amalgam environmental issues ppt with audio
TRANSCRIPT
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DENTAL OFFICEEnvironmental Issues
Stephen C. Bayne
Professor and ChairDept of Cariology, Rest Sciences, & EndoSchool of DentistryUniversity of MichiganAnn Arbor, MI 48109-1078
2006, Bayne and Thompson
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Solid WasteManagement
RECYCLING and DENTISTRY
Source Reductionand Reuse
Incinerationand Landfilling
Recycling /Composting
MOSTPREFERRED
LEASTDESIRABLE
US 2001 Total Waste(229 Million Tons)
Paper 35.7 %Yard Trimmings 12.2 %Food Scraps 11.4 %
Plastics 11.1 %Metals 7.9 %Rubber, Leather, .. 7.1 %Glass 5.5 %Wood 5.7 %Other 3.4 %
Cell Phones,Computers.
Fluorescents,
ZERO WASTE5 lbs / person / day
http://www.epa.gov/ -
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IN THE NEWS
Coal burning releases arsenic,selenium, and mercury. Thisleads to profound health effects.
COAL
Great Lakes Pollution Prevention and Toxics Reduction
http://www.epa.gov/glnpo/bns/index.htmlhttp://www.epa.gov/glnpo/bns/index.htmlhttp://www.epa.gov/http://www.pnas.org/ -
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IN THE NEWS
ADA NEWSMay 17, 2004
Life SciencesResearch Office
Review and Analysis of theLiterature on the Potential Health Effectsof Dental Amalgams
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OVERVIEWOF CURRENT EVENTS INVOLVING DENTAL Hg
AMALGAMDIS-USE
Hg
CONTROVERSY
OFFICEISSUES
ENVIRONMENTALISSUES
F, Sealants, High-Cu Amalgam, Composites, Replacement Criteria
n=150 per100 patientsin United States
n= 95 n=55
HalHuggins
60 MinutesProgram
StonePhillips
Anti-Amalgamists
1980 201020001990
?
Precapsulated Dental Amalgams
ADA Hg HygieneStatement
ChairsideFilters Separators
Air, Water, Land, Food
US-EPA OSHA FDA NAS
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LAND
SPREADING
TrapDENTALOFFICE
Waste WaterTREATMENT
PLANTMAINSewer Line
LocalSewer
FeederSewer
Line
INCINERATION
COMMERCIAL (76%)-- Dental Offices (90% / year)-- Industries
RESIDENTIAL (24%)-- Human wastes (33%)
Hg Contributions to a WWTP
4% Hg in Cotton Rolls / Capsules15% Trituration Surplus33% HVAC to Sewer48% Amalgam Restoration
SLUDGE =Heavy Metals;
Nitrogen; Phosphate
0.0001 mg/l = 0.1 g/l = 0.1 ppb
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Hg ROAD MAP
FDA
Safety,Efficacy
Patients Personnel
BMPs
Purchase Storage Usage Non-Contact Filters Training, Spills
OSHA / ADA
TRASH
SanitaryLandfill(audits)
Incinerator(audits)
RECYCLINGPLANT(audits)
EPA / NCDENR
Leach Field Stream Dumping
Burning Land Spreading
CITY / EPA
WASTE-WATER
TREATMENTPLANT
Hg
OFFICEPLUMBING
[Chairside Filter] [Vacuum System and Trap] Separators Flushing Plumbing Lines
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Best Management Practices[ Use alternatives / Keep products separate / Recycle everything]
1. Dental Amalgam(a) Hg Hygiene Recommendations(b) Spent Amalgam Capsules(c) Non-Contact Amalgam (left-over from mixing procedures)(d) Chair-side Traps (contact-amalgam trapped by coarse filter)(e) Vacuum Pump Filter (contact-amalgam trapped by medium filter)(f) Separator or Recapture Device (added before vacuum with fine filter)(g) Plumbing and Sink Traps(h) Hg Spill Kits
Hg
3. Chemical Sterilant Wastes(a) Chemiclave/Chemical-Sterilant (dilute 4:1 with water before draining)
4. Waste Waters
5. Fluorescent Lamps and Batteries (recycle only)
Cl
CrPb
Ag
2. X-ray Wastes(a) Fixer (Ag recovery or recycling processes)(b) Developer (controlled discharge into sanitary sewer)(c) Cleaners (Cr-containing cleaners must be recycled)(d) Lead foil (must be recycled)(e) Lead Shields (e.g., aprons) (must be recycled)
(1) Awareness(2) Training(3) Documentation
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BMPsin UNITED STATES
30 states use ADA BMP 10 states have additional BMPs
TNNC
GAALMS
IN
MI
SD
NV
RI
NC
MN
WA
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Recommendations are changing staycurrent.
Understand recycling documentation. Look for similar recommendations for
other office materials.
ADA Hg HYGIENERecommendations
Dental mercury hygiene recommendations:
Sources of dental mercury in the office. General mercury hygiene recommendations.
Office emergencies.
Hygiene recommendations duringpreparation and placement of dentalamalgam.
Management of mercury spills. Management of small mercury spills. Management of large mercury spills.
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Residual Hg in Capsules
Stone ME, Pederson ED, Cohen ME, Ragain JC, Karaway RS, Auxer RA, Saluta AR.Residual mercury content and leaching of mercury and silver from used amalgam capsules.
Dent Mater 2002;18:289-294.
OBJECTIVE: Measure (1) residual Hg in capsulesand (2) potential for leaching in landfill.
METHODS: Residual Hg (USEPA Method 7471);Leaching Hg (USEPA Method 1311).
Capsule: Residual Hg Leached Hg
P/F(mg / capsule) (mg / L / capsule)
Dispersalloy Regular Set 1.255 0.793 0.0477 (P)Valliant PhD 0.770 0.330 0.0261 (P)Optaloy 0.650 0.644 0.0340 (P)Megalloy 0.590 0.504 0.0399 (P)Valliant Snap Set 0.534 0.398 0.0425 (P)
Tytin Regular Set 0.266 0.184 0.0104 (P)Tytin FC 0.223 0.120 0.1640 (P)Contour Self-Activating 0.181 0.121 0.4120 (F)Sybraloy Regular Set 0.142 0.163 0.2530 (F)Tytin Regular Set 0.125 0.063 0.0110 (P)
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Non-Contact Amalgam
Spent fixer,glycerine,or water
Unused amalgamand mercury collection
Pass-throughjar lid
Rubber dam
with slitHg Vapor
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Hg Spill Kits
Spills = small; medium; largeSpills = accidents; daily micro-spills
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Hg-Spill Kit
Amalgam
Storage
HG HYGIENE PLUMBING
AmalgamMixing
Capsules Non-Contact Hg
60% Large Particles >100 mm30% Small Particles 10-100 mm10% Very Small Particles,
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Amalgam/Hg Separators
Amalgam Separator: EMPTY FULL Total Effluent Hg(% Efficiency) (% Efficiency) (ppb, range)
A1000 96.09 0.39 96.24 0.46 30,200 - 34,899Amalgam Collector 99.89 0.06 99.96 0.03 1,180 - 3,350Asdex 99.10 0.09 99.36 0.14 9,930 - 15,750BullfroHg 98.88 0.64 99.38 0.48 5,850 - 16,270Durr 7800/7801 98.06 1.08 97.66 0.35 970 4,070ECO II 98.17 0.43 97.51 0.74 16,310 - 26,340HgS 99.36 0.15 99.28 0.10 6,430 - 9,600
Hg10 99.99 0.06 (not tested) 20 - 100MRU 99.96 0.03 99.95 0.04 200 - 570MSS 2000 99.66 0.30 98.94 0.06 730 - 4,040Rasch 890-4000 99.93 0.03 99.90 0.03 600 - 1,250RME 2000 99.67 0.13 99.66 0.24 1,530 - 3,430
Fan PL, Batchu H, Chou HN, Gasparac W, Sandrik J, Meyer DM. Laboratory evaluation of amalgamseparators. J Am Dent Assoc 2002; 133: 577-589.
OBJECTIVE: Remove amalgam and/or mercuryfrom air/water stream in HVAC system.
METHODS: ISO 11143 for Amalgam Separators.
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Amalgam/Hg Separators
Fan PL, Batchu H, Chou HN, Gasparac W, Sandrik J, Meyer DM. Laboratory evaluation of amalgamseparators. J Am Dent Assoc 2002; 133: 577-589.
Cost = Separator Unit + Installation + CartridgesCost = Rental of unit (with free cartridges)
Amalgam Claimed % Unit ReplacementSeparator: Efficiency Cost: Filter Cost:
A1000 > 95% $750 $500Amalgam Collector > 90% $350 $350Asdex = 97.5% $215 $ 35BullfroHg > 95% $100/monthDurr 7800/7801 > 96% $4,000 $ 95ECO II > 95% $29/monthHgS > 98% $500 $ 75Hg10 (Solmetex) > 99.9+ % $696 $150
MRU (DRNA) > 95% $150/monthMSS 2000 = 98.8% $3,000 $296Rasch 890-4000 > 95% $1,650 $750RME 2000 = 96.9% $1,895 $395
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Company: Location: Telephone Number
SOLMETEX (Northburough, MA) 978-262-9690DRNA (Hackensack,NJ) 800-360-1001Max. Separ. Systems (Sanichton, BC) 800-799-7147AB Dental Trends (Lynden, WA) 360-354-4722Rebec (Edmonds, WA) 800-569-1088
Air Techniques Inc. (Hicksville, NY) 800-Air-Tech
Current Separator Technologies
http://www.ncddental.org
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P.O. Box 1069
Hackensack, NJ 076011-800-360-1001 (TEL)1-201-489-4740 (FAX)
SEWER 99+ %
http://www.drna.com/
http://www.drna.com/http://www.drna.com/http://www.drna.com/http://www.drna.com/index.html -
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SolmeteX29 Cook StreetBillerica, MA 01821TEL = 978-262-9690FAX = 978-262-9889
$695 for installation$150 per cartridge exchange
99.5% recovery is typical
SOLMETEX
Air-Water Separator
Filter and Hg Absorber
http://www.solmetex.com/
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Hg ROAD MAP
FDA
Safety,Efficacy
Patients Personnel
TRASH
SanitaryLandfill(audits)
Incinerator(audits)
RECYCLINGPLANT(audits)
EPA / NCDENR
BMPs
Purchase Storage Usage Non-Contact Filters Training, Spills
OSHA / ADA
Leach Field Stream Dumping
Burning Land Spreading
WASTE-WATER
TREATMENTPLANT
CITY / EPA
Hg
OFFICEPLUMBING
[Chairside Filter] [Vacuum System and Trap] Separators Flushing Plumbing Lines
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THANK YOU