congress.

Mr. BURTON. Thank you, Mr. Chairman. I really appreciate it.

Mr. KUCINICH. You have really been outstanding and courageous

in your pursuit of the questions underlying the effects of mercury

in vaccines and a whole range of areas, and I really appreciate it.

Mr. BURTON. Thank you very much. I wish you would call my

wife and tell her that. She doesn’t appreciate it. [Laughter.]

A little levity won’t hurt.

Mr. KUCINICH. Anything I can do to help you, Mr. Burton, I will

be glad to.

Now I am going to go to a final round of questions of this witness.

I am concerned that EPA signed a memorandum of understanding with someone who can’t make the change the memorandum of

understanding seeks. When my staff spoke with a top official at the

ADA about steps ADA has taken to measure the effectiveness of its

outreach campaign such as tracking if dentists are using best management practices or even viewing the brochure produced, we

learned that the ADA is not even tracking that.

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How can ADA optimize its efficacy in promoting compliance with

its best management practices if it doesn’t track dentists’ compliance with its best management practices, or even whether they

look at its brochure?

Ms. STONER. I agree with you, Congressman. It would be better

to have more outreach and more installation of those amalgam separators.

Mr. KUCINICH. What we are seeing is a perfunctory performance

here. We have learned that just this month ADA held a conference

in Chicago for Illinois dentists on the topic of limiting mercury pollution from dental offices. The results weren’t particularly impressive. Of the 8,500 dentists in the State of which 6,600 are members

of the State Dental Society, only 21 came to the conference.

Now, Ms. Stoner, I am calling this to your attention because I

think it is worth you looking at the ADA’s outreach efforts and to

see if they can be more encouraging.

You have a report from the Quicksilver Caucus of the State EPA

offices, a report from this subcommittee, and the most recent sales

data of the largest seller of mercury separators all showing that

dentists are not, in fact, voluntarily adopting mercury separators

in significant numbers, yet the memorandum of understanding depends upon their doing so.

Can they demonstrate the importance of a realistic prospect for

mandatory requirements for obtaining dentists’ adoption of amalgam separators? I am wondering what procedure EPA would follow

to reconsider its exemption of dentists’ offices from effluent guidelines?

Ms. STONER. We will be gathering additional information. We

agree with you about the need to get additional information in

order to make a determination, and we have committed to doing

that, including from the manufacturers.

Mr. KUCINICH. I am wondering why you wouldn’t strongly say

right now that you intend to rescind the dentist office exception as

of, say, the 2012 effluent guidelines unless you see verifiable compliance with the memorandum of understanding goals in 2010 and

2011?

Ms. STONER. We have a process we have to go through on the

effluent guidelines planning, and I don’t want to get ahead of that

process, so we are committing to you that we will look at it in that

process and make a determination.

Mr. KUCINICH. Ms. Stoner, we have a process here, too, and what

is noteworthy is that there is nothing that is separating individuals

from both political parties who are determined to get to the truth

of exactly what is happening here. So I understand about your

process. Our process here is going to continue to go deeply into

what I personally feel are the shortcomings of the EPA’s responsibility in this regard. And I come to this not as someone who is

a consistent foe of the Environmental Protection Agency. I am a

friend. And I am such a good friend that if I see something wrong

I am going to tell you.

The Chair recognizes Mr. Jordan.

Mr. JORDAN. Thank you, Mr. Chairman. I will just be real brief

and we will get to the second panel. I want to talk with the witness

from the ADA.

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The chairman, in his comments, talked about the fact that only

21 dentists I believe showed up at a conference in Illinois. While

the conference obviously was important to talk about mercury, I

would just remind members of the committee that these guys are

small business owners. They have to attend to their practice. They

have to attend to meeting the needs of their patients in their communities. It is not always easy just to pack up and go. So I think

there is a balance we have to keep in mind as we look at this whole

issue and evaluate what is the best means and best process as we

move forward.

As I said, Mr. Chairman, I will yield back and wait for the second panel.

Mr. KUCINICH. I thank the gentleman.

The Chair recognizes Ms. Watson.

Ms. WATSON. Mr. Chairman, I want to thank you. I also want

to thank Member Burton, who is not in the room at the moment.

We have been working on this issue ever since I have been here,

and I am completing my 10th year and I will be retiring after this

year. I worked on this same issue on mercury pollution when I was

chairing the Health and Human Services Committee in California

for 17 years. I finally had a Governor that appointed a dental board

who looked at the dental amalgams and said we see some problems

here. That particular Governor was recalled and this has been hidden again.

So what I want to do, I will wait until the second panel comes

up, and I would like to read my opening statement if I may.

I yield back my time.

Mr. KUCINICH. And I would just say to the gentlelady, if she

would like to read her opening statement now, so that Ms. Stoner

will have the benefit of hearing it, and then when you conclude I

will call the second panel.

Ms. WATSON. Thank you so very much.

Mr. KUCINICH. Without objection.

Ms. WATSON. I have been a staunch opponent of mercury amalgams. For those of you that do not know what an amalgam is, it

is a substance that you put into a cavity to fill it, and it is what

is in that amalgam. The amalgam looks like silver, it is 50 percent

mercury. SB 65 in California of about 20 years ago rates mercury

as the most toxic substance in the environment. So I have been an

opponent of mercury amalgams since my days in the California

State Senate, where I helped pass a law that requires a fact sheet

about dental fillings being given to consumers without any information about what is being put into their mouth.

I believe that it is very important, it is essential for consumers

to know about the toxins they are putting into their bodies, especially when it is one that implanted into their mouths and helpless

children’s mouths and senior citizens, and could possibly affect

them for the rest of their lives.

For this reason, this Congress I introduced the CHOMP Act,

H.R. 4615, CHOMP. This bill will require dentists to give consumers a fact sheet prepared by the Food and Drug Administration

outlining the dangers of each type of filling.

Now, you know in California, and I would hope in the rest of the

country, we are concerned about the atmosphere. We were the first

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State to outlaw and ban smoking on airplanes in California air

space. It took us 14 years to do that, and then the rest of the country followed, and now it is global.

Now, I am sure that we all know that mercury is one of the most

toxic substances. If you don’t know, we are going to tell you. Third

on the CERCLA list of toxic chemicals. We also know that amalgam releases sufficient amounts of mercury that can be absorbed

by our bodies.

That is the reason why, if you are in California, you are warned

not to eat tuna along the western coast of southern California, because in a dental office what do you do with the waste? You put

it into a tube. It goes right out into the plant and into the ocean

and gets into the sea life and gets into the shell life and so on. That

is a fact.

Mercury poisoning has been shown to cause mental disorders,

autoimmune disorders, and other chronic illnesses. It is thought

that mercury also plays a role in Alzheimer’s disease and in MS.

It is a documented fact that mercury can also transfer from pregnant women through the placenta to the developing fetus. Children

and fetuses are especially at risk because of the developmental risk

posed by mercury, yet women who are pregnant or plan on becoming pregnant are not told of the risk associated with their new mercury fillings. Everyone likes to show their new fillings. Look at this

silver I have in my mouth.

So informing the consumer is the right thing to do. I think everyone needs to know what is added to whatever they put in their

body, because you know if you look at cigarettes and tobacco, it

tells you what it can do to your health, and I think you make the

choice. You suffer the consequences.

I know that many of these ill effects are real. In my time fighting

for this issue I have met so many people who have told me their

health histories, of being constantly fatigued after getting their

mercury amalgam fillings, of their lives being crippled by chronic

headaches, of being told that they have an unknown autoimmune

disorder only to be relieved of their troubles after they removed

their mercury amalgam fillings.

I sit in front of you as a witness and a victim. I had my mercury

amalgams, Mr. Chair, put into my mouth when I was 9 years old.

My father was a police officer, so he could practically get it done

free. I have suffered from allergies all of my life until an investigating team from abroad came in and they said, my God, you are suffering from mercury poisoning.

I went to my dentist, asked him to remove, and he would not.

Very few people know how to do it. I had to go to Mexico, Ms. Stoner, and it took me 6 weeks and was very expensive. It has changed

my life. It has changed my looks. And it changes the aging process,

I can tell you that. I can tell you that. And the doctor who did it

was educated here, and he would not do the mercury fillings that

were required at his university, so he left and went to the University of Mexico, and he lives here in the States and goes over the

border to practice, because dentists will tell me now. I didn’t get

the backing of the EPA, so that is the situation. It really made a

difference.

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He didn’t give me medication, he gave me herbs. He told me take

these herbs until you clean your system. I tell you, it has made a

difference. People have accused me of having a face lift. No. I took

the mercury out, and I tell everyone I can, remove your mercury

amalgams.

So in response to the CHOMP Act the American Dental Association, quoting the FDA, issued a statement saying that mercury

amalgams are safe. That is a lie. Quote me. And if there is any

press in this room, quote me, please. I have the facts. You can come

to my office. I will share this with you.

We have done research nationally and internationally. We are

killing ourselves because, as one group of dentists said to me, people of color don’t like to go to the dentist. So that is the reason why

we continue to use amalgams, because they are safely combined

and well filled. I said, do you ever consider that kids go skating or

biking and they fall and crack their teeth? Happens every day. Do

you ever consider that they get teeth pulled out? Happens every

day.

If you want a test, there is a probe you can put in your mouth

and you can see the vapors from the mercury going to your T-zone.

What is at the top of your T-zone? Yes. I see a lady in the back.

She says, What’s at the top of your T-zone? Your brain. And what

is covering your brain? A thin skin called the meninges. And guess

what? Mercury affects the meninges of the brain.

So why do so many of our children do poorly in school? Because

they chew on paint on their cribs that have lead in it, and the mercury that they put in 9 years old in their teeth also goes up.

So just think about that. We are going to find why so many

women are having cancer and breast cancer now. It is something

we add in or something in that can and so on. We are going to continue to do the research until we can convince that mercury has

no place in the human body.

Now, if you read FDA’s rule, FDA, itself, admits that the report

that was published by the Trans-Agency Working Group on the

Health Effects of Dental Amalgam in 2004 concluded that there

were ‘‘important data gaps, including whether low-level mercury

vapor results in neurotoxicity.’’ I am a witness and I will testify on

any stand to it. Also, studies that have been performed do not account for mercury from other sources, nor are they sufficiently long

term. That is why we need to inform people so they can make their

own choices.

We have for years informed and warned consumers about the

risks of consuming fish with a high mercury content. Now we are

learning that dentists’ offices contribute approximately—get this—

50 percent of mercury in wastewater, much of which makes it into

the environment. In 2002 a report from the University of Chicago

concludes this number could be as high as 70 percent.

After the passage of the mercury ban by then-Senator Obama, it

is baffling that we still allow dentists to pollute our water and air

with mercury. Mercury has vapors that are always being emitted,

always being emitted, especially when they can install a $500 mercury separator that has the ability to capture more than 90 percent

of the mercury waste. I have been thinking so much about how our

sea waters now are polluted down in the Gulf because of the escapVerDate 11-MAY-2000 14:34 Jun 09, 2011 Jkt 000000 PO 00000 Frm 00064 Fmt 6633 Sfmt 6633 C:\KATIES\DOCS\65133.TXT KATIE PsN: KATIE
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ing oil, and they are trying to break it up, and whatever they are

putting in to break up the modules, killing the fish and the birds

and so on. We need to be more proactive and wiser.

Additionally, dental mercury amalgams contribute to the mercury burden in the environment through a very unlikely source,

and that is crematoriums. As dentists continue to install mercury

amalgams into mouths, these installations release mercury into the

air during the cremation. Is there no end to the ill effects of mercury, right to the end of the life process and the disposal of the bodies?

So in conclusion, Mr. Chairman, I want to say that I firmly believe that mercury amalgams should not be used. If the ADA is

going to insist on their continued use, then dentists have the obligation to inform their patients in advance, and dentists also have

the obligation to prevent environmental harm, remember, you take

that Hippocratic Oath, by installing mercury separators as a voluntary program has not worked. It is time the EPA takes the initiative to regulate mercury in water and air, and one very important aspect of that air is the pollution of mercury amalgam.

Mr. Chairman, I really want to thank you and the minority

Member again for holding this hearing. As you can hear, I am very

emotional about this issue. Thank you.

[The prepared statement of Hon. Diane E. Watson follows:]

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Mr. KUCINICH. I thank the gentlelady for her testimony.

Thank you, Ms. Stoner, for your presence and joining us and listening to Ms. Watson’s statement.

I want to thank Mr. Jordan for being here. You are welcome to

come back, if you are able to, from your busy schedule.

Ms. Stoner, you are dismissed as a witness.

Ms. STONER. Thank you.

Mr. KUCINICH. We want to invite the other witnesses to come forward.

While the witnesses are coming forward, I would like to make

the introduction of our second panel.

Mr. William Walsh is of counsel, Pepper Hamilton, LLP, where

he heads that office’s environmental practice group, and he is representing the American Dental Association. Before 1986, when he

joined Pepper, Mr. Walsh served as Section Chief of the U.S. EPA

Office of Enforcement as lead EPA counsel on a precedent-setting

hazardous waste lawsuit brought against Occidental Chemical

Corp. concerning Love Canal and related landfills.

Next will be Mr. R. Steven Brown, the executive director of the

Environmental Council of the States, the national nonpartisan association of the States’ environmental agency leaders. Mr. Brown

helped form the Environmental Council of States in 1993. Previously he worked with the Council of State Governments as its

chief environmental staff and with private engineering firms in the

Kentucky Environmental Agency. He has 34 years of experience in

State environmental matters. As the chief executive of ECOS, Mr.

Brown has been closely involved in its mercury policy matters for

the last 10 years, including the work of the Quicksilver Caucus and

mercury policies of the association.

Another witness that we were anticipating, Mr. Alfred Dube, who

is National Sales Manager of SolmeteX, had to cancel his appearance here today due to death in the family. Without objection, I ask

unanimous consent to include Mr. Dube’s statement in the record

of hearing, and this committee sends its condolence to him on the

death in the family.

[The prepared statement of Mr. Dube follows:]

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Mr. KUCINICH. Mr. Alexis Cain is an environmental scientist

with the U.S. EPA Region 5 Air and Radiation Division. Mr. Cain

holds a Master’s in International Affairs from American University,

Master’s in Environmental Studies from Yale. He has been with

the U.S. EPA for 15 years. He works on mercury control efforts including as the U.S. co-lead from the Great Lakes Bi-National Toxic

Strategy and on the development of mercury reduction strategies

under the Great Lakes Regional Collaboration. He is testifying before this subcommittee on his own behalf and his testimony is not

in his official capacity and he does not represent the positions of

the EPA. I wanted to make sure that disclaimer is put out there.

Mr. John Reindl is a retired professional engineer who worked

for Dane County, Wisconsin, as their recycling manager for many

years, including on programs to reduce the flow of mercury to the

environment from products. He has researched and written on mercury air emissions from crematoria. His reference paper on

crematoria, which is updated on an ongoing basis, has over 130 references to both literature and discussions with people everywhere.

The Mercury Policy Project was formed in 1998 and works to promote policies to eliminate mercury uses, reduce the export and trafficking of mercury, and significantly reduce mercury exposures at

the local, national, and international levels. That is certainly due,

in great part, to the initiation work of Mr. John Reindl.

It is the policy of the Committee on Oversight and Government

Reform to swear in all witnesses before they testify. I would ask

that you rise and raise your right hands.

[Witnesses sworn.]

Mr. KUCINICH. Thank you. Let the record reflect that each of the

witnesses has answered in the affirmative.

I would ask that each witness give an oral summary of your testimony. Keep this summary, if you would, to 5 minutes in duration.

Your complete written statement will be included in the hearing

record.

Mr. Walsh, you are our first witness on this panel. I ask that you

proceed, and thank you for being here.

STATEMENTS OF WILLIAM WALSH, OF COUNSEL, PEPPER

HAMILTON, LLP, REPRESENTING AMERICAN DENTAL ASSOCIATION; STEVEN BROWN, EXECUTIVE DIRECTOR, THE ENVIRONMENTAL COUNCIL OF THE STATES; ALEXIS CAIN, SCIENTIST, U.S. ENVIRONMENTAL PROTECTION AGENCY, REGION 5; AND JOHN REINDL, MERCURY POLICY PROJECT

STATEMENT OF WILLIAM WALSH

Mr. WALSH. I am William Walsh, outside counsel for the American Dental Association on amalgam wastewater issues. On behalf

of the ADA’s more than 157,000 member dentists, thank you, Mr.

Chairman, and committee members for the opportunity to discuss

the memorandum of understanding with EPA.

Prior to that MOU, the ADA met periodically with EPA urging

a national voluntary program to reduce dental amalgam in wastewater and implement educational programs and take other actions.

Even without amalgam separators, approximately 99 percent of the

amalgam is captured either in the office by other parts of the

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plumbing system or in the sewage treatment plant, which captures

prior to discharge into the rivers, a substantial amount, 95 percent

of the mercury that enters that is related to amalgam.

Now, let me make it clear, because my earlier testimony in the

last hearing I was less clear. There is a large amount of mercury

that goes into the sewage treatment plant. The ADA has done studies: 50 percent, and maybe more in some places, less in others, but

because the POTW captures in the biosolids, what goes out into the

streams is less than that. But separators will reduce that somewhat if implemented.

In 2007 EPA was studying whether the release of dental office

wastewater into sewers warranted the issuance of an enforceable

pre-treatment standard. The ADA filed public comments consistent

with its earlier comments explaining why no such standard was

necessary, in part because the dentists can and will act on their

own. For example, the ADA had added separators to its best management practices in 2007. We asked, as we had in the past, to

work with EPA on this issue. In response, EPA contacted us in

early 2008 and proposed an MOU to promote the use of separators.

EPA’s consultant had estimated that approximately 40 percent of

the dentists in the United States were using separators, but I think

the report made it clear that was an estimate for the purposes of

the regulation and the information was uncertain.

The MOU required ADA to prepare a baseline report on the

number of separators in use. Based on numerous data sources, including surveys of ADA members, we determined information concerning the number of separators and the percentage of separators

being used, in essence tracking as of 2009 what the compliance of

dentists were with separators. We looked both at States where

there are mandatory requirements as well as voluntary requirements.

Unfortunately, as we pointed out to EPA and the National Association of Clean Water Agencies, the data is somewhat contradictory and incomplete, and there wasn’t a clear answer from the various surveys and various sources of information, and that more information may be necessary from the manufacturers, and EPA decided to seek additional data from manufacturers.

Without a baseline, developing a progress goal has been difficult.

Nevertheless, the parties have agreed upon, and I should say this

agreement has come after some of the other testimony that has

been submitted here today, so the testimony of ECOS, for example,

talks about a goal not being set.

We have reached a goal that in the first 12 months after setting

the goal, that 20 percent of the dentists in jurisdictions where

there is no mandatory requirement would have separators. The

next 12 months after that, an additional 25 percent would have to

meet, be shown through surveys with the separator manufacturers,

to meet the requirement of having a separator, and every 12-month

period after that another 25 percent, until 100 percent is met or

some plateau is reached.

These are absolute numbers. If the baseline is determined to be

20 percent, our goal is 40 percent in 12 months and 65 percent in

2 years.

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We are only counting for the purpose of compliance those dentists in voluntary areas, although obviously a number of dentists

in the States where there are mandatory requirements would be

additional number of separators.

This voluntary approach should be successful, in our opinion, because it is directed at dentists as health professionals. We think

that is important in communicating a voluntary program from a familiar source, the ADA, using all of its communication outlets, and

the same communication from EPA and from the Sewer Authority

Association. It is based on the lessons learned from previous unsuccessful voluntary efforts, and there is no question that some of the

earlier efforts were not successful.

It recognizes that if voluntary efforts fail, nothing in the MOU,

in fact, the MOU specifically provides EPA, the States, or the local

agencies the authority now to continue to go ahead, regardless of

what is happening with the MOU, with any mandatory program

that they so decide. That was deliberately put in there and agreed

upon by all the parties from the beginning so we would not compromise the authority of the States or local authorities or EPA, if

EPA in its discretion decided that it was insufficient.

Mr. KUCINICH. Mr. Walsh, I am going to ask you if you could

summarize, because I asked the witnesses to go for five. I have let

you go for a little bit more than that.

Mr. WALSH. I have concluded. We have sought to do our fair

share, and that is what we are trying to do.

Thank you, sir.

[The prepared statement of Mr. Walsh follows:]

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Mr. KUCINICH. Thank you.

Mr. Brown.

STATEMENT OF STEVEN BROWN

Mr. BROWN. I am here representing the Environmental Council

of States, you have already explained what that is, and also the

Quicksilver Caucus, which is a group of associations of State environmental officials that are interested in mercury.

There are three primary things I want to talk with you today,

and fortunately the committee has already added several of them

extensively, so I am going to cut my remarks somewhat shorter.

First is I want to outline some of the State experiences with voluntary and mandatory programs in States on this topic. Second, I

want to discuss the MOU, which we have been discussing extensively today. And third, I want to tell you something about the approach that ECOS and the Quicksilver Caucus are recommending

to EPA to address this topic.

As you know, Quicksilver Caucus research has looked at five

State programs, and the short version of that is that we found in

every case, when it became mandatory, as the graph you showed

earlier demonstrated, the results went up considerably. And consequently also, I might add, the amount of mercury in the sewage

treatment sludge went down.

Now, I want to say something about the testimony Mr. Walsh

made regarding the fate of mercury in sewage treatment systems

when it leaves a dental office or any other source, for that matter.

It doesn’t mysteriously disappear. That mercury that is not in the

water effluent is in the biosolids, and from there it is either applied

to land, it is incinerated and goes out the stack, or it is buried in

a landfill. Landfills have a lifetime, but they don’t last forever. And

so the fate of that mercury is to be put back into the environment,

regardless, sooner or later, when it goes into the POTW.

Coming back to my second point, the MOU, as you have already

stated, we were not involved in the development of the MOU. It

was a surprise to us when it came out. If we were asked to be on

it, we would say yes immediately, and we hope that happens because we think the States obviously have a lot to contribute on this

subject matter. States are ahead of EPA on removing mercury from

dental facilities.

I would say, though, lest I leave a bad impression about our relationship with EPA, we do have a good relationship with EPA on

other mercury issues, for example, the State/EPA mercury dialog

kick-off meeting that is going to happen in June. Ms. Stoner mentioned that. It is just that we can’t say we had the same relationship on this particular topic.

The third point I wanted to make is a resolution that ECOS

passed at its spring meeting only a couple of months ago. I think

that one is significant because the States recognize that amalgam

can be the single largest source of mercury for a POTW, and that

it is a water discharge concern and a source of pollution when

sludge is incinerated or land applied. And this is the significant

part, because in these days when State budgets are down and we

are concerned about the cost to implement EPA rules, that issue

was not brought up on this topic. In fact, our members agreed that

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EPA needs to include dental facilities under the health care sector

for rulemaking in its effluent guidelines program plan and require

the use of best management practices to comply with that rule.

In March just recently the Quicksilver Caucus sent a letter to

EPA with the same recommendations, and we pointed out that the

BMP’s recommendations included the installation and use of separators. There doesn’t seem to be much dispute about that as a best

management practice. Even ADA, as they have said, have recommended that.

So our two-pronged strategy acknowledges the value of voluntary

programs. They do have some value, and that is that EPA should

amend the MOU to include the role of a decisionmaking to include

the States, and EPA should set and implement ambitious voluntary

reduction goals throughout the MOU, and perhaps they have done

that now. That will hold us to some results during the period of

time in which a rule becomes final, and that can take quite a long

time, as you probably know.

But eventually EPA should require the dental facilities to implement BMPs, and they should install that and use separators, and

that rulemaking should come out this year, in our opinion.

Thank you very much.

[The prepared statement of Mr. Brown follows:]

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Mr. KUCINICH. Mr. Cain, you may proceed.

STATEMENT OF ALEXIS CAIN

Mr. CAIN. I appreciate the opportunity to speak to the subcommittee today about releases of mercury resulting from the use

of dental amalgam. In 2007, some colleagues and I published an article in the Journal of Industrial Ecology on the life cycle environmental releases resulting from the use of a variety of mercury-containing products including dental amalgam. This paper was based

on a mass balance model developed by Barr Engineering, with help

from the environmental agencies of Minnesota, Wisconsin, and

Dane County, Wisconsin, along with the U.S. EPA.

The model estimated the life cycle flow of mercury and products

from production through use and disposal, using distribution factors to estimate how much mercury would enter various disposal

pathways, and using release factors to estimate how much of this

mercury would be released to air, land, and water at each of these

stages. I will focus my testimony on the air and water releases.

We estimated, based on the model, that use of dental amalgam

was responsible for approximately 41⁄2 metric tons of mercury release to the atmosphere in 2005. There is considerable uncertainty

around this estimate, and all of the estimates that I will discuss

today.

Based on our estimates, dental amalgam is certainly not the

largest source of mercury to the atmosphere, but it is, nonetheless,

a significant source, accounting for roughly 4 to 5 percent of total

emissions.

Emissions from human cremation that is the result of the presence of dental amalgam fillings in corpses accounted for approximately half of the emissions related to dental mercury. Other significant air emissions pathways included volatilization of mercury

within the dental office, itself, and disposal of sewage sludge, both

from incineration and land application. Dental office mercury enters sewage sludge because of discharges to sanitary sewers from

dental wastewater systems.

We also estimated that dental amalgam was responsible for approximately 0.4 metric tons of mercury releases to water in 2005.

We estimated using the model that implementation of best practices, including amalgam separators, at all dental offices would reduce water discharges by approximately 0.3 metric tons, and air

emissions by approximately one metric ton through reducing the

mercury content of sewage sludge which is incinerated or land applied.

You may wonder what the value of this type of modeling is. Why

use a model to estimate releases instead of measuring these releases directly? I think that there are several reasons that a model

can be useful. First, a model can provide estimates, however rough,

of sources that are difficult to measure directly, such as releases

from the land application of sewage sludge.

Second, a model can generate estimates of releases caused by

particular products. Direct measurement, for instance, can give us

an estimate of how much mercury is emitted by incinerators, but

it requires a model to estimate how much of those emissions result

from the disposal of a particular type of product.

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Third, a model allows us to predict the impact of various management options. For instance, to estimate the potential decline in

mercury releases resulting from installation of amalgam separators.

Finally, a model provides a check on emissions measurements

and indicates where additional measurement may be warranted.

I would like to focus now on mercury emissions from crematories.

In the case of these releases, EPA’s estimate is that total nationwide emissions were 0.3 tons in 2005, based on extrapolating from

emissions measurements. The model, however, estimates that these

emissions are more than two tons per year, based on data on the

average mercury content of fillings, the number of fillings that an

average person has at the end of life, and the number of corpses

that are cremated.

As a general rule, there are good reasons to prioritize measured

results over an output from a model; however, I believe that in this

case the model’s results are more reliable. U.S. EPA’s estimates are

extrapolated from a small number of emissions tests at a single facility, which could generate a misleading result, given that we

would expect releases per cremation to vary greatly, depending on

the number of dental amalgam fillings in the particular corpse

being cremated at the time that the measurements were being

made.

The hypothesis that emissions inventories may under-state the

significance of mercury emissions from crematories is supported by

evidence from emissions testing in Europe, where there has been

more testing done than has been the case in the United States. For

instance, the National Emissions Inventory in the United Kingdom

uses an emissions factor of three grams per cremation, while Norway and Sweden each use an emissions factor of five grams per

cremation. U.S. EPA’s emissions inventory implies emissions of 0.4

grams per cremation, far lower than the likely range suggested by

the European evidence. The life cycle flow model implies emissions

of 2.7 grams per cremation, which is more consistent with the European evidence.

Given all the uncertainties, I certainly do not claim that the mercury flow model has produced a correct estimate of mercury emissions from human cremation; however, I believe that the evidence

is strong that EPA’s estimate understates emissions from this

source category. I believe that an appropriate evaluation of all the

available evidence would lead to an increase in EPA’s estimate of

mercury emissions from crematoria.

[The prepared statement of Mr. Cain follows:]

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Mr. KUCINICH. I thank the gentleman.

Mr. Reindl? Thank you.

STATEMENT OF JOHN REINDL

Mr. REINDL. Thank you, Mr. Chairman and Congresswoman

Watson. My name is John Reindl. I am a volunteer for the Mercury

Policy Project, because, unfortunately, Mr. Bender became ill and

has been unable to attend. I do have 13 slides that I would go

through very quickly, since a lot of these topics have been covered

already.

This chart, and it is repeated in the written testimony, shows the

quantity of mercury used in 2004 and the quantity of mercury that

is currently in products. As noted in the chart on the left, about

25 percent of all the mercury used in 2004 was, in fact, for dental

amalgams. As stated before by your Chair, about 1,000 tons of mercury are currently in the teeth of people in the United States, by

far the largest source of mercury in any products in the United

States.

We believe that mercury from tooth fillings is one of the largest

sources of mercury that is discharged from various sources to

wastewater treatment plants. Since a typical amalgam has a lifetime of 10 to 20 years, we have to look not only to mercury that

is currently being used, but the mercury that was used, because

those fillings will come out approximately 15 years later, and, as

has been noted before, mercury that escapes into the environment,

regardless of what form it is, is going to be converted to

methylmercury, which is going to buildup into fish and enter the

human body.

We have gone over the memorandum of understanding several

times before, so I will skip this slide and, in fact, the next slide

talks about the memorandum of understanding even more, so I will

skip that one, as well.

EPA testified that there were 12 States that have mandatory

agreements. We were aware of 11 of them. Obviously, if 11 States

or 12 States have agreements, 38 or 39 do not have agreements.

What we find is that, for a suitable best management practices

program, these are the elements that need to be included. It needs

to include the installation and proper management of amalgam

separators, requiring the dentists to recycle their mercury and requiring reporting to verify compliance.

This chart will show the partial estimate of sales of mercury

amalgam separators. The States in the white, which are the far

right of those bar charts, shows those States without legislation or

requirements, and the tall ones represent those States with legislation. Only 13 percent of amalgam separators have been sold in the

non-regulated States, even though those are 38 to 39 States, three

times the number of regulated States, the amount of amalgam separators is less than one-seventh of those otherwise sold.

Here is a comparison of the EPA’s estimate of mercury releases

from dental sources to the atmosphere compared to those represented by the Mercury Policy Project. As your Chair mentioned

before, the estimates of the Mercury Policy Project are five to seven

times larger than those estimates of EPA. And, as you can see from

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the slide, there are several areas that EPA did not include any estimates whatsoever.

This shows a flow diagram that was originally developed by a

Swedish chemical agency and was used actually as the basis for

our mercury flow models throughout the United States.

My big focus, though, is going to be on cremation. This is the

area that I have specialized in. As we see from this chart, and,

again, it is in the written testimony, the number of cremations is

expected to dramatically increase in the future. We believe that

this is going to increase the amount of mercury that is emitted to

the environment.

Additionally, what is happening is, because of improved dental

care in this country, the dental community has really done a super

job, and more people are having more of their teeth when they pass

away, but in those teeth there are more dental restorations; that

is, mercury fillings. Therefore, we are going to have an increase in

mercury emissions for two reasons: one is increased number of cremations, and the second is more dental restorations.

This shows a bunch of numbers, which is kind of hard to see on

the wall, but if you look in your testimony you will see that our

estimate is that the amount of mercury will over double within the

next 10 years as air emissions from cremations, because of the

combined impact of more cremations and more dental restorations.

The last slide is a summary. There are seven to nine metric tons

of mercury released to the environment per year. That is growing

rapidly. We don’t feel that the premise of the MOU was based on

true facts. We believe EPA should establish effluent guidelines for

dental offices. We believe that the dental air emissions data should

be updated, especially for cremation. We believe that EPA should

regulate mercury emissions from crematoria, and we believe that

EPA should maintain a transparent, open process to include the

non-governmental organizations.

Thank you.

[The prepared statement of Mr. Reindl follows:]

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Mr. KUCINICH. Thank you very much, Mr. Reindl.

Mr. Walsh, we are going to go to questions now. You testified

that the ADA filed public comment in 2007 against bringing dentist

offices under mandatory effluent guidelines. The reason you exempt dentists was, as you state, because dentists can and will act

on their own. But isn’t it true that nearly every State or local jurisdiction that has tried to get dentists to voluntarily adopt mercury

separators has then chosen to mandate or threatened to mandate

a separator requirement because dentists were not, in fact, acting

in large numbers on their own?

Mr. WALSH. Well, I think it is inherent in any voluntary program

that I am aware of that there is the implicit or explicit consideration that the next step is regulation. In the MOU, we specifically

say that EPA and the States reserve that right. In fact, in the communications that the ADA uses to its members, it points out, as it

must, to be honest and forthright with its members, that if they do

not do a voluntary compliance the likely next step is enforcement.

Mr. KUCINICH. So are just some members waiting for mandatory?

Mr. WALSH. There has been, I think, a very long education road

to educate the dental professionals about this issue. When I was

first retained by the ADA back in 2001, there was very little knowledge of what the regulatory regime was. They were dentists. They

had not been involved in many environmental issues.

They also had some scientific issues about what was being said.

A lot of people took the 50 percent numbers of what was going into

the plant, POTW plants, and said that was what was coming out.

We built a factual basis that showed that it was a problem that

was significant in terms of the effluent, the benefits of recycling,

and on a science basis, which professionals like the Dental Association and its members are understanding more, and we look at the

data and there were early failures, and the dental community was

part of the reason for the failures.

But if you look at the pattern not only in the voluntary programs

involving dentists, but other voluntary programs, because for 20

years the Water Office has used voluntary programs. In situations

like this where there is a large number of small entities that have

to be regulated and it has mainly to do with their own resources

and their own priorities, we thought that if we have a consistent

message from the ADA, from the regulators, and those States or localities where there are either local conditions that are required

more stringent, they should go ahead and do what they think is appropriate. We reserved all the rights to do that, but we think that

it actually will be quicker to do this on a voluntary basis, and we

understand that if we are not successful that a likely outcome is

that EPA will issue a regulation.

Mr. KUCINICH. Mr. Brown, would you like to respond to what Mr.

Walsh said?

Mr. BROWN. Voluntary programs have a purpose and a place, but

our position is that their time as the solution has passed. We need

to have EPA, under the Clean Water Act, assert its authority to

issue a rule on this matter, and during the process when that rule

is developed, before it is finalized, it takes years, typically, that the

voluntary programs can help educate dentists about their obligaVerDate 11-MAY-2000 14:34 Jun 09, 2011 Jkt 000000 PO 00000 Frm 00112 Fmt 6633 Sfmt 6633 C:\KATIES\DOCS\65133.TXT KATIE PsN: KATIE
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tions and get some results before the rule actually comes into

place.

Mr. KUCINICH. Mr. Walsh, you saw that chart on the wall, right?

Mr. WALSH. I did, yes.

Mr. KUCINICH. The one that deals with dentists seemingly responding when mandatory regulations are requiring adoption of

mercury separators. I mean, I just wanted to ask you, because you

have seen it, isn’t that evidence that dentists respond when you

have mandatory regulations?

Mr. WALSH. I think you need to look at the individual cases.

Mr. KUCINICH. I am asking what you saw, not what I saw.

Mr. WALSH. Well, what I saw is a number of different factual

backgrounds. One of the charts shows, I believe, either Minnesota

or Minneapolis in its voluntary program. That was a relatively successful voluntary program, and it was followed by agreement of the

local dental association to go to a——

Mr. KUCINICH. Are you talking about Massachusetts?

Mr. WALSH. No, I am talking about——

Mr. KUCINICH. Take a look at that chart. I just want to make

sure we are talking about the same thing, because if you are talking about Massachusetts, they had a different reason for their compliance in Massachusetts. This letter from the Commonwealth of

Massachusetts, which I will put into the record, says a big jump

in SolmeteX, Inc. separator sales apparent in Mr. Dube’s exhibits

starting 24 months prior to the effective date of Massachusetts’

regulations, which were adopted in 2006, this sales increase started

in 2004 was concurrent with an innovative incentivized early compliance effort implemented by MassDep in concert with the development of State regulations requiring separator use.

We will put that in the record, without objection.

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Mr. KUCINICH. Do you have any comment on that?

Mr. WALSH. Without having read the details——

Mr. KUCINICH. I am going to ask my staff to take——

Mr. WALSH. As a general matter, as I said a few seconds ago,

many of these programs, voluntary programs, some of them were

do it voluntary within X number of years or we are going to make

it mandatory. In a couple of cases they decided they didn’t need to

go to the mandatory case. Part and parcel of any of these voluntary

kinds of programs is the implicit or explicit threat of there being

a mandatory requirement.

Mr. KUCINICH. But if there is no mandatory requirement in the

offing——

Mr. WALSH. If there is no mandatory——

Mr. KUCINICH [continuing]. The voluntary compliance is going to

be low, right?

Mr. WALSH. That is true, but——

Mr. KUCINICH. OK. I am done. That is my question.

Mr. WALSH. Fine.

Mr. KUCINICH. That is what I wanted to hear.

Now, Ms. Watson is going to have 5 minutes, and then we will

be back. Thanks.

The Chair recognizes Ms. Watson.

Ms. WATSON. Thank you very much.

I mentioned a bill that I have called the CHOMP Act, and it

stands for Consumers Have Options for Molar Protection. First letter of each word spells CHOMP, and we chomp on food.

Your organization came out in opposition to my bill, the CHOMP

act, because the ADA believes that mercury amalgam is safe. However, the CHOMP Act addresses important consumer knowledge.

Do you believe dentists should tell every patient that amalgam

is mainly mercury?

Mr. WALSH. Testimony that I have prepared and what I have

been prepared to talk about——

Ms. WATSON. Yes? No?

Mr. WALSH [continuing]. Has to do with the——

Mr. WALSH. Can you answer my——

Mr. WALSH [continuing]. MOU and——

Ms. WATSON [continuing]. Question very specifically?

Mr. WALSH. No, I can’t answer your question because I am not

the person at the ADA who has responded to you. We can respond

in writing.

Ms. WATSON. Let me ask it again, and listen to it very carefully.

If I am not speaking clearly, just let me know.

Do you believe dentists should tell every patient that amalgam

is mainly mercury? Yes? No?

Mr. WALSH. You mean me personally, you are asking?

Ms. WATSON. Do you, Mr. Walsh?

Mr. WALSH. Just as Mr. Walsh?

Ms. WATSON. Do you believe that dentists should ask that question or tell the patients that amalgam is mainly mercury?

Mr. WALSH. I think I would have to know more about the issue

than I do, because——

Ms. WATSON. All right. If not, state in what circumstances should

dentists withhold from patients that amalgam is mainly mercury?

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Mr. WALSH. I am not aware of any circumstance in which dentists withhold that information.

Ms. WATSON. Can you think of a time when they should tell their

patients what amalgam is composed of and what percentages of

mercury is in amalgam?

Mr. WALSH. This is not something I am either qualified to——

Ms. WATSON. You are not aware?

Mr. WALSH [continuing]. Or prepared to respond.

Ms. WATSON. You are not aware? Yes? No?

Mr. WALSH. It is not a question I am capable or qualified to answer.

Ms. WATSON. Or are you capable or qualified to know what is

amalgam? What is an amalgam?

Mr. WALSH. I do know what an amalgam is, yes.

Ms. WATSON. OK. Do you know the percentages of what makes

up the amalgam?

Mr. WALSH. Yes.

Ms. WATSON. OK. Is amalgam 50 percent mercury?

Mr. WALSH. On average, yes.

Ms. WATSON. OK. Do you think a person should know that amalgam is 50 percent mercury?

Mr. WALSH. It is beyond my preparation for this meeting and I

have to think——

Ms. WATSON. Is mercury safe?

Mr. WALSH. The FDA has said mercury in amalgam use is safe.

Ms. WATSON. Is mercury safe?

Mr. WALSH. Well, you have to look at the use, the exposure to

determine it. In certain uses it is not safe, in other uses, at least

government agencies have found it to be safe.

Ms. WATSON. Let me see. Maybe I don’t really speak clearly, so

let me speak real clearly. You have a 9-year old child in the dental

chair and you are going to fill that cavity in that child’s mouth, the

mother is sitting right outside the door or maybe inside because no

one likes to go to the dentist. If the mother would ask the dentist,

what are you putting into my child’s mouth, do you think the dentist should tell that mother what is going in the mouth?

Mr. WALSH. If I were——

Ms. WATSON. We are talking about professionals.

Mr. WALSH. If I were asked the question I would answer the

question, but you are asking in a policy context.

Ms. WATSON. We are talking about a professional dentist, DDS,

and the mother wants to know what is going in the child’s mouth.

What do you think? Who do you represent?

Mr. WALSH. I represent the American Dental Association on

amalgam wastewater issues.

Ms. WATSON. OK. I will accept that. OK. Now, something goes

in that amalgam, and when they finish they usually give you some

water and you spit it out. It becomes wastewater. It goes out into

the sewage plant and then it goes into the ocean.

Now, if you were asked by a parent, is there anything in there

that will put my child at risk, do you think a dentist should say

yes, no?

Mr. WALSH. [No audible response.]

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Ms. WATSON. Apparently you are having trouble with my questions. Let me go on.

Mr. WALSH. OK. Go on.

Ms. WATSON. I do understand that historically——

Mr. KUCINICH. The gentlelady’s time is expired, but you can ask

your question.

Ms. WATSON. OK. I will just ask this one and then I will leave

it alone, but I think we are getting the picture. I think we are getting the picture here, and we are talking about a toxic substance.

I do understand that historically mercury fillings have been labeled

silver fillings because of their color. Is that something you understand?

Mr. WALSH. I have heard and used that phrase. Yes.

Ms. WATSON. OK. However, that title is no longer relevant and

it no longer fits and is desperately in need of a scientific update.

Why does the ADA insist on using the term silver fillings to describe amalgam rather than more appropriately referring to mercury fillings? And why doesn’t the ADA advocate for implementation of the recognized best practice of calling these fillings mercury

fillings? Now, you represent the ADA. Can you tell us?

Mr. KUCINICH. The witness can answer the question and then we

are going to complete this round.

Ms. WATSON. Yes.

Mr. WALSH. I think the ADA can answer that question in writing. Again, that is not within the area in which I represent them.

Ms. WATSON. Are you refusing to answer verbally?

Mr. WALSH. I am saying I am not the one that knows the answer, so I——

Ms. WATSON. But you are representing the ADA.

Mr. WALSH. I am representing them, as I said in my opening

statement——

Ms. WATSON. I yield back.

Mr. WALSH [continuing]. Based on amalgam wastewater issues.

Ms. WATSON. I yield back.

Mr. KUCINICH. Well, let me pick up where the gentlelady left off,

and that is that you heard the question or asked, and I would like

to see an answer in writing.

Mr. WALSH. We will.

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Mr. KUCINICH. I appreciate your being here. Until myself and my

colleagues get answers, definitive answers to these questions, we

are not going to be able to put this issue to rest and we will be

coming back and back and back.

Mr. WALSH. We will be happy to answer all of those questions.

Mr. KUCINICH. That is why we are hoping these hearings are——

Ms. WATSON. Mr. Chairman, could you yield so I can ask you a

question?

Mr. KUCINICH. All right.

Ms. WATSON. I would hope that if we do another hearing, we will

require someone who is a professional dentist from the ADA rather

than the attorney, because the questions I am asking really should

be responded to by a professional——

Mr. KUCINICH. Well, I will ask staff to be mindful of your request.

Ms. WATSON. Maybe we can put it in writing and see if we can

get somebody, not the attorney.

Mr. KUCINICH. Mr. Walsh is aware of the rules that this committee has to produce witnesses, so you can facilitate that working

with the committee, I am sure. Thank you.

Ms. WATSON. Thank you.

Mr. KUCINICH. Mr. Cain, in your testimony you conclude that

‘‘EPA’s estimate under-states emissions of mercury from human

cremation.’’ Your own scientific work estimates the true emissions

to be about at least seven times the estimate from EPA; isn’t that

right?

Mr. CAIN. That is right.

Mr. KUCINICH. The problem of mercury air emissions by

crematoria likely to increase, decrease, or stay the same, in your

opinion?

Mr. CAIN. In my opinion I agree with Mr. Reindl that over the

next 10 years it will increase. I think over the much longer term

it will decrease as a result of better dental care and the reduced

need for dental amalgam fillings. But for the next decade, it will

certainly increase.

Mr. KUCINICH. Mr. Reindl, what is the European research about

mercury air emissions from crematoria showing?

Mr. REINDL. I would agree with what Mr. Cain had said. The

peak appears to be forecast to occur about 2020, and after that period of time it will start to decrease.

Mr. KUCINICH. So does mercury in the teeth of deceased persons

amount to a significant source of air emissions from crematoria?

Mr. REINDL. In my opinion, yes, a very significant source.

Mr. KUCINICH. Going back to Mr. Cain, your paper in the Journal of Industrial Ecology was published in 2007, but you have been

presenting your work since 2005 at scientific conferences; isn’t that

right?

Mr. CAIN. That is correct.

Mr. KUCINICH. And in those years did your work ever have an

impact on EPA’s official air emissions inventory?

Mr. CAIN. No, it did not.

Mr. KUCINICH. Now EPA has informed us that they are in the

process—that was the word that Ms. Stoner used—process of developing an automated, internet-based procedure of receiving actual

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emission measurements and calculating with them by algorithm

emissions factors in a dynamic way. Before my staff spoke with you

about that, have you ever heard from anyone in the EPA that the

agency was revamping its emissions inventory in this way?

Mr. CAIN. No, I had not.

Mr. KUCINICH. And do you think, based on what you know so far,

that this new procedure is assured of getting the air emissions of

mercury from crematoria right, or are there possible complications

that could compromise the new inventory system?

Mr. CAIN. I think there are complications. I mean, certainly to

have additional stack testing would be a beneficial thing. I think,

for some of the reasons I stated in my testimony, you need to be

careful that the stack testing is representative and that it is probably a good idea to not rely entirely on stack tests but also to look

at techniques such as looking at how much mercury is actually

going into the crematoria, which is easier to do than to measure

the mercury coming out.

Mr. KUCINICH. So what are some of the difficulties that could get

in the way of the EPA’s new system of emission factors accurately

determining emission factors for mercury air emissions from

crematoria and sludge incinerators?

Mr. CAIN. I think the biggest problem is getting representative

samples for emissions tests. The other problem is that mercury air

emissions testing is difficult to do. It is easier to make mistakes.

I mean, it is fairly easy to count fillings in a person’s mouth, but

more difficult to measure micrograms of mercury per cubic meter

of air. So I think it would require a lot of air emissions testing.

Mr. KUCINICH. So what questions do you think Congress should

be pursuing with EPA to ensure that their new air mercury emissions aren’t as mistaken as the old estimates?

Mr. CAIN. I would think that asking EPA to consider all the

available evidence, both stack testing and other types of evidence,

would be appropriate.

Mr. KUCINICH. Mr. Reindl, do you have any comment on that?

Mr. REINDL. Besides the comments that Mr. Cain made about

the difficulty measuring the stack emissions, what we have found

through our literature review is actually much of the mercury

doesn’t go through the stack, and that they have found that the

mercury emissions actually in the office of the crematoria are higher than the emissions outside, suggesting that the emissions are

not going necessarily up the stack but are going through leaks, if

you will, in the actual cremation unit, and so measuring the emissions from the stack is going to be very, very difficult.

Another point to note is that there is no crematorium in the

country that is required to have any air emission controls whatsoever. We have almost no data on an ongoing basis from any crematorium. The one crematory that was used 10 years ago had mainly

just a water spray system to reduce some of the dust, but there is

no other emissions control on any crematorium in the country otherwise.

Mr. KUCINICH. To staff, one of the things that occurs to me is

that as the EPA is going through this process we should call to the

EPA’s attention experts who are available who have done research

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that might enable their process to be enriched by that research. Especially ones who work there. Just a thought.

The Chair recognizes Ms. Watson.

Ms. WATSON. Mr. Brown, you have heard my line of questioning,

and you heard the responses that have come from Mr. Walsh. Can

you help us understand the position of the ADA? Do you know anything about the American Dental Association and their opposition

to the amalgam fillings, the silver fillings?

Mr. BROWN. I don’t. In fact, it pains me to have to say I have

sort of the same answer that Mr. Walsh did. I can talk to you about

the environmental disposition of the mercury once it leaves the

dental office, but not the rest.

Ms. WATSON. OK. Well, can you? Maybe that is something that

might be compelling as we try to gather more evidence and try to

change the ADA’s position about amalgams.

Mr. BROWN. Yes, ma’am.

Ms. WATSON. The environmental impact, because we all know

that the waste goes to the sewer management and then out into

the ocean, and we just heard the emissions. There is no way or

they have not come up with a way to capture and to change the

particles in the emissions. They go out into the environment.

Can you help us?

Mr. BROWN. Well, one of the things that in preparation for this

hearing and listening to the testimony is it occurs to me that I

need to go back and ask the Quicksilver Caucus if it has any recommendations to ECOS about incinerators and mercury emissions

from crematoria, because that is not an issue that, I mean, we are

aware of it and we have looked at it, but we don’t have a position

on it, and it strikes me that we need to have one.

Ms. WATSON. All right. Mr. Cain, can you help us?

Mr. CAIN. I can note on the question of controlling mercury emissions from incinerators that one of the States in Region 5, Minnesota, has worked on a voluntary basis with the mortuary association in the State and the University of Minnesota, and they have

come up with a goal of reducing mercury emissions from

crematoria by 75 percent.

Ms. WATSON. Yes.

Mr. CAIN. There is a variety of alternatives that they are going

to look at, including alkaline hydrolysis or dechlorinating teeth

prior to cremation.

Ms. WATSON. I am aware of many substances, Mr. Brown, that

can be used in place of the mercury in the amalgam, and I was told

by the National Dental Association that they are too expensive and

people will stop coming and bringing their children or coming in for

fillings because of the cost.

Does anyone at the table here know of any of the substitutes?

Mr. Walsh, you can’t speak professionally. You just told me that,

so I will refer this to other panelists, maybe Mr. Reindl. The separators, yes, and, Mr. Reindl, can you tell us how we can protect

from further pollution of our environment because of the mercury

switch?

Mr. REINDL. Well, speaking on the cremation issue, obviously

there are two ways to deal with it. One is to remove the teeth prior

to cremation, and the other is to control the mercury emissions

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during the process or use an alternative process such as the alkaline hydrolysis process. One of the challenges that Minnesota is

facing is that they are not sure of what technology can help them

meet their goal for stack emissions and, as I mentioned before, not

all the emissions to through the stack, so that is a very big challenge.

Ms. WATSON. So we still need more research is what you are saying?

Mr. REINDL. We still need more research. When your Chair noted

to staff that EPA ought to involve experts on the cremation issue,

I raised my hand to make a note that unfortunately we don’t have

many experts on this. When I have been doing this literature and

survey and contacting people in the field for over 10 years, I have

never found anybody at a university in North America that has

worked on this. I have never found anybody in the entire world

that has done such a survey of references on cremation. In fact,

some of the people that I was in contact with in Germany and Norway are no longer involved in it. There simply aren’t any experts

in this field.

Ms. WATSON. I hear you loud and clear. I think that is one of the

reasons why we are having this hearing, and I just appreciate the

Chair for allowing me to take part in this hearing. I am on the subcommittee, too. Mercury is a toxic substance that can do harm. I

am just shocked that professionals don’t understand the harm that

mercury can do in a filling, and they are still calling these silver

filings. You know, people like gold fillings and silver and so on. I

think these mis-statements and holding back this information is

very harmful to the health.

Mr. Chairman, I will just end by saying this: I am about this for

improving our environment and keeping Americans healthy, and

people who only consider the money that comes out of this profession from doing this I think are an abomination to society. I am

concerned about the health of young people. I am a victim. And

when we come and we bring professionals to this panel and they

are not straightforward and honest to us and do not want to share

with the public, the public has a right to know about anything that

is inserted in their bodies.

It is a proven fact that mercury is a very toxic substance, and

I would hope that the dentists would understand and would have

the knowledge, Mr. Reindl, of how they are polluting the wastewater. And I would hope that they would not send an attorney who

really doesn’t understand the chemicals and the ingredients and

what makes up an amalgam here to testify in front of this committee, and particularly when I am on it, because I don’t buy it.

We have been studying this, Mr. Chairman, for years, and so I

would like a professional in front of me that can tell me what they

put into a person’s mouth and will share that information. We

fought for years to get the warnings on smoking, and now almost

on everything you buy in a market you can find out the ingredients

in there. If you have allergies to peanuts, you had better know

there are peanuts in that candy bar you give to a kid, because they

can kill you. And if you are a professional medical person and you

don’t know, you are just as guilty as somebody who put a gun to

their head.

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With that, I yield back.

Mr. KUCINICH. I thank the gentlelady from California for her

participation in this hearing, and all the other Members who participated.

This is the Domestic Policy Subcommittee of Oversight and Government Reform. Today’s hearing, Assessing EPA’s Efforts to Measure and Reduce Mercury Pollution from Dentists’ Offices. We have

had two panels of witnesses. I want to thank the panel in front of

us for their participation.

This committee will continue to retain jurisdiction over this matter related to various types of mercury toxicity and their circulation

in the broader society.

As you can see, there are members of this subcommittee, myself

included, who have very strong feelings on this. It is noteworthy

because, as chairman, I rely very closely on how the members of

my committee feel about what we should pay attention to.

That having been said, to the best of your ability to help us move

this along to compliance and to protect the public health would be

much appreciated.

With that, this subcommittee stands adjourned. Thank you.

[Whereupon, at 4:22 p.m., the subcommittee was adjourned.]

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