UNITED STATES DEPARTMENT OF LABOR

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ADVISORY BOARD ON TOXIC SUBSTANCES AND WORKER HEALTH

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SUBCOMMITTEE ON THE SITE EXPOSURE MATRICES (AREA #1)

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SUMMARY MINUTES

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TUESDAY,

MARCH 21, 2017

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The Subcommittee met telephonically at 1:00 p.m. Eastern 

Time, Laura S. Welch, Chair, presiding.

MEMBERS

SCIENTIFIC COMMUNITY:

JOHN M. DEMENT

MEDICAL COMMUNITY:

LAURA S. WELCH, Chair

STEVEN MARKOWITZ

CLAIMANT COMMUNITY:

DURONDA M. POPE

OTHER ADVISORY BOARD MEMBERS PRESENT

FAYE VLIEGER

DESIGNATED FEDERAL OFFICIAL:

CARRIE RHOADS
Call to order and roll call

Ms. Rhoads called the meeting to order at 1:03 p.m. and conducted

roll call. Laura Welch, John Dement, Steven Markowitz, Duronda Pope, 

and Faye Vlieger were present. 

Discussion of draft recommendations for OHQ (Occupational Health 

Questionnaire)

On the last conference call the committee decided that the OHQ 

revisions made by Paragon, the DOL contractor, did not seem to be an 

improvement. It has been difficult to develop a list of tasks for 

production workers. The committee walked through the recommendations 

for improvements to the OHQ. 

The current version of the OHQ has a list of hazards, exposures, and 

materials. The recommendation is that this list be maintained on a 

future version of the OHQ and that it also be expanded to include the 

BTMed hazards, exposures, and materials. It would be too cumbersome 

and unhelpful to include a list of tasks, and instead it would be 

more helpful to ask workers to describe what they did on the 

questionnaire and the frequency with which they had specific 

exposures. Assumptions will need to be made about the intensity of 

exposures. The industrial hygienist (IH) should be able to understand 

the intensity of the exposure by looking at the tasks.

The committee also recommended that the flow of questions on the 

questionnaire be more logical. Another recommendation is to add

vapors, dust, gas, and fumes to the OHQ to help with causation for 

COPD.

It would be nice if the claims examiner (CE) had a simple algorithm 

with which he could make a decision about COPD based on a series of 

questions answered by the claimant. 

Any new questionnaire needs to be tested. Member Vlieger said that 

the labor categories for construction workers are not consistent. 

Member Vlieger suggested that DOL do a demonstration of the SEM (Site 

Exposure Matrix) at the upcoming board meeting. Member Pope said that 

RCTs (radiological control technicians) were exposed to many things, 

and breaking their exposures down by task may be difficult and leave 

out important exposures. 

Discussion on draft recommendations for a presumption on COPD

The committee recommended that a range of specific agents be presumed 

to cause COPD. A lot of the case-controlled studies assessed COPD 

based primarily on worker jobs and tasks. 
Member Markowitz said that the compensation process might be 

vulnerable if a worker is prompted to answer “yes” to the vapors, 

gas, dust, and fumes (VGDF) question without any supporting evidence.

It's important to note that one can't assume that certain exposures 

have been eliminated simply because the exposures took place in 

recent years. 

With regard to the five-year exposure presumption, the problem comes 

with aggravation. A worker may have only worked at a DOE site for a 

small amount of time but have continued to have been exposed to toxic 

substances over the course of his career at other jobs. The DOL only 

counts exposures at DOE sites, but these workers probably had 

continuous exposure throughout their careers. The OHQ does ask about 

the total employment history of a claimant and what substances

claimants were exposed to in non-DOE employment. The CMCs (contract 

medical consultants) need to be aware that a claim can be accepted as 

a result of an aggravated condition. The CMCs should be given primers 

in their referrals to explain what the compensation program standards 

are. For example, there could be a brochure that goes with each claim 

to help the CMCs.

The committee can ask DOL how strict their policy on considering nonDOE exposures is and whether or not the 5-year threshold can be 

lowered to 2-years. COPD is a condition that can be aggravated, and 

all the players in the claims process need to think more about 

aggravation and contribution instead of just about cause. 

Approach to exposure assessment at sites without a SEM

Member Vlieger said that the SEM should contain labor categories 

across sites. Exposure information should flow across sites, as well. 

Some documents that are at the individual site libraries contain 

information that are not in the SEM. 

If a worker has a labor category, but no SEM, perhaps the IH could 

receive information on that labor category from other SEM sites. This 

is similar to what is done with radiation dose and coworker data. 

Member Markowitz noted that many of the board's activities are geared 

towards moving away from the SEM through improving the questionnaire, 

interviews, presumptions, etc.

Additional recommendations from IOM that should again be recommended

to DOL

Member Markowitz said that the DOL needs to enhance its scientific 

capacity. That includes assembling all of the current relevant 

scientific data. Chair Welch said there might need to be an outside 

assessment of SEM and Haz-Map. Member Markowitz said that he would