_________________________________________________________________ 

Executive Summary/Minutes: July 5-7, 2005 

NIOSH/CDC Advisory Board on Radiation and Worker Health
 

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 Thirty-first Meeting

July 5-7, 2005 

The Thirty-first Meeting of the Advisory Board on Radiation and Worker

Health (ABRWH or the Board) was held at the Chase Park Plaza Hotel in St.

Louis, Missouri on July 5, 6, and 7, 2005. The meeting was called by the

Centers for Disease Control and Prevention's (CDC's) National Institute

for Occupational Safety and Health (NIOSH), the agency charged with

administering the ABRWH. These summary minutes, as well as a verbatim

transcript certified by a court reporter, are available on the internet

on the NIOSH/Office of Compensation Analysis and Support (OCAS) web site

located at www.cdc.gov/niosh/ocas. Those present included the following: 

ABRWH Members: Dr. Paul Ziemer, Chair; Dr. Henry Anderson; Dr. Roy

DeHart; Mr. Richard Espinosa; Mr. Michael Gibson (via telephone); Mr.

Mark Griffon; Dr. James Melius; Ms. Wanda Munn; Mr. Leon Owens; Mr.

Robert Presley; and Dr. Genevieve Roessler. 

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

Federal Agency Attendees: 

Senator Christopher Bond, US Senate 

Department of Energy:

Ms. Kate Kimpan 

Department of Health and Human Services:

Mr. Fred Blosser, Ms. Anstice Brand, Ms. Heidi Deep, Ms. Chris Ellison,

Ms. Nichole Herbert, Mr. Stuart Hinnefeld, Ms. Cori Homer, Ms. LaShawn

Shields, Ms. Liz Homoki-Titus, Mr. Ted Katz, Mr. Judson Kenoyer, Relada

L. Miller, Dr. James Neton, Mr. LaVon Rutherford, Mr. Dan Stempfley, Mr.

Tim Taulbee, Chris Underwood 

Department of Labor:

Mr. Shelby Hallmark, Mr. Jeff Kotsch, Mr. Jeff Nesvet, Mr. Peter Turcic 

Government Accounting Office:

Ms. Mary Nugent 

Contractors: Dr. Hans Behling, Ms. Kathy Behling, Mr. Joe Fitzgerald,

Dr. John Mauro 

Public Attendees: See Registration 

1 
 

Executive Summary/Minutes: July 5-7, 2005 

NIOSH/CDC Advisory Board on Radiation and Worker Health
 

 Executive Summary 

The Thirty-first Meeting of the Advisory Board on Radiation and Worker

Health (ABRWH or the Board) was held at the Chase Park Plaza Hotel in

St. Louis, Missouri on July 5, 6, and 7, 2005. All members were in 

attendance. Others in attendance included staff of various Federal 

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

Meeting Thirty were approved without comment. 

* * * * * 

Tuesday, July 5, 2005
 

Bethlehem Steel Technical Basis Document
 

Status of Revisions
 

Dr. Jim Neton of NIOSH presented a history of the Bethlehem Steel Site

Profile Revision and the NIOSH responses to SC&A's review. He included 

information regarding five motions passed by the Board at the February

7th meeting in St. Louis as a result of those revisions. 

Questions were entertained from the Board following the conclusion of

Dr. Neton's presentation. The Board determined a smaller workgroup or

subcommittee should be assembled to identify and review issues items and

coordinate resolution with SC&A's comments and findings. 

* * * * * 

Comments by Members of Congress 

Senator Christopher Bond of Missouri reiterated previous reminders of

the urgent need to designate former workers at the Mallinckrodt downtown

site as members of the Special Exposure Cohort, or SEC. He also 

addressed the Board regarding dose reconstruction feasibility and timely

worker compensation. 

* * * * * 

Privacy Issues 

Ms. Liz Homoki-Titus from the Office of General Counsel of the 

Department of Health and Human Services addressed the Board regarding

conflict of interest and conditions under which a Board member might be

required to recuse himself. She also suggested that the Board establish

a procedure to follow when they may be called upon to provide public

comment. 

Ms. Homoki-Titus answered questions from the Board. 

* * * * * 

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Executive Summary/Minutes: July 5-7, 2005 

NIOSH/CDC Advisory Board on Radiation and Worker Health
 

Y-12 Site Profile Review 

Mr. Joe Fitzgerald of Sanford Cohen & Associates briefed the Board in 

general terms on accomplishments in the last 30 days regarding document

review and interviews. He noted the workers were very mobile at the

site, certain worker classes were not monitored, and the high-fired

oxide workers had been switched from periodic urinalysis and lung count

monitoring to only periodic fecal analysis. 

Mr. Fitzgerald stated he would like to follow the issue resolution 

process with NIOSH and ORAU to isolate what is important regarding

issues of concern. 

Following his presentation, Mr. Fitzgerald took questions from the

Board. 

* * * * *
 

Y-12 Special Exposure Cohort (SEC) Petition

Evaluation Report and Board Discussion 

Mr. Robert Presley recused himself and stepped away from the table. 

Mr. Larry Elliott, Director of NIOSH's Office of Compensation Analysis

and Support, acknowledged the work SC&A and Mr. Fitzgerald did on the Y12 site profile, noting it would provide for a more comprehensive

technical basis document. 

Mr. Elliott described the three Y-12 petitions (18, 26, and 28) received

on behalf of employees at the plant. He reminded the Board of the 

statutory requirements required for adding a class of worker to the

Special Exposure Cohort. 

The original class definitions from the petitions were described by Mr. 

Elliott, with time periods ranging from January 1944 through December

1957. Noting that no data existed for the early years at the facility,

he described NIOSH's use of portions of the site profile in evaluating

the petitions. Documents provided by the petitioners were included in

that review. 

Mr. Elliott summarized the NIOSH conclusions, in part stating that:

#The workers described in Petitions 18 and 26, and in Petition 28

through December 1947 be combined, and provided the Board with

wording for the new proposed class definition.

#That combined class of worker had met the feasibility and health

endangerment requirements of the two-pronged statutory test.

#The evaluation process would continue relative to the remainder of

the Petition 28 workers in the period January 1948 through December

1957, with a further evaluation report to be presented at a

subsequent meeting. 

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Executive Summary/Minutes: July 5-7, 2005 

NIOSH/CDC Advisory Board on Radiation and Worker Health
 

Mr. Elliott added the work done by the SC&A site profile review would be

important in completing NIOSH's evaluation of Petition 28. 

Mr. Elliott answered questions from the Board. Petitioners available 

via telephone indicated they had no comments regarding the evaluation

report. 

Following extensive discussion, a motion carried recommending the

combined class of worker be granted inclusion in the Special Exposure

Cohort. 

* * * * *
 

IAAP SEC Petition
 

Evaluation Report and Board Discussion
 

Dr. Wade and Dr. Ziemer acknowledged Mr. Presley's return to the table. 

Mr. Larry Elliot of NIOSH presented information regarding industrial

radiographers who conducted radiography on a nonradiological high

explosive weapon components at the Iowa Army Ammunition Plant from May

of 1948 to March of 1949. He provided details of the evaluation report

and concluded the presentation by defining the proposed class. 

After extensive discussion, the Board passed a motion granting an SEC

petition for the industrial radiographers who worked at the Iowa

Ammunition Plant from May 1948 to March 1949. 

* * * * * 

Public Comment Period 

The following is a list of the members of the public who spoke. A full 

transcript of their comments is available on the OCAS web site,

www.cdc.gov/niosh/ocas. 

Mr. Richard Miller, GAP; Mr. Dan McKeel, Missouri Coalition for the

Environment; Mr. Clarence Schwendesen, Mallinckrodt; Mr. Ed Lamzik,

Mallinckrodt; Ms. Eileen Adams, Destrehan Plant; Ms. Marilyn Schneider,

Mallinckrodt; Ms. Mary Generi, Mallinckrodt: Mr. George Vogt,

Mallinckrodt; Mr. Roni Steger, Mallinckrodt; and Mr. Ed Walker,

Bethlehem Steel. 

* * * * * 

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Executive Summary/Minutes: July 5-7, 2005 

NIOSH/CDC Advisory Board on Radiation and Worker Health
 

Wednesday, July 6, 2005 

Dr. Wade reviewed the meeting items and provided background information

on previous Board actions dealing with Mallinckrodt. 

Supplemental Review

Mallinckrodt Site Profile 

Dr. Arjun Makhijani of Sanford Cohen & Associates reiterated what the 

Board charged SC&A to do -- basically to review the data reliability

issue and the usability of the site profile for the Mallinckrodt

downtown site for the '49 to '57 time period, the St. Louis Airport

Site, and the decommissioning section. 

Dr. Makhijani briefly reviewed the three categories of doses: the

minimum dose, reasonable dose, and maximum dose. He provided the Board

technical issues regarding why they believe reasonable dose estimates

will not likely be possible. 

A question-and-answer session ensued with Dr. Makhijani regarding his

presentation. 

* * * * * 

Mallinckrodt Site Profile 

Dr. Jim Neton of NIOSH presented information concerning the data issue

and raffinate issue with respect to Mallinckrodt dose reconstruction

process. Dr. Neton outlined to the Board the dose reconstruction 

process and gave a detailed description of the raffinate extraction

process. Data is collected from the DOE, claimant files are reviewed

along with CER data set (unique to Mallinckrodt,) site profiles, and

then the data is interpreted using procedures and implementation guides,

Technical Information Bulletins and claimant interviews. 

Dr. Neton presented to the Board information on the data sources:

► The only data is the individual and summary film badge reports.

► The CER database is a compilation of all the information at the site. 

Dr. Neton presented statistical values of the data set that compared the

air dust data against the urine data for a subset of workers for the

ether house. He concluded that based on the lognormal fit of the urine

and air data, the integrity of the data is not an issue. 

Dr. Neton concluded his presentation with a couple of slides on

raffinate whereby he stated that NIOSH would pick the higher of the air

and urine test results to assign the dose to the worker. Before stating

his conclusion, he gave a detailed process description of the raffinate

process. 

Following his presentation, Dr. Neton answered questions from the Board. 

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Executive Summary/Minutes: July 5-7, 2005 

NIOSH/CDC Advisory Board on Radiation and Worker Health
 

* * * * * 

Mallinckrodt SEC Petition

 Evaluation Report 

Mr. Larry Elliott of NIOSH began his presentation by reviewing, as

required by statute, the two-pronged test that must be met. Next he 

summarized pertinent dates of the petition and outlined for the Board

the three class definitions. 

Additional issues were identified by the Board at the February meeting

following the presentation of the evaluation report. NIOSH responded to

those additional issues in a supplemental report. 

Mr. Elliott briefed the Board that NIOSH concluded, based on the

monitoring activities of employees and work areas established in 1949 by

Mallinckrodt, as well as the information on radiological sources and

processes, there is sufficient information to validate the dose

estimates for the period 1949 to 1957 and notwithstanding any data

reliability concerns raised for the earlier time period. 

Mr. Elliott further presented information regarding three items outlined

in SEC petition Report 00012-2, Section 7.3. 

Mr. Elliott concluded information on Item 4 by stating that they would

use the highest and most claimant favorable data set between the urine

and air data for use in dose reconstruction. 

Mr. Elliott concluded his presentation by summarizing that for the years

1949 to 1957 NIOSH finds that radiation dose estimates can be 

reconstructed and validated for compensation purposes for this

particular class. It is feasible to do dose reconstruction and,

therefore, while it is believed that health was endangered here, there

is no need to address that particular prong of the two-part question. 

* * * * * 

Mallinckrodt SEC Petition 

Board Discussion 

Dr. Ziemer opened the floor for discussion. 

Dr. Melius requested confirmation on the verification of data issue and

examples of dose reconstruction using actual data. Dr. Neton and Mr. 

Elliott both provided input on the dose reconstruction issue. 

Dr. Neton provided additional comments stating that 100% of the 109

active cases in possession who worked in the 1949 to 1957 time period

would fall into the evaluation report. Dr. Neton added that there are 

an additional 50 or 60 cases that have employment that spill over into

the 1949 to 1957 time period that are also members of the original

class. 

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Executive Summary/Minutes: July 5-7, 2005 

NIOSH/CDC Advisory Board on Radiation and Worker Health
 

Dr. Anderson followed up with comment regarding feasibility of actually

doing dose reconstruction. Dr. Melius raised the feasibility issue and

also raised issue with what the Board previously requested concerning

dose reconstruction feasibility and what was actually presented. 

Dr. Neton elaborated by stating that his understanding was to present to

the Board examples of graphical data using real data versus the

graphically presented information at the Cedar Rapids meeting which

utilized hypothetical data. 

Comments from Petitioners 

Ms. Denise Brock provided to the Board an account regarding events since

filing the SEC petition for the Mallinckrodt workers from 1942 to 1957 a

year ago. She cited to the Board at a February meeting a decision was

made to split the cohort. SEC status was granted for workers during the

time period 1942 to 1948, and to table a decision on the workers from

1949 to 1957 based on recently discovered data and the so-called Mont

Mason memo. 

Ms. Brock stated that NIOSH felt that the newly discovered data

information and on-going site profile revision provided enough

information to conduct an accurate dose reconstruction on the workers 

from 1949 to 1957. Board allowed more time for NIOSH and SC&A to 

complete their analysis at the April meeting in Iowa. 

Ms. Brock expressed concern regarding the timeliness of written

information being relayed to her. She cited to the Board findings of

the Rev. 1 report does not appear to provide a basis to do accurate dose

reconstruction. She quoted to the Board examples regarding Mallinckrodt

site profile audit. 

Ms. Brock spoke to specific examples dealing with lack of data issue and

worker interview information. Ms. Brock restated to the Board for the 

record what Congress directed NIOSH to do with respect to Special

Exposure Cohorts. She emphasized to Board members that feasibility

concept goes beyond just scientific and technical issues, it should also

consider the timeliness and cost of dose reconstruction in the absence 

of relevant or missing data. She mentioned the lack of proper

procedures to provide petitioners information regarding meeting

notification and written document transmittal. 

Ms. Brock urged the Board to add the Mallinckrodt workers from 1949 to

1957 to the Special Exposure Cohort. 

Mr. George Blue testified regarding his working experience in the 

raffinate extraction process. He described his specific duty was to

reheat the raffinate in an acid for the purpose of extracting an

element. 

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Executive Summary/Minutes: July 5-7, 2005 

NIOSH/CDC Advisory Board on Radiation and Worker Health
 

Mr. Blue testified that he had to be catheterized to obtain urine 

sample. He also mentioned that he was not aware of radon exposure with

his work. He relayed in detail to the Board a specific tank explosion

incident and sampling of drums procedure. 

Mr. Anthony Windisch stated that he worked at the Mallinckrodt uranium 

plant in St. Louis from 1945 to 1957, and the Weldon Springs plant from

1958 to 1967. He acknowledged he was a certified computer professional

and testified that Mason memo shows that most of the recently-found

computer keypunch cards and other radiation records was a bunch of

garbage and useless. He referenced a meeting with the audit

investigator where he testified that as an electrician at the

Mallinckrodt uranium plant he witnessed and/or experienced production

mishaps at almost every processing step during the production of uranium

metal. 

Mr. Windisch cited to the Board the frequency of occurrence when uranium

processing bomb exploded and he had to repair the electric furnaces. He 

made reference that safety department maintained a current dose

reconstruction profile for each unique work site at the Destrehan

uranium plant. 

Mr. Windisch concluded his remarks by stating that there is no specific

dose reconstruction profile to measure ether house explosion, exploding

radium processing bombs, overflowing raffinate tanks and other

production mishaps. 

Mr. Steven Eugene Pape stated that his father was Eugene C. Pape and

worked at the Destrehan Mallinckrodt Chemical Company plant from 1945

until his death May 10, 1977. He stated his father was diagnosed with

carcinoma lung cancer April 21, 1977. He commented that he did not know 

any answers to their questions, except to state that his father worked

seven days a week for a number of years. 

Mr. Robert Leach commented that he went to work for Mallinckrodt in 

1950, transferred to uranium plant in 1952, worked in plant 4 from 1952

to 1957, transferred to Weldon Springs in 1957 and worked there until

the plant closed in 1965. He stated his job was to clean up the inside

of the furnaces after they cooled down. He testified that more than 

once the molten metal came through the bottom of the furnace and would

run into the work area. Mr. Leach stated that in case he was not around 

for Weldon Springs petition, that he worked 40 to 76 hours per week. 

Mr. Ed Luecke stated he began working at Mallinckrodt May 6, 1947 in

plant 4. He described for the Board that he worked in plant 4, which he

referred to as the coffin area. He commented they wore no monitoring

badges and there were fumes all over the place. He commented that he 

moved to plant 6E and worked as a utility man where he stated he was

exposed to a lot of dust. 

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Executive Summary/Minutes: July 5-7, 2005 

NIOSH/CDC Advisory Board on Radiation and Worker Health
 

Ms. Brock felt that NIOSH should incorporate workers’ statements into

site profile. She felt time was being wasted because there are no

assurances that once the revisions take place, actual dose

reconstruction could be done. 

* * * * * 

Mallinckrodt SEC Petition 

Board Discussion 

Dr. Ziemer opened the floor for discussion. Mr. Owens opened the

discussion with a question for Dr. Makhijani concerning the completeness 

and accuracy of the records as presented earlier. 

Dr. Makhijani summarized by stating that aside from the radionuclides

ratios and Fernald K-65 silos there are data sufficiency problems in

several areas. He further defined those areas as infrequent incidents,

environmental doses, and roving workers. 

Dr. Neton added comment regarding the issue of the inability to

reconstruct infrequent incidents. 

Dr. Makhijani clarified by stating that a claimant favorable way or

maximizing way hasn't been demonstrated for modeling infrequent

incidents. 

Dr. Anderson commented on the timeliness and feasibility issue regarding

the dose reconstruction of the 109 cases. If tasked with dose 

reconstruction, what is the time frame. Mr. Elliott responded that four

months would be required for 107 cases of dose reconstruction; the first

month reserved for ironing out remaining issues and three months for

work on the claims. 

Dr. Anderson and Dr. Neton provided comments regarding the meaning of

the statistical information presented in Dr. Neton's presentation. Dr. 

Melius provided comments with options to address how to put together

issues from the SC&A evaluation of the site profile and NIOSH's

evaluation of the SEC petition. 

Dr. DeHart asked for clarification regarding the issue of selfidentified exclusion for dose reconstruction. He restated his question,

can you identify an individual in which dose reconstruction cannot be

done and move along toward identifying a specific cohort. Mr. Elliott 

said yes, and cited regulation that allowed that. 

Dr. Ziemer at this time reminded the Board to consider the timeliness of 

the various options discussed. He posed a question to Denise Brock 

regarding raffinate workers and subcohort. Ms. Brock responded she

thought plant 6 was raffinate area. Dr. Ziemer further asked if the 

information could be retrieved from the job description information. 

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Executive Summary/Minutes: July 5-7, 2005 

NIOSH/CDC Advisory Board on Radiation and Worker Health
 

Dr. Neton and Dr. Ziemer exchanged dialogue regarding the issue of job

description information, K-65 digestion process, and dose

reconstruction. Dr. Neton responded that the dose reconstruction would

be by an individual case-by-case basis if job category information is

utilized. He added that it is the Department of Labor's responsibility

to qualify a subset of workers based on their application as to whether

they are in the SEC. 

Mr. Elliott gave a timeline of development of a case file. 

Dr. Melius commented that an interim step that would allow SC&A comments

to be resolved could help identify if dose reconstruction would apply to

a larger percentage of workers that would require dose reconstruction

than previously anticipated. 

Dr. Ziemer agreed with Dr. Melius's comment, but noted how hard the

Board was pushing SC&A and NIOSH to meet the Board's deadlines. Dr. 

Melius suggested that the committee or subcommittee continue dialogue to

resolve SC&A site profile comments. 

Ms. Brock asked that probability of causation chart be developed for the

next meeting. 

Mr. Gibson questioned how NIOSH can provide accurate and reasonable dose

reconstruction for the raffinate workers in plant 6 with the lack of

individual bioassay data. Dr. Ziemer informed Mr. Gibson that there are 

a lot of urinalysis data and air data for the dose reconstruction

effort. 

Ms. Brock expressed concern to the Board about time issue regarding dose

reconstruction issue, especially regarding thorium-230, actinium-227,

protactinium raffinates. Dr. Neton suggested the use of the air

monitoring data to support inhalation intakes from the raffinate

material. 

Dr. Makhijani remarked that there are a significant number of issues to

be resolved. SC&A will engage the issues at the Board's direction and

report those findings at a time mandated by the Board. 

Mr. Griffon felt that the Board, SC&A and NIOSH, on the subcommittee

level, should identify or prioritize issues that need to be resolved for

the purpose of resolving this SEC petition. He also added that he would 

like to see specific representative cases of dose reconstruction,

especially for the raffinate assumption. 

Mr. Elliott said he agreed with Mr. Griffon, but clarified that they

couldn't bring an example dose reconstruction case unless it's an

adjudicated case. Ms. Homoki-Titus presented clarification on bringing

cases before the Board that haven't been adjudicated by the Department

of Labor. 

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Executive Summary/Minutes: July 5-7, 2005 

NIOSH/CDC Advisory Board on Radiation and Worker Health
 

Mr. Elliott commented to the Board regarding questions raised from Cedar

Rapids meeting explaining how to validate the data and how to use the

data in dose reconstruction. 

Ms. Munn commented on the effort to gather and analyze as much

information as possible about exposures of the workers in the proposed

class. 

Dr. Ziemer pointed out to the Board that a delay has the same effect as

denying the petition. 

Mr. Espinosa wanted to know if adjudicated claims could be discussed by

the Board in executive session. Ms. Homoki-Titus remarked to the Board 

that they are an advisory board not an appeals board for individual

claims. 

Dr. Melius made a comment that the Board still must decide on issues 

related to contractor doing SEC evaluations. He stated preference for

postponement on a decision on the Mallinckrodt petition until NIOSH has

had time to evaluate the SC&A report. 

Dr. Ziemer inquired if building 6 workers are being viewed as a possible

subset of the cohort that might contain eligibility status on its own. 

Dr. Melius stated once NIOSH had a chance to comment on the SC&A 

evaluation of the site profile they would be able to come to a

conclusion on building 6 issues. 

Ms. Brock provided comment that she has not had an opportunity to take

in all the information. She asked for clarification on the issue if 

halting the decision will also not halt the dose reconstruction. 

Mr. Elliott clarified that work on the Mallinckrodt claims had been 

suspended for the Destrehan facility unless there was a claim that

allowed NIOSH to move forward using the efficiency process. NIOSH could 

move forward on dose reconstruction of specific claims where SC&A site

profile comments have been resolved. Claims with outstanding site

profile issues will have to wait for dose reconstruction until issues

are resolved. 

Ms. Munn commented that there was no need for a Special Exposure Cohort

since NIOSH has committed that they can do the dose reconstruction. 

Mr. Elliott remarked that two things have happened to put the

Mallinckrodt claims on hold that were not reconstructable using

efficiency approaches: review of the revision for the site profile and

the petition. He added that the 75 claims completed were all lung and

prostate cancer claims. 

Dr. Wade proceeded to remind the Board of the requirements of the SEC

legislation by reading pertinent portions of the Special Exposure Cohort

rule 42 CFR 83. 

11 
 

 

Executive Summary/Minutes: July 5-7, 2005 

NIOSH/CDC Advisory Board on Radiation and Worker Health
 

A motion was made and seconded that the SEC petition for the 1949

through 1957 time period at the Mallinckrodt Destrehan facility be

denied. Motion was tabled. 

A motion was made and seconded for the Board to consider formulating a

letter of apology or regret for delaying SEC petition. Motion 

passed. 

Dr. Ziemer proposed postponement until tomorrow on the SEC policy issue

discussion so that working group may get underway. The Board proceeded

with future meeting logistics discussion before Dr. Ziemer formally

recessed the meeting. 

* * * * * 

Thursday, July 7, 2005 

SC&A Task III/Workbook Issues 

Dr. Hans Behling of Sanford Cohen & Associates opened the presentation

by providing background dealing with Task III. He defined Task III as 

being procedures and methods used by NIOSH to do dose reconstruction and

outlined Task III subject matters as follows:

● Procedures that deal with external dosimetry,

● Procedures that deal with internal dosimetry,

●	 Procedures that deal with CATI interviews, quality assurance,

documentation and record management. 

As directed by the Board, SC&A developed a method to conduct a review of

the 33 procedures. Task III was broken down into two phases:

►	 Phase 1 -- develop method to systematically review and standardize

the review process that was presented to the Board September 2004. 

►	 Phase II -- review of the NIOSH and ORAU procedures that was

presented to the Board in January of 2005. 

Dr. Behling presented information on the development of a checklist

comprised of secondary questions and rating system for evaluating the

procedures based on the previously presented seven objectives. 

Dr. Behling identified for the Board seven basic objectives followed for

Task III work. 

Following the presentation, Dr. Behling entertained questions from the

Board. 

* * * * * 

12 
Executive Summary/Minutes: July 5-7, 2005 

NIOSH/CDC Advisory Board on Radiation and Worker Health
 

Report on the Review of the First 20 Dose Reconstructions 

Dr. Ziemer explained to the Board the matrix details. He pointed out

Items 1 through 7 are the ones on which the Board will have to take

action. 

Dr. Ziemer and Mr. Griffon explained the definitions of the 7

categories. The Advisory Board then proceeded on with the task of

categorizing the first 20 procedures. The Board produced a modified

matrix. 

A motion was made and seconded to accept the summary of findings matrix

as part of the Board=s report on the first 20 cases. With no 

discussion, the motion carried unanimously. 

* * * * * 

Board Discussion 

The Board then proceeded to discuss the modified summary of findings

matrix. Dr. Ziemer noted the Board also has to consider the narrative 

wording to the Secretary of Health and Human Services report on dose

reconstruction findings. The only wording change to the latest report

version as reported by Mr. Griffon dealt with case ranking and

site/program-wide ranking totals. 

A motion was made and seconded to approve the modified report document,

along with the modified summary of findings matrix document as the

report to the Secretary. 

A friendly amendment was filed to the motion for a slight change in the

report wording to include all the pertinent attachments together

with the table that NIOSH will supply and the matrix be included in

the report. The motion was amended and passed without opposition. 

Dr. Ziemer next identified for the Board recommended changes in a

document entitled "Priority Issues for Demonstrating Feasibility of Dose

Reconstruction for MCW Destrehan Street Workers for the Time Period 1949 

to 1947, List of Tasks." 

After discussion and after a few amendments the Board unanimously

approved the amended document. 

With that Dr. Wade cited to the Board how the engagement process should

proceed. Workgroup meetings will be noticed in the Federal Register

opened to the public and a transcript officially recorded. 

Ms. Munn commented on the requirement that subcommittee meetings be

noticed in the Federal Register. 

Dr. Ziemer identified the subcommittee workgroup participants as Mark

Griffon, Wanda Munn, Jim Neton, Mike Gibson, with Rich Espinosa as an 

13 
Executive Summary/Minutes: July 5-7, 2005 

NIOSH/CDC Advisory Board on Radiation and Worker Health
 

alternate. 

Dr. Melius proposed a motion dealing with the provisions governing

communication and program direction with the Board's audit contractor. 

A motion was made and seconded that the Advisory Board on Radiation and

Worker Health adopt provisions governing communication and program

direction with the Board’s audit contractor. 

A written copy of the motion was distributed to all Board members and

Dr. Ziemer presented each item of the motion. Items 1 and 2 as read 

were commented on and slightly modified. Item 3 as read was commented 

on and slightly modified through friendly amendments. 

The Board voted on amended motion and was unanimously passed with one

abstention. 

A motion was made that the Board recognize Cori Homer for her superior

administrative support and assistance to individuals and the Board.

This was seconded and overwhelmingly passed. 

Ms. Homer informed the Board that her duties would now be in the capable

hands of LaShawn Shields. 

The Board continued the meeting. Dr. Melius commented on the conflict 

of interest issue brought up in the public comment period. 

Dr. John Mauro of SC&A commented that their conflict of interest planned

procedures and forms have been completed and signed by project members

and are on file in hard copy at corporate headquarters. Dr. Toohey

informed the Board that all ORAU forms are posted on project web site at

www.oraucoc.org. 

Dr. Wade reminded the Board about the SC&A SEC task order developed by

the Board. The task order has been submitted to the contractor SC&A for 

approval. The Board will consider the proposal in closed session when

received. 

* * * * * 

Report on Review of the Second Round,

18 Dose Reconstructions 

Ms. Kathy Behling of Sanford Cohen & Associates started the presentation

by outlining three key elements of SC&A's approach to doing dose

reconstruction review. 

Ms. Behling reviewed for the Board NIOSH and ORAU's approach to the dose

reconstruction process. Ms. Behling presented a chart detailing how the

18 cases and the 113 findings broke down by category. 

14 
 

Executive Summary/Minutes: July 5-7, 2005 

NIOSH/CDC Advisory Board on Radiation and Worker Health
 

Ms. Behling then presented a chart of the breakdown of the findings for

all 30 cases reviewed. She summarized for the Board the majority causes

of the 113 findings were due to procedural issues made by the dose

reconstructor. 

Ms. Behling entertained questions from the Board. 

Dr. Ziemer before closing out the board discussion commented that the

contractor and NIOSH should proceed on the development of the matrix for

the 18 cases just as what was presented earlier for the first 20 cases. 

* * * * * 

SC&A Contract Issues 

Dr. John Mauro of Sanford Cohen & Associates updated the Board relative

to the four tasks performed by the contractor over the past year and a

half. He felt that based on the fact that NIOSH was moving more toward

doing realistic dose reconstruction and away from the minimum/maximum

procedure, this has resulted in more sophisticated TIBs and workbooks

produced for best estimate dose reconstruction. 

Dr. Mauro further stated that he felt minimum/maximum cases reviewed so

far were showing the same conclusions and weren't adding any real value.

He recommended that for Task IV more realistic cases for testing be

selected. 

Dr. Mauro fielded questions from the Board. 

A quorum was not available for the Board to act on issues discussed, so

the Board halted the discussion. Dr. Wade concluded that Board members 

should continue this discussion via a phone conference. 

* * * * * 

Public Comment Period 

Dr. Ziemer introduced Colonel Ed Taylor from the newly formed advisory

board administered through the National Council on Radiation Protection

and Measurements. This will be a parallel group handling the veteran=s 

cases. Colonel Taylor thanked the Board for allowing him to sit in all

week and learn. 

The following is a list of the members of the public who spoke. A full 

transcript of their comments is available on the OCAS web site,

www.cdc.gov/niosh/ocas. 

Mr. Dan McKeel, Missouri Coalition for the Environment; Mr. Larry

Gassei; Ms. Denise Brock, UNWW/Mallinckrodt; Mr. Roni Steger,

Mallinckrodt. 

End of Executive Summary 

15 
Executive Summary/Minutes: July 5-7, 2005 

NIOSH/CDC Advisory Board on Radiation and Worker Health
 

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 Thirty-first Meeting

July 5-7, 2005 

_________________________________________________________________
 

The Thirty-first Meeting of the Advisory Board on Radiation and Worker

Health (ABRWH or the Board) was held at the Chase Park Plaza Hotel in St.

Louis, Missouri on July 5, 6, and 7, 2005. The meeting was called by the

Centers for Disease Control and Prevention's (CDC's) National Institute

for Occupational Safety and Health (NIOSH), the agency charged with

administering the ABRWH. These summary minutes, as well as a verbatim

transcript certified by a court reporter, are available on the internet

on the NIOSH/Office of Compensation Analysis and Support (OCAS) web site

located at www.cdc.gov/niosh/ocas. Those present included the following: 

ABRWH Members: Dr. Paul Ziemer, Chair; Dr. Henry Anderson; Dr. Roy

DeHart; Mr. Richard Espinosa; Mr. Michael Gibson (via telephone); Mr.

Mark Griffon; Dr. James Melius; Ms. Wanda Munn; Mr. Leon Owens; Mr.

Robert Presley; and Dr. Genevieve Roessler. 

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

Federal Agency Attendees: 

Senator Christopher Bond, US Senate 

Department of Energy:

Ms. Kate Kimpan 

Department of Health and Human Services:

Mr. Fred Blosser, Ms. Anstice Brand, Ms. Heidi Deep, Ms. Chris Ellison,

Ms. Nichole Herbert, Mr. Stuart Hinnefeld, Ms. Cori Homer, Ms. Liz

Homoki-Titus, Mr. Ted Katz, Mr. Judson Kenoyer, Relada L. Miller, Dr. 

James Neton, Mr. LaVon Rutherford, Mr. Dan Stempfley, Mr. Tim Taulbee,

Chris Underwood 

Department of Labor:

Mr. Shelby Hallmark, Mr. Jeff Kotsch, Mr. Jeff Nesvet, Mr. Peter Turcic 

Government Accounting Office:

Ms. Mary Nugent 

Contractors: Dr. Hans Behling, Ms. Kathy Behling, Mr. Joe Fitzgerald,

Dr. John Mauro 

Public Attendees: See Registration 

16 
__________________________________________________________________ 

__________________________________________________________________ 

 

Executive Summary/Minutes: July 5-7, 2005 

NIOSH/CDC Advisory Board on Radiation and Worker Health
 

Summary Minutes of the Thirty-first Meeting

July 5-7, 2005
 

Tuesday, July 5, 2005 

Dr. Paul Ziemer called the meeting to order, welcoming the attendees.

He asked that everyone register their attendance and discussed the signup sheet for anyone desiring an opportunity to speak during the public

comment session. Dr. Ziemer noted that Michael Gibson would not 

physically be in attendance, but they would try a phone hookup. Dr. 

Ziemer also noted that Senator Christopher Bond would arrive to address

the committee and they would interrupt the presentation at that time for

his comments. 

Dr. Ziemer recognized Dr. Lew Wade, the Designated Federal Official, for

his opening remarks. 

Following a reminder regarding the Subcommittee on Dose Reconstruction

and Site Profile Review meeting the following morning at 7:30, Dr.

Ziemer then went on to the next agenda item. 

* * * * *
 

Bethlehem Steel Technical Basis Document
 

Status of Revisions
 

Dr. Jim Neton,

NIOSH 

Dr. Neton presented a history of the Bethlehem Steel Site Profile

Revision and responses to SC&A's review. He discussed five motions 

passed by the Board at the February 7th meeting in St. Louis as a result

of those Bethlehem Steel Site Profile Revisions. 

Those motions were: 

● that the Board accepted NIOSH's response to the SC&A review;

●	 that the Board concurred with the use of the 95th percentile for

estimating worker intakes;

●	 that the Board request NIOSH review the use of the ICRP default

values for heavy work and oro-nasal breathing;

●	 that the Board concurred with the NIOSH characterization of the 

aerosol default particle size, as well as the default density;

●	 and that the Board also concurred with NIOSH's approach to

characterizing external exposure. 

Dr. Neton went on to state that they have added more rationale behind

the approaches used to reconstruct doses such as the background on

rolling operations; the appropriateness of Simonds Saw & Steel as a

surrogate facility; information from Joslyn Steel, also used to roll 

17 
Executive Summary/Minutes: July 5-7, 2005 

NIOSH/CDC Advisory Board on Radiation and Worker Health
 

uranium; and characterized in more detail the air sampling program. 

Dr. Neton's presentation continued with a discussion of the internal

exposure model adopted for Bethlehem Steel. Dr. Neton described 

background information on data evaluation and interpretation from

several studies he utilized in arriving at his conclusions. The 

presentation ended by concluding that both the ICRP default value for

heavy workers and for nasal augmentation are appropriate for Bethlehem

Steel. 

Questions raised and observations made included the following: 

● The five Board motions relative to the SC&A comment items. 

● Percentiles on model. 

●	 The letter from Mr. Ed Walker from the Bethlehem Steel claimants' 

group.

● Coming to closure on the site profile revisions. 

The Board determined a smaller workgroup or subcommittee should be

assembled to identify and review issue items and coordinate resolution

with SC&A's comments and findings. This group was charged with

providing a recommendation to the Board regarding issues. Formal Board 

action was deferred until the recommendation could be made. 

* * * * * 

Comments by Members of Congress 

Senator Christopher Bond of Missouri reiterated earlier comments 

regarding the urgent need to designate the remaining class of former

workers at the Mallinckrodt downtown site as members of the Special

Exposure Cohort, or SEC. He thanked the Advisory Board for the

inclusion of those workers covering the period 1942 to 1948 into the

SEC. He outlined the statutory requirements he believes are applicable

to the Mallinckrodt downtown workers from 1949 to 1957 which would 

justify their inclusion as well. He also addressed the Board regarding

worker dose reconstruction feasibility and timely compensation. 

* * * * *

 Privacy Information 

Ms. Liz Homoki-Titus, Office of the General Counsel

Department of Health and Human Services 

Ms. Homoki-Titus addressed the Board regarding conflict of interest.

She briefed the Board on the proper action that Board members should

follow regarding conflicts of interest for a dose reconstruction or an

SEC site consideration. Ms. Homoki-Titus presented information

regarding document review and document comments. She suggested that the

Board establish a procedure to follow when they may be called upon to

provide public comments. 

18 
 

Executive Summary/Minutes: July 5-7, 2005 

NIOSH/CDC Advisory Board on Radiation and Worker Health
 

Ms. Homoki-Titus entertained specific questions from Board members

regarding conflict of interest examples. A discussion ensued among

Board members regarding public documents. From this discussion it was 

agreed upon by Board members that they would post public documents on

the NIOSH web site. 

* * * * * 

Before commencement of the next presentation, a suggestion was made that

the Board discuss the site profile review, if one has been made, before

its consideration of any SEC petition from said site. 

Y-12 Site Profile Review 

Mr. Joe Fitzgerald,

Sanford Cohen & Associates 

Mr. Fitzgerald began his presentation by briefing the Board in general

terms, noting a lot had been accomplished in the last 30 days regarding

document review and interviews. He expected the report should be ready

later this month. Mr. Fitzgerald gave a short perspective and

background on Y-12, recognizing work conducted by Hap West regarding

health physics. Mr. Fitzgerald described information gathered by

interviewing various worker classes at the site. He explained the

workers were very mobile at the site, certain worker classes were not

monitored, and the high-fired oxide workers had been switched from

periodic urinalysis and lung count monitoring to only periodic fecal

analysis. 

Mr. Fitzgerald had learned from conducting interviews that workers were

concerned that management did not pick the most maximally exposed

individual for monitoring. He discussed information that monitoring

data obtained were subject to variations in what worker categories were

monitored, monitoring periods, and the monitoring medium utilized. Mr. 

Fitzgerald further reported that not enough information had been

captured or recorded for support category workers at the site to

adequately develop doses and he felt the issue should be addressed. He 

also touched upon the ability of bioassay monitoring programs to capture

acute releases. 

Mr. Fitzgerald presented findings on radon, radium, and nuclide exposure

in the site profile. 

He concluded his presentation by summing up what he considered the

issues of concern: 

●	 Attention to the bioassay program in terms of its ability to detect

uranium oxides, high-fired oxides in particular.

● Acute exposure. 

● Radionuclides other than uranium. 

● Coworker and recycled uranium issues.

● Spectral field measurements for neutrons. 

19 
Executive Summary/Minutes: July 5-7, 2005 

NIOSH/CDC Advisory Board on Radiation and Worker Health
 

● Unmonitored or intermittently monitored workers.

● Environmental dose methodologies. 

Mr. Fitzgerald remarked he would like to follow the issue resolution 

process with NIOSH and ORAU to isolate what is important regarding

issues of concern. 

Questions raised and observations made by the Board included the

following: 

#Acknowledgement that this is a work in progress.

#Information acquired from interviews with regard to service workers

handling uranium.

#Exhaust systems. 

* * * * * 

Y-12 Special Exposure Cohort (SEC) Petition 

Mr. Robert Presley recused himself and stepped away from the table. 

Mr. Larry Elliott, Director

Office of Compensation Analysis and Support, NIOSH 

Mr. Elliott began by acknowledging the work done by SC&A and Mr. 

Fitzgerald on the Y-12 site profile would provide for a more

comprehensive technical basis document. He noted the site profile under

review had reserved the early years due to absence of data. However, he

observed his presentation and the ensuing discussion would address the

issue of three SEC petitions from that facility. 

After describing the Y-12 petitions (18, 26, and 28) received on behalf

of employees at the plant, Mr. Elliott reminded the Board of the 

statutory requirements for adding a class of worker to the Special

Exposure Cohort. This included the requirement of meeting the twopronged test, detailed in earlier Board meetings and outlined briefly in

his presentation. 

Mr. Elliott described the original class definitions from the petitions.

Each addressed a specific group of worker, and the three time periods

covered ranged from January 1944 through December 1957. Reiterating

that no data existed for the early years, Mr. Elliott explained NIOSH

conducted a review of information available through the site profile to

examine process history, monitoring, radiation source description, and

primary documents relevant to various radiological operations at the

facility. Their review also included documents provided by the

petitioners. 

Following their review, NIOSH proposed combining the workers described

in Petitions 18 and 26, as well as the workers described in Petition 28

through December 1947. Announcing NIOSH had concluded the combined 

20 
Executive Summary/Minutes: July 5-7, 2005 

NIOSH/CDC Advisory Board on Radiation and Worker Health
 

group of workers had met the requirements of the two-pronged test of

dose reconstruction feasibility and health endangerment, Mr. Elliott 

presented the Board with wording for the new proposed class definition. 

Mr. Elliott explained the evaluation process would continue for the

remainder of the workers described in Petition 28 for the period January

1948 through December 1957. An evaluation report would be presented on

that group at a later meeting. Mr. Elliott added Mr. Fitzgerald's 

observation of site profile issues would be important in completing

NIOSH's evaluation of Petition 28. 

* * * * * 

Board Discussion 

Questions raised and observations made by the Board included the

following: 

●	 Confirmation that the lack of data was not due to the information 

being classified, but that no data exists.

●	 The revised class definition broadened both the category of worker

and the relevant time frame. 

●	 Clarification of final definition of worker classes included in the 

petition.

●	 Clarification on potential change of outcome on completed individual

dose reconstructions that overlap with the subject petitions.

● When a plausible maximum dose might be calculated. 

* * * * * 

Response by Petitioners 

Mr. James Duvall and Ms. Betty Duvall were available via telephone.

They acknowledged they had listened to the presentation of the

evaluation report and the ensuing discussion, but had no comments. 

 Board Action 

A motion was made and seconded that the Board recommend a Special

Exposure Cohort be accorded to all Department of Energy (DOE) DOE

contractor or subcontractors, or DOE employees who worked in

uranium enrichment operations or other radiological activities at

the Y-12 facility in Oak Ridge, Tennessee from March 1943 through

December 1947, and whom were employed for a number of days

occurring either solely under this employment or in combination

with work days of employment occurring within the parameters

(excluding aggregate work day requirements) established for other

classes of employees included in the SEC, and that this SEC

petition be granted. 

21 
 

Executive Summary/Minutes: July 5-7, 2005 

NIOSH/CDC Advisory Board on Radiation and Worker Health
 

The motion was open for discussion, which included the following issues: 

#How NIOSH concluded maximum plausible dose calculations were

impossible for the original Petition 18 class of workers.

#Uranium as the radionuclide of concern was known, but not the quantity

nor degree of enrichment.

#How was conclusion of significant intakes reached relative to health

endangerment.

#In dealing with enriched uranium in loose form, inhalation exposure

and lung cancer are not unlikely scenarios.

#Concern was expressed that class parameters become over-broad. 

The motion was put to vote and passed with one abstention. 

* * * * *
 

IAAP SEC Petition
 

Evaluation Report
 

Dr. Wade and Dr. Ziemer acknowledged Mr. Presley's return to the table. 

Larry Elliott, NIOSH 

Mr. Elliott provided detailed background information on pertinent dates,

initial class definition, regulatory guidelines utilized for the

evaluation, NIOSH class definition, and other supporting relevant

information. He presented only information regarding industrial

radiographers who conducted radiography on nonradiological highexplosive weapon components at the Iowa Army Ammunition Plant from May

of 1948 to March of 1949. Mr. Elliott gave details of the evaluation

report and concluded the presentation by defining the proposed class. 

* * * * * 

IAAP SEC Petition 

Board Discussion 

Following Mr. Elliott=s presentation the Board discussed the following: 

● Concern about the time period being less than 250 days.

●	 Follow-up question about the proposed definition presented in the

evaluation report. 

Mr. Elliott clarified the issue by stating that a worker who worked only

during this time period (May 1948 to March 1949) would not acquire 250

days. The worker would have had to work at some other Special Exposure

Cohort class to aggregate the days. 

22 
 

 

Executive Summary/Minutes: July 5-7, 2005 

NIOSH/CDC Advisory Board on Radiation and Worker Health
 

A motion was made and seconded that an SEC petition be accorded to all

DOE employees or its contractor or subcontractor employees who

worked as radiographers from May 1948 to March 1949 in support of

Line 1 operations of the Iowa Ordnance Plant and whom were employed

for a number of work days aggregating at least 250 work days

occurring either solely under this employment or in combination

with work days of employment occurring within the parameters,

(excluding aggregate work day requirements) established for other

classes of employees included in the SEC and based on two factors,

which he outlined. 

The motion was then opened for discussion by the Chair. 

The wording of the motion was questioned as it pertains to the 250-day

issue. 

After continued discussion on the issue the Chair proposed a friendly

amendment to the motion. Dr. Melius amended the motion to say and

whom were employed for a number of work days aggregating at least

250 work days occurring under this employment in combination with

work days of employment occurring within the parameters.

Discussion ensued, and the chair proposed a vote on the amended

motion. The amended motion passed without opposition. 

Mr. Elliott read a prepared statement from Mr. Robert Anderson on behalf

of the Iowa petitioners thanking the Board and NIOSH for their addition

of the X-ray workers on Line 1 into the petition. 

Dr. Ziemer reminded the members about the morning subcommittee meetings

and other housekeeping items before officially recessing the meeting

until 7:30 p.m. 

* * * * * 

Public Comment Period 

The following is a list of the members of the public who spoke. A full 

transcript of their comments is available on the OCAS web site,

www.cdc.gov/niosh/ocas. 

Mr. Richard Miller, GAP; Mr. Dan McKeel, Missouri Coalition for the

Environment; Mr. Clarence Schwendesen, Mallinckrodt; Mr. Ed Lamzik,

Mallinckrodt; Ms. Eileen Adams, Destrehan Plant; Ms. Marilyn Schneider,

Mallinckrodt; Ms. Mary Generi, Mallinckrodt: Mr. George Vogt,

Mallinckrodt; Mr. Roni Steger, Mallinckrodt; and Mr. Ed Walker,

Bethlehem Steel. 

* * * * *
 

23 
Executive Summary/Minutes: July 5-7, 2005 

NIOSH/CDC Advisory Board on Radiation and Worker Health
 

Wednesday, July 6, 2005 

Dr. Ziemer opened the second day by repeating some of the previous

announcements related to registration and availability of handouts. 

Dr. Ziemer introduced Dr. Wade. 

Dr. Lew Wade, Designated Federal Official, commented that the day's

agenda was almost exclusively devoted to Mallinckrodt-related issues.

He also provided background on previous Board actions dealing with

Mallinckrodt: 

●	 Board approved an SEC for the addition of a class to the SEC for

Mallinckrodt for the years '42 to '48.

●	 NIOSH presented a petition evaluation to the Board to deny adding a

class to the SEC for the years '49 to '57 for Mallinckrodt.

●	 After the Board debated the NIOSH denial, it asked that NIOSH review

and report back on data reliability issue and that the SC&A

continue with detailed review of Mallinckrodt site profile. 

Dr. Wade ended his opening remarks by stating that once the Board hears

the reports about the Mallinckrodt data reliability issue and site

profile issue, then the Board will proceed with discussion on the SEC

petition for the years '49 to '57. 

* * * * * 

Supplemental Review

Mallinckrodt Site Profile 

Dr. Arjun Makhijani, Sanford Cohen & Associates 

Dr. Makhijani opened his presentation by acknowledging Denise Brock, Kay

Drey and NIOSH for their hard work. Dr. Makhijani reiterated the Board 

had asked SC&A to review the data reliability issue and the usability of

the site profile for the Mallinckrodt downtown site for the '49 to '57

time period, the St. Louis Airport Site, and the decommissioning

section. 

Dr. Makhijani stated SC&A's previous conclusion was the same as before:

to do anything other than minimum doses for compensation, major

modifications to the site profile would be necessary. 

Dr. Makhijani touched upon the three categories of doses: the minimum

dose, reasonable dose, and maximum dose. He provided the Board the

following technical issues regarding why reasonable dose estimates will

not likely be possible: 

● Radon exposures were primarily puff exposures.

●	 Unclear of the residue processing history of the plant and it would

not be possible to make an accurate assumption about radionuclides

ratios and the composition of the air or the existing data. 

24 
Executive Summary/Minutes: July 5-7, 2005 

NIOSH/CDC Advisory Board on Radiation and Worker Health
 

● Only one radium 226 data taken in 1947.

●	 No radionuclide specific bioassay data for the most important

radionuclides (thorium 230, radium 226, actinium 227, and

protactinium 231) for most workers.

●	 No environmental release data in the site profile and not enough data

on incidents to construct accurate doses for rare incidents. 

●	 Worst-case assumptions will need to be made at airport site due to

lack of air monitoring data.

●	 Maximizing assumptions will have to be made for unmonitored workers

because there was risk of significant exposure.

●	 To obtain TBD for maximum dose, an incorporation of all the available

radon data, the residue composition, processing history, and

development of worst-case assumptions need to be done.

● Air concentrations cannot be used for dose reconstructions. 

● Ratios have to be developed for the bioassay data to be utilized.

● Need to develop correction factor for Board's hospital data.

●	 Air concentration measurements in Table 22 of the site profile are

not useful. 

● Thorium 230 doses cannot be reconstructed without bioassay data.

●	 Based on review of data SC&A is not comfortable that a defensible or 

worst-case approach can be demonstrated for infrequent incidents.

● There are serious data gaps with regard to incidents.

●	 Mallinckrodt job type data was good and could be utilized for the

development of corrections factors by job type and by organ.

●	 Worker monitoring history of plant 1 and 2 decommissioning needs to

be established. 

● Current default working hours are not good enough.

● Incorporation of breathing rates for heavy work periods.

● Proper consideration of the importance of environmental release data.

●	 Commented that the decommissioning bioassay data were done in

triplicate with some quality control.

●	 Remarked he didn't see clear evidence that the SLAPS workers were 

monitored. 

● Has concerns with the way NIOSH is handling ingestion issue.

●	 Concluded that due to the absence of reliable data reasonable dose 

reconstructions are unlikely to be possible at Mallinckrodt, and if

possible only maximum doses reconstructions will be made, but

pointed out that quite a bit of work remains for establishment of

maximum doses. 

●	 All six cases that have been denied at Mallinckrodt have been 

reviewed and feels that the use of the internal doses are not 

scientifically defensible. 

* * * * * 

Questions/Discussions 

The Board raised the following issues with Dr. Makhijani following his

presentation: 

►	 Pertinence of slide 13, decommissioning of 1958 onward, with regard

to this petition which ends with the 1957 period. 

25 
Executive Summary/Minutes: July 5-7, 2005 

NIOSH/CDC Advisory Board on Radiation and Worker Health
 

►	 Clarification needed of sixth slide, "Bases for finding that

reasonable dose estimates are unlikely," but then the following

slide suggests or implicates that if a number of changes to the TBD

were made, then reasonable dose estimates could be made. What is 

SC&A=s position.

►	 Response provided that there could be some items that fall into the

reasonable dose category, but for the most part the majority of

items were related to the development of scientifically defensible

worst-case assumptions. There could be some items that fall into 

the reasonable dose category, but for the most part the majority of

items were related to the development of scientifically defensible

worst-case assumptions.

► Issues need to be clearly characterized with respect to Barnes data.

►	 With respect to Barnes data, they didn't find any evidence of

contaminated urine samples, but that based on the standard itself

deteriorating over time that a systematic error of overestimation

could have occurred. 

►	 There seems to be a systematic overestimation error of the Barnes

data due to the standard precipitating which artificially jacked up

the calibration curve back up to expectation. This issue is well 

documented and characterized and should be taken into account. 

Mr. Gibson requested (via telephone) if a copy of the presentation could

be e-mailed to him. Dr. Ziemer complied with Mr. Gibson's request and

introduced Dr. Neton as the next presenter. 

* * * * * 

Mallinckrodt Site Profile 

Jim Neton, NIOSH 

Dr. Neton began his presentation to the Board by outlining the subject

of his presentation. He stated he would be presenting two issues in

regard to the Mallinckrodt dose reconstruction. One is the integrity of

the data issue and the other is the raffinate issue. Dr. Neton 

outlined to the Board the dose reconstruction process. NIOSH collects 

data from DOE, reviews claimant file, reviews CER data set (unique to

Mallinckrodt,) reviews site profiles, and use procedures and

implementation guides, Technical Information Bulletins and claimant

interviews to interpret the data. Dr. Neton presented to the Board

information on the data sources: 

► The only data is the individual and summary film badge reports.

► The CER database is a compilation of all the information at the site. 

He cited for the Board specific data information; such as:

► Over 9,000 air dust cards representing 1,443 workers through 1955.

►	 13,600 urine sample results almost exclusively for uranium, but do

have some for thorium. 

► 8,000 person-years of film badge results.

► 4,700 area radon measurements. 

26 
Executive Summary/Minutes: July 5-7, 2005 

NIOSH/CDC Advisory Board on Radiation and Worker Health
 

► 2,400 radon breath measurements. 

He stated that radon measurements could be utilized to trace workers who 

were involved in the raffinate processing. 

Dr. Neton presented statistical values of the data set that compared the

air dust data against the urine data for a subset of workers for the

ether house. He stated that ether house was where raffinate extraction 

process occurred. Dr. Neton concluded that based on the lognormal fit

of the urine and air data, the integrity of the data is not an issue. 

Dr. Neton cited information on the percentage of workers monitored: 

►	 15 to 20 percent of workers monitored for breath radon, terminated in

'55. 

►	 Less than 60 percent in '48 and increasing over time to about 80

percent of the workers in '55 being monitored by urine samples,

followed by a slight downturn after 1956 because of declining

production operations. 

Dr. Neton stated that '57 and '58 was the end of production for the

Mallinckrodt facilities. The workers monitored for air dust was 50 

percent in '50, increased to 80 percent plus in '51 and '52. The film 

badge data percentages ranged from 75 to 80 percent to almost 100% of

the workers monitored in later years. 

Dr. Neton stated that they went back and looked at the records available

for claims presented. This includes 109 cases that are not part of the

SEC with employment start dates between 1949 and 1957. He concluded 

that based on this review, reliable urine data for dose reconstruction

does exist. 

Dr. Neton concluded his presentation with a couple of slides on

raffinate where he stated that they would pick the higher of the air and

urine test results to assign the dose to the worker. Before stating his

conclusion, he gave a detailed process description of the raffinate

process. 

* * * * * 

Question/Discussion 

The Board raised the following issues with Dr. Neton following his

presentation: 

●	 Clarification needed as to radon breath analysis having nothing to do

with radon in the environment, but rather how much radium is in the

body and comes out in breath.

●	 Response was if they knew about the radon breath analysis, then a

likelihood existed workers monitored for radon in breath also had a 

potential for raffinate exposure.

● Is assumption being made based on the fact that these people might 

27 
 

Executive Summary/Minutes: July 5-7, 2005 

NIOSH/CDC Advisory Board on Radiation and Worker Health
 

have been expected to be exposed to radium, did they know back then

about the raffinate, protactinium and thorium and other

radionuclides of concern. 

● Is there any documentation regarding the sampling.

●	 What is the reality and feasibility of doing the dose reconstruction

of the 109 individual cases, even though technically it could be

done. 

●	 The efficiency process or maximum credible dose could be used in lieu

of doing full complete, refined dose reconstructions.

● Has any of the employee information of petitioners been reported.

●	 Comment made regarding the representativeness of air sampling data

and default assumptions.

●	 The use of worst-case values when comparing air and urine data for

dose calculation. 

* * * * * 

Mallinckrodt SEC Petition 

Evaluation Report 

Dr. Wade reminded the Board that after they hear information from NIOSH

on the SEC petition evaluation report and from petitioners as to the

report, the Board will proceed with deliberation to make a

recommendation. He outlined the procedural steps to the Board once a

recommendation is formed. 

Larry Elliott, NIOSH 

Mr. Elliott opened his presentation by reviewing, as required by

statute, the two-pronged test that must be met. Next he summarized 

pertinent dates of the petition:

● July 21, 2004 -- petition submitted to NIOSH.

● November 24, 2004 -- petition qualified for evaluation.

●	 December 20, 2004 -- Federal Register notice provided and petitioners

notified regarding qualification of the petition.

●	 February 2, 2005 -- NIOSH submitted a summary of findings and

petition evaluation report to the advisory board and petitioners.

● February 3, 2005 -- evaluation report summary was published in the

Federal Register.

●	 February 8, 2005 -- presented evaluation reports and proposed three

class definitions. 

Outlined for the Board the three class definitions: 

●	 Class one, All DOE, DOE contractors or subcontractors employed by the

uranium division of Mallinckrodt during the period from 1942

through 1945;

●	 Class two, all DOE, DOE contractors or subcontractors who worked at

the uranium division at the Mallinckrodt Destrehan Street facility

during the period of 1946 through 1948;

●	 Class three, all DOE, DOE contractors or subcontractors who worked at

the uranium division of the Mallinckrodt Destrehan Street facility 

28 
Executive Summary/Minutes: July 5-7, 2005 

NIOSH/CDC Advisory Board on Radiation and Worker Health
 

during the period from 1949 through 1957. 

Additional issues were identified by the Board at the February meeting

following the presentation of the evaluation report. NIOSH responded to

those additional issues in a supplemental report.

●	 March 11, 2005 -- Board sent recommendation to SEC of Health and

Human Services. In that recommendation the Board asked that an SEC 

designation for all DOE contractors or subcontractors or Atomic

Weapons Employees who worked at the uranium division at

Mallinckrodt Destrehan Street facility during the period from 1942

through 1948, the first two classes that were identified, be added

to the Special Exposure Cohort. The Board reserved judgment for

workers employed during the period of 1949 through 1957 until NIOSH

had completed its supplemental report on that time period and

answered some of the questions the Board had raised.

●	 April 6, 2005 -- Director of NIOSH sent a recommended decision

consistent with the board's recommendation to add a class of 

workers for the time period 1942 to 1948.

●	 April 11, 2005 -- Secretary of Health and Human Services sent his

decision to Congress to add the uranium division employees at the

Mallinckrodt Destrehan facility for the period of 1942 through 1948

to the Special Exposure Cohort.

●	 April 27, 2005 -- NIOSH presented supplemental report to the Board.

At the presentation the Board requested verification of data and

examples of dose reconstructions using actual data. Dr. Neton 

presented that information to you today. Also at that time the 

Board reserved judgment pending that information from NIOSH for

workers employed during the period 1949 to 1957. 

Mr. Elliott briefed the Board that NIOSH concluded, based on the

monitoring activities of employees and work areas established in 1949 by

Mallinckrodt, as well as the information on radiological sources and

processes, there is sufficient information to validate the dose

estimates for the period 1949 to 1957 and notwithstanding any data

reliability concerns raised for the earlier time period. 

Mr. Elliott presented information regarding three items outlined in SEC

petition report 00012-2, Section 7.3. 

●	 Item 2 dealt with radon breath issue and the limited data and the use 

of zeroes in the data. Stated that Dr. Neton presented to you

today a solution to Item 2 by using urinalysis data to fill the

data gap.

●	 Item 3 dealt with unconfirmed lost medical records that NIOSH has 

been unable to confirm to date. 

●	 Item 4 dealt with a 1949 dust study that was never finalized,

believed due to altered records and conscious cover-up. 

Mr. Elliott reviewed the solution to this presented earlier in the day

by Dr. Neton. The solution consisted of using available data collected

in a program that had oversight from AEC HASL Laboratory for the time 

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Executive Summary/Minutes: July 5-7, 2005 

NIOSH/CDC Advisory Board on Radiation and Worker Health
 

period 1949 to 1957 and the ability to cross-reference data streams and

validate the data sources. 

Mr. Elliott referenced the part of Dr. Neton's presentation dealing with

statistical evaluation of the data that revealed no significant data

alterations, and these were consistent with expectations. Mr. Elliott 

concluded information on Item 4 stating NIOSH would use the highest and

most claimant favorable data set between the urine and air data for use 

in dose reconstruction. 

Mr. Elliott concluded his presentation by summarizing that for the years

1949 to 1957 NIOSH finds that radiation dose estimates can be 

reconstructed and validated for compensation purposes for this

particular class. NIOSH finds it is feasible to do dose reconstruction 

and, therefore, an answer to that particular prong of the two-part

question is not warranted. 

* * * * * 

Mallinckrodt SEC Petition 

Board Discussion 

Dr. Ziemer opened the floor for discussion. 

Dr. Melius requested confirmation on the verification of data issue and

examples of dose reconstruction using actual data. Dr. Neton and Mr. 

Elliott both provided input on the dose reconstruction issue. Dr. 

Anderson asked how many individuals in the existing claims filed would

fit into dose reconstruction. Mr. Elliott responded by referencing

information presented in the program status reports. 

Dr. Neton provided additional comments to Dr. Anderson's question by

stating that 100% of the 109 active cases in possession who worked in

the 1949 to 1957 time period would fall into the evaluation report. Dr. 

Neton added that there are an additional 50 or 60 cases that have 

employment that spill over into the 1949 to 1957 time period that are

also members of the original class. He also pointed out that the 109

cases have no employment in the SEC classes that have already been

awarded. 

Dr. Anderson followed up with comment regarding feasibility of actually

doing dose reconstruction. Dr. Melius commented that the only new thing

on record from NIOSH was Jim Neton's recent presentation. Mr. Elliott 

confirmed Dr. Melius' comment. Dr. Melius also raised the feasibility

issue and also raised issue with what the Board previously requested

concerning dose reconstruction feasibility and what was actually

presented. 

Dr. Neton stated his understanding was to present to the Board examples

of graphical data using real data versus the graphically presented

information at the Cedar Rapids meeting which utilized hypothetical

data. Dr. Melius commented that the Board will have a more difficult 

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Executive Summary/Minutes: July 5-7, 2005 

NIOSH/CDC Advisory Board on Radiation and Worker Health
 

decision-making process based on the fact that example cases have not

been conducted with full feasibility. 

* * * * * 

Mallinckrodt SEC Petition 

Comments from Petitioners
 

Ms. Denise Brock provided to the Board an account regarding events since

filing the SEC petition for the Mallinckrodt workers from 1942 to 1957 a

year ago. She cited to the Board at a February meeting a decision was

made to split the cohort. SEC status was granted for workers during the

time period 1942 to 1948, and to table a decision on the workers from

1949 to 1957 based on recently discovered data and the so-called Mont

Mason memo. 

Ms. Brock stated that NIOSH felt that the newly discovered data

information and on-going site profile revision provided enough

information to conduct an accurate dose reconstruction on the workers 

from 1949 to 1957. Board allowed more time for NIOSH and SC&A to 

complete their analysis at the April meeting in Iowa. 

Ms. Brock voiced to the Board her concern why she was not appropriately

notified of a June 1st and 2nd meeting between SC&A, NIOSH, and the

Board. She also expressed concern regarding timeliness written

information was relayed to her. She cited to the Board findings of the

Rev 1 report that it does not appear it provides a basis to do accurate

dose reconstruction. She quoted to the Board examples regarding

Mallinckrodt site profile audit. 

Ms. Brock spoke to specific examples dealing with lack of data issue and

worker interview information. She described to the Board detailed plant

work practices that occurred in several different areas of the plant.

Ms. Brock restated to the Board for the record what Congress directed

NIOSH to do with respect to Special Exposure Cohorts. She emphasized to

Board members that feasibility concept goes beyond just scientific and

technical issues, it should also consider the timeliness and cost of

dose reconstruction in the absence of relevant or missing data. She 

mentioned the lack of proper procedures to provide petitioners

information regarding meeting notification and written document

transmittal. 

Ms. Brock pledged to the Board to add the Mallinckrodt workers from 1949

to 1957 to the Special Exposure Cohort. She urged the Board that if

they determine that entire group should not be included, then they

should consider a specific sub-cohort of workers at the facility. At 

this time she notified the Board that there were several workers who 

would provide comments. 

Mr. George Blue testified regarding his working experience in the 

raffinate extraction process. He described his specific duty was to

reheat the raffinate in an acid for the purpose of extracting an 

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Executive Summary/Minutes: July 5-7, 2005 

NIOSH/CDC Advisory Board on Radiation and Worker Health
 

element. He explained to the Board in detail a work incident in which

he was covered (80% of his body) with the tank contents and hospitalized

at Barnes Hospital for eight days. 

Mr. Blue remarked he has scars on his body as a result of this incident.

A few days after being released from the Barnes Hospital, the plant

called him back to work and said he would not have to do anything.

However, the foreman asked him to clean up something and upon starting

the work, he got real weak and was sent home. After a few days he went

back to work and plant personnel told him that getting sick had nothing

to do with the recent accident. 

Mr. Blue testified that he had to be catheterized to obtain urine 

sample. He also mentioned that he was not aware of radon exposure with

his work. He relayed in detail to the Board a specific tank explosion

incident and sampling of drums procedure. 

Mr. Anthony Windisch stated that he worked at the Mallinckrodt uranium 

plant in St. Louis from 1945 to 1957, and the Weldon Springs plant from

1958 to 1967. He reminded the Board that at an earlier meeting he

previously testified that in 1962 he began working with computers at the

Weldon Springs plant. He acknowledged he was a certified computer

professional and testified that mason memo shows that most of the

recently-found computer keypunch cards and other radiation records was a

bunch of garbage and useless. He referenced a meeting with the audit

investigator where he testified that as an electrician at the

Mallinckrodt uranium plant he witnessed and/or experienced production

mishaps at almost every processing step during the production of uranium

metal. 

Mr. Windisch cited to the Board the frequency of occurrence when uranium

processing bomb exploded and he had to repair the electric furnaces. He 

informed the Board that beginning in 1962 he worked as a computer

programmer and analyst. This work involved worker badge monitoring

data, and felt he was well versed in obtaining air monitoring data for

creating a site dose reconstruction profile.

He made reference that safety department maintained a current dose

reconstruction profile for each unique work site at the Destrehan

uranium plant. 

Mr. Windisch concluded his remarks by stating that there is no specific

dose reconstruction profile to measure ether house explosion, exploding

radium processing bombs, overflowing raffinate tanks and other

production mishaps. 

Mr. Steven Eugene Pape stated that his father was Eugene C. Pape and

worked at the Destrehan Mallinckrodt Chemical Company plant from 1945

until his death May 10, 1977. He stated his father was diagnosed with

carcinoma lung cancer April 21, 1977. Mr. Pape stated that his father 

never spoke to him about his work and he never knew what his father did

until October 28, 2004, when he had to do the NIOSH dose reconstruction.

He found that he was a production operator in building 7. He commented 

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Executive Summary/Minutes: July 5-7, 2005 

NIOSH/CDC Advisory Board on Radiation and Worker Health
 

that he did not know any answers to their questions, except to state

that his father worked seven days a week for a number of years. 

Mr. Robert Leach commented that he went to work for Mallinckrodt in 

1950, transferred to uranium plant in 1952, worked in plant 4 from 1952

to 1957, transferred to Weldon Springs in 1957 and worked there until

the plant closed in 1965. Mr. Leach commented that plant 4 was the

dirtiest and filthiest place he had ever worked in. He stated his job

was to clean up the inside of the furnaces after they cooled down. He 

testified that more than once the molten metal came through the bottom

of the furnace and would run into the work area. Mr. Leach stated that 

in case he was not around for Weldon Springs petition, that he worked 40

to 76 hours per week. 

In closing, Mr. Leach commented that there is no way in the world that

you can figure out one man’s exposure. 

Mr. Ed Luecke stated he began working at Mallinckrodt May 6, 1947 in

plant 4. He described for the Board that he worked in plant 4 which he

referred to as the coffin area. He commented they wore no monitoring

badges and there were fumes all over the place. The company issued

respirators, but were very uncomfortable to work with. He commented 

that he moved to plant 6E and worked as a utility man where he stated he

was exposed to a lot of dust. 

Ms. Brock felt that NIOSH should incorporate workers’ statements into

site profile. She felt time was being wasted because there are no

assurances that once the revisions take place, actual dose

reconstruction could be done. 

* * * * * 

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Executive Summary/Minutes: July 5-7, 2005 

NIOSH/CDC Advisory Board on Radiation and Worker Health
 

Mallinckrodt SEC Petition 

Board Discussion 

Dr. Ziemer called the meeting to order and opened the floor for

discussion. He briefed the Board on procedure. Mr. Owens opened with a

question for Dr. Makhijani concerning the completeness and accuracy of 

the records presented earlier. 

Dr. Makhijani summarized by stating that aside from the radionuclides

ratios and Fernald K-65 silos he felt there are data sufficiency

problems in several areas: infrequent incidents, environmental doses,

and roving workers. 

Dr. Ziemer confirmed Mike Gibson's participation via telephone and

recognized Jim Neton for follow-up. 

Dr. Neton added comment regarding the issue of the inability to

reconstruct infrequent incidents. He voiced his concern that the SC&A 

report contends somewhat frequent incidents can be reconstructed using

chronic inhalation intake, but infrequent incidents cannot be. 

Dr. Makhijani clarified his remarks by stating that he didn't say that

infrequent incidents couldn't be modeled, but that a claimant favorable

way or maximizing way hasn't been demonstrated. He proceeded to expound

on the issue by summarizing previously presented information. 

Dr. Anderson commented on the timeliness and feasibility issue regarding

the dose reconstruction of the 109 cases. He wanted to know a time 

frame if tasked with dose reconstruction. Mr. Elliott responded that

four months would be required for 107 cases of dose reconstruction; the

first month reserved for ironing out remaining issues and three months

for work on the claims. 

Dr. Anderson and Dr. Neton provided comments regarding the meaning of

the statistical information presented in Dr. Neton's presentation. Dr. 

Anderson observed that a lot of the questions previously raised have

been addressed. 

Dr. Melius provided comments with options to address how to put together

issues from the SC&A evaluation of the site profile and NIOSH's

evaluation of the SEC petition. One option is to take NIOSH’s word that

individual dose reconstruction are feasible and let them proceed.

Another option would be to let NIOSH and SC&A work together to resolve

the site profile issues and postpone any decision until this work is

completed. A third option is to have NIOSH actually work through some

representative number of dose reconstruction cases to determine the

actual feasibility of the process. Another option would be to

incorporate third option and have SC&A work to resolve comments on site

profile and present results to the Board. 

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Executive Summary/Minutes: July 5-7, 2005 

NIOSH/CDC Advisory Board on Radiation and Worker Health
 

Dr. Ziemer asked for additional comments. Dr. DeHart asked for 

clarification regarding the issue of self-identified exclusion for dose

reconstruction. He restated his question, can you identify an

individual in which dose reconstruction cannot be done and move along

toward identifying a specific cohort. Mr. Elliott cited regulation that

allowed that. Dr. Neton added to Mr. Elliott's comment by stating that

there is a possibility that there is something out there that was not

anticipated. 

Dr. Ziemer at this time reminded the Board to consider the timeliness of 

the various options discussed. He posed a question to Denise Brock 

regarding raffinate workers and subcohort. Ms. Brock commented that she 

thought plant 6 was raffinate area. However, Dr. Ziemer stated he 

understood that part, but wanted to know if the information could be

retrieved from the job description information. 

Dr. Neton and Dr. Ziemer exchanged dialogue regarding the issue of job

description information, K-65 digestion process, and dose

reconstruction. Dr. Neton responded that the dose reconstruction would

be on individual case-by-case basis if job category information is

utilized. He added that it is the Department of Labor's responsibility

to qualify a subset of workers based on their application as to whether

they are in the SEC. 

Mr. Elliott added that when DOL makes its determination of eligibility

for a class, case file information that has been developed is relied

upon. Ms. Brock asked for clarification. 

Mr. Elliott said development of case file starts when a file is

submitted to DOL by the claimant. DOL claims examiner determines if the 

claim is eligible based on medical history records and site job

information. Once DOL deems the case eligible, the case is referred to

NIOSH to work up the claimant's work history. NIOSH utilizes 

interviews, document review, and any other information that would

benefit the claimant. NIOSH provides all the information gained back to

the Department of Labor for eligibility determination. 

Dr. Melius commented that an interim step that would allow SC&A comments

to be resolved could help identify if dose reconstruction would apply to

a larger percentage of workers that would require dose reconstruction

than previously anticipated. He also commented that actual individual 

dose reconstruction examples were necessary to resolve the SC&A comments

on the site profile. 

Dr. Ziemer agreed with Dr. Melius's comment, but noted how hard the

Board was pushing SC&A and NIOSH to meet the Board's deadlines. It is 

difficult for NIOSH to provide comment on a report that was presented to

them a day or two before the meeting. Dr. Melius suggested that the

committee or subcommittee continue dialogue to resolve SC&A site profile

comments. 

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Executive Summary/Minutes: July 5-7, 2005 

NIOSH/CDC Advisory Board on Radiation and Worker Health
 

Mr. Elliott reiterated Dr. Melius's suggestion. Ms. Brock concurred 

with Dr. Ziemer's comment regarding difficulty with interpreting the

information given on such short notice. She also asked that probability

of causation chart be developed for the next meeting. Mr. Elliott 

stated it could be a competing resource problem. Dr. Neton expanded on

Mr. Elliott's resource issue in constructing the charts. 

Mr. Gibson questioned how NIOSH can provide accurate and reasonable dose

reconstruction for the raffinate workers in plant 6 with the lack of

individual bioassay data. Dr. Ziemer informed Mr. Gibson that there are 

a lot of urinalysis data and air data for the dose reconstruction

effort. Dr. Neton and Mr. Gibson continued dialogue concerning data

information. 

Ms. Brock expressed concern to the Board about time issue regarding dose

reconstruction issue, especially regarding thorium-230, actinium -227,

protactinium raffinates. Dr. Neton suggested the use of the air

monitoring data to support inhalation intakes from the raffinate

material. He also commented that there are a number of approaches that

can be used to bound these estimates. 

Dr. Makhijani remarked that there are a significant number of issues to

be resolved. He will engage the issues at the Board's direction and

report those findings at a time mandated by the Board. He concluded by

stating that there's no guarantee of an answer. 

Mr. Griffon felt that the Board, SC&A and NIOSH, on the subcommittee

level, should identify or prioritize issues that need to be resolved for

the purpose of resolving this SEC petition. He also added that he would 

like to see specific representative cases of dose reconstruction,

especially for the raffinate assumption. This would provide us with an

evaluation of feasibility and timeliness for the dose reconstruction

effort. 

Mr. Elliott said he agreed 100% with Mr. Griffon, but clarified that

they couldn't bring an example dose reconstruction case unless it's an

adjudicated case. Dr. Anderson stated that this is a very complex site

and site profile is complex, and would like to try to simplify the

process. He remarked that he wasn't sure of resolving the data

uncertainties, but it's a matter of addressing the uncertainties in the

dose reconstruction. 

Ms. Homoki-Titus presented clarification on bringing cases before the

Board that haven't been adjudicated by the Department of Labor. Dr. 

Melius pointed out that they were not asking for complete data on

individual cases that would violate legal issues. All we're asking to

do is go through and show that it's feasible. Dr. Ziemer commented that 

the Board is not for specific cases, but possibly a group of cases could

be summarized. 

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Executive Summary/Minutes: July 5-7, 2005 

NIOSH/CDC Advisory Board on Radiation and Worker Health
 

Mr. Elliott commented to the Board regarding questions raised from Cedar

Rapids meeting explaining how to validate the data and how to use the

data in dose reconstruction. He felt this was accomplished. 

Ms. Munn commented on the effort to gather and analyze as much

information as possible about exposures of the workers in the proposed

class. The detail and availability of the data clearly shows concern

for the workers= safety and welfare by both the contractor and

governmental agency overseeing work at Mallinckrodt site. There should 

be no reason why a subcommittee couldn't provide direction on

priorities, and why SC&A and NIOSH couldn't come to some agreement on

the major issues to resolve while at the same time moving forward with

resolution on the outstanding cases. 

Ms. Munn wanted to know if her understanding was correct that nothing

could be done on outstanding cases until a decision with respect to the

SEC was made. Dr. Ziemer stated there is nothing in the law that

requires dose reconstruction be halted while the petition is in process.

Dr. Wade asked Dr. Neton if there is a subset of the 107 that you could

begin to work on now and Dr. Neton responded that, yes, there is. 

Dr. Ziemer pointed out to the Board that a delay has the same effect as

denying the petition. Ms. Munn commented that she was prepared to make

a motion. Dr. Ziemer said that before a motion was put on the floor he

asked if there were additional discussion. Mr. Espinosa wanted to know 

if adjudicated claims could be discussed by the Board in executive

session. Ms. Homoki-Titus remarked to the Board that they are an

advisory board not an appeals board for individual claims. 

Dr. Melius made a comment that the Board still must decide on issues 

related to contractor doing SEC evaluations. The Board must come up

with a better process. He stated preference for postponement on a

decision on the Mallinckrodt petition until NIOSH has had time to

evaluate the SC&A report. This will also provide time for the

petitioners to evaluate the SC&A report. 

Dr. Ziemer inquired if building 6 workers are being viewed as a possible

subset of the cohort that might contain eligibility status on its own.

Dr. Melius commented his belief that once NIOSH had a chance to comment 

on the SC&A evaluation of the site profile they would be able to come to

a conclusion on building 6 issues. Ms. Brock interjected that she has

not had an opportunity to take in all the information. She asked for 

clarification on the issue if halting the decision will also not halt

the dose reconstruction. 

Mr. Elliott clarified that work on the Mallinckrodt claims had been 

suspended for the Destrehan facility unless there was a claim that

allowed us to move forward using the efficiency process. Dr. Melius 

commented that certain aspects of individual dose reconstruction should

move forward except for when particular issues have not been resolved

for the dose reconstruction. Mr. Elliott concurred. 

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Executive Summary/Minutes: July 5-7, 2005 

NIOSH/CDC Advisory Board on Radiation and Worker Health
 

Mr. Elliott reiterated that they could move forward on dose

reconstruction of specific claims where SC&A site profile comments have

been resolved. Claims with outstanding site profile issues will have to

wait for dose reconstruction until issues are resolved. 

Dr. Anderson concurred and dialogue continued between Mr. Elliott and 

Dr. Anderson. Ms. Munn commented that there was no need for a Special

Exposure Cohort since NIOSH has committed that they can do the dose

reconstruction. Ms. Brock commented that if the dose reconstructions 

can be done, why have they not already been done. 

Mr. Elliott remarked that two things have happened to put the

Mallinckrodt claims on hold that were not reconstructable using

efficiency approaches: review of the revision for the site profile and

the petition. He added that the 75 claims completed were all lung and

prostate cancer claims. 

Dr. Ziemer announced a break and that upon reconvening motions would be

accepted. 

Dr. Wade proceeded to remind the Board of the requirements of the SEC

legislation by reciting appropriate parts of the Federal Register. 

Dr. Ziemer recognized Ms. Munn for making a motion. 

A motion was made and seconded that the SEC petition for the 1949

through 1957 time period at the Mallinckrodt Destrehan facility be

denied. Motion is on the floor for discussion. 

Dr. Anderson moved to table the motion and this was seconded by Mr.

Gibson. Dr. Ziemer stated that a vote must be taken on tabling a motion

and requires a two-thirds vote. The vote carries for tabling motion. 

A motion was made and seconded for the Board to consider formulating a

letter of apology or regret for delaying SEC petition. Motion

passed. 

Dr. Ziemer proposed postponement until tomorrow on the SEC policy issue

discussion so that working group may get underway. The Board proceeded

with a future meeting logistics discussion before Dr. Ziemer formally

recessed the meeting. 

* * * * * 

38 
 

Executive Summary/Minutes: July 5-7, 2005 

NIOSH/CDC Advisory Board on Radiation and Worker Health
 

Thursday, July 7, 2005 

Dr. Ziemer opened the third day by repeating some of the previous

announcements related to registration and availability of handouts. 

* * * * * 

SC&A Task III/Workbook Issues 

Hans Behling, Sanford Cohen & Associates 

Dr. Behling opened the presentation by providing background dealing with

Task III. He defined Task III as being procedures and methods used by

NIOSH to do dose reconstruction and outlined Task III subject matters as

follows: 

● Procedures that deal with external dosimetry,

● Procedures that deal with internal dosimetry,

●	 Procedures that deal with CATI interviews, quality assurance,

documentation and record management. 

Dr. Behling stated that the federal regulations mandate that the

Advisory Board will conduct an independent review of the methods and

procedures used by NIOSH for dose reconstruction. NIOSH identified 33 

procedures for this review. Dr. Behling commented in regard to the

documents reviewed, the details, specificity and nonspecificity when

reviewing the 33 procedures. 

As directed by the Board SC&A was tasked to develop a method to conduct

a review of the 33 procedures. He decided to break down Task III into 

two phases: 

●	 Phase 1 -- develop method to systematically review and standardize

the review process that was presented to the Board September 2004. 

●	 Phase II -- review of the NIOSH and ORAU procedures that was

presented to the Board in January of 2005. 

In addition, SC&A was asked to evaluate a list of issues from a

technical as well as a non-technical viewpoint. He identified for the 

Board seven basic objectives followed for Task III work: 

● Timelines issue. 

● Is procedure written in an effective and efficient manner.

● Is the procedure as written complete or standalone document.

● Is the procedure fairly consistent among different DOE sites.

●	 Is the procedure fair and will it provide benefit of the doubt to

claimant. 

● Uncertainty of procedure.

●	 Does the procedure have a proper balance between technical precision

and process efficiency. 

39 
 

Executive Summary/Minutes: July 5-7, 2005 

NIOSH/CDC Advisory Board on Radiation and Worker Health
 

Dr. Behling presented information on the development of a checklist

comprised of secondary questions and rating system for evaluating the

procedures based on the previously presented seven objectives. The 

ratings scheme is 1 through 5, 1 represents "never" and five represents

"perfect." Rating scheme also provided for "NA" determination. 

Dr. Behling referenced for the Board SC&A's nearly 300-page report which

contained the application of the checklist and rating system of the

seven objectives for the 33 dose reconstruction procedures reviewed.

The remaining presentation to the Board provided detailed examples of

the checklist and rating system results. 

* * * * * 

Questions/Discussion from Board 

The Board raised the following questions with regard to the

presentation: 

►	 Does anything actually have to be done with deficiency side of the

procedures, are the deficiencies being corrected by later

procedures.

►	 Response was that subcommittee is trying to rank or develop a matrix

for the more technical issues they're trying to address and

questioned the higher number (525) of "NA" in matrix; are we using

the right matrix. 

* * * * * 

Report on the Review of the First 20 Dose Reconstructions 

Dr. Ziemer explained to the Board the matrix details; such as, the

finding number, ranking, case rank, external, et cetera. He pointed out

to the Board in the matrix the proposed Board actions categorized as 1

through 7 are the ones on which action will have to be taken. 

Dr. Ziemer and Mr. Griffon presented the definitions of the 7

categories: 

● NIOSH agrees and accepts findings.

● NIOSH disagrees but will comply.

●	 NIOSH disagrees and will not implement unless Board recommends action

through HHS.

● NIOSH disagrees and the Board and NIOSH reach a compromise.

● NIOSH disagrees and the Board concurs.

● Issue is deferred to a site profile, TBD or procedure review process.

● SC&A concurs with NIOSH's view. 

The Advisory Board then proceeded on with the task of categorizing the

first 20 procedures. The Board produced a modified matrix. 

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Executive Summary/Minutes: July 5-7, 2005 

NIOSH/CDC Advisory Board on Radiation and Worker Health
 

A motion was made and seconded to accept the summary of findings matrix

as part of the Board=s report on the first 20 cases. With no 

discussion, the motion carried unanimously. 

* * * * * 

Board Discussion 

The Board then proceeded to discuss the modified summary of findings

matrix. Dr. Ziemer noted the Board also has to consider the narrative 

wording to the Secretary of Health and Human Services report on dose

reconstruction findings. The only wording change to the latest report

version as reported by Mr. Griffon dealt with case ranking and

site/program-wide ranking totals. 

A motion was made and seconded to approve the modified report document,

along with the modified summary of findings matrix document as the

report to the Secretary. 

The motion was open for discussion. Mr. Griffon referenced a 

summarizing table as not being included in the report but will be added.

Board members discussed placeholders to be filled in and wording

changes. 

As a result a friendly amendment was filed to the motion for a slight

change in the report wording to include all the pertinent

attachments together with the table that NIOSH will supply and the

matrix be included in the report. The motion was amended and 

passed without opposition. 

Dr. Ziemer next identified for the Board recommended changes in a

document entitled "Priority Issues for Demonstrating Feasibility of Dose

Reconstruction for MCW Destrehan Street Workers for the Time Period 1949 

to 1947, List of Tasks." 

Dr. Ziemer proceeded to outline the modifications recommended by the

subcommittee. 

Timetable recommendation: 

●	 July 26 -- work group conference call for status report and task

clarification;

●	 July 31 -- NIOSH will provide a draft report on the following tasks,

in consultation with SC&A;

● August 7 -- NIOSH completes the tasks with the SC&A;

●	 July 31 through August 7 -- schedule work group meeting within this

time frame;

● August 16 -- SCA to review NIOSH response;

●	 August 16 through August 22 -- schedule work group conference call

during this time frame;

● August 25 & 26 -- scheduled board meeting. 

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Executive Summary/Minutes: July 5-7, 2005 

NIOSH/CDC Advisory Board on Radiation and Worker Health
 

He further recommended specific wording changes for the list of tasks

within the document report. 

After discussion and a few amendments the Board unanimously approved the

amended document. 

With that Dr. Wade cited to the Board how the engagement process should

proceed. He indicated that any workgroup telephone conference

participants keep records of their calls. Workgroup meetings will be

noticed in the Federal Register, opened to the public and transcripts

officially recorded. 

Ms. Munn commented on the requirement that subcommittee meetings be

noticed in the Federal Register. Dr. Wade commented that they are not

required, but proposed that workgroup meetings be noticed in the Federal 

Register. Dr. Ziemer identified the workgroup participants as Mark

Griffon, Wanda Munn, Jim Neton, Mike Gibson, with Rich Espinosa as an

alternate. 

Dr. Melius proposed a motion dealing with the provisions governing

communication and program direction with the Board's audit contractor. 

A motion was made and seconded that the Advisory Board on Radiation and

Worker Health adopt the following provisions governing

communication and program direction with the Board’s audit

contractor. Number one, all communications initiated or received

by the Chair, NIOSH and/or the audit contractor regarding the

scope, performance or activities of the audit contractor will be

copied to the entire Board. The audit contractor shall prepare and

disseminate to the Board a written summary of all telephone calls

and meetings with NIOSH regarding issues related to contracting

scope or performance. Number two, no approvals, changes or

directives related to task orders or procedures may be provided by

the Chair and/or NIOSH to the audit contractor without first

securing concurrence from the Board for these approvals, changes

and directives in advance to the entire Board. If three or more 

Board members raise concerns or objections about the proposed

changes, then the Chair shall convene a meeting of the Board

forthwith to review the proposed changes. Number three, all

working groups and subcommittee meetings, including conference

calls, involving NIOSH and the audit contractor to review findings

of the audit contractor will include the participation of at least

two Board members. All Board members will be notified about the 

meetings at least two weeks prior to the meeting, and the Chair

will ensure that adequate Board representation will be present at

the meeting. Such meeting shall be noticed in advance to the

public through the e-mail list and on the NIOSH web site and open

to the public, consistent with the Open Governments Act. Such 

meetings, including those by teleconference, shall be transcribed. 

The motion consisted of three distinct wording parts and was read to the

Board. The motion was seconded by Mr. Gibson and put on the floor for 

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Executive Summary/Minutes: July 5-7, 2005 

NIOSH/CDC Advisory Board on Radiation and Worker Health
 

discussion. Ms. Munn strongly protested the motion and would not vote

on it unless it was a vote to table the motion. At which time Ms. Munn 

put forth a motion to table and it was seconded by Dr. DeHart. 

Dr. Ziemer informed the Board the motion to table is not debatable and 

requires an immediate vote. Two-thirds vote is required for tabling.

Ms. Homoki-Titus stated that only one-half is required for tabling a

motion. The vote on motion by Board to table motion failed, therefore

the original motion is put back on the floor for discussion. 

Dr. DeHart commented that he had concerns about the lack of flexibility

in the drafted document. Ms. Homoki-Titus wanted to double check the 

written motion to make sure there was no violation of FACA regarding

board approvals. Dr. Melius thought that the Board needed to be more

transparent or open regarding dealings with contractor. 

Mr. Gibson noted that the Board members accepted an obligation with

their Presidential appointment and felt that all Board members should be

sent all the correspondences to review, not just certain members on the

list. 

A written copy of the motion was distributed to all Board members and

Dr. Ziemer presented each item of the motion. Items 1 and 2 as read 

were commented on and slightly modified. 

At this time Item 3 as read was commented on and slightly modified

through friendly amendments. Dr. Ziemer relayed to the Board an issue

regarding the time the contractor spends briefing people on the Hill

when requested. He noted that this work was outside the scope of the

contract, however, the existing contract funds were being utilized for

this task. He has previously approved this work by the contractor, but

suggests a formal policy regarding this matter. The Board just wanted

this action as it occurs to be notified or communicated about it. 

Board voted on amended motion and was unanimously passed except Ms. Munn 

who abstained. 

A motion was made and seconded that the Board recognize Cori Homer for

her superior administrative support and assistance to individuals

and the Board. The motion passed overwhelmingly. 

Ms. Homer indicated she will miss everyone and thanked the Board for the

last three years. She informed the Board that her duties would now be 

in the capable hands of LaShawn Shields. 

The Board continued the meeting. Dr. Melius commented on the conflict 

of interest issue brought up in the public comment period. He felt that 

the Board should consider having their own conflict of interest

statement on the web site for public view. 

Dr. Mauro of SC&A commented that their conflict of interest planned

procedures and forms have been completed and signed by project members 

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Executive Summary/Minutes: July 5-7, 2005 

NIOSH/CDC Advisory Board on Radiation and Worker Health
 

and are on file in hard copy at corporate headquarters. He can provide

to the Board conflict of interest documents in any form the Board

requests for the purpose of posting on web site. Dr. Toohey informed 

the Board that all ORAU forms are posted on their project web site at

www.oraucoc.org. 

Dr. Wade reminded the Board about the SC&A SEC task order developed by

the Board. The task order has been submitted to the contractor, SC&A,

for approval. The Board will consider the proposal in closed session

when received. 

* * * * * 

Report on Review of the Second Round,

18 Dose Reconstructions 

Kathy Behling, SC&A 

Ms. Behling started the presentation by outlining three key elements of

SC&A's approach to doing dose reconstruction review. 

●	 Review all the collected data for completeness and adequacy for use

in estimating doses.

●	 Look at internal and external doses and attempt to reproduce all the

doses assigned by the dose reconstructor.

●	 Review the CATI and evaluate whether NIOSH has addressed all 

information regarding the claimant. 

Ms. Behling reviewed for the Board the NIOSH/ORAU approach to the dose

reconstruction process. She presented various examples to the Board of

maximizing external dose cases, maximizing internal dose estimates, and

best estimate external dose. She stated that the overwhelming majority

of cases fell into the external dose category. 

Ms. Behling presented a chart detailing how the 18 cases and the 113

findings broke down by category. The categories consisted of the

following: 

● reviewer could not reproduce assigned dose,

● procedure used to estimate dose was not referenced,

● procedural errors and inconsistencies,

● unresolved CATI issues,

● data collection issues,

● procedural noncompliance or misinterpretation of procedures,

●	 use of inappropriate procedure method or assumption, model or model

assumptions selection is not scientifically sound,

●	 all potential sources of exposure were not considered or the exposure

was not accounted for. 

Ms. Behling then presented a chart of the breakdown of the findings for

all 30 cases reviewed. She summarized for the Board the majority causes

of the 113 findings were due to procedural issues with choices made by 

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Executive Summary/Minutes: July 5-7, 2005 

NIOSH/CDC Advisory Board on Radiation and Worker Health
 

the dose reconstructor. She pointed out to the Board that the dose

reconstruction audits so far have not impacted the changes in

compensability. 

* * * * * 

Board Comments/Questions on Presentation 

The Board raised the following questions with regard to the

presentation: 

● Future pie chart should be consistent with color and location.

●	 Procedure used, audit summary of the dose reconstruction, was very

effective. 

● What will have to be done with advanced dose reconstructions. 

●	 Indication was that these advanced dose reconstructions will require

more extensive data review. 

●	 Audit of the internal doses will be required for the advanced cases

and that this will be a major challenge for both dose reconstructor

and auditor. 

●	 Question to the subcommittee members regarding future dose

reconstruction issue in terms of resources and priorities.

● What is the status on the next round of reviews. 

●	 A better understanding of the use of workbooks, especially for the

Savannah River Site, will be required for the next round of dose

reconstruction reviews. 

Dr. Ziemer, before closing out the Board discussion, commented that the

contractor and NIOSH should proceed on the development of the matrix for

the 18 cases just as was presented earlier for the first 20 cases. 

* * * * * 

SC&A Contract Issues 

John Mauro, SC&A 

Dr. Mauro updated the Board relative to the four tasks performed by the

contractor over the past year and a half. He stated that the work has 

been performed on the 22 additional cases and work on the three site

profiles, the first four tasks would be completed. He felt that based 

on the fact that NIOSH was moving more toward doing realistic dose

reconstruction and away from the minimum/maximum procedure, this has

resulted in more sophisticated TIBs and workbooks produced for best

estimate dose reconstruction. 

Dr. Mauro felt that Task I scope of work had to be modified to capture a

more detailed effort NIOSH is now using and that to actually have dose

reconstruction cases completed by the contractor is now part of Task I.

He felt that Task IV needed to be modified to include more bestestimate case selections for dose reconstruction rather than 

minimum/maximum reconstruction. 

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Executive Summary/Minutes: July 5-7, 2005 

NIOSH/CDC Advisory Board on Radiation and Worker Health
 

Dr. Mauro further stated that he felt minimum/maximum cases reviewed so

far were showing the same conclusions and weren't adding any real value.

He recommended site profile reviews conducted under Task I include

workbooks and cases which have used best estimate methods; for Task IV

they should select more realistic cases for testing. 

* * * * * 

Board Questions and Comments 

Questions raised and observations made included the following: 

►	 Is there some procedure (sorting tool) that can be utilized to

provide information as to whether the case is a best estimate case

or a minimum/maximum case.

►	 Response was that dose reconstructor makes the choice at the time he

approves the dose reconstruction.

►	 Comment provided that in principal you should be able to make the

procedure to use on the basis of POC, but presented a case as to

why this has not been successful.

►	 Task I needed to be modified to have the contractor review the 

workbooks and include several specific best estimate cases when

they review a site profile.

►	 For Task IV, selection of the next 20 cases by the subcommittee

include more realistic cases would suffice. 

►	 Concern about including actual cases in the procedural review for

Task I, actual cases selected is part of Task IV.

►	 Comment provided as to why including actual cases selected should be

under Task I. 

► Workbook review should already be included in Task I.

► Workbook review as part of Task I is with contracting officer.

►	 Concern that the subcommittee choosing the next 20 cases for review

was not the process that had been used previously.

►	 Clarification that the Board and subcommittee use the same procedures

utilized in the past, but for the next 20 consider the criteria of

using realistic cases for case selection. 

A quorum was not available for the Board to act on issues discussed, so

the Board halted the discussion. Dr. Wade concluded that Board members 

should continue this discussion via a phone conference.

* * * * * 

Public Comment Period 

Dr. Ziemer introduced Colonel Ed Taylor from the newly formed advisory

board administered through the National Council on Radiation Protection

and Measurements. This will be a parallel group handling the veteran=s 

cases. Colonel Taylor thanked the Board for allowing him to sit in all

week and learn. 

The following is a list of the members of the public who spoke. A full 

46 
 

__________________________________________ 

__________________________________________ 

Executive Summary/Minutes: July 5-7, 2005 

NIOSH/CDC Advisory Board on Radiation and Worker Health 

transcript of their comments is available on the OCAS web site,

www.cdc.gov/niosh/ocas. 

Mr. Dan McKeel, Missouri Coalition for the Environment; Mr. Larry

Gassei; Ms. Denise Brock, UNWW/Mallinckrodt; Mr. Roni Steger,

Mallinckrodt. 

* * * * * 

With no further business to come before the Board, the meeting was

adjourned. 

End of Summary Minutes 

Ë Ë Ë Ë Ë 

I hereby confirm these Summary Minutes are

accurate, to the best of my knowledge. 

Paul L. Ziemer, Ph.D., Chair 

Date 

47