Appraisal Survey Occupational Health Program Hanford Occupational Health Foundation, Inc. Richland, Washington April 20-21, 1966

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OCCUPATIONAL HEALTH PROGRAM HANFORD OCCUPATIONAL HEALTH FOUNDATION , INC. Introduction and Summary t ional Safety, liQ, reviewed and appraised Hanford Occupational Health Foundation,Inc. (HOHF) Occupational Health Operation,on April 20-21, 1966. I n ddd it ion,atthe request of the Contractor and the Health & Safety Division, KL, related matters were discussed and advice given. Elements of the program Messrs. E.Quigley and A.Adeline,administrators,and related matters with sent ed by Mr. G. Yes berger, and final reports were given orally to Messrs. The HOHF program istop - notch and has carried on the excellent quality, fine ccjveragtz and reasonable costs program provided by the same staff when they formerly worked for General Electric. health services ; sick absenteeism reporting coordination ; research projects ; : J ~ Ois eligible for service among plants and government workers at Richland ; and the current status of program since last reviewed in July 1964. Discussions dealt with AEC employee 1. HOHF should provide staff and services for all Federal employees and Al X Contractor emp1oyi;c.s o f the Federal Building at the facility built for tlii s purpose inthe Fzderal Building. 2 . HOHF should prs cee d in the de ve lap ment of research projects proposed 3 . HOHF should pd rt ici pate in a free exchange of information refer able t o tlie OH program with the HOHF Contract Administrator ' s Office and the H&SD,RL. 4 . HGHF should cant hue to routine1.y receive and utilize for study and program direction a bsc ii tee data from all of R L ' s prime contractors. An updating oi the description of facility,organization,personnel, administ - ra liu n,operation, program content and experience,records,reports and std tis tics can be found in Attachment B.This may be referenced for comparison t.xc : elle ~ lta unu al Ht?!aLth Operation reports of GE and HOHF may be reviewed.

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Since the overall Occupational Health program remains superior,changes only from the 1964 report prepared by Lloyd Tepper will be mentioned. HOHF incorporated not for profit on August 1, 1965. Dr. Norwood i s All staff who report directly to the President are Trustees, a total of 10 persons. 51% of the voting stock is owned by Drs. Norwood and Fuqua. A 5 - year contract has been made between AEC-RL and HOHF with a negotiable fee the technical contacts are Mr. Zangar and his staff.For good communications, it is therefore obvious that there must be at all times back - and - forth communi cations between Mr.Zan gar ' s staff,Mr. Waggoner's staff and HOHF, s o all are mutually aware o f what is happening. In the contract,periodic examinations are provided at r5-month intervals. HOHF assumes state tax and city business tax and pays Kadlec hospital,for The average yearly total cost is around $684,174 - an average per employee of $65-70. The negotiable fee each year is $20,000 witha $5,000 contingency fund. The attachments (C & D) "Hanford Services and Facilities Catalog Available Services " and "RL Manual Chapter 0528-01" illustrate the mechanisms RL has instituted to in sure that all contractors utilize HOHF services. H&SD, RL asked HOHF to staff and provide services for the health unit constructed for that purpose in the Federal Building. HOHF indicated their willingness to do so and to supply a full - time nurse and supplies at areas - on able cost of around $13,000 ayear. ful discussions were held with Mr.Williams,Mr. Waggoner, Mr. Zangar and Dr. Norwood resulting in tlie attached Letter (Attachment E).During the appraiser ' s visit, it became clear that because the distance from the Federal Building to HOHF is too far for easy walking,persons with minor occupational injuries were not seeking medical attention as they should. Since our last appraisal,the 100 F area reactor has been shut down resulting in the closure of lOOF dispensary.Bat tell e ' s Biology Operation is still in this area - - they receive service from tlie next dispensary6miles Staffing changes include : resignation of Dr. Cooper; retirement of joined the Seattle Northwest Industrial Clinic.Dr.Berry recently reported,having previously been in private practice in Washington State combined with occupational medicine for construction and orchard workers. Dr. Hughes from Montana is planning a career in Occupational Medicine and will enter the Fellowship Program this year.Dr. Kaufman was with the Maytag Medical Division in Iowa for some years, more recently in Samoa and is eligible for Occupational Health Board examinations.

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with prior experience in DEwline, Greenland,has just finished a residency in O lola ry ng ology at the University of Vermont Mary Fletcher Hospital. There are three fewer nurses - all have retired.There has been are duc - tion o f two nurses since the last appraisal.Since the medical treatment station in 100-F Area was closed following reactor cutbacks,the nurses were not replaced.There is pre s cnt ly one psychologist with HOHF. Future plans are for recruiting an additional psychologist. Changes i n program include a considerable expansion in pulmonary function testing,including non - occupational indications such a s emphysema, heavy smokers, cardiac s,etc.Dr. Cooper as a Consultant devotes one - half day to this activity.A proc to sco pica x ami nation is routinely offered to executives and other selected ei u ploy ars.Screening tests for glaucoma have been given to those 35 and older,rather than the former40.In connection with security,a mencal health screen followed by an interview with the psychologist is given t o new employees as indicated.A program to assist problem drinkers is carried out with the assistance of contractor management. A tetanus to x oid immunization program has been instituted.Offers are made t o employees at time of routine examination for assistance to stop smoking. Detection of cancer of breast and cervix health education for females has been instituted. An excellent descriptive brochure describing HOHF (Attachment F) has been issued - HOHF has shtmn admirable community leadership in spearheading the pro - duct ion of a pamphlet entitled and describing "Medicine & Industry " which has been distributed to the public by the Benton - Franklin County Medical Society. HOHF continues masterfully to sample employee reaction to health services This activity spurs individual physicians and nurse sby use o f Attachment G . The new Research6 Dtvelopment Radio-Surgery Unit for surgery of ill juries lil'v-olving radiation is scheduled to be constructed in 1966. An artist ' s sketch is now available. Discussions at th s request of HOHF and RL were held on matters which may be grouped in four general areas; research projects,educational programs, administrative problems on data gathering, and eligibility for HOlIF services. surgery project, HOHF is deeply involved in the Mancuso "Study of Correlation of Mortality of AE'C and AEC Workers Occupational Radiation Exposure Received." ln this connection HOHF will study the amount of medical diagnostic radiation r scei ved by RL contractor workers. This is possible since,in the early years,

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all workers received diagnostic radiation at the Kadlec Hospital. These films, the roentgen o logi st and the original x - ray equipment, and directions for tak - ing various types of x - rays, are still available. By use of a mock-up with film badges placed on x - ray films and on dummies, it will be possible generally to reconstruct the amount of radiation received. ItOHF is interested in stlidyiiig effects of various doses of Promethium and Plutonium237 on healthy human volunteers. the problem of effect of insoluble plutonium through inhalation. Through our assistance, problem areas,such as legal requirements and liabilities and application for AEC license to administer radioisotopes by Drs. Norwood and Fuqiia for overnight observation of subjects at Kadlec Hospital, were success - This work is associated with Another project involves a study of the " Biological Effects of Asbestos is. " IJp t o 200 persons involved primarily in construction worked d months or more with asbestos at RL over the years. What has happened t o them? Current reports suggest the incidence of lung cancer to be 6 times normal in those who have had asbestos is ; tlie incidence of mes i the lio ma is said to be 1000 times normal. HOHF knows o f cases now who worked a t RL. Another project is to study the " Genetic Effects on Offspring of AEC and AEC Contractor Employees from 1944 t o 1959." The HOHF psychologist has interesting studies underway on the " Psycho logi - cal Aspects of Absenteeism" and the " Effects of Temperature Variation on Product iv it y. " The Industrial Hygiene group at HOHF is interested in research projects involving various types of air filters and Oil Mist Air,Cleaning Equipment. All these activities are commendable and should be encouraged. The second area of discussion involved a major education effort which involves a Symi>osium t o be held at RL in Spring 1967 on the " Diagnosis and .-----Treatiuent -of Deposited Radio nuclides. " This Symposium is jointly sponsored quest of Drs. Nur wo d and Harry Kornberg of BNW and with the prior knowledge to assist tlizni i n the overall planning of the scope and agenda ofthe Symposium. 3he yl xv a requested that I chair and coordinate the kf forts of BM and OS t o gather tag ether a completelist of statistics of human cases of (a) significant disposition,(b)poisoning,(c)injury through various portals of entry to describe the ''known'' prt>blem. This is to be followed by description of studies under my to get at the " projected " problem. ?'he Symposium is outlined to follow a certain format : 1)working def in i - t ions will be formulated at start ; 2) the Symposium will be divided into approximately 10 separate areas of interest - each with a chairman and a recorder.Sing la or several papers may be presented in each area but a par - ti cula r attempt will bz made t o have thisa working conference with all par - tic i pants taking part in discussion groups in each area; 3 ) summary panels dl1be presented at the end to formulate conclusions with feed - in having bsen contributed by Chairman and Recorders, and resulting in finalized def i -- n it ions to replace original working definitions ; 4)a text for graduate - level

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reference will result ; 5)since all deposit able radio nuclides are included in the Scope of the Symposium, speakers will be requested to prepare and submit to Richland well in adv;lnce their papers. Then RL will attempt to develop simplified summary brochures on each radio nuclide and these will be sent to all participants before the Symposium to organize discussion and to keep individual radio nuclides separate to avoid confusion. The third related activities area of discussion revolved about what must be done to in sure that NOHF receive routinely and quickly sickness absenteeism experiences from all contractors serviced. To be effective such data must b e comparable one contractor to another, and grouped by small enough organ iz a - t ional units to reflect incipient changes in health status and experiences of groups of employees. HUHP has a great deal of experience and much success in intErpreting the mehning of such data and quickly and productively acting in a preventive manner to obviate more disastrous complications and limit cost from such absence to management toa minimum. To effectively meet this probt o know he has offered to give this matter his urgent attention. Finally,there is the problem asto which employers on RL property should beE lig ib ld fur service fioiri tiOHF. The pro bl tin is illustrated by the follow - in gci r cum st Ln ces.First,there is no question that cost fixed fee plus contractors are eligible for HOHF services. Isochem is to build a plant to process isotopes and since many ofthe employees will move back and forth in assignment from this to their present Rictildnd plant,the company has requested time,there has not been a decision or a request by Washington Public & Power Supply Carp. (WPPSC) t o have their 60 persons receive service. WPPSC will < > pirat * t tie generating portion of the dual purpose reactor program. T t would stem highly dr sirs ble fruin the public relations standpoint, and to prevent conflicts and inequalities for WPPSC employees to receive full HOHF services.