must attest that they suffer from a disease that is linked to an exposure at one or more of the sites that are listed by DOL.

DOL uses a database, the Site Exposure Matrix (SEM), as a tool to assist with compensation determinations for DOE contractors who have illnesses related to their work for DOE. SEM was developed to organize, display, and communicate information on the toxic substances and possible health effects associated with them for each DOE site, buildings at the sites, and job processes conducted in those buildings. Originally developed for DOL claims examiners, the database is available to the public, and individuals can submit site-related and toxic substance—related information to it. However, the database has been criticized by claimants and their advocates, particularly regarding the accuracy of its substance—disease links. SEM has also been the subject of a study by the Government Accountability Office, which has evaluated its use in DOL’s EEOICPA claims process.

COMMITTEE’S CHARGE AND APPROACH

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 databases (see Box S-1 for the Statement of Task). 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.



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