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Steve Kubo Hospital Pollution Prevention Program (HP 3 ) California Department of Health Services

Mercury Reduction in Hospitals. Steve Kubo Hospital Pollution Prevention Program (HP 3 ) California Department of Health Services. Mercury Elimination Goal:. The EPA and American Hospital Association Pollution Prevention MOU

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Steve Kubo Hospital Pollution Prevention Program (HP 3 ) California Department of Health Services

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  1. Mercury Reduction in Hospitals Steve Kubo Hospital Pollution Prevention Program (HP3) California Department of Health Services

  2. Mercury Elimination Goal: • The EPA and American Hospital Association Pollution Prevention MOU “Virtual elimination of Hg containing waste from hospitals by 2005”

  3. Hg Elimination Programs • Hospitals for a Healthy Environment (H2E) – Making Medicine Mercury Free http://www.h2e-online.org/ 2003 Making Medicine Mercury Free Award Winners Kaiser Permanente Sacramento Medical Center Sutter Davis HospitalSacramento, California Davis, California Kaiser Permanente South San Francisco Medical Center Sutter Roseville Medical Center South San Francisco, CaliforniaRoseville, California Kaiser Permanente West L.A. Medical Center University of California Medical CenterLos Angeles, California San Francisco, California Mills-Peninsula Health Services Sutter Warrack HospitalBurlingame, California Santa Rosa, California Sutter Lakeside Hospital Sutter Auburn Faith HospitalLakeport, California Auburn, California Sutter Medical Center of Santa RosaSanta Rosa, California Sutter Medical Center, SacramentoSacramento, California UCSF/Langley Porter Psychiatric InstituteSan Francisco, California

  4. California Mercury (Hg) Elimination Leadership Program (HELP)

  5. California HELP Award Program • Step One – Sign up to be a Partner • Step Two – Attend training • Step Three – Submit spreadsheet and certification • HELP Award !!

  6. Mercury Assessment Toolkit • Excel Spreadsheet • “Pareto” chart (Descending Contribution) • Cumulative Percentage

  7. Assessment “Tool”

  8. Total Hg in Facility

  9. Hospital Before Sphygmomanometer Removal

  10. After removal of sphygmomanometers and bougies • Total mercury reduced from 13,816 grams (30.4 lbs.) to 480 grams (1.06 lbs) • This represents a 96.5% mercury removal in the hospital

  11. Business or Action Plan • Recommendations • Develop Priorities for removal of mercury containing devices • Follow-up – implement removal plan

  12. The Mercury Assessment Where to look Whom to ask What to look for

  13. Bougies and other GI Devices • Bougies in Outpatient Surgery • Bougies in Gastroenterology Lab • Blakemore tubes in ER • Blakemore tubes in Supply • Miller-Abbott Tube

  14. Bougies – over 10 kgs. Of Hg

  15. A complete set of tungsten gel-weighted bougies

  16. Miller-Abbott Tube 117 grams of Hg

  17. Sphygmomanometers • Bedside • Examination Room • Physical Therapy Exercise Room • In Drawer

  18. Typical sphygmomanometer

  19. Sphygmomanometer in patient room

  20. Hidden sphyg stored in drawer in storage room

  21. Aneroid Sphygmomanometers

  22. Replacing mercury-containing sphygs with aneroid sphygs

  23. Bulk Mercury • Associated with Sphygmomanometers • Kit in Engineering • Bottles in Engineering • Other

  24. Bulk Hg used for sphyg maintenance

  25. Bulk Hg for sphyg maintenance – one bottle of “new” Hg and one bottle of Hg waste

  26. Sphyg service kit – Contained bottle of Hg – (see previous slide)

  27. Wee Bag O’Mercury – over 600 grams of Hg

  28. Replacement Device This device uses air pressure – no Hg (Honan Balloon)

  29. Barometers • Pulmonary Laboratory

  30. Mercury from broken barometer

  31. Thermometers • Neonatal Nursery • Laboratory • Refrigerators • Barometer with attached Thermometer

  32. Laboratory thermometers

  33. More Laboratory thermometers NIST-traceable thermometer

  34. Chemicals in the laboratory With this Zinc chloride can cause irritation of the nose and throat and conjunctivitis Replace Mercuric chloride is highly toxic

  35. Switches • Vacuum system barostats • Boiler Barostats • Boiler water level switch • Mercury Room Thermostat • Sump pump switch • X-ray tube

  36. Thermostats containing mercury

  37. Non-mercury thermostat

  38. Hg devices in mechanical rooms Bank of Hg switches – not in use

  39. Hg devices in mechanical rooms Stored devices Devices in a panel

  40. More Hg Devices In mechanical rooms

  41. Boiler Room

  42. Fluorescent Lighting • Fluorescent tubes • Bilirubin lights

  43. Other devices Tip switch – 1.25 grams of mercury

  44. Look for Hg devices -

  45. For more information • The Hg Toolkit and other information on pollution prevention – DHS Medical Waste Management Program • www.dhs.ca.gov/medicalwaste • Skubo@dhs.ca.gov • 916-449-5684

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