A Guide to Proper Waste Management in Dental Offices

A Guide to Proper Waste Management in Dental Offices
The Environmentally
Responsible Dental Office:
A Guide to Proper
Waste Management
in Dental Offices
Northeast Natural Resource Center of the
National Wildlife Federation
and
The Vermont State Dental Society
June 1999
People and Nature:
Our Future is in the Balance
The Environmentally Responsible
Dental Office Guide
t may come as a surprise that dental care professionals have an extraordinary
opportunity to help protect and restore the nation’s rivers and lakes with simple
changes in the way you dispose of waste in your office. We know, for example, that
40 states have fish consumption advisories due to mercury contamination. Mercury
and other materials critical to your work can become poisons to people and wildlife
if they are disposed of improperly. Your choices in disposing of those materials can
make a tremendous difference.
That’s why the National Wildlife Federation created this guide to running an
environmentally responsible dental office. It’s intended to give dentists, dental assistants, and
office staff simple ideas for changes that can go a long way in preventing the release of mercury
and other potentially harmful contaminants to our nation’s streams, lakes and rivers.
As you are well aware, elemental mercury is among the most common hazardous materials
in the dental office. It is a toxic substance that threatens the health of humans and wildlife
throughout North America. Mercury is particularly threatening because it “bioaccumulates” in
the food chain, collecting and building up in the tissues of small fish and other species and then
accumulating in ever-increasing amounts as those creatures are consumed by others higher up
the chain.
Humans, as well as wildlife, can suffer severe health effects from consuming mercurycontaminated fish. Currently, fish consumption advisories are issued in many areas to warn
sensitive populations, such as pregnant women, women of childbearing age, and young children, to limit their intake of certain species of fish, or to avoid eating these fish altogether. But
this approach poses problems for people who eat fish as a mainstay of their diets and for local
economies that depend on the fishing industry for local jobs. A far better solution is to end the
contamination at its source. And that’s where you come in.
Please read this guide to learn how dental offices can limit the amount of mercury and other
chemicals entering the environment by using common-sense pollution prevention and waste
management techniques. You’ll also find tips on the proper handling of other harmful chemicals
present in dental offices.
This guide is part of the National Wildlife Federation’s ongoing efforts to provide citizens
with the knowledge, the tools and the help they need to restore our nation’s rivers and lakes and
keep them free from toxic pollution. That work has never been more urgent. Despite incredible
progress in addressing some of the most visible sources of pollution, others, like mercury,
remain a significant threat. Addressing such threats and ensuring a healthier world for humans
and wildlife begins with knowledge and understanding, followed by the action of people who
care. We hope you will use the information provided by this guide to act on your own desire to
help. Together, we can make a difference.
I
Mark Van Putten, President and CEO
National Wildlife Federation
The Environmentally
Responsible
Dental Office:
A Guide to Proper
Waste Management
in Dental Offices
T
he following guide was created by the
National Wildlife Federation (NWF) and
the Vermont State Dental Society (VSDS)
in collaboration with the following
project Task Force Members:
Dr. Jerome DeSnyder, DDS
Plattsburgh, New York
Dr. Daniel Ferraris, DMD
South Burlington, Vermont
Doug Kievit-Kylar
Pollution Prevention Planner
Vermont Agency of Natural Resources
Waterbury, Vermont
Tom Moreau
District Manager, Chittenden Solid Waste District
Williston, Vermont
Mark Moroukian, P.E.
Environmental Engineer, Pollution Prevention Unit
New York State Department of Environmental
Conservation
Albany, New York
Hollie Shaner, RN, MSA
Environmental Health Coordinator
Fletcher Allen Healthcare
Burlington, Vermont
Founded in 1936, NWF, its members and supporters,
and a national network of affiliated organizations,
works to educate citizens about the need for sustainable use and proper management of our natural
resources.
NWF’s mission is “...to educate, inspire, and assist
individuals and organizations of diverse cultures to
conserve wildlife and other natural resources while
protecting the Earth’s environment to promote a
peaceful, equitable, and sustainable future.”
The NWF’s NNRC has three overall purposes:
to represent NWF on a local and regional basis among
the New England states; to work with state affiliate
organizations within the region; and, to conduct
research, education, and advocacy programs on
conservation issues of regional significance in the
Northeast.
The principal authors of this report are Monique
Gilbert and Wendy Houston-Anderson, Water
Resources Project Associates at NWF. The authors
would like to thank the following people for their
editorial support: Kari Dolan, NNRC Water Resources
Project Manager; Eric Palola, NNRC Director; Guy
Williams, NWF Pollution Prevention Specialist; Terri
Goldberg, Pollution Prevention Program Manager,
Northeast Waste Management Official’s Association;
and, the following dental staff members: Debb
Dowling; Joanna Hoke; Judy Jones; and, Dixie Vallie.
The NWF would like to thank the Vermont State
Dental Society for its time, donation of office space,
and expertise throughout the process of developing
this guide, and the project’s Task Force, which greatly
contributed to the overall success of this undertaking.
Funding for this guide was provided through a
grant from the Lake Champlain Basin Program
to the National Wildlife Federation’s Northeast Natural
Resource Center. NWF would also like to thank the
Ward M. and Mariam C. Canaday Educational and
Charitable Trust for their financial support.
The views expressed in this report are the views
of the National Wildlife Federation and not those of
the Task Force.
For additional copies of this guide or more
information, please contact:
The National Wildlife Federation
Northeast Natural Resource Center
58 State Street
Montpelier, Vermont 05602
(802) 229-0650 gilbert@nwf.org
Peter Taylor
Executive Director, Vermont State Dental Society
South Burlington, Vermont
The National Wildlife Federation’s Northeast
Natural Resource Center (NNRC), based in Montpelier, Vermont, is one of ten field offices of NWF.
NWF is a non-profit conservation and education
organization with headquarters in Vienna, Virginia.
or
Vermont State Dental Society
100 Dorset Street, Suite 18
South Burlington, Vermont 05403
(800) 640-5099 ptaylorvt@aol.com
Table of Contents
Introduction.................................................................................................................... Page 4
Why is Mercury a Concern?..................................................................................................... 4
Reducing Mercury Contamination – Opportunities for Dentists........................................... 5
• Pollution Prevention........................................................................................................5
• Best Management Practices.............................................................................................5
Dental Office Wastes - Handling Procedures............................................... Page 6
Amalgam (Containing Mercury and Silver)..............................................................................6
• Steps You Can Take - Some General Guidelines.......................................................... 6
• Elemental Mercury........................................................................................................6
• Amalgam Capsules........................................................................................................7
• Scrap Amalgam.............................................................................................................7
• Chairside Traps............................................................................................................. 7
• Vacuum Pump Filters................................................................................................... 8
• Additional Sources of Mercury in Dental Offices....................................................... 8
• Amalgam Separators.....................................................................................................9
• Plumbing Replacement and Repairs........................................................................... 9
• Office Renovations....................................................................................................... 9
Used X-Ray Fixer Solution (Containing Silver)................................................................... 10
X-Ray Developer ................................................................................................................. 10
Cleaners for X-Ray Developer Systems .............................................................................. 11
Lead Foils, Shields and Aprons ...........................................................................................11
Chemiclave/Chemical Sterilant Solutions.............................................................................11
Disinfectants, Cleaners and Other Chemicals..................................................................... 12
Office Waste......................................................................................................................... 12
• General Office Waste................................................................................................. 12
• Fluorescent Bulbs....................................................................................................... 12
• Batteries...................................................................................................................... 12
Resource Handbook ......................................................................... Located in Back Pocket
Dental Amalgam Recyclers........................................................................................................1
Dental Amalgam Separator Product Vendors.......................................................................... 5
Hazardous Waste Programs..................................................................................................... 5
Hazardous Waste Haulers........................................................................................................ 6
Lead Foil Recyclers................................................................................................................... 6
Mercury Recyclers..................................................................................................................... 7
Occupational Safety and Health Administration (OSHA)....................................................... 7
Compliance Supplies and Equipment Vendors ............................................................... 7
Regional Solid Waste Contacts................................................................................................. 7
Lake Champlain Basin – New York.................................................................................. 7
Lake Champlain Basin – Vermont ................................................................................... 7
Rental Test Equipment Companies.......................................................................................... 8
Silver Reclamation Facilities......................................................................................................8
State Dental Societies............................................................................................................... 8
State Departments of Environmental Conservation Contacts................................................. 9
Dental Office Waste Management Tables.............................. Located in Back Pocket
Introduction
Why is Mercury a Concern?
One possible environmental impact from the
practice of dentistry results from the unwanted
release of elemental mercury and mercury-containing amalgam from dental offices. Mercury is a
persistent, toxic contaminant and it bioaccumulates
in the tissue of fish. High concentrations of mercury
in fish pose serious health risks to people and
wildlife that consume them. New York and Vermont
began testing for mercury in fish as early as 1969
and 1970, respectively. Studies in both states illustrate that mercury levels vary by species and among
waterbodies, but appear to be highest in larger
(older), piscivore (fish-eating) species. Both states
currently have state-wide fish consumption advisories in effect.1 Populations that are particularly
sensitive to the health risk of consuming contaminated fish include: pregnant women, women of
childbearing age, children, and people dependent
upon fish for their daily diet.
There are several ways that mercury from dental
amalgam can get into the environment:
T
he Environmentally Responsible Dental
Office: A Guide to Proper Waste Management in Dental Offices is intended to assist
New York and Vermont dentists in dealing
with mercury and other dental office waste
problems in a proactive way. This guide
provides dentists with the information they
need to properly dispose of mercury and amalgam
waste, and provides suggestions for managing the
other wastes that result from the day-to-day activities
of a dental office such as: used X-ray fixers and
developers; cleaners for X-ray developer systems;
lead foils, shields and aprons; chemiclave/chemical
sterilant solutions; disinfectants, cleaners, and other
chemicals; and, general office waste.
Throughout the document, reference will be
made to the appropriate parties to contact for
information on issues such as amalgam recycling,
silver reclamation, and hazardous waste disposal.
At the back of this Guide, in the inside cover pocket,
there is a separate Resource Handbook that
contains lists of companies, contact names, and/or
phone numbers to assist dentists and dental office
staff in obtaining the information they need to take
action on the guidance provided in this document.
The following symbol will be used throughout the
Guide to indicate when the Resource Handbook
should be consulted for additional information:
= refer to the Resource Handbook in the inside
•
Wastewater: Amalgam that is rinsed down drains
or escapes from poorly maintained chairside traps
and vacuum pump filters enters the wastewater
stream and eventually the wastewater treatment
plant or the septic system. Any mercury contained
in treated wastewater will either end up in the
sewage sludge, which may be land applied
(under an appropriate permit), or in the liquid
effluent to be discharged into lakes or rivers.
•
Medical Waste: Scrap amalgam, both contact and
non-contact, should not be treated as medical
waste. Amalgam that is improperly put into red
biohazard bags might be either incinerated or
autoclaved. If amalgam is present in waste that is
incinerated, the mercury will volatilize and enter
the atmosphere. The volatilized mercury then
precipitates to the ground or a waterbody. If
amalgam is present in waste that is autoclaved, the
volatilized mercury will escape from the autoclave
when the door is opened, presenting an immediate health hazard to dental office staff.
•
Garbage: If amalgam scrap is discarded into
ordinary trash, it may eventually be incinerated
(see previous paragraph) or placed in a landfill.
If discarded amalgam scrap ends up in a landfill,
it may lead to soil and/or water contamination.
cover pocket.
Also located at the back of the Guide, in the
inside cover pocket, are two Dental Office Waste
Management Tables–laminated tables of consolidated dental office waste management options and
restrictions, organized according to the type of
waste. These tables are designed to be displayed
on the wall in the dental office for quick and easy
reference.
4.
Most landfills are outfitted with leachate collection
systems. Leachate results from the normal decomposition of the garbage in landfills. The collected
leachate is piped to the local publicly owned
treatment works (POTW), where it can be released
to the environment through ways described under
“wastewater” above.
•
Pollution prevention programs can also include:
education and training, good housekeeping practices, chemical inventory control, and recycling.
Elements of a successful pollution prevention
program are: (a) a written statement of policies and
goals tailored to each dental practice; (b) a commitment to consistent administration of the program;
and, (c) continuous monitoring of pollution prevention policies and goals by the dentists and their staff
members.
You should consider implementing a pollution
prevention program for your dental office using the
following pollution prevention practices:
Antiquated Techniques: Older techniques that
use bottles to dispense elemental (also referred
to as free, bulk, or raw) mercury for amalgam
production can lead to accidental spills and
increase the chances that elemental mercury will
end up in the wastestream. In addition, if the
elemental mercury is poured into the drain, it may
settle in sink traps, gradually releasing into the
wastewater over time.
Use amalgam substitutes in cases where they are
Reducing Mercury Contamination –
Opportunities for Dentists
Dentists have many options available to them to
reduce the amount of amalgam inadvertently leaving
their office. The information presented in this guide
falls into two categories of waste management
strategies: pollution prevention actions and control
actions–also called “best management practices.”
appropriate, ethical, and economically feasible.
Use non-hazardous or biodegradeable detergents
for clean-up.
Use non-chromium containing X-ray developer
system cleaners.
Educate your staff and cleaning service on these
practices so they can properly follow the
program that you have established.
Best Management Practices
While pollution prevention is the ideal solution
for solving the mercury problem, it is not always
feasible in practice. Therefore, the following
sections present information on best management
practices for the dental office. Best management
practices are economically achievable measures or
actions that can be used to control or reduce the
entry of pollutants (mercury, amalgam and other
dental office wastes) into the environment.
Pollution Prevention
The goal of pollution prevention is to reduce or
eliminate the use of toxic or polluting substances at
the source. Pollution prevention activities and
recycling in dental offices are essential in order to
minimize releases of polluting substances into the
sewer system, medical waste, or ordinary trash.
An effective pollution prevention strategy is to
use products that are less harmful to the environment. For dentistry, this strategy includes the
development and use of amalgam substitutes, as
appropriate, and the use of less hazardous cleaning
products.
1Northeast
States for Coordinated Air Use Management
(NESCAUM), et.al. 1998. Northeast States and Eastern Canadian
Provinces Mercury Study, A Framework for Action.
pp. IV-6 - IV-7.
5.
Minimize the generation of amalgam waste.
Dental Office
Wastes – Handling
Procedures
Don’t mix a two-spill capsule if a one-spill capsule
will do. Less waste means less amalgam that needs
to be recycled.
Recycle as much amalgam as possible.
When removing an existing amalgam, attempt to
remove it in “chunks” so that it is more likely to be
caught in the chairside trap.
REMINDER: = refer to the Resource Handbook
in the inside cover pocket.
Amalgam
Never put scrap amalgam in the sharps
container.
(Containing Mercury and Silver)
Never put scrap amalgam where it will end up
in the red biohazard bag.
Never discard scrap amalgam in the trash.
Steps You Can Take– Some General
Guidelines:
Never rinse scrap amalgam down the drain.
Use amalgam substitutes in cases where they are
Never remove excess amalgam from the
amalgam well with the high-speed suction (the
vacuum line).
appropriate, ethical, and economically feasible.
Convert to single use amalgam capsules. This
Never clean up a mercury spill using a vacuum
cleaner.
change will help to minimize the chance of an
accidental mercury spill.
In the event of a mercury spill, put on nitrile
Never place extracted teeth with amalgam
restorations in the red biohazard bag. They should
be placed in the CONTACT AMALGAM container.
Use universal precautions when handling extracted
teeth (glasses, gloves and mask).
gloves and clean it up immediately.
(Do not use latex gloves as mercury can penetrate
latex.) Mercury spill kits are available from a
number of sources, including: companies that
specialize in Occupational Safety and Health Administration (OSHA) compliance supplies and equipment (); amalgam recyclers (); and, dental
product suppliers. Before purchasing a kit, make
sure it comes with complete instructions on how to
perform a spill clean-up. Train several staff members in proper spill clean-up procedures.
Elemental Mercury
uncontained presence of mercury in your dental
office, due to historical or recent mercury spills,
equipment is available for the detection of mercury
vapor in the workplace environment, and for the
location of mercury spills. This equipment can be
rented from rental test equipment companies ().
Never rinse elemental mercury down the drain.
Never dispose of elemental mercury in the
trash.
(also referred to as free, bulk, or raw
mercury)
Use precapsulated alloy to eliminate the
possibility of an elemental mercury spill.
In the event that elemental mercury is present in
your dental office, it should be properly handled
in the following way:
If you are concerned about the possible
Never dispose of elemental mercury in the
sharps container, or as medical waste.
6.
Recycle unused elemental mercury. Many
hazardous waste haulers () and dental amalgam
recyclers () will accept elemental mercury for
recycling. If you have any other questions regarding
the recycling of elemental mercury, you can contact
the following state offices: in New York, contact the
New York Department of Conservation, Bureau of
Hazardous Waste Management, Technical Determination Section (); in Vermont, contact the Vermont
Department of Environmental Conservation, Waste
Management Division, Resource Conservation and
Recovery Act (RCRA) Section ().
If contact amalgam must be disinfected before
shipment to your recycler, do not use any method
that utilizes heat. The heat will cause the mercury
to volatilize and be released to the environment.
If you store scrap amalgam under used radiographic fixer, water, or other liquid, do not, under
any circumstances, decant the liquid down the
drain. Contact your dental amalgam recycler ()
or hazardous waste hauler () for more
information on how to dispose of this material
properly.
If a small amount of elemental mercury is to be
disposed of, initiate a reaction with amalgam alloy to
form scrap amalgam, which can then be recycled
through your amalgam recycler ().
Chairside Traps
The control of waste dental amalgam includes
proper management of the traps and filters used in
your office vacuum system. Disposable amalgam
traps are preferable to
reusable traps because of the
difficulty in effectively
removing amalgam particles
from the trap without spilling
them into the drain or
garbage. In addition, consider
replacing 40 mesh traps with
100 mesh traps if your suction
system can function
adequately with the
smaller mesh. Finer
screens may be more
effective at trapping amalgam
particles. However, they may require cleaning and
changing more often.
Most solid waste districts (in Vermont only) offer
elemental mercury recycling programs, which allow
dentists to safely dispose of their elemental mercury.
Call your regional solid waste district () to
inquire about such programs.
Amalgam Capsules
After mixing amalgam, the
empty amalgam capsules containing no visible
amalgam may be disposed of in the garbage.
Any defective capsules that cannot be emptied
should be placed with the non-contact scrap amalgam so they can be recycled. Be sure to check with
your amalgam recycler () to see if they will take
capsules with your scrap amalgam.
Scrap Amalgam
Be sure to check with your dental amalgam
recycler () to determine if they will accept
disposable amalgam traps in the same container with
your contact amalgam.
Salvage and store all contact and non-contact
scrap amalgam in separate, appropriately labeled,
tightly closed containers.
Recycle scrap amalgam through an amalgam
recycler ().
The following recommendations will help you to
properly manage your trap systems:
Follow the requirements of your amalgam
recycler for the storage, disinfection and shipping
of scrap amalgam.
Disposable and Reusable Amalgam Traps:
Use universal precautions when handling the
chairside trap.
Change chairside amalgam traps as often as
necessary.
7.
Vacuum Pump Filters
Flush the vacuum system with disinfecting line
solution before changing the chairside trap.
✔
✔
(by the central suction pump)
Replace vacuum pump filters regularly as recommended by the equipment manufacturer.
The best method is to flush the line at the
end of the day, and then change the trap
the next morning before the suction is used.
This method will allow the particles in the
trap to dry.
Use universal precautions when handling the
filters.
Remove the filter. While holding it over a tray or
other container that can catch spills, decant as much
liquid as possible without losing visible amalgam. The
decanted, amalgam-free, liquid can be rinsed down
the drain.
An alternative method is to flush the system
with a cleaning solution according to
the product’s directions; then remove the lid
from the trap and allow air to pass through
the trap until the contents are dry (usually
not more than five minutes).
Put the lid on the filter and place it in the box in
which it was originally shipped. When the box is full,
the filters should be recycled. Be sure to check with
your amalgam recycler () to ensure that they will
take these filters.
Follow the steps below that apply to the type
of trap you have.
Disposable Amalgam Traps:
Do not dispose of used vacuum pump filters as
medical waste.
Open the chairside dental unit to expose
the amalgam trap.
Additional Sources of Mercury in
Dental Offices
Remove the amalgam trap and place it
directly into the contact amalgam recycling
container. You may need to have a contact
amalgam container that is large enough to
accommodate the disposable chairside
traps.
Any electrical equipment with switches, relays or
temperature controls (thermostats) may contain
mercury and should be disposed of through a hazardous waste hauler ().
•
If the trap is visually clean, it can be put in
the trash or re-used. Visually clean traps
have been determined to be nonhazardous.
A heavily contaminated trap should always
be recycled. Store contaminated traps in the
contact amalgam container.
Mercury thermometers and blood pressure units are
sources of elemental mercury. The following steps
should be followed in the event that one of these
items should become broken.
•
Reusable Amalgam Traps:
Remove non-amalgam fragments such as
cement from the trap with cotton forceps
and discard in the garbage. Remove all
visible amalgam by tapping the contents
into the container labeled “CONTACT
AMALGAM.” Close the cover tightly.
Do not clean reusable traps under running
water or discharge the trapped amalgam
into the wastewater system.
Do not discharge the trapped amalgam into
the sharps container, biohazard bag, or
trash.
8.
Put on nitrile gloves. (Do not use latex gloves.)
Clean up all visible elemental mercury using
a mercury spill kit. Mercury spill kits are
available from a number of sources,
including: companies that specialize in
Occupational Safety and Health
Administration (OSHA) compliance supplies
and equipment (); amalgam recyclers
(); and, dental product suppliers. Before
purchasing a kit, make sure it comes with
complete instructions on how to perform a
spill clean-up. Train several staff members
in proper spill clean-up procedures.
Place all contaminated items (materials used
during the clean up procedure and broken
pieces of glass) in a sealable plastic bag or
container. Label the bag or container as
“Mercury Waste”.
Dispose of all contaminated materials
through a hazardous waste hauler ().
•
The unit should operate quietly.
•
The unit should come with a “fail-safe”
mechanism that protects you from a spill or
back-up in the event that a blockage occurs.
•
The unit should install centrally so that the
whole wastewater stream passes through it
before discharging into the sewer system.
•
The unit should be reasonably priced.
Obtain information from the companies on
the total cost for all services, including cost of
the unit over a 5-10 year period, before
making a decision.
Never dispose of contaminated waste in
the sharps container, biohazard bag, or trash.
Never dispose of elemental mercury down
the drain or in the sharps container,
biohazard bag, or trash.
Amalgam Separators
Your office may wish to consider purchasing an
amalgam separator. The ability of amalgam separators to remove amalgam from the dental wastewater
may be superior to filters and traps used in chairside
dental units and vacuum lines. These separator
systems are used to capture scrap amalgam in
wastewater which is too fine to be removed by a
trap or a screen.
Amalgam separators are used in Europe and are
currently being evaluated in selected areas of the
United States. Contact your state dental association
() or an amalgam separator vendor () for
more information.
If you decide that you want to purchase an
amalgam separator, be prepared to shop around for
the machine that works best for you. These separators vary widely in sophistication and effectiveness.
The following criteria should help you select the
right system.2
•
2Balogh,
Cynthia Welland and Paul G. Rubin. 1998. Removal of
Mercury from Dental Amalgam Wastewater. A New Prescription:
Pollution Prevention Strategies for the Health Care Industry
Conference. pp 131-155.
Plumbing Replacement and Repairs
After your office
adopts its new
amalgam management practices, it
may be a good
time to clean or
replace sink traps.
Mercury from past
practices often
settles at low
points such as sink
traps and sumps. The slow dissolution of the
mercury in a sink trap or sump can release mercury
into the wastewater for years after past disposal
practices have been corrected.
The system should be effective, meaning that
the company should be able to prove that it
can remove the amalgam from the
wastewater, regardless of particle size.
• There
should be no compromise in suction
Whenever plumbing parts are removed or
cleaned, caution should be taken to avoid spilling
the contents in case amalgam or mercury are
present.
power.
•
•
•
You may want to consider a unit that is
“hands-off,” meaning that the dentist or staff
does not have to perform a series of manual
operations, or be required to handle and
change filters.
Pour and brush out the sludge and handle it as
you would handle contact amalgam.
The plumbing parts can then be put back in
place or recycled.
The captured amalgam should be recycled.
Make sure that the company which sold you
the unit also arranges for the recycling of the
captured amalgam. The company needs to
provide you with the appropriate information
on how to recycle the captured amalgam.
Office Renovations
Alert renovators to the possibility of historical
mercury spills that may have resulted in the presence of mercury in carpets, floor cracks, behind
moldings and other areas where elemental mercury
may have been used, or where amalgam capsules
may have been spilled.
Simplicity of design is a plus. There will be
fewer chances for something to go wrong.
9.
Purchase your own silver recovery unit.
If you suspect the presence of uncontained
Please check with your local publicly owned
treatment works (POTW) prior to purchasing a silver
recovery unit to ensure that the level of silver
removal meets the POTW’s discharge standards.
If it does, you may rinse the recovery process waste
down the drain. (Check in the phone book under
your town’s Public Works Department for the
number of your local POTW).
mercury in your dental office due to historical or
recent mercury spills, equipment is available to
detect mercury vapor and locate mercury spills. This
equipment can be rented from rental test equipment
companies ().
Guidance is available on the proper disposal of
renovation debris. In New York, contact the New
York State Department of Environmental Conservation, Bureau of Hazardous Waste Management,
Technical Determination Section (). In Vermont,
contact the Vermont Department of Environmental
Conservation, Waste Management Division, Solid
Waste Program ().
If your dental office is on a septic system,
do not wash the liquid that has gone through the
silver recovery process down the drain. The recovery process waste may disrupt the proper functioning of the septic system. Therefore, recovery
systems may not be a viable option for offices on
septic systems.
Used X-Ray Fixer
Solution
X-Ray Developer
(Containing Silver)
Do not mix X-ray developer and used X-ray
fixer. The silver-laden used X-ray fixer is considered
hazardous waste and can not be flushed down the
drain. Please refer to the previous section on
Used X-Ray Fixer Solution for proper handling
procedures.
U
sed fixer is the solution left over from Xray processing. The used fixer is considered a hazardous waste because of its high
silver content. Used fixer should be
reclaimed off-site by another company,
handled by a hazardous waste management firm, or reclaimed in-house.
Reclaiming the silver in used fixer conserves a
valuable resource and reduces your business
liability. Many reclaimers will pay to take your
silver. Suitable recycling methods for used fixer
include:
Check with your local publicly owned treatment
works (POTW) to determine if waste X-ray developer can be flushed down the drain. (Check in the
phone book under your town’s Public Works
Department for the number of your local POTW).
If X-ray developer is acidentally mixed with used
X-ray fixer, the mixture must be disposed of through
a hazardous waste hauler ().
Reclamation Facility/Hazardous Waste
Management Firm. Used fixer can be taken to a
silver reclamation facility () that is licensed to
accept hazardous waste, or disposed of through a
hazardous waste hauler (). In either case, make
sure you get a receipt or certificate of reclamation.
10.
Cleaners for X-Ray
Developer Systems
M
Dispose of lead foils, shields and aprons through
a hazardous waste hauler ().
Check with the manufacturer for recycling
possibilities for lead aprons that become worn out or
damaged.
Remember to always get documentation from the
company handling your lead waste confirming that
the waste has been disposed of properly.
any cleaners for X-ray developer systems
contain chromium. Chromium is considered a toxic substance that must be
managed as a hazardous waste.
Chemiclave/Chemical
Sterilant Solutions
Dispose of chromium-containing
cleaners through a hazardous waste
hauler ().
Check the package label or the Material Safety
Data Sheet (MSDS) to see if the cleaner you use
contains chromium. If it does, ask your supplier to
provide a non-chromium cleaner.
S
Never put a cleaning solution, disinfectant or
any other process waste into a septic system,
regardless of its concentration. It may disrupt the
proper functioning of the septic system.
pent chemiclave solution is the liquid left
over from the chemical sterilization of
dental instruments. This used solution is
an ignitable waste because it contains
more than 24% alcohol and has a
flashpoint below 140ºF.
Dilute the spent chemiclave solution
with at least 4 parts of water (4 parts water to one
part chemiclave solution) or more before discharging
down the drain.
Lead Foils, Shields
& Aprons
Do not wash the chemiclave solution down the
drain undiluted, or put in the garbage.
Never put a cleaning solution, disinfectant or
any other process waste into a septic system,
regardless of its concentration. It may disrupt the
proper functioning of the septic system.
Do not put the lead foil that shields X-ray film,
protective lead shields, and lead aprons into the
trash or into biohazard bags.
The lead content of these items makes them
hazardous waste, even if they are recycled for their
scrap metal content.
11.
Disinfectants,
Cleaners and other
Chemicals
Fluorescent Bulbs:
Recycle fluorescent bulbs through your regional
solid waste district (). Fluorescent bulbs are
hazardous waste and a significant source of mercury.
They should not be placed in the trash.
Do not place fluorescent bulbs in the trash.
Follow the label
directions on the product
container for guidance
on the proper handling
and disposal of used
disinfectants and cleaners,
along with the residue remaining in the product
containers.
Batteries:
Recycle all types of batteries. Most, if not all,
batteries have hazardous properties and should be
recycled. Contact your regional solid waste district
for recycling directions ().
•
Single Use Batteries: As a result of federal and
state legislation, mercury is no longer added
to domestically produced alkaline batteries.
However, certain other kinds of batteries–
including certain button batteries, some
medical batteries, small sealed lead-acid
batteries, and other specialty batteries–
continue to contain mercury and other metals
that are intentionally
added.
•
Rechargeable
Batteries: Batteries
such as nickel/
cadmium (Ni/Cd)
that are no longer
useful are hazardous
waste and should
also be recycled
since they contain
lead and cadmium.
Recycle the empty container through your local
program or dispose of it in the trash.
Alcohols, ethers, and peroxides are considered
ignitable and must not be discarded down the drain
because they could explode. These materials are
considered to be hazardous waste. Unused products
should be disposed of through a hazardous waste
hauler ().
Never put a cleaning solution, disinfectant or
any other process waste into a septic system,
regardless of its concentration. It may disrupt the
proper functioning of the septic system.
Office Waste
General Office Waste:
Do not place batteries in the trash, biohazard
bag, or sharps container.
Contact your trash hauler or your regional solid
waste district () for information on how to start
an office waste recycling program.
Recycle aluminum, glass, plastics,
newspaper, corrugated cardboard,
paperboard, and office paper through
your trash hauler or local recycling
program. Due to confidential
patient information you may want
to have office paper shredded prior
to recycling.
Recycle spent toner cartridges
that have been used in printers and copiers.
Printed on recycled paper with soy-based inks
Design: Mirabile Graphics
Illustrations: Carolyn Shapiro
12.
For additional copies of the Resource Handbook or Dental Office
Waste Management Table, please contact:
The National Wildlife Federation
Northeast Natural Resource Center
58 State Street
Montpelier, Vermont 05602
(802) 229-0650 gilbert@nwf.org
or
Vermont State Dental Society
100 Dorset Street, Suite 18
South Burlington, Vermont 05403
(800) 640-5099 ptaylorvt@aol.com
People and Nature:
Our Future is in the Balance
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