Eliminating Mercury in Health Care Setting
Background
Mercury is a toxic metal. Many health care devices contain mercury. Disposal of health care 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 health care devices are readily available. The American Nurses Association (ANA), the American Hospital Association, the United States Environmental Protection Agency, and Health Care Without Harm partnered to form Hospitals for a Healthy Environment (H2E [www.h2e-online.org]) in order to support the virtual elimination of mercury in health care through the use of mercury free alternatives. A major goal of H2E was to eliminate the use of mercury in health care by 2005. Legislation is needed to expedite this initiative.
Activities/Actions
As of June 30, 2007, 6 states have introduced legislation related to mercury in medical devices. Comprehensive IL, MN, MT and NH legislation would prohibit the sale or distribution of mercury containing medical instruments, including thermometers, sphygmomanometers, and gastrointestinal devices. MN SF 1085 and NH HB 907 have been enacted while IL HB 943 is awaiting the governor’s signature. The MN legislation also bans mercury in over-the-counter pharmaceuticals and in cosmetics, toiletries, and fragrances. The MT legislation was enacted. HI and PA have introduced legislation that would ban mercury containing thermometers.
In 2006, LA enacted similar comprehensive legislation while MI and MA 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 2006, ME, NY, VT, and WA also enacted comprehensive legislation.
In 2006, OH and PA introduced legislation that would ban mercury fever thermometers, but were not enacted. Prior to 2006, 15 states enacted legislation to ban the sale/distribution of mercury fever thermometers: CA, CT, IL, IN, ME, MD, MA, MI, MN, 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 June 30 2007, 18 states have introduced legislation related to thimerosal (AK, DE, IL,IN, IA, KS, MD, MA, MN, MT, NE, NH, NJ, NM, NC, RI, VT, VW). NM SJM 25 has been enacted. This bill encourages production, purchase and use of vaccines containing no more than trace amounts of mercury; especially those administered to pregnant women and young children with the ultimate goal of eliminating mercury in vaccines. IL SB 133, similar to the NM bill, is awaiting the governor’s approval.
In 2006 DE and WA enacted legislation related to thimerosal in vaccines. DE HB 108 eliminates the use of mercury-containing vaccines for pregnant women and for children less than eight years of age. WA SB 5305 limits the amount of mercury in the influenza vaccine and any vaccine administered to pregnant woman or children less than three years of age.
Last updated: 6/30/07