Centers for Disease Control and Prevention 

National Institute for Occupational Safety and Health 

Summary Minutes 

Nineteenth Meeting of the 

Advisory Board on Radiation and Worker Health 

December 9-10, 2003 

Meeting Held at the Westin Casuarina 

Las Vegas, Nevada 
 

 

 Executive Summary 

The Nineteenth Meeting of the Advisory Board on Radiation and Worker

Health (ABRWH or the Board) was held at the Westin Casuarina Hotel in

Las Vegas, Nevada on December 9-10, 2003. All members were in 

attendance. Others in attendance included staff of various Federal 

agencies, as well as members of the public. The Summary Minutes of

Meeting Eighteen were approved with minor changes. 

* * * * * 

Tuesday, December 9, 2003 

OCAS Program Status Report 

Ms. Chris Ellison of the National Institute for Occupational Safety

and Health (NIOSH) announced that since commencement of the program

in October of 2001, the Department of Labor (DOL) had forwarded NIOSH

a total of 14,895 cases for dose reconstruction. Of that number,

13,563 are active cases currently in process. 

Requests to the Department of Energy (DOE) for exposure information

total 14,041. Requests outside of the response time goal of 60 days

range from 132 past 60 days to 64 past 150 days. 

Appointment of an additional 36 physicians to the DOE physician

panels raises the total to 159. NIOSH reached a milestone of 1,000

completed dose reconstructions returned to the DOL. New documents 

posted on the web site include the Atomic Weapon Employer (AWE) and

DOE site-wide documents; completed site profiles for Hanford and the

Huntington Pilot Plant, and Technical Basis Documents (TBDs) for

Idaho National Engineering Laboratory (INEEL), Portsmouth, X-10, and

Y-12. 

Following her presentation, Ms. Ellison entertained questions from

the Board. 

* * * * * 

DOL Program Status Report 

2
 

 

Executive Summary/Minutes December 9-10, 2003 

NIOSH/CDC Advisory Board on Radiation and Worker Health 

Mr. Jeff Kotsch presented the DOL’s program status report. The 

majority of the 49,113 claims are for cancer. Final decision had 

been issued in 53.3 percent of the cases. 

As of November 27, 2003, a total of $700,474,957 has been paid in

compensation. DOL is continuing to surpass its stated goals for

claims processing times. NIOSH has returned 902 completed dose

reconstructions and 154 cases where reconstruction was not required. 

Mr. Kotsch advised the Board that Mr. Pete Turcic would present an

overview of the DOL outreach plan at the next scheduled meeting. 

Mr. Kotsch answered questions from the Board following his

presentation. 

* * * * * 

Site Profile Update 

Mr. Stuart Hinnefeld updated the Board on progress in site profile

and TBD development. He announced completion of two DOE sites,

Savannah River Site and Hanford. A meeting was held at the Savannah

River Site in November and one is scheduled for Hanford in January to

review the completed documents with union representatives and other

interested parties. 

TBDs, or site profile chapters, have been completed on INEEL, Oak

Ridge National Laboratory, and Portsmouth Gaseous Diffusion Plant

(GDP). Technical Information Bulletins (TIBs) that describe dose

reconstruction approaches for DOE complex-wide and complex-wide

uranium AWE facilities have also been completed. 

Mr. Hinnefeld described the structure of the complex-wide documents

and described the approaches followed in the complex-wide regimen for

dose reconstruction. These documents were devised as an efficiency

measure for use with a limited set of claimants. 

Mr. Hinnefeld responded to questions from the Board following his

presentation. 

* * * * * 

3
 
 

 

Executive Summary/Minutes December 9-10, 2003 

NIOSH/CDC Advisory Board on Radiation and Worker Health 

Update on the IMBA Program 

Mr. David Allen provided a history of the development of the

Integrated Modules for Bioassay Analysis (IMBA), describing its

versions and how it had evolved to the system used for this program's

dose reconstructions. 

A presentation was made of screen shots to describe how the program

operated and the options provided through user input. 

Following his presentation, Mr. Allen answered questions from the

Board. 

* * * * *
 

Report from Workgroup on

Options for Evaluating Claimant Interviews
 

Dr. James Melius led the Board in a discussion of a recommendation by

the workgroup which assures a record suitable for review be

maintained and that NIOSH evaluate the interview portion to determine

if improvements are needed. 

After extensive debate and input from all the Board members, and

following minor editorial revisions to the document provided from the

workgroup, the recommendation was voted on and approved unanimously. 

* * * * * 

Public Comment Period 

Public comment was solicited on both days of the meeting. Public 

input on the first day included the following: 

•	 Difficulty in matching employment records when a claimant worked

at two facilities. 

•	 The problems in dose reconstruction for construction worker

claimants. 

•	 Objections to and flaws in completed site profiles. 

* * * * * 

4
 
 

 

Executive Summary/Minutes December 9-10, 2003 

NIOSH/CDC Advisory Board on Radiation and Worker Health 

Wednesday, December 10, 2003

 Board Discussion 

With the opening agenda item being an introductory presentation by

Sanford Cohen & Associates, Mr. Mark Griffon inquired into

questioning options following the presentation. 

Ms. Martha DiMuzio and Mr. Larry Elliott explained the necessary

restraints due to the status of the contract, generally describing

what could be done prior to the Executive Session and what would have

to be reserved until that time. 

* * * * * 

Introduction to Sanford Cohen & Associates 

Dr. John Mauro provided an introduction to the structure of the

company, its history, personnel, and clientele. He presented an

organizational chart of the project, demonstrating key personnel

involved in the task order proposals. 

Dr. Mauro described how their corporate structure provided expertise

in every area of the tasks against which they were offering their

proposals. He briefly outlined the company's approach to the project

and described the four tasks contained in the task order. 

Following his presentation, Dr. Mauro entertained questions from the

Board. 

* * * * * 

Board Working Session 

Review and Approval of Draft Minutes 

A motion to approve the Executive Summary and Minutes of the

Eighteenth meeting, as modified, was seconded and

unanimously passed. 

5
 
 

 

Executive Summary/Minutes December 9-10, 2003 

NIOSH/CDC Advisory Board on Radiation and Worker Health 

Mr. Larry Elliott called for a sense of the Board as to detail of the 

minutes in their present style or if modification was desired. After 

discussion, it was determined that the Board was satisfied with the

current level of detail. 

Dr. Paul Ziemer asked if the Board cared to discuss an earlier 

proposal for development of a subcommittee to handle ongoing issues

with the contractor. 

The issue was debated from the standpoint of time saved, availability

of members for meetings on short notice, specificity of charge, and

authority to be granted. Following discussion of procedures

necessary for establishment and length of time involved, Dr. Ziemer 

ruled they would continue to operate as a committee of the whole for

now. 

Administrative/Housekeeping 

Ms. Cori Homer addressed a variety of housekeeping matters, including

detailed information for those participating in the trip to the Test

Site the following day. 

It was decided that the Board would meet January 15 in Cincinnati if

the afternoon Executive Session proved such to be necessary. 

Possibility of a Savannah River Site tour during the February meeting

in Augusta was discussed. Evening hours for public comment was

discussed, along with ideas for better distribution of meeting

information to local claimants. Future agenda items were proposed.

Dr. Ziemer reminded the Board that he and Mr. Elliott developed the

agenda jointly, and any ideas that came to mind later could be

relayed to either of them. 

Board training on the IMBA program was discussed, with Mr. Elliott 

offering training any time a Board member happened to be in

Cincinnati. 

* * * * * 

Public Comment Period 

6
 
 

 

Executive Summary/Minutes December 9-10, 2003 

NIOSH/CDC Advisory Board on Radiation and Worker Health 

Public comment was solicited on both days. Public input on the

second day included the following. 

•	 Questions about discovery of new Mallinckrodt documents in

Georgia.

•	 Estimated time of completion of site profiles for other

facilities in the St. Louis area. 

•	 Status of interviews with St. Louis employees.

•	 Whether Sanford Cohen & Associates could review an off-site 

exposure issue in St. Louis.

•	 Accuracy of coworker data and site profile extrapolation in the

absence of data. 

•	 An invitation for the Board to meet in western New York. 

•	 Various policy issues the Board may address in the future.

•	 Flaws in the Blockson Chemical site profile.

•	 Conflict of interest issues. 

With all further business to come before the Board requiring action

in Executive Session, the public portion of the meeting was

adjourned. 

End of Executive Summary 

Ë Ë Ë 

7
 
 

 

Executive Summary/Minutes December 9-10, 2003 

NIOSH/CDC Advisory Board on Radiation and Worker Health 

Tuesday, December 9, 2003

 OPENING REMARKS 

Dr. Paul Ziemer, Chairman of the Advisory Board on Radiation and

Worker Health (ABRWH or the Board), called the meeting to order,

welcoming the attendees. 

Dr. Ziemer asked that everyone register their attendance in the book

provided. He instructed members of the public to sign up if they

wished to address the Board during the public comment period. 

Noting that perhaps all members of the Board had not had an

opportunity to review the minutes, Dr. Ziemer suggested the members

do so over the evening and to defer approval until the following day.

The members agreed. 

* * * * * 

OCAS PROGRAM STATUS REPORT 

Ms. Chris Ellison 

NIOSH/OCAS 

Ms. Ellison presented a program status update from the NIOSH/OCAS

perspective. Since commencement in October 2001 the Department of

Labor (DOL) had forwarded for dose reconstruction a total of 14,895

cases by December 5, 2003. Atomic Weapons Employer (AWE) employees

accounted for 2,090 of the cases, with the balance being the

Departmentof Energy (DOE) employees. Of those, 13,563 are active

cases currently in process. The number of cases received from DOL is 

continuing to decline, but still average slightly over 200 per month. 

Requests to DOE for exposure information to date total 14,041

covering 12,704 cases. Responses received total 21,951, covering

11,461 cases. Requests and responses are always unequal, due to

multiple requests being made if a claimant worked at multiple sites,

as well as responses often being sent in parts. 

DOE is asked to respond to requests within 60 days. To date 132 

requests are past 60 days, 116 past 90 days, 77 past 120 days, and 64

past 150 days. These numbers are improving, indicating that 

8
 
 

 

 

Executive Summary/Minutes December 9-10, 2003 

NIOSH/CDC Advisory Board on Radiation and Worker Health 

continued meetings between NIOSH and DOE are working. Ms. Ellison 

reminded the Board that the DOE had to get their programs up and

running in order to provide the information, so they are responding

to the requests. 

The NIOSH subcontractor, Oak Ridge Associated Universities (ORAU), is

operating at a claimant interview capacity of 200 to 300 per week.

At least one interview has been completed in a total of 8,954 cases.

Approximately 11,500 interview summary reports have been sent to

claimants. 

Previous updates have included a category called "cases initiated,"

which has now been divided into two parts, the first being cases

staged for dose reconstruction. Ms. Ellison explained this new

description as an indication that interviews have been conducted and

information to do the dose reconstruction has been received. The 

claimant has been informed of that and, if applicable, that a site

profile has been completed for their site. The case is ready for

assignment to a health physicist for dose reconstruction. Those 

cases now number approximately 2,700. The second part is number of

cases assigned to a health physicist who is currently working on the

dose reconstruction. That number is now 631 cases. 

Roughly 250 draft dose reconstruction reports have been sent to

claimants for their review and comment and/or execution of the OCAS-1

form, followed by a close-out interview with ORAU. Following

claimant's return of the OCAS-1 form, the final dose reconstruction

report for the case is sent to DOL with a copy to DOE. These now 

number 1,045, according to information Ms. Ellison had learned in a 

phone call earlier in the day. 

To date OCAS has logged just under 26,000 phone calls, ORAU just over

53,000. Ms. Ellison noted that OCAS takes claimant calls, but ORAU

schedules the telephone interviews and each attempt to contact a

claimant is included in their total. OCAS’ public health advisors

have indicated their calls have diminished since the advent of the 

quarterly activity report, declining by about 600 per month. Receipt

of e-mails within the system has been fairly consistent, now totaling

some 2,400. 

9
 
 

 

Executive Summary/Minutes December 9-10, 2003 

NIOSH/CDC Advisory Board on Radiation and Worker Health 

Ms. Ellison enumerated recent NIOSH accomplishments including

appointment of 36 additional physicians to the DOE physician panels,

bringing that total to 159; release of the residual contamination

final report; the milestone of 1,000 final dose reconstructions

having been forwarded to DOL for adjudication; and a number of new

documents posted on the web site. These include the AWE and DOE 

site-wide documents, as well as completed site profiles for Hanford

and the Huntington Pilot Plant. Technical Basis Documents (TBDs), or

chapters within a completed site profile, have been posted for Idaho

National Engineering Laboratory (INEEL), Portsmouth Gaseous Diffusion

Plant, X-10, and Y-12. 

Ms. Ellison informed the Board that NIOSH Director Dr. John Howard 

had made a request to be able to visualize where the cases currently

in-house are in the process specifically, which has led to

development of a flow chart. The plan is to post the flow chart on

the web site, and Ms. Ellison indicated she would send the Board 

members screen shots as it got further along prior to its posting.

Information is broken into the four district offices and is being

designed to show the public how many of the 14,000-plus cases are

waiting on exposure information, how many are at the interview stage,

et cetera. 

Discussion Points 

•	 Dr. Paul Ziemer asked for clarification between the number given

for interview summary reports sent to claimants and cases where

one or more interview has been conducted. Ms. Ellison explained

that with many cases there are multiple survivors, each of whom

has an opportunity to participate. There are more claimants 

than cases. 

•	 Dr. Ziemer further inquired whether the number of draft reports

shown is a current number. Ms. Ellison responded that is the

number of reports awaiting return of the OCAS-1 form.

•	 Mr. Robert Presley wondered if DOE had given an explanation for

why Savannah River, Idaho, and Los Alamos have so many requests

more than 150 days old. Ms. Ellison replied that those sites

had been setting up their systems. They are maintaining a

constant level now. Specific cases being waited on have been

identified and they are working on them. 

10
 
 

 

Executive Summary/Minutes December 9-10, 2003 

NIOSH/CDC Advisory Board on Radiation and Worker Health 

•	 Dr. James Melius asked if the number was diminishing, and if the

problem with the Iowa site, which wasn't listed, had been

resolved. Ms. Ellison indicated that the monthly report to DOE

indicates the cases they're waiting on information for, and DOE

is required to respond if no information can be found. That 

response has not been received in the cases shown.

•	 Mr. Larry Elliott added that a small number of the old cases was 

a static number and NIOSH is working on those cases with the

sites to understand better what the problem is. In some cases 

they're having difficulty verifying employment, that

verification having been provided to DOL by Internal Revenue

Service or Social Security records. The majority of the cases

change, however. The ORAU team provided assistance to Idaho in

scanning and indexing thousands of boxes of records so that dose

histories could be retrieved. That has now been completed. As 

for the Iowa plant, five or six boxes of records held by

Department of Defense have been received and are now in the

hands of the TBD team members to go through that information.

Each situation is being addressed independently.

•	 Mr. Mark Griffon inquired as to how many interviewers were being

used to conduct the 200 to 300 weekly interviews, and if

interviewers familiar with a specific site were being grouped

with claimants from that site. Dr. Richard Toohey of ORAU 

responded that there are a total of 16 interviewers, with the

average working per day at 12 to 14. While the goal has been to

have site-specific interviewers, the process is still operating

in what they refer to as a batch mode and that is not being done

presently.

•	 Mr. Griffon further inquired if the number of information

requests to DOE included information to be used for site

profiles. Mr. Elliott indicated the number represented requests

for personal dose information only, noting requests to DOE for

site profile information are tracked in a separate system.

•	 Dr. Antonio Andrade commented that it should be remembered that 

dosimetry records are both difficult to understand and to

provide in an appropriate format for dose reconstruction. Dose 

was recorded in a variety of ways, as well as now merging dose

from multiple sites. Sending dose records for one person back

quickly is not an easy process. Mr. Elliott noted that requests

were for raw numbers, which also added to the difficulty of

providing a response. 

11
 
 

 

Executive Summary/Minutes December 9-10, 2003 

NIOSH/CDC Advisory Board on Radiation and Worker Health 

•	 Dr. Roy DeHart asked what kind of response was being received

from claimants on the final reports being forwarded to DOL for

adjudication. Mr. Elliott noted that the point at which they

received response from the claimant was when the draft report

was sent to them with the OCAS-1 form for signature. Those 

comments run the gamut from a thank you to disagreement with the

report to things which have no bearing on the case at all, all

of which is captured and tracked in the administrative record.

The majority are simply signed and returned. Claimants are 

notified when the final report is forwarded to DOL and there is

no further commentary from NIOSH.

•	 Dr. Melius commented he didn't think most people cared about the

district offices shown on the flow chart and asked if it could 

be broken down by site. He also suggested a screen with numbers

and stages in table form by site listed down the left-hand side.

Ms. Ellison replied that this is a presentation being worked on

and that such comments were appreciated.

•	 Dr. Henry Anderson suggested that it was difficult to keep up

with whether or not the backlog is being diminished or if it

continues to grow. Ms. Ellison replied she would send shots of

the various screens for further comment and review. 

* * * * * 

DEPARTMENT OF LABOR STATUS REPORT 

Mr. Jeff Kotsch,

Department of Labor 

Mr. Jeff Kotsch updated the Board on the number of claims, 49,113,

with a breakout of claim types. The majority of claims, 33,766, are

for cancer, with smaller numbers for other conditions covered under

the statute. More than 24,000 claims have been received for

conditions not covered under the statute, but which are included in

the claim total. 

Mr. Kotsch explained that there is a case for every employee; if the

employee is living, he/she is the claimant. In the case of 

survivors, multiple claims may be involved in a single case. 

12
 
 

 

Executive Summary/Minutes December 9-10, 2003 

NIOSH/CDC Advisory Board on Radiation and Worker Health 

Mr. Kotsch noted that of the 37,192 cases, a final decision had been

issued in 19,835 cases, or 53.3 percent of the cases received. Those 

cases constitute 25,053 claims, 10,729 of which received approval,

with 14,324 claims being denied. 

Initial or recommended decisions have been reached in 21,396 cases.

These cases are represented by 27,701 claims, of which 11,177

recommendations were for approval and 16,524 recommendations were for

denial. A total of 14,838 cases have been sent to NIOSH for dose

reconstruction. The initial process has thus been completed for 95.7

percent of the cases received. 

As of November 27, 2003, a total of 9,483 payments have been issued.

The amount of compensation paid totals $700,474,957, with medical

benefits of $21,205,814 having been paid. 

Mr. Kotsch indicated the DOL is continuing to surpass its stated

goals for initial claims processing times. The average 180-day goal

for processing AWE, beryllium vendor, and DOE subcontractor claims is

being accomplished in 103.5 days. The average 120-day goal for

DOE/RECA claims processing is being accomplished in 75.8 days. 

Of the 14,838 cases referred to NIOSH for dose reconstruction, 1,146

have been returned. There were 902 completed dose reconstructions

and 154 cases where dose reconstruction was not required. There were 

recommended decisions on 863 of the cases, 321 for acceptance and 542

for denial. Final decisions have been made on 478 of those cases,

254 accepted and 224 denied. 

Mr. Kotsch commented that at the previous meeting he had been asked

about outreach activities. He advised the Board that the issue had 

been discussed with Mr. Turcic, who is developing an overview he

intends to present at the next meeting. 

Discussion Points 

•	 Dr. Paul Ziemer inquired whether specific numbers were available

on Special Exposure Cohort (SEC) cases which had been processed.

Mr. Kotsch replied that case numbers were outside his area of

responsibility and he could not recall the statistics he'd seen. 

13
 
 

 

Executive Summary/Minutes December 9-10, 2003 

NIOSH/CDC Advisory Board on Radiation and Worker Health 

Dr. Ziemer suggested it might be of interest to the Board to

hear those numbers at the next meeting.

•	 Mr. Leon Owens asked if the time for initial claims processing

included time for DOE to do records retrieval. Mr. Kotsch 

indicated it included time to get an answer back relative to

employment. He noted that if a response is not forthcoming in a

timely manner, other mechanisms such as Social Security are used

to confirm employment, adding that DOL tries to get a DOE

response that there are no records before alternative

verification is used. 

•	 Dr. Antonio Andrade asked for the time period between initial

decision and the case being sent to NIOSH, as well as the method

by which the case was forwarded. Mr. Kotsch replied that once

the information on employment and medical condition has been

developed, it is transferred to NIOSH as a hard copy. The 

possibility of digital transfer has been examined.

•	 Dr. James Melius commented that at some point, once the SEC

regulations are finalized, the issue of overlap of claims from

SEC sites which don't meet the SEC time criteria will have to be 

dealt with. Dr. Ziemer inquired if Dr. Melius were asking about

those who may have submitted a claim although they didn't meet

the time requirement. Dr. Melius responded that he believed

knowing the numbers involved would help deal with the issue once

the SEC regulations are out. Mr. Larry Elliott confirmed that 

Dr. Melius was asking for the numbers of cases submitted which

didn't qualify under the SEC, and indicated that those cases

came to NIOSH for dose reconstruction. Dr. Melius responded

there was an issue of how those dose reconstructions would be 

done. Mr. Elliott replied that they were being done and that

several cases for Portsmouth GDP, Paducah GDP, and K-25 had

already been returned to DOL. Dr. Melius opined the issue

needed to be looked at. 

•	 Dr. Genevieve Roessler expressed surprise that the medical

benefits paid were such a small fraction of the total

compensation and inquired into the reason. Mr. Kotsch indicated 

that of course survivor claims were not for medical payments.

But early on there were problems with health care providers not

wanting to deal directly with DOL, and DOL didn't want the

employees to have to be reimbursed for payments. There were 

some things that had needed to be adjusted in order to move

forward, but agreed the numbers are lower than expected. 

14
 
 

 

Executive Summary/Minutes December 9-10, 2003 

NIOSH/CDC Advisory Board on Radiation and Worker Health 

•	 Dr. Henry Anderson observed that there appeared to be a number

of cases where medical records were insufficient, and wondered

what other sorts of things were insufficient and what could be

done when a claimant has a condition which records can't 

document. Mr. Kotsch replied it was indeed difficult to find or

help the claimant find medical evidence to substantiate a claim,

but all that can be done is ask for affidavits from physicians,

et cetera, of perhaps their recollections of having treated the

claimant. Mr. Kotsch also noted it was amazing that, even

though they'd been destroyed by the hospitals, sometimes people

had kept their own records.

•	 Dr. Paul Ziemer inquired into the numbers of appeals to both

NIOSH cases and those which had not required dose

reconstruction. Mr. Kotsch indicated he was the focal point for

technical objections to NIOSH dose reconstructions and had,

since the beginning, seen perhaps 25 technical appeals to the

NIOSH process. As for overall objections to denials for all

other things and not just NIOSH cases, they would be higher and

could be presented at the next meeting. Dr. Ziemer indicated he 

was interested in the appeals to the final decisions and

suggested perhaps someone could supply that information.

•	 Dr. Roy DeHart commented that, as a member of the physicians

panel reviewing Subtitle D cases, they have seen cases with no

medical documentation at all, no diagnosis, no treatment or

management. Those are typically survivor claims and the

relative has little or no knowledge of even the doctor or

hospital, and there's no way to move forward with that lack of

information. Mr. Kotsch acknowledged that the same is seen in

Subtitle B cases. 

* * * * * 

SITE PROFILE UPDATES 

Mr. Stuart Hinnefeld 

NIOSH 

Mr. Stuart Hinnefeld provided the Board with an update on progress in

TBD and site profile development since Dr. Neton's presentation in

October. He reiterated the purpose of the documents was to support 

15
 
 

 

Executive Summary/Minutes December 9-10, 2003 

NIOSH/CDC Advisory Board on Radiation and Worker Health 

dose reconstructors by providing site-specific information, helping

minimize interpretation of data. The documents help provide

consistency and are used much like a handbook. They are dynamic

documents, the information in them to be modified as more is learned

about various sites, their technologies and approaches. 

All completed TBDs, or pieces of a site profile, are being published

as they are approved and may be viewed on the web page. Comments are 

encouraged and can be made to the NIOSH Docket Office. On the web 

site are easy-to-identify links to the docket for a particular

document. Mr. Hinnefeld provided information on how to comment via

mail, telephone, FAX, and e-mail. 

Presentations are being arranged with union representatives and other

interested parties to solicit input as each document is completed. A 

meeting was held at the Savannah River Site in November, and

arrangements have been made to visit Hanford in January. Information 

on members of the teams who compiled the initial versions of the site

profiles is available on the ORAU web site. 

Unchanged since October are the 15 DOE facility TBDs under

development in parallel, with targeted completion still by end of the

calendar year. Many of those documents have been reviewed and are in

comment resolution, very close to being approved. Completion of

those documents will provide the ability to address approximately 77

percent of the claims currently pending at NIOSH. 

Mr. Hinnefeld indicated that as of November 24, 2003, the site

profiles for two DOE sites, Savannah River Site and Hanford, are

complete. Noting that site profiles consist of five TBDs and an

introduction, Mr. Hinnefeld indicated that one of five TBDs had been 

completed for the Idaho National Engineering and Environmental

Laboratory facility, the Oak Ridge National Laboratory facility, and

the Portsmouth GDP. Three of the five parts have been approved for

the Y-12 plant. The document relative to a DOE complex-wide approach

is also complete. 

Site profiles are complete on four AWE facilities, Bethlehem Steel,

Blockson Chemical, Huntington Pilot Plant, and Mallinckrodt Chemical

Co., as well as complex-wide uranium AWE facilities. 

Specifically addressing the TBDs making up the site profile for the 

16
 
 

 

Executive Summary/Minutes December 9-10, 2003 

NIOSH/CDC Advisory Board on Radiation and Worker Health 

Nevada Test Site, Mr. Hinnefeld noted the TBDs relative to 

occupational medical X-ray, internal, and environmental exposures are

in review and comment resolution. The section on external dosimetry

is in contractor review. The final section or introduction is a 

summary of the information in the other five sections. 

A complex-wide TBD was completed for a limited set of AWEs that met

certain conditions. Their AWE work had to be limited to uranium. If 

any other radionuclides were associated with their work at a

particular site, claims from that site could not be processed through

the complex-wide approach. They would be expected to have a fairly

limited scope of work. The AWE complex-wide approach takes very high

potential exposures and assumes that even under specific worst-case

conditions for a certain set of cancers, the claims won't be

compensable, and allows some processing of some AWE site claims. 

The complex-wide process is an efficiency process following the

regulations statement that if a dose reconstruction is done under

worst-case assumptions and it is clear the probability of causation

would not exceed 50 percent, the cases can be considered complete.

In such cases, where the probability of causation will not rise to

the 50 percent level, worst-case assumptions can be used to complete

dose reconstructions and provide answers to claimants who may have

been waiting for quite some time for an answer to their compensation

claim. With that in mind, there is a population of claims that it

would appear would fall into the category where worst-case

assumptions can be made. 

Mr. Hinnefeld indicated that the complex-wide approach is structured

in four documents called Technical Information Bulletins (TIBs).

They address the four major types of exposure found in a site

profile. Not described are facility and processes, one section in a

full site profile, as well as the introduction to the site profile. 

The TIBs are specifically entitled "Maximum Internal Dose Estimates

for Certain DOE Complex Claims," "Standard Complex-wide

Conversion/Correction factor for Overestimating External Doses

Measured with Thermoluminescent Dosimeters," "Dose Reconstruction

from Occupationally-related Diagnostic X-ray Procedures," and

"Occupational Dose from Elevated Ambient Levels of External

Radiation," often referred to as environmental dose. 

17
 
 

 

Executive Summary/Minutes December 9-10, 2003 

NIOSH/CDC Advisory Board on Radiation and Worker Health 

Mr. Hinnefeld then described the approaches followed in the complexwide regimen for dose reconstruction. The case selection criteria 

limit the applicability of this regimen to more recent employment.

Certain assumptions are made which would not apply to very early

work, so the approach is applicable primarily from 1970 or 1980

forward. 

Maximizing factors are applied to recorded doses and missed doses in

order to provide confidence that the worst case a person may have

been exposed to has been captured. Maximum credible undetected 

intakes are used to evaluate a worst-case assumption for an internal

dose. Parameters are chosen that maximize probability of causation

by maximizing the dose and by selection of the radiation types and

photon energy types. 

Mr. Hinnefeld reiterated that the complex-wide approach is for a

limited set of claims and to facilitate the ability to provide timely

answers to claimants. 

NIOSH is engaged in processes to identify populations of workers to

provide input in the preparation of TBDs or for documents nearing

completion; and further, after completion of the TBDs, to provide

comments to see if there is a need to provide additional information

or modify the document. The meeting at the Savannah River Site in

November and at Hanford in January, as well as the Docket Office link

on the web site, are but two information-gathering approaches.

Others are being looked into, including workers' monitoring programs. 

Discussion Points 

•	 Dr. Paul Ziemer asked if someone could inform the Board of the 

response at the Savannah River Site meeting in terms of input

from people on the site. Mr. Hinnefeld indicated that he only

knew what he had been told, but his understanding was that at

the end of the meeting the participants who spoke were

appreciative and thought it had been done well. Dr. Ziemer 

inquired as to the size of the turnout. Mr. Hinnefeld noted it 

was not a public meeting, but included eight to ten individuals

who had been identified as contact points.

•	 Dr. James Melius observed he thought the entire Board had 

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Executive Summary/Minutes December 9-10, 2003 

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received an e-mail from a person related to a conflict of

interest issue with the Rocky Flats site profile and wondered

when the appropriate time might be to address that matter.

Dr. Ziemer indicated he had received the e-mail and inquired if

the staff had seen it or were aware of the issue. Mr. Larry

Elliott indicated he had not seen the e-mail sent to the Board,

but had been sent one prior to that. It was from a woman who 

advised that a person on the ORAU team working on the Rocky

Flats site profile had, prior to the EEOICPA program, provided

testimony in litigation on her husband's claim. What needs to 

be done in this regard is being evaluated by the Department. In 

a slightly different situation, testimony had been provided

against a claim in the courts by a principal in a firm

subcontracting with ORAU, although the individual was not

serving on site profile development or dose reconstruction.

That subcontractor will be released. 

•	 Dr. Melius indicated his hope that, as issues are dealt with, a

policy is established so that individual issues don't have to be

constantly addressed. Mr. Elliott agreed, indicating that it

was part of the review underway currently and that discussions

are being held relative to the type of contract language

necessary to have in place to avoid the problem.

•	 Dr. Melius inquired if everyone were aware of a letter from

three New York congressmen to Dr. Ziemer asking the Board to

review the site profile for Bethlehem Steel and raising a number

of questions to address. Dr. Ziemer indicated he had studied 

the letter on the plane and felt it should be discussed with the

Department and to review issues relative to how the matter

should be handled. He was unaware whether other Board members 

had received copies, but they would be made available to them.

•	 Dr. Melius commented that he was still unsure exactly how the

site profiles were to be used as a handbook for dose

reconstruction. He suggested that possibly a briefing, with

examples, using a completed site profile could be given which

would be useful to gaining a better understanding of the

process. Dr. Melius further observed that the Board wasn't 

reviewing the documents, as had been originally discussed,

noting that some earlier documents had gotten outside technical

peer review. He wondered what the process was going to be,

pointing out that as they began individual dose reconstruction

reviews the Board didn't want to be in the position of finding a 

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Executive Summary/Minutes December 9-10, 2003 

NIOSH/CDC Advisory Board on Radiation and Worker Health 

technical document to be wrong or seriously problematic.

Dr. Ziemer asked for other Board member comment, noting that

part of the audit process included asking the Board contractor

to audit the usefulness of the site profiles in assisting dose

reconstruction. He added that if the process works properly it

should point out the strengths or weaknesses on site profiles,

either generically or individually. Dr. Ziemer further noted 

that the Board's charter did not call for approval of site

profiles in advance. Dr. Melius countered that while 

Dr. Ziemer's observation was correct, the charter did call for

review of individual dose reconstructions which would utilize 

the site profiles. He further commented that when the Board 

approved the regulations which guided the dose reconstruction

process, it had discussed the Board advising NIOSH on technical

issues developed over time. Dr. Melius questioned the full scope

of the Board's dose reconstruction review contract, if it would

entail review of every procedure or if it would be selective,

and if it included every site profile, noting that now the Board

was receiving Congressional letters of inquiry.

•	 Dr. Ziemer reminded all present that an audit process is not a

100 percent review of everything done. The Board's audit 

process called for a review of two and a half percent of the

dose reconstructions. Noting that many of those reconstructions

will have used the same site profile for a portion of the

reconstruction process, he opined the Board would be able to

evaluate them in some form or another. 

•	 Dr. Antonio Andrade commented that the members should also 

remember they were not an expert board but an advisory board,

questioning the extent to which they should review technical

details of any of the site profiles. Dr. Andrade recalled that 

it was announced that site profiles would be developed and used

in a limited sense, and that today's presentation had conveyed a

feeling for the limitations imposed on their applicability.

Given the fact that the Board has a task order out directing its

subcontractor to look at site profiles on top of dose

reconstruction, Dr. Andrade expressed his satisfaction with the

type of updates just presented. He indicated he was given a

feeling for how they are being used, the details going into them

and the types of analyses and assumptions being made within

them. Dr. Andrade opined that adding work to the Board did not

necessarily add value. 

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Executive Summary/Minutes December 9-10, 2003 

NIOSH/CDC Advisory Board on Radiation and Worker Health 

•	 Mr. Mark Griffon observed that the contractor's work is the 

Board's work, so the Board would be reviewing site profiles.

Mr. Griffon commented that while he understood what was meant by

the term "limited scope," he was concerned that a better

understanding of operational detail on some sites was going to

give a very different picture of worst-case doses. Mr. Griffon 

queried how unmonitored dose was being addressed in the complexwide documents, given anecdotal reports of badge tampering or

not being badged for certain operations. Mr. Hinnefeld replied

that without looking at specifics, it would be more difficult to

apply a complex-wide approach, so it would fall into the case

selection portion of the process. Those are the kind of issues 

that would affect case selection. 

•	 Dr. Melius responded to Dr. Andrade's comment by stating he

wasn't suggesting adding work for the Board. He observed that,

in addition to the scientific confidence the Board has in what 

NIOSH does, the Board has its own credibility issues and should

remember that at the end of the process the credibility of what

the Board has not reviewed must be defended in some way. Dr. 

Melius indicated he wanted to make sure NIOSH wasn't expecting

the Board to provide the technical review on all those

procedures.

•	 Dr. Andrade inquired of Mr. Griffon if he recalled the 

percentage of work the Board subcontractor would be looking at

site profiles. Mr. Griffon replied he didn't recall, but that

it was a fairly high percentage of overall site profiles. Dr. 

Ziemer added that it was much higher than for individual cases,

which was understandable since most of the cases would come from 

a relatively small number of sites. 

* * * * * 

UPDATE ON INTEGRATED MODULES FOR BIOASSAY ANALYSIS (IMBA) 

Mr. David Allen 

NIOSH 

Mr. David Allen explained that the Integrated Modules for Bioassay

Analysis (IMBA) is the computer software used in the EEOICPA program

to make internal dosimetry calculations. The difference between IMBA 

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Executive Summary/Minutes December 9-10, 2003 

NIOSH/CDC Advisory Board on Radiation and Worker Health 

and other commercially-available software for that purpose is that

IMBA uses the current International Commission on Radiological

Protection (ICRP) models, as opposed to the ICRP-30 model which is a

generation back. 

ICRP is the acronym for International Commission on Radiological

Protection, the recognized worldwide expert on internal dosimetry and

radiological protection in general. In 1994 ICRP published a new

lung model for internal dosimetry, which was the beginning of various

new models, including biokinetic models. That lung model was more

complicated than the last and so while it was being produced,

computer programs to help evaluate the model were also produced. 

The computer software was developed by the National Radiological

Protection Board (NRPB), a semi-private/semi-government agency of

Great Britain. People from NRPB were involved when the ICRP

committee was developing the lung model, and they developed the

evaluation software while the model was being produced. 

Once the lung model was produced, the software was connected to the

ICRP-30 biokinetic models and packaged in a form known as LUDEP. It 

was a hybrid of current and old models, DOS-based and clunky to run,

but it was there. 

As ICRP began producing new biokinetic models, the individuals at

NRPB produced new computational models, or modules, to do the

calculations. This was eventually put together into one computer

program known as IMBA. NRPB copyrighted the computational modules

and produced IMBA-URAN in an integrated fashion. It was limited to 

uranium, but did put everything together. 

DOE contracted for a version to include more isotopes and more

versatility, IMBA EXPERT, which took some time to complete. During

that process, NIOSH contracted for a version that allowed for annual

doses for a limited number of isotopes, IMBA-NIOSH, providing what

was needed for this program on a limited basis. Once the DOE version 

was completed, NIOSH asked for a modification to include all the

isotopes plus some additional isotopes. That was put together into

what is now known as the IMBA EXPERT OCAS edition. 

Mr. Allen explained briefly how the IMBA program operated, and

presented an array of screen shots to demonstrate the variety of 

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Executive Summary/Minutes December 9-10, 2003 

NIOSH/CDC Advisory Board on Radiation and Worker Health 

options provided through user input. Specific features of the

program described by Mr. Allen were the ability to select date, route

of entry, chronic versus acute dose. Solubility parameters may

utilize ICRP defaults or individual parameters may be entered.

Bioassay may be specified as whole body, lung, urine, et cetera, to

determine intakes. Dose may be calculated from a given intake or the

calculated intake. Dose may be calculated as whole body, tissue or

organ, and can be specified as either 50-year committed or annual

dose. 

Discussion Points 

•	 Dr. Antonio Andrade asked for another explanation of Mr. Allen's

comment that either the model predicted points below the

detection limit or data were entered that were below the 

detection limit. He wasn't sure which Mr. Allen had said. Mr. 

Allen replied that, as an example, if urinalysis results were

less than one picocurie per day, the program allowed the user to

put in that value and say it was less-than. Dr. Andrade 

inquired whether a reasonable health physicist, using classical

statistics, wouldn't have a decision limit above your detection

limit. Mr. Allen agreed, noting that in a lot of cases there

will be no detectable samples, therefore a lot of less-thans.

This allows them to be plotted. Mr. Allen indicated there were 

a number of options available. Dr. Andrade suggested it was

artificially establishing a floor below the detection limit for

the system. Mr. Allen disagreed, explaining that it is using a

maximum likelihood method on the fit. By establishing that the

value is less than detection limit, it says it has to be in the

range somewhere between zero and the detection limit.

•	 Dr. Genevieve Roessler inquired if the IMBA model had been

developed by NRPB. Mr. Allen responded that NRPB had

copyrighted the calculational model used for LUDEP and the lung

model. Dr. Roessler asked if that had been done more recently.

Mr. Allen replied it was probably post-'94, and then as the

biokinetic models were developed, new modules were copyrighted.

Dr. Roessler indicated she had been under the impression NIOSH

had developed IMBA, when it's actually using a program developed

by NRPB. Mr. Allen agreed that it consists mostly of

copyrighted calculational engines, with a user interface

developed for NIOSH. 

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Executive Summary/Minutes December 9-10, 2003 

NIOSH/CDC Advisory Board on Radiation and Worker Health 

•	 Dr. Roessler asked who validated the model, indicating she

wanted to know it was working right and that it was the model

NIOSH wanted to use and that they were getting the right

answers. Mr. Allen responded that NRPB did a lot of quality

control. They were basically the only entity with credibility

when NIOSH was looking for something. NIOSH has used the 

committed dose section, entering a one becquerel intake to see

if they get the right effective and organ doses according to

ICRP publications. They are using the ICRP models, and the

program with the particular input yields the correct output

based on the publications. The NRPB quality control documents

are available also. 

•	 Dr. James Melius asked how he knew it was giving correct answers

for other situations, adding he assumed there'd been more to the

quality control that went into developing this than what Mr. 

Allen had described. Mr. Allen replied that NRPB had put a lot

into it. What NIOSH has done is, for each isotope, to put in

one becquerel and see if the effective dose and committed dose

to organs matches what is in the publications. They then

calculated annual dose for 50 years, put them in Excel, added

them and made sure that matched. Using ICRP-78 dates for

bioassay, they can put in standard input like a one becquerel

intake and predict what the bioassay should be at various points

in the ICRP publication and verify that it matches with the

publication. Mr. Allen added that some spot-checking had been

done against the Potter magazine of tables for bioassay

analysis.

•	 Dr. Melius indicated he was confused or concerned by mention

that when an outlier was found, it was excluded. Mr. Allen 

replied the option was there for the dosimetrist. Dr. Melius 

asked if that's what was being done. Mr. Allen responded that

it could be, because errant bioassay samples do occur. Dr. 

Melius inquired how one would know it was being excluded because

it was a bad bioassay sample versus a wrong assumption because

of poor information, and how does that eventually get into the

IREP model in terms of certainty about the dose. Dr. Melius 

clarified his question as being if ten health physicists used

the same data, would they make the same calculation. Mr. Allen 

replied that for internal dosimetry, you would get ten different

answers. He noted that their job is to make sure they were on

the same side of the 50 percent probability of causation. Mr. 

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Executive Summary/Minutes December 9-10, 2003 

NIOSH/CDC Advisory Board on Radiation and Worker Health 

Allen further indicated that uncertainty was avoided by

overestimating or underestimating bioassay in order to bound the

intake, eliminating the need to deal with percentage of error.

Dr. Melius countered that his concern was for cases where that 

couldn't be done and where assumptions would be critical to

outcome and how to get consistency in doing it.

•	 Mr. Mark Griffon asked if all the radionuclides needed for the 

program are available in the newest version of IMBA. Mr. Allen 

responded that it now numbered approximately 54. While the most 

important ones related to DOE are included, it was not every

single one, noting there was always an occasional odd case. He 

indicated that what is missing either has a short half-life or a

short biological half-life, and the published 50-year committed

dose can be used without the computer program.

•	 Dr. Andrade inquired if all the raw data collected by the

laboratories are used or if final values were used. Mr. Allen 

replied that raw data are asked for and used.

•	 Dr. Melius commented he had thought Mr. Elliott had agreed to

look into the issue of accessibility of IMBA for people not

directly involved and wondered if that had been given any more

thought. Mr. Elliott indicated he had already answered that

question. Mr. Allen added he had encouraged the vendor to look

into producing a publicly-available version for sale, but it has

not been made yet. The vendor has indicated a version with 

fewer functions that might possibly be affordable is what

they're shooting for, noting that purchase would be required

because of licensing issues with copyrighted software.

•	 Mr. Griffon inquired into availability of the software for the

Board or its subcontractor. Mr. Elliott replied that the Board,

its subcontractor and ORAU have access to IMBA-OCAS as special

government employees or contractors to the government. But Mr. 

Allen was right and accurate in his statement that the ICRP

models and the calculation engine are copyrighted and protected,

and NIOSH cannot distribute them to the public without a user's

license. Somebody has to pay for that. Mr. Griffon asked if a 

copy could be made available prior to the next meeting. Mr. 

Allen indicated that it could be done, although he wasn't sure

how the details would be worked out. Mr. Elliott asked if he 

was correct in his understanding that it was not in CD form.

Mr. Allen replied that it is on CD, which Mr. Elliott agreed to

provide. 

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Executive Summary/Minutes December 9-10, 2003 

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•	 Mr. Michael Gibson asked how much of the data from DOE sites is 

based on assumptions relative to default factors, solubility

class or date of intake which may be assumption. Mr. Allen 

replied that was why they asked for raw data. In a bioassay

analysis there are no assumptions. It is a laboratory analysis

from which assumptions are made as far as solubility, et cetera.

The assumptions used are the reason for the site profiles, in

order to have an idea of materials on a site so that they know

what type of solubilities would be associated with it, and

whether the bioassay fits the data. Mr. Gibson asked if the 

date of the bioassay was looked at. Mr. Allen indicated they

looked at the date the sample was taken; what was taken; whether

it was a 24-hour sample or an allotment; the actual results; and

what isotope, if available. He indicated they got everything

they could get, and were not shy about asking for it. Dr. 

Ziemer asked if that answered Mr. Gibson's question. Mr. Gibson 

replied he wasn't sure he'd understood it all, but he was fine

with the answer for now. 

•	 Dr. Ziemer inquired if Mr. Allen were saying assumptions made on

the site were not utilized. Mr. Allen replied that the doses

calculated were not necessarily good for NIOSH purposes, and

that very few sites calculated an annual organ dose. Dr. Ziemer 

asked if Mr. Allen found no value in looking at what may have

ultimately been calculated for tissue or organ dose. Mr. Allen 

agreed there could be some value, and if the only thing

available is calculated dose, with enough details one can backcalculate what the bioassay was that it came from.

•	 Mr. Gibson asked if one would be able to distinguish a super-Y

class of plutonium or if it could mask the raw data out of the

bioassay. Mr. Allen responded that it couldn't really mask the

raw data, but could mask the dose and intake, calculated from

the raw data. IMBA provides default classes which can be

selected, but user input is also available. Mr. Allen indicated 

that in the case of a super class-Y plutonium, a Technical

Information Bulletin would probably be developed evaluating a

particular site, indicating the solubility doesn't follow the

defaults and more information is available, and in that case use

these absorption parameters for this site. He indicated that 

had not been done yet, there had been no changes from defaults

yet, but noted they were still young into that part.

•	 Dr. Melius inquired if the validation done by NIOSH had been 

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Executive Summary/Minutes December 9-10, 2003 

NIOSH/CDC Advisory Board on Radiation and Worker Health 

documented. Mr. Allen replied that part of the contract for the

upgrade was documentation on all the V&V done by NRPB. Further 

evaluation has not been documented in a very formal manner,

though the numbers are available and it's just a matter of doing

it. Dr. Melius commented it would be good to have if questions

were raised. 

•	 Mr. Griffon asked if there are any plans to update the CINDY

code to be ICRP-60/66 compatible. Mr. Allen replied he'd not

heard of it and didn't know if it were happening. Dr. Andrade 

commented that when they were asked by DOE to assist in the

development of IMBA, big dollars were spent; and in doing so DOE

elected for this particular code to be invested in. Therefore,

if CINDY is being upgraded, it is getting done at the grassroots

level somewhere. 

•	 Mr. Griffon inquired if there had been an occasion to use air

sampling data to validate dose calculations from bioassay. Mr. 

Allen replied that while he would love to do so, getting air

sample data and correlating that to an individual throughout a

20-year career is virtually impossible. 

* * * * * 

WORKGROUP ON OPTIONS FOR EVALUATING CLAIMANT INTERVIEWS 

Dr. James Melius,

Workgroup Chair 

Dr. James Melius reported that the workgroup had met once by

conference call since October, and had received the ORAU procedures

for scheduling and conducting the interviews. After reviewing that

material and recognizing that the NIOSH/ORAU program for Quality

Assurance/Quality Control (QA/QC) measures related to the interviews

were a work in progress, the workgroup developed a set of

recommendations covering two areas. A written copy of the

recommendations was provided to the Board members. 

Noting that NIOSH may very well already be doing so, the workgroup

felt the procedures or events should be captured as part of the

database, allowing the Board or its contractor to evaluate the

interview process. The recommendation is primarily to assure a 

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Executive Summary/Minutes December 9-10, 2003 

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record is maintained that would allow for review. The second part of

the recommendation was that NIOSH take steps to evaluate the

interview portion of the program to determine if improvements are

needed. 

Dr. Melius acknowledged that the Board was split on the issue of

whether a re-interview should be conducted as a means of evaluating

the process. The information provided through the suggested method

of review would make it possible for the Board to assess whether it

felt a more intrusive form of review would be necessary. 

Dr. Paul Ziemer announced that, as Chair, he was interpreting Dr. 

Melius' document as a recommendation from a working group, which

constitutes a formal motion requiring no second. Dr. Ziemer 

indicated he had availed himself of the opportunity to listen in on

the working group conference call and wanted to assure NIOSH staff

that the Board was not mandating tasks for NIOSH. The recommendation 

was a list of the kinds of records the Board would like to be able to 

sample, if available. 

Discussion Points 

•	 Ms. Wanda Munn commented that she had anticipated another

meeting of the workgroup before a formal presentation would be

made to the Board, and felt perhaps comments made during the

workgroup's discussion were not fully captured in the document.

Of primary importance was a suggestion that a tracking document,

which had been signed off on at various stages in the process by

individuals performing specific tasks, go along with the case

file. 

•	 Dr. Ziemer asked if that were not included in item 1(f). Ms. 

Munn agreed 1(f) incorporated the suggestion, but felt it was

not as clear as what she'd had in mind. She was asking for a

clarification statement in the document. 

•	 Dr. Antonio Andrade observed that if an electronic system were

put in place, a "traveler" could be generated at any point in

time with any particular case, making the audit function very

easy to accomplish. Dr. Andrade commented that a QA/QC system

is meant for those people implementing the process for their own

quality development and improvement. He cautioned the Board not 

to lose sight of the fact that NIOSH should own and evaluate 

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Executive Summary/Minutes December 9-10, 2003 

NIOSH/CDC Advisory Board on Radiation and Worker Health 

that program, ORAU should use the procedures developed, and the

Board should keep track of what's going on through its

subcontractor review. 

•	 Dr. Andrade pointed out that QA/QC is meant for quality

improvement, improving processes in the future, not as an avenue

to go back and evaluate retrospectively. Observing that the

last sentence in the last paragraph of the document speaks to

re-interviewing claimants, Dr. Andrade suggested the Board

decide once and for all whether that is even an option. Dr. 

Andrade offered his opinion that it should not be, that it is

onerous and that, because the only re-interviews conducted would

be with claimants who'd been denied, it could only be a heartwrenching experience for those people.

•	 Dr. Ziemer asked whether Dr. Andrade's intent were to make a 

motion to amend or to reflect a point of view. Dr. Andrade 

replied there would be a two-phased approach. It was his 

feeling the Board should discuss whether re-interview is open

for consideration. If not, he would move to amend the draft. 

•	 Dr. Ziemer observed that the document did not bind the Board in 

any direction. He further noted that he had personally been

opposed to re-interview, if only because the original interview

cannot be reproduced for any number of reasons, rendering it

useless as a quality check on the original interview.

•	 Dr. Henry Anderson expressed his approval of the

recommendations. He opined that the document set aside the

decision of re-interview, dependent on what the QA/QC program

is, noting that its design would relieve a great deal of concern

about the interview. That could not be determined until 

individual cases were reviewed or the contractor indicated there 

were some improvements to recommend.

•	 Mr. Mark Griffon indicated he had expected the recommendations

to involve a Board function rather than an internal audit. He 

inquired whether the workgroup had discussed having the Board do

steps (a) through (f). Dr. Melius explained that paragraphs one

and two are the NIOSH QA/QC program to improve the interview.

The last paragraph is what the Board would do, and is perhaps

for another working group. Noting that the wording may not be

as complete as it could be, the statement is that based on the

implementation of the NIOSH QA/QC program, the work group is not

recommending there be any potentially more intrusive way of

reviewing the interviews at this time. It is left open to see 

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Executive Summary/Minutes December 9-10, 2003 

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what the results of the NIOSH QA/QC program may be.

•	 Mr. Larry Elliott observed that the set of recommendations are 

appropriate for an understanding of what the Board would like to

audit on this piece of the process. He noted that while all of 

the suggestions are not fully developed and functional, it

reflects the direction in which NIOSH is moving. Mr. Elliott 

reminded the Board that he had said from the beginning that the

Board's audit should evaluate the interview process and how

those interviews contribute to dose reconstructions. Mr. 

Elliott further reminded the Board that he had also said reinterviewing claimants is off the table. Noting that it was not

the Board's decision to make, Mr. Elliott advised the Board that 

the Department of Health and Human Services would have to become

involved in that decision and will have to decide the value of 

that component if the Board chooses to re-interview claimants.

•	 Mr. Leon Owens reminded the Board of its need to at all times 

consider the credibility of the program and offered his opinion

that re-interview would be valuable from the standpoint of

quality assurance.

•	 Dr. Roy DeHart commented that he assumed the rationale for the 

recommendation is an uncertainty the current interview system is

working effectively. He asked if there was an awareness of any

significant problems, in light of some 20,000 interviews having

been done. Mr. Elliott responded that they are not aware of

problems in the interview process. The ORAU manager and other

delegated people in the interview part of the program listen in

on entire interviews and provide feedback. Mr. Elliott 

indicated he was personally aware of how interviews have been

captured and utilized in dose reconstructions and how they're

reflected in the dose reconstruction report, and so is

comfortable and confident in saying the process is a

contributing factor to dose reconstruction. He added that while 

no major problems have been identified with the process, they

continue to watch it closely.

•	 Dr. DeHart asked if that meant NIOSH is in the process of

developing what had been suggested in (a) through (f). Mr. 

Elliott replied that some of these are in place, though perhaps

not yet at a state of readiness that he is happy with, and that

NIOSH intends to put others in place. He noted that the tracking

system is not yet in place, but that he agrees with it. The 

traveling document would go along with that. He expressed his 

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Executive Summary/Minutes December 9-10, 2003 

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appreciation for the Board’s thoughts and comments.

•	 Dr. Ziemer commented that in his observation of the working

group, he did not think there was an assumption of fault with

the interview process. The issue had been one of how the Board 

could carry out its responsibility of evaluating it.

•	 Dr. Andrade clarified his position that if an ORAU observer

decides a re-interview is appropriate before a case is closed,

they have that option. But his concern is for the closed cases 

being reviewed by the Board, and having Board recommendations

used as an avenue to redress the decision. Dr. Ziemer indicated 

he did not think that was the case; he thought the desire was to

re-interview a closed case. 

•	 Mr. Mark Griffon reminded the Board that often in public comment

there has been concern expressed by claimants with the interview

and the information collected. So while those comments were 

made some time back, it is not entirely accurate to say there

was no concern over this part of the process. Mr. Griffon 

inquired if the possibility of taping and creating a transcript

of interviews, with the claimant's consent, were also off the

table or if the Department would consider doing that. Mr. 

Elliott responded that it had been considered and the problems

associated with it had been articulated many times, noting that

at this junction it is not a viable recourse.

•	 Dr. Melius responded to some of the previous comments by stating

that people are more likely to be concerned about their

interviews than what assumptions were used or other technical

information. And perhaps more importance than is appropriate

may be attributed in an individual case, given the time frame,

survivor issue, et cetera. NIOSH needs a credible program to

review the interviews and continue improvement. The Board needs 

a credible process for review, even though no particular

problems were seen. The workgroup noted NIOSH had steps in

place that reviewed the interview. They listened in, there was

an initial review and a later review. The probable point at

which a problem may come up is in dose reconstruction, when

someone is looking in detail at all the information and would

notice discrepancies. Those may be dealt with by a check of the

record, a call back to the person for clarification, and that's

fine. The recommendation is simply to report it in some way so

there's a record of having done that. It is understood the

Department is going to be resistant to re-interview. However, 

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Executive Summary/Minutes December 9-10, 2003 

NIOSH/CDC Advisory Board on Radiation and Worker Health 

Congress gave the Board the charge to review the dose

reconstruction program and it must be able to say the review had

been done properly. That means the Board has to be able to say

something about the interview process. The Board does not want 

to be put in the position of saying it could not carry out its

mission because it wasn't given access to review a major part of

the program. What the workgroup has laid out is an effort to

get the Board where it needs to go.

•	 Dr. Ziemer indicated that from what he had heard of workgroup

discussions, the feeling was that if a good quality assurance

program were in place which could be audited, the Board could

reach the level of confidence it wanted without re-interview. 

The recommendation contained the key pieces to help get to that

point.

•	 Dr. Genevieve Roessler voiced her support for everything

contained in the recommendation absent mention of re-interview,

for the reasons Dr. Andrade had expressed previously. Dr. 

Ziemer again pointed out that removal now does not preclude

Board action at a later date, and inquired if Dr. Roessler were 

moving to amend by deleting the last two sentences. Dr. 

Roessler countered that if it could be done at a later date, it

should be left for later. 

•	 Mr. Michael Gibson remarked that some things may come up during

a site profile that could require re-interview of a claimant.

•	 Dr. Andrade commented that Mr. Gibson had raised a good point,

and there were other concerns on the table, but the Board had

been advised about the likelihood of ever doing retrospective

interviews after final decision. 

Motion was made and seconded to amend the workgroup

recommendation by striking the last two sentences of the

last paragraph. 

Dr. Ziemer called for discussion on the motion to amend. 

Dr. Melius noted his understanding of the charge to the working group

was to deal with the issue and in some way the reference to reinterviewing is because of the charge given the working group by Dr. 

Ziemer and the discussions they had in order to carry it out. It 

asked if there were things that could be done that would be

sufficient short of re-interviewing or some other intrusive process, 

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Executive Summary/Minutes December 9-10, 2003 

NIOSH/CDC Advisory Board on Radiation and Worker Health 

and Dr. Melius stated he felt the reference should be in the 

recommendation. Acknowledging that the Board was split on the issue

and that it was difficult to deal with, Dr. Melius offered that the 

recommendation was a way of developing a compromise that can be lived

with until they're able to make a more informed recommendation, a

time at which differences may be less. 

Mr. Elliott offered as a point of clarification that the charge to

the working group was specific in evaluating options or identifying

options to evaluate the interview process. 

Dr. Ziemer indicated he could not recall the exact wording, but that

the Chair's objective is to find a way to audit without doing

interviews. 

Mr. Elliott assured the Board that had been the exact charge from the

transcript which he had sent to the working group just recently. 

Dr. Ziemer reiterated that striking the sentences does not preclude

anything. It simply doesn't address it at the present. 

Dr. Anderson commented that if it were left in, it would provide some

institutional memory for future Board members as current members are

rotated off. 

Dr. Ziemer observed that the institutional memory is in the

transcripts. 

Dr. Anderson countered that on other boards he'd found that what the 

agency and subsequent board members pay attention to are action

items, of which this Board has tended not to maintain a list. 

Mr. Rich Espinosa agreed with Dr. Anderson. 

Dr. DeHart noted that the title of the document is "Recommendations 

of..." and that the next to last sentence begins "The working group

is not recommending...," noting that it counters what is expressed in

the document. 

Mr. Griffon reminded the Board of Dr. John Till's report to the Board

on a review of a veteran's program, with one finding being that doses

may have been underestimated because information in written documents 

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Executive Summary/Minutes December 9-10, 2003 

NIOSH/CDC Advisory Board on Radiation and Worker Health 

provided by some of the claimants in those cases had not been

adequately incorporated by dose reconstructors. Mr. Griffon noted 

that this is an important program component and how it's designed is

critical to how much information is elicited from the claimants and 

how useful it can be. 

Dr. Ziemer noted, for clarification, that Dr. Till's concern was that

the material was not utilized at all, as opposed to an issue of

inadequate interviews. Mr. Griffon agreed, commenting that they

hadn't actually had interviews, but dose reconstructors hadn't paid

attention to material provided. Dr. Ziemer observed that the issue 

now is a separate issue. Mr. Griffon agreed, though it demonstrates

the importance of the tool. 

Ms. Munn asked, as a point of clarification, if the issue is not one

of closed claims. Dr. Ziemer confirmed they were indeed discussing

closed claims. Ms. Munn noted that the consideration of re-interview 

then put the Board in the position of being viewed by the public as a

quasi-appellate body. Dr. Andrade and Mr. Robert Presley agreed that

Ms. Munn was correct in that observation. Ms. Munn indicated she was 

not prepared to serve in that capacity, did not believe it was the

charter of the Board and would not go there. 

Mr. Presley commented that early on in Cincinnati he had observed

some of the interviews and was accepting of what was being done,

noting that the Board could be getting itself in trouble with the reinterviews. 

Dr. Ziemer called for a vote on the motion to amend the 

recommendation of the working group. 

With the Chair voting in favor of the motion, the motion failed

for lack of a majority in a six to six tie. 

Dr. Anderson observed that he'd thought the Chair only voted in the

event of a tie. Dr. Ziemer replied that in the Board's own rules

they had agreed that the Chair would always vote so that people knew

where the Chair stood on any given issue. 

Noting that they must now return to the original document, Dr. Ziemer 

asked if the Board were ready to vote. Dr. Andrade asked if he might

offer his editorial comments as friendly amendments. Dr. Ziemer 

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Executive Summary/Minutes December 9-10, 2003 

NIOSH/CDC Advisory Board on Radiation and Worker Health 

agreed. 

Dr. Andrade suggested the term "supervisory monitoring" in item 1(a)

be changed to "management monitoring." With no objection, the change

was so ordered. 

Noting that in item 1(b) the review is not necessarily done by

management but rather a group looking for both technical and

editorial accuracy, Dr. Andrade suggested the paragraph be changed to

read "Records of the review of the summary report, to include items

that are found to need further clarification, including corrective

actions." With no objection, the change was so ordered. 

In item 1(c) Dr. Andrade suggested striking the words "significant

problems" and replacing them with the words "to include any items" in

the second line. Dr. Ziemer observed that change may be slightly

more than editorial and inquired of the Chair of the working group if

such a change would be considered a friendly amendment. Dr. Melius 

acquiesced. With no objection, the change was so ordered. 

Continuing with that paragraph, Dr. Andrade suggested inserting the

words "to need further clarification" after the word "found," so that

when edited the paragraph, in its entirety, would read "Records of

the health physicist's review of the completed interviews at the time

that the dose reconstruction is being done, to include any items

found to need further clarification and corrective actions." 

Dr. Andrade noted that he had not yet constructed a comment that he

felt should be included to indicate the Board's contractor would 

perform part of the review. He wasn't sure where to fit it in. Dr. 

Ziemer observed that (a) through (f) were things it was suggested be

part of NIOSH's system for the Board to review, identifying the kinds

of records that could be reviewed, and perhaps the Board's

subcontractor should not be brought in at this point. Dr. Ziemer 

asked if the Board were comfortable with the friendly amendments. 

Mr. Leon Owens asked if, since in item 1(b) the words "completed

interview" had been changed to "summary report," they should also be

changed in item 1(c) to be consistent. Dr. Ziemer asked the staff 

for clarification on what the health physicist uses, the summary or

the interview. 

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Executive Summary/Minutes December 9-10, 2003 

NIOSH/CDC Advisory Board on Radiation and Worker Health 

Mr. David Allen responded that the term "summary report" is used

because there is no transcript of the interview. The difference is 

that in item 1(b) the summary is a draft, not yet reviewed, and could

possibly change for grammar, et cetera. Dr. Andrade observed that 

the health physicist could review this first report and ask for more

information or even re-interview if necessary. Mr. Allen agreed,

noting that summary report in item 1(b) is before the claimant has

seen it. After that review, it goes to the claimant, who can make

changes he feels are needed. In item 1(c) the claimant has reviewed

it, made changes and the dose reconstructionist is the one looking at

it. Dr. Andrade asked what it's called if a question or point of

clarification is made. Mr. Allen replied that if the claimant was

called back or a letter from a claimant was received to change

anything, it's changed and called an updated summary report. It was 

agreed it was a matter of semantics. 

Dr. Ziemer asked if the Board was ready to vote. Mr. Presley called 

for a point of clarification, noting that perhaps the term "working

group" in the last paragraph should be changed to "Board." With no 

objection, the change was so ordered. Dr. Ziemer called for a vote. 

The motion to accept the recommendations of the working group on

evaluation of the interview process was passed unanimously. 

* * * * * 

PUBLIC COMMENT PERIOD 

Ms. Patricia Ehlmann 

Wright City, Missouri 

Ms. Ehlmann, along with her brother, are survivor claimants for their

father, a Mallinckrodt employee from 4/43 to 10/66 at the St. Louis

plantand later at Weldon Spring. when he was diagnosed with multiple

myeloma in 1983 and died in 1987. Ms. Ehlmann was told DOL could 

verify her father’s cancers, but could verify only that her father

had worked at Weldon Spring. With assistance from Denise Brock Ms. 

Ehlmann later was told that DOL paperwork showed her father had only

worked in St. Louis. Ms. Ehlemann indicated that it only took common

sense to understand that if an employee worked from '43 to '66 they

had to work at both plants because the plants weren't in operation at 

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Executive Summary/Minutes December 9-10, 2003 

NIOSH/CDC Advisory Board on Radiation and Worker Health 

the same time. 

Mr. Knut Ringen, Science Advisor

Center to Protect Workers Rights

Seattle, Washington 

Mr. Ringen announced that the Center to Protect Workers Rights (CPWR)

is a non-profit research and development arm of the National Building

Trades Department of the AFL/CIO, with a longstanding partnership

with NIOSH in the area of construction safety and health. CPWR has a 

contract with OCAS to try to develop better dose and radiation

monitoring estimates for construction workers, and is involved in

medical screening programs for construction workers at Hanford,

Savannah River Site, Oak Ridge, Portsmouth GDP, Paducah GDP, and

Amchitka. He indicated that in the last six years CPWR has probably

interviewed more than 10,000 workers at those sites. . 

Mr. Ringen stated his comments would be limited specifically to

construction workers and claimants who are construction workers. 

Roughly half the current claimants in the EEOICPA program are

construction workers or their survivors, according to Mr. Ringen. He 

was concerned about the 30 to 40 percent of his members where there

are no valid dose data and claimants have difficulty recalling their

work history. 

Mr. Ringen indicated that his organization did not agree with the

NIOSH interpretation of the law and its plans for dose

reconstruction. He described what he felt were fundamental flaws in 

the way the program was set up. 

Mr. Ringen stated he had been present at the Savannah River Site

meeting in November, characterizing it as a very good meeting with

open give and take. 

Mr. Ringen observed that all the site profile documents are very

important. He noted that the quoted purpose, "to evaluate both

internal and external dosimetry data for unmonitored and monitored

workers and to serve as a supplement to or substitute for individual

monitoring data," was a very large charge and not very specific

He listed a number of reasons why his organization became very 

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Executive Summary/Minutes December 9-10, 2003 

NIOSH/CDC Advisory Board on Radiation and Worker Health 

concerned when the site profile was reviewed. 

Mr. Ringen stated that following the meeting, his organization agreed

to make available to NIOSH all the information they have. 

Mr. Ringen raised the issue of inviting comment after a site profile

is posted on the web site, claiming it puts a burden on the claimants

to show deficiencies in the document. 

Mr. Ringen asked the Board to consider recommending to NIOSH that it

issue a replicable method for preparation of the site profiles and

that this include validation of the information it receives from the 

site in terms of accuracy and completeness 

Mr. Ringen further suggested that for future meetings, notice be sent

out to all claimants within a 50- to 80-mile radius. He also 

suggested holding an evening session for public comment. 

Dr. Henry Anderson asked what kind of follow-up had been received

from NIOSH after the Augusta meeting. 

Mr. Ringen replied Mr. Elliott had asked them to submit all their 

information and documentation, as well as their results from the

worker interviews. Mr. Ringen further commented that interviewing

construction workers is difficult because it has to be put in

occupational terms the workers are used to. 

Mr. Rich Espinosa inquired about the 20 percent of construction

worker claimants whose employment could not be verified. 

Mr. Ringen responded that in about 20 percent of the claims from

construction workers, DOE is unable to verify employment. He noted 

that a problem is that a number of the members of his group have been

employed by subcontractors and sub-subcontractors 

Mr. Espinosa asked about using co-worker data with construction

workers and getting differences in dose reconstructions. Mr. Ringen

explained that extrapolating from co-worker data is difficult with

construction workers Exposures are hard to predict because the

environment isn't anticipated and the work isn't anticipated. 

With no further comments, the Board officially recessed until 

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Executive Summary/Minutes December 9-10, 2003 

NIOSH/CDC Advisory Board on Radiation and Worker Health 

the 

following morning. 

* * * * * 

Wednesday, December 10, 2003 

Dr. Paul Ziemer called the second day to order, reminding guests to

register their attendance and requesting that those wishing to make

public comment sign in for that opportunity. 

The first item on the day's agenda was an introduction to the

subcontractor who would be providing support to the Board in its

audit of dose reconstructions. Dr. Ziemer pointed out to the Board

members and the public that the presentation and any ensuing

discussion would have to be very general. The proprietary document

to be addressed in this afternoon's closed session had yet to be

reviewed by the Board. 

Mr. Mark Griffon asked if the Board might inquire regarding the

technical skill proposal. 

Dr. Ziemer referred the question to Ms. Martha DiMuzio for response.

Ms. DiMuzio indicated that there was a document before the government

for consideration and would not be a public document until final

award had been made. General questions may be asked, but specific

discussion about the proposal was for the afternoon closed session. 

Confirming that no Sanford Cohen and Associates (SC&A) representative

would be permitted in the closed session, Mr. Griffon queried how

negotiations or discussions of technical scope might be accomplished.

Ms. DiMuzio replied that questions would be developed and referred to

SC&A for response within seven days. Dr. Ziemer noted that while it 

had the effect of prolonging the process, the contractor had a right

to formulate their response. Mr. Larry Elliott added that it also 

provided an opportunity for redirection in the event the Board found

the contractor had made proposal outside what the scope of the task

called for, commenting that both redirection and questions are

confidential. Ms. DiMuzio cautioned that it could not appear as if

the Board were leading the contractor to arrive at a certain point. 

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Executive Summary/Minutes December 9-10, 2003 

NIOSH/CDC Advisory Board on Radiation and Worker Health 

Dr. Ziemer asked if the ground rules were understood by the Board

before commencing. A member of the audience, Mr. Richard Miller of

the Government Accountability Project, interjected his opinion that

the technical scope was what was of interest to the public and NIOSH

should make public the accepted bid proposal so that the public could

have a sense of the structure, organization, methods, et cetera. Dr. 

Ziemer pointed out to Mr. Miller that the scope of the work had been

defined by the Board and was public. The determination to be made is 

whether the contractor is capable of responding to those tasks. The 

upcoming presentation will provide information on the organization of

the company and its personnel. Ms. DiMuzio advised Mr. Miller that 

the original proposal would require a specific Freedom of Information

Act (FOIA) request and could be released if SC&A is willing to

release it in light of proprietary information it contains. 

INTRODUCTION TO THE ADVISORY BOARD'S SUBCONTRACTOR 

Dr. John Mauro 

Sanford Cohen & Associates 

As Senior Vice President of the consulting division of SC&A, Dr. John 

Mauro offered an overview of the company selected in October 2003 to

provide technical support to the Board in fulfilling its mandate

under EEOICPA. He described SC&A as a small radiological consulting

company incorporated in 1982 with headquarters in McLean, Virginia,

specializing in doing dose calculations A full service radiological

laboratory is located in Montgomery, Alabama. Employing

approximately 30 nuclear engineers and health physicists, and with

some 50 associates who specialize in a variety of areas, principal

clients are primarily government agencies such as the U.S. Nuclear

Regulatory Commission, the U.S. Environmental Protection Agency and

the Federal Emergency Management Agency. 

In addition to the consulting division headed by Dr. Mauro, the

company also has laboratory, radiation field services and quality

assurance divisions. Dr. Mauro presented an organization chart of

the project, identifying the key personnel who will support his role

as project manager, and describing their education and experience.

Dr. Mauro commented that a powerful conflict of interest control

process had been put in place to make sure everyone on the project

met all conflict of interest issues. 

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Executive Summary/Minutes December 9-10, 2003 

NIOSH/CDC Advisory Board on Radiation and Worker Health 

The scope of work covered by SC&A’s proposal involes four tasks.

Dr. Mauro described each task, including any deliverables called for,

and briefly outlined the company’s approach to the project. The four 

tasks are; (1) individual dose reconstruction reviews, (2) site

profile reviews, (3) dose reconstruction procedure and methods

review, and (4) dose reconstruction review tracking. 

Discussion Points
 

•	 Dr. Paul Ziemer reminded the Board that comments and questions

must be confined to material Dr. Mauro had presented. He 

inquired if the company has the capability of bringing in, on

short notice, other experts in addition to the 30 employees.

Dr. Mauro replied that over the years the company had developed

a network of hundreds of specialists in the radiological and

nuclear sciences. This gives the company the ability to quickly

bring aboard an associate within a day if a need arose.

•	 Dr. Roy DeHart commented he had been about to inquire into the

absence of a physician among the associates, but had noticed the

inclusion of Dr. Art Upton. Mr. Mauro noted that Dr. Upton was 

part of the New York University Medical Center program and has

been an SC&A associate for many years. 

* * * * * 

BOARD WORKING SESSION 

REVIEW AND APPROVAL OF DRAFT MINUTES 

Dr. Paul Ziemer informed the Board of some clarifications he had 

requested in the Executive Summary, and inquired if there were

further substantive comments. Ms. Wanda Munn and Dr. Genevieve 

Roessler discussed portions of the minutes which needed addition of a

clarifying phrase or would perhaps require reference to the

transcript of the meeting for clarification. Dr. Ziemer inquired if

the Board were willing to approve the Minutes and Executive Summary,

with the discussed modifications being made prior to publication. 

A motion to approve the Executive Summary and Minutes of the 

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Executive Summary/Minutes December 9-10, 2003 

NIOSH/CDC Advisory Board on Radiation and Worker Health 

eighteenth meeting, with modifications as discussed, was

seconded and unanimously passed. 

Mr. Larry Elliott asked for a sense of the Board as relates to the 

level of detail in the minutes. Noting that the minutes were very

detailed, he wondered if the Board would perhaps prefer something

shorter, with the verbatim transcript to rely on what was actually

said. 

Dr. Ziemer called for some feedback, noting he had been attempting to

condense them. Mr. Elliott confirmed that the style is something

that can be changed, if they so desire. 

Dr. James Melius indicated he liked the style and spoke in favor of

keeping it. Dr. Ziemer asked if he liked the level of detail. Dr. 

Melius replied that he did, noting it was helpful not to have to

refer back to the transcript to find what someone had said. 

Dr. Genevieve Roessler commented that this amount of detail is 

important to people looking at the minutes. She noted that she knew 

of people, particularly those in health physics who are reviewing

what the Board is doing. 

Mr. Mark Griffon agreed with Dr. Melius, observing that not many

people were going to turn to the transcript. 

Mr. Presley agreed with the comments of Mr. Griffon and Drs. Melius 

and Roessler. Dr. Ziemer observed the consensus seemed to be that 

the proper level of detail had been attained. 

Dr. Ziemer inquired if the Board wished to move forward with

discussion on the proposal of formation of a subcommittee to handle

ongoing issues with the contractor, or remain operating as a

committee of the whole on how the Board directs and works with the 

contractor. 

Dr. Melius conceded specific discussion was difficult until after the

afternoon closed session, but noted he was uncomfortable with major

changes in Board procedure being done in closed session. Dr. Ziemer 

advised the subcommittee discussion could not be part of the closed

session, which was limited to the cost proposal. His suggestion was

that it might wait until results of the afternoon discussions were 

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Executive Summary/Minutes December 9-10, 2003 

NIOSH/CDC Advisory Board on Radiation and Worker Health 

known, noting there was not a necessity to have a subcommittee at the

moment. 

Dr. Melius suggested looking at what might be lost or gained in terms

of timing of the task orders through facilitation of a subcommittee

to last until the next meeting with a very specific charge. A second 

question would be whether it is worthwhile to have a larger

discussion later on about what a subcommittee might do on an ongoing

basis. 

Dr. Ziemer observed that a subcommittee of limited duration was more 

a working group, but would be operating in the absence of precise

knowledge of what the charge would be to such a workgroup. Mr. 

Melius commented it was his understanding a subcommittee could act on

behalf of the Board between meetings, but a workgroup could not. Dr. 

Ziemer agreed it could, if authorized by the Board. Dr. Melius 

inquired of Mr. Elliott if any of the possibilities of what might

happen in the afternoon session would be assisted by having action

taken by the time of the next meeting. 

Observing that it might benefit the Board to hear a review of the

process from this point forward, Mr. Elliott asked Ms. Martha DiMuzio 

to describe how it will work. Ms. DiMuzio explained that in closed

session the Board would review the proposals and cost estimates

provided by the contractor. The Board could determine to accept the

proposals as submitted, at which point they would move forward with

award. If there are questions related to the approach or level of

effort being proposed, specific questions would be generated. Those 

questions would be forwarded to the procurement office, who would in

turn provide them to SC&A for response. SC&A then has seven days to

respond to the questions and potentially re-propose against the

tasks, after which those responses and/or proposals would be

forwarded to the Board for approval. Mr. Elliott added that a time 

extension could be granted to SC&A it it is appropriate, necessary,

and justified. 

Dr. Henry Anderson offered that if the intent is for a subcommittee 

to move expeditiously, there is still the matter of advance notice to

be dealt with, noting that if they operated as a committee of the

whole, they only needed a quorum. Dr. Anderson commented that later 

there may be routine activities that would make having a subcommittee

advantageous, but it's early enough in the process that everybody

wants to be involved in it. He suggested the Board should just 

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Executive Summary/Minutes December 9-10, 2003 

NIOSH/CDC Advisory Board on Radiation and Worker Health 

recognize that some people may not be present on short call, and just

be sure a quorum is present, inquiring if it might be done by phone

call. Mr. Elliott replied that closed session cannot be conducted by

phone, and further negotiations would be the equivalent of what was

going to be done this afternoon, assuming further revisions were

needed. 

Ms. Wanda Munn observed that, although it appears cumbersome to act

as a committee of the whole, she could see no reason to further

discuss establishing a subcommittee, absent some triggering event or

circumstances which would clearly require its more concentrated

efforts. 

Confirming his understanding that the earliest a new proposal could

be expected would be the first of the year, Dr. Melius pointed out

that the next Board meeting in February would mean the loss of a

month of work on the tasks, should they have to be revised, inquiring

if the process can continue to go back and forth. Ms. DiMuzio 

indicated that if things were still not correct, the contractor still

didn't fully understand what was wanted of them, the Board could be

going back with follow-up. 

Mr. Elliott asked if written back-and-forth communications between 

the Board and SC&A is permissible. Further, if specific issues or

questions regarding a given task result in a revised proposal which

is acceptable to the Board, can the Board take action and make the

award by letter to Procurement? Ms. DiMuzio acknowledged it could,

but a mechanism for approval and agreement by all the Board would be

necessary. Mr. Elliott asked Ms. Cori Homer if the back-and-forth 

business between the Board and contractor could be done by mail, with

a sense that the full Board is in agreement. Ms. Homer replied it

was her belief that any action taken by the Board is considered a

meeting and must be announced as closed, after having gained approval

for it. 

Dr. Ziemer agreed that sounded as if it were the case. Ms. Homer 

added that this also applied to subcommittees. 

Dr. Ziemer inquired into the possibility of announcing a closed

meeting for the purpose of taking final action on the proposal,

assuming further proposal was necessary following the afternoon

session, and the Board felt some urgency to act on the new proposal.

Dr. Ziemer further suggested reserving some time in advance for that 

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Executive Summary/Minutes December 9-10, 2003 

NIOSH/CDC Advisory Board on Radiation and Worker Health 

possibility. Ms. Homer indicated she needed seven days for the

announcement, and agreed with Dr. Ziemer's suggestion. 

Mr. Elliott suggested that, for the benefit of the discussion, the

meeting could be held at NIOSH offices in Cincinnati, and that

expectations for meeting set-up should be minimal. Ms. Homer 

observed notice could be published on an emergency basis. 

Dr. Melius returned to the issue of a subcommittee being charged with

reviewing a response from the subcontractor and approving it within

bounds set this afternoon. Ms. Homer pointed out that the decision

can be made to establish a subcommittee, but it has to be established

prior to a meeting taking place. Mr. Elliott observed it had to have 

a charter which had been signed off on. Ms. Homer added an 

establishment memo would provide membership, function, and frequency

of meetings. Mr. Elliott remarked authority would have to be

delegated by the Board. Dr. Melius asked how long this would take,

and was informed by Ms. Homer that, with holidays coming, two weeks

or longer. 

Dr. Roy DeHart observed that with only a quorum being needed to act,

the odds of finding 50 percent plus one to attend a meeting is

greater than having a subcommittee with limited numbers available,

and thus saw no advantage to an effort to create and generate a

subcommittee. Dr. Melius commented he had been thinking just the

opposite, that four people would be easier to gather than seven, and

observed the real question was whether the Board wanted to spend the

time and come to agreement at this meeting on a subcommittee charter.

Dr. Ziemer indicated it wasn't obvious to him that it would be easier 

to gather a specific four people than any seven out of 12, that it

would depend on the four people and what the dates were. 

Dr. Anderson remarked that it might be advantageous to have a small

group act, in effect, as Project Officer for the Board. Dr. Ziemer 

replied that the original idea had been for such a group to serve in

a management role, to work with the contractor and help determine

which Board members would participate in different cases, as opposed

to making specific decisions such as on the contract itself. 

Mr. Homer advised that if a subcommittee has been formed and 

establishment has taken place, the Board has to meet to determine

what authority it will give the subcommittee, which would take at 

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Executive Summary/Minutes December 9-10, 2003 

NIOSH/CDC Advisory Board on Radiation and Worker Health 

least one full meeting of the Board. Dr. Melius asked if doing that

today wouldn't establish the charter. Ms. Homer agreed, but

indicated that it did not establish authority, and without authority,

the subcommittee cannot take action without approval of the full

Board. If the Board gives authority to act on their behalf, that

authority has to be developed and approved before the subcommittee

can take any action. Dr. Ziemer asked if the authority can be given

prior to approval of a charter. Ms. Homer replied they could be

developed at the same time, but until then, there was no authority. 

Dr. Ziemer ruled that they would continue to operate as a committee

of the whole for now and possibly call some emergency meeting of the

Board if it becomes necessary to do something before the next

meeting. 

* * * * *

 ADMINISTRATIVE/HOUSEKEEPING MATTERS 

Ms. Cori Homer addressed a variety of administrative and housekeeping

issues. She also advised parties planning to participate in the tour

the following morning that all forms of electronic communication

devices were prohibited, including cell phones, palm pilots, cameras,

et cetera. They were advised to dress casually, bring water if they

wished, and be in the hotel lobby for a 6:30 a.m. departure time. 

Mr. Larry Elliott reminded members of both Mr. Mark Griffon's and 

Dr. James Melius' working groups that those groups had completed

their respective charges and that time could not be billed against

them beyond that completion date. 

January 15 in Cincinnati was decided upon as a contingency date and

site, should it be necessary to deal with the issue of a

subcontractor re-proposal. Dr. Melius suggested 11:00 a.m. to 2:00

p.m. so that people could fly in and out as a day trip, if they

wished. That was acceptable. 

Dr. Paul Ziemer indicated some question had come up as to the

possibility of a Savannah River Site tour and asked Mr. Robert 

Presley if he could help in that regard. Mr. Presley replied that

the former head of the Savannah River Site is now at Oak Ridge and he 

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Executive Summary/Minutes December 9-10, 2003 

NIOSH/CDC Advisory Board on Radiation and Worker Health 

would speak with him when he returned home. He did point out that a

Savannah River Site tour would have to be before the meeting, which

is on February 5 and 6, so the tour would have to be on a week day,

the 4th. 

Dr. Melius asked if evening public comment could be scheduled for the

next two scheduled Board meetings. Dr. Ziemer asked if the members 

objected, noting the meeting could be adjusted so they didn't go all

day and night. Mr. Elliott indicated he'd like to hear the sense of 

the Board, but stated they may be limited by the ability for space

since they have to contract that with the hotel. 

Dr. Ziemer reminded the Board of comments from the previous day about

finding ways to get better attendance at meetings. He wondered if 

the staff had had a chance to think about other channels for 

disseminating information of upcoming Board meetings to potential

claimants and workers in an area other than the Federal Register. 

Ms. Homer indicated other methods had been used, such as

announcements prepared and distributed to news agencies, newspapers,

and TV stations. 

Dr. Ziemer observed that the good turnout in St. Louis was largely

due to local effort, suggesting there might be key contact persons at

other sites who would be helpful. 

Ms. Wanda Munn suggested that in meeting announcements to the public,

it should be mentioned what the Board does. She indicated it was 

misleading for people to think they may have an opportunity to

address an adjudicating body, when the Board's responsibility is one

of process. Dr. Ziemer agreed, noting that it should be recognized

the process is within the framework of individual claims, and

knowledge of what's happened in individual cases helps in

understanding where the process may or may not be working, and that

should not be discouraged. Ms. Munn indicated that had not been her 

intent. 

Dr. Henry Anderson suggested saying in the notice the Board was

interested in hearing about people's experiences with the process,

interview and/or paperwork, assuming those interested in coming are

claimants and would want to share that experience. He noted that 

while it would be a biased sample, it would give insight into their

perceptions. 

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Executive Summary/Minutes December 9-10, 2003 

NIOSH/CDC Advisory Board on Radiation and Worker Health 

Dr. Ziemer asked the Board members to refer any ideas to staff,

confirming with Mr. Elliott that such would be useful. 

Dr. Melius asked what were planned in response to the letter from the

three Congressmen discussed yesterday. Dr. Ziemer reiterated his 

desire to discuss a response with counsel or the Department as some

of the suggestions made in the letter seemed to be well outside the

charge of the Board, but agreed he needed to prepare a response.

Dr. Melius asked if it would be shared with the Board. Dr. Ziemer 

agreed that it would, indicated that a copy had been provided to the

Board members, and asked that anyone with any particular comment on

the issue contact him. 

Dr. Melius asked if future agenda items could be discussed, noting

that the research group should have a report by the next meeting. He 

reminded the staff of his suggestion yesterday that a presentation be

made on the use of the site profiles in dose reconstruction.

Mr. Elliott asked if Dr. Melius would like to see a sampling of dose

reconstructions conducted under the site-wide document as well as 

site-specific documents. Dr. Melius agreed and indicated he would

leave selection to NIOSH discretion, but would suggest a complex

site. 

Dr. Melius inquired if there were a way to move forward on the

subcommittee issue. Dr. Ziemer replied that he and Mr. Mark Griffon 

had done some work on it, and that he had asked Ms. Homer to provide

him with details on setting up a subcommittee, structure and ground

rules. It was agreed it would be a specific agenda item designated

as discussion of subcommittee on dose reconstruction reviews. 

Mr. Elliott remarked that at some time in the near future the Board 

would have to identify, from the pool of completed cases, those that

meet their sample for assignment. Mr. Griffon commented he wasn't 

sure there was a large enough pool to sample much from at this point,

but there were site profiles and other things to be working on. 

Dr. Melius asked if it would make sense to have a presentation from

NIOSH on their outreach to complement the presentation Mr. Pete 

Turcic had committed to making on the DOL outreach plan. Dr. Ziemer 

suggested that if anything else came to mind, Board members should

contact him or Mr. Elliott as they would be developing the agenda

jointly. 

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Executive Summary/Minutes December 9-10, 2003 

NIOSH/CDC Advisory Board on Radiation and Worker Health 

Mr. Griffon asked if it would be possible for Board members to

receive a training session on IMBA at night, since they would be

provided the software prior to the next meeting. Dr. Ziemer observed 

that training could probably more easily be done in Cincinnati. Mr. 

Elliott offered that any time a Board member traveling through

Cincinnati wanted to stop by and have an afternoon available to them

for training, they would be accommodated. 

* * * * * 

PUBLIC COMMENT PERIOD 

Public comment was solicited on both days of the meeting. Public 

input on the second day included the following. 

Ms. Denise Brock 

United Nuclear Weapons Workers 

Ms. Brock thanked the Board for coming to St. Louis and asked if the

Board had discussed coming back to discuss the site profile with

claimants. Mr. Elliott indicated the Board had not, but NIOSH

planned to do so, though he could not give a specific date. 

Ms. Brock inquired into discovery by DOE of more Mallinckrodt

Chemical worker records in Georgia. Dr. Richard Toohey replied that

on an ORAU data capture trip to the Atlanta National Archives, more

files on Mallinckrodt were found, though he did not know what they

contained. They are being reviewed and analyzed and would be

incorporated into the TBD if there was anything new in them. Mr. 

Elliott added they were unaware of anything DOE had provided on

Mallinckrodt, noting the discovery had been the benefit of NIOSH and

ORAU labor. Ms. Brock asked if it could be individual personal data

or site information or both. Dr. Toohey reiterated he did not know 

what the information was. 

Ms. Brock inquired if there is an expected time for completion of

either Weldon Spring or Hematite facilities, as neither are listed as

up and coming site profiles. Dr. Toohey responded that as a result

of the St. Louis meeting, Weldon Spring had been moved up on the list

for site profile development and commencement was expected after the 

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Executive Summary/Minutes December 9-10, 2003 

NIOSH/CDC Advisory Board on Radiation and Worker Health 

first of the year. Dr. Toohey indicated he didn't have his list with 

him, but he didn't believe Hematite was on the drawing board. Noting

a desire to be responsive to the Board or the public's interest, he

added that could be moved up, especially since those sites did much

the same things. 

Ms. Brock asked if perhaps a person who had been employed at more

than one of the Mallinckrodt facilities might be reviewed for

compensability through Destrehan Street employment at the downtown

St. Louis site without having to wait for completion of the site

profile on other facilities. Dr. Toohey replied that could be done. 

Ms. Brock inquired if all the telephone interviews for Destrehan

Street employees had been completed. Dr. Toohey responded that he

couldn't say they'd all been completed, but what had been completed

were those they felt the files were ready to move into dose

reconstruction. Some who had worked at downtown and Weldon Spring

had been set aside because the Weldon Spring site profile was not

done. Others had some inconsistency or problem they prefer to get

corrected before going into interview and dose reconstruction. 

Ms. Brock commented that she had seen a dose reconstruction in which 

Elizabeth Dupree-Ellis was cited, which caused Ms. Brock concern as a 

result of Dupree-Ellis' exclusion of internal dose and Ms. Brock's 

feeling that Dupree-Ellis underestimated things. 

Ms. Brock asked if a member of the public could request SC&A to look

into off-site exposure relative to Hematite, St. Louis and Weldon

Spring residual radioactivity, ground water problems, et cetera. Mr. 

Elliott responded that the contract with SC&A is with the Board as a

government entity in which they're given a specific charge, a scope

of work against which they are proposing. What Ms. Brock is asking

is not included in that scope. Ms. Brock asked if that meant find 

other health physicists. Mr. Elliott added that money to support the

effort would also be necessary. 

Relative to dose reconstruction, Ms. Brock expressed concern about

the reliance on surrogate co-worker data and on data extrapolated

from the site profiles, because these data may be unreliable. In 

addition, Ms. Brock said that due to cover-ups and altering of 

records, the dates recorded for badge readings may be incorrect. 

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Executive Summary/Minutes December 9-10, 2003 

NIOSH/CDC Advisory Board on Radiation and Worker Health 

Dr. Melius asked if there is a schedule of site profile completions

on the web site. Dr. Toohey replied it was not on the web site, but

it had been provided to NIOSH. Dr. Melius asked if it would be 

possible to put it on the web site. Mr. Elliott indicated he could 

not give a guarantee today, but it would be considered, noting that

it was a plan that was being reviewed and evaluated now for

feasibility, if it can be achieved. 

Dr. Toohey asked to comment to Ms. Brock's last observation, noting

that every dose reconstruction contains an uncertainty estimate,

often very large, which gets run through IREP in the uncertainty on

probability of causation. At the 99 percent confidence interval for

decision criteria, many errors or inaccuracy in the point estimates

are accounted for by including the uncertainty in those values. Dr. 

Ziemer added that many people don't realize that in most cases larger

uncertainties help the claimant because it spreads the distribution

out more. 

Mr. Richard Miller 

Government Accountability Project 

Mr. Miller invited the Board to consider western New York as a 

meeting site. He indicated there were plenty of people who would be

happy to cooperate with the Board and NIOSH in having either evening

sessions or outreach activity to ensure good participation, noting it

has one of the largest concentrations of facilities in the country. 

Mr. Miller raised the issue of a discussion of how the Board will 

address policy if people want to have a site profile reviewed.

Mr. Miller observed this is an opportunity for policy development

about what the Board takes in and how inputs get resolved and

addressed. 

Mr. Miller indicated he was raising for the third time the issue of

radon in the Blockson Chemical TBD. Mr. Miller reiterated his 

position on the issue, discussing again the intake of rock phosphate

to the final uranium process and whether radon exposure is included. 

Mr. Miller reiterated his call for development of a policy with

respect to professional standards, describing conflict of interest as

too narrow a term. He opined that this should be a Federal 

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Executive Summary/Minutes December 9-10, 2003 

NIOSH/CDC Advisory Board on Radiation and Worker Health 

function up front rather than having people identifying things for

NIOSH. 

Mr. Miller offered that, with respect to the question of evening

public comment, it should be figured out in advance whether it would

be productive rather than sit in an empty room for two hours and then

close the record. 

Mr. Miller raised the issue of availability of IMBA to the public.

He opined there should be some creative solution to the issue of

dealing with proprietary software, and questioned how much creativity

had been applied to it at this point. Mr. Miller urged consideration

of whether it makes sense to have a program relying on proprietary

dose reconstruction software inaccessible to the public except with

what he called a very high barrier. 

Noting that he didn't understand it completely, Dr. Melius observed 

there is a generic issue with a number of AEC sites where there were

exposures from other industrial processes as well as the AEC process.

Though he didn't understand to what extent it would be policy, legal

or whatever, Dr. Melius felt a briefing would help the Board

understand what is involved in the decision-making regarding the

parsing out of exposures, as well as how it affects future dose

reconstruction. 

Dr. Ziemer indicated Mr. Miller had also entered into the public

record some related comments, and that the Board members had gotten

copies of Mr. Miller's written comments on the Biloxi issue. 

Dr. Ziemer asked if the problem revolved around the official

definition of the facility insofar as it relates to weapons

production. Mr. Miller remarked it depends who you ask. 

Dr. Ziemer observed that at the crux of the matter was that it's 

defined a certain way and then that gets interpreted. One wonders 

where the line is exactly. There is the issue of radon–related 

phosphate, but where does that end as far as what the company was

doing, and where does the uranium work begin? Were uranium workers 

also exposed and is this part of their occupational exposures?

Dr. Ziemer indicated that Dr. Melius had been saying we don't

necessarily know what those issues are, either, and perhaps NIOSH has

been addressing that or looking at that, and that's been part of the 

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Executive Summary/Minutes December 9-10, 2003 

NIOSH/CDC Advisory Board on Radiation and Worker Health 

issue. Dr. Ziemer asked Mr. Miller if he were perhaps questioning

whether the decision had been made and is fixed in concrete and may

affect other facilities, as well. 

Mr. Miller opined that the issue was what he termed a thought puzzle,

noting he had sketched out about five different ways he could draw

the line. He noted it was partly a question of health physics,

partly engineering and partly a policy call about how to deal with

equities for individuals, and reasonable people could differ on it.

He offered a belief that it should be aired out and not be decided in 

an interagency deliberation process. 

Mr. Miller observed that in his review of the Mallinckrodt site 

profile he had found a footnote for a document he'd been searching

for for over a year and was pleased to see it footnoted in the site

profile. The Eisenbud document was the basis for an article which 

had run in the Riverfront Times and Mr. Miller read a portion of it

to the Board. Mr. Miller thanked NIOSH for producing the document in

a transparent way and without need for a FOIA request. 

Ms. Brock described some of the methods she has used to locate and 

contact claimants, and noted that public service announcements and

other outreach efforts are useful in alerting claimants and the media

to scheduled meetings. 

With all further business to come before the Board requiring action

in Executive Session, the public portion of the meeting was

adjourned. 

End of Summary Minutes 

I hereby confirm that these Summary Minutes 

are accurate to the best of my knowledge. 

53
 
 

 

_______________________________________ 

_______________________________________ 

Executive Summary/Minutes December 9-10, 2003 

NIOSH/CDC Advisory Board on Radiation and Worker Health 

Paul L. Ziemer, Ph.D., Chair 

Date 

54