As a primary healthcare professional, a particular healthcare application attracts my attention, and causes concern. A bit of keen research makes it evident, that the clinical use and healthcare application of mercury is a cause of grave public and environmental health concern. Unfortunately, greater sensitisation, awareness, regulation and policy implementation are needed to ensure safety in this regard, and one would find that greater and faster action than debate is needed on this issue.
Mercury is an extremely interesting metal and finds extensive application in healthcare. It is amazing to study the extent to which mercury is used in medical equipment, gadgets, materials, drug manufacturing, vaccines and laboratory processes. Apart from finding use in modern medical applications, mercury also finds application in traditional healing methods such as Ayurvedic and Siddha schools of therapy as well as alternative treatment modalities like Homeopathy. Ironically it is the health concerns of mercury contact, which are increasingly causing alarm in many medical and environmental circles, having known for long that mercury is a potent neurotoxin. As mercury toxicity has long-term repercussions, it has become imperative to limit or severely regulate its use to minimise the chances of unwanted human contact with the metal. These efforts include the judicious disposal of the metal, already in use, as improper management leads to ready contamination of the ecosystem and environment, and entry of mercury compounds into the food chain, endangering human and animal life.
In areas related to health, there seems to be greater need to reduce any chances of human mercury contact. One cannot have a healthcare sector, which itself contributes to the health risk of the community. Sadly, mechanisms to report exposure to mercury, or to dispose it off safely are not easily available in many countries, including India, as part of management of general biomedical waste. This generally results in mercury either being disposed along with regular waste, or poured down the drain; both of which can be environmentally hazardous. Moreover, in case mercury or an amalgam finds its way to the community biomedical waste incinerator, the mercury fumes are released into the atmosphere. Undoubtedly, this situation needs to be improved.
This book covers the various applications that mercury finds in the healthcare sector, and how public and professional view has changed regarding its efficacy in these applications. Moreover, it also covers the various available options, of phasing out mercury from medicine. This would be part of other efforts to make healthcare safer. The ultimate aim, as supported by a unanimous world opinion, and quite clearly stated in the policy document of the World Health Organisation, is to totally rid healthcare of mercury, in a phased manner.
The healthcare sector employs a large section of the population, and many others are employed in sectors allied with healthcare. The occupational hazards of a certain avoidable substance in the healthcare sector, therefore, have the potential to affect a large section of the population as well. In the UK, for example, the National Health Service (NHS) is the largest employer which in 2015 employed 1.6 million people (Source: NHS England website), and UK health expenditure in 2013 was close to 9 per cent of GDP (Source: World Bank website). In India too, it is estimated that the Healthcare sector employs a large section of the population. Also, the spending on healthcare in India is increasing and stood at approximately 4 per cent of GDP in 2013 (Source: World Bank website) including Central and State governments spending. In western countries however, this spending is much higher. There is therefore a lot of public stake in healthcare spending. Mechanisms need to be put in place to reduce the incidence and possibility of exposure to mercury, to the healthcare provider and to the recipients of healthcare. Increasingly this threat has expanded, from being chiefly an occupational health risk to that of a potential environmental problem, with the potential to affect public health.
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