How Safe Is The US Food Supply?

Byoliveridley

A good summary of the state of food safety regulation in the United States.

How Safe Is The Food Supply?

These known cases make up a tiny fraction of the overall problem–an estimated 76 million illnesses and 5,000 deaths in the U.S. from food poisoning each year. Meanwhile, imports of food, some from countries without strict controls, soared to more than 9 million shipments last year doubling since 2002. The cash-strapped FDA is able to inspect less than 1% of imports. It’s a recipe for disaster. “Our food-safety system in this country is broken,” warned former FDA Commissioner Dr. David A. Kessler at a recent congressional hearing.

Few incidents ever have a body count high enough to shock the country into making fundamental changes. Overall, “we do have a very safe food supply,” says Sanford A. Miller, former director of the FDA’s Center for Food Safety & Applied Nutrition. But the alarms over pet food and vitamin A have lit a fire under lawmakers and executives. On May 2 the Senate rushed to pass a bill by a vote of 94-0 giving the FDA more responsibilities, such as creating databases of adulterated food. Meanwhile, food producers have been holding emergency meetings with suppliers, looking for problems in their factories or supply chains. Companies are “feverishly examining their own purchasing policies and trying to ensure they are followed,” says Kovacs.

Note that it is always tempting to blame the bureaucrats here. Bureaucracy is a dirty word in this country, associated with “red tape”, “corruption”, “standing in the way of business”, “pencil pushers”, “big government”, you name it, they get called it. But, agencies like the EPA and the FDA have competent scientists who know what they are doing. But, without the money and the authority, which is given to them by the political arm of the government, they cannot do much. They have also, in recent years, been headed by political appointees who come from the industry they are supposed to regulate and show a distaste for regulation which is in complete opposition of the mandate they are supposed to fulfill as the head of a regulatory agency.

It’s easy to take potshots at the FDA, but remember who gives them the money, makes the rules and tells them what not to oversee.

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  • FDA proscribes Chinese toothpaste

    Byoliveridley

    The FDA follows its proud tradtion of Friday afternoon recalls!

    The issue is the adulteration/replacement of glycerin with diethylene glycol, which tastes similar, but is very poisonous. This story has been well covered in the last few weeks.

    My question is, why only toothpaste? I would have extended the ban on all products containing glycerin. But, the FDA is a cautious beast, so things happen slowly and incrementally, if at all.

    FDA News Release

    The U.S. Food and Drug Administration (FDA) today warned consumers to avoid using tubes of toothpaste labeled as made in China, and issued an import alert to prevent toothpaste containing the poisonous chemical diethylene glycol (DEG) from entering the United States.

    DEG is used in antifreeze and as a solvent.

    Consumers should examine toothpaste products for labeling that says the product is made in China. Out of an abundance of caution, FDA suggests that consumers throw away toothpaste with that labeling. FDA is concerned that these products may contain “diethylene glycol,” also known as “diglycol” or “diglycol stearate.”

    FDA is not aware of any U.S. reports of poisonings from toothpaste containing DEG. However, the agency is concerned about potential risks from chronic exposure to DEG and exposure to DEG in certain populations, such as children and individuals with kidney or liver disease. DEG in toothpaste has a low but meaningful risk of toxicity and injury to these populations. Toothpaste is not intended to be swallowed, but FDA is concerned about unintentional swallowing or ingestion of toothpaste containing DEG.

    FDA has identified the following brands of toothpaste from China that contain DEG and are included in the import alert: Cooldent Fluoride; Cooldent Spearmint; Cooldent ICE; Dr. Cool, Everfresh Toothpaste; Superdent Toothpaste; Clean Rite Toothpaste; Oralmax Extreme; Oral Bright Fresh Spearmint Flavor; Bright Max Peppermint Flavor; and ShiR Fresh Mint Fluoride Paste. Manufacturers of these products are: Goldcredit International Enterprises Limited; Goldcredit International Trading Company Limited; and Suzhou City Jinmao Daily Chemicals Company Limited. The products typically are sold at low-cost, “bargain” retail outlets.

    Based on reports of contaminated toothpaste from China found in several countries, including Panama, FDA increased its scrutiny and began sampling toothpaste and other dental products manufactured in China that were imported into the United States.

    FDA inspectors identified and detained one shipment of toothpaste at the U.S. border, containing about 3 percent DEG by weight. In addition, FDA inspectors found and tested toothpaste products from China located at a distribution center and a retail store. The highest level found was between 3-4 percent by weight. The product at the retail store was not labeled as containing DEG but was found to contain the substance.

    DEG poisoning is an important public safety issue. The agency is aware of reports of patient deaths and injuries in other countries over the past several years from ingesting DEG-contaminated pharmaceutical preparations, such as cough syrups and acetaminophen syrup. FDA recently issued a guidance document to urge U.S. pharmaceutical manufacturers to be vigilant in assuring that glycerin, a sweetener commonly used worldwide in liquid over-the-counter and prescription drug products, is not contaminated with DEG.

    FDA continues to investigate this problem. If FDA identifies other brands of toothpaste products containing DEG, FDA will take appropriate actions, including adding products and their manufacturers to the import alert to prevent them from entering the United States.

  • | | |

    Shaming People into Pooping Indoors

    Byoliveridley

    Meanwhile, in the other India, people still poop outdoors…

    Using shame to change sanitary habits – Los Angeles Times

    Every morning before sunrise, Ravi Shankar Singh, a cheerful man known to his neighbors as “Luv” Singh, sets out to patrol the potholed roads and rice fields of this north Indian village. He carries a whistle and a flashlight. He sings while he walks. The village’s self-appointed sanitation guardian, Singh is on the lookout for anyone squatting in the fields or alleys, using the cover of darkness to do what millions of people have always done across India: defecate outdoors. After years of programs to increase the number of latrines in villages, the government still has not managed to eradicate a practice that is cited in the spread of water-borne illnesses and parasites, such as diarrhea and hookworms. Critics say the obstacle is not so much the shortage of latrines, though that, too, remains a problem for nearly half of India’s rural population. The main challenge is getting people to use the facilities they have. Singh says he’s found a way. When he spots someone squatting, he lets loose with a blast on his whistle. Or shines his light on the offender. Or both.

    This is clearly a serious public health issue and one that is linked to many avoidable deaths from disease. I am not sure if blowing whistles at people is an ethical way to do it. In a country where actual toilet facilities are still rare, and the people who grew up in this scarcity have internalized the fact that they have to “externalize” their poop, just providing facilities and shaming them is not enough.

    Just as with most things in India, no easy answers, I guess the right combination of education (especially targeting the young), enforcement through fines, and most importantly, saturation coverage of clean and easily available toilets would eventually work.  But it will take time, and of course, public urination is a completely  different beast!

  • All eyes on China

    Byoliveridley

    First it was the melamine. Then this weekend, there was that horrible story about deaths in Panama linked to the use of diethylene glycol in cough syrup. Now, pigs are dying mysteriously.

    Epidemic Is Killing Pigs in Southeastern China – New York Times

    Hong Kong television broadcasts and newspapers were full of lurid accounts today of pigs staggering around with blood pouring from their bodies in Gaoyao and neighboring Yunfu, both in Guangdong Province. The Apple Daily newspaper said that as many as 80 percent of the pigs in the area had died, that panicky farmers were selling ailing animals at deep discounts and that pig carcasses were floating in a river.

    Lovely. China has exploded out of the gate with its development and incredible growth. But its infrastructure, bureaucracy, attitudes, government accountability and transparency are obviously way behind. The whole world faces the consequences of this lag. But my guess is that it is the rural Chinese and the ones who have been “left behind” that suffer the most, something to keep in mind I guess as people rush to blame China for yet another safety issue. We have the option of being more careful, the rural Chinese don’t.

  • |

    Break the link between employment and healthcare!

    Byoliveridley

    Cross-posted from Interrobang:

    The US Supreme Court ruled along political lines on the 30th of June, 2014 that “closely held corporations”, over 90% of all US businesses, are now free to discriminate against women (and it was specifically women and birth control) if their religion leads them to believe birth control kills babies, or that women who use birth control are Satan’s spawn (the belief does not have to be factual).

    The Supreme Court says corporations can hold religious objections that allow them to opt out of the new health law requirement that they cover contraceptives for women.

    The justices’ 5-4 decision Monday is the first time that the high court has ruled that profit-seeking businesses can hold religious views under federal law. And it means the Obama administration must search for a different way of providing free contraception to women who are covered under objecting companies’ health insurance plans.

    Salon AP coverage

    I am not going to debate the wrongness of this decision, the notion that businesses can have religious beliefs, and can use them to discriminate against certain types of people is not up for debate. And, the discrimination is very specific and targeted…

    The other, more ubiquitous discrimination is in the notion that the health care you get has anything to do with the work-for-pay arrangement you have with the organization you work for. I am probably the millionth person to mention this, and whole books have been written on the subject, but, the link between healthcare and your employer is wrong because it anchors discrimination. This particular egregious case goes one step further and discriminates based on gender as well, not just work status.

    The US had a chance to sever health benefits from employment when they had a three-year debate on expanding health insurance coverage. Thanks to the ability of small political minorities to filibuster and block action, and a corporate-funded reluctance for change, the US kept their employer-based health insurance system in place, and with it, all the discrimination that entails. Uwe Reinhardt reiterated a number of these points recently in the New York Times.

    Back Home

    Is BC any better? Yes and no. Thanks to Canada’s Medicare, parts of our health care system are universal and not subject to employment ties. But, there are several exceptions making us a two-tier health care system:

    1. The health insurance tax or MSP (what our government cutely calls a “fee” in order to not call the yearly increase in this fee a tax increase): Many employers will pick up part/all of this tax for their employees, whereas one that doesn’t can pay more than 1000 dollars a year for a family. While there is an element of progressiveness to the pricing with very low-income people paying less/nothing, it is weak, families making > 30K per year pay full price.
    2. Drugs: For some reason, drugs are not covered by our “universal” healthcare system and are provided by workplace “supplemental benefits”, as if taking a thyroid pill every day is a “supplement”. The CCPA makes an excellent case for universal pharmacare, if you need more convincing. 10% of Canadians cannot fill prescriptions for financial reasons.
    3. Our public health insurance system assumes people don’t have eyes or teeth. So, if you want your cavities filled, a root canal, or want to see clearly, you need “supplemental benefits”, and these are mostly employer-provided. Oral health is a clear marker of health inequality.
    4. Mental health is not covered, this is inexcusable, as Andre Picard notes.
    5. Treatments that improve overall health, like massages, are not really covered. Once again, your employment status determines whether you have the “luxury” of holistic preventative measures to reduce stress, pain, and many other issues.
    6. Historically and currently oppressed groups, Canada’s indigenous people for example, get a short shrift on the benefits like massage, nutrition, counselling and holistic treatment they need because of disparity in employment availability.

    This quote from the Andre Picard article I mentioned summarizes the discrimination.

    The well-to-do pay. The middle-class scrape together the money the best they can, sacrificing so their child can get care. And those without the means wait, or do without care.

    There are other side-effects. Because “benefits” are expensive, companies have a vested interest in only having certain “valuable” employees benefit. The rest get treated as contractors, have their hours strategically reduced, and much more.

    It’s almost as if there’s an unspoken moral argument here, you don’t deserve good teeth or a massage if you don’t work for a living.

    Yes, you can buy individual supplemental insurance, or pay per use, but neither of these are cheap because you as an individual have no bargaining power.

    We in BC also have a long way to go to break the link between healthcare and employment. Will it cost the average BC resident more money? Let’s consider:

    1. A simpler system with one buyer is administratively efficient. It takes the thousands of decision points every HR administrator or group in every company/union has to make and transfers that to a single entity. Public universal plans are about four to ten times more efficient (pdf) than fragmented private plans.
    2. A bigger entity can negotiate much better rates for you, whether it is for drugs, or for dentistry, or for anything else (a bigger risk pool). If all of Canada administered one simple pharmacare system, we would negotiate much lower prices with pharmaceutical companies. We would also have better funding to run and evaluate effectiveness studies.
    3. Funding preventative, holistic healthcare means fewer hospital visits. In a universal system, there are no artificial barriers between a massage, drug treatment, surgery, stress reduction counselling, or ergonomic counseling for back pain. You don’t have to prove your work injured you in order to get the right treatment, your first point of contact with a medical professional (not necessarily a doctor) decides which path works best. You do not have to get sick enough to go to the hospital before you get treatment covered by insurance.

    Pitfalls

    There are concerns with a universal single-payer system:

    1. As Vox points out, if a government administering the single-payer system decides not to pay for contraception, then no one gets it. So, getting good universal healthcare is about constantly winning political battles. The good thing about universal healthcare in Canada is that it is incredibly popular, polling near 90% approval (pdf). So once quality is improved, governments will find it hard to cut back.
    2. Like any other public system, the quality of the institutions drafting policy and administering the system is vitally important. Well run public systems are efficient. But conservative movements in the last 30+ years have worked hard to dismantle the quality of public institutions and trust in such institutions. In this reality of shrinking budgets and staff levels where bureaucrat is a term of insult, ensuring that public system expansion is handled efficiently is no given. There is an entire industry of political parties, think tanks and media devoted to tearing down the concept of a publicly administered good, and ready to pounce on every little misstep (Remember the Obamacare roll out anyone?)
    3. Will employers raise wages from all the savings they get from not providing health benefits, and will these raises cover the increase in taxes we will pay for universal healthcare? Probably not right away, but it will happen eventually.

    Transitions

    Clearly, we can’t transition tomorrow. A public system would need to be in place and functioning before our employers get out of the health insurance business. I would phase universality in the following order:

    1. Drugs
    2. Teeth and eyes
    3. Preventative and palliative care.

    We would also need to rethink the”fee for service”, where healthcare providers are paid per widget, and think about a different system closer to a salaried model, more on that in future blog posts.

  • | | |

    The real terrorist: Pollution

    Byoliveridley

    It is true. A staggering number of people die every year due to lack of access to clean water, air or food. Aggregate statistics like these are a good way to summarize the humongous nature of the problem. While reams and reams of coverage and attention are focused on “terrorists”, people all around the world die of much more mundane causes such as bacteria in water, smog, poverty, starvation, malnourishment, etc.

    ScienceDaily: Pollution Causes 40 Percent Of Deaths Worldwide, Study Finds

    About 40 percent of deaths worldwide are caused by water, air and soil pollution, concludes a Cornell researcher. Such environmental degradation, coupled with the growth in world population, are major causes behind the rapid increase in human diseases, which the World Health Organization has recently reported. Both factors contribute to the malnourishment and disease susceptibility of 3.7 billion people, he says.

  • |

    Al Franken is good for health

    Byoliveridley

    You know what's in your food and many beauty products. Senator Al Franken wants to make it possible to see exactly what's in your household cleaning products as well.The Minnesota Democrat introduced a bill in the U.S. Senate requiring producers to fully disclose all ingredients on their product labels, including those suspected of causing long-term harm. Currently the warnings on cleansers are designed to prevent immediate harm due to swallowing, splashing in eyes or other unintended uses.

    via Kare 11

    It would seem common sense to have information on labels, especially on the harsh and powerful chemicals we use every day. You may not understand what they mean, or how to pronounce the chemical names, but you don’t have to! Organizations such as the Environmental Working Group have extensive information on common high volume chemicals so people can match what they see on the label with what they would like to avoid.

    But it is not the law of the land in the US, or Canada for that matter. Al Franken, comedian, talk show host and an intelligent man turned senator would like to change that in the US. Of course, we in Canada would benefit as well.

    Chemical manufacturers aren’t having any of this.

    There’s always a concern about turning labels into encyclopedias,” Brian Sansoni of the Soap and Detergent Association, in Washington, D.C., told KARE Tuesday.

    Pretty insulting, claiming that your consumer does not like encyclopedias, or is not capable of reading and googling.

    Information helps drive consumers to safer alternatives. If you see two cleaners, both of which claim to work equally well, a quick read of the ingredients will drive you to the safer (or simpler) choice. Clearly, sale by obfuscation is the preferred marketing strategy here.

    If I were American, I would call my senator/congressperson and ask them to support Al Franken.