Thanks Ram; Welcome Chetna

[Guest guest]

Hi

Thanks to our field activist member from Nepal Mr Ram Sah for moderating discussion on Mercury. Ram do return as moderator for another discussion.

Welcome Dr Chetna Desai for moderating the discussion on "Medical research ethics" which will run from 28 Nov to 03 Dec 2008. Chetna, kindly take over NetRUM right earnestly.

Vijay

Groupie

> > From: cephed org cephed04 (DOT) com>> Subject: Mercury Issue in Health Care Systems> "netrum" netrumgroups (DOT) com>> Date: Monday, 24 November, 2008, 8:27 PM> > > > Dear NetRUM friends> Greeting from Ram Charitra Sah> > > First of all sorry for initiating late discussion due to my unespected visit to Thailand in the remote area without access of Net. Please appologies for that andrequest all for take participate actively in the dicussion. > > > > MERCURY (Hg) and its Implication in Health Sectors > Facts and Figures > Mercury is a chemical element that occurs in nature and can be found almost everywhere in the environment. Mercury is only metal which is liquid at ordinary temperature; in fact it is liquid at 298 Kelvin. Mercury is sometimes called quicksilver because of its silvery-white appearance. It is naturally occurring heavy, odorless, lustrous liquid metal found in three forms; metallic, inorganic and organic. Total 3,439 metrics tons of mercury had demanded by various sector in 2005. Among which 240-300 metrics tons were being used in dental use. South Asia alone share highest demand. South Asia has comparatively higher demand of 300-500 tonnes. > Recognizing the impacts of mercury on human health and contribution from the health care system, the WHO issued its policy paper providing guidance to its member countries and healthcare institutions therein on substitution of mercury based medical devices with safer alternatives. The World Health Organization (WHO) has issued a policy paper calling for short, medium and long terms measures to substitute mercury based medical devices with safer alternative. > > 1. Health sector remains one of the major consumers of Mercury (equipments, Chemicals and even vaccines) and continuously being part of the toxic health care waste posing high risks of human health and environment. > 2. There are safer and cheaper alternatives available as well as being practiced to avoid mercury poisoning. > a. Digital alcohol thermometer, Glass gallium-indium- tin (galinstan) thermometer, Flexible forehead and ear canal thermometer are available in place of Mercury base thermometer with equal accuracy and economic over the life cycle. > b. Digital and alcohol thermometers found to be increasingly demanded by the consumers as well. > c. Accuracy issues: Most of the Mercury free alternate equipments are proven to be as accurate as mercury based equipments up on technical and clinical trials. > d. Cost analysis / comparison: Ratio of Digital to Mercury Thermometer 11.3 : 1 in China to 3 : 1 in Mexico/Argentina & that in USA is 0 : 1 meaning no mercury thermometer available is USA . Over the long run, digital thermometer is economic. > e. Aneroid barometer and alcohol barometer available in place of Sphygmomanometer. > f. Mercury also being used in the vaccines(as preservative in form of ethylmercury in thimerosal) > g. Composite amalgam in place of mercury based dental amalgam > 3. Ayurvedic medicine and Heavy Metals:An American study published in 2004 found that of 70 Ayurvedic remedies purchased over-the-counter (all had been manufactured in South Asia), 14 (one-fifth) contained lead, mercury, and/or arsenic at levels that could be harmful. > > Health Impacts of Mercury > Mercury is highly toxic, especially when metabolized into methyl mercury. It may be fatal if inhaled and harmful if absorbed through the skin. Around 80% of the inhaled mercury vapour is absorbed in the blood through the lungs. It may cause harmful effects to the nervous, digestive, respiratory, immune systems and to the kidneys, besides causing lung damage. Adverse health effects from mercury exposure can be: tremors, impaired vision and hearing, paralysis, insomnia, emotional instability, developmental deficits during fetal development, and attention deficit and developmental delays during childhood. Recent studies suggest that mercury may have no threshold below which some adverse effects do not occur. > International Movement, Laws and Standard > > a. The UNEP Governing Council concluded that there is sufficient evidence of significant global adverse impacts to warrant international action aimed at reducing the risks to human health and the environment, which arise from the release of mercury into the environment. > b. EU directive: EU council has adopted Mercury Free Health Care Policy > c. Male Declaration on Control and Prevention of Air Pollution and Its Likely Transboundary Effects for South Asia, SACEP April 1998. > d. The Bureau of Indian Standards (BIS) has laid down safety limits for drinking water at 0.001 mg of mercury per liter. > e. Since January 2008, Delhi Government hospitals are on the fast track to eliminate toxic heavy metal mercury from the health care system. > f. There is consumer legislation in place – the Prevention of Food Adulteration Act,1955,–which aims to protect consumers from adulterated food and ensure food safety. The Rules declare mercury as a poisonous metal and limit its concentration in fish to 0.5 ppm and in other food items to 1.0 ppm. Methyl mercury concentration in fish is limited to 0.25 ppm.(TL)5 > g. The WHO and the Food and Agriculture Organization (FAO), in their codex alimentarius guidelines, have also limited the concentration of methyl mercury to 0.5 mg/kg for all fishes except predatory fishes, and 1 mg/kg for predatory fishes such as shark, swordfish, tuna, pike, etc (TL.6) > > International Incidence > a. Minamata bays: high dose of exposure though contaminated fish consumption in minamata bays caused death toll of people and its impact on health and environment has been still significant. > b. Impact of consumption of Seed treated with Hg in Iraq is second reported health implication episodes > So I want to propose the following discussion point based on the above facts and figures and satiation. > 1. Mercury being toxic to health and environment still being used heavenly in the health sectors equipments, chemicals, infrastructures etc) despites of several safer, accurate and economic alternatives are available. Why these alternatives are not well accepted and adopted by our health communities? > 2. Mercury being toxic chemicals still being used in Vaccines, is there is room for safer alternative? > 3. Worldwide movement of Mercury free health care system, do we adopt same and join global movement? > 4. Mercury exposure to health care professional is still high, is there is occupational safety guidelines adequately address this issue? > 5. There is well practice of Mercury Spillage collection practice in very few selected hospitals India ( St. Josheph Hospital, New Delhi) and other developed country. How many of us aware of Mercury Spill Collection Toolkits (www.hcwh.org) ? Why it is not been practiced massively to protect our self and environment? > 6. What we can do together to address this issues in our continent to control its impacts? > > Ram Charitra Sah > Executive Director > CEPHED, Kathmandu, Nepal> > ________________________________> Be the first one to try the new Messenger 9 Beta! Click here. > ________________________________> Unlimited freedom, unlimited storage. Get it now > > ________________________________> Add more friends to your messenger and enjoy! Invite them now. > > ________________________________> Add more friends to your messenger and enjoy! 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