If only things were as easy as Tony Kwilas writes about the Toxic Free Kids Act ("Mere presence of chemical doesn't mean harm," April 1). He uses an out-of-date premise about toxic chemicals when he writes that "dose and exposure are key components of any regulation." New toxicological theory recognizes that endocrine disrupters are harmful at minuscule doses during critical times in our children's development, and small exposures from multiple sources do add up in their bodies.

The original Toxic Free Kids Act required a list of high-priority chemicals. The Legislature passed that bill and the agencies developed the list. However, parents still can't tell which products contain those chemicals.

This session's bill would require manufacturers to report whether their products contain a chemical on that list. Why would Kwilas object to that? The whole intent of the Toxic Free Kids Act is that we as consumers should not have to worry about what we are exposing our families to. Companies providing our products should care enough to take responsibility for ensuring that their products are toxin-free. They should not fight our right to know. The protection we're seeking for all of our children is neither duplicative nor confusing!

Emily Moore, Minneapolis
EARLY EDUCATION

Why wait until age 3 or 4 to help kids? Try starting before birth

Brenda Cassellius, Minnesota's education commissioner, draws on her own experience as a "Head Start baby" to point the ways to "make sure all Minnesota children have a strong educational foundation" ("Early ed mattered then, and does now," March 31). Her recommendations to the governor include about $400 million in long-awaited new spending on children and families.

Commissioner Cassellius has the right prescription for spending the very welcome dollars, writing that "to truly close achievement gaps, our work with children must start earlier, with comprehensive efforts targeted toward our youngest Minnesotans." However, the proposed budget has funding to only partly fill her prescription.

Parenting, health, education, housing, employment and income disadvantages begin even before birth, then accumulate and produce more adversity — with lifelong consequences. When we wait until age 3 or 4, the disadvantaged children already lag developmentally.

A strong educational foundation for children begins with a strong developmental foundation, which begins with adequate prenatal care, secure attachment to a positive and competent person, and positive early relationships and experiences. Another key way to promote optimal healthy child development is to invest in each community's capacities to forge their own solutions for success.

When will state and federal budgets spend as much trying to prevent the achievement gaps as they spend with limited success trying to close them?

Richard Chase, St. Paul

The writer is a researcher for St. Paul-based Wilder Research.

FOOD SAFETY

For World Health Day, let's get testing standards implemented

To understand the importance of food safety, we need look no further than Minnesotan Jeff Almer. Almer's mother fought and beat brain cancer only to die eating peanut butter contaminated with salmonella. This should never happen.

I was trained as a medical technologist. One of the first things we learn is that laboratory testing for pathogens, like salmonella, isn't worth much without the proper quality controls and other laboratory standards. A bipartisan Congress agreed, and in 2011 passed a law, the Food Safety Modernization Act, which calls for laboratory accreditation and model laboratory standards. These provisions will help to assure the public and food manufacturers that laboratory test results are accurate and reliable. Yet these provisions have not yet been implemented by the federal Food and Drug Administration.

The World Health Organization will recognize the critical importance of food safety on World Health Day on Tuesday. In support, let's call for the quality standards for food laboratory testing for a safer, healthier world.

Brad Goskowicz, St. Cloud

The writer is CEO of St. Paul-based Microbiologics.

GUN SILENCERS

Suppressors plus ear protection can lower the risk of hearing loss

The use of suppressors significantly reduces the health risks of the people who fire guns for recreation and work, such as hunters, target shooters, police and gun-range employees (Readers Write, March 27 and March 28). As an audiologist who specializes in hearing-loss prevention and hearing protection, I can tell you that the risk of hearing loss and other health effects is much lower when a suppressor is used.

Some have argued that suppressors don't protect the wearers' hearing, since hearing protection must still be worn. This is not true. The sound level that reaches the ears of the wearer when hearing protectors are worn is far lower when a suppressor is used. In other words, we can protect the hearing of the shooter by a much greater amount by reducing the level of the blast and wearing hearing-protection devices.

Another benefit of using suppressors may be improved situational awareness for people who wear hearing protection while exposed to gunfire. If police officers, target shooters, hunters and gun-range employees don't have to wear as much hearing protection, they may be better able to hear important sounds nearby, such as range commands, movements of game animals or the noises made by criminals who are trying to evade capture.

Whether or not the use of suppressors will lead to an increase in gun violence is a separate issue that I will leave to others to debate.

Ted Madison, St. Paul
DAN MARKINGSON CASE

With new recommendations, maybe we can finally move on

As a practicing psychiatrist, I've long followed the Dan Markingson case. I know the field, the researchers and many who struggle with schizophrenia. I've read the two recent outside reviews, and I hope the implementation of their recommendations will allow all survivors to move on.

A recent related editorial (" 'Trust but verify' to rebuild trust in the U," March 29) implied that it was irresponsible to recruit someone into the CAFE study who had an initial response to Risperdal. In fact, it isn't possible to know within several days whether a new antipsychotic will be the best long-term treatment. This implication follows many unjustified negative conclusions, including that the researchers were motivated by financial gain, when they actually work on salary.

Commentators have further singled out psychiatric patients as being unable to act in their own interests, taking agency from these individuals and contributing to stigma. Patients with various serious medical illnesses have areas of both capacity and lack of capacity. All deserve appropriate safeguards as well as respect for autonomy to the degree possible.

Schizophrenia is a terrible disease, and premature death is all too common. Our knowledge, treatment options and prognostic abilities are limited. Continued research is sorely needed. The investigators in this and similar studies have devoted their careers to advancing knowledge so that we can better help our patients.

Family and friends have suffered greatly from the death of this young man. Many others continue to suffer.

John Vuchetich, Minneapolis