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Thursday,  January 21, 2010

From the Public Health Law Program, Office of Strategy and Innovation, CDC
http://www2a.cdc.gov/phlp/

Announcements

  *** Workshop on Public Health Emergency Legal Preparedness (02/16).  NACCHO, ASTHO, and the CDC Public Health Law Program are co-sponsoring the workshop "High-Priority Tools for Public Health Emergency Legal Preparedness," 8:00-3:00, February 16, as part of the 2010 annual Public Health Preparedness Summit in Atlanta.  The workshop will feature tools local, state, and Tribal public health practitioners can use to improve use of their public health laws to address influenza outbreaks and other, all-hazards public health emergencies.  To register, please visit http://www.phprep.org/2010/agenda/Pre-Conference-Workshops_1.cfm.

*** CRS H1N1 Influenza Legal Issues Report.  The Congress Research Service (CRS) has released a Report for Congress entitled, The 2009 Influenza Pandemic: Selected Legal Issues. The report provides a brief overview of legal issues including emergency measures, civil rights, liability issues, and employment issues. To view the report, please visit http://www.fas.org/sgp/crs/misc/R40560.pdf.

*** Nation's Health Security Strategy. On January 7, HHS Secretary Kathleen Sebelius released "The National Health Security Strategy," the nation's first comprehensive strategy focused on protecting people's health during a large-scale emergency. To view the report, please visit http://www.hhs.gov/disasters.

*** Ready or Not? 2009 Report.  The Trust for America's Health (TFAH) and the Robert Wood Johnson Foundation (RWJF) released the 2009 annual Ready or Not? Protecting the Public's Health from Diseases, Disasters, and Bioterrorism report. The report contains state-by-state health preparedness scores based on 10 key indicators to assess health emergency preparedness capabilities. To view the report, please visit http://healthyamericans.org/reports/bioterror09/.

Top Story

1. After the destruction: what will it take to rebuild Haiti?

States and Localities

2. Illinois: Treating sex partners for chlamydia, gonorrhea to get easier
3. Louisiana: The new Katrina flood: hospital liability
4. Pennsylvania: Changes may cut spread of disease from needles

National

5. Feds probe cadmium in kids' jewelry from China

International

6. Thailand: In industrial Thailand, health and business collide

Briefly Noted

Louisiana disaster medicine · Maine MRSA screening · New Jersey menu labeling · New York sodium reduction · North Carolina water adjudication · Pennsylvania hospital acquired infections · Texas HIV screening · Newborn blood samples · Washington Hanford compensation · Wyoming food licensing · National antibiotic-free chicken · Football concussions · TB traveler

Journal Articles

School nutrition · Rule of law initiatives · Greenhouse gas legislation · Smoke-free Africa ·  Public health law

Court Opinions

Colorado smoking regulation · Idaho tobacco permit · Montana attorney visits · Nevada pharmacies · Federal tobacco control · HIV threat · Electronic cigarettes

Quotation of the Month

Michael R. Harbut, M.D.,  director of the environmental cancer program at the Karmanos Cancer Institute in Detroit

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"After the destruction: what will it take to rebuild Haiti?"
Time     (01/16/2010)     Bryan Walsh
http://www.time.com/time/specials/packages/article/0,28804,1953379_1953494_1954338,00.html

Haiti's poor building codes, which are rarely enforced, likely contributed to the extensive death and destruction from the January 12, 2010, earthquake. The earthquake measured 7.0 on the Richter scale, the same level as the 1989 San Francisco Bay Area earthquake. However, while the San Francisco earthquake left 12,000 people homeless and 63 dead, the Haiti disaster is estimated to have left over a million people homeless and 50,000 or more dead. Some disaster experts believe that the difference can be attributed to good, enforced building codes in San Francisco. "Earthquakes don't kill people. Bad buildings kill them," said John Mutter, a seismologist and disaster expert at Columbia University's Earth Institute. Many of Haiti's buildings were poorly constructed, using handmade concrete blocks, causing them to collapse and pancake during the earthquake. "In Haiti a block is maybe an eighth of the weight of a concrete block that you'd buy in the U.S. You end up providing buildings quickly and cheaply but at great risk," said Peter Haas, executive direction of the Appropriate Infrastructure Development Group, an NGO. A challenge of the recovery effort will be to build buildings that can withstand earthquakes, floods, hurricanes, and mud slides, while also being affordable. "It would be unconscionable to turn Port au Prince back to the way it was," Mutter said.

[Editor's note: For information on CDC's response and recovery efforts in Haiti, visit: http://emergency.cdc.gov/disasters/earthquakes/.]

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"Treating sex partners for chlamydia, gonorrhea to get easier"
The State Journal-Register     (12/29/2009)     Dean Olson
http://www.behealthyspringfield.com/sections/local-news/treating-sex-partners-for-chlamydia-gonorrhea-to-get-easier

Effective January 1, 2010, Illinois will allow doctors and other health-care providers to treat partners of patients diagnosed with the sexually transmitted infections (STIs) chlamydia and gonorrhea without examining the partners directly. The practice is referred to as expedited partner therapy. Under this arrangement, the diagnosed individual is given single doses of antibiotic pills to distribute to each of their previous sexual partners; both infections can be treated with a single dose of oral antibiotics.  The U.S. Centers for Disease Control and Prevention, in endorsing the practice, called it a "cost-saving and cost-effective partner management strategy" for the two commonly diagnosed STIs.  The bill also contains, at the insistence of the Illinois State Medical Society, provisions that provide legal immunity from medical malpractice judgments against participating providers. However, the bill does have its detractors.  State Sen. David Syverson  questioned the unintended consequences of the legislation:  "When you're dealing with a younger person, does it start to send the message that your sexual activities are going to be safe?  Ultimately, parents need to be held more responsible."  Because Illinois has among the highest STI rates in the nation, compounded with the seriousness of these chronically untreated and underreported infections, many are confident that expedited partner therapy is a "strategy that works."

[Editor's note: For more information on expedited partner therapy, visit: http://www.cdc.gov/std/ept/default.htm.]  

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"The new Katrina flood: hospital liability"
The New York Times     (12/31/2009)     Sheri Fink
http://www.nytimes.com/2010/01/03/weekinreview/03fink.html?scp=1&sq=sheri%20fink&st=cse

The Louisiana Supreme Court is hearing a case in which the family of Althea Lacoste, a 73-year-old patient who died in a New Orleans hospital during Hurricane Katrina, alleges her death was due to "lack of emergency preparedness."  This new theory of liability, if accepted by the court, would set a new precedent in Louisiana, and is being watched closely by other courts around the country.  The state's Supreme Court has already set new precedent for the case by deciding that it was classified on general negligence claims as opposed to medical malpractice claims.  General negligence claims are not subject to the $500,000 cap on damages that medical malpractice claims are, thereby increasing hospital owners' potential liability.  The Lacoste family is arguing that the hospital was negligent for having inadequate emergency power systems, evacuation plans, and floodwater prevention.  Specifically, the family is bringing the court's attention to a fuel pump that failed after being flooded, causing the higher-elevated generator to shut down.  They allege this could have been avoided had the hospital invested less than $10,000 in a submersible pump.  In response, the hospital owners argue that Hurricane Katrina was an "act of God" that could not be foreseen, and maintain that their emergency power system "met or exceeded applicable electrical codes and standards."  With the lack of sufficient regulation imposed upon hospitals to prepare for major catastrophes, and with hospitals often operating on thin margins, the difficult decision regarding how to allocate available resources may soon be decided by the courts.

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"Changes may cut spread of disease from needles"
The Philadelphia Inquirer     (12/23/2009)     Don Sapatkin http://www.philly.com/inquirer/local/20091223_Changes_may_ease_way_for_needle_exchanges.html

As part of the omnibus spending bill President Obama signed in December 2009, a long-standing ban on federal funding of needle exchange programs was lifted.  Needle exchange programs allow drug addicts to turn in used syringes for new ones with "no questions asked."  Since the Pennsylvania State Board of Pharmacy's September 2009 decision to drop the requirement for a prescription to purchase syringes at pharmacies, now only two states, New Jersey and Delaware, require a prescription to purchase syringes.  Both the federal and state actions were delayed for years over fears that they could increase crime.  However, proponents of these programs point to  statistics that demonstrate easing access to sterile syringes reduces transmission of HIV and Hepatitis C without increasing the rates of drug addiction.   Harvey Weiner, addiction counselor and program manager of the Drug Policy Alliance of New Jersey, in support of easing access to clean needles, adds "Addicts are not stupid people.  If they are able without too much hassle to keep themselves disease free, they will do that."  Indeed, a study published last year in the Journal of Urban Health showed drastically lower rates of HIV, Hepatitis B, and Hepatitis C, in areas where needles were available at exchanges or in pharmacies without a prescription when compared to areas that had restrictions against such programs.

[Editor's note: For more information about disease prevention among Injection Drug Users, visit http://www.cdc.gov/idu/.]

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"Feds probe cadmium in kids' jewelry from China"
Associated Press     (01/11/2010)     Justin Pritchard
http://www.washingtonpost.com/wp-dyn/content/article/2010/01/10/AR2010011001601.html?hpid=sec-health

An Associated Press (AP) investigative report found high levels of the toxic heavy metal cadmium in some children's jewelry imported from China. Despite levels as high as 91% cadmium by weight, the products are sold legally. The Consumer Product Safety Improvement Act of 2008 regulates cadmium in consumer products, but it only applies to painted toys, not jewelry. Cadmium is a toxic metal like lead that can cause developmental disabilities in children and is a known carcinogen. Children can be exposed to cadmium by frequently sucking or biting products containing the metal. Chinese jewelry industry workers say cadmium is commonly used in products now that the use of lead is strictly regulated. "Some of their products contain 90 percent cadmium or higher. Usually, though, they are more careful with export products," said Xu Hongli, a cadmium specialist with the Beijing office of Asian Metal, Ltd., a market research and consultancy firm. The U.S. Consumer Product Safety Commission (CPSC), the federal agency charged with protecting the public from unreasonable risks of serious injury or death from consumer products, has the authority to regulate a product deemed a public danger under the Federal Hazardous Substances Act. Following release of the AP's investigation, the CPSC announced it was launching an investigation and, in a speech delivered to regulators at the Asia-Pacific Economic Cooperation Toy Safety Initiative/Dialogue in Hong Kong, CPSC Chairman Inez Tenenbaum warned against the use of heavy metals in children's products.

[Editor's note: New York Senator Charles Schumer introduced legislation on January 13, 2010, to ban the use of cadmium and certain other heavy metals in children's jewelry sold in the United States. For more information on the Consumer Product Safety Commission, please visit http://www.cpsc.gov/.]

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"In industrial Thailand, health and business collide"
The New York Times     (12/19/2009)     Thomas Fuller
http://www.nytimes.com/2009/12/19/world/asia/19thai.html?_r=1&ref=world

As a result of a lawsuit filed by 27 village residents in Thailand two years ago, a series of court decisions have suspended 9 billion dollars worth of industrial projects, including Japanese steel factories and German-owned chemical plants. The injunctions, hailed as a major victory for Thailand's environmental movement, were ordered by judges presiding over lawsuits initiated by villagers of Map Ta Phut, a village seen as the heart of Thailand's industrial underbelly, against companies for being in violation of environmental provisions in the country's new Constitution.  The villagers complained of not being able to walk in the rain because they say it burns their skin and causes their hair to fall out.  Additionally, they alleged that they suffered from trouble breathing as a result of toxic fumes released by factories, and pointed to unusually high cancer rates in the area. In addition to the possible negative ramifications for the Thai economy, lawyers for companies affected by the injunction say that they cannot possibly comply with the law because detailed regulations have yet to be written. Sivapong Viriyabusaya, an attorney representing the affected industries, said, "Right now companies don't know which way to turn.  They want to comply but they cannot because there are no rules."  The Thai government, acknowledging the lack of detailed regulations, says it is moving as quickly as it can to pass the requisite laws which companies could follow to have the injunctions lifted.

_____________________BRIEFLY NOTED______________________

Louisiana: Health professionals develop disaster medicine guidelines
"Louisiana doctors working on 'crisis standards' for when medical system is overwhelmed"
Times-Picayune     (12/27/2009)     Sheri Fink
http://www.nola.com/health/index.ssf/2009/12/post_16.html

Maine: All acute-care hospitals must screen admitted patients for MRSA
"Maine begins testing for potentially devastating bacteria"
Bangor Daily News     (01/07/2010)     Meg Haskell
http://www.bangordailynews.com/detail/134223.html

New Jersey: Chain restaurants required to post calories on menu boards
"N.J. chain restaurants are required to add calorie counts to menus"
Star-Ledger     (01/18/2010)     Susan K. Livio
http://blog.nj.com/ledgerupdates_impact/print.html?entry=/2010/01/nj_chain_restaurants_are_requi.html

New York: New York City reveals sodium reduction plan for packaged and restaurant foods
"Citing hazard, New York says hold the salt"
New York Times     (01/11/2010)     William Neuman
http://www.nytimes.com/2010/01/11/business/11salt.html?hpw

North Carolina: Navy cannot adjudicate claims of military exposed to contaminated water
"Lejeune amendment signed into law as part of defense funding bill"
Jacksonville Daily News     (12/24/2009)     Hope Hodge
http://www.jdnews.com/news/navy-71129-lejeune-water.html

Pennsylvania: Unexpectedly high numbers of hospital acquired infections reported
"High numbers of bloodstream infections logged"
Philadelphia Inquirer     (01/13/2010)     Marie McCullough and Josh Goldstein
http://www.philly.com/philly/news/local/81300642.html

Texas: Providers must test pregnant women for HIV during last trimester
"New HIV-testing law focuses on pregnant women"
Austin American-Statesman     (01/19/2010)     Mary Ann Roser
http://www.philly.com/philly/news/local/81300642.html

Texas: State to destroy stored newborn blood samples to end lawsuit
"State agrees to destroy more than 5 million stored blood samples from newborns"
Austin American-Statesman     (12/23/2009)     Mary Ann Roser
http://www.statesman.com/news/texas/state-agrees-to-destroy-more-than-5-million-141734.html

Washington: HHS expands compensation to Hanford workers with cancer from radiation
"Hanford workers new cancer package OK'd"
Tri-City Herald     (12/18/2009)     Annette Cary
http://www.tri-cityherald.com/yahoonews/story/833295.html

Wyoming: Relaxed food licensing rules for homemade food business prompt fears
"New rules prompt debate over food licensing"
Star-Tribune     (12/21/2009)     Joshua Wolfson
http://www.trib.com/news/local/article_e7c3b293-7693-5e77-9bff-192066686e99.html

National: Class-action settlement for "antibiotic-free" chicken includes cash, coupons
"Judge to weigh Tyson deal over 'antibiotic-free' chicken"
Baltimore Sun     (01/14/2010)     Tricia Bishop
http://www.baltimoresun.com/news/maryland/baltimore-city/bal-md.tyson14jan14,0,668363.story

National: House Judiciary Committee holds hearing on impact of new football brain injury rules
"Lawmakers grill doctor for his views on concussions"
New York Times     (01/05/2010)     Alan Schwarz
http://www.nytimes.com/2010/01/05/health/05docs.html?ref=health

National: Patient with drug-resistant TB flies to San Francisco despite public health order
"TB patient flies to SFO despite air travel ban"
San Francisco Chronicle     (01/13/2010)     Erin Allday
http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2010/01/13/BA0U1BHA65.DTL

___________________JOURNAL ARTICLES____________________

"State school nutrition and physical activity policy environments and youth obesity"
American Journal of Preventive Medicine     (01/2010)     Marilyn S. Nanney and others
http://www.ajpm-online.net/article/S0749-3797(09)00641-2/abstract

" 'Rule of law' initiatives and the liberal peace: the impact of politicised reform in post-conflict states"
Disasters     (01/2010)     Jenny H. Peterson
http://www3.interscience.wiley.com/journal/122296404/abstract

"Cap and trade legislation for greenhouse gas emissions: public health benefits from air pollution mitigation"
Journal of the American Medical Association     (01/06/2010)    Christopher D. Barr and Francesca Dominici
http://jama.ama-assn.org/cgi/content/extract/303/1/69 (subscription required)

"Africa's struggle to be smoke free"
The Lancet     (01/09/2010)     Adele Baleta
http://www.lancet.com/journals/lancet/article/PIIS0140-6736(10)60032-3/fulltext (registration required)

"Law and the public's health"
Public Health Reports     (01/2010)     Taylor Burke
http://www.publichealthreports.org/archives/issuecontents.cfm?Volume=125&Issue=1 (subscription required"

___________________COURT OPINIONS____________________

Colorado: Content-neutral smoking regulation not ban on freedom of expression in theaters
Curious Theatre Co. v. Colorado Dept. of Public Health and Environment
Supreme Court of Colorado
Docket No. 08SC351
Filed December 14, 2009
Opinion by Justice Coats
http://www.cobar.org/opinions/opinion.cfm?opinionid=7433&courtid=1

Idaho: Tobacco sale permit requirement not preempted by Indian Commerce Clause
State v. Maybee
Supreme Court of Idaho
Docket No. 35200, 2010 Opinion No. 2
Filed January 15, 2010
Opinion by Justice Burdick
http://www.isc.idaho.gov/opinions/maybee%20final%20opn.pdf

Montana: County detention facility required to allow attorney visits during influenza outbreak
Office of State Public Defender v. McMeekin
Supreme Court of Montana
Docket No. OP 09-0610
Filed December 23, 2009
Opinion by Justice McGrath
http://caselaw.lp.findlaw.com/data2/montanastatecases/2009/003823942.pdf

Nevada: Pharmacies do not owe a duty of care to unidentifiable third parties
Sanchez v. Wal-Mart Stores, Inc.
Supreme Court of Nevada
Docket No. 47851
Filed December 24, 2009
Opinion by Chief Justice Hardesty
http://www.nevadajudiciary.us/images/advanceopinions/125nevadvopno60.pdf

Federal: Challenges to Family Smoking Prevention and Tobacco Control Act dismissed
Commonwealth Brands, Inc. v. U.S.
U.S. District Court for the Western District of Kentucky, Bowling Green Division
Civil Action No. 1:09-CV-117-M
Filed January 5, 2010
Opinion by District Judge McKinley
http://www2a.cdc.gov/phlp/docs/KY%20decision.pdf

Federal: Camp had duty to base assessment of threat of  HIV spread on medical evidence
Doe v. Deer Mountain Day Camp, Inc.
U.S. District Court for the Southern District of New York
Civil Action No. 07 Civ. 5495 (DCP)
Filed January 13, 2010
Opinion by District Judge Pogue
https://ecf.nysd.uscourts.gov/ (registration required)

Federal:  FDA does not have authority to regulate e-cigarettes as drug-device combination           
Smoking Everywhere, Inc. v. U.S. Food and Drug Administration
U.S. District Court for the District of Columbia
Civil Case No. 09-771 (RJL)
Filed January 14, 2010
Opinion by District Judge Leon
http://www2a.cdc.gov/phlp/docs/E-cigarette%20decision.pdf

__________PHL NEWS QUOTATION OF THE MONTH___________

"Cadmium causes cancer. How much cadmium do you want your child eating?"

-- Michael R. Harbut, M.D.,  director of the environmental cancer program at the Karmanos Cancer Institute in Detroit, on children's jewelry containing cadmium.

The CDC Public Health Law News is published the third Thursday of each month except holidays, plus special issues when warranted. It is distributed only in electronic form and is free of charge. News content is selected solely on the basis of newsworthiness and potential interest to readers. CDC and DHHS assume no responsibility for the factual accuracy of the items presented. The selection, omission, or content of items does not imply any endorsement or other position taken by CDC or DHHS. Opinions expressed by the original authors of items included in the News, or persons quoted therein, are strictly their own and are in no way meant to represent the opinion or views of CDC or DHHS. References to products, trade names, publications, news sources, and non-CDC websites are provided solely for informational purposes and do not imply endorsement by CDC or DHHS. Legal cases are presented for educational purposes only, and are not meant to represent the current state of the law. The findings and conclusions reported in this document are those of the author(s) and do not necessarily represent the views of CDC. The News is in the public domain and may be freely forwarded and reproduced without permission. The original news sources and the CDC Public Health Law News should be cited as sources. Readers should contact the cited sources for the full text of the articles.

For past issues or to subscribe to the CDC Public Health Law News, visit http://www2a.cdc.gov/phlp/cphln.asp. For help with subscriptions or to make comments or suggestions, send an email to Lindsay Culp at lculp@cdc.gov.

The News is published by the Public Health Law Program, Office of State and Local Support, Centers for Disease Control and Prevention (CDC), U.S. Department of Health and Human Services (DHHS). Lindsay Culp, M.P.H., Editor; Vinay Chopra, Writer. Special thanks to Tara Ramanathan, M.P.H., for her help on this issue.