Products that contain mercury are becoming a worry for hospitals because of hazards to humans and wildlife from the buildup of methylmercury, a neurotoxin, in aquatic systems.
As a result, many hospitals are deciding to phase out the use of mercury-containing products where suitable alternatives exist.
Concern is particularly strong in the Great Lakes region. In fact, the healthcare subgroup of a Michigan state task force on mercury pollution recently suggested banning the sale of such products if hospitals failed to reduce use.
Great Lakes-area wastewater treatment plants often cite hospitals as a major source of mercury, regulators said.
Florida, Oregon, Washington and other states also are exhibiting more interest in preventing mercury pollution.
Many common healthcare products contain mercury. They include batteries, blood-pressure cuffs, feeding tubes, laboratory stains and thermometers.
Problems arise when mercury waste contaminates oceans, lakes and other waterways. Converted into methylmercury, it accumulates in the tissues of fish. There, it represents a potential poison to humans and animals consuming fish, although the actual risks are debated.
Because of such concerns, U.S. mercury use dropped 72% from 1983 to 1994, according to an April report by the Michigan Mercury Pollution Prevention Task Force.
The federal Environmental Protection Agency recently banned mercury use in batteries and is pushing for further limits. "We're moving in the direction of eliminating mercury," said Angela Bandemehr, an environmental engineer in the EPA's Great Lakes National Program Office, Chicago.
Many hospitals already recycle metallic mercury or get rid of it through licensed hazardous waste disposal companies.
But broken blood-pressure monitors and other products sometimes are mixed up with medical waste. Incineration releases all the mercury into the air, said John Gilkeson, a problem-materials specialist at the Minnesota Office of Environmental Assistance.
Laboratory chemicals can easily pollute water systems, Gilkeson said. Many hospital technicians don't know they're pouring mercury down the drain because the product information doesn't list it as an ingredient, he said.
The EPA has developed a brochure that lists mercury sources in hospitals along with known alternatives. The Minnesota OEA is working on additional educational materials for hospitals.
Butterworth Hospital in Grand Rapids, Mich., wanted to help the environment. When it spent $2,000 to clean up mercury from a broken blood-pressure monitor, the hospital decided that products with mercury were getting to be too much trouble, said Dan Stickles, Butterworth's director of environmental services. That was two years ago.
Stickles estimates he has rid Butterworth of about 280 pounds of elemental mercury since then. Where practical, the hospital has stopped buying products with mercury. It now sends mothers and their newborns home with paper-strip thermometers instead of mercury thermometers. Among other steps, Butterworth is replacing mercury blood-pressure monitors with aneroid products. The new monitors aren't as precise, but the difference hasn't mattered clinically, Stickles said.
In hospitals, few mercury-containing products are irreplaceable, according to the Michigan report on mercury. The exceptions are fluorescent lights and possibly some specific uses of batteries, calibration equipment, laboratory stains and blood-pressure monitors, the report said.
Stickles said environmentally sound products generally cost more upfront. Not so much, though, as to trigger complaints from administrators. He recommends hospitals make a long-term commitment to phasing out mercury-containing products as they break and as facilities are remodeled. Plans should be backed by doctors, chief financial officers and purchasing executives.
As long as patient care doesn't suffer, the change makes sense, he said: "We're a hospital whose mission is to tend to the ill, and here we were spreading around this hazardous substance."