Fast-acting 'Team D' sleuths out sources of foodborne illness

Graduate students in the University of Minnesota School of Public Health vie to get on an elite team, even if they have to put up with its icky nickname—Team D. That's D as in diarrhea. The team's claim to fame is the speed at which it has tracked down the culprits in several recent high-profile outbreaks of foodborne illness involving salmonella and E. coli.

Team D played a vital role in figuring out that jalapeño peppers were behind a nationwide outbreak of salmonella last summer, accurately contradicting the best guesses of federal food-safety officials that tomatoes were the likely source. Earlier this year, Team D played a similarly critical role in identifying institutional jars of peanut butter as the source of a cluster of salmonella cases in Minnesota, a finding that ultimately led to one of the largest food recalls in U.S. history by the Peanut Corporation of America.

So what’s the secret? It’s pretty simple: The students lose no time getting on the phone with every person in the state who has reported contracting a foodborne illness, quizzing them about what they ate and where they ate it in the days before they became ill. All that information is immediately sent to epidemiologists and other disease-detecting experts at the Minnesota Department of Health, which operates one of the top labs in the country for fingerprinting the DNA of viruses.

“I don’t know how we could do the job we do without Team D,” says Kirk Smith, supervisor of the department's foodborne disease division. “It’s probably fair to say they are the brawn, and we—along with the (Minnesota) Department of Agriculture—are the brains.”

Smith says several key factors have made Minnesota’s foodborne illness sleuthing efforts so successful. First, Minnesota law requires hospitals and clinics to send stool samples from suspected salmonella and E. coli victims to a state lab for testing. The lab is able to test samples within a day or two, according to Smith. In other states, it can take weeks.

The lab issues daily reports to the state’s epidemiologists, comparing the results to other cases both within Minnesota and nationally. The scientists look for clusters and patterns that could indicate an outbreak.

Team D has become a model that Michael Osterholm, director of the university's infectious disease research center, hopes other states will follow. “We believe a series of regional Team Ds or a national Team D would go a long way to providing precisely the real-time support for outbreak investigations at the state and local levels that is so sorely needed,” he told a congressional subcommittee well before the peanut product recall.

Craig Hedberg, a professor at the school of public health who helps coordinate Team D, says working on the team is among the most sought after positions for graduate students. “Unlike a lot of graduate student jobs, working for Team D doesn’t involve tuition credits of assistance, but they want to do it anyway,” he says. “It is some of the best experience they can get if they want to be involved in epidemiology and public health. The Team D experience is teaching a whole group of graduate students the best on-the-ground techniques for effectively interviewing victims.”

Kids in Danger calls for tougher crib standards

The Product Safety Letter is required reading for the safety blog team. Until recently, most of the content was for subscribers only but lately the editors have invited safety advocates and experts to share their views on a free part of the site called the Product Safety Forum.

Today's feature, "Crib safety at a crossroads" is by Nancy Cowles, executive director of Kids In Danger (KID), a nonprofit organization dedicated to protecting children by improving children’s product safety. In it, Cowles talks about the need for tougher crib standards in the wake of the recall of millions of cribs over the past two years.

"Kids In Danger was founded in 1998 by parents who lost a son to an unsafe portable crib. Danny was trapped and strangled when the top rail of the Playskool Travel-Lite Crib collapsed around his neck," Cowles writes. "Danny’s death highlights the problems with sleep environment safety."

"The existing testing standards don’t go far enough," she continues. "Performance requirements in the mandatory and ASTM standards are currently not stringent enough as it pertains to: (1) the durability of drop-side systems and related hardware, (2) the durability of other crib hardware, (3) wood strength or quality, and (4) the hazards that can result from incorrect assembly." 

We couldn't agree more. Cowles hits on points we've made on previous blog postings on crib durability and we were happy to see her well-reasoned argument for tougher standards.

Dr. Gary Smith: Product designers should think more like kids

Bunk beds, ATVs, fireworks, shopping carts, play grounds—these are just a few of the causes of injuries to children that concern Dr. Gary Smith. Founder and director of the Center for Injury Research and Policy at Nationwide Children’s Hospital in Columbus, Ohio, Smith spends his time studying the safety of products and activities from a kid’s point of view

“The world around us is designed by adults for the convenience of adults,” says Smith, who is also an associate professor of pediatrics, emergency medicine and epidemiology at Ohio State University. “What is perfectly safe for adults sometimes isn’t safe for children.”

Smith says the makers of many different products often don’t do a good job addressing child safety issues at the initial design stage. “There often isn’t good testing until products are on the market,” says Smith. “There are many safety issues that should be considered pre-market, not post market. It would be nice to prevent the problems rather than deal with them after they have occurred.”

Take smoke alarms, for example. Smith and his team wanted to determine if the typical smoke alarm did an effective job waking up children so they can get to safety. “Anyone who has kids knows how hard it is to wake them up out of a deep sleep and how they are groggy for a bit when you do,” says Smith. “That’s something called ‘sleep inertia’ and it is critical to making an effective smoke alarm for kids.”

The researchers used several methods to try and awaken the child subjects including the familiar smoke alarms that emit loud blasts. They also experimented with a parent's voice telling a child to wake up. Smith says the research showed the sound of a parent’s voice awakened the children quicker than loud sounds and flashing lights. The voice also cut through the initial grogginess much quicker.

As a result of that study and similar findings, including those of Australian researchers, the National Fire Prevention Association, which sets standards for fire alert equipment, changed its rules in 2007 to allow voice smoke alarms.

In his time at the CIRP, Smith has studied everything from tree house safety to bicycle accidents to injuries sustained during soccer games and cheerleading. His activism has led to changed practices and laws resulting in safer playgrounds, helmet use for biking and other sports, seat belt use for children in shopping carts, and greater awareness of fireworks-related injuries, among other things.

Until recently, most of CIRP’s research focused on the United States, but that is changing. The new goal is to go international. The center recently began a project studying the effects of sleep disturbance and school work pressures on farm work-related injuries among middle school students in China.

Around the world, approximately 2,500 children die each day from injuries, and 95 percent of those deaths occur in middle and low income countries, says Smith. “To take this to the international level where it can literally save the lives of millions of children is an extraordinary opportunity.”—Bob Williams

Andrew Hartung: Dogged dad's persistence results in a crib recall

Early one morning in September 2007 Andrew Hartung and his wife Carolyn of Manalapan, N.J. awoke to a sound no parent wants to hear: shrieks of pain from their 14-month-old daughter Abigail.

The Hartungs looked at the video baby monitor in their bedroom and quickly realized something was wrong with the baby's crib. They rushed into her room and found Abigail with her fingers trapped in a gap between the top rails.

After freeing his daughter, Andrew Hartung inspected the crib and discovered the bolts at the corners of the crib had come loose, creating the gap. Upon closer inspection, he discovered that the bolt holes had been drilled too closely to the edge, causing the wood to split.

Fearful that other children would become entrapped in similar cribs, Hartung called the company that distributed them, Bassettbaby, a unit of the well-known furniture maker Bassett. He said that a Bassettbaby vice president told him that his was the only complaint the company had received about the crib and that it was not going to take any action to notify other consumers who might have bought one, part of a Wendy Bellisimo Collection line sold exclusively at Babies 'R' Us.

“That made me mad,” says Hartung. “That was a big mistake on their part.”

Suspecting the company was not telling him the truth, Hartung contacted the Consumer Product Safety Commission. According to the CPSC, Bassettbaby had already received 85 reports of bolts loosening on the cribs, including one report of a 13-month-old child's hand becoming trapped between the railings.

Hartung didn’t stop there. He contacted children's-product designer Wendy Bellisimo’s company. A few days later, Hartung said, Bellisimo’s husband called back and said they had not heard anything about any problems with the cribs and that they were “horrified” by what he had told them.

A few weeks after the Hartung incident, a CPSC investigator came to their house and took away the faulty crib. And a month later the CPSC announced a recall of 8,900 of the cribs and cautioned parents to stop using them.

Bassettbaby has since issued two other recalls of Wendy Bellisimo cribs.  All of the recalled cribs were manufactured in China and sold exclusively at Babies 'R' Us. In February, 18 cribs were recalled because spindles on the drop-side of the crib could loosen creating a gap that poses an entrapment and strangulation hazard.  And in June, 550 more cribs were recalled because the space between the spindles on some failed to meet federal standards and could pose an entrapment hazard.

When contacted this week, Bassettbaby spokesperson Angela Mize said the company would not comment on any of the recalls or on Hartung's story.

This past August young Abigail and her family traveled to Washington to attend a Congressional signing ceremony for a landmark product-safety bill, part of which requires the CPSC to study and develop safety standards for infant and toddler products including cribs. The legislation was pushed through with the help of hundreds of citizen consumer advocates like Hartung.

In a fitting coda, at the end of the ceremony House Speaker Nancy Pelosi handed Abigail one of the pens used to sign the legislation.

Professor Jeffrey Weidenhamer: Lessons learned about lead

When the Consumer Product Safety Commission recently recalled a lead-laden key chain sold at Wal-Mart for three years, Ashland University Professor Jeffrey Weidenhamer was pleased but puzzled. Pleased that the CPSC had acted to remove the key chain from the market but puzzled that it had taken them so long to do so. After all, Weidenhamer had found high lead levels in a similar key chain when he tested it in 2006 and reported his results to the CPSC that December. What prompted the April recall was not Weidenhamer's testing but reports that a nine-month-old child who had mouthed one had elevated levels of lead in her blood.

"You shouldn't have to wait a year or 16 months to recall a product,"  Weidenhamer told a reporter for the Cleveland Plain Dealer.

Until recently, Weidenhamer’s research specialty had been chemical compounds produced by plants. Now he is more widely known for the research that he and his students at the Ohio college have done on lead in children’s toys. His findings may have resulted in at least 11 recalls by the Consumer Product Safety Commission involving more than 1.4 million individual items. That’s an impressive track record—although Weidenhamer is hesitant about touting it. As he wrote in Ashland's alumni magazine, “It is unfortunate that someone can become well known for drawing attention to lead contamination issues. It certainly would be far better for the kids if there were no story at all about lead contamination in these products.”

Weidenhamer’s fame all started with a chemistry class, Lead and Civilization, that he taught for non-majors and that focused on the chemistry and toxicity of lead. Then in the spring semester of 2006, he learned that a four-year-old Minnesota boy had died of lead poisoning after swallowing a lead-laden charm given away with a pair of shoes by Reebok International. (Earlier this year, Reebok agreed to pay a record $1 million penalty for distributing the charm bracelet).

Knowing that the analysis of metal samples for lead was not too involved, Weidenhamer thought his class would be able to conduct tests in the lab to see if similar items were on store shelves in his Ohio city. “I was not prepared for what my students found,” he said. “In the first set of 20 inexpensive jewelry items, 14 were heavily leaded, in two cases as high as 100 percent lead by weight.” CPSC guidelines for lead in children’s jewelry items sets a maximum level of 0.06 percent lead by weight.

Weidenhamer and his students have done repeated testing since the spring of 2006, including some tests of Halloween toys completed at the request of Ohio Senator Sherrod Brown.  Weidenhamer says he tested more than 50 different items and found lead contamination in six of them, including plastic teeth. That, he says “seemed like the worst since they were clearly designed to go into a child’s mouth.” (The teeth were recalled by the CPSC.)

This spring, Weidenhamer found lead in several Easter products, two of which were recalled by the CPSC the Friday before Easter.  “It is a surprise that after all the publicity about toy recalls of last year ... you can still find items on the shelves with lead in them.” He said he will continue to test products. “Hopefully by Halloween this year, we won’t be finding lead in paint in these products,” he said. “It shouldn’t be remotely possible for me or anyone to go out to American stores and pull products from shelves, test them and find levels of lead in them.”

Let's hope he's right but as long as it is possible, we are thankful for Weidenhamer’s efforts. And for that, he becomes one of our safety crusaders.

CPSC recalls related to complaints filed by Weidenhamer

• 86,400 children's "Ultra Gear" bracelets (DM Merchandising) Feb. 7, 2007
• 115,000 "Claudia Jublot" children's rings (Big Lots) Feb. 23, 2007
• 396,000 metal key chains (Dollar General) April 3, 2007
• 63,000 Frankenstein tumblers (Dollar General) Oct. 4, 2007
• 55,000 Halloween skull pails (Albert’s) Oct. 17, 2007
• 142,000 purple Halloween pails with witch decorations (Family Dollar Store) Oct. 25, 2007
• 43,000 “Ugly teeth” party favors (Amscan Inc.) Oct. 31, 2007
• 10,000 Halloween-themed baskets (Hobby Lobby) Nov. 16, 2007
• 205,000 pieces assorted Rachel Rose jewelry (Family Dollar Store) Nov. 21, 2007
• 13,000 camouflage eggs and spinning egg top toys (Hobby Lobby) Mar. 21, 2008
• 310,000 seasonal writing pads (Michaels Stores)

Shelby Esses: A mother's intuition exposes a toy hazard

When 20-month old Jacob Esses ended up in an inexplicable coma last October, one person was sure she knew the answers that the doctors couldn’t find—his mom. Shelby Esses was certain her son’s frightening state was due to the Aqua Dots beads he had swallowed earlier that day. Esses was so confident that as she waited for news about her son’s condition, she asked her mother and mother-in-law to scour store shelves for Aqua Dots looking for the ingredients on the package. 

Fortunately, six hours after falling into a coma, Jacob woke up.  Determined to find out what had caused her son to become so severely ill, Esses didn't give up her search until she found the answer. And after she did, she took a number of steps that illustrate what one person can do to make a difference.

When her son became sick, Esses did all of the right things: She contacted the company that manufactured Aqua Dots to inform them of her son’s condition. She asked for the toy’s ingredient list and even submitted this list to the toxicology lab at her son’s hospital. The lab results showed that the toy was indeed toxic—it contained ingredients that when ingested metabolized into GHB, also known as the date-rape drug. Her information helped lead to a recall of Aqua Dots on November 7, 2007. The recall of 4.2 million sets was one of the fastest toy recalls in U.S. history.

But Esses didn’t stop at the recall. In the following months, she and several other parents of children who also suffered injuries from toys, played a critical role in lobbying Congress to enact tougher safety rules. She was an articulate spokeswoman who helped to put a human face on the issue.  As she told her story in Congress: “I was angry.  I am still angry. I think that there needs to be a few changes made for toys and other children's products that are sold in the United States.”

Among other things, Esses believes that products should be tested by independent labs to ensure that they do not contain lead or other harmful ingredients and that companies should post phone numbers on their Web sites for parents to call with questions about products.

The good news for all parents, families and caregivers is that both the Senate and the House of Representatives have just passed new legislation governing the safety of toys. The language of the two measures needs to be reconciled so we end up with one powerful bill. We are hopeful that Congress will get to work and do just that in the days ahead. When that happens, we will have Esses, among others, to thank.

For her efforts, we are naming Esses one of our safety crusaders. If you know someone who should be a safety crusader please let us know.

Ward and Montana Stone: Father-daughter safety sleuthing team

Genetics may help explain why 11-year-old Montana Stone became so interested in what was in her jewelry box.

Montana’s mother is a biology teacher who, according to Montana, frequently cautioned her children about going to old houses because of lead paint hazards. Montana’s father is a leading wildlife pathologist for New York State's Department of Environmental Conservation who developed a lead testing process to determine if animals had been killed by bullets illegally when hunters were claiming they had used only a bow and arrow.

So it’s really not hard to understand why Montana started wondering earlier this year if the favorite items in her jewelry box contained lead. “There were a lot of people just talking about lead in jewelry and I started wondering if there's lead in [mine],” Montana recalled in a recent telephone interview.

Her curiosity was all that her father needed to launch a full-scale testing of children’s jewelry. Together, Montana and her dad went to stores near their home in Albany and bought dozens of pieces of children’s jewelry. “We bought about 75 pieces and tested into the night,” at Stone’s office, the elder Stone said. “I would hand a piece to him and he would test it,” Montana added. (Don’t worry, both wore surgical gloves so they wouldn’t get exposed to any lead). What they found was distressing: “We found lots and lots of lead, far more than half” of the pieces they purchased, Ward Stone said. And some of those pieces had very high levels of lead.

The father-daughter team then bought more items, including metal beads at Michaels Stores, where Montana buys a lot of arts and crafts items. Those items also had high levels of lead.

Disturbed by the findings, Ward Stone took his results to the office of New York Attorney General Andrew Cuomo. The staff conducted another round of tests resulting in both a nationwide recall of more than 500,000 pieces of jewelry as well as a settlement with 12 companies, including the national chains of Michaels and Big Lots, in which they promised to stop selling lead-tainted items in their stores.

Father Stone gives all the credit to his daughter. “If it had not been for her, Dad would not have done what he did”—or continues to do. Both Montana and her dad are still buying and testing jewelry. And they’ve expanded their studies to include plates and mugs as well. The results continue to be disturbing; much of the dishware has been coated with lead paint, Stone reports.

Certainly, both Montana and Ward Stone deserve to be added to our list of Safety Crusaders for their curiosity, persistence, diligence—and results.

If you know of any safety crusaders who should be added to our list, please let us know.

Congress takes some key consumer actions before holiday recess

Congress left town for the holidays Thursday, after giving consumer safety advocates some of the items on their wish list, and leaving them tantalizing close to others.

Congress made substantial progress on a number of key issues—most notably the House’s unanimous passage of a bill to update the Consumer Product Safety Commission to help it become more effective in regulating the 15,000 types of products under its purview. The measure still has a way to go before it can become law. The Senate has yet to consider its version, which includes stronger enforcement provisions than the House version and has run into some opposition.  Even so, we are pleased that so many in Congress realize how important it is to reform our current product safety system.

The House bill is a compromise that is supported by a number of consumer groups including Consumers Union, the publisher of Consumer Reports, the Consumer Federation of America, and the U.S. Public Interest Research Group. It would make meaningful improvements to the under-funded and understaffed agency and includes a major provision to reduce lead in children’s toys and other products. It also establishes new testing requirements for children’s products. Sen. Mark Pryor (D-Ark), the author of the Senate version, has said he is “one hundred percent committed to passing” the Senate version in 2008. We can’t imagine a better way to start the New Year.

While we wish the effort to upgrade the CPSC’s powers had been completed in 2007, we are pleased that both the House and Senate did agree to boost the agency’s budget to $80 million this fiscal year. That’s a $17 million increase, or nearly 30 percent, over last year’s funding and more than $16.75 million more than what President Bush requested for the current fiscal year.  The measure is part of an omnibus federal funding bill to keep the government running. So far, the CPSC hasn’t said what it plans to do with the extra money but we await that announcement with eager interest.

Nancy Baker: A daughter's drowning leads to pool safety reforms

Nancy Baker never envisioned becoming a leading advocate for safer pools and spas.  However, the tragic accident that killed her 7-year old daughter Graeme in 2002 prompted her to act. As she says, “It helps me make some sense of something that makes no sense at all. It was an utterly preventable and senseless death.”

Baker’s personal story, coupled with her tireless campaign to make sure such a tragedy doesn’t happen to others, is one of the chief reasons why Congress could soon enact a federal pool and spa safety bill named for Graeme. The bill, which would direct the Consumer Product Safety Commission to set an anti-entrapment safety standard for pool and spa covers, was passed by unanimous vote in the House in October and now awaits Senate action. The measure also encourages states, through financial incentives, to pass strong laws to require fences and anti-entrapment drain cover devices to reduce childhood drowning. Although the measure has strong bipartisan support, its fate is uncertain according to The Washington Post because the fiscal conservative Sen. Tom Coburn, (R-Okla.) has put a legislative hold on the measure, along with several dozen other bills, because they authorize new spending without offsetting that expense elsewhere in the federal budget.

Graeme Baker, who had been swimming unassisted since she was three, drowned after becoming trapped underwater by hundreds of pounds of suction force from a hot-tub drain. Graeme had gone to the graduation party of a family friend with her mother and four sisters, including her twin, Jackie. Soon after they arrived, one of Baker's daughters ran toward her and screamed, "Mommy! Mommy! Graeme is in the hot tub." Baker says: "I jumped in."

As she later testified in Congress: “It took two adults to pull her off this drain, the force so great that the cover of the drain cracked in half removing her.” 

Janette Fennell: Safety at under 5-miles-per-hour

“It if can’t be done, don’t interrupt the person who is doing it.”

Janette Fennell says that quote has become her motto. And in safety circles, Fennell has certainly become better known than the person who uttered those words -- he, or she, is known as “anonymous.” Fennell, the founder and president of Kids and Cars, is determined to “make a difference.”  So, she says, don’t interrupt her when she’s trying to figure out how to do something that many say can’t be done.

Kids and Cars is a nonprofit safety group whose mission is to make sure no child is killed or injured in non-traffic motor vehicle accidents. Such incidents include children being backed over by adults—often by their own parents in a driveway; children left in cars in hot weather; children inadvertently setting cars in motion and children caught—and sometimes strangled—when the power window switch is unwittingly turned on. According to data collected by Kids and Cars, at least 598 children were involved in such incidents last year, resulting in 219 fatalities. Already this year, there have been 468 incidents and 133 fatalities.

This summer there have been some harrowing examples. In Kyle, Texas a, mother accidentally backed over her 18-month-old son when he wandered behind her pickup. On Long Island, New York, this week, a mother ran over her five-year-old when she didn't realize he was in front of her minivan as she pulled into the driveway. And earlier this summer in Concord, California, an 11-month-old was found dead buckled into his car seat in an oven-hot minivan after his father forgot he was in the back seat and went to work.

For more than a decade, Fennell has worked tirelessly for new government rules to reduce such incidents. It was largely through her efforts that the government, in 2000, mandated release latches in car trunks. More recently, her safety campaign helped prompt the government to issue new rules requiring safer power switches on windows although Fennell wants even tougher rules that would require windows to auto-reverse when the window glass hits an obstacle.

Fennell believes that little has changed since Ralph Nader  emerged as a national consumer advocate with his book “Unsafe at Any Speed” in 1965. At the time Nader accused the car makers of resisting safety features such as seat belts.  “We have the same problems today,” says Fennell, although now, there are so many non-traffic incidents that she suggests the book be retitled “Unsafe at No Speed.” Backovers are “one of the top reasons for child fatalities in this country,” causing about about 2,400 hospital emergency room visits and 100 fatalities a year, she said.  "There is a huge hole missing in education and understanding of dangers of vehicles at zero to five miles-per-hour," she says. 

Fennell is now pressing Congress to pass legislation that would require the government to issue a standard for vehicles that would require car makers to improve the field of view when backing up.  The legislation, spearheaded by Fennell, is called the Cameron Gulbransen Kids and Cars Safety Act and has companion bills in both the Senate and the House.  Consumers Union, the nonprofit publisher of Consumer Reports, supports this bi-partisan legislation and has collected more than 32,000 signatures petitioning Congress for its passage.

Calling herself a survivor advocate, Fennell explains that she became a car-safety missionary after a bone-chilling event. In October 1995, she and her husband and their then-infant child, Alex, were returning to their California home around midnight when two men kidnapped them, forcing the adults at gunpoint into the trunk of their own car. They were driven to a remote area, robbed and abandoned. The Fennells were able to tear apart the trunk’s interior, find the release cable and free themselves. Realizing that their son was no longer in the back seat, they called police who discovered the boy unharmed outside their house. Fennell knows her family was lucky; the outcome could have been very different. And her work makes it clear she’s determined to make sure that’s the case for hundreds of other families.

By any definition, Fennell (who now lives in Kansas) is a safety crusader, someone who belongs on our growing list of citizens and groups determined to make the world a safer place.

Do you know any crusader we should meet? Please send us your nominations by adding your comments.