NACOSH Meeting                ) PRIVATE

                              )

Pages:  1 through 256

Place:  Washington, D.C.

Date:   September 14, 2010

IN THE UNITED STATES DEPARTMENT OF LABOR

OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION

NACOSH Meeting                )

                              )

			Tuesday,

			September 14, 2010

ATTENDEES:

		MICHAEL SILVERSTEIN, MD, MPH

		LINDA RAE MURRAY, MD, MPH

		ROY BUCHAN, DR.P.H., MPH

		DENISE POUGET

		JIM SWARTZ

		JOSEPH VAN HOUTEN, Ph.D.

		TIMOTHY J. KEY, MD, MPH

		SUSAN RANDOLPH, MSN, RN, COHN-S

		WILLIAM BORWEGEN, MPH

		MARGARET SEMINARIO, M.S.

		EMORY KNOWLES III, CSP, CIH

		PETER DOOLEY, M.S., CSP, CIH

		DEBORAH PAGE CRAWFORD

		VENETA CHATMON

		SARAH J. SHORTALL

		PAUL J. MIDDENDORF, Ph.D., CIH

		KEITH GODDARD

		DEBORAH BERKOWITZ

		ROBERT SADLER

		DR. JOHN HOWARD

		TINA JONES

		AMANDA EDENS

		MICHAEL SEYMOUR

		DR. DAVID MICHAELS

		FRANK HEARL

	P R O C E E D I N G S

(8:39 a.m.)

		CHAIRMAN SILVERSTEIN:  We do have a quorum here today, although three
members who are currently absent.  My understanding is that Tim Key and
Jim Swartz are not going to be here.  We expect Linda Rae Murray and
she's just not here yet.

		But rather than delay any further, I'd like to get started.  So I want
to bring the meeting of the National Advisory Committee on Occupational
Safety and Health to order.  And you'll see on your agenda that the
first item we have is a discussion about ethics rules.  But prior to
that, Debbie Berkowitz, who is OSHA's chief of staff, wanted to say a
couple of words.  She'll be back later for a full discussion, but Debbie
you wanted to do some introductory comments.

		MS. BERKOWITZ:  Yes.  Hi, I just wanted to welcome everybody to come
here.  I know it's a big trip to get here.  I want to tell you how much
we appreciate all the advice and assistance we get from NACOSH.  I know
this is a two-day meeting and everybody have very busy schedules.  You
will have big jobs.  So I just wanted to, on behalf of Dr. Michaels who
couldn't be here and Jordan Baran who will be here later, I just wanted
to welcome everybody here and I'll be back on the agenda in about an
hour or so.  And I know John Howard will be up first.  So I just wanted
to thank everybody.  So that's all I wanted to say.

		CHAIRMAN SILVERSTEIN:  Okay.

		MS. BERKOWITZ:  Thanks.

		CHAIRMAN SILVERSTEIN:  Thank you, Debbie.

		This is a public meeting of course, and I think because of that it
would be useful if we went around the table here and if each of the
committee members could just identify themselves and their organization.
 That will be useful.

		So Peg, would you start?

		MS. SEMINARIO:  I'm Peg Seminario.  I'm director of Safety and Health
of the AFL-CIO and I'm a labor member on the committee.

		MR. BORWEGEN:  Bill Borwegen, Health and Safety Director, Services
Employees International Union.

		MR. BUCHAN:  Roy Buchan.  I represent NIJ and I'm at Colorado State
University in the Department of Environmental Health & Radiological
Health Sciences.

		MR. POUGET:  Denise Pouget.  I'm assistant fire chief in Alexandria,
Virginia.

		MR. MIDDENDORF:  I'm Paul Middendorf with NIOSH.

		MR. SHORTALL:  I'm Sarah Shortall with the Office of the Solicitor and
I'm counsel for NACOSH.

		CHAIRMAN SILVERSTEIN:  Michael Silverstein.  I'm chair of NACOSH and
I'm with the Washington State Department of Labor and Industries.

		MS. CRAWFORD:  Good morning.  My name is Deborah Crawford and I am the
designated federal official for NACOSH.

		MR. GOODARD:  I'm Keith Goodard with OSHA.

		MR. KNOWLES:  Emory Knowles, manager, Industrial Hygiene and Safety
for Northrop Grumman Electronic System Sector.

		MR. VAN HOUTEN:  Good morning.  I'm Joe Van Houten, senior director
for Worldwide Environment, Health and Safety with Johnson & Johnson.

		MR. DOOLEY:  Peter Dooley with Labor Safe Health and Safety
Consulting.

		MS. RANDOLPH:  Susan Randolph, the Occupation Health Nursing Program
at UNC, Chapel Hill, School of Public Health, and I'm one of the health
representatives.

		CHAIRMAN SILVERSTEIN:  Before we get into the full agenda, I do want
to take a couple of minutes just to go over the materials you have.  But
even prior to that, we have Robert Sadler from the Office of the
Solicitor who is going to walk us through some of the ethics issues that
we need to know about.  Please Robert.

		MR. SADLER:  Good morning everyone.  I'd like to echo Debbie
Berkowitz's remarks.  We certainly appreciate when we get this kind of
help from such an esteemed group to help us make our decisions and work
on the matters that are before our particular agencies.

		As Mr. Silverstein said, I'm Rob Sadler.  I'm the counsel for ethics
here at the Department of Labor with the Office of the Solicitor.  And
I'm here actually to provide ethics advice for all advisory committees.
You may be aware that we have a number here at the Department, so 20 I
believe.

		And certain types of committees are composed differently.  We have
some that are composed of special government employees.  They actually
are federal employees for purposes of their service.  But we have other
committees, like yourself, that are composed of representatives who
represent particular viewpoints or particular organizations before the
advisory committees.  So that's why I think in the summary that you've
been provided, or you should have a summary called The Summary of Ethics
Rules for Non-Federal Employees.

		The emphasis on the negative there.  You're not federal employees, so
there are a variety of less stringent ethics rules.  Although, I always
hesitate to say less stringent.  We should always be conscience of
ethics rules when we're conducting business with the government or even
in our own private sector organizations.  Many organizations these days
have very complex ethics structures within their organizations, so I'm
sure many of you are familiar somewhat with this, even before coming
here today.

		This is going to be a very short briefing.  The numbers of rules that
you're subject to are few.  I am here, obviously, to help the committee
at any time during the course of your deliberations.  If you have
questions about ethics that come up, you should certainly direct them to
the Chair or to Sarah or Deborah who can get in touch with me to get my
advice with respect to issues that come up.

		But let's talk briefly in the document you're going to see that this
is divided into three major areas, all sort of negative in their
connotation, but it says 'Misuse of Government Information, Misuse of
Government Affiliation.'  I think you can probably discern a particular
theme here.

		When you're serving on the committee in your representative capacity,
it's permissible, obviously, to use government resources, to be privy to
government information that may be provided to the committee, and to use
your position in furtherance of the mission and roles that the committee
assigns to you.

		Obviously, what this means is that you can use government resources in
conducting any of the activities, so this mean government computers or
email or access, whatever you may have, your title, your affiliation
with the Department, your title as representative member of NACOSH when
you're conducting activities in furtherance of the advisory committee.

		This could be while you're here in Washington, but certainly in the
past it's been my experience that in many cases assignments where
activities have been conducted when you're away from Washington I don't
know if that's contemplated, but that could at some point.  There could
activity subgroups that are looking at particular issues that are
working on these while they're away from Washington, D.C.

		So when you are conducting activities, whether they're here in
Washington or away, you are functioning as a member of the committee and
need to keep in mind these particular rules.

		I think the more interesting one may be the information that you may
become privy to while you're on the committee.  Generally, the
information that you're going to be getting some of it may be public.
Some of it may not be public.  Some of it may be classified.  Some of it
may have business proprietary or personal information about individuals
that are contained in the information.

		Generally, the rule is that you're not allowed to disseminate further
information that you may become privy to while on the committee, unless
at the director of the Chair or Sarah or Deborah or you understand that
this is public information that can become available to others.

		With respect to your affiliation with the committee, it's certainly
permissible for you to say that are a representative serving on the
NACOSH Committee, to include that in your biography, to make
representations to others that you are in that capacity.  But obviously,
you need to be careful about invoking that affiliation if it is not in
furtherance of activities of the committee.  So that's essentially in a
nutshell the advice.

		My contact, I believe, is on the very front page of this document.
That's my direct telephone number at the bottom of the very first page.
And certain Sarah and Deborah know how to get in touch with me if there
are any questions or issues that come up.

		In the past there has been one particular issue that has arisen.
Generally, if you're here conducting business on behalf NACOSH, for that
day I would advise, generally because of appearance issues that it's
best if there are other matters before the Department that other
representatives from your organizations should be handling those rather
than you, in particular.  I think you need to make a little bit of a
dichotomy.

		If you're here conducting or furthering activities on behalf of the
committee that's perfectly fine.  But if there are other matters pending
before the Department, then I believe if there are issues that need to
be conducted or meetings that need to be held it's probably best to have
someone else in your organization conduct that so that there's no
appearance that you're mixing the issues or some how using your position
to get general, further access to members of the agency.

		But with that, I will close.  And if there are any questions, I'd be
glad to entertain them or talk about them.

		CHAIRMAN SILVERSTEIN:  Are there questions?

		MS. SHORTALL:  Rob, I'd like to add one comment what you were talking
about in terms of the information that members may become privy to.

		MR. SADLER:  Sure.

		MS. SHORTALL:  I cannot remember the last time the committee held a
closed meeting, which if it were to be held requires that the Department
be notified and provide a justification for that.  And everything that
is presented to this committee in a meeting is added to a public record.
 So it's less likely here that we're going to have that type of
information.

		In addition, work group material is also made available and put in the
record too.

		MR. SADLER:  That clarifies that.  Good.  That should be no problem at
all.

		CHAIRMAN SILVERSTEIN:  Any other questions.

		(No response.)

		CHAIRMAN SILVERSTEIN:  All right.  Robert, thank you very much.

		MR. SADLER: Thank you very much.  Have a good day everyone.

		CHAIRMAN SILVERSTEIN:  For the record, we've been joined now by Linda
Rae Murray.

		MS. MURRAY:  Good morning, everyone.

		CHAIRMAN SILVERSTEIN:  Linda, you missed the discussion on ethics.  So
you can proceed at your own risk.

		MS. MURRAY:  That means I can be unethical?  Very good.  More
flexibility.

		(Laughter.)

		MS. SHORTALL:  Mr. Chair, I'd like to take care of a couple of
housekeeping items at this time.  I need to enter a few things into the
record.

		I'm going to preface that with a number of people have indicated that
the new system that we have were you get all the public information and
can download it from the website www.regulations.gov sometimes is not
the most user friendly item, although they're trying to improve it all
the time.

		And so to try to make the exhibits as identifiable as possible for
each meeting what we're going to do from this point forward is to put
all exhibits from a meeting in a file set and the file set will be
labeled exhibits from the September 14/15, 2010 NACOSH meeting.  And all
the items within that file set will then be a point 1, 2, 3, 4, 5.

		So what I'd like to do for that file set for this -- exhibits for the
September 14/15, 2010 NACOSH meeting indicate the agenda for the two-day
meeting is Exhibit .1.  The current roster of NACOSH members would be
Exhibit .2.  The approved or the certified minutes of the June 8, 2010
meeting as Exhibit .3.  And the summary of ethics rules for non-federal
individuals that accompanied Mr. Sadler's presentation is Exhibit .4.

		CHAIRMAN SILVERSTEIN:  Okay, anything else Sarah?

		MS. SHORTALL:  Not at this time.

		CHAIRMAN SILVERSTEIN:  Okay.  Before calling Dr. Howard up for an
update from NIOSH, I just want to go over the materials we have for
today.  Everyone should have a copy of the minutes.  You all had an
opportunity to look at those previously, but I will ask you whether or
not there were any additions, corrections, problems that were not noted
earlier?  They have been signed and certified, but one opportunity to
make any comments.

		(No response.)

		CHAIRMAN SILVERSTEIN:  You will find in your packet materials that
accompany a couple of the discussions.  And I think we'll go over those
as each item in the agenda comes up.  You should have in addition to the
items that are actually in the folder there are three or four other
documents that OSHA wanted us to have that I think are at your desk.

		There is a document entitled OSHA at 40, which was a paper that Dr.
Michaels released a few weeks ago.  There's a copy of the letter to
Grain Storage Facility Operators that OSHA and many of the states sent
out a few weeks ago.  There is a statement from Dr. Michaels on long
work hours and a letter that OSHA sent out on cleaning fuel-gas piping
systems.

		I just want to be sure everybody did receive a copy of all of those.
There is a booklet entitled Safety and Health Awareness for Oil Spill
Cleanup Workers and a set of three cards in languages other than
English.

		MS. SHORTALL:  Spanish, English, and Vietnamese.

		MS. SEMINARIO:  We don't have the letters that you spoke about that
had come out.

		CHAIRMAN SILVERSTEIN:  That's why I mentioned it.  I wasn't sure if
they got out or not.

		MS. SEMINARIO:  We have those booklets.  We don't have the letters
that were sent out.

		CHAIRMAN SILVERSTEIN:  Okay.

		MS. SEMINARIO:  One comment?

		CHAIRMAN SILVERSTEIN:  Yes, Peg Seminario.

		MS. SEMINARIO:  I would just say that it would be very helpful if we
could get, not all of the materials, but some of the materials
pertaining to the agenda beforehand by way of background because it
makes it really difficult to do any preparatory work and thought.  And
if we're going to be providing advice and not just listening to
presentations, having the information in advance would be really, really
helpful.

		CHAIRMAN SILVERSTEIN:  I agree with that, Peg.  And one of the things
that I am learning very quickly is the need for me to spend a bit more
time with senior OSHA staff in a couple of weeks prior to the meeting so
we can take care of those things.

		MS. SEMINARIO:  Okay.

		CHAIRMAN SILVERSTEIN:  And I will definitely do that in the future.

		MS. SEMINARIO:  And I would just also ask if you want to then solicit
from folks if they have other materials that they'd like to offer as
well that would be a useful time to do it beforehand.  And I know that
right now the timing of this meeting makes it difficult because trying
to get anything done during August was like impossible.  I appreciate
that.  But for the future meetings that would be most helpful.

		CHAIRMAN SILVERSTEIN:  Difficult, not impossible.  And I will take
your suggestions seriously and we will do better in that regard.

		Any other preparatory comments?

		(No response.)

		CHAIRMAN SILVERSTEIN:  Then I'd like to call up Dr. Howard for an
update on NIOSH activities.  You'll see that Dr. Howard is on the agenda
at two other times during the course of the day.  A little bit later
he'll be joined by Debbie Berkowitz to talk about Gulf Oil spill
response.  And then later on there's another NIOSH agenda item dealing
with influenza.  But now Dr. Howard.

		DR. HOWARD:  Thank you very much Dr. Silverstein and welcome
everybody to the neighborhood.  It's a beautiful day today, primary day
in the District and I believe in Maryland, too.  So we have quite a
mayoral race going on here in Washington, so it's an exciting day.

		Thank you all for coming.  We really appreciate at NACOSH all advice,
whether we like it or not.  And so please feel free to comment and give
us lots of good advice.

		The last NACOSH meeting I had mentioned three topics.  One, social
media; two, prevention through design; and three, H1N1.  So we're going
to have a special presentation on H1N1 and there's a lot of issues
there, as some of you know.  And we're really welcome all of your
thoughts on how we handle the next seasonal influenza outbreak, which
will be upon us soon and how we prepare best for H1N1, which is the
Avian influenza that we hope never appears.

		We also have, as Michael mentioned, a special little panel here on
Gulf Oil, so I won't mention any of those things.  I'll save that.  But
the last item for advice I think is really important is anything that
you see that are interactions between NIOSH and OSHA that are not
occurring that need to occur, or interactions that are occurring, but
are not that productive from your standpoint.  I think that's an
important bit of advice that we always seek because folks give us ideas
about how to interact with OSHA that sometimes we haven't thought of.
So that, I think, is extremely helpful.

		On the budget issue, No. 1 issue, we don't have one yet.  And
apparently, we may or may not have one by the September 30 date.  I was
thinking the other day I really can't remember in the last few years
when we've had a budget actually on October 1, the beginning of the
federal fiscal year.  But we're always hopeful and hope that that comes
to pass and NIOSH resources at least remain stable if not replenished.

		NIOSH is also watching as a second congressional legislative issue the
movement of the World Trade Center Program bill.  At NIOSH, of course,
we're very anxious to see an actual authorizing legislation.  We've had
appropriations for that program, but we'd really love to see
authorization from Congress that will give us specific guidance on how
we should conduct that program.  So we're looking forward to that.

		I just want to mention a couple CDC issues. One issue is that CDC is
in the process of creating or projecting strategic projections for this
$14 billion organization.  And obviously, NIOSH is a part of CDC but
it's not the tail that wags the dog.  So I'm going to read off a couple
of these strategic directions that CDC is working on and plans to work
to work on for the next year or so.

		And I think what I'll do is we'll highlight where we feel that we can
make a contribution from the occupational side.  One is healthcare
associated infections.  This is a serious issue in medical care, et
cetera.  And obviously, a healthcare worker is involved to some extent
in that.

		HIV is a longstanding issue at CDC, obesity, nutritional issues,
physical activity are also important issues.  Food safety is an
important issue that CDC works with FDA on, and there's been a lot of
issues related to food safety.  Teen pregnancy is another important
issue for CDC.  Tobacco is an important issue.

		Environmental health, per say, we have a new director of -- associate
director of ATSGH and director of the National Center for Environmental
Health, Chris Poiterioirer, who is formally of the National Institute
for Environmental Health Sciences and a former associate administrator
of the National Toxicology Program.  So Chris just joined CDC in the
last month.  We're looking forward to some good collaborations with him.

		Immunization is an important issue for CDC, as you can imagine.  And
it does impact, obviously, as we'll talk about in seasonal influenza the
issue of vaccination for flu.  Preparedness is an important issue,
strategic direction for CDC and obviously global collaborations.  And in
that area, the global efforts at CDC are directed chiefly at HIV and
polio in that regard.

		The last direction is one that we have contributed significant effort
in, and we hope to continue in this area.  The strategic direction is
motor vehicle injuries and accident and fatalities.

		As we all know, motor vehicles accidents are the leading cause of
occupational fatality.  So we feel that we have a lot to contribute
here.  We have a NIOSH sector program in Transportation.  So we think
this will be very synergistic with CDC declaring this as one of their 12
strategic goals.

		So I think those we'll look through time.  CDC maybe looking at how to
align budgetary resources to these strategic directions, so we'll see
how that works out.

		One other issue that I wanted to mention with regard to the strong
support that we have with Dr. Friedan, the CDC director, concerns the
elimination of Black Lung disease or Coalworker's Pneumoconiosis.  This
obviously involves more the Mine Safety and Health Administration that
we also are joined with them in statute in the Mine Safety & Health Act
of 1977.  And we're working with them on a number of different things
and updating our 1995 criteria document, which actually recommended a
REL for coal-mine dust.

		We have a mobile van that does x-ray examinations for miners.  We have
our personal desk monitor that measures the coal dust in the mines in
real time, et cetera.  What has been very positive is Dr. Friedan's
interest in creating a campaign around Black Lung elimination.  So we're
very happy that we can have that interest and his also interest in
involving Cat Silverstein at OIRA in supporting this as a public health
issue.  So that, I think, is an important activity that we're involved
in with CDC support.

		The next major activity -- I just want to mention two OSHA-related
issues that I think are worth talking about, and I'm sure Dr. Michaels
and others from OSHA will talk about it also.  But on the 3rd of
September NIOSH response to an OSHA request to look at 15 candidate
chemical substances that are proposed for OSHA PEL development:
Perchloroethylene, Hexane, Isocyanate, Manganese, Styrene, Toluene,
Acetone, Carbon Monoxide, Diesel, Mercury, n-Propyl Bromide,
Glutaraldehyde, anesthetic gases as a class, chemotherapeutics and
welding fumes.

		We added one more, Trichloroethylene, to the list and sent back to
OSHA all of our information to help OSHA in their efforts in this area.
As you know that's a major issue for OSHA that you'll hear about and
have heard about and we're trying to support them as much as possible in
that area.

		Secondly, we entered into an interagency agreement, specifically on
Nano.  As you know, this is a major area in NIOSH and we have been
trying to interest OSHA in this area and finally have a very receptive
assistant secretary in Dr. Michaels in this area.

		So we've done an interagency agreement to look at control banding and
prevention through design principles for the manufacture and use of
engineered Nano materials.  So we'll be leading this effort.  The
objective, obviously, is to design and contribute to control risk
management strategies and guidance materials and others that we hope
then can be co-branded and produce a large impact in this emerging area.
 So we're very happy about that.

		There is some science updates that I wanted to give you.  The first
one has to do with quantitative risk assessments that are in the
planning stage.  We've just started a new quantitative risk assessments
and some draft criteria documents for Formaldehyde, Diethanolamine,
Benzene and Toluene Diisocyanate.

		We're also going to be looking and reexamining, if you will, and
updating the quantitative risk assessment issues and the scientific
literature on metal-working fluids.  As you know, this was a major topic
in the late nineties, I believe.  So we're going to look at that again,
do a new hazard review.  And we're also looking at lead.

		And most importantly, I think, for us in NIOSH is several aspects of
work hours and shift work. As you know, and as we'll talk about later on
this was a significant issue in the Deep Water Horizon response and is
an issue across a lot of different industries. The science, if you will,
of fatigue, even though it's kind of a fuzzy word has really started
advancing in terms of finally recognizing that the human being is a
biological entity and not a machine.  And therefore there are fatigue
issues associated with work.

		The Europeans, of course, lead in this area.  And I think it's
important for us to look at our issues.  It does tend to -- honestly, it
does tend to scare employees to be talking about this issue.  And it's
difficult, but we want to look at the science and see where we are at
this point in time on those issues.

		We have some criteria documents and current intelligence bulletins
that we're working on, criteria documents for Hexovalent Chromium,
Glutaraldehyde, 1-Bromopropane, and Diacetyl.  We have some current
intelligence bulletins that we're working on for Titanium Dioxide, for
Carbon Nanotubials and Manganese and welding fumes are underway.  And
we'll talk about what publications have resulted so far.

		In our food-flavoring related lung diseases issue, I first have to
thank OSHA and compliment them on their patience and forbearance with us
in getting risk assessment data to OSHA for their rulemaking in food
flavoring.  The generation of our data involves very small cohorts of
folks that we have an ethical obligation to protect their identity.  And
this is difficult with regard to risk assessment where a risk assessment
package that OSHA would do in its rule must be fully vetted publicly and
is available and so people can recalculate and that sort of thing.

		So protecting the identities of the individuals that participated in
our studies and yet be able to provide OSHA with the information they
need has taken a little more time than I think than we would have wanted
and I want to thank OSHA for their patience.  But I think we're on the
right track and we're getting all of that work together, both on
Diacetyl as well as other food flavorings, such as Pentanedione, which
has lately come to the fore as another food flavoring that may have the
same respiratory toxic affects as Diacetyl.

		One other issue I wanted to mention in terms of evolving issues
scientifically is an interesting issue with regard to Indium Tin Oxide,
which some of you say, well, where do we see that?  It's actually in
that flat panel TV and it's probably in your TV.  And it's in conductive
touch pads and all sorts of other things.  And it's an emerging
occupational issue.

		In March of this year, NIOSH investigators published a report
describing two Indium Tin Oxide workers at one facility with a fairly
rare disease.  And of course, in epidemiology it's always easier to find
the very rare diseases because they stand out.  And this is a disease
that's called Alveolar Proteinosis, which essentially a disease where
the terminal airways or the air sacks in the lungs fill up with protein
that should not be there and obviously there's no more room for gas
exchange in that air sack.  It's a very serious disease.

		And then we were contacted then subsequently by some Asian
investigators who have seen similar cases.  And for those of you that
follow the flat panel TV market, you'll know that most of the flat panel
TVs are made in Asia.  They're not made here in the United States in a
large proportion of the market.

		So on Monday and Tuesday of this week, we are holding a workshop in
Morgantown that's going to bring together Japanese and Chinese, Korean,
U.S. investigators to look at this issue, to identify practices and to
see where we're at with this emerging issue.

		As some of you know who follow the rare earth metals and perhaps
dabble in investment in this area because they are a very serious issue,
they are being used up quite a bit in the world markets and there's just
not that many of them, hence the name rare earth.  So Indium is one of
those and it's a serious issue that we're looking at.

		A couple of science process updates I wanted to give you.  One has to
do with the electronic medical record.  And this is a complex area.  But
it's one that for us in the Department of Health and Human Services that
a lot of resources are being spent on.  The budget for the national
coordinator health information technology went from $60 million last
year to $2 billion.  This is a pivotal issue in health reform.  A lot of
researchers believe that administrative costs can be saved by the use of
an electronic medical record.

		Now to make an electronic medical record, it's a very complicated
process and it involves significant advisory committees in the
Department that then have to -- to require something in the electronic
medical record or to put it in the medical record it has to pass through
this very narrow test called 'meaningful use.'  It has to be meaningful
to a clinician who's filling out the electronic medical record.

		Now for us in public health, we would love to see a lot of things on
the electronic medical record.  We'd like to see occupation and we'd
like to see all sorts of things.  But it has to pass this test of
meaningful use to a clinician.

		Now what we're trying to do in NIOSH, and we have a team that's
working on that with CDC and with HHS folks on the meaningful use of
electronic medical records.  And we've met with David Blumenthal, who's
the national coordinator is we're trying to get Canada projects that
could demonstrate the usefulness or how meaningful having a field on
there.

		For instance, a person who comes to a clinician with asthma, well, it
may be very meaningful for the clinician to know what are your
occupational exposures.  Clearly, if you're a clinician and you're
treating somebody with asthma and you're asking them about their cats
and that sort of thing, but you're not asking them what kind of work
they do you may have a patient with seemingly recalcitrant asthma to
your therapy because you're not dealing with the occupational side.  So
that would be a strong argument to adding that to the electronic medical
record.

		So we're looking at Canada issues like that.  And as I say, be happy
to be discuss that further and get our experts to give you -- but it is
an important issue because it does relate to expanding the issue of
surveilling what kind of data is being collected in the U.S. and
figuring out how we in occupational health can make use of this big
train that's moving down the track with a lot of money attached to it.

	The second process issue I wanted to mention is the transition of our
chest radiography surveillance, which we do for lots of different
diseases, including Black Lung from the old film that you put up with
silver in it and all that.  You've seen those on TV.  I always like it
on TV because they always turn the thing -- the heart is usually upside
down or it's facing the wrong way or something.

		But we're transitioning from the flat, plain film to digital
radiography.  So the clinical world has done that for many years.  And
through a lot of work by our Division of Respiratory Disease Studies,
working with the International Labor Office that establishes the
B-reader system and the ILO system for looking at x-rays for
occupational purposes we've done three publications that highlight that
and we're aggressively moving forward to incorporate digital radiography
in our Coworkers Surveillance Program, our B-reader Certification
Program, et cetera.

		The next process issue I wanted to mention is the Ryan White HIV/Aides
Treatment Extension Act of 2009.  This is an act that passed last year.
And in Part G of that act, which is entitled Notification of Possible
Exposure to Infectious Diseases.  It states that not later than 180 days
after the date of this enactment the Secretary of HHS has to complete a
list of potentially life-treating infectious disease, emerging
infectious diseases to which an emergency responder could be exposed
during an emergency.

		Some guidelines then describing the circumstances in which the
employee -- the emergency responder may be exposes, the various
conditions.  And then how the medical facility should make
determinations that exposure took place because you want to then go back
to the individual responder and say you transported somebody that had
Anthrax, by the way, last week so that you can do necessary follow up.

		So we have been working on our list and I'm told by Frank Hearl that
it will shortly be published in the Federal Register so everybody can
look at it and see whether we have the right diseases on it.  And then
it's the responsibility of health departments and hospitals and
emergency response organizations then to implement that list.  So that
is I think an important issue you may have some questions on.

		A couple of other things just shortly I wanted to mention.  One is our
Youth Education Project.  We, as you know, have curriculum for all
states -- actually a new version of our 51 versions that are on the
website for curriculum for safety and health for high school students.
And we're just adding a Washington, D.C. version of youth at work
curriculum.  So we're kind of excited about that.

		And we're looking to award a contract to the Labor Education and
Research Center at the University of Oregon to explore multiple options
that would help us integrate the curriculum into vocational high schools
and other high schools within the State of Oregon.  So we're happy about
that.

		Publication-wise, we're going to have a CD for you a little later.
Our little batch didn't arrive on time, but we're going to have it by
the time you leave the meeting.  On that will be a newly published
publication that we're highlight.

		As you know, in 2004, we did an alert called Preventing Occupational
Exposure to Anti-Neoplastic and Other Hazardous Drugs in Healthcare
Settings.  As a part of that alert, there's a list of hazardous drugs.
And that list has been updated recently for 2010 and that's on our
website, but we'll have that for you on our CD.

		The publications that are expected, and some of these have been
expected for a while, is one our NIOSH alert on Beryllium sensitization
and Chronic Beryllium Disease.  And second is our current intelligence
bulletin on asbestos fibers.  And Paul Middendorf is our
editor-and-chief of that and I think is probably as anxious as I am to
see a publication of that so we can get on with the research that the
publication sets out.  So those are expected, hopefully, by the end of
the year.

		We have some drafts that are published for comments on our website.
One is our skin notations profile.  The other is our recommended
standard for 1-Bromopropane and a current intelligence bulletin for
Titanium Dioxide.  So those are already on.

		In terms of global collaborations, I wanted to mention that we're
hosting two physicians from Afghanistan who worked for the Afghanistan
Ministry of Public Health and the Afghan Public Health Institute.
They're coming to NIOSH October 9 through the November 4.

		These two physicians are working with NIOSH to introduce occupational
safety and health issues to the Afghan public health infrastructure,
chiefly in the areas primarily of agricultural workers, which both
America and Afghanistan are trying to make an infrastructure investment.
 And so they're going to spend a month with us and we're excited about
having them here for training.

		The last thing I wanted to mention is that it's finally happened.  I
certainly never thought it would ever happen, but if you do enter
NIOSH.gov on any URL the NIOSH website will come up.  This has been a
longstanding goal of ours and I really have to thank Ken McNealy who is
our IT guru for getting it to happen.

		Now when it appears, the URL will appear on your browser
www.CDC.gov\NIOSH.  We haven't gotten that far, but for those folks that
are looking for NIOSH they can enter it and it will pop up.  So I think
that will help a lot of users who aren't the Cota Shenty of NIOSH and
OSHA, but rather are just looking for some basic information and know
the NIOSH name, et cetera.  So we consider that to be a battle well won
and we're very happy about that.

		So I think I'm going to end there and open it for comments and
questions and advice and all sorts of good stuff.  Thanks.

		CHAIRMAN SILVERSTEIN:  Thank you, John.

		Peg would like to start.

		MS. SEMINARIO:  So much to talk about here. First, I want to thank you
for that very comprehensive overview, and particularly thank you for all
the good work that NIOSH has done in setting up and carrying out the 911
health program.  Just as a point of personal privileges this is a
program that I've worked very closely on for years and it's one that is
a reminder of the fact that there are major occupational health risks
involved in all kinds of responses.

		And currently, we've got 15,000 responders and community members who
are quite sick as a result of exposures from their work or their
proximity to the World Trade Center.  And so trying to get this done on
a permanent basis is important to all of us.  So thank for your efforts
there.

		One of the areas that you didn't mentioned, and looking forward,
looking out to what I see as probably being a major issue, and it's one
that I know NIOSH has done work on and that has to do with the aging
workforce.  There's a lot of discussion going on right now around
deficit, possible recommendations for changes in social security
eligibility.

		And clearly, for all of us who work in this area are quite cognizant
of the fact that you said the human body isn't a machine.  It's a
biological system that has limitations.  And as a representative of
workers, very cognizant that we have a lot of disability, injury,
disease in younger workers, but particularly as people get older I mean
they just can't do these jobs and would ask you think about and also for
OSHA to think about the implications of people working longer.

		And first of all, the kind of work that needs to be done just
currently to give some assessment of what that demographic is, what we
know about exposures, disability, injury rates, et cetera, amongst older
workers because I can see a lot of this happening very quickly if there
are decisions, recommendations mad.  And having some background that
helps inform the discussions on that I think would be quite helpful.

		I'm not asking you at this point in time to go out and do a lot of
research, but I am suggesting it would be a very useful activity for
both NIOSH, OSHA as well as BLS to put together that information at this
point in time and so it is available and so some of the issues that are
related to some of the policy decisions that may be made is available to
the decision makers because it's something that obviously people have
somewhere in the back of their minds.  But unless they're really
involved in work and workplaces, it's not something that is readily
apparent to a large number of people.

		DR. HOWARD:  This is music to my ears because our Work Life Program
has a major emphasis in the aging workforce.  And so I think that your
recommendation for us to consider the implications of people working
longer more formally I think is well taken, especially with the three
occupational, safety and health agencies -- OSHA, NIOSH and BLS.

		For us in NIOSH, in our Work Life Program, we are developing
relationships to be able to prepare a series of policy recommendations
from the safety and health perspective.  Yesterday, I met with the
National Institute on Aging in Bethesda to try to figure out how their
-- they fund about $150 million in aging American workforce -- not
workforce, but aging Americans and then how much of their portfolio
actually relates to work.

		One of the most interesting studies that they funded, which appeared
in the Journal of Economic Perspectives, which is a journal that I don't
usually read, and it's entitled Mental Retirement.  And what's
fascinating about that because we talk about some of the negative
implications to safety and health issues related to muscular skeletal
work and others as well as the serious policy issue of extending
retirement age, which sounds and may not be that much of an issue for
folks in white collar jobs, but is a real issues for folks who have much
physically-demanding work.

		All of a sudden you tell them, well, you're not going to retire at
this age.  You're going to retire three or four years later.  In fact,
there was an article in the New York Times the other day about that.  In
addition to all those policy things, we tend to think in the negative,
but this is actually a positive.  I was struck by this study about what
happens when people retire early that they're actual cognitive
limitation onset comes earlier than a cohort peer group.  So there is
some positive, but the question is there's a lot of negative.

		So I think we want to look at both the positive side and the negative
side of the aging workforce implication.  So I would love to be able, if
the committee is interested, to be able to tell you what you're doing in
the Work Life Program and what we're doing on the aging workforce issues
because we do have three Work Life Centers that we fund.  One is at the
University of Iowa.  The other is the New England Center, which is a
combination of the University of Connecticut and the University of
Massachusetts at Lowell.  And then the third center is at Harvard.

		And we also, even though we don't fund it, we're in collaboration with
the Veterans Administration.  Their Director of Environmental and
Occupational Health, Michael Hodgson, is a former NIOSH and he has a
very large Work Life Program for the 174 facilities that the VA has.
And we're also working with OPM and OMB on federal workforce
demonstration areas.  So there's a lot to talk about if the committee
was interested in pursuing this.

		So I thank you for bringing that up.  I didn't put it in my remarks
because I tend to get a little carried away with this topic because it
really is to me a demographic demand that we have to look at carefully.
In the Congress right now, there are at least three or four bills that
talk about extending retirement age, keeping federal workers on, et
cetera, et cetera.  And in none of that is there really any safety and
health issues and I think you've identified a serious gap that we need
to fill.

		One of the issues that I just want to mention that I think we have a
role to play at NIOSH is in the meeting with National Institute on Aging
folks they are essentially providing the funds to conduct the scientific
research, but they can't make recommendations.  So they don't really
have a channel to bring all of that science that they're paying for into
the recommendation outcome.  So I think that's where we could have a
good relationship.

		CHAIRMAN SILVERSTEIN:  Bill Buchan had his hand up first.

		MR. BUCHAN:  Dr. Howard, you mentioned that the Afghans are coming
over.

		DR. HOWARD:  Two of them.

		MR. BUCHAN:  Pardon me?

		DR. HOWARD:  Two of them.

		MR. BUCHAN:  Two of them.  You're going to emphasize agriculture.

		DR. HOWARD:  That's their interest.

		MR. BUCHAN:  That's their interest.  Okay.  Well, that pleases me
anyway.  As you know, I've been working in that area since 1973.

		This country really has not placed an emphasis on agriculture, other
than what NIOSH is currently doing.  OSHA has been restricted
legislatively and also writers on appropriations bills to go into
agricultural operations.

		The one thing that I see is really missing.  We do research in AG
health and safety.  There is really no outreach, education or on-site
intervention where it's really needed.  And I think the Afghans need to
know that that's an important aspect of occupational safety and health
in that arena.

		DR. HOWARD:  Sure.  And I think that we'll be able to help them out in
that area.  Also, again, if the committee is interested, we fund 10
agricultural safety and health centers throughout the United States.

		MR. BUCHAN:  No, it's seven.

		DR. HOWARD:  Seven.  But we have three others that we're working on.
And so those centers I think do a good job at the mission of outreach
and education.  So I'm not sure I would agree that there's nothing going
on.  Things can always improve I think.

		MR. BUCHAN:  A minimum.

		DR. HOWARD:  Right.  Well, minimum is in the eye of the beholder.  I
think they're doing a great job in what they're -- the money that we
give them.  I think that that's always the issue.  Outreach is really
dependent on how much resource you can make available.  And I certainly
think that we would want to make more resources available to them.  But
again, that's an area that we don't have that much of a reflection on
the OSHA side with for obvious reasons.  But again, if the committee is
interested in that aspect of our work, we'd be happy to do that.

		MR. BUCHAN:  I didn't mean to criticize NIOSH in the AG work they're
doing.  I just think it's a minimal investment considering the magnitude
of the problem.

		DR. HOWARD:  Sure.  I think the AG center directors would probably
agree with you.

		CHAIRMAN SILVERSTEIN:  Bill Borwegen.

		MR. BORWEGEN:  Dr. Howard, thanks for an excellent, comprehensive
presentation, wetting our appetites in a number of areas.

		I had a question about the medical records.  This is obviously a very
interesting opportunity to identify occupational health concerns among
patients.  Is there a way so that -- this is going to be electronic.  So
is there a way that symptoms could trigger more detailed questions about
working exposures.  So the question is when you answer yes to a certain
question like do you have asthma, can the electronic system drill down
versus going on to the next question?

		DR. HOWARD:  Right.  It's a record for the physician, not for the
patient.  So it's not like a symptom survey or something like that that
you would give to a patient.  That's entirely within the purview of the
clinician.  But rather it's a record that the physician fills out.

		MR. BORWEGEN:  I see.

		DR. HOWARD:  It has nothing to do with the patient directly in that
sense.

		MR. BORWEGEN:  Do you think you're going to be able to get any
questions onto this timeframe?

		DR. HOWARD:  Well, we certainly are going to try.  You know, I think
this is a difficult area.  The electronic medical record for physicians
throughout the United States is not a gee whiz let me just get out that
record.  I just can't wait to fill out an electronic medical record that
government came up with.

		So there's a lot of resistant to this and it's a very prolonged,
protracted process and the criteria that's being used is the meaningful
use criteria.  Unless clinicians think that it can enhance their care of
the patient, they don't want to fill out some government form that has
extraneous information.  Unfortunately, for us in public health what we
consider to be extraneous -- what they consider to be extraneous we
consider to be extremely important, surveillance information.

		MR. BORWEGEN:  And I assume ACON and others are weighing on this.

		DR. HOWARD:  Yes.  Everybody is involved in this that has anything to
do with the medical profession.

		MR. BORWEGEN:  Okay.  A couple of other points.  Just responding to
our comments about the aging workforce, it would be nice for NIOSH if
you could look into what is going on with the safe patient handling laws
that are passed around the country where nurses are getting older and
patients are getting heavier.  And we're starting to see some initial
results.  I know in Washington State, Dr. Barbara Silverstein has
results there.  But New Jersey, Minnesota, other states that have
implemented laws I think it would be useful for NIOSH to add this to
their webpage, links to some of these state laws on safe patient
handling or for instance either linked to the New York State Public
Employee Workplace Violence Prevention Law.  I think it would give
examples to others on what states have done, concerning that for the
last recent years states have been leaders in passing state legislation.
 I think it would be useful for others to see this kind of information.

		It would be nice to form maybe some type of internal or external
workgroup to see what NIOSH could do in the way of perhaps an alert or
some other type of publication on the issue of safe patient handling
because I think the alert you did on hazardous drugs was very useful and
can we do something now on -- knowing the excellent work that Dr.
Collins and others at NIOSH have done documenting that these programs
are incredibly economic -- they say back and bucks is what I say.  And I
mean if it was an investment on Wall Street it would be like the best
investment there is.

		You invest this money and then you save money, not only the first year
but subsequent years on these safe patient handling program.  How do we
highlight that?  You were talking about a lot of different documents
coming out, but I'd like to see how do we put that in a nutshell into a
document that would really create some -- I know you've done some
already in this area, but how would we create a bigger splash for -- a
bigger bang for the buck?

		In the area of Glutaraldehyde I'm glad that's on the list, both on
this PEL list and also a criteria document.  Just the fact that you're
looking at Glutaraldehyde more closely means that there's going to be a
tendency that they're going to move towards using an alternative called
OPA and we don't know if OPA is a safer chemical.  So I would urge you
to simultaneously look at OPA as you look at Glutaraldehyde to see are
is the alternate safer than Glutaraldehyde because we don't know that
and we're getting mixed information.  So that's my third and final
comment.

		I'd like to see the Ryan White language, but I can look at it on the
Internet.

		DR. HOWARD:  Not yet.

		MR. BORWEGEN:  I just want to read Section G right now.  I think you
for alerting us to that.  That looks like it might be a useful hook for
a number of reasons.

		CHAIRMAN SILVERSTEIN:  Linda Rae Murray.

		MS. MURRAY:  Well, thank you, John.  As always, you're a gentleman.

		Let me just say that at some point it would be nice to have some sense
of NIOSH's strategic direction buried at CDC.  And I will here be
critical of CDC as a local health officer I am more than -- CDC is a
major source of frustration for me.  But this listing of solo activities
is not a strategic plan.  Let me just say that.

		But what I really wanted to comment on actually was the electronic
health record because -- and I think NIOSH can help us a great deal in
this area.

		If you have a notion of public health as separate disconnected
campaigns, which is often what I think CDC thinks public health is, then
how you describe the electronic health record and our present efforts in
this effort fall into that category.  That's not how I would describe
it.

		First, I still see patients and I use an electronic health record and
it's not where it needs to be.  So it's not magic.  It's not like on
Star Trek or anything yet.  And it is fundamentally a clinical, as
you've describe it, interaction between the provider and individual
patient.  However, I think that how you describe meaningful use is a
narrow, clinician definition.  I agree.  It's the dominate way it's
discussed and it misses the public health implications.  This
technology, electronic health record is the least of it.  That's the
interface that the doctor fills out.

		Right now, if I go into any hospital in this city, they'll have for
any patient next of kin.  They'll have the address.  They'll have the
zip code. They'll have where they work because they'll have the
insurance.

		DR. HOWARD:  Is there any reason they actually know where they work?

		MS. MURRAY:  No, they won't have what department they work in.  So
what's the really powerful thing that public health needs to be
concerned about and we in public health need to be defining meaningful
use.  And it's easier for us in health and safety than in many other
areas of public health is that we now have a centralized database
through these health information exchanges, which I know the economists
think the different hospitals will put information and they won't repeat
a test or an x-ray.  That's their theory behind it.  We'll probably
still repeat the x-ray, but that's all right.  We won't tell them that.

		But there are so many other sources of information that could be put
in a health information exchange that would allow us in public health to
engage in active surveillance.  For example, where people are working.
If we have the ability to know that people at -- and don't forget most
of our companies are small.  At XYZ Plating Company that employs 100
people in the past ten years and we see a pattern of something that's
really powerful, whether or not the individual clinician learns how to
take an occupational history.

		If I knew where the foreclosed houses were in my community and what
communities had higher rates of foreclosures, I'm betting I could
predict we would have higher rates of strokes and heart attacks, but I
certainly would like an opportunity to test that hypothesis.  So I would
call on NIOSH and OSHA and other components of public health at the
federal level to begin to get away from this clinical approach.  I mean
I'm willing to have a clinical discussion with anyone.  I'm a clinician.
 I don't mind that.  But ask ourselves what population-based information
do we need in these health information exchanges.

		If I knew what the age of houses were in my community, and easily
there, and that could be tagged to children that were being seen by the
doctor, that's a big clue of where my childhood lead poisonings are
going to be.  So we really have to have a public health population eye
towards this, not just an individual-focused clinical eye.

		And what does this mean in English?  I think it may mean, for example,
requiring for OSHA that companies with the ability maybe they need to
file in the HIEs what departments people are working in so that we can,
in fact, begin to track lifelong exposures.

		So the technology that exist today that didn't exist 10 years ago or
20 years ago, and it will evolve will give us a lot of tools that we
don't now have.  And because the country is focused on trying to save
money in medical care, we can use the medical care backbone that's being
built to, in fact, allow us to make different kinds of advances to
protect workers.

		So my challenge to NIOSH and OSHA is this is not just a get on the
bandwagon.  I think this is a really major tool.  It will not help
clinicians that much.  We still practice medicine the old fashion way.
I'm going to sit there and what I know I'm going to ask the patient and
I'm going to treat them.  But it will advance public health if we do
right because then we can actually being to have some science-based
population-based approaches.

		So I have not seen a major, national meetings called on public health,
except for the traditional communicable disease meaningful use things.
I know locally in our health department we are trying to think about
some meaningful use cases for our local health department.  But I think
this should go on at the national level.  And I think in health and
safety and environment where we have other databases.  They may not be
quite the way we want, but we have existing databases now.  We force
people to keep MSDS sheets now.  What if we force them to keep them
electronically?  And what is there was some way to match them up where
people worked?  I think we're missing a major opportunity to make
advances.  Because if we continue to just do 15 PELs every decade and
put out one or two criteria statements a quarter we'll be forever and
workers will continue to die.

		DR. HOWARD:  Certainly, you're very eloquent on this point, and
especially the point about public health needing to define meaningful
use because as we've been talking about the driver right now is what a
clinician thinks, per say.  So this is I think something that we are
very I think supportive of.

		Dr. Eileen Story is our representative for all of these committees.
So what I'm going to do is take your messages back to Eileen who I'm
sure they will resonate with and I think she's trying to do some of the
same things that you're recommending.  And maybe she can get in touch
with you and figure out how the public health voice can be a little
stronger in this very large effort that is driven, as we've said
primarily by the clinician field.

		But Eileen is no shrinking violet either and is trying to make the
very same arguments that you so eloquently made here.

		CHAIRMAN SILVERSTEIN:  Susan Randolph.

		DR. HOWARD:  And if I could ask Deborah, when the transcript is done
let me know so that we can capture Dr. Murray's comments.

		MS. CRAWFORD:  We will send the form to you.

		MS. RANDOLPH:  Thank you very much.  Susan Randolph.  I would just
echo what Linda Rae was saying about the individual versus
population-based records and the importance of having at least
occupation there.

		Granted, oftentimes clinicians, unless they have an occupational
background may not even associate that as being very valuable.  And I
think it goes back to training and education and why you need to ask
that question.

		The other issue with electronic medical records is that of
confidentiality.  And if they are electronic, who else has access to
those or if they're certain firewalls and how to keep some private
information private, but realizing the risk through surveillance an
opportunity to link certain information, but trying to keep the
important information confidential.

		DR. HOWARD:  Right.  And unfortunately, we don't have a couple of
hours to discuss the intersection of HIPAA and the meaningful use test
for the electronic medical record.

		MS. RANDOLPH:  Thank goodness.

		DR. HOWARD:  I was going to say thank God we don't have that time.

		CHAIRMAN SILVERSTEIN:  Peter Dooley.

		MR. DOOLEY:  Yes, Peter Dooley.

		Just a comment, John, on one of the issues that you raised, which was
work hours and fatigue and such.  Just as an urging about how much we
need to be doing research as well as intervention.  I've been doing a
lot of work in manufacturing recently that has really, really frightened
me about this whole doing more with less that is the national theme
these days in workplaces.  And the fact that the workers who are
remaining on jobs are being increasingly put on demands for extended
work hours and the health and safety implications of that I think are
really severe.

		People are really being pressured to do more work and they're being
pressured to report less injuries.  And the whole environment is
tremendously stressful in a way that we need to be really doing as much
intervention as much as we can as soon as we can.  Thank you.

		CHAIRMAN SILVERSTEIN:  Yes, John?

		MR. VAN HOUTEN:  Dr. Howard, three points that I wanted to comment on.
 The first is building on what Peter just said.

		At least in our company, we're seeing increased claims for workplace
stress and illnesses associated with workplace stress.  So I'm not sure
if NIOSH is looking at that, but it would be very helpful to examine
whether it's the economy or other stresses in life that are weighing on
people's shoulders, but it is spilling over into the workplace.

		DR. HOWARD:  Just before you jump to the second, the answer is very
definitely yes.  We have a Legacy Program, if you will, in work
organization and stress.  And we have probably internationally one of
the most famous researchers in that area Steve Sadder, who with Richard
Kerosac and a number of others have done the essential work on saying
just because a worker's stressed it's not necessarily because they  have
family problems or personal problems.  The work itself and how work is
organized and the pressures that someone has at work can be s source of
stress.  So this is pioneering scientist in this area.

		We have a number of publications.  We lead the Triennial Conference
with the American Psychological Association on Work and Stress.  So this
is an area that NIOSH as deep research and intervention involvement in.

		MR. VAN HOUTEN:  On the coping side, would you tie your health -- with
that reassuring message.

		(Laughter.)

		MS. SHORTALL:  Michael, that was the sheltered place announced
announcing as clear.  The reason why we didn't hear about the sheltered
place mostly likely is that the announcement is given over people's
computers at work.  But we were save because right over here are the
sheltered place supplies and this is a designated sheltered place area.

		MR. VAN HOUTEN:  What about the building service workers who don't
have a computer in front of them on their desks?

		MS. SHORTALL:  The building service workers?

		MR. VAN HOUTEN:  Well, how do they find out that you're doing a
sheltered place?

		MS. SHORTALL:  I don't know.

		MR. VAN HOUTEN:  Okay.

		CHAIRMAN SILVERSTEIN:  It's off the agenda, so let's pick up, Joe.

		DR. VAN HOUTEN:  I'm just going to return to my comment.  One of the
things we're looking at is improving or enhancing our health and
wellness programs to help people deal with stress, making access to
employee assistance programs that much more visible to employees.  So
it's just something that NIOSH is looking at from the standpoint of
helping employees deal with workplace stress, looking at the outlets
that help reduce that.

		DR. HOWARD:  The words that are used in the scientific literature is
'resiliency.'  The idea that we all suffer some traumatigens that we
encountered in work, life, et cetera.  But how resilient we are to be
able to handle that is really the issue.  How we build up resiliency.
For instance, as we'll discuss later on in the Deep Water Horizon issue,
long hours, et cetera, how resilient are people to be able to handle
issues that face them.

		So that science of resiliency is a new area of research that a lot of
folks in occupational psychology are into now and so that replaces the
older term of 'coping' issue.  So yes, we are looking at that issue and
we have a number of folks that have published papers in that area.

		MR. VAN HOUTEN:  Thank you.

		Regarding electronic medical records, I have several comments.  One is
from the standpoint of a patient and caretaker of older parents that it
would be very helpful if we could have one repository for information
that physicians could access because personally I get tired of filling
out a medical history form every time I have to go to a new physician.
and I know I always forget information going from one physician to the
other.  So I think it would help my care if we had one repository.

		DR. HOWARD:  That idea has a lot of traction in the Department of
Defense military medical establishment where there are smart cards that
soldiers have that have all their medical history and all what's done on
their smart card.  So that idea is significantly being used military
medicine, but as yet in civilian it really hasn't taken hold.

		MR. VAN HOUTEN:  And from the occupational side, we see examples of
where having access to the employees medical history would be very
helpful in the occupational setting.  I use the term looking at the
holistic approach.  Ergonomics is one that comes to mind.  If somebody
is using their computer four hours at home and then they're coming to
work and working four hours on a computer at work, it would be nice to
know that they've got this kind of exposure on the job and off the job.
So I'm not sure how that plays into electronic medical records, but
looking at the patient as an individual rather that on the job/off the
job is very helpful from an occupational health standpoint.

		DR. HOWARD:  Right.  And one of the reasons that this sort of issue of
electronic history hasn't caught on in the civilian side as it has in
the military, in the military you give up a lot of rights when you go to
work for the Army and the Navy and the Marines.

		On the civilian side there are issues related to what an employer is
entitled to know and it's a very complex area of confidentiality and et
cetera.  So it's a much deeper thicket of issues to go through on the
civilian side.  It's not to say that there aren't some compelling ideas
that one could discuss, but it is a more complicated area.

		MR. VAN HOUTEN:  The final comment I wanted to make was around motor
vehicle accidents injuries and fatalities.  It's a favorite of mine, as
you know. I'm very happy to see that CDC is stressing this as an area.

		I would be interested if you have comments or maybe OSHA has comments
later on about the coordination among government agencies on this
effort.  For instance, Secretary LaHood is sponsoring a symposium on
distracted driving next Tuesday and I'd like to know how does that tie
in with what OSHA and NIOSH are doing in this area.

		DR. HOWARD:  It's very interesting you mention that.  A few months ago
David Michaels and the NIOSH deputy, Dr. Kidd, attended a meeting at the
DOT on the issue of distracted driving, which is a huge issue for this
Administration.  And we're all participating, as we can, in that
distracted driver initiative.  So I don't know next week events.  There
are a number of events that are planned in this area.  There's a big
push on this area.

		So I can check back and we can get back to you about whether we're
involved in that effort.  Is it next Tuesday?

		MR. VAN HOUTEN:  Next Tuesday.

		DR. HOWARD:  Okay.

		MR. VAN HOUTEN:  That's the 21.

		CHAIRMAN SILVERSTEIN:  I'd like to put on table of couple of themes
that I hope we're going to come back repeatedly during the course of the
next two days.  And they're some things that you said Dr. Howard as well
as some of the panel members that I think lead us into these areas.

		The first is something that Linda Rae said earlier, which is that it's
important to distinguish between solo activities, all of which may be
interesting and important, and a strategic view that ties things
together and moves in a calculated direction.

		And I really feel that we have an obligation on this committee to
think strategically and so I want to introduce into the conversations
and I think that we become most useful to OSHA and NIOSH if we give some
help with strategical direction.

		While it may be useful to comment on very specific issues, I think
it's more useful to operate at a somewhat higher level and I want to
keep sure that we keep coming back to that.

		The second point I want to make is it's actually related.  I found
your presentation really informative and useful.  And in fact, I'm
impressed with the range of things that NIOSH is tackling and the
variety of areas that you're touching on.  And I find that I'm tempted
to ask for more details about a lot of it, and you offered to provide
more details.

		DR. HOWARD:  Sure.  Any time.

		CHAIRMAN SILVERSTEIN:  This committee could easily become one in which
we treat OSHA and NIOSH as learning institutions in which you're
providing us information and we're learning.  And I think all of us have
an appetite for knowledge, so it's a big temptation for us to ask for
more presentations.  I want to resist that temptation and turn the coin
over, if you will, because we're not here for our own education.

		I think we have an obligation and we're charged with providing the
agency with advice and making recommendations.  And so there are two
ways that we can go about that.  One is self-generated.  And I'm sure
that we're going to have discussion later in the course of today and
tomorrow in which we will generate some of our own ideas about ways that
we think we might be helpful to the agencies.

		But while you're here and tomorrow while Dr. Michaels is here I want
to ask you the question, put you on the spot a little bit and to ask for
your thoughts about some of the areas that you're working on or not
working on for that matter where you think that our advice may be
actually helpful to moving you ahead, helping you to make decisions or
choosing directions or deciding on resources allocations.  So if there
are some in the areas, either some of the ones you've mentioned already
or others where you think we might be particularly useful I'd like to
get that on a list of things so that we can make some choices before the
end of tomorrow.

		DR. HOWARD:  As I said in the last meeting, the three areas that I
pointed out was social, media, prevention through design, and H1N1.  Now
we're going to about H1N1 influenza, whatever you want to call it.
We're going to talk about that later.

		And there are some impressing issues in that area that I think we all,
and I certainly would welcome any -- the learning thing I think that's
great.  But to emphasize the doing part and the advice part, but
sometimes you have to get a presentation about what the agency is doing
and we can certainly shorten those so that we can get to the tail end.

		CHAIRMAN SILVERSTEIN:  Don't misunderstand.  I think the presentation
was great.

		DR. HOWARD:  Some of this stuff is detailed and the EMR stuff is
extremely detailed, and all of these things are very detailed.  So we
would be happy to do shorter, 10 or 15 minute limit the presentation.
Here's the basic stuff and it's a taking off point to discuss strategic
views and stuff.

		For NIOSH, we have a large strategic view of things because we have a
national occupational research agenda, which is a public/private
partnership, so we generate essentially new knowledge through the field
of occupation through that mechanism.  But I think today the comments on
the Deep Water Horizons are extremely important for us to be able to get
views and the H1N1.

		But as each member of the advisory committee offers their views, we
get some advice in that process.  We at least get are you for it or
against it.  We come up with a lot of ideas that somebody doesn't like
or they like.  So we get that right away.  That's basic advice.  And
since you all are very knowledgeable and you represent organizations,
that's important information.

		We have an interest.  We have some researchers that are interested,
and I personally am interested in the aging workforce issue.  But when I
first came up with the idea of the Work Life and all that, I though
nobody is going to like that because they're going to be very upset that
we're not spending the precious dollars we have on getting enough rails
done and why are you doing this other stuff that is worthless?  I turned
out to be wrong because people think it's worthwhile.

		So just having individuals on the committee comment about what we're
doing is extremely helpful.  Extremely helpful.

		CHAIRMAN SILVERSTEIN:  Good.  And I will not in any way discourage
individuals from continuing to throw ideas and suggestions at the
agencies.  I'm glad to hear that feedback.

		DR. HOWARD:  It's a rich experience for us.  I have on my list, and
I'm sure others from NIOSH are making their own list, five things right
away.  An alert on patient safety I never thought of that, but I will
take that back and see what people think.  That's an important thing.

		The issue about whether Dr. Story is getting her group around a public
health perspective on meaningful use.  There are lots of ideas that have
come out just this morning.  It's been very productive, so don't think
that it hasn't been.

		CHAIRMAN SILVERSTEIN:  No, I appreciate that feedback.  I do think
that advice, suggestions, recommendations that we can make you as a
group have a bit more power than individual suggestions.  And so as we
go on, I want to pool our ideas and move in that direction.

		DR. HOWARD:  If I could just comment on that because I still have,
because Deborah sent me a copy, of the letter that you all did on June
30.  And while we were going through the Deep Water Horizon event and
then just recently read it again to see what did we do n respect with
that.  And we'll talk about that later, but that was very valuable.

		CHAIRMAN SILVERSTEIN:  Yes.  Good.  And we will come back to that in
just a couple of minutes.  I just wanted to make one other comment and
then see if other committee members do, and then we'll move on to talk
about the Gulf issues.

		It struck me when I think Bill was talking a little bit earlier and we
started talking about the aging workforce.  I mean it struck me that the
world of work is substantially different in many ways than it was when
the OSHA Act was written and NIOSH and OSHA were charged with their
responsibilities.

		I mean not only have there been huge demographic changes of both age
and ethnicity, but there are also huge changes in the nature of
industry.  The distribution of work in different sectors is
fundamentally different than it was 40 years ago.  And then of course
there are exposures that exist now that were not anticipated by Congress
when it put together the Act.

		And so one of the things that I wonder about and I think this
committee might be well advised to look into is whether the deployment
of resources by OSHA and NIOSH match the current circumstances.  I know
within my own agency -- I'm responsible for a state OSHA program and I
think that in some ways we're locked into the past.  We've got a lot of
inspectors who are real good at doing construction inspections and that
what they do.  But we have almost nobody on staff who really knows how
to go into a healthcare facility and evaluate how to find and fix
hazards.  And so there's a real mismatch.

		And so I'd be really interested in seeing some information from NIOSH
and from OSHA about what your budget looks like, how you're deployed
resources so that we can maybe help you look at whether or not the way
that you're using the resources available to you to matches what the
needs are.  So for a future meeting, if there's a way that you can
present to us some basic information about where your dollars are, where
your people are that would be really very helpful to us.  Bill?

		MR. BORWEGEN:  Yes, if I could just embellish before you respond.
I've always been struck by the mismatch between where OSHA spends their
time and energy and NIOSH and the BLS statistics on where people work
today and where they're getting injured and the reality that -- well,
it's kind of startling since the last meeting the reality that there are
more healthcare workers today than there are manufacturing workers in
this country.  There are 13.7 million healthcare and I think we're down
to 11.5 million manufacturing workers.  Yet, my understanding and I've
yet to find out if this has changed from decades ago that OSHA spend 85
percent of their inspections in manufacturing and construction.

		That number might be different now, but again how do we balance the
resource commitment to where people work today and where they're getting
injured.  I think that would be an interesting exercise to make sure
that the scarce resources that these two agencies have are being put to
the best use.

		DR. HOWARD:  Okay.

		MS. SEMINARIO:  Later on the agenda is an OSHA topic, but it's also
something that you had raised was an activity that NIOSH was engage is
the interaction of the agencies in dealing with rather than say
permissible exposure limits talk about exposure to chemicals.  It's
obviously a huge area that we've fallen way behind in.  And I think
looking at this issue is one that we may want to think about as a
committee, particularly with respect to the interaction of the agencies.

		And at maybe a future meeting to talk about not just the particular
projects that NIOSH is involved with OSHA on in providing data
information on particular standards, but again, the strategy.  What
should that relationship look like?  Who should have what
responsibility?  Should NIOSH have the responsibility?  I mean under the
statute if you go back and you read it what was envisioned was that
NIOSH would develop the recommendations for standards and then six
months later OSHA would have them in the Code of Federal Regulations and
obviously that hasn't happened.

		But I think going back and looking at that issue, and again the
resource questions, the resource issues, but to look at it around a
concrete program and area, particularly where NIOSH has background
history and expertise and to think about that and how these things fit
together.  And so I'd like to put that forward to get your reaction to
that.  And also put it to the committee as an area for future work.

		CHAIRMAN SILVERSTEIN:  Are there any other thoughts to wrap up this
part of the discussion from any of the committee members or John if you
have anything to add at this point.

		DR. HOWARD:  No.  As I said at the outset, how NIOSH and OSHA interact
is a very important issue for every stakeholder that I've ever talked
to.  Some of it is very opaque.  I think that's one of the problems.
Now for all of you who are little closer to both the agencies that may
not be totally true.  But in general, people don't understand how the
two agencies work and how does the collaboration work.  Who calls who?
That sort of thing.

		And I think some presentation about how we work together is great and
then how we can better work together and what areas that we're not
working in.

And I think we a have very receptive assistant secretary of OSHA who
wants to enhance the relationship.  We've always wanted to because we're
in a role of take our stuff and do something with it.  So we're on the
role trying to get more people paying attention because for us a chief
outcome measure is did it end up in a OSHA or MSHA policy?  Did it end
up in a reg or a rule?  That's a chief way that we assess how our
outcomes have worked.  We have other ways, but that's a chief way.

		So that would be great.  I think that's a central focus of us
strategically is can people suggest how better to do this.  For us it's
always a difficult issue because you don't want to be one of those pesky
partners who's always beating the door down and putting the agencies who
are responsible for these larger approaches in a difficult position
because then they develop an animosity to you.  So we always have to
calibrate how we approach OSHA and MSHA form our perspective.  We can't
be utterly pushy.

		But for instance, in the area of nanotechnology, I think a real
achievement is being able to have an interagency agreement on that.
I've been talking to the last three assistant secretaries about getting
it.  So it's  a real achievement, but you have to know how to approach
it.

		CHAIRMAN SILVERSTEIN:  The point is really well taken.  When you
initially made the comment about the OSHA and NIOSH relationship I
starred that one and Peg brings it back in a specific context about
rulemaking, which I think has been an area where we have really failed
to meet congressional intent for a long time and it may be a possibility
to make some breakthroughs there.  So we'll keep that on the list for
discussion later today.

		Other comments before we move on to Gulf Oil issues?

		(No response.)

		CHAIRMAN SILVERSTEIN:  The next item on the agenda is an update on
Gulf Oil response.  We're interested in hearing where the agencies are,
what you've been doing as well as thoughts you've had about the
recommendations that we made to you.

		So I think Debbie you're going to come up and join John.

		MS. BERKOWITZ:  Yes.  We're a little early.  Do you want to take a
break now?

		CHAIRMAN SILVERSTEIN:  We could.  Would the committee like to take a
break now?  It would be a good time.  It's 10:15 now.  So we'll
reconvene for Gulf Oil at 10:30.

		(Whereupon, a short recess was taken.)

		CHAIRMAN SILVERSTEIN:  Our next agenda item is a discussion about the
Gulf Oil spill response from both OSHA and NIOSH.  There are some
materials in your packet that I'll draw your attention to, but this
takes me back to something Peg mentioned at the very beginning.

		As part of my learning experience as Chair of this committee, I really
feel like it's my responsibility to make sure that we've done some up
front work so that you're provided with materials well in advance of the
meeting.  So I bring your attention to some documents that are in your
packet that you did not receive earlier, but it is a personal intention
of mine to do some more work with the agencies well in advance of the
meetings so that you have materials and prepare yourself for the meeting
better.  And you can hold me accountable for that.

		One of the items that is in the packet is a letter that I received
from John Howard in response to the recommendations that we'd made at
our last meeting.  And I apologize to the committee for having let that
fall through the cracks, and I did not get that out to you in advance of
the meeting.  We'll have a chance to discuss it here, but it's one of
those things that I intend to clean up in the future.

		But with that, let me turn the meeting over to both Debbie Berkowitz
and John Howard.  I'm not sure which one of you would like to speak
first.  You've been on the agenda for a while, so you can take a rest.
So Debbie.

		MS. BERKOWITZ:  So I'm going to give an update of where we are on the
oil spill and answer questions.  And then Dr. Michaels will be back
tomorrow to talk more about this.

		One thing I wanted to say is I know yesterday there was a report that
was sent around by the Center for Progressive Reform that had some
organizational issue recommendations regarding the National Contingency
Plan and the oil spill.  It was sent to us midday and we haven't really
had a chance to completely look at the report.

		It raises issues and recommendations that we're looking at closely.
And one thing I wanted to say that we noticed right off the bat in the
executive summary and in other places throughout the report that there
were a lot of errors.  And so I thought I would start our presentation
just talking about what the reality was in OSHA and NIOSH in the oil
spill and how it worked for us.

		I'm sorry that the authors of the report didn't talk to OSHA, but
that's what happens.  Our staff actually is meeting today.  We asked
them all together to do a 'lessons learned' and that's where everybody
-- we still have people in the Gulf full-time.  But everybody that isn't
there has been pulled today and that's where Tom Galosi, Cindy Coe, our
regional administrators that were involved, all the area directors are
having a 'lessons learned' that we asked them to do on the oil spill.
And so we will have that for you in our next meeting.  And maybe, as
Mike said, we can get something out ahead of time so you can read it and
then formulate your questions ahead of time.

		So looking back, I was just telling somebody that the Latino Summit
ended on April 16 and came back.  We had the weekend.  And then on April
20, the Deep Water Horizon break exploded and I never unpacked my car.
And I just did it yesterday.  I just took the boxes out on the Latino
Summit.  It really engulfed the agency in a way that I was very proud to
work with people that gave up so many nights and weekends to protect
workers who really rallied to a cause and a calling, especially people
in the field and the people in a couple different divisions here at
OSHA, especially the department DITSM, Technology and Emergency
Management.

		It was a pleasure working with NIOSH.  We got very close to the Coast
Guard and EPA and other agencies.  And at the same time we try very hard
to keep everything moving in the agency so that we weren't sacrificing
other workers health and safety.  And I think that was a challenge and
people rose to it.

		The chronology is, as you probably know, on April 20 the Deep Water
Horizon oil rig exploded.  That afternoon or that evening we had a
meeting at OSHA to figure out what this meant for us.  By April 22, we
had already been talking to the White House about OSHA's involvement,
the national response team was activated.

		On April 23, OSHA went to the first White House briefing on what was
happening.  And by April 26, we had sent our first staff into the field
before oil was anywhere near the shore to start talking with BP and the
Coast Guard of how they were going to clear this up, what they were
going to do.  As you know, at that point we thought the oil was headed
to Louisiana and Louisiana has marshes in all its shore land and this
wasn't going to wash up on a rocky shore.  Also, at that point we didn't
realize it was going to continue until the middle of July.

		So we were down there on the week of April 26, and we started talking
with BP right away about the kind of training they would have to give
workers who were sent out.  And BP brought out a lot of 40-hour HAZ
worker trained people from other parts of the country, put them in their
own housing, gave them their own food.  And starting about that week, we
were on every single morning with the governors of the states that were
involved.

		And as you know, Florida later joined us and Texas.  We had a call
every afternoon with local officials.  And there was real push to hire
local workers.  Hire local workers -- the people, the fishermen that was
displaced.  It was very clear that a lot of the fishermen that were
displaced -- and this all happened to us within the first seven days or
eight days of the spill.  There were a lot of Vietnamese fishermen, so
we started engaging right away with BP on the kind of training that
people would have to have.

		The first actions that all the states, that everybody in terms of the
national contingency plan were laying out clean boom to prevent the oil
from coming to the shore, so there would be no oil exposure.  So those
workers did go out with just about an hour of training from BP.  A lot
of those had already been brought in, as I said, from other parts of the
country to start laying out the clean boom.

		And then by I think it was the second week of the spill, BP had come
up with a four-hour training program that we had required that every
single person that was going to at all come into contact with what's
called 'weathered oil,' and that is people who would be connecting with
oil, not at the source, but as it was coming -- if they're running
skimming operations or on the shore would be exposed to.

		BP hired a company to do that training.  Chip Hughes from NIEHS, our
staff all reviewed the training to make sure it went over health and
safety hazards that they would face, what to do.  And then BP started a
process when they did an open call for workers to send them through this
four-hour training program.

		Our compliance staff by May 3 we already had 20 people in the Gulf and
then until really last week or the week and a half we had mostly about
50 people every day assigned solely to workers in the Gulf.  As you
know, we went into compliance assistance mode, which meant that what we
did was we went to every single staging site.  We went to all the
beaches.  We were on the boats and we were doing hazard identification
and demanding abatement.

		Our job was to ensure that BP protect workers.  Our job was to keep
BP's feet to the fire.  Very early on -- really my first memo I remember
to the deputy secretary was about heat and the problem with -- it was
already 90 degrees by the first week in May and we were already having
first people drop from heat exhaustion.  And we started implementing and
people were starting to work long hours.  And so we started demanding
that BP implement a work rest cycle, shade, Gatorade.

		And what we found was the company would implement it at one site and
it wasn't implemented in the other.  And then we'd go to the next site
and said you have to implement this here.  And then we go back and it
wasn't implemented at the first site because they had changed managers.
At that point, we got very frustrated because that was a bad sign if
this is how BP was going to take workers's safety.  And so Dr. Michaels
connected with Coast Guard because in the end Admiral Allen was then the
head of the spill.

		We wrote him a letter saying we're upset about BP's compliance with
what we're asking.  We signed an MOU with the Coast Guard and what our
jurisdiction was, just making it clear that BP had to implement this
site-wide and BP then implemented this heat stress program site-wide.
And one of the things I wanted to say here was I look back on the spill,
OSHA does not have a specific heat stress standard.  And what BP ended
up implementing site-wide was the Coast Guard's heat stress regimen.  It
is the Army's heat stress regimen, which is a work/rest cycle, plus
shade, plus Gatorade.

		And I think it's because they implemented that that we had 930 people
get sick from heat stress.  Most of that was first aid.  There were some
that were taken to the hospital, but we would have had so many  more
because it is so hot down there.  And we got a lot of the local --
officials were very upset about this heat/rest regimen because they
thought the cleanup wasn't going to happen fast enough.

		And so there was a lot of pressure on the agency to lift that and say,
no, no, no that's okay.  Let people work.  And instead we went back to
BP and said work at night.  Hire more people.  I mean we're trying to
protect workers and be efficient and effective in the cleanup of the
spill.

		The other thing that I think for us as an agency, as you know, and Dr.
Michaels will talk about this tomorrow, is the chemical exposures for
the workers.  We were very concerned about -- we brought in a lot of our
industrial hygienist and then we brought our health response team down
from Utah and they were also there by the second week in May or the
first week in May.

		And our permissible exposure limits are incredibly old and outdated.
And right way we worked with the Coast Guard and BP because we are part
of the unified command right from the beginning that we would be looking
at the lowest recommended occupational exposure limit to judge where
BP's compliance and when workers would need respirators and other
protective equipment.  And that is how we stayed the entire spill.

		And in addition, the other thing that was different in this spill that
I think was very helpful and NIOSH was very instrumental is that we
demanded that BP keep a site-wide injury and illness log, including all
first aid cases.  So you know how the injury and illness logs they're
usually for all cases above first aid.  This was for everything because
this is the way we tried to figure out are there clusters of respiratory
hazards.  We looked at that data every single day to just figure out
what are the patterns, what's happening.

		We were in contact with all local health departments.  We had a call
once a week with all of them.  But then again, as you remember, we're on
with local officials every day.  So if they wanted, they could join that
call also.  So we could hear where are the illnesses, what's happening,
what do people need, where are things going?

		In the end, our staff made 4,000 site visits, and that's all the
beaches and on the boats.  We took over 6,000 exposure assessments
ourselves.  We did put all of this up on our website.  We also demanded
that BP put their exposures up on their website.  We reviewed, I think,
8,000 data exposures from BP through the whole entire spill.

		Very early on, it was clear to us that workers needed to be educated,
not with just a four-training program, and so we instituted that BP
would have safety talks every day on the staging areas before people
went out and when people came in from the boats before they went back
out again they would have safety talks, especially about heat stress and
especially about why you need your personal protective equipment.

		People were provided the gloves and the boots and the Tyvek suits.  We
got a lot of complaints from a lot of local residents, and I completely
understand this that they wanted to keep the beaches open and there were
all these workers in Tyvek suits signaling that this is really toxic and
you can't keep the beaches open.  And so we went through a lot of this
as the oil moved from state to state.  First, it was Louisiana then it
was Mississippi, Alabama, and then in Florida.  So there was a lot of
dialogue.  We worked very hard with local officials in educating the
public and why workers needed to be protected.

		And then our staff did a very good job of constantly bringing up to
BP, every day we would get a list of every site that they went to and
every hazard that they found and all the measurements that they took and
where they were going.  And we would review it at night and the next
morning we would talk to them on the phone, and then we would talk at
9:00 with BP, and that's how the days went.  So it was a constant.

		I remember getting a phone call from Frank Myra, who is a professor at
Hunter saying if all workers could be protected like this.  But it was
great.  We did put as much as we could on the web as we had it.  The
first personal protective equipment matrix got on the web at the
beginning of May and that was replaced later in June by a much more
complicated matrix that went over all those different jobs.

		But if you were working on this spill, if you were doing beach cleanup
and land cleanup, OSHA was there.  We knew the protective equipment you
needed and you were educated about it as you started in your staging
areas.

		As you know, the workers at the source were given respirators right
away.  We didn't really have access to the workers at the source where
the oil was coming out.  That is the Coast Guard's jurisdiction and they
continuous monitoring there and they reviewed the data.  We looked at
the data and NIOSH looked at the data.

		In the beginning of June when they started doing a lot of in-situ oil
burning, we sent our industrial hygienist and we sent NIOSH people going
out and doing the burns and we found that if they followed the
administrative procedures that were supposed to be followed and other
processes that they did not have exposure got above the lowest
recommended levels.  Most of them were very low.

		However, we felt especially as we were moving into the summer with the
wind shifting that wind shifted and all of a sudden workers who were out
there doing the control burns that they could get exposed to high levels
of chemicals.  And so we said to BP you have to provide these workers
with respirators.  The Louisiana Shrimpers Association had really --
that's the one group that had expressed a concern about this and wanted
respirators.

		We then worked with them because they didn't realize they'd have to
shave their beards to have respirators, so we adopted other kind
respirators that they could wear.

		The other thing that happened was at the beginning of the spill people
were laying out clean boom.  By the end of June, they were bringing in
boom that was filled with oil and they were getting covered with oil.
And we demanded right away that BP increase the amount of training
workers get because this is a whole lot more exposure than when we first
started.  So BP came up with an eight-hour training program and they
were just about to start running all the workers.  It's called the
Vessels of Opportunity, which is what they called any boat that they
hired for the spill to run these through the program.

		We were working with the National Institute of Environmental Health
Sciences who was going to help teach this course and of course, so much
of this course was about identifying symptoms and reporting symptoms.
Anyway, there was some training going on, but then there was a fire.
They were going to do the training off-site.  It's about a couple miles
offshore where the boats would come in.  They would go through the
eight-hour training.  They would go out.  There was a fire.  They had to
come into the States and then there was a hurricane and then they capped
the oil.

		So not a whole lot of that training, in the end, went on because there
was no more boats.  There was no more skimming.  There was no burning
and the hurricanes and the booms were lost.  However, some of that
training did go on.  Right after all of the weather that went on, BP
scaled down.  So I think when we addressed you last or within a week of
when we addressed you last there were 6,000 boats and 35,000 workers
employed on the spill or 37,000 on the spill.

		Today there are a whole lot less.  The most number I think there were
37,062 boats.  Today BP on their website says there are 3,000 boats and
20,000 workers, but I think that's an old number.  And I think they need
to update it because we have a list of exactly what beaches they're
going to.  Most of what they're doing now is decontamination.  It's
decontamination of all the boats and the booms and that's really what
we're focused on.

		But before I tell you where we are now, I also want to say one thing
about the agency that was very different in this spill than previous
spills.  I mean, one, I think we were very cognizant of all the concerns
that had been raised to us about Exxon oil spill cleanup and also the
disaster of 911.  And I think we integrated a lot of that knowledge into
making sure that we did things differently.

		And the other thing is that right from the beginning we were part of
the Coast Guard and part of the unified command with the Coast Guard at
the lead and never had any real issues in being there at the table and
having worker safety at the table.  That may be a function of our
President.  It may be a function of our personalities, but we were
there.

		One thing we did right from the beginning was an enormous amount of
community outreach.  OSHA brought in what we call our compliance
assistance specialist who really had done a whole lot of work with
employers, especially small employers and what OSHA requirements are.

		And we had them go down into the Gulf, not only to meet with employers
who were affected by this spill and who now were now were going to go
out on boats or now join the cleanup because that was the only job to
have, but also community and faith-based groups who represented workers
who had lost their jobs and were on the spill.

		We must have done between 50 and 75 organizations that we reached out
to.  We gave presentations to many of them.  We joined up with EPA for a
lot of these.  But from the Vietnamese community and Boat People SOS to
the Latino community to Catholic Charities to United Way we have a list
of where people went so that we would hear from the community, that we
were here for workers.  And our message right way was call us.  We have
1-800 number.  We want to hear from you.

		Right away within the third week of the spill we came up with these
brochures that they're not really low literacy, but it's what we had and
so we put it out so people could see what they could be exposed to.  We
did it in three languages, in Vietnamese, Spanish, and English.  I don't
know if you have it in your packets the little cards in Vietnamese,
English, and Spanish that we distributed.

		When we first testified in Congress in May about what we were doing,
we had already distributed like 30,000 copies of our fact sheets, our
little cards, our books.  And we continue throughout to blanket so that
people would know to call us.

		At the very end of the spill, I would say the last three or four weeks
when the spill moved into Florida we encountered an issue that is
something that I think as an agency we need to review and figure out
what needs to be done to prevent this from the next time.  And that is
we had these companies move in.  BP had required that any supervisor on
a boat or supervisor on an onshore cleanup had to had 40 hours of
training.  And I know NIEHS had their trainers come down and train a lot
of the people initially.

		But then what happened is these companies set up shop.  They came from
out-of-state and they would advertise we can give you the 40 hour in
less.  So that was the first thing that happened and some of our
complaint source officers actually sat in on these and just said no, no,
no.  Or they would train a thousand people with one trainer in a
straight 40 hours, 12 hours days.  It didn't add to 40, but three days a
week, so you figure the math.

		And then the other thing that happened was people then would get
training from some where, a company and they would say we're not giving
you your certificate until you get a job.  And then the people would get
a job and then for some reasons those companies were laid off.  BP were
constantly allocating resources.  We don't need you here in this beach.
We need you here.  So you were hired one day, fired the next and the
workers wouldn't get their certificate after they worked so they could
go to the next company or the next state to get a job.

		And we ended up getting about 60 OSHA complaints during the spill.  I
would say most of them had to do with not getting their certificate in
the end.  That was really the number one complaint that we were getting.
 We got some whistle blower.  We got some heat stress.  We investigated
all of them.

		We did turn over a lot of this aspects of training that were
fraudulent and that they were holding certificates and taking advantage
of people, or they were not providing 40 hours of quality training and
saying that they were and misrepresenting it in what they were then
saying in their certificates to the Department of Labor's IG's office
and also to the different attorney generals in different states.  So
there are ongoing investigations about that.  That happened at the end
and Dr. Michaels put out a statement about it that I think is in your
packet.

		So that's in nutshell the experience.  As I said, we are now
transitioning in the Gulf because things are very different.  A lot of
the staging areas have been closed.  There is no longer beach cleanup on
a lot of the beaches.  It's mostly tar balls and our main concern is all
the decontamination sites and especially with boats and confined space
entry.  And that's been something we've really been over BP on and that
we're focusing on.  And that's were we are today.

		CHAIRMAN SILVERSTEIN:  Let's hold questions until after Dr. Howard
speaks.  Before I forget it, though, I would make one request of you and
that's if the lessons learned discussions you're having right now
produce a document I would like you to provide us with that document as
soon as it's available.  Dr. Howard?

		DR. HOWARD:  I'm not going to repeat a lot of stuff that Debbie said
because certainly we were involved hand and glove with OSHA and we
really appreciate that.  And I want to extend a personal thanks to
Debbie and Frank Hearl from our office who were literally tirelessly on
all the activities that we did in common.

		I just wanted to emphasize a couple of things.  First of all, you know
this wasn't a Stafford Act FEMA event.  And we've done quite a few of
those Stafford Act FEMA events on the land, but this is a very different
kind of thing on the water.  And I wasn't around when the Exxon Valdez,
working in government, although I was there because I did trainer for
the contractor who was contracted to do the trainer/trainer program.

		But still, this is a very different kind of thing and I thought that
even though it was very different it was very new for all of us.  We did
a pretty good job in interacting with the power structure, which
essentially was Coast Guard and not FEMA. We're very used to the FEMA
issue.

		The other point that I would make, and I've made it several times and
some day I'm going to get the OSHA Medal of Freedom for this is that I
really think that the National Recovery Plan, all of the Stafford Act
issues that OSHA can't be handmaiden to FEMA or the Coast Guard in
getting activated and inserting themselves into the process.  They have
to have their own ability to do it.

		So if you look in the National Plan, you look at ES8 and all that,
they're an annex.  Safety and Health is an annex to the larger issues
and that's really not right.  OSHA needs to be able to say we're coming
in.  We activate ourselves.  That's a point I've been making to anyone
who will listen for several years.

		But the other point I wanted to make is from the perspective of HHS we
had a lot of involvement.  The FTA is much involved, still is in whether
it's safe to eat the fish with NOAA.  SAMSHA was our agency on mental
health issues, very involved in community, issues related to mental
health issues.  NIH, International Institute of Environmental Health
Sciences with the worker education training program, obviously will be
involved very soon and now a little more involved in some of the longer
term health issues.

		CDC, the National Center for Environmental Health and others involved
in working with state health departments in the Gulf trying to do
surveillance, I think that the State of Louisiana health department just
did a terrific job in both collecting information as well as putting it
on the website and giving us all a sense of what was going on there.  I
really thought they did just a tremendous job.

		We're thrilled to work with them on the occupational health side.
Indeed, they're one of our grantees with our state surveillance program,
but they just did a super terrific job.

		From the NIOSH perspective, again, I want to draw attention to
NACOSH's letter from the end of June having to do with the few issues --
the long work hour issues, the assessment of comprehensive resources,
activities that maybe foregone within the two agencies, the third
recommendation about identifying, evaluating, characterizing major
operations that are being conducted in the Gulf, et cetera.

		Those kinds of information helped us as we formulated and went through
this issue.  The first thing that we did is try to do what the
recommendation that you all made is what's really going on there?
What's the matrix here of what's happening?  And we came up with
basically on the water exposure scenarios and on the land exposure
scenarios.  So we had six of them, three on the water and three on the
land.

		The water ones, as Debbie has mentioned, is the source control folks.
That work is obviously exposed to crude as it peculated through the
water column as well as subsurface application of disbursement and they
certainly are at the highest exposure.  And we had the folks that were
engaged in burning, as Debbie mentioned.  And then we had the people
that are engaged in not burning, but in booming and skimming on the
water.

		Then on the land we have the vast number of true cleanup workers, if
you will, responders who are doing all of that kind of cleanup.  You
know a very interesting group of folks.  They were not necessarily what
you would call pure worker types.  All of them were just community
people that came down.  Some of them even volunteered actually, weren't
paid by anybody and the parishes.  That happened a lot.  So that's the
bulk of the people that were involved.

		And then, as Debbie mentioned, this cadre of people that are still now
engaged in decontamination.  Not only decontamination of equipment and
boom and boats and all that, but lots of volunteers came to clean the
turtles and the pelicans and all of that wildlife stuff.

		And lastly, where we had most of the motor vehicle accidents and
people getting squished by trucks and all that kind of stuff is in the
waste stream management process where you're bagging all that dirty sand
and stuff and taking it somewhere, to toxic dumps and all that.  Lots of
trucks and lots of motor vehicles issues going on there during that
process.

		So what we did is we did, and are in the process of still publishing,
we published our sixth HHE report on those essential six exposure
scenarios.  And then when we had that matrix and we presented it to the
Institute of Medicine at their 22nd July meeting -- June?  I can't
remember which month it was.  I think it was July in New Orleans.  Then
we used that as our structure as we went forward.  And one of the
greatest achievements I think that this OSHA/NIOSH interaction over this
particular event was our co-branded interim guidance.

		Now everybody always says OSHA and NIOSH should work well together and
all that.  And they should also do more in this and that and the other
thing.  But to do it is not easy because you have two agencies with
different missions, different viewpoints.  We're in the same statute,
that's true.  Different views about the same set of exposures.
Different opinions about what's more important to emphasize.

		One part of the partnership can't get into some issues like long
hours.  The other part can and make statements about that, co-branded
document.  How do you work all of that out?  That's where I have to
really give credit to Debbie and Frank because in a series -- I mean
every day on the phone going through words and language.  But the end
was, I think,  a real achievement of a co-branded interim guidance for
all the issues that we saw as important for the Deep Water Horizon
response, including the committee's recommendation about long hours of
work.

		And I think that section alone is a real placeholder that we need to
pay attention as important and we need to build on that issue.  Because
I think as we've talked about this morning it's an extremely positive
achievement between OSHA and NIOSH.

		The other thing that we did in addition to producing that guidance on
our side is, as Debbie mentioned, we learned from the World Trade Center
that the first thing that we have to do if there's to be any kind of
followup, and also to help us during response is who's there?  At the
World Trade Center we didn't have a roster of those individuals who were
there.

		It's not anything but basic demographic information, but we began to
roster by running around the Gulf at the beginning trying to find people
who were already out there and then we did it more routinized within the
training centers.  As people came in, then they got rostered.

		So if you look at our website, and believe me, everything that I'm
talking about is on the website.  We have about 52,000 people rostered.
Now there are lots of people on there.  It's a different list than the
badging list that the Coast Guard kept.  President Obama's name is on
the badging list, for instance.  My name is on the badging list because
we visited there.  So you get a badge, your name gets on the list.  So
there are two lists.  They don't necessarily correlate.  The roster list
is everybody.

		Now that we will have for the future as we go through time and doing
studies.  The HHEs are all there.  The interim reports are there.  We're
going to have a final report that will be one comprehensive, global HHE
report.  We're not there yet because we're still analyzing data.

		As Debbie mentioned, one of the other, I think, significant
achievement is that we made a realtime injury and illness safety log
kind of information.  And that is, we then took it -- and believe me it
was in sorry shape.  And our staff and the Emergency Response
Preparedness Unit spent hours and hours and hours making it into a
legible, readable, utilizable piece of information and those are on our
website.

		Bar none, heat stress was the number one problem and lacerations,
rashes, and getting hit by a vehicle that you're in the wrong place for
and all these vehicles in a very small area.  I explained to a committee
one time that I was testifying in front of when they're obsessed with
the cruel oil.  I said, yes, there's cruel oil exposure, but there's
also 50,000 people out there in a very small area running into each
other.  Those are real hazards, too.  So that entry notice data I think
is another real achievement.

		We also obtained, through a lot of work and effort, and I thank BP for
this.  We obtained samples of the disbursements, 50-gallon samples of
the disbursement.  And we also obtained unadulterated, meaning
non-disbursement contaminated crude oil from the Macondo well.  So we
are doing animal toxicity studies now as a first step to look at acute
toxicity of crude and disbursement.

		This is a very unusual crude.  It's not the same kind of crude that
exist all over the world.  There's a very, very absent kind of sulfur
content to this crude.  It's a very different kind of crude.  The
disbursement are the big issue and they will continue to be the big
issue.

		I think primarily because if you're going to put a million pounds of
them, even though the workplace that you're talking about is a 600,000
square mile body of water, nevertheless, a million pounds of a chemical
in close proximity either in three ways -- through subsurface
application or the airplanes, which I testified several times please
stop spraying this by an airplane because there are people underneath.
And then on the vessels with little sprayers over the side and they
would go through the surface.

		So whatever way I think that will be continuing to be the toxicity
issue that will follow because there's a couple issues with regard to
that.  Not only did the event happen, but what are the implications for
the use of that large amount of disbursement in future tanker spills or
oil spills?  Have we now established that's going to be pattern and
practice?

		We have to establish whether or not that's a helpful pattern and
practice if that's going to be the way that you break up oil and take
care of oil spills.  So I think that's going to be the number one health
issue as we go through.  And the second big health issue will be the
community behavioral stress issues due to social disruption, economic
disruption, all of that within the community.  I think that would be the
next big thing.

		So in terms of where we're going now, there will be an Institute of
Medicine meeting on the 22nd of September in Tampa, Florida.  The
Institute of Medicine has a panel of health experts that will be looking
at whether or not longer term studies are warranted, what kind of
studies should be done.  One example of a study is the National
Institute of Health have a 91-page protocol on the ION website that you
may want to look at trying to look at perhaps a longitudinal, a large
longitudinal cohort of folks that were exposed in this response.

		So I just wanted to also point out that the committee, in addition to
their long hours recommendation, which we incorporated into the interim
guidance, made the second recommendation about having OSHA and NIOSH
prepare a comprehensive assessment of resources.

		What we did there from our perspective is that what we did is say,
look, we're sending a lot of people down there for travel and hotel.  We
billed the Coast Guard for that and the Coast Guard gave us an account
for that.  What we did not do is that we used our own funds to do all of
our HHE analysis because we didn't want our HHE results to -- anyone to
say that they were compromised by funding from outside of NIOSH.

		We continue to that with animal toxicity studies.  We will only pay
for that by ourselves and we look forward to those studies.  I'm happy
to report about those as we go through time.

		CHAIRMAN SILVERSTEIN:  Thank you.  Questions for either OSHA or NIOSH?

		MR. BUCHAN:  This is a learning experience for me.

		DR. HOWARD:  For all of us.

		MR. BUCHAN:  I've heard a lot about the disbursements, but I don't
know what they are chemically and what the toxicology is.

		DR. HOWARD:  They're more hydrocarbons.  And the point that I made
don't we have enough hydrocarbons in the Gulf already.  But they're
hydrocarbons that are essentially like a surfactant type of chemical.
The problem is there were two major types.  One was used for only a very
short period of time in may called 95/27, or corrective 95/27
manufactured by the Nalco Corporation, which we have to thank for
getting us the samples of the disbursement to study through an agreement
that we have with them.

		97/25A has a hemolytic agent in it, which can cause blood dysplasia,
hemolytic issues with kidney problems and all this and that.  Then they
switched.  The EPA said no, no, no.  We don't like that.  There was a
very short use there, so we don't  know really how much exposure
actually happened here with that.

		But the larger amount is 95/00A, okay, which does not have as high a
concentration of the butoxyethyl as the 95/27.  It resembles as has been
said by a number of folks more your dishwater detergent as opposed this
high concentration of butoxyethyl.

		MR. BUCHAN:

		CHAIRMAN SILVERSTEIN:  Bill?

		MR. BORWEGEN:  Is this related to the -- any related to the chemicals
EPA just decided to ban in industrial laundry detergents as of a week or
two ago?

		DR. HOWARD:  That I don't know.  I'm not 100 percent sure of.

		CHAIRMAN SILVERSTEIN:  Peg?

		MS. SEMINARIO:  Thank you very much for comprehensive presentations
and for all the terrific work that both agencies did.  I mean I think
it's clear that both OSHA and NIOSH got themselves quickly organized and
activated to be fully engaged in these response activities.

		But I think one of the things that's worth noting here, and it's
similar to what has happened in 911.  It's similar to what happened
after Exxon Valdez, Anthrax that when we have these incidents, and this
was again a different kind of major incident, that all of it is learning
as we go and we need to get beyond that.  And the work that was done
here I think not only your internal lessons learned, but I think laying
out some templates for what needs to happen in the future is really
important.

		And the point that you made, John, at the beginning is that when you
look at the role of occupational safety and health in OSHA, in
particular, in all the formal planning activities and authorities,
whether it's under the Coast Guard in oil spills or the Stafford Act and
instituting national response activities there, worker safety and health
is a side issue.

		DR. HOWARD:  An annex.

		MS. SEMINARIO:  And an annex.  And I think one of the things that
would be important here in the lessons learned is that it does need to
be front and center and integrated and have the plan up front.

		In my recollection also in terms of dealing with the annex, at least
under the Stafford Act is that part of what happens there in the annex
activities is looking at the health and safety of the federal resources,
but not necessarily the private resources.  And here the issue was
mainly the workers who were responding and then also the citizens in the
Gulf.  So I think that's one of the things that we should really think
about and look at here as to how does the work that was done here then
become basically institutionalized in some way so that the next time
this happens, and there will be a next time.  We don't know where it
will be.  Will it be on land or sea, and what the exposure will be?
That there is a better system in place to begin with that can be
followed and so that every step of the way you're not trying to just
figure out this piece, that piece.

		And in this regard, I know from the activity that we were involved
with a lot of the success is -- Debbie said something about
personalities here.  It really was the strength that Dr. Michaels and
Debbie and Dr. Howard and others brought to this in insisting that the
worker safety issues be there.  But if you look at the plan on paper,
that wasn't necessarily the case.

		And we won't always have a David Michaels or a Debbie Berkowitz or a
Dr. Howard.  And so we shouldn't just be relying on the fortuitous
situation that we've got the strong people there who believe, but that
it's got to be built into the systems.  And that has not really taken --
and that's the one thing we take away from this that I think perhaps is
important as we look forward on this.

		And in doing the lessons learned, I think to be clear about what would
have been helpful to the agencies in terms of both authorities,
resources, et cetera to be able to do your job in a more effective way.

		CHAIRMAN SILVERSTEIN:  Debbie?

		MS. BERKOWITZ:  I just wanted to say that at the beginning, Mike, you
talked about issues where the agency could use NACOSH's involvement and
I think this would be a great one about the planning and what should we
do so we're ready for the next one.  I mean this wasn't the Stafford
Act.  This was very different.  This was the National Contingency -- it
was a very different vehicle.  And right from the beginning we were
there.  We were part of it.  And that may or may not be what was on
paper, but we weren't pigeon-holed to having to follow certain things on
paper.

		We did, as John said, we all are getting reimbursed from BP for our
field staff, but our national staff is not and we're all keeping track
of our hours so we can look back and just see, yes, we all did work
24-hour days.  But I think it would be very helpful if this is something
that NACOSH could take a look at and we're happy to work with you.

		CHAIRMAN SILVERSTEIN:  We do have time scheduled for workgroups later
and we do have one workgroup already in place, specifically on this
issue and I think it certainly ought to be taken up during that
conversation later.

		Are there other comments or responses to this issue that was just
brought up?

		(No response.)

		CHAIRMAN SILVERSTEIN:  We'll deal with that in the working group later
today.  We will not let that one drop.

		Other thoughts, questions, comments on Gulf Oil issues?

		MS. SEMINARIO:  I have just a question of a follow up of a specific
question here.

		You talked about the major work going on right now is decontamination
and also the fact that those are the folks that needed more training,
like the eight-hour training I think you said.

		MS. BERKOWITZ:  No, they didn't --

		MS. SEMINARIO:  Because there's more exposure in terms of what they're
dealing with as far as contaminated booms, boats, whatever.  And so what
kind of training are these people who are involved in this having,
because obviously their exposure is more than dealing with the tar balls
on the beach.  And what level of resources is the agency now devoting to
the follow up with the work that remains?

		DR. HOWARD:  On the exposure issue for decontamination workers, we
have an HHE on that issue.  We were concerned earlier on.  I think
Debbie mentioned this is not Exxon Valdez where we had that ridiculous
power washing of the rocks like you were Ms. Manners trying to clean up
the Laura Ashley showroom after an oil spill or something.

		First of all, we knew that it was a marsh.  There were no rocks that
they'd want to pressure wash. But then we thought if they're
decontaminating all this stuff and they're going to be using hoses and
all that kind of stuff we were concerned about that.  So we did an HHE
about that issue.

		Now I don't know how it got translated then in terms of the training
those particular individuals have.  That I don't know because we weren't
so much involved on the training side.  But we were very concerned about
exposure and being able to figure out what was going on in that area.

		MS. BERKOWITZ:  We are monitoring the decontamination sites because
that's one of the areas where we'd let BP know workers may need
respirators and they should have them.  And as I read most of the site
reports, so far the exposures have not been high enough to trigger any
of that.

		And in terms of the training, it's not completely true that they have
higher exposures.  I mean the people that were going to get the
eight-hour were the workers who were on the vessels of opportunity who
were handling bringing in the contaminated boom, not decontaminating.
They were actually getting it out of the water and getting soaked with
weather oil.  And some of them were fairly close to the source.

		So I can get back to you on -- I actually have all that.  My staff are
not here.  They're all in the 'lessons learned.'

		MS. SEMINARIO:  Right.

		MS. BERKOWITZ:  The exposures that we're really concerned about are
not so much with the weathered oil, breathing it in, but is with dying
in a confined space and just making sure people have their protective
equipment.  And we're constantly monitoring some situations.  As they
set up new areas, we go right in there.

		One thing we've also been in a lot is there's still a lot of wildlife
rescue going on.  And some of this are volunteers and some not.  All of
those people have very extensive training.  They've all had to get 24 or
40 hours.  And we have gone in and done site visits there just to
measure exposure levels and do spot checks of where people are.  And so
we're still keeping our eyes on them because there are still quite a
number of them.  And in terms of the beach cleanup, it's just mostly
removing the tar balls now.

		CHAIRMAN SILVERSTEIN:  Joe, you had your hand up?

		MR. VAN HOUTEN:  It's still a nagging question that I never got an
answer to.  Who has jurisdiction over this whole incident, like who's
investigating the initial deaths of the workers and the follow up to the
explosion?

		DR. HOWARD:  Those are two different questions.  One, who is in charge
is the Department of Homeland Security, Secretary Napolitano.  And then
she appointed the incident commander, Thad Allen.  The Coast Guard is
part of the Department of Homeland Security.  So for purposes of this
type of on-the-water response, they're in charge.

		MR. VAN HOUTEN:  I'm looking at the grander incident, so who's
investigating the explosion that killed the 11 workers?

		DR. HOWARD:  There are a whole bunch of people that are investigating
that.  There's a panel.  The President appointed a panel.

		MS. BERKOWITZ:  Right.  And BP just came out with their analysis,
which was in the -- so BP did there own investigation.  But there are
many federal government investigations in addition.

		MR. VAN HOUTEN:  OSHA does not have jurisdiction?

		MS. BERKOWITZ:  No.

		DR. HOWARD:  No.  It's 3 miles.  That's the end of the line.  But it's
interesting because in this whole process, during this we had a
reorganization of the Minerals Management agency, which has some
jurisdiction.  The Coast Guard has some jurisdiction.  There was a
hearing in front of Energy and Commerce that Dr. Michaels and I
participated in with the new BOMA, the Bureau of Oceans.  I forget their
new name.  They're not Minerals Management any more.  And the Cost Guard
was there.  It was very hard for me to follow who had jurisdiction over
what particular activity on those offshore platforms.  It's a whole area
that I'm not capable of explaining.  But you could read the transcript
from that hearing and try to figure it out.

		MR. VAN HOUTEN:  That's not what this group could talk about?

		CHAIRMAN SILVERSTEIN:  Perhaps.  And I think when we're really
exploring what areas we want to dig into I think we ought to think more
about this one.

		MS. BERKOWITZ:  Let me just add to this and say that even though we