News News
with breast and ovarian cancer who may be candidates for treatment with taxol is approximately 50,000 persons per year," he added. At the hearing, Rep. Rosa L. DeLauro (D-Conn.) praised the Bureau of Land Management and the Forest Service for exceeding their collection goal of yew bark for 1991. More than 825,000 pounds of yew bark was collected from federal lands last year, surpassing the goal of 750,000 pounds. Several congressional subcommittees sponsored the hearing chaired by Rep. Gerry Studds (D-Mass.) to discuss the availability and conservation of the Pacific yew tree.
—By Mary Folkemer and Sylvia Bennett
Do More Studds recently introduced the Pacific Yew Act of 1991 (H.R. 3836). The act calls for development of a conservation and management plan for the Pacific yew, an inventory of yew trees, and establishment of task forces within the Departments of Agriculture and the Interior to "ensure the development and implementation of consistent policies for 480
Rep. Gerry Studds
EPA's Passive Smoke Assessment: Where Is It? The Environmental Protection Agency's long-awaited risk assessment on passive smoking, including the designation of environmental tobacco smoke as a Class A carcinogen, will likely be released later this year, EPA officials said. A newly revised draft of the document, incorporating results of additional studies on lung cancer in adults and respiratory disease in children, will be reviewed by the agency's science advisory board starting in April, and should be ready for release by late summer or fall - more than 2 years after a preliminary version was made public.
Industry Pressure? Anti-smoking activists have blamed tobacco industry pressure for EPA's failure to release the report earlier, but agency officials insisted the delay is due to limited resources and to the science advisory board's suggestion to better substantiate the conclusions with more evidence. An earlier version of the risk assessment was reviewed by the advisory board in December 1990, and appeared to be headed for a summer 1991 release. The report estimated that passive smoking causes 3,700 lung cancer deaths per year, making it the third largest cause behind direct smoking and radon. Athena Mueller, J.D., general counsel for the anti-smoking organization Action on Smoking and Health, said "EPA top brass were then approached by the tobacco industry, which asked them to send the report back to the science advisory board to rethink its opinions. The board came back and said there was no reason to rethink its previous recommendations." Journal of the National Cancer Institute
Downloaded from http://jnci.oxfordjournals.org/ at New York University on May 29, 2015
Bruce S. Manheim, Jr.
the conservation and management of the Pacific yew." Environmental Defense Fund senior attorney Bruce S. Manheim, Jr., testified that existing logging procedures must be changed to ensure that taxol is available to as many patients as need it. Manheim said the EDF is urging the U.S. Forest Service and the Bureau of Land Management to avoid wasting yew trees by adopting a prelogging strategy on federal lands: to collect and harvest yew bark before other timber, so it is not destroyed or damaged. Rep. Ron Wyden (D-Ore.) testified at the hearing that congressional oversight should be used as a vehicle to ensure that waste is controlled. The Bureau of Land Management and the Forest Service have agreed to develop a conservation and management plan for the yew before the new harvesting season begins. The Forest Service announced that all commercial sales of Pacific yew trees on national forests will be limited to the purpose of taxol production (see Awards, Appointments, Announcements, page 482).
News News
No Undue Influence 'The tobacco industry would love to see this thing delayed forever," he added, "but we've done everything possible to ensure no undue influence is brought to bear on the process, and there really hasn't been." EPA biostatistician Steven Bayard, Ph.D., manager of the passive smoking risk assessment program, said limitations on resources within the agency have slowed progress somewhat, but noted that the passive smoking assessment is moving faster than other comparable health risk assessments. Bayard said the report has been revised and expanded to include additional studies and to take account of extensive comments from the science advisory board and the public. The new revision will include eight new studies on lung cancer risk from passive smoking, including the largest case-control study ever done, and more than 50 studies on risk of childhood respiratory disease. The studies have been subjected to a more critical review this time around, Bayard said. "There are a lot of potentially confounding variables in this research," he said. "Some studies are of higher quality, and we've tried to give these more weight in our analysis." Vol. 84, No. 7, April-1, 1992
Only IS substances are now classified as Class A carcinogens, including asbestos, benzene, and radon. The designation means a substance is known, through sound scientific evidence, to cause cancer in humans. Because tobacco smoke is exempt from regulation under the Toxic Substances Control Act of 1976, EPA is prohibited from doing anything to control exposures to it. But the agency's risk assessment, and a policy guide that is being developed as a companion document, are certain to influence the smoking policies of other groups, Axelrad said. "Everybody, from corporate decision makers to state and local governments you name it, will probably make use of it," he said. The Occupational Safety and Health Administration, which regulates workplace air quality, would have a much stronger mandate to control tobacco smoke exposures in work settings, said OSHA health scientist Deborah Janes. The EPA document would join a 1991 report by the National Institute for Occupational Safety and Health that calls for restricting, or, preferably, banning, smoking on the job.
Guidelines Released On Acute Pain Management Downloaded from http://jnci.oxfordjournals.org/ at New York University on May 29, 2015
Robert Axelrad, director of EPA's Indoor Air Division, said the board was never asked to rethink its recommendations. He said the board agreed with the draft report's conclusions, but suggested it could be improved. "They thought we could have done a better job in a lot of areas to make it a stronger document," Axelrad said. 'The only reason it's going back to the board is that when they submitted their earlier report, they asked for another look at our draft to see how well we'd implemented their recommendations."
The Agency for Health Care Policy and Research, a part of the Public Health Service, recently released the first of a new series of federally sponsored medical care guidelines. The guidelines, on acute pain management, call for aggressive pain management before, during, and after surgery. Failure to control pain not only causes unnecessary suffering but can delay recovery and prolong hospitalization, according to the accompanying AHCPR report. "This guideline discusses the actual physical damage that a patient can sometimes suffer as a result of pain," said Health and Human Services Secretary Louis W. Sullivan, M.D. "And it shows that inadequately managed pain can inhibit recovery, prolong hospitalization, and thus potentially contribute to higherthan-necessary costs." According to
Challenged OSHA Anti-smoking groups such as ASH have challenged OSHA in the courts to force a workplace smoking ban, but have so far been unsuccessful. Janes said OSHA is developing recommendations on indoor air quality, but cannot simply regulate smoking because it is linked to other air quality issues such as biological pathogens, solvents, carbon dioxide levels, temperature, and lighting. However, "if EPA publishes their risk assessment, there's going to be more pressure" on OSHA to regulate tobacco exposures, she said. —By Tom Reynolds
Dr. Louis W. Sullivan NEWS
481
with breast and ovarian cancer who may be candidates for treatment with taxol is approximately 50,000 persons per year," he added. At the hearing, Rep. Rosa L. DeLauro (D-Conn.) praised the Bureau of Land Management and the Forest Service for exceeding their collection goal of yew bark for 1991. More than 825,000 pounds of yew bark was collected from federal lands last year, surpassing the goal of 750,000 pounds. Several congressional subcommittees sponsored the hearing chaired by Rep. Gerry Studds (D-Mass.) to discuss the availability and conservation of the Pacific yew tree.
—By Mary Folkemer and Sylvia Bennett
Do More Studds recently introduced the Pacific Yew Act of 1991 (H.R. 3836). The act calls for development of a conservation and management plan for the Pacific yew, an inventory of yew trees, and establishment of task forces within the Departments of Agriculture and the Interior to "ensure the development and implementation of consistent policies for 480
Rep. Gerry Studds
EPA's Passive Smoke Assessment: Where Is It? The Environmental Protection Agency's long-awaited risk assessment on passive smoking, including the designation of environmental tobacco smoke as a Class A carcinogen, will likely be released later this year, EPA officials said. A newly revised draft of the document, incorporating results of additional studies on lung cancer in adults and respiratory disease in children, will be reviewed by the agency's science advisory board starting in April, and should be ready for release by late summer or fall - more than 2 years after a preliminary version was made public.
Industry Pressure? Anti-smoking activists have blamed tobacco industry pressure for EPA's failure to release the report earlier, but agency officials insisted the delay is due to limited resources and to the science advisory board's suggestion to better substantiate the conclusions with more evidence. An earlier version of the risk assessment was reviewed by the advisory board in December 1990, and appeared to be headed for a summer 1991 release. The report estimated that passive smoking causes 3,700 lung cancer deaths per year, making it the third largest cause behind direct smoking and radon. Athena Mueller, J.D., general counsel for the anti-smoking organization Action on Smoking and Health, said "EPA top brass were then approached by the tobacco industry, which asked them to send the report back to the science advisory board to rethink its opinions. The board came back and said there was no reason to rethink its previous recommendations." Journal of the National Cancer Institute
Downloaded from http://jnci.oxfordjournals.org/ at New York University on May 29, 2015
Bruce S. Manheim, Jr.
the conservation and management of the Pacific yew." Environmental Defense Fund senior attorney Bruce S. Manheim, Jr., testified that existing logging procedures must be changed to ensure that taxol is available to as many patients as need it. Manheim said the EDF is urging the U.S. Forest Service and the Bureau of Land Management to avoid wasting yew trees by adopting a prelogging strategy on federal lands: to collect and harvest yew bark before other timber, so it is not destroyed or damaged. Rep. Ron Wyden (D-Ore.) testified at the hearing that congressional oversight should be used as a vehicle to ensure that waste is controlled. The Bureau of Land Management and the Forest Service have agreed to develop a conservation and management plan for the yew before the new harvesting season begins. The Forest Service announced that all commercial sales of Pacific yew trees on national forests will be limited to the purpose of taxol production (see Awards, Appointments, Announcements, page 482).
News News
No Undue Influence 'The tobacco industry would love to see this thing delayed forever," he added, "but we've done everything possible to ensure no undue influence is brought to bear on the process, and there really hasn't been." EPA biostatistician Steven Bayard, Ph.D., manager of the passive smoking risk assessment program, said limitations on resources within the agency have slowed progress somewhat, but noted that the passive smoking assessment is moving faster than other comparable health risk assessments. Bayard said the report has been revised and expanded to include additional studies and to take account of extensive comments from the science advisory board and the public. The new revision will include eight new studies on lung cancer risk from passive smoking, including the largest case-control study ever done, and more than 50 studies on risk of childhood respiratory disease. The studies have been subjected to a more critical review this time around, Bayard said. "There are a lot of potentially confounding variables in this research," he said. "Some studies are of higher quality, and we've tried to give these more weight in our analysis." Vol. 84, No. 7, April-1, 1992
Only IS substances are now classified as Class A carcinogens, including asbestos, benzene, and radon. The designation means a substance is known, through sound scientific evidence, to cause cancer in humans. Because tobacco smoke is exempt from regulation under the Toxic Substances Control Act of 1976, EPA is prohibited from doing anything to control exposures to it. But the agency's risk assessment, and a policy guide that is being developed as a companion document, are certain to influence the smoking policies of other groups, Axelrad said. "Everybody, from corporate decision makers to state and local governments you name it, will probably make use of it," he said. The Occupational Safety and Health Administration, which regulates workplace air quality, would have a much stronger mandate to control tobacco smoke exposures in work settings, said OSHA health scientist Deborah Janes. The EPA document would join a 1991 report by the National Institute for Occupational Safety and Health that calls for restricting, or, preferably, banning, smoking on the job.
Guidelines Released On Acute Pain Management Downloaded from http://jnci.oxfordjournals.org/ at New York University on May 29, 2015
Robert Axelrad, director of EPA's Indoor Air Division, said the board was never asked to rethink its recommendations. He said the board agreed with the draft report's conclusions, but suggested it could be improved. "They thought we could have done a better job in a lot of areas to make it a stronger document," Axelrad said. 'The only reason it's going back to the board is that when they submitted their earlier report, they asked for another look at our draft to see how well we'd implemented their recommendations."
The Agency for Health Care Policy and Research, a part of the Public Health Service, recently released the first of a new series of federally sponsored medical care guidelines. The guidelines, on acute pain management, call for aggressive pain management before, during, and after surgery. Failure to control pain not only causes unnecessary suffering but can delay recovery and prolong hospitalization, according to the accompanying AHCPR report. "This guideline discusses the actual physical damage that a patient can sometimes suffer as a result of pain," said Health and Human Services Secretary Louis W. Sullivan, M.D. "And it shows that inadequately managed pain can inhibit recovery, prolong hospitalization, and thus potentially contribute to higherthan-necessary costs." According to
Challenged OSHA Anti-smoking groups such as ASH have challenged OSHA in the courts to force a workplace smoking ban, but have so far been unsuccessful. Janes said OSHA is developing recommendations on indoor air quality, but cannot simply regulate smoking because it is linked to other air quality issues such as biological pathogens, solvents, carbon dioxide levels, temperature, and lighting. However, "if EPA publishes their risk assessment, there's going to be more pressure" on OSHA to regulate tobacco exposures, she said. —By Tom Reynolds
Dr. Louis W. Sullivan NEWS
481
