The Child Labor Coalition expresses alarm over the results of DOL’s investigation into child labor at meatpacking plants in the U.S. and calls for current protections to be enhanced, not weakened

February 21, 2023

Media contact: National Consumers League – Katie Brown, 823-8442

Washington, D.C. – The Child Labor Coalition, consisting of 39 organizational members who work to end exploitative child labor domestically and internationally, calls attention to today’s announcement by the U.S. Department of Labor (DOL) that its just-completed investigation found 102 children working in cleaning crews in 13 meatpacking plants in eight states. DOL levied a fine of $1.5 million in civil money penalties against Packer Sanitation Services, Inc. (PSSI).

The children often worked the graveyard shift and used caustic chemical agents while they cleaned meat processing equipment including backsaws, brisket saws and head splitters. DOL learned that three minors were injured while working for PSSI.

Sally Greenberg, chair of the Child Labor Coalition, publicly called for meatpacking plants to be investigated for underage worker in 2008 during a congressional hearing on child labor.

“While we applaud this seemingly robust investigation by U.S. DOL, we wonder why the meatpacking firms who benefited from illegal child labor are not being held liable,” said Reid Maki, who is the Child Labor Coalitions coordinator and the Director of Child labor Advocacy for U.S. DOL. “Firms like JBS Foods, Tyson Food, Cargill, Turkey Valley Farms and others, hired PSSI to do the cleaning but company employees witness underage workers performing hazardous work with dangerous chemicals and did nothing to stop it. Why aren’t these companies being punished?” he asked.

Maki noted that the fine amount is the legal maximum that DOL could assess in the case but $1.5 million is roughly one day’s revenue for a company like PSSI that has over $450 million in annual revenue. “We would really love to see maximum and minimum child labor fines increased, and we had discussions with Senator Schatz’s office about it this very week,” he noted.

Maki noted that the investigation results are well-timed because the state of Iowa is considering a reprehensible child labor bill that would allow children to work expanded hours and in hazardous work areas.

“Iowa bill S.F. 167 not only extends hours for teen work, it permits minors to work in highly hazardous areas like meatpacking loading docks and assembly areas,” said Maki. “It’s a cynical, dangerous bill that builds in liability waivers for employers against teen worker injuries that the legislative authors know will happen. We strongly oppose this bill.”

Other states, including Ohio and Minnesota, are considering bills to weaken hard-won child protections.

Maki also noted giant loopholes in U.S. child labor law that expose child workers on farms to great risks. “Our weak child labor laws allow kids who are only 12 to work unlimited hours on farms when school is not in session. We’ve met many 12-year-olds who work 70–80-hours a week in the summer and in stifling heat, performing back-breaking labor,” explained Maki. “A teen worker has to be 18 to perform hazardous work in the U.S. but in agriculture they only need to be 16,” he added.

“The presence of young children in farm work, makes it critical that U.S.DOL begin enhancing hazardous work rules for child workers in agriculture,” said Maki. “DOL succumbed to political pressure when it scuttled needed protections over a decade ago and since then has refused to honor its responsibility to protect kids from known work dangers.”

We have also been waiting for DOL to protect child tobacco workers who regularly become ill from nicotine absorption and poisoning, noted Maki. “You must be 21 to buy cigarettes in the U.S., why does U.S. law allow tobacco growers to hire 12-year-olds to harvest this toxic crop? DOL needs to do more to protect these vulnerable workers.”


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My path from strawberry and blueberry fields to college

By Alma Hernandez, NCL Child Labor Coalition Summer 2022 Intern

Alma attends the University of South Florida, where she is pursuing a Bachelor of Science in Public Health.

Alma Hernandez (far right) is joined by fellow National Migrant and Seasonal Head Start Association  farmworker youth interns Jose Velasquez Castellano and Gizela Gaspar. NCL CLC Coordinator Reid Maki is also in the photo.

Imagine being a five-year-old child – happy and carefree. The age where you either attend pre-K or start kindergarten. But can you imagine a five-year-old working in farm fields in hot 90-degree humid weather with her parents? I was that child. I wore a long-sleeved shirt, jeans, closed-toed shoes, and a hat to protect me from the hot sun. At five years old, I was unaware of how difficult agricultural labor is. My mom had enrolled me at the Redlands Christian Migrant Association (RCMA), a Migrant and Seasonal Head Start program, but she also wanted to teach me to value my education.

My mother’s life lesson started during the weekend after I did not want to wake up for school. My mother remembers that I was full of confidence when asked if I wanted to go to work with her and my father. However, I did not know what was in store for me.

Arriving at the fields around 7:30 am, I first saw endless rows of strawberry fields. I felt enthusiastic. My task: collect as many bright red strawberries as I could and place them in my pink Halloween bucket. After filling my bucket, I would give the strawberries to one of my parents. Around 12, I felt the heat. It was around 90 degrees. The humidity made it feel worse. I felt like I was in 100-degree weather; I did not like that at all and wanted to go home. I was already tired and asked if we could leave. My mom said no; I had to stay until they finished. And so I kept working.

I do not recall what happened the rest of the time I was there, but I remember what happened afterward. I went home and sat on the stairs of the house with a red face, a headache, and clothes covered in dirt, and reflected on the decision I had made to join my parents in the strawberry fields. I went inside. I was so tired that I ignored dinner and skipped a shower and went straight to bed just to wake up the next day, to repeat another day of long, hard work. My parents had me help them one more day; and convinced that my lesson was learned, they let stay home where, in the next few years, I could help take care of younger siblings when my parents could not find childcare.

Although my work in the strawberry fields was short-lived, I have much more experience harvesting blueberries. I started working on blueberry farms when I was 12 years old and worked every summer until I was 16. The blueberry season starts in the summer after school ends in Florida.

My family and I would leave Florida near the end of June and start the 17-hour drive to Michigan. Unlike the strawberry season, I liked picking blueberries because I did not have to bend down low to the ground all day; blueberry plants grow higher. My job was to fill up my six buckets. Once they were all filled, I would carry all the buckets to place them into plastic containers and have them weighed. On average, six buckets would be 42 to 45 pounds, and depending on who we were working for, the average pay was 0.45 to 0.55 cents a pound. I had to pick as many pounds as I could. On good days, I would be able to pick 200 pounds or more; on many other days, I would pick less.

The clothing I wore was also the same: long sleeves, jeans, closed toes shoes, and a hat to protect myself from the sun. The weather in Michigan is not as humid as it is in Florida; usually, it was in the mid-80s to low 90-degrees however it was still hot being there all day. We would go in each morning at 8:30 or later depending on how wet the blueberry plants were and leave the fields around 8 or 9 at night.

I did not like going to a new school in Michigan every September just to leave in late October and return to Florida and start school. The curriculum was very different; I would excel quickly in Michigan since what I was learning I had already studied in Florida. But I also did not like how every time I would go to a new school, I’d be the “new girl,” struggling to make friends but knowing I would soon be migrating. “What is the point?” I would wonder. So I always kept to myself and only spoke when I was spoken to, and to this day I still do.

I also did not like the “what did you do during the summer?” question on the first day of school when I returned to Florida because all I did was work all summer and had no fun. Work caused my parents to miss many school functions that other parents would attend. Sometimes, it felt like a lack of support, but I understood that this type of work was their only way to generate income to provide for the family.

This summer, after four years away, I came back to Michigan with my family for the blueberry harvest one more time. Now that I am 20 and reflecting on my family’s agricultural experience, I appreciate my parents for what they have done for my siblings and me. They wake up early every day, go to work, come home to cook, and still spend a little bit of time with my younger siblings. I help around as much as I can because I know they cannot do everything on their own, especially now that they are getting older. I know they are tired and have no rest days. But thanks to them, I am the first person in my family to go to college and serve as an example to my siblings which proves to them that there is a reason for our parent’s sacrifices.

Treating cold or flu? Take special care with OTC meds – National Consumers League

takewithcare.pngThere are more than 600 over-the-counter and prescription medications that contain acetaminophen making it the most commonly used drug ingredient in the United States. Acetaminpophen can be found in pain relievers, fever reducers, sleep aids, and cough, cold, and allergy medicine. It is especially important during cold and flu season to understand the dangers of mixing medicines.

When used correctly, acetaminophen is safe, effective, and able to treat many symptoms. When people take their medicine incorrectly, however, and consume more acetaminophen than the daily limit, serious liver damage is possible. The Know Your Dose campaign gives consumers three simple steps to make sure they do not misuse medicine containing acetaminophen:

  1. Make sure you read labels. Do not take more than the recommended doses on the label. Taking more acetaminophen than recommended can cause serious liver damage.
  2. Be aware of what medicine contains acetaminophen. Acetaminophen is listed as an active ingredient on over-the-counter drugs. On prescription drugs, it may be listed as “APAP” or “acetam.”
  3. Never take multiple medicines that contain acetaminophen. Using more than one medicine that contains Acetaminophen makes it much easier to accidentally overdose.

NCL recently launched, an interactive site for teens to educate them about the safe use of OTC pain medications. In a study, a majority of teens self report having used OTC pain medications, but overall teens lack knowledge about OTC pain medications. There is little awareness of the active ingredients in their pain medications and they lack familiarity with acetaminophen. Only one in four (27%) teens said they knew what the active ingredient is in their most-often used OTC pain medication.

The U.S. Food and Drug Administration (FDA) recently issued a recommendation to limit the amount of acetaminophen in all prescription pain relievers nationwide to 325mg per dose to prevent unintentional overdose. This cold and flu season NCL is encouraging consumers, and teens especially, to double check and not double up on medicines.

If you aren’t aware of exactly what ingredients are in the product you’re taking, you are putting yourself at risk for doubling-up on the same active ingredient and exposing your body to the potential harm caused by overdosing. Many consumers who self treat pain and cold or flu symptoms may turn to more than one product, often multi-ingredient, without realizing that they’re putting themselves at potential risk of stomach or liver problems.

In February 2014, the American Gastroenterological Association (AGA) launched Gut Check: Know Your Medicine, an education campaign to encourage Americas to read the labels on their medication and be more aware of not taking multiple medications that include the same ingredients. The campaign includes a video that highlights the importance of reading and following OTC medicine labels

Visit today and share this resource with teens in your community.  For more resources on safe use of acetaminophen, visit

Latest on meningitis outbreak – National Consumers League

A multistate fungal meningitis outbreak has occurred among patients who received an injectable steroid. The New England Compounding Center (NECC) based in Farmingham, MA, distributed contaminated steroid medication, used in spinal epidural injections and to treat joint pain, to outpatient facilities across the country. Upwards of 14,000 patients have been exposed to these contaminated injections, resulting in 328 cases and causing 24 deaths across 23 states.

NCL has issued a statement calling for increased oversight on compounding pharmacies, in order to prevent similar tragedies in the future. Read it here>>>


Traditionally, drug compounding involved pharmacies preparing specific doses of approved medications based on guidance from a health care professional to meet an individual patient’s needs. However, in recent years compounding pharmacy companies are engaging in large scale manufacturing of prescription drugs. The compounding pharmacies are not regulated by the FDA, but at the state level.

In 2007 Senator Edward Kennedy introduced legislation – the Safe Compounding Drug Act – with two Republican senators – Burr (NC) and Roberts (KS) to establish protections for the public to ensure the safety of compounded drugs, but it faced opposition from the compounding pharmacy industry and was not passed.

What’s being done?

The Food and Drug Administration (FDA) and the Centers for Disease Control (CDC) have taken steps to notify the public about this outbreak and potential exposures.

CDC Information:
FDA Information:

About the investigation

  • On September 26, 2012, three lots of steroid compound (methylprednisone acetate) were recalled by NECC due to contamination with a fungus.
  • Fungal meningitis is not contagious. This form of meningitis can not be passed from one person to another through contact; only individuals who received the contaminated injection are at risk for developing fungal meningitis.
  • The CDC continues to investigate the exact cause of the contamination, how many people have been exposed and how to best inform patients at risk.
  • For more information:

What is fungal meningitis?

  • Fungal meningitis occurs when the protective membranes covering the brain and spinal cord are infected with a fungus. Fungal meningitis is rare and usually caused by the spread of a fungus through blood to the spinal cord. The severity of meningitis and treatment varies depending on the cause of meningitis; it is important to know the source!

Monitoring for symptoms

  • Fungal infections take time to develop. Symptoms can be seen anywhere from 1 to 6 weeks after exposure. However, shorter and longer periods of time between receiving the injection and the onset of symptoms can occur. It is important to know the symptoms and monitor yourself and others, if you think you might be at risk. As always, contact your health care professional right away if you have any concerns or symptoms.

Symptoms of Fungal Meningitis [Adapted from the CDC].

If you had an epidural steroid injection since May 21, 2012, and have any of the following symptoms, see your health care professional as soon as possible (

  • New or worsening headache
  • Fever
  • Sensitivity to light
  • Stiff neck
  • New weakness or numbness in any part of your body
  • Slurred speech
  • Increased pain, redness or swelling at your injection site

Symptoms of Joint Infection

Individuals who received injections for joint pain should monitor symptoms as the CDC is investigating possible contamination with these injections as well. If you have any of the following symptoms, see your health care provider as soon as possible:

  • Fever
  • Increased pain
  • Redness, warmth, or swelling in the joint that received the injection or at the injection site.

Where is the Outbreak?

Other Information Related to the Outbreak

Spring is in the air – achoo! – National Consumers League

Spring seems to be arriving earlier than ever this year, and — along with it — allergy season. As seasons change and rains bring budding trees, green lawns, and fields of flowers, millions of Americans are plagued with spring allergies. More than 35 million people in the United States suffer from allergic rhinitis — and some may be surprised to learn it’s possible to develop allergies later in life as well. It is estimated that the work missed due to allergies amounts to $250 million annually. So, what’s an allergy sufferer to do?

Seasonal allergies often come in three forms: eye allergies (conjunctivitis), skin reactions (dermatitis), and the most common – allergic rhinitis. More than 35 million people in the United States suffer from allergic rhinitis, and it is estimated that the work missed due to allergies amounts to $250 million annually.

Pollen triggers

The first pollen triggers tend to come from tree pollen, especially in the northern parts of the country. Grass pollen tends to fill the air in late spring. Mold allergens emerge after the first thaw through the first frost, and peak in the late-summer throughout much of the United States.

If you are unsure of your allergy triggers, you can visit your primary care doctor or an allergist to have a skin test.  An allergy skin test is the quickest, cheapest, and most accurate way to determine what allergies you have.

Once you know your triggers, it is important to check the local pollen counts and to stay ahead of the triggers.  If you decide to treat your allergies with medication, you should ideally start your over-the-counter allergy regimen 1-2 weeks before the pollen season begins.

Allergy treatment: avoid pollen

There are many ways to treat allergies. One of the best ways is to avoid the pollen.

  • Keep windows and doors shut at home and in the car – pollen makes its way through screens and open spaces and into your carpeting, seats, and bedding.
  • Avoid peak pollen periods – try to avoid early- to mid-morning outdoor activity when pollen counts are highest.
  • Minimize pollen contact – if spending a lot of time outside, remove and wash clothes upon returning inside, try to rinse the pollen off your body with a shower, and even consider wearing a dust mask if spending a lot of time in a pollen-rich environment.
  • Be careful with pets who go outside – don’t let pets who play outside spend time on your couches or beds, as they will bring pollen with them.
  • Don’t hang laundry outside to dry – pollen will stick to clothes that have been hanging outside.

Hot, dry or windy days result in higher pollen counts and often spread the pollen beyond the source; rain helps lower pollen counts by washing it away.

Allergy treatment: medications

Seasonal allergies can also be treated with medications, usually OTC medications. The first step in treating allergic rhinitis is to use over-the-counter, non-sedating antihistamines each morning. If you are still congested, try using a saline nasal rinse or an oral decongestant (talk to your doctor if you have high blood pressure).  Saline nasal rinses, when used 1-3 times daily, help reduce congestion and sinus drainage.

If you are unable to find relief through these treatments, talk to your doctor about other options, including corticosteroid nose spray.

You can also treat many allergy-related problems with simple over-the-counter remedies such as lozenges for sore throats and antihistamine drops for itchy, watery eyes.

Talk to your doctor

If you continue to feel badly, are unsure of your symptoms, or have questions about seasonal allergies, talk with your doctor or care team.

Changes for asthma medication – National Consumers League

Recently there has been important news from the Food and Drug Administration about the medications used to treat asthma. Understanding your asthma medications will help you understand your asthma and keep you healthy.

If you have asthma you should be seeing a health care practitioner and have a treatment plan in place, which may include medications. Asthma is usually treated with two kinds of medications – fast-acting inhalers (or rescue inhalers) and long-term controllers. Recently the Food and Drug Administration (FDA) made some important announcements regarding both long-term controllers and fast-acting inhalers.

Long-term controllers: long-acting beta-agonists (LABAs)

LABAs are used as long-term asthma controllers relax muscles in the airways and lungs. They can help patients breathe easier and lessen symptoms of asthma such as wheezing and shortness of breath. Because of safety concerns, FDA is requiring changes to how LABAs are used to treat asthma. Studies have shown that use of LABAs increase the risk of hospitalization and even death.

FDA is now requiring the following to appear on the label to ensure the safe use of the LABAs:

  1. LABAs should only be used by those who cannot control their asthma with other medications, and then only for the shortest possible time.
  2. LABAs should never be used without also taking an asthma controller medication, like an inhaled corticosteroid. Medications that include both a LABA and an inhaled corticsteroid are Advair and Symbicort. Single ingredient LABAs such as Serevent and Foradil, should not be used alone.
  3. Children and teens should be prescribed only the combination LABAs to ensure compliance with both medications.

In addition to the label changes, FDA is requiring the manufacturers of LABAs to study the drug’s safety when combined with other drugs, such as inhaled corticosteroids. The manufacturers must also develop risk evaluation and mitigation strategies. These include new medication guides for patients and an education plan for healthcare professionals about the appropriate use of LABAs,

Fast-acting inhalers

Recently the FDA announced the phase out of seven fast acting inhalers that use chlorofluorocarbons (CFCs). Due to concerns about how CFCs damage the earth’s ozone, which protects life from the damaging effects of the sun’s ultraviolet rays, the US has been banning the use of CFCs since the 1970s. CFCs, which make the contents of a canister spray out, have been banned in most consumer aerols, (such as hairspray) for decades. CFCs aren’t harmful to people. Medical devices using CFCs are among the last to be affected.

Many manufacturers have reformulated or are reformulating their inhalers so they don’t contain CFCs. Four of the seven inhalers that were part of FDA’s announcement are no longer being made. The three other inhalers will be phased out over the next three years, and will be banned after the end of 2013. A new way of delivering asthma medications has started replacing CFCs and is called hydrofluoroalkane (HFA). It has been used in inhalers for more than a decade and will continue to replace CFC inhalers as they’re phased out.

The asthma medication in the new inhalers is the same. Only the way the inhaler gets the medicine to your lungs is different. If you use one of the CFC inhalers being phased out, talk to your health care practitioner about using another type of inhaler that does not use CFCs

For more information on the devices that are no longer being made and whose sale will be forbidden after 2013 see the FDA’s announcement.

Flu facts for expectant moms – National Consumers League

Recent reports show that up to 30 percent of pregnant women who are infected with the H1N1 flu virus require hospitalization. And of the H1N1-related deaths reported in the United States, 6 percent of them – a disproportionately high percentage – are pregnant women. According to the U.S. Centers for Disease Control, “Getting a flu shot is the single best way to protect against the flu.” Yet many pregnant women are either hesitant to get a flu shot or have been unable to get vaccinated due to limited supplies.

The National Consumers League wants to make sure that expectant moms have the best information available, so they can make good decisions about protecting their health—and the health of their babies—and know where to go to get the care they need. The following is a fact-filled discussion featuring NCL executive director Sally Greenberg and, providing the answers, Dr. Annelise Swigert, a board certified Ob/Gyn and fellow of the American College of Obstetricians and Gynecologists.

Sally: What is H1N1 flu, also known as swine flu? And what is a flu vaccine?

Dr. Swigert: Every year, the public is faced with a seasonal flu which usually arrives in late fall. This year, the U.S. and many other parts of the world must deal with an additional flu called H1N1 or swine flu. H1N1 is a relatively new virus that was first detected in April 2009. It is contagious, spreading from person-to-person worldwide. Illness with H1N1 has ranged from mild to severe, including hospitalizations, and some deaths. Flu vaccines, given as a shot or inhaled through the nose, protect against contracting the disease.

Sally: Why is it important for women to be vaccinated for the H1N1 “swine flu”?

Dr. Swigert: H1N1 can cause serious complications during pregnancy. Pregnant women who are infected by H1N1 are more likely to end up in the hospital. A recent report showed up to 30 percent of pregnant women with H1N1 required hospitalization. Even if they are otherwise healthy, pregnant women who get the H1N1 virus can develop severe pneumonia and respiratory failure, deliver their babies early, or possibly miscarry. Of all the deaths related to H1N1, six percent have been in pregnant women, an unusually high percentage.

Getting the H1N1 vaccine while pregnant will continue to protect the baby after he or she is born. Studies on previous influenza vaccine use in pregnancy have shown more than a 60 percent decrease in serious illness in infants born to mothers who received the vaccine when they were pregnant.

Sally: Is the vaccine for the H1N1 flu safe for pregnant women and their babies?

Dr. Swigert: Yes, the H1N1 flu vaccine is safe for

pregnant women and their babies, and has been approved by the Food and Drug Administration. The H1N1 vaccine is the same as the seasonal flu vaccine with a slightly different strain of influenza. If H1N1 had been identified a few months sooner, it would have been the seasonal flu vaccine for 2009-2010. The seasonal flu vaccine has been safely given to pregnant women for more than 40 years. The vaccine can be given during any trimester of pregnancy and also postpartum, while breastfeeding.

As with all medication use in pregnancy, your doctor will review risk versus benefit. For most women, the benefit of getting the vaccine and preventing active infection from H1N1 far outweighs the extremely small risk of serious side effects.

Sally: Where can a pregnant woman get the vaccine?

Dr. Swigert: Pregnant women should start by contacting their Ob/Gyn or other primary health care provider if they don’t have access to an Ob/Gyn. The vaccine is available at many Ob/Gyn clinics, and those that don’t have it may be able to help their patients find it elsewhere. Community centers are now holding flu shot clinics for high-risk populations, such as pregnant women or those with certain chronic conditions, like asthma. Some employers will have the vaccine, especially those in health care fields. Always let the doctor or clinic know you are pregnant, as you’re in a high-risk group and should receive priority.

Sally: Is there any way the H1N1 vaccine could have been made more quickly?

Dr. Swigert: This year was particularly challenging because vaccine manufacturers needed to produce many millions of doses of both the seasonal flu vaccine and the H1N1 vaccine – simultaneously. As a result, production of the H1N1 vaccine is being completed in about half the time it usually takes. For the most part, pregnant women and other high-risk groups have been able to get vaccinated, and health officials believe enough vaccine will be available by the end of the year to safely vaccinate all those who wish to receive it.

In Europe, government regulators have approved the use of what are called “adjuvants,” additives that can be added to the vaccine supply to greatly increase its yield

or number of doses available. U.S. officials have not yet approved adjuvants, although many in the medical community believe they are a safe and effective way to expand the vaccine supply.

Sally: How is the vaccine delivered?

Dr. Swigert: The vaccine is available in two ways: an injection and an inhaled version. The injection contains a part of the virus that causes the immune system to make antibodies to protect the body from actual infection. The inhaled vaccine has the live virus that also causes the immune system to make antibodies. Both vaccines are safe and effective.

Pregnant women should receive the shot, and not the inhaled vaccine. Women who are postpartum or breastfeeding can receive either the shot or the inhaled vaccine. Only one injection is necessary to fully protect pregnant women from infection with H1N1.

Sally: Are there side effects?

Dr. Swigert: Some women have mild side effects such as soreness at the injection site or mild headache or body aches 2-3 days after the shot. These are not signs of infection or an allergic reaction, but signs that the immune system is responding as it should to the vaccine.

Women who have an allergy to eggs could have an allergic reaction to the shot and should not receive the vaccine. Serious reac­tions to the vaccine are very rare and occur in only one in every million women.

Sally: Have any unborn babies been harmed by the vaccine?

Dr. Swigert: The only danger to unborn babies is if their mothers get sick with the H1N1 virus. The vaccine is not dangerous, but getting the H1N1 virus is. Studies of pregnant women and their children who received the seasonal flu shot have shown no bad outcomes.

Sally: Will pregnant women who don’t get the vaccine risk getting sick?

Dr. Swigert: Pregnant women who do not get vaccinated risk becoming acutely ill with the H1N1 virus. Many of these women will have mild to moderate illness, but they risk possible complications such as pneumonia and respi­ratory failure. These complications cannot be predicted or prevented, even once the illness is diagnosed. Risks to unborn babies can include premature delivery and respiratory distress.

Sally: Does the H1N1 flu vaccine contain any additives that could interfere with a child’s development?

Dr. Swigert: Thimerosal, a preservative, is used in flu vaccines, including the H1N1 vaccine. Although thimerosal has never been scientifically proven to be harmful to children or pregnant women, due to public perception, vaccine manufacturers have produced preservative-free, single-dose syringes for use in pregnant women. These vaccines are more costly and time con­suming to produce than vaccines with thimerosal, and may not be available in all communities. Your clinic will be able to give you information on the vaccines they have available.

Also remember that because thimerosal has never been scientifically proven to be harmful to pregnant women or the fetus, injections using this preservative should be safe for use in pregnant women.

Sally: My friend gave birth a month ago. Should she get the vaccine now?

Dr. Swigert: Yes. Infants under 6 months of age are at extremely high-risk for complications from H1N1. By getting vaccinated not only will you decrease the risk of getting sick and giving it to your baby, but if you are breastfeeding, the baby will get protection from the illness through antibodies in the breast milk.

Sally: Is the vaccine safe for women who are breastfeeding?

Dr. Swigert: Yes. It is safe to receive either the shot or the inhaled vaccine while breastfeeding.

Sally: What if your family already had the flu this fall? Should expectant mothers still need to get vaccinated?

Dr. Swigert: Yes. Even if members of your family or you have had an influenza-like illness, it is still impor­tant to get vaccinated to protect you and your baby.

Sally: How can we avoid getting the flu?

Dr. Swigert: The best way to prevent the flu is to be vaccinated. Like many viruses, it is transmitted from person to person most commonly through coughing or sneezing. Other important ways to reduce the risk include: washing your hands often and thoroughly with soap, using alcohol-based hand sanitizers, and not touching your nose, eyes, and mouth.

Sally: What are the symptoms of the H1N1 flu?

Dr. Swigert: The two main symptoms of H1N1 are a fever of 100 degrees or higher, and cough and/or sore throat. Other symptoms may include headache, body aches, chills, runny nose, fatigue, diarrhea, and vomiting. Pregnant women should contact their doctor or clinic immediately if they experience any of these symptoms, as they will need to start anti-viral medication.

Sally: What should a pregnant woman do if she thinks she has H1N1? Should she take an anti-viral medication?

Dr. Swigert: H1N1 can be dangerous for a pregnant woman and her baby. Contact your doctor or clinic immediately if you have any symptoms. Treat any initial fever with acetaminophen (Tylenol), which is safe in pregnancy. Anti-viral prescription medications, such as Tamiflu, are recommended for pregnant women and safe to use.

Medication should be started within 48 hours of the onset of symptoms. Confirmation that the illness is the H1N1 virus is not necessary to begin treatment. A pregnant woman should follow her physician’s instruc­tions and should not delay seeking treatment under any circumstances.

Emergency care is necessary if a pregnant woman experiences difficulty breathing, chest pain or pressure, vomiting, dehydration, dizziness, confusion or loss of alertness. It is also important to contact your doctor if your symptoms have improved and then get worse again.

Sally: If a pregnant woman’s child or family member becomes sick with H1N1, should she avoid contact with the sick family member?

Dr. Swigert: If a family member becomes sick, a pregnant woman should contact her doctor immediately to be treated with anti-viral medication. In addition, families should have a plan to care for each other that protects pregnant mothers from the risk of infection. If others aren’t available to help care for a sick child, pregnant mothers should try to limit exposure by washing their hands often, throwing away dirty tissues, and avoiding touching their nose, mouth, or eyes as much as possible. Pregnant mothers may also wear surgical-quality face­masks if they must care for sick family members.

Sally: If a pregnant woman gets the H1N1 flu vaccine, does she need to get the seasonal flu vaccine too?

Dr. Swigert: Yes. The H1N1 flu vaccine will not protect against the seasonal flu. The seasonal flu is also a threat to a pregnant woman’s health – and the health of her baby. The seasonal flu should be treated with the same caution, care, and preventative measures as H1N1 flu.

Cholesterol 101 factsheet – National Consumers League

Cholesterol is a waxy substance made by the liver and supplied in our diet through animal products such as meats, poultry, fish and dairy. Cholesterol is needed (in the body) to insulate nerves, make cell membranes and produce certain hormones. However, too much cholesterol can be unhealthy. How do you know if you are at risk?

Why should you care?

Elevated cholesterol levels can significantly increase the risk of coronary events, such as heart attack and stroke.

What is cholesterol?

Cholesterol is a waxy substance made by the liver and also supplied in the diet through animal products such as meats, poultry, fish and dairy products. Cholesterol is needed (in the body) to insulate nerves, make cell membranes and produce certain hormones. However, the body makes enough cholesterol, so any dietary cholesterol isn’t needed.

Why should you care?

Elevated cholesterol levels can significantly increase the risk of coronary events, such as heart attack and stroke. Excess cholesterol in the bloodstream can form plaque (a thick, hard deposit) in artery walls. The cholesterol or plaque build-up causes arteries to become thicker, harder and less flexible, slowing down and sometimes blocking blood flow to the heart. When blood flow is restricted, angina (chest pain) can result. When blood flow to the heart is severely impaired and a clot stops blood flow completely, a heart attack results.

Are you at risk?

An estimated 104.7 million American adults have high cholesterol (total blood cholesterol values of 200 mg/dL and higher) and about 37 million of these are consideredhigh risk, having levels of 240 or above.

A family history of high blood cholesterol increases the risk of heart disease. Other factors can contribute to a person’s risk of heart disease; these are called risk factors. Some risk factors such as age, family heredity, and gender (male), cannot be controlled. But others — such as smoking tobacco, high blood pressure, physical inactivity, and being overweight — can be controlled. Changes to these controllable risk factors are called “lifestyle modifications.”

Curbing cholesterol

For some, lifestyle modifications are enough to lower cholesterol to safer levels. For others with a hereditary pre-disposition, or who have a hard time making lifestyle adjustments, medical therapy is necessary.

Millions of people trying to control their cholesterol have turned to a class of drugs called statins, which have been used in the United States for more than 18 years to lower LDL (“bad”) cholesterol levels. They have been shown to reduce risk for heart attack and stroke by up to a third, and generally have few immediate short-term side effects.

An OTC statin?

Two companies are working to bring statin therapies — in doses identical to lower strengths currently available by prescription — over-the-counter (OTC). These low-dose options would be recommended only for individuals with borderline-high cholesterol. These companies believe that an OTC statin will both increase public awareness about high cholesterol and encourage people with moderately-elevated cholesterol levels (who don’t often seek treatment) to do something about it.

NCL’s response

Recognizing that an OTC statin would have a large impact on consumers, in July 2004, NCL convened a small roundtable of consumer and patient advocates to discuss the issue, explore whether there is existing research on the subject, and discuss the possibility of further research by NCL. Following that meeting, NCL began working with Harris Interactive, an international survey research and polling firm, to conduct a study to explore consumers’ attitudes toward the possibility of an OTC statinoption. NCL commissioned Harris Interactive to conduct a survey with an unrestricted educational grant from Johnson & Johnson Merck. NCL will continue its collaboration with other interested groups to provide relevant information to consumers about statin therapy options. For the results of the study and more information about this issue, visit

What’s next?

A number of stakeholders are awaiting FDA evaluation of the OTC statin options. We anticipate that the FDA will consider the following issues with great scrutiny:

  • Would patients be interested in using an OTC statin if one were to be made available in the US?
  • Would patients have enough information about the OTC product, written in clear language on the package, to determine whether it would be appropriate for them?
  • Would patients have enough information about the OTC product, written in clear language on the package, to determine how to use it safely?
  • Would patients be likely/willing to undergo the regular cholesterol testing required to determine whether, and to what extent, the medication is working?
  • Would patients still talk with their doctors before and during treatment with an OTC statin?

Obesity survey: The disconnect between size and weight – National Consumers League

According to the Centers for Disease Control and Prevention, an estimated 66 percent of U.S. adults are overweight (33 percent) or obese (33 percent) but, according to a new National Consumers League study conducted by Harris Interactive®, only 12 percent of U.S. adults say they have ever been told by a doctor, nurse, or other health care professional that they are obese. 

Following the recent announcement by RAND Corporation, which notes that the prevalence of American adults who are classified with severe or morbid obesity is increasing at a much faster rate than the prevalence of moderate obesity, the National Consumers League today is releasing troubling new survey data about consumers’ misconceptions about their weight and knowledge of weight-loss options. NCL is also announcing new Web resources for consumers who may need to lose weight but don’t know where to begin the daunting process.The survey of 1,978 adult Americans, was conducted online by Harris Interactive from March 6th to 12th, 2007. NCL has launched a new consumer education campaign, “Choose to Lose”. The new materials available at aim to help consumers overcome the overwhelming task of honestly evaluating their individual weight and work with their doctor to do something about it.

‘Obesity’: Not Admitted by Most

NCL’s new survey found a startling disconnect between the way people perceive their weight, and their actual weight category based on the body mass index (BMI), the most common measurement for obesity. U.S. adults were much more likely to refer to themselves as “overweight” rather than “obese”, and consistently identified themselves as being in less severely overweight groups.  In fact, 52 percent of respondents referred to themselves as overweight, and only 12 percent as obese, severely obese, or morbidly obese. But, based on actual BMI calculations using self-reported height and weight information, among the 96 percent of respondents who reported height and weight, 35 percent are actually “overweight,” whereas 34 percent are actually obese, severely obese, or morbidly obese. Among respondents who are obese according to BMI, 82 percent consider themselves to be simply “overweight.” Alarmingly, only a minority of all respondents (20 percent) claimed to know their BMI number.

“This discrepancy between perceived and actual weight categories suggests that the stigma associated with being obese is a powerful one; many consumers would benefit from a more realistic picture of their own weight,” said NCL President Linda Golodner. “We wanted to find out how consumers feel about their weight, their health, their need to lose pounds, and the stigma surrounding treatment options. We found that while many consumers view obesity as a legitimate disease, they don’t want to identify themselves as ‘obese.’ Weight is a highly personalized, complicated issue, and many overweight and obese consumers are in need of help.”

Perceptions about Obesity: Real Disease, Real Treatment, Real Stigma

Despite the commonly held view that obesity is a serious disease, significant levels of cultural bias persist. Most respondents (78 percent) say that obesity is a serious, chronic disease and that it requires medical treatment (54 percent). Most U.S. adults (61 percent) report, however, that obesity is considered taboo in society today, and half (50 percent) attribute the condition to a “lack of will power.” More than a third of U.S. adults (37 percent) agree that obese people should pay more for health insurance, and more than a quarter (27 percent) say that it is still acceptable to make fun of obesity. And, although many U.S. adults were accepting of many different types of treatment (more below), ranging from diet and exercise to acupuncture, there are still some negatives associated with certain options. For example, although 79 percent of respondents say weight-loss surgery can be a life-saving treatment, half (49 percent) agree that there is a stigma associated with using surgery as a weight-loss option. Moreover, forty-seven percent held a very negative or somewhat negative view of weight-loss surgery.

“There is a serious disconnect between an individual’s perception of both what it means to be overweight and the health risks of carrying extra pounds. While many consumers know that weight loss can improve the illnesses associated with excess weight, they do not have the information to separate unsubstantiated weight-loss claims from evidence-based strategies to support their weight-loss efforts,” said Madelyn H. Fernstrom, PhD, CNS, Associate Professor and founding Director of the Weight Management Center at the University of Pittsburgh Medical Center. “Consumers need accurate information about the lifestyle changes they need to make to not only lose weight, but keep it off. Lifestyle change is the foundation of successful weight loss, but other treatment options, including prescription medications and surgery, can be added to help support—not replace—the lifestyle effort. When it comes to losing weight, one size does not fit all, and obesity treatment should be individually tailored, with careful consideration to both biological and behavioral factors.”

Personal Reflections on Weight & Weight Loss

According to findings, 64 percent of respondents are not happy with their current weight, and many say that more time to exercise (59 percent), better access to healthful foods (31 percent, and more time to cook and eat at home (31 percent) would help them achieve and maintain a healthier weight. More than three quarters (77 percent) of respondents have tried to lose weight at some point, and among these, 60 percent agree that it is one of the hardest things they have ever tried to do. Despite the attempts, many are unsuccessful at either losing weight or keeping it off. Less than a third (29 percent) of those who have ever tried to lose weight report being successful, and about a third (34 percent) have only been able to keep off the weight they lost for less than one year.

“I was fortunate to have a doctor tell me that I seriously needed to lose weight. But not all consumers who need that push from their healthcare professional get it,” said Peggy Kindler, a 51-year-old Pittsburgh, PA resident who has battled weight issues all her life. In the year since gastric banding surgery, Kindler has lost 53 pounds but continues to struggle with the challenges of weight-loss. “As someone who has experienced the very real benefits of losing a significant amount of weight, and being able to keep it off, I truly hope that these new materials for consumers at will help people recognize their weight problem, understand the weight-loss options available and motivate them to get help.”

Getting on Track for Weight Loss

About half (52 percent) of people say that they have talked about losing weight with their doctor, although respondents who are obese are more likely to have done so. Among those who have discussed weight loss with their doctor, nearly three in five (59 percent) report that their doctors recommended a diet change (47 percent) and/or exercise regimen (35 percent). However, only one third discussed the health risks associated with their weight, and only ten percent said their doctor helped them develop a plan to lose weight.

Of the weight-loss options other than regular diet and exercise discussed in the survey, respondents reported being most familiar with: organized weight loss programs (56 percent); over-the-counter medications (42 percent); weight-loss surgery (41 percent); and prescription medications (39 percent). Organized weight-loss plans also were perceived very or somewhat positively by most (69 percent) respondents, followed by counseling/psychiatry (55 percent), and intensive weight loss “camp” (45 percent). More than a third (38 percent) held a very positive or somewhat positive view of weight-loss surgery, while a third thought positively of prescription weight-loss medications (35 percent), acupuncture (34 percent), and hypnosis (33 percent).

About the Survey

The survey was conducted online within the United States from March 6 to 12, 2007 by Harris Interactive® on behalf of the National Consumers League among 1,978 adults aged 18+. According to BMI calculations out of this sample of 1,978, 25 are underweight, 528 are normal weight, 679 are overweight, 351 are obese, 164 are severely obese, 138 are morbidly obese. According to self-assessment 58 are underweight, 590 are normal weight, 1,032 are overweight, 180 are obese, 60 are severely obese, and 48 are morbidly obese. Figures for age, gender, race/ethnicity, education, region and household income were weighted where necessary to bring them into line with their respective total populations. Propensity score weighting was also used to adjust for respondents’ propensity to be online.

With a pure probability sample of 1,978 adults one could say with a 95 percent probability that the overall results would have a sampling error of +/-5 percentage points would have a sampling error of +/-3 percentage points.  Sampling error for data from sub-samples may be higher and vary.  However, that does not take other sources of error into account. The online survey is not based on a probability sample and therefore no theoretical sampling error can be calculated.

NCL thanks Allergan, Inc. for an unrestricted educational grant that made this survey and educational effort possible.



Aspirin and coronary vascular disease – National Consumers League

Aspirin is a very common medication. It can be used to reduce pain, fever, and inflammation. Aspirin has another important benefit: it can reduce the risk of another heart attack or stroke in a person who has already had one. Studies are being conducted to see whether aspirin can prevent a first heart attack or stroke; some doctors recommend aspirin to certain patients who are at risk.

To be effective in helping prevent a heart attack or stroke, aspirin must be used properly. Using aspirin for the prevention of coronary vascular disease (CVD) is very different from using it to treat a headache or fever.

Like all medications, there are risks when taking aspirin—including stomach bleeding and kidney, heart, and liver problems—when taken daily for weeks, months, or years. This Web site will help answer some basic questions about aspirin use for CVD. Talk to your health professional before taking aspirin for CVD prevention. Follow all directions on the label before you take any over-the-counter medicine. If you are not sure, or have any questions about any medication, ask your doctor, pharmacist, or other health professional. 

Questions and answers

Aren’t all pain killers/analgesics the same?

No. There are many types of pain killers/analgesics. They work in different ways in the body, and some are more appropriate than others for certain types of conditions.

How do I know which analgesic is right for me?

You should talk with your health professional (doctor, nurse, pharmacist) about the most appropriate medicine for your situation.

I heard that aspirin is effective in helping to reduce my risk of heart attack or stroke. Are any other analgesics/pain killers also effective?

Only aspirin (salicylic acid) has been proven to effectively reduce the risk of CVD. Many common analgesics contain other ingredients such as ibuprofen (Advil‘, Motrin IB‘), acetaminophen (Tylenol‘), and naproxen (Aleve‘, Naprosyn‘) that have not been proven to reduce the risk of CVD. Read the labels to make sure you are taking aspirin. Many products have more than one active ingredient, including aspirin.

Can I just take the same aspirin that is in my medicine chest at home?

A. You should consult with your health professional before beginning an aspirin-therapy regimen. There are many different varieties of aspirin products to meet your needs. For example, if you have gastrointestinal (GI) problems or are already on medication for GI problems, you may want to take an “enteric coated” (Ecotrin‘, Ascriptin‘) or “buffered” (Bufferin‘) aspirin to reduce your chances of stomach upset. Enteric-coated aspirin is specially designed to dissolve more slowly to avoid stomach upset. Buffered aspirin contains antacids to neutralize the acid in your stomach that causes upset. Read the label to make sure you are taking the appropriate product.

How many aspirin should I take to get the benefit? What is the right dose?

A. Studies have shown that a low-dose (81 mg.) a day is effective in reducing the risk of CVD and stroke. Most aspirins come in doses of 325 mg. or extra strength doses of 500 mg. Look for the product with the dose recommended to you by your health professional

Are aspirin products available in a low-dose form?

Yes. There are a variety of low-dose aspirin products available. Your doctor can recommend one for you. Some common low-dose products include Ecotrin‘ and Bayer‘. If you have trouble finding them at the pharmacy, ask your pharmacist to help you.

What about side effects or interactions with other medicines?

As with any medication, you should talk to your health provider about any and all medicines, including over-the-counter and prescription medicines and dietary supplements (vitamins, minerals, herbals) you are currently taking. Certain medications and dietary supplements can interact with aspirin and cause serious problems. Aspirin is a blood thinner. If you are on a blood-thinning medicine such as coumadin/warfarin or heparin, taking high doses of vitamin E or certain other dietary supplements (gingko biloba, ginseng, garlic, willow bark), check with your health provider. Always read the labels of all your medicines to check for side effect and interaction warnings.