Summary Minutes May 02, 2007 
 

NIOSH/CDC Advisory Board on Radiation and Worker Health 


Subcommittee for Dose Reconstruction Review
 

THE SUBCOMMITTEE FOR DOSE RECONSTRUCTION REVIEW


 OF THE
 

ADVISORY BOARD ON RADIATION AND WORKER HEALTH 


NATIONAL INSTITUTE FOR OCCUPATIONAL SAFETY AND HEALTH 


CENTERS FOR DISEASE CONTROL AND PREVENTION


 _______________________________________________________ 


Summary Minutes of the Fourth Meeting 


May 02, 2007


 _______________________________________________________ 


The Fourth Meeting of the Subcommittee for Dose Reconstruction Review 


(the subcommittee) of the Advisory Board on Radiation and Worker Health 


(ABRWH or the Board) was held at The Westin Westminster in Westminster, 


Colorado, May 02, 2007. The meeting was called to order by Dr. Lewis 


Wade, the Designated Federal Official, Centers for Disease Control and 


Prevention's (CDC) National Institute for Occupational Safety and 


Health (NIOSH), the agency charted with administering the ABRWH. These 


summary minutes, as well as a verbatim transcript certified by a court 


reporter, are available on 

Compensation Analysis and 

www.cdc.gov/niosh/ocas. 

the internet 

Support (OCAS) 

on 

web 

the NIOSH/Office 

site located 

of 

at 

Those present included the following: 

Subcommittee Members: 

Mr. Mark Griffon, Chair; Mr. Michael Gibson; Mr. Brad Clawson (first 


alternate serving for Dr. John Poston;) Ms. Wanda Munn, and Robert 


Presley (alternate). 


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


Federal Agency Attendees: 


Department of Health and Human Services: 


Representing NIOSH, Mr. Stuart Hinnefeld; Representing the Office of 


General Counsel, Ms. Liz Homoki-Titus, Ms. Emily Howell. 


Contractors: 


Dr. Hans Behling and Ms. Kathy Behling (telephonically); Dr. John 


Mauro, Sanford Cohen & Associates (SC&A). 

Summary Minutes May 02, 2007 
 

NIOSH/CDC Advisory Board on Radiation and Worker Health 


Subcommittee for Dose Reconstruction Review


* * * * *


 Opening Remarks
 

Dr. Lewis Wade, 


NIOSH
 

Dr. Wade opened the meeting with an introduction of the subcommittee 


members and outlined the brief agenda, which would include: Discussion 


of reviewed cases, selection of cases to be reviewed, and discussion of 


overall review process. He then turned the meeting over to Mr. Mark 


Griffon, subcommittee Chair. 


* * * * *


 Agenda Outline
 

Mr. Mark Griffon, 


Subcommittee Chair
 

Mr. Griffon remarked he was reversing the order of the agenda to begin 


with a discussion of DR guidelines. He described the DR guidelines 


(known by several names), how they are used, and referred to the 


discussion of these same guidelines at the previous meeting. He 


explained how he felt they would be helpful to the audit process, 


adding he had drafted a motion regarding the DR guides to bring to the 


full Board. 


While copies were being circulated he continued to the second item, 


blind reviews, explaining he had also drafted a motion regarding the 


proposed conduct of those reviews. He outlined some issues previously 


discussed which were being addressed in the draft motion. 


Mr. Griffon announced item three would be a discussion and review of 


the original scope of work for the case reviews, including advanced 


reviews. He explained there was a need to re-examine the original 


scope, determine any subtasks which had been missed, and refocus the 


case reviews to capture those. 


Mr. Griffon continued that the fourth item would be an update on the 


previous sets of reviews followed by the final item, the preliminary 


identification of cases for the eighth set of cases. 


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Summary Minutes May 02, 2007 
 

NIOSH/CDC Advisory Board on Radiation and Worker Health 


Subcommittee for Dose Reconstruction Review


* * * * *
 

DR Guides (Guidelines, Instructions or similar documents) 


Mr. Griffon's motion regarding DR guides was duly made and seconded.
 

Dr. Wade read the motion into the record, and the motion was open for 


discussion. How the scope of the word "available" might be interpreted 


was questioned. Counsel also expressed concern for the use of 


"administrative record," indicating that term refers to a legal 


document. The term "analysis record" was suggested. Discussion led to 


agreement the terms "available to the Board" and "analysis record" 


should be used in the motion. 


Mr. Stu Hinnefeld from NIOSH suggested that "where possible" be added 


after "appropriate version." He indicated these were not controlled 


documents and it might not be possible to be certain which versions 


were used. It was agreed to add the language suggested so that, when 


edited, the motion would read as follows: 


NIOSH should make DR guides (guidelines, instructions or 


similar documents) available to the Board for all future 


cases (included as part of the analysis record). 


Additionally, NIOSH should make appropriate versions of DR 


guides (guidelines, instructions or similar documents), where 


possible, available to the Board for all cases currently 


under review by the Board. 


The motion carried by unanimous vote.
 

* * * * *
 

Blind Reviews: Motion
 

Dr. Wade announced the motion regarding blind reviews and called for a 


second. 


Having been duly made and seconded, Dr. Wade read the motion into the 


record, and it was open for discussion. 


Mr. Griffon acknowledged the second paragraph was a mechanical step and 


asked for input. After discussion of various methods which could be 


used to prevent SC&A from having the ability to identify the case 


selected for blind review, Ms. Wanda Munn questioned whether it was 


really possible to provide the case for review without giving 


information which could be traced back to the case. Mr. Hinnefeld
 

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Summary Minutes May 02, 2007 
 

NIOSH/CDC Advisory Board on Radiation and Worker Health 


Subcommittee for Dose Reconstruction Review


wondered whether it was critical that SC&A not know the case, or just 


that they not know the outcome. He further suggested that the case be 


put on a CD with all the information necessary for the review and 


restrict SC&A to the information on the CD during the blind review. 


There seeming to be a consensus on this approach, Ms. Munn suggested 


the second sentence of the second paragraph be reworked and the words 


"to the extent possible" added at the end of the motion. 


Dr. John Mauro from SC&A raised a question regarding the reference in 


the first paragraph to "tools" and whether that restricted the review. 


After discussion it was concluded that the wording was not intended to 


and did not serve to restrict the review to such use. It was, however, 


agreed to add "consistent and scientifically defensible results" to the 


first paragraph. 


Following discussion the motion was edited to read as follows: 


The purpose of the blind reviews is to determine if required 


assumptions, application of tools, interpretation of data and 


treatment of data yield consistent and scientifically 


defensible results for the dose to the organ of interest. 


The Board will select cases for blind review. NIOSH will 


provide the Board and SC&A case information on a CD for 


review. The Board and SC&A will not access the NOCTS 


database or any other claimant databases for such reviews. 


The blind reviews will be conducted using available tools 


developed by NIOSH/ORAU, but without any case-specific 


analytical files. These blind reviews will be focused on 


best estimate cases, to the extent possible.
 

The motion carried by unanimous vote.


 * * * * *
 

Original scope for case reviews
 

Mr. Griffon announced the next item was simply a preliminary discussion 


of the types of reviews being done, and offered the following as 


proposed discussion points: 


1. Basic and advanced reviews have not been defined. 


2. What should be considered an advanced review? 


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Summary Minutes May 02, 2007 
 

NIOSH/CDC Advisory Board on Radiation and Worker Health 


Subcommittee for Dose Reconstruction Review


3. Can the Board or SC&A re-interview the claimant? 


4. 	Would an advanced review involve looking at a coworker's radiation 


file? 


Dr. Mauro raised the question of SC&A contacting the dose 


reconstructor. 


Mr. Griffon pointed out that issue had been discussed previously and he 


was not in favor of that approach. Ms. Munn suggested there should be 


a way to have the dose reconstructor answer a question without a 


personal contact. Mr. Griffon observed this is being done where NIOSH 


has provided further written analysis, and indicated he preferred the 


separation between the auditor and the dose reconstructor. 


Dr. Mauro questioned the application of the site profile to an advanced 


review, and whether a site profile issue would be addressed in the 


advanced review or put off until the site profile review is done. 


Mr. Griffon's proposal to draft language to clarifying the scope for an 


advanced review prior to the next subcommittee meeting was accepted as 


the subcommittee's next action. 


There followed a discussion of statistical information provided by 


SC&A. It was concluded that SC&A would add a column to their table, 


"Comparison of Numbers of Cases by Site to the 2.5% Goal" which would 


show 2.5 percent of the referred cases. Mr. Griffon suggested they 


should reflect on the information provided by SC&A as selections for 


the eighth set are made. 


 * * * * *
 

Review of Fourth and Fifth Sets of Cases
 

Mr. Griffon reported that the fourth set was in the comment resolution 


phase, noting there are several best estimate cases where NIOSH is 


providing more in-depth written responses. These are cases where the 


findings could have a significant effect. After discussion, he 


continued that many of the findings had been closed, but those 


requiring the more in-depth response would be pulled up at the next 


subcommittee meeting. 


With regard to the fifth set, Mr. Griffon indicated they had been 


through the entire matrix and had begun the resolution process. He 


noted that, while he has edited the matrix to include both resolution 


and those cases where NIOSH will provide more information, it is at the 


stage where other subcommittee members, NIOSH, and SC&A should review 


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Summary Minutes May 02, 2007 
 

NIOSH/CDC Advisory Board on Radiation and Worker Health 


Subcommittee for Dose Reconstruction Review


it to be sure his reflection and understanding of everyone's respective 


position is accurate. 


Mr. Griffon added he presumed they would try to come to closure on both 


matrices at the next meeting. 


* * * * *
 

Preliminary Identification of the Eighth Set of Cases 


Mr. Griffon announced Mr. Hinnefeld had provided two spreadsheets 


containing cases for the eighth set selections. Mr. Hinnefeld
 

explained what was on the two lists and how they were compiled and 


sorted. In response to a query from Dr. Wade, Dr. Mauro indicated 32 


cases were needed to complete the quota of cases for fiscal year 2007. 


Following another discussion of blind review cases and how to select 


them, Dr. Mauro reminded the subcommittee that blind review cases would 


be in addition to the 32. It was decided the cases for blind review 


could be selected at the next subcommittee meeting. 


The cases for the eighth set were then selected from the lists Mr. 


Hinnefeld provided, with associated discussions of each of the cases 


and how they might relate to the earlier report from SC&A. In the 


course of the selection process a decision was made to select from 40 


to 45 cases rather than the 32 needed, agreeing the Board could then 


cull the list to 32 and vote during teleconference. Forty-three cases 


were selected. 


* * * * *
 

With no further business to come before the Subcommittee, the 


meeting was adjourned.
 

Ë Ë Ë Ë Ë 

I hereby confirm these Summary Minutes are 


accurate, to the best of my knowledge. 


Mr. Mark Griffon, Chair 


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