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Amalgam Rules Development & Implementation in New Hampshire Paul Lockwood (603) 271-2956 [email protected] 2005 Northeast Environmental Summit September 28, 2005
Amalgam Rules Development & Implementation
inNew Hampshire
Paul Lockwood (603) [email protected]
2005 Northeast Environmental SummitSeptember 28, 2005
Background: NH Mercury reduction efforts
House Bill 1251 & Rules adoption process
Rules implementation and status
Amalgam Rules Development & Implementation
inNew Hampshire
NH Mercury Reduction Strategy
4.7.1 Recommended Actions Regarding
Dental AmalgamConduct outreach to the general public and dentist’s offices…to encourage the voluntary use of alternatives to mercury-containing amalgam and encourage the proper collection and disposal of waste amalgam.
Draft legislation…with an effective date of July 1, 2003 to prohibit the use of mercury-containing amalgam.
R-27
R-28
NH Mercury Reduction Strategy
2002 Legislation
HB 1251 – “An Act relative to the use of mercury amalgam fillings by dentists.”
Introduced June, 2002 as a ban on the use of mercury-amalgam in New Hampshire
NH Mercury Reduction Strategy
2002 Legislation
Problems and Issues:
• Environmental or Public Health issue?
• Insurance issues
• Credibility of support data
• NH Dental Society support
HB 1251 – “An Act relative to the use of mercury amalgam fillings by dentists.”
NH Mercury Reduction Strategy
2002 Legislation
Final outcome:
• DES to draft rules relative to amalgam disposal
• DHHS to create pamphlet for dentists to provide to patients
HB 1251 – “An Act relative to the use of mercury amalgam fillings by dentists.”
Amalgam Management Rules DevelopmentIn
New Hampshire
Stakeholder workgroup met in summer, 2002
Key issue = Enforcement
Discharge limit?
or
Performance standard?
Amalgam Management Rules DevelopmentIn
New Hampshire
Performance Standard = Amalgam Separator
Issues:• Level of performance required?
• “Home built” technologies?
• Particulate and soluble Hg?
• Self-certification procedures?
• Waivers and exemptions?
Amalgam Rules ImplementationIn
New Hampshire
• installation of ISO 11143-certified amalgam separator
or
• practitioner is exempt or requesting waiver
Env-Ws 905 STANDARDS FOR MANAGEMENT OF MERCURY-CONTAINING AMALGAMRequires written self-certification from “owner of the practice”:
Amalgam Rules ImplementationIn
New Hampshire
Exemption for:
• Orthodonists, periodontists, oral or maxillofacial surgeons, oral pathologists, oral or maxillofacial radiologists who don’t generate amalgam wastes
• Retired practitioners
Amalgam Rules ImplementationIn
New Hampshire
Waiver for:
• “de minimis” discharge of up to 0.5 gram Hg/year (= 1 gram amalgam = 2 fillings)
• equivalent alternative technology
• “zero discharge” (holding tank)
Amalgam Rules ImplementationIn
New Hampshire
Initial Notification July 8, 2005
1,260 Licensed practitioners notified
10% response in first two weeks even though none required until October 1.
Amalgam Rules ImplementationIn
New Hampshire
Early issues & problems:
• Mobile units & schools
• Semi-retired or not in state
• “Amalgam-free” practitioners
• Endodontists
Amalgam Rules ImplementationIn
New Hampshire
Next steps
• Certifications due by Oct 1, 2005
• Requests for de-minimis waivers will be reviewed
• Random sampling to determine accuracy of self-certification
