Dieuwertje Kuin

1
Dental waste management in the Netherlands

• Dieuwertje Kuin
• Florien Stoel

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ACTA

• Faculty in Amsterdam, the Netherlands
• 800 students
• 1200 employees
• Patients are treated within the faculty
• -medical waste
• -non- medical waste
• Concerning waste, ACTA is a hospital

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Hospital waste

• Hospital specific waste
• Hospital non-specific waste

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Contaminated hospital wastedentistry related

• Human anatomical waste and parts of organs which
  come free at operative procedures, scientific
  research and education
• Waste from clinical and microbiological
  laboratory that has been infected by bacteria,
  viruses or moulds
• Sharp instruments, like injection needles, cuts
  of capillaries, scalpels, broken instruments and
  blood tubes

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Hospital wasteprocessing

• Collected in dental depots
• Hermetically sealed
• Saved separately
• Pre-cultivation
• Only bacterial, virus and mould contaminated
  waste can be pre-cultivated by the hospital
  because of reduction of contamination
• Other waste cannot be pre-cultivated

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Other hospital waste

• Waste different from hospital waste
• -Office- and canteen waste
• -non-specific hospital waste like with blood
  polluted bandages
• -gauze
• -plasters
• -tubes
• -teeth
• Mercury containing waste
• -amalgam
• Photographic waste
• -developer and fixative

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Waste different from hospital waste

• HDO-waste (business, cervices and government
  waste)
• Environmentally harmful waste

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Mercury containing waste

• 1st and 2nd stage of filtering (filters 95 of
  the mercury)
• Grove and fine filter in the dental units
• 3th stage of filtering (filters out 2 to 3
  more.)
• Machine with a very fine filter
• After filtering, the water has been stored (with
  chloride) and collected and brought to a waste
  processing company
• The rest goes to the drain

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Mercury containing waste

• Mercury waste from hospitals (ACTA)?
• 1st, 2nd and 3th stage of filtering
• Mercury waste from other dental practices ?
• Only 1st and 2nd stage of filtering

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Photographic waste developer en fixative

• Collected in separate boxes
• Then Collected by a company which transports the
  waste to a waste processing company
• ACTA uses digital radiography ? no environmental
  harmful waste

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Waste streams

• Hospital specific waste
• Waste different from hospital waste
• Environmentally harmful waste
• Mercury containing waste
• Photographic waste

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Laws and Controls for draining of amalgam

• legislation for draining of wastes in the drain
  hole and surface water is are established in the
  WVO (law pollution surface water),
• Control and exact rules are being prosecuted/made
  up by regional corporations
• Waternetwork, for region Amsterdam

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Laws and inspection for draining of amalgam

• Within ACTA
• An independent company is hired by ACTA to
  determine the composition of the water which is
  collected for draining in the drain hole
• Waternetwork controls the reports of the test
  lab, whether a standard is being exceeded.

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Dental Practise

• Waste licence
• Starting
• Running
• Changing
• Map of your practise
• Composition of water in company sewer
• Equipment in which the water flows before it
  enters the public sewers.
• Copy of the test certificate of the amalgam
  separator used

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Dental Practise

• Ground protection
• No leakage
• Save no more chemicals then used
• Outsiders no access to waste
• Amalgam separator
• Test certificate
• Amount of separation established by minister
• Clearing min. once a year

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Dental Practise

• Other waste
• The saving of waste mustnt lead to inconvenience
  in smell or mustnt leak into the ground.
• Medical waste is being save separately and is
  being discharged in a environmentally responsible
  way.

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Comments

• Teeth with amalgam fillings
• Radiographic materials