Phase-out of Mercury Containing Fever Thermometer and Sphygmomanometer :Thailand

Pilot project in 12 Regional Health Promoting Hospitals

Twisuk Punpeng Department of Health, Thailand

Situation
There has been no policy on phase-out of mercury containing fever thermometer and sphygmomanometer Mercury containing fever thermometers and sphygmomanometers are widely used in health care In creasing trend of using non-mercury fever thermometers and sphygmomanometers

 Mercury thermometers and sphygmomanometers were made in Japan , China and Germany. (None is manufactured in Thailand). The alternative devices, i.e. digital thermometers and sphygmomanometers are manufactured in Japan, Korea and China.

Pilot project in 12 Regional Health Promoting Hospitals

(started in November 2010)

Objectives - gradual reduction of mercury containing devices - achieve environmental and health friendly hospitals

Total amount of mercury thermometers and sphygmomanometers in 11 pilot hospitals

In use
Mercury thermometer Mercury Sphygmomanometer 968 175

In stock
645 -

Out of order
446 9

Total
2059 184

One hospital completely replaced mercury thermometers and sphygmomanometers with nonmercury ones.

8th Regional Health Promoting Hospital

a 60 bed hospitals, OPD services at 300 cases per day, has replaced all the mercury thermometers and sphygmomanometers by digital ones, all in one lot consisted of 133 digital thermometers and 24 sphygmomanometers. Total expense of 50,000 Baht (1,250 USD.)

OPD IPD Operating rooms Total

Digital thermometers Sphygmonometers (Lithium battery) (OMRON*, (TERUMO*) DINAMAP*) 47 10 86 10 4 133 24

The calibration of both thermometers and sphygmomanometers were performed once a year by the companies that sold the equipments.

Dental clinic
Traditional mercury amalgam is still used for dental filling. Composite resin filling that contains no mercury is also being used. Prevention of occupational exposure during the mixing of mercury amalgam is minimized by using encapsulated amalgam mixture. The used capsules were treated as a hazardous waste when disposed. The excess amalgam materials was collected and kept underwater in a plastic bottle waiting for the waste collector who will buy it for reclamation of silver and other metals.

 The amount of the excess amalgam material was on the average of about 800 grams a year. Small amount of the excess amalgam material in the patients mouth was suctioned out to the sewer leading to the sewage disposal system of the hospital.

Existing or proposed policies or initiatives at the local, state/provincial and national level to phase-out mercury in health care.
no policy on phasing-out of mercury in health care at any level transition from mercury to non-mercury equipment is on voluntary basis A sub-committee on management of mercury will be established under the National Environmental Board to collaborate with UNEP to develop a convention on international mercury control.

Challenges faced in substituting mercury-based medical devices (financial, technical, political, etc).

No financial problem for replacement No policy for the substitution No standards for control since they were not classified as a special type that need stringent control, e.g. specifications and calibration. No specific regulation for the storage and disposal of the ones that were replaced.

Thank You for Your Attention