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UNITED STATES DEPARTMENT OF LABOR

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ADVISORY BOARD ON TOXIC SUBSTANCES

AND WORKER HEALTH

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SUBCOMMITTEE ON THE SITE EXPOSURE MATRICES

(AREA #1)

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MEETING

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TUESDAY,

JANUARY 16, 2018

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The Subcommittee met telephonically 

at 1:00 p.m. Eastern Time, Laura S. Welch, 

Chair, presiding.

MEMBERS

SCIENTIFIC COMMUNITY:

JOHN M. DEMENT

MARK GRIFFON

MEDICAL COMMUNITY:

LAURA S. WELCH, Chair
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CLAIMANT COMMUNITY:

KIRK D. DOMINA

DURONDA M. POPE

GARRY M. WHITLEY

OTHER ADVISORY BOARD MEMBERS PRESENT:

FAYE VLIEGER

DESIGNATED FEDERAL OFFICIAL:

CARRIE RHOADS
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TABLE OF CONTENTS

Page

Welcome and Roll Call

Carrie Rhoads............................4

COMMENTS ON DOL RESPONSES TO BOARD 

RECOMMENDATIONS 

Recommendation #4: 

Revisions of the Occupational History

Questionnaire (OHQ)

Laura Welch.............................10

Recommendation #3:

Causal Link between COPD and VGDF

Laura Welch.............................27

Adjourn

Carrie Rhoads...........................40
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1 P-R-O-C-E-E-D-I-N-G-S

2 1:10 p.m.

3 MS. RHOADS: Hello, everybody. My 

4 name is Carrie Rhoads. I'd like to welcome you 

5 to today's teleconference meeting of the 

6 Department of Labor's Advisory Board on Toxic 

7 Substances and Worker Health, the Subcommittee 

8 on the Site Exposure Matrices or SEM.

9 I am the Board's Designated Federal 

10 Officer or DFO for today's meeting.

11 First, we'd like to let the Board 

12 Members know that we appreciate their work in 

13 preparing for this meeting and for all the work 

14 they've been doing the whole time.

15 I'll introduce the Board Members and 

16 we'll take a quick roll.

17 Dr. Laura Welch is the chair of this 

18 group. Are you on the line?

19 CHAIR WELCH: Yes.

20 MS. RHOADS: And the other members 

21 are Dr. John Dement --

22 MEMBER DEMENT: Here.
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1 MS. RHOADS: Mr. Garry Whitley.

2 MEMBER WHITLEY: Yes, here.

3 MS. RHOADS: Mr. Kirk Domina.

4 MEMBER DOMINA: Yes, I'm here.

5 MS. RHOADS: Mr. Mark Griffon. I'm 

6 not sure if he's joined but we'll give him a 

7 second.

8 MEMBER GRIFFON: Yes, I'm here. I 

9 am here.

10 MS. RHOADS: Great, thank you.

11 And then we also have Ms. Duronda 

12 Pope.

13 MEMBER POPE: Here.

14 MS. RHOADS: And Ms. Vlieger is also 

15 on the line as well.

16 MEMBER VLIEGER: Yes.

17 MS. RHOADS: Okay, we're scheduled 

18 to meet from 1:00 to 3:00 p.m. Eastern Time 

19 today.

20 In the room with me is Kevin Bird 

21 from SIDEM, our contractor.

22 In terms of timing, I wasn't 
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1 planning on taking a break today but that can 

2 be up to Dr. Welch, if she would like to take 

3 one.

4 Copies of all meeting materials and 

5 any written public comments are or will be 

6 available on the Board's website under the 

7 heading meetings and the listing there for this 

8 subcommittee meeting.

9 The documents will also be up on the 

10 WebEx screen so everyone can follow along with 

11 the discussion. 

12 The Board's website can be found at

13 dol.gov/owcp/energy/regs/compliance/advisoryboa

14 rd.htm.

15 If you haven't visited the Board's 

16 website, I encourage you to do so. After 

17 clicking on today's meeting date you will see a 

18 page dedicated entirely to today's meeting. 

19 The page contains publically available 

20 materials submitted to us in advance of the 

21 meeting. We will publish any materials that 

22 are provided to the subcommittee even after the 
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1 meeting as well.

2 If you are participating remotely 

3 and you are having a problem, please email us 

4 at EnergyAdvisoryBoard@dol.gov. The sign-in 

5 instructions are up on the web page.

6 If you are joining by WebEx, please 

7 note that the session is for viewing only and 

8 will not be interactive. The phones will also 

9 be muted for non-Advisory Board Members.

10 Please also note that we do not have 

11 a scheduled public comment session today. The 

12 call-in information is posted so that the 

13 public can listen in but not participate in 

14 this subcommittee discussion.

15 The Advisory Board voted at its 

16 April 2016 meeting that subcommittee meetings 

17 should be open to the public and so we'll do a 

18 transcript and minutes from today's meeting.

19 During the Board discussions, as we 

20 are on a teleconference line, please make sure 

21 to speak clearly enough for the transcriber to

22 understand. When you begin speaking, 
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1 especially at the start of the meeting, please 

2 state your name so we can get an accurate 

3 record of the discussion. And also I would 

4 like to ask our transcriber to let us know if 

5 you are having an issue with hearing anyone or 

6 with recording.

7 As the DFO, I see that the minutes 

8 are prepared and ensure they are certified by 

9 the chair. The minutes of today's meeting will 

10 be available on the Board's website no later 

11 than 90 calendar days from today per the FACA 

12 regulations. If they are available sooner, we 

13 will publish them sooner.

14 Also we will be publishing verbatim 

15 transcripts. Those transcripts should be 

16 available on the Board's website within 30 

17 days.

18 I would like to remind Advisory 

19 Board Members that there are some materials 

20 that have been provided to you in your capacity 

21 as Special Government Employees and Members of 

22 the Board, which are not for public disclosure 
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1 and cannot be shared or discussed publicly, 

2 including in this meeting. Please be aware of 

3 this, as we continue with the meeting today.

4 These materials can be discussed in 

5 a general way, which does not include using any 

6 personally identifiable information such as 

7 names, addresses, specific facilities if a case

8 is being discussed, or doctors' names.

9 And with that, I convene this 

10 meeting of the Advisory Board on Toxic 

11 Substances and Worker Health SEM Subcommittee. 

12 And I'm going to turn it over to Dr. Welch, who 

13 is the chair.

14 CHAIR WELCH: Thank you, Carrie. 

15 We have two documents to discuss 

16 today. One is -- and these are both responses 

17 to the comments we received from OWCP on our 

18 prior recommendations.

19 So one is a response to the response 

20 on our recommended revisions of the OHQ and the 

21 other is the COPD presumption.

22 I thought we would take the OHQ one 
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1 first. I thought first I'd see if you all --

2 hopefully, you have had a chance to read it 

3 and, if you have any comments. And then if 

4 not, I have some specific things I want to 

5 point out just to be sure we're all in 

6 agreement.

7 So to open it up, does anybody have 

8 any comments on the Recommendation number 4, 

9 Revisions of the OHQ?

10 Okay. Well, the way -- John Dement 

11 put this one together, primarily. And what we 

12 did was simply summarize why they didn't accept 

13 the Board's recommendation and reiterate why we 

14 think it's important that they should.

15 The Item 1 is about some things that 

16 OWCP has already developed a revised OHQ and 

17 Item 2 is specifically about vapors, gases, 

18 dust, and fumes which we will discuss a little 

19 bit more in the COPD one.

20 We had discussed many of these 

21 points at the last meeting when we were all 

22 together that we didn't particularly like the 
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1 new draft OHQ because it includes free text, 

2 which is one of our recommendations that really 

3 doesn't structure the rest of the question that 

4 would help people remember specific tasks and 

5 exposures and that, you know I think all of our 

6 experience is that they really need to 

7 structure it to use tasks and materials, not 

8 just ask people for a list of what they were 

9 exposed to.

10 And we are reiterating the 

11 importance of having tasks and materials, not 

12 just asking them what were you exposed to.

13 Does anybody have any -- if you 

14 agree with it, you don't have to speak up. I 

15 just want to make sure that you got the gist of 

16 that and that you are agreeing with it.

17 Really what we're doing today is 

18 making sure that our committee is in agreement 

19 so on January 30th, when we review for the 

20 whole Board, we could tell them the 

21 subcommittee discussed it agrees with its 

22 response to comments.
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1 Are you all good with that concept 

2 that we're going back and reiterating that they 

3 really need to use tasks and memory triggers 

4 around tasks and materials?

5 Okay. Is there anything that we 

6 left out of this that you all think you know 

7 when you remember our discussion about the OHQ, 

8 anything you think we should reemphasize?

9 MEMBER GRIFFON: Laurie, this is 

10 Mark Griffon. Can you say a little bit more 

11 about memory triggers because I totally agree 

12 with the concept? I'm just wondering how it is 

13 done and not in a site-specific questionnaire.

14 CHAIR WELCH: Let me see what we 

15 had. I'll get up my --

16 MEMBER GRIFFON: Yes, I'm trying to 

17 remember.

18 CHAIR WELCH: -- yes, what we had 

19 recommended. I can find that in a second.

20 MEMBER GRIFFON: Okay.

21 MEMBER DEMENT: Mark, this is John. 

22 I think one of the issues was we have a fairly 
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1 respectable list of tasks for construction and 

2 it's based on using it for a lot of years. We 

3 don't have as good a list for production 

4 workers.

5 And so this a two-prong attack. One 

6 is to include the tasks we knew about and that 

7 are fairly routine for construction and 

8 maintenance workers but then also to provide --

9 and it is sort of the same context -- if a 

10 worker lists an exposure, you again ask the 

11 task that they did to result in that exposure.

12 The issue with memory triggers is we 

13 found in the BT Medical exam that if we list 

14 tasks and ask workers about them, they are more 

15 likely to remember having done them than if we 

16 simply give them a blank sheet of paper and ask 

17 them to list the tasks that they did. And it's 

18 just a simple jogging of the memory; yes, I did 

19 that task.

20 CHAIR WELCH: I think that one of 

21 the -- so the BTMed we have worked at a list 

22 of tasks. And I think that the other programs 
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1 didn't focus on tasks as much but it wouldn't 

2 be extremely complicated to make some general 

3 list of tasks that would be memory-triggered 

4 for individuals who worked in production 

5 facilities such as you know cleaning carts, 

6 machine parts. We could sit down and make up 

7 such a list. It probably wouldn't be complete 

8 but it would be helpful.

9 And the same with materials. So in 

10 our recommendations, we listed some agents that 

11 should be on the list of hazards that then 

12 would, if someone said yes, I was exposed to 

13 acids and caustics, then the questionnaire 

14 would ask them well what tasks would you do 

15 that led to that kind of exposure. And that we 

16 included in our original recommendation a list 

17 of hazards.

18 And the original questionnaire that 

19 DOL has used for a long time does have some 

20 list of hazards. These are more categories, 

21 which shorten, rather than extending it.

22 I guess in our recommendations, the 
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1 first time around, we didn't really describe 

2 memory triggers but we did talk about how a 

3 worker may not know the names of all the 

4 materials he or she used but will know the 

5 tasks performed. The task alone, even without 

6 the names of the associated hazards can give 

7 the industrial hygienist a sense of what 

8 exposure occurred and then additional questions 

9 need to be asked.

10 And it is reported out in this 

11 response that it's all linked together. So 

12 then the industrial hygienist should be able to 

13 go back and talk to the worker to get more 

14 detail, which is the recommendation that 

15 Department of Labor did accept.

16 MEMBER GRIFFON: Okay, thanks, 

17 Laurie. That's a good clarification for me. I 

18 was thinking we were -- I mean I remember the 

19 expression on tasks. I was thinking of 

20 different sort of memory triggers that you know 

21 we have used things like group interviews and 

22 things like that. I think it would be hard to 
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1 put in a generic. 

2 You know so I'm thinking like it 

3 sounds like there are certain campaigns and if 

4 we said you know we had a list of campaigns 

5 that took place over the years, a lot of the 

6 workers would remember oh, yes, I've worked on 

7 that campaign, or that project, or you know and 

8 that might trigger them to remember what sort 

9 of exposures were involved, et cetera. But 

10 that would be more site-specific and that would 

11 be difficult to do.

12 CHAIR WELCH: Well, no, you know I 

13 mean how many sites are there? Twenty-seven. 

14 It's not like there are thousands of them. And 

15 there's probably only campaigns that you know -

16 - a dozen. So it's really a good idea. It's 

17 another way -- you know in the same way using 

18 maps. If people are able to look at a map, 

19 it's not asking for that task.

20 (Simultaneous speaking.)

21 MEMBER GRIFFON: I didn't think of 

22 that.
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1 CHAIR WELCH: Oh, yes, yes, I 

2 remember working in that building and here's 

3 what I did.

4 MEMBER GRIFFON: Right.

5 MEMBER POPE: This is Duronda Pope. 

6 You could even put down those tasks and have 

7 like a slash or something, or campaign, or 

8 project that you might have worked on in that 

9 building.

10 CHAIR WELCH: Do you think we should 

11 add that, the idea of campaigns added as an 

12 example here that that would be another way in 

13 addition to a list of tasks to see if specific 

14 campaigns would help workers remember?

15 MEMBER POPE: I think that would be 

16 a good idea.

17 CHAIR WELCH: Okay.

18 MEMBER DOMINA: Hey, this is Kirk. 

19 I've got a question.

20 On that campaign type of thing --

21 and Mark might know the answer to this, I would 

22 think with all the data that NIOSH has gone 
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1 through over the years, because they look at 

2 specific things at specific sites when they 

3 know things come up through their interviews or 

4 group interviews, that that would identify not 

5 just the rad site but the chemical, any other 

6 type of occupational exposure because it goes 

7 hand in hand with any of these campaigns that 

8 we've done.

9 MEMBER GRIFFON: Yes, I mean they 

10 have the Site Profile documents that NIOSH has 

11 developed for the large Site Survey, usually in 

12 multiple parts because of the bigger sites, 

13 anyway. But there is also -- they also realize 

14 that they are sort of ever-changing. I mean 

15 they try to get as much information as they can 

16 but often they're missing quite a bit of 

17 information on the first revision and then they

18 modify it as they get more information. Over 

19 the last 15 years, they have certainly modified 

20 many times. 

21 So they're not perfect but they have 

22 a pretty good history of, and like you said, 
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1 it's not only radiation work, it's you know all 

2 these plants, or chemical plants, really, you 

3 know with radiation exposures as well. So they 

4 list the history of projects, too.

5 So yes, and I don't know how much --

6 you know the other thing I would envision is 

7 if, and Kirk, I don't know how they do the 

8 questionnaires but, oftentimes, if you're going 

9 to have the intake person working with them on 

10 the questionnaire, I think this would be where 

11 the intake person could say, if they have 

12 knowledge of the site, they could have that 

13 sort of information to trigger, to help them 

14 answer some of these questions.

15 So I don't know exactly how they 

16 conduct these questionnaires, if they're just 

17 sent out and then someone goes over it with 

18 them on the phone, or how they do that.

19 CHAIR WELCH: I think they do them 

20 in person and they --

21 MEMBER GRIFFON: Oh, they do them in 

22 person?
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1 CHAIR WELCH: Yes, they do them at -

2 - I forget the name -- the centers that they 

3 have.

4 MEMBER GRIFFON: At the centers, 

5 right.

6 MEMBER VLIEGER: This is Faye. Some 

7 are done in person and some are not?

8 CHAIR WELCH: Okay.

9 MEMBER GRIFFON: Yes. 

10 CHAIR WELCH: But Faye if it was, 

11 say it was a Hanford worker, if it was done 

12 over the phone, would it be someone from the 

13 Hanford Resource Center that calls them?

14 MEMBER VLIEGER: Yes, they do phone 

15 interviews but some of are just done on paper. 

16 But people don't remember these things and so 

17 the Resource Center workers have some 

18 experience but they really don't understand the 

19 chemical processes so they can't fill it in for 

20 them and the people don't know the names of the 

21 chemicals.

22 So this use of specific chemicals is 
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1 just daunting.

2 CHAIR WELCH: Yes. Well what I was 

3 thinking too, though, is if there you know this 

4 idea of either things that come out of the 

5 NIOSH Site Profiles for these campaigns, if 

6 there are people at Hanford who are doing the 

7 questionnaire for Hanford workers, there is 

8 even fewer -- they could become a little more 

9 expert in the kind of exposures that people 

10 have or what was done at the facility using 

11 these resources.

12 MEMBER VLIEGER: This is Faye. It 

13 is interesting that on the Site Exposure 

14 Matrix, and I'm looking at Hanford, they have 

15 work processes already but I don't know that 

16 the CEs ever look at this or if the chemicals 

17 listed in these have been vetted to be accurate 

18 and then used for the claimants.

19 CHAIR WELCH: Well DOL recently 

20 added this directory to these linked work 

21 process and it's a pretty narrow, very specific 

22 -- it's a short list of processes and they are 
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1 very specific and some of them probably didn't 

2 occur in the DOE facilities. I think it's a 

3 list of work processes that comes out of HAZ4 MAP.

5 I was very excited when they first 

6 started this process. I thought it was very 

7 helpful but I don't know that they've got a way 

8 to add work processes to the list. I don't 

9 think they have a system. That's something 

10 that the Board can continue to look at down the 

11 road.

12 Because the work processes would be 

13 very helpful. It's a much easier way to do a 

14 claim.

15 MEMBER VLIEGER: I just looked at 

16 one of the work processes at the Hanford Site 

17 Exposure Matrix for coal handler and they list 

18 diesel exhaust, gasoline, gasoline exhaust, 

19 kerosene, kerosene and petroleum mid-distillate 

20 but they don't list coal dust.

21 So I don't know that this is going 

22 to help us either.
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1 CHAIR WELCH: I'm not sure. That 

2 probably doesn't exist there, does it, coal?

3 MEMBER VLIEGER: Yes, it did. 

4 Hanford had a coal-fired power plant for many, 

5 many years.

6 CHAIR WELCH: Oh, okay. Yes, I mean 

7 it's a great idea. It's a very complicated 

8 process but some of them are useful, you know 

9 like if you're a welder, you are exposed to 

10 welding fumes. It helps presume some 

11 exposures, anyway, but making the list longer 

12 would be good. And some of them -- I mean you 

13 look at the list because you can go into SEM 

14 and get a list of all the processes. You don't 

15 even have to do it site by site. I think they 

16 may have about 30 of them in there, quite 

17 specific.

18 So I'll add to this document that we 

19 recommend they add a list of campaigns at each 

20 site as a memory trigger. And then they may or 

21 may not know even what we're talking about but 

22 we need to get it in the recommendation.
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1 What do you think we could do with 

2 the NIOSH Site Profiles? Should we recommend -

3 -

4 MEMBER GRIFFON: Well, I don't know 

5 if that -- I mean I would hope that people that 

6 are working on the SEMs and updating the SEM 

7 are consulting with those documents as well. 

8 So I don't know.

9 But I certainly think --

10 CHAIR WELCH: I think those do get 

11 incorporated into the SEM. It's not --

12 MEMBER GRIFFON: Right.

13 CHAIR WELCH: It may be more useful 

14 like a narrative for people as training. 

15 Because once it goes into the SEM, it becomes 

16 this specific agent at a specific building and 

17 that's maybe not quite as -- you can't just 

18 read it.

19 MEMBER GRIFFON: Right.

20 CHAIR WELCH: Well, I'll put a note 

21 in here that the Site Profiles prepared by 

22 NIOSH could be helpful as background 
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1 documentation for the interviewers.

2 MEMBER GRIFFON: For the 

3 interviewers. Yes, that's good.

4 And I would say campaigns or 

5 projects maybe. I mean campaigns I think tends 

6 to be a specific term for like -- I'm not sure 

7 but I think it's more specific to like Nevada 

8 Test Site; whereas, projects might be a broader 

9 term.

10 CHAIR WELCH: And a project would be 

11 like making a particular like you know -- that 

12 they were machining something for a short 

13 period of time on-site or --

14 MEMBER GRIFFON: Yes, if there was a 

15 project during which they were working on a 

16 certain part or a certain -- you know.

17 And some of them even had classified 

18 names. So it might have been like Project X or 

19 something you know.

20 CHAIR WELCH: And are there lists of 

21 projects?

22 MEMBER GRIFFON: I'm not sure there 
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1 is a master list anywhere but I know that we 

2 ran across that kind of information when we 

3 were putting together the medical surveillance 

4 needs assessment stuff. And I'm pretty sure 

5 NIOSH also did when making their Site Profiles.

6 CHAIR WELCH: Okay.

7 MEMBER POPE: Duronda Pope. I know 

8 at Rocky Flats we had several projects from 

9 time to time that we started and completed. So 

10 projects -- Mark is right, projects might be a 

11 better term than campaign, now that I think 

12 about it.

13 CHAIR WELCH: Okay.

14 So we could add that they should 

15 add, in addition to tasks, they should add 

16 projects to OHQ and then, ideally, have a list 

17 of projects to each site that could be used as 

18 memory triggers for the workers and see how 

19 that goes.

20 That's good, though.

21 MEMBER WHITLEY: Garry Whitley here. 

22 If you go in and file a claim in OHQ and then 
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1 at a later date you go back and file a 

2 different claim for like the first one might be 

3 hearing and the next one might be lung cancer, 

4 do you automatically get to update your OHQ or 

5 do you have to request it?

6 MEMBER VLIEGER: No but you can file 

7 a supplemental.

8 MEMBER WHITLEY: So they don't --

9 you have to request to do that, though, don't 

10 you?

11 MEMBER VLIEGER: You just -- you can 

12 just fill out the form or request to do it at 

13 the Resource Center, yes.

14 MEMBER WHITLEY: Okay.

15 CHAIR WELCH: Do you think you're 

16 done with this one? It's more of the 

17 conversation might spark other ideas. Like I 

18 just don't want to close it out.

19 But we can move to the other one if 

20 people feel we got that one done.

21 MEMBER VLIEGER: Ultimately, what I 

22 would like to see is an interactive form that 
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1 actually looks at these databases because the 

2 Resource Center workers are only as good as 

3 their memories.

4 CHAIR WELCH: Yes, now that would be 

5 good. I know many people in that position that 

6 over the years have talked about developing 

7 that computer-based Occupational History 

8 Questionnaire that could be fairly general, 

9 that would start out with general categories of 

10 work and then ask questions within that that 

11 then become even more specific based on an 

12 algorithm but it has never happened. But it 

13 would be a good idea.

14 Okay, let's go to the COPD one. 

15 This one, I put together -- I took the old 

16 recommendations that we've made but added in 

17 some -- changed it a little bit in trying to 

18 respond to OWCP's comments. Remember we had 

19 the discussion that they said well, vaporous 

20 gas, dust, and fumes isn't the toxic stuff so 

21 it has to be -- the language says the covered 

22 illness has to be at least as likely as not 
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1 exposure to a specific toxic substance was 

2 related to employment and the program has a 

3 definition they use for toxic substance. Plus 

4 they thought that VGDF was way too broad.

5 So the response I put together was 

6 basically that the language -- the enabling 

7 language doesn't need to be in specifics. And 

8 that they have -- there's many examples where 

9 OWCP has been using complex mixtures and 

10 accepting claims from those.

11 We had at the meeting or I had said 

12 I would try to put together a list of -- a more 

13 specific list of agents. But as I thought 

14 about it and talked with John and Mark, we 

15 realized it really wasn't possible to have a 

16 list. There could be a list but then there had 

17 to be ways for other people to get their claims 

18 in.

19 So what we ended up with was that 

20 the presumption may be someone has to have a 

21 presumption of significant exposure to chronic 

22 substance use would occur if they had five 
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1 years of work in a DOE site with the shorter 

2 list of agents; five years of work in any one 

3 of the job titles at a DOE site encompassed by 

4 these major categories of construction, 

5 installation, maintenance and repair and the 

6 claimant's job title is linked to a toxic 

7 substance in the SEM; or five years exposure to 

8 VGDF as recorded in the revised OWCP that 

9 included something that is in one of these 

10 categories of agents.

11 So instead of it just being any dust 

12 or any vapor, we narrowed it but not really 

13 narrowed it that much. It's just I think it's 

14 more understandable to say that we presume if 

15 people were in these job titles, they would 

16 have had an exposure. Or if they weren't in 

17 one of those job titles, if they report 

18 exposures in these categories or the SEM links 

19 their job title to HED categories.

20 And within the SEM for any agent it 

21 tells what category it belongs to. So it's 

22 possible for the claims examiner to do this, to 
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1 say that the worker said they had exposure to 

2 you know trichloroethylene and they can see 

3 that it's in the group of solvents.

4 So my hope was it's a little more --

5 it's more responsive to what their criticisms 

6 were but we're still hanging on to the concept 

7 of VGDF has been an important causative agent 

8 for COPD.

9 So with that intro, any comments, or 

10 thoughts, or additions, or suggestions? Or I 

11 didn't -- I don't think I included here the job 

12 list, those categories of -- Category 47 

13 Construction, and 49, Installation, Maintenance 

14 and Repair.

15 Steve Markowitz has produced some 

16 expanded version of that for the accepted 

17 presumptions. So we would be using the same 

18 list. And he's got very specific job titles 

19 within that community of 30 or 40 job titles 

20 that fall under those categories.

21 All right, somebody was going to say 

22 something.
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1 MEMBER DOMINA: Yes, this is Kirk. 

2 We need to stay with the VDGF just because I 

3 think I brought up at the meeting in Santa Fe 

4 about our tank farm workers are a prime example 

5 because you have all of this mixed into one or 

6 some of the different other processes that we 

7 did, based on lack of ventilation in these 

8 different buildings. And I think that 

9 kind of showed a little bit, too, when we went 

10 into the machine shop at Los Alamos, where you 

11 have the building built in 1953 and all these 

12 different things that has gone on there for 

13 years and years, and all these different 

14 processes, that it is a very real lexicon or 

15 whatever they want to call it. 

16 It needs to be included because I 

17 think some of these people that are making the 

18 decisions don't understand the complexity and 

19 all these things are rolled into one every day 

20 when we were working it.

21 MEMBER DEMENT: This is John. I 

22 think the other thing, based on the discussion 
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1 that Laura, and Steve, and I had with the 

2 literature on COPD clearly supports this VGDF 

3 exposure metric and its relationship to COPD 

4 risk.

5 And so I think scientifically it's 

6 valid, it's defensible, it's supported by the 

7 literature. And as Laura said, there are ample 

8 examples in the SEM itself where complex 

9 mixtures are already considered collectively 

10 together in their relationship with disease.

11 So I think we should stick with our 

12 guns on VGDF.

13 MEMBER GRIFFON: This is Mark 

14 Griffon. I wholeheartedly agree with John on 

15 that.

16 I just had one question on the -- I 

17 think it's at the bottom of the second page, 

18 number 4, Laurie, where it talks about duration 

19 of exposure.

20 CHAIR WELCH: Oh, yes, I'm looking 

21 at that. Yes.

22 MEMBER GRIFFON: The five years can 
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1 be accumulated by a combination of DOE 

2 employment and employment outside of the DOE. 

3 Have we talked --

4 CHAIR WELCH: Yes, I must have 

5 edited that. We decided to take that out.

6 MEMBER GRIFFON: Oh, okay. Yes, I 

7 thought so.

8 CHAIR WELCH: And I'm sorry. I must 

9 have been working from an old document because 

10 at the meeting I understood that the DOL can't 

11 take into account exposure.

12 MEMBER GRIFFON: That's what I 

13 thought, yes. That's the only thing I caught.

14 CHAIR WELCH: Yes, thanks for that.

15 MEMBER GRIFFON: Yes, that needs to 

16 come out.

17 CHAIR WELCH: Yes, I just took it 

18 out of my version and I'm creating a new 

19 version here.

20 I mean I think by combining -- by 

21 using these broad categories of agents, which 

22 are then complex mixtures but dust and fibers, 
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1 I think they really accept that as a complex 

2 mixture. And then the acids and caustics -- I 

3 think this makes it more understandable for 

4 people who are not really versed in the 

5 technicalities of the research and it makes it 

6 more -- I think it's not really changing that 

7 much but I think it's making it more manageable 

8 for a claims examiner. So hopefully, this will 

9 be acceptable.

10 MEMBER POPE: This is Duronda. I am 

11 in agreement with Kirk in regards to do we have 

12 to, do we need to spell it out in terms of the 

13 tank farm. Do we have to spell that out in 

14 order for them to accept them being included?

15 CHAIR WELCH: I don't think so.

16 MEMBER POPE: Okay. 

17 CHAIR WELCH: I mean the tank farms 

18 clearly are a complex mixture, probably vapors 

19 and solvents. The only problem would be that 

20 the workers at the tank farm, they can't 

21 describe any specific exposures. Because they 

22 wouldn't be able to say they were exposed to an 
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1 acid, or a caustic, or a dust, or a solvent.

2 MEMBER DEMENT: But if they filled 

3 out – this is John -- their OHQ, they clearly 

4 could state they were exposed to VGDF and they 

5 could then state where they got it -- from the 

6 tank farm.

7 CHAIR WELCH: Oh, okay.

8 MEMBER DEMENT: I think that is --

9 so if you take the Occupational History 

10 Questionnaire and this presumption collectively 

11 together, I think we're covered there.

12 CHAIR WELCH: That's what I'm 

13 looking at right now. They'd have to be in the 

14 category of this number C, the five years of 

15 exposure to VGDF during DOE employment as 

16 reported in the revised OHQ that assesses VGDF 

17 exposures. But then we say and the SEM shows 

18 this job title or tasks are linked to agents in 

19 one or more of the following toxic substance 

20 groups. 

21 So if the SEM hasn't incorporated 

22 tank farms, then this isn't really going to 
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1 help them.

2 But in a way, this is a presumption, 

3 right? So if there are people whose job 

4 doesn't fit, then they put together industrial 

5 hygiene assessments.

6 You know I think what I should do, 

7 based on that -- what we had before was claims 

8 examiners shouldn't deny claims for COPD if the 

9 worker had fewer than five years of exposure. 

10 But I think what we need to add and they 

11 shouldn't be denied. They should go to full 

12 review if they report VGDF for five years, even

13 if it's not identified in the SEM or something 

14 like that. 

15 Does that make sense? Because I 

16 think -- I don't know that tank farm people 

17 would be covered.

18 MEMBER POPE: Right. So I just 

19 wanted to make sure that you know if we didn't 

20 have to -- if they have to have it spelled out 

21 so they're not excluded from being on that 

22 list, per se.
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1 CHAIR WELCH: So they would need an 

2 IH review. But we still need the -- we need 

3 the questionnaire to have the VGDF questions 

4 and I'm presuming that's true based on the way 

5 this is written.

6 MEMBER DEMENT: The other way they 

7 could possibly get in as a tank farm worker is 

8 a job title. I'm not sure exactly -- you know 

9 there are many different job titles that work 

10 on the tank farms.

11 MEMBER POPE: As a production 

12 worker, like I was, operator, tank farm workers 

13 wasn't, per se, part of the job but it was a 

14 part of the operator job.

15 MEMBER DEMENT: Okay.

16 MEMBER POPE: As an operator, you 

17 would operate a section of tank farms.

18 CHAIR WELCH: So it wouldn't fall 

19 under installation, maintenance, and repair?

20 MEMBER POPE: No.

21 CHAIR WELCH: It would be an 

22 operator job.
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1 MEMBER POPE: Yes.

2 CHAIR WELCH: Because then it 

3 wouldn't be covered under our presumptive job 

4 title.

5 So we have to still put in that 

6 someone who has -- the VGDF question has to be 

7 on the questionnaire. And if people report 

8 that and they are not -- the presumption 

9 doesn't really fit, then we need a detailed IH 

10 review. 

11 And that's because there are going 

12 to be other people, too, who their job title or 

13 task may not even be in the SEM so it can't be 

14 linked to toxic substances groups if it's not 

15 even in the SEM or the exposures they had are 

16 not characterized for that job. 

17 So I will do that.

18 MEMBER DEMENT: Here's another 

19 question. In our response to the comments on 

20 the OHQ, we didn't specifically say that we 

21 still recommended this VGDF exposure questions 

22 be added to the questionnaire.
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1 I mean we've said it in the original 

2 recommendation but in our response, you know 

3 they came back. I think we should probably, in 

4 that response --

5 CHAIR WELCH: Yes.

6 MEMBER DEMENT: -- state that those 

7 questions need to be retained.

8 CHAIR WELCH: Yes, because what we 

9 did say was it would be addressed --

10 MEMBER DEMENT: Right.

11 CHAIR WELCH: -- in the response so 

12 they could do the recommended presumptions. I 

13 can say they will be addressed in more detail 

14 but it has to be retained.

15 MEMBER DEMENT: Yes, they were 

16 linked together.

17 CHAIR WELCH: Okay. I'm making 

18 notes but I'll make it sound a little bit 

19 better and then I can send it to everybody just 

20 to see if you like the way I have expressed it.

21 Well, I think we're okay. We're 

22 going to get a chance to talk about this again 
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1 on our January 30th call. But I will send this 

2 around again with these edits and then mark the 

3 edits and you can make sure they're okay with 

4 you.

5 And if anything else comes up, let 

6 me know and I can -- or we can all respond to 

7 each other, I think as long as respond okay and 

8 see if there is any final edits we want to make 

9 before the 30th.

10 Does that sound okay?

11 Anybody have anything else they want 

12 to add now? Any other comments now? I figured 

13 it would be quick today.

14 Okay, Carrie, I think we're done.

15 MS. RHOADS: Great. Like you said, 

16 if you're sending drafts around, make sure to 

17 copy the Board's inbox as well.

18 And then I think if nobody has 

19 anything else, then we will hear from everybody 

20 on the 30th at our next meeting.

21 (Whereupon, the above-entitled 

22 matter went off the record at 1:53 p.m.)
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