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Keith Stalnaker, Project Manager Paragon Technical Services, Inc. 1 What is SEM? A web accessible relational database of information about toxic substance use at Department of Energy and RECA sites covered by Part E of the EEOICPA SEM houses exposure information SEM houses medical/disease/health effect data Identifies toxins at DOE facilities and links those toxins to buildings, and to job categories Links toxic exposure to occupational illness 2 What is SEM? (continued) SEM is not a claims decision tool; it is used only to assist in claim development. SEM contains information that includes: 113 DOE sites 4122 RECA sites 12,270 toxic substances 128 occupational diseases 3 Brief history of the SEM project Started with “clean sheet of paper” in early 2005 Developed design criteria and conducted a pilot project with DOL during 2005 SEM website design/format has changed very little since early 2006 Populated SEM with data as documentation was collected and reviewed 4 Brief history of the SEM project (continued) Data collection at DOE sites and archives from late 2005 – late 2009 Initial focus on production processes where toxic material usage was greatest and where the largest number of potential claimants worked Examples: chemical processing operations, foundries, maintenance shops (machining, welding, electrical, others), metal working, reactor operations, decontamination and chemical cleaning, laboratories 5 Documentation sources Worker and site interviews Almost 100 meetings with over 1000 current and former DOE workers from 53 DOE facilities 20 RECA uranium mine/mill/ore transport worker meetings A team was sent to all the major DOE facilities to gather records on the substances used at those facilities 19,012 records in SEM library 43 DOE facilities visited to gather records 10 records archives visited 6 Documentation sources (continued) DOE records (e.g., work procedures, industrial hygiene reports, safety analysis reports, job hazard analyses) State and Federal agencies (EPA, State of Colorado) NIOSH profiles (Part B) Textbooks (RECA sites) Former Worker Program documents Other credible sources 7 Information displayed in SEM Data organized by site (e.g., DOE site, mine, mill) Chemical/toxic materials used -- Labor categories -- Work processes -- Buildings -- Major incidents Generic profiles were prepared for common industry jobs for which DOE did not prepare many procedures or technical documents. 8 SEM disease/toxic substance relationships DEEOIC sought out means of showing established links between toxins and occupational illness that could assist claims examiners. DEEOIC examined commercially available databases linking toxic substance and health information. NLM’s Haz-Map was identified as the most appropriate resource for this purpose. SEM disease/toxic substance relationships (continued) SEM does not use Haz-Map information unless it is applicable to Part E. Example 1: Teratogenic health effects Example 2: Non occupational activities with risk of exposure to a toxic substance 10 SEM disease/toxic substance relationships (continued) SEM includes only those occupational diseases listed in Haz-Map that are linked to toxic substance or biological exposures expected in DOE or RECA facilities. Example 1: Vibrio vulnificus infection is an occupational disease in Haz-Map but not in SEM (oyster shucking and fishing). Example 2: Rabies is in Haz-Map and SEM as an occupational disease (extensive animal handling at several DOE sites). Example 3: Diabetes is not listed in either Haz-Map or SEM (not considered an occupational disease). 11 SEM disease/toxic substance relationships (continued) If a new toxic substance is linked to a Haz-Map disease that is not in SEM, that disease is added. SEM and Haz-Map disease/toxic substance relationships are consistent with few exceptions: For trade name substances that are not in Haz-Map, SEM displays the consolidated health effects of the individual chemicals that comprise the substance. ○ Example: WD-40 lubricant Haz-Map does not cover alloys separately but includes the guidance “For potential adverse health effects, see the profile of each metal in the alloy.” SEM shows the compiled list of health effects linked to each of those metals. ○ Example: Bronze 12 There are three SEM websites DOL SEM (access controlled) DOE SEM (access controlled) Internet accessible SEM (no controlled access) Each website includes the same content in the same format, but DOE classification reviews delay content on the internet accessible SEM by 3-12 months. 13 Internet accessible SEM Access to site chemical lists was provided to the public in 2007. Access to expanded SEM data was initally provided to the public in March 2010. 14 Updating of SEM is continuous SEM is not complete and never will be. Many DOE sites are massive industrial complexes with hundreds of buildings, changing missions, and long histories. Not all covered sites have SEM profiles. 15 Portsmouth GDP 16 Updating of SEM is continuous (continued) SEM is constantly updated with new information from: DOE and advocate submissions Updates to Haz-Map Numerous avenues are available to submit information to the SEM team. Input directly to internet accessible SEM website As part of DOL case review, new information is provided to the SEM team. DOE submissions to the SEM team DOL Resource Centers 17 Updating during 2011 SEM changes in the past year Data revised on 40 DOE sites between March-Sept 2011 Added over 2000 new toxic substances Another round of site visits will be needed in the future New facilities and operations since the prior visits 18 Public input is used to update SEM Input received on 7953 toxic substances 3415 toxic substances were added to site profiles. 3193 toxic substances were already in the profiles. 805 could not be verified. 540 are still under review. Input received on 309 occupational diseases 51 diseases were already in SEM. 2 diseases were added to SEM. 256 could not be verified as occupational diseases linked to substances used in DOE facilities. 19 Internet Accessible SEM Demonstration http://www.sem.dol.gov/ Features of home page Public input process and status Link to the User’s Guide Selection of site type (e.g., DOE site or uranium mine) For the Portsmouth GDP, review the master chemical list. 1197 toxic substances are known to have been used at the site. This information parallels the DOL SEM chemical list (30 day update). 20 Internet Accessible SEM Demonstration (continued) Select expanded data for the Portsmouth GDP site. The returned page (“Main Menu”) is the same format as that used in the DOL SEM. Note that the number of chemicals in the expanded profile is less than 1197. ○ This tells us that an update has been made that has not yet been approved for release by DOE. Examples ○ Interpretations of SEM information; example, Building X-600 • Correct: 46 chemicals in building, 2 labor categories, 3 work processes • Incorrect: Each of the labor categories performed all the work processes and used all the chemicals listed. ○ Filters 21 The relationship between Paragon and Dr. Jay Brown Administrative only Funding is provided to Dr. Brown for research of toxic substances of interest to DOL. Protocols for the establishment of disease relationships are defined by NLM/Dr. Brown with no involvement of Paragon or DOL. 22 Dr. Jay Brown Board Certified Occupational Medicine physician in Tacoma, Washington. Developed Haz-Map in his spare time from 1991-2006 and full time since 2007. Member of the American Conference of Governmental Industrial Hygienists and the American College of Occupational and Environmental Medicine. Published in 2008: "An Internet Database for the Classification and Dissemination of Information about Hazardous Chemicals and Occupational Disease" in the American Journal of Industrial Medicine and "How to Use Haz-Map" in Professional Safety. Taught a webinar in 2009 sponsored by the American College of Occupational & Environmental Medicine entitled “Occupational Toxicology and Medical Informatics: A Good Match.” Education: Sociology (Indiana University, 1970); MD (Indiana University, 1978); MPH (University of Washington, 1996); Family Practice Residency (Evansville, IN, 1978-81); Occupational Medicine Fellowship (Seattle, WA, 1994-96). Worked full time for 30 years treating patients in hospitals and clinics (family practice, urgent care, and occupational medicine). 23