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July 20, 2012


Washington Letter
July 20, 2012
Newsletter of the American Thoracic Society's Washington Office

1150 18th Street NW
Suite 300
Washington, D.C. 20036
Telephone:(202) 296-9770


NIH Receives Flat Funding in House Labor, Health and Human Services Bill

The House Labor, Health and Human Services and Education Appropriations Subcommittee passed a fiscal year 2013 bill that provides funding to the Departments of Labor, Health and Human Services, and Education as well as related agencies. The bill provides level funding for the National Institutes of Health but cuts $787 million from the Centers for Disease Control and Prevention and $453 million from the Health Resource and Services Administration.

The bill contains a number of policy riders that prevent any funds from being used to implement the Affordable Care Act; prevent any patient-centered outcomes research; defund a black lung-disease prevention program; eliminate the Agency for Health Research and Quality; and cut $1billion from the Public Health Prevention Fund of the Affordable Care Act.

The bill also contains a provision that lowers the salary support for federal grants, including NIH grants, from level II to level III —effectively cutting grant salary support for grant recipients.

It is expected that many of these policy riders will be removed as the bill moves through the legislative process.


House Subcommittee Passes Bill to Restore Primatene Mist to the US Market

The Energy and Power subcommittee of the House Energy and Commerce Committee passed legislation that would return Armstrong Pharmaceuticals’ Primatene Mist chlorofluorocarbon (CFC) inhalers to the U.S. market.

As part of an international treaty to remove ozone depleting substances from consumer products, the Environmental Protection Agency (EPA) ended the essential use permit for CFC for inhaled epinephrine beginning on Jan. 1, 2012. This effectively removed Primatene Mist CFC from drugstore shelves. The EPA had originally planned to remove Primatene Mist starting in 2011, but granted a one-year extension in response to Armstrong’s request. Several other respiratory drugs that used CFC as a propellant have already successfully transitioned to non-ozone depleting formulation.

Because of EPA’s decision to remove the CFC essential use designation for Primatene Mist CFC, the product has been off the market for the past six months. The legislation passed by the committee would allow the existing 1.2 to 1.4 million units of Primatene Mist CFC to be sold in the U.S. until the existing stockpile is exhausted. If the legislation is enacted, it will mark the first time Congress has intervened in the CFC transition process to protect the interest of a particular company.

Earlier in the week, the Energy and Power subcommittee held a hearing on legislation to restore Primatene Mist. ATS President Monica Kraft, MD, testified in opposition to the legislation and noted the potential adverse side effects associated with epinephrine use. The ATS also joined 10 other medical and public health organizations in a letter to the committee expressing strong concerns with the legislation to return Primatene Mist CFC to the U.S. market.


ATS Testifies at EPA Field Hearing on Particulate Matter Pollution

This week ATS members testified at two field hearings conducted by the Environmental Protection Agency (EPA) to collect public input on revising the National Ambient Air Quality Standard for particulate matter. At a hearing in Philadelphia, ATS member Scott Manaker, MD, noted the Society’s strong support for issuing a stricter standard for particulate matter. In his comments, Dr. Manaker noted the strong scientific basis for issuing a stricter standard. “ What is most impressive about the scientific literature regarding air pollution is that it is comprehensive, with literally hundreds of studies documenting that particulate matter air pollution is bad for human health,” Dr. Manaker said. “The research is also consistent, over decades; researchers have been able to apply improved research technologies to document the health effects of air pollution at consistently smaller doses.”

ATS member Kent Pinkerton, PhD, presented the ATS testimony at an EPA field hearing in Sacramento, Calif., and noted the strong scientific basis for a stricter standard. Dr. Pinkerton said the Society supports:

  • 11 ug/m3 for the average annual standard;
  • 25 ug/m3 for the 24-hour standard; and
  • 99th percentile for data monitoring.

The current standard is:

  • 15 ug/m3 for the average annual standard;
  • 35 ug/m3 for the 24-hour standard; and
  • 98th percentile for data monitoring.

”When particulate matter pollution is reduced, human health improves,” Dr. Pinkerton said. “A three-year closure of a steel plant in Utah Valley in the state of Utah significantly reduced particulate matter in the valley leading to a statistically significant reduction in all cause mortality. In Atlanta, Ga., particulate matter reductions associated with 1996 Atlanta Olympics lead to reductions in pediatric asthma emergency room visits, asthma exacerbations, and asthma inhaler use. Similar health improvements were noticed in particulate matter reductions related to the Beijing Olympics.”

The ATS will continue to advocate for a stricter particulate matter standard and will file written comment on the EPA’s proposed rule.


The Washington Letter is written by the American Thoracic Society government relations office and emailed to all ATS members living in the United States. The letter keeps clinicians, scientists, and patients abreast of legislative, judicial, and regulatory issues in pulmonary, critical care, and sleep medicine. Each week's edition is archived on the ATS Web site, www.thoracic.org. If you have any questions or want more information about becoming involved in advocacy, please contact the ATS Washington office at 202-296-9770.