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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

CENTERS FOR DISEASE CONTROL

NATIONAL INSTITUTE FOR OCCUPATIONAL

SAFETY AND HEALTH 

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ADVISORY BOARD ON RADIATION AND

WORKER HEALTH 

+ + + + +

DOSE RECONSTRUCTION REVIEW METHODS WORK GROUP

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THURSDAY

NOVEMBER 30, 2017

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The Subcommittee convened via 

teleconference at 2:00 p.m. Eastern Time, James 

M. Melius, Chair, presiding.

PRESENT:

JAMES M. MELIUS, Chair

JOSIE BEACH, Member

DAVID KOTELCHUCK, Member

PAUL L. ZIEMER, Member
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ALSO PRESENT:

TED KATZ, Designated Federal Official

BOB BARTON, SC&A

KATHY BEHLING, SC&A

RON BUCHANAN, SC&A

GRADY CALHOUN, DCAS

ROSE GOGLIOTTI, SC&A

MARK GRIFFON, NIOSH Contractor

STU HINNEFELD, DCAS

JENNY LIN, HHS

JOHN MAURO, SC&A

JIM NETON, DCAS

JOHN STIVER, SC&A
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Contents

No table of contents entries found.
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1 P-R-O-C-E-E-D-I-N-G-S 

2 2:02 p.m.

3 Welcome and Roll Call 

4 MR. KATZ: So, welcome, this is the 

5 Advisory Board on Radiation and Worker Health. 

6 It is the Dose Reconstruction Methods Work Group 

7 and Dose Reconstruction Review Methods Work 

8 Group.

9 And the agenda for today and as well 

10 as a primary document that we'll be discussing 

11 today is posted on the NIOSH website under this 

12 program under the Board Section Schedule of 

13 Meetings today's date.

14 So, anyone online can go there and 

15 pull up that. It's quite a big document that 

16 will be discussed today.

17 All right, and so, otherwise, let me 

18 just take the roll call as there aren’t any 

19 conflict of interest matters.

20 Actually, I could just deal with the 

21 roll call because I know who's on.

22 (Roll call.)

23 MR. KATZ: Okay then, the Members of 
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1 Board, I'm going to mute your phones and, Dr. 

2 Melius, it's your meeting.

3 CHAIR MELIUS: Okay, thank you. Thank 

4 you, Ted.

5 I think we're going to be discussing, 

6 there are two documents today. One is the one -

7 - the large one by Mark Griffon and then, I can't 

8 remember if it was sent out separately, but it's 

9 also included as the second appendix on Mark's 

10 document is a document dated March 11, 2016 from 

11 SC&A from Rose regarding -- sort of summarizing 

12 of some ideas on ways that we can look into or 

13 subjects for looking at consistency and among the 

14 dose reconstructions in terms of our review 

15 process.

16 I don't think we've met since some 

17 time in 2015, maybe in '16, I can't remember. 

18 But, since our meeting, one is for the Review 

19 Subcommittee to sort of get caught up and then 

20 starting -- where we started any new endeavors.

21 And then, secondly, we've also been 

22 waiting for Mark's report to get completed and 

23 through review. And so, back and forth there. 
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1 So, we have that.

2 I think, if I'm understanding things 

3 right, we're almost at the point where the Dose 

4 Construction Review Subcommittee is sort of 

5 caught up, I think is fair to say. There's still 

6 some work to do, but they're going along at decent 

7 speed.

8 I guess one of us just got taken away.

9 MEMBER KOTELCHUCK: Right, yes, we're 

10 moving along.

11 CHAIR MELIUS: Yes. And so, we need 

12 to start thinking about the new assignments for 

13 them. So, one of the rationales for getting this 

14 Methods Committee meeting again and trying to 

15 move that whole process along with that.

16 Since we're meeting in a couple weeks 

17 on the agenda for the Board meeting, we have sort 

18 of a presentation from Dave Kotelchuck to bring 

19 us up to date on where the Subcommittee is.

20 And then, we'll also talk about the 

21 methods or new methods.

22 Then, we'll get a more complete 

23 presentation of Mark's report. But, all I asked 
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1 him to do today was to sort of summarize it.

2 And, I was hoping to accomplish this 

3 so everybody knows that information is out there 

4 and thinking about what we need to do.

5 Obviously, if we are going to change 

6 the approach to dose reconstruction reviews, 

7 that, you know, really is a decision for the full 

8 Board to make. And, hoping at our meeting in 

9 Albuquerque in a few weeks, we'll have some good 

10 discussion on that and be able to at least chart 

11 our plan for moving forward on this.

12 So, let me start with asking Mark to 

13 do a brief summary of his report.

14 Are you there, Mark?

15 Report on Assuring Consistency in 

16 Dose Reconstructions 

17 MR. GRIFFON: Sure. This is Mark 

18 Griffon, contractor for NIOSH.

19 And, I, yes, I'll keep it brief today. 

20 I planned in this call just to give an overview 

21 and then have a quite a bit more granularity in 

22 the presentation in a couple weeks in 

23 Albuquerque, if that makes sense.
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1 So, first of all, I mean, the focus of 

2 this report was to try to look a little further 

3 at, and maybe in more detail, look at where 

4 professional judgments are necessary in the dose 

5 reconstructions.

6 And, I did that through -- we selected 

7 a couple sample sites and, perhaps, not 

8 completely representative of all sites, but we 

9 wanted to have at least one large DOE site to 

10 look at and one AWE type site to look at as 

11 examples. And, I looked at Savannah River and 

12 Linde Ceramics for the two examples.

13 The idea was to, first of all, 

14 determine whether professional judgments could 

15 result in potential inconsistencies. In other 

16 words, are these judgments such that two 

17 different dose reconstructors could get 

18 significantly different, you know, answers or 

19 doses or whatever in certain areas of the dose 

20 reconstruction.

21 And then, possible approaches for 

22 assessing the dose reconstructions to determine 

23 where professional judgments may result in these 
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1 inconsistencies.

2 So, the assessment, you know, sort of 

3 the how can we examine that?

4 And, if you look at the document 

5 itself, I did an executive summary. And then, 

6 the frame of the report. And then, further back 

7 in the report, there's a section on Savannah 

8 River, the review I did of Savannah River and 

9 then Linde and then several appendices at the 

10 end, or attachments at the end.

11 To look at -- to do this review, just 

12 quickly, I mean, I looked at those two sites. I 

13 reviewed a lot of different TBDs, TIBs and 

14 procedures and in more depth than I --

15 And certainly, I appreciated what 

16 happens in the dose reconstruction reviews. I 

17 went down into the details of calculating the 

18 doses, so I had a little re-learning curve on 

19 some of that.

20 I also looked at SC&A's reviews of a 

21 lot of the TIBs and TBDs and Technical Basis 

22 Documents.

23 Importantly, I reviewed internal 
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1 guidance documents, such examples, DR Guidelines 

2 for Savannah River Site.

3 And so, these are not controlled 

4 documents. They're sort of done in between 

5 revisions of TBDs sometimes. And, I think 

6 sometimes they spend a little more detail of 

7 prescriptive guidelines for the dose 

8 reconstructor to do certain parts of the dose 

9 reconstruction, whether it be external or 

10 internal dose calculations, that sort of thing.

11 And, they become very important in the 

12 process.

13 And then, I looked at many individual 

14 cases. My focus on the cases was from trying to 

15 select best estimate cases through querying 

16 NOCTS. NOCTS usually is -- to get those, you 

17 sort of have to look at full internal, full 

18 external. I couldn't necessarily query based on 

19 45 to 52 percent PoC, but I tried to get the ones 

20 that would likely be best estimate cases.

21 And I also did, some ones that were 

22 identified in some of the other databases, 

23 tracking databases, where findings have been 
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1 found, even the Board's -- the Dose 

2 Reconstruction Subcommittee, a few of those cases 

3 I also included.

4 One -- so, one thing I want to note 

5 up front is I sort of defined this notion of two 

6 general categories of judgments.

7 And, one is what I defined as personal 

8 judgments and the other is program judgments.

9 And, personal judgments are -- I 

10 defined them as being judgments that the 

11 individual dose reconstructor has to make in 

12 reconstructing an individual case.

13 Whereas, the program judgments are 

14 still professional judgments, but they're made 

15 sort of for the dose reconstructor ahead of time. 

16 So, they're either in Technical Information 

17 Bulletins or the Tech Basis Document or these DR 

18 Guidelines and through the work of ORAU and then 

19 often reviewed by NIOSH and the Board.

20 These procedures have professional 

21 judgments in them, but they're not individual 

22 judgments that the dose reconstructor has to 

23 worry about. They've been taken care of. They're 
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1 sort of prescribed for the case work.

2 So, and then, if you look at a lot of 

3 my -- there is a listing of sort of personal 

4 judgments. And, in Albuquerque I will expand on 

5 some of these so you get a better sense of the 

6 specific ones, especially the ones I found at 

7 Savannah River and more at Savannah River, and 

8 I'll get to it in a second.

9 But, a lot of the, I think, if you 

10 look at the two documents you have, not 

11 surprisingly, these overlap quite a bit with ones 

12 that SC&A identified through, you know, through 

13 their ten years or so of experiences in dose 

14 reconstructions.

15 And, you know, they include the one 

16 that we all remember very well is the judgments 

17 regarding worker location for the purposes of, 

18 you know, both internal and external dose 

19 estimates.

20 I think the -- an example of one of 

21 those that came up often in -- while I was on the 

22 Dose Reconstruction Subcommittee was the 

23 assignment of neutron dose.
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1 And, sometimes you wouldn't have data 

2 and there had to be a judgment depending on the 

3 individual's job title and/or work location 

4 whether they were likely -- or whether neutron 

5 dose should be assigned.

6 So, that's one we all remember very 

7 well.

8 Job title and this sometimes gets into 

9 the construction trades question versus non-CTW 

10 jobs by calculation of missed dose both internal 

11 and external.

12 And, judgments require reconciling 

13 discrepancies and, I don't need to go through all 

14 of them, but that's just some of the personal 

15 judgments.

16 As an example for the personal 

17 judgments, you know, resolving missed doses, the 

18 individual dose reconstructor has -- often has a 

19 few options.

20 They can use either nearby doses. 

21 They can use a coworker dose of, you know, 

22 sometimes an option of either if it's in the 95th 

23 percentile of the coworker dose or they can use 
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1 LOD over 2 in many cases to fill in those missed 

2 dose areas.

3 Some of that is, I should note, is 

4 often pretty well prescribed on like for Savannah 

5 River where they've done the guidance, the DR 

6 Guidance lays out pretty precisely in different 

7 time periods what some of the -- it certainly 

8 narrows down the options for the individual, you 

9 know, individual dose reconstruction to help 

10 facilitate that decision.

11 And then, the other broad category 

12 that is the professional judgment. And, you 

13 know, some that I noted, and I included this in 

14 the report because I think some of these are 

15 fairly important and very cross cutting issues.

16 And, for instance, one of them would 

17 be the judgment on how to handle doses from 

18 residual contamination at the AWE sites. So, 

19 this after the operational period and, I believe 

20 it's TIB-70 outlined this protocol.

21 There's other ones that have, you 

22 know, certainly have come up over the years and 

23 some are still included in the Board tracking 
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1 system as sort of global issues.

2 One would be, even estimating 

3 uncertainty for internal, external doses, there 

4 is some overall guidance and there's some level 

5 of individual or site specific approaches that 

6 are used there.

7 And, you know, and so, I mean, that's 

8 -- this is why I used these is because -- or 

9 include these is because they're pretty cross 

10 cutting issues.

11 Now, I should note that, you know, 

12 that's what the Board's been doing for 13 or so 

13 years is looking at a lot of these, you know, the 

14 procedures, the TIBs, everything else and 

15 reviewing them and approving these, what I would 

16 call program judgments.

17 So, one reason I raise this, though, 

18 is that, and Jim Neton wrote a very nice summary 

19 document for the first one that I just raised, 

20 the residual contamination, summarizing the sort 

21 of history of that document and the review by 

22 SC&A and the Board and then the sort of final 

23 agreement by the Board of the approach in the 
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1 final revision of TIB-70.

2 And, I thought that was a very useful 

3 summary. And, for some of these other issues, 

4 I'll use uncertainty as an example, I found 

5 myself really, really trying to track through and 

6 see where these issues stood and how and whether 

7 they were completely closed out by the Board.

8 And, I thought that, for some of the 

9 bigger issues, it might be useful to have a nice 

10 summary document, you know, outlining all the 

11 years of work that have gone into these issues 

12 and the final decision that, you know, that was 

13 arrived upon.

14 And then, I'll just go into the -- so, 

15 some recommendations that came out of this.

16 The first recommendation was to do 

17 assessments in these areas that were identified 

18 for the personal professional judgments.

19 And, I left some options of how, and 

20 the options and/or a combination of things that 

21 I think might be appropriate, including ORAU and 

22 NIOSH blind and/or focused reviews.

23 And, the idea of -- the idea -- and 
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1 then, when the Board blind and focus reviews and 

2 also another part of that recommendation was to 

3 perhaps refine the current approach for the peer 

4 review by NIOSH to get a greater percentage of 

5 best estimate cases that are -- that go through 

6 the comprehensive review.

7 The one thing, when I say ORAU, I'm 

8 not certain how this would work but, if for ORAU, 

9 I know right now that they -- I think it was in 

10 2012 enhanced their internal peer review.

11 So, and I believe I have this right, 

12 that all their best estimate cases, anything in 

13 that 45 to 52 percent range of PoC, they were 

14 actually put through an extra peer review for 

15 those cases.

16 And, the idea of this -- these -- for 

17 the ORAU blinds would be to take one case that 

18 would have some of these professional judgments 

19 and give it to two separate dose reconstructors 

20 and see if, given the guidance available to see 

21 if they came up with the same answers and where 

22 there were inconsistencies. And so, sort of a 

23 split sample approach internally before, you 
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1 know, before it gets to the Board.

2 I think, you know, one note I will 

3 make on this recommendation is that I think this 

4 works -- this will work best if there is a --

5 well, let me preface this by saying that, over 

6 the years in this program, it's obvious that the 

7 improvement in the sort of question we had 

8 earlier on in the Board about showing the work in 

9 the case files, and it's drastically improved 

10 from the early days.

11 And, but, on the best estimate cases, 

12 I think there is some enhancements that might be 

13 made. And, I give in the report an example of 

14 the Hanford. Hanford has a workbook, a time line 

15 workbook, for cases.

16 I'm not sure how old or new that, you 

17 know, when they started using this, but it even 

18 notes in the instructions on the workbook how the 

19 importance of using the time line to do the dose 

20 reconstructions including that it will make the 

21 review, the peer reviews, more efficient.

22 That, in other words, the more of the 

23 work that is shown up front, it makes it a lot 
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1 easier in the review process so there is no --

2 less guess work on what, you know, where the 

3 judgments were made and what the basis for making 

4 a certain judgment was.

5 If it's just included right there in 

6 some sort of a road map or a time line of the 

7 case, that would make it easier.

8 And, you know, so, that's just one 

9 point I wanted to make on that.

10 The other recommendations, and these 

11 will be quicker because I'm sure people want to 

12 discuss this and have questions.

13 Recommendation two was what I just 

14 mentioned a few minutes ago about a summary 

15 document for some of these bigger issues, the 

16 program-wide issues.

17 And, recommendation three is 

18 similarly is looking at these sort of the broader 

19 approach on AWE sites. And, they're all based on 

20 similar case underlying data.

21 And, I think it would be worthwhile to 

22 do some inter-comparison to assure that similar 

23 protocol and, you know, the hierarchical approach 
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1 of which data should be used when available, you 

2 know, that should be compared across some of 

3 these sites to make sure that there is 

4 consistency there in the way that the sort of 

5 non-personal dosimetry data is being used to 

6 estimate personal doses.

7 And then, moving toward the end of the 

8 executive summary, the additional 

9 recommendations.

10 One was for a tracking system. And, 

11 I think there is a few database tracking systems 

12 right now that have some of the internal peer 

13 review information.

14 And, I know that since 2012, ORAU has 

15 done a more expansive tracking of these sort of 

16 internal peer review findings.

17 And, I think it may be useful to see 

18 if some of those various ones can be merged into 

19 one database so that if there's a way to track 

20 the Board findings with the internal findings.

21 And perhaps some things will jump out 

22 at us there, you know, certain types of -- I mean, 

23 anecdotally, we see this, but searching through 
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1 the database might show some other things where 

2 professional judgments are coming up in findings 

3 fairly frequently.

4 The second was this -- I think I 

5 mentioned this earlier, the increased level of 

6 peer review for best estimate cases or cases with 

7 significant professional judgment.

8 And, that was currently, I believe 

9 NIOSH does a comprehensive peer review of five 

10 percent of the cases that come from ORAU. And, 

11 I believe they are randomly selected.

12 And, if possible, if practicable, I 

13 would say that it may be -- you may want to bias 

14 that sampling a little towards best estimate type 

15 cases.

16 Although, we, you know, I know the 

17 Board already reviews many, many, many of the 

18 best estimate cases, but that's just one other 

19 possible additional peer review.

20 And, as I was, you know, writing this 

21 document, ORAU also did note to me that they, I 

22 believe, again, it was in 2012, that they 

23 modified their own QA/QC approach to require an 
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1 additional peer review for the best estimate type 

2 cases.

3 So, and then, the last one was the 

4 idea, during this review, I looked at a lot of 

5 the CATI information.

6 And, you know, one thing I wanted to 

7 look at was how the judgments were made, if 

8 individuals noted incidents or accidents or those 

9 sort of information in their CATI, what sort of 

10 judgments had to be made in terms of handling 

11 that.

12 But, also, another thing that struck 

13 me was, you know, the question, and this is 

14 perhaps an older issue, but the question of 

15 whether the CATI information might be useful in 

16 aggregate.

17 I did a sampling of certain -- a few 

18 job titles and found that there was a fairly, 

19 well, not always including great information on 

20 dates, it was just a pretty high level of 

21 specificity about a number of accidents and 

22 incidents and that sorts of thing.

23 And, I thought the dose reconstructor 
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1 is handling this, you know, in the individual 

2 claims development, but would there be any 

3 utility in sort of aggregating some of this data 

4 from the CATIs, from the questionnaires.

5 And, I also think that, and I'm not 

6 sure about this, but I believe early on in the 

7 program, there were some efforts to look at the 

8 -- some of the AWE questionnaires sort of in 

9 aggregate form.

10 But, that was on sites where they had 

11 a much -- NIOSH and ORAU had a much less certain 

12 idea of the history of the sites.

13 So, you know, but anyway, that's sort 

14 of the final recommendation along the lines of 

15 CATI.

16 And, I guess I'll leave it there. I 

17 mean, I think it's, you know, that's, like I said, 

18 I plan to present and give some more detail on 

19 the individual professional judgment examples, 

20 personal professional judgment examples that I 

21 found, especially in the Savannah River Site 

22 example.

23 And, I think a lot of them are 
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1 probably applicable at many of the DOE sites. 

2 You know, the one I just talked about, the missed 

3 dose and how do you form the absent doses for

4 external, for internal. You know, there's a lot 

5 of overlap there.

6 And, that does bring up one final 

7 issue I think which is important in terms of the 

8 assessment that's done, I think it would be 

9 useful, at least on some of these professional 

10 judgment instances, in looking at -- or looking 

11 at them in a cross cutting way.

12 For example, their internal dose is 

13 largely covered by TIB-60, I believe. And, it's 

14 applicable at several or many of the DOE sites. 

15 And, it is the overarching guidance.

16 And, it would be useful to see if the 

17 internal dose reconstructor is doing the cases 

18 for Hanford are following sort of a similar 

19 claimant favorable approach as the ones at 

20 Savannah River?

21 You know, are they using similar rules 

22 of thumb in cases where one example would be the 

23 bioassay data runs through a certain time period 
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1 and then there's another ten years where the 

2 person is employed, how do they handle internal 

3 dose for that later ten years of employment?

4 And there's some, again, there's 

5 guidelines on that in the TIBs. It would be --

6 I think it would be useful to assure that it's 

7 being handled consistently across sites as well 

8 as within one site. But, that's just one example 

9 of that.

10 And, that's it, Jim. I'll leave it 

11 there for now.

12 CHAIR MELIUS: And, I'll take my call 

13 off mute.

14 Thanks, Mark.

15 MR. GRIFFON: Okay.

16 CHAIR MELIUS: That was helpful. I 

17 didn't want you to think that we had all hung up 

18 or something.

19 MR. GRIFFON: Not at all, not at all, 

20 am I connected still?

21 CHAIR MELIUS: You were talking to a 

22 conference call for a half hour.

23 MR. GRIFFON: Right.
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1 CHAIR MELIUS: Twenty minutes, 

2 whatever.

3 No, I mean, what struck me about your 

4 report and things like this is, you know, how 

5 complicated this all is. And, so, how do we pick 

6 the priorities, where to look and so forth and 

7 make those, you know, useful to the program.

8 And, again, not in a way that -- not 

9 to sort of catch fault with ORAU or NIOSH in terms 

10 of what they're doing, but just, you know, 

11 assuring that things, you know, are being done 

12 appropriately and are there ways of improving the 

13 program going forward.

14 So, anybody else on the Work Group 

15 have questions, comments at this point?

16 MR. GRIFFON: Jim, can I make one more 

17 comment just before you open it up? Is that okay?

18 CHAIR MELIUS: Yes, sure.

19 MR. GRIFFON: I just wanted to say 

20 that, you know, the other thing, and it is within 

21 the body of my report, but I want to emphasize it 

22 here is that, this is my opinion anyway, I think 

23 the focus on any assessment that's done here 
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1 should be on improving the system and assuring 

2 consistency, not to try to question or red flag 

3 any individual dose reconstructor.

4 You know, like this dose reconstructor 

5 A is always not conservative and this one is 

6 always doing it conservative, you know.

7 So, I believe this shouldn't be in any 

8 way looking at sort of the, you know, results 

9 that way, but more of the process so that, if, 

10 you know, as I looked at these DR Guidance, the 

11 guidelines for Savannah River have evolved over, 

12 I think, I forget, more than seven or eight 

13 different versions of the DR Guidelines.

14 And, it's clear in through my review 

15 and through discussions with ORAU and NIOSH that 

16 there is very much a team approach so that when 

17 they run into one of these, you know, questions 

18 on professional judgment, they don't just do it 

19 in isolation and try to, you know, they will bring 

20 it back to the team sometimes and, you know, say 

21 how do I handle this.

22 And, the SRS group, especially, it 

23 seems that the site level group gets together and 
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1 shares these, you know.

2 And then, often, that'll -- that may 

3 result in, I think, and that's why some of these 

4 guidelines evolve, is that they run into these 

5 questions and then they say, okay, let's add that 

6 to the guidelines to be as prescriptive in 

7 certain areas as we can.

8 Now, you know, the other point I think 

9 that's important is, you know, this is 

10 professional judgment. On some level, you can 

11 only get so prescriptive. So, then the way might 

12 be to, you know, fix other parts of the QA.

13 You know, maybe, you know, for these 

14 certain areas we need, you know, to assure 

15 there's a, you know, the double peer review or 

16 whatever, that sort of thing.

17 And, but I think there is -- they've 

18 done a lot in terms of this sort of shared 

19 approach I think helps to ensure consistency.

20 The workbook certainly, over the 

21 years, has evolved so that you, you know, there's 

22 a lot of prescriptive information in there that 

23 makes sure the dose reconstructor does it a 
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1 certain way, given certain up front assumptions, 

2 a lot of fields then are almost auto filled, you 

3 know.

4 So, that's a good thing, that's the 

5 good work that's been done over the years.

6 So, anyway, I just -- the only reason 

7 I mention that is because I know there's a source 

8 of discussion on one of the Subcommittees, I 

9 think it was the Dose Reconstruction 

10 Subcommittee.

11 MEMBER KOTELCHUCK: That's correct, 

12 yes.

13 MR. GRIFFON: Was, you know, do we 

14 really want to get into the questioning someone's 

15 professional judgments?

16 And, I say no, that's my opinion. I 

17 think this should be focused on the process and 

18 what can we find out that may help to add better 

19 instructions or better, you know, better QA 

20 process, whatever. It's not about comparing 

21 individuals' work.

22 So, anyway, that's all, that's it.
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1 Path Forward and/or Work Group Recommendations 

2 for Dose Reconstruction Case Reviews 

3 CHAIR MELIUS: See, I'm not sure I 

4 agree with you on that, Mark, in the sense that 

5 I agree that we're not here to try to, you know, 

6 evaluate each dose reconstructor at ORAU.

7 But, we do have to look at those -- I 

8 mean, it is legitimate to look at are those 

9 professional judgments made, you know, 

10 consistently so that, you know, a claimant gets 

11 treated the same as the other.

12 And, if, you know, they were working 

13 side by side and had similar histories and so 

14 forth and so that.

15 And, again, I expect that they are 

16 doing that because I think the process is pretty 

17 good and robust. But, I think it's our job as 

18 the Advisory Board and what the legislation asked 

19 us to do is to confirm that and do that.

20 But, then, if we find that there's 

21 inconsistency, then it's up to the program to 

22 figure out why and to do that. And, I suspect 

23 that maybe there would be a need for 
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1 clarification or more -- better guidelines or 

2 whatever.

3 But, that's not, you know, it is a 

4 complicated process and --

5 MR. GRIFFON: Yes, okay, yes.

6 CHAIR MELIUS: -- we're not expecting 

7 everything to match up perfectly either. I mean, 

8 it can't, it's not the nature of the information 

9 that people have to work with. And, we have to 

10 recognize that at the same time.

11 They have limited information and, 

12 therefore, they have to make judgments.

13 MR. GRIFFON: Yes, okay.

14 CHAIR MELIUS: So, I think that's --

15 MEMBER ZIEMER: Good point.

16 CHAIR MELIUS: Yes, Paul?

17 MEMBER ZIEMER: Yes, good point.

18 If I could make some comments as well. 

19 First of all, let me say hello to Mark, I know -

20 - I'm aware he's attended a number of meetings 

21 recently. But, since I haven't been able to 

22 travel, I haven't seen him since he left the 

23 Board. So, good to have you back, Mark, working 
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1 on this.

2 I've appreciated all the work you've 

3 done on this particular report.

4 Several items that struck me, I think, 

5 worth pursuing, not just the recommendations per 

6 se, but related to them.

7 The issue of the internal guidance 

8 documents on the major sites and the possibility 

9 of them impacting doses more significantly than 

10 one might otherwise guess.

11 I think you've raised this, sort of as 

12 a point, and I think that one is worth pursuing 

13 as well.

14 The impact of the changes in the 

15 internal guidance documents versus the changes in 

16 the basis documents as well.

17 Another one I thought was worth 

18 pursuing was the use of the time lines. Mark, 

19 you provided a lot of details on dose 

20 reconstruction that I wasn't even personally 

21 aware of. I thought I knew pretty well how things 

22 were done, but the time line thing struck me.

23 It sounded like it's done at some 
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1 sites and not at others. And, perhaps that was 

2 not the case, but it seemed like you were raising 

3 that question. And, it seemed to me that was 

4 another one worth pursuing.

5 The other thing I wanted to mention, 

6 of course, you raised a lot of things that related 

7 to how dose reconstruction is done at Savannah 

8 River. And, it seems to me that we do need to -

9 - and you did some inter-comparisons of some of 

10 the different issues there.

11 I think it's also important that we 

12 think about inter-comparing several of the major 

13 sites to look for those kind of consistencies in 

14 approaches where the -- where we have either the 

15 guidance documents or Technical Basis Documents.

16 I know we're trying to be consistent 

17 on that and we have a number of documents that 

18 cut across all of the sites. So, the consistency 

19 across the sites on these kind of judgmental 

20 things I think is going to be important.

21 The other thing I'm going to mention, 

22 this is one thing that I'm always picking on and 

23 that is, editing. I guess I'll ask, is NIOSH 
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1 going to edit the report when your draft is at 

2 some point, Mark?

3 When I say edit, I'm not talking about 

4 editing the technical content so much as the sort 

5 of things I also look for like: “data was,” “data 

6 were,” use of “howevers.”

7 I didn't see any dangling participles, 

8 so I'm okay there. But, who does the editing on 

9 these things?

10 MR. GRIFFON: I think we should stop 

11 there, Paul. You didn't see any dangling 

12 participles.

13 MEMBER ZIEMER: I should stop there?

14 CHAIR MELIUS: Mark, now that you're 

15 off the Board, you're like this open season so -

16 -

17 MR. GRIFFON: Yes, I know. I haven't 

18 talked to Stu, but even after I submit it --

19 MEMBER ZIEMER: Well, there's just 

20 some --

21 MR. GRIFFON: I'm not an editor.

22 MEMBER ZIEMER: -- regular editing 

23 that I think will need to be done. And, I don't 
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1 want to have to do it on this length of a report 

2 myself, but I wondered if NIOSH is going to do 

3 that?

4 Then the other thing I assume we're 

5 going to hear from ORAU and NIOSH on the 

6 recommendations to make sure that if you or we 

7 have misunderstood what's being recommended or if 

8 they're already doing these that they clarify 

9 that.

10 So, those are the comments, my initial 

11 comments on it. But I appreciate all the work 

12 that was done on it. I think it's a good report.

13 MR. GRIFFON: Thank you, Paul. And, 

14 it's good to hear you and I hope I see you in --

15 you're going to be in Albuquerque, I hope.

16 MEMBER ZIEMER: I won't be for medical 

17 reasons. So, I'll be on the phone.

18 MR. GRIFFON: Good to hear from you, 

19 yes, thank you, Paul.

20 CHAIR MELIUS: Any other -- Dave?

21 Yes, go ahead.

22 MEMBER KOTELCHUCK: First, I thought 

23 overall, it was a very good report. And, it 
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1 helped clarify the confusion I think when we 

2 first discussed this in the Dose Reconstruction 

3 Review Subcommittee, that it's not a question of 

4 one professional looking at another professional 

5 and questioning them.

6 But, what you suggested was that 

7 there's a percentile group and there are 

8 programmatic issues.

9 And, in a way, what you've showed many 

10 of them, and I'm -- I'll talk about specific 

11 things later -- but, it seems to me that the 

12 programmatic dose reconstruction judgments can -

13 - we can use the -- we can focus on those and use 

14 those either to narrow the scope of personal 

15 professional judgments or give better guidance to 

16 the persons doing the dose reconstruction so that 

17 there's a more limited -- better guidance for 

18 them.

19 So, it was quite useful and convincing 

20 to me of the importance and value of this effort.

21 And, when we later as we talk about 

22 specific items, I'll have some suggestions about 

23 things I would like to look at among the very 
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1 many different kinds of suggestions that you 

2 made.

3 Thank you.

4 MR. GRIFFON: Thank you, yes, thank 

5 you.

6 CHAIR MELIUS: Anybody else?

7 (No audible response.)

8 CHAIR MELIUS: I would just weigh in. 

9 I think, at least in major areas, think in a 

10 similar fashion.

11 And, I guess what -- and I think we've 

12 talked about this before, we sort of have this 

13 higher level procedure, TIB Review process and 

14 Site Profiles and so forth.

15 And then, sort of -- and then we have 

16 this, you know, individual case reviews and it's 

17 these, you know, guidance documents and other 

18 things that are sort of in between that don't 

19 always get done that you sort of translate the 

20 higher level document down to, you know, how do 

21 you -- how should dose reconstruction be done at 

22 an individual site.

23 And, again, there's this dynamic, 
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1 these sites are complicated and, you know, it's 

2 important that they -- these internal guidance 

3 documents be sort of flexible and can be updated 

4 relatively quickly.

5 At the same time, I think we need to 

6 think about, at what point do we, you know, review 

7 some of them or review -- how do we chose which 

8 ones that need to be reviewed and how do we also 

9 look at this issue of consistency across the 

10 different sites.

11 Or, how maybe some of the higher level 

12 documents are being applied at those sites. And 

13 are the, you know, are they all being done in a, 

14 you know, appropriate fashion?

15 So, I think that's sort of one task in 

16 sort of how to approach it is complicated.

17 I think the other one that I think 

18 that you brought up in yours is, I guess, I think 

19 they're related issues.

20 One is sort of the initial interviews 

21 that the claimants go through and how that 

22 information is used and so forth.

23 And then, you -- closely related to 
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1 that is how do we get a handle on, which always 

2 seems to be the most problematic area for people 

3 -- so claimants understand it is this whole issue 

4 of, you know, individual incidents and so forth, 

5 many of which are I think we found to be very 

6 poorly documented at many of the sites.

7 And so, the dose reconstructor is sort 

8 of left with, you know, limited information and 

9 limited documentation and trying to figure out 

10 what the potential exposure was.

11 And again, it's hard to say just how 

12 important it is overall, but certainly can be 

13 important in individual cases. And, obviously, 

14 it's further complicated by the fact that many of 

15 our claimants have died and, you know, the family 

16 is the claimant and have less information about 

17 the site.

18 So, I think that's another area we

19 need to explore of doing things and sort of doing 

20 some sort of evaluation or study of the CATI 

21 interviews I think may be, you know, a focus study 

22 would may be one way of approaching that.

23 So, that was another idea that I sort 
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1 of liked that you had raised, Mark.

2 MR. GRIFFON: Yes, no, I think -- and 

3 I agree that it's -- and, I mean, it's a very 

4 fair point to say that you'd review many of the 

5 CATIs and a lot of them, even though they 

6 mentioned incidents, there is very little to help 

7 the dose reconstructor to go on.

8 They often don't have dates or areas 

9 or, you know. So, it does make it challenging.

10 But, I am curious whether, in 

11 aggregate -- so, yes, we at least put out the 

12 idea of perhaps a partial, you know, look at this 

13 at one of the sites to determine if there's any 

14 usefulness in aggregate data in this regard.

15 CHAIR MELIUS: Yes, it would be both 

16 aggregate data and then, this may be a pipe dream 

17 on my part, but it's sort of, you know, maybe one 

18 of those incidents was documented.

19 MR. GRIFFON: Right.

20 CHAIR MELIUS: You know, some sort of 

21 exposure evaluation, whatever did take place. 

22 And so, you know, maybe that information could be 

23 helpful. It wouldn't be in the individual's, you 
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1 know, you'd have to track it down in the aggregate 

2 and then see if it would apply to other reports 

3 of incidents from people.

4 MR. GRIFFON: Oh yes, I see what 

5 you're --

6 CHAIR MELIUS: Or areas, you know, 

7 that kind of thing. And, again, it may be -- I 

8 may be, you know, maybe wishful thinking on my 

9 part, but --

10 MR. GRIFFON: That would -- that might 

11 be challenging to piece together, but I know I 

12 reviewed several cases where there were mentions 

13 in the CATI of skin contamination and in the dose 

14 reconstruction report, the dose reconstructor 

15 found in a DOE record some, you know, instances 

16 where the person had been contaminated.

17 And, in some cases, they even did a, 

18 you know, a more detailed skin exposure, you 

19 know, focus using a VARSKIN code, they were able 

20 to do.

21 Because they actually had 

22 contamination numbers, you know.

23 CHAIR MELIUS: Yes.
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1 MR. GRIFFON: They could do a dose to 

2 a certain area of the skin or whatever.

3 But, yes, piecing the CATIs together 

4 with the DOE records, yes, might be a challenge. 

5 But, I know what you mean. Yes, that was my hope 

6 also in one of the incidents that I actually 

7 mention in here, you know, with a Californium, 

8 not an incident, but work that the person was 

9 doing with the Californium source, and mentioned 

10 in the, I think, Section 9, the other work or 

11 other incidents or, you know.

12 And, you know, the question is, were 

13 other people involved in that work or in that 

14 area where they could have got similar exposures.

15 And, this might help shed light on 

16 some of those things.

17 MEMBER KOTELCHUCK: Dave?

18 CHAIR MELIUS: Yes?

19 MEMBER KOTELCHUCK: I want -- I have 

20 trouble getting my hands around the entire 

21 report. And I had hoped or assumed that today, 

22 what we might do would be to set a few priorities 

23 of issues that we think are fairly major and worth 
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1 the initial assessment.

2 And then go ahead and have, if you 

3 will, a series of our Working Group meetings to 

4 go over whole portions and to discuss some 

5 portions in detail about internal exposure, 

6 external, CATI, et cetera as well as some of the 

7 items raised in the SC&A report that Rose did 

8 earlier which do not quite overlap. They are 

9 specific issues rather than a broader statement 

10 of issues.

11 So, to me, I mean, I wish -- I would 

12 hope we could maybe set a few priorities today or 

13 to recommend to the Board.

14 CHAIR MELIUS: But what I was going 

15 to, I mean, that was a similar plan, but it was 

16 a little bit different than what you're 

17 suggesting, Dave.

18 MEMBER KOTELCHUCK: How's that?

19 CHAIR MELIUS: Was that, I really 

20 think it's important that the Board get as much 

21 involvement from the Board as we can on this 

22 effort.

23 It's an important function of the 
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1 Board to do, how we do individual case reviews 

2 and how we approach this.

3 So, what I was going to do was for --

4 after Mark does his presentation in Albuquerque 

5 is do a quick PowerPoint that would list some of 

6 those ideas that came out of it and get, you know, 

7 people's thoughts on -- Board Members thoughts 

8 on, you know, what are good, what are bad, where 

9 do we start? Are there other ideas they have?

10 MEMBER KOTELCHUCK: Well, that sounds 

11 good to me.

12 CHAIR MELIUS: Yes, and if you want to 

13 email me some of your thoughts beyond what's 

14 involved or Rose's report or what you think are 

15 priorities within that, I'll include those.

16 MEMBER KOTELCHUCK: I can do -- I'd be 

17 very glad to.

18 CHAIR MELIUS: Yes.

19 MEMBER KOTELCHUCK: I can just say one 

20 line off coworker data.

21 CHAIR MELIUS: Yes.

22 MEMBER KOTELCHUCK: Fifty or the 95th 

23 percentile, which have a major impact on the PoC. 
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1 But, yes, and I perhaps have a few others I'll 

2 email you.

3 MR. GRIFFON: That's very good, Dave.

4 And, I would just say, I think I did 

5 compare, I mean, it's not necessarily all the 

6 same issues that SC&A covered, but I -- in the 

7 front end of this report, it -- I tried to put 

8 them in broader terms.

9 But, if you get back into the Savannah 

10 River section, I think you'll see that a lot of 

11 these same things that the specifics about 

12 coworker data, about in vivo versus in vitro or 

13 the combination thereof.

14 I mean, some of the same things, I 

15 did.

16 MEMBER KOTELCHUCK: Okay, good, good.

17 MR. GRIFFON: Yes, yes, yes. I just 

18 felt it was, you know, it was -- I made it broader 

19 statements on the front end for discussion 

20 purposes, yes.

21 MEMBER KOTELCHUCK: That's right, 

22 okay, good, good. And I'll look at that a little 

23 more carefully, too.
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1 MR. GRIFFON: Oh sure.

2 MEMBER KOTELCHUCK: In preparation for 

3 the meeting.

4 CHAIR MELIUS: Yes, and it is a lot 

5 to sort through.

6 MR. GRIFFON: And I also, in the 

7 PowerPoint I'm putting together now for the 

8 meeting in a couple weeks, I'm trying, I'm still 

9 working on it, but I'm trying to put a table that 

10 sort of gives the broad category and then some of 

11 the specifics and also making a slide that's 

12 readable for the audience.

13 You know, so but I'm trying to do some 

14 of that. And I think you're right, I think there 

15 are some maybe that, you know, the Board may want 

16 to start on as priorities and that might also 

17 allow you to fine tune the review approach.

18 I know in reviewing transcripts from 

19 past meetings, there was some question about how 

20 to do these assessments, too.

21 And I think that's going to -- I think 

22 you guys are going to have to get involved with 

23 that.
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1 But I'm less concerned about, because 

2 I thought I remembered seeing some discussion 

3 about, well, we have to have, in order to do a 

4 review like this, we have to have people that 

5 worked in the exact same areas and did the exact 

6 same job and did the, you know.

7 And, I'm less convinced of that. I 

8 think if we focused on issues and then focused on 

9 is the guidance sufficient to make -- is the 

10 decision making process consistent rather than 

11 we're not looking to compare exact answers, but 

12 rather is the decision making process consistent?

13 If not, is the guidance -- can the 

14 guidance be improved or can other parts of the 

15 system improve?

16 That's sort of my look at this.

17 MEMBER KOTELCHUCK: Yes, that would be 

18 helpful. Okay.

19 CHAIR MELIUS: And, I would just add 

20 to that as one sort of the idea is one is, you 

21 know, there may be some preliminary work we need 

22 to do just to see if some of these ideas are 

23 feasible. Which sites they're feasible at and so 
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1 forth.

2 So, that's one reason we may want to 

3 get started on some sort of separate evaluations 

4 that would just sort of, you know, be sort of 

5 pilots or whatever, studies to let us see if it 

6 makes sense to do.

7 I think the other thing they could 

8 think about is how do we prioritize the, you know, 

9 what we focus on and what we do.

10 And I think you mentioned in your 

11 report the, Mark, but, I mean, it makes no sense 

12 to spend a lot of time on, you know, trivial 

13 exposures, I mean, just, you know, if something 

14 isn't going to be important in terms of, you know, 

15 upping the dose or what happens to a claimant.

16 Then, you know, we shouldn't be 

17 spending a lot of effort trying to get 

18 consistent, you know, perfect consistency in the 

19 evaluation of that particular exposure and nor 

20 should we fault ORAU or NIOSH for, you know, 

21 taking that into account in terms of how they 

22 focus as much as they do with the sort of the 

23 over estimates, under estimates and, you know, 
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1 best estimate approach for dose reconstruction.

2 So, I think, you know, do we just 

3 focus on best estimate cases or, you know, it may 

4 depend on how evaluations are done and so forth.

5 So, I think it's another thing to keep 

6 in mind, again, it makes no sense to do something 

7 that's not going to really even be meaningful 

8 and, you know, just makes -- we can make a 

9 recommendation that would make, you know, more 

10 work for NIOSH and ORAU and not really be very 

11 meaningful in terms of the actual dose 

12 reconstruction.

13 MR. GRIFFON: Yes, I totally agree 

14 with that, yes.

15 CHAIR MELIUS: Stu, do you have any 

16 comments?

17 MR. HINNEFELD: Well, nothing 

18 particularly earth-shaking.

19 I guess I am interested in sort of a 

20 kind of a consensus priority on recommendations 

21 for -- to be pursued here.

22 Because there are a number of 

23 recommendations in the report and, some probably 
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1 more work-intensive or effort-intensive than 

2 others.

3 And, I'm -- every time, you know, my 

4 view of, you know, additional recommendations and 

5 additional work means that, doing -- embarking on 

6 that work can supplant some of the other work 

7 we're doing.

8 I think we'll continue to keep up with 

9 dose reconstructions, but it would supplant site 

10 research work that is also, of course, takes a 

11 long time.

12 So, I'd like to be selective in terms 

13 of the recommendations that we really engage in 

14 and try to, you know, essentially take on. So, 

15 that's one aspect.

16 And, we've not really had a particular 

17 discussion with ORAU yet about how we view the 

18 various efforts required for these various 

19 recommendations. So that would be part of the 

20 consideration also.

21 So, that's kind of my overriding 

22 approach to Mark's report is that I thought that 

23 I have no particular complaint with any of the 
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1 recommendations that he made. I just felt like 

2 we have to balance recommendations that come from 

3 that report with our already relatively full 

4 inbox.

5 And then, as to Paul's question about 

6 who will edit the report, we can certainly give 

7 that a shot. You know, if Mark wants us to do 

8 that.

9 We didn't attempt to edit this when 

10 Mark delivered it. I just sent it on to the Work 

11 Group or to Ted to distribute to the Work Group.

12 So, we can certainly take that on if 

13 you would like. I think ORAU might actually have 

14 better technical editors than we do. We may farm 

15 it out to them.

16 MR. GRIFFON: Yes, I'm certainly happy 

17 with that. Like I said, I realized after issuing 

18 it that I read through and found many edits on my 

19 own. So --

20 MR. HINNEFELD: Well, we'll let Mark 

21 start, how's that sound? We'll let Mark start 

22 editing.

23 MR. GRIFFON: Yes.
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1 CHAIR MELIUS: You just got assigned, 

2 Mark.

3 MR. HINNEFELD: I keep -- I have to 

4 keep reminding myself, he works for me now.

5 CHAIR MELIUS: Yes, I know, I know.

6 Along the lines of what you were 

7 saying, Stu, I think the other thing that's 

8 important is we sort of -- some of the 

9 recommendations pertain sort of less to the Board 

10 and more to you.

11 MR. HINNEFELD: Exactly.

12 CHAIR MELIUS: And then, sort of --

13 but sort of also want to avoid, you know, 

14 duplication in terms of -- needless duplication, 

15 unnecessary duplication in terms of the work 

16 we're doing and as we pursue this.

17 So, if you're already, you know, 

18 working on it or that's on your list to get done 

19 at some point, it makes no sense. And hopefully, 

20 at the same time, where we can supplement with 

21 work and divide it up appropriately.

22 Again, recognizing that we have 

23 certain different responsibilities here. You, 
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1 you know, run the program and manage it and us 

2 to, you know, be sort of the quality, you know, 

3 independent quality check on it that Congress 

4 asked us to be. So, do that as part.

5 Let's see, Dave, John or whoever else 

6 is on, John Stiver?

7 MR. STIVER: I was on mute there.

8 CHAIR MELIUS: Yes.

9 MR. STIVER: I know John Mauro had a 

10 few things he'd like to talk about if given the 

11 chance to weigh in here.

12 DR. MAURO: Oh yes, hi. Hello, 

13 everyone.

14 I did put together a -- this is John 

15 Mauro -- by the way, I did carefully read the 

16 main body of Mark's report and just a couple of 

17 quick observations.

18 One, I was very impressed that Mark 

19 would operate up in the stratosphere, 

20 understanding the big picture and then down in 

21 the weeds, really getting down there and going -

22 - and bouncing back and forth, tried to come to 

23 grips what I believe to be a herculean task to 
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1 try to find out, you know, get your arms around 

2 ensuring consistency.

3 So, I just wanted to have a positive 

4 statement. And, like Mark, I've been around for 

5 a while and watched the program mature. And I've 

6 been listening.

7 And I sent out a memo of what my notes 

8 were. I had some notes as I was reading Mark's 

9 report. And I forwarded them on to John just --

10 and the other members of our team just for food 

11 for thought.

12 But, John, am I correct, did you 

13 forward anything on to Ted regarding those five 

14 or six items that I sort of jotted down? I saw 

15 a memo that you may have passed that on.

16 MR. STIVER: Yes, yes, I did. I sent 

17 it on to Ted, I think he passed it on to Dr. 

18 Melius.

19 DR. MAURO: Good.

20 CHAIR MELIUS: John, I was using it as 

21 my cheat sheet for -- so I could sound intelligent 

22 when Mark was --

23 (LAUGHTER)
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1 CHAIR MELIUS: -- asking questions and 

2 making suggestions. But, it was helpful and I 

3 don't think there's a problem with forwarding it 

4 to the rest of the Work Group either.

5 I wasn't sure if it had been or not, 

6 but then I realized that just before the meeting 

7 it hadn't been. So, I was keeping it as my 

8 private, you know --

9 DR. MAURO: Well, great, you found it 

10 useful.

11 It was never intended to be other than 

12 internal to SC&A just to get us thinking about it 

13 at that level.

14 Rather than go through some of those 

15 items and everyone, if you would, distribute 

16 them, you could make that part of the milieu of 

17 material covered.

18 I had a couple of thoughts listening 

19 very, very carefully to Mark and thinking about 

20 everything that we do. And I'm just going to put 

21 a couple of, you know, musings as was mentioned 

22 about some of these thoughts I have sometimes. 

23 You know, I have a couple of musings.
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1 It goes toward the actual DR 

2 documentation. And I'm envisioning a dose 

3 reconstructor doing his work and there's a very 

4 complex process.

5 And I learned more about it by reading 

6 Mark's report. We don't always see behind the 

7 curtain. Mark takes a look behind the curtain 

8 and understand the richness of the -- and 

9 complexity of the process at an even higher level 

10 than I thought that I understood.

11 But one thought I had is when -- while 

12 I was reading Mark's report, I said, you know, 

13 all said and done, if there are places where there 

14 are problems, it either has to do with a quality 

15 assurance question or a judgment question.

16 And, of course, Mark's report focused 

17 on judgments and consistencies in judgments.

18 So, I was thinking and, you know, and 

19 I think after our reviews and how we make them 

20 and we have findings and then we try to resolve 

21 findings.

22 But the thought I had is two things. 

23 One is, when the DR is being done, one of the 
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1 things that the DR -- the person doing the dose 

2 reconstruction, the originator of the document, 

3 to keep track of where he has made a judgment.

4 Now, the judgment is sort of 

5 interesting in that it's a judgment on how he 

6 interprets the guidance.

7 Now, of course, if you have a 

8 workbook, there is no judgment.

9 But there are times when a judgment is 

10 being made interpreting how the particular OTIB, 

11 Site Profile, OTIB, applies to this problem. And 

12 so, he makes the judgment that if, and this falls 

13 in an interesting area, he's making a judgment of 

14 the degree to which how he's going to use that 

15 guidance for this particular problem.

16 And so, I think that's a judgment 

17 call. I think that should be written down, kept 

18 track of.

19 And the other place is where the dose 

20 reconstructor truly has a situation where he had 

21 to come up with a fix for how am I going to deal 

22 with a particular scenario, exposure scenario, 

23 that might be associated with an accident or some 
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1 unusual circumstance.

2 By the way, we just encountered that 

3 in how to deal with an issue working on Metals 

4 and Controls which sort of led me to think about 

5 this.

6 So, there are two kinds of judgments 

7 that are made. One, and it goes toward the way 

8 Mark defined an individual professional judgment 

9 and then the judgment that's made 

10 programmatically. And I agree with that 

11 dichotomy.

12 But I think the way you bring that 

13 down to where the rubber meets the road is really 

14 a process. How do we capture a process that, in 

15 some regards, is somewhat creative?

16 You know, you try to make as strict, 

17 very disciplined process, but we all know that 

18 individual dose reconstruction is really dealing 

19 with each person, interestingly enough, trying to 

20 be -- deal with them on a case by case basis but 

21 in a way that's very consistent.

22 And so, my first thought, just to lead 

23 you folks to this is perhaps while the dose 
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1 reconstructor is performing his dose 

2 reconstruction, he documents where he feels I 

3 have to -- I found myself in a place where I 

4 needed to make a judgment and how to interpret 

5 and apply a particular OTIB or in a place where 

6 he has to actually come up with something new 

7 like we recently had to do with Metals and 

8 Controls.

9 So, that actually makes it into the 

10 actual DR report. And that'll create a platform 

11 that will allow people to be introspective about 

12 consistency and almost force it. Granted, it 

13 requires additional work.

14 And I'm going to flip real quick now 

15 on SC&A's end when we do a review. We start off, 

16 and we still do, have findings.

17 And, in a way, maybe there's another 

18 way to think about this, go back to a process.

19 Maybe the reviews should be a 

20 discussion of the -- where we feel that maybe a 

21 judgment was made either in applying or 

22 interpreting the existing guidance where -- that 

23 needs to be discussed.
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1 Or, where something new is invented to 

2 solve a particular problem. And, we look at that.

3 So, it's no longer a matter of 

4 findings, it becomes a matter of the judgments 

5 that we made and the degree to which they are 

6 consistent and that we interpret and any -- and 

7 the perspective that we might have on those 

8 judgments that are being made.

9 This is sort of like an extemporaneous 

10 thoughts that came to mind as Mark was describing 

11 his report, his excellent report. And I hope 

12 that it just sort of helps to stir the pot a 

13 little bit.

14 CHAIR MELIUS: Thank you, John.

15 Actually, you made me think of one 

16 other area of where this process could look at 

17 is, I think one of the other things a dose 

18 reconstructor may run into, and I'm sure he does 

19 or he or she does quite often, is they really 

20 just don't have adequate information to base a 

21 judgment on or they're basing it on very little 

22 information.

23 Some of that's just, you know, the 
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1 nature of the DOE sites and record keeping and so 

2 forth.

3 But some of them may be programmatic 

4 that there isn't enough information and whatever 

5 documentation on a particular exposure or part of 

6 a facility or whatever just hasn't been retrieved 

7 yet or whatever.

8 And that will be another, I think, 

9 interesting thing to try to document. Is that -

10 - so one would think where you had less 

11 information, it's more wide open. You're going 

12 to have less consistent results because there's 

13 more judgment involved.

14 And I guess you can narrow the 

15 consistency by making a, you know, a guestimate 

16 in applying that for every person in that similar 

17 situation.

18 But, it would also be a way of sort 

19 of feedback in terms of what, you know, what 

20 further information needs to be looked for. 

21 Because it may very well be available and just 

22 hasn't been a priority or whatever.

23 Again, it may not be a very important 
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1 exposure, but where it is or where it could have 

2 a significant impact on people working in that 

3 area under dose reconstruction, it would be, I 

4 think, important to note that and so forth.

5 Much as the way, you know, SC&A, I 

6 think you just mentioned, John, would do it --

7 when you're doing your reviews, you note that as 

8 a problem.

9 But, it's also, I think, you know, 

10 some cases it may be more a solvable problem than 

11 we think because we just assume that the 

12 information is just missing and has already been 

13 looked for or whatever.

14 Just one more aspect to sort of think 

15 about in terms of this process.

16 MR. GRIFFON: I just have a comment, 

17 Jim, on John's comments.

18 Thank you, John, for your input.

19 I do -- I think what John was 

20 discussing in his first part is sort of captured 

21 in what I was saying as this time line. It goes 

22 a little further. There may be a better term for 

23 it, but it's sort of a roadmap to the case, you 
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1 know, that so that --

2 And, I mean, I really appreciated 

3 something in the Hanford document that was 

4 developed. That says that the supplied time 

5 line, a time line should be used for most -- all 

6 but the simplest of dose reconstructions since 

7 they help the DR ensure consistent and systematic 

8 dose reconstructions, assure all information is 

9 considered, provide a final check of completion.

10 They also help the PR, the peer 

11 review, understand the DR's approach. And I 

12 think that's a critical point in these judgment 

13 things. The better that it's outlined in the 

14 case file, it'll be a lot more efficient when a 

15 peer review is done.

16 I think in the past on the Dose 

17 Reconstruction Subcommittee, where we start 

18 looking at a case wondering exactly why neutrons 

19 weren't assigned in this time period. And, you 

20 know, it was sort of a best guess of what the 

21 dose reconstructor was doing with that, you know, 

22 for that particular situation.

23 Whereas, if the judgments had been 
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1 detailed like John said, it would allow for 

2 efficient external review. It would also help in 

3 the internal peer review and they could capture 

4 these things and perhaps, you know, tighten up 

5 consistency before it ever gets to a Board 

6 review.

7 So, anyway.

8 CHAIR MELIUS: Good. Thanks, Mark.

9 Any other comments from SC&A?

10 (NO RESPONSE)

11 CHAIR MELIUS: Comments or musings?

12 MR. STIVER: Nothing from me, I don't 

13 know if Kathy --

14 DR. MAURO: No, that's it. But --

15 this is John -- if you can circulate those 

16 thoughts that I had, that would be good, just it 

17 keeps everyone engaged.

18 MEMBER KOTELCHUCK: And I appreciate 

19 that.

20 DR. MAURO: Sure, thank you.

21 MR. KATZ: Jim, I'll send them around 

22 to the rest of the group.

23 CHAIR MELIUS: Okay, thanks, good, to 
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1 that.

2 Well, unless there are further 

3 questions for Mark at this point or other 

4 recommendations, what I think we'll plan is -- at 

5 least what I'm proposing we do is, I'll put 

6 together a short set of PowerPoint slides that 

7 can be presented, you know, sort of listing a 

8 number of these ideas we've talked about are 

9 included in the report.

10 But, that will -- I will present that 

11 following Mark's presentation. And then, we can 

12 -- use that as sort of as a basis for discussion 

13 during the meeting.

14 And then, and again, I think we'll 

15 come back to another Work Group meeting probably 

16 after the first of the year to discuss where we, 

17 you know, try to pin down a little bit more where 

18 we go and so forth.

19 Does that sound reasonable to 

20 everybody?

21 MEMBER KOTELCHUCK: Yes.

22 CHAIR MELIUS: And, so well good.

23 And, then, as I said, Dave will be 
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1 presenting, I guess, before Mark. So, on -- sort 

2 of an update on the dose reconstruction review 

3 and where that stands. So, I think that'll 

4 provide a good background for the discussion 

5 also.

6 MEMBER KOTELCHUCK: Yes.

7 CHAIR MELIUS: I think that's where we 

8 all are. Well, most of us have been sort of 

9 divorced from the dose reconstruction review 

10 process while you've been catching up on the 

11 backlog. So, it'll be good to remind us all of 

12 what's going on.

13 MEMBER KOTELCHUCK: Right. Well, we 

14 have our new categorization of the cases for 

15 review has been very helpful in speeding us up 

16 and doing a good job, I hope.

17 CHAIR MELIUS: That's what I've been 

18 hearing.

19 MEMBER KOTELCHUCK: Yes.

20 CHAIR MELIUS: Okay, no further 

21 discussion, I think we can close the meeting.

22 Ted, do you have any final words?

23 MR. KATZ: No, I don't, but thanks 
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1 everyone.

2 Adjourn 

3 CHAIR MELIUS: Yes, thank you. Thank 

4 you, Mark, for taking the time and everybody 

5 else.

6 Okay, see you in Albuquerque in a 

7 couple weeks.

8 (Whereupon, the above-entitled matter 

9 went off the record at 3:20 p.m.)

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