Medical Monitoring


A new drug created by Cuban doctors may give hope to lung cancer victims, according to a story on CNN.com.  The drug, named ClimaVax EGF has been in development for almost 20 years.  Clinical trials have taken place in the UK, Canada and Cuba and over 700 patients have received the vaccine.

The vaccine extended the lives of terminal patients by four months, but some patients have had their lives extended for several years.  The results were compared against those who only received conventional therapies like chemo and radiation.  Younger patients appeared to have greater rates of success. 

The drug encourages production of an antibody that inhibits EGF (epidermal growth factor), a substance in the body which drives lung cancer cell  growth.  It is hoped this treatment can be developed into something that can bring lung cancer under control, in the same way other chronic diseases are controlled by medication.  Promising news.

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New article on CNN on Flexipel Stand N’ Seal, manufactured by Roanoke (now known as BRTT) that has a timeline for the Stand ‘N Seal disaster.  The manufacturer started receiving complaints about the product in May 2005.  The manufacturer’s chairman wrote in an email in June 2005 that the company had received complaints about the product for two month, and that the situation was “very serious”.  The CPSC started their investigation into the complaints in June of 2005 and finally recalled the product in August of 2005. 

At some point, the CPSC let the manufacturer of Stand ‘N Seal put the product back on the market with a new formula.  The CNN story relates the case of a man who bought Stand ‘N Seal after the recall, used the product according to the manufacturer’s directions and sustained a severe case of chemical pneumonia after the exposure to the product.  The story takes the CPSC to task for not effectively handling the matter.

The fall out from this public health fiasco continues.  The CPSC needs to assess how these cases can be handle more efficiently on their end.  Two people were killed by this product and dozens more have sustained lung injuries from their exposures.  Attorneys need to look into whether there is a need for medical monitoring in the long term for those who were exposed to this product. 

The City of New York has opened two new clinics to service people who lived in the vicinity of ground zero or worked at the site and have medical problems arising from exposures at the site, according to the NY Times.  The clinics are part of the World Trade Center Environmental Health Center, which has treated 1,600 patients so far.  They expect to treat 20,000 people over the next five years.

Doctors treating ground zero related illnesses in workers from the 9-11 site testified to Congress regarding the outlook for the workers, according to a story in the Washington Post.  One doctor testified that “respiratory illness, psychological distress, and financial devastation have become a new way of life for many” of the workers.  An OSHA employee testified that workers arriving at the site in the first 48 hours after the attack received an “incredible assault” on their systems, from all of the toxins in the air. 

A study presented at the hearing shows 70% of the workers had new or worsened respiratory symptoms after exposure to debris at the site.  The study found mental health conditions, including PTSD and depression, in 36% of the workers studied, lower respiratory problems in 40% of the workers studied, and upper respiratory conditions in 59% of the workers studied.

It is unknown how long these types of problems will last in the affected workers and whether new problems, such as cancers related to the exposures, will emerge.  Congress has not yet set up a program for long term health care and health screening for these workers.  It would be the right thing to do.

New study by the New York Department of Health and Mental Hygiene finds increased risk of asthma in Ground Zero workers (story in New York Times).  Ground Zero workers have a 12 times greater chance of developing asthma than the general popluation.  The risk of developing asthma is greater in those who were at the site initially, when the smoke and dust clouds were thick and few respirators were available, as well as in those who stayed at the site longer, suggesting the risk is dose related.     

One of the authors of the study concluded that the study corroborates the other studies regarding Ground Zero workers, that have found the workers are at an increased risk for lung disease because of their exposures at the site.  The author suggests that every worker should be enrolled in a medical monitoring program or under a physician’s care.

The study also found respirators provided a moderate amount of protection for the workers.  But, the study found that even among workers who reported wearing masks, the incidence of asthma was increased.  The study found that paper masks and utuility masks did not prevent the inhalation of toxic dust in the workers who wore such masks, which explained the increased risk in these workers.   

Continuing the EPA’s parade of incompetence, there is an article in the New York Times regarding Whitman’s testimony on the EPA’s response to the 9-11 clean up.  Whitman repeatedly denied the agency downplayed their findings regarding air quality around the attack site in the days following 9-11.  Whitman might still be in denial, but the proof is in the pudding.  There was ample evidence of dangerous environmental conditions around the site immediately after 9-11, particularly evidence on dangerous levels of dust in the air, including hazardous silica dust and asbestos dust.  Now there is medical proof of the dangers in the worker’s afflicted with World Trade Center dust disease (see previous posts). 

Two quotes from the story:

“She (Whitman) said that she was addressing residents of Lower Manhattan — not workers at ground zero — when she said a week after the attack that the air was safe to breathe”,  and

“(s)everal members of the subcommittee also pressed Ms. Whitman to acknowledge that exposure to the dust from the collapsed twin towers had made workers and residents sick. Ms. Whitman declined to do so, saying that the evidence linking the dust to disease was not conclusive.  She said she had not read clinical reports from the Mount Sinai World Trade Center Screening and Monitoring Program. A preliminary study released last year showed that 70 percent of the first 9,000 workers examined had reported developing some kind of respiratory problem after working on the debris pile.”

She could have come to the hearing and taken responsibility for what she did, but she chose not to.  What a shame.

Only 16% of Kentucky coal miners get screened for black lung disease, an occupational lung disease caused by prolonged breathing of coal mine dust.  As early as 1822 the disease was recognized in coal miners.  It was called miner’s asthma at that time.  Black lung is preventable, just like all occupational diseases. 

The government provides free programs to screen miners for black lung.  But, according to a story in the Appalachian News, miners avoid screenings out of fear of losing their jobs: 

“Miners must share their black-lung diagnosis with their bosses almost immediately if they want to receive state benefits. And if miners are found to have black lung, there’s often no safe place for them to work in a mine. That leaves many worried that their employers would find reasons to let them go.”  

The highest paying jobs are the ones that expose miners to a lot of dust.  Additionally black lung disease has a long latency period, it does not manifest itself until years after the initial exposures occurred.  The disease is also dose related.  If you are taken out of the dusty environment it will slow the progression of the disease.   

In Kentucky, black lung disease death have increased 38 percent from 1998 to 2004, whole the rates have dropped in other coal mining states.  KY miners who were x-rayed last year had several times higher rates of black lung disease than expected.   

This situation needs to change.  Miners should not have to suffer from a preventable disease.  The government needs to change the rules regarding compensation, so that miners are comfortable diagnosing the disease earlier.  The companies that use up these employees, until they are no longer fit for any employment, need to be held accountable for the condition they leave their employees in and the employment laws need to be changed to prevent firings.  Unions might be the answer.

Occupational dust disease is preventable.  The levels which cause disease are known and dust control measures that would prevent disease can be implemented.  Companies have refused to do this for many years.  No reason to believe they will change any time soon.

COAL MINING

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