“More than Just a Number”: Lee Lecturer Defends Occupational Health Guidelines

By Ed Rutkowski

Baltimore Convention Center, Inner Harbor Baltimore, Md. (May 24, 2016)—During the annual Jeffrey S. Lee Lecture at AIHce yesterday, Patrick Breysse, PhD, CIH, issued a strong defense of independent occupational health guidelines, arguing that exposure limits produced by nonprofit organizations and government agencies are indispensable tools for worker protection. Currently head of the National Center for Environmental Health and the Agency for Toxic Substances and Disease Registry (NCEH/ATSDR), Breysse oversees the development of ATSDR Minimal Risk Levels, which estimate the daily human exposure to a substance that is likely to be without significant risk of non-cancer health effects for short-term, intermediate, and long-term exposure durations. MRLs are intended as screening levels to be used by ATSDR assessors to identify potential health effects at hazardous waste sites.

ATSDR—“a gem of an agency,” in Breysse’s words—was created following the Love Canal disaster in the late 1970s to work with EPA on issues surrounding the disposal and cleanup of hazardous waste, and the possible health effects to communities. The agency has worked in more than 6,000 communities in every American state, and is the only agency that responds to petitions from private citizens to perform health studies, Breysse said.

Breysse came to NCEH/ATSDR in 2014 with both a professional and a personal background in industrial hygiene. Breysse credited his father, an industrial hygienist, for getting him started in the field. “My projects in high school were on noise exposure and carbon monoxide exposure,” Breysse joked. He attained his masters in industrial hygiene from Johns Hopkins in 1978 and then joined the faculty of the Hopkins school of public health, where he remained for thirty years. For part of that time he served on the ACGIH Board of Directors as a representative to the Threshold Limit Values for Chemical Substances committee, which develops TLVs. In this role, Breysse said, he developed a lasting appreciation for the committee’s work and the value of occupational health guidelines such as TLVs. At the time, several lawsuits were brought against ACGIH by groups challenging the organization’s right to produce guidelines such as TLVs.

“The guideline is a tool that industrial hygienists and public health professionals can use to determine how much is too much,” Breysse said. Without guidelines, industrial hygienists would be forced to make individual determinations about the health effects of chemicals by personally studying published research on their own. “TLVs are complex distillations of a large body of literature that can be used by industrial hygienists to protect the health of workers,” Breysse said, “and let's not forget how important that is.”

Breysse also emphasized that guidelines such as TLVs are “more than just a number”: they provide extensive documentation about how the number was chosen. He warned that industrial hygienists should not use TLVs without first consulting the documentation. “The documentation is crucial, and without the documentation you shouldn’t be using the number,” he said.

Breysse’s move into government was motivated as much by his father’s professional legacy as it was by his desire for a new challenge. “I was looking for something different, and boy did I get it,” Breysse said.

In addition to MRLs, ATSDR produces “ToxProfiles”—thick technical documents on individual chemicals found at hazardous waste sites, intended for public health professionals—as well as shorter documents called “ToxFAQs” intended for the general public.

Even for an agency such as ASTDR, Breysse said, staying on top of the latest science is a significant challenge. For individual practitioners, that challenge would be insurmountable without occupational health guidelines. “How much is too much is a complicated question, and you have to start with some distillation of the literature,” Bryesse said.

For more information about ASTDR, visit the agency website.

Ed Rutkowski is editor in chief of The Synergist. He can be reached at (703) 846-0734.

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