From the Public Health Law Program, Office of the Chief of Public Health Practice, CDC
http://www2a.cdc.gov/phlp/

*** Mental Health Court Guidance Document. The Council of State Governments and the Bureau of Justice Assistance recently released a guidance document for the rising number of mental health courts. The document entitled "Improving Responses to People with Mental Illnesses: the Essential Elements of a Mental Health Court" is available at http://consensusproject.org/mhcp/essential.elements.pdf .

*** 1918 Influenza Information. The U.S. Department of Health and Human Services recently released an online resource that explains the circumstances and history of the 1918 influenza pandemic. "The Great Pandemic: the United States in 1918-1919" is available at http://1918.pandemicflu.gov/index.htm.

*** Climate Change Legislation White Paper. The U.S. House Committee on Energy and Commerce and its Subcommittee on Energy and Air Quality have issued a white paper as the next step toward legislation establishing a climate change program. To read the white paper, see http://energycommerce.house.gov/Climate_Change/white%20paper%20st-lcl%20roles%20final%
202-22.pdf.

*** Immunization Conference (3/17-3/20). Regular registration for the 42nd National Immunization Conference runs through February 29, 2008. The conference will be held on March 17-20, 2008, in Atlanta, Georgia, and includes sessions covering on health education policy and legislation. For more information, see http://www.cdc.gov/vaccines/events/nic/default.htm.

Top Story

1. Climate change: the public health response

States and Localities

2. California: Beef in massive recall proves tough to trace

3. Georgia: Georgia syphilis rate is 3rd highest

4. Louisiana: Lawsuits over formaldehyde in trailers likely won't target dealers

5. Maine: Court invalidates Maine tobacco law

National

6. Fewer youths jump behind the wheel at 16

7. States redefine family health policies, seeking to cover young adults

8. U.S.: states better prepared for disasters

Briefly Noted

California health care · Gulf Coast deaths · Minnesota smoking ban · Mississippi flood regulations · New Jersey autism ruling · Oklahoma emergency managers · Poultry litter case · West Virginia smelter case · National caffeinated alcoholic beverages · OSHAct review · Toxics testing · HPV vaccination · Foreign service HIV ban · Brazil alcohol ban · Canada helmet case · China alcohol ban · Mexico smoking ban

Quotation of the Week

A Chinese government official

This Week's Feature

New Tools in Public Health Law. This week, the News features a Memorandum of Understanding forged between federal agencies responsible for assessing the toxicity of chemicals. See below for more.

_____________________________1_____________________________

"Climate change: the public health response"

American Journal of Public Health     (03/08)     Howard Frumkin and others

http://www.ajph.org/cgi/content/abstract/AJPH.2007.119362v1 (subscription required)

The authors of this paper propose a public health approach to climate change based on the ten essential services of public health. First, they review the links between weather, climate, and the health of the public. As a result of climate change, public health practitioners can expect "injuries and fatalities related to severe weather events and heat waves; infectious diseases related to changes in vector biology, water, and food contamination; allergic symptoms related to increased allergen production; respiratory and cardiovascular disease related to worsening air pollution; and nutritional shortages related to changes in food production." The authors introduce principles of a proactive response to these issues, including preparedness, risk management, and ethics. The standard framework for public health action is the ten essential services of public health, which include "mobilizing community partnerships to identify and solve health problems," "developing policies and plans that support individual and community health efforts," and "enforcing laws and regulations that protect health and ensure safety." The authors point to several areas where coordination and collaboration with government agencies, non-governmental legal partners, and emergency planners could strengthen the public health response to challenges caused by climate change. The authors also call on public health practitioners to share information with decision makers and to "explain the health rationale for climate change mitigation in terms of reduced morbidity and mortality," and "provide evidence on the health impacts of various approaches to climate change mitigation."

[Editor's note: To read more about climate change, visit the Intergovernmental Panel on Climate Change, a scientific intergovernmental body established by the World Meteorological Organization and the United Nations Environment Programme, at http://www.ipcc.ch/.]

_____________________________2_____________________________

"Beef in massive recall proves tough to trace"

Sacramento Bee     (02/20/08)     Carrie Peyton Dahlberg

http://www.sacbee.com/101/story/724950.html

This month's national beef recall has highlighted a new California law and prompted debate over the role of regulators in informing the public about products that contain potentially tainted meat. Earlier this month, the U.S. Department of Agriculture (USDA) declared 143 million pounds of beef production from Westland/Hallmark Meat Co. unfit for human consumption. "There would be no way you would know if [the recalled beef is] an ingredient" in a canned pasta sauce or a frozen dinner, said Linda Harris, a food microbiologist at the University of California Davis. However, under a California law that took effect last year, wholesalers of recalled meat are required to provide state public health officials with a full list of their customers. This beef recall will provide the first test of the law, according to the Consumers Union, which lobbied heavily for the law. To date, neither USDA nor Westland/Hallmark Meat Co. has revealed all the products in which recalled beef was used, but according to a spokeswoman at the California Department of Public Health, officials there are "working closely with USDA and others to obtain distribution information." The recall was prompted by a Humane Society undercover video showing that Westland/Hallmark violated a federal rule requiring veterinary approval prior to food-processing cows which are not able to walk to their deaths on their own; falling can be a sign of bovine spongiform encephalopathy (mad cow disease) or other health problems. More than 37 million pounds of the recalled meat went to school lunch or other nutrition programs.

[Editor's note: To read California SB 611, establishing California Health and Safety Code Section 110806-110807, see http://info.sen.ca.gov/pub/05-06/bill/sen/sb_0601-0650/sb_611_bill_20060929_chaptered.pdf.]

_____________________________3_____________________________

"Georgia syphilis rate is 3rd highest"

Chattanooga Times Free Press     (02/18/08)     Erin Fuchs

http://www.timesfreepress.com/news/2008/feb/18/georgia-syphilis-rate-3rd-highest/

Almost five years after the Georgia legislature eliminated pre-marriage blood testing, syphilis infections have fluctuated, making the state third among those with highest rates in the nation. Rates in Georgia were 2.7 times the national average the year the mandate was eliminated; two years later, the state rose to become first-in-the-nation with 645 cases. Syphilis cases have decreased slightly since then, dropping Georgia to third place. National statistics show that syphilis cases have increased 13.8 percent between 2005 and 2006. According to CDC, the increase is "driven largely" by homosexual men; an 11 percent increase in earlier-stage syphilis among women nationally from 2005 to 2006 is another concern for health officials. The testing mandate was eliminated in 2003, when state lawmakers believed the need for such tests was "outdated." But experts still debate the utility of pre-marriage testing. Testing usually will not affect the spread of syphilis, according to Fred Wyand, spokesman for the American Social Health Association. "They've probably already had sex, in most cases," he said. Georgia recently launched a "Get Tested" campaign, designed to encourage early testing, when the disease is most treatable. Ken Ellinger, a political science professor at Dalton State College, said he believes the legislature acted in good faith when it eliminated the testing requirement, but says, "[i]t only seems logical to seriously consider reinstating the syphilis testing requirement. Marriage is one of the few activities where the state is in a strong legal position to mandate a medically necessary test."

[Editor's note: To learn more about syphilis from CDC, visit http://www.cdc.gov/std/syphilis/default.htm.]

_____________________________4_____________________________

"Lawsuits over formaldehyde in trailers likely won't target dealers"

The Courier-Journal     (02/26/08)     Ben Zion Hershberg

http://www.courier-journal.com/apps/pbcs.dll/article?Date=20080219&Category=NEWS02&Art
No=802190418&SectionCat=ZONE11&Template=printart

An estimated 10,000 occupants or former occupants of Federal Emergency Management Agency (FEMA) trailers have filed lawsuits over formaldehyde exposure, mainly naming manufacturers as defendants. Last week, CDC released a study that found one-third of 519 trailers being used by victims of Hurricane Katrina had formaldehyde levels high enough to create breathing problems for children, the elderly, and susceptible adults. Five percent of the trailers were found to have levels high enough to make healthy adults ill. Formaldehyde -- a preservative that can irritate the respiratory system and is classified as a probable carcinogen by the U.S. Environmental Protection Agency -- is used in composite-wood and particle-board products found in trailers. Allegedly affected occupants may also be able to sue trailer dealers if relevant state laws make dealers potentially responsible for health problems, said Tony Buzbee, an attorney for trailer occupants. Buzbee said FEMA could also be added as a defendant in the litigation. However, proving that health problems resulted from the formaldehyde exposure is difficult and may lead to a relatively small settlement, according to Thad Goldfish, a Ball State University professor who has consulted on some 300 lawsuits involving health problems in trailers and mobile homes. "I don't think [trailer dealers] need to worry too much," Goldfish said. A New Orleans federal court consolidated about a dozen FEMA trailer cases in December with six law firms now handling litigation for the plaintiffs, Buzbee said.

_____________________________5______________________________

"Court invalidates Maine tobacco law"

Washington Post     (02/20/08)     Pete Yost

http://www.washingtonpost.com/wp-dyn/content/article/2008/02/20/AR2008022001103.html

Last week the Supreme Court invalidated segments of a Maine law regulating transportation companies that deliver tobacco products ordered online. Maine required delivery companies to intercept packages from unlicensed tobacco sellers and to verify the age of the buyers, arguing that federal transportation law "does not pre-empt a State's efforts to protect its citizens' public health," according to the Court opinion. But the Court held that federal law, specifically the Federal Aviation Administration Authorization Act of 1994, preempted the state regulation. "The Act says nothing about a public health exception. To the contrary, it explicitly lists a set of exceptions (governing motor vehicle safety, certain local route controls, and the like), but the list says nothing about public health," wrote Justice Stephen Breyer. The delivery companies fighting Maine's law had argued that it saddled the industry with additional costs and that when Congress deregulated the transportation industry, states were not supposed to step in and fill the void. The Court ruling came at a time when several of the transportation industry's biggest players had agreed to stop shipping cigarettes directly to consumers from illegal Internet sellers, largely in response to an aggressive campaign in the state of New York. The Court ruling could clear the way for companies to challenge the agreements they made and enable the transportation industry to argue that similar laws in other states are invalid. In addition to Maine, 31 other states have cigarette delivery laws to target the problem of underage smoking. 

[Editor's note: To read Rowe v. New Hampshire Motor Transport Association, No. 06-457 (U.S. Feb. 20, 2008), see http://www.supremecourtus.gov/opinions/07pdf/06-457.pdf.]

_____________________________6_____________________________

"Fewer youths jump behind the wheel at 16"

New York Times     (02/25/08)     Mary M. Chapman and Micheline Maynard

http://www.nytimes.com/2008/02/25/business/25drive.html?em&ex=1204088400&en=5a8064ee1
f7f7db9&ei=5087%0AA

Nationwide, the proportion of 16 year-olds with driver's licenses has declined in the aftermath of graduated driver-licensing laws, which have been in existence for about a decade. According to the Federal Highway Administration, the national rate of licensed 16 year-olds dropped from 43.8 percent in 1998 to 29.8 percent in 2006. "It's a big change in a major American ritual of driving as early as possible," said Michael T. Marsden, an expert on car culture and dean of St. Norbert College in De Pere, Wisconsin. Graduated driver-licensing laws delay awarding a full license until a teenager spends a certain amount of time driving with a parent or driving under certain conditions. Since these laws have been enacted, the number of fatal crashes involving 16-year-old drivers has fallen by 11 percent, according to a 2006 study by Johns Hopkins Bloomberg School of Public Health. Graduated driver-licensing laws that took effect in Illinois last month rank are among the most restrictive in the country, according to the National Conference of State Legislatures. Under the those laws, Illinois drivers up to age 17 have a weekend driving curfew of 11:00 p.m.; the length of a learner's permit is increased from three to nine months; and the number of training hours behind the wheel increased from one hour of actual driving time to six. In addition to the more-restrictive laws, the decline in 16-year-old drivers is also being attributed to parental overprotection, computer addiction, higher insurance rates, and the decline of driver's education courses in local schools.

[Editor's note: To read the text of the changes to Illinois driving laws, see http://www.ilga.gov/legislation/publicacts/95/PDF/095-0310.pdf and scroll to Sec. 6-107 Graduated license. For general information on the Illinois Graduated Driver's Licensing Program, see http://www.cyberdriveillinois.com/publications/pdf_publications/dsd_a1328.pdf.]

_____________________________7_____________________________

"States redefine family health policies, seeking to cover young adults"

Associated Press     (02/21/08)     Kevin Freking

http://www.dailyherald.com/story/?id=1393644

Over the past two years, 17 states have passed "slacker mandate" laws allowing young adults to remain on their parents' health insurance plans even if they are not enrolled in college full time. In the past, almost all states regulating insurance plans for small- and medium-sized employers set a maximum age for dependent children: usually 19 for non-students and 23 for full-time college students. In the 17 states with new laws, the age limits range from 24 in Delaware, Indiana and South Dakota, to 30 in New Jersey. Eleven states settled on age 25. According to the Commonwealth Fund, a health research organization, 1.4 million people would gain health insurance if every state extended dependent coverage to age 23. "This is one way states can address a specific age group and not have to expend a lot of state resources to extend health coverage," said Laura Tobler, health program director at the National Conference of State Legislatures. However, some in the insurance industry claim that such a policy mandate ultimately would result in increased premiums for families and employers. "Sometimes when states jump on a bandwagon, it's not necessarily the right bandwagon for the people they're trying to help," said Susan Laudina, director of state research and policy at the Blue Cross and Blue Shield Association. The National Conference of Insurance Legislators will vote within the next two weeks on a policy recommendation that supports increasing the age for dependent coverage to 25.

[Editor's note: To read New Jersey's law, Chapter 375, see http://www.njleg.state.nj.us/2004/Bills/PL05/375_.HTM.]

_____________________________8_____________________________

"U.S.: states better prepared for disasters"

Associated Press     (02/21/08)     Mike Stobbe

http://ap.google.com/article/ALeqM5jsW6cOpnsCKm0KQkAH7dPbxG-6kAD8UUC9KO0

CDC's Coordinating Office for Terrorism Preparedness and Emergency Response (COTPER) has released its inaugural report on emergency public health preparedness in U.S. states. The report was the first assessment of states' readiness since 2001, when the federal government began investing what would become $5 billion to make the country better prepared. The report considered the staffing, laboratory capabilities, and other resources available to local, state, and territorial health departments for response to bioterrorism or other public health disasters. For example, more local and state health departments are now able to detect biological agents than in 2002; nearly 50 laboratories for detecting chemical agents exist now, up from zero in 2001. COTPER also found that all states are now conducting year-round influenza surveillance, and have improved their ability to share information between laboratories and public health departments. COTPER indicated that some areas are still in need of improvement: many states do not have enough epidemiologists; state laws need to be updated; and disease surveillance data exchange in 16 states appears to be inadequate. Public health experts cited a steady decrease in funding from the federal government as an impediment to states' readiness. "You can't expect states to be doing better if the federal government keeps cutting funding," said Jeff Levi, executive director of Trust for America's Health. Overall, COTPER officials were positive about states' progress. "I think in terms of effort and progress, an 'A.' In terms of amount of work to be done, I would say that's absolutely enormous," said Director Richard Besser.

[Editor's note: To read "Public Health Preparedness: Mobilizing State by State: A CDC Report on the Public Health Emergency Preparedness Cooperative Agreement," visit http://emergency.cdc.gov/publications/feb08phprep/.]

_____________________BRIEFLY NOTED______________________

California: SCOTUS upholds nation's first ordinance offering health care to all uninsured

"Top U.S. court backs S.F. health care"

San Francisco Chronicle     (02/22/08)     Bob Egelko

http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2008/02/22/BAEKV6KF2.DTL

Gulf Coast: Expert suspects strong social ties helped blacks survive

"Data: Most Hurricane Katrina victims were not black"

Scripps Howard News Service     (02/20/08)     Gavin Off

http://www.scrippsnews.net/node/30871

Minnesota: Bars stage 'theater nights' to dodge ban

"Smoking ban workaround catches on at bars across state"

Star Tribune     (02/22/08)     Mary Lynn Smith

http://www.startribune.com/local/15859722.html

Mississippi: Gulfport officials will send letters for buildings below federal flood regs

"City dotting FEMA's I's, crossing its T's"

Sun Herald     (02/21/08)     Ryan LaFontaine

http://www.sunherald.com/201/story/383468.html

New Jersey: Judge rules testimony did not meet standards of admissibility

"Wyeth says it wins autism case"

Associated Press     (02/19/08)

http://www.forbes.com/markets/feeds/afx/2008/02/19/afx4671605.html

Oklahoma: State had most presidential disaster declarations in 2007

"After disaster-filled year, emergency managers meet at Capitol"

Associated Press     (02/20/08)     Murray Evans

http://newsok.com/article/3206426/1203469468

Oklahoma: Poultry industry said to 'infest' waterways, threaten public health

"State seeks injunction in poultry litter case";

Daily Oklahoman     (02/20/08)     Jim Stafford

http://newsok.com/article/3206454/1203479878

West Virginia: Court erred in estimating cost of medical monitoring, DuPont says

"DuPont to appeal rulings in Spelter case"

Reuters     (02/26/08)   

http://www.reuters.com/article/rbssIndustryMaterialsUtilitiesNews/idUSWNAS243020080226

National: AGs issue demands for documents regarding caffeinated alcoholic drinks

"Anheuser, Miller face marketing probes"

Wall Street Journal     (02/21/08)     David Kesmodel

http://online.wsj.com/article/SB120353386557580553.html (subscription required)

National: Article reviews promise of OSHAct of 1970

"Getting home safe and sound: Occupational Safety and Health Administration at 38"

American Journal of Public Health     (03/08)     Michael Silverstein

http://www.ajph.org/cgi/content/abstract/AJPH.2007.117382v1 (subscription required)

National: Agencies change approach to meeting regulatory requirements

"Transforming environmental health protection"

Science     (02/15/08)     Francis S. Collins and others

http://www.sciencemag.org/cgi/content/summary/319/5865/906 (subscription required)

National: Author examines ethics regarding mandatory HPV vaccines for boys

"Vaccinating boys for girls' sake?"

New York Times     (02/24/08)     Jan Hoffman

http://www.nytimes.com/2008/02/24/fashion/24virus.html

National: State Dept removes HIV from list of conditions preventing foreign service

"U.S. drops ban on HIV-positive diplomats"

Associated Press     (02/15/08)     Matthew Lee

http://ap.google.com/article/ALeqM5hlY6eMq8aiHFMKf686i8V9VKxvZAD8UR5UV01

Brazil: Government tries to limit alcohol advertising and sales along highways

"Brazil alcohol ban hard for retailers to swallow"

Christian Science Monitor     (02/19/08)     Andrew Downie

http://www.csmonitor.com/2008/0219/p04s01-woam.html

Canada: Devout Sikh battles fine for wearing a turban while motorcycling

"Judge to rule March 6 in Sikh's battle over helmet law"

Canadian Press     (02/20/08) 

http://www.thesudburystar.com/ArticleDisplay.aspx?e=908705

China: Alcohol makers to fight ban on government officials drinking during lunch break

"China firms fight boozy lunch ban"

BBC     (02/20/08)

http://news.bbc.co.uk/2/hi/asia-pacific/7254380.stm

Mexico: New smoking ban to take effect in July

"Banning smokes"

Mexico City News     (02/25/08)     Nacha Cattan

http://www.canada.com/ottawacitizen/news/opinion/story.html?id=c81bf07c-bc1d-40db-8b3f-35fb69
ef756e

__________PHL NEWS QUOTATION OF THE WEEK___________

"Since the ban took effect, I have fallen into the habit of not drinking at midday on workdays."

-- A Chinese government official on a ruling banning officials from drinking during their lunch break. The ban was introduced in a bid to improve government efficiency. [See Briefly Noted item, above.]

___________NEW TOOLS IN PUBLIC HEALTH LAW____________

In an unprecedented move, the U.S. Department of Health and Human Services (HHS) National Institute of Environmental Health Science (NIEHS)/National Toxicology Program (NTP), the HHS National Human Genome Research Institute (NHGRI) NIH Chemical Genomics Center (NCGC) and the U.S. Environmental Protection Agency (EPA) have come together to begin the reduction or replacement of in vivo (live organism) research.

The agencies are charged with evaluating the toxicity of chemicals, traditionally by using a variety of animal species to predict the human response. According to a Memorandum of Understanding between the agencies, "reduction or replacement of animals in regulatory testing is anticipated to occur in parallel with an increased ability to evaluate the large numbers of chemicals that currently lack adequate toxicological evaluation." In other words, the move from using animals to test toxic chemicals will allow the agencies to test more chemicals more quickly and will make the results of that testing more predictive of the human response to such chemicals.

A main impetus for the project "was a strong commitment by both agencies that future toxicity testing and assessment paradigms meet evolving regulatory needs (e.g., that the paradigms readily accommodate the increasingly large numbers of substances that need to be tested)." Data generated by alternatives to animal-based testing will be "provided to risk assessors to use in the protection of human health and the environment."

The agencies entered into the Memorandum pursuant to their respective authorities under the Clean Air Act, the Safe Drinking Water Act, the Toxic Substances Control Act, the Federal Insecticide, Fungicide, and Rodenticide Act, and the Public Health Service Act.

To read the Memorandum of Understanding, visit http://www2a.cdc.gov/phlp/docs/ntpncgcepamou.pdf.

For more information, read Toxicity Testing in the 21st Century: A Vision and a Strategy, a publication of the National Academies Press, available at http://www.nap.edu/catalog.php?record_id=11970#toc.

___________________________________________________________

The CDC Public Health Law News is published each Wednesday 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 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 news sources for the full text of the articles.

For past issues or to subscribe to the weekly 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 Rachel Weiss at rweiss@cdc.gov.

The News is published by the Public Health Law Program, Office of the Chief of Public Health Practice, Centers for Disease Control and Prevention (CDC), U.S. Department of Health and Human Services (DHHS). Rachel Weiss, J.D., Editor; Christopher Seely, J.D., Associate Editor; Karen L. McKie, J.D., M.L.S., Editorial Advisor.