REVIEW OF THE
DEPARTMENT OF LABOR’S
Committee on the Review of the Department of Labor’s
Site Exposure Matrix (SEM) Database
Board on the Health of Select Populations
INSTITUTE OF MEDICINE
OF THE NATIONAL ACADEMIES
THE NATIONAL ACADEMIES PRESS
THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001
NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.
This study was supported by Contract No. DOLJ119E32292 between the National Academy of Sciences and the Department of Labor. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the organizations or agencies that provided support for this project.
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Suggested citation: IOM (Institute of Medicine). 2013. Review of the Department of Labor’s Site Exposure Matrix Database. Washington, DC: The National Academies Press.
THE NATIONAL ACADEMIES
Advisers to the Nation on Science, Engineering, and Medicine
The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Ralph J. Cicerone is president of the National Academy of Sciences.
The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. Charles M. Vest is president of the National Academy of Engineering.
The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Harvey V. Fineberg is president of the Institute of Medicine.
The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Ralph J. Cicerone and Dr. Charles M. Vest are chair and vice chair, respectively, of the National Research Council.
COMMITTEE ON THE REVIEW OF THE DEPARTMENT OF LABOR’S SITE EXPOSURE MATRIX (SEM) DATABASE
MARK UTELL (Chair), Professor of Medicine and Environmental Medicine and Director of Occupational and Environmental Medicine, University of Rochester School of Medicine and Dentistry, NY
JOHN R. BALMES, Professor of Medicine, University of California, San Francisco, School of Medicine; Professor of Environmental Health Sciences, School of Public Health, University of California, Berkeley
STANLEY C. HAIMES, Medical Director, Center for Occupational and Environmental Health, Orlando, FL
WILLIAM E. HALPERIN, Professor and Chair, Department of Preventive Medicine and Community Health, University of Medicine and Dentistry of New Jersey, Newark
PHILIP I. HARBER, Professor of Public Health, Community, Environment and Policy, University of Arizona, Tucson
FRANCINE LADEN, Mark and Catherine Winkler Associate Professor of Epidemiology, Departments of Environmental Health and Epidemiology, Harvard School of Public Health, Boston, MA
EPHRAIM MASSAWE, Assistant Professor, Department of Computer Science and Industrial Technology, Southeastern Louisiana University, Hammond
JULIA B. QUINT, Research Scientist and Section Chief (Retired), Ocupational Health Branch, California Department of Public Health, Berkeley
DAVID RICHARDSON, Associate Professor of Epidemiology, University of North Carolina School of Global Public Health, Chapel Hill
HOWARD E. ROCKETTE, Professor Emeritus, Department of Biostatistics, University of Pittsburgh Graduate School of Public Health, PA
MARA SEELEY, Senior Toxicologist, Gradient, Cambridge, MA
ROSEMARY K. SOKAS, Professor and Chair, Department of Human Science, Georgetown University School of Nursing and Health Studies, Washington, DC
REBECCA KOEHLER, Study Director
ROBERTA WEDGE, Study Director
CARY HAVER, Associate Program Officer
JONATHAN SCHMELZER, Senior Program Assistant
FREDERICK (RICK) ERDTMANN, Director, Board on the Health of Select Populations
This report has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the National Research Council’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published report as sound as possible and to ensure that the report meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process. We wish to thank the following individuals for their review of this report:
Donna Cragle, Occupational Exposure and Worker Health Programs, Oak Ridge Associated Universities
John R. Froines, University of California, Los Angeles
Linda A. McCauley, Emory University
Michael S. Morgan, University of Washington
John L. O’Donoghue, University of Rochester School of Medicine and Dentistry
Joseph V. Rodricks, ENVIRON, Arlington, VA
Glenn Talaska, University of Cincinnati
Although the reviewers listed above have provided many constructive comments and suggestions, they were not asked to endorse the conclusions or recommendations nor did they see the final draft of the report before its release. The
review of this report was overseen by Frank E. Speizer, Harvard Medical School, and Mark R. Cullen, Stanford University. Appointed by the National Research Council and Institute of Medicine, they were responsible for making certain that an independent examination of this report was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this report rests entirely with the authoring committee and the institution.
The Institute of Medicine (IOM) has a longstanding role in providing guidance to the federal government on improving and maintaining the health and well-being of people who have served the United States, both in the military and on the homefront. Service to our country includes those individuals who were instrumental in developing and manufacturing nuclear weapons before and during the Cold War. The Cold War has long since ended, but its effects remain. Workers who suffer from illnesses as a result of employment in the nuclear weapons industry are still seeking medical care and a means to pay for it.
In response to a request from the Department of Labor (DOL), this study is the product of a concentrated and careful endeavor by this committee to evaluate the scientific rigor of DOL’s Site Exposure Matrix (SEM) database. SEM is used in support of the DOL claims process for former workers and contractors of the Department of Energy (DOE), as mandated in the Energy Employees Occupational Illness Compensation Program Act (EEOICPA). Though commenting on the claims process itself was beyond the scope of the committee’s work, we believe that any effective compensation program should be based on sound scientific evidence. Therefore, we sought to provide guidance and a framework for DOL to create a better and more transparent system for identifying the most scientifically sound information to be included in SEM and thus improve the claims process. We are honored to have been of service to DOL and to the many men and women who worked at DOE facilities and their families and who helped maintain a secure nation.
The committee appreciates the presentations made by DOL staff (Karoline Anders and Rachel Leiton) and its contractors (Keith Stalnaker and Jay Brown) and by staff of the National Library of Medicine (Florence Chang, Lucie Chen,
and Pertti Hakkinen) in providing information for the study. In addition, the committee would like to thank the many claimants and worker advocates for the presentations and statements they submitted to the committee, particularly Terrie Barrie, Laurence Fuortes, and Deb Jerison.
Finally, I am deeply appreciative of the dedication of the committee members and the IOM staff who assisted them in producing this report. The committee trusts that it will assist not only DOL in its efforts to implement EEOICPA, but also will inform the broader research community.
Mark Utell, Chair
Committee on the Review of the Department of Labor’s
Site Exposure Matrix (SEM) Database