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CRS — Sanitary and Phytosanitary (SPS) and Related Non-Tariff Barriers to Agricultural Trade

April 17, 2014 Comments off

Sanitary and Phytosanitary (SPS) and Related Non-Tariff Barriers to Agricultural Trade (PDF)
Source: Congressional Research Service (via National Agricultural Law Center)

Sanitary and phytosanitary (SPS) measures are the laws, rules, standards, and procedures that governments employ to protect humans, animals, and plants from diseases, pests, toxins, and other contaminants. Examples include meat and poultry processing standards to reduce pathogens, residue limits for pesticides in foods, and regulation of agricultural biotechnology. Technical barriers to trade (TBT) cover technical regulations, product standards, environmental regulations, and voluntary procedures relating to human health and animal welfare. Examples include trademarks and patents, labeling and packaging requirements, certification and inspection procedures, product specifications, and marketing of biotechnology. SPS and TBT measures both comprise a group of widely divergent standards and standards-based measures that countries use to regulate markets, protect their consumers, and preserve natural resources.

According to the World Trade Organization (WTO), SPS and TBT measures have become more prominent concerns for agricultural exporters and policy makers, as tariff-related barriers to trade have been reduced by various multilateral, regional, and bilateral negotiations and trade agreements. The concerns include whether SPS and TBT measures might be used to unfairly discriminate against imported products or create unnecessary obstacles to trade in agricultural, food, and other traded goods. Notable U.S. trade disputes involving SPS and TBT measures have included a European Union (EU) ban on U.S. meats treated with growth-promoting hormones and also certain pathogen reduction treatments, and an EU moratorium on approvals of biotechnology products, among other types of trade concerns with other countries. Foreign countries have also objected to various U.S. trade measures.

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CRS — Drinking Water State Revolving Fund (DWSRF): Program Overview and Issues

April 17, 2014 Comments off

Drinking Water State Revolving Fund (DWSRF): Program Overview and Issues (PDF)
Source: Congressional Research Service (via National Agricultural Law Center)

In the Safe Drinking Water Act (SDWA) Amendments of 1996, Congress authorized a drinking water state revolving loan fund (DWSRF) program to help public water systems finance infrastructure projects needed to comply with federal drinking water regulations and to meet the act’s health objectives. Under this program, states receive annual capitalization grants to provide financial assistance (primarily subsidized loans) to public water systems for drinking water projects and other specified activities. Through June 2012, Congress had provided $14.7 billion for the DWSRF program, and combined with the 20% state match, bond proceeds, and other funds, the program generated $23.6 billion in assistance and supported 9,990 projects.

The latest Environmental Protection Agency (EPA) survey of capital improvement needs for public water systems indicates that these water systems need to invest $384.2 billion on infrastructure improvements over 20 years to ensure the provision of safe tap water. EPA reports that, although all of the identified projects promote the public health objectives of the SDWA, just $42.0 billion (10.9%) of reported needs are attributable to SDWA compliance.

CRS — Air Quality Issues and Animal Agriculture: A Primer

April 17, 2014 Comments off

Air Quality Issues and Animal Agriculture: A Primer (PDF)
Source: Congressional Research Service (via National Agricultural Law Center)

From an environmental quality standpoint, much of the public and policy interest in animal agriculture has focused on impacts on water resources, because animal waste, if not properly managed, can harm water quality through surface runoff, direct discharges, spills, and leaching into soil and groundwater. A more recent issue is the contribution of air emissions from animal feeding operations (AFOs), enterprises where animals are raised in confinement. This report provides background on the latter issue.

Secretary of Energy Advisory Board — Task Force Report on FracFocus 2.0 (March 28, 2014)

April 11, 2014 Comments off

Secretary of Energy Advisory Board — Task Force Report on FracFocus 2.0 (March 28, 2014) (PDF)
Source: U.S. Department of Energy (Energy Advisory Board)

This report presents the findings and recommendations for the Secretary of Energy Advisory Board (SEAB) Task Force on FracFocus. This Task Force report builds upon and extends the 2011 SEAB Subcommittee report on the environmental impacts of unconventional gas production.

The Task Force believes that the FracFocus experience to date demonstrates the ease of disclosure of chemicals added to fracturing fluid for companies, the value of this disclosure for the public, and the importance of public confidence in the quality and accessibility of the FracFocus chemical registry data. It has accomplished a good deal and shows the capacity to make improvements at modest additional cost. FracFocus has greatly improved public disclosure quickly and with a significant degree of uniformity.

The Task Force recommends a number of actions that will further improve the effectiveness of the FracFocus disclosure of chemical additives and improve transparency for regulators, operating companies, and the public. Recommendations are made for improving the accuracy and completeness of registry submissions. In addition, the Task Force believes that an independent audit to assess the accuracy and compliance of the process will be useful for all stakeholders.

Taking on the Rising Death Toll from Traffic & Pollution

April 11, 2014 Comments off

Taking on the Rising Death Toll from Traffic & Pollution
Source: World Bank

+ The annual death toll linked to road transportation is higher than many policy makers realize, reaching at least 1.5 million people worldwide and rising, according to a new analysis.

+ The report, Transport for Health, counts the number of lives lost to road crashes and, for the first time, also quantifies deaths related to vehicle pollution.

+ It offers practical actions countries can take now to improve transportation, air quality, and road safety data.

EU — The future of public health: A horizon scan

April 10, 2014 Comments off

The future of public health: A horizon scan
Source: RAND Corporation

Public Health England (PHE) commissioned RAND Europe to undertake a horizon scanning study exploring the future of public health and related scientific services. This work was intended to help inform thinking at the strategic level within PHE, firstly in relation to the wider vision of the Agency (which was only established in April 2013) and, secondly, in relation to the proposals for the creation of an integrated public health science hub.

The report is based on a literature review, a brief Delphi exercise using the ExpertLens platform and key informant interviews with a range of PHE staff and external experts. It focuses on the different future public health science needs and the extent to which an integrated science hub could serve PHE as it evolves over the next twenty years. Thus, the report considers PHE’s future remit and objectives in order that decisions about an integrated and co-located science hub be made in context and with reference to expert perceptions about the future.

CBO — Presentation on Raising the Excise Tax on Cigarettes: Effects on Health and the Federal Budget

April 9, 2014 Comments off

Presentation on Raising the Excise Tax on Cigarettes: Effects on Health and the Federal Budget
Source: Congressional Budget Office

Presentation by James Baumgardner, CBO’s Deputy Assistant Director for Health, Retirement, and Long-Term Analysis, to the 30th International Congress of Actuaries

Diabetes Spending Dips in States: NCSL Report

April 9, 2014 Comments off

Diabetes Spending Dips in States: NCSL Report
Source: National Conference of State Legislatures

State and federal spending to combat diabetes decreased slightly in 2013 compared to the previous year, according to a new report from the National Conference of State Legislatures (NCSL). The report, “States Address the Costs of Diabetes: A 50-State Budget Survey for Fiscal Year 2013,” tracks the funds specifically appropriated by state legislatures for diabetes in FY 2013. It also reviews the funding provided by the Centers for Disease Control and Prevention (CDC) to states in FY 2012 for Diabetes Prevention and Control Programs (DPCPs), as well as changes in grant funds received from the CDC.

The total of state and federal funding appropriated by state legislatures specifically for diabetes prevention and control was $11,347,038 in FY 2013, compared to $11,947,129 in FY 2012, a difference of about 5 percent. Those figures, however, do not represent total spending by states on diabetes. The CDC also supports state efforts through grant programs, providing roughly $27 million per year.

NRDC Report: Potentially Unsafe Chemicals in Food Threaten Public Health

April 9, 2014 Comments off

NRDC Report: Potentially Unsafe Chemicals in Food Threaten Public Health
Source: Natural Resources Defense Council

Federal protections to keep potentially unsafe chemicals out of our foods are woefully inadequate and may be putting the health of Americans at risk, a Natural Resources Defense Council investigation found.

The food safety protection system is marred by minimal supervision by the U.S. Food and Drug Administration, rife with apparent conflicts of interest in safety evaluations, and rendered all but toothless by a gaping loophole that allows companies to simply declare as safe hundreds of chemicals added to our foods—without any notification to the FDA or the public, according to an NRDC report released today.

Restaurant Owners’ Perspectives on a Voluntary Program to Recognize Restaurants for Offering Reduced-Size Portions, Los Angeles County, 2012

April 8, 2014 Comments off

Restaurant Owners’ Perspectives on a Voluntary Program to Recognize Restaurants for Offering Reduced-Size Portions, Los Angeles County, 2012
Source: Preventing Chronic Disease (CDC)

Introduction
Reducing the portion size of food and beverages served at restaurants has emerged as a strategy for addressing the obesity epidemic; however, barriers and facilitators to achieving this goal are not well characterized.

Methods
In fall 2012, the Los Angeles County Department of Public Health conducted semistructured interviews with restaurant owners to better understand contextual factors that may impede or facilitate participation in a voluntary program to recognize restaurants for offering reduced-size portions.

Results
Interviews were completed with 18 restaurant owners (representing nearly 350 restaurants). Analyses of qualitative data revealed 6 themes related to portion size: 1) perceived customer demand is central to menu planning; 2) multiple portion sizes are already being offered for at least some food items; 3) numerous logistical barriers exist for offering reduced-size portions; 4) restaurant owners have concerns about potential revenue losses from offering reduced-size portions; 5) healthful eating is the responsibility of the customer; and 6) a few owners want to be socially responsible industry leaders.

Conclusion
A program to recognize restaurants for offering reduced-size portions may be a feasible approach in Los Angeles County. These findings may have applications for jurisdictions interested in engaging restaurants as partners in reducing the obesity epidemic.

CDC Grand Rounds: Global Tobacco Control

April 8, 2014 Comments off

CDC Grand Rounds: Global Tobacco Control
Source: Morbidity and Mortality Weekly Report (CDC)

During the 20th century, use of tobacco products contributed to the deaths of 100 million persons worldwide (1). In 2011, approximately 6 million additional deaths were linked to tobacco use, the world’s leading underlying cause of death, responsible for more deaths each year than human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), tuberculosis, and malaria combined (1). One third to one half of lifetime users die from tobacco products, and smokers die an average of 14 years earlier than nonsmokers (2,3). Manufactured cigarettes account for 96% of all tobacco sales worldwide. From 1880 to 2009, annual global consumption of cigarettes increased from an estimated 10 billion cigarettes to approximately 5.9 trillion cigarettes (Figure 1), with five countries accounting for 58% of the total consumption: China (38%), Russia (7%), the United States (5%), Indonesia (4%), and Japan (4%). Among the estimated 1 billion smokers worldwide, men outnumber women by four to one. In 14 countries, at least 50% of men smoke, whereas in more than half of these same countries, fewer than 10% of women smoke (4). If current trends persist, an estimated 500 million persons alive today will die from use of tobacco products. By 2030, tobacco use will result in the deaths of approximately 8 million persons worldwide each year (4). Yet, every death from tobacco products is preventable.

CRS — Regulation of Clinical Tests: In Vitro Diagnostic (IVD) Devices, Laboratory Developed Tests (LDTs), and Genetic Tests

April 7, 2014 Comments off

Regulation of Clinical Tests: In Vitro Diagnostic (IVD) Devices, Laboratory Developed Tests (LDTs), and Genetic Tests (PDF)
Source: Congressional Research Service (via Federation of American Scientists)

In vitro diagnostic (IVD) devices are used in the analysis of human samples, such as blood or tissue, to provide information in making health care decisions. Examples of IVDs include (1) pregnancy test kits or blood glucose tests for home use; (2) laboratory tests for infectious disease, such as HIV or hepatitis and routine office blood tests such as for cholesterol and anemia; and (3) tests for various genetic diseases or conditions. More recently, a specific diagnostic test—called a companion diagnostic—may be used to select the best therapy, at the right dose, at the correct time for a particular patient; this is often referred to as personalized medicine.

Federal agencies involved in the regulation of IVDs include the Food and Drug Administration (FDA) and the Centers for Medicare & Medicaid Services (CMS). FDA derives its authority to regulate the sale and distribution of medical devices, such as IVDs, from the Federal Food, Drug, and Cosmetics Act and the Public Health Service Act. CMS’s authority to regulate IVDs is through the Clinical Laboratory Improvement Amendments of 1988. FDA regulates the safety and effectiveness of the diagnostic test as well as the quality of the design and manufacture of the diagnostic test, and CMS regulates the quality of clinical laboratories and the clinical testing process.

Traditionally, most genetic tests have not been subject to premarket review by the FDA. This is because in the past, genetic tests were developed by laboratories primarily for their in-house use—referred to as laboratory-developed tests (LDTs)—to diagnose rare diseases and were highly dependent on expert interpretation. However, more recently LDTs have been developed to assess relatively common diseases and conditions, thus affecting more people, and direct-to-consumer (DTC) genetic testing has become widely available over the Internet. In June 2010 FDA announced its decision to exercise its authority over all LDTs. FDA has provided a number of reasons for the decision to assert its enforcement authority over LDTs, including that the public needs assurances that LDTs are sound and reliable. FDA has not yet finalized guidance with respect to all LDTs. A provision in the Food and Drug Administration Safety and Innovation Act stipulates that the agency “may not issue any draft or final guidance on the regulation” of LDTs without “at least 60 days prior to such issuance,” first notifying Congress “of the anticipated details of such action.”

Notes from the Field: Calls to Poison Centers for Exposures to Electronic Cigarettes — United States, September 2010–February 2014

April 4, 2014 Comments off

Notes from the Field: Calls to Poison Centers for Exposures to Electronic Cigarettes — United States, September 2010–February 2014
Source: Morbidity and Mortality Weekly Report (CDC)

Electronic nicotine delivery devices such as electronic cigarettes (e-cigarettes) are battery-powered devices that deliver nicotine, flavorings (e.g., fruit, mint, and chocolate), and other chemicals via an inhaled aerosol. E-cigarettes that are marketed without a therapeutic claim by the product manufacturer are currently not regulated by the Food and Drug Administration (FDA) (1).* In many states, there are no restrictions on the sale of e-cigarettes to minors. Although e-cigarette use is increasing among U.S. adolescents and adults (2,3), its overall impact on public health remains unclear. One area of concern is the potential of e-cigarettes to cause acute nicotine toxicity (4). To assess the frequency of exposures to e-cigarettes and characterize the reported adverse health effects associated with e-cigarettes, CDC analyzed data on calls to U.S. poison centers (PCs) about human exposures to e-cigarettes (exposure calls) for the period September 2010 (when new, unique codes were added specifically for capturing e-cigarette calls) through February 2014. To provide a comparison to a conventional product with known toxicity, the number and characteristics of e-cigarette exposure calls were compared with those of conventional tobacco cigarette exposure calls.

An e-cigarette exposure call was defined as a call regarding an exposure to the e-cigarette device itself or to the nicotine liquid, which typically is contained in a cartridge that the user inserts into the e-cigarette. A cigarette exposure call was defined as a call regarding an exposure to tobacco cigarettes, but not cigarette butts. Calls involving multiple substance exposures (e.g., cigarettes and ethanol) were excluded. E-cigarette exposure calls were compared with cigarette exposure calls by proportion of calls from health-care facilities (versus residential and other non–health-care facilities), demographic characteristics, exposure routes, and report of adverse health effect. Statistical significance of differences (p<0.05) was assessed using chi-square tests.

During the study period, PCs reported 2,405 e-cigarette and 16,248 cigarette exposure calls from across the United States, the District of Columbia, and U.S. territories. E-cigarette exposure calls per month increased from one in September 2010 to 215 in February 2014 (Figure). Cigarette exposure calls ranged from 301 to 512 calls per month and were more frequent in summer months, a pattern also observed with total call volume to PCs involving all exposures (5).

E-cigarettes accounted for an increasing proportion of combined monthly e-cigarette and cigarette exposure calls, increasing from 0.3% in September 2010 to 41.7% in February 2014. A greater proportion of e-cigarette exposure calls came from health-care facilities than cigarette exposure calls (12.8% versus 5.9%) (p20 years (42.0%). E-cigarette exposures were more likely to be reported as inhalations (16.8% versus 2.0%), eye exposures (8.5% versus 0.1%), and skin exposures (5.9% versus 0.1%), and less likely to be reported as ingestions (68.9% versus 97.8%) compared with cigarette exposures (p<0.001).

Effectiveness of influenza vaccine against life-threatening RT-PCR-confirmed influenza illness in US children, 2010-2012

April 4, 2014 Comments off

Effectiveness of influenza vaccine against life-threatening RT-PCR-confirmed influenza illness in US children, 2010-2012
Source: Journal of Infectious Diseases

Background. 
No studies have examined the effectiveness of influenza vaccine against ICU admission associated with influenza virus infection among children.

Methods. 
In 2010-11 and 2011-12, children aged 6 months to 17 years admitted to 21 US pediatric intensive care units (PICUs) with acute severe respiratory illness and testing positive for influenza were enrolled as cases; children who tested negative were PICU controls. Community controls were children without an influenza-related hospitalization, matched to cases by comorbidities and geographic region. Vaccine effectiveness was estimated with logistic regression models.

Results. 
We analyzed data from 44 cases, 172 PICU controls, and 93 community controls. Eighteen percent of cases, 31% of PICU controls, and 51% of community controls were fully vaccinated. Compared to unvaccinated children, children who were fully vaccinated were 74% (95% CI, 19 to 91%) or 82% (95% CI, 23 to 96%) less likely to be admitted to a PICU for influenza compared to PICU controls or community controls, respectively. Receipt of one dose of vaccine among children for whom two doses were recommended was not protective.

Conclusion. 
During the 2010-11 and 2011-12 US influenza seasons, influenza vaccination was associated with a three-quarters reduction in the risk of life-threatening influenza illness in children.

Where America is sprawling and what it means

April 2, 2014 Comments off

Where America is sprawling and what it means (PDF)
Source: Smart Growth America

People in compact, connected metropolitan regions are more likely to move up the economic ladder, have lower household costs, enjoy more transportation choices and lead longer, safer, healthier lives according to a new report out today by Smart Growth America and the University of Utah’s Metropolitan Research Center.

Measuring Sprawl 2014 evaluates development in 221 major metropolitan areas in the United States, and ranks these areas based on how sprawling or compact they are. The report also examines how sprawl relates to life in those communities, based on factors like economic mobility, the cost of housing and transportation, life expectancy, obesity, chronic disease and safety.

Development of a Systematic Review of Public Health Interventions to Prevent Children Drowning

April 2, 2014 Comments off

Development of a Systematic Review of Public Health Interventions to Prevent Children Drowning
Source: Open Journal of Preventive Medicine

Drowning is the leading cause of death from unintended injury in children globally. Drowning is preventable, and mechanisms exist which can reduce its impact, however the peer-reviewed literature to guide public health interventions is lacking. This paper describes a protocol for a review of drowning prevention interventions for children. Electronic searching will identify relevant peer-reviewed literature describing interventions to prevent child drowning worldwide. Outcome measures will include: drowning rates, water safety behaviour change, knowledge and/or attitude change, water safety policy and legislation, changes to environment and water safety skills. Quality appraisal and data extraction will be independently completed by two researchers using standardised forms recording descriptive and outcome data for each included article. Data analysis and presentation of results will occur after data have been extracted. This review will map the types of interventions being implemented to prevent drowning amongst children and identify gaps within the literature.

7 million premature deaths annually linked to air pollution

March 25, 2014 Comments off

7 million premature deaths annually linked to air pollution
Source: World Health Organization

In new estimates released today, WHO reports that in 2012 around 7 million people died – one in eight of total global deaths – as a result of air pollution exposure. This finding more than doubles previous estimates and confirms that air pollution is now the world’s largest single environmental health risk. Reducing air pollution could save millions of lives.

CRS — Keystone XL: Greenhouse Gas Emissions Assessments in the Final Environmental Impact Statement

March 12, 2014 Comments off

Keystone XL: Greenhouse Gas Emissions Assessments in the Final Environmental Impact Statement (PDF)
Source: Congressional Research Service (via Federation of American Scientists)

On June 25, 2013, President Obama announced a national “Climate Action Plan” to reduce emissions of carbon dioxide (CO2) and other greenhouse gases (GHG), as well as to encourage adaptation to climate change. During his speech, the President made reference to the proposed Keystone XL Pipeline project—a pipeline that would transport crude oil derived from Canadian oil sands deposits in Alberta to a market hub in Nebraska for further delivery to U.S. Gulf Coast refineries. He stated that an evaluation of the proposed pipeline’s impacts on climate change would be “critical to determining whether this project is allowed to go forward.”

The State Department released a Final Environmental Impact Statement (FEIS) on January 31, 2014, to inform the project’s national interest determination. Among the various environmental impacts analyzed, the FEIS estimates GHG emissions that would be attributable to both the approval and the denial of the permit application for the project.

Members of Congress remain divided on the merits of the project, as many have expressed support for the potential energy security and economic benefits, while others have reservations about its potential health and environmental impacts. Though Congress, to date, has had no direct role in permitting the pipeline’s construction, it has oversight stemming from federal environmental statutes that govern the review. Further, Congress may seek to influence the State Department’s process or to assert direct congressional authority over approval through new legislation.

CRS — The Federal Food Safety System: A Primer (updated)

March 11, 2014 Comments off

The Federal Food Safety System: A Primer (PDF)
Source: Congressional Research Service (via University of North Texas Digital Library)

Numerous federal, state, and local agencies share responsibilities for regulating the safety of the U.S. food supply. Federal responsibility for food safety rests primarily with the Food and Drug Administration (FDA) and the U.S. Department of Agriculture (USDA). FDA, an agency of the Department of Health and Human Services, is responsible for ensuring the safety of all domestic and imported food products (except for most meats and poultry). FDA also has oversight of all seafood, fish, and shellfish products. USDA’s Food Safety and Inspection Service (FSIS) regulates most meat and poultry and some egg products. State and local food safety authorities collaborate with federal agencies for inspection and other food safety functions, and they regulate retail food establishments. Other federal agencies also play a role. The Government Accountability Office (GAO) has identified as many as 15 federal agencies, including FDA and FSIS, as collectively administering at least 30 laws related to food safety. State and local food safety authorities collaborate with federal agencies for inspection and other food safety functions, and they regulate retail food establishments.

Environmental Noise Pollution in the United States: Developing an Effective Public Health Response

March 7, 2014 Comments off

Environmental Noise Pollution in the United States: Developing an Effective Public Health Response (PDF)
Source: Environmental Health Perspectives

Background:
Tens of millions of Americans suffer from a range of adverse health outcomes due to noise exposure, including heart disease and hearing loss. Reducing environmental noise pollution is achievable and consistent with national prevention goals, yet there is no national plan to reduce environmental noise pollution.

Objectives:
We aimed to describe some of the most serious health effects associated with noise, summarize exposures from several highly prevalent noise sources based on published estimates as well as extrapolations made using these estimates, and lay out proven mechanisms and strategies to reduce noise by incorporating scientific insight and technological innovations into existing public health infrastructure.

Discussion:
We estimated that 104 million individuals had annual LEQ(24) levels > 70 dBA (equivalent to a continuous average exposure level of >70 dBA over 24 hr) in 2013 and were at risk of noise-induced hearing loss. Tens of millions more may be at risk of heart disease, and other noise-related health effects. Direct regulation, altering the informational environment, and altering the built environment are the least costly, most logistically feasible, and most effective noise reduction interventions.

Conclusion:
Significant public health benefit can be achieved by integrating interventions that reduce environmental noise levels and exposures into the federal public health agenda.

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