Introduced by Representatives Hosford of Waitsfield, Botzow of Pownal, Clarkson of Woodstock, Deen of Westminster, Donahue of Northfield, French of Randolph, Grad of Moretown, Green of Berlin, Haas of Rochester, Head of S. Burlington, Johnson of South Hero, Keenan of St. Albans City, McCullough of Williston, McLaughlin of Royalton, Miller of Shaftsbury, Pellett of Chester, Reese of Pomfret, Seibert of Norwich and Sharpe of Bristol
Subject: Mercury; prohibited vaccines and fillings; dental coverage; nonmercury vaccines; dental fillings; mercury amalgam notice; contaminated fish advisory
Statement of purpose: This bill proposes to: (1) prohibit the use of mercury‑containing vaccines for children and require coverage for mercury‑free vaccines for those under 18 and over 65 when insurance coverage for vaccines is provided; (2) prohibit dentists from using mercury amalgam dental fillings in pregnant women except in an emergency; (3) require use of nonmercury filling materials for children unless otherwise medically indicated; (4) require coverage for mercury-free dental fillings when insurance coverage for dental fillings is provided; (5) require the state to ensure that the state employees’ dental insurance contract provides coverage for nonmercury dental fillings at no greater expense than for mercury‑containing dental fillings; (6) require the commissioner of health to develop a poster and a brochure related to dental procedures involving mercury amalgam and other dental filling materials; (7) require dentists to make such information available to their patients; (8) direct the commissioner of health to develop and distribute to grocery stores where fish is sold an advisory on contaminated fish; and (9) require grocery stores to place consumer advisories where fish is displayed for sale.
AN ACT RELATING TO MERCURY EXPOSURE REDUCTION
It is hereby enacted by the General Assembly of the State of Vermont:
Sec. 1. LEGISLATIVE FINDINGS
The general assembly finds:
(1) Mercury is a heavy liquid metallic chemical compound, and elemental mercury and mercury compounds are known to be toxic and hazardous to human health and the environment.
(2) Human exposure to mercury can result in significant damage to the central nervous system, brain, heart, kidneys, liver, and gastrointestinal and reproductive organs. Research has established that developing fetuses and young children are very sensitive to the toxic effects of mercury, which can result in lifetime developmental delays, reduction in of IQ, and neurological damage.
(3) People are exposed to mercury in many ways, including by eating mercury-contaminated fish, by inhaling mercury vapors, and by coming into contact with other mercury‑containing products, such as mercury-containing injections and thimerosal in vaccines.
(4) According to a report of the U.S. Agency for Toxic Substances and Disease Registry, mercury from dental amalgams constantly vaporizes and is exacerbated by activities such as chewing, tooth brushing, and consumption of hot liquids. These vapors are then inhaled by the human body where they are distributed by the bloodstream to vital organs throughout the body.
(5) Each dental amalgam contains approximately 50 percent mercury. Researchers for the U.S. Naval Dental Research Institute have indicated that, when discharged into the environment, waste dental mercury may methylate, become bioavailable, and subsequently biomagnify in fish as methylmercury, the most toxic form of mercury.
(6) Health Canada, the Canadian federal department responsible for helping Canadians maintain and improve their health, advises dentists to consider using nonmercury dental filling materials for restoring the primary teeth of children and recommends that amalgam fillings should not be placed in or removed from the teeth of pregnant women.
(7) The state of Maine requires dentists to post notices at their clinics and provide pamphlets to patients explaining the potential advantages and disadvantages to oral health, overall human health, and the environment of using mercury or a mercury amalgam in dental procedures.
(8) The primary means of exposure to methylmercury is the consumption of contaminated fish and shellfish.
(9) The U.S. Food and Drug Administration, the Environmental Protection Agency, and the Vermont Department of Health recommend that pregnant women, women of child-bearing age, and children not eat certain seafood and limit consumption of white albacore canned tuna to six ounces per week.
(10) In 1999, at the request of the American Academy of Pediatrics and the U.S. Public Health Service, vaccine manufacturers began removing thimerosal from the vaccines that are given to children from birth to age four.
(11) Thimerosal continues to be used in the optional flu vaccine that is annually given to adults and children in Vermont and across the United States.
Sec. 2. 18 V.S.A. § 1130 is added to read:
§ 1130. VACCINES CONTAINING MERCURY
(a) No child younger than 18 years old shall be vaccinated with a vaccine or injected with any product that contains or prior to dilution had contained as an additive any mercury‑based product, whether at preservative or trace amount levels.
(b) The health department may exempt the use of a vaccine from this subdivision if the department finds that an actual or potential bio-terrorist incident or public health emergency requires the administration of a vaccine containing mercury. A public health emergency may include an epidemic or shortage of supply of a vaccine at a reasonable cost that would prevent a child from receiving the needed vaccine. The department shall:
(1) not issue an exemption for more than 12 months, but may extend the exemption for an additional 12 months;
(2) notify the general assembly within 48 hours of issuing an exemption or extension and include the department’s findings justifying the exemption or extension;
(3) notify within seven days of the request any party who has expressed interest in writing to the department that an exemption or extension has been requested; and
(4) notify within seven days of granting the exemption or extension a party who has expressed interest in writing to the department about any exemption or extension and the department’s findings justifying the exemption or extension.
Sec. 3. 8 V.S.A. § 4100d is amended to read:
CHILD VACCINE BENEFITS
(a) No insurer shall reduce its coverage for pediatric vaccines below the coverage provided as of May 1, 1993.
(b) A health insurance plan shall provide coverage for mercury-free vaccines and injections for all children under the age of 18 and all adults age 65 and older. This coverage shall be the same as that provided under the health insurance plan for vaccines and injections that contain mercury and shall not establish any rate, term, or condition that places a greater financial burden on an insured for access to mercury-free vaccines and injections for a child under the age of 18 or an adult who is age 65 or older than for access to vaccines and injections containing mercury.
Sec. 4. 8 V.S.A. § 4100e is added to read:
§ 4100e. MERCURY-FREE DENTAL FILLINGS
(a) An insurance plan that provides coverage for dental fillings shall provide coverage for mercury-free dental fillings for all children under the age of 18 and all adults over the age of 65. This coverage shall be the same as that provided under the insurance plan for dental fillings that contain mercury and shall not establish any rate, term, or condition that places a greater financial burden on an insured for access to mercury-free dental fillings than for access to dental fillings containing mercury.
(b) State dental insurance contracts negotiated after the effective date of this section shall provide coverage for nonmercury fillings at no greater expense to the state employee than for mercury amalgam fillings.
Sec. 5. 18 V.S.A. § 12 is added to read:
§ 12. MERCURY DENTAL FILLINGS; BROCHURE AND POSTER
The commissioner, after reviewing similar initiatives in other states, shall produce a poster and a brochure explaining the potential advantages and disadvantages of using mercury or a mercury amalgam in dental procedures to oral health, overall human health, and the environment. The department shall make the poster and brochure available on the internet or upon request. The brochure shall describe the alternatives to a mercury amalgam available in various dental procedures and the potential advantages and disadvantages posed by using those alternatives. The brochure may also include other information that contributes to the patient’s ability to make an informed decision when choosing between the use of a mercury amalgam and an alternative material in dental procedures, including information on durability, cost, aesthetic quality, and other characteristics of the mercury amalgam and alternative materials. The poster shall inform dental patients of the availability of the brochure.
Sec. 6. 26 V.S.A. § 726 is added to read:
§ 726. MERCURY DENTAL FILLINGS; NOTICE TO PATIENTS
(a) A dentist who uses mercury or a mercury amalgam in any dental procedure shall display the poster produced under section 12 of Title 18 in the public waiting area of the dentist’s office and provide each patient with the accompanying brochure.
(b) Mercury amalgam fillings shall not be placed in or removed from the teeth of pregnant women, except in the case of an emergency. Mercury amalgam fillings shall not be used for restoring the primary teeth of children unless medically indicated.
Sec. 7. 18 V.S.A. § 13 is added to read:
§ 13. FISH AND SEAFOOD MERCURY ADVISORY
The commissioner shall develop an advisory notice to pregnant and nursing women, women who may become pregnant, and children about the risks presented by ingestion of mercury through the consumption of certain fish found to contain high mercury levels. The notice shall be made available on the internet. The notice shall be printed in large type and shall state the following: “Mercury Advisory. Fish and seafood can be an important source of nutrients and an important part of a balanced diet. However, the federal Food and Drug Administration and the Vermont Department of Health advise pregnant and nursing women, women who may become pregnant, and children to limit their consumption of all fish to no more than 12 ounces per week and to limit consumption of frozen or fresh tuna, including sushi and white albacore canned tuna, to no more than 6 ounces per week. Pregnant and nursing women, women who may become pregnant, and children should not eat the following fish: Swordfish, Shark, King Mackerel, and Tilefish.”
Sec. 8. 10 V.S.A. § 7116 is added to read:
§ 7116. MERCURY IN FISH SOLD FOR CONSUMPTION
No person may sell or offer for sale any fresh, canned, or frozen saltwater fish or other fish product intended for human consumption, unless said food establishment or facility shall post a copy of the notice adopted under section 13 of Title 18 in a conspicuous place near the fish.
Sec. 9. EFFECTIVE DATE
This act shall take effect July 1, 2006, except for Secs. 4, 6, and 8 which shall take effect on January 1, 2007.
The Vermont General Assembly
115 State Street