Gerenciamento dos resíduos de amálgama odontológico na atenção primária à saúde nos municípios do Estado do Espírito Santo

Abstract

OBJECTIVE: To analyze the management of waste from dental amalgam generated in Primary Health Care in the municipalities of the state of the Espírito Santo (ES), Brazil, since a proper management of this waste has proven sufficient to control the environmental impact of mercury from dental activity and to verify the compliance with current legislation. METHODS: Data were collected through a structured questionnaire answered by 30 municipalities coordinators of oral health in the municipalities of ES, between the months of may and august 2016. The sample included randomly municipalities of four administrative health regions and different population size. RESULTS: The amalgam is used in the public service in 93% of the participating municipalities, but its residue is generated in 100% of the municipalities. In 96% of the municipalities, less than 30 restorations / day of amalgam. Temporary storage of this waste is done in a specific container, as required legislation in 89.3% of the municipalities. Disposal of waste from the wear and amalgam filling removal occurs through the spittoon / sewage system in 100% of the municipalities. The RDC ANVISA 306/2004 content is 30% lack of municipal coordinators of oral health and Plan Health Services Waste Management is absent in at least 54% of the municipalities. Only four municipalities (18%) reported that the final destination of the waste in question is recovery, provided the current regulations, but none of them could tell the name of the company recovers this waste. All counties using amalgam as a restorative material using pre dosed capsules for their preparation, and these have been discarded improperly, with the waste of group A, in 57% of municipalities. CONCLUSIONS: The amalgam is still used in Primary Health Care and its waste is generated in cities. The Plan Health Services Waste Management the dental service is not yet a reality. The management of amalgam waste partially meets what is expected in the RDC 306/04, with the final destination has constituted the weakest point. The amount of amalgam waste generated in Primary Health Care justifies the proposition of a state policy for its proper management. The simple fact of the amalgam waste is composed of heavy metals (especially mercury), does not constitute a significant risk to human health nor to the environment, provided that there is an adequate management of its waste, with an emphasis on disposal.