STEVEN RAY GREEN AND ASSOCIATES 

NATIONALLY CERTIFIED COURT REPORTERS 

404/733-6070 

THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 

PUBLIC HEALTH SERVICE 

CENTERS FOR DISEASE CONTROL AND PREVENTION 

NATIONAL INSTITUTE FOR OCCUPATIONAL SAFETY AND HEALTH 

convenes 

WORKING GROUP 

ADVISORY BOARD ON 

RADIATION AND WORKER HEALTH 

PROCEDURES REVIEW

 

The verbatim transcript of the Working Group 

Meeting of the Advisory Board on Radiation and 

Worker Health held telephonically on Mar. 19, 

2008. 
2

C O N T E N T S

Mar. 19, 2008 

OPENING REMARKS 6 

DR. CHRISTINE BRANCHE, DFO 

PURPOSE OF CALL: STATUS REPORT TO THE SECRETARY 9 

MS. WANDA MUNN, WORK GROUP CHAIR 

WORKING GROUP DISCUSSION 10 

COURT REPORTER’S CERTIFICATE 46 

 
3

TRANSCRIPT LEGEND

The following transcript contains quoted material. Such 

material is reproduced as read or spoken. 

In the following transcript: a dash (--) indicates 

an unintentional or purposeful interruption of a 

sentence. An ellipsis (. . .) indicates halting speech 

or an unfinished sentence in dialogue or omission(s) of 

word(s) when reading written material. 

-- (sic) denotes an incorrect usage or pronunciation 

of a word which is transcribed in its original form as 

reported. 

-- (phonetically) indicates a phonetic spelling of 

the word if no confirmation of the correct spelling is 

available. 

-- "uh-huh" represents an affirmative response, and 

"uh-uh" represents a negative response. 

 -- "*" denotes a spelling based on phonetics, 

without reference available. 

-- (inaudible)/ (unintelligible) signifies speaker 

failure, usually failure to use a microphone. 
4

 P A R T I C I P A N T S 

(By Group, in Alphabetical Order) 

BOARD MEMBERS

CHAIR

ZIEMER, Paul L., Ph.D. 

Professor Emeritus 

School of Health Sciences 

Purdue University 

Lafayette, Indiana 

DESIGNATED FEDERAL OFFICIAL

BRANCHE, Christine, Ph.D. 

Principal Associate Director 

National Institute for Occupational Safety and Health 

Centers for Disease Control and Prevention 

Washington, DC 

 

 

MEMBERSHIP

GIBSON, Michael H. 

President 

Paper, Allied-Industrial, Chemical, and Energy Union 

Local 5-4200 

Miamisburg, Ohio 

MUNN, Wanda I. 

Senior Nuclear Engineer (Retired) 

Richland, Washington 
5

IDENTIFIED PARTICIPANTS 

BEHLING, KATHY, SC&A 

BURGOS, ZAIDA, NIOSH 

CASE, DIANE, DOL 

ELLIOTT, LARRY, NIOSH 

HINNEFELD, STUART, NIOSH 

HOMOKI-TITUS, LIZ, HHS 

HOWELL, EMILY, HHS 

MAURO, JOHN, SC&A 

THOMAS, ELYSE, ORAU 

 
6

1 P R O C E E D I N G S

2 MARCH 19, 2008 

3 (2:00 p.m.) 

4 OPENING REMARKS

5 DR. BRANCHE: This is the Procedures working 

6 group meeting of the Advisory Board on 

7 Radiation and Worker Health. I’m Christine 

8 Branche. I’m the Designated Federal Official 

9 and the Principal Associate Director of the 

10 National Institute for Occupational Safety and 

11 Health. 

12 I’m going to call the names of the 

13 Board members, or actually, would the Board 

14 members please announce your names? 

15 DR. ZIEMER: Paul Ziemer. 

16 MS. MUNN: Wanda Munn. 

17 DR. BRANCHE: Well, so far we do not have a 

18 quorum so we can proceed. Did someone just 

19 join the call? A Board member? 

20 (no response) 

21 DR. BRANCHE: NIOSH staff, would you please 

22 announce yourselves? 

23 MR. ELLIOTT: This is Larry Elliott, the 

24 Director of OCAS. 

25 DR. BRANCHE: I heard Zaida. Was there 
7

1 anyone else? 

2 MR. HINNEFELD: Did you get me, Stu 

3 Hinnefeld, on that? 

4 DR. BRANCHE: No, I think you and Zaida were 

5 speaking at the same time, so thank you, Stu. 

6 Any other NIOSH staff? 

7 MR. ELLIOTT: This is Larry Elliott. I 

8 don’t know if I spoke over or under Zaida and 

9 Stu, but I’m here as well. 

10 DR. ZIEMER: Yeah, we heard you. 

11 DR. BRANCHE: Thank you. Any other NIOSH 

12 staff? 

13 (no response) 

14 DR. BRANCHE: ORAU staff? 

15 MS. THOMAS: Elyse Thomas with O-R-A-U. 

16 DR. BRANCHE: SC&A staff? 

17 DR. MAURO: This is John Mauro. 

18 MS. BEHLING: This is Kathy Behling. 

19 DR. BRANCHE: Other federal agency staff, 

20 please identify yourselves. 

21 MS. HOMOKI-TITUS: This is Liz Homoki-Titus 

22 with HHS. 

23 MS. HOWELL: This is Emily Howell with HHS. 

24 DR. CASE: Diane Case with DOL. 

25 DR. BRANCHE: Are there any petitioners or 
8

1 their representatives on the line? 

2 (no response) 

3 DR. BRANCHE: Any workers or their 

4 representatives on the line, please? 

5 (no response) 

6 DR. BRANCHE: Are there any members of 

7 Congress or their representatives on the line? 

8 (no response) 

9 DR. BRANCHE: Are there any others on the 

10 phone who would like to mention their names at 

11 this time? 

12 (no response) 

13 DR. BRANCHE: Michael Gibson, have you 

14 joined the call yet? 

15 (no response) 

16 DR. BRANCHE: Before I turn it over to Ms. 

17 Munn I’d just ask that if you are not speaking 

18 on the line to please mute your phone to 

19 enhance the quality of our transcription. We 

20 do have a court reporter, and it’s important 

21 that our court reporter be able to catch 

22 everyone’s spoken word. It actually enhances 

23 the quality of all of our being able to hear 

24 what’s being said. 

25 When you’re ready to speak then please 
9

1 unmute your phone. And if you do not have a 

2 mute button, then please dial star six to mute 

3 your phone and the same star six to unmute 

4 your phone. Thank you very much. 

5 Ms. Munn, it’s yours. 

6 PURPOSE OF CALL: STATUS REPORT TO THE SECRETARY

7 MS. MUNN: I think you all have before you 

8 the overview and summary results from the 

9 first set of 33 procedure reviews that SC&A 

10 has put together for us as a starting point 

11 for our discussions. What we’re attempting to 

12 do here is to provide a report which can be 

13 forwarded to the Secretary to keep the 

14 Secretary aware of the progress that’s being 

15 made. 

16 We considered this a good time to be 

17 looking at this particular set of findings 

18 because we have expended, all of us have 

19 expended so much effort in the last year. We 

20 changed the matrix process into a new 

21 archiving capability that we now have. That 

22 was a major step forward and the virtual 

23 completion of our work with the first set. At 

24 least getting it to a point where we know 

25 exactly what’s outstanding and is not is 
10

1 considered a milestone I think for all of us. 

2 The real question that I wanted to 

3 raise for us today is what the form needs to 

4 take if we are going to recommend to the full 

5 Board that we submit such a report. As I 

6 understand it there’s no requirement for us to 

7 submit this report. It would, in fact, be 

8 specifically an information only for the 

9 Secretary, not a recommendation of any sort 

10 involved here. 

11 WORKING GROUP DISCUSSION

12 DR. ZIEMER: I think that’s correct. 

13 MS. MUNN: To the best of my knowledge we 

14 have not done -- 

15 You might remember, Paul. Have we 

16 done a status report of this sort prior? 

17 DR. ZIEMER: The only thing that would look 

18 somewhat like a status report as opposed to a 

19 recommendation on the reports that we have 

20 forwarded to the Secretary on the dose 

21 reconstruction findings and their resolutions. 

22 Those in a sense we would consider required 

23 because we are reporting to him on the 

24 scientific validity of the dose 

25 reconstructions or the quality of the dose 
11

1 reconstructions. 

2 I would look at this as a supplement 

3 to that in a way because the quality of the 

4 dose reconstructions also are related to the 

5 appropriateness of the procedures that are 

6 used to do dose reconstructions; and 

7 therefore, I think it’s appropriate that we 

8 summarize and present the Secretary with this 

9 information because it does relate to the 

10 scientific quality of the work that’s being 

11 done. 

12 MS. MUNN: Yeah, that does relate. I 

13 consider this personally as not a requisite 

14 report but one which prudence would dictate 

15 the issues, and this is a good time to do it. 

16 Now the question that rises in my mind 

17 is whether this format that’s been presented 

18 to us is the appropriate one. I have a major 

19 concern with it. The concern is not with the 

20 content. The concern is with the length. 

21 DR. ZIEMER: I have suggestions on that, 

22 Wanda, I’d be pleased to share. 

23 MS. MUNN: Good. Please do. 

24 DR. ZIEMER: Again, this is Ziemer. I want 

25 to first acknowledge the work of SC&A. I 
12

1 think they’ve done an excellent job in 

2 summarizing the efforts of the review and the 

3 outcomes, and this is a very helpful starting 

4 point. It did occur to me that it has a lot 

5 of detail in terms of what we would usually 

6 submit to the Secretary; and therefore, what I 

7 would suggest is the following or some 

8 variation of this: 

9 Number one, I think we need an 

10 executive summary which I would say should be 

11 about two pages, and I have some suggestions 

12 on what should go in that. And that is the 

13 main thing probably that the Secretary would 

14 see would be a concise summary of what’s in 

15 this report. We could then append this to 

16 that because as you know, for example, our SEC 

17 recommendations are one or two pages 

18 typically, a petition recommendation. But 

19 then we append a lot of backup information for 

20 the record. I’m not convinced that the 

21 Secretary reads all that, but at least he and 

22 his staff have that available as backup. 

23 And I think it’s important for the 

24 record. So I think if we had a good executive 

25 summary, that could constitute the report or 
13

1 the, what you call the main thing we would 

2 give the Secretary. And then this would be 

3 appended to it as the details that provide the 

4 backup. And if I can further elaborate or 

5 shall I stop at this point? 

6 MS. MUNN: Please do. Go right ahead. 

7 Although I want it to be known up front that 

8 Paul and I have not discussed this separately, 

9 but you’re saying precisely what I planned to 

10 say, Paul, so please continue. 

11 DR. ZIEMER: I took the words right out of 

12 your mouth, right? 

13 MS. MUNN: Yes, indeed. 

14 DR. ZIEMER: Here’s what I’m suggesting 

15 should go in the, or something close to this 

16 in an executive summary. First of all I think 

17 an introductory paragraph is appropriate in 

18 both the report and the executive summary. 

19 Then I would say something very close to the 

20 summary of the documents reviewed, not 

21 necessarily the list in the executive report, 

22 but the fact that there were 33 documents 

23 reviewed, maybe something along the line of 

24 the first paragraph of section one. 

25 Then I think the review criteria 
14

1 should be summarized. It may be that we 

2 should include the seven objectives. Maybe 

3 they can be simplified and in executive 

4 summary but indicate what the review criteria 

5 are. I think that would be important. 

6 Then a summary of the numbers of 

7 findings, and I think that should be both by 

8 category, well, I think the total findings, 

9 something like Table 3, Overview of the 

10 Findings. Just the first part of that section 

11 would be enough for an executive summary. 

12 And also we would need a brief 

13 description of the review process. Again, 

14 that could be condensed out of the body of 

15 this report. 

16 And then a summary of the outcomes. 

17 Now here in an executive summary I think we 

18 just need to point out what was the result of 

19 all this, of these findings were. And this 

20 was not as clear I don’t think in the report 

21 itself. But, for example, if we could speak 

22 to the extent to which these findings resulted 

23 either in updates or revisions of procedures, 

24 the extent to which these revisions have 

25 impacted on what NIOSH is now doing, and also 
15

1 -- and this would be along the lines of either 

2 improving or revising procedures. 

3 And then I think we need to say 

4 something along the lines of whether or not 

5 this has resulted in any changes in actual 

6 dose reconstructions. Now, I think we will be 

7 able to say that in spite of these findings 

8 the actual, where there were problems 

9 identified with procedures, that in most or 

10 nearly all cases even with those concerns and 

11 with changes that might have been made, the 

12 previous dose reconstructions were 

13 nonetheless, I think by-and-large, the 

14 decisions would have been the same or pretty 

15 much the same. To the extent that we can 

16 identify the impact of this process on dose 

17 reconstruction I think that’s the part that 

18 needs to be made more clear. 

19 MS. MUNN: Yeah, I agree that that is a 

20 worthwhile -- 

21 DR. ZIEMER: In other words what’s the 

22 impact of doing this. 

23 MS. MUNN: Yeah, and something that I had 

24 not really come to grips with. But what I had 

25 anticipated is showing a number of the items 
16

1 that you just listed by expanding Table 4. If 

2 we expand Table 4 so that it’s including not 

3 just the number of findings but an additional 

4 column or two, one of which indicates perhaps 

5 the number of open items that still remain or 

6 the number that may have been transferred into 

7 some other procedure or to some other work 

8 group for attention would, I think, resolve a 

9 number of the questions that would naturally 

10 arise from looking at this. 

11 If we did that and included not 

12 necessarily a blow-by-blow list of exactly 

13 what transpired with each of these, but an 

14 overall statement with respect to the general 

15 nature of the findings, I think would be very 

16 helpful. It has occurred to me that one of 

17 the things that we needed to say something 

18 about in the earlier part of the executive 

19 summary was a statement that’s already been 

20 made with respect to the significance rating. 

21 But in my mind the significance of 

22 these outstanding items is almost as important 

23 as the fact that it’s an outstanding item, as 

24 a matter of fact, more so. Because if it’s 

25 clear that the items that are currently 
17

1 outstanding are of relatively low significance 

2 as it impacts the overall program are not very 

3 especially as it impacts dose reconstruction, 

4 then I think we’ve made the point. It doesn’t 

5 seem to me that expanding Table 4 with sorting 

6 capability that we have now would be that much 

7 of a problem. 

8 Would it, John, Kathy? 

9 DR. MAURO: I’ll take a stab at that. 

10 Before I answer that I’d like to just say 

11 something about what Dr. Ziemer mentioned 

12 earlier about the (inaudible). I think that’s 

13 going to be very difficult (inaudible) in the 

14 context of the way Dr. Ziemer described. 

15 The way I look at it is we’ve offered 

16 up a number of comments on various procedures. 

17 To a certain extent we know that they’ve been 

18 either accepted by NIOSH and changes made. I 

19 think it’s important to point that out, those 

20 that resulted in part or in whole, some 

21 revision to the existing procedure. I think 

22 that level can be done perhaps working a 

23 little bit with NIOSH. 

24 That change though, let’s say we do 

25 have a change. Then the next level is, well, 
18

1 if that procedure was changed or will be 

2 changed, to talk about its impact, I think 

3 that that’s going to be very difficult. It 

4 very much depends on the case. 

5 MS. MUNN: Now, numerically, I don’t know 

6 how we could actually pull -- 

7 DR. MAURO: No, we could do that. 

8 MS. MUNN: -- pull those numbers out. 

9 DR. MAURO: Unless it triggered a PER. Let 

10 me say it this way. If one of the comments, 

11 let’s say, (inaudible) procedure was of such a 

12 nature that it triggered a PER whereby a 

13 number of cases were (inaudible) reviewed 

14 under the program evaluation, I think that’s 

15 probably the most we could say. 

16 And, of course, that might be true. 

17 That may have happened. Or some of these, I 

18 don’t know if in particular this set of 33 did 

19 trigger or was contributory to a PER. This is 

20 something we’d have to probably work pretty 

21 closely with NIOSH because it’s not apparent -

22 - 

23 DR. ZIEMER: Actually, John, if I might 

24 comment at this point, I actually wouldn’t 

25 expect that this would be an SC&A task to 
19

1 actually assess that particular thing. 

2 DR. MAURO: Okay. 

3 DR. ZIEMER: Because you wouldn’t 

4 necessarily know all the case, suppose there 

5 was a change and Larry and his folks said, you 

6 know, we need to go back and do something or 

7 review something, I don’t think you would 

8 necessarily know, number one, what cases they 

9 reviewed or what they did. Once an issue is 

10 identified and, for example, if NIOSH revised 

11 something, then isn’t it in their sort of 

12 bailiwick to do whatever follow up they feel 

13 is necessary that would have resulted from 

14 that change? Just like a change in some of 

15 the models. They go back and review old cases 

16 and so on. 

17 What I’m wondering though is, and 

18 maybe we would have to have input from NIOSH 

19 on this or maybe we can simply say that 

20 NIOSH’s normal procedure with these findings 

21 is to review their impact as needed or 

22 something like that. 

23 But, Larry, I don’t know if you can 

24 comment on this, but is there some way that, I 

25 think if I’m the Secretary, I want to know 
20

1 what is the impact of this, and how can we 

2 inform him in a way that is helpful. You 

3 know, yeah, we have these procedures and it 

4 looks like there’s a bunch of findings which 

5 if someone just looks at this casually, they’d 

6 say, wow, they have all these problems with 

7 these procedures. So we need to have some way 

8 to give him an idea of what the impact of this 

9 is. 

10 MS. MUNN: Well, and this is one of the 

11 reasons why I think it’s so important for us 

12 to include something about significance 

13 ratings on the summary table that we present 

14 because that is a key issue. And it would 

15 seem to me that if we are going to be able to 

16 put together a summary table that touches on 

17 what are the key points, one of those key 

18 points would be whether any of these have 

19 triggered a PER. We haven’t even mentioned 

20 PERs. 

21 DR. ZIEMER: On dose reconstructions we do 

22 indicate sort of the significance levels of 

23 the various findings. 

24 MR. ELLIOTT: This is Larry Elliott. I’ll 

25 try to answer your question. And certainly I 
21

1 feel Stu is probably more knowledgeable of all 

2 of the procedures that have been reviewed and 

3 where, in fact, an impact might have been made 

4 that we could identify for you. 

5 I do agree though that the PER trigger 

6 is certainly one that would fall out right 

7 away if we can point to one or two of those. 

8 I’m not sure that we can, and I don’t know if 

9 Stu has any thoughts or ideas about this, but 

10 I would also say that it could be that you 

11 send your report transmittal letter to the 

12 Secretary and that’s a question he asks of us. 

13 DR. ZIEMER: We don’t necessarily have to 

14 report to the Secretary what the outcome is. 

15 We could say something about our assessment of 

16 significance. 

17 MR. ELLIOTT: Yes, and it’s your report, and 

18 it’s based upon your efforts and the efforts 

19 of SC&A. You know, I hadn’t seen it going to 

20 include the efforts of NIOSH at this point. 

21 DR. ZIEMER: Right, right. 

22 MR. ELLIOTT: And NIOSH would have to 

23 provide in response to the Secretary’s 

24 specific question in this regard what impact 

25 has been made by all of this work. 
22

1 DR. ZIEMER: Yeah, that would be logical. 

2 MR. ELLIOTT: A reply, but I don’t know. 

3 Stu, do you have any thoughts? 

4 MR. HINNEFELD: Well, only that it would 

5 take a little effort because I think to do 

6 this justice, you’d have to go through the 

7 findings or the findings matrix for those 

8 first 33 and kind of get a, I would have to go 

9 through there and get a handle on what the 

10 resolutions are, and for the resolutions that 

11 changed everything make some judgment or some 

12 statement about how far reaching is the 

13 ramification of that. 

14 MR. ELLIOTT: Okay, I think it is, does 

15 anybody on the phone here know of any PER that 

16 was triggered by any of this work? I 

17 certainly don’t. 

18 MS. MUNN: I don’t right off hand. 

19 MR. HINNEFELD: There was a, I don’t 

20 remember if this triggered the, there was a 

21 Savannah River PER. I don’t know if it was 

22 triggered by this or not or just was, there 

23 was one already underway and so this was added 

24 to it. And I think this came out of procedure 

25 review although it might have come out of a 
23

1 dose reconstruction review. 

2 DR. BRANCHE: This is Christine Branche. 

3 And I’ve been listening to this discussion. I 

4 think the most helpful information to the 

5 Secretary, as Dr. Ziemer as you suggested, was 

6 to summarize it in such a way that if the 

7 Secretary wants to know more, the Secretary 

8 can turn to NIOSH. NIOSH would cull from this 

9 report as well as its own work to provide the 

10 most rich answer to the Secretary. 

11 But I think in order to keep the work 

12 in its proper context and not throw so much 

13 information at the Secretary that it becomes 

14 confusing, and you risk his dismissing it, I 

15 think a good summary that could pique his 

16 interest would be the best advice I can give 

17 you. 

18 MS. MUNN: Thank you, Christine. And I 

19 personally would like to see this done in no 

20 more than three pages. Two would be my 

21 preference, but if we’re going to follow my 

22 own suggestion and expand Table 4 to include 

23 significance ratings and the possibilities of 

24 PERs and whether they’re opened or closed, 

25 then that in itself is going to take a page. 
24

1 And I don’t see how we can get by with less 

2 than -- 

3 DR. ZIEMER: But that could still be in the 

4 body of the report and simply summarized 

5 briefly in a few sentences in the executive 

6 summary. Some certain percent of the items 

7 had this level of significance and many others 

8 had another level. It seems to me that, 

9 again, we want to keep the so-called executive 

10 summary pretty concise and not, I don’t even 

11 see it as having tables itself. 

12 MS. MUNN: Yeah, I certainly did not see any 

13 other table that I would want to appear in the 

14 executive summary other than I was thinking in 

15 terms of Table 4, but you’re absolutely right. 

16 It can be expanded. 

17 DR. ZIEMER: Well, Table 4 itself, you know, 

18 has all the findings by procedure. I think 

19 that’s more detail than you need. 

20 MS. MUNN: Probably is. 

21 DR. BRANCHE: This is Christine again, and 

22 when you mention impact that actually piqued 

23 my interest because I know that the 

24 Department, the Secretary as well as his key 

25 staff are looking for impact. And again, 
25

1 impact is how are programs being changed; how 

2 is the health of, in this case, radiation 

3 workers and claimants, how is their situation 

4 being impacted. But text that’s rich with 

5 information that puts this in its proper 

6 context and can still speak to the impact that 

7 this effort has had on the overall work of the 

8 Board or how it’s reflected on the back of the 

9 work of NIOSH I think will be most helpful. 

10 MS. MUNN: In that light also it is my 

11 feeling that this executive summary should 

12 include a brief paragraph about the newly 

13 developed system that we’ve spent so much time 

14 on, moving from the original matrix to this 

15 one highlighting the fact that this will make 

16 it, this current system which has required so 

17 much effort from all of us will now allow any 

18 individual to be able to track forever the 

19 history of each of these findings from 

20 literally their first presentation to the 

21 final closure. 

22 DR. ZIEMER: That could be included I think 

23 in the description of the review process and 

24 the resolutions of the findings. 

25 MS. MUNN: Yes, I think we need to be very 
26

1 clear about that and make sure it gets the 

2 level of notice that it needs to get. Because 

3 in that description we need to make it clear 

4 that this seems to be such an excellent 

5 archiving tool that in all probability it will 

6 be used by almost, by many of the other 

7 functional –- of the subcommittee and other 

8 work groups in being able to track their 

9 activities. So it’s now an enricher. 

10 MS. BEHLING: Excuse me, Wanda. This is 

11 Kathy Behling. In this report I did include a 

12 Section 3 which just briefly talks about the 

13 new matrix. I just want to understand 

14 clearly. Do we want to expand possibly on 

15 this in the main report plus also put some 

16 discussion of this in the executive summary? 

17 Is that what I’m hearing? 

18 MS. MUNN: I don’t know that Section 3 needs 

19 to be expanded particularly in the report. I 

20 think you summarized it very well so far. I 

21 just wanted to make sure that this particular 

22 section got its due in the executive summary 

23 as well. 

24 MS. BEHLING: Okay, very good. 

25 MS. MUNN: I didn’t want that to get lost 
27

1 because I think that’s very important. We’ve 

2 all spent endless weeks on this, and certainly 

3 SC&A has done a fantastic job of working 

4 through how we’re going to do this and getting 

5 it in the electronic form that will make it 

6 easy for everyone inside the complex to work 

7 with. 

8 MS. BEHLING: Okay, very good. I 

9 understand. 

10 DR. MAURO: Wanda, this is John. I’d like 

11 to go back to the question you raised a little 

12 earlier regarding Table 4 and adding a column 

13 or at least the concept, the concept of 

14 significance of the findings. I think we have 

15 a bit, that may not be doable the way we were 

16 able to do it with regard to, let’s say, the 

17 dose reconstruction reviews where significance 

18 of the finding was able to be scored because 

19 of the magnitude that finding had on the dose 

20 reconstruction. In this case you’ll notice 

21 that we don’t really have a significance. 

22 What we really say is the degree. 

23 MS. MUNN: Well, we have a rating. 

24 DR. MAURO: You can say, well, okay, is the 

25 procedure claimant favorable in instances 
28

1 where, you know, we have all these different 

2 questions. 

3 MS. MUNN: Yes. 

4 DR. MAURO: And the way we answer it, well, 

5 yes, it is to a large degree it does do that 

6 or to a large degree it does not do that. But 

7 it really talks to the degree to which the 

8 procedure is responsive to the question that 

9 was raised. Did it do a good job of doing 

10 this or did it do a poor job? But the 

11 significance of that, when you use the term 

12 significance, I hear does this have a high 

13 level of importance in regard to how it will 

14 affect a dose reconstruction. I don’t think 

15 this, we really don’t address that here. 

16 MS. MUNN: No, we don’t, and I understand 

17 that we really and truly can’t because whether 

18 or not the procedure has a particular weakness 

19 at the time that it is reviewed doesn’t 

20 necessarily mean that that would have any 

21 effect at all on, any significant effect that 

22 would concern us, with respect to dose 

23 reconstructions. 

24 It would, however, give us a feel for 

25 whether the procedures as they were being 
29

1 provided had received the kind of scrutiny and 

2 processed internally before they were released 

3 that we had said that we wanted to see. It 

4 wouldn’t, I guess we would have to be clear 

5 that this would not be, you couldn’t draw a 

6 direct line from that rating to dose 

7 reconstruction impact. That would be 

8 inappropriate. But it would give us a feel 

9 for whether the procedures as they were coming 

10 out of the chute had the kinds of material in 

11 them and met the seven criteria that you’d 

12 established for it. 

13 I guess I have mixed emotions about, I 

14 understand what you’re trying to say, but at 

15 the same time I’m, it seems to me that that 

16 might be of interest certainly to the 

17 Procedures working group itself as we go 

18 forward. 

19 DR. ZIEMER: Wanda, this is Ziemer again. 

20 After listening to John’s comment and kind of 

21 looking again at the questions that we ask in 

22 this review process, I think I tend to agree 

23 that any one of these findings by itself it 

24 would be very hard to assess the impact of 

25 that on, because in a lot of cases you would 
30

1 have to take a whole group of findings in a 

2 given procedure and try to assess that. 

3 I think trying to assess the impact of 

4 individual findings is almost impossible. And 

5 so what we would have to do I think would be 

6 to couch this whole thing in terms of whether 

7 or not we think any of the procedures 

8 themselves have been (inaudible), but grossly 

9 inadequate to the point where they were 

10 inappropriate. 

11 I’m exaggerating things here a bit 

12 because I’m trying to think off the top of my 

13 head how one would approach this. But by-and14 large the procedures have served us well. 

15 We’ve found some flaws and shortcomings in 

16 some of them. Some of these NIOSH finds and 

17 corrects as they go. Others we’ve identified 

18 and found that NIOSH has already gone past 

19 that point anyway and so on. 

20 So I’m not sure what we say here other 

21 than the review process is a continuous, 

22 ongoing one where we’re trying to improve how 

23 we handle things, try to identify where we’re 

24 not claimant favorable and that sort of thing. 

25 Rating the individual findings I do agree is 
31

1 going to be extremely difficult if not 

2 impossible. 

3 DR. MAURO: I have an idea. When looking at 

4 these procedures, many of which I’m familiar 

5 with, familiar with what transpired at these 

6 meetings and try to capture and summarize it 

7 here. But when all is said and done what 

8 really happens here is the number of comments 

9 and their level of importance on some 

10 occasions have triggered the need to make 

11 revisions to procedures and that process is 

12 implemented or has already been implemented. 

13 In other cases it triggered the possibility of 

14 other procedures being written. 

15 For example, I’m looking at OTIB-0004. 

16 I think OTIB-0004 had to do with AWEs, and I 

17 think a lot of the discussion we had on OTIB18 0004 actually triggered -- correct me if I’m 

19 wrong -- some additional work, for example, 

20 the work that was done by Battelle related to 

21 AWEs. I think that was sort of like what 

22 happens, it’s almost like we’re building. 

23 This is one of the steps in the process that 

24 triggers refinement of procedures on some 

25 occasions or revisions, clarifications absent 
32

1 the identification of the ability of new 

2 procedures. So it’s almost like one of the 

3 gears that are part of the overall machinery 

4 that affect the continual improvement and the 

5 timing of the process. 

6 DR. ZIEMER: Exactly, exactly. You said 

7 that well. 

8 MS. MUNN: And in many ways it has also 

9 given us the opportunity to combine a number 

10 of these individual procedures to some other 

11 procedure so that it reduces, it has in some 

12 cases reduced the number of reference points 

13 that we need to look to in order to complete 

14 those reviews. 

15 DR. MAURO: If we were to go down the path 

16 of you’re talking about what this would 

17 trigger, let’s say, we were to. We are moving 

18 into the area that we talked about earlier, 

19 that Christine brought up and Stu, it’s more 

20 in the purview of NIOSH. Even though I think 

21 right now if we were to sit down and go over 

22 these with Stu, we’d probably say, yes, we did 

23 make some, we are making some changes or did 

24 make some changes or, no, we didn’t. But 

25 still you may want to leave that to the back 
33

1 end of the process so to speak the way 

2 Christine described it. 

3 MS. MUNN: Well, again, we don’t want to get 

4 to a point where we’re confusing the 

5 information we’re transmitting. We want to 

6 keep it as crystal clear as possible. And if 

7 we, I can see that the ratings, my suggestion 

8 with respect to the ratings is probably not as 

9 clear as I was seeing it at the time I was 

10 thinking about it. However, that doesn’t 

11 change the fact that I do believe an 

12 additional column showing open, transferred, 

13 that kind of information which -- 

14 DR. ZIEMER: Now what’s happened to the 

15 findings, number of them closed, number of 

16 them transferred out? 

17 MS. MUNN: Yeah, exactly. If we have that 

18 kind of column added to it, then if I were in 

19 an administrative position wanting a quick 

20 piece of information it would give me a feel 

21 for how thoroughly this has been addressed. 

22 MS. BEHLING: This is Kathy Behling. If we 

23 did want to go back to the idea of expanding 

24 on Table 4 by introducing some of the rating 

25 issues, we might be able to do that by 
34

1 segregating that by these seven objectives 

2 because that could also, as you’ve indicated, 

3 in some cases the objective was how clear and 

4 concise and straightforward is the procedure. 

5 And so if that got a rating of one as opposed 

6 to some more technical issue, it’s not quite 

7 as important. But if we were to rate things 

8 and segregate those ratings by under various 

9 objectives -- 

10 DR. ZIEMER: Well, you have that in Table 3. 

11 It’s not on a per-finding basis. I mean it’s 

12 not on a procedure basis, but you have the 

13 number of the objective one finding, seven. 

14 MS. MUNN: Yeah, which is a good table. 

15 MS. BEHLING: Yes, but we could do that for 

16 each of the individual procedures by expanding 

17 Table 4 to add that type of information if you 

18 want to -- 

19 DR. ZIEMER: That might address what Wanda’s 

20 talking about and that is show the ultimate 

21 resolution of these. How many have closed; 

22 how many have been transferred. It’s sort of 

23 a different question, isn’t it? 

24 MS. MUNN: Yeah, I think it is. I think it 

25 is. The ratings, if we attempted the 
35

1 complexity of a rating system, it more than 

2 likely would expand this table beyond what I 

3 would deem appropriate for this kind of 

4 report. 

5 MS. BEHLING: Okay. 

6 MS. MUNN: But certainly open, transferred 

7 are even, I guess we don’t have a category to 

8 show that the procedure was now covered in 

9 some other procedure. 

10 DR. ZIEMER: Well, you have the status of 

11 these items, whether it’s closed or in 

12 abeyance or -- 

13 MS. MUNN: Yeah. 

14 DR. ZIEMER: Is that what you’re talking 

15 about? 

16 MS. MUNN: That’s what I’m talking about. 

17 DR. ZIEMER: Number closed, number in 

18 abeyance, number transferred. 

19 MS. MUNN: And a number of these findings 

20 are -- 

21 DR. ZIEMER: We haven’t got a box for those 

22 findings. 

23 MS. MUNN: Yeah. 

24 DR. ZIEMER: In the appendix. That could 

25 certainly be done. 
36

1 MS. BEHLING: Yes, that wouldn’t be a 

2 problem. 

3 DR. ZIEMER: I was kind of assuming that, am 

4 I correct in assuming that everybody’s okay 

5 with the idea of in addition to the executive 

6 summary providing as an appendix the full 

7 report? 

8 MS. MUNN: That was my intention when we 

9 first started this call. 

10 DR. ZIEMER: And if so, I have a couple of 

11 questions (inaudible) and point out that for 

12 the tables that deal with findings there are 

13 fairly objective (inaudible) be 6.0 like the 

14 other tables or 5-0 or 4-0 and so on. Just 

15 make that minor change. 

16 Then I have a question on, do we need 

17 more than one example of each type? Some of 

18 these you’ve got several ones. Is there any 

19 reason why one example wouldn’t be sufficient? 

20 Or, John or Kathy, any reason for 

21 having multiple examples on certain ones of 

22 these? Trying to get a, show the variety of -

23 - 

24 MS. BEHLING: I believe actually Steve 

25 Marschke had introduced these examples, and I 
37

1 believe he was just trying to show a variety. 

2 But we can certainly narrow it down to one. 

3 DR. ZIEMER: All we’re trying to show is an 

4 example of what the findings look like and the 

5 resolution process, right? 

6 MS. BEHLING: That’s correct. 

7 DR. ZIEMER: If that’s the case, and, again, 

8 it would be (inaudible) with the report itself 

9 (inaudible) example of each would be adequate 

10 I would think. 

11 MS. MUNN: Yeah, I agree. We probably have 

12 more information in the attached tables. 

13 DR. ZIEMER: Those three changes and then 

14 the one that Wanda suggested. 

15 MS. BEHLING: We can certainly do that. 

16 MS. MUNN: Shall we give that a try and see 

17 if we can -- I’m worried about time here. If 

18 this, are we loading you up in terms of 

19 available time and what we’re asking you to do 

20 here? I shouldn’t think that the executive 

21 summary itself should be too difficult. 

22 MS. BEHLING: When are you hoping to get 

23 this, to see this? Before the -- 

24 MS. MUNN: Well, that’s the decision I’m 

25 trying to make right now is whether or not, we 
38

1 don’t want to overload people when we’re 

2 coming up to a full Board meeting here. I had 

3 hoped to be able to discuss this at the Board 

4 meeting, but I think that’s going to be 

5 impossible to do. 

6 DR. ZIEMER: I would see the revisions in 

7 the main report itself as being very minor. 

8 You’re going to delete a few tables in there 

9 where we have more than one example. You’re 

10 going to add a column or two on Table 4 to 

11 indicate how many are closed, how many are in 

12 abeyance. What’s the other? 

13 MS. MUNN: And we’re going to do a two-page 

14 executive summary factoring in those -- 

15 DR. ZIEMER: But I think for the Board 

16 meeting, if the Board is willing to accept 

17 this report, if the agreement that the, if we 

18 don’t have it available then with the 

19 agreement that there would be a roughly two20 page executive summary of this report, that 

21 that would be transmitted to the Secretary, I 

22 would ask for action. 

23 MS. BEHLING: I believe we can provide that 

24 to you before the next Board meeting. Like I 

25 said, we’ll work on revising this full report 
39

1 first and then attempt to put together the 

2 executive summary. And I guess we should try 

3 to have that in your hands by the (inaudible). 

4 Is that reasonable? 

5 MS. MUNN: Any time before our 

teleconference on April 2nd 6 . We have a 

7 teleconference set up for 1:00 p.m. eastern 

time on April the 2nd 8 because we had so many 

9 items at our last face-to-face meeting that 

10 we’re almost ready but not quite. And we 

11 wanted to have them cross the Board or easy to 

12 report on at the Board meeting and so we set 

13 up this additional teleconference. 

14 DR. ZIEMER: Are we only really talking 

15 about adding how many columns to Table 4? 

16 MS. MUNN: At least, no more than two. If 

17 we do that it depends on how -- 

18 DR. ZIEMER: It’d have number of closed 

19 items? 

20 MS. MUNN: I don’t know whether we even need 

21 the number of closed items if we indicate the 

22 number that are left open. The arithmetic -- 

23 DR. ZIEMER: In a way in number open, number 

24 -- 

25 MS. MUNN: Transferred. 
40

1 DR. ZIEMER: How many categories do we have 

2 in the, on the form under status? We have in 

3 abeyance as a category. We have closed as a 

4 category. 

5 DR. MAURO: And transferred. 

6 DR. ZIEMER: Transferred, three? 

7 DR. MAURO: Yeah. 

8 DR. ZIEMER: We have three, so three columns 

9 and that’s a pretty quick matter of counting, 

10 and the last half of Table 4 is all zeros 

11 anyway. 

12 MS. MUNN: All zeros anyway. 

13 DR. ZIEMER: So that’s about five minutes, 

14 right, Kathy? 

15 DR. MAURO: This is John. Let me jump in 

16 here. The challenge here I really believe is 

17 to capture the sensibility that you 

18 communicated to us with that three-page 

19 executive summary. I believe that there, in 

20 other words, we have to just capture this in a 

21 way that resonates with everyone on the phone, 

22 Paul and Christine and Wanda. 

23 And I think we have to as quickly as 

24 we can since it’s only three pages to try to 

25 put up a straw man for that executive summary. 
41

1 I think the mechanics, the appendix of the 

2 document we’re looking at now by filling in 

3 tables is a mechanical process. So I’m not 

4 worried about that. We can do that. 

5 I’m more concerned that we’re going to 

6 capture the sensibility that you communicate 

7 to us. And there’s only one way to do that is 

8 to make a run at it and show it to you. Say, 

9 yeah, this is it or, no, we’re only halfway 

10 home. So I think it’s essential that we get 

11 into your hands as soon as possible this 

12 executive summary to see if we’re on the right 

13 track. 

14 MS. MUNN: If you can get that to us by the 

28th 15 everybody will have had the time to look 

16 at it before the teleconference. 

17 DR. ZIEMER: And actually, John, probably we 

18 need to add then to the report itself also I 

19 would call it a Section 5-0 which is impact of 

20 the review process or something, four-zero’s 

21 overview of the findings. 

22 MS. MUNN: But I don’t think that the impact 

23 needs to be presented in numerical terms. 

24 DR. ZIEMER: No, don’t -- 

25 MS. MUNN: Don’t attempt to do the 
42

1 statistical work on it. 

2 DR. ZIEMER: No, no, just a description of 

3 what we talked about. How does this affect, 

4 John talked about continuous improvement of 

5 the process like the -- 

6 That concept, John, is really what 

7 we’re talking about here. 

8 DR. MAURO: That’s the theme of Section 5 

9 and how, and so we’ll capture that. 

10 DR. ZIEMER: Yeah, yeah, that’s just a -- 

11 DR. MAURO: I gather that could be -- 

12 DR. ZIEMER: -- I think it’s just a nice, 

13 concise paragraph or two. 

14 DR. MAURO: I could see that being part of 

15 the executive summary also. 

16 DR. ZIEMER: Yes, both, both. 

17 MS. MUNN: Yes, absolutely. As a matter of 

18 fact it’s a key part of the -- 

19 DR. ZIEMER: It’s sort of why are we doing 

20 all this. 

21 MS. MUNN: That’s what we want to convey is 

22 that the improvement has been significant, and 

23 it has had noted impact on those dose 

24 reconstructions that we all do. 

25 It sounds like we are -- 
43

1 DR. ZIEMER: I think that description is in, 

2 more in general terms, qualitative terms not 

3 quantitative terms. 

4 MS. MUNN: Sounds like we’re all on the same 

5 page with this. 

6 DR. BRANCHE: Wanda, this is Christine. I 

7 just wanted to see if Michael Gibson or Mark 

8 Griffon had joined the call or Robert Presley 

9 even. 

10 MR. GIBSON: Mike Gibson. I’m here. 

11 DR. BRANCHE: Okay, so Michael Gibson did 

12 make it. 

13 Okay, Wanda. 

14 MS. MUNN: Good. Do you have any comment, 

15 Mike? Did you hear enough of what was going 

16 on to be able to follow? 

17 MR. GIBSON: Yes, I was (inaudible). 

18 MS. MUNN: Okay, you’re breaking up badly, 

19 but I think I’m hearing you say it sounds 

20 good. 

21 MS. BEHLING: I guess -- this is Kathy 

22 again. The only reason I had suggested the 

28th 23 because as I’m looking at my calendar I 

24 see next week we have an all day, Tuesday and 

25 Wednesday -- 
44

1 MS. MUNN: Yes, you do. And definitely 

2 Tuesday with the DR folks. If there’s 

3 anything that relates, this is our opportunity 

4 to put it in front of that group. But I don’t 

5 think the subcommittee would have anything 

6 other than I certainly feel that Mark’s 

7 presence on this group would be enough to send 

8 up a flag if there’s anything that needs to 

9 overlap between the two. I don’t believe 

10 that’s the case. 

11 All right, then we’re all on the same 

12 page hopefully. And we will anticipate a new 

13 draft from SC&A and the executive summary 

first draft by the end of the month, the 28th 14 

15 hopefully. And we well see the rest of you or 

16 rather hear the rest of you on the afternoon 

teleconference of April the 2nd 17 . 

18 DR. ZIEMER: Very good. 

19 DR. BRANCHE: Very good. 

20 DR. ZIEMER: Thank you, Wanda. 

21 MS. MUNN: I think we’re finished here 

22 unless anyone else has any last comments. 

23 MR. HINNEFELD: Wanda, this is Stu Hinnefeld 

24 with one completely unrelated comment for 

25 accuracy’s sake, but this sentence in the 
45

1 report I think says that both the statute and 

2 the rule mandate that the Board conduct a 

3 (inaudible) review. I believe that only 

4 appears in the statute and not in the dose 

5 reconstruction. 

6 MS. MUNN: Okay. 

7 MS. BEHLING: Okay. 

8 MS. MUNN: Do you have that, guys? Change 

9 can be done easily. Thank you, Stu, 

10 appreciate that. We want to be accurate to 

11 the greatest degree that we can be. 

12 Thank you all, appreciate it. We’ll 

13 be in touch prior to our teleconference. I’m 

14 going to be traveling during that 

15 teleconference so heaven knows where I will 

16 be, but we will convene at 1:00 p.m. eastern, 

Wednesday, April the 2nd 17 . Thank you very much. 

18 (Whereupon, the working group meeting was 

19 adjourned at 3:00 p.m.) 

20 

21 
46

1 CERTIFICATE OF COURT REPORTER 

STATE OF GEORGIA 

COUNTY OF FULTON 

 I, Steven Ray Green, Certified Merit Court 

Reporter, do hereby certify that I reported the 

above and foregoing on the day of Mar. 19, 

2008; and it is a true and accurate transcript 

of the testimony captioned herein. 

 I further certify that I am neither kin 

nor counsel to any of the parties herein, nor 

have any interest in the cause named herein. 

 WITNESS my hand and official seal this the 

14th day of Apr., 2008. 

______________________________ 

STEVEN RAY GREEN, CCR, CVR-CM 

CERTIFIED MERIT COURT REPORTER 

CERTIFICATE NUMBER: A-2102