Many of them would also know that the black line which rises and falls to reflect the variations in body temperature is mercury. [break]
But if you ask them whether they know that mercury is a hazardous chemical that can even have a fatal consequence, most people will go mute with an expression of ignorance on their face.
The seemingly innocuous traditional thermometer contains extremely harmful mercury an unwanted exposure to which, doctors say, could result in damages to brain, spinal cord, kidney and liver.
Not just thermometer, the use of mercury is common in many items of daily use, which poses a direct threat to people´s health.
In the health sector alone, mercury is widely used in sphygmomanometers, dental amalgam, laboratory reagents, vaccines, apart from thermometers. Similarly, mercury is used in batteries, measuring and control equipments, electrical and electronic lighting, gold mining, etc.
Mercury thermometer
The use of mercury is common across the health sector, but it is particularly rife in dental hospitals and clinics. Mercury-based dental amalgam is very widely used in treating teeth cavities.
However, the process of preparing the amalgam has a grave impact on environment. Toxic mercury vapor released during the process pollutes the surrounding air, experts say.
Even more alarming is the careless manner in which dental hospitals and clinics dispose of unused amalgam. It leads to soil and water pollution that has serious consequences over time.
Dr Praveen Mishra, secretary at Ministry of Health and Population (MOHP), says he knows about some dental surgeons who developed health complications due to careless handling of mercury.
"Some have even lost their lives,” Mishra said, while addressing an interaction program organized by CEPHED. But he was quick to add that the situation has changed because “we now have many alternatives to avoid the use mercury-based amalgam.”
Even in Ayurved, mercury plays a very important role in preparation of medicines. Makar Dhoj, Rash Sindur, Inganeshwor, etc., are some of the popular Ayurvedic medicines that use mercury as ingredient.
Ayurved experts, however, say that they only used refined mercury. “Even poison, let alone the mercury, is used to make Ayurved medicines,” says Dr Ram Narayan Sah, deputy chief of the Department of Ayurved, Nepal.
“Yes, mercury is harmful, but we only use refined mercury because as of now we haven´t found any other substance that can replace it,” adds Sah.
A research conducted by Center for Public Health and Environmental Development (CEPHED) shows mercury is found not only in the environment but also on the bodies of doctors and nurses.
“As the study showed that traces of mercury were found on the bodies of health workers, it is high time to replace the objects that use mercury,” says Ram Charitra Sah, executive director at CEPHED. “Not enough is being done to protect health professionals from the negative effects of mercury,” added Sah.
Though the problem is emerging as a major challenge, the government has taken little initiative to ensure a mercury free health service.
Though mercury is known as a chemical element widely found in nature, when it dissolves with water and air or mixes with soil, it can harm nervous, digestive and respiratory systems and causes skin sensitization.
The effects to nervous system can cause tremors, sleeplessness, memory loss, headache, vomiting, diarrhea, emotional instability, among others.
The exposure can also cause infertility and negatively affect both the mother and child during pregnancy.
Despite the country´s participation in the last five international conventions on mercury-free health sector, Nepal has yet to come up with provisions on licensing import and sale of mercury and introduce mercury emission standards.
The Anti-Mercury UN Minimata Convention pledges to make the whole earth free of mercury by 2020.
There is no way that Nepal will meet the convention´s deadline as neither people nor health workers have been properly trained to handle and dispose mercury-based waste.
For example, every now and then mercury thermometer breaks at hospitals and clinics but their staff is not trained to deal with the mercury spill, so there is a high-degree of mercury contamination of air, water and soil around hospitals.
"Seven-year is not enough to deal with the situation," opines Sah of CEPHED.
“The problem of mercury cannot be solved overnight. We have to tackle it step by step,” says Govind Prasad Pokhrel, a senior engineer with Ministry of Science, Technology and Environment, who has participated in international conventions.
“It takes a lot of time to replace mercury by other alternatives. Therefore, we must have patience,” adds Pokhrel.
Many countries like Sweden, Netherlands, France, Norway and Denmark have banned the use of mercury-based equipment such as thermometer and dental amalgam as it is hazardous to the environment.
Nepal, however, has yet to conduct a proper study about the effects of mercury and its proper management.
The government must join the fight to create a mercury-free environment. Since the measures are already in place internationally, concerned authorities should have no problem in following them.
They can even engage private sector in the effort.
The data prepared by CEPHED shows a majority of dental hospitals and clinics in the Kathmandu Valley using mercury-based equipment like thermometer, barometer and sphygmomanometers.
In the Valley, where the health officials are aware that mercury is dangerous to environment and human health, no serious initiative have been launched to curb it´s use.
In this scenario, how the situation outside the valley is could be anybody´s guess.
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INTERVIEW
Mercury is like slow poisonRam Charitra Sah
Executive Director
Centre for Public Health and Environmental Development (CEPHED)
Why is mercury a problem?
If mercury dissolves in water, air and soil, people may suffer from different health complications like tremors, sleeplessness, memory loss, headache, emotional instability, digestive and respiratory problems, skin sensitization and infertility.
Who are prone to the effects of mercury?
Especially health workers and the environment are prone to the adverse effects of mercury. In our survey, we have found several doctors and nurses affected by mercury.
How can people be affected by mercury?
Mercury is like slow poison. Dental amalgam, used to fill teeth cavity, contains mercury. While filling cavity with amalgam or removing it, mercury may be dissolved with our environment. Haphazard handling and disposal of mercury not only affects human beings but also aquatic and terrestrial animals, micro-organisms, plants and the whole environment. Besides, people with dental amalgam are likely to swallow mercury while chewing food.
What should we avoid the potential risks of exposure to mercury?
To get rid of mercury, we have to ban equipments that use the substance. There are many alternatives available in the market. For instance, mercury thermometer can be replaced with digital electronic thermometers or glass alcohol thermometers. Similarly, aneroid, electronic blood sphygmomanometer can be used instead of mercury sphygmomanometer. Dentists, likewise, should switch to non-mercury fillings such as composite fillings. Academic institute should incorporate mercury and mercury based waste management in the school, college and medical school curriculum.
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