September, 2008
OFFICIAL International Association of Plumbing & Mechanical Officials

Mercury Worries Give Rise to New Industry
New York company poised to capture market share through certification and regulation of technology for dental offices

By Deanna Glick

While it’s debatable whether the material that comprises silver fillings in teeth poses a public health threat, diverting its waste particles — and the mercury contained within —from dentist office drains has been gaining favor.

The issue has spawned the industry of amalgam separators, devices to remove waste particles of amalgam — the material used for silver fillings — from dental office wastewater. Now, the markets for the devices and recycling of the material they capture appear to be growing, as more states mandate the technology in the spirit of environmental responsibility. Proponents say it prevents vast amounts of mercury, a toxic metal believed to cause various health problems in humans and wildlife, from entering the water supply.

A company based in one such state, New York, has leveraged its position via certification with the International Organization for Standardization. ISO compliance required an amalgam separator to remove 95 percent of the mercury released by the facility where it’s installed.

Dental Recycling North America is the only provider whose product has undergone rigorous testing and the subsequent stamp of safety approval from a third-party certification organization.

“Over the next three years, most of the market will be regulated,” said Marc Sussman, president and chief executive office of DRNA at a June press conference announcing the certification. “Federal regulation is possible.”

Studies show dental amalgam is a major source of mercury in wastewater. In fact, according to the original proposal for New Jersey regulations passed last year, facilities where the placing or removing of dental amalgams occurs contribute more than any other sector to the mercury entering public water systems. Other sources include iron and steel melters, incinerators and coal-fired power plants that emit mercury into the air that is then deposited in surface waters.

According to the American Dental Association, 35 to 45 percent of the mercury entering the public water supply comes from dental facility sources. Another study cited in the New Jersey proposal estimated that dental facilities contribute approximately half of the estimated total mercury load to public water systems in the United States.

Although fish and shellfish remain the largest source of human exposure to the most toxic form of the metal, mercury contained in dental amalgam has received increasing scrutiny from regulators in their efforts to reduce the discharge of mercury and mercury-containing materials into the environment. Thus a growing number of states are seeking to require use of amalgam separators, a move that marks a potential shift in the market for the technology. DRNA sought to stand out in its field through a partnership with the nonprofit National Sanitation Foundation International. NSF issued the certification last fall after verifying the company’s ISO compliance.

According to a press release, DRNA is also the only company to have its amalgam separation technology verified by the EPA’s Environmental Technology Verification Program, which is administered by NSF. Ongoing audits performed by NSF field auditors at the manufacturing facility will ensure continued compliance with the ISO standard.

The American Dental Association’s endorsement of amalgam separators via inclusion in its Best Management Practices last year could also have an impact, though some state dental associations were slow to accept the idea and may still be skeptical. According to an article on the association’s Website, associations in California and New York originally disputed the amount of mercy being discharged into the environment due to amalgam use and opposed legislation requiring amalgam separators due to the cost.

Sussman said some dentists remain resistant to spending money on the technology, but he believes the cost of equipment and disposal is reasonable given the average dentist’s annual salary range of $125,000 to $250,000.

A 2002 report prepared for the ADA by Environ International Corporation, and referenced in the New Jersey proposal, stated such costs typically range from $1,000 to $2,000 per facility. With the life of the separator estimated to be 10 years, the annual average cost over this period would be $340,000 to $680,000. The annual operating cost for a separator, which includes the cost of recycling the captured material, is estimated at $700 to $1,000 per year. The state of New Jersey also argued its regulations would have a positive economic impact on health care costs, due to reduced mercury related illness, as well as on the fishing industry, due to reduced mercury levels in water.

Former Environmental Protection Agency Administrator Carol Browner said amalgam separators are the most cost-effective option for removing mercury via amalgam waste from the water supply.

“When the water leaves the dental office and contaminates the sewer pipeline, they can’t segregate that water back out, so you have all of the water that needs to be treated,” Browner said. “That’s where the cost comes in. As opposed to treating a fraction of that water before it enters the system.”

Regardless of cost, some dismiss the technology out of a belief that mercury contained within amalgam, even when it’s disturbed during filling replacements, doesn’t pose any risk to human health or the environment. Despite the alternative composite fillings that can be tinted to match the teeth, amalgam remains popular because of its low cost. And, in a solid, undisturbed state such as a dental filling, dentists generally believe mercury used in amalgam doesn’t represent a threat. But opinions tend to diverge when it comes to removing such fillings.

Increasing public pressure regarding environmental issues appears to be pushing regulatory efforts toward the “better safe than sorry” route. Soon, dentists may be required, whether it be by local, state or federal law, to install and maintain amalgam separators regardless of their stance on the issue.

“The environment is a major issue to people right now and that’s really driving this,” Sussman said. Tom Downey, a former U.S. Congressman in attendance at the press conference, added: “There’s no real pro-mercury lobby out there.”

Those gathered at DRNA’s press conference discussed recruiting a Senate sponsor for the bill and the possibility of passing federal legislation under the Safe Drinking Water Act. All were confident legislation would eventually be pushed through Congress, possibly during the next presidential administration. Efforts before then could be futile. Browner said the Bush administration has backed off of mercury air emissions and actually reversed the EPA’s designation of mercury as a neurotoxin. She said legislation would likely be supported by either of next year’s potential White House inhabitants.

For now, efforts at the state level continue. Sussman said favorable discussion has occurred in Pennsylvania, Michigan and Ohio. The ADA cites main among the first states to pass a statute requiring amalgam separators, and it was the Maine Dental Association that introduced the legislative bill. Statutes have also been passed in New Hampshire, Connecticut and Vermont, according to the New Jersey proposal. Sussman said New York and New Jersey are the largest markets to seek and adopt legislation so far.