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by Richard Denison, PhD, cross-posted from EDF Blog

The Washington Post ran a front-page article Saturday, written by Spencer Hsu, which reported the auction sale by FEMA of most of the 120,000 notorious formaldehyde-tainted trailers it had purchased five years ago to house the victims of Hurricane Katrina.  The article cites FEMA as saying that “wholesale buyers from the auction must sign contracts attesting that trailers will not be used, sold or advertised as housing, and that trailers will carry a sticker saying, ‘Not to be used for housing’.”

Think that’s likely to be enough? 

Think again. 

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TIME’s Laura Blue notes that the U.S. has an appalling rate of preterm births (we were ranked 30th in the world in 2005, behind Cuba and Poland) and that prematurity costs us around $26 billion a year – but, she tells us, researchers don’t know why we have this problem. In many cases, there’s an apparent cause – like the mother’s age or health status, the babies being multiples, or a caesarean-section delivery – but doctors still can’t pinpoint a culprit in approximately 40% of preterm births.

Blue highlights the work of Emory University researcher Dr. Alfred Brann, who uses a different strategy than most other researchers studying this issue:

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Less than two weeks ago, Dr. George Tiller, one of the few health providers who would still perform late-term abortions, was murdered. (Judith Warner’s column on Dr. Tiller’s important work is well worth a read.) Police arrested Scott Roeder of Kansas City, and the office manager of a Kansas City women’s clinic says that Roeder matches the description of a man found vandalizing the clinic on two recent occasions, including the day before Tiller’s murder. The office manager filed police reports after both incidents and gave details to the FBI, including the suspect’s license plate number. Could a swift response by police or the FBI have prevented Tiller’s death?

Yesterday, another ideologically motivated killer struck. The attacker shot Stephen T. Johns, 39, of Temple Hills, Maryland, a security guard at the Holocaust Memorial Museum. Police arrested James von Brunn of Annapolis, who is said to be a leading writer in the white supremacist movement.

This kind of terrorism aims to instill fear in people who work for organizations targeted by extremist groups. Employees at women’s clinics nationwide are increasing security measures, and the Anti-Defamation League is encouraging Jewish institutions to review security protocols and use increased alert statuses. While law-enforcement patrols at these types of sites have evidently increased in the wake of these shootings, there are also questions about what kinds of larger efforts the government should be making to prevent such acts of terrorism.

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By Leslie Mancuso

Imagine being diagnosed with a preventable disease in a country where access to quality health care services is not available to you. Not because you live in a remote area or because people don’t care, but because the training was not available for the skilled healthcare providers treating you. 

Now imagine being an HIV positive woman in this country.  You may be getting sophisticated antiretroviral therapy, but suffer without knowing it from another disease that can kill you if left untreated: cervical cancer.

As a leader in international health, I see these women facing this situation far too often. Globally, 473,000 new cases and more than 250,000 deaths due to cervical cancer are reported each year. More than 85 percent of those cases occur in low-resource countries where fewer than 5 percent of women have ever had a Pap test. Women living with HIV are particularly vulnerable to infection by the human papillomavirus (HPV) that causes cervical cancer. The good news is that there are innovative, low-cost solutions to this problem.

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The Washington Post obtained a copy of a draft report on mercury that Food and Drug Administration sent to the White House Office of Management and Budget, and reports that it contains advice that alarms scientists from the Environmental Protection Agency. At issue is advice about fish consumption for women of child-bearing age, pregnant women, nursing mothers, and young children. All of these groups can benefit from fish’s omega-3s, but the mercury that contaminates many fish can interfere with neurological development in fetuses and young children.

FDA regulates mercury in commercially available seafood, while EPA is responsible for mercury in fish caught recreationally. In 2004, the two agencies released a joint advisory aimed at these sensitive groups. They advised avoiding consumption of four kinds of fish that contain high levels of mercury (shark, swordfish, King Mackerel, Tilefish) and eating up to 12 ounces per week “of a variety of fish and shellfish that are lower in mercury.”

Now, though, it seems the FDA wants to recommend eating more than 12 ounces of fish per week, because that will deliver the greatest benefit from the nutrients contained in fish. The Washington Post’s Lyndsey Layton explains that this move does not meet with approval from EPA:

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A former Department of Labor career employee who is expert in administrative law offers three simple steps for the Obama Administration to revitalize the federal rulemaking system.  Pete Galvin’s open letter to President-elect Obama provides thoughtful insight and recommendations that, if implemented, would go a long way to get our public health agencies (OSHA, MSHA, EPA) back on track for the common good.  One in particular might be most difficult for the Obama team to swallow is:

“…trust your appointees to do their jobs without direct oversight by the White House staff.  Specifically, I would urge you to dispense with any direct White House role in the regulatory activities of Federal agencies for a test period of a year.”

Galvin’s talking about OMB.

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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:

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Public health values prevention. In many cases, this means spending a relatively small amount of money up front (on things like water treatment and vaccination) to avoid spending a lot more money later (on medical care, lost productivity, and reduced earning potential – not to mention quality of life).

In the past few days, I’ve come across two examples of governments facing a stark choice between paying for something now, or paying a lot more later. It at least one case, it looks like the elected officials will stick with boneheaded option.

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by Susan F. Wood, PhD 

Today’s Washington Post writes about one more instance where women’s health and children’s health were a lower priority than the interests of a powerful group.  In this case, it was breastfeeding vs. the formula industry.

Marc Kaufman and Christopher Lee write:

In an attempt to raise the nation’s historically low rate of breast-feeding, federal health officials commissioned an attention-grabbing advertising campaign a few years ago to convince mothers that their babies faced real health risks if they did not breast-feed. It featured striking photos of insulin syringes and asthma inhalers topped with rubber nipples.
Plans to run these blunt ads infuriated the politically powerful infant formula industry, which hired a former chairman of the Republican National Committee and a former top regulatory official to lobby the Health and Human Services Department. Not long afterward, department political appointees toned down the campaign.
The ads ran instead with more friendly images of dandelions and cherry-topped ice cream scoops, to dramatize how breast-feeding could help avert respiratory problems and obesity. In a February 2004 letter, the lobbyists told then-HHS Secretary Tommy G. Thompson they were “grateful” for his staff’s intervention to stop health officials from “scaring expectant mothers into breast-feeding,” and asked for help in scaling back more of the ads.

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 by Susan F. Wood, PhD

 The last week of August is full of anniversaries for me, both public and personal.  On August 24, it has been one year since the partial approval of Plan B emergency contraception over-the-counter (OTC) for those over 18 years old.  Two days later on August 26 is the 87th anniversary of the day that women got the right to vote, Women’s Equality Day.  It also is the 2nd anniversary of the day that FDA leadership once again denied the approval of Plan B OTC despite all of the evidence and support within FDA for its approval.  August 31st, just 5 days later, marks the two-year anniversary of my resignation from FDA as Assistant Commissioner for Women’s Health in response to the Aug. 26th decision.

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