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Mercury-Health Care: Complete List of Reference Documents
Table of Contents
Background and Overview
Operations
Reasons for Change
P2 Opportunities
Key Contacts
Acknowledgements
Complete List of Links

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Article/report (12) / Audio/video (1) / Case study/success story (2) / Fact sheet/checklist (38) / List (4) / Manual/handbook/curriculum (11) / Other resources (7) / Periodical (1) / Software/electronic tool (3) / Web site (20)

NOTE: [PDF] links require Acrobat Reader from Adobe.


- Article/report -    Top of Page

America's Top 10 Green Hospitals
Abstract: With 24/7 operations and powerful medical equipment, hospitals are one of the greatest consumers of energy - and one of the greatest generators of waste. Increasingly hospitals are finding that they can improve the care they give to patients and protect the natural environment by making greener choices in building materials, food, cleaners, lighting and landscaping. The Green Guide has released its first-ever exclusive report on 10 hospitals, from New York, NY, to Boulder, CO, that have set a green standard with innovative operational programs and new buildings. Three hospitals in the Great Lakes states made the top 10 list, and four hospitals in Great Lakes states received honorable mentions.
Source: The Green Guide Institute
URL: http://www.thegreenguide.com/doc.mhtml?i=113&s=top10hospital
s

Characteristics and Treatment of the Dental Waste Water Stream
Abstract: Written by Michael D. Cailas, James L. Drummond, Tung-Yi Wu, and Victor G. Ovsey of the University of Illinois--Chicago, this Illinois Waste Management and Research Center (WMRC) research report characterizes the properties of the dental waste stream. The other major objective of this research project was to assess the relative effectiveness of removal procedures for mercury and silver in the dental waste water stream. (PDF format; Length: 54 pages)
Source: IL Waste Management & Research Center
URL: http://www.wmrc.uiuc.edu/main_sections/info_services/library
_docs/rr/RR-97.pdf

Dentist the Menace? The Uncontrolled Release of Dental Mercury
Abstract: Written by Michael Bender, this Health Care Without Harm report explores the issue of waste dental mercury disposal. Includes sections on the occurrence and toxicity of mercury, dental mercury disposal routes, challenges to reducing dental mercury releases, and case studies of dental mercury reduction initiatives from several U.S. states as well as other countries. The report ends with a list of recommendations for addressing the proper handling of dental mercury waste. (PDF Format; Length: 20 pages)
Source: Health Care Without Harm
URL: http://www.noharm.org/details.cfm?type=document&id=655

Doctors, Children's Advocates, Public Health Organizations and Hospitals Announce Support for (IL) Governor's Mercury Pollution Reduction Plan [PDF]
Abstract: A strong coalition of doctors, children's advocates, public health organizations and hospitals have commended Illinois Governor Blagojevich's new mercury pollution reduction plan and announced their support. They then called on the CEOs of companies owning Illinois coal plants to reduce the mercury pollution from their coal plants by 90 percent by June 30, 2009 as provided in the Governor's plan. Press release from Environmental Law and Policy Center. (PDF Format; Length: 2 pages)
Source: Environmental Law and Policy Center
URL: http://www.stopmercurypollution.org/documents/mercury_pressr
elease_01-11-06.pdf

Environmentally Preferable LED Exit Signs: Saving Money and Protecting the Environment Through Energy Efficiency [PDF]
Abstract: This fact sheet from INFORM, Inc. discusses LED exit signs; these signs are more energy efficient than fluorescent lamp exit signs and contain no mercury. One fluorescent lamp exit sign can contain more than 10 mg of mercury. Topics covered in this fact sheet include comparative performance of incandescent, fluorescent and LED exit signs, financial savings estimates for using LED exit signs, and retrofit options. (PDF Format; 3 pages)
Source: INFORM, Inc.
URL: http://www.informinc.org/fs_P3exitsigns.pdf

Health Consultation: Drum-top Bulb Crusher Demonstration at the Minneapolis-St. Paul International Airport [PDF]
Abstract: Prepared by Carl Herbrandson of the Minnesota Department of Health under a cooperative agreement with the Agency for Toxic Substances and Disease Registry, this report summarizes public health issues related to levels of mercury emitted from a fluorescent bulb recycling system considered for use at a Minnesota company. Based on the results of this health consultation, the Minnesota Pollution Control Agency (MPCA) has banned the use of drum-top bulb crushers in Minnesota. (PDF Format; Length: 28 pages)
Source: Minnesota Department of Health
URL: http://www.health.state.mn.us/divs/eh/hazardous/topics/drumt
op.pdf

Indoor Air Mercury [PDF]
Abstract: This report describes why mercury is a problem in indoor air, the sources of mercury in indoor air, guidelines for mercury exposure, and studies on indoor air mercury. (PDF Format; Length: 8 pages)
Source: NEWMOA
URL: http://www.newmoa.org/prevention/mercury/Mercuryindoor.pdf

Mercury Elimination
Abstract: From the proceedings of the Setting Healthcare's Environmental Agenda conference of October 16, 2000. Gives good overview of mercury reduction in healthcare facilities.
Source: Institute for a Sustainable Future
URL: http://www.noharm.org/

The Mercury Challenge Handbook: The Opportunity to Become a Mercury-Free Facility [PDF]
Abstract: Provides information on participating in the Mercury Challenge Program, a cooperative effort of Ohio EPA and the Ohio Hospital Association. Also outlines how to reduce and eliminate mercury from heathcare facilities, as well as where to go for information
Source: Ohio Environmental Protection Agency, Office of Pollution Prevention
URL: http://infohouse.p2ric.org/ref/16/15822.pdf

Wisconsin Mercury SourceBook: Section One (Background) [PDF]
Abstract: Provides background information about mercury, it's effects on human health and the environment, and Wisconsin and federal regulation covering it's use. (PDF Format; Length: 90 pages)
Source: Wisconsin Department of Natural Resources
URL: http://infohouse.p2ric.org/ref/04/03851/section1.pdf

Wisconsin Mercury SourceBook: Section One (Background) [PDF]
Abstract: Provides background information about mercury, it's effects on human health and the environment, and Wisconsin and federal regulation covering it's use. (PDF Format; Length: 90 pages)
Source: Wisconsin Department of Natural Resources
URL: http://infohouse.p2ric.org/ref/04/03851/section1.pdf

Wisconsin Mercury SourceBook: Section Two (Developing a Mercury Minimization Plan) [PDF]
Abstract: Provides detailed steps in helping communities draft a comprehensive community mercury reduction plan.
Source: Wisconsin Department of Natural Resources
URL: http://infohouse.p2ric.org/ref/04/03851/section2.pdf


- Audio/video -    Top of Page

Keep Mercury From Rising
Abstract: Free 12-min. video describing sources & dangers of mercury in the environment. Send self-addressed video mailer with prepaid postage of $1.44 (in U.S.) to Deborah MacCormac, FDEP, 3319 Maguire Blvd. Suite 232, Orlando, FL, 32803.
Source: Florida Department of Environmental Protection
URL: http://www.glrppr.org/contacts/fullrecord.cfm?sectordocid=88
6


- Case study/success story -    Top of Page

Health Consultation: Mercury Spill Assist in Watervliet, Michigan
Abstract: This Agency for Toxic Substances and Disease Registry/Michigan Department of Community Health consultation report outlines the case of a mercury spill in a home resulting from the replacement of a wall-mounted thermostat. The family?s two-year-child required admission to a hospital and extensive medical treatment due to accidental ingestion of beads of mercury. The report summarizes air monitoring in the home, biological sampling on the children involved, the temporary relocation of the family, and the removal and disposal of contaminated furniture, home items, carpeting and padding. Includes a section on ?Addressing the Unique Vulnerabilities of Children.?
Source: Agency for Toxic Substances and Disease Registry (ASTDR) and the Michigan Department of Community Health
URL: http://www.atsdr.cdc.gov/HAC/PHA/watervliet/msa_p1.html

New York State Governor's Award for Pollution Prevention: University of Rochester - Strong Memorial Hospital, Rochester
Abstract: The University implemented a project at Strong Memorial Hospital to reduce mercury pollution. To demonstrate the effectiveness of the mercury reduction program, the hospital substituted equipment that uses mercury with electronic and mercury-free equipment and eliminated mercury compounds from certain activities within the clinical labs.
Source: New York State Dept. of Environmental Conservation
URL: http://www.dec.state.ny.us/website/ppu/success/rochestr.html


- Fact sheet/checklist -    Top of Page

Amounts of Mercury in Hospital Equipment
Abstract: This fact sheet provides information on the approximate amount of mercury found in medical devices and facility equipment.
Source: Sustainable Hospitals Project
URL: http://www.sustainablehospitals.org/HTMLSrc/IP_mercury_amoun
ts.html

Aneroid Sphygmomanometers
Abstract: Aneroid sphygmomanometers are comparable to mercury sphygmomanometers in cost, technique and performance. However, some medical professionals hesitate to adopt aneroid blood pressure devices because of conflicting statements they have heard about aneroid gauge performance. This fact sheet addresses common perceptions about aneroid sphygmomanometers.
Source: Sustainable Hospitals Project
URL: http://www.sustainablehospitals.org/HTMLSrc/IP_aneroid_sphyg
mo.html

Best Management Practices for Mercury-Containing Products in the Hospital
Abstract: "Best management practices" for mercury are the procedures that have been found by experience to effectively prevent the release of mercury into the environment. This document provides best management practices for the following products and topics: fever thermometers, sphygmomanometers, gastrointestinal tubes, dental amalgam and mercury, laboratory chemicals, pharmaceutical products, cleaners and degreasers, batteries, lamps, electrical equipment, thermostat probes in gas appliances, industrial thermometers, pressure gauges, plumbing, spills, storage areas, and hospital employee health and safety.
Source: Sustainable Hospitals Project
URL: http://www.sustainablehospitals.org/HTMLSrc/IP_Merc_BMP.html

Comparing Mercury and Aneroid Sphygmomanometers
Abstract: Provides comparison of mercury and aneroid sphygmomanometers. Includes a table comparing aneroid, electronic and mercury devices based on initial cost, maintenance, accuracy, ease of use, reliability and environmental exposure. Also lists inherent disadvantages of mercury sphygmomanometers as compared to aneroid devices, and a list of faults found in a recent study of 444 mercury sphygmomanometers in a hospital setting.
Source: Sustainable Hospitals Project
URL: http://www.sustainablehospitals.org/HTMLSrc/IP_Merc_Tools_Co
mpSphyg.html

Eliminating Mercury in Hospitals: Environmental Best Practices for Health Care Facilities [PDF]
Abstract: Comprehensive factsheet including info. on environmental effects of mercury, exposure pathways, industrial sources, case studies & reduction strategies for health care facilities. Cost & efficacy comparisons for sphygmomanometers & thermometers.
Source: U.S. EPA Region 9 Pollution Prevention Program
URL: http://www.ciwmb.ca.gov/wpie/HealthCare/EPAHgInHosp.pdf

Examples of Mercury Purchasing Language
Abstract: This document contains examples of mercury purchasing policy language from several health care organizations.
Source: Sustainable Hospitals Project
URL: http://www.sustainablehospitals.org/HTMLSrc/IP_Merc_Tools_Pu
rchpolicy.html

Frequently Asked Questions Recycling of Elemental Mercury and Dental Amalgam in New York
Abstract: This portion of the New York State Department of Environmental Conservation (NYSDEC) web site provides frequently asked questions and answers related to recycling of elemental mercury and dental amalgam in the state of New York.
Source: NYSDEC
URL: http://www.dec.state.ny.us/website/dshm/redrecy/mercfaq.htm

Guidelines for Mercury-Containing Fever Thermometer Exchanges (Indiana) [PDF]
Abstract: This fact sheet provides guidelines for holding a successful mercury thermometer exchange event in Indiana. Includes IDEM contact information for additional assistance. (PDF Format; Length: 1 page)
Source: Indiana Department of Environmental Management (IDEM)
URL: http://www.in.gov/idem/files/mercury_exchange_guidelines.pdf

H2E Self Assessment Guide [PDF]
Abstract: This tool helps facilities conduct self-surveys to help prioritize activities and develop action plans. The guide addresses solid waste, hazardous waste, mercury and other issues. See sections 5A and 5B on mercury assessment. (PDF Format; Length: 27 pages)
Source: Hospitals for a Healthy Environment (H2E)
URL: http://www.h2e-online.org/pubs/selfasmt.pdf

H2E's 10 Step Guide to Fluorescent Lamp Recycling [PDF]
Abstract: This fact sheet from H2E provides 10 steps for implementing a fluorescent lamp recycling program at a health care facility. (PDF Format; Length: 4 pages)
Source: Hospitals for a Healthy Environment (H2E)
URL: http://www.h2e-online.org/docs/h2e10stepfluorescent121802.pd
f

Healthier Choices for Electronic Equipment: From Procurement to End-of-Life [PDF]
Abstract: This fact sheet provides purchasing tips for more environmentally-friendly electronic equipment, and considerations for what to do with equipment when it has reached its end-of-life. Suggestions are provided in 10 steps. (PDF Format; Length: 5 pages)
Source: Health Care Without Harm & H2E
URL: http://www.h2e-online.org/docs/h2eelectronics40504.pdf

High-Bay Lighting: Opportunities for Mercury Reduction and Energy Efficiency [PDF]
Abstract: This fact sheet from INFORM, Inc. focuses on high-bay lighting, a type of lighting used in high-ceiling areas to light surfaces more than 15 feet away. This type of lighting is often used in warehouses, gymnasiums, manufacturing facilities and warehouse-type retail facilities. Different high-bay lighting options are compared in terms of mercury use, energy efficiency, and cost of purchasing and running the lights. Specifically, metal halide, induction fluorescents, and T5 linear fluorescents are compared. (PDF Format; Length: 4 pages)
Source: INFORM, Inc.
URL: http://www.solarislantern.com/PDFs/industrial/learn/InformHg
Reduction_DD1A4.pdf

Interpreting Analytical Results for Mercury and Other Substances
Abstract: In many hospitals, purchased products, laboratory reagents, or waste samples are tested to determine their mercury content for regulatory compliance. To get the most out of testing, it is important to understand how to read and interpret the results. This fact sheet provides interpretation guidance in a question and answer format.
Source: Sustainable Hospitals Project
URL: http://www.sustainablehospitals.org/HTMLSrc/IP_analytical_me
rcury.html

Is there Mercury in Your Coulter Counter?
Abstract: This fact sheet provides information on where mercury may be found within Coulter Counters and how to find out whether your model contains mercury gauges or switches and whether these can be replaced.
Source: Sustainable Hospitals Project
URL: http://www.sustainablehospitals.org/HTMLSrc/IP_Merc_Coulter.
html

Managing Used Fluorescent Lamps, High-Intensity Discharge Lamps & PCB Ballasts [PDF]
Abstract: This fact sheet discusses waste management of fluorescent lamps, ballasts, and similar waste. Includes information on environmental concerns, pollution prevention, disposal options, lamp handling and storage requirements, choosing a lamp transporter and collection site and other considerations that apply to handling these sorts of wastes. (PDF Format; Length: 6 pages)
Source: Minnesota Pollution Control Agency
URL: http://www.acesolidwaste.com/FluorescentLampDisposal.pdf

Managing Wastes From Health Care Providers [PDF]
Abstract: This MPCA fact sheet is intended to assist health care providers with proper waste management. For the purposes of this fact sheet "health care providers" include "a school or plant nurse's office, a physicians' office, a dental office, a medical clinic or center, an assisted-care or long-term care facility, a hospital, a veterinary clinic or animal hospital and those personnel providing health care or operating such facilities." Waste types discussed include hazardous wastes, industrial solid waste, infectious waste, pharmaceutical waste, radioactive wastes, and sewerable waste. (PDF Format; Length: 7 pages)
Source: Minnesota Pollution Control Agency (MPCA)
URL: http://www.pca.state.mn.us/publications/w-hw3-34.pdf

Mercury Disclosure Requirements and the New Jersey Lamp Contract [PDF]
Abstract: The state of New Jersey required vendors to disclose the amount of mercury in the mercury-containing lamps sold on its 2002 and 2003 contracts for incandescent, HID, and fluorescent lamps (contract T-1092). This fact sheet provides examples of the mercury disclosure language used in, and the results of, the New Jersey lamp contract. (PDF Format; Length: 4 pages)
Source: INFORM, Inc.
URL: http://www.informinc.org/fs_P3NJlampcontract.pdf

Mercury in Eye Surgery Settings [PDF]
Abstract: This fact sheet provides suggestions for facilities that still have mercury intraocular pressure reducers?little bags of mercury used as weights to apply pressure to the eye prior to cataract surgery. While these devices are no longer commercially available and the practice is largely obsolete, many facilities may still have these devices. (PDF Format; Length: 1 page)
Source: Sustainable Hospitals Project
URL: http://www.sustainablehospitals.org/PDF/Hg_in_Eye_Surgery.pd
f

Mercury in Gauges and Switches
Abstract: Many pieces of hospital, laboratory, and industrial equipment utilize mercury-containing switches and gauges. This fact sheet provides some suggestions for interim management of mercury containing equipment:
Source: Sutsainable Hospitals Project
URL: http://www.sustainablehospitals.org/HTMLSrc/IP_Mercurygauges
.html

Mercury in Health Care Lab Reagents
Abstract: This fact sheet provides steps to identify mercury in lab reagents, a list of potential mercury containing reagents, and a list of brand specific potential mercury-containing lab reagents. Also available at this web page in PDF format (Length: 8 pages)
Source: Minnesota Technical Assistance Program (MnTAP)
URL: http://mntap.umn.edu/health/92-Mercury.htm

Mercury in Plasma-Derived Products
Abstract: FDA fact sheet on mercury ingredients, such as thimerosal, in plasma-derived products.
Source: U.S. Food & Drug Administration (FDA)
URL: http://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability
/BloodSafety/ucm095529.htm

Mercury Sources and Alternatives in Health Care
Abstract: This list is designed to assist staff at health care facilities in pollution prevention activities. While the list is by no means exhaustive, this sampling is intended to provide a starting point for hospital staff to assess the presence of mercury in their instituition. Additionally, alternatives to mercury-containing products are identified.
Source: Sustainable Hospitals Project
URL: http://www.sustainablehospitals.org/HTMLSrc/IP_Merc_Tools_Li
st.html

Mercury Spills in New York State
Abstract: Since 1992, the New York State Department of Health has collected information about mercury spills and releases as part of the Hazardous Substances Emergency Events Surveillance (HSEES) project. The goal of this federal project is to reduce injury and death from accidental chemical releases through an improved understanding of the causes. This document summarizes the findings of the study for the years 1992-1997.
Source: New York State Department of Health
URL: http://www.health.state.ny.us/environmental/chemicals/hsees/
mercury/brochures/cleanup.htm

Mercury Spills:How Much Do They Cost? [PDF]
Abstract: The true costs of mercury spills are not well documented and tend to be anecdotal. This fact sheet provides references and excerpts from those references to help estimate the potential cost of various types of mercury spills that may occur in a health care setting. (PDF Format; Length: 2 pages)
Source: Sustainable Hospitals Project
URL: http://www.sustainablehospitals.org/PDF/IP_spills_cost.pdf

Mercury Use in Measuring Devices [PDF]
Abstract: This fact sheet summarizes the use of mercury in products that measure physical data, such as temperature, pressure, or humidity. It is based on data obtained only from the Interstate Mercury Education & Reduction Clearinghouse (IMERC) Mercury-Added Products Database. The measuring devices using mercury that are included in this fact sheet are barometers, hydrometers, manometers, psychrometers, sphygmomanometers, strain gauges and thermometers. These devices must use mercury in its elemental form to be included in this fact sheet. Measuring devices that contain mercury solely from the use of a button cell battery are excluded. Thermostats are covered in a separate fact sheet. (PDF Format; Length: 5 pages)
Source: NEWMOA
URL: http://www.newmoa.org/prevention/mercury/imerc/FactSheets/me
asuring_devices.pdf

Mercury Use in Thermostats [PDF]
Abstract: This fact sheet summarizes the use of mercury in thermostats. It is based on data obtained only from the Interstate Mercury Education & Reduction Clearinghouse (IMERC) Mercury-Added Products Database. It covers thermostats used in residences, businesses and industrial settings, including thermostats sold as stand-alone units and as components within heating and cooling equipment. It does not include mercury thermostats used in cooking ranges; those thermostats are covered in the NEWMOA fact sheet entitled, ?Mercury Use in Gas & Electric Cooking Ranges and Other Cooking Equipment.? (PDF Format; Length: 3 pages)
Source: NEWMOA
URL: http://www.newmoa.org/prevention/mercury/imerc/FactSheets/th
ermostats.pdf

Mercury-containing Lamps and EPA's Toxicity Characteristic Leaching Procedure (TCLP) [PDF]
Abstract: This fact sheet from INFORM, Inc. explains the U.S. EPA?s Toxicity Characteristic Leaching Procedure (TCLP). The U.S. EPA has identified 40 toxic chemicals that can cause harm when products containing them are disposed of in landfills and the chemicals leach out. In order to determine the potential of specific wastes in a landfill to leach dangerous concentrations of toxic chemicals into groundwater, the EPA developed a protocol known as the toxicity characteristic leaching procedure (TCLP). Products containing one or more of the listed toxins are assessed using the TCLP to estimate how much of their toxic contents would be released into landfill leachate under ordinary conditions. If the amount of a particular chemical released under test conditions exceeds regulatory limits, the waste qualifies as hazardous and must be handled according to regulations governing hazardous waste. Products that do not leach toxic materials at levels exceeding regulatory limits are termed TCLP-compliant. This fact sheet discusses the limitations of the TCLP, particularly in regards to mercury-containing lamps, and issues related to appropriate disposal of mercury-containing lamps. (PDF Format; Length: 2 pages)
Source: INFORM, Inc.
URL: http://www.informinc.org/fs_P3tclp.pdf

National Wildlife Federation Mercury Products Guide: The Hidden Dangers of Mercury [PDF]
Abstract: This National Wildlife Federation (NWF) guide serves as a resource guide for procurement officers and consumers on mercury in products and their alternatives. Compiled by Todd Kuiken. Includes information on alternatives, mercury-containing products for which there currently are no alternatives, cost comparisons of mercury-containing products and their alternatives, recycling of mercury-containing products, sample procurement contract language and state products legislation from across the United States. (PDF Format; Length: 51 pages)
Source: National Wildlife Federation (NWF)
URL: http://www.nwf.org/nwfWebAdmin/binaryVault/mercuryproducts.p
df

OSHA Hospital eTool: Mercury
Abstract: This portion of the Occupational Safety & Health Administration (OSHA) Hospital eTool addresses mercury. It outlines potential hazards, health effects of both acute and chronic exposure, possible solutions, OSHA requirements, and National Institute for Occupational Safety and Health (NIOSH) recommendations.
Source: U.S. Dept. of Labor OSHA
URL: http://www.osha.gov/SLTC/etools/hospital/hazards/mercury/mer
cury.html

Removing Mercury from Hospital Labs
Abstract: This fact sheet outlines problems you may face when attempting to remove mercury from your hospital labs, steps for tackling mercury in the lab and a table with synonyms and trade names for thimerosal (a widely used preservative with a high level of mercury).
Source: Sustainable Hospitals Project
URL: http://www.sustainablehospitals.org/HTMLSrc/IP_mercury_remov
elabs.html

Selecting Non-Mercury Thermometers
Abstract: This fact sheet outlines points worth thinking about when considering non-mercury thermometers.
Source: Sutsainable Hospitals Project
URL: http://www.sustainablehospitals.org/HTMLSrc/IP_Merc_FTNonmer
c.html

Specifying and Sourcing Mercury-Free HVAC and Building Equipment [PDF]
Abstract: This ?Purchasing for Pollution Prevention? fact sheet from INFORM, Inc. provides information on mercury in building and HVAC (heating, ventilation and air conditioning) equipment. Includes information on mercury-free alternatives and sources for those alternatives, as well as how to deal with mercury components during renovation or demolition. (PDF Format; Length: 4 pages).
Source: INFORM, Inc.
URL: http://www.informinc.org/fs_P3merchvac.pdf

State Government Regulations:2005 Legislation: Eliminating Mercury in Health Care Setting
Abstract: This portion of the American Nurses Association web site provides an overview of legislation related to the elimination of mercury in health care devices in the United States for 2005. A map of the U.S. is provided, showing where such legislation has been introduced or enacted in 2005, and where such legislation has been enacted in prior years.
Source: American Nurses Association (ANA)
URL: http://www.nursingworld.org/gova/state/2005/mercury.htm

The Case Against Mercury: The Problem with Mercury Thermometers
Abstract: A fact sheet providing general information about mercury and mercury thermometers.
Source: Dartmouth Hitchcock Medical Center
URL: http://www.sustainablehospitals.org/HTMLSrc/IP_Merc_Tools_Ca
re.html

The Lowdown on Mercury in Fluorescent Lamps [PDF]
Abstract: This fact sheet from INFORM, Inc. discusses how to tell if a lamp is ?low-mercury,? the amount of mercury in a typical fluorescent lamp, EPA?s Toxic Characteristic Leaching Procedure (TCLP), a comparison of TCLP compliant and non-TCLP lamps, and information on what to do with spent lamps. Recommended specifications for lamp purchasing contracts are also included. (PDF Format; Length: 3 pages)
Source: INFORM, Inc.
URL: http://www.lightcorp.com/PDFs/industrial/learn/InformHgLowdo
wn_DD19D.pdf

Thimerosal in Vaccines
Abstract: Thimerosal is a mercury-containing organic compound (an organomercurial). Since the 1930s, it has been widely used as a preservative in a number of biological and drug products, including many vaccines, to help prevent potentially life threatening contamination with harmful microbes. Over the past several years, because of an increasing awareness of the theoretical potential for neurotoxicity of even low levels of organomercurials and because of the increased number of thimerosal containing vaccines that had been added to the infant immunization schedule, concerns about the use of thimerosal in vaccines and other products have been raised. Thimerosal has been removed from or reduced to trace amounts in all vaccines routinely recommended for children 6 years of age and younger, with the exception of inactivated influenza vaccine; a preservative-free version of the inactivated influenza vaccine (contains trace amounts of thimerosal) is available in limited supply at this time for use in infants, children and pregnant women. In this document, a discussion of preservatives, the use of thimerosal as a preservative, guidelines on exposure to organomercurials (primarily methylmercury), thimerosal toxicity, recent and future FDA actions, and the conclusions of the Institute of Medicine's most recent review of thimerosal in vaccines are presented. This narrative on thimerosal contains references to the literature and links to other sites for readers who wish additional information; for quick reference, a number of frequently asked questions (FAQs) and answers are provided.
Source: U.S. Food & Drug Administration (FDA)
URL: http://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability
/VaccineSafety/UCM096228

Tips for Procuring Aneroid Sphygmomanometers
Abstract: This fact sheet provides a list of considerations to keep in mind when procuring aneroid sphygmomanometers.
Source: Sustainable Hospitals Project
URL: http://www.sustainablehospitals.org/HTMLSrc/IP_Sphygmotips.h
tml

Tips on Testing Reagents and Chemicals
Abstract: Testing reagents and chemicals for mercury can be a very expensive undertaking. This fact sheet lists points to consider before sending out samples for testing
Source: Sustainable Hospitals Project
URL: http://www.sustainablehospitals.org/HTMLSrc/IP_mercury_testt
ips.html


- List -    Top of Page

Mercury and Dental Amalgam Recyclers in New York State
Abstract: This portion of the New York State Department of Environmental Conservation (NYSDEC) web site provides a list of mercury and dental amalgam recyclers in the state of New York. Each record includes a phone number, services provided, what types of amalgam are accepted, cost, and other notes.
Source: NYSDEC
URL: http://www.dec.state.ny.us/website/dshm/redrecy/merclist.htm

Mercury in Drug and Biological Products
Abstract: FDA list of mercury ingredients in drug and biological products, as derived from submissions made by manufacturers in response to the agency's call-for-data notices of December 14, 1998 (63 FR 68775), April 29, 1999 (64 FR 23083) and February 3, 2003 (68 FR 5299), the agency's Drug Registration and Listing System, and other agency sources. List includes manufacturer's name, product name, the mercury ingredient involved, and the percentage of that ingredient in the product. The mercury ingredients are abbreviated as TM for thimerosal, PMA for phenylmercuric acetate, PMN for phenylmercuric nitrate, MA for mercuric acetate, MN for mercuric nitrate, MB for merbromin, and MOY for mercuric oxide yellow. The list includes nonhomeopathic human and veterinary drug products and human biological products. Homeopathic drug products are not included because of the low amounts of mercury present in the products.
Source: U.S. Food & Drug Administration (FDA)
URL: http://www.fda.gov/RegulatoryInformation/Legislation/Federal
FoodDrugandCosmeticActFDCAct/SignificantAmendmentstotheF
DCAct/FDAMA/ucm100218.htm

Mercury Ordinances/Resolutions
Abstract: This portion of the Health Care Without Harm website lists state laws, local ordinances and resolutions from throughout the United States banning the manufacture, sale or distribution of mercury-containing devices. This list includes links to the actual text of each of the laws, ordinances and resolutions.
Source: Health Care Without Harm
URL: http://www.noharm.org/mercury/ordinances

Mercury-Free Pharmacies
Abstract: This portion of the Health Care Without Harm web site lists pharmacies throughout the United States that have phased out the manufacture, distribution and sale of mercury-containing devices.
Source: Health Care Without Harm
URL: http://www.noharm.org/us/mercury/mercuryFree


- Manual/handbook/curriculum -    Top of Page

A Guide for Managing Mercury and Amalgam Wastes
Abstract: This portion of the New York State Department of Environmental Conservation (NYSDEC) web site provides guidelines for managing mercury and amalgam wastes in dental offices. Included are information on elemental mercury, amalgam capsules, dental amalgam, recycling scrap amalgam, chair-side traps, amalgam traps, amalgam separators, plumbing replacement and repairs, additional sources of mercury in dental offices, and office renovations.
Source: NYSDEC
URL: http://www.dec.state.ny.us/website/dshm/redrecy/mercbmp.htm

A Guide to Mercury Assessment and Elimination in Health Care Facilities [PDF]
Abstract: Following an introduction to mercury in Chapter I, this document is arranged to that the reader is presented with information on where mercury may be found in healthcare settings, how it should be handled, how to assess where it is located and plan for its removal, and the impacts from mercury spills. Chapter II discusses what pieces of equipment and devices found in healthcare facilities may contain mercury and what non mercury-containing replacements or alternatives are available. Chapter III discusses how to handle mercury safely within healthcare facilities to reduce spills and contamination. The chapter also includes spill response information. Chapter IV presents the findings from the mercury assessments conducted at the six San Franciso Bay Area healthcare facilities that participated in this project. Included in Chapter IV is a business plan for each facility for mercury removal. Chapter V provides insight as to where mercury-containing equipment and devices are typically found in healthcare facilities. The use of the mercury assessment tool is described in Chapter VI. Chapter VII covers the impact from a mercury spill at a healthcare facility on the University of California, Los Angeles campus. (PDF Format; Length: 79 pages)
Source: California Department of Health Services
URL: http://www.dhs.ca.gov/ps/ddwem/environmental/Med_Waste/hp3/G
uidetoMercuryAssess%20wd2000%20v1.11.pdf

A Pollution Prevention Guide to Reducing Mercury Emissions from Health Care Facility Incinerators [PDF]
Abstract: The recommendations in this guidance document will help minimize or eliminate mercury releases from health care facility incinerators. Includes information on medical instruments and products that may contain mercury, laboratory chemicals that may contain mercury, benefits of mercury source reduction, recommended actions to be taken, best management practices for the management of mercury in health care facilities, mercury free alternatives, and mercury recyclers in the Northeast U.S. (PDF format; Length: 11 pages)
Source: New York State Dept. of Environmental Conservation
URL: http://www.dec.state.ny.us/website/ppu/merchosp.pdf

How to Establish Mercury Pollution Prevention in Your Hospital
Abstract: This how-to manual from the Sustainable Hospitals Project outlines the five steps involved with establishing a mercury pollution prevention program at your hospital: getting started, gathering data, establishing realistic goals and implementation plans, instituting best management practices, and measuring, documenting and advertising success.
Source: Sustainable Hospitals Project
URL: http://www.sustainablehospitals.org/HTMLSrc/IP_Merc_How.html

Mercury Use: Dentists
Abstract: Part of the Wisconsin Mercury Sourcebook covering mercury use and pollution prevention in dental offices, primarily amalgams.
Source: Wisconsin Department of Natural Resources
URL: http://infohouse.p2ric.org/ref/04/03851/dentist.pdf

Mercury Use: Hospitals and Clinics [PDF]
Abstract: Part of the Wisconsin Mercury Sourcebook covering mercury use and pollution prevention in hospitals and clinics.
Source: Wisconsin Department of Natural Resources
URL: http://infohouse.p2ric.org/ref/04/03851/hospital.pdf

Mercury Use: Nursing Homes [PDF]
Abstract: Part of the Wisconsin Mercury Sourcebook covering mercury use and pollution prevention in nursing homes.
Source: Wisconsin Department of Natural Resources
URL: http://infohouse.p2ric.org/ref/04/03851/nursing.pdf

Mercury Use: Veterinary Clinics [PDF]
Abstract: Part of the Wisconsin Mercury Sourcebook covering mercury use and pollution prevention in veterinary clinics.
Source: Wisconsin Department of Natural Resources
URL: http://infohouse.p2ric.org/ref/04/03851/veterinary.PDF

Reducing Mercury Use in Healthcare: Promoting a Healthier Environment: A How-to Manual
Abstract: The purpose of this manual is to help hospitals start mercury pollution prevention programs or accelerate programs that have already begun.
Source: U.S. Environmental Protection Agency, Great Lakes National Program Office
URL: http://www.epa.gov/glnpo/bnsdocs/merchealth/

Reducing Mercury Use in Healthcare: Promoting a Healthier Environment: A How-to Manual
Abstract: The purpose of this manual is to help hospitals start mercury pollution prevention programs or accelerate programs that have already begun.
Source: U.S. Environmental Protection Agency, Great Lakes National Program Office
URL: http://www.epa.gov/glnpo/bnsdocs/merchealth/

Replacing Mercury in Healthcare Facilities--A Step-by-Step Approach
Abstract: This H2E guide provides 10 steps for reducing mercury in healthcare facilities.
Source: Hospitals for a Healthy Environment (H2E)
URL: http://www.h2e-online.org/hazmat/mercguide.html


- Other resources -    Top of Page

Introduction to Mercury Issues
Abstract: This on-line training (PowerPoint presentation) from the Ohio EPA provides an introduction to mercury issues for the general public and businesses. It is meant to provide an introduction to the various forms of mercury and their health effects, identify where mercury is found, identify steps to take to reduce mercury use and provide some basic resources to further explore mercury issues. Information on mercury P2 assistance for Ohio is included. Note: This presentation was optimized for more recent versions of Microsoft Internet Explorer.
Source: Ohio EPA OCAPP
URL: http://www.epa.state.oh.us/ocapp/p2/mercury_presentation/mer
cury_presentation_files/frame.htm

Main Hospitals for a Healthy Environment Pollution Prevention Agreement
Abstract: Every hospital in Maine has signed a landmark agreement with the state?s Department of Environmental Protection (DEP) and environmental groups to significantly reduce or eliminate use of products that contribute to the release or mercury and dioxin to Maine?s environment. This is the text of the pollution prevention agreement between the Maine DEP and the Maine Hospital Association.
Source: Maine Department of Environmental Protection
URL: http://www.maine.gov/dep/ppagree.htm

New York State's Dental Mercury and Amalgam Recycling Law
Abstract: This portion of the New York State Department of Environmental Conservation (NYSDEC) web site provides the text of a New York state law dealing with the recycling of elemental mercury and dental amalgam by dentists.
Source: NYSDEC
URL: http://www.dec.state.ny.us/website/dshm/redrecy/chap506.htm

New York: Regulations for Mercury and Amalgam Recycling at Dental Facilities
Abstract: This portion of the New York State Department of Environmental Conservation (NYSDEC) web site describes standards for management of mercury and dental amalgam wastes at dental facilities in New York. The 6 NYCRR Part 374-4 regulations are effective May 12, 2006.
Source: NYSDEC
URL: http://www.dec.state.ny.us/website/dshm/redrecy/374regs.html

Online Mercury Products Photo Database
Abstract: Cuoco & Cormier Engineering has been hired by a Massachusetts solid waste incinerator to perform a mercury survey of schools in their service area. The intent of this effort is to identify and recover mercury bearing products as well as to promote the proper management of universal waste. This online database contains photographs of common mercury bearing products that the company's staff has identified in schools, office buildings and manufacturing facilities. Images may be useful in training facility managers to identify mercury-containing products.
Source: Cuoco &Cormier Engineering Associates, Inc.
URL: http://www.cuocoandcormier.com/Environmental-mercuryrecovery
.shtml

Truth Revealed: New Scientific Discoveries Regarding Mercury in Medicine and Autism
Abstract: Hearing held on September 8, 2004 on mercury use in vaccines and other medicines and findings suggesting a possible link between mercury exposure and autism.
Source: U.S. House of Representatives Committee on Government Reform
URL: http://www.whale.to/a/gov.html

Wisconsin: Safe Communities and Safe Schools Mercury Reduction Act
Abstract: Congresswoman Tammy Baldwin of Wisconsin introduced H.R. 4260 into the House of Representatives on May 04, 2004. This legislation will provide $75 million in grants to support comprehensive mercury reduction efforts, while restricting the sale of mercury containing fever thermometers and requiring amalgam separation by dentists.
Source: Thomas Register
URL: http://thomas.loc.gov/cgi-bin/bdquery/z?d108:HR04260:@@@L&su
mm2=m&


- Periodical -    Top of Page

The Mercury Menace (Chicago Tribune Series)
Abstract: This multimedia series from the Chicago Tribune includes articles on the newspaper's investigation into the amount of mercury in seafood being sold in Chicago area stores. This site includes links to the articles, including those on the toxic risks and how to minimize those risks, those on the flawed mercury warning system, and those specific to tuna. Also included are a calculator to determine how much fish you can safely consume, a survey, answers to readers' questions in an online forum, links for more information, photos, a graphic showing sources of mercury and a video introduction to the series. Copyright 2005, Chicago Tribune.
Source: Chicago Tribune
URL: http://www.chicagotribune.com/news/specials/broadband/chi-me
rcury-htmlstory,0,3799369.htmlstory


- Software/electronic tool -    Top of Page

Mercury in Medical Facilities
Abstract: Teaches health care professionals about the hazards of mercury as commonly used in health care facilities, especially hospitals and clinics.
Source: U.S. Environmental Protection Agency, Great Lakes National Program Office
URL:

Mercury Use Reduction & Waste Prevention in Medical Facilities
Abstract: This is an interactive environmental education software program developed jointly by the U.S. Environmental Protection Agency and Purdue University to provide information on the proper handling and disposal of mercury wastes produced by medical facilities. Copyright 1996 by Purdue Research Foundation, West Lafayette, Indiana 47907. All Rights Reserved.
Source: U.S. EPA & Purdue University
URL: http://www.purdue.edu/envirosoft/mercury/src/title.htm

The PBT Profiler
Abstract: Designed to be an easy to use, widely available, no-cost tool to screen chemicals lacking experimental data in order to help identify pollution prevention (P2) opportunities. Use to identify persistent bioaccumulative toxic chemicals.
Source: U.S. EPA
URL: http://www.epa.gov/oppt/sf/tools/pbtprofiler.htm


- Web site -    Top of Page

Dentist Offices & Mercury
Abstract: Milwaukee Metropolitan Sewage District (MMSD), is among the Wisconsin DNR, UW-Extension, Wisconsin Dental Association and member components, and other publicly owned wastewater treatment works working together in The Wisconsin Dental Mercury Pollution Prevention Program. This program is intended to reduce the mercury discharge from dental offices. Site includes general information about reducing discharges of mercury from dental offices, a guide booklet on amalgam management, an amalgam separator installation schedule report, and a link to the text of relevant rules.
Source: Milwaukee Metropolitan Sewerage District
URL: http://v3.mmsd.com/dentistofficesmercury.aspx

Environmental Law and Policy Center: Stop Mercury Pollution Now!
Abstract: This portion of the Environmental Law and Policy Center web site provides details on Illinois Governor Rod Blagojevich's Mercury Pollution Reduction Plan, which proposes standards to require coal fired power plants to reduce mercury pollution by 90% or more by June 30, 2009. This site also provides details on a coalition of public health and environmental leaders supporting the Governor's pollution reduction plan and links to additional information.
Source: Environmental Law and Policy Center
URL: http://www.stopmercurypollution.org/

Health Care Without Harm: Mercury
Abstract: Health Care Without Harm seeks to transform the health care industry so it is no longer a source of environmental harm by eliminating pollution in health care practices without compromising safety or care. Site includes a section on mercury.
Source: Health Care Without Harm
URL: http://www.noharm.org/all_regions/issues/toxins/mercury/

Hospitals for a Healthy Environment (H2E)
Abstract: Cooperative effort between the American Hospital Association and EPA with goal of virtual mercury elimination by 2005. Site includes information on mercury, waste reduction, chemicals/P2, green buildings, green purchasing, and other tools.
Source: American Hospital Association
URL: http://cms.h2e-online.org/about/

Interstate Mercury Education & Reduction Clearinghouse (IMERC) Mercury-Added Products Database
Abstract: Maintained by the Northeast Waste Management Officials? Association (NEWMOA), this database presents information submitted to IMERC on the amount and purpose of mercury in consumer products. The database is intended to inform consumers, recyclers, policy makers and others about: products that contain intentionally-added mercury; the amount of mercury in a specific product; the amount of mercury in a specific product line sold in the U.S. in a given year; and manufacturers of mercury added products. The information in this database was submitted to IMERC by or on behalf of product manufacturers in compliance with laws in the states of Connecticut, Maine, New Hampshire and Rhode Island. The database may be searched by sector, product category, manufacturer or amount of mercury content.
Source: NEWMOA
URL: http://www.newmoa.org/prevention/mercury/imerc.cfm

Mercury
Abstract: From MedlinePlus, a very good compilation of links relating to mercury.
Source: National Library of Medicine
URL: http://www.nlm.nih.gov/medlineplus/mercury.html

Mercury Facts
Abstract: Contains links to information about mercury and mercury thermometers.
Source: Pennsylvania Department of Environmental Protection
URL: http://www.dep.state.pa.us/dep/deputate/pollprev/mercury/the
rmometer.htm

Mercury P2
Abstract: This website contains several resources on mercury free alternatives, best management practices, recycling sites and more.
Source: Michigan Department of Environmental Quality
URL: http://www.michigan.gov/deq/0,1607,7-135-3307_29693_4175---,
00.html

Mercury Reduction
Abstract: Includes information on all aspects of mercury in health care settings including best management practices for products containing mercury.
Source: Sustainable Hospitals/Lowell Center for Sustainable Production
URL: http://www.sustainablehospitals.org/HTMLSrc/IP_Mercury.html

Mercury Reduction at Healthcare Facilities
Abstract: In 1999, The NH Department of Environmental Services Pollution Prevention Program partnered with the U.S. Environmental Protection Agency and the NH Hospital Association's Foundation for Healthy Communities to promote the reduction of mercury in health care facilities. This page provides the results of this project and information on the dangers of mercury, sources of mercury in healthcare facilities, and tips for reducing mercury in healthcare facilities.
Source: New Hamshire Department of Environmental Services Pollution Prevention Program
URL: http://des.nh.gov/organization/commissioner/p2au/pps/hs/pphf
p/mercury_reduction.htm

Mercury Reduction Programs Database
Abstract: Maintained by the Northeast Waste Management Officials? Association (NEWMOA), a searchable database that includes descriptions of mercury reduction programs underway around the U.S. Each profile provides a brief description of the project, its title, a list of products affected, program results, sources of funding, and contact information. The database may be searched by state, program title or agency. An online form is available for submission of information on programs not currently included in the database.
Source: NEWMOA
URL: http://www.newmoa.org/prevention/mercury/programs/

Mercury Website - Minnesota
Abstract: Minnesota website dedicated to mercury information.
Source: Minnesota Pollution Control Agency
URL: http://www.pca.state.mn.us/oea/p2/mercury.cfm

National Compliance Assistance Clearinghouse
Abstract: The clearinghouse provides quick access to compliance tools, contacts, and information on planned activities available on the internet from across the EPA as well as other compliance assistance providers.
Source: U.S. EPA
URL: http://www.epa.gov/compliance/assistance/clearinghouse.html

Nearly Everything You Need to Know About Mercury Fever Thermometer Exchanges
Abstract: This portion of the Northeast Waste Management Officials? Association (NEWMOA) web site provides guidance for planning, promoting and conducting a mercury fever thermometer exchange event.
Source: NEWMOA
URL: http://v3.mmsd.com/DentistOfficesMercury.aspx

Nurses Impact 2001: Environmental Quality as a Public Health Issue
Abstract: Issue brief describing current bills dealing with mercury that have been introduced in the Michigan legislature.
Source: Michigan Nurses Association
URL: http://www.minurses.org/gov/issueenvquality.shtml

Ohio Mercury Reduction Group
Abstract: The Ohio Mercury Reduction Group works to reduce the use, release, and emission of mercury in Ohio, to evaluate relevant departmental mercury programs and regulations, collect and assess data, promote the use of mercury alternatives and the collection of retired mercury and products, and educate industry, government and the general public on ways to reduce the sources of mercury in Ohio.
Source: Ohio EPA
URL: http://www.epa.state.oh.us/ocapp/p2/mercury_pbt/mercury.aspx

Targeted Toxins: Mercury
Abstract: The Women's Health and Environment Network (WHEN) focuses on three specific toxins in health care, including mercury.
Source: Women's Health and Environment Network
URL: http://www.when.org/mercury.html

U.S. EPA Mercury Portal
Abstract: This mercury site provides a broad range of information: actions by EPA and others, including international actions; effects on people and the environment; and how to protect you and your family. The site includes collections of information specifically geared toward consumers, parents, schools, health care providers, and business and industry. The site may also be viewed in Spanish.
Source: U.S. Environmental Protection Agency (EPA)
URL: http://www.epa.gov/mercury/

U.S. EPA Safe Mercury Management Program
Abstract: The objective of this web site is to provide comprehensive, accurate, up-to-date information and easy access to web-based resources relating to the management of mercury-containing products and wastes. The site features links to more than 200 state, local, federal and non-governmental organizations and provides information for the general public, regulatory officials, industry and environmental professionals. It also provides technical assistance and information transfer for cleanup of mercury products and wastes.
Source: U.S. EPA
URL: http://www.epa.gov/epawaste/hazard/tsd/mercury/index.htm

U.S. EPA: Human Health Research Program
Abstract: EPA's Human Health Research Program offers this Web site on the latest information on its research to protect public health. The program's science looks at such questions as why some people are more sensitive to pollution and how exposure to chemicals affects people's health. The site is designed for the general public as well as for the scientific community. The site provides easy access to research and results on methods, tools, and data needed to improve risk assessments to protect the public. Visitors to the site will find an overview of the research, information on how research has contributed to decision making, resource materials available in journal publications and reports, and a listing of meetings and conferences.
Source: U.S. Environmental Protection Agency (EPA)
URL: http://www.epa.gov/hhrp/

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The Topic Hub™ is a product of the Pollution Prevention Resource Exchange (P2Rx)

The Mercury-Health Care Topic Hub™ was developed by:

Great Lakes Regional Pollution Prevention Roundtable
Great Lakes Regional Pollution Prevention Roundtable
Contact email: glrppr@istc.illinois.edu

Hub Last Updated: 8/2/2012

GLRPPR is a member of the Pollution Prevention Resource Exchange, a national network of regional information centers: NEWMOA (Northeast), WRRC (Southeast), GLRPPR (Great Lakes), ZeroWasteNet (Southwest), P2RIC (Plains), Peaks to Prairies (Mountain), WSPPN (Pacific Southwest), PPRC (Northwest).

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