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”Some substitutes to mercury devices:Special Mercury spill kit in case of breakage, leakageHeart of England NHS Foundation Trust uses tympanic thermometers which is an infra redmethod of measuring temperature in the ear. The Hospital has 200 of these in use whichwould cost £73.00 each. However because they are contracted to buy disposable covers forthe instruments - the instruments are provided free of charge under the contract (in yearending 1.3.2009 1,280,800 covers were purchased costing £56,902.52). Calibration is doneinternally by trained medical engineers departments who have been trained on calibratingequipment by the companies. The calibrating equipment that is used also has to be calibratedand is sent away every 12 months.Electronic blood pressure machinesThey are multi functional and are not only used to measure blood pressure. They also givean electronic record which mercury blood pressure machines do not give. The average use isone per eight beds (~200 machines in use throughout the organisation). Mercury calibrationdevices are not used, instead an electronic one is used and there is a manual one supportingit as well. It is calibrated by the manufacturers annually. Colored out-of-date stickers areused and there is an electronic database where the information is kept. It is the manager’sresponsibility to make sure that the equipment is functional and not out of date.In different instances, the electronic devices are used followed by the backup device. Forhypertension and pre-eclampsia electronic device are supported by manual devices.Training is particularly important: In use of all types of machines Training in calibrating equipment Training to recognize when to revert from electronic to manual – that can probably onlycome with experience. Knowing when the machine is not functioning or does not appear tobe functioning correctly and when to step up to manual. Training on recognizing status of equipment i.e. that is out of calibration Training in mercury spillage procedures.29
REPORT FROM THE CONFERENCE “EU MERCURY PHASE OUT IN MEASURING AND CONTROL EQUIPMENT”Arguments for retaining mercury devices: More personal in touch with patient Accuracy Cost of replacement Problems with cuff sizes for standard electric.Arguments against retaining mercury devices: Environmental impact Health and Safety issues –spillages Ease of use Flexibility of some electrical equipment to perform multiple functions and also recordmeasurements over a period of time.6. The experience of Rezekne Hospital as a mercury-free hospital(Presentation by Jelena Stepule, Rezekne Hospital, Latvia)Rezekne Hospital is a multipurpose emergency medical health care institution with a total amountof 385 beds. The departments of the hospital provide medical assistance and services for more than20 profiles. The Hospital serves residents of Rezekne city and region. In some profiles the hospitalalso serves people of other regions of Latgale, e.g. Ludza, Preili and Daugavpils. There are morethan 130 000 inhabitants in the service area. Rezekne Hospital is a municipal state institution andemploys 77 physicians, 220 nurses, 75 nurse assistants, 73 hospital attendants and 71 other workers.There are 30 departments in the Hospital: Emergency medical assistance and patient receiving –room, Anesthesia and Intensive Care Unit, Necrology Division, children’s department, Gynecologicand obstetric department, neurology and neurosurgery department, therapy department,traumatology department, Surgery department, Infectious diseases department Hemodialysisdepartment, Pathology department, Sterilization department, Cabinet of blood, Pharmacy, ClinicalLaboratory, Ray diagnostic department, Physical medical department.Rezekne Hospital is involved as a pilot hospital in the UNDP/GEF project “Demonstrating andPromoting Best Techniques and Practices for Reducing Health Care Waste to Avoid EnvironmentalReleases of Dioxins and Mercury”. 8 The overall objective of the project is to reduce environmentalreleases of dioxins and mercury by demonstrating and promoting best techniques and practices forreducing and managing health care waste in a number of countries and regions. In the framework ofthe project the improvement of the waste management (collection, treatment and disposal) will beimplemented in the hospital as well as the manual for the personnel will be developed and tested.The hospital switched to mercury free thermometers three years ago. Mercury sphygmomanometersare not in use since 1998 - 2000 (and this refers to most of the hospitals in Latvia).Problems with mercury use: Mercury evaporates at room temperature with a rate of 0.002 mg of 1cm 2 surface within 1hour and the vapor has no color and fragrance. In the case of breakage the harmful substances (in the shape of small balls) are difficult tocollect. Mercury is harmful to the environment and toxic to the body. While in the room it slowlyevaporates. In humans the effects of inhalation may occur even after several years.8 http://www.gefmedwaste.org/article.php?list=type&type=330
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Eu Mercury phase out in Measuring and Control Equipment - EEB

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