Policy Tag: Chemical Exposure

Adopted by the 42nd World Medical Assembly Rancho Mirage, CA., USA, October 1990
and rescinded at the WMA General Assembly, Santiago 2005

The World Medical Association draws the attention of the medical profession throughout the world to the dangers presented by chemical and biological weapons. Among other, more obvious, dangers, it should be noted:

  1. The use of such weapons would have a devastating effect on civilian populations in addition to military personnel, and not only in the target area but also in distant places, perhaps beyond the national boundaries of the combatants.
  2. The effects of exposure to chemical and biological weapons present a continuing threat to the health of human beings on a long term basis, possibly causing illness, injury, disease and defects in the population over a long period of time.
  3. The effects of exposure to chemical and biological weapons may also result in permanent, complex and unpredictable changes in the natural environment, including animals, plant life and water supply, thus destroying the food source of human beings and resulting in extensive morbidity.
  4. Existing health care services, technology and manpower may be helpless to relieve the suffering caused by exposure to chemical and biological weapons.

The World Medical Association Declaration of Geneva asks physicians to consecrate their lives to the service of humanity, to pledge that the health of the patient will be the physician’s first consideration, and that the physician will not used medical knowledge contrary to the laws of humanity.

The World Medical Association Declaration of Helsinki states that it is the mission of the physician to safeguard the health of the people. The physician’s knowledge and conscience are dedicated to the fulfillment of this mission.

The World Medical Association Declaration of Tokyo begins with the following statement:

“It is the privilege of the medical doctor to practice medicine in the service of humanity, to preserve and restore bodily and mental health without distinction as to persons, to comfort and ease the suffering of his or her patients. The utmost respect for human life is to be maintained even under threat, and no use made of any medical knowledge contrary to the laws of humanity.”

Therefore, the World Medical Association considers that it would be unethical for the physician, whose mission is to provide health care, to participate in the research and development of chemical and biological weapons, and to use his or her personal and scientific knowledge in the conception and manufacture of such weapons.

Furthermore, the World Medical Association:

  1. Condemns the development and use of chemical and biological weapons.
  2. Asks all governments to refrain from the development and use of chemical and biological weapons.
  3. Asks all National Medical Associations to join WMA in actively supporting this Declaration.

Adopted by the 59th WMA General Assembly, Seoul, Korea, October 2008
and reaffirmed with minor revision by the 210th WMA Council Session, Reykjavik, Iceland, October 2018

PREAMBLE

Mercury is a naturally occurring heavy metal that is a potent neurotoxin. The most likely routes of human exposure on a population basis are ingestion of methylmercury from contaminated fish. Less commonly, individuals are exposed via inhalation of inorganic mercury vapor after a spill or during a manufacturing process.

Mercury has been the ideal choice for use in medical devices that measure temperature and pressure. Therefore, a typical large hospital may have more than a hundred pounds of mercury onsite incorporated into various devices in separate locations.

Hospitals and clinics can avoid the occupational or environmental risk of mercury by using products that don’t rely on mercury-based technology. Major healthcare institutions around the world have demonstrated that safe, effective alternative products exist, and can be safely used for most situations, such as electronic thermometers, recently calibrated aneroid devices and mercury-free batteries.

Although the rationale for instituting voluntary mercury replacement initiatives is compelling from both occupational and environmental perspectives, financial considerations may ultimately motivate hospitals to undertake a mercury replacement program. Hazardous waste clean-up costs, reporting requirements for spills, disruptions in services, and staff training are costly. The cost of cleaning up one significant contamination can be substantially higher than the cost of converting to mercury-free alternatives.

By implementing a “best practices” management method for mercury use, the need for increased government regulations in the future, may be avoided. Such regulations may create costly burdens that some facilities may not be able to meet.

The World Medical Association (WMA) recalls its statement on Environmental Degradation and Sound Management of Chemicals that provides recommendations for advocacy measures and capacity building in order to tackle this issue.

RECOMMENDATIONS

The following recommendations are based on the urgent need to reduce both the supply and demand of mercury in the health care sector:

Global

The World Medical Association and its member national medical associations should:

  • Advocate for the United Nations and individual governments to voluntarily cooperate to implement key features of the United Nations Environment Programme (UNEP) Mercury Programme, which provides a framework for reducing the use, release, trade and risk related to mercury.
  • Enhance the activity of existing partnerships.

Regional/National

National medical associations should advocate that their governments work to reduce risks related to mercury in the environment by:

  • Reducing reliance on mercury mining in favor of environmentally-friendly sources of mercury, such as recycled mercury.
  • Developing options and scientifically sound plans for the long term safe storage of excess mercury supplies.
  • Urging Member States to ratify and implement the United Nations Minamata Convention on Mercury adopted in 2013 and designed to protect human health and the environment from anthropogenic emissions and releases of mercury and mercury compounds.
  • Encouraging a phase-out of mercury use in the health care sector
  • Designing and implementing regulations and/or requirements designed to significantly reduce mercury emissions from coal combustion and cement production by using specific mercury emission controls.

Local

Physicians should:

  • Explore eliminating mercury-containing products in their offices and clinical practices, including thermometers, sphygmomanometers, gastrointestinal tubes, batteries, lamps, electrical supplies, thermostats, pressure gauges, and other laboratory reagents and devices.
  • Ensure that local hospitals and medical facilities have a plan to identify sources of mercury in their workplace, a commitment to mercury reduction, and a mercury management policy regarding recycling, disposal and education.
  • Encourage local hospitals and medical facilities to phase out mercury-containing products and switch to non-mercury equivalents.
  • Counsel patients about local and national advisories related to fish consumption designed to limit exposure to mercury in children and women of childbearing age.