Harm Reduction

Do you remember doing the limbo as a kid? The idea was to see how low you could bend your body to get under a stick that got increasingly close to the floor. Today’s regulatory process is the modern version of the limbo. The problem is that science can’t even measure how low they want the limbo stick to go.
In several respects, the latest draft of EPA’s formaldehyde IRIS toxicological review is an improvement over an earlier version I reviewed as an EPA advisor in 2017.  Unfortunately, other aspects of EPA’s current draft suffer from a lack of judgment and adherence to EPA’s guidelines and is a missed opportunity to work with outside parties, such as our European colleagues.  The overall impression of EPA’s current draft is that formaldehyde is toxic at levels below what is often found indoors or in outdoor air. 
Federal regulators and anti-tobacco campaigners are on the warpath against flavored vaping products. Though alcohol and marijuana use are more common (and more harmful) teenage vices, there seems to be little interest in restricting access to these products.
As a bipartisan group of Senators seeks a regulatory path away from gun violence, “One proposal being discussed would possibly incentivize states to enact red flag laws on an individual, rather than national, basis. But for some Republicans, red flag laws are already too invasive of a regulation.” [1] Are red flag laws helpful, or more safety theater? A new study provides some useful information. I wonder if the Senators will take “the science” into account?
Everyone I know is against STDs (Sexually transmitted diseases). I haven’t heard anyone say the solution is to ban sex. Instead, most health specialists advocate “safe sex.” When it comes to guns, however, this rationality is lost. We’re either categorically in favor or against, with some focusing on gun safety. So, how would you make a safer gun?
Every action we take, every discovery or innovation we make, has consequences, many of them unintentional. Consider artificial sweeteners (AS), developed to fulfill many needs: to reduce calories in processed foods such as soft drinks, lower glycemic indices for patients with diabetes, and aid dieters in weight loss. Now, scientific literature reports that AS, like microplastics, are emerging as trace pollutants in our waters and soils.
While the nation reels from the horror of Uvalde and the paralysis following Sandy Hook, we should note a statistical analysis of 133 school shootings published last year. The findings should transcend politics, wishful thinking, scapegoating, and conspiracy theories. We present highlights here and summarize the authors’ conclusions.
From the academic center of the city by the bay comes a new study on e-cigarettes – in this instance, looking at the modeled health costs. Is their conclusion that “healthcare utilization and expenditures attributable to e-cigarette use are substantial and likely to increase over time” true? I will give them a B for the math but, at best, a D for the underlying assumptions and narrative.
According to the Office of the Inspector General of Health and Human Services, 1 out of every 4 Medicare beneficiaries admitted to the hospital in 2018 experienced harm. Do I have your attention? Good, because the reality may be quite different when you know more about the study underpinning that headline.
Every year there are approximately 400,000 medication errors involving hospitalized patients. Many are medications given at the wrong time or not at all. Of those 400,000 somewhere between seven and 9,000 [1] of those errors result in the death of a patient. RaDonda Vaught, a nurse employed at the Vanderbilt University Medical Center, caused the death of a patient with a medication error. I have been thinking about Ms. Vaught a lot lately.
We’ve all been there: Searching online for something to buy, deciding not to, and then having the item stalk us as we move from site to site. (It doesn’t even disappear if we purchase it.) Advertising tracking has been accepted as the price for a “free” Internet, but a new study shows that ad tracking from Big Pharma is alive and well in medical journals. We shouldn’t be surprised.
A recent study suggests that vaping is much less harmful than smoking. The authors and the journal that published the paper tried to minimize this result. Do they have an anti-vaping bias?