General Introduction

We recognize the need to develop, or support the development of incentives to move pollutant generators to policies and practices that rely more heavily on pollution prevention, rather than on management practices of pollution of disposal and release. This is especially true for persistent toxic pollutants which are sometimes managed in ways that essentially shift the pollutant from one media to another.

Keeping mercury out of water and the atmosphere is critical to our health and safety.

The purpose of this program is:

1. to introduce you to the dangers of mercury in the environment, and
2. to identify preventive measures against environmental pollution by mercury from medical facilities.

Alternatives to mercury use in health care settings are identified, and proper management techniques for handling used mercury and mercury spills are described.

Mercury in Medical Care Settings

Mercury or mercury compounds are found in many instruments regularly used in medical institutions such as blood pressure monitors, dental amalgam, thermometers and thermostats. Mercury and mercury-containing products are used in patient areas and pathology labs, in clinical procedures (such as x-rays), and in medicines.  At least 20 different medical products contain mercury, and many mercury-containing solvents and degreasers are found in labs, housekeeping departments, kitchens, and maintenance areas. Storage rooms may also be filled with used, damaged, or outdated equipment or supplies that contain mercury. Mercury is an ingredient in some proprietary formulas used to manufacture medical and industrial supplies.

Breakage, waste disposal, and spills from these products release mercury to the atmosphere or to drains, where it can persist for many years. Some products that formerly contained mercury are no longer manufactured. However, older products are still part of the environment. In fact, broken or obsolete equipment is often the primary source of mercury waste at many hospitals and clinics.  Industrial and chemical uses of mercury are manifold in the medical community: mercury is present in fluorescent and high-intensity lamps, thermostats and switches, and a variety of generators, manometers, and batteries.

Non-medical uses of mercury are also present in a variety of products: cleaning solutions, preservatives, paints, and antifouling agents for wood and other surfaces. Some uses of mercury are purely playful or convenient, such as singing greeting cards, talking refrigerator magnets, lighted athletics shoes, and toys. Patients, visitors, and employees bring these products into the facility.

According to the EPA's proposed rule for medical waste incinerators, incinerators are a significant source of mercury emissions to the atmosphere. Medical care facilities may also emit mercury through accidental spills and releases, that is, through discharges to wastewater and landfills. The amount of mercury in such releases may be quite small. Still, any release is costly and may add to mercury's buildup in the environment. Mercury spills may result in additional fish advisories, and in some circumstances, mercury spill cleanups can be expensive. The guidelines recommended in this program will help minimize or eliminate mercury releases from medical facilities.