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Page 29 5 Findings and Recommendations The following findings and recommendations on occupational health and workplace chemical monitoring at CSDP facilities are based on the review described in Chapter 1 , Chapter 2 , Chapter 3 through Chapter 4 of this report. Finding 1. Consistent with the Stockpile Committee's prior recommendation that the CSDP use technology that will minimize overall risk to the public and to the workers at each site, protecting the health and well-being of the workforce at chemical agent disposal facilities is an overarching priority, on a par with protection of the public health and safety. Recommendation 1. The Army should continue to select technologies and implement programs at disposal facilities that ensure the expeditious disposal of the chemical agents and munitions stockpile and minimize overall risk to workers and the public at each site. Finding 2a. Current workplace monitoring systems for chemical agents are generally adequate for normal operations but may have serious deficiencies during accidents or departures from nominal operating conditions. Potential employee exposures as a result of process upsets and/or accidents can be detected by existing monitoring systems, but not in real time. Finding 2b. Currently, ACAMS and DAAMS data are available electronically, but only at the operating site where agent measurements were made. Finding 2c. Advances in monitoring technology could reduce response times and/or false positive alarm rates and could possibly make simultaneous monitoring of different agents feasible. This could reduce the risk of worker exposure during both disposal and closure operations. Finding 2d. Workplace monitoring for nonagent-related chemicals is conducted on an as needed basis as part of the industrial hygiene program. Recommendation 2a. The Army should continue to pursue improvements in airborne agent monitoring, including improved ACAMS technology (for multi-agent monitoring and lower false alarm rates), and in methods for identifying interferents that cause false alarms. It should also pursue new analytical techniques that could lead to real-time agent detection. Recommendation 2b. The Army should consider developing the capability of reviewing and analyzing agent monitoring data from several or all sites at the programmatic level. Finding 3. Some chemical agent reaction products from surface hydrolysis or produced in liquid-phase process streams can be almost as toxic as the parent agent and more resistant to degradation. Standard technology used in routine operations for detecting the presence of agent generally does not detect decomposition
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Page 30 products. The possible presence of decomposition products during weapons processing or closure operations has received little attention to date. Liquid-phase processing technologies will be used at the bulk-only sites (Aberdeen, Maryland, and Newport, Indiana), and surface hydrolysis products may be encountered during closure activities at all disposal sites. Therefore, analytical techniques must be capable of detecting both residual chemical agent and toxic chemical agent degradation (chiefly hydrolysis) products in liquids and in solids. Established techniques and analytical measurement practices for detecting agent and/or agent degradation products in liquid-phase matrices or associated with solid materials are not sensitive or rapid enough to provide the near-real-time process control or waste materials screening required for worker protection. The current techniques for analyzing headspace may be inadequate for detecting agent or agent degradation products associated with spent activated carbon or other absorptive materials. This extends the committee's previous recommendation to develop better detection methods for residual liquid-phase VX and mustard agents associated with the liquid-phase process streams planned for Aberdeen and Newport (NRC, 2000a). Recommendation 3a. For better monitoring of liquid-phase process streams, the Army should actively pursue the development of more accurate and faster liquid-phase analytical techniques for detecting residual agent, as well as agent degradation products of concern. Recommendation 3b. The Army should identify toxic agent reaction products likely to be present at potentially harmful levels in liquid-phase process streams, liquid wastes, and solid wastes, including waste streams generated during closure activities. Recommendation 3c. The Army should develop and deploy advanced technologies for rapidly and accurately measuring residual agent and agent degradation products of concern associated with solid waste, particularly on solid waste surfaces and spent activated-carbon stocks encountered during closure operations. Finding 4. The CSDP's overall occupational and environmental health program, as well as the specific versions implemented at JACADS and TOCDF, are comprehensive. That is, they include all of the required components, as well as some optional components, recommended by the American College of Occupational and Environmental Medicine. Based on committee briefings and discussions with PMCD and contractor site personnel involved in chemical monitoring, industrial hygiene, and occupational medicine, these programs appear to be staffed by competent professionals who understand the importance of their roles and appear to be fulfilling them responsibly. Recommendation 4. The Army and its operating contractors should continue to execute and refine a vigorous, proactive occupational and environmental health program at all chemical agent disposal sites. Finding 5. As disposal activities near completion, some workers will want to continue working in the CSDP at other sites. During visits to the operating TOCDF site and the construction sites at Anniston, Alabama, Aberdeen, Maryland, and Newport, Indiana, committee members encountered many veteran employees of JACADS both among contractor personnel and Army oversight personnel. The formatting and maintenance of workplace monitoring and worker medical records for contractor personnel are currently the responsibility of the prime operating contractor at each site. Consistent formats and methods of archiving these records would clearly facilitate the creation of career medical and potential exposure profiles for individuals who work at more than one disposal facility. An easily accessible database of records for all sites (subject to maintaining workers' privacy rights) would be extremely useful for epidemiological studies of health trends among CSDP workers. A useful method of reconstructing potential worker exposure to agents can be to correlate data from records of shift duty, hazardous operations, toxic area entries, and area airborne agent concentrations. These correlations are only practical if the records are electronically archived and centrally searchable. Recommendation 5a. The Army and its operating contractors should use the same medical forms, especially for key program elements, such as agent exposures and heat-stress monitoring. Recommendation 5b. The Army and its operating contractors should retain medical records in a way that allows for continuity in the event personnel are transferred to other disposal facilities.
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Page 31 Recommendation 5c. The Army and its operating contractors should automate as much as feasible important medical information related to worker exposure to facilitate epidemiological studies. Automated information, available at the programmatic level, should include, but should not be limited to, results of medical examinations, evaluations of exposure to agents, measurements of cholinesterase levels, heat-stress data, and accident/injury information. Recommendation 5d. The Army should consider requiring that electronic records relating to potential worker exposure to agent or other toxic chemicals be stored in a common format and be available at a programmatic level. Finding 6. Ongoing analyses of worker medical data across disposal facilities could be a valuable tool for identifying and minimizing health threats to workers. Recommendation 6a. The Army should provide summary facility and cross-facility statistics annually on the outcomes of key medical surveillance programs, such as programs for exposures to chemical agents and heat stress. Recommendation 6b. The Army should thoroughly investigate the need and opportunities for population-based comparisons and/or epidemiological studies. Finding 7. Just as advancing technology can be expected to provide better workplace chemical monitoring techniques, rapidly advancing biotechnology can be expected to provide more sensitive and specific methods of measuring worker exposure to harmful substances. For instance, adducts of DNA and protein formed by carcinogens that are alkylating agents, such as sulfur mustard, can now be detected at very low levels of exposure. Measurements of sulfur mustard adducts could be incorporated into the Army's medical surveillance program for assessing low-level exposures to blister agents. Future advances in genetics may provide new methods of screening for low-level exposures in individuals and populations. Recommendation 7. The Army should keep abreast of, and adopt where appropriate, developments in medical diagnostic techniques for detecting and quantifying low-level exposures to toxic substances, including research related to the use of DNA and protein adducts as measures of toxicologically relevant metabolites.
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