title: The Minamata Convention on Mercury: attempting to address the global controversy of dental amalgam use and mercury waste disposal.
abstract: In October 2013, a new international binding treaty instrument called the Minamata Convention on Mercury opened for signature in Minamata City, Japan, the site of arguably the worst public health and environmental disaster involving mercury contamination. The treaty aims to curb the significant health and environmental impacts of mercury pollution and includes provisions addressing the mining, export and import, storage, and waste management of products containing mercury. Importantly, a provision heavily negotiated in the treaty addresses the use of dental fillings using mercury amalgam, an issue that has been subject to decades of global controversy. Though use of dental amalgam is widespread and has benefits, concerns have been raised regarding the potential for human health risk and environmental damage from emissions and improper waste management. While the Minamata Convention attempts to address these issues by calling for a voluntary phase-down of dental amalgam use and commitment to other measures, it falls short by failing to require binding and measurable targets to achieve these goals. In response, the international community should begin exploring ways to strengthen the implementation of the dental amalgam treaty provisions by establishing binding phase-down targets and milestones as well as exploring financing mechanisms to support treaty measures. Through strengthening of the Convention, stakeholders can ensure equitable access to global oral health treatment while also promoting responsible environmental stewardship.
authors.affiliation: Joint Master of Advanced Studies in Health Policy and Law Program, University of California, San Diego School of Medicine and California Western School of Law, United States; San Diego Center for Patient Safety, University of California, San Diego School of Medicine, United States; Department of Anesthesiology, University of California, San Diego School of Medicine, United States; Institute of Health Law Studies, California Western School of Law, United States. Electronic address: tmackey@ucsd.edu.
authors.forename: Tim K
authors.initials: TK
authors.lastname: Mackey
authors.affiliation: Joint Master of Advanced Studies in Health Policy and Law Program, University of California, San Diego School of Medicine and California Western School of Law, United States.
authors.forename: John T
authors.initials: JT
authors.lastname: Contreras
authors.affiliation: Joint Master of Advanced Studies in Health Policy and Law Program, University of California, San Diego School of Medicine and California Western School of Law, United States; San Diego Center for Patient Safety, University of California, San Diego School of Medicine, United States; Department of Anesthesiology, University of California, San Diego School of Medicine, United States.
authors.forename: Bryan A
authors.initials: BA
authors.lastname: Liang
mesh_terms: D003723:Dental Amalgam / Q000032:analysis*; D018057:Dental Waste / Q000032:analysis*; D058735:Environmental Policy / Q000331:legislation & jurisprudence*; D004785:Environmental Pollutants / Q000032:analysis*; D004787:Environmental Pollution / Q000331:legislation & jurisprudence; D006801:Humans; D007564:Japan; D017744:Medical Waste Disposal / Q000379:methods; D008628:Mercury / Q000032:analysis*; D011634:Public Health
chemical_list: D018057:Dental Waste; D004785:Environmental Pollutants; D017744:Medical Waste Disposal; D003723:Dental Amalgam; D008628:Mercury
keywords: Dental amalgam; Global health; Global oral health; Mercury Global Environmental Programme; Mercury pollution; Minamata Convention on Mercury