Review of the Department of Labor's Site Exposure Matrix Database

by Institute of Medicine, Board on the Health of Select Populations, Committee on the Review of the Department of Labor's Site Exposure Matrix (SEM) Database

Overview

Beginning with the development of the atomic bomb during World War II, the United States continued to build nuclear weapons throughout the Cold War. Thousands of people mined and milled uranium, conducted research on nuclear warfare, or worked in nuclear munitions factories around the country from the 1940s through the 1980s. Such work continues today, albeit to a smaller extent. The Department of Energy (DOE) is now responsible for overseeing those sites and facilities, many of which were, and continue to be, run by government contractors. The materials used at those sites were varied and ranged from the benign to the toxic and highly radioactive. Workers at DOE facilities often did not know the identity of the materials with which they worked and often were unaware of health risks related to their use. In many instances, the work was considered top secret, and employees were cautioned not to reveal any work-related information to family or others. Workers could be exposed to both radioactive and nonradioactive toxic substances for weeks or even years. Consequently, some of the workers have developed health problems and continue to have concerns about potential health effects of their exposures to occupational hazards during their employment in the nuclear weapons industry.

In response to the concerns expressed by workers and their representatives, DOL asked the Institute of Medicine (IOM) to review the SEM database and its use of a particular database, Haz-Map, as the source of its toxic substance-occupational disease links. Accordingly, this IOM consensus report reflects careful consideration of its charge by the committee, and describes the strengths and shortcomings of both. To complete its task, IOM formed an ad hoc committee of experts in occupational medicine, toxicology, epidemiology, industrial hygiene, public health, and biostatistics to conduct an 18-month study to review the scientific rigor of the SEM database. The committee held two public meetings at which it heard from DOL Division of Energy Employee Occupational Illness Compensation (DEEOIC) representatives, the DOL contractor that developed the SEM database, the developer of the Haz-Map database, DOE worker advocacy groups, and several individual workers. The committee also submitted written questions to DOL to seek clarification of specific issues and received written responses from DEEOIC. The committee's report considers both the strengths and weaknesses of the SEM and the Haz-Map databases, recognizing that the latter was developed first and for a different purpose. The committee then discusses its findings and recommends improvements that could be made in both databases with a focus on enhancing the usability of SEM for both DOL claims examiners and for former DOE workers and their representatives. Review of the Department of Labor's Site Exposure Matrix Database summarizes the committee's findings.

Product Details

ISBN-13:	9780309268691
Publisher:	National Academies Press
Publication date:	04/14/2013
Pages:	134
Product dimensions:	5.90(w) x 8.80(h) x 0.40(d)

Table of Contents

Preface xi

Summary 1

1 Introduction 15

Energy Employees Occupational Illness Compensation Program Act 16

Site Exposure Matrix Database 19

Committee's Charge 20

Committee's Approach 20

Organization of the Report 23

References 23

2 Haz-Map Database 25

Development of Haz-Map 25

Content of Haz-Map 26

Haz-Map Information Sources 31

Toxic Substance-Disease Links 31

Strengths and Weaknesses of Haz-Map 43

Summary 48

References 48

3 Site Exposure Matrix Database 51

Use of SEM in the EEOICPA Claims Process 52

Development of SEM 54

Content and Structure of SEM 55

Government Accountability Office Report 63

Strengths of SEM 64

Weaknesses of SEM 65

Toxic Substance-Disease Links Not in SEM 80

Summary 89

References 89

4 Flings and Recommendations 95

Haz-Map Findings 96

SEM Findings 96

Recommendations to Improve SEM 97

Statement of Task Questions and Responses 107

Appendixes

A Biosketches of Committee Members 111

B Substances Evaluated by the Committee to Identify Toxic Substance-Occupational Disease Links Not Found in SEM 117

C Individuals Who Made Presentations to the Committee 121

Editorial Reviews

Reviewer: John Pierce, MBBS (MD) PhD(Navy Environmental Health Center)
Description: This book constitutes a short report describing the Institute of Medicine's (IOM) critique of the Site Exposure Matrix database (SEM), which is intended to support the claims process pursuant to the Energy Employee Occupational Illness Compensation Program Act (EEOICPA) Part E (PL 106-398, Title XXXVI). While the title or even the description might appear rather dry, this is actually a lively read that includes a discussion of strengths and weaknesses.
Purpose: The purpose is best described in the committee's tasking statement, which states that the IOM convened a panel of experts to review the scientific rigor and organization of the SEM. Because past or present employees will be financially compensated under the EEOICPA, there must be a scientific basis for the National Institute of Health's construction and review of Haz-Map. The purpose of the IOM work is further described in a series of rhetorical questions (SEM/Haz-Map). These questions include, "What, if any, occupational disease that might have affected the DOE contractor workforce are missing from SEM," and "How scientifically rigorous are the disease links contained in the SEM and Haz-Map?"
Audience: Likely readers include employees of the U.S. Departments of Labor and Energy, employee claimants and their attorneys, and others interested in the SEM process. Some readers may be interested in constructing a similar SEM for other cohorts of exposed workers.
Features: The book is divided into an introduction (EEOICPA SEM database, committee's charge and approach and report organization), the Haz-Map database (development, content, information sources, toxic substance-disease links, etc.), SEM database (use in the EEOICPA claims process, development, content and structure, etc.), and findings and recommendations.
Assessment: This will useful to those who choose to read and study its contents. Ultimately, the issue is how well the SEM database satisfies those who question the basis for occupational disease linkage currently used for compensation purposes. Questioners of the process have included the Rocky Mountain News and the Government Accountability Office. The IOM recommends a way forward in a series of three recommendations: Use more supplemental information sources for the SEM; improve its structure and function; and establish an expert advisory panel. These recommendations appear reasonable. They will ultimately be judged in the court of public opinion which includes, but is not limited by, science. My only suggestions beyond these would have been for IOM to have included a recommendation as to frequency and scope of a revisit to assess progress in light of the report's findings.

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