Document daQd5GVxKrLyOmVekE50pnr40

American Petroleum Institute 1220 L Street, Northwest Washington, D.C. 20005 David A Mongitto, Health Scientist (202) 682-8341 PAC. MEMORANDUM TO: FROM: DATE: SUBJECT Occupational and Community Medicine Group David Mongillo 'ON' November 20, 1989 Meeting Minutes from October 26, 1989 Attached please find the minutes from the Occupational and Community Medicine Group meeting held October 26, 1989, in Houston, Texas. In addition, the overheads from Dr. Molenaars presentation are provied. Feel free to call me if you have any questions or comments. cc: H. Spitzer DAM/DR An aquai opooMunty mptoyar American Petroleum Institute Health and Environmental Sciences Department OCCUPATIONAL AND COMMUNITY MEDICINE GROUP Subject to Approval MEET1NG MINUTES Inn on the Park Hotel Houston, TX October 26, 1989 8:30 AM - 3:30 PM ATTENDANCE: Reynold T. Schmidt, M.D. - Chairman Members (or representatives) Present: T. Bridge - Chevron S. Cowles - Shell E. Horvath - BP America D. Logan - Mobil E. Rodriguez - ARCO J. Ross - Ashland R. Schmidt - UNOCAL R. Ficke - Sun K. Gould - Exxon G. Lovett - Conoco D. Molenaar - UNOCAL C. Ross - Shell R* Shaw - Texaco G. Spivey - UNOCAL Others Present: B. Divine - Texaco A. Fisher - Amoco S. Mahagaokar - Pennzoil C. Montgomery - Exxon G. Douglas - Texaco K. Froats - Esso Petroleum Cana H. McDaniel - Unocal C. Skisak - Pennzoil Staff Present: D. Mongillo - API/HESD V. Ughetta - API/OGC R. Drew - API/HESD I. INTRODUCTORY REMARKS Dr. Schmidt welcomed the group. It is his observation that increasing emphasis is on environmental issues. This was highlighted by an earlier plenary session presentation (as part of the API Fall Meeting) which summarized a management report to the API Public Policy Committee. Environmental issues are ranked number one priority and it was speculated in the report, that environmental issues will gain in importance over the next decade. Dr. Schmidt stressed the need for occupational medicine to broaden its horizons in order to MCD 000015011 2 play a meaningful role in responding to environmental health issues. IX. UPDATE API COMMITTEE ACTIVITIES A. Ozone Health Effects (Dr. Logan) Congress is undertaking reauthorization of the Clean Air Act (CAA) and examining the role of petroleum products' contribution to ozone formation and air toxics production. The API Ozone Health Effects Task Force has been focusing on the question of health effects from low level ozone exposure. They are considering the following; o Attempt to duplicate low level ozone health effects from human exposure chamber studies. This is considered a difficult task and may not provide meaningful data. o Focus on the exposure side of the equation. Goal is to get more accurate picture of respiratory function during exercise in the general population. Dr. Logan pointed out that there is a limited budget for research activities and they are therefore trying to develop joint funding with other interested parties. B. Motor Fuels Task Force (Dr. Cowles) Two ongoing API epidemiology studies were briefly summarized: o OH-38A - "A Case-Control Study of Kidney Cancer Among Petroleum Refinery Workers." A revised draft report was received from the contractor in September 1989. All analyses of the exposure ratings revealed either no association or weak associations between kidney cancer and refinery exposures. Analysis of the longest job held produced results somewhat more consistent with a relation between employment and kidney cancer, with increased risk evident among downstream (storage and oil movement) workers. A final report is expected by the end of 1989. o OH-38D - "A Cohort Mortality Study of Marketing and Marine Distribution Worker in the Petroleum Industry with Potential Exposure to Gasoline." The study is approaching the exposure assessment integration phase. Preliminary results should be available in mid 1990 with a final report by the end of 1990. MCD 000015012 3 III. NEUROBEHAVIORAL TASK FORCE UPDATE (Dr, Spivey) Dr. Spivey gave a presentation to the API Research Science Policy (RSP) Group in September, 1989. The presentation was intended to update them about solvent/neurobehavioral effects data and discuss possible API research in this area. Dr. Chris Ryan, a clinical psychologist at the University of Pittsburgh, assisted in the presentation. It is Dr. Ryan's experience that a subset of the solvent exposed population exhibit symptoms compatible with "solvent syndrome." Reference was made to an article by Dr. Ryan in the September issue of Journal of Occupational Medicine on this subject. The RSP agreed to bring the issue to the attention of higher level API committees. In addition, the Neurobehavioral Task Force has received a draft report of a literature search by Drs. Rosenberg and Schaumburg, "Neurotoxicity of Petrochemicals with Special Reference to Neurobehavioral Effects." The report is undergoing review and a revised draft is due by the end of the year. IV. PROJECT UPDATE o API has contracted a report on "Use of Biological Monitoring and Biomarkers - State of the Art Review". Comments were requested of OCMG members on the draft submitted by Battelle. It was generally agreed the report was well written and technically correct. A caution was expressed regarding the many confounders and scientific uncertainties which limit the practical widespread application of biological monitoring/biomarkers in occupational health surveillance programs. The report was accepted by the group. V. PRESENTATIONS o Dr. Gould presented an overview of the medical program Exxon provided in response to the Valdez oil spill. o Dr. Molenaar reported on the results of a substance abuse survey performed by the National Petroleum Refinery Association (see attached). It was his impression that industry physicians did not play an integral role in responding to the survey. He encouraged the group to think of activities API could pursue in the area of substance abuse. Following lunch we had two excellent presentations by speakers outside the petroleum industry: Robert Harrison, M.D. University of California at San Francisco Div. of Occupational and Environmental Medicine San Francisco, CA 94117-0924 (415) 476-1841 MOD 000015013 4 "Sensitivity, Allergy and the Immune System" Paul Brandt-Rauf, Sc.D., M.D. Director, Occupational Medicine Columbia University New York, N.Y. 10032 (212) 305-3464 "Occupational Cancer Biomonitoring" VI. NEXT MEETING Our next meeting is tentatively scheduled for April 1990. Agenda items are welcome. Details will be forthcoming as the date approaches. Submitted by. David A. Mongillo Reviewed by, Reynold T. Schmidt 1989 NPRA MEETING NATIONAL ASSOCIATION (NPRA) MEMBERSHIP US REFINERY OPERATORS - MAJORITY PETROCHEMICAL MANUFACTURERS UTILIZING REFINERY LIKE PROCESSES 1989 NPRA MEETING SUBSTANCE ABUSE PANEL DISCUSSION 32 ITEM QUESTIONNAIRE 118 QUESTIONNAIRES MAILED 64 RESPONDENTS, 50 (REFINERY) 14 (FETCHEM) RESPONDENTS REPRESENT 73% TOTAL US REFINING CAPACITY (16M B/D) .V<6 o.' o.0,ov 1989 NPRA MEETING RESPONDENT DRUG TESTING POLICIES 66% 07 REFINERY RESPONDENTS WITH WRITTEN SUBSTANCE ABUSE POLICIES THE LARGER THE RESPONDENT, THE MORE LIKELY A WRITTEN SUBSTANCE ABUSE POLICY MOST RESPONDENTS APPLY POLICY TO ALCOHOL (13% WITH SEPARATE POLICY FOR ALCOHOL) 100% OP RESPONDENTS WITH SUBSTANCE ABUSE POLICIES PERFORM DRUG ABUSE TESTING \ POLICY COMMUNICATION --WRITTEN MATERIAL --TRAINING SESSIONS --OTHER 1989 NPRA MEETING RESPONDENT DRUG TESTING PROCEDURES REASONS FOR DRUG TESTING DRUG ABUSE TESTING BY CLASS: -- PRE-EMPLOYMENT.............................................................................. 9 6% --FOR CAUSE.............................................................................................93% --ACCIDENT/INCIDENT ....................................................................... 71% --PERIODIC (DOT PHYSICALS) ................................................ 42% --RANDOM TESTING (PROBABLY CONFINED TO POST REHABILITATION) 29% --PERIODIC (ANNUAL PHYSICALS).............................................. 20% DRUG ABUSE TESTING WRITTEN CONSENT (41/45) . 91% 000 ViCV 1989 NPRA MEETING RESPONDENT DRUG TESTING, PROCEDURES AVERAGE DRUG TESTING CONCENTRATION LIMITS SCREENING ALCOHOL AMPHETAMINES BARBITURATES CANNABINOIDS COCAINE HEROXM/MORPHINE BENZODIAZEPINE PCP 05 1000 300 50 300 300 300 25 ( HHS ) CONFIRMATORY (1000) - (100) (300) (300) (25) .05 500 300 50 300 300 300 25 ( HHS ) (500) - (15) (150) (300) - (25) 93% (40/43) CONFIRM INITIAL POSITIVE RESULTS HEALTH AND HUMAN SERVICES GUIDELINES 1989 NPRA MEETING RESPONDENT DRUG TESTING PROCEDURES COST OP TESTING SCREENING, WITH CONFIRMATION SCREENING, WITHOUT CONFIRMATION CONFIRMATION .... 26.97 AVG 22.47 AVG 54.18 AVG MOD 000015020 1989 NPRA MEETING RESPONDENT SUBSTANCE ABUSE TESTING RESULTS 25/000 TESTS IN 1988 (1/2 PRE-EMPLOYMENT) POSITIVE TEST RESULTS AVERAGE 5% (0 - 39%) VARIATION IN POSITIVE DRUG TESTS BY TEST CLASS --DOT (82/714) . . - 8.7% --RANDOM (5 RESPONDERS] (85/2596) . . 3.3% MANNER 07 DATA COLLECTION DID MOT ALLOW DETERMINATION 07 POSITIVE TEST RESULTS POR OTHER TEST REASONS ^C 0001S021 1989 NPRA MEETING RESPONDENT DRUG TESTING RESULTS BY TYPE AMD EMPLOYEE STATUS THC COCAINE BENZODIAZEPINE HEROIN/MORPHINE ALCOHOL BARBITURATES OTHER 59%* 13% 7% 5% 4% 3% 3% 100% EMPLOYEES 45%* 20% 4% 5% 10% 4% 8* 100% *HAY RBTLXCT LONGER RETENTION TIMES WCD 0001502o 1989 NPRA MEETING COUNSELLING AND REFERRAL PROCEDURES FOLLOW-UP ACTION FOR POSITIVE TEST RESULTS BY TEST REASON UNDER INFLUENCE RANDOM injury ACCIDENT/INCIDENT PtQtTt BAP ADMINISTRATIVE EAP ADMINISTRATIVE OTHER EAP ADMINISTRATIVE OTHER EAP ADMINISTRATIVE EAP ADMINISTRATIVE 63% 37% 59% 30% 11% 38% 56% 6% 27% 73% 24% 76% 1989 NPRA MEETING COUNSELLING AND REFERRAL PROCEDURES DRUG TESTING DURING REHABILITATION YES - 87% NO - 13% DURATION AND FREQUENCY OF TESTING NOT CLARIFIED 00 1989 NPRA MEETING COUNSELLING AND_RBFERRAL PROCEDURES REHABILITATION RESTRICTIONS TREATMENT ONLY ONCE.....................................................47% TREATMENT* MORE THAN ONCE.......................................... 53% *(BUT ROUGHLY 1/2 RESPONDENTS LIMIT - FURTHER TREATMENT IN SOME WAY) *00 1989 NPRA MEETING RESPONDENT EMPLOYEE EDUCATION EMPLOYEE AWARENESS CAMPAIGN SUPERVISORIAL TRAINING IN DRUG IDENTIFICATION AND RESPONSE 70% 80%