Cost-effectiveness of removing amalgam from dental wastewater.

Mercury in the form of amalgam is commonly introduced into dental wastewater as a result of amalgam placements and removals. Dental wastewater is primarily discharged to municipal sewers that convey industrial and residential wastewater to publicly owned treatment works (POTWs) for treatment prior to discharge to surface waters. In some localities, the sewage sludge generated by POTWs from the treatment of wastewater is incinerated, resulting in the emission of mercury to the atmosphere. Some of the mercury emitted from the incinerators is deposited locally or regionally and will enter surface waters. An assessment was conducted of the use of mercury in amalgam in California and the discharge of that mercury from dental facilities to surface waters via the effluent from POTWs and air emissions from sewage sludge incinerators (SSIs). The annual use of mercury in amalgam placements conducted in California was estimated to be approximately 2.5 tons. The annual discharge of mercury in the form of amalgam from dental facilities to POTWs as a result of amalgam placements and removals was estimated as approximately one ton. The discharge of mercury to surface waters in California via POTW effluents and SSI emissions was estimated to total approximately 163 pounds. A cost-effectiveness analysis determined that the annual cost to the California dental industry to reduce mercury discharges to surface waters through the use of amalgam separators would range from 130,000 dollars to 280,000 dollars per pound.