By Sally Greenberg, NCL Executive Director

The Washington Post had an interesting piece yesterday by writer Juliet Eilperin about using filtered or bottled water when she was pregnant and losing out on the important benefits that fluoridation in tap water provides. What I found interesting is that she expressed surprise about this fact. If a reporter for the Washington Post doesn’t know this important health information, then we need to do a whole lot more educating.

Bottled water consumption has doubled over the past decade and as a result, the exposure to fluoride from tap water, which can not only prevent tooth decay, it can repair tooth decay, has been reduced as well. Eilperin quotes a professor of dental sciences who says we should “look at this issue.” That’s an understatement. Eilperin opted for bottled water because of various trace chemicals found in the District of Columbia’s water system that are potentially harmful to health. She’s right that water that contains dangerous concentrations of harmful chemicals can be a threat to health of adults and children. But whether DC’s water reaches those levels is another question and whether it’s the right calculus to trade away the benefits of fluoride because of fear of these trace chemicals is another matter. That really does need to be studied. I also live in DC and make a point of drinking the water here and using ice cubes from DC water for my family because I want all of us to benefit from the fluoride. I guess I’ve made the decision that having healthy teeth is more important than worrying about ingesting tiny concentrations of chemicals.

But the value of fluoride cannot be understated. United States municipalities began adding it to public drinking water systems in the 1940s. Today, about 65 percent of Americans get fluoridated tap water, including 95 percent of people in Virginia, 99 percent in Maryland, and 100 percent in the District. It’s a huge public health advancement, because tooth decay and dental disease has such a ripple effect on health. If a child has a toothache, she can’t go to school, her parent has to take time off work to see a dentist, and the costs involved can be very high. For families with low and moderate income, dental care can be prohibitively expensive. So fluoride, as a prevention tool, is a very important health measure. And for an adult with tooth decay, missing a front tooth can prevent them from getting a job or getting a promotion.

Eilperin’s DC dentist told her that after officials began fluoridating public water supplies, “the cavities rate was cut in half. The only thing they could attribute it to was fluoridating the water.”

The Centers for Disease Control and Prevention identifies fluoridation of public drinking water as one of the top 10 public health achievements of the 20th century, noting that studies show it reduces cavities in adolescents by between 8 and 37 percent, and among adults by 20 to 40 percent.

Still, a South Australia study conducted between 1991 and 1995 showed that children who drank only rainwater and bottled water had a 52.7 percent higher rate of cavities in their baby teeth than those who drank only public, fluoridated tap water.

Not all filtered or bottled waters are totally devoid of fluoride: Brita filters do not strip it out of tap water, and some bottled brands such as Nursery Water advertise that they add the mineral. The ADA has introduced a certification program for foods and beverages that are beneficial to oral health, including fluoridated bottled water, in part to encourage bottlers to provide optimally fluoridated water.

Martha Ann Keels, the division chief of pediatric dentistry at Duke University, tells parents that taking a fluoride supplement (if you don’t drink fluoridated tap water) as effective as fluoride toothpaste in helping your teeth resist the impact of acid they’re exposed to during the day.

“The main benefit of fluoride is topical: You put it on the enamel to recharge it,” Keels said. “It’s like putting shoe polish on your shoe.”

That sounds good to me. Oral health is a critical component of overall health, and we need to spread the word about the importance of brushing with fluoridated toothpaste twice a day, drinking tap water wherever possible, and seeing the dentist twice a year. The benefits will pay off exponentially.

The days of Mystery Meat Mondays may soon be over for schoolchildren across the nation. The U.S. Department of Agriculture (USDA) is proposing new guidelines for school lunches subsidized by the federal government, the first major nutritional overhaul in 15 years.

The new guidelines would require schools to drastically lower the amount of sodium in school meals, limit children to one cup of starchy vegetables (such as French fries) per week, and increase servings of fruit, whole grains, and low-fat milk.

The requirements are based on the 2009 recommendations by the Institute of Medicine that advocated reducing sugar, saturated fat, and sodium but increasing protein and whole grains.

Following these recommendations, the new USDA guidelines would:

• Establish the first calorie limits for school meals
• Ban trans fats
• Reduce the amount of sodium in school meals by 50 percent over a 10-year period
• Gradually increase the amount of whole grains required
• Require both a grain and protein served for breakfast
• Require more servings of fruits and vegetables
• Require all milk to be either low-fat or non-fat

A before-and-after comparison of the new lunch standards can be viewed here

The proposal arrives at a critical time for America’s youth. According to the USDA, roughly one-third of children between 6 and 19 years old are overweight or obese, and the number of obese children has tripled over the past few decades. Obesity, a serious health concern in its own right, often leads to other problematic and hard-to-treat medical conditions such as diabetes and sleep apnea.

Experts argue that improving the nutritional value of school meals would be a giant step toward a healthier America. According to Agriculture Secretary Tom Vilsack, the new guidelines could affect more than 32 million children, an impressive number given that children consume more than half of their calories at school.

Although these guidelines are just a proposal and implementation could be far off, the Obama administration has been moving quickly on the nutrition issue; today’s announcement comes just a few weeks after President Obama signed the $4.5 billion Healthy Hunger-Free Kinds Act of 2010 that required the new nutritional standards and helps schools pay for healthier foods.

The USDA is seeking feedback on the proposed rule at www.regulations.gov through April 13, 2011.

A child falls off a bike with faulty handlebars. A toddler gets injured in a poorly designed stroller. An entire family becomes ill from their home’s toxic drywall. The Consumer Product Safety Commission (CPSC) collects thousands of safety incident reports like these each year, but never before have those complaints been made public.

All that is set to change in March of 2011, when the CPSC will launch its new public complaint database, *www.saferproducts.gov, and will allow consumers to post and view safety reports of products that fall under the agency’s jurisdiction (the CPSC does not oversee products like cosmetics, pharmaceuticals, cars, or tires).

The CPSC’s decision to make all its complaints public, as required by the Consumer Product Safety Improvement Act of 2008, was immediately celebrated by consumer rights advocates as a valuable resource in helping consumers make informed decisions about the safety of the products they buy.

Major manufactures have been less enthusiastic about the plan. In a *recent Washington Post article, Rosario Palmieri, vice president of the National Association of Manufacturers, voiced concern that the database will subject businesses to inaccurate and malicious reports by competitors or fanatical consumers who intentionally want to damage a brand.

This argument seems weak in light of the popularity of user-generated review sites like Yelp and Angie’s List, where it’s relatively easy to weed out the rantings of disgruntled employees or bitter competitors from more legitimate complaints.

A concern with considerable more weight is the fact that, as a government agency, the CPSC carries a lot of clout; a negative report posted by a government-sponsored site could be much more damaging than complaints posted in less official channels. To prevent this, the CPSC has implemented a variety of safeguards to ensure public postings don’t recklessly damage a brand’s reputation:

• When a consumer files a complaint, the CPSC has five days to notify the manufacturer
• The manufacturer then has 10 days to respond
• If a company believes the complaint is false or gives away a trade secret, the CPSC will make a decision of whether or not to publish it
• If the report is published, the manufacturer still has the opportunity to write a response that will be published alongside the complaint

*www.saferproducts.gov has the potential to be an effective early warning system that saves lives and injury by alerting customers to potential dangers—long before the years and months it can take the CPSC and manufacturer to coordinate a successful recall.

*Links are no longer active as the original sources have removed the content, sometimes due to federal website changes or restructurings

NCL recently sent the following letter to the Internal Revenue Service, calling for change with the way the IRS doesn’t classify breast pumps for breast-feeding moms as an item (under IRS Publication 502) that can be reimbursed because they aid in the  “prevention of disease” — an outrageous idea to health advocates who cite numerous data about the proven reduction in health risks to both nursing moms and babies. The letter originally appeared in the Disruptive Women in Health Care blog.

December 29, 2010

Dear Internal Revenue Service Commissioner Douglas H. Shulman:

The National Consumers League has been advocating on behalf of women and children’s health since our founding in 1899. We were therefore very concerned to read about the IRS’ decision to deny nursing mothers the ability to use  their tax-sheltered health care accounts to pay for breast pumps and other supplies. Under IRS regulations, eligible medical expenses under the flex programs.

According to IRS Publication 502, items that can be reimbursed  include those that aid in the  “prevention of disease.” The IRS apparently has inexplicably determined that breastfeeding does not help in the “prevention of disease.” The National Consumers League could not disagree more with this determination. We ask that you review and reverse this misguided decision. Indeed, the medical evidence is overwhelming that far more widespread breastfeeding would not only “prevent disease” in the United States, but would save our health care system billions of dollars.

Consider the following evidence about the myriad health benefits to both mother and child of breastfeeding:

• According to a Harvard study published in April of this year, if 90 percent of US families would comply with medical recommendationsto breastfeed exclusively for 6 months, the United States wouldsave $13 billion per year and prevent an excess 911 deaths,nearly all of which would be among infants ($10.5 billion and 741deaths at 80 percent compliance).
• The risk of infant death due to Sudden Infant Death Syndrome (SIDS) is lowered, and respiratory infections such as pneumonia, and necrotizing enterocolitis is nearly eliminated if mothers breastfeed their infants until at least six months after birth.
• The US Department of Health and Human Services has found that  breastfed infants have a lower risk of contracting ear infections, stomach viruses, atopic dermatitis, type 1 and 2 diabetes, childhood leukemia, and other health problems.
• Mothers also benefit from breastfeeding because of lower risk of contracting type 2 diabetes, breast cancer, ovarian cancer, and postpartum depression (PPD).
• A former acting Surgeon General, Steven Galson, has noted that for most women, breastfeeding is biologically possible. Both babies and mothers gain many benefits from breastfeeding. Breast milk is easy to digest and contains antibodies that can protect infants from bacterial and viral infections.
• Breastfed infants typically need fewer sick care visits, Congress recently acknowledged the importance of breastfeeding in the landmark health care reform legislation it enacted this year by requiring that workplaces provide women with a private place to nurse or use a breast pump.

As  Dr. Robert W. Block, president-elect of the American Academy of Pediatrics noted in the New York Times this week “The old adage that breast-feeding is a child’s first immunization really is true … So we need to do everything we can to remove the barriers that make it difficult.”

We agree with Dr. Block. We need to encourage, not discourage, barriers to widespread breastfeeding. Unfortunately, the IRS determination NOT to allow parents to use their tax-sheltered flex accounts to cover the cost of breast pumps has the impact of further discouraging  women  from breast-feeding and directly undermines what is by every measure a critical practice for improved public health.  We ask that you, as IRS Commissioner, review this decision and, in light of the overwhelming evidence, reverse it. We believe the cost of breast pumps should and must be a covered cost in these flex plans.

Thank you for your attention to our concerns.

Sincerely,

Sally Greenberg
Executive Director, National Consumers League

Cc:

Senate HELP Committee Chairman Tom Harkin
Treasury Secretary Timothy Geithner
Surgeon General Regina Benjamin
House Energy and Commerce Chairman Henry Waxman

By Sally Greenberg, NCL Executive Director

Patient safety should be a paramount consideration when someone is admitted to the hospital, but new research is discouraging on that front. Researchers looked at 10 North Carolina hospitals over the 2002-2007 period. They found many problems. About 18 percent of patients were harmed by medical care, some more than once, and 63.1 percent of injuries were preventable. Most problems patients faced were temporary, but some were serious, and 2.4 percent caused or contributed to a patient’s death.

The thing that is so discouraging is that, in 1999 when an Institute of Medicine report – entitled “To Err is Human” – found that up to 98,000 people each year die, and more than one million people are injured because of medical errors, the medical community made a commitment to try to make a dent in these numbers. It appears that things for consumers and patients haven’t improved much.

Common problems appeared when hospitals failed to use measures proven to avert hazards from devices like urinary catheters, ventilators, and lines inserted into veins and arteries. Medication errors caused problems in 162 cases – computerized systems for ordering drugs can cut such mistakes by 80 percent, the researchers found, but only 17 percent of hospitals have such systems.

These errors not only injure people, but they cost the health care system a bundle. The report estimated that these errors cost Medicare several billion dollars a year. Not only that, but researchers estimate that these numbers are vastly underestimated because reporting medical errors is voluntary.