Gerenciamento de resíduos odontológicos no serviço público e o seu impacto no meio ambiente / Dental waste management in the public service and its impact on the environment

Os estabelecimentos de saúde geram diariamente uma imensa quantidade de resíduos considerados prejudiciais ao meio ambiente. Na maioria das vezes, esses locais não possuem um sistema adequado de segregação e destino de seus resíduos, sendo estes lançados em lixões a céu aberto. Esse problema vem sendo cada vez mais objeto de preocupação de instituições de saúde, ambientalistas, órgãos governamentais e pesquisadores. No presente trabalho o objetivo foi verificar o processo de gerenciamento dos resíduos Odontológicos no serviço público e a conformidade com a legislação vigente. O estudo foi do tipo descritivo, exploratório, transversal, teve como universo amostral as unidades de atendimento odontológico do sistema público de onze municípios que compõem a Região Central do Departamento Regional de Saúde II, Araçatuba-SP. Uma única pesquisadora realizou as visitas e as observações foram anotadas em um roteiro previamente elaborado e testado. Foram visitadas 50 unidades de saúde, sendo que nenhuma apresentou cópia do plano de gerenciamento de resíduos de saúde. Do total de estabelecimentos 62% realizavam a correta segregação dos resíduos no momento da sua geração. A presença de recipientes adequados a cada tipo de resíduo gerado no consultório odontológico foi observado em 74% e desses, 94% apresentava capacidade adequada ao tipo de resíduo gerado. A identificação do tipo de resíduo nas embalagens plásticas bem como as anotações identificando o estabelecimento gerador dos resíduos foi encontrada em 8% e 6% respectivamente. Somente 21% dos estabelecimentos apresentavam locais apropriados, de acordo com as normas vigentes para o armazenamento dos resíduos até que fosse feita a coleta externa. Constatou-se na presente pesquisa que a rotina adotada pela rede pública de saúde bucal, no que tange ao gerenciamento de resíduos de saúde apresentou falhas. Faz-se necessária a qualificação das equipes de saúde quanto aos aspectos de preservação e educação ambiental

Health facilities generate a tremendous amount of daily waste considered hazardous to the environment. Most often, these places do not have an adequate system of segregation and fate of their waste being released in open dumps. This problem has been increasingly a concern of health care organizations, environmentalists, government agencies and researchers. In the present work aims to verify the process of waste management in the public service Dental and compliance with current legislation. The study was a descriptive, exploratory cross-sectional sampling universe was the units of dental care in the public system of eleven districts within the Central Region of the Regional Health Department II, Araçatuba-SP, a single researcher carried out the visits and observations were recorded on a previously elaborated and tested. We visited 50 health units and none had a copy of the waste management plan. Of the total establishments 62% performed the correct segregation of waste at the time of their generation The presence of containers for each type of waste generated in the dental office was observed in 74% and of those, 94% had adequate capacity for the type of waste generated. The identification of the type of waste in plastic bags and notes identifying the establishment from which the waste was found in 8% and 6% respectively. Only 21% of establishments had appropriate locations in accordance with the standards for the storage of waste until the collection was done outside. It was found in this study that the routine adopted by the public oral health in relation to the management of healthcare waste had flaws. It is necessary qualifications of health staff on the aspects of preservation and environmental education

Regulatory compliance in the dental office.

Dentists in the private sector, as well as their academic counterparts, must comply with a variety of federal, state, and local regulations. The scope of this regulation ranges from specifying who may engage in the practice of dentistry to the disposition of extracted teeth. In this review, some requirements imposed by various regulatory agencies are described. Because of the importance of state and local oversight, each clinician must determine what state and local requirements exist for them. A number of states have enacted various regulations that are more stringent than the federal versions. It is necessary, therefore, to seek appropriate local counsel regarding applicable statutes and regulations.

Amalgam waste management.

Dental amalgam has been extensively used as a tooth filling material for many decades and has beyond doubt saved millions of teeth that otherwise would have needed to be extracted. The release of amalgam particles into dental office wastewater is a matter of particular concern as amalgam particles could then be discharged into the environment. Amalgam waste discharges contribute to mercury in the environment through direct wastewater discharge, incineration, land-filling and sewage sludge incineration, although the discharge from dentistry is probably responsible for less than 1% of the total mercury discharged annually into the environment as a result of human activities. Nevertheless, dentists, by being producers of amalgam waste, have a responsibility and a duty of care for the proper management of this waste within their practices. Appropriate measures should be taken to minimise the amount of waste where possible or take action to ensure that all generated waste is disposed of in accordance with environmental legislation.

Dental amalgam: regulating its use and disposal.

Although dental amalgam has been a restorative material for more than 150 years, government regulation of its use and disposal came much later with the creation of new federal laws and agencies. None of the federal laws regulating dental amalgam today were written specifically to regulate amalgam. Instead, these new laws and agencies were created to address broad public safety concerns, where little or no regulation existed before, in the areas of medical devices and drugs and environmental pollution. It is the interpretation and implementation of environmental laws that recently have had the greatest impact on dental practices.