Re: Mercury Issue in Health Care Systems

[Guest guest]

Dear Dr Ram Charitra,

Mercury is one of the most significant environmental offenders associated with the healthcare industry. It is mostly found in healthcare products in its elemental or liquid form. It is used in thermometers, blood pressure cuffs and esophageal dilators. It is also found in cleaning agents and fixatives used for laboratory work. In a list of more than 5,000 medical or healthcare products compiled by a technical assistance organisation more than 15 per cent contained mercury.

Since mercury is in a liquid state at room temperature. When spilt from an instrument due to breakage, it can easily disperse into the surrounding air through vaporisation. This can cause exposure to those in the vicinity through inhalation. Severity of the exposure in such cases depends on the air temperature, amount of mercury spilled, air flow in the room, and the built of the person exposed. Accidental spills can deposit mercury even in gaps and cracks in the floorings.

Studies have shown that even a single thermometer breakage can cause adverse health impacts. In a typical healthcare setting, mercury may be released from thermometers, blood pressure devices, gastrointestinal and other healthcare product. Fixatives, preservatives, lab chemicals, cleaners etc. may also contain mercury which, when discarded into the general waste stream, can result in serious environmental contamination.

More on:

http://enews.toxicslink.org/feature-view.php?id=3

-Anupama

From: cephed org <cephed04@...>Subject: Mercury Issue in Health Care Systems"netrum" <netrum >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.

[Guest guest]

Dear Dr. Anupama:

Your revelation that "even a single thermometer breakage can cause adverse health impacts" makes me stroll down the memory lane for a while and recollect the (now horrible) moments when during our PG days we as students used to freely (mis)handle mercury while doing our DOG B.P. experiment that requires filling up of mercury into the manometer and removing it at the end of the experiment with bare hands. At places where this experiment is conducted even today by PG students, human beings continue to remain exposed to the ill-effects of mercury. Though computer simulated DOG B.P experiments are also demonstrated to students nowadays at some places instead of using the whole animals, still I feel worried about those who do conduct the experiment on dogs manually and handle mercury like we used to do.

With regards

Dr. Geer M. Ishaq

Assistant Professor

Dept. of Pharmaceutical Sciences

University of Kashmir

Srinagar-190006 (J & K)

Ph: 9419970971, 9906673100

Website: http://ishaqgeer.googlepages.com

From: anupama sukhlecha <anupama_acad@...>netrum Sent: Wednesday, 26 November, 2008 1:48:40 AMSubject: Re: Mercury Issue in Health Care Systems

Dear Dr Ram Charitra,

Mercury is one of the most significant environmental offenders associated with the healthcare industry. It is mostly found in healthcare products in its elemental or liquid form. It is used in thermometers, blood pressure cuffs and esophageal dilators. It is also found in cleaning agents and fixatives used for laboratory work. In a list of more than 5,000 medical or healthcare products compiled by a technical assistance organisation more than 15 per cent contained mercury.

Since mercury is in a liquid state at room temperature. When spilt from an instrument due to breakage, it can easily disperse into the surrounding air through vaporisation. This can cause exposure to those in the vicinity through inhalation. Severity of the exposure in such cases depends on the air temperature, amount of mercury spilled, air flow in the room, and the built of the person exposed. Accidental spills can deposit mercury even in gaps and cracks in the floorings.

Studies have shown that even a single thermometer breakage can cause adverse health impacts. In a typical healthcare setting, mercury may be released from thermometers, blood pressure devices, gastrointestinal and other healthcare product. Fixatives, preservatives, lab chemicals, cleaners etc. may also contain mercury which, when discarded into the general waste stream, can result in serious environmental contamination.

More on:

http://enews. toxicslink. org/feature- view.php? id=3

-Anupama

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

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[Guest guest]

Dear Dr. Geer and Dr. Anupma

Greeting

The situation is even severe while one can consider the effort made by the concerned communities and government as well. If we consider its potential to reach to the direct to the brain passing through blood brain barriers. You have talked about the free unaided hand handling the mercury during the experiments. Once it come in contact with our skins, no barrier will stop its readily absorbed through our skins and reached to the blood streams and then to cross over the blood brain barrier to reach to the brain enough to cause serious health implication.

If one can visit the dental hospital, it has been found that he or she hardly given the choice of the selection of amalgam and advise to go for the filling whatever amalgam available in the hospital.

The breakage rate of thermometer is very high in some hospital than other. In case of Nepal, there is no any record keeping system for the replacement of any breakage. It was even harder to find the exact rate of thermometer breakage because of lack of record keeping. Even more dangerous things we came to know from our research that the new perspective doctors under internship use to replace the breakage thermometer by direct purchasing from market without going through the regular replacement procedure to get it replaced from hospital stores. This practice were not limited only with the people under internship but the other old health care professional.

What about the adoption of the Mercury free health care system in our part of the world. Some of country have already gone for policy and regulatory level decision to adopt the Mercury Free Health care system. So why not we can go for it?

Most of the mercury based equipments and chemicals have cost effective, accurate and safer alternatives and most of them are well adopted and under use in the developed countries as well as some of the progressive developing countries as well.

What about the use of mercury based vaccines still prevails and recommended even the toxic effect of it were well known and documented?

Yours

Ram C Sah

From: Geer M. Ishaq <ishaqgeer@...>netrum Sent: Wednesday, November 26, 2008 11:14:22 AMSubject: Re: Mercury Issue in Health Care Systems

Dear Dr. Anupama:

Your revelation that "even a single thermometer breakage can cause adverse health impacts" makes me stroll down the memory lane for a while and recollect the (now horrible) moments when during our PG days we as students used to freely (mis)handle mercury while doing our DOG B.P. experiment that requires filling up of mercury into the manometer and removing it at the end of the experiment with bare hands. At places where this experiment is conducted even today by PG students, human beings continue to remain exposed to the ill-effects of mercury. Though computer simulated DOG B.P experiments are also demonstrated to students nowadays at some places instead of using the whole animals, still I feel worried about those who do conduct the experiment on dogs manually and handle mercury like we used to do.

With regards

Dr. Geer M. Ishaq

Assistant Professor

Dept. of Pharmaceutical Sciences

University of Kashmir

Srinagar-190006 (J & K)

Ph: 9419970971, 9906673100

Website: http://ishaqgeer. googlepages. com

From: anupama sukhlecha <anupama_acad@ .co. in>netrumgroups (DOT) comSent: Wednesday, 26 November, 2008 1:48:40 AMSubject: Re: Mercury Issue in Health Care Systems

Dear Dr Ram Charitra,

Mercury is one of the most significant environmental offenders associated with the healthcare industry. It is mostly found in healthcare products in its elemental or liquid form. It is used in thermometers, blood pressure cuffs and esophageal dilators. It is also found in cleaning agents and fixatives used for laboratory work. In a list of more than 5,000 medical or healthcare products compiled by a technical assistance organisation more than 15 per cent contained mercury.

Since mercury is in a liquid state at room temperature. When spilt from an instrument due to breakage, it can easily disperse into the surrounding air through vaporisation. This can cause exposure to those in the vicinity through inhalation. Severity of the exposure in such cases depends on the air temperature, amount of mercury spilled, air flow in the room, and the built of the person exposed. Accidental spills can deposit mercury even in gaps and cracks in the floorings.

Studies have shown that even a single thermometer breakage can cause adverse health impacts. In a typical healthcare setting, mercury may be released from thermometers, blood pressure devices, gastrointestinal and other healthcare product. Fixatives, preservatives, lab chemicals, cleaners etc. may also contain mercury which, when discarded into the general waste stream, can result in serious environmental contamination.

More on:

http://enews. toxicslink. org/feature- view.php? id=3

-Anupama

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

[Guest guest]

Dear Dr Ram, Dr Geer,

Thiomersal used in vaccines as preservative has been found to very toxic.

Here is a youtube link as an evidence:

http://in.youtube.com/watch?v=J5WNLOjmAiw

The mercury compound, thimerosal, was used as a vaccine preservative since the 1930s, and was viewed as a safe, reliable, and somewhat drab defender against bacterial and fungal contamination. Thimerosal was sometimes added to vaccines during manufacturing to offset production-related contamination. It was thought to have its greatest value in the field, where it acted as a fail-safe against imperfect aseptic handling, especially for multi-dose vaccines, in which the re-entry of needles increases the risk of bacterial contamination. Thimerosal's only competitor, 2-phenoxyethanol, was less effective in suppressing potential contaminants like Pseudomonas aeruginosa, E. coli, and Staph. Aureus.Thimerosal contains 49.6% mercury by weight. Thimerosal is a water-soluble, cream-colored, crystalline powder. . In the human body, thimerosal is metabolized to ethylmercury and thiosalicylate. Toxicological information on the chief metabolite of thimerosal, ethylmercury, is extremely limited. Total mercury levels before and after the administration of hepatitis B vaccine (which contains thimerosal) was measured in 15 preterm and 5 term infants. Comparison of pre- and post-vaccination mercury levels showed a significant increase in both preterm and term infants after vaccination. Additionally, post-vaccination mercury levels were significantly higher in preterm infants as compared with term infants. During the recent controversy over the safety of thimerosal in vaccines, toxicologists have assumed that the toxicity of ethylmercury is equivalent to the toxicity of methylmercury. The primary environmental exposure is through consumption of predator fish. A 6-ounce can of tuna fish contains an average of 17 micrograms of mercury. A pediatric dose of hepatitis B vaccine contains very little more mercury than that

Source: http://www.healing-arts.org/children/vaccines/vaccines-mercury.htm

-Anupama

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

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Dear Dr. Anupma

Greeting

As I have said earlier that there is no any barrier acts to resist the transportation of Hg in blood stream. As you have rightly pointed out the risks of Hg as preservative in the vaccines. Does alternative available? if yes why not national, regional and international level initiative has been initiated?

yours

Ram C Sah

From: anupama sukhlecha <anupama_acad@...>netrum Sent: Wednesday, November 26, 2008 11:20:52 PMSubject: Re: Mercury Issue in Health Care Systems

Dear Dr Ram, Dr Geer,

Thiomersal used in vaccines as preservative has been found to very toxic.

Here is a youtube link as an evidence:

http://in.youtube. com/watch? v=J5WNLOjmAiw

The mercury compound, thimerosal, was used as a vaccine preservative since the 1930s, and was viewed as a safe, reliable, and somewhat drab defender against bacterial and fungal contamination. Thimerosal was sometimes added to vaccines during manufacturing to offset production-related contamination. It was thought to have its greatest value in the field, where it acted as a fail-safe against imperfect aseptic handling, especially for multi-dose vaccines, in which the re-entry of needles increases the risk of bacterial contamination. Thimerosal's only competitor, 2-phenoxyethanol, was less effective in suppressing potential contaminants like Pseudomonas aeruginosa, E. coli, and Staph. Aureus.Thimerosal contains 49.6% mercury by weight. Thimerosal is a water-soluble, cream-colored, crystalline powder. . In the human body, thimerosal is metabolized to ethylmercury and thiosalicylate. Toxicological information on the chief metabolite of thimerosal, ethylmercury, is extremely limited. Total mercury levels before and after the administration of hepatitis B vaccine (which contains thimerosal) was measured in 15 preterm and 5 term infants. Comparison of pre- and post-vaccination mercury levels showed a significant increase in both preterm and term infants after vaccination. Additionally, post-vaccination mercury levels were significantly higher in preterm infants as compared with term infants. During the recent controversy over the safety of thimerosal in vaccines, toxicologists have assumed that the toxicity of ethylmercury is equivalent to the toxicity of methylmercury. The primary environmental exposure is through consumption of predator fish. A 6-ounce can of tuna fish contains an average of 17 micrograms of mercury. A pediatric dose of hepatitis B vaccine contains very little more mercury than that

Source: http://www.healing- arts.org/ children/ vaccines/ vaccines- mercury.htm

-Anupama

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

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It is importatnt to draw all of your attention about the Mercury Spill collection toolkits, can be assembled locally at each health care facilites in order to reduce the first level of occupational exposure to health care professional and the patients as well as reduce environment load of the mercury contamination.

Following test will explaind very briefly about the toolkits.

What to Do if a Mercury Thermometer Breaks

· Have everyone else leave the area; don't let anyone walk through the mercury on their way out. Make sure all pets are removed from the area. Open all windows and doors to the outside; shut all doors to other parts of the house.

· DO NOT allow children to help you clean up the spill.

· Mercury can be cleaned up easily from the following surfaces: wood, linoleum, tile and any similarly smooth surfaces.

· If a spill occurs on carpet, curtains, upholstery or other absorbent surfaces, these contaminated items should be thrown away in accordance with the disposal means outlined below. Only cut and remove the affected portion of the contaminated carpet for disposal.

Items needed to clean up a small mercury spill

1. 4-5 ziplock-type bags2. trash bags (2 to 6 mm thick)3. rubber, nitrile or latex gloves4. paper towels5. cardboard or squeegee6. eyedropper7. duct tape, or shaving cream and small paint brush8. flashlight9. powdered sulfur (optional)

Cleanup Instructions

1. Put on rubber, nitrile or latex gloves.

2. If there are any broken pieces of glass or sharp objects, pick them up with care. Place all broken objects on a paper towel. Fold the paper towel and place in a zip lock bag. Secure the bag and label it as directed by your local health or fire department.

3. Locate visible mercury beads. Use a squeegee or cardboard to gather mercury beads. Use slow sweeping motions to keep mercury from becoming uncontrollable. Take a flashlight, hold it at a low angle close to the floor in a darkened room and look for additional glistening beads of mercury that may be sticking to the surface or in small cracked areas of the surface. Note: Mercury can move surprising distances on hard-flat surfaces, so be sure to inspect the entire room when "searching."

4. Use the eyedropper to collect or draw up the mercury beads. Slowly and carefully squeeze mercury onto a damp paper towel. Place the paper towel in a zip lock bag and secure. Make sure to label the bag as directed by your local health or fire department.

5. After you remove larger beads, put shaving cream on top of small paint brush and gently "dot" the affected area to pick up smaller hard-to-see beads. Alternatively, use duct tape to collect smaller hard-to-see beads. Place the paint brush or duct tape in a zip lock bag and secure. Make sure to label the bag as directed by your local health or fire department.

6. OPTIONAL STEP: It is OPTIONAL to use commercially available powdered sulfur to absorb the beads that are too small to see. The sulfur does two things: (1) it makes the mercury easier to see since there may be a color change from yellow to brown and (2) it binds the mercury so that it can be easily removed and suppresses the vapor of any missing mercury. Where to get commercialized sulfur? It may be supplied as mercury vapor absorbent in mercury spill kits, which can be purchased from laboratory,

chemical supply and hazardous materials response supply manufacturers. Note: Powdered sulfur may stain fabrics a dark color. When using powdered sulfur, do not breathe in the powder as it can be moderately toxic. Additionally, users should read and understand product information before use.

7. If you choose not to use this option, you may want to request the services of a contractor who has monitoring equipment to screen for mercury vapors. Consult your local environmental or health agency to inquire about contractors in your area. Place all materials used with the cleanup, including gloves, in a trash bag. Place all mercury beads and objects into the trash bag. Secure trash bag and label it as directed by your local health or fire department.

8. Contact your local health department, municipal waste authority or your local fire department for proper disposal in accordance with local, state and federal laws.

9. Remember to keep the area well ventilated to the outside (i.e., windows open and fans in exterior windows running) for at least 24 hours after your successful cleanup. Continue to keep pets and children out of cleanup area. If sickness occurs, seek medical attention immediately.

Recommendation: If there are young children or pregnant women in the house, seek additional advice from your local or state health or state environmental agency

yours

Ram Charitra Sah

From: anupama sukhlecha <anupama_acad@...>netrum Sent: Wednesday, November 26, 2008 11:20:52 PMSubject: Re: Mercury Issue in Health Care Systems

Dear Dr Ram, Dr Geer,

Thiomersal used in vaccines as preservative has been found to very toxic.

Here is a youtube link as an evidence:

http://in.youtube. com/watch? v=J5WNLOjmAiw

The mercury compound, thimerosal, was used as a vaccine preservative since the 1930s, and was viewed as a safe, reliable, and somewhat drab defender against bacterial and fungal contamination. Thimerosal was sometimes added to vaccines during manufacturing to offset production-related contamination. It was thought to have its greatest value in the field, where it acted as a fail-safe against imperfect aseptic handling, especially for multi-dose vaccines, in which the re-entry of needles increases the risk of bacterial contamination. Thimerosal's only competitor, 2-phenoxyethanol, was less effective in suppressing potential contaminants like Pseudomonas aeruginosa, E. coli, and Staph. Aureus.Thimerosal contains 49.6% mercury by weight. Thimerosal is a water-soluble, cream-colored, crystalline powder. . In the human body, thimerosal is metabolized to ethylmercury and thiosalicylate. Toxicological information on the chief metabolite of thimerosal, ethylmercury, is extremely limited. Total mercury levels before and after the administration of hepatitis B vaccine (which contains thimerosal) was measured in 15 preterm and 5 term infants. Comparison of pre- and post-vaccination mercury levels showed a significant increase in both preterm and term infants after vaccination. Additionally, post-vaccination mercury levels were significantly higher in preterm infants as compared with term infants. During the recent controversy over the safety of thimerosal in vaccines, toxicologists have assumed that the toxicity of ethylmercury is equivalent to the toxicity of methylmercury. The primary environmental exposure is through consumption of predator fish. A 6-ounce can of tuna fish contains an average of 17 micrograms of mercury. A pediatric dose of hepatitis B vaccine contains very little more mercury than that

Source: http://www.healing- arts.org/ children/ vaccines/ vaccines- mercury.htm

-Anupama

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.

[Guest guest]

Dear Sir,

This really an eye opener. We deal with mercury so carelessly in our labs esplly while handling the manometer.

-Anupama

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! Invite them now.

[Guest guest]

Dear Dr. Anupma

Greeting

Thanks for your complement. Please make this massage about mercury spill toolkit as wide as possible and share with any one, even a housewives should be knowing such simple techniques to control the exposure to this deadly toxic elements.

Yours

Ram C Sah

From: anupama sukhlecha <anupama_acad@...>netrum Sent: Thursday, November 27, 2008 11:22:22 PMSubject: Re: Mercury Issue in Health Care Systems

Dear Sir,

This really an eye opener. We deal with mercury so carelessly in our labs esplly while handling the manometer.

-Anupama

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

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