Centers for Disease Control and Prevention 

National Institute for Occupational Safety and Health 

Summary Minutes

Twenty-third Meeting of the 

Advisory Board on Radiation and Worker Health 

April 20-21, 2004 

Meeting Held at the Red Lion Richland 

Richland, Washington 
NIOSH/CDC Advisory Board on Radiation and Worker Health 

April 20-21, 2004 

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Summary Minutes of the Twenty-third Meeting 

April 20-21, 2004 

The Twenty-third Meeting of the Advisory Board on Radiation and Worker Health (ABRWH or the Board) 

was held at the Red Lion Richland on April 20-21, 2004. The meeting was called by the Centers for Disease 

Control and Prevention's (CDC's) National Institute for Occupational Safety and Health (NIOSH), the 

agency charged with administering the ABRWH. These summary minutes, as well as a verbatim transcript 

certified by a court reporter, are available on the internet on the NIOSH/Office of Compensation Analysis 

and Support (OCAS) web site located at www.cdc.gov/niosh/ocas. Those present included the following: 

ABRWH Members: Dr. Paul Ziemer, Chair; Dr. Henry Anderson; Dr. Antonio Andrade; Dr. Roy DeHart; 

Mr. Richard Espinosa; Mr. Michael Gibson; Mr. Mark Griffon; Dr. James Melius; Ms. Wanda Munn; Mr. 

Leon Owens; Mr. Robert Presley; and Dr. Genevieve Roessler. 

Designated Federal Official: Mr. Larry Elliott, Executive Secretary 

Federal Agency Attendees:

Department of Health and Human Services: 

Mr. Russ Henshaw, Ms. Nichole Herbert, Ms. Cori Homer, Ms. Liz Homoki-Titus, Mr. Ted Katz; 

Mr. David Naimon; and Dr. Jim Neton. 

Department of Energy: 

Mr. Tom Rollow 

Department of Labor: 

Dr. Diane Case, Mr. Jeff Nesvet, Mr. Pete Turcic, Mr. Larry Hoss, and Ms. Christy Long 

Defense Threat Reduction Agency: 

Mr. Dennis Schaeffer 

Contractors: Mr. Hans Behling; Dr. Joe Fitzgerald; and Dr. John Mauro. 

Public Attendees: See registration. 
NIOSH/CDC Advisory Board on Radiation and Worker Health 

April 20-21, 2004 

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Executive Summary

The Twenty-third Meeting of the Advisory Board on Radiation and Worker Health (ABRWH or the Board) 

was held at the Red Lion Hotel Richland in Richland, Washington on April 20-21, 2004. All members were 

in attendance. Others in attendance included staff of various Federal agencies, as well as members of the 

public. The Summary Minutes of Meetings Twenty-one and Twenty-two were approved with minor 

changes. 

 * * * * *

 Tuesday, April 20, 2004

 OCAS Program Status Report

Dr. James Neton presented program statistics as of April 15th. Cases referred from the Department of 

Labor (DOL) had exceeded 16,000. Requests to the Department of Energy (DOE) for information total 

15,373, with 14,711 responses received. To date, 13,127 have had at least on1 interview completed. Over 

12,000 draft interview reports have been sent to claimants. 

Over 4,300 claims are staged for dose reconstruction, with 1,020 assigned to dose reconstructors. There 

have been 2,700 draft dose reconstruction reports sent to claimants, with 2,319 final reports to DOL. 

Oak Ridge Associated Universities (ORAU) has received over 84,000 phone calls. These include 

interviews, scheduling interviews, closeouts, et cetera. Over 3,900 e-mails have been received. 

Forty new appointments were made to the physicians panel bringing the total appointments to 215. 

Site profiles continue to be developed. Four sites -- Savannah River, Hanford, Y-12, and Rocky Flats -- are 

now completed. 

The Web site has been redesigned. A new feature is claimant status request. The claimant information page 

has been updated and provides some good statistics. 

Following his presentation, Dr. Neton took questions from the Board. 

 * * * * *

 Department of Labor Status Report
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April 20-21, 2004 

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An update was presented by Mr. Pete Turcic from DOL. Over 53,000 claims have been filed. Recent 

outreach efforts are increasing numbers. There have been almost 12,000 final decisions to award benefits 

and 16,000 final decisions to deny. 

DOL, working with PACE to increase claims from the Hanford site, has received 275 new claims in the past 

two months. Seventy payments for over $9 million has been paid to individuals at the Hanford work site. 

The outreach goal has been to identify potential claimant populations. DOL has been working with the 

Center to Protect Workers Rights, Cancer Treatment Centers of America, the National Councils of Laborers 

and others on a national scope. The district offices have strategic plans for the next six months in this effort. 

 DOL is also developing some education outreach efforts. 

Mr. Turcic entertained questions from the Board. 

 * * * * *

 Department of Energy Status Report

A presentation by Mr. Tom Rollow from DOE illustrated the differences between the portions of the 

program administered by DOE and DOL, respectively. He indicated the DOE portion had a sizeable 

backlog of cases. A plan has been developed to eliminate the backlog within two and a half years. 

A proposed rule change that would potentially double production is in public comment period. Efforts are 

underway to improve the physician pay schedule to attract more physicians to the physicians panel. 

A variety of changes sought were outlined, including a $33 million appropriations transfer. DOE is in the 

process of reauthorizing a new advisory board. 

The Board addressed questions to Mr. Rollow following his presentation. 

 * * * * *

 Site Profile Status, Use in Dose 

 Reconstructions, and Roll-Out

Dr. Neton described the purpose and composition of a site profile. Approximately 7,000 cases may now be 

addressed by various site profiles, approximately 40 percent of the claimant population. Site profiles under 

development will enable another 1,400 cases to move forward. Target goal for completion is end of summer 

or early fall. 
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April 20-21, 2004 

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ORAU has written a worker outreach plan to address worker input to the site profiles. Building trades have 

a unique perspective which needs to be incorporated. The National Institute for Occupational Safety and 

Health (NIOSH) is committed to adding construction activity chapters to flesh out gaps. Minutes are taken 

at worker input meetings to verify understanding of worker comments. 

Obvious through the meetings is a need for site safety rep training. Plans are underway for a dose 

reconstruction workshop to aid their ability to address issues from their workers. 

Following his presentation, Dr. Neton answered questions from the Board. 

* * * * *

Research Issues Status

Mr. Russ Henshaw addressed the issues identified by the Board as their items of priority interest and an 

update on compensation results from completed claims. He outlined current plans to address the three 

priority one items in this year. There are no plans to address the two priority two topics at this time. Studies 

are underway on two topics not on the lists but of relevance to the program, Dose and Dose-Rate 

Effectiveness Factor (DDREF) and chronic lymphocytic leukemia (CLL). 

Claims results were through March 31, 2004, and represented about two-thirds of the completed dose 

reconstructions submitted to DOL. Results were presented in table form according to the 32 Interactive 

Radio Epidemiological Program (IREP) cancer models and represented statistics including cases processed 

with each model, number, and percentage of compensable claims. He noted there were some surprises, and 

NIOSH will continue to monitor data for trends and keep the Board updated. 

Mr. Henshaw took questions from the Board following his presentation. 

* * * * *

Public Comment Period

Public comment was solicited on both days of the meeting. Public input on the first day was in a separate 

session commencing in the evening, but one comment was taken before the recess. Comments the first day 

included the following. 

#A coordinator is needed to get justice done for the workers. 

#Much of the public information was inaccurate, contradictory, and being ignored. 

#Concern for surviving widows living on fixed incomes who need the money. 

#Exposure records which gave widely conflicting information. 
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April 20-21, 2004 

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#Confusion about a claim approved under the Subtitle B and denied under Subtitle D. 

#Claims denied because medical samples were taken from the wrong part of the body. 

#Program seems to be a dead end. 

#Clarification of probability of causation criteria. 

#A filing cabinet previously full of log books would be helpful if it could be located. 

#When comparing compensation to numbers applied, program had not done its job. 

#Film badges didn't give a true reading. 

#Compliments to the helpful and resourceful people at DOL's Kennewick resource center. 

#Some exposures not accounted for so records didn't reflect dose accurately. 

#Physicians unable to piece multiple health problems with varied exposures. 

#Beryllium found in lungs of son who never worked at Hanford brought home on husband's shoes and 

 clothing. 

 * * * * *

 Wednesday, April 21, 2004

 Contractor Update and Report

 Sanford Cohen & Associates

Dr. John Mauro announced Sanford Cohen & Associates (SC&A) had been working on tasks one, two, 

and three. The first deliverable on task one, procedure used to review site profiles, was delivered to the 

Board on March 3rd and approved on April 2nd. That work began on April 5th. 

Task two was the development of tracking software. The software and report were delivered April 3rd. 

SC&A is awaiting comment. 

SC&A was authorized on February 13 to review the Office of Compensation Analysis and Support (OCAS) 

and ORAU procedures which are the heart of the protocol to perform dose reconstructions. The first 

deliverable was to write a procedure to perform the review. That was delivered on April 13th. The scope of 

task three does not include performing the reviews. 

Dr. Mauro took questions from the Board. 

 Status Update, Task One 

 Site Profile Review

Mr. Joe Fitzgerald, site profile review manager, announced review of the Savannah River site profile had 

commenced on April 5. The first phase consisted of review of documentation, which has been completed. 

The second phase is validation, where timely access to people and data sources is key. SC&A is exploring a 
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April 20-21, 2004 

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strategy to avoid being nonproductive while awaiting receipt of information if that will take some time. 

Mr. Fitzgerald entered a dialogue with the Board following his presentation. 

 Status Update, Task Three 

 Protocol for Review of NIOSH Methods 

 and Procedures for Dose Reconstruction

Mr. Hans Behling, a SC&A health physicist, was asked to develop a procedure to provide both an outline 

and a general approach for review of procedures adopted by NIOSH for dose reconstruction. 

He presented the seven criteria he had identified from review of the Act and final rule, and described the 

criteria SC&A will use to determine whether the procedures under review meet the objectives. 

 * * * * *

 Public Comment Period 

Public comment was solicited on both days. Public input on the second day included the following. 

#No need to spend money to have meetings when nothing is being settled. 

#Suggestion that a safety net be created to protect people worried about losing their jobs if they file a claim. 

#A belief that records have been expunged. 

#Hanford should be a Special Exposure Cohort (SEC)site. 

#Hope that the Board would be more attentive to claimants' problems and speed up the process. 

#Today people dress as if they're going to the moon to do the same job they used to do wearing coveralls 

and a baseball cap. 

#Worst exposure was being stuck in an office with chain smokers. 

#Working at commercial plants led to realization workers hadn't been covered properly at Hanford. 

#Post-retirement monitoring promised due to plant explosion had never taken place. 

#Make Hanford a SEC site because records could not be found, although the commenter knows where they 

are. 

#Hope that the spirit of the Memorandum of Understanding between HHS and DOE will carry forward to 

audit phase. 

#Health studies schedule appeared slow as molasses. 

#Question what happens with substantive facts from public comment. 

#Suggestion to notify claimants whose CLL claim had been denied that research is being undertaken and 

they'll be contacted in the future. 

* * * * *
NIOSH/CDC Advisory Board on Radiation and Worker Health 

April 20-21, 2004 

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 Update on AWE Facilities 

Dr. James Neton provided an update on the status of the Atomic Weapons Employer (AWE) facility 

profiles and dose reconstruction efforts. There are approximately 2,000 AWE cases at NIOSH. The top ten 

sites produced 1,195 of those cases. There are 518 cases from Bethlehem Steel. Total cases represent 124 

facilities. 

Dr. Neton described the differences in site profiles for DOE and AWE facilities. Four AWE profiles have 

been issued. The latest is Tennessee Valley Authority, Muscle Shoals, which only covers five facilities. 

Some sites are being revised. NIOSH is still deliberating on how to address radon exposure at Blockson 

Chemical, so that section remains reserved. 

Dr. Neton entertained questions from the Board following his presentation. 

 * * * * *

 Board Discussion/Working Session 

 Procedure Review and Selection of Cases

Two documents relative to task three had been provided to the Board for review. Beginning with the 

technical review, the first ten pages laid the background. The seven criteria from Mr. Behling's presentation 

garnered no discussion from the Board. 

The review objectives and approach were discussed relative to objectivity of the scoring method. It was 

explained the scoring method was for quick overview, but it was anticipated the Board would focus on the 

attendant comments. 

Discussion on technical issues included changes in wording to be less pre-judgmental. Deliverables 

described in the documents will result from the next task. The technical review document was approved 

with minor changes. 

The administrative review document was considered and approved with the Board offering no discussion. 

Requirements for the necessary task order and independent government cost estimate (IGCE) were 

discussed. Scheduling was considered. The task order was developed during a recess and approved when 

the Board reconvened. 

The Board discussed and approved the draft of a memorandum to the Secretary of Energy. The 
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April 20-21, 2004 

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memorandum was intended to alert the Secretary of Energy of the need for the ABRWH contractor to have 

access to DOE sites and records. The Chair was authorized to polish and send the memo, through Secretary 

Tommy Thompson, to the Department of Energy. 

Correspondence from three members of Congress from New York was discussed. It was concluded that the 

Board should be sensitive to their concerns, yet not yield to specific requests relative to the audit, noting that 

the integrity of the audit must be preserved. 

The Board authorized the Chair to craft a response based on the discussions, and circulate it to the Board for 

input before sending it. Mr. Elliott asked that Dr. Ziemer work closely with NIOSH in that the Office of 

General Counsel may have to offer an opinion on whether circulation of the draft would violate Federal 

Advisory Committee Act (FACA) rules. 

The working group for development of a subcommittee charter provided its proposal and discussion topics. 

After protracted discussion relative to structure, composition, meetings and other details of establishment, it 

was agreed to remand the documents to the working group for additional work on the wording, taking into 

consideration the issues discussed. 

Addressing the schedule for future meetings, the Board decided to meet in closed session on May 17 in 

Cincinnati to develop the IGCE. Some housekeeping matters were addressed. 

With no further business to come before the Board, the meeting was adjourned. 

End of Executive Summary 

Ë Ë Ë
NIOSH/CDC Advisory Board on Radiation and Worker Health 

April 20-21, 2004 

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 The Advisory Board on Radiation and Worker Health 

 National Institute for Occupational Safety and Health 

 Centers for Disease Control and Prevention 

 _________________________________________________________________ 

 Summary Minutes of the Twenty-third Meeting 

 April 20-21, 2004 

 _________________________________________________________________

The Twenty-third Meeting of the Advisory Board on Radiation and Worker Health (ABRWH or the Board) 

was held at the Red Lion Hotel Richland in Richland, Washington on April 20 and 21, 2004. The meeting 

was called by the Centers for Disease Control and Prevention's (CDC's) National Institute for Occupational 

Safety and Health (NIOSH), the agency charged with administering the ABRWH. These summary minutes, 

as well as a verbatim transcript certified by a court reporter, are available on the internet on the 

NIOSH/Office of Compensation Analysis and Support (OCAS) web site located at 

www.cdc.gov/niosh/ocas. Those present included the following: 

ABRWH Members: Dr. Paul Ziemer, Chair; Dr. Henry Anderson; Dr. Antonio Andrade; Dr. Roy DeHart; 

Mr. Richard Espinosa; Mr. Michael Gibson; Mr. Mark Griffon; Dr. James Melius; Ms. Wanda Munn; Mr. 

Leon Owens; Mr. Robert Presley; and Dr. Genevieve Roessler. 

Designated Federal Official: Mr. Larry Elliott, Executive Secretary. 

Federal Agency Attendees:

Department of Defense: 

Mr. D. Michael Schaeffer 

Department of Energy: 

Mr. Tom Rollow 

Department of Health and Human Services: 

Mr. Russ Henshaw, Ms. Nichole Herbert, Ms. Cori Homer, Ms. Liz Homoki-Titus, Mr. Ted Katz, Mr. 

David Naimon, Dr. James Neton. 

Department of Labor: 

Dr. Diane Case, Mr. Jeff Nesvet, Mr. Peter Turcic, Mr. Larry Hoss, and Ms. Christy Long 
NIOSH/CDC Advisory Board on Radiation and Worker Health 

April 20-21, 2004 

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Dr. Paul Ziemer called the meeting to order, welcoming the attendees. He asked that everyone register 

their attendance and discussed the sign-up sheet for those who wanted to speak during the public comment 

session. 

He introduced some special guests, including Shawn Bills from Senator Patty Murray's office and Joyce 

Olson, chief of staff for the tri-cities office for Congressman Doc Hastings. Ms. Olson added her welcome 

to the tri-cities area on behalf of Congressman Hastings, who was unable to attend. She gave a bit of 

information about the area and noted that the towns in the area are a legacy of the World War II Manhattan 

Project to produce plutonium for the first atomic bomb. 

Mr. Larry Elliott added his welcome on behalf of Secretary Tommy Thompson of the Department of 

Health and Human Services and Dr. John Howard, director of NIOSH. 

 * * * * *

 REVIEW AND APPROVAL OF DRAFT MINUTES

The first item of business on the agenda was approval of two sets of minutes covering the 21st meeting of 

the Board in Augusta, Georgia on February 5 and 6 and the 22nd meeting by telephone conference on 

March 11. Dr. Ziemer noted that the minutes of the Augusta meeting had been provided the Board the 

previous week, but the minutes of the telephone conference, although short, may not have been available 

long enough for the Board to review. Dr. Ziemer offered to defer review of the telephone conference 

minutes to the following day, if the Board preferred. By consensus, the Board indicated their preference to 

do so. 

Dr. Ziemer called for any substantive corrections or additions to the minutes of the 21st meeting of the 

Advisory Board. Some areas in need of clarification were noted; modifications were discussed and agreed 

upon. 

Motion to approve the Executive Summary and Minutes of the Twenty-first Meeting, 

with modifications as discussed, was seconded and unanimously passed.

Dr. DeHart commented that he liked the format of the minutes and would like it to be maintained in the 

future. 

 * * * * *

 OCAS PROGRAM STATUS REPORT
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April 20-21, 2004 

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Dr. James Neton 

NIOSH/OCAS 

Dr. Neton presented a number of slides showing that the number of cases referred from the Department of 

Labor (DOL) as of April 15th had gone over the 16,000 mark, reflecting a steady increase. The proportions 

from various district offices of the DOL are remaining fairly constant, with two-thirds of the claims being 

received from Seattle and Jacksonville combined, and Cleveland and Denver constituting the remaining 

third. 

Cases received from DOL has been dropping steadily, down to around 200 claims a month. The number of 

requests for information sent to the Department of Energy (DOE) has reached 15,373, representing 13,897 

cases. Requests exceed the number of cases because of multiple work histories. To date, 14,711 responses 

have been received, which represent over 13,000 cases. 

NIOSH has requested of DOE that they be provided with a response within 60 days. There are some claims 

over 60 days, with 114 being over 150 days. These typically represent claims from very early in the process 

-- late '40's to mid '40's -- or have some bioassay records that, although an attempt is being made to capture, 

are not available in a retrievable form. NIOSH puts out a monthly report to DOE to ensure that they are in 

agreement as to which claims are still outstanding. 

Telephone interview process by Oak Ridge Associated Universities (ORAU) has been very successful. To 

date, 13,127 cases have had at least one interview done. Many cases require multiple interviews because 

there are multiple claimants. Almost 12,300 draft reports have been sent to claimants. The capacity of 200 

to 300 interviews per week is well in place. There were months where as many as 1,700 interviews had 

been done. 

There are currently 4,338 claims staged for dose reconstruction, meaning the claimant has received a letter 

from ORAU notifying them that their dose reconstructor will be assigned. There are 1,020 claims that have 

been assigned to dose reconstructors, meaning there is a name attached to that file and it's in a 

reconstructor's queue to be done. 

Over 2,700 draft reports have been sent to claimants, with 2,319 final reports to the Department of Labor. 

Most of those 2,700 claims have been completed in the last 12 months. Production is increasing and Dr. 

Neton indicated they were moving toward their goal of 200 complete dose reconstructions per week. 

The claimant has up to 60 days to sign the OCAS-1 form, which is required before the case can be moved to 

the DOL. In cases where there are multiple claimants, it takes time to do all the closeout interviews and 

acquire the OCAS-1 forms. 

A number of claims have been in the hands of the claimants for more than 60 days without receipt of an 
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April 20-21, 2004 

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OCAS-1 form and the claimant has not come forth with any additional information. Under the regulations, 

that dose reconstruction can be administratively closed. A letter is sent to the claimant notifying them that 

action has been taken, with a copy to the Department of Labor. The DOL may close the case itself. There 

are presently 14 claims which have received administrative closure letters. The dose reconstruction can be 

reopened if the claimant signs the OCAS-1 form or provides additional information. 

Every claimant is assigned an I.D. number, starting with claimant number one. Dr. Neton presented a slide 

which broke down the claims received into blocks of 1,000 and reflecting the number of claims completed 

per block. For example, out of the first 1,000 claims received, 253 dose reconstructions have been 

completed. 

Efforts are being concentrated to move those earlier claims when possible. However, there is also a policy 

that if a claim can be done and processed with the information available, that claim will not be delayed. In 

general, the trend shows efforts to move the earlier claims out in a priority manner. 

Dr. Neton noted that in February and April the number of completed claims going to the DOL exceeded the 

number of claims being received for dose reconstruction, an indication that the backlog of claims is 

beginning to be reduced. 

Dr. Neton presented a new category entitled "Reworks", which is claims that have been completed, the 

claimants received the draft, signed OCAS-1, closeout interview has been done and the claim was sent to the 

Department of Labor. For a variety of reasons, it is returned to NIOSH to be redone. Those reasons range 

from the claimant having developed an additional cancer in the period of time the dose reconstruction was 

being processed, perhaps an issue with the ICD-9 coding that was on the original referral, or even 

differences in employment dates. 

This constitutes about five percent of the workload that goes to Labor comes back for rework. NIOSH is 

committed to getting those reworks done within 60 days because the claimant has already received a report 

and has signed the OCAS-1 form. Generally that is possible because many of the reworks are adding a 

month or two of employment or an additional cancer that isn't difficult to reconstruct. However, in some 

cases there are blocks of cancers or unique cancers that require a lot of additional work, a full analysis, and it 

sometimes is not possible to be done in 60 days. And although the graph indicated what appeared to be a 

trend toward increasing numbers, Dr. Neton indicated he believed that was an artifact of the increased 

number of claims being processed. 

OCAS has received over 29,000 phone calls since the program started. That number is diminishing since 

the advent of the quarterly activity reports being issued to claimants. ORAU, however, has received over 

84,000 phone calls. This includes telephone interviews, scheduling interviews, closeouts, et cetera. They 

have taken on the bulk of the burden of handling the phones and have their own 800 number that claimants 

are aware of. 
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April 20-21, 2004 

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E-mail is popular, with over 3,900 received to date. Timely response is a goal, within a day of receipt, 

sometimes a little longer depending on the nature of the question. 

Forty new appointments were made to the physicians panel on April 12th, bringing the total appointments 

by NIOSH to 215 physicians for the DOE Subtitle D activity. 

Site profiles continue to be developed and approved. Dr. Neton will present further information on that on 

Tuesday, but four DOE sites are now completed -- Savannah River, Hanford, Y-12, and Rocky Flats. Last 

Friday the Iowa Ordnance Plant profile was issued. 

The third quarterly activity report was issued last week with a mailing of 20,000 to claimants. This report 

indicates the status of their claim. 

The web site has been redesigned. The site profile portion now has its own page with some explanatory 

text. There's an archive page for previous site profiles that have been revised so that the versions can be 

compared, if one cares to do so. 

The claimant status request is a new feature allowing claimants to request a status report through e-mail. 

Since NIOSH tries very hard to maintain claimant privacy, if a request is sent, NIOSH will do some basic 

validation and then send a response directly to the claimant or the authorized representative's home address. 

 That way if they weren't the one to make the request, there would be no harm done. 

The claimant information page has been updated and provides some good statistics. A flow chart depicts a 

summary of the status, how many claims, how many responses from DOE, interviews, et cetera. There is 

also a feature whereby claim sites can be viewed. It's organized by state. You can look up where NIOSH is 

with every facility. If you wanted to know the status of the Hanford claims, go to Washington state, find 

Hanford and it will reveal that there are 1,865 claims from Hanford, 233 of which have been returned to 

DOL with completed dose reconstructions. It's a dynamic site and is updated once a day. Dr. Neton 

cautioned that if statistics were to be quoted from this web site, one should be careful about what day is 

being quoted. 

Discussion Points:

Dr. Melius indicated he had three questions, the first concerning the backlog, and asked for an explanation 

of how NIOSH was triaging the requests. He was concerned about the early requests and that the 

newer claims are being handled ahead of the old ones. 

Dr. Neton explained that with 4,000 claims staged for dose reconstruction, about 40 percent of the cases can 

be done with the four major site profiles for DOE facilities. There is other technical documentation 

being used such as the DOE or AWE complex-wide approach where very large exposures are 
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April 20-21, 2004 

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assigned and certain claims can be moved that way. They tend to go across many sites. 

Dr. Neton indicated dose reconstructions had been completed on 65 different sites the last time he checked 

and there would be more now. That is a function of the complex-wide documents. The bulk of the 

ones that are going to be moving forward are the ones covered by major site profiles. 

Dr. Melius described his concern as being that as the backlog is worked through, the most recent cases are 

going to be completed first and that it's going to leave people who filed claims four or five years ago. 

Dr. Neton indicated that once a site profile is completed, those older claims will be done first. But if newer 

claims can be done because the site profile is available, it's in the claimants' interests not to delay and 

wait until an older claim can be done. Emphasis will be given to moving the older claims first. 

Dr. Toohey added that ORAU has a small group of about four people referred to as the supplemental dose 

reconstruction team whose mission is to work on the oldest cases. They start with claim number 

one, and if it can be done in the absence of a completed site profile, they do it. The other efficiency 

process is to look at the easily compensable cases, such as lung cancer with positive lung counts for 

transuranic inhalation. Most of those are some of the earlier cases, so while it's not a huge effort, 

there is some additional effort to complete some of the oldest cases. 

Dr. Melius then asked for an update on the Special Exposure Cohort process. 

Mr. Larry Elliott commented that the rule had been revised according to public comment, has cleared 

through the Department of Health and Human Services and they're waiting on clearance from the 

Office of Management and Budget. 

Dr. Ziemer noted that he had just received a letter from Secretary Thompson in reply to the Board's letter 

on that subject. He distributed Secretary Thompson's letter to the Board and indicated to the public 

that it simply updated the Board as Mr. Elliott had just stated. Copies of the letter were also made 

available for the public. 

Dr. Melius' third question had to do with the interview process and queried the status of the quality 

assurance steps the working group had recommended and everybody had agreed were being 

implemented to allow for better quality control. He suggested that as a possible agenda item for the 

next meeting. 

Dr. Toohey responded that the procedures had been drafted, some are in internal review, some have been 

sent to NIOSH for review. There is an internal QA group which completed a semi-annual quality 

conformance assessment of all the ORAU operations in February. That report is out. They looked 

at how the interview procedure is working and what additional procedures or controls may be 

needed, if any. 

Dr. Melius suggested putting an update on the interview process on the agenda because that would be 

timely and helpful in terms of the Board's review of the individual dose reconstructions. 

Dr. Henry Anderson offered some suggestions for changing the layout of the slides to clarify the time 

frames in which the blocks of 1,000 claims had been received, noting that generally a time frame 

would give a more dynamic sense than just totals. He also suggested it might be helpful to note the 

number of hits on the various components of the web site. 

Mr. Robert Presley asked if the older outstanding requests, 60 to 150 days, were scattered or from a few 

specific sites. 
NIOSH/CDC Advisory Board on Radiation and Worker Health 

April 20-21, 2004 

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Dr. Neton indicated they were probably reflective now of a few sites, although he couldn't give the exact 

details. He noted that there were some sites where they were working to get the data into the proper 

form to be retrieved, so he suspected that some selected sites constituted the bulk of the delinquent 

requests. 

Mr. Presley asked if a letter requesting more attention be given to getting the information out would be 

helpful. 

Dr. Neton indicated there was good coordination between NIOSH and DOE, and he believed the 

appropriate level of resources was being dedicated to the effort, that it was really availability of the 

information. 

Dr. Melius noted he had seen on an earlier draft agenda that Ted Katz was going to give a report on access 

to exposure records and inquired about that. 

Mr. Elliott commented that there had at one point been scheduled an agenda item for this particular meeting 

to have Mr. Katz report on matters that influenced dose reconstruction that had been a report NIOSH 

had prepared for Congress on that subject. It was envisioned the report would be available for 

presentation because it was very educational and informative, but it's not available at this time. 

They're hopeful that by next meeting it will be. 

Dr. Melius observed that it appeared a lot of the backlog of information requests had been cleared. 

Mr. Elliott agreed that there was a very good relationship and that NIOSH and DOE were working very 

hard to be coordinated on it. 

Dr. Neton added he had forgotten to mention that NIOSH is working to get IMBA available to members of 

the public through the web site by developing a template for people to fill out requesting outputs 

from IMBA via e-mail. Calls to the 800 number may request guidance as to how to submit a 

request. It had been determined it was too complicated to be practical to do on line, but they would 

work with people to establish parameters of what they're truly interested in obtaining information for 

and how to put it in writing and issue a request via e-mail or regular mail. 

Dr. Melius asked about the commitment to make IMBA available to the Board members and wondered if 

that had been resolved. 

Dr. Neton replied that it had not been resolved, but they were working diligently to resolve the licensing 

issues. They were close, but no decision had been made yet. 

Mr. Elliott indicated a decision would be issued as soon as they could do so. There was a realization that 

the Board needs IMBA, the Board's contractor needs IMBA, as well as ORAU, and they're currently 

operating under a different user's license agreement and have to put everything into place. 

 * * * * *

 DEPARTMENT OF LABOR STATUS REPORT

Mr. Pete Turcic 

Department of Labor
NIOSH/CDC Advisory Board on Radiation and Worker Health 

April 20-21, 2004 

- 17 -

An update on the program was given from the perspective of the Department of Labor by Mr. Pete Turcic. 

Over 53,000 claims have been filed, the majority of which are cancer claims. There are approximately 

15,600 pending at NIOSH, with over 2,000 pending action in DOL district offices, claims that have not 

received a recommended decision yet. 

Recent efforts in enhancing outreach have caused the number of claims to increase considerably. The past 

several months they've been averaging from 250 to 320 claims per week. A smaller percentage now are 

non-covered conditions, so not only is the number of claims up, but the percentage for covered conditions is 

greater. 

Another 1,900 claims have a recommended decision and are in the process of awaiting final decision. Over 

22,000 final decisions have been issued out of almost 40,000 cases received. Recommended decisions to 

approve number 12,500, with 19,000 recommended decisions to deny. There have been almost 12,000 final 

decisions to approve benefits and 16,000 final decisions to deny. Payments have been issued in 10,619 and 

they're approaching $800 million in benefits and $30 million in medical benefits having been paid. 

Of the 16,000 decisions to deny benefits, almost 9,600 were denied because of non-covered conditions; 

2,500 where the employee was not covered; 700-plus where the survivor was not eligible; 2,200, insufficient 

medical evidence to demonstrate a covered condition; and, a number that is going up, now over 900 where 

the cancer was not related or had a probability of causation of less than 50 percent. 

Mr. Turcic noted that under the Government Performance Result Act, the DOL standards for initial 

processing is for a timely decision. This year that standard was raised from 75 percent to 77 percent. The 

two standards used are that a decision be made within 120 days if it's a DOE facility or a RECA claim; 

within 180 days if it's an AWE or subcontractor claim. DOL met their goals last year. For this fiscal year 

93 percent of the initial decisions were within those time frames, with an average of 92 days. 

The standard on final decisions is within 75 days of receipt of a waiver or objections or a request for review 

of the written record, and within 250 days if the individual requests a hearing. This fiscal year 99 percent of 

the cases met the standards. 

DOL has received 2,213 of their referrals back from NIOSH with completed dose reconstructions and 189 

where dose reconstruction was not necessary for various reasons. Most were early CLL cases which came 

back. Of those, there were 528 recommended decisions to approve benefits; 1,388 to deny benefits. Final 

decisions totaled 470 to pay and 691 to deny benefits. 

In the past two months DOL has worked with PACE in an effort to increase the number of claims received 

from the Hanford site and has been very successful, receiving over 275 new claims since that outreach effort 

began. They're now up to 3,565 claims from individuals claiming Hanford as a work site. Most are cancer 

claims, with 192 beryllium sensitivity, 126 chronic beryllium disease, and other non-covered conditions 
NIOSH/CDC Advisory Board on Radiation and Worker Health 

April 20-21, 2004 

- 18 -

totaling 607. Seventy payments for over $9 million has been paid to individuals at the Hanford work site. 

Since the initiation of increased outreach efforts, an additional 16 cases have been approved for benefits, 32 

denied, 14 additional that have had payments issued and 159 in that time period referred to NIOSH for dose 

reconstruction. 

Of the 70 payments issued, 30 were for cancer, 40 for chronic beryllium disease, and 100 individuals have 

been awarded benefits for beryllium sensitivity and to receive medical monitoring. 

Of the total Hanford claims referred to NIOSH, 209 have been received back, 205 with completed dose 

reconstructions; recommended decisions in 28 cases to approve benefits, 138 to deny; 27 final decisions to 

approve and 33 to deny. 

The goal of the outreach efforts has been to identify potential claimant populations, solicit claims from nonfilers. DOL has been tracking where they're not getting the number of claims that had been expected, and 

collecting facility information to promote public knowledge and awareness of the program and provide 

assistance in filing claims. 

District offices have been charged with coordinating the outreach efforts with the resource centers in each of 

those areas, with a focus on increasing stakeholder involvement in the outreach efforts with unions, media 

outlets, advocacy groups and health care providers. 

On a national scope, DOL has been working with the Center to Protect Workers' Rights in a very good effort 

where they have been able to get employment verification completed on a number of difficult cases that 

were presenting problems where records just didn't exist. The group has access to some record sources that 

have turned out to be very useful. Discussions are beginning on an effort to reach many of the construction 

workers that were employed at different sites. 

There's an effort with the Cancer Treatment Centers of America where DOL is providing them with a list of 

employers at various sites that have been identified. They will then cross-match their records for anyone 

who may have listed that facility as an employer. They will then send a letter that will be provided by DOL 

to that patient or former patient notifying them about the program and potential eligibility for benefits. 

Additional work is underway with the California Beryllium Vendors, the National Councils of Laborers, as 

well as the Ohio Bureau of Worker Compensation. 

The district offices, along with the affected resource centers, have come up with a strategic plan for the next 

six months in the outreach effort. The Cleveland district office and its resource centers will focus on 

outreach to Fernald and Mound for the next three to six months. Denver will focus on Rocky Flats and Los 

Alamos. Seattle will focus at Hanford and California. Jacksonville will be nailing down their plan week 

after next. 
NIOSH/CDC Advisory Board on Radiation and Worker Health 

April 20-21, 2004 

- 19 -

Mr. Turcic commented that he didn't feel a good job has been done in educating people on the process itself 

as far as explaining why two people who had worked together and go through dose reconstruction, one has a 

certain type cancer and is being compensated; the person they worked next to is not. Therefore DOL is 

working to develop some education outreach efforts in that regard. 

Discussion Points:

Dr. Ziemer pointed out some specific items in Mr. Turcic's slides which may lead to misunderstanding. 

They discussed clarification of the slides for future use. 

Mr. Turcic indicated the slides would be restructured in an effort to make them clearer. 

Dr. Roy DeHart asked for clarification of the hearing process, the issues involved. 

Mr. Turcic replied that once a claimant gets a recommended decision, one option is to file objections and 

ask for a hearing. At the hearing they can present their objections. Previously most of the hearings 

dealt with factual information or non-covered conditions. Now they're beginning to get requests 

dealing with the specifics on a dose reconstruction. DOL will have to adjudicate factual information 

that goes into the dose reconstruction and the application of methodology. This will allow someone 

to raise an issue that a factual piece of information was not covered. That would have to be 

addressed in the final decision or it would be remanded back to NIOSH to redo the dose 

reconstruction. The claimant could also object to the application of methodology, saying it wasn't 

consistent with other cases or whatever the objection may be. Mr. Turcic indicated that possibly at 

the next meeting he would have hard data for the Board and noted that they had asked their hearing 

representatives to identify and report issues which were coming up when claimants requested 

hearings. 

Dr. Melius inquired about Dr. Neton's presentation on reworks and asked for further explanation of the 

process and what kind of issues would cause a rework. 

Mr. Turcic reiterated the explanation previously given by Dr. Neton. The rework could be due to a change 

in situation, diagnosis of another cancer, errors or changes in the ICD-9 codes. None have been 

remanded on dose reconstructions. 

Noting one cause mentioned by Dr. Neton was employment history discrepancies, Dr. Melius was trying to 

figure out how that could occur since one issue has been figuring out how the employment history 

matches up with employment records, so he wondered if it is related to that or if it is related to new 

information or more information. 

Mr. Turcic replied it could be both. Sometimes that information is not received until after a final decision 

and the individual asks for a reopening. Sometimes NIOSH gets exposure records and finds 

additional employment information that was not verified up front. They continue working it and 

note it, but before the case can become final DOL has to verify the employment. If additional 

employment was found through records, it's easy to verify. If it came about through an interview, 

then they have to go back and redevelop that, so there may be instances where the case needs to be 

reworked. 
NIOSH/CDC Advisory Board on Radiation and Worker Health 

April 20-21, 2004 

- 20 -

Ms. Wanda Munn observed that in the Hanford compensation figures it was not clear how much of the 

compensation is applicable to the concerns of this Board, and wondered if that could be broken out 

in the future so that they may know what their specific cases are doing and indicated that she would 

appreciate that in the future. 

Mr. Turcic indicated he would accommodate her request. 

Dr. Melius asked whether Mr. Turcic had any views on how the review process of dose reconstructions 

through the Board's contractor tied in with DOL's efforts. 

Mr. Turcic commented that it was very important. He looked at it as a quality control function and his only 

request was that he would like to have issues identified early on so that they could be addressed, 

rather than waiting until thousands of decisions had been issued from a particular site and then find 

out there were problems and that all those cases have to be reopened. He would appreciate Board 

input, especially as they get into hearings on specific issues relative to dose reconstruction. 

Dr. Genevieve Roessler commented that it appears the DOL program is doing a good outreach with 

potential claimants, but it also appears there's a big disconnect, misinformation or lack of up-to-date 

information, with Congressmen and the public and the media. She wondered if it's the Board's 

responsibility to possibly have a quarterly newsletter to be handed out to interested people. While 

NIOSH has a fantastic web site, she wondered what percentage of people really used that site and if 

there were a statement on there concise enough to convey the progress being made in the project. 

Dr. Ziemer noted that he didn't know if those were rhetorical questions, but they were thought-provoking 

ideas. 

* * * * *

DEPARTMENT OF ENERGY STATUS REPORT

Mr. Tom Rollow 

Department of Energy 

An update from the perspective of the Department of Energy was presented by Mr. Tom Rollow, who 

presented graphic illustrations of the differences in the portions of the program administered by DOL and 

DOE, respectively. He also noted the portions of the program in which DOE works hand-in-hand with 

NIOSH. This includes answering NIOSH requests for exposure information for claimants in the DOLadministered Subtitle B, and NIOSH making physician appointments to the physicians panels for the DOEadministered Subtitle D. 

There is a sizeable backlog of cases. There have been approximately 23,000 applications, with somewhat 

over 1,000 processed. Changes in how the physicians panels function has improved the movement of cases. 

 A plan has been developed to eliminate the backlog within two and a half years, but will require 

Congressional help, both financially and legislatively. 
NIOSH/CDC Advisory Board on Radiation and Worker Health 

April 20-21, 2004 

- 21 -

A proposed rule change is currently in public comment period which will allow a positive determination to 

be made by a single physician. A negative determination would then require a second physician review, and 

possibly a third, until two physicians concur. This would replace the three-physician requirement currently 

in place and would double the number of cases processed. 

Efforts are underway to improve the physicians' pay cap, currently set at executive level three, 

approximately $68 an hour. Physicians in this field are typically receiving double that amount on a per-hour 

basis, limiting the ability to attract additional physicians. 

Mr. Rollow outlined a variety of changes he is seeking to make to the program in an effort to provide the 

contemplated benefits to claimants. These included a $33 million appropriations transfer, prioritizing cases, 

implementation of a tiger team to help categorize and rate suggestions for improvements and implementing 

the changes. Mr. Rollow noted that the supply of physicians is the major bottleneck to the program. 

Mr. Rollow described the concept of full-time equivalency hours, noting that the physicians appointed by 

NIOSH originally committed to working 16 hours per month on the panels, but are presently averaging 

about four hours per month. So while the number of physicians appointed seems generous, the hours 

worked are few. 

Noting that the entire program has benefited from having a lot of records available in the DOE system, Mr. 

Rollow indicating that was partially due to security. Information was classified and stayed classified, 

making it more difficult to destroy. There are regulations for retaining records, such as radiation exposure 

records must be maintained 75 years. The records look different at each site, however, having been treated 

differently from site to site. 

Some records have been digitized; some are stored in boxes. Some have names; some have employee 

numbers that have to be correlated to names and Social Security numbers. 

The DOE advisory committee was allowed to expire last January. The process of reauthorizing a new 

advisory board which will focus more on the production end and less on program conceptualization is 

underway. Members are expected to be appointed in three or four weeks. 

Mr. Rollow presented a group of slides which looked at the DOE program from varying perspectives -- 

cumulative cases processed, determinations per week, budget and legislation. 

Discussion Points:

Dr. Roy DeHart inquired if his understanding was correct in that DOE was asking the participants in its 

advisory board to be volunteers and not reimbursed, observing that he couldn't understand why that 

would be done when the program was having difficulty moving forward, and noted that this Board is 
NIOSH/CDC Advisory Board on Radiation and Worker Health 

April 20-21, 2004 

- 22 -

not all voluntary. 

Mr. Rollow indicated that was information he had not possessed and he would take it back to Washington. 

Dr. DeHart also queried Mr. Rollow relative to insurance issues with the physicians. 

Mr. Rollow expressed concern that, as one of their practicing physicians, Dr. DeHart was unaware the 

insurance was in place, noting that was an indication of a communication problem he would work on 

when he returned. 

Dr. Melius asked about cutting back staff if the appropriations reprogramming were not forthcoming, and 

wondered if the staff were involved in activities related to this program. 

Mr. Rollow noted that would be staff working at the DOE sites collecting records. He explained they were 

working at a rate exceeding a level budget in anticipation of seeing the reappropriation. If that is not 

forthcoming, they will have to begin laying off staff. 

Dr. Melius wondered if that would mean records coming to NIOSH would be cut back, as well. 

Mr. Rollow replied that he had made a decision to put NIOSH and DOL first and had never wavered on that 

commitment. Among many reasons, one was that this program was more mature and moving faster. 

 His intention is to continue that commitment, but noted that as he started to run out of resources, 

anything could happen. 

Dr. Antonio Andrade asked if he had missed mention of where the money in the reprogramming action 

would be coming from, and what Mr. Rollow's personal assessment of the likelihood of 

reprogramming might be. 

Mr. Rollow indicated that he believed in large part the sources identified were construction projects with 

excess or leftover money and needed Congressional approval to use it. It may represent projects that 

will not get moving as fast this year as they would like and the Department will use that money on 

this project. He commented he thought there was a high probability Congress will agree that the 

sources would be acceptable. 

Mr. Leon Owens commented on the deficiency at a lot of sites regarding the willing payer issue. He 

wondered if, as part of the overall programmatic changes, the Department had considered a 

legislative fix to the willing payer issue. 

Explaining that a willing payer is a contractor still under the control of the DOE, Mr. Rollow noted there 

might be many payers not controlled by DOE, willing or otherwise. The official position of the 

Department is that the National Academies will be asked to study the issue because it is also a social 

and legislative question. Until then there will be no legislative fixes coming forth to the willing 

payer problem because they don't know if it is a problem. 

Mr. Rollow further noted that for Paducah, exposures that occurred prior to that site being turned over to 

USEC would be covered by Bechtel-Jacobs, and was concerned Mr. Owens had not heard that. 

DOE will issue a do-not-contest order to Bechtel-Jacobs Company. 

Mr. Owens countered that his concern was whether Bechtel-Jacobs would continue to be on the site, noting 

that two contracts are recompeting at the moment. 

Mr. Rollow stated that Bechtel-Jacobs will be a willing payer until contracts are placed for the Paducah and 

Portsmouth sites. Prior to that time the Department intends to order Bechtel-Jacobs to continue that 

responsibility. That legal document has not been written yet, however, so it can't be counted on until 
NIOSH/CDC Advisory Board on Radiation and Worker Health 

April 20-21, 2004 

- 23 -

it's done. 

Mr. Elliott indicated he presumed the DOE advisory committee would be FACA chartered, and inquired 

into its size and balance of perspective. 

Mr. Rollow replied he had forgotten the exact description from the Federal Register, but believed it 

included insurance, DOE contractors, DOE employees, work comp people. They were expecting 

about 12 members, noting the Secretary of DOE is in the process of selecting members, whose 

names will be sent to the White House for endorsement. 

 * * * * *

 SITE PROFILE STATUS, USE IN DOSE 

 RECONSTRUCTIONS, AND ROLL-OUT

Dr. James Neton 

NIOSH/OCAS

Dr. Neton began his update on site profile status with the basic definition which appears on the site profile 

web page. Dr. Neton noted that at the Board conference call the issue was raised that site profiles do not 

intend to be comprehensive evaluations of incident reports. He noted there was some incident report 

information included, major incidents, but they are not all-inclusive. That information is maintained in a 

separate site information image database where major incidents are collected and catalogued. The database 

is searchable by keyword. Some incident reports are very large, and he didn't intend to give the impression 

that incidents were not included in site profiles, but they're not contained within the documents themselves. 

He noted that when doing dose reconstructions for monitored workers, the incident reports would not 

necessarily be relied upon. 

Dr. Neton reiterated that site profiles are a compilation of technical documents, six separate chapters, and 

are dynamic documents in that they are subject to revision any time new information is available that would 

affect dose reconstruction outcome for any claimants. 

Dr. Neton commented that he'd had a number of questions about the concept of missed dose versus 

unmonitored dose, noting that those concepts are not necessarily addressed in the site profile, but are 

included in the implementation guide. If a worker were monitored routinely for every monitoring period, 

NIOSH would assess and attempt to assign the missed dose or what dose the worker could have received 

and still had all of his measurements show up as non-detectable. If the claimant were unmonitored, missed 

dose should not be assigned unless it could be demonstrated fairly conclusively that the missed dose would 

conservatively estimate unmonitored exposure. It has to be done with very good justification. Dr. Neton 

noted that these are difficult concepts to grasp in that they're abstract, but they are covered in the 

implementation guides. Missed dose is assigned and unmonitored dose is recognized. 
NIOSH/CDC Advisory Board on Radiation and Worker Health 

April 20-21, 2004 

- 24 -

Newly released site profiles include Rocky Flats, which will allow commencement of processing on 834 

claims from that facility. There are 2,088 claims from Oak Ridge Y-12 which can now be addressed. Last 

Friday the Iowa Ordnance site profile was approved. There are some 400 to 500 claims from that facility. 

Collectively, roughly 7,000 cases may now be addressed by various site profiles. That represents 40 percent 

of the claimant population. 

Dr. Neton noted that he refers to site profiles having been issued rather than completed because a site 

profile can be issued without having every single piece of information included. Often sections will be 

reserved. In the Rocky Flats external dosimetry Technical Basis Document, the neutron monitoring section 

for certain time periods is listed as reserved. Work is still being done on the details of what the neutron 

exposures really were during those time periods. But for a claimant who didn't work in those time periods 

and had low potential for neutron exposure, that site profile could be used in evaluating the case. That is the 

concept behind pushing the site profiles out as soon as it's felt they're technically accurate and complete 

enough to address certain blocks of dose reconstructions. They then continue to move forward with further 

information after the fact. 

Noting that site profiles are subject to revision, Dr. Neton stated that the Mallinckrodt site profile was 

undergoing revision one, and the Hanford site profile is also undergoing some limited amount of revision. 

Dr. Neton pointed out that the Iowa Ordnance Plant site profile is unique in that it has been handled like an 

Atomic Weapons Employer site. It had a limited operation from DOE activities and it's covered in one 

document rather than having the individual chapters. 

Additional site profiles under development will enable another 1,400 cases to move forward. Weldon 

Spring is a key document to develop in that a number of Mallinckrodt employees worked at both places and 

that will enable a number of those claims to move forward. The target goal for completion of the remaining 

site profiles is end of summer or early fall. 

A decision must be made as to whether resources to generate an extensive document should be invested in 

preparing a site profile where the number of cases that would be affected is limited, or if it might be better to 

do hand-crafted dose reconstructions at those facilities. Dr. Neton noted that once the site profiles now in 

development are released, they will be at the point of making that determination. 

Dr. Neton announced that ORAU had written a worker outreach plan which has been completed and is 

available for distribution. It is a controlled document written by ORAU, reviewed and approved by NIOSH, 

that lays out the intent of the program and establishes an outreach group for worker input. Meetings are 

being arranged. There was a meeting in Portsmouth last week. They provide excellent input for workers to 

comment on site profiles. It had been indicated that the profiles tended to be written in a vacuum and 

NIOSH agreed and decided to meet with workers and get their input and let them talk about the type of 

information that may be missing from the profiles. This has been very productive, with a lot of good 
NIOSH/CDC Advisory Board on Radiation and Worker Health 

April 20-21, 2004 

- 25 -

information-sharing. Building trades have a unique perspective on what was done and what was monitored. 

 That needs to be incorporated. NIOSH is committed to adding construction activity chapters to several site 

profiles to help flesh out gaps they perceive to be in those documents. 

Minutes are taken at the worker input meetings to capture what has been done. They'll be distributed to a 

representative at the meeting, to be further distributed to the workers. They use sign-up sheets and ask 

people to input and say whether the minutes cover the issues that came up at the meeting. All this is in the 

plan. There have been five worker input meetings so far. The third one at Hanford will take place Thursday 

after this Board meeting. Sometimes it's difficult to get everybody together on the same day, so NIOSH 

tries to accommodate wherever possible. They prefer fewer trips, but if it requires multiple trips to a site, 

that will be done. Scheduled meetings are at INEEL in April, Nevada Test Site in May and Pantex in June. 

There are some tentative negotiations with Mound site in May. 

One thing coming out of the meetings is that site safety reps need training. Workers are going to their union 

reps and asking for interpretation of forms, what is IREP, what is IMBA. Plans are being made for union 

reps, health and safety reps to come to Cincinnati to a NIOSH-funded one or two-day dose reconstruction 

workshop to give them a baseline of knowledge to be comfortable with the process. It is complex and 

people may never be totally comfortable, but to the extent that some educational input can be provided, 

NIOSH is committed to do that. Dr. Neton indicated he looked forward to getting the information shared 

and working with the groups in the very near future. 

Discussion Points:

Dr. Roessler inquired about a concept that had come up early on in the preparation of the site profiles about 

meetings with old-timers, with workers -- where possible -- from the '40's who where there during 

times that information may not be so readily available, and inquired what success they had achieved 

in contacting those people. 

Dr. Neton acknowledged that a lot had not been done in that area, but data were being collected and that he 

had spoken to someone at this particular meeting who had a fascinating knowledge about what had 

happened in the early monitoring days for construction workers, and they intended to interview him. 

 He noted they had done one interview at Rocky Flats for a person discovered there who was about 

to retire. This is something that should be aggressively pursued. 

Dr. Melius raised a question about ORAU and NIOSH developing a conflict of interest policy. 

Dr. Neton apologized for having skipped over it in his notes, but stated ORAU has drafted a site profile 

conflict of interest policy. NIOSH is still in the process of reviewing it. Revisions are similar to 

concepts included in dose reconstruction conflict of interest policy. Any worker who currently 

works or previously worked at a site could not be a principal author on a Technical Basis Document 

chapter. They are not precluded from using site subject matter experts as resources. They are the 

most knowledgeable. The person who puts pen to paper cannot have that conflict of interest. Even 

though the official policy is not approved, ORAU is following that voluntarily at this point. 
NIOSH/CDC Advisory Board on Radiation and Worker Health 

April 20-21, 2004 

- 26 -

Dr. Melius asked if the Board could see it. 

Dr. Neton replied that could not be done until they got the final form out. 

Dr. Melius commented that people would be skeptical until they could see how it was being implemented, 

noting that one of the major issues is going to be transparency. If people with potential conflicts of 

interest are going to be accessed as a resource, it's transparency for references that would be helpful. 

Dr. Neton agreed that anyone who works as a member of the site profile team needs to file a biographical 

sketch indicating conflict of interest and what their role was. But until the formal policy has been 

issued, you can't tell. 

Mr. Elliott added that whoever contributes to the documents needs to be referenced, and indicated that 

when the conflict of interest plan comes out it will make sure that principal authors are not 

conflicted. As soon as the plan is approved it will be given to the Board. 

Dr. Melius indicated it would be helpful to the credibility of the process to see references to people at the 

worker input meetings, the old-timers. 

Dr. Neton advised the minutes of those meetings would be on the web site, as well as the attendance sheets. 

Dr. Melius commented he was confused on the implementation guides and that he wasn't clear whether they 

were site specific or more general. 

Dr. Neton responded that implementation guides are more general. There is an implementation guide, for 

example, for internal and external dosimetry. They are conceptual based. 

Dr. Melius inquired about the repository of incident reports. 

Dr. Neton replied that it was not just incident reports and didn't intend to give an incorrect impression of 

that. It is called a Department of Energy site images database. A lot of data capture efforts have 

been done at facilities and thousands of pages of records have been scanned and catalogued as PDF 

files by site. For example, one could go to the Savannah River section, do a keyword search and 

pull up anything that had "incident" or "accident" in the title and receive those documents. It's not 

purely an incident database, but the incidents are catalogued. 

Dr. Melius wanted to know if they were referenced or indexed anywhere relative to the site profile technical 

document. 

Mr. Elliott noted that they were all indexed and that the Board certainly had access to it, as well as the 

Board's contractor. If one of those are used in a dose reconstruction, it is cited in the dose 

reconstruction report that an incident report was found and the date cited. 

Dr. Neton agreed that if the incident were used in the dose reconstruction, it is cited, adding that the first 

ones done were the Y-12 criticality accident, which are referenced. 

Dr. Melius countered that they were not referenced in the site profile technical document. 

Dr. Neton explained that some are referenced, but it is not an exhaustive list because a line has to be drawn 

somewhere. The incident reports have been catalogued the best they can. All incident monitoring 

data is requested from DOE when they issue a request for information. They request incident 

information during the interview process. There are a number of sources that bring the incidents to 

the forefront. In certain dose reconstructions where monitoring data is available, it isn't essential to 

have a small incident in there. Any incident that would have been there is covered in a claimantfavorable manner. If they're known, they'll be dealt with; if they aren't known, using a claimant-
NIOSH/CDC Advisory Board on Radiation and Worker Health 

April 20-21, 2004 

- 27 -

favorable approach, it is assumed some type of incident happened. 

Dr. Melius declared that if this is a base document that's supposed to guide the individual dose 

reconstructions and other technical documents are being used -- realizing that every incident can't be 

covered -- but there's no name attached to it, it would seem you would want a system to make that 

association with a building or a process or a type of job that would raise suspicion. 

Dr. Neton commented that he was probably confusing Dr. Melius, who agreed he probably didn't realize he 

was confused. They entered a protracted discussion where lines blurred between implementation 

guides, site profiles, missed dose and unmonitored dose. Numerous and varied examples were given 

in an effort to clarify. 

Mr. Elliott offered that some time back Dave Allen and Tim Taulbee had given presentations on internal 

dose and external dose implementation guides, respectively. He noted that while they were on the 

web site, if it was felt it would be helpful to revisit the issue, Mr. Allen and Mr. Taulbee could be 

brought back to illustrate how what was being proposed then is being done now, using those 

methods and concepts. 

Dr. Ziemer inquired if Dr. Melius' query related to what method is being used to assure linkage of an 

incident report to a particular individual who might have been there. 

Dr. Melius confirmed that was his question. 

Mr. Elliott replied that the answer would then be yes and no. 

Dr. Ziemer explained that he understood Dr. Neton to be saying that if it's an internal dose issue and there's 

bioassay data, the fact that you made the linkage may not matter that that's the cause. If a claimant is 

unmonitored, it may be a different matter. 

Dr. Neton agreed, acknowledging that unmonitored workers are much more difficult, which is why the 

worker database is being constructed. Incidents are not being ignored. They're being catalogued, 

but dose reconstructions are being performed without necessarily having to link internal exposure to 

an incident. 

Mr. Elliott offered that perhaps a more illustrative example is what is being done when there is no ability to 

link. In that case, the claimant is given the benefit of the doubt. The reasonableness of the 

allegation is looked at. If a claimant says an incident happened a particular place they worked, but 

NIOSH's best efforts can't find that incident was ever recorded, if an affidavit can be provided, that 

is pursued. 

Dr. Melius then asked how the claimants are assured that the incidents are accessible to NIOSH and that 

there may be a reported incident that's not recorded -- as in the case of a survivor who may not have 

that information -- but assurance there's an attempt to find out. 

Mr. Elliott explained that was the practice of dose reconstruction and had nothing to do with the site profile. 

 Each dose reconstructor is expected to ask those questions and pursue that line of thought until 

satisfied. 

Dr. Neton suggested that as the Board got into the dose reconstruction reviews, it may become more 

obvious how it works. He reiterated that the site profile is a guide that helps the dose reconstructor 

be more uniform and consistent. It does not require inclusion of every piece of data existent at the 

site for it to be used. On the other hand, one cannot review a site profile without looking at 
NIOSH/CDC Advisory Board on Radiation and Worker Health 

April 20-21, 2004 

- 28 -

corresponding dose reconstruction done with it to see that it makes sense. 

Dr. Melius commented that he wasn't convinced that consistency was being maintained among cases so that 

the same type of information was being accessed, which could be provided in the site profile, but he 

wanted to think about it some more. 

Mr. Robert Presley asked if there was any feedback from old-timers groups on site profiles on the web site. 

 If so, is there a means by which site profiles can be updated. 

Dr. Neton replied there had only been a handful of feedback from the web site, but the union briefings 

provided feedback and valuable information, and there had been some from write-ins. Any 

substantive information would be incorporated into a site profile modification and put on the web 

site as a revision. 

Mr. Elliott added that one comment had resulted in reviewing source documents to see if a reference given 

by the commenter had been included, which it had, and they were able to tell them that. Another 

reference was given by a commenter which they didn't have. It was added, although it didn't make 

any change in the site profile. But it was a piece of information they hadn't had before. 

Dr. Melius commented that the idea of educational outreach was good, and urged NIOSH to work with Pete 

Turcic and DOL in that they seemed to want to engage in much the same activities. Given the 

potential confusion, he felt it would be helpful for everyone to go out together to do that, within 

resources. 

Mr. Mark Griffon asked for clarification on unmonitored workers versus unmonitored exposures. He 

related having interviewed former workers who said there had been various jobs or various time 

periods where they were close to their quarterly limit and "volunteered", after being told they would 

be rotated out of their job, to leave their badge in their locker when they worked the next couple of 

weeks. Another example is a worker being monitored for the wrong thing. Mr. Griffon wondered 

if that were addressed in the concept of unmonitored dose. 

Dr. Neton replied that the first example came up at a worker outreach briefing and NIOSH is looking at 

that. This is a good example of something learned at a worker meeting. They plan to write a 

technical bulletin on the issue and are looking at ways to accommodate that. While it may not affect 

a large number of workers, it is an important segment because they're the ones very close to 

compensation value. That is being looked at very closely. It isn't addressed right now, but they're 

looking at ways to do so. 

The second example, bioassay programs where source term had nuclides that weren't monitored, speaks to 

the site profile. The internal dosimetry section is supposed to cover and flesh out what radionuclides 

were there, were transuranic nuclides mixed in with the uranium source term, were there other types 

of materials. Then that would require the health physicist to go back and reconstruct those. 

Suggesting this may be the linkage Dr. Melius was talking about, Mr. Griffon asked how the individual 

being dose reconstructed was placed with that source term. 

Dr. Neton explained that they know what years the source term existed, and the site profile would address 

that. That is not an incident-related issue, but is a source term-related fact. If that is not known, the 

most claimant-favorable approach will be assumed and the claimant will be assigned the worst 

source term that existed at the site. He noted that was fairly standard practice in the program. 
NIOSH/CDC Advisory Board on Radiation and Worker Health 

April 20-21, 2004 

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 * * * * *

 RESEARCH ISSUES STATUS

MR. RUSS HENSHAW 

NIOSH/OCAS

The Board had earlier identified a number of items of interest in terms of dose reconstruction and related 

issues. Mr. Henshaw indicated his presentation would be divided between an update on the Board's 

priority list of those issues, as well as a review of compensation results of completed claims through the first 

quarter of this year. 

First on the priority list is the incorporation of occupational studies into NIOSH-IREP. While it was 

recognized at the onset of this program that the DOE work force would be the ideal source population from 

which to derive IREP risk coefficients, NIOSH judged that worker studies were insufficient for derivation of 

quantitative risk estimates. This was primarily due to complexity of study factors, but also because of often 

conflicting findings. 

It was determined that the issue would be periodically revisited. This will be done this year. A feasibility 

study will be conducted to review the current state of knowledge of worker studies. If it appears warranted, 

launching a more formal evaluation leading to possible adjustment of IREP risk coefficients would be 

proposed. 

The NIOSH-IREP lung and smoking model is a priority one topic that has been discussed often. The model 

in NIOSH-IREP now conflicts with the one currently in use in NCI's version of IREP known as NIH-IREP. 

To answer the question of how to deal with that, this year SENES will convene an expert panel to evaluate 

the new model for its applicability in this program. This approach could also be used for other model 

differences, such as the bone model. 

The final priority one topic is how cancers are grouped in IREP, the grouping of rare and miscellaneous 

cancers, including prostate. That will be addressed this year. SENES will begin re-evaluating the risk 

coefficients used in IREP. They are being asked to focus on the possible discrepancies in the uncertainty 

distributions. 

There are two priority two topics. The age at exposure workshop concept has been shelved, but could be 

revisited at a later date. The problem is lack of development of a standardized database, as well as lack of 

staff time to pursue the project. However, age at exposure is a potentially crucial and controversial factor, so 

it can't be allowed to be dropped altogether. 
NIOSH/CDC Advisory Board on Radiation and Worker Health 

April 20-21, 2004 

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Interaction with other work exposures was the other priority two topic. Mr. Henshaw indicated that had 

been discussed within OCAS, but there simply has not been time to properly consider it and nothing is 

currently planned. 

There are other potential research topics than those on the Board's lists. One is DDREF or dose and doserate effectiveness factor, a risk modifier used to adjust for low level radiation doses in non-leukemia cancers. 

 The first phase of the project is nearing completion, with a progress report from SENES expected within a 

few weeks. The next phase would probably involve convening an expert panel, but Mr. Henshaw indicated 

they would wait for the written report before commenting further. 

There was a Congressional appropriation for research on chronic lymphocytic leukemia, the only cancer 

specifically excluded from compensation in IREP. CLL has been traditionally regarded as a non-radiogenic 

cancer. 

There are other cancers with little evidence for radiogenecity. There are quantitative risk models for those 

cancers in IREP. The Health-related Energy Research Branch, or HERB, will begin a research project on 

CLL this year. That will include acceleration of two of their own leukemia studies already in progress, as 

well as a meta-analysis of other relevant studies, published and unpublished. Mr. Henshaw indicated the 

intent was to convene an expert panel, which was planned for this summer. If findings warrant, a 

quantitative risk model for CLL could be developed and incorporated into NIOSH-IREP. 

Mr. Elliott commented that whatever the findings and recommendations are from the scientific expert 

panels or technical peer panels, however they're referred to, they will be brought to the Board. 

Following up on that comment, Mr. Henshaw noted that NIOSH is required to submit proposed substantive 

changes to the Board for review and to then consider the Board's comments. 

Mr. Henshaw described briefly a change underway in the computational engine operating in the 

background of NIOSH-IREP. A newer version of the program was released that will increase the capacity 

and processing speed of NIOSH-IREP. Before changing to it, however, it must be thoroughly tested to 

ensure there are no inadvertent effects on PC results. A test is planned that is just getting underway. 

As a final thought, Mr. Henshaw mentioned it was possible an epidemiological analysis of NIOSH claims 

data could prove useful in the IREP risk model, noting however that there are limitations and some very 

serious challenges in working with these data. Specifically, data are currently limited and results should not 

be construed as being representative of all claims. The dose reconstruction efficiency approach carries 

serious limitations, especially when attempting to assess dose response. 

There are challenges in comparing data with national cancer figures, difficult under the best of 

circumstances. There are hundreds of types of cancer, but less than three dozen cancer models in NIOSH-
NIOSH/CDC Advisory Board on Radiation and Worker Health 

April 20-21, 2004 

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IREP. The claimant-friendly process further complicates an epidemiological analysis of the completed data. 

Moving to the claims results, Mr. Henshaw pointed out they were through March 31, 2004, and included 

dose reconstructions submitted to DOL for which NIOSH has received notice from DOL of a decision. 

Through that date, it represented about two-thirds of the dose reconstructions submitted to DOL. For that 

reason and also because of the efficiency process, it would be surprising if it were predictive of future 

results. Cancer model-specific compensation rates reflect only claims with one primary cancer. 

Mr. Henshaw presented the information in slide form, having put the 32 IREP cancer models into a table 

arranged in the order the models appear, in ascending numerical order by ICD-9 code. The table indicated 

the total number of cases processed using each particular model, the probability of causation equal to or 

greater than 50 percent, the number and percentage of claims that were compensable. 

Dr. Owen Hoffman suggested that for members of the public it's important to point out that there is only a 

one percent chance that probability of causation would be greater than 50 percent, a highly conservative 

estimate of probability of causation. 

Mr. Mark Griffon inquired if there were available a breakdown of claims by cancer type by site, noting 

that in terms of the Board's case selection process it might be important to see distribution across all the 

claims currently in the system. 

Dr. Ziemer indicated Mr. Griffon was asking, for example, if a particular cancer appeared to be more 

prevalent at Savannah River or some other site. He observed that it might be helpful information as the 

Board moved into the selection process, and that maybe at some future point that could be provided. 

Noting that the simple answer is that he hasn't looked at that yet, Mr. Henshaw explained the information 

contained on each slide in his presentation. He observed that there were a number of surprises in the results, 

but cautioned the Board to bear in mind that results almost certainly will change. 

Mr. Henshaw explained how he had further studied rate of compensability by graphing cancer models with 

at least ten claims from highest to lowest and found the highest compensation rate was lung cancer. There 

were nine cancer models with no compensable cases. 

As Mr. Henshaw presented graphs demonstrating compensability from a number of perspectives, Dr. 

Andrade commented that the apparent linearity of some of the results might be somewhat artificial, given 

the efficiency process. Mr. Henshaw agreed, noting that the trend lines for compensation rates by age at 

diagnosis and by years worked could simply be a proxy for estimated dose. 

Mr. Henshaw summarized by stating that projects will be underway within the year addressing the Board's 

three priority one topics, with other research projects underway or in planning. Mr. Henshaw observed that 
NIOSH/CDC Advisory Board on Radiation and Worker Health 

April 20-21, 2004 

- 32 -

completed claims results revealed some surprises, noting results are skewed by the efficiency process and 

incomplete data. NIOSH will continue to monitor data for trends and anomalies, and will keep the Board 

updated. 

Discussion Points:

Dr. Roy DeHart inquired how skin cancer was handled in the case of multiple primaries. 

Mr. Henshaw replied that multiple skin cancers were not included in the skin cancer-specific results. It was 

attempted initially, but proved unfeasible. Mr. Henshaw concluded it was more honest and clean to 

exclude all multiple primaries from cancer model-specific rates. 

Dr. Melius asked what happened when the limits of the old software was reached, if it slowed down or was 

unable to handle it. 

Mr. Henshaw indicated the awareness occurred when it was discovered there were claims in the hopper 

with rows that exceeded IREP's capacity. Those cases had not yet reached dose reconstruction. 

Dr. Henry Anderson commented it would be interesting to see if the distribution of cancers here are 

different than what would be expected in the general population, and to see whether people were 

putting in claims because they believe a cancer is radiation-related. He noted that prostate and breast 

cancer appeared not out of line, but some seemed to be a bit more than might be expected. He 

observed that in this population the radiation-sensitive cancers ought to be over-represented. 

Mr. Henshaw agreed, stating that he intended to do that. 

Dr. Roessler offered that even though Mr. Henshaw had qualified his interpretation of the data, caution 

should be exercised not to make too much of those interpretations at this point. 

Mr. Henshaw agreed. 

* * * * *

SPECIAL PUBLIC COMMENT PERIOD

Dr. Ziemer inquired if there were any who had signed up for public comment who would find it very 

inconvenient to return for the scheduled comment period in the evening. If so, he indicated his willingness 

to accommodate those members of the public. 

Mr. Thad Coleman 

Retired Hanford Employee

Mr. Coleman spoke of his experiences at a plutonium test recycle reactor and the types of jobs he 

performed. He described his current health status and stated no one could tell him what was causing his 

lung problems. He called for a coordinator to get justice done for the workers. 
NIOSH/CDC Advisory Board on Radiation and Worker Health 

April 20-21, 2004 

- 33 -

Dr. Ziemer indicated the Board probably couldn't answer Mr. Coleman's questions, but perhaps the staff 

might give him some direction. 

Dr. Ziemer declared the Board in recess until 7:00 p.m., at which time public comment would be received. 

* * * * *

SCHEDULED PUBLIC COMMENT PERIOD

Dr. Ziemer welcomed the public and thanked them for attending the evening session. He explained the 

responsibilities of the Board and the focus of their meetings. Dr. Ziemer described the Federal agencies 

involved in various aspects of the compensation program. 

Dr. Ziemer identified Mr. Larry Elliott as the designated Federal official who serves as Executive 

Secretary of the Board, and described his role at NIOSH and with the program. 

Dr. Ziemer introduced the individual Board members and elaborated on the Board's role in development of 

guidelines, assessment of scientific validity and quality of dose reconstructions. 

Dr. Ziemer emphasized that the Board does not deal with individual cases. The Board will not review a 

claim on behalf of a claimant. 

Dr. Ziemer explained that the public comment period is intended as an opportunity for the Board members 

to hear from the public. It does not operate as a question and answer function. The Board's interest is in 

hearing how effective the program is or where it is not effective, whatever a commenter's experience may 

be. 

Dr. Ziemer informed the group that a list of those in attendance is desired for public record, and asked that 

members of the public enter their names on the sign-in sheet if they hadn't already done so. An additional 

sheet is provided for those who wish to speak, in order to keep the flow going and make sure everyone gets 

an opportunity to do so. 

Ms. Gai Oglesbee

National Nuclear Victims for Justice

Ms. Oglesbee announced she was very experienced and knowledgeable, with nine people in her family 

battling cancer currently. She offered her opinion that much of the public information was inaccurate, 

contradictory and being ignored. She indicated health physicists were not "expert witnesses" and that she 

had her own experts. She stated she was in a conflict with Dr. John Howard, director of NIOSH, regarding 
NIOSH/CDC Advisory Board on Radiation and Worker Health 

April 20-21, 2004 

- 34 -

what he feels is his right to dismiss her generic dose reconstruction. She declared the IREP program was 

based on Dr. Owen Hoffman's unreliable methodology. She questioned whether records being processed 

are the same records she submitted. 

Mr. E. R. Samson, 

Kennewick, Washington

Mr. Samson observed that more information has been provided in one day (of the Advisory Board meeting) 

 than in the past four years. He indicated he felt he had a pretty good claim, but his concern was for a group 

of surviving widows living on a fixed income who need the money, particularly the medical payments. He 

said more help would be appreciated. 

Mr. Charles Moore, 

Yakima, Washington

Mr. Moore indicated he had worked 23 years on the Hanford project, was fired because he has asbestosis, 

and has never received any compensation. He stated his purpose in being there was to discuss dose 

reconstruction. Mr. Moore had with him documentation relative to his exposure records which he indicated 

gave widely conflicting information, as well as one document which purported to bear his signature but 

which he declared was forged. He asked the Board to go through the documents and tell him if it felt 

accurate dose reconstruction could be done from that type information. 

Mr. James Williamson, 

Survivor

Mr. Williamson spoke on behalf of his mother and his family regarding his father, who was hired in 1967 

and worked for 25 years before his retirement in 1993, the year he was diagnosed with cancer. Mr. 

Williamson expressed his confusion at the fact that his mother's claim was a rarity in that it was a Hanford 

cancer-related claim that had won in the State of Washington, but for some reason it didn't work under the 

Federal part and they didn't understand why. 

Mr. Ken Staley, 

Claimant

Mr. Staley described his work experience at Hanford and the difference in radiation exposures allowed in 

the '40's and now. He spoke about other people in the room, their health issues and the lack of financial 

assistance they'd received. He described a group of some 20 or so widows, some of whom have had to 

borrow money to eat, and questioned the fairness of that because their husbands have died. Mr. Staley

stated he had a claim number, and had been denied. He asserted that the sample taken from his arm had 

come back benign because it had been taken from the wrong place. 
NIOSH/CDC Advisory Board on Radiation and Worker Health 

April 20-21, 2004 

- 35 -

Ms. Donna Beecroft, 

Survivor Claimant

Ms. Beecroft indicated her family had moved to the area in January of 1943 when her father became one of 

the first reactor operators at Hanford. She commented that she didn't believe anyone understood what they 

were up against back then, and it was fun and exciting and they loved living there. 

Ms. Beecroft commented on Mr. Moore's records that were from 1950 to 1976, and wondered if anyone 

thought records were kept better in the '40's. She described her father changing rods with his hands before 

they had robots, and working until he couldn't make the Geiger counter stop ticking by showering and 

scrubbing and soaping. And then he came home like that. Her three brothers have thyroid problems, her 

sister had breast cancer and her mother died of cancer. 

Asking the Board not to think they were a pitiful little family, Ms. Beecroft declared her family was proud 

of what her father did and proud of him -- and proud of Hanford. She stated they loved it there and had 

enjoyed their lives there. It had cost them to be there, but it was worth it. She reiterated she had not asked 

for the money, she had been approached. But now that it's been offered, it seems to be a dead end. 

Mr. Mike Henning, 

Claimant

Mr. Henning stated he had worked at Hanford since 1978 in almost every building. He filed a claim in 

December of 2001 and had his dose reconstruction done. The report indicated he had X rem, less than the 

50 percent required. But nothing told him what 50 percent would have been. He not only didn't know what 

the criteria consisted of, he didn't know how it had been arrived at. 

Mr. Henning indicated he'd had lymphoma five or six years ago, which had so far not returned, but he 

didn't know if it would. He noted that when people asked if he's clear from cancer, he observes he was clear 

before he got it, so he doesn't know. He indicated criteria clarification would be helpful. 

Dr. Ziemer acknowledged that Mr. Henning's comments had been noted, remarking that the issue of 

communication is one raised fairly regularly and something that is being worked on. 

Mr. Charles W. Shatell, 

Claimant

Mr. Shatell declared he was only 86 years old and had come to Hanford with the duPont Company in 1944. 

 Radiation work began in 1948 when he worked the contractor under the Jones Company and did radiation 

work for all the reactors and finally ended up with cancer. 
NIOSH/CDC Advisory Board on Radiation and Worker Health 

April 20-21, 2004 

- 36 -

Mr. Shatell described his work experiences, the exposures they encountered, how they devised ways to deal 

with them. He described calculating how quickly they would reach their known exposure limits in certain 

areas. That calculation was then used to determine how much time they could allot themselves to complete 

a job, sometimes measured in only seconds. 

Mr. Shatell indicated that when he had filed his claim, his exposure information was needed. He knew that 

when he worked at the Jones Company a daily log book had been kept of exactly what everybody did, how 

much radiation they received and the location. Mr. Shatell stated that when he left, there was a filing 

cabinet full of the log books, which he understood the Jones Company had in turn passed on to DOE. He 

commented that discovery of those logs could be very helpful, but he'd been told they could not be located. 

Mr. Shatell observed that he's now at the point in the process where he's being asked how much money he's 

spent, so he's hopeful that's an indication he might get paid. He discussed how much his insurance coverage 

costs and that it will continue to go up. 

He also commented that during his time there, DOE had been very cooperative with whatever was asked for, 

such as clean-up before being sent into a high radiation area and lead-lined blankets. 

Mr. John David, 

Sheet Metal Workers Local 66

Mr. David announced he was fortunate to represent the sheet metal workers in Local 66, and noted that it 

was pretty evident to anybody who'd heard the people speak that dose reconstruction does not work. He 

observed that whether a sheet metal worker or pipe fitter or whatever you did, you took a lot of dose. 

Mr. David recollected people called timekeepers, whose job was to keep track of dose. He indicated he 

found it amazing nobody knew where those books went. 

Mr. David expressed his thanks to the Board for coming, but indicated that people had to be given what 

they have coming. He remarked that he had worked with a gentleman who'd spoken at an earlier meeting 

and had offered to grant permission for NIOSH to exhume his father's body. He had made that offer 

because there was no record of his father ever being contaminated, and it was his belief that plutonium 

would be found in his body. 

In conclusion, Mr. David commented that when comparing compensation to the numbers who have applied 

under the program, he didn't think anyone could say it had done its job so far. 

J. L. Mitchell, 

Claimant
NIOSH/CDC Advisory Board on Radiation and Worker Health 

April 20-21, 2004 

- 37 -

Mr. Mitchell indicated he had worked at Hanford 33 and a half years in all areas, all buildings and with 

various types of materials. He commented he'd been exposed to americium the night the plant blew up, and 

had worked with thorium and beryllium during his employment. He described why he didn't believe the 

film badges gave a true reading, and noted that air samples would be allowed to decay 24 hours before 

readings were taken. That would not accurately reflect exposures to employees in the labs. 

Hank Hartley, 

Hanford Building Trades Medical Screening

Mr. Hartley indicated he had managed the Hanford Building Trades Medical Screening program for six 

and a half years, and wanted to address a number of subjects, beginning with Mr. Shatell. Mr. Hartley had 

been one of the young guys working under Mr. Shatell, who had always warned them to be careful of the 

shine. Mr. Hartley stated he'd only had a bit of skin cancer. 

Mr. Hartley said he had often wanted to know his dose rate, but nobody could ever tell him. So he was 

hoping that can be done now, although he didn't see how it could. 

Mr. Hartley said he referred a lot of people from the medical screening to apply under the program, but 

they were afraid because they can't remember details of where and when, et cetera. He wanted to announce 

that there are ways of finding out that information, it just takes a little work and research. Mr. Hartley

suggested that Mr. Shatell would be a good contact for a lot of people because he had good faculties and 

could recall who people were and where they worked. Mr. Hartley also suggested the people at the 

resource center in Kennewick were very helpful and resourceful, and encouraged claimants to call them, 

regardless of their fear. 

Mr. Roy Yates, 

Electrician, Hanford

Mr. Yates commented that he had had colon cancer, taken nine months of chemotherapy and now suffered 

osteoporosis as a result of the chemo. He related inconsistencies he'd witnessed on the site, as well as 

situations in which he felt no records would cover, such as getting hot coveralls back from the laundry. He 

described other workers relating instances of monitors being turned off because of nuisance alarms. He 

spoke of corrosion of aluminum components, leading to another element of exposure from the toxins of 

corrosion. 

Mr. Yates indicated he had made a claim for his cancer which had been denied. However, he felt some 

exposures were not accounted for and that records didn't reflect everything accurately. 

Ms. Catherine Van Dyke, 
NIOSH/CDC Advisory Board on Radiation and Worker Health 

April 20-21, 2004 

- 38 -

Claimant

Ms. Van Dyke stated she had been a quality control inspector at Hanford for ten years before quitting to 

stay at home and take care of her child. She also had ongoing health problems. She had applied for the 

former Hanford checkup and found she was beryllium sensitized and is currently going to National Jewish 

annually. Her claim has been approved for ongoing testing. 

Ms. Van Dyke indicated her main concern is that she's 45 years old and permanently disabled, but she can't 

find a physician or anyone to piece her multiple problems with the other things she's been exposed to. 

Ms. Louisa Jahnke, 

Survivor Claimant

Ms. Jahnke spoke of her husband who had gone to work at Hanford straight out of the Marines and worked 

there 40 years. She had documented every building he'd worked in and what he'd done. She indicated he 

had been exposed to asbestos and beryllium, and had documentation on two accidents resulting in radiation 

exposure. He had ended up completely paralyzed. 

Ms. Jahnke went on to say that her children had all been born and raised in the area. Beryllium had been 

found in the lungs of her youngest son, who had never worked at Hanford. His doctor had concluded it had 

been brought home on her husband's shoes and his clothing, which was washed with that of the rest of the 

family. She indicated a wish that the program would take care of something. 

 * * * * *

Dr. Ziemer thanked everyone who had attended and had participated. He noted the Board would meet 

again the following day and any who wished to attend would be welcome. He agreed with an earlier 

speaker who had observed there was a lot of information, and pointed out the various presenters were 

educating the Board, as well. Dr. Ziemer announced the formal part of tomorrow's session would 

commence at 8:30, continuing through the day, with a public comment period in late morning. 

With no further comments, the Board officially recessed until the following morning.

 * * * * *

 Wednesday, April 21, 2004

Dr. Ziemer called the second day to order, commencing the day's session with administrative and 

housekeeping items. 
NIOSH/CDC Advisory Board on Radiation and Worker Health 

April 20-21, 2004 

- 39 -

 * * * * *

 REVIEW AND APPROVAL OF DRAFT MINUTES

Dr. Ziemer called for substantive corrections or additions to the minutes of the 22nd meeting of the 

Advisory Board on March 11 by teleconference. 

Dr. DeHart noted that on page 3 the minutes indicated his attendance, which was incorrect, and that it was 

correctly noted in other places in the minutes. 

Motion to approve the Executive Summary and Minutes of the Twenty-second Meeting, with 

modifications as discussed, was seconded and unanimously passed.

 * * * * *

 ADMINISTRATIVE AND HOUSEKEEPING

Dr. Ziemer reminded the Board that at the February meeting they had requested Board participation when 

responding to any Congressional letters. After that meeting Dr. Ziemer had written to the three New York 

members of Congress informing them of decisions on the site profile audits. A letter from the three 

members of Congress in response to that letter had since been received and Dr. Ziemer wanted to make 

sure everybody had a copy of that letter. He suggested the Board consider and discuss it later in the 

afternoon during the working session. 

Ms. Cori Homer addressed some housekeeping matters, including travel arrangements and scheduling 

additional Board meetings. She reminded the Board that the next meeting is June 2nd and 3rd in Buffalo, 

New York. 

In discussing the future meeting schedule, Mr. Elliott informed the Board of deadlines relative to task order 

modifications and new task orders, as they may impact that planning process in order for those changes to be 

effectuated during this fiscal year. Dr. Ziemer suggested it might be better to wait until after the 

presentation by Sanford Cohen & Associates to determine exactly where they were with contractual matters. 

Dr. Ziemer indicated there were some matters that had come to the Chair in relation to the contractor, 

reminding the Board that some things had been specified or authorized for the Chair to handle on behalf of 

the Board, and he wanted to report on those items. There were progress reports received on task orders one, 

two and three, all dated March 15th, from Sanford Cohen & Associates. The reports indicated time and 

effort spent on various tasks and were invoice-related, and had come to Dr. Ziemer for approval. He did no 

technical review, but simply gave the okay to NIOSH to pay the bills. Those three were approved for 

payment, and copies were available to any Board member wanting to see them. They contained no technical 
NIOSH/CDC Advisory Board on Radiation and Worker Health 

April 20-21, 2004 

- 40 -

information. 

Two additional progress reports had been received on task orders three and four dated April 15. They were 

similar type reports which had been received just before coming to the meeting. Dr. Ziemer indicated he 

would give the okay to proceed with payment of those two, so there will be a total of five that have been 

processed and approved for payment. 

 * * * * *

 CONTRACTOR UPDATE AND REPORT

Dr. John Mauro, 

Sanford Cohen & Associates 

Dr. Mauro began by reminding everyone that in January SC&A was awarded a task order contract, 

meaning from time to time the Board would ask them to perform certain tasks. To date they have been 

authorized to proceed with four. Primarily the contractor has been working on tasks one, two and three. 

Task one relates to site profiles. The first deliverable was a procedure that will be used to perform the 

reviews. That procedure was delivered to the Board on March 3rd and on April 2nd the Board approved it. 

They began work on performing those reviews on April 5th. Joe Fitzgerald is the task one manager and will 

be giving a status report on those activities. 

Task two is the case tracking software. Under task four the contractor will be receiving a number of cases 

for review. The purpose of the case tracking is to maintain a relational database that will help advise the 

Board of the degree to which the cases being audited are representative of the totality of cases. As the 

contractor proceeds through the audits, that database will be loaded with information to inform what 

percentage of the audits are from which site, what percentage are a certain type of cancer, et cetera. Data 

will also be loaded indicating results of audits. From that database should emerge trends to gain insight into 

areas where the dose reconstruction process could be improved. 

The software and report were delivered on April 3rd, and SC&A is awaiting any comments. That is a 

software program that is expected to be revised as time goes by. It is simply a tool. 

On the NIOSH web site are a large number of OCAS and ORAU procedures which are the heart of the 

protocol used to perform dose reconstructions. SC&A in task three was authorized on February 13 to 

review those procedures. Their first deliverable was to write a procedure for reviewing the procedures. 

That was delivered on April 13th. After it is reviewed, with any comments, that procedure will be finalized. 

 Once that has been done, that particular task order is over. The scope of task three does not include 

performing the reviews. That would require either a modification or a new task order to proceed. 
NIOSH/CDC Advisory Board on Radiation and Worker Health 

April 20-21, 2004 

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Discussion Points:

Mr. Griffon asked Dr. Ziemer if the two deliverables, the tracking software and procedure, would be 

available to the Board. 

Dr. Ziemer indicated the procedures were in the packet and would be addressed in this afternoon's working 

session. If those are approved or approved with little change, then the contractor can officially be 

given the go-ahead to do those reviews. 

Dr. Mauro noted there were two sets of procedures relative to task three. One dealt with methodology for 

reviewing the OCAS/ORAU procedures and the other related to quality assurance. The plan was to 

independently review all the OCAS/ORAU procedures that are being used for quality assurance. 

Dr. Ziemer clarified that once the Board approved the procedures for review, SC&A could be told to 

proceed with that review based on the approved procedures. 

Dr. Mauro agreed, indicating that they could not go forward, however, until they had received a 

modification to the contract. 

In discussing which would be easier, a modification of task three or a new task five, Mr. Elliott indicated a 

modification would be easiest to effectuate. 

Dr. Ziemer commented that if the Board decides to proceed, they still have to define the task and there 

would have to be an independent cost estimate on the actual review. 

Status Update, Task One

Site Profile Review

Mr. Joe Fitzgerald, 

Sanford Cohen & Associates

Mr. Fitzgerald introduced himself as the site profile review manager for the overall program, and noted that 

they had commenced the Savannah River review on April 5th. Mr. Fitzgerald commented that these 

evaluations require the ability to jump in and look at the issues with a certain degree of experience, not 

something to be learned on the job. His approach is to bring in expertise and experience for the particular 

site and put together a team to hit the ground running and add value to the process in terms of insights and 

understanding of the history of the site. He had taken that approach in assembling the team for Savannah 

River, gathering what he would consider national experts on operational history, as well as the radiation 

protection programs for the history of the site. Mr. Fitzgerald indicated that was a precedent he wanted to 

set for this task. 

The first phase is considered review of documentation, and that phase has been completed. Mr. Fitzgerald 

indicated he had sent Dr. Ziemer a letter to summarize what SC&A thought the issues surrounding moving 

to the second phase would entail. The second phase is to actually get into validation, looking at data 

sources, as well as individuals who would have various perspectives at sites, with the goal of looking at 
NIOSH/CDC Advisory Board on Radiation and Worker Health 

April 20-21, 2004 

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completeness and adequacy of the site profiles. 

In the second phase timely access to people and data sources is going to be a key challenge and key 

imperative to a productive review on the site profiles. An effort is being made to put into effect a process 

which was outlined in a conceptual way. They will be working with the Board on how to proceed and 

identify issues as they see them in what they consider a prototype review. They will also try to better define 

the process to follow. They will work through how the team will be able to evaluate the data sources and 

have access to people in a timely way, and work with the Board to figure out how that can be expedited. 

The letter outlines some of those issues. 

In terms of next steps, while this issue of expedited site access and data access goes along, the team will 

want to spend time understanding better how NIOSH and ORAU have put the site profiles together, 

understand some of the criteria and bases, using Savannah River as the test. That will help frame better 

what is sought in terms of the evaluation and will proceed over the next several weeks. A report will made 

to the Board on progress in that area. 

In general Mr. Fitzgerald indicated he believed the group had started off strongly, there is a good team. 

They had proceeded with the initial part of the Savannah River review. They have an important second 

phase to continue. They're exploring next steps that would permit the team to start looking at some of the 

other sites, assuming some lag in getting data on Savannah River. While waiting for data to come in from 

DOE they plan to continue to move ahead on the review of other sites to get as much done as they can, and 

then go back to Savannah River when that data comes in, complete the review and be able to report to the 

Board. This is an effort at a strategy to not be held up waiting for information to come in if that information 

is going to take some time. 

Discussion Points:

Dr. Ziemer reminded the Board that in order to assure a level of independence for the contractor, the Board 

had set ground rules that contractor requests for information or access to documents or individuals 

would be made to the Board Chair, who would relay the request to NIOSH, noting that the nature of 

the letter is such a request. Dr. Ziemer indicated it would be his intent to officially ask NIOSH to 

provide the information requested. 

Dr. Ziemer identified some statements in the document which he felt might raise questions, such as 

determining whether there's a scientifically valid dose estimate made. Dr. Ziemer pointed out that 

in this program they are interested in determining compensable doses, which may not be 

scientifically accurate. He wanted it understood that in giving a go-ahead the Board is not assuming 

that every statement is technically correct. The letter is actually a request for access. 

Mr. Fitzgerald indicated he had wanted to provide some discussion of their basis for pointing to certain 

data sources, and commented that at this phase of the review it's fair to say there are more questions 

than answers. Dr. Ziemer acknowledged his understanding of that intent, noting that the main 
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thrust is to access documents and individuals. Some may be on DOE sites and not in the files of 

NIOSH. 

Mr. Fitzgerald's response was that, realizing the Savannah River review is the prototype, they understand 

the issue will come up again and again. The question of access may be the pacing element to the 

ability to deliver completed reviews to the Board. Anything the contractor can do with the Board to 

expedite that would be the ideal. And in the context of implementing the reviews, they wanted to 

cite the kinds of questions that are arising out of their initial phase as reflective of what they're going 

to have to tackle in the second phase. 

Dr. Ziemer asked Mr. Elliott if the agency's Memorandum of Understanding with DOE covered the type of 

access being described, and if NIOSH had any issues with requests for such access as far as the 

agency was concerned. 

Mr. Elliott replied that the MOU does cover everything in the letter, both requested and by intent. And 

while it had not been mentioned yet, there was also a request to have Q clearances reinstated for 

people who had held them before, and he indicated they would work that through. It was also 

covered under the MOU. NIOSH would facilitate the availability of the authors of the dose 

reconstructions or site profiles for the line of questioning SC&A had added in the letter. Some 

preliminary documents and references and source information was also identified, and so NIOSH 

will submit that to the Department of Energy under a request for that information. 

Mr. Fitzgerald expressed his appreciation for Mr. Elliott's responsiveness. He commented that one issue is 

the process of going through the documentation. Maybe the most insidious part that could be a 

problem would be to get into a process of reviewing documentation and data sources, identifying 

issues that point to other data sources, and then have to go back through another cycle of requests 

through DOE. That may be a challenge to be faced and solved. 

Dr. Ziemer commented that it would not necessarily be the job of the auditor to pursue those documents 

they had learned about. They want to make sure the audit remains the audit. If things like that arise 

and something maybe should have been pursued, then the Board can go back to the agency and raise 

that as an issue. Dr. Ziemer reminded everyone that they would hear him say over and over again 

he does not want the auditors to do the job of the agency. They simply want to identify issues. And 

if they need to be raised, they raise them and say go back and do something. 

In answer to the second question, Mr. Elliott remarked that the role he plays here is to facilitate Board 

access, but he is also concerned about production and impacting resources. He will work with 

everyone to make sure they get what they want and need, but not at the price of slowing down 

development of site profiles and dose reconstruction production. Mr. Elliott indicated NIOSH 

welcomed the audit and was receptive to identification of areas of improvement, but its delicate role 

needed to be recognized. 

Mr. Griffon commented the SC&A letter seemed to be requesting a specific agreement between DOL, 

DOE and the Board. Such does not exist, and the MOU is between NIOSH and DOE. 

Mr. Fitzgerald responded that administrative support is essential and he knew from personal experience 

there was a lot of sensitivity on the sites, and that could be an issue. 

After discussion, Mr. Elliott indicated the MOU would have to be used as-is and he saw no issue. He noted 
NIOSH/CDC Advisory Board on Radiation and Worker Health 

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that because of the Secretary of DOE's commitment, there was a considerable difference in access 

under the compensation program and that of the health research program he and Mr. Fitzgerald had 

experience in. 

Dr. Melius indicated he was concerned by Mr. Elliott's comment that he didn't want this process to slow 

down other processes. Since NIOSH was being audited, he didn't want it to appear NIOSH didn't 

provide adequate resources to the Board to do that, and if there are resource issues, they should be 

identified up front and addressed. 

Mr. Elliott responded that it was not a resource issue. If NIOSH needed to go onto a DOE site with the 

contractor, they would do so. This is viewed as a request from NIOSH on behalf of the Board. The 

resource impact is providing face time with dose reconstructors, site profile authors, site profile 

development managers which takes them away from their work setting. That can be managed and 

balanced, but not to the detriment of the audit. 

Mr. Melius wondered if it were worthwhile for the Board to write to the Secretary of Energy to point out 

the commencement of the audit function. 

Mr. Rollow agreed with Mr. Elliott's summary of how the process would work using the existing MOU 

with DOE, noting that NIOSH has full and free access to all information at the sites. He opined the 

sites will view the review team no differently than they do NIOSH people. As far as a letter, Mr. 

Rollow didn't feel it was needed, but it could be sent to the Secretary to remind him of the 

importance of the audit, and they'd take a look at it when it arrives. 

Ms. Munn observed that attitudes toward clearance had markedly changed since September of 2001. Not 

wanting to see the definition of security from site to site influencing accessibility to information, 

perhaps a letter would at least not be harmful if it requested the Secretary of Energy to notify his site 

managers of the audit and request they provide access as necessary for the records. 

Dr. Andrade offered to try to provide a set of thoughts that could be used in developing a solution. One is 

that the auditing contractor use the site profile authors to get an idea of specifically what they would 

like to get their hands on when they get on site. Another is there should be a general handshake 

agreement between the Board, the DHHS and the auditing contractor with respect to accelerated Q's 

or re-establishing Q clearances. It's a good idea for DOE to let sites know this function is occurring. 

 It will affect them, and everyone should just be up front about it, with an effort to try to minimize 

the impact on the work ongoing at the DOE sites. Dr. Anderson agreed, noting it could limit what 

would have to be requested once the auditors got on site. 

Dr. Ziemer commented that Mr. Fitzgerald is very experienced in this sort of thing. Requested access 

does not necessarily mean that they would look at all those things, but they were simply 

demonstrating things they may need access to. 

Mr. Fitzgerald replied that the procedures had in their first phase to talk to site profile authors, interview 

site experts and review the site profile preliminarily. Those things lead to second phase of looking at 

data sources and validation. It sets the stage to better know what information they should examine 

more closely. It can be done in a way to mitigate burden on the profile authors. 

Mr. Presley commented the letter was a great idea, but it should not stop at DOE but to take the letter down 

to the NNSA level as DOE and NNSA don't always talk. He suggested that data needed and 
NIOSH/CDC Advisory Board on Radiation and Worker Health 

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clearance levels should be coordinated, and Q clearances should be requested only when necessary. 

It takes a lot longer to get. 

Dr. Ziemer observed that a recurrent theme throughout the general suggestions and observations was the 

issuance of a letter or memo, but it wasn't clear to him whether the idea was that this should come 

from the Board or from NIOSH or from the auditing contractor. He also noted that if the Board 

wanted to do something formally, he would be looking for a motion. 

A motion was made and seconded that the Board direct a letter to the Secretary of the 

Department of Energy as notification of the audit process, describing the needs of the 

audit contractor, and requesting the Secretary notify the sites accordingly.

Dr. Ziemer declared the motion open for discussion. 

Ms. Munn wondered if the letter should address the issue of funding and identify funding is through 

NIOSH. 

Dr. Ziemer said it was his understanding Mr. Elliott had indicated there was no need to mention funding. 

Mr. Elliott responded that he interpreted Ms. Munn's question as whether DOE will have funds available 

or whether it would be an unfunded mandate. Mr. Elliott indicated his commitment is to support and 

facilitate Board access, which means if the Board gets access and, because DOE doesn't have enough 

clerical support, needs somebody to retrieve the records, they'll help. If the Board chooses to address 

funding in its letter to DOE, it should address the funding support down through the chain in DOE to the 

sites. 

Dr. Andrade commented that one purpose of the letter is to ameliorate surprise, as well as to allow sites to 

prepare for a visit that would have minimal impact. Because of the MOU, they know they will do the work, 

but the Board wants to be considerate and provide them with notice, and reassurance that the impact will be 

minimal. 

Dr. Anderson observed that it was in the order of an FYI so they could prepare. 

Mr. Elliott offered that it might help their understanding of the agreement with DOE to know that NIOSH 

transfers money to DOE only when technical advice or consultation is sought, or if DOE has a technical 

expert whose help NIOSH needs in understanding a piece of information or data. They are compensated 

back for that, but not for accessing, providing and retrieving information. They assist, but do not transfer 

funds for that. 

Dr. Ziemer announced that he would be calling for a vote on the intent to send the letter, which will include 

the discussed concepts. If the motion passes, he will assign a couple of people to draft the document and the 
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April 20-21, 2004 

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Board will have an opportunity to approve the actual letter later in the day, if that is agreeable with the 

mover and the seconder. 

Dr. Melius asked if the letter could be circulated by e-mail after the meeting, with Dr. Ziemer as final 

approver. 

Dr. Ziemer answered that it depended on what the Board authorized. The Board could not approve or take 

formal action on it outside the public forum, but the Chair could be authorized to send the letter, so long as 

the general content is agreed upon by the Board at the meeting. 

The Chair called for a vote on the motion of intent to send the letter, as discussed, to the 

Secretary of the Department of Energy. The motion carried unanimously.

Dr. Ziemer asked Dr. Melius and Dr. Andrade to make an effort to provide the Board with a rough draft 

as a preliminary idea of the content during the afternoon session. He indicated they were welcome to call on 

anyone else for expert advice in the preparation. 

 * * * * *

 Status Update, Task Three 

 Protocol for Review of NIOSH Methods 

 and Procedures for Dose Reconstruction

Mr. Hans Behling, 

Sanford Cohen & Associates

Mr. Behling introduced himself as a health physicist by training. He described that there is a statutory 

requirement under EEOICPA for the Board to independently review the methods for dose reconstruction. 

He explained that he had been asked to develop a procedure to provide both an outline and a general 

approach for the review of procedures that have been adopted by NIOSH for dose reconstruction. 

Thirty-three procedures representing OCAS implementation guides, technical information bulletins, 

program evaluation reports and procedures, ORAU's plans, procedures and technical information bulletins 

were provided to Sanford Cohen & Associates. They are a part of the package before the Board which 

briefly identifies and gives a one or two-sentence summary of each. 

They are quite diverse in both content and scope. Mr. Behling admitted it took a while to understand how 

to write a procedure to review procedures so varied. He indicated he re-read the Act and final rule 42 CFR 

82 and the regulations themselves for inspiration. 
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He felt a key was the Act requirement that DHHS establish regulations and methods for arriving at 

reasonable estimates. Further, the Act specifically states a key objective of the program is to provide timely 

compensation. Other directives state methodologies should be efficient, consistently applied, reasonable and 

fair to the claimant, adequate and complete, and well-grounded in the best available science. Science has to 

be an integral part of the review protocol, but it's not the only part. 

Mr. Behling stated he would present slides identifying seven objectives from review of the Act and final 

rule, and identifying criteria SC&A will use to determine whether the procedures under review meet the 

objectives. 

To establish a sense of timeliness became the first objective, that procedures allow for rapid analysis of 

dose, et cetera. Objective two, that procedures establish a sense of efficiency in instances where a more 

detailed approach would add no value. Completeness and adequacy of data is objective number three. 

Objective four is to provide a consistent approach to dose reconstruction that would assure consistency, 

regardless of time and employment location. The fifth objective is to account for unknowns -- loss of data, 

missing records, unmonitored exposures -- and in the process be fair and give the benefit of doubt to the 

claimant. The requirement for quantifying the uncertainty of dose estimates is objective number six. The 

last objective is to strike a proper balance in terms of the guidance for doing dose reconstruction efficiently, 

without sacrificing the quality of science. 

Mr. Behling's slides indicated each objective, below which he listed the criteria by which SC&A will assess 

the procedures. For example, in the first objective of establishing a sense of timeliness, the first assessment 

is whether the procedure is written in a style that is clear and unambiguous. Mr. Behling then led the Board 

through each step of the review protocol. 

 * * * * *

 PUBLIC COMMENT PERIOD

Dr. Ziemer announced he was going to delay the next item on the agenda because he regards the public 

comment period as time-certain. There are individuals who have come specifically for that purpose. He 

indicated he had nine individuals who have requested to speak. Reminding the public that time is somewhat 

limited, he asked the speakers to be aware of their fellow speakers in that regard and that they confine their 

remarks, is possible, without being repetitive. 

Ms. Beverly Westerfield Cochrane, 

Survivor

Ms. Westerfield described her father's work history at Hanford from 1948 until his retirement 35 years 

later, noting he worked there when exposure was probably greatest. She spoke of some of his work 
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experiences and his illness. She expressed her belief that her father's service entitled his survivors to 

compensation. Having filed a claim some three years earlier, she suggested the program is being studied to 

death. She indicated she saw no need to spend money to have meetings to do the same thing over and over 

when nothing is being settled, and commented that the public didn't understand that. 

Ms. Teresa Moran, 

Richland, Washington 

Ms. Moran indicated she wanted to let the Board know that she had heard people still working at Hanford 

were afraid to make a complaint because of retaliation, although she had no proof of it. Ms. Moran had 

lived with her grandfather, who had moved to Richland to work at Hanford. She recalled his illnesses and 

that he had been afraid to say anything because he didn't want to lose his pension. After his death, her 

grandmother didn't want to cause any problems because she was afraid the money would be cut off. 

Another family member has had cancer and still works at Hanford, and is afraid to come forward because of 

worry about losing a job. Ms. Moran suggested if there isn't a safety net, something should be created so 

that people could feel secure about discussing their problems without worrying about losing their jobs. 

Mr. Frank Trent, 

Claimant

Mr. Trent stated he had been with the Army in 1950 and stationed at Hanford, where they all lived in tents 

with stuff coming through the stacks. Years later he had gone to work at Hanford in the 200 areas, and 

related several incidents that happened during his employment. He expressed his belief that records have 

been expunged because he has seen his personal files and they are not totally representative of what 

happened. Mr. Trent suggested that either building 712 or 713 had contained records which went back 

quite a long way. 

Mr. John David, 

Local No. 66 

Mr. David advised the Board that he had been in touch with the person who had offered exhumation of his 

father's body, and the offer stood. He indicated a woman who had spoken last night would probably do the 

same with her husband. Mr. David indicated his point in bringing that up is an effort to help the Board 

understand how important this matter is. He urged the Board to go back to whoever it is and say the process 

is not working, regardless of the efforts of individuals involved. He reiterated his belief that Hanford should 

be a Special Exposure Cohort site. 

Mr. David also commented that he hoped the earlier suggestions of retaliation were inaccurate. In a free 

country where people are being asked to come forward with this information, suffering retaliation would be 

criminal. 
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Mr. Gayle Shook, 

Claimant

Mr. Shook indicated he had worked 38 years at Hanford in nuclear research. He described his cancers and 

berylliosis and expressed his hope that the Board would be more attentive to the claimants' problems and 

maybe make it move faster to a resolution. 

Mr. Roland Haney, 

Claimant

Mr. Haney stated he had lived in the area since 1950 and had worked seven years at Hanford as a 

serviceman. He described a serviceman as a laborer who does all the dirty jobs. He enumerated his various 

health problems which began after five years, noting that when his health got bad enough, working was 

made so difficult he finally quit. He commented that today people dress as if they're going to the moon to do 

things he did wearing coveralls and a baseball cap. 

Mr. Jim Knight, 

Richland, Washington

Mr. Knight indicated he hadn't started at Hanford until 1963, so he can only speak from his experience 

from that time forward. He declared his worst exposure had been being stuck in an office with two chain 

smokers. This included work in areas dealing with uranium, plutonium and waste product. 

Mr. Ron Strait, 

Kennewick, Washington

Mr. Strait had worked for contractors at Hanford and had thought they generally ran a safe, stable work 

site. He recounted a few incidents that had occurred, however, in which he felt he had received high 

exposures and was unmonitored, which made him believe their dose cannot be reconstructed properly. 

After working at some commercial plants, he considered them to be more careful with workers. He 

described dosimetry as being more carefully tracked. He described badges tied to a computer system to 

keep control of dose and how they were alerted by that. Mr. Strait indicated that over a long period of time 

it dawned on him that he hadn't been properly covered at Hanford. 

Mr. J. L. Mitchell, 

Claimant

Mr. Mitchell indicated he had overlooked some things the night before that he'd wanted to mention. He 

said his transfer from Atlantic Richfield to Westinghouse was a paper transfer because he had so much 

foreign objects in his system he wasn't supposed to have. 
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Mr. Mitchell said that he had been told when he retired 15 years ago that he and the other employees 

involved in the McCluskey explosion would be monitored. He's never had any such monitoring. He stated 

there had never been a signal to stay away from 912 and they knew McCluskey was in 912 alone, so seven 

or eight had gone in to get him. He commented that when they opened the air locks, black smoke was 

rolling like a tornado and they knew they were in trouble. He said nobody would ever tell them how much 

exposure they received, but that some was in his head, some in his lungs and possibly in his bones. 

Ms. Gai Oglesbee, 

National Nuclear Victims for Justice

Ms. Oglesbee said she didn't think she'd mentioned she was working at the site and facility at large at 

Hanford from 1992 through 1996 when she took voluntary early retirement. She stated she would not be a 

bionic person. 

Ms. Oglesbee read into the record several pages of court rulings which she purported to be critical of 

methodology developed by Dr. Owen Hoffman. 

Ms. Oglesbee stated she knew of only one person from Hanford who'd received compensation, regardless of 

statistics. But she indicated she knew a lot of people had been paid in Special Exposure Cohort issues back 

east. She declared Hanford a Special Exposure Cohort site because the records couldn't be found, although 

she knows where they are. She indicated they are hidden and she knows where a lot of them are. 

Ms. Oglesbee then read a number of what she called witness quotes into the record related to qualifications 

of doctors on the physicians panels, nurses making a 300 percent profit for "the entity" who are not familiar 

with military medicine, the order the chart gets put in before it goes to the panel, et cetera. 

Mr. Richard Miller, 

Government Accountability Project

Mr. Miller commented that one of the nice things about the Board's meeting so frequently is the opportunity 

it affords to hear about the program and plans. Without that information, it would be impossible to analyze 

what needs to be fixed. 

Mr. Miller offered his opinion about what it will take for the program to succeed and his pleasure at Mr. 

Rollow's assurance of access to full and open records. He expressed a belief that it would be not the words 

of the MOU but the spirit which would carry forward to the audit phase. Mr. Miller delivered a challenge 

that requests for records be full and transparent and any questions about what the auditors need, if they're 

well-reasoned, should be provided. 
NIOSH/CDC Advisory Board on Radiation and Worker Health 

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Regarding the presentation on health studies, Mr. Miller commented that the statute clearly calls for 

consideration of worker studies. He indicated that the schedule laid out by Mr. Henshaw appeared to be 

slow as molasses in addressing the agenda the Board had identified a year ago. 

Mr. Miller asked if the substantive facts offered during public comment got rolled into the process in any 

way, such as transcripts provided to Dr. Toohey or if the information is distilled in some way. 

Mr. Elliott replied that NIOSH and ORAU had staff in attendance who observed, heard and considered. It 

was not taken lightly. 

Mr. Miller's final topic had to do with chronic lymphocytic leukemia. He suggested it would be useful to 

make clear how large a claimant base of CLL cases have applied under the program. There was information 

yesterday that 180 cases had been returned to DOL as non-compensable. Might it be worthwhile to notify 

those claimants that research is being undertaken and they'll be contacted at some point in the future. 

* * * * *

UPDATE ON AWE FACILITIES

Dr. James Neton 

NIOSH/OCAS

Dr. Neton offered a companion presentation to the DOE site profile update from the day before, addressing 

the status of AWE facilities, where they are with the site profiles and dose reconstruction efforts. There are 

approximately 2,000 AWE cases at NIOSH. Dr. Neton outlined the top ten sites as far as number of cases, 

with Bethlehem Steel having the largest number at 518. The bulk of those cases have been completed and 

most are back at DOL for final adjudication. 

Cases have been received from 124 different AWE facilities, but those top ten sites represent 1,195 of the 

total cases. Dr. Neton pointed out that beyond those ten sites there was a point of diminishing return, and 

the practicality of developing a profile document to move five or ten or one case must be examined. 

Dr. Neton described the differences in site profiles for an AWE and a DOE facility, primarily that the AWE 

profiles do not have the six chapters. There is usually very little personnel monitoring data for AWEs. 

Many facilities were uranium foundries and general commercial activities, with no health physics support. 

The Environmental Measurements Laboratory in New York provided that, and did much of the urine 

monitoring information available has come from their retrieved records. Using their hierarchical approach, 

NIOSH wants to make sure bioassay data are used if it exists. 

For the majority of the claimants, NIOSH is in a situation of developing an exposure model. There is some 
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air sampling data, some knowledge of the processes. They generate a best-estimate for the intake of the 

workers and put an uncertainty distribution about it, and apply the model to most of the cases. There are 

allowances for work history, cancer type and diagnosis date. Where work history and something about what 

people did at the sites is known, they can partition it. If they don't know, they take the claimant-favorable 

approach and assume all workers breathed in the same amount indicated by the best estimate and the 

uncertainty distribution. 

Four AWE profiles have been issued. The new one is Tennessee Valley Authority, Muscle Shoals, which 

only covers five facilities. It was a uranium development plant where they made uranium from phosphate 

ore, very similar to the Blockson Chemical process. So it was an easy adaptation to estimate those 

exposures. 

Some sites are being revised, just as with DOE site profiles. Bethlehem Steel is undergoing revision to 

include an ingestion pathway model and there is a draft on the table for review. It is not anticipated it will 

add a lot of exposure. 

Dr. Neton indicated they are still deliberating on how to characterize the radon exposure at the Blockson 

Chemical facility. That section of the profile remains reserved. 

A number of AWE site profiles are under development going along the lines of the number of claims at 

those sites. Nine sites ORAU is looking at represent 132 cases. Below these, there is a situation of only 

having one or two or three cases per site. 

There are data capture efforts underway to secure information on these facilities. Information is obtained 

from a lot of sites. Many, but not all, are AWE's. Information is scan-captured and put onto the site 

database. Relevant bioassay data or TLD data are extracted and put into another database the health 

physicists can access. 

There have been 650 dose reconstructions conducted thus far, representing 43 different AWE sites. That is 

by virtue of the complex-wide AWE profile Dr. Neton described in earlier meetings. That document allows 

dose reconstructions for sites that had uranium principally, natural and very low enriched uranium, no other 

radionuclides, and the time frame had to be after a certain time period. So there are some limitations on the 

use of that document. 

Discussion Points:

Dr. Melius asked the schedule for completion of the new chapter on construction being developed for the 

DOE site profiles. 

Dr. Neton indicated they were going to attempt to complete Savannah River first since they'd gotten good 

feedback there in November. The Center to Protect Workers Rights had done a study that 
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catalogued a fair amount of information. Savannah River may become the prototype for future 

profiles. The problem is health physicists with free time, particularly health physicists with 

construction-related experience. Dr. Neton expressed hope to have a draft out in the next month or 

so, and indicated he would be happy to discuss their progress at the next Board meeting. 

Dr. Melius commented that if he understood correctly, lack of such a chapter is going to hold up individual 

dose reconstructions. 

Dr. Neton agreed, noting that oftentimes construction workers are unmonitored. If they have no bioassay 

data and no good handle on how to do it, it will be held up until they can get a chapter done on that. 

Mr. Leon Owens asked Dr. Neton's thoughts about site profiles for sites with only a few claims filed. 

Dr. Neton opined that they wouldn't have individual site profiles because it doesn't make economic sense. 

He doubted they would do individual profiles for sites with less than 20 cases, although there could 

be exceptions. If it's an easy adaptation of another one, they may do that. Most likely they would 

end up doing hand-crafted dose reconstructions, but would rely heavily, to the extent possible, on 

information from the other profiles. 

Dr. Melius asked if anyone had looked at the number of potential people who had worked at these sites 

during the appropriate time periods, offering that the number of requests is going to be dependent on 

the extent of outreach by DOL. 

Dr. Neton replied they had not looked at numbers, but there had been some outreach. He acknowledged 

awareness is an issue at smaller sites and workers are hard to locate. 

Mr. Elliott added that they had never tried to estimate how many claims might come in for a given site, but 

noted that it also goes back to eligibility, in which NIOSH plays no part. He pointed out records 

from Bethlehem Steel would have indicated only a handful of people, yet after eligibility 

determination they saw about 500 claims. 

Mr. Turcic commented that most AWE's are not like Bethlehem Steel, however, and were small operations 

where it's difficult to find people. DOL is working hard at it and will coordinate with NIOSH so that 

as they research a facility and locate potential claimants, if it should become necessary to do a site 

profile there will be ample time to do it. 

* * * * *

BOARD DISCUSSION/WORKING SESSION 

PROCEDURE REVIEW AND SELECTION OF CASES

Dr. Ziemer remarked there were a number of matters to be addressed and they would begin with the task 

three documents. He called on Dr. Mauro to clarify the difference in the two documents relative to task 

three that had been provided to the Board. 

Dr. Mauro indicated the smaller document is more an administrative audit. SC&A will look at NIOSH 

procedures and use their judgment and experience in the application of QA/QC as to the degree to which 

those procedures are consistent with the philosophy of what constitutes a good QA/QC set of protocols. The 
NIOSH/CDC Advisory Board on Radiation and Worker Health 

April 20-21, 2004 

- 54 -

larger document is a technical review. 

Dr. Ziemer stated they would begin with the technical review. He indicated he thought the Board would 

want to end up either approving the procedures, approving it with minor modifications, or -- if there are 

major changes needed -- they would identify those and ask the contractor to come back with a revision. 

Leading the Board through the document, Dr. Ziemer noted that the first ten pages of the document laid the 

background, with nothing for the Board to approve. 

Dr. Andrade commented that he'd been through the document and it began to be substantive at about page 

23. 

Dr. Ziemer noted that a discussion of the seven criteria from Mr. Behling's presentation began on page ten 

and the Board may wish to discuss those criteria. That becomes the basis for which the review will be 

evaluated, and to the extent that it can be objective, it's dependent on the criteria. Calling for comments 

from the Board on the criteria, there were none. 

Following the criteria are the review objectives and approach, then the technical issues. Dr. Ziemer

remarked it seemed what the Board needed to sign off on were the review criteria on pages 10 to 23, and 

then address the technical issues and make sure it was comfortable with both sides. Dr. Ziemer called for 

any concerns, issues, questions or comments relative to the review criteria. 

Ms. Munn commented that the issue of completeness had been a concern for her. She complimented the 

authors of the document, noting that her review indicated every item which would have concerned her had 

been considered. 

Dr. Ziemer, paraphrasing section 3.4, commented it was a statement that SC&A's evaluation is subjective in 

nature. Acknowledging there was judgment in a scoring system, he asked if there were any way to make it 

more objective, to have a higher level of confidence in the objectivity. 

Mr. Behling indicated the scoring method was there for a quick overview. But the outline allowed for 

comments, which is where SC&A would offer detailed explanation of why they believe there are 

deficiencies that could be looked at and ask if this is a credible evaluation. He would not expect the Board 

to focus on the zero to five scoring, but the comments, noting that comments would not be limited to the size 

of the box on the document. 

Dr. Ziemer asked if SC&A believed the graduated scoring system lends itself to being more objective 

insofar as they explain the reason for the score. 

Mr. Mauro indicated they felt it captured nuance, but were prepared to discuss other strategies. 
NIOSH/CDC Advisory Board on Radiation and Worker Health 

April 20-21, 2004 

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Dr. Ziemer remarked certainly professional judgment came into play. And once SC&A makes its 

evaluation, the Board will have to judge their judgment. 

Dr. Mauro commented they hoped the score and commentary would provide a dialogue for improvement. 

Dr. Melius offered it was a balance and the SC&A approach seemed a better way of communicating that. 

He indicated it was going to be a matter of finding the right balance, and he felt that was what NIOSH had 

tried to achieve. 

Dr. Roessler said she couldn't figure out if five was good or zero was good. 

Commenting that they understood the intent, Dr. Ziemer suggested they may have to reverse some of the 

questions. He noted it was an easy fix just to be consistent. 

Mr. Behling observed that, for example, not all procedures will have certain aspects requiring the issue of 

timeliness. So the continuum is one to five. Zero would represent not applicable. 

Dr. DeHart encouraged the use of the range. 

Mr. Griffon observed that bullet number 5.3 on page 18 was a concern, in that a person could have 

monitoring records, but not for certain things. 

Dr. Ziemer indicated that 5.3 was all-inclusive and it was the intent to cover unmonitored and missed dose, 

but it doesn't hurt to clarify it. 

Moving to the section on technical issues, Dr. Ziemer called attention to page 30 where there are comments 

that SC&A "will question use of" ICRP-30, surrogate radionuclides and arbitrary fractions. He expressed 

his understanding that the meaning was that SC&A would evaluate those, not question their use. 

Dr. Mauro replied that in the OCAS documents citing specific ICRP guidance, if that guidance isn't the 

most claimant-friendly, for example, SC&A is going to be cognizant of that and reveal it when found. 

Dr. Ziemer pointed out that the thrust of his remark was that it sounds as if SC&A is questioning the use of 

the documents, as opposed to evaluating their use in the paragraph where that term is used three times. He 

suggested it might be less pre-judgmental to say "evaluate." 

Dr. Neton commented that, although he couldn't recall specific wording, in the regulation the terminology 

related to most recent ICRP models, with no judgment as to claimant favorability. 
NIOSH/CDC Advisory Board on Radiation and Worker Health 

April 20-21, 2004 

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Dr. Mauro indicated that SC&A had been thinking in terms of taking advantage of their access to 

information from an associate active in preparing ICRP documents. They were looking to keep the Board 

informed of developments related to ICRP internal dosimetry when there may be revisions upcoming. They 

weren't judging, but letting the Board know things were in the offing. 

Dr. Andrade called attention to the term "arbitrary fractions" in that same paragraph, suggesting "different 

fractions" might be more appropriate. 

Dr. Ziemer noted that there is a rationale behind the fractions used, so they are not completely arbitrary. 

Mr. Behling commented that he would assume part of the responsibility for harsh wording. He had shared 

authorship with an associate whose first language is not English and he recognized he should have edited 

some of the wording, noting that it was a matter of familiarity with terminology perhaps less sensitive than it 

should have been. 

A motion was made and seconded to approve, with modifications as discussed, "A Protocol for 

the Review of Procedures and Methods Employed by NIOSH for Dose 

Reconstructions", and was passed unanimously.

Dr. Ziemer noted Dr. Henry Anderson had had to leave the meeting and was not present for the vote. 

The Board's attention was called to the QA/QC document as the next one requiring approval. Noting that it 

was rather brief and fairly straightforward, Dr. Ziemer asked if there were any comments, questions or 

concerns. There were none. 

Dr. Ziemer noted that the deliverables described in the documents are deliverables that will result from the 

next task. This document is describing how they will do the QA on the procedures. 

A motion was made and seconded to approve "SC&A's Procedure to Perform QA Reviews of 

NIOSH/ORAU Dose Reconstruction Procedures," and was passed unanimously.

Dr. Ziemer asked for staff assistance on what was needed and when for the next task order to do the 

reviews based on the approved procedure. 

Mr. Elliott indicated it would be the same as for the other four, to sit together and discuss the scope of the 

task, define it in open public forum. Then the independent government cost estimate would have to be 

developed in closed session. He cautioned that new task orders are due in by July 6, so if they felt they 

would need a teleconference between the June meeting and July 6, that should be scheduled. That would 

not be a closed meeting, though, and if everything couldn't be done in June, there may be another face-toface meeting needed in order to award the task and have it submitted by July 6th. 
NIOSH/CDC Advisory Board on Radiation and Worker Health 

April 20-21, 2004 

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Dr. Melius asked which of these things could be delegated to a subcommittee, development of a task order 

and development of an independent cost estimate. 

Ms. Homer indicated it would still have to come back to the Board. 

Answering Dr. Ziemer's question about the amount of detail needed in the task order, Mr. Elliott indicated 

it could be a paragraph, three or four sentences. 

Dr. Ziemer observed that the Board should be able to do a task order today that says go review these 

documents in accordance with the approved procedures. Then the independent cost estimate would have to 

be developed in closed session, which could not be today since it would have to be noticed in the Federal 

Register and scheduled in advance. But to get ahead of the game, get the task order done today. 

Mr. Elliott reminded the Board a deliverable should be considered, X number procedures reviewed or a 

report of the review of procedures completed in time frame X. He commented there were a number of ways 

it could be handled in two or three sentences, providing a scope of work with a time line and deliverable 

developed. 

Dr. Ziemer called for a recess during which he would ask Mr. Griffon, Dr. Andrade and Dr. DeHart to 

assist him in developing something that could be projected onto the screen for the Board's review. 

 * * *

A motion was made and seconded to approve a task to be referred to as the Procedures 

Review Task.

Dr. Ziemer opened the motion for discussion, indicating that they're basically identifying procedures from 

the document just reviewed. The period of performance is designated as four months. The contractor will 

provide monthly progress reports to the Board. Priority should be given to review of the OCAS 

implementation guides. A final report should be provided at the completion of the task. Dr. Ziemer 

indicated he would appreciate hearing from SC&A regarding the period of performance. 

Dr. Mauro commented he would like the four months to be for delivery of the draft review document, with 

the final due at some appropriate time after receipt of the Board's comments, perhaps within two weeks. 

A motion was made and seconded to revise the Procedures Review Task as discussed, and was 

passed unanimously.

Dr. Roessler commented someone had to clean up the use of "will," "should," and "shall," suggesting 
NIOSH/CDC Advisory Board on Radiation and Worker Health 

April 20-21, 2004 

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NIOSH knows how to do it. 

Mr. Elliott replied that the Board needed to make the decisions on this, not NIOSH. 

After discussion, it was taken by consent that the wording of the task order would use the term "will." 

Mr. Griffon wondered if a clarification might be necessary to reflect that whatever may be the latest 

revision of a procedure is the one that will be reviewed subject to this task order. 

Dr. Ziemer queried whether the addition of new procedures, or naming procedures related to this document, 

but a revision includes a title change, would require a new task order. He suggested a modifier to provide 

clarification of which procedure was being reviewed. 

Mr. Elliott asked that the record reflect a caucus was being conducted without use of a microphone and 

therefore could not be captured. 

Dr. Neton remarked that in the SC&A task three report there are no revision numbers associated with the 

procedures, so there would be nothing inconsistent with reviewing, for example, revision two. It would be 

well understood that would be the current procedure. 

The Chair called for a vote on the motion to approve a task order referred to as the 

Procedures Review Task. The motion was passed unanimously. 

Dr. Ziemer commented that an independent government cost estimate would have to be developed before 

the contractor was asked to submit his bid. That will affect the Board's scheduling for future meetings, 

which will be addressed shortly. 

Dr. Ziemer announced that Drs. Melius and Andrade had prepared a draft of a proposed letter to the 

Secretary of Energy. This morning's motion had been a motion of intent or a motion of the concept. They 

now have a draft letter, which has been distributed to the Board members. 

A motion was made and seconded to send the proposed letter to the Secretary of Energy, 

Spencer Abraham.

Dr. Ziemer opened the motion for discussion. 

Dr. Andrade explained the handwritten comments on the draft are his and were made with the intent that 

the letter be signed by Dr. Ziemer on behalf of the Board; that it be written through the Secretary for HHS 

and then to the Secretary of Energy. He expressed a belief that it should be a cabinet-level communication, 

adding that the way it reads should suffice to carry it through at that level. 
NIOSH/CDC Advisory Board on Radiation and Worker Health 

April 20-21, 2004 

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Dr. Andrade responded to Dr. Ziemer's request for clarification and Mr. Presley's query about NNSA by 

stating that a copy could go to Ambassador Brooks, the head of NNSA and who had oversight over the DOE 

complex for the weapons complex, but the MOU existed between HHS and DOE. 

It was agreed since both Secretaries had executed the MOU, it should go to Secretary Abraham with a copy 

to NNSA. 

Dr. Roessler suggested the use of something stronger than "communication," commenting that word 

sounded wimpy. It was agreed the proper term in this context would be "directive." 

Dr. DeHart commented editorially that the letter format would not carry abbreviations, but the full law, et 

cetera, would be identified throughout the document. 

Dr. Ziemer assured the Board he would take care of the editorial matters, and asked if there were any 

substantive changes. 

Mr. Elliott called for a point of clarification, noting that in the second paragraph the author had struck 

DHHS and inserted DOL, and that it should in fact be DHHS. Mr. Elliott also offered that the memo 

format, accurately portrayed by Dr. Andrade, is the appropriate way to go from one Secretary to the other, 

and felt it would be appreciated in this case. The memo format has a line indicating To:, and From:, which 

would be the Board; and a line indicating Through:, where you would put Secretary Thompson's name. He 

would see it first, initial it and make sure it gets transmitted to Secretary Abraham. At the bottom would be 

cc's so that the recipients would see who got copies of it, as well. 

The Chair called for a vote on the motion to send the proposed memorandum to Secretary 

Abraham. The motion was passed unanimously.

Dr. Ziemer announced the next matter was correspondence from the three members of Congress from New 

York. The Board had asked that Congressional letters come before them to assist in generating a response. 

Following the February meeting, Dr. Ziemer had written the three of them with an update on the site profile 

review process and to inform them one of the sites selected for audit was Bethlehem Steel. Another letter 

has been received from them in reply, with a couple of items in it that Dr. Ziemer felt called for a response. 

They requested a detailed description of the scope and methodology for audit strategy be made available to 

them prior to commencement of the site audit. Dr. Ziemer noted the Board had committed to providing the 

audit procedure to them, as indicated in the initial letter. But there is an implication in their letter that there 

is a site-specific audit process, although the procedures approved by the Board are generic. They would be 

adapted as the audit occurs, but the commitment is to provide the process, and Dr. Ziemer felt the Board 

should discuss that. 
NIOSH/CDC Advisory Board on Radiation and Worker Health 

April 20-21, 2004 

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They had also attached a list of questions they would like to see asked. Dr. Ziemer indicated in his initial 

letter he had suggested it would be more appropriate to ask those questions of NIOSH, the agency doing the 

site profiles. And while the audit may answer their questions, Dr. Ziemer commented he had a conceptual 

concern of any group asking the Board to shape an audit to meet their needs. 

Dr. Andrade suggested the Board not be coy about what he felt was a definite agenda. He indicated the 

types of questions reeked of micromanagement of the Board's work and that it would be inappropriate to 

respond to those detailed questions. A description of the efficiency process, copy of the site profile for 

Bethlehem Steel, along with statistics of some of the cases that have been accepted and worked should be 

sufficient. Anything further should not be directed to the Board. 

Dr. Melius disagreed in part. He indicated he didn't know if NIOSH had received similar communication, 

but he did know there was an issue related to the residual radiation report which had led to the raising of 

some of the issues in the letter. And today NIOSH said they had decided to modify the site profile to take 

into account the ingestion pathway, which is question four on their list. He suggested be responsive without 

saying we will address all these issues. 

Dr. Ziemer acknowledged the review might very well answer some of the questions. His concern, though, 

is a process one of having a group come in and say here's what you need to address in this audit. That is a 

concern in terms of credibility and makes audits subject to whoever's got the game. 

Dr. DeHart suggested the question might be one of for whom does the Board work, noting that it is a 

Presidential Advisory Committee. Now members of Congress are giving direction, and should they next 

expect to receive letters of query from the Tennessee delegation. The Board needs to make sure, legally and 

politically, where they belong in the way they answer the letter. 

Ms. Munn agreed that the response should state precisely what Dr. DeHart had said, that the Board is 

responsible to the Administration. In its interactions with the agencies doing the work, the Board will 

consider the questions raised. But it's a serious mistake to establish a precedent of responding to itemized 

requests from anyone outside the authorities who have appointed the members. 

Mr. Melius commented that Bethlehem Steel had been chosen for other reasons, not in response to a 

request from an outside group, so that was not the issue. He indicated that these members of Congress are 

upset about a problem with a posting of the residual radiation report on the NIOSH web site with incorrect 

dates and have been extremely critical, had done a press release saying NIOSH has little scientific credibility 

because of this error. Being responsive may be more helpful in this situation in a political sense, so long as 

it's done within what the Board's role is, adding that he didn't think the Board wanted to put NIOSH in the 

position of telling it not to respond. 

Mr. Elliott replied that for clarification, NIOSH received the first letter before the issue of the error in the 
NIOSH/CDC Advisory Board on Radiation and Worker Health 

April 20-21, 2004 

- 61 -

report surfaced, so he didn't know how much correlation there is between their letters, the concerns they 

express and the residual radiation report clerical error on Bethlehem Steel. 

Dr. Melius said what should be understood is that Quinn and Slaughter had offered legislation based on 

information from the posted report and were embarrassed by that fact. 

Dr. Andrade offered to join in statement clarification and declared he had not meant to imply the Board 

should not be responsive. It should respond, state its roles and responsibilities. But it's up to the Board how 

much information should be provided. He had suggested sending them generic documents and statistics 

about their stated concerns. The letter should defer answering that list of detailed questions to the 

appropriate agency, and in that way make it clear that's the way the Board does business. The appropriate 

agency is probably NIOSH. 

Dr. Ziemer indicated his original letter stated that he would transmit that list of questions to NIOSH, which 

he had done. He also sent Secretary Thompson a copy of the letter, along with a statement that it seemed the 

agency was in the best position to answer specific questions dealing with a site. 

Dr. Ziemer further commented that the Board wanted to be sensitive to their concerns, yet there is an 

overriding process concern that the integrity of the audit has to be preserved, whether from Congress, a 

special interest group or whatever it might be. Any number of groups could come along and say here's my 

set of questions for this site; assure me you'll ask them. 

Dr. Melius countered that his concern with being too recalcitrant was that Congress had set up the 

committee that gave it the role to do an independent review. They had an option use other entities. 

Dr. Ziemer pointed out that the key is "independent review". Indicating that he didn't believe the letter 

could be crafted today, Dr. Ziemer indicated he could take the input and craft a response, which he'd be 

glad to share even before it's sent. He asked if the Board wanted to make any specific motions to outline 

parameters, or just allow him to proceed on that basis. 

Dr. Melius indicated if Dr. Ziemer proceeded on that basis, he would be fine. 

Dr. Ziemer acknowledged he would craft a response, and inquired if he could circulate it to the Board for 

input before sending it. He indicated the Board had given him authority to send the last letter, and called for 

a motion. 

A motion was made and seconded that the Chair be given authority to draft a letter to the 

three New York members of Congress, taking into consideration the comments made 

during discussion, submit it to the Board for scrutiny and send it on the Board's behalf, 

and was passed unanimously. 
NIOSH/CDC Advisory Board on Radiation and Worker Health 

April 20-21, 2004 

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Mr. Elliott commented that there was a question he didn't think had been clearly answered yet, as to 

whether, even given the authority, a draft could be distributed and a Board decision gotten out of the 

process. Mr. Elliott suggested that Dr. Ziemer work closely with NIOSH on it, noting that the Office of 

General Counsel may have to offer an opinion. 

Dr. Melius asked for clarification, and Mr. Elliott indicated he was concerned about sharing the draft and 

then all of a sudden it becomes a decision, which would not be appropriate under FACA. Dr. Ziemer

asserted that if the decision is that legally they have to do the additional step to bring it back to open 

committee, that's they way it will be done. It just delays sending the letter. 

Dr. Melius commented that he had served on many, many FACA advisory committees and he'd never heard 

of a situation where the chairman couldn't be authorized to send a letter. 

Mr. Elliott reiterated that authority was not the issue, it was how the final letter was developed, and they 

had to check FACA to make sure there was no violation. 

Dr. Ziemer announced that the Board members had been provided subcommittee discussion documents in 

their booklets. A working group had been assigned to prepare a proposed charter for a subcommittee. 

Under FACA rules a subcommittee has to be duly established with a charter or statement of responsibilities 

and is an ongoing subset of the main committee. Meetings have to be announced in the Federal Register, it 

meets in open forum. It merely entails a smaller group of the total committee. It may or may not be 

authorized to make final decisions, depending on what level of authority is granted by the main body for it to 

act on its behalf. 

Dr. Ziemer declared that he and Dr. Andrade and Mr. Griffon had collaborated to develop a proposed 

structure, along with a list of items for discussion, things the Board may wish to consider as they go about 

setting up the subcommittee. 

Dr. Ziemer described the number of members they were proposing for the subcommittee and its function. 

A motion was made and seconded to adopt the subcommittee charter and charges outlined in 

the draft document.

Dr. Ziemer opened the motion for discussion, suggesting they begin with structure. After extensive 

discussion, Dr. Ziemer commented that the working group's intent had been to prepare a draft for the 

Board's action. Considering the short time left and the number of items for revision, since a subcommittee is 

not needed before the next meeting, he declared he would like to see some cleaned-up language for the 

Board's action. Dr. Ziemer noted that the subcommittee will become an important entity as they move 

forward, and he wanted to ensure it was properly structured. He observed that they were going to have to 
NIOSH/CDC Advisory Board on Radiation and Worker Health 

April 20-21, 2004 

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meet as a full Board to do the independent cost estimate, although it might be delegated if the subcommittee 

were in place. 

Dr. Melius commented he thought he had asked that, and Dr. Ziemer and Mr. Elliott explained that the 

same steps would have to be followed; the subcommittee could develop it, but the Board would have to 

meet to approve it. 

A motion was made and seconded to remand the subcommittee document back to the working 

group for additional work, and was passed unanimously.

Ms. Homer addressed some housekeeping matters related to travel plans for the Buffalo meeting, and 

information for those attending the Hanford tour the following day. 

Dr. Ziemer indicated they were up to their final item, which was their calendars. Noting that the task is 

ready, the next matter is the independent government cost estimate. If that didn't occur until June, they 

would be into July before the document reviews begin. He suggested a half-day meeting in a closed session 

to address that item of business. 

After a discussion of time needed for Federal Register notice and the schedules of individual Board 

members, it was determined that the Board would meet in closed session at 9:00 a.m. on May 17 in 

Cincinnati, Ohio for the purpose of developing an independent government cost estimate for the newlyapproved task order. 

Dr. Ziemer noted that there was a full Board meeting scheduled on June 2nd and 3rd in Buffalo, New York, 

and inquired if the Board wanted to go beyond that in advance scheduling. 

After discussion it was determined that the Board would meet August 24th and 25th in Idaho Falls, Idaho, 

with San Francisco as the alternate site. In the event a subcommittee is established, it would meet at the 

same location on August 23rd in order to prepare for the main meeting. 

Mr. Griffon observed that he wasn't advocating it as a consideration for an August meeting, but 

Washington, D.C. might be considered soon. He noted that other people show up at those meetings who are 

interested in the process, and the SEC rule might be available to look at. 

Mr. Espinosa commented that he liked the evening comment session, but would like to see the Board begin 

its meeting in early afternoon and work through that evening session, rather than having a long break later in 

the day. 

Dr. Melius asserted there was no easy way to do it. As Mr. Espinosa had been talking, Dr. Melius had 

thought perhaps the subcommittee could use that morning time to meet, which he immediately recognized 
NIOSH/CDC Advisorv Board on Radiation and Worker Health

Anri120-21.2004

Mo.. Homer offered that, just from a logistics point of view, the dinner break gave them time to clean up,

reset and expand if they needed to.

Dr. Melius commented that there is a public meeting of some kind scheduled in Buffalo in May, so there

may not be as much interest in an evening meeting.

Dr. Ziemer suggested m~in~ the opportunity available and see how it goes.

With no further business to come before the Board, the meeting was adjourned.

End of Summary Minutes

~

I hereby confirm these Summary Minutes are

accurate, to the best of my knowledge.

~.I ~~L""'/,. -7- - ;-- . .. .

-64
NIOSH/CDC Advisory Board on Radiation and Worker Health 

April 20-21, 2004 

- 65 -

ABRWH TWENTY-THIRD MEETING: ACTION ITEMS

RICHLAND, WASHINGTON 

APRIL 20, 21, 2004 

 
NIOSH/CDC Advisory Board on Radiation and Worker Health 

April 20-21, 2004 

- 66 -

 I

The following came up for discussion and vote during the morning session of Day Two. The vote 

carried and a final version was submitted later by Dr. Melius. 

To: Spencer Abraham, Secretary, Department of Energy 

Through: Tommy Thompson, Secretary, Department of Health and Human Services 

From: Paul Ziemer, Ph.D., Chair, Advisory Board on Radiation and Worker Health 

On behalf of the Advisory Board on Radiation and Worker Health I am writing to request your 

assistance in the implementation of our review of the dose reconstruction activities being carried out by 

the National Institute for Occupational Safety and Health (NIOSH) under EEOICPA. 

Under that law, our Board is mandated to conduct an independent review of NIOSH dose reconstruction 

activities. This independent review is critical to the credibility of the individual dose reconstructions 

being done by NIOSH. To assist the Board in carrying out this activity, the Board through NIOSH has 

hired a contractor (SC&A). This contractor working under guidelines established by the Board will 

need access to Department of Energy sites, to site operational history experts, and to appropriate records 

maintained at the site or by DOE. Security clearances will also be needed for some contractor staff. 

The Board believes that the best way to facilitate this process is to use the current Memorandum of 

Understanding (MOU) between DHHS and DOE and the procedures established under that MOU. 

These procedures appear to be working well in providing NIOSH with the records (both classified and 

unclassified) and other information needed for their dose reconstruction activities while minimizing 

unnecessary disruptions and burdens for DOE and site staff. 

Given the importance of this review activity, the Board is requesting that you inform the appropriate 

DOE offices and site contractors about this review activity and direct their assistance in facilitating 

access to the DOE sites and to the personnel and records necessary for this review (consistent with the 

current procedures established under the MOU with DHHS ). This assistance should also include 

addressing necessary security clearance issues. We believe that this directive from you will help to 

ensure that the Board can carry out our mutual, legally mandated dose reconstruction review activities as 

quickly and efficiently as possible. 

We greatly appreciate your assistance with this effort. 

Cc: Director,NNAS 
NIOSH/CDC Advisory Board on Radiation and Worker Health 

April 20-21, 2004 

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 II

During the afternoon session of Day Two the following two documents were discussed and voted on: 

 Draft Report: Task 3, A Protocol for the Review of Procedures and Methods Employed by 

NIOSH for Dose Reconstruction. This document was accepted by the vote to be carried out, with minor 

changes. 

 Draft Report: Task 3, SC&A’s Procedure to Perform QA Reviews of NIOSH/ORAU Dose 

Reconstruction Procedures. This was voted on and accepted. 

 III

The following was submitted by Mark Griffon, voted on and accepted as a new task. 

Procedures Review Task 

Descriptive Title: Procedures Review Task 

Task #:3A 

Task Order Technical Monitor: 

Purpose and Description of Work 

To conduct reviews of all procedures adopted by NIOSH and its contractors for performing dose 

reconstructions under EEOICPA and as identified in SC&A Task 3 Report dated April 12, 2004. 

Period of Performance 

This task will be 4 month task. 

Reporting / Deliverable Requirements 

The contractor will provide monthly progress reports to the Board. Priority will be given to OCAS 
NIOSH/CDC Advisory Board on Radiation and Worker Health 

April 20-21, 2004 

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Implementation Guides. A draft report will be provided to the Board at the end of the four month 

period. A final report will be provided to the Board two weeks after receipt of the Board’s comments. 

 IV

In reference to the letter of April 6, 2004 from Congress members Quinn, Reynolds and Slaughter, it 

was voted on and decided the Chairman, Dr. Ziemer, would compose a letter in response. 

 V

The document titled, “Issues for Discussion (Subcommittee for Dose Reconstruction and Site Profile 

Reviews)” was discussed and the vote was accepted to remand the document back to the working group 

for additional work, to be brought up at the next meeting. 

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