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June 2007

More confusion means more deaths

That's half of the title of a piece I did recently.  The full title is  "Infection Control:   More Confusion Means More Deaths."

Lest you think the title is overkill, we make the case for confusion causing at least the deaths of two preemies in Los Angeles last year.  We relate actual correspondence between doctors and an infection control expert.  The doc is confused by conflicting standards, and the expert has to make his recommendations in an environment of regulatory malfeasance.  This would include the miserable influence of an NGO  (Non-Governmental Organization) that has WAY too much say-so in these matters.

As you will see, the FDA does not exactly have clean hands in this case, either.

At least the state of California finally overruled the absurd recommendations of AORN.  Of course, we understand that even then, the state relied very heavily on the free advice of this same expert.  That's fine, I guess, but you would think that they would have a bit more courage in their convictions.

Read all about it here, and bear in mind that despite this very public bitch-slapping, AORN has not changed anything in their best practices for the particular medical device involved.

Don't think for a moment that confusion in infection control is limited to this one case.

Yes--Lawns really are good for you and the environment

Love your lawn, and never mind the Greenie wackos, who always try to make you feel guilty about enjoying one or more of the benefits of civilization.

We take on the shrill crowd, and knock down the critics of 2,4-D (a popular weed-killer) and more right here.

This one set the record for the quickest hate mail reaction to any of my articles.  The e-mail came from a supposed Ph.D. in Canada, who tells us his dog got lymphoma from ONE small exposure to 2,4-D.

As unlikely as this is, he further revealed himself to be clueless when he added that but for the quick excision of the dog's tumor, his canine buddy would have died.  The thing is, lymphomas don't quite work that way.  This disease is a SYSTEMIC cancer of the lymphatic system.  Any tumor is simply an enlarged lymph node (or group of lymph nodes), and removal is done for diagnostic, not therapeutic purposes.

An enlarged node can be caused by any number of things, including a simple infection (as in your "glands" are swollen.)

And, just as you can't cure a cold or flu by excising the enlarged nodes, you can't cure lymphoma that way, either.  Cures are effected either by the immune system itself, or via conventional radiation or chemotherapy.

The most amusing thing on his e-mail was the assertion that EPA is not tough enough on carcinogens, since the Agency did give 2,4-D a clean bill of health.  To anyone familiar with the Agency, this assertion is so absurd as to beggar description.  In fact, the EPA has eliminated entire classes of chemicals based on the flimsiest evidence, and errs on the side of caution to such an incredible extent that this contention left me almost breathless.

But then, what can we expect from a Greenie true believer?

Has the tide turned on ethylene oxide?

Back in January, the Environmental Protection Agency presented its draft "Evaluation of the Carcinogenicity of Ethylene Oxide." On hand were members of affected industry, along with the Agency's own Science Advisory Board (SAB).

While the negative reaction of industry was expected, few anticipated that the SAB would also harshly attack the report.

Stung by this bruising rejection, EPA has to adjust some of the findings. We now discover that the Agency has contracted the services of Dr. Kyle Steenland, Professor of Environmental and Occupational Health at Emory University, Atlanta, Georgia.

According to EPA, Dr. Steenland "...has unique qualifications to provide assistance to the Agency in the evaluation of the carcinogenicity of ethylene oxide."

The Agency continues:  "He has devoted a significant part of his career to the study and evaluation of the effects of ethylene oxide on humans and has published extensively on the epidemiology of ethylene oxide related effects and methodology for analyzing data that relate to these effects."

This is a major development since even though the Agency—in its own words— "...relied heavily on the work of Dr. Steenland and his colleagues in preparing the draft," they have always taken a far more alarmist view toward this chemical than Steenland.

For more on this very important chemical, surf over here.

Sometimes, the regulators get it right: Cooperation in the enviro biz

For a textbook example of how to do things right, in the matter of restoring species to the environment, check out how steelhead and salmon are being brought back to Oregon's Deschutes Basin.

Yes, friends:  A power company, non-profits, an Indian tribe, and a state agency can work together—apparently without the need for litigation!

Colony Collapse Disorder

If you know about the birds and the bees, you are aware of the great importance of honey bees in pollinating all sorts of crops.

Too bad that there seems to be a major crisis brewing as bees are contracting a mysterious condition that some have termed as "AIDS in bees."

Get yourself up to speed on the least-reported environmental disaster since millions of Africans started dying of malaria in increased numbers after DDT was banned.

More shenanigans in infection control

Most of the public seems to be quite unaware of all the behind the scenes activities of the so-called "non governmental organizations."  We call them NGOs here in the DC area.

NGOs are usually non-profit associations, existing to promote the interests of their membership, and there is nothing inherently wrong with that.  The trouble starts when they reach a status whereby they can create consensus standards.

Far too often, these consensus standards—created without any outside scrutiny—are adopted as best practices, when they are anything but.  Readers of this blog may remember the tragic case of two preemies, who died because of a very foolish and self-serving consensus standard.

In that case, the offending NGO was AORN (Association of periOperative Registered Nurses).  Despite the rather obvious conclusion that their standard was at least indirectly responsible for the deaths, AORN did nothing.  Fortunately, the state of California did, and mandated a higher disinfection standard for the instruments involved in the fatal infection.  You might say that the State bitch-slapped AORN.

However, the beat goes on, and an even more absurd dereliction of duty is currently being promulgated by another NGO—AAMI (Association for the Advancement of Medical Instrumentation).  You can read all about it here.

If it gets you riled up—and it should—please feel free to voice your extreme displeasure to AAMI's VP of standards development, Mr. Joe Lewelling.

The life you save may be your own.