Effect Measure is a forum for progressive public health discussion and argument as well as a source of public health information from around the web that interests the Editor(s)
The Editors of Effect Measure are senior public health scientists and practitioners. Paul Revere was a member of the first local Board of Health in the United States (Boston, 1799). The Editors sign their posts "Revere" to recognize the public service of a professional forerunner better known for other things.
At this moment I'm sitting in a Chicago O'Hare airport waiting room reading a news article on MSNBC's website telling me I am in more danger from breathing the air here in the terminal than I would be breathing the air on the airplane when it reaches cruising altitude. This was the conclusion from a just published study done by the National Institute for Occupational Study and Health (NIOSH), the federal research agency on workplace health problems, and two collaborating universities, Harvard and University of Massachusetts. NIOSH has been looking into the environment of the cabin crews, but of course the flying public shares the same air so the findings are also of interest to those of us who stand and wait. Or sit and wait, in this instance. We've discussed it here before, so consider this an update.
Last week WHO's flu maven, Keiji Fukuda, said what we and others have been saying for a long time. Flu scientists need to change their research ethics. The world of flu virology has developed a mandarinate that is impeding progress for its own benefit. And their bad behavior is enabled and imitated by some public health agencies, like CDC. Researchers and CDC are sitting on H5N1 genetic and other flu sequences of public health importance. They treat their data as proprietary, to be used for their own benefit in scientific publications.
This isn't unusual. It is the normal way of doing academic science. But when it comes to research on one of the major global public health problems this is no longer acceptable. And WHO is saying so, gently but clearly:
Second Life is a virtual reality site, superficially similar to some massive multiplayer role playing games one finds on the net (like World of Warcraft). But it's not a game but a social venue. I've tried it out and posted on or mentioned it several times (here, here, here and here). Second Life is a global phenomenon, not just a US one. Now Spanish public health officials are trying it out as a way to reach young people about drugs and sexually transmitted diseases:
Suppose someone owned and managed business premises which had recently experienced a dangerous incident. They were also carrying out work there that was generally acknowledged by the industry to be risky. But when a government official came around they misrepresented the earlier incident and publicly denied they were engaging in any risky practices. The government official wasn't too inquisitive and told them it was OK by him to use the risky technique. So they continued to do so and six of their workers died as a result along with three rescue workers. What would you say about such a business person? That perhaps someone should check to see if he was criminally liable? That's what Congressman George Miller, Chair of the House Education and Labor Committee, thinks:
The subject of a recent post, rabies, put us in mind of another rare, invariably fatal neurodegenerative disease, Creutzfeld-Jakob Disease (CJD). There is now pretty good evidence that the outbreak of CJD in Europe since the 1990s is caused by the same agent that causes Bovine Spongiform Encephalopathy (BSE), also known as mad cow disease. The incriminated transmissible material is an unconventional agent, an infectious protein (now called a prion). When a prion from a BSE case in cattle is consumed it causes a disease very like CJD in humans. Technically it is called new variant CJD (nvCJD). The BSE prion is thought to stem from feeding cattle other cattle via feed, a practice which is now outlawed. As a result BSE is decreasing in Europe, where extensive testing of cattle is done prior to letting the meat into the chain of commerce. Only a few cases of BSE have been detected in the US, where allegedly stringent controls have been instituted to prevent BSE from occurring. But only a tiny fraction of US cattle is tested and the cattle industry has strenuously resisted any calls for better coverage. You would think that an enterprising meatpacker would test their own products and market it as safe, thus gaining a competitive advantage, especially in export markets highly sensitive to the BSE problem, like Japan. You would be wrong. Not because it isn't a good idea but because the US Department of Agriculture (USDA) forbids the practice. We've discussed it three times here in the context of a Kansas company trying to test its own cattle and being told it cannot.
Let's face it. Tolerance for other religions is bad for religion. As long as people only knew about their own religion (translation: their parents' religion) they didn't question it. As soon as they became aware there were a lot of religions and theirs only one among them, then the question of why this one rather than that one raised its ugly head. Religious instruction is sometimes smuggled into public school under the guise of "comparative religion" but that will only hasten its down fall. Once people know there are not dozens but hundreds of religions, the inevitable question arises. Which one?
We talk a fair amount about intellectual property issues here. When it comes to the free exchange of scientific information already paid for by taxpayers or the rapacious use of intellectual property laws by Big Pharma to price gouge the developed world and pillage the developing world the connections to public health are clear to us. Maybe some of you thought they were a stretch but now we have agreement from an unlikely source: the Los Angeles County Board of Supervisors. Of course their take is 180 degrees in the opposite direction. For them it's infringement that's the public health and safety threat:
Last October (2007) a 46 year old Minnesota man died of rabies, the only known victim in the US last year. Rabies is a rare disease in the US because we have good veterinary services. Most animals in routine and regular contact with humans are vaccinated against the disease. But bats have become a significant wild animal reservoir and the Minnesota case was a bat case:
