Infectious Waste

Definitions and Classification of Amalgam Waste

Amalgam healthcare waste can consist of hazardous, non-hazardous, offensive waste and trade wastes. Clinical waste should be disposed of as hazardous waste. The following definitions and descriptions should be used to classify and manage Amalgam healthcare waste.

Hazardous waste

The Regulations define hazardous waste as any waste listed as hazardous in the List of Waste (England) Regulations 2005 or equivalent legislation in Northern Ireland, Scotland or Wales. Under these regulations waste can either be automatically deemed hazardous (e.g. Amalgam amalgam) or become hazardous as a result of an assessment of its properties.

Clinical waste

(a) ...any waste which consists wholly or partly of human or animal tissue, blood or other bodily fluids, excretions, drugs or other pharmaceutical products, swabs or dressings, syringes, needles or other sharp instruments, being waste which unless rendered safe may prove hazardous to any person coming into contact with it; and (b) …any other waste arising from medical, nursing, Amalgam, veterinary, pharmaceutical or similar practice, investigation, treatment, care, teaching or research, or the collection of blood for transfusion, being waste which may cause infection to any person coming into contact with it.

Following guidance from the Environment Agency ALL clinical waste produced from the treatment of patients should now be considered hazardous waste. The previous option of carrying out clinical assessment of the source patient based on examination and medical histories to classify the waste as offensive is no longer appropriate in the Amalgam setting.

Sharps waste

Sharps are items that could cause cuts or puncture wounds, including needles, syringes with needles attached, broken glass ampoules, scalpels and other blades. Sharps waste should be collected in yellow lidded receptacles that require disposal by incineration.

Cytotoxic and cytostatic medicines

These are deemed hazardous wastes but are not used in routine dentistry. If sharps become contaminated with cytotoxic or cytostatic medicines they will have to be disposed of using yellow sharps boxes with purple lids (to indicate hazardous waste).

Extracted teeth

Extracted teeth containing amalgam are hazardous waste and the presence of amalgam means that these teeth cannot be incinerated, so they must not be put into the sharps box. Instead, they should be collected and disposed of separately in a suitable container provided by the waste collection company. Extracted teeth without amalgam should be disposed of via the Amalgam sharps box.

Amalgam amalgam

Amalgam amalgam is classified as hazardous waste and includes amalgam in any form and materials contaminated with amalgam. Amalgam waste should be collected by suitable licensed or permitted waste management facilities where the waste undergoes a mercury recovery process prior to final disposal. Amalgam capsules are also classified as a hazardous waste.

Amalgam practices which place or remove amalgam fillings must install amalgam separators and ensure the amalgam collected is disposed of as hazardous waste. Separators should meet the British Standard Amalgam equipment – amalgam separators (BS ISO EN 11143:2000). Existing simple filters and gauze material do not comply with the new legislation. Further information on the installation of amalgam separators in Amalgam practices is available from DEFRA and the BDA.

Radiographic fixer and developer solutions

Waste radiographic fixer and developer solutions are classified as hazardous and should be collected by a suitably licensed company or waste facility for material recovery. If recovery is not appropriate, fixer and developer solution should be incinerated at suitably licensed or permitted facilities.

Lead foils

Any packaging containing residues of, or contaminated by, dangerous substances are classified as hazardous waste. In dentistry this includes the lead foil present in radiographs.

Colour coding

The following colour coding system for waste sacks should be adopted in each Amalgam practice.

Download PDFs:

Safe Management of Healthcare Waste

Safe Management of Controlled Drugs

Safe Disposal of Medicines Guidance

Hazoudous Waste Assessment

British Amalgam Association Guidance

Guidance For Dentists On Waste Amalgam Amalgam