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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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by Ken Ward, Jr., cross-posted from CoalTattoo

Shortly after taking office, President Barack Obama issued a memo in which he asserted this his administration

“is committed to creating an unprecedented level of openness in government.”

The memo continued:

“We will work together to ensure the public trust and establish a system of transparency, public participation, and collaboration. Openness will strengthen our democracy and promote efficiency and effectiveness in Government.”

Well, Obama’s Labor Department has now received formal requests from two of the widows of the Massey Energy Upper Big Branch Mine Disaster, asking that the department’s Mine Safety and Health Administration (MSHA) conduct its investigation of the disaster through the public hearing provisions of the federal mine safety law.  But so far, neither the White House nor MSHA has publicly offered any response to these requests. 

Were MSHA to grant the requests, all investigative interviews would be open to the families, the press and the public.  There would be no exclusive access for coal company lawyers (as Gov. Joe Manchin’s mine safety director, Ron Wooten, has said the state would allow) or for the United Mine Workers union.  Everybody would be able to watch and listen, and know whether the investigation was asking the right questions and digging for real answers about what caused this horrible disaster.

Are there potential downsides to doing this through a public hearing?  Sure.

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by Kathy Snyder, cross-posted from MineSafetyWatch

On April 9, wearing my correspondent’s hat for Mine Safety and Health News, I emailed a member of the Department of Labor public affairs staff, suggesting that this document be posted. On April 12, I again requested the plan.  On April 13, I filed a FOIA.  The documentation has now been added by the agency to its single-source Upper Big Branch

(You might think that, as a requester, I might have got word from someone at MSHA that the plan was now posted, rather being left to stumble across it.  Or maybe not. Ken Ward has had some things to say lately about transparency at MSHA.)

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By Joe Uehlein, cross-posted from Common Dreams

The approach of the 40th anniversary of Earth Day on April 22 provides us an opportunity to reflect on the “long, strange trip” shared by the environmental movement and the labor movement over four decades here on Spaceship Earth. 

A billion people participate in Earth Day events, making it the largest secular civic event in the world.  But when it was founded in 1970, according to Earth Day’s first national coordinator Denis Hayes, “Without the UAW, the first Earth Day would have likely flopped!”

Less than a week after he first announced the idea for Earth Day, Senator Gaylord Nelson presented his proposal to the Industrial Union Department of the AFL-CIO.  Walter Ruther, President of the UAW, enthusiastically donated $2000 to help kick the effort off — to be followed by much more.  Hayes recalls:

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by the Spirit of Frances Perkins

During last week’s Latino Action Summit on Worker Health and Safety in Houston, Labor Secretary Solis said:

“…I am urging Congress to pass the Protecting Americas Workers Act to give vulnerable workers more security when they speak out to defend their lives.”

That was the first time I’ve heard the Labor Secretary publicly mention PAWA and those were some welcome words.  The bill, HR 2067, is quite modest in its approach to enhancing the OSH Act.  It would:

  • adjust monetary penalties for violating H&S standards to the inflation rate
  • improve whistleblower protections and procedures for workers who exercise their H&S rights
  • ensure State and local employees are given H&S protections
  • require OSHA to investigate all fatalities and serious injury incidents
  • give family-member victims of workplace fatalities the right to meet with OSHA before citations are issued, make a victim’s impact statement to the OSH Review Commission

Yet, prior to last week, Mrs. Solis had been largely silent about it.  In fact, it was just a month ago that we first heard officially the Obama Administration’s position on the bill when Dr. David Michaels, the OSHA Assistant Secretary testified in support of the legislation.  (TPH post here)

Regrettably, it seems that the death of six refinery workers in Washington State from a blast on April 2 and the explosion at Massey Energy’s Upper Big Branch mine that killed 29 coal miners has focused the Secretary’s attention on worker health and safety.   Better late than never, I suppose.

Now that Secretary Solis told the audience in Houston that she strongly supports PAWA, I hope she contacts key Members of Congress—especially in the Senate—and convinces them that the nation’s working people need these and more workplace H&S protections.  The Senators who currently endorse the bill are:

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by Kathy Snyder, cross-posted from MineSafetyWatch

MSHA last Tuesday issued a citation to the Performance Coal Co. Upper Big Branch Mine – South, alleging insufficient measures to control explosive coal dust before the fatal April 5 explosion.  The April 13 citation was based on a sample taken March 15 – three weeks before the fatal accident. The time required for lab analysis of such samples creates a lag in obtaining results.  An MSHA inspector took eight dust samples from mine surfaces on March 15, the citation stated.

“One out of eight samples taken were less than 80 per centum of combustible [sic] content,”

read the text of the citation, in a printout from MSHA’s computer system obtained by Mine Safety and Health News.

MSHA alleged that the mine violated standard 75.403.  The standard specifies that incombustible content of underground coal mine surfaces required to be rock dusted must be at least 65% in general, 80% in return air courses, and still higher – according to a formula – for each 0.1% methane present.  The samples were taken on Mechanized Mining Unit 029-0, according to the citation.  A detailed mine map provided by MSHA indicated that that 029-0 was the number of the unit engaged in developing a new area for future longwall mining.

In issuing the citation – 8 days after the blast – MSHA characterized the alleged violation as “reasonably” likely to cause up to 30 deaths. Negligence by the mine operator was characterized as “low,” however.  The April 5 accident remains under investigation, and whether the alleged violation could have actually contributed remains undetermined.

MSHA also on April 13 issued a withdrawal order to the Upper Big Branch Mine under section 104(b) for alleged failure to correct a previously cited violation within the time allowed, the agency database showed.

MSHA did not respond today to a request for specifics on the alleged uncorrected violation.

Kathy Snyder worked at MSHA for 26 years in the office of public affairs.  She retired from her career position at the agency in 2004, and is the Washington, DC correspondent for Ellen’s Smith publication  Mine Safety and Health News

by Pete Galvin

In response to the recent tragedy at the Upper Big Branch (Massey) mine in WestVirginia, the President instructed the Mine Safety and Health Administration (MSHA) to take some rulemaking actions.  Accordingly, it is a good time to take a look at how the President’s own directives and the Office of Information and Regulatory Affairs (OIRA) determinations make it much harder for MSHA to protect this Nation’s miners.

As it happens, the specific rulemaking MSHA was asked to undertake is not likely to call the President’s rulemaking oversight policies into question.  The rule that is apparently to be changed involves the procedures for determining whether a mine is eligible to be charged with a “pattern of violations.”  MSHA can basically shut down a mine’s production unless the pattern (i.e., a whole series of separate violations) is abated.  There are a variety of methods available under the Administrative Procedure Act (APA) to accomplish such a change without extensive notice and comment, provided the agency makes the required findings under the APA — and provided the mining industry decides not to challenge these findings in court. 

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by Kathy Snyder, cross-posted from MineSafetyWatch

I wasn’t able to catch President Obama’s remarks on mine safety live, but immediatley saw the summary by Ken Ward at Coal Tattoo.  Two main thrusts in the points flagged by Ken: MSHA needs a better way of identifying mines that need extra enforcement attention.  And new legislation is almost 100% certain in the next months.  Update: exceptionally strong words from the President’s actual statement:

….we do know that this tragedy was triggered by a failure at the Upper Big Branch mine — a failure first and foremost of management, but also a failure of oversight and a failure of laws so riddled with loopholes that they allow unsafe conditions to continue.

Many experienced, intelligent and thoughtful people will be giving their best attention to reforming mine safety.  The S-Miner Act, which was proposed but not enacted after Crandall Canyon in 2007, is one likely starting point.  Not an engineer, nor an attorney — but nevertheless, having worked more than 30 years around mine safety issues, I would like to offer a few personal reflections that someone might possibly find useful.

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by Tom Bethell

Twenty-nine coal miners lost their lives in last week’s massive explosion at Massey Energy’s Upper Big Branch mine in West Virginia.


Part of the answer to that question will have to wait until the federal Mine Safety and Health Administration (MSHA) conducts its investigation of the disaster.  Only then will we know precisely where the ignition point was and why methane was allowed to build to the point where it constituted 5 to 15 percent of the mine atmosphere — the range at which the otherwise inert gas becomes lethally explosive.

But no one familiar with the coal mining industry will have to wait to answer the larger question:

Why do coal miners die?

They die because of negligence.  They die because the company they work for cares more about running coal than making mines safe.  And they die because the federal agency that is charged with protecting them fails in its mission.

About the first instance of negligence there can be no question.  The explosion was too violent and too extensive to have been caused by a pocket of methane alone.  The initial blast must have ignited coal dust — which is even more explosive than methane — and that couldn’t have happened if management had been diligent about cleaning up accumulations of loose coal, particularly along the conveyor belt carrying coal out of the mine.  But we know from MSHA’s inspection records that maintenance at Upper Big Branch never got top priority.  That went to production — regardless of how many times the mine was cited for lax safety practices.

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by Kathy Snyder, cross-posted from MineSafetyWatch

One week after the Upper Big Branch explosion, apparently no confirmed listing yet exists of the 29 miners who lost their lives in the catastrophe.  A spokeswoman at Massey Energy told me this morning,

“Out of respect for the families, the company is not releasing names at this time.”

A state spokesperson also advised this morning that Office of Mine Safety & Licensing (OMSL) is not releasing names and suggested contacting the medical examiner’s (ME) office; an administrative person at the ME’s office did not immediately return a message.  No official fatality list has appeared on MSHA’s helpful single-source page to date, and an email to the MSHA press office about this has not been answered.

Journalists apparently have been left to piece the fatality list together by combing through obituaries and Facebook pages and by seeking out family members, neighbors and others in the community.  While I respect the wish of accident victims’ families for privacy, I find the apparent official secrecy at this stage somewhat troubling.  It is a week since the explosion and almost three days since family members, sadly, knew the worst.

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