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Q & A:Phasing Out

Mercury

Thermometers

and Blood

Pressure Devices

Are Alternatives to Mercury Ther-

mometers and Blood Pressure

Devices Accurate?

The WHO Technical Guidance documentReplacement of mercury thermometers and

sphygmomanometers in health care,published in 2011 concludes that alter-natives to mercury-containing thermom-eters and sphygmomanometers areavailable, and are accurate and practicalin clinical seings.

Are Alternatives to Mercury Ther-

mometers and Blood Pressure

Devices Aordable?

The experience of hospitals and healthsystems and studies conducted innumerous developing countries havefound that while an individual digitalthermometer is more expensive than amercurial device, given much higherbreakage rates of the mercury thermom-eter, within a year hospitals are oftensaving money. Savings have also beenfound when substituting sphygmoma-nometers.

What is the World Health

Organizations Policy?

In 2005 WHO issued aPolicy Papercalling for support for short, mediumand long-term solutions to the issue ofmercury in health care. In the short-term WHO called for the safe manage-ment of mercury waste. In the mediumterm it called for the progressive replace-ment of mercury-based medical devices

with alternatives. The long-termsolution proposed by WHO includes aban for use of mercury containingdevices and effectively promote the useof mercury free alternatives.

What Other Policies Exist to

Substitute Mercury-based Medi-

cal Devices with Aordable,

Accurate Alternatives?

Many countries from every continenthave developed substitution policies,including but not limited to:

Argentina In February 2009, theArgentine Ministry of Health issued a

resolution 139/2009 calling for an endto purchase of mercury medical devicesin all Argentine hospitals. In February2010, the Ministry of Health of Argen-tina published anAdministrative Orderbanning mercury sphygmomanom-eters.

Brazil In 2010, the Health Secretariatof So Paulo Statebanned thepurchase and the use of any equipmentcontain ing mercury in public hospitals

and other health services. The SantaCatarina State government has alsobanned mercury thermometers inhospital systems and pharmacies.

Chile In April 2011, the Ministry ofHealth Issued aNational Guidance forMercury-free Health Care.

Cuba Since the 1980s, Cuba hasreplaced most of its mercury sphyg-momanometers with aneroid devices .

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http://whqlibdoc.who.int/publications/2011/9789241548182_eng.pdfhttp://whqlibdoc.who.int/publications/2011/9789241548182_eng.pdfhttp://whqlibdoc.who.int/publications/2011/9789241548182_eng.pdfhttp://whqlibdoc.who.int/publications/2011/9789241548182_eng.pdfhttp://whqlibdoc.who.int/publications/2011/9789241548182_eng.pdfhttp://whqlibdoc.who.int/publications/2011/9789241548182_eng.pdfhttp://www.mercuryfreehealthcare.org/Toward_the_Tipping_Point.pdfhttp://www.mercuryfreehealthcare.org/Toward_the_Tipping_Point.pdfhttp://www.mercuryfreehealthcare.org/Toward_the_Tipping_Point.pdfhttp://www.mercuryfreehealthcare.org/Toward_the_Tipping_Point.pdfhttp://www.who.int/water_sanitation_health/medicalwaste/mercurypolpap230506.pdfhttp://www.who.int/water_sanitation_health/medicalwaste/mercurypolpap230506.pdfhttp://www.who.int/water_sanitation_health/medicalwaste/mercurypolpap230506.pdfhttp://www.mercuryfreehealthcare.org/arg_resolution_139-2009.pdfhttp://www.mercuryfreehealthcare.org/arg_resolution_139-2009.pdfhttp://www.mercuryfreehealthcare.org/Argentina_Administrative_Decision%20_274.pdfhttp://www.mercuryfreehealthcare.org/Argentina_Administrative_Decision%20_274.pdfhttp://www.mercuryfreehealthcare.org/Argentina_Administrative_Decision%20_274.pdfftp://ftp.saude.sp.gov.br/ftpsessp/bibliote/informe_eletronico/2010/iels.dez.10/Iels233/E_R-SS-239_071210.pdfftp://ftp.saude.sp.gov.br/ftpsessp/bibliote/informe_eletronico/2010/iels.dez.10/Iels233/E_R-SS-239_071210.pdfftp://ftp.saude.sp.gov.br/ftpsessp/bibliote/informe_eletronico/2010/iels.dez.10/Iels233/E_R-SS-239_071210.pdfhttp://www.adjorisc.com.br/jornais/asemana/regi-o/termometro-de-mercurio-proibido-1.333837http://www.adjorisc.com.br/jornais/asemana/regi-o/termometro-de-mercurio-proibido-1.333837http://www.noharm.org/lib/downloads/espanol/Chile_Compromiso_Gestion15.pdfhttp://www.noharm.org/lib/downloads/espanol/Chile_Compromiso_Gestion15.pdfhttp://www.noharm.org/lib/downloads/espanol/Chile_Compromiso_Gestion15.pdfhttp://www.mercuryfreehealthcare.org/cuba2007.pdfhttp://www.mercuryfreehealthcare.org/cuba2007.pdfhttp://www.mercuryfreehealthcare.org/cuba2007.pdfhttp://whqlibdoc.who.int/publications/2011/9789241548182_eng.pdfhttp://www.mercuryfreehealthcare.org/Toward_the_Tipping_Point.pdfhttp://www.who.int/water_sanitation_health/medicalwaste/mercurypolpap230506.pdfhttp://www.mercuryfreehealthcare.org/arg_resolution_139-2009.pdfhttp://www.mercuryfreehealthcare.org/Argentina_Administrative_Decision%20_274.pdfftp://ftp.saude.sp.gov.br/ftpsessp/bibliote/informe_eletronico/2010/iels.dez.10/Iels233/E_R-SS-239_071210.pdfhttp://www.adjorisc.com.br/jornais/asemana/regi-o/termometro-de-mercurio-proibido-1.333837http://www.noharm.org/lib/downloads/espanol/Chile_Compromiso_Gestion15.pdfhttp://www.mercuryfreehealthcare.org/cuba2007.pdfhttp://www.noharm.org/global/http://whqlibdoc.who.int/publications/2011/9789241548182_eng.pdfhttp://www.noharm.org/lib/downloads/mercury/Toward_the_Tipping_Point.pdfhttp://www.mercuryfreehealthcare.org/Mercury_Elimination_Guide_for_Hospitals.pdfhttp://www.mercuryfreehealthcare.org/cuba2007.pdfhttp://www.noharm.org/lib/downloads/espanol/Chile_Compromiso_Gestion15.pdfhttp://www.adjorisc.com.br/jornais/asemana/regi-o/termometro-de-mercurio-proibido-1.333837ftp://ftp.saude.sp.gov.br/ftpsessp/bibliote/informe_eletronico/2010/iels.dez.10/Iels233/E_R-SS-239_071210.pdfhttp://www.mercuryfreehealthcare.org/Argentina_Administrative_Decision%20_274.pdfhttp://www.mercuryfreehealthcare.org/arg_resolution_139-2009.pdfhttp://www.who.int/water_sanitation_health/medicalwaste/mercurypolpap230506.pdfhttp://www.mercuryfreehealthcare.org/Toward_the_Tipping_Point.pdfhttp://whqlibdoc.who.int/publications/2011/9789241548182_eng.pdf

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The European Unionbanned mercurythermometers for home and healthcare use in 2008 and will enact asphygmomanometer ban withextremely limited exceptions in 2014.

India In May 2010, Indias Central

Government issuedguidelines tophase-out mercury containing equip-ment from all Government-run Hospi-tals. In Delhi, all government-runhospitals have stopped purchasingnew mercury-based medical devices.

Mongolia The Ministry of Health andthe National Emergency ManagementAgency of Mongolia issued aJointOrder to "ban further procurement ofthe mercury containing thermometer,sphygmomanometer and dental

amalgam, beginning January 15, 2011.

Philippines In 2008, the Philippinesissued and subsequently implementedan Administrative Order calling forthe phase-out of mercury based medicaldevices across the country.

South Africa The Province of KwaZulu Natal, South Africa has issued andis implementing directives banningthe purchase of mercury thermometers

and spygmomanometers. In 2011,South Africa's Department of Environ-mental Affairs called on the countrysMinistry of Health to issue a directiveimmediately suspending the purchaseof mercury-based thermometers, bloodpressure devices and dental amalgam.

Taiwan Republic of China In March2008, the Environmental ProtectionAdministration announced a nationalpolicy to phase-out of mercurythermometers.

United States The United States hasvirtually phased out mercury-basedmedical devices. Withbans or severerestrictions in the majority of US states.It is nearly impossible to purchase amercury thermometer in the UnitedStates today.

The World Medical Associationpasseda resolution in 2008 calling for thesubstitution of mercury-based medical

devices with safer alternatives.

What Position Should Countries

Take at INC5 Regarding

Mercury-based Thermometers

and Blood Pressure Devices?

Countries should support the listing of

mercury thermometers andsphygmomanometers in Annex C -Mercury AddedProducts - of the treatywith a timetable for rapid phase-out thatincludes the manufacture, import orexport of mercury-added products withno exemptions. Mercury freealternatives to these products arealready globally widely available andphase-out can be achieved within clearand reasonable time frames that shouldbe agreed to in Annex C and Article 6.

References

HCWH International Coordination

Tamborini 2838

1429 Buenos Aires, Argentina

ph/fax: +54 11 4545 7204

e: alejandra@hcwh.org

www.noharm.org/global

HCWH Southeast Asia

Unit 330, Eagle Court Condominium,

26 Matalino Street, Brgy. Central Diliman,

Quezon City 1100 Philippines

ph: +63 2 9287572

fax: +63 2 9262649

e: sonia@hcwh.org

www.noharm.org/seasia

HCWH Latin AmericaTamborini 2838

1429 Buenos Aires, Argentina

ph/fax: +54 11 4545 7204e: info@saludsindanio.orgwww.saludsindanio.org

HCWH Europe

Rue de la Pepiniere B1000

Brussels, Belgium

ph: +49 6224 994871

ph: +32 2503 0481

e: anja.leetz@hcwh.org

www.noharm.org/europe

HCWH USA and Canada

12355 Sunrise Valley Dr., Suite 680

Reston, VA 20191 United States of America

ph: +1 703 860 9790

fax: +1 703 860 9795

e: cfunkhouser@hcwh.org

www.noharm.org/us_canada

http://whqlibdoc.who.int/publications/2011/9789241548182_eng.pdf

http://www.mercuryfreehealthcare.org/Toward_the_Tipping_Point.pdf

http://www.who.int/water_sanitation_health/medicalwaste/mercuryp

olpap230506.pdf

http://www.mercuryfreehealthcare.org/arg_resolution_139-2009.pdf

http://www.mercuryfreehealthcare.org/Argentina_Administrative_Deci

sion%20_274.pdf

ftp://ftp.saude.sp.gov.br/ftpsessp/bibliote/informe_eletronico/2010/iels.dez.10/Iels233/E_R-SS-239_071210.pdf

http://www.adjorisc.com.br/jornais/asemana/regi-o/termometro-

de-mercurio-proibido-1.333837

http://www.noharm.org/lib/downloads/espanol/Chile_Compromiso_G

estion15.pdf

http://www.mercuryfreehealthcare.org/cuba2007.pdf

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N:PDF

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http://www.mercuryfreehealthcare.org/reporthgTL.pdf

http://www.mercuryfreehealthcare.org/Hg_Spill_Guideline_Mongolia.

pdf

http://www.mercuryfreehealthcare.org/Philippines_AO21.pdf

http://www.mercuryfreehealthcare.org/ao-kn-2.pdf

http://www.mercuryfreehealthcare.org/SA_Mercury_Report.pdf

http://law.epa.gov.tw/en/laws/229386189.html

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#s

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