Colorado Law Blog

Just in time for Halloween, school officials around the country have been scrambling with the prospect of an invasion of bacterial infections. A federal report released last week indicated that the bacteria, methicillin-resistant Staphylococcus aureus, or MRSA, are responsible for more deaths in the United States each year than AIDS.
MRSA is a strain of staph bacteria that does not respond to penicillin or related antibiotics, though it can be treated with other drugs. The infection can be spread by sharing items, like a towel or a piece of sports equipment that has been used by an infected person, or through skin-to-skin contact with an open wound.

At the same time the federal report was released, scores of schools were closed and events were canceled in Connecticut, Maryland, North Carolina, Ohio and Virginia as cleaning crews disinfected buses, lockers and classrooms.

In Sandy Spring, Maryland the football players here at a local high school were not getting the message about washing their uniforms and using only their own jerseys, so the school nurse paid a surprise visit to the locker room. She brought along a baseball bat to get her point across – wash your hands! Seven players on the team had already contracted the deadly drug-resistant strain of bacteria this year.

School officials in Mississippi, New Hampshire and Virginia reported student deaths within the past month from the bacteria, while officials in at least four other states reported cases of students being infected.

The federal report, written by doctors at the Centers for Disease Control and Prevention, found that nearly 19,000 people had died in the United States in 2005 after an invasive MRSA infection. The study also suggested that such infections might be twice as common as previously thought.

Health officials have begun reporting a growing number of cases in schools, gyms and day care centers, and not just in nursing homes and hospitals, as has often been the case in the past. Although the bacteria mostly affect student athletes, cases have been reported in children of elementary school age as well.

The C.D.C. study found that 27 percent of all invasive MRSA infections originated in hospitals, while 58 percent began outside of a hospital but in patients with some recent exposure to the health care system. The remaining 15 percent of invasive MRSA cases originated in the community without any apparent health care risk factor.

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The names are familiar to children and adults alike: Pirates of the Caribbean, Winnie the Pooh, Barbie, Elmo. The brands are familiar too: Mattel, Banquet, Fischer-Price, J.C. Penny, and Dunkin Doughnuts. In the past few months, companies have asked you to check your closets and toy boxes for brightly colored but toxic toys, and your refrigerator for foods that may be unsafe too.

The recalls keep on coming -- poisonous pet food, contaminated chicken pot pies, brightly painted but toxic toys sold by trusted companies. Last week, Consumer Product Safety Commission reports the recall of a lead-laden Cub Scout merit badge!

With more than 400 recalled items each year, the challenge to consumers to stay informed is overwhelming. But the folks at Consumers Union are trying to make it a little easier with a new website: www.notinmycart.org.

The website presents the Consumer Product Safety Commission recalls in a simple list with a quick photo. Convenient links also allow consumers to the USDA and the FDA for food recalls, and an easy form to complete to send a message to your representative in Congress asking for tougher oversight of the nation’s retail shelves.

Posted by Linda Chalat at 03:04 PM | Permalink | Comments (0) | TrackBacks (0)

The proper treatment for appendicitis is surgery, and the time to operation is the most significant predictor of a rupture. A perforated appendix can lead to longer stays in the hospital, increased health care costs and sometimes fatal infection. But the liklihood of receiving the surgery may depend upon your insurance card in your wallet.

Last month in The Journal of the American College of Surgeons, a group of scientists used New York state data from 2003 and 2004 which included 26,637 appendicitis patients, of whom 7,969 had a ruptured appendix. There were no significant differences in the likelihood of perforation among whites, African-Americans, Hispanics and Asians.

But the kind of insurance — or lack of it — had a significant effect. Compared with patients who had private insurance coverage, those on Medicare were 14 percent more likely to have a burst appendix, people on Medicaid were 22 percent more likely, and those with no insurance at all were 18 percent more likely to have a rupture. The differences persisted even after controlling for age, sex, socioeconomic status, type of hospital and other factors.

The finding on race was surprising because of data showing that minority patients use fewer health care services than others and are less often recommended for necessary medical procedures. Although the authors caution against generalizing their results to other geographic areas, they suggest that there may be a growing awareness in the medical community of racial inequalities in treatment, which has led to better care for minorities. Not surprisingly, it is thought that the main reason for lack of surgery for the under-insured or uninsured is “fear of financial repercussions.” Not surprising, but certainly disconcerting.

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Pop Weaver, the nation's second-largest popcorn producer, has pulled the synthetic flavoring, diacetyl, from its microwave popcorn products because of the link between exposure to the chemical and lung disease. ConAgra, the world's largest supplier of the 3 billion bags of microwave popcorn sold each year, said Tuesday that it will eliminate the use of a controversial chemical butter flavoring linked to severe lung disease in workers from its Act II and Orville Redenbacher products.

A naturally occurring substance found in many dairy products, diacetyl was first produced synthetically in Europe and is added to thousands of products throughout the world to increase or enrich butter flavoring. The lung disease caused by diacetyl, bronchiolitis obliterans, has been found coast-to-coast in workers in plants that make and use flavorings, in candy factories and in a dozen different food production operations that use the synthetic chemical butter flavoring.

The threat was thought to be relevant only to popcorn factory workers. But then a lung specialist from Denver's National Jewish Medical and Research Center, Dr. Cecile Rose, notified federal agencies that she may have identified the first known case of a man who ate popcorn at home and had the same disease as the workers.

Dr. Rose wrote to the Food and Drug Administration, the Environmental Protection Agency, the Centers for Disease Control and Prevention and the Occupational Health and Safety Administration in July, advising them of her patient and the possibility that people who pop microwave corn at home can be at risk.

The rare lung disease that Dr. Rose diagnosed in her patient -- bronchiolitis obliterans -- can cause death in severe cases. Lung transplants are the only hope that patients have. The disease quickly leads to breathing difficulties and is often misidentified by physicians unfamiliar with the disease.

"I am surprised that none of the regulatory agencies has called me to learn more about the case," said the pulmonologist, but Rose added that she has received "numerous calls from industry representatives who were very interested in hearing more details than were presented in my letter."

Rose admits that it's difficult to make a positive link based on a single report but added, "We have no other plausible explanation."

Weaver, the first microwave popcorn company to remove diacetyl, said it had taken its action because of concerns for consumers who were "growing more anxious" over the presence of the chemical.

Workers from ConAgra were among more than 200 employees from six Midwest microwave popcorn plants whose lungs were damaged or destroyed by exposure to the butter flavoring used in the bags.

Although diacetyl may have serious public health consequences beyond the workplace, only the National Institute of Occupational Safety and Health has done extensive research on diacetyl in the workplace. Other agencies bounce responsibility for diacetyl in consumer products elsewhere.

The only agency studying how much diacetyl is generated in home microwaving is the EPA, but it has been sitting on the results of its research for more than two years. It is looking at the vapors as an air pollutant. The EPA's explanation for not sharing its finding with the public health community or other federal investigators was that it did not want to endanger its scientist's chance of having her research published in a scientific journal.

When asked what its reaction was to Rose's letter, the agency released this statement: "EPA scientists do cutting-edge research to protect public health. EPA's popcorn study was of emissions, not health effect research."

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