Coffee Consumption and Parkinson's

 Yujia Zhao, MSc https://orcid.org/0000-0002-5275-0036, Yunjia Lai, PhD https://orcid.org/0000-0002-1081-0897, Hilde Konijnenberg, MSc, José María Huerta, PhD, Ana Vinagre-Aragon, MD, Jara Anna Sabin, Johnni Hansen, PhD, … SHOW ALL …, and Roel Vermeulen, PhD

https://doi.org/10.1212/WNL.0000000000209201

Abstract

Background and Objectives

Inverse associations between caffeine intake and Parkinson disease (PD) have been frequently implicated in human studies. However, no studies have quantified biomarkers of caffeine intake years before PD onset and investigated whether and which caffeine metabolites are related to PD.

Methods

Associations between self-reported total coffee consumption and future PD risk were examined in the EPIC4PD study, a prospective population-based cohort including 6 European countries. Cases with PD were identified through medical records and reviewed by expert neurologists. Hazard ratios (HRs) and 95% CIs for coffee consumption and PD incidence were estimated using Cox proportional hazards models. A case-control study nested within the EPIC4PD was conducted, recruiting cases with incident PD and matching each case with a control by age, sex, study center, and fasting status at blood collection. Caffeine metabolites were quantified by high-resolution mass spectrometry in baseline collected plasma samples. Using conditional logistic regression models, odds ratios (ORs) and 95% CIs were estimated for caffeine metabolites and PD risk.

Results

In the EPIC4PD cohort (comprising 184,024 individuals), the multivariable-adjusted HR comparing the highest coffee intake with nonconsumers was 0.63 (95% CI 0.46–0.88, p = 0.006). In the nested case-control study, which included 351 cases with incident PD and 351 matched controls, prediagnostic caffeine and its primary metabolites, paraxanthine and theophylline, were inversely associated with PD risk. The ORs were 0.80 (95% CI 0.67–0.95, p = 0.009), 0.82 (95% CI 0.69–0.96, p = 0.015), and 0.78 (95% CI 0.65–0.93, p = 0.005), respectively. Adjusting for smoking and alcohol consumption did not substantially change these results.

Discussion

This study demonstrates that the neuroprotection of coffee on PD is attributed to caffeine and its metabolites by detailed quantification of plasma caffeine and its metabolites years before diagnosis.

https://www.neurology.org/doi/10.1212/WNL.0000000000209201

'Bracing for a Surge in Prostate Cancer Diagnoses'

 Driven by increased life expectancy and related changes in age structure, global prostate cancer cases will more than double over the next 15 years, a panel of experts concluded.

The number of new cases will increase from 1.4 million in 2020 to 2.9 million in 2040. Neither lifestyle changes nor public health interventions alone can alter the projections. At the same time, annual prostate cancer mortality will increase by 85% to almost 700,000, primarily among men in lower- and middle-income countries (LMICs). The frequency of late-stage diagnosis, which has become the norm in LMICs, will continue to increase worldwide, members of the Lancet Commission on prostate concluded in a report published in The Lancetopens in a new tab or window.

Despite the report's global perspective, the findings and conclusions readily apply to North America, according to co-author Brandon Mahal, MD, of the University of Miami Sylvester Comprehensive Cancer Center.

"We anticipate there will be an increasing incidence of prostate cancer in the United States, and that's due to our aging population and our growing population, especially with the Baby Boomer generation coming into the age where prostate cancer is most common," Mahal told MedPage Today. "Looking forward into the next 20 or 30 years, you're going to start seeing the Millennial generation coming into that age group, so the United States should brace for an increasing public health burden of prostate cancer cases."

Moreover, disadvantaged populations in the U.S. share some of the same characteristics as individuals in LMICs, such as limited healthcare resources and limited access to healthcare, he added.

Authors of the report call for new approaches to early detection of prostate cancer. In high-income countries (HICs), such as the U.S., early detection typically centers on prostate-specific antigen (PSA) testing, which often detects clinically insignificant disease that may never cause symptoms or require treatment.

In the U.S., England, and other HICs, "informed choice" PSA testing has become the norm: Men 50 or older can request a PSA test from their doctor after a discussion of the risks and benefits. Authors of the Commission report maintain that such an approach leads to overtesting in low-risk men with no increase in cancer detection among high-risk younger men. Additionally, informed choice increases the likelihood of late-stage diagnosis.

"With prostate cancer, we cannot wait for people to feel ill and seek help," said report co-author Nick James, MBBS, PhD, of the Institute of Cancer Research in London. "We must encourage testing in those who feel well but who have a high risk of the disease in order to catch lethal prostate cancer early. Pop-up clinics and mobile testing offer cost-effective solutions that combine health checks and education."

James headed a recent outreach program that provided free health checks that included PSA testing to high-risk men 45 or older. Called the Man Vanopens in a new tab or window, the mobile clinic brought healthcare services to men at their places of work, resulting in more than 100 prostate cancer diagnoses in men who might otherwise have seen a doctor only after the disease became symptomatic.

By providing a variety of routine services, the Man Van addressed another issue raised in the Commission report: increased rates of other age-related conditions, such as diabetes and heart disease.

"Early diagnosis programs should focus not just on prostate cancer but on men's health more broadly," the authors stated.

Not all of the recommendations are consistent with current practice in the U.S. For example, the Commission recommends use of prostate MRI with PSA testing in high-risk men in HICs.

"Standard prostate cancer screening guidelines have not yet incorporated MRI, but there's increasing expert consensus that MRI ought to be incorporated into screening," said Mahal. "It's already been incorporated into diagnosis of prostate cancer. MRI can help with detecting clinically significant prostate cancer and potentially reduce the chance of catching early cancers that don't necessarily need to be treated. The Commission is urging consideration of this."

With a forward-looking perspective, the panel acknowledged that germline testing for BRCA mutations has yet to gain acceptance as a part of routine clinical practice anywhere in the world. However, they stated that testing for such mutations "could make a meaningful contribution to the diagnostic pathway."

Among other recommendations, the Commission called for implementation of programs to raise awareness of prostate cancer in LMICs and improve early diagnosis and treatment. The panel also supported more prostate cancer research involving men of different ethnicities, especially men of West African descent.

The authors acknowledged that improved rates of early detection will exert greater demand on under-resourced healthcare systems in LMICs. They suggested creation of regional hubs to provide the infrastructure needed to increase specialist training and improve patients access to radiotherapy and surgery.

Disclosures

Mahal reported no relevant relationships with industry.

James disclosed relationships with AstraZeneca, Bayer, Clovis, Janssen, Merck, Merck Sharp & Dohme, Novartis, Sanofi, Astellas, and AAA Accelerator Solutions. Co-authors reported multiple relationships with industry.

Primary Source

The Lancet

Source Reference: opens in a new tab or windowJames ND, et al "The Lancet Commission on prostate cancer: Planning for the surge in cases" Lancet 2024; DOI: 10.1016/S0140-6736(24)00651-2.

https://www.medpagetoday.com/hematologyoncology/prostatecancer/109528

Despite Pushback, Anti-DEI Congressman to Speak at Medical Meeting

 Rep. Greg Murphy, MD (R-N.C.), will speak at the American College of Emergency Physicians' (ACEP) leadership meeting later this month, despite calls for the congressman to be disinvited over his bill proposing a ban on federal funding for medical schools with diversity initiatives.

Last month, the North Carolina congressmen introduced the Embracing anti-Discrimination, Unbiased Curricula, and Advancing Truth in Education (EDUCATE) Act, which per a press release on Murphy's websiteopens in a new tab or window aims "to ban race-based mandates at medical schools and accrediting institutions."

ACEP's president, Aisha Terry, MD, MPH, took to videoopens in a new tab or window on Monday to explain why, despite pushback from members, Murphy is still scheduled to speakopens in a new tab or window April 16 at the organization's Leadership & Advocacy Conference in Washington, D.C.

In the video, Terry said that she and Murphy had a candid 35-minute conversation. She expressed ACEP's position that a diverse physician workforce is "essential and fundamental to the proud practice of emergency medicine" and told him that some ACEP members were uncomfortable with the EDUCATE Act and thus Murphy's scheduled appearance at the conference.

The EDUCATE Actopens in a new tab or window, which currently has over 40 co-sponsors, would amend the Higher Education Act of 1965 and cut federal funding to medical schools with diversity, equity, and inclusion (DEI) offices or initiatives, calling for a "colorblind" approach to admissions.

For his part, Murphy told Terry that "he is in favor of a diverse physician workforce, but concerned about forced liberal policy and ideology in medical school, which he feels distracts from the goal of producing well-equipped physicians."

"I emphasized that we share the goal of producing competent physicians who receive outstanding training," said Terry. "I also shared, however, that I'm not aware of any objective or anecdotal data that the bar has been lowered, that diversity inherently comes at the expense of quality, that DEI initiatives negatively impact the quality of medical education, or that physician diversity impairs health outcomes. In fact, there's plenty of data to the contrary."

Murphy's bill has been rebuked by a number of major medical societies, including the American College of Physiciansopens in a new tab or window, the Association of American Medical Collegesopens in a new tab or window, the American College of Obstetricians and Gynecologistsopens in a new tab or window, and others.

And on Monday, ACEP released a statementopens in a new tab or window saying the organization reaffirms its "unwavering commitment to ensuring a diverse and representative emergency physician workforce and opposes any legislation that runs counter to this goal." The statement cited ACEP's policy statement on workforce diversityopens in a new tab or window from 2001, which was last revised in June 2023.

"While there is clear recognition that Murphy's bill is starkly counter to ACEP policy, after exhaustive deliberation and many discussions with several, there is consensus amongst the board of directors to not uninvite him," Terry said in the video.

"I'd like to emphasize that ACEP is not afraid to defend our policies while having tough conversations on topics about which we might not agree," she continued. "ACEP believes in holding our elected officials accountable, while having respectful discourse and fighting for our broad and long mission."

After the conversation with Murphy, Terry noted she met with four ACEP members who strongly advocated for Murphy to be disinvited. MedPage Today spoke with three of those members.

"I don't think that it could have been stressed any clearer from us that this was a bad decision," said Italo Brown, MD, MPH, an emergency medicine physician in Palo Alto, California, adding that emergency medicine and ACEP would be painted poorly "by giving this guy a platform to talk about something that was not only extremely harmful, but deleterious to decades of work in this space."

Fred Kency Jr., MD, of Baptist Medical Center in Jackson, Mississippi, said that "the diversity of medicine is what makes medicine great and there's plenty of research that shows when places are more diverse there are better patient outcomes."

All three emphasized that Terry was receptive to their feedback, has a strong record of working toward equity, and is in a tough spot as the first Black woman president of ACEP. While Terry has been the messenger, they cautioned that this situation is beyond her and comes down to the ACEP board, which is majority white.

The third ACEP member, who requested anonymity, said the group discussed other avenues for compromise if ACEP would not rescind Murphy's invite: moving his talk to a smaller room; inviting other physician legislators to be in the conversation such as Rep. Raul Ruiz, MD (D-Calif.), an emergency room physician; or shortening Murphy's time slot. The member also noted that this situation makes emergency medicine look bad and distracts from the other good work at the conference.

"Somebody likened it to inviting the CEO of a tobacco company to a high school graduation commencement speech," Brown said.

The anonymous ACEP member pointed out that the Emergency Medicine Residents' Association (EMRA) was particularly upset. "You're going to maintain your relationship with this congressman, but you're going to jeopardize your future [ACEP] membership," the member said.

Indeed, in a statement,opens in a new tab or window EMRA said that Murphy's legislation "threatens the advancements made toward creating diverse and inclusive healthcare environments." Blake Denley, MD, EMRA's president and an emergency medicine physician in New Orleans, posted on Xopens in a new tab or window that "the EDUCATE Act is dangerous, racist legislation, and its introduction only further demonstrates the need for increased diversity, equity, and inclusion efforts in medical education and healthcare in general."

Tanesha Beckford, MD, an emergency medicine resident physician in Boston and EMRA's former diversity and inclusion committee chair, noted on Xopens in a new tab or window that the act is "a misled representation of what it means to truly have DEI efforts in medical school and it intentionally misconstrues the language of equity leaders to build its platform and misinform the public. This is unacceptable and a detriment to our healthcare system."

An ACEP spokesperson told MedPage Today that Murphy was invited to discuss "healthcare issues being considered in Congress, given his history of leadership on physician issues, his role as co-chair of the House GOP Doctors' Caucus, and his position as a physician member of the Ways and Means Committee" and that "the invitation was extended prior to his introducing the EDUCATE Act." They also confirmed Murphy's session will be followed by a brief Q&A.

Murphy did not reply to MedPage Today's multiple requests for comment.

https://www.medpagetoday.com/emergencymedicine/emergencymedicine/109531

'CDC Tells Docs to Be on Lookout for Bird Flu Cases — No new cases identified'

 The CDC wants clinicians and health departments to consider potential infections with the highly pathogenic avian influenza (HPAI) A(H5N1) virus, commonly known as bird flu, in people with exposure to potentially infected animal sources.

The health advisory alertopens in a new tab or window comes on the heels of Monday's announcementopens in a new tab or window by the CDC and the Texas State Department of Health that a farmworker on a commercial dairy farm was infected with the H5N1 virus after exposure to presumably infected cattle. That person's only symptom was mild conjunctivitis. The case was the second one in the U.S., following a case in 2022 in Coloradoopens in a new tab or window.

The new case is notable because it is the first instance of presumed transmission from a cow to a human, occurring in the midst of a first-ever outbreakopens in a new tab or window of the virus in dairy cattle. The CDC alert said no additional cases in humans have been reported and that no human-to-human transmission of the virus has been identified, with the patient's household members receiving post-exposure prophylaxis with oseltamivir (Tamiflu).

"The current risk these viruses pose to the public remains low," the CDC alert stated. However, people with job-related or recreational exposures to potentially infected animals are at higher risk of infection.

The advisory alert recommended that clinicians should consider the possibility of H5N1 infection in people showing signs or symptoms of acute respiratory illness and/or conjunctivitis and who have relevant exposure historyopens in a new tab or window, such as:

• Contact with potentially infected sick or dead birds, livestock, or other animals within the week before symptom onset
• Direct contact with water or surfaces contaminated with feces, unpasteurized milk or unpasteurized dairy products, or parts (carcasses, internal organs, etc.) of potentially infected animals
• Persons who have had prolonged exposure to potentially infected birds or other animals in a confined space

Symptoms compatible with bird flu can range from mild upper respiratory illness to severe systemic disease. If compatible signs and symptoms are present, the CDC recommends that clinicians should do the following:

• Isolate the patient, use personal protective equipment (PPE), and follow infection control recommendations
• Initiate empiric antiviral treatment as soon as possible with oral or enteric oseltamivir, twice daily for 5 days
• Treatment should not be delayed while waiting for laboratory results and should be initiated regardless of the time since onset of symptoms
• Notify state and local health department to arrange testing for the H5N1 virus
• Collect respiratory specimens from the patient to test for H5N1 virus at the state health department; if the affected person has conjunctivitis, with or without respiratory symptoms, both a conjunctival swab and a nasopharyngeal swab should be collected for testing

Patients should be encouraged to isolate away from household members and not go to work or school until test results indicate they are not infected with the virus.

https://www.medpagetoday.com/infectiousdisease/publichealth/109532

Border Patrol must care for migrant children it locks up, federal judge rules

 When the federal government locks migrants up, it’s responsible for them — regardless of whether they’ve been formally processed, a federal judge found Wednesday. 

As migrant crossings over the border between Mexico and Southern California have overwhelmed local detention facilities, thousands of people have been left to camp in the desert, often for days.

In the case under dispute, Flores v. Garland, civil rights groups sued on behalf of migrant children living in the camps, who they argued were being housed in “inhumane” conditions.

The U.S. Border Patrol largely didn’t challenge the idea that the conditions weren’t adequate. Instead, it argued the court didn’t have jurisdiction over the agency on this issue because the agency had not formally taken on responsibility for the children by processing them.

Judge Dolly Gee of the U.S. District Court of Central California roundly rejected that idea.

The agency may not have intended for temporary camping sites to become polluted open air detention sites “collectively holding thousands of migrants,” Gee conceded.

But she added the situation has “evolved such that the minors held there” are in the agency’s legal custody — and therefore it is responsible to care for them.

At the core of the present case is the 27-year-old decision in Flores v. Sessions, which established that the Department of Homeland Security is responsible for providing housing to “all minors who are detained in the legal custody” of the agency.

Gee determined it didn’t matter that the children had not been formally processed: They were held in a fenced area to which they were forcibly returned if they tried to leave, by an agency with “decision-making authority over [their] health and welfare,” she wrote in the ruling.

The court found that Customers and Border Protection (CBP), for example, “largely controls the provision” of necessities like drinking water and handwashing stations at the camping sites — as well as portable toilets and dumpsters, the last of which Gee noted were “quickly filled and infrequently serviced.” 

Volunteers reported to the court that the water and handwashing stations were also poorly maintained — on a recent inspection, “the handwashing stations have been filled with trash and the spigots to the waters stations [were] dirty,” Gee wrote.

That overloaded infrastructure is part of generally grim conditions. The camps themselves are an archipelago of rocky, barren quadrangle encircled by the border wall, train tracks, desert and mountains.

In the dry air, temperatures can be above 110 degrees in the summer and below 20 degrees in the winter, with little shelter, save for “various forms of brush that the migrants try to burn to keep warm at night,” Gee wrote.

While volunteer groups try to supply people in the open air detention site with food, clothing and sanitation services, “the need outpaces their ability to provide this assistance,” the court found.

National standards for migrant detention require kids to get a meal every six hours, and two hot meals per day; generally, migrants in the detention sites get “one bottle of water and one pack of crackers” each day, according to the court.

Also, the insufficiently abundant and infrequently cleaned dumpsters and portable toilets “are unflowing and unusable,” Gee found.

“This means that the [open-air detention sites] not only have a foul smell, but also that trash is strewn about, and [migrants] are forced to relieve themselves outdoors.”

All of this, Gee found, violated immigration authorities’ responsibility under the 1997 Flores decree to hold “minors in facilities that are safe and sanitary.”

The mere fact that CBP had provided services — or that those services were inadequate for need — would not imply that they had the minors in “custody,” except for the crucial fact that the migrants can’t leave, Gee wrote in the ruling. 

On their arrival, migrants are given a wristband marked with a date; when they ask CBP officers if they can leave to get told food and water, they are told no, she noted in the decision. And “if an individual does leave [the site], Border Patrol brings them back.”

Having established that the children at these camping sites are in U.S. custody, the court found “abundant evidence” that the care they were receiving “is not adequate for minors.”

Finally, the court found that CBP “had not been processing [migrants] as expeditiously as possible,” though Gee declined to give the agency a hard limit for the time they could take to process them.

But she warned that the agency’s “failure to process minors in a reasonably expedition manner” would lead to “further remedial measures” by the court.

https://thehill.com/regulation/court-battles/4574773-border-patrol-must-care-for-migrant-children-it-locks-up-federal-judge-rules/

House Democrats campaign arm zeroes in on races where abortion is on ballot

 The campaign arm for House Democrats has zeroed in on races in states where abortion is on the ballot in 2024.

In a Friday memo, first obtained by Politico, the Democratic Congressional Campaign Committee (DCCC) noted the multiple states in the U.S. that either will have measures in favor of abortion rights on the ballot in November or those that have movements to get those measures on the ballot currently in progress. These states include New York, Florida and Colorado.

“This further guarantees that reproductive freedom will remain a driving issue for voters this November, putting vulnerable House Republicans and GOP candidates on the hook for their anti-abortion and anti-freedom positions,” the DCCC said in the memo. “The Democratic Congressional Campaign Committee will ensure that House Republicans’ efforts to ban abortion nationwide are top of mind as voters head to the polls to protect their reproductive rights.”

The memo also noted 18 congressional districts that are on the organization’s “offensive and defensive battleground” that “are in states that have or will likely have an abortion ballot initiative on election day.” These districts included those currently represented by Republican House members including Reps. Anna Paulina Luna (R-Fla.), Nick LaLota (R-N.Y.) and Don Bacon (R-Neb.).

“Vulnerable House Republicans have attempted to skirt responsibility by claiming abortion is now a ‘states issue,’” the memo continues. “This empty rhetoric runs counter to their efforts to criminalize abortion care at the federal level. In the 118th Congress, House Republicans have passed four bills that would restrict access to reproductive care nationwide and introduced an additional six anti-abortion bills – including two total national abortion bans.”

In 2022, voters in states including California, Michigan and Vermont approved ballot measures that enshrined abortion rights in their state constitutions. On the same day, voters in the right-leaning states of Kentucky and Montana turned down measures that would’ve limited reproductive care accessibility. Late last year, Ohioans voted in favor of a measure to enshrine abortion protections in the Buckeye State’s Constitution.

Will Reinert, the National press secretary for the National Republican Congressional Committee (NRCC), the campaign arm of House Republicans, said in an emailed statement to The Hill that “[a] top non-partisan election analyst just dumped cold water on the DCCC’s pipe dream that ballot initiatives will be a ‘silver bullet’ for overcoming extreme House Democrats’ dangerous open-border, pro-crime and pro-inflation policies.”

Reinert’s statement also linked to a Cook Political Report analysis on whether pro-abortion rights measures will help Democrats in the upcoming 2024 elections.

https://thehill.com/homenews/campaign/4577285-house-democrats-campaign-arm-zeroes-in-on-races-abortion-on-ballot/

How much time do federal bureaucrats spend working for unions?

 According to a George Washington University survey released in February, nearly two-in-three Americans view the government as “totally ineffective” at “getting things done” and, by an even larger margin, believe the government mostly makes decisions for “political reasons” rather than the “public interest.”

Unfortunately, recent actions by the Biden administration to increase the amount of “official time” federal employees spend during the workday serving what is perhaps the president’s favorite special interest — while simultaneously obscuring the public visibility of the associated cost to taxpayers — couldn’t be better calibrated to worsen these dismal trends. 

“Official time” gets its name from the 1978 law authorizing the practice but, since it involves federal employees spending some or all of their workday engaging in labor union advocacy while continuing to receive their full, taxpayer-funded salary and benefits, “taxpayer-funded union time” would be a more accurate description.

As part of his effort to tame an out-of-control federal bureaucracy, President Trump issued an executive order in 2018 limiting taxpayer-funded union time to the extent legally possible.

However, President Biden — who promised to lead “the most pro-union administration in American history” — promptly rescinded Trump’s reform on his third day in office.

And he didn’t stop there.

In April 2021, Mr. Biden established a special task force to develop recommendations for increasing unionization. Among other things, the task force’s initial, February 2022 report identified a “suite of strategies” for the Office of Personnel Management (OPM) to unionize more federal employees.

As an example of how the administration was already pursuing such policies, the report boasted of how Biden had “restored” official time at the Department of Veterans Affairs. The upshot: The more than 400 medical staff Trump had returned to their actual federal jobs could once again spend their workday on union activism rather than caring for the nation’s veterans.

In a March 2023 update, the task force “proudly announced” the unionization of 80,000 more federal employees, purportedly due to the administration’s pro-union strategies.

And earlier this month, Biden issued still another order directing federal agencies to establish “labor-management forums” at which agency leaders will engage in “pre-decisional” consultation with union officials over “workplace matters” and discuss how to “promote satisfactory labor relations.”

Eased restrictions, more unionized federal workers, and added labor relations busywork are a recipe for a spike in the amount of on-the-clock union work by federal employees, which could explain OPM’s recent efforts to obscure official time’s visibility to the public.

In November, the Freedom Foundation reported that OPM had taken down a page on its website explaining official time and housing a series of OPM reports estimating the amount and costs of official time dating back to the Clinton administration.

Since its first 1998 report, OPM has typically released updated estimates of official time use every year or so, a practice that continued unabated through the Bush, Obama and Trump administrations.

Under Biden, however, OPM has failed to release a single official time report.

In response to an inquiry led by Sen. Marsha Blackburn (R-Tenn.), OPM director Kiran Ahuja recently acknowledged her agency had no intention of restoring the official time webpage it deep-sixed last summer, much less conduct another study on the costs of taxpayer-funded union time.

Ahuja did, however, admit that the last such report — covering fiscal year 2019 — showed nearly a 30 percent decline in official time use, a testament to Trump’s now-reversed reforms. Even still, federal bureaucrats spent an estimated 2.6 million hours on taxpayer-funded union time that year at a cost of about $135 million.

As far back as 1979, the Government Accountability Office noted the difficulty of accurately measuring official time given federal agencies “widespread failure” to keep adequate records. The periodic OPM estimates of recent decades were better than nothing but, with the politicized agency now stonewalling, a more durable solution is needed.

According to the GWU survey, more transparency is Americans’ top recommendation for increasing trust in government, so, if government quietly aiding a favored special interest group at a cost of hundreds of millions of dollars is the problem, then sunlight is at least the first step towards a solution.

To that end, Sen. Joni Ernst (R-Iowa) and Rep. Scott Franklin (R-Fla.), just introduced the Taxpayer-Funded Union Time Transparency Act, which would require each federal agency to track and annually report the amount of time its employees spend on union business and the cost of such official time to taxpayers.

Love government unions or hate them, taxpayers at least deserve to know how much union work is being done on their tab.

Maxford Nelsen is director of research and government affairs at the Freedom Foundation and senior fellow at the Institute for the American Worker.

https://thehill.com/opinion/4577050-how-much-time-do-federal-bureaucrats-spend-working-for-unions/