Photo credit: World Health Organization
When merchant Daniel Gabriel Fahrenheit teamed up with astronomer Olaus Rømer in 1714 to create the world’s first mercury thermometer, it was hailed as a breakthrough by a medical community that had known for centuries that a high body temperature meant illness.
And when Scipione Riva-Rocci introduced the mercury sphygmomanometer some 180 years later, his invention quickly became the gold standard for assessing blood pressure and spotting hypertension: a condition that today affects one-third of all adults globally and is a major cause of premature death.
But while mercury, with its unique properties, lent these essential medical tools unprecedented accuracy, the silver-gray metal has since been exposed as a deadly toxin that poses a threat to human health and the environment.
Three centuries after Fahrenheit and Rømer’s discovery, countries around the world came together to sign the Minamata Convention on Mercury, a global, legally binding treaty to wean humanity off its dependence on this useful but poisonous metal.
As financial mechanism to the treaty – and reflecting a commitment to a greener and healthier medical system – the Global Environment Facility has launched a UN Environment Programme-managed initiative to support Albania, Burkina Faso, India, Montenegro, and Uganda as they phase out mercury-containing devices from their medical systems in favor of non-toxic alternatives.
Small devices add up to bigger problems
Mercury exposure can have a range of adverse health effects, up to and including death. It can damage the brain, thyroid, kidneys, lungs, immune system, eyes, gums, and skin, impair memory and language, and cause birth defects and developmental delays in children.
While the amount of mercury in a single thermometer – most contain less than a gram – may seem too tiny to worry about, the World Health Organization says exposure to even small quantities carries risks.
And when used throughout a country’s clinics, hospitals, and doctor’s offices, the cumulative impact can be enormous. Healthcare systems that rely on old-style devices can be a major source of mercury releases, either through damage to instruments or improper disposal.
According to a 2011 report from New Delhi-based Toxics Link, a non-profit that aims to shine a spotlight on the perils of hazardous substances, eight metric tons of mercury are released in India each year due to improper handling and disposal of medical equipment alone: 69 percent from sphygmomanometers and 31 percent from thermometers.
UNEP estimates that, as of 2015, up to 392 metric tons of mercury were used globally in measuring and control devices – a category chiefly made up of thermometers and sphygmomanometers.
The project ‘Phasing out mercury measuring devices in healthcare’ will see the five participating countries develop national strategies for the transition, transform their procurement chains and waste management practices, and run campaigns to garner public support for the replacement drive.
The growing number of national bans around the world has prompted a proliferation of mercury-free alternatives – both digital and analogue – on the market.
Despite studies that show that most of these gauges are as accurate as their predecessors, some medical professionals remain skeptical, while the cost of replacement can be an issue in lower-income countries. The project will work to tackle any lingering hesitancy and fund the purchase of the new devices.
Once strategies are in place, country-specific pilots will demonstrate the practical benefits of leaving mercury behind. Teams will help clinics, hospitals, and other medical facilities create inventories of devices for replacement, advise on the acquisition of alternatives, and train staff on how to use them.
In India, the only one of the target countries to have a homegrown mercury-added device base, the project will offer companies the training and support they need to switch their product lines to more sustainable options.
Waste management will play a critical role in the transition. Since mercury is an element and cannot be destroyed, disposing of it safely and sustainably can be both complex and costly. The toxic metal must either be stabilized with sulfide and deposited in a specially designed landfill, or turned into a solid and stored deep underground. This is why many healthcare operations in middle-income and developing economies often opt instead to burn instruments containing mercury and other medical waste – a process that exposes communities to poisonous smoke and fumes.
Project teams will work with each participating country to promote the safe disposal of discarded devices to ensure the change does not lead to a spike in mercury contamination. They will help identify sites equipped to handle waste mercury, educate hazardous waste management companies, and promote cooperation among all parties to ensure legacy wastes are handled correctly over the long term.
Finally, the project will establish a knowledge management campaign to ensure all participating countries can learn from one another’s successes – and challenges – as they build healthcare systems that are healthier for both people and the planet.
