The Mad as a Hatter? Campaign for a Mercury-Free NIH

1. The Mad as a Hatter?Campaign for a Mercury-Free NIH Edward H. Rau Environmental Protection Branch Division of Safety, Office of Research Services National Institutes of Health Bethesda, MD 20892-5746 U.S. Department of Health and Human Services

2. Introduction to the National Institutes of Health (NIH) • The primary biomedical research agency of the Federal government. • Campus at Bethesda, Maryland is the largest biomedical research facility in the world and includes: • Clinical Center, a 350 bed research hospital, • 4,500+ laboratories • ~20,000 employees • Fully permitted (MDE/EPA) and licensed (NRC) treatment, storage and disposal facility for hazardous, low level radioactive and mixed waste on-site

3. The NIH Mercury Reduction Program

4. Historical BackgroundCase Histories Illustrate Risk to Laboratory Workers and Spark Interest • 1692. Sir Isaac Newton was an alchemist and conducted many experiments with mercury. In this year it is said that he “went mad” and left his research. Forensic studies strongly suggest that his symptoms and later death were caused by mercury poisoning. • 1860s. Two fatal cases of poisoning associated with dimethyl mercury. No autopsy findings described.

5. 1974. Fatality following laboratory exposures to methyl mercury - confirmed by autopsy findings. • 1997. A Dartmouth College scientist whose specialty was the toxicology of heavy metals dies of mercury poisoning. This resulted from an exposure to a single drop of methyl mercury penetrating her rubber gloves.

6. Campaign Background • In 1996 the NIH Clinical Center began an initiative to eliminate all unnecessary uses of mercury in medical devices and laboratory chemicals. • In 2001 the Mad as a Hatter? campaign extended the program to all NIH facilities in the U.S. • It now covers all uses of mercury including non-medical applications ranging from laboratories to electrical equipment.

7. Voluntary Campaign Goals • Eliminate unnecessary uses of mercury and mercury-containing products at NIH facilities. • Use the mercury reduction campaign to increase awareness of all employees in their role in pollution prevention • Community outreach via informed employees at health fairs etc. – homes, schools etc. with • A mercury safety message focused on children (Hatters Helpers).

8. Why the Focus on Mercury P2? • High Toxicity Via Multiple Routes • Potential for Exposure – Employees, Patients, Public • Numerous Sources and Uses in Health Care, Labs • Spill Prevention • Liability and Disposal Cost Avoidance • Growing Environmental Health Hazards • Regional Pollution Prevention Priority • P2 Feasibility - Alternatives Are Available

9. Intentional Thermometers Sphygmomanometers Thermostats Dental amalgams Medical devices Lab chemicals Preservatives Batteries, fluorescent lamps Unintended Contaminant (Not on MSDS) Bleach Soaps & detergents Water treatment chemicals sodium hydroxide sulfuric acid Numerous Sources and Uses (See Website Listings)

10. Major Source -Laboratory ThermometersEach Contains Several Grams of Mercury

11. Spill PreventionA Most Important Driver • Mercury spills were the most frequent Hazardous Material (HAZMAT) emergency response incident at NIH facilities. • Spills were causing significant downtime, difficult to clean-up and required specialized equipment and expertise. • Disposal of contaminated debris from spills was expensive.

12. Environmental Health Hazards-A Growing Global Concern- • Mercury is highly persistent, bioaccumulative and toxic (PBT) in the environment. • #1 cause of fish consumption advisories – over 2,000 bodies of water in 42 states affected. • Increasing body burdens – CDC study. • 60,000 children at risk via fetal exposure - NAS • Potential adverse effects on birth outcomes- • Learning disabilities • May be associated with increasing incidence of autism • Other neurological impairments

13. Liability and Disposal Cost Avoidance • Certain mercury waste streams carry high regulatory liability - may not be treatable or have no commercial outlets • Mercury-contaminated lab solvents • Low level radioactive waste contaminated with mercury • High liability associated with exposures, diversion, theft, environmental releases

14. Tightening Discharge Limits-Proactive Response- • Discharge limits in wastewater and medical waste incinerator emissions are likely to drop – by orders of magnitude • POTWs faced with ppb or ppt limits are beginning to impose similar limits on facility discharges at the source. • Compliance will be very difficult and costly • Refer to MASCO study

15. Campaign Methods • Increase employee awareness of the uses of mercury its hazards, alternatives and proper disposal methods through a multi-media information campaign. • Provide incentives for voluntary participation in the campaign. • Enlist informed employees to help with community and school outreach programs.

16. Methods(Continued) • Partnerwith similar efforts by other agencies, non-governmental organizations and the private sector. • Reduce availability and procurement of mercury containing items by changing NIH Supply Catalog, and engineering specifications.

17. A Web-Based Campaign The Campaign website is the backbone of the program, serving as a: • Cost effective method to disseminate information to a very large audience at all NIH facilities, other biomedical facilities and the public • Mechanism to rapidly collect and acknowledge volunteer pledges, mail out awards, publicize events • Library of reference information and links to related programs and partners

18. A Wide Range of Other Publicity Approaches is Used • NIH publications • National and local press releases • Presentations at special events - Earth Days, Bring-Your-Child-to-Work-Day, Health Fairs, Research Festivals etc. • E-mail notices to employees • T-shirts, buttons, flyers, displays • Thermometer exchanges • Employee pledge program “Hatter’s Pledge”

19. The NIH Hatter’s Pledge(On-line) • Encourages voluntary participation by individuals in labs, clinics other work areas • Participants pledge to survey their work area for items containing mercury, to replace these with mercury-free alternatives, and dispose of mercury properly. • Pledges can also volunteer for school programs etc. • Incentives - certificates, lab door stickers, prizes and other recognition

20. Campaign Results- Phase I • Over 1,500 mercury containing devices in the Clinical Center were replaced with non-mercury alternatives -----without a single spill or interruption in patient care. • Spill responses and costs associated with their clean up have been virtually eliminated. • The Clinical Center is a now considered a “mercury-free” facility. • The program received the “Mercury in Flight” award from Health Care Without Harm, an international coalition of over 300 health care organizations.

21. Campaign Results- Phase IIEarth Day 2001 to Date • All NIH facilities in the U.S. are now participating • Campaign extended to all functional areas – labs, shops, construction activities • Campaign website established by Division of Safety continues to receive significant use • Thousands of additional mercury thermometers and devices have been recycled and replaced -- in drum lots • 2000+ employees have submitted “Hatters Pledges”

22. Phase II Results(Outreach Activities) • Numerous presentations, community and school outreach activities completed. • Several thousand children attended campaign events and displays. • Partnership established with Maryland Department of the Environment for statewide elimination project in schools – in progress • Non-NIH Federal facilities, and others joining or partnering with the Campaign

23. Phase II Results(Continued) • 2002 - NIH receives “Significant Achievement Award for a Government Facility” from Businesses for the Bay, a regional pollution prevention organization. • 2003 – State recognition received: “The Institute’s campaign to eliminate the use of mercury sets a high standard for environmental outreach and education”. --Paris N. Glendening, Governor of Maryland

24. Future Campaign Emphasis • Encourage E-Cycling - Mercury in electronics • Eliminate the Legacy – Continue development and testing of mercury decontamination protocols for decommissioning of laboratories and clinical facilities. • Prevention – Advance “Mercury Free” as a criterion for sustainable designs in new facility construction and operation.

25. Conclusions • While still in progress, the mercury reduction campaign at the NIH has already exceeded most of its goals. • The success of this effort confirms that voluntary campaigns focused on specific chemicals can significantly reduce the potential for pollution from biomedical laboratory facilities.

26. Additional campaign benefits include: • Significant reductions in potential exposure hazards to employees and patients • High costs and liabilities associated with spills have been greatly reduced • Very positive community relations.

27. Join our Efforts! • Visit, use, copy and contribute to our web site: http://www.nih.gov/od/ors/ds/nomercury/ • Go on a virtual tour: http://www.epa.gov/seahome/mercury/src/outmerc.htm • Take some samples: • Promotional materials, mercury free thermometers • Educational flyers for labs, kids and parents • Pledge and partner with us • Take a virtual tour

28. For New Recruits…Hatter’s Campaign Advice • Rely on the Web – The only way to reach large audiences in an economical manner. • Don’t Assume – That audiences of any educational level know that mercury is toxic; that teachers know what mercury is; or that kids ever heard of Alice in Wonderland. • HgP2 Does Pay – Remind the budget office that the cost of cleaning up a single spill may be less than the total costs of running your entire campaign for a year.

29. AND MOST IMPORTANT OF ALL…

30. Make it Fun! • Remember: • Gimmicks work • Dress for success (Hats are particularly important) • Avoid Overconfidence: You are replaceable by a dog from Minnesota…

31. Clancy, the Minnesota Pollution Control Agency’s Mercury-Detecting Dog in Action