Confined Spaces and Failed Rescue Attempts

At a Queens, New York waste transfer station, investigators read the signs of a tragic story: Harel Dahan, 23, descended a ladder into a stinking well that caught runoff water from the recycling yard, and was overcome by hydrogen sulfide fumes. His father, Shlomo Dahan, 49, went down after him but was also overcome by the fumes. Rene Francisco Rivas, 52, tried to help the two men but met the same fate. A firefighter wearing protective clothing and enclosed breathing apparatus retrieved the three workers’ bodies from the well.

Shlomo Dahan’s company, S. Dahan Piping and Heating Corporation, had been contracted by the Regal Recycling Company to vacuum out the well, and Rivas was a Regal employee. The New York Times’ Robert D. McFadden notes that OSHA fined the plant $1,500 in 2006 after a worker was crushed to death by a wheel loader, and identified several serious violations at the facility in an inspection conducted earlier this year.

In a follow-up Times article, Ray Rivera points out that this kind of scenario – where one worker is overcome by fumes, and other workers die trying to save their colleague – is all too common, especially in the waste management and sewage industries:

Swine flu and Tamiflu resistance

by revere, cross-posted from Effect Measure

Currently the only antiviral drugs effective against the swine flu (novel H1N1) virus are the two neuriminidase inhibitors, oseltamivir (trade name Tamiflu) and zanamivir (trade name Relenza). Relenza is in active form at the outset and cannot be absorbed orally. It must be inhaled, leading to asthmatic reactions in some, ineffective dosage in those with breathing difficulties, and no drug at sites beyond the respiratory tract. Despite these drawbacks, it has so far produced little or no viral resistance. Tamiflu is absorbed orally and converted by the liver into the active form, so it gets to other organs and can be taken by people unable to inhale Relenza. But it has other problems. One is a tendency for the flu virus to become resistant to it. Until today, however, there have been no reports of Tamiflu resistance in swine flu isolates, although most flu experts were waiting for the other shoe to drop. Today may have been the day we heard it fall:

Occupational Health News Roundup

Two recent studies add the knowledge about the risks associated with on-the-job exposure to pesticides. University of Ottowa researchers analyzed 35 studies on parental occupational exposure to pesticides and childhood leukemia, and found that children whose mothers were exposed to pesticides at work while pregnant have twice the risk of developing childhood leukemia.

Researchers at France’s national institute for health research have helped confirm the link between occupational exposures to pesticides and Parkinson’s disease, which has been found in other recent studies, too. They found among the main groups of pesticides (fungicides, herbicides, and insecticides), the association was strongest for insecticides. Men exposed to organochlorine insecticides, which are highly persistent in the environment, had more than double the risk of Parkinson’s as men without exposure.

In other news:

Slow going on Labor Dept nominations

We are approaching day 160 of the Obama Administration, yet the Solicitor of Labor is not yet in place,  neither are the Assistant Secretaries for most other DOL agencies, including Employment Training Administration, MSHA, OSHA, VETS and Women’s Bureau.   Attorney Patricia M. Smith was nominated by President Obama on March 19 to serve as the Solicitor, and her confirmation hearing on May 7 seemed quite tame.  I’d not imagined that I’d be writing this blog post 8 weeks after that Senate proceeding, with her nomination stuck in Committee.  The slow pace of the Solicitor of Labor’s nomination got me thinking about how this Administration’s appointment process for DOL officials compares to G.W. Bush’s first term.   Here are a few facts to ponder:

• G.W. Bush’s Labor Secretary, Elaine Chao, was confirmed on January 29, 2001; Labor Secretary Hilda Solis was confirmed on February 24, 2009.
• G.W. Bush’s OSHA chief, John Henshaw, was nominated on June 12, 2001 and confirmed by the Senate on August 3.  A nominee to head OSHA has not yet been announced, but Jordan Barab was selected by Secretary Solis to serve as acting OSHA chief.
• G.W. Bush’s MSHA chief, David Lauriski, was nominated on April 3, 2001 and confirmed on May 9, 2001.  A nominee to head MSHA has not yet been announced.

Taking the measure of the swine flu pandemic

by revere, cross-posted from Effect Measure

Crafting a message on swine flu is not easy, and it’s easy to make missteps. I think CDC has gotten it pretty much right over the last two months, but not everyone has. We’ve written here since the beginning (some examples here and here) that describing any flu outbreak as “mild” is inapt. Flu always has the potential to be a serious disease and kill people, even in flu seasons termed “mild” by comparing them to flu seasons that are “bad.” Even with virulent flu viruses many people have minimal illness — in comparison to those who don’t. But flu, even in its most common form of a self-limiting illness with complete recovery, is often a miserable affair during its acute phase and it can leave a person debilitated for extended periods afterwards. For some there’s nothing mild or self-limiting about it. A bout with the flu becomes a mortal threat that can make good on its fatal potential.

Now the frequent use of “mild” by public officials to characterize swine flu is causing concern:

Climate Bill up for Vote in House

The House is voting today on the American Clean Energy and Security Act (aka the Waxman-Markey bill); at 5:30pm, members of Congress are still taking the floor to speak for or against it. Head over to Grist’s site to check out climatebill@twitter feed, or watch it on C-SPAN.

The political compromises that Henry Waxman and Ed Markey made to attract sufficient votes have significantly watered down the legislation, but its mandated reduction in greenhouse-gas emissions — a 17% reduction from 2005 levels by 2020, and 83% by 2050 — is at least a step in the right direction.

If the bill passes the House, it will also take some doing to get it through the Senate. And then we’ll need to do a lot more beyond it to really address global climate disruption.

UPDATE: It passed, 219 – 212.

Global Health Links

A few recent items highlight programs and innovations that are helping improve health in developing countries:

• Journalist and Nieman Fellow Christine Gorman spent three months in Malawi to learn about a new program that’s tackling the country’s severe nursing shortage with higher pay and more support for nursing education and training.  She’s been writing about her trip and the issues it raised for her on her blog, Global Health Report, and now reports that the American Journal of Nursing has published a photo essay on nurses in Malawi, featuring text from Gorman and photos by Eileen Hohmuth-Lemonick. Gorman convinced AJN to make it available free to non-subscribers, so check it out – the PDF online-only content is even more stunning.
• As part of its “Death in Birth” series on high maternal mortality rates in Tanzania, the New York Times published a piece about what happens to children whose mothers died giving birth to them. Several Tanzanian orphanages are taking a promising approach to helping those children: bringing a teenaged female relative to care for the child in the orphanage for two or three years, and then returning both the caregiver and child to their community. The young children can spend their first fragile years in a setting where malnutrition and infection are less of a threat, and their teenaged caregivers get a chance at education – many of them arrive illiterate and leave knowing how to read.
• And, finally, the blog Technology, Health & Development has moved to a new site and become Global Health Ideas, which aims to “document solutions and exchange ideas on innovative projects in global health.” Recent post topics include shortening doctors’ coat sleeves to reduce disease spread, new technologies’ impacts on communities, and innovations for stopping postpartum hemorrhaging.  Their Case Studies/Publications page also includes a lot of useful links.

If you’ve come across anything recently about a promising approach to tackling global health challenges, feel free to post a link in the comments.

Pandemic prep teachable moment

by revere, cross-posted from Effect Measure

For years those concerned about the consequences of an influenza pandemic from an exceptionally virulent flu virus, like A/H5N1 (”bird flu”) have despaired about motivating business, government and neighbors to take it seriously enough to make serious preparations. It’s understandable. There’s are a lot of potential catastrophes competing for our attention and while each can be made plausible if we can get someone to listen long enough, it’s rare we can do this. As I said, too much competition. Now that a real life influenza pandemic has arrived, the concern of some is that the public isn’t being told how bad this could become, possibly even 1918 level. My view is different. In terms of stimulating genuine pandemic preparedness, I think we are extremely lucky to have a pandemic that so far is nowhere near worst case scenario (and let’s be clear: it isn’t anywhere near worst case). The pandemic is no longer theoretical. It is here and tangible. And it is having some tangible effects in unlikely places, like hedge funds. Hedge funds?

This is a trade secret under FOIA?

I’ve often suspected that some federal agencies apply very broad definitions to the exemptions provided under the Freedom of Information Act (FOIA).  Now, thanks to one diligent journalist I can judge for myself whether the Mine Safety and Health Administration (MSHA) is an offender. 

Ellen Smith of Mine Safety and Health News requested records from MSHA and the Solicitor’s Office (SOL) about its legal determination that the haulage road on which coal-truck drive Chad Cook, 25, died, was under MSHA jurisdication.  MSHA had made a gross error in 2005-2006 when it concluded that the road was private property.  (In November 2007, the senior officials reversed themselves, but it was too late to get justice for Chad Cook.)   Smith made her FOIA request for the legal determination in August 2008, and MSHA responded 7 months later.   They provided a four-page memo written by SOL, but redacted certain portions under FOIA Exemption 4.   This exemption is allowed to protect

“trade secrets and commercial or financial information obtained from a person [that is] privileged or confidential.”

Costs and Benefits of Appalachian Coal

Mining’s environmental costs are high, but many residents of coal-mining communities support continued mining because they rely (directly or indirectly) on mining jobs. Now, reports Ken Ward Jr. of the Charleston Gazette, two researchers have put price tags on the economic costs and benefits of coal mining in Appalachia, and found that the benefits don’t even come close to covering the costs: