THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 


PUBLIC HEALTH SERVICE 


CENTERS FOR DISEASE CONTROL AND PREVENTION 


NATIONAL INSTITUTE FOR OCCUPATIONAL SAFETY AND HEALTH 


convenes the 


WORKING GROUP MEETING 


ADVISORY BOARD ON 


RADIATION AND WORKER HEALTH 


ABRWH WORKING GROUP MEETING
 

The verbatim transcript of the Working Group 


Meeting of the Advisory Board on Radiation and 


Worker Health held at the Cincinnati Airport 


Marriott, Hebron, Kentucky, on February 13, 2006. 

 

2 

C O N T E N T S
 

February 13, 2006 


WELCOME AND OPENING COMMENTS 6 

DR. LEWIS WADE, EXECUTIVE SECRETARY 

WORKING GROUP 8 

COURT REPORTER’S CERTIFICATE 405 
3 

TRANSCRIPT LEGEND
 

The following transcript contains quoted material. Such 


material is reproduced as read or spoken. 


In the following transcript: a dash (--) indicates 


an unintentional or purposeful interruption of a 


sentence. An ellipsis (. . .) indicates halting speech 


or an unfinished sentence in dialogue or omission(s) of 


word(s) when reading written material. 


-- (sic) denotes an incorrect usage or pronunciation 


of a word which is transcribed in its original form as 


reported. 


-- (phonetically) indicates a phonetic spelling of 


the word if no confirmation of the correct spelling is 


available. 


-- "uh-huh" represents an affirmative response, and 


"uh-uh" represents a negative response. 


-- "*" denotes a spelling based on phonetics, 


without reference available. 


-- (inaudible)/ (unintelligible) signifies speaker 


failure, usually failure to use a microphone. 

 

 

4

 P A R T I C I P A N T S 


(By Group, in Alphabetical Order) 


BOARD MEMBERS
 

EXECUTIVE SECRETARY
 

WADE, Lewis, Ph.D. 


Senior Science Advisor 


National Institute for Occupational Safety and Health 


Centers for Disease Control and Prevention 


Washington, DC 


MEMBERSHIP
 

GIBSON, Michael H. 


President 


Paper, Allied-Industrial, Chemical, and Energy Union 


Local 5-4200 


Miamisburg, Ohio 


GRIFFON, Mark A. 


President 


Creative Pollution Solutions, Inc. 


Salem, New Hampshire 


MUNN, Wanda I. 


Senior Nuclear Engineer (Retired) 


Richland, Washington 


PRESLEY, Robert W. 


Special Projects Engineer 


BWXT Y12 National Security Complex 


Clinton, Tennessee 

 

5 

P A R T I C I P A N T S 


Dept of Labor: 


Jeff Kotsch 


Dept of HHS: 


Emily Howell 


NIOSH: 


Dave Allen 


Larry Elliott 


Stuart Hinnefeld 


Jim Neton 


Tom Tomes 


SC&A: 


Hans Behling 


Kathy Behling 


Joyce Lipsztein 


John Mauro 


Kathy Robertson-DeMers 


STAFF
 

LASHAWN SHIELDS, Committee Management Specialist, NIOSH 


STEVEN RAY GREEN, Certified Merit Court Reporter 

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P R O C E E D I N G S


 (8:00 a.m.) 

 DR. WADE: We should begin. This is Lew Wade. 


This is a meeting of the working group of the 


Advisory Board. This is a working group that 


looks at a variety of things, including 


individual dose reconstruction reviews, some 


site profile reviews and procedures reviews. 


The announced purpose of this working group 


meeting is to focus on procedures -- procedure 


reviews and individual dose reconstruction 


reviews, so those are the topics I think we can 


stick to. 


We do need to talk about, you know, future 


scheduling of meetings and we'll do that at the 


end of this call. 


Maybe we can start here in Cincinnati and 


identify who's around the table. This is Lew 


Wade, the Designated Federal Official. 


 MR. HINNEFELD: Stu Hinnefeld with NIOSH in 


Cincinnati. 


MR. ALLEN: Dave Allen with NIOSH. 


MR. TOMES: Tom Tomes with NIOSH. 


 MS. MUNN: Wanda Munn with the Board. 


DR. NETON: Jim Neton with NIOSH. 


 MS. ROBERTSON-DEMERS: Kathy Robertson-DeMers 

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with SC&A. 


 MS. BEHLING: Kathy Behling with SC&A. 


 DR. BEHLING: Hans Behling, SC&A. 


 DR. WADE: And on the phone line we have? 


 MR. GRIFFON: Mark Griffon with the Board. 


 MR. GIBSON: Mike Gibson with the Board. 


DR. MAURO: John Mauro with SC&A. 


 MR. KOTSCH: Jeff Kotsch with DOL. 


 DR. WADE: And no Robert Presley yet. Okay. 


Well, we're not -- we're not in search of a 


quorum, so we can begin our deliberations. 


This august working group is chaired by Mark, 


so Mark, any instructions or direction from 


you? 


 MR. GRIFFON: No, I mean I think it's -- it'll 


probably be a little difficult for me to -- to 


chair things from the phone, but we'll -- I 


guess we'll -- we'll be able to move through 


this. But I think we were going to start with 


the procedures review and possibly -- I talked 


to Kathy and Hans a little bit, and possibly 


might want to start with the CATI review 


section first, depending on -- on whether Joyce 


is on the phone yet, but I think we were 


planning on doing the CATI review section first 

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and then move into the internal dose 


procedures, and then go forward from there to 


the case reviews. 


 MS. BEHLING: That's correct. 


 DR. WADE: Okay. 


 MS. MUNN: So we're on page 27. 


 MS. BEHLING: Yes. 


 DR. WADE: How do you want to proceed? Do you 


want NIOSH to deliver their response or... 


 MR. GRIFFON: Yeah, I think that makes the most 


sense, if -- if NIOSH can -- 


 DR. WADE: Okay, Stu, I guess --


 MR. GRIFFON: -- just introduce their response, 


then --


 DR. WADE: -- you'll be doing the talking? 


 MR. GRIFFON: -- we can discuss it, maybe. 


 MR. HINNEFELD: Yeah, I'll -- I'll do the 


talking I guess --


 MR. GRIFFON: Yeah. 


 MR. HINNEFELD: -- for the most part, for NIOSH 


-- at least in this portion. 


The -- well, the first finding for -- this is 


Procedure No. 4, which is one of the interview 


procedures, interview procedures. As captured 


in the matrix is that the interview letter sent 

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out -- is sent out without adequate dose 


reconstruction information. And I guess we 


have a fair amount of information to provide on 


this. I think some of the -- some of the 


comments that were made in this finding, 


although they're not captured in the finding 


description, had to do with sort of the -- 


there's a sort of course of nature of 


attachment that went with the letter to the -- 


the CATI letter that went to the claimant 


before they -- before they have the interview, 


and it kind of gave the impression that the 


interview was sort of this do or die thing, 


there's some -- there's some quotes farther -- 


farther back in our response, and we did in 


fact -- that language has in fact been changed. 


It's been changed for quite some time and it's 


a little milder now in the attachment. It 


doesn't try to -- we're hoping does not instill 


this anxiety in the claimant, which I think 


rightfully was mentioned in the -- in the 


comment. And so we think we've modified that 


language in that letter some time ago so that 


it's a little less anxiety-producing to the 


claimant, so... 

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And then the second comment had to do with the 


amount of preparation, and I think there's some 


-- some merit there, but we think that probably 


the preparation and information to the claimant 


is better provided at the acknowledgement 


letter. There's an acknowledgement letter that 


we send to the claimant when we first receive 


the claim from -- from Labor. And that 


acknowledgement letter contains some 


information -- what it contains right now is a 


cover letter and then the one fact sheet -- or 


a couple of fact sheets about what a claimant 


should know about radiation dose 


reconstruction, and then sort of a flow chart 


on how it goes -- how the process goes. In 


fact, we've been engaged in an initiative to 


have an acknowledgement packet which contains 


considerably more information. 


I'm showing this, for those of you on the 


phone. It's a packet that includes the letter 


and probably four or five handouts, including a 


glossary and several pieces of information that 


we hope will provide better insight into the -- 


to the employee. Now I didn't make these to 


hand out because this is the draft and it's 

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being rewritten. It's being revised based upon 


our internal review, so it's timely time for us 


to take some of this information from these 


comments and make -- and see if we can 


incorporate it into this material readily. So 


I think there are a couple of things we can do 


-- well, one -- one thing we've already done. 


The second thing we can already do in the 


acknowledgement -- at the acknowledgement stage 


that provides better information to the 


claimant about what goes on with the process, 


overestimating techniques, things like that. 


 MS. MUNN: Stu, this is Wanda. Even though you 


haven't had -- I wouldn't have expected you to 


keep data on this sort of thing. Do you have 


the feeling that you're getting fewer negative 


bits of feedback from the claimant since you've 


revised your -- the tone of your letter a 


little? Can you tell? Was it too --


 MR. HINNEFELD: Well, I can only speak 


anecdotally. I mean that was -- that was 


revised very -- you know, about the time I 


started in the program, really. I mean it was 


revised quite some time ago. 


 MS. MUNN: That was a long time ago. 

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 MR. HINNEFELD: Yeah, it was revised quite some 


time ago. And so I don't have -- you know, 


other than anecdotally -- I do know I was 


approached -- before I ever started with NIOSH, 


I was -- you know, since I worked at Fernald, I 


was approached by people who had received 


letters --


 MS. MUNN: Uh-huh. 


 MR. HINNEFELD: -- claimants had these received 


these letters and said how in the world can I 


answer this? 


 MS. MUNN: Yeah, yeah. 


 MR. HINNEFELD: And so there was certainly some 


anxiety on the part of the claimants based on ­

- this seemed to be -- like this is key; if you 


mess this up, you don't have a chance -- you 


know, your claim doesn't have a chance -- 


 MS. MUNN: Yeah. 


 MR. HINNEFELD: -- was sort of the impression 


they got. And so I would think that the 


current language would be better, and -- and I 


don't -- I don't necessari-- I haven't really 


heard any complaints or any large body of 


complaints about that aspect of the letter -- 


you know, how -- if it makes them feel anxious 

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or not, the way it used to. But it would be 


only anecdotal. I mean the -- we don't -- that 


doesn't seem to be the complaint we get and -- 


now. 


 MS. MUNN: I'd appreciate having an opportunity 


to take a look at the packet you're going to 


send out, because one of the -- one of my 


concerns is that in our attempt to ameliorate 


the errors that we saw up front, we don't go 


too far the other way and overload people with 


so much information that they feel overwhelmed. 


My personal observation has been that many 


people, even who work in the industry for long 


periods of time, still don't really have a firm 


idea of what the terminology means -- 


 MR. HINNEFELD: Right. 


 MS. MUNN: -- and what's -- if -- if what's in 


your packet is -- I guess I am expressing a 


mild concern that we not overload them with too 


much information, which is almost as bad as 


telling them they only have one chance anyway. 


 MR. HINNEFELD: Right. Let me provide these -- 


I mean everybody's free to look at these. 


Recognize that the packet has been commented on 


significantly on the internal review, and I 

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don't know what the nature of those comments -- 


I haven't seen the comments. I was just told 


that it's going to be revised considerably 


based on the comments on the internal review, 


and I don't know the nature of those comments. 


But we have significant comments, a few more 


from this body probably wouldn't hurt and -- 


you know, that I can take back as my comments 


on this packet, so --


 MS. ROBERTSON-DEMERS: This is Kathy DeMers. 


would also like to look at a copy of the 


packet. 


 MR. HINNEFELD: Why don't we just look at this 


one, if that's okay, while we're here then. 


 MS. MUNN: Yeah. 


 MR. HINNEFELD: 'Cause I just picked up the 


one. Like I said, it's a draft. It's really 


not for distribution, but since we're com-- we 


have commented on it internally, I don't think 


it would be a problem to take back more 


comments. 


 MS. MUNN: Sure a lot of stuff here. 


 MR. HINNEFELD: Yeah. 


 MS. BEHLING: Can I ask him if this -- this is 


Kathy Behling. Can I ask him if this 


I 
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information will ultimately be put on the web 


site, also, for the claimants? 


 MR. HINNEFELD: I don't know, I'll have to ask. 


I don't necessarily control that part and I 


haven't really thought about whether this 


information is appropriate to the web site or 


not. It might be, but I haven't really 


thought... 


 MS. BEHLING: I think from SC&A's standpoint -- 


again, this is Kathy Behling -- we are in 


agreement that the letter has been modified. 


 MR. HINNEFELD: Okay. 


 MS. ROBERTSON-DEMERS: I guess before signing 


off on it, I'd like to see the packet. 


 MR. HINNEFELD: Well, it -- I mean we're -- 


we're obliged to provide the packet. I mean 


we're embarked on providing the packet and 


we'll -- we'll provide probably the final 


version then, you know, rather than this draft 


version. 


 MR. GRIFFON: Hello? 


 MS. MUNN: Uh-huh, yeah? 


 MR. GRIFFON: Hi, it's Mark Griffon. 


 MS. MUNN: I'm reading. Would you like me to 


read out loud, Mark? 

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 MR. GRIFFON: No, that's okay. I got 


disconnected and I'm -- I'm dialing in again, 


that's why. 


 MS. MUNN: Oh, you're -- you're back? 


 MR. GRIFFON: Yeah, I'm back. I'm off to a 


roaring start here on the phone. 


 MS. MUNN: Well, I'm occupying time here by -- 


everybody's time here by thumbing through the 


packet --


 MR. GRIFFON: Oh, okay. 


 MS. MUNN: -- that's being --

 DR. WADE: Stu, could you --

 MS. MUNN: -- put together for these folks. 

 DR. WADE: Stu, could you just tell the story 

of the packet again, just in case Mark didn't 


hear it? 


 MR. HINNEFELD: Yeah, Mark, the --


 MR. GRIFFON: Yeah, please. 


 MR. HINNEFELD: With -- the comment relates to 


the inf-- the amount of information provided to 


the claimant with the CATI letter, when they're 


sent their letter arranging it, and -- and we 


feel like there's a better opportunity to 


provide that type of information, which is at 


the time of acknowledgement, and that's when we 

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receive the let-- when we receive a claim from 


the Department of Labor, we send an 


acknowledgement letter to the claimant telling 


them they have a -- we have their claim and 


kind of describing to them what will happen. 


And so we're actually changing from the 


acknowledgement letter with a couple of flyers 


inserted to a packet that has a number of 


flyers, including a glossary and several pieces 


of information. And so we believe that it -- 


that would be the better time to provide some 


of this information about what's going to 


happen with dose reconstruction, rather than at 


the CATI -- CATI stage. And --


 MR. GRIFFON: Okay, yeah, I saw reference to 


that, too, and I wasn't sure what exactly -- 


 MS. MUNN: What Wanda's looking at is a draft 


version of that packet, which is really draft 


because it's been commented on pretty 


considerably internally, but I thought we could 


-- if there are additional comments on it from 


here, I can make it part of the internal 


comments and address it in the final version. 


 MS. MUNN: And Mark, I had said that my concern 


was that we not overload the client with too 

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much stuff because that is almost sure to raise 


as many issues as scaring him to death does. 


 MR. GRIFFON: Yeah, it just -- it may defeat 


the purpose, but -- yeah. 


 MS. MUNN: Yeah, this packet that I'm looking 


at is in a very nice folder. On the right side 


is a two-page letter from DHHS and NIOSH to 


them, and on the left-hand side there is a 


review of the claims process under the Act -- 


that's one sheet; a small booklet that's a 


glossary of terms, another sheet that's a 


detailed steps in the claims process under the 


Act, another page of dose reconstruction FAQs, 


and a sheet entitled "Employment and Cancer 


History as Reported by the Department of 


Labor". And is that going to be an individual 


 MR. HINNEFELD: Yes. 


 MS. MUNN: -- thing? 


 MR. HINNEFELD: Yes. 


 MR. GRIFFON: Now is this something, Stu, that 


we can review -- I mean I know that we've sort 


of said that Proc. 90 is replacing these other 


procedures for the CATI, but this wouldn't 


really be part of Proc. 90, would it? This 

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would all come before -- 


 MR. HINNEFELD: This actually becomes before 


any of the CATI procedures, yeah. 


 MR. GRIFFON: Before the CATI stuff, yeah. 


 MS. MUNN: Oh, and then there's -- 


 MR. GRIFFON: I'm just wondering, not having 


this in front of me, I -- I think it is 


probably -- 'cause I think the most important 


thing that we -- we brought up, anyway -- was 


the question of -- of being very clear about 


the efficiency methods and those kind of things 


'cause that's created some confusion I think 


already amongst --


 MR. HINNEFELD: Right. 


 MR. GRIFFON: -- people that have their reports 


back. 


 MR. HINNEFELD: Right. 


 MR. GRIFFON: And that's in this -- this 


package, is that --


 MR. HINNEFELD: Well, we can make it there. 


Like I said, it's under -- it's in internal 


comment, and I think --


 MR. GRIFFON: Oh, okay. 


 MR. HINNEFELD: -- that the comments from this 


-- this finding and from this set of findings 

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on these procedures, we need to make sure we 


address, to the extent we can, in this packet. 


 DR. WADE: Okay, so Stu, are we in a position 


then to deliver the packet to each member of 


the working group and then formally to SC&A? 


 MR. HINNEFELD: Well, this part of our work is 


not really under my control particularly. It's 


communications team's work, and so I hate to 


commit to those sorts of things. 


 DR. WADE: Okay, so I'll take on that task of ­

- of discussing it with the communications team 


and unless you hear from me otherwise I would 


expect that we would share this with the 


working group as well as with SC&A and accept 


comment back from those folks. 


 MS. MUNN: There really is a lot of stuff 


there. 


 MR. GRIFFON: Yeah. 


 MS. MUNN: And in addition to what I just 


enumerated, Mark, there's also an envelope that 


contains --


 MR. HINNEFELD: Well, no, that's -- that's what 


we're currently doing. The envelope is now. 


 MS. MUNN: Ah, okay. 


 MR. HINNEFELD: The --

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 MS. MUNN: That wasn't clear to me. 


 MR. HINNEFELD: Yeah, I'm sorry, the envelope 


is now; the folder is what we hope to do. 


 MS. MUNN: Is what you propose, okay. 


 DR. BEHLING: Is the letter that's sent the 


same whether the individual is the worker 


himself or a member of the family of the 


deceased worker? And I think one of the common 


complaints is that questions might be readily 


answered if the claimant was the worker, but 


certainly more difficult if the individual is a 


survivor where many of that -- much of that 


information simply is not available to that 


individual. 


 MR. HINNEFELD: The questionnaire is different. 


I don't know off-hand if the cover letter is or 


not -- meaning the CATI -- 


 DR. BEHLING: Yes. 


 MR. HINNEFELD: -- the CATI questionnaire is 


different. 


DR. NETON: Not substantively, though. I mean 


it's the same line of questioning, just sort of 


in the third person almost I think -- 


 MR. HINNEFELD: Yeah. 


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information. 


DR. NETON: The idea there is that you really 


can't a priori know the level or anticipate the 


level of detail that the survivor would be 


aware of. I mean, you know, coworkers or 


something. 


 MS. MUNN: Yeah. 


 MR. HINNEFELD: It's also a fact I think that 


if you have a -- if you have a survivor 


claimant, there is going to be less knowledge 


about the work environment, and nothing we can 


do is going to change that. 


DR. NETON: I understand that, but you know, 


you can't tailor the survey to that person -- 


 MR. HINNEFELD: Oh, no, I understand --


DR. NETON: -- you need to afford them the 


opportunity to answer all the detailed 


questions they want. I think the communication 


piece is that we don't expect that you're going 


to know all this information, but in case you 


do, you know, we're asking these -- 


 MS. MUNN: Yeah. 


DR. NETON: -- and you might -- your claim 


won't be prejudiced by not knowing 


(unintelligible). 

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 MS. MUNN: Yeah. 


 MR. HINNEFELD: My comment was really more 


addressed to other comments that are coming 


later on in this -- in the procedure review 


about the process. In fact, it's the next 


comment if we're ready to move on to the next 


comment. 


 DR. WADE: Okay, so the action item on this 


comment will be I'll discuss with the 


appropriate people the possibility of getting 


this folder to the working group and SC&A for 


comment. 


 MS. MUNN: Thank you, Lew. 


 MR. PRESLEY: Good morning, this is Bob 


Presley. 


 MS. MUNN: Well, good morning, Mr. No-back, how 


are you? 


 MR. PRESLEY: Well, I'm here. 


 MS. MUNN: Well, sorry to hear you're ailing. 


 MR. PRESLEY: Yeah, well, I am, too. 


 DR. WADE: Why don't we identify ourselves 


involved in the call for Mr. Presley's benefit. 


This is Lew Wade with NIOSH. 


 MR. HINNEFELD: Stu Hinnefeld with NIOSH. 


MR. ALLEN: Dave Allen with NIOSH. 

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MR. TOMES: Tom Tomes with NIOSH. 


 MS. MUNN: Wanda's here. 


 MR. PRESLEY: Okay. 


DR. NETON: Jim Neton, NIOSH. 


 MS. ROBERTSON-DEMERS: Kathy DeMers, SC&A. 


 MS. BEHLING: Kathy Behling, SC&A. 


 DR. BEHLING: Hans Behling, SC&A. 


 DR. WADE: And on the phone line we have? 


 MR. GRIFFON: Mark Griffon with the Board. 


 MR. GIBSON: Mike --


 MR. PRESLEY: Morning, Mark. 


 MR. GIBSON: Mike Gibson with the Board. 


 MR. PRESLEY: Good morning, Mike. 


 MR. GIBSON: Hi, Bob. 


DR. MAURO: John Mauro, SC&A. 


 DR. WADE: Is Jeff still with us? 


 MR. KOTSCH: Yeah, I'm still here, I'm sorry. 


 MR. PRESLEY: Okay. 


 DR. WADE: Okay, so that's us, Robert. We're ­

- we're just starting with the inter-- with the 


review procedures and we started, if you have 


your paper in front of you, on page 27 with the 


interview process documents and that finding. 


And the summary of that discussion is that 


NIOSH is contemplating a different 

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communications package and I'm going to work 


with NIOSH to share that package with the 


working group and SC&A, and NIOSH willingly 


accept their comments. 


 MR. PRESLEY: Okay. 


 MR. GRIFFON: So if we were -- and I -- I 


apologize 'cause I went off the call for a few 


minutes there. We were looking at Proc. 4 dash 


-- finding -- finding number Proc. 4-01? 


 MR. HINNEFELD: Yes. 


 MS. MUNN: Uh-huh, yes. 


 MR. GRIFFON: And so their response right now 


is that some of that language has been moved 


from the -- moved and is now going to be 


addressed in this new package that Stu's 


talking about. Right? 


 MR. HINNEFELD: Well, kind of. I don't know 


that there's a lot of language in the existing 


CATI letter that's going to be moved to the 


acknowledgement letter. I mean we've always 


sent an acknowledgement letter. The fact --


what we're saying is that the acknowledgement 


letter -- information provided with the 


acknowledgement letter will be expanded to 


hope-- to achieve some of this discussion about 

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providing better information to the claimant. 


And we've got -- you know, doing it at the 


acknowledgement part is what we -- where we 


felt like it would be a better part to do it, 


the acknowledgement letter. 


 MR. GRIFFON: Oh, okay, I'm looking on down in 


the response, it says -- 


 MR. HINNEFELD: Now we did --


 MR. GRIFFON: -- the overriding message is that 


these passage --


 MR. HINNEFELD: Right. 


 MR. GRIFFON: -- place undue stress on the 


claimant --


 MR. HINNEFELD: With respect to --


 MR. GRIFFON: -- and they were deleted. 


Right? 


 MR. HINNEFELD: That -- that language has been 


deleted from --


 MR. GRIFFON: Okay. 


 MR. HINNEFELD: -- from the CATI letter -- it's 


actually an attachment to the CATI letter -- 


and it's been substituted with other language, 


which is significantly less coercive, in my 


mind. 


 MR. GRIFFON: Okay. 

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 MS. MUNN: Apparently that was done a long time 


ago, Mark. 


 MR. HINNEFELD: Yeah, that was done quite some 


time ago. 


 MR. GRIFFON: Yeah, but -- but after I guess 


SC&A was reviewing a prior version. Correct? 


A version before that? 


 MR. HINNEFELD: Yes. 


 MR. GRIFFON: So I guess two -- two questions, 


do we need to review the updated version of the 


CATI letter, and also this acknowledgement 


package? 


 MR. HINNEFELD: Well, Lew said that the 


acknowledgement packet will go out to -- he can 


get it sent out to the members. I'm trying to 


recall if I've got the new attachment with me 


or not. I don't think I do. It's -- or I 


don't know if I quoted it in here or not. 


 DR. WADE: We'll package it all up and send it 


out. 


 MR. GRIFFON: But then the second part is that 


this -- this -- what -- what we originally 


reviewed -- what SC&A reviewed has been 


modified, but we haven't reviewed the 


modification. 

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 MR. HINNEFELD: Yeah, that's -- we'll -- I can 


send that. I didn't think I -- I don't think I 


brought it today, unfortunately. 


 MR. GRIFFON: I think that probably is our -- 


is a follow-up action on this. 


 MS. MUNN: Yeah. 

 DR. WADE: Correct. 

 MS. MUNN: Lew's going to handle that for us. 

 MR. GRIFFON: Okay. 


 MR. HINNEFELD: Okay. I think we're now maybe 


ready for finding number two on Proc. 04 -- 


 MS. MUNN: Uh-huh. 


 MR. HINNEFELD: -- which is letter lacking in 


essential content, especially for family member 


claimants. And I guess that we think that 


trying to -- I guess we think that it's 


appropriate. You know, the amount of 


information provided or at least that will be 


provided with the acknowledgement letter is -- 


is appropriate. I don't think we can remedy 


the disparity of knowledge in a meaningful 


fashion -- you know, the disparity of knowledge 


between a claimant survivor and an energy -- an 


EE surv-- an EE claimant, so I don't know that 


we can remedy that. I don't think there's 

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anything we can do that can remedy that. We --


as a general rule, at CATI time we don't 


necessarily try to inform the claimant all that 


much. We try to get the claimant to tell us 


what the claimant knows based on -- you know, 


about -- that would affect their work 


environment or aspects of their work 


environment, and we don't necessarily take it 


upon ourselves to try to inform them. That's 


what we've done. 


 MS. MUNN: And this enhanced packet that we 


have will have -- obviously contains in it, as 


-- as I -- as it exists now in the draft form, 


all of the information that we have with 


respect to medical background for the claimant 


anyway. 


 MR. HINNEFELD: Right, it contains some 


specific stuff. It will not -- it will not 


provide things like this is what we know about 


the Y-12 plant so that you can understand more 


about where your husband -- 


 MS. MUNN: No. 

 MR. HINNEFELD: -- worked and stuff like that. 

 MS. MUNN: No. 

 MR. HINNEFELD: It's not going to do that. 
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 MS. MUNN: Well --


 MR. HINNEFELD: And -- and we don't --


 MS. MUNN: -- it shouldn't, really. 


 MR. HINNEFELD: -- our position is we don't 


feel that that is what we're trying to 


accomplish on these interviews. 


 MS. MUNN: Agreed. 


 DR. BEHLING: Is there ever a time when the 


claimant has some understanding about the 


natural incidence of cancer that gives him some 


sense of perspective that radiation is clearly 


not the only -- in fact not even the most 


dominant cause of cancer? I think sometimes 


people are under the impression that radiation 


is the principal, if not the exclusive, cause 


of human cancer. And I think it would help 


them to understand that cancer is a very 


ubiquitous disease that affects all members of 


the population. 


 MR. HINNEFELD: I don't know that any of our 


communication material does that. 


 MS. MUNN: And that's -- that has been one of 


my concerns from the outset of this entire 


program, is that lacking basic information 


about what the general population can expect in 

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terms of these kinds of diseases, claimants are 


naturally constrained to move to the assumption 


that they would not have been subjected to this 


kind of physical insult had it not been for the 


occupation that they had chosen. And that's -- 


it seems un-- has always seemed unrealistic to 


me, and I know some of the Board members do 


object to any reference to -- to the kind of 


basic information that is available to anybody 


anywhere who wants to bother to -- to look at 


it. But that seems to me to be a very helpful 


thing. I'm not sure exactly how that should be 


presented, but it seems inappropriate for us to 


be telling all of these individuals -- trying 


to communicate all of these individuals with 


respect to their specific situation without 


giving them any acknowledged background of what 


the circumstances are epidemiologically 


throughout the entire United States. That just 


seems -- seems that we're missing something 


somehow by not doing that, and it's very clear 


from listening to public comments that we hear 


that this is not understood by the claimants. 


It's clear, they keep telling us over and over 


again -- Mama would not have had any problem at 

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all if she hadn't been a secretary for three 


months and walked through that dreadful miasma 


that caused her to have breast cancer. And 


that just -- we all know that that is so 


unlikely that it's -- it borders on being 


ridiculous for us to consider it, and yet it -- 


the misunderstanding is, in my view, not going 


to be cleared up if we don't try to do 


something about it. And this is a topic we 


probably need to address in full Board since 


there clearly is a disagreement on the Board as 


to whether or not established epidemiological 


information should be made (unintelligible) -- 


you know --


 DR. BEHLING: And one of those would be the 


National Cancer Institute that issues a 


complete report every year, available to the 


members of the public, and of course with the 


likelihood that people will view that as an 


independent source of information, it certainly 


won't be construed as a biased piece of 


information. And I get -- every year I get my 


updated version of what the National Cancer 


Institute issues, and it gives some very 


beautiful statistics, graphs, tables, that 

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would certainly provide some information to 


people about the ubiquity of cancers, 


especially with prostate cancers and breast 


cancers and so many other cancers that are the 


bulk of the claims that I'm sure NIOSH is 


processing, and if people understood that -- I 


don't know how many times I've had people come 


up to me during these meetings and when I tell 


them about 30, 40 percent of the natural 


population that has nothing to do with 


occupational radiation will have some day -- at 


some point in their life an issue with cancer, 


all of a sudden it --


 MS. MUNN: They're shocked. 


 DR. BEHLING: -- it opens up a door for them to 


understand that maybe radiation wasn't the 


cause of their cancer, and they will feel 


certainly a lot more at ease thinking that 


perhaps -- maybe my prostate cancer has nothing 


to do with occupational radiation. 


 MS. MUNN: Yeah. 


DR. MAURO: Wanda, this is John Mauro. I'd 


like to jump in with a perspective, also, on 


this matter. Notwithstanding the kinds of 


information that might go into the letters and 

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written communication, one of my concerns has 


always been something that I refer to as 


bedside manner. I think even if you include 


this kind of information in a letter, it's too 


cold. 


 MS. MUNN: Yeah --


DR. MAURO: Right now I think the interaction ­

- personal interaction comes through the CATI 


interview, and if we want to relieve some of 


the anxiety on the part of the claimants and 


their spouses, it seems to me as early as 


possible -- this may not be feasible -- opening 


up one-on-one dialogues with the individuals, 


it's that type of bedside manner that I think 


creates confidence and comfort, and not, you 


know, letters coming from bureaucracy regarding 


matters of the kinds we're talking about right 


now. 


 MR. PRESLEY: This is Bob Presley. I agree 


with Wanda and I agree with John. I hate to 


say it, but we are almost too late on this. 


This is something that we should have started a 


long time ago. I'm afraid that the public is 


going to think that -- well, y'all are trying 


to cover up something now -- when we start 

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doing this, so you're going to have to really 


be careful the way you present it. 


 MS. MUNN: True. 


 DR. WADE: Any more discussion on this topic? 


 MR. GRIFFON: Yeah, that -- and I agree with -- 


I agree with the entire discussion. I mean I 


think one of the problems we've had is setting 


up -- I think we've set up for some people 


false expectations by -- somewhere they're 


getting the message that, you know, I fil-- if 


I just file, I can get this money. And in 


fact, you know, like -- like you've indicated, 


some of these prostate cancers, somewhere the 


message should get through that it's probably 


highly unlikely, you know, it's -- you can 


still file, but it's highly unlikely that some 


of these cancers will be compensable, you know, 


just because they're non-radiogenic and they're 


very common amongst the general population, et 


cetera. But I agree with all the discussion so 


far. I'm just -- how we communicate that is 


very important, too, yeah. 


 MS. MUNN: Well, this is Wanda again. My 


primary concern is that we have been, in my 


view, misleading claimants with respect to what 

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the possible genesis of their disease might be 


by -- in our attempt to be claimant-favorable, 


and I, to a large degree, blame the Board for 


having made that -- made such a strong 


statement in that regard early on and having, 


in my view, sort of pushed NIOSH into -- to 


looking at maximizing doses in almost -- in far 


too many cases. So you're right, Bob, I think 


we may be almost too late on this. But at some 


juncture I think we ought to try to clean up 


our act a little bit if we possibly can and 


this is likely to be a fairly rancorous 


discussion in open Board, but I do think it's 


time for us to do that. 


 MR. PRESLEY: After -- after listening to some 


of the comments in Oak Ridge and the times past 


in other places, I agree 100 percent. But boy, 


we've really got to be careful how we present 


this. 


 MS. MUNN: Yeah, I -- and I am -- am concerned 


about the rancor and language that may occur 


during our -- our Board comment, but I think 


we're going to have to do it. 


 MR. GIBSON: This is --


 MR. GRIFFON: Yeah, go ahead. 

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 MR. GIBSON: This is Mike Gibson. I -- I kind 


of agree with what -- everything said, 


especially what Bob said. I think we're going 


to have to be very careful at this point. 
I 


mean I don't like sitting there getting beat up 


by the public, although I understand their -- 


and I empathize with their problems they've had 


with their relatives and et cetera, but you 


know, I think we also have to look at when we 


go beyond our scope. Our scope is -- is an 


Advisory Board to NIOSH, not necessarily to 


educate the public. So --


 MS. MUNN: Uh-huh. 


 MR. GIBSON: -- you know, it's -- it's a really 


fine line in my opinion, so -- but I do agree 


that I think the Board really needs to discuss 


it in whole. 


 DR. WADE: Is there any more comment on this 


particular topic? 


What I would suggest -- obviously this is an 


issue of great sensitivity. What I would 


suggest is we capture this discussion by 


highlighting the transcript and sharing it with 


the Board and then, at the working group 


Chair's discretion, we could have a discussion 

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with the full Board on this topic. Again, this 


is an Advisory Board. The final decisions rest 


with the Secretary. But I'm sure the Secretary 


would appreciate Board comment on this issue if 


the Board would wish to comment. 


Okay, we can move on to the next -- and I'll 


make sure that this part of the transcript is 


highlighted and made available to the Board 


before the next face-to-face Board meeting. 


 MR. HINNEFELD: Okay, I think findings two, 


three and four for Procedure No. 4 have kind of 


a similar genesis, and that has to do with the 


letter to the family members -- or letter to -- 


finding about survivor claimants and the 


disadvantage that survivor claimants are at 


with respect to providing information about the 


workplace. One has to do with the letter, 


another has to do with the procedural guidance 


that's given to the interviewers, and then the 


third has to do with the request for the 


telephone interview. So -- but it all -- to 


us, the way I read it, all seems to hit kind of 


at the same fact is that the survivor claimants 


are not prepped -- they're provided additional 


information in order to assist them through the 

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process. And -- and again, like I said, we 


feel like -- you know, we're trying to let them 


provide what they can provide to us. You know, 


we have gained -- you know, we've learned a lot 


about the work-- the workplaces -- the various 


workplaces from our research. We don't 


necessarily view this as an approach to give 


the claimant, you know, what we've learned 


about their work site and then to let them cast 


their work experience in the context of that 


because we feel like we can provide -- you 


know, we can place their -- their knowledge of 


the workplace into the context of the site 


based on what we know. So we hadn't envisioned 


this as being a part of the claimant interview 


process; that is, to provide them more 


understanding about their husband's or parent's 


workplace, thinking that that may in fact 


elicit more response. I don't know if it will 


or not, but we have not viewed that as part of 


the -- part of our obligation. 


 MS. ROBERTSON-DEMERS: This is Kathy DeMers. 


I've got a couple of comments. First of all, 


in -- in addressing some of these, we need to 


look at the packet. 

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 MR. HINNEFELD: Okay. 


 MS. ROBERTSON-DEMERS: And the slight 


differences in the two letters that are sent -- 


 MR. GRIFFON: Kathy, could you speak up just a 

little --

 MR. PRESLEY: Yeah, please. 

 MR. GRIFFON: -- into --

 MS. ROBERTSON-DEMERS: Okay, I'll yell. 


 MR. HINNEFELD: She's blocking the mike there. 


DR. NETON: (Unintelligible) good sound-


absorbing material. 


 MS. ROBERTSON-DEMERS: Can you hear? 


 MR. PRESLEY: That's a little bit better. 


 MR. GRIFFON: Little better, yeah. 


 MS. ROBERTSON-DEMERS: Okay. I was just saying 


that we need to review the packet and both 


letters that are sent out, the one to the 


survivors and the one to the claimants. I kind 


of wanted to make some comments with making the 


interview process more equal. As we're sitting 


here talking, it occurs to me that one of the 


ways that you can prep individuals for the 


interview process is to address it in the 


worker outreach commit-- meetings that are 


held. 

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Another way that I've seen that makes the 


interview process equate better is if the 


interviewees have an advocate. A good example 


would be at Mallinckrodt where Denise Brock has 


gone through and pulled together information 


and provided it to the claimants and prepped 


them prior to their interview process. It 


makes them feel more at ease and you may get 


more detailed information with respect to that. 


With regard to incidents, this is -- this is 


kind of a real sticking point because even if 


they have an advocate if there is not a list of 


incidents or if there was not something 


unforeseen that happened, like maybe the Energy 


employee came home in different clothes, the 


survivor -- even an advocate like Denise Brock 


would not be aware of that. This is why it's 


so important for NIOSH to have a list of the 


incidents that occurred at the site and to be 


communicating these to the dose reconstructor. 


It is very evident that with the survivor 


claims you're getting a lot of I don't know, I 


don't know, I don't know. And with somebody 


helping them out, they're actually answering 


the questions. I also notice that more people 

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from the survivor side are declining the 


interview. 


It looks as though the individuals from the DOE 


complex are doing a little bit better at 


answering the questions, even the survivors, 


than from the AWE sites where the exposure's 


just become public within the last couple of 


years, and that's probably attributed to the 


fact that they have people around that they can 


ask questions to. 


But these -- these are just kind of some ideas 


that I think would make the process easier, and 


someone needs to be available that's a little 


bit familiar with the site to help survivors 


out, and this might be one way of equating the 


survivor interviews with the Energy employee 


interviews -- or making it at least more fair. 


 MS. MUNN: Yeah, Kathy, this is Wanda. My 


guess would be that you will continue to see a 


large discrepancy between the information from 


the AWE employees and from the DOE employees. 


Whether or not -- one could -- one could always 


argue whether or not DOE procedures were 


adequate in all cases, but at least they did 


have established procedures and they were 

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documented, and they did badge employees. And 


a lot of the earlier employers, prior to that 


time, may not -- appear to not have had an 


extensive formulated program the way many of 


the -- most of the major DOE sites did. So 


that alone could account for some of the 


difference in -- in how the employees respond 


to things. Most of the DOE sites -- it's my 


understanding, even in the early days -- did 


have formal instructions, safety instructions 


and -- that went along with the badging 


activities for the -- for the folks who worked 


there, which may not have been true of all the 


AWEs. 


 MS. ROBERTSON-DEMERS: This is Kathy DeMers. 


Actually the very strongest advocates who have 


been interviewed as a part of our review are 


from AWE sites, and there -- they really do 


have a calming effect on the survivors. 


 MS. MUNN: Sure, they need to. 


 MS. ROBERTSON-DEMERS: And actually there is 


some differences as you look at DOE site to DOE 


site. Some of them are better represented than 


others. But I think that the interview process 


would be more productive if you could address 

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this issue in the worker outreach committee and 


at least make them aware of -- the survivors 


aware of individuals who are knowledgeable 


about the site and allow them to contact these 


people, or allow that person to be involved in 


the interview process. 


 DR. WADE: Thank you, Kathy. 


 MR. GRIFFON: This is Mark Griffon. 


 DR. WADE: We appreciate that info. 


 MR. GRIFFON: I just -- I just had a couple of 


comments on this -- I mean I'm not -- not sure 


where -- what -- what exact finding this would 


be related to, but I think, you know, one of 


the concerns from the beginning is what was the 


-- what was the intent of this interview. You 


know, there's a couple thoughts that I had from 


the beginning of this process, that not only 


could the interview be useful for the 


individual claimant, but also possibly it could 


be used in aggregate for certain sites. You 


know, if they looked at all the Hanford 


interviews in aggregate, there might be 


something that -- that could come out of that, 


pending the design of the interview. And I 


think that was an early dispute that we had 

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with NIOSH that we ended up sticking with what 


we had. But I think -- you know, I'm just 


wondering, I'm not sure that we can do much 


about it now 'cause I think a lot of people 


have already been through the process, but it ­

- in -- in the response to Proc. 4 No. 3, you 


know, the -- the phrase, (reading) the 


telephone interview process is used to give 


each and every claimant an opportunity to 


provide their input into the dose 


reconstruction process, that -- that -- I think 


that says, to me, that this is a passive 


process. And I understand that there's this 


fine line between you don't want to coach, you 


know -- I don't think you should coach on an 


interview and I -- that -- that may even be a 


problem with advocates 'cause if you have the 


same advocate for 40 or 50 interviews, you tend 


to get the same responses. But also I don't 


think that this interview gave much opportunity 


for pulling information out of these 


interviewees -- and not -- not so much the 


survivors, but the -- the claimants themselves 


that -- the former workers themselves. I think 


if the interview was designed differently it 

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could have -- and maybe conducted differently, 


it could have been designed to trigger memories 


and to pull out information. And that's been 


my criticism from the beginning is that a lot 


of times it's -- it's important to have site-


specific knowledge in order to trigger these 


memories so that you are talking the talk, you 


know the certain names of -- of -- trade names 


that were used in place of certain 


radionuclides or -- or certain building numbers 


and names that -- that would trigger memories, 


and I don't think that really happened in this 


process. So again, I think we're -- we're 


probably too far along with all these 


interviews that have been conducted to do much 


about that, but I just wanted to -- to get that 


out there. 


 MR. PRESLEY: This is Bob Presley. I agree 


with Mark. I remember three or four years ago 


when we first started this thing and we were in 


Cincinnati and we actually set down as a 


working group one day and listened to a -- an 


interview being conducted, and I think that was 


one of the comments was, you know, is there any 


way that the interviewer could get more 

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information about what he's talking about. If 


I remember correctly, that's something that we 


had a concern about early on. 


 MS. ROBERTSON-DEMERS: Well, I would agree that 


you would have to keep a collection of comments 


from the interviews and consider that in the 


dose reconstruction process. 


 MS. MUNN: This is Wanda. My knee-jerk 


reaction is that it would be pretty hard to 


train interviewers in the specifics of a site. 


I guess -- especially the old, old ones. Now I 


certainly understand what you're talking about, 


Bob and Mark, when you -- when you talk about 


the terminology and the internal code words 


that were used by people who clearly were never 


allowed to speak of what they did elsewhere. 


It would be really nice if we could -- could 


tailor each one of our interviews to each 


individual claimant. But given the number of 


claimants we have, given the number of 


interviews that exist, I guess my partially 


uninformed thought would be it would be almost 


impossible for us to allow the amount of time 


that would be necessary to -- to train specific 


individuals to interview specific other 

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individuals. That would seem a little too 


difficult to do. 


 MR. PRESLEY: This is Bob Presley. That was 


what our -- I think that was what our thing was 


early on, that -- that we just could not tailor 


the -- there were so many sites, that you could 


not tailor any type of a standard interview to 


each site. 


DR. NETON: Bob, this is Jim Neton. You raise 


a very good point, and also I think early on 


the issue was that these scripts need to be 


cleared by OMB when you interview ten or more 


people. And to make a specific OMB-approved 


script for all the various sites would be 


virtually -- next to impossible. 


 MR. GRIFFON: That's what kind of created the 


problem, Jim, I -- yeah, that -- that was -- 


DR. NETON: I just wanted to remind every-- 


that -- that was the reason why we couldn't 


tailor those scripts. 


 MR. PRESLEY: Right, I remember us going 


through that. 


 MR. GRIFFON: But I'm still not clear, Jim, on 


-- on what -- what -- how much has to be 


scripted or -- or can the interview -- you 

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know, for instance, if the interviewer had sort 


of a cheat-sheet or whatever you want to call 


it, a long (unintelligible) that could be used 


to trigger memories, is that considered part of 


a script or is that -- I just don't know how 


much --


DR. NETON: Yeah --


 MR. GRIFFON: -- how much is -- is considered 


part of the, quote/unquote, script versus how 


much can just be something that the interviewer 


uses during the process. 


DR. NETON: It's been my experience that they 


look at those pretty closely. I mean you can't 


 MR. GRIFFON: Yeah. 


DR. NETON: -- have open-ended questions that 


just say tell me about Y-12 -- 


 MS. MUNN: Uh-huh, yeah. 


DR. NETON: -- and then have a little cheat-


sheet that says, you know, there's all these 


other acronyms that you might want to know 


about, but --


 DR. WADE: Right, and OMB would -- would not 


want, you know, large migrations from the 


questions. It's not something that we can 

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follow the information given to a different 


place. I mean you have to be pretty -- you 


have to stick to the script pretty closely. 


DR. NETON: Right, 'cause the whole point of 


that script review is for the Paperwork 


Reduction Act and, you know, making efficient 


use of people's time and not having the 


government, you know, using a large block of 


people's times without it being reviewed and 


that sort of thing. Anyway... 


 MR. GRIFFON: Can you -- can you, Jim, compare 


that to the interview proc-- I don't know if 


you even know this, but in the veterans program 


when Till presented to us he described some of 


the interviews that were done there. They seem 


more like freeform interviews. I don't know if 


they had to get similar approval for their 


interviews that were done or if they were just 


DR. NETON: You're talking about the interviews 


by the Academy in reviewing the program. 


 MR. GRIFFON: Well, I -- I thought they were 


looking at notes that were in the case files. 


DR. NETON: No, it's my understanding that the 


DTRA program did not require interviews of 

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anyone, and in fact that's how we ended up with 


interviews. One of our first -- 


 MR. GRIFFON: Okay. 


DR. NETON: -- questions to them was what would 


you do differently, and we heard across the 


board that it would have been nice to establish 


some rapport with the claimant at the early 


stages of the process, and that's specifically 


why we -- one of the reasons we added it -- 


other than --


 MR. GRIFFON: Yeah, 'cause --


DR. NETON: -- the fact we thought it was a 


good idea, but --


 MR. GRIFFON: Well, that's what I'm reflecting 


on, too, is that one of the -- as I recall, one 


of the findings in that report was -- by Till's 


group was that the -- the -- I think these 


might have been voluntarily provided sort of 


testimonies on the claimant's part. 


DR. NETON: That's possible. 


 MR. GRIFFON: They wrote up -- some of them 


wrote up their memory of what they had done, 


and Till's finding in a few -- in some cases 


was that the dose reconstructors didn't 


consider the claimant's intervi-- or the 

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claimant's testimony --


DR. NETON: Right. 


 MR. GRIFFON: -- or whatever it was --


DR. NETON: Right. 


 MR. GRIFFON: -- in doing the DR. They -- they 


sort of disregarded --


DR. NETON: Yeah. 


 MR. GRIFFON: And so those -- but those weren't 


-- everybody didn't get an interview, so to 


speak, did they --


DR. NETON: Right. 


 MR. GRIFFON: -- in that process? 


DR. NETON: There was no requirement in that 


program. 


 MR. GRIFFON: Okay. All right. 


DR. NETON: I would say that our interview 


process does not preclude someone from -- from 


elaborating. At the end there's a general 


question that says if you have anything else 


that we didn't ask, or something to that 


effect, and -- and to my knowledge, some of 


these interviews go on for hours. You know, 


there is no attempt to cut them off and say 


well, we have to stick to the standard script 


and you're done. These people do -- do open up 

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when they feel like it. And again, I don't 


think we make any attempt to -- to cut them 


off. 


 DR. BEHLING: Is there any attempt to somehow 


or other pacify people in instances -- having 


audited so many of the dose reconstructions at 


this point, we have also come across CATI 


interviews where there's basically nothing but 


blank spaces -- I don't know, I don't know, I 


don't know. And I guess the concern here is 


that at the end of such an interview I'm sure 


the person who's being interviewed -- in some 


cases may even be second generation family 


member who knows nothing at all about the 


environment of the Energy employee -- and I 


guess my concern would be that this individual 


now feels he has completely failed in every 


respect in providing critical information that 


may at this point prove to be detrimental to 


the -- to the adjudication of that claim. I 


think it would be very important for the 


interviewer to give some understanding of how 


this fits into the bigger piece of the dose 


reconstruction so as not to give the impression 


that, in the absence of information, this claim 

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has no chance of being adjudicated in a 


positive way. Is there any attempt to -- to 


inform the interviewer that, under those 


circumstances, he has an obligation to sort of 


say the information that is being sought is 


only just one of many sources of information 


and this is really potentially not going to 


adversely affect the outcome of the claim so as 


not to give the impression that you've -- 


you've -- obviously you're out of the picture 


entirely? 


DR. NETON: I thought that was -- that was the 


language that was added into the letter was 


that, you know, you're -- you're asked to 


interview, but by not participating -- or 


something to that effect -- it would not 


adversely affect the outcome. There's some -- 


some language to that effect in the -- in the 


modified letter, but it doesn't go much beyond 


that. 


 DR. BEHLING: No, it just needs to be stated 


that the whole dose reconstruction process 


looks at a wealth of information from records 


to site profiles where all this information is 


integrated and the CATI interview is just one 

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of many sources of information and may be not 


necessarily the most important one, so as -- 


 MR. GRIFFON: From -- from what I've heard, 


Hans, my guess is that the interviewer probably 


does convey that, you know, that even if you 


don't have a lot of information, you know, 


don't worry about -- you know, we -- we have 


other information we're going to use. 


MR. ALLEN: Yeah, they've been doing that. 


 MR. GRIFFON: I think they -- I think they do 


emphasize that, Jim, if I -- I mean that's my 


impression, anyway. 


MR. ALLEN: I don't think there's any formal 


process or script or anything, but they've been 


coached all along that -- you know, to reassure 


them that we're asking questions to get what 


information we can, and I don't know is -- is 


typical or, you know, it happens a lot and 


don't -- don't worry about it type of thing. 


 MS. MUNN: It's okay to say I don't know. 


MR. ALLEN: Yeah. 


 MR. GRIFFON: Let me see if I can move on to 


Proc. 5-01, finding Proc. 5-01. I think we've 


covered things up to this -- I mean I think 


we're kind of getting a little off-track. Some 

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of these things overlap a little bit. As far 


as I can see for the Proc. 4 findings, most of 


our actions are going to hinge on reviewing the 


acknowledgement package that you discussed and 


reviewing the revised CATI language, the 


revised CATI form language that some was 


deleted and replaced by other language. And 


then I think, if it's okay, maybe we can move 


on to Proc. 5-01 and pick it up there. Stu, is 


that okay? 


 MR. HINNEFELD: Okay. 


 MS. MUNN: Yeah, you keep us on track. 


 MR. GRIFFON: I'm trying, I'm trying. 


 MR. HINNEFELD: The -- for -- comment number 


one on Proc. 05 says procedure provides no 


reference to site profile or closing 


interviews. And see, this is in the conduct, I 


believe, of the inter-- Proc. 5, I believe, is 


conduct of the interview. We went through the 


finding, the body of the finding, and 


identified several -- several points that were 


made in the body of the finding and the report, 


and have kind of -- and have provided responses 


from that because, based on the summarized 


finding in the -- in the matrix, we had -- you 

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know, we felt like there was more -- more text 


that we could respond to and so we've kind of 


reproduced either a finding or our 


understanding of a comment that was made for 


various things. Those are the numbered -- in 


italicized bullets -- and then responded there. 


One of the things that we did point out is we 


do now have a closeout procedure -- a procedure 


for closeout interviews and -- 


(Whereupon, Mr. Elliott joins the group.) 


 MR. GRIFFON: Proc. 92. Right? 


 MR. HINNEFELD: Right. 


 MS. MUNN: Yeah. 


 MR. HINNEFELD: We do in fact log the 


interviews, all -- all the conversations with 


claimants are logged in our NOCTS 


(unintelligible) log. There's no interview 


form for the closeout interview because we're 


just trying to be -- be -- trying to make -- 


trying to help the claimant understand the dose 


reconstruction and see -- answer questions they 


might have with the dose reconstruction and 


tell them that if they have no more information 


to provide then the next step in the processing 


claim is to submit -- sign and submit the OCAS­
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1. We ask them not to submit the OCAS-1 until 


we've addressed, you know, their concerns or at 


least tried to answer their questions. 


Now if we've answered the question and it's not 


the answer they want and they -- you know, we 


will still say at that point we can't provide 


any more -- you know, answer any more 


explanation than we've provided to you. We 


would like you to sign the OCAS-1 and send it 


in. We do get to that point. But we do want 


to try to answer the questions they have on 


their dose reconstruction before they sign the 


OCAS-1 and send it back. That's what the 


closeout interview's supposed to cover before 


the OCAS-1 comes back. 


We've made some changes since the review of the 


procedures to try to make health physicists 


more available for closeouts so they can -- 


they're more readily available to the 


interviewer for assistance if need be. And --


so anyway, you can just go on down the list 


there. 


 MS. MUNN: So is SCA happy with that? Did that 


address the concern adequately? 


 MS. ROBERTSON-DEMERS: I would say that we 

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would need to review Proc. 92 to make sure that 


it has all the elements. 


 MR. PRESLEY: Kathy, this is Bob Presley. 


Speak up, please. 


 MS. ROBERTSON-DEMERS: Okay. I have some 


concerns about the availability of health 


physicists during the closeout interview. I've 


heard from numerous people that they've had to 


go to educated health physicists outside of 


NIOSH to get explanations of what exactly is 


being discussed in the -- in the DR provided to 


the -- to -- to them. And this includes, you 


know, some fairly educated people, so they're 


pretty difficult to understand and probably 


very difficult to communicate. 


 MS. MUNN: How often did that happen, Kathy, do 


you know? Is that --


 MS. ROBERTSON-DEMERS: The survivors, you know, 


that I've been in touch with pretty much do not 


understand at all what is contained in the DR. 


 MS. MUNN: Well, and -- and I don't think any 


degree of -- of education that we can provide ­

-


 MS. ROBERTSON-DEMERS: Right. 


 MS. MUNN: -- would likely do that. 

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 MS. ROBERTSON-DEMERS: Well, one of the things 


that has come up, and this was brought up to me 


by one of the -- the DOE health physicists -- 


is when they see that their dose is much, much, 


much higher than what is on record, they 


automatically assume the site is not monitoring 


them adequately. So the maximizing and 


minimizing dose procedure has to be clarified 


absolutely, you know -- 


 MR. GRIFFON: Or the communication of it has to 


be very clear, yeah. 


 MS. MUNN: Yeah, I guess it's a major concern. 


I've used this word before and I'll continue to 


use it because I really feel that's what 


happens. Too often we mislead survivors and 


claimants when we use maximized doses, and 


these folks are -- mistakenly believe that 


they've received more -- that they might have 


received more dose than they were recorded as 


having received. And if -- if we don't have a 


very clear way of letting them know that they 


are being given the -- not just given the 


question of the doubt, but actually being 


allotted additional exposure that an -- that 


there's very little probability anyone 

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received, then we're -- we're misleading them 


badly. 


 MR. GRIFFON: Also -- I mean this -- this is a 


bigger discussion, Wanda, and I'm not sure -- 


you know, you suggested that the Board drove 


NIOSH to this. I know I've been -- I've had 


issues with the efficiency process since the 


beginning, and I -- maximizing doses is in no 


way to be confused with claimant favorability 


'cause it's --


 MS. MUNN: No. 


 MR. GRIFFON: -- there's nothing about claimant 


favorability in this 'cause they're denial 


claims, you know, so -- but I agree, it's got 


to be -- 'cause it creates confusion on the 


tail end with people 'cause they have dose 


records for all these years when they have 


almost all zeroes and then they get this very 


high dose and they -- it creates doubt. And 


the worst cases that we hear about is when they 


come back with another primary cancer and then 


they have a lower dose, and that creates -- you 


know, and rightly so technically. But you 


know, from the communications standpoint it's ­

- it's creating -- creating some problems so I 

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think we -- you know, we're on the same page 


here, but... 


 MS. MUNN: Yeah, and I -- my guess is that 


we're not going to get a great many of those, 


but the ones that we do get are going to be 


highly publicized and will help to increase 


doubt, I think, in the minds of other people 


who have been through the process, which isn't 


-- isn't fair, either. And I'm not sure that 


we in this working group here today can -- can 


find a way around this, but it seems to me that 


we really and truly need to be addressing this 


straight on before it gets any further -- 


 MR. GRIFFON: Well, except --


 MS. MUNN: -- down the road. 


 MR. GRIFFON: I guess the only thing I would 


recommend is that, you know, we have an 


opportunity to review this acknowledgement 


package and maybe we just might -- you know, 


when we consider that, we might want to 


consider having some language in there about 


this whole efficiency process and what -- you 


know, so I guess that maybe will be our 


opportunity to -- in some way to comment on it. 


 MR. HINNEFELD: This is Stu Hinnefeld. I want 

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to -- I want to comment on some things that 


have gone on and continue to go on that relate 


to this understandability and what 


communication we make to the claimant. We've ­

- we have, throughout the time we've been 


saying dose reconstructions, been adjusting the 


language in a dose reconstruction in order to 


try to make it more understandable. When we 


get feedback about a certain passage or type of 


language or certain activity, we will then 


modify sort of the boilerplate language that 


goes into a dose reconstruction to try to 


explain that. An example now is that there is 


a -- a sentence, or a couple of sentences that 


goes into overestimating claims -- 


(unintelligible) overestimating claims, that 


says that this is overestimated for the 


purposes of efficiency, and if the information 


changes in the future and the case is redone, 


quite likely the number will be lower. I mean 


we -- we're trying to -- so we've done things 


like that. We have done other adjustments and 


tweaks to the language that's selected in the 


dose reconstructions to address items that come 


up -- you know, lack of understanding, poor 

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understanding that occurs because of the 


language in there. So that has been going on 


all along. 


In addition, there has -- you know, early on, 


the earliest dose reconstructions, there's this 


comment that boy, these things are hard to 


read. 


 MS. MUNN: Uh-huh, yeah. 


 MR. HINNEFELD: These things really aren't easy 


to follow. It's been there from the start. 


 MS. MUNN: Yeah. 


 MR. HINNEFELD: And so it takes us a while, but 


we do have now that sort of a draft package of 


a revised dose reconstruction report that will 


-- that will have a section that's intended for 


the claimant. The problem with the current 


dose reconstruction is there's nothing in there 


that is intended to be readable by the 


claimant. 


 MS. MUNN: Uh-huh. 


 MR. HINNEFELD: It's got a whole lot of people 


it's supposed to be intended to; none of them 


are the claimant. So this is supposed to have 


a summary for the claimant that explains things 


like why is this so much different than your 

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recorded dose; you know, what monitoring 


information did we have for you, those -- those 


things. So -- so they're trying to lay it out 


in layman's language what we did with what we ­

- what we knew about their work and what we did 


with it. And then there will be a back portion 


for a health physicist reviewer or a health 


physicist who -- whether it's us or whoever 


wants to review it, where it will 


(unintelligible) just these were the decisions 


we made and how we went about it. And so it'll 


be much briefer and you don't have to have as 


much language in the -- in the health physicist 


part because you would have to know -- you need 


-- it'll just tell you what selections were 


made, why choices were made the way they were 


made. So that's the intent. 


 MR. ELLIOTT: If I could make a statement here, 


I'd like to add to what Stu's offered. We take 


this concern very seriously. We've heard it 


and I think, as Stu's walked you through, when 


we've heard it we've taken steps to address the 


issues that were raised in those concerns. And 


I don't think we're there yet. I think we're 


working hard to get there. I'm anxious to see 

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us get this -- this draft, claimant audience 


included, report out and in -- in use. It 


takes us a while to do that. It's my hope that 


we will reach a broader audience through this, 


and I'm certain that we will. So -- and we're 


glad to work with the Board in making that 


happen. I expect we will bring it all to the 


Board so that you can see what we're proposing 


to do. So just to let you know, we're working 


on this in concert. 


 MS. MUNN: That was Larry, y'all. He's joined 


 DR. WADE: Yeah, for the record --


 MS. MUNN: -- us here at the table. 


 DR. WADE: For the record, Larry joined the 


table just before Stu made his last comment. 


Larry came to the table so Larry's with us now. 


 MS. ROBERTSON-DEMERS: This is Kathy DeMers. 


guess we would like to see the Proc. 92. We 


would like to see this revised dose 


reconstruction language, and I think we 


probably would get a better idea of what's 


going on if we could sit in on some closeout 


interviews. 


 MR. HINNEFELD: Will that have to be tasked 


I 
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from the Board? Will that have to be tasked 


from the Board, Proc. 92? I mean SC&A was -- 


 MR. GRIFFON: Oh, Proc. 92, I -- I had actually 


written down and I did write down this -- this 


revised DR report, Stu, I think in part that 


was one of the things we said from the first 20 


cases --


 MR. HINNEFELD: Right. 


 MR. GRIFFON: -- and so as a follow-up action I 


think we -- you know, we -- you -- you said at 


that time you were modifying -- 


 MR. HINNEFELD: Right. 


 MR. GRIFFON: -- the boilerplate language, and 


I think as a follow-up we would -- we would, 


you know, want to look at that language -- 


 MR. HINNEFELD: Okay. 


 MR. GRIFFON: -- which it sounds like you've 


made, you know, good strides on that. I'm not 


sure about -- you know, I -- I was going to ask 


SC&A whether these set of seven items listed -- 


I think many of them -- we've sort of got a 


follow-up action here now, but I'm wondering 


about the -- the questions about the health 


physicists and -- and number seven, I think -- 


 DR. WADE: Just -- this is Lew Wade, just -- 

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 MR. GRIFFON: -- whether they've been 


adequately -- you know, whether SC&A is 


comfortable with the NIOSH response here. 


 MS. MUNN: Yeah, that was my question earlier. 


 MR. GRIFFON: Yeah. 


 MS. ROBERTSON-DEMERS: Well, I guess -- sorry, 


(unintelligible). 


 MS. MUNN: No -- no, and I think Kathy's saying 


they don't want to commit to that until they've 


seen Proc. 92's revision. 


 MS. ROBERTSON-DEMERS: Yeah, and that's why, 


you know, I'm kind of recommending that we 


might sit in on some of these -- on a couple of 


closeout interviews because it would give us a 


better familiarity with what's being 


communicated to the claimant. 


 DR. WADE: Just to deal with the official 


communications between the Board, NIOSH and the 


contractor, my -- if my understanding serves 


me, at the last Board meeting we took the 


action of adding Proc. 90 to the list of 


procedures to be reviewed. I don't believe the 


Board has acted on Proc. 92. 


 MR. GRIFFON: Right, we haven't. 


 MS. MUNN: I didn't remember it. 

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 DR. WADE: Okay, but -- but you know, this -- 


the working group can certainly bring that to 


the Board --


 MR. GRIFFON: Bring that forward, yeah. 


 DR. WADE: -- at the next call and we can deal 


with that, but Proc. 90 has been added -- 


 MS. BEHLING: Yes, it has. 


 DR. WADE: -- but not Proc. 92 --


 MR. GRIFFON: Right. 


 DR. WADE: -- so you need to keep your marginal 


notes, and if that's a recommendation of the 


working group to the Board, it needs -- it 


would require a full Board action -- as would 


this suggestion of sitting in on interviews. 


think this is something -- 


 MR. GRIFFON: Sure. 


 DR. WADE: -- that the Board would need to 


consider and decide on its -- its 


recommendation. 


 MS. MUNN: I personally am a little concerned 


about the privacy issues with that one. 


 MR. ELLIOTT: Did you sit in on --


 MS. MUNN: Right. 


 MR. ELLIOTT: -- the interviews, the CATIs that 


are done to develop work histories? Did SC&A 


I 
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sit in on any of those? Some Board members 


did. 


 MS. ROBERTSON-DEMERS: It would be nice to sit 


in on both ends and see how they tie together. 


 MR. ELLIOTT: So you did sit in on the CATIs? 


 MS. MUNN: I don't think so --


 MR. HINNEFELD: I don't know that --


 MS. MUNN: -- no. 


 MR. HINNEFELD: -- I don't think 


(unintelligible) be interviewed -- 


 MS. MUNN: Part of the Board did, but the 


contractors did not. We were really concerned 


about privacy issues and having third parties 


sit in on any of these -- 


 MS. ROBERTSON-DEMERS: And of course --


 MS. MUNN: -- interviews. 


 MS. ROBERTSON-DEMERS: -- it would -- it would 


have to be okayed by the person being 


interviewed or... 


 DR. WADE: Well, the working group can -- can 


think about this and bring a recommendation to 


the Board. 


 DR. BEHLING: Well, what was the difference 


between us sitting in versus me reading the 


CATI report when it's sent to me as part of the 

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audit? I mean that has certainly privacy 


information in the CATI report, so I see no 


reason why it can't be expanded to actually sit 


in on the interview itself. 


 MR. ELLIOTT: It -- it was advised, with regard 


to your sitting in on CATIs, that it would 


perhaps chill the collection of information. 


 MS. MUNN: I think we actually had a legal 


finding on that, too. 


 MR. PRESLEY: Yeah --

 MR. GRIFFON: I think that --

 MR. PRESLEY: -- I remember, we did. 

 MR. GRIFFON: -- there are consent issues, 

though, aren't there? I mean --


 MR. PRESLEY: Yes. 


 MR. GRIFFON: Yeah. But we -- we can -- we can 


look into that. I mean I think actually Proc. 


92 should probably come before -- well, I don't 


know, you know, but -- it may be that we want 


to look at Proc. 92 first and then consider 


sitting in on some of those, given that they're 


using a new procedure and we haven't looked at 


the new procedure. 


 MS. MUNN: I would suggest that we add Proc. 92 


to our agenda for the next Board call. 

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 MR. GRIFFON: Yeah, I agree with that. 


 DR. BEHLING: Can I make just a comment 


regarding the issue of the dose reconstruction 


report and the clarity, or lack of clarity, 


having again looked at so many of the audits 


now. It's a challenge for any health physicist 


to decipher what's in those reports. And 


clearly I think one of the most challenging 


aspects of the report is the IREP input data. 


I mean I can't imagine a lay person looking at 


those datasheets and saying what does this 


mean? A lognormal distribution with a 


geometric standard deviation means nothing -- 


they don't even know what goes with what area. 


You get, in some instance, up to 400 dose 


entries and you don't know where the medical 


occupational starts and the actual recorded 


dose starts, et cetera. And one of the things 


that Kathy and I have discussed about the 


potential for a beneficial introduction of 


information to the claimant would be to 


introduce a table that we have introduced in 


our audit report that says okay, here's your 


recorded photon dose, here's your missed photon 


dose, recorded neutron, missed neutron, 

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occupational medical, on-site ambient, et 


cetera, et cetera. And then give you, as a 


minimum, the -- the entries that correspond to 


those particular segments. If they never look 


at that, that's fine, too. But they can 


instantly look at that, and that would also 


benefit the QA internal process -- and we'll 


talk about it probably later on, touch on that 


very subject again. But you can instantly look 


down and say oh, my God, yeah, that's right; I 


only got something like two rem of lifetime 


reported photon dose, but look at this, they 


gave me a hypothetical internal dose of 16 rem. 


And they would instantly recognize, in terms of 


magnitude, what those numbers and the total 


dose really represent and -- and get to some 


understanding as to how much is real, how much 


is simply added there for the sake of maximized 


efficiency, et cetera, et cetera. But that 


table would prove to be invaluable for a 


claimant who has no way of understanding the 


IREP datasheet. 


 MS. MUNN: This is Wanda. I would submit it 


would be extremely important for us to choose 


the terminology appropriately if we were to 

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undertake such a list of what's been done. And 


I agree, I think it would be enormously helpful 


for the five percent of the population that had 


any idea what a photon dose was, or who have 


any idea what the difference in a photon dose 


and a neutron dose was. But -- but even if 


they didn't know, understanding the difference 


between what they actually were recorded to 


have and what they were then assumed later 


could have had is -- is a good thing to do. 


But I would also caution that this now brings 


up one of the fine points that the technical 


people go back and forth with with respect to 


"and how good is the measured dose to begin 


with, and what is our correction factor that we 


use there, and why do we use that correction 


factor, and was the film badge really 


adequate"? You know, we can understand -- the 


people sitting around this table understand 


what that means. The claimant doesn't 


understand what that means. All that means to 


many people -- who are heartbroken over having 


lost someone that they care about -- is "you 


see, the information that they gave us wasn't 


even good to begin with". I -- and so my 

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warning would be, if we're going to do 


something like that -- and I have no objection 


to it, I think it's a good thing, but -- at 


least to consider because I think people ought 


to know the difference between what they 


actually received and what they were 


essentially given by this program. But please, 


if we're going to consider that, language -- 


the terminology that's used to identify what 


that gift of additional dose rate is is very 


important, in my mind. 


 MS. BEHLING: In fact what we do in our report 


that goes to the Board, which I think does 


help, is simply -- something as simple as 


putting in bold and highlighting the fact that 


this is an overestimate of this dose. And if 


you're now introducing that into the letter 


that goes to the claimant, I think that would 


be very helpful. But definitely make that a 


strong point and explain what that means to the 


best of your (unintelligible) -- 


 MR. GRIFFON: Yeah, I think we definitely need 


to follow up on -- on the DR report -- the new 


boilerplate DR report language that Stu 


described. I think some of these questions may 

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be addressed in there. It sounds like they've 


been trying to address those, so -- 


 MS. BEHLING: Yes. 


 MR. GRIFFON: I think, if it's okay, can we 


move on to Proc. 5-02? 


 MR. HINNEFELD: Yeah, Proc. 5-02 says there's 


no procedural requirement for coworker 


interview or explanation if coworker is not 


interviewed. And I guess the issue here is 


kind of a timing issue, it's that we don't know 


if we're going to have to talk to coworkers 


until we assemble all the information package 


for the claim. And then the dose reconstructor 


gets the assembled information and decides do 


we need to talk to the coworker. So the 


interviewer -- at the time of the CATI 


interview -- the CATI interview is part of the 


information that you gather, part of the 


information that's assembled to do the dose 


reconstruction. So at the time of the CATI 


interview there's really no way to know if 


you're going to talk to the interview -- 


interview -- into -- the coworkers or not. 


There is a statement in the script that says we 


may or may not talk to the coworkers. You 

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know, there's no -- so it kind of doesn't imply 


a promise, but maybe it does -- it doesn't go 


out and overtly imply one. Maybe people would 


assume that they're -- we're going to talk to 


them since we asked for them. So there's no 


way to know at that time whether the coworkers 


are going to be talked to or not because we 


won't know at the time of the interview whether 


we're going to have to talk to the coworkers. 


So we have in fact included language -- and I 


think -- I don't think this is actually going 


to wait -- the new modify -- you know, the 


simplified dose reconstruction. This is just 


another boilerplate change that we make 


periodically, you know, text language -- text 


change that we make periodically where we 


intend to put in the sentence that if we didn't 


talk to the coworker -- it's just a sentence to 


the effect that coworkers were not consulted 


because sufficient information was available 


from other sources, so at the time of that the 


claimant will know whether we talked to the 


coworkers. 


 DR. BEHLING: Or there was no conflict. 
I 


think a trigger should be put in -- let's 

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assume that the CATI interview takes place 


before anything that's really assembled in the 


way of DOE records, and there's no need to 


worry about, but perhaps request coworker data 


or information so that when you finally look at 


the CATI report and you have your DOE records 


and you look and say well, he says he was 


monitored internally by bioassay, and all of a 


sudden you look through the records and there 


are no bioassay records. At that point I think 


it would be wise to -- to trigger an inquiry 


that says well, is this an issue of missing 


records or is this an issue of a person's 


failed memory, but a resolution process should 


be there when you sense that the records and 


CATI interview data are not consistent, or he 


says he was badged but there are no dosimetry 


records; he says he was monitored internally 


with urine bioassays but there are no records. 


I think there should be a trigger that says 


well, now that we have gotten the DOE records 


and we review the CATI interview sheets and 


realize that he says this and the record shows 


something different, that that would trigger 


someone to say let's go talk to coworkers and 

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see if in fact there was any reason for us to 


assume that either it's a case of missing 


records or the person's memory is not quite 


what it should be. 


 MR. HINNEFELD: Well, I think that -- 


 MS. BEHLING: I would -- oh, I'm sorry, go -- 


 MR. HINNEFELD: -- there's another aspect of 


that is that will what we learn change 


anything? 


 MS. MUNN: Uh-huh, yeah. 


 MR. HINNEFELD: For instance, if you're getting 


ready to do dose reconstruction and someone 


worked for five or ten years and they said they 


were monitored with bioassay and you didn't get 


a bioassay record, and it was -- pick your 


employment period based on the site -- and this 


claim was going to be done with an 


overestimating technique, an overestimating 


internal intake so the bioassay record's 


probably not going to -- almost no chance is 


going to change your mind, you know, we may not 


request it. We may not go further at that 


point because what we would learn would not 


change what we're going to do. 


DR. MAURO: Stu, this is John Mauro. What I'm 

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hearing is that we have a bit of a dilemma 


because the CATI interview and then the reports 


that go out and the collection of information 


that eventually is transmitted to the claimant, 


it's -- all this material really is trying to 


serve two purposes. One, as you correctly 


point out, if you really don't need that 


information and you don't really need to follow 


up with coworkers because of an efficiency 


process, for example, that certainly serves 


your purposes regarding dose reconstruction and 


coming to the correct decisions. 


On the other hand, it creates a situation where 


the claimant now is sort of confused. So in a 


funny sort of way (unintelligible) we have to 


decide -- or a decision has to be made -- this 


material that's being provided, is it also 


being provided not only to document what was 


done but also to try to explain some of the -- 


would appear to be contradictory information. 


For example, as Hans pointed out, if there is 


this contradiction, the degree -- the degree to 


which it is appropriate for us or for NIOSH to 


explain all this to -- in the record for the 


benefit of the claimant as opposed to for the 

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benefit of the dose reconstructor. 


 MR. ELLIOTT: John, this is Larry Elliott. 
I 


would reply that -- that it's important for us 


to know that the purpose of these dose 


reconstruction reports are to provide 


reasonable estimates upon which a compensation 


decision can be adjudicated. And you know, in 


our -- in our vigor to complete as many of 


those as we can to help those claimants out, we 


have I think done them a discourtesy in 


explaining how we've gone about our work fully. 


And I'm -- I'm concerned about contradictions, 


and I think we need to be very knowledgeable of 


those so we can react to those. And so I 


appreciate hearing this. 


 MS. BEHLING: I in fact would -- this is Kathy 


Behling -- I believe that the interview of the 


coworker should be done for survivor cases 


where all of the answers are I don't know. 


There may be some information out there that a 


coworker might have that would impact that dose 


reconstruction, and I would take that interview 


process a step further by saying for the 


survivors -- and again, this is sort of helping 


them to be on an equal playing field -- if 

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there's -- they just have no information at all 


and they can provide coworker information or a 


coworker, I think in that particular case it 


may be worthwhile to talk to a coworker, just 


to be sure that we're not missing any 


information on incidents and so on. 


 MR. ELLIOTT: Would it be -- have you looked at 


what the effect of our work has been that's 


been adjudicated at DOL and how much -- how 


much of that -- the concern that we've been 


talking about in this problem of communication 


and contradictions, how much of that has -- has 


been raised as issues in the final adjudication 


of the claim? I mean we've sent out over 


12,500 claims now and we -- we look at that 


through the rework that comes back from the DOL 


appeal process and, you know, we should look at 


that. We should examine that and see if -- if 


that compels us to take -- how far we should 


take this in balancing our resources 'cause it 


is resource-intensive to make these additional 


phone calls. 


 MS. MUNN: It is. 


 MR. ELLIOTT: It's resource-intensive, you 


know, to change boilerplate. But we're 

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interested in making sure we do a good job of 


communicating, so maybe we should look at that 


piece to (unintelligible) -- 


 DR. BEHLING: On one hand, however, I think we 


need to -- and Stu said it correctly, if there 


is a conflict between what's stated in the CATI 


and -- and what records would indicate and we 


default to a hypothetical intake of 12 or 28, 


it's clear that you're going to be giving that 


individual a much higher dose than what 


potentially may be missing as part of the 


records. 


On the other hand, if that person now appeals 


this case -- and you mentioned, Larry, that 


we're talking about time and costliness, the 


appeal process will probably take an awful lot 


of more man hours than a few phone calls would 


that would pacify the survivor of a claim into 


realizing they made an effort to contact a 


coworker and it turns out that the individual's 


recollection was at fault, that the coworkers 


who worked right next to a person's father or 


somebody also wasn't monitored, and that solve 


the problem -- which might be a much easier 


approach to resolution than going through an 

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appeals process. 


 MR. ELLIOTT: Sure, sure. Quite possible. 


 MS. ROBERTSON-DEMERS: This is Kathy DeMers. 


I've kind of got some ideas on this. Could you 


develop a criteria for conducting coworker 


interviews? Such as: when you're compensating, 


why would you need to do a coworker interview; 


whereas when you're trying to do a best 


(unintelligible) analysis or you have some 


questions on the accuracy of what the 


interviewee has stated, then you could go to a 


coworker interview. 


 MR. GRIFFON: Well, I -- this is Mark Griffon. 


I think what -- some of what I'm hearing -- I 


mean I had a similar comment before and Hans I 


think captured it that what are the triggers 


for a coworker interview, and maybe Proc. 5 has 


to consider that further. You know, what are 


the triggers, is it -- and Kathy also captured 


-- Kathy DeM-- Kathy Behling also captured one 


thing I was thinking of which is does a 


survivor automatically trigger a coworker 


interview. Maybe not, you know. Maybe there's 


more to it than that. But I think Proc. 5 


should consider what triggers a coworker 

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interview. 


As a follow-up to that, I don't know if -- do 


you keep any statistics on how many coworker 


interviews you've done actually through this 


process? 


 MR. HINNEFELD: I think there've been a fairly 


limited number of coworker interviews. 


 MR. GRIFFON: Yeah, 'cau-- is that what -- you 


know, your statement in your response says 


coworker interviews are conducted only when 


they are necessary to complete the DR. And I 


was just curious at this point how many 


coworker interviews have -- you know, so I 


think there's two parts of this. One is a 


trigger -- what triggers the coworker 


interview, and then the other part is the 


communications aspect. And I think that's -- 


that could be covered in the DR boilerplate 


language that we discussed earlier, the -- this 


question, which we've heard comments on, 


actually, which is -- you know, I gave all 


these names and -- and you know, NIOSH didn't 


even bother to contact them or whatever, and 


even if you -- you know, if you don't, you may 


have a good reason not for needing to do that, 

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but it should be communicated in the DR report 


in some way so that the claimant is comfortable 


with the process, you know, so I think there's 


two parts to this, what -- you know, what would 


trigger and -- and then -- and if there -- you 


know, that -- that issue that Hans raised on 


the, you know, potential discrepancies, and 


that might be one trigger, and then the 


communications aspect. 


 MS. MUNN: Mark, what action are you suggesting 


here? 


 MR. GRIFFON: I'm suggesting that -- that -- 


that Proc. 5 needs to include something on -- 


on triggers for coworker interviews -- language 


on triggers for coworker interviews. 


 MS. MUNN: Okay, so you're asking for a 


revision that identifies that. 


 MR. GRIFFON: That -- that's what I'm ask-- 


that's what I think, yeah. And then the other 


part I think is covered in our earlier action, 


which is to review the DR boilerplate language. 


I think that would be covered in there. 


 MS. MUNN: I have one question for Larry and 


Jim. What's your sense of -- I gathered from 


what you said you hadn't actually been keeping 

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records on it, and I can see why, but what's 


your sense of -- of the level of rework that 


you're getting back from DOL? 


 MR. ELLIOTT: Well, we get -- of course we get 


rework back from DOL where an Energy employee 


has acquired another cancer that was not in the 


original --


 MS. MUNN: Oh, yeah, yeah, but I'm -- 


 MR. ELLIOTT: -- dose reconstruction. You need 


 MS. MUNN: -- I'm not -- yeah, that's not -- 


 MR. ELLIOTT: -- to understand that. We get it 


back for additional employment that we may have 


helped identify, or that has been identified by 


the claimant, so those are two things that, you 


know, probably -- you just need to know they're 


there, but those are not --


 MS. MUNN: Yeah. Yeah, that's --


 MR. ELLIOTT: -- the one at issue here. The 


one at issue is technical remands -- 


 MS. MUNN: Right. 


 MR. ELLIOTT: -- and perhaps Stu or Jim can 


talk better about the variety and extent, but I 


think our rework -- the total amount of rework 


we're seeing from DOL's in the eight percent 

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range, eight to ten percent, fluctuates. 


 MS. MUNN: Oh, then probably no more than one ­

-


 MR. ELLIOTT: And I don't know what the -- 


 MS. MUNN: -- or two percent, right? 


 MR. ELLIOTT: -- percentages of technical -- 


 MR. HINNEFELD: Almost nothing. 


DR. NETON: Almost nothing. 


 MS. MUNN: Practically nothing. 


 MR. HINNEFELD: Less -- less than -- I'd say 


less than ten percent of the rework burden is 


actually a technical remand. Almost all of the 


rework we get back from the Department of Labor 


is either diagnoses and employment that they 


didn't identify to us originally that were in 


the case file that they just didn't develop 


originally, or conditions that have been -- you 


know, diagnoses have developed since the person 


first claimed -- filed a claim -- you know, 


additional cancer diagnoses. The overwhelming 


 MS. MUNN: You ought to claim a gold star for 


that. 


 MR. HINNEFELD: -- majority of the rework we 


get back from the Department of Labor -- 

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 MS. MUNN: That's good. 


 MR. HINNEFELD: -- falls in those categories. 


 MS. MUNN: That's good. 


 MR. HINNEFELD: I'd say well less than ten 


percent --


 MS. MUNN: Yeah. 


 MR. HINNEFELD: -- of the rework is some type 


of remand. 


 MR. ELLIOTT: We could have DOL present more on 


that. They would have better -- better 


understanding. It comes from four district 


offices. We can't break it down that way. 


 MS. MUNN: Oh, I'm not sure anybody -- does 


anybody on the telephone want that? I didn't 


really want that except just a sense of how 


large it was. Does anybody want those hard 


numbers? I don't need it. 


 MR. GRIFFON: I don't think so at this time. 


 MS. MUNN: No, I just wanted a sense. 


 MR. ELLIOTT: If Jeff Kotsch is on the line -- 


Jeff, I don't know if you -- you see all of 


these. Can you verify that what Stu's saying 


is what you see? 


 MR. KOTSCH: Part of it is that we don't see 


all the -- well, we see all the rework requests 

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that come from our district offices, but that 


is still just a subset of, you know, all the -- 


the dose reconstructions that are out there. 


And the other thing is we have specific efforts 


underway to look at certain kinds of dose 


reconstructions and so from those you may get 


more technical comments rather than the normal 


comments from the district offices, which are ­

- I mean most of their things that they're 


identifying have to do with additional 


employment or changes of employment, changes in 


medical condition, things like that. 


I think what Larry was saying as far as the 


frequency of the reworks and the levels are 


probably right. But we don't -- you know, 


that's just an intuitive sense, I have to 


admit. I don't -- haven't looked at -- we keep 


the records, but I haven't really crunched the 


numbers recently. 


 MS. MUNN: Well, it's obvious from what I'm 


hearing that it's not a -- not a truly 


significant --


DR. NETON: No. 


 MS. MUNN: -- item, so --


DR. NETON: This is Jim. I think Stu's 

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correct, it's much less than one percent of the 


cases completed -- substantially probably less. 


We don't have the exact number, but that's our 


sense. And I kind of -- kind of keep track as 


they come through, and I -- my feeling is that 


coworker interviews probably would not have 


influenced the outcome of those cases -- 


 MS. MUNN: Yeah. 


DR. NETON: -- even ones that were -- 


 MS. MUNN: Yeah. 


DR. NETON: -- had requested rework. They 


tended to be more typically narrowly-focused 


issues related to glovebox work or something -- 


 MS. MUNN: Yeah. 


DR. NETON: -- of that nature, so... 


 MR. HINNEFELD: I understand also a coworker 


interview -- to call someone who's identified 


as Joe Smith's coworker 20 years ago, it's just 


as likely as not he doesn't remember Joe Smith. 


 MS. MUNN: He doesn't remember Joe, yeah. 


 MR. HINNEFELD: I mean -- bear in mind -- I 


mean I'm not trying to denigrate coworker 


interviews. 


 MS. MUNN: No --


 MR. HINNEFELD: I think we have to --

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 MS. MUNN: No. 


 MR. HINNEFELD: -- have a realistic 


understanding that when you ask a coworker or 


you ask an Energy employee about their 


workplace, you're asking them the visual things 


that -- the things that they can observe, the 


things that they saw, they knew with their 


senses, and the fact is that the things that 


you see with your senses are not necessarily 


the telling factor in your dose reconstruction. 


 MS. MUNN: Yeah. 


DR. NETON: You also have to remember these 


people may have a -- their statements may have 


a bearing on the outcome of their coworker's 


claim, so they may be reluctant to chime in 


with -- with the facts. And the one or two 


that I'm aware of -- I sat in on some of these 


calls and it's -- it's interesting. For 


instance, a guy in his CATI would claim that he 


received 5,000 millirem per quarter dose or 


something of that nature, and he was insistent 


that this was his exposure. Well, all facts of 


the issues, his dosimetry and what he did for a 


living, didn't come close. So we'd call the 


coworkers and say does this make senses to you 

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that these fields may have been there or 


something to that effect, and the person was 


reluctant to verify but eventually did verify 


that no, these levels were nowhere near -- near 


that -- that type of exposure. So you know, 


they come into play in those very unique type 


situations. 


 MS. MUNN: Yeah. 


 MS. ROBERTSON-DEMERS: This is Kathy DeMers -- 


 MR. GRIFFON: I -- I -- like I said, I think, 


you know, you should consider maybe in this 


procedure having some sort of -- of triggers, 


and I'm not saying -- I agree with Stu that, 


you know, they -- they're certainly not going 


to help in all cases, but if you had some sort 


of guidelines in this procedure of what -- what 


triggers -- what -- what would potentially 


trigger a coworker interview, it might be 


helpful. 


 MS. ROBERTSON-DEMERS: This is Kathy DeMers. I 


agree with Mark that we need to develop some 


triggers, but I wanted to kind of make you 


aware of something that I -- I checked out. I 


went and I reviewed several survivor interviews 


that had been done in the last year, and about 

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50 percent of them don't know coworkers, so 


they don't provide them, you know. 


 MR. GRIFFON: Right, right. 


 MS. ROBERTSON-DEMERS: So my question to NIOSH 


is have you retrieved organization charts from 


these facilities so that you might determine 


who the coworkers are? 


 MR. HINNEFELD: No, we haven't. 


DR. NETON: No. You've got to look where we've 


defaulted for coworker distributions. As you 


know, we tend to take a broad stroke -- broad 


brush approach to this and develop site-wide 


distributions of coworkers and assign either 


the 95th or 50th percentile of all the 


monitored population. We feel it'd be very 


difficult to get down in the organization chart 


level --


 MS. MUNN: Uh-huh. 


DR. NETON: -- and assign a plumber coworker to 


another plumber. They're just -- it's fraught 


with uncertainty --


 MS. ROBERTSON-DEMERS: Well --


DR. NETON: -- and issues. 


 MR. GRIFFON: Especially when they move around 


in jobs, too. 

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DR. NETON: When they move around and -- 


 MS. ROBERTSON-DEMERS: -- I guess what I was 


getting at is that in the cases where they 


haven't identified coworkers and you need a 


coworker interview, that may be one mechanism 


to identify coworkers. 


 DR. BEHLING: Or RWPs if they had instituted 


RWPs in those days. 


 MS. MUNN: A lot didn't. 


 MR. GRIFFON: Yeah. I mean I would agree with 


Kathy's comment that -- you know, some -- some 


that I've talked to, they tend to remember 


often who their -- their spouse went to work 


with and -- and commuted with more than who 


they actually worked with when they were in the 


plant, so sometimes coworkers can mean 


different things to -- you've got to be kind of 


careful that they're -- they're just not 


commuting together and they're actually working 


in the similar areas, so I'm not -- I'm not 


suggesting that it's always going to be the, 


you know, sort of a fountain of information. 


But I think -- you know, I think it's 


worthwhile at this point maybe establish some 


sort of triggers that, you know, could be 

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considered by the dos-- you know, how you 


phrase it is up to you, but you know, triggers 


to consider for coworker interviews. I think 


that might flesh this topic out a little bit. 


 MR. PRESLEY: Mark, this is Bob Presley. I 


agree with you, but I don't think a tremendous 


amount of emphasis is going to -- that needs to 


be put on this, and the reason being is when -- 


like you said, when they -- when they tell you 


that they have a -- who the coworker is, a lot 


of times they don't even know where the 


coworkers are alive or not. And if you're 


talking -- especially to a spouse of a deceased 


person, the elderly --


 MR. GRIFFON: Yeah. 


 MR. PRESLEY: -- I mean it's -- it's good to 


have something like that in there that says, 


you know, has a coworker been contacted, but I 


really wouldn't put a whole lot of emphasis on 


that. 


 MR. GRIFFON: Well, the other -- the other 


thing I noted was coworker follow-up versus 


coworker follow-up interview. I mean I could 


see an instance where, you know, three 


coworkers were identified during the interview 

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and there's some discrepancy in the CATI versus 


the person's records. And I said well, let me 


look in the identified database and look these 


other people up to see if they actually were in 


this same area and they were actually receiving 


bioassay as opposed to this person -- you know 


-- you know, why -- why do I have this 


discrepancy, so you can follow up without 


actually calling them up. 


 MR. PRESLEY: Right, right. 


 MR. GRIFFON: You know, you can sort of check 


coworker records, but -- 


 MR. PRESLEY: That's correct. 


 MR. GRIFFON: -- yeah. But I think -- I -- I 


mean -- not to cut this topic off, but I think 


maybe, you know, that -- that all falls under 


the concept of some sort of -- of triggering 


devices for coworker follow-up, and I think 


that should be considered -- my opinion, 


anyway. 


 MR. PRESLEY: I -- I agree, it should be 


considered, but I don't agree that it's a 


earthshaking thing here. 


 MR. GRIFFON: Right, I don't mean to suggest 


that, either. 

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 DR. WADE: Might I suggest a brief break, 


Wanda, if that's okay? We're --


 MS. MUNN: I think that would be wonderful. 


 MR. GRIFFON: I think we all got agreement on 

that one. 

 MR. PRESLEY: Be fabulous. 

 DR. WADE: Back in -- back by 10:00. 


 MR. GRIFFON: Ten o'clock? Okay. 


 MS. MUNN: Uh-huh. 


 MR. PRESLEY: I'm going to cut off and then 


I'll come back on the phone. 


 MS. MUNN: Thank you. 


 MR. GRIFFON: Me, too. Thanks. 


 (Whereupon, a recess was taken from 9:50 a.m. 


to 10:05 a.m.) 


 DR. WADE: Larry is a little late joining us, 


but let's pick up where we left off, Mark or 


Wanda. 


 MS. MUNN: Go, Mark. 


 MR. GRIFFON: I think we're on Proc. 5, finding 


5-03 -- some of these I think we've covered 


already, but we might as well go through them 


in order just to make sure we don't miss 


anything. But Stu, maybe you can pick up on 5­

03? 

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 MR. HINNEFELD: Well, 5-03 to me is -- I mean 


we've talked about this before -- 


 MR. GRIFFON: Right. 


 MR. HINNEFELD: -- it's preparation of the 


claimant. We've kind of given our -- our 


position on that. 


 MR. GRIFFON: Okay, and I think we've covered 


it with our -- with our action on the 


subsequent item. 

 MS. ROBERTSON-DEMERS: Mark, can I add 

something here? 

 MR. GRIFFON: Sure. 

 MS. ROBERTSON-DEMERS: One of the things that I 

noticed in the interview is the very 


complicated language -- like radiation-


generating devices -- and there needs to be 


some explanation, perhaps in the glossary that 


is sent out, to explain what that is, 'cause 


people know X-ray units. They don't know 


radiation-generating devices. 


 The other thing is we're not really looking for 


the interviewer to coach an individual, but to 


provide information without coaching. And I 


have an example of an interview that was 


actually put together by ORAU for the Y-12 

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beryllium worker surveillance and it actually 


allows -- it provides information that will 


make it easier for the claimant to answer the 


question. 


 MR. GRIFFON: Well, along those lines, Kathy, I 


-- I have -- I've had similar suggestions from 


the medical surveillance programs that are 


around the country. But as Jim Neton stated 


earlier, we have this OMB-approved interview 


with an approved script, and I'm not sure how ­

- how far we can stray upon that without -- you 


know, and then if we go for a -- modifying 


that, you know, how long would that take, how 


many interviews are already done that it 


wouldn't anymore, and I guess there's a lot of 


questions. 

 MS. ROBERTSON-DEMERS: Well, that's a question. 

 MR. GRIFFON: Yeah. 

 MS. ROBERTSON-DEMERS: I'm going to go ahead 

and give Stu and Wanda a copy of this so they 


can see what I'm talking about, and it's just 


further information for them to consider. 


 MS. MUNN: That'd be helpful. Do you have it 


in electronic form? 


 MS. ROBERTSON-DEMERS: Yes. 

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 MS. MUNN: If you can send it to us 


electronically, then I'll see that the rest of 


this working group gets it. 


DR. NETON: I've got a question for Larry. If 


that's generated by ORAU as a non-government 


agency, are they subject to OMB requirements, 


as well? 


 MR. ELLIOTT: Yes. 


DR. NETON: They are? 


 MR. ELLIOTT: As our contractor working on -- 


DR. NETON: No, I'm talking about ORAU, as an 


independent contractor to the government -- 


 MS. MUNN: For the beryllium. 


DR. NETON: -- doing it on their own as a 


contract -- for beryllium work, for example -- 


would that still -- I'm just curious, I don't 


know. 


 MS. MUNN: I don't know if it does, either. 


 MR. GRIFFON: Good question. 


DR. NETON: You know what I'm saying? If --


 MR. ELLIOTT: You've lost -- you've lost me, I 


guess. 


DR. NETON: If ORAU as a -- who is 


administrating a -- under a contract to DOE -- 


 MR. ELLIOTT: Yeah. 

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DR. NETON: -- apparently that's what this is, 


are they then still required to file OMB-


clearance paperwork? 


 DR. WADE: My understanding would be if -- if 


they are taking the action under a contract 


with the federal government, they're required. 


DR. NETON: Okay. 


 MS. MUNN: That was my understanding. 


DR. NETON: I just didn't know that. 


 MR. ELLIOTT: They don't have an OMB-approved 


date on this, which I would have suspected they 


should have had. 


DR. NETON: See, that was my question. I don't 


know --


 MS. MUNN: Which makes you nervous to begin 


with. 


DR. NETON: -- how this really works, whether 


this is a --


 MR. ELLIOTT: It's DOE, too, so --


DR. NETON: Yeah, I was just curious about 


that. 


 MR. HINNEFELD: I believe we can in -- we can 


in fact modify the --


 MR. ELLIOTT: Yes. 


 MR. HINNEFELD: -- the questionnaire and go 

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back to OMB and get (unintelligible) approval 


of a modified questionnaire. It's not out of ­

- out of the question --


 MR. ELLIOTT: Yes, we just --


 MR. HINNEFELD: -- to modify the questionnaire. 


 MR. ELLIOTT: We have just finished obtaining a 


renewal of OMB approval on the CATI 


questionnaire. There were some modifications 


made in that renewal, and we can certainly put 


forward additional revisions, as -- as we see 


the need to do so. 


 DR. WADE: You cannot circumvent the OMB intent 


by issuing a contract. Now you can by -- by 


enlisting the services of a third party that's 


not operating under a contract. Not 


circumvent, but you're no longer required -- 


DR. NETON: Right. 


 DR. WADE: -- but... 


 MR. ELLIOTT: Well, when the government brings 


a burden to bear on an individual citizen, if 


we ask more than -- ten or more, we have to 


have OMB approval for collecting when we 


provide a burden to the claimants, whether it's 


us or our contractor. 


 MS. ROBERTSON-DEMERS: Mark, this is Kathy. In 

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this particular questionnaire, for example, it 


gives a list of job titles -- which would have 


to be really job categories if you wanted to 


make it applicable to all sites -- and it 


allows them to say yes or no, he was a 


machinist, or he was an engineer. And that 


would be somewhat helpful to the survivors. 


Also people are more familiar with general 


terms like did -- did your spouse work at 


accelerator or did they work at a reactor, et 


cetera, and if we ask these questions it just 


provides them with a little bit more 


information without actually coaching the 


interviewee. 


DR. NETON: Well, you know we already have the 


DOL application that shows that where they -- 


what their job was every year at the sites 


where they -- you know, to the extent they 


could answer the information, and the interview 


actually starts with that. You said you were 


an electrician at Oak Ridge from this year to 


this year, that kind of stuff. So it's a 


little different. It's not starting, you know, 


from scratch I guess. It's not a de novo 


interview (unintelligible). 

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 MS. ROBERTSON-DEMERS: Yeah, you know, I -- I 


just give this as an example. Because it's -- 


it has to do with beryllium it would definitely 


have to be modified, but it's just a mechanism 


that you can sort of provide information 


without coaching. 


 DR. WADE: We appreciate that. 


 MS. MUNN: Yeah. I'll see the other members of 


the working group get a copy of this and try to 


make some judgment as to how much of it is not 


the kind of thing that isn't already covered on 


the original paperwork that our folks do. 


 MS. ROBERTSON-DEMERS: I think as far as work 


location, it would be very helpful if -- if 


they had did he work at a reactor, did he work 


at an accelerator, did he work in a chemical 


processing plant -- you know, some generalized 


terms that might actually mean something to 


them. 


 MS. MUNN: Uh-huh. An awful lot of places I 


can think of -- I'm thinking of some of the 


employers that we've just gone through over the 


last year or so, and it would never have 


occurred to me, for example, to include a 


question like did he work at a rolling mill. 
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would never have thought about a rolling mill 


in terms of radiation exposure. I guess how 


complete such a list could be might be an 


issue, too. 


 MR. GRIFFON: I guess -- and maybe I -- I mean 


I -- I'm looking ahead at these findings, and 


to me the -- the other question here is, you 


know, to what extent can the -- can the 


interviewer use a -- a sort -- I'm going off of 


what Wanda said, the rolling mills. I mean I 


could see not -- not even site-specific, but 


type of operation specific, and a lot of these 


uranium facilities are very similar and they 


have similar terminology and -- you know, but 


to what extent can the interviewer stray from ­

- from the script, quote/unquote, to -- to 


elicit -- you know, to sort of pull information 


out of the interviewee. And I think the answer 


I got before was you can't stray very much. 


 MS. MUNN: Well, yeah, and -- and it's been so 


long since I've looked at the original 


questionnaire that we have approved, I'd have 


to go back and look at that by comparison to 


what Kathy's proposing here and see -- 


 MR. PRESLEY: This is Bob Presley. I agree. 

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If you start getting into specifics, you're -- 


if -- if y'all remember what Jim Neton had here 


not too long ago, it was about 30-something 


pages of job titles --


 MS. MUNN: Uh-huh, I remember that. 


 MR. PRESLEY: -- if you get into that, 


somebody's going to be reading job titles for 


four or five days. I don't think we want to do 


that. 


 MS. ROBERTSON-DEMERS: Well, ORAU has -- at 


least for Y-12 -- kind of developed job 


categories, but as Jim was saying, you know, 


it's not so much the job titles because they're 


available. It's -- it's general working 


location -- for example, the employee interview 


has a list of radionuclides. 


 MR. PRESLEY: Of what? 


 MS. ROBERTSON-DEMERS: Of --


 MS. MUNN: Radionuclides. 


 MS. ROBERTSON-DEMERS: -- radionuclides. If 


you could do a similar thing for general 


location and design it so that it would be 


understandable to someone who is likely not 


told any details about their spouse's work. 


You know, they would know that he worked at say 

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a reactor, but they wouldn't know that he 


worked out at Hanford in -- at N reactor, or 


that he moved between reactors. 


 MS. MUNN: Yeah, it may be helpful. I'll --


I'll undertake as a responsibility to get a 


copy of this to the other members of the 


working group and I'll go back and try to take 


a look at our original questionnaire, which I 


haven't looked at in three years I think, and ­

-


 MR. GRIFFON: I guess my -- I guess part of the 


reason I was thinking of these interviewer 


cheat-sheets, if you will, was, you know, that 


-- that, you know, because of the restrictions 


or the time -- you know, the time it might take 


to modify an OMB-approved interview, not to 


mention the fact that we've done so many of 


these already -- NIOSH has done so many of 


these already --


 MS. MUNN: Yeah. 


 MR. GRIFFON: -- that you already have a system 


full of CATI interviews, and to drastically 


modify your interview approach now, I don't 


know if that's -- if that's realistic -- 


 MS. ROBERTSON-DEMERS: Well, I guess --

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 MR. GRIFFON: -- but -- but I mean I was 


thinking if -- if, you know, as a -- a sort of 


stop-gap measure that, you know, site-specific 


cheat-sheets would be -- I'm agreeing with you, 


Kathy, in principle, but I'm thinking what can 


we do at this stage of the game to maybe 


instead of just -- I think these -- in my 


opinion, anyway, the interviews are a bit too 


passive and -- and certain -- certain -- 


certain memory -- memory triggers may be 


helpful in -- in this process of pulling out 


information. Maybe not even -- from the 


survivors it's even more unlikely, but from 


former workers. You say certain buildings and 


not even the building number -- official 


building number, sometimes it had a -- 


 MS. ROBERTSON-DEMERS: (Unintelligible), right. 


 MR. GRIFFON: -- a name they used for the 


building, you know, and they say oh, yeah, you 


know, where -- I worked on that -- in that 


building for four years, you know, and it -- it 


may not be captured in the job title 


information 'cause it may just say machinist, 


but they may have worked, you know, in several 


areas around and they may have very impli-- 

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very different implications as far as 


exposures, so I'm -- I'm with you there. The 


question I have is, you know, if -- what can we 


-- how can we sort of effectively enhance the 


process now without turning the whole thing 


upside -- you know, I mean I think we have a 


lot of existing interview data and how can we 


improve it now or enhance it now as opposed to 


changing the whole -- the whole interview 


itself, the -- you know, the construct. 


 MS. ROBERTSON-DEMERS: Mark, this is Kathy. 


don't think that we necessarily have to change 


the interview. I -- I think we could use 


cheat-sheets or site-specific sheets to trigger 


memories. 


 MR. PRESLEY: This is Bob Presley. Let me ask 


a question to Stu or Jim Neton. Have you all 


had any type of comments back from your 


interviewers that they need this type of 


information? 


 MR. HINNEFELD: If I'm not mistaken, they do 


get kind of continuing education sessions, 


continuing training --


 MR. PRESLEY: That's what I remember. 


 MR. HINNEFELD: -- sessions for the 


I 
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interviewers to address things like that, but I 


guess I -- I don't -- I've not heard from the 


interviewers, but I don't know that I'm in a 


position where I would have heard it. You 


know, if they're making those comments, I don't 


know if I would have heard them. 


 MR. PRESLEY: As I remember, though, before 


they are -- are let out on their own to be an 


interview, they get some formal training on the 


sites they're going to be working on. Is that 


not correct? 


 MR. HINNEFELD: To be honest, I don't really 


know exactly. 


 MR. PRESLEY: Okay. 


 MR. HINNEFELD: Do you know, Dave? 


DR. NETON: I think they get -- they do get 


some basic radiation background training if 


they're not, you know, a technical person, but 


I don't think it'd be possible to give them 


education on all 200 sites we're trying to -- 


 MR. PRESLEY: No -- no, no --

 MR. GRIFFON: But that -- that's -- yeah, but ­

-

MR. ALLEN: They get some familiarization with 


the complex. I'm not sure if do site by site. 

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DR. NETON: Right. 


 MR. ELLIOTT: ORAU has a process in place, 


don't they, where they bring in a person who 


can answer the claimant's issue or question? 


 MR. HINNEFELD: They have -- they have health 


physicists, if you're talking about during a -- 


DR. NETON: A closeout (unintelligible) -- 


 MR. HINNEFELD: -- a closeout (unintelligible). 


DR. NETON: -- a closeout interview, but during 


their regular CATI interview, I'm sure they 


could bring a health physicist in, but I don't 


think that's been formalized. 


 MR. HINNEFELD: I -- I don't know. 


 DR. BEHLING: Is there an attempt to put 


certain cases to a select interviewer -- 


meaning that if there's a Savannah River Site 


and you have the option of going down the line 


but I know you've done them before, you're 


going to keep getting them because as you 


progress, as you experience the interview 


process over and over again, you'll become 


certainly much more adept in understanding the 


process for the interview if you stick with one 


site as opposed to just randomly saying who's 


next and throw them a case. 

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 MR. HINNEFELD: Yeah, I -- I don't know if 


they've tried to do that or not. I would 


suspect you'll have -- that would be a pretty 


difficult scheduling activity for them, for 


this reason. The claimant -- the interviews 


occur, to a large extent, in chronological 


order as -- you know, in the order that the 


claims came in. And so scheduling -- so you're 


essentially -- the sites you're going to talk 


to essentially dictated by situation outside 


your control. In other words, what order you 


got them in. Scheduling an interview isn't the 


easiest thing in the world. You know, you send 


them a letter saying we're going to call you 


and schedule an interview, and then you call 


them and you schedule an interview and you set 


the schedule. And so they're scheduled at the 


convenience of the claimant, so you have -- you 


know, so you have a time -- interview block 


that pops up that is then when the claimant is 


available to talk, and so now you have -- now 


you're faced with the further problem now of 


trying to match your -- your interviewer for 


the site where this person worked and have them 


available at that time. So the scheduling 

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would get really cumbersome. I would bet they 


try. I would bet they try to do that because ­

- Joe has interviewed several Savannah Rivers, 


let's try to keep him on Savannah River -- I 


bet they try, but I bet it's not rigorous 


because of scheduling problems. That would be 


my judgment. 


 MS. ROBERTSON-DEMERS: Can we get some further 


information on --


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


 MR. ELLIOTT: I think it's safe to say, though, 


that things have changed over time. In the 


early days when they were doing interviews, I 


think they had more people on staff doing 


interviews, and they were doing them very fast. 


I think as we proceed through the time line of 


doing dose reconstructions over the course of 


the last three years and compare what happens 


in those time frames, we're probably doing 


interviews a little bit differently now because 


we're only doing about 100, 150 a week. Right? 


 MR. HINNEFELD: Probably. 


 MR. ELLIOTT: You know, at one time they were 


doing 300, 400 a week. 


 MR. HINNEFELD: Quite a few. 

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 MR. ELLIOTT: So I'd just offer that. Keep 


that in mind. You'll see different names 


associated with different time periods. 


 MS. ROBERTSON-DEMERS: Well, we -- we brought 


up connecting, you know, familiarity with the 


site profiles, and this would be one way to 


kind of limit the scope that they would have to 


be familiar with. They should at least read 


through the site description. 


DR. NETON: I think these are all great 


suggestions, and I'm all for -- for improving 


our process at every step along the way. But I 


think we've got to -- got to look at the bigger 


picture here, and is there real evidence that 


the DRs are biased due to inadequacies in the 


interview process. I mean are we working on 


some -- some factual basis that shows us that 


this process is just flat-out not working and 


we need to embark on wholesale changes? I mean 


improvements are great. I think we should 


tweak them as we go, but I'm not sure that the 


-- that the interview process is -- 


 MR. GRIFFON: No, I --


DR. NETON: -- completely broken, and -- and 


this --

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 MR. GRIFFON: And Jim, there's also the other 


side of this, too, which is that, you know, for 


-- for all good reasons, we're into this 


interview process now. But when -- when the -- 


when the people being interviewed are 


frustrated by it, then that's another prob-- 


you know --


DR. NETON: Yeah, I --


 MR. GRIFFON: -- another side of it. 


DR. NETON: Right. 


 MR. GRIFFON: So you know, we've got to 


consider that, too. 


DR. NETON: I definitely agree with that aspect 


 MR. GRIFFON: Yeah. 


DR. NETON: -- and we need to communicate 


better. But as far as the site knowledge and 


educating people on all the specific sites, I 


think we need to be careful about, you know, 


committing a lot of resources to something that 


may or may not be a value-added effort. That's 


all I'm saying. 


 MS. ROBERTSON-DEMERS: I guess what we're 


really after is just a general familiarity with 


the site. For example, with Savannah River 

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that they would be aware that there were 


reactors, that there was a sep-- separation 


facilities, that they worked with tritium and 


that they did uranium fabrication, kind of -- 


kind of that level of familiarity, just so... 


 MS. MUNN: This is Wanda. Perhaps it wouldn't 


be unreasonable to ask that -- that the 


interviewers who have claims from a specific 


site perhaps read one segment of the -- of the 


site profile that defined what -- what -- the 


segment of the site profile that tells us 


what's there. That -- that might not be an 


unreasonable -- would that be a logical 


compromise point? 'Cause it's not -- those -- 


the summaries aren't that long, and the summary 


of the site description. 


MR. ALLEN: For the major DOE sites. 


 MS. MUNN: For the major DOE sites, yes. 


MR. ALLEN: I mean we have a lot of sites we 


don't have site profiles for. 


 MR. GRIFFON: Right, right. 


 MS. ROBERTSON-DEMERS: Well, the other thing 


is, Mark, that you mentioned having a site-


specific sheet in the hands of the interviewer 


when they're doing the interview, and that 

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would provide them with some knowledge, also. 


And that can be developed from the site 


description. 


 MS. MUNN: Well, yeah, but we get back to the 


issue of resources again, and the resources 


being who's going to develop that, and if it's 


-- if it needs to be more -- if it needs to be 


more focused than the summary of what's 


available in the site profile, then who's going 


to do that and how much time is that going to 


take? Or is it just reasonable to say -- 


suggest that -- that interviewers read the 


summary of the site profile and get a feel for 


what's there? That's --


 MS. ROBERTSON-DEMERS: Well, that certainly 


would be an improvement. 


 MS. MUNN: -- better than... 


 MS. ROBERTSON-DEMERS: And then they'd gain 


knowledge, again, if you had a particular 


interview -- interviewer assigned to a series 


of sites. That would limit the amount of -- of 


reading that they would have to do. 


 MS. MUNN: But I think we just identified that 


we don't have interviewers working on specific 


sites. Right? That --

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DR. NETON: We're not sure of that. 


 MR. HINNEFELD: We're not sure. 


DR. NETON: We don't really know. 


 MR. ELLIOTT: What we are talking about here is 


process, and certainly we're interested in 


hearing, you know, how we can improve the 


process. But when we make those 


considerations, we have to examine, you know, 


what -- what the need was that's driving a 


process change and will that need result in -- 


in more benefit and use of resources than not. 


 MS. MUNN: Yeah, you have to have -- 


 MR. ELLIOTT: So I'm glad to hear these -- 


these comments. 


 MS. MUNN: So how did we resolve that? 


 MR. GRIFFON: Yeah, I'm sorry, I was just -- I 


mean, you know, there -- there's two things, 


this -- this question of assigning interviewers 


to certain sites or types of sites, I guess I 


would --


 MS. ROBERTSON-DEMERS: Yeah. 


 MR. GRIFFON: -- you know, maybe make a 


category like that, and I know the scheduling ­

- I understand what Stu said, the scheduling 


difficulties, but it might be -- some way that 

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-- that the procedure can be revised to say 


that, you know -- I mean this may be a 


recommendation from the Board and, you know, 


this is just open for discussion, but you know, 


that, you know, NIOSH will attempt, within 


scheduling constraints, to, you know, try to do 


something like that where they try to put -- 


put certain interviewees toward certain 


interviewers. I think that lends to the 


credibility of a program, too, that -- you 


know, as a person becomes more knowledgeable 


about a site, the -- you know, this is -- this 


is sort of the face of the NIOSH program for 


that claimant, so you know, when they're 


talking to the person if they get the sense 


right off that they have no idea what processes 


or buildings or areas they're talking about -- 


we've heard this in public comment that, you 


know, they got a draft back from their CATI 


interview and the person wrote down words that 


were completely wrong. They were mentioning 


one process and the person obviously didn't 


know what process they were mentioning 'cause 


they wrote down a completely different thing, 


and that -- that takes away from the program's 

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credibility, I think. 


That's one thing maybe that this scheduling can 


be done, to -- to the extent possible, to sort 


of tie certain interview -- certain sites to 


certain interviewers. And a second thing might 


be that some sort of enhanced training 


requirement -- you know, that we recommend 


training for the -- the sites that the 


interviewer is likely to cover. Again, this is 


to the extent practical -- you know, I think, 


and it would have to be for the larger sites or 


for, you know, like AWE uranium sites all in 


one lump training session, you know, something 


like that, that they've got an overview at 


least of the major processes at some of the 


major sites that they're likely to cover as an 


interviewer. 


 MS. MUNN: But Mark --


 MR. GRIFFON: That might (unintelligible). 


 MS. MUNN: -- this is Wanda, and again, I -- I 


continually am concerned about our resource 


limitations here. And I'm also concerned about 


what we've already been told today about the 


Board's instruction to NIOSH to do the best 


they can to address these on a first come, 

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first served basis, to try to work off the 


older cases first. And if we're going to try 


to do that, then to add to that the -- oh, by 


the way, you should have -- you should assign 


these cases to individuals who already know 


something about that site or who have worked 


with a significant number of people from that 


site, then you're very likely getting yourself 


into a situation where you can't match where 


Peter's going with where Paul's going. It's 


just --


 MR. GRIFFON: Well, that's why -- I guess maybe 


I didn't qualify it strong enough, but there's 


why I think you need to -- and -- and I 


wouldn't write a "shall" statement in this 


procedure. I would say, you know, that it -- 


it's, you know -- this -- this is kind of, you 


know, if scheduling allows, we will, you know, 


funnel the -- you know, but certainly you want 


-- you want to provide the claimant with the 


interviewer at their -- you know, when they can 


do it, they -- you know, it's sort of 


contingent upon their schedule more than on -- 


on NIOSH staff schedule or -- or ORAU staff 


schedule, so you're -- you know, you're not 

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going to always get that match, but -- but to 


the extent possible you'll try to match certain 


interviewers with certain sites or types of 


sites, you know. I don't know, that -- that's 


just a suggestion, you know, and -- 


 MS. MUNN: Can we say that's possible, Larry? 


 MR. ELLIOTT: Well, let me just offer this. 


think -- you know, there's two things that can 


happen here and certainly we find this is -- as 


a good discussion and I hear constructive 


criticism and I'm sure that we will take this 


back and we'll talk it over with Kate Kimpan 


and the ORAU team and let them know that you'll 


-- you folks have brought these thoughts to the 


table. And you know, that's one thing that 


will happen. We will talk -- talk about these 


comments. 


The other thing that can happen is -- and we 


would welcome, you know, a Board discussion on 


this, and if you have a Board recommendation to 


make, we would be happy to hear that. 


 MR. GRIFFON: Right, at this point this is just 


a workgroup, yes, so -- you know. 


 MS. ROBERTSON-DEMERS: Is it possible for us to 


see the DOE complex training module? 


I 
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DR. NETON: I think so. We can -- I don't see 


why you shouldn't be able to. 


 MR. GRIFFON: I didn't hear that comment, 


Kathy. 


 MS. ROBERTSON-DEMERS: I was asking to see the 


DOE complex training module that they receive. 


 MR. GRIFFON: Oh, okay. 


 MS. MUNN: And Jim said he thought that was 


possible. 


 MR. GRIFFON: Yeah, I think that's probably out 


there on the O drive on the training -- 


DR. NETON: I'm not sure. 


 MR. GRIFFON: -- 'cause -- yeah. Okay, well --


 MR. ELLIOTT: We have to be careful -- we have 


-- we'll -- just for the record, we'll have to 


look into this, Kathy, 'cause I'm not sure the 


training materials have been deemed under the 


contract to be business confidential or not, so 


DR. NETON: (Unintelligible) 


 MR. ELLIOTT: -- I don't believe so, but we'll 


have to look at that. 


 MS. ROBERTSON-DEMERS: Do you have handouts 


that you give the trainees? 


DR. NETON: I believe they do. It was at least 

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a full day class, if not longer. I've 


forgotten. It's been a while since -- I'm 


aware that --


MR. ALLEN: They had several days worth of 


training and this was one piece of it. There 


was, you know, Privacy Act, et cetera, there 


were all kinds of training and -- 


DR. NETON: Yeah, it was a fairly --


MR. ALLEN: -- I really don't remember any 


details on this particular one. 


 MS. ROBERTSON-DEMERS: Well, that might be an 


alternative if you run into that issue. 


DR. NETON: We'll look into it and see and get 


back to you, see what we can -- can give you 


(unintelligible). 


 MR. GRIFFON: I think -- I think at this point 


this brings us down to Proc. 05-08, finding 08, 


unless I missed something. I mean I think we 


covered sort of the find-- the discussions in 


five -- four, five, six and seven. 


 MS. MUNN: Yeah, and I -- I hesitate at this 


juncture for us to make any specific 


recommendation to the Board in this regard 


while SC&A and NIOSH are still talking about 


it, simply because I'm not at all sure that the 

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process is broken. And if it's not broken, 


then --


 MR. PRESLEY: Don't fix it. 


 MS. MUNN: -- then perhaps simple tweaks and a 


little more communication will resolve it. 


 MR. GRIFFON: Yeah, I think at this point what 


I would do to the Board, Wanda, if it's okay, 


is report back that, you know, we had these 


discussions on these items and some possible 


recommendations discussed were as follows, but 


we -- we wanted to, you know, do more follow-up 


first before we would make these 


recommendations --


 MS. MUNN: Yeah. 


 MR. GRIFFON: -- so just sort of bring this 


discussion to the full Board on these items and 


not bring any specific recommendation yet, I 


guess. 


 MS. MUNN: Yeah. 


 MR. PRESLEY: Mark, this is Bob Presley. I 


don't know if you'd even want to say they're 


recommendations. At this point they're 


discussions. 


 MR. GRIFFON: Right. 


 MR. PRESLEY: And that these are the items 

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being discussed and we will bring them back to 


the Board at a later date. 


 MS. MUNN: If necessary. 


 MR. PRESLEY: Right, and there's -- you know, 


you've got some legal ramifications in here, 


too. 


 MR. GRIFFON: Right, that's fine. Okay. 


 MR. HINNEFELD: Are we leaving it then that we 


should get with ORAU to go over these -- this 


list of suggestions --


 MR. ELLIOTT: I think we should share -- share 


what we've heard with ORAU. 


 MS. MUNN: Yeah. 


 MR. HINNEFELD: -- and get some additional 


feedback from them on terms of the impact of 


implementing some of these things. And maybe 


they have things in place that they feel meets 


the intent of these that we -- sitting here 


today, I just don't know about. So I think 


there's probably additional information for us 


to get from ORAU with respond -- with respect 


to --


 MR. GRIFFON: And maybe a sense on this 


question of who's doing -- if there are certain 


people that are doing certain interviews for 

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sites. I mean we're not sure that that's not 


taking place --


 MR. HINNEFELD: That's right. I mean they --


they could be able to provide us -- well, this 


is what we're doing, you know, and so we may 


actually have a better -- you know, a better 


response than --


 MR. GRIFFON: So maybe that's a fol-- follow-up 


 MR. HINNEFELD: -- what we're able to put 


together for this. 


 MR. GRIFFON: -- item would be that -- that 


ORAU would give us a little more specific 


response on these discussion topics. 


 MR. ELLIOTT: It would certainly help us if 


somebody would frame the need, you know, that ­

- that's being addressed here. What's --


what's driving this? Is it -- is it -- you 


know, is it -- well, I won't frame that for 


you. I think you need to frame that for us. 


I'm certain that ORAU will want to hear what -- 


you know, well, what are we trying to fix here? 


I mean --


 MS. MUNN: Yeah. 


 MR. ELLIOTT: -- certainly there are things 

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that you've heard in this conversation that 


are, you know, good things to do and right 


things to do and we should take those up and 


get them done. 


DR. MAURO: Larry, this is John Mauro. I was 


thinking about the same thing you brought up. 


You know, we've reviewed a number of -- I guess 


where we've done 60 and we're working on the 


next 20, so we'll have 80 actual cases 


reviewed, and in each case we looked at the 


CATI. I think that in order to put I guess 


some legs to this one, the question becomes out 


of -- out of the 80 cases that we've reviewed 


to date, are there many places where we felt 


that there was some deficiencies related to 


either the interviews -- the CATI interview 


data and how it was followed up on that might 


have been important to the dose reconstruction. 


At least that would give us some kind of 


quantitative sense of whether we're gilding the 


lily or not. 


And Hans, is that something we can put 


together? That is, out of the 80 cases, how 


many -- and this would a judgment call of 


course on our part -- how many where we felt 

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that either the CATI interview was done in 


accordance with some of the things we've been 


talking about may have added significant value 


that could have had a substantial effect on the 


dose reconstruction, or perhaps some follow-up 


work, like the coworker aspects, that might -- 


that perhaps coworker follow-up should have 


been done in that case because it was -- it 


would have added some value. Is that something 


we can do to help out here? 


 MR. ELLIOTT: Before Hans or Kathy answers 


that, let me give them time to think and just 


ask this. You used a couple of different 


phrases there, John -- "significant 


difference", "important difference in the dose 


reconstruction", do both of those equate to a 


change in the decision on the dose 


reconstruction --


DR. MAURO: You know, that's a -- that's great 


question. 


 MR. ELLIOTT: -- and that's where we come from. 


DR. MAURO: We -- I -- I wouldn't say it would 


change the decision, abso-- in other words, we 


would not be looking at it from that 


perspective. But I think we would look at it 

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from the point of view do we think that there 


could have been a substantial change in the 


doses, whether --


 MR. ELLIOTT: So -- so does that --


DR. MAURO: -- or not that would change the 


compensation --


 MR. ELLIOTT: -- equate to --


DR. MAURO: -- decision, I don't think we'd 


want to go there. 


 MR. ELLIOTT: -- to -- do -- could we say that 


equates to a change -- a 20-plus percent change 


in dose reconstruction -- 


DR. MAURO: I wish I could --


 MR. ELLIOTT: -- the POC or --


DR. MAURO: -- answer that question. 


 DR. BEHLING: Well, let me make an attempt. To 


date, of the 80 audits that we've done, there 


may have been a couple of instances where a 


CATI report would have potentially made a 


difference that might have affected the dose, 


to some extent. It's uncertain. Sometimes, 


you know, the -- the ability to decipher what 


might have come had a line of inquiry been 


pursued by the dose reconstructor that would 


resolve a potential conflict between what was 

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stated in -- by -- in -- by the interviewee 


versus the DOE records, the outcome of that is 


difficult to quantify, John. But I believe, 


really, the -- the CATI report oftentimes is -- 


is done for multiple reasons, and I don't want 


to understate the importance, but it's really 


for the optics, it's for the public relations, 


it's for a number of things. But in truth, I 


don't believe I've seen too many cases where 


what was perhaps a deficiency in the CATI 


report would translate into a significant 


change in the dose reconstruction. And since 


most of the cases to date we've seen do in fact 


involve maximized dose reconstructions, the 


question -- as we've always said up front -- is 


if you find a deficiency and the person was in 


fact shortchanged, let's say in a number of 


missed neutron dosimeter cycles that were 


awarded, and then you realize that oh, my God, 


they gave him a hypothetical of 28 radionuclide 


internal, that translates to an organ dose of 


18 rem; well, the truth is, yes, the neutron 


dose might be significantly increased, let's 


say by one or two rem, but at the same time the 


gift of 18 rem would be withdrawn the minute 

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you approached 50 percent. So it's one of 


those catch-22s where yes, the dose will 


change, but there is so much maneuverability 


built into the maximized dose reconstruction 


process that when you approach the 50 percent 


value there is so much taken back again that's 


potentially going to adversely impact the 


overall dose to the point where you end up with 


less as a result of an improvement in another 


area. 


 MR. ELLIOTT: You know what I would think would 


tell us the most on this would be some blind 


dose reconstructions. If we had somebody else 


-- if we had you -- take the information that 


we used and do a blind, or even use the -- you 


know, do a --


 DR. BEHLING: Yeah. 


 MR. ELLIOTT: -- dose reconstruction on the 


ones you've identified that you have concerns 


about in this regard, how would it turn out? 


 DR. BEHLING: Yeah, we've discussed it in some 


of the previous instances where we've been 


asked the question, would it change. And I 


keep saying yes, the doses might change, but 


again, the -- the possibility exists that 

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there's so much maximized dose that has been 


assigned that can be readily taken away again 


the minute you approach a 50 percent POC value, 


and so you end up with less than what you 


started off. 

 MR. GRIFFON: At least on the ones reviewed so 

far. 

 DR. BEHLING: Yes, yes. 

DR. MAURO: What I'm -- what I'm hearing -- 


 MR. GRIFFON: Let me -- let me -- John, let me 


just say that in the first 20 report that we -- 


that I thought we submitted but apparently it's 


not gone in yet, there's a section, ongoing 


concerns, and Computer Assisted Telephone 


Interview is topic one. And I might refer 


everybody to that paragraph that -- and it says 


in several cases -- case 6, 8, 10, 11 and 12, 


that's 25 percent of the first 20 -- SC&A 


reviewers indicated that there was either 


inadequate follow-up on items raised in the 


CATI interview, or that incidents identified 


were not considered in the DR report. 


Now as -- that -- that doesn't change Hans's 


point that, you know, most of these cases were 


maximi-- you know, probably wouldn't have 

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affected the outcome, but it was raised, at 


least as a concern --


 DR. BEHLING: Yes. 

 MR. GRIFFON: -- in 25 percent of the first 

set. 

 MS. BEHLING: In fact --

 MR. GRIFFON: So -- and I think a big part of 

that is not only deficiencies, but of this -- 


this inconsistency question, you know, that if 


-- if a person in the interview says that he 


had bioassay all the time and that the DR 


report comes out and says the person was not 


monitored by bioassay, you know, wait a second, 


that should raise a flag to me, you know, at 


least that may deserve a follow-up to make sure 


that we're not missing something major. And it 


may still be that the dose assigned was -- was 


maximizing, but to the claimant receiving that 


back, they're going to say wait a second, I got 


bioassay all the time. This thing says I never 


got it; they don't know what they're talking 


about. 


 MS. BEHLING: Exactly. 


 MR. GRIFFON: You know, so that -- that's --


that's a big part of the concern, I think. 

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 DR. BEHLING: Yeah, it's the optics, Mark. 

 MS. BEHLING: Yeah. 

 MR. GRIFFON: Yeah, the optics, right. 

 MS. BEHLING: And in fact, Mark, we could 

easily go down through the matrix and look at 


our numbering system on the matrix for all 


three of the sets of cases and quickly identify 


how many times -- I think it's B-4 -- was 


identified and that would tell us an 


inconsistency between the interview and what 


NIOSH used in the dose reconstruction. 


I guess --


 MR. GRIFFON: Well, maybe we should bring that 


back to the discussion next time, too, as well, 


Kathy, that -- as an action for SC&A -- 


 MS. BEHLING: Okay, that's --


 MR. GRIFFON: -- to bring that information. 


 MS. BEHLING: -- that's easy enough to do. If 


-- if I can just give my thoughts also, though, 


with regard to -- we keep talking about what's 


broken with the interview process. I believe 


what -- what SC&A's point here is not so much 


what's broken, but I believe what I'm hearing 


is -- and Kathy and Mark, is that we really 


want to try and -- and level the playing field 

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between the survivor and -- you know, the 


interview that's done with the survivor as 


opposed to the actual employee. And I think 


that is a lot of our concern, also. We realize 


this process -- you can't -- you can be fair 


with this process, and we just think it's not 


quite as fair as it could be to the survivor. 


And everything that's being suggested here I 


think is in -- is items that should help or -- 


help that survivor get through this interview 


process and make that interview process more 


meaningful to the dose reconstructor. 


(Unintelligible) Yes? No? 


 MR. GRIFFON: Yeah, I -- I think so. 

 MS. BEHLING: I think I hear the same thing. 

 MR. GRIFFON: I think we've kind of exhausted 

this discussion topic maybe. 


DR. MAURO: But Mark, before we move on on 


this, I did have a thought that I think is 


important. It has to do with what I call a 


metric for satisfaction. Right now, as I 


understand it, after the letter goes out -- 


let's say denying a claim -- it's my 


understanding that there is no phone call, or 


is there, to the claimant explaining to him on 

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the phone what -- what was done and why the 


decision was made to deny. Am I correct in 


that assumption? 


 MS. ROBERTSON-DEMERS: There is a closeout 


interview, John. 


UNIDENTIFIED: Closeout interview. 


DR. MAURO: There's a closeout -- and that -- I 


thought the closeout interview was after the 


dose reconstruction --


UNIDENTIFIED: That's right. 


DR. MAURO: -- started, or is it after the 


actual decision is made regarding granting or 


denying the -- the -- the claim? 


DR. NETON: I don't want to speak for the 


Department of Labor, but I don't think they 


call them after a letter goes out denying the 


claim. 


DR. MAURO: Now I only bring this up for one 


reason. I think that -- right now we've been 


talking a lot about the use of the interview 


process as a way of getting good information to 


help us do -- do good dose reconstructions. 


And we've only marginally talked about the use 


of the interview process as a way of 


engendering confidence on the part of the 

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claimants that the process is in fact working. 


I believe that there is a need for a metric 


that will allow NIOSH and the Board to get a 


sense of whether or not confidence in the 


program is increasing or decreasing as a result 


of the ongoing program. I don't -- I don't 


know if there's a way to do that readily, 


except perhaps a phone call to the ones who 


have -- who received the letter, whether it's 


both the ones who were granted and denied, and 


ask them, do you feel as if you've been treated 


fairly and that we were thorough and do you 


feel confident that the decision that was made 


was appropriate in your case. I would -- I 


mean -- and a measure of that as a function of 


time as a way to judge whether or not the thing 


-- all the things that we're all doing are in 


fact creating confidence. I think that's very 


important 'cause I think half of the -- the 


interview process is engendering confidence and 


the other half of course is getting good 


information to help us do good dose 


reconstructions. And we've been paying too 


little time to -- to the former, and all of 


this discussion was really geared toward, you 

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know, making sure we're getting enough and good 


information. 


 DR. WADE: I think when the Board discusses 


this we have to be clear that we understand 


roles and responsibilities, the NIOSH role 


versus the DOL role in terms of, you know, 


making those decisions. But I think the point 


is well made and understood. 


 MS. MUNN: And this is Wanda. I may be a 


little less than hopeful about that, but my 


guess would be that in most cases anyone who 


has received a positive response will say they 


were treated fairly. Anyone who has received a 


negative response will think that they were not 


treated fairly. 


 MR. GRIFFON: I'm not sure it'll cut that -- 


that straight, but -- you know, but -- 


 MS. MUNN: Pretty close. 


 MR. GRIFFON: -- you're probably right on -- 


you're probably right on the positive ones. 


 MS. MUNN: Pretty close. 


 MR. GRIFFON: Yeah. 


 MS. ROBERTSON-DEMERS: Actually let me just 


share some feedback I've gotten during 


interviews. They're not really looking at what 

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cancers are being compensated and all. They're 


looking at -- well, Fernald has been 


compensated, so many of the people at Fernald 


have been compensated, and they're comparing 


that with other facilities that have a higher 


percent and they're wondering why. Why aren't 


we receiving compensation -- as a group. 


 MS. MUNN: Yeah. 


 MR. GRIFFON: Right. 


 MS. MUNN: Any -- anybody who -- certainly 


anyone who knows anything at all about the 


existence of an SEC is going to question that. 


 MS. ROBERTSON-DEMERS: Sure. 


 MR. GRIFFON: That's right, yeah. 


 MS. MUNN: So? 


 MR. GRIFFON: Well, can we go on to finding 


nine, Proc. 5, finding nine. 


 MS. MUNN: Yeah. 


 MR. GRIFFON: I have a question on that, 


without having the full report in front of me. 


It says that NIOSH would consider the revisions 


-- or revising based on the comments, but I 


think there's a whole list of specific comments 


in that section. Am I -- am I right about 


that? 

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 MS. MUNN: Yeah, there's --


 MS. ROBERTSON-DEMERS: You're right. 


 MS. MUNN: -- a whole bunch of them, whatever 


the gaps were. 


 MS. ROBERTSON-DEMERS: I -- I looked -- I've 


been looking at the most recent version of the 


questionnaire, and they have made some 


improvements, but it's not all-encompassing of 


the suggestions that were made in the review. 


 MS. MUNN: Were the most significant points 


covered, do you think, Kathy? 'Cause I don't 


know what the most significant points were. 


 MS. ROBERTSON-DEMERS: Well, just as an -- just 


as an example, we said that you hadn't included 


in vivo counting and now it's included. I 


think that's going to be part of the review of 


Procedure 90. 


 MR. HINNEFELD: I think that the revisions that 


were made to the questionnaire actually 


occurred independent of this procedures find-- 


of the report of the procedures review, so 


there are -- there are a lot of suggested items 


in the review -- in the procedure review 


report. I think that it would serve well to 


have -- to me, the logical audience are the 

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dose reconstructors, and are there things that 


-- or at least at that CATI as to these 


questions, would we have a better product, a 


better compilation of information available to 


you at the time you do the dose reconstruction. 


So we think there's probably some -- some merit 


to taking a look at the -- at the interview 


form and -- to see if there's some adjustment 


that should be made, so -- again, that -- 


 MR. GRIFFON: I think this goes back to our 


earlier discussions, doesn't it, of -- you 


know, just whether -- what -- whether are you 


can change the interview, to what extent you -- 


you know, if you have to get OMB approval to 


change the interview --


 MR. HINNEFELD: Well, we would have to do that. 


DR. NETON: Yeah. 


 MR. GRIFFON: Yeah, or can you -- can you have 


notes to assist the interviewer, and to what 


extent will these be effective in -- in the 


whole DR process. Is it really worth the time 


and effort, so I think if -- we covered a lot 


of this in the earlier discussions, didn't we? 


 MS. MUNN: I think so. 


 MS. ROBERTSON-DEMERS: Yeah. 

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 MS. MUNN: I'm not sure whether there's any 


action to produce some kind of an outstanding 


list of what has not yet been addressed that 


remains a concern. 


 MS. ROBERTSON-DEMERS: I think that will come 


with the review of Procedure 90. 


 MS. MUNN: Okay. 


 MR. GRIFFON: Well, I guess maybe an action on 


-- on it -- it -- OCAS says here they will 


evaluate revising, so maybe, you know, a -- a 


detailed account of that evaluation would be 


useful. 


 MS. MUNN: Well, I thought I was hearing that 


the revisions had been done or had been 


incorporated in 90 or 92. Did -- did I not 


hear that? 


 MR. HINNEFELD: Well, the --


 MS. MUNN: I heard the wrong thing? 


 MR. HINNEFELD: -- the interview --


 MR. GRIFFON: That's the procedure versus the 


interview. 

 MR. HINNEFELD: Yeah, there's -- there's a 

questionnaire. There's an interview 

questionnaire. 

 MS. MUNN: Yeah. 

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 MR. HINNEFELD: That's what we're talking about 


taking a look at, seeing, you know, with the -- 


there's quite a number of them suggested in the 


proce-- in the report, in SC&A's report when 


they reviewed the procedures. There's quite a 


number of things that -- an example of things 


that maybe should be included in the interview 


questionnaire. And so what we're saying here 


is we will -- we will take a look at those and 


maybe -- and other things. You know, we've got 


dose reconstructors who've done 12,000 dose 


reconstruction reports. Maybe they have their 


own ideas about it would be -- 


 MS. MUNN: Yeah. 


 MR. HINNEFELD: -- you know, it would be good 


for the CATI to ask these things, as well, and 


decide, you know, are we getting the 


information we want. Now once we decide that, 


then the process of revising the questionnaire 


will take a long time because there'll be the 


OMB clearance requirement in order to get the 


questionnaire changed. So -- you know, so --


you know, weighing -- we'll have to weigh is 


the additional information that we would get 


from the revised interview and the -- for dose 

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reconstructions, is that enough -- you know, 


significant enough change we want to go ahead 


and pursue that, knowing full well that it'll ­

- maybe a year before we actually start 


gathering it in interviews. 


 MS. MUNN: Yeah, the real question is is it 


worth it and do we have the -- the resources to 


do it, what'll it buy us when it's all done. 


 MR. HINNEFELD: Well, I think we can -- you 


know, we can take a -- the first step, the 


evaluation step, we should be able to do. I 


mean the eval-- the evaluation step is just 


sort of process improvement that you do all the 


time. You know, what are we doing and are 


there ways to improve it. I mean that's just 


something that we should all be doing, so I 


don't mind doing the evaluation part. Now I 


can't promise an outcome of what will happen in 


the evaluation part. 


 MS. MUNN: Good, an evaluation will occur and 


we will take a look at it. 


 MR. HINNEFELD: Right. 


 MS. MUNN: Good. 


 MR. GRIFFON: That sounds good. 


 DR. WADE: And maybe for the record, Hans has 

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used the word "optics", the optics of the 


process. The Board needs to decide the advice 


it wants to offer on the scientific quality of 


the dose reconstruction, and then consider 


whether it wants to comment on the optics of 


the process. And those are very different 


issues. And again, I think the Board needs to 


discuss that and decide the advice it wants to 


offer. 


 MS. MUNN: When people are saying optics today, 


optics to me means something that my 


optometrist does or how I see a thing. Are we 


talking about the appearance -- 


 DR. BEHLING: Yes. 


 MS. MUNN: -- of things --


 DR. WADE: I think that's how Hans used the 


term. 


 MS. MUNN: -- to --


 DR. BEHLING: Yeah. And I -- and I think 


people feel that they're an integral part of 


the process and that may have an emotional -- 


it's like a doctor who's a very good doctor, 


but doesn't explain to his patient what the 


problem is. The patient feels short-changed, 


that he's not part of the process, even though 

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he is not -- as a medically-qualified person to 


affect the diagnosis or the treatment of his 


problem. But in just simply discussing it with 


the patient, there's a tremendous amount of 


benefit that the patient receives from having 


had the benefit of the discussion. 


 MS. MUNN: So you're saying how does this look 


to the claimant --


 DR. BEHLING: Yes. 


 MS. MUNN: -- specifically when you're saying 


optics. Okay, how does -- 


 MR. PRESLEY: This is Bob Presley. You want to 


say perception. 


 MS. MUNN: Yeah, the client's perception -- 


 MR. PRESLEY: That's correct. 


 MS. MUNN: -- specifically, because how the 


outside world sees it and how a senator sees it 


is an entirely different thing to how the 


claimant sees it, so --


 DR. WADE: And that -- and that's separate from 


the issue of the quality of the dose -- 


 MS. MUNN: Yes. 


 DR. WADE: -- reconstruction. 


 MR. PRESLEY: That's right. 


 DR. WADE: It's not that it's not valid. 

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 MS. MUNN: No. 


 DR. WADE: But they're different issues and the 


Board needs to decide how it wants to advise. 


 MR. GRIFFON: Well, yeah, it's separate from 


the -- it -- it's definitely separate from the 


scientific validity of the -- of the DR. Maybe 


it's part of the quality -- 


 DR. BEHLING: Well, the one thing that -- 

 MR. GRIFFON: -- (unintelligible) 

 DR. BEHLING: The one thing I was going to ask 

is when -- when you look at the regulations and 


you look under the section of hierarchy of 


data, we talk about obviously number one is the 


records themselves that take priority over 


everything else, and then you have obviously 


coworker data, and then you have source term 


reconstruction. I find nothing that is 


critically related to the CATI report as a 


source of information that is entered into this 


hierarchy for dose reconstruction. I think 


this is perhaps where a problem comes in at 


where the people who are being interviewed feel 


that they have a critical role to play, but all 


too often they don't perceive that that has had 


any impact on the dose reconstruction process 

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because the regulations don't even address it. 


DR. NETON: Well, I'm not sure about that, 


Hans. I mean it clearly says in the 


regulations that the claimant's assertions will 


be taken at face value unless they can prove 


them to be essentially false, so it's -- the 


burden is on us to take the CATI interview and 


demonstrate conclusively that what they said 


can't be true. 


 DR. BEHLING: Well, in that case we're 


delinquent because if there are issues, for 


instance, that says there are no records for 


you to have been monitored internally because 


they're simply not there, and the CATI report 


states that yes, I was monitored externally and 


I was faithfully monitored internally, I -- I 


don't see there --


DR. NETON: But we're not -- we're not required 


to go back and obtain those records if they do 


not exist, but I think the dose reconstruction 


would demonstrate that we were -- we used data 


that -- a valid substitute for those datapoints 


that we couldn't obtain. We're not arguing the 


fact that he wasn't monitored. We don't -- we 


don't assert that he wasn't monitored if we 

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couldn't obtain those monitoring records, and 


we're using a substitute for that. It's --


we're not -- it's a little different issue, I 


think. 


 DR. BEHLING: Well, in most instances the -- 


the report usually states that while they -- if 


they acknowledge that there is a discrepancy, 


the assumption is always that well, we gave you 


the 12 or 28 and that should take care of it. 


DR. NETON: Right, and that brackets on -- 


that's a bracketing surrogate bounding approach 


that we've adopted. I don't think there's 


anything inconsistent with that in our 


regulations. 


 MR. ELLIOTT: Is it your sense that the -- the 


people that we interview and the claimants we 


give a dose reconstruction report to don't 


realize and understand that all of the data 


that we've collected, including the CATI, 


including the DOE submittals to us, including 


all correspondence, is all rolled up into what 


is called a -- we call it an analysis file that 


supports the dose reconstruction report? Are 


we -- are we missing our audience on that 


point? 

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 MR. GIBSON: Could you say that again, Larry? 


I didn't hear you. 


 MR. ELLIOTT: Well, I'm wondering whether or 


not, you know, the claimants just see the dose 


reconstruction report and think that's the end 


of, you know, the NIOSH effort and that's all 


that the NIOSH effort is going to say about 


their claim, when in fact we give over to the 


Department of Labor what we call a full 


analysis record, an AR, and that's what you 


folks have been reviewing. You know, it's all 


of that information. I'm just wondering if the 


claimants don't realize that and that's part of 


the problem they think their CATI has not been 


used. We -- I -- I grant you we don't give 


enough credit in the report to say here's how 


your CATI information was used or not used. 


It's -- it's just a -- it's a hand-off. It's a 


throwaway, almost. It's -- and we could do a 


better job in speaking about what we used or 


didn't use there and why, but maybe they missed 


the point that we've given all of that 


information up. 


 MS. ROBERTSON-DEMERS: I think that --


 MR. GRIFFON: I -- I think what Stu said 

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earlier is -- is -- and that's why we're -- 


we're waiting to see the -- the revision of the 


-- the DR report language, the boilerplate 


language, 'cause this -- this kind of was 


brought up in the first set of cases, you know, 


and I think you're right that -- that there was 


-- it wasn't -- it wasn't that, as Jim said, 


most of these cases, you know, would have 


bounded any incidents that they were involved 


in, but the fact that they per-- you know, they 


thought they provided information that wasn't 


even considered, and it wasn't brought up in 


their DR report, then they thought well, why am 


I even bothering giv-- you know, so I think -- 


I think to some extent you -- you -- I think 


you have probably -- I mean we haven't seen the 


final draft yet, but you've -- you've taken 


that into account and -- and are modifying the 


DR report language so I think that -- that's 


helpful. 


DR. NETON: Yeah, that -- that's a very 


difficult concept to explain. I mean they -- 


 MR. GRIFFON: Right. 


DR. NETON: A person has a very personal impact 


of what happened to them at the site. A good 

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example is this -- this assertion of many 


people at Savannah River that they ate nuts and 


berries and it wasn't addressed in the dose 


reconstruction. Now most health physicists 


look at that and say there's millirem involved 


here, very trivial. But to them it's a very 


real thing and it needs to be addressed and 


brought out, and we've learned our lesson there 


and gone back and gone out of our way now to 


try to communicate that. But that's a very 


small example, but that happens many times in 


all these dose reconstructions I think. 


 MS. MUNN: You'll get a lot of that at Hanford, 


too. 


DR. NETON: Yeah, environmental exposures or 


some --


 MS. MUNN: Uh-huh. 


DR. NETON: -- some particular incident strikes 


out -- strikes a person's mind that even if 


they were --


 MS. MUNN: He ate the fish all the time, yeah. 


Uh-huh. 


DR. NETON: We can certainly do a better job 


there. 


 MR. HINNEFELD: Well, kind of on the topic of 

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finding number ten here, which is information 


from the CATI being used, there's been an 


evolution of the language in the dose 


reconstruction reports that today we are much 


more attentive to -- if -- you know, whatever 


the claimant relates in the CATI is addressed 


in some fashion in the dose reconstruction 


report in the dose due to incident section. 


You know, they assert this and they assert 


that, and we discuss them in there. We may say 


things like the -- the hypothetical intake that 


was assigned was certainly bounding for the 


situation that the claimant is describing here. 


But we have in fact -- we are now, today, a lot 


more attentive to that specific issue, is what 


the claimant told us in the CATI addressed in 


some fashion in the dose reconstruction. We're 


a lot more attentive to that today than we were 


say two years ago or two and a half years ago 


in the dose reconstructions that were being 


done at that time. So -- I mean the fact that 


we haven't come out with our new modified dose 


reconstruction that we think will improve 


communication to the claimant doesn't mean we 


haven't made language changes along the way 

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that have tried to improve the 


understandability in -- of these -- of these 


topics. So I am thinking -- you know, while 


the procedure -- well, Procedure 5, which is -- 


you know, that work in Procedure 5 is executed 


well before the dose reconstruction is done, so 


you can't really put in Procedure 5, you know, 


the requirement to explain why you didn't 


include some of the information in the dose 


reconstruction. I think we're kind of 


addressing that now. I think --


 MR. GRIFFON: Right, I think back in --


 MR. HINNEFELD: -- we're making sure we hit 


that now. 


 MR. GRIFFON: -- your DR report comment, you 


know, you -- modifications as you've gone 


along, yeah. 


 DR. BEHLING: Can I ask a question with regard 


to the information that you receive from the 


DOE in behalf of the dose reconstruction 


effort. Is that information shared with the 


claimant himself? I think it would be helpful 


if they saw that -- like what we get are 


sometimes hundreds of pages of dosimeter 


readings for each cycle, shallow dose, deep 

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dose, neutron components, tritium bioassays, 


urine bioassays, whole body counts, chest 


counts. If they understood that this is really 


the source of data that is really in many 


instances the full -- the driver of the dose 


reconstruction process, they would realize the 


-- the importance of that data and put their 


CATI information in perspective in saying well, 


you know, this is the best semi-quantitative 


information that can certainly not override the 


definitive and quantitative data that has been 


supplied by the DOE. Is that -- am I asking a 


question that has an answer? 


 MR. HINNEFELD: Yeah. 


 DR. BEHLING: Do people get that information? 


 MR. ELLIOTT: I think that's part of the 


script, isn't it, that they go over in part of 


the interview? 


 DR. BEHLING: But do they actually have the -- 

 MR. ELLIOTT: They say this is what we got from 

DOE? 

 DR. BEHLING: Do they have the records 

themselves? 

 MR. HINNEFELD: The claimant -- the claimant -- 


 DR. BEHLING: Are they entitled to get those 

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records? 


 MR. HINNEFELD: They're entitled -- they're 


entitled to it if they -- if they ask for it, 


they're entitled to --


 DR. BEHLING: You know, I think it would be 


helpful if they were told listen, if you want 


those records, you are in the position to -- 


under the Freedom of Information Act -- to get 


those records to verify the voluminous amount 


of information that we have had at our disposal 


in reconstructing your dose. And they would 


probably feel impressed by how much information 


-- in many cases, now not always, but in many 


cases they would be impressed by the volume of 


information that has been used in 


reconstructing their dose. 


 MR. GRIFFON: Do they have to go through the 


FOIA process to get it? 


 MR. ELLIOTT: Yes. 

 MR. GRIFFON: They do? 

 MR. ELLIOTT: Yes. 

 MS. MUNN: Yeah. 


 MS. ROBERTSON-DEMERS: The other thing that 


that would do is to help them identify gaps. 


For example, if the --

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159

 MR. ELLIOTT: Well, I'm sure it's part of the 


script that they talk about the information 


we've got, they talk about the years it covers, 


they talk about the numbers in it if the person 


wants to hear that and asks the question. I 


believe it's part of the interview, is it not? 


 MR. HINNEFELD: I don't -- I don't recall. 


 MR. ELLIOTT: It's not in the list of 


questions. It's one of those follow-up 


questions that you give as you work through the 


interview with the interviewee. 


DR. NETON: I don't think we offer them an 


opportunity to issue a FOIA request, though. 


Nothing that (unintelligible) -- 


 MR. ELLIOTT: If they ask, they --


DR. NETON: If they ask (unintelligible) -- 


 MR. ELLIOTT: -- (unintelligible) directed to 


do. 


 DR. BEHLING: Does the CATI have access to the 


large DOE data file that comes with the dose 


reconstruction during the closeout interview? 


 MR. ELLIOTT: The CATI folks have access to -- 


 MR. GRIFFON: Well, that's number 11 now you're 


on. Right? 


 MR. ELLIOTT: They have the access to NOCTS, to 

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the case file and (unintelligible) -- 


 MR. HINNEFELD: You know more about the 


interviews --


 MS. ROBERTSON-DEMERS: Yeah, but the case file 


 MR. HINNEFELD: -- than the rest of us. 


 MS. MUNN: Yeah, I was going to --


 MS. ROBERTSON-DEMERS: The case file is 


requested in parallel with the interview. 


DR. NETON: We may not have the DOE information 


at that time. 


 MR. HINNEFELD: Right. 


DR. NETON: I mean we try to get an interview 


out within a couple of weeks of when the case 


comes in. More often than not we're not going 


to have the DOE response in our possession at 


that point. Earlier on that was true when we 


were behind --


 DR. BEHLING: It would be important to have it 


as part of the closeout. At that point you 


have come to some reasonable understanding of 


what the doses are and -- 


DR. NETON: Well, you have to be careful, 


because oftentimes we don't get these for 


individuals. We get bundled packages where 

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we're going to have to redact a lot of 


information to respond to a FOIA request, and 


then when you start offering something that you 


can't produce in a timely manner, you're going 


to --

 MR. ELLIOTT: One name on 50 pages with 100 

other names. 

 DR. BEHLING: No, I realize that -- that's a 

problem. 

DR. NETON: There are timing issues. 


 DR. BEHLING: That's a problem. 


DR. NETON: We may have every legal right to do 


that and they may have every right to -- 


 DR. BEHLING: I mean most of --


DR. NETON: -- ask for it. 


 DR. BEHLING: -- the dosimetry records is 


usually a page and has a single line that 


underscores that individual. 


DR. NETON: Right, so that's what I'm saying, 


if you offer it at the time of the closeout, it 


could take us months to get this through the 


FOIA process. 


 MS. MUNN: It would be very --


 MR. GIBSON: This is --


 MS. MUNN: -- unwise. 

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162

 MR. GIBSON: This is Mike Gibson. If I could ­

- you know, I -- I think that's probably good 


information to show them how intense that you 


go into these dose reconstructions, but to give 


them a two-inch stack of data, even if they go 


through the FOIA process, what I seem to hear 


from the people when they make their public 


comments is more of the missed dose, more of 


the missed incidents or the things that weren't 


con-- they don't believe were considered and 


may not have been considered, and may not have 


even been recorded, that -- that NIOSH doesn't 


have record of, rather than just showing them 


that you've really went through an exhaustive 


process of the information you do have. 


 MS. MUNN: But if they believe there are missed 


doses, and if they believe there were missed 


incidents, they would have reported that in the 


CATI. And NIOSH is required to take that into 


consideration. Right? 


 MS. ROBERTSON-DEMERS: Can I -- can I bring up 


something with regard to incidents? It's not 


always clear to people what an incident is, so 


some of them will compensate for it by telling 


everything and some of them will just flat-out 

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say no, where there may be an incident present, 


because they don't know what it is. 


 MS. MUNN: But how can we get them to... 


 MS. ROBERTSON-DEMERS: Well, in that case, I 


would add it to your terms. 


 MR. GIBSON: This is Mike again, Wanda, and 


what I -- what I meant is two things. A 


survivor may not know of a missed -- an 


unmonitored dose where I mean in an atmosphere 


with a radionuclide present at -- maybe once 


they exited the area they were bioassayed for 


plutonium but not for some other isotope. The 


claimant or the survivor may not even -- they 


may have, you know, known that by some other 


reason, and the contractor may not have done 


that, and NIOSH has no way of proving or 


disproving that that other isotope was there, 


and that seems to be what I hear is they -- you 


know, there was this incident about these 


unmonitored doses, these unmonitored isotopes, 


and you know, granted, there's no way NIOSH can 


go back and prove or disprove that, but that's 


what I hear from -- it seems like I hear from 


the people. 


 MS. ROBERTSON-DEMERS: I also ran into a 

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situation where this gentleman showed me his -- 


his dose record, and there were a lot of zeroes 


in the extremity monitoring field. I think he 


requested it through DOE. And he says I was 


never monitored for that. So then seeing some 


sort of summarized version may help them help 


NIOSH by identifying missing items. 


 MR. HINNEFELD: Well, one of the -- the fact 


is, does the claimant hear this stuff? Right 


now some dose reconstructions will include this 


was what the DOE reported as your total 


recorded dose -- we don't do it in every one, 


but some of them say that. What we intend to 


do with the new format is to explain to the 


claimant what records we have. We won't 


necessarily say page numbers, but we'll say we 


have a monitoring record for you that says you 


were monitored for external -- you know, 


externally from this year to this year, and 


internally from this date to this date via 


(unintelligible) --


 MR. GRIFFON: Where does -- where does -- Stu, 


where does that occur or when does that occur? 


 MR. HINNEFELD: That would be in the dose 


reconstruction report. 

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165

 MR. GRIFFON: In the report, right, okay. 


 MR. HINNEFELD: And so -- so they will see -- 


they will have the opportunity at that point to 


say that sounds right or this doesn't sound 


right, and a closeout interview -- we would 


have an opportunity to correct or fill in 


information that's missing. See, at the CATI 


interview we may not yet have the DOE response. 


We may not be able to do it at that point. 


 MR. GRIFFON: I'm looking at finding 11 here, 


at the closeout interview will the interviewer 


have -- then they'll have everything. Right? 


They'll have the full file available for them? 


 MS. MUNN: Yes. 


 MR. HINNEFELD: It's all available to them, 


right. 


 MR. GRIFFON: So at that point they -- would 


they likely attempt to discuss inconsistencies 


or is that beyond the scope of the closeout 


interview? 


 MR. HINNEFELD: Closeout interviews talk about 


a lot of topics and there are many -- many 


situations, based on a closeout interview, that 


require us to go back and revisit the dose 


reconstruction or pursue different -- 

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additional information. I mean --


 MR. GRIFFON: Right. 


 MR. HINNEFELD: -- that's not particularly 


uncommon for a -- for a case to get pended at 


closeout interview time while we try to chase 


down something that we were told during 


closeout interview. 


 MR. GRIFFON: Well, I'm specifically trying to 


get ahold of your -- get a handle on your 


response for finding 11. The interviewer's not 


required to have that DOE file with them or -- 


or on their computer screen when -- 


 MR. HINNEFELD: Procedure 5 is the CATI 


interview. 


 MS. MUNN: CATI. 


 MR. GRIFFON: Oh, it's -- oh, Procedure 5 is 


the CATI, that's right. Okay. So at that 


point they wouldn't necessarily even have -- 


'cause that occurs before you get all that 


information sometimes. 


 MR. HINNEFELD: It can. 


 MR. GRIFFON: Is that what I heard? Okay. 


 MR. HINNEFELD: Right, it can. 


 MS. MUNN: Should we add a sentence to the end 


of that that says this is covered by the 

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closeout interview, to keep there from being 


any further question about whether or not 


that's a closed item? 


 MR. HINNEFELD: You mean our response? 


 MS. MUNN: Yeah, I'm trying to figure out ways 


to close out --


 MR. GRIFFON: Yeah, that --


 MS. MUNN: -- the items on this list. 


 MR. GRIFFON: -- that's what I'm thinking, too. 


 MS. MUNN: Okay, that one's done. 


 MR. GRIFFON: Can -- can you say --


 MR. HINNEFELD: I can do all sorts of stuff 


with the NIOSH response column, yeah. 


 MR. GRIFFON: I mean is NIOSH -- yeah, is NIOSH 


willing to say this is required for the 


closeout interview? 


 MS. MUNN: Can we say that? This occurs at the 


closeout interview. Right? 


 MR. ELLIOTT: Sure, I think we can make that, 


can't we? 


 MR. HINNEFELD: I think so. 


 MR. ELLIOTT: That it's available. 


 MR. HINNEFELD: It's available. 


DR. NETON: I'm not sure it's required. 


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to be at the interview, it's available to the 


interviewer. 


 MR. GRIFFON: Well, that's different. 


Available is different than -- than requiring 


the interview to have it. I mean I'm not 


saying it's -- it's not acceptable, but I'm -- 


 MR. HINNEFELD: I think -- I think the solution 


to this question about having the claimant -- 


if the question is does the claimant know what 


records we had available to them, you know, on 


them, on the case, I think the -- the fix is, 


the new dose reconstruction format, when you 


have a section for the claimant that says this 


was the -- these were the monitoring records we 


had that the DOE sent for us -- sent on this 


claim, this is what was available to us 


(unintelligible) monitoring records. We'll 


probably also put in there this was your total 


reported dose from the Department of Energy, 


and with the suitable caveats because 


frequently the Department of Energy didn't 


throw in any dose from their internal 


monitoring. They may have a long internal 


monitoring record with no calculation 


associated with it, so we have -- we're -- we 

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have to try to ca-- we have to put in the 


information we want to put in without making 


this too long and too technical and too hard, 


so it's going to be a little difficult to put 


this together because all this stuff -- 


everything we want to tell them has got to be 


caveated in some way or another. So --


 MR. GRIFFON: Now -- now Stu, I agree with 


that. I'm -- I'm just saying it -- it would be 


different to -- I think if I were interviewer 


and I was required to have the person's full 


DOE with me when I did the closeout interview, 


that -- to me, as the interviewer -- would say 


well, I better -- I better darned well flip 


through this and -- and compare it with the 


CATI interview and -- and, you know, be 


prepared to address inconsistencies, discuss 


inconsistencies, et cetera -- as opposed to is 


available. That just tells me well, now if 


this guy raises some question on the phone, I 


might have to pull this DOE file out; otherwise 


I can probably just close this out. 


MR. ALLEN: Well, Mark, it's important to 


realize -- this is Dave Allen. It's important 


to realize it doesn't have to be a one-shot 

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deal on this -- this closeout interview. If --


 MR. GRIFFON: True. 


MR. ALLEN: -- if the questions become 


technical, the interviewers will often tell 


them that they'll have to have somebody more 


technical call them back. They get ahold of 


the -- usually the HP that did the dose 


reconstruction and they set up a new schedule 


to call them back, finish it off. 


 MS. MUNN: Can we just close this out by saying 


the DOE file is available to the interviewer at 


the closeout interview -- at the time of the 


closeout --


 MR. GRIFFON: That -- that -- that's -- that's 


what I was just discussing, Wanda. 


 MS. ROBERTSON-DEMERS: I think Mark's saying -- 


 MR. GRIFFON: Available or required --


 MS. ROBERTSON-DEMERS: -- that it should be a 


requirement --


 MR. GRIFFON: -- is different, that's all, you 


know. 


 MS. ROBERTSON-DEMERS: -- that they've looked 


through it. 


MR. ALLEN: Most claimants don't have a lot of 


questions on the actual file itself, so -- I 

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mean it seems --


 MR. GRIFFON: Well, that -- that -- that's -- 


that's sort of my point. 


 MS. ROBERTSON-DEMERS: Actually --


 MR. GRIFFON: You know, my point is not to be 


passive but to be proactive, that the 


interviewer would -- would, you know, have one 


last look at this. I mean I know that the dose 


reconstructor is the primar-- you know, but the 


closeout interviewer -- 


 MR. HINNEFELD: I think the only --


 MR. GRIFFON: -- would also --


 MR. HINNEFELD: -- way to do this and be fair 


to the interviewer is to have a summary of some 


sort, like (unintelligible) describe the dose 


reconstructor --


 MR. GRIFFON: Right, right, right. 


 MR. HINNEFELD: -- because these things are 


hundreds of pages long. Sometimes you get the 


same information multiple times in different 


formats --


 MR. GRIFFON: So they'll definitely -- 


 MR. HINNEFELD: -- and to have it -- have the 


interviewer go through it and -- and be able to 


talk to the claimant knowledgeably about it I 

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don't think is a realistic expectation be-- 


 MR. GRIFFON: I think you just answered my 


question, Stu. So the interviewer will 


definitely have the -- the -- this revised DR 


report format in front of them -- 


 MR. HINNEFELD: Yeah. 


 MR. GRIFFON: -- the whole DR report --


 MR. HINNEFELD: Oh, yeah, they'll have the DR 


in front of them. 


 MR. ELLIOTT: Are we still talking about the 


NIOSH column? 


 MR. GRIFFON: So -- and then the other -- the 


other should be available. I agree with that 


then, okay. 

 MR. ELLIOTT: Are we still --

 MR. GRIFFON: 'Cause you're going --

 MR. ELLIOTT: -- talking about the NIOSH 

column? 

 MR. HINNEFELD: No, no. No, no. 


 MS. MUNN: I am. 


 MR. HINNEFELD: I think --


 MR. ELLIOTT: I think you are, yeah. 


 MR. HINNEFELD: The NIOSH column should be -- I 


think the resolution of the issue would be the 


revised DR structure and having a summary of 

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the monitoring record, what -- that we received 


in that, in the dose reconstruction. 


 DR. BEHLING: I think part of the salesmanship 


should be to convince the person that what has 


been done was done with as many records as are 


available. Here are the records, and there's 


credibility behind the dose reconstruction 


process, and when there are gaps or 


uncertainties that the individual was given the 


benefit of the doubt by such things as 


hypothetical intake, et cetera. And I think it 


-- it's part of the salesmanship that says we 


didn't fish these numbers out of thin air. 


They're part of a record, and when they're not 


part of a record we've given you the benefit of 


doubt by putting in missing doses for neutrons 


and photons and hypothetical intakes, et 


cetera, et cetera, and in the process perhaps 


assure the individual that what he has been 


assigned as a dose is -- is perhaps -- if it's 


not just fair, it's perhaps more than fair and 


claimant-favorable and -- and satisfy that 


curiosity, how did you come up with these 


numbers. 


 MR. ELLIOTT: I would say the NIOSH column 

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should say that we are going to roll out this 


new dose reconstruction report and implement 


it. To roll it out we're going to have to look 


at our script language that is used, not only 


for the CATI but for the closeout interview, 


and make sure that there are certain goals that 


is -- is to -- that are defined to be the 


purpose of that closeout interview. And many 


of what you just outlined for us, Hans, I think 


are central to that. I think we could commit 


to that, we need to look at our script, we need 


to carefully consider how to roll out, you 


know, this new dose reconstruction reporting 


mechanism and tool and -- and take in account a 


lot of what we've heard here this morning. 


 MR. GRIFFON: Yeah, I -- I think -- Stu, I 


apologize, I think you just answered number 11 


for me. I -- I think if -- Wanda -- I think 


you were saying the same thing. If we revise 


the NIOSH response, add on a last line saying 


DOE file will be available at the closeout 


interview, I think that satisfies it -- for me, 


anyway. 


 MS. MUNN: Just enhance it so that it meets 


Hans's test for bedside manner, which is really 

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 MR. GRIFFON: Well, and --


 MS. MUNN: -- what we're talking about here. 


 MR. GRIFFON: -- but -- and there's a 


difference between the DOE file and the DR 


report --


 MS. MUNN: Yes. 


 MR. GRIFFON: -- and that's what I was -- I was 


 MS. MUNN: Yes. 


 MR. GRIFFON: -- sort of merging those two, but 


the DR report will be in the hands of the 


interviewer so -- at the closeout interview, so 


-- and -- and the enhanced DR report will have 


more of this -- you know, that -- that chance 


for the interviewer to look down and -- and 


sort of look for these red flag things as 


they're doing the closeout interview. That's 


kind of what I was getting at, and I don't 


think you necessarily need the whole DOE file 


to be able to do that. 


 MS. MUNN: No. 


 MR. GRIFFON: At least with this enhanced 


report as described, yeah. 


 DR. BEHLING: In fact --

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 MR. GRIFFON: Right. 


 DR. BEHLING: -- Mark, the full DOE file, 


especially since in many instances will be 


issues involving periodic urinalysis, chest 


counts -- it's almost undecipherable to someone 


who's not familiar with the format of the 


records or understands their content. You 


can't possibly explain that to -- 


 MR. GRIFFON: Oh, no, yeah, yeah. 


 DR. BEHLING: -- especially -- unless you are a 


dose reconstructor and bona fide health 


physicist, those records would mean very 


little. But for instance, the summary external 


dosimetry sheet, which does not involve other 


people's data, might be a very useful tool that 


says we have records that you were monitored 


for external neutrons, external photons, and 


these are the numbers, and these are the 


additional val-- assignments that we gave for 


those cycles where the report came back as a 


zero, so these are all the things that we added 


to that number. And I think people probably 


have a pretty good -- especially if it's the -- 


he himself who's being interviewed here, he 


will have a pretty good understanding what his 

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lifetime dosimetry was -- 


 MR. GRIFFON: Right. 


 DR. BEHLING: -- and he will get to understand 


that the records are accurate, that the records 


have been amended for missed doses involving 


zero or blanks, et cetera, et cetera. And I 


think that would probably be a very useful 


component as part of the closeout interview. 


 MR. GRIFFON: Yeah, I --


 MS. MUNN: Whoa, you went static. 


 MR. PRESLEY: Something happened. You still 


there? 


 MS. MUNN: Yeah, we're still here. 


 MR. GIBSON: Hello? 


 MR. PRESLEY: Hello? 


 MS. MUNN: Hello? 


 MR. GIBSON: I can hear you, Bob. 


 MR. PRESLEY: Hey. 


 MS. MUNN: Mark has overwhelmed us. 


 MR. PRESLEY: There's a tremendous amount -- 


 MS. ROBERTSON-DEMERS: I think we have a lot of 


static. 


 MR. PRESLEY: Tremendous amount of static on 


the line. 


 MS. MUNN: Sure is. 

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178

 DR. WADE: Okay, who's on the phone right now? 


 MR. PRESLEY: Bob Presley. 


DR. MAURO: John Mauro. 


 MR. GIBSON: Mike Gibson, and a lot of static. 


 MS. MUNN: Lot of static, yeah. 

(Pause) 

 MS. MUNN: Somebody's doing something that 

makes it go away. 


 DR. WADE: (Unintelligible) doing something 


right now is the source of the static. 


 MR. PRESLEY: I'm going to hang up and I'll 


dial back in. This is Bob Presley. 


 DR. WADE: Thank you. 


 MS. MUNN: Okay, thanks, Bob. 


 MR. GIBSON: I'm going to dial back in, too. 


 DR. WADE: Okay. 


 MS. MUNN: Thanks. 


 DR. WADE: Who else is on the line? 


 DR. LIPSZTEIN: I am, this is Joyce Lipsztein. 


 DR. WADE: Is it possible for you to hang up 


and dial back in? 


 DR. LIPSZTEIN: Okay. 


 MS. MUNN: Oh, wait --


 DR. WADE: Wait a minute --


 MS. MUNN: -- stop, stop. It went away. 

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 DR. WADE: Is anyone on the line? 


 MR. KOTSCH: I'm still here. 


 DR. WADE: Okay, you're good. Anyone else? 


 (No responses) 


Okay, let's see what happens as people dial 


back in. 


(Pause) 


We did pretty well for a while so we can't 


complain. 


 MS. MUNN: Have to tell Mark to get off that 


cheap phone. 


 MR. GIBSON: Mike Gibson, I'm back. 


 MS. MUNN: Good. 


DR. MAURO: John Mauro back, and I -- and I 


don't hear any static. 


 MS. MUNN: No. 


 MS. BEHLING: It was Mark. 


 MS. MUNN: Two of you are all okay -- three of 


you are all okay. Four, I guess. 


 MS. BEHLING: It's Mark. 


 (Whereupon, a recess was taken from 11:30 a.m. 


to 11:33 a.m.) 


 DR. WADE: (Unintelligible) will give us sort 


of a diversion from the -- the CATI interview 


discussions. This working group, which is the 

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working group that looks at individual dose 


reconstruction reviews, procedures reviews and 


two site profiles -- right now we're looking at 


Hanford and Y-12 -- had scheduled this -- 


 MR. GRIFFON: Rocky and --


 MS. MUNN: Not Hanford. 


 MR. GRIFFON: -- Rocky and Y-12. 


 DR. WADE: Rocky Flats -- Rocky Flats, so I 


have -- what did I say here? Rocky Flats and 


Y-12. 


 MS. MUNN: Yeah. 


 DR. WADE: Have scheduled a face-to-face 


meeting for Cincinnati on the 27th of February. 


That's two weeks from today. 


 MR. PRESLEY: Right. 


 DR. WADE: Mark has raised to my attention the 


fact that he has a conflict on that day. 


 MS. MUNN: Well, fix it, Mark. 


 MR. GRIFFON: And I picked these days out, too. 


 DR. WADE: Let me -- let me throw out some 


options, not all of them terribly attractive. 


One of the things we could -- Mark has a -- a 


conflict -- a personal conflict on the evening 


of the 27th that requires him to be home. 


 MR. GRIFFON: Right. 

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181

 DR. WADE: We could conceivably hold the 


meeting in Boston. We could conceivably 


involve Mark by telephone. We could reschedule 


the meeting. There are a number of options 


available to us. I thought we would have a 


discussion. Mark, do you want to say any more? 


 MR. GRIFFON: Yeah -- no, I mean or we could -- 


we could move it to the week prior. I know 


that -- that we've got a lot to do prior to 


that meeting, so --


 MS. MUNN: You're -- you're getting pale faces 


from NIOSH. I don't think they can do that. 


DR. NETON: Mark, we did plan on using every 


day up till that meeting to try -- 


 MR. GRIFFON: I figured that, yeah, yeah. 


 MS. MUNN: I don't have any problem with 


Boston. 


 DR. WADE: What about thinking outside the box 


and bringing the mountain to you? 


 MR. GRIFFON: Well, that's -- yeah, that'd be 


great. It's lovely this time of year. Yeah, 


23 inches of fresh snow in my back yard. 


 MS. MUNN: That's wonderful. All right. You 


can provide the skis. 


 MR. GRIFFON: Yeah. 

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 DR. WADE: Again, this -- NIOSH -- we usually 


meet here 'cause it's convenient for NIOSH, and 


what about taking your act on the road? 


DR. NETON: Well, we did -- we did plan on 


having a number of ORAU participants, and I 


don't know how that would -- 


 MR. GRIFFON: Yeah, I know that's --


DR. NETON: -- whether they're going to be -- I 


guess many of them are going to be from out of 


town anyway, so they're going to be traveling 


either way, so maybe that's not -- 


 MR. GRIFFON: The other -- the other question, 


Jim, maybe is if we moved in -- into like March 


6th. I don't know if that's too late, but I 


think you need more time rather than less, 


actually. 


DR. NETON: I don't disagree with that, Mark. 


I mean --


 MR. GRIFFON: You know, given what we talked 


about in the last calls, I'm -- I'm -- you 


know, there's a lot to be -- you know -- 


DR. NETON: Well, we --


 MR. PRESLEY: I don't have any problem with 


March 6th. 


 MS. MUNN: Well, I have a problem with it. 

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 MR. GRIFFON: Or that -- that week, I meant, 


that week in general, you know. 


 MS. MUNN: I have a problem with it, and one of 


the -- one of the problems that I have with it 


is you have to remember, this is not the only 


working group we now have. 


 MR. PRESLEY: Right. 


 MR. GRIFFON: Yeah. 


 MS. MUNN: And we have the NTS issues that are 


coming up --


 MR. PRESLEY: Well, that's what I --


 MS. MUNN: -- and we've already postponed that, 


we've knocked that off the 28th. And I guess 


my feeling is if we're going to start pushing 


this workgroup back into the 6th, then we're 


just really muddying the water for other -- for 


other workgroup schedules. 


 MR. PRESLEY: Well, what I was wondering about 


is if we pushed this thing back to the 6th, 


would we be able to do the 20-- the NTS on the 


7th? You know, that's -- that's -- 


 MS. MUNN: I -- I've got a caucus at my house 


on the 7th --


 MR. PRESLEY: Okay. 


 MS. MUNN: -- that is almost impossible for me 

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to change. 


 MR. PRESLEY: No problem. 


DR. NETON: I've got outside meetings in Oak 


Ridge on the 7th and 8th both, myself. 


 MS. MUNN: So my -- my suggestion would be we 


go to Boston, if it's possible for us to do 


that. 


 MR. PRESLEY: I've got no problems coming -- 


coming to Boston on the 27th if -- you know, 


if you can have this thing out at the airport 


where we don't have to go into town. 


 MS. MUNN: Yeah. 


 MR. GRIFFON: Yeah, there's a Hilton right at 


the airport. I don't know if that's the 


reason-- you know, I guess LaShawn will have to 


check that out, but... 


 DR. WADE: Well, let me take it as a task. 


We'll start to work it now and hopefully have 


you an answer even this afternoon. 


 MR. GRIFFON: All right. 


 DR. WADE: You know, flying to Cincinnati for 


some of us, or Boston, is not that different, 


just for the people in Cincinnati. 


 MS. MUNN: Yeah. 


 MR. GRIFFON: Right. Okay. 

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185

 DR. WADE: Okay. So Larry, pursuing the 


possibility of a Boston meeting, acceptable? 


 MR. ELLIOTT: Yeah, I think we'll -- we may be 


limited in number of staff we'll have available 


to attend, but --


DR. NETON: But they'll be on the phone, for 


sure. 


 MR. ELLIOTT: -- they'll be on the phone. 


 DR. WADE: Okay. 


DR. NETON: We'll try to get -- see what we can 


do. 


 DR. WADE: So let -- now again, for my 


edification, the 27th meeting was to focus on 


what issue? 


 MS. MUNN: Y-12 and Rocky. 

 DR. WADE: Okay, so both Y-12 and Rocky. 

 MS. MUNN: Yeah. 

 DR. WADE: Okay, I'll get to work over the 


lunch hour to see what we could do in terms of 


the Boston -- Logan Airport, and your job is to 


work on the snow, Mark, that's all. 


 MR. GRIFFON: Okay. We haven't -- it hadn't 


snowed all January, so I think we might be in a 


make-up mode here. 


 DR. WADE: That's encouraging. 

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186

 MR. GRIFFON: Yeah. 


 DR. WADE: Okay, back to the much more 


interesting business of discussing Proc. 5. 


 MR. GRIFFON: Yeah. So we're on Proc. 5 item 


12 now. Right? 


 MR. HINNEFELD: I believe this is the same 


issue that we've talked about earlier. 


 MR. GRIFFON: Yeah, and I think we've covered 


this. 


 MS. MUNN: That's done, and not much you can do 


about that. 


 MR. PRESLEY: There's one comment I have on 


what -- what Hans had a while ago about making 


available the data to these people. 


 MS. MUNN: Uh-huh. 


 MR. PRESLEY: It's my perception that -- that 


I'd say 90 percent of the people wouldn't know 


what they got. 


 MS. MUNN: I'd say 98 percent of them wouldn't 


know what they got. 


 MR. PRESLEY: I was giving them the benefit of 


the doubt. 


DR. MAURO: John Mauro, I'd take it a step 


further. I would -- I think in many cases 


it'll do -- cause more confusion and 

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frustration --


 MR. PRESLEY: Oh, I do, too --


DR. MAURO: -- than it would --


 MR. PRESLEY: -- definitely. 


DR. MAURO: -- relieve. 


 MS. MUNN: If our -- if one of our tasks is to 


make the claimants comfortable, then there are 


times when excess information does not meet 


that criteria. 


 MR. PRESLEY: I agree. 


 MR. GRIFFON: Yeah, I think -- I think we're 


better off focusing on improving the DR report 


rather than -- rather than, you know, making 


the DOE files readily accessible. I mean --


 MR. PRESLEY: I agree --

 MR. GRIFFON: -- they certainly have a legal 

right --

 MR. PRESLEY: -- 100 percent on that. 

 MR. GRIFFON: -- yeah. 

DR. MAURO: I'd like to add, I think we need to 


start thinking about bedside manner side as 


much as we're thinking about the technical 


side. 


 MR. PRESLEY: I agree there, John. This is Bob 


Presley. 

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 MR. GRIFFON: Okay. So let's -- let's move on 


with that -- those comments. Let's go to 13. 


I think we've -- we've got 12 under 


consideration under the other items, so -- I 


don't know that we can talk much more about 


that. 


 MS. MUNN: Yeah, I don't think so. Response is 


applicable to the earlier stuff. 


 MR. GRIFFON: Yeah. And number 13 --


 MR. HINNEFELD: 5-13 actually has two parts. 


The second part, CATI has many gaps, is one 


that was commented on earlier. We said --


 MR. GRIFFON: Right --


 MR. HINNEFELD: -- we were going to 


(unintelligible) --


 MR. GRIFFON: -- you're going to evaluate that 


so that falls under the evaluation step. 


Right? 


 MR. HINNEFELD: The interviewer training 


appears to be insufficient, at least in some 


cases. I think the only thing I can do maybe 


is provide you with a summary of the training 


they've received. It's not like they got their 


initial training and then stopped. I mean they 


do continuing education with them periodically, 

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and I can probably assemble a summary of it. 


Again -- and depending upon -- I think -- I may 


be naive, but I believe you'll find the 


interviewers, the ones who've been here for a 


while, and I think most of them have been here 


for quite a while, probably a lot more savvy 


today than they were two years ago when they 


were doing interviews, so -- but I can -- I can 


compile this training. ORAU feels that their 


interviewers are trained sufficient to the 


task, that they're trained to do what they're 


asked to do. 


 MR. GRIFFON: Okay. Yeah, I think providing a 


summary of the trai-- you know, a summary of 


the training would be good. 


 MS. ROBERTSON-DEMERS: Yeah, and we'd 


previously asked to see the DOE complex 


training module. 


 MR. HINNEFELD: Yeah, uh-huh. Right. 


DR. NETON: If we can release it. 


 MS. ROBERTSON-DEMERS: (Unintelligible) 


 MR. GRIFFON: Okay, number 14 is the coworker 


question, and I think this falls under the 


earlier discussion of coworker triggers. 


 MS. MUNN: Uh-huh. 

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 MS. ROBERTSON-DEMERS: Yeah. 


 MR. GRIFFON: You know, and -- and I think, you 


know, how that -- how that's worded 


specifically, but I think that should be 


considered, anyway -- how that's worded is up 


to NIO-- you know, NIOSH. 


 MS. MUNN: Yeah, this response seems adequate 


to me, based on our previous conversations 


about it. OCAS is going to include some extra 


language. Right? Isn't that --


 MR. HINNEFELD: Right. 


 MR. GRIFFON: And that's in the DR reports, but 


it does-- that doesn't speak to the -- and I 


agree that's good, but that doesn't speak to 


the question of whether -- whether or not to 


require coworker follow-up or when to require 


coworker follow-up, you know. 


 MS. MUNN: But I thought we'd already agreed -- 


there were earlier discussions that there was 


going to be an attempt to identify some 


criterion for that trigger. 


 MR. GRIFFON: Yes. 


 MR. PRESLEY: Right. 


 MS. MUNN: Didn't we agree to that? 


 MR. GRIFFON: That's what I'm saying, it falls 

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into that, yeah. 


 MS. MUNN: Yeah. 


 MR. GRIFFON: Yeah. I guess it's 


(unintelligible) --


 MR. PRESLEY: As required, yep. 


 MS. MUNN: As required -- when required. 


 MR. PRESLEY: Right. 


 MR. GRIFFON: Okay, I think we're on to fif-- 5 


number 15. 


 MR. HINNEFELD: Off the top of my head I don't 


remember the details of the comment. 


 MR. GRIFFON: Yeah, I think they were here -- 


 MR. HINNEFELD: I think it -- it may fall into 


the general discomfort with the claimant, 


though, with the interview questionnaire. 


 MS. ROBERTSON-DEMERS: Actually I --


 MR. GRIFFON: It looks like it does, yeah. 


 MR. HINNEFELD: Do you remember? 


 MS. ROBERTSON-DEMERS: I think I -- I think I 


remember this. When you ask about an incident 


and they say yes, you ask for follow-up 


information. When you ask other questions, you 


don't. And this -- this would go back to 


reviewing, as a part of the 90 procedure, the 


most recent interview. 

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 MR. GRIFFON: So does this fall under evaluate 


the gaps in the... 


 MR. HINNEFELD: Would it fit into that, 


evaluating gaps in the interview -- interview 


questionnaire? 


 MS. ROBERTSON-DEMERS: Yeah. 


 MR. HINNEFELD: Okay. 


 MR. GRIFFON: All right, so this falls under 


that earlier action, Stu. Correct? 


 MR. HINNEFELD: Okay. 


 MR. GRIFFON: All right. 


 MS. MUNN: Now --


 MR. GRIFFON: Now we're on --


 MS. MUNN: -- Proc. 17. 


 MR. GRIFFON: -- Proc. 17 --


 MS. MUNN: Yay. 


 MR. GRIFFON: -- (unintelligible), Wanda. 


 MS. ROBERTSON-DEMERS: And actually this one's 


been -- been replaced by Procedure 90 -- 


 MS. MUNN: Uh-huh. 


 MS. ROBERTSON-DEMERS: -- so it's going to be 


included in our review. 


 MS. MUNN: Yeah. 


 MR. GRIFFON: Well, they've all been kind of 


replaced by Proc. 90. Right? 

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 MS. ROBERTSON-DEMERS: Yeah. 


 MR. HINNEFELD: Well, in this -- in this case, 


Proc. 90 I think added additional information 


that Proc. 17 didn't have. 


 MS. ROBERTSON-DEMERS: Right. 


 MR. GRIFFON: Okay. So this first one on 


definitions --


UNIDENTIFIED: (Unintelligible) not in here. 


 MS. ROBERTSON-DEMERS: I think NIOSH had said 


something about NIOSH providing an explanation 


for how they had reviewed Proc. 90 in relation 


to some of these concerns. 


 MR. HINNEFELD: I don't recall that. But we 


have -- but we have to --


 MS. ROBERTSON-DEMERS: It was a -- it was a 


while back, yeah. 


 MR. GRIFFON: Okay, I think what -- I think 


you're right, Stu, that you say Proc. 90 is 


going to provide examples of what constitutes 


complete, so I think we -- we -- this is sort 


of -- the action on this is -- is we're going 


to review Proc. 90 as part of SCA's expanded 


scope. Right? 


 MR. HINNEFELD: Right. That one, I believe -- 


 MS. MUNN: Yeah. 

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 MR. HINNEFELD: -- has already been tasked to ­

- yeah. 


 MS. MUNN: Yeah, everybody's agreed to that, I 


think. 


 MR. GRIFFON: Okay, okay. So then number two 


we're on, I guess. All right, I guess --


 MS. MUNN: That's going to be covered, also. 


 MR. GRIFFON: Yeah, and this is a little re-- 


this is a little similar. It refers to Proc. 


5-01, finding 01. 


 MS. MUNN: Uh-huh. 


 MR. GRIFFON: As we look -- glance down here, 


are there any new that we haven't covered 


already in our discussions? That's the big 


thing, I guess. 


(Pause) 


 Reviewer qualif-- 


DR. MAURO: I don't see anything new -- if 


anyone else sees something new. 


 MR. GRIFFON: I'm looking at finding number 


five, reviewer qualifications, that -- that 


falls under the training, sort of? 


 MS. MUNN: Yeah. 


 MR. GRIFFON: Is that right? 


 MR. PRESLEY: Yeah. 

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 MS. ROBERTSON-DEMERS: In the familiarity with 


the complex. 


 MR. GRIFFON: I mean qualifications, to me, is 


sometimes different than just training. 
I 


don't know what SC&A meant by that, 


necessarily. 


 MS. MUNN: I think, based on what Kathy was 


saying, she was still concerned about whether 


or not the -- this was the concern about 


whether or not the reviewers had real knowledge 


of the site. 


 MR. GRIFFON: Of the site, right. 


 MS. MUNN: Yeah. 


 MR. GRIFFON: Not necessarily their educational 


background or things like that. 


 MS. MUNN: That wasn't my interpretation. 


Kathy? 


 MS. ROBERTSON-DEMERS: And knowled-- and 


knowledge of the claimant file and -- 


 MR. GRIFFON: Knowledge of the claimant's file 


and the site, right. 


 MS. MUNN: Which we've already talked about. 


 MR. GRIFFON: Right. Okay. 


 MR. HINNEFELD: Also I want to point out part 


of our response to the previous one, to finding 

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number four, about eight lines from the bottom, 


the sentence that starts with "The HP review" ­

- starts in the middle of the line. 


 MS. MUNN: Uh-huh. 


 MR. HINNEFELD: The HP rev-- the HP review of 


the -- of the CATI is not the review that 


they're being talked -- that's being talked 


about here. This is a review of the -- of the 


CATI form to make sure essentially the boxes 


are checked and it's completely filled out. 


The HP review occurs at the dose reconstruction 


part, at -- you've got a -- you know, so 


they're -- I don't know that you would say 


there's an HP who looks at a -- strictly at a 


CATI interview. 


 MS. ROBERTSON-DEMERS: Well, I think we had 


some concern about the review by the health 


physicist and what it contained, and you -- 


 MR. HINNEFELD: This procedure doesn't guide 


that. This procedure doesn't -- 


 MS. ROBERTSON-DEMERS: Actually you have an 


appendix in -- in 90 -- 


 MR. HINNEFELD: Okay, and that --


 MS. ROBERTSON-DEMERS: -- that starts to 


address that issue. 

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 MR. HINNEFELD: Okay. So then are the actions 


then to deal with that appendix to 90 and -- 


and what's done there? 


 MS. ROBERTSON-DEMERS: Well, I think it would 


fall into the review of -- our review of 


Procedure 90 and --


 MR. HINNEFELD: Okay. 


 MR. GRIFFON: Okay. 


 MS. ROBERTSON-DEMERS: -- and your further 


evaluation where you've said we need to 


consider this. 


 MR. HINNEFELD: Uh-huh. 


 MR. GRIFFON: Hey, Stu, that line you referred 


to, could I offer a little editing, just to -- 


to clarify it for me? 


 MR. HINNEFELD: Yeah. 


 MR. GRIFFON: I -- I -- I would suggest maybe 


rephrasing that to say the HP review required 


by the contract is performed on the initial 


telephone interview by the dose reconstructor 


during the completion of the dose 


reconstruction. I -- I mean he's not really 


reviewing the telephone interview. It's during 


the entire reconstruction process. Right? 


Maybe that doesn't help clarify. 

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 MR. HINNEFELD: Yeah, he prep-- yeah, he 


performs that while he's -- at the -- during -- 


you were right, during the completion of the 


dose reconstruction. 


 MS. MUNN: During the completion of the -- 


yeah. I don't see anything else on here that 


we haven't already covered. 


 MR. GRIFFON: I don't understand -- the only 


other thing I high-- I highlighted things as I 


went through the screen, and Proc. 17 finding 


seven, I don't understand what S-- and maybe I 


-- I need to look back at the full report, but 


review requirement is sound but incomplete. 


Sound but incomplete is a little bit vague, to 


me. 


 MS. ROBERTSON-DEMERS: Well, there's really two 


reviews that go on. One is basically an 


editorial review by the CATI interviewer, and I 


-- I think we're happy with that. And then 


there's a more detailed review by the health 


physicist that gets into some of the content, 


and that wasn't addressed in the earlier 


procedures, but it started to address it in 90 


in that appendix. 


 MR. GRIFFON: And you feel the review by the 

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HP, that portion is incomplete or... 


 MS. ROBERTSON-DEMERS: Well, looking at the -- 


the original review of 17, it was incomplete. 


 MR. HINNEFELD: So this will then be after the 


review of Proc. 90 you would maybe change or 


have another opinion -- 


 MS. ROBERTSON-DEMERS: Right. 


 MR. HINNEFELD: -- or have the same opinion, 


but... 


 MS. ROBERTSON-DEMERS: Right. 


 MS. MUNN: I only have one outstanding 


question, and Mark, you may already -- 


 MR. GRIFFON: Well, where do we stand with that 


one before you go, Wan-- I'm sorry --


 MS. MUNN: Okay. 


 MR. GRIFFON: -- where -- how --


 MR. HINNEFELD: I think it's an after Proc. 90 


review issue. 


 MR. GRIFFON: It's going to fall under Proc. 


90? Okay. Is that agreed? All right. Go 


ahead, Wanda. I'm sorry. 


 MS. MUNN: Oh, that's quite all right. It was 


not clear to me, have we defined who is 


tracking what this workgroup considers the 


outstanding issues? Lew's nodding his head. 

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 DR. WADE: I think we've decided, but let's 


hear Mark's answers and see if that's my 


answer. 


 MR. GRIFFON: Yeah, I'm trying -- I'm trying to 


track the -- the outstanding issues, is that 


what you're saying? Yeah, I've been keeping 


track of them throughout the phone -- 


 MS. MUNN: You're the official stuckee. 


 MR. GRIFFON: Yeah, I'll -- I'll fill in a 


column and then e-mail it to everyone and we 


can get a consensus on that. 


 MS. MUNN: Okay. 


 MR. GRIFFON: You know, like we've done before, 


yeah. 


 MS. MUNN: Right. 


 DR. WADE: Now we still have the internal dose 


in front of us, and then we have the two sets 


of individual DR reviews. This might be an 


appropriate time to break. 


 MS. MUNN: Yes, it would be an appropriate 


time. 


 DR. WADE: We have a lot to do, so --


 MS. MUNN: I know. 


 DR. WADE: -- but when do we want to be back? 


We want to be back at quarter of 1:00? Is that 

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not enough time, or --


 MS. MUNN: We can try. 


 DR. WADE: Let's try. We won't make it, but 


then we'll start at 1:00 -- but no, quarter of 


1:00. 


 MR. GRIFFON: Quarter of 1:00, okay. 


 MR. PRESLEY: Okay. This is Bob Presley. I'll 


be back on then. 


 DR. WADE: We'll break the call now and we'll 


join -- we'll be -- we'll join back at a 


quarter of 1:00. 


 MR. GRIFFON: Okay, thanks. 


 MR. PRESLEY: All right. Bye-bye. 


 (Whereupon, a recess was taken from 11:55 a.m. 


to 1:00 p.m.) 


 DR. WADE: Maybe we can have the people on the 


telephone identify themselves. 


 MR. PRESLEY: Bob Presley. 


 MR. GIBSON: Mike Gibson. 


DR. MAURO: John Mauro. 


 DR. LIPSZTEIN: Joyce Lipsztein. 


 MS. HOWELL: Emily Howell. 


 MR. KOTSCH: Jeff Kotsch with Labor. 


 DR. WADE: Well, that's quite a collection. 


 MS. MUNN: That's good. 

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202

 DR. WADE: And we are slowly assembling around 


the table, but I think we have a sufficient 


body of intellect that we can begin. 


 DR. BEHLING: Critical mass. 


 DR. WADE: (Unintelligible) say that, but -- 


 MS. MUNN: This is -- this is a hopeful man. 


 MR. GRIFFON: Hey, I -- I'm actually hopeful, 


too. I think -- I'm looking in my notes for 


the internal dose section, and I believe we can 


skip to page -- maybe I'm wrong, but skip to 


page 16, that's the first page I saw any note 


for more discussion needed. 


 MS. MUNN: On the first set of -- on --


 MR. GRIFFON: Oh, I take that back -- oh, no, 


no, no, I -- okay, the first note I have is on 


OCAS IG-002, finding number six. That's on 


page 13, but that refers to TIB-8. 


 MS. MUNN: We're going back to procedures 


(unintelligible). 


 DR. WADE: We're on internal dose procedures is 


where we are. 


 MS. MUNN: Right. 


 MR. GRIFFON: I'm sorry, yeah, internal dose 


procedures. 


 MS. MUNN: Page 16. 

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 MR. GRIFFON: And -- and I -- all my notes from 


the last meeting indicate up through page 16 we 


had pretty much concurrence. It was a lot of 


the edit-- editorial stuff on the 


implementation guide and either it would be 


edited or that there was no revision necessary. 


And I'll make those edits and put them in the 


Board action column and then we can, you know, 


send them around to make sure everybody is in 


agreement with that. But I don't think there 


was any further discussion needed on those. 


I think the real discussion item was -- the 


first one was on page 16, TIB-8 -- TIB-8, 


finding number one, and I have a note that says 


we -- you know, SC&A preferred if Joyce was on 


the call for this and -- and Joyce is on the 


call today, so I think we should start there, 


if it's okay. 


 DR. BEHLING: Joyce -- Joyce, before you start 


-- this is Hans --


 DR. LIPSZTEIN: Yeah. 


 DR. BEHLING: -- I'm speaking in behalf of our 


court reporter. Right now you're coming 


through loud and clear and -- and he has asked 


me to ask you to either use a hand-held 

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telephone and speak directly into it because 


he's obviously concerned about making sure he 


captures everything that you're about to tell 


us so -- so that he does not have to ask for a 


repeat. If you could, speak loud so that he 


has every chance to capture everything he needs 


to. 


 DR. LIPSZTEIN: Okay, I'll try to. 


 DR. BEHLING: You're -- you're sounding very 


good. 


 DR. LIPSZTEIN: Okay, good. Okay. This is a 


voice over ID phone, so I hope everything is 


okay. 


 MR. GRIFFON: All right, so TIB -- TIB-8, 


finding number one, Joyce, is where we're at, 


and maybe -- maybe we can do this similar 


approach that we've done so far, which is Stu, 


you can maybe give an overview on your 


response. 


 DR. LIPSZTEIN: Are you talking about TIB 


number eight? 


 MR. GRIFFON: Yeah, TIB-008-01. It's on page 


16 --


 DR. LIPSZTEIN: Okay. 


 MR. GRIFFON: -- in my printout. 

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 DR. LIPSZTEIN: Okay, this is a long discussion 


about the mouth, the -- where -- where to put 


the mouth, and I think this is going to be 


clarified now because ICRP has published a new 


GI tract model and it puts a lot of 


clarification on it. 


DR. NETON: Is that in draft form, Joyce, or -- 


is -- is the ICRP... 


 MR. GRIFFON: Is that a draft, Joyce, or is 


that... 


 DR. LIPSZTEIN: I'm sorry? 


 MR. GRIFFON: Is that a draft? 


 DR. LIPSZTEIN: No, this is -- this was just 


published now, and I think a lot of the 


discussions was that NIOSH did not accept the 


fact that where to -- to put the mouth and 


which kind of compartment should it be in, and 


-- well, we -- we at SC&A were following 


exactly what the ICRP was doing. But since now 


we have a new GI tract, maybe it's better if we 


-- if we could ask people from NIOSH to read 


the new GI tract model and then we'll discuss 


again where -- where the mouth would be in. 


 MR. GRIFFON: What is the publication number on 


that? Where -- where is it published? 

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 DR. LIPSZTEIN: It's -- it's published by the 


ICRP. 


DR. NETON: Do you have a number? 


 MR. GRIFFON: A document number --


 DR. LIPSZTEIN: (Unintelligible) the number of 


it, yeah. I -- if you want to wait. You want 


to wait, I'll check it. 


 MR. GRIFFON: Sure, or you can -- yeah. 


 DR. LIPSZTEIN: You want to wait, I'll just go 


into the ICRP -- or I can send you the number 


of it 'cause it was (unintelligible). 


MR. ALLEN: I've seen the draft of that. 


 DR. LIPSZTEIN: So we'll -- we are discussing 


something that was changed, so I think it's 


better to discuss it in -- okay. 


MR. ALLEN: Joyce, this is Dave Allen. Are you 


saying that publication clarifies via the mouth 


part of the respiratory tract? 


 DR. LIPSZTEIN: Yes, it does. It does, it 


does. It does. 


MR. ALLEN: Is it like an annex to that 


publication or... 


 DR. LIPSZTEIN: No, it's the new GI tract 


model, because they had a problem with the new 


human GI -- animal -- they call it the head, 

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the human alimentary tract, it's the new GI 


tract, and they had a problem exactly with the 


mouth because the mouth was part of the -- of ­

- of the lung model, and now it's part of the 


human alimentary tract. So most of the things 


that we are discussing here, they were 


discussed by the ICRP, so maybe it would be 


better to -- you know, for the people from 


NIOSH to look at the new ICRP on the human 


alimentary tract and then we'll discuss it 


again to see if we accept what the new ICRP is 


saying about it, how much of it -- it's already 


on the -- the NIOSH procedures and -- and 


what's different. I think it's... 


MR. ALLEN: Yeah, that seems reasonable to me 


to get -- I can't really talk to it today. 


I've seen the draft of that, but I haven't 


pored over it in detail. You say it is 


published now, though? 


 DR. LIPSZTEIN: Yes, it's published now. I can 


try to send you the -- by e-mail for whoever 


wants the --


MR. ALLEN: Yeah, it'd probably be the quickest 


 MR. GRIFFON: Yeah --

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 DR. LIPSZTEIN: -- new -- uh-huh, because I 


think it's better if we discuss when we see it. 


DR. NETON: Okay. 


MR. ALLEN: Okay. 


 DR. LIPSZTEIN: So I suggest that we postpone 


this discussion to -- to see if NIOSH agrees 


with the new ICRP model -- 


DR. NETON: I'm not sure we're going to disa-- 


 DR. LIPSZTEIN: -- (unintelligible) the mouth 


is and -- and other things. 


DR. NETON: I'm sure we'll agree with it, 


Joyce. How we apply it might be a different 


issue. 


 MR. GRIFFON: That's the question, yeah. 


 DR. LIPSZTEIN: No, because it's different from 


what it was, so --


DR. NETON: Okay, good, we'll look. 


 DR. LIPSZTEIN: I think it's more on what NIOSH 


was doing than before. 


DR. NETON: Okay. 


 MS. MUNN: So who is Joyce going to send that 


information to? 


 DR. LIPSZTEIN: I'm sorry? I'm sorry? 


 MS. MUNN: I was asking who you were going to 


send the information to. 

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 DR. LIPSZTEIN: Who do you want me to send -- I 


can send it to Jim, I can send it to -- 


DR. NETON: Yeah, just send it to me, Joyce, 


I'll -- I'll pass it on. 


 DR. WADE: And then send a copy to Mark, as 


well. 


 DR. LIPSZTEIN: Okay. 


 MR. GRIFFON: Right. 


 DR. LIPSZTEIN: Okay, I will do it. I'll do 


it. I'll do it today. Okay? 


DR. NETON: Okay. 


 MS. MUNN: Thank you. 


 DR. LIPSZTEIN: When we finish. 


 MR. GRIFFON: So this one's on hold -- on hold 


pending a review of that model. 


 DR. LIPSZTEIN: Yeah. 


 MR. GRIFFON: Okay. And I guess along with 


that would be some sort of not only review on 


the model, but an assessment of the impact of 


any changes --


 DR. LIPSZTEIN: Yeah. 


 MR. GRIFFON: -- in that approach versus the 


old approach. 


DR. NETON: Yeah. 


 DR. LIPSZTEIN: Yeah. 

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 MR. GRIFFON: Yeah. Okay. 


 DR. LIPSZTEIN: So I suggest we skip TIB-8 and 


I'll send to Jim the new GI tract model, and 


then he'll distribute (unintelligible) fastest 


way? 


DR. NETON: Yes. 


 DR. LIPSZTEIN: And then we'll come with that 


discussion again. 


 MR. ELLIOTT: Well, I don't want to throw a 


monkey wrench into the works here, but are we 


getting the cart before the horse? Our rules 


say that we will utilize international 


consensus -- you know, we'll examine it, we'll 


consider it and we'll utilize it as we -- as we 


think best fits the circumstances. 


 DR. LIPSZTEIN: I'm sorry, I didn't hear. 


 MR. ELLIOTT: Joyce, this is Larry Elliott. 


I'm worried that we're getting the cart before 


the horse a little bit here. Normally we would 


pick up any international consensus standard 


that's just been released and look at it and 


then make an evaluation ourselves and then make 


a determination on how that will be applied, if 


so. We have some regulatory process we have to 


adhere to in that, and we would put out a 

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program evaluation review that would examine, 


you know, whether or not -- if we so chose to 


implement it, we'd put out a program evaluation 


review on completed cases and how that -- that 


might affect those and what actions we would 


need to take. 


I don't want to get -- I don't want it to be 


lost that this comment says -- I think it says 


-- that there's some un-- there's -- guidance 


on the use of certain organs as surrogates is 


not clear. 


 MR. HINNEFELD: No, that's a different finding, 


isn't it? 


 MR. ELLIOTT: This is OL-8-01, I thought that's 


what you were talking about. And if we ha-- if 


this is a valid comment -- 


 MR. HINNEFELD: Oh, you're right, you're right. 


Sorry. 


 MR. ELLIOTT: -- you know, I think it's well 


and good that we know about ICRP committee 


releasing a new standard; as an international 


standard, we'd pick that up and look at it. 


But are we getting the cart before the horse, 


Jim, or --


DR. NETON: No, I think, Larry, what Joyce is 

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saying is that -- that the lung model itself is 


not as clear-cut as it need-- it should be, 


possibly, on the dose reconstruction for the 


mouth when you have an inhalation exposure. 


And Joyce is suggesting that they have 


clarified what role the mouth plays in 


inhalation versus ingestion in this new 


document --


 MR. ELLIOTT: Okay. 


DR. NETON: -- and my sense is -- I'm hopeful, 


it sounds like she may be saying that it's sort 


of validating what we may have been doing. 


 MR. ELLIOTT: All right. 


DR. NETON: And if that's true, that's -- 


that's great. 


 MR. ELLIOTT: I see. I see. 


DR. NETON: Then we can -- we're not going to 


adopt the new GI tract model right this second, 


but --


 MR. ELLIOTT: Certainly if there's a simple 


solution to this comment and that's relevant to 


that solution, we want to -- 


DR. NETON: Right, and I think that's where 


we're heading. We just --


 MR. ELLIOTT: I understand that. 

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DR. NETON: -- maybe use this to help -- help 


flesh out the issue in some more detail. 


 MR. GRIFFON: But to go back to what Larry 


said, actually -- I'm sorry, go -- 


 DR. LIPSZTEIN: Yes, because what happens if 


the ICRP went into most of the same discussions 


that we are having here about the mouth, and 


they had some new conclusions and they -- they 


-- they have done it a little bit different 


from what it was before, so it's better to look 


at it before we -- we try to discuss it 


ourselves again. 


 MR. ELLIOTT: Understood. I thank you. 


 MR. GRIFFON: Can I go back to -- to --


although Larry did point out in the finding it 


says guidance on the use of certain organs as 


surrogates, and this mouth question is given as 


an example. Are there other -- are there 


overall concerns in that guidance or is it 


specifically just -- is it just that one 


instance or is it -- other concerns in there? 


MR. ALLEN: I think it was just various tissues 


in the mouth, if I'm not mistaken on that. It 


-- it's all the same issue, but there's more -- 


DR. NETON: Yeah, you've got the whole cavity, 

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you've got the tongue, you've got a number of 


(unintelligible) --


 DR. BEHLING: Salivary (unintelligible) -- 


 MR. GRIFFON: Okay, that was it, I was trying 


to remember what was -- 


 DR. LIPSZTEIN: Yeah, it's all -- it's all in 


the same -- the same region. 


 MR. GRIFFON: Okay. Okay. 


 MR. ELLIOTT: So this parenthetical -- 


DR. MAURO: John Mauro. To get back to Larry's 


 MR. ELLIOTT: -- is specific to the concern. 


It --


DR. MAURO: -- question, though, so do we --are 


we --


 MR. ELLIOTT: -- is an answer. 


DR. MAURO: -- in agreement that the guidance 


that is currently provided in OTIB-8 is 


somewhat ambiguous and -- I mean -- or do you 


folks feel that -- that the guidance that you 


currently are using is not a -- in other words, 


I'd like -- I think -- I think Larry hit the 


nail on the head. Does NIOSH agree that there 


is ambig-- are ambiguities in TIB-8 and -- and 


for -- and the solu-- the action that's going 

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to be taken is to look into clearing those 


ambigui-- ambiguities up in light of the new 


ICRP? 


MR. ALLEN: Well, I'm not sure the -- this is 


Dave Allen. I'm not sure -- you know, Joyce, 


you can speak for -- but I'm not sure the 


comment really was that the guidance is 


ambiguous, more that the basis for the guidance 


was --


DR. NETON: Right. 


MR. ALLEN: -- ambiguous. 


 MR. GRIFFON: Right. 


MR. ALLEN: Is that true, Joyce, or -- 


 DR. LIPSZTEIN: Yes. 


MR. ALLEN: Okay. 


 DR. LIPSZTEIN: Yeah, what I was telling is 


that the -- the -- the TIB.008 was not in 


accordance with the ICRP, but now the ICRP has 


issued a new document where it discusses 


specifically those organs that were not in 


agreement, so I think it's better to look at it 


first and then discuss it again. 


 MR. GRIFFON: It might -- it might help us -- 


 DR. LIPSZTEIN: Because obviously --


 MR. GRIFFON: -- resolve it. 

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 DR. LIPSZTEIN: -- obviously NIOSH -- obviously 


NIOSH were not the -- gave an -- a lot of 


examples why they did not feel the ICRP was 


right. That's why they did not allow the -- 


what the ICRP indicated to do. And what I'm 


saying is that the ICRP went into discussion on 


those same organs and they made a -- they 


issued a new document, so we should look at 


this new document and then come back to the 


discussion again. 


DR. NETON: Yeah, I think that's fair. 


 MR. ELLIOTT: I think everybody here -- 


 DR. LIPSZTEIN: In other words, some of the 


things that we both hear are old. Some of the 


things that NIOSH justified are old also in 


view of the new ICRP, so this was done a long 


time ago. And we have new things from the 


ICRP, so probably we should discuss it again, 


the arguments of the ICRP again, the arguments 


of NIOSH again, in view of the new things. I 


would feel it -- better. 


 MR. ELLIOTT: We agree and we accept that. 


 DR. LIPSZTEIN: If NIOSH still doesn't agree 


with the ICRP, okay, so we'll say okay, we'll 


discuss it again, but if NIOSH now will agree 

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with the ICRP way... 


 DR. WADE: Okay, let's move on. 


 MR. GRIFFON: Okay. The next -- the next one 


that I have past TIB-8 -- TIB-8, the next item 


I have that has more discussion written on it 


was page 18, it's ORAU-OTIB number two, finding 


number one, it's at the very bottom of the 


page. 


 MS. MUNN: Uh-huh. 


 MR. GRIFFON: The guidance not written in a 


clear and logical manner, the ten -- ten and 20 


times the ten percent of the maximum personal 


(sic) body burden --


 DR. LIPSZTEIN: Oh, okay. 


 MR. GRIFFON: Someone can speak to that, either 


-- Stu, if you -- or Jim Neton, I'm not sure 


who was presenting this, but... 


 MR. HINNEFELD: Well, our -- our initial take 


on reading the comment here is that the -- the 


descrip-- the logical thinking isn't very clear 


is we're kind of in agreement with that. It's 


not written terribly clearly, and so you know, 


we can make editorial revisions to the 


procedure to more -- to maybe give a more clear 


explanation of why we chose those numbers. But 

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one thing that -- you know, to keep in mind 


during discussions of TIB-2 is that, you know, 


this is the hypothetical intake model and it's 


really a basis for determining an implausibly 


large intake for -- for this hypothetical 


exposure situation. So you know, before we 


get, you know, too far down the road -- you 


know, naturally we always want to be clear, we 


want to write clearly, but you know, bear in 


mind that this is for -- it was -- this 


approach is put together for that purpose, it's 


to come up with a hyp-- an implausibly large 


intake that can be used on these hypothetical 


cases -- hypothetical intake cases. 


 MR. ELLIOTT: Implausible overestimate or -- 


you said an implausible -- 


 MS. MUNN: Yeah. 


 MR. ELLIOTT: We're not talking about driving 


something to implausibility. Right? 


DR. NETON: Yeah, you need to be careful when 


you say implausible. I think it's a -- it's a 


bounding overestimate, I think is what I'd -- 


 MR. HINNEFELD: Right --


DR. NETON: -- prefer to characterize that. 


 MR. HINNEFELD: -- bounding overestimate. 

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DR. NETON: So it's a bounding overestimate for 


the -- for the particular group of claimants to 


which this was applied. You have to keep that 


in mind, as well. This is not to be applied --


 DR. LIPSZTEIN: Could you speak a little bit 


louder? 


DR. NETON: Sure. We viewed it as a bounding 


overestimate, and we apply it to a very 


specific group of claimants. And I think that 


is those claimants who have what we would call 


these non-metabolic cancers so that it's a very 


large intake and it allows us to demonstrate 


that even under those bounding overestimating 


conditions that the case is not compensable. 


So I think the trick is not that it is 


completely grounded in -- in exhaustive review 


of the site exposure conditions, but is it 


indeed a bounding for the -- for the person to 


whom this is being applied. 


 MR. GRIFFON: So Jim, you would -- you would 


change the last phrase in that response? 


'Cause it says larger than credibly could have 


been received. That suggests that plausibility 


sort of phrase. 


DR. NETON: Yeah, I --

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 MR. GRIFFON: Would you -- would you have 


changed that to -- to developed as a bounding 


overestimate approach -- 


DR. NETON: I would prefer that language, 


myself. I mean we have to be sensitive to 


these implausible conditions now. I mean we're 


 MR. GRIFFON: I'm asking you, though. I mean 


this is your --


 MR. ELLIOTT: Can't they be the same? 


 MR. GRIFFON: -- response, so I'm asking you. 


 MR. ELLIOTT: Are those the -- aren't the -- 


can't those be the same thing? 


DR. NETON: What's that? 


 MR. ELLIOTT: The larger than credibly -- 


larger than credible? 


 MS. MUNN: Larger than credibly could have been 


received. 


 MR. ELLIOTT: Credibly could have been 


received, and still be a bounding dose? 


DR. NETON: Yeah, I'd --


 MS. MUNN: That sounds like a bounding dose to 


me. 


DR. NETON: Yeah. 


 MR. GRIFFON: I think so, okay --

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DR. NETON: I think we have to be careful. 
I 


don't know that implausible is the right word. 


That was one thing that I was -- 


 MS. MUNN: Well, we don't have implausible. 


DR. NETON: Credibly bounding --


 MS. MUNN: We used credibly, that -- 


DR. NETON: -- yeah, that --


 MS. MUNN: -- makes sense to me, it -- 


 MR. GRIFFON: Yeah, okay. 


 MS. MUNN: Because those doses are -- let's be 


truthful about it, those doses are not 


credible, they're just stretching the limits, 


and we're back to that same old thing that I 


keep leaning on about misleading people about 


what their doses might have been. 


 DR. LIPSZTEIN: What I think about it is that 


the way it was done was all based on ICRP-30 


and so sometimes you take some nuclides and 


it's not only uranium, and this factor that -- 


used by NIOSH is not always claimant-favorable. 


DR. NETON: I don't think it was based on ICRP30 -- or 2, for that matter. It was based on 


an amount of intake. It happened to be this 


ten percent of the maximum permissible body 


burden, which is old ICRP-2 nomenclature, but 

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the reality is that we believe that that -- the 


value that happened to correspond to ten 


percent MPBB is a bounding estimate. We're not 


-- and then we would do the dosimetry based on 


the 66 and all the other models, so -- 


 DR. LIPSZTEIN: No, now if you -- the ten 


percent maximum permissible dose -- okay, 


you've got ten percent of the maximum 


permissible dose --


DR. NETON: Body burden. 


 DR. LIPSZTEIN: -- then you take ten to 20 


times the ten percent, and this ten to 20 times 


is the one -- the thing that I'm questioning. 


DR. NETON: That there is no rationale -- well-


documented rationale for that, is that what 


you're questioning? 


 DR. LIPSZTEIN: Exactly. You -- you -- you 


justify it in terms -- using the ICRP-30 model, 


and when they -- you -- you go to -- to the new 


models you cannot justify it anymore. 


DR. NETON: I don't --


 DR. LIPSZTEIN: (Unintelligible) -- you know, 


of course the ten percent is something 


arbitrary that you are justifying as that they 


couldn't possible get it. Let's say we accept 

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it, but the problem is the ten to 20 times the 


ten percent. 


DR. NETON: Okay. Now I think -- I'll start 


off with Stu's response then. 


 DR. LIPSZTEIN: And if they -- your answer is 


that for uranium we recognize that, so you use 


the factor as (unintelligible). What I'm 


thinking is that there are other radionuclides 


that have the same problem as uranium. 


 MR. HINNEFELD: Well, I think we can clarify 


the reasoning behind it. I think there's --


there's sufficient -- there's other information 


in TIB-2 that kind of explains what -- why we 


think it's bounding in terms of what kind of a 


chronic exposure would this translate into, so 


-- but certainly TIB-2 can be clarified 


editorially to -- to make that -- that link 


better, there's no doubt about that. 


DR. NETON: Yeah. 


 DR. BEHLING: Let me make a --


 DR. LIPSZTEIN: (Unintelligible) 


 DR. BEHLING: -- a comment -- excuse me, Joyce, 


I just wanted the opportunity -- for 


interrupting, but I do want to take the 


opportunity to make a comment here about if 

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there's modification to TIB-8 -- or TIB-2 is 


that I think we need to be very clear when you 


should use it. I think the -- under section 


one of purpose, it says that when there is 


little or no data involving bioassay data for 


that individual, as a bounding estimate you 


assign these -- this approach. But I think -- 


and you will see it in the next set of cases 


that we have that will be issued as -- draft 


form shortly, there's one individual dose 


reconstruction where this TIB-2 was employed, 


and I have to say the guy was monitored 157 


times for urine bioassay for uranium alone, and 


somebody was probably just a little too 


uncomfortable in pursuing that approach and 


saying well, we'll bound it by using TIB-2. 


And I'd just like to inform you that there -- 


there should be some strong language when you 


use it and when not to use it. 


DR. NETON: Well, I don't know if this 


specifically applies to TIB-2, but we've 


adopted the approach that if -- under the 


bounding conditions, if that over-arched the -- 


 DR. BEHLING: Oh, yeah, yeah. 


DR. NETON: -- predicted bioassay results, then 

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it was okay to use that. 


 DR. BEHLING: Yeah, but you would -- you should 


-- you should at least provide some evidence 


that you actually pursued it in that manner -- 


DR. NETON: Oh, yeah, it should be documented. 


 DR. BEHLING: -- and you could clearly show 


quantitatively that this bounds the actual -- 


DR. NETON: I agree. 


 DR. BEHLING: -- empirical data --


DR. NETON: I agree. 


 DR. BEHLING: -- but that was clearly -- or at 


least in my estimation --


 MR. ELLIOTT: It was lacking. 


 DR. BEHLING: -- is not done. 


DR. NETON: I think -- I agree, that should 


have been our approach. 


 DR. BEHLING: I'm sorry to interrupt, Joyce, 


but I just wanted to make that comment while we 


were talking about TIB-2. 


 DR. LIPSZTEIN: Okay. 


 MR. GRIFFON: Can I go back to Joyce's 


question, just for the -- the clarification of 


the -- first of all, the ten percent body 


burden and then the ten to 20 times the 


factors? What -- what is that or are you going 

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to provide more information on that or... 


DR. NETON: Yeah, I think that was -- the first 


-- Stu's original response, which was we can 


certainly provide better clarification as to 


our logic behind the ten to 20. I'm -- I'm not 


prepared to speak. 


 MR. GRIFFON: Oh, okay. 


 DR. LIPSZTEIN: Jim, let me put it that I don't 


think -- I don't know if I made myself very 


well understood because some of the things, 


they are repeated. First example, what happens 


is that when you look at the specification for 


the ten and 20 times in the TIB, it says that 


it comes because of the current ICRP models and 


the difference between an intake and the 


activity that is present in the body after the 


initial clearance of the short-term 


compartments. And then there is a whole table 


trying to justify it. But the problem is that 


those numbers from those tables, they were made 


with certain mistakes. And because of that, 


this ten and 20 not always is claimant-


favorable, and so it would be better if instead 


of, you know, just taking an arbitrary number 


and doing it, the ten and 20, you would use 

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IMBA, for example, and get the exact number you 


have to multiply. So sometimes you had to 


multiply the number by 60 and you end up 


multiplying it by ten or -- I -- I -- because 


most of the comments, they all refer to the 


same thing. If you -- if you look, for 


example, on the technical issue of the same -- 


finding number eight of this same document on 


page 21, for example, you -- it should look 


like, for example, for (unintelligible) 95, you 


should multiply it by 67 and 144 if it was 90 


days, and not 20 as was used in the table, and 


so on for other radionuclides because there was 


some kind of mistake in deriving those numbers, 


then this number ten and 20 is not always 


claimant favorable. For cobalt-58, for 


example, you should multiply it by 71 and not 


20, as it was used, and so on. So what I'm 


saying is that there was a technical mistake on 


deriving those tables instead of using the 


exact numbers that should have been, and that ­

- all this should be corrected, and then this 


multiplication by ten and 20 is not -- is not 


correct -- it's not technically correct and 


it's not claimant favorable, also. So I would 

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suggest we use the IMBA that you have and get 


the exact number. 


MR. ALLEN: Joyce, this is Dave Allen, and the 


one thing I wanted to point out is at the time 


when this was originally written, IMBA didn't 


include these isotopes. That's why that 


Potter's --


 DR. LIPSZTEIN: Oh, okay. 


MR. ALLEN: Yeah, that's why Potter's tables 


were used. And you're right, there was a 


technical error in that the -- the radioactive 


decay was not accounted for when the table was 


produced, but --


 DR. LIPSZTEIN: Yeah, and that's why -- 


MR. ALLEN: Yes, that's --


 DR. LIPSZTEIN: -- you (unintelligible) those 


mistakes, yes, and this has to be corrected 


because for some nuclides you give a very big 


number. 


MR. ALLEN: Right, but -- but the big -- 


 DR. LIPSZTEIN: You know, like 67 instead of 20 


or (unintelligible). 


DR. NETON: I would point out that where this 


is important, the doses are pretty small. 


MR. ALLEN: Right, because --

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DR. NETON: I'm not justifying that there 


should be a technical error, but the correction 


is going to be very small. 


MR. ALLEN: Yeah, because the --


 DR. LIPSZTEIN: It's not so small, because you 


have to multiply -- it's instead of ten you 


multiply by 60, that's not -- you know it's six 


times more. I -- you know, I -- 


MR. ALLEN: It's -- Joyce, this is Dave -- 


 DR. LIPSZTEIN: I think that now that you have 


IMBA and you have all those nuclides, maybe you 


should correct it, or maybe use it the right 


way from the Potter table. 


MR. ALLEN: We'll -- we'll beef this up and 


either -- either completely correct it or make 


an attachment to it that justifies the number a 


little better. But from what we've seen 


preliminarily, it's -- the major difference is 


the short-lived elements, and the short-lived 


elements, you know, by their nature don't 


deliver a dose very long, so the doses are -- 


tend to be pretty small for the ones that the 


biggest errors occur. 


DR. NETON: I mean a factor of six change on 


something that delivers five millirem is not a 

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huge dose, although you're absolutely right, it 


should be correct (unintelligible). 


MR. ALLEN: And we do intend to beef it up -- 


DR. NETON: We'll address it. 


MR. ALLEN: -- yeah. 


DR. NETON: I'd forgotten this comment, Joyce. 


This was a long time ago I heard the comment -- 


 MR. GRIFFON: Yeah. 


DR. NETON: -- and it's coming back to me now, 


and you're absolutely correct. This is a 


technical issue that needs to be addressed and 


we will -- we will deal with it. 


 DR. WADE: Good. 


 MR. GRIFFON: Okay, so -- so NIOSH is going to 


provide some kind of written response on this ­

- right? -- clarifying the -- these factors -- 


 MS. MUNN: Yep. 


 MR. GRIFFON: -- and discrepancies in that 


table, I would say, too. 


 DR. LIPSZTEIN: Okay. 


 MR. GRIFFON: Okay. I'm just going to go 


through these items. Some of them may overlap 


with that same issue, but OTIB-2 number two. 


I'm on the top of page 19 now. 


 DR. LIPSZTEIN: Top of page 19? 

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 MR. GRIFFON: Yeah. 


 DR. BEHLING: Some of us have different 


pagination, Mark --


 MR. GRIFFON: Oh, it's probably different 


paging, yeah. OTIB -- it's -- it's the same 


OTIB, number two, finding number two. 


 MR. HINNEFELD: Yeah, the best we could 


interpret this one was that it was sort of a 


compilation or a summary of other comments -- 


you know, a couple of comments that occur later 


on, because we couldn't find the original -- 


you know, sources that we're missing. There 


were comments later on that we thought may be 


relevant to this, but as it's stated here, it 


says it references data from that need to be 


known in order to understand the procedures 


described, and we didn't quite get the take on 


what we were supposed to provide. 


 MR. GRIFFON: Can SC&A clarify this one, the 


finding, in some --


 DR. BEHLING: Yeah, it may -- Mark, it may very 


well go back to something that we identified in 


our protocol for review of procedures, and that 


is when you provide a document that is to serve 


as a guidance document, try to avoid the need 

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to reference secondary documents that the 


individual may have to assess in order to 


follow through. For instance, in -- I'll give 


you an example in the case of the medical 


occupational exposure, TIB-6 for instance would 


make reference to NCRP reports regarding a 


graph or a table that -- that would only add 


dimensions of time that the dose reconstructor 


would have to invest in pursuing that 


information. And the recommendation was if 


there is additional information needed for -- 


for dose reconstruction, provide it in the 


document itself rather than ask somebody to go 


and -- and hunt down some other document that 


he may or may not even have access to. I think 


that was the intent here is to -- if you're 


going to have a document that's to serve as 


guidance, provide the necessary information so 


that there is no need to go to another document 


in order to complete the picture for guidance. 


 MR. HINNEFELD: Okay, I think we can probably ­

- if we're going to revise this for clarity 


purposes anyway, we can probably look for those 


type of things in here and avoid 


(unintelligible) --

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 MR. GRIFFON: I would say this is one of those 


that -- that NIOSH should modify, but it's not 


a high priority item. I think we recognize 


some of those -- I mean in the implementation 


guidelines -- you know, modi-- you will modify 


it, but it's not a high priority issue, I would 


think. Right? 


 MR. HINNEFELD: Right. 


 MR. GRIFFON: All right, I'm on to number 


three, if there's nothing else on that one. 


This is the guidance not consistent with other 


documents that are part of the hierarchy of 


procedures; i.e., OTIB-1. And NIOSH -- Stu, 


your response said there's no direct 


relationship. Right? 


 MR. HINNEFELD: Our response is that there -- 


OTIB-1 and OTIB-2 are two different approaches 


for arriving at a hypothetical intake, based on 


what's known about where they're used. So we 


felt like it's okay to have two different 


approaches for hypothetical intakes. OTIB-1 is 


just used at Savannah River. OTIB-2 is used at 


other DOE sites. 


 DR. LIPSZTEIN: What we were thinking is that 


if you have one working in one installation and 

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another working in another installation that 


people should get the maximum doses the same 


way. But we have this with most of the -- of 


NIOSH documents. Some -- some cases you -- you 


calculate the maximum doses one way, the other 


-- another document in another way, so it's 


(unintelligible) you have to do. 


 MR. GRIFFON: Is it -- is it a question of 


consistency or is there an equity issue here 


or... 


 MR. HINNEFELD: Well, it's a hypothetical 


overestimate for a case that's not going to 


reach 50 percent, so I don't think it's going 


to be an equity issue. It would -- if one is 


providing a higher dose than the other 


approach, then that just means that there will 


be -- you -- there are few cases that can be 


done this way with the higher -- you know, the 


higher number, so --


 MR. GRIFFON: So that's an important part of 


your answer, that the procedures both will 


never be used for cases that exceed 50 percent, 


or -- or --


 DR. BEHLING: By definition, Mark. 


 MR. GRIFFON: Right. Right. That -- that's an 

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important part. I mean... 


 MS. MUNN: Can we just add that statement and 


have this resolved? 


 DR. BEHLING: A curious thing would be to 


perhaps do a bunch of organs under the -- 


common organs, but by using the 12/28 


radionuclides versus these Savannah River high 


five and see, you know, how different are they. 


As has already been mentioned, they're not to 


be used for anything other than noncompensables, so the differences may be all 


academic, but it may just be something that we 


might want to do just to see how different the 


two sets of data would result in common organ 


doses. 


MR. ALLEN: Well, I think you'll find that at 


Savannah River OTIB-1 is lower than the OTIB-2, 


but OTIB-2 was intended to apply complex-wide, 


so it had to be much more encompassing, whereas 


OTIB-1 was based on an actual -- Savannah River 


kept a good list of --


 DR. BEHLING: Yes. 


MR. ALLEN: -- estimated intakes of all their 


employees and we took the top ones. That 


allowed us to overestimate Savannah River much 

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more plausible --


 MS. MUNN: We had a better implausible number 


(unintelligible). 


MR. ALLEN: Basically we -- we had the 


information to refine the Savannah River 


overestimate as compared to a complex-wide type 


overestimate, was the main difference between 


the two. 


 MR. GRIFFON: So Wanda, you suggested adding 


that clarifying statement. 


 MS. MUNN: I just would add --


 MR. GRIFFON: What was the clarifying 


statement, that these are not used for -- 


 MS. MUNN: That neither of these will be used 


for cases that would exceed 50 percent POC. 


 DR. BEHLING: Well, that's clearly written in 


the procedure itself. 


 MS. MUNN: Yeah, it already says so, but if we 


say it here, then that (unintelligible). 


 DR. BEHLING: And the inequity issue won't come 


up because TIB-2 is used for everything other 


than Savannah and TIB-1 is only for Savannah, 


so --


 MS. MUNN: Uh-huh. 


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people from Savannah, one being assessed by the 


12 or 28 and the other one by the high five. 


 MR. GRIFFON: That's what I was looking for. 


SC&A is concurrent with this then. Right? 


 DR. BEHLING: Yes. 


 MS. MUNN: Yeah. 


 MR. GRIFFON: Okay. All right, moving on, 


OTIB-2, finding four. 


 MS. MUNN: It said another revision is coming. 


 MR. GRIFFON: Okay. And then five, we just 


discussed. Right? We're going to get a 


response on that. 


 MR. HINNEFELD: Yeah, five was what we 


discussed a minute ago. 


 MR. GRIFFON: Very similar, right. And six, I 


think. 


 MS. MUNN: Uh-huh. 


 MR. GRIFFON: Although this --


DR. NETON: Yeah, that's the same issue we 


talked about --


 MR. GRIFFON: Right. 


DR. NETON: -- the decay factors. 


 MR. GRIFFON: Okay. And seven --


 DR. BEHLING: Joyce, do you have a comment? 


 DR. LIPSZTEIN: Yeah, on seven, when you -- 

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also be -- it's a technical issue again, and 


some of the things that were written on the 


documents, they are not -- they are not true. 


And there's a comment here that the OCAS did 


not evaluate this comment because the nuclides 


in question were not specified. That's not 


true on the basis that were given here, 138 and 


139. We gave examples of things that were 


technically wrong. For example, the assumption 


of type S for cobalt-58 and cobalt-60, it said 


it's -- this is used because it results in 


larger doses to systemic organs because of the 


high energy photons, and then if you look up 


you'll see that not for all organs you should 


use type S, for certain organs you should use 


type M. So there's some small -- I don't know 


if you -- I should call it small, but there's 


some technical incorrections on -- on the 


classes that -- on the types that were -- 


absorption types that were assumed. And we 


gave examples, some -- for -- some -- some 


nuclides that were wrong. 


 DR. BEHLING: Joyce, we also brought that up 


with regard to plutonium and uranium, and I 


think you and Mike Thorne may have also 

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commented or written responses to that, but I 


personally have also found this out in my own 


review of audits of -- of dose reconstruction 


cases, and this is particularly true when you 


start out with a urine sample that you first 


have to use to determine what was the 


inhalation quantity, and then again work 


forward in saying how does that inhalation 


affect -- or how does that correlate to a 


specific organ dose. We found that if you -- 


if you start out with type S as opposed to M, 


you end up with higher organ doses if you start 


out with urine data to first calculate the 


inhalation dose and then use the inhalation 


dose to calculate organ dose. And so I think 


you're talking about the same thing that I've 


also (unintelligible). 


DR. NETON: I think that's true for urine, but 


TIB-2 does not --


 DR. LIPSZTEIN: But I --


DR. NETON: -- start with urine. 


 DR. LIPSZTEIN: -- but I think on those 


particular example of what's happened is that 


you could not use -- if you use the same type 


of nuclide (unintelligible) that's in the old 

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ICRP nomenclature, sometimes NIOSH call it 


class, but no class was in 30, now it's type, 


but it's almost the same thing. What I mean is 


that for some nuclides you cannot say you 


should use only type S or you should only use 


type M 'cause some nuclides -- it depends on 


the organ you get the cancer. 


 MR. GRIFFON: Okay. And -- and Jim --


 DR. LIPSZTEIN: Because for some organs you get 


a more favorable result if you use type S, for 


-- for other organs you get a more favorable 


result if you use type M. For example, cobalt60, it's written on the document that you 


should always use type S because it will result 


in a larger dose to the systemic organs. And 


what I'm saying is that okay, for many organs, 


yes. But for the bladder or the brain, for the 


uterus and for the colon you should use type M 


because it gives a higher dose than type S, so 


it's -- there's some technical incorrection. 


 MR. GRIFFON: So Joyce, you have -- these are 


examples in the report, I agree, I see them. 


 DR. LIPSZTEIN: Yeah. 


 MR. GRIFFON: Do you have an extensive list or 


-- or --

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 DR. LIPSZTEIN: We ga-- we -- we did it for all 


the nuclides that were given in the -- the 


document. 


 MR. GRIFFON: And are these --


 DR. LIPSZTEIN: (Unintelligible) 


 MR. GRIFFON: -- the ones you found -- these 


are the ones that you found problems with and 


listed in your report? 


 DR. LIPSZTEIN: Yes. Yes, they 


(unintelligible). 


 MR. GRIFFON: So if NIOSH can -- can maybe 


respond to that or look at that and -- and 


respond to that, would that be -- 


 DR. LIPSZTEIN: Yes. 


 MR. GRIFFON: -- a fair follow-up? 


 DR. LIPSZTEIN: Yes, yes. I -- yes. We -- I 


think for all the nuclides NIOSH should review 


this and -- and see which nuclides they should 


apply which type of -- of nuclide they should 


(unintelligible) --


DR. NETON: Joyce, I'm curious --


 DR. LIPSZTEIN: -- (unintelligible) -- 


DR. NETON: -- the calculations you did, were 


they for 50-year committed doses? 


 DR. LIPSZTEIN: -- (unintelligible). 

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 MR. GRIFFON: Okay. 


 DR. BEHLING: She didn't hear you. 


DR. NETON: Joyce --


 DR. LIPSZTEIN: (Unintelligible) this one type 


DR. NETON: -- this is Jim --


 DR. LIPSZTEIN: -- (unintelligible) it's -- 


it's something that you -- you get 


(unintelligible) as a technical thing. 


DR. NETON: Joyce? Hello, Joyce? 


 DR. LIPSZTEIN: Yes? 


DR. NETON: Are these 50-year doses that you're 


basing these comments on? 


 DR. LIPSZTEIN: You could do it for 50 years or 


you could do it for less years, too 


(unintelligible). 


DR. NETON: Well, I'm saying it makes a 


difference. I think you almost have to do it 


on a --


 DR. LIPSZTEIN: Yeah, it does. Yes, of course 


it does. 


DR. NETON: Yeah, so I don't think you can 


generically say that those numbers are valid 


always because rarely do we have 50-year doses, 


but we certainly need to look at it and -- 

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DR. MAURO: Jim, this is John --


 DR. LIPSZTEIN: Yeah, it's always the technical 


things that have to be examined very carefully 


instead of just, you know, pointing out 


something for the DR that it's not always 


(unintelligible) it will be a -- a -- 


DR. NETON: Yeah, I agree. 


 DR. LIPSZTEIN: -- claimant favorable -- 


DR. NETON: Dave -- Dave, correct me if I'm -- 


 DR. LIPSZTEIN: -- so it's something you have 


to look very carefully. 


DR. NETON: Yeah, I -- I think it's been our 


approach -- and Dave Allen can correct me if 


I'm wrong here -- but we would normally do it 


both ways and pick the higher of the two. This 


may be an artifact of an earlier TIB that was 


put out there that --


 (Whereupon, Dr. Lipsztein, Mr. Griffon and Dr. 


Neton all spoke simultaneously, rendering 


transcription of their individual comments 


impossible.) 


 DR. LIPSZTEIN: I think the advice should be 


(unintelligible) for all types and see which 


one gives you the highest dose (unintelligible) 

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DR. NETON: Well, and more importantly, you 


need to bring into account the integration 


period because if it's one year, five years, 


ten years, 50 years, it could make a 


difference. 


 MR. GRIFFON: Yeah. 


DR. NETON: See, and I --


 DR. LIPSZTEIN: It could. Yeah, it could. 


DR. NETON: 'Cause if you have class Y and it's 


in the first year --


 DR. LIPSZTEIN: (Unintelligible) 


DR. NETON: -- M would be more favorable. 


 DR. LIPSZTEIN: -- for some numbers 


(unintelligible). 


 DR. BEHLING: Well, we're still dealing with -- 


 MR. GRIFFON: That might be the best action, 


Jim, is the --


 DR. BEHLING: -- the efficiency process, though 


(unintelligible). 


DR. MAURO: (Unintelligible) that I want to 


step back for a second because I think the 


NIOSH response is interesting. And the last 


sentence in the NIOSH response is -- it says it 


is not important how these large intakes were 


developed, as long as they are larger than 

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credibly could have been received by the 


subject employees. And I want to draw your 


attention to that because this goes toward not 


only comments on this particular TIB, but also 


on the high five approach, on the 28 


radionuclides or the 12 radionuclides, and it's 


something that I was anxious to engage in. It 


is my understanding that it -- this statement 


says -- we -- we use this construct whether -- 


to get us to a certain dose, and a -- and NIOSH 


gives -- well, we went with the high five. Now 


we know from doing the review that we probably 


could find some people that got higher than 


your high five. That doesn't invalidate your 


doses, it just says that well, your rationale 


for picking what you pick, the high five -- 


well, if we go into the literature or go into 


the databases, we could find other people that 


were even higher. Same -- same thing Joyce -- 


now you had pointed out here, correctly so, 


that there are some other assumptions that 


could be used for certain radionuclides that 


could give you -- regarding let's say 


solubility, that could give you a higher dose. 


And the answer that was given here by NIOSH is 

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-- is going down a different path. It's almost 


as if don't let's talk about the rationale, 


let's just talk about the dose. We're -- we're 


arbitrarily selecting a very high dose for each 


of these organs, and we're going to use the 


assigned dose as long as we feel confident that 


they are in fact bounding for the class of 


individuals that would apply this to, or the -- 


the individual. So I guess we -- we need to 


come to some resolution here, whether there -- 


NIOSH needs to have a rationale for the dose it 


picks and -- and -- and then stick to it, such 


as picking the solubility that's most claimant 


favorable, picking the high five and 


demonstrating that those in fact are the 


highest five, or is it just -- is it sufficient 


for NIOSH simply to pick a dose and -- and the 


rationale's really not what's important, and 


provide assurance that that dose is in fact 


above the credible upper bound. 


DR. NETON: John, this is Jim. I'd go back one 


step further, though, and -- and not talk about 


picking a dose, but picking an intake. 


 DR. BEHLING: Yeah, you have --


DR. NETON: Because that's really -- 

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DR. MAURO: Okay, an in-- let's --

DR. NETON: -- what we're talking about here. 

DR. MAURO: -- go with intake, so I mean I 

think we can --


DR. NETON: Because intake can be grounded in 


the plant conditions, to some degree. 


DR. MAURO: Yeah. 


DR. NETON: Just arbitrarily picking a dose 


doesn't make any sense to me. 


DR. MAURO: Okay, I stand corrected. But you 


see the point I'm making. I'm trying to find a 


way that -- it's really an intake in the end 


that you're picking. 


DR. NETON: Right, and I would -- I would 


suggest that I think what you say is true about 


the intake, that we -- we just have to be able 


to get people comfortable that it's a bounding 


intake for that plant or that exposure 


scenario. Now how you get the dose is a 


different issue, and I think we would -- I 


would feel comfortable in saying we need to be 


consistent on how we're applying that intake 


and converting it to dose. And yes, we would 


use the most claimant favorable scenario that 


made -- if it made sense. If we couldn't pick 

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between two, Y or W, we would pick the higher 


one. But I think the intake itself is -- is 


where we would argue, and I think -- I hope 


people would agree that we -- we have the -- we 


can pick a bounding intake value for a 


particular plant, and that's what we tried to 


do with Savannah River and these other TIBs. 


 DR. BEHLING: And I also think, just to add 


something to what you started out, John, and I 


concur. If we start to decipher this whole 


issue and then break it down into different 


time periods, as Joyce correctly states -- and 


Jim, too -- that it's not necessarily 


consistent that one solubility class will 


always give you the higher. It may also be 


affected by the duration between exposure and ­

- and cancer diagnosis. But if we go and 


follow that path, we no longer have an 


efficiency process. You're going to end up 


with an awful lot of computations that will 


determine which one is the highest, when in 


fact the intent is to save time by saying let's 


just go with the high one. It may not always 


be technically correct, but we do know it's 


bounding, whether it's necessarily the highest 

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one -- and -- and use that as a tool for saying 


let's be done with it because this is a noncompensable claim and we're looking for 


efficiency. 


 DR. LIPSZTEIN: I -- I don't agree because if 


the (unintelligible) were small, I would agree 


with you. But when you have a difference of 


six or ten times, you know, higher, it makes a 


difference. 


 DR. BEHLING: Well, Joyce, but just to -- to 


tell you, again, if that difference of six to 


ten brings a guy over 50, we'd withdraw the 


whole efficiency process to begin with and 


start looking at best estimates, in which case 


we -- we end up with a whole different ball 


game in computating (sic) the internal dose, so 


 MR. GRIFFON: That's -- that's what she's 


saying, you're on the low side of a six to ten. 


You're on the low side, Hans, so you wouldn't 


get -- you know, what -- what about this a -- 


 DR. BEHLING: Well, that's what I'm saying. If 


you do go to a more restrictive dose 


calculation that would ultimately bring the 


person up to or beyond 50 percent, we withdraw 

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the whole procedure entirely. 


 MR. GRIFFON: Let me -- let me ask this, 'cause 


I think Jim Neton shed a lot of light on this 


with the last statement he made about three 


minutes ago. I mean what if -- what if, as an 


action, NIOSH evaluates this, but it may be 


that you, for certain nu-- nuclides, you put in 


there -- the guidance is for the DR dose 


reconstructor to run all solubilities and pick 


the highest in that case, and for some you may 


be so clear that -- that class S is always 


going to give you the highest, then you can 


just leave it at that. I would almost 


recommend, you know, take -- take the -- remove 


the table and say just run all -- you know, run 


all solubility choices and pick the highest for 


the organ of interest. That would clarify the 


guidance completely, and I don't think it's 


that inefficient when you're just picking one 


intake, anyway. 


MR. ALLEN: Well, that's annual doses for 28 


nuclides at various solubilities each, that 


turns out to be a hell of a lot of -- 


 MR. GRIFFON: Oh, yeah, okay, okay, so I'll go 


back to the -- for those certain nuclides where 

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there's an issue, then you put run -- you know, 


asterisk, run -- run two solubilities and -- 


and check this out in this instance, you know, 


or something like that. 


MR. ALLEN: I think maybe an evaluation by us 


could probably reach a compromise -- 


 MR. GRIFFON: Okay. 


MR. ALLEN: -- in what everybody is saying here 


'cause I think the six to seven times that 


Joyce is talking about might be some of the 


smaller dose isotopes -- 


 MR. GRIFFON: Smaller overall doses. 


MR. ALLEN: -- to where, you know, the total --


and in keeping with what Hans is saying here, 


if it's -- if the difference is, you know, in 


the ten percent range, it's probably not worth 


dealing with in an overestimating TIB like 


this. 


 MR. GRIFFON: Right. 


DR. NETON: I think -- I think Dave's got a 


good -- good solution here. 


 MR. GRIFFON: Okay, well, why don't -- 


 DR. LIPSZTEIN: (Unintelligible) intake -- 


(unintelligible) intake of ten times -- if a 


difference in dose of ten times 

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(unintelligible) proportional to the intake -- 


don't forget, the difference of ten times -- 


you will never make a difference on the dose, 


then we might as well say what -- what are we 


doing, nobody will get anything. 


DR. NETON: Yeah, we don't --


MR. ALLEN: Joyce, the point -- the -- 


 DR. LIPSZTEIN: A difference of ten times in 


the intakes is a difference of ten times in the 


dose. 


MR. ALLEN: The point, Joyce, was that some of 


those isotopes were a small fraction. We're --


we're including like say 28 -- all 28 nuclides 


for one intake, we're not just picking the 


highest isotope. 


DR. NETON: I think we need to go back and look 


and see where these may have an effect and -- 


and behave accordingly. I think that -- I 


agree with Joyce that we just can't say we're 


just going to -- it doesn't matter which is 


higher because we're so generous. I think we 


need to evaluate it, at least put some brackets 


around what -- what difference it makes. And I 


think we'd be hard-pressed to argue that we 


shouldn't know what the upper bound doses are 

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with these intakes. I mean that's sort of a 


given, so --


 MR. GRIFFON: I think that -- that's as far as 


we're going to get on this phone call -- 


DR. NETON: We'll take a look at it. 


 MR. GRIFFON: -- today anyway -- yeah. 


DR. NETON: It's easy for me to say, I don't 


have to do all the work behind it. 


 MR. GRIFFON: Okay. So now we're on to -- to 


finding eight. 


 DR. LIPSZTEIN: It's the same. 


 MR. GRIFFON: Oh, it's the same thing, okay. 


I'm just moving ahead here, and nine's the 


same, also. Right? Seven, eight and nine, 


they're all the same issue anyway. 


 DR. LIPSZTEIN: Yeah, (unintelligible). 


 MR. GRIFFON: Okay. How about ten and 11? 


 DR. LIPSZTEIN: (Unintelligible) 


 MS. MUNN: We've done them. We did those 


first. 


 MR. GRIFFON: Okay. 


 DR. LIPSZTEIN: Okay, and 11 also, it's agreed? 


 MS. MUNN: So now we're down to TIB-5. 


 MR. GRIFFON: We have agreement on ten and 11, 


right? Okay. I'm making sure I capture these 

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notes so I can revise the matrix to -- okay, 


TIB-5, finding one, see response to TIB-8. 


Okay, so we've got this one. This is a --


we're going to review the new ICRP model. 


Correct? 


 DR. LIPSZTEIN: Yeah. 


 MR. GRIFFON: And number two, SCA agrees with 


NIOSH, I have on this, so I think this one's 


not an issue. Now we're going to go down to 


ORAU-OTIB-1, finding number one. 


 DR. LIPSZTEIN: (Unintelligible) 


 MR. GRIFFON: Surrogate radionuclides, is this 


-- this is the same issue for TIB-1 or no? 


 MS. MUNN: It's going to be clarified in a 


subsequent revision. One of those things for 


you to track, Mark. 


 MR. GRIFFON: Mark. 


 MS. MUNN: Action, Griffon. 


 MR. GRIFFON: Wait, I have -- I have a more 


discussion note on this, though. Could someone 


clarify that, OTIB-1? 


MR. ALLEN: This is Dave Allen, I think I can 


shed just a little bit light on that one. At 


the time OTIB-1 was written, again, the version 


of IMBA we had didn't do all isotopes -- well, 

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it'll never do all isotopes -- but there was a 


number of important isotopes it did not do and 


we tried to account for that by using isotopes 


that it did do as a surrogate. At this point I 


believe all of the isotopes on there are 


included in IMBA, so we -- we can go back and 


calculate a more correct version rather than 


using a surrogate isotope. 


 MR. GRIFFON: So it's really probably no longer 


an issue and the revision will clarify it. 


Right? The -- the -- 


MR. ALLEN: I think we -- what we have to do is 


rerun those numbers, and if it's a very small 


difference at least write this up and present 


it to you, you know, as -- you know, we don't 


think a change is warranted, but I suspect one 


is going to be warranted and in that case we'll 


revise the OTIB. 


 MR. GRIFFON: Okay. So evaluate and revise as 


necessary? 


MR. ALLEN: Yeah, that's basically it. 


 MR. GRIFFON: Okay. Finding two on that same 


OTIB? 


 DR. LIPSZTEIN: (Unintelligible) I think NIOSH 


-- what they are saying is that they will 

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clarify -- it took me a long time to understand 


why they did it like that, and then I knew -- 


I... so but it -- it says that in a subsequent 


revision it will -- NIOSH will clarify that 


intakes occurred before the adoption of ICRP-30 


where (unintelligible) using ICRP-30 


methodology. 


 MR. GRIFFON: Okay. And I guess --


 DR. LIPSZTEIN: I think -- I understand that 


NIOSH agrees with the commentary. 


 MR. HINNEFELD: Yeah, we agree to clarify the 


write-up here because -- 


MR. ALLEN: We agree it's ambiguous. 


 MR. GRIFFON: Okay, and this -- is this for the 


-- is this the high five procedure? 


DR. NETON: Uh-huh. 


 MR. HINNEFELD: Yeah. 


MR. ALLEN: Yes. 


 DR. LIPSZTEIN: Yes, this is the Savannah 


River, yeah --


 MR. GRIFFON: And --


 DR. LIPSZTEIN: -- document. 


 MR. GRIFFON: -- I guess I had a -- I don't 


know if it's captured in this same finding, but 


a question as to whether -- and this might be 

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in the site profile review more than in here, I 


forget, but the question's come up on the -- 


you know, where the high five came from and 


whether NIOSH independently calculated those 


intakes from the -- from the accident or 


whether they were provided by Savannah River -- 


how -- how those actual high five intakes were 


-- were derived. 


 DR. LIPSZTEIN: For me this is a very good 


question because I -- I only reviewed some 


cases for -- some of the 20 cases, but some of 


them were from the Savannah River Site, and I 


kind of looked at some of the data and I -- I 


could see some intakes that were higher than 


the ones cited on the high five. So --


 MR. GRIFFON: Yeah, I looked -- I looked -- 


 DR. LIPSZTEIN: -- you know, when I -- when I ­

- when I reviewed the document I didn't see the 


cases, but then I saw the cases -- I don't know 


how, you know, should say this in a conference 


call or not, but I --


DR. NETON: I think this is getting into sort 


of the issue that -- that John Mauro brought up 


a little bit ago in that, you know, are these 


reasonable bounding intakes for the workers to 

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which the -- you know, the approach is applied. 


In other words, we're not arguing that there 


was no higher intake ever in the history of 


Savannah River, but based on the average of the 


highest high five that were evaluated by the 


dosimetry program, we believe that these are 


sufficiently bounding for the class of workers 


that we're using them for. And that's really 


the relevant issue here. It's not, you know, 


can we find someone who had a higher intake of 


plutonium. I mean I think that -- the intake 


is something like 160 nanocuries of plutonium, 


something in that ball park. Is it reasonable 


to conclude that a -- an administrative 


personnel who was not monitored had a higher 


intake than that. I mean that's really what 


we're trying to get at here. And whether that 


was done with ICRP-30 methodology or not is -- 


is not really -- I'm not saying it's not 


relevant, but it's -- it's not as important as 


it would seem. 


 MR. GRIFFON: Yeah, I guess that -- that is 


what -- what is of issue in -- I -- 


DR. NETON: Yeah. 


 MR. GRIFFON: You know, if the highest five -- 

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I mean I think that -- we -- we've -- I think ­

- I guess maybe I got caught up in this -- this 


quick and easy terminology of the high five, 


the highest --


DR. NETON: Yeah, sure. 


 MR. GRIFFON: -- five intakes ever, and maybe 


there's a better --


DR. NETON: There might be a better descriptor, 


and --


 MR. GRIFFON: -- a better descriptor that says, 


you know --


DR. NETON: Yeah. 


 MR. GRIFFON: And I think you're right, Jim, 


the application's important because it's not 


intended for application to production workers 


or --


DR. NETON: Right. 


 MR. GRIFFON: Right? 


DR. NETON: Right, there -- there are limits on 


the application of the high five approach. 


Again, it was part of the efficiency process, 


and rather than --


 MR. GRIFFON: (Unintelligible) efficiency 


model, right. 


DR. NETON: -- rather than picking numbers out 

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of a hat, I mean we -- you know, we -- ORAU 


went out and said well, this seems reasonable 


that -- you know, they have the very robust 


monitoring system and over the years here are 


the -- you know, the high intakes that they've 


experienced for -- for workers who were in the 


production environment. And we're applying 


these to non-production workers, so I think 


there's some real credibility here that we've 


gained from this, but maybe there is a 


nomenclature issue or how we described it, 


but... 


 MR. GRIFFON: I guess what -- what strikes me 


now, in retrospect, is that -- that most of the 


other sites you're not using this sort of 


approach --


DR. NETON: Right. 


 MR. GRIFFON: -- for the unmonitored workers in 


establishing, you know, the 95th or 50th 


percentile intakes. 


DR. NETON: Well, and that -- that's part and 


parcel of this program. As we learn more and 


develop coworker databases -- and again, these 


are not used to pay people. They are used --


you know, is -- is it on the right side of the 

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50 percent mark is what we're trying to say, 


and I -- I suspect that we -- you know, if we 


had the coworker data available at the time for 


Savannah River, we would have used it. 


 DR. BEHLING: Possibly a way to avoid would 


have been to maybe use the 95th percentile 


among production workers where you leave the 


door wide open and say well, there'll be the 


other five percent that will be higher, but -- 


for instance, in one of the most recent 20 


cases we evalued (sic) I identified a person 


who was not among the high five. In fact, if ­

- if we used his data, he would be number two. 


And so, again, just -- this is another case 


that fell through the cracks, but it doesn't 


invalidate the process of using the high five 


as an efficiency measure that says for those 


people who were really not production workers, 


this is still a bounding approach to estimating 


any unmonitored intakes. 


 MR. GRIFFON: But I -- I think -- I mean I 


guess my -- my question -- I still have the 


question as to what -- where this -- you know, 


how this data was derived, where the high five 


came from, and then -- and then we might come 

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to that very conclusion, Jim, that you said 


which is that it's bounding. It's not the 


highest five ever, but it seems very bounding 


for the people it's applied to and for the 


efficiency model that it's used in. 


DR. NETON: Right. I mean I haven't read the 


TIB in a while, but there is a -- 


 DR. LIPSZTEIN: It's worth a discussion because 


what is written is that those are the largest 


intakes that were ever assigned at Savannah 


River Site, and -- and (unintelligible) the 


five intakes are cited, but there is no 


(unintelligible) how they were calculated, from 


-- where did they come from, if this same 


approach was used and from where this data was 


used. And as I -- I was telling when I 


analyzed one of the cases, I found an intake 


that was bigger than the five listed, so I said 


well, I don't know from where the data came 


from anyway. Maybe it was calculated in a 


different way and it was (unintelligible) the 


same event, I don't know. But it doesn't say 


how it was calculated, and that's a big problem 


because we don't know from where it comes and 


how it were -- was calculated. 

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 MR. GRIFFON: So I think we -- I think this is 


also in our case review matrix to -- to follow 


up on this in the site profile review. 


Correct, Jim? 


DR. NETON: Yes. 


 MR. GRIFFON: So I -- I -- we won't lose this 


issue, but I think it -- that question still 


remains. 


DR. NETON: I thought the site profile said it 


was going to be handled in the dose 


reconstruction review, too. 


 DR. BEHLING: Yeah, just to add to that 

statement --

 MR. GRIFFON: Well, that's one of my fears 

here. 

DR. NETON: No, it's in -- it's in the site 


profile review and we're committed to 


addressing -- I think -- it sounds to me like 


we just maybe need to go back and expand on 


that section of the TIB and -- and convince 


folks as to what we've done and what the real 


intent was rather than, you know, sort of 


leaving people with the assumption that this 


was the highest five recorded ever in the 


history of whatever, you know. 

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 MR. GRIFFON: And another thing that struck me, 


I -- I also -- I think I saw that same case 


that Hans and Joyce are referring to, but prior 


to that I just looked at the -- the dates of 


these highest five -- quote/unquote, highest 


five intakes, and it struck me that they 


weren't all in the '50s and '60s. They were --


there were some that were quite a bit later, 


and I -- that -- that was a little flag for me, 


although -- you know, it may well be true, but 


it surprised me to see that (unintelligible). 


DR. NETON: Yeah, again, you know, I think if 


we couch this properly with the right, you 


know, caveats around it and let people know 


that we're not saying these were the highest 


ever, these are the highest we believe are 


reasonable, credible bounds for -- for this 


class of workers and that's maybe where we fell 


down here. And I think if we take a crack at 


that and expand it a little bit, maybe we'll 


make people feel a little more comfortable with 


the approach. 


 DR. BEHLING: I mean the case that I'm 


referring to, and I talked to you about, Mark, 


it's a urine data. And of course how we 

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calculate the intake is to use IMBA, and of 


course IMBA wasn't available at the time these 


-- these cases were classified as high -- high 


exposures. Whatever they used -- ICRP-30, 


manual hand calculations -- they're bound to be 


different from the ones that we're calculating 


starting out with the urine sample, working 


backwards through IMBA and saying okay, here's 


what IMBA predicts would have been the high -- 


inhalation intake, and so it's quite possible 


that just on the methodology that we're using 


versus what was used initially as part of the 


database by -- from which you pick that -- that 


-- those high five, that that may account for ­

- for discrepancies. 


DR. NETON: Type S versus class Y would make 


that kind of difference on an intake. 


MR. ALLEN: Well, these were definitely ICRP-30 


calculated intakes. 


DR. NETON: Right, and so, you know, you have 


differences in the model. 


MR. ALLEN: That's the whole reason for all 


that convoluted evaluation in there about ICRP 


-- or the current models versus ICRP-30, to 


show that not so much, you know, a small 

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correction, but the -- to kind of bound how 


much of a difference it would make. Some of 


them went up, some of them went down. I think 


you're generally talking, worst case, around a 


factor of two on the big ones, on the important 


ones, so it's -- it's -- still says it's 


bounding because it's not a huge difference 


between the models. 


DR. NETON: I think there's enough confusion 


here that we need to take on the responsibility 


here to go an clarify what we really meant to 


do here, and -- I don't think we -- I'm going 


to maybe embark on an entire reanalysis, but at 


least a few paragraphs to characterize the 


intent a little better and see how that flies, 


and then work from there. 


 MR. GRIFFON: Okay. Finding three is on the 


tritium. Right? 


 MS. MUNN: Agreed. We agree, it's just a 


tracking issue. Right? Mark? 


 MR. GRIFFON: Excuse me? 


 MS. MUNN: I said they agree, it's just a 


tracking issue, Mark. 


 DR. BEHLING: Is this the issue, Mark, that 


involves the assignment of tritium doses for 

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one microcurie versus five microcurie, the 71 


versus 355? Because there -- there were about 


-- there's three different procedures you can 


reference. Some have algorithms that you can 


use, but in many instances the issue stands 


around do I assign one microcurie or five 


microcurie, and the difference is obviously 


five-fold for an assigned dose for a lot of 


people. And I think Joyce may brought up, I 


certainly brought up in some of my reviews of ­

- of case -- cases that I've audited. 


 MR. GRIFFON: Yeah, I think that -- I think 


that might be the issue. I mean I guess the -- 


the OTIB-3 versus 1, I guess they have to be 


consistent or complement each other. Right? 


MR. ALLEN: Or cancel one. 


 MR. GRIFFON: Or cancel one. 


 MS. MUNN: We talked about that. 


 DR. LIPSZTEIN: Yeah. 


 DR. BEHLING: Yeah, I think in the first set of 


cases we had identified several maximized 


internal doses, some of which used the five 


microcurie per 24-hour urine volume and 


assigned 355 millirem each of those years, and 


another one was only the one microcurie per 

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liter or whatever it is that assigned the 71, 


and so there was an inconsistency by which the 


tritium doses were assigned. 


DR. NETON: But were those compensable or not? 


 DR. BEHLING: No, no, they were not 


(unintelligible) --


DR. NETON: See, if they're not compensable -- 


it's a similar issue to what we just talked 


about is -- you know, you could use multiple 


methods to come up with a dose that's less than 


50 percent. I mean that doesn't necessarily 


mean it's wrong or they're inconsistent. 


 DR. BEHLING: There's -- there's only one issue 


here, in fact, that -- and it's confusing, 


because then it says prior to the 


computerization of records, five microcuries 


per liter were not considered documentable -- 


MR. ALLEN: Intakes. 


 DR. BEHLING: -- urine intakes, and so that 


raised the question of what is really the more 


probable. 


MR. ALLEN: That's what was going on was -- 


you're seeing a progression of our methods 


through the program there, and OTIB-3, if I'm 


not mistaken -- whichever one had the five 

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microcuries --


 MR. HINNEFELD: That was three. 


MR. ALLEN: -- Savannah River -- they -- they 


took routine -- they took analysis on a lot of 


people, and they would record the analysis as 


read, but they didn't bother to calculate a 


dose from the tritium unless they exceeded five 


microcuries per liter, so the one TIB said 


therefore if there's no dose recorded, it had 


to be less than five microcuries per liter, and 


it gave a continuous five microcurie per liter 


type of dose as a very quick and easy 


efficiency way of doing it. And later that 


progressed on to going to their -- the actual 


bioassay and the recorded values there, and 


calculating a dose based on that and the OTIB-3 


five microcurie wasn't used anymore. And what 


you see in the procedure review was remnants of 


past methods, and that OTIB has been canceled 


now and I think we're probably -- got things 


cleaned up quite a bit better than 


(unintelligible) --


 MR. GRIFFON: So which one's been canceled, 


Dave? 


MR. ALLEN: OTIB-3. 

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 MS. MUNN: Three. 


MR. ALLEN: It was a --


 MR. HINNEFELD: With --


MR. ALLEN: Go ahead. 


 MR. HINNEFELD: Yeah, with respect to the 


tritium approach in TIB-1, what we should do is 


see if we want to take that out and delete it, 


or if we just need to modify it to be 


consistent with the TIB-11, which is the new -- 


sort of newest word on tritium intake. So 


that's our action on TIB-1, as part of the 


revision either to take out the tritium part or 


to make it consistent with the last word on 


tritium intake. I think. 


 DR. BEHLING: What is the new OTIB that treats 


tritium? I think we just got (unintelligible) 


 MR. GRIFFON: (Unintelligible) yeah, we just -- 

okay. 

 DR. BEHLING: Okay. 

 MR. GRIFFON: So you -- you're at -- that's 

what I was going to ask, in your NIOSH 


response, you haven't decided whether it'll be 


del-- removed or -- or modified at this point. 


 MR. HINNEFELD: Right. 

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 MR. GRIFFON: You're still just deciding that. 


Okay, so it stands -- the same response stands 


and we'll wait and see for the revision of 


OTIB-1. All right. How about finding number 


four? 


It seems to me the values in TIB-1 and 2 are 


going to be addressed in the subsequent 


revision. 


 MR. HINNEFELD: Right. 


 MR. GRIFFON: But as to the second point, 


there's no intent to relate it to job-specific 


-- relate the data to specific jobs. 


 MR. HINNEFELD: Right. TIB-1's -- we didn't 


intend to apply it to certain -- you know, or 


different numbers to different job categories 


if we're going to use TIB-1, so we didn't 


intend to do that as part of our clarification. 


 MR. GRIFFON: Okay, so more detail's going to 


be provided to clarify the values in TIB-1 and 


2, and reproduce the intakes in tables 3 and 5. 


Right? 


 MR. HINNEFELD: Uh-huh, right. 


 MR. GRIFFON: And then the middle part is not 


going to be addressed in this OTIB and SCA -- 


 DR. LIPSZTEIN: Yeah, because some -- there is 

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some description of how they -- they -- they 


found the mean value, but even following the 


description you cannot get the same numbers -- 


 MR. GRIFFON: Okay. 


 DR. LIPSZTEIN: -- so something different might 


have been done. 


 MR. GRIFFON: Okay. But as far as the second 


point in the SCA finding, relate data to 


specific jobs, I think that wasn't the intent 


of the OTIB to do that. Is SC&A okay with -- 


 DR. LIPSZTEIN: That's okay. 


 MR. GRIFFON: All right. 


 DR. LIPSZTEIN: Right. 


 MR. GRIFFON: Moving on, finding five. 


 DR. LIPSZTEIN: It's the same thing. 

 MR. HINNEFELD: Same as number four. 

 DR. LIPSZTEIN: (Unintelligible) 

 MR. GRIFFON: Okay. Hello? 


 MR. HINNEFELD: We're still here. 


 MS. MUNN: Yes? 


 MR. GRIFFON: Oh, okay. Did Joyce fall off? 


 MS. MUNN: Don't know. 


DR. NETON: Sounds like it. 


 MR. PRESLEY: This is Bob Presley. I'm still 


here. 

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 MR. GRIFFON: Okay, so -- so finding five is 


the same, I think. 


 DR. BEHLING: Joyce didn't say anything, I 


believe --


DR. NETON: Joyce, are you still there? 


 (No response) 


 MR. GRIFFON: I think Joyce got disconnected, 


but she was just saying that's the same as 


finding four. Then we're on to finding six, 


and if we need her, we'll pause. 


 MS. MUNN: Is Mike there still? 


 MR. GIBSON: Yeah, I'm still here. 


 MS. MUNN: Okay. 


 MR. GRIFFON: All right, this is a question of 


consistency with other OTIBs, and I think we 


talked about this in another instance. 


 MS. MUNN: Yeah, I think we did before. 


 MR. GRIFFON: So no requirement, and SCA is -- 


was in agreement with this. Correct, or --


 DR. BEHLING: Yeah, we discussed the issue of 


TIB-1 and 2 as -- as being separate and not 


applicable to -- in other words, Savannah 


River, TIB-1 is only for Savannah and the 


other's for all -- TIB-2. 


 MR. GRIFFON: Right. And there's no equity 

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question 'cause they're all -- 


 DR. BEHLING: No. 

 MR. GRIFFON: -- for under 50 percent dose. 

 DR. BEHLING: Yes. 

 MS. MUNN: Uh-huh. 


 MR. GRIFFON: Right. Okay, finding seven? 


 DR. BEHLING: I think the issue here, and 


speaking in behalf of Joyce, perhaps is the -- 


maybe this is an equity issue where we apply 


the same maximized dose for a guy who works 


there for six months and do the same thing for 


a guy who worked there for 30 years. In other 


words, we give them a one-time dose on the 


first day he starts out, then that's it, and 


one size fits all and I guess some people have 


raised the question is this fair. And perhaps 


you may start to encroach the issue of well, 


suppose the guy was there for 30 years, and 


every now and then there was a monitoring of 


urine and so forth, but I guess we will still 


say -- maybe it's easier just to throw in the 


high five or the 12 and 28 and be done with it, 


when in fact -- where's the bound-- where's the 


breaking point between saying the -- the onetime gift of 12 and 28 or high five is perhaps 

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maybe not always claimant favorable if you deal 


with a guy who started at Savannah River in 


1952 and worked to -- into the '90s. The 


question is where do we sort of look at this 


more skeptically and say maybe we should 


consider something a little more appropriate 


than a one-shot deal that occurred 50 years 


ago. 


DR. NETON: Well, I think -- we talked earlier, 


if we had bioassay data, we would use it to 


make sure that the TIB was bounding, gave a 


higher dose and it was still not compensable. 


So we would -- we're supposed to do that. I 


mean if they come through the -- 


 DR. BEHLING: The question, on the other hand, 


is early on in the '50s, the start-up of the 


reactors, perhaps there were no real monitoring 


data available for these people and is it 


possible that this unquestionable maximizing 


dose may not always be so certain as to be a 


maximizing dose for all people, given the 


longevity of employment and the time periods of 


employment. 


DR. NETON: I think we need to look at the 


category of the workers to -- 

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 MR. GRIFFON: Yeah, I guess that's --


DR. NETON: -- what is being applied. 


 MR. HINNEFELD: It's a case selection issue, 


really. I mean --


 MR. GRIFFON: That gets to the definition of -- 


 MR. HINNEFELD: -- there may be cases where 


it's not appropriate -- 


 MR. GRIFFON: -- unexposed or lightly --


 MR. HINNEFELD: -- to choose to use that. 


 MR. GRIFFON: -- exposed. Right? 


 DR. BEHLING: Yes. 


DR. NETON: I mean if the guy's a reactor 


operator and we applied the -- that high five, 


you know, and he had no bioassay in the '50s, 


that's probably not appropriate. 


 DR. BEHLING: Yeah, yeah. 


DR. NETON: And so I think, you know, we have 


to be careful where we apply it. 


 MR. GRIFFON: So I think -- Hans, I think 


you're saying you're in agreement as long as 


care is taken in defining exposed -- I mean 


unexposed or lightly exposed. 


 DR. BEHLING: Yes. Yes. 

 MR. GRIFFON: Yeah, I would agree with that. 

 DR. BEHLING: I mean I would look at it in 
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terms of not just even the duration of 


employment, but the period of employment. You 


know, we always -- we're all aware of the fact 


that health physics has certainly improved over 


the years. 

 MR. GRIFFON: Period of employment and location 

and --

 DR. BEHLING: Yes. 

 MR. GRIFFON: -- job type and --

 DR. BEHLING: Yes. 

 MR. GRIFFON: -- all those factors. 

DR. NETON: All those things have to be... 


 MR. GRIFFON: Okay, but I don't think there's 


any disagreement with NIOSH on that. Right. 


So does this -- I don't know that this requires 


any modification to the OTIB, does it, or does 


it? 


 DR. BEHLING: I mean it's possible if you 


wanted to accommodate and say that if a guy 


worked there for -- let's say for every 15 


years you apply this and say okay, he got it on 


the first day, and if he worked for 30 years, 


15 years later he got another maximized dose, 


in order to establish some equity between 


people on the basis of longevity of employment. 

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But that has a danger that it might bring 


certain dose assessments over the 50 percent 


value, and it's no longer a issue of 


compensability of a -- non-compensability of a 


claim. 


 MR. HINNEFELD: Yeah, I don't really view it as 


an equitable issue or equity issue for people 


you're doing dose reconstructions less than 50 


percent. You know, granted, a person who 


worked there six months clearly didn't get the 


same internal exposure as somebody who worked 


there ten years, but their dose reconstruction 


comes out less than 50 percent in both cases, I 


don't really view it as an equitable issue. 


think it's really a case selection issue. It's 


not -- it's not something that we can address 


in the context of TIB-1, but would be a case 


selection process; are the cases appropriately 


selected to use TIB-1. That's really 


independent of what TIB-1 says to do. I'm not 


so sure -- I'm not so sure we can put a hard 


and fast time limit on there, either, because 


there are people who worked for 30 years at 


Savannah River who are lightly or unexposed the 


entire 30 years, in which case it would be 


I 
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perfectly fine to use TIB-1 for those people. 


So I just -- I don't see a remedy that we can 


really manage -- I mean in TIB-1. 


MR. ALLEN: I would like to point out, though, 


that TIB-1 includes a number of nuclides. It's 


the high -- you know, intended to be the high 


five intake of each of those nuclides, and 


there is nobody -- documented, anyway -- that's 


gotten the highest of any two or three of 


those, let alone -- I don't know how many are 


here -- 15 or more, so it still ends up being 


very bounding. 


 MR. GRIFFON: So -- so where do we -- I -- I 


understand you -- I mean I guess -- I guess 


OTIB-1 applies then an acute intake of these 


high five. Right? 


 MR. HINNEFELD: Yeah. 


 DR. BEHLING: Yes, first day of employment. 


 MR. GRIFFON: I'm refreshing my memory on 


these. So where -- where are we leaving this, 


'cause I -- I do -- I know some of your other ­

- again this is an overestimating technique, 


but -- but then there would be that question of 


-- I guess -- I guess that is -- you know, 


careful consideration to the -- to the -- I 

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could certainly see certain classifications of 


workers in certain areas that they would easily 


fit in this and be very -- a very claimant-


favorable overestimating technique, but if 


someone was 30 years reactor operator, then 


you'd have to wonder if it -- if it applied. 


Right? 


 MS. MUNN: Yeah. 


MR. ALLEN: Well, I guess the point I was 


trying to make is you'd have to almost believe 


he was involved with some 15 separate incidents 


to get this highest exposure to each of these 


isotopes. It's not like it's a one-shot acute 


intake, even though that's how it's calculated. 


It's more like there was, you know, say -- say 


15 isotopes, you know, it's like 15 different 


major incidents he would have had to have been 


involved in, but --


 MS. MUNN: And that's so unlikely -- 


MR. ALLEN: -- should pretty well bound a 30­

year career, I would think. 


 MS. MUNN: That's so unlikely as to be 


unreasonable. 


 MR. GRIFFON: Yeah. 


 MS. MUNN: And that's not --

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DR. MAURO: This is John. I agree, this goes 


to the matter of does the dose reconstructor 


apply this at the right times. And of course 


it's going to be his judgment, I guess, looking 


at his particular case. If he's got a person 


there that's worked for 30 years, does have 


some bioassay data that would indicate he had 


some intakes periodically and perhaps even 


chronically, at some point he has to make a 


judgment whether he's going to go with the real 


data and do I guess a realistic case or -- and 


come in underneath, or go with the high five 


approach and come in underneath. Either way, 


what I'm hearing is when he makes these 


judgments, in the end this person's going to 


come in with a dose that is non-compensable. 


So there's a -- I could see where there is -- 


the optics, to use Hans's term, could be 


difficult in that the same approach -- from an 


implementation side, you're -- a situation is 


created where there's an awful lot of judgment 


left in the hands of the dose reconstructor, 


and I guess how -- how is there some assurance 


that in fact this -- this methodology is in 


fact being used -- the selection process is 

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correct? 


 MS. MUNN: Well, John -- this is Wanda -- from 


my viewpoint, unless the case reviews that we 


see lead us to believe that there is a systemic 


error being made by the reconstructors in this 


-- in these cases, I don't see that there's an 


issue. There's always going to be a matter of 


judgment in any of these cases we pick up -- 


DR. MAURO: Yeah, that's true. 


 MS. MUNN: -- so unless we see that there's a 


recurrent problem as we review cases, I don't 


see that this is an issue we need to beat to 


death. 


DR. MAURO: Yeah, I agree. Say, Hans, I don't 


know if you could -- do you remember off the 


top of your head, but in general are you seeing 


that this problem doesn't emerge, that it is 


being used appropriately? 


 DR. BEHLING: Well, I have one case currently, 


and I already made reference to it earlier in 


context with something that came up, but I do 


have a case currently among the 20 cases in set 


four where an individual had numerous 


urinalysis -- 157, I believe -- all of them 


very high, well above MDA for uranium. He was 

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in an environment that involved recycled 


uranium, so there are obviously contaminants in 


addition to uranium. He had numerous chest 


counts that indicated at least trace quantities 


of uranium and plutonium. And the guy opted to 


go with the 12 radionuclides, and -- I haven't 


run it yet, but it may very well be that the 12 


radionuclides will still end up with a higher 


dose, but I have to say, in the absence of 


running that data, you would be hard-pressed to 


come to that conclusion. 


 MS. BEHLING: I think the other issue that 


we're discussing on this particular item is 


looking at a long-term employee or an employee 


in some job function that would be at higher 


risk that's been unmonitored, and we're trying 


to -- am I -- and we're trying to determine 


will this high five approach -- and I think, 


based on what David Allen just said, that we're 


using all of these different radionuclides and 


it's as -- it's as if there would be 15 acute 


intakes, possibly, that helps to clarify it in 


my mind a little bit better. 


 DR. BEHLING: The improbability that even a 


long-term employee would exceed the 12 or 28. 

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 MS. BEHLING: Right, we're looking at 


unmonitored, not necessarily would the person ­

- I think the dose reconstructors pretty well 


know to look at the bioassay data and if 


there's -- in most cases we see, if there's 


bioassay data there that they think may give 


some kind of a dose, they will run IMBA. But 


if they don't have to -- obviously they can run 


the efficiency process; it's easier for them -- 


but that's I don't think what we're talking 


about in this particular issue, it's 


unmonitored --


 MR. GRIFFON: Well, I don't think we're looking 


at unmonitored, either. I think --


 MS. BEHLING: Oh --


 MR. GRIFFON: -- the term is unexposed or 


lightly exposed. 


 DR. BEHLING: Yeah, it's a combination of 


everything --


 MR. GRIFFON: It's a combination, but I think 


that's sort of the intent (unintelligible). 


 DR. BEHLING: And in so many cases, you know, 


the dose reconstructor actually ran IMBA and 


said this is what I would get, and you're 


getting the benefit of doubt by me giving you 

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the 12 or 28, and that's the right way to do 


it. This way there's no question that the -- 


the assumed dose is always higher than the 


empirical dose. And we have plenty of cases 


where that was done. 


DR. NETON: I'm curious if the --


DR. MAURO: Hans, I didn't quite follow that. 


Are you saying that you're seeing cases where 


the dose reconstructor did both -- 


 DR. BEHLING: Yes. 


DR. MAURO: -- that he used the monitoring data 


to see what dose that generated and then -- 


 DR. BEHLING: Exact--


DR. MAURO: -- used the default -- 


 DR. BEHLING: Exactly. 


DR. MAURO: Oh, okay. 


MR. ALLEN: Well, just -- this is Dave Allen. 


Just to clarify that, they ran like the 02 


numbers to predict a urine, right, for a -- 


what 02 would give you, then com-- just 


visually compared that to the -- the bioassay 


the guy actually had. It's not like they went 


through a hard core internal dose estimate 


(unintelligible) --


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urine data and basically said what's the 


inhalation, and then basically went through the 


hoops of trying to determine what would be the 


real dose if I relied on -- on bioassay data. 


We've seen (unintelligible). 


DR. NETON: That's certainly not the most 


efficient way to do it. 


 DR. BEHLING: No, I realize that, but I think 


when you get to the cutting edge where you're 


not sure which one is going to give you the 


higher number, then you almost have no choice. 


DR. NETON: No, but as you know, it's much 


easier to take an acute intake at day one and 


generate a series of curves and say are all 


those curves above all the datapoints that I 


might have for the person. It's much more 


efficient. 


MR. ALLEN: Generate them (unintelligible) like 


TIB-2, it's a one-shot deal and you just -- 


 DR. BEHLING: Oh, I realize that 


(unintelligible) --


DR. NETON: You have one intake and you 


generate the bioassay projections and -- and 


then you can say based on those bioassay 


projections, this is much higher than anything 

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I've seen in any of the (unintelligible) -- 


 DR. BEHLING: Well, the -- the bioassay may 


have confined itself to a lot of uranium and -- 


and then you're sort of hard-pressed to 


determine whether, you know, you can just make 


the comparison between uranium bioassay data 


against 12 or 28. 


DR. NETON: Well, I mean if you had uranium -- 


 DR. BEHLING: Well, I realize uranium is part 


of it, but you know, again -- 


DR. NETON: That's my point. I mean if the 


uranium bioassay's below the uranium intake 


that you'd assign, and then -- 


 DR. BEHLING: Well, that -- that's the first 


cut. 


DR. NETON: That's really the way it's supposed 


to work. I mean I don't know what you have for 


that particular case. Maybe somewhere imbedded 


in the files are some runs and possibly just 


didn't get written up in the dose 


reconstruction. I mean it -- I've got to 


believe at some point they ran something to 


show that the TIB numbers were higher than the 


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did, and they state so. I mean they state that 


the --


DR. NETON: Well, you were talking about a 


current case you have where that wasn't -- 


 DR. BEHLING: No, no, not on this one. The 


current case -- I'm sure that -- 


DR. NETON: Different story, yeah. 


 DR. BEHLING: -- the person didn't look at all. 


 MR. GRIFFON: Well, I think -- getting back to 


finding seven here, I think, you know, part of 


this comment can maybe be covered in NIOSH -- 


Jim, you offered to -- or you offer that the 


staff would develop a clarifying approa-- you 


know, a couple paragraphs clarifying this 


approach, and I think that might also address 


this -- this question of, you know, the six 


months versus ten years versus 30 years and 


(unintelligible) --


DR. NETON: Yeah, that's a little different 


issue. We were tal-- I was speaking about 


addressing the high five and how they -- 


 MR. GRIFFON: Right. 


DR. NETON: -- they arrived at being bounding, 


and now I think I'm hearing another write-up, 


which would be a different issue, and that's 

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how one applies the high five or the bounding 


approaches to --


 MR. GRIFFON: I guess I was going to add 


another paragraph to that, yeah. 


DR. NETON: Yeah, and -- yeah, I don't know 


that we're going to act much differently than 


what we've been doing. There is some level of 


judgment required. You know, whether a person 


was unmonitored, it's pretty clear. Lightly 


monitored, there's some bioassay. I think 


we've got a direction for dose reconstructors, 


you need to compare the bioassay. Possibly 


this -- this gray area where it's -- I don't 


know, between lightly and -- my -- my guess is, 


and I don't do these every day, but that they 


tend to be conservative in the application of 


this and would not use it in cases where there 


was a gray area, but how we define that in a -- 


in a paragraph, I'm not sure. I -- we can --


we can try. I'll commit to that. 


 MR. GRIFFON: All right. 


 DR. BEHLING: And before you go on, Mark, I 


guess I do have a question because when the 


dose reconstructor receives a case isn't it 


true that someone screens that case ahead of 

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time and says treat this as a maximized dose 


reconstruction based on preliminary assessment, 


in which case he may not pursue any subjective 


interpretation of the data. He accepts the 


notion that this is a maximized dose 


reconstruction and that's just as far as he's 


going to evaluate it. 


DR. NETON: I think --


MR. ALLEN: That's -- that's --


 MR. HINNEFELD: Not entirely, no. 


MR. ALLEN: I think -- like an administrative 


way of trying to triage claims, but the dose 


reconstructor's the one who's responsible. 


DR. NETON: He's got the ultimate 


responsibility. 


 DR. BEHLING: Because in one of the Proc. 6 


there's a statement about the Task 2 people who 


will identify this or -- or essentially label 


this as a non-compensable case versus -- 


DR. NETON: Well, I think there's some of that 


judgment made, but -- but oftentimes it's -- 


it's the very clear-cut cases get triaged that 


way where maybe you have zero bioassay data. 


The person is a -- an administrative type and 


it would go down one path and -- and, you know, 

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it may be a different set of dose 


reconstructors would be assigned those type of 


cases, but --


MR. ALLEN: It's not unusual for them to triage 


it one way, the dose reconstructor get ahold of 


it and say no, that's not going to work, you 


know. 


DR. NETON: These are -- these are rough cuts. 


 DR. BEHLING: Okay. But I mean the -- the -- 


the ultimate person who makes a -- or a final 


decision is in fact then the dose 


reconstructor. 


DR. NETON: Yeah. 


 DR. BEHLING: He can overturn that -- that 


assessment. 


 MR. HINNEFELD: Yeah. 


DR. NETON: Yeah, he signs it as having, you 


know, done the case. Or she, (unintelligible). 


 MR. GRIFFON: Can I -- I think we're going on 


to finding number eight, but can I -- is this a 


good time for a short comfort break here? 


 DR. WADE: I think so. 


 MR. GRIFFON: And then I don't know how -- Lew, 


how long can we go today or how long can people 


go? I mean --

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 DR. WADE: It's a matter of personal stamina. 


 MR. GRIFFON: You know, I was -- I was 


personally thinking --


UNIDENTIFIED: I think Lew's done. 


 MR. GRIFFON: I was personally thinking 4:00 or 


4:30, so... 


 DR. WADE: Well, let's say 4:30. 


 MR. GRIFFON: All right. 


 DR. WADE: Is that merciful? 


 MS. MUNN: That's merciful. 


 MR. GRIFFON: I didn't know if anybody there 


had flights to ca-- you know, flight issues. 


DR. NETON: Flight issues? 

 DR. WADE: I think we have no flight issues. 

 MS. MUNN: We're trying to avoid that, 

remember? 

 MR. GRIFFON: Yeah, I know. 


 MS. MUNN: We're trying to get around that. 


 DR. WADE: Okay, let's take ten minutes, come 


back and we'll push hard to 4:30 and -- 


 DR. BEHLING: Yeah, let's try to move this on. 


 DR. WADE: Okay, thank you. 


 (Whereupon, a recess was taken from 2:30 p.m. 


to 2:48 p.m.) 


 DR. WADE: ... people are mostly here. Who do 

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we have on the line, please? 


 MR. GRIFFON: Mark Griffon. 


 MR. PRESLEY: Bob Presley. 


 MR. GIBSON: Mike Gibson. 


DR. MAURO: John Mauro. 


 MR. KOTSCH: Jeff Kotsch. 


 MS. HOWELL: Emily Howell. 


 DR. LIPSZTEIN: Joyce Lipsztein. 


 DR. WADE: Okay, well, you're all welcome back. 


You're troopers to be back. So let's -- let's 


continue. 


 MR. GRIFFON: All right. We're on finding 


number eight, I believe, OTIB-1, finding eight. 


 DR. LIPSZTEIN: I think OCAS -- NIOSH has 


agreed with our commentary. 


 MR. GRIFFON: And does this -- is this -- more 


details needed to easily verify the values. Is 


this part of what we're going to get as this 


explanation, or is this going to be included in 


those tables? I'm not exactly clear, the 


response there. 


 MR. HINNEFELD: Well --


 MR. GRIFFON: In a subsequent revision these'll 


be -- more details will be provided, is that 


what we're agreeing on? 

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MR. ALLEN: I think we're definitely agreeing 


on an evaluation and we suspect that's going to 


lead to a revision. 


 MR. GRIFFON: Okay. 


MR. ALLEN: Does that work? 


 MR. GRIFFON: Okay, evaluate and revise as 


needed. Right? 


 MS. MUNN: Now originally we had said a 


revision was going to occur. 


MR. ALLEN: Okay, I think you can pretty much 


say yeah, a revision is going to occur. 


 MS. MUNN: Good. Mark needs to track it. 


 MR. GRIFFON: All right, revise. And finding 


nine? I think we discussed -- 


 DR. LIPSZTEIN: A finding -- can I -- or 


someone wants to speak? 


 MR. GRIFFON: Go ahead, Joyce. 


 DR. LIPSZTEIN: Okay. Finding nine, for me, is 


a big technical issue. I disagree with both 


arguments, the NIOSH response. We -- when we 


wrote the report, SC&A, we made a long 


explanation with a long list of -- for all 


radionuclides that were cited from the document 


showing that for most of them if you had used 


ICRP-68 instead of ICRP-30 you would get a more 

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claimant favorable result. Hello? Hello? Can 


you -- can you hear me? 


 MR. GRIFFON: You're still on -- yes. 


MR. ALLEN: Yep. 


 MS. MUNN: Yeah. 


 DR. LIPSZTEIN: Okay, 'cause there was a buzz. 


 MS. MUNN: Yes, there was something strange. 


 DR. LIPSZTEIN: Yeah. So what happens is -- 


and we wrote that -- that when -- the document 


says that -- they -- they used ICRP-30 models 


instead of the new models, and they say that it 


is necessary -- it's not necessary to use the 


exact values, but it must be shown that the 


values are indeed a likely overestimate. And 


then in this document (unintelligible) were 


calculated for ICRP-30 and ICRP-68, and they 


try to show that ICRP-30 methodology was -- 


take a more claimant-favorable number than 


ICRP-68, but there were two mistakes on this. 


The first one was that when ICRP-30 and ICRP-68 


were compared, instead of comparing type F with 


class D, type M with class diablo, type S with 


class Y, they used for ICRP-68 the most soluble 


form of the material, and for ICRP-30 they were 


-- used the material class system to calculate 

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the intakes, what really happened. So there 


are two problems. The first, that when you use 


the most soluble form of the material, this 


doesn't give the higher dose because intakes 


when -- you don't -- don't come from the 


intake, you come from the bioassay results, 


from urine results, so you are going back. 


So sometimes type S -- if you have the same 


excretion in urine, sometimes type S gives a 


higher result than type F, a higher dose than 


type F. Because of that, if you want to 


compare ICRP-30 with ICRP-68, you have to 


compare class type S, class D with type F, 


class diablo with type M and class Y with type 


S. When you do this for most of the 


radionuclides, then we went on with that big 


list of them, each one by each one, and we 


showed that for most of them if you use ICRP -- 


the new ICRP methodology you got numbers that 


were -- doses that -- intakes and doses that 


were higher than if you used ICRP-30. And was 


not something that you (unintelligible) just 


throw out, for example, for plutonium you -- 


for type M plutonium -- for type S plutonium, 


for example, you got a difference -- like if 

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you used ICRP-30 you would get a dose and an 


intake between 15 percent and 22 percent of the 


dose using ICRP-30. So it's substantial. The 


variation was because of the number of the 


(unintelligible) that the -- if you have a 


urine sample -- it doesn't say -- the numbers 


that were written in the document, it doesn't 


say when it was taken, how many days after the 


intake was it taken, so you have to analyze to 


-- to right number of days and that's what was 


done also in the document. And we went through 


extensive list and there was only -- not to say 


that all of them ICRP -- the new ICRP 


methodology gave high results, but you had some 


like (unintelligible), for example, that would 


give -- the ICRP-30 would give a -- a more 


claimant-favorable result, but for most of the 


nuclides, especially the most important ones 


like uranium, plutonium, cobalt, strontium and 


magnesium, you get a higher dose and a higher 


intake if you use ICR-- the new ICRP method 


instead of ICRP-30. 


DR. NETON: Well, I think the same argument and 


logic applies to what we discussed about a half 


an hour ago in that, you know, we've agreed to 

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go back and put a few paragraphs in there 


explaining our logic for using these values and 


whether or not we believe, for instance, the 


ICRP-30 calculated intake of say 160 nanocuries 


for plutonium is a bounding estimate for the 


class of workers. Joyce raises a lot of good 


points on -- on when you're trying to mix and 


match metabolic models, and I take no exception 


to that. But I think we need to do a better 


job explaining why we believe that the 100 


nanocuries or so for each of these 


radionuclides is -- is a credible overestimate 


for, again, the workers that we're applying 


this to. 


I would -- I think I do remember some of these 


analyses, and I think we need to remember also 


that this applies primarily to non-metabolic 


organs. I don't think it applies to lung doses 


or anything like that. So it applies to organs 


that really are not in the metabolic model and 


so some of the calculations I think might have 


been a little bit off, but -- but again, I 


think the argument to be made here is that, you 


know, we need to justify why we believe these 


are high values. 

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 MR. GRIFFON: Okay. Yeah, you -- and you -- 


this -- this is covered in the few paragraphs 


that you offered earlier. Right, Jim? 


DR. NETON: I hope so. 


 MR. GRIFFON: Same thing, yeah. Okay, and the 


next finding 10 is a little different question. 


 DR. LIPSZTEIN: Yes. 


 MR. GRIFFON: Go ahead, Joyce. 


 DR. LIPSZTEIN: No, I just -- if I -- if I was 


someone that didn't get -- I was just thinking 


if I'm the client, if I'm someone that I'm 


arguing to get a compensation, I would ask 


NIOSH why did you chose the five largest intake 


instead of the largest intake. 


DR. NETON: Again, I think it's the same -- 


same discussion. 


 MR. GRIFFON: Same -- yeah. 


MR. ALLEN: Slightly different, I mean the high 


five rather than the highest one is -- is 


arbitrary. I mean there's no -- well, no doubt 

about that. I mean --

DR. NETON: Yeah, again, but you need to look 

at it --

MR. ALLEN: -- it's intended to be an 

overestimate, the highest intake or the highest 

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five intakes or the highest ten intakes should 


represent a high -- a bounding estimate for 


most non-monitored workers or low exposure 


workers. 


DR. NETON: The thought just occurred to me 


that I think we're on the cusp of coming up 


with a Savannah River coworker model, or am I 


dreaming that? 


MR. ALLEN: I think you're dreaming that one. 


DR. NETON: Well, scratch that thought. I was 


just thinking if we had -- if we had a model 


developed since then or were about to publish 


one, it would easily address this issue by 


showing that the coworker -- a coworker model 


would be substantially lower in assigned dose 


than what we're doing here, but apparently I 


dreamt that over the weekend, so scratch -- 


scratch that. 


 MS. MUNN: It's the snow. 


MR. ALLEN: This particular comment does bring 


up an interesting question. I mean there's no 


reason to believe that an average of the 


highest ten won't overestimate the majority of 


workers out there in Savannah River, so I'm 


wondering if some of these smaller changes in 

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dose, if we increase doses for some of these -- 


or at least evaluate, based on increases from 


some of Joyce's comments versus the decrease 


that would be caused by the highest ten, if 


we're not acceptable to say okay, we're good to 


go as-is. 


DR. NETON: Yeah, we're thinking on the fly 


here, and I think maybe -- my thought was -- 


behind this is that we -- we have to have some 


empirical thought process between why is say 


160 nanocuries bounding and if -- for a non-


monitored worker who probably shouldn't have 


been monitored and -- you know, I'll use the 


extreme as an example; the administrative 


support staff, secretarial type, who barely 


entered the production environment -- I think 


we can build the argument in this few 


paragraphs as to why it's unlikely that this 


person who was not on the production lines, not 


opening drums, not doing the real mechanical 


processes, would fall in that category. I 


think we need to build that case. 


 MR. GRIFFON: Well, and Jim -- Jim, your 


comment was kind of leading to what I've been 


thinking, which is, you know, is -- is coworker 

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model for Savannah River being developed that's 


consistent with Y-12 and Mallinckrodt and, you 


know, that -- that sort of approach that you've 


been using at many of the other sites. 


DR. NETON: Yeah, and I -- I thought that there 


was some efforts going down that path -- maybe 


we're not as close or far along as I -- as I 


had thought, but -- and that would -- that 


would be the ultimate, I think, 'cause then we 


could compare it to the monitoring data that 


are out there. And in fact this is kind of 


what we try to do. I mean rather than resort 


to coworker distributions, you take the highest 


five intakes that were assigned and -- and 


almost by definition those are going to fall 


somewhere in the coworker -- you know, the high 


end of the -- the very high end of the coworker 


model. It's just, you know, how do you -- how 


do you convince folks of that. It's something 


that's fairly intuitive, I think, but you know, 


can you put a slam dunk on it by -- you know, 


by looking at some existing processes and... 


 MR. GRIFFON: Well, yeah, and I guess that -- 


you know, back to my point on that, I think 


your -- your evaluation report will go along 

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way to helping us to clarify this, though. But 


I mean back to -- to my other point on this 


whole thing, which is -- sort of falls in with 


Joyce's evaluation of 68 versus 30, I mean if ­

- if you had -- if NIOSH had independently 


evaluated these intakes, then you would have 


used 68 if you went back to the -- you know, 


the raw data and said okay, here's the -- 


here's the incidents, let's re-evaluate the 


data itself, instead of taking just the intake 


from those cases. 


DR. NETON: Yeah. 


 MR. GRIFFON: So you know, and -- and this 


issue would go away completely. But anyway, I 


think we'll wait for your evaluation report I 


think --


DR. NETON: Yeah. 


 MR. GRIFFON: -- I think, at this point, yeah. 


 DR. LIPSZTEIN: One of the thing -- I don't 


know how valid this is, but I was just thinking 


if I was someone that was applying for 


compensation, so for example if you look at the 


-- for example, for plutonium 241, there was 


that very high intake in '62, and then there 


was a high intake in '77 also, and then if I 

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worked in the '60s period, I would -- I would 


rather use the -- I would actually 


(unintelligible) I would -- why didn't they use 


the data from the '60, why did they mix with 


data from the '70s and -- and I get a lower 


intake on the calculation of my dose when I was 


not there in the '70s, for example. 


(Unintelligible) you know, I know 


(unintelligible) you have to -- you have to 


find a (unintelligible) criteria to use, but 


the criteria is objective and if you think on 


the side of the client, he might, you know, go 


with (unintelligible) and say look, I -- you 


know, this -- this was the -- where the largest 


intakes et cetera (unintelligible) they were 


from a time I was not working there. And 


that's why the -- the -- the mean of the five 


is lower than the highest intakes from the 


period I was working there. 


MR. ALLEN: But the idea that it was -- we had 


some, I don't know, 6,000 intakes estimated by 


Savannah River and they were done using ICRP-30 


methodology is why we had all the 


consternations in there, but they were 


throughout time, so we picked the highest five 

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for each isotope that there was an intake 


calculated for. If we were to refine that to a 


-- say a decade, then by definition there's 


going to be some -- some in there that are much 


lower in that decade, so the average should 


drop. So I mean it's just a question of -- you 


know, is high five throughout -- high five 


throughout time is going to be higher than the 


high five for any given decade, generally. 


 DR. LIPSZTEIN: Depends on the decade 


(unintelligible) --


DR. NETON: It does, but --


 DR. LIPSZTEIN: -- and I know you have to have 


a criteria, I don't argue with that. I'm just 


saying that if I was someone claiming for 


something, I wouldn't -- you know, and I 


understood what was on those tables, I wouldn't 


let it go like that. 


 MR. GRIFFON: I think -- I think at this point 


we'll wait -- you know, Jim's offered an 


evaluation report. I think we need -- you 


know. 


 DR. LIPSZTEIN: (Unintelligible) 


 MR. GRIFFON: Short evaluation report will help 


us, and then we can go from there. Right, Jim? 

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Is that --


 DR. LIPSZTEIN: Okay. 


DR. NETON: Yeah. 


 MR. GRIFFON: All right. Number 11? 


 DR. LIPSZTEIN: Number 11 -- I think Jim 


explained that at that time IMBA didn't have 


the -- all the numbers. Right? 


 MR. GRIFFON: Oh, right. 


 DR. LIPSZTEIN: And they had to use surrogates, 


and now this can be (unintelligible), is that ­

- did I understand right? 


MR. ALLEN: Yeah, that was discussed earlier, I 


remember, anyway. 


 MR. GRIFFON: So this is the one revised as 


needed, sort of. 


DR. NETON: Right. 


 MR. GRIFFON: Yeah, and it's -- so you didn't 


have the -- the most current version of IMBA, 


obviously. 


DR. NETON: Right. 


 MR. GRIFFON: Right. Okay. Number 12? Oh, 


we've gone through the IMBA. A new topic, 


anyway. 


 MS. MUNN: Oh, goody-goody. 


MR. ALLEN: Well, if nobody else will speak up 

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 MR. GRIFFON: Yeah, go ahead. 


 MS. MUNN: Please do. 


MR. ALLEN: This one our issue -- if I'm not 


mistaken, the comment was essentially if we 


assumed tritium was organically-bound tritium, 


the doses would be higher, and we agree. What 


we -- the problem is we cannot find any reason 


to believe at Savannah River that organically-


bound tritium would be a significant -- 


significant hazard compared to other forms of 


tritium. 


 MS. MUNN: That's good news. 


DR. MAURO: John Mauro. We've been discussing 


this amongst ourselves also, and we feel that, 


given the -- that organically-bound tritium I 


believe may have up to a four-fold higher dose 


conversion factor -- I'm not quite sure, in 


that range -- and that the percent of exposure, 


though, to organically-bound tritium at 


Savannah River -- at least in the case of 


Savannah River, is -- is very small, so bottom 


line is this issue is really an extremely minor 


issue. And --


 MR. GRIFFON: So in your --

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DR. MAURO: -- so Hans or Kathy -- 


 MR. GRIFFON: -- in your opinion --


DR. MAURO: -- did I correctly characterize 


this? 


 DR. BEHLING: Yeah, I think you said it. I 


guess the assumption of a ten-day biological 


half-life (unintelligible) in 40 days so it 


raises the (unintelligible) time integrated 


dose, but the percent of the organified tritium 


is so small as to make a difference as maybe 


one or two percent or something like that, 


which really is an insignificant -- has an 


insignificant impact on total dose. 


 MR. GRIFFON: So in your opinion, any -- any 


modification necessary to the TIB or no? 


 DR. BEHLING: No. 


 MR. GRIFFON: And did this finding cover metal 


tritides? I thought it also covered -- I guess 


just OBT, huh? 


DR. MAURO: That's a separate one, yeah. 


 MS. MUNN: Just organics. 


 MR. GRIFFON: Metal tritides is separate? 
I 


don't see it. 


DR. MAURO: I think they have it later 


(unintelligible). 

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 MR. HINNEFELD: Metal -- metal tritides is -- 


 MS. MUNN: Uh-huh. 


 MR. GRIFFON: Oh, okay. 


DR. MAURO: We'll see, but I guess the only 


point being made here is that there's reason to 


believe that there's a large fraction of the 


tritium exposure was to organically-bound 


tritium. Well, yeah, then we have a three or 


four-fold (unintelligible), but if it's not, as 


is the case at Savannah River, I can't see 


really worrying too much about this. 


 MR. GIBSON: This is Mike Gibson. So you're 


speaking right now specifically at Savannah 


River and organically-bound tritium and, just 


as Mark said, not necessarily other forms of 


stable tritides? 


DR. MAURO: Yeah -- yeah, there were these -- 


another issue of I guess metal tritides that 


was -- I think that's here or -- I'm not sure 


if that's discussed with a specific -- other 


procedures, I'm not sure, but -- other separate 


issue, and I'm not quite sure where we came 


down on that one. 


 DR. BEHLING: I think it's part of the revised 


TIB-11, I think. Don't they discuss metal 

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tritides in TIB-11? 


 MR. GRIFFON: I guess that's what I was asking. 


It's coming up next, so we'll (unintelligible) 


in a second here. But yeah, OB-- so OBT for 


the -- for Savannah River Site for this TIB-1, 


you don't think that the TIB has to be modified 


in any way? I mean is -- is clarification 


needed that if it's likely that -- if -- if 


data suggests that a person was, you know, 


exposed to organically-bound tritium in any 


significant way, then -- then consideration 


should be given for a different -- I guess 


that's obvious, you know. I think that a dose 


reconstructor would do that if -- if data was 


there to present itself and -- so I guess no -- 


no change is needed. Is that what --


 MS. MUNN: Yeah. 


 MR. GRIFFON: -- I'm hearing? 


 DR. BEHLING: Perhaps a statement should be 


made that the issue of organified tritium has 


been looked into and there's no supportive data 


to suggest that it's there in significant 


quantities, which would then minimize the 


potential concern. 


MR. ALLEN: You're talking about that statement 

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in the TIB --


 DR. BEHLING: Yeah. 


MR. ALLEN: -- or in the review of your -- 


 DR. BEHLING: In the TIB, so that you can take 


a preemptive position in saying that this has 


been looked into and if there is data to 


support that statement perhaps then that would 


put that whole issue to rest. 


MR. ALLEN: I'm kind of worried about it 


confusing people more than clearing things up 


if it's in the TIB. 


 DR. BEHLING: Well --


MR. ALLEN: It'd be great in the review, you 


know, or some documentation here. 


 MR. GIBSON: I couldn't hear that. What was 


that again? Who was talking? 


MR. ALLEN: I'm sorry, this is Dave Allen. I 


was -- me and Hans were just talking across the 


table here and he's suggesting possibly a -- a 


few sentences in the TIB saying that 


organically-bound tritium was looked into and 


it's not an issue at Savannah River. I'm just 


wondering if it might not confuse the issue 


more than clarify it if it's in the TIB, and 


suggest maybe the -- somewhere in this review 

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might be a better place for it. 


 MR. GRIFFON: Yeah, and I think it's in the 


NIOSH response right now as -- you know, what 


you said is so far OCAS has not conceptualized 


an exposure scenario da da da da da da. Could 


I --


 DR. LIPSZTEIN: Yeah, because -- I'm sorry -- 


because the way it's written makes people more 


confused 'cause it only says organically-bound 


tritium historically has been ignored for 


occupational dose assessment, and the Savannah 


River Site assumes that there is no significant 


quantities of stable metal tritides. 


 MR. GRIFFON: Oh, that's different. 


 DR. LIPSZTEIN: So it just says that this 


historically has been ignored and then nothing 


else about organically-bound, so maybe -- would 


say that there are no significant quantities of 


SMT and OBT, also. 


 MR. ELLIOTT: Another thing to evaluate and -- 


 MR. GIBSON: This is Mike Gibson. Could I ask 


this question of I guess someone from NIOSH, 


and maybe this is not the right place for it, 


but when -- if someone gets some illness, how ­

- you know, whether it's -- I know you guys 

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deal with subtitle B and Labor deal with E, but 


how do we consider the combination of the 


radiation dose and possibly the toxicity of the 


metal that this tritium that's bound to that's 


lodged in the lungs and -- and the 


synchronization of -- of those two elements 


that may have caused whatever illness the 


people have? 


DR. NETON: Well, I guess the short answer, 


Mike --


 MR. GRIFFON: I guess, you know, in answer to 


your question, Mike, I think it's up to -- to 


Labor to do that under subtitle E, but -- 


DR. NETON: Right, we're -- we're not 


addressing at this point any -- any synergistic 


effects between other agents and radiation, 


mostly because we don't have the models 


available to do anything in that area 


(unintelligible). 


 MR. HINNEFELD: That'd be Labor, anyway. 


DR. NETON: And Labor -- subpart E, as you -- 


as you pointed out, is -- is tasked with doing 


that. 


 MS. MUNN: We are not charged to do so. 


 MR. GIBSON: So would it -- would be our -- 

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would it -- this is Mike again. Is it under 


our charge to ask the Department of Labor to 


make sure that they are considering that, or 


should we raise that issue with them or who -- 


how do we make sure this issue is addressed? 


 MS. MUNN: It wasn't -- this is Wanda. It 


wasn't in our charge when we were originally 


established, because that's the question I 


asked of several people at the time and read 


the documentation very carefully because I was 


concerned about having to express some opinions 


or develop expertise with respect to something 


other than radiation effects. I was hesitant 


to do that. 


 DR. WADE: It's not the responsibility of the 


Board. Certainly any individual member of the 


Board could comment to Labor, as they might 


wish --


 MR. GRIFFON: Right. 


 DR. WADE: -- on the importance of that issue. 


But it's not the responsibility of this Board 


as constituted to look at that issue. Again, I 


would encourage you, if you have strong 


feelings, to let those feelings be known on a 


personal level. 

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 MR. GIBSON: Okay, thank you. 


 MR. GRIFFON: Right, right, we don't advise 


Department of Labor. 


Okay, so -- but -- but I'm just going back -- I 


guess Joyce is reading from the TIB, and that 


to me -- I mean that -- that raises a question 


of -- of -- in my mind, anyway, of NIOSH's 


response here. I mean I get the opinion, if 


I'm reading this right, from -- from your 


response that -- that -- that NIOSH has looked 


into this, that it's not just that historically 


OBT has not been considered, as is stated in 


the -- in the OTIB now. It's that NIOSH has 


investigated this and determined that no 


exposure scenario -- there's a difference 


there. It's subtle, but I think it's an 


important difference because I think if -- if 


workers at Savannah read that and said well, 


yeah, we know historically they haven't 


considered OBT, that's why we're concerned 


about it, or what -- you know, someone could 


say that. And I think it's different for NIOSH 


to say that we've looked at all possib-- you 


know, not all possible, but we've looked at, 


you know, all exposure scenarios we can think 

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of and we don't think OBT would be a -- have 


any kind of impact on the overall dose. Is 


that what was done here or... 


MR. ALLEN: That's basically it, Mark, and we 


agree that the sentence in the TIB is very 


poorly worded and we -- I guess it's just a 


debate, you know, between us what's -- whether 


it's better to revise that or to eliminate the 


issue altogether from the TIB. 


 MR. ELLIOTT: We can certainly revise the 


sentence, but it's -- am I hearing that it's 


our understanding that we've not identified any 


processes or relevant exposure scenarios that 


would lead us to believe there was a high 


potential for organically-bound tritium? 


MR. ALLEN: Right. 


 MR. GRIFFON: Right. 


 MR. ELLIOTT: And I hear SC&A must have come to 


that same conclusion in their evaluation of 


this piece. They don't find any process-


related commentary that leads us to believe 


there's organically-bound tritium in -- 


 MS. MUNN: Of any significance, yeah, 


(unintelligible). 


 MR. HINNEFELD: Of significance. 

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 MR. ELLIOTT: Of significance. 


 MR. HINNEFELD: There would be some 


organically-bound tritium there, but we don't 


believe it's a significant exposure source for 


the workers --


 MR. GRIFFON: Right. 


 MR. HINNEFELD: -- compared to the other 


tritium -- tritium forms, and so that's our 


opinion and I believe that's -- 


 MR. ELLIOTT: So it goes back to how we -- how 


we characterize what we've done here and how we 


explain and communicate what we've done. 


 MR. HINNEFELD: Right. 


 MR. ELLIOTT: So it's -- we will take that to 

note. 

 MR. GRIFFON: Okay, yes -- yeah, thanks for 

that clarification, Joyce. I mean 


 MR. ELLIOTT: Open for suggestions. 


 MR. GRIFFON: -- so I put -- I put that NIOSH 


will consider revising or deleting language in 


TIB related to organically-bound tritides. 


SC&A agrees -- I'll put that first, that SC&A 


is in agreement with the NIOSH response, and 


NIOSH -- additionally, NIOSH will revise or 


delete language in TIB related to organically­
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bound tritides. Is that okay? 


 DR. LIPSZTEIN: Okay. 


 MR. GRIFFON: Number 13. 


 DR. LIPSZTEIN: The uncertainty problem. 
I 


agree with some of the arguments saying that 


there's an overestimate of the dose, given the 


high five. On the other hand, we know that the 


IREP program, it depends a lot on the 


uncertainty issue. If the uncertainty is 


higher, you get a higher probability of getting 


compensation. Now when you consider the 


intakes from the high five, you have some 


intakes that were taken in the early years, so 


they had a higher -- high uncertainty linked to 


them. So I think something has to be written 


about the uncertainty. I might even consider 


okay, it's an overestimate, the high five, and 


so we don't need to consider the uncertainty. 


But something has to be said about uncertainty 


because we know IREP depends on -- the result 


of IREP depends on the uncertainty. 


DR. NETON: Well, IREP has a lot of uncertainty 


other than the dosimetric uncertainty. In 


fact, the radiation effectiveness factors are 


all in there with a fair amount of uncertainty, 

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but I suppose -- I don't have a fundamental 


argument against saying why uncertainty's not 


included. I would object to including 


uncertainty in that analysis if we do agree 


that these are bounding values 'cause otherwise 


why have a bounding value. Why not use our 


best estimate of the maximum intake. I mean 


then we -- you know, it doesn't -- 


 MR. HINNEFELD: Our best estimate of the 


person's intake. Remember --


DR. NETON: Yeah -- yeah, right --


 MR. HINNEFELD: -- these are overestimates for 


DR. NETON: Right, and that's my point. 


 MR. HINNEFELD: -- this person, and so that's 


just the general approach on it. 


(Unintelligible) overestimate or an 


underestimate on a quantity that we put in IREP 


we enter as a constant so IREP has to sample a 


distribution, it samples that number every 


time. 


MR. ALLEN: I think Joyce was just saying that 


we should --


 MR. HINNEFELD: Explain it in --


MR. ALLEN: -- include that statement -- 

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 MR. HINNEFELD: -- the TIB, right. 


MR. ALLEN: -- yeah, I --

DR. NETON: Yeah, I don't have a problem with 

that. 

 MR. HINNEFELD: That -- that's appropriate. 


DR. NETON: If we -- if we include a statement 


saying that a constant will be used and -- 


because of, you know, way -- a rationale as to 


why. 


 MR. GRIFFON: Okay. Number 14. 


 MR. HINNEFELD: Number 14 I thought was sort of 


a summary comment 'cause it kind of encompasses 


many of the other comments -- 


 MR. GRIFFON: Okay. 


 MR. HINNEFELD: -- that were made, unless I 


misinterpreted. 


 MR. GRIFFON: Okay. That's fine, then we've 


covered that one. Is that a separate finding 


even, or can it be deleted as a finding? 


 DR. LIPSZTEIN: Yeah, it could -- yeah, it -- 


everything that is -- is said again, yeah. 


It's just a (unintelligible). 


 MR. GRIFFON: I'm asking, I'm not stating it. 


 DR. LIPSZTEIN: No, no, it's just -- just a 


repetition, yeah. 

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 MR. GRIFFON: So just drop -- I think just drop 


the finding 'cause it's repetitive. Right. 


 DR. LIPSZTEIN: Yeah. 


 MR. GRIFFON: All right. On the next -- we're 


on to TIB-3 --


 MS. MUNN: Which is then --


 MR. GRIFFON: -- and for almost all of these I 


have see TIB-11 in new review. 


 MS. MUNN: And it's -- it's gone, anyhow. 


 MR. GRIFFON: Right, so we -- we've -- have we 


committed -- Lew, you have a listing of these, 


or someone is tracking this -- or John, maybe, 


TIB-11, have we assigned that? 


DR. MAURO: If it's not on the list we'll put 


it on the list and we'll -- but I believe it 


is. Okay -- Kathy, did you bring the list with 


you? 


 MS. BEHLING: Yes, I did, and it is on the 


list. 


DR. MAURO: Okay, thank you. 


 MR. GRIFFON: So I don't know that we have to 


go through these if... 


 MS. MUNN: I think we can dispense with three, 


can't we? 


 DR. BEHLING: Yes, yes. 

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 MR. GRIFFON: Now going to the bottom of the 


page, TIB-4, again, we also committed to 


reviewing TIB-4, P -- Rev. 3-P (unintelligible) 


like that? 


 MS. BEHLING: Yes. 


 MR. GRIFFON: What was the number, for the 


record, TIB --


DR. MAURO: TIB-4, Rev. 3-P-1. 


 MR. GRIFFON: P-1? Okay. 


DR. NETON: P-1? PC change? 


 MR. HINNEFELD: PC -- probably PC-1. 


DR. MAURO: (Unintelligible) were requested to 


add that to the list, which we will. 


 MR. GRIFFON: So I'm not sure, again, if we 


need to -- well, do we need to go through these 


if -- if everyone could look down them and see 


if there's anything we need to go through or if 


they can wait for the revision. Most of them 


refer to the fact that things have been changed 


in the revised TIB. 


 MS. MUNN: Item six, is that still -- 


 MR. GRIFFON: Yeah, that's what I'm looking at 


is number six. 


 MS. MUNN: -- still hanging out there? 


 MR. GRIFFON: Stu, on item six, is there -- I 

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see disagree. 


 MS. MUNN: Yeah. 


 MR. GRIFFON: And then it refers to TIB -- to ­

-


 MR. HINNEFELD: Yeah, actually it refers you to 


the next response, which refers to the 


revision. 


 DR. LIPSZTEIN: The response for seven says 


that --


 MR. GRIFFON: A major revision. Right? 


 MR. HINNEFELD: Yeah. 


 DR. LIPSZTEIN: -- a revision. 


 MR. HINNEFELD: So if that -- so the first part 


there has to go to the -- to the new -- the 


revised -- the review of the revised version we 


just talked about. Right? It has to wait for 


that since the response says it's based on 


that. And then the parenthetical number two 


here has -- that has to do with breathing rate, 


which has kind of been worked over pretty hard 


on Bethlehem -- in the Bethlehem Steel context, 


I think, so I don't know where we stand exactly 


on that today. 


 MR. GRIFFON: Well, I was going to ask that -- 


okay, let's -- let's leave that one for a 

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second and we'll come back to that. Finding 


number eight, I think this was also discussed ­

- discussed in Bethlehem, this -- the one 


percent --


 DR. LIPSZTEIN: Yeah. 


 MR. GRIFFON: -- per day question, and there's 


a disagreement. But NIOSH is developing a 


generic position on this, aren't you? 


DR. NETON: What's the specific issue? 


 MR. HINNEFELD: Residual contamination and how 


quickly it --


 DR. BEHLING: One percent per day. 


 MR. HINNEFELD: -- how -- how quickly it 


changes. That's the residual contamination 


model. 


DR. NETON: Residual contamination model, 


right, has been revised. We agreed to review 


this at other sites where it may be applicable, 


that's correct. 


 MR. GRIFFON: And you're -- are you going to 


try to establish some kind of generic -- 


DR. NETON: Yeah, that's a -- that would be 


more of a generic approach -- well -- 


 MR. GRIFFON: At least generic guidance. 


Right? Yeah. 

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DR. NETON: Is there not a TIB that already has 


generic guidance? 


 MR. GRIFFON: I don't know. 


DR. NETON: I thought -- well --


MR. ALLEN: There is for ingestion. We've --


DR. NETON: -- yeah, this -- this -- in the 


context --


MR. ALLEN: -- got several issues we're -- 


might be mixing up here. 


DR. NETON: Right, but we do -- we did agree to 


-- to -- we agreed to review the residual 


contamination approach at all the sites, based 


on our experience at the Bethlehem Steel 


review. I think we did. 


 MS. MUNN: Yeah, I thought you did, too. So we 


can say generic guidance will be developed? 


 MR. GRIFFON: Am I confusing issues? Is --


Dave, did you say -- I think -- 


MR. ALLEN: Either you are or I am, Mark, I'm 


not sure. 


 MR. GRIFFON: I could be, that's for sure. 


MR. ALLEN: No, I suspect I'm just forgetting 


what all we've committed to here, I just -- 


DR. NETON: Well, remember, I thought -- I 


thought --

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MR. ALLEN: We keep (unintelligible) a list. 


DR. NETON: -- and I'm speaking probably cold 


here -- I am speaking cold here so it's a 


little bit vague, but I thought -- remember at 


Bethlehem Steel how we came up with, you know, 


the air monitoring model that we used and -- 


and --

MR. ALLEN: That was all for ingestion. 

DR. NETON: That was for ingestion. 

MR. ALLEN: The -- Bethlehem Steel, the 

residual contamination was handled on -- on its 


own data, it was --


DR. NETON: Right. 


MR. ALLEN: Actually I take it back, it ended 


up being that dilution model. 


DR. NETON: Right, so we've adopted a slightly 


different approach. I think -- I think the 


best we can commit to here is go back and see 


what we committed to doing. I've forgotten, 


honestly, where this stands. 


 MR. GRIFFON: Okay, we'll -- we'll -- yeah, 


we'll agree --


DR. NETON: I don't want to -- I don't want 


to... 


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commit at this point on that action, but I 


think there was some -- some agreement on some 


sort of generic... 


DR. NETON: I know with Bethlehem Steel there 


were two other bigger issues, which were oronasal breathing we committed to evaluating -- 


 MR. GRIFFON: Right. 


DR. NETON: -- and also the extent of ingestion 


at DOE facilities. And those are the two I'm 


very certain of. The third piece I'm a little 


fuzzy on. 


 MR. GRIFFON: And those two come down in items 


ten and 11, I think. 


DR. NETON: Right, and if that -- if those are 


addressed there, we are going to -- that is 


true that we are working on generic guidance 


there. It would be its own separate TIB. 


 MR. GRIFFON: Okay, so -- so eight we'll leave 


-- we'll leave as a question mark, you know, 


let's look back at Bethlehem Steel, but 


possibly generic guidance. Nine I think is -- 


is the new revision -- it's being addressed in 


the new revision and we'll cover it there. Ten 


is, again, this breathing rate which was 


referenced a little earlier on I think also in 

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-- in finding six and the light worker model. 


 MS. MUNN: Yeah, we worked that one pretty 


hard. 


 MR. GRIFFON: Yeah, but the -- did we commit to 


-- is this part of that generic guidance? 


 MS. MUNN: My memory is that it was agreed that 


a generic guidance would be forthcoming with 


respect to the oro-nasal breathing thing, the 


light worker, et cetera. That was my memory. 


I thought we had that one closed and on a 


working list somewhere. 


 MR. GRIFFON: I -- I think so. Is that true? 


 DR. WADE: It's what I remember. 


 MR. HINNEFELD: (Unintelligible) 


 DR. WADE: Yep, we're saying yes. 


 MR. GRIFFON: Okay. 


MR. ALLEN: Don't ask me, I've slept since 


then. 


 MS. MUNN: Twice. 


 MR. GRIFFON: And then number 11, do we have a 


similar response, or no response? 


 MS. MUNN: Yeah. Yeah, I think it was a 


similar response. 


MR. ALLEN: That one I remember. 


 MS. MUNN: Yeah, they were both -- 

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 MR. GRIFFON: Yeah, okay. One-third of the way 


through what we intended to do. Okay, 3:30, 


shall we move on to the second set of 18? 


 DR. WADE: Might as well. 


 MR. GRIFFON: And at least -- at least make a 


dent in it if -- I'm not sure how far along 


we'll get, but at least move it ahead a little. 


Is everybody ready? I -- wait for you to the 


document in front of you or... 


 MS. MUNN: On your mark, get set -- 


 MR. GRIFFON: Get set --


 MS. MUNN: -- go. 


 MR. GRIFFON: -- take a deep breath and go. 


All right. First page, case 21.1, finding -- 


finding one. And -- and I should say in 


starting this discussion, I've penciled in some 


-- these other rankings that we've done as a 


workgroup before, so we don't have to discuss 


those now, but I've tried to get a handle on 


this site/program ranking, the category -- 


technical, procedural, otherwise -- the 


section, external or medical, internal. And 


lastly, after we hear a NIOSH response or NIOSH 


resolution, I guess we'll fill in that Board 


action number that was done in the first set of 

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20. 


So 21.1 says reviewer identified errors in 


calculation of recorded photon doses. 


 MR. HINNEFELD: Yeah, it looked to me like 


there are two different records in this 


claimant's folder about getting their exposure 


record. There was one that gives a skin -- or 


a shallow and a deep number that appeared to be 


photon only because there was also a neutron 


column on there. And then there's a 


handwritten summarized page that only gives a 


deep and shallow. And if you look at the 


numbers, the neutron -- the neutron number has 


been added to the deep photon on the first 


sheet in order to get the deep number on this 


sheet. And so the years that correspond to the 


arithmetic error were the years when there was 


a neutron number other than zero. So it seems 


like the starting point -- what the dose 


reconstructor did was -- to put a starting 


point on this calculation was to take the 


difference between the shallow and deep photon, 


ignoring the neutron part, and used that as the 


starting point of the calculation. The 


difference is so small, though, I don't know 

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that we want to spend a lot of time fighting 


this out. 


 MS. BEHLING: No --


 MR. HINNEFELD: I mean it's a trivial 


difference. 


 MS. BEHLING: -- in fact I think what happened 


in this case, there was an underestimation of 


the 30 to 250 keV dose and overestimation of 


the over 30, so they (unintelligible) out. 


 MR. HINNEFELD: Yeah, it kind of balanced out. 


It really makes no difference in the outcome of 


the case. I mean we'd have to fight through a 


lot of details here to come to resolution on it 


here, so I'd just as soon go on. 


 MS. BEHLING: Yeah. No, it's just one of the 


things that we look at and we saw that there 


was an error. 


 DR. BEHLING: Let me --


 MR. GRIFFON: So --


 DR. BEHLING: Mark, let me make a couple of 


comments. I think when -- when we look at the 


dose reconstruction audits, you can classify 


some of the findings in several categories. 


Some of -- some of those categories may not 


require any resolution. And what do I mean by 

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that? If -- if we see, for instance, that 


there was a mathematical error done by one dose 


reconstructor, it's a finding for that 


particular audit, but it has no implications 


for the program and for the process of dose 


reconstruction, and I don't think we need to 


invest a lot of time under those conditions. 


If, on the other hand, we find that there is 


recurrent error committed by -- 


 MR. GRIFFON: Right. 


 DR. BEHLING: -- a dose reconstructor after 


dose reconstructor, and we find that root cause 


is an ambiguously-phrased procedure, then I 


think there is reason to request that changes 


be made in order to rectify that. And so I 


think -- let's be careful in identifying errors 


that are one of a kind because a dose 


reconstructor was -- probably had his mind on 


something else, as opposed to systemic errors 


that reflect ambiguous procedures or -- or 


insufficient training on the part of the dose 


reconstructor, et cetera. Those we can fix. 


 MR. GRIFFON: Yeah -- yeah, I agree with you, 


Hans, or -- or the other reason for looking for 


those patterns might be a quality control 

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effort --

 DR. BEHLING: Yes. 

 MS. BEHLING: Exactly. 

 MR. GRIFFON: -- which -- which, again, in 

these maximizing cases is, you know, probably 


not as -- as relevant. But as we get into the 


best estimates, certainly -- 


 DR. BEHLING: Yes. Yes. 


 MR. GRIFFON: Yeah. So for this, I think -- 


you know, we have SC&A and NIO-- I'm just 


writing this in the NIOSH resolution column, 


SC&A and NIOSH agree with minor technical 


errors; however it would have no effect on -- 


 DR. BEHLING: Yes. And for that reason, we 


have that checklist that says what is the 


implication of the findings, and we you see a 


low finding that says yeah, technically it's 


incorrect, but does it really impact anything 


regarding the dose, let alone the POC. And if 


the answer's no, then it's just a technical 


issue that -- because we started off with the ­

- with the -- on the premise that we have to 


demonstrate to the members of the Board that we 


understand the dose reconstruction process by 


tracking each and every number through all of 

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the manipulations that went into the dose 


reconstruction. And in the process we 


uncovered errors that oftentimes are so minimal 


and so subtle -- subtle that they require no 


resolution. 


 MR. GRIFFON: Right. Okay. 


 DR. LIPSZTEIN: May I ask where are you, 


because I'm completely lost. 


 MS. BEHLING: Joyce, we're onto a new matrix. 


This is the Task IV matrix. 


 DR. BEHLING: You may not have it, Joyce. 


 DR. LIPSZTEIN: I don't have it, so -- okay, so 


then I think -- do you need me or should I hang 


up, because I don't have it. 


DR. MAURO: Well, Joyce, you know what you 


could do -- because I'm working from the actual 


report, the big report, the three-ring binder. 


It tracks very nicely to the matrix 'cause 


that's how he built it, and so I'm able to 


track it even though I don't actually have the 


matrix in front of me. 


 MS. BEHLING: I apologize, Joyce. I didn't 


know if you were going to participate in this 


portion, but you certainly -- you can do -- you 


know, do what John is suggesting here. 

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 DR. LIPSZTEIN: Uh-huh, which -- which document 


is it? 


DR. MAURO: You know the big white book, three-


ring binder --


 DR. LIPSZTEIN: Uh-huh. 


DR. MAURO: -- it says (unintelligible) second 


set of cases, May 2005. 


 DR. LIPSZTEIN: Oh, okay. 


 MR. GRIFFON: Second -- second set of cases, 


yeah. 


 MS. MUNN: Cases 21 through 38. 


 DR. LIPSZTEIN: Okay, I'll try to look for it 


and I'll come back if I find it. 


 MS. MUNN: Mark --


 DR. LIPSZTEIN: Okay? 


 MR. GRIFFON: Yeah. 

 DR. BEHLING: Okay. 

 MS. BEHLING: Okay, thanks, Joyce. 

 DR. LIPSZTEIN: 'Bye. Thank you. 


 MS. MUNN: Mark, I --


 MR. GRIFFON: Yeah. 


 MS. MUNN: I know that we haven't done this in 


the past, but it has occurred to me that 


perhaps the most effective way for us to 


address these very detailed findings on the 

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case reviews would be to change our approach 


just a little bit and perhaps look at those -- 


only those cases that are going to have a large 


impact or a definable impact first, and then go 


back and see -- then go through the lower case 


ones. Perhaps that -- that may not be 


effective in the long run, but I'd certainly 


like to try that at some juncture. As Hans has 


pointed out, are findings that are not 


repeatable things or are findings about which 


we really cannot do anything. And if that's 


the case, then -- then our -- our resolution 


will need to end up being no action necessary. 


On the other hand, if there is an appreciable 


effect, potentially, from the error, then 


that's something that we may have an amount of 


discussion about. 


 MR. GRIFFON: I don't disagree with you, Wanda. 


I -- I've actually tried this in the past, 


though, and it ends up that we end up going 


back through them one by one. I think part of 


the problem is that we -- you know, the matrix 


is useful, but it's also written in very 


shorthand summary fashion. And if we skip some 


of these I think we might -- we might miss 

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something that we should have probably went 


through. 


 MS. MUNN: Oh, I wasn't suggesting that we skip 


them. I just --


 MR. GRIFFON: Oh, okay. 


 MS. MUNN: -- suggest that we reprioritize our 


approach to them so that the ones that are of 


significance we can tell, that those be the 


ones we discuss first so that the others, which 


may respond only -- the result -- the resulting 


response may only be no action necessary, no 


action necessary --


 MR. GRIFFON: Yeah, okay, I -- I just think -- 


I mean my -- my impression is that if we go 


through them one by one we might -- I think 


those ones are going to pop out that are easy 


to dispose of and we won't have a lengthy 


discussion on them. 


 MS. MUNN: Okay, you're the guy that -- 


 MR. GRIFFON: I hope. I hope. I mean I --


'cause I'm looking through -- I highlighted on 


-- on the computer and I have little tidbits 


highlighted sporadically here, and it's not 


obvious --


 MS. MUNN: That's fine. You don't -- you don't 

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need to --


 MR. GRIFFON: It's not obvious how to -- 


 MS. MUNN: -- placate me, just go -- go with 


it. 


 MR. GRIFFON: -- prioritize, that's what I'm 


trying to say. Okay. 


 MS. BEHLING: Now I agree with you, Mark, 


because in some of these cases we might be able 


to say let's go through the case rankings and 


pick mediums or highs, but we will miss issues 


that I think --


 MR. GRIFFON: Right. 

 MS. BEHLING: -- are important to discuss along 

the way. 

 MS. MUNN: Well, I think we need to discuss 


them all. 


 MS. BEHLING: Yeah. 


 MS. MUNN: I wasn't suggesting not discussing 


them. 


 MR. GRIFFON: Yeah, I'm just trying to -- 


 DR. BEHLING: And -- and when you --


 MR. GRIFFON: I'm try-- I think right now it'd 


be better just to go through and maybe -- 


 MS. BEHLING: Be sen--


 MR. GRIFFON: -- for the next -- for the next 

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version we'll try to prioritize ahead of time. 


That's not a bad idea, but -- 


 MS. BEHLING: Yeah, in fact that's something I 


want to discuss as we go through these. But I 


-- I think we do need to go through these 


sequentially, and we'll be sensitive to the 


fact that there's some that we can just move 


along. 


 DR. BEHLING: In fact, you'll -- you'll see an 


awful lot of findings that are repetitious 


because the -- in fact, the first three sets 


were maximized -- mostly maximized, some were 


minimized dose reconstructions, and -- and you 


will find that there's a repetition of errors 


that -- that you see throughout these different 


sets. And so when we come across them you're 


going to probably realize that well, we've 


discussed that before so let's go on. 


 MR. GRIFFON: Yeah, okay. 21.2 actually -- I 


think this is one that can be fairly quickly 


disposed of. NIOSH agrees, but it -- again, 


this is an overestimating approach -- 


 MS. BEHLING: Yes, that's fine. It's 


uncertainty, so we can move on. 


 MR. GRIFFON: And 21.3 --

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 MS. BEHLING: Same, it's an uncertainty issue 


and it is a high -- it's unnecessarily high. 


 MR. GRIFFON: Right. 21.4 -- and stop me, 


anybody, if we need a longer discussion on any 


of these. 


 MS. BEHLING: Okay. I'm not sure 


(unintelligible), can NIOSH explain this? 


 MR. HINNEFELD: Well, I can --


 MR. GRIFFON: Yeah, this is a lengthy one. 


 MR. HINNEFELD: I think the -- the numbers 


aren't worth spending a lot of time on because 


the numbers are very small, no matter how you 


do it. When I went through the TBD tables I 


could reproduce essentially the 38 -- I 


actually got 37 millirem for the total dose 


over the (unintelligible) years because it 


breaks at various years, and I got one year at 


the highest -- he only had one pre-1970 X-ray 


when the dose would have been 25, and then the 


others -- the table calls for lower doses, but 


it doesn't really matter. And then I thought 


that the medical exposure was pretty much right 


on light, maybe a slight overestimate as 


opposed to the underestimate, but the values 


were so small I don't think it warrants much 

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time. 


 MS. BEHLING: Okay. Okay, I just --


 MR. GRIFFON: I mean do you need to go back to 


this one, Kathy? That's -- you know --


 MS. BEHLING: No, it just surprises me that we 


would have identified this as a finding if it 


was a one millirem difference. We just -- we 


wouldn't have done that, and so -- 


 MR. GRIFFON: Right, I don't think so, so -- 


 MS. BEHLING: -- and so that's why I'm 


questioning --


 MR. HINNEFELD: No, it was -- your -- your 


estimate was 25 millirem a year for the entire 


employment period times the 1.3, and then what 


I said was well, the 25 millirem is only the 


pre-1970 value. The TBD gives lower values for 


later years for X-rays, so I essentially 


reproduced what -- what I thought the number 


should be and didn't quite get the 38, which is 


what the DR-ist (sic) had. I got to 37. So I 


think that's what the -- the issue was was that 


there's a certain cut year where the medical 


doses are lower. 


 MS. BEHLING: Okay. 


 MR. HINNEFELD: And then there is a discussion 

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in here about the -- the lumbar spine X-ray 


that the person got. The -- it looks like the 


-- the DR-ist just doubled one of the views, 


the higher exposure view. There's two views on 


the lumbar spine X-ray and it looks like what 


the DR-ist did was just double the higher 


exposure view rather than to put two separate 


lines in for the different -- for the different 


views. 


 MS. BEHLING: But I think what we wrote here in 


-- is saying that we thought there was 21 years 


of dose that may have been missing, which would 


have -- which would have resulted in about 700 


millirem, or -- yeah, 700 millirem. 


 MR. HINNEFELD: What I'd like you to do is look 


back at the site profile for Rocky Flats and 


the X-ray doses that are cited for years 


because I think -- I think what you've done -- 


if you take 21 years of X-ray dose at 25 


millirem, when in fact, based on the site 


profile -- the equipment changed in 1970, so 


only the 1969 X-ray would be 25 millirem, and 


the later X-rays would be lower doses. 


 MS. BEHLING: Yeah, we have down here that you 


used OTIB-6 for this, and that only one chest 

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X-ray was assigned rather than for -- one for 


every year of employment. I believe that's 


what we are saying. 


 DR. BEHLING: You have to go back to the actual 


audit itself to identify -- 


DR. MAURO: I have the report open in front of 


me. It's very helpful to -- it's written up 


here and Kathy, will you just -- I don't know 


if you have the report -- 


 DR. BEHLING: Yeah, we do, John --

 MS. BEHLING: Yes, we do. 

 DR. BEHLING: -- and the matrix is not very 

clear in identifying the issues. 


 MS. BEHLING: Right, it's too -- it's too 


abbreviated. 


 DR. BEHLING: It's too abridged. 


 MR. GRIFFON: Well --


 MS. BEHLING: But I think that our point was 


that you only assigned chest X-ray dose for one 


year where --


 DR. BEHLING: It was 21 years. 


 MS. BEHLING: -- there was 21-year employment 


and we -- I guess we came to the conclusion 


that he probably -- or this person probably had 


an annual chest X-ray. That's what I said, I 

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couldn't imagine we would have written 


something up for one millirem. 


 DR. BEHLING: No. 


 MR. GRIFFON: Right, right, so there's still a 


discrepancy here. I mean I think -- 


 MS. BEHLING: Yes. 


 MR. GRIFFON: -- maybe -- I -- I think this can 


be done off-line, though. Right? That's --


 MS. BEHLING: Yes. 


 DR. BEHLING: Yes. 


 MR. GRIFFON: You can go back and look at your 


numbers and maybe talk to Stu and -- 


 MS. BEHLING: Okay, we'll look at that again. 


 MR. GRIFFON: -- try to figure this out or 


resolve this calculation discrepancy. 


 MS. MUNN: Might have depended on his job 


description. He might have only had -- 


 MR. GIBSON: (Unintelligible) this is Mike. My 


phone died. I had to get another one and get 


back on line. Where are we at here? 


 MR. GRIFFON: We're in the second set of cases, 


Mike, on finding number 21.5. 


 MR. GIBSON: Okay. 


 MS. BEHLING: Yeah, matrix for cases 21 through 


38. 

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 MR. GRIFFON: Second pa-- third page into it, 


whatever, something like that -- 21.5 in the 


matrix. 


 MR. GIBSON: Okay, great. Thanks. 


 MR. HINNEFELD: Kathy, the medical X-ray 


exposures are lines 212 through 233 in the dose 


reconstruction. 


 MR. GRIFFON: All right. Thanks. Yeah, we'll 


-- let's see, so -- are we on 21.5? We can --


I mean you don't have to redo those 


calculations while we're on the line. I think 


it'd be better served to work our way through 


the matrix and you guys can work that out. 


Right? 

 MS. BEHLING: Okay, yeah, we'll look at that. 

 MR. GRIFFON: Okay. 

 MS. BEHLING: I see they're all zeroes below 

that, so maybe that's where it's changed. 


 MR. HINNEFELD: They round -- less than one 


millirem. 


 MS. BEHLING: Is that what the -- okay. I'll 


look at that. 


 MR. GRIFFON: And if you're in agreement, 


that's fine, we can get -- you know. 


 MS. BEHLING: I just -- I want to look at it 

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again. 


 MR. GRIFFON: All right. 21.5 --


 MS. MUNN: Incorrectly calculated on-site 


ambient dose. 


 MS. BEHLING: Let's see --


 DR. BEHLING: (Unintelligible) 


 MS. BEHLING: I don't know. We don't quite 


understand NIOSH's response. (Unintelligible) 


 MR. HINNEFELD: I copied some pages out of the 


site profile, hang on a second. 


(Pause) 


 MS. BEHLING: And as you see in our write-up, 


we said that the discussion on the on-site 


ambient dose in the Technical Basis Document is 


very confusing, so maybe we misunderstood it. 


 MR. HINNEFELD: We agree it's very confusing. 


Hang on, I thought I copied the pages. 


 MR. GRIFFON: And we're looking at that 

profile, too. Right? So... 

 MS. BEHLING: This is what, Rocky? 

 MR. GRIFFON: Yeah. 

 MS. BEHLING: This is Rocky Flats? Yes. Yeah, 

we should make note of that in the Technical 


Basis Document review. 


 MR. GRIFFON: So is this another one that -- 

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 MS. BEHLING: Well, Stu right now is trying to 


get us some information. He's trying to dig 


out some of the pages. 


 MR. HINNEFELD: Our response refers to the pag­

- to the tables in the site profile, and 


there's a text -- I thought I had it a while 


ago, I don't seem to be able to get my hands on 


it real quick. 


 MR. GRIFFON: I'll tell you one thing that 


jumped out at me, just to stall so Stu has some 


time, is the highest annual value in the table 


is for 1989. I don't know, that struck me as 

interesting. 

 MS. BEHLING: Yeah, it is interesting. 

 MS. MUNN: There was a lot going on there in 


'98 (sic). 


 MR. GRIFFON: Yeah, there was. There was. 


 MS. MUNN: Ask the Feds. 


 MS. BEHLING: I guess to keep things moving 


along, we could also do this off-line when Stu 


 MR. GRIFFON: Yeah, okay. 


 MR. HINNEFELD: I apologize, I thought I had 


copied some pages. 


 MS. BEHLING: That's okay. 

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 MR. GRIFFON: That's okay. 


 MS. BEHLING: Usually when on-site ambient is 


not significant doses here, but -- 


 MR. GRIFFON: Right. 


 MS. BEHLING: -- this guidance was very 


confusing. We'll deal with that one separate. 


 MR. GRIFFON: Okay, let's move to 21.6 then. 


 MS. BEHLING: Okay, now here's where I want to 


pause for just a second because I believe that 


this -- this finding is one that we've talked 


about over and over again, and everybody's very 


well aware of this excessive claimant-favorable 


approach to things. And I think that there is 


-- based on the response from NIOSH on this -- 


no, no, right here. NIOSH's response is they 


agree, however it's a high dose and this is a 


case that's less than 50 percent. Here is 


where -- where I might pause to say I think 


that there's a difference in philosophy between 


what NIOSH is doing and what SC&A would maybe 


recommend that is being done with these, quote, 


claimant-favorable cases. And I think it's 


best to explain it in terms of our -- and I 


think the regulations state claimant 


favorability is in cases of unknowns. And so 

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if you don't know if the person was monitored 


and if you have to go back and calculate missed 


dose and you don't know whether he was -- 


received internal doses, you do want to 


calculate a hypothetical internal. However, 


you do know what the cancer is, and there's -- 


you haven't lost any efficiency by pulling the 


correct cancer model from your hypothetical 


internal dose and using 12 radionuclides as 


opposed to 28 radionuclides when 


(unintelligible) doesn't have a reactor, 


doesn't have all your fission products. So I 


don't know that I agree with NIOSH's response 


that we can just -- it's okay because this was 


less than 50 percent and it was excessively 


high. I feel, and you hear it in the public 


comment area, that --


 MS. MUNN: If it's wrong, it's wrong. 


 MS. BEHLING: Yeah, and it's not necessarily 


scientifically sound to do this. So I believe 


this is an approach that has been adopted by 


NIOSH and it's a way of thinking today, and I'm 


not sure that we want the dose reconstructors 


to continue to think in this way. 


 MR. HINNEFELD: It was -- it was a way of 

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thinking up until a few months ago. 


 MS. BEHLING: Okay. 


 DR. BEHLING: I mean I think it would be very, 


very difficult to defend when a person says 


they modeled it, even though it was claimant 


favorable, for a cancer that -- I didn't have 


colon cancer and it -- and it lets somebody 


who's on the sidelines say well, boy, they're 


not even looking to see which cancer this guy 


had. 


 MR. HINNEFELD: I think -- well, this is 


actually the -- we selec-- (unintelligible) 


selected 28 radionuclides rather than 12 in 


this specific case. 


 MS. BEHLING: That's right. 


 MR. HINNEFELD: But this was an attitude up 


until a few months ago, and -- and it's not the 


attitude now because of the recurring issue of 


returns coming back from the Department of 


Labor with new information and now we're in the 


process of explaining why the dose 


reconstruction's so much lower. So I'd say the 


days of sort of being -- shall we say cavalier 


about overestimates in non-compensable cases is 


pretty much gone now. 

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 MS. BEHLING: It was just based on NIOSH's 


response. 


 MR. HINNEFELD: I originally wrote that a few 


months ago. 


 MR. GRIFFON: So -- so Stu, what -- what --


what concrete changes have been made? You said 


it's -- there's a change in attitude now? Are 


there concrete procedural changes that have 


been made as a result of this or -- 


 MR. HINNEFELD: I don't know that I'd say 


they're procedural changes, but I'd say it's a 


fact that we don't typically see just these 


artificial inflated dose reconstructions just 


for the sake of having a high dose. I think 


it's -- more attention is paid to choosing the 


right model now. Am I wrong? You guys read 


more than I do. 


 MS. BEHLING: Okay --


MR. ALLEN: Generally. 


 MR. HINNEFELD: Okay. 


 MS. BEHLING: Now the other thing -- and I know 


in this particular case I may have jumped the 


gun a little bit because, although I -- I guess 


I phrased this finding incorrectly, they used 


the hypothetical -- the 12 radionuclide 

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hypothetical intake model, and I guess they did 


probably select the right cancer here, I'm not 


sure. But in the cases where they do select 


the colon as the highest non-metabolic cancer, 


I believe that that's stated in TIB-2 that 


that's recommended. I haven't read through 


TIB-2 in a while, but I do think that that's 


recommended in one of the procedures. No? 


You're shaking your head. 


MR. ALLEN: Not TIB-2, maybe a procedure, 


'cause I remember when we first did that they 


calculated the dose for all 28 nuclides to the 


colon, and when we first started doing some 


claims by that and we started seeing the same 


dose on each one, saying this is not right. 


 MR. GRIFFON: Right. 


MR. ALLEN: Then ORAU explained that they had 


one set of numbers calculated, that they were 


going to fire through as much as they could 


with that set of numbers, and we reluctantly 


agreed to it, essentially. 


 MS. BEHLING: Okay. I just would like -- you 


know, need to be sure that that's not stated 


anywhere in the procedures for the dose 


reconstructors to -- to use the col-- I thought 

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I read that --


MR. ALLEN: Yeah, I can't --


 MS. BEHLING: -- somewhere. 


MR. ALLEN: -- can't guarantee on the 


procedure, but the TIB -- 


 DR. BEHLING: Well, I -- I think that we -- it 


may be in the procedure that it says -- 


 MS. BEHLING: Yes. 


 DR. BEHLING: -- the colon ends up being the 


highest non-metabolic organ, so if you have 


prostate cancer we'll go with the colon. But 


it just looks awfully stupid for us to use a 


cancer -- a site that doesn't even apply to the 


individual claim, even though it gives -- it 


gives you a higher dose. 


 MS. BEHLING: And I just want to be sure the 


dose reconstructors aren't being -- it's not 


being suggested to them that they -- 


 MR. GRIFFON: Right. 


MR. ALLEN: I think the NIOSH response there 


applies to the individual claim. We wouldn't 


go back and rework that to lower the dose since 


it was already a denial -- 


 MR. GRIFFON: Right. 


MR. ALLEN: -- but as far as the programmatic 

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issue goes, you -- we're trying to get better. 


 DR. WADE: We all remember the lady who stood 


up at the last Board meeting in public comment 


and talked about the pain of getting a letter 


where the wrong cancer was identified. And for 


the record, that wasn't a NIOSH letter she 


received, but I think we all need to take care. 


 MR. GRIFFON: Right, right. Okay, 22.1 I think 

we're on. 

 DR. BEHLING: Yeah, this is one that has 

cropped up over and over again. I think we 


have beaten up Stu on this one on more than one 


occasion regarding TIB-8 and 10 that are -- and 


here's a classic case of a procedure that 


consistently, among every one of the dose 


reconstructors, has been misinterpreted and -- 


and fortunately -- or unfortunately, I guess 


fortunately for the claimant, it results in 


doses that are usually higher than -- than what 


the true interpretation would yield and -- and 


I think Stu's fully aware of it. I don't know 


if at this point TIB-8 and 10 have been revised 


to clarify --


 MR. HINNEFELD: Coming soon, yeah. We hope to 


-- we expect to see them this month, but we 

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have not seen them yet. 


 DR. BEHLING: And -- and in short, if you 


recall, Mark, the issue is one of using LOD 


times N multiply that yet by two, then divide 


by two and ultimately end up with a GSD, and so 


an error one cancels error two, left with error 


three, which is GSD, which doesn't belong when 


you have a 95th percentile value. It's three 


errors, two cancel out, one error's left which 


is the GSD for a maximized dose. That's --


that's a consistent error that has been 


introduced over and over again. 


 MR. GRIFFON: And this was over and over in the 


first 20, yeah, we saw several times. 


 MS. BEHLING: Yes. 

 MR. GRIFFON: Yeah. 

 DR. BEHLING: And we're still seeing it. 

 MS. BEHLING: And actually what I've decided to 

do, unless someone wants to make a 


recommendation different from this, for this 


fourth set of cases, because I didn't see a 


revision to TIB-8 and 10 yet, I felt that it 


was necessary for us to include it again as a 


finding. And when we finally see a revision 


that we're satisfied with, I think at that 

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point we will make something like an 


observation and not include it on this -- this 


matrix -- this matrix list anymore and -- 


unless it has some significant impact on the 


case. 


 MR. GRIFFON: On the case, right, I agree. 


 MS. MUNN: But for the time being, that's 


right, this is what we're looking for. That's 


exactly it. 


 DR. BEHLING: But I think once there is a 


resolution such as a revision to a TIB that 


clarifies the issue, even though we may be 


auditing a case that was done two years ago, we 


will cease to make it a finding because the 


resolution has already occurred. 


 MS. MUNN: Yeah. 


 MS. BEHLING: Exactly. 


 MR. GRIFFON: Okay, 22.2? 


 MS. BEHLING: Gives you a motivation to make 


those changes in the procedure. 


 MS. MUNN: Yes, it does. 


 DR. BEHLING: We're at 22.2, Mark? 


 MR. GRIFFON: Yeah. 


 MR. HINNEFELD: This is more -- this is another 


of the same --

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 DR. BEHLING: Yeah --

 MS. BEHLING: Yeah, this is the same. 

 DR. BEHLING: -- this is a case where -- 

 MR. HINNEFELD: -- why use 12 when it says 


four. 


 DR. BEHLING: -- the records indicate the 


person was monitored quarterly, and there's 


firm evidence to that, and so, again, there was 


an excessive assignment of missed dose assuming 


a 12-cycle per year exchange and when the 


records clearly say there's only -- he was only 


monitored four times, we're assigning, you 


know, three times as many -- or an excess of 


three times more than what he should. And 


again, I would say stick with the facts when 


you have it. If you're not sure, give the 


benefit of the doubt, but here we have the 


facts. 


 MS. MUNN: Is this the continuing problem? 


 MR. GRIFFON: It's the same as the 21.6, pretty 


much as a follow-up. 


 MS. BEHLING: Well -- just one second, Mark. 


Say what? 


 MR. GRIFFON: I'm saying the response or the 


resolution to that is similar to 21.6, that -- 

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you know, there's agreement, but no change for 


that case is needed, but -- 


 MS. BEHLING: Yes. 

 MR. GRIFFON: -- programmatically --

 DR. BEHLING: Well, that -- that may be again a 

one-time deal. I'm not saying that every dose 


reconstructor opts to give excess number of 


cycles when in fact the data suggests 


otherwise. Again, this could -- this is 


perhaps a flaw that is linked to one dose 


reconstructor and as a result there may not be 


a resolution to that other than to perhaps 


maybe issue a memo from NIOSH that says please 


don't engage in overly-excessive assignment of 


doses when there's no need for it -- 


 MR. GRIFFON: Well, and I think that --


 DR. BEHLING: -- or the data suggests 


otherwise. 


 MS. BEHLING: Exactly. 


 MR. GRIFFON: I think that's the programmatic 


response that Stu just alluded to is that 


they're not going to -- as a policy matter, 


they're sort of -- going to kind of shy away 


from that --


 MS. BEHLING: Yes. 

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 MR. HINNEFELD: Yes. 


 MR. GRIFFON: -- both internal and external, I 


would assume, you know. 


 MR. HINNEFELD: Send them a directive at least 


-- average at least one a day, do this, honest 


to goodness. 


 DR. BEHLING: Does it come return mail? 


 MR. HINNEFELD: (Unintelligible) no, I send 


them e-mail so they can't -- can't come back 


address unknown. 


 MS. BEHLING: This is -- goes back to that 


philosophy issue. 


 MS. MUNN: Well, yeah, and I continue to be 


very concerned that -- that the Board perhaps 


unrealistically over-emphasized that -- the 


claimant-favorability aspect of every decision 


that's being made -- and that's not a smart 


thing to do and we -- if -- if we, as -- if the 


Board needs to take some action in this regard, 


please tell us that it would be wise for us to 


be more specific with respect to our claimant 


favorable comments that started this whole 


business. 


 DR. WADE: I don't -- I don't --


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started the whole business -- 


 DR. WADE: No, I don't think so, either. 


 MR. GRIFFON: -- Wanda. I'd take exception to 


that, 'cause I think the efficiency mode 


started this -- this business. I --


 MS. MUNN: Well, yeah, but the effi-- 


 MR. GRIFFON: -- I think you give us too credit 


-- too much credit. I'm not sure that our com­

- our recommendations are carrying that much 


weight. 


 MS. MUNN: But the efficiency mode more -- 


doesn't just duplicate, it more than -- more 


than amplifies our original position about 


being claimant-friendly. And that's where -- 


 DR. WADE: I think this was really a pressure 


to -- to -- to move things through the system 


and a little bit of sloppiness developed and it 


was tolerated because it really didn't make a 


difference. But I think we're realizing that 


when you live in a fishbowl like this, those 


things can matter --


 MS. MUNN: They do matter. 

 DR. WADE: -- so it's a matter of just getting 

it right. 

 MS. MUNN: Yeah. 
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 MR. GRIFFON: Okay, 22.3? 


 DR. BEHLING: Again you have to look at the 


actual report. I think TIB-8 was used for that 


and -- let me see here --


 MS. BEHLING: TIB-8 spe--


 DR. BEHLING: -- yeah, and TIB-8 clearly states 


this is not to be used for skin doses or those 


doses that may require a shallow dose 


reconstruction. That includes the testes and 


the breast and so in -- in essence the 


procedure was incorrect for -- for deriving a 


skin dose. They should have really used Proc. 


6 and one of those appendices that are defined 


under Proc. 6 for deriving skin dose. I do 


think --


 MR. GRIFFON: (Unintelligible) do you agree 


with that? 


 MR. HINNEFELD: Yeah, I don't -- I don't 


dispute that. 


 MR. GRIFFON: I -- I mean I think this a -- I ­

- and -- and Hans, do you agree with the NIOSH 


respon-- inasmuch as it doesn't affect -- that 


-- that still the approach -- 


 DR. BEHLING: Well, again, you know, we -- 


 MR. GRIFFON: -- sufficiently maximized the 

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dose for this case? 


 DR. BEHLING: Yeah, we have been dealing 


principally with maximized doses for the first 


three sets, and even in the fourth set. So I 


suppose in the end if the ultimate excuse is 


that well, is this a maximized and it's noncompensable, so all these errors really don't 


mean anything, there's -- there's an element of 


truth in that. Clearly we're not going to turn 


anything over on the basis of these things, but 


it's a matter of technical accuracy and, again, 


the issue of the optics. Which procedure did 


you use that you should have used but failed to 


use in arriving at these doses, whether or not 


they contribute to a significant difference 


that would affect the compensability of the 


claim. Well, that's really a second level of 


concern and -- and we would -- and during our 


audit we were not looking at that other than to 


identify the findings under the checklist as 


having a low. And as you will see in just 


about every one of these the checklist 


identifies this error as a low impact. So 


nevertheless, it's a technical issue that we 


want to bring to everyone's attention. We're 

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not saying it's going to change anything. 


 MR. GRIFFON: Oh, yeah, no, I'm not -- I'm not 


taking away the finding. I'm just saying for 


this particular case the dose would have not 


been a lot different or a lot greater or would 


it have been or did you assess that? 


 DR. BEHLING: Well, the skin dose I guess under 


Proc. 6 would have been higher. 


 MR. GRIFFON: High-- high-- higher enough to 


make a significant difference or -- in your 


opinion, or --


 DR. BEHLING: Well, again, that's subjective 


when you say significant. Significant, would 


it have changed the compensability? No. Would 


it be a significant fractional increase in 


dose? Probably. But again, it's in context 


with all the other doses that are assigned 


under maximized, chances are it's not all that 


much of a dose. 


 MS. BEHLING: It's not that significant. 


 DR. BEHLING: In fact, on that issue -- and I 


talked to Dave Allen -- there's a concern on my 


part that people still haven't recognized that 


when you deal with a skin dose and especially a 


skin cancer, forget about the HP-10 dose. Look 

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at the shallow dose. That's your dose of 


reference, and don't worry about whether it's 


beta -- 200 -- greater than 250 or 30 to 250, 


none of these matter. It's your skin dose, and 


that should be the dose that should be entered 


as your dose for determining whether or not the 


-- the cancer is -- is compensable, and -- and 


too many of the people are still not looking at 


the footnote that is in Appendix B of 


Implementation Guide 1 that clearly says if 


you're talking about a skin cancer, forget 


about the HP-10 dose because if the HP-10 dose 


is cited, also -- there is also the likelihood 


that the shallow dose is also cited, and use 


that and forget everything else. 


 MR. GRIFFON: Right. 


 MS. MUNN: Can we put the footnote in bold? 


Move it up from footnote status, put it 


somewhere else? 


 MR. GRIFFON: Okay, 22-- Hans, just to let you 


know, part of the reason I asked you those 


questions was I -- I think I'd define this more 


as a procedural -- I'm categorizing here, too, 


in my little ma-- in the matrix, and I think I 


see that more as a procedural finding in this 

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case. 


 DR. BEHLING: Yeah, it is. 


 MR. GRIFFON: And so that's why I'm -- I'm 


going down this -- aiming these questions for 


you. I totally agree with your assessment, but 


I -- anyway, 22.4? 


 MS. BEHLING: Here again they just used -- 


NIOSH used I guess 40 millirem for LOD and 


we're not sure -- it was not referenced, and 


actually I believe that Attachment F of Proc. 6 


was not even issued at this time, which would 


have recommended 50 millirem, so it's -- it's a 


minor difference, but we didn't know where they 


came up with that LOD value. 


 DR. BEHLING: It's a generic value that's 


commonly used in the early years during film 


dosimetry, but I think under Proc. 6 or 17 I 


think for the beta component 50 is a common 


used value for LOD for shallow or beta 


component. So again it's a marginal 


difference. 


 MR. GRIFFON: Okay, but -- and -- and this -- 


when it says see response for finding 22.3-D.1, 


that should have been D.1.2? Is that correct? 


I don't see any D.1.1. 

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 DR. BEHLING: No, I don't either. 


 MS. BEHLING: Actually I -- I marked that -- 


I'm not sure if I incorrectly identified those 


finding numbers in the matrix, because in our 


report finding 22.3 is D.1.1 and 22.4 is D.2.1. 


 MR. GRIFFON: Okay, so we -- I can work with 


you, Kathy --


 MS. BEHLING: Yes. 


 MR. GRIFFON: -- on these edit --


 MS. BEHLING: Yes. 


 MR. GRIFFON: -- things, but we should just 


make that consistent. 


 MS. BEHLING: Yes, I'm sorry. 


 MR. GRIFFON: All right. 


 MS. MUNN: That -- that same nomenclature 


appears in the preceding finding. 


 MR. GRIFFON: Right. 


 MS. BEHLING: Yeah, I --


 MR. GRIFFON: Right. 22.5? 


 MS. BEHLING: Okay, this (unintelligible) 


internal. 


 DR. BEHLING: We've probably gone through this 


one again already, the selection of the cancer 


that yields a dose higher than necessary. 


 MS. BEHLING: Uh-huh. 

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 MR. GRIFFON: In this case you have case 


ranking unresolved, though. Why is that? 


That's different than your other ones, Hans. 


 DR. BEHLING: Let's see here, where are we? 


(Unintelligible) 


 MS. BEHLING: I don't know. 


 MS. MUNN: You gave it a UR. 


 MS. BEHLING: Oh, unresolved? 

 DR. BEHLING: (Unintelligible) 

 MR. GRIFFON: That stuck out to me as something 

--

 MS. BEHLING: Yes, (unintelligible) -- 

 MR. GRIFFON: -- was going on --

 MS. BEHLING: -- was that. 

 MR. GRIFFON: -- differently there. 

 MS. BEHLING: I don't know why we did that. 

That's not correct. 


 MR. GRIFFON: We can check that out, but -- but 


otherwise the response is similar to the 


previous one. Right? 


 MS. BEHLING: Yes. Uh-huh, yes. 


 MR. GRIFFON: All right. And the same -- is 


the same true with 22.6? 


 MS. BEHLING: Yes. There again -- let me look 


-- there again they selected colon as the 

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cancer as opposed to the actual cancer, which 


is -- breast? 


 DR. BEHLING: (Unintelligible) 


 MS. BEHLING: Yeah, as opposed to the breast, 


and here again if you would have used the 


breast for running the hypothetical internal, 


your dose would have been significantly lower. 


 MR. GRIFFON: Is that -- that finding -- if you 


look up above, 21.6 versus -- versus what you 


have here, 22.6 --


 MS. BEHLING: Uh-huh. 


 MR. GRIFFON: -- they're -- they're written 


differently. Are they the same fin-- type of 


finding? 


 MS. BEHLING: Yes. When we were on 21.6 -- 


 MR. GRIFFON: 'Cause cancer type for modeling ­

-


 DR. BEHLING: It -- no (unintelligible) --


 MS. BEHLING: No, it --


 MR. GRIFFON: -- says something differently to 


me --


 DR. BEHLING: Yes, it --


 MR. GRIFFON: -- in summary form than -- that ­

-


 MS. BEHLING: Yes. 

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 DR. BEHLING: Mark, it should have said 


reviewer disagrees with NIOSH's selection of 


the hypothetical dose model for modeling the 


hypothetical intake. In other words, the 


difference between the 12 and 28. 


 MS. BEHLING: You need to make that change to 

the matrix. 

 MR. GRIFFON: Okay, I wi-- yeah. 

 MS. BEHLING: Okay. 

 MR. GRIFFON: I'm just trying to get my notes 

up -- up to speed here. Okay, what time is it? 


4:10, we've got a little while more. 22.7. 


 MS. BEHLING: Okay. 


 MS. MUNN: We're all in the same boat. 


 MS. BEHLING: We were talking about this 


earlier, and this speaks to the CATI -- there's 


an unresolved discrepancy between the CATI 


report and DOE records. Apparently in this 


case I believe the claimant indicated that they 


participated in the bioassay monitoring 


program, but the records didn't show that and 


so we identified this as a discrepancy. 


 DR. BEHLING: Unresolved. 


 MS. BEHLING: Unresolved. 


 MR. GRIFFON: And -- and NIOSH's response refer 

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to bullets one, two and three, and I don't have 


the full report opened. 


 MR. HINNEFELD: Bullet one was about the 


claimant claimed that he had participated in in 


vivo program, but we didn't get any DOE 


records. Bullet three was the claimant stated 


that worker had whole body counts annually 


through '92, but we only got records for four 


of them conducted from 1980 to '84. And then 


the second bullet was the claimant also stated 


that a medical X-ray was taken in all but the 


last year of employment. However, the DOE 


records provide no evidence of any chest X-ray 


examinations. 


The second bullet, we -- the dose 


reconstruction assigns an annual X-ray anyway, 


so despite the fact the record didn't show -- 


the DOE record didn't show any medical X-rays, 


that -- we didn't feel like that mattered. We 


assigned an annual X-ray. For the first and 


third bullets, this has to do with the bioassay 


record of the individual, and we feel that the 


hypothetical intake is higher than this person 


would have received. There's more information 


available on this specific claimant in terms 

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of, you know, work and when they worked and the 


type of job they did that would lead us to 


believe that they truly were unexposed or 


moderately exposed and that the hypothetical 


intake is the appropriate one to use. And so 


the absence of that record we didn't think was 


-- prevented the dose reconstruction from going 


forward. 


 MR. GRIFFON: I guess -- I guess the follow-up 


from this morning would be was this adequately 


communicated in the DR report. And -- and I 


mean I know you're advising that now, but you 


know, I guess that would be, you know, one 


question I would have is if it was clearly 


explained to the claimant that this is what we 


did and even though you may have participated, 


we believe this would be bounding, you know. 


 MR. HINNEFELD: I don't know if it was said. 


would be a little surprised if it was that 


specific. 


 MR. GRIFFON: Probably not, another early on. 


Right. 


 MR. HINNEFELD: At the time it was done, I 


would be really surprised. 


 MR. GRIFFON: So at this point I don't think 


I 
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this is any case-specific ramification, but I 


would I guess in a -- one resolution I see from 


the programmatic standpoint is that NIOSH, you 


know, is modifying the DR reports and is 


undertaking modifications on the CATI 


procedures. Right? I don't know if they're 


specifically addressing this comment, but... 


 MS. BEHLING: Stu, (unintelligible). 


 MR. HINNEFELD: Oh, you want me to say 


something? All right, let me say that the CATI 


-- the CATI procedure modification would not 


specifically address this comment. I would 


think the dose reconstruction modification, the 


new model dose reconstruction would address 


this to some fashion, would at least put in 


front of the claimant at closeout interview 


time this is the record we had. And whether or 


not the interviewer will be prepared to say 


"and it differs from what you said in the 


CATI", I don't know if that -- I don't know how 


far that can go. It might -- that might be 


possible. I don't know. So certainly we -- we 


intend to have in the dose reconstruction this 


is the exposure record we had and with the -- 


with the expectation that the claimant would 

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say that's not right, I was monitored more than 


that, or something like that. 


 MR. GRIFFON: Right. 


 MR. HINNEFELD: Also the CATI sometimes is a 


little difficult to interpret in terms of the 


information that's written on it. I mean it 


may say in vivo annually, and the claimant may 


not recognize that -- he -- you know, that may 


not -- he may not have meant that to mean 


annually for my entire employment. It may have 


been annually for the times when I was 


monitored, or annually for a while, things like 


that. I personally don't remember my bioassay 


record from Fernald. I cannot tell you what 


years I was bioassayed monthly, what years I 


was bioassayed quarterly and what years I was 


in vivo'd and what years I was not in vivo'd. 


 MS. MUNN: Huh-uh. 


 MR. GRIFFON: Right, 'cause -- and it varied 


over time --


 MR. HINNEFELD: Sure. 


 MR. GRIFFON: -- and what jobs for people, 


sure, sure. 


 MS. MUNN: Nobody can remember that. 


 MR. GRIFFON: Okay, so I'm -- I'm grasping for 

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a response on this, but -- 


 DR. BEHLING: Well, from --


 MR. GRIFFON: -- I think one thing is that the 


DR report -- the boilerplate language is being 


-- changes are being considered and are 


underway by NIOSH to improve the communication 


of how, you know, these discrepancies are dealt 


with. 


 MS. BEHLING: Yes. 


 MR. GRIFFON: And I think -- I guess that's 


about it. I don't know -- is it -- it seems to 


be the consensus that this would not have 


impacted this case. Again, I -- you know, most 


of these cases that's true for, but I figure I 


should ask. 


 DR. BEHLING: No, it's clear that the assigned 


dose of 12.4 rem based on the hypothetical 


intake and using the colon as the surrogate for 


the breast was obviously going to be a 


claimant-favorable assignment of dose. It's 


just still a discrepancy here. SC&A does not 


question that the doses that he would have -- 


that she would have received had a more 


detailed and complete internal bioassay dataset 


been supplied would have exceeded anything she 

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would have gotten. I think it's clear that 


which would -- doses were assigned are bounding 


values. 


 MS. BEHLING: In fact, I --


 MR. GRIFFON: For this -- for this case was the 


-- the job title information consistent with 


someone who should not have been monitored that 


often or -- or do you recall or -- I -- I -- 


again, I don't have the specifics in front of 


me. 


 MS. BEHLING: Let's see --


 MR. GRIFFON: The job title or --


 DR. BEHLING: She was a machine cleaner, that's 


what it says here. 


 MR. GRIFFON: Oh, okay. 


 MS. BEHLING: Oh, okay, yeah. 


 DR. BEHLING: Yeah, and I guess those people 


were subjected to a certain amount of potential 


contamination during the process of cleaning 


machinery. 


 MS. MUNN: Well, it depends on what machinery 


they were cleaning. 


 MR. GRIFFON: Yeah, it depends on the 


machinery, but machine cleaners in certain 


areas would have been pretty -- 

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 MS. MUNN: Yeah. 


 MR. GRIFFON: -- potentially exposed, yeah. 


 MS. BEHLING: Yeah, but I think that we go on 


to elaborate in finding 22.8 the fact that, 


although there is this inconsistency, we do 


recognize that NIOSH did assign the 28 


radionuclides and actually we state that that 


may have been the reason that they selected to 


use the 28 radionuclides and use the colon as 


the surrogate organ for the breast and -- in 


order to potentially account for any records 


that were missing. We go on to elaborate on 


that in the next finding. 


 MR. GRIFFON: And -- and -- I mean the other 


reason I'm pausing on this one is 'cause on 


both of these, 22.7 and 8, you have a case 


ranking unresolved, so again I'm won-- you 


know, is there... 


 MS. BEHLING: I guess at this point we -- based 


on looking at this case a little closer, we 


could make those low just because the 


hypothetical internal is used for the 


(unintelligible) --


 DR. BEHLING: Well, certainly it encompass 


anything that --

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 MS. BEHLING: Yes. 


 DR. BEHLING: -- might have been missed. 


 MS. BEHLING: Yes. 


 DR. BEHLING: If there -- if it turns out to be 


a case of missing records. 


 MS. BEHLING: Yeah. The reason it was 


categorized initially as under review is in 


order to potentially --


 MR. GRIFFON: Oh, under review, not unresolved, 


I'm sorry. 


 MS. BEHLING: Yeah, under review. 


 MR. GRIFFON: Okay. 


 MS. BEHLING: Is in order to encourage NIOSH to 


look to see if they could find any bioassay 


data. 


 DR. BEHLING: I mean to -- Mark, to answer a 


question earlier you had, you know, I'm looking 


at -- again at the summary table up front in 


our dose audit, and this person had a total of 


26 millirem of assigned -- of recorded photon 


dose, and that's usually an indication of a low 


exposure environment, and so she may have been 


a machine cleaner, chances are these kinds of 


exposures are -- are almost background or 


within the error band of a TLD or film badge. 

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So again, my gut feeling is that whatever she 


was assigned is more than going to compensate 


any missed exposure that involved missing 


records. 


 MR. GRIFFON: Yeah, that -- that certainly 


reinforces the determination, sure. 


 DR. WADE: Well, I think that the strength and 


the importance of this finding generically is 


that -- is the discrepancy between the CATI 


report and the DOE records. The question is 


was that discrepancy recognized and dealt with, 


and I think you're saying yes in this case, but 


it could be in another finding it wasn't. 


 MS. BEHLING: It wasn't. 


 DR. BEHLING: I think it would be helpful if -- 


just if there was a recognition in the dose 


reconstruction report that emphatically states 


yes, it's possible that we're missing records, 


but look, we're giving you 12.3 rem of internal 


exposure using a model that is more than likely 


to overestimate anything by an order of 


magnitude, and having stated that, you sort of 


walk away from this missing data -- potentially 


missing data, without feeling that you're 


potentially hurting the claimant in -- in not 

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considering it. 


 MR. GRIFFON: Right, right. 


 MS. MUNN: As long as they understand that any 


shortcoming that they perceive their employers 


as having foisted upon them was taken into 


consideration and more than adequately 


compensated for. 


 DR. WADE: But what we don't know at this 


point, Stu, I guess is whether or not the 


revised dose reconstruction report would 


identify the discrepancies and speak to how the 


discrepancies were dealt with. 


 MR. GRIFFON: Yeah, that's what I put as the -- 


you know, ongoing action that NIOSH is 


modifying the DR report boilerplate language, 


you know, and we've captured that in the 


procedures review, too, so we'll -- we're 


certainly going to be looking at that. 


 DR. WADE: Certainly that would be a good 


thing. Whether or not the investment in time 


will be made to do that is something that we 


have to determine. 


 MR. GRIFFON: Right. 


 MS. MUNN: Uh-huh. 


 MR. GRIFFON: Right. All right. Was that the 

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time clock? All right --


 MR. GIBSON: (Unintelligible) phone going bad. 


 MR. GRIFFON: What? Yeah, I know, I'm on my 


second phone, too, Mike. 23.1. 


 MS. BEHLING: Okay, in this case -- this is 


something that we've discussed with NIOSH 


before -- this was a prostate cancer and, let's 


see, OCAS Implementation Guide 1 indicates that 


the testes should be used as the surrogate 


organ and TIB-5 states the bladder. And I 


think TIB-5 is correct and there needs to be a 


change made to the Implementation Guide. 


 MR. HINNEFELD: Yeah, we've done that. 


 MS. BEHLING: You've done that. 


 MR. HINNEFELD: Yeah. 


 MS. BEHLING: Okay. 


 MR. GRIFFON: So IG -- IG has been modified. 


 MR. HINNEFELD: Yeah, there's a page change 


from like October or (unintelligible). 


 MS. BEHLING: Okay, great. 


 MR. GRIFFON: NIOSH agrees, IG has been 


modified. Okay. 


 MS. MUNN: I would submit, however, that this 


is one of those things where the technical 


reality may not be -- is -- is not likely to be 

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381 

the same way the patient -- the client sees it. 


That -- that is -- the use of that surrogate 


organ would, in the patient's mind, probably 


more likely be testes than bladder and -- 


 MS. BEHLING: Sure. 


 MS. MUNN: -- it's one of those things that 


perhaps requires some additional explanation. 


 DR. BEHLING: Well, that the difference being 


is the DCF which accommodates an attenuation 


component --


 MS. MUNN: Yeah. 


 DR. BEHLING: -- and of course the bladder is 


more proximal to the prostate than for -- for 


external radiation --


 MS. MUNN: That's not what they're going to 


think. 

 DR. BEHLING: I know. 

 MR. GRIFFON: Yeah, I... 

 MS. BEHLING: Okay. 

 MR. GRIFFON: Good point, though. All right, 

23.2. 

 MS. BEHLING: Again this is an issue that we've 

discussed many times. It's -- they did not 


assign any uncertainty associated with the 


recorded dose, and it's because the 

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382 

Implementation Guide has such complex procedure 


and equations for calculating what the 


uncertainty should be surrounding that recorded 


dose. Now this is one of those cases when 


there is a best estimate used or the workbook 


is used and they do Monte Carlo techniques, 


this is taken into consideration. But I think 


here again the Implementation Guide just needs 


to be changed. 


 DR. BEHLING: Well, I think the -- the current 


workbooks that have been developed make -- make 


an attempt to introduce that calculation that's 


identified in -- in the Implementation Guide 


and -- and does it for you. You can't do it 


manually. It's impossible. 


 MR. GRIFFON: So this was a pre-workbook phase 

--

 DR. BEHLING: Yes. 

 MR. GRIFFON: -- case? 

 DR. BEHLING: Yes. 

 MR. GRIFFON: Okay. 

 DR. BEHLING: And people have either 

circumvented the need for uncertainty 


calculation by doing one of two things. They 


multiply everything by two, which gives you the 

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95th percentile value which is allowable under 


TIB-8 and 10, or they -- and then enter it as a 


constant, or they simply ignore it, which is 


now missing an uncertainty value. So we cite 


it, even though I'm very sympathetic in saying 


if I had to do it, I wouldn't know how. And so 


I have to say the workbook has taken care of 


that, but that has only been recently 


introduced. 


 MS. BEHLING: However --


 MR. GRIFFON: Well, can I ask NIOSH that? Has 


the -- have the workbooks taken care of this 


issue? I mean are -- 


 MS. BEHLING: No, and maybe I can answer that 


with -- just quickly. I believe actually the 


workbook takes care of it, and this is what I 


was trying to say, when they're using -- when 


they're doing a best estimate because that's 


when they run Crystal Ball and -- 


 MR. GRIFFON: Oh, right. 


 MS. BEHLING: -- that's when all of the 


uncertainty, so -- so this is not resolved on 


most cases. I feel that the Implementation 


Guide should be changed to either put in 


something that's a reasonable -- 

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384

 DR. BEHLING: Thirty percent. 


 MS. BEHLING: -- 30 percent, exactly, that's 


what I was going to suggest -- uncertainty be 


put in with these recorded doses. 


 MR. HINNEFELD: Well, in our view --


 MR. GRIFFON: For cases that aren't best 


estimate? Is that what -- 


 MS. BEHLING: Yes. 


 MR. HINNEFELD: Yeah. In our view, a -- a 


measured -- measured dosimeter dose is normally 


distributed, and so the way that -- there -- 


there are a few acceptable ways of getting 


around that, we think. One is that if you're 


doing a -- an underestimating approach, for 


instance, so you -- you don't include all of 


it, for instance, you shave it down, you submit 


it as a constant 'cause it's at least that 


high. There is a way to get around it by -- if 


you're -- if the target organ has a dose 


conversion factor that is completely less than 


one, like below -- usually about .8 or so, or 


.9, the entire breadth of the triangular 


distribution is below that number, you can 


enter one as a DCF which overestimates that, 


and then enter your -- read a dose number as a 

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constant. We've been doing that for a while. 


We're verifying right now that that's 


appropriate, that that is in fact more 


favorable than a 30 percent distribution -- 


(unintelligible) normal distribution -- 30 


percent uncertainty (unintelligible) normal 


distribution. We are doing that verification 


now. So so far it's looking pretty good, 30 


percent -- 30 percent distribution normally 


distributed times the triangular DCF so far is 


-- is consistently less than using the measured 


value as a constant times one for DCF and 


reporting that value as a -- as a constant. So 


we're in -- we're in the middle of verifying -- 


 DR. BEHLING: And -- but if that is adopted, I 


guess I would recommend you proceduralize that 


option so it's clear to -- to the dose 


reconstructor if you're going to use 


(unintelligible) as a DCF for those organs 


where the DCF is well below some value, then 


that accounts for uncertainty, so skip it. 


 MR. HINNEFELD: It is certainly -- it is 


certainly our position that you cannot just 


ignore the uncertainty 'cause it's hard. You 


know, there should be a way to do it, like -- 

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like you said, 30 percent and -- on the 


measured dose. A measured value is normally 


distributed. 


 MR. GRIFFON: Okay. So can -- can I say, Stu, 


this is -- you're -- you're doing -- you're in 


the throes of a final evaluation for this or... 


 MR. HINNEFELD: Well, on this particular one, 


the dose conversion factor isn't entirely below 


one, I don't think, so that shorthand wouldn't 


be appropriate for this case. 


 DR. BEHLING: No, for skin, for instance, it 


wouldn't be appropriate. 


 MR. GRIFFON: Right. 


 MR. HINNEFELD: Right. 


 MR. GRIFFON: Right, for this case, but then 


for the -- for the broader issue of this 


general finding --


 MR. HINNEFELD: Yeah. 


 MR. GRIFFON: -- you're -- are you going to 


revise --


 MR. HINNEFELD: I think we -- we promised that. 


I mean that's been promised -- that's part of 


our response in the first 20 DR reviews. 


 MR. GRIFFON: And -- and to revise what? In --


in the -- in the --

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 MR. HINNEFELD: Well, the first thing -- 


 MR. GRIFFON: -- IG or where -- where is the 


procedural revision going to take place? 


 MR. HINNEFELD: I'll have to get with ORAU and 


find out from them where it belongs because 


they're the ones who worked on the procedures 


more than us. 


 MR. GRIFFON: And 23.3? 


 MS. MUNN: Before we do anything else on 23.3, 


how about turning the page up to page six and 


making sure that all names are removed from 


this. 


 MR. GRIFFON: Yeah, I was going to -- I saw 


that, too. 


 MS. MUNN: Please, mark out the name. 


 MR. GRIFFON: Yeah, a name got in there. 

 DR. BEHLING: I'm very cautious about ever 

using --

 MR. HINNEFELD: That was ours. That was ours. 


 MS. BEHLING: That was NIOSH's. In this 


particular finding we -- 


 MR. GRIFFON: We're on 22. -- we're at 23.3. 


 MS. BEHLING: 23.3. 


 MR. GRIFFON: Yes. 


 MS. BEHLING: Yeah, looking at the records and 

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looking at the CATI report, we came to the 


conclusion that possibly this individual should 


have been assigned missed neutron dose. 
I 


believe the records actually had zeroes under 


neutron dose for '61 through '90, and then 


there were blanks from -- no, no, I guess there 


were zeroes between '61 through '74 and then -- 


 DR. BEHLING: After 1974 they were recorded as 

blanks. 

 MS. BEHLING: -- after '74 there were blanks, 

and so -- and also based on the fact that in 


the CATI report the individual indicated that 


he may have been exposed to californium and 


uranium, and so based on that information we 


just felt that possibly missed neutron dose 


should have been assessed. 


 MS. MUNN: He said he may have been, did not -- 


was not clear? 


 MS. BEHLING: What happens on the CATI report, 


there's a list of radionuclides and -- 


 MS. MUNN: Yeah, I remember that. 


 MS. BEHLING: -- they're asked to checkmark 


those that they have been exposed to or they 


(unintelligible) --


 MS. MUNN: But there wasn't any verbal 

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expansion on that? 


 MS. BEHLING: No, it's just check marked. 


 MS. MUNN: Okay. 


 DR. BEHLING: But also his work station loc-- 


location was building 92-12 and I think if I 


looked at the TBD that might suggest potential 


exposures to neutrons. 


 MS. BEHLING: Stu's digging for papers again. 


 MR. HINNEFELD: Yeah, I'm digging -- I thought 


I'd brought something -- I'm digging. I 


thought I brought something on this, but maybe 


not. 


 MS. MUNN: These kind of judgment calls are the 


kind that I have the most difficulty with, and 


I guess I've always had difficulty with 


assigning dose to people who are monitored and 


show zero exposure. It's one thing if you're 


not monitored and there's reason to believe you 


might have been exposed. But if you're 


monitored and you're showing zero exposure, 


then how much -- how can we just dismiss that 


as being unacceptable, inaccurate -- 


 MS. BEHLING: We don't write the procedures on 


 MS. MUNN: I know, I know. 

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 MS. BEHLING: -- how to calculate missed dose. 

 MR. GRIFFON: (Unintelligible) 

 DR. BEHLING: Wanda, what I always do is I look 

at the report. If I see out of a -- let's say 


five years' worth or ten years' worth of 


monitoring a handful of positive ones, I say 


okay, now he was -- the exposure must have been 


very nominal where a few of them went over the 


point where there are recorded dose but the 


rest are zeroes. Now that gives me reason to 


believe that I'm not near zero, but I'm 


somewhere between zero and recordable, and 


that's evidenced by a few that went over the 


top that actually became recorded dose, so I 


usually try to look at that in saying where am 


I. If a secretary was monitored and she has 


ten years' worth of zeroes, you're closer to 


zero down here, there's no question about that. 


But if you have someone who was monitored for a 


period of time and even a handful went above 


that LOD level and reported as positive, then 


you can be sure that the missing data or the 


missed dose data is somewhere between zero and 


LOD. 


 MS. BEHLING: And I think the other thing that 

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we do, and you'll see it in this particular 


case, we try to look at supporting data such 


as, in this case, first of all the CATI report 


indicated the uranium and the californium. We 


also went back and verified what buildings he 


worked at -- in and checked the TBD to 


determine could he have been exposed to 


neutrons in this building, 92-12. So we look 


at a number of issues before we make a decision 


as to whether we believe that there -- there 


should have been missed dose -- neutron dose 


assigned, not just zeroes on the -- the DOE 


records. 


 MR. HINNEFELD: Yeah, Y-12 hung a badge that 


included a neutron component on everybody. I 


mean when they badged them, the neutron 


component went along, regardless of their 


potential for exposure to neutrons. It's just 


part of (unintelligible). 


 DR. BEHLING: Yeah, in fact that's a question I 


have. When the TLND was introduced at Savannah 


River or at Hanford, was a person who was not 


even remotely likely to be exposed to neutron, 


was that badge analyzed? Was the algorithm 


followed to see if there was a neutron 

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component even though, based on location, the 


likelihood of a neutron exposure was zilch? 


 MR. HINNEFELD: Well, I guess sitting here 


today I don't know. I really don't 


(unintelligible). 


 DR. BEHLING: Because I never know how to 


interpret -- if I see a blank, I feel more 


comfortable the person wasn't exposed. If I 


see a zero, there must have been a reason why 


that badge was processed. 


 MS. BEHLING: Uh-huh. 


 MR. HINNEFELD: So -- and I don't know, sitting 


here. We could provide, you know, additional 


research with the dose reconstructors and 


people who know more about Y-12 and Y-12 dose 


reconstructions than I do and -- and come up 


with maybe a better explanation, but from our 


view, that -- you know, this was someone who -- 


well, a machinist at Y-12, you know, other than 


californium, you know, is there really going to 


be that much neutron around the uranium -- 


chunk of uranium, you know. You're not going 


to find it around uranium unless he happened to 


be around the californium source, which must 


have been a calibration source of some sort. 

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Really where's the neutron exposure, and as a 


machinist, would he have spent that much time 


around the californium source. So there's a 


number of questions that play in your mind 


about why -- was this guy really -- you know, 


was there really significant potential for 


neutron doses here beyond some nominal amount 


that we feel like the overestimating approaches 


address. But we can -- I mean we can get 


additional information from more expert dose 


reconstructors than I to look through this and 


say okay, what's the thought process here and 


why is this not a missed neutron dose in the 


case. 


 DR. WADE: Well, I think we're at the witching 


hour, so I (unintelligible) -- 


 MR. GRIFFON: Yeah, I think we're at the -- so 


-- so what -- just to conclude that last one, 


though, is -- are you going to look into this 


further --


 MR. HINNEFELD: Yes. 


 MR. GRIFFON: -- Stu? 


 MR. HINNEFELD: Yes. 


 MR. GRIFFON: Okay. Yeah, I think it's time to 

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 MS. BEHLING: I guess we could close out this ­

- this number 23, though, because the last 


finding is one that we've discussed before, so 


we've -- this is, again, the selection of 28 


radionuclides as opposed to 12 radionuclides, 


and this is not necessarily a site with a 


reactor, so we just questioned that, so just -- 


 MR. GRIFFON: No, I see three more findings, 

though. 

 MS. BEHLING: Oh --

 MR. GRIFFON: 23.4, 23.5 --

 MS. BEHLING: -- oh, I'm sorry, I jumped ahead. 

 MR. GRIFFON: Yeah, I was going to try to close 

it out, too, but I think there's more CATI 


discussion there and it looks like a pretty 


lengthy one. 


 MS. BEHLING: Okay, never mind. 


 MR. GRIFFON: Or I -- yeah, let's just break 


here at 23.3 --


 MR. HINNEFELD: I think -- I think we just 


ought to take another look at the case in 


general. We'll take all the comments on this 


case and make it all part of our additional 


evaluation of -- of the components of this dose 


reconstruction and what support do we have for 

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the approach that was taken. 


 MR. GRIFFON: That sounds reasonable. All 


right, we're --


 DR. WADE: Now I don't have any -- 


 MR. GRIFFON: -- at a good break point. I'm 


sure everybody is just about broken. 


 DR. WADE: -- information -- I don't have any 


information on the -- the Boston hotels, but 


LaShawn is working on that. That'll be our 


operative strategy. We'll try and meet the 


27th, close to the Logan Airport. We'll get 


information to you as soon as we have it. 


 MR. GRIFFON: There is -- there is a Hilton 


right at the airport which -- you can -- you 


don't even have to leave the terminal, but I 


don't know what -- you know, that's -- that's 


one option, anyway. 


 DR. WADE: Right, I just don't know that 


availability. LaShawn's working on that. 


 MR. GRIFFON: Okay. 


 DR. WADE: And then, you know, I'll leave to 


the working group how it wants to conclude its 


work on this set of 20 and the next 20. You 


know, it'd be good to get this thing wrapped up 


before the next Board meeting -- 

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 MS. MUNN: Sure would. 

 DR. WADE: -- that's at the end of April. 

 MS. MUNN: That means March. 

 MR. GRIFFON: Yeah. 


 DR. WADE: March, both the month and the 


activity required. 


 MS. MUNN: Yes. 


 MR. GRIFFON: All right. 


 MS. MUNN: And any other definitions you can 


(unintelligible) trickle on downwards. 


 DR. WADE: On that note, thank you for your -- 


 MR. GRIFFON: Yeah, let -- let's think of -- of 


-- I mean I think we might want to reconvene 


this group --


 MS. MUNN: Yeah. 


 MR. GRIFFON: -- and maybe piggyback with one 


of the other site profile groups -- I'm not on 


any other workgroup on the other site profiles, 


so -- but -- but we can discuss that maybe in 


Boston, if we come up to Boston -- 


 MS. MUNN: Well --


 MR. GRIFFON: -- on the --


 MS. MUNN: -- it would really be very helpful 


for me if we could do that sooner than Boston. 


 MR. GRIFFON: Well, do -- do you know the other 

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dates, though, for the other meetings, or do 


you have your own --


 MS. MUNN: Well, I do know that the Nevada Test 


Site working group does not have a date 


established. Right, Bob? 


 MR. PRESLEY: That's correct. 


 MS. MUNN: Because our original choice of the 


28th couldn't be met by NIOSH staff. They 


didn't have enough time -- not enough hours in 


their lives --


 MR. GRIFFON: Right. 


 MS. MUNN: -- to get there, so that group is 


going to have to meet sometime in March, and 


that has not been determined yet. And my 


calendar is looking kind of funny. I don't 


know, it just -- what does your calendar look 


like, Mark? 


 MR. GRIFFON: Disastrous, but you know. 


 MS. MUNN: Well, can we squeeze out another day 


in March out of this somehow to -- to get -- 


finish this one up? 


 DR. WADE: Could be if you pick the day, others 


will sort of gather around you, so... 


 MR. GRIFFON: I think we -- I think we have to. 


Right? We could do -- I could do March 7th or 

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8th. 


 MS. MUNN: I (unintelligible) 8th. As I said, 


I'm -- I'm tied up with a caucus on the 7th 


which will make it impossible for me to fly on 


the 7th. 


 MR. GRIFFON: 7th, 8th or 9th I can do, 


actually. How about -- 


 MR. PRESLEY: The day of the 8th and the 9th 


I'm tied up. 


 MS. MUNN: Okay. How about Friday? 


 MR. GRIFFON: The 10th? 


 MR. PRESLEY: Well, that's -- that'd -- that'd 


be a problem for me 'cause I --


 MR. GRIFFON: Getting there? 

 MR. PRESLEY: -- my meeting is all day on the 

9th. 

 MS. MUNN: Okay. Well, we have our full Board 


call on the 14th. Can we --


 MR. PRESLEY: That's correct. 


 MS. MUNN: Can we do this the day before or 


something, or -- well, no, that'd put us 


traveling, wouldn't it? 


 MR. GRIFFON: Yeah. 


 MS. MUNN: Can't do that. I guess we could all 


be in one place for the call on the 14th and -- 

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 MR. GRIFFON: Other-- otherwise I'm kind of out 


to like March 28th or 29th or 30th. 


 MS. MUNN: That's awful. 


 MR. GRIFFON: Yeah, that's a ways away. 


 MS. MUNN: We need to be able to do that before 

then. 

 DR. WADE: How about March 2nd? 

 MS. MUNN: I can't do it, but you can certainly 

work around me. I have Oregon State's NE 


Department in my lap on the 2nd. 


 MR. PRESLEY: Let me ask you something. Can we 


have another conference call? This has worked 


pretty good today. 


 MS. MUNN: Yeah. 


 DR. WADE: We can. 


 MR. GRIFFON: Ray, what do you think about 


that? Was it okay for you? 


 DR. WADE: Say again? 


 MR. GRIFFON: I'm asking Ray if it was okay for 


him. 


THE COURT REPORTER: Yeah, the phone has been 


good today. 


 MR. GRIFFON: Yeah. 


 MS. MUNN: As long as we can get one or two of 


us somewhere and the -- the NIOSH folks and 

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SC&A face to face. They're the people who need 


to be together with the paper more than 


anything else. 


 MR. GRIFFON: That gives us more flexibility. 


 DR. WADE: How about the 3rd of March with that 


model? 


 MR. GRIFFON: (Unintelligible) -- with that 


model. 


 DR. WADE: Well, I mean some --


 MR. GRIFFON: Yeah. 


 DR. WADE: -- NIOSH and some SC&A people here, 


others by phone. 


 MR. PRESLEY: I can make it the 3rd up until 


about 4:30, then I've got to back off of that, 


but I'm available. 


 MR. GRIFFON: But we -- can we do that model on 


the 2nd? Is that possible? 


 DR. WADE: This is Wanda's visit. 


 MR. GRIFFON: Oh, is that your --


 MS. MUNN: Yeah, I've -- I've got Oregon State 


 MR. GRIFFON: The 3rd I've got --


 MS. MUNN: -- (unintelligible) people. 


 MR. GRIFFON: The 3rd I've got a conflict in 


the morning. 

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 MS. MUNN: We've got -- well --


 MR. PRESLEY: Y'all know (unintelligible) -- 


 MS. MUNN: -- we're meeting on the 27th on the 


Y-12 and SEC and -- and Rocky thing. 


 MR. GRIFFON: Right. 


 MS. MUNN: And NIOSH has said they couldn't 


support the 28th for a different thing, but 


could we -- would it be possible for us to 


finish up these procedures that day? 


 MR. HINNEFELD: It's okay with us. 


 MR. PRESLEY: When's that? 


 MS. MUNN: Huh? 


 MR. PRESLEY: When is that? 


 MS. MUNN: The 28th. 


 MR. GRIFFON: 28th, be back onto the --


 MS. MUNN: If we were going to meet in Boston 


anyway. 


 MR. PRESLEY: I can handle that now -- oh, you 


mean two days in Boston? 


 MS. MUNN: Well, or -- yeah -- yeah. Two days 


wherever we're going to be. Since we're going 


to be in -- in the face-to-face process anyhow 


on a --


 MR. GRIFFON: Yeah, I could do that. 


 MS. MUNN: -- on a different tack, and Jim has 

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said the NIOSH folks couldn't work up NTS for 


the other working group, but -- 


 MR. HINNEFELD: We can -- we can be -- we can 


attend your -- on -- we can do it the 28th. 


 MS. MUNN: Good. 


 MR. PRESLEY: I -- I can make the two days in 


Boston. 

 MS. MUNN: Okay, let's --

 DR. WADE: I'll tentatively schedule that. 

 MS. MUNN: Okay. 

 MR. GIBSON: So that -- that's February 27th 


and 28th? 


 MS. MUNN: Correct. 


 MR. GIBSON: Okay. 


 MR. HINNEFELD: We'll have to travel out on the 


28th. We'll have to leave Boston and come home 


on the 28th. We have to be in the office on 


the 1st. 


 DR. WADE: Okay. Okay. 


 MR. GRIFFON: Okay. 


 DR. WADE: So we can start early that morning 


'cause we'll be there already. 


 MS. MUNN: Uh-huh. 


 DR. WADE: And we'll try and leave people time 


to get home to their -- their homes by the -- 

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by close of the shift on the 28th. 


 MS. MUNN: Yeah. 


 DR. WADE: It's a plan. 


 MS. MUNN: Everybody but me. 


 MR. PRESLEY: I don't know how much I can fly 


out of Boston that late in the afternoon, 


either. 


 MS. MUNN: No, might as well hang out. 


 MR. HINNEFELD: Oh, shoot --


 DR. WADE: What (unintelligible) -- 


 MR. HINNEFELD: Forget -- forget it, we'll get 


out of it. 


 MR. GIBSON: Mark, they have flights back to 


Cincinnati on the 28th. Right? 


 MS. MUNN: Sure. 


 MR. GRIFFON: They should -- they should go -- 


I think -- I think at least till 9:00 or so -- 


8:00 or 9:00. 


 MR. GIBSON: Okay. 


 MR. GRIFFON: Yeah. So you should be 


(unintelligible) --


 MR. GIBSON: (Unintelligible) 


 MR. GRIFFON: -- yeah, you should be all right. 


 MR. GIBSON: I've got the kids to take care of, 


so... 

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 MR. GRIFFON: Yeah. Okay, that -- that should 


work, 27th and 28th then in Bos-- hopefully in 


Boston. 


 MS. MUNN: Yeah, we'll all be numb by then. 


 MR. HINNEFELD: You're not already? 


 DR. WADE: I'll let you know as soon as I know 


about the hotel availability. 


 MS. MUNN: Good. 


 MR. GRIFFON: All right. 


 MS. MUNN: It ought to be someplace close. 


 DR. WADE: We'll figure out something. 


 MR. GRIFFON: Thanks a lot, everyone. Sorry I 


couldn't be there in person. 


 MS. MUNN: Thank you. 


(Whereupon, the working group meeting was 


adjourned at 4:45 p.m.) 

______________________________ 

405 

1 CERTIFICATE OF COURT REPORTER 


STATE OF GEORGIA 


COUNTY OF FULTON 


 I, Steven Ray Green, Certified Merit Court 


Reporter, do hereby certify that I reported the 


above and foregoing on the day of February 13, 


2006; and it is a true and accurate transcript 


of the testimony captioned herein. 


 I further certify that I am neither kin 


nor counsel to any of the parties herein, nor 


have any interest in the cause named herein. 


 WITNESS my hand and official seal this the 


3rd day of April, 2006. 


STEVEN RAY GREEN, CCR 


CERTIFIED MERIT COURT REPORTER 


CERTIFICATE NUMBER: A-2102