Update:
President Bush signed into law a new bill that improves U.S. mine safety standards, however the law remains far short of the measures in place in Canada that have saved the lives of numerous miners that would have likely been fatalities under the older or current U.S. safety requirements. Read the full story here.
The new law, the first of its kind since 1977, requires miners to have two hours' worth of oxygen on hand while they work, rather than one.
Mine operators also must store additional oxygen supplies underground and must put new communications equipment and devices to track lost miners in mines within three years.
The new safety law includes a requirement that rescue teams be located within an hour of each mine, rather than two hours away.
The law also calls for the government to study whether mine rescue chambers ought to be built into underground coal mines. Such refuges are credited with saving the lives of 72 potash miners in Canada earlier this year.
In reality, this new legislation would likely have had little impact on the mining deaths recorded this year. Without the rescue chambers, which were responsible for the successful rescue of the Canadian miners, it is doubtful that any lives would have been saved under these new measures. The provision to study the rescue chambers is, in my opinion, simply a deferral of necessary and proven life saving improvements that would be the most costly element of meaningful mine safety reform.
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Original Posting:
Two recent mining disasters clearly demonstrate the differences in mine safety standards between the United States and Canada. Further, the two events illuminate the inadequacy of American safety measures. According to Randal McCloy, the lone survivor of the recent Sago mine disaster, in a letter written to the families of the deceased miners, four of the emergency oxygen devices failed to operate. Twelve miners died in that ordeal. In contrast, just this January, a Canadian mine disaster ended with the successful rescue of 70 miners. The following excerpts explain the Canadian safety procedures that prevented the loss of life.
On Sunday morning, at about 3 a.m., a fire broke out more than half a mile below the surface at a potash mine in eastern Saskatchewan owned by Mosaic Co., a US-based firm that extracts the mineral used in fertilizer production.
According to the Canadian press, the miners reported smoke and then went into “refuge stations" for protection until rescuers arrived. These safe rooms are sealed-off areas as large as 15 meters (49 feet) to 45 meters (148 feet) that have an internal supply of oxygen lasting up to 36 hours, along with food, water, chairs and beds.
Throughout the ordeal, rescuers were able to stay in regular communication with two groups of mine workers in separate safe rooms. A company spokesman said they were in phone contact with the miners, as well as family members, and were able to give them reports on the progress of rescuers.
In contrast, the miners in the Sago mine, following mining safey guidelines, found an area where they could take refuge behind a makeshift curtain that they put in place after the explosion. Absent a safe room with a supply of oxygen and with only a one hour supply of oxygen, it isn't difficult to calculate the odds of a successful U.S. mine rescue.
If such safe rooms, caches of oxygen and other basic safety equipment that are commonly used in Canada, Australia and other countries were mandated in the US, it is likely that most of the men killed at the Sago Mine and the Alma Mine would be alive today. However, US mining laws do not mandate these technologies and protections. Therefore, refuge stations, for example, exist only in a handful of the largest mines and have not been widely adopted by mine companies, especially smaller ones.
US miners are only required to wear Self-Contained Self-Rescuers (SCSR)—a breathing apparatus that provides just one hour’s worth of oxygen. Even this technology—which was developed 50 years ago—was sternly opposed by the coal bosses and their representatives in government. It took 13 years after the 1968 explosion that killed 78 miners in Farmington, West Virginia, which led to the passage of the Mine Act the following year, before the adoption of SCSR regulations in 1981.
In his recent testimony before a Senate hearing, Davitt McAteer, the former head of the Mine Safety and Health Administration (MSHA), admitted that mine safety methods and technology in the US were still in “the dark ages." He noted that the lack of equipment to track the location of miners trapped underground and communicate with them had contributed to the loss of precious hours during the attempted rescue at Sago.
Unfortunately, mine safety gets little attention except for brief periods following highly publicized disasters. Sadly, the mining companies often oppose any significant safety modifications and given their financial clout, they have been able to defeat any wholesale safety reform. In this particular industry, out of sight, out of mind seems an appropriate summation of the plight of the American mine worker.
Daniel DiRito | June 15, 2006 | 2:51 PM |
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Former Food and Drug Administration Chief, Lester Crawford, testified that the delay in approving the Plan B contraceptive was primarily to allow more time to determine the guidelines for its distribution. He indicated the administration was trying to determine how to limit the over the counter sales of the product to women over the age of 17. Read the full article here.
Former FDA commissioner Lester Crawford, in a sworn statement, said he had reserved the right to decide whether to loosen the sales restrictions on the prescription-only emergency contraceptive pills. His account of that unusual and perhaps unprecedented move, given in a deposition over a lawsuit against the FDA, confirmed earlier testimony given by two senior agency officials who said he'd shut them out of the decision-making process.
Crawford said he had expected the FDA would take six to nine months — "tops" — to work out the enforcement issue following his August announcement. Crawford abruptly resigned from the agency the next month; nearly nine months later, the FDA still has not announced a Plan B decision.
Crawford's August announcement that the decision was being delayed stirred accusations that the FDA was allowing politics to trump science. But Crawford testified that the science had concluded that it was "possible" for women older than 16 to use Plan B without a prescription.
"I made a decision that that was correct. What I could not decide on is whether or not I could stand before the American people and say this will be successfully enforced. That I could not decide," Crawford said in his deposition.
The question of whether the decision was being influenced by politics becomes an increasingly significant consideration as the country approaches the November midterm elections. Senator Clinton of New York and Senator Murray of Washington have vowed to block the nomination of Dr. Andrew von Eschenbach, Crawford's replacement, until the Plan B decision is rendered.
Strategically, a decision in the next few months could influence voter sentiment. If the FDA were to deny the approval of Plan B or place numerous restrictions on its sale, it might satisfy social conservatives while also motivating the turnout of the liberal Democratic base. On the other hand, if Plan B is approved and there aren't restrictions on over the counter sales to minors, social conservatives could expand their threats to sit out the midterm election. An alternative possibility is that no decision will be forthcoming until after November if the administration feels that the potential impact on voters is too uncertain.
Crawford's actions may have left the FDA forever vulnerable to suspicion that politics is being allowed to influence decisions related to scientific and health matters. This controversy seems to be another example of the expanded executive influence sought by the Bush administration...whether that is perception or reality is yet to be determined.
Daniel DiRito | June 13, 2006 | 1:49 PM |
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The Food and Drug Administration has approved Merck's cervical cancer vaccine, Gardasil. The vaccine has garnered significant attention from the religious right as many feel the vaccine might encourage children to engage in sexual activity. See prior Thought Theater postings on the controversial nature of the vaccine here.
June 8, 2006 — The U.S. Food and Drug Administration announced today that it has approved Gardasil, a vaccine that prevents infection by some strains of the human papillomavirus, which can cause cervical cancer if left untreated.
Gardasil will protect against at least four of the 10 known cancer-causing strains, Merck said. About 270,000 women worldwide die from cervical cancer each year; about 4,000 die in the United States.
HPV is the most common sexually transmitted infection in the United States, with about 20 million people currently estimated to have it, according to the National Institute of Allergy and Infectious Diseases.
Now that the vaccine has received approval for use, the next step will be for another committee to make usage recommendations. Much of the controversy surrounding the vaccine relates to the age at which the vaccine should be administered. Some religious groups have sought to prevent the vaccine from being part of any schools health requirements.
"There is a great debate because medically speaking, it is clear it would best be given to very young girls before they become sexually active, even if they intend to be abstinent," Johnson said.
The ACIP will make a recommendation for the age requirement of Gardasil after the FDA licenses the vaccine for certain age groups. The committee also will recommend whether children should be vaccinated as a school requirement, although states are not required to follow ACIP guidelines.
"Then the state decides whether it should be a school entry law, [so] these laws will vary state to state," said Curtis Allen, spokesperson for the CDC. The recommendations of the ACIP are important since doctors practicing in the U.S. should follow them.
The FDA has been the subject of concern by some groups that have accused the organization of allowing political considerations to impact health decisions. The delayed approval of the morning after contraception pill has been the most notable instance. The Bush administration's focus on abstinence may well become an issue as the recommendations for the vaccine are finalized.
Daniel DiRito | June 8, 2006 | 2:54 PM |
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The Washington Post ran an op-ed piece by George Will on Tuesday in which he reflected on the "lessons" of the AIDS epidemic some twenty-five years after it first began. You can read the entire piece here. Quite frankly, Will's piece is wholesale trash packaged in the longstanding rhetoric that has sought to make AIDS a moral judgment...not a virus. He wastes no time in establishing his assertion.
At first it was called GRID -- gay-related immune deficiency. In September 1982 the CDC renamed it acquired immune deficiency syndrome -- AIDS.
An epidemic requires both a microbe and an enabling social context. In Africa, aspects of modernity in a primitive setting became a deadly combination: HIV was spread by roadside prostitutes serving truckers and soldiers traveling on modern roads. Africa's wars caused population dislocations; economic development caused migrations of workers across porous borders. Both weakened families and dissolved traditional sexual norms. Jet aircraft integrated Africa into the world flow of commerce and tourism. In 1980s America, the enabling context included a gay community feeling more assertive and emancipated, and IV drug users sharing needles.
If one were to connect the crafting of a paragraph intended to deliver the necessary guilty verdict with the loading of a gun in preparation for an execution, then Will has successfully appointed himself judge, jury, and executioner. He begins his invective assault with the immediate linking of the illness and enabling behavior. Never mind that every contagious or transmittable illness requires a social context; Will is simply setting the table for the coming judgments. I doubt he has written about the morality associated with failing to wash ones hands after sneezing while ill with a cold and before shaking the hand of an associate and I wonder if he will write about moral imperatives should the bird flu become an illness spread by human to human contact. Seemingly only choices involving sexual contact have moral implications.
He wastes no time asserting that "modernity" set the spread of the virus in motion in Africa and with the use of the phraseology, "HIV was spread by roadside prostitutes serving truckers and soldiers traveling on modern roads", one is left to wonder if he is insinuating that modernity brought prostitution (the oldest profession) or that only truckers and soldiers torn from their families of necessity were apt to partake in extramarital sex. He then links the spread of HIV to weakened families with dissolving "traditional" sexual norms. However, he conveniently fails to discuss the moral considerations associated with wealthy nations ignoring perpetual poverty and how it is also an enabling factor.
It is difficult to fully distill his intended nuance, but my impression is that he seeks to infer that the impact of "modernity" offers Africa some lesser moral responsibility. That assumption seems to be supported when one reads his next remark that points out the "elective" behavior of "a gay community feeling more assertive and emancipated" and they therefore must have traveled to Africa to engage in sex and return with the virus to the United States. My conclusion is that Will's moral hierarchy places gays at the bottom...where they are guilty of the sin of a chosen immorality. He proceeds to expand his moral argument.
The 14th-century Black Death killed one-third of Europe's population, but it was in the air, food and water, so breathing, eating and drinking were risky behaviors. AIDS is much more difficult to acquire. Like other large components of America's health-care costs (e.g., violence, vehicular accidents, coronary artery disease, lung cancer), AIDS is mostly the result of behavior that is by now widely known to be risky.
In providing his explanation for the deaths associated with the Black Death...whereby it resulted from inherently "innocent" actions...breathing along with eating and drinking for sustenance, he is establishing the structure with which to determine moral equivalence. He then points out that violence (crime), vehicular accidents (drunken driving), coronary artery disease (obesity), lung cancer (smoking), and AIDS (gay sex, prostitution, and extramarital sex) are the result of "risky" behavior. Not only is there an implied moral judgment, he seems to be attaching an economic moral judgment...these chosen behaviors have cost the health care system a lot of money. I wonder if he believes they should be excluded from insurance coverage. Note that he makes a moral judgment when behaviors draw money from the society but he previously omitted any discussion of moral responsibility when the lack of forthcoming money from wealthy nations could be connected to the poverty and high death rates found in Africa.
Will then asserts that "political values impeded public health requirements. Unhelpful messages were sent by slogans designed to democratize the disease -- "AIDS does not discriminate" and "AIDS is an equal opportunity disease." He goes on to conclude that by targeting "25 to 30 neighborhoods from New York and Miami to San Francisco"; HIV "could have been greatly contained". I assume that by concluding that there were efforts "to democratize the disease", Will is saying we just didn't want to place blame where it belonged. He seems to be suggesting that what was needed was a focus on gay neighborhoods. Those remarks ignore the fact that the Reagan administration simply ignored the disease. His statement also discounts the proactive efforts of gay communities to take the lead in educating and informing themselves...even without adequate government support or funding. The reality is that gays have driven the efforts to combat HIV from the outset...because we have often had a government that has ignored the disease or failed to lead.
He then has the audacity to offer an absurd defense of Ronald Reagan's failure to address AIDS by stating, "No president considers it part of his job description to tell the country that the human rectum, with its delicate and absorptive lining, makes anal-receptive sexual intercourse dangerous when HIV is prevalent." Really" Is Will arguing that Reagan or any President can only be expected to talk about and address the issues of those who have heterosexual sex? I'm not certain what Will is trying to say, but I find it illogical and offensive. First, no one asked Reagan to explain the human rectum (Will does a good job of depicting one)...the issue was that he failed to even speak the acronym or discuss the topic at all until 1987. Again, the inference is that a President has no responsibility to those who "elect" to engage in "risky" behavior...and of course what he really means to say, those who do are actually engaging in immoral behavior. He doesn't stop there.
There has, however, been an increase in unsafe sex, because pharmacological progress has complicated the campaign against this behavior-driven epidemic. Life-extending cocktails of antiviral drugs now lead some at-risk people to regard HIV infection as a manageable chronic disease, and hence to engage in risky behavior. Furthermore, the decline of AIDS mortality rates means that more persons are surviving with HIV infection -- persons who can spread the virus. And drugs such as Viagra mean that more older men are sexually active.
I'm not sure if Will is lamenting that the disease has become more manageable, or that at least when people died we were rid of the carriers, or that positive individuals should be celibate, or that only older heterosexual men should have access to Viagra. Instead of celebrating the fact that AIDS is no longer a certain death sentence; he seems to simply focus on the fact that living longer merely increases the potential to spread the disease.
Sex is a natural human activity and while one won't die from its absence, as with the deprival of food and water, each individual is entitled to make reasonable decisions to participate in the human experience. Does HIV come with responsibilities to protect sexual partners...absolutely. Are there risks...certainly. Do we have the right to prevent people from engaging in consensual sexual activities...I don't think we do. The reality of sexual contact is the same reality that comes with all human contact...there are risks. We live each day with the possibility that other transmittable and potentially fatal diseases could be on the horizon. If they emerge, they will be unfortunate diseases, not new opportunities to affix moral judgments.
The Centers for Disease Control and Prevention estimates that there are nineteen million new STD infections each year. If they were to become life threatening diseases similar to HIV, the 25 years of AIDS that have resulted in some 530,000 deaths will seem insignificant by comparison. We all live with the hope that a sneeze won't expose us to a deadly flu or that a handshake won't pass a fatal infection. Unfortunately the forces of nature bring changes that may one day make it risky to leave one's home.
Will seems to think he is imparting some insightful observations that demonstrate that he has a grasp on the AIDS epidemic as well as human nature. Instead, his article provides a better view of the bias and judgment that has hindered the progress to combat HIV and that is also an all too frequently chosen human behavior. In concluding that humans are slow to learn from the AIDS epidemic, he has at the same time pointed out that he and many others are even slower to shed their propensity to make moral judgments that result from longstanding bias and bigotry. In failing to point out the costs associated with that behavior, Will seems unable or unwilling to heed his own final words, "Human beings do learn. But they often do at a lethally slow pace." If George Will won't point that out, I will.
Daniel DiRito | June 6, 2006 | 9:03 PM |
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Following up on prior condemnations, the Vatican issued a statement expressing strong opposition to abortion, same-sex marriage, and in-vitro fertilization...calling them threats to the traditional family. Read the full article here. See prior Thought Theater postings on the subject here.
The document was issued by the Pontifical Council for the Family, whose head, Cardinal Alfonso Lopez Trujillo, is a strong opponent of the use of condoms under any circumstances.
However, the document did not mention an ongoing debate within the Vatican on whether the Roman Catholic Church could permit condoms to battle AIDS in a particular circumstance -- when one partner in a marriage has the virus.
While there has been some hopeful mention that the Church would moderate its opposition to the use of condoms in order to combat HIV, the Church remains slow to react to the realities of the AIDS crisis. At the same time, the latest condemnation is one in a long string of statements released that continue to emphasize the rigid position of the Church.
It reaffirmed the famous 1968 encyclical "Humanae Vitae" that stated the Vatican's opposition to contraception. Since then, it said, couples "have been limiting themselves to one, or maximum two children."
"Never before in history has human procreation, and therefore the family, which is its natural place, been so threatened as in today's culture," said the 57-page document.
It also condemned in-vitro fertilization, artificial insemination and the use of embryos.
"The human being has the right to be generated, not produced, to come to life not in virtue of an artificial process but of a human act in the full sense of the term: the union between a man and a woman," the document said.
Lopez Trujillo sparked controversy three years ago when he said condoms don't prevent AIDS and may help spread it because they create a false sense of security. The Vatican insists sexual abstinence is the only sure way to fight AIDS.
The document made a broad attack on what it said were threats to the "the natural institution of marriage."
Daniel DiRito | June 6, 2006 | 8:51 AM |
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