This Background Paper examines whether the agencies responsible for administering Federal environmental and health and safety laws have taken this concern for respiratory health to heart. This paper provides a partial response to the committees’ request for an assessment of noncancer health risks in the environment and follows OTA’s previous work on carcinogenic, neurotoxic, and immunotoxic substances.

In this report, OTA places testing in its historical and policy context, examines the reasons for testing and the ways it is done, and identifies particular ways Federal policy affects the picture, The report also explores new approaches to testing that derive from modem technology and cognitive research.

This report deals with the drug and biological infusion treatments (including blood transfusions) being used in the home but not yet explicitly covered by Medicare in that setting. Medicare does cover total parenteral nutrition (TPN) in the home for individuals with long-term disabilities that prevent them from being able to digest food. TPN has many similarities to the therapies discussed in detail in this report, and many providers of HDIT also provide TPN and other nutritional products and services.

This report finds little likelihood that a NAFTA, by itself, will lead to the most dismal scenarios. But OTA’s analysis also indicates that market forces alone are not likely to produce the social and economic rewards the heads of both states have promised from a free trade agreement.

This report concludes that the value of the cystic fibrosis (CF) carrier test is the information it provides. No one can estimate in common terms what it means to an individual to possess information about his or her genetic status, especially when the value concerns reproductive decision-making. As our knowledge of the human genome increases, what we do with information such as CF carrier status will depend on the perceptions and beliefs of all Americans.