Mercury and waste issues with mercury substances from health services
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FERDOHLEB, Alina, BAHNAREL, Ion, SIMINOVICI, Svetlana. Mercury and waste issues with mercury substances from health services. In: Ecological and environmental chemistry : - 2017, Ed. 6, 2-3 martie 2017, Chișinău. Chisinau, Republic of Moldova: Academy of Sciences of Moldova, 2017, Ediția 6, p. 208.
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Ecological and environmental chemistry
Ediția 6, 2017
Conferința "Ecological and environmental chemistry 2017"
6, Chișinău, Moldova, 2-3 martie 2017

Mercury and waste issues with mercury substances from health services


Pag. 208-208

Ferdohleb Alina12, Bahnarel Ion12, Siminovici Svetlana1
 
1 National Center of Public Health,
2 ”Nicolae Testemițanu” State University of Medicine and Pharmacy
 
 
Disponibil în IBN: 19 martie 2019


Rezumat

Mercury is one of 10 chemicals, which is a public health problem. Dentistry is the branch of the health care system, in which this heavy metal is used. The currently growing dental tourism, mobility of health service users have aggravated problems of waste of mercury substances. Currently, 78% US population still have fillings with amalgam, and health insurance recommends the use of this restoration material. United Nations Environment Program of Global Mercury Assessment showed that mercury used for dental purpose represented globally up to 270-341 metric tons. These data represent approximately 20% of global consumption of mercury. World Health Organization published arguments which sustain that amalgam restorations (fillings) are the largest source of mercury poisoning of organism. It is considered that the daily dose absorbed from these fillings is from 3.8 to 21 micrograms/day, amount which depends on the number and size of fillings, the degree of friction during mastication, consumption of beverages with increased temperatures, the electrical currents created when two different metals get in contacted (a crown of gold and amalgam filling). Dental amalgam is used to restore teeth for almost 200 years, and disputes over the controversial influence of material containing mercury and the use of mixtures of mercury (Hg) and dust (alloy) which containing one or more metal, persist for a long time. Based on the number of metals, the alloy can be binary (Hg + Cu), ternary (Hg + Ag + Sn), quaternary (Hg + Ag + Sn + Cu). There is a set of mandatory rules for working with mercury amalgam: 1) storage and amalgamation in capsules; 2) use / application of techniques without contact of the instrument; 3) well-ventilated workspace and cold temperature / cold instruments; 4) training of staff on the toxic potential of mercury vapor; 5) immediate hands’ washing after applying / removing the filling; 6) storage of mercury remains in a sealed container preferably under glycerin film and use of special disposable containers. The experiences with mercury-free dental restorations in surveyed countries demonstrate that amalgam use can be phased down and even eliminated. The major force now driving global momentum toward reducing mercury use in dentistry is the Minamata Convention. Each country adhering to the Convention is obliged to implement more of the measures of amalgam use, while taking into account the country’s domestic circumstances and relevant international guidance, which identifies a number of actions that can be taken: 1) Setting national objectives aiming at dental caries prevention and health promotion, thereby minimizing the need for dental restoration; 2) Setting national objectives aiming at minimizing the use of dental amalgam; 3) Promoting the use of cost-effective and clinically effective mercury-free alternatives for dental restoration; 4) Promoting research and development of quality mercury-free materials for dental restoration; 5) Encouraging representative professional organizations and dental schools to educate and train dental professionals and students in the use of mercury-free dental restoration alternatives and in promoting best management practices; 6) Discouraging insurance policies and programs that favor dental amalgam use over mercury-free dental restoration; 7) Encouraging insurance policies and programs that favor the use of quality alternatives to dental amalgam for dental restoration; 8) Restricting the use of dental amalgam to its encapsulated form; 9) Promoting the use of best environmental practices in dental facilities to reduce releases of mercury and mercury compounds to water and land.