DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Service Centers for Disease Control And Prevention National Institute for Occupational Safety and Health 1090 Tusculum Avenue Cincinnati OH 45226-1998 November 21, 2017 HHE 2018-0022 Sergeant Daniel Hils President, Fraternal Order of Police Lodge 69 1900 Central Parkway Cincinnati, Ohio 45214 Dear Sergeant Hils: Thank you for voicing your thoughts about the health hazard evaluation (HHE) in your November 20, 2017, telephone call. In response, I want to further describe our approach to this HHE. Our scientific approach to investigating cancer cluster concerns includes an evaluation of current workplace conditions and a summary of health concerns from the recent past. We evaluated the current workplace conditions during our walk-through survey on November 15, 2017, and will follow up with additional questions about the building to the facilities manager. To understand recent health concerns, in our letter dated November 20, 2017, we requested information on “each current or past District 5 employee diagnosed with cancer since January 1, 2014.” This sentence was intended to request information on all current or past District 5 employees who had been identified with cancer since 2014. It was not intended to restrict information to only employees with new diagnoses of cancer as of 2014. We apologize for the confusion. As we stated at our opening meeting at District 5 headquarters on November 15, 2017, if union, management, or employee representatives have other records concerning District 5 employees with cancer, we would be happy to review those records as well. We are requesting this information as the first step of an evaluation of a possible cancer cluster. We are following established guidelines for investigating cancer cluster concerns published in a document from the Centers for Disease and Control (CDC) and the Council of State and Territorial Epidemiologists (CSTE) in 2013 (https://www.cdc.gov/mmwr/pdf/rr/rr6208.pdf ). We have adopted these standard principles of cancer cluster evaluations to the occupational setting. For example, the information we requested is part of the “assess initial cases” step in a scientific paper entitled “Investigating clusters in the workplace and beyond” by Brown (1999). 1 These principles, framed in four questions, were described during our November 15, 2017, meeting. Application of this approach can be seen on a NIOSH webpage about cancer clusters (https://www.cdc.gov/niosh/topics/cancer/clusters.html). 1 Brown AM [1999]. Investigating clusters in the workplace and beyond. Occup Med 49(7): 443–447. Page 2 – Sergeant Daniel Hils Please let me know if you have any additional questions about this HHE. I can be reached at (513) 841-4289 or yjx9@cdc.gov. Thank you. Sincerely yours, Sophia K. Chiu -S (Affiliate) Digitally signed by Sophia K. Chiu -S (Affiliate) Date: 2017.11.21 10:50:20 -05'00' Sophia Chiu, MD, MPH Medical Officer Hazard Evaluations and Technical Assistance Branch Division of Surveillance, Hazard Evaluations and Field Studies cc: Ms. Julie Reese, Senior Environmental Safety Specialist, Employee Safety, City of Cincinnati Assistant Chief Terri Theetge, Cincinnati Police Department Captain Bridget Bardua, District 5 Commander, Cincinnati Police Department Dr. Marilyn Crumpton, Interim Health Commissioner, City of Cincinnati Ms. Deborah Allison, Risk Manager, City of Cincinnati Mr. Larry Falkin, Director, Office of Environment and Sustainability, City of Cincinnati Ms. Jamie Accurso, Facilities Manager, Facility Management, City of Cincinnati