1. Amalgam Rules Development & Implementation in New Hampshire
2005 Northeast Environmental Summit
September 28, 2005
Paul Lockwood (603)

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

3. NH Mercury Reduction Strategy
(Reports & Documents)

4. 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.

5. 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

6. 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

7. 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

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

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

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

11. 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

12. 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)

13. 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.

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

15. 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