by revere, cross-posted from Effect Measure

I’m an epidemiologist and I train epidemiologists so you expect me to think epidemiology is important to public health. Epidemiology describes the pattern of diseases in the community and tries to figure out why some patterns exist and not others. It is used for both applied health research (causes of disease and disease outbreaks), disease control and for administrative purposes (how many hospital beds will we need, for example). When I was in medical school most epidemiology, such as there was, was done by medical doctors or employees of federal, state and local health departments. Starting in the sixties, academic programs in epidemiology started to take off, and now there are many masters and doctoral level training programs in epidemiology. But still not enough epidemiologists to meet the need, apparently. And we aren’t moving forward. We’re sliding backward.

Periodically since 2001 the Council of State and Territorial Epidemiologists (CSTE) (a non-profit organization of state epidemiologists that advises CDC and promotes the interests of epidemiology in state service) does a survey of the states to see what’s happening in the epidemiology workforce and capacity to perform epidemiological functions. The latest results were just reported in CDC’s Morbidity and Mortality Weekly Reports (MMWR) and the present the kind of dismal picture we all could see with our own eyes without a formal survey. Almost everything in public health at the state and local level is deteriorating even as the demands are escalating, sometimes to the breaking level. Here, for example, are two graphs showing what has happened between the last survey in 2006 and this one (2009) and the current state of affairs for various program areas:

The bars on the left are the number of states have substantial to full (>50%) full capcaity in four key program areas are for 2006. The bars on the right are for 2009. Except for research, which went from 9 states to 10 states, the other program areas showed smaller capacity. The survey was done between April to June of this year, concurrent with the first wave of the swine flu pandemic. The sudden demand to count cases, prepare new programs, measure spread, interpret data and all the rest of the things the public and press was clamoring for feel on fewer shoulders than just 3 years ago. As a result, personnel were borrowed from other essential public health functions, which suffered even more.

This graph shows the status of those other functions before they were stripped to handle the pandemic:

What you are looking at here is the percent of state health departments that have substantial to full capacity (>50%, left bar) and minimal capacity (less than 25%) in key public health program areas. While infectious diseases was reasonably (although not fully staffed; the left bars are percentages of states with more than 50% capacity, not all full capacity), many important public health programs had more states that had no to minimal capacity than states that had substantial to full capacity. It’s a dismal picture for routine but important public health functions.

What kind of things are we talking about here?

Here are four big functions where capacity decreased from just three years ago to the start of the pandemic:

• Monitor the health status of the community
• Diagnose and investigate health problems in the community
• evaluate effectiveness and access of health services
• Research into health problems

As the pandemic showed us (although any idiot could have seen it), this was an utterly stupid disinvestment. But we did it, and now everyone is hollering about how we haven’t been able to handle swine flu. You get what you pay for.

It’s a lot more than it appears on the surface, too. I’m in an academic environment where we use the latest tools in computational epidemiology and the laboratory sciences. But in state and local health departments they are starved for people and deprived of these same tools. Despite the importance of timely information and early warning, only about half (53%) the states had automated electronic lab reporting and far fewer web-based provider reporting (41%), automated cluster detection software (24%) or routine coding of location for disease or deaths (29%). Even when the tools exist, most require the basic data to be geocoded by location and that still isn’t routine in more than 70% of state health departments.

I’ve been in public health a long time and I’ve seen many changes. We can do things now we couldn’t dream of doing even ten years ago (cluster detection, routine mapping of disease outbreaks, data mining of routine health data, etc.). We can do them, theoretically, that is. The infrastructure, human and otherwise, that would produce the raw data for these sophisticated tools isn’t there and we aren’t providing it. On the contrary we are gutting state and local health.

Some things are just so stupid it takes your breath away. Not that there are enough ventilators for that problem, either.

Lt. Col. Jim Gentry was exposed to the carcinogen hexavalanet chromium while stationed as an Indiana National Guardsman at the Qarmat Ali water plant in Iraq. Now, he has died of lung cancer at age 52. As we’ve written before, contractor KBR was in charge of the facility and failed to address the extensive contamination of the site until months after soldiers and workers there began having nosebleeds, nasal infections, and skin abrasions. In his article about Gentry’s death in the Evansville Courier & Press Eric Bradner reports:

“I’m dying now because of it,” Gentry said 11 months ago while answering questions from lawyers embroiled in a legal battle over who is to blame for hundreds of soldiers’ exposure to the chemical.

Gentry, of the 1st Battalion, 152nd Infantry of the Indiana National Guard, commanded more than 600 soldiers in Iraq, including about 140 from Indiana.

He is included among a growing group of those soldiers who are suing Houston-based defense contractor KBR Inc., which the soldiers blame for not properly protecting them. …

“I understand and accept there’s danger with my line of service, in my line of service,” Gentry said in the December 2008 deposition. “What’s very difficult for me to accept is if I’m working for KBR and they have knowledge of hazardous chemicals on the ground that can cause cancer and (they don’t) share that knowledge, then that is putting my men at risk that is unnecessary.

In other news:

The Canadian Press: Activist Mariano Abarca Roblero, 51, refused to stop campaigning to halt environmental damage from a barite mine in his community, despite having been repeatedly threatened and assaulted. Last month, he was gunned down in front of his home in Chiapas, Mexico.

Boston Globe: The Chemical Safety Board issued urgent recommendations to improve safety at a Citgo refinery in Corpus Christi, where tons of hydrofluoric acid were released and a worker seriously injured in July.

Chicago Tribune: Vietnam veterans who were exposed to Agent Orange and now suffer from cancer, diabetes, and Parkinson’s – all diseases linked to exposure to the defoliant – often face lengthy bureaucratic battles when they seek compensation.

National Institute for Occupational Safety and Health: Older workers tend to be more severely injured and more likely to die from their injuries than their younger counterparts; a report from a recent conference offers ways to ensure “work ability” for workers of all ages in a variety of work environments.

Environmental Protection Agency: EPA is asking for public comment on plans to strengthen assessment of pesticide health risk, including risks to farmworkers and farm children. (Read more from Jennifer Sass at Switchboard.)

In April-May 2008, there were a spate of fatalities involving workers doing installations or maintenance on cell phone towers.  I blogged about seven of these worker deaths and promised to report back on the outcome of the Federal or State OSHA investigations.   Of the seven fatal incidents, three were resulted in informal settlements of serious violations with penalties ranging from $2,100 to $4,900; and two investigations resulted in no citations or penalties, with one of these cases closed just two days after the worker’s death.  For another, I was unable to locate any data about the incident using OSHA’s on-line establishment search tool.  The details of six of the incidents appear at the end of this post.  The most complete information I can provide relates to the fatal fall on May 16, 2008 of Mr. Jonathan Guilford, 25, who was employed by Phoenix of Tennessee, dba All About Towers.   The information comes from documents provided by Indiana OSHA (IOSHA) which I requested under the State’s Access to Public Records Act.  It took a few back-and-forths and about 90 days to receive the information. 

The 36 pages of IOSHA’s fatality investigation, citations and penalties reveal many troubling details of working conditions for Mr. Guilford and his co-workers, including that the surviving workers

“were fired” because they “did not look after each other.” [see page 20]

This revelation came after I’d just read in the inspector’s notes about the employer’s failure to provide appropriate climbing and rigging equipment.  The hook used by Mr. Guilford

“was missing the safety latch (‘keeper’)” and the equipment rope “was routinely used for moving material up/down the tower and was not suitable for life safety purposes.”  [see page 7, page 19]

As the IOSHA inspector reiterated in his notes:

“Equipment ropes are used for material, safety ropes are used for people. Period.” [see page 19]

A company supervisor reported to the CSHO:

“The day after Jay’s fall, the company sent me to all of the other tower sites in this market to check for and remove bad climbing and rigging equipment.  I found several hooks with missing keepers.” [see page 20]

And another worker stated:

“I know what happened.  I be he [deceased worker Guilford] used the bad hook—you know, the one with the missing gate.” [see page 20]

When asked by the investigator, ‘how come it was available for use’?

“It was just hanging on the hook in the trailer.”

Tell me:  How does a company that specializes in communication tower construction and services—climbing and working hundreds of feet off the ground—fail to have an exceptional fall protection program?? 

This particular cell-tower site was rented to corporate giant AT&T which hired General Dynamics to oversee the upgrade of the tower equipment.  Wouldn’t you think that AT&T and General Dynamics would have taken steps to ensure that Phoenix of Tennessee, dba All About Towers, had an A+ fall protection program and a Five-Star H&S system??  

Well, General Dynamics’ lack of attention to safety on the front-end of this project was not repeated when it came to attention to the IOSHA investigation of Mr. Guilford’s fatal fall.  During IOSHA CSHO’s opening conference, there were four officials from General Dynamics as well as one rep from All Around Tower and the property owner [page 30].  Likewise, General Dynamics’ officials participated three months later in IOSHA’s closing conference.  [No worker reps are listed on the attendance sheet.  The employees of All Around Tower were not represented by a labor organization, and the documents don't indicate how (or if) workers were notified of their right to participate in these official briefings. ]

The company, Phoenix of Tennessee, dba All About Towers, received four serious violations of safety standards related to safety belts, lifelines and lanyards; safety nets; and rigging equipment.  The unadjusted monetary penalty was $20,000 but because the firm’s size and history, received a 50% penalty reduction for an assessed penalty of $10,000.  Through a settlement agreement, three of the four violations were deleted and the penalty reduced to $2,500.  Neither the information I received from IOSHA, nor the OSHA on-line summary indicates what the employer has done to ensure that this gross disregard for workers’ safety never happens again.

My final revelation from the documents provided by IOSHA comes from the OSHA 300A form [page 14].  The company’s DART rate for 2007 was 1.8.  What happens to the employer’s DART rate because of a fatality?  As far as I can tell looking at OSHA’s injury recordkeeping system, a fatality counts as a single incident with no extra days “lost” figured into the rate.  If DART rates are used by companies [and even OSHA] as a measure of an employer’s injury prevention program, shouldn’t a few thousand lost workdays be charged against the company’s rate?   For example, an old Bureau of Mines guidance document assessed 6,000 days to a fatality or case of permanent disability.  As it stands under the current DART calculation system, a prospective employee, contractor or member of the public could be substantially deceived by today’s DART rates exclude these most severe of all injuries. 

As noted above, here is addition information on the six fatalities of cell-tower workers that occurred in April-May 2008:

**Darren Joe Reed, employed by Structural Systems Technology (McLean, Virginia) died at the Channel 7 WSVN antenna farm near Miami, Florida on May 22.  The OSHA on-line summary for this incident tells us that the firm was cited for two serious violations of fall protection standards and assessed a $9,800 penalty.  Through an informal settlement agreement, the penalty was reduced to $4,900.  The OSHA site does not indicate what the employer has done to ensure the future safety and health of their employees and contractors.

**Mark Haynes, 31, of Griffin, Georgia was killed at a job in Natchez, Mississippi on April 23.  He was employed by Overland Contracting, Inc of Black & Veatch Company.  The OSHA on-line summary for this incident tells us that no citations or penalties were assessed following OSHA’s investigation.

**James Daryl Friesenhaun, 38, fatally fell 200 feet on April 15, 2008 at a job for the City of San Antonio’s CPS Energy.  He was employed by Ransor Incorporated.  The OSHA on-line summary for this incident tells us that OSHA closed its investigation after two days, and no citatons or penalties were assessed.  [Was Mr. Friesenhaun considered a public sector employee, and therefore federal OSHA didn't have authority to investigate his work-related death?]

**An unnamed worker employed by Cornerstone Tower of Grand Island, NE was killed at a job in Moorcroft, WY on April 14. The OSHA on-line summary for this incident tells us that WY-OSHA cited the employer for two serious violations of fall protection standards and assessed a $5,000 penalty.  

**Charles Wade Lupton, 34, of Midwest City, OK was fell 150 to his death at a job in Wake Forest, NC on April 12.  He was employed by MJM Group.  The OSHA on-line summary for this incident tells us that NC-OSHA cited the employer for two serious violations and assessed a $4,200 penalty.  Through an informal settlement, one of the violations was deleted and the penalty was reduced to $2,100.  The summary does not indicate what the employer has done to ensure the future safety and health of their employees and contractors.

**William Edward Bernard Jr., 46, of Chesapeake, Virginia was killed at a job in Frisco, NC on April 17.  He was employed by Brook Hill Communication.  I have been unable to locate information on OSHA’s on-line “Establishment Search” page about the status of this fatality investigation.

by revere, cross-posted from Effect Measure

There’s a lot to like about Canada (their health care system, for starters) but there are some things that are less than praiseworthy (I understate), and towards the top of that list would have to be a hundred years of peddling, with government support, protection and outright lying, a product that brought the world one of the 20th century’s greatest public health catastrophes: asbestos.

Asbestos is a fibrous mineral that exists in two main categories, the serpentine minerals and amphibole group. Asbestos saw myriad uses and 90% of those used the serpentine form whose main representative is called chrysotile asbestos. It is no longer mined in the US but the main source in North America was always Canada. Use of asbestos in industrialized countries has shrunk dramatically and the sole mine in Thetford, in Quebec, now only employs about 300 people. But they still export this fiber to places in the developing world and the industry is protected — and promoted — by the Canadian government.

Make no mistake. Asbestos is a deadly product. It causes a scarring of the lungs (an interstitial fibrosis) in workers and lung cancer and cancer of the lining of the lungs and abdomen in workers, their spouses and children and in consumers. The fragile confederation between Quebec and anglophone Canada has been exploited by asbestos lobbyists and pro-asbestos messages have infiltrated the news media with regularity.

I know quite a bit about asbestos and its history and used to joke that the Canadian asbestos industry would say anything, even that it wouldn’t hurt you to eat it for breakfast. It was just a joke. I thought. Then one weekend, maybe 15 years ago, I got a call from the Canadian Broadcasting Corporation (CBC) asking if I would agree to be interviewed on their popular Sunday morning live coast to coast broadcast. I was to come on after the Canadian Minister of Mines (or some minister, anyway, don’t remember at this point), who had been saying publicly that asbestos was so safe he wouldn’t hesitate to put a teaspoon in his morning coffee. Holy shit!, I thought. They really are saying you can eat it for breakfast. So I got on the phone and listened to the first part of the interview and he said it again!

The Canadian government, in fact, has been doing this for a century. Even in the decades where we knew how deadly asbestos dust was, they aggressively marketed it to the developing world on the grounds that doctors in those countries now knew well how dangerous it was and would protect the workers. I remember well a visit to a shipyard in Ismailaya, Egypt, on the Suez Canal, and seeing workers using asbestos without any personal protection. I asked the company doctor about it. He told me that it was his understanding that asbestos was harmless as long as workers weren’t exposed for too long. Egypt, let it be said, has one of the better trained medical cadres on the African continent.

But the resistance to this irresponsible behavior is growing in Canada. Quebec’s public health authorities are demanding that the government cease support for the mining and use of asbestos:

The group has sent a letter to federal Health Minister Leona Aglukkaq criticizing the government for its support of the mineral that has been banned in many countries as a health hazard.The issue is a sensitive one in Quebec, home to the country’s only operational asbestos mine, located in the town of Thetford Mines.

In the letter sent to Aglukkaq by the Canadian Association of Physicians for the Environment and the Rideau Institute, Quebec public health officials said they are “extremely disturbed” by what they call “misleading, inadequate and, at times, false information” about the risks of asbestos found on Health Canada’s and other government websites.

“This industry in Canada should not be promoted like it is currently with federal and provincial funds,” said Dr. Pierre Gosselin, a researcher affiliated with Quebec’s National Institute of Public Health. (Mines and communities.org)

Conservative Prime Minister Stephen Harper continues to support the industry and Canada’s health minister has yet to respond to her Quebec colleagues. Rumors are circulating that the provincial government is sitting on a report of asbestos cancer in the community near the mine. The Canadian public health institute report was delivered to the government in March (8 months ago).

Meanwhile I continue to drink my coffee black. No sugar. No cream. And no asbestos.

Although most of the focus in Copenhagen is on reducing emissions of carbon dioxide, negotiators are also looking at other greenhouse gases, reports Jim Tankersley in the Los Angeles Times. Methane, which is produced by livestock and landfills, has 23 times the global warming potential of CO2. Hydrofluorocarbons are used in refrigeration and cooling, and came into wide use after the Montreal Protocol slashed the use of CFCs because they damage the ozone layer; that agreement’s structure could now help speed the phase-out of HFCs.

While not actually a gas, black carbon is also a major contributor to climate change – by one estimate, it’s responsible for 18% of the world’s warming. These particles of soot come from biomass-burning cookstoves and some ships, and retain the sun’s heat rather than allowing it to be reflected back up into the atmosphere. Black carbon deposited on snow and ice can speed melting, which contributes to sea level rise and water-supply problems.

Tankersley notes that addressing these less-high-profile contributors is potentially easier than tackling CO2 emission:

Many scientists and environmentalists say reducing the “forgotten 50%” of pollutants will be faster, easier and substantially cheaper than cutting carbon dioxide, and could buy the world time in its climate clock race.

“We can eliminate — not just cut — one of the six greenhouse gases this week,” said Durwood Zaelke, a longtime environmental lawyer who is president of the Institute for Governance and Sustainable Development. “This can buy us more than a decade of delay” against the worst effects of climate change, he said.

[...]

Action on black carbon and hydrofluorocarbons is a particularly appealing goal for island nations concerned that the world may be nearing “tipping points” of global warming, in which increased greenhouse gas concentrations in the atmosphere start a chain reaction of temperature rise that would lead to their nations being swallowed by rising seawater.

The island nations are desperate for measures that will reduce warming in the short term. Black carbon is an ideal target because it stays in the atmosphere for only a few weeks, compared with 100 years for carbon dioxide, meaning that if black carbon emissions were eliminated, atmospheric heat-trapping would drop quickly.

This doesn’t let us off the hook when it comes to cutting CO2 emissions, and shouldn’t distract from that important task, either. The ability to pursue multiple solutions simultaneously is essential for saving the planet.

One of my all-time favorite investigative journalist and public health heroes, Andrew Schneider, is writing for the new AOL News venture: Sphere.    Schneider is exceptional because of the dogged way he pursues topics and sticks with them over the long haul—not a couple of weeks or a few months, but for years.  He understands the health and safety regulatory system moves like cold molasses, but never stops asking: why that is, especially when evidence of harm continues to mount, or when we ignore lessons from public health history. 

In “Just When You Thought It Was Safe to Make Popcorn,” Schneider reminds us that two years ago, microwave popcorn manufacturers removed the butter-flavoring agent diacetyl from their product.  Their rapid response followed reports that a heavy user-ingester of extra buttery microwave popcorn had developed the severe lung disease called bronchiolitis obliterans.  Schneider now reports:

“government health investigators are reporting that the ‘new, safer, butter substitutes’ used in popcorn and others foods are, in some cases, at least as toxic as what they replaced.  Even the top lawyer for the flavoring industry said his organization has told anyone who would listen that diacetyl substitutes are actually just another form of diacetyl.”

In a script that we’ve all seen before, Schneider notes:

“Those companies, citing competition, repeatedly refuse to discuss what they’re using today to add the butter flavor to what they sell.  But, at their professional conferences, food scientists and flavorists openly discuss that they are using blends called starter distillates and trimmers as substitutes for the rich butter flavors that consumers love so much.”

We learned a few months ago during OSHA’s SBREFA panel on diacetyl that at least one microwave popcorn manufacturer is conducting its own toxicology tests on potential substitute flavoring agents.  The Pop Weaver company is trying to take a precautionary approach, saying in a May 2009 statement to OSHA:

“we were concerned that substituting an unknown, potentially more hazardous substance for diacetyl may not be in our associates’ [workers] best interest.  …So Weaver established a policy that no new flavorings will be introduced without laboratory toxicology testing and evaluation by professional third party providers to determine the chemicals present in the proposed new flavorings.”

On the one hand, I commend Pop Weaver for doing its own toxicology testing to help identify butter-flavoring substitutes that might also be harmful to their employees’ health.  I’ve not heard of any other food manufacturer take their responsibility to protect their employees from flavoring agents as seriously as their concern for the end-users and consumers.     

On the other hand, we don’t know which or how many alternative compounds Pop Weaver has tested and rejected (a good thing); without that information one can’t press their less-proactive competitors from disclosing whether they use these same flavoring chemicals.  And, how do we make sure that a responsible firm like Pop Weaver isn’t penalized for being precautionary?  Or put at an economic disadvantage because they are spending money on the tox testing, while other firms prefer to wait around until they are forced to take action because of regulation or litigation? 

This situation again exposes the silos in which our public health agencies operate.  Diacetyl is designated by the US Food and Drug Administration (FDA) as “generally recognized as safe” (GRAS), based on its safety as a food additive, despite the fact that inhalation exposure to it is associated with severe lung disease.   In September 2006, we (SKAPP) filed a petition with the FDA asking the agency to revoke the GRAS designation for diacetyl, noting the compelling evidence of disease caused by breathing diacetyl vapors and the lack of data revealing an exposure level below which the chemical does not cause lung disease.  After three years with no FDA action, we wrote last week to the new FDA commissioner, Margaret Hamburg, MD, asking her for a status report on FDA’s scientific review of diacetyl, a timeline for next steps, and again, urged the cancellation of diacetyl’s GRAS designation.

Of course, Schneider’s reporting of the diacetyl saga also extends to the agencies responsible for protecting the public’s health and safety.  As we also reported on The Pump Handle (here,) Labor Secretary Solis announced her regulatory agenda for the coming year.  There was little sense of urgency with respect to workers’ exposed to diacetyl.   In classic Schneider-style, he introduces us yet again to another victim of regulatory delay: Ms. Elaine Khoury. 

“Khoury worked for Blockbuster Video for five years in Florida and Missouri.  As the store manager, every Friday and Saturday, she would pop 30 bags of microwave popcorn in a small back room, then empty them into a popcorn machine to give the appearance that they had been freshly popped.  Last year, a lung biopsy at the Mayo Clinic confirmed that she had full-blown bronchiolitis obliterans.  She is now waiting for a lung transplant.”

Schneider describes Ms. Khoury’s exposure as a “consumer case,” (for FDA) where I’d describe it as an occupational exposure (for OSHA).   Either way, it’s a compelling example that our system of public health safeguards still isn’t working.  Read all of Schneider’s latest reporting on diacetyl in AOL’s Sphere at ”Just When You Thought It Was Safe to Make Popcorn.”

Celeste Monforton, DrPH, MPH is with the Project on Scientific Knowledge and Public Policy (SKAPP) at George Washington University School of Public Health.  She first came to know Andrew Schneider when he was reporting for the Seattle Post-Intelligencer on the public health disaster caused by W.R. Grace in Libby, Montana.

by Rena Steinzor, cross-posted from CPRBlog

What Progressives Expect from OIRA: An Open Letter to Cass Sunstein

Dear Cass:

As you know, we picked a spat with the Office of Information and Regulatory Affairs (OIRA) last week over Randy Lutter’s supposedly temporary detail appointment to your office.  It’s not the first time we’ve criticized the workings of OIRA, and almost certainly won’t be the last. 

I’ve spoken to a number of people in the media and elsewhere who have expressed surprise that progressive organizations like CPR are such relentless critics of a progressive Administration.  I’m sure Administration officials feel this frustration as well.  That dynamic is at work in OIRA’s case because you have a reputation as a progressive thinker on many issues.

I won’t try to speak for all progressives, but I can assure you that very few of us criticize the Administration lightly.  Nor do we do it with any sense of pleasure. 

The Obama Administration inherited an absolute mess on every front and progressives are well aware of the herculean effort you are making to dig out.  But while it is tempting to take refuge in the notion that if only a few things are better at the end of however many terms the voters give President Obama, that limited vision is not why you signed up to serve, nor is it why so many of us voted for your man.

President Obama promised a transformation and that’s what we will keep asking you to deliver. We won’t settle for “better than Bush” or even “better than Clinton.”  We want the worst problems to improve a lot, not comparatively.

We want the President to succeed in his stated goals of protecting the environment and people’s health and safety, and we’d be delighted to do nothing but applaud and throw rose petals – and in fact, we have, when it was merited.  I was impressed, for example, that OIRA opened up the process for devising its forthcoming executive order on the regulatory process to public comment.  It wasn’t required; doing so was a nice bow to transparency, and I said so at the time.  Petal-throwing was also in order when you pledged to leave EPA alone as it proceeds with its program for endocrine disrupter testing.  Some damage had been done by OIRA interference before you were confirmed, but things seem to be back on track now.

But frankly, I’m very worried about the direction of OIRA – worried that close to a year into the Obama Administration, your staff has not yet embraced the President’s call for a reinvigorated regulatory system.  True, you spent most of this period awaiting confirmation while right-wing extremists invented far-fetched and unfair reasons to slow that process down.  But progress on the President’s agenda need not wait for the confirmation process.  To pick just a couple of examples of business-as-usual at OIRA:

• L’affaire du Lutter.  Temporary or otherwise, Mr. Lutter was brought to OIRA despite a plainly right-wing track record on the very issues he’s working on, and has pursued that agenda while there.
• Meetings with industry.  OIRA staff have had a lengthy series of meetings with industry representatives to discuss an EPA coal ash regulation that hasn’t even been formally started yet.  Industry should raise its concerns with EPA, not OIRA. OIRA shouldn’t be setting itself up to conduct a parallel review of the substance of the regulation, certainly not before EPA has done its work.   
• The Executive Order.  We’re eager for the Administration to issue its update to Executive Order 12,866, establishing a regulatory roadmap for the Obama years.  We hope for a surprise, but we’re fully expecting it to continue to employ cost-benefit analysis as a yardstick for grading the worth of proposed regulations.  There’s a lot to say about this, but I’ll confine myself to one, threshold point: A quarter century of experience with cost-benefit demonstrates that it is a badly warped yardstick, that its application overstates costs to industry and understates benefits of regulations to consumers and families.  And in most cases, it’s not what the law calls for.

Those are all worrisome issues that do not portend a bright future.

Undoing each of Bush’s anti-regulatory maneuvers should be a start, but I fear that the actions enumerated above mean that your office hasn’t yet begun serious work on achieving that baseline goal.

Instead, while we argue about when OIRA will begin to change, the bigger picture is left unaddressed.   Undoing Bush is just the start.  The real challenge is to actually reinvigorate the regulatory system so that Americans can count on safe food and drugs, safe workplaces, breathable air, drinkable water, a toxic-free environment – and more.  In other words, Bush took a regulatory system that was underfunded and in general disrepair and reduced it to shambles.  OIRA’s challenge is to revive EPA, FDA, CPSC, NHTSA, and OSHA so that they are independent, strong, and effective.  To accomplish that larger and overridingly important mission, here’s what needs to happen at OIRA:

First, the agencies responsible for safeguarding our environment, our food, our workplaces, our cars, and our toys need to be restored to full fighting weight, with enough resources to mount credible enforcement programs, write appropriately stringent rules, and, most difficult of all, rediscover their autonomy, self-respect, and independence.  Your staff should help agency chief financial officers figure out a method for estimating what they really need to do their jobs, and you should help the CFOs and agency heads present those findings to Congress, preferably outside the routine appropriations process.

Second, the three dozen or so professionals under your supervision should redefine their role, giving up the posture of guardians against regulatory excess and becoming guardians of public health, worker safety, and the environment.  They should stop serving as a backdoor for industry to work its will on regulations because they’ve got other things to do, including working to correct exaggerated industry estimates of the potential costs of proposed regulation, helping agencies overturn the various Bush midnight regulations that remain on their books, and developing a methodology for calculating the budget increases that are necessary to make it possible for the agencies to carry out their statutory mandates.

Third, to accomplish the difficult but crucial culture change of shifting OIRA’s attention from industry complaints to an affirmative agenda appropriate for the Obama presidency, your staff should spend each and every day thinking of ways to streamline and hasten the regulatory process, delivering on mandates communicated by Congress long ago.  You might consider telling everyone who wants to meet with you about an issue within the purview of the agencies that they have to go to the agencies first, and come back to OIRA only when you actually have a regulatory decision under review.  You should meet with them only when their concerns are rationally related to OIRA’s appropriate role.  Don’t allow them to repeat complaints about issues—especially scientific issues–within the expertise of the regulatory agency itself.  And you should set standards for your staff on when and with whom to meet, ensuring that OIRA hears from all sides of the debate evenly, rather than expending large amounts of OIRA staff time hearing only from those with the money to field dozens of “experts.”

Fourth, your office should set a sterling example on a central tenet of the President’s agenda, posting online all of your communications, both incoming and outgoing, with agencies and stakeholders about rules and other regulatory decisions that you choose to monitor.  These postings should include agency communications to you, which some agency staff apparently want to keep confidential, for reasons that should not be permitted to trump the President’s overriding commitment to transparency. 

This affirmative agenda goes beyond fixing the extreme policies of the Bush Administration, and takes on the real work of using the regulatory structure to do exactly what it was created to do: keep Americans safe from a variety of hazards. We’re eager to help you move in that direction.

Rena Steinzor

Rena Steinzor is a Professor of Law at the University of Maryland School of Law and has a secondary appointment to the University’s School of Medicine faculty.  She is the President of the Center for Progressive Reform.

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:

A cholera epidemic is sweeping across Kenya, with 4,700 cases reported in the past month and 119 deaths in what Kenyan officials are calling “one of the worst outbreaks in a decade.”

The most stricken areas are the arid swaths of northern Kenya, which were hit this year by a devastating drought. The scant rains have meant that many people are surviving off dirty, germ-infested water, which is how cholera spreads.

The drought has also left thousands of people malnourished and weak, making them vulnerable to infectious diseases. Because of the remoteness of many of the infected areas, aid workers say they believe that the officially reported numbers of cases and deaths may vastly understate the severity of the outbreak.

We don’t know precisely how global warming will affect the spread of diseases (for instance, it’s hard to predict exactly how changes in complex ecosystems will affect the spread of insect-borne diseases), but we do know that the communities with fewer resources will have a harder time withstanding droughts and other disasters.

When people here in the US complain about the cost of slowing climate change, we have to remember that we’re not the ones who will bear the worst of its impacts. It won’t be our malnourished children dying of cholera, at least not in the near future. Do we really think our lifestyle is worth the toll it’s taking on the rest of the world?

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.

WNV is a mosquito-borne flavivirus of birds that occasionally infects humans (in this sense it is like bird flu, although only in this sense; bird flu is not passed from birds to humans via mosquitoes). The resulting infection can range from asymptomatic to fatal, with a significant number of cases of meningoencephalitis (inflammation of the brain and its coverings). Since the first cluster of cases in a residential area of Queens, New York, WNV cases have appeared in all state of the continental US. It is a reportable disease and 25,000 cases have been so registered in the last 10 years, more than a thousand of them fatal. Most cases aren’t so serious, but somewhere under 1% develop a neuroinvasive form that can lead to serious neurological symptoms, sometimes of long standing, or be fatal. The number of deaths and cases is undoubtedly under reported and we are still learning about the natural history of the disease. “Natural history” refers to the clinical course of the disease over time.

In order to study natural history you need to follow people who have been infected and see what happens to them over time. Early on it appeared that either you got sick and died or you got over your infection. Then some cases turned up that seemed to have prolonged effects. And now we are finding that some of those who are apparently recovered may harboring persistent infection. A new paper (available online here) in the Journal of Infectious Diseases has the first reports:

When WNV reached Houston in 2002, we established a longitudinal study to follow hospitalized WNV‐infected patients to determine risk factors for encephalitis and to understand long‐term clinical sequelae. Methods for WNV confirmation and study inclusion criteria have been described elsewhere. [snip] At 1 year after infection, 60% of patients remain symptomatic, particularly those who were encephalitic. Resolution of symptoms plateaued 2 years after infection, and after 5 years 60% of patients who presented with encephalitis continued to report clinical symptoms. Chronic symptoms were significantly associated with the persistence of detectable anti‐WNV serum immunoglobulin M and also with a history of hypertension. Cytokine studies showed that many of the chronically symptomatic patients also had significantly elevated plasma levels of interferon γ-inducing protein, a marker of active viral infection (Murray et al., Persistent Infection with West Nile Virus Years after Initial Infection, The Journal of Infectious Diseases 2010;201:2-4).

Studies in monkeys and hamsters had already shown that WNV could persist in brain tissue and in the hamsters was also found in the kidney. The hamsters continued to shed virus in their urine up to 8 months. Now it appears the same is true of people. The Houston group has now followed 100 cases of severe WNV infection for 7 years, and while symptoms decreased over that time they seemed to level out at 2 years. As noted above, more than half were still having symptoms after 5 years. But five of them died of kidney failure, and putting that together with the hamster studies made the Texas researchers look at the urine of a sample of 25 from the cohort of 100. 5 of them, or 20%, seemed to be shedding virus in the urine. The evidence was in the form of entire viral genomic material. So far no virus has been isolated. But the length of time that genetic material is being shed indicates that virus is still being formed. So this is persistent infection.

WNV if now the most common arbovirus (arthropod borne virus) infection in the US. It may turn out to be a significant cause of kidney failure, although that is still unclear. What’s intriguing (and worrying) is that we still don’t have good fix on the epidemiology of this disease. We have assumed that significant levels of virus in the blood (viremia) of infected animals (birds) was required for a mosquito to have a large enough viral load to infect a human. That’s why infected people didn’t pass it on to others by having a mosquito bite both of them. But if the virus is present in other tissues there might be other modes of transmission. In an accompanying editorial by Ernest A. Gould of the Centre for Ecology and Hydrology, Oxford (UK) raised that issue:

Finally, one can ask, what is the significance of these findings to WNV transmission? Nonviremic transmission of WNV between mosquitoes cofeeding on mice and nonviremic transmission of Japanese encephalitis virus [3] from healthy nonviremic bats to feeding mosquitoes have both been reported. The findings of Murray and colleagues could therefore also raise important issues concerning the potential for WNV and other related flaviviruses to be transmitted to mosquitoes by apparently healthy humans or animals (assuming a similar pattern of WNV behavior in animals) and thus potentially initiate epidemics in new regions of the world. Could this be the method by which WNV arrived in North America in 1999?

This kind of science can be very worrying. But for a scientist it’s also very, very interesting. Never a dull moment.

by Ken Ward, Jr., cross-posted from Coal Tattoo

I checked out the Web chat that Joe Main, assistant labor secretary in charge of the Mine Safety and Health Administration (MSHA), had this afternoon to discuss the MSHA portion of the Department of Labor’s regulatory agenda.  Mostly, I was hoping that Main would clarify why the Obama administration removed from its agenda the specific proposal to lower the permissible exposure limit for coal dust that had been added to the DOL plan only six months ago.

Remember that previously, MSHA had a specific regulatory proposal called Occupational Exposure to Coal Mine Dust (Lowering Exposure Limit).  It said: MSHA will publish a proposed rule to lower the coal mine dust permissible exposure limit.

After last week announcing a new campaign called, “End Black Lung: Act Now,”  MSHA this week published a regulatory agenda that instead included an item called Occupational Exposure to Coal Mine Dust (Lowering Exposure). It said: MSHA will publish a proposed rule to address miners’ exposure to respirable coal mine dust. 

During today’s Web chat, I and several others questioned Main, trying to pin him down on whether this new proposed rule — expected to be published in September 2010 — would or would not include a proposed lowering of the exposure limit. I’ll let you decide whether he really answered the question …

Question from Ellen Smith, Mine Safety and Health News:

Can you plase explain why it will take so long for MSHA to finalize new dust and silica standards when there is ample evidence of a problem, and solutions?

Answer from Joe Main:

Ellen, MSHA must follow the notice and comment rulemaking process which provides for public input.   The process includes other administrative and regulatory requirements.   As you will notice the process has been shortened from the last regulatory agenda.

Question from me:

Why has MSHA removed the word “limits” from its agenda item calling for reducing coal dust exposure … is MSHA no longer committed to reducing the PEL?

Answer from Joe Main:

Ken, MSHA did not remove the plan to  lower the PEL.   MSHA consolidated the rulemaking from the previous regulatory agenda on plan verification and compliance sampling, determination of concentration of respirable coal mine dust (single sample) and lowering the respirable coal mine dust PEL into one rulemaking.   The new rulemaking – as noted – will be designed to lower exposure to coal mine dust.

Another question from me:

Why has MSHA removed the specific plan to lower the PEL on coal dust from its regulatory agenda? What is the argument in favor of not reducing the PEL, given the recommendation from NIOSH to do so?

Answer from Joe Main:

MSHA did not remove the plan to lower the PEL.   MSHA consolidated the rulemaking from the previous regulatory agenda on plan verification and compliance sampling, determination of concentration of respirable coal mine dust (single sample) and lowering the respirable coal mine dust PEL into one rulemaking.   The new rulemaking–as noted–will be designed to lower exposure to coal mine dust.

Me again:

Joe — Perhaps you could clarify — MSHA previously announced it was going to issue a rule to lower the PEL … could you speak perfectly clearly here today and pledge that when your proposed rule comes out, it will include a lowering of the PEL?

And Joe Main’s response:

Ken, in the Regulatory Agenda there is reference to the NIOSH criteria document that recommends lowering the PEL. That would be part of the rulemaking.   MSHA is committed to proposing a rule that will reduce miners’ exposure to respirable coal mine dust.

OK … what do you all think?

Here’s one more thing to keep in mind: Main mentioned that the new Obama rulemaking agenda item references the NIOSH recommendation to tighten the dust limit.  Well, both the new agenda item and the previous one issued in May contained this same reference to the NIOSH recommendation:

In September 1995, NIOSH issued a Criteria Document in which it recommended that the respirable coal mine dust permissible exposure limit (PEL) be cut in half.

Basically, what Main is saying is that MSHA took other rulemaking agenda items concerning coal dust — such as changing the way dust is measured for regulatory purposes and the way MSHA confirms dust levels measured by operators — and combined them with the May 2009 item that proposed to lower the legal dust limit. It’s interesting to note that MSHA did not also combine the agenda item for one of Joe Main’s priority projects, personal dust monitors, into that larger agenda item. It’s still listed separately.

I compared the two regulatory agenda items and found other differences.

For example, both agenda items noted that in 1996, a federal advisory committee made recommendations to the Secretary of Labor concerning coal dust and black lung.

But, the May agenda item said:

The Committee recommended that MSHA consider lowering the coal dust PEL. 

While the new agenda item released this week said only:

The Committee recommended a number of actions to reduce miners’ exposure to respirable coal mine dust.

And, as I’ve mentioned before, while the May agenda item specifically said:

MSHA will publish a proposed rule to lower the coal mine dust permissible exposure limit.

The new agenda item has that sentence phrased this way:

MSHA will publish a proposed rule to address miners’ exposure to respirable coal mine dust.

Perhaps I’m over analyzing here … but I tried one more time to get Joe Main to clarify this. I asked something to the effect of:

Joe, you said that MSHA is committed to proposing a rule that will reduce miners’ exposure to respirable coal mine dust.  Is MSHA also committed to lowering the permissible exposure limit for coal dust?

Joe never answered that one.

Ken Ward Jr. is a reporter with the Charleston (WV) Gazette, covers coal mining and worker health and safety extensively, along with many other environmental health topics.  He is chair of the Society of Environmental Journalists’ First Amendement Taskforce.

by revere, cross-posted from Effect Measure

In the US we are about to embark on the Thanksgiving holiday, a 4 day period where families get together for a celebratory meal (at least celebratory unless you are one of the original inhabitants of the continent). There is lots of intergenerational visiting (grandparents to great grandchildren and lots of mingling of people from disparate geographic areas). In the midst of a swine flu pandemic, the obvious question is the epidemiologic implications. Ordinarily there is some effect. Ordinarily.

Thanksgiving is typically followed by at least a modest bump in early seasonal flu cases, according to reports from the past few years. But this, of course, is not a typical year. Swine flu is a new virus that accounts for nearly all flu cases right now. (AP via MSNBC)

Not a typical year indeed. We’ve already had as much or more flu at a time by which we usually have recorded little flu, although the flu is in a portion of the population unused to bearing the brunt. So what are the issues here? We’ve already mentioned some of them.

Thanksgiving festivities produce two things of epidemiological import. There are increased close contacts between different age groups (for example elementary, highschool and college age and the over 65 age group); and close personal contacts between people from widely separated geographic areas. It’s a heady mix. December is the time when seasonal flu starts, slowly at first, then picking up steam in January and February. But this year we’ve already had a whole flu season (and more), although the usual victims (old folks like me) have so far been spared the worst. Will it now be our turn, falling prey as we usually do to seasonal flu? Or has the new kid on the block, swine flu, in some way we don’t quite understand, “crowded out” the usual residents? We don’t know yet.

There’s also a new and completely different mix of the susceptible and immune in the population, a vaccination campaign targeting younger populations just starting to get underway, weather turning colder (which increases flu in ways we don’t understand) and a major economic recession that is affecting habits, living patterns and perhaps susceptibilities in unknown ways. The dynamics of seasonal flu — how the disease unfolds in space in time — still isn’t understood and now we have a completely novel situation: not only the aforementioned factors, but possibly four flu viruses (swine flu, two seasonal influenza A subtypes and influenza B) all circulating — maybe — along with the usual other respiratory viruses (respiratory syncytial and rhinoviruses chief among them).

What will be the result? We’re going to find out soon.

The title of a new report from Physicians for Social Responsibility (via the Charleston Gazette’s Ken Ward) doesn’t pull any punches – it’s called Coal’s Assault on Human Health. While noting that coal mining presents risks to miners and local communities, the report focuses mostly on the health effects of coal combustion. The authors discuss the effects on humans’ respiratory, cardiovascular, and nervous systems, and then explore the more indirect health effects from global warming, to which coal-burning contributes:

• Respiratory effects linked to pollutants from coal combustion include asthma (both development and exacerbation), chronic obstructive pulmonary disease, stunted lung development, lung cancer, and infant mortality (which may be due to pollution’s effects on infants’ respiratory systems, or on other organs).  Particulate matter, nitrous oxides, and ozone are the pollutants implicated.
• Cardiovascular effects include cardiac arrhythmias, heart attacks, and congestive heart failure. Particulate matter and nitrous oxides are also the pollutants to watch here.
• Nervous-system effects include ischemic stroke and developmental delays; particulate matter and nitrous oxides are implicated in the ischemic strokes, while mercury is a neurotoxin that can interfere with neurological development.

The health effects of global warming, to which coal combustion is a major contributor, are more numerous and harder to pin down. The authors identify several conditions that we can expect to see more of, and list some of the health effects that are likely to result. These include:

• More heat waves will mean more heat exhaustion and heat strokes. Higher temperatures will also increase production of ground-level ozone, which will exacerbate asthma and other respiratory diseases.
• Flooding will cause more drowning deaths, and infrastructure damage from flooding will hasten the spread of waterborne bacteria that cause diarrheal disease and other infections.
• Droughts, extreme weather events, and the loss of agricultural land to saltwater intrusion will reduce agricultural yields, causing hunger, malnutrition, and starvation.
• These and other problems will contribute to social instability and mental health problems.

The authors note at the beginning of the report that “electricity provides many health benefits worldwide and is a significant contributor to economic development, a higher standard of living, and an increased life expectancy.” Given the high health costs associated with burning coal, though, they encourage us to switch to cleaner sources of energy.

By Myra Karstadt

During World War II, the United States was the “Arsenal of Democracy,” and American manufacturing literally won the war.  After World War II and through approximately 1970, Americans manufactured and exported more goods than any other country, and the manufacturing sector’s robust state provided workers with enviable incomes and job security. The United States is no longer the manufacturing powerhouse it was, and these days it sometimes seems the most notable product and export of the U.S.A. is dubious financial instruments.

Even though manufacturing and heavy industry generally may no longer be central to the country’s industrial base, the problem of worker exposure to hazardous chemicals remains.  The decline of manufacturing, where workplaces might have had unions and been relatively large, might even make the issue of hazards of worker exposure to hazardous chemicals more important and more problematic. Workers in industries not thought of in the past as chemical-dependent may be more likely to be working in small facilities and less likely to have union representation and/or access to occupational health professionals, and they may well be unfamiliar with chemical hazards.  In fact, workers in industries not previously seen as primarily concerned with chemicals could be likened to bystander workers, exposed to hazardous substances being used by others in their vicinity but who are themselves unprotected and untrained.

The issue of information needed by workers exposed to chemicals has always been the same: who needs to know what?  

The “who” part of the question is easy to answer.

As noted above, workers in manufacturing and non-manufacturing industries alike may have significant exposure to hazardous chemicals.  Examples of non-manufacturing workers with possible exposures to hazardous chemicals abound.  For instance, people who work in auto repair and body shops may be exposed to asbestos, fibrous glass, talc, plastic resin monomers, and solvents (potentially carcinogenic and/or neurotoxic).  People in other types of repair shops- more common in days of old, when consumers fixed appliances such as mixers, toasters and even TVs rather than discard them- had extensive exposures to various solvents, and repair work of various types still typically involves use of solventsThose who repair appliances- a practice less common than it used to be- may be exposed to high levels of hazardous chemicals, since repair work often involves the use of solvents.   Refurbishing furniture, a popular approach in this Craig’s List and flea-market age, can result in furniture strippers being exposed to methylene chloride.  Housekeeping workers in office buildings and hospitality facilities such as hotels and convention/conference centers may be exposed to hazardous cleaning materials.    

Chemical exposures in non-manufacturing industries may be particularly interesting because those exposures may extend to consumers.  People who fix cars at home, work as artists (stained glass, plastic sculpture) at home, or do fix-it jobs or work with their children on projects involving plastics or solvents all need information on what they’re working with.  The National Library of Medicine has a data base that includes several thousand unedited material safety data sheets (MSDS) and is called the “Household Products Database.”  There doesn’t seem to be an equivalent resource, holding MSDSs and accessible on-line free of charge, available for workers.

So it’s clear that all workers, whether in industrial sectors that have long experience with using chemicals or in sectors that have not usually been thought of as having extensive exposure to chemicals, may well have significant exposure to hazardous chemicals.     

The question of “what” people exposed to hazardous chemicals need to know is harder than the issue of who needs the information.

In the 1960s and 1970s, it was established during Congressional hearings and in government reports that workers generally didn’t know the identity of the chemicals to which they were being exposed.  At that time, it was acceptable practice to have containers in the workplace labeled “Mix A” or “Product 146,” without identification of the chemicals in the containers.  The worker right-to-know movement was predicated on the importance of giving workers the identity of the chemicals to which they were being exposed, so that there would be no more “mystery containers.” 

The federal government has developed two federal worker-right-to-know regulations.  The first, the Hazards Identification proposed regulation, had as its principal goal giving workers chemical identity information.  Confidential treatment for chemical identity was severely restricted, especially when it came to extremely hazardous chemicals such as carcinogens.  The Hazards Identification proposed regulation was “label-based,” with chemical identity information appearing on the label of any container of a product with a covered chemical.  Having a label-based regulation would be particularly helpful for a worker in a small or non-union facility, since the worker would not have to ask permission to see a list or a product safety manual, but would only need to look at the label for the container he was using.

As noted in a previous post, the Hazards Identification proposed regulation, which appeared as a “midnight reg” just before the end of the Carter Administration and the beginning of the Reagan Administration, was withdrawn soon after its publication by the anti-labor Reagan appointees to the Department of Labor.  The idea of giving workers information on the identities of the chemicals with which they were working was anathema to the chemical companies and other big businesses to which the Reagan Administration was highly responsive.

The Reagan Administration’s proposal for dealing with worker right-to-know, the Hazard Communication Standard, became final in 1983, and has been in effect ever since.  That standard not only downplays worker access to the identity of chemicals to which they are exposed, but provides for virtually unlimited confidentiality for any chemical, no matter how hazardous.  Rather than provide workers with chemical identity data, HazCom gives workers the right to see material safety data sheets (MSDSs) prepared by their employers or the manufacturer (or marketer) of a product.  The MSDSs are supposed to provide evaluated toxicity information for chemicals, but safeguards to ensure high quality of those evaluations are seriously lacking.  (In fact, the HazCom standard is a travesty, and needs to be replaced or given a major re-do; some problems with HazCom were identified in my February post on MSDSs, and a subsequent post will deal with that issue in greater detail.)

These days, MSDSs are usually available through product marketers’ websites, but results of a recent preliminary research project established that that is not always the case:  some marketers don’t have Websites, some don’t link MSDSs directly (or easily) with product descriptions on the Website, and some companies require a written request to release MSDSs.  Previously identified problems with toxicity information provided on MSDSs persist: many contain out-of-date or inaccurate information, and data may be inconsistent, even within groups of MSDS from a single company.  Even with some efforts at OSHA to improve MSDSs (proposed regs), the sheets are unlikely to improve meaningfully for workers and consumers without major changes in HazCom and in OSHA’s implementation and enforcement of the regulation.

What are the special problems likely to be for workers in non-manufacturing industries who use chemicals and rely on HazCom for protection against unsafe chemical exposures?  Since workers may well be in small non-union facilities relative to the large facilities used in classic manufacturing, occupational safety and health staff may not be available through the employer.  Similarly, union health and safety personnel may be unavailable to non-union shops (and these days even unions with occupational health and safety staff may have cut back, so even union shops may have a difficult time obtaining the technical assistance they would have expected a few decades ago).  Because both labels and MSDSs may require extensive interpretation to be useful to workers, lack of access to company safety and health staff at the worker’s facility, inability to get help from union safety and health staff, and OSHA’s (and NIOSH’s) failures to reach out to workers with interpretation of training materials, workers in non-industrial settings may have particular problems obtaining and interpreting data on hazardous chemicals.   

What if the current “post-industrial” condition turns out to be only temporary?  What if the U.S. is successful in creating a major manufacturing industry based on “green” technology?  Previous experience with fabrication of computer chips could be instructive as regards safety and health issues.  During the period when chips were being fabricated in clean rooms in the U.S., one thing you could have said about the clean rooms was that it was good to be a chip in a clean room, but not so good to be a worker.  The workers were exposed to a variety of common solvents and exotic materials, such as special metals.  Workers needed information on those chemicals, and it would appear that not much was done by employers to give workers those important data on possible hazards of chemical exposures during chip fabrication.

It’s interesting to speculate about where workers for new industries would come from, and whether those workers would be sophisticated users of chemicals- because they came from manufacturing-sector industries that have laid off many workers who were used to dealing with chemical hazards- or whether the “green” technology workers would be new to manufacturing and, possibly, unsophisticated users of chemicals.  It might be wise for OSHA and NIOSH to begin to plan for new workers with likely specialized needs for information on the consequences of exposure to some exotic chemical products, as well as exposure to solvents of varying degrees of novelty.  
 
So what’s needed now to provide workers with adequate information on the chemicals with which they’re working?  In an ideal situation, we would start from scratch, providing for fully informative labels and support from OSHA (and NIOSH) for publications and data- sharing sessions during which chemical hazards in particular workplaces could be discussed with federal agency personnel.  OSHA would also be providing funding for labor unions and industry groups (or associations) working together in labor-management consortia or separately.  If we’re going to be stuck with MSDSs and HazCom, some careful and, at the same time, aggressive work by OSHA will be needed to get meaningful data out to workers.   NIOSH has a role to play, too, in educating healthcare providers about problems associated with workplace chemical exposures.  Ties will have to be established with EPA, since that agency’s decisions on chemical carcinogenicity can affect OSHA and since EPA does not have a good record providing public information on hazardous chemicals, either in or out of the workplace.

Finally, there’s an important role to be played by unions.  Union health and safety experts have played major roles in advocating for control of toxic chemicals and have worked hard to counsel workers about prevention of exposures to hazardous chemicals.  Unions will have to make sure OSHA and NIOSH, in the hands of leadership sympathetic to workers for the first time in many years, provide resources adequate to ensure that all workers obtain the information they need to protect themselves against hazardous chemicals.

Myra L. Karstadt, Ph.D is a consultant in toxicology, and is located in Chevy Chase, MD.

reported by Mine Safety and Health News: Martin County: New Information  Released, But Information on Mine Seals Still  Redacted

A Labor Dept.’s Inspector General report on  the whistle-blower complaints surrounding the 2000 Martin County Coal Co.  impoundment failure in Kentucky, verifies a change in MSHA’s  investigation  after the administration of George W. Bush came into power.  In addition, the IG report shows that it  never questioned the lead investigator into the impoundment failure – Tony  Oppegard – who headed the
investigation team until the day G.W. Bush was  inaugurated. 
 
The IG investigation was launched after Mine  Academy head Jack Spadaro claimed that Bush Administration officials were  interfering in the investigation into one of the largest environmental disasters  in the eastern U.S.    Spadaro was “second in command” on the MSHA  investigation team looking into the causes of the failure, and was head of the  team when Oppegard was absent.

The IG report shows that after the top  echelon of MSHA changed with administrations, the tone and scope of the  investigation also changed. 

One of Spadaro’s complaints was that MSHA District  Manager Tim Thompson ended the evidence-gathering phase of the  investigation early.  Thompson told the IG he believed he was wrapping  up when he took over from Oppegard.  However, Oppegard told Mine  Safety and Health News that when Thompson took over

“We had  only interviewed about 1/2 of the witnesses that Ronnie Brock and I had targeted  for interview.”

The MSHA accident investigators described to  the IG intense and often heated discussions regarding various facets of the  investigation.  The conflicts included the inclusion of information related to the Martin County Coal Company (MCCC) impoundment approval process, proposed violations against MCCC, the  seal construction in the abandoned mine below the impoundment, access to  investigative records, the inclusion of MSHA District Manager Tim Thompson’s  “postscripts,” he wanted added to the report,  the accuracy of impoundment  maps, the Triad Engineering report, MSHA management influence, and the relevance  and availability of several memorandums.
 
 The document also shows that an MSHA engineer  Larry Wilson believed there were major problems with the Martin County impoundment after a small failure in 1994, and made nine recommendations, some  of which were over-ridden or not considered by a new MSHA District Manager Carl  Boone, who was not
familiar with the 1994 failure.  Wilson stated he felt the  impoundment should not have been used anymore and made the nine recommendations  “to make it difficult or unfeasible to continue its use.”
 
Mine Safety and Health  News has been trying to get a completely unredacted version of the  IG report since 2003.  A new request for the report was made on February 3,  2009.  MSHN raised concerns with the Labor Dept. after the newsletter was told on Oct. 9, 2009 that Tom Mascolino [who retired from DOL/SOL/ MSH in 2006] who is now a FOIA contractor for MSHA, was reviewing the IG report before it was  released to Mine Safety and Health News.  A formal  letter of protest was sent to the Labor Dept., since Mascolino was part of  the citation process against MCCC, and was involved in some of the controversies  brought up by Spadaro. 
 
There are still major redactions in the report,  including the entire section on the mine seals, and Mine Safety and  Health News is considering an appeal to U.S. District Court.  A complete story will be in the next issue of  Mine Safety and Health News.

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.

It’s time for me to boast about the most amazing assembly of worker H&S researchers and activists: the OHS Section of the American Public Health Association.   We closed out our 95th year with the association adopting three progressive policy resolutions and electing Linda Rae Murray, MD, MPH as the next APHA president. 

First, CONGRATULATIONS! to the OHS Section’s own Linda Rae Murray who is a 30-year member of APHA—-the largest and most diverse public health organization in the world.  Dr. Murray is the chief medical officer for the Cook County (IL) Dept of Public Health, a general internist who practices at a south side Chicago community health center, and on the faculty at the Univ of Illinois Chicago in the Dept of Occupational and Environmental Health.

Linda Rae’s platform resonates with many of us in the OHS community: 

“If  we are going to make progress toward a healthy nation we have to overcome those issues which divide us: issues of racism, immigrant rights, gender discrimination and workers’ rights.  It is only through unity that we will have the strength to make the changes our country needs.”

Linda Rae’s guiding principles include:

• The United States must join the rest of the industrialized world in guaranteeing the right to medical care to everyone, including those in the country without proper documents.  [APHA supports a single payer insurance plan.]
• We must continue the struggle for full and equal rights for everyone, especially people of color and workers.
• Health is a fundamental human right and a state of social well being.
• Health requires peace.
• Health requires a planet that is whole and sustainable.
• Health requires equity and social justice.

Second, APHA’s membership considered 15 new policy proposals, three of which were developed by the OHS Section.   Our perseverance and in-depth knowledge of the issues paid off.  APHA’s Governing Council adopted all three new policies involving worker health and safety.  The association now has progressive policies on the books calling for

1. the elimination of asbestos and improvements in asbestos-disease prevention;
2. a major overhaul of the workers’ compensation system; and
3. attention on border crossing deaths along U.S.-Mexico lands.

The newly adopted APHA policy on asbestos calls on Congress to pass legislation banning the manufacture, sale, export and import of asbestos-containing products.  That means product to which asbestos is intentionally added and products in which asbestos is a contaminant, such as quarried stone, talc and vermiculite.  Among other things, the resolution urges the US Surgeon General to warn and educate people periodically about the public health issues related to asbestos exposure, and for NIOSH and OSHA to issue an annual statement to alert workers in high-hazard occupations (e.g., vehicle mechanics, construction, shipbuilding) of the adverse health risks associated with exposure to asbestos, and include information on potential early warning symptoms.

The newly adopted APHA resolution on workers compensation, describes the disparities in coverage and care for workers who suffer work-related injuries and illnesses.  It provides a mini-history of efforts to reform the system, none of which have resulted in fundamental improvements, and offers insight into more just and equitable workers’ care and compensation programs in other nations.  The resolutions offers eleven specific recommendations, including:

• the current fragmented workers’ compensation system should be replaced by a national program with uniform coverage of health care and adequate loss-of-earnings benefits for all occupational injuries and illnesses;
• the system should be a more comprehensive system based on disabilty, not impairment, such as exists in The Netherlands, where all employees are covered by a compulsory government administered plan that insures against loss of earnings from long-term disability resulting from any occupational injury or disease;
• the system should include a national standard of coverage for all workers, including part-time workers, contractors, immigrant workers, and employees of small companies;
• the system should be integrated in a seamless manner with the Social Security disability program (SSDI);
• health care for injured workers should be provided by a national health care system independent of industry involvement and insurance industry control;
• the system must have mandatory root cause investigation requirements for all occupational injuries and illnesses; and
• the system must have money set aside for training of occupational health and safety professionals, preventative initiatives based on root injury and illness analysis, worker health and safety training, and mandatory reporting by health professionals.

The new APHA policy on the public health crisis of border crossing deaths along the US-Mexico border provides evidence demonstrating how the militarization of the US-Mexico border has created a public health crisis.  The policy includes numerous recommendations for government, health care providers and educators, such as urging:

• the Immigration and Customs Enforcement (ICE) and the Border Patrol to comply with international standards of health and human rights by adopting policies and strategies that do not endanger the lives and health of migrants;
• the Border Patrol to comply with the recommendations of the GAO to improve its methods for collecting data in order to accurately record border crossing deaths; and
• healthcare organizations to provide needed acute health care services to undocumented border crossers to take appropriate steps to assure adequate continuity of care to those currently within the detention center system.

The election of Dr. Linda Rae Murray, and the successful adoption of these three policy resolutions demonstrates the vibrancy and relevance of the APHA OHS Section in the movement to advance workers’ rights and health & safety.   

!!Special offer to federal or State OSHA or MSHA employees!!   The first 5 federal or State OSHA or MSHA employees to join APHA (only $16.25 per month) after reading this post can receive a fabulous tote bag (made in the USA) featuring an Earl Dotter photograph from his Farmworkers Feed Us All exhibit.   Just join APHA now, select OHS as your primary Section, and send me an email (celeste.monforton@gwumc.edu) with your mailing address, and I’ll send you a tote bag.    

Will it be you from OR-OSHA, or you from Kansas City-OSHA, or you from MSHA HQ??   Who from OSHA, State OSHAs, or MSHA will be the newest members of our 700-strong APHA OHS family?

Celeste Monforton, DrPH, MPH is with the George Washington University School of Public Health.  She has been a member of APHA since 1997, and served this year as Chair of the APHA OHS Section. 

Cong. George Miller (D-CA) and Lynn Woolsey (D-CA) of the House Education and Labor Committee sent a letter to the chair of the U.S. Chemical Safety and Hazard Investigation Board (CSB) urging him to take immediate action to make public all of their votes.    It turns out that about 99% of the CSB’s votes are conducted through a “paper notation process, in which documents are circulated for individual voting without public discussion between Board members.”  Thus, these paper deliberations are not subject to the Sunshine Act.   Miller and Woolsey’s letter notes that the CSB has taken:

“approximately 720 notation votes since its inception, but with few exceptions, neither Congress nor the public knows the outcome because notation votes are not publicly disclosed or posted on the CSB website.”

Moreover, in a 2002 Inspector General report, the CSB was asked to post its notation votes on a public website.  Cong. Miller and Woolsey wrote, “we are troubled that this recommendation was not implemented.”  Besides chastizing the CSB’s Chairman and Board members, Miller and Woolsey offer worthwhile examples of federal agencies with much more transparent voting records:  the Nuclear Regulatory Commission (NRC) and the National Transportation Safety Board (NTSB).  They also give Mr. Bresland some specific marching orders and timelines for making public previous and future notation votes.

Earlier this week, Army Vice Chief of Staff Gen. Peter W. Chiarelli reported a record number of suicides in the Army: 140 active-duty soldiers and 71 not on active duty are suspected of taking their own lives. Last year’s suicide total set a record, and this year’s total is on track to surpass it. The Washington Post’s Ann Scott Tyson got Gen. Chiarelli’s perspective on the effectiveness of current suicide-prevention efforts, which include improved screening and training, and the barriers that remain:

In January and February, there were about 40 suicides, or about one-third of the active-duty total this year, and since March the general trend has been down, with the exception of a couple of months, he said. He attributed that progress primarily to a campaign to increase the involvement of Army leaders at all ranks in suicide prevention efforts. …

Substance abuse, which can be related to mental health problems and suicide, is on the rise in the Army, Chiarelli said, and he added that the force is short about 300 substance abuse counselors.

The Army is also short an estimated 800 behavioral health specialists, he said, describing prewar authorization levels for such specialists as outdated. “I have been pounding the system to . . . determine what we need after eight years of war,” Chiarelli said.

In other news:

New York Times: After a long campaign by student activists, Russell Athletics has agreed to reopen a Honduran factory it closed after workers there unionized, and rehire the workers who lost their jobs to the shutdown.

CIDRAP: At a House Education and Labor Committee hearing, witnesses from CDC,  APHA, and the National Partnership for Women and Families spoke in favor of requiring employers to provide paid sick days, which could help prevent the spread of diseases like swine flu.

Hazards Magazine: Some green jobs, like those in recycling and the manufacturing of solar panels, can be hazardous to workers.

MedPage Today: A study presented at the American College of Chest Physicians meeting found the prevalence of asthma among Ground Zero responders (including law-enforcement officials and cleanup workers) to be nearly double that of the general population.

European Agency for Safety and Health at Work: EU-OSHA collaborated with the International Leipzig Festival for Documentary and Animated Film to offer a “Healthy Workplace Film Award” to the best festival entry on a work-related topic. Dutch director Tony Van Zantvoort won the award for “A Blooming Business,” which shows working conditions in the global flower industry.

The Senate Health, Education, Labor, and Pensions Committee voted out the nomination of David Michaels, PhD, MPH for the position of Assistant Secretary of Labor for Occupational Safety and Health. The voice vote crossed party lines, with Republican Senators Isakson, Enzi, Alexander, Gregg, Murkowski, as well as all the Democratic Senators, voting in favor of sending the nomination on to the full Senate.  Senators Richard Burr (R-North Carolina) and Tom Coburn (R-Oklahoma) recorded their votes as no.

Congratulations, Professor David Michaels!   Read the media release issued by the American Public Health Association, urging swift Senate confirmation of Dr. Michaels.   Georges C. Benjamin, MD, FACP, FACEP (E), the executive director of APHA, notes:

“Dr. Michaels is eminently qualified to lead OSHA.  He has proven his skill at protecting workers in a regulatory setting and has earned the respect of the scientific community for his commitment to science as the backbone of sound public health and environmental regulation.”

by Richard Denison, PhD, cross-posted from EDF’s ChemNano Blog

Over the last few months, I was heartened to hear a number of industry stakeholders in the debate over TSCA reform embrace the idea of designating in TSCA reform legislation a “jump-start” or “quick-start” list of chemicals of high concern or priority.  The idea was to allow EPA to hit the ground running, by having an agreed-to list of chemicals on which it could immediately initiate action.  Well it now appears many in industry actually have something far slower and far more cumbersome in mind.

The Subcommittee on Commerce, Trade and Consumer Protection of the U.S House of Representatives’ Energy and Commerce Committee held a hearing yesterday on the question of “prioritization”:  How a new law could best spur prompt identification of and action on the chemicals of highest concern.  Mr. Bill Greggs testified on behalf of three trade associations prominent in the debate over TSCA reform:  The Consumer Specialty Products Association, the Soap and Detergent Association, and the Grocery Manufacturers of America.

In Mr. Greggs’ testimony and answers to questions from subcommittee members, what industry has in mind when it talks about a quick start became much clearer:

• There would be no list of chemicals in the bill.  Nor would there even be a process laid out by which EPA would identify chemicals of highest concern for the purpose of promptly taking action to reduce exposure to them.
• Instead, the bill would merely contain some potential hazard and exposure triggers for EPA to consider.
• The legislation would then impose a risk-finding requirement on EPA (sound familiar?), by restricting any further effort to only those chemicals that are found – on the basis of existing information, however incomplete – to pose BOTH the highest hazard and the highest exposure.
• Once the legislation passed, EPA would first have to develop specific high-hazard and high-exposure criteria, and then apply the criteria through a review of all chemicals it knows to be in commerce and for which such hazard and exposure data exist.
• Then EPA would have to provide industry with a robust process by which industry could – and surely would – challenge each and every designation of such a chemical by EPA.
• Assuming any chemical made it through that process, such highest-of the-high-priority chemicals would then merely enter a further limbo:  a review and risk assessment process as a prelude to a “safe use” determination by EPA.

Hardly the quick start I had hoped for.

If the last decade of voluntary programs and ChAMP has taught us anything, it’s that it’s time to move beyond the endless cycle of having one round of assessment to identify chemicals of highest concern lead to nothing more than a further round of assessment.

The re-energized new leadership at EPA recently took upon itself to identify an initial handful of bad-actor chemicals, for which it is developing action plans to reduce the harm those chemicals are causing.  EPA didn’t ask for industry’s blessing before listing those chemicals.  Can you imagine what would have transpired had it done so?

Nor should EPA have to provide an opportunity for industry to challenge such listing decisions:  Under Greggs’ scheme, any listing of chemicals is pre-regulatory –  indeed, it’s arguably pre-pre-regulatory or even pre-pre-pre-regulatory.  The notion that EPA’s mere identification of a chemical through such a process should be eligible for challenge by the very companies that make or use the chemical is preposterous – not to mention a recipe for endless delay and fights.

And hey:  Wasn’t avoiding all that the motivation behind having a quick-start list in the first place?

Lest you think I’m reading too much into a 5-minute statement at a hearing, I’ll point you to a detailed proposal these same three trade associations (joined by a dozen others) gave to California earlier this year, as a “model” for regulations under the state’s Green Chemistry Initiative.  By my count, that proposal would provide no fewer than six – 6 – opportunities for industry input into and challenge of the state agency’s process for designating and prioritizing a chemical of concern.

Talk about greedy:  In addition to requiring formal notice and comment on any proposed listing of chemicals, that proposal would require another round of notice and comment on the “final” list.  And it would repeat that dual-intervention process at each of several steps in a process that would precede any regulatory action to restrict the use of the chemical.

That makes the federal rulemaking process under the Administrative Procedures Act look like a cakewalk in comparison, even after factoring in the interventions by the Office of Management and Budget called for under Executive Orders and such.

A prominent refrain in the industry’s new TSCA hymn book has been to say that EPA needs more authority.  I, for one, would like to hear that tune sung more than just in Sunday choir and have it enter the actual work week.

Richard Denison, PhD is a senior scientist with Environmental Defense Fund, and an expert in molecular biophysics and biochemistry.   He uses his training, experience and talent to improves public health policy on the development, production and use of industrial chemicals and nanomaterials.