Mercury exposure during the prenatal period has been linked to serious birth defects, and also poses occupational risk in many workplaces, including healthcare facilities. As part of our mission to eliminate toxins in the environment, our Center is an advocate for mercury elimination in hospitals. Based at Hackensack University Medical Center, we have worked to reduce mercury wherever possible on our own campus for over sixteen years, and joined with other hospitals in this effort to protect public health. By advocating for mercury-free products and practices, we have helped establish a healthier environment for patients, their families, and staff.
Mercury in Hospitals
Great strides have been made in mercury elimination in hospitals in the past 20 years. In 1998, the EPA and the American Hospital Association (AHA) signed a memorandum of understanding to eliminate mercury in hospitals by 2005. Traditionally, over 265 items containing mercury could be found in American hospitals in items as diverse as thermometers to defibrillators to feeding tubes (click here for a list from Healthcare Without Harm). Thanks to increased awareness of the potential health effects of mercury exposure, many hospitals have successfully adopted best practices to limit these items and replace them with healthier alternatives. For most healthcare facilities, mercury elimination is an ongoing process and must include key departments such as purchasing, environmental services and safety. Free tools from inventory checklists to webinars are available from Practice Greenhealth. According to the U.S. EPA, mercury may still be found in some hospital devices and materials including:
Sphygmomanometers (blood pressure monitors)
Sengstaken-Blakemore tubes)— Used to clear gastrointestinal [GI] restrictions
According to the U.S. EPA: “Mercury waste is regulated under the Resource Conservation Recovery Act (RCRA), which requires all hazardous waste handlers to have specially trained staff and equipment on hand in case of a spill or release. Additionally, these facilities must meet special storage, handling, disposal, waste tracking, and reporting requirements. Failure to meet any of these requirements can result in fines up to $25,000 per day.”
Mercury waste not properly disposed of ends up in our air, water and land, as detailed in the sections below. Health effects from mercury exposure are profound. According to the Agency for Toxic Substances and Disease Registry (ATSDR), short-term exposure to mercury vapors may cause: Cough, sore throat • Shortness of breath • Chest pain • Nausea, vomiting, diarrhea • Increase in blood pressure or heart rate • A metallic taste in the mouth • Eye irritation • Headache • Vision problems
Long-term exposure to mercury vapors may cause: • Anxiety • Excessive shyness • Anorexia • Sleeping problems • Loss of appetite • Irritability • Fatigue • Forgetfulness • Tremors • Changes in vision • Changes in hearing
Mercury Elimination Resources from EPA’s Pollution Prevention Resources for Healthcare:
· Mercury Elimination (EPA Region 9): http://www.epa.gov/region9/waste/p2/projects/hospital/mercury.pdf
· California DHS – A Guide to Mercury Assessment and Elimination in HealthCare Facilities and Toolkit: www.dhs.ca.gov/ps/ddwem/environmental/Med_Waste/guide_to_mercury_assessment_v1.00.pdf
· Sustainable Hospitals Websites: http://www.sustainablehospitals.org/HTMLSrc/IP_Mercury.html
· Removing Mercury from Laboratories: www.sustainablehospitals.org/HTMLSrc/IP_mercury_removelabs.html
· Reducing Mercury Use in Health Care – How-to (Monroe County Dept of Health): www.epa.gov/glnpo/bnsdocs/merchealth/index.html
Other Sources of Mercury
• Staining solutions and laboratory reagents (thimerosal, mercury chloride, immusal, and carbol-fuchin).
• Manometers on medical equipment
• Esophageal dilators (also called Maloney or Hurst bougies)
• Fluorescent and high-intensity lamps
• Tissue fixatives (Zenker’s solution and B5)
• Cleaning solutions
Source: U.S. EPA: Eliminating Mercury in Hospitals, Environmental Best Practices for Health Care Facilities
Mercury in Land & Air
In September 2016, the US Geological Survey published a comprehensive report showing mercury contamination across western North America. The report detailed contamination in air, soil, waterways, forests, fish and other wildlife. Areas of high precipitation such as the Oregon Coastal Range are especially vulnerable, as rain carries mercury from the atmosphere, depositing it onto the land where it binds to vegetation and soil.
Methylmercury is the type of mercury found in fish, wildlife and land. It accumulates in humans through the diet, increasing in concentration up the food chain. Methylmercury in humans primarily affects the nervous and reproductive systems. (USGS 2016)
Check the U.S. EPA Fish Advisories Web Site for details on which fish to avoid and which are safer to eat.
Coal-fired power plants are the primary source of mercury air pollution in the nation, contributing 50% of total mercury emissions (US EPA). Polluted air falls to the earth from precipitation, and gets absorbed by plants, wildlife, fish, and by humans via the food chain.
Like lead, mercury can cause severe neurological and developmental problems in unborn babies and very young children whose brains are still developing. Click here for EPA’s power plant emissions information, and Mercury and Air Toxics Standards.
Mercury in Water
Mercury enters our water supply through a variety of sources including contamination from factories. In December 2016, DuPont agreed to pay Virginia $50 million to cleanup mercury pollution from a former DuPont factory outside Waynesboro which polluted the South River from 1929 to 1950. Decades later, the mercury contaminating this water supply still remains.
Mercury in Food
Bioaccumulation of mercury through the food chain reaches from plants and animals to humans. Over 80% of fish consumption advisories in the United States and Canada are due to mercury contamination (US Geological Survey 2016). Recreational and industrial fishing have been impacted by mercury contamination for decades, creating a continuing economic burden in communities around the globe.
In 2014, the EPA and FDA published an Advisory on Mercury in Fish and Shellfish for women who may become pregnant, pregnant women, nursing mothers, and young children.
Mercury in Schools
Mercury may exist in school settings such as chemistry labs and art rooms. Ensuring only safe products are used, and that all chemicals are inventoried and stored in a safe manner is essential to protecting the health of children, teachers and all school personnel. Classroom and laboratory resources are available here from the EPA.
Mercury in Vaccines
Thimerosal is 49.6% mercury by weight. It is used as a preservative or during the manufacture of some vaccines. The health effects of human exposure to mercury, including cognitive difficulties, memory and vision loss, coordination issues, tremors, skin rashes and mood instability, is shown in a collection of 55 research studies compiled by the World Mercury Project. Mercury is a known neurotoxin, meaning it is poisonous to nerve tissue. The list of adverse health effects are acknowledged by the U.S. Centers for Disease Control and Prevention (CDC)and the U.S. Environmental Protection Agency (EPA).
Ask about thimerosal before you vaccinate and insist on thimerosal-free vaccines. The Food and Drug Administration (FDA) removed thimerosal from routine childhood vaccines on the CDC immunization schedule starting in 1999 though “trace amounts” do remain in some vaccines. Other vaccines not on the routine immunization schedule, such as the multi-dose flu vaccine, still may contain thimerosal. If you decide to give the flu shot, a thimerosal-free version may need to be special-ordered by your doctor. For more information on vaccines, please see our Greening Vaccines page. (hotlink here)
Mercury in Consumer Products
The following categories represent some of the major consumer items that may contain mercury: batteries, dental amalgam (“silver” fillings), fluorescent lamps, necklaces and other jewelry, paint, thermometers, and thermostats. Check the U.S. EPA website on mercury, for what to avoid, how to clean up a spill, information for parents and schools and EPA’s pages on mercury in consumer products.
Mercury in Dentistry
Dental amalgam, also known as “silver” fillings, are 50% mercury. These fillings can endanger public health and our environment via pollution of air, water and land. While many dental clinics are mercury-free, amalgams are still in use and are sometimes the only filling option covered by insurance. According to the U.S. EPA facts on dental amalgam, there are five other options for fillings: resin composite, glass ionomer, resin ionomer, porcelain, and gold alloys.
U.S. EPA – dental amalgam
Last updated February 17, 2017