1. Goals For This Meeting Receive input and comment on the recent literature regarding the potential adverse health effects of dental amalgams (to the LSRO and the Expert Panel) Receive input and comment on the recent literature regarding the potential adverse health effects of dental amalgams (to the LSRO and the Expert Panel) Provide background to Expert Panel Provide background to Expert Panel Report on the process and current thinking (to the stakeholder communities) Report on the process and current thinking (to the stakeholder communities)

2. Goals For This Project Identify and evaluate recent literature Identify and evaluate recent literature Provide scientific, evidence-based opinion on the potential adverse health effects of dental amalgam Provide scientific, evidence-based opinion on the potential adverse health effects of dental amalgam Not recommending public policy Not recommending public policy

3. General Procedures Time frame: Summer 2003 – Spring 2004 Time frame: Summer 2003 – Spring 2004 Call(s) for public comment Call(s) for public comment Selection of Expert Panel Selection of Expert Panel Transparent process Transparent process Publicly available report Publicly available report Restricted communication Restricted communication

4. Expert Panel Selection principles Selection principles Recognized scientific authorities Recognized scientific authorities Disciplinary expertise Disciplinary expertise Un-biased – excluded: Un-biased – excluded: Dental community Dental community Previously expressed opinion Previously expressed opinion Selected and appointed by LSRO Selected and appointed by LSRO

5. Expert Panel Meryl Karol, PhD (Chair) Meryl Karol, PhD (Chair) U of Pittsburgh U of Pittsburgh Stanley Berent, MS, PhD Stanley Berent, MS, PhD U of Michigan Robert Brent, MD, PhD Robert Brent, MD, PhD Thomas Jefferson U James Bruckner, MS, PhD James Bruckner, MS, PhD U of Georgia John Doull, MD, PhD John Doull, MD, PhD U of Kansas Med School M. Eric Gershwin, MD U Cal School of Med Ronald Hood, MS, PhD U of Alabama Genevieve Matanoski, MD, DrPH Johns Hopkins U Raphael Rubin, MD Thomas Jefferson U Bernard Weiss, PhD (Consultant) U of Rochester

6. Panel Experience Past presidents of toxicology societies Past presidents of toxicology societies Editors of major scientific journals Editors of major scientific journals Department chairs Department chairs Endowed professorships Endowed professorships Authors of preeminent textbooks Authors of preeminent textbooks Authors of thousands of publications Authors of thousands of publications Members of advisory & NAS panels Members of advisory & NAS panels Recipient of numerous awards Recipient of numerous awards

7. Panel Expertise Toxicology (5) Toxicology (5) Neuro/behavioral toxicol (2) Neuro/behavioral toxicol (2) Pathology (1) Pathology (1) Allergy (1) Allergy (1) Immunology (2) Immunology (2) Pediatrics (1) Pediatrics (1) Developmental tox (3) Developmental tox (3) Reproductive tox (1) Psychology (1) Epidemiology (2) Public health (2) Environmental and occupational health (2) Toxicokinetics (1) Risk assessment (1)

8. Panel Experience Past presidents of toxicology societies Past presidents of toxicology societies Editors of major scientific journals Editors of major scientific journals Department chairs Department chairs Endowed professorships Endowed professorships Authors of preeminent textbooks Authors of preeminent textbooks Authors of thousands of publications Authors of thousands of publications Members of government advisory & NAS panels Members of government advisory & NAS panels Recipient of numerous awards Recipient of numerous awards

9. Restricted Communication Communicate with the Panel through LSRO Communicate with the Panel through LSRO Maintain transparency Maintain transparency Eliminate bias Eliminate bias Ensure the entire panel receives all input Ensure the entire panel receives all input Panel reports any unofficial or ex parte communication Panel reports any unofficial or ex parte communication

10. Miscellany LSRO staff will write the report LSRO staff will write the report Report will express Expert Panel consensus and will not attribute individual opinions Report will express Expert Panel consensus and will not attribute individual opinions Attempt to reach consensus wording Attempt to reach consensus wording If necessary include minority opinions If necessary include minority opinions Post presentation slides on our web site Post presentation slides on our web site