Summary Minutes April 11, 2007 
 

Subcommittee for Dose Reconstruction Review
 

THE SUBCOMMITTEE FOR DOSE RECONSTRUCTION REVIEW


 OF THE
 

ADVISORY BOARD ON RADIATION AND WORKER HEALTH 


NATIONAL INSTITUTE FOR OCCUPATIONAL SAFETY AND HEALTH 


CENTERS FOR DISEASE CONTROL AND PREVENTION


 _______________________________________________________ 


Summary Minutes of the Third Meeting 


April 11, 2007


 _______________________________________________________ 


The Third Meeting of the Subcommittee for Dose Reconstruction Review 


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


(ABRWH or the Board) was held at the NIOSH offices in Cincinnati, Ohio 


on April 11, 2007. The meeting was called to order by Dr. Lewis Wade, 


the Designated Federal Official, Centers for Disease Control and 


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


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


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


reporter, are available on 

Compensation Analysis and 

www.cdc.gov/niosh/ocas. 

the internet 

Support (OCAS) 

on 

web 

the NIOSH/Office 

site located 

of 

at 

Those present included the following: 

Subcommittee Members: 

Mr. Mark Griffon, Chair; Mr. Michael Gibson (telephonically); Dr. John 


Poston; Ms. Wanda Munn. 


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


Federal Agency Attendees: 


Department of Health and Human Services: 


Representing NIOSH: Mr. Dave Allen, Mr. Larry Elliott, Mr. Stuart 


Hinnefeld; Representing the Office of General Counsel: Ms. Liz Homoki-


Titus, Ms. Emily Howell (telephonically). 


Contractors: 


Dr. Hans Behling, Ms. Kathy Behling (telephonically); Dr. John Mauro, 


Sanford Cohen & Associates (SC&A). 


Ms. Liz Brackett, Mr. Mutty Sharfi, Mr. Scott Siebert, Oak Ridge 


Associated Universities (ORAU). 


Other Participants: 

Summary Minutes April 11, 2007 
 

Subcommittee for Dose Reconstruction Review


Mr. Jim Key, United Steel Workers, Paducah, Kentucky. 


* * * * *


 Opening Remarks
 

Dr. Lewis Wade, 


NIOSH
 

Dr. Wade opened the meeting by thanking everyone for their attendance, 


after which he announced the subcommittee's chair and individual 


members. Attendees were asked to introduce themselves and the entity 


they represent, first around the table and then those participating by 


telephone. Reminding everyone to observe proper phone etiquette 


throughout the day for the benefit of the court reporter and 


preparation of a clear transcript, Dr. Wade turned the meeting over to 


the subcommittee chair, Mr. Mark Griffon. 


* * * * *


 Agenda Outline
 

Mr. Mark Griffon, 


Subcommittee Chair
 

Mr. Griffon announced that, in absence of expected written materials, 


the fourth set of cases would not be reviewed as planned. However, 


NIOSH and the ORAU team would give an update on actions and perhaps 


clarify technical aspects of the task. 


A first preliminary review of the fifth set of cases is planned, as 


well as a discussion of the dose reconstruction guidelines, the DR 


templates used by dose reconstructors for certain sites. 


As an agenda item for the May subcommittee meeting, Mr. Griffon
 

proposed a discussion of the blind and advanced review protocols. Dr. 


Wade agreed that could be done the morning of May 2, 2007. 


* * * * *
 

Individual Dose Reconstruction Review 


Fourth Set of Cases
 

Mr. Griffon acknowledged SC&A had just received the updated matrix for 


the fourth set this morning, but asked if they could quickly scan to 


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Summary Minutes April 11, 2007 
 

Subcommittee for Dose Reconstruction Review


see if the resolution column prepared by NIOSH agreed with their 


understanding from the previous discussions. 


Dr. Hans Behling, SC&A, commented that this fourth set was the first 


time best-estimate dose reconstructions were reviewed. In doing so, 


some cases were noted where the POCs came close to a point where 


correction of deficiencies might bring the person over the 50 percent 


level. Dr. Behling indicated his hope was that NIOSH's action would be 


to address those findings and then report back that they had 


essentially reworked the entire case, showing the change in the POC, if 


any. 


Ms. Homoki-Titus reminded the subcommittee that the Board's purpose is 


not as an appeals board in any way. Furthermore, it is not within the 


purview of SC&A's contract to bring individual cases forward to NIOSH 


for a rework. That is for the Department of Labor to determine. Ms. 


Wanda Munn agreed, indicating the Board had been clear it would not 


assume any task that could be perceived as an appeal function, and this 


caused her real concern. 


After much discussion, Dr. Wade asserted the Board was clear it didn't 


want SC&A's review function to go to the issue of compensability, but 


the focus should be on a scientific review of the product. 


Ms. Kathy Behling commented that at the end of her presentation on each 


of the first three sets, she had been asked if any of SC&A's findings 


would have altered the determination in any cases. Dr. Wade noted that 


she should not answer the question until it's asked. Ms. Homoki-Titus
 

also observed that the question was generalized, not related to a 


specific case. 


Dr. Wade summarized by explaining the Board is chartered to review the 


quality of the science. Once done, it's then reasonable for the Board 


or subcommittee to inquire into any impact. He concluded the final 


test is not being avoided, it just has to be done carefully. 


Mr. Griffon returned attention to the action list and suggested moving 


the cases as far as could be done. Mr. Stu Hinnefeld, NIOSH, 


distributed his compilation of an additional analysis of the 4th set of 


DRs, and an extensive discussion of the SC&A findings and NIOSH 


responses was conducted. 


* * * * *
 

Preliminary Individual Dose Reconstruction Review 


Fifth Set of Cases
 

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Subcommittee for Dose Reconstruction Review


Mr. Griffon reiterated the subcommittee's review of the fifth set of 


cases will be a preliminary run-through, anticipating there would be 


issues also seen in the first four sets. 


Ms. Behling explained there had been some ten Atomic Weapons Employer 


(AWE) sites in this group, all of which are at the front of the report, 


with the DOE site cases following. She reminded the subcommittee that 


AWE cases are approached differently, in that SC&A evaluates both the 


case and the exposure matrix, and looks at global issues. 


Observing that often exposure matrix issues were pushed off into Task I 


site profile review for resolution, Ms. Behling expressed a need to be 


sure any exposure matrix issues are followed in this Task IV review 


matrix. Mr. Griffon and Mr. Hinnefeld agreed. 


As primary reviewer on the AWE cases, Dr. John Mauro remarked that each 


of those sites is special, with its own story to be told in order to 


understand the context and bring the NIOSH responses to life. He asked 


for 30 seconds to set the stage for each site before the corresponding 


case was discussed. 


There followed an item-by-item discussion of the "Summary of Findings 


Matrix (Cases 81-100)". 


* * * * *


 DR Guidelines
 

Mr. Griffon explained Mr. Hinnefeld had provided some samples of DR 


instructions or guides, noting they'd had various titles depending on 


sites. He continued that he had come across these documents earlier 


and found them instructive in that they provide a template for the dose 


reconstructor's thought process. Mr. Griffon described the document, 


how it was used and updated, and commented it would be nice if they 


were a part of the claimant file. 


While the suggestion received general consensus, Mr. Larry Elliott, 


NIOSH, cautioned that the use of these documents had evolved over time, 


earlier files would not have them, and in some instances it might be 


random. 


Mr. Griffon suggested consideration of two things: One, the 


subcommittee offers a recommendation for the full Board that all cases 


going forward have these added to the claim file; second, and perhaps 


not feasible, that it also be done retroactively. 


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Subcommittee for Dose Reconstruction Review


Mr. Elliott expressed reluctance regarding the retroactive aspect, but 


agreed it was something that could be examined to see what might be 


involved in making that addition to the analysis records of closed 


cases. Providing the document from the eighth set of cases going 


forward was a more achievable prospect, and Mr. Elliott agreed to 


report NIOSH's position at the May meeting. Ms. Homoki-Titus expressed 


concern about internal documents, not normally made public, suddenly 


becoming public. 


Dr. Mauro again offered a suggestion that many questions could be 


answered if SC&A reviewers could contact the original dose 


reconstructor directly. Mr. Elliott responded by noting that the DR 


reports were signed off on by NIOSH, and any questions about those 


products should be directed through NIOSH. 


The discussion continued, with concern expressed about the reviewers 


getting too comfortable with an ability to ask for the answer to a 


question. It was agreed there are benefits to maintaining a certain 


distance and having to work through issues. Mr. Elliott indicated 


NIOSH would be receptive to technical discussions as to what was done, 


how it was done or what was meant, particularly as it might shorten the 


content of the review matrices. There was consensus that these 


discussions should be limited in nature, with Mr. Griffon observing 


there should also be a record maintained as this Board is dedicated to 


conducting business openly. 


* * * * *
 

Addressing the case pool for selection of the eighth set of cases, Mr. 


Griffon proposed using the same criteria as for the seventh set. He 


indicated Mr. Hinnefeld is generating a list of best-estimate cases to 


present at the May meeting for a preliminary selection. From that pool 


a group of cases will be selected, for which Mr. Hinnefeld will provide 


some additional information. The subcommittee will select cases from 


that group as their recommendation to the Board. It is anticipated the 


eighth set will total 32 cases, which should complete the FY 2007 case 


review total for SC&A. 


* * * * * 


5
 
 

_______________________________________ 

_______________________________________ 

Summary Minutes April 11, 2007 
 

Subcommittee for Dose Reconstruction Review


With no further business to come before the Subcommittee, the 


meeting was adjourned.
 

Ë Ë Ë Ë Ë 

I hereby confirm these Summary Minutes are 


accurate, to the best of my knowledge. 


Mr. Mark Griffon, Chair 


Date 


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