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After a long silence on the question, the European Commission has just re-opened the debate on dental amalgam (better known as fillings). It has asked two of its expert committees to draft an opinion on the environmental and health risks from the use of dental amalgam(1). The Commission's final decision will depend on these reports, due to be finalised by mid-2014. It could also be influenced by recent developments in the international sphere, particularly the signature by 94 states parties (including the EU) of the first global legal instrument for the gradual prohibition of mercury (Minamata Convention).

Dental amalgam has been used for more than 150 years to treat cavities, due to its excellent mechanical properties and durability. It is composed of mercury, a chemical element known for its interesting physical and chemical characteristics, but also for its toxicity to humans, ecosystems and nature. It is estimated that around 20 tonnes a year are released into the atmosphere due to dental care, ie 14% of total emissions from human sources (estimated at 140 tonnes per year in 2010). France and Poland are the two largest consumers of dental amalgam.

In its 2005 mercury strategy, the Commission did not take a position on the question. Its two scientific committees - the Scientific Committee on Health and Environmental Risks (SCHER) and the Scientific Committee on Emerging and Newly Identified Health Risks (SCENIHR) - both backed this approach in 2008, finding that the use of dental amalgam containing mercury did not pose serious or long-term threats to health, apart from allergies.

Over the years, however, calls for a prohibition have become more pressing. In 2011, the Council of Europe adopted a recommendation calling for "the restriction or even a prohibition of amalgam as a dental material". The World Health Organisation (WHO) recommended the use of alternatives. In 2010 and 2012, an external consultant, BIO Intelligence Service, drew up two reports for the European Commission expressing support for the prohibition of amalgam containing mercury by 2018. Denmark and Sweden have already taken that step, banning dental mercury on their territory.

Against this background, the Commission recently instructed SCENIHR (health aspect) and SCHER (environment aspect) to "update their opinions in the light of new information available". The first is still working and is expected to publish a draft text in spring 2014. The second published a preliminary opinion (2)in June 2013, on which a public hearing was held on 6 November and a public consultation between September and November. The consultation produced the following conclusions: 1. for aquatic environments, mercury from amalgam does not pose a risk to European surface waters. However, in particular local conditions, the quantity of mercury can be superior to environmental quality standards and a risk to the aquatic ecosystem cannot be ruled out; 2. for soil and air, information is currently too limited to allow a risk assessment; and 3. in certain local conditions where mercury concentration in aquatic environments exceeds environmental quality standards, a risk of secondary poisoning in humans through the food chain cannot be ruled out, though it is minimised by EU food standards.

Once the two final reports have been published, the Commission will decide whether EU action is necessary or not.

(1) According to an EU source, the proposals on medical devices and in vitro medical devices, currently being negotiated, are not expected to have much impact on dental amalgam

(2) See
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Publication:Europe Environment
Date:Jan 24, 2014

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