2. Mercury containing product can be found almost
anywhere in healthcare facility
• Medical insrument
• Clinical laboratory chemical to electrical equipment
• Cleaning solutions

3. Medical instrument
Fever thermometer (including used in home
care)
 Spygmo manometer
 Commercial manometer
 Gastrointestinal diagnostic equipment
Feeding tube

4. 1. Mercury is naturally occuring heavy metal
2. At ambient temperature and pressure, mercury
is silvery-white liquid that readily vaporize and
stay at atmoshpere for up one year
3. When release to the air, mercury is transported
and deposit globally
4. mercury accumulates in lake bottom sediment,
transformed into its more toxic organic form,
methyl mercury (accumulation fish tissue

5. 1. it's highly toxic
2. It may be fatal if inhaled (80% mercury
vapour is aborbed in blood throughthe lung)
3. it harmful if absorbed through skin

6. METHYLMERCURY
 It's harmful efects to the nervous system,
dygestive, respiratory, immune system, and
kidney more causing lung damage
 Adverse health efects (exposure) : tremor,
impaired vision and hearing, paralysis,
insomnia, emotional instability, development
deficit (fetal), development delays (childhood)

7. PATIENT SAFETY
 Several european countries (sweden, france, denmark,
norway banned mercury containing thermometer from 1991)
 A european wide facilities resoution on the issue of
mercury pending
 In the USA hospitals have significant reduced the amount
of mercury found in their facilities
 more than 1000 hospitals (USA) eliminate mercury medical
device and more than 90% pharmacy chains have stopped
selling mercury fever thermometer

9. • A gradual phase out plan for mercury elimination in
the health care facilities (how to prevent the release
of mercury into the environment).
• Need best management practices for mercury
elimination is to replace the mercury containing
product with mercury-free products

10. • It may be not be possible to replace all the
health care facility's mercury products at once.
• Need the effective procedures for handling
and environmentally safe management of
mercury containing products, need mercury
recycling facilities

11. In order to ensure safety and contamination control,
mercury elimination in facility must be consistent and
predetermined with the goal of,
- Raising awareness on the dangers posed by mercury
and mercury containing devices
- Developing a clear preference for the use of
alternatives to mercury-containing devices
- Preventing the further release of mercury to the
environment through proper disposal

12. • Conducted a mercury audit
• Developed and managed a mercury
containing devices

13. • Drafted and implemented a purchasing policy that
require a vendors to sign a mercury content
disclosure agreement
• Conducted a facility wide information campaign
and employee education on consequences of
continued mercury use

14. • Educate people on how to safety clean-up
• How temporarily store broken mercury thermometers
• Need the written information at the health care
facilities

15. • It is not yet feasible for the health care facility
to replace all its mercury
sphygmomanometer make sure there is a
policy or guideline for its safe use and
handling.

16. The policy or guideline for example;
- Check for possible mercury leaks before and
after use
- Mark the casing with" containing mercury".
- After use safely return to its proper storage
- Wear appropriate protective clothing and work
within a hood to provide ventilation.

17. • Use a mercury spill cleanup kit in house or in health
care facilities (one kit for every 20 beds).
• The kit contents : 4-5 zip lock bags, trash bags (2-6
mm thicks), rubber or latex gloves, paper towels,
cardboard paper, syringe (without needle),
masking or duct tape, flaslight, powered sulfur
(optional), marker for labeling

18. • Cleanup instruction
1. Remove all jewelry from hands and wrists so the
mercury does not combine (amalgamate) with the
precious metals. Change into old clothes and shoes
that can be safely discarde should they happen to
become contaminated
2. Remove everyone from the area where cleanup will
take place. Shut door of impacted area. Turn Off
inferiorr ventilation system to avoid dispersing mercury
vapor.
3. Mercury can be cleaned up easily from the following
surfaces; wood, linoleum tile. If a spill occurs on carpet,
curtains, upholstery or other like surfaces. Cut and
remove the affected portion of the contaminated
carpets for disposal

19. 4. Put on rubber or latex gloves
5. If there are any broken pieces of glass or sharp objects, pick
them up with care,
6. Place all broken objects on a paper towel. Fold the paper towel
and place in a zip lock back. Secure the bag and label It.
7. Locate visible mercury beads. Use squeegee or cardboard to
gather mercury beads, keep mercury from becoming
ubcontrollable. Take a flashlight hold it at low angle close to a
darkened room and look for additional glistening beads of
mercury.
8. Use the eyedropper to cllect or draw up the mercury heads
Squeeze mercury on to a damp papel towel. Place in a zip lock
bag and secure.

20. 9. After you remove larger beads, put shaving cream on top
of a small paint brush and gently "dot" the affected area to
pick up smaller hard to see beads alternatively use the
duct tape. Place in zip lock bag and secure. Make sure to
label the bag
10. Optional step. Use powdered sulfur to absorb the beads
that are too small to see. (there may be a color change
from yellow to brown and it binds the mercury and
suppressed the vapor of any missing mercury) (note: when
using powdered sulfur, do not breathe in the powder as it
can be moderately toxic)
11. Place all materials used with the cleanup, including goves
in a trash bag. Place all mercury beds and objects into the
trash bag. Secure it and label it.

21. 12. Remember to keep the area well ventilated
to the outside for at least 24 hours after your
successful cleanup. The all material used in
cleanup should be stored and contained in a
safe place

22. • Mercury containing products not in use must be
stored in non breakable containers with the tight-
fitting lids. Labeled it.
In health care facilities.
- Rooms where mercury containing products shall be
tested periodically using a mercury

23. There are some conditions,example;
- Shall have adequate roof and walls to prevent rain
water
- Floor must be constructed as a concrete or steel, if
mercury is a liquid form , shall be surrounded by a
bund wall to contain spills
- Visible warning signs and notices
- Drainage facilities shall be installed

24. There are some conditions example;
- Emergency showers and eyewash units with adequate
water supply
- Fire fighting facilities
- Adequate security,
- Project loading and unloading of containers shall be
observed.
- A workable emergency plan and trained personnel to
handling containers in storage

25. • How to recognizing the unnecessary risks posed by the
continued use of mercury containing products in the
health care system
• a Hospitals have a guidelines for the gradual phase out
of mercury or hospital shall make a mercury minimization
program based on regulation.