A Medical Device Daily
Nanotechnology has not made a huge impact on the device industry, but things continue to inch along, partly thanks to the taxpayer. However, the investment made by Uncle Sam will, at least for the next few years, require more study of the environmental and health effects of nanotechnology.
The House of Representatives reauthorized the 21st Century Nanotechnology Research & Development Act last week in fairly short order. Rep. Bart Gordon (D-Tennessee) introduced H.R. 5940 to the House Committee on Science and Technology on May 1, and the bill passed by a vote of 407-6 on June 5.
H.R. 5940 requires that the director of the Office of Science and Technology Policy, which is part of the White House, designate an associate director of the office as "the Coordinator for Societal Dimensions of Nanotechnology." This individual would be required to name a panel that would direct research into short- and long-term effects of nanotechnology on the environment and public health.
The Congressional Budget Office scored the effect of the bill in a May 19 analysis, which states that the net impact would be $5 million in direct costs over the five years of the reauthorization (2009-2013). The analysis also states that the bill "would not affect direct spending or revenues."
As for the Senate, the Commerce Committee has jurisdiction in one of its subcommittees, the Science, Technology and Innovation Subcommittee, chaired by John Kerry (D-Massachusetts). The subcommittee is said to be at work on a draft, but calls to the subcommittee were not returned by press time.
The greater emphasis on environmental health and safety comes as no surprise, given the considerable controversy over nanotechnology that has arisen over the past couple of years. The Project on Emerging Technologies (PEN; Washington), a private foundation that scrutinizes the impact of new technologies on public safety, has staked out a position that the federal government is not doing enough to screen nanotechnology products for potential hazards (Medical Device Daily, Feb. 22, 2008).
The director of PEN, David Rejeski, told Medical Device Daily's Lynn Yoffee that despite a recent update to the strategic plan for the National Nanotechnology Initiative (MDD, Jan. 4, 2008), such efforts at NNI and at the Environmental Protection Agency "fail to employ a top-down, strategic approach aimed at directing funds and research at the places where there's likely to be the most risk."
Rejeski said any such funds should go through FDA, stating that the Congress "may try to change what goes on and make sure the research money goes to the most appropriate places."
The latest edition of the NNI strategic plan includes a new program component area for studies of environmental health and safety. The Feb. 14 plan, a 102-page paper dubbed Strategy for Nanotechnology-Related Environmental Health and Safety Research, calls for the participation of a number of federal agencies, including NIH, EPA and FDA.
More recently, a May 20 article in Nature Nanotechnology highlighted the results of a pilot study that indicated that some longer carbon nanotubes introduced into the abdominal cavities of mice tend to behave much like asbestos. The study, conducted at the University of Edinburgh (Edinburgh, Scotland), indicated that "exposing the mesothelial lining of the body cavity of mice, as a surrogate for the mesothelial lining of the chest cavity, to long multi-walled carbon nanotubes results in asbestos-like, length-dependent, pathogenic behavior," according to the study abstract. The abstract also states that the effect "includes inflammation and the formation of lesions known as granulomas."
Transparency no help on healthcare costs
Number-crunchers have a reputation for skepticism, and the Congressional Budget Office has played that role on a number of healthcare issues, including on the potential for savings attributed to healthcare information technology.
Skeptics of the value of transparency among providers doctors and hospitals alike can now take comfort in having a bean-counting ally. CBO recently published an analysis on transparency, and the director's blog, attributed to CBO analyst Sheila Campbell, casts doubt on the value of transparency.
According to the blog entry, the fact that "more than 80% of the population is covered by some form of health insurance" insulates enrollees "from the full price of the healthcare they consume, limiting their incentive to compare prices." Campbell also says that since most recommendations are made by healthcare professionals and address matters that most patients are not qualified to analyze, patients are typically in a poor position to make a comparison.
Furthermore, "for the insured and uninsured alike, awareness of prices would make little difference in emergency situations or in the relatively small number of cases that account for disproportionate share of overall healthcare spending," CBO concluded
Transparency could also offer unintended consequences, according to Campbell. She writes that prices could rise in markets that "are highly concentrated" because "higher prices are easier to maintain when the prices charged by each provider involved can be observed by all the others."
Whatever the overall impact, "more transparent prices would probably reduce the range of prices," at the very least.