Transcript Minamata Convention And Its Implication To Dentistry

MINAMATA CONVENTION AND ITS IMPLICATION
TO DENTISTRY
Nik Mohd Haziq Asyraff Nik Alim
(1090051)
Nur Fatin Rusli (1090028)
Objectives:
1.
2.
3.
4.
Able to understand the Minamata disease and its
history.
Know the content of Minamata Convention on mercury.
Describe the relationship of Minamata convention on
mercury and dentistry.
Can relate the implication of Minamata Convention on
mercury towards dentistry.
MINAMATA DISEASE

Is a Methylmercury poisoning with neurological
symptoms and caused by daily consumption of
large quantities of fish and shelfish that were
heavily contaminated with toxic in the sea. It is the
first epidemic occurred in southern costal area of
Yatsushiro including Minamata through 1950s to
1960s.

This diseases is a negative consequence
associated with environmental pollution caused by
industrial activity. Where little consideration was
given to environment and more priority in
productivity.
HISTORY OF MINAMATA

Minamata is small town facing the Yatsushiro sea in
southern japan. It is abundant fishing resources for
the residents.

On spring day 1956, a girl of 5 years old was found
to have unusual neurological symptoms. She had
convulsion and difficulties in walking and speaking.
She was the first documented case of Minamata
disease. The clinical symptoms varies depend on
exposure level to the chemical.
SIGN AND SYMPTOMS
Severe cases of Minamata disease are
characterized by Hunter Russel syndrome that
includes sensory disturbance predominantly in
distal portions of extremities, cerebellar ataxia, and
bilateral concentric constriction of the visual field.
Other neurological sign and symptoms are:
 1. Dysarthria
 2. Hearing impairment
 3. Disturbance of ocular movement
 4. Equilibrium disturbance
 5. Tremors.

MILD CASES
It has been reported it associated with:
 1. Paresthesia
 2. Athralgia
 3. Myalgia of extremities
 4. Disability using fingers
 5. Easy stumbling and unsteadiness
 6. Cramp
 7. Headaches.
 8. Failure of memory
 9. Insomia.

The company that responsible for the epidemic was
the chemical company named, Chisso.
 It’s a predominant company with advance
technology in japan at that time. Methylmercury
was generated as by product in reaction chamber
as for manufacturing Acetyldehyde that was
synthesize by a hydrolysis of acetylene using
mercury as a catalyst.
 Acetyldehyde production increase because of high
demand during that era.
 Methylmercury is discharge into the sea and
accumulated in fish and shellfish through
absorption.

MINAMATA CONVENTION

Is a global treaty to protect human health and the
environment from adverse effects of mercury. It was
agreed at fifth session of intergovernmental
Negotiating Committee in Geneva, Switzerland 19
January 2013.

Highlights on ban a new mercury mines, phase out
of existing one, control measure on air emissions,
and the international regulation of the informal
sector for artisan and small scale gold mining.

It was open for signature at special meeting in
japan in October 11, 2013. 92 countries have
signed the treaty to prevent such a tragedy from
happening again.
IMPLICATION WITH DENTISTRY
Dental amalgam is a compound containing mercury
and therefore is among the products regulated in
the treaty.
 Under Article 4 paragraph 3 of the treaty: “Each
Party shall take measures for the mercury added
products listed in Part II of Annex A in accordance
with the provisions set out there in.”

Widely used
since more
than 150 years
ago
-Strength
-Durable
Amalgam
Inexpensive
Composition:
-mercury (50%),
-silver (22-32%),
-tin (14%),
-other metals
Not
aesthetic
1) Phasing down
the use of
amalgam
2) Promoting
research into
new
dental materials
IMPLICATION
TO
DENTISTRY
3) Best
management
techniques for
amalgam waste
4) Prevention
of dental
caries
1)
Phase Down Amalgam Use Over An Appropriate Time
Period
An approach advocated by the World Health Organisation
(WHO)
 Minimizing the use of mercury in fillings by promoting
alternatives.
 Phase down phase out


Steps to “phase down amalgam use.”
 Setting national objectives aimed at minimizing
(amalgam) use;
 Promoting the use of cost-effective and clinicallyeffective mercury-free alternatives;
 Encouraging professional societies and dental schools
to educate and train dental professionals in the use of
mercury-free dental restoration; and
 Encouraging insurance policies and programs that
favor the use of quality alternatives to amalgam.
3) Best Management Of Dental Amalgam Waste

Dental amalgam waste should be recycled

Should not be disposed of in the general waste, infectious
waste “yellow bag,” pharmaceutical waste or sharps container

Should not be rinsed down the drain.

Amalgam waste, if kept separate from other waste, can be
safely recycled.

The mercury can be extracted from amalgam wastes through
a distillation process and can be reused in new products.

Recycling is best practice for amalgam waste management for
dental clinics.
2) Promoting Research Into New Dental Materials

Comparison between new dental materials (eg:
composite, GIC, RMGIC, Giomer, compomer) and dental
amalgam.

New dental material costly
Types of Amalgam Waste
• Non-contact amalgam (scrap)
• Contact amalgam
• Amalgam separators- 95% of amalgam waste but also
trap other treatment debris
• Chair side traps
• Vacuum pump filters
• Amalgam sludge
• Empty amalgam capsules
Steps for Recycling Amalgam Waste
1.
Stock amalgam capsules in a variety of sizes to
minimize the amount of amalgam waste generated.
2.
Use high velocity evacuation
3.
Use personal protective equipment such as gloves,
masks, and protective eyewear when handling amalgam
waste
4.
Store amalgam waste in a covered plastic container
with labelling.
5.Arrange for your recycler to collect your amalgam waste
on a regular basis.
4) Reduce The Need For Restorative By Prevention Of
Oral Disease
 Dental caries cavity  restoration
 Prevention to minimize restorative treatment
 Prevention could be:
Plaque control
 Diet counselling
 Fluoride
 Fissure sealant

References:
 Alternative to Mercury Product, Global Mercury
Partnership, UNEP.
 http://www.ada.org/sections/publicResources/pdfs/topics
_amalgamwaste.pdf
 http://mercurypolicy.org/wpcontent/uploads/2013/01/dental_news_march_2013.pdf
 On The Minamata Convention Concerning Mercury –
UNEP Programme, NOVEMBER 2013.
 Minamata Convention Text And Annexe,
www.mercuryconvention.org
Thank you