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by Susan F. Wood, PhD
Recently the New York Times and RHRealityCheck reported on a leaked internal proposed regulation that calls for more and different enforcement of anti-discrimination provisions for health care providers. The provisions are forms of conscience clauses that do not allow discrimination in hiring or promotion of health care workers who do not wish to perform abortion or sterilization (or indeed in the reverse, no discrimination against those who do perform abortions or sterilizations) in federally funded settings.
The draft regulation goes into detail outlining the history of the laws protecting the conscience of health providers and entities and then outlines the problem. It seems that the central concern is not discrimination against those who won’t perform abortions, but that the US Department of Health and Human Services sees a real problem with requiring health professionals (and anyone in the healthcare workforce) to be involved with contraception, even if it is part of the job. The majority of the section outlining “The Problem” concerns states that have passed laws or issued executive orders requiring pharmacies to dispense contraception, including emergency contraception, and that require hospitals to provide emergency contraception to rape victims.
From the regulation:
Pens, pads, and other trinkets bearing prescription-drug logos have come to symbolize the extensive presence of pharmaceutical marketing in healthcare settings, but they may be on their way out. Pharmaceutical-industry trade association The Pharmaceutical Research and Manufacturers of America (PhRMA) is announcing a new voluntary code of conduct that bans drug reps from distributing these logoed items to doctors and other healthcare professionals.
The rule’s voluntary nature will limit its effectiveness, and, of course, it only addresses one of the many avenues through which drug companies seek to influence prescribing behavior (Merrill Goozner lists other avenues). In Gardiner Harris’s New York Times article on the PhRMA code, National Legislative Association on Prescription Drug Prices executive director Sharon Treat warns that it’s probably “an attempt to persuade people against doing anything that’s serious.”
One thing we can say for sure about this move, though, is that it demonstrates the strength of the backlash against pharmaceutical marketing. PhRMA wouldn’t have made this move unless it really felt that it had to do something. Alicia Mundy reports in the Wall Street Journal:
It might be hard to recall a time when we didn’t know that exercise is good for your heart, and smoking is bad for it – but, back in 1948, researchers and clinicians knew little about the causes of cardiovascular disease. That year, the National Heart Institute (now the National Heart, Lung, and Blood Institute, part of the National Institutes of Health) launched the ambitious Framingham Heart Study to “identify the common factors or characteristics that contribute to CVD by following its development over a long period of time in a large group of participants who had not yet developed overt symptoms of CVD or suffered a heart attack or stroke.”
Researchers recruited 5,209 study participants from the town of Framingham, Massachusetts; these volunteers show up for an extensive checkup once every two years, submitting to multiple lab tests and completing lifestyle questionnaires. In 1971, the study enrolled 5,124 of the original participants’ adult children and their spouses – and it’s now recruiting the Third Generation cohort. From all the Framingham data, researchers have learned a great deal about how lifestyle factors can affect CVD risk. Here are some of the Most Significant Research Milestones from the NHLBI’s Framingham Heart Study website:
DuPont was busted a couple of years ago by U.S. EPA for failing to report information about adverse health effects associated with exposure to perfluorooctanoic acid (PFOA or C8), the chemical used to make Teflon and other non-stick surfaces. Now it seems that DuPont is dutifully submitting information to EPA’s TSCA 8(e) docket and we can thank the Charleston Gazette’s Ken Ward for trolling through the docket to find items of public interest.* Ward recently reported on an analysis conducted by DuPont which identified 19 cases of carcinoid tumors among DuPont employees; 6 of the cases were among workers at the Parkersburg, WV Washington Works plant.
In the submitted report to EPA, the DuPont official wrote:
“Six cases of this rare tumor type among approximately 5,000 workers at the Washington Works plant introduces the possibility of a cancer cluster…”
An attorney representing a large group of PFOA-exposed individuals sent a letter to EPA Administrator Stephen Johnson and ATSDR Director Howard Frumkin, urging them not to delay any further the release of hazard information and risk assessments on the contaminant perfluorooctanoic acid (PFOA, a.k.a. C8). Mr. Bilott was writing on behalf of residents who live near DuPont’s Washington Works plant near Parkersburg, WV and
“who continue to be exposed to this poison in their residential drinking water on a daily basis.”
Do you know of any cases of Parkinson’s disease among workers at flavoring companies?
David Egilman, MD, Clinical Associate Professor, Brown University, is aware of two cases of Parkinson’s disease in men in their fifties who were flavorists at a large flavorings company. The plant alone had 15 “flavorists.” (The average age of onset for Parkinson’s is 60 and it is a relatively rare disease.) Dr. Egilman is making an appeal to see if others are aware of a possible disease-exposure relationship. As Pump Handle readers know, workers are typically the canaries for the rest of us. If you know of similar cases in flavoring-exposed workers, contact Dr. Egilman at degilman@egilman.com
By Susan F. Wood, PhD
Much has been written at the Pump Handle and elsewhere in the media and scientific literature about ensuring that science appropriately drives government policies. Questions and concerns have abounded regarding inappropriate non-scientific interference, while at the same time many health and environmental agencies (and the scientific staff within them) continue their incredibly important work in research, evaluation, development, regulation and service delivery. Several organizations have done surveys and developed principles on scientific integrity including the American Association for the Advancement of Science, the Union of Concerned Scientists, and Scientists and Engineers for America.
At the Project on Scientific Knowledge and Public Policy at George Washington University School of Public Health, we are launching a multi-part study to get a strong handle on the written policies regarding the role of scientists in government that are currently in place, an understanding of how they are implemented at various agencies, and what recommendations can be made to specifically create policies that support strong science and the appropriate role of scientists and researchers within our health and environment agencies.
This is where we need your help:
We are seeking current and former government scientists to participate in interviews for the Scientists in Government project. Interviews will be conducted in Summer 2008.
If you are a current or former government scientist (with an advanced degree and at least five years of experience working for a science-based health or environment federal agency), you can help us in our work to strengthen policies on science in the federal government. Participation involves a phone or in-person interview of 1-2 hours. Our study is approved by George Washington University’s IRB (#030823).More information about the project can be found at: http://www.defendingscience.org/Scientists-in-Government-Project.cfm.
If you are interested in participating, please contact Ruth Long at 202-994-7993 or eohrwl@gwumc.edu. If you know others who might be interested in participating, please send them to this webpage: http://www.defendingscience.org/Participate-in-the-Scientists-in-Government-Project.cfm
Susan F. Wood, PhD is Research Professor at George Washington University School of Public Health and Health Services, where she is part of the Project on Scientific Knowledge and Public Policy (SKAPP). She also served as Director of the FDA Office of Women’s Health from 2000-2005 and is a member of the Board of Directors for Scientists and Engineers for America.
by Susan F. Wood, PhD
Last year, Congress passed new legislation on the Food and Drug Administration, known as the FDA Amendments Act (FDAAA) of 2007.This legislation, while limited, made some significant steps forward, see here and here. It reauthorizes the user fee systems for drugs, biologics and medical devices, and expands FDA’s authority on labeling, requires new transparency for the Agency and establishes broader registries of clinical trials and requires results from clinical trials to be released to the public The public concern over the handling of medications like Vioxx and Ketek highlighted problems ranging from companies misleading FDA, to fraud by investigators, to FDA scientific management and lack of priority on safety studies. The new law provided some additional requirements on safety as well as some additional resources for this critical area. It also added some new requirements focused on reducing financial conflicts of interest of FDA Advisory Committee members.
When FDAAA was signed into law last fall, many thought that this would be the last major FDA legislation to be taken up by Congress for another 5 years. But it seems we were mistaken. Read the rest of this entry »
By Ally Petrilla
I read the Jackson Sun’s (Tennessee) headline “Churches ‘go green’ as they as they aim to protect God’s creation from more harm” and said to myself, “Finally!” I am not that excited that my home state is catching the Go Green bug (although that’s a great thing, too!); I was more excited to see that people are having enough sense to use churches as an outlet for health messages for people in the South.
Most of us probably take our tap water for granted, but recent events remind us that we shouldn’t. Salmonella contamination of the water supply in Alamosa, Colorado sickened over 300 people and left residents avoiding showers and drinking bottled water for a week. Abel Pharmboy explains that the city was one of the few that didn’t have a water chlorination program – but that’s changed now, and the episode reminds us that trace amounts of chlorinated acid byproducts in the water seem less alarming when compared to potentially fatal bacterial illness.
Meanwhile, in Iowa, manure and commercial fertilizers spread on frozen ground contributed to record-high levels of ammonia in the water. Des Moines’s utility had to draw on alternate water sources to keep taps running in the metro area, and use four times the usual amount of chlorine. As alarming as such instances of contamination are, though, water supply and infrastructure should probably be more of a concern.
Proposals for reforming our country’s dysfunctional healthcare system often emphasize that prevention can save us money, but the Washington Post’s David Brown cautions that it doesn’t always work out that way. He notes that some interventions, like uniform childhood immunization and colonoscopies for men ages 60-64, are clear financial winners, either because they don’t cost a whole lot or because they prevent diseases that are expensive to treat. But when it comes to reducing smoking and obesity, two of the big risk factors for the U.S. population, the answers aren’t as clear-cut.
Major public health organizations are drawing attention to climate change’s effects on health: the American Public Health Association has chosen “Climate Change: Our Health in the Balance” as the theme for National Public Health Week (April 7-13), and the World Health Organization used World Health Day (April 7th) to remind us that we’re already starting to see climate change’s effects on health, and it’s not pretty. We can expect to see more deadly weather events, like Hurricane Katrina and the 2003 European heat wave, as well as more widespread and severe outbreaks of Rift Valley fever, malaria, cholera, and other diseases influenced by climate and weather.
At yesterday’s Public Health Grand Rounds at the George Washington University School of Public Health, Dr. Kristie Ebi – a lead author for the human health chapter of the IPCC Fourth Assessment Report (PDF) – pointed out that pathogens may not even be the biggest health problem climate change brings (Kaisernetwork.org has a webcast of the event). Farming will become harder due to hotter, drier conditions in some places and sea-level rise in others, so we’ll probably see more widespread hunger and malnutrition. In fact, that seems to be the trend already.
No, not V-8 the vegetable drink, but C8, the common name for ammonium perfluorooctanoate, an ingredient in Teflon and other non-stick products. Ken Ward of the Charleston Gazette reports today on the levels of perfluorooctanoic acid in the blood of about 69,000 residents living near the DuPont Co.’s Parkersburg, WV plant where C8 was manufactured. The results are posted on the West Virginia University’s Health Science’s center website. The median C8 blood-level was
“more than five times the U.S. general population.”
The highest median blood-concentration levels (i.e., 132 ppb) were found among residents who get their tap water from the Little Hocking Water Association in Ohio. Ward’s story indicates the median level in the general U.S. population is 5 ppb.
by Susan F. Wood, PhD
The FDA Amendments Act (FDAAA) of 2007 includes a small section addressing direct to consumer (DTC) advertising. The bill doesn’t limit advertising to consumers, nor does it give FDA authority to put a moratorium on advertising while more data on safety or effectiveness is collected during the first months or years that a product is on the market. A moratorium was recommended by the IOM in it’s drug safety report in 2006, but was not adopted by Congress - perhaps due to arguments about first amendment rights, but perhaps due to objections by both the pharmaceutical industry and the advertising industry.
What was included is a small section requiring that all print DTC ads carry “the following statment printed in conspicuous text: ‘You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088′ “
In response to a recommendation from the Department of Labor’s Inspector General, MSHA released data on 40 additional deaths which occurred (mostly) in 2007 at U.S. mining operations but were deemed not “chargeable” to the mining industry. The information, which includes 5 deaths in late 2006 and 35 in 2007, involved miners, contract workers, a mine owner, children of mine operators, and trespassers onto mine property. Of the 40 deaths, 30 were classified as “natural causes,” based on autopsy reports with notations such as “acute cardiac dysrhthmia,” “acute myocardial infarction,” “atherosclerotic cardiovascular disease,” “pulmonary thromboembolism,” “ischemic heart disease.” The remaining 10 deaths included two suicides and eight fatal injuries involving individuals not authorized to be on the mine property such as former employees and apparent burglers.
The Palm Beach (Florida) Post is reporting that Ag-Mart has settled a civil suit filed by a migrant farmworker family who alleged their son’s serious birth defects were associated with the company’s improper handling of pesticides. Earlier reporting in March 2005 by the PB Post exposed the working and living conditions of this family and other farmworkers, and birth defects among some of their children.
At the same time this settlement was reported, another Florida newspaper wrote that violations against Ag-Mart for failure to comply with the State’s pesticide use rules had nearly all been dropped by an administrative law judge. Oddly, these violations (e.g., failing to provide protective equipment for employees working with pesticides, allowing workers to harvest crops too soon after chemicals were sprayed, burning pesticide containers) all seem like the type of practices that might have contributed to the workers’ exposure and possible link with the infants’ malformations. This development, coupled with the fact that the Ag-Mart case settlement is protected by a confidentiality agreement, creates serious obstacles for public health prevention.
Rachel Nugent at Global Health Policy reminds us that it’s World TB Day. She’s got good news and bad news about tuberculosis around the globe. On the plus side, tuberculosis control funding has reached an all-time high, and the number of TB cases per capita has dropped. On the minus side, the number of cases is increasing, and more and more of these cases are turning out to be resistant to many of the drugs generally used to fight them.
In today’s New York Times, Celia W. Dugger looks at the lives of South Africans with MDR and XDR TB (MDR is multi-drug-resistant, XDR extensively drug-resistant). Many of them are held in a hospital that’s essentially “a prison for the sick”:
By Adam Finkel
I am always on the lookout for examples of how laypeople and/or experts fail to appreciate the enormity of the risks workers face. As someone who came to OSHA from a background in environmental health policy, where an excess lifetime fatality risk greater than one chance per million is often seen as unacceptably high, I am still amazed at the unfinished business on the occupational agenda. I sent the letter below to the New York Times on March 14th, and it was not printed amid a group of other letters focusing on more lurid aspects of Eliot Spitzer’s downfall. I appreciate columnist Nicholas Kristof calling attention to the hazards of “the oldest profession” (well, except for agriculture, perhaps), but I wish more people understood that as intolerable as a 1% lifetime risk is, it is by no means confined to one particular occupation.
Yesterday, the Supreme Court heard District of Columbia v. Heller, which pits DC’s handgun ban against the Second Amendment. DC’s gun law is the strictest in the nation, since it effectively all handguns; it does, however, allow for rifles and shotguns if they’re kept disassembled or under trigger lock. The big issue is whether the Second Amendment – “A well regulated Militia, being necessary to the security of a free State, the right of the people to keep and bear Arms, shall not be infringed” – guarantees an individual right to gun ownership, or only a collective right that hinges on militia service.
For the public health community, the question isn’t what the framers intended, but what works.
The Health Affairs Blog has put up links to its top 10 most-read blog posts of 2007, which gave me a chance to read one I’d missed when it was first posted: Linda Aiken’s myth-busting about the nursing shortage. She starts with the grim statistics:
Currently, the United States is short an estimated 150,000 nurses. Yet over the next decade, more than 650,000 new jobs in nursing will be created. At the same time, an estimated 450,000 nurses will have retired. By 2020, the nurse shortage is expected to increase to 800,000.
This isn’t because we don’t have enough Americans wanting to be nurses, Aiken explains; there are actually plenty of nursing-school applicants, but not nearly enough nursing-school slots for them. It does seem to me that this problem is recognized, and that efforts are underway to address it – for instance, the Robert Wood Johnson Foundation’s Building Human Capital program makes grants in this area, and their news digests regularly highlight stories about nursing-school expansions. Although it remains to be seen whether current efforts will be able to add enough nursing-school capacity to meet our needs, I’m more worried about another mistaken belief that Aiken highlights, which may be harder to correct.
We’ve written before about the problems with conflicts of interest on EPA scientific advisory panels. In particular, we think scientists working for product defense firms, whose money comes from clients seeking to avoid regulation of their products, ought to be barred from such panels. Now, a group is raising concerns about bias on an EPA panel reviewing the brominated flame retardant deca – but the charge comes from an industry group that’s concerned about the state-government scientist chairing the panel, and the EPA has acceded quickly to their wishes.
Today’s front page story in USA Today is about a shortage of surgeons at U.S. hospitals, with a focus on rural areas; the shortage threatens the health of 54 million rural Americans, reports Robert Davis. Part of the problem is that medical schools held enrollment steady for too long, rather than increasing it to account for the fact that so many doctors will be retiring at the same time that aging Boomers are needing more care. But changes in U.S. healthcare have also played a role.
Most of us are lucky enough not to have to worry about our sewage. We flush the toilet, it goes away somewhere, and we don’t have to worry about cholera or other diseases that spread when waste contaminates the water supply.
While most of sewage systems do a great job of making the water look clean and getting rid of bacteria and viruses, they often aren’t designed to remove synthetic chemicals. With so many of us dependent on daily doses of pharmaceuticals, we’re excreting lots of drugs (or their metabolites), and they’re sticking around in treated wastewater. Researchers are now starting to discover what that means for the environment.
In an 8-1 decision, the Supreme Court has ruled that medical-device manufacturers whose products secured pre-market FDA approval are immune from liability for personal injuries. So, if you’re injured by a medical device (like a drug-coated stent or prosthetic hip) that’s received this approval, you won’t be able to sue the manufacturer.
This might not be such a problem if we could have faith in FDA’s approval process. But, as reports from the Institute of Medicine and the FDA’s own Science Board have made clear, the agency lacks the resources and scientific infrastructure to do its job properly. Under such circumstances, it’s important the people be able to turn to the courts, as David Michaels explained in a post about a Texas Vioxx case:
This month’s Environmental Health Perspectives features an informative but disturbing article by Andrea Hricko entitled “Global Trade Comes Home”. It describes the adverse impact on communities of the “goods movement” system, where imports to the U.S.—electronics, food, toys, furniture— make their way from waterfront ports to trains and trucks, and into warehouses and to our neighborhood stores. Hricko, an associate professor at USC’s Keck School of Medicine, with first-hand experience working with families who live near the ports of Los Angeles and Long Beach, paints the picture of residents who:
“are exposed to diesel exhaust and other truck emissions, noise from truck-congested roads, bright lights from round-the-clock operations, and other potential health threats. Transportation experts refer to these impacts as ‘externalities’ of transport, but to community residents they can directly harm the quality of daily life.”
In his last state of the union address, President Bush glossed over the seriousness of some of the most pressing problems facing our country, and suggested they could be solved with something that’s been in short supply during his tenure.
“Global climate change” got one brief mention, as something that the nation is committed to confronting with cleaner and more energy-efficient technology. Unacceptable rates of uninsurance and spiraling healthcare costs were obliquely referenced with a stated goal of “making health care more affordable and accessible for all Americans.” Bush invoked technology as the cure for our energy and health care woes, and said this about the energy, medical, and physical sciences research that’s required:
By Les Leopold
If you need a quick snooze, read a US Government Accountability Office report with its carefully parsed prose. But lost in the holiday rush was a December GAO report that could keep you awake as it bashes the Bush administration’s effort to water down the community Right to Know regulations that provide us with potentially life-saving information about the use, storage and release of toxic substances. These regulations require that companies make detailed reports which form the Toxics Release Inventory – an accessible public database on the quantity of toxic chemicals on site and how much has been released into the air, land and water.
The rule changes have the smell of freshly minted money. Industry saves as the paperwork declines. More protection from histrionic public peeping toms is also welcomed by these secretive corporations The GAO estimates the new rules permits “3,500 facilities to no longer report detailed information about their toxic chemical releases and waste management practices.” Of the 90,000 Toxic Release Inventory reports now filed, 22,000 could no longer be available to the public. Although the EPA claimed the rules would impact reporting on less than one percent of total toxic releases nationwide, the GAO warned that it “masked the disproportionately large impact the rule would have on individual communities across the country.” But really, should anybody care about these arcane fine points?
Revere at Effect Measure addresses a troubling article, published in yesterday’s Atlanta Journal-Constitution, about the Centers for Disease Control and Prevention’s handling of the Andrew Speaker tuberculosis case. You might remember the case, because it got a lot of media attention. Speaker was the Atlanta lawyer who was thought to have XDR TB and boarded a plane to return home from Italy despite having been told not to by health authorities. CDC issued an isolation order for Speaker, and held a press conference about how he could’ve spread the disease aboard his international flight. It was later determined that Speaker had multi-drug-resistant (MDR TB) rather than the more-feared XDR form.
Now, Alison Young reports in the AJC, “The handling of the Speaker case was so unusual that it has raised questions among other TB experts, including whether CDC publicized Speaker’s case in a quest for more money.”
A study published in the Journal of Neuroscience last week reports a link between lead exposure and accumulation of Alzheimer’s-type plaque in the brains of primates. The National Institutes of Health-funded study examined the brain tissues of 23-year-old monkeys that had been exposed to lead for the first 400 days of their lives (resulting in blood lead levels of 19–26 µg/dl, but no overt signs of toxicity), and found that they had elevated expression of Alzheimer’s-related genes as well as altered levels, characteristics, and distribution of amyloid plaques, which are one of the hallmarks of Alzheimer’s Disease.
The study’s lead researcher, Dr. Nasser Zawia of the University of Rhode Island, told the Providence Journal that the research is significant because, while he’s found similar results in mice and rats, this is the first time scientists have found the lead-Alzheimer’s link in primates. Zawia and a spokesperson for the Alzheimer’s Association put the results in context for people worried about their own disease risk:
The latest issue of National Geographic includes a story on e-waste that’s worth reading – especially if you got a new computer, TV, or other electronic gift over the holidays and now need to figure out how to get rid of the old one.
Discarded electronic goods often contain a few useful bits – drives, memory chips, copper used in wiring – along with toxic substances like lead, mercury, arsenic, cadmium, and beryllium. For an impoverished family, breaking down old computers can be a reliable way to earn much-needed cash, but the job is hazardous. Chris Carroll reports:
In all the rigmarole of the holiday season, you might not have heard about the consumer safety hazard associated with Christmas lights (or noticed the fine print warnings on their boxes).
It’s no secret that lead is used in light strings’ polyvinyl chloride insulation to prevent deterioration and to guard against fire. But what is a new development this year is the revelation that handling the wiring while you “deck the halls” may result in significant lead exposure.
OSHA? No. It’s Andrew Schneider and his colleagues at the Seattle Post-Intelligencer. In “Flavoring Additive Puts Professional Cooks at Risk,” the reporter describes a study commissioned by the newspaper to determine how much of the butter-flavoring agent diacetyl becomes airborne when used in a restaurant cook’s work setting. Exposure to diacetyl is associated with the severe lung disease bronchiolitis obliterans in microwave popcorn plant workers and others, yet Schneider writes:
“Government indifference to the possible threat posed by breathing diacetyl is epidemic. The CPSC repeatedly has said it’s not its problem. For at least three years the FDA has been ignoring the question and only now, almost eight years after the first solid links between diacetyl and workers, has OSHA said it will attempt to set standards for worker exposure, and this is only after repeated hammering by unions and Congress.”
Frankly, we should be exasperated by the Seattle Post-Intelligencer’s study. We’ve come to rely on a newspaper to do our public health investigations??
Michael Pollan, author of The Omnivore’s Dilemma, writes in the latest New York Times Magazine about two stories that “may point to an imminent breakdown in the way we’re growing food today.” The first is the rise of community-acquired MRSA (that’s Methicillin-resistant Staphylococcus aureus, a nasty antibiotic-resistant bacteria) and the growing body of evidence linking it to the overuse of antibiotics in industrial pig production. The second is Colony Collapse Disorder, which is wiping out many of the honeybee colonies that farmers rely on for crop pollination.
“We’re asking a lot of our bees. We’re asking a lot of our pigs, too. That seems to be a hallmark of industrial agriculture: to maximize production and keep food as cheap as possible, it pushes natural organisms to their limit, asking them to function as efficiently as machines,” Pollan explains, offering these stories as examples of the unsustainability of our current industrial-agriculture system. Today’s Environmental Health News provides three more examples of this problem.
Susan Wood (see her past Pump Handle posts here) has an op-ed in today’s Boston Globe: “A public health system defeated at the hands of ideology.” She focuses on the Bush administration’s “failure to staff important health-related positions with qualified individuals willing to provide science-based advice” — a problem that’s particularly glaring when it comes to reproductive health issues.
If you live near a facility that releases between 500 and 2,000 pounds of a toxic chemical each year, you may be about to lose your access to important information about what you and your neighbors are potentially exposed to. That’s because EPA has changed its Toxics Release Inventory reporting requirements, raising the level at which facilities have to start detailed reporting on the release of designated chemicals from 500 pounds to 2,000. (More on the TRI and why it’s important here.) Thanks to the new rule, more than 3,500 facilities will be able to skip filing more than 22,000 TRI reports.
A report released yesterday by the Government Accountability Office (PDF) tells us that the change is a blow to EPA programs, the IRS, state governments, researchers, and local advocacy groups that rely on TRI data. It also tells us that the EPA skipped some important steps in the usual process in order to meet a commitment to the White House Office of Management and Budget.
There are times when it makes sense to rush a rule process and skip some of the usual steps – for instance, when exposure to a dangerous chemical is destroying workers’ lungs, and delay will mean that more workers will be hurt. What was the urgent reason for rushing this rule to completion?
Once again, toys are turning up with high lead levels – and, once again, it was an advocacy group, rather than the Consumer Product Safety Commission, that did the tests and broke the news.
The nonprofit Ecology Center, working with other groups across the country, bought and tested 1,268 children’s products, and found that 35 percent of them contained lead. The results from their tests – which also looked for polyvinyl chloride, cadmium, and arsenic – are available at www.healthytoys.org.
Tracey Easthope, Director of the Center’s Environmental Health Project, explains why they took on the project:
by Susan F. Wood, PhD
It’s not often, if ever, that an FDA sponsored report calls out for more resources, more direct action and organizational change for FDA. The recently released report (PDF) by the Subcommittee on Science and Technology for the FDA Science Board does just that. Although I wouldn’t necessary agree with all of the recommendations, and would call out for a few more, the report identifies some of the real needs at FDA for strengthened science. The FDA Science Board, an Advisory Committee to the FDA, has issued earlier reports, but none with the timeliness and potential impact of this one. Most of the press coverage has been on the call for expanded resources - which are truly needed - but the report also identifies some of the scientific infrastructure needs that trail behind our expectations of this critical public health agency. I don’t know if FDA expected this type of report, but hopefully it can be useful as a way to move the agency forward.
From the report:
The Asbestos Disease Awareness Organization, a group created by asbestos victims and their families, bought products from national retailers and had them tested at independent labs. One of the most disturbing findings was high levels of asbestos in powder from a toy CSI fingerprint kit. The powder is intended to be sprinkled on surfaces and brushed with a soft-bristle brush – creating conditions ripe for inhalation.
Andrew Schneider reports on the group’s findings in the Seattle P-I, and notes that CBS, which licenses the kit, has asked its licensees to have the kits tested immediately and to remove the toy from the market if it’s found to be unsafe.
Why is a small organization – which spent more than $165,000 getting products tested at government-certified labs – taking on the job of policing consumer products? Schneider explains:
by Susan F. Wood, PhD
FDA recently announced two draft guidances regarding advisory committees, one on public disclosure of financial conflicts of interests and the other on voting procedures.
The Center for American Progress has been running some new TV ads in Midwestern media markets as part of “a pilot experiment to begin defining progressivism in the public’s mind” (hat tip to Common Sense). Here are two that are styled after the Mac/PC ads – but in these, the two guys wear stickers identifying them as “Pro” and “Con”:
By Paul D. Blanc
The interconnections among toxic butter flavoring, fatal coal mine “bumps,” and tainted Barbie accessories may not be immediately obvious - but they all reflect the failures of an increasingly compromised U. S. regulatory apparatus.
In early September, news broke that the artificial butter flavoring chemical diacetyl had caused severe lung disease in a hapless consumer who liked his popcorn just a bit too much. The resulting publicity spurred the leading industrial user of diacetyl, ConAgra, to remove the chemical from its product line. Thus was accomplished in one day what the Occupational Safety and Health Administration (OSHA) was unable to do despite half a dozen years of accumulated evidence that the chemical was causing lung disease in workers exposed to it on the job.
Earlier this week, the Washington Post’s Elizabeth Williamson reported on industry-financed trips that Consumer Product Safety Commission chairs had taken. Today, she writes about other CPSC staff members (from both the Clinton and Bush administrations) who took such trips, and about proposed legislation spurred by the CPSC travel revelations. Meanwhile, eight new toy recalls have been issued.
On Friday, the Washington Post reported that Consumer Product Safety Commission acting chair Nancy Nord and her predecessor, Hal Stratton, accepted dozens of trips paid for by companies and industries they oversee. (Nord, you might remember, is in the spotlight for objecting to legislation that would give her agency more money and authority.) Nord defended her actions by saying that they all went through the agency’s usual approval process, though she also called for an outside review of CPSC travel policies after news of her trips sparked anger in Congress.
In today’s Washington Post, Elizabeth Williamson provides more details about Nord’s and Stratton’s industry-sponsored travel and gets ethics experts’ reactions to the situation.
At the opening general session of the American Public Health Association’s 135th Annual Meeting in Washington, DC, speakers urged the public health professionals in attendance to address the glaring inequities in the U.S. and throughout the world.
Carlos Cano, interim director of the DC Department of Health, told the audience that in the District of Columbia, a few blocks from the Capitol building, exist “some of the most glaring health disparities in the Western Hemisphere.” CDC Director Julie Gerberding stressed that as a nation, we’ve failed to address disparities not only in healthcare, but in access to opportunity. Keynote speaker Laurie Garrett, author of The Coming Plague and Betrayal of Trust and senior fellow for global health at the Council on Foreign Relations, focused on the inequities between the rich world and poor world, which are visible in dramatically different life expectancies and maternal mortality rates.
Speakers offered a range of solutions, most of them linked to this meeting’s theme of politics and policy.
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Monday’s edition of the On Point radio show (a production of WBUR in Boston) focused on the issue of the chemicals that surround us, and the movement for “green chemistry.” The first guest was Pete Myers, who produces the indispensable Environmental Health News and co-authored the book Our Stolen Future: Are We Threatening Our Fertility, Intelligence, and Survival?; John Warner, president and CTO of the Warner Babcock Institute for Green Chemistry, joined the show part way through.
Myers gave concise, easy-to-understand explanations of the concerns surrounding phthalates and bispehnol A; the show is worth a listen for anyone who’s beginning to explore potential risks associated with chemicals in wide use today. For those already familiar with these chemical issues, it’s interesting to hear the common consumer attitudes surrounding chemical-containing products.
On both sides of the Atlantic, new research into lead and crime is attracting attention. The New York Times and The Independent both reported on a new study by Amherst College economist Jessica Wolpaw Reyes, who found a correlation between blood lead levels and violent crime rates. Jascha Hoffman explains in the New York Times:
Julie Gerberding, director of the Centers for Disease Control and Prevention, testified on Tuesday at the Senate Committee on Environment & Public Works hearing “Examining the Human Health Impacts of Global Warming.” Yesterday, the Associated Press reported that Gerberding’s written testimony had been severely edited by the White House, which chopped it from 14 pages to 4. Gerberding and spokespersons from the White House and CDC then insisted that everything was fine – the editing process was normal, Gerberding had been able to communicate what she needed to, etc. But a look at the original draft of Gerberding’s testimony, supplied to the Atlanta Journal-Constitution by Physicians for Social Responsibility, shows that the two versions paint very different pictures.
The Council of Science Editors has organized 235 journals from 37 countries are publishing more than 750 articles on poverty and human development this week. For its theme issue, PLoS Medicine asked a variety of commentators from around the world to name the single intervention that they think would improve the health of those living on less than $1 per day. While reading the article, I was struck by three themes that emerged in multiple responses:
In late September, Topps Meat Company recalled 21.7 million pounds of ground beef for possible contamination with E. coli O157:H7, which can leave consumers with bloody diarrhea and, in the worse cases, kidney failure and death. The recall put Topps out of business, but the problem goes beyond a single company. In today’s New York Times, Christopher Drew and Andrew Martin report that safety problems existed at Topps for months prior to the recall, but federal inspectors failed to cite the company for anything besides cleanliness problems (which the USDA described as routine).
This week, the Salt Lake Tribune is running a must-read series of reports by Loretta Tofani about the human cost of the cheap goods we get from China. Tofani begins with the story of Wei Chaihua, a 44-year-old former farmer who sought factory work in order to give his children education and a better future. Wei didn’t know that such a thing as an outdoor gas oven existed until he got a job sanding and polishing steel in a factory that manufactured them, and he didn’t know about the disease silicosis until he was diagnosed with it.
Wei is hardly an isolated case, Tofani explains:
A lot of people who care about the high rates of uninsurance in the U.S. do so because it just seems wrong that the wealthiest country in the world leaves a large swath of its population without healthcare – and, thus, facing employment difficulties, financial ruin, years of unnecessary pain or disability, and an overall impediment to pursuing the American Dream.
If you’re an unpopular president with a bizarre sense of what fiscal responsibility means, this argument might not convince you. Even if it doesn’t, you should still try to bring the rate of uninsurance toward zero out of sheer self-interest. That’s because even those of us with good health insurance plans get worse healthcare when our neighbors are uninsured.
At a presentation on Tuesday Dr. Arthur Kellermann, an emergency-room doctor and professor of emergency medicine at Emory School of Medicine, explained how high rates of uninsurance affect communities’ health in several ways.
California Governor Arnold Schwarzenegger has signed a state law that will require manufacturers to remove six types of phthalates from products intended for children under the age of three. The San Francisco Chronicle quotes the bill’s author, Assemblywoman Fiona Ma: