Eliminating Mercury in Health Care Setting
Background
Mercury is a toxic metal. Many healthcare devices contain mercury. Disposal of healthcare devices containing mercury causes mercury to be released into the environment. Exposure to mercury adversely affects the brain, kidney, and fetus.
Cost effective mercury free alternatives for healthcare devices are readily available. The American Nurses Association is a founding member of Practice Greenhealth ( http://www.practicegreenhealth.org/ ) which is the nation’s leading membership and networking organization for institutions in the healthcare community that have made a commitment to sustainable, eco-friendly practices. A major goal is to eliminate mercury in health care. Although tremendous strides have been made, legislation is needed to expedite this initiative.
Activities/Actions
As of December 1, 2008, 3 states (HI, IL, PA) introduced legislation related to mercury in medical devices. Comprehensive IL legislation would prohibit the sale or distribution of mercury containing medical instruments, including thermometers, sphygmomanometers, and gastrointestinal devices. HI and PA introduced legislation that would ban mercury containing thermometers. None have been enacted.
Prior to 2008, LA, ME, MN, NY, VT, and WA also enacted comprehensive legislation, while MI and MA have enacted legislation that bans the sale or promotion of any monitoring product containing mercury, exempting those products purchased prior to enactment and used in a private residence.
Prior to 2008, 16 states enacted legislation to ban the sale/distribution of mercury fever thermometers: CA, CT, IL, IN, ME, MD, MA, MI, MN, MT, NH, NJ, NY, OR, RI, and WA. The NJ legislation does not apply to thermometers used for professional health care.
Thimerosal in Vaccines
Background
Thimerosal is a preservative used in vaccines. Thimerosal metabolizes into ethylmercury, a neurotoxic form of mercury. In 1999 the Public Health Service agencies, the American Academy of Pediatrics, and vaccine manufacturers agreed that thimerosal should be reduced or eliminated in vaccines as a precautionary measure in response to increasing concern. However, the continued use of thimerosal as a preservative in influenza vaccine remains controversial for many due to the concern that thimerosal is associated with the increase in Autism Spectrum Disorder. Subsequent legislation has limited thimerosal in vaccines primarily to protect vulnerable populations such as children, pregnant women and their unborn fetuses.
Activities/Actions
In 2007 the ANA developed a position statement on thimerosal containing vaccines. Key points in the ANA position are that the ANA: 1) insists that pharmaceutical companies develop technology to produce seasonal influenza vaccine without using thimerosal as a preservative and cease using thimerosal as a preservative in vaccines immediately; 2) insists that pharmaceutical companies increase the availability of single dose vials and pre-filled syringes to meet the subsequent increased demand with discontinuation of the use of thimerosal as a preservative in multi-dose vials of seasonal influenza vaccine, 3) in recognition of a public health emergency, urges the use of the available vaccine in the event that a pandemic influenza and/or avian influenza pandemic occurs to help protect registered nurses, their families, their patients and communities from extending the outbreak, and; 4) recognizes the World Health Organization’s leadership role in promoting efforts to develop alternatives to using multi-dose vials of any thimerosal containing vaccine in the developing world.
As of December 1, 2008, 18 states have introduced legislation related to thimerosal in vaccines:(AL, FL, HI, IN, IA, KS, MD, MA, MN, NH, NJ, NC, OH, OK, PA, RI, SD, VT) None have been enacted.
Prior to 2008, 4 states (DE, IL, NM, WA) enacted legislation that prohibits or restricts mercury in vaccines, especially when intended for pregnant woman and children.
Last updated: 8/04/08