What Is the Dentist’s Liability When Recycling Amalgam Waste From Mercury Separators?
Jack Dillenberg, DDS, MPH
In recent years the dental community has increased its commitment to protect the environment-in particular, water sources-by separating the mercury from amalgam before discharging it to wastewater systems. Now, the Environmental Protection Agency (EPA) is requiring all dental offices, clinics, and dental schools to comply in doing this, beginning in July of this year. While there are a few specialty exemptions, all general dentists will be mandated to comply.
One lingering issue, however, that seems to have been inadequately addressed and appears to be somewhat misunderstood by many dental practitioners, managers, and practice owners is their responsibility for the appropriate handling of the recycling of the amalgam waste collected in separator cartridges.
When choosing a recycling company, dental providers should look for one that offers what I call a 360-degree solution: both equipment and recycling as a package deal. While some companies appear to offer a cheaper price, they may be just selling the equipment and not providing recycling. Additionally, the company should recycle the waste at an EPA-verified facility (ie, a facility with a permit) and provide the disposer (ie, dental provider) with recycling documentation that certifies the cartridge contents were appropriately recycled.
I've outlined several myths and facts regarding the recycling of amalgam and the liability of the dentist as a generator of hazardous waste:
Myth: "I am absolved of any liability because I gave my amalgam waste to my dental supplier or recycling company."
Fact:The Resource Conservation and Recovery Act (RCRA) established a "cradle to grave" responsibility for hazardous waste generators. This means that dental practitioners are responsible for their waste from the time it is generated to when it is disposed of or recycled. Therefore, if practitioners are using a recycling facility that is not EPA verified, or if their supplier is not bringing the waste to an EPA-verified facility, they are liable for the waste. Because of this liability, to prevent being fined it is recommended that dental providers research the companies and facilities that will be taking their waste.
Myth:"I have a valid waste receipt, therefore I am in compliance."
Fact:Waste receipts only prove that the waste was received at a facility. The facility at which the waste was received, however, may differ from the recycling facility. According to the EPA final rule, the proper documentation must include "all dates that collected dental amalgam is picked up or shipped for proper disposal in accordance with 40 CFR 261.5(g)(3), and the name of the permitted or licensed treatment, storage, or disposal facility receiving the amalgam retaining containers." Also, the EPA's "Effluent Limitations Guidelines and Standards for the Dental Category" requires the receipts to have the recycling facility's information as well.
Myth:"I can ship my hazardous waste overseas."
Fact:Under 40 CFR 262.83 - Exports of hazardous waste, it is true that the waste may be exported and recycled overseas. However, the rules for exporting hazardous waste are quite onerous. While there are some companies that recycle the waste overseas, dental providers/waste generators should exercise extreme caution if choosing to go this route. The best way to avoid liability is to be risk adverse, and the best way to be risk adverse under this regulation is to send the waste to a US RCRA-approved facility, because the liability with sending the waste overseas is significant. The company sending the waste overseas will be required to include the dental provider's information as the waste generator, so anything that happens to that waste in transit and disposal is part of the waste generator's legal responsibility. There is additional risk in using companies that recycle overseas in that it will take longer for the waste to arrive at the disposal facility, and, therefore, the turnaround time to receive the recycling receipt could be several months, potentially leading to issues if local authorities conduct an inspection before the receipt arrives.
In short, all dentists should do their due diligence when picking an amalgam separator company/amalgam recycler to decrease liability. The waste generated is ultimately the responsibility of the dental provider, who will be accountable should the waste be improperly disposed of or recycled.
About the Author
Jack Dillenberg, DDS, MPH
Dean Emeritus, Arizona School of Dentistry & Oral Health, A.T. Still University, Mesa, Arizona; The ATSU Center for the Future of the Health Professions
1. Three companies indicted for illegally transporting hazardous material. Office of Inspector General, US Dept of Transportation. July 18, 2018. https://www.oig.dot.gov/library-item/36649. Accessed January 31, 2020.
2. Effluent Limitations Guidelines and Standards for the Dental Category. Environmental Protection Agency. Federal Register. June 14, 2017. https://www.federalregister.gov/documents/2017/06/14/2017-12338/effluent-limitations-guidelines-and-standards-for-the-dental-category 1. Accessed January 31, 2020.
3. 40 CFR 262.83 - Exports of hazardous waste. Legal Information Institute, Cornell Law School. https://www.law.cornell.edu/cfr/text/40/262.83#f 1. Accessed January 31, 2020.