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Mercury Reductions in the Dental Sector in Sweden
Eva Sandberg
Senior Adviser
International Secretariat
Swedish Chemicals Agency
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Outline
• Background (brief)- The mercury problem in Sweden- Swedish policy on mercury- Actions
• Dental amalgam phase-out• Mercury Reductions in the Health
Care Sector (2nd part)
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Europe and the European Union
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Sweden in brief
9 million inhabitants3 major urban areas
410 000 km2 total area240 000 km2 forest land>100 000 lakes
0.7 tonnes Hg air emission4.2 tonnes Hg deposition (mainly from outside Sweden)
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Mercury is a problem in SwedenFish in 50 000 lakes exceeds WHO limit (0.5 mg Hg/kg).
Levels in forest soil increases and probably effects important soil microbial functions.
Deposition must be reduced by 80% to reach safe levels.
International action needed.
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Environmental Quality Objective: A non-toxic environment
Interim target regarding mercury
• Newly manufactured finished products will as far as possible be free from mercury, as soon as possible, but no later than 2007.
• Nor will mercury be used in production processes unless the company can prove that human health and the environment will not be harmed.
• Finished products already available will be handled in such a way that mercury is not released to the environment.
• The spread to Sweden by air or water of mercury will decrease continuously.
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Phase out use in products and processes.
No export.
Mercury already in society should be collected and treated.
Mercury should not
be recycled.
Mercury should be safely disposed in a final storage.
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Swedish actions in brief
• Ban on the sale of fish from certain lakes in the early 1970´s
• General recommendation for fish consumption - Pregnant and breast-feeding women: No consumption- General public: Once a week
• Reductions of emissions from point sources
• Ban on certain Hg-containing products in 1992
• Export ban entered into force1997
X
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… actions in brief
• Collection of Hg and identification of Hg-products
1994 – 1999
• Parliament decision 2003 on final storage of Hg
and Hg-containing waste, latest 2015 • Notification Feb 2006 to EU and WTO of a general
ban on Hg and Hg- containing products (use, placing on the Swedish market, export and import) – Not yet entered into force
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Swedish regulation on mercury
• Mercury and its compounds and preparations may not be exported professionally from Sweden
• Certain goods (measuring instruments, electrical components such as switches, thermostats, relays and circuit breakers) containing mercury may not be manufactured or sold or used if not in use before 1995
• These goods may not be imported from third countries or exported from Sweden
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Investigation of a national general ban on the marketing and use of Mercury
• Includes for example dental amalgam,
chemicals and chlor-alkali industry
• Proposal to Government 30 June 2004
• Report is available in English at www.kemi.se
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Yearly supply of mercury in products in Sweden (kg)
0
50010001500200025003000
3500400045005000
1991/92 1997 2003
Measuringinstruments,electrical devices
Batteries
Light sources
Dental amalgam
Analytical chemicals
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Dental amalgam
• Dental amalgam contains about 50 % Hg
• Mercury is released to the environment at several steps
• Risks to the environment and to human health
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Sewage sludge
Cremation
Incineration
Land application
Sewer system
Waste
Hg
Sep
arat
or
Landfill
Waste
Hg
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0
200
400
600
800
1000
1200
1400
1600
1800
1991/92 1997 2003
Mercury supplied to dental amalgam in Sweden (kg)
US (280 million people): >30 tonnes Hg (2005)
EU (460 million people): est. 90 tonnes Hg (2005, 25 MS)
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Mercury-free dental fillings
• Dental amalgam has been replaced almost totally during the last six to seven years in Sweden
• Swedish suppliers of dental materials and users from both public and private sector are the sources of the used statistics in the new report
• Composites are the most commonly used materials in Sweden
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The shares of dental filling materials used in Sweden (% by weight*)
Composites
78 %
Glassionomers
Amalgam
Compomers 3%
Ceramics <1%
13 %
6 %
* One kilo of composites will fix many more teeth than one kilo of amalgam due to the differences in weight of the materials.
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Amalgam fillings in % of total fillings at Folktandvården in Sweden 2002 and 2003
0
0,5
1
1,5
2
2,5
3
Adults
Children
Adults 3 1,8
Children 0,1 0,05
2002 2003
Source: Swedish Board of Health and Welfare
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Success factors
• High awareness of the environmental and health risks among patients and dentists.
• Demand for and access to other filling materials.• Agreement between the state and the county
councils in 1995 to phase-out use from children's dentistry.
• Since 1999 no financial support given from Swedish dental insurance for amalgam fillings.
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Thank you for your attention!
Thanks to colleagues Petra Ekblom and Ulla Falk