The new SI Report (html 43.56 kB) (html 48.85 kB) , January 2010, has been published and features stories on a FHWA report on performance measurement, the hazards of "politically-correct" weather forecasting and third quarter industry safety statistics. Read it now (html 43.56 kB) .

The Occupational Safety and Health Administration (OSHA) collects and compiles worker injury data, but its reporting system contains "disincentives that may discourage workers from reporting work-related injuries and illnesses to their employers and disincentives that may discourage employers from recording them," according to a recent report from the US Government Accountability Office (GAO). Examples include:

...workers may not report a work-related injury or illness because they fear job loss or other disciplinary action, or fear jeopardizing rewardsbased on having low injury and illness rates. In addition, employers may not record injuries or illnesses because they are afraid of increasing their workers’ compensation costs or jeopardizing their chances of winning contract bids for new work. Disincentives for reporting and recording injuries and illnesses can result in pressure on occupational health practitioners from employers or workers to provide insufficient medical treatment that avoids the need to record the injury or illness.

GAO estimates that a third of US employers face these pressures. Still other factors undermine the accuracy of employers' injury and illness data, said GAO, including "a lack of understanding of OSHA’s recordkeeping requirements by individuals responsible for recording injuries and illnesses."

GAO recommends that OSHA:

(1) require inspectors to interview workers during records audits, and substitute other workers when those initially selected are unavailable;

(2) minimize the time between the date injuries and illnesses are recorded by employers and the date they are audited;

(3) update the list of high hazard industries used to select worksites for records audits; and

(4) increase education and training to help employers better understand the recordkeeping requirements.

GAO says OSHA has agreed with the changes.

As Washington, DC, digs out from two feet of snow a week before Christmas, another round of winter weather paralyzed Christmas Day travel in the US midwest. A picture is worth a thousand words. It seems we've enjoyed above-average snow and ice events since the recent global warming confab in Copenhagen.

Weather forecasts from London's Met office for a "probably mild" winter and "light snow" December 21 were not just mistakes, according to WeatherAction long-range weather and climate forecasters. The easy-winter forecasts were designed to please the
Government’s ‘Global warming’ ideology when the forecasting method used has consistently failed," maintains WeatherAction.
WeatherAction says its models predicted the huge storms that immobilized the UK (and Copenhagen) at the end of the Global Warming summit last week. Moreover, the group forecasts major snowstorms in January and predicts "Salt to run out -- again."
Most snowfighters, whether they subscribe to the global warming hypothesis, know the vagaries of weather require prudent preparation so we doubt the Brits will have a salt shortage.

No, this post doesn’t concern Dan Brown’s best-selling mystery novel by this title nor even reference the seasonally-referenced celestial battle presaging the birth of Christ which celebration is quickly upon us. But, like the engaging plot of a quick-read novel or the enduring scriptural lessons about man’s struggle to live good lives resisting evil designs and temptations, the notion of “angels and demons” leapt to mind when I read the recent study in the International Journal of Obesity on “white hat bias.”

Coming on the heels of “Climategate” with its ethically-challenged but politically-correct data suppression and intimidation, the article by David B. Allison, director of the Nutrition and Obesity Research Center at the University of Alabama-Birmingham and former colleague Dr. Mark Cope, touches many of the same sensitivities. The two scientists reviewed studies of the effects of consuming sugar-based beverages and breastfeeding and found consistent “white hat bias (WHB).” Without regard to how one feels about the quality of research into global warming or the contributions of sugar-sweetened beverages or breastfeeding to consequent obesity, we hope we can all agree that the assault on scientific integrity in the name of assorted “white hat” do-good causes is, ultimately, self-defeating and something worthy of universal concern.

They define WHB as “bias leading to distortion of research-based information in the service of what may be perceived as righteous ends.” (The reference to “white hats” being to early Hollywood western films where the “good guys” wore white hats while outlaws wore black hats).

Allison and Cope conclude that obesity research “may be misrepresented by scientists operating with particular biases … sufficient to mislead readers.” Allison sounds “a warning bell,” stating: “White-hat bias is a slippery slope that science and medicine need to resist.” He continued: “Some researchers like to demonize certain products or defend practices with a kind of righteous zeal, but it’s wrong to stray from truthfulness in research reporting.”

The NIH-funded study noted that “this bias appeared in studies not funded by industry.”

As in Climategate, the parallels with the salt/health controversy are uncanny. Scientists have long been accorded vast public credibility owing to their systemic pursuit of truth. We all need vigilance to unmask those (hopefully, few) who would abuse this credibility and play fast-and-loose with the expected high standards of scientific inquiry. We all want medical researchers who are angels of truth who rigorously resist the corruption of white hat bias in pursuit of their personal “righteous” – but wrong – political preferences.

The Federal Highway Administration’s Office of Operations has published an important benchmarking report on use of performance measures which assesses state DOT adoption and effectiveness of harnessing new techniques and technologies to improve roadway operations impaired by adverse weather conditions.

As FHWA reports, “The impact of weather events on roadway safety and capacity is substantial.” Two measures, in particular, address major concerns for those dedicated to improving winter roadway safety and mobility. They are:

• The percentage of time a roadway meets safety and capacity level of service (LOS) standards during and after weather events (normalized by the frequency/intensity of winter events), and
• The reduction in roadway user costs as measured in traffic delays, crashes, vehicle operating costs, emissions and salt damage attributable to road weather strategies.

As the Salt Institute has argued, FHWA concludes that “national level statistics do no exist yet to directly measure” the goal of measuring safety and LOS/capacity impairment. Nearly a third of agencies (32%) measure “time to wet/bare pavement.” Only 4% measure “percent of time that lanes are open during a weather event, 7% measure “pavement friction,” 11% measure “time to pre-event travel speeds after a weather event” and 18% measure “customer satisfaction with maintenance and recover time.” Another 25% use undefined additional performance indicators.

While performance measures are “in an early phase of deployment,” there is better news in adoption of new operations strategies. New Sensible Salting techniques are being adopted. Road Weather Information Systems (RWIS) is credited with reducing crashes by 17% and anti-icing by 83%, but since the latter figure is equivalent to the 85% crash reduction in using older deicing techniques, the finding hardly represents great progress.

Snow and ice on roadways cause significant service degradation, the report explains, cutting roadway capacity by 25% or more (to say nothing of the number of would-be drivers who abandon planned trips entirely). Free-flow speed declines 19% in snow conditions. Despite this reduced load, weather-impaired roads are the cause of 22% of all injury and fatal traffic crashes, half of them due to slick roadway surface conditions. Overall, weather causes more than 500 million vehicle-hours of delays every year, the report documents. “Most of this estimated delay (90 percent) was due to snow in urban areas.”

Pursuit of road weather performance measures “has enabled and continues to strive for a culture shift among traffic operators to a more proactive weather management approach that in turn will improve safety and capacity,” the report concludes. The federal program is also “undertaking studies relevant to safety, including studies of the microscopic and macroscopic behavior of traffic in inclement weather conditions, weather-sensitive traffic prediction and estimation modeling, and evaluation of the effectiveness and safety implications of road weather advisory and control information.” FHWA is promoting its Maintenance Decision Support System (MDSS) to automate winter operations and participating in the IntelliDrive program to harness new “smart car” technology to improve road weather operations.

Congratulations to the management and production teams at these facilities for their recent safety achievements:

• Cargill Salt - Watkins Glen, NY evap plant, 600,000 hours
• Cargill Deicing Technology - Avery Island, LA mine, 500,000 hours
• Compass Minerals - Duluth, MN processing facility, 200,000 hours & six years
• Cargill Deicing Technology - Lansing, NY mine, 100,000 hours
  
• Cargill Salt - Newark, CA processing facility, 100,000 hours
  
• Compass Minerals - Chicago, IL processing facility, 100,000 hours & two years
  
• Sifto Canada - Goderich, ON evap plant, 100,000 hours & one year
  
• Cargill Salt - Buffalo, IA terminal, six years
• Cargill Salt - Cincinnati, OH terminal, four years
  
• Cargill Salt - Hutchinson, KS evap plant, two years
  
• Cargill Deicing Technology - Cleveland, OH mine, one year

The latest new study from Oxford University says that traffic-light labelling on the front of food packages do not influence consumer choices. Technical Director Mort Satin provides his opinion on the traffic light label..and..the UK, where the label was invented...and the Food Standards Agency who are actively promoting it. Vlog on (x-ms-wmv 18.35 MB) ...

An evaluation of road deicing alternatives directed by Xianming Shi and Laura Fay of the Western Transportation Institute at Montana State University and conducted for the Colorado Department of Transportation examined common chloride, acetate and ag byproduct deicers and concluded:

• Corrosion-inhibited salt (NaCl) and mag chloride (MgCl2) is preferred "until better deicer alternatives are identified."
• Training, calibration and minimized application rates -- the essence of the Salt Institute's Sensible Salting program -- are key to minimizing adverse environmental impacts.
• Chlorides in the environment did not exceed the water quality standard. This is an aesthetic standard for taste, not a health standard.

The report formulated a "deicer composite index" similar to that published a few years ago as NCHRP Report 577 . The model, like that of Report 577, allows local customization. Using the current weighting for Colorado users, the method validated current CDOT user priorities ("the inhibited liquid MgCl2 deicer products present a better alternative than either the non-inhibited NaCl or the K- or Na-acetate/formate deicers").

Better watch out. Better not slide. Better watch out; I'm telling you why. Officials who don't clear roads, may lose their jobs.

Citizens know when you are sleeping; they know when you're awake. They know when you've been bad or good, so be good for goodness sake.

Tis the season for a little reminder to government officials: Ignore winter maintenance at your peril because there are a number of legendary examples of officials who have had worse than coal in their stockings.

In New York City during the winter of '68-'69, Republican mayor John Lindsey was held responsible for a snow removal debacle in the borough of Queens. He had the poor judgment to go out in his limo to survey the mess and his limo was stuck in the snow. He was retrieved by rescuers in a four-wheel drive--a complete public relations disaster.

During the harsh winter of '78 and '79 in Chicago, Mayor Michael Bilandic was labeled as incompetent for the city's failure to adequately clear roads. His opponent used this to her advantage during the campaign and pundits blame the snow for Bilandic's defeat.

In Washington DC in 1996, infamous Mayor Marion Barry took a bit less heat for disastrous snow removal efforts mostly because residents in the District were accustomed to the city's inadequate snow response. In fact, if you look at the antics of Marion Barry, you might draw the conclusion that the citizens were willing to overlook most any bad behavior.

And more recently, the Valentine's Day Blizzard of 2007 drastically affected the eastern half of North America, halting commerce and causing 37 deaths. In Pennsylvania, officials were under attack by residents who believed that they did not adequately respond to the snowfall. Although citizens don't need a study to know that salting and plowing saves lives, a study by Marquette University details the safety benefits of proper winter maintenance.

Since there is also an economic cost to poor winter maintenance, in this tough economy, we encourage officials to keep the roads clear for commerce and for the safety of their residents. They know when you've been bad or good. It is a little difficult to hide poor winter maintenance (video ).

Stories this month (html 48.91 kB) include a consensus that salt iodization does not interfere with attempts to reduce population salt intakes, the relevance of "climategate" to the salt and health debate, how New York City is risking its greatest culinary achievement and severe economic loss in China due to poor winter road maintenance.

The recent revelation that some global warming scientists have fudged data to hide information that didn't suit their purposes is very similar to the process we are now witnessing in the Dietary Guidelined Advisory Process. Once you start tampering with data, you can be sure it will not stand the test of time. Click on the photo for a short VLOG on the issue.

The Wall Street Journal's on a roll on "climategate," and we recently pointed to the disturbing parallel of the parasitic relationship of government advocates and special interest groups on the global warming and salt reduction issues. Today's WSJ carries an opinion column by Daniel Henniger, "Climategate: Science Is Dying ," making another observation relevant to the salt and health debate: the use of junk science to prop up government policy goals -- whether by the Bush or Obama Administrations -- is creating, in Henniger's words, a "credibility bubble. If it pops, centuries of what we understand to be the role of science go with with it."

Henniger points out the corrosive effect on science of the environmentalists'-touted "precautionary principle" whereby objective standards of evidence are replaced by subjective judgments -- "this slippery and variable intellectual world has crossed into the hard sciences."

Henniger quotes an Obama Administration spokesperson on the "precautionary principle:"

The Obama administration's new head of policy at EPA, Lisa Heinzerling, is an advocate of turning precaution into standard policy. In a law-review article titled "Law and Economics for a Warming World," Ms. Heinzerling wrote, "Policy formation based on prediction and calculation of expected harm is no longer relevant; the only coherent response to a situation of chaotically worsening outcomes is a precautionary policy. . . ."

If the new ethos is that "close-enough" science is now sufficient to achieve political goals, serious scientists should be under no illusion that politicians will press-gang them into service for future agendas. Everyone working in science, no matter their politics, has an stake in cleaning up the mess revealed by the East Anglia emails.

The tie to salt, we hope, is obvious. In the absence of evidence from even a single controlled trial of whether salt reduction would improve health and in the absence of any evidence that physiological salt appetite can be modified as a "behavior" by either education of policy diktat, the government errs on the side of precaution. I use "err" purposefully since the current policy is erroneous both on the science and even on the question of precaution. Low-salt diets are risky for some people and may be risky for the entire population. So even advocates of the "precautionary principle" should favor our longstanding advocacy of a controlled trial to get the evidence right. Close isn't "close enough for government work."

A commentary by Bret Stephens in today's Wall Street Journal , "Climategate: Follow the Money," raises issues, believe it or not, that pertain directly to salt. Salt? Bear with me. Stephens explains:

Climategate, as readers of these pages know, concerns some of the world's leading climate scientists working in tandem to block freedom of information requests, blackball dissenting scientists, manipulate the peer-review process, and obscure, destroy or massage inconvenient temperature data—facts that were laid bare by last week's disclosure of thousands of emails from the University of East Anglia's Climate Research Unit, or CRU.

We have no direct evidence that World Action on Salt and Health (WASH) and its salt reductionist members are engaged in such nefarious activities, but Stephens goes on to explain how "follow the money" makes sense when you take off the blinders that only money coming from corporate sources may be influencing a policy debate. "Money" is why we continue to see studies of salt and blood pressure when everyone accepts a relationship and why we're seeing more observational studies of the right question: salt and health outcomes. But the reluctance of the federal government to fund a controlled trial of salt and health outcomes may be linked to the tangled web of "money" as well.

Consider that thought when reading what Stephens says about the devotion of the universities and groups advocating on global warming:

(T)hey depend on an inherently corrupting premise, namely that the hypothesis on which their livelihood depends has in fact been proved. Absent that proof, everything they represent—including the thousands of jobs they provide—vanishes. This is what's known as a vested interest, and vested interests are an enemy of sound science.

Which brings us back to the climategate scientists, the keepers of the keys to the global warming cathedral. In one of the more telling disclosures from last week, a computer programmer writes of the CRU's temperature database: "I am very sorry to report that the rest of the databases seems to be in nearly as poor a state as Australia was. . . . Aarrggghhh! There truly is no end in sight. . . . We can have a proper result, but only by including a load of garbage!"

This is not the sound of settled science, but of a cracking empirical foundation. And however many billion-dollar edifices may be built on it, sooner or later it is bound to crumble.

The American College of Physicians has weighed-in the media flap over evidence-based medical recommendations . ACP's for them. So are we. We have no expertise in the area of mammography, but we are close students of the larger question over whether "evidence" or "experts" should be the source of our public health policies. We weigh-in on the side of evidence-based recommendations.

ACP president Joseph W. Stubbs decries "the politicization of evidence-based clinical research." He calls for reliance on evidence and a transparent process. Noble words, we'd agree.

But inconsistent. ACP still carries on its website, a 2004 advisory to ignore the 2003 findings of this same US Preventive Services Task Force ; USPSTF found insufficient evidence to support a population salt-reduction strategy . We agree with that evidence-based conclusion as well and invite Dr. Stubbs to join us in advocating a "constructive and transparent" process on the salt/health controversy.

With that single caveat, we commend the ACP statement that

... critics have made unfair and unsubstantiated attacks on the expertise, motivations, and independence of the scientists and clinician experts on the USPSTF.

ACP believes that it is essential that clinicians and patients be able to make their own decisions on diagnosis and treatment informed by the best available scientific evidence on the effectiveness of different treatments and diagnostic interventions. The USPSTF is a highly regarded, credible and independent group of experts that performs this role, on a purely advisory basis, to the Department of Health and Human Services, as it relates to interventions to prevent or detect diseases. As is often the case with evidence-based reviews, the USPTF’s recommendations will not always be consistent with the guidelines established by other experts in the field, by professional medical societies, and by patient advocacy groups. Such differences of opinion, expressed in a constructive and transparent manner so that patients and their clinicians can make their own best judgment, are important and welcome. It is not constructive to make ill-founded attacks on the integrity, credibility, motivations, and expertise of the clinicians and scientists on the USPSTF.

Some critics have erroneously charged that the USPSTF’s recommendations were motivated by a desire to control costs. According to the Agency for Health Care Research and Quality, “the USPSTF does not consider economic costs in making recommendations.” The Agency continues, “it realizes that these costs are important in the decision to implement preventive services. Thus, in situations where there is likely to be some effectiveness of the service, the Task Force searches for evidence of the costs and cost-effectiveness of implementation, presenting this information separately from its recommendation” and the “recommendations are not modified to accommodate concerns about insurance coverage of preventive services, medicolegal liability, or legislation, but users of the recommendations may need to do so.” [emphasis added in bold]

Under the bills being considered by Congress, the USPSTF will have an important role in making evidence-based recommendations on preventive services that insurers will be required to cover, but the bills do not give the Task Force — or the federal government itself — any authority to put limitations on coverage, ration care, or require that insurers deny coverage. Specifically, the House and Senate bills would require health plans to cover preventive services based in large part on the evidence-based reviews by the USPSTF, but no limits are placed on health plans’ ability to offer additional preventive benefits, or in considering advice from sources other than the USPSTF in making such coverage determinations. Accordingly, patients will benefit by having a floor – not a limit – on essential preventive services that would be covered by all health insurers, usually with no out-of-pocket cost to them. Patients will also benefit from having independent research on the comparative effectiveness of different treatments, as proposed in the bills before Congress. The bills specifically prohibit use of comparative effectiveness research to limit coverage or deny care based on cost.

The controversy over the mammography guidelines illustrates the importance of communicating information on evidence-based reviews to the public in a way that facilitates an understanding of how such reviews are conducted and how they are intended to support, not supplant, individual decision-making by patients and their clinicians.

ACP urges Congress, the administration, and patient and physician advocacy groups to respect and support the importance of protecting evidence-based research by respected scientists and clinicians from being used to score political points that do not serve the public’s interest.

Let's all agree on the process: follow the science. And then let's agree that digging in to defend the current politically-correct policies -- whatever they may be, but in our area of concern, policies that try to guide salt intake levels -- should be seriously questioned when such independent policy auditors as the USPSTF point out discrepancies between policy and evidence. To paraphrase the strategy that unraveled the Watergate scandal: follow the evidence. Let's not cherry-pick the science and support only the outcomes we like.