Sharuɗɗan yarjejeniyar IAOMT don ƙaurawar haɗuwa an san su da Fasaha na Cire Mercarƙirar Amalgam (SMART). Lura cewa an gabatar da SMART azaman saitin shawarwari. Masu aikin lasisi dole ne suyi aikin kansu game da takamaiman zaɓuɓɓukan magani don amfani da ayyukansu. Shawarwarin yarjejeniyar SMART sun haɗa da waɗannan matakan, waɗanda aka jera su anan tare da binciken kimiyya:
An sabunta sabunta shawarwarin yarjejeniyar amalgam na amintarwar IAOMT kwanan nan a ranar 19 ga watan Yulin, 2019. Hakanan, a ranar 1 ga Yulin, 2016, shawarwarin yarjejeniya ta IAOMT aka sake suna a hukumance kamar Safe Mercury Amalgam Removal Technique (SMART), da kuma horon horo ga likitocin IAOMT don zama bokan a cikin SMART an fara shi.
Duk gyaran hakoran amalgam suna dauke da kusan 50% mercury,1 kuma rahotanni da bincike sunyi daidai da cewa waɗannan abubuwan cikewar suna fitar da iskar mercury vapors.2-16
Bincike na kimiyya ya nuna cewa amalgam din hakoran yana nuna kwararrun likitocin hakori, ma’aikatan hakori, marassa lafiyar hakora, da / ko ‘yan tayi ne ga fitowar tururin mercury, abubuwan da ke dauke da sinadarin na mercury, da / ko wasu nau’ikan gurbatattun kayan.4-48
Bugu da ƙari kuma, an san fitowar tururi na mercury daga haƙoɗen amalgam na haƙori a ƙimar mafi girma yayin goge-goge, tsabtacewa, haƙoran hakora, tauna, da sauransu,5, 14, 15, 24, 30, 49-54 kuma ana sananniyar mercury a yayin sanyawa, sauyawa, da kuma cire kayan amalgam na haƙori na haƙori.2, 25, 28, 29, 32, 36, 41, 45, 46, 55-60
Yin amfani da shaidun kimiyya da ke akwai, IAOMT ya ƙaddamar da shawarwari masu yawa game da kariya don cire abubuwan cikewar amalgam na haƙori, wanda ya haɗa da cikakkun matakan kariya waɗanda za a yi amfani da su don aikin. Shawarwarin na IAOMT suna ginawa ne akan dabarun cire amalgam na gargajiya na gargajiya kamar su amfani da maski, ban ruwa, da tsotso mai girma ta hanyar ƙarin waɗannan dabarun na yau da kullun tare da ƙarin ƙarin matakan kariya, waɗanda ba a daɗe da gano su ba a binciken kimiyya.
- Dole ne a sanya mai raba amalgam yadda ya kamata, ayi amfani da shi, a kuma kiyaye shi don tara kayan kwalliyar mercury ta yadda ba za a sake shi a cikin kwararar daga ofishin hakori ba.25, 61-73, XNUMX
- Kowane ɗakin da aka cire abubuwan da ke cike da mercury dole ne su sami isasshen filtata a wurin,29, 74-76, XNUMX wanda ke buƙatar babban matattarar iska mai iska (kamar a tushen asalin aerosol vacuum) wanda zai iya cire tururin mercury da ƙwayoyin amalgam waɗanda aka samar yayin cirewar ɗaya ko fiye da abubuwan cikewar mercury.45, 77
- Idan za ta yiwu, ya kamata a buɗe tagogi don rage iskar mercury a cikin iska.29, 77-79, XNUMX
- Mai haƙuri za a ba shi silsilar gawayi, chlorella, ko mai tallata irin wannan don kurkurawa da haɗiyewa kafin a aiwatar da shi (sai dai idan mai haƙuri ya ƙi ko kuma akwai wasu takaddun da ke sa wannan rashin lafiyar ta asibiti).77, 80, 81
- Riga da sutura don likitan hakora,25, 45 ma'aikatan hakori,25, 45 da kuma mai haƙuri45 dole ne a wuri. Duk wanda ke cikin dakin dole ne a kiyaye shi saboda yawancin ƙwayoyin da aka samar yayin aikin zasu gujewa tara ta na'urorin tsotsa.36, 45 An nuna cewa wadannan kwayoyin za su iya yaduwa daga bakin mara lafiya zuwa hannaye, hannaye, fuska, kirji da sauran bangarorin likitan hakori da na jikin mai haƙuri.45
- Dole ne safofin hannu ba-latex nitrile dole ne likitan hakora da duk ma'aikatan haƙori a cikin ɗakin.45, 46, 77, 82-83
- Garkuwar fuska da suturar gashi / kai sune za'ayi amfani da su daga likitan hakori da duk ma'aikatan haƙori a cikin ɗakin.45, 77, 80
- Ko dai a rufe sosai, a rufe mashin mai dauke da numfashi don kama mercury ko matsin lamba mai kyau, toshe rufin da kyau wanda ke ba da iska ko iskar oxygen dole ne likitan hakora da duk ma'aikatan haƙori a cikin ɗakin su sanya shi.36, 45, 76, 77
- Don kare fata da suturar mara lafiyar, ana bukatar amfani da cikakken jiki, shingen da ba zai iya yuwuwa ba, da kuma cikakken katangar kai / fuska / wuya a ƙarƙashin / kewayen madatsar ruwan.45, 77, 80
- Iskar waje ko iskar oxygen da aka kawo ta hanci ta hanci don mai haƙuri shima ana buƙatar amfani dashi don tabbatar da cewa mai haƙuri baya shaƙar duk wata tururin mercury ko kuma amalgam a yayin aikin.45, 77, 80 Cannula ta hanci hanya ce mai karɓa don wannan dalilin muddin hanci mara lafiya ya rufe shi da shamaki mara kan gado.
- Dam din hakori74-76, 84-87 wancan an yi shi ne da kayan lectri non-latex45, 77, 83 dole ne a sanya shi kuma a rufe shi da kyau a cikin bakin mai haƙuri.
- Dole ne a sanya mai sashin saliva a ƙarƙashin haƙƙin haƙori don rage tasirin mekuri ga mai haƙuri.45, 77
- Yayinda ake cire amalgam, likitan hakora dole ne yayi amfani da wani wuri na aerosol a cikin kusancin filin aiki (watau inci biyu zuwa hudu daga bakin mai haƙuri) don rage tasirin mercury.45, 88
- Gudun gudu mai sauri yana samar da mafi kyawun kama lokacin da aka sanya shi da na'urar Tsaftacewa mai tsabta,45, 87 wanda ba farilla bane amma an fi so.
- Ruwa mai yawa don rage zafi45, 74, 76, 77, 86, 89-91 da kuma wata na'ura mai saurin gudu don kamawa da zubar da sinadarin mercury25, 29, 45, 74-77, 86, 90, 91 ana buƙatar rage matakan mercury na yanayi.46
- Amalgam ya buƙaci a rarraba shi cikin ɓangarori kuma a cire shi da yawa kamar yadda ya kamata,45, 74, 77, 80 ta yin amfani da ƙaramin ƙaramin faren carbide.29, 86
- Da zarar an cire aikin cirewa, ya kamata bakin mara lafiya ya zama an watsa shi da ruwa sosai77, 80 sannan a kurkura tare da dusar gawayi, chlorella ko makamancin haka.81
- Dole ne likitocin hakora su bi ƙa'idodin tarayya, na jihohi, da na gida waɗanda ke magana game da yadda ya dace, tsabtace, da / ko zubar da abubuwan da aka gurɓata na merkuri, tufafi, kayan aiki, saman ɗakunan, da kuma shimfida cikin ofishin hakori.
- Yayin budewa da kuma lura da tarkunan tsotsa a cikin wuraren aiki ko kuma a babban sashin tsotso, ma'aikatan hakora suyi amfani da kayan aikin kariya na mutum wanda aka bayyana a sama.
Yana da mahimmanci a lura cewa a matsayin kiyayewa, IAOMT ba ta ba da shawarar cire ƙazamar cika ga mata masu juna biyu ko masu shayarwa kuma IAOMT ba ta ba da shawarar cewa ma'aikatan haƙori waɗanda ke da ciki ko aikin shayar da nono aikin da zai tarwatsa amalgam cikawa (gami da cire su).