SÃO PAULO HOSPITALS APPROVE TO REPLACE MERCURY DEVICES WITH EQUIPMENTS FREE FROM THIS TOXIC METAL BRAZIL

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1 SÃO PAULO HOSPITALS APPROVE TO REPLACE MERCURY DEVICES WITH EQUIPMENTS FREE FROM THIS TOXIC METAL BRAZIL Cecília Zavariz 1 - Ph.D. The pathological picture of mercury contamination ranges from light to extremely serious intoxication, which can culminate in death or sequels. Therefore, any possibility of exposition to this harmful agent must be eliminated, from both an occupational and environmental point of view; all the more since there are no secure levels of exposition, which can guarantee the integrity of the individuals health. The huge amount of mercury manipulated by man during centuries and the increase during the last decades with the dissemination all over the planet, is an extremely worrying reality which has mobilized the international community to make countries promote efficient means to reduce/eliminate this malefic element. The work we have developed regarding mercury in several situations of usage and manipulation began in the middle of the 80 s and since then we have concentrated efforts on the diagnostic formulation of the intoxication, as well as on the maximum reduction and elimination of the usage and discard of this extremely poisonous product. Even if the evaporation of mercury is bigger the higher the temperature is, the metal evaporates in low temperatures as well. In steam form, it is generally invisible in the environment. This characteristic, along with the fact that is does not smell or cause immediate symptoms at inhalation, except when in big quantities which can lead to acute problems, it becomes harder to understand and realize the * Work Authorized Physician Labor Fiscal Auditor at the Ministry of Labor and Employment - MTE/DRT/SP Manager of the National Program on Mercury Master on Environment Health on Assessment on the use of Hg and intervention methodology on work conditions by University of São Paulo - USP, College of Public Health PHD in Epidemiology on Health alterations due to exposition to metallic mercury by University of São Paulo - USP, College on Public Health

2 risk of exposition. However, in a long-term, it causes serious and irreversible harm to several organs and systems of the human body. It easily penetrates in cracks, recesses and several materials such as wood, cement and others and continues to evaporate thus contaminating the environment. As cumulative metal mercury does not get inert in nature and, besides evaporating thus contaminating both air and people, can be chemically altered, turning into the organic flora and fauna, and particularly fish. Devices containing mercury, most commonly used in the health sector, are thermometers and mercury-column sphygmomanometers. In the present approach we are going to specifically focus on the work we have been developing in the hospital sector since 2003, aiming at using mercury equipment and as a result prevent the contamination and intoxication of the environment. A summarized description of the developed activities has been published in the Mercury website The sensitization, conscientization and transmission of information regarding mercury done through informal dialogues and talks in events, were the first steps of this work, which resulted in stopping the use of such equipment on the part of several institutions in São Paulo, Brazil. At the end of June 2006 we started a series of round tables at the Regional Labor Office DRT/SP, to which we invited hospitals of São Paulo city and proceeded to enter into consignment agreements to replace mercury devices. It is important to emphasize that many hospitals have not answered our replacement proposal as yet. Until December 2006 we counted the hospitals that no longer use any type of mercury equipment and those which entered into an agreement to replace such devices for mercury-free ones, totaling 79 hospitals, as listed below. List of Hospitals that replaced mercury equipment: 1. Associação do Sanatório Sírio - Hospital do Coração 2. Hospital Alemão Oswaldo Cruz

3 3. Medial Saúde S/A - Hospital Alvorada Moema 4. Medial Saúde S/A - Hospital Alvorada Santo Amaro 5. Medial Saúde S/A - Hospital Alvorada Unidade de Reabilitação 6. Medial Saúde S/A Pronto Socorro de Reabilitação de São Bernardo do Campo 7. IGESP Instituto de Gastrenterologia de São Paulo S/A 8. Hospital Paulista Ltda. 9. Sociedade Beneficente Israelita Brasileira - Hospital Albert Einstein 10. Irmandade da Santa Casa de Misericórdia de São Paulo Hospital Santa Isabel 11. Hospital de Clínicas Jardim Helena 12. Hospital e Maternidade Dr. Décio Kato 13. Hospital em Casa Internação Médica Domiciliar Ltda. 14. SASMEM Sociedade de Assistência Médica de Ermelino Matarazzo Ltda. Hospital e Maternidade Menino Jesus 15. Hospital e Maternidade Esperança Ltda. 16. Sanatório João Evangelista Hospital João Evangelista Ltda. 17. CME Consultoria Médica e Empresarial Ltda. Hospital Sancta Maggiore I 18. Prevent Labor Atendimento Clínico e Hospitalar Ltda-Hospital Sancta Maggiore II 19. DIOSP Serviços Médicos Ltda. Hospital Saint Paul 20. Hospital São Jorge Serviços Nefrológicos Ltda. 21. Med Life Saúde Ltda. Hospital São Conrado List of Hospitals which entered into an agreement to replace mercurycontaining devices: 22. Lifecare Participações Hospitalares Ltda Hospital Paulistano 20/07/2006 # 23. Centro Médico Especializado Ltda Hospital São Rafael - 31/08/2006 # 24. Hospital e Maternidade 8 de Maio Ltda. - 30/09/2006 #

4 25. Hospital e Pronto Socorro Nova Iguatemi Ltda. - 30/09/2006 # 26. Intermédica Sistema Saúde S/A - Hospital Santa Cecília - 31/10/2006 # 27. Hospital e Pronto Socorro Portinari Ltda. 31/10/2006 # 28. Green Line Sistema de Saúde Ltda. Hospital e Pronto Socorro Itamaraty - 30/11/2006# 29. Hospital Bosque da Saúde - 31/12/2006 # 30. Associação e Congregação de Santa Catarina Hospital Geral de Pedreira 30/12/2006 # 31. Saúde ABC Planos de Saúde Ltda. Hospital Evaldo Foz - 31/12/2006 # 32. Hospital de Maternidade Casa Verde Ltda. 31/12/2006 # 33. Hospital e Maternidade Jardins Ltda. 31/01/2007 # 34. Hospital Itatiaia Ltda. - 31/01/2007 # 35. Hospital Santa Paula S/A 14/02/2007 # 36. Associação de Beneficência e Filantropia São Cristóvão Hospital e Maternidade São Cristóvão 28/02/2007 # 37. Serviço Social da Indústria do Papel Papelão e Cortiça do Estado de São Paulo - Hospital do SEPACO 28/02/2007 # 38. Santa Casa de Misericórdia de Santo Amaro Hospital Imaculada Conceição - 30/03/2007 # 39. Hospital Cidade Jardim Ltda. Hospital São Luiz - 31/03/2007 # 40. Autarquia Hospitalar Municipal Regional Leste Hospital Municipal Dr. Benedito Montenegro - 31/03/2007 # 41. Autarquia Hospitalar Municipal Regional Leste Pronto Socorro Municipal Augusto Gomes de Matos - 31/03/2007 # 42. Autarquia Hospitalar Municipal Regional Leste Hospital Municipal Dr. Arthur Ribeiro Saboya - 31/03/2007 # 43. SPDM Associação Paulista para o e Desenvolvimento da Medicina Hospital Vila Maria - 31/03/2007 # 44. Sociedade Beneficente de Senhoras Hospital Sírio Libanês - 30/04/2007# 45. Hospital Santo Amaro Ltda I Unidade Barão de Duprat 30/04/2007#

5 46. Hospital Santo Amaro Ltda II - Unidade Santo Amaro 30/04/2007# 47. Associação Beneficente de Assistência Social Nossa Senhora do Pari - Hospital Maternidade Pronto Socorro Nossa Senhora do Pari - 31/05/2007 # 48. Congregação das Filhas de Nossa Senhora do Monte Calvário Hospital Santa Virgínia 31/05/2007# 49. Hospital Central da Irmandade Santa Casa de Misericórdia de São Paulo - 31/05/2007 # 50. Hospital Geral de São Mateus Hospital Geriátrico e Convalescente D. Pedro II Irmandade Santa Casa de Misericórdia de São Paulo - 31/05/2007 # 51. Hospital São Luis Gonzaga - Irmandade Santa Casa de Misericórdia de São Paulo - 31/05/2007 # 52. Lapa Assistência Médica Ltda. Hospital Albert Sabin I 31/05/2007 # 53. Lapa Assistência Médica Ltda. Hospital Albert Sabin II 31/05/2007 # 54. Hospital Geral de São Mateus Dr. Manoel Bifulco - 30 de junho de 2007 # 55. Hospital 9 de Julho S. A. - 30/06/2007 # 56. Associação Congregação Santa Catarina Hospital Santa Catarina 30/06/2007# 57. Sociedade Beneficente São Camilo Hospital e Maternidade São Camilo Santana 31/08/2007 # 58. Unimed Paulistana Sociedade Cooperativa de Trabalho Médico Hospital Santa Helena 30/09/2007 # 59. Fundação Instituto de Moléstias do Aparelho Digestivo e da Nutrição Hospital Professor Edmundo Vasconcelos 31/10/2007# 60. Pró Saúde Assistência Médica Ltda. SANCIL - 30/10/2007 # 61. Pró Saúde Assistência Médica Ltda. Hospital Panamericano-30/10/2007 # 62. Pró Saúde Assistência Médica Ltda. Hospital Modelo - 30/10/2007 # 63. Pró Saúde Assistência Médica Ltda. Hospital São Leopoldo -30/10/2007 # 64. Pró Saúde Assistência Médica Ltda - Hospital Vasco da Gama-30/10/2007 # 65. Pró Saúde Assistência Médica Ltda - Hospital S P Zona Norte-30/10/2007 # 66. Hospital Itaquera Simples Ltda. - 31/10/2007 #

6 67. Hospital Independência Zona Leste Ltda. - 30/11/2007 # 68. Beneficência Nipo-Brasileira de São Paulo Hospital Nipo Brasileiro 20/12/2007# 69. Hospital e Maternidade São Camilo Pompéia - 30/12/2007 # 70. Real e Benemérita Associação Portuguesa de Beneficência Hospital São Joaquim 31/01/2008# 71. Hospital do Servidor Público Municipal 30/04/2008# 72. Autarquia Hospitalar Municipal Regional Leste Hospital Municipal Tide Setúbal - 30/06/2008# 73. Autarquia Hospitalar Municipal Regional Leste Hospital Municipal Prof. Alípio Correia Neto - 30/06/2008# 74. Autarquia Hospitalar Municipal Regional Leste Hospital Municipal Prof. Dr. Waldomiro de Paula - 30/06/2008# 75. Autarquia Hospitalar Municipal Regional Leste Pronto Socorro Municipal Júlio Tupi 30/06/2008# 76. Autarquia Hospitalar Municipal Regional Leste Pronto Atendimento Dra. Glória R. S. Bonfim - 30/06/2008# 77. Autarquia Hospitalar Municipal Regional Leste Pronto Atendimento Dr. Atualpa Girão Rabelo - 30/06/2008# 78. Autarquia Hospitalar Municipal Regional Leste Pronto Atendimento São Mateus II - 30/06/2008# 79. SIM - Serviço Ibirapuera de Medicina Ltda. - Hospital e Maternidade Santa Marta Ltda. 30/09/2008 # Foreseen date to fully eliminate the use of mercury equipment, according to consignment of agreement signed in the Labor and Employment Ministry /DRT/SP. A poster has also been prepared, under the sponsorship of MTE/DRT/SP, to be posted in the hospitals which banned mercury equipment, stating that those institutions protect health by eliminating the use of thermometers and mercury-

7 column sphygmomanometers or any equipment containing such toxic metal. As the dates for the elimination of mercury take place we carry out inspections in the places and post the mentioned signs. We estimate that by the first semester of 2008 the use of mercury devices will have being banned from São Paulo city hospitals. Considering the cumulative nature and diffusion of mercury in the planet, no nation shall be able to solve the mercury problem alone. However, once united, we shall be able to walk towards banning the anthropological sources of mercury, thus contributing to improve the quality of life in our world.