Dental activity is prone to various types of professional risk, the most significant being biological risk. Proper management of contaminated waste is necessary for reducing the risk of infection for medical staff, patients, and operators. Most of the waste produced in a dental practice falls under the hazardous waste category and prevents the risk of infection from PPE and other medical equipment. Hazardous waste is subjected to a controlled, individual disposal process because it is a possible source of contagion. Any dental waste that is a hazard can remain in practice until an authorized company collects it for disposal. It is safe to do this as long as it is far from patients, medical staff, and third parties. The most likely risk associated with hazardous waste is contracting infections like TB and AIDS.
Steps for proper management and disposal of hazardous waste (hazardous waste)
Hazardous waste is commonplace in every dental practice. Like every other medical establishment, employees of dental clinics must have a blueprint for dealing with the various forms of hazardous waste they encounter while performing their duties.
· Generation, transportation, and disposal of hazardous waste are traceable to the facility where they originate. According to the EPA, these generators must follow best practices for hazardous waste management. Transporters are the ones who move the material to a facility that can recycle, treat, dispose or store the waste. Landfills or incinerators are employed to deposit some of the remains. Other forms of debris are safely recycled. It reduces the amount of space needed for securely storing non-recycled material.
· Not all the waste in a dental office is considered hazardous, many of the garbage that dental facilities generate is not dangerous as they are similar to standard household waste. Nevertheless, dental practice employees must be familiar with hazardous waste when they come in contact with them. The popular one is dental amalgam disposal. As a substance commonly used in cavity fillings, it is a mixture of metals considered hazardous because it contains mercury, which is harmful to people and the environment. After the installation of an amalgam separator, recycling should take place after use. Waste management organizations like the DRNA are helpful in this regard.
· X-ray waste and lead disposal: Lead is often associated with X-rays although, other kinds of effluent emanate from X-rays. Some of them include processing chemicals, acid etch, monomers, disinfectants, adhesive and x-ray films.
· Sharps should be in a container that is puncture and leak-proof and labeled for sharps disposal. They should be easily accessible to those who will use them. However, avoid high traffic areas.
· Pharmaceutical waste disposal is also important because many of the ingredients in pharmaceutical products that make them effective are also the things that make them hazardous, particularly when they are used outside their intended purpose or introduced to wastewater systems. They must be disposed of in labeled containers and separated from regular trash.
Regulations on special and hazardous waste management
Dental professions are required to adhere to clinical waste regulations. It is essential to prevent harm to the environment and human health. These are spelled out in the United States Environmental Protection Agency’s dental effluent guidelines that issued pretreatment standards in 2017 to reduce discharges from mercury in dental offices. The amalgam used in dental practice for filling contains mercury. It is why amalgam separators are necessary to separate mercury and other metals. When captured by a Separator, the mercury is recycled. The EPA projects that compliance with this rule will reduce mercury discharge by 5.1 tons, including 5.3 tons of other metals found in dental amalgams. Mercury is a potent neurotoxin that accumulates in shellfish and fish. It is a global concern that sprung from many diverse sources like air deposition from industrial incinerators and combustion of fossil fuels.
Facts about mercury and dental clinics
· Dental clinics are the primary source of mercury discharge to publicly owned treatment works (POTWs)
· Data from the EPA states that about 103,000 dental offices use or remove amalgam in the United States, and they all send their wastewater to POTWs
· Most of the mercury released to the environment is from dental offices. It amounts to 5.1 tons of mercury each year.
Dental office category rule
The EPA developed this rule to ensure that dental offices align with best practices in waste management. Some of the basic requirements of the guidelines are as follows:
· Ensuring the removal of dental amalgam solids from all amalgam process wastewater through amalgam separators or equivalent device(s) that meet the standard of the final rule
· Comply with reporting requirements
· Records that document compliance must be maintained and made available for inspection.
Many of the dental facilities that discharge wastewater into publicly owned treatment works are subject to this rule. However, there are exemptions for dental dischargers that do not place dental amalgam and do not remove dental amalgam except in emergencies. Where this is the case, send a one-time compliance report to the Control Authority of your office. In addition, dental dischargers that exclusively practice one or more of the following are not subject to submitting a one-time compliance report or any of the rule’s requirements. These are
· Oral and maxillofacial radiology
· Oral pathology
· Oral and maxillofacial surgery
Also, mobile units are not subject to the rule's requirements, including submitting a one-time compliance report. A mobile unit refers to a specialized self-contained van, trailer, or equipment used in rendering dentistry services at multiple locations. Dental facilities that do not discharge their amalgam process wastewater into a POTW are also not subject to the requirements mentioned earlier. For instance, dental facilities that discharge amalgam process wastewater into a septic system. Visit the EPA website if you want to know the rules that apply to your facility.
Contact us at DRNA for more information about hazardous waste. We can also give more details on regulations that affect the disposal of dental waste in general.