office runoff. The ignored will no doubt remain so. The silence is deafening.
http://www.epa.gov/guide/304m/2008/hsi-dental-200809.pdfDENTAL MERCURY SOURCES AND ENVIRONMENTAL IMPACTS
The EPA Office of Compliance’s Sector Notebook for the Healthcare Industry identified mercury as the major pollutant of concern (POC) for wastewater discharges from dental facilities (see EPA-HQ-OW-2004-0032-0729). Sources of amalgam in dental wastewater include the placement of amalgam fillings and removal of amalgam during restorations. Other constituents of dental amalgam include metals such as silver, tin, copper, zinc, indium, and palladium. Of the dental amalgam constituents, mercury is of greatest concern to human health because it is a persistent, bioaccumulative, toxic chemical and can bioaccumulate three to ten times across each trophic level of the food chain. For wastewater mercury discharges, the major route for human exposure is the consumption of mercury-contaminated fish.
While mercury used in U.S. dental offices accounts for only a small percentage of the total mercury discharged to air and water each year, mercury in the form of dental amalgam is among the largest sources of mercury found in wastewater influent reaching POTWs. The American Dental Association (ADA) estimates that up to 50 percent of the mercury entering POTWs originates in dental offices (Vandeven and McGinnis, 2005). Recent data compiled from across the country indicate that varying amounts of the mercury in wastewater reaching POTWs originates from dental offices:
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The East Bay Municipal Utility District (EBMUD) of Oakland, CA, estimates that dental offices account for 34 percent of the mercury influent loading to wastewater treatment plants (EBMUD, 2007);
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Dental clinics contribute 11 to 14 percent of the mercury loading to local sanitary districts in Seattle, WA (Stone, 2004);
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Dental clinics account for almost 50 percent of the mercury in wastewater in Palo Alto, CA (Palo Alto, 2007); and
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A study by the Association of Metropolitan Sewerage Agencies (AMSA) — now the National Association of Clean Water Agencies (NACWA) — found that dental offices account for an average of 35 percent of the mercury influent to POTWs (AMSA, 2002).
Due to the increased concern regarding mercury in the environment, several U.S. industries have significantly decreased mercury usage since the 1980s (Vandeven and McGinnis, 2005). Although dentists have also reduced their mercury use, as of 1999, amalgam was still widely used for restorations (66 million amalgam restorations in 1999) (Stone, 2004). ADA predicts that use of amalgam will continue to decrease due to various factors such as the introduction of improved filling material, overall decrease in tooth decay and earlier detection of tooth decay (EPA, 2007a). In 2007, TheWealthyDentist.com, a website and weekly newsletter for dentists, surveyed dentists to determine amalgam use. The survey found that 52 percent of dentists do not place amalgam fillings (The Wealthy Dentist, 2007).
The remainder of this section describes the wastewater sources of amalgam, environmental impacts of dental mercury, and treatment of dental mercury at POTWs.