Environmental Health News: Mercury falling

Faye Ferrer talks about the day she went to an outlet of the largest and most popular drug store in the country to find out whether the staff would sell her a mercury-based thermometer. Administrative Order 21 of the Department of Health, issued in July 2008, calls for the phaseout of all mercury-containing devices by September this year.

Ferrer was not an ordinary customer. She is program officer for mercury in healthcare for Healthcare Without Harm-Southeast Asia. Much to her surprise, the sales person told her that yes, such thermometers were available over the counter. “Have you heard about the order from the DoH banning these?” Ferrer asked. “Sure, we know about that,” the sales person said. “pero inuubos pa naming ang stock (but first we are selling off our stock).” Ferrer was appalled. She did not know whether the stock clear-out was a company policy, a store policy, or a judgment call by that person.

Mercury is toxic, as most of us know. “It may be fatal if inhaled and harmful if absorbed through the skin,” says the World Health Organization. Among the adverse health effects are tremors, impaired vision and hearing, paralysis, insomnia, emotional instability, defects in fetal development and developmental delays during childhood. Indeed exposure to mercury, depending on severity, affects the nervous, digestive, respiratory and immune systems, among others.

I last wrote about the phaseout efforts in February, just right after Health Secretary Esperanza Cabral, who had assumed her post the previous month, made a verbal commitment to civil society to intensify the government campaign against the healthcare industry’s use of devices containing the toxic chemical and to coordinate with the Department of Trade and Industry with regard to banning thermometers and sphygmomanometers.

But in the few remaining days of a Cabral-led Health Department, implementation of the AO invites questions. While the 70 or so DoH-controlled hospitals all over the country claim they are already mercury-free, there is disagreement in the matter of storage. The hospitals want the devices out of their premises in time for the reckoning day in September, and seem to turn to the Environmental Management Bureau of the Department of Environment and Natural Resources to identify where these phased-out devices should be stored (you can’t destroy mercury, you can only store it safely, at best). Owing to the dangers posed by the chemical, storage becomes a sensitive, political and controversial issue. The decision must be a product of consultation and deliberation—and the order provides for a few years’ holding period in the hospitals themselves, anyway, Ferrer says.

Local government-controlled medical centers and rural health clinics, on the other hand, face a different challenge. Healthcare Without Harm’s regional conferences revealed that these health centers, especially in far-flung areas, are not even aware of the September deadline. An unfortunate few are not even aware of the dangers posed by the devices, should they break. There are also problems regarding funding for alternatives —digital, non-mercury based thermometers and sphygmomanometers which would substitute phased-out devices certainly don’t come cheap. Ferrer says her group may soon touch base with local government executives, specifically through the League of Cities and League of Municipalities, to get them to act within their respective spheres. She is also looking forward to working with the next administration. Jaime Galvez Tan, who many say will be the next Health Secretary, is esteemed in civil society circles, Ferrer says.

Healthcare Without Harm put together a green Covenant before last month’s elections and tried to get as many signatures from candidates and incumbent officials as possible. Cabral signed, as did some presidential candidates, but not Senator Noynoy Aquino, who left the signing business to Florencio Abad, his campaign manager. The Aquino camp, however, sent a letter expressing the then-candidate’s support for the principles of the covenant. The next weeks and months will show whether Aquino, in sending that letter, was sincere or was simply going through the motions.

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Ferrer has just arrived from Stockholm, Sweden, where she, along with representatives of around 150 other countries, attended the first meeting of the Intergovernmental Negotiating Committee to Prepare a Global Legally Binding Instrument on Mercury. In that meeting, the WHO and HCWH presented a progress report on the global initiative for a mercury-free healthcare industry. The participating countries affirmed their commitment to phase out all mercury containing devices in health care by 2017. For now, the focus is on building citizens’ awareness on the hazards posed by the chemical.

Some organizations at the conference resorted to ingenious ways to make the delegates appreciate the urgency of the mercury problem. One group took hair samples from delegates and scanned them for mercury levels. The tolerable level is right about 0.1 mg, according to Ferrer, and everybody was surprised when a delegate was found to have 20,000 mg of mercury in his body. Indeed, nobody can be totally safe, even the knowledgeable ones. How much worse can things go for people who have no idea of the dangers altogether?

In Asia, the Philippines is a trailblazer—at least in policy, because of the administrative order and the September 2010 deadline. Taiwan has banned thermometers, as has Delhi. A pilot phaseout program is ongoing in 12 hospitals in Thailand and two big ones in China.

Talks for long-term storage will be a pivotal issue in succeeding conferences, Ferrer adds. The organizers also hope to influence other industries (outside of healthcare) that expose the public to mercury, even in very small amounts. Dental amalgams, for example, contain mercury, as do some types of batteries, and compact fluorescent lights.

These days, Ferrer has been dealing with yet another chain of drug stores. Watsons, together with Omron (distributor of digital healthcare devices), has inked a partnership with Healthcare Without Harm to come up with public service announcements on the hazards posed by mercury-based thermometers and sphygmomanometers, as well as on button-cell batteries and CFLs. Videos and posters will tell the public what to do in case of a mercury spill in the home, where old mercury thermometers given by some hospital or purchased at some drug store, are usually found. Show business personalities Albert Martinez and Juddah Paolo have shot their spiels; on the afternoon of my interview with Ferrer, I chanced upon Survivor contestant Shaun Rodriguez studying his script.

The posters will be put up and the videos played in Watsons outlets all over the country. Chances are, when somebody asks for mercury thermometers from this chain, he or she won’t be given one. He or she will get a healthy dose of information instead.