. 

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UNITED STATES OF AMERICA

CENTERS FOR DISEASE CONTROL

+ + + + +

NATIONAL INSTITUTE FOR OCCUPATIONAL

SAFETY AND HEALTH

+ + + + +

ADVISORY BOARD ON RADIATION AND

WORKER HEALTH

+ + + + +

77th MEETING

+ + + + +

TUESDAY

MAY 24, 2011

+ + + + +

The meeting convened at 8:30 a.m., 

Central Daylight Time, in the Crowne Plaza St. 

Louis-Downtown, 200 North Fourth Street, St. 

Louis, MO, James M. Melius, Chairman, presiding.

PRESENT:

JAMES M. MELIUS, Chairman

HENRY ANDERSON, Member

JOSIE BEACH, Member

BRADLEY P. CLAWSON, Member

R. WILLIAM FIELD, Member

MARK GRIFFON, Member*

RICHARD LEMEN, Member

JAMES E. LOCKEY

WANDA I. MUNN, Member
. 

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PRESENT: (continued)

ROBERT W. PRESLEY, Member

GENEVIEVE S. ROESSLER, Member

PHILLIP SCHOFIELD, Member

PAUL L. ZIEMER, Member*

TED KATZ, Designated Federal Official
. 

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REGISTERED AND/OR PUBLIC COMMENT PARTICIPANTS:

ADAMS, NANCY, NIOSH Contractor

BALDRIDGE, SANDRA*

BARRIE, TERRIE*

BURGOS, ZAIDA, NIOSH

ELLISON, CHRIS, DCAS

FITZGERALD, JOE, SC&A

HINNEFELD, STU, DCAS

KINMAN, JOSH, DCAS

KOTSCH, JEFF, DOL

LEITON, RACHEL, DOL

LEWIS, GREG, DOE

LIN, JENNY, HHS

MAKHIJANI, ARJUN, SC&A

MORRIS, ROBERT, ORAU Team*

NESVET, JEFF, DOL

NETON, JIM, DCAS

RABINOWITZ, RANDY 

ROLFES, MARK, DCAS

RUTHERFORD, LAVON, DCAS

STEPHAN, ROBERT, Office of Congressman Jerry

Costello*

STEINBERG, GARY, DOL

STIVER, JOHN, SC&A

VLIEGER, FAYE*

WADE, LEW, NIOSH Contractor

*Participating via telephone
. 

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T-A-B-L-E O-F C-O-N-T-E-N-T-S

Welcome, Dr. James Melius, Chair........... 4

NIOSH Program Update,

Mr. Stuart Hinnefeld...................... 8

NIOSH 10-Year Review, Dr. Lewis Wade..... 21

DOL Program Update, 

Mr. Gary Steinberg ................. 72

Ms. Rachel Leiton ................... 85

DOE Program Update, Mr. Greg Lewis....... 121

HHS Proposed Rule to Amend Probability of 

Causation Guidelines Regarding CLL,

Dr. James Neton, NIOSH................... 142

Lunch

Feed Materials Production Center, Mr. Bradley 

Clawson, WG Chair........................ 186

SEC Petition WG Report, Mr. John Stiver, SC&A 194

Board Work Session....................... 265

Administrative Session for Board Members Only: 

Conflict of Interest Procedures

Public Comment........................... 289

Adjourn
. 

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

2 8:29 a.m.

3 CHAIRMAN MELIUS: Good morning and 

4 welcome to the 77th meeting of the Advisory 

5 Board on Radiation and Worker Health and I 

6 think a third time in St. Louis. I can't 

7 remember. We've been here six times? Okay. 

8 Several times. Not for a while so we're glad 

9 to be back.

10 Let me turn it over to Ted who 

11 will go through the usual housekeeping.

12 MR. KATZ: Good morning everybody. 

13 Welcome everyone on the line and in the room. 

14 This is the Advisory Board on Radiation and 

15 Worker Health. It's our 77th, I think, 

16 meeting which is quite an accomplishment in 

17 and of itself. Welcome from Secretary of HHS 

18 Sebelius and Director of NIOSH Dr. Howard as 

19 well.

20 Let me just cover a few things 

21 here. On the agenda we have a public comment 

22 session today at 6:00, from 6:00 to 7:00 and 
. 

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1 tomorrow at 5:30 p.m. 

2 If you would like to comment, for 

3 people here in St. Louis there's a sign-in 

4 sheet outside the door here. We would like 

5 for you to sign in and I'll try to remind 

6 people later because people will probably show 

7 up later in the day about that.

8 The agenda for the meeting as well 

9 as all the presentations that were here on 

10 time to be put up on the web so people who are 

11 listening in by phone can follow along with 

12 the PowerPoint presentations on the web there. 

13 They are on the NIOSH webpage 

14 under the DCAS program under the Board, as 

15 well as under the meeting section so I think 

16 you can find it in either place.

17 Also, let me just note for people 

18 who are listening in by phone if you would 

19 please mute your phones during the meeting, 

20 except if you're commenting, for example, 

21 during the public comment session. 

22 To mute your phone, if you don't 
. 

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1 have a mute button on your phone, press *6 and 

2 then to unmute your phone you press *6 again. 

3 It's very important that you mute your phone, 

4 particularly for all the other people who are 

5 on the line as well because they will 

6 otherwise hear whatever background noise is 

7 coming through your phone. 

8 And then last just a little bit of 

9 housekeeping about exits. Were there an 

10 emergency and you need to get out of the hotel 

11 for a fire or what have you, you go out these 

12 exit doors, take an immediate left, go through 

13 the two double glass doors, and then an 

14 immediate right. That's the quickest way. 

15 That puts you out on 6th Street, or some 

16 street, that's right out there.

17 I think that covers it. I would 

18 like to also check on the rolls. We have a 

19 number of Board Members who are attending by 

20 phone as opposed to in person here so let me 

21 check now and have Board Members who are on 

22 the line right now register your attendance, 
. 

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1 please.

2 MEMBER ZIEMER: This is Paul 

3 Ziemer. I'm on the line.

4 MR. KATZ: Welcome, Paul. 

5 How about Mr. Griffon? Or Mr. 

6 Gibson? Or Dr. Richardson? Very well. At 

7 this point they are not on the line. I think 

8 we expect some of them to join us.

9 CHAIRMAN MELIUS: Some of the 

10 Board Members had some travel problems getting 

11 in here due to the weather.

12 Why don't we start. Stu, you want 

13 to give us a NIOSH update? Then you can be 

14 followed by Lew who is going to give us an 

15 update. Lew Wade is going to give us an 

16 update on the 10-Year Review.

17 MR. HINNEFELD: Thank you and good 

18 morning everyone. For anyone who doesn't know 

19 me, I think maybe everybody here does know me, 

20 I'm Stu Hinnefeld from NIOSH from the Division 

21 of Compensation Analysis and Support.

22 I'm going to be very brief today 
. 

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1 following the pattern that I followed at the 

2 last Board meeting rather than run through all 

3 the statistics. I'll talk a little bit about 

4 the news from the program. The statistics 

5 package has been available. If you have any 

6 questions, I'll try and answer any questions 

7 about the package that I forwarded in terms of 

8 progress. 

9 Suffice it to day that we are 

10 continuing to make nice progress against the 

11 backlog of claims. Some number of years ago 

12 all who were here probably remember the 

13 backlog of approaching 10,000 dose 

14 reconstructions we had to do. We're now down 

15 to a total population in house of about 1,400 

16 claims with us that need to be done or 

17 dispositioned in one way or another. We are 

18 very happy about that.

19 During the -- let's see. I think 

20 I went too far. Here is our program news 

21 slide. During this past period if you'll 

22 recall, we had an objective to complete claims 
. 

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1 that were over a year old by last June 1st, I 

2 think, or June 30th, and there are certain 

3 categories of claims that kind of fall outside 

4 our accomplishment and these are kind of well5 known situations. 

6 Some of them belong to SECs where 

7 we believe -- sites where we believe there is 

8 likely going to be an SEC but it hasn't become 

9 effective yet and there are one or two 

10 technical issues. On occasion we'll be 

11 waiting for information from the DOE or DOL.

12 Typically that is because in 

13 trying to do the dose reconstruction we 

14 encountered this need for additional records. 

15 Oftentimes this will be based on something 

16 the claimant told us in the interview so we 

17 have to go back. 

18 It's rare that an initial response 

19 from either agency takes that long. We make 

20 the supplemental request at sometime and they 

21 just didn't have time to respond. June of 

22 last year we got to the point where we could 
. 

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1 do claims within a year of the time we got 

2 them. By May of this year, May of 2011, we 

3 have managed to get that down to nine months. 

4 Claims that we get today, whether they be new 

5 claims or reworked claims coming back to us, 

6 we've been successful in getting the maximum 

7 time down to nine months. Many of them are 

8 done more quickly than that.

9 Now, we have new objectives for 

10 the coming period in terms of timeliness. We 

11 want to have a high percentage of claims done 

12 within 60 days. I'm sorry, within six months. 

13 Approximately half within six months. 

14 For reworks where we don't have to 

15 get additional data we want to get as many as 

16 possible. We set an objective as 80. The 

17 reason we don't make these 100 percent is it's 

18 hard to get 100 percent of everything because 

19 there are certain issues that pop up, odds and 

20 ends or unusual claims that you don't really 

21 get to 100 percent. We are trying, though, to 

22 continue to shorten the period for dose 
. 

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1 reconstruction completion down to what we feel 

2 is maybe a more reasonable amount of time. 

3 Those are objectives going forward for 

4 timeliness that we intend to meet. 

5 The reason for the six-month 

6 objective ending November 1st is that's a six7 month period on our main contractor, Oak Ridge 

8 Associated Universities team. They have an 

9 award fee performance rating system and their 

10 contract date starts -- what would that be? 

11 May 1st. 

12 They are evaluated on six-month 

13 intervals so that's the end of their 

14 evaluation period. We found the most 

15 effective way to make an objective on 

16 timeliness. To improve your timeliness is to 

17 make it award fee objective for your 

18 contractor so they have some incentive to 

19 agree with your objectives.

20 So that's how that works going 

21 forward. I believe that's the only actually 

22 new slide I have up there. I did with as 
. 

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1 little time to think about this over the 

2 weekend come up with a couple more things that 

3 I wanted to mention very quickly. 

4 One is that in early May we 

5 conducted another dose reconstruction SEC 

6 workshop in Cincinnati. We do this in 

7 conjunction with our worker outreach 

8 contractor ATL. They essentially identify an 

9 invitation list of advocates and people who 

10 are interested in the program, learning more 

11 about the program. 

12 Very often these are 

13 representatives from sites that are currently 

14 working, maybe labor representatives that are 

15 asked frequently by their constituency, by 

16 their members for information about a program.

17 Many times these people don't feel 

18 that well equipped to answer the questions so 

19 we try to help them out and give them 

20 additional information to provide to their 

21 constituency. That was held in early May. 

22 Between 20 and 30 people attended. 
. 

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1 ATL does conduct a satisfaction 

2 survey or a feedback survey at the end of it. 

3 I enjoy reading those feedback surveys 

4 because in general they really provide good 

5 feedback. People really valued the 

6 information they received and they thought it 

7 would be really useful to them in their jobs. 

8 I get at least one opportunity, or two 

9 opportunities a year, to read some good 

10 feedback. That's kind of nice.

11 The other item I wanted to 

12 mention, which is kind of addresses some thing 

13 that we'll probably hear about in a little bit 

14 which is that people don't seem to understand 

15 us very well, is that there have been a little 

16 bit news story lately about this Plain 

17 Language Act, or Plain Language Initiative 

18 that the government is supposed to embark on. 

19 There's really not been a lot of 

20 guidance come down through the administration 

21 for how exactly or what's expected. We 

22 figured, well, certainly in our program it 
. 

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1 cries out for some sort of action like that 

2 just based on the feedback we hear from polls 

3 of our claimants and feedback we hear from our 

4 claimants and some things you'll hear in the 

5 program review. 

6 We are embarking on that trying, 

7 first of all, with some of our written 

8 products and we have a lot of them, to try to 

9 rewrite them with the idea of making them more 

10 readable and understandable to the general 

11 public. We tended to write them for ourselves 

12 and we like what they sounded like. 

13 Not everybody talks like us which 

14 probably is good for most everybody. We're 

15 trying to rewrite those relying on our 

16 communications team to try to maybe make these 

17 a little more understandable. We have a lot 

18 of written products. It will take a long time 

19 to get through that. I think we are capable 

20 of doing it. It just takes a different way of 

21 working and perhaps a little more effort.

22 Those are the news items I wanted 
. 

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1 to cover. I'm pretty sure my slides go into 

2 the statistics which I had not planned to 

3 cover. I would be willing to answer any 

4 questions about anything I talked about today 

5 or any of the statistics on the slides.

6 CHAIRMAN MELIUS: Anybody have 

7 questions for Stu? I do.

8 On one of those statistical 

9 slides, and you've probably explained this 

10 before but I'm still confused, if you take the 

11 status of the first 10,000 claims and you have 

12 228 claims at NIOSH, 192 closed, 14 DRs with 

13 claimants, and then the parenthesis is what's 

14 got me confused. Three initial and 31 DOL 

15 reworks. I can't understand how 14, 3, and 31 

16 relate to each other.

17 MR. HINNEFELD: What was the 

18 statistic again?

19 CHAIRMAN MELIUS: It says 14 DRs

20 with claimants. In parentheses three initial 

21 and then 31 DOL reworks within the past year.

22 MR. HINNEFELD: Okay. I think 
. 

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1 that's probably a typo.

2 CHAIRMAN MELIUS: Okay. There is 

3 a similar one down below, 19 DRs in process, 

4 five initial, 47 DOL reworks within the past 

5 year.

6 MR. HINNEFELD: Again, those are 

7 typos. Sorry about that.

8 CHAIRMAN MELIUS: Okay. The final 

9 line was the one I also had a question on 

10 which says three gathering information.

11 MR. HINNEFELD: I think probably 

12 what happened, I'm guess that those were 

13 reworks that came back to us with some new 

14 information that we have to then maybe get 

15 some clarification on the additional cancer of 

16 the additional employment or something to that 

17 effect. Or the employment was added and we 

18 have to get some more information.

19 CHAIRMAN MELIUS: Okay. I'm just 

20 trying to understand how there's a site that 

21 hasn't been worked on at all or if there is 

22 some other --
. 

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1 MR. HINNEFELD: No. I think all 

2 the sites we've -- I think we've worked on all 

3 the sites. During the past year you guys know 

4 we brought a lot of SEC petitions, 83.14s. We 

5 tried to finish up a lot of them during that.

6 CHAIRMAN MELIUS: Okay. Thank 

7 you.

8 Anybody else have questions for 

9 Stu?

10 Dr. Ziemer, do you?

11 MEMBER ZIEMER: I have no 

12 questions for Stu but I do have a general 

13 question. I think this is for Ted.

14 Did you say that the slides and so 

15 on or on the O: drive or where do I find 

16 those?

17 MR. KATZ: Yeah, Paul. They are 

18 on the O: drive. For most of the 

19 presentations they are actually on the 

20 internet for everybody and the public as well.

21 MEMBER ZIEMER: Okay. Well, on 

22 the internet I found the agenda under the 
. 

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1 meeting but I didn't find the slides. Where 

2 would those be?

3 MR. KATZ: They should be --

4 Chris, go ahead. Why don't you 

5 come up to the mic so we can hear.

6 MS. ELLISON: This is Chris 

7 Ellison. They are in the process of being put 

8 up there. I believe by 10:00 a.m. this 

9 morning.

10 MEMBER ZIEMER: Oh, okay.

11 MS. ELLISON: Okay? Sorry about 

12 that.

13 MEMBER ZIEMER: On the regular 

14 website under the meeting when you click on 

15 that all you find is the agenda.

16 MS. ELLISON: And they will 

17 eventually be listed under the agenda on both 

18 the Advisory Board page and the public meeting 

19 page. 

20 MEMBER ZIEMER: Great. Okay. 

21 Thank you.

22 MR. KATZ: Thanks, Chris.
. 

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1 MEMBER ZIEMER: I have no 

2 questions for Stu.

3 CHAIRMAN MELIUS: Okay. Thanks, 

4 Paul.

5 Any other Board Members on the 

6 line yet that have questions? Okay.

7 Lew. Lew Wade will now give us an 

8 update on the 10-Year Review.

9 DR. WADE: Good morning. As 

10 always, it's a pleasure and an honor to come 

11 and speak to the Board. I must say I get 

12 energized when I come and see all you fine 

13 people and get to chat with you a little. I 

14 sort of mourn the passing of this 10-Year 

15 Review as we end it because I won't get to do 

16 that so much. 

17 I'm here and let me start by 

18 introducing two colleagues, authors in terms 

19 of the Phase I Reports, Randy Rabinowitz, and 

20 Nancy Adams who are here in the room should 

21 there be any questions about their pieces.

22 On Thursday you're going to have 
. 

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1 the opportunity to hear a presentation on the 

2 quality of science, a piece that is going to 

3 be presented by Doug Daniels and you'll get to 

4 interact with Doug in a much more detailed way 

5 concerning his aspect of the 10-Year Program 

6 Review.

7 Let me remind you of the premise 

8 of the 10-Year Review. The only reason Dr. 

9 Howard decided to undertake such a review was 

10 on the hope that this would result in a better 

11 program. By better program we mean program 

12 that will better serve the people that we're 

13 here to serve, the claimants and petitioners. 

14 That's the end result of it.

15 It was going to happen in two 

16 phases. The first phase, which was to be a 

17 data-driven look at aspects of the program. 

18 There were five aspects of the program that 

19 were to be looked at; dose reconstruction, 

20 Special Exposure Cohort, timeliness, quality 

21 of science, and quality of service.

22 They were to be data-driven looks 
. 

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1 at the program resulting in some 

2 recommendations as to potential improvement. 

3 Phrase II, which will begin in 

4 earnest after this meeting, would be Dr. 

5 Howard and the senior NIOSH leadership looking 

6 at those recommendations and deciding which of 

7 those recommendations should be implemented 

8 and how exactly those recommendations should 

9 be implemented to make a better program. So 

10 Phase I and Phase II.

11 In terms of the status you now 

12 have, I'm going to shutter to say, on the 

13 website on the docket the five latest versions 

14 of the Phase I reports. You've seen various 

15 manifestations of them as we've evolved. You 

16 now should have the five latest versions of 

17 those reports in front of you.

18 The SEC report was, I think, the 

19 last to appear as an edited document that is 

20 there now, Randy Rabinowitz' report. So all 

21 five of those are in your possession in near22 final form. I say in near-final form because 
. 

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1 they will be changed again based upon public 

2 comments and we receive comments from this 

3 Advisory Board. Hopefully they are nearing 

4 their final form and probably by the next full 

5 Board meeting they will be in final form for 

6 you.

7 The Phase II will begin in earnest 

8 when Dr. Howard convenes a meeting of his 

9 senior leadership. It's scheduled for June 

10 8th, next month, where they will start to look 

11 at the recommendations that have flowed from 

12 Phase I. Believe it or not there are 78 

13 recommendations. A boat load of 

14 recommendation have resulted from Phase I.

15 Dr. Howard and his senior 

16 leadership will begin to look at those 

17 recommendations and decide which should be 

18 implemented and exactly how those 

19 recommendations should be implemented again to 

20 make a better program. That's where all of 

21 this is going.

22 Now, what I'm going to do with the 
. 

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1 brief time I have with you today is sort of 

2 highlight some of those recommendations. I'm 

3 not going to go through all 78 of them, 

4 although I'm sure we would thoroughly enjoy 

5 the quality time we would spend together as I 

6 went through all 78 of those recommendations 

7 but we're not going to do that. I'm going to 

8 highlight for you some of them that are the 

9 author's picks as to their most significant or 

10 highest priority recommendations.

11 The Board can react spontaneously 

12 as we present in their working time. You 

13 might have things you want to say to Dr. 

14 Howard and his leadership. You can say them 

15 on the record here and he will hear those 

16 comments and will react to those comments.

17 You might lend your voice to 

18 certain of the recommendations. You might say 

19 that you don't agree with certain of the 

20 recommendations. You might want to offer 

21 additional recommendations. All that can 

22 happen on the record. 
. 

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1 Certainly after this meeting 

2 individual Board Members can communicate in 

3 writing to Dr. Howard or myself in terms of 

4 thoughts you might have. We would ask that 

5 all of that be also made available to the 

6 public docket. We've tried to make this 

7 process as transparent as possible.

8 The Board might wish as a body to 

9 offer its opinion to Dr. Howard. I talked to 

10 some of you at breakfast this morning and you 

11 said, "I'm sorry. I haven't gotten you this 

12 comment or that comment." Let me tell you 

13 that the Board has done a tremendous job in 

14 terms of shaping this review. 

15 If you read this review, a lot of 

16 it is based upon the fine work that you guys 

17 have done over the years. The Board has had a 

18 great hand in the review to this point. I 

19 know Dr. Howard would welcome comments by 

20 individual Board Members or the Board as a 

21 whole as he begins to move forward in terms of 

22 choosing those recommendation that will form 
. 

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1 the basis of NIOSH's attempt to improve its 

2 program. 

3 Those are the introductory 

4 comments. I'm sure this is all painfully 

5 familiar to you because I've had this 

6 discussion with you before. It is enjoyable 

7 if you consider it in a certain way.

8 You have these documents. There 

9 are all of these recommendations that exist in 

10 your package. I'm going to go through and 

11 highlight several handful of them to try and 

12 engender a reaction from you or to simply put 

13 on the record those that are considered to be 

14 the highest priority by the authors. 

15 I'll start with dose 

16 reconstruction which was written by a very 

17 able author, that was me. This author would 

18 highlight Recommendation No. 1 which goes to 

19 the fact that the Board in its review of 

20 individual dose reconstructions has come to 

21 several hundred findings. 

22 I think it's incumbent upon NIOSH 
. 

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1 to reevaluate its QAQC programs to try and 

2 understand why NIOSH internally didn't come to 

3 these findings and the Board had to. I'm not 

4 minimizing the importance of the Board's work. 

5 I think it's wonderful that you're there to 

6 find these things. 

7 I do think that NIOSH based upon 

8 the body of findings that have resulted from 

9 the Board's review of individual dose 

10 reconstructions, I think NIOSH really needs to 

11 take a hard internal look in terms of its QAQC 

12 procedures.

13 Let me pause here and say that 

14 when Dr. Howard first spoke to you about this 

15 review he also said he was not going to wait 

16 for the review to be over to begin to 

17 implement some of the changes. A number of 

18 the changes that I'm going to highlight for 

19 you under consideration I know Stu and his 

20 people have already started to work on and 

21 that's most appropriate. 

22 I think this is one of them, but I 
. 

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1 think NIOSH in a public forum speak to its 

2 QAQC efforts and begin to understand why the 

3 Board review found these findings and they 

4 weren't scrubbed by NIOSH before those 

5 findings came from the Board so one 

6 recommendation.

7 If you throttle down to No. 6 

8 under the DR, this is a bit of a complicated 

9 one. Let me speak to it a bit. This goes to 

10 the fundamental tension that exist between

11 realizing the best possible science and the 

12 need to get things done in a timely way.

13 NIOSH has issued many changes to 

14 the manner in which it does individual dose 

15 reconstructions based again upon the work of 

16 this Board. When that happens NIOSH has to go

17 back and redo individual dose reconstructions. 

18 When that happens that takes time. 

19 People are confused as to why they 

20 are getting now a new dose reconstruction 

21 done. These is this fundamental tension that 

22 exist between getting the science complete and 
. 

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1 right and the need to do things in a timely 

2 way. 

3 This recommendation goes to the 

4 fact that NIOSH needs to better manage that 

5 tension. Again, the people at DCAS need to 

6 think about this. It is right to get the 

7 science right. But it also creates confusion 

8 within the claimant community as we go through 

9 this process. 

10 We have to think about ways to 

11 manage both of those values, complete science 

12 and the tension associated with the redoing of 

13 dose reconstructions. You'll see this point 

14 echoed again when we talk about Special 

15 Exposure Cohort petitions because that tension 

16 exist again. 

17 When do you know that you've done 

18 enough work to make a decision on an SEC 

19 petition in a timely way versus chasing that 

20 next piece of evidence that might be the magic 

21 box that would allow you to move forward and 

22 make a better "decision."
. 

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1 This tension between complete 

2 science and timing needs to be better managed 

3 by NIOSH. Again, that's the basis of 

4 Recommendation No. 6. At any point anyone can 

5 chime in on any of these. Okay. Good. I've 

6 got one agreement.

7 MEMBER ZIEMER: Can I chime in?

8 DR. WADE: Sure, Dr. Ziemer.

9 MEMBER ZIEMER: This is Paul 

10 Ziemer. I just wanted to -- I appreciate 

11 those comments, Lew, and I just wanted to echo 

12 that. I think it's a very important issue 

13 that we might need to deal with in terms of 

14 maybe developing some guidelines.

15 We have this situation even now at 

16 a number of sites. I think to some extent at 

17 Mound, at Fernald, at General Steel 

18 Industries. The tension between how much time 

19 it takes to get the science just right and 

20 closing out petitions is a very important 

21 issue.

22 DR. WADE: I did change the 
. 

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1 wording, Dr. Ziemer, based upon your edits of 

2 the report to best available science. In 

3 inappropriately used "right science" and Dr. 

4 Ziemer pointed out that employed that we were 

5 using the wrong science.

6 MEMBER ZIEMER: Yeah, that was the 

7 point I was trying to make. I just think the 

8 issue is a key issue that we need to grapple 

9 with and come to closure on in some organized 

10 way because when do we make that decision that 

11 we have gone as far as we should go?

12 DR. WADE: And when we come to 

13 Randy's comments, you'll see this point 

14 underlined again with regard to SEC petitions.

15 MEMBER ZIEMER: Right.

16 DR. WADE: In my report looking at

17 individual DRs it happens when the Board goes 

18 through the review of a Site Profile. It 

19 says, "We need to make certain changes." 

20 Those changes trigger the redo of individual 

21 dose reconstructions. That adds time but adds 

22 confusion. 
. 

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1 I'm not saying it's wrong but it 

2 needs to be managed consciously. I think Dr. 

3 Ziemer is right. We need to think about 

4 procedures for doing this that are uniformly 

5 followed that people can understand. Again, 

6 an important one to think about. Any other 

7 comments on that one?

8 Brad.

9 MEMBER CLAWSON: I just wanted to 

10 -- also one of the biggest things that I have 

11 seen is communication. A lot of people when 

12 we go into this process they don't understand 

13 it and the process of communicating to them is 

14 somewhat lacking. I don't know if that will 

15 come up or not. A lot of these people are 

16 older and so forth like that. 

17 All of a sudden they've got one 

18 dose reconstruction. Another one is being 

19 done. To communicate to them kind of a little 

20 bit more of a personal touch of explaining to 

21 them that we have found that there are some 

22 things we need to change. I think that is 
. 

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1 critical of the communication point.

2 DR. WADE: I think it's true. In 

3 fact, that point will be underscored by No. 7 

4 which is the third I would highlight here. 

5 That goes to the use of over or 

6 underestimating techniques, efficiency 

7 techniques versus the performance of a full 

8 dose reconstruction.

9 We do have situations where NIOSH 

10 in an attempt early in the program to get 

11 through this tremendous mountain of individual 

12 dose reconstructions would say let's do an 

13 overestimating approach on a dose 

14 reconstruction and, as a result of that, still 

15 result in a Probability of Causation less than 

16 50 percent. 

17 If there is a need to go back and 

18 redo that dose reconstruction and redo a best 

19 estimate for whatever reason, a new cancer, 

20 additional employment, change in science. 

21 Sometimes it comes back that the redo results 

22 in a lower PoC. 
. 

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1 This makes sense to us sort of 

2 scientific nerds inside the program. It makes 

3 absolutely no sense to the people out there 

4 who had 36 percent, another cancer. It comes 

5 back 24 percent. This is an unclimable 

6 mountain for NIOSH to deal with from a 

7 communications point of view. 

8 In the report I find that the time 

9 efficiencies realized by the use of over and 

10 underestimating techniques really aren't so 

11 great anymore. I'm not going to quote you the 

12 numbers. They are in the report. If you 

13 start to look at 2006, 2007, 2008, the savings 

14 in time of using overestimating techniques is 

15 not so great. 

16 I would offer the perspective that 

17 maybe it's time just to do best estimate dose 

18 reconstructions and remove this conundrum of 

19 how do you explain to people that a new cancer 

20 resulted in a lower dose and things like that. 

21 I think Dr. Howard will ask Stu to 

22 consider this issue and to speak to the cost 
. 

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1 that will result in terms of the increased 

2 time of only doing best estimates versus doing 

3 efficiency approaches. I think maybe the time 

4 has come to think about just doing best 

5 estimates and not have to try to climb this 

6 hurdle anymore. 

7 Brad, this is a communications 

8 nightmare that Solomon could not explain away 

9 to people I don't believe. That's 

10 recommendation No. 7. Any comments on that?

11 Okay. Now we'll come to No. 8. 

12 This goes to the vehicle of partial dose 

13 reconstructions. You guys know what that's 

14 about. If you grant an SEC, then people with 

15 the 22 cancers are compensated. People with 

16 the cancer other than those 22 have to have a 

17 partial dose reconstruction done.

18 I think the NIOSH, the Board, the 

19 Department of Labor have done a wonderful job 

20 of trying to see that partial dose 

21 reconstructions can include as much reasonable 

22 dose as is possible. I think we need to work 
. 

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1 harder at that. 

2 The way you work harder at that is 

3 making evermore precise the dose that is 

4 excluded from consideration in doing a partial 

5 dose reconstruction by the granting of a 

6 Special Exposure Cohort petition. Again, you 

7 have a little bit of an intellectual 

8 conundrum. 

9 To grant the SEC petition you have 

10 to say, "I can't do dose reconstruction." But 

11 it doesn't say I can't do everything. It 

12 says, "I can't do this." This is enough to 

13 warrant the granting of the SEC. Everything 

14 else is in play. 

15 I think the Board, I think NIOSH, 

16 I think the Department of Labor, have moved in 

17 a positive direction towards allowing as much 

18 dose to enter into a partial dose 

19 reconstruction as possible. 

20 I think we have to work even 

21 harder at it in the future to see that as much 

22 dose is allowed in to a partial dose 
. 

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1 reconstruction once the decision has been made 

2 to grant an SEC. Again, a fourth 

3 recommendation that would be highlighted here. 

4 Any comment on that? I know you 

5 guys struggle with that through your 

6 definitions. I think we just need to all work 

7 harder at it so that people who are not on 

8 that list of 22 cancers have their best shot 

9 at getting allowable dose considered in their 

10 partial dose reconstruction.

11 CHAIRMAN MELIUS: Lew, I'd have 

12 one comment on that. My only concern there 

13 because, first of all, I think we large do 

14 that now and I don't think it's as much of a 

15 problem as it may have been in the past.

16 Secondly, I do get concerned that 

17 given how long it takes to do an SEC 

18 evaluation and the review of that, adding 

19 additional tasks to that process is just going 

20 to delay it because I think the Board has some 

21 reluctance, at least some of us do, of 

22 approving the use of the method without having 
. 

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1 had the time to review it. 

2 We tend to concentrate in an SEC 

3 evaluation only on those exposures where there 

4 might be difficulty doing dose reconstruction 

5 or the situations. We don't tend to focus on 

6 what can be done.

7 I know it's come up in the past 

8 that by approving something that we haven't 

9 reviewed, we then at least give DCAS sort of 

10 the sense that the Board would then accept 

11 that in other situations without the benefit 

12 of any real in-depth review. I think the 

13 Board does need to do a better job of coming 

14 back and looking at sort of what we would 

15 refer to as Site Profile issues. 

16 You approve the SEC but there are 

17 these other issues out there that need to be 

18 looked at. I worry about trying to integrate 

19 it too much into the SEC evaluation process 

20 just on the basis of timeliness. You would 

21 add another several months, I think, to the 

22 process.
. 

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1 DR. WADE: Point taken. I agree, 

2 Jim. I think the record shows based upon your 

3 comment, and I'll certainly carry to Dr. 

4 Howard, I don't think that decision should 

5 slow the decision of the SEC. Once that 

6 decision is made, I think NIOSH has work to do 

7 in terms of these Site Profile issues, as you 

8 define them, to see what can be in and what 

9 can be out. That's where I think the work 

10 needs to be done, not prior to the making of 

11 an SEC judgement. Point well made.

12 MR. KATZ: Bob, can you use the 

13 mic, please? You have to turn these mics on. 

14 Thanks.

15 MEMBER PRESLEY: This is Bob 

16 Presley. On the SEC petitions I don't have a 

17 problem with us granting SEC petitions, but 

18 making some of these SEC petitions very, very 

19 large so that they encompass a tremendous 

20 amount of people that may not have had 

21 anything to do with working with radiation. 

22 It bothers me that cancer is one 
. 

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1 of the number one killers in the United States 

2 whether you worked with radiation or whether 

3 you didn't. It bothers me some that we have 

4 broadened some of these SEC petitions not only 

5 in the length of the SEC but also in the 

6 broadness of not tying down these SEC 

7 petitions to various parts of some of the work 

8 environments. Thank you, Lew.

9 DR. WADE: I think that's 

10 important point, Bob. Thank you for getting 

11 that on the record.

12 Anything more? If not, we'll move 

13 into the timeliness part that was ably 

14 authored by Nancy Adams. No. 2, "NIOSH should 

15 consider a target of 90 days or less to 

16 complete the dose reconstruction once 

17 information is in their hands."

18 Again, Stu talked this morning 

19 about nine months. Again, this is the finding 

20 of the author. I support the finding. I 

21 think Stu would support it as well. It has 

22 worked towards that but I think once 
. 

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1 information is in hand, once the tools are in 

2 place that 90 days is a target that could be 

3 achieved. It doesn't have to be achieved 

4 overnight but I think the movement has been in 

5 that direction from the years it used to take 

6 to the year it took last June to the nine 

7 months now. I think that 90 days might be a 

8 reasonable target and I think the author feels 

9 that.

10 John Howard can start to debate 

11 that with Stu and his staff as to if and when 

12 such a mark should be put in the sand but 

13 wouldn't that be a glorious day when it was 90 

14 days after the receipt of information that a 

15 dose reconstruction was done. I think it's 

16 within our sights.

17 No. 3, "NIOSH should give a higher 

18 priority to return claims in setting its goals 

19 for a timely completion of claims." Again, I 

20 think this is something that Stu has begun to 

21 work on. Again, you have this universe of 

22 claims that need to be dealt with, new dose 
. 

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1 reconstruction and then rework claims. I 

2 think the author's point, and I think I would 

3 agree, that priority needs to be given to the 

4 rework claims. People that have already been 

5 through the process once and for some reason 

6 have to go through it again, I think priority 

7 should be given to those claims as opposed to 

8 the next new claim. Again, I don't know if 

9 you have any comments on those two timeliness 

10 issues but they seem to make sense to me.

11 Now we are going to come to the 

12 most provocative part of the report, at least 

13 in my opinion, and that's the SEC piece, ably 

14 authored by Randy Rabinowitz. I will 

15 highlight some of the things but Randy is here 

16 to talk about them should you wish.

17 No. 2 is an old favorite, "NIOSH 

18 should revisit its interpretation of the 

19 statutory phrase, "with sufficient accuracy to 

20 give fuller effect to the role of scientific 

21 uncertainty."

22 We've all struggled with the 
. 

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1 definition of that phrase and what it means. 

2 Some of us feel there is a definition 

3 somewhere. Some of us feel that there isn't. 

4 I think Randy's point is that recognizing 

5 that there is uncertainty that surrounds 

6 everything, NIOSH needs to revisit its 

7 interpretation of the phrase. 

8 I think the Board talks about this 

9 from time to time. I think this would be an 

10 interesting one for Dr. Howard to begin to 

11 discuss with his staff as to how we go about 

12 that. 

13 I don't know if there is any 

14 comment on the record you would like to make 

15 or, Randy, if you have anything you would like 

16 to add on that one. Okay. Just a small 

17 simple little sentence that carries with it 

18 God knows how much work.

19 No. 3 is a complicated one. Let 

20 me speak to it and then, again, if you have 

21 comments or Randy can speak to it. "NIOSH 

22 should recognize that SEC petitions often 
. 

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1 raise science policy questions where science 

2 can inform the policy decision but that 

3 science may not provide the facts to govern 

4 these choices. 

5 NIOSH should clearly articulate 

6 these policy choices and should compare the 

7 policy choices it makes in reconstructing 

8 radiation dose across SEC petitions against 

9 other occupational health policy choices."

10 This goes to things like the use 

11 of coworker data, the use of surrogate data 

12 where, again, these are not simply science 

13 decisions but they do represent policy choices 

14 that NIOSH makes. 

15 Randy is saying, if I might 

16 paraphrase for her even though she's here, 

17 that NIOSH needs to clearly articulate these 

18 decisions and then it needs to weigh these 

19 decisions against other statements and other 

20 policies it follows in other aspects of 

21 occupational safety and health and, if there 

22 are differences, begin to articulate the 
. 

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1 reason and the rationale for such differences. 

2 We will be talking more about surrogate data 

3 on Thursday, coworker data. I think this 

4 points goes to that issue.

5 Randy.

6 MS. RABINOWITZ: This is Randy 

7 Rabinowitz. I would add another layer to that 

8 which is where there's scientific information 

9 at stake and science can provide answers, then 

10 deference to the judgment of scientists seems 

11 most appropriate.

12 But when you are choosing among 

13 really policy inferences, different people can 

14 reasonably bring different conclusions to it 

15 based on their own backgrounds and experiences 

16 often from different disciplines. Scientists 

17 don't necessarily have any monopoly on making 

18 good policy choices in those instances. If 

19 the policy choices are clearly articulated, 

20 different decision makers may come to 

21 different conclusions even if the science done 

22 by DCAS is done well and done with high 
. 

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1 professional quality, it's not a critique of 

2 their scientific work as much as just drawing 

3 a different policy conclusion from the same 

4 information.

5 DR. WADE: Bob.

6 MEMBER PRESLEY: Randy, when we do 

7 this now do we document this information so 

8 that down the road somebody can go back and 

9 say, "Yeah, this is what we did?"

10 MS. RABINOWITZ: More or less well 

11 depending. I don't think there's a consistent 

12 approach to it. I do think not being a 

13 scientist this may not be the greatest example 

14 but I'll try and offer one. There are certain 

15 uncertainties that surround all kinds of 

16 model. If you articulate what those 

17 uncertainties are, then it might be that the 

18 Board says this is more uncertainty than I'm 

19 willing to tolerate in my decision making. 

20 It's not that the modeling exercise was bad or 

21 it wasn't very sophisticated one but it's just 

22 that this is more than I think is reasonable 
. 

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1 and different people can have different 

2 judgments about it. Having the debate be 

3 between DCAS and SC&A sort of masks the fact, 

4 I think, that it's really just a policy 

5 choice. Other people could equally 

6 participate in the choice without in any way 

7 diminishing the scientific quality of the 

8 underlying evaluation.

9 MEMBER PRESLEY: Thank you.

10 CHAIRMAN MELIUS: Can I just each 

11 back? I think if you look in both No. 2 and 

12 No. 3 there are some key terms that we as the 

13 Board struggle with every time we are 

14 reviewing either dose reconstructions and more 

15 likely the SEC evaluations. 

16 Those are of sufficient accuracy, 

17 claimant friendliness, plausibility situation 

18 involved and so forth and that need to be 

19 narrowed down or not necessarily in a 

20 scientific way, though science would 

21 contribute to that, certainly to the 

22 sufficient accuracy but less so probably to 
. 

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1 claimant friendliness. I think coming to some 

2 agreement and some guidelines on those I think 

3 would be helpful for everybody involved in 

4 this effort.

5 DR. WADE: I think if prudent ears 

6 listen to the deliberations of this Board over 

7 the years, there is much to inform that 

8 process but it needs to be done. It needs to 

9 be done and someone needs to put it down and 

10 then let this Board react to it or let NIOSH 

11 leadership react to it.

12 MEMBER CLAWSON: Lew, this is 

13 Brad. Also the one that we hear quite often 

14 is professional judgment. I won't take it 

15 away, but these all kind of run together in 

16 the issues that we deal with.

17 DR. WADE: Just keep your comments 

18 for one second. I take you to No. 9 on 

19 Randy's list which says, "NIOSH's heavy 

20 reliance on expert judgment to evaluate SEC 

21 petitions is an inherently subjective criteria 

22 in the sense that reasonable experts can 
. 

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1 reasonably disagree about the outcome of any 

2 petition. 

3 NIOSH should consider developing 

4 objective criteria to limit the exercise of 

5 expert discretion so that similarly documented 

6 exposures are treated similarly across sites."

7 Brad, I think that's your point. 

8 I think that's Jim's point. I think it's an 

9 important point. It's not an easy point. 

10 It's not an easy thing to do but I think it 

11 needs to be done.

12 MEMBER CLAWSON: Something that 

13 Mr. Presley brought up was understanding what 

14 the process and what has been done. One of 

15 the things we've seen in the dose 

16 reconstruction, and Stu is working on getting 

17 a better -- when we look at their dose 

18 reconstruction, we can't come up with how they 

19 did it because there's been so many changes to 

20 different work books and so forth like that in 

21 the process. 

22 We're trying now to be able when 
. 

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1 the dose reconstructor goes through this that 

2 he makes a paper trail of what was used so we 

3 can understand because we can't determine how 

4 he did it.

5 DR. WADE: I think a very 

6 important point Randy makes. It doesn't mean 

7 that those of us who have practiced this art 

8 before are bad people. It just means that we 

9 can do a better job, a more definitive job, a 

10 more repeatable job. I think that's 

11 important.

12 Now I'm going to buck you down to 

13 Nos. 19 and 20. "NIOSH should consider 

14 creating presumptions to be applied across all 

15 SECs. Such presumptions should be based upon 

16 objective criteria. Increased use of 

17 presumptions would create more timely uniform 

18 decisions on SEC petitions."

19 No. 20 says, "In developing 

20 presumptions under EEOICPA NIOSH should take 

21 steps to ensure that its policy choices under 

22 this program are either consistent with its 
. 

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1 policy choices on related issues and other 

2 occupational health context are justified by 

3 the different statutes and regulations for 

4 each program."

5 When I asked Nancy for 

6 illustrative presumptions, you might be 

7 talking about dose reconstructions in the 

8 1940s and early '50s. Maybe there needs to be 

9 a presumption about those years that apply 

10 across SEC petitions.

11 You guys have worked with Super S 

12 plutonium and issues related to that. Maybe 

13 these become presumptions that apply across 

14 SEC petitions and we don't have to go through 

15 each time and work those issues. Maybe we can 

16 apply them across the board to petitions that 

17 come in. I think that's Nancy's point. 

18 Correct? Randy. I'm sorry. My wife's name 

19 is Nancy.

20 MS. RABINOWITZ: I think a lot of 

21 programs use presumptions so you don't have to 

22 repeat it. I was struck with data from the 
. 

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1 40s or internal thorium doses. The Board and 

2 NIOSH overwhelmingly SEC petitions are granted 

3 for the absence of internal thorium monitoring 

4 but there are few instances where NIOSH has 

5 modeled thorium doses in the absence of 

6 internal dosimetry. 

7 One question I would have as an 

8 outsider is it seems like that would be ripe, 

9 fertile ground for a presumption. If you were 

10 going to part from the presumption, then NIOSH 

11 would have an obligation to just clearly 

12 articulate the rationale for not applying the 

13 presumption in a particular instance and it 

14 would make it easier for the Board to judge on 

15 a policy basis whether it agreed with that 

16 choice or did not agree with that choice.

17 DR. WADE: Thank you, Randy. Not 

18 a trivial discussion but one that needs to 

19 take place.

20 I take you all the way down to No. 

21 27, one little sentence that carries with it a 

22 great deal of effort. "NIOSH should minimize 
. 

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1 revisions to Site Profiles while an SEC 

2 petition is pending." 

3 You know, it goes beyond those 

4 simple words. This goes to the issue of if 

5 the scientific basis for the evaluation of an 

6 SEC petition is constantly changing, then what 

7 burden does that put on the petitioners. The 

8 whole issue needs to be rethought. We lived 

9 through a number of situations where NIOSH 

10 says "I'm going to do it this way." The Board 

11 in its wisdom says, "Well, what about this and 

12 that?" NIOSH says, "I think I'll do it that 

13 way." Things change. It puts the petitioners 

14 in a very difficult situation and that needs 

15 to be thought through. I'm not saying that --

16 Wanda and I talked about fairness as a false 

17 god earlier today. I'm not saying that 

18 fairness is the answer to this but 

19 consideration of the position it puts 

20 petitioners in I think needs to be thought 

21 about by NIOSH as it imagines how it will 

22 conduct its business. Again, this goes back 
. 

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1 to the tension between getting it done to the 

2 best available science versus the playing 

3 field as it relates to petitioners. I think 

4 that needs to be thought about. Or Randy 

5 thinks that needs to be thought about.

6 MS. RABINOWITZ: One other comment 

7 which is the more revisions there are to 

8 method, the more it suggest to me that we are 

9 not talking about scientific facts and we're 

10 talking about inferences and policy choices 

11 from science because reasonable people are 

12 disagreeing about the methods and revising 

13 them constantly. I think it's just an 

14 illustration of an area where we are treading 

15 not in fact but in science policy.

16 DR. WADE: Thank you.

17 CHAIRMAN MELIUS: I would just --

18 I noticed you left No. 8 off your list but you 

19 had many to choose from and they were good 

20 recommendation. I do think that is also key. 

21 I think it's not just in terms of the 

22 methodology. It's also in terms of data 
. 

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1 availability. I think as we recognized in the 

2 last -- come to realize in the last year that 

3 despite a lot of efforts to gather all the 

4 data that DCAS and others think is available 

5 for a particular site, there always seems to 

6 be more data or new boxes discovered or more 

7 information. If SEC evaluations will stretch 

8 on for years, or the review of that stretches 

9 on for years, then I think we're almost bound 

10 to find new data along the way. That does 

11 really further because it's not just new 

12 methods. It's the new data that comes up. I 

13 think at some point going back to the 

14 recommendation on dose reconstruction, we just 

15 sort of have to close the books and say this 

16 is what we have now and let's reach a 

17 conclusion. I think we all recognize that in 

18 five or 10 or 15 years we may find more data. 

19 We may understand the science better in some 

20 way that these methods may -- what we thought 

21 couldn't be done in terms of dose 

22 reconstruction will now be feasible to do. We 
. 

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1 may have to revisit this, or revisit an SEC as 

2 much as we revisit a dose reconstruction. I 

3 think there needs to be some closure in terms 

4 of that part of it also.

5 DR. WADE: Thank you. For the 

6 audience No. 8 says, "NIOSH should consider 

7 limiting the number of revisions it makes to 

8 its SEC petition analysis." The harsh truth 

9 be told, that is what I thought I put the star 

10 next to and I put it next to the other one but 

11 they both make the point. It's a terrible 

12 thing to get old.

13 MEMBER CLAWSON: Lew, this is Brad 

14 again. On No. 27 where it says, "NIOSH should 

15 minimize revisions to the Site Profile," it 

16 also is kind of a catch-22 because when we go 

17 into the SEC a lot of things change and it 

18 puts a lot of dose reconstructions on hold. 

19 This is where the petitioners really have a 

20 hard time understanding, "How come can't you 

21 work it?" Some of these SECs have gone on for 

22 four years or even longer.
. 

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1 DR. WADE: This whole issue of the 

2 tension of completing it, getting it as 

3 complete as -- well, finding the best 

4 available science and timing is, I think, a 

5 mega issue. It appears in dose reconstruction 

6 and it appears more here.

7 I'm going to skip over the quality 

8 of science recommendations because you are 

9 going to have your shot at the author Dr. 

10 Daniels come Thursday. We'll go to the 

11 seemingly innocuous but really not innocuous 

12 recommendations relative to quality of 

13 service. In my opinion, these are maybe the 

14 most vexing. 

15 I'll take you to No. 7 which is --

16 MEMBER ZIEMER: This is Ziemer. 

17 Can I make one comment --

18 DR. WADE: Please, Paul.

19 MEMBER ZIEMER: -- on minimizing 

20 SEC revisions, or Site Profile revisions while 

21 an SEC is pending. I think in essence NIOSH 

22 does try to minimize the number of revisions 
. 

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1 by waiting until all of the issues are 

2 resolved on a Site Profile before a revision 

3 is made. 

4 That delay is actually 

5 implementing a number of revisions that have 

6 been agreed to. A case in point is General 

7 Steel Industries where we have agreed to a 

8 number of changes which would change previous 

9 dose reconstructions because when you make the 

10 change, then you have to go back and redo 

11 those dose reconstructions. 

12 There have been a number of 

13 changes agreed to but they are not yet 

14 implemented because not all of the Site 

15 Profile issues have been resolved. In the 

16 effort to minimize revisions, you are delaying 

17 all of those things. Many of those are 

18 underway while an SEC comes into play. There 

19 is a down side to doing what No. 27 talks 

20 about. That is not making the revisions as 

21 you identify the issues.

22 CHAIRMAN MELIUS: Can I comment? 
. 

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1 I need that recommendation. I agree with what 

2 you're saying, Paul, but I think that 

3 recommendation goes to the issues of that as 

4 part of the SEC evaluation review of that 

5 evaluation where DCAS then in response to the 

6 criticism then comes up with a new method 

7 which is essentially --

8 MEMBER ZIEMER: Which is driven by 

9 the SEC.

10 CHAIRMAN MELIUS: -- driven by the 

11 SEC. I think that is the problem. I agree 

12 with you that if it's another issue and there 

13 are problems with the contracting process. 

14 They may have already charged ORAU or whoever, 

15 the contractor, with making changes to the 

16 Site Profile. You don't want to stop that 

17 process. 

18 I think when the change or what is 

19 going on in terms of Site Profile or dose 

20 reconstruction methods is directed at the 

21 major issue that is under consideration for 

22 the SEC that it becomes problematic because 
. 

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1 you keep changing it. 

2 We've had SEC Evaluation Reports 

3 that basically say, "Well, we're going to try 

4 this method. If this method doesn't work, 

5 we'll get this data. If that method doesn't 

6 work, we'll try a third time." I think that 

7 part of it is the more problematic part. It's 

8 not looking at something that is just an 

9 agreement that dose reconstruction can be done 

10 but it could be done in a better way and the 

11 recommendation goes to that.

12 DR. WADE: The motivation to get 

13 it right or to get it complete is a good one 

14 but it goes against another value and those 

15 values need to be laid out and decisions made.

16 I would like to put on the record 

17 one very interesting finding from the DR 

18 piece. About 20 percent of the dose 

19 reconstructions that NIOSH does it redoes for 

20 whatever reason; change in science, new 

21 cancer, or new employment, 20 percent. 

22 Of that 20 percent 10 percent have 
. 

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1 resulted in the Probability of Causation going 

2 from below 50 percent to above 50 percent so 

3 there is benefit to all of this rework. One 

4 just has to put it in context. Enough said on 

5 that. 

6 If we go to the quality of service 

7 No. 7, I won't read you all the words but just 

8 the first sentence. "Not making changes to 

9 dose reconstruction because no DOE records 

10 were found seemed to indicate that DOE records 

11 are more accurate (and I would add 

12 parenthetically and more important) than 

13 worker comments."

14 We've all heard this. I think the 

15 recommendation needs to be considered by NIOSH 

16 leadership where workers say, "I remember 

17 this." They seem to come away with the 

18 feeling that their comment doesn't carry the 

19 work of some record. 

20 Maybe that's true but that 

21 communications issue needs to be dealt with. 

22 It's not trivial. It's a terribly powerful 
. 

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1 point that was found here by Ms. Chang and I 

2 think it needs to be talked about.

3 No. 10 reinforces something I 

4 think Brad or Phil said earlier. That is 

5 people feel they need more tutorials and 

6 workshops available to them to understand 

7 what's going on. We can always do a better 

8 job of bringing information to those we serve. 

9 I think that is a point that's made here and 

10 I think it's a powerful point.

11 No. 13 and 14 is the last I'll 

12 touch upon here. It basically speaks to the 

13 fact that through the CATI process submission 

14 of work history, although voluntary, they seem 

15 to place a great burden on the worker and a 

16 burden that is hard for them to meet because 

17 they are just a person without the resources 

18 of a government agency or a contractor. This 

19 whole idea of burden and where burden falls, 

20 even if you could say you don't have to do it, 

21 it seems in people's mind that it's in their 

22 best interest to do it, and yet there's a 
. 

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1 burden for them to meet that is hard for them 

2 to meet. NIOSH needs to think about where 

3 this burden is placed and how we might assist 

4 in their carrying of that burden.

5 Phil.

6 MEMBER SCHOFIELD: I would like to 

7 make one comment to that. Many of these 

8 cases, particularly some of the older 

9 facilities, you didn't talk about what you did 

10 at home so your families don't really know 

11 what kind of work went on behind those gates. 

12 Because of security concerns you weren't 

13 allowed to share any of this information. 

14 That puts a great deal of burden on people who 

15 have no way of knowing what happened.

16 DR. WADE: So I think this whole 

17 issue of burden needs to be thought about.

18 That's the end of the 

19 recommendations I would highlight. In the 

20 minute I have, let me make one promise to you. 

21 Dr. Howard will meet with his leadership. 

22 He'll come to a list of recommendations that 
. 

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1 he thinks should be implemented and a draft 

2 list of recommendations that he thinks should 

3 be implemented and some beginning thoughts as 

4 to how those recommendations should be 

5 implemented. The Board will see that in draft 

6 form before it's final. You will get to react 

7 to Dr. Howard's reaction to this list of 87 

8 and you'll have another opportunity to say, "I 

9 think you left out something terribly 

10 important. I think your approach needs to be 

11 modified." So you'll get another bite out of 

12 the apple when this comes back to you. Again, 

13 Dr. Howard meets with his people in early 

14 June. I don't know if we'll have something 

15 for the next Board call. Certainly by the 

16 next Board face to face you'll see a draft of 

17 Dr. Howard's implementation plan and you can 

18 react to that. Again, sorry for the long19 winded tutorial but I think it was worth 

20 sharing this with you. Individual comments, 

21 collective comments. Again, remember that we 

22 value the transparency of this exercise. 
. 

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1 Anything you want to say to us as individual 

2 Board Members, please say on the docket as 

3 well so everyone can read your comments. The 

4 docket will remain open for individuals to 

5 make comment on not only Phase I but also Dr. 

6 Howard's draft Phase II. Thank to the Board 

7 for their forbearance today, but also for the 

8 tremendous foundation you've provided for the 

9 conduct of this review. You have to see 

10 clearly your hand in the basis of what was 

11 done here and I commend you for your work.

12 CHAIRMAN MELIUS: Don't leave yet.

13 Mark, are you still on the line? 

14 You have one comment. Mark was going to be on 

15 and off this morning. If not --

16 MEMBER GRIFFON: Yeah, I'm on.

17 CHAIRMAN MELIUS: Do you want to 

18 make that comment?

19 MEMBER GRIFFON: Which one? I 

20 have several.

21 CHAIRMAN MELIUS: Oh, go ahead.

22 MEMBER GRIFFON: Looking at the 
. 

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1 last section you presented, Lew, I was looking 

2 at Item 3, and also later in that section, 

3 Item 13, a couple things struck me. In my 

4 opinion this is more than just a communication 

5 issue with the claimant. 

6 There is serious consideration 

7 around the impression that they can provide 

8 that and it can be useful in the overall 

9 program of dose reconstruction. The same, I 

10 guess, for Item 13 with the CATIs. 

11 I think that is something that we 

12 touched on in the Dose Reconstruction 

13 Subcommittee as well for our first 100 cases 

14 review. The other thing that strikes me is 

15 that those two items are in the quality of 

16 service section rather than dose 

17 reconstruction section. 

18 I wonder if that is something that 

19 sort of is reflective of how NIOSH is 

20 perceiving the use of that information. It's 

21 more of a service to customer issue rather 

22 than a serious information resource. I just 
. 

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1 wanted to make those comments.

2 DR. WADE: Point well taken. I 

3 would encourage you to read this change report 

4 where what she tried to do was listen to new 

5 information that was presented by people in 

6 CATI and then follow that through to see 

7 whether or not NIOSH reacted to that 

8 information or used that information. 

9 That's the basis of the points 

10 Mark is making. I never thought about what 

11 you said, Mark, as to where it appeared and 

12 whether that speaks to a mindset. I think 

13 there is something maybe there to think about.

14 CHAIRMAN MELIUS: I agree. I

15 thought her report was very useful. Mark's 

16 other comment, earlier comment I was referring 

17 to, was in Randy Rabinowitz' report on the SEC 

18 was No. 24 he wanted to highlight also. 

19 "NIOSH should reduce delay between filing of a 

20 claim and decision that a petition under 83.14 

21 should be pursued." That may be more of a 

22 process now but I think it speaks to the fact 
. 

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1 that we've had these long delays for giving up 

2 on some of these 83.14s, or in terms, I think, 

3 developing the information that would be 

4 needed for doing dose reconstruction. I'm not 

5 sure how many of those are left but on an 

6 ongoing basis I think it would be helpful. I 

7 think DCAS has been improving at doing that.

8 DR. WADE: This goes back to the 

9 early triage, sites with large numbers of 

10 cases and putting focus on those and let some 

11 of the smaller sites to later in the queue. I 

12 think that's partial explanation but I think 

13 it's a good part. All of these will be 

14 considered. 

15 Ma'am.

16 MEMBER BEACH: I have a question. 

17 It looks like you've gotten quite a few 

18 comments from workers on the docket. I know 

19 from the Board and other folks some of them 

20 are making it into the report. Some of the 

21 comments may be important but not to the level 

22 of getting into these reports. How are you 
. 

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1 handling those comments to get back to the 

2 public based on the comments that they've 

3 made?

4 DR. WADE: Well, first, the 

5 comments that come in are sort of triage to 

6 the authors for consideration and then 

7 inclusion. I think at the end of the process 

8 it would be incumbent upon us if possible to 

9 respond back to the author saying, "We heard 

10 your comment. We modified the report in a 

11 certain way." Or, "We heard your comment and 

12 we didn't modify the report." In some cases 

13 we don't know who made the comment.

14 MEMBER BEACH: Oh, is that true?

15 DR. WADE: Where possible I think 

16 we would try to close the loop at the end.

17 MEMBER BEACH: Okay.

18 DR. WADE: Right now we're sending 

19 the comments to the appropriate authors. They 

20 are to be included in the appendix of each 

21 report and the report is modified based upon 

22 the office consideration as to whether it 
. 

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1 should be done or not.

2 MEMBER BEACH: I guess I was 

3 interested in the ones that didn't make it to 

4 any of the authors but it sounds like you --

5 DR. WADE: If it hasn't been given 

6 to any author, it would appear in the final 

7 summary. All the comments will appear. If we 

8 didn't think it related to one of the five 

9 sections, then it wasn't dealt with but it 

10 would be included on the record.

11 MEMBER BEACH: I read some of them 

12 and they are in a great deal of detail. Thank 

13 you.

14 DR. WADE: Thank you. 

15 MEMBER CLAWSON: Lew, I have one 

16 more. On 27 where NIOSH should minimize the 

17 revision Site Profile, that also falls under 

18 something to the Board's responsibility, 

19 especially as a Work Group chair myself. When 

20 we go through this SEC process, we may have 

21 20, 30, 40 different changes to the Site 

22 Profile from the information that we receive 
. 

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1 but then we've got to go back -- say an SEC 

2 was granted, we've got to go back to the Work 

3 Group and assure that these changes were made, 

4 too. I think that falls under the Board's 

5 responsibility.

6 DR. WADE: This was not undertaken 

7 as a review of the Board but we're in this 

8 together.

9 MEMBER CLAWSON: That's part of 

10 the thing is NIOSH takes that on but then we 

11 don't see anything after that.

12 DR. WADE: Enough. Thank you.

13 CHAIRMAN MELIUS: Thank you, Lew.

14 Next on the program we have an 

15 update from Department of Labor. I'm not sure 

16 how you're going to do this. We have a new 

17 person, a new face. Welcome, Gary Steinberg, 

18 who -- I'm not sure of the exact title but 

19 it's at the Department of Labor. I should 

20 know this. I've heard you speak a few weeks 

21 ago and I've already gotten the title. 

22 Welcome, Gary.
. 

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1 MR. STEINBERG: Thank you. It's a 

2 pleasure to be here. Good morning to 

3 everybody. I guess I want to start by 

4 congratulating you on your 77th meeting. I 

5 think that is certainly reflective of the 

6 enduring value that the Board has and the 

7 important role that the Board has in terms of 

8 working with us in DOL, working with NIOSH, 

9 working with Energy, and to carry out the 

10 program in a highly effective way.

11 My name is Gary Steinberg and I'm 

12 now the Acting Director for the Office of 

13 Workers Compensation Programs. I guess I'll 

14 put it into context. As I shared with you 

15 just a couple of weeks ago, I'm new to DOL but 

16 I'm not new to the federal government. I've 

17 been in the federal government for 21 years.

18 I spent nine years at NASA so I 

19 know a little bit about science but more of 

20 the rocket science and the space science side 

21 of things so I've had an opportunity to 

22 support the Aeronautics and Space Program.
. 

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1 I spent about three-and-a-half 

2 years actually at HHS in one of the 

3 headquarters organizations, and nine years at 

4 the Department of Veterans Affairs. In that 

5 respect, if you will, providing health care 

6 and benefits as the Deputy Assistant Secretary 

7 for Planning and Evaluation looking across all 

8 of the programs in terms of where the 

9 organization should be going and how the 

10 organization can better serve the veteran 

11 population and their families.

12 One of the opportunities, though, 

13 that I had when I was at VA was to look at the 

14 Department workers' compensation program and 

15 the safety program. These were programs that 

16 really were in difficult straits.

17 Our IG had done a comprehensive 

18 review of the workers' comp program and 

19 determined that there were a number of major 

20 flaws with the operations of the program, 

21 communications, training, a whole variety of 

22 different things. 
. 

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1 We endeavored to, if you will, 

2 evaluate the program and we put together a 

3 strategic plan and an implementation plan. 

4 This was all new to me but, quite honestly, I 

5 was asked to lead the implementation of the 

6 plan once it was developed. 

7 Over a four or five-year period I 

8 developed, if you will, a great appreciation 

9 for the importance of all different types of 

10 workers' comp programs. The reality over a 

11 five-year period we became a best practice and 

12 that's where I met Shelby Hallmark, the 

13 individual who brought me to DOL and who 

14 suggested that I be his successor. 

15 Shelby's thought was with the 

16 hands-on experience at the Department of 

17 Veterans Affairs dealing with, if you will, 

18 both planning, operational issues, and 

19 implementation that I could bring some of the 

20 best practices to DOL for not only the Federal 

21 Workers' Comp Program but for the other 

22 programs that we have responsibility for as 
. 

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1 well including the Energy Program, the Black 

2 Lung Program, the Long Shore Program, and the 

3 DBA Program where we provide service to 

4 civilians who were supporting the government. 

5 That's exactly what I hoped to be able to do. 

6 With that, I really would want to 

7 turn and applaud Stu and Lew and others at 

8 NIOSH for after 10 years taking a 

9 comprehensive look at their aspect of the 

10 program and really being able to look and 

11 coming up with 78 initiatives. 

12 As you suggested, there are 

13 probably more that have been melded into the 

14 78 but you have an opportunity to really look 

15 at where are we now. How do we move forward 

16 after 10 years of operations. 

17 How can we improve operations. 

18 How can we improve efficiency. I've heard 

19 talk about how we improve customer 

20 satisfaction. That is something core to what 

21 I want to achieve at DOL as well. 

22 I won't go into the specifics of 
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1 what we do at DOL because you already know. I 

2 know that Rachel and Shelby have talked to you 

3 in the past. Let me talk a little bit about 

4 some of the things that I view as priorities 

5 as we move forward and I think they directly 

6 correlate with the conversation that you've 

7 had thus far this morning. I think we're in 

8 lock step and moving forward.

9 In organizations that I've gone 

10 into and, again, I've been a senior executive 

11 for 13 years, and oftentimes brought into 

12 organizations that have problems either from 

13 an operational perspective or a customer

14 satisfaction or an employee dimensioned 

15 perspective, I don't think we have that within 

16 the Office of Workers Compensation Program but 

17 I do think we have an opportunity for 

18 continuous improvement. 

19 I think that's what NIOSH is 

20 looking at as well. In that respect I really 

21 see four overarching themes that we're going 

22 to be looking at across all of our OWCP 
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1 programs. The first is maintaining high 

2 levels of customer satisfaction. 

3 I've only been there for six 

4 months but one of the things that we've 

5 already instituted is a new electronic 

6 customer satisfaction survey. It's not highly 

7 complicated. It has seven questions to it. 

8 We're looking at, not if you will, the outcome 

9 and the decision with regard to a particular 

10 claim but the nature of the interaction. 

11 Was our staff responsive, did they 

12 provide a timely response, were they 

13 knowledgeable, were they able to provide 

14 answers, were they courteous, and what was the 

15 over level of satisfaction with regards to the 

16 engagement and the interaction. 

17 I think it's important we look at 

18 that for anybody who wants to share with us 

19 the good, the bad, and the ugly because the 

20 good we can enhance. The bad and the ugly, 

21 well, we need to be aware of that so we can 

22 improve on things. 
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1 I don't think we have too many bad 

2 and uglies with respect to the nature of the 

3 interaction. Clearly we are going to have 

4 individuals who are frustrated on any one of 

5 our four programs when their claim is denied. 

6 I think what we're talking about 

7 here in terms of making sure that we have a 

8 good science based decision as to acceptance 

9 or denial, that's fundamental to what we're 

10 doing. Customer satisfaction, I think, is job 

11 one from my perspective.

12 Two is continuing to enhance our 

13 operations and our effectiveness. I talked 

14 about continuous improvement. I don't think 

15 that any of the programs that we have 

16 responsibility need to be re-engineered. They 

17 don't need to be blown up and restarted. 

18 They need to be continuously 

19 improved and we're going to be looking for 

20 ways to continuously improve our operations, 

21 our implementation, improving timeliness, 

22 improving quality, improving the nature of the 
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1 interaction with our claimants. Improving 

2 internal and external communication. 

3 That is something that you talked 

4 about in terms of the dialogue, not only with 

5 the claimants but with the stakeholders as 

6 well. I think even with a program that is 10 

7 years old there is always an opportunity to 

8 improve the level of engagement, improve the 

9 level of communication because things change 

10 and people need to receive information as the 

11 program changes and the requirements change 

12 and so forth. 

13 That's going to be the fourth 

14 priority. I'm sorry, the third priority. The 

15 fourth priority is working with our internal 

16 workforce. I think, as everybody knows, 

17 within the federal government we're, if you 

18 will, at a cusp of the detention for 

19 retirement. 

20 I want to make our office an 

21 office where people want to come to work, 

22 where they feel motivated, they feel excited, 
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1 they feel rewarded, and they want to keep 

2 doing the great work that they're doing 

3 because I think by in large we have a 

4 passionate and highly dedicated workforce and 

5 I want to make their work environment even 

6 better for them. 

7 Those are really going to be the 

8 priorities that we're going to be focusing on 

9 in the years to come. I think it coalesces 

10 from what I've heard from NIOSH. I hope these 

11 are concepts and theories that you endorse and 

12 over time we'll provide you with updates in 

13 terms of how we're progressing as an 

14 organization.

15 When I look at those four 

16 priorities, two of the things are really 

17 fundamental to where we are moving forward on 

18 the energy program. The first is obviously 

19 outreach and community. I know that Rachel 

20 and her leadership team have endeavored to 

21 develop the joint outreach task force working 

22 hand-in-hand with NIOSH, with DOE, with our 
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1 ombudsman. 

2 You play a role in that as well in 

3 terms of the Board and in terms of your 

4 findings and recommendations. We need to be 

5 able to communicate to both stakeholders as 

6 well as to claimants. That's a core function 

7 in terms of moving forward. 

8 It's something that I endorse and 

9 it's something that we're going to be 

10 monitoring and hopefully, again, we'll be able 

11 to share more with you in terms of how that's 

12 progressing, where we are experiencing 

13 successes. 

14 I welcome input from you in terms 

15 of areas where you think we can do a better 

16 job in terms of communication and outreach 

17 both in terms of the fundamental tenants of 

18 the program, what the eligibility requirements 

19 are, what the process is, but also the changes 

20 that are taking place as we look at the SECs 

21 and we look at other aspects of the program.

22 The other areas from an 
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1 operational perspective. Lew in his 

2 discussion talked about timeliness. Obviously 

3 that is something critical from our 

4 perspective as well. It shouldn't take three 

5 years to make a determination. It's something 

6 that we should be able to do much sooner 

7 because lives depend on this. 

8 The well being of individuals 

9 depend on this and it's something that we need 

10 to do as quickly as we possibly can. Clearly 

11 one of the things that I'm going to be working 

12 with with Rachel with the help of you and 

13 others is how can we make our process more 

14 timely, more effective. 

15 How can we maintain the high 

16 levels of quality that we have. Those are two 

17 of the things that I think have even been 

18 reinforced this morning that we're going to be 

19 focusing on as we move forward.

20 Before I turn the podium over to 

21 Rachel, I guess I wanted to acknowledge just a 

22 couple of people. With me today is Jeff 
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1 Nesvet. Jeff has been the counsel, the 

2 associate listener on this program since the 

3 onset. He was involved in the development of 

4 the statute. 

5 I would suggest that there are a 

6 lot of attorneys in the federal government, as 

7 we all know, but I think he's one of the best. 

8 I've worked in four different departments. I 

9 think it's a rarity when you have an 

10 individual who is so well versed on both the 

11 program as well as the law. I encourage you 

12 to spend some time talking with him over the 

13 day.

14 Janette is our regional director 

15 in Denver. I think she does a marvelous job 

16 in terms of the interaction with the 

17 stakeholder community, with the claimants and 

18 so forth. She volunteered her and her staff 

19 to come and help with some of the 

20 administrative work over the next couple of 

21 days. 

22 I think that is emblematic of the 
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1 nature of the program and the people that we 

2 have. Then I'll finish off with Rachel who in 

3 the short time that I've known her this is the 

4 future of the government. 

5 This is the type of people that we 

6 need to nurture and grow because she's 

7 passionate about the program day in and day 

8 out, both of her employees as well as the 

9 claimants that we serve as well as the 

10 stakeholders that we work with. 

11 I'm very pleased now to turn the 

12 podium over to her. She's going to talk a 

13 little bit about some of the things that we're 

14 moving forward with and some of our 

15 priorities. I look forward to the 

16 opportunities to talk with many of you during 

17 the day. 

18 Although this is your 77th 

19 meeting, this is my first meeting. You can 

20 count on me being at more of these meetings. 

21 I'm passionate about serving the public. 

22 That's why I came to work in the federal 
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1 government 21 years ago. 

2 I think the Department of Labor is 

3 the foundation of what serving the American 

4 public is about. You an expect to see me for 

5 many more years to come. I applaud you for 

6 the work that you're doing for the individuals 

7 who have supported the country in terms of our 

8 nuclear weapons. Thank you and I look forward 

9 to working with you in years to come.

10 MS. LEITON: Thank you, Gary. 

11 I'm very happy that Gary is with 

12 us. I think he's going to lend some positive 

13 support to the program. I think we are going 

14 to be able to work closely together on some 

15 improvements on customer service and various 

16 other factors in service to our workers.

17 Before I run through the 

18 presentation, I just wanted to mention a 

19 couple of things we have done in the last 

20 year. We did have a customer service 

21 satisfaction survey that we conducted last 

22 year with all of our -- well, random 
. 

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1 selections of claimants. That included 

2 survivors. 

3 It included people who were denied 

4 benefits, who were accepted benefits, who had 

5 hearings, who had not had hearings just to ask 

6 them what their experience was with the 

7 process, with the letters that they got, with 

8 the communication with our hearing reps and 

9 our district office staff.

10 The results of that were actually 

11 not -- they were fairly positive in that 71 

12 percent of them said they would recommend the 

13 program to others. Of course, we found that 

14 the ones who had been denied benefits were a 

15 little bit more frustrated than those who had 

16 been approved.

17 One thing in particular that we 

18 did take away from it, as I believe Lew Wade 

19 had pointed out, is the complication of the 

20 program and the frustration with the claimants 

21 with the process. They don't understand all 

22 the various complexities. That's one of our 
. 

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1 priorities that we've been working on in the 

2 last year is to try to make it a little bit 

3 more understandable.

4 We revised our procedure manual 

5 for our claims examiners combining Part B and 

6 Part E. As you know, we've had -- you may or 

7 may not know we've had two separate procedure 

8 manuals since we had two separate programs but 

9 it's really one program. 

10 We revised that and we've combined 

11 it, updated it with various changes that have 

12 occurred over the years. That's currently 

13 online for everyone. It's helpful for our 

14 claims examiners. 

15 In addition to that we are about 

16 to publish a new recommended decision chapter 

17 which kind of makes the process for how we 

18 explain the decisions a little bit easier for 

19 the claimants to understand I'm hoping. 

20 Basically the format is a little bit more 

21 claimant friendly. 

22 Various little things like that we 
. 

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1 are hoping to make a difference. We've also 

2 developed more brochures that explain wage 

3 loss, impairment, our process for recommended 

4 decisions and final decisions. Those are the 

5 sorts of customer service activities that 

6 we're engaging in at the moment to just try to 

7 help them understand, the claimants 

8 understand, our process.

9 We are also going to be conducting 

10 some more training at our district offices 

11 that actually conduct training on a regular 

12 basis that they have new staff or new 

13 procedures come around. 

14 Our national office staff is going 

15 to go out and talk to our claimants and 

16 families, train them a little bit on various 

17 factions of the program that may be more 

18 complex than others. I'm hoping that will 

19 also help to improve customer service.

20 As Gary mentioned, we have new 

21 goals that we are going to be looking at for 

22 Fiscal Year '12. High priority goals with 
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1 regard to overall processing times from 

2 beginning to the end of the process. NIOSH 

3 looking at your processing time will affect 

4 our processing time in terms of those goals in 

5 the years coming forward. 

6 I think we've seen improvements in 

7 the amount of time that it's taking at NIOSH. 

8 I think working together with NIOSH we'll be 

9 able to improve that overall for the claimants 

10 who are the ones that become the most 

11 frustrated with our processes and our 

12 processing time.

13 In addition, our website we are 

14 looking at ways to make it more claimant 

15 friendly, help claimants so that maybe they 

16 can determine and have a better understanding 

17 exactly what the process means, where their 

18 claim might be in the process, that sort of 

19 thing.

20 We also have a new medical 

21 director in the last year who has been working 

22 with us on medical directives. She just 
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1 conducted training with all of our district 

2 offices. She is still in the process but I 

3 think she's almost done.

4 Just on some basic concepts, 

5 understanding better some of the cancer 

6 diagnoses and all of our Part E conditions. 

7 I've heard from the districts that's been a 

8 pretty beneficial training for our claims 

9 examiners.

10 She's also working with our 

11 district medical consultants and having 

12 regular telephone calls with them so that 

13 their reports are a little bit more consistent 

14 across. 

15 It's always difficult for doctors 

16 to have the same format and they are obviously 

17 not going to have the same opinions but 

18 understanding what causation means and that 

19 sort of thing, what we are looking for in our 

20 reports and how we can best serve our claimant 

21 population. Those are just some of the things 

22 that we're looking at right now, what we've 
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1 been moving forward on.

2 Now I'll go through our 

3 presentation. As most of you know, the 

4 program was enacted in October of 2000. We 

5 had a Part B and a Part D at that time. Part 

6 D was administered by the Department of 

7 Energy. Then in 2004 they abolished Part D 

8 and they created a federal program called Part 

9 B. All of the cases that were with Department 

10 of Energy were transferred to Department of 

11 Labor to administer Part E.

12 Over the last 10 years we've had 

13 almost 144,000 cases filed. Now we've just 

14 hit over $7 billion of compensation paid to 

15 date. As you know, we have four different 

16 federal agencies involved in the program, 

17 Labor, Energy, HHS, and Justice. 

18 We do have four district offices 

19 in Jacksonville, Cleveland, Denver, and 

20 Seattle. Our Washington, D.C. national office 

21 is in our Final Adjudication Branch. As I 

22 indicated, of the $7 billion we have a 
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1 majority in Part B. The rest are in Part E 

2 and 11 percent of that in medical.

3 For the number of payees that 

4 we've actually been able to compensate, a 

5 majority, again, are Part B cases, 60 percent 

6 and 40 percent for Part E.

7 There are very important 

8 distinctions between Part B and Part E with 

9 regard to employment factors. That would be 

10 that under Part E just DOE contractors and 

11 subcontractors and that's also under B but B 

12 is more inclusive in terms of coverage for DOE 

13 federal employees, Atomic Weapons Employers, 

14 beryllium vendors. Those are not covered 

15 under Part E. 

16 The relevancy to a case that is 

17 accepted from NIOSH if it's a Part B case, 

18 it's going to be accepted under Part E but 

19 they have to have met these eligibility 

20 criteria under E so those AWEs will not be 

21 covered. RECA, Radiation Exposure 

22 Compensation Act, is covered under Part B.
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1 Again, very important distinctions 

2 between the two parts are the covered 

3 conditions. Under Part E pretty much 

4 essentially any condition that an individual 

5 develops that is related to toxic substance 

6 exposure would be covered. Under Part B there 

7 are only four conditions; that's CBD, 

8 beryllium sensitivity, chronic silicosis, and 

9 cancer.

10 Survivor definition is also 

11 different under Part B and Part E. As you can 

12 imagine these differences are rather 

13 frustrating and confusing to claimants but 

14 that's the way the law was written. We try to 

15 explain it to them as best we can. Basically 

16 adult children are covered under Part B and 

17 they are not under Part E. That's the main 

18 distinction there.

19 Benefits between the two parts. 

20 Under Part B there's a lump sum compensation 

21 of $150,000 for an employee survivor. For 

22 RECA employees it's a $50,000 lump sum. Under 
. 

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1 Part E it's impairment and wage loss. 

2 Impairment is $2,500 per 

3 percentage of whole person impairment as 

4 determined by a medical physician and testing 

5 that's conducted. Or wage loss which is 

6 between $10,000 and $15,000 depending on the 

7 level of wages that were lost as a result of 

8 the covered condition. For survivors under 

9 Part E it's $125,000. The cap is $400,000. 

10 The main difference for Part E really is that 

11 they can receive ongoing compensation. 

12 If they have an impairment and 

13 then it worsens over the next two years, they 

14 can file again. And the same for wage loss. 

15 That can be an ongoing benefit which is 

16 different from Part B which is just lump sum 

17 compensation. 

18 Some of the challenges that we 

19 have are probably similar to the challenges 

20 that NIOSH has with regard to the data that is 

21 available out there. One of our challenges is 

22 to verify employment and obtaining records. 
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1 We go to various lengths to assist 

2 claimants in verifying this employment that's 

3 going to the Department of Energy first and 

4 foremost. Then we also have access to the 

5 ORISE database which has various information 

6 about where people worked.

7 The Center for Construction 

8 Research and Training, CPWR. We also look at 

9 corporate verifiers, SSA wage data and 

10 affidavits. This becomes very important, as 

11 you know. When it comes to SEC Classes trying 

12 to place people in particular locations can be 

13 a challenge. A Class Definition is very 

14 specific, that's where we run into challenges 

15 at certain times. We try to work as closely 

16 as possible with NIOSH to let them know where 

17 our challenges may lie.

18 MEMBER FIELD: Can I ask a 

19 question?

20 MS. LEITON: Yes.

21 MEMBER FIELD: For Social Security 

22 wage information do you have data prior to the 
. 

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1 70s?

2 MS. LEITON: They have --

3 MEMBER FIELD: Employer specific?

4 MS. LEITON: Yes. Well, they do. 

5 Often times that data is more scare that they 

6 have to go back to microfiche. They can do 

7 it. It's a little bit more time consuming and 

8 it's usually a certain cutoff where they 

9 divide it into quarters, when they don't, but 

10 we are able to get information from them.

11 Okay. Dose reconstruction 

12 probably causation. Obviously dose 

13 reconstructions are conducted by NIOSH and 

14 determine the level and extent of occupational 

15 radiation dose. A Probability of Causation is 

16 undertaken which is a scientific calculation 

17 of likelihood that radiation exposure, cause 

18 of cancer. 

19 Department of Labor uses the NIOSH 

20 IREP database system to determine the PoC 

21 based on the dose reconstruction what is 

22 conducted by NIOSH. If once we have used that 
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1 report and plugged it into the program, it's 

2 50 percent or greater, then an individual is 

3 compensated. Otherwise, they are not.

4 Special Exposure Cohort. Probably 

5 don't need to go into this too much, as you 

6 all know, but it's a worker group designation 

7 of presumption that the occupational radiation 

8 causes cancer. You have to have had 22 

9 cancers that are named in the law. If you 

10 don't, hopefully there's a partial dose 

11 reconstruction available to the employees.

12 There's also employment work 

13 criteria. In the majority of cases that's 250 

14 workdays having worked in a particular 

15 location for a particular time frame that is 

16 defined by HHS. If an individual is 

17 determined to have fit into that Class, they 

18 do not have to undergo dose reconstruction.

19 There were four legislative SEC 

20 Classes at three gaseous diffusion plants plus 

21 Amchitka. NIOSH also designates new SEC 

22 Classes and thus far there have been 72 
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1 additional SEC Classes added as of May 24th.

2 We adjudicate the SEC Classes but we have no 

3 role in the actual designation of those 

4 Classes.

5 Just some of our statistics here. 

6 We've approved overall 32,000 cases and about 

7 22,000 have been denied. A majority of the 

8 reason for that is the PoC less than 50 

9 percent under Part B. Then the second is that 

10 sometimes we do not get enough medical 

11 evidence to support the claim.

12 Part E briefly. As I indicated, 

13 you have to establish that any toxic 

14 substances they were exposed to in the work 

15 place caused the condition, caused, 

16 aggravated, or contributed to a condition and 

17 the causation standard is at least as likely 

18 as not.

19 We have various tools that we work 

20 with to establish causation under Part E. We 

21 conduct occupational health questionnaires 

22 with the claimants, either the employees or 
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1 their survivors. We've developed a Site 

2 Exposure Matrix which is basically a tool that 

3 is used by our claims examiners. 

4 We found that early in Part E our 

5 claims examiners weren't able to place people. 

6 They weren't able to determine what they 

7 might have been exposed to. The claimants 

8 were having a difficult time providing us with 

9 that information. 

10 Although it's their burden, we 

11 wanted to help our claims examiners and help 

12 our claimants to try to establish exposure so 

13 we developed the Site Exposure Matrix working 

14 in close collaboration with the Department of 

15 Energy. 

16 It's basically a database that 

17 provides information about facilities, the 

18 buildings that were there, what types of 

19 exposures might have been there. Then there's 

20 a link to Haz-Map which is a relational 

21 database which determines in some cases what 

22 an individual might have been exposed to that 
. 

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1 was related to a condition. 

2 The SEM is not an end all and be 

3 all. It's just a tool to assist the claims 

4 examiners in adjudication and development of 

5 the claim. We also rely on the document 

6 acquisition request from the Department of 

7 Energy, Former Worker Program work history 

8 interviews, CPWR. The DOE had position panel 

9 findings from Part D that we also used in this 

10 determination. We also rely in some cases on 

11 affidavits and facility records.

12 Under Part E this is our 

13 distribution for final decisions. We have 

14 approved almost 27,000. We have denied about 

15 22,000. You'll see here that the PoC is a 

16 factor in some of these denials. For cancer 

17 cases related to radiation we do rely on the 

18 dose reconstruction process for Part E. 

19 We will be able to accept a cancer 

20 if we determine that a different toxic 

21 substance other than radiation caused it. In 

22 a lot of cases since it is an "at least as 
. 

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1 likely as not" threshold we do rely on dose 

2 reconstruction for that.

3 This is our information on the 

4 NIOSH referral case status. As I indicated 

5 earlier, I believe there's been a lot of 

6 improvement over the last several years in 

7 terms of the timeliness, the amount of cases 

8 that have been returned from NIOSH. We've had 

9 34,000 referrals and 32,000 have been 

10 returned, some with dose reconstruction, 4,000 

11 without dose reconstruction. Our records 

12 indicate there are approximately almost 2,800 

13 cases that are currently at NIOSH, 2,100 of 

14 which are initial referrals and 668 which are 

15 reworks or returns to NIOSH.

16 I know that Jeff has been through 

17 this with you before. Our statistics 

18 sometimes are a little at variance with 

19 NIOSH's but that is partly because of the way 

20 we define certain items.

21 SEC Classes that had been added. 

22 There have been almost 3,300 cases withdrawn 
. 

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1 from NIOSH for SEC Class review. We've issued 

2 almost 3,000 final decisions of which almost 

3 2,900 have been final approvals. Right now we 

4 have 24 recommended decisions awaiting final 

5 decision. 

6 There are 80 cases total pending 

7 from all the SEC Classes and 275 cases were 

8 closed. Either they weren't eligible -- for 

9 some reason they were not eligible. We also 

10 have five new Classes that were just added and 

11 we're working on the bulletins for those. 

12 We've actually been very successful in meeting 

13 our goals. 

14 Once an SEC is created we have 

15 very specific goals for issuing a recommended 

16 decision, particularly in those that have been 

17 screened and determined will likely be in the 

18 Class. They have 60 days to issue a decision 

19 on that case. We've been measuring that and 

20 have been successful. 

21 We've been very lucky to have been 

22 able to work closely with NIOSH in developing 
. 

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1 lists, on pulling back cases that may be 

2 there. Our claims examiners are trained now 

3 and have a pretty good understanding of 

4 exactly what they need to be doing to screen 

5 through these cases and pay the individuals 

6 that should be approved as soon as possible.

7 NIOSH dose reconstruction case 

8 status. This is just a breakdown of what I 

9 basically said before. A majority are denials 

10 for dose reconstruction cases but it's about a 

11 35 percent approval.

12 Part B cancers with a final 

13 decision to accept. Accepted dose 

14 reconstruction cases about 7,600. SEC cases 

15 obviously are the majority, 13,000. Then we 

16 break it up a little bit. In some cases we 

17 have a 50 percent or greater and an SEC status 

18 just because there might have been an 

19 acceptance under dose reconstruction and then 

20 an SEC Class was added or a new cancer was 

21 added, or something along those lines.

22 Part B cases sent to NIOSH. 
. 

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1 Monthly this kind of gives you a general idea. 

2 As you can see it's pretty steady at this 

3 point. We are getting to a steady state at 

4 the Department of Labor with both Part B and 

5 Part E. It hasn't fluctuated very much in the 

6 last year. New Part B cases received monthly. 

7 Again, this is just another breakdown that 

8 shows pretty much a steady state of receipts. 

9 Top four work sites are still 

10 Hanford, Y-12, Oak Ridge, and Bethlehem Steel. 

11 We've got some breakdown of these statistics. 

12 You can review them at your leisure but they 

13 are declining slightly over all in these four 

14 top facilities. I think it just might be that 

15 we've gotten all the cases that we can in some 

16 of these situation and we are working through 

17 them.

18 This is just a breakdown of AWE 

19 cases versus our DOE cases received monthly. 

20 While they are still pretty steady, we had a 

21 little uptake in April but AWEs are always 

22 smaller because they are smaller facilities 
. 

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1 and we don't get as many cases from AWE 

2 facilities.

3 This is just a run-through and you 

4 can look at these on your own. These are the 

5 cases that we've received and the claims that 

6 we've received from the various facilities 

7 that are under discussion with the Board. The 

8 majority have been from Hanford, Savannah 

9 River Site, and then FMPC. The rest are 

10 smaller but steady.

11 Then Part B cases filed. The 

12 majority are NIOSH cases. Well, it's a good 

13 portion. Thirty-five percent are NIOSH cases 

14 and 36 percent other.

15 That's really all I have for the 

16 presentation but I'm happy to take any 

17 questions you may have.

18 CHAIRMAN MELIUS: Board Members 

19 with questions for Rachel or Gary?

20 Yes, Brad.

21 MEMBER CLAWSON: I was just 

22 wondering if a person filed under Subpart E 
. 

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1 and then receives a letter from you stating 

2 that they are waiting pending a dose 

3 reconstruction, or it's under Part E and it 

4 doesn't need one, why would that be that way? 

5 Is that verifying employment or --

6 MS. LEITON: No. Actually, the 

7 only time that we would be waiting for a dose 

8 reconstruction under Part E is if it's for a 

9 cancer case for radiation exposure because the 

10 definition as the law states is "at least as 

11 likely as not" which we have defined to be a 

12 50 percent or greater threshold.

13 For radiation it would be 

14 inconsistent to be saying for radiation that 

15 at least as likely as not threshold means 

16 something different. It means the same. It 

17 is confusing for claimants. It's the way for 

18 consistency purposes that we've interpreted 

19 the law. 

20 It's a relation state. Basically 

21 for anything else other than radiation for 

22 cancer cases, we need to rely on the NIOSH 
. 

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1 dose reconstruction due to the way the 

2 definition reads.

3 MEMBER CLAWSON: The reason why is 

4 because this was actually a harmful substance. 

5 He was a decon tech is what he was. His dose 

6 levels weren't that high but the chemicals 

7 that he dealt with and that's why he filed 

8 under like --

9 MS. LEITON: We would look at that 

10 separately. If there are other toxic 

11 substances besides radiation, we definitely 

12 look at that and there are instances where 

13 we'll accept a cancer case that is related to 

14 somebody besides the radiation when the dose 

15 reconstruction is below 50 percent.

16 CHAIRMAN MELIUS: Phil.

17 MEMBER SCHOFIELD: When you use 

18 the SEM database how is that applied because a 

19 lot of these people have no idea what 

20 chemicals they're exposed to and, in some 

21 cases, we're talking an excess of 10,000, 

22 15,000 different chemicals. How does that 
. 

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1 apply to a claimant's case?

2 MS. LEITON: Well, basically we 

3 look at the job category, where they worked, 

4 what buildings they may have worked in and 

5 that narrows it down in the database. If a 

6 person files and they worked at Hanford, we 

7 can talk to them and say, "Do you know what 

8 building you may have worked in?" 

9 Or even if we don't know what 

10 building they may have worked in, if they know 

11 what job category they worked in, that may 

12 narrow it down to what buildings. Within 

13 those buildings and within those job 

14 categories we've been able to gather enough 

15 records to establish these are the things that 

16 likely this person would have been exposed to 

17 in this building in that job category. 

18 As I said, it's not the end all 

19 and be all and we are always updating it. We 

20 take information from the public and we are 

21 constantly doing research with DOE records to 

22 update it. It is a struggle for the claimant 
. 

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1 and that's part of the reason we developed 

2 this Site Exposure Matrix was to help them 

3 determine -- help us determine what they might 

4 have been exposed to.

5 MEMBER SCHOFIELD: Let me throw 

6 out this scenario. You have people who for 

7 whatever their job category is may not 

8 directly work with the chemicals but they go 

9 through these laboratories. They go through 

10 all these rooms with all these different 

11 chemicals maybe once or twice a day. They are 

12 taking recordings. 

13 They are checking security, 

14 checking doors, whatever it is, but they are 

15 in these facilities day in and day out. Even 

16 though their job category doesn't say they 

17 work with these chemicals, they are around 

18 them constantly.

19 MS. LEITON: That's part of the 

20 reason that we do occupational history 

21 questionnaires. It's also part of the reason 

22 that the Site Exposure Matrix is not a 
. 

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1 decision making tool. If they are not in 

2 there, if their job -- you know, if they say 

3 they may have been exposed to something, in 

4 particular when they say it, their doctor says 

5 it, their records show it, and it's not in the 

6 SEM, we don't rely solely on the SEM. 

7 In some cases we've had cases 

8 referred to national office where we have 

9 industrial hygienists that will review the 

10 information, the specifics of the case, and 

11 say this is what we determined. This person 

12 likely would have been exposed to for this 

13 duration. 

14 Then we make a causation 

15 determination based on medical evidence using 

16 whatever resources we can to get that medical 

17 evidence. The SEM is just a tool when we 

18 don't have other information. If it's not in 

19 there, we will seek further information. We 

20 will not deny it based solely on the SEM.

21 CHAIRMAN MELIUS: I have a couple 

22 questions and actually a couple requests. 
. 

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1 I'll start with the requests. The 

2 information, the new communications 

3 information you've talked about for claimants, 

4 could you share that with the Board when 

5 that's ready because it would be --

6 MS. LEITON: Sure. You mean our 

7 brochures?

8 CHAIRMAN MELIUS: Brochures and so 

9 forth. I think it would be useful given we do 

10 the public comment periods and just for us to 

11 understand how you're communicating there and 

12 hopefully we can --

13 MS. LEITON: We can send you the 

14 weblinks with that information on it.

15 CHAIRMAN MELIUS: Whenever that's 

16 ready.

17 The second request is sort of 

18 related back to Lew's presentation. One part 

19 of the Quality Assurance Program for dose 

20 reconstruction is the review that is done by 

21 DOL as cases go and then the reworks that you 

22 ask for. 
. 

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1 I think a number of years ago we 

2 got a presentation from DOL on cases that were 

3 referred back sort of by category and so 

4 forth. Pete Turcic came in and did that. 

5 Maybe my memory is off. I think that would be 

6 useful at some point.

7 MS. LEITON: The number of 

8 reworks?

9 CHAIRMAN MELIUS: Well, number but 

10 also classify why were they sent back.

11 MS. LEITON: Right.

12 CHAIRMAN MELIUS: I think it helps 

13 us understand is there something because we 

14 have our own program for reviewing dose 

15 reconstruction. It's a little bit different 

16 obviously. I think it's useful in terms of 

17 understand the process and so forth. 

18 It may not have changed and a lot 

19 of it is just new information becomes 

20 available on the second cancer or job site 

21 information or whatever. I think it's helpful 

22 for us to understand that at some point.
. 

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1 Third item is actually a question 

2 and that is the Rocky Flats issue with 

3 Ruttenber Data.

4 MS. LEITON: I know this has been 

5 a challenge for a while now. We keep telling 

6 you that we're going to get you an answer. We 

7 actually are much closer. We've been working 

8 with NIOSH on this. Our struggle currently is 

9 what the neutron dose means in the Ruttenber 

10 database. We are working with NIOSH on that 

11 determination. 

12 In terms of the buildings, we are 

13 also working with DOE. I was hoping to have 

14 an answer for you today. I really hope to 

15 have an answer to you by next time.

16 CHAIRMAN MELIUS: Okay. Thank 

17 you. We'll ask again next time.

18 MS. LEITON: I'm sure you will.

19 CHAIRMAN MELIUS: Okay. Then my 

20 final question goes back to, I think, part of 

21 the hardest issue we have, at least from the 

22 Board's perspective, in working with you, and 
. 

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1 it's just a difficulty we share, and that's 

2 the Class Definition issue that comes up. We 

3 struggle with it. 

4 I think we've gotten better with 

5 it over the 10 years or so but it still is a 

6 problem trying to come up with -- one is for 

7 us to define a Class in conjunction with NIOSH 

8 on a particular site is re-review the 

9 information site and then how do you turn that 

10 Class into something that's workable or 

11 useable by the Department of Labor. 

12 I think it's probably best 

13 discussed on individual cases because every 

14 situation is different in terms of what is 

15 available but it's certainly something we 

16 would like to continue to work with you on and 

17 communicate as much as possible on so we sort 

18 of get the intent of the SEC turned into 

19 something that you can implement.

20 MS. LEITON: Right. I do really 

21 appreciate those efforts and the efforts of 

22 NIOSH to share your ideas on it. Our biggest 
. 

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1 thing is always can we place them there. If 

2 DOE can't provide us with records or we don't 

3 have any other methods to get them in a 

4 particular location that has made the Class, 

5 then we are going to have to deny these cases 

6 in which case it kind of defeats your purpose. 

7 I do appreciate that collaboration.

8 CHAIRMAN MELIUS: Thank you.

9 Paul or Mark on the line, do you 

10 have any questions?

11 MEMBER ZIEMER: Dr. Melius, I have 

12 a question.

13 CHAIRMAN MELIUS: Yes.

14 MEMBER ZIEMER: First, let me 

15 thank both Gary and Rachel for their excellent 

16 presentations.

17 Rachel, I would like to ask a 

18 question that has been kind of an ongoing

19 question of mine over a number of years but 

20 I'm going to ask it in a slightly different 

21 way. It has to do with the final number that 

22 cranks out of the Probability of Causation 
. 

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1 calculation, the IREP Program.

2 I'll ask it this way. Does Labor 

3 have an official policy on the number of 

4 decimal places to which they make the 

5 calculation? The reason I ask that is I've 

6 always maintained that two decimal points are 

7 unjustified by the uncertainty in the 

8 calculation. 

9 I believe one is also unjustified. 

10 The question boils down to why aren't we 

11 going to simply whole numbers? The official 

12 policy on that that demands two decimal places 

13 is a misleading figure in my mind.

14 MS. LEITON: I'm going to have 

15 Jeff Kotsch help me with this, our resident --

16 CHAIRMAN MELIUS: I thought that 

17 is why Jeff Nesvet came. We haven't seen you 

18 for a number of years.

19 MR. KOTSCH: Jeff Kotsch, DOL. We 

20 still adhere to the number of decimal points 

21 that NIOSH provides is generally the way the 

22 output comes which is two decimal places.
. 

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1 MEMBER ZIEMER: Is that a policy -

2 - or an official policy?

3 MR. KOTSCH: I have to hesitate.

4 MS. LEITON: I think we basically 

5 adhere to what NIOSH --

6 CHAIRMAN MELIUS: Legal counsel is 

7 really going to --

8 MEMBER ZIEMER: They really show 

9 me that Labor has to make the decision on that 

10 issue.

11 MR. NESVET: Well, I think this is 

12 something we'll probably have to talk to NIOSH 

13 about. One has to keep in mind that the 

14 Probability of Causation regulations are 

15 regulations that are issued by the Department 

16 of HHS, not the Department of Labor. We do 

17 our best to interpret those regulations and we 

18 clearly work with HHS in shaping them. Some 

19 of you folks recognize me. 

20 I've been around the block on this 

21 program for some years starting from before it 

22 was a program. To the extent that we need a 
. 

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1 legal interpretation of decimal points, that 

2 is something we would have to work with HHS to 

3 come to so I don't think we're in a position 

4 to give you an answer right now.

5 MEMBER ZIEMER: I've got a burr in 

6 my saddle. I think at some point, and maybe 

7 the 10-Year Review should bring this up, and I 

8 haven't raised that in the 10-Year Review with 

9 Dr. Wade, but it would seem to me to push 

10 anything beyond a full number is really a 

11 stretch from a scientific point of view. 

12 That means, for example, a 49.7 is 

13 a 50 percent. You can't scientifically say it 

14 isn't. It's that kind of issue. I don't know 

15 at what point we are in a position to address 

16 this but I thought I would at least get it on 

17 the record. 

18 I think it's very misleading even 

19 I think to claimants to think that we can do 

20 this to two decimal places. We're at four 

21 significant figures. That's personal. I 

22 don't know if the other Board Members agree 
. 

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1 with this but it certainly is an issue in my 

2 mind.

3 CHAIRMAN MELIUS: I think now that 

4 you've raised it, Paul, I think we probably 

5 would be interested in an answer. 

6 I will tell you, Jeff, we didn't 

7 wait five years or however long it's been 

8 since you've been to a meeting. We haven't 

9 saved up the question.

10 MR. NESVET: I appreciate that. 

11 I'll be back in another five years. That is 

12 something we can talk to NIOSH. We may have 

13 to get some interpretation of that. As I 

14 said, it is an HHS regulation that we are 

15 bound by so we certainly are bound in this 

16 instance to consult with the authors of the 

17 regulation, one of them I see in front of me.

18 CHAIRMAN MELIUS: Who's not being 

19 helpful either. Okay. Thank you.

20 Anybody else? Josie. I'm sorry.

21 MEMBER BEACH: I just have a quick 

22 question, Rachel. You mentioned the survey at 
. 

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1 the beginning of your presentation. I don't 

2 know if I caught it. Is that available on the 

3 website so we can look at those results?

4 MS. LEITON: It is not currently 

5 but we are working towards putting the results 

6 online.

7 MEMBER BEACH: Okay. Thanks.

8 CHAIRMAN MELIUS: Anything else? 

9 Okay. Thank you, Rachel. 

10 MS. LEITON: Thank you.

11 CHAIRMAN MELIUS: Thank you, Gary 

12 and Jeff. We appreciate you coming here. 

13 Thank you for the presentations, the updates. 

14 We look forward to seeing you all again.

15 Next item on our agenda is 

16 Department of Energy. I do want to give you

17 -- we will do this presentation and then we 

18 will take our break.

19 LaVon, I think you're going to get 

20 bumped.

21 He expects it, you know. I think 

22 Friday morning -- no. Guess Pat didn't make 
. 

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1 it so Greg is here. Okay.

2 Welcome, Greg.

3 MR. LEWIS: So I'm Greg Lewis with 

4 the Department of Energy, Office of Health, 

5 Safety, and Security. Pat Worthington was 

6 planning on being here but couldn't make it. 

7 She assures everyone she will be at the August 

8 meeting in Hanford so you've got me for today.

9 I'm going to talk a little bit 

10 about how we support the EEOICPA Program over 

11 at the DOE. Again, the Office of Health, 

12 Safety, and Security is the office that 

13 administers the program and coordinates within 

14 DOE. We work closely with all of the field 

15 sites, at least over 20 that have a 

16 significant role in the program.

17 Our core mandate at the Department 

18 of Energy is to work on behalf of the program 

19 claimants to ensure that all available worker 

20 and facility records are provided to DOL, 

21 NIOSH, and the Advisory Board. 

22 Today I'm going to talk first 
. 

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1 about our responsibilities and the role of the 

2 DOE. Then I'm going to talk a little bit 

3 about some initiatives that we've been doing 

4 over the past few months. Then I'll talk 

5 about another program that closely relates to 

6 the EEOICPA Program, the former Worker Medical 

7 Screening Program, and then I'll take 

8 questions.

9 Many of you have seen this before 

10 and we are getting close to a break. If I'm 

11 going too fast or you have questions, please 

12 feel free to stop me.

13 We have three main 

14 responsibilities under the program. We 

15 respond to individual records requests from 

16 the Department of Labor and NIOSH for 

17 employment verification, radiological exposure 

18 records, and other exposure records.

19 We provide support to large-scale 

20 records research projects at various 

21 facilities. This would be, of course, the 

22 Special Exposure Cohort projects, Site Profile 
. 

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1 updates, as well as things the Department of 

2 Labor does like Site Exposure Matrix.

3 Then our third responsibility 

4 which is somewhat smaller but equally 

5 important is to conduct research along with 

6 the Department of Labor and NIOSH on issues 

7 related to covered facility designations.

8 So for all three of those things 

9 at the Department of Energy we primarily rely 

10 on our site point of contact, POCs as we call 

11 them. We have one at every Department of 

12 Energy facility out there and they are really 

13 the backbone of our program. 

14 They coordinate all records 

15 research activities with NIOSH, the Advisory 

16 Board, and the Department of Labor. They set 

17 up site visits and tours, some of which can be 

18 extremely complex and can require coordination 

19 and participation from many site departments 

20 and security and things like that so those can 

21 be a little bit tricky.

22 They work with DOL and NIOSH to 
. 

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1 identify subject matter experts and put them 

2 in contact with the right person on site that 

3 can answer the many complex questions that 

4 these researchers seem to have.

5 Then, of course, they manage our 

6 site's response to individual records 

7 requests. I'll get to that later but we do 

8 close to 20,000 records requests a year which 

9 keep these POCs pretty busy.

10 Then they are also an onsite 

11 source of information to current workers, and 

12 even former workers if they still have a 

13 relationship with the site because many of our 

14 POCs have been working on site for 20 or more 

15 years. They have contacts within the 

16 community, within the site. They often help 

17 individuals if they are trying to file or to 

18 get to the right agency, whether that's DOL or 

19 NIOSH.

20 Just to give you an example of 

21 something that is somewhat outside our scope 

22 but it gives you an example of what our POCs 
. 

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1 do, recently one of our POCs was attending a 

2 local meeting sponsored by the Cold War 

3 Patriots, a nonprofit group. She was 

4 attending just to provide information on DOE 

5 and what we do and how we process records 

6 requests. 

7 She started talking to a gentleman 

8 who was explaining to her that he planned to 

9 file a EEOICPA claim and he had a brain tumor. 

10 He was waiting until after he had surgery, 

11 which was the next day, just because 

12 everything had been crazy with going to 

13 doctors and that whole process. 

14 Immediately our POC explained that 

15 if he were to file today and he could get in 

16 the program because the Department of Labor 

17 would be the primary payer if his claim was 

18 eventually compensated the payment for the 

19 medical care would be retroactively applied to 

20 the date where he filed. 

21 Because she was aware of that and 

22 familiar with the program, she contacted -- I 
. 

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1 don't know if it was the resource center or 

2 the local district office had them contact 

3 that gentleman that afternoon and got his 

4 claim filed. I believe he was compensated 

5 but, either way, it's knowledge of the program 

6 and things like that that our POCs really 

7 provide to both their current and former 

8 workers.

9 So for individual records we 

10 respond to about 7,000 employment 

11 verifications from the Department of Labor, 

12 about 4,000 requests for radiological data 

13 from NIOSH, about 7,000 what we call DARs, 

14 document acquisition requests, which are 

15 requests for other exposure data, IH, medical 

16 records, things like that that show what the 

17 worker might have been exposed to.

18 In FY 2010 we responded to about 

19 17,000 records requests, In FY 2011, which 

20 goes through October, we anticipate responding 

21 to about 18,000 this year.

22 With our records request we have a 
. 

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1 fairly involved process to respond to those. 

2 Claimants often worked at multiple DOE sites. 

3 They might have worked at multiple divisions, 

4 had multiple job titles on site throughout 

5 their career. 

6 When we prepare a records package 

7 it can be hundreds of pages long and it can 

8 consist of medical records, as I've seen 

9 before, radiological records, badging, 

10 incident and accident reports. It can have a 

11 number of different components.

12 We also have to go to many 

13 different sources. One site, as I have on the 

14 slide up here, routinely checks about 40 

15 different sources for response of records 

16 including hard copy records, microfilm, 

17 microfiche, database scan records. 

18 They both consist of different 

19 formats in terms of electronic or paper, but 

20 they can also depending on the years worked 

21 have to go to multiple different sources for 

22 the same type of record because some of our 
. 

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1 sites change contractors every five to 10 

2 years. They often brought in a brand new 

3 system, a brand new database. 

4 For example, if a worker worked 

5 from 1970 to 1990, we may have to go to one 

6 database for records from '70 to '75, another 

7 database from '74 to '82, and so on. It's not 

8 just a matter of going to a file cabinet and 

9 pulling out an individual's record. We really 

10 have to dig and it's more of an investigatory 

11 process.

12 The second main function that we 

13 have is to support large-scale records 

14 research projects. These can be very 

15 challenging for us because we often don't have 

16 a lot of heads up. The project will just 

17 start. We need to juggle existing funding to 

18 make sure that the right site has the right 

19 funding to support the project.

20 It's also difficult to tell how 

21 extensive a project is going to be. As you 

22 guy know and as Lew was discussing before, the 
. 

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1 more you find the more you might need to dig 

2 or, at least, that's how it ends up being at 

3 some of our sites. We really try to make sure 

4 the right funding is in place and we have the 

5 right resources available to support the needs 

6 of NIOSH and the Advisory Board and the 

7 associated contractors.

8 With the large-scale records 

9 research projects we also review not all but 

10 many of the records for classification related 

11 concerns. We have reviewed millions of pages 

12 so far at our various sites. This can be a 

13 difficult and time-consuming process. 

14 In addition, this is also an area 

15 where a site has a certain available staff or 

16 classification of reviews. Typically they 

17 have a somewhat constant workload. When the 

18 researchers for this program come in, you 

19 know, it can be over a period of months or 

20 even a year or more. 

21 The volume can go up considerably 

22 so if they have a site visit, you know, it can 
. 

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1 take the site two, three, four weeks or more 

2 just to review the records requested during 

3 that one site visit. 

4 Many times by the time they are 

5 done reviewing those records, the researchers 

6 are back for another visit. We've had to hire 

7 subcontractors or even bring back retired 

8 classification officers to help review for 

9 search capacity.

10 Here are a few of the projects 

11 that we are supporting right now. Some of 

12 these are just starting. Some are hopefully 

13 wrapping up, we believe. I'll talk a little 

14 bit about a few of them.

15 With Sandia we've supported five 

16 visits since August. I believe we have 

17 another visit scheduled -- we are starting to 

18 schedule it for the July/August time frame. 

19 We are also supporting requests for Ross 

20 Aviation and Medina and Clarksville with 

21 Sandia. Medina and Clarksville are also 

22 something that we're supporting at Pantex 
. 

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1 because as closure facilities those records 

2 were spread throughout a couple locations.

3 We scheduled a meeting at DOE 

4 headquarters back in April to get Members of 

5 the Advisory Board, SC&A, NIOSH, and everyone 

6 together to review the classified information. 

7 Unfortunately, that happened to be scheduled 

8 the week after the almost government shutdown. 

9 As Ted knows, we held off until 

10 about Friday at 1:00 before we ended up having

11 to cancel that. Of course, they averted the 

12 shutdown about 11:55 for thereabouts so I 

13 guess if we had held off until Saturday 

14 morning, we might have been able to do it.

15 Unfortunately we had to postpone 

16 it and weren't able to reschedule until mid17 June but we're going to be supporting that 

18 visit in mid-June as well as a site data 

19 capture visit which we have heard may be the 

20 last one. Of course, you never know but it 

21 looks like things are coming to a close there 

22 so we are glad to have been able to support to 
. 

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1 these visits.

2 At Savannah River we've supported 

3 over 10 different data capture visits over the 

4 last year or so. We continue to support these 

5 data capture efforts, although they seem to be 

6 more targeted toward specific issues now.

7 Now, with our document reviews all 

8 final documents, all final reports that are 

9 created by NIOSH, the Advisory Board, SC&A, 

10 etc., go through DOE headquarters for a 

11 classification review. We believe we've 

12 gotten our process pretty much down at this 

13 point. We follow our security plan in terms 

14 of protocol. 

15 They are sent in to our 

16 headquarters and we get them back typically 

17 within about eight working days. I guess 

18 since February, since the last Board meeting, 

19 we've had 61 documents submitted and the 

20 average has been eight days. In certain cases 

21 we've done them in one or two when necessary.

22 Actually, back to that last slide. 
. 

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1 I will also say we do struggle -- I see Brad 

2 over there. We do struggle somewhat with our 

3 DOE sites, with headquarters, because it's 

4 centralized. Because we work closely with 

5 that one office, we are able to make sure that 

6 those documents are returned in eight days. 

7 I know at our sites it's certainly 

8 not as quick as eight days. But also at our 

9 sites they are more reviewing source documents 

10 and not reports so whereas the reports might 

11 be 10, 20, 30, 40 pages, source documents 

12 could be hundreds of pages and could have been 

13 created back in the '40s or '50s. 

14 It's both difficult to review and 

15 the classification officer may not have the 

16 expertise because it's 40 or 50 years old so 

17 they may have to refer to the guides quite 

18 frequently and go off information that they 

19 need to look up.

20 Again, it's a slower process. We 

21 try to get them to return documents as quickly 

22 as possible. When SC&A or NIOSH alert us to 
. 

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1 problems, we try to resolve those as quickly 

2 as possible.

3 Then with general SEC support we 

4 have routine conference calls. We have our 

5 site experts participate in Advisory Board 

6 Working Groups in conference calls. We 

7 facilitate secure classified meetings and 

8 discussions like I was just talking about with 

9 Pantex.

10 The third, and final, 

11 responsibility the Department of Energy has 

12 under the program is facility research. We 

13 actually maintain the database of over 300 

14 facilities covered under EEOICPA. That's 

15 AWEs, beryllium vendors and DOE facilities. 

16 We work closely with DOL and NIOSH to conduct 

17 research. 

18 There are facilities where we 

19 added years or have taken years away based on 

20 new information. We've also added 

21 descriptions, or even added new facilities. 

22 Any time new information comes to light we 
. 

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1 take a look at that, we'll conduct an 

2 independent research effort on our part to 

3 find new information and try to make the right 

4 decision as far as facility coverage.

5 Our Office of Legacy Management 

6 supports us in that. I have a bunch of 

7 information on the slide but essentially they 

8 are a records management office within DOE so 

9 they understand records. They understand 

10 where they would be. 

11 They also have experience with the 

12 DOE history in understanding how the facility 

13 is related, where they might need to go to 

14 find the right records to respond to an 

15 inquiry.

16 Now I'm going to talk a little bit 

17 about some of the initiatives we've been 

18 undertaking in the last few months. We have 

19 an ongoing effort to identify any additional 

20 records useful for EEOICPA. Just one example. 

21 At the Hanford site recently as part of the 

22 SEC research there was a collection uncovered. 
. 

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1 I believe it had to do with source terms. 

2 I'm sure Sam Glover can correct me if I'm

3 wrong.

4 Anyway, they found this collection 

5 and realized the way it was indexed was not as 

6 useful as it could be to both NIOSH and for 

7 DOE to respond to claims so we are going 

8 through with an indexing effort right now. 

9 Because they are classified records we had to 

10 hire normal employees with Q clearances and we 

11 have them on a separate subcontract. 

12 They are actually working weekends 

13 for the next few months to index and get this 

14 collection into useable form. Of course, we 

15 didn't make them work weekends. This is 

16 something they wanted to do, extra money. 

17 It ends up being both efficient 

18 for us and probably the fastest way to get 

19 this collection into useable format. There is 

20 always a few things like that going on around 

21 the complex. We are just starting one at 

22 Kansas City Plant as well.
. 

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1 The Site Exposure Matrix effort. 

2 I talked about this a little bit at the last 

3 Board meeting. We started the initial review 

4 back in, I believe, it was 2009. We started 

5 it in early 2010 and finished at the end of 

6 2010. It took about a year. We were able to 

7 review the entire database and provide 

8 clearance for DOL to put that online, which 

9 they have done. 

10 Almost immediately after this was 

11 finished in early January we started a second 

12 review of the information, the new information 

13 that has been submitted since we started our 

14 initial review. Of course, when we started 

15 our review we cut off the database and made 

16 sure it was static because if it's constantly 

17 changing, it's going to be extremely difficult 

18 for us to review. 

19 Almost immediately after 

20 completing the initial review we started the 

21 second review. It took about four months for 

22 the second as opposed to a year for the first. 
. 

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1 Just within the last few weeks we responded 

2 to DOL that there were no problems with the 

3 database. 

4 I believe they are going to be 

5 getting that update up there, if they haven't 

6 already, within the next few weeks I would 

7 imagine. So outreach. I know Gary mentioned, 

8 I think, the outreach efforts that have been 

9 going on in coordination with DOL and NIOSH. 

10 The Joint Outreach Task Group was 

11 created a few years ago to combine efforts 

12 between DOL, NIOSH, the Former Worker Medical 

13 Screening Program, the Office of the Ombudsman 

14 for DOL and NIOSH with the general idea that 

15 all of these groups are trying to reach the 

16 same population so with combined efforts we 

17 could both create efficiency in terms of the 

18 cost for outreach and reach more groups with 

19 the same effort. 

20 We think it's been very 

21 successful. We had, I guess, about 19 town 

22 hall meetings within the last year. The next 
. 

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1 meeting is, I think, scheduled for Chicago in 

2 early June. If anyone wants more information 

3 about that meeting, they can just let me know.

4 So the Former Worker Medical 

5 Screening Program is the other program 

6 administered by my office, HS-14. The mission 

7 of the Former Worker Screen Program is to 

8 identify and notify former workers at risk for 

9 occupational diseases. We provide them free 

10 medical screening. We do it close to their 

11 home. We have established screening programs 

12 near the larger DOE communities, Oak Ridge and 

13 Savannah River and Hanford, things like that. 

14 But we also have two national 

15 programs, the National Supplemental Screening 

16 Program which contracts through clinics 

17 throughout the country to provide screenings 

18 to former production workers, and the Building 

19 Trades Medical Group which also contracts with 

20 local clinics to provide screenings around the 

21 country for former construction and trades 

22 workers.
. 

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1 For this area the local screening 

2 programs are the National Supplemental, as I 

3 mentioned, and the Building Trades Program. 

4 There is contact information on the slide. I 

5 believe these slides will be up on the NIOSH 

6 website eventually once they post the 

7 information for the meeting. Of course, 

8 anyone can contact my office if they want more 

9 information about these programs.

10 With that, does anyone have any 

11 questions?

12 CHAIRMAN MELIUS: Well, thank you, 

13 Greg, for a good update.

14 Anybody with questions? Your 

15 timing is good. You go up against the break 

16 and everybody is quiet.

17 MR. LEWIS: This is a first. You 

18 can put me before the break next time.

19 CHAIRMAN MELIUS: Paul or Mark on 

20 the line, do you have questions?

21 MEMBER ZIEMER: I have no 

22 questions.
. 

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1 CHAIRMAN MELIUS: Okay. Thanks. 

2 Mark was going to be in and out. Okay. With 

3 that then, it's 10:43. Why don't we come back 

4 around five after 11:00. Thank you.

5 (Whereupon, the above-entitled 

6 matter went off the record at 10:45 a.m. and 

7 resumed at 11:09 a.m.)

8 CHAIRMAN MELIUS: If everyone 

9 could get seated, we'll get started. We'll 

10 get started again and welcome Dr. Lockey who 

11 has joined us now. He got on his plane this 

12 morning and made it after abandoning the 

13 airport last night. Tornado watch -- warning.

14 Ted, you want to check the line?

15 MR. KATZ: Yes. Can I check to 

16 see which Board Members we have on the phone 

17 line right now?

18 MEMBER ZIEMER: Paul Ziemer here.

19 MR. KATZ: Hi Paul. How about 

20 Mark Griffon. Are you with us?

21 Mike Gibson, are you on with us by 

22 any chance? Okay.
. 

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1 CHAIRMAN MELIUS: Okay. As I 

2 mentioned earlier, we're going to skip LaVon 

3 and go to -- LaVon is a short presentation. 

4 We can fit it in maybe 5:00 a.m. tomorrow 

5 morning if anybody wants to come. No, we'll 

6 find time in some of our Board work time for 

7 that.

8 So we'll have an update now on the 

9 HHS proposed rule on CLL, Jim.

10 DR. NETON: Thank you, Dr. Melius. 

11 My formal remarks probably won't last the 

12 full hour so depending on the Board 

13 discussion, maybe there will be some time to 

14 fit Bomber in after all.

15 It is with great pleasure, I have 

16 to say, that I am finally able to get up here 

17 and present to you HHS' formal position, or 

18 NIOSH's formal position on chronic lymphocytic 

19 leukemia and its inclusion as a covered cancer 

20 under EEOICPA.

21 It's been going on for quite some 

22 time, as most of you know, and many of you 
. 

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1 might suggest probably too long. I would say 

2 this is probably one of the most challenging 

3 scientific issues that we've had to deal with 

4 in this program. Not only from the risk model 

5 perspective, which is somewhat complex, but 

6 also from the dose reconstruction aspect as 

7 well which I'll cover a little bit later in my 

8 remarks.

9 The proposed rulemaking issue was 

10 issued in the Federal Register March 11th, a 

11 little over a month ago. The comment period 

12 is out there and ends officially, I think, 

13 June 20th so there's still plenty of time to 

14 comment. Most recently I looked at the 

15 regulatory docket and I think we have right 

16 now only three comments listed in the docket.

17 Before I do forget, the regulatory 

18 docket is out there. I'll have a link to it 

19 later in my presentation but it's also 

20 reachable from our DCAS website. You can 

21 click to get over there. Not only the docket 

22 but also the option to make a comment if so 
. 

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1 desired.

2 A little bit about the background 

3 that most of you already know. I think I 

4 presented pieces and parts of this at various 

5 Board meetings. This is the first time I'm 

6 able to sort of put it all together. As is 

7 well known, CLL is the only cancer that the 

8 Probability of Causation is zero under the 

9 Probability of Causation rule in 2002. 

10 That decision was a conscious 

11 effort on NIOSH based on a couple facts. One 

12 was the unavailability of existing 

13 epidemiologic studies that demonstrate a link 

14 between radiation and CLL. There were studies 

15 out there that were suggestive. Many had 

16 negative risk coefficients and some have 

17 positive but nothing out there that would 

18 conclusively link CLL. 

19 In general even among the 

20 radiation research bodies that exist and make 

21 comments on these risk models, there was 

22 pretty much a consensus of opinion in 2002 
. 

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1 that CLL should be considered non-radiogenic. 

2 To some extent that thought pattern persist 

3 in some organizations.

4 Probably as important is the 

5 feasibility of development of quantitative 

6 risk model. Even if we determine that CLL was 

7 radiogenic, as you know, most of the risk 

8 coefficients were generated using the life 

9 span study of Hiroshima and Nagasaki 

10 survivors. 

11 In the entire cohort the 80,000 or 

12 so people in that cohort there were only four 

13 cases of chronic lymphocytic leukemia total 

14 which is not many to develop a quantitative 

15 risk model from. 

16 In fact, I think it was estimated 

17 that only maybe one of those were possibly 

18 related to radiation exposure out of four but 

19 the numbers are so small it's hard to tell. 

20 That's due to the fact that CLL is a rare 

21 cancer in the Japanese population. Much rarer 

22 than it is in the U.S. population. We'll talk 
. 

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1 a little bit more about that later.

2 At the time of the publication of 

3 the Probability of Causation rule in 2002, 

4 this was listed in the preamble, that NIOSH 

5 was committed to revisiting the decision on 

6 radiogenicity as new scientific information 

7 became available. We kept our ear to the 

8 ground and over time evidence started to 

9 emerge that made us start to rethink that 

10 position.

11 Continuing on to summary of 

12 activities, I just made a couple of brief 

13 slides on this because it has been a long 

14 process. It started way back in, I think, 

15 2004 when a public meeting was convened by the 

16 NIOSH Office of Energy Research Programs to

17 evaluate this radiogenicity issue. 

18 That was using some money that was 

19 earmarked by Congress and funded directly to 

20 the Office of Energy Research Programs to look 

21 at this issue. The meeting was one aspect of 

22 it. Also NIOSH at that time engaged in some 
. 

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1 additional leukemia-type research of their 

2 own. 

3 At the end of this meeting the 

4 participants determined that the current 

5 evidence was still inconclusive. They were 

6 looking at it from a purely scientific 

7 perspective. Although some new information 

8 had emerged to possibly make one think that 

9 CLL could be radiogenic, there was nothing 

10 still conclusive on the table. 

11 Subsequent to that meeting NIOSH, 

12 and that is specifically DCAS or OCAS at the 

13 time, polled subject matter experts regarding 

14 the radiogenicity of CLL from a slightly 

15 different perspective. We asked the question 

16 is there sufficient evidence to continue to 

17 disregard CLL as a radiogenic cancer under 

18 EEOICPA compensation program. 

19 If you think about it, that's a 

20 slightly different question to be asked. The 

21 majority of the reviewers, three out of five 

22 reviewers supported the position that CLL 
. 

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1 should be considered radiogenic. There's a 

2 couple reasons for that. 

3 One is that new epidemiologic 

4 information had emerged that even though the 

5 risk coefficients were positive but not 

6 statistically significant, there were more and 

7 more studies out there indicating that, yes, 

8 maybe there was a connection between radiation 

9 exposure and CLL. A lot of it had to do with 

10 the way the data were analyzed as a function 

11 of latency period.

12 Secondly, if one thinks about this 

13 from a biological plausibility issue, is it 

14 really reasonable to conclude that CLL is the 

15 only cancer that could not be caused by 

16 radiation given what we know about the way 

17 radiation causes cancer and that it 

18 specifically damages DNA.

19 Given that, it was hard to fathom 

20 why CLL couldn't at least plausibly be caused 

21 by radiation. There's a number of reasons why 

22 the epidemiologic data was not informative and 
. 

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1 those have been wide reported in the 

2 literature. Partly because it's a disease of 

3 old age. It takes years to develop. 

4 It's also been misclassified many 

5 times. It's a hard one to nail down with a 

6 specific ICD-9 code. It's often been 

7 considered to be -- it could be misclassified 

8 as hairy cell leukemia or small lymphocytic 

9 lymphoma. Those sort of things make the 

10 epidemiology a little bit less than robust in 

11 trying to determine the radiogenicity. 

12 Anyway, bolstered by the -- there 

13 were two reviewers that did not support the 

14 position. One reviewer was neutral on the 

15 subject and basically said the information was 

16 still in her opinion inconclusive. There was 

17 one reviewer out of the five that concluded 

18 that it was not radiogenic CLL. 

19 In fact, that same particular 

20 reviewer also felt that lymphomas in general 

21 were not -- if they were radiogenic they would 

22 be radiogenic themselves. Bolstered by the 
. 

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1 three out of the five reviews as a supported 

2 position CLL should be considered, we started 

3 to conduct some research into appropriate risk 

4 model for CLL. 

5 When I say we, we actually engaged 

6 the services of SENES Oak Ridge, Inc., our 

7 dose risk model contractor. They are the same 

8 organization that developed in consort with 

9 National Cancer Institute the risk models that 

10 currently exist in NIOSH IREP. 

11 They did a detailed look into the 

12 molecular biological basis, the epidemiology, 

13 and the clinical basis of what was going on 

14 with CLL to see if a risk model could be 

15 assembled. I'll talk a little bit more about 

16 that later.

17 Concomitant with that effort we 

18 also -- these first two bullets should be 

19 reversed to get the chronology right. We are 

20 also doing research into the dosimetric target 

21 organ for chronic lymphocytic leukemia because 

22 being a disease or cancer of the lymphocytes 
. 

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1 it was not clear to us at that time what 

2 target organs should be reconstructed when we 

3 did dose reconstructions. 

4 Lymphocytes are present throughout 

5 the body so is there one particular organ that 

6 we need to consider or is it more diffuse? 

7 Well, the answer as it turned out was, in our 

8 opinion at that point, that the lymphocytes 

9 are diffusely disseminated throughout the body 

10 in both the hematopoietic system; that is, the 

11 bone marrow and the blood stream, as well as 

12 the entire lymph system of the body. That 

13 created somewhat of a difficult situation for 

14 us to reconstruct doses. 

15 We came up with that concept and 

16 Oak Ridge was the main player in this helping 

17 us out. We did pull subject matter experts on 

18 a draft opinion on this. I think we pulled 

19 three subject matter experts and they agreed 

20 with us that the etiology of CLL -- the origin 

21 of the cancer could be anywhere in the 

22 lymphatic or hematopoietic system and we 
. 

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1 proceeded to develop a dose model based on 

2 that concept.

3 After the risk model was drafted 

4 and dose reconstruction approach completed, it 

5 took sometime and it wasn't until actually 

6 January of 2010 that both of those pieces were 

7 finalized within NIOSH. Shortly thereafter on 

8 March 11th of 2011 we issued a Notice of 

9 Proposed Rulemaking in the Federal Register.

10 As I mentioned regarding the CLL 

11 risk models, SENES Oak Ridge conducted a 

12 comprehensive review of public papers that 

13 were out there. There were a lot of 

14 epidemiologic papers out there, notably those 

15 published by David Richardson, John Boice. 

16 There was an entire issue of the British 

17 Journal of Hematology that covered CLL that 

18 NIOSH researchers including Schubauer-Berigan 

19 and Silver contributed to. 

20 We considered all those in context 

21 and also compiled sex and age specific 

22 incidence rates because the incidence rates in 
. 

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1 Japan, as I mentioned, were very low and it 

2 would certainly not match those, we didn't 

3 expect, in the United States.

4 The third bullet here, one thing 

5 that is probably one of the more significant 

6 issues with CLL is the critically evaluated

7 epidemiologic data related to the issue of 

8 latency. CLL has been considered a disease of 

9 old age. A latency period was considered to 

10 be much longer than that of other leukemias, 

11 for example. 

12 Certainly of leukemias and 

13 actually even longer than those of solid 

14 tumors that we consider in NIOSH IREP. There 

15 was a lot of effort put into that. In fact, 

16 that was one of the larger sources of comments 

17 we received when the model was reviewed.

18 So as a starting point, SENES Oak 

19 Ridge used the existing myeloma and lymphoma 

20 model as a starting point for the model. One 

21 might remember that we have one model that 

22 covers non-Hodgkin's lymphoma, lymphoma, and 
. 

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1 multiple myeloma. 

2 That model is based on 117 cases 

3 that were in the life span study of the 

4 Japanese Hiroshima and Nagasaki survivors and 

5 those were used. We took that model and then 

6 developed an extended latency period tail on 

7 that model.

8 One of the reasons that we thought 

9 this was a good starting point is CLL is 

10 classified now as a form of non-Hodgkin's 

11 lymphoma by the World Health Organization. 

12 Given that it's no longer in the leukemia 

13 realm. 

14 At least in the World Health 

15 Organization's eyes it's a lymphoma, although 

16 that is inconsistent with the ICD-9, 

17 International Classification of Disease 

18 Registry, which still considered it leukemia 

19 but we strongly believe that the lymphoma 

20 designation is correct. 

21 Again, start with a multiple 

22 myeloma lymphoma model and then extend the 
. 

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1 latency period. The original draft model had 

2 a latency period of 15 plus or minus five 

3 years. 

4 As with other risk models, it's 

5 not a set value. The risk is very low. It's 

6 short latency period and there is an S-shape 

7 function that increases over time to confer 

8 maximum risk at some point out in time. 

9 As I said, we did have the model 

10 reviewed by four subject matter experts. I 

11 think two of them were the same ones that we 

12 asked the opinion on radiogenicity. We 

13 received a number of comments, reviewed those 

14 comments, and adjusted the model -- the 

15 document as appropriate.

16 But the major modification was to 

17 the risk model. One major modification risk 

18 model was the latency period which was 

19 shortened from 15 plus or minus five years to 

20 10 plus or minus five years. There was some 

21 evidence that there is a fair amount of 

22 uncertainty of the latency period with CLL and 
. 

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1 that has a lot to do with the way it's 

2 diagnosed in the field. 

3 Oftentimes CLL is diagnosed sort 

4 of coincidentally to other illnesses when a 

5 person goes in for a checkup. It oftentimes 

6 has no real clinical symptoms until it's 

7 fairly far progressed.

8 This is just a graph of the 

9 latency adjustment. Maybe I should explain 

10 this a little bit. The Y-axis here is a 

11 latency adjustment which is some fraction of 

12 the full excess relative risk per sievert.

13 If you look at .5, the 50 percent 

14 value, that would be 10 years. Then the 

15 dotted lines are the uncertainty about that 

16 latency adjustment plus or minus five years. 

17 At 10 years one gets 50 percent of the excess 

18 relative risk per sievert and an uncertainty 

19 factor is included in there as a triangular 

20 distribution of plus or minus five years. 

21 The lower bound would be five 

22 years, the upper bound would be 15 years. 
. 

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1 This latency adjustment will be incorporated 

2 into the multiple myeloma lymphoma model for 

3 the CLL excess relative risk per sievert 

4 calculation.

5 One thing we wanted to do was to 

6 sort of do a reasonableness check on the 

7 model. Let's quantitatively look at the model 

8 and see what kind of Probability of Causations 

9 that it generates because this is a brand new 

10 model and no one has ever looked at it before. 

11 We evaluated the model under a 

12 somewhat restricted exposure scenario and that 

13 was recalculated for males exposed between 20 

14 and 40 years of age who were acutely exposed 

15 to one sievert of high energy gamma radiation

16 so about 100 rem of gamma radiation exposed 

17 earlier in their career between 20 and 40 

18 years of age.

19 This will give you a sense of what 

20 the Probability of Causation results might be 

21 for someone exposed externally with a uniform 

22 beam of photons. Although the analysis was 
. 

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1 restricted to males, the results should be 

2 similar for females and that's because the 

3 same risk coefficient is used for both.

4 It turns out in the multiple 

5 myeloma and lymphoma in the Japanese survivor 

6 data the point estimates for risk in females 

7 is negative. It's only positive for males so 

8 we've applied the male positive estimates for 

9 use in this model.

10 What we found, I have a table to 

11 show this, the PC results were greater than 50 

12 percent for some cases under some 

13 circumstances. This slide is a little small 

14 and potentially hard to read but what you see 

15 here, and I highlighted in yellow on the 

16 slide, one reaches greater than 50 percent 

17 only under situations of the latency time of 

18 greater than 10 years and for early ages at 

19 exposure like 20 and 25 years. 

20 You can't get over 50 percent in 

21 this graph if you are exposed over 30 years of 

22 age to one sievert of external radiation. 
. 

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1 Interestingly, I put the 50th percentile on 

2 here and none of the 50th percentiles which, 

3 of course, we don't use approach the 50 

4 percent value.

5 There are certain circumstances 

6 under 100 rem of external radiation that would 

7 be compensated under this specific condition. 

8 I would say that 100 rem of external exposure 

9 is a fairly significant dose. We rarely see 

10 that in current days. 

11 I would think in the very early 

12 years in situations where you had a lot of the 

13 pitchblende ore processing going on, maybe in 

14 the Mallinckrodt era where they were doing a 

15 lot of that, you could get to that level. It 

16 would be fairly difficult to be compensated. 

17 The probability is not zero but you need some 

18 fairly substantial external doses to be 

19 compensated for CLL under this circumstance.

20 Let's talk a little bit about the 

21 dose reconstruction methodology. I mentioned 

22 CLL is a disease that originates from a 
. 

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1 population of lymphocytes and specifically of 

2 mature B lymphocytes, and more specifically 

3 antigen stimulated mature B lymphocytes. I've 

4 learned a lot in the research of this program.

5 We would call those precursor 

6 cells, CLL precursor cells these antigen 

7 stimulated mature B lymphocytes that can 

8 circulate basically throughout the lymphatic 

9 and hematopoietic system.

10 As we learned in our review, and 

11 our subject matter experts concur, these 

12 lymphocytes could undergo transformation to 

13 CLL clones anywhere in the blood forming or 

14 lymphatic system. Because of that, a dose 

15 reconstruction for a non-homogeneous exposure. 

16 The biggest example this, of course, would be 

17 internal dose must account for this. 

18 If you inhale plutonium we all

19 know it's going to preferentially accumulate 

20 in certain organs once it becomes systemic. 

21 Strontium-90 the same way. The dose to the 

22 CLL precursors is going to be very different 
. 

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1 from an internal perspective depending upon 

2 the radionuclide that is inhaled.

3 Because of that we're proposing to 

4 use a probabilistic approach based on the 

5 weighted average of the doses to the various 

6 irradiated sites. I've got a couple slides 

7 that hopefully can give you a feel for how 

8 that is going to work.

9 This is a slide of the 

10 distribution of lymphocytes in the body along 

11 with their 95 percentile confidence intervals. 

12 You can see that about almost 90 percent of 

13 the B cells reside in the lymph nodes, the 

14 spleen, bone marrow, and the intestine. 

15 Nonetheless, there are 12 various sites where 

16 these lymphocytes could reside and 13 if you 

17 count residential soft tissue component.

18 The biology is not extremely well 

19 known and that's why we put confidence 

20 intervals about these values because this 

21 represents the range of our knowledge based on 

22 the current available science. 
. 

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1 If one knows the distribution of 

2 lymphocytes and one knows the uncertainty 

3 about that distribution, then one could 

4 calculate an effective dose to the B 

5 lymphocytes in a spreadsheet type calculation. 

6 That's what is portrayed here in this example 

7 of dose calculation.

8 Here we have -- it's kind of hard 

9 to read, I understand, but I couldn't figure 

10 out a way to fit this on a more readable 

11 slide. Here you have the various compartments 

12 in the first column, the fraction of the pre13 CLL cells in that tissue in the second column. 

14 There's a column labeled "additional 

15 fractions" because that melds this stuff with 

16 the ICRP biological models.

17 In this particular example we've 

18 calculated what I would call the effective 

19 lymphocytic dose to ingestion of one becquerel 

20 of strontium-90. 

21 In the second column from the 

22 right you have the dose per unit intake of 
. 

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1 strontium-90 in sieverts per becquerel so one 

2 merely multiplies that dose coefficient times 

3 the fraction of the cells that are radiated in 

4 that compartment and you come up with the 

5 strontium-90 ingested per unit intake on the 

6 weighted dose component issue on the far 

7 right. 

8 If you sum that entire column up, 

9 you end up with the effective dose to the 

10 lymphocytes from an ingestion. In this 

11 particular case, strontium-90. The value in 

12 the lower right-hand column in yellow is the 

13 effective dose input that would go into the 

14 NIOSH IREP spreadsheet. 

15 It would also have though the 

16 propagated uncertainty of the distributions of

17 all of those various compartments. We have 

18 this running in a model basis as a 

19 spreadsheet. We are working towards tying 

20 this in with our IMBA program right now.

21 Interestingly, the overall spread 

22 of the distribution based on the uncertainty 
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1 of the location of all the lymphocytes is much 

2 smaller than the overall uncertainty we 

3 normally assign to an internal dose because 

4 all internal doses that we assign unless they 

5 are upper-bound estimates are recorded with a 

6 geometric standard deviation of three.

7 I can't remember exactly now what 

8 the overall uncertainty it adds to that GSD of 

9 3 is not insignificant but it's not a major 

10 portion of that GSD of 3. We're looking at 

11 ways to sort of streamline this a little bit 

12 and maybe just include the GSD of 3 for the 

13 internal dose and add a component, an 

14 additional uncertainty that is likely going to 

15 be a standard addition to that uncertainty in 

16 each case. That's where we are. It sounds 

17 complex but it's easily put into a spreadsheet 

18 type format.

19 In summary our proposed rule would 

20 rescind the designation of CLL as being non21 radiogenic and added as one of the covered 

22 cancers. I want to make sure, though, as 
. 

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1 pointed out, we're not talking about making 

2 this a presumptive cancer. We're talking 

3 about making this a covered cancer so that 

4 dose reconstructions can move forward.

5 A new risk model would be added to 

6 allow for calculation of Probability of 

7 Causation for CLL and that would be the 

8 modified version of the existing lymphoma and 

9 multiple myeloma model. The dose 

10 reconstruction methodology would use a 

11 probabilistic approach to calculate the 

12 weighted average dose for the population of 

13 the mature lymphocytes in the body.

14 All the information I just talked 

15 about, including the Notice of Proposed 

16 Rulemaking, the various reviews, subject 

17 matter expert reviews, our responses to their 

18 comments, the proposed dosimetry model are all 

19 included at this address in the regulatory 

20 docket 209. 

21 It's also available as a link from 

22 our DCAS website. If you go under Probability 
. 

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1 of Causation, you'll find the link there. As 

2 I said, it includes all the various 

3 information that we could think to put in 

4 there including all the relevant references. 

5 The public comment period closes June 20th. 

6 That's it. Thank you.

7 CHAIRMAN MELIUS: Thank you, Jim. 

8 I just want to correct one thing for the 

9 record. Although it's correct in your slide, 

10 I don't think it was clear when you presented 

11 it, and that is even though you're using the 

12 male risk model, you're applying it to both 

13 males and females. You just weren't complete, 

14 that's all. I didn't want anybody listening 

15 in not seeing the slides not to understand 

16 that.

17 I also would like some 

18 clarification because I'm confused. When I 

19 first went to the docket, and I still am 

20 confused based on what's in the rulemaking, 

21 but you have the SENES document which was the 

22 proposed risk model. Is there a document that 
. 

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1 updates that?

2 DR. NETON: That proposed risk 

3 model was modified and finalized to 

4 incorporate the comments that were received 

5 from the subject matter experts.

6 CHAIRMAN MELIUS: And is there a 

7 document that states that that is on the 

8 docket?

9 DR. NETON: Yes. There is a 

10 document called Responses to the Subject 

11 Matter Expert Comments. It's a 20-page 

12 document where we listed all the comments we 

13 received and our interpretation of those 

14 comments and whether we modified the final 

15 version or not.

16 CHAIRMAN MELIUS: But there is no 

17 final version?

18 DR. NETON: Well, it's a final 

19 version of the proposed model. This is 

20 proposed rulemaking. It's a proposed model. 

21 It could be modified based on comments we 

22 received. It's our final model but it's a 
. 

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1 proposed model until we finalize it based on 

2 comments.

3 CHAIRMAN MELIUS: It's confusing 

4 the way it's stated in the rule in the 

5 proposed regulations as opposed to what you're 

6 telling us now. That's why I'm just trying to 

7 understand what the Board is supposed to be 

8 responding to.

9 DR. NETON: The document to review 

10 is a proposed risk model that was modified 

11 based on public comments and those public 

12 comments are there as well.

13 CHAIRMAN MELIUS: So it's really 

14 the two.

15 DR. NETON: There's a third piece, 

16 though, which is the proposed dosimetric 

17 approach that is also out there on the 

18 regulatory docket which talks about this 

19 weighted probabilistic dose reconstruction 

20 approach. That took quite a bit of effort. 

21 This was really cutting edge science that we 

22 were dealing with. 
. 

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1 CHAIRMAN MELIUS: I guess I'm 

2 having a little trouble finding that on the 

3 docket. That's all.

4 Then let me just clarify so the 

5 Board knows, and I know, what we're suppose to 

6 do, or expected to do. You are expecting us 

7 to comment on the regulation or on the 

8 proposed dose model?

9 DR. NETON: Both.

10 CHAIRMAN MELIUS: Both.

11 DR. NETON: They are listed both 

12 in the NPRM. The NPRM discusses both pieces. 

13 It talks about the risk model. I think the 

14 last few paragraphs talk about the proposed 

15 dosimetric approach and it references the 

16 document that is on the regulatory docket.

17 CHAIRMAN MELIUS: Because, again, 

18 you state on the Notice of Proposed Rulemaking 

19 that EEOICPA has required that HHS obtain a 

20 technical review by the Advisory Board prior 

21 to establishing the Probability of Causation 

22 guidelines. That's why I wanted to make sure 
. 

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1 it's clear and clarify.

2 With that as background, does 

3 anybody on the Board have comments or 

4 questions?

5 MEMBER ZIEMER: Dr. Melius.

6 CHAIRMAN MELIUS: Yes, Paul. Go 

7 ahead.

8 MEMBER ZIEMER: Paul Ziemer here. 

9 I have two questions. One is procedural and 

10 one is technical. On the procedural is there 

11 an expectation that the Science Issues Work 

12 Group will look specifically at this proposal?

13 CHAIRMAN MELIUS: Paul, I would 

14 say that is one possibility. I think that 

15 they are trying to get comments back by June 

16 21st is the close so that's why I was asking 

17 what we were expected to review and comment 

18 on. There's different possibilities. 

19 I'm not saying this is what I 

20 would prefer but if one could approve the 

21 general concept and certainly the addition of 

22 the change in the regulation and say that we 
. 

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1 need more time to really look at the proposed 

2 guidelines and how they are going to do the 

3 guidance of dose reconstruction. 

4 Alternatively we could say that we 

5 approve both but I think we're really 

6 approving based on what's in the docket and 

7 what's the presentation that we got today. I 

8 don't think it was as straightforward to 

9 figure out exactly what we were expected to do 

10 when we received this but that certainly is 

11 one possibility. 

12 We could refer that part of it if 

13 people aren't comfortable approving both or 

14 there may be some other options between now 

15 and June 21st but we don't have any meetings 

16 scheduled in that time period. It would be 

17 difficult to even schedule one given some of 

18 the notice requirements for the Board.

19 MEMBER ZIEMER: My second question 

20 is technical. Admittedly, I haven't read the 

21 details on the reviewer's reports at this 

22 point. Maybe Dr. Neton can help me understand 
. 

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1 the final column on the weighted dose 

2 components and the rationale for adding those 

3 up. 

4 I tried to think of an analogy. 

5 Let's say, for example, there was an exposure. 

6 Just remove it from this and just say some 

7 kind of exposure where different organs in the 

8 body received different doses. If you wanted 

9 to know the total body dose, you wouldn't 

10 typically add up those doses.

11 In fact, if you had a total body 

12 dose of 5 rem, each organ in the body would 

13 have received that dose so you don't add them 

14 up. Or if you took a skin dose to the arm and 

15 a skin dose to the leg and so on, you don't 

16 typically add those up and get a total skin 

17 dose. 

18 I'm having a little difficulty in 

19 following the rationale for adding up the 

20 components here. I know the weighted part 

21 should be accounting for that but I'm missing 

22 something here.
. 

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1 DR. NETON: Well, this is very 

2 akin to how one does effective dose in the 

3 ICRP nomenclature where you have weighting 

4 values for each of the tissues that add up to 

5 100 percent and then you --

6 MEMBER ZIEMER: Okay. So, Jim, 

7 it's sort of like if you take the weighted 

8 doses from radon and add them up, then you get 

9 the 5 rem total even though the lung dose may 

10 be much higher. That's what you're saying. 

11 DR. NETON: Correct.

12 MEMBER ZIEMER: I got you. So, in 

13 a sense, it's been accounted for --

14 DR. NETON: Yes.

15 MEMBER ZIEMER: -- that particular 

16 organs got higher than this weight number.

17 DR. NETON: Well, it's what 

18 fraction of the total --

19 MEMBER ZIEMER: It's a fraction of 

20 the risk really that we're looking at here.

21 DR. NETON: Exactly. 

22 MEMBER ZIEMER: I got you. Okay. 
. 

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1 Thank you. That makes sense. 

2 CHAIRMAN MELIUS: I think our 

3 legal counsel would like to comment.

4 MS. LIN: Obviously not to the 

5 technical question. I just want to note that 

6 the public comment closes on June 20th so you 

7 need to submit your comment by then, not the 

8 21st. However, if the Board decides they need 

9 more time to consider the NPRM, then you need 

10 to tell the agency.

11 Additionally, in the NPRM there is 

12 a set of questions, right? Three or four 

13 questions?

14 DR. NETON: Yes, at the very 

15 beginning.

16 MS. LIN: Those questions would 

17 help guide your review.

18 CHAIRMAN MELIUS: Thank you for 

19 that clarification.

20 Other Board Members have 

21 questions?

22 I'm sorry, Jim.
. 

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1 MEMBER ROESSLER: Jim, I have a 

2 question on the latency adjustment. I assume 

3 that is sort of a multiplier that you apply 

4 after you do all the other calculations?

5 DR. NETON: Exactly. You take the 

6 excess relative risk based on attained age and 

7 age of exposure and you come up with that 

8 value. Then you multiply the excess relative 

9 risk value times the value in the Y-axis 

10 depending on where you are.

11 MEMBER ROESSLER: Then the 

12 uncertainty, you said, is you use a triangular 

13 distribution?

14 DR. NETON: Uncertainty is a 

15 triangular distribution about that. The 

16 dotted line, plus or minus five years, at 10 

17 years would be a lower bound of a triangular 

18 distribution. Five years and an upper bound 

19 of 15 years.

20 MEMBER ROESSLER: So then once you 

21 apply that, it could be zero.

22 DR. NETON: No.
. 

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1 MEMBER ROESSLER: The multiplier 

2 will never be zero?

3 DR. NETON: It approaches zero 

4 very asymptotically there as you see but it's 

5 never zero.

6 MEMBER ROESSLER: Never zero. 

7 Okay. Thank you.

8 DR. NETON: Pretty close to zero 

9 though, I think. If you're one month after 

10 exposure, you're not going to get much 

11 conferred risk.

12 CHAIRMAN MELIUS: Other questions? 

13 Yes, Bill.

14 MEMBER FIELD: Jim, again I have 

15 to congratulate you for taking the lead on 

16 this. I think this is really cutting-edge 

17 science. I think you put a lot of work into 

18 it. I think it's very sound. I guess my 

19 question has to do more with not the inclusion 

20 but the diagnoses. Is there a set criteria 

21 now for diagnoses? It's not like normal 

22 cancer where you use pathology. Most of the 
. 

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1 time you have to use flow cytometry to make 

2 the diagnoses.

3 DR. NETON: That's a good question 

4 and I don't know the answer to that other than 

5 we rely on the Department of Labor to provide 

6 us the cases and I'm trying to hide behind 

7 them. That's just the way the program is set 

8 up. 

9 If they present us a case that has 

10 an ICD-9 code that says it's chronic 

11 lymphocytic leukemia, then that's what we're 

12 going to do. That doesn't help, I'm sure, but 

13 I understand the issues. I'm well aware of 

14 the issues in diagnosing CLL.

15 MEMBER FIELD: Unlike Japan I 

16 think the rates are much higher in Europe 

17 versus what we have in the United States. I 

18 think part of that different is we have a very 

19 hard time making that and tracking that in 

20 cancer registries and just patient to patient. 

21 I think it's very under-reported.

22 DR. NETON: I agree.
. 

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1 MEMBER FIELD: Do you have a rate? 

2 Is it like around 15,000 estimated per year? 

3 Something like that?

4 DR. NETON: I know it's in the 

5 NPRM somewhere.

6 MEMBER FIELD: That's fine.

7 DR. NETON: There's a regulatory 

8 cost. I can't remember off the top of my head 

9 but it's pretty low. We don't expect to have 

10 too many cases of CLL come to this program. 

11 We expect a bolus in the beginning 

12 because, obviously, Department of Labor had 

13 some CLL cases in the very beginning and we 

14 worked through those but I don't think the 

15 overall number we are expecting to come 

16 through is going to be that large.

17 MS. LIN: I have reviewed the 

18 answer and it says $15,273. It says that the 

19 agency expects to review 363 reopened cases 

20 plus 132 new CLL cases in the first five 

21 years.

22 DR. NETON: So it's a pretty small 
. 

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1 number compared to the overall statistics.

2 CHAIRMAN MELIUS: Okay. I'm going 

3 back to one of my original questions. I'm 

4 looking through the docket and I do not see 

5 any final guidelines. I don't see anything in 

6 Responses to Comments and so forth that go 

7 back before the SENES report. 

8 The last description I see of any 

9 sort of dose reconstruction guidelines and 

10 model and so forth that really is the SENES 

11 report, plus what's in the Announcement of 

12 Proposed Rulemaking.

13 DR. NETON: There is a Response to 

14 Comments. I just printed it out.

15 CHAIRMAN MELIUS: Well --

16 DR. NETON: Isn't it called 

17 Responses to Comments of the CLL Risk Model. 

18 It should say Responses to Comments or 

19 something of that nature.

20 CHAIRMAN MELIUS: There is 

21 Response to Review Comments on the draft 

22 report --
. 

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1 DR. NETON: That's right.

2 CHAIRMAN MELIUS: -- dated 

3 December 1, 2009.

4 DR. NETON: Yes. That's it. Then 

5 the final --

6 CHAIRMAN MELIUS: That's before 

7 the SENES. I guess my question is is the

8 SENES report the January 2010 model?

9 DR. NETON: That's the final 

10 model.

11 CHAIRMAN MELIUS: Okay. Okay. 

12 That's what I was trying --

13 DR. NETON: Sorry for the 

14 confusion but I didn't want to call it the 

15 final model or the model. I just left it as a 

16 proposed model because it could change based 

17 on additional public comment during the open 

18 comment period.

19 CHAIRMAN MELIUS: Okay.

20 DR. NETON: What we did was we 

21 took the 2009 comments, and they're all 

22 listed, and incorporated them or not, based on 
. 

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1 our judgment, into that 2010 SENES document.

2 CHAIRMAN MELIUS: Okay.

3 DR. NETON: Sorry for the 

4 confusion.

5 CHAIRMAN MELIUS: No, no.

6 What's the Board's wishes in terms 

7 of going forward on this? I suspect we're not 

8 ready to take action right now, and we don't 

9 have to take action at this moment. We can 

10 think about it and come back during one of our 

11 work periods to talk about what to do and so 

12 forth.

13 Yes, Wanda.

14 MEMBER MUNN: Unless we come in 

15 individually I see no logical way between now 

16 and June 20th that we as a Board could make 

17 any comment unless we do as has been implied 

18 that we might do have our Work Group take a 

19 look at this, bring a recommendation before 

20 the Board prior to its next meeting, and make 

21 a recommendation at the next meeting.

22 This, of course, would require our 
. 

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1 notification to the agency that we have 

2 comment but can't make it by June 20 but it is 

3 one path we might follow if we really want to 

4 spend the time and effort to look at this as 

5 closely as it probably should be looked at 

6 given the amount of effort that's gone into it 

7 so far.

8 CHAIRMAN MELIUS: This may 

9 surprise you, Wanda, but I tend to agree with 

10 that approach. I think that may be feasible. 

11 I will say it's not -- if I understand the 

12 rulemaking process, while they are in the

13 process of developing the rule and so forth, 

14 they really aren't in a position to let us 

15 comment so it's not that they sort of kept 

16 this from us deliberately. Some of it is just 

17 the way the regulatory rules are and so forth.

18 MEMBER MUNN: We knew they were 

19 working on it and asked them to do so.

20 CHAIRMAN MELIUS: Yes. No, 

21 obviously. We talked about this before. It's 

22 also gone on for a long period of time.
. 

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1 Any other comments? If not, why 

2 don't we think about this over lunch. We'll 

3 come back during our work periods and decide 

4 what we should do and so forth on that. 

5 Thank you very much, Jim. That 

6 was a good presentation and I appreciate it.

7 With that, why don't we take our 

8 break. Actually, we are scheduled to start at 

9 1:30. We'll be talking about the Fernald 

10 petition. We will have petitioners, we 

11 believe, listening in so we will start 

12 directly at 1:30.

13 (Whereupon, the above-entitled 

14 matter went off the record at 11:52 a.m. and 

15 resumed at 1:30 p.m.)

16

17

18

19

20

21

22
. 

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1

2 A-F-T-E-R-N-O-O-N S-E-S-S-I-O-N

3 1:32 p.m.

4 CHAIRMAN MELIUS: We will 

5 reconvene now. It's 1:30. The Federal 

6 Executive Officer here is giving the Board 

7 Chair a hard time.

8 Ted, you want to check the line 

9 and do the housekeeping?

10 MR. KATZ: Yes. In case we have 

11 new people on the line, let me just ask people 

12 in general on the line to mute your phones. 

13 Use *6 if you don't have a mute button and 

14 that will help everyone else on the line here 

15 in the proceedings.

16 Can I check with my Board Members 

17 on the line and see who we have.

18 MEMBER GRIFFON: Mark Griffon.

19 MR. KATZ: Mark, welcome.

20 How about Dr. Ziemer or Mr. 

21 Gibson?

22 Okay. I think we'll just carry 
. 

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1 on.

2 CHAIRMAN MELIUS: First thing on 

3 our agenda for this afternoon is the Fernald 

4 site. This site, and we'll be talking 

5 tomorrow about Savannah River, are updates on 

6 what's been happening at the site. Both of 

7 these are fairly lengthy processes that the 

8 Work Groups have gone through. I believe 

9 Fernald longer than Savannah River.

10 I believe that we could very well 

11 be taking Board action on both of these sites 

12 at the August meeting. We are not planning on 

13 doing it at this meeting but the idea of these 

14 presentations is to bring the entire Board up 

15 to date on what the Work Group has been doing, 

16 SC&A and NIOSH and the back and forth and 

17 review that is under way. 

18 These are both large sites. They 

19 are both complicated. I thought that would be 

20 a way that we could at least get information 

21 so that if we are going to be ready to take 

22 action in August, at least we'll have a 
. 

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1 background and understand what's going on. 

2 Also it will give an opportunity for Board 

3 Members who aren't on the Work Group to raise 

4 questions or suggestions they might have for 

5 part of these evaluations. 

6 Obviously I don't expect people 

7 have read all the documents and gone through 

8 everything on these but, again, it will give 

9 us hopefully enough initial familiarity with 

10 the site and what's going on with the 

11 evaluation at that site, the SEC evaluation, 

12 that will be helpful for us in August. 

13 I think as you may see from the 

14 rest of the agenda here, we have a relatively 

15 lighter agenda than normal, at least in terms 

16 of voting and dealing with SECs than we did in 

17 the last few meetings but August will probably 

18 make up for it when we're in Hanford. 

19 Hopefully this will help to get us ready. 

20 With that, I'll turn it over to Brad to do an 

21 introduction and then --

22 MEMBER CLAWSON: Thank you, Dr. 
. 

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1 Melius. I'm Brad Clawson. I'm the Work Group 

2 chair for Fernald. What I wanted to make up 

3 front is I'm just going to give an overview of 

4 what we have done. John Stiver from SC&A is 

5 going to go into detail of each one of these 

6 items and we'll go from there.

7 First of all, SC&A submitted a 

8 Site Profile review 11/10/06. SC&A submitted 

9 an SEC review on 07/02/07. Six particular SEC 

10 issues were identified. There were 10 Work 

11 Group meetings held from August 2007 to April 

12 2011. Numerous White Papers exchanged from 

13 Work Group discussions. SC&A and NIOSH have 

14 prepared over 20 White Papers supporting 

15 documents during this time.

16 April 19, 2011 Work Group met. 

17 Three SEC issues remain. April 15, 2011 NIOSH 

18 submitted 0025 feed material, process center, 

19 internal dose topics in response to the Work 

20 Group's action item.

21 April 17, 2011 NIOSH delivered a 

22 response to SC&A second RU, recycled uranium, 
. 

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1 White Paper.

2 Outstanding issues. Coworker 

3 model for uranium internal exposure. November 

4 10th NIOSH performed an analysis of 

5 construction workers. What we got into was 

6 were we going to be able to capture the 

7 construction workers with the nonconstruction 

8 workers on their urinalysis bioassay. 

9 One thing about Fernald is it had 

10 a lot of uranium urinalysis data but not much 

11 OTIB-78 and delivered a report to the Board no 

12 deliverable as of April 19 of this year.

13 Issue No. 3, recycled uranium, RU. 

14 Two SC&A papers, March 2009, February 2011. 

15 Topics ongoing discussions since April of 

16 2009, five meetings. No progress until April 

17 19, 2011 at the Work Group. There's a little 

18 bit of movement on it but we kind of begged to 

19 differ on a few subjects.

20 Significant SEC issues remain. 

21 SC&A prepared responses. We have none at this 

22 time. We've kind of come to an impasse and 
. 

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1 this is where we're coming to the Board. 

2 Something that came out of the April 19th 

3 meeting was NIOSH indicated that they had 

4 located 450 boxes of site specific records. 

5 We don't know what the contents are on those.

6 Outstanding issues going on. 

7 Issue 6B, reconstruction of internal exposure 

8 for inhalation of thorium-232 from in vivo 

9 chest count data from 1968 to 1988. NIOSH has

10 a White Paper issued in January of 2008. The 

11 topic of the Work Group discussion since 

12 January 2010, four meetings. 

13 SC&A issued a review of NIOSH's 

14 White Paper July 2010. NIOSH responded to 

15 SC&A's review at the November 10, 2010 Work 

16 Group meeting. NIOSH submitted two memos 

17 January 19, 2011 in response to the SC&A 

18 review. Issues discussed in detail at the 

19 April 2011 meeting.

20 Issues remaining regarding data 

21 accuracy and completeness. This has been 

22 brought up by the petitioner. The time that 
. 

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1 it would take and the money it would take we 

2 never really -- we didn't think that we could 

3 go on on that one. We wouldn't even be able 

4 to understand if we could get something that 

5 was out of it.

6 To summarize this, we've been at 

7 this five years, 10 Work Group discussions. 

8 The timeliness issue comes up quite a bit, 

9 especially by the petitioners. Two SEC issues 

10 resolved with some caveats. 

11 The HIS-20 validation was 

12 completed. The thorium-232 daily weighted 

13 average there are a few caveats with this but 

14 two SECs that we've deemed at our Site Profile 

15 is raffinates thorium with Ra-226 and the K-65 

16 silos. They are in the process. We feel that 

17 these are going to become Site Profile issues 

18 but we haven't come to a conclusion on that.

19 The uranium coworker model, the 

20 construction versus subgroup issue one, still 

21 out there. Low progress on two significant 

22 issues prior to the April 19th Work Group 
. 

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1 meeting. We still have significant ones out 

2 there. We have new data that has come in that 

3 we haven't been able to review or that we even 

4 know what is in there.

5 The Work Groups work very hard on 

6 this, same as NIOSH and SC&A. At the last 

7 meeting I asked both sides if you go on to the 

8 database, the O: drive, SC&A has combined all 

9 of our White Papers and everything that we've 

10 done on it and so has NIOSH. They've put them 

11 in there so that you will be able to review 

12 this. 

13 We're bringing this to the Board 

14 because we're kind of at a point where we've 

15 kind of at an impasse and it's going to come 

16 down to the Board to be able to get involved 

17 and be able to review many of these things and 

18 be able to help us from there. 

19 That's about it. I'll turn the 

20 time over to John Stiver. Is there any 

21 questions?

22 CHAIRMAN MELIUS: First, any 
. 

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1 questions for Brad? Okay.

2 MEMBER CLAWSON: I'll turn it over 

3 to John.

4 CHAIRMAN MELIUS: I actually have 

5 one, Brad.

6 MEMBER CLAWSON: Okay.

7 CHAIRMAN MELIUS: Maybe John or 

8 somebody could -- what is a blunder?

9 MR. STIVER: This is a term that 

10 came out of a paper published in Health 

11 Physics by Adam Davis and Dan Strom. It's 

12 basically an uncertainty analysis of this 

13 whole weighted-air sampling data and its use 

14 in dose reconstruction in this program.

15 The problem there was that these 

16 data have been collected since the 1940s and 

17 it's pretty much a continuous process through 

18 time. It really wasn't intended to be used in 

19 the dose reconstruction setting. It was 

20 mainly for industrial hygiene purposes. 

21 As a result of that we never 

22 really did any kind of an uncertainty analysis 
. 

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1 on these data sets. Davis and Strom did this. 

2 One of the things they discovered they 

3 weren't expecting were a lot of typographical 

4 errors, math errors and things of that nature. 

5

6 They refer to them as blunders. 

7 It doesn't imply any degree of stupidity or 

8 anything like that. They are just mistakes. 

9 It's kind of an odd term. I expected to get 

10 that question actually.

11 MEMBER CLAWSON: Dr. Melius, I'm 

12 glad you brought that up because I thought 

13 what are we saying here.

14 CHAIRMAN MELIUS: Is this 

15 something you health physicists use commonly? 

16 I can't imagine it being a professional term 

17 but thanks for the explanation, John.

18 MR. STIVER: Okay.

19 MR. MORRIS: This is Robert Morris 

20 with ORAU team. I worked on some of that and 

21 I can answer your question, Dr. Melius.

22 CHAIRMAN MELIUS: Okay. Go ahead.
. 

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1 MR. MORRIS: Blunders is a 

2 technical term in one of the ISO standards on 

3 uncertainty.

4 CHAIRMAN MELIUS: Oh, okay.

5 MR. MORRIS: And it conveyed the 

6 idea of mistakes, typically a rounding error, 

7 a typographical error, a transcription error, 

8 or a mathematical mistake which you would see 

9 quite a few of in the 50s with no calculators 

10 handy.

11 CHAIRMAN MELIUS: Okay. I can see 

12 where blunder would sort of fit that.

13 MEMBER CLAWSON: We were not 

14 trying in anyway --

15 CHAIRMAN MELIUS: Thank you very 

16 much.

17 MEMBER CLAWSON: I didn't 

18 understand it either. I know what a blunder 

19 is. I get that quite a bit.

20 MR. KATZ: While John is coming 

21 up, I'm remiss to note for the record that Dr. 

22 Lockey has recused himself. Thank you.
. 

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1 MR. STIVER: Good afternoon, 

2 everybody. My name is John Stiver. I'm the 

3 Health Physicist with SC&A. The last couple 

4 of years I've been involved pretty heavily in 

5 the Fernald SEC issues resolution process. 

6 I'm actually fairly close to it. 

7 As Brad mentioned earlier, this is 

8 probably one of the SECs that has gone on the 

9 longest, about five years in time. I think 

10 the main reason for that is there are some 

11 very complex technical issues that have 

12 involved a lot of discussion. Kind of an 

13 iterative process of White Paper exchanges, 

14 knowledge being developed, new models being 

15 proposed in response and so forth.

16 So what you're going to see today 

17 is really a snapshot in time. This is the 

18 state of affairs as of the 10th Work Group 

19 meeting, the April 19th meeting. What you're 

20 going to see in summary may not make a lot of 

21 sense in terms of what you might typically 

22 expect for an SEC. Mainly that you would 
. 

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1 expect in the early years when there is a poor 

2 industrial hygiene process is data collection 

3 isn't very good.

4 You would think that would be 

5 always the -- in most cases that would be the 

6 time frame we need to be concerned with. 

7 Fernald has some kind of unique aspects to it 

8 that are going to result in some kind of 

9 unusual, not really recommendations but 

10 periods during which we feel that there may be 

11 issues involved in being able to reconstruct 

12 doses.

13 We can go ahead and get started 

14 here. You may have seen this slide not too 

15 long ago, or something very similar to it. 

16 This basically is just the overview. The six 

17 issues that were identified in the SEC 

18 Evaluation Report were the coworker model for 

19 uranium internal exposures, validation of the 

20 electronic database from which the hard copy 

21 records were transcribed. 

22 The issue of recycled uranium has 
. 

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1 probably been the most complicated of all. 

2 There is the use of radon breath data for 

3 reconstructing doses from radium and thorium4 230 mainly for workers in the refinery who 

5 handled raffinates which is a term for the 

6 waste product after uranium extraction. It 

7 contains high quantities typically of radium 

8 and thorium and subsequent U-238 decay 

9 progeny.

10 Associated with that is the review 

11 of radon emissions from the K-65 silos which 

12 were the principal source of radon exposure to 

13 workers at Fernald. Finally, issue 6 is the 

14 reconstruction internal inhalation exposures 

15 from thorium-232. This is really a two-part 

16 issue based on two different time frames.

17 The first being the use of these 

18 daily weighted exposures, weighted air 

19 concentrations from about 1954 up through '67. 

20 Then in '68 Fernald brought in this mobile in 

21 vivo rad monitoring laboratory from Y-12. At 

22 that time then the use of the air sampling was 
. 

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1 pretty sharply curtailed in favor of doing 

2 chest counts. From then on these chest counts 

3 were then used to assess intakes of thorium4 232.

5 As we said earlier, there have 

6 been 10 Work Group meetings, SC&A's work 

7 products and associated summary information. 

8 There's a file in there called "Read Me" that 

9 kind of gives you a synopsis of each one of 

10 these documents and what issue it fits into 

11 and kind of how it was developed. 

12 Sort of a CliffsNotes version I 

13 guess. Those can be found at the blue 

14 highlighted path file name there. As Brad 

15 said, after the April 19th meeting, just last 

16 month, there were still two main issues 

17 outstanding being the recycled uranium and 

18 thorium chest count issues.

19 Let's go ahead and take a look at 

20 these issues. I've been very close to this 

21 and so if I start going too fast and makes 

22 leaps of faith here, please sure to tell me to 
. 

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1 slow down the train and I'll do that. Or if 

2 there is something, some particular issue that 

3 comes up you want to discuss, you can stop me 

4 and we'll go through that.

5 This issue No. 1 is really about 

6 the completeness and adequacy of the bioassay 

7 data because this is really the cornerstone. 

8 Fernald has a lot of problems. What they do 

9 have is a lot of bioassay data, a lot of 

10 uranium bioassay data all the way back into 

11 the 50s.

12 Really the first step in 

13 developing a coworker model was to assess the 

14 quality and completeness of this data set. As 

15 of the April meeting all these issues have 

16 been resolved except for the issue of the 

17 coworker model for construction workers. 

18 I'm going to diverge a little bit 

19 here. At the Savannah River site we did some 

20 work on that site and we found that at least 

21 for certain years and certain buildings the 

22 construction worker exposures were 
. 

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1 statistically significantly higher than those 

2 for all workers. 

3 So what we want to do is kind of 

4 get a better handle on whether that issue is

5 going to be a problem for Fernald as well. 

6 NIOSH is in the process of developing this 

7 model as of the April 19th meeting. That 

8 report had not yet been completed.

9 Issue No. 2 is the validation of 

10 the HIS-20 database. This is really a two11 part issue, the first being the at some point 

12 in time NIOSH had done a validation study but 

13 stopped short of a complete analysis because 

14 they felt they had adequately analyzed the 

15 data to the level of significance that was 

16 required.

17 We at SC&A had some issues related

18 to that. As a result of the Work Group 

19 meetings NIOSH went ahead and completed that 

20 study. It was delivered in December of last 

21 year. It resolved all of SC&A's concerns. At 

22 the February 8th meeting it was recommended 
. 

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1 that Subpart A be closed out. Consequently 

2 there are no action items at this time.

3 Issue 2B. There were concerns 

4 raised by the petitioner about the integrity 

5 of the hard copy bioassay data; namely, that 

6 it may have been tampered with to create the 

7 appearance of lower exposures than actually 

8 took place.

9 SC&A prepared a report at the 

10 Board's instruction that looked at some 

11 strategies that could be used to analyze data 

12 sets for corrupt monitoring practices. We 

13 came up with three possible approaches to 

14 this. One was comparing the urinalysis to in 

15 vivo monitoring. Of course, you would be 

16 limited there by a subset of workers who 

17 really had complete sets in both time frames.

18 Another was to look at the 

19 consistency and reliability of the urinalysis 

20 results. Do the results really comport with 

21 the known biokinetics. If not, is there some 

22 kind of pattern where you have high followed 
. 

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1 by several lows that would make sense in terms 

2 of excretion rates.

3 The third approach was to compare 

4 the daily weighted exposure data to urinalysis 

5 records. There's a couple problems with that. 

6 You would have to have detailed knowledge of 

7 the workers' locations, job types throughout 

8 time, whether respiratory protections were 

9 worn and that type of thing.

10 The Work Group had agreed that 

11 such investigations, as Brad also mentioned, 

12 would consume considerable resources and would 

13 likely be inconclusive. As a result there are 

14 no action items at this time.

15 Now, the next few slides will be 

16 devoted to recycled uranium. This is probably 

17 the most complex of all the issues and still 

18 has some outstanding problems. 

19 Our main concern is, as you know, 

20 we've established that Fernald had a 

21 comprehensive set of uranium bioassay 

22 measurements but not much for some of these 
. 

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1 other constituents that would be found in 

2 recycled uranium, that being plutonium-239, 

3 neptunium-237, fission products such as 

4 technetium-99, strontium-90 and so forth.

5 The concern is really that the 

6 proposed defaults of a sort of one-size-fits7 all model that NIOSH will use, with what would 

8 considered bounding defaults and 

9 proportionality to the uranium content, was 

10 that there may be certain groups of workers in 

11 certain processes and certain time frames for 

12 which those values would not be bounding.

13 Here is an example of the 

14 dosimetric significance for the proposed 

15 original NIOSH default of 100 parts per 

16 billion on a uranium mass basis. The doses 

17 for plutonium could be up to five times higher 

18 than the uranium dose. Of course, that would 

19 scale with higher defaults, higher 

20 concentrations.

21 The period of interest. When we 

22 look at the timeline of the uranium receipts, 
. 

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1 they were first received in 1953. Between '53 

2 and 1961 I think there is about 45 metric 

3 tons. Then receipts really started to ramp up 

4 and peaked in the mid-1960s and then again in 

5 the mid-1980s for a total of about 18,000 

6 metric tons. There's a table in one of the 

7 DOE field office reports that illustrates that 

8 quite nicely. 

9 1986 after a long tenure by 

10 National Lead of Ohio, the M&O, Westinghouse 

11 Materials Company came along and replaced 

12 them. This was a result of some DOE 

13 investigations as well as an attached report 

14 on recycled uranium. A lot of things were 

15 kind of coming together in that time frame.

16 So Westinghouse came in and they 

17 really changed up the entire industrial health 

18 process. They introduced a comprehensive 

19 improvement, monitoring, air sampling, regular 

20 bioassay for different subgroups of workers. 

21 From 1986 and beyond we are fairly confident 

22 that doses from recycled uranium can be 
. 

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1 reconstructed.

2 Prior to 1986 one of the findings 

3 in our report was that the Rad-Safe program 

4 was probably not adequate to control exposures 

5 from these contaminants. Thus, the period of 

6 interest is really from 1953 to 1985.

7 Here is a little history of the 

8 different Work Group discussions and what 

9 happens to kind of give you a snapshot, a 

10 thumbnail sketch, I guess, if you will of what 

11 the issues were at various time frames.

12 All the way back in October of 

13 2008 we were tasked to review the NIOSH White 

14 Paper on RU with basically the same goal in 

15 mind throughout the entire period which was 

16 are these defaults going to be appropriate and 

17 bounding for all the workers.

18 As of January of 2010 we produced 

19 our White Paper. We discussed it. NIOSH had 

20 not had time to respond to it and agreed to 

21 prepare their response for those 11 findings 

22 which they indeed did at the November 9th 
. 

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1 meeting of last year. The responses were 

2 discussed in detail and some action items 

3 emerged from that.

4 This particular meeting really 

5 concentrated on the source of data that were 

6 used to generate these defaults, mainly these 

7 DOE reports that came out around the year 

8 2000, these mass balance reports that really 

9 traced quantities of recycled uranium 

10 throughout the DOE complex.

11 In addition to that, there were 

12 some site-specific data that we felt indicated 

13 that these defaults may not be applicable to 

14 actual worker exposures at the site. Our 

15 action items produced the second RU report 

16 that really focused in on the availability of 

17 site-specific data. 

18 Also really look into the veracity 

19 of the field office report subgroups. 

20 Basically what they did was they came up with 

21 19 different process subgroups for this data. 

22 There are about 4,000 plutonium measurements 
. 

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1 mostly taken in the 1980s. They used process 

2 knowledge experts. 

3 Also the available data to parse 

4 this data set down in different processes 

5 which would then correlate to various 

6 activities that might have taken place in the 

7 facilities.

8 At the February meeting we 

9 presented our second RU White Paper. These 

10 were some key findings here many of which were 

11 unchanged from our first report, one of those 

12 being there was a lack of data and limited 

13 health physics program integrity during the 

14 NLO tenure.

15 There were limitations associated 

16 with the DOE reports, these mass balance 

17 reports. Typically variability uncertainty 

18 and data completeness issues. The big issue 

19 that emerged from our review of the site20 specific data was this dolomite problem. This 

21 was magnesium fluoride used in the reduction 

22 of green salt to uranium medal. This takes 
. 

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1 place in Plant 5.

2 This is a process that 

3 concentrates these contaminants. Every time 

4 one of these reduction pots is utilized, about 

5 50 percent -- 50 to 60 percent of the 

6 plutonium transuranics and other fission 

7 products move into the slag.

8 Then the slag is then re-milled 

9 through Plant 1, recycled, and used again so 

10 you have this continuous loop. Actually a 

11 small part of it is either sent off to be re12 extracted if the uranium content is high 

13 enough. Another portion is disposed of. 

14 About half of it each time around gets reused 

15 so you have this concentration loop that's 

16 going on. These are the most highly exposed 

17 process subgroups in the entire facility.

18 We found high plutonium and 

19 neptunium in concentrations in dust collector 

20 samples which also correlate to Plant 5 and 

21 Plant 1. We found high concentrations in 

22 boundary air samples. I think there were 
. 

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1 seven of them, seven different locations. 

2 There were well over 200 parts per billion in 

3 1983.

4 We also looked at subsequent 

5 years. You see the spike coming in about 1982 

6 which correlates to this time frame of 

7 processing of the most highly contaminated 

8 materials. It peaks out about '84 and then 

9 drops back down to less than 100.

10 We also found high concentrations 

11 and onsite air samples collected in 1989. We 

12 have concerns to some extent about back 

13 extrapolating this data from the 1980s to 

14 earlier time periods. 

15 This idea of one size fits all 

16 model where it's kind of an all or nothing 

17 phenomenon you don't have the granularity to 

18 look at the subgroups and say, "Okay, for this 

19 group of workers and this year and this plant 

20 we can't reconstruct the doses but these other 

21 guys over here we think we're okay with." 

22 Here you've got one size fits all. 
. 

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1 It's either you've got it or you don't. It's 

2 very critical that you have bounding yet 

3 plausible upper bounds. 

4 NIOSH was tasked then to respond 

5 to the second report and provide a response 

6 for the next meeting. They did deliver a 

7 response. It turned out it was right before 

8 the meeting so these next slides are really 

9 based on about one-day's review of the 

10 response. It's just the way it turned out. 

11 We haven't been tasked to continue our work at 

12 this point so what you're seeing now are 

13 preliminary observations based on what NIOSH 

14 provided.

15 We found some very good things 

16 about this new report, couple of things that 

17 we'd had troubles with before. Now their 

18 acknowledgment of these chemical processes and 

19 magnesium fluoride could pose a potential 

20 exposure above their previous default levels.

21 They acknowledge the limitations 

22 and the uncertainties in the DOE field office 
. 

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1 reports. Previously they had used the 

2 arithmetic mean values for these subgroup 

3 processes to define their defaults. Those 

4 ranges of data were very extreme. Very large 

5 spread in the data. We felt that log-normal 

6 fit was probably more appropriate based on our 

7 analysis in our first RU report.

8 They proposed using the upper 95th 

9 percentage for log-normal distributions for 

10 all but the highest process subgroup for the 

11 period of 1973 to 1989. This period is when 

12 these tower ash and incinerator ash residues 

13 from the gaseous diffusion plants were sent to 

14 Fernald for extraction of uranium.

15 This material was significantly 

16 more elevated in these contaminants than 

17 previous shipments had been. This subgroup 

18 represents probably the highest concentration 

19 of any amount of material

20 In the 1980s the most contaminated 

21 there were 16 hoppers that this tower ash that 

22 came in from Paducah. The term they use for 
. 

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1 this is plutonium out of specs, or POOS for

2 short. This POOS material in 1980 really had 

3 contributed about 50 percent of the entire 

4 plutonium inventory from that point on at 

5 Fernald.

6 The net result was an increase in 

7 the default values. Factor of 4 for 

8 plutonium. It went up from 100 to 400 parts 

9 per billion. They used the subgroup 8 which 

10 happened to be the magnesium fluoride data 

11 set. A factor of 3 for neptunium and a factor 

12 of 2 for technetium-99.

13 There are still some outstanding 

14 problems with it and this is probably -- slide 

15 10 really lays out our position on this at 

16 this point based on our preliminary review. 

17 NIOSH continues to correlate the increase in 

18 worker exposure potential with receipts of 

19 this POOS material beginning in 1973.

20 Remember the new higher defaults 

21 are to be applied from '73 on. Prior to 1973, 

22 though, they are proposing these very low 
. 

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1 continuant concentrations, seven parts per 

2 billion uranium, two parts per billion 

3 neptunium, and tech-99 is way down there at 

4 19.

5 However, at the last meeting in 

6 our discussions, one thing we weren't really 

7 clear about was where in the process does this 

8 POOS material get downblended? Is it up front 

9 or a subsequent process that might allow a 

10 higher fraction of workers to be exposed. It 

11 turns out that this material was downblended 

12 before it ever went to the refinery.

13 You have in Plant 1 the sampling 

14 plant, milling plant, and also a little bit in 

15 Plant 4. This is where this material was 

16 downblended. It was downblended to bring it 

17 into specifications with uncontaminated 

18 uranium oxide before it was fed into the 

19 refinery.

20 From the standpoint of the workers 

21 downstream of that initial processing, or 

22 initial downblending, the arrival of this 
. 

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1 material in 1973 really has no impact on 

2 exposures that would have been experienced 

3 before. So the magnesium fluoride data, which 

4 is significantly farther down the stream from 

5 the refinery, is really indicative of 

6 conditions that existed in this plant from the 

7 get go. 

8 You've got metal production that 

9 has not changed from the inception when the 

10 plant was first brought on line until when 

11 they stopped. They used the same process, 

12 green salt reduction. The same types of 

13 apparatus. These high values you're seeing 

14 don't just apply to '73 and beyond. They 

15 apply all the way back to the extent that they 

16 apply at all.

17 From 1973 on, though, '73 to '85, 

18 you have this other group of workers who are 

19 subjected to the group 10A materials, the most 

20 highly contaminated group. We feel that post21 downblending are not to be correlated with 

22 POOS receipts and the higher defaults may be 
. 

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1 applicable. I should have gone to the next 

2 slide here. I think I got ahead of myself. 

3 Anyway, in summary we've got --

4 this is the snapshot of where we stand on RU 

5 right now. NIOSH has proposed higher 

6 defaults. They considered variability in the 

7 DOE field office reports and their 

8 uncertainties. 

9 The plutonium defaults were based 

10 on the magnesium fluoride data set which is a 

11 very robust data set in our opinion. Four 

12 hundred data points, site specific. It is 

13 limited to the 1980s but the process was 

14 unchanged from earlier periods. Back 

15 extrapolation is not the kind of issue it 

16 might normally be.

17 It is the highest group except for 

18 subgroup 10A. Log-normal fit actually over19 predicts the 95th percentile of the data. If 

20 you look at the data set, the probability plot 

21 actually has kind of a hockey stick shape to 

22 it. The 95th percentile fit is above most of 
. 

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1 the data points.

2 The initial POOS feed 

3 concentrations in subgroup 10A is where we 

4 still have an issue. This may impact the 

5 handlers, downblenders, and possibly indirect 

6 exposures to nearby workers, bystanders who 

7 may also be subjected to these high 

8 concentrations.

9 The data set contained only 39 

10 points. It's extremely variable and 

11 uncertain. We have in the DOE a Ohio report.

12 I think it's Appendix F where they have the 

13 summary statistics. No, it might be C. I 

14 forget. Basically they have all the different 

15 data points tabulated for the different 

16 groups. 

17 What they have is for this group 

18 10A it's about the only set where you've got 

19 measurements taken by two different 

20 laboratories at two different locations. 

21 You've got measurements taken at Paducah and 

22 you also have measurements on the receiving 
. 

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1 end at Fernald. 

2 Just an example, one of the most 

3 highly contaminated batches, one of the 

4 hoppers, there was a variability of almost a 

5 factor of 10 based on two measurements from 

6 that one hopper. You've got very sparse data 

7 set, highly uncertain, high amount of 

8 variability.

9 NIOSH in our meeting claimed that 

10 the operators at the plant, at NLO, knew that 

11 this material was coming. They used airline 

12 respirators, special procedures to protect the 

13 workers. From a common sense standpoint that 

14 makes perfect sense. However, our review of 

15 the historical documentation, the RU Task 

16 Force report, kind of cast doubt on the 

17 effectiveness of these procedures in time. 

18 We have a potential exposure whose 

19 impact has not been quantified or estimated at 

20 this time. We feel that it's significant from 

21 about '73 to '85, particularly from 1980 to 

22 1986 when the most contaminated ash was 
. 

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1 received.

2 As Brad mentioned, one of the 

3 action items from the November meeting for 

4 NIOSH to conduct a search for additional 

5 documentation, the raw data, and that's where 

6 this 450 boxes from Legacy National came from. 

7 Any questions about recycled uranium at this 

8 point or can I go on? Any questions? Too 

9 many questions? Okay. Let's go ahead and 

10 move on.

11 CHAIRMAN MELIUS: Well, maybe I 

12 can ask now since you brought it up again. Do 

13 we have any idea on these 450 boxes what they 

14 contain?

15 MR. STIVER: As of the meeting the 

16 contents were unknown.

17 CHAIRMAN MELIUS: Mark.

18 MR. ROLFES: This is Mark Rolfes. 

19 We have samples some of the 450 boxes held at 

20 DOE Legacy Management. I think we sampled 

21 roughly 25 to 35 of those boxes. They do 

22 contain isotopic analyses from the Fernald 
. 

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1 site for the various constituents of the 

2 recycled uranium that was processed at 

3 Fernald.

4 From my recollection these samples 

5 were collected from the '60s, '70s, '80s. 

6 There was a lot of focus on the 1980s 

7 primarily because that was the time period 

8 that the highest transuranic contaminated 

9 materials were processed.

10 We haven't gone through an 

11 extensive -- we haven't gone through the 

12 entire contents obviously because of the 

13 volume of records that are available. I don't 

14 know if you have any other questions.

15 CHAIRMAN MELIUS: No, just trying 

16 to get at least a preliminary understanding. 

17 Thanks, Mark.

18 Wanda, you had a question? Then 

19 Bob.

20 MEMBER MUNN: I'm not sure I can 

21 even phrase this question properly because I 

22 think I missed something on what you were 
. 

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1 saying, John, when we were talking about POOS 

2 when it went into the process. I didn't quite 

3 follow after you said it came into the front 

4 end. Therefore, it would not have had any 

5 effect on the downstream exposure prior to the 

6 time that it arrived or after it arrived. Did 

7 I misstate that?

8 MR. STIVER: Yes. The reason 

9 being is the POOS materials were downblended 

10 in Plant 1 before they were ever fed into the 

11 refinery.

12 MEMBER MUNN: Right.

13 MR. STIVER: The concentrations in 

14 that material going into the refinery would 

15 have been diluted down so it wouldn't have had 

16 this big bolus of highly contaminated material 

17 going through the refinery and on to 

18 subsequent steps. It was downblended and 

19 diluted beforehand.

20 MEMBER MUNN: It was downblended 

21 to the point that there was no significant 

22 difference between that blend and what the 
. 

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1 downstream workers were handling before this 

2 process began?

3 MR. STIVER: I believe they were 

4 downblending it not to 10 parts per billion. 

5 I don't remember the exact number. I believe 

6 it was between 10 and 20. You can see from 

7 the magnesium fluoride data sets that has an 

8 order of magnitude higher than what's coming 

9 in in the feed. 

10 You really have this group of 

11 workers who have the highest exposure 

12 potential by virtue of this concentration 

13 mechanism that is going on. That 

14 concentration if you look at the content of 

15 the feed materials over time after 

16 downblending, if you look at it on a graph, it 

17 would pretty much be a flat line. 

18 There might be some little blips 

19 here and there. The concentration you're 

20 seeing in the 1980s we believe would most 

21 likely be applicable to early time periods 

22 just based on the process knowledge and the 
. 

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1 chemistry that is going on.

2 MEMBER MUNN: So what you're 

3 really saying is the POOS doesn't matter.

4 MR. STIVER: It matters for this 

5 other group. It matters for the handlers and 

6 the downblenders.

7 MEMBER MUNN: Only in Plant 1 only 

8 upfront.

9 MR. STIVER: But do we know who 

10 those workers are? That's the point beings 

11 that hasn't yet been estimated or quantified 

12 so that's why we can still consider that an 

13 outstanding issue.

14 MEMBER MUNN: Okay. My other 

15 question dates back prior to a couple of 

16 earlier comments. I have the impression that 

17 there is no -- you're saying there's no real 

18 reliance on any of the bioassay data that's 

19 available.

20 MR. STIVER: Bioassay data that 

21 were collected for transurancis and recycled 

22 uranium were after 1986 when Westinghouse came 
. 

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1 on board.

2 MEMBER MUNN: There isn't anything 

3 for the earlier years?

4 MR. STIVER: No, there is nothing 

5 for the earlier years but you do have a lot of 

6 uranium bioassay data. If you can bound the 

7 constituents in that uranium, then you can 

8 link that after the uranium bioassay result 

9 and that's the strategy that's been employed 

10 here.

11 MEMBER MUNN: I guess what I'm 

12 really trying to get at is whether there is 

13 any question being raised with respect to the 

14 bioassay data that does exist for the earlier 

15 years.

16 MR. STIVER: The uranium bioassay 

17 data has been validated for issue one about 

18 the adequacy of the data.

19 MEMBER MUNN: That's what I wanted 

20 to verify.

21 MR. STIVER: It was all 

22 interrelated. As John Mauro likes to say, 
. 

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1 that's the rock we're standing on. That's 

2 really the cornerstone.

3 MEMBER MUNN: Something you said 

4 led me to believe that because the existing 

5 bioassay data did not have some counter test 

6 that it was not being relied upon but I 

7 misheard what you were saying then.

8 MR. STIVER: That might have been.

9 MEMBER MUNN: All right. Thank 

10 you, John.

11 MEMBER CLAWSON: John, if I could 

12 just make a comment, too, for the Board. One 

13 thing to remember is that Fernald was run as a 

14 heavy metals plant, Lead of Ohio. They ran it 

15 like a heavy metals plant. They were doing 

16 urinalysis just like you would for lead or 

17 anything else like that but they were looking 

18 for uranium. 

19 That's what they had. We've got 

20 fairly good data on that. I think it's 450 

21 different ones but that's all they did. They 

22 ran it like a heavy metals plant until in the 
. 

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1 late 1980s and so forth when they were 

2 replaced by Dow and so forth. Then they 

3 really started -- that's when they started to 

4 have a RadCon program for the radionuclides 

5 that were out there.

6 MEMBER MUNN: But I think I hear 

7 you saying that since you are not -- you don't 

8 have enough confidence in your knowledge of 

9 the constituents of what was being handled to 

10 be able to extrapolate from the uranium data 

11 to other radionuclides. I think that's what 

12 I'm hearing. Right?

13 MR. STIVER: No. The issue is we 

14 felt the default values that NIOSH had chosen 

15 were not bounding. 

16 MEMBER MUNN: Oh.

17 MR. STIVER: It's tied back to the 

18 uranium bioassay data which we feel is solid. 

19 It's just those ratios of the contaminants 

20 you're going to add into that and 

21 corresponding activity to account for these 

22 other materials, are those values bounding. 
. 

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1 If it's a one-size-fits-all kind of model, 

2 it's critical that those values be bounding 

3 for all Classes of workers.

4 MEMBER MUNN: So it's the bounding 

5 that you are questioning.

6 MR. STIVER: It's really the 

7 bounding.

8 MEMBER MUNN: All right. Okay.

9 CHAIRMAN MELIUS: Isn't it whether 

10 you can set a reasonable bound?

11 MR. STIVER: Yes, and that's why 

12 we think this magnesium fluoride data is so 

13 critical to the process.

14 CHAIRMAN MELIUS: Okay.

15 Bob.

16 MEMBER PRESLEY: This is an issue 

17 that we've struggled with for a long time and 

18 this is a lot of data that's come out. It's 

19 not new. We've been discussing this for a 

20 while. There's some new stuff that SC&A has 

21 brought up here. I would like to know, has 

22 HHS had a chance to look at this and see if 
. 

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1 they agree with it or what? These issues that 

2 we've got now, or what their position is.

3 CHAIRMAN MELIUS: Well, if I 

4 understand this correctly, and I hope the 

5 issues that you are referring to is that for 

6 whatever reason SC&A and the Work Group 

7 received the latest NIOSH report relevant to 

8 just before the last Work Group meeting.

9 MR. STIVER: Right. It's 

10 preliminary. 

11 CHAIRMAN MELIUS: So this is a 

12 preliminary analysis. SC&A have not even 

13 committed to -- have not even been tasked yet 

14 with a more complete analysis of that. I 

15 think one of the issues -- one of the things 

16 going through my mind is we need to get SC&A 

17 tasked and then it will be appropriate for 

18 either as part of a Work Group session or part 

19 of a more formal response for NIOSH to weigh 

20 in. 

21 I think to resolve this we need at 

22 least a response to the NIOSH report and then 
. 

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1 we need another Work Group meeting to hash 

2 this out. That would include some response 

3 from NIOSH. We're not trying to presume that 

4 this is all closed at this point in time.

5 MR. STIVER: I would agree with 

6 you 100 percent on that.

7 CHAIRMAN MELIUS: Is that fair, 

8 Bob? Okay.

9 MR. STIVER: Should we go ahead to 

10 the next --

11 MEMBER FIELD: Just a quick 

12 question. You said earlier on that 

13 construction workers had higher exposures?

14 MR. STIVER: For Savannah River 

15 site I did some analysis of their data and for 

16 certain years and certain buildings the 

17 construction worker values were statistically 

18 higher than they were for other workers. 

19 Especially when you have a subdistribution.

20 MEMBER FIELD: Do you know why 

21 that would be?

22 MR. STIVER: I'm really not sure. 
. 

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1 There are probably many different factors 

2 that could contribute to that. The fact that 

3 they are moving among a lot of different 

4 buildings. Plus they may not have had the 

5 same level of scrutiny and monitoring that the 

6 other workers might have had. We have that 

7 uncertainty there.

8 MEMBER FIELD: Okay. Then you 

9 mentioned there's a good number of 

10 subprocesses that go on?

11 MR. STIVER: I was talking about 

12 in relation to the mass balance reports that 

13 DOE put out. What they tried to do was 

14 account for the movement of these materials 

15 throughout the DOE complex. They did that by 

16 assigning these data into a subgroup process 

17 based on process type.

18 MEMBER FIELD: I see. Okay.

19 MR. STIVER: They came up with 19 

20 different subgroup processes.

21 MEMBER FIELD: Okay. Are there 

22 workers associated with those?
. 

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1 MR. STIVER: That's where you 

2 would be able to identify, I would say for 

3 this particular one I keep bringing up, the 

4 magnesium fluoride, we know that process was 

5 involved in metals production which was also 

6 the dustiest process. The dirtiest jobs in 

7 the entire plant were metals production. Not 

8 only the dirtiest but they also have the 

9 highest concentrations.

10 MEMBER FIELD: What I'm wondering 

11 is can you like assign workers that match 

12 those processes?

13 MR. STIVER: Do you have the 

14 granularity to say --

15 MEMBER FIELD: Right. He worked 

16 in this process.

17 MR. STIVER: You may on an 

18 individual basis. I believe the reason we are 

19 going to these -- I don't want to be speaking 

20 for NIOSH but it's apparent from my 

21 involvement you just don't have the 

22 granularity to assign workers into particular 
. 

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1 buildings at certain periods of time. A lot 

2 of them moved among different buildings. 

3 There wasn't always a good record of tracking 

4 where they went and when they went and that 

5 type of thing.

6 MEMBER FIELD: Do you have any 

7 insights whether or not the bioassay data 

8 covered most employees or was there just a 

9 lockdown on some employees?

10 MR. STIVER: That's a little 

11 outside my area of expertise. I believe even 

12 in the 1950s about 25 percent of workers were 

13 covered. Then in the '60s it was up to 90 

14 percent.

15 MEMBER FIELD: Okay. Thanks.

16 MR. STIVER: John might be able to 

17 weigh in on that. He did the analysis on that 

18 issue.

19 DR. MAURO: Awhile back we looked 

20 really carefully at issue No. 1, the 

21 completeness and adequacy of the uranium 

22 bioassay data which basically was they took 
. 

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1 urine samples and measured milligrams per 

2 liter of uranium in urine. The data starting 

3 in '52 up through '57, 25 percent of all 

4 workers had data which is a lot. 

5 They had more than one urine 

6 sample in a given year. Then starting in '57 

7 over 90 percent of all the workers had 

8 bioassay data of that type where they had more 

9 than one urine sample per year. When I say 

10 this is the rock you stand on, it means you 

11 got really good urine bioassay data. 

12 There still is this question 

13 whether the -- there may be a few workers, 

14 some workers, who need to use a coworker model 

15 but, remember, over 90 percent have the data. 

16 Maybe 10 percent you'll have to resort to a 

17 coworker model. 

18 The coworker model was developed 

19 and this question that came up on construction 

20 workers really goes to the question, okay, 

21 when you do have to use coworker data, does 

22 the distribution that you build with all of 
. 

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1 this data apply to all workers or is it 

2 possible that construction workers may need

3 some adjustment as was done with Savannah 

4 River?

5 That's the question that is being 

6 looked at by NIOSH by looking at that subset 

7 because they do have that data. They could 

8 break out those workers and ask themselves if 

9 one size fits all or do you need an adjustment 

10 factor. 

11 SC&A's position is that if there 

12 is a difference, it will be apparent once you 

13 sort that data and the degree to which you 

14 need an adjustment factor will emerge from 

15 that. That's why we refer to it as a Site 

16 Profile issue more than an SEC issue.

17 MR. STIVER: Okay. Issue 4. This 

18 is for the intakes of radium and thorium-230 

19 by the raffinate workers, the Plant 23 

20 refinery workers who handled these wastes.

21 Based on our former discussions 

22 and exchanges of White Papers, we believe that 
. 

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1 the NIOSH OTIB-25 which utilizes radon breath 

2 data to ascertain radium and thorium intakes 

3 is a sound methodology. We have no issues 

4 regarding that with this caveat that the 

5 intake ratio of the two radionuclides are 

6 known and the worker population be identified. 

7 The remaining issue we had with 

8 this is there is a subgroup of workers for 

9 which they have potentially high intakes of 

10 thorium-230 in these waste streams without a 

11 corresponding radium concentration or a 

12 significant uranium concentration. 

13 This is what sparked the review of 

14 Revision 7 of this White Paper that is listed 

15 here under the status of the issue. NIOSH 

16 posted their response to our review of their 

17 White Paper, this Revision 7 White Paper on 

18 Fernald thorium-230 and other associated 

19 radionuclides Revision 7 so NIOSH has posted 

20 their response to that.

21 Let me just back up and say what 

22 the issue was here. Most of these Q-11 pitch 
. 

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1 blend sources of feed materials came in from 

2 the early '50s until about 1958. Then after 

3 that Fernald went more -- started processing 

4 yellowcake produced in the U.S. and Canada. 

5 This material already had the 

6 radium extracted from it but not the thorium7 230 so you have material going to these three 

8 different silos. There's 1 and 2 contain the 

9 K-65 materials, a great deal which came from 

10 Mallinckrodt in about 20,000 barrels that were 

11 then hand dumped into a slurrying device and 

12 then fed into the silos. They have radon 

13 breath data for that group of workers.

14 But we're concerned with these 

15 people for which uranium bioassay data is 

16 going to be below the detection limit and you 

17 don't have any radium that could be measured 

18 either. How do you get a handle on these 

19 potential thorium-230 intakes for these 

20 workers?

21 Well, at our last Work Group 

22 meeting -- Mark, correct me if I'm wrong on 
. 

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1 this but the way I understood it was what they 

2 are going to do they essentially consider that 

3 this is going to be an non-exposure situation 

4 because this material that was -- this 

5 yellowcake, when it was handled, when the 

6 raffinates were produced, the material was 

7 calcined. 

8 This was from a period about up 

9 until 1962. The reason they did that was to 

10 recapture the nitric acid because it was 

11 valuable. What you are left with here is this 

12 fine dispersable dry powder. But NIOSH's 

13 position, and what the source documentation 

14 indicates, is that this process took place in 

15 a closed system. 

16 Calcining mechanism was closed and 

17 then it was airlifted over to silo 3. Then 

18 they showed in Appendix A of this report a 

19 series of air-sampling data that show in the 

20 raffinate area you've got basically detection 

21 limits, MDL levels of air concentration. 

22 What they are proposing to do is 
. 

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1 then they're saying, "Okay. Well, we know 

2 this material. If there was any kind of an 

3 intake, the uranium content is not zero but 

4 it's going to be below the detection limit." 

5 It becomes one of these missed dose situations 

6 where you take half the detection limit. 

7 Then based on the known ratios for 

8 measurements of what was in the silo, you know 

9 the ratio of uranium to thorium-230 and then 

10 you can make an adjustment factor. It becomes 

11 one of these using the uranium data as a 

12 surrogate for these other nuclides when the 

13 concentration ratios are known. 

14 Mark, is that pretty close to 

15 what --

16 MR. ROLFES: This is Mark. Yes, 

17 what you said is essentially correct. The DWE 

18 data in the raffinate areas were very low air 

19 concentrations right around background 

20 essentially. 

21 If, for example, an individual was 

22 potentially exposed to silo 3 material, we 
. 

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1 could use their urinalysis data and it could 

2 be a positive urinalysis data. There is 

3 nothing -- you know, even if it's not a 

4 positive urinalysis data, we would still use 

5 that data to assign ratios of other 

6 radionuclides.

7 MR. STIVER: So there is no 

8 intention of using the DWE data for the entire 

9 plant to do any kind of bounding doses?

10 MR. ROLFES: We can certainly do 

11 that if we needed to but we're using the 

12 urinalysis data.

13 MR. STIVER: At this point you're 

14 not doing that. Okay. All right. I just 

15 wanted to be clear on that. Thank you.

16 The small script down here under 

17 the second main bullet really is just a 

18 bulleted outline of what we just discussed, 

19 how this material was calcined, how it was 

20 transferred in a closed system. 

21 We basically agree with this 

22 adjustment factor. We think that would be an 
. 

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1 adequate way to control these doses which are 

2 in all likelihood very small.

3 We believe it's a tractable Site Profile-type 

4 issue and no action items emerged related to 

5 Issue 4.

6 Issue 5. This has a long and 

7 storied history. There have been numerous 

8 White Paper exchanges. I know SC&A has 

9 produced five papers on this particular issue.

10 In summary, our position on this 

11 is that the NIOSH estimate for radon release 

12 from the K-65 silos is substantially 

13 underestimated. We also believe that their 

14 atmospheric dispersion modeling is not 

15 scientifically valid for the configuration for 

16 the silos that exist. 

17 While it actually results in an 

18 overestimate, the overall net effect is still 

19 not enough to compensate for the 

20 underestimated source term. Lots of back and 

21 forth discussions, lots of White Paper 

22 reviews. As a practical matter, both DCAS and 
. 

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1 SC&A believe this is a tractable problem.

2 It is not an SEC issue. We have 

3 agreed to disagree. They have not accepted 

4 our approach and we believe that there are 

5 still significant problems with ours. This 

6 really is -- we have confidence that this can 

7 be bounded based on our own analyses that have 

8 been done in these White Paper reviews.

9 At the April meeting, I believe in 

10 the transcript you'll see, that the Board 

11 agreed to move this from the SEC list of 

12 issues into TBDs. 

13 There were some outstanding action 

14 items from February 9th. One was to go back 

15 and look at any cases that might have been 

16 impacted by these findings. I don't think 

17 there was any resolution of that.

18 I know there was kind of an 

19 outstanding item but we thought it would be a 

20 very small number if any at all because the 

21 lung cancers were basically treated as --

22 DR. MAURO: In concept though 
. 

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1 we've had all these disagreements on how much 

2 radon is coming out of the silos, we think 

3 it's quite a bit more than their estimate and 

4 have the disagreements on how you model the 

5 atmospheric dispersion. In the end what 

6 you're really saying is how is that going to 

7 change your dose reconstruction. 

8 Are there people that where there 

9 were dose reconstructions done, would the 

10 outcome of those dose reconstructions, which 

11 mainly affect the respiratory tract, would any 

12 of them be affected by whether we used our 

13 approach or we used their approach. I think 

14 that was the question that you are referring 

15 to.

16 MR. STIVER: That was the 

17 question. I don't know if that had been 

18 looked into at this point.

19 DR. MAURO: I would have to say I 

20 think NIOSH did look into that matter but I 

21 don't recall the answer.

22 MR. STIVER: Okay. In any case, 
. 

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1 this is no longer considered an SEC issue and 

2 it will be discussed in the TBD context.

3 Issue 6. This is a two-part 

4 issue. This regards the reconstruction of 

5 exposures from the inhalation of thorium-232. 

6 There is a time period for which monitoring 

7 is not available from 1954 to 1967. This is 

8 Issue 6A, the use of this DWE data.

9 Basically what you have for the 

10 different plants -- let me back up here. Is 

11 everybody familiar with what a DWE is? Do you 

12 all understand that concept? Basically it's a 

13 time weighting of these general air samples 

14 and breathing zone samples for a particular 

15 job and particular facility.

16 What they do by doing time motion 

17 studies for particular work, a particular type 

18 of worker is known to do a certain number of 

19 tasks throughout the day. They know the time 

20 it takes to produce these tasks, what the 

21 tasks entail. What they do is they monitor. 

22 They set up samplers, little 
. 

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1 lapel-type breathing zone sampler, to really 

2 capture what this worker might be exposed to 

3 based on the air concentrations during the 

4 course of the day. Anywhere from about --

5 I've seen any number of about three to 22 

6 different types of tasks associated with a 

7 given job. For each one of these tasks 

8 there's replicate measurements taken. 

9 There's a high degree of 

10 variability, particularly in the general air 

11 sample for the fixed samplers. There are 

12 changes in airflow patterns, there are changes 

13 in the particular size distribution, and a lot 

14 of other factors that can come to play here 

15 that result in a lot of variation and when you 

16 look at the source data you see that.

17 What we have then is NIOSH's 

18 proposed response to our White Paper. First 

19 of all, this is such a complicated issue it's 

20 hard to frame it sometimes. Back in March of 

21 2009 NIOSH put out a White Paper where they 

22 laid out a methodology for using this DWE data 
. 

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1 to bound thorium intakes, or to assess thorium 

2 intakes.

3 We were tasked to review that and 

4 we produced a White Paper response that July. 

5 In that response we had 20 findings. Eight 

6 of those were related to the data adequacy and 

7 validity. The others were related to the 

8 modeling mechanisms.

9 Basically our problem with the 

10 data validity had to do with the fact that the 

11 DWE, which was instituted by the Health and 

12 Safety Laboratory back in the 1940s, it was 

13 really intended just to monitor work place 

14 conditions. It was not ever intended to be 

15 used for dose assessment.

16 They would collect these data. 

17 It's obviously a snapshot in time. It's 

18 representative of what that particular worker 

19 was exposed to during that sampling period for 

20 that day in that facility. 

21 They compiled these things and 

22 they looked at them and they said, "Okay. 
. 

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1 We've got people that are above the maximum 

2 allowable concentrations in this particular 

3 part of the building doing this particular 

4 operation. How can we modify that to bring 

5 these values down?" So it was basically an 

6 index to exposure but not used directly for 

7 dose assessment. 

8 What they did not do was perform 

9 any kind of an uncertainty analysis on these 

10 data. Really what you have is you've got a 

11 whole distribution of DWEs but you only have 

12 one average. Basically these reports will 

13 show you a high value and a low value and an 

14 average and it will tell you the number of 

15 samples that were taken.

16 In some cases the raw data exist. 

17 In other cases we haven't located that data. 

18 As a result of this issue it's common within 

19 the EEOICPA program. Adam Davis and Dan Strom 

20 in 2008 published an uncertainty analysis 

21 where they looked at five different facilities 

22 that used DWEs from 1948 to 1955. 
. 

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1 There were approximately 165 

2 workers, 63 job categories, about 430 air 

3 samples. They used Monte Carlo methods and 

4 they looked at the different -- they basically 

5 looked at the variability in the data set. 

6 The fundamental unit of measure here was this 

7 task air concentration measurement for which 

8 there were typically replicates. 

9 I've seen up to 15 or 20 samples 

10 for one given task. They would take this and 

11 look at it two different ways. They looked at 

12 a discrete distribution where using Monte 

13 Carlo methods they would go through. For each 

14 run they would pick at random one task value 

15 for each of those, multiply by the time 

16 weighting and there's one outcome. 

17 They would do that 10,000 times 

18 and build an output distribution. For the 

19 discrete data it's very spiky. It doesn't 

20 really seem to comport with any type of 

21 statistical distribution.

22 They also looked at log-normal fit 
. 

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1 of this data. They took the data set and 

2 constructed a log-normal -- assumed that it 

3 followed log-normal statistics. They did a 

4 fit and then they would go through and do the 

5 same Monte Carlo methods. Go through and pick 

6 off one of these values, 10,000 iterations or 

7 whatever, and produce a nice output 

8 distribution. 

9 When you overlay those two the 

10 discrete, which is based on the actual data, 

11 and then the log-normal fit you see that the 

12 log-normal always has a tail that extends far 

13 beyond the highest actual measurement. That's 

14 one of the advantages of using the log-normal 

15 is because it accounts for the potential for 

16 values that were not measured. 

17 In actuality I believe the 

18 standard deviations were about one-and-a-half 

19 to two-and-a-half times higher for the log 

20 fits than they were for the discrete fits. 

21 This is important because one of the problems 

22 we've always had with this DWE concept is that 
. 

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1 you've got types of admissions or events that 

2 might take place over a short period of time, 

3 or sometimes chronic events like some of these 

4 fugitive emissions from ball mills and things 

5 like that. 

6 The historic record is just rife 

7 with these descriptions of how dirty these 

8 operations were. But, you know, as a general 

9 air sample is it in the right place for a 

10 particular day to measure the dust that is 

11 coming off of that fugitive emission. We have 

12 these uncertainties in data that weren't 

13 measured. The log-normal gives you a way to 

14 at least account for that. 

15 Davis and Strom went through and 

16 they analyzed all these data and they produced 

17 geometric standard deviations, GSDs for these 

18 data sets, and they came up with a 95th 

19 percentile GSD of about 4 and the 99th 

20 percentile ranged up to about 7 or 8. 

21 The GSD of 5 is probably pretty 

22 good for DWE data so you have kind of a 
. 

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1 recommendation, and it's not really an 

2 endorsement or policy statement or anything, 

3 but they recommend that a GSD of 5 is probably 

4 going to be adequate to bound DWE data for 

5 particular jobs.

6 And NIOSH came back after our 

7 review in July actually in response to -- we 

8 found out about this through Weldon Spring 

9 because they had the same kind of problem at 

10 the Weldon Spring site. It turns out NIOSH 

11 had issued a new revision to their method that 

12 had abandoned the previous approach in favor 

13 of this Davis and Strom method.

14 It's really kind of a shortcut 

15 method because -- actually I can show you. 

16 Okay, here we go. My eyes aren't as good as 

17 they used to be. You can really distill this 

18 down to four recommendations. NIOSH has taken 

19 the Davis and Strom methodology and applied it 

20 to their particular situation here and this is 

21 what emerged.

22 They are going to assign the DWE 
. 

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1 for the job description with the highest DWE 

2 in the facility where thorium was handled for 

3 a particular year to every worker in that 

4 plant with a GSD of 5.

5 Just think about what this means. 

6 You've got, say, a guy in Plant 9 where they 

7 did the metals production for thorium. You've 

8 got a whole range of workers in there. You've 

9 got supervisors. You've got people who really 

10 don't handle the metal so much. And you've 

11 got the guys like the laborers and helpers 

12 who've got their heads down in these reduction 

13 pots scrubbing them out. 

14 Maybe they had respiratory 

15 protection and maybe they didn't. You've got 

16 that guy who is doing that job in Plant 9 in 

17 1955, has a DWE of 685 MAC. MAC is the 

18 maximum allowable concentration. This guy is 

19 getting huge intake. 

20 It's a very dusty environment. 

21 You're looking at that guy and say, "We're 

22 going to take him. Everybody in this plant is 
. 

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1 going to get this DWE. Not only that, we're 

2 going to assign a GSD of 5 for the uncertainty 

3 to account for what we may have missed." You 

4 might look at that and say is that really 

5 plausible? 

6 Yes, it is because you actually 

7 have the data. You have an average 

8 concentration of 685 MAC for this category of 

9 worker and there is uncertainty involved in 

10 that. Now, did every single worker in that 

11 plant do that job? No, but some of them did 

12 but you don't know who they are. We believe 

13 that is a reasonable approach to take.

14 The next step. If you don't have 

15 air sampling data or you don't have DWEs at 

16 all, what you can do is take a high DWE from 

17 an adjacent year. If you are missing one or 

18 two years but you have information for the 

19 previous year and later years and you know the 

20 processes hadn't been altered during that 

21 time, you can be reasonably sure that you can 

22 use the data from another year. 
. 

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1 It's a pretty common practice. 

2 I've seen it done a lot in dose 

3 reconstruction. Again, assign a GSD of 5. If 

4 you don't have DWE, if you don't have time 

5 waiting, what they are proposing to do is use 

6 the 95th percentile of year sampling data. 

7 Basically you just take all this data. 

8 For the guy whose got the 685 MAC, 

9 he's got one job that took 15 minutes to do, 

10 scrubbing out the pots. The concentration in 

11 that particular job was like a million DPM per 

12 cubic meter. It's so dusty you couldn't 

13 breathe it for any length of time at all. 

14 If you're using the 95th 

15 percentile, Davis and Strom showed that if you 

16 do this you are going to capture every DWE but 

17 it may not be physiologically realistic. 

18 That's not always going to be the case. You 

19 may have another plant somewhere, say the 

20 pilot plant, or the refinery where you've got 

21 low concentrations. You take the 95th 

22 percentile and it's physiological possible. 
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1 Davis and Strom aren't really --

2 they don't really come down with any 

3 particular recommendation on this. They do 

4 seem to be believe that the average of the 

5 unweighted air concentrations is adequately 

6 claimant-favorable.

7 However, they showed that it 

8 bracketed 60 of the 63 job categories so you 

9 still have three jobs for which it didn't 

10 apply. This is still kind of an area that is 

11 open here.

12 CHAIRMAN MELIUS: John, can we try 

13 to move this along a little bit because we're 

14 running up against --

15 MR. STIVER: I'm sorry. I'm too 

16 far into the details.

17 CHAIRMAN MELIUS: We have to have 

18 questions and so forth.

19 MR. STIVER: So basically one of 

20 the other things Davis Strom found is that 

21 this idea of what they call blunders in the 

22 ISO document, they found those could result 
. 

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1 and they did take place on the average of 

2 about a factor of 200 underestimate all the 

3 way up to a factor of 10 underestimate.

4 We believe that NIOSH should 

5 undertake a review of the raw data to just get 

6 some kind of a bound on the frequency and 

7 magnitude of these blunders. We also believe 

8 that this issue of the 95th percentile needs 

9 to be reviewed.

10 At this point there really are no 

11 action items regarding Fernald. I know NIOSH 

12 is developing a method for looking at blunders 

13 for Weldon Spring which would evidently be 

14 used for these other sites as well.

15 Issue 6B. This is the later 

16 period from 1968 to 1988. NIOSH used chest 

17 count data from the mobile laboratory from Y18 12. Again, lots of White Papers going back 

19 and forth. There's no DWE data after '68 so 

20 the ability to reconstruct these doses is 

21 completely dependent on the integrity of this 

22 chest count data.
. 

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1 We have two issues, data adequacy, 

2 data completeness. Regarding data adequacy, 

3 from the early decade 1968 to '78, the data 

4 reported in milligrams of thorium. However, 

5 we have no information on the calibration. We 

6 don't know which decay daughter product was 

7 used, whether it was actinium or lead-212.

8 We have highly variable and 

9 uncertain data that doesn't comport well with 

10 biokinetics during this period of time and an 

11 MDL which appears to be not supported by the 

12 data set or by the references. The subgroups 

13 are easily distinguishable below the detection 

14 levels which we don't feel should be possible.

15 From '79 to '88 they reported 

16 nanocuries of thorium based on lead-212. Once 

17 again, the MDA appears high, in 85 percent of 

18 the data or below the detection limit. This 

19 equilibrium factor, this is a factor to 

20 account for this equilibrium once thorium is 

21 separated. In theory it would reach a low of 

22 about .4 several years after separation and 
. 

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1 build back in to one.

2 I know NIOSH posted a new document 

3 yesterday and one of the things they did was 

4 revise their estimate of this equilibrium 

5 factor down. We still have issues on that 

6 regarding some of the experimental data that 

7 shows it could be a factor of 10 to 100 lower 

8 based on the solubility type.

9 Data completeness. At the last 

10 meeting NIOSH indicated that they thought that 

11 their distribution was broad enough to account 

12 for all the workers and thorium workers would 

13 probably be -- if you couldn't identify them, 

14 then the chemical workers would be a 

15 reasonable surrogate.

16 Our position is we looked at that 

17 and we found that, first of all, you only got 

18 thorium workers for 1968. There's like 60 

19 people who are identified as thorium workers. 

20 We took a look at their distributions 

21 compared to chemical workers and this is what 

22 we find. The thorium workers have 
. 

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1 significantly higher intakes throughout the 

2 entire portion of that curve compared to 

3 chemical operators who were non-thorium 

4 chemical operators.

5 You also see that in all this data 

6 you are below 6 milligrams for almost all of 

7 it, yet you can still discern these subgroup 

8 differences which gets back to the MDA issue.

9 Here is all chemical operators and all 

10 workers. They are basically the same.

11 Action items that emerged. NIOSH 

12 is going to post about 300 pages of 

13 calibration information from the Y-12 lab. 

14 SC&A will prepare a formal White Paper report 

15 on this thorium worker subgroup issue.

16 So, in summary, this is the last 

17 slide Brad showed you, we've got the issue 1, 

18 the construction worker subgroup analysis. 

19 Issue 3, still SEC issue, we believe, 

20 regarding recycled uranium for these front-end 

21 workers that handle the most highly 

22 contaminated materials.
. 

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1 Issue 6B. I think there's SEC and 

2 TBD components. The SEC component being that 

3 the milligram thorium data adequate for dose 

4 reconstruction for that first 10-year period. 

5 Also more of a TBD issue given that the data 

6 are adequate and what kind of adjustment 

7 factor would be needed to account for the 

8 thorium worker subpopulation. 

9 That's it. I am certainly willing 

10 to entertain questions at this point.

11 CHAIRMAN MELIUS: Thank you, John. 

12 Questions? I have a couple. Just out of 

13 curiosity the Davis and Strom paper, is that 

14 something that was done for this program or is 

15 that something independent?

16 MR. STIVER: It wasn't done under 

17 the aegis of EEOICPA but it was done to 

18 address this issue that has come up in this 

19 program. I don't know if it was funded 

20 through DCAS or what organization did that. 

21 It was published in Health Physics literature.

22 CHAIRMAN MELIUS: Okay. I would 
. 

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1 just be curious to understand that. It 

2 certainly seems to have been something for 

3 this program. It's certainly relevant to it.

4 My second question is on your 

5 summary. Maybe I misunderstood the item issue 

6 No. 1, the coworker model. It seems to me, at 

7 least one of the messages I got from you, it 

8 wasn't even clear to me that a coworker model 

9 was feasible partly because people were moving 

10 around so much and so forth and whether you 

11 would have enough data to do that.

12 MR. STIVER: That construction 

13 worker sub-issue. 

14 CHAIRMAN MELIUS: I guess we'll 

15 see with the report but to me it still appears 

16 to be potentially an SEC issue.

17 MR. STIVER: It's what kind of 

18 adjustment would it take. We figure they use 

19 about 10 percent of the values to determine 

20 the kind of adjustment to ensure bounding.

21 CHAIRMAN MELIUS: Okay.

22 Anybody else have questions? 
. 

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1 Okay.

2 Brad, do you want to say anything 

3 just to finish up here?

4 MEMBER CLAWSON: We never tasked 

5 SC&A with the final report for NIOSH's 

6 response.

7 MR. STIVER: For the RU issue?

8 MEMBER CLAWSON: For the RU. I'm 

9 wondering if we need to address that.

10 MR. STIVER: Go ahead and do that? 

11 It will be an action item?

12 CHAIRMAN MELIUS: Yes, but let's -

13 - Josie.

14 MEMBER BEACH: I have a question. 

15 The additional 450 boxes has come up several 

16 times. Both SC&A mentioned it and NIOSH. Is 

17 there going to be some tasking for SC&A based 

18 on that or -- I'm just curious what's going to 

19 happen with the boxes or what is the forward 

20 path.

21 CHAIRMAN MELIUS: You know, I 

22 think to me going forward certainly SC&A --
. 

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1 the Work Group needs to meet again, I think, 

2 between now and August. 

3 Secondly, the SC&A needs to be 

4 tasked to review the NIOSH report that came 

5 out just before the last Work Group meeting 

6 and they need to have some -- then NIOSH 

7 probably needs some time to also build into 

8 that to review and at least be familiar with 

9 the SC&A report. 

10 We need to bring that to closure. 

11 I would also think NIOSH needs to sort of 

12 figure out what the schedule is for dealing 

13 with those 450 boxes because I think it's a 

14 question of what's feasible. 

15 I don't think we are even at a 

16 point of having SC&A review them as much as 

17 the question is are they relevant enough that 

18 some judgment be made that they are going to 

19 affect the outcome and what is the time frame 

20 for that. I assume eventually they will get 

21 inventory but whether that's two months, six 

22 months, five years, I don't know. 
. 

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1 I don't think it's fair given 

2 resource issues related to that to give an 

3 answer right here but I think at some point 

4 the Work Group needs to understand that. We 

5 certainly need to understand that by our 

6 August meeting.

7 Are there any other sort of action 

8 items that people see? Henry.

9 MEMBER ANDERSON: Just the issue 

10 of the boxes. From worker interviews and any 

11 other -- I mean, is there a claim somewhere 

12 that there's missing data as far as 

13 biomonitoring, things like that, that this 

14 could represent versus, you know, there's a 

15 lot of records that are just records that 

16 wouldn't deal with this.

17 CHAIRMAN MELIUS: I think based on 

18 -- Mark, why don't you go to the mic? You can 

19 correct me. These might be relevant but it's 

20 the question of what time frame they were 

21 collected in or what's in those boxes in terms 

22 of what time frame may determine how relevant 
. 

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1 they are. It may be difficult to tell without 

2 going through all 450 to determine that. Then 

3 the question is what time period and how 

4 relevant they are. Is that a fair statement?

5 MR. ROLFES: I was going to say --

6 this is Mark Rolfes. Some of the information 

7 that we've seen in the boxes that we've 

8 sampled have, for example, each uranium ingot 

9 that was produced by the Fernald site.

10 Each of the uranium ingots that 

11 was produced at the Fernald site would have 

12 been sampled. They would have taken a little 

13 bit of the uranium metal that was produced. 

14 Those are the types of records that we've seen 

15 primarily in this 450 boxes of records. 

16 These are not worker bioassay 

17 results or air monitoring results which would 

18 be directly used in dose reconstruction. 

19 These are essentially the raw data which I 

20 suspect were compiled by the Department of 

21 Energy for the recycled uranium Ohio field 

22 office report in 2000.
. 

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1 CHAIRMAN MELIUS: Any other items 

2 that people -- can we at least formally task 

3 SC&A? I guess since we are meeting as a 

4 Board, we should do it as a Board. 

5 Brad, want to make a motion?

6 MEMBER CLAWSON: I would like to 

7 make a motion that we task SC&A to review 

8 NIOSH's recycled uranium paper.

9 MEMBER BEACH: I'll second that.

10 CHAIRMAN MELIUS: All in favor, 

11 say aye.

12 (Chorus of ayes.)

13 CHAIRMAN MELIUS: Opposed? Okay. 

14 So tasked.

15 Brad, as Work Group chair, if you 

16 can sort of organize the follow-up meetings 

17 and do some of this coordination. Thank you.

18 Thank you, John, for a very 

19 thorough and helpful review. Obviously a lot 

20 of work has been done but it's been a long 

21 time also. Hopefully we get resolution, or at 

22 least I would like to aim for resolution on 
. 

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1 this for August. If not, at least a lot of 

2 progress trying to narrow down what needs to 

3 be done here. It's been five years, Brad? 

4 Yes. Do that.

5 Did Jim rejoin us? Let's try to 

6 plan on doing some of our work session until 

7 3:30 and then we'll take a break and come back 

8 at 4:00. Is that satisfactory? I think we 

9 have enough time in our schedule.

10 MR. KINMAN: I apologize. Can I 

11 just interrupt? Ted, I'm not sure if you 

12 spoke to the petitioner but I believe that she 

13 was expecting to possibly address the Board.

14 MR. KATZ: I'm sorry. The sheet I 

15 have indicates that you didn't get a hold of 

16 her.

17 MR. KINMAN: I apologize that you 

18 may not have the most updated information.

19 MS. BALDRIDGE: This is Sandra.

20 MR. KINMAN: She's on. Okay.

21 CHAIRMAN MELIUS: Okay. Go ahead.

22 MS. BALDRIDGE: I've been 
. 

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1 listening to the discussion and made a couple 

2 notes, especially since I still have concerns 

3 about the data quality. When it was mentioned 

4 about the HIS-20 data, that was examined for 

5 transcription errors and the transcription was 

6 sound and was confirmed to be accurate. It 

7 wasn't examined, to my knowledge, for accuracy 

8 in the data itself but only for transcription.

9 National Lead of Ohio acknowledged 

10 in their historical documents that were 

11 included in the petition that there were 

12 deficiency in the work records to the point 

13 that they often didn't have knowledge of the 

14 jobs or the tasks that the individual workers 

15 would perform.

16 Now, dose reconstruction requires 

17 knowledge of what workers were exposed to 

18 based on where they were working. The 

19 individual data was never compared to the high 

20 air monitoring MAC, the general air count. 

21 The urinalysis were never compared to that to 

22 see if there was a correlation between what 
. 

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1 the urinalysis was showing or the dosimetry 

2 was showing to see if they were actually 

3 assigned the right job task for dosing or even 

4 the right job location, plant location. 

5 That is part of my concern. There 

6 have been assumptions made in dose 

7 reconstruction based on where they think 

8 people were working and they, therefore, 

9 assigned those doses when, in fact, the 

10 individual was not working at that job 

11 assignment and did not receive the doses 

12 assigned that corresponded with that job.

13 Now, it was recommended probably 

14 three, three-and-a-half years ago, that they 

15 take a look to see if some of the individuals 

16 that were suppose to have been working in 

17 areas with extremely high general air level 

18 MACs, I mean, in some cases we're talking 

19 thousands over months and months and years, 

20 and whether those individuals' records showed 

21 that. 

22 Now, it should have been a 
. 

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1 relatively simple task if they knew who was 

2 working at what job and who actually was 

3 receiving those exposures but nothing was ever 

4 pursued to see if there was a correlation that 

5 could confirm that the job assignments were, 

6 in fact, the correct ones. That is still an 

7 issue that hasn't been addressed.

8 At this point we have finished 

9 five years. We are into the sixth year. The 

10 petition was submitted in '05. We are in '11. 

11 By August we will almost have completed five12 and-a-half years of evaluating documents and 

13 data. I really think enough is enough.

14 There are answers that we are 

15 never going to have. This could be an ongoing 

16 project, as was mentioned, to go through 450 

17 boxes of documents. Why were they just now 

18 received? When this petition was presented 

19 NIOSH didn't even know that there had been any 

20 storing processing done in Plant 6.

21 The Technical Basis Document 

22 stated that data has been destroyed so they 
. 

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1 proceeded to reconstruct data which absolutely 

2 did not reflect the work place or the 

3 exposure. Those people who worked in those 

4 conditions had their dose reconstructions done 

5 based on it being a strictly uranium process 

6 and no allowance was made to those workers for 

7 thorium exposure.

8 Now, that Technical Basis Document 

9 has never been corrected and those dose 

10 reconstructions have never been reexamined or 

11 redone. That's kind of where I stand, I 

12 think. The process I found has deficiencies, 

13 at least in my point of view. I just hope 

14 things get straightened out and the people who 

15 gave their lives are compensated, their 

16 families.

17 CHAIRMAN MELIUS: Okay.

18 MS. BALDRIDGE: That's it. Thank 

19 you.

20 CHAIRMAN MELIUS: Thank you. 

21 Also, Dr. Ziemer, are you on the line? I 

22 don't know if you had questions. I neglected 
. 

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1 to also ask if you had questions.

2 MEMBER ZIEMER: No, I have none.

3 CHAIRMAN MELIUS: Okay. Thank 

4 you.

5 Yes, Brad.

6 MEMBER CLAWSON: You know, Sandra 

7 brought up something that we neglected. 

8 Fernald actually became the national 

9 repository for thorium and we're not talking 

10 small amounts. We're talking train cars. I 

11 found some documents in Hanford that this was 

12 being set up because in the later years they 

13 were trying to control all this and it 

14 basically became the repository for it.

15 MS. BALDRIDGE: Could I add 

16 something to that? The Technical Basis 

17 Document acknowledged that it became the 

18 repository in the '70s when, in fact, the 

19 petition has a document where they are asked 

20 to start stockpiling back in the late '50s so 

21 there is a considerable time span between the 

22 acknowledgment of it being the repository and 
. 

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1 when they actually started stockpiling them 

2 and storing them on site.

3 CHAIRMAN MELIUS: Okay. Thank 

4 you.

5 For our Board work time I guess 

6 one of the issues is that -- we have the 

7 comments from the November Board meeting, 

8 public comments that Ted has provided us. 

9 This is one that took some time. Right? So 

10 it's a little distance. 

11 I don't know if others have had a 

12 chance to go through it. It looks like a 

13 formidable document but it actually isn't. I 

14 did go through it and I actually thought the 

15 responses were appropriate except I have 

16 questions on one which is on page 90 of the 

17 document. 

18 LaVon is not here. There he is. 

19 Okay. LaVon. This was a comment from 

20 Antoinette Bonsignore about Linde. It was a 

21 question about failure to meet the time limit 

22 requirements and evaluating the SEC petition. 
. 

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1 As it summarizes here, LaVon's 

2 response was it's always the intent to try and 

3 achieve -- I believe there is also 

4 correspondence that she had with the Board, 

5 and I thought also with NIOSH that the Office 

6 of General Counsel had responded to which I 

7 don't believe we have ever seen a copy of. 

8 I think it would be useful just to 

9 reflect that in the response because I think 

10 there has been a more formal response. I 

11 think you were actually aware of it, LaVon, 

12 and so forth. I think that should be 

13 reflected in this document. 

14 I would also serve that as a 

15 reminder if Office of General Counsel could 

16 share their response to that issue with us 

17 because it keeps coming up at other meetings. 

18 That was the only comment I had. I don't 

19 know if anybody else has had a chance to go 

20 through this or had responses. I thought 

21 otherwise it was fine as I recall.

22 MEMBER BEACH: I would like to say 
. 

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1 that it's well done and I like that addition 

2 of the meeting minutes. That was very helpful 

3 in reviewing this. Thank you.

4 CHAIRMAN MELIUS: When I went to 

5 look at it and saw how many pages, I said, 

6 "Oh, no." Then you see, since I have to 

7 review the transcripts anyway.

8 Henry.

9 MEMBER ANDERSON: I was just going 

10 to say I did look at it. When you first open 

11 it and you see all the pages, but it really 

12 was organized well so you should read it but 

13 you didn't have to read. The comments were 

14 easy to find and I thought they were 

15 understandable and succinct which was helpful.

16 CHAIRMAN MELIUS: I'm not sure if 

17 I understand what the categories are, the 

18 category numbers.

19 Do we need to take formal action 

20 on this, Ted?

21 MR. KATZ: No, you don't.

22 CHAIRMAN MELIUS: Then I think we 
. 

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1 can consider that closed -- archived. Anybody 

2 have any thoughts on the CLL issue or do you 

3 want more time until tomorrow to consider 

4 that? Or reaction to Wanda's suggestion? I'm 

5 asking if people want more time or just get it 

6 done. Wanda's suggestion was that we ask for 

7 an extension in the comment period from June 

8 20th until after our next Board conference 

9 call. 

10 I would ask, Ted, what is the 

11 procedure for doing that? Do we need to just 

12 adopt a motion here to that effect or 

13 correspondence?

14 MR. KATZ: I'm not even sure you 

15 need a formal motion. I mean, clearly it's 

16 your intent if that's what you want. If you 

17 all say that's what you want, then I think we 

18 communicate that to HHS.

19 CHAIRMAN MELIUS: I think we 

20 should do that through a motion.

21 MR. KATZ: That's fine. I think 

22 you can just do a voice vote.
. 

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1 CHAIRMAN MELIUS: Do we have the 

2 date? I don't have the date with me for the 

3 next conference call.

4 MR. KATZ: Let me tell you. It is 

5 July 11th.

6 CHAIRMAN MELIUS: Okay. Then we 

7 would -- I'm trying to pull up dates. That's 

8 what day of the week? Do you know? So the 

9 comment period could be open until Friday of 

10 that week. That would give us time to adopt a 

11 letter or set of comments at the conference 

12 call and then give some time to submit that in 

13 case there is some redrafting or something 

14 that has to be done before we send it in. 

15 I think the motion would be to --

16 let me make sure I get the dates right --

17 leave the comment period open until July 15th 

18 in order for us to be able to have our 

19 Scientific Issues Work Group review report 

20 back to the Board at our July call and then 

21 for us to assemble or review those comments 

22 and submit them to the docket. Can someone so 
. 

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1 move?

2 MEMBER CLAWSON: So moved.

3 CHAIRMAN MELIUS: The meeting is 

4 the 11th. I just wanted to give time. If we 

5 have a set of comments, we need to make some 

6 changes to those or if there are additional 

7 comments that come out of the Board meeting, 

8 that would give us to the end of the week. 

9 We are going to have to adopt 

10 those comments at the Board meeting. We're 

11 not going to have time for another Board 

12 meeting or call but it would give us a chance 

13 just to re-graph those and get those into the 

14 docket.

15 MEMBER LEMEN: And that presumes 

16 that somebody is going to call a meeting of 

17 the Scientific Issues Work Group.

18 CHAIRMAN MELIUS: Correct, to 

19 review it. We also have one sort of 

20 logistical issue there. David Richardson, who 

21 is the chair of that Work Group, has a 

22 conflict on this particular issue because of 
. 

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1 previous involvement with it. We are going to 

2 need a new chair, someone other than David to 

3 chair. There are lots of people on that Work 

4 Group so I don't think that will be a problem. 

5 I will identify someone and make sure that 

6 occurs.

7 MEMBER CLAWSON: I would say Dick 

8 Lemen but it's up to you. You need a motion 

9 to move?

10 CHAIRMAN MELIUS: Yes.

11 MEMBER CLAWSON: I so move.

12 CHAIRMAN MELIUS: A second to the 

13 so move?

14 MEMBER BEACH: I will second it.

15 CHAIRMAN MELIUS: Okay. All in 

16 favor say aye.

17 (Chorus of aye.)

18 CHAIRMAN MELIUS: Opposed? 

19 Abstain? Okay. Good. See, we move along.

20 MEMBER ANDERSON: Now you are 

21 committed to having comments.

22 CHAIRMAN MELIUS: But I actually 
. 

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1 think if the comment is that these are 

2 acceptable -- I mean, these are good, I think 

3 it behooves us to go into more detail than we 

4 have been able to go through and more than 

5 what's in the proposed rulemaking submissions, 

6 the other document and so forth.

7 MEMBER LEMEN: I would just say 

8 it's going to be hard to get the scientific 

9 group together. It's only a month and a week 

10 to do that and there are a lot of people on 

11 that group.

12 CHAIRMAN MELIUS: It will be by 

13 conference call and it's going to have to be 

14 who is available for a conference call. I 

15 don't think it necessarily needs to be long. 

16 I think the preparation for it is probably 

17 more of an issue. 

18 We are getting into summer time so 

19 maybe some vacation issues but I don't think 

20 it has to be an in-person meeting. I don't

21 think it would necessarily has to -- are you 

22 worried we are going to make you chair and do 
. 

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1 all the work? Do I hear another motion? I 

2 guess we should say for the record Brad 

3 Clawson had to leave to return home. 

4 His son is graduating tomorrow. I 

5 think he'll be with us on the phone at least 

6 tomorrow morning. We are expecting Mark 

7 Griffon to arrive tomorrow morning weather 

8 permitting. He's got a flight from Boston.

9 MR. KATZ: Related to Mark coming 

10 in tomorrow morning, we are actually -- I 

11 think folks at DCAS are going to try to get in 

12 touch or may have already got in touch with 

13 some of the petitioners. For SRS we are 

14 actually going to move the time to allow for 

15 Mark to participate that. 

16 Savannah River right now is on the 

17 agenda for 8:30 to 9:30 but we are going to 

18 move it to 11:00 a.m. which is within the 

19 Board working session so that we can have Mark 

20 participate. Like I said, we are trying to 

21 get in touch with the petitioners directly but 

22 I'm also saying this for the record now and 
. 

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1 I'll probably mention it again so that we can 

2 get the word out on that.

3 CHAIRMAN MELIUS: At least on your 

4 annotated agendas one of the other issues we 

5 wanted to work on are dates for our 2012 

6 meetings. Let's get on the right calendars, 

7 everybody, because I certainly didn't start 

8 out that way when I saw these dates.

9 MEMBER LEMEN: When is the 

10 December meeting?

11 MR. KATZ: One sec. 

12 CHAIRMAN MELIUS: 7th, 8th, and 

13 9th.

14 MR. KATZ: Right, 7th through 9th.

15 MEMBER PRESLEY: Tampa?

16 MR. KATZ: Yes.

17 CHAIRMAN MELIUS: And so the week 

18 that Ted has suggest for our teleconference is 

19 the weeks of January 17th through 20th, 2012, 

20 or the following week, the 23rd through the 

21 27th. Anybody have preferences or major 

22 conflicts that they are aware of? Bring your 
. 

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1 cell phone.

2 MEMBER MUNN: Which day?

3 CHAIRMAN MELIUS: The 17th through 

4 20th or the 23rd through the 27th.

5 MEMBER MUNN: Since we're having a 

6 December meeting, perhaps the second --

7 perhaps the later time would be better served 

8 for our purposes.

9 MR. KATZ: So the 25th would be 

10 Wednesday if you like to stick with 

11 Wednesdays. Does that work for everyone? 

12 Dr. Ziemer, Paul, does that work 

13 for you?

14 MEMBER ZIEMER: Yes, that's good.

15 MR. KATZ: 11:00 a.m. is the 

16 normal.

17 CHAIRMAN MELIUS: Our west coast 

18 Members need their beauty sleep. January 

19 25th, 11:00. Then for a meeting Ted is 

20 proposing the last week in February starting 

21 with the 27th or the first week in March.

22 MEMBER MUNN: I would request that 
. 

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1 you avoid March simply because I won't be 

2 there. The last week in February. I will be 

3 gone from the 1st of March for two weeks.

4 CHAIRMAN MELIUS: How about other 

5 people?

6 MEMBER ZIEMER: I would prefer the 

7 end of February. Ziemer.

8 CHAIRMAN MELIUS: Thank you, Paul. 

9 MEMBER ANDERSON: So you're saying 

10 the week of the 21st?

11 CHAIRMAN MELIUS: The 27th.

12 MEMBER ANDERSON: So that would 

13 run us through --

14 MR. KATZ: The 27th is a Monday. 

15 It would be the 27th, 28th, 29th.

16 CHAIRMAN MELIUS: We could do the 

17 27th, 28th, 29th.

18 MR. KATZ: We could do that. That 

19 would be preferable.

20 CHAIRMAN MELIUS: Wanda would at 

21 least have to miss the last day and depending 

22 on where we're located, it could be more.
. 

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1 MEMBER MUNN: Honolulu.

2 CHAIRMAN MELIUS: Well, we could 

3 meet in Honolulu.

4 MEMBER MUNN: You are welcome to 

5 join the Society of Women Engineers there. 

6 We're chartering a new section.

7 CHAIRMAN MELIUS: I'll join anyone 

8 there. We could start Monday depending on 

9 location. I guess that's hard for anybody. 

10 It depends on where we are. We could travel 

11 Monday morning and start 1:00 or 2:00 in the 

12 afternoon but it really is going to depend on 

13 location. We could start on Tuesday. 

14 It's also a location making sure 

15 that Wanda can make it back so she can go on 

16 vacation and not have to miss two days of the 

17 meeting. Why don't we keep open the 27th 

18 through March 1st. Then as we get closer and 

19 start to talk about locations, we can pin this 

20 down more.

21 MEMBER MUNN: It isn't actually a 

22 vacation. It really and truly is a 
. 

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1 professional meeting that starts on the 1st. 

2 CHAIRMAN MELIUS: And goes for two 

3 weeks?

4 MEMBER MUNN: No. The vacation 

5 comes after the professional meeting.

6 CHAIRMAN MELIUS: We can work that 

7 out then. Okay. 

8 MR. KATZ: Okay. So we're going 

9 to block off the 27th through the 1st for the 

10 present.

11 CHAIRMAN MELIUS: Yes.

12 MR. KATZ: And think about 

13 location. Just suggestions for thinking about 

14 location. The end of February you probably 

15 want to stay relatively south for that so 

16 we've got Georgia, New Mexico, Texas, 

17 California. We'll have been in Florida in 

18 December.

19 CHAIRMAN MELIUS: Notice how well 

20 we did in the spring here.

21 MR. KATZ: Indeed.

22 CHAIRMAN MELIUS: I'm not sure 
. 

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1 there is ever a good time.

2 MEMBER ZIEMER: Where do we stand 

3 on the Santa Susana issues? Is it time to go 

4 back out to California?

5 CHAIRMAN MELIUS: It's possible. 

6 I think we've got a few meetings in between 

7 that we haven't located yet. We have 

8 Florida/Tampa in December. Have we done 

9 beyond?

10 MR. KATZ: No. This would be the 

11 next one.

12 CHAIRMAN MELIUS: The next 

13 meeting. Okay.

14 MR. KATZ: We have a number of 

15 sites in New Mexico that are still live.

16 CHAIRMAN MELIUS: Santa Susana.

17 MR. KATZ: And Santa Susana.

18 MEMBER ZIEMER: We've just been to 

19 New Mexico.

20 MEMBER PRESLEY: Tennessee.

21 MR. KATZ: I mean, Tennessee late 

22 February is really asking for trouble it seems 
. 

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1 like with weather.

2 MEMBER ANDERSON: We all want to 

3 get there.

4 MR. KATZ: We have wanted to go to 

5 Nashville, that's true.

6 CHAIRMAN MELIUS: Other 

7 suggestions for that? 

8 MR. KATZ: We've been to Augusta 

9 but there's --

10 CHAIRMAN MELIUS: We've been there 

11 very recently.

12 MEMBER BEACH: I think we should 

13 put Nashville on the list. Santa Susana, I 

14 know Mike is the Work Group chair and we 

15 haven't met for some time. I believe we have 

16 some documents coming out towards the end of 

17 this year.

18 MR. KATZ: Okay. Why don't we 

19 ponder. We don't have to settle it here.

20 CHAIRMAN MELIUS: We can follow up 

21 tomorrow. Let's look at the document list. 

22 It's almost coming on 3:30. We will take a 
. 

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1 break.

2 MEMBER ANDERSON: We are just 

3 scheduled through March?

4 CHAIRMAN MELIUS: Correct.

5 MEMBER ANDERSON: Okay.

6 CHAIRMAN MELIUS: We haven't got a 

7 place for the 2012 meeting. The Board will be 

8 back here at 4:00. We have an administrative 

9 session, Board Members only, conflict of 

10 interest procedures. Those tend to go longer 

11 than expected but hopefully less than an hour. 

12 Maybe even half hour. I don't know. Then we 

13 will reconvene as a Board in open session at 

14 6:00 in this room again for those of you who 

15 don't have to attend our sort of private 

16 meeting here.

17 MEMBER ZIEMER: Dr. Melius.

18 CHAIRMAN MELIUS: Yes.

19 MEMBER ZIEMER: Paul Ziemer here. 

20 On that closed session is there a separate 

21 call in number that I should be calling in 

22 and, if so, somebody will need to email that 
. 

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1 to me.

2 MR. KATZ: Paul, yes. I sent it 

3 to the people I expected not to be here. I'm 

4 sorry. We will email that to you.

5 MEMBER ZIEMER: Okay.

6 CHAIRMAN MELIUS: Thank you for 

7 asking, Paul.

8 Okay. We'll break until 4:00 back 

9 here.

10 (Whereupon, the above-entitled 

11 matter went off the record at 3:30 p.m. and 

12 resumed at 6:00 p.m.)

13

14

15

16

17

18

19

20

21

22
. 

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1 E-V-E-N-I-N-G S-E-S-S-I-O-N

2 6:01 p.m.

3 CHAIRMAN MELIUS: Well, you're 

4 addressing the people on the phone.

5 Welcome. This is the public 

6 comment period for the Advisory Board on 

7 Radiation and Worker Health for those of you 

8 phoning in. We will be starting our public 

9 comment period. We have the Congressional 

10 Office scheduled for 6:00 but, before we do 

11 that, I'll let Ted do the introductions.

12 MR. KATZ: Right. Welcome 

13 everybody on the line. In the room so far it 

14 looks like it's mostly staff here. I'm not 

15 sure if there are any members of the public 

16 who are going to be addressing us in the room. 

17 No one has signed up from here locally, 

18 although we have one person signed up to 

19 address us by phone. 

20 In case there are others on the 

21 phone, though, let me just very quickly run 

22 through sort of the guidelines about public 
. 

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1 address and the Board with it's transcripts. 

2 These public comment sessions are transcribed 

3 verbatim so your comments are captured in full 

4 word for word. 

5 Any information you give about 

6 yourself personally will be in the transcript 

7 and published on the Board's webpage. Any 

8 information, though, you might give about a 

9 third party would be redacted to the extent to 

10 protect their privacy. That's the basic 

11 ground rules. 

12 If there is someone on the line 

13 planning to comment, you can have sort of the 

14 full ground rules by looking at the NIOSH 

15 website. Under the Board section there is 

16 something called a Redaction Policy and that 

17 will tell you exactly how this works. That 

18 concludes my introductory remarks.

19 CHAIRMAN MELIUS: And our first 

20 public comment period is going to be a letter 

21 from Representative Costello. I believe we 

22 have on the line his Chief of Staff David 
. 

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1 Gillies and another staff member Robert 

2 Stephan. 

3 I believe, Robert, you were going 

4 to read the letter into the record?

5 MR. STEPHAN: Yes. Thank you, Dr. 

6 Melius. I'm on the line. Is David on the 

7 line? I believe David has already called in 

8 as well. He may have his phone muted.

9 CHAIRMAN MELIUS: Okay. Go ahead, 

10 Robert.

11 MR. STEPHAN: Thank you, Dr. 

12 Melius. Congressman Costello could not be 

13 with you tonight because the Congress is in 

14 session but he has drafted a letter with 

15 respect to General Steel Industries that he 

16 has asked me to read into the record. We also 

17 have provided a hard copy that we hope will be 

18 submitted as well if it's needed. 

19 Chairman Melius and Members of the 

20 Board, I write you on behalf of many of my 

21 constituents who work at the former General 

22 Steel Industries in Granite City, Illinois.
. 

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1 In the past I have advocated to 

2 you on behalf of former nuclear weapons 

3 workers at Dow Chemical and Allied Chemical. 

4 Thankfully, significant progress has been made 

5 by all those involved on behalf of these 

6 workers for which I want to express my 

7 gratitude.

8 I am equally thankful for those 

9 GSI claimants that have been approved for 

10 compensation through the dose reconstruction 

11 process. However, as I believe we all would 

12 agree, significant work remains with respect 

13 to compensating the remaining GSI workers.

14 Indeed, the Board has numerous 

15 issues before it related to GSI that currently 

16 rest with the TBD-6000 Work Group. It is my 

17 understanding the Work Group anticipates 

18 receiving from NIOSH two White Papers in July 

19 and December of 2011 which will provide 

20 guidance on the outstanding issues originally 

21 proposed in NIOSH's GSI October 2010 Path 

22 Forward document.
. 

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1 I also understand from reading 

2 transcripts of recent TBD-6000 Work Group 

3 meetings the Work Group Members share my 

4 sentiment that the outstanding GSI issues need 

5 to be resolved as quickly as possible for 

6 which I remain appreciative.

7 However, despite the hard work and 

8 dedication by all involved, I am concerned GSI 

9 workers would be facing an additional six 

10 months, and possibly much longer, until the 

11 TBD-6000 Work Group is finished with their GSI 

12 issues and determinations have been made based 

13 on the information provided.

14 It should not be the policy of the 

15 Advisory Board that Work Groups have unlimited 

16 time to conclude their work. I respectfully 

17 request the full Board monitor closely the 

18 TBD-6000 Work Group progress and not hesitate 

19 to vote on the GSI SEC if TBD-6000 progress 

20 does not conclude soon.

21 In closing, I thank you for your 

22 service and dedication to our nation's Cold 
. 

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1 War heroes and look forward to concluding the 

2 work necessary to bring closure for former 

3 workers of General Steel Industries.

4 Sincerely, Jerry F. Costello, 

5 Member of Congress.

6 CHAIRMAN MELIUS: Okay. Thank 

7 you, Robert. Thank the Representative on our 

8 behalf. We will have a report from that TBD9 6000 Work Group probably at tomorrow's meeting 

10 and can update us on their progress. We will 

11 certainly do our best to get this done as 

12 expeditiously as possible.

13 MR. STEPHAN: Thank you, Dr. 

14 Melius.

15 CHAIRMAN MELIUS: The other public 

16 comment person that signed up for public 

17 comment was Terrie Barrie.

18 Terrie, are you on the line?

19 MS. BARRIE: Yes, Dr., I am.

20 CHAIRMAN MELIUS: Okay. Go ahead.

21 MS. BARRIE: Thank you again for 

22 allowing me to call in these comments. 
. 

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1 Good evening, everyone. I have 

2 two issues that I would like to address 

3 tonight. The obvious one is Rocky Flats. The 

4 other is the Federal Agency's response to a 

5 Freedom of Information Act request. In case I 

6 go a little bit longer, you can cut me off 

7 anytime and I'll be happy to send my comments 

8 to be entered into the transcript.

9 In February, Dr. Melius, you 

10 reactivated the Rocky Flats Work Group. 

11 Unfortunately, in the past three months no 

12 meeting has been scheduled to review the 

13 concerns with the emails I have slated or with 

14 the Site Profile issues that remain after the 

15 vote on the SEC petition.

16 I fear that because of this lack 

17 of action that some Rocky Flats claimants may 

18 be having their dose underestimated. For 

19 instance, a Rocky Flats claimant contacted me 

20 to help him with his objection to his denial 

21 of Part B.

22 I reviewed the NIOSH report and 
. 

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1 among other issues I noted that there was no 

2 mention of his work at the stacker/retriever. 

3 You may remember that one email dated August 

4 1, 2006, states that a person who empties the 

5 americium bird cages in the stacker/retriever 

6 would have been exposed to radiation levels as 

7 much as, and I quote, "a couple of hundred 

8 millirems per hour."

9 The claimant estimated that he 

10 worked as a stacker/retriever for 

11 approximately 54 hours. It appears that he 

12 would have received a pretty hefty dose. Yet, 

13 this is not considered in his dose 

14 reconstruction.

15 NIOSH's report for this claimant 

16 still remains difficult to understand. He 

17 worked in buildings where thorium strikes 

18 happened, or may have happened, where he was, 

19 or may have been, exposed to tritium. Yet, I 

20 could not find where OTIB-28 or OTIB-66 was 

21 used to reconstruct dose. Nor could I locate 

22 that the dose reconstructor utilized OTIB-10 
. 

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1 for glove box workers' exposure. 

2 This claimant was a machinist in 

3 the Rocky Flats hot buildings and he would 

4 have used a glove box during his employment. 

5 I don't understand why a meeting hasn't been 

6 scheduled. I hope it is not because the Rocky 

7 Flats Work Group is waiting for SC&A's report 

8 to the Worker Outreach Work Group concerning 

9 the public comments.

10 These are two separate albeit 

11 related issues. However, because it may be 

12 possible that the dose being reconstructed for 

13 Rocky Flats claimants may be underestimated. 

14 The Rocky Flats Work Group needs to resolve 

15 these outstanding Site Profiles and other 

16 issues.

17 The second issue I wish to bring 

18 to your attention tonight is the agency's 

19 response to the Freedom of Information Act 

20 request. Perhaps I should rephrase that to be 

21 the lack of response. Honestly, I am not 

22 trying to be sarcastic here but the excuses I 
. 

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1 have seen for delaying or denying a FOIA 

2 request honestly makes me wonder if the 

3 agencies have read President Obama's Executive 

4 Order.

5 I won't get into the details with 

6 my ongoing discussions with the Department of 

7 Labor on documents I've requested, but perhaps 

8 this battle resulted in the frustration I will 

9 air tonight concerning NIOSH and the 

10 Department of Energy.

11 In February of this year I 

12 requested a copy of the DOE document entitled 

13 "Thorium Use at Rocky Flat." This document 

14 was reviewed by NIOSH in its investigation for 

15 the SEC petition. It was also cited in the 

16 NIOSH-ORAU article published in the Health 

17 Physics Journal, I believe, in July of 2008.

18 I received a letter last week from 

19 the Department of Energy denying the release 

20 of those documents because the document they 

21 located, and I quote, "is marked as a draft 

22 copy." They decided they will withhold this 
. 

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1 document in its entirety because it's a draft 

2 document, and I quote, "By their very nature 

3 are typically predecisional and deliberative."

4 Therefore, the Department of 

5 Energy has determined that this document can 

6 be withheld under FOIA Exemption No. 5. I ask 

7 you, is that fair? NIOSH reviewed it and 

8 incorporated this document in their methods. 

9 DOE did not cite any kind of national security 

10 interest in withholding this document but, as 

11 a result, the Rocky Flats claimants are denied 

12 access to this report. Again, I ask you, is 

13 this fair? Is this claimant-friendly?

14 I also checked with [identifying 

15 information redacted], the SEC petitioner, for 

16 National Bureau of Standards and I have 

17 permission to speak on her behalf. A travesty 

18 happened with that petition. 

19 In order to understand the 

20 workings of the government agencies, she 

21 FOIA'ed from NIOSH in February again all 

22 emails related to her SEC petition. So far 
. 

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1 all she has received is an acknowledgment of 

2 the FOIA request. This FOIA request is now 

3 over 100 days old which is a little bit past 

4 the 20-day time limit required by law. 

5 In conclusion, I respectfully ask 

6 that the Rocky Flats Work Group immediately 

7 schedule its first meeting to resolve the 

8 outstanding Site Profile issues and other 

9 issues related to the FOIA email.

10 An update on SC&A's report to the 

11 Work Group, or do the Worker Outreach Work 

12 Group, on its audit of NIOSH's response to 

13 public comment. That the document titled 

14 "Thorium Use at Rocky Flats" be released 

15 either directly to me to circulate or posted 

16 to DCAS' website.

17 That all draft White Papers 

18 developed by DCAS, ORAU, or SC&A be posted to 

19 DCAS' website immediately after review for 

20 national security and privacy issues.

21 DOL, NIOSH, and DOE must abide by 

22 the spirit and the letter of the FOIA 
. 

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1 legislation, especially with President Obama's 

2 Executive Order. The agencies must release 

3 documents within the time frame designated by 

4 law and in the format requested. 

5 The delay in releasing the 

6 requested documents, the agency's unreasonable 

7 request for clarification, or the misuse of 

8 FOIA exemptions goes against the concept that 

9 the U.S. Government bureaucracy operates with 

10 openness and worthy of examination by the 

11 public.

12 I also want to add that I am very 

13 happy to hear that stage one of the 10-year 

14 review has been completed and I look forward 

15 to learning more about how the recommendations 

16 are going to be implemented.

17 Again, I thank you for the 

18 opportunity to bring these concerns to your 

19 attention. Thank you.

20 CHAIRMAN MELIUS: Thank you, 

21 Terrie. Mark Griffon will be here tomorrow. 

22 He was delayed by weather. A number of people 
. 

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1 had difficulty getting out here. I will talk 

2 to him and we will work together to try to get 

3 that Rocky Flats group going again to address 

4 some of these issues.

5 There were some other issues we 

6 were waiting on. That group is not waiting 

7 for the Worker Outreach. That, as you say, is 

8 separate and so forth. We were discussing 

9 today and believe that the Worker Outreach 

10 group will meet again shortly to take up and 

11 follow up on their work including their work 

12 involving Rocky Flats.

13 Greg Lewis is here and hopefully 

14 can at least make a note and follow up. You 

15 don't need to say anything unless you have 

16 information but we'll be able to follow up on 

17 that issue on the FOIA request. It may just 

18 be a matter of communications. 

19 If it ended up as a draft 

20 document, I don't know -- I can see where that 

21 would get turned down. That's sort of 

22 standard policy for Freedom of Information but 
. 

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1 maybe that can be resolved in some way.

2 I may have missed it but the 

3 National Bureau of Standards, that was a 

4 request to NIOSH?

5 MS. BARRIE: Yes. Ms. Virginia 

6 Bond requested emails to NIOSH -- from NIOSH.

7 CHAIRMAN MELIUS: Okay. We'll ask 

8 Stu Hinnefeld or someone from NIOSH to follow 

9 up and at least find out that that didn't get 

10 somehow misplaced or whatever. It is long 

11 enough and they should have gotten the 

12 communication on that.

13 I will say that we are working and 

14 continuing to work to get the White Papers and 

15 other documents available. I think we're 

16 making progress. It may not be complete yet 

17 but that is something that we're working on to 

18 make them both sort of accessible not only for 

19 the public but also for other Board Members. 

20 That's been an issue we've raised before.

21 Ted.

22 MR. KATZ: I can just give an 
. 

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1 update on that while we're on that topic. So 

2 we are making progress, Terrie. What we're 

3 doing now is trying to start with getting up 

4 everything that has already been PA cleared. 

5 There is more than PA clearance. There is 

6 also what's called 508 compliance. 

7 Anyway, it's making documents 

8 compliant for people that are visually 

9 impaired. It actually takes a lot of 

10 resources to do this so we are dealing with 

11 the ones that are already ready to be put up 

12 first. We will eventually get through 

13 everything. 

14 I could just tell you if inundated 

15 Office of General Counsel and the other 

16 parties who have to do this work with all the 

17 White Papers that would have to be cleared, it 

18 just couldn't happen very quickly. We are 

19 trying to do this sort of stepwise fashion.

20 MS. BARRIE: I appreciate that.

21 CHAIRMAN MELIUS: Terrie, I will 

22 get back to you personally on the Rocky Flats 
. 

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1 Work Group issue after the meeting, after I've 

2 talked to Mark.

3 MS. BARRIE: Okay. Thank you so 

4 much.

5 CHAIRMAN MELIUS: Thank you.

6 Is there anybody else on the phone 

7 that would like to make public comments?

8 MS. VLIEGER: This is Faye Vlieger 

9 from Washington. I had let Dr. Melius know 

10 that I wanted to make comments.

11 CHAIRMAN MELIUS: Okay. Go ahead.

12 MS. VLIEGER: Over the past few 

13 months I've been communicating with Dr. Melius 

14 concerning the unusual fines during the 

15 mediation process at the Hanford site.

16 My initial request was whether or 

17 not the Board was being kept apprized of these 

18 unusual fines of contamination and different 

19 radionuclides in places they hadn't discovered 

20 them, if the Board was being kept aware --

21 made aware that the old contamination being 

22 found was now exposing new people to things 
. 

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1 that were unexpected.

2 To my surprise the Board was not 

3 being kept apprized by DOE of these fines. 

4 Fortunately, at the end of March SC&A did come 

5 and discuss with a number of former workers 

6 the discovery that was found in Building 324. 

7 I am happy that happened. 

8 I am concerned that the Hanford 

9 SEC that is being petitioned and considered 

10 right now is not receiving the information 

11 about this contamination that is unexpectedly 

12 found, and the surprises that they are finding 

13 during remediation not only under buildings 

14 but at the old landfill and that where that 

15 contamination came from is not being advised 

16 to the Board.

17 What I would really like to see, 

18 because the Hanford meeting is coming up here 

19 in August, is to ensure that all of the 

20 surveys and the information from the 

21 remediation project is being made available to 

22 the Board in as much of a real-time basis as 
. 

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1 possible because it will affect the outcome of 

2 the SEC consideration.

3 CHAIRMAN MELIUS: Okay. Thank 

4 you. We'll follow up on that. It's a little 

5 hard to guarantee that we keep absolutely 

6 current on all information. We will hear 

7 tomorrow about the evaluation of the most 

8 recent petition. 

9 We will be having, as I've told 

10 you, a Work Group meeting for the Hanford Work 

11 Group between now and August so we'll be able 

12 to report on that by the August meeting.

13 MS. VLIEGER: In the meantime dose 

14 reconstructions that are being done for 

15 Hanford workers, is any consideration being 

16 given to the fines in Building 324 and the 300 

17 area in general or is that all on hold until 

18 after the SC&A report is turned in?

19 CHAIRMAN MELIUS: The Board 

20 currently is focusing on the SEC petitions 

21 which really cover, I think, mostly an earlier 

22 time period. I can't tell you off the top of 
. 

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1 my head. Stu Hinnefeld is at the microphone 

2 and will try to address it.

3 MR. HINNEFELD: Stu Hinnefeld from 

4 DCAS, from NIOSH. I know that we have heard 

5 about the unexpected findings during 

6 remediation work at Hanford. 

7 Our most knowledgeable Hanford 

8 person isn't here tonight and I'm not able to 

9 ask him exactly. I know he keeps pretty up to 

10 date with what's being learned out there and 

11 we'll do this.

12 As to the specific question 

13 whether dose reconstructions today have taken 

14 it into account, I would say that is probably 

15 not likely because we are going to have to 

16 have some sort of understanding about 

17 historically how does this discovery today 

18 affect things historically and what can we 

19 know about that. 

20 What can we know about what that 

21 says about our interpretation of the 

22 historical doses compared to what we already 
. 

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1 knew. I'm not 100 percent sure that I can 

2 give a satisfactory answer on that today. 

3 It's unlikely that dose reconstructions being 

4 done today have overtly taken that into 

5 account. 

6 It's also not inconceivable that 

7 dose reconstructions being done today just 

8 because of the data available from that time 

9 period have taken it into account. 

10 If it's an external exposure 

11 situation, for instance, the film badges 

12 theoretically would read the external exposure 

13 even though there's material found under this 

14 building that no one thought was there. 

15 Internal exposure would be a 

16 little different question. It's a fairly 

17 difficult question to answer and it will be a 

18 difficult question to answer, not something we 

19 can do very quickly but it will be something 

20 that we will have to investigate as we learn 

21 more about it.

22 CHAIRMAN MELIUS: This is Dr. 
. 

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1 Melius again. We'll be able to report back to 

2 you more on that, both from the Work Group 

3 meeting and the time we're at Hanford in 

4 August.

5 MS. VLIEGER: Do you have a report 

6 that is going to be generated from the 

7 interviews that were done here in March? Is 

8 there a time frame for when that report is 

9 going to be done?

10 DR. MAKHIJANI: Arjun Makhijani 

11 from SC&A. Two things. As you know, we've 

12 done the interviews. The interviews have been 

13 reviewed for classification. They have gone 

14 to the interviewees back so they can approve 

15 and correct the interview record.

16 So far as the SEC review is 

17 concerned, we are examining the implications 

18 of the 324 building findings for the period up 

19 to 1990 but we're not examining any 

20 implications for the period for which there is 

21 no SEC to my knowledge. There is no SEC that 

22 SC&A is reviewing.
. 

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1 I don't know that we will have all 

2 the interviews for you by the August meeting 

3 because there is an elaborate process of 

4 hearing back from the workers and I have no 

5 guarantee as to when they are going to get 

6 back. 

7 I know a few have gotten back but 

8 not all have gotten back to us. We will have 

9 a summary and our conclusions for the SEC 

10 process in the report that we are preparing. 

11 In fact, you know, I'm going through that 

12 during this meeting and shortly after this 

13 meeting.

14 MS. VLIEGER: I've been asking for 

15 a list of the references that are being called 

16 from DOE concerning this find in the ground 

17 under Building 324. At one point I was told 

18 by another advocate that there was a report 

19 generated by DOE when they knew that that 

20 floor drain had ruptured and that they 

21 cemented it over and that there was a DOE 

22 report that was generated. 
. 

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1 I have not been able to find that 

2 report. I know you can't tell me if it's a 

3 national security report but have you queried 

4 DOE about some sort of report that they did? 

5 I was told it was 20 years ago that they knew 

6 that floor drain had ruptured and they just 

7 cemented it over.

8 CHAIRMAN MELIUS: I think we will 

9 have to follow up on that. Sam Glover is not 

10 here and I think he'd be most knowledgeable 

11 about that, at least to the people who are 

12 directly involved at this point in time. We 

13 will follow up on it. We understand the 

14 concern. Thank you.

15 Is there anybody else on the line 

16 that wishes to make public comments? Okay. 

17 If not, then we'll close our public comment 

18 period and we'll see everybody tomorrow 

19 morning at 8:15.

20 (Whereupon, the above-entitled 

21 matter went off the record at 6:25 p.m.)

22