KATHMANDU: Mercury disposal has been a neglected issue in Nepal despite its link to health hazards. Mercury is life-threatening and its exposure to human beings may pose a threat to neurological functioning and cause serious damage to brain, kidneys and lungs.

Mahesh Nakarmi, Director of Health Care Waste Management Programme at Health Care Foundation Nepal, said the government should promote alternatives of mercury health equipments. The government should take an initiative to make government hospitals mercury-free and should keep a record of destroyed mercury equipments. “Time has come to take an initiative to phase out mercury-based equipment from hospitals,” said Nakarmi, adding that the government should ensure safe storage as well as disposal of mercury.

Mercury can adversely affect the nervous, digestive, respiratory, immune systems, kidneys and lungs. Exposure to it may result in tremors, impaired vision and hearing, paralysis, insomnia and emotional instability. According to World Health Organisation, it also causes developmental deficits during pregnancy and childhood.

Health professionals should take an initiative to phase out mercury use from health care sector, as it has a direct effect on their health compared to other people, stressed the director. He said the government should motivate them for ‘spill management training’ and the hospital should have ‘spill kit’ for managing destroyed mercury. The spill kit costs around Rs 1,500.

“We are planning to study the condition of fish in various ponds, as people may have disposed mercury in the water sources,” informed Nakarmi, adding that goldsmiths are another potential group that are directly affected by the use of mercury. Number of kidney failure cases among the goldsmiths is high.

Mercury is found in batteries, lab chemicals, fluorescent tubes, pharmaceutical products, housekeeping devices and dental amalgam. National Kidney Centre is the first mercury-free health centre in Nepal. Nakarmi said they were working to manage mercury waste in Patan Hospital, apart from 10 hospitals in Pokhara.

Ram Charitra Sah, executive director of Centre for Public Health and Environmental Development, said the government should formulate policies and strategies for making Nepal a mercury-free country before it is too late.

“Creating awareness among heath-care professionals about the hazards of mercury is a must in the present situation,” said Sah, calling for proper and environmentally sound management of CFL lighting equipments.

According to CEPHED research on ‘Sector wise Import, Use and Management of Mercury in Nepal’ in 2008, Nepal imported 150 kg of mercury compounds during fiscal year 2007-08. The research showed that import, sale and distribution of mercury does not require any government licence. It points out low level of awareness about the mercury and its impact on health among the health care workers, general public, traders, academicians and lab -instructors. It states that there is no provision of formal training on the safe handling of mercury, its compounds and instruments, as well as on the management of spillage and mercury containing waste. The research recommends developing inventory of uses of mercury in Nepal. It also suggests assessment of health impact of mercury use and exploring the alternatives of mercury in different sectors. There is a need for multi-sectorial coordination for substitution of mercury in Nepal.

He said Nepal was moving progressively towards mercury-free healthcare facilities and Ministry of Environment is positive about formulating policies on hazardous waste in coordination with Ministry of Health and Population.

The World Medical Association unanimously passed a resolution in 2008, calling for the phasing out of mercury-use in the health care sector, where delegates said hospitals and medical facilities should switch to mercury-free alternatives.

Mercury impact episodes

• The hazards of methyl mercury poisoning received international attention in 1956 when many residents of Minamata, Japan, became seriously ill, or died, after eating the fish and shellfish in Minamata Bay. Some 35,000 people were affected. More than half of them have now died.

• Another modern mercury tragedy occurred in Iraq in 1971, when 6,500 people were hospitalised and more than 400 died after eating wheat grain treated with a methyl mercury fungicide.

• Several serious incidents of mercury contamination occurred in Canada soon after the Minamata and Nigata cases. In 1969, a pulp and paper mill contaminated the English Wabigoon River system near Dryden in north-western Ontario.

• A study of 180 dentists by researchers at the Glasgow Royal Infirmary in Scotland found the dentists had up to four times the normal level of mercury in their urine and nails and had more kidney disorders and memory lapses than the general public.