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for disposal or reclamation of "post-consumption" wastes could be coupled more fully to the initial product design process. It examines how present economic incentives and environmental regulations influence choices made by designers, and what changes in public policies might encourage a new environmental ethic in product design.
House of Representatives
Committee on Science, Space and Technology
Hon. Robert A. Roe, Chairman
Committee on Energy and Commerce
Hon. John Dingell, Chairman
Hon. George E. Brown, Member
MONITORING LIMITS ON SEA-LAUNCHED CRUISE MISSILES
Beginning with a hypothetical arms control regime for nuclear sea-launched cruise missiles (SLCMs), this report examines in detail ways in which compliance with such a regime might be monitored. Surveying the life-cycle of SLCMs from development testing through deployment and storage, the assessment identifies the "indicators" by which the missiles might be tracked and accounted for. It also assesses the paths of evasion that a determined cheater might take to avoid the proposed monitoring measures.
Committee on Foreign Relations
Hon. Claiborne Pell, Chairman
Hon. Jesse Helms, Ranking Minority
House of Representatives
Hon. Dante B. Fascell, Chairman
U.S.-MEXICO TRADE: PULLING TOGETHER OR PULLING APART?
Technological changes such as computer-aided manufacturing combined with the evolving strategies of U.S., Mexican, and third-country corporations (e.g., Japanese multinationals) will affect jobs and job opportunities for Americans. The assessment focused on plant location and technology decisions, as revealed by interviews with corporate managers and influenced by local labor market conditions, including prevailing wage levels and available skills. The report includes: (1) analysis of production technologies, particularly in the motor vehicles and parts industry, and in electronics; (2) analysis of corporate locational decisions and the public policy factors affecting them (e.g., environmental and workplace regulations); and (3) analysis of the relative attractiveness of Mexico as a site for foreign direct investment. OTA examined the range of possible impacts on U.S. jobs and job opportunities, in terms of occupational categories and their skill requirements, as well as wage levels.
Committee on Labor and Human Resources
Hon. Edward M. Kennedy, Chairman
Hon. Orrin G. Hatch,
Ranking Minority Member
Hon. Claiborne Pell
House of Representatives
Committee on Education and Labor
Hon. William D. Ford, Chairman
Subcommittee on Labor-Management Relations
Hon. Pat Williams, Chairman
Hon. Marge Roukema, Ranking Minority
SPECIAL CARE UNITS FOR PEOPLE WITH ALZHEIMER'S AND OTHER DEMENTIAS: CONSUMER EDUCATION, RESEARCH, REGULATORY AND REIMBURSEMENT ISSUES
Several million Americans have Alzheimer's disease or another disease or condition that causes dementia. As our population ages, the number of people with these devastating diseases and conditions will increase relentlessly. Families take care of individuals with dementia at home for as long as possible, but most individuals with dementia are likely to spend some time in a nursing home in the often long course of their illness. Until recently, little attention has been paid to the special needs of nursing home residents with dementia. In many nursing homes, they have received and continue to receive inappropriate care that exacerbates their cognitive impairments and behavioral symptoms and further reduces their quality of life. This OTA report analyzes the available information about special care units for people with dementia. It discusses ways in which the Federal Government could encourage and support what is positive about special care units and at the same time protect vulnerable patients and their families from special care units that actually provide nothing special for their patients.
SCREENING MAMMOGRAPHY IN PRIMARY CARE SETTINGS: IMPLICATIONS,
Until recently, primary care physicians rarely offered screening mammograms as part of their practices. The interest of primary care practices in becoming suppliers of screening mammograms has been growing, however. The proliferation of equipment in the primary care setting has implications for the volume of services obtained by individual providers and, hence, for the cost and quality of the services provided in all settings of care. This Background Paper examines the implications for cost and quality, as well as for access to mammography, of expanding the supply of mammographic services in the primary care setting. The special issues raised by third-party businesses that package mammography services for primary care physicians are also discussed.
MEDICAL MONITORING AND SCREENING IN THE WORKPLACE:
Screening of prospective employees for health status and certain behaviors and monitoring of workers' health are generally thought to be widespread in American workplaces, but few data exist about either practices. This OTA Background Paper presents the results of a survey of 1,500 U.S. companies, the 50 largest utilities, and the largest unions. The survey was designed to obtain information about the types of medical monitoring and screening done in the U.S. and the extent of their use.
AMERICAN MILITARY POWER: FUTURE NEEDS, FUTURE CHOICES
America's global security environment is changing profoundly, pushing the country toward a fundamental reevaluation of its military requirements and those of the supporting defense technology and industrial base. If U.S.-Soviet relations do not deteriorate, defense procurement could accelerate its present decline though the end of the decade. This Background Paper outlines some of the issues of importance for making choices about the future nature and role of the U.S. armed forces, and suggests how these choices will affect defense base requirements.
HIV IN THE HEALTHCARE WORKPLACE
Reports of five cases of HIV transmission within a dental practice raised issues regarding patient safety and received much public attention. The Centers for Disease Control's reports of these cases and CDC's subsequent recommendations for preventing transmission of HIV and the hepatitis B virus to patients during exposure-prone invasive procedures have in turn led Congress to consider several actions directed at HIV in the health care workplace. This Background Paper examines evidence of the risk of HIV transmission in the health care workplace and discusses the policy implications of CDC guidelines and congressional actions in response to this risk.
THE 1992 WORLD ADMINISTRATIVE RADIO CONFERENCE (WARC 1992: ISSUES FOR U.S.
A host of new technologies and services, such as digital audio broadcasting, high-definition television, and personal communications services, are vying with existing radio-based applications for a slice of the valuable, but crowded, radio spectrum. The radio frequency spectrum is a common natural resource shared by the nations of the world. The World Administrative Radio Conference meeting in Spain in February 1992 (WARC-92) will attempt to reassign the radio frequencies in order to take advantage of these new applications, while still accommodating the needs of existing users. The Background Paper examined the U.S. preparations process for WARC-92, highlighting efforts to integrate the needs and concerns of various interest groups. It also reviewed the forces and trends affecting the U.S. as it approached WARC-92, and is intended to inform future congressional oversight of the domestic and international radio communication policy process.
THE FBI FINGERPRINT IDENTIFICATION AUTOMATION PROGRAM:
This Background Paper assesses the FBI's strategic plans to modernize and fully automate its fingerprint identification and criminal history record system. The paper focuses on key assumptions that will affect the sizing and procurement of the new FBI system, and on other related steps that appear necessary to ensure complete and up-to-date record systems. These include full implementation of a Federal/State/local partnership for maintaining and exchanging fingerprint and criminal history records; enactment of an interstate compact of Federal legislation setting out uniform rules for the exchange of such records; standards and funding for improving criminal history record completeness and disposition reporting, and privacy and security protections for electronic fingerprint and record information.
DIOXIN TREATMENT TECHNOLOGIES
Nearly 100 hazardous waste sites around the United States have serious problems with dioxin contamination. Very little actual cleanup has been done at these sites. Plans to incinerate dioxin-contaminated materials at some sites have caused concern in the local communities that has led to public debate about the effectiveness of incineration and the availability of other remediation alternatives. This Background Paper presents the status of national efforts to cleanup dioxin-contaminated sites and the technologies that have been used, proposed, and researched. It covers thermal and nonthermal treatment techniques as well as approaches
such as stabilization and storage. It discusses the development of these technologies as well as advantages and disadvantages of their use.
REVIEW OF A PROTOCOL FOR A STUDY OF REPRODUCTIVE HEALTH OUTCOMES AMONG
OTA's Veterans Studies Advisory Panel met on November 21, 1991, to review the protocol for "A Study of Reproductive Health Outcomes Among Women Vietnam Veterans." This Background Paper contains the results of the review.
NASA'S OFFICE OF SPACE SCIENCE AND APPLICATIONS: PROCESS,
This Background Paper summarizes a one-day workshop convened to assess the effectiveness of the planning and priority-setting mechanisms used by NASA's Office of Space Science and Applications (OSSA) in carrying out its diverse scientific program.
MANAGING INDUSTRIAL SOLID WASTES FROM MANUFACTURING, MINING, OIL AND GAS PRODUCTION, AND UTILITY COAL COMBUSTION March 1992
The 1976 Resource Conservation and Recovery Act (RCRA) is the major statute governing what are called solid wastes. Federal efforts to date under RCRA have focused on controlling the management and disposal of certain "hazardous" wastes. The remaining solid wastestream, the subject of this Background Paper, dwarfs that defined as hazardous. Although not classified as hazardous, some of this remaining wastestream does contain toxic and other undesirable constituents. This Background Paper examines wastes generated by industrial activities that play a dominant role in our national economy - oil and gas production, mining and mineral processing, coal combustion, and manufacturing.
ALASKAN WATER FOR CALIFORNIA? THE SUBSEA PIPELINE OPTION
The availability of fresh water has shaped--and will continue to shape-- the development of the Western United States. Questions about who gets the available water, where it will come from, how it is used, how much is paid for it and by whom, and where future demand will go are of paramount importance to farmers, planners, environmentalist, professional water managers, and, increasingly, average citizens. This Background Paper focuses on one technological option for increasing the supply of fresh water to the Southwest--that of building a freshwater subsea pipeline to transport water from Alaska to California. This paper examines important issues related to this subject, including engineering feasibility and cost, Alaskan water availability, California's projected water demand, and other alternatives for meeting future water needs.
THE MENOPAUSE, HORMONE THERAPY, AND WOMEN'S HEALTH
Ongoing debate about the risks and benefits of estrogen replacement for menopausal and postmenopausal women has raised questions about the adequacy of research in this area. This study evaluates research conducted to date, assesses the extent to which research areas are being addressed, and proposes topics that should be considered in investigating the acute and long-term effects of menopause and designing
TRADE AND ENVIRONMENT: CONFLICTS AND OPPORTUNITIES
Industry throughout the world increasingly must take into account environmental issues such as ozone depletion and climate change. The challenge for American firms and the U.S. government will be to resolve the
need for environmentally sound practices with the need to stay competitive internationally. This study examines the context in which trade and environmental issues interact, including how to address environmental concerns in trade negotiations and agreements, what forms of technical assistance our major competitors give their industries in dealing with environmental regulations, and the competitiveness of U.S. business in the growing global market for environmental technologies such as pollution control and waste disposal. It also examines the role U.S. firms and the U.S. government could play in technology transfer to the developing world.
LESSONS IN RESTRUCTURING DEFENSE INDUSTRY:
This Background Paper describes the structure and management of the French defense-industrial base and reviews a variety of strategies the French Government and industry are pursuing to nationalized the base while preserving key French defense contractors in world markets.
IDENTIFYING AND CONTROLLING PULMONARY TOXICANTS
This Background Paper describes technologies available to identify substances toxic to the lung and Federal efforts to control human exposure to such substances through regulatory and research programs. DISPOSAL OF CHEMICAL WEAPONS: ALTERNATIVE TECHNOLOGIES
This Background Paper briefly describes the Army's chemical weapons destruction program, discusses the factors that could affect a decision to develop state of development of proposed alternatives, discusses the alternatives, and illustrates the difficulty of gaining public acceptance of complex technical systems. CDC'S CASE DEFINITION OF AIDS: IMPLICATIONS OF PROPOSED REVISIONS
The Centers for Disease Control's (CDC) AIDS case definition is used to monitor trends in the number and distribution of AIDS cases in the U.S. The AIDS case definition measures severe morbidity due to infection with human immunodeficiency virus (HIV). This information is then used in formulating Federal and State policies for the prevention, treatment, and control of AIDS. In addition, the AIDS case definition has been used in disability determinations by the Social Security Administration. This Background Paper examines the epidemiologic evidence used by the CDC in deciding to revise the AIDS case definition, and the impact the proposed definition will have on surveillance. The paper also explores the logistical consequences and other implications of the revised definition, including its impact on Social Security disability determinations.
REMOTELY SENSED DATA FROM SPACE: DISTRIBUTION, PRICING
This Background Paper focuses on decisions about the future course of the Landsat land remote sensing satellite program and the experiment with commercialization that began in 1984. A consensus is emerging within the government that Landsat 7 will be funded and managed by the public sector. While giving greater assurance that Landsat data will continue to be available for scientists and other users of the data, returning Landsat operations to the public sector creates a new set of problems.
DO MEDICAID AND MEDICARE PATIENTS SUE MORE OFTEN THAN OTHER PATIENTS? July 1992
Whether Medicaid and Medicare patients are likely to sue more or less often than other patients is a critical question in studying the recent trend of reduced physician participation in Medicaid and other publicly funded programs. OTA concluded that these patients are not more likely to sue and may actually sue less often than would be expected on the basis of their medical risks.