Unintended Consequences

Thousands of the nation’s largest water polluters are outside the Clean Water Act’s reach because the Supreme Court has left uncertain which waterways are protected by that law, according to interviews with regulators. As a result, some businesses are declaring that the law no longer applies to them. And pollution rates are rising. Companies that have spilled oil, carcinogens and dangerous bacteria into lakes, rivers and other waters are not being prosecuted, according to Environmental Protection Agency regulators working on those cases, who estimate that more than 1,500 major pollution investigations have been discontinued or shelved in the last four years. Story continues below ↓advertisement | your ad heredap('&PG=NBCMSN&AP=1089','300','250');The Clean Water Act was intended to end dangerous water pollution by regulating every major polluter. But today, regulators may be unable to prosecute as many as half of the nation’s largest known polluters because officials lack jurisdiction or because proving jurisdiction would be overwhelmingly difficult or time consuming, according to midlevel officials.

The timing is unfortunate for Dubai, which is trying to restore its once gilded image as it wades through a torrent of negative publicity generated by its burst property bubble, crippling debt pile and the assassination of a top Hamas commander in an airport hotel last month. The incident also raises new questions about building safety in the city-state, which pushed through ever more extravagant and complicated construction projects until the economic downturn halted its rapid-fire growth. Less than three weeks ago, trapped tourists had to be pulled from a stuck elevator in the mall owner's record-breaking Burj Khalifa skyscraper nearby. The world's largest tower, due to accept its first permanent tenants in March, has yet to reopen to the public. The breach in the 2.6 million gallon tank at the Dubai Mall, open little more than a year, was quickly plugged and caused no harm to the 33,000 fish inside, according to mall owner Emaar Properties. It was not clear when the attraction featuring an "underwater" tunnel would reopen. Visitors were kept far from the scene shortly after the water began pouring from behind the 2-1/2 foot (0.75 meter) thick viewing panel, making it difficult to gauge the extent of the damage. From a distance, most of the water and fish appeared to be contained inside the tank. Mahmoud Hamid, a spokesman for the sheikdom's civil defense department, described the leak as "a small break in the glass" that maintenance crews were able to close later in the day.

"People tend to conform their factual beliefs to ones that are consistent with their cultural outlook, their world view," Braman says. The Cultural Cognition Project has conducted several experiments to back that up. Participants in these experiments are asked to describe their cultural beliefs. Some embrace new technology, authority and free enterprise. They are labeled the "individualistic" group. Others are suspicious of authority or of commerce and industry. Braman calls them "communitarians." In one experiment, Braman queried these subjects about something unfamiliar to them: nanotechnology — new research into tiny, molecule-sized objects that could lead to novel products. "These two groups start to polarize as soon as you start to describe some of the potential benefits and harms," Braman says. The individualists tended to like nanotechnology. The communitarians generally viewed it as dangerous. Both groups made their decisions based on the same information. "It doesn't matter whether you show them negative or positive information, they reject the information that is contrary to what they would like to believe, and they glom onto the positive information," Braman says.

"Basically the reason that people react in a close-minded way to information is that the implications of it threaten their values," says Dan Kahan, a law professor at Yale University and a member of The Cultural Cognition Project. Kahan says people test new information against their preexisting view of how the world should work. "If the implication, the outcome, can affirm your values, you think about it in a much more open-minded way," he says. And if the information doesn't, you tend to reject it. In another experiment, people read a United Nations study about the dangers of global warming. Then the researchers told the participants that the solution to global warming is to regulate industrial pollution. Many in the individualistic group then rejected the climate science. But when more nuclear power was offered as the solution, says Braman, "they said, you know, it turns out global warming is a serious problem."And for the communitarians, climate danger seemed less serious if the only solution was more nuclear power.

This is the largest nationally representative study to date of the toll taken by sepsis and pneumonia, two conditions often caused by deadly microbes, including the antibiotic-resistant bacteria MRSA. Such infections can lead to longer hospital stays, serious complications and even death. "In many cases, these conditions could have been avoided with better infection control in hospitals," said Ramanan Laxminarayan, Ph.D., principal investigator for Extending the Cure, a project examining antibiotic resistance based at the Washington, D.C. think-tank Resources for the Future. "Infections that are acquired during the course of a hospital stay cost the United States a staggering amount in terms of lives lost and health care costs," he said. "Hospitals and other health care providers must act now to protect patients from this growing menace." Laxminarayan and his colleagues analyzed 69 million discharge records from hospitals in 40 states and identified two conditions caused by health care-associated infections: sepsis, a potentially lethal systemic response to infection and pneumonia, an infection of the lungs and respiratory tract. The researchers looked at infections that developed after hospitalization. They zeroed in on infections that are often preventable, like a serious bloodstream infection that occurs because of a lapse in sterile technique during surgery, and discovered that the cost of such infections can be quite high: For example, people who developed sepsis after surgery stayed in the hospital 11 days longer and the infections cost an extra $33,000 to treat per person. Even worse, the team found that nearly 20 percent of people who developed sepsis after surgery died as a result of the infection. "That's the tragedy of such cases," said Anup Malani, a study co-author, investigator at Extending the Cure, and professor at the University of Chicago. "In some cases, relatively healthy people check into the hospital for routine surgery. They develop sepsis because of a lapse in infection control—and they can die." The team also looked at pneumonia, an infection that can set in if a disease-causing microbe gets into the lungs—in some cases when a dirty ventilator tube is used. They found that people who developed pneumonia after surgery, which is also thought to be preventable, stayed in the hospital an extra 14 days. Such cases cost an extra $46,000 per person to treat. In 11 percent of the cases, the patient died as a result of the pneumonia infection.