Sunday, September 27, 2020

Botswana in acute mercury poison scare

Botswana faces a public health disaster as local hospitals and clinics choke under mercury vapor contamination levels, high enough to cause acute poisoning.

Preliminary findings from a University of Botswana Research by Bontle Mbongwe, Lauren Smalls-Mantey, Rafael J. Veraza, Baagi Mmereki, T. Maswabi, Reginald Matchaba-Hove and Sesai Mpuchane have revealed mercury vapor levels in some Gaborone health facilities to be as high as 36mg/m3 which is many times above the standard minimal risk level of 0.2 mg/m3 recommended by Agency for Toxic Substances and Disease Registry.

The preliminary findings of the report reveal that, “patients and health care workers are at risk of mercury poisoning”, while “babies and fetuses are at risk of adverse health effects”.

According to the report, under the title “High Levels of Mercury Vapor in Health Care Facilities in the City of Gaborone, An indicator for Policy Change in the Botswana Health Care System”, acute mercury poisoning can result in blindness, deafness and kidney damage. Infants born to women who ingested high levels of methyl mercury exhibited mental retardation, ataxia, blindness, and cerebral palsy.

The team of researchers randomly selected four council clinics in Gaborone, Princess Marina Hospital, Gaborone Private Hospital and three private clinics and picked maternity wards, pharmacies, consultation rooms and outpatient (screen) rooms.

In all the facilities under research, broken thermometer storage rooms levels ranged from 4mg/m3 to 36mg/m3.

Maternity wards at Old Naledi and Broadhurst Clinics ranged from 4.5mg/m3 to 28mg/m3 and outpatient screening rooms exhibited highest values, ranging from 22mg/m3 to 36mg/m3.

In all the cases, the vapor levels far exceed the standard minimal risk level of 0.2 mg/m3 recommended by Agency for Toxic Substances and Disease Registry.
The high mercury vapor is blamed on the poor handling and storage of mercury in local health facilities. The research revealed that “the handling and storage of mercury in facilities does not follow the prescribed Procedures & standards in the Botswana Clinical Waste Management Code of Practice or those of the World Health Organisation (WHO)”.

The problem is further aggravated by improper mercury spill clean ups in health care facilities. The research preliminary findings revealed that 55% of the facilities broke between 1 and 3 thermometers a week, 35% broke more than 10 thermometers a week while 10% broke between 4 and 7 thermometers a week.

Despite these high incidents of mercury spills, 71% of the workers in local health facilities reported that they disposed of the mercury through “the regular waste disposal, 10% could not account for how they dispose off the mercury while 14% use the incinerator and five percent use waste contractors.
The report states that “like any other liquid, mercury evaporates. Once in the vapor state, it passes very efficiently into the lungs (about 80% of what is inhaled stays in the body).

Some is converted to inorganic salts. The rest dissolves in fatty tissue, and can enter the central nervous system, where it can cause neurological problems ranging from subtle to severe. It does not readily pass though skin, nor is it absorbed well from the digestive tract.”

The research recommends “urgent” consideration by the Government of Botswana to join the Health Care Without Harm and the World Health Organization’s global initiative to achieve virtual elimination of mercury-based thermometers and sphygmomanometers.

It further urged Botswana to “urgently” adopt and implement proper mercury spill clean ups in health care facilities already polluted by mercury.

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Sunday Standard September 27 – 3 October

Digital copy of Sunday Standard issue of September 27 - 3 October, 2020.