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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

CENTERS FOR DISEASE CONTROL AND PREVENTION

NATIONAL INSTITUTE FOR OCCUPATIONAL

SAFETY AND HEALTH

+ + + + +

ADVISORY BOARD ON RADIATION

AND WORKER HEALTH

+ + + + +

SUBCOMMITTEE ON DOSE RECONSTRUCTION

+ + + + +

FRIDAY

MARCH 30, 2012

+ + + + +

The meeting came to order at 9:00 

a.m., in the Zurich Room of the Cincinnati 

Airport Marriott Hotel, Hebron, Kentucky, Mark 

Griffon, Chairman, presiding.

PRESENT:

MARK GRIFFON, Chairman

BRADLEY P. CLAWSON, Member

WANDA I. MUNN, Member

JOHN W. POSTON, Member*
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ALSO PRESENT:

TED KATZ, Designated Federal Official

HANS BEHLING, SC&A*

KATHY BEHLING, SC&A*

ELIZABETH BRACKETT, ORAU Team*

GRADY CALHOUN, DCAS

DOUG FARVER, SC&A

STU HINNEFELD, DCAS

JENNY LIN, HHS

JOHN MAURO, SC&A*

SCOTT SIEBERT, ORAU Team*

JOHN STIVER, SC&A

BRANT ULSH, DCAS

KEITH VARNADO, ORAU Team*

*Participating via telephone
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CONTENTS

Welcome and roll-call...................... 4

Discussion

DCAS report on QA/QC analysis of

5 cases from Set 12 .................. 9

Off-agenda discussion of QA issues

and error-tracking .................. 16

First set of DCAS blind DR quality

control evaluations ................. 26

DCAS report on DR efficiency process

change options and resource

implications ....................... 125

DCAS report (update) on current

timeliness of dose reconstructions

DCAS follow-up on ORAU quality

management system (error rate

tracking/control)

SC&A evaluation of themes in sets

10-13 of draft dose reconstruction

reviews ............................ 150

Lunch

Other items related to

NIOSH 10-year review..................... 202

Preparing second Board report to the

Secretary on dose reconstruction reviews. 215

Continuation of issue resolution for

sets 7-9 ................................ 220

Adjourn.................................. 314
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1 P-R-O-C-E-E-D-I-N-G-S

2 (8:57 a.m.)

3 MR. KATZ: Good morning, everyone 

4 in the room and on the line. It's the 

5 Advisory Board on Radiation and Worker Health, 

6 Dose Reconstruction Review Subcommittee. 

7 Let's do roll call.

8 We need to, because this is a 

9 Subcommittee, we need to do roll call a little 

10 bit differently in the sense that we have to 

11 speak about conflict of interest to -- with 

12 respect to each Board Member.

13 So we have to -- I brought it to 

14 make things, matters easier, but we have to 

15 acknowledge conflict of interest at the front 

16 end since this Subcommittee deals with really 

17 all the sites, in effect, even though we are 

18 not speaking about individual sites or 

19 focusing on them, but our dose reconstructions 

20 are from individual sites.

21 So let me find my list and we'll 

22 just do it this way, so -- because I'm not 
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1 sure all of you have an easy time rattling off 

2 your conflicts. So I'll just speak for your 

3 conflicts as we do roll call.

4 So, beginning with Mark.

5 (Roll call.)

6 CHAIRMAN GRIFFON: Okay. All 

7 right, welcome, everybody and I thank Ted for 

8 sending all the correspondence in the last two 

9 weeks or so, and getting a lot of deliverables 

10 sent in to us.

11 And we have the agenda and I think 

12 -- well, I'm not sure of the order, but I 

13 think it basically puts the case review stuff 

14 towards the end, so -- which I think would 

15 make sense.

16 So we can just probably start down 

17 the list. DCAS report on QA/QC analysis, the 

18 five cases from set 12.

19 MR. HINNEFELD: Well, I can, I can 

20 start.

21 CHAIRMAN GRIFFON: This is a 

22 different piece, I thought it was the other -
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1 MR. HINNEFELD: The blind one is 

2 the next, right?

3 CHAIRMAN GRIFFON: Why don't we 

4 start there, because I'm --

5 MR. HINNEFELD: This will be 

6 really quick.

7 CHAIRMAN GRIFFON: Okay.

8 MR. HINNEFELD: We've got a 

9 preliminary analysis of the last -- of the 

10 latest five cases from the twelfth set and --

11 of the errors that have been identified in 

12 reviews, and you know, of errors, and you 

13 know, yes, these are errors, you know, they 

14 are -- the second piece that we were obliged 

15 to do though, is to say where in our system 

16 should we have caught this error, if we should 

17 have, and that part's not done yet.

18 We can provide, you know, we can 

19 provide everybody what we have, but we have 

20 the second part of where in our system should 

21 we have caught it, and should we have caught 

22 it, that's not done yet.
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1 So we can wait -- we can also wait 

2 for that. But there is a judgement about 

3 whether -- on these cases -- and whether we 

4 think is really an error or just unacceptable, 

5 different from the way it was done. So that 

6 is written down in the five cases.

7 CHAIRMAN GRIFFON: Can you back up 

8 just a step and explain to us how this process 

9 started, because we are still --

10 MR. HINNEFELD: Well, this came 

11 from a discussion of well, how, you know, how 

12 are we doing now. In order to find out some 

13 information about the quality of the program 

14 and the conversation about many of the cases 

15 that are reviewed by the Subcommittee are old, 

16 quite old by the time they come through.

17 So let's try to get the most 

18 recent information available to look at for 

19 this question, so that's the most recent 

20 information on how we were doing it.

21 Even then it was not 

22 contemporaneous. It was somewhat -- at the 
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1 time we made the selection, the last case, the 

2 last set of findings that we had was the 12th 

3 set.

4 Now, there have been others since 

5 then, but let me talk about the 12th set. We 

6 selected from the 12th set the five cases that 

7 had the latest dose reconstruction completion 

8 date, you know, not the review date, but the 

9 latest dose reconstruction completion date.

10 We selected those five cases, went 

11 through the findings on the SC&A report and 

12 made, you know kind of made our own judgment, 

13 yes, this is a mistake of this nature, this 

14 one we think is just different acceptable ways 

15 of doing it, those kinds, those kinds of 

16 judgments.

17 That much judgment is made. So, 

18 then the follow-on, which is not yet done, is 

19 to say okay, for these mistakes, where in that 

20 system should it have been caught, and if 

21 there is nowhere in our system it should have 

22 been caught, what should we do then for the 
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1 system, if anything, in order to catch this 

2 mistake in the future.

3 So that's the part that's not done 

4 yet. So that was -- that's a big effort, and 

5 we are kind of midstream in terms of the 

6 totality of the effort.

7 So that's where we are. Like I 

8 said, we can share what we've done now --

9 CHAIRMAN GRIFFON: And these were 

10 -- and this task, this tasking was internal, 

11 right? But you decided from the 10-year 

12 review to do this? I mean we didn't drive 

13 this process, right? We -- did we, or -- no.

14 MR. HINNEFELD: No. I think we 

15 came to the Subcommittee with it from the 10-

16 year review.

17 CHAIRMAN GRIFFON: Right, okay.

18 MR. HINNEFELD: The main 

19 recommendation of the 10-year review, I mean, 

20 it identified stuff. The main recommendation 

21 of it was to work with this Subcommittee --

22 CHAIRMAN GRIFFON: Okay, right.
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1 MR. HINNEFELD: -- on the dose 

2 reconstruction and the quality issue.

3 CHAIRMAN GRIFFON: Right.

4 MR. HINNEFELD: So we talked about 

5 it at the last Subcommittee meeting. I don't 

6 know that it was a tasking from the 

7 Subcommittee, but we kind of came to the 

8 committee with this idea that we would do 

9 this.

10 CHAIRMAN GRIFFON: We said we'll 

11 do this, right. Okay.

12 MR. HINNEFELD: Okay. Because 

13 that was one of the actions that -- if there 

14 were mistakes being found, it was actually 

15 straight from the dose reconstruction, we get 

16 there are errors being found in dose 

17 reconstruction, why didn't our system find it.

18 CHAIRMAN GRIFFON: Right.

19 MR. HINNEFELD: And so that's to 

20 address that and then we hope to work with the 

21 Subcommittee going forward on the resolution, 

22 because the 10-year review is essentially --
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1 has passed on it. To continue the work, in 

2 order to continue to follow it, there has to 

3 be a sort of a continuing issue. There's no 

4 way to continue the reviews checking a box.

5 MR. KATZ: So, should we have this 

6 on the agenda for the next meeting? I don't 

7 know what the timeframe is for that, sorting 

8 it out.

9 MR. HINNEFELD: Well, I would 

10 think certainly we should have it. I mean, 

11 we're kind of -- we're late with it already. 

12 We should have had it, you know, it was 

13 something we need to, it's like everything 

14 else, you know, you've got to keep it on your 

15 program list or nobody gets assigned it.

16 CHAIRMAN GRIFFON: And a little 

17 heads up, what did you find? I mean you said 

18 that you hadn't done the second part --

19 MR. HINNEFELD: No, you ran them 

20 more carefully than I --

21 DR. ULSH: It was a mix. There 

22 were -- for each of the five cases there were 
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1 multiple findings and some observations as 

2 well. Some of them we agreed with SC&A that 

3 they were indeed errors and that they 

4 represented quality assurance, QA issues. 

5 Some of them we disagreed and thought that it 

6 was not an error and some of them, we agreed 

7 with the finding but we didn't consider it a 

8 QA issue. So it's a mix of those.

9 MEMBER RICHARDSON: So the 

10 question that you are posing, why didn't the 

11 system find it, is only a question that you 

12 can answer about certain classes of these 

13 problems that you've laid out: those that are 

14 -- for those that you don't agree with, you 

15 shouldn't have found, so that's actually a 

16 success; those that are quality issues, those 

17 would be the ones you could engage with; those 

18 which are -- you said were findings but were 

19 technical issues, you are not necessarily 

20 going to have in place anything other than 

21 this committee I wouldn't think, that would be 

22 systematically going through or struggling 
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1 with those sorts of problems, or would you?

2 DR. ULSH: Well, you are correct 

3 that those findings where we agreed that an 

4 error was made but we don't feel that it was a 

5 QA issue, those are harder to address on a 

6 systematic basis because they tend to be 

7 unique.

8 I don't know that I want to go 

9 quite so far as to say we shouldn't have 

10 caught it.

11 MEMBER RICHARDSON: There would be 

12 a way to -- the dose reconstructor could send 

13 a flag and say this is an interesting problem.

14 DR. ULSH: I don't think I'd go 

15 quite that far, but I understand what you are 

16 saying. It's going to be harder to address in 

17 a systematic --

18 MEMBER RICHARDSON: And when you 

19 are going to go back and trying to understand 

20 the quality issue, is it looking through steps 

21 that are within NIOSH, or is going all the way 

22 back through, kind of contractors as well?
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1 DR. ULSH: I think it's actually 

2 more --

3 MR. CALHOUN: All the way back. 

4 You would want to start from the very 

5 beginning, you know, you could have caught it 

6 at some point, we should have caught it at 

7 some point, what can we do to fix it?

8 MEMBER RICHARDSON: That's good.

9 CHAIRMAN GRIFFON: All right.

10 MR. HINNEFELD: That can be on the 

11 agenda for the next meeting.

12 MR. KATZ: I have it marked.

13 CHAIRMAN GRIFFON: All right. You 

14 know, this might be a good, a good time to go 

15 off the agenda just for one second, which is 

16 something I had mentioned at the last Board 

17 meeting, and we didn't get it on this agenda 

18 so I don't think we'll be able to discuss it a 

19 lot today but I think we, we should at least 

20 make a note of it for our next meeting.

21 And we had talked about this at a 

22 previous Subcommittee meeting as well, but 
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1 we'd like NIOSH and/or ORAU, I'm not sure who 

2 is in the best place to do this, but to 

3 provide an overview presentation, and also 

4 maybe some specifics, you know, the procedures 

5 or whatever, on their QA/QC program currently, 

6 or you know, and if it's been modified in the 

7 recent history, that's fine with modifications 

8 as well, but we had a presentation at the ORAU 

9 office, but I don't think that really -- you 

10 know, that was sort of an overview at the 

11 highest program level I think. It didn't 

12 really address the mechanics of what you are 

13 doing for QA, I don't think.

14 So I guess that's what we'd like 

15 to know, is what sort of QA was in place or is 

16 in place, and are you tracking errors, I mean, 

17 what are they doing on ORAU's side as well as 

18 NIOSH's side?

19 And Stu, I think you had agreed to 

20 sort of come back, you know, I'm sure we, you 

21 know, I forgot about it, we all forgot about 

22 it. But --
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1 MR. HINNEFELD: Oh, we can -- yes, 

2 we can come up with that. But you're not 

3 interested in sort of a detailed 

4 error-tracking -- I was not able to make the

5 meeting at the ORAU office so I don't know 

6 what was presented there.

7 But you're looking at -- you feel 

8 like that was sort of the general systems as 

9 it goes to the specific details, and whether -

10 - what sort of, what information is coming 

11 out.

12 CHAIRMAN GRIFFON: Right. Right, 

13 that was the sense, that was --

14 MR. HINNEFELD: Okay. I would 

15 propose that --

16 CHAIRMAN GRIFFON: I mean for 

17 instance we had talked about the benchmark in 

18 question, you know?

19 MR. HINNEFELD: Yes.

20 CHAIRMAN GRIFFON: Like, you are 

21 making all these changes which in theory, it 

22 seems, a lot of what was presented in that 
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1 meeting at ORAU, would you know, definitely 

2 have made improvements, because they were 

3 avoiding for instance physical data entry 

4 steps, you know, they were tying things 

5 electronically so there was no more physical 

6 re-entering of data in some cases.

7 So some of those things, you know, 

8 it seems obvious that they are going to 

9 improve or reduce errors, but it was noted by 

10 several of the, you know, was there any error11 tracking and how do you know you were 

12 improving, you know, and other than just, you 

13 know, a gut feeling that this is going to make 

14 it better, how do you know? Are you tracking 

15 it, and going forward, are you tracking it?

16 MR. HINNEFELD: Well, I'd propose 

17 then that we have some sort of interaction 

18 between -- to try to focus, you know, between 

19 us and the Subcommittee Members about --

20 CHAIRMAN GRIFFON: Right.

21 MR. HINNEFELD: -- this is the 

22 kind of stuff we found, and you can say, well, 
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1 that's not exactly what we want, and so, 

2 because I am a little worried we are going to 

3 run along the wrong --

4 CHAIRMAN GRIFFON: Right.

5 MR. HINNEFELD: If we don't bring 

6 up some of these factors. So I guess we can -

7 - I mean, Scott's listening on the phone, so -

8 -

9 CHAIRMAN GRIFFON: That's fine. 

10 Yes, we can do this off-line.

11 MR. HINNEFELD: I'm just thinking 

12 that, you know, we'll need to say okay, well, 

13 what do we think they want, you know, come up 

14 with something, and kind of share it. It's 

15 this kind of thing you are looking for, and 

16 then some back and forth as to modifying it.

17 I don't know that -- how much 

18 error-tracking particularly historical error19 tracking we'll be able to come up with, and I 

20 just don't know --

21 DR. ULSH: So are you proposing 

22 that we maybe put together a draft agenda for 
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1 a presentation, or outline of a presentation?

2 MR. HINNEFELD: Yes, an outline of 

3 a presentation with some description, you 

4 know, but probably an outline is, it may sound 

5 right, but you know, you've got to have a 

6 little bit of flesh on it --

7 CHAIRMAN GRIFFON: Yes.

8 MR. HINNEFELD: -- on those 

9 outlines, as I say, to have details of this or 

10 not.

11 MR. KATZ: Yes, and if you just 

12 recall, in the last meeting, what I was saying 

13 was under ISO, International Standards 

14 Organization, if you have an ISO-approved 

15 quality system, you would have a quality 

16 manual that would actually make that very easy 

17 to present because it lays out all your 

18 parameters that you are evaluating your 

19 quality by --

20 MR. HINNEFELD: Yes.

21 MR. KATZ: What your metrics are, 

22 are laid out in a quality manual.
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1 MR. HINNEFELD: Yes.

2 MEMBER CLAWSON: Mark, if I am 

3 hearing what you are saying, you want to be 

4 able to see what ORAU has tracked as far as 

5 problems and then the corrective action for 

6 that, kind of a historical, how they are 

7 doing, just like any different QA program 

8 should be set up as, as you even find these 

9 marks yourself, what are you doing to --

10 CHAIRMAN GRIFFON: Correct, and 

11 sort of like what Ted said, what are they 

12 doing, they indicated they are tracking and 

13 they are showing improvement and all those 

14 factors, yes.

15 I don't think -- I don't remember 

16 that being in our previous, you know, the 

17 presentation because, you know, it was useful. 

18 I'm not saying that it wasn't a useful meeting 

19 at ORAU, but I don't think we went there.

20 DR. ULSH: No, my thought is that 

21 we have some performance metrics but if -- the 

22 kind of things that you are talking about, 
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1 error-tracking and pursuing a reduction in 

2 error rate, I'm not so sure that we're doing 

3 that.

4 MR. HINNEFELD: Yes, I'm not sure 

5 what we are going to be able to come up with, 

6 but we will see what we can come up with.

7 CHAIRMAN GRIFFON: Well, it's 

8 useful to know whether they are doing it or 

9 not, so, yes.

10 MEMBER RICHARDSON: And I think 

11 those -- I mean all of those are important 

12 things to understand, but I would take 

13 performance metrics as a focus on production 

14 cost-efficiency and quality as a different set 

15 of metrics that you might also wish to track 

16 and which I think are overlapping with some of 

17 the findings, that they are not -- I mean all 

18 of these, I mean all of these issues, and they 

19 were all kind of laid out I think nicely in 

20 the 10-year review, of timeliness and those 

21 things, those are part of the performance 

22 issues, but there is -- I think that's what we 
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1 had a hard time in the discussion at ORAU, was 

2 asking -- and it partly comes from, I mean I 

3 can say, I had my own experience with having a 

4 programmer implement something which was 

5 supposed to be -- reduce human error and 

6 introduce technical error, instead, and you 

7 know, you find that the database system was 

8 not performing -- and so you need a metric, 

9 you need some -- I felt like I wanted to see 

10 some sort of metrics in place that let me say 

11 this was the error rate for the intervention, 

12 and after the intervention there's a 

13 demonstrable kind of increase in quality and 

14 so I think that's what we are back wanting to 

15 understand.

16 And there was -- I think there was 

17 receptiveness to that issue at the discussion, 

18 and so one of the things also was, now several

19 months forward, is has something been put in 

20 place that's going to let us -- you know, you 

21 can look at the -- not at the past issue but 

22 at the state of the program today.
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1 MR. KATZ: So, just one more 

2 example. So a critical factor -- I'm just 

3 thinking because I'm fairly familiar with what 

4 we do with the respirator certification, with 

5 -- we have a regulation on what kind of 

6 quality systems respirator manufacturers have 

7 to have, for the performance of the 

8 respirators according to the certification 

9 status.

10 And therefore, sort of analogous, 

11 I think, to this, I think you have different 

12 levels of severity or importance in your 

13 tracking system for metrics, and the most 

14 serious would then be of course, I think 

15 analogous here would be a case for which the 

16 Probability of Causation -- the decision was 

17 impacted by the error. That would be the most 

18 serious type of error or, you know, if you 

19 talk about degrees of error, a hierarchy of 

20 errors, but that would be the most serious 

21 kind of error, and that would be one example 

22 of the category to track --
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1 CHAIRMAN GRIFFON: Yes, yes.

2 MR. KATZ: I'm just trying to --

3 CHAIRMAN GRIFFON: No, no, right.

4 MR. KATZ: -- illustrate the --

5 MEMBER MUNN: But that was 

6 essentially how we set up the form originally 

7 when we were talking about how we were going 

8 to track things. We had -- we were very 

9 careful to establish a level of consequence 

10 for -- but in the actual measures taken --

11 CHAIRMAN GRIFFON: In our review 

12 you mean. Yes, yes, yes.

13 MEMBER MUNN: Yes.

14 CHAIRMAN GRIFFON: So we'd like to 

15 know what -- internally what they are doing as 

16 well.

17 MEMBER MUNN: Yes.

18 CHAIRMAN GRIFFON: Yes. Okay. I 

19 mean I don't think we have to harp on that and 

20 I'll -- Stu, if you want to communicate on the 

21 side and --

22 MR. HINNEFELD: Yes, I think we'd 
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1 want to have a little bit of communication 

2 back and forth --

3 CHAIRMAN GRIFFON: Yes.

4 MR. HINNEFELD: Because I have --

5 CHAIRMAN GRIFFON: Yes, just to 

6 make sure --

7 MR. HINNEFELD: -- no idea what we 

8 would find.

9 CHAIRMAN GRIFFON: Right, right 

10 right, and/or forward, like here's what I --

11 here's a document that ORAU is going from or 

12 whatever. Is this what you're looking for, you 

13 know, that kind of thing. That's fine.

14 MR. HINNEFELD: All right. I 

15 haven't been -- I have met with a couple of 

16 individual people just on the side, kind of 

17 briefed because I'm going to be coming to this 

18 Subcommittee from now on, just, just -- I just 

19 can't keep my eye on this very much. I mean, 

20 Grady is the contracting officer 

21 representative for the ORAU contract, and so 

22 he's in more direct and constant communication 
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1 with them. So I think it'll be more effective 

2 with Grady here than me trying to show up in 

3 addition to the work that Brant is doing.

4 CHAIRMAN GRIFFON: I'm sorry, 

5 Grady.

6 MR. CALHOUN: It's okay.

7 (Simultaneous speakers.)

8 MR. HINNEFELD: I'm taking care of 

9 him by adjusting the lever on his chair.

10 (Laughter.)

11 CHAIRMAN GRIFFON: Okay, let's go 

12 on to the next topic, I think, the blind 

13 quality control evaluation.

14 MR. HINNEFELD: Yes, this could be 

15 an interesting topic.

16 CHAIRMAN GRIFFON: Yes. And does 

17 everybody have the -- you sent out your 

18 summary report --

19 MR. HINNEFELD: We did send our 

20 summary report --

21 CHAIRMAN GRIFFON: Is Paul on the 

22 phone by the way, is Paul -- Paul's on this --
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1 MR. KATZ: He is not, Procedures.

2 MEMBER MUNN: That other one.

3 CHAIRMAN GRIFFON: Who chairs 

4 that? I can't recall.

5 MR. HINNEFELD: The assessment 

6 report is just a vehicle we had in existence 

7 for this kind of activity, where you go and 

8 assess -- we've done an assessment on 

9 contractor performance, that's been done. 

10 That's -- it was a vehicle we had that we just 

11 said, okay, this is how we are running this 

12 thing. We hadn't really thought about how we 

13 are going to run its results yet. But it fits 

14 exactly with what this is intended for, and if 

15 presented, the comparison that was done on the 

16 -- I think there were actually eight cases 

17 that were selected.

18 CHAIRMAN GRIFFON: Hey Ted, can 

19 you send this to David --

20 MR. HINNEFELD: Oh, David didn't 

21 get it?

22 CHAIRMAN GRIFFON: Yes.
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1 MR. HINNEFELD: I'm sorry.

2 MR. SIEBERT: This is Scott. 

3 Could you also send it to me because I don't 

4 seem to have it?

5 MR. KATZ: Okay, send it to --

6 MEMBER RICHARDSON: Did it go to 

7 the CDC account?

8 PARTICIPANT: Yes.

9 MEMBER RICHARDSON: Can you send 

10 it to my UNC account?

11 PARTICIPANT: Sure.

12 MR. HINNEFELD: Well, wait a 

13 minute, there's some privacy information on 

14 there.

15 MR. KATZ: That's why it would 

16 have gone it to your CDC --

17 (Simultaneous speakers.)

18 CHAIRMAN GRIFFON: We can share, I 

19 guess.

20 MEMBER MUNN: I have a hard copy.

21 MR. KATZ: Thank you Wanda.

22 DR. ULSH: All right Scott, it's 
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1 on its way to you.

2 MR. SIEBERT: Thank you.

3 MR. HINNEFELD: I guess the meat 

4 of it is kind of at the end, the attachments. 

5 I mean there are conclusions drawn, the 

6 action that we felt like you pointed out to us 

7 that we clearly needed to take was to clarify 

8 the use of Site Profile, limit of detection 

9 versus actually a number that's reported on a 

10 bioassay result as the limit of detection for 

11 bioassay, because that actually -- there was a 

12 misinterpretation on our person's part, and 

13 what kind of comes out of this is ORAU is 

14 better doing these from scratch than we are, 

15 because they do them all the time from 

16 scratch, plus they have review and -- a review 

17 system on our side and we don't, and we didn't 

18 intend to put a review system on our side for 

19 this.

20 And so there was -- in that 

21 instance ORAU correctly interpreted -- I think 

22 I got this right -- they correctly interpreted 
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1 the Site Profile number as the correct limit 

2 of detection that you use, which is important 

3 in this dose calculation.

4 And our reviewer incorrectly chose 

5 a value that was reported on the bioassay 

6 result as the limit of detection in order to 

7 do the missed dose calculation.

8 So the missed dose calculation was 

9 smaller on our side. The case was actually 

10 compensable as it came over. But our review 

11 did not have a compensable outcome. So that 

12 was the big -- the big difference between the 

13 two and it was our error, because of the lack 

14 of clarity in the documents that described how 

15 to -- what to choose as the limit of detection 

16 value.

17 So that was the big finding and 

18 that is the action we need to take, we know we 

19 need to take as a result of this. There was 

20 another -- there's another on there if you 

21 look at it very much. I'll have to look at it 

22 to find the number. But there's one in there 
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1 where you have a -- it's like with the covered 

2 period -- the covered period ends and then 

3 there's a continuing commercial operation 

4 period.

5 So the -- our dose reconstructor 

6 included doses from the commercial operation 

7 that really should not have been included. It 

8 couldn't have been from the residual 

9 contamination of the covered period. The 

10 medical X-rays for that period that was 

11 covered, they should not have been included. 

12 So our person just made a mistake in doing 

13 that. Now, in that case both dose 

14 reconstructions were --

15 CHAIRMAN GRIFFON: It couldn't 

16 have been from residual --

17 (Simultaneous speakers.)

18 CHAIRMAN GRIFFON: -- just from a 

19 policy standpoint, it couldn't be --

20 MR. HINNEFELD: It was probably a 

21 different isotope.

22 CHAIRMAN GRIFFON: Oh, different 
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1 isotope.

2 MR. HINNEFELD: Yes. So -- or, 

3 for whatever reason, it really looked like it 

4 couldn't have been from the residual -- from 

5 the residual, from the covered period and 

6 should not have been included in the dose 

7 reconstruction that our person did because 

8 their coverage continued into the --

9 CHAIRMAN GRIFFON: So this is the 

10 one that had like 12 years versus 19 years --

11 MR. HINNEFELD: That's probably --

12 CHAIRMAN GRIFFON: Yes, there was 

13 some big --

14 MR. HINNEFELD: That was probably 

15 the one, yes. Okay. So the -- now, both of 

16 those -- in both of those cases, the PoC was 

17 still less than 50 percent, so this did not 

18 change the outcome of the case.

19 And there were some other 

20 differences that seemed to be more minor and 

21 that would be what we would consider an 

22 acceptable variation in some sort of 
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1 selection.

2 A lot of these, I think, were 

3 overestimated cases because this is a, sort of 

4 an early artifact of the way the system is set 

5 up. We kind of -- these kind of lean towards 

6 AWE cases. The reason for that is the AWE 

7 cases are predominantly done by contractors 

8 who sit in our building, and you don't have to 

9 ask for an exposure history for an AWE case.

10 So these were assigned, you know, 

11 from our pool, from new cases -- isn't that 

12 right Grady? Don't we assign -- we assign 

13 them one a week from new cases?

14 MR. CALHOUN: Yes, at random.

15 CHAIRMAN GRIFFON: At random.

16 MR. CALHOUN: Yes.

17 CHAIRMAN GRIFFON: It used to be 

18 two, we are down to one case. We can't keep 

19 up with two people.

20 MR. CALHOUN: And then what 

21 actually happens is, is we -- our team is 

22 assigned to do the blind dose reconstruction 
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1 before we get it from anybody else. We do 

2 that first. The one comes in from either ORAU 

3 or our contractor and then we compare it, 

4 because we don't want to do one that's already 

5 been completed because we want to be 

6 completely -- we don't want to be biased at 

7 all. Yes.

8 MR. HINNEFELD: Yes. We don't 

9 trust our people not to --

10 (Laughter.)

11 MR. HINNEFELD: So, since it --

12 since you don't have to request an exposure 

13 history for a DOE facility, those get done 

14 quick. And so the AWEs are the ones that kind 

15 of show up first, where you have, you know, 

16 it's independent of how quickly the duplicate 

17 is done on our side, but what is the driving 

18 factor is when does the production DR show up.

19 And the production DR for an AWE 

20 shows up quicker and so that's why the first -

21 - the first ones are heavily weighted towards 

22 AWE cases.
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1 So that's why they are heavily 

2 weighted and then there are AWE cases tend to 

3 be overestimates, a lot of them are pretty 

4 simple, maybe not that long in duration and 

5 it's usually a uranium place and there are 

6 only a certain number of cancers that you can 

7 compensate with the uranium exposure usually.

8 So that's how that worked. This 

9 application is visible on my screen. I don't 

10 think the Board Members can probably see it. I 

11 can let you know in a minute if you can see 

12 the implication or not. I'd be surprised if 

13 you could.

14 And then the application just 

15 shows you the progress, shows you the cases 

16 that have been selected and the ones that have 

17 been deferred, and it gives us quality 

18 analysis, the attachment on the assessment 

19 just do that, that analysis of the two cases.

20 I think also, remember, this is 

21 are the first eight times we have done this 

22 and I think we need to work with our group to 
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1 get a little better documentation of their 

2 thought process in their review.

3 They haven't really gone through 

4 and decided, okay, why did you decide this 

5 technique that's supposed to be in there? 

6 There's not -- they haven't done that very 

7 well either. So we need to kind of bring our 

8 troops up to give us some feedback on how this 

9 is being done and improve what we are doing.

10 CHAIRMAN GRIFFON: Yes, this 

11 document here worked kind of all right --

12 MR. HINNEFELD: Yes.

13 CHAIRMAN GRIFFON: Is that what 

14 you are saying?

15 MR. HINNEFELD: Yes.

16 CHAIRMAN GRIFFON: Yes.

17 MEMBER CLAWSON: That's been one 

18 of our findings through all the --

19 CHAIRMAN GRIFFON: Yes. From the 

20 beginning, yes, yes. State your assumptions.

21 MR. HINNEFELD: Now, we need to 

22 continue this discussion because I know 
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1 there's an expectation that this would go to 

2 Doug or to SC&A or something, and there was 

3 some sort of SC&A action apparently that was 

4 going to be done and that completely slipped 

5 my mind.

6 Now, these are not adjudicated 

7 cases. These are all -- they are still with 

8 FAB, so these are not adjudicated cases.

9 And so we certainly don't mind 

10 looking at the quality system but I think we 

11 have got to be careful about getting into 

12 another review of this case which has not yet 

13 been adjudicated, you know, and we are not 

14 calling ours a review of the case. We are 

15 just trying to see if the instructions are 

16 consistent enough that we do have the same, 

17 you know. The production, you know, the ORAU 

18 DR or the contract with ORAU, the DR is the 

19 production DR. We are not trying to 

20 substitute our judgment on that. That is a 

21 production DR.

22 Now, I suppose if we found one 
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1 that was flagrantly wrong, we stopped it, 

2 because I would have thought that --

3 MR. CALHOUN: But mostly, that 

4 would have stopped -- will get stopped anyway 

5 because those have not gone through the system 

6 yet. They come over to us from the contractor 

7 and we compare it to our individual one before 

8 it even gets into our normal QC processes and 

9 those processes, and those could be rejected 

10 just like any of the other ones are.

11 MR. STIVER: This is John Stiver 

12 from SC&A. We were kind of expecting a little 

13 more detail on the report that would kind of 

14 allow us to not really -- our intention was 

15 never to try to do a full, de novo DR audit on 

16 these things, but really to just try -- you 

17 know, as we have been talking about it this 

18 morning, to track the performance metric.

19 So we have two HPs with presumably 

20 comparable levels of experience on a 

21 particular site, all in the same documents, 

22 and so we would expect to see, not necessarily 
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1 in lock-step but pretty close estimates, 

2 especially under the external dose.

3 And a couple of the issues that 

4 Stu mentioned, like the detection limit for 

5 plutonium at Savannah River and I believe, 

6 what was the other, about the residual period 

7 on the AWE site, it appeared to me more a 

8 matter of the DCAS reviewer not necessarily 

9 having the same level of experience as, say as 

10 the person at ORAU, so there's another kind of 

11 level of uncertainty that's creeping in there.

12 But the kind of things we would 

13 like to see, you know, having a PoC would be 

14 nice, the type of case, whether it's, you 

15 know, a best estimate, a hybrid case, or an 

16 under- or overestimate, and then some 

17 documentation of these decision points, 

18 basically where the reconstructor has free 

19 will to exercise their professional judgment 

20 in making a determination about a particular 

21 exposure scenario or TBD interpretation to 

22 use.
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1 And you know, presumably, they'd 

2 like all roads to lead to Rome and eventually 

3 it becomes a certain error limit in that it 

4 kind of concerns us that we are seeing factors 

5 of two or three in some of these comparisons.

6 And this may very well be from --

7 this is the first set that kind of learning 

8 and refining the process as we go and that 

9 type of thing. But just more documentation of 

10 the thought process with some decisions.

11 MR. HINNEFELD: Yes, well, we 

12 agree that that was intended if not --

13 MR. STIVER: Right. And I think 

14 we were basically talking the same -- about 

15 the same thing.

16 CHAIRMAN GRIFFON: I mean, I 

17 guess, to me, one thing that I was thinking 

18 about, and reading through these summaries 

19 it's a little difficult, I'm like -- it's hard 

20 to understand which ones are -- I mean it's 

21 obvious that many are over- or underestimates.

22 But just this thing you said 
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1 earlier about these decision points, or the 

2 assumptions that are made not being 

3 documented, I think that, to me, might be a 

4 bigger, more important finding than the 

5 Savannah River document.

6 I mean that sets an overall trend 

7 because I think that clarifies a lot in your 

8 quality review if people are documenting what 

9 DCF they use and why, and then when you are 

10 doing your reviews, the reviewer can 

11 theoretically see that and agree or disagree. 

12 But --

13 DR. ULSH: I think the errors, 

14 though, in that regard, Mark, where we didn't 

15 sufficiently describe the decision points, 

16 were on the DCAS side, not on the ORAU side.

17 CHAIRMAN GRIFFON: Was it because 

18 both --

19 DR. ULSH: Well, in other words, 

20 when the DCAS reviewer -- when the DCAS --

21 CHAIRMAN GRIFFON: Was it because 

22 the instructions weren't clear enough, though, 
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1 or was it because, I mean why, why?

2 MR. KATZ: I understand what you 

3 are saying.

4 CHAIRMAN GRIFFON: Yes.

5 MR. KATZ: Yes, well -- so I mean 

6 they are saying that -- I mean this is new for 

7 DCAS --

8 (Simultaneous speakers.)

9 MR. KATZ: -- concessions and 

10 they're not doing -- even though ORAU is in 

11 the practice of doing this document your 

12 assumptions and all that, the DCAS folks were 

13 not in the practice of --

14 (Simultaneous speakers.)

15 MR. KATZ: -- so their blind 

16 copies are not documented as well -- right, 

17 isn't that what you're saying?

18 DR. ULSH: Exactly. We didn't 

19 find ORAU to be --

20 CHAIRMAN GRIFFON: So they were 

21 documenting the --

22 DR. ULSH: Yes, they were -
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1 CHAIRMAN GRIFFON: Okay.

2 DR. ULSH: It was the DCAS HP that 

3 was put in the --

4 CHAIRMAN GRIFFON: Okay. Okay.

5 MR. CALHOUN: I am not sure that 

6 you could go into an ORAU DR record and say I 

7 chose this DCF because of this, you know, 

8 there's tools that are available that select 

9 the DCF based on the organ, for example, that 

10 you're doing, you know, external dose. I 

11 don't think you're going to go in and find I 

12 used this neutron spectrum because of this. 

13 It's just a template that's used as part of 

14 their tools.

15 Now, I may be wrong but it's not 

16 anything we would see and I'm fairly certain 

17 that that - that does not exist to the level 

18 that you might want to see. But I'm not sure 

19 I think it needs to exist.

20 You know, I think it's more 

21 important for our folks to explain their 

22 determination as to why they made the decision 
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1 and then compare to that, to the mass 

2 production of these dose reconstructions that 

3 are coming out and then we can determine if 

4 their overall process meets our expectations. 

5 That seems to me like how I would like to see 

6 it go.

7 MEMBER MUNN: I agree with Grady. 

8 I think that's correct, and I have a little 

9 problem with one thing that John said. I 

10 don't know of any way that we can quantify the 

11 respective experience of individual dose 

12 reconstructors with respect to any given site. 

13 I just don't know how you could quantify that 

14 --

15 MR. STIVER: You could. It's just 

16 a matter of you -- you are dealt a certain 

17 hand and you've got people that are your best 

18 reconstructors and you know, they will learn 

19 over time as they do more of these things, but 

20 probably you'll see less of that as --

21 MEMBER MUNN: Yes. I can 

22 understand why you would say that you know 
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1 that --

2 (Simultaneous speakers.)

3 MEMBER MUNN: -- but I don't see 

4 any way that we can do that before the fact, 

5 and I don't see any real way we could do that 

6 even after the fact.

7 They are either cognizant of 

8 activities on the site or they are not. I --

9 MR. STIVER: Well --

10 CHAIRMAN GRIFFON: Just to go back 

11 to Grady's point, I mean maybe I misstated it 

12 in that the DCF may not be the best example 

13 but I'm just thinking of situations where, 

14 because we have run across this in the years 

15 of our reviews, is that we have -- you know, 

16 even for internal dose reconstructions, I can 

17 remember many times when Scott's on the phone 

18 saying, you know, well I think that what the 

19 dose reconstructor probably did was made this 

20 assumption, because when I redid it, this is 

21 the numbers I got, and so that the assumptions 

22 weren't stated and when SC&A reviewed it, it 
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1 was kind of a guessing game of what 

2 assumptions they made and so I'm saying 

3 critical assumptions, maybe DCFs are all, you 

4 know loaded into a workbook and you know, that 

5 may not be the best example.

6 But you know, for some that you 

7 have to make a decision, maybe it's a 

8 claimant-favorable case or whatever the 

9 decision is based on. Maybe it's on a worker 

10 versus a more environmental dose decision, you 

11 know, you -- somehow that is noted in the case 

12 and I don't know if that's you know, if you 

13 found that or looked at that in these cases. 

14 But that's what I was talking about, but I, 

15 you know --

16 DR. H. BEHLING: This is Hans 

17 Behling. Can I make a couple of comments here 

18 because I have been involved in the dose 

19 reconstruction process since the time we first 

20 got the contract back in 2004, and I have some 

21 fairly strong comments about this particular 

22 report that I have had the chance to review, 
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1 and I would like to make a few comments here 

2 that will perhaps rain on somebody's parade 

3 here a little bit but I think it needs to be 

4 stated.

5 I remember back in January 2005 

6 when we first reported on our first set of 

7 cases that I came to a couple of conclusions 

8 that one, the guidance documents were not 

9 really sufficiently prescriptive. There was 

10 too much wiggle room, too much subjective 

11 interpretation that would allow a certain 

12 variability that was probably not warranted.

13 Secondly, I also questioned the 

14 quality of the dose reconstructors who were 

15 doing these things. In other words I came to 

16 a disturbing conclusion that perhaps not all 

17 dose reconstructors were created equal, which 

18 in combination of those two things, not 

19 sufficiently prescriptive documentation for 

20 dose reconstructors to follow and perhaps the 

21 quality of the dose reconstructors themselves, 

22 would ultimately lead to a situation where the 
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1 luck of the draw for the claimant whose claim 

2 was being evaluated, was potentially open to a 

3 high degree of variability.

4 And back in 2005, at one of the 

5 meetings, I went on record in stating that 

6 perhaps blind dose reconstructions should be 

7 done in-house, not by SC&A, to do two things: 

8 one, verify at the prescriptive level of each 

9 of the guidance documents; and two, make sure 

10 that it is not the luck of the draw that would 

11 decide whether or not a claim would be 

12 compensated or denied.

13 And apparently, obviously, my 

14 recommendation was ignored. But in looking at 

15 this document, first of all, currently the 

16 document is a little late in coming, and 

17 secondly, by design, it falls very short of 

18 what I thought it would actually do.

19 And the reason I say this is 

20 because I looked at the eight cases and I 

21 looked at the PoCs that were actually assigned 

22 to them, out of -- six out of the eight PoCs 
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1 were below 10 percent and three of them were 

2 below one percent.

3 And so when I read the conclusion 

4 in your report that all of the blind dose 

5 reconstruction there was one that had 59 

6 percent and that was the only one that had a 

7 problem, but for the other seven, the 

8 statement says, "All of the blind dose 

9 reconstructions were consistent with the 

10 official dose reconstructions," in 

11 parentheses, "i.e. both calculated with PoC 

12 values greater than 50, of those calculated 

13 with PoC less than 50."

14 Of course that's something that 

15 comes as no surprise when you had cases here 

16 that six of which were below 10 percent, it 

17 would be absolutely horrid for me to say that 

18 any of those six would have actually gone over 

19 50 percent and conversely.

20 And so what I really think needs 

21 to be done here for this process to have any 

22 meaning, is to not select the cases as is 
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1 stated here -- the cases are selected randomly 

2 with each week for the review.

3 I mean I think the issue that 

4 needs to be addressed here is what would 

5 happen if we had cases that had a PoC, DCAS 

6 PoC between 45 percent and 55 percent, five 

7 percent on either side of the pivotal point, 

8 and then determine how many of those cases 

9 would remain consistent as being compensable 

10 and non-compensable.

11 When I see PoC values less than 10 

12 percent, in fact three of them were less than 

13 one percent, of course you are going to be 

14 consistent, and I would believe that the 

15 future cases that should be assessed, should 

16 have a PoC, a DCAS PoC, between 45 and 55 

17 percent so that we can then assess is it 

18 really luck of the draw for the claimant in 

19 terms of a dose reconstruction that has --

20 that is sitting near the pivotal point, near 

21 the edge.

22 And if you were to tell me, or if 
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1 these cases would have been in that particular 

2 range of PoC, then I would say you've got a 

3 Quality Assurance Program that says yes, the 

4 guidance documents are highly prescriptive to 

5 the competence of the individual dose 

6 reconstruction is such, where we can 

7 reasonably assure that no matter gets this 

8 case, it's going to end up with the same PoC 

9 either denied or compensated. And I think 

10 right now I don't see that.

11 MEMBER RICHARDSON: Can I respond? 

12 I -- there are several -- there are a number 

13 of points there which are good. One had to do 

14 with variability in the dose reconstruction, 

15 and the luck of the draw in terms of the dose 

16 reconstructor, and how you could minimize that 

17 through what you have described as reducing 

18 the wiggle room in the guidance documents, and 

19 I think those are very valuable points.

20 And I had the same sort of 

21 question in mind. I imagined ORAU losing a 

22 dose reconstructor on Monday and being able to 
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1 offer a package which seduced a NIOSH dose 

2 reconstructor to go and work for them 

3 privately.

4 And we had a situation here where 

5 two people, both trained with experience, came 

6 up in one of these eight cases with different 

7 determinations and it was decided it was 

8 because, in this realization of that, the ORAU 

9 dose reconstructor was more experienced and 

10 followed the documents in a different way, and 

11 the NIOSH person had less experience with it.

12 But if that person had quit on 

13 Monday and you had hired the NIOSH person on 

14 Wednesday, that dose reconstruction may have 

15 been done by the less experienced person, and 

16 the decision would have slipped in the other 

17 direction.

18 I think that was the scenario you 

19 were sort of discussing. Now perhaps we will 

20 learn that in-house, ORAU does have a process 

21 in place which would catch that before it came 

22 out, but at least there's, I mean -- to me 
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1 this opens up the possibility that there are, 

2 as you said, not everybody is created equal, 

3 there are different levels of experience and 

4 there's the possibility that two people with 

5 the best of intentions could have led to the 

6 very extreme case of having different 

7 decisions.

8 DR. H. BEHLING: Well, in the 

9 reviews saying --

10 MEMBER RICHARDSON: If I could 

11 finish up, because you had a number of points 

12 and I wanted to get to them.

13 DR. H. BEHLING: Okay.

14 MEMBER RICHARDSON: The issue of 

15 sampling based on Probability of Causation as 

16 opposed to the process which is in place here 

17 of a random draw I think has a number of flaws 

18 in it.

19 It would be, it would be ideal to 

20 do if you knew the truth. If -- what you are 

21 proposing is to take the Probability of 

22 Causation as per -- what we want to audit is 
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1 the quality of the dose reconstruction. You 

2 would be able to find those situations in 

3 which that had erroneously been high, but you 

4 wouldn't find the situations in which it had 

5 been erroneously reconstructed low.

6 So we don't know what the gold 

7 standard is until we do the audit, so there is 

8 a real advantage to random sampling from the 

9 base in which you want to base your inference, 

10 and not targeting it on one of the, one of the 

11 data points which itself is measured with 

12 error.

13 So I think, I mean I sort of am 

14 leaning towards, I really like -- I like the 

15 process that has been put in place by NIOSH. 

16 It requires that you run this audit system --

17 DR. H. BEHLING: For a longer 

18 time.

19 MEMBER RICHARDSON: -- for a 

20 longer period of time before you are going to 

21 get the information, but the type of 

22 information you get is going to be -- allow 
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1 you to catch false negatives as well as false 

2 positives.

3 And if all you are interested in 

4 is the final -- the only metric you are 

5 interested in is the determination being true 

6 or false, which I really don't think is what 

7 this Subcommittee needs to be solely focused 

8 on. I think there are other quality issues.

9 Because there's risk coefficients 

10 that tie into the other, into the dose data in 

11 order to get that Probability of Causation, 

12 and that's -- we're -- the whole system is set 

13 up to be very, very insensitive to errors that 

14 are -- we're going to say are very low, like 

15 an audit of eight or 80 cases hopefully is not 

16 going to really be powered to find those 

17 problems.

18 DR. ULSH: I have a couple of 

19 comments.

20 CHAIRMAN GRIFFON: Yes, Brant. Go 

21 ahead.

22 DR. ULSH: I think we need to be 
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1 careful talking about the competence of ORAU 

2 dose reconstructors and focus on the product 

3 that comes out.

4 If we see some deficient dose 

5 reconstructions coming out from a particular 

6 dose reconstructor, that's a matter that NIOSH 

7 will bring up with ORAU for sure.

8 That's not what this process is 

9 designed to do, to root out weak dose 

10 reconstructors.

11 CHAIRMAN GRIFFON: No --

12 DR. ULSH: In terms of --

13 CHAIRMAN GRIFFON: And that's 

14 totally not where I'm heading, I mean, that's 

15 a blame the worker approach quite frankly, and 

16 if the system works, then those things are 

17 caught, and can be taken care of in training, 

18 whatever.

19 DR. ULSH: Yes. In terms of 

20 selecting cases and going after ones that are 

21 near the 50 percent Probability of Causation, 

22 if you want this process to be blind that's 
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1 not possible, because at the point where we 

2 pick the cases, the dose reconstructions 

3 haven't been done yet. We don't have an 

4 estimate of the PoC.

5 So if you want a different 

6 process, that's fine. We can discuss that. 

7 But that's not the way this was set up.

8 DR. H. BEHLING: Let me just make 

9 a comment here. It's obvious that the bulk of 

10 these cases, with the exception of 59th 

11 percentile are cases that were probably 

12 subject to best estimates and of course we 

13 know by definition that there's a tremendous 

14 amount of wiggle room built into the maximized 

15 dose.

16 And there's no point in looking 

17 for consistency because by definition, we 

18 allow a lot of leeway to the dose 

19 reconstructor to throw in everything but the 

20 kitchen sink to say given the worst-case 

21 scenario you are still not going to be 

22 compensated, and therefore there's a lot of 
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1 subjective issue here in the dose 

2 reconstruction with no penalty, because we are 

3 trying to convince the claimant that no matter 

4 how you look at his case, he is not going to 

5 be to compensated, and so for consistency 

6 point, yes, if we all come below the 50 

7 percentile, we say we won the argument.

8 But the truth is there is really 

9 very little prescriptive approach to a 

10 maximized reconstruction, and so I don't see 

11 the value in it.

12 DR. ULSH: Well, the guidance 

13 document should be prescriptive enough so that 

14 the compensation decision is consistently 

15 correct. If two dose reconstructors do a dose 

16 reconstruction in a different way, but both 

17 are equally correct, in other words, let's say 

18 I have vast experience in internal dosimetry 

19 so I choose to look at the internal dose and 

20 that's enough to put the guy over. A second 

21 dose reconstructor comes from an external 

22 dosimetry background. He chooses to do the 
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1 external and that's enough to put him over. 

2 Is one of them wrong? No.

3 And the guidance document should 

4 allow that kind of latitude, as long as the 

5 compensation decision that is reached, is 

6 correct.

7 DR. H. BEHLING: Well, early on, 

8 when we were doing dose reconstruction and I 

9 was very much part of it, so it was the first 

10 several sets before I started to wean myself, 

11 but one of the things we always said, we need 

12 to really look at the best estimate, because 

13 that's where the rubber meets the road.

14 This is where quality assurance 

15 comes in. This is where prescriptive guidance 

16 documents come into play. All the other ones, 

17 as far as I'm concerned, were questionable 

18 because we always knew up front that those 

19 were the hanging low fruit, as we referred to 

20 them in those days, and they had very little 

21 to say about the quality of the guidance 

22 documents, because you were by and large in a 
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1 position where you could assign almost 

2 anything as long as we knew for a fact that 

3 ultimately they were not going to be a PoC 

4 that was subject to compensation because 

5 that's when we would kick in, into next year, 

6 where there would have to be thousands of 

7 iterations and review of everything.

8 And we have had cases where we had 

9 a PoC of 49 point some change percent. Those 

10 are the cases where obviously would have 

11 changed with the luck of the draw here. Where 

12 do we have the ability to say no, you are 

13 going to be denied a compensation or you will, 

14 and this is where I would love to see people -

15 - the dose reconstructors sit down blindly and 

16 say how many of you would agree with you're 

17 not going to be compensated versus you are?

18 And this is where I believe the 

19 quality assurance would come at its finest 

20 test to see how consistent are we. Is it the 

21 luck of the draw or is it not? And we are not 

22 going to know this by the cases you are 
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1 reviewing right here.

2 MEMBER RICHARDSON: Could I ask, 

3 because John had suggested that the report 

4 indicate -- that the summary report indicate 

5 what the approach was taken, and I think that 

6 would be useful and it may actually guide how 

7 later on these descriptions develop, whether 

8 there's different levels of resolution or 

9 information put in for different types of dose 

10 reconstruction.

11 I guess one of the things I am not 

12 clear about is do we imagine that there will 

13 be situations where NIOSH -- a NIOSH dose 

14 reconstructor tried to do an -- or took the 

15 overestimating approach and an ORAU dose 

16 reconstructor did not, will there be, I mean, 

17 does that -- do we need three categories, or 

18 do you need a cross-classification of all 

19 possible categories?

20 MEMBER MUNN: Isn't that covered 

21 by the third of the purposes that we -- that 

22 were listed in your summary there? The 
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1 finding prepared decision points and 

2 assumptions used, doesn't that fall under that 

3 category?

4 MEMBER RICHARDSON: Maybe, but I 

5 am just imagining, is the summary report, is 

6 the -- the easy one is where let's say they 

7 are both doing overestimating approaches, and 

8 you have got a brief report that says they are 

9 going -- there's -- there's less, kind of, 

10 nuance that needs to be done on entry, but are 

11 there going to be situations where one dose 

12 reconstructor decides to do an overestimate 

13 and the other one has --

14 DR. ULSH: Well, I think at the 

15 outset that could happen. I mean, both ORAU 

16 and NIOSH dose reconstructors have a feel for 

17 what kind of cases tend to be compensable or 

18 not and so we might start out with a 

19 particular assumption, like --

20 MEMBER RICHARDSON: Prostate 

21 cancer --

22 DR. ULSH: Yes, if it's a prostate 
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1 with very little exposure, we are going to 

2 start with an overestimating assumption. Now, 

3 could it happen that ORAU and NIOSH would 

4 start out with different initial assumptions? 

5 Yes, that could happen. It would be unusual 

6 but it could happen.

7 But what should happen is if I 

8 start out with an overestimating assumption 

9 and I get a PoC over 50 -- let me make sure 

10 I'm saying that right -- then I've got to slam 

11 on my brakes and say I did it wrong. Then you 

12 go back and do a best estimate.

13 MR. CALHOUN: And I kind of think 

14 everybody is going to start out with either an 

15 over or an under. Nobody is going to start 

16 out with a best because it takes too long.

17 You know, that's just, that's just 

18 how we --

19 CHAIRMAN GRIFFON: You just want 

20 to get a feel for where you are, yes.

21 MR. CALHOUN: They're all, ORAU 

22 and us, we are going to start out either 
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1 overestimating or underestimating, and you 

2 know, there's really not just an 

3 overestimating and just an underestimating and 

4 just a best, it's a gradient and it's just a -

5 - you know, you start out at one and you 

6 gradually work your way to the center, to the 

7 best estimate in all cases really.

8 But if the overestimate is 

9 successful, you are done, and if the 

10 underestimate is successful you are done.

11 MEMBER MUNN: Well, you have to be 

12 practical --

13 MR. CALHOUN: Right.

14 MEMBER MUNN: -- in your estimate 

15 approach when you think we have so many cases 

16 to look at.

17 MR. CALHOUN: Now the degree of 

18 overestimating or underestimating is certainly 

19 going to be different.

20 MEMBER MUNN: That comes in the 

21 comparison of the decision points and 

22 assumptions.
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1 CHAIRMAN GRIFFON: And I 

2 appreciate, I mean, I understand Wanda's 

3 point. I also think the way we are sampling 

4 is correct for an ongoing program at NIOSH.

5 But I guess the concern I would 

6 have is the sampling rate or, you know, at 

7 what point are we going to have enough to 

8 address some of Hans' concerns, you know, if 

9 you're down to one a week now, it worries me a 

10 bit. I understand resource-wise, you know --

11 MR. HINNEFELD: I got to tell you 

12 guys, there's a lot of activity now being, you 

13 know, demanded by the Subcommittee, you know, 

14 we are, like Ted was pointing out earlier, we 

15 are six reviews behind.

16 CHAIRMAN GRIFFON: I'm asking. 

17 I'm asking.

18 MR. HINNEFELD: We're behind.

19 CHAIRMAN GRIFFON: I'm not --

20 MR. HINNEFELD: We've got this 

21 additional process that we're doing, you know, 

22 I made the decision to back off the one 
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1 because we weren't keeping up with two, and 

2 with the others, and you know, I'm not sort of 

3 crying on anybody's shoulder, we just had a 

4 resignation of one of our top DR review 

5 performers, of a guy who really keeps the DRs 

6 going out the door.

7 CHAIRMAN GRIFFON: Well, and this 

8 is something you can -- I mean you are doing 

9 one per week, you get in about 250 a month, is 

10 that, is that --

11 MR. HINNEFELD: Yes. Two to two 

12 fifty in there. Actually the new ones are 

13 closer to 200.

14 CHAIRMAN GRIFFON: So you are 

15 doing four per month and it's about -- two 

16 percent, around two percent, right?

17 MEMBER MUNN: This is close to 

18 what we originally said we would try to 

19 sample.

20 CHAIRMAN GRIFFON: So I mean I 

21 think you can look at the -- at least 

22 historically, how many cases have fallen 
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1 between 45 and 50.

2 MR. HINNEFELD: Not that many.

3 CHAIRMAN GRIFFON: And then how 

4 long is it going to take you to get a good 

5 number of those --

6 MR. CALHOUN: I thought that just 

7 was picked up here in the committee. I know I 

8 have --

9 (Simultaneous speakers.)

10 CHAIRMAN GRIFFON: This is really 

11 a different process --

12 MR. CALHOUN: But still, still 

13 it's a process, it's going to go through the 

14 TBD and say okay, I don't believe this was 

15 correct and you don't believe this is correct 

16 and we'll kind of hash out our differences. 

17 You'll find it's similar.

18 DR. ULSH: I was going to make a -

19 -

20 (Simultaneous speakers.)

21 CHAIRMAN GRIFFON: Yes, we are 

22 focused on those. You are right, you are 
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1 right. I'm just asking how long it might be -

2 -

3 DR. ULSH: It'll be a while --

4 CHAIRMAN GRIFFON: Well yes, 

5 right.

6 MR. HINNEFELD: But I mean, we've 

7 got a, we've got an inbox full. I mean we 

8 have done 80 and we were selecting two a week 

9 for what, four months?

10 You know, so we have got an inbox 

11 full and so --

12 MR. CALHOUN: Yes -- a lot of 

13 them, you know, assigned and --

14 MR. STIVER: And given enough 

15 time, you guys, we'll have a representative 

16 sample.

17 MR. HINNEFELD: But do you know 

18 off the top of your head -- the representative 

19 is going to be skewed towards low --

20 (Simultaneous speakers.)

21 CHAIRMAN GRIFFON: So 45 to 50 is 

22 what, maybe five percent or not even?
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1 MR. HINNEFELD: Oh I don't know. 

2 It's not a whole lot. Not even five percent. 

3 I'd have to go see what my -- I might have a 

4 slide somewhere that says something about --

5 MR. STIVER: I think that was on 

6 one of your summary slides has the stats on 

7 it.

8 DR. ULSH: I was going to follow 

9 up on Grady's point, and that is that we have

10 other ways of looking at best estimate dose 

11 reconstructions. As you are all intimately 

12 familiar with, this committee focuses 

13 specifically on those dose reconstructions.

14 CHAIRMAN GRIFFON: Right.

15 DR. ULSH: But we also have other 

16 ways of evaluating whether our guidance 

17 documents are sufficiently prescriptive at the 

18 Procedures Subcommittee. That's one of the 

19 things that, you know, when SC&A reviews 

20 procedure, if it's unclear, that's one of the 

21 things that they comment on frequently.

22 So it's not like those topics are 
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1 being ignored. It's just that this particular 

2 process, the blind dose reconstruction review, 

3 is not designed to address those particular 

4 issues.

5 MR. KATZ: Actually, it's sort of 

6 integrative. I mean it addresses all issues, 

7 really, it's just that it can take a while to 

8 build up the data but --

9 MR. CALHOUN: And --

10 DR. H. BEHLING: The problem is I 

11 have seen that this whole process was in 

12 essence a final QA test and as such, I stand 

13 by what I said earlier, and in fact I even 

14 thought -- early on when I made those comments 

15 back in January 2005 to the Advisory Board, 

16 that maybe this whole process could actually 

17 be used to select dose reconstructors as part 

18 of the screening process. It's like accepting 

19 a candidate into graduate school, you have to 

20 pass a test, and for instance a blind dose 

21 reconstruction by dose reconstructors would be 

22 that test that says you came within five 
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1 points of our estimate of a PoC, and I think 

2 you make the grade in becoming one of the dose 

3 reconstructors.

4 And then I think this is exactly 

5 what I always felt, that blind dose 

6 reconstructions that initially was passed on 

7 to SC&A, we were the ones, we were asked to do 

8 blind dose reconstruction, and I questioned, 

9 what is the value? We don't do dose 

10 reconstructions; we audit them.

11 And it was always my understanding 

12 that that whole process was aimed at the final 

13 quality assurance test.

14 CHAIRMAN GRIFFON: Well, we may 

15 have some disagreement on that. But I mean I 

16 --

17 MR. HINNEFELD: With respect to 

18 training programs, ORAU has a more robust dose 

19 reconstruction training program, candidly, 

20 than we do.

21 CHAIRMAN GRIFFON: And see I think 

22 that's all part of this, of looking at the 
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1 quality program, because I am pretty sure, I 

2 mean just by knowing some of the individuals 

3 even at ORAU, that you get these difficult 

4 internal dose cases and you've got certain 

5 people that work in that area, right?

6 MR. HINNEFELD: Yes. Yes.

7 CHAIRMAN GRIFFON: And then the 

8 other, I mean the other, the other sort of 

9 checks that we're interested in is the peer 

10 reviews, and you know, sometimes -- and we've 

11 noted this in past -- some of the audits, I 

12 mean Doug has demonstrated this on several 

13 occasions, where you know, this, this is a big 

14 difference in dose, and not that it made any 

15 difference in the ultimate compensation, but 

16 how did this not -- how did this get signed 

17 off by three reviewers without getting caught? 

18 You know, this kind of -- so I guess that's 

19 the, the -- I think the system is more 

20 important than, you know, is the DR --

21 individual DR person competent enough. I 

22 think if it were a typical case then you have 
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1 certain people that are going to do certain 

2 elements of it, and you have a -- if you have 

3 rigorous review, then it gets caught, and if 

4 you are finding one DR is deficient constantly 

5 in one area, then you should have a feedback 

6 loop that says they need more training in this 

7 area --

8 MR. HINNEFELD: I suspect there's 

9 a lot of that that goes on on the ORAU side. 

10 To your question, how many are -- I'm sorry, 

11 45 or 50, let's just get this out of the way. 

12 I don't have 45 and 50. I have 41 and 49 as 

13 of February --

14 MR. CALHOUN: I can find out.

15 MR. HINNEFELD: Out of 30,000 

16 cases that had been done, 2,100. So that's 

17 less than 10 percent are using 41 --

18 CHAIRMAN GRIFFON: Forty-one to --

19 yes.

20 MR. STIVER: So we are talking 

21 five to 10 percent.

22 CHAIRMAN GRIFFON: Yes.
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1 MR. STIVER: It's at 10 percent.

2 MR. HINNEFELD: Probably less 

3 because that was -- 41 and 49 is less than 10 

4 percent, so 45 to 50 is below five.

5 DR. MAURO: Mark, this is John. 

6 If it's an appropriate place to jump in, I 

7 heard something earlier that went right by, 

8 that I think needs to be talked about a little 

9 bit, and -- or put to bed.

10 During the discussion, a statement 

11 was made that very often most dose 

12 reconstructions really start off as you know, 

13 either maximizing or minimizing the -- and 

14 which was -- and then of course, and if it's 

15 maximizing, and you come in above, you know, 

16 it slips, it gradually slips into more and 

17 more realistic.

18 Now, this is the concern I have. 

19 It has to do with the implications, if this in 

20 fact is the case -- it may have been not 

21 exactly the way it's done -- but what I heard 

22 was, well, we came in, we did a quick one and 
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1 we came in you know, at 58 percent or whatever 

2 it came in, you did a maximizing and you said, 

3 hmm, let's take a closer look, we probably 

4 threw in too many conservative assumptions, 

5 and let's get a little more realistic.

6 And I have seen a few of these and 

7 what happens is the skilled dose reconstructor 

8 could take a closer look and start to work on 

9 it and said listen, we could do better, this 

10 is just too crude.

11 And all that is very 

12 understandable but there is an unintended 

13 consequence here and I have run across these, 

14 where we get to the point where the ability to 

15 shave -- and it might be legitimate, don't get 

16 me wrong -- and it's a hmm, we could take a 

17 close look at this, let's take a close look at 

18 this, and little by little work your way and 

19 just dip it below the 50 percent and deny.

20 Now, all of that might be 

21 legitimate. What I mean by that is when you 

22 bring a level of excellence and saying listen, 
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1 we could do better, and do a better scientific 

2 analysis of the data and the assumptions and 

3 get it below, and one of the -- and there's 

4 nothing wrong with that except that what 

5 happens is, it goes back to Hans' point, if 

6 that's the process, I'm not saying that it is 

7 or it always is, but if that is the process, 

8 what you have is a process that on two levels 

9 could be problematic.

10 One is the optics of it, that is 

11 it certainly looks like you're working and I 

12 mentioned this once before, I got myself in a 

13 little trouble, it looks like you're working 

14 real hard to get below that 50 percent and you 

15 do not want that optic.

16 And the second thing is -- goes to 

17 what Hans pointed out about the skill of the 

18 dose reconstructor who has a great deal of 

19 knowledge on internal or external dosimetry 

20 and what the processes are.

21 So if what I just described is a 

22 fair representation of the process, there are 
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1 these unintended consequences of what appear 

2 on the surface to be certainly a valid 

3 approach, but it has this unintended outcome.

4 What I just described is there's a 

5 general sense that that process that I just 

6 described is in fact going on and is a matter 

7 of routine.

8 MR. CALHOUN: Well, this is Grady 

9 and one thing that I can clarify on that is 

10 that any time that we have a DR that a 

11 cumulative PoC, Probability of Causation, 

12 comes between 45 and 52 percent, there can be 

13 no aspects of that DR that are overestimated 

14 or underestimated.

15 So that would eliminate, I think, 

16 at least a portion of what you are getting to. 

17 You can't just eliminate some of the 

18 overestimating portions to get you to 48 

19 percent. Once you get into that 45 to 52 

20 percent, there can be no overestimates or 

21 underestimates as part of that DR, at least 

22 there shouldn't be, that's the --
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1 MR. FARVER: You see that all the 

2 time. They call them hybrid cases.

3 MR. HINNEFELD: In the 45 to 52 --

4 MR. FARVER: Yes.

5 MR. CALHOUN: I'll check on that. 

6 I've never heard of a hybrid case, ever.

7 MR. FARVER: Well, we used to call 

8 them best-estimate cases and then we started 

9 tracking best-estimate and we said this is a 

10 best estimate, and you'll say, oh no, we 

11 overestimated these doses, just you know, a 

12 small --

13 MR. CALHOUN: That's okay as long 

14 as it's below 45 and above 52.

15 MR. FARVER: But not within that 

16 range of 45 --

17 MR. CALHOUN: Correct.

18 MR. FARVER: Okay. I believe we 

19 have seen them.

20 MR. CALHOUN: Yes, I have to check 

21 on --

22 MR. FARVER: I wouldn't --
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1 (Simultaneous speakers.)

2 MR. FARVER: I'm not sure if they 

3 are under 52.

4 MR. CALHOUN: There's a selfish 

5 reason for that, in that it's a pain in the 

6 butt to run the thousand -- the EE runs on 

7 IREP.

8 MR. FARVER: The 10,000 runs --

9 MR. CALHOUN: Yes, and that delays 

10 us getting case out the door. So when I look 

11 at cases, and I'm sure that the other guys 

12 too, when they look at cases that are going to 

13 require that 10,000-iteration run, they make 

14 sure that there is no -- there are no 

15 overestimating aspects of that dose 

16 reconstruction.

17 DR. ULSH: You could both be right 

18 though, however, because we implemented that 

19 best-estimate procedure, 45 to 52, at a 

20 particular point in time --

21 MR. CALHOUN: Oh yes.

22 DR. ULSH: And before that, we 
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1 might have done something different and that -

2 -

3 (Simultaneous speakers.)

4 CHAIRMAN GRIFFON: You might be 

5 remembering older cases --

6 MR. FARVER: Could we have that 

7 data at some point?

8 MR. CALHOUN: I am checking right 

9 now to see if we can get some numbers on the 

10 total number between 45 and 52 percent.

11 DR. ULSH: Grady, won't it be the 

12 -- the date that we made that change, won't it 

13 be about the time we did the PER and we re14 looked at all those cases?

15 MR. SIEBERT: The PER on that 

16 issue, I'm looking to find it right now.

17 MR. HINNEFELD: But won't it be 

18 about the time you made the change, is when we 

19 did that PER?

20 MR. SIEBERT: Yes, I'm going to 

21 say it's somewhere around March to May of 

22 2005. But let me pull that up.
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1 MEMBER MUNN: That sounds about 

2 right. And, John, I have to take issue with 

3 something that you said. You continually made 

4 the assertion that anyone who was attempting 

5 to be more precise in their dose calculation 

6 was deliberately attempting to go below a 

7 certain point rather than to be accurate and, 

8 which would, in terms of accuracy, just as 

9 likely place you above the point.

10 That just doesn't seem reasonable 

11 that you would make the assumption that 

12 someone was attempting to avoid a just claim.

13 DR. MAURO: You know, it's funny, 

14 I didn't want to characterize it that way, 

15 Wanda, and I understand --

16 MEMBER MUNN: That's the way it 

17 came across, John.

18 DR. MAURO: Yes, what I, what I --

19 see, it's a process, the process being when 

20 you start off with the idea that listen, we 

21 want to move these out quickly, we'll do an 

22 overestimate, you come in and everyone agrees 
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1 it's an overestimate, we come in below 50 

2 percent, we're done.

3 And that's fully -- that makes 

4 perfect sense. But what it does, then, is it 

5 puts you in a process that -- where you are 

6 not, you are not deliberately -- how can I say 

7 this. You are not deliberately trying to get 

8 the guy below 50 percent, but --

9 MS. LIN: Dr. Mauro, this is Jenny 

10 Lin with HHS, and I think the agency has a 

11 statutory responsibility to make best 

12 estimate, a reasonable estimate, dose 

13 estimate, under the statute for a compensable 

14 claim.

15 So I appreciate your input but I 

16 think we can rest that conversation at this 

17 point.

18 DR. MAURO: Okay.

19 MEMBER POSTON: Hello? This is 

20 John Poston. I just wanted to let you know I 

21 was about a minute late. Sorry.

22 MR. KATZ: Oh, John Poston.
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1 MEMBER POSTON: I couldn't get a 

2 word in edgewise, so --

3 MR. KATZ: Well welcome, we are 

4 glad to have you, John. And I need to do my -

5 -

6 (Simultaneous speakers.)

7 MR. KATZ: I have to just announce 

8 your conflicts since you are on the line, 

9 because that's a procedure that we have put in 

10 place for all FACA committees across the CDC, 

11 Subcommittees.

12 MEMBER POSTON: Well, that should 

13 be everything, isn't it?

14 MR. KATZ: Yes, it's everything --

15 no. No, but -- so let me just -- I don't 

16 expect you to recall these but let me just 

17 note, these are BWXT, X-10, Sandia, LANL and 

18 any DR matters involving Dr. Poston's son, 

19 Y-12, West Valley Demonstration Project, 

20 Pantex and any DR matters involving Dr. 

21 Poston's daughter.

22 MEMBER POSTON: My son is pretty 
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1 well versed at making sure that I don't see 

2 anything that -- he keeps me straight.

3 MR. KATZ: Right, right. No, I --

4 and, John, this is just a requirement, I have 

5 to announce it for each Member, for the DR 

6 Subcommittee and same with Procedures when we 

7 go to Procedures Subcommittee meetings.

8 MEMBER POSTON: Thank you.

9 CHAIRMAN GRIFFON: Can I just 

10 follow up, I'm not exactly sure what -- why 

11 John was cut off, I'm not -- you know, but 

12 anyway, I think what we have seen, this could 

13 get to that point, what we have seen is, when 

14 we sharpen the pencil, I think it's more a 

15 question of, even in those best estimates, 

16 there's still assumptions that have to be made 

17 by the dose reconstructor often, especially in 

18 internal dose reconstructions, and when we 

19 have reviewed -- several of these in the first 

20 set were Savannah River cases, and they were 

21 very close, and I guess sort of to build on 

22 Hans' point, I don't think you want the luck 
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1 of the draw, and I think the system at ORAU 

2 has to -- and NIOSH has to protect from this 

3 that you don't give one -- you don't, by luck 

4 of the draw, get a more, a person that's going 

5 to make, you know, tend to make more 

6 restrictive assumptions as opposed to a more 

7 generous assumption. You know, it should be 

8 neutral to that, it should be -- and 

9 sometimes, just by the nature of people's 

10 backgrounds, they have done dose -- they have 

11 done it a certain way all their life, they 

12 know -- you know they really feel this is 

13 correct and right, they're not trying to bias 

14 or get the number low, they just feel like 

15 that's the way they're doing things.

16 On the other hand you don't want 

17 it to be a luck of the draw situation so that 

18 -- but I'm saying the system should catch 

19 that, if you find that this is happening 

20 constantly with one dose reconstructor, you 

21 may have to say well, you know, I understand 

22 the way you've done things, however we are 
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1 giving a little more, you know, 

2 claimant-favorability and this is the approach 

3 here. Whatever.

4 MS. LIN: Sure, I mean I 

5 understand that perspective --

6 CHAIRMAN GRIFFON: Yes, that's I'm 

7 trying to get at.

8 MS. LIN: But I would encourage 

9 that this Subcommittee to --

10 CHAIRMAN GRIFFON: I think that's 

11 sort of what John was getting at.

12 MS. LIN: -- the technical part of

13 it as opposed to making a generalized 

14 discussion about how best estimate is never 

15 becoming a tool of minimizing compensability. 

16 That's all I'm saying here.

17 CHAIRMAN GRIFFON: Yes, I don't 

18 think -- I don't --

19 MS. LIN: It shouldn't -- I mean, 

20 for public members who may be listening or 

21 may be reading the transcript, it's very 

22 dangerous for the agency to be -- the agency's 
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1 credibility to be tainted by that kind of 

2 allegation.

3 CHAIRMAN GRIFFON: And I don't 

4 think John -- I don't think John meant that, 

5 but I don't speak for John.

6 MEMBER RICHARDSON: Can I ask --

7 CHAIRMAN GRIFFON: But anyway, 

8 we'll --

9 MEMBER RICHARDSON: Can I ask for 

10 clarification? The -- I mean this is all 

11 framed within how to -- how to usefully 

12 summarize the blind reviews.

13 And my -- my suggestion earlier, 

14 or thought, building off of John Stiver's 

15 comment, was the -- was that the dose 

16 reconstructors would each -- each indicate 

17 what type of reconstruction they had done.

18 It's sounding from Grady's 

19 comments like that -- that's a little bit 

20 fluid and actually what's -- you, maybe the 

21 name that would be given to most dose 

22 reconstructions is, is not purely that it was 
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1 an overestimating or a best estimate, but it 

2 has aspects of each to it.

3 MR. CALHOUN: Sure, we'll call it 

4 that. We'll -- if there's an overestimate of 

5 missed dose for example, let's say that we 

6 used the actual x-ray doses, which would be a 

7 best estimate, and we used a maximizing 

8 approach to missed dose, the case is still an 

9 overestimate because there was some portion of 

10 that dose reconstruction that was 

11 overestimated.

12 MR. HINNEFELD: But some people 

13 may refer to that as a hybrid of best -- I 

14 mean, there -- we haven't really defined it as 

15 a hybrid but some people could, you know, 

16 really use that --

17 MR. CALHOUN: I would contend that 

18 all DRs are hybrids then, because there's 

19 always a degree of over or under.

20 MR. STIVER: My experience -- this 

21 is John Stiver - is that what Grady's saying 

22 is true, that they are hybrid cases. It 
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1 depends how much refinement was applied and 

2 then what brought -- the type of scenario that 

3 was affected --

4 MR. HINNEFELD: And whether you 

5 gain any time, I mean, the whole idea of that 

6 overestimate is, it's got to be -- it should 

7 be more efficient. If it's not more efficient 

8 -- it's just as efficient to give the actual 

9 X-ray dose as to give the actual X-ray.

10 MEMBER RICHARDSON: And so, if we 

11 were to measure a report that had components 

12 of the dose broken out, and they would flag, 

13 okay the X-rays are best estimates, yes or no, 

14 the internal doses is a best estimate, they're 

15 a hybrid, or --

16 CHAIRMAN GRIFFON: We do that on 

17 our case selection matrices.

18 (Simultaneous speakers.)

19 MR. STIVER: There may be more, 

20 you know, in complete documentation, for if a 

21 particular aspect of the reconstruction, say, 

22 a measured photon dose was -- or a missed dose 
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1 was overestimated and then was changed later, 

2 just a comment to that effect.

3 MEMBER RICHARDSON: I mean we 

4 talked about --

5 (Simultaneous speakers.)

6 MEMBER RICHARDSON: -- in terms of 

7 summarizing, and I think it's fine to talk 

8 about, you know, briefly summarize those where 

9 the decision flips, but I am agreeing kind of 

10 with the idea that the intention of this sort 

11 of line review is less to focus on that, and 

12 in part is to -- I'm wondering if like the 

13 experience from the other sort of work that 

14 has been done by the committee, where we flag 

15 things that are quality issues, what the 

16 nature of, of those -- what are the processes 

17 that led to those and maybe we could try and 

18 kind of get, get those sort of -- are those, I 

19 mean, so you can help, you can remind me what 

20 sorts of -- where those came up. Are those 

21 anything from data entry onwards?

22 MR. SIEBERT: Oh, there were some, 
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1 I think it was a matter of transcription 

2 errors that were found, decimal point, it 

3 might be a millirem versus rem issue.

4 (Simultaneous speakers.)

5 MR. SIEBERT: It could probably be 

6 caught with an interview review I would think, 

7 or outside.

8 MR. FARVER: Or years were omitted 

9 in the final IREP table. In other words the 

10 workbook tool calculates the doses, they are 

11 in the workbook tool. Somehow they don't make 

12 it to the final IREP table.

13 MR. STIVER: Yes. There's the 

14 hand transfer of --

15 MR. FARVER: A year just gets cut 

16 out.

17 MEMBER RICHARDSON: And so that's 

18 where I was -- when I was first reading this, 

19 and there were kind of -- there was 

20 information about the number of years of dose 

21 from one organization versus the other, that 

22 was -- those were the sort of things I thought 
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1 I was catching which I think maybe I wasn't 

2 understanding.

3 But if there was -- if the summary 

4 report had a little bit more focus on these --

5 those things which we have been passing as 

6 quality issues, as separate from judgement 

7 issues, maybe that would be a way of --

8 MR. HINNEFELD: Yes, we could --

9 you are getting this, right, Grady?

10 MR. CALHOUN: Yes, our plan is 

11 certainly -- we -- I agree that we do need to 

12 improve the usability of the information that 

13 we get out of these blind reviews, and one of 

14 the things that -- one of the most important 

15 things that we -- that could come out of this 

16 and will come out of this, is that we're going 

17 to end up changing documents that add to that 

18 confusion between the ORAU team and our guys.

19 So this is the very first line, 

20 you know, we are going to add that TBD 

21 modified so that it is more instructive to 

22 people who are doing the dose reconstruction.
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1 And that's what -- that's one of 

2 the biggest benefits I see coming out of this, 

3 is we should be able to come up with very 

4 similar approaches. You know, the degree of 

5 overestimate will always be an issue, but for 

6 this one in particular, there should be some 

7 more clarification as far as when to use a 

8 critical level or an MDA.

9 MR. FARVER: On these blind 

10 evaluations, are you looking at the IREP 

11 tables and comparing them, the final IREP 

12 tables?

13 MR. CALHOUN: Yes.

14 MR. FARVER: Or are you comparing 

15 the DR report?

16 MR. CALHOUN: We're not so 

17 concerned about the text as we are the numbers 

18 that have come out. But the text will help us 

19 see how they determined it.

20 Now, you've got a guy who does the 

21 blind DR, the calculations on our side, and we 

22 are -- I'm just going to say ORAU does the 
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1 other one, and then there's a third person who 

2 compares them.

3 MR. FARVER: Okay.

4 MR. HINNEFELD: And the -- our 

5 people don't really write the text.

6 MR. CALHOUN: No, they don't write 

7 the text, no.

8 MR. FARVER: That's okay --

9 (Simultaneous speakers.)

10 MR. CALHOUN: We have seen 

11 problems before with the DR text not matching 

12 the IREP table.

13 MR. FARVER: Right, and that's why 

14 I was wondering, you know, how are we going to 

15 catch that, or --

16 (Simultaneous speakers.)

17 MR. CALHOUN: No, we wouldn't 

18 catch that --

19 MR. FARVER: Okay, that's okay.

20 MR. CALHOUN: But we'd catch that 

21 here, as evidenced by the fine reviews that 

22 you just got
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1 (Simultaneous speakers.)

2 MR. HINNEFELD: They should be 

3 caught in the internal review.

4 MR. CALHOUN: Yes.

5 DR. ULSH: And I think the kind of 

6 things that you were talking about, David, the 

7 QA issues and where should they have been 

8 caught, that's not the purpose of the blind 

9 DR, that's those other five cases that we 

10 picked from the 12th set, and they are exactly 

11 what I think you described there.

12 MEMBER RICHARDSON: I wasn't 

13 thinking about digging into them. I was just 

14 thinking about, kind of the usability, trying 

15 to break out sort of classes of problems with, 

16 with these blind reviews -- I was having a 

17 hard time just -- I mean it was the first stab 

18 at a summary.

19 MR. CALHOUN: I would have a hard 

20 time understanding it, you know, looking at 

21 everything that everybody had done, because it 

22 wasn't as consistent as I would like to see, 
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1 and I just looked, there's 93 in the queues 

2 right now for us to do, so we've done eight. 

3 It's our first eight that are complete, so we 

4 are going to get better at this, I promise. 

5 It's just a matter of getting a little bit of 

6 experience.

7 MEMBER MUNN: The process is 

8 always the harder barrier to go over.

9 (Simultaneous speakers.)

10 MR. FARVER: Could I ask a few 

11 questions about this batch?

12 CHAIRMAN GRIFFON: Sure.

13 MEMBER RICHARDSON: One thing I 

14 just, I would point out, is as was just said, 

15 I mean one of the purposes of this was to keep 

16 them timely. If they build up into this queue 

17 where you've got two years' backlog already. 

18 There's a problem of maybe wanting to purge 

19 that queue and --

20 MR. HINNEFELD: Yes, it's all --

21 it's a few months, you may be able to bring 

22 some of the earlier selections out. But we 
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1 only started selecting, what --

2 MR. CALHOUN: Yes. Yes. It 

3 wasn't very long ago at all. So we do need to 

4 just get a hold of this. This is just one 

5 more thing we started and just need to rein in 

6 -- I need to rein in.

7 MR. HINNEFELD: That's why he's 

8 coming.

9 (Laughter.)

10 MEMBER MUNN: But in some ways 

11 this is fortuitous because it gives us an 

12 opportunity to have this discussion, which 

13 should inform the entire process.

14 MR. CALHOUN: Right, I agree.

15 MR. KATZ: Doug.

16 MR. FARVER: The first was page 6, 

17 the first claim or the first case. And this 

18 is just -- well this is just -- I don't 

19 understand. I'm trying to learn.

20 If you look at B.1.4.

21 MR. CALHOUN: Hold on. I've got 

22 to find this still.
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1 CHAIRMAN GRIFFON: B.1.4.

2 MR. FARVER: Yes. 1.4 talks about 

3 the DCFs for the one year. I believe it's one 

4 year.

5 CHAIRMAN GRIFFON: Oh yes. That's 

6 the one I was looking at, and that's why I 

7 brought the DCF up --

8 MR. FARVER: I don't understand 

9 how you can have an overestimate of one and an 

10 overestimate of 1.244, and both be 

11 overestimates. If it's higher than one, you 

12 should use the higher value.

13 MR. CALHOUN: I am still not there 

14 yet.

15 MR. FARVER: Perhaps that's one to 

16 follow.

17 CHAIRMAN GRIFFON: That's the 

18 exact one I was looking at when I made my 

19 example before.

20 MR. STIVER: How can that be an 

21 overestimate if you are using the value of 

22 one?
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1 MR. FARVER: Well, one of them 

2 should not be correct. 

3 MR. CALHOUN: Where am I? Which 

4 one is this?

5 CHAIRMAN GRIFFON: B.1.4.

6 MR. FARVER: I could see if one 

7 was 0.8 and the other was 0.1. Okay.

8 CHAIRMAN GRIFFON: Or one.

9 MR. FARVER: Right.

10 MR. CALHOUN: I'd have to see that 

11 -- I don't know what kind of cancer this is. 

12 The term DCF may be less than one.

13 MR. FARVER: Well, then the 1.244 

14 is wrong. I mean if you just used that 

15 number, you would use one.

16 MR. CALHOUN: Yes, I can't, I 

17 can't tell you.

18 MR. FARVER: But I mean isn't that 

19 the proper process? If it's 0.8 you could 

20 round up to one, you know, we've seen that a 

21 lot. You don't typically round over one to 

22 some odd number.
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1 MR. CALHOUN: Yes, see that's one 

2 of those things, I don't know what the process 

3 is. I'd have to look and I'd have to see 

4 actual documents.

5 MR. FARVER: Things like this, I 

6 would like to see more --

7 MR. CALHOUN: Exactly. Exactly.

8 MR. SIEBERT: Well, I can probably 

9 shed a little light on that, because as you

10 guys say, when you do these enough, you tend 

11 to notice numbers.

12 MR. KATZ: Go ahead, Scott.

13 MR. SIEBERT: It's likely -- this 

14 is Scott Siebert -- it's likely a bladder 

15 cancer because that's the upper, the maximum 

16 number of the DCF in the triangular 

17 distribution, though using the maximum number 

18 would obviously be overestimating.

19 Using a one -- the way the 

20 triangular distribution is laid out, using a 

21 one actually overestimates the full triangular 

22 distribution as well. So both of them could 
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1 easily be overestimates of the full triangular 

2 distribution.

3 MR. FARVER: Which one would you 

4 typically use?

5 MR. SIEBERT: As an overestimate, 

6 likely one. But once again, using the maximum 

7 as an overestimate also would not be 

8 inappropriate.

9 MR. FARVER: But that's not the 

10 typical process, is my point.

11 MR. SIEBERT: Yes.

12 CHAIRMAN GRIFFON: Go ahead on 

13 your next --

14 MR. FARVER: Now, if you look at 

15 the second claim, or second case number, I 

16 like this, it started at the beginning and 

17 everything is -- it's a mirror, one side to 

18 the other. And that's the way I think it 

19 should be. That's what you would expect if 

20 you look down page 8, and that's -- that's how 

21 it should be.

22 MR. SIEBERT: What page were you 
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1 talking about there Doug? I'm sorry.

2 MR. FARVER: Page 8.

3 MR. SIEBERT: Thank you.

4 MR. FARVER: And then we get down 

5 to the internal dose, F.1.1 and we see a 

6 difference. And then in the comments section 

7 they say that the two selected different 

8 uranium intakes -- well, that kind of bothers 

9 me.

10 MEMBER MUNN: Wondering why.

11 MR. FARVER: Right, because you 

12 are pulling a number from a table. It should 

13 be pretty cut and dried. No, for this case, 

14 it won't affect the compensation claim, but 

15 you know, that tells me there's something 

16 different in the minds going on here.

17 DR. ULSH: You know, I think you 

18 make a good point. We should put in more 

19 explanation about why there was a difference. 

20 I would caution you, though that in cases 

21 where there is a difference, ORAU, probably 

22 did it right and we probably did it wrong.
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1 I think it's reasonable to expect 

2 that we should have analyzed the differences 

3 and say --

4 MR. FARVER: Well, what they are 

5 telling you is two knowledgeable people looked 

6 at it and they came up with different 

7 conclusions, you know, they picked two 

8 different values.

9 CHAIRMAN GRIFFON: And also, no 

10 matter who did it wrong, the more important 

11 question is why, you know, was there not 

12 enough guidance there to --

13 MEMBER CLAWSON: Doesn't this come 

14 back to what we've said, show your work, so 

15 we'll be able to understand why we did -- why 

16 they did that? That's something we have been 

17 dealing with all the way through this.

18 MR. FARVER: And then if you go on 

19 to the next case, and you go down to the 

20 bottom of page 11 in the comments, this 

21 concerns the F.2.2, but it came up with 

22 different internal doses and it talked about -
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1 -

2 CHAIRMAN GRIFFON: Can I ask, 

3 before you go on to that one, just talking 

4 about your mirror images, on page 9, right 

5 below that internal doses -- go on the 

6 internal dose section. It says, "Correct 

7 solubility used per TBD." And there's a false 

8 and a true. I mean, is it that DCAS used the 

9 different solubility and that's why they got a 

10 different number? Is that -- anyway, I don't 

11 just --

12 MR. FARVER: That could be. They 

13 might have chosen the wrong value from the 

14 table. But that's an error.

15 CHAIRMAN GRIFFON: Okay, anyway. 

16 Go ahead. I'm sorry.

17 MR. FARVER: Okay. Bottom of page 

18 11, if you look through those comments, and --

19 I took a look at the internal dose and they 

20 used reporting level or MDA. The TBD does not 

21 specify. Well, maybe it should.

22 MR. STIVER: Is this one of the 
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1 findings you said was pretty important that 

2 was going to maybe result in a PER?

3 CHAIRMAN GRIFFON: Is this that 

4 one?

5 MR. CALHOUN: This is the one 

6 that, that we believe that ORAU did correctly, 

7 but I have already put out a request to ORAU 

8 to look at this and clarify that, so that's 

9 the one --

10 CHAIRMAN GRIFFON: Clarify the 

11 instructions.

12 MR. CALHOUN: There's going to be 

13 a change in the TBD.

14 MR. HINNEFELD: Yes, this is the 

15 one that gave rise to the --

16 MR. CALHOUN: Yes.

17 MR. HINNEFELD: Observations that 

18 we --

19 (Simultaneous speakers.)

20 MR. CALHOUN: And that's exactly 

21 what we're looking for, is when we can find 

22 things that we can improve our process and our 
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1 instruction, that's what we're going to do.

2 CHAIRMAN GRIFFON: But for this 

3 kind of situation, do you think that there was 

4 a possibility that other people at ORAU made 

5 the mistake that -- you know, made the 

6 assumption that DCAS made in this case? In 

7 other words is it a broader --

8 MR. CALHOUN: We'll have them look 

9 at that, because this could be very well 

10 embedded into a program that they don't have a 

11 big selection for.

12 MR. FARVER: We'll move on to page 

13 12 on the next case, just by reading you can 

14 see it's an AWE case. It's using TBD-6000, 

15 and if you go to the bottom of page 13 and 

16 read the comments, a lot of it stems from 

17 choosing rolling operator as opposed to 

18 plant-floor load and I believe this has been 

19 an issue that's been brought up before about 

20 what value do you choose from the table.

21 And in some cases we believe you 

22 should choose a different one than what is 
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1 chosen by ORAU, by the, you know, the dose 

2 reconstructor.

3 So this is an issue we've run into 

4 in the past and it's obviously something that 

5 the dose reconstructors disagreed on. I don't 

6 know which one is right, I'm just saying 

7 there's some disagreement here.

8 MR. CALHOUN: Right, and I just 

9 looked, the person is listed as a lab 

10 assistant and I don't know the details of all 

11 these cases to that level, but I agree, when 

12 there's something that was different, we 

13 should have a sentence or two that says why.

14 MR. FARVER: And I think somewhere 

15 in there it says that the DCAS person did it 

16 because it was more claimant-favorable, which 

17 tells me that he wasn't sure, so he used the 

18 one that was more claimant-favorable.

19 MEMBER MUNN: There's some kind of 

20 comment about that in the text.

21 MR. FARVER: Is there? Okay, I'll 

22 comment about that. And if you look at the 
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1 internal doses in you know, F.1.1, it's off by 

2 a factor of 10 approximately. So for this 

3 case it didn't matter, but it could.

4 DR. MAURO: This is John. In 

5 OTIB-70, one of the things that we found very 

6 favorably, was there is a statement in there 

7 that says whenever there's some ambiguity 

8 regarding what category to assign the worker 

9 to, the direction is to give him the benefit 

10 of the doubt and put him in that higher 

11 category, which is a very good posture to 

12 take.

13 And what I'm hearing here is that, 

14 and most of the time -- I do a lot of these 

15 AWEs -- most of the time that's exactly what's 

16 done, that is I've seen on very rare 

17 occasions, they give a lower assignment to a 

18 worker. It sounds like you do have one case 

19 here that you looked at, where a lower 

20 assignment was given, and there's reason to 

21 question whether or not that was the right 

22 thing to do.
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1 But I'd just like to make sure 

2 everybody recognizes that OTIB-70 is very good 

3 with regard to this, giving direct 

4 instructions to give the benefit of the doubt 

5 when there's any question because, where to 

6 place the person.

7 MR. FARVER: So maybe ORAU didn't 

8 do an overestimate on this dose. I don't 

9 know.

10 CHAIRMAN GRIFFON: And I guess 

11 this could become important. I'm just 

12 thinking of this 45 to 52 criteria that they 

13 have, that if ORAU chose an -- what they 

14 viewed as an overestimating technique, which 

15 you know, based on this DCAS review, wasn't 

16 quite as claimant-favorable, and it didn't, 

17 you know, if you used DCAS's model and I'm not 

18 saying it happened in this case, obviously it 

19 didn't, but if you used DCAS's model it kicked 

20 them into the 47 percent say, they would kick 

21 into a best estimate, whereas the -- you know, 

22 so I don't know how often that scenario would 
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1 actually happen, but do you follow what I'm 

2 saying, that if your overestimating technique 

3 is not truly overestimating, and you, you 

4 know, follow your procedure, if you get the 45 

5 you'll go to best estimate but it doesn't, you 

6 know, get you to 42 percent, then you would, 

7 you know, you never may do that more sensitive

8 analysis.

9 MR. HINNEFELD: So in -- yes, but 

10 specifically in this case, I mean, you said he 

11 was the lab assistant.

12 MR. CALHOUN: Yes, it's the lab 

13 assistant. I just looked up the CATI and they 

14 didn't ever knowingly work with radioactive 

15 material. They entered areas and oversaw 

16 steel operations.

17 CHAIRMAN GRIFFON: So there's 

18 overestimating and overestimating -

19 (Simultaneous speakers.)

20 MR. HINNEFELD: But we don't have 

21 any specific instruction about that.

22 MR. CALHOUN: Or discussion as to 
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1 why --

2 MR. HINNEFELD: -- a discussion as 

3 to why I selected this category, which 

4 probably should be here.

5 DR. ULSH: Since you just brought 

6 up the 45 to 52, to answer an earlier 

7 question, Scott just emailed me. "PER-16 

8 states that we started doing the 30 IREP runs 

9 on June 6th of 2006." And that's that 

10 procedure we were talking about earlier.

11 MR. FARVER: Okay.

12 MEMBER RICHARDSON: There was an 

13 ORAU response for -- this is on page 13 for 

14 E.1.1, and I've -- this is one of these places 

15 where it seemed like there were several types 

16 of information maybe within this box. There 

17 was -- there's the -- if I am understanding it 

18 correctly, there's the total medical dose, 

19 which differs by a factor of 10 between the 

20 DCAS and the ORAU, which may be it's a DCAS 

21 key-punch error. And then there's a comment 

22 that says, "An X-ray for each year of 
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1 employment but in accordance with TBD-600, 

2 possibly should have also assigned a pre3 employment X-ray for the first year of 

4 employment.

5 So three X-rays could have been 

6 assigned and it seems like there's a lot of, 

7 you know, I don't know, hedging there. Is the 

8 TBD not specific about that, and if so, did 

9 neither DCAS nor ORAU, but only the person who 

10 audited the comparison of all three, I mean, 

11 it seems like there's -- there probably is a 

12 clear statement about what was supposed to be 

13 done, and maybe nobody did it. If so, that 

14 should just be stated. I -- again, that would 

15 be another category of types of errors that 

16 could be captured. That was my reading anyway 

17 of the comment, was it sort of implied nobody 

18 had done it.

19 MR. CALHOUN: Yes, again, I am 

20 just going to have to take these all back and 

21 look at them.

22 MR. HINNEFELD: I mean, it's good 
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1 that there's a lot of information in here and 

2 that you can look at.

3 MEMBER RICHARDSON: I am still, I 

4 am just, I am still thinking about trying to 

5 synthesize it, because it's making me imagine 

6 that there's actually a third category.

7 There's the concordance between he 

8 two reconstructors, and then there was an 

9 audit which was done which suggested, well in 

10 fact, maybe nobody, nobody did what could 

11 have, what should have been done according to 

12 the document.

13 MEMBER MUNN: I can't address what 

14 TBD-6000 says, right?

15 DR. ULSH: So both did it correct, 

16 this is one category. Another category is one 

17 side or the other did it correct, and the 

18 other didn't. And what you are saying is a 

19 third category is we all screwed up.

20 MEMBER RICHARDSON: That's what I 

21 think --

22 DR. ULSH: In which case you would 
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1 wonder why, maybe the guidance document --

2 MEMBER RICHARDSON: I get it, 

3 right.

4 DR. ULSH: and they're all just 

5 boneheads.

6 MEMBER RICHARDSON: But I mean, 

7 that's because you've got multiple eyes 

8 looking at the same one now, and so I can 

9 imagine that, but that is another category of 

10 thing, it's the last person who does the 

11 judgment.

12 DR. ULSH: That's probably the 

13 worst situation because it means there really 

14 is something that's not clear that everybody 

15 is missing.

16 MEMBER RICHARDSON: Right.

17 MR. HINNEFELD: Yes, and the way 

18 the reviewer wrote the finding makes you 

19 wonder if even TBD-6000 is very clear about 

20 this situation.

21 MEMBER RICHARDSON: Right.

22 CHAIRMAN GRIFFON: Any others, 
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1 Doug?

2 MR. FARVER: I'll try and close it 

3 up here. I think you get the gist of it, just 

4 by looking through, you can identify the 

5 differences and kind of say, well, I wonder 

6 why those are different.

7 And even if you just look at their 

8 comments, I don't know, we can look at the 

9 page 18, let's look at the unmonitored dose, 

10 B.3.1. It came up a little bit different 

11 unmonitored.

12 CHAIRMAN GRIFFON: What was it, 

13 B.3.1?

14 MR. FARVER: Yes. And there just 

15 some confusion about the hours and one person 

16 looked at it one way, one person looked at it 

17 another.

18 MR. HINNEFELD: Yes, that's one I 

19 know that there was some issue with that tool 

20 that, maybe, we'll have to take a look at.

21 MR. FARVER: And I mention that 

22 because we have seen that before in the 
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1 unmonitored dose with the hours and so I'm 

2 familiar with that problem.

3 MEMBER RICHARDSON: Yes, this is a 

4 great one for what a blind review should 

5 catch, right?

6 MR. FARVER: Yes.

7 MEMBER RICHARDSON: Suggesting 

8 that somebody independently couldn't replicate 

9 something which you think is embedded in the 

10 equation there, in their tool.

11 MR. FARVER: When you're pulling 

12 things from tables, and --

13 CHAIRMAN GRIFFON: It's not even 

14 used in that table, I think it's in the 

15 workbook, right?

16 MEMBER RICHARDSON: I think it's 

17 in their --

18 MR. FARVER: Oh, it's in the 

19 workbook but it's in the document table.

20 MEMBER RICHARDSON: Right.

21 MR. FARVER: I mean that's how we 

22 usually go in and look at the table and see if 
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1 it matches and try and get it to match the 

2 number in there.

3 MEMBER RICHARDSON: But am reading 

4 what this person says, that they couldn't 

5 recover that value independently because there 

6 is some question about an error in the 

7 equation used to adjust the hours worked.

8 So it's -- maybe the table is 

9 correct, but whatever ORAU is using as a tool.

10 MR. FARVER: Could be. And I'll 

11 bring that up -- because I get after our own 

12 people when it's a value from the table, and 

13 they can't put it down in our document and 

14 make it match a NIOSH number.

15 Because something is wrong. 

16 You're just pulling it from the table. 

17 Somebody is wrong.

18 MR. STIVER: Yes, this was just an 

19 adjustment, to go from 8,760 down to 2,600 

20 hours so it should have been pretty 

21 straightforward.

22 MEMBER RICHARDSON: You mean it's 
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1 not a very complicated equation?

2 MR. STIVER: Right.

3 MR. FARVER: I guess that's enough 

4 comments. You guys kind of get the idea.

5 Page 21, another unmonitored dose. 

6 Oh that's a prorated dose I'm sorry.

7 DR. ULSH: So I guess going 

8 forward --

9 MR. FARVER: No, I just suggested 

10 that -- I was kind of looking at some of these 

11 differences and saying you know, you wonder 

12 why they're different, two people looked at 

13 things differently.

14 DR. ULSH: Yes, the message that I 

15 got from all of this discussion so far is that 

16 number one, we need to more clearly define why 

17 there were differences and whether or not an 

18 error was made, and I think a third part of 

19 that, I don't know if we have explicitly said 

20 it, is if there was an error made, what 

21 corrective actions have we taken as a result.

22 So going forward, you are going to 
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1 see another report on the next set of blind 

2 DRs. That's one item. My question is, what 

3 about this report?

4 MR. CALHOUN: There will be 

5 close-out report for that one, and the 

6 observations and recommendations from the 

7 group.

8 MR. HINNEFELD: Meaning the 

9 corrective actions --

10 MR. CALHOUN: Yes when they are 

11 completed.

12 MR. HINNEFELD: and the actions 

13 that are recommended --

14 MR. CALHOUN: Yes. Officially we 

15 don't need to do it for findings but I'll do 

16 it for -- if we only need to do it for 

17 findings and concerns, but we'll do it for 

18 observations and recommendations for 

19 improvement on this one.

20 MR. HINNEFELD: But part of what 

21 Doug was saying is that in order to make, you 

22 know, get the value out of this, we really 
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1 need to investigate these differences and make 

2 a judgment about a preferred method to the 

3 extent that there is some -- some of that --

4 when you are talking about 1.24 times 1.0 and 

5 they are both overestimates, I don't know that 

6 there's -- we're going to come up with a 

7 confirmed method for that. I have to be 

8 honest with you.

9 But some of these, it seems like 

10 there is a preferred method, that should be 

11 done, and they should be done the same way, 

12 even though they are both overestimates and 

13 they are not -- it doesn't affect the case, 

14 that there should be a preferred method.

15 MR. FARVER: I have never seen an 

16 overestimate where they have chosen the 

17 maximum of the distribution. I have seen the 

18 ones where they choose one, you know, if it's 

19 below one.

20 DR. ULSH: Well I don't know the 

21 particulars of that case but it does go back 

22 to the principle that you said, that if it's 
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1 just as easy to pick one number versus 

2 another, then we should pick the --

3 MR. HINNEFELD: Well, there should 

4 probably be a preferred method.

5 MR. FARVER: From what I've seen 

6 you pick one, or you just -- the DCF is 

7 greater than one, then you use the DCF.

8 That's all. We don't have to beat 

9 this to death any further.

10 CHAIRMAN GRIFFON: Right, and I am 

11 trying to think, I mean, maybe once we have 

12 this other discussion on the Quality Assurance 

13 Program at ORAU, this might gel better.

14 But I mean you said if we find --

15 if we find errors in this, the other thing is 

16 to correct that, what are we doing, you know? 

17 And, but you know, from my other line of work 

18 right now, I guess I would caution, and I 

19 think, Stu, you said this at a couple of 

20 meetings, caution that you're -- we're not 

21 just -- you know, you might want to look at 

22 this systematically, like fixing one thing at 
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1 a time is not what you are setting this 

2 program up to do.

3 You may look at the more root 

4 cause of why, you know, why did this happen so 

5 yes, in some cases, I think you are right that 

6 certain procedures in identifying that, you 

7 know, what value to use as the MBA or 

8 whatever, I mean, that, that's pretty clear, 

9 but there might be others that are -- it's not 

10 just fixing the immediate problem but it's 

11 looking beyond, like why did that -- why is 

12 that happening? Why is that getting through -

13 - yes.

14 DR. ULSH: To give a totally 

15 made-up example, if we discovered that there's 

16 a problem with the DCF and the Idaho tool, all 

17 right, we fix that.

18 If we see the same kind of a 

19 problem in the Hanford tool and the Savannah 

20 River tool, maybe something's going on and we 

21 need to figure out why this is happening.

22 CHAIRMAN GRIFFON: Right.
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1 MR. HINNEFELD: Right. You're 

2 talking about you know, you --

3 CHAIRMAN GRIFFON: Or even the 

4 8,760 hours, I mean you might want to step one 

5 further back and say let's check our other 

6 tools to make sure that they are doing this 

7 calculation correctly, you know, that we --

8 MR. STIVER: Well I wish this 

9 would be captured in the V&V with the tool 

10 itself.

11 CHAIRMAN GRIFFON: It should be 

12 yes, right, right, right. Anyway you -- yes, 

13 I think you get the idea. Anything else to 

14 add before we -- I think it's a -- I am 

15 worried about the production but you need to 

16 hire some more --

17 MR. HINNEFELD: I am quite worried 

18 about the resource demand. And while so far 

19 federal budgets -- our federal budget is okay, 

20 every year I get called about when can you 

21 start turning some of this money back. I get 

22 that call every year. In fact I just got it 
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1 for 2015. Do you really need all that money? 

2 We still think you should finish the backlog. 

3 So I just got that call. But yes, it's a 

4 worry.

5 MR. KATZ: We can circle back on 

6 this question after we get the other resources 

7 used to -- that we'll need to talk about 

8 today.

9 CHAIRMAN GRIFFON: Right. Well 

10 why don't we -- let's take a break.

11 MEMBER MUNN: Let's do.

12 CHAIRMAN GRIFFON: For early 

13 lunch? No. Let's take like 10 minutes or so 

14 and then we'll work through to lunch, right?

15 (Whereupon, the above-entitled matter went off 

16 the record at 10:44 a.m. and 

17 resumed at 11:03 a.m.) 

18 MR. KATZ: We are back from a 

19 short break. Mark.

20 CHAIRMAN GRIFFON: Okay. The next 

21 couple of items on the agenda are -- looks 

22 like DCAS reports really. The question of DR 
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1 efficiency process and you've looked at this 

2 and whether it was going to save any time, 

3 what the impact of doing all I guess best 

4 estimates as opposed to -- I think that was 

5 the original question.

6 MR. HINNEFELD: Why don't you just 

7 go ahead while I look for this?

8 MR. CALHOUN: Okay, I just didn't 

9 know if it wasn't the right place, I didn't 

10 think, but we asked about the 45 to 52 percent 

11 in the last five years and we started tracking 

12 that. It's been 1.9 percent of the DRs.

13 CHAIRMAN GRIFFON: All right.

14 MEMBER MUNN: That's pretty close 

15 to two.

16 MR. CALHOUN: It's very close to 

17 two, it is, in my mind.

18 MEMBER MUNN: I'll have to think 

19 about it, though.

20 MEMBER RICHARDSON: You said 

21 that's 45 to 52 percent?

22 MR. CALHOUN: Correct. So if 
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1 there's --

2 MEMBER RICHARDSON: So are you 

3 talking about it's two percent within that 

4 bounds, and at 10 percent over the range, 

5 which is -- which is a 10 percent range, 40 to 

6 49, versus 45 to 52 which is a seven percent 

7 span, which only owns two percent of the mass. 

8 It's a weird distribution.

9 MR. CALHOUN: I don't know what 

10 that means.

11 MEMBER RICHARDSON: I certainly 

12 don't, because when they cross that threshold, 

13 they get scrutinized and bounced back out of 

14 that threshold. Right?

15 I mean that must -- something is 

16 driving observation data there.

17 (Simultaneous speakers.)

18 MR. CALHOUN: -- overestimate one 

19 underestimate portion of the DR that falls --

20 CHAIRMAN GRIFFON: That is the 

21 process, yes.

22 MR. STIVER: If you looked at the 
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1 adjacent three or four percent which makes you 

2 --

3 MEMBER RICHARDSON: You do, 

4 because the 45 to 49 holds 10 percent of the 

5 observations and yet you've got only two 

6 percent.

7 MR. STIVER: Forty to 49.

8 CHAIRMAN GRIFFON: Forty to 49. 

9 All right Stu, we gave you time to look at 

10 your update and --

11 MR. HINNEFELD: Yes, the history 

12 on this was that we have an analysis from our 

13 contract about the impact of doing away with 

14 this and it included information that we 

15 thought they might consider confidential.

16 And so we just send it back to 

17 them and say hey, can you give us a version of 

18 this that you are okay going public, you know 

19 being public, because once it's hear, it's 

20 essentially public?

21 And they made some -- they 

22 modified it and they sent it to me with so 
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1 many caveats on it that I said, well, what 

2 good is this, you know, you said it shouldn't 

3 be shared, you know, this is just for our 

4 internal conversation and it shouldn't be 

5 shared and I said well, hey, the idea for you 

6 to change it was to share it. So can you kind 

7 of lighten up on your message?

8 Now, I think she's done that but I 

9 want to make sure I get the right version 

10 here, and I can share her most recent one, if 

11 -- when I'm confident I have it. I hate to 

12 make the judgment sitting here today but I'll 

13 send it to everybody after this.

14 I think we talked about this a 

15 little bit verbally at the last meeting, is 

16 that there is a very large cost associated 

17 with doing away with the best estimates --

18 with doing away with the overestimates.

19 Because right now to the majority 

20 of the claims are an overestimate rather than 

21 an underestimate of some fashion. To the 

22 extent that for a given manpower loading which 
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1 would -- this is actually a little dated 

2 because we don't have this much manpower 

3 working on dose reconstructions right now. 

4 But the time they did this, they could produce 

5 about 76 dose reconstructions a week and only 

6 about 10 percent of those were best estimates.

7 And if we had gone to 100 percent 

8 best estimates, production would have been 

9 half, about 35 -- about 35 a week. So you 

10 would have to double -- in order to maintain 

11 the same production level, you would kind of 

12 roughly double the price, for dose 

13 reconstruction if you didn't do any best 

14 estimate.

15 So we just said well it's not 

16 something we want to pursue right now, and 

17 then there was some additional analysis of 

18 partial -- of what, some things we could do. 

19 And I'm going to have to study this a little 

20 bit I think to make much more sense of than I 

21 said last time. I think I talked about it a 

22 little bit at the last meeting.
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1 There's not a -- nothing that 

2 really seems to get us very much in terms of 

3 really reducing the number of -- of really 

4 reducing the number of overestimates, is a low 

5 cost item.

6 You know, if -- you know, even 

7 skin cancers, for instance, skin cancers are a 

8 big chunk of claims, and so it's not really a 

9 low cost item to do all --

10 CHAIRMAN GRIFFON: Yes, that's the 

11 one we did talk about because of the chances 

12 of secondary cancers. Yes.

13 MR. HINNEFELD: But even that's a 

14 pretty significant cause. And we've talked --

15 I talked earlier today a little bit about the 

16 ways we are behind for the Subcommittee, and 

17 so taking on, so I really hate to take on a 

18 more expensive, existing process, you know, to 

19 make the existing process for dose 

20 reconstruction more expensive, which is time 

21 really, I mean, just people's time, in light 

22 of the fact that we have all this other work 
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1 that we really need to focus on to catch up.

2 So as much as I hate to have to 

3 explain to people why their rework went down, 

4 you know, when they got an additional cancer, 

5 because I had a lot of those conversations, 

6 you know, as much as I hate to do that, I 

7 don't see a way out of it right now that we 

8 can afford. You know, that's kind of where we 

9 are.

10 I apologize, I didn't get this 

11 ready, I've had kind of a busy week, and, and 

12 I just failed to pick it up off the agenda 

13 when the agenda came out, I said oh it's just 

14 something I think I can get in.

15 I'm pretty sure I have that, that 

16 revised non-business-sensitive analysis from 

17 ORAU that I will share. And I'll just go 

18 ahead and send all of it to everybody here.

19 But it's -- the original analysis 

20 kind of talked about how many hours it takes 

21 to do a dose reconstruction, things like that 

22 that ORAU feels may be a little business 
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1 sensitive because realistically, all these 

2 contracts are competitive, and you know, and 

3 in fact we are only about a year away from 

4 beginning that process again.

5 MEMBER RICHARDSON: So, you know, 

6 one of the things that struck me in the past 

7 is not so much the logic of doing the 

8 overestimate as the communication issue of 

9 doing an overestimate, and I certainly 

10 appreciate the time -- the kind of the time 

11 demands that make it not feasible to do best 

12 estimates for everybody, and I took from that 

13 report raising the issue that it was kind of 

14 the -- it was an issue of kind of the 

15 perception of the program and the kind of --

16 the feelings that people had when their dose -

17 - their Probability of Causation was changing 

18 and the compensation decisions seemed to be 

19 backing in the wrong direction.

20 Some of it seems to me like it's a 

21 secondary product of kind of a false level of 

22 precision in which certain numbers are 
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1 communicated to claimants.

2 Like, when you say, well, we 

3 calculated your Probability of Causation and 

4 our best estimate, or you know, or our 

5 estimate is 43 percent.

6 You know, and then it's going to 

7 get back and it's going to be -- and when 

8 there's -- when that's not in that sense the 

9 best estimate, because I'm wondering if 

10 there's a way of pulling off from that.

11 I mean, I just -- yes.

12 MR. HINNEFELD: Well, that's 

13 interesting.

14 CHAIRMAN GRIFFON: If the PoC is 

15 less -- yes.

16 MEMBER RICHARDSON: It's in this 

17 range, it's in the bottom quartile. You know, 

18 I don't know, if that -- it's useful to people 

19 or not, but I think one of the things they're 

20 seeing is that number is shifting.

21 MR. CALHOUN: They don't see the 

22 actual PoC. They just see the dose.
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1 MR. HINNEFELD: Labor tells them. 

2 MR. CALHOUN: And every time we 

3 have an overestimate, there is a sentence in 

4 the dose reconstruction that says, "This is an 

5 overestimate and any changes could result in a 

6 lower dose."

7 CHAIRMAN GRIFFON: That was 

8 actually a result of our, our work.

9 MR. HINNEFELD: I think that came 

10 out --

11 MEMBER RICHARDSON: They have been 

12 in place for a long, long time. They get a 

13 PoC thought, don't they?

14 MR. CALHOUN: Not from us. No.

15 CHAIRMAN GRIFFON: They see the 

16 PoC --

17 MR. CALHOUN: They get it from 

18 Labor.

19 (Simultaneous speakers.)

20 MR. CALHOUN: -- that it's over or 

21 under 50 percent. You know, it will say that 

22 is the internal dose alone resulted in a 
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1 Probability of Causation greater than 50 

2 percent. We won't say it 's 55. And -- or 

3 we'll say even under these assumptions, the 

4 dose for the -- the dose will not reach a 

5 Probability of Causation of 50 percent or 

6 greater, and that's the only thing they get 

7 from us.

8 MR. FARVER: And that's in the DR 

9 report.

10 MR. CALHOUN: Yes.

11 CHAIRMAN GRIFFON: So they are 

12 getting it from one agency or another. But --

13 and they do get the specific doses, even 

14 though we -- even though you qualify, correct?

15 And that's why they have come 

16 before the Board several times saying you 

17 know, I've got, you know, here I was 20 rem 

18 and now I've got another cancer, and now it's 

19 10 rem, or you know, how has this happened. 

20 The next time I get a cancer is it going to be 

21 two rem? You know, I mean, they -- it creates 

22 that mistrust I think so yes.
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1 MEMBER MUNN: Several is a very 

2 conservative number.

3 MR. HINNEFELD: Yes.

4 MEMBER MUNN: It's been more than 

5 several. But the language has been changed on 

6 two or three different occasions, to try to be 

7 more and more clear and to be as specific as 

8 possible.

9 MR. HINNEFELD: Yes, I struggle 

10 with this because I would dearly love to have 

11 fewer of those conversations, or have some 

12 other way, you know, having people not have to 

13 face that, gee, I was 40 and now I'm -- got 

14 another cancer, I'm 25, what are you guys 

15 doing to me here? I'm 30, or you know, you 

16 are changing the rules so you don't pay me.

17 But I really struggle with how 

18 well you communicate this idea. I mean, you 

19 know, what comes to mind, I'm just thinking, I 

20 don't know if you knew this or not, you know, 

21 rather than give them their dose numbers, then 

22 you know, your dose would be less than this 
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1 number.

2 I mean, but that's going to be 

3 buried, I mean that's going to occur as the 

4 dose reconstruction is now, as it comes 

5 designed, it's going to occur at the various 

6 places where you have an overestimating dose. 

7 You get to the extra dose and you are saying 

8 our dose reconstruction indicates that the 

9 dose would be less than this number as opposed 

10 to the number.

11 You know, but I don't think that 

12 is fixing it. I don't know --

13 MR. CALHOUN: No. I mean --

14 (Simultaneous speakers.)

15 MR. CALHOUN: There's a space in 

16 the top and the bottom to give the overall 

17 dose.

18 MR. HINNEFELD: Yes.

19 MR. CALHOUN: For cancer. And you 

20 could say, and I know Chris used to put into 

21 there, "We determined that your dose is no 

22 greater than" for non-comp cases.
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1 MR. FARVER: Is this something 

2 that the Worker Outreach Group could help out 

3 with? Ask the workers how they -- how best is 

4 it to present this to you. Say this is what 

5 could happen. You know, we -- this is the 

6 process and if it gets reworked, these things 

7 can happen. How's it best to explain it to 

8 you? You know, what --

9 DR. ULSH: Well you know, I was 

10 thinking of not necessarily Worker Outreach 

11 Group, but and it's always dangerous to think 

12 on the fly, I get in trouble a lot. In 

13 situations where -- okay, the problem is that 

14 we have got this perception about what happens 

15 when my dose goes down, and I wonder if, in 

16 those situations, if we could develop a 

17 communications piece that goes into more 

18 detail and says look, this is the situation, 

19 let's walk you through an example case, here's 

20 why you're seeing what you're seeing, that we 

21 insert in with the dose reconstruction when we 

22 mail it out to them the second time around or 
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1 whatever. That would be cheaper than 

2 eliminating best estimate cases.

3 MR. CALHOUN: Or even just a full 

4 paragraph --

5 MR. FARVER: That's kind of what I 

6 was getting at, you know, you work through the 

7 workers and find out what they -- what they 

8 would want to see or what would help them 

9 understand better, and I just thought the 

10 outreach group, that might be something for 

11 them to work on.

12 MR. KATZ: I am not so sure the 

13 Subcommittee -- the Work Group is really the 

14 place to have expertise on this. This is a 

15 communication issue and this is something you 

16 would do, you would develop some -- with 

17 communications people you would develop some 

18 different approaches and you would test them 

19 out on a focus group of people you determined 

20 and that's how you would figure out what works 

21 best.

22 I mean, that's as good as it gets 
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1 I think for this kind of behavioral issue --

2 communication issue.

3 DR. ULSH: I think that would be a 

4 more plausible and economical way of dealing 

5 with it.

6 MR. KATZ: But that -- and that 

7 would be sort of a very robust, professional 

8 approach to it.

9 CHAIRMAN GRIFFON: I mean, you 

10 know, there's a lot of -- it's probably 

11 outside of what we're doing here, I agree. 

12 But there might be other -- because it's part 

13 of the -- unfortunately it hits at questioning 

14 the credibility of NIOSH, and I think even 

15 outreach, NIOSH doing outreach, for some of 

16 the larger sites, you might even want to tie 

17 in with the unions, as long as they are 

18 supporting your position, you know make sure 

19 they understand -- because when you go to 

20 these things, I mean I can tell you, if you do 

21 a town hall meeting or a meeting in a local 

22 union, and try to explain this, you have got 
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1 the best intentions and but you are going to 

2 get some people saying oh yes, oh so now you 

3 are trying to explain away this? 

4 You know, and I mean -- well it's 

5 big government telling them how -- whereas if 

6 you have some local people that they trust 

7 more, it -- the message is more credible, you 

8 know?

9 I mean that's a lot of what we do 

10 with the medical surveillance program was that 

11 -- this is getting off track a little bit --

12 but with the Department of Energy, they didn't 

13 have a lot of trust for the Department of 

14 Energy but they had more trust for these more 

15 neutral programs, university-based, 

16 union-based relationships.

17 And we went in with DOE which was 

18 initially awkward but you know, you sort of --

19 it was building the trust thing. So that

20 might be another way but it's all about the --

21 that's part of it. I mean I was hoping, I'd 

22 still be interested in that report, Stu, the -
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1 - you know I hear what you're saying but it 

2 seems like a big fraction of these were --

3 could be the skin cancer type things, but even 

4 that's going to be a large cost impact.

5 MR. HINNEFELD: I apologize, I'm 

6 pretty sure I have this. I got the, I got 

7 the, quote, sanitized analysis but with the 

8 caveat, and I think I got that -- I certainly 

9 got an apology when I raised the point, 

10 because hey the whole point was to make them 

11 public.

12 I got an apology but I don't know 

13 if I actually got a version that they had 

14 gotten an okay from you.

15 MR. CALHOUN: You know, we 

16 actually cover this in the workshops we do. 

17 But I think it could be improved because I do 

18 most of the workshops and dose reconstructions 

19 when it comes to overestimate and 

20 underestimate, and you know, we go all over 

21 and dose these things, and we've got union 

22 reps there and we've got DOL reps there and 
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1 we've got worker advocates there to help 

2 explain the process to people.

3 And maybe just beefing up, you 

4 know, the portion that talks about, in the 

5 overestimate section, what if my dose 

6 reconstruction goes down, just even a few 

7 slides, I think that would certainly help, 

8 because those people are there to help educate 

9 the people that come to them for help on this 

10 program, and I think that would be at least 

11 one -- it would be easy to do.

12 MR. HINNEFELD: Good, this is your 

13 action.

14 MEMBER RICHARDSON: So the other 

15 thing it relates to is how overestimates are 

16 derived right now. So, like this example of a 

17 triangular distribution where an overestimate, 

18 if the assumption for the overestimate was 

19 that you took the rightmost tail of the 

20 triangle as the value and did the 

21 reconstruction, then when you went and redid 

22 that with a best estimate approach, the dose 
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1 is going to shift much more dramatically than 

2 if you had taken a point of the mass which was 

3 more central.

4 So to the extent that there is 

5 clarification on how overestimates are done, 

6 which is in some sense still being 

7 overestimating but not being wildly 

8 overestimating, there should be less shifting 

9 of the dose upon -- I think, you know it's --

10 MR. KATZ: That was a point of 

11 conversation actually. That was exactly a 

12 point of conversation, about how do we at 

13 least moderate the overestimation so that it's 

14 not so extreme.

15 DR. MAURO: This is John. You 

16 know one of the things that came out of the 

17 skin conversation the last time we had, and I 

18 was thinking a little bit more about it, I 

19 notice when I do a dose reconstruction, most 

20 of my time is on the internal. That's the 

21 tough one. External, it seems to me a 

22 realistic estimate of external, the difference 
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1 between let's say doing an expedited analysis, 

2 a maximizing, and actually trying to do the 

3 number itself, I don't know if there's that 

4 much of a difference in the cost for that 

5 side, and that has a direct bearing, and 

6 really dominates the skin and the prostate, 

7 and I think between skin and prostate we are 

8 talking about perhaps 30 percent of all the 

9 cancers that are -- you have all the numbers.

10 I mean that's -- skin and prostate 

11 are the ones that by far dominate the cancers 

12 that people get, if you add them up. And I 

13 think those -- I think when you speak to ORAU, 

14 you may want to make a distinction, is there 

15 that much of a difference between overestimate 

16 and realistic for external exposures?

17 MR. HINNEFELD: I don't know but I 

18 know if Scott would talk or anything, I think 

19 if you really do a best estimate on the 

20 external, you Monte Carlo the dose in the DCF, 

21 don't you?

22 DR. MAURO: Yes.
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1 MR. HINNEFELD: So, I mean, you've 

2 got a Monte Carlo then built in just to get 

3 each external dose number.

4 DR. MAURO: Okay, no, if that's 

5 their experience then that's that. I know 

6 from my experience, I found the externals a 

7 lot easier.

8 MR. HINNEFELD: Well, I won't deny 

9 that externals are a lot easier. I just don't 

10 think that the efficiency -- it's not a fact 

11 that efficiency processes in external dose 

12 don't save you much time, because I think they 

13 do.

14 MR. CALHOUN: Yes, I think you get 

15 the biggest bang for you buck with externals 

16 when it comes to like, assuming missed dosed 

17 badge change-out frequencies, rather than 

18 using these and the actual number zeroes in 

19 their records, or with X-rays, instead of 

20 assuming a frequency, you just go with a 

21 number of records in their file.

22 That's my thought.
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1 DR. MAURO: Okay, it was just a 

2 thought.

3 CHAIRMAN GRIFFON: Well, so Stu, 

4 you can have this sort of version next time, 

5 right, this report?

6 MR. HINNEFELD: Oh, I'll email it.

7 CHAIRMAN GRIFFON: Okay. But it 

8 seems like, I mean, the preliminary --

9 MR. HINNEFELD: There's not a lot 

10 to gain there.

11 CHAIRMAN GRIFFON: Right.

12 MR. HINNEFELD: I mean we have 

13 taken some preliminary steps with some DOE 

14 sites that don't normally send us medical 

15 history when we send exposure requests, but we 

16 can get it.

17 CHAIRMAN GRIFFON: Yes.

18 MR. HINNEFELD: So why don't you 

19 just send it to start with so we've got the 

20 record, because that, you know, just do a best 

21 estimate on it, just count the X-rays because 

22 it's a little extra and that doesn't seem to 
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1 be a lot extra.

2 CHAIRMAN GRIFFON: I guess we --

3 yes. It might be most interesting for our 

4 discussion, the middle stuff, you know, that -

5 - not whether you can or cannot do this, but 

6 are there certain --

7 MR. HINNEFELD: And there are some 

8 things that --

9 CHAIRMAN GRIFFON: Well we might 

10 be able to -- yes --

11 MR. HINNEFELD: There are certain 

12 things that fall into that category --

13 CHAIRMAN GRIFFON: Right.

14 MR. HINNEFELD: That maybe cost 

15 two, three, a couple of million dollars or 

16 maybe out of the year, a couple of million out 

17 of the year, and that's --

18 CHAIRMAN GRIFFON: So then it's 

19 the cost benefit you know, and if you analyze 

20 that a little bit it would be useful, I think 

21 to discuss that further --

22 MR. HINNEFELD: Yes, and some 
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1 stuff, but again, I'm behind. You know, it's 

2 not like I'm staying even. I'm behind.

3 CHAIRMAN GRIFFON: Yes, and 

4 they're taking money away.

5 MR. HINNEFELD: Yes, I know, you 

6 can call them about 2015 when you call them 

7 about 2014. I don't know how it's going to go 

8 in 2014. They finished them off last year, 

9 2013, I think.

10 CHAIRMAN GRIFFON: Okay.

11 MR. HINNEFELD: The President's 

12 budget request went in okay.

13 CHAIRMAN GRIFFON: Was there 

14 anything more on that item then? I'm not sure 

15 we can --

16 MR. HINNEFELD: I don't really 

17 have much more to hand there I don't think.

18 CHAIRMAN GRIFFON: How about the 

19 DCAS follow-up on ORAU quality management 

20 system?

21 MR. KATZ: We talked about that.

22 CHAIRMAN GRIFFON: We just kind of 
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1 talked about that.

2 MR. KATZ: We did --

3 CHAIRMAN GRIFFON: I thought you 

4 didn't have it on the agenda, yes, so you kind 

5 of did --

6 MR. KATZ: I did, yes.

7 CHAIRMAN GRIFFON: So the action 

8 there is that for the next meeting Stu, do you 

9 think that we can -- we'll talk in between to 

10 figure out exactly what we'd like to see. But 

11 for the next meeting I'd like to plan some 

12 sort of -- and if you need some ORAU folks to 

13 be in attendance or whatever.

14 Alright, SC&A – oh, okay. The 

15 evaluation of sets 10 through 13. This was 

16 looking for the sort of trends or bins or like 

17 type of findings, right?

18 MR. STIVER: At the last meeting, 

19 remember, there was concern about this ever20 widening gap between our production rate 

21 what's actually being reviewed -- but I 

22 believe that we are talking about sets 7 or 8.
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1 It sparked this discussion about 

2 how best we could kind of expedite this 

3 intervening set of about four, I believe it 

4 was sets 10 through 13, and there was already 

5 discussion about how best to do that, and the 

6 conclusion was that we would bin types of 

7 findings by categories.

8 And I believe we looked at 

9 overarching scientific issues as one kind of 

10 broad category with three sub-categories 

11 within that.

12 And it really came down to looking 

13 at worker placement, basically the spatial and 

14 temporal placement of workers in their 

15 radiation environment.

16 There was development of the 

17 exposure scenario within the placement 

18 basically while potential sources and modes of 

19 exposure accounted for.

20 And within that really are sub21 headings to that or related to them, what are 

22 the appropriate models for external and 
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1 internal dose used in the analysis.

2 And then we added two other 

3 categories to this. One was quality issues 

4 basically, the things that we have been 

5 talking about today, were the TBDs properly 

6 applied, were mistakes made on the part of the 

7 reconstructor, were there shortcomings 

8 identified in the guidance documents 

9 themselves.

10 And then the final category was 

11 basically those that really didn't fit any of 

12 those other five categories, which would 

13 include replicates, findings that have already 

14 been resolved in previous discussions.

15 And so Doug went through and put 

16 all this together into a report. We looked at 

17 I believe there were about 275 findings and 

18 116 cases within those four sets.

19 And they were binned out by those 

20 categories, and I believe what was about four 

21 percent came in as a worker placement issue, 

22 about 10 percent were scenario development and 
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1 notably, what was about 28 percent were 

2 related to the selection of the external 

3 exposure models, a small fraction -- 28 

4 percent.

5 This is in the report. I believe 

6 it's the last table here. It's in the 

7 executive summary and also on page 15, there's 

8 this summary conclusion here.

9 But the executive summary lays it 

10 out, and so basically, yes, 27 percent were 

11 external, 14 percent were the internal models, 

12 12 percent were related to quality issues and 

13 33 percent actually came into this category of 

14 none of the above.

15 And so we have looked at different 

16 ways to deal with the -- how best to implement 

17 the process and the meetings, but before we 

18 get into that, I'd like Doug, who was the 

19 author of the report, to maybe give you a kind 

20 of a more detailed description of how the 

21 categories were selected and the various 

22 findings.
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1 MR. FARVER: Do you really want to 

2 know how the categories were selected?

3 MEMBER MUNN: Sure.

4 MR. FARVER: I went back and read 

5 the transcripts for the last meeting, because 

6 during the meeting, I'm sitting here thinking 

7 I haven't a clue how I'm going to do this. I 

8 went back and read the transcripts, and from 

9 the transcripts, I determined the categories, 

10 the work location.

11 We talked about exposure scenario. 

12 We talked about the dose-modeling assumptions 

13 where you break it down into internal and 

14 external, and then I threw in quality because 

15 we talk about that a lot, and just so 

16 everything tallies up, I have the other 

17 criteria.

18 So it was not an elaborate process 

19 determining the categories. Now, when you try 

20 to group these into the categories, that's a 

21 little bit more difficult. It's always a 

22 little bit subjective and I'd say in all 
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1 cases, I had to go back at least to our report 

2 that we wrote, and in many cases I went back 

3 to the DR report for the actual files, the DR 

4 files, for each finding.

5 And just because -- you can't 

6 always, just by what's written down in the 

7 finding, you can't tell what that means. So 

8 there really was an elaborate process, once 

9 you get the criteria established.

10 Then I tried to go through and 

11 give examples, you know, maybe for an external 

12 dose and an internal dose example, two 

13 examples for each type of -- each category of 

14 findings.

15 I don't know if you want me to go 

16 into details about those, or just let the 

17 folks read those.

18 MR. STIVER: You may as well just 

19 kind of go through and give them an overview.

20 MR. FARVER: Okay, so the first 

21 category is work location. And if we go to --

22 we can look at page 7, we're onto page 7, 
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1 where I give an example.

2 The work location -- the potential

3 radiological sources were not documented. 

4 This is kind of a hairy case because this 

5 talks about Oak Ridge Institute for Nuclear 

6 Studies and Oak Ridge Institute for Science 

7 and there's an odd one in there.

8 Oh, nuclear studies, which was not 

9 around very long, I don't believe. And you 

10 know, the management changes and the name 

11 changes, ORAU and ORISE.

12 And you know, to come back to our 

13 finding, we talk about well, they used doses 

14 from Y-12 and X-10, and those might not have 

15 been appropriate, might not have been the 

16 proper work location for this person, having 

17 worked at the institute for nuclear studies, 

18 worked on a facility hospital doing cancer 

19 studies.

20 So that's kind of what brought 

21 about that finding. So that raises a little 

22 question about is there -- are those the 
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1 appropriate doses to use. I don't know.

2 Example two, external dose from 

3 penetrating radiation is underestimated. And 

4 this is something we talked about earlier 

5 where you choose plant floor low, or what 

6 other value you choose from the table in 

7 TBD-6000.

8 The person's position was a motor 

9 inspector and then I believe it goes on to, 

10 there's electrician and crane operator. So 

11 there's some concern, is plant floor low the 

12 proper category or should it be plant floor 

13 high?

14 These are just two examples where 

15 work location comes into play. Now I guess 

16 you could consider that second example 

17 exposure scenario. I don't know. But I kind 

18 of grouped it into work location.

19 Move on to exposure scenario, and 

20 on page 9 I give two more examples. We talk 

21 about the CATI information, identifying 

22 uranium fires that could affect skin doses.
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1 And this goes back to the 

2 skin-dose issue, because I mean there's some 

3 particles on the skin as a result of the 

4 fires. Me, I believe this would be an 

5 exposure scenario for external dose.

6 Number two is a failure to assign 

7 external neutron dose and this almost falls 

8 into is it the right work location, but it 

9 kind of falls on the edge of whether it's a 

10 work location issue or a -- the work location 

11 is what determines the neutron dose.

12 And that's a Pinellas case, I 

13 guess there's some issues about neutron doses 

14 in Pinellas. We can go on with you external 

15 dose and a few more examples of -- excuse me -

16 - issues.

17 Incorrect accounting of medical 

18 doses. They may not have accounted for all of 

19 the exams that were listed in the dosimetry 

20 records.

21 And I pretty much just 

22 cut-and-pasted these findings from our reports 
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1 and so they may not be extremely detailed, 

2 there should be more details in the report.

3 CHAIRMAN GRIFFON: I am looking at 

4 your -- just going down your listing in the 

5 back, the appendix, well, the findings and the 

6 categories.

7 Category F interested me the most. 

8 I just glanced through and I mean, in my quick 

9 review, it seems like a lot of those had the 

10 word medical in, or the word CATI, and several 

11 other ones I thought fit into internal dose, 

12 but I am sure you the judge.

13 (Simultaneous speakers.)

14 MR. FARVER: -- for the AWE PFG 

15 medical dose, you know, we have talked about 

16 that before and I believe that's been 

17 resolved.

18 CHAIRMAN GRIFFON: Well that was 

19 my question. How --

20 MR. FARVER: This is one of those 

21 findings that's redundant, it's been resolved.

22 CHAIRMAN GRIFFON: Okay. Because 
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1 some of these, 33 percent, I mean do you know 

2 many in that other category are resolved 

3 versus just didn't fit into the bins?

4 MR. FARVER: No, I got all, and 

5 there's also, in that group, ones that are 

6 redundant, ones that had been identified and 

7 put into a bin, but I didn't repeat them and 

8 they just keep crawling in the bin.

9 I mean it's been identified once, 

10 and we're just going to throw all the others 

11 into F because if you identify it once and 

12 correct it, then I can deal with it again.

13 MR. STIVER: This is John. So if 

14 I could jump in for just a second. One of the 

15 reasons we went with this particular process 

16 was, in the interest of making these meetings 

17 a bit more efficient.

18 And while we haven't changed any 

19 of the aspects of the actual dose 

20 reconstructions and the findings and how we go 

21 about doing that, we felt that it might be 

22 more efficient for the use of the 
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1 Subcommittee's time to, instead of going 

2 through and plodding through each individual 

3 case, one at a time, for each of the different 

4 sets, and doing that, we have -- at least I 

5 have noticed during the time that I have been 

6 involved with this process -- that there's a 

7 lot of revisiting of old issues, of things 

8 that have been talked about maybe a meeting or 

9 two back and which -- our memories aren't 

10 quite up to speed yet so we end up talking 

11 about a lot of these things over again, some 

12 of which have already been resolved in 

13 different venues.

14 And so we're thinking maybe the 

15 best -- or better approach would be to look at 

16 these by -- these bins, these categories of 

17 like types of findings.

18 And so, for, say, sets 10 through 

19 13, we would just dedicate a meeting to say, 

20 looking at say, quality issues across all 

21 these various reconstructions.

22 Now we would probably have to have 
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1 some adjustments to the matrices and things as 

2 to how that was handled, the mechanics of it. 

3 But then we would have the advantage of, we 

4 could focus in on a particular topic and 

5 granted the first two or three might take as 

6 long as it would be in the conventional 

7 approach, but after that I think that it would 

8 probably go quite a bit faster. The focus 

9 would be on one particular subject, there 

10 would be a lot of similar types of issues, 

11 different aspects of the same type of problem 

12 coming up.

13 So we thought that might be a 

14 better use of the Board's time to help get up 

15 to speed to where we are kind of looking at 

16 the same sets.

17 And also, given the fact that, you 

18 know, the budgetary issues at DCAS are such 

19 that it doesn't appear to me that there's 

20 going to be more funding available for more 

21 meetings and more resources dedicated to this 

22 type of thing while the other activities are 
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1 going on.

2 So I just want to put that out 

3 there as an idea for discussion that maybe 

4 that would be a --

5 CHAIRMAN GRIFFON: Yes, and we had 

6 talked a little bit and I mean the question I 

7 would have is just, and it's hard to do this

8 in theoretical terms, but would we actually 

9 gain these efficiencies? I think if, say we 

10 are looking at sets 10 through 13, or 

11 whatever, was it -- we'll say 10 through 13 --

12 and if -- I would totally agree with this 

13 approach if NIOSH has already done responses 

14 to sets 10 through 13, and it was just the 

15 Subcommittee that was holding up, that I'd say 

16 okay let's just not, let's do it like you are 

17 saying.

18 My question is, and this is sort 

19 of directed to you guys, you know, would this 

20 process gain you efficiencies because if we 

21 have -- if we decide to take this work 

22 location one, you know we said okay, we've 
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1 found, in sets 10 through 13, there's you 

2 know, 12 cases that involve that, well, then 

3 NIOSH still has to go back and review those 12 

4 cases and their specific findings.

5 Then if we do the next bin, you 

6 are doing 13 different cases maybe, and then 

7 we might back to other findings and those 

8 original 12 cases at some point -- I'm not 

9 sure if the gains, you know, I'm not sure if -

10 -

11 MR. HINNEFELD: Well from my

12 standpoint there is a certain disadvantage to 

13 do it by group because you are going to go 

14 back and look at the same, the same case, 

15 multiple times.

16 (Simultaneous speakers.)

17 MR. HINNEFELD: I think there's an 

18 opportunity here, depending on how comfortable 

19 the Subcommittee feels, with SC&A's sorting 

20 into group F of the result, duplicate, you 

21 know, that category, in the 37 percent, to in 

22 our responses, you know, mark on the matrices 
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1 which ones are F’s and just say no response 

2 Category F, and just not worry about those 

3 particular findings.

4 CHAIRMAN GRIFFON: But that's why 

5 I was asking what Category F meant, because I 

6 think it's more than just the already been 

7 resolved, right?

8 MR. FARVER: It's others, some 

9 that I didn't feel fit into the other 

10 categories.

11 MR. HINNEFELD: Okay so it's going 

12 to be other things.

13 MR. STIVER: So there could be 

14 some other things that -- so that's something 

15 that we could probably work on.

16 CHAIRMAN GRIFFON: But if that has 

17 already been resolved -- well explain to me 

18 the duplicate. The only concern I have about 

19 thee duplicates is you get into a situation 

20 where, did it affect the case?

21 MR. FARVER: Typically it would be 

22 -- remember we talked about the Hanford 
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1 fission products?

2 CHAIRMAN GRIFFON: Right.

3 MR. FARVER: And we went and we 

4 rattled that around for, I don't know, it 

5 seemed like years. And we finally got that 

6 resolved.

7 And I think, you know, in these 

8 groups, we still have identified issues, just 

9 like for Savannah River case when there was an 

10 issue with the workbook, and --

11 CHAIRMAN GRIFFON: But when you 

12 say resolved, what was the resolution?

13 MR. FARVER: Gosh what was that? 

14 It was OTIB-54 --

15 CHAIRMAN GRIFFON: Had to be --

16 yes, OTIB-54.

17 MR. FARVER: Yes.

18 CHAIRMAN GRIFFON: So it was the -

19 - I guess what I'm getting at is just because 

20 it was resolved, if you have a case that's at 

21 49 percent and you say, oh, we have already 

22 looked at that finding, if it's got a bunch of 
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1 findings and you've got that one, you know, in 

2 aggregate they can make a difference to that 

3 case. You know what I'm saying?

4 Instead of the overall issue, I 

5 think we agree on that, that the overall issue 

6 was dealt with, but part of our mission was 

7 also to look at the cases we review, would any 

8 likely have flipped, you know?

9 So in that situation --

10 MEMBER RICHARDSON: So this is --

11 you are saying that this was the case, the 

12 case heard -- the case is an old case, there's 

13 a finding, and the issue has been resolved 

14 subsequently by a revised policy document, a 

15 change in technical document.

16 MR. FARVER: Yes, now I don't know 

17 if that triggered a PER or anything.

18 MEMBER RICHARDSON: And you are 

19 raising a question about whether that reopens 

20 your evaluation for this particular claim?

21 CHAIRMAN GRIFFON: Right, and if 

22 it did a PER or whatever, yes. That may --
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1 MR. KATZ: Then that would put it 

2 to bed.

3 CHAIRMAN GRIFFON: Right, that 

4 would put it to bed, right.

5 MR. KATZ: Because that would have 

6 been fixed.

7 CHAIRMAN GRIFFON: I'm just saying 

8 there might be a little more nuance to it. I 

9 don't disagree with the idea that we might --

10 we shouldn't have to go through them again, 

11 but --

12 MR. FARVER: Oh, I just think that 

13 if we go back and we say when we look at that 

14 issue in case, let's say, during set 11, we 

15 look at it, and we say oh well, you know, we 

16 have OTIB-54 and we have all this done and 

17 it's not going to affect this case.

18 CHAIRMAN GRIFFON: Well, that's 

19 what -- that's -- the last part is -- the 

20 point is what I'm questioning, you know?

21 MR. FARVER: Well I don't see how, 

22 how would it affect the case if it's -- what 
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1 they have been doing, they have been doing 

2 correctly? 

3 CHAIRMAN GRIFFON: Well, that's 

4 what I don't know. If you're telling me that 

5 then yes, I agree with you. If one resolution 

6 was that SC&A agrees with NIOSH and everything 

7 was okay, then yes, all these are not going to 

8 affect the case.

9 If the resolution was that NIOSH 

10 changed their protocol and it resulted in some 

11 higher doses and maybe, you know, --

12 MR. FARVER: Yes, I don't believe 

13 I have -- I think this was the case in the --

14 CHAIRMAN GRIFFON: I'm just 

15 saying, not this specific example, but in 

16 general.

17 MR. STIVER: There is one example 

18 where it could have an effect in reducing the 

19 PoC and this is what the -- this issue of 

20 whether to use PFG exam -- presumption of PFG 

21 is greater in many cases, for several examples 

22 where that one comes up, and you know the PFG, 
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1 it gets a much higher dose.

2 So because the TBD has been 

3 changed to adjust that, basically, the big DOE 

4 facilities obviously you make an assumption 

5 but not for an AWE unless it was specifically 

6 called out in some document.

7 And so in a case like that, where 

8 it might have to be reworked, there could 

9 actually be a difference in PoC. It 

10 definitely has the potential for changes to --

11 (Simultaneous speakers.)

12 MR. FARVER: Well, I don't think 

13 they typically assign PFG, and you did do, and 

14 our finding was that maybe you should and then 

15 it would resolve it and maybe you shouldn't 

16 for AWE so no, we are not --

17 MR. STIVER: So it was never the 

18 opposite when you had done it when you should 

19 not have.

20 CHAIRMAN GRIFFON: I don't want to 

21 get lost too much on this issue. I think 

22 generally it's a good idea if we can, you 
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1 know, for most of that 33 percent maybe we can 

2 just say take no further action --

3 MR. FARVER: I would think if 

4 anything, for the issue that we have resolved, 

5 it would result in higher doses, should have 

6 generated a PER.

7 CHAIRMAN GRIFFON: Should have 

8 generated a PER, yes. We might just want to 

9 flag that as we are going through this 

10 process, but otherwise we didn't --

11 MR. FARVER: Well that was my 

12 thought when I included --

13 CHAIRMAN GRIFFON: We did 

14 administratively close those --

15 MR. FARVER: We want a result 

16 because if we fixed it, and if it changed the 

17 doses, it should have triggered a PER.

18 CHAIRMAN GRIFFON: That's fine, 

19 and if your numbers are close, I mean, even if 

20 it's not the full 32 percent, if it's 25 

21 percent, you are still saving quite a bit of 

22 time, right.
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1 So I agree generally but I think 

2 you need to maybe help us break out that -- or 

3 as we are doing it, we need more nuance in 

4 that last category.

5 MR. FARVER: And it's tough to 

6 tell because you really have to go back and 

7 look at the technical documents. It's not 

8 just a matter of reading the finding and 

9 saying well gee, I don't think this fits here, 

10 because then you have to dig deeper and say 

11 well, which bin would I put it in, does it 

12 really fit in one of those, or -- and then you 

13 just find out well, it doesn't really fit.

14 DR. MAURO: Mark, this is John. I 

15 understand the conversation and I agree that 

16 it would be difficult for NIOSH to go through 

17 by these groupings. You make a very good 

18 point there. 

19 There's another perspective to 

20 this though, and it has to do with this -- you 

21 want may want to say it's part of the 10-year 

22 review concepts and improvements.
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1 Remember, the groupings were done 

2 to say okay, let's separate those types of 

3 findings where judgment was needed. For 

4 example, placement of a person in a given area 

5 or location, it was at the highest tier.

6 Everything was sort of nested and 

7 that was your starting point, and was there a 

8 judgment made here where we placed a person in 

9 a place that perhaps that person should not 

10 have been placed?

11 And this is not something that is 

12 usually laid out in the Site Profile. It's 

13 something that the dose reconstructor, as best 

14 he can tell, is going to do that.

15 And where I'm leading up to is 

16 that perhaps the value of this may not so much 

17 be in expediting the issues resolution 

18 process, but it also, by grouping this way, it 

19 sort of is a pointer, okay, with respect to 

20 let's say placing people in locations, 

21 judgments were made and we had some percentage 

22 of our findings fell into that category, and 
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1 now it gets you what you might call a root 

2 cause analysis, and it may be helpful to the 

3 Subcommittee and to NIOSH to sort of take a 

4 look at all of the places where we felt there 

5 was a problem with placing people in a 

6 location, and it might help focus in on what 

7 we need to do by way of procedures or Site 

8 Profiles etcetera, that might help preclude 

9 that in the future.

10 The same thing goes with scenarios 

11 etcetera. So maybe the value here is not so -

12 - unfortunately -- maybe the value is not so 

13 much in expediting the closeout issues, but it 

14 may lean more toward helping to focus in on 

15 improving, reducing the number of findings in 

16 the future.

17 CHAIRMAN GRIFFON: I agree with 

18 you John, but characterization is very helpful 

19 actually, so yes.

20 MEMBER RICHARDSON: So if you were 

21 to sort, like right now we moved through the 

22 cases in some sort of numerical sequence, 
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1 right? And we -- on -- you hit a case that 

2 has got some string of issues and then we hit 

3 a next record that's got a string of perhaps 

4 overlapping issues and perhaps not.

5 Is it possible to sort the cases 

6 now based on your -- we've got a sequence of 

7 cases all of which share, like, problems of 

8 class A, whatever it's going to be, whatever 

9 your grouping is.

10 But it's a series of cases which 

11 should all have only -- perhaps only suffered 

12 problems of types 1 and types 2, and we could 

13 deal with those at a meeting.

14 And we could see if we could move 

15 on to deal with those which --

16 MR. STIVER: We can kind of nest 

17 within each category -

18 MEMBER RICHARDSON: And part of 

19 what you are saying is maybe they only have 

20 these type F problems which we can -- we are 

21 just going to basically drop those out, but 

22 they might be there somewhere just suffering 
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1 type F and whatever quality control issues.

2 And we just want to deal with 

3 those, get them off the table, and then we'll 

4 be left with ones which are looking more 

5 similar. I mean your concern was that you 

6 don't want to deal with them cutting across 

7 the problems.

8 MR. HINNEFELD: To my mind, and 

9 maybe Scott could speak to this better than 

10 me, but to my mind, it's easier to deal with 

11 the case --

12 CHAIRMAN GRIFFON: Case at a time. 

13 I agree.

14 MR. HINNEFELD: And write the 

15 response for all the things, because you have 

16 to, you have to get your head into the game so 

17 as to examine what went on in this case.

18 And if you only do some and then 

19 come back to do it again, then that's several 

20 times you have to get this case familiar in 

21 your mind.

22 CHAIRMAN GRIFFON: Exactly. So if 
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1 you're familiar with the issue --

2 (Simultaneous speakers.)

3 MEMBER RICHARDSON: But now 

4 they've gone through the cases. They've put 

5 them in the bins. Can we sort them and deal 

6 with those cases which deal with one kind of 

7 set of problems, or maybe --

8 MR. HINNEFELD: Yes, if you look 

9 at a category and say there's two cases that 

10 had this one finding in this category, let's 

11 put those on the top, you know, we'll do them 

12 however you want.

13 CHAIRMAN GRIFFON: Yes, we can 

14 order them -- you can try to just do it --

15 MR. STIVER: I'm just going to 

16 like Stu has said, I mean it makes more sense 

17 if -- for this other approach to work we'd 

18 have to have -- they would have to have 

19 already gone through.

20 CHAIRMAN GRIFFON: Oh, yes.

21 MR. SIEBERT: And then we could 

22 hash them out that way.
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1 CHAIRMAN GRIFFON: That's exactly 

2 what I thought.

3 MR. SIEBERT: But yes, maybe we'd 

4 be better to look at cases that have similar 

5 issues in common for a particular --

6 CHAIRMAN GRIFFON: And then you 

7 know what, we -- I mean, we have got a history 

8 of that. We have found that by default. 

9 Sometimes we have had in our listing, several 

10 Savannah River cases in a row, and we're like, 

11 well, just like last time, you know --

12 (Simultaneous speakers.)

13 CHAIRMAN GRIFFON: And so if we 

14 try to proactively set it up that way, it may 

15 add some efficiency.

16 MR. KATZ: So then we would be 

17 choosing them in thematic sets but you would 

18 cover everything for these cases.

19 And I think that's a good sort of 

20 hybrid approach that, it's the best we can get 

21 out of the --

22 CHAIRMAN GRIFFON: Look at that, 
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1 we got consensus.

2 (Simultaneous speakers.)

3 CHAIRMAN GRIFFON: Well, before we 

4 stop on the categories though, I would offer, 

5 at least for your consideration, for the 

6 group's consideration, the one in there I 

7 understand these medical ones may, in that 

8 Category F may have been closed issues.

9 But there's several that say CATI 

10 and I know that's been a repeated theme in our 

11 findings, that the information in the CATI 

12 didn't seem to be considered an incident or a 

13 placement or a, you know --

14 MR. STIVER: That's a judgment 

15 issue.

16 CHAIRMAN GRIFFON: It's judgment, 

17 for sure, and it overlaps a little bit maybe 

18 with workplace sometimes. There's sometimes 

19 where the CATI mentioned that they had worked 

20 in a certain area and the records didn't seem 

21 to show that same location or whatever.

22 But you think, I mean, I'm just 
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1 glancing through and it seems like that's 

2 mentioned many times.

3 I don't know if that's breaking 

4 out as another theme or you know --

5 MR. FARVER: Yes, I can look 

6 closer at that other category and see if I can 

7 refine it any. 

8 MEMBER MUNN: It was kind of 

9 included in A, wasn't it?

10 CHAIRMAN GRIFFON: Sometimes work 

11 location, I think it is, but sometimes it's 

12 incidents and -- but incidents, I don't think 

13 fall in the work location necessarily.

14 MR. FARVER: Let's assume we start 

15 with Category A, we are going to have 10 cases 

16 because there have been 10 findings I'm 

17 assuming from the one per case. So let's 

18 assume we have 10 cases to look at.

19 In those cases there may be also 

20 some F's, some of the other categories. Just 

21 because I don't know exactly which cases those 

22 10 are, some of those F’s might be something 
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1 we need to address that's redundant in other 

2 cases but didn't pop up first.

3 So the first thing I would do is 

4 look at those 10 cases and see what those 

5 findings are. And then see if there's any F’s

6 in there that really should be bumped into 

7 another category and addressed now instead of 

8 oh, this is redundant but it gets addressed 

9 later on in this other case.

10 CHAIRMAN GRIFFON: And before we 

11 started thinking about this reordering, 

12 another question for your side of the shop is 

13 have they started to work on 10 yet, because 

14 that may impact our --

15 DR. ULSH: Scott, do we -- have we 

16 started on 10th set?

17 MR. SIEBERT: We have initial 

18 responses that we can start getting over to 

19 you but that's it.

20 DR. ULSH: Okay, so not really.

21 CHAIRMAN GRIFFON: Okay. So 

22 reordering them wouldn't be a big issue? 
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1 MR. HINNEFELD: It doesn't sound 

2 like it's a big disruption, right?

3 CHAIRMAN GRIFFON: I hate to like, 

4 you know, if you're almost all through the 

5 10th set, and then we -- okay. Okay. So 

6 reordering them would not be a --

7 MR. FARVER: The reason I'd take A 

8 first is because that's the smallest number, 

9 10. Start small, see how it goes because 10 

10 cases could take us quite a while.

11 MR. KATZ: This is -- just to add 

12 to this conversation, I'm just trying to 

13 think, stepping back even further and thinking 

14 about the disparity between where we are and 

15 where we want to be.

16 I mean if we wanted to get more or 

17 less caught up to, I mean, we're pretty much 

18 at sets 9 through 14, right, have been done by 

19 SC&A. There haven't really been much too 

20 much, this resolution here, I don't remember 

21 how much -- whether we've gotten much into 9.

22 MR. FARVER: I believe we got 
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1 quite a bit --

2 MR. KATZ: Okay. Okay. But 10 

3 through 14, that's five sets right there, and 

4 15 is getting -- is getting work through right 

5 now, so that'll be six sets.

6 I mean if we wanted to -- I think 

7 it would be good to aim for a date, say for 

8 example, December, end of the year, some point 

9 where we want it aimed to have got through all 

10 this mass, and then figure out what size sets 

11 and what periodicity would be, we need to meet 

12 to work through that.

13 And I think -- so in set building 

14 also, I think you want to think about not 

15 necessarily just, you know, whether it's --

16 combining sets to the extent that you keep the 

17 workload pretty even from meeting to meeting, 

18 but so it wouldn't necessarily be one set per 

19 meeting or whatever, or two sets, but if we 

20 think about this so we have, you know, now to 

21 December, what's that, nine months or 

22 whatever, if we are going to meet, whatever, 
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1 we are going to meet every six, what, eight 

2 weeks maybe, would be realistic, if we were 

3 going to try to do that, meet every eight 

4 weeks, how much do we need to get done from 

5 DCAS in responses, back to SC&A so that they 

6 can review those before a meeting.

7 If we can think about that then we 

8 can think about what resource impact that 

9 would have on you, what you would have to, how 

10 you -- how much you would have to turn the 

11 crank on ORAU to meet at this pace.

12 MR. HINNEFELD: Okay. So then 

13 that's essentially a planning exercise for us, 

14 do we -- are we going to go, it doesn't really 

15 matter, or are we not certain of our findings.

16 CHAIRMAN GRIFFON: Right. It's 

17 just more cases, right.

18 MR. HINNEFELD: So we just have to 

19 decide how fast we have to, would we have to 

20 work to get through 15 of -- set 15.

21 MR. KATZ: Well, I am throwing it 

22 out as a possible goal, get through set 15 by 
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1 the end of the year.

2 MR. HINNEFELD: By the end of 

3 December and how fast would we have to work to 

4 do this and have meetings every eight weeks.

5 DR. ULSH: It is not as clean as 

6 that because not all findings are equal.

7 MR. KATZ: No, I know but it's the 

8 best you can do, you can't -- there's no way 

9 to -- right, I mean, there's just no way to 

10 figure that out.

11 MR. STIVER: It could be a lot 

12 harder or this could go quite quickly.

13 MR. KATZ: Absolutely, no, I 

14 understand that.

15 MR. HINNEFELD: And the fact is, 

16 you know, I think the point here is that 

17 certain ones will be resolved upon our first 

18 response and a discussion, and others are 

19 going to be iterated out --

20 MR. KATZ: It would be randomly --

21 MR. HINNEFELD: It is extremely 

22 hopeful to be able to say that we will have 
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1 completed all these strung out, you know, the 

2 extended conversation by the end of December, 

3 that would be really hopeful.

4 MR. KATZ: Well, I mean I think 

5 once you look at your -- what the resource 

6 implications are, I mean, you may come back 

7 and say really, you should aim for March, or 

8 whatever.

9 But I think it would be good to 

10 actually come up with a concrete goal, and how 

11 frequently we need to meet, and what pace we 

12 are going to be delivering cases, you know, 

13 responses on cases back to SC&A, you know, and 

14 always thinking about giving SC&A at least, 

15 you know, a week and a half before meetings so 

16 that they can be prepared, when we meet, we 

17 can be prepared to resolve those cases.

18 CHAIRMAN GRIFFON: Okay, well, 

19 your resource and availability is --

20 (Simultaneous speakers.)

21 MR. KATZ: Well, that's what I'm 

22 saying.
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1 MR. HINNEFELD: We would have a 

2 planning meeting with ORAU --

3 MR. FARVER: And of these 116 

4 cases, there are probably, I don't know, maybe 

5 110 that had findings. So there were several 

6 that didn't have any findings. So that's 110 

7 cases just in these sets that you are going to 

8 have to look at.

9 CHAIRMAN GRIFFON: Ten through the 

10 14th, right?

11 MR. FARVER: Then through the 

12 13th.

13 CHAIRMAN GRIFFON: Sorry, yes.

14 MR. HINNEFELD: So that we'll have 

15 10 through 13, that's four cases, so that's 

16 two-thirds of the total that we are talking 

17 about, but it may not be two-thirds of total 

18 cases. It might be then they might be 

19 selected in detail.

20 There's not that many available 

21 for us to make a -- what the best estimate you 

22 can make when you are planning work like this, 
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1 you know, it's the same thing you have to do 

2 no matter what your plan is, so we'll make the 

3 estimate --

4 CHAIRMAN GRIFFON: And Doug, you 

5 are through the 14th -

6 MR. FARVER: We are through the 

7 14th of that set of that matrix ready to go, 

8 because we are ready to -- we'd love you Board 

9 Members to do one on one --

10 CHAIRMAN GRIFFON: A one on one is 

11 okay, we are still doing those. And the 15th 

12 set is --

13 MR. FARVER: It's half done.

14 MR. STIVER: We are more than 

15 halfway through, yes.

16 CHAIRMAN GRIFFON: Because what I 

17 was thinking is, for the 10th through 14th can 

18 you do some sort of master matrix and put them 

19 in these -- in the order you proposed to sort 

20 of work through them?

21 MR. FARVER: So 13th wasn't good 

22 enough for you?
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1 CHAIRMAN GRIFFON: I'm adding one 

2 on because you're finished.

3 MR. FARVER: What I'll do is, when 

4 I do get to 14th set --

5 CHAIRMAN GRIFFON: You can use 

6 these categories.

7 MR. FARVER: We'll break down to 

8 these categories, and I'll --

9 CHAIRMAN GRIFFON: But then 

10 reorder them and send that matrix out to all 

11 of us --

12 MR. FARVER: I'll probably do this 

13 from here on out until someone says stop. You 

14 know, every time a matrix comes out from a 

15 set, it will be grouped into the normal group, 

16 plus put into categories like you see at the 

17 back of this document. So all I'm going to do 

18 is add another table on at the end of this.

19 MR. HINNEFELD: Now, if we are to 

20 make any progress eight weeks from today, 

21 despite you know, going through our planning 

22 exercise, we'll need to know what group of 
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1 things do you want us to work on, because we -

2 -

3 CHAIRMAN GRIFFON: Well, that's 

4 why I'm saying, really without --

5 MR. HINNEFELD: We haven't sent 

6 all our responses for 9. We should finish out 

7 our responses.

8 MR. KATZ: On the way, you're 

9 doing it now, right.

10 MR. HINNEFELD: So we can do that, 

11 and then beyond that, right now, we have a 

12 listing of, Category A is what we are going to 

13 start on --

14 MR. FARVER: If that's what you 

15 want to start on, I can get you those numbers 

16 real easy.

17 MR. HINNEFELD: I mean you have 

18 already given us Category A for 10 through 13 

19 --

20 MR. STIVER: There may be some of 

21 14 in one of those --

22 MR. FARVER: But I just don't have 
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1 that ready yet, so we can start on these 10.

2 MR. HINNEFELD: So our action as 

3 of today is to start working on Category A 

4 from 10 through 13, as well as anything --

5 MR. FARVER: I can't finish the 

6 14th set until after we do the --

7 MR. HINNEFELD: That gives us the 

8 stuff to start working on now, if we already 

9 have some sort of progress going forward.

10 DR. ULSH: We've got enough to 

11 keep us busy for a few weeks. 

12 MR. HINNEFELD: We've got plenty 

13 to keep us busy, I just want to make sure 

14 we're doing it in the right order.

15 MR. KATZ: Right, but so you will 

16 be -- it'll be good for you to do that pretty 

17 quickly, your putting them in the right 

18 baskets and figuring out how much you have in 

19 each basket too, so that there's enough in the 

20 basket for the next meeting.

21 CHAIRMAN GRIFFON: Well, let's 

22 think about this. If the 14th is still 
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1 waiting for the one on ones, why don't you use 

2 submit a 10th through 13th master matrix, 

3 reorder it by these bins --

4 MR. STIVER: Rather than wait on 

5 14.

6 CHAIRMAN GRIFFON: Yes, rather 

7 than wait on 14.

8 MR. HINNEFELD: We can do that.

9 CHAIRMAN GRIFFON: No, I meant --

10 well they should reissue it, right?

11 MR. FARVER: You mean order it by 

12 which came in --

13 (Simultaneous speakers.)

14 MR. FARVER: Group A.

15 CHAIRMAN GRIFFON: Yes. Just 

16 sorting them, right, just sorting them. But 

17 reissue it just so we are all on the same, you 

18 know, we know what's going on, we aren't 

19 confused.

20 MR. FARVER: So will I send you a 

21 spreadsheet --

22 MR. HINNEFELD: Sure.
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1 MR. FARVER: And you can do the 

2 sort?

3 MR. HINNEFELD: Sure.

4 CHAIRMAN GRIFFON: Well, somebody 

5 just send it around is all I'm saying.

6 MR. HINNEFELD: Okay, so what 

7 you're looking for now is the matrix of all 

8 the findings. We're going to take this 

9 report, 10 through 13, we're going to get the 

10 Category A findings and that will help us 

11 identify the case that was linked at the time.

12 So you know, all the findings in 

13 all those cases, not just the Category A --

14 all those findings --

15 (Simultaneous speakers.)

16 MR. HINNEFELD: You'll be able to 

17 find a matrix with all the findings for those 

18 cases that then that becomes essentially the 

19 10 through 13 Category A set or something like 

20 that.

21 CHAIRMAN GRIFFON: Right.

22 MR. HINNEFELD: So, and that 
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1 becomes the matrix to work on for that. So 

2 that will give us plenty to do, as well as 

3 trying to figure out if this is even -- if 

4 this is doable.

5 MR. KATZ: Right, and I think --

6 right, no, I know, I think at the next meeting 

7 you can report on the planning and what that 

8 told you in terms of what pace is feasible.

9 MR. HINNEFELD: If I had my way I 

10 would report to the --

11 MR. KATZ: Yes. But I think that 

12 will be good. I think that will be helpful.

13 DR. MAURO: Mark, one more 

14 suggestion, if it's acceptable by way of 

15 process.

16 CHAIRMAN GRIFFON: Unacceptable.

17 DR. MAURO: I know, the idea being 

18 I noticed that many times when we are going 

19 through the individual findings, there is a 

20 miscommunication or understanding of where our 

21 finding is, and as a result, I would say a 

22 significant percent, this represents 
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1 inadequate communication of our finding and 

2 the understanding and response, would it 

3 benefit the process? I don't think it would 

4 undermine the role of the Subcommittee if, as 

5 NIOSH is looking at one of our comments, and 

6 if there's another ambiguity or uncertainty, 

7 regarding what is it we are concerned about, 

8 would it be appropriate for the author of the 

9 -- who is doing the review to talk to our guy 

10 who made the comment, just to get 

11 clarification?

12 I know that there's been a lot of 

13 these kinds of -- when we filled the matrix 

14 out and we show up at the meeting, and we'll 

15 look at it and we'll see that there was a 

16 misunderstanding, and we don't actually 

17 resolve the problem I think at the meeting, 

18 and it has to go through another iteration, a 

19 little communication beforehand may really 

20 expedite this.

21 MR. HINNEFELD: We've kind of 

22 always been okay to do that.
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1 MR. STIVER: We have done 

2 technical calls on Site Profile -

3 DR. MAURO: Yes, I wouldn't make 

4 it that formal. It would be just a matter, 

5 listen, I don't understand why you are 

6 concerned about this. Is this what you are 

7 concerned about? As opposed to making it a 

8 formal technical call.

9 If you feel that undermines the 

10 process, certainly forget about it. But I 

11 know that that would push things, that would 

12 move things very nicely.

13 MR. KATZ: I think that would be 

14 good. Mark?

15 CHAIRMAN GRIFFON: Yes, I think 

16 we're okay with that. You would be calling 

17 NIOSH not ORAU people, right?

18 DR. MAURO: Well, I would say the 

19 NIOSH folks would call us. In other words, 

20 we'd have a comment that's in the matrix.

21 CHAIRMAN GRIFFON: Right, right 

22 right.
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1 DR. MAURO: All right, and they 

2 have the report of course, but if there's any 

3 confusion or concern regarding what our 

4 problem is, you now, I don't think -- I think 

5 we'd be --

6 CHAIRMAN GRIFFON: That's useful 

7 because still we are going to have the 

8 conversation on the record, and then you would 

9 say, well, we talked to each other and our 

10 original finding, there was a bit of a 

11 misunderstanding on this and --

12 DR. MAURO: Exactly. Exactly.

13 CHAIRMAN GRIFFON: Okay, so that 

14 would just expedite the public discussion.

15 DR. MAURO: Yes.

16 CHAIRMAN GRIFFON: That's fine. I 

17 don't think it undermines --

18 MR. KATZ: And I think you're 

19 right John, I think that a lot of those 

20 instances over the years, the 

21 misunderstandings that --

22 CHAIRMAN GRIFFON: I think it's 
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1 okay, and the discussion and the final 

2 resolution is still -- still is on the public 

3 record and so we're okay.

4 DR. ULSH: So you envision a 

5 process where -- in practice it would be Scott 

6 or one of his people working on a particular 

7 finding, he comes across one that he doesn't 

8 quite understand, and he lets me know, I send 

9 it to Doug, Doug funnels it to wherever it 

10 goes on SC&A's side -- so we can copy you in 

11 on those communications if you want --

12 CHAIRMAN GRIFFON: No.

13 MR. KATZ: You can do them by 

14 phone if you want, but I just envision --

15 MR. HINNEFELD: We just need to 

16 find the right two people to talk, the person 

17 on our side and the person on their side.

18 (Simultaneous speakers.)

19 CHAIRMAN GRIFFON: That's right, 

20 because it's still going to come back here. 

21 MR. HINNEFELD: I'd be insulted if 

22 I were you, because I think your reports are 
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1 pretty clear.

2 CHAIRMAN GRIFFON: Wanda has a 

3 question.

4 MEMBER MUNN: No, I just have a 

5 statement. Gentlemen, I don't know how you 

6 expect to get a transcript out of this 

7 meeting. I really don't know how you do. 

8 Because at least 50 percent of the time, a 

9 minimum of two of you is talking at the same 

10 time, and usually it's three or more. Are you 

11 getting half of what's being said here? I 

12 don't see how it's possible.

13 MR. KATZ: Charles is really good.

14 MEMBER MUNN: No, it's just -- I 

15 just want to warn you, you know, we are trying 

16 to transcribe our proceedings and we are all 

17 talking at the same time.

18 CHAIRMAN GRIFFON: Good point. 

19 Good point.

20 MEMBER MUNN: My other concern is 

21 whether there are going to be punitive damages 

22 if we don't meet this goal that was set here. 
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1 I'm always afraid we're going to be locked in 

2 the meeting room through -- over New Year's 

3 Eve.

4 (Simultaneous speakers.)

5 MR. KATZ: All options are on the 

6 table.

7 DR. MAURO: I like change of --

8 CHAIRMAN GRIFFON: And I thought 

9 Wanda was going to make a motion to take 

10 lunch, but --

11 MEMBER MUNN: I would be very 

12 pleased to be the person to step forward and 

13 suggest that we break for lunch.

14 CHAIRMAN GRIFFON: Are we -- I 

15 think we are done with that topic -- we have a 

16 path forward so -- okay. Let's take that 

17 break.

18 MR. KATZ: Thank you everyone on 

19 the line and we'll hook back in with you at --

20 what time is it now?

21 MEMBER MUNN: About 10 after.

22 MR. KATZ: Okay, so about 10 after 
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1 one. 

2 CHAIRMAN GRIFFON: Ten after one, 

3 yes.

4 (Whereupon, the above entitled 

5 matter went off the record at 12:10 p.m. and 

6 resumed at 1:10 p.m.)

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23
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1 A-F-T-E-R-N-O-O-N S-E-S-S-I-O-N

2 (1:10 p.m.)

3 MR. KATZ: Good afternoon. 

4 Advisory Board on Radiation and Worker Health, 

5 Dose Reconstruction Review Subcommittee. We 

6 are just reconvening after lunch.

7 Let me just check on the line, 

8 specifically for Board Members. Dr. Poston, 

9 are you back with us?

10 (No response)

11 MR. KATZ: Okay. How about John 

12 Mauro, are you with us, and Scott Siebert?

13 DR. MAURO: Yes I am still here.

14 MR. KATZ: Great.

15 MR. SIEBERT: Yes, I am too.

16 MR. KATZ: Great. Okay. Mark.

17 CHAIRMAN GRIFFON: Okay. The next 

18 item on the agenda is, and Ted, you might have 

19 to help me with this, other items related to 

20 NIOSH 10-year review. I'm not sure what we 

21 mean by --

22 MR. KATZ: I just wasn't 100 
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1 percent sure that I would have caught 

2 everything that --

3 CHAIRMAN GRIFFON: Oh, okay.

4 (Simultaneous speakers.)

5 MR. KATZ: Open door.

6 MR. HINNEFELD: Well, we talked 

7 about the items, I mean the quality items from 

8 the 10-year review were the -- how come your 

9 system doesn't find it, and that's what we're 

10 going to be talking about, and then work with 

11 the DR Subcommittee, essentially it's just 

12 work with the DR Subcommittee to continue the 

13 effort on evaluations.

14 And it also wants us to continue 

15 to focus on timeliness.

16 CHAIRMAN GRIFFON: Timeliness.

17 MR. HINNEFELD: It's just one of 

18 the things on there. We can write a report on 

19 timeliness, I can tell you that we are getting 

20 claims out within nine months. We are getting 

21 the bulk of them out quicker than that.

22 We could run, if you want to see 
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1 what's the average age of the cases we 

2 completed last quarter or the quarter before, 

3 we can do that.

4 CHAIRMAN GRIFFON: You've looked 

5 at some of that from the past. You can show 

6 improvement, too, right, on --

7 MR. HINNEFELD: Oh, certainly. 

8 Oh, certainly. So, I mean --

9 MR. CALHOUN: We're getting to the 

10 point now where it's steady state truly, and 

11 we are not going to be able to improve much 

12 more getting them out any sooner, just because 

13 we have got to wait for data to come back and 

14 things like that --

15 CHAIRMAN GRIFFON: Right. A 

16 certain fixed time --

17 MR. KATZ: So like, at the last 

18 meeting you had said you would like a little 

19 report on that on timeliness, but do you, do 

20 you want something more concrete?

21 MR. HINNEFELD: I mean we can 

22 provide -- see the thing about it is there are 
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1 a lot of ways to present it, like I said. We 

2 can present annual age or average age of the 

3 ones we have completed. We could give you the 

4 distribution of the claims that are with us 

5 now in terms of how old they are. There are a 

6 few older ones on there because there's the 

7 surrogate data we are still putting to bed.

8 CHAIRMAN GRIFFON: I mean I think 

9 it might be useful just to update your NIOSH 

10 update to the Board as something along those 

11 lines --

12 MR. HINNEFELD: Okay.

13 CHAIRMAN GRIFFON: -- that looks 

14 at that timeliness and you know, we briefly 

15 discussed it here, but you know --

16 MR. HINNEFELD: We can send some 

17 information between now and the next --

18 MR. KATZ: Well, you can just then 

19 make it as a presentation, part of your 

20 program update for the Board Members --

21 MR. HINNEFELD: All right. But I 

22 don't have to start through here -
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1 MR. KATZ: And let it be 

2 independently --

3 MR. HINNEFELD: All right.

4 CHAIRMAN GRIFFON: I think that's 

5 fine.

6 MR. KATZ: That takes care of that 

7 then.

8 CHAIRMAN GRIFFON: And I think 

9 that was -- the only other thing I have on 

10 other factors in the 10-year review was the 

11 degree of claimant-favorability. I mean this 

12 is a fuzzy one. But wasn't that brought up 

13 with --

14 MR. HINNEFELD: Yes, the idea was, 

15 well, we say we are claimant-favorable, but we 

16 don't really try to quantify it or there's no 

17 real example.

18 And it's not just an example 

19 because we have got a lot of examples of 

20 claimant-favorable approaches, but really how 

21 favorable are these approaches.

22 I don't know we've got much on 
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1 that. But yes. That didn't actually come out 

2 of the DR set of the 10-year review, but it 

3 was -- came out of a different piece and was 

4 assigned to the Subcommittee as I recall.

5 So I don't think we've got 

6 anything to share on that right now. But if 

7 something will -- the 10-year review is like 

8 everything else, you know, these are all good 

9 ideas but unfortunately we've got jobs.

10 MEMBER MUNN: How can you evaluate 

11 that?

12 CHAIRMAN GRIFFON: I know. That's 

13 what I was just going to ask. Do you have any 

14 ideas --

15 MR. HINNEFELD: Well, we're pretty 

16 creative. I'd have to just go back and think 

17 about it a little bit, but if we were to --

18 I'm just thinking on the fly. I mean, we 

19 could have probably a range of favorability or 

20 pick a handful of claimants, you know, 

21 sampling of claimants and say that we did an 

22 overestimated missed dose on, and in this case 
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1 that approach was favorable by this amount.

2 I mean I don't, I don't know and I 

3 don't know if it's really down to an 

4 overestimating thing or if it's to -- I guess 

5 I'm going back a little bit, and I'm not --

6 it's not familiar enough to me to really 

7 remember now exactly what the point was.

8 It came out of the quality of 

9 science review I'm pretty sure. So I have to 

10 go back and see where it came from and what 

11 exactly the wording is.

12 I kind of thought at one time I 

13 had an idea that we might be able to do 

14 something, but right now, I don't remember 

15 well enough to be able to say.

16 CHAIRMAN GRIFFON: Yes. I would 

17 think it would be less on the overestimating 

18 cases and more on the best estimate cases 

19 where you know that there's an inherent 

20 uncertainty in the sites and how claimant21 favorable are we, is NIOSH, in those cases?

22 I mean I think that, it seems to 
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1 me that that would be more of the concern and 

2 I guess if you are overestimating, who cares 

3 how overestimating you are, or I mean, if you 

4 are --

5 MR. HINNEFELD: Yes, you're right. 

6 I think you are probably right. When you say 

7 we make a claimant-favorable decision, these 

8 are the best estimates. But you know --

9 CHAIRMAN GRIFFON: Right.

10 MR. HINNEFELD: How much really --

11 how claimant-favorable is that really. 

12 CHAIRMAN GRIFFON: Right. I think 

13 that would be more the issue because, you 

14 know, if you're overestimating, you're saying 

15 we're not quite claimant-favorable enough, we 

16 are going to be more overestimating, you are 

17 still don't get compensated.

18 So I don't think that's -- I don't 

19 think that's the rub. I think the question 

20 would be more on the closer cases, the cases 

21 on borderline compensability, right? Wanda?

22 MEMBER MUNN: One of the things 
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1 that I don't believe is understood outside of 

2 the confines of the agency and the contractors 

3 and the Board, is the extent to which 

4 uncertainties are added to the claimant's 

5 known or estimated dose.

6 It seems very few people 

7 understand that they are given credit for this 

8 fairly significant list of uncertainties that 

9 are not the way most people think about 

10 numerical results.

11 They just don't think about 

12 numerical results as incorporating 

13 uncertainties that have been credited to them. 

14 It seems that if we are going to try to make 

15 some kind of quantification, that it might be 

16 of some benefit to identify how many of those 

17 types of added doses are granted to claimants 

18 because of uncertainties. Don't know whether 

19 that's feasible or not, but it's certainly one 

20 of the unknowns to most claimants, I think, 

21 and their families.

22 MR. HINNEFELD: I'll take all this 
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1 on advisement and get back to you.

2 CHAIRMAN GRIFFON: Yes. Because 

3 even on some of the internal dose stuff, I 

4 mean, I know there's some assumptions about 

5 the GSD. We had lots of discussions around 

6 the table about that, on previous cases that 

7 we've been through, so --

8 MR. KATZ: I think it's a very 

9 complex question because some of it is 

10 procedure-specific that cuts across sites, and 

11 some of it is site-specific and it will be 

12 pretty different from site to site, what the 

13 factors are that are claimant-favorable, that 

14 are applied to dose reconstructions for that 

15 site, so I think it's a pretty difficult 

16 question to handle monolithically.

17 CHAIRMAN GRIFFON: It is. It is.

18 MR. HINNEFELD: Well, we'll just 

19 have to do some more studies. Fortunately 

20 it's in the quality of science review so we've 

21 documented the draft --

22 CHAIRMAN GRIFFON: And yes, and 
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1 since it's coming from the quality of science 

2 review, I mean, I think it would be more 

3 focused on these tools, like IMBA, how much 

4 built-in claimant-favorability is there in 

5 these models, like Wanda said, for when you 

6 are putting in the uncertainty, are, you know, 

7 how generous are they.

8 MEMBER RICHARDSON: The other way 

9 of doing it is to possibly start peeling off 

10 some of those things and examine how sensitive 

11 the Probability of Causation estimate is to 

12 those.

13 CHAIRMAN GRIFFON: Right.

14 MEMBER RICHARDSON: It's not, I 

15 mean -- it's not even obvious to me what the 

16 answer to that is. I mean, because the 

17 uncertainties are symmetrical, they are -- by 

18 saying they are uncertain it means that over 

19 some iterations of the Monte Carlo draws, you 

20 are pulling values less than the value as well 

21 as values that are different, and a lot of the 

22 distributions aren't proper distributions, I 
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1 mean, the triangles are something like that, 

2 but they don't have long tails, so I don't 

3 even have a good intuition for, I mean, you 

4 know, going into this program I thought, given 

5 how many uncertainties, how many factors all 

6 had uncertain distributions around them, I 

7 thought, well, everybody will be compensated.

8 I mean, just, you know, this --

9 you layer these on top of each other, on top 

10 of each other, I was imagining things with 

11 tails layered on top of tails on top of tails 

12 and drawing the 99th percentile of it, seemed 

13 like it should, but it doesn't.

14 So I don't, I don't understand 

15 clearly if you would take -- start to pull 

16 these apart, which ones actually have leverage 

17 and which ones don't.

18 MEMBER MUNN: Well, if you don't 

19 understand it, then there are very few people 

20 in the outside world who would. But I think -

21 -

22 MEMBER RICHARDSON: I think it's 
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1 because a lot of those triangles, instead of 

2 normal distribution, I think that's part of 

3 the story at least. 

4 MEMBER MUNN: I only suggested 

5 that because I thought it would be instructive 

6 for people to know that there are multiple 

7 factors that are decided in their favor. I 

8 don't think they know that and I don't expect 

9 them to understand it.

10 But if they understand that there 

11 are a half a dozen or more factors that had a 

12 decision point, each of which was made in 

13 their favor, that it might be helpful.

14 One can't predict what's going to 

15 be helpful and isn't, I don't think.

16 CHAIRMAN GRIFFON: Well, you 

17 probably have to take, I mean, look at this 

18 internally. I know Jim Neton has looked at 

19 that exact question that David was raising in 

20 the past.

21 MR. HINNEFELD: Yes.

22 CHAIRMAN GRIFFON: Because we have 
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1 had that discussion, and what's the 

2 sensitivity of this. So, alright. But just, 

3 so that's another topic that we shouldn't 

4 forget on our other 10-year review issues.

5 MR. HINNEFELD: Okay.

6 CHAIRMAN GRIFFON: And maybe you 

7 can -- at the next meeting of the --

8 (Simultaneous speakers.)

9 MR. HINNEFELD: We'll do some stuff 

10 and see what we can do for the next meeting.

11 CHAIRMAN GRIFFON: The next topic 

12 is the seventh to ninth sets, but I'm going to 

13 skip that for a second and go to the last 

14 topic, which is preparing the second Board 

15 report, which was brought up at the last Board 

16 meeting that we should -- this Subcommittee 

17 should consider having a second report to the 

18 Secretary on our, you know, the status, where 

19 we are.

20 I mean, right now we, we reported 

21 on the first through the fifth sets, and at 

22 this point we have the sixth set done. We 
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1 reported one through five, right? Yes. So we 

2 have the sixth set and the seventh and ninth -

3 - seventh is almost done I believe, and maybe 

4 today it will be.

5 And, you know, so I am wondering 

6 if -- I think we might want to at least wait 

7 until the ninth set until we get through that 

8 group.

9 And another thing we might want to 

10 think about is, for the next meeting, I will 

11 pull out our last report and circulate that, 

12 just so people get a sense of what we 

13 reported.

14 But we may -- I mean, I would 

15 actually lean toward not reporting necessarily 

16 that same format. You know, it may not be 

17 that instructive, especially if we are finding 

18 there are some kinds of -- I think, in the 

19 last four sets we have had similar kinds of 

20 findings and similar -- so it may not be as 

21 instructive. We might want to think about 

22 what we can say at this point, you know, from 
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1 our current work, and then also maybe just the 

2 status of what the continuing work is, and if 

3 we can report on anything that NIOSH has done 

4 since our last report came out, you know, I 

5 think we might want to include that.

6 So I don't know if anybody has 

7 thoughts on this report idea.

8 MEMBER MUNN: I would certainly 

9 agree with postponing it and I also agree with 

10 your observation with respect to, not 

11 necessarily the format, but probably the 

12 content, what we look at and what we do has 

13 changed significantly since the early days.

14 We have many more procedures in 

15 place and many more workbooks and a much more 

16 formalized structure than we had at the 

17 outset, and I would anticipate that our 

18 progress therefore would be of a different 

19 type from what we've had before, although I'm 

20 sure that the metric will be -- how many cases 

21 have you done?

22 CHAIRMAN GRIFFON: Yes, yes.
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1 MEMBER MUNN: It seems logical to 

2 wait until we close a couple of these 

3 outstanding matrices.

4 CHAIRMAN GRIFFON: Right, I'd hate 

5 to report three years later that we got 

6 through another 20 cases, set 6.

7 MEMBER MUNN: Let's do better than 

8 that.

9 CHAIRMAN GRIFFON: Yes, we can do 

10 better than that. But in the meantime, I 

11 think this may be, if people can think about 

12 what we might want to have in that report, 

13 I'll circulate the previous report, maybe that 

14 will generate some ideas or thought.

15 And the other thing we should 

16 probably keep in our minds is the 10-year 

17 review report. Maybe that will spur some 

18 ideas on what we might want to report on as 

19 well. I don't know if people have thoughts 

20 right now, but I'm just planting the seed that 

21 we should start to think about developing that 

22 report.
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1 MR. KATZ: The previous report 

2 should be on the website too.

3 CHAIRMAN GRIFFON: So we don't 

4 have to circulate it.

5 MR. KATZ: I don't think you have 

6 to circulate it. I think you can find it 

7 under Board recommendations or correspondence, 

8 wherever. Somewhere on the website. It should 

9 be there, I think, because that was a formal 

10 transmission to the Secretary.

11 MEMBER MUNN: It might be nice to 

12 forward the website URL so that we won't have 

13 to all go trying to find it. The copies that 

14 I have were in bits and pieces, you know, as 

15 we got them.

16 CHAIRMAN GRIFFON: Yes, I should 

17 make sure -- yes. Oh, and for the final 

18 transmitted copy, we want to circulate that.

19 MS. LIN: Mark, did you just say 

20 that you are going to include the progress --

21 the results of the 10-year review in the 

22 report to the Secretary?
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1 CHAIRMAN GRIFFON: No.

2 (Fire alarm interruption.)

3 CHAIRMAN GRIFFON: To respond to 

4 Jenny's question, I don't think we are 

5 reporting on what you have done in response to 

6 the 10-year review. That's separate.

7 MS. LIN: Okay, good.

8 CHAIRMAN GRIFFON: You know, but I 

9 think we should consider what was brought up 

10 in the 10-year review, in terms of maybe we 

11 should address these similar issues that were 

12 brought out in that. That's all I'm saying.

13 MS. LIN: Okay.

14 CHAIRMAN GRIFFON: Yes. Okay. 

15 It's going to take us a few minutes anyway to 

16 pull up the cases, sets seven through nine. 

17 I'm probably going to need some help on the 

18 distribution that was done.

19 But if we're ready, let's delve 

20 into the -- John, how did you describe this? 

21 Pulling through the cases, or trudging --

22 MR. STIVER: Plodding.
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1 CHAIRMAN GRIFFON: Plodding. 

2 That's the right word. Plodding through the 

3 matrices. 

4 MR. STIVER: I can get us off to a 

5 fast start.

6 CHAIRMAN GRIFFON: Well, first of 

7 all, Brant, before you get us off to a quick 

8 start, tell us which files, because I have a 

9 bunch of Word documents that came through.

10 DR. ULSH: The seventh -- there 

11 was kind of a seventh set matrix.

12 CHAIRMAN GRIFFON: But I have 

13 several seven things here listed. Brant, can 

14 you read the whole file name, sort of?

15 DR. ULSH: Well, the seventh 28 

16 case matrix 12-19-2011 NIOSH for March 2012 

17 meeting, dot doc.

18 CHAIRMAN GRIFFON: Seventh case 

19 matrix 12-19-2011, that one?

20 DR. ULSH: Yes.

21 CHAIRMAN GRIFFON: I just have 

22 several that say "seven case matrix."
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1 DR. ULSH: There should be one that 

2 says NIOSH for March 2012.

3 CHAIRMAN GRIFFON: NIOSH for March 

4 2012, okay, got it.

5 MEMBER MUNN: This is 1/21 through 

6 1/48.

7 CHAIRMAN GRIFFON: Alright.

8 DR. ULSH: I can make this pretty 

9 quick. There are three remaining items that 

10 are open, at least on our side. I think you 

11 guys don't have any.

12 MR. STIVER: We don't have any 

13 open on our side.

14 DR. ULSH: And all three of those 

15 depend on revision of the Aliquippa Forge TBD, 

16 so you are going to see the same response in 

17 there, that that TBD is currently under 

18 revision but it hasn't been accomplished yet, 

19 so we can't close it until that happens.

20 CHAIRMAN GRIFFON: And the other 

21 thing we may do, just in thinking of our 

22 report coming up, you know, if we have 
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1 something like this on the seventh, eighth and 

2 ninth set, I think we can say we reviewed this 

3 many cases and skip over the cases that are 

4 just hanging out there.

5 DR. ULSH: Scott, do you know the 

6 timeframe on issuing that revision?

7 MR. SIEBERT: I believe it is in 

8 internal review over here right now. Outside 

9 of that, I can't really say. I don't know if 

10 Mutty has gotten back on the line or not.

11 CHAIRMAN GRIFFON: Okay. We'll 

12 leave it on hold for now. It's in the process.

13 (Simultaneous speakers.)

14 MEMBER MUNN: 1/21 again.

15 CHAIRMAN GRIFFON: So I took all 

16 that time finding that and --

17 DR. ULSH: I was going to say, you 

18 have some work finding it.

19 CHAIRMAN GRIFFON: We probably 

20 should have let you just --

21 DR. ULSH: The next one will be 

22 even harder.
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1 CHAIRMAN GRIFFON: Now, the eighth 

2 set which -- I see an eighth set responses 

3 3/22/2012 but that might not be it.

4 MR. HINNEFELD: This one is saying 

5 NIOSH eight case matrix, it says working 

6 draft, and the right hand side says NIOSH 

7 March 2012.

8 CHAIRMAN GRIFFON: The other may 

9 be Doug's response -- it would be two 

10 different files for this.

11 MR. HINNEFELD: Doug's, I don't 

12 know if Doug has put his responses on top of 

13 ours or if you put them in a different --

14 MEMBER MUNN: You have 1/49 and 

15 1/78 and 1/66.

16 MR. HINNEFELD: Okay.

17 CHAIRMAN GRIFFON: I think you 

18 sent them on different --

19 MR. HINNEFELD: He used a 

20 different starting point.

21 CHAIRMAN GRIFFON: When you did 

22 your responses, Brant, you put them in the 
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1 matrix that I had sent out from the last 

2 meeting?

3 DR. ULSH: It's a --

4 CHAIRMAN GRIFFON: Because just in 

5 terms of me updating that --

6 DR. ULSH: It's an excerpt from 

7 your matrix that only includes the items that 

8 are open for us.

9 CHAIRMAN GRIFFON: Oh, okay.

10 MR. STIVER: We did the same 

11 thing. It's just an excerpt.

12 CHAIRMAN GRIFFON: All right.

13 MR. FARVER: Now, I sent a file 

14 out yesterday and that has our responses to 

15 your recent responses. In other words, it's 

16 that one that you sent out in March this year.

17 DR. ULSH: The 22nd maybe.

18 MR. FARVER: I got some responses 

19 back for that one.

20 (Simultaneous speakers.)

21 MR. FARVER: But I can just talk 

22 you through them --
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1 CHAIRMAN GRIFFON: And, Doug, that 

2 file is called eighth set responses 3/22/2012, 

3 is that it?

4 MR. FARVER: That is other 

5 responses. So you'll need that within a 

6 minute.

7 CHAIRMAN GRIFFON: Okay.

8 MR. SIEBERT: This is Scott. I 

9 don't believe I have received Doug's, so if 

10 someone could forward that one from yesterday, 

11 that would be helpful.

12 MR. FARVER: We don't really need 

13 them. It's not that much responding to --

14 MR. HINNEFELD: All right. Well, 

15 I'm not doing anything, Scott, this is Stu, 

16 I'll send it to you.

17 MR. SIEBERT: Okay. That's fine, 

18 thanks.

19 DR. ULSH: I don't know if I got 

20 it either. You sent it yesterday?

21 MR. FARVER: I thought you 

22 received it.
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1 MR. HINNEFELD: I don't remember 

2 seeing it. Now I'm trying to find it.

3 DR. ULSH: I'm not showing any 

4 email from Doug yesterday.

5 MEMBER MUNN: Well, let me see what 

6 mine says.

7 MEMBER RICHARDSON: It was 1:59 

8 p.m. on Tuesday. 

9 DR. ULSH: Yesterday or Tuesday?

10 MEMBER RICHARDSON: Tuesday at 

11 1:59.

12 MR. FARVER: I did send one on 

13 Tuesday. I did send one yesterday.

14 DR. ULSH: The one yesterday was 

15 the responses to their --

16 MR. HINNEFELD: Hang on. Who else 

17 needs it? Okay, right now I am sending it to 

18 Brant and Scott. This is the one from 

19 yesterday morning.

20 MS. K. BEHLING: Excuse me, this 

21 is Kathy Behling, and I didn't receive that 

22 either.
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1 MS. LIN: Does it have Privacy2 Act-protected information?

3 MR. HINNEFELD: Well, let's see. 

4 We try to avoid it in these things.

5 MR. KATZ: It has the tabs.

6 MR. HINNEFELD: Well, it has the 

7 tab numbers but those don't relate to 

8 anything.

9 MS. LIN: Well, we are trying to 

10 find a way to actually account for people's 

11 information --

12 MEMBER RICHARDSON: That's fine. 

13 I don't -- just send it to everyone.

14 MR. FARVER: I can do it verbally. 

15 It's really not that much information. 

16 CHAIRMAN GRIFFON: All right, I 

17 think let's just -- let's just proceed and you 

18 can tell us the responses.

19 (Fire alarm interruption.)

20 (Whereupon, the above-mentioned matter went 

21 off the record at 1:36 p.m. and 

22 resumed at 1:39 p.m.)
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1 CHAIRMAN GRIFFON: We're going 

2 back on the record now. Sorry, on the phone, 

3 we had a little fire drill thing here. Okay, 

4 so I'm --

5 MEMBER MUNN: You said it was two 

6 files and I only see one.

7 MR. FARVER: No, that was one file 

8 from yesterday. It's two files on Tuesday.

9 CHAIRMAN GRIFFON: I am trying not 

10 to violate Wanda's rule.

11 MEMBER MUNN: That is not my rule. 

12 That's a common sense rule. We want a 

13 transcript here.

14 CHAIRMAN GRIFFON: It is, right. So 

15 can we work from the -- I have the eighth 30 

16 case matrix working draft, December 19, 2011, 

17 NIOSH from March 2012 meeting document. 

18 Correct. Okay.

19 DR. ULSH: All right. The first 

20 item on there is 149.1, and basically the 

21 status is we are still continuing to work on 

22 that. We haven't closed that yet.
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1 CHAIRMAN GRIFFON: Okay.

2 DR. ULSH: Unless there's any 

3 objections, I'll just walk through and you can 

4 stop me when you want to.

5 149.2, basically we are committing 

6 to include a 50th percentile option in the 

7 next revision of the TBD.

8 MR. FARVER: SC&A has no further 

9 response since you are just closing the issue.

10 CHAIRMAN GRIFFON: Let's not get 

11 too quick here. 149.2, you said you were 

12 revising what?

13 DR. ULSH: The TBD.

14 CHAIRMAN GRIFFON: And how does 

15 that affect the case? No further --

16 MR. SIEBERT: This is one where --

17 this is Scott -- where we used the 95th 

18 percentile because it was a one size fits all 

19 TBD and it's a nurse, and it was discussed 

20 that maybe that was too high for the 

21 individual, so from a point of view of what 

22 would it do to the case, it would only reduce 
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1 the dose in this instance.

2 CHAIRMAN GRIFFON: And so you are 

3 just revising the TBD to have better guidance 

4 on it, on the model selection or whatever?

5 DR. ULSH: Yes, to include a 50th 

6 percentile option. It doesn't have that in 

7 there now.

8 CHAIRMAN GRIFFON: Okay. Are we 

9 okay with that?

10 MR. KATZ: Closed? 

11 CHAIRMAN GRIFFON: Closed.

12 DR. ULSH: All right, 149.3 is 

13 another one where we have not closed it yet, I 

14 mean we have not resolved it yet.

15 And 149.5 is another one where we 

16 are going to include the 50th percentile.

17 CHAIRMAN GRIFFON: And SC&A, 

18 that's the same response?

19 MR. FARVER: Same response. 

20 Suggest closing it.

21 DR. ULSH: All right. 149.6, same 

22 thing, we are including a 50th percentile.
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1 MEMBER MUNN: And the same 

2 response?

3 MR. FARVER: Same response. 

4 Suggest closing it.

5 DR. ULSH: Should we keep going, 

6 Mark? Are you keeping up?

7 CHAIRMAN GRIFFON: Let me just 

8 catch up with that. That was 149.6, right?

9 MR. KATZ: Yes.

10 CHAIRMAN GRIFFON: Okay. All 

11 right. Go ahead.

12 DR. ULSH: All right. The next 

13 one is 153.6 and the newest development is 

14 that we agree with SC&A's finding. We have 

15 reviewed OCAS-TIB-7 and we don't see the 

16 necessity for a revision.

17 The problem with this case was 

18 that the guidance in the TBD was not followed, 

19 not that the TBD was deficient in some way.

20 CHAIRMAN GRIFFON: So that is 

21 153.6 and --

22 DR. ULSH: Yes.
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1 CHAIRMAN GRIFFON: So NIOSH is 

2 saying no changes. It was just -- so you're 

3 agreeing that a mistake was made following the 

4 guidance, right?

5 DR. ULSH: Yes, so the latest 

6 action item from December 19th, 2011, was that 

7 -- yes. So the remaining action item for us 

8 was to check and see whether OCAS -- I think 

9 it should be OCAS-TIB-7 -- needed to be 

10 revised.

11 So we have done that now and our 

12 judgment, at least, is that it does need to be 

13 revised.

14 CHAIRMAN GRIFFON: And SC&A?

15 MR. FARVER: There is no further 

16 response and suggest closing the issue.

17 CHAIRMAN GRIFFON: And it is 

18 closed. All right, 153.7.

19 DR. ULSH: Same answer.

20 CHAIRMAN GRIFFON: Same answer.

21 DR. ULSH: Yes.

22 CHAIRMAN GRIFFON: Okay
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1 DR. ULSH: All right, sadly, we 

2 are not going to be able to go as quickly 

3 through the next one. 161.2, our latest 

4 response is that we have provided some more 

5 discussion on the use of OTIB-2 for a Hanford 

6 thyroid case. It was attached as a separate 

7 file.

8 And OTIB-2 overestimated the dose 

9 to the thyroid in this case, based on the 

10 actual data that we determined from a later 

11 rework.

12 I assume that you are going to 

13 want to discuss this in a little more detail. 

14 Scott, do you want to walk us through that?

15 MS. BRACKETT: This is Liz. I 

16 think I was going to do this one.

17 DR. ULSH: All right. 

18 MS. BRACKETT: Since it was 

19 internal dose and OTIB-2.

20 DR. ULSH: Wait, before you get 

21 started, Liz, it was a separate file. Do you 

22 want some time to pull that file up?
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1 MS. BRACKETT: Are you asking me 

2 or everybody there?

3 DR. ULSH: I'm asking everybody in 

4 the room. It's called SC&A 161.2 March 2012.

5 MEMBER MUNN: I think you have a 

6 hard copy of it, don't you?

7 CHAIRMAN GRIFFON: I see a SC&A 

8 161.2?

9 DR. ULSH: Yes, March 2012.

10 CHAIRMAN GRIFFON: Got it, okay. 

11 Go ahead, Liz.

12 MS. BRACKETT: Okay. Well, the 

13 first part of the comment said that it's hard 

14 to believe 202 millirem is maximizing dose for 

15 22 years. We can provide comparison 

16 calculations.

17 I think that there must have been 

18 a paragraph missed when reading that. That is 

19 only the assessment for the one positive 

20 bioassay result. There was a positive 

21 cobalt-60 result and that was the dose from 

22 assessing that.
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1 But in addition, OTIB-2 was 

2 assigned, which brought the total to 5.503 

3 rem. The document, I believe, says 5.705. 

4 That was a misinterpretation on my part of the 

5 paragraph. I added the 202 but it was already 

6 included.

7 So -- but the actual total 

8 internal dose was 5.5 rem that was assigned. 

9 So there was some discussion about -- besides 

10 that, the appropriateness of OTIB-2.

11 It didn't -- it doesn't -- well, 

12 OTIB-2 has been cancelled since this was done. 

13 That was done about a year ago and we 

14 discussed that in the Procedures Subcommittee. 

15 But it was based on the assumption that 

16 intakes above a certain level would have been 

17 detected by a bioassay or workplace 

18 monitoring. This person was monitored 

19 throughout his career, but his results, aside 

20 from that one cobalt-60, were not positive.

21 So that's why OTIB-2 was applied, 

22 and there is an iodine-131 intake included. 
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1 Since this was a thyroid cancer, that would 

2 have been important to consider iodine.

3 So this case was reassessed as 

4 part of the plutonium Super S PER a few years 

5 ago, and when the reassessment was done, the 

6 next dose was done based on all the bioassay, 

7 rather than applying OTIB-2 again, and so in 

8 that case, the total dose assigned was only 

9 1.93 rem, and that included missed doses for 

10 plutonium, iodine-131, mixed fission products 

11 and strontium-90, as well as the addition of 

12 coworker dose because he had no bioassay 

13 results for the last two years of employment, 

14 so coworker dose was assigned for that 

15 timeframe.

16 So part of the comment said: 

17 please provide comparison calculation, so 

18 these would be an appropriate set of 

19 comparisons. So the original dose assigned 

20 was 5.5 rem using OTIB-2 as an overestimate, 

21 and then, based on the individual's bioassay 

22 data, the total dose was 1.9 rem.
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1 CHAIRMAN GRIFFON: So did you get 

2 a chance --

3 MR. FARVER: Yes, well, the 

4 finding came from the fact that they used the

5 OTIB-2 when the employee had bioassay data, in 

6 vitro data from '94 to 2005, and in vivo data 

7 from 1983 through 2005, but they didn't use 

8 it.

9 So that's what constituted the 

10 finding. Okay? I guess along the way, things 

11 got a little convoluted, and when I mentioned 

12 that the 202 millirem was kind of hard to 

13 believe for over 20 years of monitoring, I was 

14 referring to the cobalt-60, where the employee 

15 was monitored from '83 to 2005, and when NIOSH 

16 did their calculations, well, I guess the 

17 employee has part of the cobalt-60 whole body 

18 count in 1985.

19 So really, that 200 millirem is 

20 from '83 to '85, covering two years, so it's 

21 really not over 20 years. The rest of the in 

22 vivo measurements were below detection limit.
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1 So that's why there was a little 

2 bit of confusion there. It really wasn't over 

3 20 years. It was over two years.

4 MEMBER MUNN: That makes better 

5 sense.

6 MR. FARVER: Yes, I mean, that's a 

7 more reasonable number for over two years. So 

8 that was kind of the confusion in that, 

9 because -- and I'm not sure -- did we 

10 determine that OTIB-2 was appropriate to use 

11 here, or should you have used the bioassay 

12 data? I know you finally did use it, but is 

13 it okay to use OTIB-2 in a situation where you 

14 actually have the bioassay data?

15 CHAIRMAN GRIFFON: OTIB-2 is no 

16 longer in effect, right?

17 MS. BRACKETT: Right.

18 MR. FARVER: Suggest we close this 

19 issue.

20 CHAIRMAN GRIFFON: The only 

21 question I would have is whether -- I mean, 

22 there might still be a valid question for old 
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1 cases that we haven't looked at, you know.

2 MR. FARVER: It could be if it 

3 comes up again, depending on when OTIB-2 got 

4 cancelled and --

5 MS. BRACKETT: Right, it was just 

6 cancelled, I believe last year.

7 CHAIRMAN GRIFFON: Right. So 

8 there were a lot of cases that had used it for 

9 decisions, right? I mean --

10 MR. FARVER: Is it okay to do that 

11 when there's bioassay data available?

12 MR. HINNEFELD: Well, I guess our 

13 preference would have been that no, you 

14 wouldn't do it, although you know, since it's 

15 in the past, you know, the use of it was in 

16 the past. So changing something now, you 

17 know, we can't change anything now back.

18 MR. FARVER: It's only if it would 

19 somehow affect other cases that have been 

20 done.

21 MR. HINNEFELD: But if it were --

22 unless there's some evidence that TIB-2 wasn't 
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1 sufficiently on --

2 CHAIRMAN GRIFFON: Right. That 

3 would be the question. Is it claimant4 favorable in all cases and if so --

5 MR. HINNEFELD: You know, if it's 

6 claimant-favorable in all cases, you know, and 

7 the fact that maybe at some point in the past, 

8 when we had bioassay data, we used TIB-2, and 

9 why didn't you use bioassay data --

10 CHAIRMAN GRIFFON: Right.

11 MR. HINNEFELD: Some said we 

12 should have used bioassay data. We're not 

13 going to do anything about it now, since we're 

14 not using TIB-2 now.

15 MS. BRACKETT: I think that OTIBs 

16 2 and 18 have sometimes been used in cases 

17 where there's bioassay data but everything is 

18 less than detection limits, because the basic 

19 premise of them is that -- both of them -- is 

20 that if there had been something there, that 

21 the levels that are in there are such that 

22 they would have been detected by the bioassay 
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1 method, and so the dose reconstructors would 

2 use this as, to -- as an efficiency method to 

3 overestimate what the dose would have been 

4 from less than detectable levels were, and 

5 then add on top of that anything that is 

6 positive, like this one did for cobalt-60.

7 I don't think that that would be 

8 encouraged now, the, you know, the dose 

9 reconstructors should be using the results, 

10 but that has been done in the past. If 

11 everything is less than detection limits and -

12 -

13 DR. MAURO: Liz, this is John 

14 Mauro here. OTIBs 2 and 18, are those the 

15 ones that sort of key into the NPCs at the 

16 time? Some fraction of the maximum 

17 permissible concentration?

18 MS. BRACKETT: Yes, well OTIB-2 

19 was based on maximum permissible body burden.

20 DR. MAURO: Okay. Now, and when 

21 it was used, at the time it was used, was that 

22 used as a maximizing approach?
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1 MS. BRACKETT: Yes, this is a 

2 maximizing approach.

3 DR. MAURO: Okay, and so people 

4 were, in theory, anyone where OTIB-2 was used, 

5 in theory, should have been denied, or do I 

6 have it wrong?

7 MS. BRACKETT: I believe that's 

8 the case.

9 DR. MAURO: You can understand why 

10 I raised the question. If it was used in the 

11 past, and people were granted, and now it's no 

12 longer being used and a different technique is 

13 being used and people are being, under the new 

14 method, are being denied, it creates a strange 

15 circumstance when you make such a transition, 

16 and I'm not quite sure what the NIOSH or the 

17 Board's posture is when these situations 

18 arise.

19 MS. BRACKETT: Well, I'm not clear 

20 -- I'm not sure I understand what you are 

21 saying. But this has all been covered at 

22 length in the procedure review. We have gone 
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1 over OTIB-2 and OTIB-18 and the transition 

2 from one to the other and old methods, new 

3 methods.

4 DR. MAURO: If I'm a cobalt case, 

5 you can understand why I raised the question, 

6 though?

7 MR. HINNEFELD: OTIB-2 is, was 

8 only for denial --

9 DR. MAURO: Okay, and that solves 

10 the problem.

11 MR. HINNEFELD: -- a single acute 

12 intake has -- and now that they are 100, like 

13 110 DAC hours of combined radionuclides. So 

14 it was this large intake.

15 CHAIRMAN GRIFFON: Overestimating 

16 approach.

17 MS. K. BEHLING: This is Kathy 

18 Behling. In fact, there's a statement in 

19 OTIB-2 that specifies that this is only to be 

20 used for maximizing cases and not for 

21 compensation.

22 DR. MAURO: Thank you. I wasn't 
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1 aware of that until I asked the question. 

2 Thank you.

3 MR. FARVER: So we should be okay.

4 CHAIRMAN GRIFFON: Yes. So what 

5 do, just to track this, what do I put?

6 DR. ULSH: Closed.

7 CHAIRMAN GRIFFON: Closed. That's 

8 short and sweet. I'll just put that NIOSH 

9 provided an assessment and SC&A is okay with 

10 it.

11 DR. ULSH: All right. The next 

12 one that we have is 161.3 and if you look over 

13 at the resolution column, I think we have 

14 already all agreed that it's a QA issue, and 

15 SC&A agrees that it would not have affected 

16 the compensation decision. The outstanding 

17 part was for us, NIOSH, to check and determine 

18 whether the directive to include this in the 

19 dose reconstruction report predates the 

20 assessment date for this case.

21 We have looked for it high and low 

22 and we simply cannot find that record.
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1 MR. HINNEFELD: I can't find the 

2 email I sent over, it goes back. I mean, that 

3 has to go back five, six, seven years, and I 

4 just, I just couldn't find, couldn't find it.

5 MEMBER MUNN: Have you looked in 

6 the cloud? I'm sorry. I shouldn't be making 

7 --

8 MR. FARVER: Should we send one 

9 out now just for completeness, saying just to 

10 reiterate, so that there is something on the 

11 record that -- so that this won't come up 

12 again?

13 MR. HINNEFELD: Well, I don't 

14 know, something we're not doing, something we 

15 haven't done for, let's see, let me think.

16 MR. FARVER: I mean this is our 

17 old issue of including CATI information into 

18 the DR report. Well, I mean, I don't know 

19 what, what should we do so we don't keep 

20 bringing this up over and over?

21 CHAIRMAN GRIFFON: So we just --

22 yes, I remember the letter, I mean, I even 
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1 think you provided it to the Board.

2 MR. HINNEFELD: I think so.

3 CHAIRMAN GRIFFON: We just can't 

4 get our hands on it.

5 MR. HINNEFELD: Well, you know, 

6 who knows what happened? I haven't been able 

7 to find it. It was -- I sent it over, I'm 

8 pretty sure I sent it to Jim Griffin who is 

9 the Deputy Director for ORAU, and it was 

10 instructions about making sure that all the 

11 information that is mentioned in the CATI is 

12 mentioned in the dose reconstruction even if 

13 it can't possibly have anything to do with the 

14 dose, like, a lot of the CATIs, they'll 

15 mention chemical exposures that they had.

16 So, but be sure to indicate to the 

17 person that we read your CATI and we paid 

18 attention to your CATI that lists everything 

19 in there. So I did it, like I said, I did it 

20 years ago, and I just couldn't come up with 

21 it.

22 I don't know. I don't, I don't, I 
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1 personally don't see a lot of point to go send 

2 an email to ORAU saying, hey, remember to do 

3 this, when as far as we know they won't do 

4 anything.

5 MR. FARVER: I am trying to 

6 prevent this from happening again, us bringing 

7 up this finding. If we had a date, we could 

8 say we're not going to bring it up after, you 

9 know, DRs that were completed after this date, 

10 because -- or before this date because that's 

11 before the directive. But I don't have that 

12 one point.

13 (Simultaneous speakers.)

14 MR. HINNEFELD: Because for -- you 

15 know, so you find, if you review an old case 

16 that was -- or you -- okay, so I see what you 

17 are saying. If you find a case where it was 

18 done after that date, then you would have 

19 found an error.

20 MR. FARVER: Right.

21 MR. HINNEFELD: Well, the best I 

22 can hope for, if you want to do something like 
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1 that, is pick an arbitrary date, it had to be 

2 -- it had to be some time at -- no later than 

3 two thousand, what, seven?

4 If you've got one that was in 2008 

5 or later, if it was done in 2008 or later --

6 MR. FARVER: So we'll say, January 

7 1, 2008, anything before that?

8 MR. HINNEFELD: Yes, anything 

9 before that, don't worry about anything after 

10 that, then we'll have to kick our contractor 

11 for not doing what we told him to do.

12 CHAIRMAN GRIFFON: When was this 

13 case done? So it doesn't look awkward in the 

14 matrix if I put that date.

15 MR. SIEBERT: This was 2006. This 

16 is Scott.

17 MR. KATZ: I would pick a later 

18 date than that, because it really doesn't 

19 matter, the practice has changed, it doesn't 

20 matter even if you found it in a 2008 case. 

21 So --

22 CHAIRMAN GRIFFON: Right, that's 
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1 true.

2 MR. FARVER: Well, it does because 

3 if they have issued a directive saying to 

4 include it in recent cases, and the quality 

5 included it -- then it doesn't matter. I mean 

6 it does matter.

7 So if you want to use January 1, 

8 2008, that's fine.

9 MEMBER MUNN: Sounds good.

10 MR. HINNEFELD: I think that's a 

11 safe date. I think I'm pretty sure I must have 

12 sent it by then.

13 CHAIRMAN GRIFFON: Okay. So we'll 

14 close it then. There's no sense in going on.

15 MR. FARVER: Oh, no no, that's 

16 fine.

17 DR. ULSH: All right. Move on?

18 CHAIRMAN GRIFFON: Yes.

19 DR. ULSH: Okay. The next one is 

20 164.1.

21 MS. K. BEHLING: Excuse me Brant?

22 DR. ULSH: Yes. 
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1 MS. K. BEHLING: This is Kathy 

2 Behling. I -- you know, correct me if I'm 

3 wrong here, but we had some comments on tab 

4 160 and I know if you want to go back to those 

5 when you're through with it, or if you wanted 

6 to discuss those now. I know you're --

7 MR. SIEBERT: This is on the 

8 rework --

9 MS. K. BEHLING: Yes.

10 MR. SIEBERT: You are talking 

11 about?

12 MS. K. BEHLING: Yes.

13 CHAIRMAN GRIFFON: Let's just do 

14 it later Kathy. Let's work through this one 

15 set --

16 MS. K. BEHLING: Okay, all right. 

17 I'm sorry.

18 CHAIRMAN GRIFFON: Okay. Thank 

19 you.

20 DR. ULSH: Okay, 164.1 I think is 

21 the next one. The outstanding action item was 

22 for NIOSH to verify that the workbook was 
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1 corrected, and the response we provided here 

2 is that the tool was replaced in February of 

3 2010 so that tool issue was resolved.

4 CHAIRMAN GRIFFON: Brant, you said 

5 that the workbook was corrected. When?

6 DR. ULSH: February 8, 2010. And 

7 the revision number is there in the response 

8 too if you want it.

9 MR. FARVER: What about cases 

10 prior to that that used the incorrect date, 

11 the workbook with the errors.

12 MR. SIEBERT: This is Scott. If 

13 you look at the previous discussions from the 

14 Board, from the dose committee, it would have 

15 resulted in an overestimate and no PER would 

16 be needed.

17 MR. STIVER: That was the building 

18 in of the 1.3 factor.

19 CHAIRMAN GRIFFON: Okay, so that 

20 was the only thing we asked, right, to close 

21 that out, so no further action. Okay?

22 DR. ULSH: All right 165.1 is the 
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1 next one. Let me see if there's anything from 

2 the resolution column. NIOSH will accept 

3 those cases through PER process. And in our 

4 latest response, I think we agree that a PER 

5 will be necessary and will be conducted. It's 

6 a rather lengthy response. You can read 

7 through it in more detail there if you want 

8 to. But I think we are all in agreement that 

9 we need to do a PER.

10 CHAIRMAN GRIFFON: Did you -- I 

11 don't know how you work with this -- but did 

12 you number that PER yet, did you assign a 

13 number? Just for tracking purposes I thought 

14 it might be useful.

15 DR. ULSH: I don't think so. I 

16 think that will be assigned once we get the 

17 PER.

18 CHAIRMAN GRIFFON: Alright. I 

19 don't think we have any further action on 

20 this, on this finding, am I right? If they 

21 are doing a PER that sort of closes it out for 

22 this.
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1 MR. FARVER: Which one are we on 

2 again, sorry?

3 DR. ULSH: We're on 165.1.

4 MR. FARVER: Okay. The only 

5 comment I want to make is that the INL 

6 specific workbook was used to calculate 

7 electron doses for the BCC and the SEC 

8 cancers. The complex-wide workbook was used to 

9 calculate the bladder dose, and we will talk 

10 about the complex-wide one with bladder dose 

11 in a couple of findings.

12 This was all with electron doses, 

13 because this was the INL workbook we were 

14 talking about.

15 CHAIRMAN GRIFFON: Oh okay, I see 

16 what you were saying. So it doesn't address 

17 the other side of that, is that your concern?

18 MR. FARVER: Well, I'm going to 

19 talk about the bladder cancer later and it was 

20 done with a different workbook, which also has 

21 some issues. I'm not sure why one, you know, 

22 why they used a complex-wide and didn't use an 
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1 INL-specific for all of them.

2 MR. SIEBERT: This is Scott 

3 Siebert. I can address that. Based on the 

4 fact that skin cancers use a fixed DCF of one, 

5 the normal workbook can be used for skin 

6 cancers because you didn't have to do Monte 

7 Carlo calculations based on the DCF 

8 distribution.

9 Once you went to the bladder 

10 cancer, you have to do the Monte Carlo 

11 calculation and there just was not a specific 

12 Monte Carlo best estimate tool for INL at that 

13 time, so the best -- the complex-wide best 

14 estimate tool had to be used for non-skin 

15 cancers.

16 DR. ULSH: Makes sense.

17 MEMBER MUNN: That is a good 

18 answer.

19 CHAIRMAN GRIFFON: So we are okay 

20 on that one.

21 MR. FARVER: We are okay on that. 

22 We'll go talk about the bladder cancer in a 
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1 couple of findings.

2 CHAIRMAN GRIFFON: Alright.

3 MEMBER MUNN: So we leave that --

4 is that closed because of the PER?

5 CHAIRMAN GRIFFON: Yes.

6 MEMBER MUNN: And his response.

7 MR. FARVER: Yes.

8 CHAIRMAN GRIFFON: 165.2 then, is 

9 that where we are?

10 DR. ULSH: Yes, 165.2, we have the 

11 same answer as the previous one. Is this the 

12 bladder cancer one or is that one later?

13 MR. FARVER: No, that's the next 

14 one.

15 DR. ULSH: All right.

16 CHAIRMAN GRIFFON: Okay. Go 

17 ahead.

18 DR. ULSH: All right. 165.3. 

19 This is the bladder cancer one I guess, and I 

20 don't know Doug, do you want to explain -- you 

21 had concerns about the latest response?

22 MR. FARVER: Yes, this comes down 
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1 to where it was dividing by 1.6 for the bias 

2 and -- which was basically, you know, division 

3 by two so it cuts the dose in half.

4 And I still think it's a workbook 

5 error, and the reason I think that is, when 

6 you open the workbook, the first thing that 

7 pops up is this little pop-up that says 

8 external dose calculation descriptions, and it 

9 describes the, and it has the equation and 

10 describes, it's in the equation, and at the 

11 end of the equation, it's divided by 1.6.

12 And I don't think the dose 

13 reconstructors are going to bother to go in 

14 and change all those descriptions if it's 

15 something that the dose reconstructors just 

16 entered on the fly.

17 MR. SIEBERT: Which version of the 

18 tool are you looking at? The one that we --

19 MR. FARVER: I'm looking at the 

20 one that was provided with the files of the --

21 MR. SIEBERT: So you're looking at 

22 the one that was used for the case?
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1 MR. FARVER: Yes.

2 MR. SIEBERT: Okay. We went back 

3 and we looked at a clean copy from that 

4 timeframe, it did not appear that factor is in 

5 the clean copy, so it appears the dose 

6 reconstructor took that, probably just added 

7 that as a factor on one year and then just 

8 copied it on straight down, because they 

9 thought it was appropriate.

10 MR. FARVER: Well, how would it 

11 show up in the little pop-up that says, 

12 "External dose calculation descriptions?" 

13 How's it going to show up there unless he 

14 changes it and puts into each one of those 

15 descriptions?

16 If you go into the case files and 

17 open up this workbook, the first thing you get 

18 is this annoying little pop-up. And then at 

19 the end of every equation, you divide by 1.6. 

20 And then you go into the workbook and look, 

21 and all those equations are divide by 1.6.

22 So it was in the workbook. And 
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1 this goes back to my other concern, is I am 

2 not confident that these workbooks are being 

3 QA'ed, you know, and that there's any good 

4 quality control on these workbooks, if they're 

5 going to put out the correct answer, or have 

6 the correct equations.

7 Now, from my understanding, 

8 there's a QA program that will talk to QA 

9 Excel to make sure Excel adds and subtracts 

10 like it's supposed to, but I don't know of any 

11 process that's in place that assures that if 

12 you put in a certain number it will calculate 

13 using correct equations and give you a correct 

14 answer.

15 And this was all the workbooks. I 

16 don't know that that's being done. But in 

17 this specific case, I don't see how the dose 

18 reconstructor's going to go through and change 

19 all that.

20 MEMBER RICHARDSON: So is your --

21 can you help me understand, is your concern 

22 about the pop-up, the pop-up box and it as 
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1 documentation of what was done, or is it about 

2 the expression, the equation used to calculate 

3 dose?

4 MR. FARVER: Well, the equation is 

5 incorrect, because it's dividing by the bias. 

6 So that's wrong. And you know, right now, in 

7 their response, it says well, we have looked 

8 at a clean copy and the clean copy was correct 

9 so the dose reconstructor must have went in 

10 and put that divide by 1.6 for some reason.

11 And I'm saying, I don't think he 

12 did that. I think it was programmed into the 

13 workbook because this little pop-up comes up 

14 and that's where anything that tells you that 

15 it describes -- divides by the bias. And I 

16 don't think -- you know, I've seen dose 

17 reconstructors will go in and they'll change 

18 an equation, but usually they don't put a

19 comment up there.

20 But they're not going to go back 

21 and change all the descriptions and things. 

22 It just doesn't make sense to me.
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1 DR. ULSH: All right. So what we 

2 have is the workbook that was provided with 

3 this case is incorrect, in the manner that 

4 Doug described. We also have an example where 

5 ORAU went back and looked at what they're 

6 calling a clean copy and did not see that in 

7 there.

8 Those are the facts. Anything 

9 else is just speculation about how it got, how 

10 that one associated with this case got to be 

11 that way.

12 We are speculating that the dose 

13 reconstructor change that you are saying, you 

14 don't see that being plausible. My question, 

15 then, is how do we move forward and close this 

16 issue? Do you want us to look at more cases?

17 MR. HINNEFELD: Here's some things 

18 we should do, find out when this case was 

19 done. And is this an INL case?

20 DR. ULSH: It's -- yes.

21 MR. HINNEFELD: Okay. So you go 

22 always, either side in time, from this time, 
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1 look for other INL cases and for the tool that 

2 was used, and look at that tool, look at the 

3 tool in those --

4 MR. FARVER: Well, it wouldn't 

5 even have to be INL-specific, complex-wide --

6 MR. HINNEFELD: This is complex7 wide. Okay, so it's a complex-wide tool, so 

8 you know, you're right, you can use any of 

9 them that used this tool, any claims that used 

10 this tool, and see whether the bias is 

11 included in others as well, and then the other 

12 thing, beyond that, is how could it have 

13 occurred that a clean copy of this tool says 

14 one thing but one that's presented, which 

15 apparently is the same version of the tool, 

16 says something different. How did that 

17 happen, if this is a one-time case, and if 

18 this is the only one we find like this, then 

19 maybe in some way the dose reconstructor did 

20 it all, odd as that may sound.

21 MR. FARVER: What threw me was at 

22 that top level --
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1 MR. HINNEFELD: Yes.

2 MR. FARVER: The description --

3 MEMBER RICHARDSON: So could we 

4 look at two things though, because one is why 

5 do you want to move off time, instead of 

6 moving on to another case that used the 

7 complex-wide workbook on the same day? And 

8 ideally --

9 MR. HINNEFELD: Well, if you have 

10 understanding, what I meant to say was that 

11 close in time, if it's the same data, it's 

12 fine.

13 MEMBER RICHARDSON: And can you 

14 have it by the same dose reconstructor?

15 MR. HINNEFELD: Your available 

16 sample is pretty small.

17 MR. SIEBERT: This is Scott. It's 

18 probably unusual that we would have 

19 specifically one right in that timeframe, 

20 especially from the same dose reconstructor, 

21 because this is an unusual circumstance that 

22 we have to use a complex-wide tool for INL 
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1 because it's only when we had to do the best 

2 estimate external portion of the case, knowing 

3 the fact that we did not have a best estimate 

4 INL tool at the time, the dose reconstructors 

5 would reduce as many other factors as they 

6 could, so they didn't have to try to use the 

7 complex-wide tool at that time.

8 So I'm not saying it's impossible 

9 by any means, you can even look --

10 MEMBER RICHARDSON: I guess what I 

11 am wondering is, did this dose reconstructor 

12 break the tool and use a broken tool, or did, 

13 you know -- or was the whole, was the tool 

14 broken throughout the shop and everybody was 

15 using it? And it could be either of those, 

16 since we don't know what happened.

17 MEMBER CLAWSON: Doug, is that 

18 going to answer the question about the book, 

19 workbooks not being QA-checked, or --

20 MR. FARVER: That's a whole other 

21 standard, this one's just kind of --

22 MR. HINNEFELD: But in this case, 
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1 even if the -- if the workbook, when it came 

2 out had been appropriately QA’ed and came out 

3 perfectly and then it was modified in some 

4 fashion, you know, this is -- this may or may 

5 not be a QA or a worksheet issue. This might 

6 be a sort of a version issue.

7 DR. ULSH: So is the action item 

8 then for us to go look right around this 

9 timeframe and see if we can find more cases 

10 that use this tool and verify that they're 

11 correct or --

12 MR. HINNEFELD: Or not, find out 

13 if they're not, right.

14 CHAIRMAN GRIFFON: I guess that's 

15 the best we can do.

16 MR. SIEBERT: Well, this is Scott, 

17 I'm sorry. That is a bunch of work which I 

18 obviously have no problem doing. I'm just 

19 wondering if it might be more useful to send 

20 the clean copy to Doug that we found first, 

21 because I don't know for sure, but something 

22 in the back of my mind, I believe those pop-
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1 ups are driven by what's in the cells, so it 

2 would depend on what's in the cell as to what 

3 shows up in the pop-up.

4 It may save us some time to give 

5 us the clean copy first, and then, you know, 

6 determine whether we need to move forward the 

7 rest.

8 MR. HINNEFELD: That may, that may 

9 help put Doug's mind at rest, but I don't know 

10 that it helps mine a whole lot.

11 CHAIRMAN GRIFFON: So you are 

12 saying if the cell is altered, these are pop13 ups are tied in programmatically, with the 

14 program, right? And --

15 MR. SIEBERT: That may be the 

16 case. I seem to recall that might be the 

17 case, but I just can't speak for sure.

18 CHAIRMAN GRIFFON: Right, right, 

19 right. I mean you have it in front of you. 

20 Can you modify the cell right now and see if 

21 it adds a pop-up?

22 MR. SIEBERT: I don't have it 
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1 right in front of me --

2 CHAIRMAN GRIFFON: Oh, okay.

3 MR. SIEBERT: Yes, I would like 

4 our tool guys to take care of that for me. I 

5 apologize.

6 CHAIRMAN GRIFFON: Okay.

7 MR. HINNEFELD: Well, okay, for a 

8 starting point go ahead and send Doug the 

9 clean tool. But we need to talk, Grady, I 

10 don't know if you're paying attention or not, 

11 but we need to talk next week about this, 

12 because this -- this causes me a little 

13 concern.

14 So we'll carry on. It's to the 

15 nature of what I said, you know, you have a 

16 tool that apparently a clean version of this 

17 tool says one thing, and a tool that was used 

18 in this case uses others.

19 There's a chance that the guy who 

20 did this one case is the one that, quote, 

21 broke it. And it was -- he picked up a clean 

22 one and broke it. Or it could be a case that 
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1 a broken one was out there and available for 

2 people to pick up because they had them --

3 (Simultaneous speakers.)

4 CHAIRMAN GRIFFON: I mean, in my 

5 mind it raises questions of do you have 

6 certain fields that you -- that are locked, or 

7 that the dose reconstructor cannot --

8 MR. HINNEFELD: Well, I wouldn't 

9 even go that far, I mean, there may be cases 

10 where you want to be able to give the dose 

11 reconstructor the ability to do some things 

12 like that --

13 CHAIRMAN GRIFFON: Well that's why 

14 I said certain but --

15 MR. HINNEFELD: The key element in 

16 here is that whenever you get this tool, you 

17 get it from the same place and nothing changes 

18 the thing you get. You always get a purer one 

19 when you get it. That's the key thing that 

20 has to happen.

21 DR. ULSH: Yes, I think what 

22 Scott's saying is that that number might be 
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1 fed by some value in the cell.

2 MR. FARVER: And if that's true, 

3 that's okay.

4 CHAIRMAN GRIFFON: All right well 

5 that's a good --

6 MR. FARVER: But you can 

7 understand my concern. If you look at that, 

8 it looks like all that's in there correctly 

9 and -- and -- but if it's -- if this changes 

10 with -- when you change equations, then that's 

11 a different story.

12 DR. ULSH: So we are going to send 

13 you the clean copy.

14 MR. FARVER: You might want to 

15 just have your people check and see if 

16 changing their equation changes the dose 

17 calculation corrections.

18 DR. ULSH: Okay, so we will check 

19 that and send out an email to you and to the 

20 Subcommittee about that. Did you get that 

21 Scott?

22 MR. SIEBERT: I am writing 
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1 furiously. Yes, I did.

2 DR. ULSH: Okay good, and then 

3 we'll have further conversations, Stu, with 

4 ORAU, about whether we want them to look 

5 further to see if this might be a more 

6 widespread issue on this too.

7 MR. FARVER: Of course the other 

8 issue is why wasn't that caught before and 

9 things like that, you know.

10 MEMBER RICHARDSON: So does your 

11 workbook, the copy you have, has -- I guess 

12 where does it have information on the version? 

13 Is that just the date on which the file was 

14 created, or is there a --

15 MR. FARVER: It's up in the title. 

16 It says, "External tool 141.0."

17 MEMBER RICHARDSON: So there's no 

18 -- there's no indication there -- the naming 

19 of it hasn't changed despite the fact that the 

20 content of it is different than the version 

21 1.10 which they are going to send you, is the 

22 clean one?
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1 MR. FARVER: Well, they usually --

2 the name usually has the case number tacked on 

3 the end of it, so it will be external tool 

4 1.10-018627, which is the case number.

5 MEMBER RICHARDSON: But it has --

6 it has a date created on it? And that's the 

7 date that the case was handled?

8 MR. FARVER: I don't know.

9 MEMBER RICHARDSON: Okay. I was 

10 just trying to think through if there's a way 

11 you could figure out if a person is starting 

12 with a clean copy each time or begins revising 

13 off-of something else, or maybe not.

14 DR. ULSH: Hey, Scott?

15 MR. SIEBERT: Yes.

16 DR. ULSH: I'm not sure if you are 

17 going to be able to answer this off the top of 

18 your head, but let's say I'm a dose 

19 reconstructor and you know, I've got let's say 

20 three Idaho claims that I'm going to try to 

21 get done today, and I start with an Idaho 

22 tool. Is there anything that instructs the 
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1 dose reconstructor to start with a clean copy 

2 of the tool for every case, or is it possible 

3 that I could make whatever changes, like maybe 

4 this one on the first claim, and then just 

5 kind of copy it over and use it for the next 

6 one?

7 MR. SIEBERT: Well, we -- I can't 

8 tell you that procedurally we are told to do 

9 that, however the managers have beaten the 

10 snot out of their people to tell them to use a 

11 new tool every time you start a case, just 

12 like you look at NOCTS every time you start a 

13 case, to make sure you are getting the latest 

14 information.

15 So the short answer is, could it 

16 occur? Sure. But it is -- certainly -- our 

17 displeasure would certainly be known rather 

18 rapidly upon that dose reconstructor.

19 DR. ULSH: It doesn't answer the 

20 question necessarily, but it just gives you a 

21 little bit of --

22 MR. STIVER: So at least you know 
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1 what the policy is, whether it was implemented 

2 --

3 DR. ULSH: Exactly.

4 MEMBER MUNN: It pains me to even 

5 point this out, but this leaves us with what I 

6 see as even the larger, global question, with 

7 respect to QA of the software.

8 CHAIRMAN GRIFFON: Yes.

9 MEMBER MUNN: I have no idea, and 

10 I don't know that we've discussed this in the 

11 Subcommittee, this specific issue of --

12 CHAIRMAN GRIFFON: V&V of the 

13 tools --

14 MEMBER MUNN: Yes --

15 CHAIRMAN GRIFFON: Yes.

16 MEMBER MUNN: For the software 

17 issues, for the tools. Do we have anything 

18 that we could point to?

19 DR. ULSH: Well, we owe you a 

20 discussion of ORAU's QA/QC procedures. Why 

21 don't we make -- would this be an appropriate 

22 time -- to do a V&V of tools?
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1 MEMBER MUNN: It certainly would.

2 MEMBER RICHARDSON: And you don't 

3 use -- because those tools are proprietary, 

4 right? So when you are doing blind --

5 DR. ULSH: No, we have --

6 MEMBER RICHARDSON: Oh you use the 

7 tools.

8 MR. KATZ: The proprietary that's 

9 not -- NIOSH buys them.

10 MEMBER RICHARDSON: So that, so 

11 the blind review doesn't allow you to --

12 you're not using a site determined tool.

13 DR. ULSH: Correct.

14 CHAIRMAN GRIFFON: Okay, so 

15 overall then that's a good idea in that 

16 discussion, and let's move on from this case 

17 for now. Let's get an action to follow up on 

18 that tool.

19 DR. ULSH: All right are we on --

20 CHAIRMAN GRIFFON: And 165.4, is 

21 that it?

22 DR. ULSH: Point four, okay. 
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1 Where we left this was SC&A believes this is a 

2 workbook error. And we were going to look at 

3 it further.

4 We have provided a rather lengthy 

5 response. Scott, do you want to walk us 

6 through that?

7 MR. SIEBERT: Sorry, I'm scrolling 

8 through 14 different things here.

9 DR. ULSH: Page 15 of 30, 165.4.

10 MR. SIEBERT: Yes, yes. Okay. 

11 Basically, and this is once again getting back 

12 to the complex-wide tool, and the fact that 

13 when a dose reconstructor is using a complex14 wide tool for a specific site, they need to be 

15 very careful, just like we're saying.

16 The dose reconstructor did include 

17 the correction factor of 2.2 in the correct 

18 column, however the complex-wide tool was not 

19 designed to apply that to missed dose.

20 INL is one of the very few sites 

21 across the complex where you would find the 

22 correction factor two missed dose as well as 
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1 measured dose.

2 So the issue is the fact that the 

3 complex-wide tool did not apply that.

4 MR. FARVER: Okay, now we are 

5 talking about missed neutron dose to the skin. 

6 And remember, this is where we use the INL 

7 workbook and the skin dose.

8 So that's what I'm saying, it's 

9 not even a complex-wide best estimate tool. 

10 It's the INL tool that's in question. And it 

11 did not apply the factor of 2.2 to the missed 

12 neutron bladder doses.

13 MR. SIEBERT: I've got to go back 

14 to the original finding here.

15 MEMBER MUNN: So that -- the 

16 calculation was based on the dosimeter report, 

17 right? This was a dosimeter correction 

18 factor, not just a site-wide correction 

19 factor.

20 MR. SIEBERT: Okay, in the 

21 original finding, SC&A states that NIOSH 

22 multiplied the number of zero cycles by the L 
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1 of V over two, the organ DCF, the ICRP-60 

2 correction factor and the dosimeter correction 

3 factor of 2.2.

4 So we actually did apply it to the 

5 skin for missed dose, and that was done in the 

6 INL tool which is appropriate. I'm finished 

7 in case anybody --

8 MEMBER MUNN: There's a lot of 

9 circular thought going on --

10 CHAIRMAN GRIFFON: Here is what I 

11 propose. Here's what I propose. We take five 

12 minutes, except for Doug, and we give him a 

13 chance to think about this response, and let's 

14 take five for a personal comfort break.

15 (Whereupon, the proceedings in the foregoing 

16 matter went off the record at 2:28 

17 p.m. and went back on the record 

18 at 2:37 p.m.)

19 MR. KATZ: We are back.

20 MEMBER CLAWSON: Okay, everyone on 

21 the phone. We are making some determinations 

22 here on flight schedules and stuff and we may 
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1 try -- we are going to try break this off a 

2 few minutes after three, so we have only got a 

3 little while left, so hang in there.

4 The one thing, before we go back 

5 to the matrix, and Ted suggested we look at 

6 dates for the next meeting, and if we are 

7 looking about eight weeks out from now, I have 

8 limitations in late May, but -- into early 

9 June actually.

10 MEMBER MUNN: Well, we're going to 

11 have to go to New Mexico in June.

12 MR. KATZ: That's later in June.

13 (Simultaneous speakers.)

14 MEMBER MUNN: It really isn't, 

15 especially since -- well, I guess we could do 

16 this two weeks before. We all go to New 

17 Mexico on July 19th.

18 CHAIRMAN GRIFFON: Is that the 

19 19th?

20 MEMBER MUNN: Yes.

21 CHAIRMAN GRIFFON: How about --

22 MR. KATZ: How about the week of 
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1 the -- let me just think about this --

2 MEMBER MUNN: The fourth?

3 MR. KATZ: Yes, what about the 

4 week of the fourth?

5 MR. CALHOUN: As long as it's not 

6 on the 8th.

7 MR. KATZ: Well, the 8th is Friday 

8 and I'd prefer it not to be the 8th anyway.

9 MR. CALHOUN: Well, we're down to 

10 the 8th through the 15th.

11 (Simultaneous speakers.)

12 MEMBER MUNN: Tuesday the fifth?

13 CHAIRMAN GRIFFON: I don't get 

14 back from Australia until the third.

15 MR. KATZ: What about the 7th? 

16 Would the 7th work?

17 CHAIRMAN GRIFFON: Yes. I have 

18 one -- the 7th can work for me, yes.

19 MR. KATZ: David, on the 

20 telephone?

21 MEMBER RICHARDSON: Yes.

22 MR. KATZ: Dr. Posner, are you on 
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1 the line? How about Brant?

2 MEMBER CLAWSON: Yes, it will 

3 work. It's a little bad, I'll just move some 

4 stuff though. It'll work.

5 MEMBER MUNN: The 7th.

6 MEMBER RICHARDSON: Do it early. 

7 Seven o'clock in the morning?

8 MR. KATZ: Start early.

9 MEMBER MUNN: Oh, geez.

10 (Simultaneous speakers.)

11 MR. KATZ: Five a.m., yes.

12 CHAIRMAN GRIFFON: We could start 

13 a little earlier if you want.

14 MEMBER RICHARDSON: Just so it 

15 doesn't run late, because I'm going to be -- I 

16 mean, I'll --

17 MR. KATZ: What time do you want 

18 to start? 8:00 a.m.?

19 CHAIRMAN GRIFFON: Start at 8:00 

20 a.m.?

21 MR. KATZ: Does that work for you?

22 CHAIRMAN GRIFFON: Wanda, you'll 
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1 be doing it the day before, so you'll be able 

2 to --

3 MR. KATZ: She has plenty of time 

4 to rest. It's only a three hour --

5 MEMBER MUNN: Listen to you.

6 (Simultaneous speakers.)

7 MR. KATZ: I was hoping for Brant 

8 and Grady, an 8:00 a.m. start, is that okay?

9 MEMBER MUNN: What's wrong with 

10 8:30?

11 CHAIRMAN GRIFFON: Let's say 8:30. 

12 I don't want Wanda all, you know, nasty at 

13 me.

14 MEMBER MUNN: Believe me, you 

15 don't want to see me at 8:00.

16 MR. KATZ: Okay, 8:30 on the 7th.

17 MEMBER RICHARDSON: Okay, 

18 Thursday, June 7th.

19 CHAIRMAN GRIFFON: All right, so 

20 let's give this a good hard 20, 25 minutes. 

21 Go ahead Doug. You have plenty of time to 

22 give your response.
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1 MR. FARVER: Okay, this is a 

2 lengthy response. No, I'm kidding. Okay, 

3 there was a little error in our response and 

4 it should say it did apply a dosimetry 

5 correction factor of 2.2. So it's incorrect 

6 to apply the 2.2 to missed neutron doses to

7 the bladder.

8 That's incorrect, and I just 

9 checked the workbook, and the workbook does 

10 apply the 2.2 to the missed doses to the 

11 bladder.

12 MEMBER MUNN: Incorrectly.

13 MR. FARVER: Incorrectly.

14 MR. SIEBERT: And I guess what I'm 

15 saying is it is correct to assign the 2.2 to 

16 the missed dose, a correction factor for a 

17 missed dose at INL, and I am entirely relying 

18 on Matt Smith's information to me, and he is 

19 not here today, I apologize for that.

20 But my understanding from Matt is 

21 for INL, which is one of the very unusual 

22 sites that is like this, the correction factor 
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1 for a neutron actually is applied to missed 

2 dose as well as measured dose.

3 MEMBER MUNN: But why?

4 CHAIRMAN GRIFFON: Yes, why? Why 

5 would INL be so special in this --

6 MEMBER CLAWSON: Because we are so 

7 special.

8 MR. FARVER: But see, then I go 

9 back and I look at your response and it says 

10 the tool, however, only applied the 2.2 factor 

11 to the measured doses, not the missed doses, 

12 as called for in section 6.5.4 of the TBD.

13 So now I'm really confused.

14 MR. SIEBERT: Okay, let's back up 

15 a second. First, let's talk about the skin 

16 doses. The skin doses appropriately applied 

17 the 2.2 correction factor to measured and 

18 missed dose for the skin cancers, and the 

19 whys and wherefores on why it applies to 

20 missed, we are going to have to wait until 

21 Matt Smith can be here to elucidate that for 

22 us. I apologize.
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1 Our response is specifically 

2 discussing the complex-wide tool, which is for 

3 the bladder, which the complex-wide tool did 

4 not apply it to the missed dose, when it 

5 should be applied to the missed dose.

6 We are agreeing there's a problem 

7 there.

8 MEMBER MUNN: And we are going to 

9 fix it how?

10 CHAIRMAN GRIFFON: Did you hear 

11 that question?

12 MR. SIEBERT: I heard that. I 

13 can't answer it at the moment.

14 CHAIRMAN GRIFFON: Okay, okay.

15 MR. FARVER: So, one of the 

16 workbooks was incorrect?

17 MR. SIEBERT: Well, one of the 

18 workbooks, once again as I said, the complex19 wide workbook was designed to be used at 

20 multiple places, and the -- I would agree it 

21 was used incorrectly in this instance because 

22 it did not apply that 2.2 factor.
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1 MR. FARVER: Okay.

2 CHAIRMAN GRIFFON: Or perhaps for 

3 any INL cases, right, wouldn't it have been 

4 incorrectly used?

5 MR. FARVER: Well, my 

6 understanding is that you would have to go in 

7 and add that value or do something --

8 MR. HINNEFELD: The dose 

9 reconstructor as I understand it -- the dose 

10 reconstructor has to manipulate what would 

11 normally come out of the complex-wide tool in 

12 order to apply that 2.2 factor.

13 MR. FARVER: And in this case --

14 MR. HINNEFELD: And in this case 

15 this dose reconstructor didn't.

16 MR. FARVER: He didn't do it.

17 MR. HINNEFELD: Right, yes.

18 MR. FARVER: So the doses were all 

19 -- missed doses were off by a factor of two 

20 for the bladder doses, missed neutron doses.

21 MR. HINNEFELD: Yes.

22 MR. FARVER: And it wasn't caught 
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1 in any other way in the review process.

2 MEMBER RICHARDSON: And the 

3 correction factor -- just let me understand 

4 this -- this is a correction factor for 

5 response of the neutron dosimeter to certain 

6 energies of neutrons or --

7 MR. HINNEFELD: Do you know off 

8 the top of your head Scott?

9 MR. SIEBERT: I honestly do not 

10 because INL is not one of my sites. I 

11 apologize.

12 MEMBER RICHARDSON: In general 

13 though, this --

14 MR. HINNEFELD: I would speculate 

15 it is because of the shortcoming of the 

16 dosimeters that we have identified, and say 

17 that these readings are low by 2.2 so you 

18 would have to adjust it.

19 MEMBER MUNN: That is essentially 

20 the question I asked David, and he said --

21 couldn't answer it until the person who really 

22 and truly understands these calculations --
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1 MEMBER RICHARDSON: But the missed 

2 dose is an environmental -- this --

3 MR. HINNEFELD: It's the lower 

4 limit of detection of the dosimeter and so if 

5 they were -- if they felt like their dosimeter 

6 performed in a certain way and it really was 

7 half that, it was twice, the dose really it 

8 was twice as high, then presumably their 

9 detection level is twice as high as well.

10 DR. ULSH: All right, so, but if 

11 you look back at the history of this 

12 particular finding, back on April 18th of 

13 2011, we determined exactly what Scott said, I 

14 think, that we agree we should have applied 

15 this 2.2 and we didn't, and the question that 

16 remained was, is this a problem with the tool?

17 NIOSH wrote and SC&A reviewed the 

18 tool and case to determine if it is a 

19 case-specific issue or a broader potential 

20 issue, and then on -- in December of last 

21 year, SC&A reviewed it further and they still 

22 believed at that time that it was a workbook 
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1 error.

2 And then we were tasked to look at 

3 it further. We have looked at it further here 

4 in our response, and at least what this 

5 response says is it's not a workbook error, 

6 it's a problem with the dose reconstructor.

7 MR. SIEBERT: No, that is not what 

8 the response is saying. The response is 

9 saying, at the very beginning, it said, the DR 

10 properly entered the 2.2 correction factor 

11 into the tool.

12 And the dose reconstructor did 

13 what they were supposed to so. The issue is 

14 the tool, being a complex-wide tool, did not 

15 apply that to missed dose as well as measured 

16 dose, based on the fact that INL is unusual.

17 DR. ULSH: So are we saying that 

18 the problem is the tool or the problem is the 

19 dose reconstructor didn't use the tool 

20 properly, make the appropriate adjustments?

21 MR. SIEBERT: I believe the tool -

22 - I believe it would be a tool issue for its 
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1 use at INL, would be the problem.

2 DR. ULSH: So do we need to go 

3 back and take corrective action and change the 

4 tool?

5 MR. SIEBERT: I am pursuing that 

6 right now to find out if we still use that 

7 tool for INL or if it's been replaced and to 

8 get a scope of the claims that have been done 

9 with this tool previously.

10 MR. HINNEFELD: So we'll know some 

11 more information on this later on.

12 MEMBER RICHARDSON: The simple 

13 thing would be to say INL is like other 

14 facilities and -- I mean, I guess this gets 

15 back to Wanda's point, well what's so special 

16 about -- what isn't special about it?

17 MR. FARVER: Either that or 

18 develop a special, specific tool for INL and 

19 their sites.

20 DR. ULSH: Maybe we have, I don't 

21 know, that's what Scott's checking into now. 

22 So put that down as our action.
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1 CHAIRMAN GRIFFON: Yes, I got it.

2 MR. SIEBERT: And before we move 

3 forward -- this is Scott -- I have an answer 

4 on that tool pop-up thing, because you know, I 

5 love to multi-task, I am also playing with 

6 that as we are trying to do this.

7 Yes, when -- and Doug, you are 

8 correct -- when you look at the version that 

9 was used for the claim, the complex-wide one, 

10 and you look at the dose calculations page,

11 and you look at the -- when you hit the 

12 button, the radio button, to show the formula, 

13 that one divided by 1.6 is shown in all those 

14 formulas.

15 But that is postulated from the 

16 earlier dose input portion of the tool, where 

17 the dose reconstructor's specifically put in 

18 the 1.6 neutron bias factor.

19 I looked at the clean copy and 

20 looked at the pop-up of those, those factors, 

21 and it said one over one in the clean copy.

22 So the pop-up is tied to what's 
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1 actually being calculated. The dose 

2 reconstructor didn't have to go in and change 

3 all those things. They just put in the 

4 neutron bias factor as they believed was 

5 appropriate at the time, and that's why it 

6 kicks out in the pop-up.

7 So it's -- the clean copy really 

8 dose have a default bias factor of one.

9 MR. FARVER: So in the 

10 descriptions in the clean copy, it still says 

11 the dosimeter correction factor and the 

12 inverse of the bias equals, and then it gives 

13 an equation.

14 In other words, the wording is in 

15 the text. It's not just in the equation. So 

16 it's not like you could use a macro and just 

17 copy the equation into this pop-up.

18 MR. SIEBERT: Are you talking --

19 I'm sorry -- are you talking about the pop-up 

20 that says external dose calculation 

21 description?

22 MR. FARVER: Yes.
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1 MR. SIEBERT: Okay, yes, it's 

2 entirely in there and it's appropriate to be 

3 in there, because all it's doing is stating in 

4 words what the --

5 MR. FARVER: Okay.

6 MR. SIEBERT: description is and 

7 it says, correction, well, dose times energy 

8 split times unit distribution times correction 

9 factor times one over bias. It does not give 

10 an indication as to what the bias number 

11 should be until you get into the actual 

12 calculation.

13 MR. FARVER: Is it correct to 

14 divide by the bias?

15 MR. SIEBERT: Yes, it would be if 

16 the bias was appropriate. In this case, you 

17 know, the bias is set as a default of one in 

18 the tool, in the clean copy of the tool, so 

19 dividing by the bias is the same as dividing 

20 by one, saying there is no bias and it cancels 

21 out.

22 MR. FARVER: Okay. So the dose 
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1 reconstructor put in a bias of 1.6.

2 MR. SIEBERT: That is correct, 

3 under the -- if you go, I don't know if you 

4 are looking at right now, or if you could, but 

5 under the dose input sheet, there is a column 

6 where the neutron bias is -- specifically can 

7 be added in by the dose reconstructor, and 

8 they put in a 1.6 all the way across the board 

9 for those years, and that's where it's coming 

10 from.

11 MEMBER RICHARDSON: So with a bias 

12 factor of 1.6, I mean I am taking this 

13 discussion as are -- should you be using the 

14 reciprocal of the bias factor, or the bias 

15 factor, or to put differently, do you divide 

16 the dose by that or do you multiply it by 

17 that?

18 This bias factor is saying that 

19 the dosimeter over responded by 60 percent due 

20 to its characteristics.

21 MR. SIEBERT: Correct. That is --

22 that's what this bias factor would be saying. 
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1 Once again, Matt really needs to address 

2 this, but there have been times in the past we 

3 have had neutron or any type of bias factor 

4 that has been determined not to be divided by 

5 just, I don't know if it's claimant 

6 favorability, it's a Matt thing that we are 

7 going to have to get that straightened out as 

8 to why it's handled that way at INL.

9 I can just tell you the tool with 

10 the clean version, to put Doug's mind at ease 

11 is the fact that the dose reconstructor 

12 specifically did enter that factor.

13 MR. FARVER: Okay. Would we know 

14 of any other cases where a dose reconstructor 

15 would put a bias number in? I mean, it seems 

16 that this could be very easy to occur again.

17 MR. SIEBERT: I cannot tell you 

18 without us actually pulling all the complex19 wide tools and looking in those cells. I just 

20 can't tell you.

21 MR. FARVER: Okay.

22 MR. HINNEFELD: That was our, part 
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1 of our follow-up on this that we are going to 

2 do later, decide how we are going to go about 

3 it, what we are going to look for.

4 DR. ULSH: All right so we were on 

5 165. 4. Are we done discussing that one or is 

6 there more to --

7 CHAIRMAN GRIFFON: I think we got 

8 that one.

9 MR. FARVER: I think we're done.

10 CHAIRMAN GRIFFON: Yes. 

11 DR. ULSH: Okay. 165.5, if I look 

12 in the resolution column, we are to provide 

13 the IREP runs and our response, we provided a 

14 file, rather a large file, that contained all 

15 of the IREP sheets.

16 MR. FARVER: This is more of an 

17 observation. The original PoC was 45.95 

18 percent. In the file submitted by Brant the 

19 PoC was 46.23 percent.

20 And after correcting the errors, 

21 the impact of the findings is now 49.02 

22 percent. So the findings look like the 
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1 findings, you know, increased it about by four 

2 percent, something like three or four percent, 

3 which, you know, I consider that kind of 

4 significant, you know, especially in cases 

5 that are maybe, say, 48 percent or so. You 

6 get an extra three percent in there and it 

7 tips it over.

8 So I don't know where to go from 

9 there. It was just kind of an observation, 

10 that the difference seemed to be, you know, 10 

11 percent or so.

12 For this case, yes. What about 

13 other cases that INL, where they are using the 

14 complex-wide and then they are using the INL 

15 workbook for a certain part, and you are still 

16 going to have some of the same issues, or you 

17 could --

18 DR. ULSH: Well, there were three 

19 cancers in this.

20 MR. SIEBERT: Which is, I believe 

21 this is why we are going to be working with 

22 Stu and Brant to determine the scope of the 
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1 issue with the tool and move forward from 

2 there.

3 MR. FARVER: That's fine.

4 DR. ULSH: So are you satisfied 

5 with being thrown this one --

6 MR. FARVER: You know, I guess 

7 somewhere we are going to keep one of these 

8 open?

9 CHAIRMAN GRIFFON: Yes, explain 

10 that again. You are working with the scope of 

11 the issue of the tool. In other words you may 

12 not be using this tool anymore? Is that -- or 

13 --

14 MR. HINNEFELD: Well no --

15 CHAIRMAN GRIFFON: Or how many 

16 cases --

17 MR. HINNEFELD: It's the 

18 investigation that these are -- I'm a little 

19 at see on this particular finding, but if 

20 these are problems with the arithmetic in the 

21 tool or the use of the tool, that's what we 

22 are going to be investing in, is this tool, 
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1 and how it was used at that time.

2 And we just have to decide, you 

3 know, how much we can reasonably do and what 

4 we can accomplish, and what we have to do.

5 But so yes, it's just part of the 

6 investigation.

7 MEMBER MUNN: And as a part of 

8 your investigation, we will do these 

9 calculations in another manner to make sure 

10 that the software is actually giving you the 

11 appropriate response that would be achieved 

12 mathematically without the software, correct?

13 MR. HINNEFELD: I don't know.

14 MEMBER MUNN: Well, that's one of 

15 the things that you were, were being concerned 

16 about.

17 MR. FARVER: For this case, we 

18 have already identified --

19 MR. HINNEFELD: We have 

20 identified, in this case we have identified 

21 issues with how the calculations are set up in 

22 the spreadsheet, and so we need to fix those.
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1 MR. FARVER: What's the impact of 

2 those calculations.

3 MR. HINNEFELD: Yes. To those 

4 things. And we need to decide, once this is 

5 fixed, what's the impact of that on the other 

6 cases. These, you know, the spreadsheets are 

7 QA’ed when they are introduced, and there are 

8 some test runs to say that they are, you know, 

9 they are getting the answer they are supposed 

10 to get.

11 So I don't know that this drives 

12 us back there because these are -- if -- to 

13 me, that is a different issue. If you want to 

14 say are these -- is the V&V of these suitable, 

15 is it sufficiently strenuous? That's a whole 

16 different thing from when we look at the V&V 

17 of spreadsheets. We don't look at dose 

18 reconstruction.

19 Okay, for this specific case, what 

20 we have to do is fix the issues with, you 

21 know, with the spreadsheet, and then once we 

22 have got that, then will those fixes look for 
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1 other cases that those fixes may have an 

2 impact on? So that's what we need to do for 

3 this one.

4 MEMBER MUNN: Right. Right. But 

5 I would think --

6 MEMBER RICHARDSON: But there was 

7 also an issue of, this sheet does not work the 

8 way it's supposed to for when it's applied to 

9 Idaho, right? That was another issue.

10 MR. HINNEFELD: Well yes, that's -

11 - it's part of the whole business here, if 

12 it's applied to Idaho.

13 MEMBER RICHARDSON: I'm still 

14 puzzling over the issue of -- I have always 

15 thought that the problem with neutron 

16 dosimetry, were under response. There tends 

17 to be very little recorded neutron dose.

18 Dividing recorded neutron dose by 

19 60 percent, just as a starting point, sounds 

20 surprising to me. I'm not -- I mean, I guess 

21 there are, there's over response sometimes 

22 with like thermal neutrons or something, in 
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1 some of the old -- is that right?

2 I -- I'm still having a hard time 

3 wrapping my head around why that -- why that 

4 factor is -- you're using the inverse of the 

5 factor.

6 MR. HINNEFELD: I, right now, 

7 sitting here I don't think any of us can 

8 reconstruct why that would happen.

9 MR. STIVER: I don't recall a case 

10 where we found dosimetry reading high like 

11 that where it would have to be adjusted down. 

12 But that doesn't it mean it's -- it didn't 

13 happen.

14 But certainly, getting back to, 

15 earlier you mentioned, you know, the whole 

16 idea is V&V, and that I think Brant mentioned 

17 earlier, that you might put that in your 

18 presentation about the ORAU QA/QC program.

19 I'm very curious about, you know, 

20 the V&V processes and how they go into these 

21 tools, and how they're tracked and updated and 

22 so forth.
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1 MR. HINNEFELD: So, that would be, 

2 then, tracked and updated would be what I 

3 would consider version control.

4 MR. STIVER: Yes, it would be a 

5 version control as well as an initial V&V --

6 MR. HINNEFELD: An initial --

7 MR. STIVER: And application, and 

8 how they actually try to break the tool.

9 MR. HINNEFELD: All right, we'll 

10 put it on the list of things we've got to find 

11 out.

12 DR. ULSH: All right Mark, we have 

13 just finished several findings on 165. I'm 

14 happy to keep going but it is 3 o'clock.

15 CHAIRMAN GRIFFON: It is 3 

16 o'clock, yes.

17 MEMBER RICHARDSON: 166 we can get 

18 done.

19 CHAIRMAN GRIFFON: Is it quick? 

20 Yes.

21 DR. ULSH: All right. Let's see. 

22 The latest that we were supposed to do, we 
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1 agreed it was a QA issue, we corrected it, 

2 verified that all additional doses identified 

3 in the case findings were addressed, and 

4 whether the outcome was affected.

5 Our response, and we provided an 

6 attached file, was that there was no impact on 

7 compensability.

8 MR. FARVER: I can understand what 

9 you did. I just don't understand what was in 

10 SC&A's 166 combined file. I --

11 DR. ULSH: All right. I'm opening 

12 that now.

13 MR. SIEBERT: Doug, I can talk you 

14 through that if you want.

15 MR. FARVER: Talk me down.

16 MR. SIEBERT: Okay. The 

17 clarification that was put in there, I mean, 

18 what we really had to do for this one was to 

19 ensure that we included any of the errors, 

20 reran the case to ensure -- determine if it 

21 went over 50 percent with the additional 

22 changes.
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1 MR. FARVER: Okay. 

2 MR. SIEBERT: While I was working 

3 through that, I realized that there may have 

4 been a clarification that hadn't been pointed 

5 out very well in one of the findings, 0.6, and 

6 I didn't want anybody too think I ignored it, 

7 because there is no error in 0.6 and so I did 

8 not make any corrections to 0.6.

9 Point six is the response, the 

10 finding and response where there was a 

11 plutonium-238 intake that was in the CADW tool 

12 that did not go in the IREP tool.

13 MR. FARVER: Okay.

14 MR. SIEBERT: Okay? When I dug 

15 into that deeply, we determined actually this 

16 is where the ORAU and NIOSH QA/QA process 

17 worked pretty well. We sent the claim over 

18 initially with that additional plutonium-238 

19 overestimate included.

20 The PoC was between 45 and 52 

21 percent. So NIOSH kicked it back to us to 

22 rework, removing that overestimate of 
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1 plutonium-238, because we just used the 

2 highest sample and assumed a chronic across 

3 the board which was a large intake if you 

4 recall.

5 When we reworked the case, the 

6 dose reconstructor ran a separate CADW run for 

7 the new plutonium-238, did not pull it out of 

8 the old one, rather than re-running all the 

9 work from the old work, just, all they did 

10 was, since it was run at a constant 

11 distribution, it was the only thing that was a 

12 constant distribution, they pulled it out of 

13 the output and replaced it with the new CADW 

14 run.

15 So the plutonium that was in the 

16 assessment that you reviewed actually was 

17 correct, and the question never was whether 

18 the plutonium was done correctly. It was why 

19 did the -- why did this large plutonium-238 

20 intake exist in the old CADW run but it's not 

21 in the IREP runs.

22 And so I spent a lot of time 
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1 determining that is the reason, it was an 

2 initial, older version which was overestimated 

3 that we had to redo, based on being between 45 

4 and 52 percent.

5 MR. FARVER: Now, wouldn't 

6 something like that be contained in the 

7 comments sheet?

8 MR. SIEBERT: Not necessarily.

9 MR. FARVER: Okay.

10 MR. SIEBERT: I mean, there is --

11 I mean, it depends on what you're talking 

12 about -- there is a NIOSH response -- when 

13 NIOSH returned it to us, they did return it to 

14 us on a form, stating that they wanted us to 

15 remove those overestimates, which is in the 

16 file, and we responded saying yes, that's 

17 exactly what we did.

18 It didn't go into the nitty-gritty 

19 of exactly how they did that thesis part, and 

20 the fact that it's still in the CADW run but 

21 not, not in the final output, I don't see as 

22 an issue as long as it's done correctly.
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1 MR. FARVER: I agree it's not a 

2 problem with being in the CADW, just the 

3 concern is for the future, if someone looks at 

4 it, they are going to come up with the same 

5 issue and I'm thinking, you know, should it be 

6 in a comments form, or if it's in a NIOSH 

7 form, is that form included with the files 

8 that we look at?

9 MR. SIEBERT: I believe it should 

10 be. I can't say for certain because I don't 

11 know what NIOSH is reporting to you. But I 

12 believe you should be seeing those.

13 MR. FARVER: Okay, if it's there I 

14 missed it.

15 MR. CALHOUN: Comment sheet are we 

16 talking about?

17 DR. ULSH: It would be the sheet -

18 - when we, when NIOSH sent it back to ORAU 

19 saying change this.

20 MR. CALHOUN: No, we don't see 

21 that. That's in the -- that's in the admin 

22 record -- it's going to be saved in the K: --
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1 our K: file under DR submitted. That's where 

2 you see all of those, for every case that's 

3 ever returned.

4 MR. FARVER: Should there be 

5 something in these files that indicates that 

6 either that shouldn't be there or we know it's 

7 there but this is why we are not including it?

8 I mean that's why I thought the 

9 comment sheet that goes along with the DR 

10 would be some place where you could put that 

11 in.

12 MEMBER MUNN: If you're going to 

13 keep going back and looking at them --

14 MEMBER CLAWSON: This has been the 

15 whole thing we have said for years back there, 

16 showing their work and why they did this, 

17 because we have seen it for years.

18 We looked at the entire thing to 

19 find out whether we changed to different -- we 

20 went to a different work package. Now we are 

21 using this up to date one. This one got sent 

22 back and -- it's kind of a thing of show your 
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1 work, really, of how you got to this, and why. 

2 I think it saves an awful lot.

3 CHAIRMAN GRIFFON: I'm not sure 

4 where to go with that one.

5 DR. ULSH: I'm not sure either.

6 MR. HINNEFELD: Yes, this is sort 

7 of an oddball, so I don't really -- yes, I 

8 don't -- and to be honest with you, I don't 

9 really have my hands around exactly what 

10 happened, so I don't know where to go farther 

11 with this. I mean our -- our comment sheets 

12 aren't going to end up in the administrative 

13 record because they are comments on a dose 

14 reconstruction and it never makes it to the 

15 administrative record.

16 You know, we make comments on dose 

17 reconstruction, then it gets fixed, and our 

18 comments go to ORAU and they fix it and then 

19 the dose reconstruction, the fixed dose 

20 reconstruction comes -- that's what goes into 

21 the administrative record. So --

22 MR. STIVER: At that point that's 
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1 when -- so an explanatory memo should be put 

2 in --

3 MR. HINNEFELD: Only, really --

4 not really. I mean, because that's, to us it's 

5 not really that important that there be this 

6 record of the back and forth between us and 

7 ORAU.

8 What has to be complete is the 

9 record, the administrative record should be a 

10 complete and accurate record of what went into 

11 the dose reconstruction.

12 So along those lines, it sounds 

13 like there should be some sort of explanation. 

14 It shouldn't have this sort of confusion in 

15 the administrative record of that -- that 

16 makes it impossible to get to the dose 

17 reconstruction from the information that's 

18 there.

19 It should be a complete and, I 

20 want to say complete and accurate record of 

21 the decision, and so there should be 

22 sufficient information there that you can find 
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1 a way through it. I agree with that. I don't 

2 know where we go exactly with that, but ORAU, 

3 we will have to talk to.

4 MR. SIEBERT: Well, and I do want 

5 to point out that all the numbers that were in 

6 the dose reconstruction report matched up with 

7 the final intakes and doses that were assigned 

8 in the final version.

9 The only issue was the fact that 

10 there was this residual plutonium-238 in a 

11 tool that is never used by -- I mean, it was 

12 reviewed in this case and the question became,

13 well, why is it there. Oh well, it's not 

14 normally an issue, I mean, we included a lot 

15 of things that we may do where comparisons 

16 where the -- it's not the final version that's 

17 actually in there, but we include it for 

18 comparison sake.

19 So I don't really see us 

20 explaining every, every change that's going on 

21 when we are going with the back and forth with 

22 NIOSH as that necessarily being helpful.
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1 MR. HINNEFELD: And in fact, to 

2 Scott's point, we have been asked before that 

3 if you try something one way, you know, it 

4 will be kind of, why don't you do a dose 

5 reconstruction this way? Well, we did, and it 

6 -- you know, and such and such. They said 

7 well, why don't you include that in here.

8 So now we are including that, and 

9 so this kind of -- at some point, you know, we 

10 are going to -- you are going to have to make 

11 too many decisions about what goes in and what 

12 goes out unless you just put it in here --

13 MR. FARVER: No, I mean, we have a 

14 question about just how are you doing, before 

15 --

16 MR. HINNEFELD: Yes, right.

17 MR. FARVER: So that he used 

18 different solubilities and that, and -- and in 

19 this case it would have been okay if somewhere 

20 there would have been a note saying oh, this 

21 is what we would have done, you know.

22 CHAIRMAN GRIFFON: I think that's 
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1 the question, like, an explanation.

2 MR. FARVER: Yes, okay.

3 CHAIRMAN GRIFFON: It's the files 

4 that are in the directory.

5 (Simultaneous speakers.)

6 MR. HINNEFELD: Okay, we'll take 

7 it under advisement.

8 MR. KATZ: If we are going to 

9 adjourn early, we should adjourn now. 

10 Otherwise it's -- we'll be sitting at the 

11 airport for three hours --

12 CHAIRMAN GRIFFON: Okay.

13 MR. SIEBERT: This is Scott. So 

14 the short answer is that's the explanation as 

15 to why there's additional information for that 

16 166. The short answer, which I really should 

17 have started with, is that when we made the 

18 actual changes that needed to be changed, 

19 which was including the K-25 X-rays, it had no 

20 impact on compensability.

21 CHAIRMAN GRIFFON: Alright. I 

22 think we are going to wrap it up there. So 
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1 the meeting is adjourned.

2 MR. KATZ: Meeting adjourned. 

3 Thank you everyone. Thank you everyone on the 

4 line as well. And have a good weekend.

5 (Whereupon, at 3:11 p.m., the meeting was 

6 adjourned.)

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