The Use of Mercury-Based Medical Devices Across Croatian Healthcare Facilities

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 fi lled by ward nurses affi liated 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 fi ve 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.

Perception and Knowledge of Mercury by Occupationally Exposed Health Care Personnel

“…Similar studies 25,26 have quantitatively evaluated the knowledge and use of mercury but have not evaluated risk perception. Karam 38 considers risk perception to be not only the perception of the probability of an event occurring but also a set of direct and indirect experiences in various situations that the individual presents, which, together with the acquired knowledge, result in an interpretation.…”

“…A considerable percentage of health professionals are inclined to use thermometers and sphygmomanometers that contain mercury because they believe that they are more precise. A study by Janev Holcer et al 26 reported that nurses prefer mercury-containing thermometers because they are accurate and reliable, although they may be slower. According to the study by Halder et al, 25 they prefer mercury-containing thermometers to digital thermometers because of their availability, affordability, precision, and ease of use.…”

“…In previous studies, no differences were reported among the types of doctors evaluated, suggesting that all had the same level of knowledge, whereas in the current study, the medical specialists were found to have better knowledge than did general practitioners. 26 Likewise, qualitative data showed us that there was a lack of concern for the proper management of mercury residues and the care that must be taken when handling the instruments that contain it. This coincides with the findings of the study by Senanayake and Gunawardena 40 in which mercury spill management practices were found to be deficient.…”

“…In previous studies, no differences were reported among the types of doctors evaluated, suggesting that all had the same level of knowledge, whereas in the current study, the medical specialists were found to have better knowledge than did general practitioners. 26…”

“…Solely, three existing studies were identified, one in India, another in Croatia, and one in Sri Lanka; all of them show the lack of knowledge and awareness and the inadequate management of mercury. 25,26 There is a lack of research on this topic in Latin American. The previous reasons justify this research; the purpose of this study was to assess this population's mercury-related knowledge and risk perception by exploring the measurement properties of an instrument designed to determine the said level of knowledge using the Rasch method.…”