This transcript of the Advisory Board on Radiation and Worker Health, Dose Reconstruction Review 

Methods, has been reviewed for concerns under the Privacy Act (5 U.S.C. § 552a) and personally 

identifiable information has been redacted as necessary. The transcript, however, has not been reviewed 

and certified by the Chair of the Dose Reconstruction Subcommittee accuracy at this time. The reader 

should be cautioned that this transcript is for information only and is subject to change.

1 

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

CENTERS FOR DISEASE CONTROL

NATIONAL INSTITUTE FOR OCCUPATIONAL

SAFETY AND HEALTH 

+ + + + +

ADVISORY BOARD ON RADIATION AND

WORKER HEALTH 

+ + + + +

DOSE RECONSTRUCTION REVIEW METHODS WORK GROUP

+ + + + +

THURSDAY

NOVEMBER 5, 2015

+ + + + +

The Work Group convened via 

teleconference at 10:00 a.m. Eastern Time, James 

M. Melius, Chairman, presiding.

PRESENT:

JAMES M. MELIUS, Chairman

JOSIE BEACH, Member

DAVID KOTELCHUCK, Member

DAVID B. RICHARDSON, Member

PAUL L. ZIEMER, Member
This transcript of the Advisory Board on Radiation and Worker Health, Dose Reconstruction Review 

Methods, has been reviewed for concerns under the Privacy Act (5 U.S.C. § 552a) and personally 

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should be cautioned that this transcript is for information only and is subject to change.

2

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ALSO PRESENT:

TED KATZ, Designated Federal Official

KATHY BEHLING, SC&A

RON BUCHANAN, SC&A

GRADY CALHOUN, DCAS

DOUG FARVER, SC&A

ROSE GOGLIOTTI, SC&A

ED MAHER, ORAU Team

DAN MCKEEL

BETH ROLFES, ORAU Team

MUTTY SHARFI, ORAU Team

SCOTT SIEBERT, ORAU Team

JOHN STIVER, SC&A
This transcript of the Advisory Board on Radiation and Worker Health, Dose Reconstruction Review 

Methods, has been reviewed for concerns under the Privacy Act (5 U.S.C. § 552a) and personally 

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and certified by the Chair of the Dose Reconstruction Subcommittee accuracy at this time. The reader 

should be cautioned that this transcript is for information only and is subject to change.

3

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C O N T E N T S

Page

Welcome and Roll Call ......................... 4

Brief Overview of SC&A Review ................ 11

Conclusions and Recommendations

of Review .................................... 21

Dose Reconstruction Findings

Statistics (SC&A report) ..................... 27

Possible Paths forward for

Individual Case Reviews ...................... 75

Plans for November Board Meeting

Discussion ................................... 85

Adjourn
This transcript of the Advisory Board on Radiation and Worker Health, Dose Reconstruction Review 

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4

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

2 10:02 a.m.

3 MR. KATZ: Okay. Welcome, everyone. 

4 This is the Advisory Board on Radiation and Worker 

5 Health, Dose Reconstruction Review Methods Work 

6 Group.

7 And we're meeting today, have Board 

8 Members, we have all five Work Group Members, 

9 including the Chair on the line already. And no 

10 conflict of interest matters to discuss. I don't 

11 think we need to run through that.

12 There's an agenda for today. It's 

13 posted. It's very simple. It's posted on the 

14 website under today's Board section. And I'm sure 

15 Jim will address that.

16 And otherwise, just please, everybody, 

17 mute your phones. Press *6 to mute your phone if 

18 you don't have a mute button, and *6 to take your 

19 phone off of mute.

20 And please, nobody put the call on hold, 
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5

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1 but hang up and dial back in if you have to leave 

2 the call for a bit.

3 And Jim, it's your meeting.

4 CHAIRMAN MELIUS: Okay. Thank you. 

5 And welcome, everybody from the Work Group. And 

6 otherwise, so forth and now we all got a long report 

7 from SC&A just recently.

8 So -- but I don't think we'll be 

9 discussing that in detail. I mentioned in an email 

10 to you that I think it's more of a background 

11 support document or a reference document that we 

12 can utilize as we go forward in terms of thinking 

13 about how we -- to what extent we would modify how 

14 we do the dose reconstruction reviews.

15 And then I think Ted had also sent out 

16 some of the documentation statistics from the Dose 

17 Reconstruction Review Committee's preparation for 

18 their upcoming report on their activities over 

19 time. So, it's just a lot of summary statistics 

20 on what the findings have been and so forth on that.
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6

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1 And I think, I'm pretty sure 

2 everybody's gotten both of those. I just want to 

3 give anybody time if there's questions you have or 

4 other documentation that you think would be helpful 

5 to have going forward.

6 We can come back to this later. But I 

7 thought we should at least talk about it somewhat 

8 now.

9 MR. KATZ: While you're thinking about 

10 that, I just realized that I didn't ask about Agency 

11 members and staff and so on for participation.

12 MEMBER ZIEMER: I was going to ask if 

13 you had done a roll call.

14 MR. KATZ: So I think we should that, 

15 please. My apologies, but --

16 CHAIRMAN MELIUS: Okay, then.

17 (Roll call.)

18 MR. KATZ: Okay, very good. Sorry. 

19 And now back to Jim's question.

20 CHAIRMAN MELIUS: Yes. Can you replay 
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7

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1 the tape, then, so I don't have to repeat? So, 

2 anyway, that's the documentation.

3 I just would indicate for people that 

4 are not part of the Board or the Work Group, a lot 

5 of this is not sort of public information. So, 

6 these reports are not generally available at this 

7 point in time.

8 And for those of you on the Board, to 

9 the extent we are -- I don't think we're going to 

10 discuss these in any detail. But to the extent 

11 that we do, it's just reminding that there is sort 

12 of -- we have to be careful because there is Privacy 

13 Act information, covered information that's in 

14 particularly the more recent SC&A report. At 

15 least as I read some of the tables and so forth. 

16 Do that, so be cognizant of that. Does anybody 

17 have questions on the recent SC&A report, any of 

18 the Board Members?

19 MEMBER KOTELCHUCK: This is Dave. I'm 

20 wondering which one's your -- which one you're 
This transcript of the Advisory Board on Radiation and Worker Health, Dose Reconstruction Review 

Methods, has been reviewed for concerns under the Privacy Act (5 U.S.C. § 552a) and personally 

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8

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1 referring to when you say recent SC&A Report.

2 CHAIRMAN MELIUS: That's the analysis 

3 of the 19th and 21st set of Dose Reconstruction 

4 Reviews.

5 MEMBER KOTELCHUCK: I've been out of 

6 town at a conference for a few days. When did that 

7 come in?

8 CHAIRMAN MELIUS: Late Thursday of 

9 last week.

10 MEMBER KOTELCHUCK: Aha. Okay. Let 

11 me -- I have not read that.

12 CHAIRMAN MELIUS: And that's why I 

13 wasn't expecting people to have, given its length. 

14 And it's -- and the time involved.

15 MEMBER KOTELCHUCK: Okay.

16 CHAIRMAN MELIUS: But again, it's more 

17 of a reference, you know, supporting document. I 

18 think it's -- I found it to be very helpful in sort 

19 of, it sort of establishes sort of the extent of 

20 how dynamic this program is in capturing what's --
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9

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1 you know, we're doing dose reconstructions that 

2 have been completed.

3 There's some lag from the time that they 

4 are completed before the time that we review them. 

5 Or SC&A review, you know, the whole process that 

6 the Dose Reconstruction Review Committee goes 

7 through.

8 And during that time period -- and it 

9 actually sort of goes back to the selection of the 

10 cases up until the time we go through the review 

11 process. You know, changes take place. The SECs 

12 may be granted. Site Profiles change. 

13 Procedures change and so forth.

14 And that happens, you know, on a sort 

15 of a continual basis. And so, I think trying to 

16 understand that. So, we may be, you know, doing 

17 an individual dose reconstruction review and 

18 actually the methods may be, you know, by the time 

19 that we review it, those methods may be different.

20 MEMBER KOTELCHUCK: Right.
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10

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1 CHAIRMAN MELIUS: How different and 

2 what changes or, you know, processes in place. But 

3 it's still -- doesn't mean that -- I mean, I think 

4 it's just helpful to our understanding of this 

5 whole process.

6 This program has always been very 

7 dynamic in the sense that rather than having a fixed 

8 set of review criteria, those review criteria are 

9 updated as more data becomes available or as we 

10 refine the procedures that are being used to do the 

11 dose reconstructions.

12 MS. BEHLING: Excuse me, Dr. Melius, 

13 this is Kathy Behling. I'm wondering, would the 

14 -- or would the Work Group benefit from just a very 

15 brief synopsis of this report? I know it's 

16 lengthy.

17 But perhaps we could just focus your 

18 attention on some of the conclusions. What we, you 

19 know, what we did. A reminder as to what we did 

20 and just some basic conclusions.
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11

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1 So, that when you go through this, it 

2 sort of focuses your attention. Do you think that 

3 that's worth doing today? Because I think either 

4 Rose or myself could do a very brief overview if 

5 you're interested.

6 CHAIRMAN MELIUS: I mean, it's really 

7 up to the other Board Members.

8 MEMBER BEACH: Jim, this is Josie. 

9 I've glanced through it. I haven't had a whole lot 

10 of time. But I think just a brief overview would 

11 be helpful for me.

12 CHAIRMAN MELIUS: Okay. But I would 

13 emphasize on the brief.

14 MEMBER BEACH: Brief. Yes, I was 

15 thinking brief.

16 CHAIRMAN MELIUS: Okay. So Rose, if 

17 you or Kathy want to go ahead.

18 MS. GOGLIOTTI: Yes, absolutely. So, 

19 this review we focused on the 19th and 21st sets. 

20 So there's 60 cases total in these sets.
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12

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1 And we set out to answer some very 

2 specific questions on how individual dose 

3 reconstruction cases were impacted by ongoing 

4 Board activities, specifically SEC Class 

5 implications, procedure revisions that have 

6 happened since the dose reconstruction was 

7 completed, and ongoing issues resolutions.

8 So, for SEC Class impacts, we looked at 

9 cases and answered the questions. Specifically 

10 was the case covered by an SEC? Was an SEC issued 

11 prior or subsequent to the case being reviewed? 

12 And if it was subsequent, would the review have --

13 significantly be affected by the SEC? Did our 

14 review identify SEC issues? And did our review 

15 identify other potentially SEC issues that were not 

16 in the actual SEC Class?

17 And from the SEC impacts standpoint, 

18 most of our cases did have an SEC that impacted them 

19 in some way, shape or form. I believe 50 of the 

20 60 cases had an SEC Class.
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13

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1 But only six of those cases were 

2 compensated as a result of the SEC. So, they had 

3 a presumptive cancer and dose reconstruction was 

4 warranted because they had non-presumptive cancers 

5 as well.

6 But from those cases, only four had SEC 

7 Classes added that impacted them subsequent to the 

8 dose reconstruction being completed. And of those 

9 four, two cases were significantly impacted by an 

10 SEC.

11 So, they did result in compensation as 

12 a result of the subsequent SEC. The remaining two 

13 cases, one had a PoC greater than 50 percent for 

14 the SEC Class, so it wouldn't be impacted by the 

15 SEC. And the other was already compensated based 

16 on a different SEC Class.

17 For references, revisions, we looked 

18 at, was a significant method in dose reconstruction 

19 updated since the dose reconstruction was 

20 completed? Would that impact -- or would that 
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14

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1 update have a significant impact on the case? And 

2 did our review identify a need for that procedure 

3 to be updated?

4 And in this case, we found most cases 

5 did have a few. I think 35 cases had a reference 

6 that was updated since it was completed. But only 

7 24 of those had a reference that was updated that 

8 impacted dose.

9 And this is more of a qualitative than 

10 a quantitative analysis. So we didn't go in and 

11 recalculate doses to see the update, if it affected 

12 the PoC in a significant way.

13 But I will say that it was a little bit 

14 complicated with OTIB-54 that's been revised five 

15 times in -- since these cases were complete. So 

16 it's a little difficult to quantify the extent of 

17 a change when there's so many revisions happening 

18 in such a short period of time.

19 And also OTIB-52, which is the 

20 construction trade workers, and that was revised 
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15

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1 to include subcontractors. And so, that wouldn't 

2 have been cited if they had erroneously excluded 

3 subcontractors in the past. So, it's really 

4 difficult to quantify if that particular change 

5 would have impacted cases.

6 And we do have a list of the procedures 

7 that were updated and used in this case set. And 

8 then we also looked at references that were, have 

9 we reviewed the references? And is there ongoing 

10 issues resolution that could impact these 

11 individual cases?

12 And so to do those we broke it up into 

13 two categories. The Site Profile findings and 

14 everything else.

15 And that's just because the Site 

16 Profiles are typically drawn-out processes. And 

17 there are numerous considerations. And it's much 

18 more complicated than some of our procedure 

19 reviews.

20 So were broke that down and looked at 
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16

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1 just Site Profiles. And we also actually pulled 

2 in SEC ER review findings because they are 

3 integrated and related to the TBD methodologies.

4 And in these cases we had 33 facilities 

5 represented of the over 300 facilities that are 

6 covered under EEOICPA. And seven of those 

7 facilities did not have formal Site Profiles.

8 And the remaining 26 facilities that 

9 did have Site Profiles, all but Pacific Northwest 

10 National Labs have been reviewed. And 22 of those 

11 reviews still have open issues.

12 So, 72 percent of cases that were 

13 reviewed in this subset, which is not a random 

14 sampling, did have ongoing issues resolution that 

15 could impact these cases.

16 We also looked at the non-TBD 

17 methodologies. And we had 34 unique NIOSH 

18 guidance documents that were not TBDs that were 

19 used in these, and the vast majority of these have 

20 been reviewed by SC&A. And the vast majority do 
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17

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1 not have open findings that impact these cases.

2 We did identify two that have not been 

3 reviewed: OTIB-70 and OTIB-64. And 64 actually a 

4 subsequent -- or a -- the document that it 

5 supersedes was reviewed and has no open findings.

6 So, it's really one full document has 

7 not been reviewed. And that is site-specific, I 

8 believe.

9 And we also had six procedures that have 

10 open issues that we determined could potentially 

11 impact these cases.

12 MS. BEHLING: Excuse me, Rose. I'm 

13 going to interrupt you for just one second at this 

14 juncture.

15 The other thing that was not reviewed 

16 and we didn't go into a lot of detail in the report, 

17 is the templates. Again, this is the dose 

18 methodology that we have now discovered is embedded 

19 into the Dose Reconstruction Reports.

20 And I believe NIOSH has put together a 
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18

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1 listing of all of the sites that actually have 

2 templates and still think that's something that, 

3 you know, has not been reviewed by SC&A. And 

4 there's a lot of data in those templates.

5 So, it's something we may still want to 

6 -- the Board may want to consider having us look 

7 at. Sorry, Rose.

8 MS. GOGLIOTTI: That's all right. 

9 Thank you, Kathy. That is actually important.

10 And then in the course of doing this 

11 evaluation, we did also draw some broader 

12 conclusions and recommendations, which is outlined 

13 in Section 1.4 of this report. And actually I 

14 think that would be very meaningful to this report.

15 I can go through those if you'd like.

16 CHAIRMAN MELIUS: Yes. Go ahead.

17 MEMBER BEACH: Oh, Jim, can I ask a 

18 question of Kathy?

19 CHAIRMAN MELIUS: Yes, sure.

20 MEMBER BEACH: You said that the 
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19

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1 template, you had a list of the templates from 

2 NIOSH. Did we get those?

3 MS. BEHLING: I was under the 

4 impression that -- Ted, can you correct me here? 

5 I thought that NIOSH had provided a list of the 

6 facilities where there is a template like the Grand 

7 Junction and Westinghouse Nuclear Fuels.

8 And has that list been provided?

9 MR. KATZ: Well, I definitely 

10 distributed it. I'm not sure how widely. Whether 

11 just to the DR Work Group or what have you.

12 But I can go check my records and see.

13 MEMBER BEACH: Okay. Thanks.

14 MS. BEHLING: Okay. I wasn't sure if 

15 it was going to be this Work Group that would make 

16 the decision as to which templates are going to be 

17 reviewed, or if that's a full Board discussion. I 

18 don't know.

19 CHAIRMAN MELIUS: That's a full Board 

20 discussion.
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20

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1 MS. BEHLING: Okay. Rose, I think you

2 can go ahead. Because I think it's important that 

3 we get a, you know, that the recommendations and 

4 the conclusions be discussed.

5 MS. GOGLIOTTI: I completely agree. 

6 Well, our first recommendation, we really strongly 

7 recommend that the Site Profile and SEC Position 

8 Evaluation Report Issues Resolution starts to 

9 become documented on the BRS similar to how the 

10 Procedures Subcommittee documents their findings.

11 This was a monumental task going in and 

12 figuring out which TBD findings are still open and 

13 relevant. Many of these TBDs were done back, some 

14 of them as early as 2005.

15 And they still have open findings. But 

16 tracking down to identify that these findings were 

17 still open was very, very difficult.

18 And we cannot stress enough how much 

19 Subcommittees would benefit from putting their 

20 findings in a centralized location so you don't 
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21

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1 have to dig through mountains of documents to 

2 identify what finding is still open and what is 

3 closed.

4 We also felt that our TBD and SEC 

5 reviews, we need a standardized and consistent 

6 numbering format for these. When we were going 

7 through findings, we noticed a lot of times Work 

8 Groups would renumber their findings midway 

9 through, which is very difficult to track a finding 

10 if the numbers are changing between documents.

11 We also noted that we would like to see 

12 an update to Section 1.3 of our DR Report. And if 

13 you remember back to our DR Report, that's where 

14 we document TBD reviews that were completed, and 

15 if there were findings associated with the TBD 

16 review that could impact the case.

17 And when we first started doing DR 

18 Reviews, that made sense. It was meaningful. We 

19 could look back and see.

20 But since then, things have changed. 
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22

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1 Ten years down the road, it's very difficult for 

2 our reviewers to know which issues are still open, 

3 which are relevant, if any of these issues have been 

4 addressed.

5 So, we stick to TBD reviews. But 

6 things have changed since then. Our DR reviews are 

7 typically not involved in issues resolution 

8 process for a site. So, we don't necessarily have 

9 access to the current status of ongoing issues 

10 resolutions or subsequent reviews that could 

11 actually impact the case.

12 So, we would recommend that either we 

13 need to commit to maintaining an up-to-date list 

14 of unresolved issues for each Work Group, or we need 

15 to move to the BRS with a more standardized system.

16 We also noted that the Procedures 

17 Subcommittee has done a really good job of 

18 capturing all of the references, but we would note 

19 that a lot of the documents that we reviewed were 

20 earlier revisions.
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23

NEAL R. GROSS

COURT REPORTERS AND TRANSCRIBERS

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1 And subsequent review -- or subsequent 

2 documents have been issued, and we think that the 

3 Procedures Subcommittee would benefit from 

4 investigating the changes that happened to these 

5 revisions and identifying when a substantial 

6 enough revision was made that may warrant us 

7 looking at the review again.

8 We also noted that the majority of cases 

9 have unresolved TBD and SEC issues. And based on 

10 that observation, we suggest that the Board should 

11 prioritize resolving open issues, especially at 

12 the larger employment sites.

13 And then I also just wanted to point out 

14 that this document focuses on unresolved issues. 

15 So, findings that are open or unresolved.

16 We did not focus on findings that are 

17 in abeyance. And what that means at least on some 

18 Subcommittees would be that the finding has been 

19 resolved but not implemented and formally closed.

20 So, those findings still have the 
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24

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1 potential to impact cases even though they are 

2 technically resolved in the Subcommittee levels. 

3 And those were our recommendations.

4 Are there any questions?

5 MS. BEHLING: And this is Kathy 

6 Behling. If I could just add one more note. As 

7 you see here, based on our conclusions or 

8 recommendations, is that it would benefit 

9 everyone, I think, if the BRS was being used more 

10 widely among all the Work Groups.

11 I think that this report really lays the 

12 foundation, for if the Work Groups decide to go in 

13 that direction, that we could assist them in 

14 updating the BRS. Because this report and all the 

15 effort that went into it would allow us to help 

16 those Work Groups to populate the BRS.

17 And it would also allow if we did it 

18 along with the Work Groups, and would allow for 

19 consistency and perhaps even consistency in 

20 numbering format.
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25

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COURT REPORTERS AND TRANSCRIBERS

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1 I realize there has been a lot of water 

2 under the bridge. And there's been, I'm sure, some 

3 of the Work Groups are a little bit hesitant to go 

4 in that direction. But if we could just start 

5 today and put in open findings. And in-progress 

6 type findings today and move forward.

7 I think that would be of a great benefit 

8 not only to the Work Group, but to us as auditors 

9 and for posterity, and making sure that we all keep 

10 track of everything that has been done in this 

11 extensive program.

12 CHAIRMAN MELIUS: Any other questions?

13 MEMBER ZIEMER: This is Ziemer. Jim, 

14 I think there's certainly a number of these 

15 recommendations that are beyond just Sets 19 and 

16 21. They're gone and proper finishing.

17 And clearly it's a little more 

18 consideration. I'm wondering if there should be 

19 a, you know, a comprehensive report on this kind 

20 of issue.
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26

NEAL R. GROSS

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1 I don't know if it's Dose 

2 Reconstruction Work Group that should deal with it. 

3 It goes beyond their Work Group. I think it covers 

4 all of them. And that's an overall report to the 

5 Board that's been suggested actually would be 

6 appropriate.

7 CHAIRMAN MELIUS: Paul, I'm actually a 

8 little puzzled by the conclusion and 

9 recommendations. You know, aside from whether or 

10 not they're, you know, helpful or useful or 

11 whatever for the overall Board.

12 They seem to have nothing to do with the 

13 dose reconstruction methods.

14 MEMBER ZIEMER: Yes, it's interesting.

15 CHAIRMAN MELIUS: I mean, I was -- and 

16 I -- you know, I'm actually always puzzled when I'm 

17 doing individual dose reconstruction reviews.

18 I mean, some of these issues seemed to 

19 be, you know, sort of a lack of communication within 

20 SC&A on what's going on in the program, and what 
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27

NEAL R. GROSS

COURT REPORTERS AND TRANSCRIBERS

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1 else.

2 I mean, stuff that can be looked up on 

3 the website in, you know, two or three minutes 

4 doesn't seem to get done. And that now -- yes, I 

5 -- there may be a need for more systemization of 

6 what -- of review process for Site Profiles and so 

7 forth.

8 But I think we're trying to focus on 

9 dose reconstruction review methods, not, you know, 

10 something as broad as this. And I didn't find that 

11 part of the report particularly helpful for us in 

12 terms of our task today.

13 MEMBER ZIEMER: No, in fact, that's why 

14 I'm saying this sounds like it should be something 

15 as a separate report to the Board for those kinds 

16 of recommendations.

17 CHAIRMAN MELIUS: Yes. Yes.

18 MEMBER KOTELCHUCK: I agree.

19 CHAIRMAN MELIUS: Yes.

20 MS. GOGLIOTTI: Well, certainly this 
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28

NEAL R. GROSS

COURT REPORTERS AND TRANSCRIBERS

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1 report looked at how the dose reconstruction work 

2 is impacted by the work that is being done in other 

3 Subcommittees and other Work Groups. So, that's 

4 why we felt this was appropriate.

5 CHAIRMAN MELIUS: Well, that was the 

6 intent of the report was how it was affected. And 

7 to try to sort of benchmark the extent at which 

8 things were in process.

9 But, you know, your conclusions and 

10 recommendations seem to focus all on that document 

11 or technical document review process, not on dose 

12 reconstruction methods and so forth.

13 And, you know, again, I'm not 

14 disputing, you know, particularly your -- the 

15 recommendations or whatever. Or findings. But 

16 that part of it wasn't what we were expecting. 

17 That's all I -- and I think there are, for some of 

18 these issues, there are other approaches that need 

19 to be considered in terms of what we're doing and 

20 so forth.
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29

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1 Any other questions or comments on that 

2 part?

3 (No response.)

4 CHAIRMAN MELIUS: Okay. So, let's go 

5 back to individual case reviews and methodologies. 

6 And I sent a short email out to the Work Group 

7 Members to sort of -- at least my thinking about 

8 how we should approach this and so forth.

9 And at least in terms of different parts 

10 or different considerations for modifying the Work 

11 Group -- the Dose Reconstruction Review process. 

12 And that's not in detail.

13 And I think all these we've discussed 

14 previously. But maybe if we go through them one 

15 at a time, it gives us some organization to this 

16 meeting.

17 So, I think what we have talked about 

18 is, you know, one, you know, continuing the 

19 current, you know, review process. And -- but 

20 with, in order to make it more efficient, do we only 
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30

NEAL R. GROSS

COURT REPORTERS AND TRANSCRIBERS

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1 focus on like the positive findings?

2 And then sort of separately from that, 

3 do we only -- do we change our selection procedures 

4 in terms of how we select cases in some way to make 

5 them, you know, sort of improve that process or --

6 and we have, I think, done that continually in the 

7 Dose Reconstruction Review Committee in terms of 

8 trying to focus on sites that haven't been 

9 evaluated before, or based on Probability of 

10 Causation, or, you know, other issues like that. 

11 But I think the key one is I'd like to 

12 get back to it for some discussion is the issue of, 

13 do we want to modify the process in a way that is 

14 -- that we would provide more focus on just the --

15 sort of the positive findings that SC&A may have 

16 when they review an individual case as it sort of 

17 goes through the resolution process.

18 MEMBER KOTELCHUCK: Jim?

19 CHAIRMAN MELIUS: Yes?

20 MEMBER KOTELCHUCK: I mean, I found the 
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31

NEAL R. GROSS

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1 SC&A proposal -- and I don't have the date on it 

2 -- of suggesting that we go through this by having 

3 more involvement with SC&A and NIOSH ORAU, before 

4 the Subcommittee meeting, and that we get sent a 

5 list of cases, that there seems to be pretty much 

6 agreement. And just check on those at the 

7 Committee before we get to the Committee meeting.

8 And that will allow the Committee to 

9 focus on problems, disagreements. And that seemed 

10 to me to be a very good way of speeding up our 

11 process, and therefore allowing us to review a 

12 greater proportion of cases. I don't know how 

13 great a proportion, how great an increase it would 

14 be because we haven't tried it.

15 But it seemed to me a good starting 

16 point for modifying the process and making it more 

17 useful and making the meetings more useful.

18 MS. BEHLING: This is Kathy Behling. 

19 If I could interject, that was a memo that I sent 

20 out on July 15, 2015. And the subject was approach 
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32

NEAL R. GROSS

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1 to expediting the Dose Reconstruction Project.

2 MEMBER KOTELCHUCK: That's it. Yes. 

3 Right.

4 MS. BEHLING: On July 15, I put 

5 together a memo. And as you're referring to type, 

6 we classified them as Type I type findings that 

7 perhaps will only require minimal discussion. And 

8 then a Type II finding which would be a more 

9 detailed discussion.

10 And we actually in that memo, I used an 

11 example of four different sites. There was a table 

12 in that memo where we looked at the Oak Ridge Site, 

13 the Paducah, Portsmouth and Savannah River Sites.

14 And we tried to put it in perspective, 

15 the number -- the total number of findings. How 

16 many are still open, what we would think might fall 

17 into this Type I and Type II classification.

18 We also included a table that we 

19 actually list the finding. We list the discussion 

20 between us and NIOSH, gave you an understanding of 
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33

NEAL R. GROSS

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1 the ranking and the PoC for that particular 

2 finding.

3 And we were hoping that, before the 

4 meeting we could get this into your hands at least 

5 a week or whatever, you know, how much time you 

6 would need. So that you could go through this.

7 And then at the meeting, for those Type 

8 I findings, perhaps the Board Members can state, 

9 yes, we agree with all these. Or no, we want to 

10 have a further discussion on this particular 

11 finding.

12 And based on these four sites that I 

13 looked at, we estimated about 79 percent of the 

14 findings for those four sites, and 94 percent of 

15 the observations appear that they are not going to 

16 need a very lengthy discussion to close.

17 Obviously, that's your call. But if we 

18 provide you with that summary table before the 

19 meeting, it would be something I think that would 

20 certainly help to expedite getting through --
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34

NEAL R. GROSS

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1 closing hopefully some of these findings.

2 But all of this that I'm discussing is 

3 in a July 15 memo.

4 MEMBER KOTELCHUCK: Right. And that 

5 -- am I on?

6 CHAIRMAN MELIUS: You're on, Dave.

7 MEMBER KOTELCHUCK: Okay. That was a 

8 very useful memo. And I just simply, how much time 

9 we'd save and how many of them would be closed with 

10 minimal discussion, I'm not sure until we try it.

11 But certainly, it seems promising. 

12 And I also -- I've for a long time -- we had a 

13 discussion in the Subcommittee about observations.

14 And a number of us wanted just to not 

15 have any discussion at all. Several Members of the 

16 Subcommittee pointed out that, in fact, 

17 occasionally we change an observation to a finding, 

18 which is important.

19 And that there are more substantive 

20 matters behind the -- what appeared at first to be 
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35

NEAL R. GROSS

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1 an observation. So, this method that you're 

2 suggesting, that SC&A is suggesting, would allow 

3 us also to look at the observations. And, you 

4 know, essentially, I hope heartily discuss any of 

5 them. And you indicated you thought 94 percent of 

6 them would be closed.

7 That seems like a reasonable number, 

8 and that would save time. And even when we talk 

9 -- because when we talk now in the Subcommittee 

10 about the observations, people go through, you 

11 know, a detailed discussion, as is proper.

12 But it just takes time. And we are not 

13 going to -- we are not going -- generally, we're 

14 not going to take a position and just say so noted. 

15 Right? And move on.

16 So, it's a waste of valuable time for 

17 the discussion group, you know, during the 

18 conference -- a waste of time during the conference 

19 call.

20 So this seems to me -- now, we haven't 
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36

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1 had a discussion in the Subcommittee. And Josie, 

2 correct me if I'm wrong. But I don't believe our 

3 Subcommittee has actually discussed this, whether 

4 we want to go ahead on this.

5 MEMBER BEACH: I thought we had a brief 

6 discussion on it. But, yes, I don't believe we've 

7 had anything --

8 MR. KATZ: No. This is Ted. I'm 

9 sorry, I think we felt this was in the purview of 

10 the Methods Group to talk about it.

11 MEMBER KOTELCHUCK: Okay. That 

12 sounds good. Okay. That's -- you're right. I 

13 think you're right.

14 MEMBER ZIEMER: Well, Ted and Jim, this 

15 is Ziemer. According to my notes from our June 22 

16 meeting, we discussed this quite a bit. I thought 

17 we had at least tentatively agreed to this kind of 

18 approach. I'm looking at my notes here and I have 

19 all those things down.

20 MR. KATZ: Paul, I think we did talk 
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37

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1 about it some. I'm quite sure we didn't come to 

2 any resolution on any of these changes -- possible 

3 changes.

4 MEMBER ZIEMER: Right.

5 MEMBER KOTELCHUCK: But you're right. 

6 I mean, this was mentioned. But, I mean, my 

7 feeling at this point is that we should move for 

8 resolution on it.

9 If we have general good feelings about 

10 it, that is that it's a reasonable method -- and 

11 I would just ask that, you know, we approve in 

12 principle, and then let the Subcommittee decide, 

13 you know, some of the details.

14 But the basic approach, I think my 

15 feeling is, I'm ready to say let's try it. You 

16 know, this is not a forever decision, and if we find 

17 after some experience that there are problematic 

18 aspects to it, we can change it.

19 But this time, again, with Board 

20 approval.
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38

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1 MEMBER BEACH: Yes, but I think we need 

2 to send that memo forward to this group if it's 

3 something you're suggesting. Because I don't 

4 think everybody has it.

5 MEMBER KOTELCHUCK: That may be. I 

6 believe you may have come onto a Subcommittee since 

7 -- did you come onto a Subcommittee since the memo 

8 was --

9 MEMBER BEACH: No, I was on a 

10 Subcommittee.

11 MEMBER KOTELCHUCK: I don't remember.

12 MEMBER BEACH: I'm just having trouble 

13 locating it.

14 MEMBER KOTELCHUCK: Okay. I was 

15 having trouble locating it, too. But that's my 

16 problem. And once I have the date here, I have it, 

17 of course.

18 MEMBER BEACH: And it was --

19 MS. GOGLIOTTI: It's a PA-cleared 

20 document, so I can send it along.
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39

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1 MEMBER KOTELCHUCK: Yes. Okay.

2 MEMBER BEACH: Thank you.

3 MS. BEHLING: I will also add -- this 

4 is Kathy Behling. That if you are --

5 CHAIRMAN MELIUS: Kathy, please, this 

6 is a Board Work Group discussion. And --

7 MS. BEHLING: I'm sorry, I was just 

8 going to say --

9 CHAIRMAN MELIUS: We'll ask for your 

10 input when we need it.

11 MS. BEHLING: Okay. I'm sorry. I was 

12 going to say SC&A could reference --

13 CHAIRMAN MELIUS: Thank you, Kathy. 

14 Please, we know that.

15 MEMBER KOTELCHUCK: Well, anyway, I 

16 would say let's go ahead -- from my own I would say, 

17 and as Chair of that Subcommittee, I would say let's 

18 adopt it. Let's formally agree to do so.

19 And then that would be, if you will, 

20 part of our report to the Secretary. In the 
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should be cautioned that this transcript is for information only and is subject to change.

40

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COURT REPORTERS AND TRANSCRIBERS

1323 RHODE ISLAND AVE., N.W.

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1 section called -- after results, called future 

2 activities.

3 CHAIRMAN MELIUS: Well, I have some 

4 concerns about that.

5 MEMBER KOTELCHUCK: Okay.

6 CHAIRMAN MELIUS: And the concern is 

7 that the Board is charged with doing Dose 

8 Reconstruction Reviews, you know, not our 

9 contractor. And we're essentially turning over 

10 that function to our contractor if we're not 

11 reviewing the findings.

12 MEMBER KOTELCHUCK: Well, but we are 

13 reviewing the findings in that it's supposed to be 

14 sent to the Board a week before, and we are supposed 

15 to go through it.

16 Now, it's our responsibility as a 

17 Subcommittee to actually read through what they 

18 say. Now, if they just send things out and we do 

19 not examine it ourselves, then we are giving up our 

20 responsibility and our required responsibility.
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41

NEAL R. GROSS

COURT REPORTERS AND TRANSCRIBERS

1323 RHODE ISLAND AVE., N.W.

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1 But my figure is that our people are 

2 disciplined enough that the Subcommittee people 

3 will read through carefully, and we can certainly 

4 check that at the meetings that we have to make sure 

5 everybody's really read it through carefully.

6 CHAIRMAN MELIUS: And give them a quiz, 

7 Dave?

8 MEMBER KOTELCHUCK: Well, no. But I 

9 think --

10 CHAIRMAN MELIUS: You and Paul can take 

11 turns writing. You've had students for many 

12 years.

13 MEMBER KOTELCHUCK: Right.

14 CHAIRMAN MELIUS: You can write out 

15 the quiz. But I guess I'm having a little bit of 

16 trouble figuring out why having a memo is -- when 

17 you're in the Board -- in a Subcommittee meeting, 

18 you're telling me that people don't have the 

19 discipline to go quickly through a -- what's called 

20 a minor finding.
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42

NEAL R. GROSS

COURT REPORTERS AND TRANSCRIBERS

1323 RHODE ISLAND AVE., N.W.

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1 MEMBER KOTELCHUCK: Well --

2 CHAIRMAN MELIUS: Well, let me finish, 

3 Dave, please.

4 MEMBER KOTELCHUCK: Sure.

5 CHAIRMAN MELIUS: But you're saying that 

6 if we shorten that in a memo and give them less 

7 information, you know, maybe they'll not feel the 

8 need to ask questions or talk about it.

9 And it seems sort of counterintuitive 

10 that that would happen. It seems to me that we're, 

11 you know, as I said, delegating our 

12 responsibilities to our contractor.

13 And without giving due diligence to 

14 what that responsibility is, which is to review 

15 and, you know, identify problems with the dose 

16 reconstruction, the individual dose 

17 reconstructions.

18 MEMBER KOTELCHUCK: Well, I certainly 

19 was concerned about that when I saw the memo, and 

20 thinking about it. But as we go through our 
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43

NEAL R. GROSS

COURT REPORTERS AND TRANSCRIBERS

1323 RHODE ISLAND AVE., N.W.

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1 Subcommittee meetings, the minute we review a case, 

2 people go through like ten or a dozen or so 

3 different, you know, the internal dose, the 

4 external dose, how we got it, how we calculated it.

5 And in many cases that is -- that's not 

6 an issue and say, okay, I mean, you know, 10 out 

7 of the 12 points that they go through are not points 

8 in which there is disagreement.

9 And at some deeper level though, we do 

10 give responsibility to the staff, the SC&A and 

11 NIOSH. We review, but we really don't as 

12 individual Board Members, we don't go through a 

13 calculation. Right?

14 And so we are giving them major 

15 responsibility and we're overseeing them. So, I 

16 would say if the oversight -- if the time spent in 

17 the Committee meeting doesn't produce any useful 

18 -- puts a lot of words and time down and doesn't 

19 present much useful material, then I just feel as 

20 if -- I'm willing to give a certain amount of 
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44

NEAL R. GROSS

COURT REPORTERS AND TRANSCRIBERS

1323 RHODE ISLAND AVE., N.W.

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1 greater responsibility to the two staffs.

2 Again, with the obligation that we go 

3 over it carefully on the Board. And no, I can't 

4 tell you -- I'm not going to give them a quiz 

5 obviously.

6 But I think the Board Members, knowing 

7 that they are giving up some degree of oversight, 

8 will certainly be careful. And I think will be 

9 honest enough and open enough to say, well, you 

10 know, I haven't reviewed this. I'm not, you know, 

11 I'm going to listen or something like that.

12 Because, obviously, if they haven't 

13 read and gone over the material, then it's not --

14 their input is not -- the oversight that we should 

15 have is not there.

16 But I just find a lot of time is spent 

17 at the meetings on repetitive items where there's 

18 no disagreement because one goes through 

19 everything. Maybe we should.

20 CHAIRMAN MELIUS: Okay.
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45

NEAL R. GROSS

COURT REPORTERS AND TRANSCRIBERS

1323 RHODE ISLAND AVE., N.W.

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1 MEMBER ZIEMER: Could I make some 

2 additional observations?

3 CHAIRMAN MELIUS: Yes, please.

4 MEMBER ZIEMER: This is Ziemer. Well, 

5 one thing is that we need to remember there's a 

6 couple of parts to this.

7 One is, a priori, before SC&A is ever 

8 involved, the Board is involved in -- and the 

9 Subcommittee -- involved in selection of cases. 

10 And I think, Jim, part of what you're asking is, 

11 should we modify that selection process in terms 

12 of either proportion of cases or what other 

13 criteria we may wish to include going forward? That 

14 this also includes whether we should increase 

15 numbers of blind reviews and that means we need to 

16 evaluate the value of the blind reviews. Are they 

17 giving us more information than the other ones that 

18 are -- that's important?

19 So, there's a lot of issues. I think 

20 that we have to, in terms of this review process, 
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46

NEAL R. GROSS

COURT REPORTERS AND TRANSCRIBERS

1323 RHODE ISLAND AVE., N.W.

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1 just in case selection, clearly we're depending on 

2 the contractor to go through what I'll call the 

3 mechanics of dose reconstruction. Because a lot 

4 of it is sort of mechanical in the sense of the 

5 procedures are there. And they're going through 

6 and sort of checking against those procedures. 

7 And then preparing a report.

8 But we have an important consideration 

9 in the selection of what they do. And then it seems 

10 to me we need to be focusing a lot on consistency 

11 issues.

12 And we may need to give instructions to 

13 our contractor as to what we want to look at in terms 

14 of consistency. You know, are people in the same 

15 category, are the cases being handled in a 

16 consistent manner, that sort of thing.

17 The issue of what we do with the 

18 observations and so on, I think the Subcommittee, 

19 the Dose Reconstruction Subcommittee, as you 

20 suggest, they can come up with those very easily. 
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47

NEAL R. GROSS

COURT REPORTERS AND TRANSCRIBERS

1323 RHODE ISLAND AVE., N.W.

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1 And they can make that determination of what things 

2 they can go through quickly or not.

3 But certainly a lot of our 

4 responsibility starts at the front end in the 

5 selection of the cases.

6 CHAIRMAN MELIUS: No, I mean, I agree. 

7 And this part of the process, which is what's called 

8 the traditional or the old process has been -- I 

9 think it's question of, is there a way of making 

10 the resolution more efficient?

11 MEMBER ZIEMER: Yes.

12 CHAIRMAN MELIUS: But in some sense we 

13 have a check on SC&A because what gets flagged is 

14 when, you know, their calculation differs from 

15 NIOSH slash ORAU's calculation. You know on a --

16 in that.

17 And usually at least my experience has 

18 been that they're very diligent at tracking down 

19 when there is a, you know, inconsistent finding. 

20 Now, I mean, what we always worry about is that 
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48

NEAL R. GROSS

COURT REPORTERS AND TRANSCRIBERS

1323 RHODE ISLAND AVE., N.W.

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1 they, you know, both NIOSH slash ORAU and SC&A get 

2 it wrong. But, usually, that's not going to be in 

3 the calculation per se but in some of the 

4 assumptions that go into the calculation, I would 

5 think and do that.

6 MEMBER ZIEMER: Right.

7 CHAIRMAN MELIUS: And usually that's 

8 -- when there is a discrepancy, that's what's that. 

9 It's sort of -- it's an error. Sort of not an error 

10 but a difference in interpretation on period.

11 And then some just, you know, simple 

12 mistakes that are probably not very -- they're 

13 usually not very important in the larger scope of 

14 the dose reconstruction that's being done.

15 Where somebody, you know, puts down the 

16 wrong month or includes an extra month or leaves 

17 off a month or that kind of thing. And based on, 

18 you know, just transcribing from the work records 

19 or there's a discrepancy in that.

20 But it would seem to me rather than 
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49

NEAL R. GROSS

COURT REPORTERS AND TRANSCRIBERS

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1 having a two-resolution process, so to speak, one, 

2 you know, without the Board involved, just SC&A and 

3 NIOSH; that we have, you know, we have one process.

4 And it's a question of how you manage 

5 that. Now, you know, a separate question is 

6 whether we want a way of sort of combining these, 

7 is that we, you know, have a process where we would 

8 only focus on positive findings, and we totally, 

9 you know -- or on major findings somehow defined. 

10 I think that would be, you know, a reasonable 

11 possibility.

12 But I still think you have to sort of 

13 mix that with sort of a complete review of the dose 

14 reconstruction process. Because, you know, there 

15 are, you know, people that have a very high 

16 Probability of Causation under 50 where, you know, 

17 a small change can make a difference. Not 

18 commonly. But, you know, it does occur. And I 

19 think we have some obligation to make sure that the 

20 overall process is going satisfactorily.
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50

NEAL R. GROSS

COURT REPORTERS AND TRANSCRIBERS

1323 RHODE ISLAND AVE., N.W.

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1 I don't remember the details of the SC&A 

2 proposal. So, I may be mischaracterizing it. But 

3 I guess I just feel more comfortable at this point 

4 of, you know, modifying the Committee, 

5 Subcommittee process.

6 MEMBER KOTELCHUCK: Mm-hmm. I mean, I 

7 just feel as if we spend a lot of time needlessly 

8 on things where there's no disagreement.

9 Now, possibly it's a question of myself

10 as Chair, simply ruling those same, let's not talk 

11 about those. Let's go to the major findings.

12 I mean, but once we review a case, 

13 typically we go over a number of -- most items in 

14 the calculation. We've always done that. And 

15 maybe we shouldn't. But I don't see, Jim, in what 

16 you're saying, I don't see what would be changed. 

17 And I am interested in changing and speeding up the 

18 process.

19 CHAIRMAN MELIUS: I think what -- and 

20 again, I don't fault you for your running the 
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51

NEAL R. GROSS

COURT REPORTERS AND TRANSCRIBERS

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1 meeting. Because I don't think it was different 

2 than Mark. And you're our two Chairs.

3 MEMBER KOTELCHUCK: Right.

4 CHAIRMAN MELIUS: Paul's, I think, 

5 been on the Subcommittee since the beginning. You 

6 can comment.

7 And I'm not, you know, I understand that 

8 people in a Work Group or a call or a meeting, 

9 whatever, like to talk and spend time. But it 

10 seems -- and when we do the individual Board Member 

11 reviews prior to the Subcommittee, we go through 

12 it finding by finding.

13 And that's been, you know, done. I 

14 mean, we all when we're reviewing it, you know, the 

15 paperwork ahead of time we focus on positive 

16 findings and observations. Because that's most 

17 likely what's going to change.

18 But there is a process of at least the 

19 ones I do, where we go through them one at a time. 

20 But I think that we have a -- I think if, you know, 
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52

NEAL R. GROSS

COURT REPORTERS AND TRANSCRIBERS

1323 RHODE ISLAND AVE., N.W.

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1 the Subcommittee reaches an understanding that, 

2 you know, we're going to, you know, start with a 

3 positive finding so to speak, or a higher priority 

4 findings.

5 And then, you know, go through and when 

6 you get to the, you know, the lower priority, the 

7 negative findings, whatever you want to call them 

8 that you sort of group them. And does anybody have 

9 questions on them or concerns they want to raise.

10 MEMBER KOTELCHUCK: Yes.

11 CHAIRMAN MELIUS: So, to me that would 

12 be, you know, possibly more efficient, you know. 

13 I don't want to be overly optimistic because, you 

14 know.

15 MEMBER KOTELCHUCK: I will admit, and 

16 first by the way, I don't -- whatever we talk about, 

17 how the Subcommittee should go, I'm more than open 

18 to suggestions. Including suggestions that I 

19 change, modify things.

20 I am not at all feeling personally 
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53

NEAL R. GROSS

COURT REPORTERS AND TRANSCRIBERS

1323 RHODE ISLAND AVE., N.W.

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1 threatened by suggestions by the Board of how we 

2 ought to function. Far from it.

3 But one of the things that has 

4 influenced me, and maybe overly so, and maybe 

5 inappropriately so. Is that we had originally 

6 said in our first Secretary's report that we were 

7 going to go over 2.5 percent of cases.

8 When I took over, we had a terrible 

9 backlog. We still do. We have a backlog. But 

10 we've been making progress on that.

11 And so I've always -- we did not even 

12 make -- we have not even reviewed SEC in the graphs 

13 that we have. We did not even review one percent 

14 of cases.

15 We have 0.86 percent of cases. So, 

16 there has been the feeling. I certainly have the 

17 feeling, and maybe have been overly influenced by 

18 that of feeling that we should be moving toward one 

19 percent and beyond.

20 If in fact, we are comfortable with one 
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54

NEAL R. GROSS

COURT REPORTERS AND TRANSCRIBERS

1323 RHODE ISLAND AVE., N.W.

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1 percent and we -- then I'm not unhappy with our 

2 current process, personally not unhappy just as a 

3 Board Member and as the Chair.

4 But if we can speed it up or do things 

5 differently, obviously I'm more than open.

6 MEMBER ZIEMER: This is Ziemer. I 

7 have a comment on that if I may.

8 MEMBER KOTELCHUCK: Please.

9 CHAIRMAN MELIUS: Go ahead.

10 MEMBER ZIEMER: It seems to me that we 

11 may be at a point, and Jim, I don't know if it's 

12 this Review Committee that should do it or what.

13 But I think we have to ask ourselves a 

14 question on that. And that is the following. The 

15 original two and a half percent in a sense was 

16 somewhat arbitrary. I don't think we knew how much 

17 effort would be required to reach that. Whether 

18 that was enough. Whether it was too much.

19 We have a number of years of experience 

20 now. And we have results. I think we have to ask 
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55

NEAL R. GROSS

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1323 RHODE ISLAND AVE., N.W.

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1 ourselves the question, is the two and a half 

2 percent necessary? Is it enough? Is it 

3 reasonable? Or is one percent enough?

4 I mean, we're actually under one 

5 percent I think. And to reach two and a half 

6 percent, I think you're talking about substantial 

7 effort. I'm not saying that shouldn't be put in.

8 But we have to ask ourselves the 

9 question as to whether or not that additional 

10 amount of review is needed. And if so, how we're 

11 going to achieve it.

12 Or, are we getting enough information 

13 from the present rate of review to assess the 

14 quality of dose reconstruction? Because we've --

15 the Board may want to say okay, we're willing to 

16 go with a different number.

17 CHAIRMAN MELIUS: And I think the one 

18 is I think we are reassessing the two and a half 

19 percent. I think the question is not just this 

20 part of the process, but is our overall dose 
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56

NEAL R. GROSS

COURT REPORTERS AND TRANSCRIBERS

1323 RHODE ISLAND AVE., N.W.

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1 reconstruction review approach sufficient?

2 And is it addressing, you know, the 

3 potential for major problems. And you know --

4 MEMBER ZIEMER: Yes, exactly.

5 CHAIRMAN MELIUS: Is it capturing 

6 consistency? Is it capturing all the changes that 

7 constantly go on within, you know, in terms of 

8 procedures and methods and data being available and 

9 so forth?

10 And it is complicated to do that. But 

11 I think we need to -- what I'm trying to say is, 

12 we step back. We look at different options we have 

13 and different ways we might want to do things and 

14 approach that.

15 But the overall package, you know, we 

16 want to be as good as it can be within our available 

17 resources. Now, if we think that, you know, five 

18 percent or, whatever is necessary, then you know, 

19 when we pick up Grady off the floor because, you 

20 know, it increases his workload a great deal and 
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57

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COURT REPORTERS AND TRANSCRIBERS

1323 RHODE ISLAND AVE., N.W.

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1 NIOSH resources.

2 But, you know, again, we need to I think 

3 say that to the Secretary.

4 MEMBER ZIEMER: Exactly.

5 CHAIRMAN MELIUS: I mean, that we need 

6 more resources, or we could, you know -- now, I'm 

7 not thinking we're at the point where we 

8 necessarily need more resources for doing this.

9 But I think we have to, you know, be able 

10 to defend what we've done so far. And I think, I'm 

11 trying to make this as sort of a critical look at 

12 what we've done so far.

13 And how we could improve it. Make it 

14 more efficient. And really address one of our key 

15 functions.

16 And I'm not sure. It's just the 

17 current approach takes up a lot of resources. Both 

18 Board time, and contractor time and NIOSH time and 

19 for money that's associated with that.

20 And so is there a better way, a more 
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58

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1323 RHODE ISLAND AVE., N.W.

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1 efficient way of doing that? And I think yes, 

2 again, we've identified one, maybe we're spending 

3 too much time and resources trying to resolve, you 

4 know, or discussing and reviewing, you know, 

5 negative findings or minor findings.

6 And I think that's legitimate to look 

7 at. But at the same time, it is a Board 

8 responsibility. More than, you know, making an 

9 SEC recommendation is a Board responsibility. 

10 It's not a contractor responsibility. Or it's not 

11 something we, you know, let NIOSH do.

12 MEMBER ZIEMER: Right.

13 CHAIRMAN MELIUS: Yes. So, do that. 

14 So, but maybe we, you know, move on at this point. 

15 And let's start and talk about some of the other 

16 potential parts of doing this.

17 For example, the blind reviews. And 

18 I'd be curious what people's, other people's 

19 assessment of the utility of those.

20 MEMBER KOTELCHUCK: I'd like to hear 
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1 from -- I'm not sure the Board Members are really 

2 up to date on our -- where we are on the blind 

3 reviews, since we've been doing a lot more 

4 recently.

5 You know, we have 14 blind reviews done 

6 now. I think that's correct, then. So, I would 

7 be -- I'm not sure, Paul, for example, whether you 

8 as a Board Member have -- we presented information 

9 to you about the blind reviews, or enough 

10 information. We certainly talked about them in 

11 Subcommittee.

12 MEMBER ZIEMER: Well, for me, I think 

13 what I would be looking for would be a 

14 recommendation from the Subcommittee to the Board 

15 as to the value of the blind reviews. Whether or 

16 not more are needed and so on.

17 I mean, you guys are looking at them in 

18 detail.

19 MEMBER KOTELCHUCK: Right.

20 MEMBER ZIEMER: I mean, the Board kind 
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1 of sees it summary-wise. But we need -- those who 

2 are working closely with it, we need, I think, a 

3 recommendation from you as to whether we should 

4 emphasize those more? Do more?

5 Where does the Subcommittee stand on 

6 the usefulness of the blind reviews? Where do 

7 others?

8 MEMBER KOTELCHUCK: Well, should I 

9 respond, Jim?

10 CHAIRMAN MELIUS: Yes.

11 MEMBER KOTELCHUCK: I mean, what has 

12 happened is, we've had long and intense discussions 

13 on a number of these blind reviews. Where at first 

14 there seems to be a disagreement.

15 And then in the discussion it turns out 

16 that there are questions -- often the questions are 

17 not the mechanics of calculating internal dose, 

18 external dose, et cetera. The issues are what 

19 radioactive materials are there?

20 Is it possible that there was depleted 
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61

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1 uranium being used? And if so, that would, you 

2 know, there could be certain assumptions and 

3 conclusions from that.

4 After we've had the discussions, what 

5 we've found -- what I've -- let me say my 

6 observation. Let me not speak for the Board and 

7 of course Josie is on the line too and should please 

8 come in.

9 My feelings on those is that oftentimes 

10 it's that the folks in SC&A aren't there working 

11 as intimately with the data. And the people, 

12 interviewing people who are at the site.

13 And so oftentimes the NIOSH folks will 

14 give us, if you will, a reality dose. And say no, 

15 no, no, they don't have that.

16 Or, while it may be possible that 

17 something like this happened, it happened and this 

18 is why. And so, we've resolved well all but three 

19 of them.

20 And those three are -- we're working on
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1 right now. There was, if you will, Subcommittee 

2 resolution that there was potential agreement. 

3 And that they're recalculating the PoCs.

4 So, we're finding quite good agreement 

5 where the assumptions are the same. There are 

6 times where quite properly SC&A is saying is it 

7 possible that this was being used?

8 Or that this radioactive material had 

9 entered the site briefly and may be around? And 

10 again, I don't know that I'm properly 

11 characterizing SC&A's position on this.

12 But my impression is that we are -- that 

13 the calculations themselves, which are very 

14 important. And I'm extraordinarily happy that 

15 we're doing these. We might want to do more even.

16 But that there's agreement at this 

17 stage between people. But only after discussion. 

18 And discussion about what's going on in the field 

19 if you will. Not with the calculations.

20 Maybe that's the way to characterize 
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1 it.

2 CHAIRMAN MELIUS: This is Jim. I 

3 would just add to that. I think it's also, at 

4 least, and I've read I think most all of the reports 

5 now. Maybe not some of them.

6 But the ones where there was a 

7 discrepancy, a significant discrepancy, there was 

8 -- I don't know how to characterize this. But I 

9 would say a methodology that was being used by ORAU 

10 that wasn't, you know, that SC&A was not aware of.

11 Or some assumptions that SC&A was not 

12 aware of --

13 MEMBER KOTELCHUCK: Yes.

14 CHAIRMAN MELIUS: About the site. And 

15 I think -- and again, that can be resolved. And 

16 my understanding is that the situations, it was 

17 resolved.

18 I think that the importance of these 

19 blind reviews are twofold. One is sort of what 

20 Dave was talking about, at least as I understood 
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64

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1 it, was that how do you interpret what exposures 

2 a person had at a site?

3 And what needs to be evaluated and so 

4 forth? And again, that may point to some of the 

5 problems with the, you know, Site Profiles or 

6 whatever.

7 Or, it may point to other documentation 

8 that's not included with the Site Profiles. So, 

9 it's not transparent to the Board or to SC&A.

10 And then, secondly, are some of these, 

11 you know, calculation procedures that I think are 

12 important for the Board, obviously SC&A to know 

13 about as they're evaluating dose reconstruction. 

14 But also for the Board to, you know, be aware of 

15 in terms of how we oversee and review the dose 

16 reconstruction process.

17 And again, I think I've said this 

18 before. It's not that I think it's, you know, 

19 these are not sort of deliberately hidden, secret 

20 methodologies or whatever. It's just, you know, 
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1 dose reconstruction's a complicated process.

2 And these are complicated sites. So, 

3 I don't think it's -- you know, I don't think we 

4 expect everything to be included in, you know, some 

5 sort of technical document or procedure that's, you 

6 know, widely available or whatever available to the 

7 Board, you know, on the website or whatever.

8 But I thought those were there was a 

9 discrepancy found, I thought that was very useful 

10 for understanding how things are being done. And 

11 I think we've always had this issue of, you know, 

12 how do we interpret the facts about a site? And 

13 what people did and so forth.

14 How many we need to do or continue to 

15 do, I don't know. But I think they're -- that they 

16 do have some value in terms of overseeing the 

17 process.

18 MEMBER KOTELCHUCK: Oh, I think --

19 CHAIRMAN MELIUS: But if the process 

20 isn't transparent and reproducible, then there's 
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66

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1 some problem with it. And if it can't be done 

2 consistently, I think there's a problem with that.

3 I don't know if we've really evaluated 

4 the consistency issue. But certainly the 

5 transparency is, you know, not necessarily there.

6 Again, it doesn't mean that dose 

7 reconstruction is being done wrong. It just 

8 limits our ability to oversee it.

9 MEMBER KOTELCHUCK: I --

10 MEMBER BEACH: This is Josie. Dave, 

11 sorry.

12 MEMBER KOTELCHUCK: Go ahead.

13 MEMBER BEACH: I agree with both of the 

14 -- what you've discussed. I think it's a really 

15 -- blind reviews are important for the reasons that 

16 you both discussed.

17 I don't think they need to be, 

18 definitely not decreased. I'm not sure how many 

19 exactly we're doing at this time number wise.

20 MR. KATZ: Josie, it's Ted. We do a 
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1 half a dozen a year now. Which was ramped up from 

2 what it was under the old contract.

3 MEMBER BEACH: Okay. Yes.

4 CHAIRMAN MELIUS: I think one thing we 

5 should do before we maybe change that number or 

6 whatever would be to have, this is more work for 

7 Dave, but have the Subcommittee do a presentation 

8 to the Board about their findings.

9 You know, because I don't think the 

10 larger Board Members are aware of it.

11 MEMBER KOTELCHUCK: Yes.

12 CHAIRMAN MELIUS: I think that might be 

13 feasible to do that at one of our Board calls. 

14 Rather than waiting, you know, four or five months 

15 to do it.

16 But, you know, we should think about 

17 that.

18 MEMBER KOTELCHUCK: I would be more 

19 than open. I think the blind reviews are really 

20 of great value. They certainly, for me, give me 
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68

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1 an enormous amount of confidence in the consistency 

2 of our methods.

3 CHAIRMAN MELIUS: Yes.

4 MEMBER KOTELCHUCK: And I was planning 

5 to have the Board have a discussion of what 

6 constitutes agreements and disagreements. 

7 Because clearly the numbers didn't come in, the 

8 PoCs didn't come in the same.

9 But after discussion we realized that 

10 there were different assumptions. And when the 

11 assumptions were the same, the results were pretty 

12 much the same. And that --

13 MEMBER ZIEMER: Could I ask a question?

14 MEMBER KOTELCHUCK: Sure.

15 MEMBER ZIEMER: Yes. This is for 

16 Dave.

17 MEMBER KOTELCHUCK: Yes?

18 MEMBER ZIEMER: Dave, I don't know if 

19 you have this information, but have you noticed any 

20 difference between blind reviews of older cases 
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69

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1 versus newer ones?

2 I was going through that ORAU document 

3 on their Quality Assurance Program. And it's 

4 clear internally at ORAU that their error rate has 

5 gone down quite a little bit over recent years.

6 And many of their earlier errors were 

7 based on assumption differences within dose 

8 reconstructors for even given sites. And they 

9 seem to have achieved a better method of assuring 

10 that dose reconstructors who were doing similar or 

11 cases from same sites were using similar or the same 

12 assumptions.

13 And the implication is that newer dose 

14 reconstructions have a much lower rate of error on 

15 the assumptions themselves. And I wonder if that 

16 shows up for us in our blind reviews as well? Our 

17 newer cases are showing a different level of error, 

18 or perceived error, than older cases. And maybe 

19 we don't know that at this point.

20 MEMBER KOTELCHUCK: Remember, we only 
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1 did -- before we did sets, was it 6 through 13, we 

2 only did two blind reviews. So, there's not enough 

3 data -- there's not enough data.

4 MEMBER ZIEMER: There's not enough 

5 data. Okay. Thank you.

6 MEMBER KOTELCHUCK: But, however, you 

7 know, looking at the sets that -- even 6 through 

8 13, I mean, as you suggested, I do see the later 

9 ones that were done. There was a group that was 

10 done for set 17, I believe. The set 17 reviews 

11 seemed to come in quite a bit better than the first 

12 set of six. Which were in the 6 through 13.

13 I must say, I did not look at it 

14 carefully in response to the kind of question that 

15 you asked. But I will.

16 And as you mentioned, it comes to mind 

17 that things are -- we're having fewer disagreements 

18 as we go along to later sets. Which is good.

19 But there's no -- again, as for the 

20 percent of cases reviewed, there's nothing magic 
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1 about how many we need to do. It's not that we're 

2 going to be able to say that.

3 It's not a statistical question, that 

4 if you do this many, then this is your confidence 

5 interval. I think it's just a matter of saying 

6 that we have to keep monitoring on a regular basis.

7 But I certainly agree that we can say 

8 to the Secretary that we have increased the number 

9 of blind cases reviewed since the first report. 

10 And that those results are very important in 

11 assuring that we have consistency in this -- in the 

12 larger process.

13 MEMBER ZIEMER: But there are sites, 

14 you know, that don't have formal worksheets and 

15 approaches. And maybe more emphasis on those for 

16 the blind reviews would be called for.

17 MEMBER KOTELCHUCK: Yes.

18 MEMBER ZIEMER: Just thinking about 

19 the fact that a lot of sites, the assumptions are 

20 pretty well spelled out.
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1 MEMBER KOTELCHUCK: And that really 

2 moves to item three I think, does it not? On to--

3 CHAIRMAN MELIUS: Well, let's stay on 

4 this just a second. I was going to make that 

5 comment.

6 But I also think it's, you know, we've 

7 done a very limited number of blind reviews. And 

8 it gives lots more sites than blind reviews.

9 And, again, I think I concur with Paul's 

10 suggestion that, yes, and that not only do we sort 

11 of need to think about how we target those in terms 

12 of sites. But also, you know, more specifically, 

13 where there may be sort of less documentation to 

14 rely on. And therefore, the findings from the 

15 blind review may be more helpful.

16 MEMBER KOTELCHUCK: Right. We speak 

17 to selection because we select only from the sets 

18 that we choose, which have PoCs between 45 and 52 

19 percent.

20 CHAIRMAN MELIUS: Yes.
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1 MEMBER KOTELCHUCK: Right? And many 

2 of the others are done on a best estimate -- on a, 

3 excuse me, maximum/minimum basis.

4 CHAIRMAN MELIUS: Right.

5 MEMBER KOTELCHUCK: And certainly we 

6 don't blind review those at all. And that seems 

7 to me well-taken and should be done. We should 

8 modify the selection of blind review cases. We 

9 should.

10 CHAIRMAN MELIUS: So, let's move on to 

11 the -- sort of the number three, which was sort of 

12 the consistency, judgment. I guess, it really 

13 comes back to what you were talking about, also what 

14 are the assumptions that are made by the dose 

15 reconstructor in doing the dose reconstruction and 

16 so forth.

17 And one thing I was just thinking, when 

18 we're talking about the assumptions now of when we 

19 -- when SC&A and ORAU discuss the -- and NIOSH 

20 discuss the assumptions involved, they reach 
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1 agreement.

2 But, you know, it's sort of, well, is 

3 that the right agreement? But overall I do think 

4 because there is by nature a lot of judgment 

5 involved in doing these and not all that judgment 

6 can be easily or is necessarily worthwhile to 

7 document.

8 I mean, these are complicated sites. 

9 And their dose reconstructions are difficult to do. 

10 And, you know, there's limited information. 

11 Placing people within these sites and what kind of 

12 work, et cetera that they might have done.

13 And, you know, all the other 

14 complications, we deal with at these sites. But 

15 it would seem to me that one important thing that 

16 we haven't looked at is our -- how are these 

17 assumptions, methodologies that may require more 

18 judgment on the part of the dose reconstructor, how 

19 consistent are they being done?

20 And you know, the QA/QC data from ORAU, 
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1 you know, it's gotten better. Which is good. But 

2 I think we -- it doesn't mean that we don't need 

3 to look at this. And their QA/QC data may not 

4 capture, you know, all of the issues. And all the 

5 consistency that we might want to do.

6 And so we need to evaluate that I think. 

7 And I think we've not really been in position or 

8 been able to do that up too now.

9 And I think that the -- how we target 

10 that I think is we need to sort of think through 

11 and develop, you know. One way of targeting it is, 

12 well, we have a finding where, you know, a 

13 significant finding in a dose reconstruction 

14 review which would indicate something was done, you 

15 know, done wrong.

16 We agree with SC&A's evaluation and so 

17 forth. Well, you know, how often is that done 

18 wrong? And what is the basis for that error so to 

19 speak?

20 You know, is it a question of judgment? 
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1 Is it a question of the underlying documentation 

2 that doesn't, you know, capture maybe what we think 

3 is the appropriate methodology or the appropriate 

4 exposure evaluation that needs to be done for --

5 at a particular site and so forth.

6 So, to me that's one selection. The 

7 other is sort of the basic, you know, methodology. 

8 And Grady, I don't know if you're still on the line. 

9 Are you?

10 MR. CALHOUN: Yes. I'm on the line. 

11 Can you hear me?

12 CHAIRMAN MELIUS: Yes. This isn't a 

13 quiz or attendance thing. But my question is, what 

14 -- we have the listing of sort of where there's 

15 documentation for doing, you know, so Site Profiles 

16 where there isn't that's being done and so forth.

17 But is there any sort of master mapping 

18 that ORAU may have or NIOSH may have for say dose 

19 reconstruction at a specific site? What 

20 methodologies are used that add up, you know, for 
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1 doing dose reconstruction at Savannah River or even 

2 a more simple site?

3 Is there sort of a single document that 

4 would sort of list all of the things that a dose 

5 reconstructor would, you know, do? All the 

6 documentation, all the procedures that would be 

7 followed?

8 MR. CALHOUN: For Savannah River, just 

9 to use Savannah River Site as an example.

10 CHAIRMAN MELIUS: Yes, yes.

11 MR. CALHOUN: You know, the starting 

12 point is obviously going to be the Technical Basis 

13 Document. The internal/external X-ray, 

14 environmental section to that.

15 And then the requirements of those 

16 documents are contained within worksheets, which 

17 really help the dose reconstructors not have to 

18 make as many decisions.

19 CHAIRMAN MELIUS: Right.

20 MR. CALHOUN: And those are the 
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1 worksheets that I believe that the DR Subcommittee 

2 folks have finally gotten access to a lot of those 

3 workbooks to them. And that's the main way.

4 Now, there's the other side to that. 

5 You know, just going off the top of my head. Just 

6 one of the sites that doesn't have a Technical Basis 

7 Document.

8 We have guidance written down, they're 

9 not approved documents. But our people are 

10 supposed to write the dose reconstruction in a 

11 detailed enough way that you can tell exactly what 

12 we did.

13 So, I would say that the key really is 

14 getting the information from the Technical Basis 

15 Documents to those workbooks. And those have 

16 evolved.

17 And, you know, through the discussions 

18 that we have during the DR Subcommittee and 

19 evaluating cases, the questions are asked pretty 

20 often like well, what have you done to prevent 
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1 there? Because as you said, a lot of these cases 

2 were done a long time ago.

3 CHAIRMAN MELIUS: Right.

4 MR. CALHOUN: So, I don't know if Scott 

5 or Ed has anything additional to add to that on the 

6 workbooks.

7 Evidently not.

8 CHAIRMAN MELIUS: Okay. Or they can't 

9 find the mute button.

10 MR. MAHER: Hold on, guys, it's the 

11 mute issue here.

12 MR. CALHOUN: Right.

13 MR. MAHER: I would also say that you 

14 need to use the basis for it. The tools, make sure 

15 that whatever can be done consistently is done 

16 consistently. And there's no transcription 

17 errors and all that.

18 CHAIRMAN MELIUS: Yes.

19 MR. MAHER: But I also want to point out 

20 that there are lots of interface between the BR, 
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1 who purely deals, who's an independent to do 

2 review. And if they disagree on the 

3 interpretation of a TBD, which has happened at 

4 times, then they work it out, you know, to move on. 

5 Because if they need to elevate it to Scott or Joe, 

6 then they will do that. But, also, Joe and Scott 

7 have the two major bits of BRs. And they meet, you 

8 know, weekly or biweekly to resolve issues.

9 You know, we're interpreting the TBD 

10 this way. We're doing it that way. And to get 

11 those resolved.

12 MR. CALHOUN: And when you say DRs, 

13 you're referring to your dose reconstructors. I'm 

14 not sure everybody knows that.

15 CHAIRMAN MELIUS: Yes.

16 MR. MAHER: Yes, dose reconstructors. 

17 And if it's a crosscutting issue that isn't just 

18 the one slice and it gets rolled up to the objective 

19 management meeting, I have it every other week. 

20 Now, and I also think it's important to point out 
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1 that the document on each of these TBDs are DRs for 

2 the most case. And they are the site lead DR.

3 So, it's not like it's a real huge 

4 disconnect between the TBD and what the DR. That 

5 the DRs are actually doing the documents. And 

6 they're also being independently reviewed by a 

7 second DR who's doing claims at that site.

8 So, you know, it's an integrated 

9 process. And you know, we do have some, you know, 

10 differences and interpretation of TBDs. But we 

11 bring them to the surface really quickly.

12 And of course, the reviews that, you 

13 know, Grady's group would do their DRs, and they 

14 would have a different interpretation and send it 

15 back for reconsideration. So, there's a lot of 

16 cross back and forth among, you know, the 

17 production managers, the DRs, PRs, and the document 

18 owners that, you know, work those things out.

19 And that's aside from the training they 

20 go through. Which, you know, all DRs have 40 hours 
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1 basic training. If they are non-experienced at a 

2 site, then they're given the DRIT, we call a 

3 DRT-status, DR-in-training status.

4 And where they need to work for a DR who 

5 is trained at that site. They must review all the 

6 DRT's DRs before it goes to PR.

7 So, really there's still some 

8 opportunity for inconsistencies. But we are very 

9 concerned with that. And the more tools involved 

10 -- the tools really help with the inconsistencies.

11 MR. KATZ: Alright, can you just 

12 identify yourself, because you're not Scott.

13 MR. MAHER: No, no. I'm Ed Maher. I 

14 have all the dose reconstruction and tool 

15 redevelopment under me.

16 MR. KATZ: Thanks so much.

17 MR. MAHER: Yes.

18 CHAIRMAN MELIUS: My question is, is 

19 that all like -- for an individual site, is that 

20 all documented in one place, what to do? Or sort 
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1 of how much of this is based on it?

2 MR. MAHER: Well, as far as the 

3 training of the DR, that's documented. I would say 

4 the other things we document it pretty quickly.

5 CHAIRMAN MELIUS: Okay. Okay. 

6 Because I'm just trying to understand, you know, 

7 again, it's not being critical of your process or 

8 whatever.

9 Again, but, you know, sort of from an 

10 outside perspective of how do we identify what 

11 needs to be reviewed and not reviewed? And how do 

12 we assess what you're doing, you know, in terms of 

13 the outcomes in terms of dose reconstruction? 

14 But that was very helpful. Thank you.

15 MR. MAHER: Okay.

16 MR. CALHOUN: And this is Grady. And 

17 I just have one more thing to add. It's a little 

18 bit -- there is probably more prescription than it 

19 asks for credit for in the actual TBDs. There's 

20 a lot of "if-then" kind of statements. You know, 
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1 if a person worked here, do this. If they worked 

2 there, find that.

3 So that is in those documents.

4 CHAIRMAN MELIUS: Yes.

5 MR. MAHER: And I think about 

6 methodology. I look at overestimates, 

7 underestimates, maximization techniques. Those 

8 are all -- I look at methodology. And they can 

9 occur at any site with any one claim.

10 CHAIRMAN MELIUS: Right.

11 MR. MAHER: And in some cases it has a 

12 mixture too.

13 CHAIRMAN MELIUS: Yes.

14 MR. MAHER: And I also want to point 

15 out, not to slight Liz because I know she's on the 

16 call, but Liz is our internal dosimetrist, 

17 principal dosimetrist, and she holds meetings 

18 weekly on issues of hey, we have issues of 

19 interpretation of internal dosimetry.

20 So there's other people that also feeds 
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1 into this now.

2 CHAIRMAN MELIUS: Okay, okay. Thank 

3 you. Does anybody else have questions on that? 

4 Any other things?

5 MEMBER ZIEMER: This is Ziemer. I 

6 have one question for Grady.

7 You know, in some fields such as 

8 laboratory testing, they do what's called split 

9 samples where you send half of each sample to two 

10 different labs. And they analyze it. And you 

11 look at the results.

12 It just occurred to me, do you ever send 

13 the same case to two or more dose reconstructors 

14 to see how their results compare?

15 MR. CALHOUN: Well, we typically -- our 

16 review, once we get the dose reconstruction from 

17 the ORAU Team, it comes over here and one of our 

18 people review it and sign it.

19 And then it goes through another kind 

20 of a higher level of review that just to see if 
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1 there's any significant policy changes or anything 

2 like that that have been changed. But we actually 

3 --

4 MEMBER ZIEMER: No, I understand what 

5 a review is. But I'm sort of asking about -- the 

6 one thing about consistency is between dose 

7 reconstructors. Do they come up with the same 

8 result? From the same case?

9 MR. CALHOUN: Yes. We actually have a 

10 blind program that we do over here as well.

11 MEMBER ZIEMER: Okay.

12 MR. CALHOUN: We haven't finished a lot 

13 of those lately because other items. But we kind 

14 of found that we were running into the same problem 

15 that SC&A was, in that we -- even us, we didn't have 

16 ready access to the tools that were used out there.

17 And I think we fixed that problem. But 

18 we truly picked at random. And so what happened 

19 was, when you've got an overestimate or an 

20 underestimate and there's somewhat of a 
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1 discrepancy there, it's not very important. 

2 Because it can be a really big overestimate or a 

3 very little overestimate. And as long as it's 

4 compensable, it's not a big deal.

5 Now, when the SC&A chooses the 48 to 52, 

6 or the Work Group does, that would require a lot 

7 more a review. And to this point, we've not done 

8 that. We've just picked at random.

9 CHAIRMAN MELIUS: Any other questions?

10 Okay. 

11 MEMBER KOTELCHUCK: Jim?

12 CHAIRMAN MELIUS: Yes?

13 MEMBER KOTELCHUCK: Okay. Coming 

14 back to something that we talked about before on 

15 the issue of the blind reviews.

16 CHAIRMAN MELIUS: Yes.

17 MEMBER KOTELCHUCK: I had a further 

18 thought if I may come back. By the time we're at 

19 14 blind reviews, it makes some sense to worry about 

20 are we making sure that we've spread the blind 
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1 reviews out among the appropriate sites.

2 And I just went back to my little table 

3 of the blind -- of the 14 we've done. And I see 

4 we've done a couple of Rocky Flats. We have three 

5 Hanford's that we've done.

6 But that actually -- we should be 

7 thinking now as we accumulate blind reviews, that 

8 we in fact cover a reasonable spectrum of the sites. 

9 And make sure that there are not medium and large 

10 sites that are not being reviewed just because.

11 So, that's something for the future 

12 that we ought to do.

13 CHAIRMAN MELIUS: Yes. And I think 

14 Paul and I were referring to that. But also, in 

15 terms of sites where there's not a Site Profile or, 

16 you know, --

17 MEMBER KOTELCHUCK: Yes. Right.

18 CHAIRMAN MELIUS: Which it's generally 

19 the smaller sites. So, I don't think we want to 

20 exclude them. But we certainly need to be 
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89

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1 spreading these out.

2 MEMBER KOTELCHUCK: Right. And I 

3 agree with you on the smaller sites.

4 CHAIRMAN MELIUS: Yes.

5 MEMBER KOTELCHUCK: The smaller sites 

6 need special attention because they're small.

7 CHAIRMAN MELIUS: Okay.

8 MEMBER KOTELCHUCK: Yes. Agreed.

9 CHAIRMAN MELIUS: Okay. Back to sort 

10 of consistency issues. I think what we need to 

11 work out there and I haven't thought it through, 

12 and I don't know if other Work Group Members have 

13 thoughts on how we do this.

14 But it's how we select -- how we target 

15 these. And how many do we have to do to show 

16 consistency or inconsistency? I think it's tricky 

17 and difficult.

18 And that's sort of why I was trying to 

19 get a sense of what, you know, can we get a better 

20 overview of the dose reconstruction methods? And 
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1 then can we -- that are actually used.

2 And then thinking about what types of 

3 situations we want to target where we think that 

4 consistency is going to be more difficult to 

5 achieve I guess is a way of putting it.

6 And I don't know if anybody has thoughts 

7 on that. That is maybe something we need to think 

8 about and come back to.

9 MEMBER ZIEMER: Well, it's certainly 

10 going to be more of an issue for sites that are not 

11 -- where we don't have the kind of detailed 

12 methodologies.

13 I assume the workbook sites will -- the 

14 sites that have detailed workbooks will inherently 

15 be more consistent in their outcomes. Would that 

16 be a fair statement Dave?

17 MEMBER KOTELCHUCK: I think so. I 

18 think so.

19 MEMBER ZIEMER: So, when we're talking 

20 about consistency here, I guess we're talking about 
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1 people doing things the same way.

2 And I think we've already identified 

3 that a lot of the inconsistencies hover around 

4 assumptions. So, and the assumptions seem to turn 

5 up more in sites that are not well characterized.

6 I'm sort of thinking off the top of my 

7 head here.

8 If we're going to focus on consistency, 

9 it kind of leads us to sampling certain types of 

10 sites I guess.

11 CHAIRMAN MELIUS: Yes.

12 MEMBER KOTELCHUCK: Right. And this 

13 is a place where I feel that you folks who have been 

14 on the Board from the beginning, not only have a 

15 real advantage, have real knowledge that I lack 

16 just as a relatively new Board Member.

17 I mean, I haven't, you know, I haven't 

18 seen the cases, a lot of the cases where -- I mean, 

19 you have to see a lot of cases to know what's usual 

20 and what's unusual. And what kinds of unusual 
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1 things may turn up.

2 So, those are -- certainly I feel like 

3 I can use help in trying to identify some of those 

4 sorts of situations.

5 MEMBER ZIEMER: Jim, Ziemer again.

6 CHAIRMAN MELIUS: Well, you bring a 

7 fresh perspective on it, Dave.

8 MEMBER KOTELCHUCK: Well, you know, 

9 but --

10 CHAIRMAN MELIUS: But we'll look at it 

11 that way. We don't want to, you know, pigeonhole 

12 you as the junior Member of the --

13 MEMBER KOTELCHUCK: Well, you know, 

14 you can say different perspective. But I also see 

15 that if you need to have a heart operation, what 

16 do you want to do? Go to a person who's been doing 

17 them for years. Or go to a person who's done half 

18 a dozen and they were all successful.

19 CHAIRMAN MELIUS: Yes.

20 MEMBER KOTELCHUCK: Well, I think I
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1 know who I'd choose. So, but in this case for 

2 purely sort of unusual things, oddball things, it's 

3 not -- one might have a new perspective on things 

4 that you have been doing.

5 But you won't have a perspective on 

6 things that you haven't seen done or you haven't 

7 noticed happened in the past.

8 CHAIRMAN MELIUS: Yes. I'll bring up 

9 another issue where I think consistency, you know, 

10 maybe a -- may be problematic. And that's how to 

11 what extent incidents, or, you know, acute 

12 exposures or accidents are taken into account in 

13 dose reconstruction.

14 MEMBER KOTELCHUCK: Yes.

15 CHAIRMAN MELIUS: And now, you know, 

16 we've wrestled with that for a long while. A lot 

17 of it's, you know, issues of documentation and so 

18 forth.

19 But, to me at least, I can think of 

20 instances where it would come up and at least in 
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1 the public comments on our SEC evaluations and --

2 or just general public comments on dose 

3 reconstruction where people are -- claimants raise 

4 concerns about, you know, why was this, you know, 

5 why did they not know about and why didn't they 

6 include this in my dose reconstruction and that?

7 So, it may be not on the sort of the 

8 actual dose reconstruction. But what information 

9 is taken into account on the dose reconstruction.

10 Does anybody have any -- is that making 

11 sense, I guess?

12 MEMBER ZIEMER: Well, that makes sense 

13 to me. I think that's an important issue.

14 It also occurred to me, and I know we 

15 don't -- this is a Board responsibility. But it 

16 seems to me, since our contractor invests a lot of 

17 time in the dose reconstruction efforts, that they 

18 may be able to observe or make note of things that 

19 they believe are not consistent. And alert us to 

20 those as well.
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1 CHAIRMAN MELIUS: Yes.

2 MEMBER KOTELCHUCK: Yes.

3 CHAIRMAN MELIUS: And I'm going to raise 

4 an old issue, which got put to bed by the lawyers 

5 many years ago. But I think it's another somewhat 

6 related to incidents.

7 But I think the overall is how the 

8 interviews are evaluated and incorporated into the 

9 dose reconstruction process. And Dave, since 

10 you're new, we had a long discussion and sort of 

11 internal disagreements within the Board and with 

12 NIOSH about our ability as part of the blind reviews 

13 to go out and re-interview the claimants.

14 And it just got everyone concerned 

15 about doing that. And so, we decided to -- the 

16 Board decided not to -- not sort of hold that in 

17 abeyance and whether we need to go, you know, in 

18 some future time consider that or not.

19 And I just want to mention it. And I 

20 think a lot of that has to do with -- now the 
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should be cautioned that this transcript is for information only and is subject to change.

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1 documentation is better. And at least individual 

2 reviews, dose reconstructions that are done, I see 

3 a lot more reference to the interviews and 

4 evaluation of them. That I think is helpful.

5 But I think in the area of incidents is 

6 where it's more problematic. And some of that's 

7 just inherent in the fact that, you know, the 

8 interviews were often with survivors and people 

9 that really don't know what their spouse or father 

10 or mother did at the -- in working at the site.

11 At any level of detail because there was 

12 secrecy, et cetera, in time.

13 And one of the things we can do is, I 

14 have no problems with, is suggesting that SC&A, you 

15 know, prepare a short report suggesting particular 

16 areas were there may be issues with, you know, 

17 consistency that we could, you know, should be 

18 focusing on.

19 Does that make sense to the other Work 

20 Group Members?
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97

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1 MEMBER BEACH: Yes, Jim. This is 

2 Josie. That makes perfect sense. And I think 

3 your comment on the interviews, it's very valuable 

4 to interview workers.

5 And I agree, you have to have the 

6 interviews with the workers and not necessarily 

7 survivors. But that's an important key.

8 MEMBER KOTELCHUCK: Yes. I agree 

9 also. I think both the incidents, 

10 accidents/incidents recording and what we do with

11 the CATI reviews is important.

12 And I agree with Josie that the 

13 interviews the survivors, I don't think what we --

14 if that's the only option we have, of course we do 

15 them.

16 But I must say, they are much less 

17 helpful than interviews with individual workers.

18 MR. MAHER: Yes. This is Ed Maher. 

19 Can I make a comment addressing that?

20 CHAIRMAN MELIUS: Sure. Go ahead Ed.
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98

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1 MR. MAHER: All right. We had one 

2 claim where we interviewed the survivor. And the 

3 survivor was a technical person.

4 And she mentioned that this individual 

5 was involved in the SL-1 accident. And of course 

6 those records were not given to us by the site. We 

7 had to go hunting for them.

8 And sure enough, she was exactly right. 

9 So, we don't treat survivor interviews lightly. 

10 Sometimes they're spot on.

11 CHAIRMAN MELIUS: Yes. No, it's a 

12 good point. And I think usually it's the opposite 

13 error is that they just don't -- aren't aware of 

14 that.

15 Or they're -- the information they have 

16 about an incident or an exposure is so vague it's, 

17 you know, -- well, you know, by the passage of time, 

18 well it was 20 years ago or whatever.

19 And unless you, you know, it's hard to 

20 evaluate that unless you can link it to a known 
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99

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1 incident or, you know, some documentation of that. 

2 And I think we know from at least some of the sites 

3 that the documentation is poor on those incidents.

4 MEMBER KOTELCHUCK: Well, we have an 

5 obligation no matter what. You know, no matter how 

6 useful or not useful they are, we have an obligation 

7 to interview those folks.

8 And it is well taken that sometimes it 

9 provides really good information that we don't 

10 otherwise have. But whether or not we get good 

11 information, it's up to us to evaluate it.

12 But we need to call them.

13 CHAIRMAN MELIUS: Right. Yes.

14 MR. MAHER: And let me also add that, 

15 you know, the quality of a survivor interview, the 

16 technical quality is not going to be --

17 CHAIRMAN MELIUS: Yes.

18 MR. MAHER: Except in rare instances. 

19 But I would also say in the past, and I'm talking 

20 about ten years ago, if in the CATI we saw a 
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100

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1 reference to an incident, and we saw them all the 

2 time saying, I was contaminated with skin counts 

3 through such and such.

4 You know, we will attempt to 

5 reconstruct it. Now if the information was not 

6 relevant to dose reconstruction, a lot of people 

7 talk about chemical exposures --

8 CHAIRMAN MELIUS: Right.

9 MR. MAHER: We would not mention it. 

10 And that was probably a mistake. Because we should 

11 at least mention it in the pre-narrative of the DR 

12 report. And say it has no bearing on the dose 

13 reconstruction.

14 Now we do that more consistently.

15 CHAIRMAN MELIUS: Yes. Yes. No, I 

16 think the documentation that you've done on the 

17 incidences and based on the interviews has been 

18 much better.

19 Any other questions on the consistency 

20 issue?
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101

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1 For our next steps, what I was going to 

2 suggest one is the -- I think we gave two 

3 assignments for Dave I think it was.

4 And I think one is -- well, first off 

5 for Dave is the presentation on summary of the blind 

6 reviews that have been completed so far for an 

7 upcoming either Board meeting or a Board call.

8 And leave it up to Dave to decide, you 

9 know, what's appropriate timing and so forth on 

10 that. We'd do that.

11 And then I think we probably need to 

12 think more, you now, and Dave may want to talk to 

13 the other Members of the Dose Reconstruction Review 

14 Committee about, you know, this issue of how do we 

15 handle -- what's the best way of handling and 

16 prioritizing the time and resources available to 

17 that Committee in terms of doing reviews?

18 And we probably should come back and for 

19 this group is to have some discussion which we 

20 really haven't done today on, you know, sort of 
This transcript of the Advisory Board on Radiation and Worker Health, Dose Reconstruction Review 

Methods, has been reviewed for concerns under the Privacy Act (5 U.S.C. § 552a) and personally 

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102

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1 selection of the -- of cases. And how we want to 

2 approach that.

3 So we can make a recommendation. 

4 Though I don't think that recommendation is going 

5 to be overly prescriptive simply because I think 

6 really the Dose Reconstruction Review Committee 

7 sort of needs to do that on an ongoing basis.

8 But I think if we can put some framework 

9 that the whole Board can agree on, I think that 

10 would be helpful. Then I think we need to come back 

11 and talk about the -- sort of think about how we 

12 -- consistency, what information would be useful.

13 And I think we're asking SC&A to, you 

14 know, give us a short report that would, you know, 

15 recommend certain -- where they think that the 

16 consistency issue -- consistency maybe an issue 

17 that, you know, in terms of how we select and what 

18 we should focus on.

19 Am I missing anything?

20 MEMBER ZIEMER: I think that covers it 
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Methods, has been reviewed for concerns under the Privacy Act (5 U.S.C. § 552a) and personally 

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103

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1 pretty well.

2 CHAIRMAN MELIUS: Okay. Any further 

3 thoughts?

4 MEMBER KOTELCHUCK: Sounds good.

5 CHAIRMAN MELIUS: Okay. At least for 

6 some of us it's getting towards lunch time. So, 

7 we get a little -- we slow down a little bit.

8 MEMBER KOTELCHUCK: Okay.

9 CHAIRMAN MELIUS: But if you have to go 

10 get another cup of coffee or --

11 MEMBER BEACH: Yes.

12 MEMBER KOTELCHUCK: Very good.

13 CHAIRMAN MELIUS: Early morning. 

14 But, anyway. So, I thank everybody for their time.

15 Ted, do you have any?

16 MR. KATZ: No, I don't. But thanks. 

17 That was a good meeting.

18 CHAIRMAN MELIUS: Yes. Final word. 

19 And thank everybody. And, oh, I know what is the 

20 final.
This transcript of the Advisory Board on Radiation and Worker Health, Dose Reconstruction Review 

Methods, has been reviewed for concerns under the Privacy Act (5 U.S.C. § 552a) and personally 

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104

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1 What I will do, they're probably 

2 overdue now, because -- but I will prepare a set 

3 aside. We've set aside 45 minutes for the Board 

4 meeting I think on the agenda.

5 And I will just sort of present an 

6 update on what we've been discussing sort of under 

7 these general categories. If that's reasonable.

8 And then, I mean, I think what we really 

9 want to do is generate, you know, more Board input 

10 and discussion. And hopefully we can. And then 

11 when we get the report back from SC&A, I'll figure 

12 out, we'll hold another meeting. And by that time, 

13 I think people will have more of a chance to review 

14 the -- their recent report that they sent us last 

15 week.

16 And that may generate some other 

17 discussion also.

18 MEMBER KOTELCHUCK: Very good.

19 CHAIRMAN MELIUS: Okay. Thank you 

20 all.
This transcript of the Advisory Board on Radiation and Worker Health, Dose Reconstruction Review 

Methods, has been reviewed for concerns under the Privacy Act (5 U.S.C. § 552a) and personally 

identifiable information has been redacted as necessary. The transcript, however, has not been reviewed 

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105

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COURT REPORTERS AND TRANSCRIBERS

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1 MEMBER KOTELCHUCK: Thank you.

2 CHAIRMAN MELIUS: And if we don't talk 

3 to you, we'll see you in Oakland --

4 MEMBER KOTELCHUCK: Very good.

5 MEMBER BEACH: Okay.

6 CHAIRMAN MELIUS: In a couple of weeks. 

7 And actually some of you in Cincinnati next week.

8 MEMBER BEACH: Oh, that's right. See 

9 you Thursday.

10 CHAIRMAN MELIUS: We have the Idaho.

11 MEMBER BEACH: Yes, we do.

12 CHAIRMAN MELIUS: Tuesday. Tuesday, 

13 not Thursday.

14 MEMBER BEACH: Yes. See you next 

15 week.

16 CHAIRMAN MELIUS: Okay. Take care. 

17 Bye-bye.

18 MEMBER KOTELCHUCK: Bye-bye, all.

19 (Whereupon, the above-entitled matter 

20 was concluded at 11:52 a.m.)