Frederic Shaw, MD, JD, founder and first editor of the CDC Public Health Law News, left the CDC Public Health Law Program this week to become Editor of the CDC Morbidity and Mortality Weekly Report (MMWR). Originally created in 2003 and distributed to a handful of CDC employees, the News now circulates to thousands of people in over 30 countries who work in state and local health departments, legislatures, public health and law schools, federal agencies, corporations, medical facilities, nonprofit organizations, private law firms, and the news media. The Public Health Law Program wishes to recognize Dr. Shaw's contributions to public health law and wishes him the very best in his new position.
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The U.S. Department of Health and Human Services has released Pandemic Preparedness Planning for US Businesses with Overseas Operations, a guide for ensuring business continuity in the face of a pandemic.
Canada's independent Commission to Investigate the Introduction and Spread of Severe Acute Respiratory Syndrome (SARS) released its final report this week. Volume 5, "SARS and Public Health Legislation," gives extensive treatment to legal issues and legislative approaches to them at the provincial and federal government levels.
The State University of New York University at Albany School of Public Health will host, "Engaging the Public in Pandemic Flu Planning," January 11, 2007, at 10:00-11:15 a.m. ET, rebroadcast at 4:00-5:15 p.m. The program will be held in Albany and will also be Webcast.
The American Bar Association Section of Administrative Law and Regulatory Practice will hold the "Second Annual Homeland Security Law Institute: Homeland Security in the Government and Private Sector," January 18-19, 2007 in Washington DC.
The U.S. Senate Committee on Commerce, Science and Transportation will hold an oversight hearing on federal efforts for rail and surface transportation security on January 18, 2007, at 10:00 a.m. ET.
Some states have begun requiring schools to issue body mass index (BMI) reports to students, but critics worry that schools are not supporting them with adequate nutrition and physical education programs. For example, Pennsylvania requires BMI notification for students in kindergarten through eighth grades, yet schools in the state's rural Southern Tioga School District continue to serve funnel cakes and pizza for breakfast, while not providing some of their students with physical education for half the school year. Dr. David Ludwig, director of the Optimal Weight for Life program at Children's Hospital Boston, said, "It would be the height of irony if we successfully identified overweight kids through BMI screening and notification while continuing to feed them atrocious quality meals and snacks, with limited if any opportunities for phys ed in school." In Pennsylvania, the BMI report cards angered many parents, and were traded by some children while others decided they no longer wanted to eat. Health authorities are concerned that BMI notification could result in misinterpretation of the results, as well as eating disorders, social stigma, and a sense of helplessness. According to Marlene Schwartz, director of research and school programs at Yale's Rudd Center for Food Policy and Obesity, "Entire states are adopting a policy that has not been tested." Schwartz said "no solid research" has been conducted on the physical or psychological impact of BMI reporting. However, Ludwig said BMI is an effective and low-cost screening tool.
[Editor's note: For CDC's child and teen BMI calculator, plus obesity resources, visit http://apps.nccd.cdc.gov/dnpabmi/Calculator.aspx.]
A new California law requires that kindergartners and first-graders have a dental screening within the first year of entering the state's public school system. The law went into effect on January 1 and is widely supported by dental health advocates and researchers, even though it contains no penalty for noncompliance. Dr. Paul Reggiardo, a dentist and past president of the American Academy of Pediatric Dentistry, said, "We always hear, 'They're only baby teeth -- they'll fall out anyway.' Long before they fall out, they can cause a child a lot of problems. More kids miss school because of dental problems than any other single health cause." The nonprofit Dental Health Foundation surveyed kindergarten and third-grade students in California schools last year, and found that two-thirds had had tooth decay and that over a quarter of students had untreated cavities. The survey found especially high levels of tooth decay among low-income and minority students. Gayle Mathe of the California Dental Association, said, "We want to find out what the specific barriers are." The new law is expected to help public health advocates learn how to reach low-income children, since families who opt out of the dental screening requirement will be asked to complete a form explaining why. Dr. Santos Cortez, a pediatric dentist in Long Beach, California, noted that a three-day hospital stay to treat a severe tooth infection could cost up to $20,000, and that the new law could help to reduce the need for such costly treatment.
The California Department of Justice is working to protect medical professionals during an emergency, under a plan authorized by California's former Attorney General. The Department is creating a security and logistics force to protect disaster medical teams and medical supplies during events such as last year's Hurricane Katrina. When a Menlo Park-based medical team was sent to New Orleans where they established a makeshift clinic, they had scant security, and conditions in the area caused the team to flee. "We actually abandoned that mission," said team lead David Lipin. "We bugged out of the Superdome." To avoid such situations in the future, the Justice Department is setting up teams whose only task will be to protect medical professionals. According to Dale Ferranto, assistant director of the Department of Justice's firearms division, that task might normally fall on the Highway Patrol or local police, but emergency planners are aware that those groups might be too overwhelmed by other tasks to assist the medical teams. Currently, the teams are composed of 32 state firearms agents, but the Department is hoping the teams will be expanded in the future.
On Monday morning, residents and government officials in Manhattan and northeastern New Jersey began responding to an unusually strong, long-lasting, and noxious smell. In a real-life test of New York City's emergency plans, schools and office buildings were evacuated, a subway station was shut down, commuter trains were rerouted, and government security officials were alerted. New York City officials said that as a component of the city's terrorism precautions, regular air monitoring is conducted for the presence of chemical, biological, or radiological substances. Mayor Michael R. Bloomberg announced that the air monitoring had found no cause for alarm, and that the odor may have stemmed from a release of mercaptan, an additive used to detect natural gas leaks. New York City's Department of Environmental Protection sent out a mobile lab to test for ammonia, chloride, cyanide, methane, carbon monoxide, hydrogen sulfide, and volatile organic compounds. Christopher Haas, the department's specialist in hazardous materials, said, "That's the hardest part, finding the source. Air is very dynamic." Prevailing winds, as well as the presence of chemical and petroleum facilities in New Jersey, led some to suspect that the smell emanated from that state. Across the Hudson River from Manhattan, in Hoboken, New Jersey, several office buildings and a police headquarters were briefly evacuated due to the odor. As of Monday night, officials still had not determined the cause of the smell.
Last week, two labor unions filed a lawsuit against the U.S. Department of Labor for failing to issue final rules that would require employers to pay for personal protective equipment for workers. Occupational Safety and Health Administration (OSHA) (part of the Labor Department) regulations require employers to provide such equipment as helmets, face shields, and gloves, but according to the AFL-CIO and the United Food and Commercial Workers, some companies require employees to pay for them themselves. The lawsuit alleges that the Department failed to finalize rules based on proposals made in 1999 which would have mandated that companies pay for all equipment required by OSHA. David James, a Labor Department spokesman, defended the Department's hesitation, and said the case "deals with complicated issues that will affect different employers and employees in different ways." Peg Seminario, the AFL-CIO's director of occupational safety and health, said 20 million workers used the required equipment, and that most employers did pay for it. But according to the unions, OSHA data reveal that 400,000 workers have been injured and 50 have died because the final rule has not been issued. The unions have asked the U.S. Court of Appeals for the District of Columbia to order Labor Secretary Elaine Chao to issue final rules.
The author of this commentary discusses the use of legal interventions in the fight against overweight and obesity in the United States. Although obesity primarily impacts the individual, its association with increased risk of death from type 2 diabetes, hypertension, coronary heart disease, stroke, and certain cancers places a high economic burden on society. The author suggests that burden may justify the implementation of legal measures, but that different measures have met with different levels of acceptance, depending on how paternalistic, invasive, or burdensome they may be perceived to be. For example, rules that require disclosure of the nutritional content of foods are considered to be "consistent with prevailing cultural values of consumer autonomy." But lawsuits based on theories of tort liability have "been largely unsuccessful and politically unpopular," leading to "'commonsense consumption' or 'personal responsibility' laws that sharply limit tort liability." According to the author, another sharply criticized tactic is the use of an infectious disease surveillance model to monitor chronic diseases associated with obesity and overweight, such as diabetes. A New York City program mandates laboratory reporting of glycated hemoglobin, and has been opposed by civil libertarians and physicians. The author also reviews legal interventions regarding advertising targeted to children, the taxation of unhealthy foods, school policies, the built environment, and prohibitions of specific foods. The author concludes that the justification for increased legal measures "lies with the epidemic rates of overweight and obesity, the preventable morbidity and mortality, and the stark health disparities based on race and socioeconomic status."
In response to a doubling of traffic fatalities in Cambodia over the last five years, the national Parliament has passed stiff new traffic laws. Traffic deaths are Cambodia's second largest killer. Before the new set of laws was introduced, money was the only requirement to drive a new car off the lot. Not even a driver's license was necessary. The new laws make drivers' licenses mandatory, require helmets for motorcycle riders, mandate seat belts for motor vehicle drivers, and outlaw speeding and drunk driving. Heng Samrin, president of Cambodia's Parliament, said, "This law is needed now." According to Jean Van Wetter, former operations coordinator for Handicap International Belgium, a group that monitors traffic injuries, "With the economy improving, many more people have the money to buy a motor scooter or car, and they want to drive ... But (drivers) don't know the rules, and when they know the rules, they don't respect them." Van Wetter also said, "The traffic system reflects the mindset of the people -- everybody wants to be a part of this growth, but at the same time people like to be free to do what they want." Inconsistent policing is seen by some to be an obstacle to traffic law enforcement. But according to some police, drivers have little regard for their authority. "Some drivers drive so nasty. It is hard for us, we don't know when they will respect the law," said traffic police chief Tin Prasoer.
Provincial smoking bans are being avoided by Native Canadian tribes who say they are simply protecting their existing rights. Native tribes in Manitoba and Saskatchewan, two of the first Canadian provinces to enact sweeping anti-smoking laws, have adopted by-laws allowing smoking in casinos, bingo halls, and restaurants. The federal government says it will not act to stop native tribes, since under the federal Indian Act, native tribes can issue by-laws that override provincial laws. Last year in Manitoba, the Court of Queen's Bench ruled that an exemption in the provincial law allowing smoking on native reserves violated the rights of non-natives, and ordered the province to apply the smoking ban equally. That decision is being appealed by the province and some native groups. The new tribal by-laws have caused non-native bar owners to complain the move has cost them customers and money. "Thriving rural bars that ... were full on a Friday and Saturday night, now you go and there's a half-dozen people," said Gary Desrosiers, a Manitoba bar owner.
Louisiana: New Orleans residents resettle without heeding federal guidelines
Louisiana: Public places, restaurants, and cars targeted as part of smoking ban
Ohio: New state law threatens lawsuits
Rhode Island: Schools reopen after joint investigation by state and CDC
Washington: Yard waste and land-clearing debris can no longer be burned outdoors
Pelosi kicks butts near House floor: No smoking
National: Homeland Security Department finds need to improve preparedness
Argentina: Buenos Aires tobacco advertising ban
Canada: Blood donors to be questioned about contact with monkeys
Ireland: Web-based reporting of notifiable diseases improves public health surveillance
Kenya: Government bans transport and slaughter of livestock in outbreak area
Lithuania: Public smoking ban kicks in
Pakistan: Punjab provincial government ends ban but institutes safety regulations
Taiwan: Government restrictions seek to protect public health and the environment
Uganda: Authorities approve use of controversial chemical
United Kingdom: Mandatory registration required of premises with 50 or more birds
Vietnam: Health Minister acts to prevent spread of avian influenza
"If you look at gang members, one of the most noticeable things you see are the state of their teeth. It's really hard to participate fully in society if your teeth are rotted out."
-- Wynne Grossman, Dental Health Foundation executive director, on the importance of good dental health for children. According to advocates, poor habits in childhood often carry over into adulthood. Toothaches that once hurt school attendance can later cost jobs, and lost teeth can hinder speaking and eating.
The Avian Influenza (Preventive Measures)(England) Regulations 2006, and corresponding laws in Scotland and Wales, established the Great Britain Poultry Register. According to the law, "a person who ... is the keeper of 50 or more poultry at any one premises must notify the Secretary of State in writing." Information given to the Secretary must include such details as the species of birds, their intended use (e.g. meat or eggs), the number of birds with access to open air, and the proximity of the birds to "any body of water which attracts wild birds."
Over 258 million birds have been registered in the last year.
To read the text of the law, visit http://www2a.cdc.gov/phlp/docs/2006_No.pdf. For more information about the Great Britain Poultry Register, visit http://www.defra.gov.uk/animalh/diseases/vetsurveillance/poultry/index.htm.