Eu Mercury phase out in Measuring and Control Equipment - EEB

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REPORT FROM THE CONFERENCE “EU MERCURY PHASE OUT IN MEASURING AND CONTROL EQUIPMENT”display at the correct points are different, leading to errors”.In the presenter’s view these are valid points, but in response there are many sphygmomanometersthat have been validated and recommended for special groups. To say that manysphygmomanometers have not been validated is not really a reason to keep mercurysphygmomanometers. Likewise aneroid sphygmomanometers need to be regularly calibrated, andvarious models that have been validated have been shown to be extremely accurate if they aremaintained and calibrated properly. Finally, digital displays, where the numbers change on an LCDscreen, are not necessary if they pose a problem for some people.The question is not whether the phase out of mercury sphygmomanometers for professional use isviable, but whether the health care sector is ready to manage this change.Discussion• On a comment on what is the extent of and on whether there is available data on the effect frommercury used in mercury-sphygmomanometers, Concorde commented that there are numerousadverse health effects from mercury emissions and mercury releases. The effect on theenvironment is that there are releases to the waste stream, water and to air. Whether themercury is coming from mercury sphygmomanometers-waste or whether it is coming from coalfired power plants, there is still unnecessary pollution and release to various environmentalmedia which needs to be reduced, considering that this is feasible, even if this appears small inrelation to other potential sources.• In the cost calculation discussed on various studies as described in the Concorde report forEEB, there is an estimate on the overall health effect of certain releases or emissions ofmercury. The number that is given there is based upon air emissions and this is what is figuredinto the cost calculation. That was based on numbers that were built up around discussions ofemissions from coal fired power plants in the US from the past 5 or 6 years. In that sense thepotential emissions from measuring devices are quantified.• Concorde clarified further that on one of the websites 7 there are 8 models ofsphygmomanometers that have been validated for use in all clinical cases. If it is only a matterof replacing the mercury column with an aneroid dial or some other manometer but keeping theauscultative approach in order to be able to listen to the appropriate sounds, there does notseem to be any intrinsic reason why one could not replace that manometer device with amercury-free manometer. But when the validation studies are done the protocols say that thosestudies have to be done against the mercury column or against a mercury sphygmomanometerand so those non-mercury devices have been validated against mercury sphygmomanometers.5. To be or not to be Hg Free – that is the question! A case for theMercury Free Hospital(Presentation by Paul Williams, Facilities Health and Safety Advisor, Heart of England NHSFoundation Trust, UK)Mercury is being phased out in all types of equipment in ‘Heart of England NHS Foundation Trust’hospitals. However, there are still some mercury containing instruments that have not beencompletely phased out. To be or not to be mercury free? This is the question hospitals have to faceup to.7 http://www.dableducational.org/sphygmomanometers/devices_3_abpm.html27
REPORT FROM THE CONFERENCE “EU MERCURY PHASE OUT IN MEASURING AND CONTROL EQUIPMENT”Heart of England NHS Foundation Trust is an inner city hospital with 10 000 staff and 1734 beds. .It is estimated that approximately 95% of the staff are not aware of the harmful effects of mercury.There are a lot of problems linked to the use of mercury such as:Breakage of instrumentsSpillage Procedure – what to do when an instrument breaks?Location of kitsFire brigade call outs when spillage occursContaminating other waste streamsStorage pending disposalCosts of disposalCosts of disposal kitsSome answers on how to remove mercury from our hospitals. Establish one person to have overall responsibility for managing use and disposal ofmercury in the organization. They can coordinate, give advice, know where the spillage kitsare, etc. Who pays for the mercury disposal and associated costs? Have a budget set up straight awayso there is no arguing over who is going to pay. Have a responsible department. For instance, the speaker’s pathology department has adedicated chemical store which stores the mercury devices in a proper and correct manner. The spillage procedure – what to do in a spillage? Heart of England NHS Foundation Trusthas clear guidance instructions on that. Knowing where the mercury is sent, so that it does not get sent to the third world orsomewhere where it is not properly dealt with and disposed of. Ensure that correctlegislative procedures are followed in the disposal process.In case there is a spillage, the Heart of England NHS Foundation Trust hospital has spillage kits(see picture below) that are correctly labeled.Mercury sent for disposal should be correctly packaged and labeled pending transportation.The following are some considerations to make when replacing mercury devices with electronicalternatives: The costs of replacement. Establishing an inventory. This will provide listing of all equipment and detail such data asserial number, location of equipment, equipment type and the next testing date. Maintenance of Electrical items, especially PAT Testing. The electrical equipment has to betested for its electrical functionability. Calibration. Use of calibration expiry date stamps. Responsibility for ensuring above.Who in the organization is going to be made responsible for making sure the rules arefollowed and determine what the rules are. Get the rules written down on who ultimately isresponsible and to whom you should report to. Policy to be written and then monitored as tocompliance. Training.28
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