News in brief - Dec. 4, 2006

Delegates act on mercury pollution - AMA seeks better access to HIV testing - AMA to develop suicide resource Web page - Federal law needed to block porn in libraries, AMA says - Delegates call on insurers to cover HPV vaccine

Delegates act on mercury pollution

AMA delegates voted to strengthen mercury pollution policy due to the global public health threat mercury causes in the environment.

The new policy, adopted at the Interim Meeting last month, calls on the United States to take a leadership role in reducing the global mercury burden and in working toward binding, health-protective international standards. It encourages state governments to be proactive in protecting citizens from harmful mercury emissions. The policy also recognizes that the trading of air pollutants is potentially harmful for vulnerable populations, and that the federal Clean Air Mercury Rule is inconsistent with the AMA's health protective approach to air pollution.

"More must be done to address the global public health threat of mercury emissions," AMA Trustee Ardis D. Hoven, MD, said in a statement. "We also encourage manufacturers to reduce mercury use wherever possible, to take advantage of available and emerging technology to reduce mercury emissions and to better track mercury's current use."

AMA seeks better access to HIV testing

The House of Delegates adopted policy that supports the Centers for Disease Control and Prevention's 2006 revised recommendations for HIV testing of adults, adolescents and pregnant women. The AMA will continue to work with the CDC to implement the recommendations, including exploring the publication of a guide regarding the use of rapid HIV testing in primary care settings.

The new policy also asks the AMA to identify legal and funding barriers to implementing the HIV testing recommendations and to develop strategies to overcome those barriers.

AMA to develop suicide resource Web page

Suicide is the third leading cause of death for U.S. residents between 10 and 24 years old, according to the Centers for Disease Control and Prevention, but resources to help doctors address the problem are scattered among more than a dozen medical societies and government agencies. At its Interim Meeting last month, the House of Delegates asked the AMA to convene a temporary task force to bring together existing resources in a useful database available to doctors at the AMA Web site.

Potential resources include continuing medical education classes, patient education programs, fact sheets and other items aimed at helping doctors recognize the warning signs of trouble in their young patients and head them off before tragedy strikes. The online information will be regularly updated to keep current with the latest evidence.

Federal law needed to block porn in libraries, AMA says

Congress should pass a law to restrict Internet access to pornographic materials in libraries and other public areas that children can enter, according to the AMA's House of Delegates. At its Interim Meeting last month, the house also adopted policy in support of school-based media literacy programs to help children as young as 5 learn to use the Internet safely.

"Safe and beneficial use of the Internet by minors requires programs that have strong educational impact on children," AMA Trustee Joseph P. Annis, MD, said in a statement.

While favoring restrictions on Internet use in libraries, the house-approved Board of Trustees report cited a 2002 JAMA study finding that the most restrictive Internet filters block 91% of pornography but also catch 24% of health information sites. As a result, filter settings should be monitored carefully so that children's access to health information isn't unduly hindered, according to the new policy.

Delegates call on insurers to cover HPV vaccine

Hailed as a landmark in preventive medicine for women when it was approved in June, insurers have so far been slow to cover the human papillomavirus vaccine or to adequately reimburse physicians for the costs associated with providing it. At its November Interim Meeting, the House of Delegates said that needs to change, directing the AMA to encourage insurers to pay for the medicine and advocate for vaccine assistance programs for the uninsured.

David A. Ellington, MD, a family physician and alternate delegate from Virginia, complained that even when insurers say they cover the vaccine doctors may be left holding the bag. "Insurers will give you 80% of what you pay for the vaccine and an administration fee that hardly covers electricity for the refrigerator," he said. "We want full reimbursement and adequate administration fees."

The Advisory Committee on Immunization Practices recommends that the HPV vaccine be given to girls 11 to 12 years old, though girls as young as 9 and women age 26 and younger can also receive it. The National Cancer Institute says women as old as 45 can benefit from the vaccination.