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World: Health Report -- Russia Fears Spread Of HIV/AIDS; UN Agency Sees Alarming Childhood Malnutrition In Iraq

In this edition of the RFE/RL Health Report, Washington correspondent K.P. Foley looks at developments at an international AIDS conference in Moscow, a United Nations report on what the organization calls unreasonably high levels of childhood malnutrition in Iraq, and new U.S. government regulations aimed at taking some of the stresses and strains out of the workplace.

Washington, 22 November 2000 (RFE/RL) -- In Moscow last week, the World Bank offered to lend Russia $150 million to combat the spread of the disease AIDS and the HIV virus that brings it on. in Washington, Bank spokesman Christopher Walsh tells RFE/RL that Russian and Bank experts on AIDS will draw up a program for spending the funds. He says the money will most likely be used for health education and AIDS prevention programs. The Bank's executive board is expected to approve the loan.

The World Bank made the offer during a Moscow conference sponsored by the United Nations Program on HIV/AIDS. HIV is the English acronym for Human Immunodeficiency Virus. AIDS is the acronym for Acquired Immune Deficiency Syndrome. Both Russian and UN experts told the conference that the spread of AIDS in Russia could reach catastrophic proportions unless action is taken quickly to stem growth rates. There is no cure for AIDS and there is no vaccine to immunize people against HIV. Experts agree that prevention offers the best protection against HIV and AIDS.

UNAIDS Executive Director Peter Piot told the conference that an estimated 130,000 people in Russia are infected with HIV and the World Bank says there are more than 10,600 reported AIDS cases. However, the actual number of AIDS cases may be four to five times higher. Piot said there could be more than 300,000 infected with HIV by the end of this year.

Arkadiusz Majszyk of UNAIDS Russia said intravenous drug use is mainly responsible for the spread of HIV. He told the conference he is concerned that "a second wave of HIV infections, spread by sexual contact, could follow the current drug-driven epidemic."

The funds for the AIDS program will be included in a package that also seeks to stem the spread of tuberculosis in Russia. The Bank says the death rate from tuberculosis in Russia is the highest in Europe at 17 deaths for every 100,000 cases. The Bank says the "epicenter" of the tuberculosis epidemic in Russia is the nation's prison system. An estimated 97,000 inmates, out of a total prison population of 1.2 million, are suffering from tuberculosis. Tuberculosis is a debilitating infectious disease caused by the spread of bacteria from infected people. It most often affects the lungs and can lead to death if not treated. Experts say drug therapy is effective but sufferers often do not seek treatment until it is too late, or do not complete treatment.

In addition, experts at the UN and the World Bank say that if health authorities do not meet international standards for treatment, drug resistant strains of the infection develop. Prisoners with the disease spread it in their local communities when released, placing additional burdens on local health officials.

The World Bank project aims to help Russia finance the development and purchase of proven anti-tuberculosis drugs.

UN Agency Sees Alarming Childhood Malnutrition In Iraq

The United Nations Food and Agriculture Organization reports that child malnutrition remains high in central and southern Iraq, despite the UN's Oil for Food Program that enables Iraq to sell oil at world prices to purchase humanitarian supplies. In a report issued earlier this month, the agency said the high levels of malnutrition may be partly responsible for an increase in child mortality, which the UN says has more than doubled since the 1980s.

According to the UN report, more than ten percent of Iraq's children under five years who live in central and southern Iraq showed signs of what is called wasting, or when bodyweight is too low for a child's height. The agency says the levels are "unreasonably high." The report says a condition called stunting, when children are too short for their age, has increased from 20 percent of children to 27 percent of children in rural areas, but, the condition is seen in just 12 percent of children under five in Baghdad.

In contrast to central and southern Iraq, the health of children is much better in northern Iraq, where the Oil for Food Program is administered by the UN. The report says malnutrition has been almost eliminated. In addition, the north is also more self-sufficient in food production and does receive more outside assistance per person than the central and southern regions, where a two-year drought has crippled agriculture.

U.S. Agency To Implement New Workplace Protections

The U.S. Occupational Safety and Health Administration (OSHA) is introducing new regulations intended to protect more than 100 million American workers from injuries caused by the repetition of their daily physical tasks. The agency has published what it refers to as an ergonomics program standard for dealing with musculo-skeletal disorders that develop at the workplace.

Ergonomics in this case refers to the practice of adapting work or working conditions to suit the worker, and a musculoskeletal disorder -- or MSD as the agency calls it -- is an ailment affecting a person's muscles, nerves, tendons, ligaments, joints, cartilage, blood vessels or spinal discs. In other words, MSDs are the problems that the government agency wants to solve and ergonomics provides the solution. The government wants employers -- large and small, from the public and private sectors -- to make adjustments to the workplace to eliminate the cause of the injuries, to provide medical treatment for the affected employees and to guarantee them their jobs while they are away from work for rehabilitation.

Gary Orr, an ergonomics specialist at OSHA, tells RFE/RL that the agency has been developing a program to address the issue of MSDs for nearly a decade. He describes MSDs as injuries that do not result from accidents or exposures to chemicals or other pollutants, but are caused by the repeated and long-term exposure to physical stresses and strains.

"There are about 600,000 lost workday cases every year of MSDs and through developing an ergonomics program we found that a lot of companies have virtually eliminated them."

He says the injuries seem to affect chiefly people who work with their hands.

"We have looked at, the data that we have shows that production type of jobs and manual handling jobs have the worst occurrence of MSDs. But, you know basically it's jobs even like, you know, computer operators, people who are in the sewing industry. A lot of folks have exposures, they're very repetitive, they don't give enough opportunity to recover and so you develop a musculo-skeletal disorder."

According to Orr, the regulation states that all employers must inform workers about the signs and symptoms of MSDs, the importance of reporting the symptoms as soon as possible, how to report MSD in the workplace and the risk factors, job and work-related activities associated with MSD hazards. If an MSD is reported, the employer must start a process that leads to a review of the employee's job to determine if it meets one or more risk factors linked to development of MSDs. These risk factors are repetition, force, awkward postures, contact stress and vibration.

Orr says some ergonomic solutions may be simple and relatively cheap.

"One thing that's very common is for everybody to be working at the same height of work surface, and we know that people vary somewhat and the way you have to accommodate is, if you're too tall you bend over -- so you've got the constant pressure on your back to support your upper body. If the table height is too high, then you move your shoulders up. So it's either raising the height of the work surface by putting some blocks under it or raising the worker if the worker is too short by putting a platform under the worker."

According to Orr, about six million workplaces will have to conform to the standards.

"The regulations would apply to everybody in what we call general industry and what that excludes are people in agriculture, construction, maritime and in the railroad industry. It would also exclude those people who work in a support staff for those particular industries, so the office workers in a construction firm, for example, would also not be covered by this standard."

Orr says OSHA economists estimate that it will cost an average of $250 per job to fix the ergonomics problems. He says the total cost to business would be about $4.5 billion a year, but, he says the savings from less sick time and improved productivity would be an estimated $9.1 billion a year.

Some advocates for business are not welcoming the regulations. The U.S. Chamber of Commerce, which, among other things, seeks to favorably influence legislation that affects business, has announced that it will file a lawsuit to block the implementation of the OSHA rules. The Chamber contends the regulations violate an employer's legal rights to have a clear standard set for them.

The regulations do not require Congressional approval and they are due to take effect on Jan. 16 but employers will have until next Oct. 15 to collect information on MSDs and then disseminate that material to their employees.