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Workshop questions use of mercury in healthcare
By Ratna Singh
Published in toxicslink.org, 02/07/2004
On June 30, Toxics link organised a workshop, at the
India International Centre, to raise the issue of usage of mercury in
the healthcare sector. The panelists included Dr M. Suba Rao, Additional
Director, MoEF; Dr T.K. Joshi, Director of Centre for Occupational and
Environmental Health; Dr Sudhir Joseph, Deputy Director of St. Stephen’s
Hospital; and Ravi Agarwal, Director of Toxics Link.
A mercury information pack containing: a report on
the usage of mercury in health care sector; an information flyer for dentists;
and an information flyer for hospitals and a poster was released during
the event.
The workshop started with a brief welcome and introduction
by Agarwal. He made some shocking revelations such as:
- India is the second largest user of mercury in
the world, after China.
- Mercury is not merely an industrial hazard but
a threat in healthcare units as well.
- Mercury has been discovered to be the most potent
neuro-nephro toxin.
- The awareness levels of the hazards of mercury
are very low.
Following this was Anu Agrawal’s presentation,
which highlighted the condition in five Delhi hospitals and one Patna
hospital. For each problem brought into the forefront, a reasonable solution
was provided.
This well-rounded presentation was followed by a panel
discussion. The panelists answered several queries from the audience and
gave useful information in the course of the discussion.
Dr Subba Rao appreciated the efforts of Toxics Link
in raising this issue and expressed his willingness in taking up the recommendations
from the meeting. He said that politically it is very difficult to coordinate
any action against mercury within the different ministries and states.
He said that each minister has to take responsibility for his own domain
and make sure that industries and health care units are running in accordance
to rules and regulations.
Dr Joseph stated autoclaving and microwaving as some
useful alternatives to incineration, while answering a question. St. Stephen’
hospital had started working on the issue of mercury about 18 months ago
and they have taken some useful measures to lower the risks of mercury
poisoning. Some of the hospital’s noteworthy achievements are:
- Complete removal of mercury thermometers and replacement
with digital ones
- Annual mercury spillage has been reduced to 0.9
kg from 2-3 kg.
- Handing over 1.6 kg of collected mercury to a thermometer
manufacturer.
Dr Joseph said the hospital was trying to replace all
mercury blood pressure apparatus with digital ones, but they have been
unsuccessful so far due to the heavy taxes imposed on these instruments.
The government needs to lower the 40% tax on such apparatus in order for
hospitals to invest in them.
He ended by declaring that the discussion needs to
be on ‘What to do to cut down mercury usage?’ rather than
on ‘Is there a need to cut down on usage?’
Dr Joshi presented facts and case studies on lead and
mercury poisoning. Differentiating between the two, he said that while
lead poisoning can be treated completely, mercury poisoning cannot. Mercury
has various levels of toxicity in the human body. Being highly permeable
and soluble, it passes all the three barriers of the body, hence seeping
into the blood and the brain tissues. Once this happens, it becomes extremely
difficult to remove it from the body. The half-life of mercury also varies
in different parts of the body. While in the blood it is just a few weeks,
it stays for years in the brain. All these factors make mercury poisoning
even more difficult to deal with. No medicine has yet been discovered
that could cure mercury poisoning, as heavy metals cannot be destroyed.
In addition, it is very hard to diagnose a case of heavy metal poisoning.
Dr Joshi then commented on the state of heavy metal
poisoning in the country. He said:
- The hospital staff and nurses are absolutely unaware
of the dangers of mercury spills and are hence ignorant of the steps
required to clean them up.
- There is no home safety in the country. Most of
the homes do not keep mercury thermometers and other medical equipment
out of reach from children.
- The country lacks a specialized Human Exposure
Assessment laboratory for research and diagnosis of such poisoning cases.
Dr Joseph stated that several hospitals still use old-fashioned
mercury instruments due to their reliability. But digital equipment has
been improved tremendously over the past few years. Not only have they
become more reliable, they are also extremely easy to calibrate. He ended
by stressing the need to educate doctors, nurses and other hospital staff
on toxicology and waste management.
Toxics Link released the following publications at
the event
1. Lurking Menace: Mercury in the healthcare sector. The report documents
the usage pattern of mercury products in five large hospitals of the city
and presents the views of leading dentists in the city regarding dental
amalgam. The report presents, in the form of case studies, the annual
consumption of thermometers and sphygmomanometers in an average-sized
hospital based on which a conservative calculation has been made regarding
the release of mercury by the hospitals and dental clinics. The report
also presents the health impacts of mercury and makes recommendations
for policy-makers, doctors as well as for dentists.
2. Information flyer for dentists: This is a four-page information sheet,
which highlights the dangers of mercury to the dentists as well as their
families.
3. Information flyer for hospitals: This document highlights the places
at which mercury is used in a healthcare institution and urges them to
move away from it. Steps to manage mercury in the hospital as well as
to safely contain it have also been highlighted.
4. Poster: This A4 size poster is targeted at the nurses, to increase
their awareness regarding the dangers associated with mercury as well
as to help them in knowing the correct procedures in safely managing and
containing it.
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