REPORT FROM THE CONFERENCE “EU MERCURY PHASE OUT IN MEASURING AND CONTROL EQUIPMENT”I. Introduction <strong>and</strong> background<strong>Mercury</strong> is an extremely toxic metal that is now ubiquitous <strong>in</strong> the environment due to centuries ofunchecked releases. When airborne, mercury is a transcont<strong>in</strong>ental pollutant that, once deposited,bioaccumulates <strong>and</strong> bioconcentrates as it makes its way up the food cha<strong>in</strong>. Exposure to mercury,even at low levels, has been l<strong>in</strong>ked to central nervous system damage, kidney <strong>and</strong> liver impairment,reproductive <strong>and</strong> development disorders, defects <strong>in</strong> fetuses <strong>and</strong> learn<strong>in</strong>g deficits.<strong>Mercury</strong> is used extensively <strong>in</strong> many <strong>in</strong>dustry sectors such as <strong>in</strong> the chlor-alkali production, as wellas <strong>in</strong> products – lamps, dental amalgams, switches <strong>and</strong> relays, as well as <strong>in</strong> equipment used formeasur<strong>in</strong>g <strong>and</strong> control purposes. <strong>Mercury</strong> conta<strong>in</strong><strong>in</strong>g sphygmomanometers are still used <strong>in</strong><strong>Eu</strong>ropean hospitals <strong>and</strong> by general practitioners <strong>and</strong> are therefore a source of mercury release to theenvironment <strong>and</strong> risk to health, when broken or leak<strong>in</strong>g. However, these measur<strong>in</strong>g devices all havecomparable <strong>and</strong> suitable alternatives that do not conta<strong>in</strong> mercury.The <strong>Eu</strong>ropean Commission (EC) Measur<strong>in</strong>g devices directive (2007/51 EC) was adopted <strong>in</strong> 2007<strong>and</strong> <strong>in</strong>cludes a ban on mercury <strong>in</strong> new fever thermometers for all uses (consumer <strong>and</strong> professional)by April 2009. The ban also covers all other measur<strong>in</strong>g <strong>and</strong> control devices for consumer use only.Accord<strong>in</strong>g to the directive, the EC will release a report by October 2009 on the availability ofmercury-free measur<strong>in</strong>g <strong>and</strong> control devices (ma<strong>in</strong>ly sphygmomanometers) that are technically <strong>and</strong>economically feasible for professional use <strong>in</strong> healthcare.In preparation for mak<strong>in</strong>g its f<strong>in</strong>d<strong>in</strong>gs, the EC started collect<strong>in</strong>g <strong>in</strong>formation ma<strong>in</strong>ly on the technicalaspects, availability <strong>and</strong> reliability of mercury-free sphygmomanometers <strong>in</strong> healthcare. In addition,one of the EU scientific committees (SCENIHR – on Emerg<strong>in</strong>g <strong>and</strong> Newly Identified Health Risks),is expected to provide its op<strong>in</strong>ion <strong>in</strong> autumn 2009 on the same issue.Given these developments, the <strong>Eu</strong>ropean Environmental Bureau (<strong>EEB</strong>), Zero <strong>Mercury</strong> Work<strong>in</strong>gGroup (ZMWG) together with Health Care With<strong>out</strong> Harm <strong>Eu</strong>rope (HCWH) organised a conferenceto provide <strong>in</strong>put <strong>in</strong>to this important debate by foster<strong>in</strong>g exchange of valuable <strong>in</strong>formation betweenexperts <strong>and</strong> policy makers.The objectives of the conference were to discuss:• The technical <strong>and</strong> economic feasibility of hospitals <strong>and</strong> healthcare <strong>in</strong>stitutions transition<strong>in</strong>gto mercury-free sphygmomanometers;• Experiences of stakeholders such as Member States <strong>and</strong> <strong>Eu</strong>ropean hospitals that have <strong>phase</strong>d<strong>out</strong> mercury conta<strong>in</strong><strong>in</strong>g measur<strong>in</strong>g devices;• The availability <strong>and</strong> adequacy of mercury-free measur<strong>in</strong>g sphygmomanometers also forcalibration, validation <strong>and</strong> special cases.Background• <strong>Mercury</strong> sphygmomanometers conta<strong>in</strong> a large amount of mercury per unit (ab<strong>out</strong> 80g to 100g).The consumption of mercury <strong>in</strong> measur<strong>in</strong>g equipment is estimated to be some 7-17 tonnes ofmercury per year <strong>in</strong> the <strong>Eu</strong>ropean Union. This total <strong>in</strong>cludes sphygmomanometers, <strong>in</strong> whichthere is approximately 3-6 tonnes of mercury distributed <strong>in</strong> 30,000 to 60,000 units.• Risks associated with mercury sphygmomanometers emerge when they are broken, <strong>in</strong> case ofspillage or leakage. Once released, mercury either can go airborne or, depend<strong>in</strong>g on the surfacearea permanently contam<strong>in</strong>ate it, if not taken care properly <strong>and</strong> adversely affect staff <strong>and</strong>patients’ health <strong>in</strong> the hospitals. <strong>Mercury</strong> sphygmomanometers also pose a risk to theenvironment <strong>and</strong> health when they enter the waste stream, when l<strong>and</strong>filled or <strong>in</strong>c<strong>in</strong>erated.• Alternatives to mercury sphygmomanometers do exist, such as aneroid or digitalsphygmomanometers (based on the auscultatory technique) or semi-automated or automatedblood pressure devices (based on the oscillometric technique). They are sold from manymedical equipment suppliers. Many mercury-free models are validated <strong>and</strong> satisfy the criteria3
REPORT FROM THE CONFERENCE “EU MERCURY PHASE OUT IN MEASURING AND CONTROL EQUIPMENT”of the professional medical organisations such as the British Hypertension Society <strong>and</strong> the<strong>Eu</strong>ropean Society for Hypertension. They have been proven to have no problems <strong>in</strong> any k<strong>in</strong>d ofcl<strong>in</strong>ical diagnosis or monitor<strong>in</strong>g – even for special medical conditions such as arrhythmia, preeclampsia,diabetes or hypertension <strong>and</strong> other vascular diseases.• It was noted that generally mercury sphygmomanometers are less expensive than mercury-freealternatives. However, when other factors are taken <strong>in</strong>to consideration such as mercurypollution <strong>and</strong> release, exposed staff <strong>and</strong> patients, special <strong>in</strong>frastructure, staff tra<strong>in</strong><strong>in</strong>g, hazardouswaste cleanup expenses, then the total cost of mercury-free alternatives is far cheaper. Studieshave concluded that the overall real cost of a good aneroid sphygmomanometer is only ab<strong>out</strong>one third of a mercury sphygmomanometer.4
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