Mercury Containing Products Found in Hospital Settings

Attachment B - Mercury Containing Products Found in Hospital Settings

Table 1. Alternatives for Mercury-Containing Thermometers

Type of Thermometer	Cost	Accuracy	Time for Reading	Calibration Frequency	Comments
Electronic (digital): oral/rectal	Thermometer approx. $300. Disposable covers: pennies a piece	Comparable to mercury	Oral: seconds Rectal: seconds	Every 6 mo. - 1 year. Some need initial testing only	Requires batteries
Electronic (digital): tympanic (also called infrared thermometer)	Thermometer approx. $300. Covers: pennies a piece	Comparable to mercury	Seconds	Every 6 mo. - 1 year. Some need initial testing only.	Requires batteries. Must use “pull and tug” method to get correct placement.
Glass filled with alloy of gallium, indium, and tin (liquid at room temperature).	Approximately $3	Comparable to mercury	3 minutes	None required	Breakable
Mercury	Approximately $0.40	Considered being the “standard”.	Oral: 5 min Rectal: 7 min	None required	Breakable. Expensive disposal.

Table 2. Alternatives for Mercury-Containing Sphygmomanometers

Type of Sphygmomanometer	Cost	Comments
Aneroid	Wall model adult: $50 - 80; portable model adult: $30 - 35	Needs calibration annually. Accuracy comparable to mercury.
Electronic	About $2,000	Common where long-term continuos monitoring is needed, such as intensive care.
Mercury	Wall model adult: $60-70.	Requires annual refilling and calibration. Expensive disposal.

Table 3. Alternatives for Mercury-Containing Gastrointestinal Tubes

Type of GI Tube	Mercury-Free Alternative and Effectiveness
Bougie Tubes (esophageal dilators)	Tungsten. Considered to be as effective as mercury
Cantor tubes (used to trace the GI tract)	Tungsten. Can be purchased empty of weighting and hospital adds the tungsten
Miller Abbott tubes (used to clear intestinal obstruction)	Tungsten. Can be purchased empty of weighting and hospital adds the weighting material. Tungsten is considered to be as effective as mercury.
Feeding tubes	Tungsten. Considered being as effective as mercury.

Table 4. Alternatives for Mercury-Containing Batteries

Battery	Quantity	Use	Voltage	Available Alternatives
Mercuric oxide (mercury zinc)	33-50% by weight	Medical	Multiples of 1.4 v	Zinc-air (may contain up to 25 mg mercury, 0.4-1.0% by weight)
Button batteries: Zinc air	No federal law, but addition for mercury over 25 mg prohibited in some states. Manufactures use this standard for all button batteries	Medical	Multiples of 1.4 v	None
Button batteries: Alkaline-manganese	Federal law allows up to 25 mg mercury	Consumer	Multiples of 1.5 v	Silver oxide (lasts longer, costs more, does not come in a full range of sizes)
Button batteries: Silver oxide	Contains some mercury but less than alkaline manganese button batteries	Consumer	Multiples of 1.5 v	None

Table 5. Alternatives for Mercury-Containing Laboratory Manometers

Type of Manometer	Cost	Comments
Electronic (digital)	Several hundred dollars	An order of magnitude more accurate than sphygmomanometers. Used in biomedical laboratory to calibrate other devices. A traceable calibration must be performed with a mercury manometer, onsite or offsite, on a regular schedule.
Aneroid (Bourdon, diaphragm, piston or capsule types)	Price varies depending on accuracy	Manufactures recommend calibration at least annually.
Liquid filled	Price varies depending on accuracy	Inadvisable to move it from place to place. Manufacturers recommend calibration at least annually.
Mercury	$100-$150 range	One meter tall. An order of magnitude more accurate than sphygmomanometers. Used in biomedical laboratory to calibrate devices. Annual calibration recommended.

Table 6. Mercury-Containing Electrical Equipment

Type of Switch	Where Equipment is Used	Possible Alternative
Tilt switch	- Airflow/fan limit control - Building security systems - Clothes iron - Fire alarm box - Fluid level, pressure or temperature devices - Laptop computer screen shutoff - Lids of clothes washers and chest freezers - Silent light switch - Space heater - Thermostats	Mechanical switch
Float switch	- Bilge pumps - Septic tank - Sump pump	- Magnetic dry reed switch - Optic sensor - Mechanical switch
Thermostat	Temperature control device may have a mercury tilt switch	Electronic thermostat
Reed delay	Low voltage, high precision analytical equipment such as electron microscope	Solid state relay, Electro-optical relay, dry reed delay
Plunger or displacement relay	High currents high voltage applications such as lighting, resistance heating, power supply switching	Mechanical switch
Thermostat probe	Electric stoves, hot water heaters	Non-mercury probe

Table 7. Pharmaceuticals Containing Mercury

Product	Notes
Merbromin/water solution	Used in plastic/reconstructive surgery as a disinfectant and marker
Ophthalmic and contact lens products	May contain mercury preservatives: Thimerosal, phenylmercuric acetate, phenylmercuric nitrate
Nasal sprays	May contain mercury preservatives: Thimerosal, phenylmercuric acetate, phenylmercuric nitrate
Vaccines	May contain Thimerosal (primarily in hemophilus, hepatitis, rabies, tetanus, influenza, diphtheria and pertussis vaccines)

Table 8. Mercury Content of Selected Cleaning Products

The mercury-cell process is one of the processes that may be used to manufacture common ingredients of cleaners and degreasers: sodium hydroxide, potassium hydroxide, chlorine and hydrochloric acid. When these chemicals are used to make other products, such as bleach or soaps, mercury contamination can be introduced in the final product. The Massachusetts Water Resources Authority (MWRA) and Medical, Academic and Scientific Community Organization, Inc. (MASCO), through a public-private partnership called the MWRA/MASCO Mercury Work Group, performed analyses on some of these products. Testing of the products was limited and many common cleaning products have not been tested. The data should not be used as a substitute for testing specific products/chemicals.

Product	Mercury Content (ppb)
Ajax Powder	0.17
Comet Cleaner	0.15
Lysol Direct	<0.011
Soft Scrub	<0.013
Alconox Soap	0.004 mg/kg, 0.005 mg/kg, <0.0025 mg/kg (3 tests)
Derm Scrub	<5.0, <2.5 (2 tests)
Dove Soap	0.0027
Ivory Dishwashing liquid	0.061
Joy Dishwashing Liquid	<0.01
Murphy’s Oil Soap	<0.012
Soft Cide Soap (Baxter)	8.1
Sparkleen Detergent	0.0086
Sunlight Dishwashing Detergent	<0.011