Through the Looking Glass

1. Through the Looking Glass Sharon Huff, MD, MS Assistant Professor, Occupational Health Sciences University of Texas Health Science Center at Tyler

2. Cooperative agreement with the Agency for Toxic Substances and Disease Registry (ATSDR) and the US Environmental Protection Agency (EPA) Pediatric Environmental Health Specialty Unit (PEHSU)a network of experts in children’s environmental health

3. PEHSU Program Disclaimer • This material was supported by the Association of Occupational and Environmental Clinics (AOEC) and funded under the cooperative agreement award number 1U61TS000118-03 from the Agency for Toxic Substances and Disease Registry (ATSDR). • Acknowledgement: The U.S. Environmental Protection Agency (EPA) supports the PEHSU by providing funds to ATSDR under Inter-Agency Agreement number DW-75-92301301-0. Neither EPA nor ATSDR endorse the purchase of any commercial products or services mentioned in PEHSU publications.

4. Organic • Methyl mercury • Ethyl mercury • Inorganic • Metallic/Elemental

6. Respiratory System • Cough • Short of Breath • Chest Pain • Nervous System • Headache • Nausea • Fever • Decreased brain wave & verbal activity • Tremor • Irritability, Depression • Memory Loss • Kidneys • Loss of kidney function

8. When spilled… Breaks up into droplets  Smaller droplets  accumulates in tiniest spaces • Carpet • Furniture • Floor cracks • Baseboards • Walls • Clothing • Backpacks • Shoes

9. If it is not cleaned up right away... Tracks throughout the school …  to buses  to cars  to homes  to children’s bedrooms

10. If it is not cleaned up right away... • Even a very small quantity of mercury spilled in a room will produce very dangerous vapor concentrations • Vapors enter HVAC system & spread throughout school • Danger: even a few drops in an enclosed/poorly ventilated space • classroom, bathroom, car, bedroom they sleep in  Vaporizes into air over time and builds up

11. Why are we so concerned about mercury in schools…..

12. Special susceptibility of children • Children are closes to the floor, where mercury vapors concentrate • Greater air exchange for body size than adults • Developing brain and nervous system • Immature protective blood-brain barrier

13. Is there Mercury in your school? • Thermometers • Barometers • Sphygmomanometer • Hygrometer • Manometer • Anemometer • Water flow meter • Fluorescent lights • Thermostats • Light switches • Paints • Lab Chemicals

14. Is there Mercury in your school? • Nurse's office • Science rooms • Home ec room • Art room • Industrial Arts classes • Auto body shop • Boiler room • Gymnasiums

15. Don’t let this happen to your school Major Causes of spills at schools • Improper Storage • Mishandling

16. Prevention • Prevent spills by removing all mercury compounds and mercury-containing equipment, and by discontinuing their use. • Containers of elemental mercury identified by staff or found during an inventory be given the highest priority for removal http://www.health.ny.gov/environmental/chemicals/hsees/mercury/brochures/docs/inventory.pdf

21. Substitute http://www.epa.gov/region7/mercury/pdf/mercury-free_alternatives.pdf

27. Secure • Store items in secure locations until the items can be properly disposed of or recycled. • Mercury-containing devices: • Double bag & tape closed • place in a covered, non-breakable container such as a plastic bucket. • Label the container "Mercury-Containing Devices" • store the container in a locked cabinet or room • Ensure mercury-containing products are well protected against breakage. • Place guards over gymnasium lights. • Check wall mounts on a mercury sphygmomanometer

28. What if there IS a spill? • Is there a mercury spill policy or procedure? • Which staff are responsible for mercury spill management or cleanup? • Are there mercury spill kits in all rooms that contain mercury? • Is staff trained in how to use these kits?

29. DO NOTs of Mercury Cleanup • NEVER use a vacuum cleaner • NEVER use a broom • NEVER pour mercury down a drain • NEVER attempt to clean up products like Windex®, Formula 409®, bleach, or similar cleaners with ammonia or chlorine • NEVER try to clean up with cloth or paper towels • NEVER wash mercury-contaminated items in a washing machine • NEVER walk around if your shoes or clothes might be contaminated with mercury • NEVER allow children to assist in the cleanup process

30. Louisiana DEQ Mercury Information Hotline 1.800.305.6621

31. Response Plan • Staff awareness about containing the spill • Prompt notification of supervisors and cleanup staff • Training appropriate personnel on cleanup procedures • Mercury spill cleanup kits • Fischer Scientific • Flinn Scientific • Lab & Safety Supply, • Mallinckrodt/Baker • VWR Scientific • Make your own

32. Mercury Spill Kit • 4 to 5 sealable plastic bags • heavy-duty trash bags • rubber, nitrile, or latex gloves • paper towels • cardboard (non-corrugated) • eyedropper • duct tape • shaving cream • small paint brush • Flashlight • Marking pen • Utility knife • Index cards • Container for tap water • Coveralls • Shoe covers • eye protection if available

33. Initial Procedures • Evacuate the room or affected area immediately; don’t let anyone walk through mercury • Leave all shoes, clothing and other articles that were splashed with mercury at the spill area. • Keep anyone who may have been contaminated in a separate room • Remove any animals • Open exterior windows to ventilate the room. • Close door and place signs prohibiting entry Keep people and animals away to prevent tracking. • Shut down any ventilation system that would spread mercury vapor to other areas (close return air vents)

34. Inform your supervisor if any personnel are involved in a spill or cleanup • Inform a school official who can determine if parental notification is necessary

35. Contaminated People • If someone has inhaled mercury vapor or ingested mercury, call a poison control center (800) 222-1222. • Remove watches and jewelry • Wash skin exposed to mercury with soap and water, ideally with a shower • Change clothing and shoes • Double bag contaminated items until proper cleaning or disposal/recycling can be arranged

36. Spills of Less than the Amount in a Thermometer • Mercury can be cleaned up easily from the following surfaces: wood, linoleum, tile and any other like surfaces. • If a spill occurs on carpet, curtains, upholstery or other like surfaces: these contaminated items should be thrown away (double bag)

37. Prep • Remove all jewelry • Put on old clothes or coveralls, old shoes or booties • Put on rubber or latex gloves • Put on eye protection

38. Large glass pieces and beads • Pick up broken glass with wet paper towel, duct tape. • Wrap all broken objects in a wet paper towel and place in a sealable plastic bag. Secure and label the bag. • Use an index card piece of cardboard to gather mercury beads onto another index card. • Use the eyedropper to collect or draw up the mercury beads. Slowly and carefully squeeze mercury onto a damp paper towel. Place the paper towel and eye dropper in a sealable plastic bag and secure. Make sure to label the bag. • Alternatively, use duct tape to collect smaller hard-to-see beads. Wrap tape around your fingers (sticky side out) and carefully use it to pick up any remaining glass or tiny beads. Place the contaminated tape in the zipper-type bag.

39. Small pieces and beads • Spray a large circle of foam shaving cream around the area • Use an index card, to spread the shaving cream and scoop it up; dump into labelled plastic bag • Put shaving cream on top of small paint brush and gently "dot" the affected area to pick up smaller hard-to-see beads • Place the paint brush in a sealable plastic bag and secure. Make sure to label the bag. • Take a flashlight, hold it at a low angle close to the floor in a darkened room and look for additional glistening beads of mercury that may be sticking to the surface or in small cracked areas of the surface.

40. Removing Carpet • Cut out the area of the carpet • Fold each carpet piece to keep the beads from spilling out • Place in large trash bag • Then cut 1 more foot out • When you fill up a bag, tie/tape place in second bag and place outside • Repeat with carpet padding

41. After Clean Up • Remove rubber gloves by grabbing them at the wrist and pulling them inside out as they come off. • Place all materials used with the cleanup, including gloves, in a labeled double bagged trash bag • Wash thoroughly; air out clothes • Contact the LA Department of Environmental Quality recycling group at 225-219-3267 for proper disposal in accordance with local, state and federal laws. • Keep the area well-ventilated to the for at least 24 hours after your successful cleanup. • Continue to keep pets and children out of cleanup area. If sickness occurs, seek medical attention immediately. If you are concerned about health effects of the spill, call local poison control or physician.

42. Spills of More than the Amount in a Thermometer, but Less Than or Similar to Two Tablespoons (One Pound) Cleanup Instructions • Have everyone else leave the area; don't let anyone walk through the mercury on their way out • Open all windows and doors to the outside. • Turn off the central heating or air conditioning system • Shut all doors to other parts of the school, and leave the area. Do not disturb or attempt to clean up the mercury. Call your local poison control center at 1-800-222-1222 Call Louisiana DEQ Mercury Information Hotline 1.800.305.6621

43. Spills of One Pound or More (i.e., if it Looks like Two Tablespoons or More) • While it is important to report any amount of mercury spilled, reporting is REQUIRED for a release of one pound (approximately two tablespoons) or more. • Any time one pound or more of mercury is released to the environment, it is mandatory to call the EPA National Response Center (NRC). (800) 424-8802. • Louisiana: Also required to contact the Louisiana Department of Environmental Quality 24-hour hotline at (225) 342-1234 or1.800.305.6621 • Call local poison control center at 1-800-222-1222

44. Resources / Phone Numbers 225-219-3267 LA DEQ recycling program 1-800-222-1222 Poison Center 1-800-305-6621 LA DEQ Mercury Hotline 800-424-8802 EPA National Response Center 888-901-5665 Southwest Center for Pediatric Environmental Health epa.gov/mercury