May 31, 2017

ANNOUNCING $56.8 Million in FY17 Brownfields Assessment and Cleanup Grants

EPA is pleased to announce that 172 communities will receive 279 grants totaling $56.8 million in EPA Brownfields funding through our Assessment and Cleanup Grants. These funds will aid under-served and economically disadvantaged communities through the assessment and cleanup of abandoned industrial and commercial properties and expand the ability of communities to recycle vacant and abandoned properties for new, productive reuses.

List of FY17 Grants Selected for Funding

Fact Sheets of All Selected Applicants

Women in Green Cleaning Free Webinar

Friday, June 2

1-2 p.m. Central Time

What are the unique challenges facing women in the cleaning industry? What are some of the ways women can help mentor and support each other to help grow the green cleaning movement? Let's take a look at these questions—and more—in this important discussion with some of Healthy Schools Campaign's strongest champions.

The Women in Green Cleaning panel will feature some of the most inspiring and hard-working women leading the field of green cleaning right now. Each woman will discuss her own career in the traditionally male-dominated cleaning industry, offering advice for how to overcome the unique challenges of the different areas in the field. Panelists will also discuss their reasons for supporting the green cleaning movement.

  • Diana Stewart, President, EnvirOx
  • Tracy Enger, Indoor Air Quality Tools for Schools Project Manager, EPA
  • Kim Thomas, Executive Director, Plant Services and Custodial Operations, Clarke County School District in Georgia
  • Shawna Cragun, Director of Custodial Services, Davis School District in Utah

We want to hear from you, too! Are you a woman in green cleaning? Whether you've been at this for decades, blazing your own trail, or if you're new to the game—please join us for this first-ever discussion of women in green cleaning. We will be leaving ample time in this webinar for questions and discussion from our network.

The Women in Green Cleaning panel will feature some of the most inspiring and hard-working women leading the field of green cleaning right now. Each woman will discuss her own career in the traditionally male-dominated cleaning industry, offering advice for how to overcome the unique challenges of the different areas in the field. Panelists will also discuss their reasons for supporting the green cleaning movement.
Women in Green Cleaning panelists include—
Kim Thomas, Executive Director of Plant Services and Custodial Operations at Clarke County School District in Georgia. Kim is a long-standing champion of the IAQ Tools for Schools program. To hear more about her stellar program, be sure to view the EPA IAQ Master Class webinar "Creating Healthy Indoor Environments in Schools: The Knowledge Network and Actions You Need." Click on this link to view this webinar and all of our webinars on-demand:

Shawna Cragun, Director of Custodial Services at Davis School District in Utah. Meet Shawna on this webinar, then dive into the details of her program on Thursday, June 22, during EPA's IAQ Knowledge-to-Action webinar "Green Cleaning for Improved Health: The Return on Investment of Green Cleaning in Schools."

Diana Stewart, President of Envirox. Diana will provide insight into Envirox's commitment to supporting student health and wellness through safer, healthier cleaning technology.


TOXIC CHOCOLATE: that 45 of the 70 chocolate products contain lead and/or cadmium above the safe harbor threshold of California’s Safe Drinking Water and Toxic Enforcement Act of 1986

As You Sow has conducted independent laboratory testing of 70 chocolate products for lead and cadmium. We found that 45 of the 70 chocolate products contain lead and/or cadmium above the safe harbor threshold of California's Safe Drinking Water and Toxic Enforcement Act of 1986 (Proposition 65). Based on these results, we have filed notices with 18 manufacturers, including Trader Joe's, Hershey's, Mondelēz, Lindt, Whole Foods, Kroger, Godiva, See's Candies, Mars, Theo Chocolate, Equal Exchange,  Ghirardelli, Earth Circle Organics, and more, for failing to provide the legally required warning to consumers that the products contain cadmium or lead, or both.

No level of lead is safe for children. Lead exposure has been a significant public health issue for decades. Lead is linked to a variety of neurological impairments, including learning disabilities, seizures, and a lower IQ. Developing fetuses and children are especially vulnerable to lead exposure because their brains are in critical growth and development stages.

"As underscored by the Flint disaster, humans have contaminated our environment with lead, and now we must do everything in our power to protect ourselves and our children, who are the most vulnerable of us, from every possible exposure," said Sean Palfrey, MD,  a pediatrician and Professor of Pediatrics and Public Health at Boston University School of Medicine. "Young children and pregnant women especially should avoid exposure to lead."

Cadmium can cause damage to the kidney, liver, and bones, while also impairing neurobehavioral development. Lead and cadmium are both listed under the act as reproductive toxins.

California law ensures consumers receive warnings before they are harmed. To protect consumers, companies should take immediate steps to remove these toxic heavy metals from their products or, at a minimum, to provide consumers with warnings according to Proposition 65. If the heavy metals are not removed, people need to be informed so they can protect themselves and their families.

Read full at:

May 30, 2017

FREE Webcast on Injury & Illness Recordkeeping @jjkeller

Injury and Illness Recordkeeping 9-1-1: Status of the revised rule

Tuesday, June 6th 10:00 AM Central Time

(11:00 ET, 9:00 MT, 8:00 PT) – Register Now!

OSHA has significantly revised its Injury and Illness Recordkeeping requirements, which will affect the recordkeeping experience for the majority of employers.

But the core of what an employer must do has not really changed.  You must still evaluate each injury and illness for its recordability according to OSHA's criteria in Sections 1904.5 through 1904.7, and log it within seven working days of finding out about it. You're still required to keep and maintain the OSHA 300 Log for each establishment that is required to keep records, and fill out and post the 300-A Summary by February 1st each year.

There have been significant changes as well. These may affect post-incident drug testing policies in your workplace and incentive programs which are tied to your incident rates.

This webcast will present a clear picture of:

• the status of the rule changes, 

• electronic reporting of injuries and illnesses, and 

• employer responsibilities under OSHA's Part 1904 Injury and Illness Recordkeeping rules

May 26, 2017

DERMaL ETool Kit for HAZMAT emergency preparedness responders, incident commanders, and other emergency management professionals

The DERMaL eToolkit provides emergency preparedness responders, incident commanders, and other emergency management professionals a resource library of references and information related to dermal (skin) exposure to chemicals.

Each resource was reviewed and rated by a team of subject matter experts in the emergency management field. This ensures the most relevant resources (according to selected criteria) are displayed at the top of the list.

To begin, click on the incident phase you are currently in, or choose...

Browse All Resources


Learn more about the DERMaL eToolkit, by viewing these publications. A dermal checklist for assessing risks during response activities involving chemicals (PDF, 205Kb) (adapted from Dotson et al.) contains key questions to ask during a risk analyses (i.e., risk assessment, risk management).

The EPA's Board of Scientific Counselors (BOSC) is seeking nominations for qualified scientists.

The EPA's Board of Scientific Counselors (BOSC) is seeking nominations for qualified scientists. The BOSC provides scientific and technical advice to EPA's Office of Research and Development. Environmental anthropology is highlighted as a "desired expertise" they are seeking. Applications are due June 30, 2017. 

Apply online at

May 24, 2017

EPA To Host Finance Forum for Drinking Water Systems on July 26

The EPA's Water Infrastructure Resiliency and Finance Center, in collaboration with the Environmental Finance Center at UNC  and the Alabama Department of Environmental Management, is hosting a finance forum for drinking water systems. The forum will take place on July 26 from 9:00 a.m. to 4:00 p.m. at the Marriott Shoals Hotel in Florence, Alabama. 

Water utilities generally get most of their revenue from user charges. In order to ensure proper funding of utilities, it is critical that small water systems fully understand both rate setting and long-term fiscal planning. Systems should understand how policy decisions that promote economic development or conservation can impact revenues and aim to set rates that promote utility priorities while recovering the full cost of operation.
The forum will help ensure the financial stability of your water system while providing safe, quality drinking water at fair rates. Topics include many aspects of financial management and planning of a water system fund including rates and rate setting, controlling costs, planning for capital expenses, benchmarking financial performance, and collaboration between nearby small systems.
This forum is designed for drinking water systems serving 10,000 or fewer people, especially targeting local government systems facing financial challenges. Owners of privately owned systems, consultants and technical assistance providers serving small water systems are also invited to attend, provided that there is space.This forum is being offered at no cost to participants.
Small drinking water systems in the following eight Region 4 states are invited to register:  Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina and Tennessee.  The forum has been submitted for CEUs to the various states. Register for the forum here.

May 23, 2017

Free Webinar: Group Lockout Techniques that Work

Wednesday, May 31, 2017 at 12:00 pm Central 

Many lockout accidents occur because one person unknowingly triggers machinery startup or a release of stored energy that injures other people working in associated danger zones. What accident investigations usually determine as a root cause is that each participating worker did not adequately protect themselves with personal control of the energy sources that hurt them. Group lockout would have made the difference.

This webinar discusses several scenarios of how hazardous energy accidents happen and how failure to communicate and insufficient or no personal lockout protection can lead to an accident. We will look in-depth at OSHA requirements for group lockout. And we will also cover a number of best-practice group lockout strategies based on ANSI Z244.1 that apply to all exposed workers, regardless of the scale of the work being performed. From simple 2- or 3-person tasks, to complex multi-employer project sites, group lockout solutions will be discussed to provide everyone the ability to participate in protecting themselves from the dangers of unexpected machinery activation or process flows.



TODD GROVER has more than 30 years of experience as a practicing safety professional and EHS manager and has a business degree in administrative management. Grover also holds an Advanced Safety Certification through the National Safety Council and is an OSHA-authorized instructor for both the general industry and construction 10- and 30-hour courses. He worked with a wide range of industries to prepare numerous lockout policies and detailed procedures, develop company-specific compliance training, and perform accident investigations. Grover has represented dozens of employers during lockout-related OSHA citation cases. He has worked with control of hazardous energy lockout/tagout since the inception of the OSHA 1910.147 standard and is currently a participating member of the ANSI Z244.1 committee on control of hazardous energy, as well as a delegate to the U.S. PC283 committee contributing to the upcoming ISO 45001 Global Standard for Occupational Health and Safety.

Committed to making safety work through a continuous improvement strategy, Grover provides a solution-driven practical approach to accident prevention, risk management and meeting compliance requirements.

Free Webinar for Risk Management: A Hands-on Approach & Transition Experiences

Join Violet Masoud, Director of Sales, MSC for DNV GL Business Assurance, North American and Jason Teliszczak, CEO/Founder of JTEnvironmental Consulting, Inc. as they delve into how risk based thinking pertains to the ISO 9001:2015 standard. They will break down the key changes and highlight, from their recent experiences, best practices with a focus on risk management implementation.

Topics to be covered include:
• Risk Based Thinking
• Risk Management Implementation
• Examples of risk and proper documentation process
• Risk Mitigation
• Transition Strategies

Thursday, May 25, 2017 9:00 am 
Pacific Daylight Time (San Francisco, GMT-07:00) 


Free Webinar on OSHA’s silica rule to implement controls and work practices that reduce workers’ exposure to silica dust.

OSHA's silica rule is one of the biggest impact standards the agency has set in years. The rule significantly reduces the amount of silica dust that workers can be exposed to on the job. That means that employers will have to implement controls and work practices that reduce workers' exposure to silica dust. This webinar will cover the following important issues:

•      Overview of the newly published rule

•      Post-rule challenges

•      Implication of challenge on compliance efforts

•      Practical tips on what employers should do

Can't attend live? Register to view the webinar on-demand!

May 19, 2017

Liberty Mutual @LibertyMutual end safety research, “will result in a major loss for the occupational safety and health field."

ISHN: An institute whose research has had a tremendous impact on worker safety over the past six decades is closing its doors – and safety advocates aren't happy about it.

The Liberty Mutual Research Institute for Safety, founded in 1954, has announced that peer-reviewed research will end and nearly four dozen scientists and researchers will be laid off when the program ends on June 6.

Bad timing
Thomas CecichAmerican Society of Safety Engineers (ASSE) President Tom Cecich, CSP, CIH  said the closure "will result in a major loss for the occupational safety and health field."

Former Deputy Assistant Secretary of Labor at OSHA Jordan Barab said the closure "couldn't come at a worse time," noting that budget cuts to NIOSH and other occupational safety agencies under the Trump administration signal a lessening of support for health and safety research going forward.

From carpal tunnel to opioid abuse
Institute researchers have studied workplace injury and illness prevention, vehicle safety, opioid abuse, repetitive motion injuries, disability management and have developed innovations in prosthetic limbs and safer car steering columns.

The Institute also produces data on the costs of injury and illness in the workplace. The 2017 Liberty Mutual Workplace Safety Index estimated that workplace injuries and accidents that cause employees to miss six or more days of work cost U.S. employers $59.9 billion in 2014. The top five injury causes (led by overexertion, same-level falls and falls to a lower level) accounted for 64.8 percent of the total cost burden.

Barab blames the closure on changes in the workers' compensation market caused by lobbying by employers and trade associations to reduce premiums and by states eliminating requirements that companies carry traditional workers' comp insurance...

"We've seen safety programs work in keeping people alive and healthy on the job while improving a company's bottom line, but the evidence still is mostly anecdotal. That scientific body of research needs to be expanded."

Read full from Source:

May 17, 2017

Free EPA Webinar - The Resilient Business: Disaster Preparation through Pollution Prevention

U.S. Environmental Protection Agency (EPA) Webinar - The Resilient Business: Disaster Preparation through Pollution Prevention

Wednesday June 7, 2017, 2:00 p.m.-3:30 p.m. EDT

Could your business cope with a major flood, snowstorm, or power failure? Do you use hazardous chemicals? Surveys show that many businesses have not prepared for disasters by taking precautions such as emergency planning, having adequate insurance, & arranging for emergency power. This webinar for Massachusetts businesses will show you how to manage hazardous chemicals safely so that they are not at risk of release during a flood or other natural disaster. Registrants will receive a presentation with links to on-line resources. Learn how to:
  • use online maps to quickly find out if you are in a floodprone area,
  • determine your elevation & assess your flood risk onsite,
  • reduce risk & save money by switching to less hazardous chemicals & using energy more efficiently,
  • comply with regulations for managing hazardous wastes & materials, &
  • find financing & technical assistance.

Speaker Agenda:
  • Roy Crystal, EPA Region 1 - The Resilient Business: Disaster Preparation through Pollution Prevention
  • Tiffany Skogstrom, Massachusetts Office of Technical Assistance – Online Maps & Resources for Disaster Preparation & Toxics Use Reduction in Massachusetts
  • Brenda Mirabile, FM Global – Onsite Assessment of Flood Risk & How to Reduce It

Register here:

A second webinar covering these topics will be scheduled during the summer.

International Reports Call for Global Phase Out of Pesticides

Several heavy-hitting, international reports have surfaced in recent years, highlighting the serious impact agricultural chemicals are having on human health, including but not limited to the following:

According to a recent United Nations (UN) report,35 pesticides are responsible for 200,000 acute poisoning deaths each year, and chronic exposure has been linked to cancer, Alzheimer'sParkinson's diseasehormone disruption, developmental disorders and sterility.36

The latest USDA report on pesticide residues in food reveals only 15 percent of all the food samples tested in 2015 were free from pesticide residues, compared to 41 percent the previous year.37 This goes to show just how quickly our food is being poisoned, and how significant a source food is when it comes to chemical exposures.

According to Dr. Joseph E. Pizzorno,38 founding president of the internationally recognized Bastyr University, toxins in the modern food supply are "a major contributor to, and in some cases the cause of, virtually all chronic diseases."

The answer, the UN report says, is reducing or eliminating pesticides around the world. It proposes a global treaty to phase out toxic pesticides and transition to a more sustainable agricultural system. Contrary to industry PR, many studies have confirmed pesticide use can be significantly reduced without impacting production:39

A World Health Organization (WHO) report warns environmental pollution — which includes but is not limited to pesticides — kills 1.7 million children annually. To address this problem, the authors recommend reducing or phasing out agricultural chemicals

A report by the International Federation of Gynecology and Obstetrics40 warns that chemical exposures, which includes pesticides, now represent a major threat to human health and reproduction41,42

An Endocrine Society task force has also issued a scientific statement43,44 on endocrine-disrupting chemicals (EDCs, i.e., chemicals that alter the normal function of your hormones), noting that the health effects are such that everyone needs to take proactive steps to avoid them.

On the list of known EDCs are organophosphate pesticides and DDE, a breakdown product of DDT. Since it lingers in the environment, exposure still occurs via food even though DDT is no longer in use.

Exposure to endocrine-disrupting chemicals costs the European Union (EU) €157 billion ($172 billion) annually in women's health care costs, infertility and male reproductive dysfunctions, birth defects, obesity, diabetes, cardiovascular disease and neurobehavioral disorders45,46,47

One in 5 cancers are thought to be due to environmental chemicals and, according to recent studies, not only can miniscule amounts of chemicals amplify each other's adverse effects when combined,48 this even applies to chemicals deemed "safe" on their own.

Basically, the analysis49 found that the cumulative effects of non-carcinogenic chemicals can act in concert to synergistically produce carcinogenic activity — a finding that overturns and more or less nullifies conventional testing for carcinogens 

May 12, 2017

Upcoming RCRA Changes and How They’ll Affect Your Business (Final Rule officially goes into effect on May 30)

The Resource Conservation and Recovery Act (RCRA), the law that oversees the proper management of hazardous and non-hazardous solid waste, is seeing some major updates go into effect on May 30, 2017. A majority of the rules within RCRA are from amendments made in 1984 so this marks the first time in over 30 years that we're seeing major changes that affect our clients.

In total, there are over 60 changes implemented through the Hazardous Waste Generator Improvements Rule. It reorganizes the regulations to make it easier to understand and address ambiguities in an effort to improve compliance throughout the business community. Additionally, the updates provide greater flexibility for hazardous waste generators to manage waste in a cost-effective manner through episodic generation and Very Small Quantity Generators of Hazardous Waste – Large Quantity Generators (VSQG-LQG) consolidation provisions.

Here are some of the main changes that may affect your business.

  • Clarifications have been added to require waste determinations be accurate.
  • Confirmation is included regarding when a generator's hazardous waste determination must be made.
  • Additional information has been added on how to determine if a solid waste is either a listed and/or characteristic hazardous waste.
  • It identifies what waste determination records must be kept.
  • Requirements have been made for small quantity generators (SQGs) and LQGs to identify and mark RCRA waste codes on containers prior to sending hazardous waste off-site.

Preparing for the Compliance Date

Again, the Hazardous Waste Generator Improvements Final Rule officially goes into effect on May 30, 2017. The U.S. Environmental Protection Agency, which oversees RCRA, has information available on their website regarding the updates.

Lea HenselSOURCE: About the AuthorLea HenselCommunications and Marketing CoordinatorIowa Waste Reduction Center, Business and Community Services

May 10, 2017

DHS Provides Answers to Industry Questions on Chemical Security Assessment Tool

(PAINT.ORG) In September, the Department of Homeland Security (DHS) launched "CSAT 2.0," which is a revised CSAT (Chemical Security Assessment Tool) Top-Screen, along with a revised Security Vulnerability Assessment (SVA) application, and a revised Site Security Plan (SSP) application. The agency believes these changes to its Chemical Facility Anti-Terrorism Standards (CFATS) program could result in companies spending 90 percent less time using DHS' Security Vulnerability Assessment (SVA) and 70 percent less time operating the Site Security Plan (SSP) application.

DHS subsequently began issuing facility-tiering notifications based on the CFATS enhanced risk-tiering methodology in April of this year.

The Chemical Sector Coordinating Committee (in which ACA is a member) recently questioned DHS about this new SVA/SSP format — specifically inquiring about 5 questions that the process asks regulated facilities to answer — and requested that DHS' Infrastructure Security Compliance Division (ISCD) clarify its expectations for how regulated facilities should respond.  The five questions related to the following:

  • Q 2.50.010 Detection Measures and Identified Vulnerabilities
  • Q 2.50.020 Delay Measures and Identified Vulnerabilities
  • Q 2.50.030 Response Measures and Identified Vulnerabilities
  • Q 2.50.040 Cyber Security Measures and Identified Vulnerabilities
  • Q 2.50.050 Policies, Procedures, and Resources and Identified Vulnerabilities

According to DHS's Office of Infrastructure Protection (part of the Infrastructure Security Compliance Division, or ISCD), "the SVA — specifically including these questions —  is designed to help facility personnel understand their current security posture and identify gaps in current security. For each of the five questions, facilities should describe the security posture and potential vulnerabilities related to the measure (detection, delay, response, cyber, or policies, procedures, and resources). For example, for detection measures, the facility should provide high-level descriptions of the protective measures that are in place to monitor the perimeter and/or critical asset(s) and to detect attacks at early stages. These measures may include some combination of personnel or protective force monitoring through stationed positions or roving patrols, intrusion detection systems (IDS), lighting, and/or closed circuit television systems (CCTV)."

The direction from ISCD went on to say that after describing the current detection security posture, "a facility should use this information to identify any gaps or vulnerabilities in its posture. For example, potential vulnerabilities may include access points to the perimeter and/or critical asset(s) not currently covered by a method of detection."

ISCD noted that the best source of additional information on what should be included for the five questions at issue begins on page 7 (Adobe page 21) of the Chemical Security Assessment Tool (CSAT) 2.0 Security Vulnerability Assessment/Site Security Plan Instructions issued on March 29, 2017, and which may be found here.

Under the 2006 law establishing the CFATS program, chemical facilities possessing more than a threshold amount of specific explosive, toxic, or other "chemicals of interest" have been required to complete a "top-screen," notifying DHS that they possess such chemicals on site. Once a facility submits its top-screen, DHS can direct the facility to submit an SVA, and based on that document, then assign the facility to one of four tiers based on the potential security threat on site, an action that triggers a requirement to submit an SSP (or an Alternative Security Plan, or ASP) to DHS for authorization and approval.

Per DHS, approximately 9,000 updated Top-Screens have been received from the 27,000 facilities that have reported holdings of chemicals of interest (COI) at the screening threshold quantity. ACA's members own and operate paint, coatings, resin, and chemical manufacturing facilities that are potentially subject to the CFATS provisions, and many ACA members have previously submitted Top-Screens identifying COI and have been assigned preliminary or final tiers by the department. As a result, a number of ACA member companies have become subject to the CFATS Risk-Based Performance Standards.


May 9, 2017

“Cumulative exposure represents the greatest health threat for people" 4,000 people die each day from pollution-related illnesses.

In 2015, the earthquake in Nepal, and a series of heat waves in France, India, Pakistan and Belgium, accounted for the top causes of natural disaster deaths according to the Centre for Research on the Epidemiology of Disasters. Cumulatively, some 16,000 people died from those incidents. But those deaths represent a drop in the bucket compared with cumulative exposure-related deaths. The same year, noted Finnigan, haze from agricultural fires in Indonesia may have led to 100,000 premature deaths. Across Southeast Asia, 3.8 million premature deaths can be traced to air quality. In China alone, 4,000 people die each day from pollution-related illnesses.

"Cumulative exposure represents the greatest health threat for people," said Finnigan. "We need to start responding to cumulative exposure health emergency disasters … we need to change the current [WHO] Emergency Response Framework model. It requires adaptations."

By keeping the focus narrowly aimed, argues Finnigan, the current WHO ERF misses the forest for the trees.

Gerard Finnigan: regional health & nutritional advisor, South Asia Pacific, World Vision International

"Our system is not well placed to deal with the cumulative effects of environmental hazards," he told Devex. "This would require a new and innovative approach in order to provide a clear framework response to a country in need, to provide the trigger mechanisms for that country and then to provide an operational response to that country. Because unlike an infectious disease outbreak, and unlike an acute disaster that causes a surge in hospital and ambulatory care, cumulative exposure events require an ongoing monitoring, the ongoing provision of advice, the ongoing provision of local care and that's a complex operational response for anyone to deliver."

Finnigan calls the new WHO Health Emergencies Program historical, and said he believes it to be an ideal time to extend focus to create similar systems to address cumulative exposure health emergencies. He's currently in the process of advocating for an innovative proposal to present to the World Health Assembly and is urging other humanitarian groups, governments, the private sector and 'non-traditional actors' to join his efforts.

"In order for us to mitigate risk and reduce risk, we'll have to approach this from as many possible directions as we can. Enabling change will occur through the World Health Assembly's determination, and so it would be my hope that all actors in the humanitarian space can collectively work on a proposal submitted to the World Health Assembly to identify this as a major issue that fits clearly and fits perfectly with their initiative within the world health emergency program. Should that happen, then I am absolutely confident that we'll be in the best position to respond in the following months, years and decades, because that's the period of time in which we'll need to be able to respond to this crisis emergency that's with us right now."

Antibiotic resistance has a language problem

Rajesh Kumar Singh/REX/Shutterstock

A physician examines a man with TB. Like the bacteria behind other common infections, Mycobacterium tuberculosis has become increasingly resistant to drugs.

Clinicians have long known that microbes such as bacteria, viruses and fungi are becoming alarmingly resistant to the medicines used to treat them. But a global response to this complex health threat — commonly termed 'antimicrobial resistance' — requires engagement from a much broader array of players, from governments, regulators and the public, to experts in health, food, the environment, economics, trade and industry.

People from these disparate domains are talking past each other. Many of the terms routinely used to describe the problem are misunderstood, interpreted differently or loaded with unhelpful connotations.

On 16 March, the United Nations formed an interagency group to coordinate the fight against drug resistance1. We urge that, as one of its first steps, this group coordinate a review of the terminology used by key actors. Such an effort could improve understanding across the board and help to engender a consistent and focused global response.

Blinded by science

A 2015 survey by the World Health Organization (WHO) in 12 countries highlighted people's unfamiliarity with the language of antibiotic resistance2. Fewer than half of the nearly 10,000 respondents had heard of the term 'antimicrobial resistance'. Only one-fifth were aware of its abbreviated form 'AMR'. By contrast, more than two-thirds knew of the terms 'antibiotic resistance' or 'drug resistance'. A similar study published the same year of people in the United Kingdom — by the UK biomedical charity the Wellcome Trust — revealed comparable trends3.

The interchangeable use of terms by the press and by scientists in publications and meetings is likely to be counterproductive in all sorts of contexts. Take food production. In recent years, different sectors have called on countries to phase out or abolish the 'antimicrobials' used to promote animal growth, to protect humans from increasing levels of drug-resistant bacteria4.

But, by definition, antimicrobials include medicines that play a crucial part in sustaining current levels of poultry production worldwide by reducing the gut inflammation caused by coccidian parasites. Anticoccidial medicines have no effect on bacteria, and do not drive bacterial resistance in humans or other animals. So a demand to abolish all antimicrobials for growth promotion misses the point and could potentially harm food security.

Simple, clear and unambiguous terminology would help to ensure that the global effort against drug resistance is focused on the greatest immediate challenge: the rise of drug-resistant bacteria that cause common illnesses, resulting from the high use of antibiotics by humans. It could also improve people's understanding and engagement. The Wellcome Trust study found that citizens either don't understand the language that scientists and the media use in relation to antibiotic resistance, or they resist engaging with the problem because they feel powerless to do anything about it.

Word power

Words matter. A 2015 study5 of word use in social-media networks, for instance, indicated that the terms 'climate change' and 'global warming' have differing effects on knowledge and awareness. Likewise, a 2013 survey6 suggested that 'global warming' is more likely than 'climate change' to prompt Americans to support large and small-scale US efforts to address the problem — presumably because the phrase imparts a greater sense of personal threat.

Similarly, use of the term 'second-hand smoke' in the past 40 years has been crucial to communicating the risks of smoking to the public7. And the decision to name the cause of AIDS as human immunodeficiency virus (HIV) in 1986 — instead of human T-cell lymphotropic virus (HTLV-III) or lymphadenopathy-associated virus (LAV) — helped people to understand that the disease was caused by a virus that harms the immune system. As such, it was crucial in tackling stigma and phasing out terms such as 'the gay plague', which had previously dominated communication around AIDS.

Jeff Swensen/NYT/Redux/eyevine

Aggressive tactics to stop the spread of pathogens such as methicillin-resistant Staphylococcus aureus will benefit from a united front in terminology.

The appointment of the United Nations Interagency Group provides an opportunity to apply the power of words to drug resistance. We urge this group to focus on three key issues.

Drug-resistant infection. We propose that this be the overarching term used (in English) to describe infections caused by organisms that are resistant to treatment, including those caused by bacteria that do not respond to antibiotics. The WHO and Wellcome Trust surveys indicate that most people understand this term, and it is already in use for tuberculosis. (Medical practitioners, among others, commonly refer to 'drug-resistant tuberculosis'.) We also suggest that more-specific words such as 'antibiotic' or 'antifungal' are used in preference to 'antimicrobial' when referring to medicines against a specific type of organism.

Stewardship. This frequently comes up in discussions about drug resistance. Specifically, it refers to how the appropriate use of antibiotics can maximize both their current e

ffects and the chances of their being available for future generations. But the term is invariably used too narrowly.

Historically, antibiotic stewardship has been conducted as part of hospital programmes, and many people use it to refer to the actions of infection specialists and pharmacists. Today, its practice is much broader (see 'Many meanings'). Antibiotic stewardship can be an individual, multidisciplinary, hospital or community-level commitment to ensuring appropriate antibiotic use for those patients or animals that have a bacterial infection that requires treatment, and ensuring that all aspects of the prescription (dose, duration and so on) are as they should be. At the other end of the scale, the WHO is now working on developing a global stewardship framework — potentially akin to the WHO Framework Convention on Tobacco Control.

​Read more from:

By "Nature" writers Marc Mendelson, Manica Balasegaram, Tim Jinks, Céline Pulcini& Mike Sharland​

May 5, 2017

17% of fatal accidents involved stoned drivers... soared in Washington since pot was legalized

Fatal crashes involving drivers who recently used marijuana more than doubled in 2014. Pot was involved in 17% of fatal crashes in Washington in 2014, up from 8% in 2013 -- the year before recreational marijuana was allowed there.

"The significant increase in fatal crashes involving marijuana is alarming," said Peter Kissinger, CEO of the foundation, which funds scientifically rigorous studies for the drivers organization. "Washington serves as an eye-opening case study for what other states may experience with road safety after legalizing the drug."

But coming up with a test to get impaired drivers off the road will be far more difficult than the blood alcohol tests used to test for drunk drivers, according to the group. While tests show the ability to drive gets worse as blood alcohol rises, laboratory studies show the same is not necessarily true with increased levels of THC, the main chemical component in marijuana, in the blood. One driver with high levels of THC might not be impaired, while another driver with very low levels can be impaired.

"There is understandably a strong desire by both lawmakers and the public to create legal limits for marijuana impairment, in the same manner as we do with alcohol," said Marshall Doney, AAA's CEO. "In the case of marijuana, this approach is flawed and not supported by scientific research. It's simply not possible today to determine whether a driver is impaired based solely on the amount of the drug in their body."

The study was criticized by the National Cannabis Industry Association, which pointed to a different study, by the Transportation Department, which found that drivers who drivers who are drunk have a much greater increase in the risk of being in an accident than drivers who used marijuana.

"All this report really shows is that more people in Washington State are likely consuming cannabis, and thus might have some THC in their systems at the time of an accident. But since having THC in your system tells us nothing about your potential impairment, it would be like a report showing how many people involved in accidents had drunk a beer in the last week," said Taylor West, deputy director of the group.

​​Mercury Poisoning at a Home Day Care Center — Hillsborough County, Florida, 2015

In November 2015, 13 cases of mercury poisoning were detected among attendees and residents of a home day care center after identification of elevated urine mercury levels in a hospitalized child who attended the day care center. The source of the mercury was an antique sphygmomanometer that was placed in the day care center as an educational toy. The owners were unaware that the device was leaking elemental mercury without appearing to be broken. Exposure continued for nearly 6 months before detection during an epidemiologic investigation.

Investigation and Results

US National Library of Medicine, launches Tox-App based on the web version of TOXMAP.

Tox-App lets iOS users search for industrial facilities that reported releasing certain chemicals into the environment to the US EPA TRI program. Tox-App includes a subset of about 100 TRI chemicals for the most current TRI year.

Tox-App was developed by NLM interns and is based on the web-based version of TOXMAP. Tox-App provides some of the basic TOXMAP functions, including the ability to search for reporting facilities, or browse for these facilities by chemical, state, or county.

You can download Tox-App from the Apple App Store

Anti-vaccine activists spark a state’s worst measles outbreak in decades Washington Post

By Lena H. Sun May 5


The young mother started getting advice early on from friends in the close-knit Somali immigrant community here. Don't let your children get the vaccine for measles, mumps and rubella — it causes autism, they said.  Suaado Salah listened. And this spring, her 3-year-old boy and 18-month-old girl contracted measles in Minnesota's largest outbreak of the highly infectious and potentially deadly disease in nearly three decades. Her daughter, who had a rash, high fever and a cough, was hospitalized for four nights and needed intravenous fluids and oxygen.  "I thought: 'I'm in America. I thought I'm in a safe place and my kids will never get sick in that disease,' " said Salah, 26, who has lived in Minnesota for more than a decade. Growing up in Somalia, she'd had measles as a child. A sister died of the disease at age 3.


Salah no longer believes that the MMR vaccine triggers autism, a discredited theory that spread rapidly through the local Somali community, fanned by meetings organized by anti-vaccine groups. The advocates repeatedly invited Andrew Wakefield, the founder of the modern anti-vaccine movement, to talk to worried parents.  Immunization rates plummeted and, last month, the first cases of measles appeared. Soon, there was a full-blown outbreak, one of the starkest consequences of an intensifying anti-vaccine movement in the United States and around the world that has gained traction in part by targeting specific communities.


"It's remarkable to come in and talk to a population that's vulnerable and marginalized and who doesn't necessarily have the capacity for advocacy for themselves, and to take advantage of that," said Siman Nuurali, a Somali American clinician who coordinates the care of medically complex patients at Children's Hospitals and Clinics of Minnesota. "It's abhorrent."  Although extensive research has disproved any relationship between vaccines and autism, the fear has become entrenched in the community. "I don't know if we will be able to dig out on our own," Nuurali said.


Anti-vaccine advocates defend their position and their role, saying they merely provided information to parents.  "The Somalis had decided themselves that they were particularly concerned," Wakefield said last week. "I was responding to that."  He maintained that he bears no fault for what is now happening within the community: "I don't feel responsible at all."

How measles outbreaks happen in the U.S.

MMR vaccination rates among U.S.-born children of Somali descent used to be higher than among other children in Minnesota. But the rates plummeted from 92 percent in 2004 to 42 percent in 2014, state health department data shows, well below the 92-94 percent threshold needed to protect a community against measles.  Wakefield, a British activist who now lives in Texas, visited Minneapolis at least three times in 2010 and 2011 to meet privately with Somali parents of autistic children, according to local anti-vaccine advocates. Wakefield's prominence stems from a 1998 study he authored, which claimed to show a link between the vaccine and autism. The study was later identified as fraudulent and was retracted by the medical journal that published it, and his medical license was revoked.


The current outbreak was identified in early April. As of Thursday, there were 41 cases, all but two occurring in people who were not vaccinated, and all but one in children 10 and younger. Nearly all have been from the Somali American community in Hennepin County. A fourth of the patients have been hospitalized. Because of the dangerously low vaccination rates and the disease's extreme infectiousness, more cases are expected in the weeks ahead.

Measles, which remains endemic in many parts of the world, was eliminated in the United States at the start of this century. It reappeared several years ago as more people — many wealthier, more educated and white — began refusing to vaccinate their children or delaying those shots.


The ramifications already have been significant. A 2014-2015 measles outbreak infected 147 people in seven states and spread to Mexico and Canada. In California, high school students were sent home because of infected classmates. One patient who was unknowingly infectious visited a hospital and exposed dozens of pregnant women and babies, including those in the neonatal intensive care unit. Another adult patient was hospitalized and on a breathing machine for three weeks.

Federal guidelines typically recommend that children get the first vaccine dose at 12 to 15 months of age and the second when they are 4 to 6 years old. The combination is 97 percent effective in preventing the viral disease, which can cause pneumonia, brain swelling, deafness and, in rare instances, death.


Minnesota's Somali community is the largest in the country. The roots of the outbreak there date to 2008, when parents raised concerns that their children were disproportionately affected by autism spectrum disorder. A limited survey by the state health department the following year found an unexpectedly high number of Somali children in a preschool autism program. But a University of Minnesota study found that Somali children were about as likely as white children to be identified with autism, although they were more likely to have intellectual disabilities.

Around that time, health-care providers began receiving reports of parents refusing the MMR vaccine.


As parents sought to learn more about the disorder, they came across websites of anti-vaccine groups. And activists from those groups started showing up at community health meetings and distributing pamphlets, recalled Lynn Bahta, a longtime state health department nurse who has worked with Somali nurses to counter MMR vaccine resistance within the community.

At one 2011 gathering featuring Wakefield, Bahta recalled, an armed guard barred her, other public health officials and reporters from attending.


Fear of autism runs so deep in the Somali community that parents whose children have recently come down with measles insist that measles preferable to risking autism. One father, who did not want his family identified to protect their privacy, sat helplessly by his daughter's bed at Children's Minnesota hospital last week as she struggled to breathe during coughing fits.

The 23-month-old was on an IV for fluids and had repeatedly pulled out the oxygen tube in her nose. Her older brother, almost 4, endured a milder bout. Neither had received the MMR vaccine.  The children now have antibodies to protect against measles, but they still need the vaccine to prevent mumps and rubella. Their father, who is 33 and studying mechanical engineering while working as a mechanic, wants to wait. His worry: autism. A colleague has a son "who is mute."  "I would hold off until she's 3 . . . or until she fluently starts talking," he explained.  His wife no longer harbors doubts, however. As soon as both children are well, she said, "they are going to get the shot."


The pervasive mistrust was evident Sunday night during a meeting, sponsored by several anti-vaccine groups, that drew a mostly Somali crowd of 90 to a Somali-owned restaurant here. Patti Carroll, a member of the Vaccine Safety Council of Minnesota, described its goal as giving parents more information, including their right to refuse to vaccinate. People have been "bullied big time" by doctors and public health officials, she said.


The presentation by anti-vaccine activist Mark Blaxill drew cheers and applause. Blaxill, a Boston businessman whose adult daughter has autism, played down the threat of measles and played up local autism rates.  "When you hear people from the state public health department saying there is no risk, that [vaccines] are safe, this is the sort of thing that should cause you to be skeptical," Blaxill said.

Two pediatricians in the audience stepped up to a microphone to denounce the claims.

"I am very concerned, especially in the midst of a measles outbreak, to have folks come into a community impacted by this disease and start talking about links between MMR and autism," said Andrew Kiragu, interim chief of pediatrics at Hennepin Medical Center in Minneapolis. "This is a travesty."  He and the other doctors were interrupted by boos and yelling.

"For God's sake, I want to know if vaccines are safe," Sahra Osman shouted. She has a nearly adult son who received an autism diagnosis when he was 3. "My people are suffering! We're not ignorant. I read a lot. I know a lot. I educate myself. . . . You don't know what you are talking about."


While scores of studies from around the world have shown conclusively that vaccines do not cause autism, that is often not a satisfactory answer for Somali American parents. They say that if science can explain that vaccines don't cause autism, science should be able to say what does.

But researchers don't really know. A growing body of evidence suggests that brain differences associated with autism may be found early in infancy — well before children receive most vaccines. Other studies have found that alterations in brain-cell development related to autism may occur before birth. There are some genetic risk factors for autism, and advanced parental age has been associated with the condition.


Meanwhile, the ongoing spread of the anti-vaccine message is making it harder to control the burgeoning number of measles cases.  The groups continue advising parents, "in the middle of their crisis," on how to opt out of vaccines, said pediatric nurse practitioner Patsy Stinchfield, an infection-control expert leading the outbreak response at Children's Minnesota. That message is "exactly the opposite of what clinicians and public health officials are urging, which is to get vaccinated as soon as possible."


Staffers at her hospital have been working around the clock to vaccinate hundreds of people who may have been exposed; an MMR dose given within 72 hours of exposure can prevent measles.

When their two sick children are well, Suaado Salah and her husband, Tahlil Wehlie, plan to talk to friends and acquaintances to spread the word that the anti-vaccine groups are wrong and that all youngsters should get immunized.  "Because when the kids get sick, it's going to affect everybody. It's not going to affect only the family who have the sick kid," she said. "They make sick for everybody. That's when you wake up and say, 'Okay, what happened?' " But she understands the apprehension that fed the outbreak. With a parent whose child has autism, she said, "It's something that you're looking for an answer for how it happened and what happened to your kid."


This video from the Centers for Disease Control and Prevention explains how measles spreads and how to prevent it. (Centers for Disease Control and Prevention)