(3) LEAP is in the city of Phoenix, Ariz. It has been a very innovative agency, not only in the depth and scope of its program, but in their sources of funding. It started with a $43,000 SOS grant. As a result of that activity, they received the first title IV research and development grant which was the original model for the nutrition program now so heavily funded through the Administration on Aging. They have been able to get large sums of money from the city which supplements each one of their programs. The $43,000 of SOS is matched by the city with $46,611. The Administration on Aging gave almost a half million dollars to the agency and this amount is matched by almost $200,000 from the city and from project income. The $24,000 which covers their title IX program and their public service employment project is matched by $1,700 by the city. Their title XX nutrition supplemental grant of $346,000 from the department of social services is matched by $16,782 by the city and their ACTION grant of $148,313 for foster grandparents is matched by the city with over $50,000. This shows considerable ingenuity in developing funding sources as well as an echo of the respect the community feels for the agency. III. CSA'S FUNDING OF PROGRAMS FOR LOW-INCOME ELDERLY (THE FUNDING AMOUNTS LISTED ARE FOR FISCAL 1976 AND THE INTERIM QUARTER JULY 1– OCTOBER) Senior opportunities and services (SOS) program. Emergency energy conservation services___ Total $12, 868, 000 19, 000, 000 5, 607, 000 227, 000 25, 000, 000 62, 702, 000 The initial aggregate computer totals of CSA's national programs survey, begun in November 1976 when projected to 865 CAA's, including 204 Senior Opportunities and Services (SOS) projects shows that more than 2 million lowincome older citizens were served by the CAA's. IV. CSA'S INTERAGENCY AGREEMENTS CSA during 1976 sought to implement the mutual support statement agreed to by CSA and the Administration on Aging, November 5, 1975, the working agreement on energy conservation actions for the elderly and the interdepartmental task force on information and referral services for older people. Considerable progress was made during 1976 to carry out the objectives of the three agreements which are summarized in last year's report. However, some obstacles were encountered and the agreements are currently being reviewed by the respective agencies in order to revise them and make possible more cooperative and coordinated responses to the needs of elderly citizens. V. CSA'S PLANNED ACTIVITIES FOR 1977 The CSA is presently engaged in the following activities impacting importantly on our agency efforts in 1977: (1) Joint funding with the Administration on Aging (AOA), Law Enforcement Assistance Administration (LEAA) and the Department of Housing and Urban Development (HUD) in a national elderly victimization prevention and assistance program. CSA will fund three research and pilot projects, in the cities of Milwaukee, New Orleans, and New York City, in the amount of $250,000 to each city. AoA will fund four cities at the same level as CSA funding and LEAA will provide $100,000 for the administration and coordination of the seven research and demonstration projects. LEAA and HUD will also provide $100,000 from each agency for the evaluation of the seven projects. (2) CSA regional offices are currently evaluating their SOS projects with the purpose of making more equitable the distribution of the SOS funds, making new grants in geographical areas having large concentrations of low-income older persons and grants to CAA's where the Administration on Aging has no title III, V, and VII programs. We intend by taking careful steps to determine new strategies and the development of better funding and program criteria to assist the. SOS grantees to be even more innovative and imaginative than in the past. We plan through a revised funding strategy, initiated in some regions, to make SOS grant awards based on the CAA's performance capability, the number and needs of the elderly poor and the income levels of the target areas in both cities and towns. We feel that testing this planned and more equitable distribution of SOS funds will prove to be a salutary effort resulting in distinctive and different programs and services for the elderly poor and will complement the efforts of the AOA area agencies on aging. (3) The CSA Director will be provided a series of options on how all of CSA's programs can better be meshed to serve the elderly and how the CAA's and SOS grantees can better generate other sources of funds to assist them in serving elderly poor citizens. ITEM 15. CONSUMER PRODUCT SAFETY COMMISSION DEAR MR. CHAIRMAN: I am pleased to submit a statement outlining the Consumer Product Safety Commission's actions on behalf of the aging, for inclusion in the annual report of the Special Committee on Aging. The Commission directs most of its efforts toward the population as a whole rather than to any specific age group. We recognize, however, the vulnerability of the Nation's elderly to injuries associated with a wide range of consumer products and are concerned with the special needs of the elderly. The Commission follows a policy on establishing and revising priorities for action which includes the following statement: Children, the elderly, and the handicapped are often less able to judge or escape certain dangers in a consumer product or in the home environment. Because these consumers are, therefore, more vulnerable to danger in products designed for their special use or frequently used by them, the Commission will usually place a higher priority, assuming other factors are equal, on preventing product related injury to children, the handicapped, and senior citizens. In addition, the Consumer Product Safety Commission Improvements Act of 1976 specifically requires that the Commission "consider and take into account the special needs of elderly and handicapped persons to determine the extent to which such persons may be adversely affected by [a consumer product safety] rule." In prior years, activities of benefit to the elderly have ranged from data collection on injuries sustained by the elderly to dissemination of information of special interest to the elderly. By far, the most extensive effort on the part of the Commission specifically on behalf of the elderly has been our promotional campaign to inform the elderly that they can obtain regular packages in lieu of those with child-resistant safety caps. I hope that the enclosed statement describing our activities in greater detail will be useful to you. Please let me know if I can be of further assistance. Sincerely, S. JOHN BYINGTON, Chairman. [Enclosure.] PROGRAMS RELATING TO THE AGING The Consumer Product Safety Act (Public Law 92-573) was enacted in 1972 in recognition of the need for Federal regulations to insure safer consumer products. The act established the Consumer Product Safety Commission and charged it with the mission of reducing the number and severity of consumer productrelated injuries, illnesses, and deaths. A recent amendment to the CPSA requires the Commission to "consider and take into account the special needs of the elderly and handicapped to determine the extent to which such persons may be adversely affected by [a consumer product safety] rule." Our 1976 activities, including injury-data collection, research studies, standards-development, and information/education programs, were not directed solely to programs for the benefit of our 20 million older Americans. However, improving product safety for the elderly is an important continuing objective of the Consumer Product Safety Commission. While none of the laws administered by CPSC is applicable solely to the elderly, the Commission recognizes that the elderly are particularly vulnerable to injuries associated with various home structures, including bathtubs and showers, floors, carpets and rugs, and stairs. The Commission has an active interest in developing programs aimed at the elderly. INJURY DATA COLLECTION The Commission's primary source of information on product-related injuries is the National Electronic Injury Surveillance System (NEISS). The NEISS is composed of a statistically selected set of 119 hospital emergency rooms located throughout the country which report to the Commission, on a daily basis, data on product-related injuries treated in those emergency rooms. We estimate that, in 1976, 276,215 persons 65 or older were treated for product-related injuries in hospital emergency rooms in the continental United States. The elderly are hospitalized for these injuries at a higher rate (17 percent) than the population as a whole (4 percent). Injuries associated with stairs, ramps and landings are suffered most frequently by the elderly. Other major product categories associated with injuries which particularly affect the elderly are floors and flooring materials, chairs, doors, beds, and bathtub and shower structures. Since not all accident victims are treated in hospital emergency rooms, the Commission must collect information from other sources. For example, we receive copies of death certificates where the cause of death appears to be product-related. In 1976, we collected 2,167 death certificates involving individuals 65 or older. INFORMATION AND EDUCATION ACTIVITIES The Commission prints and distributes materials on a wide variety of hazards associated with consumer products. Those of special interest to the elderly include fact sheets on "The Elderly and Stairway Accidents," "Upholstered Furniture," "Stairs, Ramps, Handrails, and Landings," "Bathtubs and Shower Injuries," "Kitchen Ranges," and "Flammable Fabrics." The Commission is also funding a controlled 3-year experiment to measure the effectiveness of various burn-injury education techniques and strategies. The elderly, as well as four other population-group targets, will receive special attention in the development of the education program. We hope that the results of this experiment will provide the basis for a nationwide burn injury education program. Under the Commission's Federal/State information and education volunteers program, States have been awarded contracts for information and education projects targeted toward the elderly. The Georgia Governor's Office of Consumer Affairs, for example, was awarded a contract of $10,000 to carry out an information and education volunteers program. That office, with the cooperation of the 4-H clubs of Georgia, the Georgia Office of Aging, and the Cooperative Extension Service of the University of Georgia, will present programs on household hazards, bicycle safety, and smoke detectors, intended for the aged, school-age children, and homeowners. Presentations will be made throughout the State in 105 nutrition centers serving the elderly, in 3,000 State 4-H clubs and through the Cooperative Extension Service with agents in over 150 countries. Under the Commission's city/community demonstration projects, information and education programs targeted toward the elderly were carried out in Texas and Kansas. The programs addressed flammable products as well as stairs, ramps, and landings. In 1977, the Commission is planning to fund several community/demonstration projects aimed at the elderly. In Chicago, for example, a study will be undertaken to determine what kinds of programs best reach the elderly. This project will measure not only the impact of existing materials, but will also provide recommendations for improving our methods of communication with the elderly and or improving our efficiency in reaching this target audience. The Commission will also fund programs in Boston, Oakland, and San Francisco, on flammability and smoke detectors. An area of particular concern to the elderly and the Commission is childresistant packaging. The Commission administers the Poison Prevention Packaging Act, regulations under which require human prescription drugs in oral dosage forms to be dispensed in child-resistant containers. The act, however, recognizes that the elderly and/or handicapped may experience difficulty in opening these closures, and provides that consumers may receive their medications in conventional packaging at their request or by request of their physician. Since many elderly people are apparently not aware of this exemption, CPSC conducted an information campaign. OTHER MAJOR ACTIVITIES RELATED TO THE AGING The Commission recognizes that many products used by all segments of the population may present special problems for the elderly. These special problems are examined carefully in our standards-setting procedures. For example, the Commission noted that the elderly were often involved in matchbook-related accidents, particularly those involving dropping a lit match. A requirement that would limit the burn-time of matches was incorporated into the proposed safety standard for matchbook published in April 1976. CPSC has also considered special structural and architectural studies of hazards in residences, using injury data to develop models of hazard accidents. Research into stairway accidents, for example, has shown that the elderly depend on handrails for stability, on good lighting, and on uniform tread conditions. The Commission is now encouraging incorporation of these requirements into building codes and standards. The Commission is also concerned about safety problems encountered by the elderly with bathroom hazards. Possible solutions include design guides to be developed for architects and engineers, proposals for mandatory product standards, assistance to the developers of voluntary standards, and general information and education campaigns. The Commission is working with the American Society for Testing and Materials' F15.03 Committee on Safety Standards for bathtubs and showers, which is developing standards for slip-resistant bath surfaces, antiscald systems, grab bars, and thermal shock preventing devices for bathing. For the past few years, we have been collecting injury data on the ignition of clothing and of interior household furnishings. One study focused on adult sleepwear, with emphasis on sleepwear for the elderly. As a result CPSC is formulating recommendations to solve serious problems that involve clothing ignitions and burns injuries to the elderly. Another study is being conducted to develop new test concepts that may predict more accurately the flammability hazards associated with all wearing apparel and interior furnishings. The feasibility of extending the existing children's sleepwear standards to certain other specified items of wearing apparel is also under consideration. The Commission staff is also considering special labeling to warn the elderly, especially those with visual problems, of hazards associated with consumer products. ITEM 16. ENERGY RESEARCH AND DEVELOPMENT ADMINISTRATION DECEMBER 17, 1976. DEAR SENATOR CHURCH: We are pleased to submit the enclosed report in response to your letter of November 9, 1976, to Dr. Seamans, requesting information on Energy Research and Development Administration (ERDA) activities in the field of aging for inclusion in the forthcoming annual report of the Senate Special Committee on Aging. ERDA sponsors large-scale research efforts aimed at evaluating the environmental and health risks associated with the use of energy. This mission includes the effects of a broad spectrum of energy-related physical and chemical hazards upon environment and health. These efforts range from basic studies of biological mechanisms at the molecular levels to more sweeping studies of human, animal, and plant populations and their responses to energy-related environmental stresses. Since age is an important factor in biological responses to environmental stress, certain of these studies touch directly or indirectly upon the phenomenon of aging. Thus, while ERDA has no specific mission in aging or geriatric research, it is clear that the ongoing and planned research activities listed herein contribute in a real way to understanding the relationships of disease states and environmental stresses to reduction of lifespan. We hope the information provided in the enclosed report will be helpful and that you will call on us if further assistance is required. Sincerely, JAMES L. LIVERMAN, Director, Division of Biomedical and [Enclosure.] ÉRDA PROGRAMS RELATED TO AGING INTRODUCTION The great majority of Energy Research and Development Administration (ERDA) programs related to aging are carried out within the Agency's Division of Biomedical and Environmental Research. The primary objectives of this Division's program are: (1) To insure that the national goal of increasing domestic energy production is achieved with a minimal impact on man and his environment; (2) to provide information for the establishment of a workable set of release and exposure standards for energy-related hazardous agents; and (3) to provide a basis for informed public judgment of the cost, risk, and benefit tradeoffs involved in the development of energy resources and production technologies. With respect to man, it is essential to evaluate the latent somatic, genetic, developmental, and pathophysiological effects that may result from continuous low-level exposure to energy-related agents. In order to extrapolate experimental results obtained from model animal populations to man, it is necessary to use both short- and long-lived animal species and to understand age-related differences in the production or development of these effects. Thus, certain ERDA biological research programs deal with an evaluation of life-shortening diseases and their increased frequency of occurrence under stress. Efforts are made to identify the cause of death in stressed and unstressed model animal populations, and a large amount of supporting research is conducted to facilitate understanding the sequence of events and the mechanisms involved in the induction of lifeshortening in stressed populations. This supporting research is performed at the whole-animal, tissue, cellular, and molecular levels of biological organization. These studies also contribute indirectly to the body of information needed to develop realistic approaches to the prevention or reduction of age-related degenerative processes that contribute to normal senescence or specific malignancies. LONG-TERM HUMAN STUDIES Since the late-effects research program is aimed at prediction of damage to the human population, long-term followup of four major human populations with radiation exposure histories is being continued. As the responsibilities of this Agency increase in terms of other energy-related pollutants, new human epidemiological studies may be initiated. At present, human population studies are of major interest to all agencies concerned with human health. The Radiation Effects Research Foundation, sponsored jointly by the United States and Japan, is continuing a lifetime followup of a sample of survivors of the atomic bombings of Hiroshima and Nagasaki in 1945. Detailed clinical and laboratory examinations of exposed and control groups will be performed on a continuing basis to obtain evidence of disease states that contribute to morbidity and mortality. A group of about 200 inhabitants of the Marshall Islands, who were exposed accidentally to fallout from a thermonuclear weapon tests, has been followed for the past 20 years by medical investigators of the Brookhaven National Laboratory. Over 1,500 persons who have been exposed to radium, many of whom have demonstrable radium burdens, have been studied at the Center for Human Radiobiology (CHR) of Argonne National Laboratory. In most cases, the exposure occurred occupationally during watch dial painting or chemical laboratory activities or medically by injection as a method of treatment. Many individuals in this study receive medical and radiologic (dosimetric) examinations periodically at the CHR. A large epidemiological cohort study of 170,000 employees of ERDA production and laboratory facilities is in progress as a cooperative effort between members of the graduate school of public health of the University of Pittsburgh and data collection and analysis groups at the Hanford and Oak Ridge plants. Various levels and modalities of radiation exposure as well as exposure to other toxic agents may be encountered in this group of employees. Most radiation exposures have been at a low level. LIFETIME STUDIES ON LONG-LIVED MAMMALS Although the aforementioned human studies are valuable for supplying direct estimates of adverse effects of radiation on man, they are inadequate to provide |