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Published on: December 17, 2018
The use of mercury-based medical devices across Croatian healthcare facilities
Nataša Janev Holcer1, Marija Maričević, Anamarija Miočić-Juran
1School of Medicine, Andrija Štampar School of Public Health, University of Zagreb, Zagreb.
Insights
Despite awareness of mercury toxicity, most Croatian nurses prefer mercury thermometers and sphygmomanometers, with many unaware of exposure risks from broken devices. Proper training and device replacement are crucial for reducing mercury exposure in healthcare settings.
Area of Science:
- Environmental Health
- Occupational Health
- Medical Device Safety
Background:
- Mercury-based medical devices like thermometers and sphygmomanometers remain in use in Croatian healthcare facilities.
- Nurses express a preference for mercury devices due to perceived precision and reliability, despite awareness of mercury toxicity.
- A significant gap exists in understanding the risks associated with broken mercury devices and proper mercury disposal procedures.
Purpose of the Study:
- To assess the utilization and disposal practices of mercury-based medical devices in Croatian healthcare facilities.
- To evaluate healthcare professionals' knowledge of mercury toxicity and their attitudes towards mercury-based versus electronic devices.
- To identify risks of mercury exposure and inform strategies for safer medical practices.
Main Methods:
- A survey was conducted in 2009 using questionnaires distributed to ward nurses in 40 Croatian healthcare facilities.
- The questionnaire covered the use of mercury devices, waste management, device preferences, and knowledge of mercury toxicity.
- Data on the frequency of device breakage and disposal procedures were collected.
Main Results:
- Only one facility had ceased using mercury devices; 84.6% of nurses underestimated risks from broken devices, though 90% knew of mercury toxicity.
- Nurses favored mercury devices (69.4%) due to precision, reliability, and limited training on electronic alternatives.
- An estimated 278 thermometers and 5 sphygmomanomanometers break monthly, with only 46.2% of facilities having proper disposal protocols.
Conclusions:
- Healthcare professionals, particularly nurses, require enhanced training on managing broken mercury devices and mercury spills.
- Croatian healthcare facilities must implement staff protection guidelines and phased replacement programs for mercury-based devices.
- Adherence to EU directives is necessary to mitigate mercury exposure risks in the healthcare environment.
Abstract:
In 2009, we conducted a survey to assess the use of mercury-based thermometers and sphygmomanometers and their disposal in Croatian healthcare facilities. The questionnaire addressing the use of mercury-based medical devices, waste management, preferences between mercury-based and electronic devices, and the knowledge on mercury toxicity was filled by ward nurses affiliated with 40 (71.4 %) out of 56 contacted healthcare facilities. Only one of these facilities had given up the use of mercury-containing medical devices at the time. As many as 84.6 % of the nurses believed that broken devices did not increase the risk of mercury exposure, even though 90 % claimed they were aware of mercury toxicity. In fact, 69.4 % of the nurses preferred mercury-containing devices on account of their precision and reliability and because they received little training in the use of electronic devices.Breaking of thermometers and sphygmomanometers is common in healthcare facilities. The number of broken thermometers and sphygmomanometers was estimated to 278 and five per month, respectively. Only 18 (46.2 %) of the surveyed healthcare facilities claimed to have had a proper disposal procedure for mercury from broken devices. Nurses, who most often handle these devices and collect mercury spills, are primarily exposed to mercury vapours via inhalation. Croatia has adopted the EU Directive 76/769/EEC intended to reduce mercury exposure in the living and working environment. Our survey suggests that all healthcare professionals need training in proper management of broken mercury-based medical devices, nurses in particular. To reduce the risk of exposure, all Croatian healthcare facilities should implement guidelines for staff protection and programmes to gradually replace mercury-based with electronic devices.
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