1. CHAPTER 20 Safety and Environmental Responsibilities in Dental Radiography

2. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson OBJECTIVES  Define the key words.  Identify agencies responsible for regulations regarding safe handling of hazardous radiographic products.  Use MSDSs to identify proper handling and disposal of chemicals and materials associated with radiographic procedures.  List the requirements of the OSHA Hazard Communication Standard.

3. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson OBJECTIVES Identify radiographic wastes that are considered hazardous to personnel and harmful to the environment. Advocate the need for safe handling and proper disposal of radiographic chemicals and materials. Demonstrate effective use of an eyewash station.

4. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson INTRODUCTION Competence in dental radiation safety results from a thorough understanding of the appropriate uses and the potential effects of x-radiation. It is equally important that oral health care professionals understand the properties and actions of the chemicals and materials that are used in the production of dental radiographs.

5. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson INTRODUCTION Although the individual oral health care practice generates a small amount of these hazardous wastes, collectively the potential exists for a significant impact on the environment. A heightened awareness of the impact of these wastes on our environment is changing the way we manage their disposal.

6. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson REQUIREMENTS FOR SAFETY AND ENVIRONMENTAL HEALTH Two agencies are responsible for recommendations and regulations regarding safe handling of chemicals and other potentially harmful materials and for the management of hazardous wastes used: Occupational Safety and Health Administration (OHSA) U.S. Environmental Protection Agency (EPA)

7. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson REQUIREMENTS FOR SAFETY AND ENVIRONMENTAL HEALTH OSHA requires that manufacturers of chemical products supply Material Safety Data Sheets (MSDSs) to oral health care practices that purchase these products: Chemical ingredients and common name Potential hazards of working with the product An explanation of the product’s stability and reactivity Requirements for safe handling and storage

8. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson FIGURE 20-1 SAMPLE MSDS. (COURTESY OF AIR TECHNIQUES, INC.)

9. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson FIGURE 20-1 (CONTINUED) SAMPLE MSDS. (COURTESY OF AIR TECHNIQUES, INC.)

10. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson FIGURE 20-2 SAMPLE LABEL THAT MEETS OSHA HAZARD COMMUNICATION STANDARD. (COURTESY CARESTREAM HEALTH.)

11. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson BOX 20-1 REQUIREMENTS OF OSHA HAZARD COMMUNICATION STANDARD

12. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson SAFE HANDLING OF RADIOGRAPHIC CHEMICALS AND MATERIALS Fixer Developer Disinfectants Cleaners used on processing equipment Lead

13. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson OF HAZARDOUS CHEMICALS

14. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson FIGURE 20-3 EYEWASH STATION. RADIOGRAPHER PREPARING TO USE THE EYEWASH STATION IN RESPONSE TO ACCIDENTAL CONTACT WITH A POTENTIALLY HAZARDOUS CHEMICAL. NOTE THE RECOGNIZABLE LABEL ON THE WALL NOTING THE LOCATION OF THE EYEWASH STATION.

15. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson PROCEDURE 20-1 USE OF AN EMERGENCY EYEWASH STATION

16. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson BOX 20-2 GENERAL RECOMMENDATION S FOR SAFE HANDLING OF HAZARDOUS CHEMICALS

17. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson FIGURE 20-4 BARRIER PLACED TO SEPARATE THE DEVELOPER AND FIXER TANKS WHEN ADDING CHEMICALS.

18. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson FIGURE 20-5 PPE USED WHEN CLEANING PROCESSING EQUIPMENT.

19. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson FIGURE 20-6 OLD LEAD-LINED STORAGE BOX SHOWING SIGNS OF FLAKING.

20. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson MANAGEMENT OF RADIOGRAPHIC WASTES Disposal of hazardous wastes generated by the oral health care practice is often mandated by federal law. The radiographer must know what laws apply in the practice area. Equally important is the ethical responsibility to recycle or properly dispose of wastes that may be harmful to the environment.

21. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson MANAGEMENT OF RADIOGRAPHIC WASTES Some of the options for proper management of radiographic wastes are: Contract with a waste management company to provide container and pick-up service. Contract with a lead or silver reclaiming company for recycling. Establish an agreement with the supplier to “take back” used fixer/unused radiographic film.

22. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson MANAGEMENT OF RADIOGRAPHIC WASTES Collect the used product and transport it to a designated drop-off center in your community. Use silver recovery or reclaiming system (for used fixer).

23. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson MANAGEMENT OF RADIOGRAPHIC WASTES Used fixer waste Lead waste Discarded radiographs waste Digital imaging equipment

24. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson BOX 20-3 QUESTIONS TO ASK OF A WASTE MANAGEMENT SERVICE

25. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson FIGURE 20-7 SILVER RECLAIMING UNIT. ATTACHED TO THE DRAIN TUBE OF THE AUTOMATIC PROCESSOR. NOTE THE APPROPRIATELY LABELED BOTTLES OF DEVELOPER AND FIXER ATTACHED TO THE UNIT FOR AUTOMATIC CHEMICAL REPLENISHMENT.

26. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson FIGURE 20-8 LEAD FOIL WASTE. COLLECTING LEAD FOIL FROM FILM PACKETS FOR PROPER DISPOSAL BY A LICENSED WASTE MANAGEMENT CONTRACTOR.

27. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson TABLE 20-1 OPTIONS FOR DISPOSAL OF RADIOGRAPHIC WASTE PRODUCTS

28. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson FIGURE 20-9 CLEANING SHEET. RUN DAILY OR MORE OFTEN, THE CLEANING SHEET CAN PICK UP DEBRIS FROM THE ROLLERS MAINTAINING THE PROCESSOR FOR LONGER INTERVALS BETWEEN CLEANINGS WITH A STRONG CHEMICAL.

29. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson REVIEW: CHAPTER SUMMARY Many of the chemicals and materials used in the radiographic process are considered hazardous and require a working knowledge of safe handling and proper disposal.

30. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson REVIEW: CHAPTER SUMMARY Two agencies responsible for regulations that help to protect and inform the radiographer are the Occupational Health and Safety Administration (OHSA) and the Environmental Protection Agnecy (EPA).

31. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson REVIEW: CHAPTER SUMMARY Safe handling instructions for hazardous chemicals can be found on the MSDSs. Oral health care practices have a legal and ethical responsibility to the environment to properly dispose of hazardous radiographic chemicals and materials.

32. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson REVIEW: CHAPTER SUMMARY Although the shift to digital imaging will eventually eliminate most of the hazardous chemicals and materials associated with film-based radiography, electronic equipment will require the development of safe disposal protocols as well.

33. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson RECALL: STUDY QUESTIONS General Chapter Review

34. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson REFLECT: CASE STUDY Oral health care practices have a legal and an ethical responsibility to the environment to properly dispose of hazardous radiographic chemicals and materials. However, today the focus has shifted from proper disposal and recycling to prerecycling, or reducing the amount of waste generated in the first place.

35. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson REFLECT: CASE STUDY Make a list of all the materials and resources you can think of that are used in the radiographic process. Include the plastic barriers used to cover equipment, the types of image receptor holders available for use, the wash water that circulates when the automatic processor is running, etc.

36. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson REFLECT: CASE STUDY Then using the technique of brainstorming, list ways to reduce the generation of waste and to conserve resources. For example: (1) eliminate the use of image receptors made from polystyrene, Styrofoam™, and (2) purchase film from a “green” company who has demonstrated environmentally sound operations in manufacturing their product.

37. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson REFLECT: CASE STUDY Combine your ideas with your classmates and consider sharing the list in a presentation at the next meeting of your professional association.

38. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson RELATE: LABORATORY APPLICATION Proceed to Chapter 20, Laboratory Application, to complete this activity.