In June last year, amid the uproar over a column and Web blog entry about formaldehyde in Sunsilk shampoo, a reader alerted me to an episode of Oprah Winfrey’s show about the ill health suffered by victims of hurricanes Katrina and Rita who had been living in trailers provided as temporary housing by the United States government. The culprit – formaldehyde fumes. Last week, the Federal Emergency Management Agency (FEMA) finally moved the occupants of the 35,000 trailer homes elsewhere. What took the FEMA so long? Read on.
Formaldehyde is a common preservative in construction materials. From the defenders of Sunsilk shampoo to statements issued by sectors in the construction industry comes a common reply – the amounts of formaldehyde are too negligible to cause any real health problems. A doctor-friend and fellow blogger was candid enough to state that little is known about the effect of repeated use, exposure and buildup of formaldehyde in our bodies.
In the case of the trailer homes occupied by the hurricane victims, FEMA’s excuse was that in the rush to provide temporary housing to the hurricane victims, “manufacturers were pressured to deliver trailers before they’d been adequately ventilated.” Whether that’s a viable explanation and sufficient excuse is highly debatable.
From a Newsweek article:
“By early 2006, word was spreading that people living in the trailers were getting sick. The Sierra Club handed out test kits; which residents used to collect air samples in their temporary homes. The results indicated elevated levels of formaldehyde, but it was hard to get government action, a Sierra Club spokesman says, because there are no federal standards for acceptable levels in travel trailers, which are meant to be used on a temporary basis — not as permanent homes.”
Note the phrase “no federal standards for acceptable levels”. That set me wondering what the acceptable levels of formaldehyde are for consumer products like shampoos. More significantly, which agencies or entities are responsible for setting the standards? In the case of the Philippines, for instance, where shampoos manufactured by multinational corporations are sold, does the government simply accept the representations made in the manufacturer’s lab reports or does it conduct its own studies? Or is it a matter of accepting the safety of a multinational’s product, without further investigation, if it bears the prior approval of, say, the U.S. Food and Drug Administration?
Considering that agencies as huge and as well-funded as the USFDA appear to accept representations by big business and how (read up on how the genetically-modified Monsanto corn got approval, pay attention to the “revolving door syndrome” and note that the Philippines is a significant customer of Monsanto), how bad can it get for government agencies of a poor country where budget is a perennial problem?
Anyway, back to formaldehyde. Exposure to formaldehyde can lead to breathing problems (which is what many of the occupants of the trailers complained of) and is believed to cause cancer, according to an Associated Press syndicated article.
Cancer. That leads us to the next series of articles that, to say it mildly, I found bewildering. The New York Times reports on a nationwide study (“Association of insurance status and ethnicity with cancer stage at diagnosis for 12 cancer sites: a retrospective analysis” by MT Halpern, EM Ward, AL Pavluck, NM Schrag, J Bian and AY Chen, published in Lancet Oncology, March 2008) on the correlation between health insurance and cancer. Major cancer types were studied side by side with information from the “National Cancer Data Base, which began collecting information about insurance in the late 1990s, to analyze 3.7 million patients who received diagnoses from 1998 to 2004” and the conclusion was mind-boggling. It appears that cancer-stricken people with Medicaid, the U.S. health program for low income families, are less likely to be so diagnosed at the early stages of the disease while those who carry private insurance benefit from early detection. In effect, poor people are less likely to survive cancer because their illness remains undiagnosed until the late stages.
From the New York Times article:
“The widest disparities were noted in cancers that could be detected early through standard screening or assessment of symptoms, like breast cancer, lung cancer, colon cancer and melanoma. For each, uninsured patients were two to three times more likely to be diagnosed in Stage III or Stage IV rather than Stage I…
“When comparing blacks to whites, the disparities in late-stage diagnosis were statistically significant for 10 of the 12 cancers. Hispanics also had a higher risk but less so than blacks.”
That last paragraph really raises controversy because between a white patient and an African-American patient both covered by private health insurance, the African-American is still likely to get a late-stage cancer diagnosis. It appears that in America, access to health care isn’t only an economic issue, it is a race issue as well. But it goes deeper.
Central to the issue of economics and race is education. In a society where race, specifically the cultural minorities, is often associated with certain income brackets, it follows that some sectors also often lack access to the kind of education that makes them aware of the importance of regular check-ups and tests vis a vis early diagnosis and treatment.
In another Newsweek article, references were made to hospitals that provide cancer care for patients without private health insurance. Despite that, a lot of patients come in too late. Lack of education is one reason forwarded. Another theory is that there are factors that are “even more race-specific, like communication or cultural barriers between patients and doctors and patient distrust of the health system because of prior experiences.”
So I was thinking: Where does all that leave a person who is poor, non-white and without private health insurance who developed cancer because he had no choice but to live in a government provided trailer that stank of formaldehyde? And if that person dies from cancer, whose fault is it?
“Toxic Trailers”, Newsweek ( HYPERLINK “http://www.newsweek.com/id/112828” http://www.newsweek.com/id/112828)
“FEMA Slammed for Using Toxic Trailers”, Associated Press ( HYPERLINK “http://ap.google.com/article/ALeqM5iuGq6yeUvlwsIsXQiT3Qx23gcpswD8UQLKNO1” http://ap.google.com/article/ALeqM5iuGq6yeUvlwsIsXQiT3Qx23gcpswD8UQLKNO1)
“Study Finds Cancer Diagnosis Linked to Insurance”, New York Times ( HYPERLINK “http://www.nytimes.com/2008/02/18/health/18cancer.html?hp” http://www.nytimes.com/2008/02/18/health/18cancer.html?hp)
“Deadly Delay”, Newsweek (http://www.newsweek.com/id/112952)
“Medicaid”, Wikipedia (http://en.wikipedia.org/wiki/Medicaid)