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Eu Mercury phase out in Measuring and Control Equipment - EEB

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”mean 1006.0 million"mentally retarded"6.0 million"gifted"406080100120 140I.Q.7 13160Effects of a small shift <strong>in</strong> IQ distribution <strong>in</strong> a population of 260To calibrate these devices the pressure measur<strong>in</strong>g end of it is taken of, the cuff <strong>and</strong> the tub<strong>in</strong>g, etc –the device is then hooked up to two read<strong>in</strong>g devices with a Y tube – one is a mercury manometer<strong>and</strong> the other is one of the other devices. Two different k<strong>in</strong>ds of measur<strong>in</strong>g manometers are thusneeded to calibrate.The American Heart Association stated some years ago that it is surpris<strong>in</strong>g that nearly 100 yearsafter it was first discovered <strong>and</strong> subsequent recognition of its limited accuracy, the Korotkofftechnique for measur<strong>in</strong>g blood pressure has cont<strong>in</strong>ued essentially unchanged. That is auscultation ofthe sounds produced by a beat<strong>in</strong>g heart as you hear it through a stethoscope. The “gold st<strong>and</strong>ard“for cl<strong>in</strong>ical blood pressure measurement has always been read<strong>in</strong>gs taken by a tra<strong>in</strong>ed health careprovider us<strong>in</strong>g a mercury sphygmomanometer <strong>and</strong> the Korotkoff sound technique. However, thereis <strong>in</strong>creas<strong>in</strong>g evidence that this procedure may lead to the misclassification of a large numbers of<strong>in</strong>dividuals.So what is the first <strong>and</strong> largest problem with the accuracy of this technique <strong>and</strong> this measurement?It is the person between the stethoscope ear pieces. If the person does not know what he/she shouldbe listen<strong>in</strong>g for or if the person is not listen<strong>in</strong>g well then there will be mistakes.There is an epidemiological study <strong>in</strong> which they tried to st<strong>and</strong>ardize across national sett<strong>in</strong>gs <strong>and</strong>between a multitude of providers <strong>in</strong> a level of accuracy for epidemiology that you really don’t have<strong>in</strong> cl<strong>in</strong>ical practice. In do<strong>in</strong>g so you identify a number of errors <strong>and</strong> <strong>in</strong>ter-observer biases thatoverwhelmed much of the rest of the <strong>in</strong>accuracy.36

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