UPDATE: CDC Names Vaping-Related Illness, Issues New Guidance

The U.S. Centers for Disease Control and Prevention (CDC) has updated its initial recommendations for healthcare providers on how to deal with vaping-associated illness, which the CDC has now named e-cigarette, or vaping, product use-associated lung injury (EVALI).

Based on the most current data, CDC’s updated interim guidance provides a framework for health care providers in their initial assessment, evaluation, management, and follow-up of persons with ​EVALI. 

Rapid recognition by health care providers of patients with EVALI and an increased understanding of treatment considerations could reduce morbidity and mortality associated with this injury.

Forty-nine states, the District of Columbia, and one U.S. territory have reported 1,299 cases of lung injury associated with the use of electronic cigarette (e-cigarette), or vaping, products. Twenty-six deaths have been reported from 21 states. The Kansas Department of Health and Environment (KDHE) has reported that two Kansans have died from vaping related illnesses since September 10, 2019.

Following on the CDC's initial recommendations in early August based on limited data from the first reported EVALI cases, the new updated report summarizes national surveillance data describing clinical features of more recently reported cases and provides interim recommendations based on these data.

Specifically, it details interim guidance for U.S. healthcare providers on initial clinical evaluation, suggested criteria for hospital admission and treatment, patient follow-up, special considerations for groups at high risk, and clinical and public health recommendations.

E-cigarettes typically contain nicotine, most also contain flavorings and other chemicals, and some may contain marijuana or other substances. They are known by many different names and come in many shapes, sizes and device types.

E-cigarettes can contain harmful or potentially harmful substances, including nicotine, heavy metals (e.g., lead), volatile organic compounds, and cancer-causing chemicals.

For assistance with managing patients suspected of illness related to recreational, illicit, or other drugs, call your local poison control center at:
1-800-222-1222.

​KDHE and KSU Remind Dentists of Upcoming Amalgam Rule, Require One-Time Compliance Report

The Kansas Department of Health and Environment ​(KDHE) and Kansas State University Pollution Prevention Institute (KSU PPI) have partnered to help dentists prepare for the upcoming compliance date of the EPA's new amalgam rule. 

The EPA requires amalgam separators to achieve at least a 95% removal efficiency. The EPA final rule on amalgam separators went into effect on July 14, 2017, and the date for compliance is July 14, 2020. Most practicing dentists who discharge wastewater into a publicly owned treatment work (POTW), such as a municipal sewer system, must comply.

Dentists are encouraged to follow dental best management practices, set forth by the ADA, for amalgam waste handling and disposal. Additional highlights and exemptions to the rule can be found at ada.org/recycleamalgam.

Dental offices must also submit a one-time compliance report to the Kansas Environmental Assistance Program by October 12, 2020; OR if you discharge to a POTW with a pretreatment program, you may have different reporting requirements. Check here to see if your city has a pretreatment program and who you would need to contact for further information.

The report can be submitted online, emailed to amalgamrule@ksu.edu,or mailed to 2323 Anderson Ave, Ste 300 in Manhattan, KS 66502.

More information on compliance in Kansas is available on the KSU PPI web site, and contact information for KDHE and our local EPA office is listed below.

KDHE Industrial Programs Section
Bureau of Water
Steve Caspers, Pretreatment Specialist
785-296-5551
steve.caspers@ks.gov

Environmental Protection Agency
Region 7 (KS, NE, IA, MO)
Paul Marshall, Pretreatment Specialist
913-551-7419
marshall.paul@epa.gov

UPDATE: ADA Sets Record Straight on Status of Petition to FDA Regarding SmileDirectClub

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Important Notice RE: KMAP Provider Registration

In compliance with the Centers for Medicare & Medicaid Services and the State of Kansas, all KanCare providers must enroll and maintain an active Kansas Medical Assistance Program (KMAP) ID prior to contracting and credentialing with any Managed Care Organization (MCO).

As a valued partner in care with the Kansas Dental Association, Envolve Benefit Options wants to ensure that dentists satisfy this requirement to receive appropriate and timely payment for the services rendered to KMAP members. 

As a reminder, KMAP sent several bulletins detailing the new process and effective dates. 

On January 1, 2018, all new provider enrollments and re-credentialed providers were to enroll with KMAP in order to be enrolled/credentialed with MCOs. 

On November 1, 2018, all providers not currently enrolled with KMAP were to complete the KMAP screening and enrollment process to receive a KMAP ID to continue contracting with MCOs. 

As of January 1, 2019, the MCOs were to deny claims from providers who did not possess an active KMAP ID.

Please visit the KMAP web site to register using the Provider Enrollment Wizard. For questions, call KMAP Provider Enrollment at 1-800-933-6593.

ADA Releases Statement on Study in JAMA Pediatrics

On Monday, August 19, the American Dental Association (ADA) released a statement in response to a recently published study linking maternal ingestion of fluoridated water during pregnancy to lower IQ scores in children. 

The ADA remains committed to fluoridation of public water supplies as the single most effective public health measure to help prevent tooth decay.

This commitment is shared by many national and international organizations, including the World Health Organization, US Public Health Service, the Centers for Disease Control and Prevention, the American Medical Association, and the American Academy of Pediatrics.  

Public health policy is based on a collective weight of scientific evidence. The ADA is aware of a new study conducted in Canada in which its authors reviewed maternal exposure to fluoride in pregnancy.

We welcome this and further scientific study of the issue to see if the findings can be replicated with methods that demonstrate more conclusive evidence."

Read the full news release at ada.org. 

KDHE Radiation Control Program: Enforcement of Handheld X-ray Device Regulations Began September 1

Radiation has been a hot topic among KDA members over the past year, due to increased dental office inspections and new requirements regarding handheld X-ray units that took effect on September 1, 2019. 

In an effort to help our members, the KDA sat down with representatives from the Kansas Department of Health and Environment (KDHE) Radiation Control Program to discuss ways we could better inform dentists of the responsibilities in their dental offices, pertaining to radiation.

View a variety of resources pertaining to proper protection, portable X-ray equipment, dental noncompliance issues, and an explanation of dental regulations at ksdental.org/radiation.

If you have questions about radiation regulations or an inspection, contact the KDHE Radiation Control Program at 785-296-1560 or kdhe.xray@ks.gov. 

   
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