The California Distance Learning Health Network has released "Pandemic Influenza and Public Health Law: What Public Health Departments Need to Know." This DVD self-study course facilitates partnering between local health departments and other key agencies (law enforcement, county counsels, etc.) within their jurisdictions to explore "what if" scenarios and clarify their respective roles.
The University of Nebraska Medical Center seeks to hire a Director of the Mid America Alliance Mutual Aid Program, which assists participating states with joint preparations for exceptional public health events. Five years of public health experience as well as a Master's degree in public health or a related field are required. Interested applicants should apply online by April 20.
Last week, the American Journal of Public Health released a series of articles concerning emergency preparedness, public health, and the law. Included in the series are such titles as "Conceptualizing and Defining Public Health Emergency Preparedness;" "The Law and Emergencies: Surveillance for Public Health-Related Legal Issues During Hurricanes Katrina and Rita;" "The Courts, Public Health, and Legal Preparedness;" "Encouraging Compliance With Quarantine: A Proposal to Provide Job Security and Income Replacement;" and "Variation in Quarantine Powers Among the 10 Most Populous U.S. States in 2004." To locate articles in this series, visit http://www.ajph.org/first_look.shtml. These articles are soon to be released in a special Supplement to the Journal.
The Special Program for Research and Training in Tropical Diseases has released, Operational Guidelines for Ethics Committees that Review Biomedical Research. These guidelines were developed for use by national and local ethics committees.
Congratulations to March Quiz Winner Lia Anderson!
The CDC Public Health Training Network and the Strategic National Stockpile will present "Hospitals, Treatment Centers, and Public Health: Partners in Emergency Planning and Response," 1:00-2:30 p.m. ET, April 26, 2007. This satellite broadcast and Webcast aims to assist state and local SNS planners and treatment center/hospital administrators in coordinating for a successful response to a public health emergency where SNS assets are deployed.
Bisphenol A, a chief ingredient in plastic products, could become the next chemical to embroil industry and public health in debate over the impact of scientific findings. The chemical, derived from petroleum, is found in products including baby bottles, tin cans, and dental sealants, and has been found to leach into bottle and can contents. Research conducted in the United States has suggested that about 95 percent of the population has been exposed to the chemical, and Canadian researchers are currently conducting a survey in that country. Last year, Environment Canada and Health Canada selected bisphenol A as one of 200 substances deemed possibly dangerous and in need of thorough safety assessments. Of about 150 studies conducted by independent researchers (not affiliated with the plastics industry), around 90 percent have found bisphenol A to cause adverse effects in research animals, ranging from enlarged prostates to abnormal breast tissue growth. A small number of studies have linked bisphenol A exposure to human health outcomes such as miscarriages and ovarian dysfunction. Independent researchers say they are shocked by the ability of the chemical to produce such results, and have rushed to remove any trace of it from their personal lives. "I would love to see it banished off the face of the Earth," said Dr. Patricia Hunt, a Washington State University geneticist. But none of the major industry studies assessing bisphenol A's safety found any adverse reaction, and industry representatives say the chemical is harmless. Currently, Canada has no regulations limiting bisphenol A leakage. A class-action lawsuit against five baby bottle manufacturers was filed last month in Los Angeles.
The authors of this analysis reviewed the current status of the law regarding agreements to share supplies, equipment, personnel, and information across political boundaries in a public health emergency. "Mutual aid" agreements like the Emergency Management Assistance Compact (EMAC) are essential to facilitate an effective response to disasters, by "establishing the rules, processes, and procedures to be followed in sharing information, resources, or personnel." In this article, the authors describe the basic legal framework for mutual aid agreements, identify gaps in that framework, and make recommendations for addressing those gaps. Mutual aid comprises at least five categories "over a gradient of potential liability, including the sharing of planning information, epidemiological and laboratory data or information, equipment and supplies, unlicensed personnel, and licensed personnel." The authors describe international cooperative agreements, such as those between the United States and Canada, and the United States and Mexico. According to the authors, states may, in some circumstances, lack the authority to share confidential health information across international borders. With regard to both international and interstate cooperation, the U.S. Constitution has provided an added complication in the compact clause, which may affect the ability of states to enter into binding agreements without the consent of Congress. However, interstate cooperation has had the support of Congress. For example, Congress has directed the Secretary of Health and Human Services to develop an Emergency System for Advance Registration of Volunteer Health Professionals. Finally, the authors suggest that states share and use lessons learned while developing new agreements, further analyze the compact clause, and cultivate relationships with attorneys from Canada and Mexico.
Last week, the U.S. Supreme Court ruled against Duke Energy Corp. and other utilities in a suit brought by Environmental Defense and other plaintiffs. In a unanimous decision, the justices ruled that Duke Energy violated the federal Clean Air Act by not obtaining permits before modifying eight coal-fired plants in North and South Carolina. According to the Justice Department, which first brought the suit in 2000, Duke Energy's modifications had extended the lives of the older plants and also emitted more air pollution. The company argued that the changes were not "major modifications," under the terms of the Clean Air Act, and thus did not require permits. The Court rejected Duke Energy's arguments. "This is a huge win for clean air. The court ruled unanimously that companies have to use the latest cost effective technology to reduce pollution when they upgrade their plants. This is not a legal abstraction -- it means we'll have cleaner air and less childhood asthma," said Fred Krupp, president of Environmental Defense. The federal government and major utility companies have debated this issue for years. A case in the U.S. District Court for the Southern District of Ohio involving American Electric Power was delayed pending the resolution of the Duke Energy case. In 2001, the Justice Department accused ten utilities of trying to modernize 51 coal-fired plants without installing pollution controls; several Northeastern states were parties to that lawsuit.
[Editor's note: To read the opinion in Environmental Defense et al. v. Duke Energy Corp. et al., visit http://www.supremecourtus.gov/opinions/06pdf/05-848.pdf.]
A survey released last week by the American Public Health Association has revealed that many people are not prepared for a public health crisis in the United States. "The National Opinion Survey to Determine Levels of Preparedness for a Public Health Crisis," involved 1,000 respondents. The survey found that while the term "public health crisis" did not mean much to the people interviewed, over half of respondents felt that an event such as a severe storm could lead to a public health crisis. The survey revealed a lack of preparedness among many sectors. For example, 32 percent of people surveyed had not taken any special steps to prepare for an emergency. And while 27 percent claimed to be prepared for a crisis, only 14 percent actually had a three-day supply of food, water, and medication on hand. Vulnerable groups were found to be minimally prepared. According to the survey, 61 percent of people with chronic conditions had at least a two-week supply of medications, and 58 percent said they had first-aid supplies to last at least three days. Only 18 percent of employers said they could pay their employees if work was interrupted by a crisis, and few employers and employees reported being prepared for a crisis at work. Schools appeared to be the most well-prepared, with a majority having emergency response and evacuation plans in place, although few reported having enough fresh drinking water and food. All sectors reported cost as a major barrier to preparedness.
[Editor's note: To read the full report of the "National Opinion Survey to Determine Levels of Preparedness for a Public Health Crisis," visit, http://www.nphw.org/2007/pg_tools_poll.htm. For guidance from the U.S. Department of Health and Human Services on pandemic influenza planning for individuals, workplaces, and schools, visit http://www.pandemicflu.gov/plan/individual/index.html, http://www.pandemicflu.gov/plan/workplaceplanning/index.html, or http://www.pandemicflu.gov/plan/school/index.html.]
Some public housing complexes across the United States are prohibiting tenants from smoking in apartments. Housing officials say they have taken measures to protect non-smokers from secondhand smoke, to prevent fires, and to reduce the cost of readying a smoker's apartment for a new tenant. All of the bans prohibit smokers from smoking inside an apartment; some allow them to smoke until they move out, while others set a deadline. "If you live in public housing, your life is regulated," said Vincent Curry of the National Fair Housing Alliance. Cheri De Mello, who has lived in a public housing complex in Montana for about nine years, said she thinks the prohibition discriminates against her. "I don't think it's fair to tell people what they can and cannot do in their own home as long as it's not illegal," she said. Smoker's rights groups and fair-housing advocates say the smoking bans are difficult for the disadvantaged. "You're talking about low-income housing, where tenants don't have a choice of other places to go," said Catherine Bishop of the National Housing Law Project.
A model law designed to simplify the organ donation process is working its way through legislatures across the United States. It has been enacted in Virginia, Idaho, Utah, and South Dakota; is awaiting governors' signatures in Arkansas, Indiana, Iowa, and New Mexico; and is being considered in at least 17 other states, the District of Columbia, and the U.S. Virgin Islands. The Revised Uniform Anatomical Gift Act was issued by the National Conference of Commissioners on Uniform State Laws (NCCUSL) to reflect medical advances and to clarify ambiguities in a 1968 law adopted in every state. The revised law is intended to encourage more organ donations by expanding the list of people who can consent to an unconscious patient becoming a donor, and clarifies that a person's decision to donate an organ is irrevocable. The law also seeks to clarify the confusion created when an unconscious patient has signed both an organ donor card and also a "living will" stating they do not want to have their life prolonged by a ventilator or other medical care -- measures at times necessary to maintain organ viability until a transplant can occur. Under the law, the donor card takes precedence over the living will. When some bioethicists and doctors objected to that provision, the NCCUSL drafted substitute language to allow family members or others to be consulted in such situations. Critics worry that the new law might make doctors hesitant about administering morphine and other drugs to dying patients, for fear of damaging the organs wanted for transplantation. According to transplant advocates, more than 95,000 Americans are currently waiting for organs.
[Editor's note: To read the NCCUSL's Revised Uniform Anatomical Gift Act, visit http://www.law.upenn.edu/bll/ulc/uaga/2006final.htm.]
The British government's Prison Service has issued a guidance document instructing prisons on how to handle inmates who smoke, as England's smoking ban comes into force July 1. Smoking will be banned in the vehicles that take inmates to court hearings and in the holding cells under the courts. Staff will be instructed to tell prisoners attending hearings that they will be unable to smoke until they return to their prison cell later in the day, and prisoners will be offered nicotine patches to help them with withdrawal symptoms. Of particular concern, "the withdrawal experienced may be quite severe, resulting in increased anxiety, stress and possible hostile or destructive behaviours," reads the instruction from Prison Service headquarters, which establishes that prisoners will be offered full-strength 16-hour nicotine patches to help them. Adult prisoners will still be allowed to smoke in their cells, which are considered to be the equivalent of an inmate's home under the law. (Prisoners under 18 years of age will not be permitted to smoke at all.) The instruction document also offers guidance on how second-hand smoke should be addressed. Officers will not be required to enter a cell if the prisoner had been observed smoking. The officer will be allowed to instruct the prisoner to extinguish the cigarette, open the window, and leave the cell. The instructions clearly indicate that the concerns over second-hand smoke must not take precedence over the duty for prison staff to intervene to protect prisoners or staff in immediate danger of harm.
[Editor's note: To read the text of "Smoke Free Legislation: Prison Service Application," the Prison Service instruction, visit http://psi.hmprisonservice.gov.uk/PSI_2007_09_smoke_free_legislation.doc.]
Arkansas: Transportation safety requirements apply to farm equipment
Hawaii: "No tsunami" alerts will be issued after quakes, when no tsunami threat
Louisiana: Court says evacuees' right to travel not violated by intrastate road block
Louisiana: 2007 National Hurricane Conference addresses pre-storm evacuations
Maryland: Expedited partner therapy pilot approved by General Assembly
New Jersey: Ruling on reliability of Alcotest will affect over ten thousand cases
New York: Mayor Bloomberg pioneers city food policy
New York: City health department launches Website to ease compliance with ban
Ohio: State Attorney General sues former lead paint manufacturers
Pennsylvania: Health professionals and others wanted as emergency volunteers
South Carolina: Incentives for prisoners to donate organs removed from bill
Texas: Bill will require healthcare facilities to submit infection data
Washington: Governor to sign bill strengthening construction crane safety
National: Electronic stability control to become mandatory for all new cars
Canada: Supreme Court rules that British Columbia can sue foreign tobacco companies
China: State Council regulations ban sale of human organs for profit
Eritrea: Widespread practice performed primarily on girls under one year of age, banned
India: Enforcement of High Court order begins
United Kingdom: Ban on junk food television advertisements enters into force
International: Global pandemic influenza vaccine stockpile a possibility
"I prefer not to think of myself as the food czar."
-- Benjamin Thomases, New York City's first official charged with coordinating policies on food. Thomases was recently appointed to the position by Mayor Michael Bloomberg, who is credited with taking innovative steps to make the city's dietary habits healthier.
This week we bring you the Emergency Management Assistance Compact, (EMAC), a Congressionally-ratified agreement that facilitates mutual aid between states. EMAC is a major legal tool for sharing resources across state boundaries, and has been enacted in all 50 states, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands. The compact provides a framework for assistance between participating states in managing an emergency or disaster. EMAC addresses three major concerns for emergency managers, public health officials, and healthcare providers: liability, reimbursement, and response. The state requesting assistance under EMAC is responsible in tort for the actions of workers from other states. The state that sends assistance is guaranteed payment for its efforts. And finally, EMAC facilitates a quick response to an emergency through the provision of personnel, equipment, and materials at a government's disposal.
To read the text of the model EMAC, which has been enacted in its entirety in across the United States, visit http://www2a.cdc.gov/phlp/docs/http___www.emacweb.pdf.
Lia Anderson was the winner of the CDC Public Health Law News March Quiz! Lia is the Assistant Director of Nursing for Kendall County (Illinois) Health Department. Besides the day-to-day functions of a local county-level health department, her work includes program design and development to address the problem of overweight/obese children and adults. Lia has been a News subscriber since February 2004. She particularly enjoys the "Law Behind the News." She is also enrolled as a MSN student through the University of South Alabama and has found the News useful in her coursework. Congratulations to Lia on her upcoming graduation, and for winning the March Quiz!
Congratulations to Lia, and thanks to everyone who played. The March Quiz covered the following issues: March 7, 14, 21, and 28 (for past issues, visit http://www2a.cdc.gov/phlp/dailynews/default.asp.) Here are the correct answers:
1. In 1999, Rhode Island became the first U.S. state to sue lead paint manufacturers. (Answer D)
2. Paraguay recently declared a national emergency in response to an epidemic of dengue fever. (Answer B)
3. An expert panel recently warned that a lack of preparedness in Florida and other states could result in unnecessary fatalities among the elderly during this year's hurricane season. The elderly accounted for 70 percent of the fatalities associated with Hurricane Katrina, despite comprising a far smaller percentage of the total population affected by the storm. (Answer B)
4. The Pennsylvania Public Health Law Bench Book was released by the Pennsylvania Supreme Court, to provide guidance to judges on the law pertaining to public health interventions, such as quarantine orders. (Answer C)
5. The High Court of New Delhi, India banned smoking while driving in order to reduce the likelihood of motor vehicle accidents. (Answer C)