Dr. Dave Janda 5-14-19… “President Trump is about to “HAMMER” Brennan & Comey” (and how this (and one other item) ‘sparked’ today’s mission)

This was the first thing I watched today. I was not quite sure whether the “190514 Mauna Kea “Releasing the Fire” Mission” was going to take place. Yes, I knew it “felt” right (it was a 5-5 day), but still, I was waiting. There was something about this “‘ball of fire’ energy” collected at the 190508 K?lauea Mission that was to be released at Mauna Kea.

Then, starting last night, two things happened:
1. I felt drawn to watch “Cajun Pawn Stars“, which I had NEVER watched since moving to my current place. Episode 3 of season 1 had someone bring in an unpublished recording (a record) of Jerry Lee Lewis. One of the most famous songs he recorded was “Great Balls of Fire“.

2. In the video here, by Dave Janda, he discusses how several insider whistleblowers (like General McInerney) had told Dave that “The Hammer” was an operation created by the deep state to take out Donald Trump out of office if he won the election. Now, who were the authors of Great Balls of Fire? Otis Blackwell and Jack HAMMER!! What a connection.

So I knew, after watching this video, that the mission was on.


Published on May 14, 2019
The spotlight of this Briefing focuses on President Trump and the take down of the Deep State’s Brennan & Comey.
Additional content available 24-7 at : www.davejanda.com
The link to the article discussed : http://theamericanreport.org/2019/05/12/comey-launched-trump-russia-investigation-day-after-general-exposed-the-hammer/
Join Our Freedom Family by becoming a subscriber at www.davejanda.com

Why You Should Never Buy Precut Fruit

Eating more vegetables may be one of the simplest choices you can make to improve your health. Just about any vegetable is good for you, but some are better than others. Some fruits, lower in fructose, are also healthy as they contain high amounts of antioxidants.

In one study1 from the Journal of the American Medical Association, researchers found a suboptimal diet was culpable in developing cardiometabolic diseases.2 Good food identified in the study to reduce the risk of cardiometabolic diseases included fruit, vegetables, nuts and seeds, seafood and red meat.

As I’ve discussed before, overeating fructose in any form may lead to obesity, Type 2 diabetes and cardiovascular disease. However, fruit in moderation is a healthy addition to your diet.

As you choose your fruits and vegetables, keep in mind that whole food is best. Outbreaks of Listeriosis,3 Cyclosporiasis4 and Salmonella5,6 associated with packaged salads, precut vegetable trays and precut melon have been reported by the U.S. Centers for Disease Control and Prevention.

Precut Fruit Raises Your Risk of Foodborne Illnesses

In the summer of 2018,7 the CDC began investigating a multistate outbreak of Salmonella linked to precut melons supplied by Caito Foods in Indianapolis. The outbreak included cantaloupe, watermelon and fruit salad mix. When the outbreak appeared to be over, the CDC reported 77 people had been infected and 36 were hospitalized.8

In what eerily mimicked the 2018 outbreak, Caito Foods was once again at the center of a precut melon recall less than a year later. April 12, 2019, the company announced the recall of fresh-cut melon products.9 According to the CDC10 these included precut watermelon, honeydew melon, cantaloupe and precut fruit medley. The products had been distributed to 16 states and sold under multiple labels.

The investigation began April 2, 2019; 22 days later, 117 people were found to have been infected across 10 states, of which 32 required hospitalization.11 In addition to throwing out the recalled food, the CDC has specific recommendations to clean your refrigerator as the bacteria may spread to drawers or shelves. You’ll find the instructions at cdc.gov/foodsafety/communication/clean-refrigerator-steps.html.

Symptoms of salmonella poisoning, which include stomach cramps, nausea, vomiting, bloody diarrhea and fever, may be experienced 12 to 72 hours after eating a contaminated product and may last four to seven days12 Keith Warriner, a professor of food science at the University of Guelph, talks about the risks precut fruit presents:13

“The problem with processed produce is that much like when you get a scratch on your skin, once it’s been cut, it loses a layer of protection and is exposed to [possible contamination]. Melons, in particular, are an extreme example because their flesh is the best growth medium for salmonella.”

Since melons are grown on the ground, the skin may pick up pathogens. These are easily transferred into the fruit as you cut through the skin. Warriner recommends14 thoroughly scrubbing the skin with a brush under running water before cutting. Either eat the melon immediately or refrigerate it, as Salmonella may double every 30 minutes.

The High Price of Precut Produce

The high price you may pay for precut convenience does not end with potential bacterial contamination. As you may have expected, as it is a convenience item, precut fruit costs more than it does to buy the whole fruit and prepare it at home. According to the Bureau of Labor Statistics,15 in 2017, food was the third largest household expense, behind housing and transportation.

In 2018, Vice16 did a comparison between precut and whole fruits and vegetables. They found that by buying whole and preparing at home, the average person would save $100 each month. For instance, they priced broccoli whole at $2.99 a pound, but the chopped florets were $4.99 a pound, and pineapple was $2.99 a pound but prepared and precut was $4.99 a pound.

One of the largest jumps was red onions, sold whole for 49 cents a pound at Walmart, but diced were $4.00 a pound.17 After factoring the additional cost into your budget, if you still consider purchasing precut fruit (a more nutritious choice than processed junk food), it’s also important to recognize that cutting exposes the flesh to oxygen and light, which increases oxidation and affects vitamin retention.

In an interview with Men’s Health,18 Caroline West Passerrello,19 consulting dietitian and spokesperson for the Academy of Nutrition and Dietetics, pointed out that whole fruits and vegetables also retain their vitamins longer than those exposed to the light. Since much of the water evaporates faster, water soluble vitamins are also at risk.

Cutting fruit increases the respiration rate leading to more active metabolism and faster deterioration.20 Despite being detached from the plant, the fruit remains a living organism after harvest and thus continues respiration, during which carbohydrates are reduced to produce energy.21 Higher respiration after cutting may also increase the loss of flavor and nutritive value.22

Another cost to purchasing precut fruit is the plastic it comes in. Much of it ends up in landfills and the ocean. Precut fruit also requires processing, packing and constant refrigeration, requiring a great deal of energy.

Precut, All-Natural Fruit Comes With Additives

Additionally, to keep the fruit from turning brown, it may be dipped in calcium ascorbate23 to preserve color and texture. The chemical was part of the ingredients in NatureSeal,24 a product available for industrial and residential use.

According to the FDA,25 calcium ascorbate has a generally recognized as safe (GRAS) designation and is exempt from the usual food additive tolerance requirements.26 In 2001 the FDA cited NatureSeal for not listing calcium ascorbate on the label. NatureSeals states:27

“Our products are comprised of ingredients that are sulfite-free (GRAS), allergen-free, GMO-free, and Kosher and Halal certified, with some blends certified for use on organic produce.

The NatureSeal line of products are precise blends of vitamins and minerals that maintain the natural texture and color of fresh-cut produce for up to 21 days, without altering the flavor. 30+ different formulations are currently being used by over 500+ processors, across 30 different countries.”

The flawed GRAS system has allowed thousands of food additives to bypass stringent testing as a part of a loophole stemming from the 1958 Food Additives Amendment.28,29 When the law was written it was meant to apply to common food ingredients known through historical use to be safe.

However, the chemicals currently used didn’t exist in the 1950s when the law was written, and countless manufactured ingredients are now slipping through this loophole.

What’s In the Container?

Mashed30 shared several other reasons why purchasing precut fruits and vegetables may mean you’re not getting what you expect. For instance, according to an article in the New York Post,31 reporting on issues raised in a documentary series entitled “Rotten,” nearly 90% of the garlic sold around the world originates in China.32

Setting aside concerns about pollution with heavy metal, processed garlic is produced by Chinese prisoners who are responsible for peeling it. The job is difficult and often the prisoners’ nails fall off. To continue to work, they are left to peel the garlic with their teeth.

Baby carrots are a popular snack food as they’re easy to grab and go, as well as sweet, and they go well with a number of different dipping sauces, such as hummus. However, while carrots are nutrient dense, baby carrots are bathed in chlorine before sale, increasing your risk of exposure to disinfection byproducts, which are some of the most dangerous chemicals to your health.

The white areas that may appear on baby carrots is not a result of the chlorinated rinse but rather a sign of dehydration.33 Baby carrots are the result of larger carrots that have been pared down and stripped of the protective layer. Dehydration results in the white areas and likely a loss of nutrition and flavor.

Prepare Fruit and Vegetables to Reduce Possible Contamination

Once upon a time, all that was required to eat an apple was polishing it off on your jeans before taking a big bite. However, now pesticide residues and bacteria play an important role in food safety. According to Reuters,34 the EPA mandates harvested apples be soaked in bleach water for two minutes to remove bacteria and other “organic matter.”

Unless you are purchasing organic produce, your food also likely contains pesticides. One study35 offered a surprisingly simple and affordable way to get rid of toxic pesticides contaminating food. The team from the University of Massachusetts used apples to examine the effectiveness of commercial and homemade washing agents.

Using highly specialized analysis, they found surface pesticide residue on apples was removed most effectively using baking soda (NaHCO3). The team tried tap water and Clorox bleach but neither worked as well as baking soda, which is highly alkaline. The authors wrote:36

“This study gives us the information that the standard postharvest washing method using Clorox bleach solution for 2 min is not an effective means to completely remove pesticide residues on the surface of apples. The NaHCO3 method is more effective in removing surface pesticide residues on apples. In the presence of NaHCO3, thiabendazole and phosmet can degrade, which assists the physical removal force of washing.”

Strengthen Your Immune System Through Daily Lifestyle Choices

Purchasing your food from high-quality, small-scale local sources is one of the best ways to protect yourself from foodborne infection and pesticides. Another way to protect yourself from infection is to strengthen your immune system.

Ideally, by making daily lifestyle choices to support your overall health, you will strengthen your immune system and reduce your risk of infection. Crucial strategies to accomplishing this task include:

Avoiding sugar — The average American consumers 17.4 teaspoons of sugar each day,37 and more disturbing is the excessive intake of fructose and high fructose corn syrup.

Fructose is a hepatotoxin, metabolized directly into fat.38 Sugar intake has a negative effect on your immune system.39 Substitute processed foods, especially those high in grains, fructose and sugar with plenty of organic raw foods.

Optimizing your gut health — Your gut microbiota play a fundamental role in the function of your immune system.40 Taking a high-quality probiotic or eating fermented foods helps populate your gastrointestinal tract with good bacteria, your best defense against harmful bacteria like Salmonella.

Optimizing your sleep — The amount of quality sleep you receive exerts a strong regulatory effect on your immune function.41 One study42 found sleep deprivation mirrors the body’s immune response to exposure to stress. For more information see my previous article, “Sleep — Why You Need It and 50 Ways to Improve It.”

Reducing stress — The level of stress you experience has a negative effect on your immune system.43,44,45 Find ways to relax; consider yoga, Emotional Freedom Techniques, meditation and other recreational activities. For more suggestions see my previous article, “How Stress Affects Your Body, and Simple Techniques to Reduce Stress and Develop Greater Resilience.”

Incorporating exercise — Incorporating plenty of regular exercise each week will help support and strengthen your immune system.46 Find a form of exercise you enjoy and use the Nitric Oxide Dump daily to help support mitochondrial biogenesis and reduce insulin resistance, as I describe in “The Benefits of Nitric Oxide Dump Exercise to Your Health.”

Optimizing vitamin D — Using sensible sun exposure to optimize your natural vitamin D production, or taking a supplement if needed, will help modulate your immune responses. Deficiency is associated with an increased susceptibility to infection.47

USDA Sued Over Failure to Address High Rates of Fecal Bacteria on Chicken

While there are many environmental and human health hazards associated with modern food production, perhaps one of the most pressing concerns for any given individual is the ever-rising risk of food poisoning.

According to preliminary data from the CDC, there were 25,606 foodborne infections, 5,893 hospitalizations and 120 deaths from food poisoning in 2018.1 In 2017, there were 24,484 infections, 5,677 hospitalization and 122 deaths.2

For further comparison, between the years of 2009 and 2015 — a span of six years — there were 5,760 reported foodborne outbreaks resulting in 100,939 illnesses, 5,699 hospitalizations and 145 deaths.3

According to the most recent report,4 the incidence of infection per 100,000 Americans was highest for Camylobacter, which was responsible for 19.5% of all cases — a 12% increase from 2015-2017 — followed by:

Salmonella 18.3% — a 9% increase from 2015-2017

Shiga toxin–producing Escherichia coli (STEC) 5.9% — an increase of 26% from 2015-2017

Shigella 4.9%

Vibrio 1.1% — an increase of 109% from 2015-2017

Yersinia 0.9% — an increase of 58% from 2015-2017

Cyclospora 0.7% — a 399% increase from 2015-2017

Listeria 0.3%

Chicken Is a Primary Source of Many Cases of Food-Borne Illnesses

While produce has become a significant source of food poisoning — two multistate outbreaks of STEC in 2018 were traced back to contaminated romaine lettuce,5 for example — raw chicken remains a primary concern. As noted in the CDC report:6

“Campylobacter has been the most commonly identified infection … since 2013. It causes diarrhea, sometimes bloody, and 18% of persons are hospitalized. A rare outcome of Campylobacter infection is Guillain-Barré syndrome, a type of autoimmune-mediated paralysis.

Poultry is a major source of Campylobacter. In August 2018, FSIS [U.S. Department of Agriculture’s (USDA) Food Safety and Inspection Service] began using a new testing method; in a study of that method, Campylobacter was isolated from 18% of chicken carcasses and 16% of chicken parts sampled …

The incidence of infections with Enteritidis, the most common Salmonella serotype, has not declined in over 10 years. Enteritidis is adapted to live in poultry, and eggs are an important source of infection.

By 2012, FDA had implemented the Egg Safety Rule, which requires preventive measures during the production of eggs in poultry houses and requires subsequent refrigeration during storage and transportation, for all farms with ?3,000 hens.

In 2018, a multistate outbreak of Enteritidis infections was traced to eggs from a farm that had not implemented the required egg safety measures after its size reached ?3,000 hens.

Chicken meat is also an important source of Enteritidis infections. In December 2018, FSIS reported that 22% of establishments that produce chicken parts failed to meet the Salmonella performance standard … ”

Factory Farmed Chicken Is Notoriously ‘Dirty’

Over the years, food testing has shown that factory farmed chickens (i.e., chickens raised in concentrated animal feeding operations or CAFOs) are particularly prone to contamination with dangerous pathogens, including antibiotic-resistant bacteria that make the illness all the more difficult to treat. For example:

Consumer Reports testing in 2007 found 80% of whole chicken broilers harbored salmonella and/or campylobacter,7 two of the leading causes of foodborne illness. Retesting in 2010 revealed a modest improvement, with two-thirds being contaminated with these disease-causing bacteria.

Three years later, in 2013, Consumer Reports8 found potentially harmful bacteria on 97% of the chicken breasts tested, and half of them had at least one type of bacteria that was resistant to three or more antibiotics.

A 2011 study conducted by the Physicians Committee for Responsible Medicine (PCRM) found 48% of the 120 chicken products tested (obtained from 15 grocery chains in 10 U.S. cities) were contaminated with E. coli, commonly found in feces.9,10 The following year, repeat testing revealed the exact same result: 48% of chicken products again tested positive for fecal bacteria (E. coli).11

An Environmental Working Group analysis12,13 of food testing done by the Food and Drug Administration (FDA) in 2015 found 36% of chicken breasts, legs, thighs and wings were contaminated with drug-resistant enterococcus faecalis, 71% of which were resistant to tetracyclines.

PCRM Sues USDA Over Failure to Address Contamination Issue

Based on its 2011 test results, the PCRM filed a petition for rulemaking14 with the USDA in 2013, asking the agency to address the issue of fecal contamination on chicken by regulating fecal contamination as an adulterant under the Federal Meat Inspection Act and the Poultry Products Inspection Act. As noted by PCRM in its April 17, 2019, press release:15

“Although USDA implements a ‘zero tolerance’ policy for fecal contamination, this policy only applies to visible fecal contamination. Chicken products pass inspection as long as feces are not visible to the naked eye.

The lawsuit and petition quote a federal inspector who said, ‘We often see birds going down the line with intestines still attached, which are full of fecal contamination. If there is no fecal contamination on the bird’s skin, however, we can do nothing to stop that bird from going down that line.

It is more than reasonable to assume that once the bird gets into the chill tank (a large vat of cold water), that contamination will enter the water and contaminate all of the other carcasses in the chiller. That’s why it is sometimes called ‘fecal soup.’”

In its petition for rulemaking, the PCRM argued that the USDA’s standard of “no visible feces” is woefully inadequate and would be considered “disgusting by the average consumer.” According to PCRM, fecal bacteria really should be regulated as an adulterant.

The lawsuit arose because the USDA failed to respond not only to the PCRM’s 2013 petition but also to its 2017 Freedom of Information Act (FOIA) request, in which the physicians group sought “documentation of fecal contamination rates detected in poultry slaughter plants and other data related to poultry inspection and slaughter line speed.”16

The lawsuit seeks to compel the USDA to provide a “substantive response” to its petition, as well as a response to its FOIA request. The New Poultry Inspection System implemented by USDA in 2014 increased allowable slaughter and processing line speeds to between 140 and 175 birds per minute. According to PCRM:

“Data show that plants operating under this model are more likely to fail USDA’s performance standards for Salmonella, a bacteria found in feces, than those operating under the traditional inspection scheme.”17

The USDA defends its standard, saying that fecal bacteria and fecal material are not interchangeable terms. KatieRose McCullough, director of regulatory and scientific affairs for the North American Meat Institute, told The Washington Post:18

“Bacteria like E. coli are naturally present in the environment as numerous studies on all types of items from foods to phones, keyboards and toothbrushes have shown. This does not mean any of those items are contaminated with feces.”

Contaminated Chicken Is a Primary Risk Factor for Urinary Tract Infections

Food poisoning isn’t the only concern when it comes to contaminated chicken. A form of E. coli known as ExPEC (extra-intestinal pathogenic E.coli) has been shown to be responsible for 85% of urinary tract infections (UTIs).19 Conventional wisdom has maintained UTIs are primarily caused by a transfer of the E. coli via sexual contact with an infected individual and/or the transferring of fecal bacteria from your anus to your urethra.

However, more recent studies have shown this to be incorrect, showing a majority of UTIs are in fact the result of exposure to contaminated chicken.20 What’s more, of the 8 million UTIs occurring in the U.S. each year, an estimated 10% are now resistant to antibiotics, which can result in kidney infection and blood poisoning (sepsis).

Drug resistance has become common enough that doctors are now advised to test for drug resistance before prescribing an antibiotic for a UTI. Part of the problem goes back to the fact that antibiotics have remained widely used in agriculture for growth promotion purposes, allowing resistance to develop.

As early as 2005, papers were published showing drug-resistant E. coli strains from supermarket meat matched strains found in human E. coli infections.21 American, Canadian and European studies22,23,24 published in 2012 all confirmed close genetic matches between drug-resistant E. coli collected from human patients and those found on poultry (chicken and turkey).

More recently, a study25 published in the journal mBio in 2018 found 79.8% of chicken, pork and turkey samples purchased from large retail stores in Flagstaff, Arizona, were contaminated with E. coli. The researchers also tested blood and urine samples from people who visited a major medical center in the area, finding E. coli in 72.4% of those diagnosed with a UTI.

In particular, a strain of E. coli known as E. coli ST131 showed up in both the meat samples (particularly poultry) and the human UTI samples. Most of the E. coli in the poultry was a variety known as ST131-H22, which is known to thrive in birds. This specific strain was also found in the human UTI samples.

“Our results suggest that one ST131 sublineage — ST131-H22 — has become established in poultry populations around the world and that meat may serve as a vehicle for human exposure and infection,” the researchers noted, adding that this E. coli lineage is just one of many that may be transmitted from poultry and other meat sources to people.

When Buying Chicken and Eggs, Make Sure They’re Organic and Free-Range

While findings such as the ones discussed in this article are a potent reminder to cook poultry thoroughly and handle it carefully during preparation, another option is to skip CAFO chicken entirely. It’s easily one of the most contaminated foods in the U.S. and also has a weak nutritional profile compared to other protein sources, including pasture-raised chicken.

For example, a study26,27,28 by the American Pastured Poultry Producers Association (APPPA), which compared the nutrient value of pastured chickens with the USDA’s National Nutrient Database for Standard Reference values for CAFO chicken, found pasture-raised chickens contained 406.8% more vitamin E (1.86 IUs per 100 grams compared to 0.367 IUs) and had an average omega-3-to-6 ratio of 1-to-5, which is near ideal, compared to the USDA’s value of 1-to-15.29

Pastured chicken also had about half the fats of CAFO chicken (saturated, monounsaturated and polyunsaturated), and 11.1% more cholesterol.

Considering the hazards associated with raw chicken, if you’re going to eat it, I would recommend making sure it’s organic and free-range, pasture-raised. Ditto for eggs, as CAFO eggs are also far more prone to pathogenic contamination than organic pastured eggs.

Your best bet is to find a local source of organic, free range eggs. The Cornucopia Institute’s egg report and scorecard ranks 136 egg producers according to 28 organic criteria, is an excellent resource if no local producers are available.

In June 2017, Cornucopia also began working on a chicken report and scorecard. Considering the egg report took six years to produce, it may still be a while before the chicken scorecard is ready. You can contribute to this report by following the simple instructions listed in their June 13 Action Alert.30

Commonsense Precautions When Handling Chicken

If and when you do cook chicken, be sure to take commonsense precautions to avoid contaminating other foods and kitchen surfaces and spreading any bacteria that may be present to yourself or others. To avoid cross-contamination between foods in your kitchen, adhere to the following recommendations:

  • Use a designated cutting board, preferably wood, not plastic, for raw meat and poultry, and never use this board for other food preparation, such as cutting up vegetables. Color coding your cutting boards is a simple way to distinguish between them
  • To sanitize your cutting board, use hot water and detergent. Simply wiping it off with a rag will not destroy the bacteria
  • For an inexpensive, safe and effective kitchen counter and cutting board sanitizer, use 3% hydrogen peroxide and vinegar. Keep each liquid in a separate spray bottle, and then spray the surface with one, followed by the other, and wipe off. Coconut oil can also be used to clean, treat and sanitize your wooden cutting boards. It’s loaded with lauric acid that has potent antimicrobial actions. The fats will also help condition the wood

Also, be sure to wash your hands with warm water and soap before and each time after you handle the chicken. The video below demonstrates how to properly wash your hands to avoid the spreading of bacteria.   

How to Treat UTIs Without Antibiotics

Lastly, should you contract a UTI, here are some helpful tips. While cranberry juice is often recommended, most cranberry juices are loaded with fructose, which tends to promote health problems when consumed in high amounts. For this reason, I don’t recommend drinking cranberry juice when you have an infection. Since your immune system is already taxed, adding fructose into the mix is inadvisable.

A far better alternative is pure D-mannose, which is the active ingredient in cranberry juice responsible for its benefit to your urinary system. It can also be derived from berries, peaches, apples and other plants. Pure D-mannose is 10 to 50 times stronger than cranberry and has been shown to cure over 90% of UTIs within one to two days. It’s nontoxic and completely safe, with no adverse effects.

I also recommend trying D-mannose before you resort to antibiotics, to avoid killing off beneficial bacteria. Digestive problems and secondary yeast infections are common side effects of antibiotics. D-mannose doesn’t actually kill bacteria — it just renders them unable to stay in your urinary tract.

The cell walls of E. coli are covered with tiny fingerlike projections called fimbria, made of a glycoprotein called lectin that makes them sticky. This allows them to cling to the inner walls of your bladder and even work their way upward to your ureter and kidneys.

The lectin on the bacteria’s fimbria binds to mannose, which naturally covers the internal lining of your urinary organs. This is why they’re so difficult to flush out. When you take D-mannose, the E. coli suddenly find mannose molecules present not only on the surface of your epithelial cells but also in the urine. As they latch on to the mannose in your urine, they are easily expelled through your urine.

To help flush the bacteria out, be sure to drink plenty of clean, pure water to encourage plentiful urination. To alleviate the burning sensation, dissolve 1 teaspoon of baking soda in 8 ounces of water and drink the whole glass first thing in the morning. Its alkaline nature can help neutralize or lessen the acidity of your urine, thereby making urination less uncomfortable.

Your Doctor’s Lab Coat Is Likely Contaminated

For some, simply seeing a physician in a white coat is enough to spike your blood pressure. This condition, known as “white coat hypertension” or “white coat syndrome,”1 happens when the blood pressure readings in your physician’s office are higher than they are in a different setting.

While it was once believed white-coat high blood pressure was triggered by stress from your doctor’s appointment, some think it might be a signal you’re at risk for high blood pressure as a long-term condition.2 To move away from the additional stress the sight of a white coat may bring to patients and their families, some doctors, such as pediatricians and psychiatrists, have stopped wearing them.3

Over the last 100 years, the white coat has been the unparalleled symbol of science and medicine.4 However, expectations about whether physicians should use a white coat or not is likely a moot point as these long-sleeved symbols of medicine have been shown to transfer bacteria from one patient to the next.5,6,7

Medical Clothing May Transmit Nosocomial Infections

Tertiary hospitals care for patients who require specialists at the request of a primary or secondary medical care personnel.8 The target of these hospitals is to treat the sickest or those needing care they could not get elsewhere.

Research now shows that when physicians use long-sleeved white coats, they may become agents transmitting multidrug-resistant organisms. In one study9 published in the Journal of Clinical and Diagnostic Research, a cross-sectional survey of bacterial contamination of medical students’ coats was done on four different areas of the coat — collar, pocket, side and lapel.

The students reported most had washed their coat within the past two weeks, yet the researchers found the sides of coats were highly contaminated with Staphylococcus aureus, Staphylococci and gram-negative nonfermenters.

Wearing a white coat may have a role in the transmission of pathogenic microorganisms and these researchers recommended physicians should possess two or more coats at any time, and that alternatives, including a universal protective gown, should be considered to reduce the spread of potentially dangerous bacteria.10

The results of this study support many others. While any articles of clothing can become contaminated, with wide sleeves and long length, these white coats come in contact with patients more frequently and are laundered less often than clothes physicians wear daily.

In a study from Brazil,11 researchers evaluated medical student coats and found microorganisms including gram-positive cocci, S. aureus and coagulase-negative Staphylococcus species. Another systematic review of 72 studies12 looked at contamination on white coats, neckties, stethoscopes and mobile electronic devices.

Contamination rates varied across the studies and by electronic devices, but in general researchers discovered up to 32% of the items tested were contaminated with methicillin-resistant S. aureus and gram-negative rods. Few studies looked for Clostridium difficile, and Enterococcus was found less frequently.

The UK Banned Long-Sleeved White Coats in 2007

The British Medical Association (BMA) began acting on this news in 200613 when they recommended physicians refrain from wearing functionless pieces of clothing such as ties, and avoid wearing clothing from the clinical setting outside the health care environment.

The BMA board of science warned physicians to presume there would be some degree of contamination on clinical clothing, even when it was not visibly soiled.14 Interestingly, the BMA’s recommendation to eliminate certain pieces of clothing to reduce the spread of bacterial contamination between patients was met with resistance.

Some who didn’t want to change supported their viewpoint using surveys to determine patient and physician clothing preference,15 and others believed hospitals should supply physicians with a clean coat each day.16

The BMA’s recommendations went further at the end of 2007 when the National Health Service, which provides health care for all U.K. citizens, banned the use of long-sleeved white coats.17 The dress code also meant doctors would be required to wear short sleeve shirts and were banned from wearing watches, jewelry and neckties to reduce potential contamination.18

The Power of the White Lab Coat

Those who have resisted removal of loose, long-sleeved white coats from a physician’s dress code may believe there is power behind the white coat. Up to the 1800s, medical doctors did not practice as they do currently. With the scientific method came reason and proof instead of relying on mysticism and old wives’ tales.19

Doctors often dressed in formal black coats to portray a serious profession.20 With the spread of medical care and the origins of germ theory, treatments were tested against control groups and doctors became scientists. As this happened, they removed formal dress jackets in lieu of a clean white coat, which was the scientists’ uniform of the day.

Nearly 100 years later the white coat continues to be an iconic symbol. In 1993 it became a rite of passage used in almost all medical schools as students are inducted, much like a graduation cap and gown ceremony.21 So, intertwined in the argument to reduce bacterial contamination in hospitals is the question of the power behind the white coat.

Some believe it’s a symbol of professionalism22 while others find it’s a symbol of hierarchical elitism. In 2018, the Association of American Medical Colleges reported 97% of medical schools have a white coat ceremony.23 The Mayo Clinic has now instructed their physicians to wear only business attire in an effort to break the barrier between physicians and patients.24

A large study25 from the University of Michigan surveyed 4,062 patients from 10 academic medical centers and found 53% thought how the physician was dressed was important to them as they were receiving care. One third agreed it influenced their satisfaction, and compared to other forms of formal dress, the white coat was more highly rated.

The researchers concluded patients’ expectations and perceptions of their physicians’ dress varied by contact and region, but policies addressing dress code may help improve patient satisfaction.

In what appeared to be an apparent disregard for research showing bacterial contamination found on the symbolic white coat, Dr. Christopher Petrilli, lead author, commented,26 “What we wear is such an easy thing to modify. At a time when we’re all trying to be more patient-centered, doesn’t it make sense to do what people want?”

Ten years ago, The New York Times27 reported the American Medical Association expressed concerns of bacterial transmission from physician lab coats. At the time they were studying a proposal doctors would give up lab coats for good. In the same article was a physician’s comment saying, “The coat is part of what defines me, and I couldn’t function without it.”

Medical Error May Be the Third Leading Cause of Death in the US — Or Greater

Medical mistakes are made in the operating room, in the emergency room and in the doctor’s office. Authors in a 2005 Canadian Journal of Surgery analysis28 said medical errors represent a serious public health problem and threat to patient safety. They called for accurate measurements of the incidence of medical error as few studies had measured it directly.

Instead, researchers have adopted measurements of error as largely dependent on adverse outcomes or injury. As a result, some research has suggested more than 250,000 people die each year due to medical errors and millions more are harmed by medication-related mistakes.29,30

A team from Johns Hopkins points out the Centers for Disease Control and Prevention’s method of collecting statistics does not classify medical errors on the death certificate. In response to their research results, the authors wrote a letter to the CDC asking for a change in the collection methodology as the list of cause of death is used to inform many research and public health priorities.31

As a result of serious limitations, the list neglects to identify medical error, which ranks as the third leading cause of death in the U.S. Lead author, Dr. Martin Makary, surgeon from Johns Hopkins University, commented in an interview:32

“You have this overappreciation and overestimate of things like cardiovascular disease, and a vast underrecognition of the place of medical care as the cause of death. That informs all our national health priorities and our research grants.”

Hospital-acquired infections kill more people each year than diabetes. Records from 2002, the most current available, show each year 1.7 million are infected and 98,987 die from health care-associated infections.33 The World Health Organization (WHO) reports health care-associated infections are the most frequent adverse events in healthcare worldwide. They report 37,000 die annually from these infections in Europe and many more could be related.34

Medical Mistakes and Nosocomial Infections Create a Health and Financial Burden

The WHO reports35 that while there is a 1 in 1 million chance an individual will be harmed during air travel, there is a 1 in 300 chance a patient will be harmed during health care. Many of the statistics impacting health care costs from medical error are presented in this short video.

According to WHO,36 these mistakes result in 15% of health care spending and hospital infections affect 14% of all patients admitted worldwide. A study37 using a literature review of four studies found a lower limit of 210,000 deaths each year associated with preventable harm in hospitals.

However, the researchers noted limitations may lead to a true number of premature deaths associated with preventable harm to be higher, estimated closer to 400,000 each year.

Unfortunately, at this point the real number of deaths attributed to medical mistakes is unknown as most death certificates do not list the trigger. Researchers from Johns Hopkins Medicine believe these shortcomings hinder research and keep the issue out of the public eye.38

Patient Safety Is Crucial

The National Opinion Research Center (NORC) at the University of Chicago is an independent social research organization. In 2017 they released survey results presented at the 10th annual IHI/NPSF Lucian Leape Institute Forum & Keynote Dinner.39

The survey found 21% of adults in the U.S. had a personal experience with medical error. The nationwide survey was done with 2,500 adults, expanding a 1997 survey conducted by the National Patient Safety Foundation. After personal experience, 31% of Americans reported knowing someone with whose care they were closely involved, who was affected by a medical error.40

Few reported worrying about patient safety, and 80% believed it was the responsibility of health care providers, leaders and administrators, as well as family members and patients. Dr. Tejal Gandhi, Chief Clinical and Safety Officer of the IHI/NPSF Lucian Leape Institute commented:41

“The survey results show that Americans recognize that patient safety is a critically important, but complex, issue. The focus on diagnostic errors and the outpatient settings closely parallels other research in this area and confirms that health care improvers need to take a systems approach to safety that encompasses all settings of care, not just hospitals.”

What To Do To Protect Yourself

In this interview with Andrew Saul, Ph.D., we discuss the importance of being your own health advocate. Once at your doctor’s office or in the hospital, you are at risk of a medical mistakes. You and your family are the best safeguards against experiencing a medical error. This is particularly important for children and senior citizens.

Any time you are hospitalized, be sure you have a personal advocate present to ask questions and take notes. It helps reduce the likelihood of mistakes when someone asks, “What is this medication? What is it for? Who is supposed to get it? What’s the dose? Are there side effects?” Merely asking the questions signals to personnel that they are being held accountable.

Another step you may consider if someone you know is scheduled for surgery is to print out the WHO surgical safety checklist,42 which may be downloaded free of charge here and may help you protect against preventable errors. Also, remind personnel (and visitors) to wash their hands and change gloves before touching you.

Needless to say, avoiding hospitalization is your safest bet. You may be able to reduce your risk of hospitalization by maintaining optimal health following specific strategies you’ll find in my previous article, “Medical Errors: STILL the Third Leading Cause of Death.”