Rachel's Precaution Reporter #73

"Foresight and Precaution, in the News and in the World"

Wednesday, January 17, 2007..........Printer-friendly version
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Table of Contents...

Canadian SARS Report Calls for Precaution to Protect Health Workers
  Chief among the recommendations of the 1200-page report is a call
  to improve infection control by making sure "a precautionary
  principle" is the reigning culture in hospitals and the public-health
Use of 'Precautionary Principle' for Chemicals Is Growing
  "The chemical industry remains the primary focus of the
  precautionary principle, as environmentalists argue federal laws are
  insufficient to regulate chemicals that may pose a threat to human
White House Plan to Alter Risk Assessment Is Totally Rejected
  The National Research Council scoffs at the White House's plan to
  modify risk assessment procedures to make life simpler for big
  polluters. Originator of the plan, John Graham, takes a hit.
Take Precaution -- Stop Fluoridation
  A new article in the Journal of Evidence-Based Dental Practice
  shows how the precautionary principle applies to fluoridation.
Dr Strangelove Saves the Earth
  "The precautionary principle, which calls for extra prudence in
  areas of scientific uncertainty, also applies. You can look at climate
  change as an experiment which mankind has -- to its horror -- found
  itself performing on the planet. To start a second experiment, in the
  hopes of counteracting the first, would be, to put it mildly, rather
Washington State Lawmakers May Embrace Precaution for Chemicals
  This may be the year when the Washington State legislature adopts a
  precautionary approach to toxic flame retardants.


From: Toronto Globe & Mail, Jan. 10, 2007
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The SARS Report: Four years after crisis, Ontario hasn't learned from
mistakes, Mr. Justice Campbell warns

By Carolyn Abraham, Medical Reporter

The final investigation into the handling of the deadly SARS crisis
has found that a gutted public-health system, command and
communication breakdowns and a blind faith in science all failed to
protect the people -- but most specifically-- the health-care workers
of Ontario in 2003.

In a cutting 1,200-page report released yesterday by the SARS
Commission, Ontario Superior Court Justice Archie Campbell concludes
that while some improvements have been made to Ontario's public-health
system, four years later "serious problems persist and much remains to
be done."

In fact, the report includes a three-page chart that suggests only
five of the 25 emergency recommendations the independent commission
has made over the last two years have been "accepted."

These involve measures to compensate people under quarantine for lost
wages, and clarify official lines of communication.

Judge Campbell, battling cancer and unavailable for interviews, warns
that correcting past mistakes is essential if Ontario is to fare
better against the next infectious threat, which many experts predict
will be an influenza outbreak that could fell tens of thousands and
prove far trickier than SARS to contain. "If we do not learn from SARS
and we do not make the government fix the problems that remain," he
writes, "we will pay a terrible price in the next pandemic."

The report singles out no individual for blame, but it concludes that
system-wide failures contributed to the outbreak of severe acute
respiratory syndrome, which in five months killed 44 people, sickened
375, quarantined thousands and brought the province's health system
"to its knees."

"The surprise is not that Ontario's response to SARS worked so badly,
but that it worked at all," the report notes, "given the lack of
preparation and systems and infrastructure."

The Ontario government created the SARS Commission under Judge
Campbell in June, 2003, to investigate the origin, spread and response
to the mysterious pneumonia that emerged from China four years ago.

The commission has since filed two reports. In this third and final
instalment, Judge Campbell focuses on improving worker safety. "The
heroes of SARS" continued to show up for shifts while colleagues fell
ill and they and their families feared for their lives.

Two nurses and a doctor died and health workers made up almost half of
the cases.

Yet health workers continued to be at risk, the report finds, due to
the lack of preparedness and infection-control policies that hospitals
never adopted and governments failed to enforce. What's more, the
report notes that worker-safety measures were prematurely relaxed in
the spring of 2003 and health workers were mistakenly led to believe
the disease was gone. The optimism contributed to a second wave of
SARS out of North York General Hospital that struck 127 people and
killed 17 of them.

Unions representing front-line workers lauded the report for
recognizing hospitals to be as dangerous as "mines and factories" and
for urging that health workers be given a stronger voice in the

Linda Haslam-Stroud, president of the Ontario Nurses Association, a
52,000-member union, said in a statement that during SARS, Ontario
"did not have an adequate supply of protective equipment, and
employers did not provide appropriate training for equipment that did

"This sort of situation cannot be allowed to happen again. The
government now has clear recommendations on what needs to be done to
prevent another similar situation."

Chief among those recommendations is a call to improve infection
control by making sure "a precautionary principle" is the reigning
culture in hospitals and the public-health system.

Initially, no one knew anything about the origins of SARS, how the
virus could be transmitted, the course of the disease or its death
rate. But instead of working from the worst-case scenario that SARS
might be spread through airborne transmission and scaling back
containment measures as more was learned, the report found that
officials waited for "scientific certainty."

"Scientific knowledge changes constantly. Yesterday's scientific dogma
is today's discarded fables. When it comes to worker safety in
hospitals, we should be driven... by the precautionary principle
that reasonable steps to reduce risk should not await scientific

But Donald Low, chief microbiologist at Toronto's Mount Sinai Hospital
and one of the key public-health experts managing the SARS outbreak,
predicted that living by the "precautionary principle" could pose big
challenges for any hospital in practice.

"If you had a cluster of patients on a ward with pneumonia, and you
wonder if this could be transmitted in the ward, do you close it? Do
you get everyone in full gear and go into full negative air pressure?"
Dr. Low asked.

The report, based on public hearings, government and hospital
documents and interviews of more than 600 people, makes a raft of new
recommendations to improve worker safety and the tragic situations
families can face in a lethal outbreak. Among them:

Develop and rehearse emergency plans to close hospitals and find a way
of immediately notifying staff, both on and off duty, of any potential

Design a system to track and trace patients and visitors to a hospital
at a given time.

Ensure the Ministry of Labour prepares and oversees initiatives
involving protective gear for workers during a health crisis

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From: Risk Policy Report, Jan. 16, 2007
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Environmentalists and other public health advocates say recent
movements by states, businesses and international regulatory bodies
are signs of increased use of the so-called 'precautionary principle'
-- efforts that come as Democrats are raising key questions about
federal toxics laws.

Activists say the precautionary principle is beginning to emerge in a
variety of political and commercial arenas, including efforts by
businesses to reduce potential toxic exposure; the growth of green
chemistry programs; and, to a lesser degree, a recently adopted
European chemical regulatory program. The precautionary principle
places the burden on those advocating new policies or products to
prove the efforts will not cause public harm. For example, the
chemical industry would be burdened with proving a chemical is safe
before introducing its use.

The chemical industry remains the primary focus of the precautionary
principle, as environmentalists argue federal laws are insufficient to
regulate chemicals that may pose a threat to human health. Activists
say it takes EPA years or decades to regulate harmful chemicals,
because the agency must first prove the chemicals pose a health
threat. They cite lead, mercury and other well-defined hazards as
examples where the agency has struggled to eliminate hazardous uses.
In particular, environmentalists say the Toxic Substances Control Act
(TSCA) is problematic. The law, which has not been updated since
Congress passed it in 1976, may face intense scrutiny from Democrats
who are promising oversight of toxics issues.

The concept of the precautionary principle ruffles chemical industry
officials, who say it is ill-defined and poses unnecessary burdens on
the industry. Officials argue TSCA is sufficient to regulate chemicals
and also note that industry voluntarily supplies data to EPA on a
number of the most highly-used chemicals in the United States. Given
that information, EPA has enough data to screen for chemicals that may
pose a threat, industry officials say.

Environmentalists, however, say the precautionary principle is already
being successfully applied. For example, the Democratic governors of
Maine and Michigan issued executive orders in 2006 promoting "green
chemistry," or the substitution of less toxic forms of chemicals for
those that may pose health risks. Environmentalists say the efforts
represent a form of the precautionary principle being actively
applied, and note the results could generate significant economic
benefits for those states. Other states, including Massachusetts and
New York, are considering similar programs. In addition, California is
considering a legislative approach to green chemistry, though it has
yet to be unveiled. (Risk Policy Report, Nov. 7, p1).

In another example, environmentalists cite San Francisco's recent
decision to ban phthalates in children's toys as a regulatory driver
for the precautionary principle. The city voted to ban the chemicals,
which are used to soften plastics, based on concerns that the
chemicals may cause reproductive harm. But industry and retailers say
the risks are minimal, and filed suit to block the ban. If the ban
sticks, toy manufacturers may be forced to examine other alternatives
(Risk Policy Report, Oct. 31, p2).Some businesses are also taking
steps to reduce toxics in their products, which environmentalists say
is another application of the precautionary principle. For instance,
some retailers are leaning on suppliers to provide furniture, medical
supplies or other products that do not contain chemicals suspected of
causing health problems.

In the international arena, the European Union (EU) adopted a new
chemical regulatory program known as Registration, Evaluation &
Authorization of Chemicals (REACH) in late 2006. REACH is aimed at
requiring data on most chemicals produced or sold in the EU, and
requires safety testing for certain chemicals before they can be used.

Environmentalists are divided on whether the program is an example of
the precautionary principle. Some argue it is one of the greatest
triumphs of the principle, while others argue it is simply a more
stringent regulatory program than that of the United States and does
little to implement the precautionary principle.

One public health advocate says REACH will generate more hazard data
but is still shy of precautionary. "What's going on in Europe is a
preview," the source says, but other regulatory efforts and incentive-
based programs will likely be needed to take a precautionary approach
to public health.

Industry officials, on the other hand are adamant that REACH is not a
sign of the precautionary principle being invoked. Instead, they say
the program simply adds significant regulatory burdens that may pose
an economic threat to industry but offer little public health

Whether REACH is founded on the principle or not, environmentalists
argue that the precautionary principle will not necessarily place an
insurmountable burden on industry or regulators. Instead, they say the
principle makes the case for analysis of available alternatives and
places burden-of-proof that a product or regulation is safe on those
advocating for use or implementation.

Public health advocate says industries invoking the precautionary
principle by aggressively pursuing green chemistry and other safer
alternatives can avoid long-term regulatory battles. "If you design
safer products to begin with, there's no need for a regulatory scheme
to control it," the advocate says.

Some environmentalists are saying that REACH will provide a benchmark,
and hint that new ideas for restricting toxics are yet to come.

For example, some argue that if the principle were to be adopted in
the United States, regulations would work differently. One researcher
cites the Food Quality Protection Act (FQPA) as a potential regulatory
precursor. FQPA requires industry to submit data to EPA detailing
whether pesticides cause adverse effects in children, and is an
example of how the precautionary principle might be applied in a
regulatory framework. The researcher argues that all chemicals, not
just pesticides, should meet similar requirements. "At least as a
first step, it would be important that industrial chemicals be given
the same scrutiny as pesticides," the researcher notes. "The current
research structure is not working to protect kids."

Some of those thoughts have been vocalized by Democrats as well,
including incoming Senate Environment & Public Works Chair Barbara
Boxer (CA), who has vowed oversight of toxics issues. Other Democrats
raising toxics concerns include Reps. Hilda Solis (CA) and Henry
Waxman (CA). Observers expect Democrats to hold key oversight hearings
in the 110th Congress, and question whether TSCA revisions might
appear on the agenda.

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From: Washington Post (pg. A17), Jan. 12, 2007
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White House Plan to Change Risk Assessment Called 'Flawed'

By Rick Weiss

When the Bush administration last year proposed a controversial
revamping of the rules by which federal agencies decide whether
chemicals and other products pose risks to human health, it offered to
run the plan by the prestigious National Research Council.

Yesterday the White House got its response: a 324-page report that
says, in no uncertain terms, "Throw it out and start all over."

The proposal by the Office of Management and Budget is "fundamentally
flawed" and should be withdrawn, the report concludes.

Echoing concerns raised by scientists, consumer groups and agency
heads, the council -- part of the congressionally chartered National
Academies -- told the OMB to limit itself to outlining guiding
principles and leave details to experts in the nation's scientific

John F. Ahearne, director of the ethics program at Sigma Xi, an
international scientific honor society, who chaired the review
committee, said that in his decades of experience working on such
reviews for the National Academies, he could not recall any other
instance when the conclusion was to reject a government proposal

"We had expected that we would review the bulletin in detail, then
recommend some modifications and improvements," he said. Instead, the
18-member group of experts voted unanimously to recommend that it be

The short but sweeping "draft bulletin" was released last January by
the OMB's Office of Information and Regulatory Affairs (OIRA), which
has enormous control over the extent to which regulated industries
must spend money ensuring that their intended actions will not harm
the public or the environment.

The research council said it supports the idea of revising current
rules. But under the proposed provisions, it concluded, risk
assessments would be "more susceptible to being manipulated to achieve
a predetermined result."

Among its problems, Ahearne said, the report too narrowly defines an
"adverse health effect" as "a fundamental impairment or lesion" --
ignoring the public health goal of preventing, not just responding to,
injury and sickness. He said it offers few protections for "sensitive
populations" such as children or pregnant women, which usually are key
to determining acceptable risk levels.

Consumer activists cheered the report. "The scientific community has
rejected this extreme effort to put economists instead of scientists
in charge of public health," said Rena Steinzor, a director of the
Center for Progressive Reform, an academic think tank that focuses on
regulatory issues.

Acting OIRA Administrator Steven D. Aitken, whose predecessor crafted
the proposal, said that under the circumstances, the OMB will not
finalize the proposed bulletin.

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From: New York State Coalition Opposed to Fluoridation, Inc, Jan. 8, 2007
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New York -- A recent article in the Journal of Evidence-Based Dental
Practice shows how the precautionary principle applies to

"Some studies have raised concerns about the safety and efficacy of
the practice [fluoridation]," write authors Joel Tickner and Melissa
Coffin of the Lowell, Massachusetts, Center for Sustainable

Precautionary principle: "When an activity raises threats of harm to
human health or the environment, precautionary measures should be
taken even if some cause and effect relationships are not fully
established scientifically."

"... there are indications that some dental procedures (and other
activities associated with dentistry) may actually cause subtle harm
at a population level," write the authors.

For example, babies fed fluoride-laced water risk discolored teeth,
according to the American Dental Association (ADA) which claims
fluoride chemicals injected into public water supplies prevent
cavities. The ADA usually endorses fluoridation mandates at the local
and state levels.

The Centers for Disease Control reports that about 23% of school
children now have dental fluorosis. Two-thirds of US water supplies
are fluoridated and virtually 100% of the food supply contains varying
amounts of fluoride, both natural and artificial, usually not listed
on labels.

In 1989, the government's National Institute of Dental Research found
little difference in cavity rates between children who do and don't
receive fluoride, report Tickner and Coffin.

"Further studies have shown that the incidence of cavities has fallen
throughout the western industrialized world regardless of fluoride
use," they report.

"...studies indicate an association between long-term, low-dose
exposure to fluoride and increased risk of hip fractures...[and
between] elevated fluoride exposure in children and decreased IQs...,"
write Tickner and Coffin.

The ADA claims "optimal" levels of fluoridation are safe.

"However, this claim is problematic since it does not consider
cumulative exposures from many other sources (toothpaste, pesticide
residues on foods, mechanically deboned meat and many processed foods
and beverages made with fluoridated water)," write Tickner and Coffin.

"As medical providers, dentists have a responsibility to understand
and prevent potential unintended impacts of their interventions," and
to uphold the medical credo of "first do no harm," they write.

The authors ask, "What are the alternatives or opportunities for
prevention?" and, "Is this activity needed in the first place?"

According to lawyer Paul S. Beeber, President of the New York State
Coalition Opposed to Fluoridation, "It's a no-brainer. Stop
fluoridation today. Absolutely no one will be harmed and many will be
helped. That's the best precaution there is."

Evidence based dentistry is the emerging standard in dental research,
representing a shift away from subjective expert opinion towards
objective, verifiable evidence through systematic review and scrutiny


New York State Coalition Opposed to Fluoridation, Inc. PO Box 263
Old Bethpage, NY 11804

Fluoride Action Network

Fluoride Journal

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From: The Economist, Jan. 15, 2006
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How big science might fix climate change

Few scientists like to say so, but cutting greenhouse-gas emissions is
not the only way to solve the problem of global warming. If man-made
technologies are capable of heating the planet, they are probably
capable of cooling it down again. Welcome to "geo-engineering", which
holds that, rather than trying to change mankind's industrial habits,
it is more efficient to counter the effects, using planetary-scale

This general approach has been kicking around for decades. A paper on
climate change prepared for President Lyndon Johnson in 1965 made no
mention of cutting greenhouse-gas emissions. It nonchalantly proposed
dealing with the results by dumping vast quantities of reflective
particles into the oceans, to increase the amount of sunlight
reflected into space.

That school of thinking has since fallen out of fashion. As scientists
have accumulated evidence for global warming and its possible
consequences, so the scientific and political consensus has favoured
attempts at reducing carbon emissions through taxes and regulations
and subsidies, many of them directed at factories and motor-cars.

More needs to be done. Greenhouse-gas levels have gone on rising. The
rapid industrialisation of China and India means they are going to
rise even more.

This gloomy outlook has encouraged new interest in a technological
fix. A scientific journal, Climatic Change, published a series of
papers on the subject in August, including one by Paul Crutzen, a
Nobel-prize-winning atmospheric chemist. Other journals followed up.
In November the Carnegie Institution and NASA held a conference.

Many big ideas for global cooling have been suggested over the years.
They include seeding the skies with compounds to encourage the
formation of low-lying, cooling clouds; building a giant sun-shade in
space; and dumping iron in the oceans to encourage the growth of algae
that would take in carbon when alive and trap it in on the sea floor
when dead.

Ken Caldeira, a scientist at the Carnegie Institution, says the most
promising idea may be to spray tiny sulphate particles into the upper
atmosphere, where they will reflect incoming sunlight. Nature has
already done the proof-of-concept work: volcanic eruptions spew such
particles into the air, and the cooling effect is well documented.

Schemes of this kind may sound half-crazy; and, admittedly, they do
tend to have some technical and aesthetic complications. Deliberately
polluting the stratosphere would make the sky less blue, although
sunsets would probably be prettier. Blocking out the sun might keep
the planet cool, but it would do little to address other effects of
high carbon-dioxide levels, such as the acidification of the oceans.

Deliberately polluting the stratosphere would make the sky less blue,
but sunsets would probably be prettierA more fundamental objection is
that the models used in geo-engineering are similar to those used in
forecasting climate change. Which is to say, they rely similarly on
assumptions and extrapolations.

Still, the basic science seems sound. "I started doing this work in an
attempt to show that geo-engineering was a bad idea," says Mr
Caldeira. "I still think it's a bad idea, but every simulation we do
seems to shows it could be made to work."

Ralph Cicerone, president of America's National Academy of Sciences,
has said that geo-engineering inspires opposition for "various and
sincere reasons that are not wholly scientific". Others might say the
same about its support. One early enthusiast was Edward Teller, an
emigre Hungarian physicist known in America as the "father of the
hydrogen bomb", and often cited as an inspiration for Dr Strangelove.

Scientists tend now to see geo-engineering research as a form of
insurance policy against the effects of continued global warning, not
as an excuse for downplaying the problem, nor for tolerating more
carbon emissions in the meantime.

You might expect green groups to applaud this belt-and-braces
approach. More often, they resist it in principle, and have little
time for the research involved. At worst they seem to see it as a
scheme by devious scientists to thwart Nature's just revenge.

Still, there is a reasonable fear here that an illusory hope of a
scientific fix might undermine the sort of dogged and grubby policy
solutions, such as carbon caps and carbon quotas, needed for taking
the fight against climate change to its source.

The precautionary principle, which calls for extra prudence in areas
of scientific uncertainty, also applies. You can look at climate
change as an experiment which mankind has -- to its horror -- found
itself performing on the planet. To start a second experiment, in the
hopes of counteracting the first, would be, to put it mildly, rather

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From: The Olympian (Olympia, Wash.), Jan. 6, 2007
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By John Dodge

The environmental community looks toward the 2007 state Legislature's
beginning Monday with high hopes it can get all four of its priority
measures passed.

Environmental groups are counting on the Democratic majority and
alliances with Gov. Chris Gregoire on key issues to advance Puget
Sound cleanup; keep the state moving on a clean-energy future; ban
toxic flame retardants in televisions, computers and residential
upholstered furniture; and double state funding for the purchase of
parks and open space.

"We're picking issues that don't pit the economy against the
environment," said Clifford Traisman, lobbyist for the Washington
Environmental Council and Washington Conservation Voters. "Given the
makeup of the Legislature, we expect to go four for four."

Although a perfect batting record might be a lofty goal, the
environmental community has spent months fine-tuning its agenda to
resonate with public values while also lining up advance legislative

A case in point: the bill to ban toxic flame retardants has 53
sponsors in the House, which is three more than what's needed for a
simple majority "yes" vote.

The House passed the bill last year, but it failed in the Senate,
where the chemical industry put up a stiff fight.

"I think we can pass it in the Senate this year," said Sen. Karen
Fraser, D-Thurston County.

Backers this year have the advantage of support from the governor and
the state Department of Ecology.

A phase-out of polybrominated diphenyl ethers, or PBDEs, is viewed as
one of the actions needed to clean up Puget Sound.

"Everywhere scientists look, from orca whales to mothers' breast milk,
they find PBDEs," said Gregg Small, executive director of the
Washington Toxics Coalition.

The chemical accumulates and is linked to learning, memory and
behavior problems in people, Small said.

"We are one bill away from significantly improving the safety and
health of our children," said one of the prime sponsors of House Bill
1024, Rep. Ross Hunter, D-Medina.

In Puget Sound

The governor and environmental community are lined up behind a $220
million package for Puget Sound recovery, part of a long-range plan
that Gregoire launched in December 2005 called the Puget Sound
Initiative. The goal is a cleaner, healthier Puget Sound by 2020.

Lawmakers will be asked to make a down payment on what will be a
multibillion-dollar effort to turn back the tide of pollution, habitat
loss and declining species in the face of growth expected to bring 1.4
million more people to the Puget Sound basin in the next 15 years.

"This is not a bipartisan issue; it's a nonpartisan issue," said Naki
Stevens, program director for People for Puget Sound. "Puget Sound is
at a crisis point, if not a tipping point."

The money, which is on top of $571 million the state spends every two
years on Puget Sound, would be used to restore habitat, curb
stormwater runoff and clean up and prevent toxic pollution, among
other things.

The legislation also calls for a new governing body to lead the
cleanup effort and require accountability and performance measures
among those assigned the task.

"Accountability is what has been lacking in the past," Stevens said.

Clean fuels

Building on 2006 legislation that launched the state's clean-energy
industry, the 2007 clean air-clean fuels bill is designed to reduce
dependence on foreign oil, eliminate greenhouse gas emissions and help
keep some of the $30 million a day in gas and oil imports from leaving
the state, said K.C. Golden, policy director for Climate Solutions, a
climate change watchdog group.

The $20 million bill would:

** Fund research to convert plant waste into fuels.

** Provide $5 million in grants to school districts and others to buy
clean-diesel buses that would reduce children's exposure to toxic air

** Call for a 25 percent reduction in petroleum use in the state's
vehicle fleet by 2020.

Open space

Environmentalists are part of a broader coalition that seeks $100
million in the two-year state capital budget to finance state and
local parks, nature preserves, freshwater and saltwater shoreline
land, and farm preservation.

Historically, the state has chipped in about $50 million every two
years for the past 16 years, but that's not keeping up with population
growth and development, lobbyist Mike Ryherd said.

For instance, the trend toward high-density housing in the urban areas
puts a premium on the need for more neighborhood parks to allow places
for children and families to gather.

"Studies show that housing values go up the closer you are to a park,"
Ryherd said.

Gregoire called for $70 million for the Washington Wildlife and
Recreation Program. Approved funding probably will land somewhere
between the governor's and the coalition's request, state Sen. Ken
Jacobsen, D-Seattle, predicted.


Sidebar: Environmentalists' Top priorities

The environmental community's top four priorities in the 2007 state
Legislature are:

1. Support Gov. Chris Gregoire's budget request of $220 million in
additional money to clean up and protect Puget Sound. Chance of
passage: good.

2. A bill to promote biofuel technology and increased use of clean
fuels and vehicles. Chance of passage: good.

3. A bill to phase out the use of toxic flame retardants in certain
consumer products. Chance of passage: better than ever, Senate vote is
the key.

4. A $100 million capital budget request to double state funding for
buying parks space, wildlife habitat, farms and shorelines. Chance of
passage: It might be tough to get the full requested $100 million.
Gregoire calls for $70 million.


John Dodge covers the environment and energy for The Olympian. He can
be reached at 360-754-5444 or jdodge@theolympian.com.

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  Rachel's Precaution Reporter offers news, views and practical
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  principle? Who is using precaution? Who is opposing precaution?

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