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PRACTICAL ISSUES FOR PURCHASING, INSTALLING AND MAINTAINING DENTAL AMALGAM SEPARATORS
ADA
PROFESSIONAL
PRODUCT
turer indicates; one manufacturer reported an MFV that was less than that found experimentally, meaning this unit can be replaced later than indicated by the manufacturer. Seven of the amalgam separators tested had bypass mechanisms, which allow suction power to remain the same even when the collecting capsule is full. These mechanisms accomplish this by completely bypassing the collecting capsule and permitting unprocessed drainage to flow directly into the public wastewater system. The advantage is that dental operations will not be interrupted when the separator is full. However, this also means that the separator’s ability to remove amalgam particles is reduced—and with the suction unaffected, the dentist will not be aware that the separator needs maintenance, thus prolonging contamination of the wastePRACTICAL ISSUES FOR PURCHASING, INSTALLING AND MAINTAINING DENTAL AMALGAM SEPARATORS
Kevin R. McManus, MA, MBA ental offices are one of the most frequently referenced sources of mercury added to public sewer systems; their contribution comes in the form of dental amalgam. Environmental agencies continue to develop regulations, outreach programs or both on a state and local basis that encourage or, in some areas, require dental offices to install amalgam separators. A dental office’s waste infrastructure and office procedures can affect the choice of an amalgam separator. Dental teams also will encounter important differences in operating and maintaining separator units properly. Before purchasing or installing an amalgam separator, consider these factors: dspace requirements; dutility requirements; ddental office/building constraints; dease of maintenance and replacement; deffect on suction equipment; dpurchase, installation and maintenance costs. Space requirements. A separator’s performance relies, in part, on the equipment’s correct installation within the dental office’s existing wastewater and vacuum system. There generally are three distinct installation locations: directly within the vacuum system piping, or “in line,” at or near individual operatory chairs; in line at a central location upstream of the vacuum pump; or at the outlet side of the airwater separator.
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SUMMARY
water system. Two separators evaluated did not have a bypass mechanism, meaning their suction power will diminish gradually when the unit is filled to capacity. Conclusions. Although the test results show that all nine amalgam separators passed the ISO 11143 requirement of 95 percent amalgam removal efficiency, for proper use, purchasers and users of these devices should note the separator’s maximum fillable volume and bypass mechanism. ■ Disclosure. Mr. Chou and Ms. Anglen did not report any disclosures. 1. U.S. Environmental Protection Agency. Dental amalgam effluent guideline. http://water.epa.gov/scitech/wastetech/guide/dental/ index.cfm. Accessed June 29, 2012. 2. International Standards Organization. ISO 11143: Dentistry— Amalgam Separators. Cited in: American National Standards Institute and American Dental Association. Specification No. 108: Amalgam Separators. Chicago: American Dental Association; 2009.
Utility requirements. Many separators rely on gravity or the vacuum system for operation and do not require an electrical power source beyond that needed to power the vacuum system. However, some units need electrical power connections for the control panel or to operate pumps. Dental office/building constraints. Building factors that affect placement and installation of amalgam separators include building configuration, available installation space, access to centralized plumbing lines and amalgam separators, office space leasing agreements, plumbing code requirements and approved equipment lists. Building configuration. Centrally plumbed offices in which all plumbing systems drain into one pipe may need modification so that only drainage from amalgam-generating sources runs through the separator. Additional water flows (cuspidors, sinks and operatories used exclusively for hygiene appointments) can affect separator performance adversely. Installation space. Many dental offices install vacuum systems and air-water separators at the basement level to conserve office space. Offices with no basement or plumbing closet may require the use of chairside amalgam separators in individual operatories. Access to plumbing lines and amalgam separators. Suitable access is needed to allow for inspection and maintenance of the separator. Dental practices that share plumbing or vacuum systems will need to coordinate maintenance activities so as not to interfere with work schedules. Office space leasing agreements. Many JADA 143(8)
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Copyright © 2012 American Dental Association. All rights reserved.
August 2012 921
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REVIEW
commercial leasing agreements contain language that restricts the tenant’s ability to modify the building infrastructure. Dentists who lease office space should review the terms of their lease before installing a separator. Plumbing code requirements. Most states and cities have their own plumbing codes, and offices should check with vendors and their local plumbing inspectors to ensure that they meet local ordinances. Approved equipment lists. Some local wastewater treatment facilities have lists of approved amalgam separators and vendors, which may be issued as a regulatory requirement or as guidance included in “best management practices” programs. Ease of maintenance and replacement. Separators must be properly maintained, including regular changing of collection canisters or, depending on the unit, changing units entirely to ensure that collection rates remain as designed. A separator that is allowed to fill beyond its capacity may result in amalgam wastes’ completely bypassing the collection system. Effect on suction equipment. Separator units may affect existing vacuum systems. Units placed upstream of vacuum systems must be installed carefully to prevent loss of suction.
922 JADA 143(8)
http://jada.ada.org
EXECUTIVE
SUMMARY
Clogs in the line also can degrade vacuum performance. Costs. True side-by-side comparisons of system costs are difficult to achieve because many pricing and leasing programs exist. Any approach used to compare the cost of separators should involve analysis of upfront and ongoing expenses, including the following: dpurchase price; dinstallation fee(s); dancillary parts included in cost (such as mounting plates, connection fittings); dcost of replacement parts, tanks or cartridges, including shipping and other, sometimes hidden, fees; doffice maintenance costs, including labor. Conclusions. There are important questions and considerations that dental offices should review before contacting vendors. The bottom line is that one size does not fit all, and office configurations and operations can significantly affect the selection and installation of an amalgam separator. ■ Mr. McManus is the senior program director, EnviroBusiness, Burlington, Mass. Address reprint requests to ADA Professional Product Review, 211 E. Chicago Ave., Chicago, Ill. 60611, e-mail [email protected]. Disclosure. Mr. McManus did not report any disclosures.
August 2012
Copyright © 2012 American Dental Association. All rights reserved.
PROFESSIONAL
PRODUCT
turer indicates; one manufacturer reported an MFV that was less than that found experimentally, meaning this unit can be replaced later than indicated by the manufacturer. Seven of the amalgam separators tested had bypass mechanisms, which allow suction power to remain the same even when the collecting capsule is full. These mechanisms accomplish this by completely bypassing the collecting capsule and permitting unprocessed drainage to flow directly into the public wastewater system. The advantage is that dental operations will not be interrupted when the separator is full. However, this also means that the separator’s ability to remove amalgam particles is reduced—and with the suction unaffected, the dentist will not be aware that the separator needs maintenance, thus prolonging contamination of the wastePRACTICAL ISSUES FOR PURCHASING, INSTALLING AND MAINTAINING DENTAL AMALGAM SEPARATORS
Kevin R. McManus, MA, MBA ental offices are one of the most frequently referenced sources of mercury added to public sewer systems; their contribution comes in the form of dental amalgam. Environmental agencies continue to develop regulations, outreach programs or both on a state and local basis that encourage or, in some areas, require dental offices to install amalgam separators. A dental office’s waste infrastructure and office procedures can affect the choice of an amalgam separator. Dental teams also will encounter important differences in operating and maintaining separator units properly. Before purchasing or installing an amalgam separator, consider these factors: dspace requirements; dutility requirements; ddental office/building constraints; dease of maintenance and replacement; deffect on suction equipment; dpurchase, installation and maintenance costs. Space requirements. A separator’s performance relies, in part, on the equipment’s correct installation within the dental office’s existing wastewater and vacuum system. There generally are three distinct installation locations: directly within the vacuum system piping, or “in line,” at or near individual operatory chairs; in line at a central location upstream of the vacuum pump; or at the outlet side of the airwater separator.
D
REVIEW
EXECUTIVE
SUMMARY
water system. Two separators evaluated did not have a bypass mechanism, meaning their suction power will diminish gradually when the unit is filled to capacity. Conclusions. Although the test results show that all nine amalgam separators passed the ISO 11143 requirement of 95 percent amalgam removal efficiency, for proper use, purchasers and users of these devices should note the separator’s maximum fillable volume and bypass mechanism. ■ Disclosure. Mr. Chou and Ms. Anglen did not report any disclosures. 1. U.S. Environmental Protection Agency. Dental amalgam effluent guideline. http://water.epa.gov/scitech/wastetech/guide/dental/ index.cfm. Accessed June 29, 2012. 2. International Standards Organization. ISO 11143: Dentistry— Amalgam Separators. Cited in: American National Standards Institute and American Dental Association. Specification No. 108: Amalgam Separators. Chicago: American Dental Association; 2009.
Utility requirements. Many separators rely on gravity or the vacuum system for operation and do not require an electrical power source beyond that needed to power the vacuum system. However, some units need electrical power connections for the control panel or to operate pumps. Dental office/building constraints. Building factors that affect placement and installation of amalgam separators include building configuration, available installation space, access to centralized plumbing lines and amalgam separators, office space leasing agreements, plumbing code requirements and approved equipment lists. Building configuration. Centrally plumbed offices in which all plumbing systems drain into one pipe may need modification so that only drainage from amalgam-generating sources runs through the separator. Additional water flows (cuspidors, sinks and operatories used exclusively for hygiene appointments) can affect separator performance adversely. Installation space. Many dental offices install vacuum systems and air-water separators at the basement level to conserve office space. Offices with no basement or plumbing closet may require the use of chairside amalgam separators in individual operatories. Access to plumbing lines and amalgam separators. Suitable access is needed to allow for inspection and maintenance of the separator. Dental practices that share plumbing or vacuum systems will need to coordinate maintenance activities so as not to interfere with work schedules. Office space leasing agreements. Many JADA 143(8)
http://jada.ada.org
Copyright © 2012 American Dental Association. All rights reserved.
August 2012 921
ADA
PROFESSIONAL
PRODUCT
REVIEW
commercial leasing agreements contain language that restricts the tenant’s ability to modify the building infrastructure. Dentists who lease office space should review the terms of their lease before installing a separator. Plumbing code requirements. Most states and cities have their own plumbing codes, and offices should check with vendors and their local plumbing inspectors to ensure that they meet local ordinances. Approved equipment lists. Some local wastewater treatment facilities have lists of approved amalgam separators and vendors, which may be issued as a regulatory requirement or as guidance included in “best management practices” programs. Ease of maintenance and replacement. Separators must be properly maintained, including regular changing of collection canisters or, depending on the unit, changing units entirely to ensure that collection rates remain as designed. A separator that is allowed to fill beyond its capacity may result in amalgam wastes’ completely bypassing the collection system. Effect on suction equipment. Separator units may affect existing vacuum systems. Units placed upstream of vacuum systems must be installed carefully to prevent loss of suction.
922 JADA 143(8)
http://jada.ada.org
EXECUTIVE
SUMMARY
Clogs in the line also can degrade vacuum performance. Costs. True side-by-side comparisons of system costs are difficult to achieve because many pricing and leasing programs exist. Any approach used to compare the cost of separators should involve analysis of upfront and ongoing expenses, including the following: dpurchase price; dinstallation fee(s); dancillary parts included in cost (such as mounting plates, connection fittings); dcost of replacement parts, tanks or cartridges, including shipping and other, sometimes hidden, fees; doffice maintenance costs, including labor. Conclusions. There are important questions and considerations that dental offices should review before contacting vendors. The bottom line is that one size does not fit all, and office configurations and operations can significantly affect the selection and installation of an amalgam separator. ■ Mr. McManus is the senior program director, EnviroBusiness, Burlington, Mass. Address reprint requests to ADA Professional Product Review, 211 E. Chicago Ave., Chicago, Ill. 60611, e-mail [email protected]. Disclosure. Mr. McManus did not report any disclosures.
August 2012
Copyright © 2012 American Dental Association. All rights reserved.