Second-Term Advisory Board to DOL Finalizes Recommendations

The telemeeting for the Advisory Board on Toxic Substances and Worker Health was held on June 16, 2020 from 12 to 5 EDT.

After a review of the agenda by Dr. Markowitz Director Pond gave an update on changes in the program.  All claims are now being directed to any District Office for adjudication now to help even out the case load.  Dr. Markowitz questioned Ms. Pond on how the expertise needed for adjudication would be handled.  Ms. Pond replied that much training had been done and there were experts within DOL to assist claims examiners if they were not familiar with a site.  The department continues to telework due to the Covid 19 pandemic.

Dr. Mulkowski reported the findings of the Parkinsonism Working Group to the board, after which the board passed a resolution recommending that DEEOIC add carbon disulfide and trichloroethylene (TCE) as agents which can cause, aggravate or contribute to the development of Parkinsonism from either inhalation or absorption through the skin.  The Working Group made no recommendation that methanol, toluene, n-hexane and PCB, or specific pesticides be added as causal agents.  The board also recommends that a periodic review of Parkinsonism be performed by DEEOIC to capture any new research conclusions.  This recommendation was passed unanimously.

Dr. Markowitz reported to the board on the work his Working Group had done on asbestos related job categories.  The Working Group recommended that DEEOIC evaluate job categories and presumed aliases across the DOE campus to reflect the current knowledge for pre-1995 asbestos exposure.  The Working Group recommended that mesothelioma be used as an indicator of asbestos use since this disease has a greater than 90% link to asbestos exposure.  This recommendation was passed unanimously.

Dr. Berenji reported for her Working Group of the investigation on 2A Carcinogens in the IARC. Dr. Friedman-Jimenez requested a definition of causation and expressed concern that the Board find a way to assure that claims examiners do not require claimants to meet this as a minimum standard.

The members of the Board volunteer their time to serve.  The Board feels it is necessary for them to have a contractor, similar to the contractor who supports the Advisory Board on Radiation and Worker Health so that they can fulfill the work assigned to them by Congress.

They currently do not have the capacity to properly oversee the quality of the work by industrial hygienists and contract medial consultants as legislated by Congress. The Board presented a draft document outlining the contractor’s scope of work.  Department of Labor (DOL) notified the Board that they must submit this and other requirements to justify the need for a support contractor.

The Board also discussed a possible recommendation that DEEOIC hire an independent third-party group to periodically audit the objectivity, quality and consistency of individual claims assessments provided by program industrial hygienists and physicians.

After a delay, DEEOIC provided the Board with a sampling of claims for denied lung cancer claims and for claims with post-1995 employment.  One Board member reported that one claim he reviewed showed that the District Director overruled a CMC because the personal physician submitted a much stronger letter linking exposure to the disease.  Another claim was found to have significant factual errors while another claim contained only 18 pages of documents. The Board also expressed concerns about one CMC.  It seems that this one CMC reviews a sizable number of claims and some Board members question the quality of his reports.

The Board intends to continue to work until their term is up mid-July.  DOL has begun the process to seat the third term board and hopes that the members will be appointed quickly so that there will not be a break in the Board’s work.  DEEOIC Director, Rachel Pond, expressed her thanks and appreciation to the members of this board.