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APPENDIX G WORK OF THE COMMITTEE Section 7 of Public Law 95-623, the "Health Services Research, Health Statistics, and Health Care Technology Act of 1978," calls for an ongoing study that would estimate expected health benefits of reducing environmental hazards and would lead to better data for making such estimates. Because of the ongoing study's broad scope, the Institute of Medicine agreed to do a planning study so that the ongoing study could proceed within a feasible framework. The IOM contract for the planning study began in September 1979. The committee sought a wide range of views, holding a series of workshops for representatives of labor, industry, environmental groups, and officials from various levels of government. Persons with relevant expertise in areas of data collection and statistics, and in environmental health problems, provided the committee with further information. The full committee held seven meetings. In addition, there were small group meetings, the workshops, and an open meeting. Table G-1 summarizes the planning study's activities. These are described in greater detail below. The Panel on Health Costs met on January 4, 1980 in Palo Alto, CA, to discuss the major issues involved in estimating costs of environmental health effects, with Kenneth Arrow as chairman Part ic ipant s were: Ralph d ' Arge; Anne Scitovsky; Alan Garber, Nat tonal Bureau o f Economic Research, St anford, CA; and Thomas Hodgson, National Center for Health Statistics, lIyattsville, MD. The Environmental Public Interest Groups Workshop met on January 15, 1980 in Washington, DC, with Evelyn Murphy as chairperson. Don Price also attended. Participants were: Thomas Conry, Environment Act ion Foundat ion, Washington, DC; Devra Davis, the Environment al Law Inst itute, Washington, DC; Barbara Fegan, League of Women Voters, Boston, MA; Thomas Hodgson, National Center for Health Statistics, Hyattsville, MD; Eric Jansen, Friends of the Earth, Washington, DC; Raphael Rasper, National Academy of Sciences, Washing~t on, DC; Carol Oppenheimer, Center for Law and Social Policy, Washington, DC; Glenn Paulson, Audubon Naturalist Society, New York, NY; George Perkel, Mt. Sinai School of Medicine, New York, NY; Debbie Sheiman, League of Women Voters , Washington, DC; Marcia Silcox, Environmental Defense Fund, Inc., Washington, DC; Larry Silverman, American Clean Water Association, Washington, DC; Eric Van Loon, Union of Concerned Scientists, Cambridge, MA. ~ was held on January 16, 1980 in Washington, DC, to obtain views of representatives of the G-1

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TABLE G-1. CHRONOLOGY OF EVENTS RELATED TO PLANNING STUDY DATE EVENT November 9, 1978 September 12, 1979 November 21, 1979 January 4, 1980 January 15, 1980 January 16, 1980 January 18, 1980 January 21-22, 198Q February 27, 1980 March 14-15, 1980 March 26, 1980 April 8, 1980 May 5-6, 1980 May 7, 1980 May 28, 1980 June 20-21, 1980 July 27-28, 1980 October 20, 1980 January 1981 Public Law 95-623 passes. Contract for planning study awarded. First committee meeting Panel on Health Costs Environmental Public Interest Groups Workshop Workshop on Interagency Coordination Workshop on Risk Assessment Second committee meeting Meeting to discuss hazards and health effects that planning study should address Third committee meeting Workshop for State and Local Environmental Health Regulatory Officials Workshop on Data Needs for Occupational Health Surveillance Fourth committee meeting Open Meeting Workshop and drafting session on Data Linkage Fifth committee meeting Sixth committee meeting Seventh committee meeting Planning study report completed Go

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various federal agencies. Theodore Cooper, Evelyn Murphy, and Don Price were workshop leaders. The following persons participated: Joseph Blair, U.S. Department of Energy, Washington, DC; Alan Carlin, U.S. Environmental Protection Agency, Washington, DC; Edwin Clark, U.S. Environmental Protection Agency, Washington, DC; Roland Droitsch, U.S. Department of Labor, Washington, DC; Joseph Duncan, U.S. Department of Commerce, Washington, DC; Manning Feinleib, National Institutes of Health, Bethesda, Ml); Jacob Feldman, National Center for Health Statistics, Hyatt sville, MD; John Froines, National Institute for Occupational Safety and Health, Rockville, MD; Karl Goller, U.S. Nuclear Regulatory Commission, Washington, DC; Ruth Hanft, U . S . Department of Health and Human Services, Washington, DC; David Harrison, Council of Economic Advisors, Washington, DC; Richard Heller, U.S. Consumer Product Safety Commission, Washington, DC; Thomas Hodgson, National Center for Health Statistics, Hyattsville, MD; Raphael Rasper, National Academy of Sciences, Washington,-DS; George Kingman, National Institute of Environmental Health Sciences, Research Triangle Park, NC; Samuel Korper, U.S. Department of Health and Human Services, Rockville, MD; Dan Maldonado, U.S. Regulatory Council, Washington, DC; Harold Margulies, U.S. Department of Health and Human Services, Rockville, MD; John Morrall, Council on Wage and Price Stability, Washington, DC; Susie Nelson, Occupational Safety and Health Administration, Washington, DC; Robert Nicholas, Council on Environmental Quality, Washington, DC; Paul Portney, Council on Environmental Quality, Washington, DC; David Rall, National Institute of Environmental Health Sciences, Research Triangle Park, NC; Dorothy Rice, National Center for Health Statistics, Hyattsville, MD; Joseph Rodricks, U.S. Food and Drug Administration, Rockville, MD; Daniel Rubin, National Institutes of Health, Bethesda, MD; Jean Rydle, U.S. Environmental Protection Agency, Washington, DC; Marvin Schneiderman, Clement Associates, Washington, DC; Miron Straf, National Academy of Sciences, Washington, DC; and Robert Tardiff, - National Academy of Sciences, Washington, DC. A Workshop on Risk Assessment met on January 18, 1980 in New York, NY, with Joshua Lederberg as chairman. Other committee members present were Theodore Cooper, Paul Marks, and Arthur Upton. Participants were: Roy Albert, New York University, New York, NY; Ivan Bennett, New York University, New York, NY; Robert Berliner, Yale University, New Haven, CT; Edmund Crouch, Harvard University, Cambridge, MA; Robert Ebert, Milbank Memorial Fund, New York, NY; Richard Furlaud, Squibb Corporation, New York, NY; James Knill, Squibb Corporation, New York, NY; William Lowrance, Stanford University, Stanford, CA; Myron Mehlman, Mobil Oil Corporation, Princeton, NJ; Rex Pinson, Pfizer, Inc., New York, NY; Frederick Putney, Columbia University, New York, NY; Ross Reed, Squibb Corporation, New York, NY; Marcus Reedenberg, Cornell University Medical College, New York, NY; Ri chard Ri fkind, Co lumbia University, New York, NY; Marvin Schneiderman, Clement Associates, Washington, DC; and Bernard Weinstein, Columbia University, New York, NY. G-3

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A ~ that the planning study should address was held on February 27, 1980 in New York, NY. The following persons participated: Roy Albert, New York University, New York, NY; Paul Marks; Frederick Robbins; Arthur Upton; and Richard Zeckhauser. Officials met on March 26, 1980, in Washington, DeCe ~ with Evelyn l Murphy as workshop leader. The following people participated: Robert K. Arnold, Columbus Health Department, Columbus, OH; Thomas E. Baca, New Mexico Environmental Improvement Agency, Santa Fe, NM; John M. Gaston, Sanitary Engineer Section, Berkeley, CA; J.T. Hamrick, Department of Health and Human Resources, New Orleans, LA; Frank Hoot, Baltimore City Health Department, Baltimore, MD; J.B. Jackson, Jr., Council on the Environment, Richmond, VA; Alden McLelland, Department of Environmental Protection, Trenton, NJ; James Swenson, Department of Environmental Quality, Portland, OR; Peter Warner, Wayne County Health Department, Detroit, MI. met on April 8, 1980, in Washington, D.C., led by Philip Landrigan, Irving Selikoff, and Herman Tyroler. Participant s were: Lawrence Braslow, UeSe Department of Labor, Washington, DC; Merle Bundy, U.S. Steel Corporation, Pittsburgh, PA; Robert Copeland, U.S. Department of Labor, Washington, DC; Jacob Feldman, National Center for Health Statistics, Hyattsville, MD; John Froines, National Institute of Occupational Safety and Health, Rockville, MD; Lawrence Haber, U.S. Department of Commerce, Washington, DC; Michael Barrington, Geomet, Gaithersburg, MD; Gerald Hillman, IBM Medical Systems Center, Elmsford, NY; Karen HofEman, National Institute of Environmental Health Sciences, Research Triangle Park, NC; James Hughes, Kaiser Aluminum and Chemical Corporation, Oakland, CA; Andrea Kopstein, National Center for Health Statistics, Hyattsville, MD; Walter Kovalick, U.S. Environmental Protection Agency, Washington, DC; Sidney Pell, E.I. DuPont Nemours and Company, Wilmington, DE; Neil Peterson, U.S. Department of Justice, Washington, DC; William Powers, Detroit, MI; Marvin Schneiderman, Clement Associates, Washington, DC; Roy Widdus, National Academy of Sciences, Washington, DC; Rod Wolford, International Brotherhood of Painters and Allied Trades, Washington, DC. An Ope= Meeting was held on May 7, 1980 in Washington, DC., with Kenneth Arrow as chairman. Other committee members present were: Theodore Cooper; Alexander Leaf; and Evelyn Murphy. Participants were: Jeff Christy, Drug Research Reports, Washington, DC; Mike Gough, Office of Technology Assessment, U.S. Congress, Washington, DC; Robert Kurtz, Consumer Product Safety Commission, Washington, DC; Ann Norberg, Monsanto Company, Washington, DC; and Ralph Tart aglione, Sigma Data Corporation, Washington, DC. G-$

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A workshop and drafting session on Data Linkage was held on May 28, 1980, in Washington, D.C., with Frederick Mosteller as chairman. Other committee members who attended were: Philip Landrigan, Herman Tyroler, and Richard Zeckhauser. The fol lowing people participated: John Bailar, III, Journal of the National Cancer Institute, Bethesda, MD; Bruce Co~r Health Statistics, Hyattsville, MD; Theodore Col~ton, Dartmouth Medical School, Hanover, NH; Morton Corn, Johns Hopkins University, Baltimore, En); Laurie Duncan, National Center for Health Statistics, Hyattsville, MD; Rosalie Dunn, National Center for Health Statistics, Hyattsville, MD; Jacob Feldman, National Center for Health Statistics, Hyattsville, MD; Todd Frazier, National Institute for Occupat tonal Safety and Health, Cincinnati, OH; Teri Gardenier, U.S. Environmental Protection Agency, Washington, DC; Lawrence Haber, U. S . Department of Commerce, Washington, DC; Doreen Hill, V.S. Environmental Protection Agency, Washington, DC; Thomas Hodgson, National Center for Health Statistics, Hyattsville, M1); Paul Leaverton, National Heart, Lung and Blood Institute - Division of Heart and Vascular Diseases, Bethesda, MD; Samuel Marcus, National Center for Health Statistics, Hyattsville, MD; Jeffrey Perlman, National Center for Health Statistics, Hyattsville, MD; Ann Reid, National Center for Health Statistics, Hyattsville, MD; Dorothy Rice, National Center for Health Statistics, Hyattsville, MD; David Sanchez, Jr., San Francisco General Hospital, San Francisco, CA; Marvin Schneiderman, Clement Associates, Washington, DC; and Michael Stoto, Harvard University, Cambridge, MA. The following individuals met with the planning committee to share viewpoints and expertise: Bruce Dohrenwend, College of Physicians and Surgeons of Columbia University, New York, NY; John Fox, The City University, London, England; Nathan Karch, Clement Associates, Washington, DC; and John Spengler, Harvard University School of Public Health, Cambridge, MA. Various people provided the staff with background information related to particular environment-related health problems. These persons included Arthur Bloom, College of Physicians & Surgeons of Columbia University, New York, NY; Robert Brent, Jefferson Medical College, Philadelphia, PA; Ben Locke, National Institute of Mental Health, Rockville, MD; John Maher, Uniformed Services University of Health Sciences, Bethesda, MD; Peter Spencer, Albert Einstein College of Medicine, New York, NY; Raymond Suskind, University of Cincinnati, Cincinnati, OH; Hyman Zimmerman, Veterans Administration Hospital, Washingt on, DC . Many other persons provided immeasurab le he lp t o the commit tee and the National Academy of Sciences staff by sharing their insights and providing reference materials. The committee and staff express deep appreciat ion to them. Special thanks are due to the staff at the National Center for Health Statistics for their continuing and inva luable assistance G~5

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List of Background Papers Prepared for the Committee At the request of the committee, various background papers were prepared by outside experts, consultants, and staff members. A list of papers prepared by experts, consultants, and committee members follows: Baer, Rudolph. New York University Medical Center, New York, NY. Environmental Factors in Dermatoses. Barancik, Jerome. Case Western Reserve University, Cleveland, OH. Injury Control. Brandt-Rauf , Paul. HofEmann-La Roche, Nutley, NJ. Evans, Hugh. New York University Medical Center, New York, By. Environmental Threats to the Eye. Jagiello, Georgiana. College of Physicians and Surgeons of Columbia University, New York, NY. Environmental Hazards to Human Female ~E2~ Karch, Nathan. Clement Associates, Washington, DC. Overview of Environmental Health Hazards. Laties, Victor. University of Rochester Medical Center, Rochester, NY. Assessing the Behavioral Impact of Environmental Agent s . Leaf, Alexander. Massachusetts General Hospital, Boston, MA. Heart Disease and Stroke--Environmental Factors. Michael, Paul. Pennsylvania State University, University Park, PA. Assessment of Hearing Problems Related to Environmental Noise Exposures. Raiffa, Howard and Zeckhauser, Richard. Harvard University, Cambridge, MA. Reporting of Uncertainties in Risk Analysis. Skirball, David. University Hospitals of Cleveland, Cleveland, OH. Relation of Environmental Factors to Respiratory Illness. Upton, Arthur. New York University Medical Center, New York, NY. Cancer. - Zeckhauser, Richard. Harvard University, Cambridge, MA. Reporting _ _~t ~ b ~ __ G-6

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The following papers and background materials were prepared by Institute of Medicine staff members: Cureton, Mary. Water Quality and Its Effects On Etcattb Garber, Alan. Mandula, Barbara. Costs of Health Effects . Neurotoxicity . Mortimer, Allyn. Environmenta1 Factors and Renal Toxicity._ Mortimer, Allyn. Environmental Influences on Mental Illnesses and Impairment . Mortimer, Allyn. ~ Lead . G-7 -

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