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Key documents

General documents

 

Memorandum of Understanding

American Hospital Association and U.S. Environmental Protection Agency, (Chicago, Ill.: June 24, 1998). A complete statement outlining the goals of the AHA and EPA for mercury reduction and elimination.

http://www.epa.gov/glnpo/toxteam/ahamou.htm

Practice Greenhealth - Hospitals for a Healthy Environment (H2E)

The American Hospital Association and the Environmental Protection Agency entered into a voluntary partnership, a Memorandum of Understanding (MOU), in June of 1998 with the agreement to "virtually eliminate" all mercury-containing waste from hospitals by 2005. As part of this MOU, tools and resources for mercury elimination made available through Hospitals for a Health Environment (H2E), are now incorporated into Practice Greenhealth. (PGH) and remain available from PGH. Links and resources on mercury reduction, including batteries are provided below

Mercury Study Report to Congress

This major study is a response to the Clean Air Act as amended in 1990, and assesses the magnitude of U.S. mercury emissions by source, the health and environmental implications of those emissions, and availability and cost of control technologies. All eight volumes are available from the Environmental Protection Agency as pdf files. Volume I is an executive summary (EPA-425/R-97-003, June 1997) of the study.

http://www.epa.gov/mercury/report.htm

Mercury White Paper –EPA

This five-page document summarizes the sources and health effects of exposure, communication efforts to inform the public, and actions and research efforts to reduce the use of mercury.

http://www.epa.gov/oar/whtpaper.pdf

EPA Mercury Web site

The Environmental Protection Agency has a wealth of information linked to this new Web site, including general information, frequently asked questions (FAQs), and technical documents. The site links to a page of background information on regulations as well as to multiple manuals and documents developed by states in collaboration with EPA.

http://www.epa.gov/mercury/healthcare.htm

EPA Guide to Fluorescent Lamp Recycling d23-0909

This document is intended to increase the awareness; provide resources and information on safe lamp recycling practices; and encourage the recycling of all spent fluorescent lamps. The EPA has awarded grants to state and nonprofit organizations through its National Mercury Lamp Recycling Outreach Program for development and implementation of mercury lamp recycling outreach programs: http://www.epa.gov/epawaste/hazard/wastetypes/universal/lamps/outreach.htm.

EPA Fact Sheets

EPA Fact Sheets address issues of interest to healthcare facilities and may be downloaded directly from the listed Web site. Topics include: 1) keeping mercury out of medical waste, 2) use of alternative products, and 3) keeping mercury out of the wastewater stream.

http://www.epa.gov/mercury/healthcare.htm

EPA Frequently Asked Questions: Mercury Thermometers

Comprehensive answers to questions about why they should be eliminated, alternatives, risks, and what to do with broken thermometers.

http://www.epa.gov/epaoswer/hazwaste/mercury/spills.htm

Mercury in Medical Facilities

Excellent interactive environmental education software package developed by Purdue University and the EPA to provide information on the proper handling and disposal of mercury waste. "Software Environmental Awareness" has other downloadable programs (such as the "virtual hospital"). Programs may be viewed or downloaded as pdf files.

http://www.epa.gov/grtlakes/seahome/mercury.html#download

Mercury Use Reduction and Waste Prevention in Medical Facilities

This "virtual hospital" is a graphic presentation on mercury sources in the hospital; includes self-study and case study materials Designed by the EPA and Purdue University.

http://www.epa.gov/seahome/mercury_disclaim.html

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State and EPA collaborations

Following is a list of Web sites that provide additional information on mercury. Information found on the Internet does not reflect the opinions or business relationships of Premier.

Mercury Management Guidebook 1999 (Massachusetts-MASCO)

Medical Academic and Scientific Community Organization, Inc. (MASCO) and the Massachusetts Water Resources Authority (MWRA) formed the MWRA/MASCO Mercury Work Group to 1) identify sources of mercury contamination and develop recommendations for their control; 2) develop guidelines for the removal of residual mercury from wastewater systems; and 3) identify and evaluate potential mercury pretreatment systems. The guidebook contains valuable case studies from hospital pathology and clinical laboratories.

http://www.masco.org

Sustainable Hospitals Project - University of Massachusetts at Lowell

This sustainable project provides technical support to the healthcare industry for selecting products and work practices that eliminate or reduce occupational and environmental hazards, maintain quality patient care, and contain costs. This includes determining alternative products by category (for example, batteries), by manufacturer, by hazard (mercury) or by product name. Additional features includes a clearinghouse function, action steps for environmentally preferable purchasing, and fact sheets.

http://www.sustainablehospitals.org

Michigan’s Mercury Pollution Prevention (P2)

Michigan Department of Environmental Quality, Environmental Assistance Division. Provides product alternatives, spill prevention, and best management practices, among other resources.

Michigan Pollution Prevention (P2)

Mercury Use in Hospitals and Clinics. Minnesota Office of Environmental Assistance, 1999.

Handout excerpted from the Wisconsin Mercury Source Book and adapted for Minnesota hospitals and clinics. It includes information on mercury-containing products unique to hospitals and clinics, case studies and action ideas for pollution prevention, recycling information, and management practices for a hospital or clinic. A good overview of the types of mercury-containing products and alternatives that may exist in hospitals and clinics is also provided. Contact: Minnesota Office of Environmental Assistance at 520 Lafayette Rd., 2nd Floor, St. Paul, MN 55155-3898, phone 612-296-3417 or 800-657-3843.

http://www.mnexchange.org

New England EPA

The mercury challenge: what to do and how to start

http://www.epa.gov/region01/eco/mercury/index.html

New Hampshire Mercury Reduction in Health Care

"Mercury in Medical Facilities" provides a comprehensive program for reducing mercury in medical facilities, including a list of mercury disposal options and mercury spill kit vendors for New England as compiled by EPA-Region 1.

http://www.des.state.nh.us/nhppp/Healthcare_P2/default.asp?link=hg

Reducing Mercury Use in Health Care: Promoting a Healthier Environment: A How-to Manual. 1998. Monroe County, New York

One of the most comprehensive and clearly written manuals for reducing mercury in the healthcare environment. Developed by the Monroe County Department of Health, Rochester, NY; also available through EPA’s mercury Web page. Can be viewed or downloaded as a pdf file.

http://www.epa.gov/glnpo/bnsdocs/merchealth

Pollution Prevention Unit, New York Department of Environmental Conservation

This site provides self-assessments for pollution prevention. Go to: "Publications" and "Environmental Self-Assessment for Health Care Facilities."

http://www.dec.state.ny.us/website/ppu/p2pub.html

Wisconsin Mercury Source Book

This manual from the Department of Natural Resources contains information applicable to specific areas, such as hospitals, clinics, laboratories, and nursing homes, Addresses mercury issues and includes case studies. Downloadable .pdf files. Go to:

http://www.epa.gov/glnpo/bnsdocs/hgsbook/index.html

Healthcare Environet Resources Canada

Established through funding from Environment Canada and the Ontario Ministry of Environment and Energy. Developed in consultation with healthcare and non-governmental organizations.

http://www.c2p2online.com/main.php3?section=83&doc_id=169&session=

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Environmentally preferable purchasing (EPP)

"How-to" guide produced by the EPP Workgroup of Hospitals for a Healthy Environment (H2E).

http://www.geocities.com/epp_how_to_guide/

Healthcare Environmental Purchasing Tool

The Association for Healthcare Resource and Material Management (AHRMM) provides a comprehensive site on reduction of "persistent, bioaccumulative, toxic" (PBT) materials in the environment, including mercury. The Health Care Environmental Purchasing Tool targets the reduction of PBTs, particularly mercury and toxic halogenated compounds, from healthcare facilities.

http://www.hospitalconnect.com/ahrmm/products/HCEPT/

Catholic Healthcare West Environmental Annual Report

An example of what a healthcare system can accomplish in developing policies for environmentally preferable purchasing.

Environmental report - Fiscal year 2004 (.pdf)

Health Care Without Harm (HCWH)

A multinational, collaborative campaign for environmentally responsible healthcare, involving more than 250 organizations. HCWH provides a wide variety of information including a fact sheet, "Making Medicine Mercury-Free."

http://www.noharm.org

Executive Order - Greening the Government

President Clinton's order on Greening the Government Through Waste Prevention, Recycling, and Federal Acquisition, September 14, 1998 (EO 13101), 49641-49651 [FR Doc. 98-25023].

http://www.access.gpo.gov/su_docs/fedreg/a980916c.html

Greening Hospitals

1998 report with executive summary, full report, and survey results available at Web site of the Environmental Working Group, Washington, DC.

http://www.ewg.org/pub/home/reports/greening/greenexec.html

Protecting by Degrees: What Hospitals Can Do to Reduce Mercury Pollution

Report from the Environmental Working Group, providing information on toxicity of mercury in fish, hospital case studies, and recommendations to reduce mercury use.

http://www.ewg.org/pub/home/reports/Protectingbydegrees/protectingpr.html

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Resources for alternative products

INFORM Inc.- Environmental research organization

INFORM Inc provides this fact sheet, Purchasing low-mercury fluorescent lamps, among many resources developed by INFORM Inc, an environmental research organization. This fact sheet provides recommendations for lamp-purchasing contracts, advice on how to ascertain that a lamp is low mercury and other purchasing considerations. This site provides additional information on toxic chemicals and promotion of waste prevention.

http://www.informinc.org/fact_P3fluorescentlamps.php

Mercury-containing laboratory reagents -MnTAP

Minnesota’s Technical Assistance program (MnTAP) provides a list of mercury-containing laboratory reagents used in healthcare laboratories. An extensive chart provides the vendor/manufacturer, product name and percent of mercury in the reagent, and MSDS information as appropriate.

http://www.mntap.umn.edu/health/92-Mercury.htm

Lowell Center for Sustainable Production -- Clinical, industrial equipment alternatives

In January 2003, the Lowell Center for Sustainable Production published An Investigation of Alternatives to Mercury Containing Products, an 85 page report prepared for the Maine Depart of Environmental Protection. I Topics include clinical equipment (e.g., manometers, thermometers,) as well as industrial equipment (thermostats, switches). It may be downloaded:

Alternatives to Mercury Containing Products (.pdf)

Mercury recycling - H2E

Hospitals for a Healthy Environment (H2E) has added additional companies to a 9 page chart of companies, processes used, special conditions and service areas. Go to:

http://www.h2e-online.org/tools/hg-recy.htm

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