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European guidelines on hypertension more flexible than those in United States

BMJ 2004; 328 doi: https://doi.org/10.1136/bmj.328.7451.1279-c (Published 27 May 2004) Cite this as: BMJ 2004;328:1279

Whither the mercury-free clinic? Australian retailers are selling mercury sphygmomanometers to the public!! Dob in a mercury user on this BMJ site!!

Editor,

Glad to see you picturing a non-mercury based sphygmomanometer in
this recent article.

Just yesterday I was at Carindale, a Westfield shopping mall complex
in the Brisbane metropolitan area. To my surprise(not really) a stall that
sells first aid equipment to passers by in the walk through part of the
complex had mercury sphygs’ for sale. I saw no evidence of any hazard
warning labels on the sphygs’. Such first hand observations tend to make
brag of claims about a general ban on medical use of mercury, at least as
applies to Australia[1]. Even Saddam seemed more transparent in his
revelations about weapons of mass destruction.

Much needed, in your rapid response section, is first hand
observation from all countries where a claim is made of mercury ban or
abatement. Nurses in Australian public hospitals tell me that replacement
of the mercury sphyg’ is not a reality at all, but rather limited to
certain hospitals or clinics. The contradiction seems obvious, if one
whole multi-specialist hospital can do without mercury, why can’t they all
do without it?

Recent acknowledgement of mercury spillage in UK doctors surgeries
seem rather matter of fact, and only mentioned in the context of a
“debate” about the accuracy of mercury free alternative sphygs’[2,3,4,5].
But I was recently made aware of a legal case for damages, now in process
in the USA, wherein a GP was poisoned after a wall mounted mercury sphyg’
spilled it’s contents leaving a lingering toxic gas in
the clinical environment. This incident of spillage would be only the tip
of the iceberg – and the medical and nursing professions play on.

My own experience of Hg exposure pertains mainly to leakage from
wall mounted sphygs’ in an Australian public hospital[6], and it
is important to note that the units leaking mercury were functioning, not
“broken”. There is no particular correlation between breakage and leakage
with mercury sphygs’, as they leak just fine when brand new.

[1]ABC 7.30 Report - 15/2/2000: European countries ban
sphygmomanometer
http://www.abc.net.au/7.30/stories/s100543.htm

[2]Sharvill J. Electronic versus mercury sphygmomanometers.
Br J Gen Pract. 2004 Feb;54(499):137-8. No abstract available.
PMID: 15046060 [PubMed - indexed for MEDLINE]

[3]Morrison CL. Electronic versus mercury sphygmomanometers.
Br J Gen Pract. 2004 Feb;54(499):136-7. No abstract available.
PMID: 15046059 [PubMed - indexed for MEDLINE]

[4]McAll G. Electronic versus mercury sphygmomanometers.
Br J Gen Pract. 2004 Feb;54(499):136. No abstract available.
PMID: 15046058 [PubMed - indexed for MEDLINE]

[5]Hartley S, Bello G, McKinley WJ. Accuracy of electronic
sphygmomanometers.
Br J Gen Pract. 2004 Jan;54(498):59. No abstract available.
PMID: 15002426 [PubMed - indexed for MEDLINE]

[6]Colquitt PJ. Mercury sphygmomanometers cause occupational mercury
exposure. Reproduced in BMJ Rapid Responses with permission from OEM.
http://bmj.bmjjournals.com/cgi/eletters/325/7358/254#24445

Competing interests:
Hg exposure

Competing interests: No competing interests

08 June 2004
Phillip J. Colquitt
Technical Adviser
Self-employed