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Almost 12,000 people died in alcohol-related vehicle crashes in 2008. About 15,000 Americans died of AIDS-related illness the same year. Both of these preventable causes of death have been the subject of massive, expensive and high-profile interventions by federal and state authorities. The Washington, D.C.-based Center for Regulatory Effectiveness (CRE) says it encourages expenditures for these programs but the public health community should be even more concerned for greater society-wide risks.
By contrast, the Centers for Disease Control and Prevention (CDC) estimates that 15,000 to 30,000 deaths occur annually in the U.S. from Clostridium difficile (C. diff), which may be as many as from all drunk driving and AIDS-related deaths combined. Three million Americans a year are sickened by C. diff.
The CRE points to a 2008 article in the American Journal of Infection Control that stated that C. diff rates were 13 per 1,000 hospitalized patients. Death rates from C. diff are as high as 1 in 40. According to the Washington Post, "one study found C. diff on the hands of almost 60 percent of doctors and nurses caring for infected patients."
The CRE says that the death and disability toll from C. diff has been met with a profound lack of appropriate response from health authorities. It adds that while federal agencies routinely order the private sector to spend enormous sums on compliance with regulations that may save a relative handful of lives, far more serious hazards go practically unnoticed.
The CRE adds that the use of cost-benefit analysis and league tables is often scorned by regulatory activists who claim that true costs are not captured by the analyses. Rejection of quantitative tools for regulatory decision-making, however, can result in agency priorities being set by NGOs and bloggers instead of by need. The CRE says that federal authorities need to focus their regulatory and enforcement activities on C. difficile with a level of resources commensurate with successfully tacking a preventable disease vector that is killing hundreds of people and sickening tens of thousands more every week.