U.S. Department of Labor + + + + + Advisory Board on Toxic
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1 U.S. DEPARTMENT OF LABOR + + + + + ADVISORY BOARD ON TOXIC SUBSTANCES AND WORKER HEALTH + + + + + MEETING + + + + + WEDNESDAY NOVEMBER 20, 2019 + + + + + The Board met in River Room A at the Holiday Inn Paducah Riverfront, 600 N 4th Street, Paducah, Kentucky, at 9:00 a.m., Steven Markowitz, Chair, presiding. MEMBERS SCIENTIFIC COMMUNITY JOHN M. DEMENT GEORGE FRIEDMAN-JIMENEZ MAREK MIKULSKI KENNETH Z. SILVER MEDICAL COMMUNITY MANIJEH BERENJI ROSE GOLDMAN STEVEN MARKOWITZ CARRIE A. REDLICH NEAL R. GROSS COURT REPORTERS AND TRANSCRIBERS 1323 RHODE ISLAND AVE., N.W. (202) 234-4433 WASHINGTON, D.C. 20005-3701 www.nealrgross.com 2 CLAIMANT COMMUNITY KIRK D. DOMINA RON MAHS DURONDA M. POPE CALIN TEBAY* DESIGNATED FEDERAL OFFICIAL DOUG FITZGERALD *Present via telephone NEAL R. GROSS COURT REPORTERS AND TRANSCRIBERS 1323 RHODE ISLAND AVE., N.W. (202) 234-4433 WASHINGTON, D.C. 20005-3701 www.nealrgross.com 3 C-O-N-T-E-N-T-S Welcome/Introductions ......................... 4 Dr. Steven Markowitz, Board Chair Review of Agenda ............................. 15 Dr. Steven Markowitz Board Operation Update ....................... 19 Doug Fitzgerald DEEOIC Updates ............................... 20 John Vance Review Action Items and Responses ........... 110 Dr. Steven Markowitz Claims Status Data, 2016-2019 ............... 128 Claims Review: Asthma, ILD, CBD, Sarcoidosis ............................ 154 Public Comment Period ....................... 312 Adjourn ..................................... 400 NEAL R. GROSS COURT REPORTERS AND TRANSCRIBERS 1323 RHODE ISLAND AVE., N.W. (202) 234-4433 WASHINGTON, D.C. 20005-3701 www.nealrgross.com 4 P-R-O-C-E-E-D-I-N-G-S 9:11 a.m. MR. FITZGERALD: Good morning, everyone. My name is Douglas Fitzgerald and I'm the Designated Federal Officer for this Advisory Board, that's DFO. I'd like to welcome you to today's meeting at the Department of Labor's Advisory Board on Toxic Substances and Worker Health here in Paducah, Kentucky. On behalf of the Department of Labor I'd like to express my appreciation for the hard work of our Board members in preparing for this public meeting and their forthcoming deliberations. I also would like to thank my alternate DFO, Carrie Rhoads, as well as Kevin Bird and the contract staff for doing a lot of work to get this meeting off the ground, getting materials out to the public. Just a couple of housekeeping items. First of all, in the unlikely event of an emergency the exits are fairly well marked out NEAL R. GROSS COURT REPORTERS AND TRANSCRIBERS 1323 RHODE ISLAND AVE., N.W. (202) 234-4433 WASHINGTON, D.C. 20005-3701 www.nealrgross.com 5 here so I don't think there will be any problem. The restrooms are to the left and across the restaurant past the elevators for your convenience. As the DFO I serve as a liaison between the Board and the Department of Labor. I'm responsible for approving meeting agendas and for opening and adjourning meetings while ensuring all provisions of the Federal Advisory Committee Act or the FACA are met regarding operations of the Board. I'm also responsible for making sure that the Board's deliberations fall within the parameters outlined in its enabling statute and charter. Within that context I work closely with the Board's chair, Dr. Markowitz, and the Office of Workers' Compensation Programs to ensure that the Board as an advisory body to the Secretary is fulfilling its mandate to advise and is addressing those issues of highest priority and of greatest benefit to the Secretary of Labor NEAL R. GROSS COURT REPORTERS AND TRANSCRIBERS 1323 RHODE ISLAND AVE., N.W. (202) 234-4433 WASHINGTON, D.C. 20005-3701 www.nealrgross.com 6 who is ultimately responsible for the administration of the Energy Employees Occupational Illness Compensation Program. And finally, I also work with the appropriate agency officials to ensure that all relevant ethics regulations are satisfied. We have a full agenda to cover over the next day and a half. Copies of all meeting materials and submitted public comments are or will be available on the Board's website under the heading Meetings. The Board's website can best be found by entering "Advisory Board on Toxic Substances and Worker Health" in any internet search engine. During Board deliberations I'd like to remind the members that when discussing specific cases to be mindful not to use personal identifying information or PII in those cases. The FACA requires that the minutes of this meeting be prepared to include a description of all matters discussed today and any conclusions reached by the Board. NEAL R. GROSS COURT REPORTERS AND TRANSCRIBERS 1323 RHODE ISLAND AVE., N.W. (202) 234-4433 WASHINGTON, D.C. 20005-3701 www.nealrgross.com 7 As the DFO I prepare the minutes and ensure they are certified by the Board's chair. The minutes of today's meeting will be available on the Board's website no later than 90 calendar days from today, but if they're available sooner they'll be posted sooner. Although formal minutes will be prepared according to FACA regulations we also prepare verbatim transcripts and they will be available on the Board's website as soon as possible. The Board's website has a page dedicated to this meeting. The page contains all materials submitted to us in advance of the meeting, and we will publish any materials that are provided by our presenters throughout the next day and a half. There you can also find today's agenda as well as instructions for participating remotely in both the meeting and the public comment period later today. If you are participating remotely I NEAL R. GROSS COURT REPORTERS AND TRANSCRIBERS 1323 RHODE ISLAND AVE., N.W. (202) 234-4433 WASHINGTON, D.C. 20005-3701 www.nealrgross.com 8 want to point out that the telephone numbers and links for the WebEx sessions are different for each day so please make sure you read the instructions carefully. If you're joining by WebEx please note that the session is for viewing only and will not be interactive. The phones will be muted during the public comment period which opens at 4:30 this afternoon. During Board deliberations and prior to the public comment period I would request that the people in the room remain as quiet as possible since we are recording the meeting to produce transcripts. The Chair will also note that the public comment period isn't a question and answer session, but rather an opportunity for the public to provide comments about the topics being discussed and considered by the Board. If for any reason the Board members require clarification on an issue that requires NEAL R. GROSS COURT REPORTERS AND TRANSCRIBERS 1323 RHODE ISLAND AVE., N.W. (202) 234-4433 WASHINGTON, D.C. 20005-3701 www.nealrgross.com 9 participation from the public the Board may request such information through the Chair or myself. I'm looking forward to working with all of you today at this hearing, and hearing your discussions over the next two days. With that, Mr. Chairman, I convene this meeting of the Advisory Board on Toxic Substances and Worker Health. CHAIR MARKOWITZ: Thank you. This is Steven Markowitz. I want to welcome back members of the Board. Welcome our new member of the Board, Dr. Rose Goldman, and the other members. We are happy to be here in Paducah. It's a beautiful day outside. Maybe we'll actually get outside, who knows. I want to thank some people, Mr. Fitzgerald, Ms. Rhoads who are the designated federal officials who work with us. I want to thank Mr. Vance actually for coming today and being both -- presenting but also being available for questions, comments and NEAL R. GROSS COURT REPORTERS AND TRANSCRIBERS 1323 RHODE ISLAND AVE., N.W. (202) 234-4433 WASHINGTON, D.C. 20005-3701 www.nealrgross.com 10 interaction. Of course we always thank SIDEM, Kevin Bird and his group for the support that they give this meeting. Yesterday we had a great tour of the Paducah site, Gaseous Diffusion Plant. Arranged by Greg Lewis. Thank you, Greg. I know Greg's here. He's outside, but he's coming back. So thank you, Greg. And thanks to the DOE officials, I didn't catch all their names yesterday, who arranged this tour and also led us through this tour. So it was very informative I thought. And I want to thank members of the public, people from the USW Local here, from the Center to Protect Workers' Rights, from the Resource Center and others. You'll have the opportunity to introduce yourselves in a moment, but thank you for coming and listening to us and in the public comments sessions having an opportunity to speak about the program. Let's do introductions and then I'll NEAL R. GROSS COURT REPORTERS AND TRANSCRIBERS 1323 RHODE ISLAND AVE., N.W. (202) 234-4433 WASHINGTON, D.C. 20005-3701 www.nealrgross.com 11 go over the agenda and see if anybody has any corrections or suggestions. I forgot to welcome Mr. Nelson, the Ombudsman, whom I couldn't see right off as well. I'm Steven Markowitz. I'm an occupational medicine physician and epidemiologist from the City University of New York. And I run the Former Worker Program for DOE at 14 different sites, 7 different states across the country. MEMBER REDLICH: Carrie Redlich. I'm getting over a cold. Professor of medicine at Yale and director of the Yale Occupational Environmental Medicine. And I'm also a pulmonologist. MEMBER GOLDMAN: Hi, Rose Goldman. I just joined the committee. I'm associate professor of medicine and also environmental health from Harvard Medical School.