1
Use of Risk Density Mapping to Refine Risk Estimates for Beryllium Exposure at Hanford Kathy Ertell*, Tim Takaro*, Katie Omri*, Lee Newman**, Elaine Faustman, Terry Kavanaugh CRESP - University of Washington; *University of Washington Occupational & Environmental Medicine Program;**National Jewish Medical and Research Center, Occupational Medicine Abstract Beryllium was used in nuclear fuel rod research and manufacturing at the US Department of Energy’s (US DOE) Hanford site in eastern Washington from approximately 1950 to 1988. With the increased recognition of chronic beryllium disease as an occupational health issue, there has been great interest in identifying buildings where beryllium was used and characterizing risk for workers. Although there are workplace exposure records indicating where beryllium was used at Hanford, the records are not believed to be a complete picture of beryllium work at Hanford. Using job histories, an exposure matrix, results of medical screening tests (beryllium LPT) for both current and retired Hanford workers, and recent building characterization data, risk density maps of Hanford work locations have been produced. These maps show person-years of beryllium exposure and job titles by work location for both sensitized and nonsensitized exposed workers. By combining and comparing these multiple sources of information for the risk density mapping, the list of building where beryllium was used has been refined; information about the types of work performed by sensitized workers has been gathered; and the work locations for beryllium-exposed workers have been defined in greater depth. The results of the risk density mapping will help prioritize future building characterization, guide work planning for decontamination and decommissioning; and refine risk estimates for current and former workers. Introduction Beryllium at Hanford Beryllium sensitization and disease have been a topic of great concern to the US Department of Energy (US DOE) in recent years, with the identification of numerous cases of beryllium sensitization and chronic beryllium disease throughout the US DOE complex. Beryllium has been an important metal in nuclear weapons production for years. At Hanford, its most important use was in a zirconium alloy braze ring used in fuel rods for the N-Reactor. It was also used in various research and development projects. Hanford’s fuels development and fabrication occurred in the 300 Area. Fuels-related manufacturing ended in 1988, but many of the buildings still exist and now are used for other purposes. The question of exposure from past activities remains a high priority for both current and former workers. Beryllium - Health Effects The most significant health effects come from inhalation of beryllium dust. In sensitized individuals, an immunologic reaction begins, usually in the lungs, which progresses to form granulomas and pulmonary fibrosis. The scarring interferes with gas exchange and makes breathing difficult. It can lead to death from respiratory failure. Skin reactions, including granuloma formation and slow wound healing, can also occur. The Lymphocyte Proliferation Test (BeLPT) can detect sensitized individuals before they show clinical signs of disease. Be Sensitization Among Hanford Workers, BeLPT (single test) Positive Retired Building Trades Workers 30/427 = 7.0% Retired Production, R&D Workers 17/354 = 4.8% Current Workers 20/420 = 4.8% All Hanford Workers with BeLPTs (Nov 2000) 67/1201 = 5.6% Long Term Stewardship of Beryllium Buildings The higher rate of sensitization in construction workers suggests that remediation workers and others who access the inner structures of buildings (walls, etc.) during maintenance, construction, decontamination, decommissioning (D&D), and demolition may be at higher risk. Improved risk characterization and disease detection along with effective risk communication is a critical need for these workers. US DOE is addressing these needs through new beryllium rules, interagency research funding, building characterizations, and risk communication materials. Evolving site implementation and validation of new laboratory technology and risk communication methods are the next challenges. Risk Density Mapping Rationale Beryllium was recognized as a renewed exposure concern in the mid 1990s. Site buildings have undergone sampling (wipe and air) to determine the level of beryllium contamination in buildings where beryllium was used in the past. As buildings undergo maintenance or D&D, additional characterization of inner spaces and inaccessible areas is being done. Risk density mapping can help prioritize ongoing characterizations. Beryllium Risk Density Mapping Goals Identify higher risk buildings in 300 Area for D&D, maintenance workers. Provide framework for combining beryllium data sets from different sources. Utilize sensitized workers as sentinel events to suggest risk associated with building, and ultimately task within building or operation. Provide a readily accessible format for describing risk to workers. Methods Using two major data sources, a job exposure matrix and occupational history questionnaires, person-years of potential beryllium exposure were summed for each building in the beryllium operations period. Person-years are color coded on the maps. Superimposed are asterisks indicating where sentinel cases with beryllium sensitization or disease have worked. The number represents jobs in a building performed by a sensitized worker. Each job is counted once, but a sensitized worker may have several jobs in the 300 Area and may have worked in several different buildings. Separate maps were produced for each data source, and a combined map of overlaps was produced. Data Sources Job Exposure Matrix A job exposure matrix (JEM) was created to estimate exposure risk for various job categories during the last five decades at Hanford. The JEM used job category and decade of job to estimate exposure. Exposures were rated as unlikely, possible, or probable. The original JEM did not include building. A revised JEM included known beryllium buildings and job categories expected to be at risk of exposure based on type of beryllium operation in building. JEM / Employer Work History File Linkage For the purposes of developing occupational histories for individuals, JEM data was linked to several existing datasets: REX - Hanford radiation exposure files OHH88 - occupational health/work history files compiled by Hanford medical contractor, 1988 Work history questionnaires gathered under Hanford beryllium prevalence study. Former Hanford Worker Questionnaires The other major data source was occupational history questionnaires completed by participants in University of Washington’s Former Hanford Worker Medical Monitoring Program: production workers, union workers (non-construction trades), maintenance workers, professionals, and research and development workers. These questionnaires asked about exposures to various agents, job titles, buildings, and years worked. JEM / Employer Work Histories Beryllium Risk Jobs Person-Years by Building Job categories, building, and production year were used to estimate risk. Jobs with probable beryllium exposure were linked to historical employer work history files and beryllium prevalence study questionnaires, matching on years and job categories. Years for all jobs with beryllium risk were summed by building for total person-years worked by building, with separate analysis for all exposed and sensitized workers. 40,892 job records for 7,769 workers were available for analysis. Former Hanford Worker Questionnaires Be Risk Job Person-Years by Building Person-years were summed for each building using worker’s occupational history questionnaire indicating beryllium risk in each job. Years were divided across several buildings if workers listed several jobs. All years listed for each job were used (10% listed more than 3 buildings per job, with a maximum of 10 buildings per job). Questionnaires for 294 workers were available. Results Results are presented in tabular and map form. Job Exposure Matrix - Employer Work Histories Beryllium Exposed Jobs, Person-Years by Building Top 15 Buildings Number of workers=7,769 Former Hanford Worker Questionnaires Beryllium Exposed Jobs, Person-Years by Building Top 15 Buildings Number of workers = 294 Jobs Held by Sensitized Workers Data from Employer Work Histories Top 15 Jobs by Job Title N=30* Jobs Held by Sensitized Workers Data from Former Hanford Worker Questionnaires Top 15 Job Types by Job Title N=12* 300 Area Buildings Where Sensitized Workers Worked Combined Data, JEM-Employer Work Histories and Former Worker Questionnaires Top 15 Buildings Number of workers = 30* Limitations The total number of beryllium-exposed workers is unknown due to the lack of comprehensive worker rosters, transient workers, and incomplete process information. Recall and memory among former workers is variable. Tracking former workers is difficult. The potential bias in nonresponders is unknown. The importance of particle size/chemistry is unknown, and data regarding details of past exposures is imprecise. No unexposed populations were evaluated for maps. Summary of Findings Risk density mapping holds promise as a technique for reconstructing, organizing, and visualizing exposure patterns and locations in complex, large-scale work environments. The utility of risk density mapping is highly dependent on the availability and quality of underlying data sources. The technique may be helpful for worker risk communication. Future versions will incorporate building characterization data. Consortium for Risk Evaluation with Stakeholder Participation CRESP - Consortium of University of Washington, University of Medicine and Dentistry of New Jersey - Rutgers, and Vanderbilt University This work was prepared with the support of the U.S. Department of Energy under Award No. DE-FG26-00NT40938. However, any opinions, findings and conclusions or recommendations expressed herein are those of the authors and do not necessarily reflect the views of the US DOE. BUILD IN G PERSO N -Y EA RS 333 315 313 280 306 217 300 A rea,unspecified 185 325 182 328 168 308 141 324 134 327 105 309 103 3745 66 329 60 3706 55 314 51 303 50 BU ILDIN G PERSON-YEARS 325 2768 326 2006 333 1989 328 1535 309 1491 3706 1454 308 1428 306 1420 331 1293 324 1016 313 1008 329 843 327 498 320 424 318 351 Job Title N um berofJob Records Engineer,unspecified 87 Environm ental Science Technician 69 U tilitiesO perator 49 M anager 38 H ealth PhysicsTechnician 31 Industrial Engineer 24 Chem ical System O perator 21 Electrician 19 ProfessionalA dm inistrative 14 Scientist,unspecified 11 Firstline Supervisor 10 Chem ical Engineer 9 Technician,unspecified 5 Laborer 5 D rafter 5 N uclearW aste ProcessO perator 4 *N otall sensitized w orkershad em ployerw ork history records.M ostw orkershad m ultiple job titles. Job Title N um berofJobs N uclearProcessO perator 3 H ealth PhysicsTechnician 3 Engineer,unspecified 2 M anager 2 Laborer 2 Security Guard 2 N uclearReactorO perator 2 Instrum entand Control Technician 2 M aterialsScientist 1 Laboratory/Research Technician 1 Technician,unspecified 1 Operator,unspecified 1 U tility O perator 1 Plum ber/Pipefitter 1 Electrician 1 * N otallsensitized w orkershave com pleted questionnairesto date. M ostw orkershad m ultiple job titles. BU ILD IN G PERSO N -Y EA RS 300 A rea,unspecified 24.78 325 23.35 328 12.86 337 11.75 306 11.50 333 10.04 3769 9.79 324 7.67 308 6.21 326 4.22 3702 3.94 3717 3.10 384 2.17 338 1.17 313 0.59 *Notall sensitized workershad em ployerwork historiesorcom pleted questionnaires. M ostworkershad m ultiple w ork locations. Hanford 300 Area Beryllium: Job Exposure History, n=294 Former Worker Beryllium Questionnaire 305 333 327 325 308 3 2 9 309 324 313 326 331 0-100 101-500 501-1250 1251-1500 >1500 Sensitized jobs/bldg (of 11 sensitized workers) Person-Years *(#) *(4) *(28) 3745 328 370 8 314 320 303 Hanford 300 Area Beryllium: Job Exposure History, n=7,769 Job Exposure Matrix 306 318 304 370 6 3718 *(24) *(4) (1) * *(7) *(1) *(1) *(18) *(6) *(8) *(9) (2)* (6)* *(10) *(1) *(14) *(6) 305 333 327 325 308 3 2 9 309 324 313 326 331 0-25 25.1-50 50.1-100 100.1-200 > 200 Sensitized jobs/bldg (of 6 sensitized workers) Person-Years *(#) *(1) *(1) 3745 328 370 8 314 320 303 306 318 304 370 6 *(3) *(1) 3702 3745 * (1) (1)* 370 7 371 7 *(1) 337 338 336 384 321 340 373 1 373 0 372 0 3760 3709 Hanford 300 Area Beryllium: Common Buildings (5/2001) Job Exposure Matrix and Former Worker Beryllium Questionnaire 305 333 327 325 308 3 2 9 309 324 313 326 331 Job Exposure Matrix Former Worker Questionnaire only Both 3745 328 370 8 314 320 303 306 318 304 370 6 3702 3745 370 7 371 7 337 338 336 384 321 340 373 1 373 0 372 0 3760 3709 371 8

Use of Risk Density Mapping to Refine Risk Estimates for Beryllium Exposure at Hanford Kathy Ertell*, Tim Takaro*, Katie Omri*, Lee Newman**, Elaine Faustman,

Embed Size (px)

Citation preview

Page 1: Use of Risk Density Mapping to Refine Risk Estimates for Beryllium Exposure at Hanford Kathy Ertell*, Tim Takaro*, Katie Omri*, Lee Newman**, Elaine Faustman,

Use of Risk Density Mapping to Refine Risk Estimates for Beryllium Exposure at HanfordKathy Ertell*, Tim Takaro*, Katie Omri*, Lee Newman**, Elaine Faustman, Terry Kavanaugh

CRESP - University of Washington; *University of Washington Occupational & Environmental Medicine Program;**National Jewish Medical and Research Center, Occupational Medicine

Abstract

Beryllium was used in nuclear fuel rod research and manufacturing at the US Department of Energy’s (US DOE) Hanford site in eastern Washington from approximately 1950 to 1988. With the increased recognition of chronic beryllium disease as an occupational health issue, there has been great interest in identifying buildings where beryllium was used and characterizing risk for workers. Although there are workplace exposure records indicating where beryllium was used at Hanford, the records are not believed to be a complete picture of beryllium work at Hanford. Using job histories, an exposure matrix, results of medical screening tests (beryllium LPT) for both current and retired Hanford workers, and recent building characterization data, risk density maps of Hanford work locations have been produced. These maps show person-years of beryllium exposure and job titles by work location for both sensitized and nonsensitized exposed workers. By combining and comparing these multiple sources of information for the risk density mapping, the list of building where beryllium was used has been refined; information about the types of work performed by sensitized workers has been gathered; and the work locations for beryllium-exposed workers have been defined in greater depth. The results of the risk density mapping will help prioritize future building characterization, guide work planning for decontamination and decommissioning; and refine risk estimates for current and former workers.

Introduction Beryllium at Hanford

Beryllium sensitization and disease have been a topic of great concern to the US Department of Energy (US DOE) in recent years, with the identification of numerous cases of beryllium sensitization and chronic beryllium disease throughout the US DOE complex. Beryllium has been an important metal in nuclear weapons production for years. At Hanford, its most important use was in a zirconium alloy braze ring used in fuel rods for the N-Reactor. It was also used in various research and development projects. Hanford’s fuels development and fabrication occurred in the 300 Area. Fuels-related manufacturing ended in 1988, but many of the buildings still exist and now are used for other purposes. The question of exposure from past activities remains a high priority for both current and former workers.

Beryllium - Health Effects

The most significant health effects come from inhalation of beryllium dust. In sensitized individuals, an immunologic reaction begins, usually in the lungs, which progresses to form granulomas and pulmonary fibrosis. The scarring interferes with gas exchange and makes breathing difficult. It can lead to death from respiratory failure. Skin reactions, including granuloma formation and slow wound healing, can also occur. The Lymphocyte Proliferation Test (BeLPT) can detect sensitized individuals before they show clinical signs of disease.

Be Sensitization Among Hanford Workers, BeLPT (single test) Positive

Retired Building Trades Workers30/427 = 7.0%

Retired Production, R&D Workers17/354 = 4.8%

Current Workers20/420 = 4.8%

All Hanford Workers with BeLPTs (Nov 2000)

67/1201 = 5.6%

Long Term Stewardship of Beryllium Buildings

The higher rate of sensitization in construction workers suggests that remediation workers and others who access the inner structures of buildings (walls, etc.) during maintenance, construction, decontamination, decommissioning (D&D), and demolition may be at higher risk. Improved risk characterization and disease detection along with effective risk communication is a critical need for these workers. US DOE is addressing these needs through new beryllium rules, interagency research funding, building characterizations, and risk communication materials. Evolving site implementation and validation of new laboratory technology and risk communication methods are the next challenges.

Risk Density Mapping Rationale

• Beryllium was recognized as a renewed exposure concern in the mid 1990s.

• Site buildings have undergone sampling (wipe and air) to determine the level of beryllium contamination in buildings where beryllium was used in the past.

• As buildings undergo maintenance or D&D, additional characterization of inner spaces and inaccessible areas is being done.

• Risk density mapping can help prioritize ongoing characterizations.

Beryllium Risk Density Mapping Goals

• Identify higher risk buildings in 300 Area for D&D, maintenance workers.

• Provide framework for combining beryllium data sets from different sources.

• Utilize sensitized workers as sentinel events to suggest risk associated with building, and ultimately task within building or operation.

• Provide a readily accessible format for describing risk to workers.

Methods

Using two major data sources, a job exposure matrix and occupational history questionnaires, person-years of potential beryllium exposure were summed for each building in the beryllium operations period. Person-years are color coded on the maps. Superimposed are asterisks indicating where sentinel cases with beryllium sensitization or disease have worked. The number represents jobs in a building performed by a sensitized worker. Each job is counted once, but a sensitized worker may have several jobs in the 300 Area and may have worked in several different buildings. Separate maps were produced for each data source, and a combined map of overlaps was produced.

Data Sources

Job Exposure Matrix

A job exposure matrix (JEM) was created to estimate exposure risk for various job categories during the last five decades at Hanford. The JEM used job category and decade of job to estimate exposure. Exposures were rated as unlikely, possible, or probable. The original JEM did not include building. A revised JEM included known beryllium buildings and job categories expected to be at risk of exposure based on type of beryllium operation in building.

JEM / Employer Work History File Linkage

For the purposes of developing occupational histories for individuals, JEM data was linked to several existing datasets:

• REX - Hanford radiation exposure files

• OHH88 - occupational health/work history files compiled by Hanford medical contractor, 1988

• Work history questionnaires gathered under Hanford beryllium prevalence study.

Former Hanford Worker Questionnaires

The other major data source was occupational history questionnaires completed by participants in University of Washington’s Former Hanford Worker Medical Monitoring Program: production workers, union workers (non-construction trades), maintenance workers, professionals, and research and development workers. These questionnaires asked about exposures to various agents, job titles, buildings, and years worked.

JEM / Employer Work Histories Beryllium Risk Jobs Person-Years by Building

Job categories, building, and production year were used to estimate risk. Jobs with probable beryllium exposure were linked to historical employer work history files and beryllium prevalence study questionnaires, matching on years and job categories. Years for all jobs with beryllium risk were summed by building for total person-years worked by building, with separate analysis for all exposed and sensitized workers. 40,892 job records for 7,769 workers were available for analysis.

Former Hanford Worker Questionnaires Be Risk Job Person-Years by Building

Person-years were summed for each building using worker’s occupational history questionnaire indicating beryllium risk in each job. Years were divided across several buildings if workers listed several jobs. All years listed for each job were used (10% listed more than 3 buildings per job, with a maximum of 10 buildings per job). Questionnaires for 294 workers were available.

ResultsResults are presented in tabular and map form.

Job Exposure Matrix - Employer Work HistoriesBeryllium Exposed Jobs, Person-Years by Building

Top 15 Buildings Number of workers=7,769

Former Hanford Worker Questionnaires Beryllium Exposed Jobs, Person-Years by Building

Top 15 Buildings Number of workers = 294

Jobs Held by Sensitized WorkersData from Employer Work HistoriesTop 15 Jobs by Job Title N=30*

Jobs Held by Sensitized WorkersData from Former Hanford Worker Questionnaires

Top 15 Job Types by Job Title N=12*

300 Area Buildings Where Sensitized Workers WorkedCombined Data, JEM-Employer Work Histories and Former Worker Questionnaires

Top 15 Buildings Number of workers = 30*

Limitations

• The total number of beryllium-exposed workers is unknown due to the lack of comprehensive worker rosters, transient workers, and incomplete process information.

• Recall and memory among former workers is variable.

• Tracking former workers is difficult.

• The potential bias in nonresponders is unknown.

• The importance of particle size/chemistry is unknown, and data regarding details of past exposures is imprecise.

• No unexposed populations were evaluated for maps.

Summary of Findings

• Risk density mapping holds promise as a technique for reconstructing, organizing, and visualizing exposure patterns and locations in complex, large-scale work environments.

• The utility of risk density mapping is highly dependent on the availability and quality of underlying data sources.

• The technique may be helpful for worker risk communication.

• Future versions will incorporate building characterization data.

Consortium for Risk Evaluation with Stakeholder Participation

CRESP - Consortium of University of Washington, University of Medicine and Dentistry of New Jersey - Rutgers, and Vanderbilt University

This work was prepared with the support of the U.S. Department of Energy under Award No. DE-FG26-00NT40938. However, any opinions, findings and conclusions or recommendations expressed herein are those of the authors and do not necessarily reflect the views of the US DOE.

BUILDING PERSON-YEARS333 315313 280306 217300 Area, unspecified 185325 182328 168308 141324 134327 105309 1033745 66329 603706 55314 51303 50

BUILDING PERSON-YEARS325 2768326 2006333 1989328 1535309 14913706 1454308 1428306 1420331 1293324 1016313 1008329 843327 498320 424318 351

Job Title Number of Job RecordsEngineer, unspecified 87Environmental Science Technician 69Utilities Operator 49Manager 38Health Physics Technician 31Industrial Engineer 24Chemical System Operator 21Electrician 19Professional Administrative 14Scientist, unspecified 11First line Supervisor 10Chemical Engineer 9Technician, unspecified 5Laborer 5Drafter 5Nuclear Waste Process Operator 4*Not all sensitized workers had employer work history records. Most workers hadmultiple job titles.

Job Title Number of JobsNuclear Process Operator 3Health Physics Technician 3Engineer, unspecified 2Manager 2Laborer 2Security Guard 2Nuclear Reactor Operator 2Instrument and Control Technician 2Materials Scientist 1Laboratory/Research Technician 1Technician, unspecified 1Operator, unspecified 1Utility Operator 1Plumber/Pipefitter 1Electrician 1* Not all sensitized workers have completed questionnaires to date. Most workers hadmultiple job titles.

BUILDING PERSON-YEARS300 Area, unspecified 24.78325 23.35328 12.86337 11.75306 11.50333 10.043769 9.79324 7.67308 6.21326 4.223702 3.943717 3.10384 2.17338 1.17313 0.59*Not all sensitized workers had employer work histories or completed questionnaires.Most workers had multiple work locations.

Hanford 300 Area Beryllium: Job Exposure History, n=294

Former Worker Beryllium Questionnaire

305

333

327

325 308

329

309

324

313

326

331

0-100101-500501-12501251-1500>1500Sensitized jobs/bldg (of 11 sensitized workers)

Person-Years

*(#)

*(4)

*(28)

3745

328

3708

314

320

303Hanford 300 Area

Beryllium: Job Exposure History, n=7,769

Job Exposure Matrix

306

318

304

37063718

*(24)

*(4)

(1)* *(7)

*(1)

*(1) *(18)

*(6)*(8)

*(9)

(2)*

(6)*

*(10)

*(1)

*(14)

*(6)

305

333

327

325 308

329

309

324

313

326

331

0-2525.1-5050.1-100100.1-200> 200Sensitized jobs/bldg (of 6 sensitized workers)

Person-Years

*(#)

*(1)

*(1)

3745

328

3708

314

320

303

306

318

304

3706

*(3)

*(1)3702

3745

*(1)

(1)*

3707

3717

*(1)

337

338

336

384

321

340

3731

3730

3720

37603709

Hanford 300 Area Beryllium:Common Buildings (5/2001)

Job Exposure Matrix and Former Worker Beryllium Questionnaire

305

333

327

325 308

329

309

324

313

326

331

Job Exposure MatrixFormer Worker Questionnaire onlyBoth

3745

328

3708

314

320

303

306

318

304

3706

3702

3745

3707

3717

337

338

336

384

321

340

3731

3730

3720

37603709

3718