# FOR 

# DENTAL OFFICES 

# Amalgam Management

# Acknowledgements

The Milwaukee Metropolitan Sewerage District and the University of Wisconsin Extension thank:
(1) all of the dentists who installed separators for the case studies, (2 the Wisconsin Dental Association, and (3) the U.S. Environmental Protection Agency, Great Lakes National Program Office, for providing financial assistance f

or the production of this booklet.

### The Wisconsin Dental Association (WDA) has worked cooperatively with the Wisconsin Department of Natural Resources, the UW-Extension and the Milwaukee Metropolitan Sewerage District (MMSD) in an effort to utilize federal grant monies to develop information that will be helpful for practicing dentists who must make important purchasing decisions in light of the recent trend of local sewerage districts throughout the state to enact amalgam separator mandates on dental practices.

To this end, the WDA worked with these governmental entities to accomplish the following:

• Developed amalgam best management practices and encouraged

dentists across the state to implement them;

• Hosted workshops and conference seminars highlighting the importance

of comprehensive amalgam management; and

• Developed a summary of the different types of separators that have already been

installed in the dental offices of some Milwaukee-area dental offices (Milwaukee, as you’ll recall, was the first large sewerage district to require amalgam separators)

. We hope that this summary will give you a sense of our pioneering dentists’ experiences prior to purchasing and installing separators in your own practice. We applaud the leadership of those dentists who volunteered to be the first in the MMSD area to install separators. WDA would like to recognize their willingness to enter unc harted territories and absorb the costs and challenges of being the first to install separators without receiving any financial incentives to do so. Those efforts will continue to benefit their fellow dentists throughout the entire state.

WDA stands firm in our belief that dental waste accounts for less than 1% of the mercury contamination problem that plagues our lakes and streams. However, it is dentistry’s desire to be responsible environmental stewards and to do our part in capturing potential wastes before they enter Wisconsin’s waterways. Hopefully, the coal burning power plants and the contributors of the other 99% of the problem will rise to the occasion and take ownership of their responsibilities in a similar fashion.

Sincerely,

Constantine Stamatelakys, DDS President 

# Dear Wisconsin Dentists:

### The dental profession has always emphasized preventive care. Now, this spirit of prevention needs to extend to preventing the release of amalgam to the environment.

At dental offices, vacuum systems discharge amalgam to the sewerage system when dentists place or remove amalgam fillings. Amalgam is typically 50% mercury, by weight. Mercury pollution has caused the Wisconsin Department of Natural Resources to issue a statewide fish consumption advisory. To address mercury in wastewater, the DNR requires sewage treatment facilities, such as the Milwaukee Metropolitan Sewerage District, to implement a mercury minimization program. A primary element of this program is reducing the amount of amalgam discharged by dental offices.

Amalgam is an efficient and effective restorative material. Dentists will continue to use it in the foreseeable future, although its use continues to gradually decline. Even if dentists completely stopped using amalgam for new fillings, the removal of old amalgam will continue to generate amalgam waste. In response to the environmental issues related to mercury, the Wisconsin Dental Association has identified best management practices for amalgam. While important, best management practices alone are not sufficient to minimize discharges. Amalgam separators are available from several suppliers and are able to decrease amalgam in wastewater by 95% or more. In January 2004, the District adopted rules requiring the implementation of best management practices and, by February 1, 2008, the installation of amalgam separators.

T he pur pose of this booklet is to inform dental offices regarding best management practices and amalg am se parators. This booklet contains: 

# Introduction

A. Best Management Practices for Amalgam
B

. Choosing an Amalg am Se par ator for Your Dental Office C. Amalgam Separator Case Studies 1. Doctors William and Nicholas Stathas 2. Nor thr idg e Dental Center 3. East Towne Dental Associates 4. Doctor s T homas E. Raimann and Ric har d A. Mueller 5. Doctor Chan D

. Tran 6. Burleigh Dental
7. Doctor J ames Del Balso 8. Doctor James C. Morgenroth 9. Doctor Rober t G

. Saur 10. Do wntown Dental Group D. Section 11.214, MMSD Rules, Amalg am Mana g ement at Dental Of f ices.

# DO

Use precapsulated alloys and stock a variety of capsule sizes

Recycle used amalgam capsules

Salvage, store, and recycle non-contact amalgam (scrap amalgam)

Salv a g e amalg am pieces fr om r estorations after

r emo v al (contact amalg am) and recycle the amalgam
waste
Use chair-side traps to retain amalgam and recycle their contents

Recycle the contents retained by the vacuum pump filter or other amalgam collection device

Recycle extracted teeth that contain amalg am restorations*

Use disinfectants and line cleaners containing enzymes, phenols, or quaternary ammonium compounds, since the y tend not to mobiliz e mer cury from amalgam.

RECYCLE AS MUCH AMALGAM WASTE AS POSSIBLE 

# DO NOT

Use bulk mercury

Put amalgam capsules in biohazard containers, infectious waste containers (red bags) or regular garbage

Put non-contact amalgam in biohazard containers, infectious waste containers (red bags) or regular garbage

Put contact amalg am in biohazar d container s, inf ec

tious w aste container s (r ed ba gs) or regular garbage

Rinse chair-side traps containing amalgam over sinks or other drains

Rinse vacuum pump filters or other amalgam collection device over sinks or other drains

Put extracted teeth with amalgam restorations in biohazar d containers, infectious waste containers (red bags) or regular garbage

Use line cleaners that contain bleach or other chlorine compounds

FLUSH AMALGAM W ASTE DOWN A SINK, T OILET, OR OTHER DRAIN 

# Best Management Practices for Amalgam

*Confirm with your recycler whether it accepts extracted teeth. Disinfect extracted teeth by storing them in an airtight container with a solution of glutar aldeh yde or 10% f ormalin until the y ar e r emoved for recycling with your other amalgam waste.
References: (1) Wisconsin Dental Association, Recycling Amalgam Waste and Other Best Management Practices for your Dental Office,

www .wda.org/member_benefits/amalgam.htm. (2) American Dental Association, Best Management Practices for Amalgam Waste, March 2004; www.ada.org/prof/resources/topics/topics_amalgamwaste.pdf

# Amalgam Capsules 1. Stock amalgam capsules in a variety of sizes 2. After mixing amalgam, place the empty capsules in a wide-mouthed, airtight, plastic container that is labeled 

### Amalgam Capsule Waste for Rec ycling * 3. Place any non-empty capsules into this container 4. Ensure that the container is tightly sealed at all times 5. When the container is full, send it to a recycler 

# Non-contact (scrap) Amalgam1. Place non-contact (scrap) amalgam into a widemouthed, airtight, plastic container that is labeled 

### Non-contact Amalgam Waste for Recycling * 2. Ensure that the container is tightly sealed at all times 3. When the container is full, send it to a recycler 

# Disposa b le Chair -Side T raps 1. Remo v e the tr ap and place it into a wide-mouthed, airtight, plastic container labeled 

### Contact Amalgam Waste for Recycling * 2. Ensure that the container is tightly sealed at all times 3. When the container is full, send it to a recycler 4. If a c hair is strictly dedicated to hygiene, then place the tr ap into the regular garbage 

# Reusable Chair-Side Traps1. Remove the trap and empty the contents into a widemouthed, airtight, plastic container labeled 

### Contact Amalgam Waste for Recycling * 2. Ensure that the container is tightly sealed at all times 3. When the container is full, send it to a recycler 4. Do NOT rinse the trap under running water 

# Vacuum Pump Filters 1. Obtain instructions and schedule for filter

r e placement fr om the manufacturer 2. Change the filter according to the recommended schedule 3. Obtain instructions for handling the used filter from your recycler 4. If you are required to decant water from the filter before recycling, pour the water into a tray or other container that can catch any spills and pour very carefully to avoid losing any amalgam. 

# Line Cleaners Use disinfectants and line cleaners containing enzymes, phenols, or quaternary ammonium compounds, since the y tend not to mobiliz e mer cury from amalgam. 

# DisinfectionDisinfecting amalgam waste for recycling is unnecessary, except for extracted teeth that contain amalgam

r estorations. For disinfection, use glutaraldehyde or 10% f ormalin, rather than bleach. Bleach dissolves amalg am and releases mercury. Use bleach only if y our recycler accepts the disinfectant solution along with the amalg am waste. 

# Best Management Practices for Amalgam Waste
Always wear safety glasses, a mask, and gloves when handling amalgam

* Some r ecyclers allow you to place all amalgam waste, including

capsules, non-contact amalgam, contact amalgam, traps, filters, and teeth into the same container. If so, you may use one container la beled Amalg am W aste f or Rec yc ling. F ollo w y our r ec yc ler’s instructions f or pac kaging and shipping amalgam waste. Ref er ence: (1) Wisconsin Dental Association, Recycling Amalgam Waste and Other Best Management Practices for your Dental Office, www.wda.org/member_benefits/amalgam.htm. (2) American Dental Association, Best Management Practices for Amalgam Waste, March 2004;
www .ada.org/pr of/resources/topics/topics_amalgamwaste.pdf

# Choosing an Amalgam Separator for Your Dental Office

More and more dentists are considering purchasing amalgam separator units to decrease the amount of amalgam in the wastewater leaving their offices.Although this decision is a positive one for the environment, it is not necessarily an easy one for the dentist. These units differ in terms of capacity, physical dimensions, amalgam removal process, how captured amalgam is removed and recycled, how easily they are
serviced and how often, and how much they cost to buy and operate. Without some guidance, evaluating amalgam separators can be like comparing apples and oranges. This guide was designed to help dentists identify their specific needs and the key aspects of their of f ice systems that determine which separator unit(s) will be most suitab le f or their oper ations.

Ste p 1 of this guide is a decision f lo w sheet. By answering a series of questions relating to your office set-up, the dentist is led to an initial list of separator units that will probably work for his or her office. These questions include: • Are your amalgam generating chairs centrally plumbed?

• Does y our of f ice have a wet ring or dry vacuum pump system? • Is the space available for installing a separator unit at office grade or below grade? • Do you need to install the separator ahead of or after either the wet ring or dry vacuum pump system? 

### The dentist’s answer to each of these questions will lead him or her to an appropriate set of potential separators for evaluation. The evaluation of these options is conducted in Ste p 2 Decision Matrix.

Ste p 2 of the guide is a ma trix tha t allo ws a comparison of the initial list of separator units generated in Step 1, helping the dentist zero in on which unit(s) is the best for his or her dental practice. The matrix provides both qualitative and quantitative comparisons of 15 differentamalgam separator units produced by 11 different companies. The units have been commercially available since early 2004. It also provides telephone and web site contact information for each manufacturer.



### The evaluation criteria include: Model Dimensions —shows the height, width and depth, indicating how much space each unit requires. 

### Flo w Capacity —indicates the number of chairs (anyw here from 1 to 25) that can be serviced by one unit. 

### Ease of Maintenance —a ranking of 1 to 3 shows the relative ease of maintenance compared to other units. 

### Frequency of Maintenance —a ranking of 1 to 3, along with more specific information where available, indicates how often amalgam waste must be removed from the unit. 

### Recycling Program Included? —indicates whether the manufacturer provides for an automatic system for removing and recycling the waste amalgam captured in the unit. 

### Purchase Cost —provides both actual cost and a relative (1 to 3) ranking among units. 

### O&M Cost—pr o vides a relative ranking of operation and maintenance costs as w ell as specif ic information

w here available. 

### F i v e-Y ear System Cost—pr o vides both an estimated f i v e-y ear cost (purchase plus O&M costs) and a relative

r anking among units. 

### After w orking through the flow sheet (Step 1) and the matrix (Ste p 2), the dentist should have a good idea about which unit(s) is most suitable for his or her specific circumstances. Hopefully, this ex ercise will also r esult in a list of more specific questionsfor your dental equipment supplier or the separator manufacturer. Working together with your supplier or manufacturer’s

re p, y ou should no w be suf f icientl y prepared to purchase an amalgam separator unit that will meet your needs and protect the environment for
many years to come. 425.SB.0404

# Step 1 - Amalgam Separator Selection Flow Sheet

Installation Factor

B elow Grade H____ W___ L_____ Total: ___sq. in (H x W x L) Y es Amalgam-Generating Chairs Centrally Plumbed?

Potentially Suitable Systems (go to Step 2) Separator Location RE: Vacuum System 3 Available Installation Space 2 T ype of Vacuum System 1

After air-water separator At Office Grade (cabinet/closet) H____ W___ L

____ Total: ___sq. in (H x W x L) D ry Vacuum Pump System? N o

(Check to determine systems on local approved equip. lists) Inline, ahead of
vacuum pump Inline, ahead of
vacuum pump After air-water separator Inline, ahead of
vacuum pump B elow Grade H____ W___ L_____ Total: ___sq. in (H x W x L) Consider Replumbing, OR I nstall individual chairside units (on unit/chair)

1 Dr y Systems using simple filtration units (e.g. ASDEX unit) may clog more easily; wet systems using smaller sedimentation devices (e.g. CH 9-12) may fill quickly , lose separa

tor capacity

. Wet ring vacuum pump systems generate additional wastewater that may affect performance of smaller capacity units (see capacity ratings in Step 2). 2 Space availability will dictate which systems may be used; offices without basement or within multistor y buildings typically require installation at office level/grade. 3 Systems installed after air/water separator must have 120V AC power and/or gravity flow available. Wet-Ring Vacuum Pump System?

After air-water separator After air-water separator Inline, ahead of
vacuum pump At Office Grade (cabinet/closet) H____ W___ L

____ Total: ___sq. in (H x W x L) ASDEX AS-9 Amalgam Collector CH9 or CH12

120 V AC Power Available? 120 V AC Power available?

Rasch 890- 1000 A/T A1010 Amalgam Collector CH12-24 Amalgam Boss DRNA BU 10 DRNA BU 30 ECO II MSS 1000/601 Rebec Catch 400/1000 Solmetex Hg5, Hg5 Mini Hg5 HV Rasch 890-1500 A/T A1010 Amalgam Collector CH12-24 Amalgam Boss DRNA BU 10 DRNA BU 30 ECO II MSS 1000/601 Rebec Catch 400/1000 Solmetex Hg5, Hg5 Mini Hg5 HV Rasch 890-1500 Rasch 890- 1000 A/T A1010 Amalgam Collector CH12-24 Amalgam Boss DRNA BU 10 DRNA BU 30 ECO II MSS 1000/601 Rebec Catch 400/1000 Solmetex Hg5, Hg5 Mini Hg5 HV Rasch 890-1500 Rasch 890- 6000 Rasch 890- 6000 A/T A1010 Amalgam Collector CH12-24 Amalgam Boss DRNA BU 10 DRNA BU 30 ECO II MSS 1000/601 Rebec Catch 400/1000 Solmetex Hg5, Hg5 Mini Hg5 HV Rasch 890-1500 120 V AC Power Available? 120 V AC Power available? No No No No Y es Y es Yes Y es No No Vacuum System? C onsult manufacturers of inline sedimentation systems 1Maximum Separation Systems 1 -800-799-7147 www.amalgamse

parators.com AB Dental Trends 1-360-354-4722 www.amalgamse p aration.com M.A.R.S. Biomed 1-866-594-3648
w

ww.marsbiomed.com Pure Water Systems 1-877-638-2797
w

ww.ecotwo.com Rebec 1-800-569-1088
w

ww.rebecsolutions.com

Model

Dimensions (WxLxH in inches)

Flow Capacity (# of Chairs)

Ease of Maintenance Frequency of Maintenance
Recycling Program Included? Purchase Cost: Affordable? O&M Cost: Affordable?

Estimated Five Year System Costs

Total MSS 1000 MSS 601 Rasch 890-1500 Rasch 890-1000 Amalgam Boss E CO II Catch 1000 C atch 400

24x15x

18.5 13x27x11 26x16x10 28x10.25x 12.75 24x12x12 14x9x9 23.5x20x8 14x8x18

2 1-11 chairs 2 1-6 chairs 3 1-12 chairs 2 1-6 chairs 2 1-6 chairs 2 1-8 chairs 2 1-4 chairs

2 2 22 2
2 3 Tank switch 18 months 2 Unit Switchout annually

(assuming 6 chairs) 1 Unit Exchanged annually 3 Annual replacement of containment collector 2 available 2 available 2 available 2 available 3
2 $1191 2 $1079 2 $695 1 $1190 (system) $796 (tank) 2 $695 3 $288 (inc. recycling) 1 $1895 1 $985 2 annual tank replacement 1 new tank required

18 mos @ $496 2 Annual unit switchout

(6 operatories) 1 M2 cleaner pouch needed 3/chair/year @ $74.70 2 Annual container replacement

2 $2591 +

labor 2 $2535 +

labor 3 $1932+

labor 2 $2430 + labor 2 $3475+labor 2 $3393 + labor 2 $3475 + labor 2 $2565 + labor

A/T Amalgam SeparatorAir Techniques 1-800-AIRTECH www.airtechniques.com The Amalgam Collector R&D Ser vices 1-800-816-4995 www.theamalgam

collector.com Asdex American Dental

Accessories 1-800-331-7993 DRNA 1-800-360-1001 www.drna.com SolmeteX 1-508-393-5115 www.solmetex.com

Model Dimensions (WxDxH in inches)

Flow Capacity (# of Chairs) Ease of Maintenance Frequency of Maintenance Recycling Program Included?
Purchase Cost: Affordable?

O&M Cost: Affordable?

Estimated Five Y ear System Costs

T otal A1010 6.25x10.5x7.5 CH9 or CH12 6x6x9 (12) CE18 or CE24 6x6x18 8x8x24 AS-9 11.5x3” diam BU10 8.5x8.5x20 Hg 5 Mini 8x11x21 Hg 5 8x14x29

2 1-8 chairs 1 1-2 chairs 3 6-12 chairs 1 1 chair 2 1-6 chairs 2 1-10 chairs 3 1-10 chairs 1 1 (manually decanted) 2 3 2 221 2 annually 2 annually 2 2 2 upon request 2 available 3 included 3 (service pack included) 1 $1500 includes 1 replacement box 2 $515 2 $785-$1,195 3 $199 2 $695 1 $750 2 $750
2 3 2 $79/filter switched

out quarterly 1 switched out annually $450 2 replace filter 2x/yr

2 $3750 + labor 3 $575 + labor 3 $715-1195

+ labor 3 $1700+ labor 2 $2495 +

labor 2 $2750 + labor 

# Step 2 - Amalgam Separator Decision Matrix Qualitative Ranking System

Note: Ranking System As Follow: 1=Fair 2=Good 3=Better (provided for illustrative purposes; individual weighting of criteria can be adjusted by user) Information current as of 6/30/06; users are encouraged to contact manufacturers to obtain up-to-date pricing, option, and reference list of dentists operating specific systems. BU30 13x13x25

3 1-12 chairs 2

1 $1395

1 switched out annually $650 1 $3895 +

labor Hg 5 HV 18x22x28

2 1-20 chairs

1 $2500

1 $5000 Rasch 890-6000 5.5x9x 12.5

2 $666

1 new tank

2 $2150 +

labor

1 replace 2 filters 2x/yr

# Amalgam Separator Case Studies
1 Office of Doctors William and Nicholas Stathas 2300 North Mayfair Road Suite 345 Wauwatosa, Wisconsin 53226 414-456-9020 (voice) 414-456-9021 (fax)
Practice type: General Office size: 3 Operatories, 1 hygiene only Building type: High rise V

acuum system type: W et Vacuum system location: Utility closet Source of supplies: Patterson 

# Amalgam Separator Manufacturer: Solmetex Model: Hg5 Purchase price: $695 Power required: No Treatment chemicals required: No Siz e: 30 inc hes tall, 14 inc hes wide, 10 inches deep Primary reason for selecting model: Ease of installation 

# Se par ator Installation

Time between ordering and delivery: 2 weeks Plumbing contr actor: Pr otel Installation date: June 3, 2003 Time needed: 1 hour Installation cost: $250 Problems encountered during installation: None 

# Amalgam Recycler Mercury Waste Solutions 

# Exper ience Rating (scale of 1-5, with 5 being the highest)

Maintenance F r equenc y 5 Clogging Problems 5 Vacuum Issues 5 Reliability 5 Ov er all P erf ormance 5 Ease of Recycling 5



# Other Comments

Gr ea t unit, lo w maintenance

. Replace every 6 months. 

# 2 Northridge Dental Center Doctors John A. Fitch, Eric P. Tesch, and Dale R. Roznik Dick Quinlan, Office Manager 7906 North 76th Street Milwaukee, Wisconsin 53223 414-354-9020 (voice) 414-354-4420 (fax) dentalq@msn.com Practice type: General Office size: 7 Operatories, 4 hygiene only Building type: T wo tenant commercial building Vacuum system type: Wet, dual pump Vacuum system location: Utility room Source of supplies: Sullivan-Schein 

# Amalgam Separator Manufacturer: Solmetex Model: Hg5 Pur c hase pr ice: $649 Power required: No T

r eatment c hemicals required: No Siz e: 26 inches tall, 10 inches wide, 8 inches deep Pr imary reason for selecting model: Ease of installation,ease of filter replacement, adaptable to dual pump vacuum system Warranty: 2 years 

# Separator Installation

Time between ordering and delivery: 6 days Plumbing contractor: Protel Installation date: January 30, 2004 Time needed: 2.5 hours Installation cost: $368 Problems during installation: Connecting the separator to the dual vacuum pumps required re-routing of the vacuum lines and w ater hoses 

# Amalg am Rec yc ler Mercury Waste Solutions 

# Experience Rating (scale of 1-5, with 5 being the highest)
Maintenance Frequency 3 Clogging Problems 5 V

acuum Issues 5 Reliability 5 Overall Performance 5 Ease of Recycling 5



# Other Comments

Fills up too quickly. Before

After
Note: Case Studies were updated in 2006 and include experience evaluations For Solmetex separators, recycling cost, including freight, are included in the cost of new filters. With the purchase of a new filter, Solmetex provides pr e-ad dr essed , fr eight-paid container s for the old filter. Replacement filters are $250.Before

After 

# 3 East Towne Dental Associates

Doctors Vali Kiaie, Jerome Gildner, and Jenny Barry 11501 North Port Washington Road M equon, Wisconsin 53092 262-241-8880 (voice) 262-241-5250 (fax) 

### Practice type : General 

### Office size: 8 Operatories, 3 hygiene only 

### Building type: Multi-tenant professional 

### Vacuum system type: Dry 

### Vacuum system location: Basement 

### Source of supplies: Sullivan-Shein 

# Amalgam Separator Manufacturer: Air Techniques Model: A/T A1047 Purchase price: $1,500 Power required: No Treatment chemicals required: No Size: 6 inches x 12 inches x 8 inchesPrimary reason for selecting model: Small size, fits available space and compatibility with existing equipment Warranty: 1 year 

# Separator Installation

Time between ordering and delivery: 3 weeks Installation date: J an uary 14, 2004 Time needed: 1 hour Installation cost: $200 Pr ob lems encountered during installation: None 

# Amalgam Recycler Bethlehem A ppar atus Company 

# Exper ience Rating (scale of 1-5, with 5 being the highest)
Maintenance Frequency 3 Clogging Problems 5 Vacuum Issues 5 Reliability 5 Overall Performance 5 Ease of Rec yc ling 5



# Other Comments

Once the separator was full, the unit shut down without
an

y decr ease in suction or w arning - unit could be lar g er for our operation.

The cost of shipping and recycling the first collection container is inc luded in the pur c hase price. Air Techniques provides shipping containers with replacement collection containers. 

# 4 Office of Doctors Thomas E. Raimann and Richard A. Mueller 11801 West Janesville Road Hales Corners, Wisconsin 53130 414-425-1510 (voice) 414-425-7810 (fax) 

### Practice type: G eneral 

### Office size: 5 Operatories, 2 hygiene only 

### Building type: Multi-tenant commercial building 

### Vacuum system type: Wet 

### Vacuum system location: Basement 

### Source of supplies: Patterson or Holt 

# Amalgam Separator Manufacturer: Solmetex Model: Hg5 Purchase price: $695 Power required: No Treatment chemicals required: No Size: 30 inches tall, 14 inches wide, 10 inches deep Primary reason for selecting model: Ease of installation, Low cost Warranty: Two years 

# Separator Installation

Time between ordering and delivery: 1 week Plumbing contractor: JM Plumbing Installation date: Mar c h 1, 2004 Time needed: 2 hours Installation cost: $289 Pr ob lems encountered during installation: None 

# Amalg am Rec yc ler Mercury Waste Solutions 

# Exper ience Rating (scale of 1-5, with 5 being the highest)
Maintenance Frequency 3 Clogging Problems 2 Vacuum Issues 4 Reliability 3 Overall Performance 4 Ease of Rec yc ling 4



# Other Comments

Switched to a larger unit which requires almost z er o maintence

. Recommends to separate hygiene from dental operations if possible.

Although the manufacturer expected the filter replacement frequency to be every 4 months, the first filter filled in only 1 month. The cause was

a ne w line c leaner that removed large amounts of residual solids. A subsequent problem was the constant filling of the upper chamber with water.Increasing the air flow through the separator eventually solved this problem. In r esponse to these prob lems, Solmetex agreed to supply a new "high

v olume" Hg5 at no cost for the device. This device was installed on July 26, 2004. To further reduce the risk of problems, the lines from the hygiene operatories were redirected around the amalgam separator. A total of three filters were shipped before the installation of the new separator.

# 5 Office of Chan D. Tran, DDS D octors Chan D. Tran and Loo T. Nguyen 2 387 South 102nd Street W

est Allis, Wisconsin 53227 414-329-1171 (voice) 414-329-1018 (fax) chantran@hotmail.com Practice type: General Office size: 5 Operatories, 2 hygiene only Building type: Multi-tenant professional building Vacuum system type: Dry Vacuum system location: Basement Source of supplies: Dental Health Products 

# Amalgam Separator Manufacturer: Solmetex Model: Hg5 Purchase price: $625 Power required: No Treatment chemicals required: No Size: 30 inches x 13 inches x 10 inches Primary reason for selecting model: Name recognition W

ar

r anty: 2 y ears 

# Separator Installation

Time betw een or der ing and deliv ery: 2 days Plumbing contractor: IHN Plumbing Installation date: A pril 9, 2004 Time needed: 3 hours Installation cost: $305 Problems during installation: None 

# Amalgam Recycler Solmetex 

# Experience Rating (scale of 1-5, with 5 being the highest)
Maintenance Frequency 3 Clogging Problems 5 Vacuum Issues 5 Reliability 4 Overall Performance 4 Ease of Recycling 3



# Other Comments

15-20 minutes spent on monthly maintenance. 

# 6 Burleigh Dental Doctors Monica Hebl and Mike Donohoo 7623 West Burleigh Street M ilwaukee, Wisconsin 53222 414-444-4334 (voice) 414-444-3222 (fax) hebldds@aol.com 

### Practice type: General 

### Office size: 6 Operatories, 0 hygiene only 

### Building type: Sole occupant 

### Vacuum system type: Wet 

### Vacuum system location: Basement 

### Source of supplies: Holt Dental 

# Amalgam Separator Manufacturer: R&D Services Model: The Amalgam Collector CE24 Purchase price: $1075 Power required: No Treatment chemicals required: 8 ounces of cold sterilizing solution once per week through suction line Size: 10 inches in diameter, 36 inches tall Primary reason for selecting model: Can see the amount of collected amalg am. Rec yc ling costs are reduced because only the collected waste is recycled, not a whole canister. Larg er size takes longer to fill. W

arranty: 1 year 

# Se par ator Installation

Time betw een ordering and delivery: 1 week Installer: Holt Dental Installation date: April 26, 2004 Time needed: 30 minutes Installation cost: $90 Pr oblems during installation: None 

# Amalgam Recycler DRN A 

# Exper ience Rating (scale of 1-5, with 5 being the highest)

Maintenance F r equency 5 Clogging Problems 5 Vacuum Issues 3 Reliability 5 Ov er all Performance 5 Ease of Recycling 1



# Other Comments

W

e ha v e to change the separator ourselves. Not a pleasant job, but saves money. Make sure there’s enough space and tha t r ecycling costs are reasonable.
The collected material is put into the same type of amalgam container

as is used f or other r ec yc led amalg am. Removing the amalgam involves

c losing v alv es, draining away the water, opening the unit, and then removing the collected waste. Although this effort is more than required by some other units, being able to see the amount of waste collected maximizes time between shipments and recycling just the waste, rather than a whole canister or cartridge, minimizes costs.
Before After

# 7 Del Balso Dental Doctor James Del Balso 2300 North Mayfair Road S uite 1040 Wauwatosa, Wisconsin 53226 414-774-4222 (voice) 414-774-5007 (fax) delbalsodental@delbalso.com www.delbalso.com 

### Practice type: General 

### Office size: 4 Operatories, 2 hygiene only 

### Building type: High rise 

### Vacuum system type: Wet 

### Vacuum system location: Utility closet 

### Source of supplies: Holt Dental 

# Amalgam Separator Manufacturer: Rebec Model: Catch 400 Purchase price: $985 Power required: No Treatment chemicals required: No Size: 14 inches by 8 inches by 8 inches Reasons f or selecting model: High quality construction, low maintenance, need to replace the collection container onl y once per y ear 

# Separator Installation

Time betw een or der ing and delivery: 5 days Plumbing contr actor: J&M Plumbing Installation date: April 27, 2004 Time needed: 40 minutes Installation cost: $108 Work included testing the cross connection control device Pr oblems encountered during installation: None 

# Amalgam Recycler

Re bec 

# Exper ience Rating (scale of 1-5, with 5 being the highest)

Maintenance F r equency 5 Clogging Problems 5 Vacuum Issues 5 Reliability 5 Ov er all Performance 5 Ease of Recycling 5



# Other Comments

T

otall y benign ef f

ect on oper ations. I spend 10 minutes per year on maintaince. Well built.

Rec ycling cost, including freight, is included in the cost of collectioncontainers. With the purchase of a new container, Rebec provides a pread dr essed , fr eight-paid container f or the old container

. Replacement container s ar e $385. 

# 8 James C. Morgenroth, D.D.S. 2500 North Mayfair Road Suite 345 W

auwatosa, Wisconsin 53226 414-257-2010 (voice) 414-257-2009 (fax) jmroth@execpc.com 

### Practice type: General 

### Office size: 3 operatories, 1 hygiene only 

### Building type: Professional building 

### Vacuum system type: Wet 

### Vacuum system location: Utility closet 

### Source of supplies: Holt Dental 

# Amalgam Separator Manufacturer: Metasys Pure Water Model: ECO II Purchase price: $650 Power required: No Treatment chemicals required: No Size: 8 inches by 8 inches by 13 inches Reasons for selecting model: Ease of installation, different from other models already installed by the case-study group 

# Separator Installation

Time between ordering and delivery: 1 week Plumbing contr actor: Holt Dental Installation date: June 1, 2004 Time needed: 45 min utes Installation cost: $140 Problems encountered during installation: None 

# Amalg am Rec yc ler

Pure Water Development 

# Experience Rating (scale of 1-5, with 5 being the highest)

Maintenance F r equenc y 5 Clogging Problems 5 Vacuum Issues 4 Reliability 5 Ov er all P erf ormance 4 Ease of Recycling 4



# Other Comments

5 min utes per month spent on maintenance

. Do y our r esearch on suitable units and don’t worry.

Rec yc ling cost, inc luding freight, is included in the cost of collection container s. With the purchase of a new container, a pre-addressed, freightpaid shipping box for the old container is provided. Replacement container s ar e $128. T he cost of r ec yc ling the f irst container was included in the pur c hase pr ice

.

Before After

# 9 Office of Robert G. Saur, D.D.S. D octors Robert G. Saur and Sam Binninger 1 2690 West North Avenue B rookfield, Wisconsin 53005 262-785-1499 (voice) 262-785-0282 (fax) 

### Practice type: General 

### Office size: 4 operatories, 2 hygiene only 

### Building type: M ulti-tenant commercial building 

### Vacuum system type: Dry 

### Vacuum system location: Basement 

### Source of supplies: Patterson 

# Amalgam Separator Manufacturer: Rebec Model: 400 Series Purchase price: $900 Power required: No Treatment chemicals required: No Size: 14 inches wide, 18 inches high, 8 inches deep Reasons for selecting model: Recommended by Patterson Warranty: 2 years 

# Se par ator Installation

Time between ordering and delivery: 3 weeks Plumbing contr actor: J&M Plumbing Installation date: June 19, 2004 Installation cost: $1,595 Problems encountered during installation: None 

# Amalgam Recycler

Rebec Solutions 

# Experience Rating (scale of 1-5, with 5 being the highest)
Maintenance Frequency 5 Clogging Problems 5 Vacuum Issues 5 Reliability 5 Overall Performance 5 Ease of Recycling 3



# Other Comments

Staff changes separator, heavy and gross to take out but saves us money. Unit hasn’t impacted office operations. 

# 10 Downtown Dental Group D octor Michael Costello 1 61 West Wisconsin Avenue S uite 5036 Milwaukee, Wisconsin 53203 414-278-6070 (voice) 414-278-6087 (fax) ddg161@sbcglobal.net
w ww.bettersmiling.com 

### Practice type: General 

### Office size: 7 operatories, none are hygiene only 

### Building type: High-rise mixed use building 

### Vacuum system type: Wet 

### Vacuum system location: Utility closet in office suite 

### Source of supplies: Patterson 

# Amalgam Separator Manufacturer: Rebec Model: Catch Hg 1000 Series Purchase price: $1,000 Power required: No Treatment chemicals required: No Siz e: 22 inches by 23.5 inches by 9 inchesReasons for selecting model: Wanted to try a model different from the other case studies Warranty: See www.rebecsolutions.com/warranty.html 

# Separator Installation

Time between ordering and delivery: 2 weeks Plumbing contractor: Schoof Plumbing Installation date: May 2004 Time needed: 4 hours Installation cost: $350 (la bor) + $50 (other) = $400 Problems encountered during installation: None 

# Amalg am Recycler

Envirotech Systems 

# Experience Rating (scale of 1-5, with 5 being the highest)
Maintenance Frequency 5 Clo g g ing Pr ob lems 5 Vacuum Issues 5 Reliability 5 Ov erall Performance 5 Ease of Recycling 5



# Other Comments

Dentists should not be concerned, once installated it’s hassle free.

Before After

# Milwaukee Metropolitan Sewerage District Rules *

11.214 Amalgam Management at Dental Offices

(1) This section applies to any dental office that places or removes amalgam. If work in a dental office is limited to work that does not involve placing or removing amalgam, such as orthodontics, periodontics, oral and maxillo-facial surgery, endodontics, or prosthodontics, then this section does not apply. (2) All dental offices shall implement best management practices for amalgam as established by the Wisconsin Dental Association. (3) Within the shortest reasonable time, but not later than February 1, 2008, every vacuum system where amalgam is placed or removed shall include an amalgam separator that meets the criteria of the International Standards Organization (ISO 11143). Dental offices shall install, operate, and maintain the amalgam separator according to instructions provided by the manufacturer. The amalgam separator shall have a design and capacity appropriate for the size and type of vacuum system.(4) On or before February 1, 2005, each dental office shall submit a report that certifies the implementation of the management practices required by sub. (2) and identifies the contractors used to remove amalgam waste within the last twelve months.(5) On or before February 1, 2006, each dental office shall provide a schedule for the installation of the amalgam separator required by sub. (3). (6) On or before February 1, 2007, each dental office shall provide a report providing the following information. (a) If installation of the amalgam separator is complete, then the report shall identify the installation date, the manuf acturer, and the model name. (b) If installation of the amalgam separator is incomplete, then the report shall briefly explain the delay, provide an installation schedule, and identify the manufacturer and the model name of the amalgam separator that will be installed. (7) If a dental office has provided a report according to sub. (6)(b), then the dental office shall notify the District of the completion of installation within five days after completion. (8) The District shall provide forms for reporting the information required by subs. (4), (5), (6), and (7). (9) From the contractors used to remove amalgam waste, dental offices shall obtain r ecords for each shipment showing: the volume or mass of amalg am waste shipped; the name and address of the destination; and the name and ad dress of the contractor. Dental offices shall maintain these r ecords for a minimum of five years. Dental offices shall make these r ecords available to the District for inspection and copying upon request from the District. (10) Dental offices shall allow the District to inspect the vacuum system, amalgam separator, and amalgam waste storage areas. (11) Inspections shall occur during the normal operating schedule of the dental office. The District shall inspect dental offices according to appointments made in advance, as long as this advanced notice does not impede enforcement of this section. (12) If a dental office is implementing the management practices required by sub. (2) and is operating and maintaining the amalgam separator required by sub. (3), then any numerical discharge limit for mercury established in any other section of this chapter does not apply.

* Other sewage districts may have alternative implementation schedules depending upon their

Wisconsin DNR discharge permit. Check with your local sewerage district for details.**For more inf ormation,**  **contact: UW-Extension Solid and Hazardous Waste Education Center**  **161 W. Wisconsin Avenue Suite 6000 Milwaukee, WI 53203**  **ph: 414-227-3160 fax: 414-227-3165**
**www .uwex.edu/shwec** 

**Univer sity of**  **Wisconsin, U.S. Department of Agriculture and Wisconsin counties cooperating UW** **-Extension provides equal opportunities in employment and programming including Title IX and ADA**

425.SB.0609 (Revised) Before - Burleigh Dental After - Burleigh Dental