amalgam environmental issues ppt with audio

7/29/2019 Amalgam Environmental Issues PPT With Audio

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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


2/21

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/


3/21

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/


4/21

IN THE NEWS

ADA NEWSMay 17, 2004

Life SciencesResearch Office

Review and Analysis of theLiterature on the Potential Health Effectsof Dental Amalgams


5/21

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


8/21

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


9/21

BMPsin UNITED STATES

30 states use ADA BMP 10 states have additional BMPs

TNNC

GAALMS

IN

MI

SD

NV

RI

NC

MN

WA


10/21

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.


11/21

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)


12/21

Non-Contact Amalgam

Spent fixer,glycerine,or water

Unused amalgamand mercury collection

Pass-throughjar lid

Rubber dam

with slitHg Vapor


13/21

Hg Spill Kits

Spills = small; medium; largeSpills = accidents; daily micro-spills
http://www.statequartersale.com/Qstore/uploads/censoredshowus.jpg


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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,


15/21

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.


16/21

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


17/21

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


18/21

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


19/21

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/
http://www.solmetex.com/http://www.solmetex.com/


20/21

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


21/21

THANK YOU

amalgam environmental issues ppt with audio

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