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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:
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:
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.
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.
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:
In Texas, a construction worker dies every two and a half days. In the Texas Observer, Melissa Del Bosque explains that it’s because of “lax enforcement of labor and safety regulations, too many overtime hours without rest breaks and a lack of safety training and equipment.” The Austin-based nonprofit Workers Defense Project, which helps construction workers seek restitution for injuries, spent three months visiting construction sites to interview workers about these issues. Del Bosque summarizes their findings:
Researchers found that Austin construction workers—whether they’re legal immigrants, undocumented workers or seventh-generation Anglos—have plenty in common: Most work long hours without overtime. Few receive adequate safety training. And few get basic safety equipment when they’re hired for a job.
“Texas has failed to guarantee even basic safety and labor protections,” [Workers Defense Project’s Cristina] Tzintzún says.
At least 45 percent of the workers surveyed earned poverty-level wages. One in five had been injured on the job. Sixty-four percent said they had not gotten basic safety or health training. Many reported that they’d had to bring their own hard hats and safety belts to both government-funded and private-job sites.
In other news:
It might seem obvious that having an entire town heavily contaminated with asbestos and hundreds of residents sickened by asbestos-related illnesses would constitute a public health emergency. Getting the federal government – specifically, the EPA – to actually declare a public health emergency in Libby, Montana took years of effort, though. Yesterday, EPA Administrator Lisa Jackson finally announced that a public health emergency exists at the Libby asbestos site, and the declaration will allow it to get more resources for cleanup and healthcare.
Andrew Schneider (who’s now blogging at Cold Truth – update your bookmarks and RSS feeds!) wrote last month about the need for this declaration:
When discussing the costs of various healthcare reform proposals, it’s crucial to keep one thing in mind: doing nothing would be a financial disaster. If we don’t change the rate at which healthcare costs are growing, total health spending is projected to double over the next 11 years, from an expected $2.6 trillion this year to $5.2 trillion in 2020. Medicare and Medicaid will eat up a growing share of the federal budget; employers will stop offering insurance as premiums become harder to afford; and families will struggle to pay for needed healthcare. These problems all exist today, and they’ll only get worse if we don’t “bend the curve” – that is, do something to slow the rate of healthcare-cost growth.
President Obama doesn’t just want to control healthcare costs, though. He wants to make insurance coverage universal, and that will cost even more money. Expanding coverage can save some money over the long term – for instance, people can get health problems treated early, instead of putting off care until they end up in the emergency room. Such savings won’t come close to covering the cost of coverage expansion, though, and they certainly won’t show up in the 10-year horizon that Congress is considering. Really, the main reason to expand coverage is that it’s simply not right for 46 million people in the world’s richest nation to lack healthcare coverage.
Due to Congressional pay-as-you-go rules, new proposals must be either offset with savings or funded through increased revenues. (Although the amount to be saved and raised will vary depending on the specifics of each healthcare proposal, $1 trillion is a good ballpark figure to keep in mind.) Here are some of the ways to raise more money for health reform:
Home health workers who care for the elderly and disabled are an indispensable part of our healthcare workforce – but the Bush Administration’s Department of Labor decided that they shouldn’t be covered by the same wage and hour laws that protect most workers. The Associated Press’s Sam Hananel explains that the administration based this determination on their interpretation of the Fair Labor Standards Act that was amended in 1974 to exempt babysitters and companions to the elderly and sick. Earlier this week, a group of 15 Democratic Senators, headed by Senator Tom Harkin of Iowa, urged Labor Secretary Hilda Solis to interpret the FLSA as applying to home health workers.
To get a sense of just how important this issue is, everyone should read Paula Span’s terrific article about home-care aides from the Washington Post Magazine. The piece focuses on Marilyn Daniel, a 63-year old home-care aide who has become a trusted and essential caregiver for the senior clients she serves. Daniel is often gone from home for 12 hours, catching buses to travel between clients’ homes and lacking any time off for meals. She’s lucky to work for a nonprofit agency located in DC, which has a living wage law; the average wage among Daniel’s co-workers is $12.40 an hour, and Span reports that many home-care aides don’t do that well. An agency that charges clients $20 an hour will likely pass less than half of that along to the worker, and not provide benefits; working on the “gray market,” an aide might earn $15 an hour, but she won’t be covered by workers’ compensation and she may be unemployed for stretches of time between clients.
As Baby Boomers age and require more assistance with activities of daily living, we’ll have an even greater need for home health workers. We should make sure they have adequate protections – and that they themselves can get healthcare, too.
In other news:
The World Health Organization has officially declared that we’re at the start of an influenza pandemic. Nearly 30,000 cases of swine flu/H1N1 have been confirmed in 74 countries, and the virus is spreading easily among people in multiple regions of the world. North America has had the highest number of cases so far – 13,217 in the US, 6,241 in Mexico, and 2,978 in Canada – and new cases are still being reported. (In fact, CDC’s count for the US, which tends to run ahead of WHO’s, is now at 17,855.)
Countries in the Southern Hemisphere are just entering flu season, and large numbers of cases have been confirmed in Chile (1,694) and Australia (1,307). The Washington Post’s David Brown quotes WHO Director General Margaret Chan explaining that H1N1 is crowding out the seasonal influenza virus, which is a typical feature of past pandemics.
Chan also emphasizes an important unknown about this virus: how it will behave in conditions typically found in the developing world. So far, swine flu has killed only 145 victims, but in her public statement Chan said, “It is prudent to anticipate a bleaker picture as the virus spreads to areas with limited resources, poor health care, and a high prevalence of underlying medical problems.”
We don’t know what will happen with this virus or how bad the pandemic will get. Keep washing your hands, covering your cough, and limiting your contact with others if you’re sick – and Revere also recommends getting a pneumococcal vaccine to prevent one of the serious common complications of influenza. This pandemic is also a good reminder that our politicians need to hear from us about the importance of a strong public health infrastructure, because our current facilities will be severely overtaxed if this virus comes back and wallops us in the fall.
