Cliff Strader, Program ManagerOffice of Epidemiology and Health

Surveillance, EH-53

May 23, 2006

Status and Outlook for the Illness and Injury Surveillance Program

SELECTED IISP ACCOMPLISHMENTS AND CHANGES: 2004-2006

• Completed 2002 Site Reports and posted to web site. Format change for 2003 reports planned.

• Submitted Health of the DOE Workforce presentation for senior management (prepared by Dr. Richter)

• Draft rollup report completed, short version under development

• Proposed nanotechnology surveillance

• Program trifold brochure updated

• Initiated work on Technical Standard for Illness & Injury Surveillance (Jasmine Kenney)

• Initial analysis of pilot industrial hygiene data (Paul Wambach)

• Outbreak investigations at DOE-HQ and INL (RESL)

• Fernald left the program

• HQ pandemic flu planning

10 CFR PART 851: WORKER SAFETY AND HEALTH PROGRAM, FINAL RULE

6922 Federal Register / Vol. 71, No. 27 / Thursday, February 9, 2006 / Rules and Regulations

“DOE further notes that worker safety and health committees and worker representatives can obtain trend data on illness and injury and trend data on safety from the Office of Environment, Safety and Health’s offices of Epidemiology and Health Surveillance, Performance and Assessment, respectively.”

RATES OF PSYCHOLOGICAL DIAGNOSES, 1995-2002

Rates of All Psychological Diagnoses per 1000 Workers by Age and Gender, 1995-2002

0

2

4

6

8

10

12

14

1995 1996 1997 1998 1999 2000 2001 2002

Year

Diag

nose

s pe

r 100

0 W

orke

rs

16-29 MEN

16-29 WOMEN

30-49 MEN

30-49 WOMEN

50+ MEN

50+ WOMEN

ANXIETY AND NEUROSES

Anxiety & Neuroses Diagnoses: Rate per 1000 Workers, 1995-2002

0

0.5

1

1.5

2

2.5

3

3.5

1995 1996 1997 1998 1999 2000 2001 2002

Year

16-29 MEN

16-29 WOMEN

30-49 MEN

30-49 WOMEN

50+ MEN

50+ WOMEN

ALL PSYCHOLOGICAL DIAGNOSES: RATES BY SITE AND GENDER, 1995-2002

0

10

20

30

40

50

60

70

80

90

1995 1996 1997 1998 1999 2000 2001 2002

Diag

nose

s pe

r 100

0 W

orke

rs

Fernald Women

Fernald Men

INITIAL INL AUTOIMMUNE DISEASE REPORT

• Report received August 2004• Employee with neurologic symptoms but no

specific diagnosis to date.• Employee knew others at worksite with

possibly similar conditions• Several former RESL employees might have

related diseases.• Diseases included neurologic symptoms,

multiple sclerosis, fibromyalgia, arthritis

Could an occupational exposure be involved?

HEADQUARTERS CONCERNS

• Diseases not similar enough to define disease cluster,

• Lack of clinical diagnoses,• Cases diagnosed over a period of

approximately six years, • No specific occupational exposure

suspected, and • NIOSH review concluded insufficient

evidence of cluster to warrant investigation

RATE OF AUTOIMMUNE DISEASES BY AGE GROUP AVERAGED OVER 8 YEARS, INEL VS. OTHER SITES

FIGURE 6c. OCTENNIAL AGE SPECIFIC AUTOIMMUNE DISEASE RATES OF FIRST ABSENCE , INL VERSUS 0THER SITES, 1995-2002

0

1

2

3

4

5

6

16-29 30-39 40-49 50+

AGE GROUP

8-Y

EA

R R

AT

E P

ER

100

0 W

OR

KE

RS

MEN - INL

MEN - OTHERS

WOMEN - INL

WOMEN - OTHERS

AUTOIMMUNE DISEASE AT INL VS. OTHER SITES, 1995-2002

FIGURE 5. AUTOIMMUNE DISEASE FIRST ABSENCE RATES AMONG MALE AND FEMALE WORKERS, INL VERSUS OTHER SITES, 1995-2002

0

1

2

3

4

5

6

7

1995 1996 1997 1998 1999 2000 2001 2002Year

Fir

st

Ab

se

nc

e R

ate

pe

r 1

00

0 W

ork

ers

MEN INEEL

MEN OTHERS

WOMEN INEEL

WOMEN OTHERS

WHERE TO FROM HERE?

• Site recruitment

• Technical Standard

• Dosimetry module

• Industrial Hygiene module

• Nanotechnology surveillance

• Special reports, roll-up reports, annual reports

• Pilot wellness projects

• HQ Pandemic Disease Surveillance