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[Purchasing for Pollution Prevention: Mercury-Free Medical and Surgical Supplies Fact Sheet]
Purchasing for Pollution Prevention: Mercury-Free Medical and Surgical Supplies Fact Sheet
A wide variety of medical equipment can contain mercury, from
thermometers and blood pressure equipment to diagnostic analyzers. Many
hospitals are now buying only mercury-free products, and government agencies
can easily follow suit by restricting mercury on their purchasing contracts.
With INFORMís technical assistance, Massachusetts changed its guidelines to
allow the sale of mercury-containing products through its state contract
only when no mercury-free substitutes are available. Since the contract's
inception in the spring of 2001, no mercury-containing devices have been
requested by state agencies.
Performance of mercury-free substitutes
- Blood pressure equipment. Peer-reviewed studies show that
electronic and aneroid sphygmomanometers are accurate within acceptable
clinical practice limits if calibrated regularly according to manufacturer
directions.1 Mercury-free blood pressure measuring devices have been
used by most major medical facilities and accepted by medical personnel for
- Gastrointestinal/feeding tubes. Tungsten-weighted tubes
can be used for x-ray viewing during use. Tubes filled with saline perform
well but may work more slowly than mercury or tungsten devices.
- Clinical fever thermometers. All thermometers for medical
use are typically tested to voluntary standards set by the American Society
for Testing and Materials (ASTM). These standards dictate the maximum error
allowed, so one can verify whether or not a non-mercury alternative is as
accurate as a mercury thermometer in the critical temperature range. For
more information on ensuring accuracy, see "Selecting Non-Mercury
Alternatives include electronic, infrared, liquid crystal, and phase-change
- Household fever thermometers. Mercury-free alternatives
should be handed out to new mothers and other patients. Many types are
available, including digital, infrared, and nonelectronic thermometers.
- Mercury and aneroid (mercury-free) blood pressure equipment are
comparable in cost.
- Gastrointestinal/feeding tubes without mercury are usually comparable in
- Clinical electronic thermometers can cost much more than mercury
thermometers depending on the type, but are more durable. Electronic
thermometers are sometimes offered free of charge if the facility also
purchases probe covers from the same vendor.
- The costs of mercury-free household fever thermometers vary depending on
volume and type. Digital thermometers can cost twice as much as mercury
thermometers, but nonelectronic types can be cheaper or comparable in price
to mercury thermometers.
As part of [state's] efforts to reduce the use and disposal of mercury
and mercury containing products, the [state] has determined that any
contracts resulting from this solicitation must meet the following
- In their response, Bidders must offer mercury-free
alternatives to all products which contain intentionally added mercury
(mercury added products) where such alternatives exist.
- Should such alternatives not be available, bidders must submit
with their response a list of products without mercury-free alternatives and
an explanation of why alternatives are not available.
- Following a contract award, contractors must not sell any
mercury added products, even if they have received a direct request from a
contract user, unless they have submitted a written request and received
written prior approval from the [procurement office].
Additionally, it is desirable that Bidders offer:
- A proposal for a collection system to ensure recycling or proper
disposal of mercury for any product containing mercury offered for sale on
this contract when no mercury-free alternative is available. This includes
any mercury containing batteries (such as button batteries) that may be sold
with equipment such as electronic thermometers.
- A proposal on the type of mercury reduction and/or elimination
training for contract users that would be offered by the bidder.
- A description of any other efforts that the bidder would undertake as
part of this contract to reduce/eliminate the sale and use of mercury
containing products, as well as any mercury reduction efforts being
undertaken or proposed by the bidder which are not related to this
- Identification of products which contain mercury (when no
mercury-free alternative are available) to contract users at the time of
purchase and delivery. This language can also be adapted if other
mercury-containing components are required.
The [purchasing office] reserves the right to remove products from
this contract that have been deemed hazardous and/or unacceptable by
federal/state/agency regulations and/or guidelines for their agencies or
Actual specifications used by a state government
Massachusetts restricts the sale of mercury-containing products,
allowing vendors to sell them only when no mercury-free substitute is
available. Since spring 2001, no vendor has sold any mercury-containing
product to the state. Note that in these specifications, "mercury-labeled"
Wisconsin restricts the sale of mercury-containing thermometers and blood pressure equipment,
and reserves the right to remove other mercury-containing items from the contract.
For more information:
1 N.D. Markandu et al., "The Mercury
Sphygmomanometers Should Be Abandoned Before it is Proscribed," Journal
of Human Hypertension (2000) 14, 31-36; Vincent J. Canzanello et
al., "Are Aneroid Sphygmomanometers Accurate in Hospital and Clinic
Settings?" Archives of Internal Medicine, March 12, 2001,