Elemental mercury is a potentially hazardous material that the WCB designates as having “reproductive critical effects.”[1,2]
Each year, two or three mercury spills are reported to the WCB. In one instance, a painter inadvertently spilled the contents of a manometer onto the carpet in a physician’s office. Ultimately the carpet was replaced and mercury contamination and elevated levels of mercury vapor were tracked throughout the building. The physician’s office was closed for several days.
In Sweden and Holland, mercury sphygmomanometers have been banned. Elsewhere, including in Canada, they are still in widespread use primarily because of their ease of calibration and maintenance.
If your office has mercury sphygmomanometers or mercury thermometers, you have a potentially hazardous material in your workplace. The most effective way to reduce the risk of exposing your staff, your patients, and yourself to an accidental mercury spill is to dispose of all mercury devices and switch to aneroid sphygmomanometers and other instruments that do not contain mercury (for information on blood pressure equipment, visit the Canadian Hypertension Society’s web site at www.hypertension.ca). If replacing all mercury instruments is not practicable, implement a mercury exposure control plan.
Exposure control plan
To implement a mercury exposure control plan:
• Evaluate the exposure risks.
• Implement necessary controls.
• Ensure Material Safety Data Sheets (MSDS) are readily accessible in your office (you can request MSDS from the manufacturers of your manometer, thermometer, and other mercury instruments. Check with the manufacturer as to whether you can obtain anti-spill plugs for your manometer.).
• Develop written procedures for safe handling, storage, use, spill cleanup, and disposal, and ensure all personnel are educated and trained in these procedures.
• Assign specific responsibilities should a spill occur.
• Monitor the health of anyone exposed to mercury in your office and document the results of your monitoring.
For assistance in developing safe procedures for mercury spill cleanup and monitoring, contact the WCB Prevention Department during business hours at 604 276-3100 or toll free 1 888 621-7233.
Disposing of mercury
To safely dispose of instruments containing mercury, contact your local municipal waste disposal department or the BC Ministry of Water, Land and Air Protection, Product Stewardship department.
If a spill occurs
All major releases of a hazardous substance such as mercury must be reported to the WCB. If you do not have safe handling procedures in place, a spill as small as one resulting from a broken thermometer is considered a major release and warrants a phone call to verify proper cleanup. In most cases there will be minimal health risk and minimal office disruption from a small spill.
If a mercury spill occurs, call the WCB emergency spill phone number at 1 888 621-7233 during normal business hours or after hours call 1 866 922-4357. Please post these numbers on or near any mercury sphygmomanometers in your office.
—Donald Krawciw, MD, Dip Sport Med, Medical Advisor
—Raymond J.P. Merriman, MSc, CIHSenior Regional Officer, Prevention
Above is the information needed to cite this article in your paper or presentation. The International Committee
of Medical Journal Editors (ICMJE) recommends the following citation style, which is the now nearly universally
accepted citation style for scientific papers:
Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.
About the ICMJE and citation styles
The ICMJE is small group of editors of general medical journals who first met informally in Vancouver, British Columbia, in 1978 to establish guidelines for the format of manuscripts submitted to their journals. The group became known as the Vancouver Group. Its requirements for manuscripts, including formats for bibliographic references developed by the U.S. National Library of Medicine (NLM), were first published in 1979. The Vancouver Group expanded and evolved into the International Committee of Medical Journal Editors (ICMJE), which meets annually. The ICMJE created the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.
An alternate version of ICMJE style is to additionally list the month an issue number, but since most journals use continuous pagination, the shorter form provides sufficient information to locate the reference. The NLM now lists all authors.
BCMJ standard citation style is a slight modification of the ICMJE/NLM style, as follows:
- Only the first three authors are listed, followed by "et al."
- There is no period after the journal name.
- Page numbers are not abbreviated.
For more information on the ICMJE Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals, visit www.icmje.org