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We keep writing about the risks involved with nanotechnology, so it’s nice to be able to highlight a potential benefit. Andrew Schneider reports for AOL News that researchers from the Australian Institute for Bioengineering and Nanotechnology have developed a “nanopatch” that can deliver vaccines more effectively than intramuscular injection:

[University of Queensland Professor Mark] Kendall told the Australian Broadcasting Corp. that the nanopatch is designed to place vaccines directly into the skin, where a “rich body of immune cells are.” A needle, by contrast, injects vaccines into muscles with few immune cells. As a result, the vaccines delivered by nanopatch are more effective, he said.

Cheap, simple, and effective vaccine administration has the potential to dramatically increase immunization rates in underresourced areas. Currently, many agencies struggle to fund struggle to fund vaccination programs that rely on refrigerated vaccines administered by trained professionals. Kendall also points out that easier transportation and administration of nanopatches can speed vaccination when the next pandemic develops. (The kind of fast response he envisions would also require us to overhaul our current vaccine-production system, but that’s a topic for another day.)

Such worthwhile applications of nanotechnology reminds us why we need to get this right — study the risks of nanotechnology, and put appropriate safeguards in place before nanoparticles are omnipresent. If several years from now nanoparticles have become the next asbestos, the chances of successfully promoting this kind of promising application will shrink.

Beginning in December 2006, I’ve written five blog post commenting on the content of the Department of Labor’s (DOL) regulatory agenda for worker health and safety rulemakings.  Most of my posts [see links below] have criticized the Labor Secretary and senior OSHA and MSHA staff for failing to offer a bold vision for progressive worker protections.  Now that the Obama & Solis team have been on board for more than a year, I’m not willing to cut them any slack for being newbies.  Regrettably, as with the Bush/Chao agendas, my posts today will question rather than compliment the OSHA team (and any bigger fish up the food chain) who are responsible for this plan.

I’ll start with the good news from OSHA’s reg agenda.   In the month of July, OSHA projects it will issue two final rules, one on cranes and derricks in construction and another to revise the OSHA 300 log with a column to record musculoskeletal disorders.  The first is a rule that has been in the works for 7 years and long overdue (here, here, here, here, here, here, here.)  The second will simply reinstate a change in injury recordkeeping requirements that should have taken affect in early 2001, but was axed by OSHA officials under direction from the Bush/Chao Administration.

Now, the reg agenda items that have me perplexed.  We’ve heard the Secretary Solis and Asst. Secretary Michaels talk about green jobs, and we know that construction workers are a large part of that workforce.  But, construction workers continue to get short-shrift at OSHA when it comes to mandatory H&S protections.

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Last week Labor Secretary Solis released in the Federal Register on April 26, 2010, her Spring 2010 regulatory agenda for the Department, including her rulemaking priorities for MSHA and OSHA.  As required by the Regulatory Flexibility Act it was published on time in April, in contrast to her Fall 2009 agenda which was six weeks late. 

This document is described by the Secretary as a:

“…listing of all the regulations it expects to have under active consideration for promulgation, proposal, or review during the coming 1-year period.  The focus of all departmental regulatory activity will be on the development of effective rules that advance the Department’s goals and that are understandable and usable to the employers and employees in all affected workplaces.”

As my mentor Dr. Eula Bingham used to say to her staff (during her tenure as OSHA chief the Carter Administration): the only rulemaking activies that truly count for worker health and safety are publishing proposed and final rules.   Efforts that distract, divert, or delay the regulation writers’ duties should be avoided.  Currently, OSHA has about 100 full-time (FTEs)  individuals assigned to its H&S standards office, and MSHA has about 17 FTEs.

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By DemFromCT, cross-posted from Daily Kos

Superbug: The Fatal Menace of MRSA
Maryn McKenna
Free Press (Simon & Schuster)
Hardcover, 288 pages, $26.00 list
Kindle Edition $12.99
March, 2010

Money quote:

To his bewildered mother and grandmother, the swirl of controlled chaos around Tony was as inexplicable as his sudden collapse; the ICU seemed to be trying everything, hoping it would bring him back from the brink. No diagnosis was possible yet. They had been in the hospital barely an hour, not long enough for test results to make it down to the lab and back. But the medical staff had a strong suspicion of what could bring a healthy boy down so quickly, and the clue lay in one of the drugs they ordered pushed into his veins. it was called vancomycin, and it was famous in hospitals as a drug of last resort. They had used it against a bacterium that had learned to protect itself against most of the other drugs thrown at it, a particularly dangerous variety of staph called methicillin-resistant Staphylococcus aureus – MRSA for short.

Basic Premise: A medical journalist, steeped in the ways of the CDC from covering them as a beat reporter, follows the threat of MRSA from the earliest reports in the 80′s of hospital nursery spread to reports of modern outbreaks of MRSA (at first rejected by medical journals) to the farms where it incubates and the prisons where it spreads. There were missed opportunities to control spread, and we are still missing opportunities (see the food chain) to do a better job of detection and control before things get even worse than they are now.

Author: Maryn McKenna is a journalist and author specializing in public health, medicine and health policy. She previously published Beating Back the Devil: On the Front Lines With the Disease Detectives of the Epidemic Intelligence Service. An award winning seven part series on flu vaccine was written for CIDRAP (University of Minnesota). Future projects include “a multi-year research project on emergency room overcrowding and stress”.

Readability/quality: This is an excellent read, with well researched science but written at a level any news magazine reader could follow. The author has the experience to write about the topic with authority, without hectoring or lecturing the reader.

Who should read it: Anyone interested in learning more about the well-publicized MRSA bacteria; anyone interested in epidemiology; understanding the relationship between animals, the food chain and human disease; and anyone who likes a good detective story. Well, medical detective story, anyway.

Bonus blog: Superbug: Research, strategies and stories from the struggle against methicillin-resistant Staph aureus (MRSA) maintained by the author.

Interview with the author:

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Of the many wrenching stories coming out of Haiti, two stories about the public-health challenges facing earthquake survivors do a particularly good job encapsulating just how daunting the weeks ahead will be.

In the Los Angeles Times, Shari Roan reports that emergency medical responders “will have to create a public health system on the fly.” Only one hospital is functioning, and the large numbers of people infected with HIV and tuberculosis will struggle to access the treatments they need. Many Haitians are already undernourished, so it’s crucial that food shortages be addressed – but, as most of us have already heard, transporting basic supplies is difficult given heavily damaged infrastructure. Roan goes on to explain how a range of illnesses can spread under current conditions:

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Climate change means more droughts in some parts of the globe, and drought spells disaster for many food crops. Recent events in Kenya also remind us that drought can spark disease outbreaks, as people are forced to rely on contaminated water sources and have less water for hygiene. 

The New York Times’ Jeffrey Gettleman reports:

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by revere, cross-posted from Effect Measure

Long time readers may have noticed that the subject of West Nile Virus (WNV) pops up periodically here (and here, here, here, here, here). It’s more than a passing fancy. I was professionally involved in public health measures around West Nile after its introduction to the US in 1999 and have maintained an interest, even though flu occupies much (too much) of my time.

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The American Public Health Association (APHA) sent a letter to President Obama urging support from the White House on CDC guidelines on N95 respiratory protection for healthcare workers from the H1N1 virus.   APHA OHS Section members learned last week that three organizations—Society for Healthcare Epidemiology of America (SHEA), Infectious Disease Society of American (IDSA), Association of Professionals in Infection Control and Epidemiology (APIC)—-asked President Obama to intervene in federal OSH policy, specifically to:

  • modify the federal PPE guidance to allow the use of surgical masks (instead of N95′s) for routine H1N1 patient care; and
  • institute an immediate moratorium on the enforcement of OSHA’s requirements for healthcare facilities related to the use of N95 respirators in relation to H1N1 influenza.         

APHA politely rebutted these ideas:

“We support the efforts of public health agencies such as HHS, CDC, NIOSH, DOL and OSHA to engage the National Academy of Sciences’ institute of Medicine to full examine the evidence that has lead to sound federal public health policy.  Thank you for your support for sensible, evidence based policies for protecting healthcare workers and the public.”    

The APHA letter was signed by the organization’s executive director, Georges Benjamin, MD, FACP, and Kate McPhaul, PhD, RN, chair of the APHA OHS Section.

by revere, cross-posted from Effect Measure

Some people find posts like this tiresome. There are so many things that need doing and so little time and resources to do them. Adding to the list makes our eyes glaze over. I understand. But that doesn’t make this any less of a Big Deal.

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The CDC has designated this week as “Get Smart About Antibiotics Week,” and is encouraging state health departments and other groups to raise awareness about the appropriate use of antibiotics. As cold season begins, CDC reminds us that antibiotics don’t cure viral infections – and using antibiotics inappropriately contributes to the evolution of antimicrobial-resistant pathogens. The campaign targets parents, healthcare providers, and pharmacists with information about when antibiotic use is and is not appropriate. 

The New York Times’ Anahad O’Connor (whether intentionally or not) has done a big service to this campaign by telling readers that green nasal discharge doesn’t necessarily indicate a bacterial infection that would improve with antibiotics. The article highlights a study that randomly assigned children with green nasal discharge to receive an antibiotic or a placebo, and found the groups’ outcomes to be similar.  

While this particular CDC campaign focuses on the use of antibiotics for human illness, the agency also has a “Get Smart on the Farm” program promoting the appropriate use of antibiotics in livestock. Large-scale livestock producers often dose their herds routinely with antibiotics to promote growth, instead of reserving the drugs for actual cases of illness. Since many of the antibiotics they use are the same as or similar to the ones we use for human infections, livestock producers’ practices also affect humans’ ability to recover quickly and safely from infections. (Visit the Union of Concerned Scientists’ website for more on the problem and where U.S. policy stands.)  

In short, neither sneezing green snot nor raising a herd of animals automatically calls for antibiotics. We should all use antibiotics judiciously so they’ll work when we really need them.

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