Condrin Amy Knepshield
OSHA Review, Inc., Sacramento, Calif 95827, USA.
J Calif Dent Assoc. 2004 Jul;32(7):583-92.
Concerns over the persistence and effects of mercury in the environment, particularly in wastewater, have increased significantly over the past decade. Because mercury is a component of dental amalgam, comprising about 50 percent of amalgam among other metals, in recent years the concern has affected dental practices and even educational curricula in the dental schools. While numbers vary widely from area to area, on average, it is estimated dentistry contributes less than 1 percent of the mercury generated from human activity to the environment. Despite dentistry's low contribution to the environmental mercury load, organized dentistry's position is that dentistry's role as a public health profession includes environmental stewardship, as well as patient safety, and that dental professionals must act responsibly by taking steps to prevent amalgam waste or any potentially harmful materials from entering the environment, no matter how small the amount. In support of this belief, both the California Dental Association and the American Dental Association have developed recommendations for best practice that dental offices should follow when handling dental amalgam waste. Many dental schools and auxiliary programs have shown their commitment to minimizing detrimental effects to the environment, evidenced by the fact that most, if not all, have incorporated safe work practices including mercury hygiene procedures as part of clinical coursework. Some local jurisdictions hardest hit by the effects of mercury in wastewater have gone even further to recommend, or even require, the installation of amalgam separators in dental offices. This article will describe the history of BMPs and amalgam separators usage in California, and examine the practical aspects of their usage in reducing the discharge of dental amalgam into waste streams.
在过去十年中，人们对环境中汞的持久性及其影响，尤其是废水中汞的关注度显著提高。由于汞是牙科汞合金的一种成分，在其他金属中约占汞合金的50%，近年来，这种担忧已经影响到牙科医疗实践，甚至牙科学校的教育课程。虽然不同地区的数字差异很大，但据估计，牙科行业向环境排放的汞占人类活动产生汞总量的比例不到1%。尽管牙科行业对环境汞负荷的贡献较低，但有组织的牙科行业的立场是，牙科作为公共卫生专业的作用包括环境管理以及患者安全，牙科专业人员必须采取负责任的行动，采取措施防止汞合金废物或任何潜在有害物质进入环境，无论数量多么少。为支持这一信念，加利福尼亚牙科协会和美国牙科协会都制定了牙科诊所处理牙科汞合金废物时应遵循的最佳实践建议。许多牙科学校和辅助项目都表明了他们致力于将对环境的有害影响降至最低，事实证明，大多数（如果不是全部的话）都将包括汞卫生程序在内的安全工作实践纳入了临床课程。一些受废水中汞影响最严重的地方司法管辖区甚至进一步建议甚至要求牙科诊所安装汞合金分离器。本文将描述加利福尼亚州最佳管理实践（BMPs）和汞合金分离器使用情况的历史，并探讨其在减少牙科汞合金排放到废水中的实际应用情况。
