CHAPTER 23 CHEMICAL & WASTE MANGEMENT

Ventilation

- Good ventilation is necessary when you are dealing with any type of chemical. -Many dental offices are equipped with special exhaust systems for fumes and dust in the laboratory, sterilization areas, and darkroom areas.

Check Expiration Date

Products that have outlived their expiration date should be disposed of immediately. -Follow instructions -avoid exposure to light -check expiration date - rotate inventory to ensure older products are used first

Hand Protection

When using chemicals, be certain to wear utility gloves made from a chemical-resistant material latex gloves worn during patient care do not provide adequate protection when one is handling chemicals. When exposed to chemical disinfectants, the latex in the glove degrades and creates a wicking (sucking) action that will actually pull contaminants and chemicals through the glove and onto the hands. mask and eye protection

Control of Chemical Spills

-Accidents and spills should not be common occurrences -Planning and practice in dealing with such spills should minimize employee exposure to harmful chemicals -Refer to the safety data sheet (SDS) for the specific product for accurate information on how to manage spills

Acute and Chronic Chemical Toxicity

-Acute chemical toxicity results from high levels of exposure over a short period. Acute toxicity is often caused by a chemical spill, in which exposure is sudden and often involves a large amount of the chemical. Symptoms are immediate dizziness, fainting, headache, nausea, and vomiting. -Chronic chemical toxicity results from many repeated exposures, generally to lower levels, over a much longer time (months or even years). Symptoms including liver disease, brain disorders, cancer, and infertility.

Inhalation Process

-Depending on the quality, the masks worn during patient care may or may not provide adequate protection when one is working with chemicals. -The proper face mask should be fluid repellent and should provide respiratory protection. -if your job requires you to pour or mix chemicals frequently, or if you are sensitive or allergic to substances, you might require a mist respirator mask approved by the National Institute of occupational Safety and Health (NIOSH)

Hazardous Waste Disposal

-Ignitable waste: flammable or combustible -corrosive waste: either highly acidic or basic with a pH less than 2.0 or greater than 12.5, respectively (water has a pH of 7.0) -Reactive waste: Chemically unstable or explosive, reacts violently with water, or is capable of giving off toxic fumes when mixed with water. -toxic waste: contains arsenic, barium, chromium, mercury, lead, silver, or certain pesticides. These types of hazardous waste are listed by the EPA.

Dental Materials that may be regulated

-Mercury and dental amalgam -Elemental mercury -Amalgam capsules -Scrap amalgam -Amalgam traps -Lead foil and shields -Disinfectant solutions -X-ray fixer solution -X-ray developer solution

Hazard Communication Program

-OSHA issued the Hazard Communication Standard because employees have the right to know the identity and hazards of chemicals that they use in the workplace. -Also known as the Employee Right-to-Know Law -Requires employers to implement a hazard communication program.

Eyewash Units

-OSHA regulations require eyewash units to be installed in every workplace where chemicals are used. -OSHA requires that all eyewash stations be inspected monthly to ensure that they are functioning properly. A record of the date of each inspection must be maintained. -Some manufacturers of eyewash units recommend a weekly 3 minute flushing to reduce microbial content in the waterline.

Responsibilities of Dental Assistant as coordinator of hazard communication program

-compile a list -obtain safety data sheets -update the ads file as new products are added to the office inventory -assist in training other employees

Hazardous Chemicals

A hazardous chemical is defined as any chemical that can cause a physical hazard or a health hazard. A chemical is considered hazardous if it: 1. can ignite 2. can react 3. is corrosive 4. is toxic A chemical of great concern? MERCURY

Labeling of Chemical Containers

Containers must be labeled to 1) the labeling system includes all required information and 2) all employees are properly trained to understand and read the label. When the chemical is transferred to a different container, however, the secondary container also must be labeled.

Employee Training

Employee training is essential for a successful hazard communication program. staff training is required once a year for all continuing employees. The chemical training program for employees must provide Information on the following: -how to safely use hazardous chemicals -how to use required ppe -safe handling and disposal methods

Extracted Teeth

Extracted teeth are considered potentially infectious materials and are regulated waste. Many states allow the dental office to sterilize the extracted teeth. Teeth that do not contain amalgam and are going to be used for educational purposes must be heat-sterilized first. restorations should never be heat-sterilized.

Lead Contamination (Lead Foil)

Lead foil from x-ray film packages, when recycled as a scrap metal, but it must be recycled through a licensed recovery facility. Eastman Kodak offers a mail-in service for recycling this material. -Easily recyclable but cannot be disposed in the garbage. -Exempt form the regulation as a hazardous waste when recycled through a licensed recovery facility.

Sharps

OSHA, the Centers for Disease Control and Prevention (CDC), and the EPA classify sharps as regulated infectious waste. According to OSHA regulations, disposable sharps must be placed in a closable leak-proof, puncture-resistant container immediately after use. State regulations may differ regarding how frequently sharps containers must be picked up. Check the regulations in your state.

Radiographic Fixer

Radiographic fixer is considered a hazardous waste because of its high silver content. On-site treatment requires the installation of silver recovery systems to remove the toxic silver from the solution.

Classification of Medical Waste

Regulated waste includes items that are contaminated from a potentially infectious material, which requires special disposal. All waste containers that hold potentially infectious materials must be labeled with the biohazard symbol.

Safety Data Sheet (SDS)

SDSs contain health and safety information. They describe the physical and chemical properties of a material, health hazards, routes of exposure, precautions for safe handling and use, emergency and first aid procedure, and spill control measures. These sheets should be organized in binders so that employees have ready access to them and can easily locate a particular SDS.

Scrap Amalgam

Scrap dental amalgam should be collected and stored in a designated, dry, airtight container.

Waste Disposal

The EPA enforces the disposal of regulated waste. Dentist is responsible for proper packaging, labeling, transportation, and ultimate disposal of waste generated in the dental office.

National Fire Protection Association Labels

The National Fire Protection Association (NFPA) has a labeling system that has long been used to label containers of hazardous chemicals. health hazard (blue) flammability (red) reactivity (yellow) oxidizers (white)

Chemical Inventory

The chemical inventory is a list of all products used in the office that contains chemicals. It includes amalgam, composites, bonding materials, etching agents, disinfectants, sterilants, and impression materials, among others.

Exposure to Chemicals

The three primary methods of chemical exposure are inhalation, skin contact, and ingestion. -Inhalation of the gases, vapors, or dusts of chemicals can cause direct damage to the lungs. Can also be absorbed by them and is sent through the blood to other organs, such as the brain, liver, or kidneys, where they can cause damage. - After repeated direct skin contact with a chemical, a skin condition called dermatitis may develop. -Ingestion (swallowing) is another way in which chemicals can enter the body. Common ways of ingesting harmful chemicals in the workplace include eating lunch in an area in which chemicals are used or eating with hands that are contaminated with chemicals. It is important to wash your hands thoroughly after contact with any chemical.

Written Program

The written program must identify, by name, all the employees in the office who are exposed to hazardous chemicals. It must also identify the individual who is responsible for the program. This is often a dental assistant. The written program must describe (1) staff training: (2) how chemicals are handled in the office, including information on all labeling and safety measures; and (3) how to respond to chemical emergencies such as spills or exposures.

Revision of the HCS Standard

Under the international GHS, each chemical will be classified and labeled the same regardless of where in the global market the chemical is manufactured or used.