Advisory Board on Toxic Substances and Worker Health

July 7, 2023

Ms. Julie A. Su

Acting Secretary, U.S. Department of Labor

Frances Perkins Building

200 Constitution Ave.

Washington, DC 

Dear Ms. Su:

I am pleased to transmit a recommendation of the Department of Labor Advisory Board 

on Toxic Substances and Worker Health in relation to the Board’s advisory capacity to the 

Energy Employees’ Occupational Illness Compensation Program (EEOICP). It was adopted 

unanimously at our meeting on May 17-18, 2023 meeting. It is:

Improvements in Industrial Hygiene Assessment of Exposures in EEOICPA Claims

 

The Board hopes that our input is useful to EEOICP. It remains an honor for the Board to 

be consulted on important issues that face the Program. I would be pleased to answer any 

questions.
Improvements in Industrial Hygiene Assessment of Exposures in EEOICPA Claims

 

Advisory Board on Toxic Substances and Worker Health Recommendation

(Adopted by the Advisory Board on Toxic Substances and Worker Health, 

May 17-18, 2022)

Recommendation 

The ABTSWH recommends that exposure assessments made by Industrial Hygienists (IH) be 

enhanced to specifically refer to the basic metrics of exposure science: (1) exposure intensity, (2) 

exposure route, (3) exposure frequency, and (4) exposure duration. These elements can have 

distinct value in determining causation. These metrics may further be divided by the facility and 

job under which they occurred for a claimant as relevant. We recommend that DOL adopt an IH 

exposure assessment form that puts the work of the IH in the context of these four basic metrics 

of exposure. The toxicants to be included on the form would be those determined relevant to the 

claimed medical conditions. An example form is provided with this recommendation.

Rationale

Referral of a case for industrial hygiene review and evaluation of potential exposure is a 

critically important part of the claim adjudication process, with numerous stakeholders relying 

on this evaluation for their next decisions. These include the claims examiner, the treating 

physician, the contract medical consultant and the claimant. The importance of this report in 

subsequent decision-making, especially causation analysis, is fundamental. 

The basic metrics of an exposure assessment influence in distinct ways the different health 

effects associated with that exposure. These basic metrics are:

1. Type of exposure (direct, bystander, or area)

2. Route of exposure (inhalation, ingestion, skin absorption)

3. Intensity of exposure (concentration)

4. Frequency of exposure

5. Duration of exposure

6. Calendar timing of exposure (appropriate latency)

7. Use of personal protective equipment (PPE), engineering controls or other mitigating 

factors
Information about each of these elements of an exposure can contribute to the determination of 

causation for one condition differently from how that same exposure may contribute to another 

condition. Their value to this process may range from very relevant, to vague, to unknown. The

accuracy of causation determinations by medical professionals can be harmed when all the 

aspects are fused together as a single metric as an exposure that may be of low relevance for one 

condition, could be of high relevance for another. For this reason, a singular assessment of 

relevance can obscure rather than aid the causation decision-making process.

Therefore, the Board recommends that the IH report explicitly state the sources of information 

used to make the determinations. In many cases, there is no documentation available, and this 

would be important information for the end user of the industrial hygiene report to have. Our 

recommendation is to implement a substantive change in the reporting of exposure assessments 

to better inform the determination of causation. Specifically, the exposure assessment and 

referenced summary report should include the key metrics describing the exposure as distinct 

categories for each relevant exposure. The Board proposes a new IH exposure assessment form 

(attached) including these metrics to help inform and guide this recommended change in process.
Proposed IH Exposure Assessment Form

Claimed 

condition:

Facility Dates Expos #1 Expos #2 Expos #3 Expos #4 Expos #5 Expos #6 Expos #7

Job #1:

Type of exposure*

Route of exposure**

Intensity***

Frequency^

Duration (# years)

Calendar years

Use of PPE^^ 

Source(s) of data  SEM

 OHQ

 Interview

 IH data

 SEM

 OHQ

 Interview

 IH 

 SEM

 OHQ

 Interview

 IH data

 SEM

 OHQ

 Interview

 IH data

 SEM

 OHQ

 Interview

 IH data

 SEM

 OHQ

 Interview

 IH data

 SEM

 OHQ

 Interview

 IH data

File page number(s) for IH monitoring data 

(or N/A)

Comments re data sources

Medical condition(s) for which compensation is being considered should be identified by the diagnostic term used in the claim.

Exposures #1, #2, etc. should be identified by name as listed in the SEM (if applicable).

*Direct, bystander, or area

** Inhalation, ingestion, skin absorption

*** High, medium, low

^ Daily, 2 or 3 X/week, a few times a month, 1/month or less

^^ Often, occasionally, never

^^^ Examples may include the SEM, on-site monitoring data (quality may be noted), OHQ, interviews, etc. Interview as source of data refers to 

interview conducted by the consulting industrial hygienist.
Proposed IH Exposure Assessment Form - Example

Claimed 

condition = 

COPD

Facility Dates Expos #1 Expos #2 Expos #3 Expos #4 Expos #5 Expos #6 Expos #7

Job #1: Pipefitter Hanford 1/1987-

9/1997

Asbestos Cement Silicon 

dioxide, 

crystalline

Welding 

fumes

Type of exposure* Direct Direct Direct Direct and 

bystander

Route of exposure** Inhalation Inhalation Inhalation Inhalation

Intensity*** Low Medium Low Medium

Frequency^ A few 

times/mo 

Daily < Monthly 2-3 X/week

Duration (# years) 10 10 10 10

Calendar years 1987-1997 1987-1997 1987-1997 1987-1997

Use of PPE^^ Often Never Occasionally Occasionally

Source(s) of data  SEM

 OHQ

 Interview

 IH data

 SEM

 OHQ

 Interview

 IH data

 SEM

 OHQ

 Interview

 IH data

SEM

 OHQ

 Interview

 IH data

File page number(s) for monitoring data

(or N/A)

180, 203, 

216

N/A N/A N/A

Comments re data sources IH 

monitoring 

1995-1997