Amalgam Rules Development & Implementation in New Hampshire 2005 Northeast Environmental Summit September 28, 2005 Paul Lockwood (603) 271-2956 plockwood@des.state.nh.us

Amalgam Rules Development & Implementation in New Hampshire Background: NH Mercury reduction efforts House Bill 1251 & Rules adoption process Rules implementation and status

NH Mercury Reduction Strategy www.des.state.nh.us (Reports & Documents)

NH Mercury Reduction Strategy 4.7.1 Recommended Actions Regarding Dental Amalgam R-27 Conduct 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. R-28 Draft legislation…with an effective date of July 1, 2003 to prohibit the use of mercury-containing amalgam.

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 HB 1251 – “An Act relative to the use of mercury amalgam fillings by dentists.” Problems and Issues: Environmental or Public Health issue? Insurance issues Credibility of support data NH Dental Society support

NH Mercury Reduction Strategy 2002 Legislation HB 1251 – “An Act relative to the use of mercury amalgam fillings by dentists.” Final outcome: DES to draft rules relative to amalgam disposal DHHS to create pamphlet for dentists to provide to patients

Amalgam Management Rules Development In New Hampshire Stakeholder workgroup met in summer, 2002 Key issue = Enforcement Discharge limit? or Performance standard?

Amalgam Management Rules Development In New Hampshire Performance Standard = Amalgam Separator Level of performance required? “Home built” technologies? Particulate and soluble Hg? Self-certification procedures? Waivers and exemptions? Issues:

Amalgam Rules Implementation In New Hampshire Env-Ws 905 STANDARDS FOR MANAGEMENT OF MERCURY-CONTAINING AMALGAM Requires written self-certification from “owner of the practice”: installation of ISO 11143-certified amalgam separator or practitioner is exempt or requesting waiver

Amalgam Rules Implementation In 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 Implementation In 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 Implementation In 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 Implementation In New Hampshire Early issues & problems: Mobile units & schools Semi-retired or not in state “Amalgam-free” practitioners Endodontists

Amalgam Rules Implementation In 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