Executive Minutes September 19-21, 2006 
 

NIOSH/CDC Advisory Board on Radiation and Worker Health
 

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 Fortieth Meeting 


September 19-21, 2006 
 _______________________________________________________ 


The Fortieth Meeting of the Advisory Board on Radiation and Worker 


Health (ABRWH or the Board) was held at the Westin Casuarina Hotel in 


Las Vegas, Nevada on September 19-21, 2006. The meeting was called to 


order by Dr. Paul Ziemer, Chairman of the Board, and by Dr. Lewis Wade, 


the Designated Federal Official, Centers for Disease Control and 


Prevention=s (CDC) National Institute for Occupational Safety and Health 

(NIOSH). 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: 


Board Members: 


Dr. Paul Ziemer, Chair; Mr. Bradley Clawson; Mr. Michael Gibson; Mr. 


Mark Griffon; Dr. James Lockey; Dr. James Melius; Ms. Wanda Munn; Dr. 


John Poston; Mr. Robert Presley; and Dr. Genevieve Roessler. 


Designated Federal Official: Dr. Lewis Wade, Executive Secretary. 


Federal Agency Attendees: 


Department of Health and Human Services: 


Mr. Jason Broehm, Mr. Larry Elliott, Mr. Stuart Hinnefeld, Ms. Liz 


Homoki-Titus, Ms. Emily Howell, Mr. Mark Rolfes, Mr. LaVon Rutherford, 


Mr. David Staudt, Dr. Brant Ulsh. 


Department of Labor: Mr. Jeff Kotsch. 


Contractors: 


Mr. Mel Chew, Ms. Kate Kimpan, representing Oak Ridge Associated 


Universities. 


Dr. Hans Behling, Ms. Kathy Behling, Mr. Joe Fitzgerald, Dr. Arjun 


Makhijani and Dr. John Mauro, representing Sanford Cohen & Associates. 


Congressional Staff Personnel: 

Executive Minutes September 19-21, 2006 
 

NIOSH/CDC Advisory Board on Radiation and Worker Health


Ms. Cindy Blackston (House Judiciary Committee staff), Ms. Carolyn 


Boller (Colorado Congressman Mark Udall), Ms. Mira Horowitz 


(Massachusetts Senator John Kerry), Ms. Michele Jacquez-Ortiz (New 


Mexico Congressman Tom Udall), Mr. William Powers (Massachusetts 


Congressman Richard Neal), Ms. Kathleen Rozner and Ms. Sandra Schubert 


(Nevada Senator Harry Reid), Ms. Portia Wu (Massachusetts Senator 


Edward Kennedy). 


Members of Congress: 


Senator Harry Reid, Nevada 


Petitioners: 


Ms. Susan Atkinson, Mr. George Eldridge, Mr. Andrew Evaskovich, Mr. 


Richard Miller, Ms. Mary Realle, Ms. Harriet Ruiz, Mr. Aaron Wilson. 


Public Attendees: See Registration. 


* * * * *
 

Dr. Ziemer called the meeting to order at 1:15 p.m., welcoming the 


public and requesting sign-ups for those wishing to make comment to the 


Board. He encouraged all those present to register their attendance 


and to avail themselves of documents to be used in the Board=s 

deliberations. 

Dr. Wade thanked Board members for their service and clarified that 


contrary to his announcement during the last Board phone conference, 


Ms. Wanda Munn continues in her post as a member of the Board. Dr. 


Wade brought regards from the Secretary of the Department of Health and 


Human Services (HHS); the Director of the Centers for Disease Control 


(CDC); and the Director of NIOSH. He welcomed all attendees. 


Dr. Ziemer noted and recognized the presence of Ms. Michele Jacquez-


Ortiz from the office of Congressman Tom Udall of New Mexico. 


* * * * *
 

CHARTER FOR SUBCOMMITTEE
 

Dr. Ziemer explained that currently the Board has only one chartered 

subcommittee, the Subcommittee on Dose Reconstruction and Site Profile 

Reviews. If action taken at the Board=s most recent phone meeting were 

to be finalized, that entity would become strictly a Subcommittee on 

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Dose Reconstruction Reviews. Site profile reviews would no longer be 

part of that subcommittee=s responsibility. When the subcommittee met 

earlier in the day, it approved a charter revision which would both 

accomplish that change and specify a smaller subgroup of the full Board 

as the membership of the subcommittee. That revision comes now to the 

Board as a recommendation from the subcommittee. 

The charter revision is fully detailed in the document entitled "Draft 


Revision 1, September 19, 2006, ABRWH, Establishment of a Committee.” 


If the Board were to approve this proposed charter language, it would 


go as a recommendation to the Secretary of HHS for his final action. 


Changes in the document resulting from the morning's subcommittee 


meeting included minor corrections and an updated Membership Roster as 


follows: Mr. Mark Griffon, Chairman; Mr. Michael Gibson, Dr. John 


Poston, Ms. Wanda Munn as members; Mr. Robert Presley, Alternate member 


1; Mr. Bradley Clawson, Alternate member 2; and Dr. Lewis Wade as the 


Designated Federal Official (DFO). It was clarified that part of the 


motion would include terminating the original charter in order to 


institute the revised charter. 


The subcommittee=s recommendation of the charter revision constituted a 

motion to approve the document. 

The motion was open for discussion. 


Following minor wordsmithing, the motion carried, with one 


abstention by Mr. Gibson as a result of his inability to hear 


much of the discussion due to poor sound quality of the 


telephone transmission. 


* * *
 

A motion was made and seconded to recommend that the previous 


charter for the Subcommittee on Dose Reconstruction and Site 


Profile Reviews be terminated. 


The motion passed unanimously and without discussion. 


* * *
 

Acknowledging that most of the site profile work takes place in 


workgroups, Dr. Ziemer asked Dr. Wade to review the workgroup 

assignments, suggesting the Board could then formally restore 

memberships. Dr. Wade listed memberships in the Board's current 

working groups and clarified that on the August 8th Board phone call, 


the only changes in that roster entailed removing Ms. Munn from two 


workgroups, which vacancies had not been replaced. They included her 


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positions on the site profile workgroups for Nevada Test Site (NTS) and 


the Rocky Flats Special Exposure Cohort (SEC) and site profile review. 


A motion was made and seconded to restore Ms. Wanda Munn's 


position on the named workgroups. 


The motion passed unanimously.
 

Dr. Wade noted that Ms. Munn had participated on all of the working 


group calls between August 8th and the present and was fully up to date 


on their deliberations. 


* * * * *
 

PROGRAM STATUS REPORT B NIOSH 

Mr. Larry Elliott, NIOSH 


Director, Office of Compensation and Analysis Support
 

Mr. Elliott brought regards from Dr. Jim Neton, who was unable to 


attend the meeting. Dr. Neton's return to the OCAS team is anticipated 


within four to six weeks. Mr. Elliott's presentation would include an 


update on the dose reconstruction program, NIOSH=s accomplishments, and 

a status report on issues. 

Mr. Elliott provided statistics on the number of claims referred by DOL 


to NIOSH for dose reconstruction and the numbers returned to DOL for 


adjudication. He discussed claims pulled by DOL for various reasons, 


claims under specific SEC class eligibility and administratively closed 


cases. Approximately 5,500 cases await dose reconstruction, roughly 25 


percent of those forwarded to NIOSH by DOL. Approximately 27 percent 


of the completed cases returned to DOL have been found to be 


compensable. 


Mr. Elliott reviewed the three dose reconstruction categories of best 


estimate, overestimate and underestimate. Of the 5,500 cases awaiting 


dose reconstruction, 1,230 have been assigned to a dose reconstructor. 


At present 622 draft DRs await the return of a signed OCAS-1 form 


which indicates the DR includes all information currently available to 


the claimant. 


Mr. Elliott discussed the next six-month period, during which time 


NIOSH expects to arrive at a steady state, holding no claims for dose 


reconstruction that are over a year old. He described the completion 


rate by ORAU and how it will relieve the backlog, the efforts to 


finalize the first 5,000 cases, and the status of cases pended. Mr. 


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Elliott announced he planned to provide statistics on SEC impact at a 


future Board meeting. 


Mr. Elliott elaborated on administratively closed cases, reworks, and 


cases awaiting DOE records. He described how NIOSH monitors trends in 


DOE response and provides regular follow-up on unanswered information 


requests. 


Addressing the SEC petitions, Mr. Elliott listed the ten classes of 


workers added as of September 11, 2006. Six have been evaluated by 


NIOSH and provided to the Board for review, four of which are on the 


agenda for this meeting. Six evaluation reports are in development. 


Thirteen requests are currently in the qualification process. Twenty-


four have been administratively closed, and Mr. Elliott described each 


of those processes in some detail. He also discussed the numbers of 


claims at DOL currently for class member eligibility determination. 


Updating the reference documents used in the DR program to address 


claims is an ongoing process. Currently NIOSH has 140 Technical Basis 


Documents and 59 Technical Information Bulletins in use, with a number 


under revision. 


Mr. Elliott discussed one of those documents, TIB-52, and how it was 


developed to address concerns expressed relative to the ability to 


reconstruct doses for construction trades workers. TIB-52 will be 


presented later in the meeting, and NIOSH is interested in comments on 


it. 


Program Evaluation Reviews were described by Mr. Elliott as a means by 


which completed non-compensable cases are evaluated to see if reference 


document modification or development would affect the decision outcome. 


The five that have been completed were named, with another three 


underway as a result of modifications in either the DR process or the 


POC rule. 


Addressing NIOSH's communications initiatives, Mr. Elliott indicated 


they have revised the notice to claimants about receiving their claim 


from DOL. The acknowledgment packet and its materials will be going 


out to claimants in January. The packet is currently in final 


technical and legal review with the Office of General Counsel. 


A second round of internal technical and peer review is underway on the 


revised draft DR report which explains to claimants how NIOSH did its 


work and the outcome of that work for a particular claimant. Mr. 


Elliott indicated NIOSH hopes to send the document to the Board in 


October for review and comment. NIOSH will seek the Board's assistance 


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NIOSH/CDC Advisory Board on Radiation and Worker Health


in providing clear communication within that proposed DR report 


language. 


The DR video is in final review, with external peer review completed. 


Final edits are being made and the video will be made available on the 


NIOSH web site, at DOL District Offices, and to anyone who requests it. 


Discussion Points: 


#The Program Evaluation Reports (PERs) will be shared with the Board. 


#Which agency originates PERs and who reads them. 


#The distinction between PERs and reworks. 


#The triggering of PERs through reviews of TBDs or site profiles. 


#A status request regarding new COI concerns on site profiles; such 


report and update is to be scheduled for the October Board 

teleconference. 

#How NIOSH can be sure data was properly reported in light of DOE's 

admitted inadequate monitoring of employees. 

#A revisit of the repeated request for information on how many site 

profiles were generated by hourly or salaried workers in the field 

who were not members of management or the radiation safety 

programs. 

#That request should be submitted in writing. 

* * * * *
 

PROGRAM STATUS REPORT B DEPARTMENT OF LABOR 

Mr. Jeff Kotsch, 


Department of Labor
 

Mr. Kotsch explained that despite attempts to coordinate the tracking 


mechanisms inherent in NIOSH's and DOL's individual systems, the 


numbers reported by the agencies in today's presentations would not 


match. 


Mr. Kotsch offered an overview of DOL activity relating to cases in 


EEOICPA, Part B. These cases concern primarily cancers, but include 


silicosis claims, chronic beryllium and beryllium sensitivity. To 


date, DOL has had 53,583 cases involving 76,540 claims. Claims always 


outnumber cases because cases can give rise to multiple claims, 


depending on the number of survivor claimants. Of 34,346 cancer cases, 


DOL has referred 22,260 cases to NIOSH. 


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NIOSH/CDC Advisory Board on Radiation and Worker Health


Mr. Kotsch described Part E, its origins and evolutions, and provided 


some updates on its progress. 


As of September 11, DOL has provided $2.1 billion in total 


compensation, with $1.7 billion of that from Part B and $456 million 


under the Part E program. Medical benefits provided to living 


employees totaled $122 million. Total payees under EEOICPA number 


about 24,500; the bulk of those, 20,800 payees, are under Part B; Part 


E payees number 3,700. 


Mr. Kotsch described how cases come into the program via four District 


Offices around the country. Claims examiners conduct an initial 


development procedure to make determinations of medical evidence to 


support the claim, employment at a covered facility (DOE or AWE), and 


availability of appropriate information in survivor claims. DOL then 


sends the claims to NIOSH for dose reconstructions. 


There are currently some 6,300 cases at NIOSH for dose reconstruction. 


At the next level there are 2,436 cases with recommended decisions 


from the District Office but no final decisions. Those dose-


reconstructed cases have District Office recommended decisions and are 


in the hands of claimants, who then have an opportunity to appeal the 


process if it's a denied case or ask for a hearing to present 


additional information. Mr. Kotsch detailed the variables within that 


appeals process. Appealed cases which now have a final decision from 


the Final Adjudication Branch total approximately 22,800; 8,297 


acceptances and 14,503 denials. 


The biggest component of denials consists of dose-reconstructed POCs of 


less than 50 percent. Other denial categories include lack of 


employment verification at a covered facility, insufficient medical 


evidence to support the claim, ineligible survivor; or a non-covered 


condition under Part E, which may be addressed under Part E. 


Under the new SEC related cases, DOL has withdrawn 884 cases for SEC 


reviews, primarily the first six newly-added classes. Of those, 690 


have final decisions, with 592 approvals. Mr. Kotsch was unsure of the 


basis for the denials. Cases with recommended decisions but no final 


decision total 171, and 23 have been received by the District Office 


and are pending the writing of the recommended decision. 


Mr. Kotsch noted the bulk of reworks come from cases which have 


evidence of additional cancers, additional employment or additional 


survivors, factors which could ultimately affect the dose 


reconstruction. 


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Mr. Kotsch provided a breakdown on the status of cases for three of the 


facilities with SEC petitions to be discussed at this Board meeting, 


namely, the Oak Ridge Institute for Nuclear Studies (ORINS), Los Alamos 


National Laboratory (LANL), and the S-50 Oak Ridge Thermal Diffusion 


Plant. His final slide detailed the status of cases at Pacific Proving 


Ground (PPG) and Nevada Test Site (NTS). Total compensation figures 


for each site, respectively, are: $1.4 million, $24 million, $700,000, 


$2.6 million, and $38 million. 


* * *
 

Discussion Points:
 

#Scientific or technical reasons for DOL=s request for NIOSH to do 

reworks. 

#Board concern over defining the classes within the SEC and a renewed 

request for employment classification information. 

#Regarding Subpart E determinations, how DOL deals with DOE records 

that were based on admittedly improper monitoring. 

#Whether DOL=s assumptions are claimant-favorable and how their 

determinations are made in cases of absent or questionable 

exposure information. 

DOL will address reworks, definitions and assumptions in detail at the 


next Board meeting. 


* * * * *


 SCIENCE ISSUES
 

Dr. Brant Ulsh, NIOSH
 

Dr. Ulsh covered three primary topics for his presentation, including 


general coworker methodology and how NIOSH applies it, the construction 


trade worker (CTW) TIB, and an update on oro-nasal breathing and 


ingestion. 


Instances in which coworker data might be applied include situations 


where workers are either unmonitored or where monitoring is incomplete. 


If NIOSH's overestimating and underestimating approaches are not 


appropriate, coworker data might be used, provided that suitable 


coworker data for the site is available. The overestimating approaches 


would be considered not appropriate if their use resulted in a POC 


above 50 percent. 


Just prior to this meeting, NIOSH finalized TIB-52 to provide 


methodologies for performing DRs for the subset of unmonitored the 


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NIOSH/CDC Advisory Board on Radiation and Worker Health


construction trade workers. Dr. Ulsh's slide listed a dozen job titles 


characterizing CTWs. He described by whom and when such workers would 


have been employed. He detailed several data sources which enabled 


NIOSH to develop this coworker TIB. 


Regarding external data, or radiation sources outside the body, NIOSH 


looked at the data for the subset of workers known as CTWs and the data 


for all monitored workers (AMWs). The AMW category includes CTWs and 


others. NIOSH then took the ratio of the CTWs and compared those to 


the AMWs at the 95th percentile because that was the most relevant 


metric for this TIB and it ensured claimant-favorability to the CTWs. 


Addressing internal dose data, Dr. Ulsh noted CTWs and AMWs were 


similar in almost all cases, except at Hanford site, where CTWs were 


seldom included in the routine bioassay program. More frequently, CTWs 


received bioassays in special situations where an intake was suspected. 


That led NIOSH to conclude the CTW data at Hanford site would be 


biased high. To ensure favorability to the CTWs, the coworker data at 


Hanford will be multiplied by a factor of two. For sites other than 


Hanford, AMW data for internal dose will apply to the construction 


trade workers. 


In summary, OTIB-52 will guide dose reconstructors to apply an 


adjustment factor of 1.4 for CTWs for the external data, and the 95th 


percentile will be applied to site-specific coworker data unless there 


is a compelling reason otherwise. NIOSH will apply the AMW internal 


data to the construction trade workers at all sites except Hanford. 


For Hanford CTW cases, NIOSH will double the results of the internal 


coworker data. NIOSH will now begin to process cases using TIB-52 for 


approximately 906 CTWs awaiting dose reconstruction. 


Dr. Ulsh could offer only a status report on oro-nasal breathing and 

ingestion, because results of NIOSH=s ongoing investigations were not 

yet available. NIOSH is interested in the impact of oro-nasal 

breathing on internal DR to avoid underestimation of anyone's internal 

dose. 

Ingestion surfaced as an issue during the Bethlehem Steel site profile 


review. NIOSH recognizes the need to develop a cross-cutting approach 


to this issue. NIOSH is working with contractors at EG&G to conduct a 


comprehensive literature review, with completion anticipated by the 


middle of October. Technical reports on both the oro-nasal breathing 


and ingestion issues will follow, hopefully by the end of 2006. 


* * *
 

Discussion Points:
 

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#Whether NIOSH will attempt to separate the ingestion and inhalation 

issues. 

#Whether ICRP-66 includes consideration of non-standard breathing. 

#Whether NIOSH anticipates any change in the particle size 

considerations, given that the ICRP model changed from one to five 

microns. 

#NIOSH's proposed adjustment factors demonstrate their commitment to 

make the doses fair and reasonable for the CTWs. 

#How the NIOSH model will account for the swallowing mechanism. 

#Whether NIOSH will apply the 1.4 factor for 1960 and later years. 

#How NIOSH would account for the anomaly of applying the 1.4 factor to 

post-1960 CTWs in cases where an AMW actually received higher 

dose. 

#Whether problems existed at the sites not used as a basis for TIB-52. 

#Whether NIOSH attempted to compare job duties performed by monitored 

versus unmonitored workers. 

#Whether NIOSH made an assumption that monitored and unmonitored 

workers fell into the same general type of work category. 

#Whether NIOSH has done anything to verify the assumption that 

monitored workers were selected for monitoring based on exposure 

potential. 

#Whether NIOSH=s sample from the monitoring data is truly representative 

within such a large number of unmonitored workers. 

#Whether applying a single adjustment factor is the appropriate 

approach. 

#Whether an adjustment factor should instead be based on something 

other than a single value for everyone. 

#A request for NIOSH to provide more detail on how rigorous its 

approach to validation. 


#A clarification on how the coworker model is applied. 

#Whether the construction workers fall into the 250-day period 

consideration. 


#A request for information on what percentage of the CTWs and the AMWs 

were actually monitored compared to the total populations of these 

workers on a site in any particular year. 

#OTIB-52 is now on the web site and a reading of it could generate 

further valuable questions. 

A carryover concern from the Board's teleconference is a response to 


Mr. Peter Stafford's letter to the Board which raised a number of 


issues relative to construction workers. It was noted TIB-52 is a 


first step towards responding to those issues. 


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* * * * *
 

SC&A ACTIVITIES AND FUNDING
 

Dr. Lewis Wade, DFO 


Mr. David Staudt, CDC
 

Contracting Officer
 

Mr. Staudt provided an update on funding for the Board's contractor, 


Sanford Cohen & Associates (SC&A), for next year; SC&A's readiness for 


specific work assignments; and a look at conflict of interest (COI) 


issues and resolutions relative to SC&A. He informed the Board that 


all the task order modifications requested in August are in place and 


SC&A is fully authorized to proceed as needed through October 1st, 


2007. He detailed the modifications for the Board. 


Dr. Wade set the stage for Board approvals and instructions for SC&A. 


Addressing each of the Task Orders in turn, he asked what additional 


information, if any, the Board would like to receive in preparation for 


discussing their choices. Various information was requested, some of 


which would come from NIOSH, some from SC&A. 


Dr. John Mauro, speaking for SC&A, provided the Board with the times by 


which they would need a Board decision on particular tasks. 


* * * * *
 

SC&A'S CONFLICT OF INTEREST B RESOLUTION PLAN 

Mr. David Staudt, CDC
 

As background, Mr. Staudt noted that SC&A has a Board-approved conflict 


of interest (COI) plan which is part of their contract. In part the 


plan provides that SC&A not bid on certain work, but no mention is made 


of work related to the Department of Defense (DoD). In late May, Dr. 


Wade contacted Mr. Staudt with concerns about work SC&A was performing 


under subcontracts with DoD's Defense Threat Reduction Agency (DTRA). 


As contracting officer, Mr. Staudt is guided by Federal Acquisition 


Regulations requiring that he exercise sound discretion on whether 


significant conflict of interest exists; and if it does, to develop 


rules for resolving it. To that end, NIOSH and SC&A had many 


exchanges, and on June 29th SC&A provided Mr. Staudt some proposed 


mitigation strategies. After careful consideration, the firewall 


strategy was chosen. 


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This strategy requires that SC&A provide non-disclosure agreements for 


the work, as well as computer password protections. Mr. Staudt is 


charged with auditing invoices to find out who is working on what 


project. 


Mr. Staudt sent an e-mail to the Board informing them of the 


resolution, noting that his main goal is to minimize any perceived or 


real conflicts of interest, and SC&A has been quick to fully implement 


the strategy. Mr. Staudt observed he is relying on the Board and the 


general public for feedback related to conflicts of interest so that 


such conflicts of interest can be mitigated. He described the firewall 


strategy's benefits to the Board, and emphasized it augments SC&A's 


original COI plan, which does not cover DoD activities. 


Without objection from the Board, Dr. Ziemer asked that Mr. Staudt take 


the lead in drafting a document the Board could adopt as an addendum to 


the SC&A COI policy. It could then become formalized and posted on the 


web site. The document is due at the next Board meeting. Because 


Board members already receive monthly progress reports which include 


the costing, it was deemed unnecessary for Board members to receive 


DTRA contract billing information, which will continue to be reviewed 


by Mr. Staudt. 


* * * * *
 

PUBLIC COMMENT SESSION
 

The following is a list of the members of the public who spoke. A full 


transcript of the public comment is available on the OCAS website, 


www.cdc.gov/niosh/ocas. 


Ms. Terrie Barrie, Alliance of Nuclear Worker Advocacy Group; Ms. Kay 


Barker, claimant; Mr. John Funk, Atomic Veterans and Victims of Nevada; 


Ms. Patty Cook, claimant; Ms. Dorothy Clayton, claimant; Dr. Jacob Paz, 


former NTS industrial hygienist; Dr. Knut Ringen, Center to Protect 


Workers' Rights; Mr. Brian Dodd, President, Health Physics Society; Ms. 


Sandra Jackson, claimant. 


* * * * *
 

With no further comments, the Board recessed until the following 


morning. 


* * * * *
 

Wednesday, September 20
 

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Dr. Ziemer called the second day to order with reminders to register 


attendance, sign up for public comment, and to make use of the handouts 


provided as desired. 


Dr. Wade joined in welcoming the public and made some informational 


remarks about the day's planned topics. 


WORKING GROUP UPDATES
 

Savannah River Site 


Mr. Michael Gibson, Chair 


Site Profile Workgroup
 

Mr. Gibson apologized for the delay in providing the findings matrix, 


and acknowledged the assistance of Messrs. Larry Elliott and Sam Glover
 

from NIOSH and Dr. John Mauro and Mr. Joe Fitzgerald from SC&A in its 


production. Referring to that document, Mr. Gibson explained a recent 


meeting in Cincinnati between the workgroup, NIOSH and SC&A had 


resulted in a resolution of several issues. There remain some open 


issues which are more site-wide than specific to SRS. Mr. Gibson
 

reported that NIOSH revisions and SC&A responses are in progress, and 


he feels the remaining issues could be resolved at a workgroup meeting 


to be held in the near future. He noted good progress is being made on 


resolution of issues working within the six-step process. 


Discussion Points: 


#The SRS site profile was one of the earliest completed, thus requiring 

perhaps more clarification and more thorough and expanded 

information to the dose reconstructors. 

#Of the 16 total issues raised in the review, five or six have been 

closed out and many of the remainder are generic. 

#While there are no showstoppers, the most significant open issue 

relates to characterization of tank farms and associated 

databases. 

#The important issue of construction trades workers is now addressed by 

the recently-released OTIB-52. 

#This site profile and review were completed two years ago, and the 

site profile is to be revised. Existence of accident report data 

from the tank farms has come to light, but is being maintained by 

a private company that has not made the materials available. 

NIOSH is working to resolve questions of access and the issue of 

paying for data, since it was originally developed with government 

funds. 

#More information was requested on the issues of high flux programs. 

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#Details and implications of the organically-bound tritium matter; lack 

of solubility is a key issue. 

#The nature of the neutron log books. 

*** 


Nevada Test Site 


Mr. Robert Presley, Chair 


Site Profile Workgroup
 

Mr. Presley described the working experience of his group's members as 


it related to their familiarity with this site's issues. He 


acknowledged the assistance provided by the SC&A group, including Dr. 


Arjun Makhijani and Mr. Joe Fitzgerald, as well as that of Mr. Mark 


Rolfes from NIOSH. Providing a history of the site profile itself, Mr. 


Presley included the status of issues, listing these considered major 


and including site-specific issues discussed during the group's recent 


teleconference. He noted that policy or guidance is being assessed or 


redefined for the issues of breathing and ingestion, badge geometry, 


employee misuse of dosimetry, extremity dose interpretation, and high-


fired or super S plutonium. Mr. Presley reported that site expert 


interviews will be added, and while much work remains to be done, all 


involved are working hard to arrive at closure on this review as soon 


as possible. 


Discussion Points: 


#Most of the 12 closed-out comments relate to pre-1962 issues. 

#The term "draft documents in review" refers to completed documents 

which are in review by NIOSH. 

#The color highlighting in the NTS matrix was a method of identifying 

speakers with their comments. 

#Many of the NTS issues are complex-wide. 

#Each outstanding issue has been assigned to a specific person or group 

of individuals in the workgroup for their focus. 

#Prospective matters for Board discussion in terms of site profile 

reviews. 

#Cross-cutting generic issues are most expeditiously addressed in 

individual site profiles. 

Mr. Presley acknowledged and thanked Dr. Genevieve Roessler and Ms. 


Wanda Munn for their assistance in the presentation. 


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Dr. Wade remarked on the need for a mechanism to track and review 


agreed-upon issues, such as modification of a site profile, after the 


workgroups have completed their work. 


***
 

Special Exposure Cohort Report
 

Dr. James Melius, Chair 


Petition Activity Workgroup
 

Dr. Melius reported the workgroup had issued a task order for SC&A to 


do some data-gathering concerning the issue of evaluating doses for 


workers with high exposure to radiation, difficult to evaluate doses, 


and exposure within very short time periods. He indicated the 


workgroup is currently concerned more with the health endangerment part 


of the regulations than the ability to reconstruct dose with sufficient 


accuracy. 


The SC&A task includes fact finding, to provide a better understanding 


of the type of exposures that would occur in criticality incidents; 


evaluating exposures at NTS, PPG and Ames Laboratory, and comparing 


them with criticality incidents; and exploring ways of classifying the 


different categories of employees under consideration to determine how 


this SEC class would be composed. 


A meeting is planned with an eye toward resolving the issues, with 


presentation to the Board by its December meeting. 


Discussion Points: 


#SC&A is now reviewing a paper by Dr. Mike Thorne on criticality doses 

and events, which they commissioned. They feel they have a good 


handle on this concern. 


#Dr. Lynn Anspaugh's work on the NTS resuspension, which has 

implications for the less-than-250-day issue, will be completed in 


the coming weeks. 


#SC&A will be conducting an internal review of some external dose data 

on each test series at PPG and NTS. The review will be 

particularly intensive if the data-gathering involves COI 

questions. 

***** 

SUBCOMMITTEE REPORTS AND BOARD ACTION
 

Dr. Paul Ziemer, Chair
 

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NIOSH/CDC Advisory Board on Radiation and Worker Health


Mr. Mark Griffon
 

Mr. Griffon stated that he had drafted a document summarizing the 


Board's findings from the second and third sets of case reviews, cases 


21 through 60. That document, in the form of a letter, is a report 


from the Board to the Secretary. 


It was determined that two attachments were not available at the 


moment, and were necessary before a vote could be taken on adopting the 


letter report. Dr. Ziemer indicated he would take it by consent that 


the vote would be postponed until all Board members had copies of all 


attachments. The vote was deferred until the Board working session on 


Thursday. 


*****
 

UPDATE ON ROCKY FLATS SEC PETITION 


As background, Dr. Wade explained this workgroup was originally tasked 


to review the Rocky Flats site profile. When the Board received an SEC 


petition evaluation report, the group shifted its focus onto site 


profile issues most pertinent to the SEC petition debate. No members 


are conflicted with regard to the Rocky Flats SEC petition. 


Mr. Mark Griffon, 


Workgroup Chair
 

Mr. Griffon announced that while this workgroup has tracked several 


issues in a lengthy matrix, for this presentation he would focus only 


on seven main items that could affect the decision-making process 


relative to the SEC petition. 


SC&A has reviewed NIOSH's procedure for addressing super S or high-


fired plutonium and is comfortable with the methodology. Of 25 cases 


available to develop NIOSH's design cases, the final action item is for 


SC&A to spot-check those not used to be sure the design cases do in 


fact bound the situation of the 1965 fire. 


Concerns regarding other radionuclides outside plutonium and uranium 


included whether they were a significant source term; whether there was 


exposure potential; if so, who was likely exposed, over what time 


periods, and how NIOSH proposes to reconstruct those doses. SC&A has 


not fully reviewed NIOSH's recently-delivered preliminary report. 


Dose reconstruction method has set several activities in motion. They 


include questions on the coworker model being proposed in OTIB-58; 


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NIOSH/CDC Advisory Board on Radiation and Worker Health


final checks on the neutron-to-photon ratio being used in a method to 


estimate neutron doses when they don't have neutron badges, a ratio 


that's part of the coworker model; whether Neutron Dose Reconstruction 


Project (NDRP) records were validated against any raw records. 


Notwithstanding the question of data reliability, the coworker method 


may be more of a site profile issue if that model can be used to 


calculate a maximum plausible dose. 


The internal coworker model used in OTIB-38 has open questions 


including whether the maximally exposed people were actually sampled 


for all the time periods and whether the distribution can be used to 


represent all the workers of concern in this SEC petition; the 


appropriateness of using an epidemiological database to develop a 


coworker model, in this case the CER dosimetry database; the pedigree 


of databases, particularly HIS-20, used to develop the coworker models. 


Ms. Donna Cragle from ORAU is investigating on behalf of the 


workgroup. NIOSH has provided SC&A a white paper explaining the basis 


for the coworker model. 


The most extensive items on the matrix relate to data reliability. Mr. 


Griffon described two broad categories as a systemic analysis seeking 


to detect any problems in database records that would make it a broad 


problem for many petitioners* within this petition; and specific 


allegations made by petitioners which the workgroup aims to group into 


categories of concerns that would impact the entire petitioning class 


or one of its subsets. 


Mr. Griffon elaborated on requests made to NIOSH and action items 


pending in furtherance of resolution in the two categories. 


Being regarded as a separate item of data reliability concern is that 


of questions related to dosimetry and the 1969 fire. SC&A has asked 


for identifiers for the workers sent for lung counts, which will be 


used to check some of the original radiation records of individuals and 


attempt to resolve the issue of gaps in the 1969 database. 


The question behind the last issue concerns whether there is sufficient 


data during the D&D time frame to reconstruct dose for all potentially 


exposed workers. NIOSH has had difficulty obtaining radiation worker-2 


rosters for those time periods in order to cross-check the database and 


confirm workers were monitored. In lieu of that, NIOSH has provided an 


internal audit of the dosimetry program during the D&D time period, but 


it has not yet been reviewed by SC&A. 


* * *
 

Discussion Points: 


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#Handling of allegations about data integrity by requiring proof from 

NIOSH that data is reliable for the entire class. 

#Despite the level of detail involved in this site overview, and 

recognizing that every dataset has deficiencies, no system-wide 

deficiencies have been found at this site and every effort is 

being made to ensure data reliability. 

#Origin, history, contents and reliability of the HIS-20 database. 

#History of handwritten and electronic urinalysis reporting at RF. 

#Anomalies between HIS-20 and the Epi Database data. 

#Petitioner's copy of a 1982 handwritten urinalysis record will be 

followed up in the workgroup format. 

#Petitioners would like the vote on this petition to be held in Denver. 

#How COI issues are being addressed and ORAU compliance with most 

restrictive or most recent COI policy. 


#Whether a revision of the RF site profile will take place based on 

ORAU's Conflict of Interest review, and a detailed description of 

efforts to accomplish that review, the process and schedule for 

its review by NIOSH. 

#Identification of Mr. Robert Meyer as the document owner on the Rocky 

Flats site profile. 


#Clarification on ownership of the Rocky Flats SEC evaluation report. 

#Details of what ORAU is doing regarding SEC evaluation reports with 

respect to COI. 


#A request for attribution of the SEC evaluation report work completed 

by ORAU. 

#Clarification that ORAU references to COI include both individual and 

corporate conflicts. 

#How conflicts are being handled by ORAU under the current policy, 

which is draft in nature. 

#Clarification that ORAU has a corporate conflict on Rocky Flats due to 

its dose reconstruction work at the site. 

#NIOSH's position on ORAU's corporate COI as it relates to the neutron 

dose reconstruction project. 

*****
 

SC&A TASKING PREPARATIONS
 

Dr. John Mauro, 


Sanford Cohen & Associates
 

At Dr. Wade's request, Dr. Mauro presented a report on procedures and 


Technical Information Bulletins previously reviewed by SC&A through 


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NIOSH/CDC Advisory Board on Radiation and Worker Health


means other than the procedures review task, which could include via 


dose reconstruction or site profile reviews. He enumerated seven 


documents in that category. 


With procedures to be reviewed yet unassigned for the coming year, Dr. 


Mauro offered his suggestions for an assortment of documents, both 


site-specific and generic. 


Discussion Points: 


#How to follow up on completed work and know it is complete. 

#How to determine, for procedures reviewed and then revised, whether 

the complete reasons for revision have been captured. 

#How to use the matrix as a tracking tool for revised and in-revision 

procedures, side by side with program actions. 

#Clarification that review of workbooks is not a stand-alone 

deliverable, but included with review of Technical Information 

Bulletins, procedures, and some site profiles. 

#How to track reviews and the significance of changes made through the 

course of multiple revisions and subtasks. 

#Workbooks are primarily reviewed when SC&A audits a dose 

reconstruction. 

#SC&A is in the process of reviewing site-specific workbooks, including 

min/max and best estimate workbooks, under Tasks I and III. These 

are stand-alone products, with delivery expected in a month. 

#Workbooks are reviewed in relation to the linked procedures rather 

than as a product in themselves. 

*****
 

OAK RIDGE INSTITUTE OF NUCLEAR STUDIES 


SEC PETITION EVALUATION REPORT
 

Mr. LaVon Rutherford, 


NIOSH, OCAS
 

Mr. Rutherford gave a brief history of the petition, noting that ORINS 


is the predecessor name for ORAU, and that Oak Ridge Institute of 


Nuclear Studies Cancer Research Hospital was a single part of ORINS. 


Recognizing their contractor would be conflicted on this petition, 


NIOSH determined to conduct the evaluation internally. 


Mr. Rutherford detailed radiological operations which took place at 


ORINS from 1950 to the mid-'70s, noting it was not a typical weapons 


complex facility. NIOSH looked at a number of different documents and 


information sources, including the existing ORAU TIBs, ORINS staff 


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NIOSH/CDC Advisory Board on Radiation and Worker Health


interviews, NIOSH database case files that fit within the class 


definition, the site research database, documents and affidavits 


submitted by the petitioner, documents from ORAU at Oak Ridge, and the 


PubMed database. Mr. Rutherford reported occupational eternal 


exposures were well-documented; film badges had been used from the very 


beginning, and a 1951 three-month report documented exposures. 


Although the hospital had originally felt that potential for internal 


exposures was low, NIOSH's research recognized scenarios for internal 


exposure issues, which Mr. Rutherford detailed. He summarized the 


availability of data for external and internal dosimetry. 


NIOSH's evaluation determined that it is not feasible to estimate dose 


for the covered class with sufficient accuracy, and individuals within 


the covered class could have received internal exposures from working 


with medicines containing radioisotopes. The covered period as 


proposed by NIOSH is from May 15, 1950 through December 31, 1963. Mr. 


Rutherford explained the period is based on admission of the hospital's 


first cancer patient in 1950 and the initiation of source term 


applications in early 1964. 


***


 PETITIONER PRESENTATION
 

Mr. George Eldridge, Petitioner
 

Speaking on behalf of himself, his brother and sister, Mr. Eldridge
 

thanked NIOSH for making clear that X-10, also known as the Oak Ridge 


National Laboratory, and the ORINS Cancer Hospital are indeed two 


separate facilities. He also thanked Mr. Rutherford and the Advisory 


Board. 


***


 BOARD DISCUSSION
 

Discussion Points: 


#Lack of evidence of leak tests done on radium sources. 


#Lack of availability of early records on amounts of iodine used in 


therapy treatments; availability begins around 1964. 

#Availability of some annual source term data. 

#Minimal indication of the use of hoods for preparation of the 

medicines in the early years. 

#Clear evidence for use of hoods in the later years. 

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NIOSH/CDC Advisory Board on Radiation and Worker Health


#Why the original covered period only went through 1956. 


#The number of claimants who might be in this petition. 


#Development and later operational use of whole body counters. 


#Clarification on the status of internal dose. 


***


 BOARD DECISION
 

Dr. Ziemer observed this petition comes as a recommendation from NIOSH, 


and the Board must make its separate recommendation to the Secretary. 


Ms. Munn commended the tremendous advances in nuclear medicine made by 


such a small group in such a short time. 


A motion was made and seconded the Board accept the NIOSH proposed 


class as stated in its report. 


Dr. Ziemer inquired relative to bioassay at X-10 and Y-12 during the 


petition years and why ORINS would not have had bioassay. Mr. 


Rutherford explained there was gross alpha and gross beta measurement 


at Y-12 where the isotopes were developed using the Cyclotron, but no 


bioassay data specifically used for those facilities at that time, and 


none at ORINS. 


Dr. Melius questioned to what extent the Board is to specify what NIOSH 


can do in terms of dose reconstruction, particularly with regard to 


external exposures. Mr. Hinnefeld supported incorporating Board 


acknowledgment of NIOSH's determination in its recommendation. Dr. 


Ziemer noted that in past recommendations the Board has recognized the 


ability of NIOSH to do certain types of DRs, such as external only. 


Through friendly amendment, the motion was amended to state that 


the Board recommends the following letter be transmitted to 


the Secretary of Health and Human Services within 21 days. 


Should the Chair become aware of any issue that, in his 


judgment, would preclude the transmittal of this letter 


within that time period, the Board requests that he promptly 


informs the Board of the delay and the reasons for this 


delay, that he immediately works with NIOSH to schedule an 


emergency meeting of the Board to discuss this issue. 


The Advisory Board on Radiation and Worker Health (the Board) has 


evaluated SEC Petition-00033 concerning workers at the Oak 


Ridge Institute of Nuclear Studies (ORINS) under the 


statutory requirements established by EEOICPA incorporated 


into 42 CFR 83.13(c)(1) and 42 CFR Section 83.13(c)(3). The 


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Board respectfully recommends that a Special Exposure Cohort 


be accorded to all employees of the DOE or DOE contractors or 


subcontractors who were monitored, or should have been 


monitored, while working at the Oak Ridge Institute of 


Nuclear Studies' Cancer Research Hospital from May 15, 1950 


through December 31, 1963, and who were employed for a number 


of work days aggregating at least 250 work days during the 


period from May 15, 1950 through December 31, 1963, or in 


combination with work days within the parameters established 


for one or more other classes of employees in the SEC. This 


recommendation is based on the following factors: 


This facility conducted research on the use of various radioactive 


isotopes for the treatment of cancer. People working in 


this facility were exposed to these radioactive materials 


through a number of work activities. Although there was a 


potential for substantial internal exposures arising from 


preparing, administering and disposing of radioisotopes and 


radioactive waste, NIOSH found no evidence of personnel or 


workplace monitoring that could be used to bound internal 


radiation exposures. 


As a result of these limitations, NIOSH cannot establish a maximum 


internal exposure scenario that addresses all of the internal 


exposure potential for the petitioning class and therefore 


cannot estimate internal doses for this class with sufficient 


accuracy. The Board concurs with this demonstration. 


NIOSH determined that health was endangered for the workers at the 


Oak Ridge Institute of Nuclear Studies' Cancer Research 


Hospital exposed to radiation at this facility during the 


time period in question. The Board concurs with this 


determination. 


The NIOSH and Board review of the data found that it was 


sufficient to support accurate individual dose 


reconstructions for external doses for workers at the ORINS 


Cancer Research Hospital. 


Enclosed is supporting documentation from the recent Advisory 


Board meeting held in Las Vegas, Nevada where the Special 


Exposure Cohort was discussed. If any of these items aren't 


available at this time, they will follow shortly. 


The motion carried unanimously.
 

Dr. Ziemer noted the recommendation will be forwarded to the Secretary 


in accordance with the requirements of the motion itself. He asked 


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NIOSH/CDC Advisory Board on Radiation and Worker Health


petitioners to recognize that although the Board is making the 


recommendation, the petition is not at this point granted. 


* * * * *
 

PREPARATION FOR BOARD TASKING ON 


ADDITIONAL SITE PROFILES FOR 2007 


Mr. Stu Hinnefeld, NIOSH
 

Mr. Hinnefeld presented the information requested the previous day, 


providing the following lists: 


Sites with site profiles and a qualified SEC petition; other qualified 


petitions not on the previous list; site profiles under development 


which should be available in time for SC&A's review process; generic 


TBDs being prepared by Battelle; ORAU sites in preparation, plus the 


Sacandaga site and the Special Separations Unit, both unlisted; and a 


list of completed cases per site. 


Discussion Points: 


#The range of difference in workload represented by various choices. 


#An explanation as to nuclear activity at the Kansas City Plant. 


#A suggestion to consider sites with the largest number of claimants, 


and five fairly different types of facilities. 

#Suggestions as to actual facilities to be considered. 

#A description of the activities at Atomics International line 

(formerly ETEC). 


Dr. Ziemer reminded the Board that action was not immediately needed. 


* * * * *
 

CHAPMAN VALVE SEC PETITION 


NIOSH EVALUATION REPORT
 

Dr. Brant Ulsh, NIOSH
 

Dr. Ulsh began with a brief history of the worked performed for the 


Atomic Energy Commission and for Manhattan Engineering District at this 


facility. Their covered work in 1948 was machining natural uranium 


slugs used in the Brookhaven reactor. All uranium scrap was removed by 


the end of that same year and a brief D&D process occurred in the early 


'90s. 


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Dr. Ulsh detailed the qualification process for the petition, its 


announcement in the Federal Register, specifics of the initial proposed 


class and its expansion by NIOSH to cover all possible operations at 


the facility, including the D&D effort. Of the sources of information 


available to inform their evaluation, NIOSH relied most heavily on 


individual dosimetry records, both internal and external. They also 


located several source documents in the site research database and used 


documentation provided by the petitioners. Speaking to the issue of 


feasibility, the status of the Chapman Valve claims as of September 13 


include 124 cases meeting the class definition, with completed DRs for 


92 of them. 


Seven bases formed the SEC petition. They are presented here, each 


with NIOSH's evaluation. 


1.The petition expressed concern that bioassay measurements were 


insufficient in number and did not capture the most exposed 


individuals at the facility. 


NIOSH has 33 bioassay measurements of 100 workers who operated with 


uranium over a 7-month period, and seven additional measurements 


which associated with the fire. Bioassay results tend to follow a 


lognormal distribution, and 33 of 100 represents a fairly sizeable 


sample, from a statistical standpoint. 


2.The petition questioned representativeness of the bioassay samples. 


NIOSH has job titles associated with the bioassay measurements which 


include a range of job functions, encompassing functions with the 


highest anticipated exposures and some with lower exposure 


potentials. Of the 33 bioassay sample results not associated with 


the fire, one was above the detection limit for the method 


employed at the time, indicating this operation had a fairly low 


exposure potential. 


3.The petition expressed concern over data sufficient to support a 


plausible upper bound, which deals with NIOSH's ability to bound 


doses; petitioners feel NIOSH does not possess sufficient 


monitoring, process knowledge and/or source term data. 


NIOSH has the best data for this situation, individual bioassay and 


dosimetry results, in addition to process knowledge. 


4.The petition expressed concern that data is insufficient regarding 


the uranium fire of June, 1948. 


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NIOSH/CDC Advisory Board on Radiation and Worker Health


NIOSH concluded there is sufficient data to adequately model any 


intakes resulting from the fire. They have the set of seven 


bioassay samples taken June 11, 1948 from workers clearly 


identified as individuals involved in responding to the fire. 


Claimant-favorable assumptions can be made using those even 


bioassay results, four of which were above the detection limit. 


5.The petition suggested the possibility that workers handled enriched 


uranium. 


The sole evidence consists of one debris sample collected several 


decades after the conclusion of AEC-related work. Some former 


workers informed NIOSH they also did radiological work for other 


entities, possibly the Navy. 


NIOSH concluded that even if enriched uranium were present during the 


covered period, it does not prevent NIOSH from doing DRs at 


sufficient accuracy; the internal doses would be higher, but the 


number is boundable. 


6.The petition contends the site profile does not account for potential 


exposures that might have resulted from rolling or operation of a 


cracking furnace or chip burner, and that there was only one day 


of uranium air sampling. 


NIOSH concluded that any and all processes are reflected in the 


available bioassay results. In the hierarchy of DR data, 


individual bioassay ranks above air data. And while air data 


results are used for comparison with other sites, they are not 


used for dose reconstruction. 


7.The petition expressed concern that the site profile provided 


inadequate treatment of routine uranium fires. 


NIOSH concluded that any intakes from possible fires would be reflected 


in the bioassay results. 


In summary, NIOSH reports the answer to the first prong of the test is 


"yes." Regarding feasibility of reconstructing dose with sufficient 


accuracy for members of the class, NIOSH has sufficient data. The 


report summarizes the class as workers who worked at Chapman Valve from 


January 1, 1948 until the end of 1949, and also again in the early '90s 


from the remediation period. 


* * * 


 PETITIONER COMMENT 


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NIOSH/CDC Advisory Board on Radiation and Worker Health


Ms. Mary Ann Realle 


Ms. Realle thanked fellow petitioners, Senators Kennedy and Kerry and 


Congressman Neal and their staffs, and NIOSH and the Board for the 


opportunity to speak. She chastised NIOSH for their failure to issue 


their evaluation report by the deadline, as well as their failure to 


provide technical assistance to petitioners in addressing the health 


physics issue or preparation for today's meeting. 


Ms. Realle detailed the comments made to NIOSH in February, 2006 by 


Chapman Valve families concerning the draft site profile, remarking 


that NIOSH issued the site profile the next day without accounting for 


any of those comments. She observed that DOL has remanded Chapman 


Valve DRs back to NIOSH as a result of the omission. 


Ms. Realle expressed the following contentions: 


The NIOSH coworker model is based on unrepresentative data; the most 


exposed workers were not monitored; during deliberations on the Iowa 


Ordnance Plant SEC NIOSH admitted the cohort sampling used was not 


representative of the most exposed workers; the SEC evaluation report 


assertion that workers would have had bioassay samples taken on the day 


they were exposed to incinerator operations is uninformed speculation; 


the report makes no effort to resolve the question of enriched uranium; 


NIOSH has not demonstrated its assertion that maximum dose can be 


estimated. 


Ms. Realle concluded by asking, on behalf of the petitioners, that the 


Board review the raw data to understand the basis of their contentions; 


to task SC&A with reviewing the SEC evaluation report; and to withhold 


judgment until a revised site profile is issued. She then designated 


Mr. Richard Miller from the Government Accountability Project to assist 


in the petitioners' presentation. 


Written statements from Senators Edward M. Kennedy and John F. Kerry, 


and Congressman Richard E. Neal in support of the petition were read 


into the record and are available in their entirety at the NIOSH/OCAS 


web site, www.cdc.gov/niosh/ocas. 


Mr. Miller supplemented the petitioners' presentation with the 


following technical points: 


#The DRs to date do not account for enriched uranium, the origin of 

which is unknown, but which NIOSH acknowledges cannot be 

attributable to background levels. Enriched uranium does not 

occur in nature. 

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#If enriched uranium did arise from a Naval reactors program, it must 

be accounted for within the provision of law, the 2004 amendments 

to the Defense Authorization Act, which define radiation dose. 

#Regarding representativeness of data, Senator Kennedy's staff advised 

that the highest exposed job category of brusher was not even 

mentioned in either the site profile or the evaluation report. A 

close look at the raw data by someone qualified was suggested. 

#The date of the fire is unknown, and being off by as little as a week 

involves a 50 percent change in the amount of uranium intake for 

an individual. He advised assignment of conservatism to the fire 

date. 

#Leaving aside the issue that the most exposed individuals were not 

sampled, NIOSH's assumption that bioassay automatically acted as 

an umbrella to capture all relevant exposures is flawed due to the 

lack of event dates and the question of whether bioassay was taken 

before or after such events. 

* * *
 

Discussion Points: 


#Clarification on the number of individual bioassay samples. 

#NIOSH's handling of the question of the date of the fire with a worstcase scenario assumption. 

#Clarification that even with the 50 percent difference asserted by Mr. 

Miller, the number is nonetheless boundable. 

#The need for more demonstration of the possibility of dose 

reconstruction before reaching a conclusion on this petition. 


#The number of people working at the facility. 

#The possibility that the highest exposed individual on a site could be 

someone with no external exposure. 


#A notation on highest internal and external exposure potentials. 

#A comment that internal and external exposures could coincide, but not 

necessarily. 


#Such exposures are not mutually exclusive and the burden is on NIOSH 

to show that its assumptions are demonstrated in the data. 

#The possibility of NIOSH comparing this data to similar processes at 

other facilities. 

#Explanation of the time frames and processes considered in defining 

the time period for the SEC. 


#Whether use of the contaminated facility continued. 

#Radioactive materials other than uranium used at the facility. 

#Clarification that NIOSH is using coworker models for calculating 

internal dose. 


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#How many claimants have individual bioassay results. 


#Whether other production processes are missing from the report. 


#Whether intake estimates derived from air sampling levels were 


consistent with those from urinalysis samples. 


* * * 


A motion was made, clarified and seconded that the Board request 


SC&A do further evaluation as a site profile task, and report 


back to the Board before further action is taken.
 

Discussion Points: 


#The intent of the motion is that SC&A's work be done as an SEC task. 

#The motion, if approved, would delay action in terms of a 

recommendation from the Board, although the intent is to be 

expeditious. 

#NIOSH is again being asked to prove a process it has proved 

repeatedly. 

#NIOSH has not adequately demonstrated its ability to do DRs at this 

facility. 

#The workgroup process is working, exemplified by NIOSH's 

acknowledgment that certain subsets of dose reconstruction 

questioned by the workgroup resulted in NIOSH admission of 

inability to do DRs. 

#If the motion were to pass, SC&A could have a draft report within two 

months. 

Before calling for a vote, Dr. Ziemer paraphrased the motion as one to 


defer action on the petition and to task SC&A to assist the Board in 


assessing the issues related to the petition as they've been discussed. 


The motion passed, with two abstentions.
 

There were no conflicts of interest relative to Chapman Valve. 


Additional petitioner comments consisted of thanks to the Board. 


* * * * *
 

BOARD WORKING TIME
 

A workgroup was appointed to focus on Chapman Valve SEC petition 


issues. Dr. Poston will chair. Other members are Mr. Griffon, Mr. 


Clawson, Dr. Roessler and Mr. Gibson. 


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Concerning the Subcommittee activity relative to individual dose 


reconstruction reviews of cases 21 to 60, or Rounds 2 and 3, Dr. Ziemer
 

noted the package comes as a recommendation, and thus a motion 


requiring no second, that the Board accept the package and that it be 


forwarded to the Secretary. There was the caveat that Mr. Griffon will 


first check the numbers for accuracy. 


The motion to accept the package as the Board's report to the 


Secretary, subject to minor editorial changes, carried 

unanimously. 

* * * * * 

PUBLIC COMMENT PERIOD
 

Dr. Ziemer called the meeting back to order, and provided a definition 


of the role of the Board, what it does and does not do under its 


charter. He introduced the Board members and gave brief summaries of 


their respective backgrounds. 


Public comment was offered by the following, whose statements in their 


entirety may be found on the NIOSH/OCAS web site, 


www.cdc.gov/niosh/ocas: 


Mr. John Funk, claimant; Ms. Jan Gaunce, survivor; Ms. Dianne Hanna 


Rudnicki, survivor; Mr. Robert Kromrei, former NTS employee; Ms. 


Patricia Niemeier, survivor; Ms. Lori Hunton, survivor; Ms. Kathleen 


Rozner (Senator Harry Reid staff member) reading a statement from Mr. 


Gene Campbell, claimant; Ms. Shirley Breeden, survivor; Ms. Dee 


Crafton, survivor; Ms. Jane Ann Williams-Lenz, survivor; Ms. Margaret 


Minster Cooley, survivor; Ms. Diane Milko Sbrocchi, survivor; Mr. 


William G. Morton, survivor; Ms. Alma Lee Mosley, survivor. 


* * * * *
 

With no further comments, the Board recessed until the following 


morning. 


* * * * *
 

Thursday, September 21
 

Dr. Ziemer opened the third and final day of the meeting with a welcome 


to all and a reminder to register attendance. 


LOS ALAMOS NATIONAL LABORATORY 


SEC PETITION EVALUATION REPORT
 

29
 
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NIOSH/CDC Advisory Board on Radiation and Worker Health


Dr. Wade announced Dr. John Poston as the sole Board member conflicted 


with regard to the site and unable to participate in the discussion and 


deliberations. Dr. Poston joined the audience. 


Mr. Stuart Hinnefeld, NIOSH
 

Mr. Hinnefeld detailed Petition 61 concerning LANL workers' exposure to 


radioactive lanthanum (RaLa), explaining this 83.14 petition occurs 


under part 14 of the rule regarding addition of classes to the SEC. 


Mr. Hinnefeld gave specifics of locations, time periods and purpose for 


work with RaLa, describing the mechanisms by which radioactive 


lanthanum was dispersed. He announced there are no personnel bioassay 


monitoring results for internal exposure, or air monitoring data. 


However, he explained NIOSH believe it will have records sufficient to 


do dose reconstruction for occupational medical and external exposures. 


NIOSH defined the covered period as September 1, 1955 through July 18, 


1963. The conclusion reached through the two-pronged test is that it 


is not feasible to estimate with sufficient accuracy the internal 


radiation doses, and that the health of the covered employees may have 


been endangered. 


* * *


 PETITIONER PRESENTATION 


Ms. Harriet Ruiz, New Mexico state representative and survivor 


claimant, requested the Board hold its March, 2007 meeting in New 


Mexico for the benefit of the claimants. 


Mr. Andrew Evaskovich, International Guards Union of America, Los 


Alamos Local Number 69, contended the TBD is not sufficient. Comments 


from his group's meeting with a NIOSH representative were not taken 


into account. The meeting occurred after the TBD was written. He 


expressed a need for correction of the TBD and to look at possible 


development of other classes. 


Ms. Michele Jaques-Ortiz, District Director for Congressman Tom Udall
 

of New Mexico, queried how the Department of Labor would determine 


potential for RaLa operations exposure in light of NIOSH's evaluation 


report, which states in Section 4.5 that NIOSH is unable to rely solely 


on worker job descriptions. She explained the Congressman had sent her 


to the meeting in order to urge the Board include wording in its letter 


to Secretary Leavitt to the effect that, in the absence of work history 


30
 
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NIOSH/CDC Advisory Board on Radiation and Worker Health


to the contrary, workers at the LANL facility who were employed during 


the class period shall be presumed to be RaLa workers. A further 


request is that the letter clarify that external and medical dose can 


be constructed by NIOSH, noting this point would allow DOL to 


adjudicate external dose for the non-SEC cancers. She urged the use of 


explicit wording due to concerns regarding DOL, as well as the passback 


memo. 


* * *
 

Dr. Wade explained the Board is not limited in speaking as clearly as 


it wishes in its recommendations to the Secretary of HHS. Mr. Elliott
 

underscored NIOSH's practice of sharing their carefully-crafted 


definition of a class with DOL to ensure its effective use in 


determining eligibility on behalf of claimants. DOL has indicated the 


LANL class definition prepared by NIOSH can be worked with effectively. 


Discussion Points: 


#Questions were posed to test NIOSH's assertion of inability to 

reconstruct dose. 

#Whether airborne radiation resulted from the volatility of radioactive 

lanthanum or from the explosions. 

#Why NIOSH cannot bound the air intakes for indoor work. 

#Clarification that the explosion tests took place outside. 

#Clarification on whether NIOSH requires claimants to file an 

affidavit. 

#How the 250-day rule comes into effect. 

#NIOSH concluded it cannot make realistic estimates of exposure with 

regard to a specific duration of time. Furthermore, they are past 

the issue of presence, although these exposures were not in the 

acute range of criticality accidents. 

#Biological plausibility of cancer risk from exposure to RaLa 

implosions at the rate of once a month for less than a year's 

period of time. 

#Dose estimation was deemed infeasible due to the multitude of process 

steps, along with uncertainties due to impurities in the 

explosion. 

#Why bioassay records were so minimal for this particular operation 

during the given time frame. 

#NIOSH's conflicting considerations regarding biological plausibility 

in light of the LANL RaLa exposures' similarities and 

dissimilarities with criticality events. 

#The SEC evaluation workgroup's report may provide a different approach 

or understanding to this complex of concerns. 

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A motion was made and seconded that the Board recommend the 


following letter be transmitted to the Secretary of Health 


and Human Services within 21 days. Should the Chair become 


aware of any issue that, in his judgment, would preclude the 


transmittal of this letter within that time period, the Board 


requests that he promptly informs the Board of the delay, the 


reasons for this delay and that he immediately works with 


NIOSH to schedule an emergency meeting of the Board to 


discuss this issue. 


The Advisory Board on Radiation and Worker Health (the Board) has 


evaluated SEC Petition 00061 concerning workers at the Los 


Alamos National Laboratory under the statutory requirements 


established by EEOICPA and incorporated into 42 CFR Section 


83.13 and 42 CFR Section 83.14. The Board respectfully 


recommends a Special Exposure Cohort be accorded to all 


employees of the DOE, predecessor agencies and their 


contractors or subcontractors who were monitored, or should 


have been monitored, for exposure to ionizing radiation 


associated with radioactive lanthanum (RaLa) operations at 


Technical Area 10 (Bayo Canyon Site), Technical Area 35 (Ten 


Site) and Buildings H, Sigma and U (located within Technical 


Area 1) at the Los Alamos National Laboratory for a number of 


work days aggregating at least 250 work days during the 


period from September 1, 1944 through July 18, 1963, or in 


combination with work days within the parameters established 


for one or more other classes of employees in the SEC. 


This recommendation is based on the following factors: 


1. 	People working in these areas of Los Alamos National 


Laboratory were associated with radioactive lanthanum 


operations as part of the early development and testing of 


nuclear weapons. In reviewing the available monitoring data 


for these operations, NIOSH found it did not have access to 


sufficient information, including internal personal 


dosimetry, workplace monitoring, or sufficient process and 


radiological source information, that would allow it to 


estimate with sufficient accuracy the potential internal RaLa 


doses to which members of the proposed class may have been 


exposed. The Board concurs with this determination. 


2. 	 NIOSH determined that health was endangered for the workers 


exposed to radiation in these areas of LANL within the time 


period in question. The Board concurs with this 


determination. 


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3. 	 The NIOSH review of data found that it was sufficient to 


support accurate individual dose reconstruction for external 


doses and occupational medical doses for workers at the areas 


in question at the Los Alamos National Laboratory. The Board 


concurs with this determination. 


In their evaluation NIOSH determined that it was difficult to identify 


people who worked in these areas of LANL based on job 


classifications. Therefore the Board recommends that 


determination of eligibility for this class take into account this 


difficulty. In the absence of work history or other information 


to the contrary, workers at the LANL facility during the time 


period in question should be presumed to have worked in the areas 


in question. 


Enclosed is supporting documentation of the recent Advisory Board 


meeting held in Las Vegas, Nevada where the Special Exposure 


Cohort was discussed. If any of these items are not 


available at this time, they will follow shortly. 


The above motion reflects revisions made as a result of discussion on 


how to most clearly and accurately define the workers. Consideration 


was given to matching the NIOSH description of the class. It was 


clarified that the possibility of other nuclides or bioassays might 


allow for reconstruction of doses other than radioactive lanthanum. 


With a non-covered cancer NIOSH would attempt a partial dose 


reconstruction using external exposure, and possibly internal exposure, 


but not dealing with lanthanum. 


The motion carried unanimously.
 

* * * * *
 

S-50 SEC PETITION EVALUATION REPORT
 

Mr. Stu Hinnefeld, NIOSH
 

Mr. Hinnefeld outlined Petition Number 00060 relating to the S-50 


Thermal Diffusion Plant, site of an early attempt to enrich uranium. 


NIOSH defined the covered period as July 9, 1944 through December 31, 


1951. Lacking exposure data sufficient to perform a feasible dose 


reconstruction, NIOSH proceeded with an 83.14 petition. 


Mr. Hinnefeld provided a brief history of the plant. Regarding the 


processes relevant to dose reconstruction, he explained the thermal 


diffusion process at the facility and detailed the availability of DR 


data. NIOSH was unable to obtain air monitoring data or personnel 


33
 
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monitoring results for either external or internal exposures. 


Contemporaneous information reports indicate significant uranium 


release during attempts at diffusion. The limited information from 


direct radiation and contamination surveys is insufficient for dose 


reconstruction in terms of magnitude and time. However, enough is 


known about the medical monitoring program in this period to allow 


NIOSH to develop protocols to reconstruct occupational medical dose for 


people in the class. 


In terms of feasibility, NIOSH found it lacked the monitoring, process 


and source term information to estimate with sufficient accuracy the 


internal or external doses for all members of the class, but they 


believe they do have sufficient information to estimate the medical 


exposures. NIOSH believes that health may have been endangered due to 


the nature of the operation, the use of UF-6 vapor, and the lack of 


information to bound workers' potential exposures. The proposed class 


definition in NIOSH's evaluation report is expressed as all employees 


of the DOE and its predecessor agencies and their contractors and 


subcontractors who were monitored, or should have been monitored, for 


ionizing radiation at S-50 Thermal Diffusion Plant for 250 days during 


the covered period. 


* * * 


 PETITIONER RESPONSE
 

No petitioners were available to make comment on this petition. 


* * *
 

Discussion Points: 


#Why a monitoring program would not have been in place at the site. 

#Whether the workforce at S-50 included employees from Y-12, K-25 or N50. 

#An exploration of the use of off-site workers and their monitoring. 

A motion was made and seconded that the Board recommend the 


following letter be transmitted to the Secretary of Health 


and Human Services within 21 days. Should the Chair become 


aware of any issue that, in his judgment, would preclude the 


transmittal of this letter within that time period, the Board 


requests that he promptly informs the Board of the delay, the 


reasons for this delay and that he immediately works with 


NIOSH to schedule an emergency meeting of the Board to 


discuss this issue. 


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The Advisory Board on Radiation and Worker Health (the Board) has 


evaluated SEC Petition 00060 concerning workers at the Oak 


Ridge National Laboratories under the statutory requirements 


established by EEOICPA and incorporated into 42 CFR Section 


83.13 and 42 CFR Section 83.14. The Board respectfully 


recommends a Special Exposure Cohort be accorded to all 


employees of the DOE, predecessor agencies and their 


contractors or subcontractors who were monitored, or should 


have been monitored, while working at the S-50 Oak Ridge 


Thermal Diffusion Plant for a number of work days aggregating 


at least 250 work days during the period from July 9, 1944 


through December 31, 1951, or in combination with work days 


within the parameters established for one or more other 


classes of employees in the SEC. 


This recommendation is based on the following factors: 


1. 	 People working in S-50 Oak Ridge Thermal Diffusion Plant were 


employed in a wartime uranium enrichment facility from July 


8, 1944 to September 9, 1945, and in feasibility studies for 


the Nuclear Energy for the Propulsion of Aircraft project 


from May 1, 1946 through December 31, 1951. NIOSH found that 


it lacked access to internal and external personnel dosimetry 


data and other workplace monitoring data necessary to 


reconstruct internal and external exposures to uranium 


compounds and other radioactive materials that may have been 


present at the facility during the time period in question, 


and thus was unable to estimate with sufficient accuracy 


radiation doses from internal and external exposures for 


these workers. The Board concurs with this determination. 


2. 	NIOSH determined that health was endangered for workers 


exposed to radiation at the S-50 Oak Ridge Thermal Diffusion 


Plant in the time period in question. The Board concurs with 


this determination. 


3. 	 The NIOSH review of the data found that it was sufficient to 


support accurate individual dose reconstruction for 


occupational medical doses for workers in the area of the S ­

50 Oak Ridge Thermal Diffusion Plant. The Board concurs with 


this determination. 


Enclosed is supporting documentation from recent Advisory Board 


meetings held in Las Vegas, Nevada where the Special Exposure 


Cohort was discussed. If any of these items are not 


available at this time, they will follow shortly. 


* * *
 

35
 
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Discussion Points: 


#To add a sentence indicating medical dose is considered feasible 

(reflected in the above language). 

#Clarification that health endangerment is governed by 83.13 and 83.14, 

both of which are cited in the NIOSH review. 

#Exploration of NIOSH's assumptions concerning the medical case. 

NOTE:Mr. Presley was asked to abstain from the vote on this 


petition due to a possible conflict of 


interest as a result of his connection with 


the Oak Ridge facilities. 


The motion carried unanimously, with one abstention.
 

* * * * *


 SC&A TASKING 


Site Profile Reviews
 

In preparation for selecting site profiles for SC&A review in FY 2007, 


the Board received additional information requested earlier in the 


meeting. Added to the list of site profiles completed and listed on 


the NIOSH web site was the total number of cases at each site and the 


number of cases with completed DRs. Sites with qualified petitions 


and those with site profiles under development were also listed. A 


free-form discussion followed to ascertain the Board's priorities. 


Discussion Points: 


#The status of the Clarksville/Medina site. 


#The Chapman Valve exposure matrix will be thoroughly reviewed as part 


of the SEC review process. 

#The large number of cases at Portsmouth. 

#The number of cases at various other sites. 

#Status of the Savannah River Site site profile review. 

Board members individually selected their top five choices and 


indicated them by a show of hands. The following selected sites are 


shown with their respective number of votes. Without objection, it was 


agreed these choices represent Board action: 


1.Lawrence Livermore National Laboratory (9 votes); 


2.K-25 (8 votes); 


3.Pantex (7 votes); 


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4.Portsmouth (6 votes); 


5.Argonne West (5 votes); 


6.Sandia Albuquerque (4 votes); 


7.Atomics International (formerly ETEC) and 


Clarksville/Medina (2 votes each). 


SC&A will proceed immediately to review site profiles for Lawrence 


Livermore National Laboratory and K-25. They will inform the Board 


when ready to start the third review, in case Board priorities have 


shifted. Absent further action by the Board, SC&A will defer to this 


priority list. 


* * *


 Procedures Reviews
 

Dr. Wade set the stage for selection of up to 30 procedures for SC&A 


review in 2007. Board members were provided Dr. Mauro's partial list 


of procedures already reviewed under other task work, a candidate list 


to which OTIB-38 and OTIB-42 had been added, and SC&A's recommended 


list of 22 procedures to be reviewed. 


Asked to comment on the preliminary list on behalf of NIOSH, Mr. 


Hinnefeld suggested using the later Performance Evaluation Report for 


Bethlehem Steel because the entire site profile had recently been 


revised, with incorporation of many changes including ingestion. He 


recommended SC&A review OTIB-6 due to its frequent citation in 


individual DR reviews. OTIB-9, however, is rarely or never used and he 


suggested there would be little utility in reviewing this early 


procedure. Review of any coworker approaches would be valuable. OTIB55 and the OTIB on Y-12 criticality doses would be of interest. He 


suggested beginning the reviews of Procedures 59 and 86 to determine if 


they are indeed worth reviewing. 


It was decided that a maximum of 15 assignments would be made, due to 


lack of the complete list of procedures reviewed and not reviewed. 


SC&A's list of 22 was reduced to 14 for various reasons including 


minimal use, site profile revisions underway, and some that were deemed 


more administrative than technical. Others were already scheduled to 


be reviewed as part of other current tasking. 


Without objection, these choices constitute a consensus of the Board 


for the contractor to proceed on their procedures review task: OCASPER-004, OCAS-TIB-013, ORAU-OTIB-006, ORAU-OTIB-0013, ORAU-OTIB-0015, 


ORAU-OTIB-0039, ORAU-OTIB-0055, ORAU-OTIB-0057, ORAUT-PROC-0060, ORAUTPROC-0094, ORAUT-PROC-0095, ORAUT-PROC-0097, OTIB-42, OTIB-38. 


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* * * * *
 

NIOSH CONFLICT OF INTEREST POLICY
 

Dr. Lewis Wade, NIOSH 


Board DFO 


Dr. Wade provided context for the NIOSH statement of their conflict of 


interest policy, revised draft dated September 14 2006. The document 


was modified to reflect comment received from its last airing. It no 


longer applies to the Board or SC&A although, to preserve a record of 


certain information, the appendix deals with remedies if a Board member 


is found to be conflicted. Dr. Wade expressed the need to finalize the 


policy so that ORAU could proceed with its review of past work and the 


plan for attribution and annotation. He emphasized the Board's ability 


to change the document as needed. 


Dr. Wade described four principal changes, as follows: 


1.The definition of operator has been changed to be more realistic and 


precise. 


2.The formerly open-ended term "business confidential" has been defined 


in relation to the type permitted to be withheld from disclosure 


within the Freedom of Information Act. 


3.NIOSH has added a new section, 3.13, concerning workers with a 


relationship subordinate to someone conflicted. This modification 


helps prevent the COI policy from finding all such workers 


conflicted, thus paralyzing the ability to move forward. 


4.This addresses the issue of key program function. Authoring a site 


profile dealing with a particular site would be a key program 


function. Authoring generic documents that cover complex-wide 


issues is not regarded as a key program function. This change 


leaves open the capability of the people working on them. 


Multiple site TIBs fall within a gray area that will need to be 


administered as the Board continues its work. 


Dr. Wade invited individual Board members to comment to him early the 


following week, with the intention that this policy could be finalized 


by September 27. 


Dr. Wade clarified the two steps for considering COI for the Board. 


One is a determination as to whether a conflict exists; the second is 


the issue of remedy, which is spelled out clearly in the appendix to 


the revised NIOSH COI document. The Board will be asked to consider 


how to determine if a conflict exists. 


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Board members were provided a document entitled "Ethics Rules for 


Advisory Committee Members and Other Individuals Appointed as Special 


Government Employees." Dr. Wade highlighted the aspects of financial 


interest and impartiality for SGEs, pointing out the Board could go 


beyond those considerations in developing its own procedures. 


* * *
 

Discussion Points: 


#The current Appendix I deals only with Advisory Board practice in 

cases of conflict, not specifics of what constitutes a conflict. 

#The Board's issues with corporate COI as expressed in their letter to 

Dr. Howard were incorporated into this policy. 

#The Appendix 2 wording does not adequately capture corporate COI. 

#A redline version of the COI policy would be helpful for Board members 

to compare changes made to the previous draft. 

#A clarification of responsibilities of the document owner would be 

helpful. 

#A reference, perhaps as a footnote, concerning single-site or 

multiple-site TIBs and how to handle related COI issues was 

suggested for this gray area. 

#How a site-specific document might appear to be generic, and how to 

avoid the appearance of conflict when conflict in fact does not 

exist. 

* * *
 

Dr. Ziemer reminded the Board of its opportunity to consider whether or 


not to develop a separate COI policy for itself, bearing in mind the 


Board is bound to other documents, including the Federal Ethics Rules. 


Dr. Melius suggested the need for expert guidance in developing the 


policy in order to avoid potential conflict with other sets of rules 


governing FACA members and SGEs. Dr. Ziemer expressed his desire for 


separate conflict parameters for Board members because, under the new 


NIOSH policy, he would likely be found conflicted on every DOE site and 


current Board members might all have to resign. 


Noting the official workgroup looking at conflict of interest is an ad 


hoc group, Dr. Ziemer suggested the Board might want to think in terms 


of a workgroup to work with legal counsel and others in developing a 


framework that would outline the needed parameters. 


It was discussed that both actual and perceived Board conflicts of 


interest need to be considered in developing their policy. 


Transparency demands clarity on these points. The ethics rules 


regarding impartiality are fairly clear on what constitutes conflict; 


39
 
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NIOSH/CDC Advisory Board on Radiation and Worker Health


however, ambiguity surrounds the issue of impartiality as it pertains 


to Board members' conflicts. 


Ms. Emily Howell from the Office of General Counsel cited the precedent 


of the Advisory Committee on Immunization Practices (ACIP), another 


advisory board within CDC, which has written its own COI policy. The 


program is very concerned with transparency and ABRWH is being asked 


for its voice on how to go beyond the FACA and other rules in 


addressing its own specific conflict of interest concerns. Any board 


COI policy must go through several layers within the General Counsel's 


office for approval. 


The Board reached consensus on developing its own policy. A conflict 


of interest workgroup was formed, to be chaired by Dr. Lockey, with Dr. 


Melius, Mr. Presley and Dr. Ziemer as members. The workgroup was 


charged to create an initial draft Board COI policy using existing 


government documents, the template of the ACIP policy, and assistance 


from counsel. Dr. Wade agreed to provide a redline version of the 


NIOSH policy to the workgroup within the next few days containing words 


to deal with the issue of single/multiple site. 


* * * * *
 

APPROVAL OF MINUTES
 

A motion was made and seconded to approve as distributed the 


minutes of the 37th meeting of the Advisory Board on 


Radiation and Worker Health held in Denver, Colorado April 25 


through 27, 2006. 


With no discussion, the motion passed unanimously. 


* * *
 

A motion was made and seconded to approve as distributed the 


minutes of the 11th meeting of the Subcommittee for Dose 


Reconstruction and Site Profile Reviews held in Washington, 


D.C. on June 14, 2006. 


With no discussion, the motion passed unanimously.
 

* * *
 

A motion was made and seconded to approve as distributed the 


minutes of the 38th meeting of the Advisory Board on 


Radiation and Worker Health held in Washington, D.C. June 14 


through 16, 2006. 


40
 
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With no discussion, the motion passed unanimously.
 

* * * * *
 

WORKING GROUPS, MEMBERSHIP AND STRUCTURE
 

Dr. Ziemer addressed some apparent confusion regarding working groups 


addressing SEC issues. He explained there is a one-time workgroup 


formed to look into SEC petitions that have not been qualified for 


evaluation by NIOSH. Dr. Lockey had earlier volunteered to chair that 


group, but a replacement is now needed for Dr. DeHart. There is an 


ongoing workgroup focusing on SEC activities chaired by Dr. Melius. 


Ms. Munn volunteered to fill the vacancy created by Dr. DeHart's 


retirement. Other members of the one-time workgroup include Dr. 


Roessler and Dr. Melius. Mr. Clawson was added to the group as a 


worker representative. Mr. Elliott invited the workgroup to schedule 


their meeting in Cincinnati at the NIOSH offices where he offered to 


provide all the documentation in its entirety, a briefing on the NIOSH 


processes to date, and a report from the NIOSH assessment team. Dr. 


Lockey was charged with arranging a meeting time. 


Dr. Wade reviewed membership of the Board's workgroups. He reminded 


the Board that the procedures review, formerly handled by the 


subcommittee, will need a tracking method. Dr. Ziemer added that a new 


workgroup will be needed to work on SC&A's review of the new set of 


procedures. 


* * * * *
 

BOARD/WORKING GROUPS' FUTURE PLANS
 

Discussion of Overarching Issues
 

Dr. Ziemer defined overarching issues as those which span multiple 


working groups and affect multiple sites. The issue is how to track 


them and keep them active. Dr. Wade expressed concerns about how to 


keep an issue alive when working groups pass an issue to another 


entity. Discussion brought forth ideas for solutions and a continued 


clarification of the issue. 


* * *
 

Discussion Points: 


#Compilation of all issues into a mega-matrix. 

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#Formation of a working group with oversight of overarching issues. 

This was objected to as overly time-consuming. 

#Formation of an individual workgroup for each overarching issue. 

#Establishment of a master deficiencies list reflecting the number of 

sites involved, to be presented to the Board on a routine basis, 

with NIOSH to remove items that are closed out. 

#A refocusing on the problem as one not only of physical tracking, but 

also of technical solutions. 

#The General Account Office had recommended the Board institute a 

tracking mechanism for issues arising not only from the workgroups 

but also from Board interactions. 

#SC&A and NIOSH are both well-positioned to track issues arising in 

both workgroup and Board meetings. 

#The clerical tracking issue must be resolved before the technical 

aspect can be addressed. 

#An individual could be named as point person for all issues. 

#A suggestion NIOSH come forward with a position paper preparatory to 

incorporating any resolved issues into TIBs or TBDs; NIOSH would 

then track the comment resolution both in the matrix for that 

given position paper and in other working group efforts. 

#NIOSH tracking would be advantageous in that they are the continuing 

agency to follow this program long after the need has ceased for a 

subcontractor and working groups. 

#The tracking issue exists not only for overarching issues but also for 

site-specific unresolved processes that are closed out with 

actions stating that someone will do something, when the ultimate 

resolution is not tracked. 

#Tracking is required for issues that are unresolved and issues marked 

for follow-up. 

#Focus will need to be kept on Board issues, not just those arising 

within the work of NIOSH and SC&A. 

#Because working groups are more familiar with details of specific 

issues, they should hear from NIOSH and SC&A, but then ultimately 

make their own recommendations to the Board concerning overarching 

issues. 

#The starting point for identification of overarching issues might 

begin with complex-wide issues identified in Mr. Presley's working 

group, with the intent of agreeing on what issues should come into 

the category. 

#Caution that rather than attempting to solve overarching issues, the 

first step should entail developing a system of documenting them, 

perhaps calling upon NIOSH, SC&A and the workgroups to prepare 

lists to be discussed on a conference call or at the December 

Board meeting. 

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Dr. Wade suggested Mr. Elliott could provide an update on the status of 


cross-cutting issues as part of his presentation at every Board 


meeting. The purpose of Mr. Elliott's proposed position paper would be 


to avoid the creation of more and more new documents by instead 


addressing existing documents and modifying them. 


It was agreed the list of cross-cutting issues from Mr. Presley's 


working group would serve as a starting list, with more issues to be 


added. 


* * *
 

Dr. Wade reminded the Board of its upcoming schedule, which includes a 


teleconference on October 18 and a Board meeting December 11 through 


13, 2006. Scheduled in 2007 is a Board meeting February 7 through 9; a 


teleconference in mid-March; a Board meeting in late April; a 


teleconference in mid-June; and a Board meeting in August. 


Possible meeting locations discussed included Denver (for Rocky Flats), 


New Mexico (for LANL), and the Cincinnati area (for Fernald). 


* * *
 

Senator Harry Reid of Nevada addressed the Board via video conference, 


expressing support for inclusion in the SEC of NTS workers who 


contracted cancer from work during the above-ground nuclear tests, even 


though they worked on the site less than 250 days. His statement in 


its entirety may be found at www.cdc.gov/niosh/ocas. 


* * * * *
 

BOARD CORRESPONDENCE/WORKING TIME
 

Several items referenced in Mr. Peter Stafford's June 23 letter to the 


Board have been addressed since its arrival. The TIB on construction 


trades workers has been issued. Mr. Elliott clarified that he has been 


in consistent dialogue with Mr. Stafford since the Denver Board meeting 


and has provided, at three points since that meeting, the status of the 


construction worker TIB and the number of CTW claims NIOSH has 


completed. 


Dr. Knut Ringen formed a working group to look at the TIB and offer 


comments to NIOSH. This same panel of experts contributed to the early 


stages of TIB-52. They sent a letter, which Mr. Elliott offered to 


copy to Board members as soon as he returns to his office. 


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NIOSH/CDC Advisory Board on Radiation and Worker Health


Four requests from Mr. Stafford's June letter need Board response. 


They are: 


1.To consider establishing a subcommittee to review the TIB. 


2.That SC&A strengthen its expertise in construction worker exposure 


estimation. 


3.That the Board agree with and suggest that OCAS do certain things. 


4.That QA procedures on the DRs track the construction trades worker 


cases and determine the distribution among them of cancers and 


other variables. 


* * * 


Dr. Ziemer observed that fulfilling request number two would require 


new tasking, and possible addition of a consultant to the SC&A staff. 


As to request number four, broad identification of CTW cases can be 


accomplished after DRs are completed, but not when DR cases are chosen. 


Job description cannot be used as a sorting mechanism in selecting 


cases to be dose reconstructed, but after the DRs are completed, some 


cases can be identified as those of construction trades workers. 


Discussion Points: 


#Request number two asks for the selection of a random sample of 

construction worker DRs for audit. 

#Requests should be answered positively. 

#The Board has charged SC&A with reviewing TIB-52, which addresses most 

of these issues. 

#A substantial number of CTW dose reconstructions are in fact under 

review. 

#A positive response to request number one includes acknowledgment that 

the review of the TIB has been tasked, and the Board has signaled 

its intent to form a procedures review working group. 

#Addressing request number three, the Board was not chartered to 

undertake such issues as malfeasance, bias and unbalanced 

policies. 

#The pitfalls of establishing a separate category of employee type, 

such as CTW. 

#The unbalanced policies in question refer to the fact that many of the 

CTWs worked for subcontractors rather than primary contractors, 

resulting in different policies for monitoring and radiation 

protection. 

#Normal procedures address such inequities where appropriate. 

Dr. Ziemer observed the suggestions were sensitive to the needs of the 


CTW group while recognizing the limitations of the Board, SC&A and 


44
 
Executive Minutes September 19-21, 2006 
 

NIOSH/CDC Advisory Board on Radiation and Worker Health


NIOSH. Mr. Stafford's and Dr. Ringen's concerns have been largely 


addressed through the new TIB and plentiful communications with NIOSH. 


Dr. Ziemer added it seemed the Board's efforts were recognized. 


Offering to prepare a letter of response to Mr. Stafford, which he will 


distribute to everyone for editorial rather than conceptual changes, 


Dr. Ziemer outlined his approach. He will indicate that review of the 


TIB will begin; it will be explained that the Board is developing its 


COI policy; QA procedures are already in place; and the Board can take 


a look, after the fact, at variables concerning CTWs as a matter of 


record. 


* * *
 

The Board then discussed problematic correspondence from DOL which has 


caused recent complaint by members of the public. Mr. Elliott wanted 


the record to show that he follows up immediately on any such problems 


at NIOSH and corrects them. He talks with DOL if the issue relates to 


their correspondence with the public. 


Many suggestions were made for how best to define the problem, and how 


to solve it. Serious consideration was given to how to inform and 


follow up with DOL to ensure correction. It was noted that the general 


public may not distinguish between DOL and NIOSH, both being viewed 


simply as the government. Therefore, any such problems discredit all 


entities within the government. 


It was decided that the Board's communication with Mr. Peter Turcic at 


DOL on this matter would be formalized in a letter, with specific 


information upon which he could act. The idea of asking DOL to share 


information on their QA and monitoring programs was considered; 


however, it was pointed out that correct QA might nevertheless 


authorize sending a poorly-written letter. 


In contemplating various actions, the Board was cautioned to consider 


its charter and its responsibilities to oversee the scientific quality 


of the dose reconstruction program. The Board was urged to be 


absolutely certain of the facts. Although an offensive form letter 


from DOL to a claimant surfaced again a year after a complaint was 


lodged, it was unclear as to when that second letter was written and 


whether its reappearance represented an ongoing, unaddressed problem. 


It was noted that, apart from the problematic letter, continuing 


problems with DOL communications should form the basis of the letter to 


Mr. Turcic. 


Mr. Elliott, observing that neither NIOSH nor DOL were completely 


blameless, indicated that following one of the Board meetings where 


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Executive Minutes September 19-21, 2006 
 

NIOSH/CDC Advisory Board on Radiation and Worker Health


public comment had addressed this issue, he had requested ORAU review 


the public comment portion of Board meetings and list each reference to 


such complaints. That information is available. Dr. Ziemer took it by 


consent that the Board would review that information and decide on a 


specific course of action in the next Board teleconference. Mr. 


Elliott committed to provide the material by October 2. 


* * * * *
 

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


adjourned at 3:50 p.m.
 

Ë Ë Ë 

End of Summary Minutes
 

Ë Ë Ë Ë Ë 

I hereby confirm that these Summary Minutes are 


accurate, to the best of my knowledge. 


Paul L. Ziemer, Ph.D., Chair 


Date 


46