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Phase-out of Mercury Containing

Fever Thermometer andSphygmomanometer:Thailand

Pilot project in 12 Regional HealthPromoting Hospitals

Twisuk PunpengDepartment of Health, Thailand

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Situation

There has been no policy on phase-out of mercury containing fever thermometer andsphygmomanometer

Mercury containing fever thermometers andsphygmomanometers are widely used inhealth care

In creasing trend of using non-mercury feverthermometers and sphygmomanometers

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Mercury thermometers andsphygmomanometers were made in Japan ,China and Germany. (None is manufactured inThailand).

The alternative devices, i.e. digital

thermometers and sphygmomanometers aremanufactured in Japan, Korea and China.

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Pilot project in 12 Regional Health Promoting Hospitals

(started in November 2010)

Objectives- gradual reduction of mercury containing

devices- achieve environmental and health friendlyhospitals

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Total amount of mercury thermometers andsphygmomanometers in 11 pilot hospitals

In use In stock Out of order

Total

Mercury thermometer 968 645 446 2059

Mercury

Sphygmomanometer

175 - 9 184

One hospital completely replaced mercury

thermometers and sphygmomanometers with non-mercury ones.

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8 th Regional Health Promoting Hospital

a 60 bed hospitals, OPD services at 300 cases per day,

has replaced all the mercury thermometersand sphygmomanometers by digital ones, allin one lot consisted of 133 digitalthermometers and 24 sphygmomanometers.

Total expense of 50,000 Baht (1,250 USD.)

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Digital thermometers(Lithium battery)(TERUMO*)

Sphygmonometers

(OMRON*,DINAMAP*)

OPD 47 10IPD 86 10Operating rooms - 4Total 133 24

The calibration of both thermometers andsphygmomanometers were performed once a year bythe companies that sold the equipments.

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Dental clinic

Traditional mercury amalgam is still used for dentalfilling. Composite resin filling that contains no mercuryis also being used.

Prevention of occupational exposure during the mixingof mercury amalgam is minimized by usingencapsulated amalgam mixture.

The used capsules were treated as a hazardous wastewhen disposed. The excess amalgam materials wascollected and kept underwater in a plastic bottlewaiting for the waste collector who will buy it forreclamation of silver and other metals.

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The amount of the excess amalgam materialwas on the average of about 800 grams a year.

Small amount of the excess amalgam materialin the patients mouth was suctioned out tothe sewer leading to the sewage disposal

system of the hospital.

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Existing or proposed policies or initiatives at thelocal, state/provincial and national level to

phase-out mercury in health care.

no policy on phasing-out of mercury in healthcare at any level

transition from mercury to non-mercuryequipment is on voluntary basis

A sub -committee on management of mercury

will be established under the NationalEnvironmental Board to collaborate with UNEP todevelop a convention on international mercurycontrol.

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Challenges faced in substituting mercury-based

medical devices (financial, technical, political, etc).

No financial problem for replacement No policy for the substitution

No standards for control since they were notclassified as a special type that need stringentcontrol, e.g. specifications and calibration.

No specific regulation for the storage anddisposal of the ones that were replaced.

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Thank You for Your Attention