ADA, CDA ask for changes in amalgam separator rule

The ADA and CDA are advocating for the U.S. Environmental Protection Agency (EPA) to revise its proposed rule, which, if adopted, would call for most dentists to install, operate and maintain amalgam separators.

Currently, the use of amalgam separators for disposal of amalgam waste is voluntary for dental practices. Under the EPA’s proposed rule, which aims to decrease discharges of dental amalgam to the environment under the Clean Water Act, dental practices must cut their dental amalgam discharges using amalgam separators and implement “Best Management Practices.”

While the proposed rule incorporates many of the important principles required by the ADA for its support of a national standard, neither ADA nor CDA support it in its current form. Each organization submitted comments with their concerns in separate letters to the EPA in February. CDA supported all of the concerns raised by the ADA and highlighted its particular concern with the financial and administrative burdens that would potentially impact local sanitation districts, dentists and, ultimately, consumers, if the proposed rule were finalized in its current form.

The cover letter of the ADA's statement breaks down the five aspects of the rule that are problematic.

  • The implementation of the rule would impose undue and unnecessary burdens on dentists and the municipalities that operate publicly owned treatment works (POTWs). The ADA and the National Association of Clean Water Agencies have repeatedly pointed out in prior comments to the EPA and the Office of Management and Budget that the amalgam pre-treatment rule should not impose an undue burden. The ADA believes such burdens result in little or no incremental benefit.
  • The proposed rule is inconsistent with several aspects of the ISO Standard 11143. For example, the proposed rule would require installation of amalgam separators that comply with ISO Standard 11143. However, the proposal also requires separators to meet a 99 percent removal efficiency requirement, rendering the reference to the ISO standard either meaningless or confusing because the ISO standard requires an amalgam removal efficiency of only 95 percent.
  • The EPA’s choice of a new 99 percent removal efficiency requirement is particularly troubling to the ADA because it is inconsistent with prior EPA statements.
  • The incremental amalgam (and therefore mercury) captured by a separator with a purported amalgam removal efficiency of 99 percent is de minimis compared to the amount of amalgam removed by a separator with a 95 percent removal efficiency.
  • The EPA’s calculated cost-effectiveness for the proposed dental amalgam separator standard is flawed and grossly overstates the proposal’s cost-effectiveness.

CDA’s letter to the EPA echoed the ADA’s concerns with the proposed rule.

“CDA supports the concerns expressed by the American Dental Association related to the technical inconsistencies with ISO Standard 11143 and the flawed cost-effectiveness estimates outlined in the proposed rule,” the letter states. “CDA encourages the EPA to withdraw the proposed rule and allow POTWs, state and regions develop their own guidelines to use when developing and enforcing dental amalgam programs which will allow for the appropriate response based on each local jurisdiction’s needs.”

To provide dentists guidance when it comes to amalgam, CDA Practice Support offers the Dental Amalgam: Public Health and the Environment and Amalgam Waste Best Management Practices resources on cda.org.

CDA will continue to keep members informed on the status of the EPA’s proposed amalgam separator rule in the Update and on cda.org.