Reducing Mercury Use in Healthcare
Promoting a Healthier Environment
A How-To-Manual
The purpose of this manual is to help hospitals start mercury pollution prevention
programs or accelerate programs that have already begun. New federal regulations greatly
reduce the amount of mercury that is allowed to be discharged from a municipal wastewater
system or an incinerator. By implementing the best management practices described in this
manual, you can reduce the level of mercury in the environment and avoid the need for
increased regulations in the years to come.
The manual offers general guidance on how to initiate a program and technical guidance
for implementing the program. The manual includes:
- Information about mercury and its impact on people and the environment (Chapter 1)
- Overview of pollution prevention strategies (Chapter 1)
- How to start a mercury pollution prevention program in your hospital
(Chapter 2)
- How to monitor your program, educate staff and measure success
(Chapter 2)
- Alternatives for mercury-containing products
(Chapter 3)
- Best management practices for handling, recycling and disposing of mercury-containing
products still in use
(Chapter 3)
- Contacts for further information, case studies and other information
(Appendices)
about the report, "Reducing
Mercury Use in Health Care" |
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Mercury in Medical Facilities
The following lists show some of the common uses of mercury that may be found in
hospitals.
Medical uses:
- Thermometers
- Sphygmomanometers (blood pressure monitors)
- Esophageal dilators (also called bougie tubes)
- Cantor tubes and Miller Abbott tubes (used to clear intestinal obstructions)
- Feeding tubes
- Dental amalgam
- Laboratory chemicals (fixatives, stains, reagents, preservatives)
- Medical batteries
Nonmedical uses common in medical settings:
- Cleaning solutions with caustic soda or chlorine that were contaminated with mercury
during the production process
- Batteries
- Fluorescent lamps and high-intensity lamps
- Non-electronic thermostats
- Pressure gauges
- Some electrical switches used for lights and appliances
More complete lists can be found in Appendix A and Appendix B. There is minimal risk of
mercury exposure during normal use of products that are handled correctly. However,
problems may occur if the mercury in a product is exposed to air, or if a product is not
properly discarded so as to keep mercury out of the environment.
Mercury Pollution Prevention
Concerns about the health impacts of mercury are leading to mercury pollution
prevention programs at the federal, state and local levels. The highest priority of any
pollution prevention program is source reduction, which means not using mercury in the
first place.
For example, some states have banned the deliberate use of mercury in certain products
for which alternatives are available.
When adequate mercury alternatives are not avail able and mercury must be used, it may
be possible to recycle it. Recycling is the second priority of mercury pollution
prevention. Disposal of mercury should be the last resort. It is expensive and increases
the potential of mercury being dispersed into the environment.
Pollution prevention programs are driven by voluntary efforts and by increasingly
strict federal and state regulations. Some of the regulations govern occupational
exposures and waste disposal. Other regulations result from the federal Clean Air Act
Amendments of 1990. The 1995 federal Great Lakes Water Quality Guidance (also referred to
as the Great Lakes Initiative) sets strict water quality standards for mercury in the
eight Great Lakes States. (For contacts for regulatory information, see Appendix C.)
Best Management Practices (BMPs) for the management of mercury within hospitals might
involve:
- Use of alternatives for products that contain mercury
- Recycling of mercury-containing products when they can no longer be used
- Correct handling and disposal of mercury,mercury-containing equipment and laboratory
chemicals
- Proper cleanup of spills involving mercury
- Hospital policies that support BMPs
The BMPs are intended to result in the greatest reduction in mercury discharge to the
environment that is currently feasible for hospitals.
Benefits of Mercury Pollution Prevention
Mercury pollution prevention in the hospital provides many benefits:
- Protection of human health and wildlife by reducing occupational exposures and releases
of mercury to the air, water and land from wastewater discharges, spills, landfilling or
incineration
- Avoidance of the costs associated with the use of mercury, such as disposal or
recycling, collection and storage prior to disposal, paper work for tracking hazardous
waste disposal, training and equipment for spill response, training for hospital employees
who handle mercury-containing products, and liability for environmental problems or worker
exposure
- Avoidance of increased regulation in the future
- Increase in the public's awareness about the dangers of mercury through publicity about
the hospital's program
- Enhancement of the positive public image of the medical facility due to publicity about
success stories
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