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Mercury in Health Care: WHO Policy Paper. Hisashi Ogawa WHO Western Pacific Regional Office. Sources of mercury in health care. Thermometers Sphygmomanometers Dental amalgam Gastrointestinal tubes Laboratory chemicals Pharmaceutical products Electrical applications
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Mercury in Health Care: WHO Policy Paper Hisashi Ogawa WHO Western Pacific Regional Office
Sources of mercury in health care • Thermometers • Sphygmomanometers • Dental amalgam • Gastrointestinal tubes • Laboratory chemicals • Pharmaceutical products • Electrical applications • Medical waste incineration, open burning, burning in barrels, gasification, pyrolysis, etc.
Occupational exposure to mercury • Common pathway is inhalation of mercury vapours (odourless and colourless) • Permissible concentration for occupational exposure by NIOSH – 0.05 mg/m3 • Equipment breakage and spills occur frequently, but risk perception is low • Spillage accident is often not reported, and handled carelessly with no protective gear
Mercury release from health care • Health care facilities are one of the main sources of mercury release into the atmosphere because of emissions from medical waste incineration • Health care facilities are responsible for mercury pollution taking place in water bodies from the release of untreated wastewater • Mercury contained in dental amalgam is the greatest source of mercury vapour in non-industrial settings
Strategies • WHO recognizes that a significant portion of mercury release comes from the health-care sector, and therefore proposes to work with countries through the following strategies • Short- term • Medium-term • Long-term
Short-term strategies • Develop clean up and waste handling procedures • Procedures should include: - Spill clean up response, - Educational programmes - Use of protective gear - Waste storage containment - Staff training • Countries to initiate phasing out process
Medium-term strategies • Reduce the number of unnecessary use of mercury equipment • Inventory of mercury use and the categorization of items into immediate replaceable and gradually replaceable • Return of replaceable devices to the manufacturer or to the provider of alternative devices • Progressively discourage the sale and use of mercury containing devices • Ensure support to countries so that recovered mercury equipment is not recycled back to the supply chain
Long-term strategies • Support a ban of use of mercury devices and promote the use of alternatives • Support in developing & implementing national plan, policies & legislation on mercury • Support allocation of human and financial resources • Promoting principles of environmentally sound management of health-care waste under the Basel Convention