THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 

PUBLIC HEALTH SERVICE 

CENTERS FOR DISEASE CONTROL AND PREVENTION 

NATIONAL INSTITUTE FOR OCCUPATIONAL SAFETY AND HEALTH 

convenes 

WORKING GROUP 

ADVISORY BOARD ON 

RADIATION AND WORKER HEALTH 

PROCEDURES REVIEW

 

The verbatim transcript of the Working Group 

Meeting of the Advisory Board on Radiation and 

Worker Health held in Cincinnati, Ohio, on Dec. 11, 

2007. 

STEVEN RAY GREEN AND ASSOCIATES 

NATIONALLY CERTIFIED COURT REPORTERS 

404/733-6070 
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C O N T E N T S

Dec. 11, 2007 

OPENING REMARKS 6 

DR. CHRISTINE BRANCHE, DFO 

INTRODUCTION BY CHAIR 9 

MS. WANDA MUNN, WORK GROUP CHAIR 

DISCUSSION OF 4 “NEW MATRIX” DOCUMENTS 9 

NIOSH – GLOBAL ISSUES REPORT 73 

SC&A – COMMENTS ON NEW RESPONSE DATA 81 

SC&A AND NIOSH – OTIB-0012 WHITE PAPER 121 

NIOSH – RESPONSES TO PROC-0092 MATRIX ISSUES 126 

NIOSH – INCORPORATION OF PROC-0090 INTO MATRIX 224 

SC&A AND NIOSH – OTIB-0023 TRACKING IN MATRIX 237 

HOUSEKEEPING AND ACTION ITEMS 242 

COURT REPORTER’S CERTIFICATE 268 

 
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TRANSCRIPT LEGEND

The following transcript contains quoted material. Such 

material is reproduced as read or spoken. 

In the following transcript: a dash (--) indicates 

an unintentional or purposeful interruption of a 

sentence. An ellipsis (. . .) indicates halting speech 

or an unfinished sentence in dialogue or omission(s) of 

word(s) when reading written material. 

-- (sic) denotes an incorrect usage or pronunciation 

of a word which is transcribed in its original form as 

reported. 

-- (phonetically) indicates a phonetic spelling of 

the word if no confirmation of the correct spelling is 

available. 

-- "uh-huh" represents an affirmative response, and 

"uh-uh" represents a negative response. 

 -- "*" denotes a spelling based on phonetics, 

without reference available. 

-- (inaudible)/ (unintelligible) signifies speaker 

failure, usually failure to use a microphone. 
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 P A R T I C I P A N T S 

(By Group, in Alphabetical Order) 

DESIGNATED FEDERAL OFFICIAL

BRANCHE, Christine, Ph.D. 

Principal Associate Director 

National Institute for Occupational Safety and Health 

Centers for Disease Control and Prevention 

Washington, DC 

BOARD MEMBERS

GIBSON, Michael H. 

President 

Paper, Allied-Industrial, Chemical, and Energy Union 

Local 5-4200 

Miamisburg, Ohio 

MUNN, Wanda I. 

Senior Nuclear Engineer (Retired) 

Richland, Washington 

PRESLEY, Robert W. 

Special Projects Engineer 

BWXT Y12 National Security Complex 

Clinton, Tennessee 

ZIEMER, Paul L., Ph.D. 

Professor Emeritus 

School of Health Sciences 

Purdue University 

Lafayette, Indiana 
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IDENTIFIED PARTICIPANTS 

ANIGSTEIN, BOB, SC&A 

BEHLING, KATHY, SC&A 

BRACKETT, LIZ, ORAU 

BURGOS, ZAIDA, NIOSH 

CHANG, CHIA-CHIA, NIOSH 

ELLIOTT, LARRY, NIOSH 

FIX, JACK, ORAU 

GUIDO, JOE, ORAU 

HINNEFELD, STUART, NIOSH 

HOMOKI-TITUS, LIZ, HHS 

HOWELL, EMILY, HHS 

KIMPAN, KATE, ORAU 

KOTSCH, JEFF, DOL 

LABONE, TOM 

MAKHIJANI, ARJUN, SC&A 

MARSCHKE, STEVE, SC&A 

MAURO, JOHN, SC&A 

OSTROW, STEVE, SC&A 

SIEBERT, SCOTT, ORAU 

SMITH, MATTHEW 

THOMAS, ELYSE, ORAU 

WADE, LEWIS, NIOSH 

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

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DEC. 11, 2007 

 (9:30 a.m.) 

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DR. BRANCHE: Hi, this is Christine again; I just want 

to check to make certain who the board members are on 

the phone, please. 

Good morning, we’re ready to begin the working group 

on procedures that’s meeting today beginning at 9:30. 

I’m Dr. Christine Branche from NIOSH. We have Wanda 

Munn and Robert Presley here with us in Cincinnati and 

Michael Gibson participating by phone. Are there any 

other board members who are participating by phone? 

(no response) 

Okay. Can we please begin with an introduction of 

NIOSH staff beginning with people who are here in the 

room. 

MR. ELLIOT: Larry Elliott, NIOSH. 

MR. HINNEFELD: Stu Hinnefeld from NIOSH. 

DR. WADE: Lou Wade with NISOH. 

MR. PRESLEY: Robert Presley with the Board. 

MS. THOMAS: Elyse Thomas with the ORAU team. 

MS. HOWELL: Emily Howell, HHS. 

DR. MAURO: SC&A, John Mauro. 

MR. MARSCHKE: Steve Marschke with SC&A. 
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1 DR. MAKHIJANI: Arjun Makhijani with SC&A. 

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DR. BRANCHE: Are there any other NIOSH staff 

participating by phone? 

MS. BURGOS: Zaida Burgos, NIOSH. 

DR. BRANCHE: Thank you. 

MS. CHANG: Chia-Chia Chang. 

DR. BRANCHE: What was that last name please? 

DR. WADE: Chia-Chia Chang. 

DR. BRANCHE: Chia-Chia, okay thank you. Are there 

any other ORAU staff participating by phone? 

MR. ELLIOTT: Dr. Ziemer’s on his way. 

MR. SIEBERT: Scott Siebert from the ORAU team.

MS. BRACKETT: Liz Brackett with the ORAU team. 

MR. SMITH: Matthew Smith -- 

MR. FIX: Jack Fix, ORAU team. 

DR. BRANCHE: Thank you. Are there -- 

MR. LABONE: Tom LaBone. 

DR. BRANCHE: Okay. 

MR. GUIDO: Joe Guido, ORAU team. 

DR. BRANCHE: Are there any other SC&A staff 

participating by phone? 

DR. OSTROW: Steve Ostrow. 

DR. ANIGSTEIN: Bob Anigstein. 

DR. BRANCHE: Who is -- Okay I got Bob, who was the 

other person? 
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DR. BRANCHE: Thank you. 

DR. WADE: And one other. 

MS. BEHLING: Kathy Behling. 

DR. BRANCHE: Thank you. Are there other federal 

agency staff participating by -- are there -- 

participating by phone? 

MR. KOTSCH: Jeff Kotsch, Department of Labor. 

DR. BRANCHE: Are there petitioners or their 

representatives participating by phone? 

(no response) 

DR. BRANCHE: Petitioners or their representatives? 

(no response) 

DR. BRANCHE: Are there workers or their 

representatives on the line? 

(no response) 

DR. BRANCHE: Are there any members of Congress or 

their representatives on the phone? 

(no response) 

DR. BRANCHE: Are there any others who’d like to 

mention their names for the record? 

(no response) 

DR. BRANCHE: Okay. Thank you very much for coming to 

participate in this meeting today. And for those of 

you who are participating by phone we do ask that you 
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mute your line until you’re ready to speak. By muting 

your line you’ll allow us to not know how you’re using 

your time at your keyboard or other ways and also it 

would allow all the participants on the line to hear 

every word of the discussion. If you are ready to 

speak by phone please let us know. And thank you so 

much. Ms. Munn. 

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MS. MUNN: Thank you, Doctor. We have received 

information that Dr. Paul Ziemer is on his way in to 

our meeting and will be here in another five minutes 

or so. I don’t think we need to wait for Paul because 

he’s well briefed on what we expect to do. Are all of 

the members of the workgroup and support staff aware 

of our proposed agenda for today? You should have it 

in hand. If not let me know and I’ll try to give you 

my copy to work with for a moment. At this moment I’d 

like to ask for any additions or revisions to that 

agenda. Does anyone have any material other than what 

we have currently proposed for today? 

(no response) 

22 DISCUSSION OF 4 “NEW MATRIX” DOCUMENTS

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MS. MUNN: If not then we’ll continue with the first 

item. We have Kathy Behling on the telephone. Kathy 

and her team have been working very hard at SC&A to 
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put together the new format that has given us so much 

grief over the past few months and have made excellent 

progress on it. I think most of the folks here have 

either hard copies or have electronic copies of 

material that Kathy has sent out in the last two or 

three days. John? 

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DR. MAURO: Yes Wanda, in addition to the electronic 

copies, the four files that Kathy sent out 

electronically earlier, she asked me to distribute 

this package to everyone here. And it would really be 

fundamental database, the Access database upon which 

we -- that we use to build the four files that 

everyone has and she wanted to say some words about 

this tool because it’s a new strategy, we’ve been 

working with Word or Excel, this is the first time we 

are using Access which is a bit more powerful tool and 

she thought it’d be worthwhile spending a few minutes 

describing the fundaments of this thing so that it get 

a better appreciation of this new Matrix approach. 

MS. MUNN: For those of us who are not regular Access 

users which includes me, this will I expect be very 

helpful and my special thanks to Kathy for having 

gotten this into our hands over the weekend so that we 

could at least have some concept of how it’s going to 

go. Kathy, are you ready to address this? 
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MS. MUNN: Please do. Go right ahead. We now have 

the hard copies of what’s been provided in hand as 

well as an electronic copy. 

MS. BEHLING: Okay, very good. Can you hear me all 

right? 

MS. MUNN: You’re fine. 

MS. BEHLING: Okay, very good. Yeah, we will start 

with the information that John just passed around. 

This is actually screen views of the Access database 

and I felt that this would give everyone a better 

understanding of how we’re entering this data, what we 

can do with the data, how we can sort things and also 

for NIOSH’s purposes although they may be more 

familiar with this than some of the rest of us, this 

is how we’re going -- this is the format and the 

information the screens that we’re going to be using 

to actually enter the data. And page one of the 

information that John just sent to you and that I also 

electronically format -- forwarded to you is the main 

form summary screen that comes up. And I’ll just 

briefly walk you through and bear with me for those of 

-- those of you who have a better understanding of 

Access, but this first screen is the main form that 

opens when you open up the Access database that we 
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have created. And if you look to the left, upper left 

side, underneath the exit button there are three tabs. 

And the first tab is the summary tab and that’s what’s 

open on your main screen. And this is actually our 

rollup table and you’ll see obviously the first column 

is our finding date and procedure number, finding 

number and page number in the third column. Then we 

have our rating in the fourth column and our procedure 

title and then the status. And you can go into any 

one of these columns, highlight that column, do a 

right click and you can sort that column ascending, 

descending, you can do filtering on these columns. So 

I -- for the purposes of this demonstration I sorted 

everything by procedure number. So you see the first 

page of the summary sheet. Now, in this particular 

instance when you first open it up we’re only looking 

at anything that is not closed; opened items, 

transferred items, items in abeyance. If we wanted to 

also include on this summary sheet closed items; if 

you go more to the upper middle portion of this screen 

you see a print summary, a detailed -- a print detail 

and underneath there, there is a box called include 

closed issues. And if you check mark that box this 

screen will change and include all of your closed 

items also. So we have the option of including them 

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1 or not including them. 

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DR. WADE: Kathy, this is Lew Wade. Just a trivial 

point but in my first sheet I see closed items appear. 

So maybe this is the full -- the full? Correct? 

MS. BEHLING: Um, yeah, I see closed items on there 

too and -- 

DR. MAURO: Kathy I -- 

MS. BEHLING: Actually I have my Access database open 

and I’m looking from on my screen and I do not have 

that check marked and the closed items are not on 

there. Perhaps when I made a copy of this screen I 

had opened up the closed -- I will -- I will check on 

that but I’m -- I’m sure because I’m actually looking 

at my database on my screen as opposed to the 

documents that you’re looking at. But you’re correct; 

there are closed items on there. They should not be 

on there because that check mark is not in that closed 

issues box so I apologize for that. 

DR. WADE: Computers, you can’t live with them; you 

can’t live without them. 

MS. MUNN: This is true. Kathy, this is Wanda. There 

are checks next to each one of the listed procedure 

numbers. 

MS. BEHLING: Okay those are actually -- those are 

little arrows, they are -- and if you click on that 
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MS. MUNN: Oh, all right. 

MS. BEHLING: Okay, so it’s not actually a checkmark. 

That’s a dropdown box and in fact I was going to get 

to that a little bit later as you see on the three 

tabs at the top we have summary, details and then 

procedures. And when we enter a new procedure and 

we’re going to be adding findings for new procedures, 

you first of all enter it into that tab and we’ll get 

to that a little bit later and then that procedure 

becomes part of that dropdown box. So it makes it a 

little bit easier. In fact as you’re typing the 

procedure number in there it tries to anticipate what 

procedure you’re going to be -- and it sort of fills 

out that line for you in advance. But yeah I see on 

your hard copy here there are some closed items here 

and I didn’t mean to add confusion to this but there 

should not be any closed items on this first -- this 

first screen because that include closed issues is not 

check marked and I do apologize for that confusion. I 

guess, okay we can move on, and obviously all the way 

to the right you have your scroll bar and you would 

just scroll down through there and as you see at the 

bottom this is -- we’re looking at the very first item 

there is one of two hundred and fourteen -- no, no, no 
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that’s my screen -- is three hundred and seventy-six 

findings and procedures and procedure type findings 

that are identified at the bottom of your -- of that 

first screen. And so if you scroll down you could see 

each one of those three hundred and seventy-six line 

items. And if we go on to page two -- 

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MS. MUNN: Before we leave Kathy -- 

MS. BEHLING: Okay, I’m sorry, go ahead. 

MS. MUNN: There under finding number and page number, 

I’m assuming the page number is the page of what is 

going to be the new current document, or is it a 

reference back to the older -- 

MS. BEHLING: No, this is actually the page number 

from the hard copy report that we submitted to you. 

MS. MUNN: Okay. 

MS. BEHLING: Okay. And I should also explain that 

the finding date here is actually the date of the 

report that we submitted to you. So in other words 

our first set report was sent to the Board on January 

17, 2005. 

MS. MUNN: Right. 

MS. BEHLING: So all procedures and findings that were 

associated -- associated with the first set will have 

that date in the first column. The second set was 

June 8, 2006, and the third set was October 29th, 
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MS. MUNN: Right, yeah we agreed that that would be 

the better way to do it so we could keep track of 

which set we were -– 

MS. BEHLING: That’s right. That’s right. And in 

fact and I’ll get to this also later, we can sort and 

print by just a date range which is the screen -- 

which is the selection at the top which will allow us 

to separate out all of these different sets. And with 

things such as addendums that we have included such as 

our PROC-0092 addendum that came in on -- or that we 

submitted to you I believe on September 20th, 2007. So 

all of the findings associated with like a PROC-0092 

will have that 9-20-2007 date associated with them. 

MS. MUNN: Which brings me back to the page number 

issue. 

MS. BEHLING: That page number is the page number in 

that hard copy document. 

MS. MUNN: And are those page numbers not likely to 

change from time to time as we add new information? 

No? 

MR. HINNEFELD: No -- 

MS. BEHLING: No -- 

MS. MUNN: Stu’s shaking his head no. 

MR. HINNEFELD: It’s their published report that they 
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submitted that’s the PDF or hard copy review of the 

procedures, you know, very first set, the next one was 

called the second set was called supplemental; it’s 

that hard copy report that they submitted. It’s 

really nothing that we’ve generated in this workgroup. 

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MS. MUNN: And we are not likely to be seeing addenda 

to those reports -- that’s my -- 

MR. HINNEFELD: Addenda would be a new date -- a new 

dated report and any findings in the addenda then 

would carry that finding date and so that would 

essentially be a new product; is that right? 

MS. BEHLING: Yes. That’s right. Thank you. 

MR. HINNEFELD: Sorry, they should do this talking. 

MS. BEHLING: No, no, I appreciate it. And -- 

MR. HINNEFELD: Later on I’m supposed to talk. 

DR. MAURO: We weren’t sure. 

MS. MUNN: We all have to understand this. And so if 

we had an addenda to say well since we’re looking at 

IG001, if we had an addendum to that then it would 

appear -- 

MS. BEHLING: In fact that’s a good -- that’s a good 

example. Let’s look at IG001, Rev. 1, the very first 

line. That finding date which is as I said January 

17th, 2005, was our first set and we had on page 

twenty-four of that report it describes our finding 
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IG00101. Now it just so happens that, that particular 

finding, the resolution for that finding was that 

NIOSH was going to revise that -- their implementation 

guide and when they revised that implementation guide 

we were going to review that and to ensure that, that 

finding was resolved in the revision. Now if you go 

down to the date of 10-29-2007, you scroll down a 

little bit further, it’s actually the last OCAS-IG001 

Rev. 2 under the finding number there again we have 

IG00101 and then that’s on page thirty-one of our 

report submitted on the October 29th and that is a 

review of that first finding. We reevaluated that 

finding under our second set -- our third set of 

procedures. Now I don’t anticipate us putting any 

additional information into our submitted reports like 

our January 17th report; if anything needs to be 

carried over it will be picked up in another report 

most likely. That’s at least how I -- I don’t see us 

adding a lot of new information to existing reports 

that have been published. 

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MS. MUNN: My concern was being able to easily follow 

this through as we build a larger and larger library 

of closed items. And to, one of the advantages I had 

perceived originally in having this listed as alpha 

numeric order that would make it easier to pick up 
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MS. BEHLING: Were you anticipating that our third 

column, the finding number and the page number would 

actually be a page number associated with the detailed 

list? Is that what I’m understanding? In other words 

are you expecting that the page number would be a page 

number that we would go to directly in the more 

detailed individual -- where there’s a finding on each 

individual sheet which is the next sheet I’m going to 

talk about. 

MS. MUNN: John? 

DR. MAURO: Yeah, I’d like to help out a little bit. 

I think what’s happening here is we’re looking at the 

colored six page overview of the Access program. And 

this is really like the table of contents or the 

scroll up type of form. Now you’re posing questions 

that go into the bowels of the big thick package. So 

eventually when we get each one of the findings, every 

single finding associated with every single procedure 

review has its own page. And in that page is all of 

the information in a historical sense that has 

unfolded at each and every workgroup meeting. So the 

really the depth -- the in-depth details of everything 

that has transpired is not contained -- you know it’s 

contained deeper into the program one of the -- in 
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fact if you folks got the four files, the second file 

that was up there, I think the second or third file 

was a very large file. That there was one page for 

every one of the findings and I think the kinds of 

questions we’re talking about now regarding the fine 

structure of the resolution of the issue that’s where 

it would be contained. Now whether or not you could 

go -– Kathy, the only question I have is if you wanted 

to go into that starting with the cover pages are 

there -- in other words, is this nested where you 

start with these cover pages, these one through six or 

one and if you wanted to track into and let’s say into 

some particular issue that -- or finding under a 

particular procedure is that something that you would 

-- you could actually go to from this first page, page 

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MS. BEHLING: Yes. 

DR. MAURO: Yes you can? 

MS. BEHLING: Yes -- 

DR. MAURO: Okay. 

MS. BEHLING: In other words if we scrolled down to 

any of these items if we went to the last item that 

you can view here on your screen and you would 

highlight that item and then we would -- or just put 

your cursor let’s assume we put our cursor in the last 
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item on your sheet here which is IG00105, I guess it’s 

on page thirty-two and again this is page thirty-two 

of our hard copy report when if you put your cursor 

anywhere in that row and you hit the details form -- 

okay, yeah, I’m on my -- I’m on my screen here again, 

okay. 

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DR. MAURO: So where -- I think some of us are on the 

screen and some of us are on hard copies. 

MS. BEHLING: Yeah, I will pull that screen right up 

but obviously you’re not -- yeah, you’re not -- you’re 

not working from that. But when you’re on -- in the 

Access database yeah, you can go -- you can go 

directly to that detailed stamp and fill in that 

information. Now with what you’re going to be looking 

at is a PDF file. And I think what Wanda -- okay I’m 

-- now I’m starting to understand what’s going on 

here. I think what Wanda would prefer and correct me 

if I’m wrong Wanda, you want that page number in that 

third column to actually represent the page in the 

detailed section, that thick section that -- and as 

you said as things close that may change. So you 

don’t want this page number necessarily to represent 

the hard copy report that we send to you? Is that 

correct? 

MS. MUNN: I’m just trying to think ahead and I don’t 
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want to complicate things. I may be asking too many 

details for where we are right now. 

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DR. MAURO: I -- 

MR. HINNEFELD: What do you want to accomplish, Wanda, 

when you’re talking about page number or tracking 

something all the way through and the addendum? 

MS. MUNN: I want to be very sure that after -- that 

because we do so much work after the original report 

occurs, I want to be sure that I can tell in our roll 

up where I need to go in the archives to find the 

current status of that specific item. And, Paul? 

DR. ZIEMER: This is Ziemer. I think probably it 

would help if you identified in this column that it’s 

the page number from the original SEC report -- or 

SC&A report as opposed to a page number in the roll up 

documents. Is -- 

MS. MUNN: Yeah, that really -- I guess you’re getting 

-- 

DR. ZIEMER: So, the page number here, that’s the page 

number in your report on that review. So if -- it’s a 

page number from SC&A review reporter something to 

clarify, and then later on I guess you could have a 

page number in the matrix or however Kathy thought it 

should be identified. 

MS. MUNN: Or addendum -- 
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DR. ZIEMER: But could I ask one other question and 

sorry I came in late but do we have the interactive 

Access database available? Is it on the website or is 

it on the O-Drive? 

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DR. MAURO: Must be on the O Drive. 

MR. HINNEFELD: We got actually PDF first. 

DR. ZIEMER: Well the PDF, you can’t do anything. 

MR. HINNEFELD: Right. That’s what I’m saying is I’ve 

not seen the actual database. 

DR. ZIEMER: I got from Kathy just a Word copy which 

is not interactive. 

MR. HINNEFELD: Right. 

MS. MUNN: Yeah, Kathy at this point I think is just 

trying to explain to the -- how it’s going to work. 

We don’t have access to it yet. 

MS. BEHLING: Yeah, in fact that was going to be my 

-- I was going to ask that question as a concluding 

question. How we’re going to -- where we’re going 

to put this information, and give you some of my 

thoughts. I guess the other thing that I’m 

thinking here is because I’ve sorted this summary 

page by procedure number, when you go to the detail 

-- when we go to the details list I’ve also sorted 

that by procedure number. So if we’re on line five 

-- let’s say if we drop down five lines here on our 
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what I sent to -- or yeah, what I gave you on this 

summary, we would be at IG001-16 page forty-eight 

of our SC&A report and page five of our -- of the 

detailed PDF file that I sent you would represent 

that particular finding. 

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DR. MAURO: Could I step back just a bit? When we 

first initiated this process where we were trying 

to come up with a table; if you remember one of our 

workgroup meetings we got up there, we put up a 

sheet of paper, we started drawing saying is this 

what you’d like? And we started to zero in on a 

particular form -- format. But we also realized 

there’s a lot of different ways you might want to 

cut it because there’s lots of information and 

you’d like to be able to package it many different 

ways and we realize that right now we might pick 

this format, might be useful to us but at some time 

in the future we may want to cut it another way, 

you know, and look at the data. So what happened 

was in order to be as flexible as possible given 

that we’re in a situation on how we’d like to 

package our reports, package our material, we 

elected to go with the Access database because that 

allows you to do just about anything you want. Now 

the question I guess I have now is now that we’ve 
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built the Access database, it’s off, it’s running, 

we’ve got it, we’ve loaded it. It was never my 

impression that the Board would want to unless they 

chose to use the Access database. It was really my 

understanding that all of the data would be 

accessible by SC&A, would be accessible by NIOSH to 

load it, to update it because it’s a living process 

every -- just before we come to such meetings. 

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MS. MUNN: All right. 

DR. MAURO: Stu and his folks are going to be 

loading up data, we’re loading up data but in the 

end we’re going to come to the room with a stack of 

paper, okay? Or on an electronic version to avoid 

the stack. But it was not I guess my original 

vision that everyone on the Board would be sitting 

at the Access machine and doing all the magic that 

you can do with Access. But if that’s what you 

want we could -- well it’s going to be a learning 

process as you can tell. 

MS. MUNN: I don’t believe it is the expectation of 

anyone on this workgroup to be actually 

manipulating the database themselves. 

DR. ZIEMER: I don’t think we should have the 

ability to change anything in the database. That 

should be reserved for either NIOSH or SC&A but 
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certainly if you want to click on an item and look 

at either the history of it or whatever it seems to 

me you’ve got to have access otherwise -- Otherwise 

you don’t want to print out every page. 

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MS. MUNN: No. 

MR. ELLIOTT: I think in Access you can affect a 

read only authorization -- 

DR. ZIEMER: Yeah. 

MR. ELLIOTT:-- versus a read and edit. So maybe 

you want to -- we could have I don’t know maybe 

Kathy knows how to do this but if not we could 

have one of our -- we have an Access person too, 

might help. 

DR. ZIEMER: Or at least make it available on the 

O-Drive or somewhere where we could look at it if 

we wanted to look at particular -- otherwise 

there’s a lot of sub information that doesn’t 

show up unless you’re going to print out all of 

that which seems to me to me to be -- 

MR. HINNEFELD: I would think the Board would 

want to be able to -- 

DR. MAURO: It’s going to take some time; in 

other words you can tell by the conversation that 

you know yeah it’s like learning some new 

software. You’re going to learn how to navigate 
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DR. ZIEMER: Now you may want to have just a hard 

copy summary for a public meeting. 

MR. HINNEFELD: Right, yeah. 

MS. MUNN: My sense is we’re getting way ahead of 

Kathy and that she probably has thought of most 

of these -- 

MR. HINNEFELD: Kathy, this is Stu, I have one 

quick question. When you were talking about 

finding the detail for a particular finding you 

said you put the cursor on that row and hit the 

details button; is that a details button that 

shows which -- is that a button that I can see on 

this hard copy? 

MS. BEHLING: That’s where I’m going next. 

MR. HINNEFELD: Okay. 

MS. BEHLING: If I can move on then maybe we can 

address all of these issues at once, but yes in 

fact page two of what John handed out is the 

details button. 

MR. HINNEFELD: Oh okay, it’s a tab. All right. 

MS. BEHLING: It’s a tab. 

MR. HINNEFELD: Perfect. 

MS. BEHLING: And so I agree with everything 

that’s been said so far. It was my intention, I 
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was going to suggest that we would put this 

database out on something like the O-Drive in the 

advisory board folder and it’s my understanding 

from the person that developed this database for 

us he can put out a read only file and he can 

also put a file out for both SC&A and NIOSH to 

use and what -- it’s my understanding that if we 

were both be using it at the same time, provided 

we’re not on the same record when we both save 

that information everything will be captured. 

However if let’s say Stu and I were both in the 

same record if Stu got into that record first and 

I went to get into that same record it would tell 

me there’s another user that is making changes to 

this record and I couldn’t make any changes until 

that was completed. So that’s one of the nice 

aspects I believe with this Access database. And 

so I definitely think that it would benefit the 

Board members to be able to look at the Access 

and that’s what I was trying to show you on each 

of these screens. The summary, you can scroll 

down that summary, put your cursor on any one of 

these rows and then when you hit that details 

screen as you see on page two of what I’ve sent 

to you, the details screen is now highlighted and 

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the screen that we’re looking at is all of the 

information that we wanted to capture here I 

hope. If there’s something we’ve missed, please 

let us know. And what is -- what was included in 

here is again their procedure number and the Rev. 

numbers, finding and a page number, page number 

again associated with the hard copy, a rating and 

then we have, you know SC&A has the checklist and 

we have the review objectives that means 

something to us. So they’ve included for 

internal use when we initially load this 

information that we do have the option of putting 

that review objective in there. However, it does 

not as you saw come up on your -- on the summary 

screen, it’s not necessarily something that the 

workgroup felt that they needed to have to sort 

on. But we did include it just for SC&A’s 

purposes. And then alongside of there you have 

your procedure number and again your status in 

this -- in -- at least the one I pulled up it’s -

- or the one I sent to you is -- is transferred 

and it’s transferred to the global issues portion 

of our review. Here again we have now our 

initial finding date, SC&A’s finding date and a 

description of the finding and then NIOSH’s 

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initial response and we have a -- a slot for in -

- you know putting in their input. Now at the 

bottom portion of the screen that you see in blue 

this shows what transpired at the workgroup 

meeting and the example I gave you is from our 

October 2nd workgroup meeting. We have our 

discussion area and then any directives that were 

given by the workgroup. Now if there were 

follow-up’s we would -- we could put those in -- 

an SC&A follow-up or a NIOSH follow-up we have a 

date and we would write in there what happened as 

a res -- after that meeting. And if you go down 

to the bottom right now you’ll see one of one. 

For the next workgroup meeting what -- for the 

information that we’re going to put in for the 

next workgroup meeting we just either hit that 

button or type a two in there and then just that 

blue portion of the screen changes and now we’ll 

enter whatever we talked about in today’s meeting 

and we’ll have our workgroup information from 

today’s meeting and so when this actually -- when 

this particular -- if we were to add a second 

record to the bottom of this when this gets 

printed in PDF it would all be on one page but 

you would just have your first workgroup then 

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your meeting information, your second workgroup 

meeting information but on this screen you’re 

only going to see the most current -- you can go 

back and forth but -- but to get to the -- your -

- your next record for the next workgroup meeting 

you would just select two of two and it could be 

three of three but when it’s printed it should be 

all printed on one page. 

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DR. MAURO: Kathy, if I can jump in by way of 

looking at this for the first time since it’s 

been evolved from the hand drawing on the screen 

here, I think it -- 

MS. MUNN: It looks nicer now. 

DR. MAURO: It looks nice here doesn’t it? But 

the fundamental theme here is -- and -- and 

correct me if I’m wrong Kathy is ultimately what 

we have is for -- for every finding, you know we 

may have thirty procedures we reviewed in one of 

these big three ring binders and every procedure 

has maybe six, seven, eight findings. Well we 

have built something here that says there’s going 

to be one page dedicated to each finding. So 

what we’re looking at on -- if I’m correct on 

page two is an example of one procedure, one 

finding and the fundamental format is in the 
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upper gray part, that’s sort of the stuff that 

happens before the first workgroup meeting. In 

other words, you wrote a report -- SC&A wrote a 

report, in that report it says SC&A finding and 

there’s a date under there, 6-8-2006, that’s in 

the gray area on the left and we write down what 

our finding is and that just comes right out of 

the big thick three ring binder report. Then 

right beneath that, you know after we deliver the 

hard copy report and we make -- we make the 

matrix like the old matrix we used to have, we’d 

have a little column, it’s an SC&A finding. But 

then what happens is we send it off to Stu. Then 

Stu says yeah, we’re going to -- we’re going to 

respond to that and then the next thing, right 

underneath it you see it says on the left-hand 

side in the gray region, NIOSH and there’s a 

response and there’s a date, well that’s when Stu 

filled in his information. And originally in the 

old one remember that was in there. But then -- 

and then we really have sort of set the base, all 

right, now we’re off and running. We’ve got 

ourselves our finding, we’ve got SC&A’s finding, 

we’ve got NIOSH’s response. Then we have our 

first meeting, okay. And the whole purpose for 

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doing it this way is that one of the things that 

we were concerned about at the last meeting when 

we talked about this is we were not able to track 

things by workgroup meetings. Now what we have 

is the blue section and that really is the new 

change when you say what are we doing differently 

now by way of packaging information, and that 

blue section is just going to keep stacking up. 

If we have five meetings there’s going to be a 

workgroup meeting date. There’s going to be one 

for this meeting, you know, and there will be one 

for the next meeting. So for every single issue 

now that’s why things are so bulky, every single 

issue is going to have this historical stack of 

workgroup meetings that just keep extending until 

we reach the point where in the upper right-hand 

corner it says closed and that’s it. And then -- 

but that -- that becomes a record, a historical 

record of everything that ever happened to get to 

the point where we closed that issue. 

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DR. WADE: Towards -- towards the issue of 

everything John, let’s say that on an issue NIOSH 

writes a white paper and then SC&A critiques that 

white paper. Now we have intellectual 

information. How is that captured? Where is 
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DR. MAURO: I have to say -- I don’t know. 

Kathy, did you give any thought to that or how 

that would be done if we have like a ten page 

white paper that’s either issued by NIOSH or by 

us dealing with one particular issue, where is 

that captured? 

MS. BEHLING: Well the actual document itself I 

don’t know where we would capture that. That’s -

- we can discuss that. Where I would enter it 

into this database is in that blue section let’s 

say SC&A was asked -- was tasked with writing a 

white paper, I would put the date of our white 

paper and I would write in the portion alongside 

of it, SC&A submitted a white paper and give the 

file name, something like that. Now for actually 

attaching the file to this record I hadn’t given 

that a lot of thought. 

DR. WADE: One of the powers of a database like 

this is that you can have those active links. 

MS. BEHLING: Yes. 

DR. WADE: I think we -- 

DR. ZIEMER: You can do exactly that. 

DR. MAURO: We could -- click on it and then 

bring you to it. 
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DR. WADE: So I mean that’s some -- to complete 

this I think that’s something that you need to 

give some thought to. 

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MS. BEHLING: Okay, that’s a very good idea. 

DR. WADE: One of the trivial questions from an 

old life of my -- from a license point of view, 

who will have the license that will cover the 

people that use this? Do we do that? Does SC&A 

do that? Have we thought through that? 

MR. ELLIOTT: We have an Access license. 

MR. HINNEFELD: Most users of Office have Access. 

DR. ZIEMER: You -- you have to have the Access 

program on your computer to use it I believe. 

And that’s -- 

DR. WADE: So the individual user would -- 

DR. ZIEMER: That’s like Microsoft Word, you 

either buy it or you get it under some license. 

DR. WADE: So the individual user would come with 

a licensed version of the program? 

MR. ELLIOTT: Yeah. 

MR. HINNEFELD: Yeah. 

DR. ZIEMER: We may have to provide the license 

version for the Board members. 

DR. WADE: Right, we might have to do that but we 

can do that offline. I just wanted to make sure 
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MR. ELLIOTT: This is a very powerful software, 

it’s actually -- 

MR. PRESLEY: How big is this? Do I really want 

this on my computer? 

MR. ELLIOTT: Well it -- you know, it’s as big as 

it’ll get. It’s as big as you’ll build it. But 

it’s a very powerful software program and it was 

the same software program we used to start our 

NOCTS tracking system which we -- you’re able to 

then convert into SQL if you want. 

DR. MAURO: No worries. 

DR. ZIEMER: It’s not big compared to pictures. 

MR. ELLIOTT: No. 

MS. MUNN: But the -- the -- I -- I in the past I 

personally have avoided Access because for a 

couple of reasons. A few years ago it had a 

large number of bugs and I just stayed away from 

it. But it’s a -- obviously going to be a 

powerful tool. Frankly when we first looked at 

the pretty pictures that John and Arjun had drawn 

for us there was some concern with respect to how 

this material was going to stack up on the page. 

I certainly was concerned about how many pages we 

were going to have regarding each individual 
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item. But now that I see it, this second page 

here I can see that having each date’s 

description of what transpired will be -- it’s 

very easy to get to exactly where you want it to 

be. 

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DR. MAURO: The reason we came to this -- to this 

approach was we were doing things in landscape. 

And the columns were getting lots and lots of 

columns. 

MS. MUNN: Out of -- 

DR. MAURO: And one column would end up having 

four pages going like this, you know, so this is 

the way to avoid that, you know. 

MS. MUNN: Right. 

DR. MAURO: So now we’re in portrait when we get 

to the workgroup meetings. 

MS. MUNN: Let’s -- unless someone else has 

something really cogent let’s let Kathy go on 

with where we are here. 

MS. BEHLING: Okay. We covered the two main 

screens now and if you go to page three this is 

the third tab that I mentioned earlier, the 

procedures tab. And this is simply -- it’s -- 

it’s a means of entering a new procedure number. 

This just identifies -- it doesn’t identify the 
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finding, it is just identifies the procedure 

number in order to make it available to the drop 

down box, and as you can see here I think there’s 

about ninety-five procedures that have been added 

and before it becomes available on that dropdown 

box either in the summary screen or the details 

screen it has to be added here. So this is 

something that’s more of an internal -- it just -

- it would be most likely SC&A that would be 

using this screen but I just wanted to make you 

aware of what that tab represented. 

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And if we go on then to page four, this is 

actually how I generated the other documents that 

I sent to you, the PDF files. As you see in the 

top -- at the top in the center there’s a print -

- a gray print summary button and that obviously 

if I select that button without a checkmark in 

the include closed items -- include closed items 

I will get everything in that roll up table or 

that summary table and it -- when I -- it will 

open up that file for me and then I print that to 

a PDF file. Same with the gray button alongside 

of it, print details. Now that’s a print details 

all button meaning I’ll either print all of the 

details that are out there that are still open, 
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transferred or in abeyance or if I check mark 

that include closed items I can print all details 

including the closed items. 

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MR. MARSCHKE: Kathy going back -- Kathy this is 

Steve Marschke. Going back to the first sheet 

where we had that question about the closed 

items. 

MS. BEHLING: Yes. 

MR. MARSCHKE: This include closed items check 

mark that doesn’t -- I believe that, that only -- 

it has functions on the print and not on what is 

displayed on the screen. Is that correct? 

MS. BEHLING: No. 

MR. MARSCHKE: No? 

MS. BEHLING: It is supposed to do both. 

MR. MARSCHKE: Oh, okay. 

MS. BEHLING: It is supposed to do both. Include 

closed -- closed issues is supposed to both -- 

because in fact as I said I’m looking at it on 

the screen and it -- in my summary sheet I’m not 

seeing any closed items but when I check mark 

that box the closed items open up. But they’re 

not there when I uncheck that box. I don’t know 

how that first screen -- so no, it functions both 

on -- on the screen and what is being printed. 
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MS. BEHLING: Okay. If we go -- and if we move 

on then to page five -- 

DR. ZIEMER: Question. 

MS. BEHLING: -- to the last page here -- oh no -

- 

MS. MUNN: Kathy, wait a minute, there’s a 

question. 

MS. BEHLING: Oh I’m sorry, go ahead. 

DR. ZIEMER: Just a question. If you do a 

printout does it automatically assign a current 

date to the printout so that you know how current 

it is? 

MS. BEHLING: That’s -- yes, in fact I’m glad you 

asked that question. When you select that gray 

button that says print summary or print details 

the first thing that comes up on your Access 

screen is it says footnote and it allows you in 

fact on the PDF files that I sent you, you’ll see 

a footnote, you’ll see the page numbers, that’s 

automatic, but you’ll see a footnote where I put 

SC&A dash December 7th 2007. So it allows you to 

put a footnote in so that we can put in the date 

that we’ve made -- that we’ve -- we’ve created 

that -- that print. 
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MR. HINNEFELD: So it’s not automatic? It’s not 

automatic but it’s possible? 

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MS. BEHLING: It’s not automatic but it allows 

you to put that footnote in; yes. 

DR. MAURO: So Kathy, does that mean that if I’m 

sitting at my machine and I decide to print out a 

hard copy to using this tool it -- I would -- I’d 

have the choice of giving it any date I want. 

Now everyone using this can do it and put in 

there whatever date I -- eventually though -- 

DR. ZIEMER: We don’t want them to be able to do 

that. 

DR. MAURO: Right, that’s where I’m going. Yeah. 

MS. BEHLING: That’s -- that’s correct. See 

again and I -- I agree with you John. I 

envisioned this Access database to just be 

something used by Stu and myself or you know -- 

you know NIOSH whoever’s going to input the data 

and SC&A whoever’s going to input the data and 

not everyone out there making changes. But 

you’re -- you’re correct, we can -- we could 

probably try to automate that based on when you 

print that it -- it automatically prints the -- 

the current date but what I was trying to do was 

make it very clear for the workgroup to 
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understand this is the last time that SC&A 

updated this database or it’s the last time that 

NIOSH updated this database. We can make any 

changes you’d like there but currently it is 

something that -- it -- like I said a footnote 

screen comes up, you type in like I did SC&A and 

the date and now you know that this is the last 

time that SC&A updated this database. 

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MS. MUNN: But wouldn’t you -- wouldn’t you want 

that more on the details sheet rather than on the 

summary sheet? 

MS. BEHLING: It will be on both. If I hit the 

print summary I’ll get a footnote screen and I 

can put my date on there and it’ll be at the 

bottom of each page. If I hit the print detail 

button it -- and I put that same footnote in it 

will show up on each page of the detailed report. 

MS. MUNN: Right. Okay actually I don’t see any 

difference between page one and page four that we 

have in our printout except the check and the 

include closed issues. Yeah, it looks to me like 

the same thing. 

DR. BRANCHE: It is. 

MS. BEHLING: Oh, it is. 

MS. MUNN: Very good. Just checking. 
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MS. BEHLING: Yeah, that is the same thing. All 

I was trying -- I guess on mine I circled the 

print button just to -- and I -- in that one 

there is a check mark under the include closed 

issues on page four. 

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MS. MUNN: Correct. Right. 

MS. BEHLING: And so that does show you the 

closed items but unfortunately page four -– 

(Sound on telephone connection) 

MS. MUNN: Oh my. 

DR. BRANCHE: For those of you who are -- this is 

Christine Branche -- for those of you who are not 

speaking if you had the opportunity -- ability to 

mute your phone it would be very helpful. 

DR. WADE: Whatever that was. Poor baby. 

DR. BRANCHE: This is Christine, I just -- as -- 

as a -- as an observer of this discussion, is 

there some utility in having the fixed 

preparation date that either NIOSH or SC&A would 

have full up only -- only opportunity to alter 

versus a printing date and have two dates and you 

would say the print date? 

DR. ZIEMER: I believe there is because each of 

the items could have different dates on them 

depending on when NIOSH or SC&A dealt with those 
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MS. MUNN: Yeah. 

DR. ZIEMER: You don’t want a whole bunch of 

different dates on your printout. I mean, in the 

columns you might have that but seems to me the 

printout date is still important so that you know 

-- 

DR. BRANCHE: So in other words whenever -- 

whatever date is on the computer of the person 

that printed it that would -- that would happen 

but it would -- but would be unaltered except for 

by SC&A or NIOSH staff would be the date that 

Kathy already has that she provided in what we 

printed out in the -- in the -- 

DR. MAURO: It seems to be -- my main concern has 

been in the past is when we’d get together and 

we’d have these hard copies and -- and -- and 

we’re into our third or fourth workgroup meeting 

where sometimes we don’t -- we didn’t always have 

the same version. 

DR. ZIEMER: Same version. 

DR. MAURO: We had a different date, and the only 

way we knew whether or not we were all on the 

same page is by looking at the date. So what we 

want to do is create a tool so that when we do 
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sit around the table and we are all looking at a 

screen we could very quickly determine are we all 

on the same page working from the same form with 

the same date. Now I think that maybe the trick 

is you know before the meeting when -- when NIOSH 

and SC&A are assembling this and making sure it’s 

all filled out as current as we could make it 

just like last week and then we show up at this 

meeting the key would be to make sure that -- 

that we date it but the -- the date would be such 

that it would be indicative to know for sure that 

everyone is looking at the same thing and that 

date becomes the form that we work from for this 

workgroup meeting. 

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MR. HINNEFELD: It’s probably a good idea to have 

an official print -- 

DR. MAURO: Yes. 

MR. HINNEFELD: -- for the work for use at the 

work group. We’ll just decide you know between 

us. 

DR. BRANCHE: And you can date that. 

DR. MAURO: Date that. 

MR. HINNEFELD: We’ll print and date on an agreed 

to date. 

DR. MAURO: Right. 
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MR. HINNEFELD: And then that will be the version 

that will be talked about at the next workgroup. 

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DR. MAURO: Do you envision that we would be 

sitting with the hundred and fifty pages of these 

forms? 

MR. HINNEFELD: Oh I would hope not. I would 

hope we would print anything that’s got you know 

information added to it. 

DR. MAURO: Okay, now what -- what I’m getting at 

is, are we going to be working from hard copy or 

you think we’ll all be sitting at our terminal? 

MS. MUNN: I would suggest that we consider 

printing only the -- 

DR. MAURO: Open items. 

MS. MUNN: Printing only open items or 

alternatively printing only the rollup. 

DR. MAURO: The rollup, okay. 

MS. MUNN: If we know what version of the rollup 

we’re dealing from then we’re working with the 

knowledge that anything that has been changed is 

shown to us in the final version of the workup -- 

the rollup that we’re using that day. 

DR. BRANCHE: That issue is the -- I’m sorry 

again, but that issue is absolved if the only 

people who have the opportunity to alter the date 
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MS. MUNN: Correct. 

DR. MAURO: And we’re working on it the week 

before so -- 

DR. BRANCHE: Everybody only has a read-only -- a 

read-only opportunity. 

MS. HOWELL: But can’t you print? 

DR. MAURO: Again? 

MS. HOWELL: I just am wondering if the Board 

members print their own copies and they don’t 

have the opportunity -- you still need an 

automatic date stamp to show up because you’re 

still going to have multiple versions. 

MR. MARSCHKE: You need a date stamp of the -- of 

the -- of the date of the -- of the Access file, 

the data file. I think that’s more important 

actually than the date that you printed it on. 

You need a -- you need to print out the date 

stamp of the data file so that you know that 

you’re working from the same data file because I 

can print it on Tuesday and somebody else can 

print it on Monday but if they’re printing from 

the same data file they should be identical. So 

really the date that you print it on really 

doesn’t matter but it’s the date that -- of the -
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- of the -- of the data file that is -- that is -

- that should show up somewheres (sic) on the 

hard copy. 

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DR. WADE: And that date should represent the 

date of the last change. 

(multiple speakers) 

DR. BRANCHE: But that currently is what has been 

organized. 

DR. MAURO: That’s what we’re doing. 

DR. WADE: That’s all you really need is the date 

of the last change if people could print that 

date if you want and print. 

MS. BEHLING: We can automate that. 

MS. MUNN: That would be great. 

MS. BEHLING: Okay. 

MS. MUNN: Thanks. 

MS. BEHLING: Okay. 

MS. MUNN: Kathy? 

MS. BEHLING: All right and I guess on page five 

what I was trying to show you here is the -- the 

gray button at the top again, this is a print 

button, details for selected procedures. Again 

underneath there is a drop down box and it 

identifies all of your procedures and if you only 

want to select the findings or the open findings 
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or open and closed findings if you check mark 

that include closed issues for one specific 

procedure that button gives you that option. And 

then on my last page, page six, same type of 

thing but this time the last gray button on the 

right is details for selected finding date and I 

did this again because I wanted to be able to 

select January 17, 2005, so if we only want to 

look at what’s remaining in the first set of 

procedures that we’ve -- that we looked at or 

what is -- like one of the -- one of the files 

that I printed or I submitted to you for this 

meeting was what are the findings associated with 

PROC-92. And so this button gave me that option 

to just select procedures and I’m -- I’m showing 

you this because these are the options we have 

available, these are not the only options and I 

wanted you to have some discussion as to other 

things that we may want to include that we might 

want to sort on. Obviously I did hear we want to 

be able to include only open items so and 

actually I believe at this point I have only 

asked our Access person to exclude closed items. 

I didn’t ask him to include items maybe that have 

been transferred or in abeyance and I will have 

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to ask him to specifically have us be able to 

include only possibly only open items so that we 

can just deal with those during our workgroup 

meeting. 

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MS. MUNN: Now but be aware abeyance also is 

open. 

MS. BEHLING: Yes. 

DR. MAURO: Kathy, could you again refresh at 

least my memory the distinction between an item 

being open and active and being open and in 

abeyance? 

MS. BEHLING: Okay, and there are also different 

forms of open which I guess in this version I 

didn’t have the time to put all of those in. But 

first of all there’s open and what we had 

discussed and Wanda correct me if I’m wrong but 

open means the item has not been discussed yet. 

It is a finding that we submitted let’s say a 

third set finding that we haven’t had any 

discussion on yet, that’s obviously an open item. 

If it’s open and in progress it means that we 

have had a workgroup meeting on this topic, we’ve 

had some discussion but the issue is not 

resolved. In abeyance is an issue that is 

actually been -- we’ve been through the entire 
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resolution process and the resolution is that 

NIOSH is going to agree to make a change to that 

procedure and in some future revision of that 

particular -- that particular procedure they’re 

going to incorporate the finding, they’re going 

change -- make that change to that procedure to 

incorporate our finding. So it’s actually an 

issue that is by -- by what we’re looking at here 

we’ve resolved it but it’s not going to be 

completely resolved until NIOSH issues a new 

procedure, a new version of a procedure. That’s 

in abeyance. 

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MS. MUNN: That’s approximately what we discussed 

at our last meeting, yes. 

MS. BEHLING: Correct. And then obviously closed 

is an issue that maybe SC&A agrees with NIOSH’s 

response and the Board agrees with -- there’s an 

agreement across the Board and that’s a closed 

item. Now the last status is also the 

transferred status meaning that we -- we can 

transfer something maybe to a site profile or we 

can transfer it to global issues. So those are 

the items that you can -- that you might see in 

that status column. The one last item which I 

don’t think we’re going to see a lot of these 
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when we get to the third set, this second set was 

a little bit unique but in some cases we 

recognize as we look down through maybe a list of 

fifteen findings that many of them are related 

and if we resolve finding one we’ll resolve the 

next five findings. So what we’ll do in the 

status of these additional five findings is say 

we’ll -- addressed in finding 001, the finding 

number in 001. So those are the types of things 

that you’ll see in the status column. Are we in 

agreement with that, and I thought that is what 

we -- 

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MS. MUNN: Yeah, yeah, that’s essentially what 

we’d agreed to. Paul? 

DR. ZIEMER: I have another question Kathy or 

anyone at the table could perhaps address. 

Suppose we have findings from different 

procedures that deal with a particular thing, 

let’s say it’s breathing rates for construction 

workers or something and you have several 

different procedures where that has arisen as a 

finding, do we have the ability to sort not only 

by procedure title but by the nature of the 

finding, for example every time that arose could 

we -- can we sort by that to see if it’s always 
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handled in the same manner or is that getting to 

be too much detail? 

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MS. BEHLING: We -- that is not built into our 

current sort because if you go back to page two 

into the details screen that is -- it would be in 

a paragraph type form here. Now I would assume 

you could sort on specific words within that 

detailed screen I can -- I can check on that. 

DR. ZIEMER: Well for example tritium 

calculations or something like that. 

MS. BEHLING: Yes. 

DR. ZIEMER: Or suppose that issue arose in 

several different procedures. Maybe -- maybe it 

wouldn’t but I think it could or some of these 

could. 

DR. MAURO: Well likely between the procedures 

and a site profile and a real case. 

DR. ZIEMER: Yeah. 

DR. MAURO: We’re going to -- because we’re going 

to see a tritium problem in all these different 

places. What you described certainly be valuable 

I have to say it’s going to be -- 

DR. ZIEMER: Is that a -- but that may only be a 

word search on the finding. Every time tritium 

comes up show us what it was. 
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MS. MUNN: That sounds like a simple word search. 

You’d have to sort through after you’ve -- 

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DR. ZIEMER: Well I think Access has that 

capability; I’m sort of asking whether it does. 

Kathy do you know if it -- 

MS. BEHLING: I don’t know if it does, I believe 

it -- 

DR. ZIEMER: Look at all the findings dealing 

with neutrons. 

DR. MAURO: Has the word neutron in it. 

DR. ZIEMER: Or something like that. Do we have 

that ability? 

MS. BEHLING: I believe that we -- that we could 

do that. Again, I’m not the expert on that -- on 

Access but I could talk to the person with SC&A 

that -- that is an expert on it. But I would 

imagine if we went into our details form we could 

do a sort on specific words. 

MS. MUNN: There -- there is an icon for search 

showing on the -- on the bar. 

DR. MAURO: That would only occur -- let me just 

point something out that might be important. 

Remember that this is the Access database that 

deals with Task Three. 

MS. MUNN: Yes. 
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DR. MAURO: Am I correct in what I heard is that 

let’s say there’s tritium issue that came up as 

something on some other site profile. 

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DR. ZIEMER: Well right now I’m just -- other 

procedures -- 

DR. MAURO: Only within its -- okay, yeah. 

DR. ZIEMER: -- but yeah. But ultimately it 

might be -- 

DR. MAURO: Okay. 

MS. BEHLING: Yeah, John he’s just assu -- he’s 

saying that there could be like the inhalation 

issue associated with several procedures. 

DR. MAURO: Right. Sure. 

MS. BEHLING: And we want to be sure that we’ve 

handled all of them consistently. 

DR. MAURO: Okay. 

MS. MUNN: But a simple word search would pull 

all of those items up? 

DR. ZIEMER: Seems to me it would, yeah. 

MS. MUNN: Yeah. I can’t see why not. 

MS. BEHLING: Yeah, I -- I am sure that we can do 

that. I will talk to our Access person. So I 

guess that -- that summarizes and like I said I 

just wanted to give you a visual understanding of 

the database and I’m glad I’ve -- we’ve -- we’ve 
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walked through this. If you all are going to 

want a -- a -- access to this information and 

you’re going to want to as I said if you went 

back to that summary sheet and you said where are 

we on an open item in IG001 you just click on 

that item and then open up your details button 

and it will give you all of those details. I 

certainly think that would be worthwhile for you 

-- for you to see and you could have a user, you 

know, user only type of format that we could make 

available to you on the O drive but when we get 

to that point if -- if anyone wants a little bit 

more detailed demonstration of this we can -- we 

can obviously do that also. But based on what 

you see do you have any other questions? Are 

there any other ways that you’d like to sort the 

data? Do you want to capture any additional 

data? 

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MR. MARSCHKE: Kathy, this is Steve Marschke 

again. I have a question on the transferred 

category. If I transfer a finding, say I 

transferred a finding to -- from -- from OTIB 4, 

an OTIB 4 finding to OTIB 52, how does OTIB 52 

know that it’s got a new finding? 

MS. BEHLING: Well -- 
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MR. MARSCHKE: How does OTIB 52 receive that 

transfer? 

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MS. BEHLING: Well what we’ve done in the past 

with the let’s say the global issues is at our 

last meeting again there was the issue of I -- I 

believe it was the inhalation discussion on -- 

and we wanted to ensure that that was going to be 

part of the global issues package and John Mauro 

as part of the follow-up action talked to Jim 

Neton and said we’re transferring this to global 

issues and it became on global issues issue of 

listing and the other thing that I have done and 

you’re asking an excellent question and this is a 

question that comes up all the time on how do we 

ensure that nothing falls through the cracks. 

One of the issues that we discussed under one of 

the procedures I guess that was a note in my dose 

reconstruction. I actually call Joe Fitzgerald 

who takes care of the site profile task and I 

ensure that he now has this finding and it 

becomes a finding under lets say a Y-12 issue and 

when they discuss -- when they resolved the 

remaining open issues under the Y-12 site profile 

he includes it there and so on my details sheet I 

would indicate that I have called and talked to 
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such and such a person and to ensure that this 

finding was transferred to something else or to 

some other task. I don’t know if that is good 

enough or not. 

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MR. HINNEFELD: I think, Steve, your question 

about transferring from you know one procedure to 

another though I think those would be indicated 

rather than transferred it would be being 

addressed by such and such find so as long as 

it’s within the procedures of Task Three it 

wouldn’t be called a transfer. The transfer to 

outside would be the question, make sure it’s -- 

MS. BEHLING: That’s correct. 

DR. MAURO: Well let me -- the example that Kathy 

used is a good one. That at the last meeting a 

question came up regarding inhalation and yes 

after that meeting I had an action item to call 

Jim, I called Jim, Jim said yes, it’s in -- it’s 

part of the global issue along with the oro-nasal 

breathing and my intent was to report that back 

to the meeting today. And what would happen then 

it would go into the discussion section that’s 

going to go into the next round. So -- so it’s a 

mechanical -- it is not a very sophisticated 

approach. 
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DR. MAURO: I just report back and if we’re -- 

you know we’re attentive I will make sure that we 

get those words in the write up but that’s it. 

There’s your wink. I wrote it down here and 

later on someone wants to say well this actually 

happened, then you got to call Jim again. 

MR. MARSCHKE: Right. 

DR. MAURO: But that -- it’s not being automated 

where all of a sudden it pops up on Jim’s screen, 

you know what I mean? 

MR. HINNEFELD: Right, right. 

MS. BEHLING: And Steve, Stu is correct. 

Anything that stays in Task Three in the 

procedures review will just have in the status -- 

the status column addressed under finding such 

and such so -- so to ensure that it’s staying 

within Task Three. 

MR. MARSCHKE: Okay. 

DR. MAURO: You know as long as we’re going to 

operate in that mode what this means is that 

we’re going to have to be especially attentive 

when we fill in the discussion section where -- 

where you know, what how -- you know to something 

that’s been transferred, it’s important that in 
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that little box it says discussion it’s been 

transferred to this other place and these are the 

action items that ought to be taken. So at least 

we have a record somewhere. But you’re right; it 

would be nice to have something a little more 

automated, but I think we’ve got to be able to 

walk before we can run. That’s pretty -- that 

gets pretty fancy when you start linking to other 

databases. 

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MS. BEHLING: If the other tasks have an Access 

database like this I guess we could -- 

DR. MAURO: Yeah, yeah, but -- 

MS. BEHLING: This is a first attempt at this. 

Any other questions or -- 

MS. MUNN: One other suggestion, Kathy. 

MS. BEHLING: Yes. 

MS. MUNN: Larry and I were looking at the title 

of -- of our database here and we’re wondering if 

perhaps the title that you have on Access 

database screens that we were looking at should 

read something other than NIOSH Issues Tracking 

Database. It is an ABRWH procedures working 

group tracking database actually. 

MS. BEHLING: Yes. 

MS. MUNN: And perhaps that designation might be 
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more appropriate, especially in light of the 

possibility that this process if it works well 

for us might end up being taken up by others in 

some other format or under some other title. 

Just for the current moment unless someone has 

real reservations about that it seems to me that 

better recognition would be ABRWH Procedures. 

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DR. ZIEMER: Yeah, or Procedures Review Database 

or something like that. 

MS. BEHLING: I agree, okay, that’s -- I can 

easily make that change. 

MS. MUNN: All righty. 

MS. BEHLING: Yes. 

MS. MUNN: Any other comments with respect to 

this? 

MR. ELLIOTT: I think I would make a suggestion 

along those lines that there’s great utility here 

in this -- this database that other working 

groups might you know latch onto and say hey, 

here’s a great way to keep track of our work 

better than maybe the matrices that we’re 

currently using and if you change these titles 

the way Wanda has suggested that opens it up to 

deliver an opportunity to the other working 

groups a subcommittee on dose reconstruction 
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MS. BEHLING: Yes. 

DR. MAKHIJANI: If I might add to that also you 

know we’ve had a little bit of complicated 

tracking for site profile databases that transfer 

over into SEC issues, kind of -- we have to do a 

lot of juggling to keep track of going through 

the way we have gone through the matrices. This 

could make that easy because we have a site 

profile tracking base and -- database and at a 

certain point we see a designation that it’s 

being transferred to SEC work. 

DR. ZIEMER: Dose reconstruction matrices can do 

this same thing. 

MR. ELLIOTT: It’s a great way to sort out the 

site profile specific issues from the SEC related 

issues and track them separately. 

DR. MAKHIJANI: Now what I’m going to do is 

handprint it. I’m going to make a separate 

matrix for SEC issues extracting from everything. 

And we can do that; I think it will be cleaner 

than what we did in Rocky Flats where we were 

going through a whole matrix every time. 

MR. ELLIOTT: Yeah. 

DR. MAKHIJANI: But this would help that. 
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DR. MAURO: And interesting that would make it a 

forcing function for dealing with. There’s 

always been this little ambiguity on is it a site 

profile issue or is it an SEC issue. Granted 

there -- there are lots of different opinions on 

that but this would force us to have to come to 

grips with that and ask where would we drop this 

one. 

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DR. ZIEMER: I’m wondering if we’re at a point in 

sort of the maturity of this where at least the 

concept could be presented to the Board maybe as 

part of Wanda’s report and maybe Kathy could make 

the presentation but to show the utility of this 

approach and suggest that other working groups 

consider adopting a similar format. 

DR. WADE: And if they were to want to do that 

what would they do, contact Kathy? 

DR. MAURO: Yeah we have our -- Kathy being the 

first member -- 

DR. WADE: Point person. 

DR. MAURO: Went through the hard knocks of 

putting it out. I think that she’s -- she can 

move on to the next one. Obviously the next 

easiest one would be the one that Kathy is 

running on the dose reconstructions. 
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process now. 

DR. WADE: Yeah I mean this obviously has good 

utility. Obviously it will expand in its use; we 

just need to plan for that and make sure we have 

the resources available to do that. 

DR. MAURO: Yeah, that -- this turned out to be a 

bit more resource intensive than we thought it 

would be as everything else. 

DR. ZIEMER: Once -- Once the model’s in place -- 

DR. MAURO: Right, that’s right. 

DR. ZIEMER: I think you can adopt it pretty 

easily. 

DR. MAURO: Yeah, no I agree, it just was getting 

from the drawing on a piece of paper. 

DR. WADE: But the maintenance of these things 

will become something that has to be resourced. 

I think we can do it. 

DR. ZIEMER: But we’re maintaining the matrices 

anyway and in some cases where it’s more 

difficult. 

DR. MAURO: I think once we get through the 

transition -- 

DR. ZIEMER: It looks to me like it would be much 
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DR. MAURO: Yeah, I agree with that. 

MS. MUNN: You’re one step ahead of me, Paul. I 

will start -- 

DR. ZIEMER: Oh, sorry. 

MS. MUNN: No, that’s quite all right. I was not 

quite sure that we were quite at the point where 

we wanted to make a very significant presentation 

to the full Board. I -- it would be nice to see 

the full set of -- of notebooks and full set of 

documents once before we made much of a 

presentation of it. I think I would like the 

full Board to know where we’re going with this 

but perhaps I’m being just a little too 

conservative if we’re really ready for it. 

DR. ZIEMER: January may be too soon but if we do 

it say at the next meeting after that then I 

could foresee having it done online where she 

could put it on the screen and do the 

(indiscernible) and show how the pages came up 

and so on. 

MS. MUNN: I can -- I would anticipate that -- 

that the Amarillo meeting would be a very good 

time to do that. But I certainly would like to 

report to the Board, the full Board, what we’re 
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working on and have a brief -- a brief once 

through of what we think it’s going to look like. 

Kathy, would that be a possibility for you for 

the January meeting? 

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MS. BEHLING: That shouldn’t be a problem. In 

fact I believe that by the January meeting we 

will have everything updated from the third set 

put into this database and I will go back and 

fine tune some of the first and second set 

information and any changes that we want to make 

will definitely be made on this database by our 

expert. Believe it or not the individual that 

put all this together for me and -- and we -- we 

had many renditions of this, we went back and 

forth many times, he did all this under forty 

hours so he’s very, very good at this and he does 

this type of thing in his sleep and so I don’t 

think there will be a problem having everything, 

pretty much everything in good order by the 

January meeting. 

MS. MUNN: Good, if we could -- we could 

anticipate perhaps a -- a five or ten minute -- a 

ten minute presentation with some Q and A time at 

the January meeting and then a full presentation 

of this is what the whole thing’s going to look 
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MS. BEHLING: That’s fine. 

MS. MUNN: Is that amenable with the other 

members of the work group? 

MS. BEHLING: Yeah. 

DR. WADE: We would do this as part of your 

presentation with Kathy then speaking to the 

workgroup update? 

MS. MUNN: Yes. Fine. That’s a plan. 

MS. BEHLING: Okay. 

MS. MUNN: Then -- 

MR. HINNEFELD: Stu Hinnefeld, I have just a 

logistics question now. Have we decided where -- 

shall we have them put this on the O drive? I 

think that would be a convenient place. And so 

whether it’s going to be a read-only or whatever 

we can work out with Kathy and then if it’s a 

read-only and it goes on the O or -- 

DR. MAURO: Where else would it be, I mean I 

think -- 

MR. HINNEFELD: Yeah, I mean that’s -- I think 

it’s got to go there. 

MS. MUNN: Yeah, I don’t know where -- 

DR. BRANCHE: This is Christine. The only other 

option is we’re trying to go -- Zaida may have 
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already sent you a message, the Board members a 

message, but we’re trying more and more to go to 

a paperless system since so many of you bring 

your laptops and so she’s preparing flash drives 

for you so there’s an opportunity that at least 

for that meeting to have it available for her to 

have on the flash drive as well ‘cause we’re 

trying -- to all those big books you all bring 

your laptops so that you know we don’t have to 

kill a tree. So there’s another opportunity 

there as well. 

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MR. HINNEFELD: Well Kathy you and I can work out 

how I’ll -- if this is going to be read-only or 

will I have a rights to read to write to it or 

something like that ‘cause I’ll need to use -- I 

want to use the official one, there should be an 

official one. 

MS. BEHLING: Yes, there will be. And yeah, 

we’ll work together on that. In fact I’ll have 

to give all that -- those files to you to update 

to put that onto the O drive. 

MR. HINNEFELD: Yeah, okay. All right, just let 

me know how it’s going to work. 

MS. BEHLING: Okay. 

MS. MUNN: Okay. So that’s an action item, 
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DR. BRANCHE: So Wanda you want to make a full 

presentation about the new matrix at the Amarillo 

meeting? 

MS. MUNN: Yes, uh-huh. All right. I had hoped 

that by this time we’d be into the other portions 

of those four matrices that had been sent out to 

us earlier rather than just these database 

tracking cover sheets. We all received those 

late last week or over the weekend I guess and 

there is an enormous amount of information in 

them but it’s very good. Thank you again Kathy 

for getting these detail sheets to us so that we 

could have an opportunity to see what they really 

would look like. 

MS. BEHLING: You’re welcome. 

DR. MAKHIJANI: Kathy, could you email that to 

me? I’m not able to locate my copy right now. 

MS. BEHLING: Yes, I will, Arjun. 

DR. MAKHIJANI: Thank you. 

MS. MUNN: So one thing that was striking as I 

was going through it is how clearly we have 

followed our original plan to try to address the 

most pressing issues first. When we see the 

material laid out in this format the number of 
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times that we see the issue was not discussed 

really jumps out at us. I don’t know that we are 

at a point quite yet where we can revise our 

start of standing process of trying to address 

the most pressing issues in a priority fashion. 

But before very long as we work in this format it 

appears that we are going to have to come to 

grips with when do we address what we have 

designated as slightly less pressing items 

because we have such a large number of them that 

are still in the not discussed category. Does 

anyone have any specific comments that they want 

to make with respect to either the format or the 

content of the format of these four sets that 

were provided to us? 

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MR. HINNEFELD: Well I have a specific comment 

about the file that’s called second set open 

items, the -- discussion -- the workgroup 

discussion on PR007 is actually the workgroup 

discussion we held on OCAS TIB 007, PR007 has to 

do with DR review. PR007 and 005 are somewhat -- 

somewhat administrative descriptions of how we 

can A, how we can best assess and B, how -- how -

- what do we do when we review dose 

reconstructions. So we’ve not discussed those 
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yet and I believe I do have some initial 

responses that were not available at the 10-2 

meeting that I sent out before the last 

teleconference meeting that I could clip and put 

on here, you know once I have the database I can 

clip them on here for initial responses. But so 

just as a comment though I was looking through 

that and I said those responses don’t meet the 

findings and I realized though that was TIB7 

responses. So I can -- I can take care of that 

once the file is updated. 

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DR. MAURO: There’s going to be populating -- 

populating the database. 

MR. HINNEFELD: Yeah. 

DR. MAURO: In a way that everyone you and SC&A -

- I mean yes this captures. First of all it’s 

factual and correct. 

MR. HINNEFELD: Right. 

DR. MAURO: And does it capture what was 

discussed adequately. But that’s true whether 

we’re doing it on a database or we’re doing it on 

hard copy. 

MR. HINNEFELD: Right, right, right. 

MS. MUNN: That’s the kind of material I hope 

we’ll have an opportunity to address between now 
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and the Amarillo meeting so that when we do 

produce a document for the entire Board to see 

we’ll be fairly comfortable with how the 

information is presented and that it’s presented 

accurately in the right place. Any other 

commentary? I will assume that Stu, you’ll work 

with SC&A to identify those? 

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MR. HINNEFELD: Well I can just change it. I 

mean once I get the data files from the Access 

data files I’ll just change them because 

(indiscernible). And actually I think all we’ve 

provided for five and seven are initial 

responses; we have had no discussions, I believe 

that’s true. 

MS. MUNN: All right. 

DR. ZIEMER: Could you identify the four 

documents? The first one was the second set, is 

that the twenty-two page document, the PDF file? 

MS. MUNN: Yes. 

DR. ZIEMER: Okay and what was the second one? 

MS. MUNN: And the second one was the PROC-92 

format to be formatted. There you are. The next 

one was the issues tracking system, the rollup of 

all items and the other one -- 

DR. ZIEMER: You’re talking about 90-02 or -- 
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DR. ZIEMER: Or 92? 

MS. MUNN: We’re talking about 92. 

DR. MAURO: Supposed to be a close out. 

MR. HINNEFELD: It’s a -- It’s an Adobe PROC0092. 

MR. ELLIOTT: Eight pages. 

MS. MUNN: Eight pages will be -- they were all 

sent the same time and we’ll be addressing that 

particular segment of course in greater detail 

after lunch. All right. 

12 NIOSH – GLOBAL ISSUES REPORT

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Let’s move on to our next item. We’re going to 

get a report on global issues and where we are 

with those. 

MR. HINNEFELD: Yeah, this is Stu, I believe we 

were asked to describe how we’re keeping track of 

global issues. 

MS. MUNN: Yes and -- 

MR. HINNEFELD: So, so far we have -- have a 

list, a meet and approve list. And what I’m 

handing around is a one page -- it’s a one page 

file and this is actually a Microsoft project 

because it’s something we use for other purposes, 

we just put it on there. It could be on a PB, we 
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don’t have -- we don’t –- we really use Access, 

our TST guy is a SQL guy and so we would do it in 

SQL if you went to a database. But in this 

fashion the advantage of projects is you can list 

under your tasks is and each of these -- not the 

blue ones are sort of categories but the black 

numbers are tasks. You can list subtasks under 

each of those, first specify how you’re going to 

do it. Some portion of this will be to put a 

responsible person on each one. Jim has his -- 

he has his list of responsible people that he has 

not shared with me yet so I’m hoping I’m not on 

it. So I say responsible person, I mean the 

health physicist who is probably going to lead 

the effort. And what we’ll have to end up with 

is then a -- some sort of technical document 

whether we call it a technical information 

bulletin or invent some new name because it 

doesn’t really tell anybody how to do stuff, it 

just provides the technical background for why we 

do something a certain way. So there will be a 

technical document prepared for each of these. 

So that is the tracking mechanism we have so far. 

And -- and you can also put in days and 

schedules, you know due dates and completion 

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dates. So it’s -- it’s a project management tool 

really all the scheduling type of things. The 

issue I was supposed to talk about I believe was 

oronasal breathing and the breathing rates which 

again Jim has been involved with and has talked 

to John about. Jim did present this at the 

Naperville meeting, he made a presentation on the 

science issue. I had forgotten that at our last 

meeting because I missed quite a lot of the 

Naperville meeting because I was on other 

business. But the -- but the rest -- the 

presentation briefly is that for dose 

reconstructions were those dose -- internal doses 

calculated from bioassay. The oronasal breathing 

becomes not much of a factor because if you might 

-- you’d have a greater deposition which then 

accounts for better urine samples and so it comes 

-- comes out in the wash. So it’s not much of a 

factor on a bioassay. The issue comes in on a -- 

on a air sampling approach and what Jim presented 

was air sampling populations have large GSB’s and 

we use high percentiles like the ninety-fifth 

percentile on the -- on -- on the -- on the 

distribution and for that reason the uncertainty 

that’s associated with the breathing technique of 

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the individual is essentially dwarfed by this 

larger uncertainty in which your ninety-five 

percentile of the air sample distribution you 

would count it sufficiently for. That was his 

presentation. Mark asked the question about well 

you’ve shown us the Simonds Saw data, air 

sampling data which clearly has a very large 

geometric standard deviation, is that really true 

universally. And so that work has yet to be 

done. And this will all be published in a 

document. 

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DR. MAURO: And what might be helpful is that 

I’ve been reviewing TBD6000, 6001, both of which 

deal with generic reviews, large, vast amounts of 

data related to the AWE facilities, the 

processing and the working. And I noticed in 

there that an attempt was made to capture the 

literature on lots of facilities and the way in 

which the data are summarized are EPN per cubic 

meter with the geometric -- the geometric 

standard deviation. So I’m just offering up one 

place that’s already been done to sort of capture 

the lease for AWE’s. 

MR. HINNEFELD: Right. 

DR. MAURO: A good sense of the spread is in that 
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document. I would like to point out though that 

the concept of ninety-fifth percentile as being 

the -- the approach, we will be getting into this 

and it’ll be peripheral but it’s not universally 

being applied and how it’s being applied is 

interesting and we’ll be talking about it. So 

there’s a little bit of linkage, I under -- I 

understand the philosophy you just described and 

I agree with it by the way. We do have a large 

spread on the air sampling, you pick ninety-fifth 

percentile, that covers a lot of ills. But we’ll 

see when we get into these other matters that 

it’s not always the ninety-fifth percentile as 

one would think it is. 

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MR. HINNEFELD: Okay. Well I’m referring to what 

Jim said. 

DR. MAURO: Yeah, no and I agree with it. And I 

think that concept is a solution for the oronasal 

breathing. 

MR. HINNEFELD: Okay. 

MS. MUNN: This is the first time I’ve had an 

opportunity to look down the list of what we’ve 

identified as global issues. Does anyone have 

any comment about these? Any additions or 

suggestions based on our prior deliberations? 
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MR. HINNEFELD: Some of these Jim indicated are 

complete. A smoking adjustment for lung cancer 

that was the alternate -- I believe that’s on the 

lung model, isn’t that the new NCI model? 

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DR. ZIEMER: Yeah. 

MR. HINNEFELD: So I believe that one is 

complete. 

MS. MUNN: So under -- 

MR. HINNEFELD: Thorium welding rods has been 

presented. I don’t guess there’s been a paper 

written on that yet. 

MS. MUNN: So somewhere out here under -- under 

actual finish we -- 

MR. HINNEFELD: Yeah, we’ll -- we’ll update this. 

Like I said all I have right now is a list of 

internal dose from Super S plutonium that’s 

completed you know the document’s out there, the 

PDR is being worked, we’re reworking the cases. 

Some of these are complete. But we’ll have an 

updated -- 

DR. MAURO: When an -- when an item makes it onto 

the global issues that’s something that emerges 

from you all’s process, that is you know whether 

-- whether it’s an interaction with SC&A and the 

Board at some point in that processing it becomes 
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apparent well you know really this has some 

cross-cutting issues and emerges in that fashion. 

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MR. HINNEFELD: Uh-huh. 

DR. MAURO: Now let’s say it turns out you know 

in -- in our SC&A’s deliberations from where we 

review the material and workgroup meetings, there 

may be certain issues that start to appear to us 

that perhaps are cross-cutting. Is this 

something that we should bring forth during the 

meeting because I have a couple in my mind right 

now quite frankly. 

MR. HINNEFELD: Well I think -- 

DR. MAURO: Or is that something that’s 

inappropriate for us to discuss? 

MR. HINNEFELD: Well I think it would be a 

question for the workgroup and the Board. It 

would seem like you know this is sort of... It 

would seem like that would be a way to findings 

you know because we don’t -- we don’t necessarily 

say that every one of these you know came to us -

- you know came to us. I think some of -- quite 

a number of these come from these -- that kind of 

discussions. 

DR. ZIEMER: Well didn’t some of these come 

through SC&A findings anyway? 
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MR. HINNEFELD: Yeah, yeah, right. Quite a 

number of them did. Yeah. 

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MS. MUNN: But also quite a number came from the 

deliberations of this group right here which is 

certainly an appropriate source for bringing them 

to the list it seems to me. If you have others 

that you’re aware of that are not on the list and 

you’re looking for a place to put them certainly 

it appears this group would be quite receptive to 

hearing those. 

DR. MAURO: Okay as -- as they come up. Because 

I do have -- I have one particular in mind. 

MS. MUNN: Right. 

MR. ELLIOTT: I think you should talk to Jim 

also, we’d be receptive to hearing what your 

thoughts are you know and however it’s placed 

into the deliberation process is you know it 

would be another matter but certainly we would 

want to hear it. 

MS. MUNN: Okay. You’ll want to get it on there 

because this resolving this particular 

overarching list resolves many problems on many 

sites so it’s crucial for -- 

DR. MAURO: I think it’s important because what 

I’m seeing after doing this now for about three 
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years is that every time we do a site profile, 

every time we do a -- well not a procedure review 

necessarily but every time we do dose 

reconstruction, these same issues are coming up -

- these same issues are coming up over and over 

and over again and we revisit them over and over 

and over again and little by little they find -- 

some of them find their way to the global issues. 

I think a little bit more of that would be create 

an efficiency where yes this is -- you know so we 

don’t -- so we -- we -- I think if we could start 

moving more of those into global issues because 

once they’re solved, they’re solved across the 

board. 

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MR. HINNEFELD: Yeah. Okay. 

MS. MUNN: But there’s no question, dealing with 

them at each site is not only painful, it’s 

wasteful and we really should be able to avoid 

that as soon as possible. So thank you, John. 

Any other comments on global or overarching 

issues? If not, let’s take a ten minute break, 

just a quick one, please. 

(Whereupon, a break was taken from 11:05 a.m. 

until 11:15 a.m.) 

25 SC&A – COMMENTS ON NEW RESPONSE DATA
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MS. MUNN: All right. We’re back on. We’re 

ready to resume where we left off on our proposed 

agenda. This past week NIOSH presented us with 

three new comments to items on our currently 

operable matrix and Stu, do you want to go over 

those very quickly to see what SC&A comments -- 

responses to those might be at this juncture? 

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MR. HINNEFELD: Okay. 

MS. MUNN: We’re starting with OTIB 17, findings 

7, page 17 of the current matrix. 

MR. HINNEFELD: Yeah, I actually wrote this on 

17-6 which I think is the -- I may have made a 

typo at some point when I -- 

MS. MUNN: I think you did. I thought that I was 

looking at 06 but I started -- 

MR. HINNEFELD: But it’s finding -- finding 17-6. 

And this relates -- the finding had to do with 

this -- this TIB, OTIB17 is about shallow dose 

calculations and mainly beta dose calculations 

but shallow dose calculations and the OTIB makes 

the statement that if the limit of detection is 

based on low energy protons for the shallow -- 

for the open window then you need to adjust that 

limited detection with the exposure with the beta 

parts because a low -- low energy proton and open 
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window film badge the film will over respond and 

so you’d have to adjust for that. You know, you 

wouldn’t use the same LOD as you would for the 

beta dose. In fact the beta dose you would like 

to have a higher limited detection. So we wrote 

that in the OTIB, that was the nature of the 

finding and then subsequently SC&A’s technical 

report that they wrote on OTIB17 which I don’t 

have my -- I didn’t get my response out, I didn’t 

have it ready until the last minute, I figured 

why send it out. We won’t have a response for 

the OTIB17 white paper. That -- from what I read 

that it sounds like in that report, SC&A agreed 

that if in fact you know that the shallow dose or 

the open window LOD was -- was derived using low 

energy protons then in fact it is appropriate. 

So that’s just what I wrote here. 

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DR. MAURO: And that’s correct. That was our 

response to it. 

MS. MUNN: So that item is now cleared? 

DR. MAURO: Yes, from SC&A’s perspective. 

MS. MUNN: All right. 0017 item 06 can be 

recorded as closed and the next item is OTIB 0019 

item 1, page 24. 

MR. HINNEFELD: Right, the finding starts on page 
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24, the new information begins on page 25, again, 

it’s headed December 11th. This finding had to 

do with OTIB 19 is the co-worker, sort of the 

general co-worker approach set and it talks about 

getting a dataset, rank ordering the data, doing 

an R squared and if it’s good then you feel good 

you’ve got log -- rank --rank ordering it a log 

normal tune of distribution file. You get a good 

R squared then you feel like it’s good that 

you’ve got lognormal data. And SC&A pointed out 

correctly that R squared test in that 

circumstance there’s a build in -- there’s a -- 

by rank ordering the data you have built in 

association. So R squared isn’t an unbiased 

indicator there. So our -- our latest and I 

relied of course Jim Neton was involved in this -

- in this discussion response, I just kind of 

handed this one to him to work on. So he’s 

provided a write up here and essentially our -- 

our position here is that we don’t -- we aren’t 

really using an R square test -- that R square 

test to infer that the data is lognormally -- 

lognormal. We -- we came to the -- we come to 

the question with the belief that the data was 

lognormal based upon what we know of published 

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literature and -- and we’ve also actually done 

some tests using the Anderson-Darling test I 

think is one Jim said, testing various you know, 

fits, various potential distributions to the 

datasets we have. And out of some sixty datasets 

that we have that we’ve collected for this 

program fifty-seven of them, lognormal was the 

best fit of the available distributions. Two of 

them were normal and one was uniform actually so 

I’d say it’d probably be a very sparsely 

populated dataset. So based on the fact that we 

have a sort of going in belief that it’s 

lognormally, we’re really just looking for -- for 

significant departure from lognormal because we 

feel like if -- if in fact the data is pretty 

close to lognormal you can draw good enough 

inferences in terms of various percentile 

distributions from that rank order distribution -

- or cumulative distribution plot and the line 

and in fact it’s a little easier to use than 

actually just counting the data and taking the 

ninety-fifth percentile from the worker data. So 

it’s a little easier to use, oftentimes ends up 

with a higher value for the ninety-fifth 

percentile because the distributions tend to fall 

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off at the straight line at the top. So if you -

- if you just counted in rank order you could be 

up on where it’s falling off the straight line 

and the straight line approximation from the -- 

from the plot actually gives you a little -- a 

little higher value than the ninety-fifth 

percentile. So. 

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DR. MAKHIJANI: Stu, when -- when -- when the I -

- you know very likely been an unknown 

distribution we lognormally what we’re assuming 

when doing our squared tests -- 

MR. HINNEFELD: Right. 

DR. MAKHIJANI: But is there some kind of 

evaluation of what happens in the few cases where 

you’re wrong and how off you could be in your 

determination? How -- how poorly you might do if 

the distribution was something else and you’re 

relying on it being lognormal? 

MR. HINNEFELD: In those three out of fiftyseven? 

DR. MAKHIJANI: Not in the -- 

MR. HINNEFELD: Or -- 

DR. MAKHIJANI: Yeah -- or -- 

MR. HINNEFELD: Because I mean there are certain 

tests for lognormality which are pretty stringent 
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and while these distributions may not actually 

pass with a high -- with a what I guess would be 

a low P value that -- those tests for 

lognormality but they clearly are approximately 

lognormal, just you know, you can see that. 

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DR. MAURO: When you have a large amount of data 

and you do rank them, because that’s one of the 

things we used to do to see how that worked. 

MR. HINNEFELD: Uh-huh. 

DR. MAURO: And we ranked them from high to low 

and you pick off the ninety-fifth percent highest 

value. 

MR. HINNEFELD: Uh-huh. 

DR. MAURO: You had mentioned that you would look 

-- did you look at this data from that 

perspective, that is -- 

MR. HINNEFELD: I don’t know if we did that rank 

order on all those -- 

DR. MAURO: I usually find that interesting. If 

it turns out that the ninety-fifth -- ninetyfifth percent value in numerical order falls more 

or less in place where your fit falls, you know I 

get a warm feeling and it looks like it’s really 

good. And but I hear your argument and I agree 

everything we looked at, everything I’ve ever 
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looked at has always been lognormal. You know, 

but Bob, yeah, I know you work with this too, 

please. 

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DR. ANIGSTEIN: Yes. We’ve found that this is 

not always the case and it’s not accurate. I 

just happen to recall one instance which was not 

dose distributions but Chi over Q’s for Y-12 the 

environmental exposure and that what happens is 

the actual data deviates from the lognormal at 

the upper end. So even though over perhaps the 

major portion of it yeah it looks lognormal, but 

if you’re trying to pick off -- if you’re doing 

actual nonparametric determination of the ninetyfifth percentile, I think we also found this at 

Bethlehem Steel. I’m just going by memory now, I 

can’t say the specific example, you find that the 

ninety-fifth percentile is significantly higher 

than the ninety-fifth percentile of the assumed 

lognormal distribution because those few points 

at the top devi -- you know, have a tendency to 

deviate upward. 

MR. HINNEFELD: Well, there may be -- 

DR. ANIGSTEIN: So, that’s the observation. 

MR. HINNEFELD: There are situations that I’m 

sure where that happens I think -- I think it was 
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(indiscernible) who published this collection of 

data that we’ve used since co-worker -- 

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DR. ANIGSTEIN: No, our -- 

MR. HINNEFELD: He indicated that -- that he 

tends to see the tail go down but I think -- it’s 

the question is shouldn’t you know, can we look 

at those datasets that we have and what is the 

difference between counting -- you know 

essentially counting the ninety-fifth percentile 

versus the straight line estimation? 

DR. ANIGSTEIN: Sometimes there have been 

significant differences. 

MR. HINNEFELD: Yeah. 

DR. ANIGSTEIN: And it would -- you know a 

suggestion, a possibility to resolve would be to 

simply use this nonparametric test where you 

actually go in and interpolate the actual data 

and get the ninety-fifth percentile and then it’s 

completely theory free, it’s free of any 

assumptions. This is the ninety-fifth percentile 

because it is the ninety-fifth percentile. 

MR. HINNEFELD: Well, I’m partly going to have to 

defer to Jim on the discussion but -- and we -- 

but we could -- I think it may be informative to 

look at the distributions we have and -- and do -
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- now Bob when you say nonparametric, you just 

mean just rank them, right? 

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DR. ANIGSTEIN: Right, you rank them and then you 

do and then there is the formula for 

interpolation you know if you -- if you happen to 

have one hundred data points or one thousand data 

points then it’s obvious the ninety-fifth or the 

nine hundred and sixtieth is your ninety-fifth 

percentile by definition and when it’s -- when 

you have some odd number as you normally would 

there -- there is just an interpolation method. 

MR. HINNEFELD: Sure, sure. Okay, I just wanted 

to make sure I understood exactly what that 

meant. 

DR. MAURO: The only time that doesn’t work well 

is when you only have four or five numbers. 

MR. HINNEFELD: Right. 

DR. MAURO: That it spread out pretty nicely but 

it gives you -- that’s -- that -- that’s not as -

- doesn’t give you the same warm feeling. 

MR. HINNEFELD: Right. Well I think we could go 

and with the same dataset I mentioned earlier, 

look at the nonparametric ninety-fifth percentile 

versus what would be generated based on the 

assumption that it’s lognormal and look at you 
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DR. MAURO: By the way just for my -- are we 

talking about air sampling data here? Is that 

what -- I -- I lost track or -- or are we talking 

about -- what is -- what are -- 

DR. ANIGSTEIN: I was just using the air sampling 

data as an example of things that I personally 

have gone in and done calculations on. 

DR. MAURO: The only -- 

DR. ANIGSTEIN: The same -- the same argument was 

made well it should be lognormal. 

DR. MAURO: The reason I ask is when you’re doing 

this and you say okay I want to pick some number 

as being claimant favorable, when talking air 

sampling data then you -- you have the confounded 

problem and usually like to work with the time 

weighted average data as opposed to -- as opposed 

to individual samples because individual samples 

could be really off the charts for a short period 

of time. 

DR. ANIGSTEIN: Sure. No, I was just using this 

as an example. 

DR. MAURO: Okay. 

DR. ANIGSTEIN: Of -- of a -- example of 

statistics of you know, statistic on databases 
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that I’ve looked at not -- I didn’t mean to apply 

this air sampling data. 

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DR. MAURO: Okay, let’s say that would be 

bioassay data, which is exactly what you want, 

okay. 

DR. ANIGSTEIN: Yeah. 

MS. MUNN: So, what did I hear with respect to 

OTIB 19-01? 

MR. HINNEFELD: Well, what I suggest is that we 

could compare the nonparametric and the 

assumption of lognormal parametric, ninety-fifth 

percentile to these various populations we have. 

I won’t have to do that, our statistician has to 

do it so I can willingly offer that we’ll do 

that. 

MR. ELLIOTT: We’d like to limit it to certain 

ones -- 

MR. HINNEFELD: Certain ones, maybe look for you 

know, Bethlehem Steel is one that Bob mentioned. 

DR. ANIGSTEIN: I think, again, going by memory I 

think the same thing applied to actual doses at 

Iowa, IAET. 

DR. MAURO: Is this almost like -- in this 

procedure, this is more of a generic procedure of 

how to deal with a co-worker model -- building 
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MR. HINNEFELD: Yes. 

DR. MAURO: So what I’m hearing is maybe the 

solution, one strategy would be okay, while the 

co-worker models -- while the dose 

reconstructor’s building his co-worker model, 

according to this protocol you would use, you 

know this fit and pick off the ninety-fifth 

percentile on the -- on the lognormally fit 

curve. Maybe there’s just another step in the 

process to the extent it’s possible to validate 

that assumption, rank order the data, see how 

they compare and if they compare well you know, 

or if it turns out the actual rank order gives 

you a higher value, at that point there’s -- 

there’s going to be some judgment. The -- 

depending on the dataset you’re looking at the 

dose reconstructor may say well listen, I -- 

these -- these numbers that are at the high end 

maybe really aren’t appropriate for whatever 

reason or maybe they are and if -- and if he 

judges there are it might be more appropriate to 

use the higher value of the two approaches. That 

would be one way to come at the problem which 

resolves the decision. 
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MR. ELLIOTT: So which way should we go here, 

Stu? We have two options here before us. 

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MR. HINNEFELD: I think -- well, I hate to offer 

a path forward without talking to Jim because -- 

but I think certainly some things we can do is 

compare parametric and nonparametric ninety-fifth 

percentiles on a selection of datasets that we 

have and then we can talk about okay, in those 

circumstances where the nonparametric is higher, 

what do we, you know, how do -- you know, it 

would certainly seem like if that were the 

situation there should be a step that okay, does 

that -- you know, should we use it then and not 

automatic -- you know, automatically you know a 

priori say that we will always adopt it but if it 

is higher then say okay, is there you know, some 

reason why that might be appropriate or not 

appropriate to use and should we make it a 

conscious decision whether to use it -- I mean 

that might be something that could be done. 

MR. ELLIOTT: I like John’s suggestion. I think 

melding the two together brings us to where we 

all want to be. We’re treating the issue and 

we’re being explicit in a technical information 

bulletin or technical places to document approach 
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in saying how we’ve handled the development of 

this data for its use and maybe that’s the way we 

should come out of this. We -- right, we should 

talk to Jim and get his input but I really 

appreciate your suggestion John, I think that’s 

helpful. 

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MS. BRACKETT: This is Liz Brackett, if I can 

make a comment on this. That -- that OTIB is not 

used by the individual dose reconstructor. It’s 

-- and in most cases we don’t use the ninetyfifth percentile. What is done is the data are 

evaluated by a few people to generate the numbers 

-- the intake rates for a site and the dose 

reconstructor simply takes the intake rates out 

of a subsequent OTIB and so I guess my question 

would be you know, how we would actually 

implement this if we came up with a different 

ninety-fifth percentile then would that mean we 

would change the GSD because what happens now is 

that the median is used to fit an intake and then 

that’s assigned as a lognormal distribution with 

the GSD determined from the fiftieth and eightyfourth percentile as the fit. 

MR. HINNEFELD: Well Liz I think that’s part of 

our discussion with Jim is what’s -- what’s the 
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possible outcome here because like I said we use 

-- we only use these to determine -- well GSD is 

the key element and so -- 

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MS. BRACKETT: Right. 

MR. HINNEFELD: But whether -- the question 

remains you know, if -- if the parametric 

approach that we’re using understates one or more 

of those higher you know, percentile numbers then 

the GSD would be understated as well. So I mean 

the question remains regardless of what’s used. 

DR. MAKHIJANI: Well it won’t be a GSD anymore 

you know, because then you’re -- 

MR. HINNEFELD: Because now you longer have a --

(multiple speakers) 

MR. HINNEFELD: You no longer have a 

distribution, that’s right. 

DR. MAKHIJANI: Liz is quite right; it’s a little 

bit more of a can of worms than what we can... 

MR. HINNEFELD: Yeah. 

MS. BRACKETT: And one other point though is that 

-- actually that specific GSD is not what’s used 

for the intake. What happens is the median or 

the means -- the -- the fit is done on the side 

of bioassay results but then those results are 

used to fit an intake and the fiftieth and 
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eighty-fourth percentiles are fit for the intakes 

and the GSD is actually the GS -- it’s -- it’s 

the ratio of the intake rates. It’s not based on 

the individual sets of bioassay data. 

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DR. ANIGSTEIN: Wouldn’t one solution be to 

simply not use a distribution for the intakes but 

just assign a fixed value corresponding to the 

ninety-fifth percentile? 

MS. BRACKETT: I’m not sure I understand what 

you’re saying. 

DR. ANIGSTEIN: Well in other words, instead of 

assigning a distribution, generating a 

distribution which is then used -- which is then 

used by the dose reconstructor, simply give the 

dose reconstructors a fixed value to use for the 

missed dose and put that into IREP. 

MS. BRACKETT: Why would you -- 

DR. ANIGSTEIN: A fixed value as opposed to a 

distribution. 

MS. BRACKETT: I don’t understand why that would 

be preferable for -- for -- for one thing most of 

these people that it’s being assigned to are less 

likely to have been exposed than the people who 

are monitored so we don’t want to assign the 

upper value. We’re looking for a reasonable 
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1 value to assume -- to assign to people. 

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DR. MAURO: As I understand it the distinction -- 

when -- when internal exposures are at play, 

we’re not talking external now, when I remember 

we’ve been through a discussion of this and SC&A 

was arguing the ninety-fifth percentile but I 

think NIOSH appropriately came back to us and 

said listen there are circumstances when the full 

distribution is the more appropriate value. So 

this is helpful because I wasn’t aware that was 

what we were really talking about that is. So 

what we’re really saying here is when -- when the 

dose reconstruction is being formed of an 

individual who was not monitored and there’s 

reason to believe there was good reason why he 

wasn’t monitored because he really wasn’t 

believed at that time to be a worker that would 

be expected to have an internal exposure. Under 

those circumstances the appropriate approach is 

to use the full distribution for the exposed 

people, not the ninety-fifth percentile and we 

fully agree with that. Now, so -- so that helps 

set the frame -- frame the problem. Now, given 

that, I guess the issue of the ninety-fifth 

percentile which is how we all started this, does 
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that have any play because I don’t even think 

that -- I mean that certainly has play if you 

were trying to pick off the ninety-fifth 

percentile. 

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MR. HINNEFELD: Right. 

DR. MAURO: Because you’re doing it for a person 

who you want to reconstruct his dose and he is a 

worker that should have been monitored but 

wasn’t. 

MR. HINNEFELD: Right. 

DR. MAURO: But now we’re in a different 

framework, this is a worker that wasn’t monitored 

and there’s evidence that there probably was good 

reason why he wasn’t monitored. 

MR. HINNEFELD: I think probably the decision was 

made that he would be -- he was not exposed and 

there are circumstances. 

DR. MAURO: Uh-huh. 

MR. HINNEFELD: And but other people were chosen 

that the site feels like they will -- 

DR. MAURO: Yes. 

MR. HINNEFELD: They are exposed and they have a 

routine monitoring program. I guess the position 

is that the monitor -- while the people who were 

selected as quote unmonitored and unexposed may 
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not truly have been unexposed, they were exposed 

more -- less than that same site decided who was 

exposed. 

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DR. MAURO: And that’s -- 

MR. HINNEFELD: And so -- 

DR. MAURO: And that’s been a recurring 

discussion that we’ve had and we understand where 

that stands. 

MR. HINNEFELD: Right. 

DR. MAURO: There was some argument of cohort 

monitoring went -- you know -- 

MR. HINNEFELD: Yeah. 

DR. MAURO: I don’t want to -- 

MR. ELLIOTT: Well it’s a global issue now too. 

DR. MAURO: Right. 

MR. ELLIOTT: It’s one on the list, unmonitored 

workers. 

DR. MAURO: No, where I’m going with is and 

correct me if I’m wrong, maybe this is a nonissue because if we’re only talking about the 

framework of application that is appropriately 

applied to workers who were not monitored and 

appropriately weren’t monitored but may have 

gotten some exposure but certainly not the upper 

ninety-fifth percentile and certainly not 
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exposures that would be attributed to people who 

were workers in the worker settings. Under those 

circumstances I know it’s NIOSH’s approach to 

assign the full distribution which would be very 

claimant favorable and I agree with that. Then 

once I get to that point I say why are we 

discussing ninety-fifth percentile? 

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MS. BRACKETT: You’re right, the ninety-fifth 

percentile as the OTIB currently stands the 

ninety-fifth percentile is not used for anything 

but fiftieth and eighty-fourth percentiles are 

what’s used to develop the intakes and having a 

different ninety-fifth percentile would not have 

any impact on the current -- 

DR. MAURO: That’s what I suspected, right, 

Arjun? 

DR. MAKHIJANI: Don’t you assign the ninety-fifth 

percentile in most cases where you know like, for 

instance at Rocky Flats uranium workers were not 

at all monitored in the 1950’s -- 

MR. HINNEFELD: I know. 

DR. MAKHIJANI: And but they should have been 

monitored -- what would -- what do you do in that 

circum -- don’t you assign the ninety-fifth 

percentile? 
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DR. MAKHIJANI: I thought you did. 

MR. ELLIOTT: In that set of circumstances, yes, 

we would -- 

DR. MAURO: Yes, that’s a different set of 

circumstances. 

DR. ZIEMER: Is that the worker who should have 

been monitored -- 

DR. MAURO: Yeah, right. 

MR. ELLIOTT: As a data gap. 

DR. MAURO: Right. But then -- then -- 

MR. HINNEFELD: But then you need that number. 

DR. MAURO: Applied. You see it’s only within 

that framework when we -- when we get to the 

point where we’re saying listen we have a person 

that wasn’t monitored but probably should have 

been monitored as the examples that we just 

talked about unless we get to the point where we 

agree, yeah, that’s true. Then the discussion 

applies. So I say it’s within that context. 

Now, if this -- if this OTIB was designed to 

address both issues you know, when you do it -- 

when you need a full distribution and when you do 

the ninety-fifth percentile then I think we’re 

getting back to then I think, you know, we’re 
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MR. HINNEFELD: I don’t think -- yeah I don’t 

think I kept this OTIB on my disk, I don’t think 

I have it here but -- 

DR. MAKHIJANI: Well it says here the purpose is 

to assign -- well let me just read what quotes or 

summarizes the purpose of the procedure from our 

review. This OTIB provides guidance for 

assigning internal doses in workers using 

coworker bioassay data for workers who do not 

have bioassay data where the possibility exists 

that the worker may have experienced internal 

exposures. So it’s pretty -- 

DR. MAURO: It’s pretty broad. 

DR. MAKHIJANI: I would say that it covers both -

- 

MR. ELLIOTT: But that’s your paraphrasing of 

what you see the purpose being of this OTIB. But 

we ought to look at the other -- 

MR. HINNEFELD: Yeah. 

DR. MAKHIJANI: I can download this. I can look 

it up. 

DR. MAURO: Well we -- I mean, I think we 

understand I mean it’s really a matter of what is 

the effect of the OTIB in the narrower use. Then 
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really this is a non-issue and goes away. If 

it’s for the broader application to capture not 

only the full distribution but also the upper 

ninety-fifth percentile for the broader 

application then yeah I think the discussion we 

just had is probably -- and the solution applies. 

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MR. HINNEFELD: Or -- or perhaps that the special 

question that we talked about like the Rocky 

Flats case is an exception that has to be dealt 

with in a site -- all -- every site has to have 

its own specific approach with its own specific 

dataset. And that’s -- this TIB is describing 

how to do you know, in general how to do the 

site’s dataset. If once you get to a site and 

say let’s use the Rocky Flats example where the 

decision was made these people were exposed, were 

heavily exposed, there’s this data gap and they 

should have been monitored but weren’t, that then 

departs you from your normal thinking and use of 

this. Now I don’t know how specific OTIB-19 is 

about that condition whether it’s a -- it 

probably doesn’t say specifically you know, only 

use this when the situation is as we expect to 

find it and when it turns out differently you 

have to go to something else. I don’t know if it 
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says that specifically but I think certainly 

that’s the way we behave is that you know, there 

are certain, you know, if there’s a site specific 

set of information that makes your assumption in 

that you use at other sites, if it makes it nonattainable at that site that means you have -- 

you have to do something different there which is 

what was done at Rocky. I think -- I think we’re 

-- we’re -- we’re spending a lot of conversation 

and a lot of time here on an issue that doesn’t 

really matter much. I mean we talked a little 

bit about parametric and non-parametric, we’ve 

talked about well, if you don’t use the 

parametric then when do you really have a GSD and 

so I don’t know that this is a real big hitter in 

the total -- in the outcome of things and the 

true test of whether data, you know, co-worker 

data is used appropriately would be in the 

individual site co-worker models which are their 

own TIB. I think that -- if we wanted to have 

this extent of discussion I think it would be in 

that circumstance, not here on -- on -- on the 

document that really doesn’t specifically drive 

any dose reconstruction. It -- it -- it -- it 

leads to the generation of other OTIBs. That’s 

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MS. MUNN: So what’s our real action item here? 

Is it to look at clarifying for the purpose of 

the matrix when the OTIB is used? Is that an 

action item? Or is the action item to actually 

compare a parametric and nonparametric ninetyfifth percentile -- tell me what this action item 

is? What will make everybody happy? 

MR. HINNEFELD: See our initial response -- our 

initial response way up at the top we said the 

information is intended -- it was very general 

guidance, not as a requirement. Each set of data 

has its own unique properties and those are taken 

into account as much as possible. So this is a 

general direction. And so the specifics have to 

be divined from the OTIBs that are site specific. 

And I think this can just probably just go away 

or be closed or whatever you want to say because 

I don’t know that any additional action needs to 

be taken at this -- on this document. 

DR. MAURO: The only scenario I want to protect 

against and I agree with what you’re saying but 

the only scenario is one in which you’re -- 

you’re in a position where you’re going to draw 

upon this general guidance. Okay, and the 
107

general -- but you’re in a circumstance -- now I 

don’t know whether you tell me if this 

circumstance could arise; if it can’t arise then 

it’s not a problem. Circumstance where I’m going 

to draw upon this guidance and -- and I’m going 

to use this method to predict the ninety-fifth 

percentile for a fixed value input into my -- for 

my dose reconstruction and then eventually for my 

IREP, and if the person were to derive the 

ninety-fifth percentile using the approach that’s 

here we run into this possible problem where you 

might be underestimating the ninety-fifth 

percentile. That’s the only circumstance that I 

think I’m concerned about might arise. Now if 

that circumstance cannot arise by the very nature 

of how this particular OTIB is being used then 

the problem goes away. But if that scenario that 

I just described can occur then I think something 

needs to be done regarding the possible disparity 

between the fitted value and the rank -- the rank 

values. 

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MR. HINNEFELD: Well I don’t know that, that 

situation’s arised when we have used it in that 

fashion but I don’t know that it could not arise. 

So, with an edit to OTIB-19 that would warn of 
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DR. MAURO: That probably would do it. 

MR. HINNEFELD: That would say this -- if -- you 

know, if you’re going to use, treat data in this 

way to identify a ninety-fifth percentile to use 

as a value you not only use the parametric but 

also comparative parametric -- 

DR. MAURO: Yeah, I think that’s the answer. 

MR. HINNEFELD: And at least if the parametric’s 

higher at least determine whether the nonparametric is the better one. Something like 

that. 

DR. MAURO: That certainly sounds like a 

suggested strategy that of course you want to 

discuss with Jim. 

MR. HINNEFELD: Yeah. 

MR. ELLIOTT: I think the action I hear is on us 

to take this discussion back and include Jim in a 

further examination of the issue now that we have 

a better understanding of where -- where this has 

led us. So, we’ll come back to you with what we 

think then. 

MS. MUNN: Possible page change? 

MR. ELLIOTT: Yeah, it could be a possible page 

change or revision to the current -- to -- 
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MS. MUNN: Okay. Report at our next workgroup 

meeting? 

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MR. ELLIOTT: Okay. 

MS. MUNN: All right, I think I’ve captured what 

I believe our action item’s going to be. OTIB 

25-01. 

MR. HINNEFELD: I believe this had to do with 

breathing rates on radon breath studies, is that 

correct? 

MS. MUNN: Yes, I believe so. 

MR. HINNEFELD: Okay. 

MS. MUNN: Page thirty-three. 

MR. HINNEFELD: Okay SC&A correctly pointed out 

that the one point two meters per minute is in 

fact a working breathing rate, it’s a combination 

of work and rest and that people who are giving 

radon breath samples certainly were at rest in 

the laboratory and they’d have to breathe aged 

air for awhile. So the exhalation rate or the 

inhalation rate in the formula for radium for the 

inhalation rate (indiscernible) rate. So the 

higher inhalation rate relate -- you know, 

results in a higher calculated radium burden. So 

but we certainly can change to there is an -- 

actually the ICRP does list the resting breathing 
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rate, I think it’s something less than a liter 

point five three -- we’ve listed it in our 

response. And we can use that anyway as -- as 

the -- as the breathing rate to do the radon 

calculations, that would be the outcome. I mean 

it’s certainly something we can do. We don’t use 

that -- we don’t do that many, you know, breath 

analysis, radium, dose reconstruction. 

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MS. MUNN: SC&A, do you have any problems that -- 

DR. MAURO: Well that’s -- that’s where we were 

concerned. It sounds like -- it sounds -- I 

don’t know this -- would this be in abeyance or 

would this be closed? 

MR. HINNEFELD: I guess it would be in abeyance 

because we have a page change to make on there 

too. Now anything done in the meantime we won’t 

go back and reconsider because -- 

MR. MARSCHKE: So you want to change it to the 

lower number? 

MR. HINNEFELD: Yes. 

DR. MAKHIJANI: Are we sure that all the radon 

breath samples were taken -- it wasn’t like an 

award rate or something like that? 

MR. HINNEFELD: Well if you would like us to, 

we’ll leave it the way it is. We’re just being 
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DR. MAKHIJANI: Well I -- you know, we -- we -- 

we -- we -- we want to be precise but we also 

don’t want to correct it in a way that erase -- 

I’m just anticipating -- 

MR. HINNEFELD: Well it occurred to me -- it 

occurred to me they’d say well look if we’re 

saying they’re at rest we have to defend the fact 

that they were at rest. And if we don’t say 

they’re at rest then we don’t have to defend it 

and we can say well they were breathing this hard 

when they took the test as well when they were 

working and so if anything we’re overestimating. 

DR. MAKHIJANI: Yeah, I think -- 

MR. HINNEFELD: I got no problem staying where it 

is either. 

DR. ZIEMER: I think we have to look at their 

procedure though. If they’re going to a lab 

they’re not coming right out of the workplace, 

they’re probably going to -- 

MR. HINNEFELD: Probably -- they probably -- 

MR. ELLIOTT: It’s not the lab going to them with 

a vacuum model. They’re going to the lab and 

doing it in the vacuum. 

DR. ZIEMER: And they’re going to breathe some 
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MR. HINNEFELD: Usually you have to -- bottled 

air, normally you have to breathe bottled air. 

DR. ZIEMER: And how long is the sampling period 

assigned? 

MR. HINNEFELD: I don’t know; I’d have to look. 

DR. MAKHIJANI: It’s a minute or two, it’s short. 

DR. ZIEMER: Yeah, short, it’s very short. 

DR. MAURO: So -- But that would be a lower 

breathing rate and therefore lower release rate, 

therefore if it’s -- you -- 

DR. MAKHIJANI: No, you -- a higher number? 

DR. MAURO: You get an underestimate, in other 

words if you’re -- 

DR. ZIEMER: So given outflow in the air -- 

DR. MAKHIJANI: You get the same amount of radon. 

DR. ZIEMER: Same amount of radon for a lesser 

volume. 

DR. MAURO: Oh, okay, okay. 

DR. ZIEMER: It makes the concentration look 

higher. 

DR. MAURO: Oh, I got you, I got you. 

MR. HINNEFELD: Well -- in the OTIB -- in the 

OTIB -- in the OTIB -- 

DR. ZIEMER: Well it’s kind of intuitive because 
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DR. MAURO: It’s less -- less air is coming out 

but the concentration -- 

DR. ZIEMER: For a given count. Right now you’re 

assuming -- if you don’t assume less than rate 

you’re assuming a higher volume of air associated 

with that given count. 

DR. MAURO: Right, right. 

DR. ZIEMER: Okay, now if you assume a lower 

volume of air with that given count then it looks 

like the concentrations are higher. 

DR. MAKHIJANI: Yeah, that can get the other way 

about from what you’re saying. 

DR. MAURO: Yeah, I mean that’s what I just 

heard. 

DR. ZIEMER: No, it -- it results in a higher -- 

DR. MAURO: Higher? 

MR. HINNEFELD: If the key -- if the key -- if 

the key factor is exhalation per unit. 

DR. ZIEMER: Higher body burden. 

MR. HINNEFELD: That’s what the key factor is. 

DR. MAURO: If you’re looking for -- oh, are you 

looking for atoms being -- 

MR. HINNEFELD: Exhalation per unit time. 

DR. MAURO: Exhalation per unit of time. 
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MR. HINNEFELD: I think is the indicator, isn’t 

it? 

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DR. MAURO: So if you’re -- 

MR. HINNEFELD: Anyway, look at -- look at the 

form -- the OTIB has the formula for radium 

burden and inhalation is in the numerator. 

DR. MAKHIJANI: Based on type of volume, right? 

DR. ZIEMER: Yeah. 

DR. MAURO: Inhalation’s in the numerator. 

MR. HINNEFELD: Inhalation -- 

DR. MAURO: Going with the higher inhalation. 

MR. HINNEFELD: Inhalation rate is in the 

numerator. 

DR. MAURO: All right this is -- 

MR. HINNEFELD: In the formula in the OTIB. 

DR. MAURO: This is one of those brain teasers; I 

have to say that. I’m trying to come up with -- 

DR. ZIEMER: You’ve come up with a concentration 

of radon in that exhaled air and then from that 

you go back to calculate particles. 

DR. MAURO: Therefore you are being claimant 

favorable. 

DR. ZIEMER: That’s right. 

MR. HINNEFELD: See, you know that’s right. 

DR. MAURO: All right, well that didn’t sink in 
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until just now unfortunately. I apologize. 

Yeah, it says that. 

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MR. MARSCHKE: We’ll reduce the estimate. 

DR. MAURO: Because, I think we can leave it 

alone. 

MR. HINNEFELD: Be glad to do that too. 

MR. ELLIOTT: I think you should look at it 

again. 

DR. MAKHIJANI: Yeah, I think we should do 

calculations. This real time mathematics is a 

little -- 

DR. ZIEMER: We had this discussion at the last 

meeting. 

DR. MAURO: We did it before and it didn’t sink 

in then either. 

MR. HINNEFELD: You have a measure -- you have a 

measured concentration and then how much air and 

then so the inhalation rate is how much air is 

coming out of a person who has that 

concentration. So a higher -- a higher 

exhalation/inhalation rate means that there’s 

more radon coming out of that person in a unit of 

time which means that there is more ra -- you 

know, radium giving off the radon in the body to 

be taking out in that unit of time. All right? 
116

DR. MAURO: I guess I was thinking about it a 

little differently. I thought the radon flux 

entering the lungs as sort of a constant and then 

the more you breathe that -- you’re saying -- 

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MR. HINNEFELD: I think the -- I think the 

presumption is that the radon is generated and 

available for exhalation at a constant rate that 

is directly related to the radium burden. 

DR. MAURO: I -- I had a different picture in my 

head. I’m picturing that you’re breathing -- 

MR. HINNEFELD: Breathing as you’re diluting it. 

DR. MAURO: Right, that’s it. But the radon is 

entering -- you know, certain weight -- 

DR. ZIEMER: Oh yeah, but the number of radon 

atoms is very small compared to the volume of air 

so it -- there’s more -- the radon’s available 

regardless of the breathing rate, it’s going to 

be exhaled. 

MR. HINNEFELD: Yeah. 

DR. ZIEMER: It’s not like you can -- you’re 

going to saturate the -- 

MR. HINNEFELD: The key -- the key factor 

actually in the numerator is actually -- 

DR. MAURO: I said the numerator is in the -- 

MR. HINNEFELD: Radon exhalation per unit of time 
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is actually -- so if you’re actually getting an 

exhalation per unit of time measurement, the 

breathing rate essentially goes away. 

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DR. MAURO: You base that on -- you base that on 

a concentration. That is you pull an air sample 

-- 

MR. HINNEFELD: Exhaled air, yeah, exhaled air. 

DR. MAURO: Yeah. You take an air sample and you 

figure out here’s a concentration of the radon 

becquerels per liter in the air I just took out 

of this person’s air. 

MR. HINNEFELD: Uh-huh, right, yeah. 

DR. MAURO: Now from that you back calculate how 

many atoms -- how many atoms per second are 

leaving and from there you go directly to the 

quantity of radium. 

DR. ZIEMER: Yeah. 

DR. MAURO: Now, now see I had in my mind a 

little different visualization on this thing. 

What you -- what you’d sample the atoms per cubic 

meter that you have in your sample that is going 

-- if you are breathing heavily, okay, you’re 

breathing heavily, that’s going to be different 

than if you were breathing lightly and the 

difference is going to be that the concentration 
118

is going to be lower when you’re breathing 

heavily. 

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DR. ZIEMER: Oh, you’re -- you’re -- yeah, you’re 

assuming that somehow the air is diluting -- 

DR. MAURO: Yeah, because the rate in which the 

radon is leaving, the breathing process that’s 

going into the lung and it’s unrelated to the 

breathing rate. 

DR. ZIEMER: Right. 

DR. MAURO: So if you double the breathing rate, 

the concentration of the atoms -- of the radon in 

the air is going to be lower because you’re 

breathing -- it’s sort of like -- 

DR. ZIEMER: Yeah, it’s going to look like you’re 

going to have a lower body burden. 

DR. MAURO: Yeah, so I have -- see I’m looking at 

it -- I’m not -- I don’t know, I don’t know. So 

I learn this stuff before the equation. 

MR. HINNEFELD: Based on time. 

DR. ZIEMER: I don’t think the breath rate is 

driving the radon out, it’s -- it’s diffusing out 

-- 

DR. MAURO: So -- 

MR. HINNEFELD: Right, the presumption in the -- 

in the presumption in the formula is that the 
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given amount of radium in the body results in a 

certain amount of radon exhalation per unit of 

time. 

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DR. MAURO: Right. 

MR. HINNEFELD: I mean that’s the presumption in 

the formula that was used in this procedure. 

DR. MAURO: Right. And that -- and embedded in 

that is the -- right, but their breathing rate is 

not in -- 

MR. HINNEFELD: Well the breathing rate is only 

in the equation because if you measure 

concentration and exhalation -- 

DR. MAURO: Because you measure concentration. 

MR. HINNEFELD: -- then you have to use the 

breathing rate in order to get the radon exhaled 

per unit of time. 

DR. MAURO: I feel as if we’re arguing about 

stuff that’s of marginal importance, but -- 

MR. HINNEFELD: We hardly ever use it anyway. 

There are only -- there are only a couple of 

sites where we would have the opportunity to use 

this. 

MR. ELLIOTT: Well convince yourself; I think 

this is favorable with the human resting rate. 

MR. MARSCHKE: Well (multiple speakers) equation 
120

of the body burden the concentration in the air 

times the breathing rate. 

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DR. MAURO: Right. 

MR. MARSCHKE: Divided by -- 

DR. MAURO: Yeah, see that’s the place I’m having 

the problem with, see. 

MS. MUNN: All right, I have an action item that 

SC&A is going to look at the equation again and 

the NIOSH response and satisfy themselves that 

that response is what they anticipate it to be. 

MR. HINNEFELD: Well actually what we would like 

to do is just change our response and say we 

aren’t going to change the document, leave the 

document the way it is; actually. I mean 

realistically you have to defend -- if you’re 

going to say they were at rest and therefore 

they’re going to give them a lower body burden of 

radium then you have to defend the fact they were 

really at rest all the time that they gave. I 

think they probably were. I think they probably 

were but I -- you gotta defend that they were at 

rest. 

MS. MUNN: Right, so I’m -- I’m saying any 

comments back from SC&A -– 

(multiple speakers) 
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DR. MAURO: I’m sorry. 

MR. HINNEFELD: You’re working it out right now. 

DR. MAURO: We’ll -- we’ll -- we’ll look at this 

right now -- 

MS. MUNN: Any comments back from SC&A by the 

next working group, otherwise this item is 

closed. 

DR. MAURO: Exactly. 

MS. MUNN: All right. 

DR. MAURO: That’s a fair -- 

MS. MUNN: Very good. 

13 SC&A AND NIOSH – OTIB-0012 WHITE PAPER

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Next item. Thank you Stu for the responses by 

the way. SC&A and NIOSH OTIB-12 white paper. 

MR. HINNEFELD: Yes. 

MS. MUNN: You were going to look at that, talk 

about it and give us what information we need to 

put the right words on the matrix. 

MR. HINNEFELD: Well we’re -- we have looked at 

it, we’re continuing to look at it and I did 

speak to Bob Anigstein about it, he actually 

called me so he took the onus on himself to make 

sure we talked. I think there are some good 

points raised in that OTIB 12 white paper and 
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we’re now evaluating you know, what’s impacts, 

possible impacts, outcomes, things like that. So 

we don’t really have a response to the white 

paper ready yet. 

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MS. MUNN: All right so the action item is NIOSH 

continue review and report to next workgroup. 

MR. HINNEFELD: Yeah, now while we’re talking 

about mechanics of getting it on the matrix, I 

guess it will stay where it is. It came out as 

an OTIB12 finding in a particular review, you 

know, OTIB12, so we can just put it on that. I 

mean it didn’t actually come out in the SC&A 

product. OTIB12 became a white paper which leads 

to that. 

DR. MAURO: But it’s here now. Right, later on -

- it emerged from one of the workgroup meetings I 

believe. 

MR. HINNEFELD: Yeah, yeah. So in this case -- 

right. 

DR. MAURO: The system is to track it. 

MR. HINNEFELD: This white paper -- this white 

paper would have to be one of those other 

documents we’d link into. 

DR. MAURO: Right and we have to reference it in 

the minutes -- that there was a white paper. 
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DR. MAURO: And in theory if we can actually 

click on that that will be great. 

MR. HINNEFELD: And link it in, yeah. 

MS. MUNN: Uh-huh. 

MR. HINNEFELD: Okay. 

MS. MUNN: Okay, so we’ll have a NIOSH response 

by the next workgroup meeting? 

MR. HINNEFELD: I would think so. Our guy who’s 

working on it is also working on Hanford and so 

his time is kind of split up but I think I’ll 

have something by then. 

MS. MUNN: All right. Since we don’t have a date 

set up yet we can treat this -- 

DR. BRANCHE: Yes -- yes you do. 

MR. HINNEFELD: We’re meeting -- I thought we 

were meeting in Las Vegas. 

DR. BRANCHE: We’re meeting -- I thought we were 

meeting in Las -- in Las Vegas. 

MS. MUNN: Yeah, we are meeting in Las Vegas but 

that -- but that’s going to be -- when I -- I’m 

sorry, when I’m thinking the next workgroup 

meeting I’m -- 

DR. BRANCHE: You mean after the next Board 

meeting. 
124

MS. MUNN: I was thinking after the next Board 

meeting because I’m not sure if -- if we can -- 

if any of these things we can have ready for the 

-- the meeting that we have before the Las Vegas 

meeting that’s great but realistically speaking 

and knowing that the holidays are upon us I don’t 

want to overburden -- 

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MR. ELLIOTT: We can definitely have it for the 

following -- the meeting following that. 

MR. HINNEFELD: Oh certainly we can have 

following January. 

MR. ELLIOTT: Whatever we can get we’ll try to 

present. 

DR. BRANCHE: There’s a February 20th conference 

call, that’s the next Board meeting. 

MS. MUNN: Yeah and the Board meeting, and we 

probably will anticipate prior to that time 

having another of these meetings. 

All right, that clears our deck for the before 

lunch issues and we are a half hour early but the 

other good news is -- and I don’t want to start 

PROC92 before lunch, we don’t want to do that. 

So let’s go ahead and take an early lunch break, 

and the other good news is one of the agenda 

items that we had for this afternoon was one that 
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I interpreted as being a separate item from the 

OTIB17 issue that we dealt with just this morning 

and -- 

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DR. BRANCHE: So it’s not a separate issue? 

MS. MUNN: It is the same issue. 06 was -- 07 

was not what we were addressing, we were actually 

addressing 06 and I did not know that until after 

I had -- was doing my review yesterday. So we 

may have -- 

MR. ELLIOTT: Got that one all done? 

MS. MUNN: Yes, we have that one done, we may -- 

DR. BRANCHE: Early Christmas. 

MS. MUNN: Yeah, Merry Christmas. 

MR. ELLIOTT: That chair is so proficient. 

MS. MUNN: Makes every effort, in terms of -- we 

do the best we can, unfortunately we hired a 

handicap. I am expecting that we will be back 

here in one hour. We can let our people on the 

telephone go eat as well. We’ll be back here at 

one o’clock. 

(Lunch break, 12:00 noon until 1:08 p.m.) 

DR. BRANCHE: Michael Gibson, are you on the 

line? This is Christine Branche, Michael Gibson 

are you on the line? 

(no response) 
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DR. BRANCHE: But Mr. Presley -- Mr. Presley is 

here. 

MS. MUNN: Yeah, we have Bob Presley -- 

DR. BRANCHE: And Paul Ziemer. 

MS. MUNN: -- and Paul Ziemer and myself from the 

Board and we’re ready to proceed with our 

afternoon agenda. 

9 NIOSH – RESPONSES TO PROC-0092 MATRIX ISSUES

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We’re going to open with our PROC0092, with 

status and the response to the white paper. We 

all are aware of the importance of this 

particular procedure and are looking forward to 

moving through the issues. Stu Hinnefeld, would 

you please present NIOSH’s responses to the 

matrix issue and give us an opportunity to 

discuss with SC&A what their reaction to those 

findings are. 

MR. ELLIOTT: Could I speak first while Stu’s 

collecting his thoughts here, making sure he’s 

got the right page where -- I would just like as 

a prelude to this I think we should make note for 

the working group and for the record that there 

was a technical conversation held with John 

Mauro, Arjun, Stu and myself and John was so kind 
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to put together a set of minutes about that 

conversation. I think they’ve all been shared 

with you on the working group; is that correct? 

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MS. MUNN: I believe so. 

MR. ELLIOTT: So I thought it was a very 

productive conversation that we had and -- and -- 

I think what Stu and SC&A’s reaction to what 

we’re going to talk about here I think our -- is 

the product of that conversation. I’ll just 

leave it at that. 

MR. HINNEFELD: Yeah, I think one of the -- one 

of the elements we did start with I think I 

should mention for others who are -- for the 

workgroup and others who are listening is that 

when we send the draft dose reconstruction to the 

claimant and we have a closing interview with the 

claimant we do have a certain time frame that we 

want to finish up that process and get a final 

dose reconstruction -- get an OCAS1 back from the 

claimant and finish and send a final dose 

reconstruction. So we’ve got a certain time 

frame. We have a sixty day time period where we 

try to get that OCAS1 back and if someone for 

some reason never sends us an OCAS1 we have a 

process called Administrative Closure where we 
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can at least be done with that claim, it doesn’t 

sit there undone forever. But Administrative 

Closure is not done forever. For instance if 

someone is administratively closed and later 

provides additional information and alters the 

dose reconstruction the claim can be re-opened, 

you know, revised if needed and we can pursue the 

OCAS1 process again. I’m not sure that quite 

came across, I’m not sure it was understood by 

the SC&A authors that, that was the -- that the 

Administrative Closure is not really done, you’re 

done forever. It’s administrative process so the 

case looks to us as if it’s done. But if more 

information comes in then it is re-opened. And 

the sixty day time window is not hard and fast, I 

mean if the claimant tells us I’m gathering 

information, I’m going to provide you 

information, then we don’t close the claim, we 

keep it open and wait for that information. If 

they keep telling us that and keep telling us and 

never provide us with anything then ultimately we 

will administratively close it. 

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MR. ELLIOTT: You have a grace period also. 

MR. HINNEFELD: There’s a two week grace period 

following the sixty days. So once the sixty days 
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is up they are -- the claimant is notified and -- 

in writing, again the letter that says we’re 

going to close it in two weeks unless we hear 

from you and get additional information. So 

there is a follow up -- there’s a warning at 

sixty days and then a two week grace period 

after. 

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DR. MAKHIJANI: That piece we were not aware of. 

It was not with procedure. 

MR. HINNEFELD: Yeah, right. 

DR. MAKHIJANI: We had some communication lapses. 

MR. HINNEFELD: We’ve had -- we’ve had -- we’ve 

talked -- we’ve talked since the report came out 

and we’ve talked about that. So that’s one thing 

I think to keep in mind when we talk about the 

Administrative Closure part of this and I guess 

in summary the report describes three observed 

interviews from about a year ago, about October 

2006; is that correct? 

DR. MAKHIJANI: Yes. 

MR. HINNEFELD: Yeah, October 2006. And then a 

description of another questionable execution of 

closing interviews from discussions that have 

occurred during another PROC. So of the three 

observed -- from the three observed interviews 
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there clearly was a serious issue with one of the 

issues and the follow-up issues -- the follow-up 

interview associated with this, it was fairly a 

serious issue, that we are working with ORAU to 

say you know, we need to fix things so things 

like this don’t happen. So, that’s -- that’s -- 

I want to tenor -- I want to give our response 

that way, kind of give that as the -- as the 

flavor for our response. The words on the 

response to findings, the NIOSH response to 

findings was prepared relatively early on, you 

know, we promised we would have it out by the 

middle of November and so it was prepared 

relatively early on and perhaps and after doing 

that and looking about at the papers some more we 

told ORAU, listen, all these recommendations, 

there are quite a number of recommendations for 

improvement in the SC&A report, I want a -- we 

want an answer on every one of those 

recommendations that either we’re going to 

implement them or that we can’t implement them 

because it’s not feasible or we don’t think it 

would be helpful or maybe we can’t do that but we 

can do something similar. So we’ve also had 

that. That product we’re getting in final form, 

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you know, we have received those -- that product, 

response to recommendations. We haven’t -- I 

haven’t sent it to the Board but we will as part 

of our response to this report. 

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MR. ELLIOTT: That’s ORAU’s perspective, it’ll be 

our -- we’ll sign off on it as -- 

MR. HINNEFELD: When it gets to say what we want 

it to say. 

MR. ELLIOTT: Yeah. 

MR. HINNEFELD: I think -- yeah. 

MR. ELLIOTT: It’ll be a NIOSH reaction. 

MR. HINNEFELD: Right. Yeah, Paul? 

DR. ZIEMER: Well aside from these particular 

findings it seems like we continue to hear what I 

would characterize as misunderstandings by the 

claimants as to what this actually is to begin 

with. I don’t know how widespread that is or if 

we’ve just heard a few and maybe they’re the only 

ones that have this problem or if they reflect a 

widespread view that somehow they’re giving up 

some kind of rights if they sign this thing. 

Like well I’m not sure I agree with the dose 

reconstructions so therefore I won’t sign it or I 

don’t know if there’s more information, therefore 

I won’t. It appears that the claimants often 
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simply misunderstand, I don’t know what can be 

done to alleviate that. Maybe some of these 

things will help with that, but is that a 

widespread misunderstanding or just a few people 

that we’ve heard from in the public comment 

period? 

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MR. HINNEFELD: Well it’s -- it’s hard to say 

definitively. You know, I don’t know if we have 

any way of gathering effective data on that. 

DR. ZIEMER: I mean most people sign that so 

maybe that’s -- it’s not a widespread. 

MR. HINNEFELD: I think that it would be 

surprising if everyone who had some objection 

with that actually spoke to you so there’s 

probably more than the specific people that 

talked to you. But I don’t know that it’s 

widespread, you know there have been I don’t even 

know how many closeout interviews we’ve done. 

We’ve done over twenty thousand -- 

DR. ZIEMER: Thousands and thousands. 

MR. HINNEFELD: -- dose reconstructions and each 

of those -- many of those have multiple claimants 

and so multiple -- 

MR. ELLIOTT: Each claimant gets a closeout 

interview. 
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MR. HINNEFELD: Each claimant gets a close 

interview so tens of thousands of these 

interviews have been done and there -- a handful 

of people have been unhappy enough with the 

process that they’ve actually sent us a message 

protesting that this wasn’t done very well. But 

that’s a very small number that’s done that. But 

that’s not to say that’s all who are upset. You 

know, just because somebody wasn’t happy doesn’t 

mean they necessarily send a message to us and 

say boy, I didn’t like this. So, it’s just a 

little hard to get a measure of the extent of the 

issue. I don’t believe it’s rampant, but I think 

as you say you hear enough things that you would 

conclude that it may be as you know, an issue 

that’s out there. 

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DR. ZIEMER: You almost only hear from those 

folks for whom it’s a problem. 

MR. HINNEFELD: Yeah and -- and another thing to 

remember is that as many parts of the dose 

reconstruction program we feel we’ve gotten 

better as time is moving on and I think that 

additional emphasis on this -- on the matter has 

improved over time. Now probably within the past 

year since the observation there’s been some 
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improvements and this is not something that you 

necessarily write down every time or we don’t 

have a complete record of all the instructions 

that are given to the interviewers because I mean 

they’d meet in staff meetings like everybody else 

has staff meetings and these things are discussed 

in that context and so you don’t necessarily have 

a record of all the process changes or all the 

admonitions that were provided to them. So it’s 

a little hard to say other than to -- other than 

to say that certainly the people interviewing, 

the managers of the interviewers and the project 

managers for ORAU all are -- are very keenly 

interested in making sure that interviews with 

the claimants are a good experience, as good of 

an experience as it can be for the claimant. I 

mean this is not -- this whole program is not 

particularly an easy process for the claimants 

and so it’s -- there’s a lot of empathy on their 

-- on their parts and a lot of feeling on the 

parts of the project interviewers that this is 

you know, something that we want to do well in 

the eyes of the claimants. Complicating these 

interviews is the fact that dose reconstruction 

isn’t really terribly well understood. It’s -- 

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it’s hard to imagine explaining enough in a 

conversation of you know, about a dose 

reconstruction to a layman to provide a real 

thorough level of understanding of what was done, 

which is not to say you shouldn’t try to explain 

and answer the questions but I just think it’s 

almost inevitable that at some point you just hit 

an impasse when you can’t -- you just can’t 

explain it anymore, you don’t know how to explain 

it anymore. So there’s some of that gets wrapped 

up in here too, it’s the difficulty of the 

process for the lay public to understand. So 

some of that I’m sure is wrapped up in it as 

well. 

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MR. ELLIOTT: We try to very carefully explain 

that signing the OCAS1 is not an indication that 

they agree or disagree with the dose 

reconstruction but they have come to a conclusion 

in the process where they have no further 

information to provide and there’s this 

disclaimer at the bottom of that form. One 

measure of a level of dissatisfaction might be 

annotated OCAS1’s. When we get an annotated 

OCAS1, and by this I mean they come back to us 

and they say I disagree with the dose 
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reconstruction, it’s all junk and you guys don’t 

know what you’re doing and they put some kind of 

commentary on it, then that defaults the -- the 

form itself and we have to go back to the person 

and say we can’t accept this OCAS1 as submitted, 

we explain again what the purpose of the document 

is and that might be one measure of the level of 

dissatisfaction. But again, you’re only going to 

get a segment of the audience. 

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DR. ZIEMER: But you’re not getting large numbers 

of those compared to -- I mean out of twenty 

thousand or so dose reconstructions you probably 

have what, less than a tenth of a percent? 

MR. ELLIOTT: Yeah. Well I talk to you at the 

Board meetings in my program report about the 

number of administrative closed cases and that’s 

you know, it’s hundreds, it’s not thousands, it’s 

a few hundred. I don’t know exactly what it is 

right now but I -- so that’s another measure of 

where we -- 

DR. ZIEMER: Right. 

MR. ELLIOTT: That measures where we’ve taken 

every attempt we could to get the person to sign 

the OCAS1 and move the claim forward even to the 

point of telling them if you don’t do this you 
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don’t have an opportunity to appeal. We -- we 

talk to them about their appeal opportunity 

coming at DOL when their recommended decision is 

offered and you can’t get there without giving 

this form up. So, yeah, we hear what we hear and 

it’s hard to put it into a full context of you 

know, is this widespread, is it perverse? I 

think one thing that I would say you know in -- 

in all of this I consistently hear things like 

well, they never said anything in the dose 

reconstruction report about X Y and Z that I told 

them about. And we’re -- we’re trying to do a 

better job at that, we’re trying to make sure 

that there is something in these reports that 

speak to the fact that the claimant raised X up, 

raised Y up and here’s -- here’s the -- here’s 

the way it’s handled. 

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DR. ZIEMER: The way it’s handled or why it’s -- 

MR. ELLIOTT: It may mean nothing to the dose 

reconstruction report but we have to say that. 

And I’d be the first to admit that we, you know, 

we have not done that in all the claims and all 

dose reconstructions over the course of this 

program. 

Another thing we talked about with John and Arjun 
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in our technical conversation was I proposed that 

in these kinds of reviews where they’re looking 

at a snapshot of a procedure in time it might be 

helpful for them to come at the program level 

folks and say to us we have a list of questions, 

we want to know the background, we want to know 

the history, what’s the purpose of this 

procedure, how’s it changed over time. And I 

think they would have benefited especially in 

this example from having that kind of discourse. 

And so I hope we can -- you know, we can -- the 

horse is out of the barn on this one right now 

but in the future I -- you know, I think John is 

amenable to that; maybe we can make that happen. 

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MS. MUNN: We seem to have dropped -- 

DR. MAURO: We discussed the possibility of just 

as -– 

(telephonic interruption) 

DR. BRANCHE: Hi, this is Christine Branche, we 

had dialed in earlier and then when we thought we 

were unmuting apparently we lost folks on the 

line. Is Michael Gibson on the line? 

MR. GIBSON: Yeah, Christine, I’m here. 

DR. BRANCHE: Thank you. So sorry, Ms. Munn. 

MS. MUNN: Yes we’re -- we’re twenty minutes into 
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a discussion on PROC92 and very sorry that we 

apparently cut you off. At the moment Larry 

Elliott is -- is expanding a bit on a great deal 

of the interaction that’s gone on between SC&A 

and NIOSH over the last couple of months with 

respect to this particular procedure and whether 

we can or cannot improve upon it. Larry, 

continue? 

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MR. ELLIOTT: Well I think I was done and John 

was going to react but I can -- I can reiterate 

if you wish me to, I don’t know if it’s 

necessary. We have a record. 

MS. MUNN: Not more than just -- no, a couple of 

sentences where we are and John then. 

MR. ELLIOTT: Okay, a couple of sentences of 

where we are. I think I was remarking upon ways 

to measure dissatisfaction from this -- this 

particular procedure and process. I pointed out 

that we can look at the number of annotated 

OCAS1’s as one measure, we could look at the 

number of administratively closed claims as 

another measure; however, I don’t believe that 

that gave us a full picture of whether or not 

there’s a pervasive problem here, a trend if you 

will, of dissatisfaction broadly disbursed across 
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the claim population. I offered that there were 

in our discussions, in the technical conversation 

that we had I suggested that this review might 

have benefited from an interaction with the 

program folks who have been instrumental in 

developing this -- this part of this procedure 

and this process and talking about how it’s 

evolved over time with for example the fourteen 

grace -- day grace period would come out in that 

conversation I’m sure and might have led to a 

different conclusion. But at any rate, those 

were the -- in a capsulized form that’s kind of 

where I was speaking from. 

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MS. MUNN: Thank you and John Mauro was ready to 

respond. 

DR. MAURO: Yes, I -- we use that process namely 

on the site profile review. That is once we get 

through our first review by the team we usually 

write down a list of questions that we’d like to 

discuss with the authors of the site profiles and 

this is very helpful because it helps to clarify, 

make sure we have a complete understanding of the 

site profile. I think the -- I think the task 

three procedure reviews would also benefit from 

that step in the process. Now -- now, unlike -- 
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but the procedure reviews, bear in mind there are 

a lot of them. Many of them are very, very 

specific technically but in this particular case 

though I think that this had -- this had a 

broader -- there were a lot of nuances to this 

and this procedure is run and it sounds like if 

we would have spoken to you about it beforehand 

and say listen, our understanding is this is how 

it works, is that understanding correct and 

complete and your answer obviously would have 

been no, there’s more to the story here. And I 

think we would have really benefited in this case 

from that conversation. I think for -- we SC&A 

would propose that in the -- in the -- in the 

future on these procedure reviews that we do 

engage in some degree of dialogue with NIOSH 

before we publish on our web -- findings. 

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MS. MUNN: That would seem to be reasonable. Any 

other comments with this -- with respect to where 

we are and what’s to be done here? 

MR. ELLIOTT: I think those serve as our general 

comments and maybe Stu could go in and there were 

five findings here that we probably ought to 

speak to here. 

DR. MAKHIJANI: Could I say one thing in regard 
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to Larry’s remarks about the explanations in the 

dose reconstruction about what the claimant had 

said. In both -- in both the cases where there 

were difficulties in -- in this close out 

interview they both related to that particular 

problem. It may not have changed the dose 

reconstruction any but claimant in one case, the 

observed interview that claimant provided some 

very specific technical information then that 

didn’t get back to the dose reconstructor to 

reaffirm, sign off that yeah we looked at this 

again and it doesn’t make a difference or we made 

X adjustment. And the second case there was an 

incident and there was no notation at all about 

that and I think on both cases that was -- that 

was the heart of the problem from -- from the 

point of view of the reviewer. 

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MR. HINNEFELD: Yeah. 

DR. MAKHIJANI: And so I think we have an 

agreement -- no, I think we -- we have an 

agreement about that. 

MR. HINNEFELD: Yeah. Okay this is, well, I’ll 

start down through the list of findings then. 

MS. KIMPAN: Stu? 

MR. HINNEFELD: Yes. 
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MS. KIMPAN: This, I just wanted you to know this 

is Kate Kimpan with the ORAU team with -- I’m 

online as well. 

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MR. HINNEFELD: Okay, thanks Kate. The -- 

MR. ELLIOTT: We ought to ask Kate if she has 

anything to offer. 

MR. HINNEFELD: Well, she didn’t hear our -- she 

didn’t hear our earlier discussion because we 

weren’t on the phone, so. Kate, at any time you 

feel like you want to chip some -- you know, add 

something to what I’ve said here please -- please 

jump right in. 

MS. KIMPAN: Thanks so much, feel free to direct 

anything that you’d like me to respond to this 

way as well. 

MR. HINNEFELD: Okay. The first finding was 

written that the closeout interview procedure 

does not ensure that the claim concerns are fully 

addressed and then it gives five, essentially 

supporting items under that. The procedure lacks 

specificity about when concerns are referred to 

the HP -- referred to HP reviewer or dose 

reconstructor, underlying data relating to 

claimant concerns was not examined in two cases, 

those were the two cases that we’ve been talking 
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about. Variable documentation of closeout 

interview process meaning that sometimes the 

interview -- closeout interview has a fairly 

extensive record of what was said and other times 

it doesn’t. Substantive claimant information not 

addressed by dose reconstructor, again relating 

to the two cases that we were talking about. And 

HP reviewers lacked health physics qualification 

and dose reconstruction experience. So starting 

down these I guess in order I think the first 

one, the first supporting I’m hear about the 

procedure lacking specificity is a good -- is a 

good point. That’s listed also I think as one of 

the recommendations, if I can toggle back and 

forth between documents here. The -- yeah, one 

of the recommendations is that the procedure 

should include instructions to the HP reviewers, 

should make detailed notes, I’m sorry, detailed 

notes. Anyway this -- the finding though relates 

to some specificity in the procedure about when 

to get the dose reconstructor involved based on 

what the claimant has said and we think that’s 

worthwhile and we intend to do that based upon 

having some years of history now with what you 

hear in closeout interview, we should be able to 

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have enough sufficient information to know that 

these are the kinds of things you hear and in 

these situations the dose reconstructor needs to 

be consulted. So that doesn’t seem like that, so 

yeah, we agree. Our -- our -- our purpose here 

is -- is to whatever we can do to improve the 

interview process we want to do that and you 

know, I can talk some specifics about these two 

claims if anybody’s interested, but I think what 

we really want to work on is what can we do to 

improve the interview process and make sure that 

things like that and so that we don’t have these 

situations. 

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DR. MAURO: Along these lines my -- my 

understanding is that when the dose 

reconstruction report does come out and it’s 

given to the claimant, a lot of the granularity 

of this process is not captured. A thought that 

I had, since that ultimately becomes the document 

that informs them of whether they’re going to 

grant it or not, the degree to which that 

document captures some of the bedside activity 

whether it be certainly the CATI is there but the 

degree to which let’s say some of the dialogue 

captured during closeout, a follow-up was done, 
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perhaps even when we do refer certain issues to 

the -- I realize that a lot of that information 

doesn’t really go toward the end -- end product, 

which is your probability of causation because in 

the end it doesn’t rise to the level of having to 

redo the analysis. But the degree to which these 

kinds of interactions are captured so that the 

claimant would be apprised that yes we’ve taken 

your commentaries very seriously, these are the 

kinds of things we did by way of actions taken in 

light of the information you either provided as a 

result of the CATI or provided -- because you do, 

do that with the CATI in some circumstances but 

that’s another subject. But now we’re talking 

about the closeout process which might trigger 

some follow-up investigations. The degree to 

which that’s done I would say that’s another 

place where I think having a documentation in a 

product might give the claimant the sense of yes, 

they’re really paying close attention to some of 

the things I expressed my concerns about. 

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MR. HINNEFELD: I think that’s a good point and I 

think maybe as we proceed with our procedure 

change and process modifications that we’re 

committing to here I think we can see what we can 
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do about that but you’re exactly right, any -- 

any of these communications with people, the more 

that you can demonstrate to them that we heard 

what you told us, the better the product that we 

receive by this. I think that’s a pretty good 

point. 

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Let’s see, I think I talked about subpart number 

one, subpart number two is underlying data 

relating to claimant concerns not examined in two 

cases reviewed by SC&A. Again these are specific 

to two cases. I think the -- the point here is 

that getting sufficient -- sufficient information 

into the -- into the procedure and instruction to 

the interviewers and reviewers such that to 

ensure that the appropriate levels of information 

are referred back to dose reconstructor. I think 

certainly in the one case had the dose 

reconstructor been told hey there’s this other in 

vivo result in the DOL initial case file that 

would have been addressed and may not have 

changed the dose reconstruction. But the dose 

reconstructor was upholding I didn’t know about 

this one, let me see how that -- if that affects 

anything. I think certainly that would have 

happened and so I think we can solve this issue 
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by having sufficient direction about when do you 

need to get the dose reconstructors involved in 

the -- in these issues. 

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Variable documentation on closeout interview 

process, again, is something that we feel like we 

intend to work on and improve the direction to 

interviewers and reviewers to make sure that 

there’s a more consistent degree of documentation 

of that. Substantive claimant information not 

addressed by dose reconstructor, I think that 

falls in with number two and what we’re trying to 

accomplish in making sure that dose 

reconstructors see that information and address 

it. And -- and then there’s a comment on HP 

reviewers aren’t really HP’s and so that’s well 

taken and we think maybe a different name for 

that -- that operation or that title or that 

position may be appropriate. So, I think that 

would be -- essentially we feel like there’s good 

stuff here, we intend to proceed in good faith 

and try to accomplish some things that will 

remediate these -- these issues. 

DR. MAURO: During the interview, closeout 

interview, to what degree does the HP reviewer 

explain that that you know, he’s -- he’s really 
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there to obtain information to -- regarding the 

completeness of the process, that is -- that is 

receiving all this information. Does the -- does 

the -- does the claimant understand that the 

person that they are talking to really does not -

- did not do their dose reconstruction and is not 

necessarily an expert on the dose reconstruction 

process, but is a bridge to the expertise? 

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MR. HINNEFELD: I’m not real sure how -- how much 

they disclose about that. Kate, can you weigh in 

on that? 

MS. KIMPAN: Yes. The -- the -– at least loosely 

and I can get an extremely specific answer. John 

I do think it’s clear to claimants in most cases 

that they’re talking about their DR report but 

that this is part of the closeout interview 

process. Folks who are asked for their -- their 

any input or comments if they’re satisfied with 

the explanation, I realize that we’ve been 

calling these folks a thing with health physics 

in the title and as Stu said, we’ll change that 

but I -- I -- I do think it is clear John made 

clear to claimants that these are not the dose 

reconstructors, certainly not the ones that did 

their case on the telephone. It’s made clear 
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that if there is salient information that a dose 

reconstructor will review that, that will occur 

as well. 

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MR. HINNEFELD: I think that took us through 

finding number one then. 

MS. MUNN: So am I -- am I hearing that there is 

some thinking going on already with respect to 

terminology regarding what we commonly call HP 

reviewer up to this point? 

MR. HINNEFELD: Yes. 

MS. MUNN: We’re -- we’re changing that. Any 

suggestions so far as to what change that might 

be? 

DR. ZIEMER: Well you need a generic title, 

something like technical reviewer or something 

like that that doesn’t imply a -- and I’m not 

sure that’s the right word but something that 

shows that there is a -- that they are reviewing 

it for some -- 

MR. HINNEFELD: Right. 

DR. ZIEMER: -- issues. What -- what do they -- 

what do these reviewers specifically look at? 

MS. KIMPAN: Well, we’ve contemplated -- this is 

Kate -- Larry one of the suggestions that has 

come from my folks and we certainly welcome input 
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from this group and direction from OCAS, but one 

of the suggestions would be closeout interview 

specialists so there’s -- we do have on our team 

people who -- whose expertise lay with the 

closeout interview, distinct from the intake 

interviews. So, that would be just very clear, 

very specific and doesn’t imply to anyone that 

it’s a health physicist but rather a closeout 

expert. 

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MS. MUNN: That sounds reasonable. Do we -- do 

we have another person or a group of persons who 

are referred to as -- as claim reviewers? 

MS. KIMPAN: We do not externally have that title 

here Wanda, but when you start using the words 

claims and examiners or reviewers, that almost 

always harkens to DOL. So one of the reasons 

that we stayed away from claim but calling it 

closeout interview is to stay unique to this 

NIOSH, OCAS process that we’re part of. 

MS. MUNN: All right. All right. The closeout 

expert sounds -- or closeout reviewer -- 

MS. KIMPAN: Yeah, closeout reviewer, closeout 

specialist, whatever you know we need to look 

obviously at you know, how we’re going to make 

certain people look properly qualified but 
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closeout interviewer, whatever this group might 

suggest will -- we’ll await Stu and Larry’s 

direction after they -- they’ve heard the 

possibilities. 

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MS. MUNN: All right. It certainly from this 

perspective sounds as if the closeout terminology 

might be the better one to -- 

MS. KIMPAN: Agreed. 

MS. MUNN: Yeah. Okay, sorry, Stu? 

MR. HINNEFELD: Finding number two is that the -- 

DR. MAURO: Before we move onto finding number 

two -- 

MR. HINNEFELD: Yeah? 

DR. MAURO: Do we agree then that this finding 

number one is in abeyance? In other words -- 

MR. HINNEFELD: That’s my understanding. 

DR. MAURO: It’s probably a good idea to -- in 

other words, it’s probably a good idea to -- in 

other words before we leave any particular 

finding let’s assign it its new name. 

MR. HINNEFELD: Right, that’s a good idea. Okay, 

finding number two is the procedure makes no 

substantive provisions for ensuring that the 

claimant actually understands the dose 

reconstruction and its implications for 
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compensation prior to signing the OCAS1 form. 

You know, when the claimant doesn’t -- complains 

they do not understand the lingo. There’s 

actually two parts here; make sure they 

understand the dose reconstruction and make sure 

they understand the implications on the 

compensation. I think the second is easier to 

address than the first. The second case, you 

know, we NIOSH, don’t really decide -- make the 

compensation decision and we have resisted saying 

-- telling claimants that your case is -- will be 

compensable or it will not be compensable. That 

decision actually is made by the Department of 

Labor. We might have some alternative language, 

I know why this is in here and it’s because of 

one of the observed interviews from reading the 

description of the interview it looks pretty 

clear that the claimant ended the interview 

believing that they were getting it 

compensability -- they had a compensable dose 

reconstruction and -- and when it was not. So 

I’m sure that’s why that finding is in here. 

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MR. ELLIOTT: Because the term claimant favorable 

-- 

MR. HINNEFELD: Because the term claimant 
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favorable was used in discussing them and they 

said oh well it’s favorable, I guess I’m getting 

compensated was the connection they made. So I 

think that while we wouldn’t say it appears that 

your case will be compensated or not, we may be 

able to say something like we were unable to show 

causation based on the information or we were 

able to show causation and -- and words to that 

effect. There may be -- and I just throw those -

- those pop into my head, they’ve been vetted to 

no one, okay. So we are working to vet some 

words and see what it is we can reasonably say 

within the constraints of you know, what we it is 

we actually do, we don’t actually make 

compensation decisions. So there might be some 

language that we can choose to be clear in our 

discussion without actually indicating we’ve made 

a compensation decision or even a tentative 

compensation decision. So there might be 

something like that. 

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DR. ZIEMER: And John I’d like to ask, in the 

finding where it says the procedure makes no 

standard provision for ensuring the claimant 

actually understands the dose reconstruction, 

that raises the question in my mind as to whether 
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it’s our objective -- I’m not sure claimants will 

in fact understand a dose reconstruction; I’m not 

sure on a given case that all the Board members 

would and maybe not all the dose reconstructors 

would. But what did -- what was -- what is it 

that you think the claimant should understand? 

Is it something about how it’s done or what -- 

what is it that’s implied in this finding that -- 

that we can correct? 

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DR. MAURO: Well I’d like to pass that on to 

Arjun because it’s a really tough question. 

DR. ZIEMER: I -- I -- I know you’re not -- 

you’re not implying that the claimant has to 

understand how to do dose reconstruction. But -- 

but there are some facets of it that they need to 

be cognizant of so maybe Arjun, you can help me 

understand. I -- I -- I think intuitively I 

mean, I feel like I know what -- what the intent 

here is but I’m not sure it’s the understanding 

of dose reconstruction per se that we’re trying 

to get the claimant to sort of meet an 

understanding criteria at that point. What is it 

we need to -- what’s the end point we’re looking 

for? 

DR. MAKHIJANI: Obviously you know, dose 
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reconstruction is hard in all its technical 

details and quantitative aspects and 

internal/external and we can’t -- we can’t -- 

it’s hard enough for a technical person to go 

through that and understand it and Hans and Kathy 

will testify to that and have plenty of times. I 

think the -- the first step in that is what 

emerged during the observation is people are 

confused between the term claimant favorable dose 

reconstruction and thinking they’re going to be 

compensated. That was a very unfortunate 

confusion and that seemed to get reinforced the 

more dose reconstruction is questioned and 

explained in the call the more the interviewer of 

course tries to say you know, this is all to your 

benefit and this dose was given to you and the 

other dose was given to you. And so I think some 

very clear way of saying even when we do claimant 

favorable dose reconstructions -- well the law is 

written -- Larry and I were chatting outside if I 

might bring that conversation in here in the room 

a more formal way. The law is written you know, 

for and a more likely than not proposition given 

the ninety-nine percentiles in the tables and so 

on, but still you have to have a significant dose 

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depending on the organ. And many can -- many 

cancer cases are denied because of the criteria 

set up under the law and even when it is claimant 

favorable, that piece of explanation would 

separate the dose reconstruction piece of it from 

the probability of causation piece of it and I 

think we did recommend in the report that NIOSH 

does have an idea of what the probability of 

causation is or whether it’s compensable or not, 

the exact number is actually not very relevant. 

Whether it’s likely compensable or not and with 

the caveats that the Department of Labor makes 

the decision and so on, going out of the closeout 

interview process it seemed that there should not 

be a confusion on the part of the claimant. 

Because if they go in thinking signing the form 

thinking they’re going to be compensated and then 

get a non-compensation decision then -- then it’s 

pretty bad. And I think there should be a very 

clear way to sort the things out. You suggested 

a couple of things in the review, Dr. Ziemer, 

that those may not be the best choice of words 

and may create, you know, legal issues or 

whatever and -- and -- it’s for -- for Larry to 

say but something should be done. 

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MR. ELLIOTT: Well, our -- our reports -- the 

reports that we deliver, the language that is 

contained therein about whether or not the claim 

is going to be compensable, is guarded language, 

it’s language that has been reviewed by our 

general counsel’s office and been blessed that 

way so that we don’t ascribe a decision to our 

work that is really DOL’s responsibility to give 

out. 

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DR. ZIEMER: And which is premature in any event. 

MR. ELLIOTT: Which is premature, especially in a 

non-compensable case. But if you look at a 

compensable dose reconstruction report I think 

the language is clearer there that the claim is 

going to be found to be compensable. But when we 

look at a non-compensable dose reconstruction 

report, it’s nebulous, it’s ambiguous, it’s 

difficult to discern for a lay reader, what does 

this really mean, you know, am I going to get my 

money or not? And we just have to take your -- 

your suggestion, your examples back to -- to the 

desk and see what general counsel has to say 

about them and see if there’s another that we can 

frame the language to make it clearer that we’ve 

done the best job we can in the most claimant 
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favorable way that we can with reason and -- and 

yet it’s still going to fall short, we’re sorry. 

We’ll have to come up with something. 

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DR. MAURO: I have something too I’d like to add. 

Though that issue did not come up in the 

interview part, one of the things that’s a 

recurring thing that we’ve all experienced in the 

evening sessions is that the folks in the 

audience and certainly the claimants who are 

being interviewed, don’t understand how could you 

possibly do a dose reconstruction if you don’t 

have adequate records from me or that the 

record’s missing or they read our -- they’ll read 

our audit report you know, of a site profile and 

disease problems. Now without getting into the 

nuts and bolts, they believe that the coworker 

model -- and the only reason I say this is from 

sitting in on those evening sessions. They 

believe the coworker model is the guy sitting 

next to them. 

MR. ELLIOTT: Nobody called him. 

DR. MAURO: And nobody called him. 

MR. ELLIOTT: Nobody called him. 

DR. MAURO: I -- I -- I think that a little bit 

of discussion that, about procedures that in your 
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particular case, in your husband’s case or 

whatever, we had very limited data you know, and 

for that reason -- you know, for that reason it’s 

difficult and this is what we did in your case to 

try to make sure that we reconstructed the doses 

in a way that you know, were fair and appropriate 

and this is -- and this is how we went about it. 

Now without getting into the details of the 

statistics but you know, we do have lots and lots 

of data from people who worked in that kind of 

job at that time period in this facility and 

looked at that data and looked at the people that 

had the highest exposures, I mean, you know where 

I’m going but I’m saying I could see the person 

at the other end of the line understanding that 

because you can -- you keep seeing it over and 

over again. You can’t build a coworker model, 

how could you -- the guy standing next to me, you 

know, so I -- I don’t know whether this is a 

place where you could I guess from a grass roots 

point of view, start the process of gaining the 

confidence that the coworker models can be used 

and how they -- and they can be used very 

productively. 

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issues here intertwined. That’s one John. I 

think another one is a much larger issue, a wider 

spread perception that dose reconstruction is 

something that we -- it’s something they see it 

different than the way we see it. We see the 

language of the law saying there needs to be a 

dose reconstruction program because there’s data 

that was -- monitoring data that was lost, 

monitoring data that was not taken, you know, 

data that was not kept or it was modified. 

That’s what dose reconstruction is designed to do 

is to fill the data gaps, fill the information 

holes and they’re coming at it from well you’ve 

got all the data on me and you’re reconstructing 

my dose, that we need to do a better job of 

communicating what dose reconstruction really 

truly is, it’s filling holes, filling the data 

gaps, it’s bridging the lack of information and 

that’s what the law requires us to do. I don’t 

know if that’s going to gain us any favorable 

ground with these folks but I just see there’s a 

number of communication issues here, you brought 

up one, I just offered another one. 

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DR. MAKHIJANI: There’s a third piece to it too 

where the data gap piece is very direct for 
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external dose, it’s not there sometimes you may 

have a period of non-monitoring or missing badge 

or a bad badge or something. The internal dose 

of course is more complicated because the intakes 

were never actually calculated until 1989 or 

something. So you’re actually having to 

interpret the data and calculate the intakes 

almost from scratch, essentially from scratch, 

you have the bioassay data in the best case but 

still it takes a lot of interpretation and work 

to calculate that dose, it’s a non -- non-trivial 

exercise -- 

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MR. ELLIOTT: And a set of numbers they’ve never 

seen before. 

DR. MAKHIJANI: That’s right. And the external 

dose I think everybody understands, they’ve got 

the badge reading, they’ve seen them quite often 

over the course of their employment but the -- 

the urine data is -- has been a black box to them 

from day one, they’ve given these samples and 

they have no idea what happened to them. 

DR. MAURO: Yeah, yeah. 

MR. ELLIOTT: And here they get something back 

from us that says, your internal dose to organ X 

was... You know, how can you get there? We 
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DR. MAKHIJANI: I think that is a very big issue 

because you’re doing that for the first time and 

they never saw that in the course of their 

employment. 

MR. ELLIOTT: I think there’s a -- recognizing 

these communication issues there’s an opportunity 

for us to look at the scripts, look at the 

communication language that’s used in these 

closeout interviews and in the CATI interviews as 

well and see what modifications and revamping we 

need to do to that. 

DR. MAURO: And I’ll say this is not an easy job 

for the closeout specialist. 

MR. ELLIOTT: Oh no, they do a heck of a job 

given what challenge they face. 

DR. MAURO: Yeah, this is a tough -- yeah, ‘cause 

I -- I mean if I put myself in the situation if I 

was trying to -- in fact sometimes I do find 

myself a claimant will call up and they’ll be 

very upset and I’m not quite sure how to ease 

their mind. But it’s -- in order to communicate 

that -- that step, that is listen yes, we don’t 

have -- we didn’t have data for your husband but 

this -- this is what we did. Now how do you 
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explain that in a way that they get a degree of 

comfort? Yeah, these folks -- 

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MR. ELLIOTT: That you did it right and to their 

benefit. 

DR. MAURO: And that’s all I’m just saying. I 

sympathize with the difficulty in trying to get 

that message across. But if it can be gotten 

across and it’s going to be -- it’s hard for dose 

reconstructor to you know, never mind the HP 

closeout -- the closeout interviewer who may not, 

I don’t know how intimately familiar he is or she 

is with that case. That’s probably an important 

point, in other words, you have to really 

understand the case so that you could communicate 

to the claimant what -- you know, what was done 

conceptually here, that was special and that we -

- that we -- case specific as opposed to let’s 

say just giving certain boilerplate explanations. 

MR. ELLIOTT: I don’t know if Kate wants to speak 

to this or not but I do believe that what my 

understanding is, is that those folks in her shop 

that do these closeout interviews prepare 

themselves before they conduct the closeout 

interview, I hope you saw that -- as part of the 

process they look at the file. They also have -- 
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and these are the HP reviewer types, but they 

also have I believe a Health Physicist who is in 

that -- that group that can be brought to bury. 

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MS. KIMPAN: Yes, that’s absolutely true, Larry. 

MR. ELLIOTT: Yeah, okay. 

MS. KIMPAN: There also is -- I’m sorry, shall I? 

MR. ELLIOTT: Go ahead. 

MS. KIMPAN: There also is at their availability 

per task five under Ed Mars* leadership the 

ability for the people who are helping with that 

call line to get to the actual dose reconstructor 

or actual expert from that site in real time as 

well. 

DR. MAKHIJANI: Well, this actually -- this 

actually we didn’t -- we didn’t find that and 

that was -- there was quite a bit of commentary 

on this point in our review is on the -- on the 

HP -- see we had -- we didn’t essentially have 

too many issues with the first step of the 

closeout interview, we thought that the claimants 

were dealt with very politely and you know, 

people tried to explain as best they could and so 

on. There were issues of not understanding that 

I think are -- we all acknowledge are difficult. 

But the major problems arose with when the thing 
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is referred to the HP reviewers and what happened 

and the fact that no one on the HP reviewer team 

was an actual health physicist or familiar you 

know, then the HP reviewer looks at the case and 

none of them were -- the two managers had some 

health physics experience in that degree so they 

were aware of dose reconstructions and they 

understood them and they had a level of technical 

proficiency that -- that we were comfortable with 

or at least I personally was. And -- but they 

don’t actually review the case, they’re the 

managers and the -- the -- but there’s no health 

physicist or dose reconstructor on the team, they 

get involved at a second stage. At least that 

was our understanding and that was what was told 

to us during our communication with the managers. 

Maybe it’s changed or wasn’t quite correct. 

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MS. KIMPAN: This is Kate. HPs get involved as 

they are needed, it can be during a call, it can 

be immediately after a call, it could be with the 

reviewer in advance of a call in preparation. So 

I’m not certain what your conclusion that they’re 

not available was based upon, but that’s less 

than accurate. 

DR. MAKHIJANI: No, no, we didn’t conclude that 
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they’re not available in general. We -- we did 

say they’re not available in real time during the 

closeout interview because that’s what -- that’s 

what’s in the procedure first of all, they’re not 

-- the procedure doesn’t specify availability. 

Secondly, that we were also explicitly told that 

the dose reconstructor never actually directly 

communicates with the claimant, never. And that 

they -- they communicate with a health physics 

reviewer when the health physics reviewer refers 

the case to the dose reconstructor or somebody in 

your dose reconstruction task, which is task four 

or five? 

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MR. HINNEFELD: Five, five is dose 

reconstruction. 

DR. MAKHIJANI: Five. And so that was our 

understanding. We did document our exchange on 

that point with ORAU team and ORAU team did 

review that documentation and sign off on that. 

So that -- I think Kate -- maybe a review of that 

documentation from your team’s side again might 

be -- might be useful because your team did sign 

off on that. 

DR. MAURO: I -- I -- I have one more thing I’d 

like to add. In thinking about this and putting 
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myself in situation, when -- when you’re talking 

to a claimant the most important thing I could 

see the closeout interview folks -- folks doing 

and it doesn’t require a sophisticated background 

in doing the dose reconstructions. They’re 

probably going to zero -- when I look -- the dose 

reconstruction reviews I’ve done, when I look at 

them I say, okay, what -- what was the driver 

here? You know this person’s problem was 

basically some neutron exposure, I mean, well two 

or three that really were important because of 

his job. And all of a sudden you make it 

personal, in other words explaining to -- I don’t 

know if you do this, explaining to the claimant 

that for your husband we look at -- we took a 

very close look at his records, his operating 

history and so on and now where we come out is 

that -- that the situations that caused him to 

get some exposures were as follows, and we had a 

problem. We -- we -- we had pretty good data on 

-– bioassay data, but we didn’t have very good 

neutron data so our real problem in your case -- 

so in other words if you had -- if all of a 

sudden you’re talking about that case and the 

places that -- your under -- your understanding 

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and appreciation of that unique person’s 

situation and what we did to uniquely address 

that person’s condition or problem, I can’t tell 

you I know so I can talk to your doctor or when 

they bring it home to you, this is you, we’re 

looking at you now, I don’t know how much of that 

is done and it’s going to be very difficult for 

the closeout interviewer to do that unless he was 

involved. But I -- but I think that -- if he -- 

if that person does enough of this and is close 

enough to the process he could appreciate where 

the -- where the real issues were for this 

particular case. The degree to which that could 

be communicated to the claimant, that’s -- this 

personal treatment is what happened here and it 

always does happen by the way when we look at 

these cases, this is -- these are tailor made 

very often. And I don’t know, I’m just making an 

offer that I don’t know whether or not that is 

brought into the process. But the degree to 

which that’s done I guarantee you it will 

engender a lot of confidence. 

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MR. HINNEFELD: Yeah, to an extent we can, I mean 

that’s -- that’s a pretty tall order, that 

specific kind of communication at that point. 
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MR. HINNEFELD: Paul? 

DR. ZIEMER: As far as the claimants’ 

understanding of the dose reconstruction process, 

I think we clearly don’t want to wait until the 

end of things to get into that, it needs to start 

further and I think you do supply some early on 

descriptions of what is going to happen. 

MR. ELLIOTT: Our acknowledgment packet includes 

fact sheets about dose reconstruction -- 

DR. ZIEMER: All right and how it’s done and so 

on. I don’t know to the extent to which those 

are read or could be referred back you know in 

the closeout to remind the person that this is 

explained and this is what we do in cases where 

there’s missing data and so on. But it seems to 

me that -- that sort of educating the claimant it 

starts at the beginning -- 

MR. ELLIOTT: It has to be a continuous process. 

DR. ZIEMER: A continuous process and we can’t 

just be relying on the closeout. There may be 

some way to tie that together to remind them. 

MR. ELLIOTT: Okay, well -- 

DR. ZIEMER: Because they have some written 

information as I recall that in fact you made a 
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concerted effort to make that lay understandable 

even. 

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MR. ELLIOTT: See, it comes at them in several 

different forms -- 

DR. ZIEMER: Right. 

MR. ELLIOTT: The acknowledgment packet, but 

there’s activity reports and we offer up 

bulletins. 

DR. ZIEMER: Right. 

MR. ELLIOTT: And then the dose reconstruction 

report itself under the current format, the whole 

front end of it is an explanation. 

DR. ZIEMER: An explanation of what was done. 

MR. ELLIOTT: Yeah. But you’re right, it needs 

to be -- 

DR. ZIEMER: Then if you’re going to personalize 

it as John said you can say now in your case this 

particular one applied where you know, we had to 

rely on source term data, whatever it is then we 

call attention to it somehow. Because I think 

there’s a lot of information out there that maybe 

doesn’t get digested because it still looks 

pretty technical I think even to lay people and 

they’ll probably, say well, this is -- this is 

sort of like when I get -- when I get my Lipitor 
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I get this fact sheet and there’s no way I’m 

going to read this fact sheet unless I have a 

problem. 

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DR. MAURO: And then you take -- 

DR. ZIEMER: Yeah. 

MS. MUNN: And there also continues to be some 

very basic information about radiation and 

radiation effects that are commonly misunderstood 

by lay people. There is sort of an understanding 

that any exposure is potentially hazardous and 

may result in certain cancers and that -- that 

perception is probably not often addressed in the 

other action that we have and that others have 

with the lay people. I don’t know whether 

there’s -- 

DR. ZIEMER: Well you know, the technical 

community has been trying to solve that one for 

as long as I can remember. 

MS. MUNN: That’s true, and have been notoriously 

poor at doing so. 

DR. ZIEMER: Everybody thinks that somewhere 

along the lines somebody is going to come up with 

a magic set of PowerPoint slides that will cause 

the whole nation to change its view and it’s not 

going to happen. 
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1 MS. MUNN: No, it won’t. 

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DR. ZIEMER: If the opposite gets reinforced by 

Jack Bauer reinforces it on 24 it will be -- 

MS. MUNN: Oh, he’s not alone. There’s not a 

program on any entertainment medium that I know 

of that doesn’t reinforce that but it’s -- I 

don’t -- it’s hard to identify whether that issue 

is even one that should be addressed in any of 

this but somehow it seems listening to the 

claimants in workshops and things of that sort -- 

DR. ZIEMER: Well see it’s inherently built into 

our program. We’re saying that there’s some 

probability of damage at any exposure. It’s sort 

of based on that premise, you’ve got to get to 

the threshold at that point of compensation. 

That part of it I think I’m not sure what we do 

on that, I don’t think we... 

MR. ELLIOTT: I think, if I could take us back to 

another issue that we talked about earlier this 

call for and need to have a health physicist at 

the ready to enter into the dialogue with a 

claimant about how a dose reconstruction was 

performed or why a certain claimant offered 

issue, will or will not make any change in dose 

estimation. We have -- I think we and ORAU have 
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tried to make sure that the dose reconstructors 

who are actually doing the business of doing dose 

reconstruction are somewhat protected and allowed 

to just do that work alone so that you know, we 

can get the product done. That’s not to say 

though in my mind that there’s not some other way 

that we can you know, maybe rotate people through 

this experience of dealing with claimants. I 

think it would be good actually. 

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DR. ZIEMER: Maybe not the person who did the 

dose reconstruction, but somebody -- 

MR. ELLIOTT: Not the person who did the dose 

reconstruction but a -- a health physicist who 

has, you know, done dose reconstructions. Maybe 

-- Maybe you could have one on call for a given 

facility and when an interview is done that 

person’s made aware of that call, books up on the 

claim and then stands at the ready to deal with 

those kind of questions. You know, there are 

those kind of approaches that we haven’t -- we 

haven’t talked about we should talk about you 

know, with our contractor. I think there’s ways 

that we can -- we can modify and improve our -- 

our process here looking at it that way. 

MR. HINNEFELD: Yeah, I think real -- real time 
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is always problematic because a dose 

reconstructor who’s not -- has not studied up on 

the -- on the claims that are being called when 

you first open the dose -- when you first open 

the file it’s not immediately apparent necessary 

-- necessarily. It takes a little looking at the 

file to understand how it was done. So, I hope 

this is real time even not necessarily the dose 

reconstruction but a dose reconstruction real 

time is a little hard to -- hard to do a logistic 

just because it’s not -- it’s hard -- you can’t 

just open it up and know immediately what was 

done. 

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DR. MAURO: But -- But -- But the truth -- But I 

have experienced that. Once you do four or five 

handfuls, several AWEs or several -- 

MR. HINNEFELD: I guess that’s true. 

DR. MAURO: You know all of a sudden you -- you 

know, I could pick -- I -- I tell you I could 

pick it off in an hour. 

MR. HINNEFELD: Yeah. 

DR. MAURO: In an hour, it takes an hour. 

MR. HINNEFELD: If it’s the same -- 

DR. MAURO: To say okay, I understand this site, 

I understand that site, I’ve looked at it enough 
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and then when you look at that case it’ll take an 

hour or so for you to say I think I’ve got it, I 

know -- I know where the buttons are here. So if 

you haven’t though, if you’re not familiar with 

the Hanford site and have not done dose 

reconstruction of Hanford, it may take you a week 

to get -- warm up to that one. 

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MR. HINNEFELD: So it’s -- and then the 

individual, you know, the actual dose 

reconstructor who did the dose reconstruction 

could very well have done it weeks earlier and 

has done dozens in the meantime. So it’s still -

- 

DR. MAURO: Yeah. 

MR. ELLIOTT: But still -- 

MR. HINNEFELD: Still got to book up for it, so 

yeah. 

DR. MAURO: Yeah, you still have to prepare. 

DR. MAKHIJANI: I think Larry’s idea seems to be 

you know, creative kind of dealing with the 

logistics of keeping the dose reconstructors 

insulated and also doing their job and moving the 

claims through. But I think some contact with 

claimants would be helpful and if you could ro -- 

consider rotating people through. I think in 
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most cases, I don’t know, this is a guess 

obviously, the claimants don’t necessarily want 

to talk to a dose reconstructor, in most cases 

everything can go smoothly or things can be 

referred to a dose reconstructor or -- or health 

physicist or for later dealing with claimants. 

But the idea that there may be somebody available 

may be very useful. 

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MR. ELLIOTT: Why not -- I mean another way to 

change this or to correct it would be an 

organizational change in that team unit and if 

you add a position as a health physicist then 

that person’s only job is to deal with the 

interviews at hand for the day and make sure 

they’re ready to respond to issues that are 

brought up you know, impromptu, from the 

claimant. I just think that would be -- that’s 

not the way to go I think ‘cause – ‘cause I don’t 

believe that a position so created would be fully 

employed. I think there -- you know, we need to 

have somebody at the ready, but you’re probably 

going to be booking up and then not even get 

called that day. 

DR. ZIEMER: Well you have no guarantee that, 

that will help the situation at all. There are 
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many technical people that will make it even more 

confusing -- 

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MR. ELLIOTT: Well there is that. 

DR. ZIEMER: Because they will be so technically 

correct. 

MR. HINNEFELD: Why are you looking at me when 

you’re saying that, Paul? 

DR. ZIEMER: Well I’m trying to get inspiration 

from your look to see whether I’m on the right 

track here, or it’s like you always have to have 

people who are teachers and they’re -- and I know 

some really good technical people and they are 

the worst teachers in the world. 

MR. ELLIOTT: It takes a special personality to 

do what these folks do. 

DR. MAURO: I -- I suspect your closeout 

specialists have those skills and it just -- they 

may have to put in an hour or two on their own or 

maybe even talk to the dose reconstructor and say 

okay, tell me about this dose reconstruction, 

give me a little more personal touch. And he 

could -- he probably do -- once he has it because 

really we’re looking at the big picture. You 

don’t want to get into the OTIBs, you know, you 

want the big picture. Where are the pressure 
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points on this one and where are the problems, 

where are the challenges? And I guarantee, I 

just feel that the specialists who are talking to 

these people they’re probably really good at it 

and all they need is a little bit more 

information regarding that case and when they’re 

on the phone with that person I guarantee you 

that person -- you’ll be able to hold that 

person’s hand a little better, walk them through 

why we had to do what we did. Sure you want to 

have the dose reconstructor on call if you need 

them but I think there’s an awful lot the 

specialist can do. 

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MR. ELLIOTT: I think this is a good discussion. 

DR. WADE: See one of the things it always comes 

down to is resource expenditure within a limited 

resource mix. I mean it’s tough. There -- There 

are certain fundamental issues that -- that -- 

that exist; John hit on one of them which is how 

can you reconstruct -- how could you possibly 

reconstruct my father’s dose when -- when there 

were records missing? I mean there -- that’s a 

fundamental question that no matter how skilled 

you are, you’re not going to answer. The other 

thing we hear all the time is that I worked there 
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and I got cancer, there’s no cancer history of 

cancer in my family. What -- How are you -- 

you’re not going to explain it. You’re just not 

going to explain it. So the -- the question is 

deciding those areas that it’s worth making 

additional investment in. Now, it seems to me 

from listening to all this that -- that getting 

the communicator a bit more up to speed on the 

case is a good thing. And maybe, I don’t know, 

they -- they probably have dealt with these sort 

of gut issues like how -- how can you reconstruct 

my dose when you don’t -- when there’s something 

missing. I don’t know if they’re prepared to 

talk about those things or not. But again you’re 

never going to get this completely right 

unfortunately and -- and there’s work to be done 

and that’s the dilemma here. It’s a tough one. 

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MS. MUNN: But whether the information that is 

given is completely accepted by the claimant, it 

still seems to be incumbent on all that are 

involved in this process to repeat at every 

possible opportunity that all the best science 

that is known leads us to the information that it 

is not necessary to have had a background of 

cancer in your family for you to have had one and 
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it is not necessary for -- for this -- for anyone 

to believe that you would not have had cancer had 

you not worked at this position. That’s -- 

that’s -- those are realities that whether 

they’re acceptable or not it appears necessary 

that we repeat those realities. 

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DR. WADE: I think that’s something to think 

about. One last comment because I think this is 

one of the main issues remaining and what -- what 

encourages me so much is you’ve got the SC&A team 

now who is completely vested in this and cares 

deeply about these people and has experienced 

something and now you’re at the table with the 

NIOSH ORAU people who are completely vested and 

care about this and this is the best group in the 

world to imagine a path forward but there’s no 

easy path forward. But -- so this is a very 

important discussion. Where it goes I don’t 

know, but these are the right people to be 

talking about it anyway. 

MS. MUNN: Where it goes is the problem for me 

because I’m not certain what action comes out of 

this discussion of our -- our item two. We have 

talked about being in abeyance and some language 

change with respect to title but -- 
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DR. WADE: I’m going to -- and I’ll speak up more 

than I should. I think one of the things I’d 

like to see happen is upon reflection I’d be very 

interested in what SC&A thinks should be done. 

And I would be very interested in NIOSH’s 

reaction to that and very interested in the 

Board’s reaction to that. Again, we all care 

about this and again, this is -- this is a time 

when we each need to speak, the other listen and 

then -- and then move forward. So I’d be very 

interested in SC&A’s reaction. 

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DR. ZIEMER: One of the reactions and I think 

it’s a good one John suggested in making sure 

that needs are personalized in the sense of 

saying in your case this is what was looked at 

and this is how something was valued. I think 

that’s got to be part of it. To some extent it 

already is, but to the extent to which the person 

feels like their issues aren’t being dealt with 

it becomes very important. Secondly, I think 

changing the nomenclature will help to the extent 

that the reviewers are not being challenged as 

being something they’re not. And if they face an 

issue which is beyond their technical 

capabilities they ought to be in a position to 
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say I’m going to go back and make sure that, that 

question gets answered for you, but I can’t 

answer it directly, but I’m going to get a dose 

reconstructor who will provide that. There’s no 

reason that we have to be able to answer 

everything. 

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MR. ELLIOTT: And the clock is not ticking on the 

sixty days for you to turn the OCAS1 around. 

DR. ZIEMER: Right. 

MR. ELLIOTT: We’ll get back to you. 

DR. ZIEMER: Right, right. 

MR. ELLIOTT: There’s no pressure here on you to 

turn over your OCAS1. 

DR. MAKHIJANI: That I think -- those -- those 

things I think would -- would mitigate a lot of 

understanding. 

DR. ZIEMER: A lot of them, I mean there’s a 

number of things that have come out here I think 

that in ORAU has heard them and NIOSH has heard 

them and it seems to me that in some form could 

be incorporated maybe on a trial basis to see if 

they improve things. 

DR. MAKHIJANI: Well, and the third thing I think 

that Larry said that I thought was very helpful 

was that to go you know, understanding that the 
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legal counsel of HHS has signed off on this 

language that’s quite vague in the case of 

denials or likely denials, that some more clear 

way of communication that would pass legal muster 

would be very good. I think -- I think that -- 

that would prevent a lot of the misunderstandings 

that do occur, at least from the observations 

that we have. I think those three or four items 

would -- would fix what’s fixable, I mean. 

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DR. WADE: Maybe that one issue -- I mean maybe 

there are three actions that have come from this 

that NIOSH is going to take to heart. 

MR. ELLIOTT: I think that we’ve committed to 

them here in our responses and we’re saying that 

we’re going to look at the procedure and revise 

it accordingly. You know, I think what needs to 

happen is we need to do that and bring back the 

revised procedure, tell you how we’re going to 

improve it based upon these comments that we’ve -

- we’ve heard. 

DR. MAURO: I have one more thought that I wanted 

to pass on and that is when the -- at some point 

in the process is there any provision to get 

feedback from the claimant? Do they feel as if -

- and this may even be after the -- after the 
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adjudicated decision is made. Do they feel as if 

that their claim -- and did we say we have twenty 

thousand adjudicated claims that have been 

processed, about twenty-five percent have been 

granted and about seventy-five percent you know, 

some -- certainly large factors still in the 

process but some a larger fraction are not. One 

of the -- I mean they always say if you don’t 

measure it you really don’t know, is there any 

way to get -- are you getting some kind of 

feedback on the degree to which they feel as if 

their claim has been processed? Is there -- is 

there a unanimous dissatisfaction amongst all the 

people that were denied or is there a substantial 

fraction of the people that were denied that feel 

no, I think you guys did the best you could and 

we accept your finding? 

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MR. HINNEFELD: Well, I don’t know because we -- 

I don’t know that we’ve measured it. 

MS. MUNN: I’m not sure how you could measure 

that kind of thing. 

MR. HINNEFELD: That would be -- 

MS. MUNN: With any kind of specificity. 

MR. HINNEFELD: If in fact you wanted to get that 

feedback after adjudication. 
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MR. HINNEFELD: Boy, that would be another -- 

MR. ELLIOTT: No, I don’t think that -- 

MR. HINNEFELD: That’s not something we just do 

casually. I’m not saying it’s not a good idea, 

it’s not something we can do casually though I 

mean because then you’re collecting information 

from thousands of people and the government 

normally doesn’t like you to do that. 

DR. BRANCHE: Does the Department of Labor have 

it in its bridgement office? 

MR. ELLIOTT: That only deals with party 

supposedly. 

DR. WADE: But even -- even if you could get it, 

what would you do with the answers? 

DR. MAURO: Well you’ll find out whether or not 

the kinds of things we’re talking about as we’ve 

put it into the program and do a little bit more 

of these kinds of things, are they -- are they 

reaping benefit? 

MS. KIMPAN: John, this is Kate. 

DR. MAURO: Yeah? 

MS. KIMPAN: The only research I know on this 

topic was conducted by the Upjohn Institute in 

Michigan. It has to do with claimant 
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satisfaction and worker’s compensation programs 

which this is one and the finding was and it’s 

singular, it’s not been replicated a lot in my 

observation, was that claimants did not appeal 

their work comp cases based on a positive and 

negative outcome. They appealed based on whether 

they quote believed they had been heard or 

listened to. 

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MR. ELLIOTT: Was this program included in that 

review, Kate? 

MS. KIMPAN: Absolutely not. This is the only 

research I know of that type, Larry. 

MR. ELLIOTT: Well we -- we would have seventy 

percent of the twenty-thousand that have been 

processed you know in a category that have been 

denied, seventy percent. 

MS. KIMPAN: Right. 

MR. ELLIOTT: And of those seventy percent I have 

no idea how we could gauge the level of 

satisfaction -- one way we could tell you what 

our good letter file looks like, it’s about this 

thick. We could tell you what our bad letter 

file looks like and you know how that goes. We 

can tell you that we hear loud voices from a few. 

I don’t know where we go to try to -- you know, 
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we can’t -- OMB won’t let us go back and do a 

follow back on the claims that have been 

adjudicated without having an OMB approved 

package to do so and that’ll take your guess is 

as good as mine, you and I may be retired before 

we get that approval. So, you know, I -- 

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DR. WADE: Even then, I mean, even if you could 

do it -- I’ll accept your fact that in a process 

controlled world you could say if I had that kind 

of mechanism to gather feedback regularly I could 

tweak the system and I could look for change in 

my tweaks. I mean that’s a good thing, but -- 

but that’s not here, that’s not the way this is 

going to work. You might be able to get one 

snapshot of it, but you’re certainly not going to 

be able to control the verney (ph) on the 

process. 

DR. MAURO: Well, you know I was looking at it 

more from the point of view is I like after I go 

and I rent a car or have some work done on my 

house and then all of a sudden the person calls 

you back a week later and said, listen, are you 

happy with the work? See, I like that and I feel 

good about that, all of a sudden I’m -- I’m -- 

I’m -- you know. This is almost the same kind of 
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DR. BRANCHE: Is it? People aren’t buying your 

product. 

DR. ZIEMER: I don’t -- I don’t agree with that 

actually. No, because you pay for a car rental 

or a truck rental. 

DR. BRANCHE: And you got to choose from whom you 

could purchase. 

DR. MAURO: After I finish the pro -- well -- 

MR. ELLIOTT: You went into it expecting a 

quality successful response to your need. 

DR. MAURO: Yes. 

MR. ELLIOTT: I don’t know what these people 

expect. They expect to be compensated. 

MS. MUNN: Well most of them expect compensation; 

I suspect otherwise they would not file a claim. 

DR. MAKHIJANI: There’s another level of problem 

with this proposal I think, and I’m thinking out 

loud like everybody else. You know, people who 

are being denied, many of them already feel very 

aggrieved and aggravated, the process is very 

difficult and then you’re going to be contacting 

them in a way that’s not going to benefit them in 

any way. Their case is already closed, it’s been 

settled, they have an appeal, and now you’re 
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making them go through another hoop for your own, 

you know, the government coming back into their 

lives to hassle them one more time. 

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MR. ELLIOTT: I think it almost expect what you 

hear. 

DR. MAURO: Okay, never mind. 

MS. MUNN: Well I have three items on this 

particular review segment that include SC&A 

taking a look at this offline and getting back to 

us with some suggestions about what the 

contractor feels might be done to improve things 

with a NIOSH taking a look at whether or not some 

revisions to the procedure would be helpful and 

the OCAS language change, possibilities on that 

one. But we can probably discuss this most of 

the afternoon. 

DR. MAKHIJANI: Ms. Munn, do we have a to do item 

before NIOSH revising that procedure or our 

suggestions? 

MS. MUNN: We’re not -- we’re not talking about 

revisions. 

MR. HINNEFELD: Well, there is a -- we are 

talking about revising the procedure to 

incorporate some of these things. 

DR. MAKHIJANI: Yeah, I heard you are saying, do 
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MR. PRESLEY: Yeah, I don’t think you’re going to 

revise that procedure. This is Bob Presley, 

until you get some recommendations back, are you? 

MR. HINNEFELD: Well, they sent us -- I mean -- 

MR. ELLIOTT: Yeah, we have the recommendations -

- 

MR. HINNEFELD: The report includes 

recommendations for improvement on each of these 

findings. 

DR. MAURO: Yeah, right. 

MR. ELLIOTT: We’ve found some of those to be 

very, very beneficial, we want to do them. 

DR. MAURO: This is -- this was triggered by 

Paul, one of the items you have mentioned, it 

seems like you hooked onto the idea of 

personalization. Now I don’t know whether or not 

we’ve captured that in any of our recommendations 

or not but I guess over and above the 

recommendations that we’ve made we have had a 

chance to cogitate on all this and there may be 

certain items that come out of this conversation 

that maybe we’d like to supplement our 

recommendation. 

DR. MAKHIJANI: That -- That’d be -- 
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DR. MAURO: That’s -- an action item I would yes 

we will supplement our recommendations based on 

some of the ideas we’ve discussed around the 

table today such as personalization. 

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MS. MUNN: All right. I think the next item may 

have already been fairly well covered by what we 

have been discussing, finding number three. 

MR. HINNEFELD: All right, finding number three 

is -- 

MR. ELLIOTT: Variable documentation -- 

MR. HINNEFELD: Signing the OCAS1 form. 

MS. MUNN: The OCAS1 form. 

MR. HINNEFELD: The fact of signing the OCAS1 

form if it’s not been signed before occurs in the 

context closeout interview may create pressures 

on our own personnel to get signature. You know, 

you can speculate to that, we don’t believe it 

happens. We believe that the interviewers tell 

claimants don’t sign the OCAS1 if you’ve got 

questions because we’re going to answer them. 

The fact that yeah, we do want to make progress 

but at the same time, you know, this is a step in 

the process and I don’t know that there’s any 

particular pressure felt by the interviewers. 

They don’t have a quota you know, get so many 
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OCAS1s this week, so there’s -- I don’t know that 

there -- I don’t know how you -- we don’t believe 

that’s the case, we don’t believe they’re 

pressuring for production. 

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DR. MAURO: I’m going to take responsibility. 

When I read the dialogue that was written up, 

question, answer, question, answer, I said and -- 

Arjun and I spoke on the phone I said you know 

Arjun when I read this and then I’ll take -- I 

read it as if this the person on that end feels a 

degree of pressure to get this form filled. 

Almost to the extent that they feel as if that’s 

the real reason for making this call. And -- and 

-- and anything else that would divert from that, 

but maybe I have to slow down the process a 

little bit, they’ll talk to the dose 

reconstructor; there’s a lot of things that have 

to be done and that could take some time. I got 

-- I mean, I’m just telling you when I read that 

dialogue, not any of the written around, just the 

dialogue I got the sense that, that was what’s 

happening, at least in that case. You know, what 

can I say, that’s what I came away with. 

MR. HINNEFELD: Well, I -- I can -- I don’t know, 

I -- of course I didn’t listen to the interview, 
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I read the transcripts and the report. I guess 

arguably the interviewer referred to the OCAS1 

more than you would have liked in that context. 

But of course in that interview -- we’re also 

reading that interview with the knowledge that 

there should have been a pursuit of other 

information. This is -- this is the one where 

they went through the follow-up interview, right? 

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DR. MAURO: Yes. 

MR. HINNEFELD: We’re reading it with the 

knowledge that they’re really -- this guy should 

be looking for that new piece of information, 

should be asking the dose reconstructor about 

that new information and he keeps asking her 

about the OCAS1. 

DR. MAURO: That’s correct. 

MR. HINNEFELD: So I think our knowledge of the 

situation may influence our reading of that -- of 

that -- of that interview a little bit. I just 

don’t think it’s a -- a -- a -- an endemic issue. 

I don’t think it’s one that happened. I don’t 

think it’s one that we do. I don’t think 

interviewers feel that pressure and -- 

DR. ZIEMER: There’s no incentives put out for 

them to get the closure on anything. There’s no 
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MR. HINNEFELD: No. 

MR. ELLIOTT: We could look at this as an example 

and say make a modification here that when -- 

when the claimant raises up an issue that needs 

to be referred to a dose reconstructor you should 

dispense with talking about the OCAS1 at that 

point. In fact you should say okay, fine, we’re 

going to hold -- you’re not under a sixty day 

clock to get us the OCAS1, you know, there’s a 

whole new script that comes to play in the 

dialogue. 

DR. MAURO: I like that. 

DR. MAKHIJANI: I think this would solve the 

problem because I think that Stu is right that in 

the background we do you know, I didn’t think of 

it that way before, but it -- it may color how we 

interpret the conversation. Where if you feel as 

I do and honestly I did feel that that matter -- 

MR. ELLIOTT: Well I could see how the claimant 

would feel that way. 

DR. MAKHIJANI: Yeah. 

MR. ELLIOTT: Wait a minute, I’ve just raised an 

issue with you and you’re still beating me up 

about signing this silly form? I want to hear 
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back from you all about my issue. I’m not going 

to sign your form until you give me my issue. 

And so I could -- you know, I could see how this 

could be perceived. 

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DR. MAKHIJANI: Yeah. I think that if the clock 

were stopped until the specific substantive issue 

were resolved, I think that would -- that would -

- that would resolve the issue. 

MS. HOMOKI-TITUS: Larry, this is Liz HomokiTitus. I’m sorry to interrupt, I just want to be 

sure that everyone understands the time frame 

here. Changes to the script are probably going 

to have to go through OMB approval again. So we 

want to be sure that we have kind of everything 

together and everything finished before you all 

send it up. 

MR. HINNEFELD: We don’t have a script for the 

closeout interview. 

MR. ELLIOTT: We don’t have to give a script to 

OMB either. 

MR. HINNEFELD: No, there’s no script. A script 

is for the beginners, the initial interviews, 

CATI, the CATI. But there’s no script on a 

closeout interview. 

MR. ELLIOTT: The OMB involvement here is on the 
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CATI interview questions, a computer assisted 

telephone interview questions. There is no OMB 

approved document used in the closeout process. 

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MR. HINNEFELD: Right. This closeout process is 

not designed to obtain information from people, 

it’s designed to explain to them what was done in 

their dose reconstruction. Since it’s not 

designed as an attempt to collect information I 

believe that’s probably why -- well, A, there is 

no script and B, since we’re not collecting 

information from thousands of citizens, OMB I 

believe is not involved. 

MR. ELLIOTT: The scripts I’m mentioning are 

standard communication messages that we use in 

instances where people hear a claimant raise this 

up, direct a comment -- comment in this way. It 

goes to our public health advisors, it could find 

its way into a closeout interview as here’s the 

standard response if that question is raised or 

if that concern is raised. That’s the script I’m 

talking about. 

MS. MUNN: So this is essentially a memorandum or 

training information. 

MR. ELLIOTT: Yes. 

MS. MUNN: That needs to be conveyed and -- 
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MR. ELLIOTT: Well when you face this set of 

circumstances in an interview this is how you 

handle it. 

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MS. MUNN: Correct. And so our action item is to 

see that this information is transmitted to the 

people who do the closeout interviews, right? 

I’m not sure exactly what the formal method of 

assuring that that information is transmitted. 

MR. ELLIOTT: I think it goes to the revision of 

the procedure to a certain extent, right? The 

revision of the procedure should attend to that 

to a certain extent. It may not present here’s 

the communication message but it would have to 

say at least if the claimant raises an issue this 

is the step you take next; take these steps. You 

say fine I’ll do -- that -- that is a substantive 

issue toward dose reconstruction I’ll have to get 

a health physicist to advise on how that should 

be handled. The clock on the -- on the sixty day 

time frame for you doesn’t -- is not ticking and 

you don’t have to worry about your OCAS1 right 

now. Those are the steps that you know, we need 

to incorporate into this procedure right now. 

MS. MUNN: And so we will see from NIOSH the 

suggested change in the procedure that will 
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MR. ELLIOTT: You may or you may not see the 

communication scripts I was referring to. 

MS. MUNN: Yeah, I understand that. The 

procedure will do it; that’s all that’s 

necessary. I have urgent requests for a fifteen 

minute break. We will reconvene in exactly 

fifteen minutes. 

(Break from 2:33 p.m. until 2:46 p.m.) 

DR. BRANCHE: Hi, this is Christine Branche and 

Ms. Munn is ready to start again. Is this line 

open, I just want to make sure? Someone could 

let me know that they can hear me. 

MS. KIMPAN: Kate Kimpan can hear you. 

DR. BRANCHE: Thank you. 

MS. MUNN: We’re beginning item number four, 

procedure 0092, procedure does not ensure 

claimant has all the information that was 

essential, and NIOSH, response? 

MR. HINNEFELD: Well this is -- this is a little 

more difficult to accommodate. All the 

information that was essential to the dose 

reconstruction is really a lot of information. I 

mean that’s really voluminous. The -- you’re 

talking there could be site profiles which are 
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available on the website but you know, that’s 

asking a lot to tell them you know, go look at 

the website. If you had the site profile, 

figuring out how that relates to your dose 

reconstruction is pretty difficult. Even the DOL 

response when we ask if it’s a claimant who’s 

been monitored and DOL provides us exposure 

records. 

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MR. ELLIOTT: DOE. 

MR. HINNEFELD: DOE I mean. The DOE response 

when you get an exposure record from DOE they -- 

some of those run over two hundred pages so -- 

MR. ELLIOTT: And they don’t contain -- in those 

entirety of the two hundred pages may not -- may 

contain other individuals’ dose information. 

MR. HINNEFELD: Some might. Some might. 

MR. ELLIOTT: So there’s a redaction issue that 

we would face there. 

MR. HINNEFELD: Yeah. So this -- this is kind of 

problematic and -- and so maybe -- I don’t know 

what to propose here. Maybe if you’ve got some 

specific ideas about what is it that would help 

the claimant the most. You know one thing that 

has occurred to me if the dose reconstruction 

would say the exposure record we received 
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indicates that you were monitored from this date 

to this date, you know something like that, to 

tell them what -- how to complete the record. 

And that your dose was recorded as such -- you 

know, this was the dose that the DOE reported to 

us. Things like that and then you have to really 

kind of specify whether you’re talking about 

external or internal but there are a few -- a few 

categories of information you could provide 

perhaps in a dose reconstruction that would allow 

them to have some idea about the information that 

was used in their dose reconstruction. Kind of 

addresses this to a certain extent. But I was 

just wondering if you’ve got -- I mean you guys 

are familiar with the -- with the records and the 

kinds of records that are in a case file and the 

site profiles and things like that, if you could 

maybe provide a little more insight into what -- 

what can be most helpful to the claimant in this 

situation. 

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MS. MUNN: Well the question arises, if it 

doesn’t ensure that the claimant has all the 

information what could one put in a procedure 

that would ensure that? 

MR. ELLIOTT: What is the information you need? 
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DR. MAURO: I would argue that, that can’t be 

done, I mean I would -- I think that the intent 

here is a little different than what’s being 

discussed right now. The claimant has to feel 

confident that all the essential information that 

was available was in fact used and used 

appropriately. They don’t need to know all the 

information that was actually used because some 

of that information is extremely obscured and 

impossible to understand. 

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MR. HINNEFELD: Right. 

DR. MAURO: So what -- what I really see here is 

to make sure that the claimant has a sense that 

all of the really important relevant information 

relative to this case and all of these exposure 

conditions that were reported to this case was in 

fact properly addressed. And that goes towards 

personalization and or so what I see this is as 

really as an extension of personalization. That 

is they -- they -- somehow it needs to be 

communicated to them what was the kinds of -- as 

you started out saying, what were the kinds of 

information that were used? Now the level of 

detail you go into I think is on a higher level, 

a (indiscernible) level, not in the weeds, and 
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what the issues were, whether there were 

incidents involved or whether -- I’m not quite 

sure how far you would go. But at the end of 

that conversation the claimant should feel that 

they understood that it was thorough and that all 

of the important information was looked at and 

analyzed. I don’t think it’s fair to expect that 

all of the real information was really used is 

communicated to the claimant, it’s impossible. 

It’s just too -- you know, some of these cases 

you know, you know the detail is truly 

incredible. So I would like to maybe and I don’t 

want and Arjun certainly step in but I think that 

the intent is not -- the intent is more that the 

claimant feels that all of the important 

information was in fact covered and have a sense 

of what that is and was. 

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DR. ZIEMER: Does this go to the issue of items 

that they may have brought up in the CATI? 

DR. MAURO: Yes. 

DR. ZIEMER: And then they’re looking for somehow 

that that has played a role in the dose 

reconstruction that they say my husband, my wife 

was in this blowout -- 

DR. MAURO: Yes. 
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DR. ZIEMER: -- And there’s no reference one way 

or the other that that was considered. Is that -

- Larry you kind of addressed this earlier I 

think, the issue of acknowledging items that may 

have been raised and indicating why or why not 

they may have not affected the final outcome or 

something like -- is this the same issue? 

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MR. ELLIOTT: Well I don’t -- I think it’s part 

in parcel, I don’t think it’s totally the issue. 

As I hear John talk I think it’s personalize the 

dialogue, the interaction with the claimant in 

the closeout interview to the point that each 

claimant can walk away and say okay, I understand 

what was critical in doing this dose 

reconstruction, what information that they had to 

work with and what information that they 

developed to make a dose estimation on my behalf. 

That’s what I hear John saying and certainly of 

course what you just brought up that I mentioned 

earlier if they raise an issue and it needs a 

dose reconstructor’s attention and response to 

that then that should be something that’s also 

included back to the claimant so they -- they do 

feel comfortable and understand how they -- they 

-- the issue has been addressed or reacted to. 
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DR. MAKHIJANI: Well I think -- I think this 

could work in some situations where you’re 

actually doing what we call best estimates. But 

in most cases of denial we’re really talking 

about the cases that are being denied because the 

cases that are likely compensated I agree with 

Larry that the language is reasonably clear and 

people know they’re going to be compensated, 

there are not too many questions about that. But 

in most cases, at least in my impression we’re 

doing the efficiency -- 

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MR. ELLIOTT: Overestimates. 

DR. MAKHIJANI: Overestimates, and that -- and in 

efficiency overestimates you’re very often not 

using the individual data by -- by definition or 

you’re not using a large -- some portion takes 

typically an internal dose you might not use any 

other bioassay data on the idea that TIB2 

suffices. 

MR. ELLIOTT: But we do go to great -- 

DR. MAKHIJANI: I’m -- that creates some problem 

in explaining -- in explaining the thing as to 

how you know that -- 

MR. ELLIOTT: Well I don’t know that it would 

create a problem. I think we go to great lengths 
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in an overestimating dose reconstruction. We 

took this step to modify how we report those out 

about two years ago or so where there’s language 

incorporated in the draft report that says here 

are the following reasons why this is an overestimate. And those are enumerated and I think a 

closeout interviewer could pick that piece up and 

incorporate that into the conversation of what 

was important about your dose reconstruction. 

Well these are the things that we didn’t have 

full data on but we’ve done a reasonable overestimate in this way to show that your claim you 

know -- 

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MR. HINNEFELD: I think if this is about 

personalizing the conversation I think that’s 

something that we should pursue and we can 

provide -- like I said we can provide a procedure 

change now that kind of gets into that with the 

idea that that’s almost like a continuing 

improvement process. You know is -- you know 

there may be additional things that occur to us 

as we get into it that would be helpful along 

with -- so. 

MR. ELLIOTT: That’s a whole different slant, 

personalization versus giving up all of the 
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records that might be ancillary to a dose 

reconstruction. 

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MR. HINNEFELD: I think one thing -- one thing 

that -- one thing that’s kind of relevant to at 

least one of the cases here is there was 

information provided in a closeout interview that 

probably was judged not to -- wouldn’t affect the 

dose reconstruction because the way it was done. 

But there was -- but the dose reconstruction 

therefore went out without modification from the 

draft despite the fact that the person had 

provided specific incident related information to 

the closeout interview and the -- and the -- the 

final dose reconstruction said that the person 

didn’t give any specific -- any information about 

specific incidents because during the CATI they 

had not given specific incidents, said I was 

involved in a lot of incidents. And so there was 

-- there was a phrase in the dose reconstruction 

the person wasn’t involved in you know, they 

didn’t name any specific incidents and that this 

is an overestimated approach to account for it. 

But in the closeout interview the person 

described in detail a specific incident. 

DR. MAURO: Right. 
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MR. HINNEFELD: But there was -- but probably 

there was -- I don’t know if the correct judgment 

that that incident won’t affect the dose 

reconstruction based on how it was done. But 

there was no language change in the dose 

reconstruction to -- 

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DR. MAURO: To capture. 

MR. HINNEFELD: To capture that information 

throughout the closeout interview. So this 

probably hits to that and it speaks to the 

personalization. So I think certainly that’s one 

thing you know, we’ve -- we’ve had for awhile now 

and it’s been with -- it may be in the last year, 

a couple years or a little more ago that we have 

specifically said that any incident raised in a 

CATI needs to be described in the dose 

reconstruction even if it doesn’t affect the 

dose, even if it’s about chemical exposure you 

need to say in the dose reconstruction in the -- 

you know, in their interview they talked about 

this exposure to beryllium on their job as well 

but that doesn’t add anything to the dose 

reconstruction, dealing with radiation. So we’ve 

made that change in the last maybe -- I forget 

how long ago, it’s probably a couple years ago, 
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make sure everything is addressed. But in this 

case it was a closeout interview where the 

information was raised. So it would -- it would 

I think fall to us to make sure that we do that 

same kind of thing, because we have a mechanism 

for changing -- for doing a change to a draft 

dose reconstruction before you issue the final 

even when there’s -- you know, because of 

information we receive in closeout interview. 

You know, we’ve got a whole rework loop so to 

speak that is for that purpose, information 

received in closeout or -- or attached to the 

OCAS1 or something like that. So we have a whole 

rework process associated with that. 

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DR. MAURO: So you know, if this is a -- maybe I 

-- the closeout interview, is that held after the 

person has received the report? 

MR. HINNEFELD: Yes. 

MR. ELLIOTT: Supposed to be. They’re supposed 

to have had an opportunity to review the report 

and then an interview is scheduled. In some 

instances we’ve -- 

MR. HINNEFELD: There has been a mistake 

apparently when some -- at least one person I 

know of got interviewed when they didn’t have it 
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MR. ELLIOTT: I don’t understand that. It’s a 

rare event. 

DR. MAURO: Okay so -- so then again -- so -- so 

when that unusual circumstance occurs that during 

the closeout interview the claimant makes 

reference to some specific incident as to what 

you have mentioned, I didn’t quite follow how do 

you resolve that is before -- in terms of 

communicating that to the claimant that since he 

already has the -- the dose reconstruction 

completed report with the denial and your person 

reads it but subsequent to that is this closeout 

interview which does raise -- 

DR. ZIEMER: Well it doesn’t have a denial 

attached? 

MR. HINNEFELD: The denial goes through DOL. 

DR. MAURO: Oh, I’m sorry, I’m sorry, you’re 

right it’s not included. 

DR. ZIEMER: All he has is the dose 

reconstruction draft. 

MR. HINNEFELD: All he has is the drafted dose 

reconstruction. 

DR. MAURO: The dose reconstruction, you know, 

I’m so used to looking at the reports that you 
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MR. HINNEFELD: Yeah. He has -- all he has is 

the drafted dose reconstruction report and so -- 

in that event -- in this -- in this instance what 

I feel like should have happened would have been 

that well, I don’t know how much evaluation was 

made of the information provided by -- by the 

person about the incident. Presumably a dose 

reconstructor would have -- should have been 

asked what about this incident, they specifically 

mentioned this incident would this affect how we 

would have done the dose reconstruction? Dose 

reconstructor could very well concluded now we 

have an overestimate. We expected this person to 

be involved in some incidents; we overestimated 

based on that. Feel like we’ve bracketed this 

kind of incident ‘cause it was a one day 

incident. 

DR. MAURO: Okay, so -- so that -- so this 

information for example in the way in which it 

could have gone down is when that incident was 

brought up in the closeout interview, that would 

have looped back in and the final -- and 

eventually there was the report that came out 

later that had here’s the dose reconstruction, 
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here’s the result and here’s the reason for 

denial. 

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MR. ELLIOTT: Even if the final -- 

MR. HINNEFELD: The final comes from us. 

DR. MAURO: We can say no, but there -- 

MR. HINNEFELD: The final answer comes from us so 

at that time when additional information is in 

closeout interview that in this case affects 

certainly the words in the dose reconstruction. 

DR. MAURO: Okay. 

MR. HINNEFELD: What should have happened at that 

point was it should have been reworked and -- and 

generally then resubmitted as a new draft. 

DR. MAURO: Oh, okay. 

MR. HINNEFELD: To the -- to the claimant. 

DR. MAURO: Put in a date. 

MR. HINNEFELD: There have been occasions where 

the claimant would say I really think my dose 

reconstructor should say such and -- my dose 

reconstruction should say this and they have 

agreed that as long as their final dose 

reconstruction said that that they had no 

additional information to hide -- to -- to 

provide, they weren’t -- they didn’t need to talk 
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to us again; we could just go ahead and send them 

the final dose reconstruction as long as we said 

that. And we’ve done some -- there are some 

cases where we just looped it to the file, change 

the file and sent a backup. In other instances 

if they don’t say that’s okay, if they really -- 

they may want to talk to us again after they see 

what we change then they’re issued a new draft 

dose reconstruction and then they get another 

interview and at that point they either say okay, 

this is what I want it to say or not, they sign 

the OCAS1 and then it goes -- and then we print 

the final and the final goes to DOL and to the 

claimant. 

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DR. MAURO: Along these lines in this process 

earlier you had mentioned the possibility of some 

language as you were going to look into that 

communicates to the claimant that I forget the 

exact words you used that you know, that the 

outcome of this dose reconstruction that you 

performed would lead one to -- that may not be 

compensated. I understand -- I -- 

MR. HINNEFELD: Yeah. 

DR. MAURO: Now, what happens -- what -- able to 

show causation. Now if those words do find their 
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way I mean and in a way this is the ultimate link 

to communication because let’s -- let’s face it 

in the end this person wants to know you know, 

where am I in the process? Does it look like I’m 

going to be compensated or not? And I -- and I 

have to say I was presently surprised to hear 

that there were some words that you possibly 

could put in here -- 

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MR. HINNEFELD: No, I think, like I said I 

haven’t vetted those with anybody. 

MR. ELLIOTT: We don’t know for sure. 

DR. MAURO: You don’t know for sure but let’s 

just -- let’s play that out a little bit. So now 

you’re in a very important place in the closeout 

process because now the person has in front of 

them the document that has those words and let’s 

say those words say something to the effect that 

it leads them to understand that they’re likely 

not going to be compensated, if you can do that. 

But that is -- it’s an important place to be 

because then it puts you in a position to open up 

a meaningful dialogue with this person on why we 

believe that we feel this was a good job and why 

we were claiming favorable or how we did what we 

did, how we believe we have addressed all of the 
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issues that you had mentioned and others. 

Because see, in a funny sort of way without that 

you don’t have context and the person is not -- 

you know but now -- now really you’re talking to 

them straight. You say listen, it looks like 

we’re not going where you want to be and this is 

why we believe we’re there and why we think we’re 

right. Now, in effect what you’re really asking 

them about is there anything about what I just 

told you that you think that maybe we got it 

wrong or there’s more -- not more in terms of -- 

is there more information? Is there some 

information you gave us before that perhaps we 

didn’t capture, other information that you have 

for us because right now it looks like this is 

where we’re headed. You know, I know that it -- 

it almost makes it a lot easier to talk to the 

person if you could -- if you could sort of be 

straight with them about where we are, you know 

what I mean? 

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MR. ELLIOTT: Yeah, we wanted that from the 

start, but we weren’t allowed to do that. See if 

we can find some middle ground here that will be 

palatable to all. 

MS. MUNN: So there’s no specific action on this 
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particular item, we can consider this item closed 

and any activity that’s going to occur as a 

result falls under the general concept of 

personalizing the information? 

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DR. MAURO: This is one of the items that sort of 

loops back that’s going to be covered by an 

earlier one? 

MR. HINNEFELD: I think it’s probably going to be 

addressed by a different finding. 

DR. MAURO: Right, an earlier one. What do we 

call those, closed? Kathy what do we call them 

when they -- 

MR. HINNEFELD: I think we just say addressed in 

finding. 

DR. MAURO: Oh, addressed in finding, an earlier 

finding. 

MS. BEHLING: That’s right. 

DR. MAURO: Okay. 

MR. HINNEFELD: I think it might fall in with 

number two. 

MS. MUNN: I would say so. 

MR. ELLIOTT: Now this is good, you know, 

understanding you intended this to be for 

personalization -- 

DR. MAURO: Yes. 
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MR. ELLIOTT: This is totally different than the 

way we read it is, we give up an analysis what we 

call an analysis record to DOL that has 

everything that’s relevant to a given claim and 

that usually consumes a whole CD. 

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DR. MAURO: Oh I know, we’ve seen them. 

MR. ELLIOTT: And so can you imagine trying to 

make sure the claimant has all of that 

information and then having to redact perhaps 

many pages in that. 

MS. MUNN: Impossible. 

MR. ELLIOTT: And at the start of the program I 

was an advocate of let’s give the person their 

own analysis record, give them a CD, we’re going 

to burn a CD for DOL, we’ve got to burn one for 

DOE, let’s give one to the claimant, I want them 

to have one; no. I was just told we -- it’s just 

not feasible, not practical and not pragmatic, 

so. 

MS. MUNN: Finding number five, I do believe that 

we have covered that one pretty thoroughly. 

We’ve already talked about the fact that we’re 

going to call health physics reviewers something 

else. 

DR. MAURO: Lesson number one. 
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MS. MUNN: It goes with number one. 

MR. HINNEFELD: Yeah. 

MS. MUNN: Finding number six. No requirement to 

connect the closeout interview with the CATI. 

MR. HINNEFELD: Is this in terms of making sure 

that during the closeout interview they describe 

that this is what you told us in the CATI? 

DR. MAURO: This goes to exactly the example that 

Paul used before. 

MR. HINNEFELD: And this is how we addressed it. 

DR. MAURO: Right. 

MR. HINNEFELD: Okay, and that could be 

instructions to be provided in the procedure to 

the interviewer; we could do that at that point. 

Okay. 

MS. MUNN: And since we’ve already talked about -

- is this also -- 

DR. MAURO: Which one was that? 

MS. MUNN: -- included in the -- 

MR. HINNEFELD: That’s ninety-two dash six on the 

matrix. 

MS. MUNN: Ninety-two dash six and then ninetytwo dash three we had said we’re going to suggest 

changes in the procedure. 
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DR. MAURO: It’s probably a good idea when -- 

when -- when three is being looked at that you 

know, this is almost like a refinement -- 

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DR. MAURO: -- on three, and it’s probably a good 

idea to make sure that when the person is working 

off number three, that they take into 

consideration six. 

MR. HINNEFELD: Okay. 

DR. MAURO: You know otherwise you could see a 

person doing three but not really addressing six. 

But this -- you understand. 

MR. HINNEFELD: Yeah. 

MR. MARSCHKE: So what’s six? 

MS. MUNN: We -- 

DR. MAURO: It goes back to three -- it goes back 

to -- 

MR. MARSCHKE: Is it addressed in finding three 

or is it closed or is it -- 

MS. MUNN: No, it’s going to be the same action 

as number three. 

DR. MAURO: Yeah, it’s being addressed -- I don’t 

know if we use the word trans -– Kathy, when do 

we use when you transfer -- not transfer but when 

we -- 
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MS. BEHLING: Addressing finding 9203. Not 

transfer, transfer is going out of the task three 

system. 

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DR. MAURO: That -- that leaves -- that leaves 

this; okay. 

MS. BEHLING: Yes. So this is just going to say 

address in finding 0092-03. 

DR. MAURO: Kathy if we address an issue in a 

different procedure still within the task three 

realm but in a different procedure is that a 

transfer or is that an addressed? 

MS. BEHLING: I would still consider that an 

address. 

DR. MAURO: Okay. 

MS. MUNN: Procedure six, oh, we have two 

procedure 92-6. 

MR. HINNEFELD: Oh yeah. 

MS. MUNN: We have a numbering issue, Kathy. 

That should be seven. 

MS. BEHLING: Okay, we’ll make that change. 

MR. MARSCHKE: Wait a minute; we’ve got a seven 

on the next one is a seven. 

MS. MUNN: And that should be eight. 

MR. MARSCHKE: The next one will be eight. 

DR. MAURO: We’ve got a ripple effect. 
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MS. MUNN: We have a total of eight. Just a 

numerical -- All right, technical questions are 

not answered in real time. Is this not also the 

same discussion that we had relative to the 

availability of personnel we discussed in item 

two? Finding two or finding three? 

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MR. MARSCHKE: I think it was finding two. If 

that -- we talked about getting back to the 

claimant with answers to the questions. 

MS. MUNN: Uh-huh. 

DR. MAURO: Okay, addressed in item two. 

MR. MARSCHKE: Well it’s not really addressed. 

DR. MAURO: No, not addressed, to be addressed. 

MR. MARSCHKE: Would it be the technical answer -

- questions not answered in real time, we’re not 

going to answer the questions in real time, we’re 

going to basically get back to them. Basically 

if -- if -- if we’ve decided that we’re not going 

to have an HP present in the closeout interview 

to answer questions in real time, we’re going to 

get back to them, we’re going to take the 

questions and get back to them later. So, it’s 

not really addressed, it’s -- 

MS. MUNN: The same issues in a dif -- presented 

in a different way. 
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MS. MUNN: So, but the resolution is the same. 

MR. MARSCHKE: Okay. 

MS. MUNN: Right? 

MS. BEHLING: Is that finding 02 or 03? Because 

03 we discussed about stopping the clock on 

signing the OCAS1 forms until their questions can 

be answered, or am I confusing that with -- 

MS. MUNN: No, that’s what we said. 

MR. MARSCHKE: I have that under -- you know, I 

have that under 03. Under 02 I had get back to 

the claimant with answers to questions and under 

03 I had you know, when a claimant asks a 

question remove the signing of the OCAS1 form 

from the discussion and get back to the claimant 

and stop the sixty day clock. So, it’s kind of 

under -- 

DR. MAURO: It’s more two than three I would say. 

MS. MUNN: Can we say we’re covering a broader 

set of issues in number two I think than in 

three. 

MS. BEHLING: Okay. 

MS. MUNN: And it will be addressed in any case. 

And the -- 

MR. HINNEFELD: Last one. 
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MS. MUNN: That was number seven, the final issue 

is number eight. No specific provision for 

responding to complaints about difficulty in 

understanding the dose reconstruction. Stu? 

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MR. HINNEFELD: Well, there’s -- there’s that -- 

a difficulty in understanding which is what we 

talked about having a health physicist get back 

to the person if need be to you know, answer 

questions or you know, make sure we answer 

questions and then it leaves room for undue and 

substantial subjectivity in addressing technical 

information. 

DR. MAURO: I think it’s a two. 

MR. HINNEFELD: Does this relate back to things 

we’ve already said we’re going to look -- we’re 

going to specify and what are -- what conditions 

does this have to be referred to a dose 

reconstructor for response and -- and then it 

would fit in with what we’ve already kind of 

committed to which was to provide more 

specificity in the procedure? 

MS. MUNN: Well the overall personalization we 

were going to do in item two. 

DR. MAURO: Yeah, see, two covers just about all 

the things we’re talking about. 
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MS. MUNN: Yeah. 

MR. HINNEFELD: Okay. 

MS. MUNN: Does anyone have any other burning 

issue they feel needs to be covered under PROC92? 

I’m not certain exactly how many action items we 

have here but I think about four, most of them 

having been identified up front. I’ll try to put 

them together afterward so that we know what 

we’re doing with them. 

DR. MAURO: By the way this is a very important 

part of our new process and I know we’ve been 

doing it but these action items are actually 

going to go into the new form on direction given 

there’s an actual box now and a form that says 

direction given by the working group and actually 

these action items have to be -- are going to be 

our scorecard so to speak. 

19 NIOSH – INCORPORATION OF PROC-0090 INTO MATRIX

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MS. MUNN: Yeah. Okay. That brings us to the 

incorporation of PROC0090 in new form into the 

matrix. I will have to admit that when I put my 

materials together last night the PROC90 issues 

were not among the pieces of paper that I picked 

up. So I am not able to direct the discussion as 
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to where we were with ninety and why we were 

concerned with a new form into the matrix. 

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DR. MAURO: I have to ask, is PROC90 one of the 

QA procedures? 

MR. HINNEFELD: No, that’s the CATI interview 

process. 

MS. MUNN: That’s CATI. 

DR. MAURO: Oh, this is the CATI. 

MS. MUNN: CATI. 

MR. HINNEFELD: This goes back to step one -- 

step one of the interview -- of the procedure 

review. There were actually three different 

procedures that described the CATI process that 

had since been consolidated into PROC90. 

DR. MAURO: Okay. 

MR. HINNEFELD: Based upon my read of PROC90, the 

consolidation is the issues remain. You know, 

the revision did not address the findings from 

earlier procedures. So, there has been limited 

discussion of the findings from those two and 

then the issue is presented here as putting it in 

the new format which is going to be largely an 

administrative task once you get the database you 

put it in there. I did send and Wanda I don’t 

think I even put those on my disk, they must 
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MS. MUNN: Nope, they were not on the -- 

MR. HINNEFELD: I sent two -- no, it was 

separate, I sent a separate message and there 

were two files on there that were essentially 

Word files but in the new format, the details 

format from the database and just showing a 

demonstration and there are some -- there are 

twenty-nine findings that’s now related to PROC90 

from the -- from the first set review. 

MR. PRESLEY: Is that the one you sent out 

December 7th? 

MR. HINNEFELD: That was Friday, probably sent it 

Friday, right. And there are -- and so I’ve only 

-- I sent a message with essentially two files 

attached which are Word files which are just the 

details page and how it would be converted of 

what I proposed and I don’t know if this will fit 

so I hope I copied Kathy on it. I don’t know 

what I proposed would fit in the database or not 

-- the database field or not because I proposed 

in the -- in the -- in the finding name not only 

listing PROC90 but listing the finding as it was 

originally numbered in that first product because 

it was like PROC4-1, which would be the first 
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finding and then that would convert to 90-1 and 

then when she gets through with PROC4-1’s, maybe 

four findings on PROC4 then you go to PROC5 

findings and so the numbering will 

(unintelligible) you’re ready for PROC number 5 

when you get to that finding then that one we’d 

convert to PROC5 and so there’d be some way to 

retain the origin of those findings. It may not 

fit with the database’s design, so I don’t know. 

It may be -- I don’t -- if it’d be possible to 

track them from their exist -- their -- you know, 

original number, like we could PROC them, you 

know track them as PROC4, PROC5 and PROC17 

findings, track them in that manner database we 

could -- and I don’t know, you know, I hate to 

add fields to that database, it seems to be 

pretty well defined. But I mean like have a 

predecessor finding; I know Kathy wants me to 

shut up. 

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MS. BEHLING: No. No, no, no, you’re doing fine. 

Stu, you did send me that email and I think that 

what you -- I like what you’ve done and I think 

that that will fit into our -- the matrix as it 

currently exists and the way I was thinking we 

could do this is to go back to we still have 
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captured on the database under the first set, the 

PROC4, PROC -- I guess there were three as you 

said, there were PROC4, PROC5 and PROC17. And so 

I can go back into the details discussion on 

those initial findings and indicate that these 

will be now addressed under the PROC90 and I 

think what you’ve done under the procedure number 

and the finding number will work just fine, that 

you put in parentheses that these were originally 

under PROC04 and 5 and 17. So, I think this 

should work. 

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DR. MAURO: So, would that be an addressed in for 

the others, the PROC -- the PROC4 and 5 that 

where these issues were originally raised now are 

we saying that those issues are being addressed 

under PROC90 and therefore are transferred -- not 

transferred, are addressed in? In other words 

I’m thinking about the form of -- is that how 

we’re going to get this -- 

MS. BEHLING: Yes. 

DR. MAURO: -- closure. So it will be addressed 

in and then when you find -- when you do get the 

PROC90 it will all be there and perhaps with a 

reference to a white paper? 

MS. BEHLING: Yes. 
229

DR. MAURO: And the -- in -- in -- in the writeup since you can’t fit it. You know, maybe some 

brief description -- conversation we’re having 

right now -- 

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MR. HINNEFELD: Yeah. 

DR. MAURO: -- with the end that -- under the 

section workgroup meeting – 

MR. HINNEFELD: Right. 

DR. MAURO: -- this discussion will somehow be 

captured. 

MR. HINNEFELD: Yeah. 

DR. MAURO: And -- and it will be making -- and 

also there would be a reference to a white paper 

that you submitted on -- is that -- 

MR. HINNEFELD: No, I didn’t submit a white 

paper. All I submitted was examples in how it 

would look. 

DR. MAURO: Oh, okay. Okay. 

MR. HINNEFELD: I did not submit a white paper on 

this. What -- What needs to happen on these is 

well A we all have to refresh our memories and 

then have a discussion about -- because the 

finding was made and we made some initial 

responses and some of those initial responses 

pointed out that well we have this new 
230

acknowledgment packet or that -- we -- at the 

time that we were developing which is -- but is 

now filed now and so some of those findings we 

think were addressed sufficiently or we hope to 

address sufficiently by the standing 

acknowledgment packet. And there have been a few 

other things that have been modified that are 

captured in those responses. So we kind of have 

to get a feeling for how far have these responses 

gone, you know, have we -- have we actually 

solved any of them and for those that are not 

solved then we need to talk about additional 

approaches, you know, other things that might 

have to happen because I don’t know that I would 

say that everything had a nice clean resolution 

likely; I don’t think they all did. So, that’s 

what would have to happen is we’d have to pull 

those back out, refresh our memories and -- and 

determine -- and -- and our part as well on our 

side, what can be done for instance, you know the 

people who actually do the work normally know 

best the feasibility of a particular change or 

that particular change or if maybe there’s an 

alternative that can satisfy the intent. And so 

get the people who do the work engaged in what is 

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it that can be done for these. So that has to 

happen and then -- then we can discuss I think 

the future work. 

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DR. MAURO: So -- so the way this would work then 

is in our matrix, what you just discussed would 

be in the discussion and I guess there’s an 

action item that is you and Kathy are going to 

work on I guess you’re going to work on some kind 

of -- I assume some kind of documentation that 

tells the story oh, you’re going to (inaudible) 

the open items and these others and how -- how 

PROC90 is or is not -- I mean -- let’s try to go 

ahead and get a hook so that we don’t lose track 

of these items. 

MR. HINNEFELD: Probably what -- what we could do 

is we could have a NIOSH you know, action, you 

know, we had -- we’ll have -- we come -- we can -

- someone, I don’t know who someone is, will 

capture this conversation at this meeting in the 

Board block and then after that there’s a NIOSH 

follow-up block or something like that. So we 

can go back and we can provide the follow-up 

information and put something in each of those 

blocks, even if it’s to say that we think our 

original response took care of this. We could 
232

provide that and then that kind of kicks us on 

down moving that along. I guess we could do 

that. 

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DR. MAURO: Okay. 

MS. MUNN: You just said the magic words, don’t 

know who does that. Can we agree on who does 

that? 

MR. HINNEFELD: Well I can -- I can write that 

summary that what I think needs to happen on 

those findings from now on and -- and then put 

that in each -- each box -- a box for each of 

those findings and then I could, at some point, I 

won’t -- this may not -- this probably won’t be 

ready for January. But at some point we could 

provide an updated NIOSH response even if it’s to 

say that we think our initial response 

(unintelligible) so and then we’d be prepared to 

go from there and gives you then the opportunity 

to see what our position is now and look at -- 

and the initial response would be on there you 

know, we’ll cut and paste that on there so it’ll 

be up above. 

DR. MAURO: Given the complexity of this and the 

fact that in order to address each of the 

subparts of these things we’re talking about and 
233

the process that will take place between you and 

-- well, between NIOSH and SC&A in terms of the 

next meeting, apparently there will be some 

document prepared of some form. It sounds to me 

it’s not something that we can easily put into 

this form. 

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MR. HINNEFELD: Well right now I think that -- I 

don’t know of anything that won’t, these are 

findings. 

DR. MAURO: Okay, well if it can, great. 

MR. HINNEFELD: These are findings. 

DR. MAURO: If it can, great. 

MR. HINNEFELD: These are findings about is at 

the time three procedures and so unless I run 

into something and unless -- well, I don’t 

remember very well, but my recollection is that 

they -- they are not so special as to require 

their own white papers. I think we could -- if 

we could address them as much as we’ve addressed 

other procedures and with, you know, initial 

response and then subsequent discussion. 

DR. MAURO: So, from a format point of view there 

would be a PROC009 and it would have a 01 through 

0 -- 

MR. HINNEFELD: 29. 
234

DR. MAURO: 29. Each one will have its own page 

and each one would be separately tracked. 

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MR. HINNEFELD: Uh-huh. 

DR. MAURO: Okay. 

MR. HINNEFELD: I mean -- don’t you think? 

DR. MAURO: Unless you feel that some of the 29 

collapse into something else. 

MR. HINNEFELD: Well you know for cleanliness of 

tracking let’s put them all on there. 

DR. MAURO: Okay. 

MR. HINNEFELD: You know -- 

MR. MARSCHKE: Don’t do that yet. 

DR. MAURO: Don’t do that yet? Okay. Play it 

out. 

MR. HINNEFELD: Yeah, let’s just play it out, get 

it in there and then it’ll be something for us to 

discuss as a you know, we’ve got to finish up the 

first set, I mean there were a series of actions 

that we need to do from the first set that I’m 

not sure are all done yet, a number have been 

done. But then these -- these actual findings, 

these are down toward the end of the table, some 

that I think they were the last few procedures on 

the matrix. We need to go ahead and work 

ultimately through resolution on those so -- 
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DR. MAURO: So -- so we’ve got to build this very 

similar to what we build let’s say PROC92. 

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MR. HINNEFELD: Yeah. 

DR. MAURO: It has its own stand alone series of 

in this case, converts into a 29 findings. 

MR. HINNEFELD: Yeah, now presumably I don’t know 

-- yeah, I don’t know if Kathy’s built -- I would 

assume that’s in there if she’s -- she’s 

populated all the data tables that those findings 

would be in there. Kathy, is that right? The 

PROC4, 5 and 17 findings, are they in there? 

MS. BEHLING: Yes, they are. 

MR. HINNEFELD: Okay. 

MS. BEHLING: The findings from the first set of 

-- the first set of procedures that were reviewed 

are already in there, yeah. 

DR. MAURO: Okay. I printed something out that 

wasn’t. 

MR. HINNFELD: So then that -- that page in the 

Access version of that page then will open up, 

where we have a folder in it and we just fill out 

what we can fill out. 

DR. MAURO: Okay. Great. 

MS. BEHLING: And Wanda I might just add that I 

had been under the impression that during this 
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meeting both Steve and I, I think have been 

taking notes and we will take on the 

responsibility of filling in the next blue 

section of our details section where we say this 

is what transpired during the 12/11/07 meeting 

and we will fill in the discussion issues and the 

workgroup directives because we -- like I said, 

have been trying to take very detailed notes and 

as this meeting has been progressing and then 

we’ll send that off to NIOSH and then they can 

also fill in you know, any follow-up actions and 

we’ll have our follow-up actions to fill in. But 

I was under the impression that SC&A would 

continue to update and complete this matrix. 

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MS. MUNN: Yes, I was under that same assumption 

so I have not been taking notes in that regard. 

I’ll be glad to work with you Kathy, just give me 

-- you send to me the information that you have 

recorded for the blue box and each of the cases 

that we’ve covered here. I’ll certainly make any 

comments that seem appropriate here and pass them 

back to you for incorporation in the next copy of 

what the working group sees. 

MS. BEHLING: Very good, that -- that will work. 

MS. MUNN: Great. Thank you very much. 
237

MS. BEHLING: So I think we’re set for PROC90 

then. That looks great actually now that I 

finally see it. 

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4 SC&A AND NIOSH – OTIB-0023 TRACKING IN MATRIX

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Next item, resolution of how to incorporate 

tracking of crucial OTIB0023 aspects in the 

matrix. This is a similar kind of problem as I 

recur -- as I -- as I recall. I believe we were 

expecting the agency and our contractor to talk 

about this offline and have some proposal for us 

today. 

MR. HINNEFELD: I’m not sure we did that. 

MS. BEHLING: Well, actually this was an issue 

that Stu, you and Hans and I discussed before the 

previous meeting. 

MR. HINNEFELD: Right, right, we did that. 

MS. BEHLING: Right, we -- we talked about this 

back in November before I believe the November 

7th meeting and I thought we had come to 

agreement and resolution on all of the findings 

and most of those resolutions was -- were that 

you were going to incorporate some changes into a 

revision of this procedure and I believe our 

discussion during the last meeting was the fact 

that maybe you were going to provide to the 
238

workgroup some wording associated with what kind 

of changes you were thinking about incorporating 

into the revisions. 

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MR. HINNEFELD: Okay, I can do that. We’ve 

already -- you know, there is a modification to 

IG1 associated with this too. That modification 

has been made already. I don’t think OTIB23 has 

been revised though. 

MS. BEHLING: I’m sure it hasn’t. Like I said we 

discussed this a month ago. But this gets 

captured into with the matrix just like all of 

the other items here. This is not a matrix -- 

anything difficult with the matrix. I -- I 

believe if I’m recalling correctly that this was 

just going to be an issue that NIOSH was going to 

come back with some wording as to how they were 

going to revise the OTIB23 procedure. 

MS. MUNN: And you have -- Kathy and her team has 

incorporated a great deal of information on that 

OTIB already. Just we don’t want to get bogged 

down and leave it. 

MS. BEHLING: Right. 

MS. MUNN: So the action is for NIOSH to provide 

wording. 

MR. HINNEFELD: Yeah. 
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MR. HINNEFELD: OTIB -- OTIB23. 

MS. MUNN: Well yeah, OTIB23 but you were going 

to incorporate you said an IG procedure. 

MR. HINNEFELD: Oh, and IG1. 

MS. MUNN: IG1 goes into it? 

MR. HINNEFELD: There was like a one page -- page 

change to IG1. 

MR. ELLIOTT: This has already been done. 

MR. HINNEFELD: That’s been done. 

MS. MUNN: So it’s just getting it into the 

matrix? 

MR. HINNEFELD: Yeah. 

DR. MAURO: Stu, I’m looking right now at the 

material you sent -- 

MR. HINNEFELD: Okay. 

DR. MAURO: OTIB23 items 1 through 8 of these. 

MR. HINNEFELD: Right. 

DR. MAURO: On your package, the old format and 

matrix. 

MR. HINNEFELD: Right. 

DR. MAURO: It starts on page ten for anyone who 

has that. Now I see that in that all of the 

issues are laid out the way we used to do it and 

-- and I see there’s a red -- there are some red 
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MR. HINNEFELD: Yeah, yeah. 

DR. MAURO: So, now that red material that’s in 

here I’m not quite sure what -- whether the 

November 7th red material that’s in your matrix 

made it into the new format or not. Steve -- 

MS. BEHLING: No -- no it didn’t. 

DR. MAURO: Oh, okay. 

MS. BEHLING: I can -- I can incorporate that. 

DR. MAURO: Okay. Now but then over and above 

that the next step in the process, I just want to 

make sure I got it right. So in effect we’ll 

load up the matrix new format with your new 

material that’s in your old matrix from November 

7th and I didn’t follow from there what were the 

next steps in terms of further loading up the 

matrix? For each one of -- 

MR. HINNEFELD: Well, we’ve talked about possible 

wording changes but I -- some of them are in 

that, these November 7th notes. 

DR. MAURO: Okay. So I mean that’s where I’m 

going. Maybe you’ve captured a lot of it 

already. 

MS. MUNN: Would the action be for the two of you 

to take a look at what we have and ascertain 
241

whether additional words need to go into the 

matrix or whether you already have them? 

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MR. HINNEFELD: Yeah, I guess actually there is 

sort of a promise as you know, -- some of them 

are pretty -- fairly specific in terms of what 

we’re going to do. Others are sort of a -- an 

ill defined promise that we’re going to do 

something so it looks like we could -- we just 

need to do a markup as we’re going to change it, 

yeah. 

DR. MAURO: The goal I think in the end is to 

assign to each of those eight findings open, 

closed, in abeyance -- 

MR. HINNEFELD: Yeah. 

DR. MAURO: And words that go with that. 

MR. HINNEFELD: Yeah. 

DR. MAURO: Right now we don’t have that. 

MR. HINNEFELD: Right. 

DR. MAURO: We do? 

MR. HINNEFELD: They’re all in abeyance. 

DR. MAURO: They’re all in abeyance, okay. 

MS. MUNN: All right. 

MR. HINNEFELD: Yeah. 

MR. ELLIOTT: Work to be done. 

MS. MUNN: Yeah, work to be done. All right. 
242

1 HOUSEKEEPING AND ACTION ITEMS

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Does anyone have anything else other than our -- 

our housekeeping issues with when, where and how 

we meet next? Any other specific matrix items we 

need to address? Any other procedure issues? If 

not, it’s calendar time. 

MS. BEHLING: Okay, Wanda? 

MS. MUNN: Yes? 

MS. BEHLING: Maybe if you would allow me to just 

ensure that I have all of the action items that 

we talked about with regard to changes that we’re 

going to introduce into the matrix. If I could 

go through those I would appreciate it and then 

you can tell me if I’ve missed anything. 

MS. MUNN: We will certainly do that if you would 

like to do it that direction or it was my intent 

to read through the action items that I have. 

MS. BEHLING: Okay, that’s fine. I also wanted 

to inform you that I did contact our Access 

person during one of the breaks and I have some 

answers with regard to whether we can or cannot 

do some of the things that -- in fact we can do 

everything that I have written down here, he’s 

going to be able to make those changes. 

MS. MUNN: Good. All right. Do you want to go 
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MS. BEHLING: No, no, go ahead; I didn’t know you 

were going to go back to the action items. Go 

ahead. 

MS. MUNN: Yeah, I try to read my notes, 

sometimes that’s impossible but we’ll see where 

we go with it. We’re currently scheduled to meet 

prior to the full Board meeting in -- 

DR. BRANCHE: The last I heard Wanda was that you 

and Robert had to work out between you how you 

all were going to organize your meetings on the 

seventh. 

MS. MUNN: I believe as far as we know right now 

there may not be a problem with -- with that. 

MR. PRESLEY: Are you planning on having yours 

start in the morning or at twelve? 

MS. MUNN: I had intended to have mine start in 

the morning but if you’re not going to -- you 

know, if it turns out we don’t have to have an 

NTS meeting or can we reverse it now and say we 

will have -- start our meeting in the afternoon 

so that, that would leave the morning free if it 

turns out we do have to have an NTS then we could 

do it in the morning. 

MR. PRESLEY: That’s fine with me. 
244

MR. ELLIOTT: The earliest that NIOSH staff from 

OCAS could get there on the Monday is I think 

around noon, right Stu? 

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MR. HINNEFELD: That’d be my guess, get there at 

noon, maybe noon. 

MR. ELLIOTT: Since we could take effect of the 

cheaper air fare rate but noon is the earliest I 

think we can -- we can make our presence. 

DR. BRANCHE: For either meeting. 

MR. ELLIOTT: For either meeting, any meeting you 

pick. 

DR. BRANCHE: So it would mean that if there’s a 

need for a Nevada Test Site meeting it might have 

to follow this one. 

MR. ELLIOTT: That’s noon -- that’s noon out 

there. 

MS. MUNN: With noon Monday where we are. 

DR. MAURO: I think our folks have made their 

plans to arrive sometime Monday morning, like ten 

o’clock, so -- 

DR. BRANCHE: Okay so I’m just saying that 

Wanda’s making her plans and just the idea of a 

Nevada Test Site meeting on the morning of the 

seventh is impractical. 

MR. HINNEFELD: Right. 
245

DR. BRANCHE: So if there’s going to be a Nevada 

Test Site meeting it’s going to have to follow 

this one. 

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MR. PRESLEY: Yeah. 

DR. BRANCHE: Just bear that in mind. Ms. Munn, 

back to you. 

MS. MUNN: I’m thinking and that’s a rare 

occasion so bear with me. 

DR. ZIEMER: So we have subcommittee Tuesday -- 

MS. MUNN: Tuesday morning. 

DR. ZIEMER: -- morning at ten? 

MS. MUNN: I believe. 

DR. BRANCHE: No, no, Linde is at eight. 

DR. ZIEMER: Linde’s at eight. 

DR. BRANCHE: Linde’s at -- 

DR. ZIEMER: No, that’s the workgroup, the 

subcommittee would be Mark. 

DR. BRANCHE: I think we tried to use ten or ten 

thirty; I can’t recall. Zaida, are you on the 

line? 

DR. ZIEMER: So Lind -- Linde and dose 

reconstruction are Tuesday morning, the full 

Board starts at noon. 

MS. MUNN: At noon. 

DR. BRANCHE: No, the full Board starts at one. 
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1 MS. MUNN: One, after lunch. 

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DR. BRANCHE: I think -- I think what we have is 

that whatever happens with the subcommittee I 

think depending upon how briskly they move I 

think we’ve scheduled to end at twelve thirty; I 

think it goes from ten to twelve thirty or ten 

thirty -- ten fifteen to twelve thirty or 

something like that. It’s a tight little frame. 

MS. MUNN: Uh-huh, yeah. I think Mark doesn’t 

expect to cover a lot of material. 

MR. PRESLEY: Arjun? 

DR. MAKHIJANI: Yes. 

MR. PRESLEY: How much have we got to discuss on 

NTS on the nineteenth? 

DR. MAKHIJANI: Oh Mr. Presley, we’ve given you 

the extent of beta dose review, so I believe and 

we’ve discussed it some I believe that that was 

for re-suspension? 

DR. MAURO: Yeah, well I guess I have a more of a 

question. To what degree have we married the 

site profile reviews and the SEC petition because 

we have been activated to start work on NTS SEC 

petition, those are -- we’re still keeping those 

separate, so the -- 

MR. PRESLEY: Nobody has -- nobody has married 
247

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DR. MAURO: Okay, so -- 

MR. PRESLEY: In fact there’s not a working group 

on the -- on the SEC that I know of. 

DR. MAKHIJANI: Okay, fine. 

DR. MAURO: So this will be solely a site profile 

-- 

MR. PRESLEY: Solely a site profile -- I’d love 

to wind it up. 

DR. MAKHIJANI: I think -- I think the overall is 

wrapped up Mr. Presley in a sense that I think 

NIOSH and us have agreed on which items they’re 

going to modify and which items they’re not; so 

we’re in that second round phase as you know and 

we looked at the pieces that NIOSH has put on the 

table. I don’t think that there’s a one piece I 

think that you’re working on -- there’s one piece 

we still owe you which was on item eleven. I 

remember the number of the item but I don’t 

remember the content because I’m not writing up 

the piece, I’m just coordinating the response to 

it. I have that should be here in the next few 

days and I should send it to you either before 

the first of the year or immediately after the 

first of the year. That’s the only piece that we 
248

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MR. PRESLEY: We’ve got that meeting on the 

nineteenth to try to wrap up as much as we can on 

that all right. It’s taking Wanda’s time I know, 

but -- 

MS. MUNN: No, it’s okay. 

MR. ELLIOTT: Well, there’s one other new thing 

that I want to offer to you -- 

MR. PRESLEY: And I want to -- 

MR. ELLIOTT: -- that you might want to take up 

either on the nineteenth or before the Board 

meeting in Vegas. We had a number of comments 

provided to us about the site profile by a 

claimant from the site. I know the Board and Mr. 

Presley’s working group, SC&A have been copied on 

those comments from this -- this person. We have 

prepared in matrices to show how we are reacting 

in our site revision to -- to his comments. I 

think it would be good if the working group were 

you know, involved in this and understood where 

we were going ‘cause it -- there’s been a lot of 

press about some of this person’s comments and so 

it would also offer the opportunity for that 

individual in a public setting to hear how his 

comments are being addressed. 
249

DR. MAKHIJANI: Was I copied on this? I’m not 

sure -- 

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MR. ELLIOTT: I’ll have to check, it may not have 

been directed to you -- it may -- well you 

haven’t seen it yet, you haven’t seen our 

matrices. I hope you’ve seen some of the input 

that this person’s been sending. 

MR. PRESLEY: Some of it, yes. 

DR. MAURO: I’ve seen some material but I have to 

say I wasn’t sure where -- what it applied to. I 

need a little help here, could you help us out? 

MR. ELLIOTT: Well this goes to a variety of 

concerns that this individual is raising, the 

Brand and the Henry activity not characterized 

accurately -- 

DR. MAURO: Okay. 

MR. ELLIOTT: -- in the site profile. That’s one 

extreme of the spectrum of comments, the other 

extreme is well there’s no -- there’s no scale 

given to certain diagrams and layouts that are 

presented as exhibits in our site profiles so how 

could the dose reconstructor use them to estimate 

distance from where a person stood to the shot 

kind of a thing. So, we have a matrices now that 

we’ve pulled together, we’re trying to wrap up a 
250

response to a couple final comments that he’s 

given us. I think it would be great if we 

submitted that to you all so that you could see 

that. We’ve -- we’ve collated all his comments 

in a long list and tried to identify those that 

are relevant to the issues in the matrix. So, 

you know, I just offer that. I think it’s going 

to take a little bit of time to go through that, 

to wade through that. 

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MR. PRESLEY: I don’t think -- I don’t -- I don’t 

think we’re going to be ready to do that by the 

nineteenth. 

MR. ELLIOTT: The nineteenth is next -- 

DR. BRANCHE: Wednesday. 

MR. ELLIOTT: Wednesday. 

DR. BRANCHE: We have an 11:00a.m. call. 

MR. ELLIOTT: I don’t know, I can’t tell you 

today how soon we’re going to put this matrix 

out, it was close yesterday except for one or two 

of these things I’ve asked for. 

MR. PRESLEY: Yeah, Mark and I talked about this 

yesterday and that’s -- 

MR. ELLIOTT: So he did talk to you? 

MR. PRESLEY: Yeah, oh yeah, we’ve -- we’ve 

discussed it, we don’t know whether we’re going 
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MR. ELLIOTT: I just think -- I encourage the 

working group if you would to consider this 

individual’s opportunity to get before you. 

MR. PRESLEY: In other words you would suggest 

that we meet with this person? 

MR. ELLIOTT: I think if we can get it to you 

before the nineteenth, now whether you want to 

take it up in a teleconference call on the 

nineteenth or not is your business but I think 

you know, if the Board, at the Vegas meeting 

site, you have an opportunity to really show this 

individual what we’re doing. 

DR. MAKHIJANI: Mr. Presley, it might be that if 

NIOSH is finished with their response then Mark 

Rolfes could present it on the nineteenth. 

MR. PRESLEY: Yeah. 

DR. MAKHIJANI: And then you can decide whether 

you want us to look at it and comment on it for 

the Board meeting. I mean, depending on how 

complex it is I think we might be able to -- 

MR. ELLIOTT: I don’t think it’s that complex 

actually. 

MR. PRESLEY: No, I don’t think it is. 

DR. MAKHIJANI: If it isn’t then we might be able 
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MR. PRESLEY: The other thing is get the NTS 

group in a meeting after Wanda’s meeting, that’s 

the only thing I know to do. 

MS. MUNN: Either that or before it. 

MR. ELLIOTT: Early the next morning. 

MS. HOWELL: There is no -- I mean -- 

MR. ELLIOTT: Compromised by the other meetings. 

MR. PRESLEY: Yeah, you’ve got the other meetings 

there. 

MS. MUNN: Yeah. We can -- if we don’t 

anticipate the NTS meeting to be very long then I 

anticipate our meeting will be four hours, 

possibly five or six; start at one and run to 

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DR. BRANCHE: Or five thirty. 

MS. MUNN: Or five thirty. 

MS. HOWELL: You can’t move the Board meeting or 

this subcommittee meeting because of the Federal 

Registry. The other thing is that if people 

haven’t booked their flights out Thursday after 

the meeting’s over -- I know. 

MR. ELLIOTT: Everybody is so exhausted at that 

point. 

MR. PRESLEY: Yeah. 
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MR. ELLIOTT: Totally exhausted. 

MS. MUNN: Yeah, I don’t mind doing that because 

I just have a short flight home. 

DR. BRANCHE: For a change. 

MS. MUNN: But it is a bad time to have a 

meeting. 

MR. HINNEFELD: Yeah, it can, it’s hard to get 

back. 

MR. PRESLEY: I’m leaving Friday morning, that’s 

the only time I can get out. 

MR. HINNEFELD: But we’ll still be worn out. 

DR. MAURO: I know. 

MS. MUNN: Then shall we -- 

MR. ELLIOTT: We’re either going to do that or 

face this individual in the full Board meeting 

during public comment and -- 

DR. BRANCHE: And not going to be able to 

respond. 

MR. ELLIOTT: And not -- you know, not be able to 

-- so I -- I hate to make life miserable for you 

folks, but -- 

MS. MUNN: Can we just set up a 7:00 p.m. meeting 

Monday evening? 

DR. BRANCHE: For Nevada -- you mean for Nevada? 
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MR. HINNEFELD: Same amount I get paid. 

MS. MUNN: Sure. 

MR. ELLIOTT: Two, three, Rolfes is one, I don’t 

know who, either somebody with Rolfes, either you 

know, it has to be Stu or me or somebody. You’d 

have two of us that are -- 

MR. PRESLEY: Yeah. 

MR. ELLIOTT: But it also -- there may be some 

ORAU team members that Mark wants to bring in 

that could be brought in by phone too. I just 

don’t want us to miss an opportunity here to try 

to do the right thing by this guy. 

DR. MAURO: I think we have a great opportunity 

on the seventeenth to get -- right now I know I’m 

disoriented. 

MR. PRESLEY: Nineteenth. 

DR. MAURO: No, no, I’m sorry, the nineteenth of 

this month we were going to have a conference 

call. 

MS. MUNN: Yes. 

DR. MAURO: And between now and then there’s no 

doubt that at least SC&A can sort of get our arms 

around what the heck is going on, what the issues 
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are, what -- you know, and so at least we can 

have a productive conversation on what we can 

accomplish on the -- on the nineteenth and maybe 

deal with and what really we’ve got to do when we 

get to -- 

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MR. ELLIOTT: We’ll make sure the individual 

knows that the working group is going to meet 

that day and there’d be a presentation from Mark 

about this and he could, you know, maybe that -- 

maybe that will be enough, I don’t know. 

MR. PRESLEY: And it may be. 

MS. MUNN: But the phone call -- you think the 

phone call on the nineteenth? 

DR. MAKHIJANI: On the nineteenth we’ll just be 

listening to Mark. 

 (multiple speakers) 

DR. MAURO: Well I know but -- and of course take 

a look at where we are on the other issues. 

DR. BRANCHE: We have an hour scheduled for 

Nevada Test Site on Wednesday January 9th, that 

morning. 

MR. ELLIOTT: That’s part of the Board agenda? 

DR. BRANCHE: It’s part of the Board agenda. 

MR. PRESLEY: Yeah, because I asked Lew in case 

that we’re able to make our recommendation. 
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DR. BRANCHE: What about Wanda’s suggestion that 

we think about having the Nevada Test Site 

meeting on the evening of the seventh at seven – 

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MS. MUNN: No, that would be a workgroup meeting, 

not a -- 

DR. BRANCHE: Yeah, a workgroup meeting. 

MR. PRESLEY: Workgroup meeting. 

MS. MUNN: That work? 

MR. PRESLEY: If we can get everybody there, 

yeah. 

MR. ELLIOTT: That just for an hour. 

DR. BRANCHE: So, that’s what you’re going to do? 

MR. PRESLEY: Go ahead and do it. 

DR. BRANCHE: Okay, 7 p.m. -- So Wanda, the 

procedures meeting is 1:00 p.m. on Monday the 

7th? 

MS. MUNN: Yeah, one o’clock will be fine. 

DR. BRANCHE: And Nevada Test Site -- now you 

definitely want one or you want to hold it now 

and make it -- make a firm decision on the 

nineteenth? 

MR. PRESLEY: We’ll make a decision on the 

nineteenth. 

DR. BRANCHE: All right but I still need to have 
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DR. ZIEMER: Hold it. 

DR. BRANCHE: Hold the time. 

MR. PRESLEY: Hold the time, yeah. 

DR. BRANCHE: 7:00 p.m. Who’s baking the 

cookies? 

MS. MUNN: Seven to nine. 

DR. MAKHIJANI: And there’s nothing for one, 

right? 

DR. BRANCHE: Yeah, on the 7th, this procedures 

is meeting on the seventh. 

DR. MAKHIJANI: At one? 

DR. BRANCHE: At 1 p.m. 

DR. MAKHIJANI: But there’s nothing before one 

o’clock, right? 

DR. BRANCHE: No, because people are flying in. 

MS. MUNN: All right, following that, there’s no 

question in my mind that we need to have -- we 

will need to have another meeting of this group 

before we go to Amarillo in April and -- 

DR. BRANCHE: But should be one -- Ms. Munn, just 

to -- so that you know, I don’t know if you want 

any of the -- anything resolved before the Board 

has its conference call on February 20th. 

MS. MUNN: No, we won’t. 
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MS. MUNN: Yes, uh–huh. 

DR. BRANCHE: Amarillo is -- 

MS. MUNN: Is the first week in April. 

DR. BRANCHE: The second -- 

MS. MUNN: No, actually, first full week. 

DR. BRANCHE: First full week, it’s April 9th 

through the 11th. 

MS. MUNN: And I’m looking at sometime in mid 

March for -- 

DR. ZIEMER: Didn’t that get changed the seventh 

to ninth; is that one that got moved? 

MS. MUNN: That’s seven through nine. 

MR. PRESLEY: Yeah, that’s what I’ve got. 

DR. ZIEMER: Nine to eleven and then it got 

changed. 

MR. PRESLEY: Yeah, seventh through ninth is what 

I’ve got on here. 

DR. BRANCHE: What did I say? 

DR. ZIEMER: You said nine through eleven. 

DR. BRANCHE: I’m wrong, you’re right, forgive 

me. It’s April 7th through 9th. Forgive me. 

Didn’t mean -- I just was making sure you were -- 

DR. ZIEMER: It got changed. 

DR. BRANCHE: I wanted to make sure you were 
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MS. MUNN: Mid March in enough time for us to get 

done whatever we’ll need to have done for 

Amarillo. My guesstimate would be something like 

Thursday the 13th? 

MR. ELLIOTT: Face to face or teleconference? 

MS. MUNN: Let’s plan on face to face, if we can 

fall back to telecon, then that’ll be fine. 

MR. PRESLEY: I’ll be there by teleconference. 

MS. MUNN: Okay. 

DR. BRANCHE: Did you say March 13th? 

MS. MUNN: March 13th, procedures. 

DR. BRANCHE: At nine thirty, something like 

that? 

MS. MUNN: Yeah. All right now then, the hard 

part. I’m going to try to read through my action 

items. Are you still awake, Kathy? 

MR. PRESLEY: Can I ask one question? 

MS. MUNN: Yes, sure. 

MR. PRESLEY: The teleconference for the total 

Board, now is that on the 20th of February? 

DR. BRANCHE: Yes. 

MR. PRESLEY: Okay, that’s what I -- I thought 

somebody said the 25th and I got the 20th there. 

MS. MUNN: No, it’s the 20th. 
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DR. BRANCHE: No, it’s the 20th. The only thing 

I goofed up on was the -- 

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sorry. I just wanted to make sure. 

MS. MUNN: Now the action items that I have 

number eleven and that’s if I lump everything 

that we’re doing with PROC92 into one lump, I’ll 

list those later. The first one was SC&A, that’s 

one of yours Kathy, to determine how we’re going 

to present the page number detail on the -- on 

the Access database. That should be easy enough. 

Revise the title of the database. Three, 

presentations and updates, report, a short report 

in January and a full report in Amarillo. 

MR. MARSCHKE: Kathy was going to give a 

presentation to the Board on the capabilities of 

the matrix? 

MS. MUNN: Yes, uh-huh, yes. Work out all 

changes to the database; both NIOSH and SCA will 

be working together on that, I think that will 

just go sort of automatically. Fifth item, NIOSH 

will have a response to the OTIB0017, SC&A white 

paper. Will that be before the Board meeting or 

will it be after that, Stu? 

MR. HINNEFELD: Well we’re running out of time 
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MS. MUNN: I’ll write in afterwards. 

MR. HINNEFELD: If I get -- I’ll get it out if I 

can. 

MS. MUNN: March -- well, March meeting probably. 

MR. HINNEFELD: That will be a good -- we should 

be able to make it easily by then. 

MS. MUNN: Item six, NIOSH is going to take part 

-- discuss with Jim OTIB001901 and possibly have 

a page change to clarify when it’s going to be 

used, that will be the next workgroup meeting, 

again March or can that be -- that was something 

we kind of hoped for today. 

MR. HINNEFELD: Well, the change was just some 

specification in that procedure that -- that kind 

of limits its usage so that you don’t just, you 

know, we can’t use it -- 

MS. MUNN: Right. 

MR. HINNEFELD: Setting it for ninety-fifth, if 

you know, it doesn’t need to (indiscernible) 

ninety-fifth percentile. 

MS. MUNN: So that should be okay for the Board 

meeting, right? Or not? 

MR. HINNEFELD: Well -- 

MS. MUNN: Well, March. 
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MR. HINNEFELD: I think so, but again, the 

resources that will make it even though it’s a 

relatively simple change, the people that will do 

it may be working on other things, so I hate to -

- I hate to promise anything in January but I’ll 

provide as much as I can by January. 

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MS. MUNN: All right. I won’t put a -- I won’t 

put a date on it. Number seven SC&A OTIB0025-01, 

look at the equations being used again. Any 

comments by the next workgroup meeting, otherwise 

it’s closed. Item eight, NIOSH OTIB12, continue 

to review, leave it on the matrix where it is 

right now and respond in the March time frame to 

the workgroup. 

MR. HINNEFELD: Sorry, what was that one again? 

MS. MUNN: OTIB12, continue your review, leave it 

on the matrix where it is. 

MR. HINNEFELD: Okay. 

MS. MUNN: And respond by March. The PROC92 

lists, number one in abeyance, change the term 

health physics reviewers to something else. Then 

number two, was where personalization takes over, 

it’s going to change language -- considering 

changing the language in the procedure itself. 

NIOSH is going to review the procedure and 
263

identify whether the language needs to be 

changed. And SC&A is going to provide us with 

their comments on what needs to be done to 

actually supplement the discussion. Under action 

item three under PROC3, NIOSH is going to suggest 

the changes indicated in the procedure. Finding 

four was addressed in other findings two, 

addressed -- addressed in three, addressed in 

finding two -- so it appears those are the only -

- does anyone have other actions, other than what 

I just read on PROC92? 

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where you talk about item number two, prior 

authorization language, to make reference to that 

this is going to be the home for several of the 

subsequent comments so the person looking at it 

knows that they have (inaudible). 

DR. MAKHIJANI: Did you mention that SC&A would 

review and supplement our recommendations? 

DR. MAURO: Yes, that was -- that was part of it. 

MS. MUNN: Yes, uh-huh. All right. Then we have 

action item ten PROC90, NIOSH will write the 

summary for each of the boxes that go in there by 

the March meeting. Action item eleven, OTIB0023, 

SC&A and NIOSH are going to provide wording to 
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incorporate IG number one into this procedure and 

we’ll talk to see about any further wording 

that’s needing -- what’s needed to be indicated 

there. That, hopefully soon. Anything else, 

Kathy? 

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MS. BEHLING: Wanda, the only thing I was going 

to go through are the changes that we wanted to 

possibly introduce into the matrix. And what I 

have listed here in addition to what you 

mentioned was that we would attach or link a 

white paper to our matrix and I did talk with Don 

Loomis and he indicated that we should be able to 

do that. So in our details list if there is a 

white paper that’s being presented we will make a 

statement to that effect to give maybe a file 

name and if you click on where -- or select that 

file name it should open up a link to that white 

paper so you can see that white paper as part of 

the database. 

MS. MUNN: Excellent, that’s perfect for the 

archives. Great. 

MS. BEHLING: Okay. The other thing we said we 

would do is we’re going to be able to sort and 

print on just about anything in the status 

column, open items, things that are still in 
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abeyance, global issues, that type of thing. The 

third item I have we -- I asked if we were going 

to be able to search for specific words or terms 

as we discussed maybe inhalation and have the 

database return to us all of the procedures and 

finding numbers where maybe a specific term such 

as -- yeah, inhalation has been identified as an 

issue. 

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MS. MUNN: All right. 

DR. MAURO: Kathy, in implementing that is that 

something that when you’re building and 

populating the database you have to mark that 

word or can you after -- after the fact say 

listen, please do a search on inhalation just 

like you do right now in Word Perfect, I can 

search on any word after the fact and it will -- 

MS. BEHLING: It -- it -- I have asked that it 

will be any word after the fact. It does not 

have to be -- the only thing we’ll have to be a 

little bit careful of is when we input this data 

into the database that we choose our words 

carefully and we try to be consistent so these 

types of issues can be identified and we can look 

at them all in a consistent format. The fourth 

item that I have listed is that we will make the 
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file available in a read-only format on the O 

drive, I guess under the Advisory Board folder 

for -- for the workgroup and the Board to be able 

to go into and look at and you know, see -- see 

any updates that we put out there. 

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MS. MUNN: Great. 

MS. BEHLING: The -- okay, you mentioned the file 

name change and the last issue excuse me, is that 

I ask that we have an auto date stamped onto the 

print format each time either NIOSH or SC&A makes 

a change to the database so that we always know 

what the latest version -- when the last time 

there were any modifications made to the database 

when we go to print. 

MS. MUNN: All right. 

MS. BEHLING: And I believe that’s it. Was there 

anything else that we committed to changing on 

the matrix? 

MS. MUNN: I don’t believe so; I think you were 

more thorough than I was making notes. I had 

just assumed you were going to magically do that. 

Magic. No, does anyone else have anything that 

you were unaware of? If not, if no one has 

anything else to add, thank you very much for 

your efforts, I appreciate your coming, thank you 
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1 for all you do, we will see you in Las Vegas. 

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(Meeting concluded 4:05 p.m.)
268

1 CERTIFICATE OF COURT REPORTER 

STATE OF GEORGIA 

COUNTY OF FULTON 

 I, Steven Ray Green, Certified Merit Court 

Reporter, do hereby certify that I reported the 

above and foregoing on the day of Dec. 11, 

2007; and it is a true and accurate transcript 

of the testimony captioned herein. 

 I further certify that I am neither kin 

nor counsel to any of the parties herein, nor 

have any interest in the cause named herein. 

 WITNESS my hand and official seal this the 

14th day of May, 2009. 

___________________________________ 

STEVEN RAY GREEN, CCR, CVR-CM, PNSC 

CERTIFIED MERIT COURT REPORTER 

CERTIFICATE NUMBER: A-2102