Mercury Reductions in the Dental Sector in Sweden

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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 inhabitants 3 major
urban areas 410 000 km2 total area 240 000 km2
forest land gt100 000 lakes 0.7 tonnes Hg air
emission 4.2 tonnes Hg deposition (mainly from
outside Sweden)
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Mercury is a problem in Sweden
Fish 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
environmentInterim 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.
Mercury already in society should be collected
and treated.
Mercury should not be recycled. Mercury should
be safely disposed in a final storage.
No export.
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Swedish actions in brief

• Ban on the sale of fish from certain lakes in the
  early 1970s
• 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)
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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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Hg
Waste
Waste
Separator
Sewer system
Incineration
Sewage sludge
Hg
Landfill
Land application
Cremation
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Mercury supplied to dental amalgam in Sweden (kg)
US (280 million people) gt30 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)
Glassionomers
13
Amalgam
6
Compomers 3
Composites 78
Ceramics lt1
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
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