SIXTEENTH CONGRESS )
REPUBLIC OF THE PHILIPPINES }
First Regular Session

HOUSE OF REPRESENTATIVES

Introduced by Representative Rufus B. Rodriguez an
Representative Maximo B. Rodriguez, Jr. |

House Bill No. 4067

EXPLANATORY NOTE

Mercury is a naturally-occurring heavy metal, At ambient temperature and pressure,
mercury is a silvery-white liquid that readily vaporizes and may stay in the atmosphere for up
to a year. When released to the air, mercury is transported and deposited globally. Mercury
ultimately accumulates in lake bottom sediments, where it is transformed into its more toxic
organic form, methyl mercury, which accumulates in fish tissue.

Mercury is highly toxic, especially when metabolized into methyl mercury. It may be
fatal if inhaled and harmful if absorbed through skin. Around 80% of the inhaled mercury
vapor is absorbed in the blood through the lungs. It may cause harmful effects to the
nervous, digestive, respiratory, immune systems and to the kidneys, besides causing lung
damage. Adverse health effects from mercury exposure can be: tremors, impaired vision and
hearing, paralysis, insomnia, emotional instability, developmental deficits during fetal
development, and attention deficit and developmental delays during childhood,

In 1991, the World Health Organization (WHO) concluded that a safe level of
mercury exposure, below which no adverse effect, has never been established.

Many countries all over the world have banned the use of mercury-containing
devices and thermometers and it is high time that the Philippine also ban the same. The
Department of Health took the first step and issued an administrative order. It is now time to
strengthen said administrative order and give it more teeth.

In view of the foregoing, early passage of this bill is earnestly sought.

kiki
MAXIMéB, ROD

Hues, JR.


SIXTEENTH CONGRESS
REPUBLIC OF THE PHILIPPINES
First Regular Session

HOUSE OF REPRESENTATIVES.

Introduced by Representative Rufus B. Rodriguez and
Representative Maximo B. Rodriquez, Jr.

House Bill No. 4067

AN ACT
BANNING THE USE OF MERCURY IN ALL PHILIPPINE HEALTH CARE FACILITIES
AND INSTITUTIONS, AND PROVIDING PENALTIES FOR VIOLATIONS THEREOF

Be it enacted by the Senate and House of the Representatives of the Philippines in
Congress assembled:

SECTION 1. Declaration of Policy — It is the policy of the State to protect and promote the
right to health of the people and instill health consciousness among them.

SEC. 2. Scope and Coverage ~ This Act shall apply to all Health Care Facilities as defined
hereunder.

SEC. 3. Definition of Terms ~
A. Health Care Facilities mean any of the following:

a, Hospitals — places devoted primary to the maintenance and operation of facilities
for the diagnosis, treatment and acre of individuals suffering from illness, disease,
injury or infirmity or in need of obstetrical or other medical and nursing care. The
term "hospital" shall also be construed as any institution, building or place where
there are installed beds or cribs or bassinets for twenty-four hour use or longer by
patients in the treatment of diseases, diseased-condition, injuries, deformities or
abnormal physical ot mental states, maternity cases, and sanitorial or sanitarial
care infirmities, nurseries, dispensaries, and such other means by which they
may be designated

b. Infirmary — a health facility that provides emergency treatment and care to the
sick and injured, as well as clinical care and management to mothers and
newborn babies

c. Birthing Home — a health facility that provides matemity services on pre-natal and
post-natal care, normal spontaneous delivery and care of newborn babies

d. Clinic - shall mean a place in which patients avail of medical consultations or
treatment on an out-patient basis and shall include the following:

i. Medical
ii. Ambulatory
iii, Dialysis
iv. Health Care Centers and Dispensaries
v. Surgical
vi. Alternative Medicine
vil. Dental

vii. Other clinical facilities not mentioned above that require a license /
certification / accreditation from the Department of Health

B. Mercury - means any substance containing element mercury, either in pure form, as
metallic salts or organo-metallic compounds.


C. Mercury Audit - a mercury audit aims to identify all the uses and sources of mercury,
and the amount present in the facility.

D. Alternative to Mercury-containing devices/products - mercury-reduced and
mercury-free products that are considered to be viable replacements for mercury-
containing devices/products.

E. Hospital Waste Management Committee (HWMC) - means a group in the Health
Care Facility with the overall responsibility of ensuring that health care waste
management plan are promoted and implemented

F, Waste Management Officer (WMO) - means a person in the Health Care Facllity
responsible for the day-to-day operation and monitoring of the waste management
system, In cases where the Health Care Facility has no HWMC, the WMO shall be the
person to assume the responsibility of ensuring the health care waste management plan
of the facility as promoted and implemented

G. Mercury Minimization Program - means a gradual phase-out plan for MDEP by a
Health Care Facility in accordance with Section V and following the management plan
described in Annex B of this Administrative Order.

SEC. 4. Itis hereby mandated that all health care facies shall immediately discontinue the
use of mercury-containing devices and the distribution of mercury thermometers to patients
through the distribution of hospital admission/discharge kits: Provided, that if instant banning
cannot be had, health care facilities shall follow the guidelines for the gradual phase-out of
mercury provided in this Act.

April 28, 2008

SEC. 5, Guidelines for the Gradual Phase-Out of Mercury in Health Cave Facilities
1. Ih order to ensure safety and contamination control, steps taken towards mercury
elimination in faclty must be consistent and predetermined. It is therefore a must to
involve the whole facility in a dedicated Mercury Management and Minimization
Program, with the goal of

a, Raising awareness on the dangers posed by mercury and mercury-containing
devices in all health care facilities and institutions; and

b. Developing a clear preference for the use of Alternative to Mercury-containing
Devices among health care personnel;

2. All Health Care Facilities are hereby tasked to designate a dedicated Mercury
Management Team within two months from the approval of this Act. This team
should be directly under the Hospital Waste Management Committee and is
mandated to:

a. Conduct a Mercury Audit of their facility. This should include an assessment
of the cost of switching to alternatives to mercury-containing devices;

b. Develop and manage a Mercury Minimization Program for their facility;

c. Draft and implement a purchasing policy that requires vendors to sign a
mercury-content disclosure agreement covering products intended for
purchase. A clear preference for Alternatives to Mercury-containing Devices
where applicable should be in effect. Efforts should be made to communicate
with suppliers about an eventual mercury-free purchasing policy and to work
with staff on finding Alternative to Mercury-containing Devices;

d. Conduct a facilty-wide information campaign and employee education on the
consequences of continued mercury use with simultaneous — personnel
training on preventing and proper handling of mercury spills; and

e. Identify and remove unnecessary practices that promote the use and
distribution of mercury-containing medical devices;

3. Within 12 months from the effectivity of this Act, all health care facilities should have
accomplished the following:

a. Fully implemented the Mercury Minimization Program developed for their
facility:


. Switched to alternatives from mercury-containing devices;

. Developed and implemented a program of waste segregation and recycling to
further reduce the mercury waste stream in cases where no alternative
products exist;

Identified a dedicated mercury collection area within the facility;
Developed a proper temporary mercury storage in the facility inaccessible to
the public:

f. Incorporated a mercury management module in their training program for new

personnel; and

@. Information materials on mercury are displayed andlor available in their

facility for the benefit of their patients and the general public.

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SEC. 6. Penal Provisions — Any health care facility caught violating any of the provisions of
this Act shall be held liable to pay a fine of not less than Five hundred Thousand Pesos
(P500,000) nor more than One Million Pesos (P1,000,000).

SEC. 7. Implementing Rules ~ The Department of Health shall issue such orders, rules and
regulations and other issuances as may be necessary to ensure the effective implementation
of this Act

SEC. 8. Separability Clause — If for any reason, any part of or provision of this Act is
declared unconstitutional or invalid, such parts not affected thereby shall remain in full force
and effect,

SEC. 9. Repealing Clause - Any law, executive order, letter of instruction, rules and
regulations, circulars, issuances or any part thereof inconsistent with any of the provisions of
this Act is hereby repealed, modified or amended accordingly.

SEC. 10, Effectivity — This Act shall take effect fifteen (15) days after its publication in at
least two (2) newspapers of general circulation.

Approved,