This transcript of the Advisory Board on Radiation and Worker Health Dose Reconstruction Review 

Methods Work Group, has been reviewed for concerns under the Privacy Act (5 U.S.C. § 552a) and 

personally identifiable information has been redacted as necessary. The transcript, however, has not 

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1 

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

CENTERS FOR DISEASE CONTROL

NATIONAL INSTITUTE FOR OCCUPATIONAL

SAFETY AND HEALTH 

+ + + + +

ADVISORY BOARD ON RADIATION AND

WORKER HEALTH

+ + + + +

DOSE RECONSTRUCTION REVIEW METHODS WORK GROUP

+ + + + +

MONDAY

JUNE 22, 2015

+ + + + +

The Subcommittee convened via 

teleconference at 10:00 a.m. Eastern Time, James 

M. Melius, Chairman, presiding.

PRESENT:

JAMES M. MELIUS, Chairman

JOSIE BEACH, Member

DAVID KOTELCHUCK, Member

PAUL L. ZIEMER, Member
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ALSO PRESENT:

TED KATZ, Designated Federal Official

TERRIE BARRIE

BOB BARTON, SC&A

KATHY BEHLING, SC&A

RON BUCHANAN, SC&A

NICOLE BRIGGS, SC&A

GRADY CALHOUN, DCAS

ROSE GOGLIOTTI, SC&A

JENNY LIN, HHS

ED MAHER, ORAU Team

JOHN MAURO, SC&A

BETH ROLFES, DCAS

SCOTT SIEBERT, ORAU Team

JOHN STIVER, SC&A
This transcript of the Advisory Board on Radiation and Worker Health Dose Reconstruction Review 

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TABLE OF CONTENTS

Page

Welcome and Roll Call

Ted Katz........................... 4

Meeting Goals

Chairman Melius.................... 6

Discussion of QA/QC Issues

Chairman Melius.................... 10

Possible Approaches to Sets 14-21

Chairman Melius.................... 18

Adjourn

Chairman Melius.................... 93
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1 P-R-O-C-E-E-D-I-N-G-S

2 (10:01 a.m.)

3 MR. KATZ: Let's get started then. 

4 This is the Advisory Board on Radiation and Worker 

5 Health. It is the Dose Reconstruction Review 

6 Methods Work Group. This is an initial meeting.

7 The agenda for the meeting is posted on 

8 the NIOSH website under the Board section 

9 scheduling meetings today or this month -- today's 

10 date. And there are no materials with that posted. 

11 Some of the materials -- the main materials are 

12 Privacy Act protected. There is another document 

13 we can get on, if someone is interested on the line 

14 afterwards, but I don't think it will be governing 

15 the discussion.

16 So, let me check and see that I have my 

17 chair and these Board Members on, the Board Members 

18 we expected. Let me just check and see for the 

19 NIOSH and ORAU teams. Who do we have on the line?

20 (Roll call.)

21 Okay, that should take care of it, then. 
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1 And let me remind everyone, since there are quite 

2 a lot of people on this line, to mute your phones, 

3 except for when you are addressing the group. If 

4 you don't have a mute button, press *6 to mute your 

5 phones and then press *6 again to take yourself off 

6 of mute and please don't put the phone on hold at 

7 any point.

8 And Dr. Melius, Jim, it is your agenda.

9 CHAIRMAN MELIUS: Okay, thanks, Ted, 

10 and good morning everybody. Actually, I think, 

11 Josie you are up earlier, unless you are still on 

12 the east coast.

13 MEMBER BEACH: No, no, I'm back home.

14 CHAIRMAN MELIUS: Good, okay.

15 MEMBER BEACH: Up early.

16 CHAIRMAN MELIUS: You are all up early. 

17 Good. Well, we are glad we could get you up and 

18 get you off to an early start.

19 MEMBER BEACH: Me, too.

20 CHAIRMAN MELIUS: A couple things on 

21 this meeting. One is sort of view this as a sort 
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1 of preliminary meeting, get some initial 

2 discussion on thoughts and so forth from Board 

3 Members what we need to do but also to identify any 

4 additional needs for data or other information that 

5 would help to shape what we would be recommending 

6 to the Board for any changes to our dose 

7 reconstruction review methods and approaches that 

8 we might use going forward.

9 I just want to add to this that we all 

10 know that reviewing dose reconstructions is a key 

11 charge in the legislation made to the Advisory 

12 Board but it is an important function and one that 

13 we need to do and take very seriously and as part 

14 of our efforts in overseeing this entire program.

15 We also, it is a little different from 

16 some of our other Work Groups or Subcommittees. 

17 So, number one, is we have a contractor involved 

18 at SC&A and to a great extent, their work is 

19 dependent on how we implement this, how we assign 

20 those, and what recommendations come out from this 

21 Work Group to our Board.
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1 So, I really don't think it is going to 

2 be -- we are not looking for SC&A to tell us how 

3 to do dose reconstruction reviews, given the 

4 contractual situation and so forth. So, we may ask 

5 them for some technical assistance, in terms of 

6 what we are doing but I don't view this as something 

7 where our contractor would be telling NIOSH and the 

8 Board what methods should be used or what 

9 approaches should be used.

10 And I think, to some extent, this also 

11 applies to NIOSH. We have to keep some distance 

12 or maybe more distance and independence than we 

13 have become accustomed to in some of our other Work 

14 Group activities.

15 So, sort of bear that in mind and I don't 

16 think it will be a problem in terms of this Work 

17 Group but I think we have to be cognizant of these 

18 changes.

19 In preparing for this Work Group 

20 meeting, we had a few documents that we sent around 

21 to everybody. Two of them were documents that had 
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1 been prepared by SC&A for a Board meeting. I think 

2 a couple of Board meetings ago, just sort of 

3 summarizing some of the information on the dose 

4 reconstruction reviews that hadn't been done, that 

5 hadn't been completed through the Subcommittee 

6 process. So, those were sets 14 through 21, I 

7 believe. A couple of those are blind reviews. 

8 So, they are not really sort of the usual ones. But 

9 there are a substantial number that have not gone 

10 through the process yet.

11 And then there is another set, another 

12 spreadsheet document that provided some other 

13 descriptive information on all of the dose 

14 reconstruction reviews that have been done to date. 

15 Those are the ones that, for those of you that are 

16 on the phone, may not be privy to them, are ones 

17 that have the Privacy Act information to them.

18 The other documents that we sent around 

19 are some information on the quality 

20 assurance/quality control procedures used by ORAU 

21 and those were used -- that was based on a document, 
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1 an ORAU document I think from 2012 and I think those 

2 reflects essentially current methods and so forth.

3 And then there was also the transcribed 

4 notes from a Dose Reconstruction Review 

5 Subcommittee meeting, where those were discussed 

6 and provided a little bit more background on that.

7 I will note I actually had Ted hunting, 

8 and I was looking also about it, at one point very 

9 early on in the work of the Advisory Board, there 

10 was actually a Work Group on QA/QC methods that, 

11 as best we can tell, we are unable to find a report 

12 from that Work Group and I don't believe there was 

13 any transcribed meetings of that Work Group. It 

14 was before we had gone to the method where all of 

15 our Work Group meetings were public and 

16 transcribed.

17 Dr. Ziemer, you and I both served on 

18 that. Dr. Andrade was the chair of that. I 

19 believe Wanda Munn was also part of that. I don't 

20 know if you recall it at all, Paul, but --

21 MEMBER ZIEMER: Only vaguely and I 
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1 think that I would have to go back into some of my 

2 early notes to try to remember what we did. 

3 If Tony was chair of that, that would 

4 have been the first couple years because he was only 

5 with us a year or two, a couple of years.

6 CHAIRMAN MELIUS: Yes, I found some 

7 reference to it in the transcriptions of the actual 

8 Board meetings but they are relatively short. And 

9 as I recall that, I don't believe that the Work 

10 Group issued a report. At that point, NIOSH was 

11 working with ORAU to develop QA/QC methods for the 

12 dose reconstructions. And so there really was 

13 sort of no full plan to review. So, it was more 

14 of a set of recommendations made to NIOSH in terms 

15 of what kinds of programs should be implemented.

16 And my guess is that what was 

17 implemented ended up being pretty close to what was 

18 being recommended and discussed at that point in 

19 time. But it was mostly interesting from sort of 

20 a historical perspective.

21 I can remember the Work Group. I could 
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1 not remember what we had actually done.

2 But I think the current ORAU documents 

3 provides some background on that and so forth. And 

4 then the other documents --

5 I guess my question to the other Board 

6 Members, is there other information that would be 

7 helpful in terms of deciding what to recommend in 

8 terms of dose reconstruction reviews? Other

9 presentations on QA/QC or on other issues or other 

10 -- in terms of what we had done.

11 MEMBER BEACH: Yes, Jim, this is Josie. 

12 I, at this point, don't have anything.

13 MEMBER KOTELCHUCK: Dave Kotelchuck. 

14 I would have been interested in some of the earlier 

15 sets, knowing what those categories -- where there 

16 were findings. They were categorized by A through 

17 F. I have seen them and we started discussing them 

18 intensely, as we ended Set 13 and started Set 14.

19 But I have always wondered if there is 

20 a summary of what was found or what was done in 10 

21 through 13. It seemed to me I wasn't aware of their 
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1 importance, as a new chair. So, Doug and other 

2 people were keeping track of that but I have never 

3 seen any summary of it or any report on that. I 

4 am curious if there was one or if that data is 

5 available.

6 MEMBER ZIEMER: I can give you a 

7 partial answer. This is Paul Ziemer. You know, 

8 the initial report to the Secretary on the first 

9 dose reconstruction I think summarized the numbers 

10 of findings and related data. How much detail 

11 there was, in terms of by data sets or whatever, 

12 but I think probably it would be worth just pulling 

13 that summary, which was in the form of a letter to 

14 the Secretary and maybe some attachments.

15 MEMBER KOTELCHUCK: I did take a look 

16 at that and that was interesting but that ends at 

17 the end of nine, I believe.

18 MEMBER ZIEMER: Right.

19 MEMBER KOTELCHUCK: But 10 through 13 

20 that I have been involved with mostly on the DR 

21 Subcommittee, I don't know of any summary of that. 
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1 Maybe the SC&A folks might know about that.

2 MR. KATZ: This is Ted, Dave. I think 

3 the issue is that they haven't been tasked yet with 

4 producing that summary.

5 MEMBER KOTELCHUCK: I see. I see.

6 MR. KATZ: That is part of what the 

7 Subcommittee would do in preparing for a report to 

8 the Secretary.

9 MEMBER KOTELCHUCK: Okay, good. That 

10 is clarifying.

11 Was this A through C categorization, 

12 when was it initiated? Was it initiated formally 

13 in that first report of the first 100 cases that 

14 Paul is referring to?

15 MR. KATZ: The categories for sort of 

16 characterizing the findings, that dates back -- I 

17 mean it may have been tweaked at some point. I sort 

18 of think it has been. But generally, it was 

19 created way back before that first report, I mean 

20 when we started tracking all these findings.

21 MEMBER KOTELCHUCK: Okay, so that 
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1 means -- fine. So, the report that Paul is 

2 referring to, those were the same categories that 

3 we are talking about now.

4 MR. KATZ: I think approximately.

5 MEMBER KOTELCHUCK: Yes.

6 MR. KATZ: But there may have been some 

7 tweaking at some point. It seems like I remember 

8 that there might have been but, generally, they are 

9 the same.

10 MEMBER KOTELCHUCK: Okay, good. 

11 Thanks.

12 MEMBER ZIEMER: Pretty much the same as 

13 we have been.

14 MEMBER KOTELCHUCK: Good.

15 CHAIRMAN MELIUS: Yes, I think those, 

16 as I recall from hearing those reconstruction 

17 Subcommittee reports and so forth, I don't think 

18 those have changed a great deal. What sort of 

19 varied more has been the selection of cases for 

20 review over time.

21 MEMBER KOTELCHUCK: Oh, okay.
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1 CHAIRMAN MELIUS: And I think how that 

2 selection has --

3 MEMBER KOTELCHUCK: Right. I would 

4 say that your chair was not aware of the importance 

5 of them. I mean it was recorded but I certainly 

6 did not pay close attention to them until we got 

7 near the end of 13 and I just counted on SC&A folks 

8 putting it down.

9 Okay.

10 CHAIRMAN MELIUS: I mean I think it is 

11 a fair question as to whether going forward that 

12 classification has the venues full and does it need 

13 to be tweaked or changed.

14 MEMBER KOTELCHUCK: Right. And I 

15 think there has been some discussion in the 

16 Subcommittee about that.

17 CHAIRMAN MELIUS: Yes. Well, I think 

18 that is something that this Work Group may want to 

19 look into also.

20 MEMBER KOTELCHUCK: Yes.

21 CHAIRMAN MELIUS: I mean, I think if we 
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1 sort of look at broader ways, we have done these 

2 individual dose reconstruction reviews and that 

3 has been the main, as we started to say, the main 

4 focus, which is to take a sample and review simply 

5 how the methodologies, the procedures, and so forth 

6 have been applied in that particular case and are 

7 there issues or problems found in terms of how that 

8 is done and to what extent do those issues or 

9 problems change or potentially change the 

10 Probability of Causation that would be calculated 

11 for that case.

12 MEMBER KOTELCHUCK: Right.

13 CHAIRMAN MELIUS: And that has been --

14 the focus has been a lesser focus on the so-called 

15 blind reviews. So, I think we are starting to 

16 catch up on those. And then --

17 MEMBER KOTELCHUCK: We are certainly 

18 trying to catch up.

19 CHAIRMAN MELIUS: Yes. So, there is 

20 question when do we -- what is the right mix between 

21 different approaches, as well as do we need to 
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1 change the specific approaches that we are using? 

2 And are there additional things that we should be 

3 looking at in some manner as part of that?

4 And I think underlying all of that, is 

5 there some efficiencies to the process that would 

6 allow for more, a larger sample, in effect, to be 

7 looked at but maybe with less intense scrutiny or 

8 involvement of the Board or whatever. There are 

9 some different approaches. Does the Board have to 

10 be part of the resolution process or does time need 

11 to be spent resolving every specific finding or 

12 non-finding on that? Lots of different possible 

13 mixes of approaches and so forth that could be used.

14 MEMBER ZIEMER: I think those are good 

15 questions. I'm noticing, and I am going to be 

16 fighting feedback most of the day, but over the past 

17 number of sets, and I guess I am looking now at the 

18 spreadsheet for 14 through 21, a lot of cases where 

19 there were no findings, I have not, myself, looked 

20 to see if there is something common about what we 

21 are finding in cases but we are finding certain 
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1 types of cases where we never see any findings. If 

2 there is a pattern there, it seems to me it would 

3 make sense to minimize the number of cases of that 

4 type that we look at and focus on the type of cases 

5 where seem to be getting more findings. I don't 

6 know if SC&A has ever tried to analyze that or 

7 already have a feel for that but it seems to me that 

8 some efficiencies could be, maybe not 

9 efficiencies, but some value could be achieved by 

10 focusing on the kind of cases where we tend to see

11 findings.

12 MEMBER KOTELCHUCK: Uh-huh.

13 MEMBER ZIEMER: I mean these numbers 

14 have changed with no findings -- are we seeing more 

15 and more of those? Does that reach up better 

16 quality control at the front end of the process like 

17 ORAU and NIOSH? I don't know the answer to that.

18 MEMBER KOTELCHUCK: It does look that 

19 way. The earlier, the first reports, had more 

20 findings than there were cases. There was at least 

21 more than one plus findings per case.
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1 MEMBER ZIEMER: Yes, right.

2 MEMBER KOTELCHUCK: And here we are 

3 talking about 29 findings among 116 cases.

4 MEMBER ZIEMER: Right, exactly.

5 MEMBER KOTELCHUCK: That's pretty 

6 good.

7 MEMBER ZIEMER: Yes but are those cases 

8 without findings, and there are a lot of them, are 

9 they a certain type of case? You know are they 

10 locations lines, a certain type of location in a 

11 facility? You know what I am saying.

12 MEMBER KOTELCHUCK: Well, I certainly 

13 do not know. It does seem to me that there were 

14 fewer findings per case, even than we did with 10 

15 through 13, which we just completed. 

16 So, I'm not sure. I would certainly 

17 think it is important to keep, for us and the 

18 Subcommittee to try to keep track of that in our 

19 minds and try to see if we can characterize it but, 

20 for the moment, I would say we have not discussed 

21 as a Subcommittee anything like that or that 
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20

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1 specific issue, I should say.

2 CHAIRMAN MELIUS: Yes, no I think the 

3 question may be that there are fewer findings now 

4 because the program is more mature. There is 

5 better documentation of the methods. And, 

6 therefore, it is easier for the dose reconstructors 

7 to do the dose reconstructions in a way that are 

8 well-documented and then therefore for SC&A to 

9 confirm that the methodology has been 

10 appropriately applied. I mean I think it is good.

11 But it is something I think you would 

12 expect from that. I think it would be, if the other 

13 Board Members agree, I think we can ask SC&A to 

14 characterize the cases with no findings, compared 

15 to those with findings. Then, see if there is any 

16 other pattern to that.

17 MEMBER KOTELCHUCK: I think that would 

18 be useful.

19 CHAIRMAN MELIUS: Paul, do you, and 

20 Josie?

21 MEMBER BEACH: Yes, I agree with that 
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1 also.

2 MEMBER ZIEMER: Well, that was the 

3 point I was making. I wasn't sure whether SC&A 

4 already sort of knows the answer to that or whether 

5 they would have to actually do the analysis.

6 CHAIRMAN MELIUS: Well, if they know, 

7 they are not telling.

8 MEMBER ZIEMER: Yes.

9 MS. BEHLING: Excuse me, this is Kathy 

10 Behling. As far as I know, we have never looked 

11 into analyzing which cases have no findings and why 

12 that might be. So, that would have to be something 

13 we are tasked to do. As far as I know, we have not 

14 done that in the past.

15 MR. STIVER: This is John. Kathy is 

16 right, we haven't actually looked into that aspect 

17 yet.

18 MEMBER ZIEMER: It is quite possible 

19 that there isn't a pattern, that it is just a 

20 reflection of what the majority of the process, the 

21 development of quality control all along the lines.
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1 CHAIRMAN MELIUS: And that may 

2 actually show up in the analysis in the sense that 

3 for sites that have been better developed or the 

4 methods have been better developed, there will be 

5 fewer findings than for those that are less 

6 developed, so to speak. There may be more.

7 MEMBER ZIEMER: If that was the case, 

8 I would certainly be more comfortable in the Board 

9 saying okay, the system is working better. We can 

10 reduce the number of cases -- well, we had a goal, 

11 I think originally. Remind me, was it two and a 

12 half percent?

13 CHAIRMAN MELIUS: Something like that, 

14 yes.

15 MEMBER BEACH: That's correct.

16 MEMBER ZIEMER: Which we would have had 

17 a hard time reaching but if we needed to reduce that 

18 to something realistically a little lower, to maybe 

19 two percent or one and a half, I think we would be 

20 more comfortable doing it if we have confidence 

21 that the system, indeed, is working better.
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1 MEMBER KOTELCHUCK: Yes, I will say 

2 that if SC&A is tasked to look at this and they find 

3 there is a pattern, if we are talking about saving 

4 time, either from SC&A and from NIOSH and from the 

5 Subcommittee, it would have to be an unusual 

6 finding to tell us don't bother with that case. 

7 Right? If we don't spend time in Subcommittee --

8 we don't spend much time in Subcommittee when there 

9 is no findings. Right? I mean it just goes very 

10 quickly and we are happy with that. But if we find 

11 that there is a pattern, the only way we will save 

12 time is if the pattern suggests to us a priori when 

13 we are selecting cases to review that we shouldn't 

14 even bother with that, which would seem like an 

15 unusually strong finding.

16 MR. CALHOUN: This is Grady. Aren't 

17 you actually talking about reducing the overall 

18 number that you start with, rather than eliminating 

19 some of those that you pick initially?

20 MEMBER KOTELCHUCK: Well, we could do 

21 that, although I should say we are only reviewing 
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1 this 10 through 13. I did take a look at it. We 

2 are only reviewing one percent of cases in the first 

3 report that was put out in 2010, they said oh, we 

4 are trying to do two and a half percent and we are 

5 nowhere near it and we have to recognize that and 

6 decide if there is something that we should either 

7 do more.

8 So, I don't think we are talking about 

9 doing fewer. We could, though. I mean we could 

10 say that. We don't have the less than one percent 

11 reviewed.

12 MEMBER ZIEMER: We are already well 

13 below two and a half percent.

14 MEMBER KOTELCHUCK: We are at one 

15 percent and we took an awfully long time for 10 

16 through 13. And I don't know because I haven't 

17 been on the Board long enough to know if we are 

18 really slowed down badly because we are not 

19 efficient as a Subcommittee. I hope that is not 

20 true. I think we are trying to be very efficient.

21 MS. BEHLING: This is Kathy Behling. 
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1 If you don't mind if I could just interject 

2 something. And probably everybody already 

3 remembers this is just to remind to everyone. When 

4 we put out the first hundred cases, that was back 

5 at a time where NIOSH was trying to work on cases 

6 that were a little bit easier, I guess, that it was 

7 pretty obvious as to what maybe the outcome was 

8 going to be. And they used, as you are fully aware 

9 of, the either maximizing approach where you try 

10 to really give them everything that you could 

11 regarding doses or a minimizing approach saying we 

12 don't even need to calculate all the doses because 

13 we already realize that this case will be 

14 compensated.

15 And so actually, when we put out our 

16 first report to the secretary, there were only 

17 eight, I think less -- or about eight percent of 

18 the cases that were best estimates.

19 Now, with this next set that we have 

20 been working on, these are now the best estimate 

21 cases and that is what we have been focusing on. 
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1 And I think one of the other things that we have 

2 to realize is as Jim Melius is saying, the process 

3 has had to get more mature and more sophisticated. 

4 The work books are very prescriptive. The 

5 procedures are much more prescriptive, in order for 

6 us to maintain consistency as best we can. So, 

7 perhaps that is why we are seeing fewer type of --

8 fewer findings and probably that is more of a 

9 quality assurance type of findings that we are 

10 having.

11 But just to refresh everyone's memory 

12 as to what the first hundred cases represent as 

13 compared to what these next hundred cases are going 

14 to represent, a different group.

15 MEMBER KOTELCHUCK: Yes, and it was an 

16 important finding of those first hundred cases that 

17 we should do fewer over estimates and we should do 

18 more full findings. And that is what we have been 

19 doing.

20 I mean we are following the conclusions 

21 from our first report.
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1 MS. BEHLING: This is Kathy Behling 

2 again. I hope I am not overstepping my bounds 

3 here. 

4 But also, one of the things that always 

5 strikes me also and perhaps I haven't looked at the 

6 details of this but the only other suggestion I 

7 would make with regard to selecting cases is to 

8 select cases from sites that perhaps don't have a 

9 real formal protocols, such as initially like one 

10 of the examples was this Allied Chemical and Dye 

11 that did a blind on. We came up with different 

12 approaches because there was, for that particular 

13 AWE site, not real clear protocols or technical 

14 documents that were available. And so I would also 

15 suggest that we look at cases from sites where you 

16 may not have as much detail with regard to how the 

17 dose reconstructor approaches doing a dose 

18 reconstruction for that particular site.

19 CHAIRMAN MELIUS: I would actually --

20 this is Jim Melius. I would actually argue against 

21 that in the sense that those sites may be more 
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1 appropriate for a blind review.

2 MS. BEHLING: That is a very good 

3 point. Yes, I agree.

4 CHAIRMAN MELIUS: Because there aren't 

5 -- and the lack of sort of the documentation, it 

6 may be better to then essentially combine sort of 

7 the Site Profile review and the actual dose 

8 reconstruction review.

9 MS. BEHLING: Exactly. As I said, the 

10 Allied Chemical and Dye was a perfect example.

11 CHAIRMAN MELIUS: Yes. I think that 

12 the other thing to remember in all of this is that 

13 as the program -- you know as time has gone by, when 

14 there have been a lot of sort of Site Profile 

15 findings, procedure findings that have changed 

16 methodology and, obviously, Special Exposure 

17 Cohort findings that have changed methodologies 

18 used, and all those have been going on at sort of 

19 different speeds for different sites, with 

20 different outcomes.

21 It may be the luck of the draw but it 
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1 seems that every time I end up doing my selected 

2 cases for dose reconstruction reviews, there 

3 always seem to be one or two SEC cases among those. 

4 That is sort of the time lag and what is going on 

5 in particular sites and so forth.

6 But I think in sort of how we report to 

7 the Secretary what the findings are, we have to keep 

8 in mind that our findings on oversight of the dose 

9 reconstruction also include all the procedure 

10 reviews, Site Profile reviews and SEC evaluations 

11 that the Board looks at. Because those, certainly 

12 in the past, have had probably a bigger impact on 

13 the program and on sort of dose reconstructions 

14 than have the individual dose reconstruction 

15 reviews.

16 Now, I think that is changing as sort 

17 of everything matures and time goes by. And we 

18 have had trouble sort of integrating all of those 

19 in terms of understanding what is happening with 

20 the program.

21 MEMBER ZIEMER: This is Ziemer. I 
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1 have just a quick question. I assume that in terms 

2 of today's meeting, we are just raising that as a 

3 potential issue to be considered. We are not 

4 making charter decisions today on yea or nay on how 

5 to do that. Right?

6 CHAIRMAN MELIUS: Correct, yes. All 

7 we are doing today is --

8 MEMBER ZIEMER: An issue to be 

9 considered going forward.

10 CHAIRMAN MELIUS: Yes.

11 MEMBER ZIEMER: Right.

12 CHAIRMAN MELIUS: I want to come back 

13 to the blind reviews for a second. I found the few 

14 that have come through and the findings have been 

15 interesting.

16 One thing that struck me about them is 

17 that when there have been discrepancies and my 

18 sample size is small, it is only a few cases, but 

19 when there have been discrepancies between SC&A's 

20 estimate and what NIOSH/ORAU found, it appears to 

21 be often due to I will call them undocumented, that 
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1 is probably too strong a word, undocumented 

2 methodologies, methodologies that aren't clearly 

3 documented in a way that, in terms of procedures 

4 or have evolved in a way that the methodology is 

5 ahead of the documentation. So, the dose 

6 reconstructors may know about it but the Board and 

7 SC&A may not be aware of those changes.

8 And I don't think that is necessarily 

9 a criticism of what is being done. These are 

10 complex sites, many different exposures that we 

11 obviously don't want to hold up a dose 

12 reconstruction while a particular procedure or 

13 something gets documented. And some of these 

14 methods are probably not important enough in the 

15 bigger scheme of things, in terms of the number of 

16 people affected that it requires all the 

17 administrative and other effort that goes into 

18 various kinds of tic-tac-toe documents are 

19 produced.

20 But it does raise the question of 

21 consistency in terms of how those are applied 
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1 within the dose reconstruction effort that goes on.

2 I think that is the sort of consistency, 

3 and the consistency comes up in other ways. It 

4 comes up in terms of how interview information is 

5 used in terms of doing does reconstruction. It may 

6 come up in terms of interpretation of work 

7 histories and so forth for people that are 

8 undergoing dose reconstruction. And I think that 

9 is one area that we ought to think about. Are there 

10 better approaches that could be used to evaluate 

11 that and make sure that there is consistency? 

12 Because I think that that is important for people 

13 undergoing dose reconstruction, that they and 

14 their fellow workers are treated -- would get the 

15 same result.

16 And it is certainly something that we 

17 repeatedly hear from in public meetings. In 

18 public comment periods, people don't understand 

19 why the person they worked with had a Probability 

20 of Causation of X and they only got Y, even though 

21 they worked side-by-side. And pretty often, that 
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1 is due to the organ affected or other technical 

2 issues but I do think the consistency is something 

3 that our review methods ought to be looking at. 

4 And I was curious about how other Board Members felt 

5 about that.

6 MEMBER ZIEMER: Well, it sounds like 

7 there is a lack of feelings on that.

8 I'm sitting here pondering it. I think 

9 that makes sense. I don't think I can add to what 

10 you said there.

11 MEMBER BEACH: Yes, I think I am silent 

12 in the same respect, Jim. I agree with what you 

13 have said. I can't add to it but agree that it is 

14 important and consistency is an important part of 

15 this.

16 MEMBER KOTELCHUCK: I agree also. 

17 Dave.

18 There is one observation from the 

19 earlier reports that I would be really curious 

20 about. And that may even impact on the cases where 

21 there are no findings.
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1 There was a recommendation that we take 

2 a look at the findings and results for cases where 

3 the information is basically provided after the 

4 death of the person versus the person who is putting 

5 the claim in, giving us the information.

6 And I have wondered whether, because I 

7 assume that if the family puts information in, they 

8 have no way of correcting the work records that we 

9 find. And I would wonder whether an individual 

10 reporting in his or her claim would actually be able 

11 to say that no, no, those work records are incorrect 

12 because I did this and this. And then one goes back 

13 and checks them and hopefully finds --

14 Put it this way. It seems to be to be 

15 an interesting question and may have a lot of

16 bearing or may have some bearing on the reliability 

17 of or the consistency of our findings. I am 

18 curious about it and I hadn't thought much about 

19 that before, until, frankly, I reviewed the report 

20 recently.

21 CHAIRMAN MELIUS: This is Jim. That 
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1 issue has come up and we, in other ways, have always 

2 been concerned about what happens, for example, 

3 when the information with the interview 

4 contradicts what is in the work records that are 

5 being used or the exposure records that are being 

6 used for dose reconstruction and it is problematic.

7 Particularly problematic are so-called 

8 incidents and how those are recorded and often not 

9 recorded and very difficult. I think that is one 

10 of the sort of consistency issues is how is that 

11 type of information interpreted.

12 The example you used, the deceased 

13 claimant, what is the gold standard there is this 

14 sort of the problem because we know that very often 

15 work records and so forth, where a person is located 

16 is not well-documented all the time or consistently 

17 documented. And in fact, that is one of the basis 

18 for -- or at least the extent of a lot of our Special 

19 Exposure Cohort Class Definitions is the fact that 

20 the records don't reflect, very often don't reflect 

21 everyone who worked within a given part of the
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1 facility. So, we end up extending the Class to a 

2 much larger group. And that is the issue we are 

3 wrestling with up in Idaho right now.

4 So, but I do think we have to think about 

5 other ways we can get that issue but also at least 

6 so that it is being handled in a consistent way.

7 MEMBER KOTELCHUCK: Are the folks at 

8 ORAU or are we aware that a claimant is alive? And 

9 if the claimant passes away, are we informed of 

10 that?

11 I mean that would impact -- if people 

12 have cancer and it will become fatal or they will 

13 die of something else, but they have cancer, there 

14 would be a value in making sure that we try to get 

15 a CATI report out while the person is still alive. 

16 That would be valuable information.

17 But if we don't know that the person is 

18 alive and I certainly don't know from the data that 

19 we see, then we may miss out. I mean a person may 

20 have six months of life, after they put a claim in. 

21 And it would be valuable to speak to the person if 
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1 we could, during that period, if we could.

2 MR. CALHOUN: This is Grady and I can 

3 give you a little bit of information on that.

4 MEMBER KOTELCHUCK: Good.

5 MR. CALHOUN: When there is a case that 

6 is terminal, you know in really bad shape, we 

7 actually will get an expedite request from the 

8 Department of Labor and we do everything we can to 

9 try to make sure that that case is done very 

10 quickly. And we do do that, and we get them done 

11 quite quickly and we do try to get a hold of the 

12 actual claimant or even if one of their authorized 

13 reps is willing to help answer questions for them 

14 so we can do that quickly and get them a result.

15 And that happens through a different 

16 ways. It can actually be initiated through the 

17 Department of Labor when they find out that someone 

18 is terminal and it also can come through our 

19 ombudsman, Denise Brock, and she actually can get 

20 the information and then she will prod the 

21 Department of Labor -- I don't use prod as it if 
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1 that is a very difficult thing to do but she will 

2 say hey, this person is critical or terminal and 

3 we need to get that through the system as quick as 

4 we can.

5 And do that. When that happens, we 

6 send a request over to ORAU, they put that at the 

7 top of their list and they get that done quite 

8 quickly. Sometimes we are waiting on Department 

9 of Energy records but I'm not going say that that 

10 is usually a hassle either because they also get 

11 the notification that it is a terminal case and most 

12 of the sites are very good about getting us the 

13 records quickly.

14 Now, if somebody dies, obviously, they 

15 are no longer an available claimant for that case 

16 and we won't know about that unless we find out, 

17 primarily, through the Department of Labor.

18 Now, if somebody dies even after a case 

19 is completed, we will allow the new claimant to 

20 provide a CATI that we can look at and see if somehow 

21 they had information that the actual employee 
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39

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1 didn't have that may affect the outcome of the case.

2 So, those mechanisms are in place. If 

3 somebody has died, though, we are very unlikely to 

4 find out about it, except for if the case is brought 

5 to the attention of Labor by other existing 

6 claimants.

7 MEMBER KOTELCHUCK: Well, what you say 

8 is quite reassuring because at the beginning of the 

9 process, there is an effort to make sure that 

10 terminal cases are looked at quickly. And the 

11 issue at the end, toward the end, when the person 

12 has died, that is to me, less critical.

13 So, I am reassured by what you say and 

14 glad to hear it.

15 MR. CALHOUN: And it is not infrequent. 

16 I don't have the numbers off the top of my head but 

17 I get all of the requests. The expedite requests 

18 that I send over to ORAU, I would say that we average 

19 more than one or two a week.

20 MR. MAHER: This is Ed Maher. I 

21 confirm that number. And I also point out that on 
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40

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1 our side when we get those expedite requests, if 

2 the data is in-house and the interview is done, we 

3 mandate a five working day turnaround on that 

4 claim.

5 Unfortunately, a lot of these claims 

6 are fairly new claims that the dosimetry data has 

7 not arrived but the CATI is done right away. Pat's 

8 group will go out and do a CATI right away.

9 MEMBER KOTELCHUCK: Good and that is 

10 what is most important.

11 CHAIRMAN MELIUS: Yes, I should 

12 mention -- DOL made a very good effort to address 

13 the issue when somebody is terminal or near 

14 terminal and has a short time left. We do have to 

15 recognize that there are lots of situations where 

16 claimants have already died.

17 MEMBER KOTELCHUCK: Oh, yes.

18 CHAIRMAN MELIUS: And because of the 

19 family members often know very little about what 

20 their family members did and certainly not the kind 

21 of work detail that might be helpful for their 
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41

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1 cases.

2 MEMBER KOTELCHUCK: Well, that is why 

3 getting the CATI quickly is so important. And 

4 obviously, folks have thought about it and this is 

5 an absolutely reasonable approach.

6 Okay, my question is answered.

7 CHAIRMAN MELIUS: Just back to the 

8 consistency issue for a second. I mean one of the 

9 possibilities of approaching this is doing it one, 

10 you start with an individual dose reconstruction 

11 but start then selecting cases based on other 

12 people with the same situation, basically, that 

13 worked roughly the same time period, the same 

14 exposures and see how their cases were handled, 

15 also, which would be a little different approach 

16 in terms of how we are selecting cases that we do 

17 now.

18 MEMBER KOTELCHUCK: Right.

19 CHAIRMAN MELIUS: One of the other 

20 things I wanted to mention earlier but I wanted to 

21 bring up, get some other thoughts from Board 
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42

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1 Members is right now we, in terms of the dose 

2 reconstruction review process, we go through, the 

3 Subcommittee goes through basically all of the 

4 findings and tries to resolve all of those with 

5 NIOSH.

6 Now, it has been mentioned if it is a 

7 negative finding, there is not a lot of time spent 

8 on it but there is some. And it takes up some 

9 administrative time.

10 So, one of the thoughts that has been 

11 mentioned has been well, let's just focus on 

12 positive findings. So, if there are no findings 

13 within a data set or a case within a data set being 

14 reviewed, that that would not get any further 

15 attention or only those findings where there is a 

16 discrepancy or question or difference would those 

17 be reviewed.

18 And I am just curious now what the other 

19 Board Members thought about that approach. The 

20 idea is it would save time but I guess the down side 

21 is that it would be maybe both NIOSH and SC&A were 
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43

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1 wrong.

2 MEMBER BEACH: This is Josie.

3 I think to save time that seems like a 

4 reasonable approach. And maybe if you don't want 

5 to totally not look at those others, do a smaller 

6 sampling of those. 

7 One of the things that I was always 

8 concerned with is when you did your reviews and you 

9 found cases where you were at a point where the 

10 findings were such that it could potentially put 

11 the percentage over the mark, and those, to me, are 

12 so important to re-look at and there has never been 

13 any feedback from those, from my point of view. 

14 And now being on the Subcommittee, I will probably 

15 see that go through.

16 MEMBER KOTELCHUCK: Right. How 

17 about, Josie, how about -- am I on, by the way?

18 MEMBER BEACH: Yes.

19 MEMBER KOTELCHUCK: Okay. How about 

20 that we say that if there are no findings but the 

21 Probability of Causation exceeds 45 percent, that 
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44

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1 we look at it, in case the Subcommittee would see 

2 a concern or even possibly an error or whatever?

3 But that if the PoC is under 45 percent 

4 and there is agreement between ORAU and SC&A, we 

5 don't bother with it? And that, to me, would work 

6 and would take care of the problem of cases that 

7 are close.

8 MEMBER ZIEMER: This is Ziemer. I 

9 have two comments on Jim's question. The ones with 

10 no findings, I think probably, for efficiency, it 

11 makes sense not to take administrative time to 

12 review those with the Subcommittee or even in the 

13 smaller groups, the peer person groups.

14 The chance of one of the Board Members, 

15 contrary to NIOSH or SC&A, actually finding an 

16 error in the dose reconstruction is pretty small 

17 because, although we have the individual 

18 information on the case and all the details of their 

19 case, we don't have all the tools that SC&A works 

20 with to actually go through those. So, I don't see 

21 that. You know and you say what if they are both 
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45

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1 wrong, I don't think that there is much chance that 

2 we would find that both were wrong.

3 MEMBER KOTELCHUCK: Well, I admit that 

4 I do not remember any case situation where that has 

5 happened. I think it is just instinctively trying 

6 to be conservative. Because when we get close, 

7 when the cases we review are close, we look very, 

8 very carefully.

9 MEMBER ZIEMER: Well, I know but I am 

10 just talking in general about the no findings 

11 cases. And if SC&A has no findings on it, then I'm 

12 not sure what we gain in terms of the smaller groups 

13 going through it before it goes up to the main 

14 committee. I certainly think those cases have to 

15 be looked at carefully.

16 One other comment I wanted to make going 

17 back to Jim's earlier consistency issue in cases 

18 where you have other people in the same categories, 

19 to some extent, Jim, we did try to select --

20 remember we often tried to select cases by cancer 

21 category so we would make sure we looked at certain 
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46

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1 types of cancers. We also were selecting by 

2 categories of how long people worked in facilities. 

3 Now, we weren't directly confirming all of those 

4 on a one-to-one basis but were trying to make sure 

5 we looked at, for example, a sufficient number of 

6 certain cancers, sufficient numbers of people who 

7 had worked several decades and that sort of thing.

8 CHAIRMAN MELIUS: This is Jim. I am 

9 aware of that. I guess I was thinking of I'm not 

10 sure it necessarily identified situations where 

11 there are, I will call them, undocumented methods 

12 being used or maybe less documented methods. I 

13 don't know what the right terminology is. I don't 

14 want to disparage what ORAU was doing.

15 MEMBER ZIEMER: Are you focusing on the 

16 ones where we don't have sort of the workbook 

17 approach?

18 CHAIRMAN MELIUS: Yes, correct.

19 MEMBER ZIEMER: Yes, okay.

20 CHAIRMAN MELIUS: And there may be 

21 other situations of have you interpreted the work 
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47

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1 history or whatever, where there is more judgment 

2 involved, individual judgment involved.

3 MEMBER ZIEMER: And don't most of them 

4 involve pretty small facilities where we don't have 

5 Site Profiles and the number of claims, themselves, 

6 are fairly small?

7 CHAIRMAN MELIUS: Yes.

8 MEMBER ZIEMER: It may be difficult to 

9 try to match up and say okay we have got several 

10 cases alike in this facility.

11 CHAIRMAN MELIUS: Not necessarily. I 

12 think they apply in some other situations also. 

13 But I do think they do come up there.

14 And sort of the other counter argument 

15 on those small sites is that because there is a lack 

16 of information, the dose reconstructions methods 

17 are usually pretty simple. It is usually some 

18 measure of exposure or does times the number of 

19 times worked.

20 MEMBER ZIEMER: Yes, the number of 

21 replies in a limited time period.
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1 CHAIRMAN MELIUS: So, I don't think 

2 those are -- I guess I was thinking more in some 

3 of the more complicated sites and complicated 

4 calculations, where these might come up or where 

5 it is based on where work history data becomes more 

6 important or interpretation of that.

7 I mean the classic example is the number 

8 of incidents. And we have gone back and forth on 

9 that and the number of the sites trying to -- it 

10 is not an easy situation to resolve because those 

11 aren't always recorded all in the same place or 

12 recorded at all and may be based on people's 

13 recollections and so forth.

14 Other thoughts on what any additional 

15 information we might --

16 MEMBER KOTELCHUCK: Well, the one 

17 thing I do have a fairly strong feeling about 

18 personally is the spending Board time -- spending 

19 Subcommittee time on observations as opposed to 

20 findings.

21 And we don't review the observations 
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1 but we talk about them. And if I may say, it gives 

2 us all an opportunity to chat and we are not going 

3 to decide on it anyway. So, sometimes the issues 

4 are intellectually interesting and it is easy to 

5 talk a little bit about that and spend time but take 

6 a look at 14 through 21. We have only 29 findings 

7 but we have 60 observations.

8 Now, we are not going to save an 

9 enormous amount of time and we will save time and 

10 I think that some Subcommittee Members have felt 

11 that we should not spend time on observations and 

12 just have ORAU and NIOSH talk with each other about 

13 the issues that are raised there.

14 Once in a while, we find an observation 

15 that should have been a finding, I will say. I 

16 don't have any sense of what percent of times that 

17 happens but it can't be more than ten percent or 

18 probably less.

19 So, we would save time by having not 

20 discussing in the Subcommittee observations.

21 MR. CALHOUN: Dave, this is Grady and 
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1 I agree with you because we actually spend time to 

2 write responses to those and I really do feel that, 

3 on average, we spend as much time discussing each 

4 observation as we do a finding.

5 MEMBER KOTELCHUCK: Well, that is 

6 interesting. I mean I don't have that perception. 

7 But if you do and if you are writing a report, then 

8 we save a lot of time in the whole overall 

9 operation, that is for ORAU as well as for the 

10 Subcommittee.

11 I would be in favor of that. I have 

12 felt that fairly strongly and more strongly as time 

13 goes on and we are trying to move through lots of 

14 cases for review.

15 MEMBER BEACH: Well, Dave, this is 

16 Josie. I think we have to be very careful that we 

17 aren't putting issues into observation when they 

18 really should be findings. And I agree with what 

19 you are saying about not spending a lot of time on 

20 the observations but I want to make sure we are not 

21 missing findings within the observations.
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1 MEMBER KOTELCHUCK: Well, I would 

2 estimate, and Grady see what you think just based 

3 on our practice recently, I would say less than ten 

4 percent of the observations, probably closer to 

5 five percent, actually end up being switched to a 

6 finding.

7 MR. CALHOUN: I agree with that. I 

8 think it might even be less than that.

9 MEMBER KOTELCHUCK: Yes, I think it 

10 might be.

11 MS. GOGLIOTTI: This is Rose. I think 

12 we have five cases in 10 through 13 that had 

13 findings switched or observations switched, if 

14 that helps.

15 MEMBER BEACH: Okay.

16 MEMBER KOTELCHUCK: Pardon? I missed 

17 that.

18 MS. GOGLIOTTI: I know we have cases 

19 that have flipped in sets 10 through 13.

20 MEMBER KOTELCHUCK: Okay.

21 MEMBER BEACH: I just think in the 
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1 beginning on the onset, we need to be careful what 

2 we are listing as findings and observations and 

3 maybe err on the side of making them findings, if 

4 they are closed. But that is a question.

5 MEMBER KOTELCHUCK: Yes, although, let 

6 me say this. Making them findings doesn't change 

7 the compensation, generally. It is having 

8 accurate reporting on our process. So, it is not 

9 a tragedy to miss them.

10 The other way is to say let's begin the 

11 process of not looking at observations by 

12 continuing to look at them for some period of time 

13 and then making a later decision. But I do think, 

14 Josie, as you come on the Subcommittee, I think you 

15 will see that we do spend a fair amount of time on 

16 them.

17 I'm not -- respectfully, I cannot tell 

18 Board Members, it is not my role to say I wish you 

19 wouldn't chat about that because we have so many 

20 more cases to do today.

21 MEMBER BEACH: No, no, I understand.
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1 MEMBER KOTELCHUCK: And it is very easy 

2 to talk about it. And the issues are, as I say, 

3 scientifically interesting, the differences of 

4 opinion but not so important for compensation.

5 MR. CALHOUN: This is Grady again. We 

6 have got a long track record of categorizing things 

7 as findings and observations and I think, 

8 generally, that SC&A does a good job of determining 

9 what should be a finding and what should be an 

10 observation. Typically, it is something that like 

11 with any QC audit type process, it is an observation 

12 when it is not a violation of a procedure or a 

13 document.

14 I think they have done a really good job 

15 of determining which are truly observations and 

16 which are findings.

17 MEMBER KOTELCHUCK: You know what, 

18 Jim? If we know that there are five observations 

19 that became findings in 10 through 13, Jim, if we 

20 could task SC&A to tell us the total number of 

21 observations, let's get a percentage on it.
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1 CHAIRMAN MELIUS: Yes, that would be 

2 fine.

3 I would just -- my question, Rose, and 

4 I don't know if you have the information on that, 

5 but at least my recollection is in the time between 

6 SC&A's draft report is then reviewed by individual 

7 Board Members, there are situations I can recall 

8 in my small sample, where we changed observations 

9 to findings and probably vice versa also. 

10 MS. GOGLIOTTI: That is a good point. 

11 In the one-to-ones, we often do change findings and 

12 observations.

13 MEMBER ZIEMER: I've had the same 

14 experience. This is Ziemer. So, they are findings 

15 before they get to the DR Subcommittee.

16 CHAIRMAN MELIUS: Yes.

17 MEMBER KOTELCHUCK: I am missing the 

18 implication of that.

19 CHAIRMAN MELIUS: Five may be an 

20 underestimate of the number of initial 

21 observations that became findings. There is an 
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1 earlier step in the process, when the individual 

2 Members go through them with SC&A.

3 MEMBER KOTELCHUCK: Well, that's true 

4 --

5 MS. GOGLIOTTI: It's not uncommon in 

6 the beginning.

7 CHAIRMAN MELIUS: And the opposite 

8 happens also but I think it is -- my guess is that 

9 it is more common for observations to become 

10 findings because the individual Board Members 

11 involved in that point in the process think that 

12 at least the Subcommittee ought to look at that 

13 issue. It may be borderline but it deserves some 

14 additional scrutiny.

15 But if we continue with it, so not to 

16 say that that what you are proposing isn't 

17 appropriate, Dave, but it is only -- I think we just 

18 have to be careful when we think where the 

19 evaluation is done and where these changes might 

20 take place.

21 MR. KATZ: Yes, this is Ted. Keep in 
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1 mind, at least I haven't heard anyone propose that 

2 you cut out that step in the process, the two Board 

3 Members meeting. So, that would still be there as 

4 sort of a safeguard if you were to follow Dave's 

5 proposal.

6 MEMBER ZIEMER: The observations have 

7 already been reviewed by that subset.

8 MR. KATZ: Right, that's what I meant.

9 MS. BEHLING: This is Kathy Behling. 

10 If I can just -- an example of what we often do on 

11 the observations is if there is inconsistencies 

12 between maybe procedures and they have these DR 

13 notes that the dose reconstructor are often looked 

14 at while they are doing the dose reconstruction. 

15 And in fact, I am looking at one observation right 

16 now that says there was an inconsistency between 

17 the Technical Basis Document, an OTIB, and a 

18 Savannah River DR note.

19 And I think a lot of times we are not 

20 trying to blame the dose reconstructor for that but 

21 we just want to make NIOSH and ORAU aware of that 
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1 type of issue.

2 So, this is our avenue to do that 

3 because NIOSH is not involved in that one-on-one 

4 process. So, we can't just completely ignore the 

5 observations during the Subcommittee meetings, in 

6 my mind.

7 Perhaps, if I could suggest this. If 

8 you would like, prior to these meetings, that SC&A 

9 actually try and categorize the observations so 

10 that to put out front those that we want to make 

11 sure get some attention, although they make an 

12 observation --

13 MR. KATZ: Well if I may, Kathy, it is 

14 not necessarily an issue of the Dose Reconstruction 

15 Subcommittee but it is an issue of whether NIOSH 

16 shouldn't be --

17 MS. BEHLING: Correct.

18 MR. KATZ: -- observing those 

19 observations as well, as opposed to -- yes.

20 MS. BEHLING: Correct. And other 

21 issues come up such as if we see something in the 
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1 documentation, DOE documentation that maybe there 

2 was some type of an incident. I am looking at 

3 another observation here in one of the matrices 

4 that says we realize that there was a tritium 

5 incident that was never reported. When we looked 

6 at the data, it looks as if NIOSH did cover that 

7 data. They did assess the data appropriately but 

8 there was no mention of that in the dose 

9 reconstruction report and, perhaps, that 

10 individual will go back and then not recognize that 

11 that was assessed or looked at.

12 So, those are the types of things we put 

13 into the observation.

14 MEMBER KOTELCHUCK: Well, we have, in 

15 the past, said why don't the ORAU and SC&A people 

16 talk together about the observations before it 

17 comes to the Subcommittee and see if you can't 

18 resolve them. And then leave it up to you folks 

19 to say no, I think we would like the Subcommittee 

20 to look at it.

21 In other words, as we are reviewing the 
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1 documents before the meeting, I would feel it would 

2 be useful, it seems to me, to have those findings 

3 discussed between the two parties and not 

4 necessarily brought to the Subcommittee, but only 

5 brought those things that you think, in your 

6 judgment, in your professional judgments, warrant 

7 a look and you would like to bring it before the 

8 Subcommittee. Is that something that could be 

9 done on a consistent basis?

10 MR. CALHOUN: Dave, this is Grady. 

11 And I believe that we do typically include 

12 responses on our matrices for the observations. 

13 Now, getting together and having a pre-meeting 

14 meeting, I hate to commit to that right now just 

15 because of all the work that goes into this already. 

16 That seems like -- I don't know if the payoff would 

17 be -- if that would involve less time or more time 

18 overall.

19 MEMBER KOTELCHUCK: Okay, so your 

20 feeling is it is a pre-meeting meeting. Well, if 

21 it is, then that is a problem.
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1 But you know, I am just looking ahead 

2 to 14 to 21 and we are going to go through 29 

3 findings and 60 observations. And I tell you, we 

4 spend time on those. Everybody who is on the 

5 Subcommittee knows that and are sitting in on the 

6 Subcommittee meetings. We do spend a fair amount 

7 of time on it, even if the Subcommittee does not 

8 make a decision.

9 And Jim, it is also true that the 

10 Subcommittee has turned back observations into 

11 findings.

12 CHAIRMAN MELIUS: Sure. Maybe we 

13 should have a 30-second timer going on when we have 

14 discussion of observations or something.

15 MEMBER KOTELCHUCK: Well, you know, a 

16 30-second timer could be the chair being instructed 

17 to suggest to the Subcommittee Members that let's 

18 keep this short. And many times, that just happens 

19 of its own accord. But I assure you, many times, 

20 it does not. And I respect the opinions and voices 

21 of every single person on the line. So, I am not 
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1 going to tell somebody please, could you -- you 

2 know, I am not going to call time on them. At least 

3 I feel it is inappropriate; whereas, I wish 

4 sometimes they would finish quickly. But it just 

5 seems to me not in my purview as chair to do that.

6 And seriously, that is an internal 

7 timer.

8 MEMBER ZIEMER: Well, maybe the 

9 Subcommittee can agree on some ground rules on how 

10 to handle those.

11 MEMBER KOTELCHUCK: Yes.

12 MEMBER ZIEMER: You know you don't have 

13 to impose them as the chair, per se, but maybe 

14 everybody could agree we won't spend more than X 

15 minutes on each of these.

16 MEMBER KOTELCHUCK: Well, why don't we 

17 do that? I mean we certainly can have a 

18 discussion.

19 MEMBER ZIEMER: We're not going to 

20 solve that today.

21 CHAIRMAN MELIUS: Yes, we are not going 
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1 to solve it today. I think some of the other 

2 Subcommittee Members want to weigh in on that one.

3 MEMBER KOTELCHUCK: I think so. So, 

4 we will have a conversation about that. We have 

5 a meeting in a couple of days and I can add that 

6 on the agenda and just have a brief discussion about 

7 that.

8 But I think that is probably all we 

9 should talk about, in terms of that issue.

10 MR. KATZ: This is Ted. Just before 

11 you close the conversation, let me just say my 

12 observation from the sidelines. I think everyone 

13 should keep in mind is just the general dictum or 

14 whatever you call it of not letting the perfect get 

15 in the way of the good.

16 I think you are going to find, at the 

17 end of the day, that you are going to have to make 

18 some sort of coarse, meaning rough, imperfect 

19 adjustments to your process that are fairly 

20 substantial that you are really going to ratchet 

21 up the pace, no matter what, even if, for example, 
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1 you manage observation discussions to a certain 

2 amount of time period or whatever, I think.

3 You know because we have tried very hard 

4 to ratchet up the pace over the last few years and 

5 really, I think, have been unsuccessful that way. 

6 And so, I think you are really going to have to think 

7 of some significant innovations to be able to --

8 if you are going to want to change the pace of how 

9 these reviews get done. 

10 Anyway, I just wanted to share that 

11 observation.

12 MEMBER KOTELCHUCK: Okay.

13 CHAIRMAN MELIUS: Well, I can throw out 

14 one possibility. Maybe we should have two Dose 

15 Reconstruction Review Subcommittees. I mean one 

16 possibility is you put more resources into -- well 

17 you have both sort of Board resources and --

18 MR. KATZ: Yes, I agree with that. 

19 That absolutely would make a significant 

20 difference.

21 CHAIRMAN MELIUS: Yes.
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1 MEMBER KOTELCHUCK: Oh, yes.

2 CHAIRMAN MELIUS: And that would mean 

3 appropriate increase, proportional increase in 

4 sort of SC&A resources and NIOSH/ORAU resources.

5 MR. KATZ: Right, exactly. And so 

6 NIOSH would have to be able to adjust its other 

7 resources accordingly to keep that pace.

8 CHAIRMAN MELIUS: Yes.

9 MR. CALHOUN: Yes, we basically have 

10 the same guys doing that and I don't know, that is 

11 basically doubling our resources on that. And you 

12 know then we are going to get into the hard decision 

13 of okay, what don't you want us to do.

14 I think that the discussions earlier 

15 about fine tuning what we look at and even the 

16 suggestion of reducing the overall number of cases 

17 we review, especially given the current findings, 

18 is the way to go.

19 You know, I appreciate trying to get 

20 through things quicker but golly, our guys are 

21 pretty slammed, as far as their workload.
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1 CHAIRMAN MELIUS: You know I still 

2 think it is something that shouldn't be off the 

3 table entirely. 

4 MR. CALHOUN: I agree with that but it 

5 will certainly not go without some impact on other 

6 parts of our program.

7 CHAIRMAN MELIUS: Or you will need some 

8 more resources for your program.

9 MR. CALHOUN: We have a fixed price 

10 contract.

11 CHAIRMAN MELIUS: I'm not saying that 

12 is what we are recommending but it should be a 

13 consideration, if we are going to get -- if the 

14 Board feels that is the only way or is part of the 

15 way of getting -- meeting its mandate to review your 

16 dose reconstructions.

17 MS. BEHLING: This is Kathy Behling. 

18 Dr. Melius, I am not sure if you were aware but I 

19 think that at the last Dose Reconstruction 

20 Subcommittee meeting, we also discussed perhaps 

21 setting a year in advance trying to establish when 
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1 the next meetings would be. And I don't know how 

2 soon they could be but like every six weeks, is that 

3 a possibility, knowing the fact that I guess you 

4 have put out a Federal Register notice? But that 

5 might also be one option we want to continue to 

6 pursue is establishing the meetings, let's say a 

7 year in advance, so that we could do them, perhaps 

8 more frequently.

9 MEMBER KOTELCHUCK: That's a 

10 possibility, certainly, and a reasonable one.

11 In a way that is more determined by what 

12 the intrinsic workload is for SC&A and ORAU. If 

13 you folks think that you could give us materials 

14 and write-ups to do that, we certainly could.

15 Although, I will say we have tried to 

16 have it in six week lumps and it starts to put 

17 pressure on our Subcommittee Members, who have 

18 other -- particularly, who have other job 

19 responsibilities. Some of us who are retired, it 

20 is easier to schedule more quickly.

21 And at times, when we have tried to 
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1 schedule a short time between meetings, we find 

2 that the meetings end up being canceled for lack 

3 of a quorum because somebody has some 

4 responsibility in their regular work. So, that is 

5 a problem.

6 Now, one could enlarge the committee. 

7 Rather than the double the committee, one could 

8 enlarge the committee but that adds to the workload 

9 of all the Board Members, which may be possible, 

10 it may not be.

11 MR. KATZ: This is Ted. I think the 

12 only way you can get more frequency is as Dr. Melius 

13 and you just mentioned, you would have to expand 

14 the Subcommittee and have, in effect, sort of a 

15 Subcommittee Part A and B or something, because it 

16 is not getting easier to schedule.

17 In scheduling, the main pitfall in 

18 scheduling has been actually Member availability. 

19 So, you will have to go that route, if you want to 

20 get more frequency.

21 CHAIRMAN MELIUS: One other issue, 
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1 this is away from efficiency, to another sort of 

2 different issue in terms of our overall approach, 

3 does anybody have any thoughts on sort of case 

4 selection? Do we need to modify the approach that 

5 we used for selecting the cases to be reviewed?

6 And I think, in essence, we have done 

7 that incrementally with each set. So, it is not 

8 like it has been a static approach since day one 

9 or even since set 13 or whatever. I think at any 

10 point in time, it keeps changing. Josie or Dave, 

11 do you have any thoughts on that?

12 MEMBER KOTELCHUCK: Well, here is a 

13 case where Members who have been on the 

14 Subcommittee longer than I have might weigh in. We 

15 have, more or less, used the same approach in 10 

16 through 13 throughout and it seems adequate to me. 

17 I have not been -- I haven't seen problems with it. 

18 I would be interested if others did and there may 

19 be other opinions. But, personally, I don't see 

20 it is in need of fixing. We usually are able to 

21 select them and agree upon the selections pretty 
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1 quickly and that is also true for blind cases. Our 

2 selection processes seem to work reasonably well 

3 within the Committee.

4 Would ORAU folks, if there is anything 

5 -- would you have any observation about that?

6 MR. CALHOUN: This is Grady. You know 

7 we have been focusing on 45 to 52 percent cases. 

8 And certainly those are the most likely to cause 

9 a change in compensation decision, if there is a 

10 significant mistake made. That limits us, though, 

11 to about 2.3 percent of all of the cases we have 

12 in hand. That is all that falls between 45 and 52 

13 percent. So, you know that is one thing out there.

14 So, certainly from your standpoint, it 

15 is a much more detailed review. All of the other 

16 ones are going to involve over estimate or 

17 underestimate. So, you are almost sharpening a 

18 marshmallow at that point.

19 The biggest problem with the thing we 

20 are looking now at is if the numbers that we can 

21 come up that fall within that range but we haven't 
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1 had a real lack of cases to review. That is why 

2 we are having this meeting. So, that is my only 

3 input on that.

4 And you know I feel good about the fact 

5 that very, very, very few cases have flipped 

6 compensability. Actually, we went back and looked 

7 and there was one that flipped a long time ago and 

8 that is when we were intentionally overestimating 

9 cases when we didn't have TBDs and that was at the 

10 very beginning of the project and that was one case. 

11 And that certainly wasn't a mistake. That was a 

12 directive given by our management at the time.

13 The second was a Rocky Flats case that 

14 went from comp to non-comp because there was no NDRP 

15 data provided by the Department of Energy. And 

16 again, that really wasn't a mistake on our part. 

17 That was information that wasn't given to us by the 

18 Department of Energy.

19 And through this entire process, there 

20 is only one other case that is currently being 

21 looked at where the compensability flipped. And 
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1 that has always been our prime focus, is to make 

2 sure that the appropriate compensation decision 

3 was given out. 

4 And given the current range that you are 

5 looking at, those are the ones most likely to flip.

6 MEMBER KOTELCHUCK: Right, I agree.

7 CHAIRMAN MELIUS: And I think we have 

8 pretty much covered the universe of sites, at least 

9 to the extent that there are dose reconstructions 

10 being done at those sites.

11 MR. KATZ: So, one thing, if you want 

12 in your tasking analysis from SC&A, you may want 

13 to look at sort of productivity by site of findings, 

14 if you want to call it productivity. But look at 

15 where you are finding more problematic cases and 

16 you may want to focus in that respect down the road, 

17 in terms of case selection. By method or site or 

18 whatever but whatever it turns out might be the more 

19 problematic types of cases.

20 MEMBER KOTELCHUCK: Yes, possibly. 

21 Although, having reviewed those cases, if 2.3 
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1 percent of the cases are 45 to 52, we are basically 

2 selecting half of those cases because we are 

3 reviewing one percent of all cases.

4 So, when we go through the selection 

5 from that 2.3 percent, we are not going to choose 

6 two from the same site or we might. But we try to 

7 spread them out with major sites and smaller sites, 

8 in terms of claims.

9 So, I don't think we can assess or I 

10 don't think we are failing in productivity by site, 

11 if you will or need improvement.

12 MR. KATZ: I guess what I am trying to 

13 say is I mean we have good distribution across the 

14 sites from our selections. 

15 MEMBER KOTELCHUCK: Right.

16 MR. KATZ: What I was trying to say is 

17 if, upon analysis, we find that there are sites 

18 where we really don't have many substantial 

19 important findings repeatedly, presumably because 

20 the dose reconstructions there just simply, 

21 whether they are simpler or better done, or what 
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1 have you, the source documents are better for those 

2 and approaches but if there are sites where they 

3 are not producing many findings of concern, then 

4 maybe those are sites that you don't focus on and 

5 you put more of your emphasis on the sites with more 

6 of the findings. That is what I was trying to say.

7 MEMBER KOTELCHUCK: I tell you, that 

8 will move us into more reviews of smaller sites, 

9 which have fewer claims, and also much less 

10 information.

11 MR. KATZ: Well no, I mean the simpler 

12 sites generally don't have so many findings because 

13 they are easier dose reconstructions to do.

14 MEMBER KOTELCHUCK: You may be right.

15 MR. KATZ: It's the big sites like SRS 

16 that are complicated that tend to be the most 

17 productive, I think. We will have to see. I don't 

18 know. Again, someone has to do the analysis.

19 MEMBER KOTELCHUCK: Yes. Other 

20 folks?

21 CHAIRMAN MELIUS: Do we want to have 
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1 that analysis done? Would that be -- I mean I don't 

2 think it would be hard to do based on, I would say 

3 do it for 14 through 21. We have already tasked 

4 SC&A to do some work on that.

5 MEMBER KOTELCHUCK: Well, I mean while 

6 I am not terribly persuaded that that is going to 

7 yield anything, I also certainly don't object and 

8 if it isn't a major task, I would be open to what 

9 other folks here suggest.

10 So, if other people would like to do it, 

11 I am open. And particularly, if it is not 

12 difficult to carry out. It is not a major task.

13 MEMBER ZIEMER: Well, we were actually 

14 asking SC&A, I think, to tell us where the findings 

15 were coming from, whether it is a type of case or 

16 a location. It seems to me, it is all part of the 

17 same analysis.

18 MEMBER KOTELCHUCK: Yes, okay. All 

19 right, we could do that. And I see that wouldn't 

20 be difficult.

21 MEMBER ZIEMER: To me, it is just a 
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1 sorting issue.

2 MEMBER KOTELCHUCK: Yes, it is. And I 

3 am looking at we have the facilities mentioned in 

4 each of the cases 14 through 21. Let's take a look 

5 at it, then.

6 CHAIRMAN MELIUS: What we don't have, 

7 and I think is harder to get at is sort of the dose 

8 reconstruction method involved and that is sort of 

9 below the surface a little bit more.

10 MEMBER KOTELCHUCK: Yes, but we are 

11 really looking at full internal and external.

12 CHAIRMAN MELIUS: Yes.

13 MR. CALHOUN: Jim, this is Grady and we 

14 certainly can give you a list of those sites for 

15 which we do not have a published TBD but for which 

16 we do have completed DRs.

17 CHAIRMAN MELIUS: That would be useful 

18 to have, Grady, I think, just to make sure we 

19 understand the universe.

20 I know in the SEC, I continually get 

21 surprised by sites that you come up with, that I 
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1 had forgotten about.

2 Any other? So, we are tasking SC&A to 

3 just do some additional analysis. Is that doable 

4 in the next 30 days, before the July meeting?

5 MS. GOGLIOTTI: Absolutely. We 

6 should have no problem doing that.

7 CHAIRMAN MELIUS: Thank you. Yes, if 

8 you can figure it out and sort of give us a date 

9 on that and whether we might want a short Work Group 

10 meeting before the July Board meeting, just to 

11 discuss that and do that.

12 And then what I was thinking of doing 

13 was doing sort of, I will call it, an early draft 

14 set of recommendations. It wouldn't be 

15 recommendations but just sort of trying to 

16 correlate different approaches that we might use 

17 in terms of recommendations, not that they would 

18 necessarily be what we would finally recommend to 

19 the Board but that it would at least provide the 

20 basis of discussion with the Board at the July 

21 meeting. And I will share that with everybody.
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1 MEMBER KOTELCHUCK: That would be 

2 fine.

3 CHAIRMAN MELIUS: Yes, I don't want 

4 anybody to get heartburn or something. In fact, 

5 just for Grady, I will propose four Dose 

6 Reconstruction Review Subcommittees or something 

7 at this point.

8 MEMBER KOTELCHUCK: Okay.

9 CHAIRMAN MELIUS: And then you can tell 

10 Stu and give him a headache, Grady, about it.

11 MR. CALHOUN: Okay.

12 CHAIRMAN MELIUS: Anything else?

13 MEMBER KOTELCHUCK: Well, let me ask 

14 you. I mean all joking aside, if we did want to 

15 enlarge the number of Subcommittees, is there any 

16 requirement in terms of this Board that there be 

17 exactly the number of Members that we have or is 

18 that really getting beyond the scope of this 

19 discussion?

20 MR. KATZ: No, that's fine. I can 

21 address that. There is not a requirement, a 
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1 numeric requirement or limit for a Subcommittee's 

2 membership, although at minimum would be three. 

3 But so you could establish multiple Subcommittees 

4 that are small, if that is what you are talking 

5 about, Dave.

6 MEMBER KOTELCHUCK: Well, that is one 

7 possibility. The other is enlarging the 

8 Subcommittee. But I am actually talking about 

9 Presidential appointments to the Board.

10 MR. KATZ: Well, okay -- that is 

11 another ballpark.

12 MEMBER KOTELCHUCK: That is another 

13 ballpark?

14 MR. KATZ: Yes, that is another 

15 ballpark.

16 MEMBER KOTELCHUCK: Let's leave it 

17 then. Okay.

18 CHAIRMAN MELIUS: I think it is just 

19 important that both the Work Group and the Board 

20 be thinking what do we need to be doing in terms 

21 of dose reconstruction reviews to meet our mandate 
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1 and be able to, with some confidence, reach 

2 conclusions about the quality of the dose 

3 reconstructions that are being done.

4 MEMBER KOTELCHUCK: Right.

5 CHAIRMAN MELIUS: If we only have the 

6 resources or the capability, whatever you want to 

7 call it, of doing one review, or one dose 

8 reconstruction per year, that is obviously not, I 

9 don't think any of us would argue that that is 

10 adequate.

11 But what the percentage is, is it one 

12 percent, two percent, or three percent, whatever? 

13 I mean I think we have to think how do we combine 

14 different approaches that would provide with some 

15 confidence be able to reach conclusions.

16 MEMBER KOTELCHUCK: Right.

17 CHAIRMAN MELIUS: And I think now that 

18 the program has matured and documentation has 

19 improved, that that number changes. That 

20 percentage changes maybe we have to think of how 

21 we can use different approaches.
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1 And we have been doing targeted 

2 approaches already in terms of our dose 

3 reconstruction reviews. We don't do a random 

4 sample. We are taking a number out of -- we are 

5 targeting reports, ones which we think are more 

6 likely to have findings that could impact the 

7 overall program.

8 So, maybe that reduces the need for such 

9 a large number of reviews. At the same time we have 

10 to make sure we are not missing ones and that we 

11 are not neglecting some area that is or could be 

12 problematic.

13 MEMBER KOTELCHUCK: Let me ask -- as 

14 chair of the Subcommittee now, let me ask -- it is 

15 my impression for the last couple of years that the 

16 progress of the Subcommittee was the thing slowing 

17 us down and that NIOSH and SC&A were ahead of us, 

18 in terms of if we could have reviewed things more 

19 rapidly. Is that observation shared by others?

20 MR. KATZ: This is Ted.

21 MEMBER KOTELCHUCK: Yes, fine, Ted.
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1 MR. KATZ: My observation is it has 

2 been a combined result. It is not singularly 

3 because of the Subcommittee not being able to meet 

4 more frequently the pace. The pace has also been 

5 controlled by how much NIOSH can do and by SC&A's 

6 performance in producing stuff for a meeting and 

7 I think everyone has kept the pace at what it has 

8 been but not just because of our problems with 

9 meeting frequency.

10 MR. CALHOUN: Dave, this is Grady. I 

11 honestly believe that we have been doing much 

12 better since you have taken over. I think we are 

13 getting through cases much quicker. I know we do 

14 have to do it faster than that, even, but to me, 

15 it seems like the meetings are moving along quicker 

16 and the Committee Members are much more okay with 

17 closing out findings.

18 MEMBER KOTELCHUCK: Well that is, in 

19 both cases, good to hear. Well fine, okay.

20 So, I should modify my sense of 

21 observation. I guess I am looking at from the 
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1 Subcommittee, primarily, and worrying that we are 

2 not moving fast enough and it doesn't sound like 

3 folks have the impression that we are the gear that 

4 is not moving. But, good.

5 Okay, thanks.

6 CHAIRMAN MELIUS: Any other thoughts 

7 or comments from Board Members?

8 If not, I think we can, end the Work 

9 Group call, when I hear from SC&A about when they 

10 will get this next small report to us, I will let 

11 everybody know and see if we can work out a time 

12 for a short Work Group call before the Board 

13 meeting.

14 MEMBER KOTELCHUCK: Good.

15 MEMBER ZIEMER: I have one question 

16 before we sign off. This is Ziemer again.

17 CHAIRMAN MELIUS: Yes.

18 MEMBER ZIEMER: One of the documents 

19 that you distributed, Jim, was the ORAU Team Dose 

20 Reconstruction Quality Assurance Control Program 

21 Inspection. I know that the Dose Reconstruction 
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1 Subcommittee vetted that pretty thoroughly because 

2 you included the minutes to that.

3 CHAIRMAN MELIUS: Right.

4 MEMBER ZIEMER: I just wanted to ask, 

5 maybe ask Dave, do you feel like you pretty well 

6 have a good handle on that and was the Dose 

7 Reconstruction Subcommittee pretty satisfied with 

8 that ORAU document and their processes?

9 MEMBER KOTELCHUCK: I am. I am 

10 satisfied. That was a good discussion. Let me 

11 put it, as one Subcommittee Member, I am satisfied.

12 I think the fact that we are having 

13 fewer findings overall suggests to me that things 

14 are integrating well. And I feel like we have a

15 handle on what ORAU is doing and what ORAU is doing 

16 is satisfying both SC&A and the Committee. So, I 

17 am satisfied, certainly.

18 I certainly have not heard from other 

19 Board Members that they wanted to open that 

20 discussion up. It was a very good discussion.

21 MEMBER ZIEMER: Okay, I just wanted to 
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1 make sure that everybody was satisfied with -- it 

2 appeared that you were but it wasn't clear to me 

3 that there was sort of a bottom line where you sort 

4 of gave it your best -- you put it that way.

5 MEMBER KOTELCHUCK: Yes, well that --

6 I wasn't chair at the time we had that discussion.

7 MEMBER ZIEMER: And I guess since they 

8 are a contractor to NIOSH but we certainly need to 

9 be aware of how they are going about their quality 

10 assurance because it does impact on how we think 

11 about and do our reviews to the dose 

12 reconstructions as well.

13 MEMBER KOTELCHUCK: Yes.

14 MEMBER ZIEMER: If the Subcommittee 

15 was comfortable, if I can use that word, or 

16 satisfied with what was being done.

17 MEMBER KOTELCHUCK: I certainly 

18 remember that meeting. And I think we ended up in 

19 good basic agreement and it was very helpful to me, 

20 as a Board Member at that time -- as a Subcommittee 

21 Member at that time, to hear that discussion and 
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1 I came away clear to me what they were doing. And 

2 what they were doing seemed good and appropriate.

3 So, I think that Subcommittee was 

4 satisfied at the end of that discussion and we have 

5 never had anybody since raise the issue should we 

6 go back over it again or look at it more carefully. 

7 So, I think we are okay.

8 MEMBER ZIEMER: Good, thank you.

9 CHAIRMAN MELIUS: Paul, if I could just 

10 add, after I couldn't find our earlier Work Group 

11 report, as I said, Ted provided that information 

12 to me. And I read through both the transcript and 

13 the procedure and I was impressed. I thought it 

14 was good.

15 I think again, short of auditing the 

16 implementation, I don't think we can say more than 

17 that. But I think it is a very good approach that 

18 they are using. It is thoughtful and I think it 

19 many ways it is as well as can be done in this type 

20 of program. But I guess, at the same time, I think 

21 we have to understand, as I said earlier, this is 
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1 a complex number of sites and lots of issues, not 

2 all of which can be documented and covered. And 

3 so we are relying on individual dose reconstructors 

4 to do this and they are being supervised and so 

5 forth, but they are making judgments of what is 

6 going on.

7 So, there are always going to be -- I 

8 think we always have to have concerns about are 

9 those being done consistently. Are they being 

10 done appropriately in terms of making those 

11 judgments and resulting consultations?

12 One of the individual dose 

13 reconstruction reviews I was involved in recently, 

14 there was a situation where a person had moved from 

15 one site to another and the dose reconstructor did, 

16 I thought, an excellent job of addressing that move 

17 and how it affected the person's exposure. It was 

18 the kind of situation that there would never be a 

19 procedure on that because it is probably pretty 

20 uncommon for a person to make that kind of a move 

21 in that kind of a situation. And I thought they 
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1 did very well.

2 But again, it was totally based on them 

3 recognizing the situation, the potential exposure, 

4 dose implications of what might happen in 

5 interpreting their exposure monitoring for an 

6 internal dose from two different sites and using 

7 two different approaches. And again, it is not 

8 something that is going to be captured.

9 So, again, I think it is something we 

10 need to keep in mind looking at this. But at the 

11 same time, looking at what we found early on in the 

12 program which was essentially before the QA/QC 

13 program had even been implemented, it was being 

14 thought through at that time, this was back in 2004 

15 or so. That, I think, what was missing then has 

16 been addressed.

17 And what was missing then was, 

18 essentially, the program was just starting. So, 

19 it wasn't necessarily anybody's thought.

20 MEMBER ZIEMER: No, I agree. I think 

21 it is a very good document. Actually, I was a 
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1 little curious about the closing paragraph of the 

2 ORAU document, which says that the ORAU team is 

3 reevaluating their current list of comment 

4 categories looking to those categories similar to 

5 those utilized by SC&A. So, I think there is an 

6 interesting effort there.

7 I'm just wondering, I'm not sure what 

8 the date is on this document but maybe someone from 

9 ORAU can tell us how that is going and where they 

10 are going on that. The document I am looking from 

11 ORAU, this is dated, right? I don't know --

12 CHAIRMAN MELIUS: I think it is 

13 electronically dated about 2012, at least the 

14 version I have.

15 MEMBER ZIEMER: Yes, so, I am wondering 

16 if there are any changes since then that we are not 

17 aware of. 

18 MR. SIEBERT: This is Scott Siebert 

19 with the ORAU team. Yes, we actually did update 

20 our categories from that time frame of August of 

21 2012. We tried to make it more consistent, as I 
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1 said. It has been so long ago, that I don't recall 

2 exactly the outcome, how close they actually were 

3 to the SC&A ones but we did take those into account 

4 and we adjusted our categories and we have been 

5 using them. We updated it quite a while ago. We 

6 actually had more discussion on this topic, if I 

7 remember in the November 2012 Subcommittee meeting 

8 as well.

9 MEMBER ZIEMER: Okay. Is there any 

10 document which says, and maybe we can have a copy 

11 of it.

12 MR. SIEBERT: Just a copy of the 

13 categories that we used?

14 MEMBER ZIEMER: Well, either that or 

15 has this document be revised, the one I am looking 

16 at? Is this an official document or is it just a 

17 descriptive summary? ORAU Dose Reconstruction 

18 Quality Assurance Quality Control Program, is that 

19 an official ORAU document?

20 MR. SIEBERT: That was only a document 

21 that was put together for the Dose Reconstruction 
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1 Subcommittee. It is not a standard document for 

2 ORAU team.

3 MEMBER ZIEMER: It's a report. Okay, 

4 I'm with you. I thought maybe this was an official 

5 document.

6 So, that answers my question. I am 

7 fine. Thanks.

8 MS. BEHLING: Dr. Melius, this is Kathy 

9 Behling. I was hoping before we ended the 

10 conversation here today if we could just revisit 

11 one additional issue regarding expediting the 

12 issues resolutions process. Do we have time to do 

13 that?

14 CHAIRMAN MELIUS: Yes, if you want to 

15 bring it up. Depends what the issue is.

16 MS. BEHLING: Okay. In the past, we 

17 did recommend that perhaps it would be helpful for 

18 the Subcommittee if we categorized not only the 

19 findings by site but within the site, if we 

20 attempted to lay out for the Subcommittee those 

21 findings that we think they could quickly close or 
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1 that could be readily be closed and then those 

2 findings that may require some additional 

3 discussion. And if we were able to get some 

4 documentation into the Subcommittee's hands, well 

5 in advance or at least a week or so, let's say, in 

6 advance of the meeting and have all the 

7 Subcommittee Members look at those and then we 

8 could maybe more quickly go through those findings 

9 or observations that we think would be readily 

10 closed.

11 And we did a little bit of background 

12 on this. For example, we looked at like the Oak 

13 Ridge, Paducah, Portsmouth, and Savannah River 

14 sites and I believe we looked at about three or 

15 four, maybe the 13th through the 15th or 16th set 

16 and analyzed all of the findings for those four 

17 sites and we can to the conclusion that there were 

18 16 observations and 32 findings that we could, 

19 perhaps lay out for the Subcommittee, saying these 

20 look as if they could be closed rather quickly and 

21 there were only five findings that appeared to us 
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1 is going to require a more extended discussion.

2 I am just wondering if that is still 

3 something that would be on the table. Is it still 

4 something that you would want to consider that 

5 would benefit the Subcommittee?

6 CHAIRMAN MELIUS: Well, I think it is 

7 more in the purview of the Subcommittee but I think 

8 it would be useful if you could share that analysis 

9 with this Work Group and with the Subcommittee.

10 MEMBER KOTELCHUCK: Yes, it would be.

11 CHAIRMAN MELIUS: It would be hard to 

12 talk about it in the abstract.

13 MEMBER KOTELCHUCK: Of course, in fact 

14 we talked about it and thought that was a good idea 

15 and let's try to do it at one of our previous 

16 meetings.

17 But right now, we are going to be 

18 looking at, coming up Thursday, we are going to be 

19 looking at blind reviews, primarily. And that is 

20 most helpful when we get to going over cases again, 

21 regular cases, as opposed to blind reviews.
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personally identifiable information has been redacted as necessary. The transcript, however, has not 

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should be cautioned that this transcript is for information only and is subject to change.

93

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1323 RHODE ISLAND AVE., N.W.

(202) 234-4433 WASHINGTON, D.C. 20005-3701 (202) 234-4433

1 So, I thought we basically agreed that 

2 we would like to do that as a Subcommittee. And 

3 I think it will -- I was kind of looking forward 

4 to it happening for this meeting and then I realized 

5 it is not appropriate because we are going to do 

6 blind reviews.

7 But let's figure that, hopefully, 

8 either at this next meeting or the meeting after 

9 it, we will finish what has been done on the blind 

10 reviews and then go back to 14 to 21. And then at 

11 that point, by all means, we would love the advance 

12 notice and let's see how it works. Let's see if 

13 it helps us.

14 MS. BEHLING: And this week, our Dose 

15 Reconstruction Subcommittee meeting is Wednesday 

16 the 24th?

17 MEMBER KOTELCHUCK: Yes, at 10:30, by 

18 the way, not 10:00.

19 MS. BEHLING: Okay, I thought I heard 

20 Thursday but I thought it was Wednesday. Thank 

21 you.
This transcript of the Advisory Board on Radiation and Worker Health Dose Reconstruction Review 

Methods Work Group, has been reviewed for concerns under the Privacy Act (5 U.S.C. § 552a) and 

personally identifiable information has been redacted as necessary. The transcript, however, has not 

been reviewed and certified by the Chair of the BNL Work Group for accuracy at this time. The reader 

should be cautioned that this transcript is for information only and is subject to change.

94

NEAL R. GROSS

COURT REPORTERS AND TRANSCRIBERS

1323 RHODE ISLAND AVE., N.W.

(202) 234-4433 WASHINGTON, D.C. 20005-3701 (202) 234-4433

1 MEMBER KOTELCHUCK: No, no, it is -- it 

2 is --

3 MR. KATZ: It's Wednesday.

4 MEMBER KOTELCHUCK: It is Wednesday.

5 MR. KATZ: Correct.

6 MEMBER KOTELCHUCK: Yes, at 10:30.

7 MS. BEHLING: Yes, thank you.

8 MEMBER KOTELCHUCK: Okay, I look 

9 forward to speaking with you then.

10 CHAIRMAN MELIUS: Anything else? If 

11 not, thank you all and I will be in communication.

12 MEMBER KOTELCHUCK: Very good.

13 CHAIRMAN MELIUS: Okay, thanks.

14 MEMBER KOTELCHUCK: Thank you.

15 MR. KATZ: Thank you, everybody.

16 (Whereupon, the above-entitled matter 

17 went off the record at 11:58 a.m.)

18

19

20

21
This transcript of the Advisory Board on Radiation and Worker Health Dose Reconstruction Review 

Methods Work Group, has been reviewed for concerns under the Privacy Act (5 U.S.C. § 552a) and 

personally identifiable information has been redacted as necessary. The transcript, however, has not 

been reviewed and certified by the Chair of the BNL Work Group for accuracy at this time. The reader 

should be cautioned that this transcript is for information only and is subject to change.

95

NEAL R. GROSS

COURT REPORTERS AND TRANSCRIBERS

1323 RHODE ISLAND AVE., N.W.

(202) 234-4433 WASHINGTON, D.C. 20005-3701 (202) 234-4433

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