NEAL R. GROSS

COURT REPORTERS AND TRANSCRIBERS

1323 RHODE ISLAND AVE., N.W.

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

United States of America Centers for Disease Control

National Institute for Occupational Safety and 

Health

Advisory Board on Radiation and Worker Health

Wednesday, April 11, 2018

122nd Meeting

The meeting convened at 9:00 a.m. Eastern Time, in 

the DoubleTree by Hilton Hotel Oak Ridge-Knoxville, 

215 S. Illinois Avenue, Oak Ridge, Tennessee, Ted 

Katz, Designated Federal Official, presiding.
2

Present:

Henry Anderson, Member*

Josie Beach, Member

Bradley P. Clawson, Member

R. William Field, Member*

David Kotelchuck, Member

Richard Lemen, Member*

James E. Lockey, Member

Wanda I. Munn, Member

David B. Richardson, Member

Genevieve S. Roessler, Member

Phillip Schofield, Member

Loretta R. Valerio, Member

Paul L. Ziemer, Member

Ted Katz, Designated Federal Official

Registered and/or Public Comment Participants:

Adams, Nancy, NIOSH Contractor

Barrie, Terrie

Behling, Kathy, SC&A*

Buchanan, Ron, SC&A*

Burgos, Zaida, NIOSH

Calhoun, Grady, DCAS

Carroll, Stephanie*

Colley, Vina*

Crawfrod, Chris, DOL*

Domina, Kirk

Fitzgerald, Joe, SC&A

Giron, Eloi*

Griffon, Mark

Hand, Donna*

Hinnefeld, Stu, DCAS

Hughes, Lara, DCAS

Kocher, David, ORCRA

Lewis, Greg, DOE

Lin, Jenny, HHS*

Neton, Jim, DCAS

Presley, Louise

Rutherford, Lavon, DCAS

Stiver, John, SC&A

Taulbee, Tim, DCAS*
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Contents

Advisory Board on Radiation and Worker Health 

Wednesday, April 11, 2018 122nd Meeting 1

Welcome and Roll Call 4

Tribute to Dr. Melius 6

NIOSH Program Update 13

Department of Labor Report 18

Department of Energy Report 22

Weldon Spring Site Profile Review 31

Procedure Reviews: OTIB-17, OVER-9, OTIB34 51

Dose and Dose-Rate Effectiveness for Low-LET 

Radiation 81

SEC Petitions Status Update 113

Board Work Session 116

Oak Ridge Facilities Update 132

Public Comment 146

Adjourn 170
4

Proceedings

(9:03 a.m.)

Welcome and Roll Call

Mr. Katz: Okay, welcome everyone. This is the 

Advisory Board on Radiation Worker Health. This is 

our 122nd meeting. I'm Ted Katz, I'm the Designated

Federal Officer for the Advisory Board, I'm also acting 

as the Chair for the time being and I'll explain a little 

bit more about that later.

So, let me say few things before I get into 

administrative matters. The Board Members came in 

yesterday and we had a tour of the Oak Ridge 

facilities, this is not our first tour, it was a marvelous 

tour.

So the first thing I would just like to say is thank you 

so much to the community, to the facility, to DOE, 

Greg and his staff. It really a terrific tour and we 

learned a lot from it, it was very useful. And maybe 

Jen wants to say something too. She's the Chair of 

the Work Group that deals with this facility.

Member Roessler: Yes, thank you Ted and thank you 

Greg and your people for helping arrange, I was a 

really good tour. We realize it took a lot of effort and 

time to put it together and much appreciated. The 

information and everything we saw was very 

pertinent to what the Board and the Work Group will 

have to deal with.

Mr. Katz: Thanks, Jen. And it's great to be here at 

Oak Ridge. It's a real touchstone for us. First of all, 

it's beautiful here this time of year, but one of our 

original Board Members, longstanding, Bob Presley, 

this is his home.

In fact, yesterday after the tour we went to the 

museum, the Oak Ridge Museum, which is an 

incredible museum and we had the privilege to go 

through Bob Presley's childhood home, which is 
5

actually a part of the museum now. And that was 

very meaningful for all of us.

It even has a picture in him, or couple pictures of 

him, of Bob Presley as a little boy, I think the only 

time he was little. And so, thank you very much for 

all that too.

Let me just talk about some administrative matters. 

The materials for this meeting are on the NIOSH 

website. They're also on the back table for people 

here in the room, but they're on the NIOSH website 

for people on the line. All the presentations that will 

be given today should be there as well as the 

background reading materials.

So you can go there, go to the NIOSH website to this 

programs portion of the website and look under 

schedule of meetings, today's date and you'll have 

access to all of those including the agenda.

And on the agenda, you'll see also a code for a Skype 

for those of you who are internet savvy you can join 

on the internet. All that will allow you to do, you'll 

keep this audio, this telephone line for listening, but 

that will allow you to actually see the slides progress 

as they are presented by the different presenters.

But otherwise you can just follow along those same 

presentations on your own at your own pace off of 

the website. Let me also note, there's a public 

comment session today, that begins at 5:00 p.m.

And if you wish to speak and you're here at Oak 

Ridge, then you would sign in in the book outside the 

room at some point today, you'll have plenty of time 

for that. For people who are on the line on the phone, 

we will take phone commenters after we have dealt 

with everyone in the room. So that's to come.

Okay. I think that takes care of logistic things, other 

thing for people on the phone is, please to keep your 

phones muted. Some Board Members are on the 

phone too, of course they don't need to do that, but 
6

for everyone else, please mute your phones.

If you don't have a mute button on your phone press 

*6, that'll mute your phone for this conference line. 

And, for example, at public comments session to take 

your phone off of mute you can just press *6 again.

But please do that and please, no one on the phone 

put this call on hold at any point because then we will 

hear whatever kind of hold music or whatever you 

have on the line and it'll prevent everyone on the line 

from hearing what goes on here.

Okay, just one note before -- well actually, I think 

what we'll do is if -- are you ready Paul?

Member Ziemer: Yes. I just wanted to get some, I'm 

looking for the water.

Mr. Katz: Oh, we'll get you a water. There's water in 

the back.Member Ziemer: Oh, I see it in the back.

Mr. Katz: We'll get it. So we're going to go first --

yes, sure. We're going to go to our -- well, let me 

actually, one thing I haven't done, which I should do 

before we get started, Paul, is roll call.

We do not have any conflicts of interest for any 

Members for any sessions. So I don't need to address 

that and most of the Board Members are here in the 

room. But I'll formally run down the list in any event, 

even though I know they're here, for the record. So 

I'll do this alphabetically.

(Roll call.)

Mr. Katz: And we have a quorum, we have all but 

one. So that's good for our meeting to proceed. Okay, 

Paul.

Tribute to Dr. Melius

Member Ziemer: Before I present this memorial 

resolution, which is a tribute to our late Chairman, 

Dr. Jim Melius, just a couple of comments. I 
7

recognize Louise Presley, who has just joined us. 

Louise, we're glad to see you here.

(Applause.)

Member Ziemer: Also I want to mention that this 

Memorial Resolution is based on contributions from 

these Board Members. I've simply put it together as 

sort of an editor.

But the places in the Resolution or the tribute that 

use the first person, first person pronouns, don't 

necessarily represent me but whoever it was that 

made that particular comment. So this is a tribute to 

Dr. James M. Melius from the Advisory Board on 

Radiation and Worker Health. 

Dr. James, Jim Melius, an occupational physician and 

international leader in occupational medicine and 

epidemiology, died unexpectedly of cardiac arrest on 

January 1st, 2018.

Members of the Advisory Board on Radiation and 

Worker Health, of which he served as Chairman, 

mourn his death and wish to pay tribute to Jim for his 

significant contributions to worker health and safety.

The extensive impact that Dr. Melius has made on 

addressing the health and safety issues of workers 

throughout his career has been well summarized in 

his obituary. Thus, as colleagues of Jim, on the 

Advisory Board, we will share our personal thoughts 

about his impact on us and on our work as a Federal 

Advisory Board.

The Advisory Board on Radiation and Worker Health 

was established under the provisions of the Energy 

Employees Occupational Illness Compensation Act in 

2000. Dr. Melius was one of the original members 

appointed by the White House and had served 

faithfully since then until his recent death. This 

included appointment as Chair of the Board in 2009.

The Advisory Board is charged with advising the 
8

Secretary of Health and Human Services on matters 

related to the compensation of employees whose 

cancers were likely to have been caused by radiation 

exposures at Department of Energy facilities or at 

Atomic Weapons Employer facilities.

Dr. Melius was a prime advocate behind the 

enactment of EEOICPA or the Energy Employees 

Occupational Illness Compensation Program Act, and 

it is fitting that he then served on the Advisory Board 

that developed from the legislation.

It was also notable that he was also a principal 

advocate for the James Zadroga 9/11 Health and 

Compensation Act in 2010, which established a 

health care program for victims of the 9/11 terrorist 

attacks on the World Trade Center and the Pentagon.

For us on the Advisory Board on Radiation and 

Worker Health, Jim Melius was a consummate bridge 

builder between all three perspectives represented 

on this Board: scientific, medical and worker.

In this pursuit, he was patient, humorous, attentive 

and insightful in doing his part to bring us closely into 

consensus as possible for a given decision. 

Throughout our activities, he was caring of his fellow 

Board Members, of the program and the Board staff 

as well as the claimants, their families and advocates.

Our personal impressions about Jim Melius include 

the following, I appreciated him for the respect and 

no-nonsense way he treated me over the years. He 

always listened and gave me advice, mostly with a 

smile or a smirk, depending on his mood that day.

To sum it up, I'll miss Jim because he was an 

honorable and dedicated man that cared about 

people and fought for people who couldn't always 

speak for themselves.

I will always remember Jim Melius as a gentle, fair, 

intelligent and effective leader of our Advisory Board. 

He had selfless and deep sense of social justice. He 
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spent his life and his efforts helping those whom he 

felt were unjustly treated. He was kind and respectful 

to everyone.

Jim was a man of great intelligence and compassion 

and worked tirelessly to improve both the health and 

safety of others. He never shirked the battle to 

improve the lot of others who he never knew.

His legacy to mankind is the many laws and 

regulations he wrote or helped get implemented to 

protect the health and safety of others. He truly 

stands out as a man of great accomplishments and 

will be missed by all those who knew him.

Reliability of character is not often given much 

attention outside the halls of commerce, but it is a 

priceless commodity in our lives and the daily 

relationships that surround us.

When a reliable person is suddenly and unexpectedly 

gone from us, the ripples in the fabric of those lives 

extend much further than we can control and the 

results are significant. Jim Melius was a very reliable 

man.

Dr. Melius demonstrated fairness, compassion and 

respect for his fellow Board Members, the claimants 

and everyone else he interacted with in the scope of 

his responsibilities as Chair of the Advisory Board.

Two quotes by Maya Angelou remind me of Jim 

Melius. 

Quote 1: "My mission in life is not merely to survive, 

but to thrive and to do so with some passion, some 

compassion, some humor and some style."

Quote 2: "A great soul serves everyone all the time. 

A great soul never dies. It brings us together again 

and again." 

Dr. Melius' legacy will bring us together again and 

again as we continue to learn from his example.
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I was always amazed at Jim's boundless enthusiasm 

and willingness to contribute his skill, expertise and 

time to thoughtfully distill solutions for everyone who 

asked.

Jim Melius always found time to assist and apply his 

intellectual ability and consensus building skills to 

achieve large and small impacts on real life concerns 

often behind the scenes.

He had a unique ability to create an impact across 

the spectrum of local, state, national and 

international occupational and environmental health 

discourse, always with an eye to benefitting the 

public's health. His calm leadership, intellectual 

curiosity and vast practical experience, all shared 

with humor, will be missed.

Although we focus on our work with Jim on the 

Advisory Board for Radiation and Worker Health, we 

must not overlook some of his activities that are not 

as widely reported. For example, Jim played a key 

role in helping establish the New York State 

Occupational Health Clinic network in the 1980's, the 

nation's only state-based Occupational Health Clinic 

network, and until his death, served on the State 

Oversight Committee for that network.

Whether it was serving on the Advisory Board for the 

New York/New Jersey NIOSH Education and Research 

Center, or helping the New York Committee on 

Occupational Safety and Health, secure a speaker or 

helping develop a training course for hazardous 

waste and emergency response workers, or simply 

providing advice to activists on dealing with the 

troublesome local health and safety issues, Jim was 

always there to turn to and help.

And Jim, despite his elevated rank, was not above 

attending to the quotidian tasks of Committee and 

Board Members and Administration which are the 

sinews of a viable health and safety movement.

Jim demonstrated the ability to provide a forum for 
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all sides of an issue to be discussed in an atmosphere 

of fairness and respect. He was always willing to 

consider factors and viewpoints that might be 

contrary to his own position.

He always made sure that everyone had an 

opportunity to participate and express their own 

ideas. He brought to the Board a healthy level of 

skepticism about the limitations of science, as this 

has a bearing on weighing what can be determined 

about the radiological exposures among workers in a 

nuclear weapons complex.

Sometimes his skepticism slipped sideways a little 

into mischievous humor. For example, he was quite 

dubious at first as to what actually went on at one of 

the nuclear weapons facilities out West, named Wah 

Chang. Why are we considering radiation exposures 

at a dry cleaners, he asked the Board's Federal 

Official.

Jim's humor and humanity also served as an amusing 

antidote to the political and administrative strictures 

of the life in government and public policy.

Despite six years as a Board Member and nine years 

as Board Chair, he never quite managed to get either 

his government identity smart card or his 

government computer to work.

So Dr. Melius, Jim, the Advisory Board on Radiation 

and Worker Health bids you farewell. We will greatly 

miss you at our meetings, but if you do find a way to 

listen in, be sure to press *6 on your phone and put 

it on mute.

Do you want to do the moment of silence now? Okay.

(Applause.)

Member Ziemer: And that hand is for Jim. But let's 

stand together for a moment of silence in the 

memory of Dr. James Melius.
12

(Moment of silence.)

Mr. Katz: Okay. And as we're getting ready for the 

next presentation, Stu, do you have a mic up there 

or we still have this snafu?

(Simultaneous speaking.)

Member Lemen: Ted.

Mr. Katz: Right, okay. I'm sorry, Dr. Lemen, Dick?

Member Lemen: I just wanted to point out to the 

Board that I gave this to Jim's family at the memorial 

service and summarized it and read it at the 

memorial service. So his family has got a copy of this.

Mr. Katz: Right. So, Dr. Lemen was just saying, the 

volume is a little bit low in the room at the moment, 

but that Dr. Lemen was a participant, he's one of Dr. 

Melius' oldest colleagues and friends.

And he is a Member of this Board, of course, and he 

presented this commemoration of Dr. Melius at the 

memorial for Dr. Melius that was held at Mount Sinai 

a couple weeks ago. And we thank you for that, Dick.

Member Lemen: And the second part is his family has 

a copy of it. I made sure I gave them a good copy.

Mr. Katz: Thanks. Thanks, Dick. Before we go on, 

we're about to start the NIOSH program update, but 

let me just also note, I said I had something to say 

about serving as acting as Chair of the Department 

and Director of NIOSH.

Dr. Howard has asked me to serve as Acting Chair so 

that we can keep our work moving forward in the 

interim because, as I think most of you understand, 

the President has to designate a new Chair for the 

Board. That's solely the President's prerogative.

So to understand a little bit about how that will work, 

I'm serving as Acting Chair, I will not be speaking to 

motions, I will not be voting on motions either.
13

So I continue, essentially, the administrative role, but 

I have, asked and Dr. Ziemer has graciously agreed, 

that he would handle the parliamentary role for when 

we have action items that require the Board's votes. 

So he will handle those and there are only two of 

those at this meeting today.

Okay, so with no further ado, we have our program 

update from Stu Hinnefeld.

NIOSH Program Update

Mr. Hinnefeld: Okay. Can you, okay, you can hear me 

now. Okay. Well, thanks, Ted. Thank you for 

Members of the Board. I'm back for my normal brief 

update from the program.

I don't have a terribly large set of news updates this 

time. We have not actually participated in an 

outreach activity since the last Board Meeting in 

December. But we have two that are imminent or one 

is imminent, one is next week in Ames, Iowa. That's 

in conjunction with the most recent extension of the 

SEC Class at Ames. The Board recommended that, I 

believe, two meetings ago.

And then, in May, we and the other federal agencies 

and our Ombudsman who are involved in EEOICPA 

are presenting another authorized representative 

workshop this time in Kennewick. We did one of these 

in December, just prior to our last, the last Board 

Meeting.

We did one of these in Tampa in December and it's 

part of our essentially labors plan to conduct these 

essentially around the country so authorized reps can 

have at least a little more convenient trip to it. That 

will be, like I said, somewhere and that's in mid-May.

I put on the slides your budget. I always feel like I 

should talk about the budget a little bit and I always 

feel like I don't know what to say about the budget 

because it's not very fixed. There is now a budget bill 

that has been passed for this year, so we're not 
14

operating on a continuing resolution, I believe it was 

called an Omnibus Bill.

That leaves our funding intact, and we didn't receive 

any bump up or cut in the bill, but there is a wrinkle 

that I've not actually been able to sort out. I've asked 

the top money person at NIOSH who's asked the 

Office of Financial Resources at CDC and no one 

knows yet whether this budget removes the 

sequester that has been applied to our budget since, 

2011.

Every year the budget that has been passed for us 

has listed one number, but automatically a 

sequester, about a ten percent reduction, was 

applied every year. So we actually got ten percent

less money than what the budget line was because 

of the application of that sequester.

Now, there's been discussion that this latest budget 

bill for 2018 removed the sequester, at least from 

many accounts, maybe not from all. I don't know. 

And so, I've been trying to find out if it removed the 

sequester from our account or not. And that's what I 

can't find out.

I was hoping to know by today, but last word I heard

was we probably won't know until the CDC gets 

what's actually called its budget ceiling and that 

won't happen for a couple more weeks. So, in a 

couple more weeks, and the only impact is this would 

be, would actually be increased money for this year. 

It wouldn't be cut, it would be increase money above 

what we've had the last several years.

So, that's all I know about the budget. And if you 

read the newspapers you hear, you also know that 

there is talk about a rescission by the White House 

which, who knows what that would be. So every time 

I feel like I want to say something about the budget, 

I know less and less about what the budget would be.

So, if there is a rescission from the White House, you 

don't know what accounts, we have no idea what 
15

accounts it might target or anything like that. So that 

would then be a rescission, it would be a budget cut 

for '18.

Okay. I believe that concludes my news. If anyone 

has any questions, I'll try to answer them, but I've 

already told you everything I don't know about the 

budget.

(Laughter.)

Mr. Hinnefeld: Okay. I'll run very briefly through the 

statistics. These are the statistics we normally 

present. These are total cases, you can see we're 

closing in on 50,000 total cases since the start of the 

program.

And if you take out the administratively closed cases, 

which we think are done, I mean they can be 

reopened if the claimant decides to reopen them or 

reinstate it, but we think we're done with the 

administrative closed ones, and we have about 

1,200. That's been pretty constant for quite a while.

And here are the ones that were submitted. Most of 

them were submitted through dose reconstruction 

and then several, and then a couple of categories 

were pulled claims also that DOL called, asked for 

those claims back, many of those because they were 

added to the SEC after the claim was submitted and 

already sent to us.

In those 1,200-and-some-odd are active cases, this 

is also a pretty constant number, somewhere around 

200 to a little over 200 pretty much every time.

We completed a draft dose reconstruction and sent it 

to claimant for them to, you know, and then we'll talk 

to them about it and see if they have any questions, 

see if we left anything out that they think should be 

in there. So, realistically, we have about 1,000 cases 

in our inbox and that's been pretty constant for quite 

a while.
16

We still get roughly, almost 200 new claims a month 

and plus another 40 or so that are returned to us, 

usually because a person got an additional cancer 

and so the Department of Labor would turn it back to 

us for rework. So, I mean, we're still getting over 200 

a month, really, of claims we have to do.

Here's our, probability of causation for the claims we 

have sent back with dose reconstruction. Here's how 

they break out in terms of being greater than 50 

percent PoC, or less than 50 percent PoC. Usually 

that's been around 28 percent, I think it's still about 

28 percent successful claims through dose 

reconstruction.

And the AWE records request, which I always report 

on is quite good. We have very few that are over 60 

days, which is what we kind of consider the date that 

we're going to send them by. So their response has 

been very prompt.

And here's summary of proof 20,000 claims that I 

have been presenting for a while now, in terms of the 

ones that have been returned, pulled for SEC or 

pulled for other issues, in terms of the totality of the 

claims. Some of those numbers were deleted.

Of the claims that are not back at DOL, the bulk of 

them are administratively closed, meaning that the 

claimant opted out of the process and did not send 

back the OCAS-1 form and so we didn't finish, we 

didn't do a final dose reconstruction. So the claimant 

opts out sometimes after receiving a draft dose 

reconstruction.

We have 14, well we have essentially 42 claims that 

are with us. And those break out, 14 of those are with 

the Claimants, those were all DOL returns meaning 

we had done the dose reconstruction once, DOL had 

returned it to us, probably because of an additional 

cancer or because they had discovered additional 

employment. And then there are 28 dose 

reconstructions we're working on, almost all those 

are returns.
17

The one that is considered an initial is a case that was 

administratively closed for many years and then the 

Claimant passed away and new survivors picked up 

the claim and reinstated the claim. So after it had 

been administratively closed for many years the 

claim was reinstated by a new survivor.

And so, since we had never sent a final claim, a final 

dose reconstruction to DOL, that still appears in our 

system as an initial claim. But it was closed for many 

years. And then there were some of those early 

claims numbers, some early claims DOL sent us by 

mistake, and so they just deleted those claim 

numbers and called those back.

Okay, that's my presentation of the statistics. Are 

there any questions about that or anything else?

(Off-microphone comment.)

Mr. Katz: Excuse me, the questions are just for Board 

Members. Yes, at this point. There is a public 

comment session at the end of the day. And certainly 

you can speak to the officials here when they come 

down from the podium too, if you want to speak to 

them personally. Board Members on the line, any 

questions for Stu?

(No audible response.)

Mr. Katz: Okay then. I think next up is DOL and I 

think they're on by phone, as well.

Chris Crawford, are you on the line?

Mr. Crawford: Can you hear me, Ted?

Mr. Katz: Yes, but faintly. I think we need more 

volume. Hold on one sec. Okay, why don't you keep 

talking, Chris, so we can see if--

Mr. Crawford: Sure.

Mr. Katz: -- the volume's okay.
18

DOL Program Update

Mr. Crawford: I am not so far away this time. You 

should have better volume. How are we doing?

Mr. Katz: Keep speaking, Chris, please.

Mr. Crawford: All right. Stu has agreed to, as usual, 

run the slides for us, which we appreciate very much. 

And how are we doing now, Ted?

Mr. Katz: It's adequate. It's a little bit faint. It's 

borderline. I don't know, are you talking into a 

speaker phone?

Mr. Crawford: No, I'm talking into a handset. I do 

have a second handset, I'm just going to switch 

between them for a moment to see if that helps.

Mr. Katz: Sure, thanks.

Mr. Crawford: Ted, I'm now on a new handset. Does 

that help?

Mr. Katz: I think that's better. That's better. Thank 

you, Chris. Go right ahead.

Mr. Crawford: All right. Stu, we probably have the 

cover slide up at this point.

Mr. Hinnefeld: Yes, yes, I do.

Department of Labor Report

Mr. Crawford: Great, thanks. Let's go on to slide 2. 

My name is Chris Crawford, even though it shows 

Frank, from the Department of Labor.

Now slide 2, we see that Part B compensation paid is 

now at 6.4 billion. Part E compensation is at 4.3 

billion. And we've also paid four billion in medical bills 

for a total compensation and bills paid of 14.7 billion. 

And we have so far, by our records, 199,316 cases 

filed.

Next slide. These slides are always a little hard to 
19

reconcile mentally, but we see here what cases have 

been accepted or declined with a final decision and, 

in this case, accepted. We have 10,514 accepted 

dose reconstruction cases representing 1.56 billion in 

compensation. We also have 26,065 accepted SEC 

cases representing 3.9 billion in compensation.

There's a smaller group of cases accepted based on 

SEC status and also having a PoC, Probability of 

Causation, of greater than 50 percent. There's 1,021 

such cases representing 153.2 million in 

compensation. And then for total, we have all of the 

accepted SEC dose reconstruction cases and 

combined cases, 37,600 cases, representing 5.6 

billion in compensation. 

Next slide, Stu. The status and location of NIOSH 

referrals, our numbers always differ somewhat from 

those of NIOSH, but we're also looking at slightly 

different periods. We have a record of 49,777 cases 

referred to NIOSH for dose reconstruction.

Of those, 47,672 cases were returned to DOL from 

NIOSH, 41,342 of those cases had a dose 

reconstruction done, 6,330 cases were withdrawn 

from NIOSH with no dose reconstruction for various 

reasons, including SEC establishment. We show 

about 1,805 cases currently at NIOSH. Again, I think 

the dates covered are different than NIOSH's dates. 

Next slide, please. Here we have Part B cases with a 

dose reconstruction and a final decision. We have 

33,068 such cases with both of dose reconstruction 

and a final decision. The final approvals are 11,572 

and the final denials 21,496. So we're approving 

roughly 35 percent and denying 65 percent with a 

dose reconstruction.

Next slide, please. Here we have Part B cases filed in 

percentages. I'll start with NIOSH. Thirty-five percent 

of the cases have been sent to NIOSH, plus we had 

another 12 percent of SEC cases referred to NIOSH. 

Those are people who are looking, have multiple 

cancers typically and are looking for medical benefits 
20

for the non-SEC cancers.

We also have 15 percent of SEC cases that are never 

sent to NIOSH. We have a small category, RECA 

cases, nine percent. And then we have a large 

category of 29 percent other. And as the slide notes 

in smaller print, many of those cases are for 

beryllium sensitivity, chronic beryllium disease, 

chronic silicosis.

Next slide, please. Now here we have Part B cases 

with a final decision, but this includes not only dose 

reconstruction, but all final decisions for Part B, 

including SEC cases. We have 98,729 cases with a 

final decision under Part B of which 51,841 were 

approved, which would be 53 percent of the overall. 

And 46,888 were denied, or 47 percent of the overall 

cases with a final decision.

Next slide, please. Here we have the top four work 

sites for Q1 2018, that is between October '17 and 

December 31st, '17. Hanford, Savannah River Site, 

Y-12 plant, Nevada Test Site. These are our usuals.

Next slide, please. And here we have our monthly 

percentage of new cases contrasting the DOE cases 

with the AWE cases. We see that we have 94 percent 

DOE cases and six percent AWE cases. So AWE cases 

have declined somewhat over the past years, but 

their holding steady for the last two now. Well, I 

should say, last two quarters.

Next slide, please. Today there'll be a discussion 

about the Site Profile for the Weldon Spring plant. 

And for that site we have currently 1,169 cases, Part 

B and Part E, of which NIOSH has done a DR on 241 

cases.

We've had 569 final decisions, this is marked Part B, 

with 196 approvals for Part B, and then for Part E, we 

have 160 approvals. The total compensation and 

medical bills paid come to $45.7 million through 

March 18th.
21

Next slide, please. The program does outreach 

events, which are basically events that take place, for 

the most part, near work sites from a nuclear 

weapons program. And this is repeated information 

from slide to slide so I'll go through this a little bit 

more quickly. The medical benefits program is going 

full swing and we've been hiring new personnel, I 

know.

And then we have the -- next slide, please -- the Joint 

Outreach Task Group with the Members as you see 

form the DOL program, DEEOIC, also from 

Department of Energy, also the DOE Former Worker 

Metal Screening Program, NIOSH, the Ombudsman 

to NIOSH for the EEOICPA program, Part B, that's 

Denise Brock. And also DOL's Office of The 

Ombudsman for EEOICPA and Malcolm Nelson. We 

have monthly conference calls and conduct town hall 

meetings.

Now looking back on the last quarter, we have -- for 

the next slide, Stu -- we have the most recent 

outreach events. The last one was March 20th and 

21st at Bridgeton, Missouri with 30 in attendance and 

four claims taken. It was a quarterly medical 

conference call on February 6th and 7th with 98 in 

attendance.

We had a workshop at Jacksonville, Florida, it was for 

authorized representatives. That was December 6th 

and 7th of 2017, with 21 attending. Before that, we 

had a Santa Fe, New Mexico joint outreach and TRC, 

I have to look that one up myself, in Santa Fe, New 

Mexico, November 15th with 80 attending and five 

claims taken at the outreach event.

Before that, actually in the last quarter of '17, but I 

don't think we have time to include it in our last slide 

presentation, we had a quarterly medical call on 

September 20th with 26 in attendance. And then on 

September 19th, I guess that was a continued 

quarterly medical conference call, with 24 in 

attendance.
22

Next slide, please. The next scheduled outreach 

event is April 17th, a Town Hall meeting at Ames, 

Iowa.

Next slide, please. And the next such event is an 

authorized representative workshop at Kennewick, 

Washington, on May 15th and 16th this year.

Now, I have no information beyond that. We've had 

some budgetary close calls and uncertainty so that 

may be part of the reason for that. I'm sure there will 

be more outreach meetings as we go along. Are there 

any further questions?

(No audible response.)

Mr. Katz: I don't see any questions in the room. Any 

questions for Board Members on the line?

Member Field: No questions.

Mr. Katz: Okay then. Thank you very much, Chris, 

we appreciate it.

Mr. Crawford: Thanks, Ted.

Mr. Katz: And next up we have Greg Lewis from the 

Department of Energy. Welcome, Greg.

Department of Energy Report

Mr. Lewis: Oh, okay. You're making me multi-task. 

Hopefully, I can handle this. Good morning, 

everyone. I'm Greg Lewis with the Department of 

Energy, Office of Worker Screening and 

Compensation Support. I'm going to be giving you 

the program update for DOE.

First, I want to thank the Board for going on the tour 

yesterday. We at DOE always like it when you folks 

do take a tour of the DOE site. We know that, you 

know, you do a lot of research into these sites and 

seeing it live, seeing it firsthand, is helpful to do your 

work. And we know the workers appreciate it when 

you are on site and able see some of what they see 
23

every day.

(Pause)

Mr. Katz: There we go.

Mr. Lewis: I've been known to do that, hit too many 

buttons, got a little frantic there. Let's see. All right, 

so I'm going to go through our program update. Our 

core mandate is to work on behalf of the claimants to 

ensure that all available worker and facility records 

get to DOL, NIOSH and the Advisory Board.

We basically do three things at DOE. We respond to 

individual claims, so if someone files a claim in DOL, 

refers it over to NIOSH. They're going to both send a 

request to DOE for that individual's records.

We also work with both DOL and NIOSH to provide 

large scale site characterization-type records such as 

Special Exposure Cohort research projects. And then 

we also work with both agencies to do research into 

facility coverage. That's mostly for the smaller AWE 

sites, you know, when we find new information that 

indicate that either years should be added or taken 

away from the coverage.

For the individual records request, we do about 

18,000 a year split between the different types of 

requests. So employment verifications, the NIOSH 

radiological information, and then what we call a 

DAR, the Department of Labor's request for all 

worker records. So, it's medical, industrial hygiene 

and HR, that kind of thing.

Workers, particularly in the Oak Ridge area, of 

course, but all over the complex, workers often 

worked at multiple sites or for different contractors 

or in different jobs. They might have moved around 

or moved up or moved into different job categories.

When we're pulling individual records, we don't go to 

one location. It's not like we go to one file cabinet 

and pull and individual's file and that's it. We have to 
24

go to multiple departments on site, multiple sites, we 

have to go to site archives.

The records can be in different formats, so it can be 

paper records, electronic database records, 

microfilm, microfiche, punch cards, you know, we can 

get into all sorts of different media over the years. So 

we do have to go to a number of different locations, 

typically for a worker's record. And we find all of 

those, get them all into one unified format and scan 

and then send back to the requested agency, be it 

DOL or NIOSH.

I'll do a little bit of statistics from last year, so these 

are FY17 numbers, so October of '16 though 

September of '17. So these are slightly out of date, 

but, you know, we won't have the new numbers for 

another six months or so for FY18, so these are FY17 

numbers. We responded to 18,522 records request 

for over 25 different DOE sites.

We just updated this for FY17 so the last presentation 

I did for the last Board Meeting I think I had our FY16 

numbers up for these statistics.

And if you were to go back and look, these numbers 

all changed slightly, but I think it was maybe between 

five or, at most, ten pages for each of these.

So we're essentially pretty consistent in what we've 

been providing this year versus last year in terms of 

numbers. The average number of pages for 

employment verification was 21. The average 

number of pages for a NIOSH request is 46. The 

average number of pages for a DAR is 158. And then 

the overall average number of pages is 225.

That's a bit misleading because typically the DAR is 

also going to have much of what is in the NIOSH 

request and the DAR may also have much of what's 

in the employment verification because the 

employment verification is HR records. The NIOSH 

request is, you know, radiation control records, 

dosimetry, that kind of thing. And those are also 
25

included in the DAR.

So that 225 is probably a little bit misleading. The 

average total number of unique pages is going to be 

somewhere between 158 and 225 and it may, you 

know, be closer to the 158 end. But our statistic just 

counts the number of pages that are provided in the 

three different kinds.

So in terms of our under 60 day numbers in FY 2017, 

we had an 87 percent on time response rate. That 

was actually a little bit lower than in previous years. 

We've been up around 95 percent for most of the, 

you know, the five or so years before that.

Last year we struggled a little bit due to budgetary 

concerns with the continuing resolution, gave us a 

little bit of trouble but, you know, we've run into that 

every year.

But then when the continuing resolution ended, if I 

remember correctly, somewhere around May or June, 

they were different than in previous years, our 

money came out in one month increments. So it was 

kind of go, stop, go, stop.

And with our operation because we're responding to 

18,000, you know, these records requests are 

coming in every week from DOL and NIOSH, it's a 

little bit like an assembly line and when we have to 

start up and shut down, and start up and shut down, 

it really gives us fits. So we did have a little bit more 

trouble this year and our number did drop to about 

87 percent instead 95.

Through the first six months or so of FY18, we're back 

up around that 95 percent response rate. And as you 

saw from Stu's numbers, we're doing fairly well right 

now, we believe. So we'll see what the '18 numbers 

end up being, but we believe they're going to be 

much better than '17.

Then our second responsibility under EEOICPA, as I 

outlined earlier, is the large scale records projects. 
26

So the Department of Labor Site Exposure Matrix or 

the NIOSH Special Exposure Cohort projects, you 

know, both agencies have to do a quite a bit of

research to pull all that information together.

We support that, we work with the different sites to 

identify the records they need, pull the records, let 

the research teams come in, look at what they need, 

identify what they want copies of and then do 

whatever type of review we need to release it to 

them, whether that's classification or review for 

public release or any kind of markings we need to do 

on the documents.

And here's a list of some of the sites that we're 

working on now, some are more active than others. 

And then I mentioned document reviews. So, you 

know, because of the nature of the information that 

they're looking at, sometimes we do have to review 

some of that for classification or official use only or 

PII, the different types of classification.

So at headquarters, and I'll specify this is 

Headquarters only, all NIOSH Final Reports come to 

Headquarters for review before getting posted online 

and distributed to the public. The average turnaround 

time for those documents, about eight working days. 

In some cases, we've done a day or two when 

needed.

And I will say that that's for those reports, when 

they're pulling large number of documents sites 

during the research projects. It could be hundreds of 

documents or, you know, documents that are 

thousands of pages long or hundreds of pages long. 

That can take longer.

We work with the requesting agency to come up with 

a reasonable timeframe based on their needs and our 

staffing and our ability. So that's always a challenge, 

but we work very hard to try to make sure we're not 

holding up their work.

And then the third thing that we do, as I outlined 
27

earlier, is facility research. We host a database for 

over 300 facilities covered under EEOICPA.

We get requests from folks, you know, fairly routinely 

to look into these sites and see if our designation is 

incorrect or needs to be adjusted in any way. And we 

try to do the best we can to find documents.

With some of those AWEs it can be a challenge 

because they operated during the '40s, '50s and '60s, 

but we try to find the best information that we can 

and make the right decision.

Outreach, both Chris and Stu mentioned that. We 

continue to participate in the JOTG, Joint Outreach 

Task Group, events. We participated in the first 

authorized representative workshop in Jacksonville 

and will be doing the same at the meeting in 

Richland, Washington, in May.

And then the other program that my office funds and 

supports is the Former Worker Medical Screening 

Program. And I always make mention, for those of 

you in the audience that may be a former worker or 

know former workers in the area or out of the area, 

the Former Worker Medical Screening Program 

provides free medical screens. We make sure that we 

can find a place that's close to your residence, you 

don't have to travel too far.

The principal investigators for these programs are 

trained Occupational Medical Physicians who are very 

familiar with DOE work and hazards that you may 

have encountered at a DOE site. So, they're going to 

have a little bit more knowledge, a little bit different 

knowledge than your typical personal physician. So I 

would encourage you to look into that program.

And if you or someone you know might be eligible for 

a screening, please, you know, you can find more 

information on it here on our website and there's also 

a brochure.

If you're in the audience, you can always talk to me 
28

later in the day. And this information will be posted 

on the Board's website, you can also find it on the 

DOE website. So with that, are there any questions?

(Off-microphone comment.)

Mr. Katz: The questions are just for Board Members.

(Off-microphone comment.)

Mr. Katz: The questions are just for Board Members. 

Any questions on the line? For people in the audience, 

if you have questions of Greg, you can ask him after 

he comes down.

(Simultaneous speaking.)

Mr. Lewis: Yes. I'll be here all day and I'll be happy 

to talk to you about whatever questions you may 

have.

Mr. Katz: Oh, there's -- David? Dave.

Member Kotelchuck: On your Slide 7, Greg, I 

wondered if the last number, overall average number 

of pages, needs either an explanation. I'm not sure 

it's terribly meaningful, it's just the sum of the other 

three categories it appears.

Mr. Lewis: Right.

Member Kotelchuck: And I do think that it needs 

some clarification or perhaps deletion, I'm not sure it 

adds much. You might check it out.

Mr. Lewis: Well, I mean, I kind of explain, you know, 

you're absolutely right. It is a sum of the three 

previous categories. So in total, that is the number 

of pages that we provide.

It's an accurate number, that is the number of pages 

that we provide, in total, on average. But because it 

can be somewhat duplicative, we don't really know 

exactly how many pages are duplicated on any given, 

for any given claimant. 
29

So again, the total number of unique pages provided 

is somewhere between 158 and 225, we don't know 

exactly where that is. And I think that's a little bit 

tough to explain on the chart.

Member Kotelchuck: But, if I may, I mean, it seems 

like the overall average number of pages would be 

the number of pages for a request that involves 

employment verification, NIOSH requests and DAR, 

which you may or may not get. Is my understanding 

correct?

Mr. Lewis: Oh, you saying because I'm adding 

averages?

Member Kotelchuck: Yes. Normally you get a request 

for an employment verification, you may get one.

Mr. Lewis: Oh, no. I would say for the vast -- for a 

large percentage of individuals, we get all three. We 

typically, we almost always get, I mean, probably 90, 

I don't want to say 90, 95 plus percentage of the time 

at least we will get an employment verification and 

DAR. We almost always get both of those. 

And, in fact, I think the only reason the Department 

of Labor asks for them separately is because they 

know we can return the employment verification, 

because it's a smaller request, faster than the DAR. 

So then they can at least have some idea of the 

employment before they go forward.

And then, you know, NIOSH would probably, 

between NIOSH and DOL they would be able to tell 

you what percentage get referred to NIOSH for dose 

reconstruction. But it's a fairly significant percentage.

Member Kotelchuck: Well, that clarifies it. So you 

usually get all three, and you might get all three and 

you might get --

Mr. Lewis: Two to three, for sure.

Member Kotelchuck: Yes. You might indicate that 
30

overall average for the three or whatever.

Mr. Lewis: Yes, yes. I'll look at, I could probably 

describe that a little bit better. Yes, I agree.

Member Kotelchuck: Thanks.

Mr. Katz: Okay. If we don't have any questions from 

Board Members on the line, then I think that takes 

care of it. And, Greg, thank you very much.

Member Field: Ted, this is Bill, I've having a hard time 

hearing speakers and the Board Members when they 

ask questions.

Mr. Katz: I think it's, Dave wasn’t speaking right into 

his mike. I think that's the trouble.

Member Field: That was it?

Mr. Katz: Yes, but thank you Bill. Just a reminder to 

all Board Members, you have to speak right into your 

mic if you want the public on the phone to be able to 

hear you, as well as your fellow Board Members.

Member Kotelchuck: I did hold my finger down the 

whole time.

Mr. Katz: No, I saw your finger was down, but you 

were facing this way which is a problem.

It's difficult, I know. That's why you have to hold the 

button down. It's intended to encourage you to get 

close to the mic.

So our next session is on Weldon Spring and, as I 

noted earlier in the meeting, I'm going to ask Dr. 

Ziemer to serve as parliamentarian for this session 

because this is a session for which we'll have a Board 

vote.

Before we go there, we have to determine who is 

actually presenting. Dr. Lemen, are you still on the 

line?
31

Member Lemen: I am.

Mr. Katz: Super. Okay. So, Dr. Lemen will present. 

Dr. Lemon, Stu will handle the slides and, let's see, 

he has them up. So we're ready when you are and 

you sound very clear, Dick, so go right ahead.

Weldon Spring Site Profile Review

Member Lemen: Okay. To start out, the Working 

Group met in February and, as you see, the Working 

Group is myself, Bill Field, and Paul Ziemer.

At the Weldon Springs plant is a 220 acre site near 

St. Louis. It processed a uranium compounds 

between '57 and '66. And the plant was in standby 

between '67 and '85.

And as you see a remediation period between 1985 

and 2002 was set up to remove all radioactive 

materials and components from off-site disposal. 

They were buried and entombed in low-level waste 

on site with concrete and rock cover. Presently, a wild 

life preserve is being monitored. 

Some of the highlights of the Weldon Spring Site 

Profile activity include the Site Profile, ORAUT-1, 2, 

3, 4 and 5, which was issued in 2005. SC&A, excuse 

me, initially had a Site Profile Review issued in 

February of 2010. And, again, there were 28 findings 

and nine observations.

I don't know if you're having trouble hearing me, but 

I get a lot of feedback.

Mr. Katz: No, you're very clear, Dick.

Member Lemen: Okay. I'll go on, but I still get a lot 

of feedback anyhow. Eight Working Group meetings 

were held between 2010 and 2012. And there were 

many revisions to the Site Profile documents through 

September of 2017. At the Advisory Board Meeting 

on the 22nd of 2017, we discussed the Weldon Spring 

site, and SC&A was assigned to the task to review 
32

the current TBDs.

Let's go through the findings. We'll start with one

through three. Finding 1, lack of personnel 

contamination and egress monitoring. This will be 

addressed on an individual basis using the DCAS-TIB13, and this was closed by the Working Group on May 

the 9th in 2011.

Finding 2, inadequate information concerning 

worker's status and exposures for 1967 through 

1984. And this will be addressed on an individual 

basis. To date, no such cases have arisen. The 

Working Group closed this on May the 9th, 2011.

Finding 3, individual exposures versus average 

exposures. Concerns of enriched uranium, recycled 

uranium, et cetera, were addressed in other findings 

and resolved and they were closed out by the 

Working Group on February 1st, 2018.

Finding 4, recycled uranium not adequately 

recognized in the TBDs. TBDs revised to include the 

recycled uranium and associated radionuclides and 

correct dates of usage. And this was closed out by 

the Working Group in our February meeting this year.

Finding 5, accident/incidents documentation not 

sufficiently addressed. This was discussed and 

clarified in September 13th of 2011. And the Working 

Group, on meeting on February the 1st, closed this 

finding out.

Let's see. Finding 6, inconsistence and frequency of 

X-ray exams.

Finding 7, photofluorography exams not adequately 

addressed.

And Finding 8, the lumbar spine exams not 

addressed. I think Ron Buchanan will have more to 

say about these if there are any questions.

Finding 9, the use of the ICRP-34 instead of ICRP-74. 
33

And resolution of these findings, all four of these 

findings, were resolved by use of ORAUT-OTIB-6 and 

also, 79.

Appropriate revisions were made to TBD-3 the 1st of 

January, Revision 1 on January 30th, 2014. And all 

these Findings, 6 thorough 9, were closed out in our 

February 1st, 2018 meeting.

Finding 14, stated uranium, beryllium, radium, led 

ratio, --

Member Lemen: Dick, Dick, you missed, you skipped 

a slide. You should be on Finding 10.

Member Lemen: I did?

Mr. Katz: Yes, you should be on Finding 10.

Member Lemen: It's kind of hard to do it remotely 

from here, but I'll try.

Finding 10, lack of atmospheric monitoring data for 

operational period.

Finding 11 was insufficient data for unmonitored 

worker's internal environmental dose.

Finding 12, lack of validation from maximum 

environmental dose.

And Finding 13, the TBD lacks sufficient effluent data 

prior to 1967. The resolution for these Findings 10 

through 13 were that all four of these findings were 

resolved by revisions in TBD-4, Revision 01 of May 

17, 2013, which added data for assigning 

environmental intakes with accompanying text for 

those reconstruction. All four findings were closed by 

our Working Group on February 1st of this year.

Finding 14 stated uranium, thorium, radium led ratio 

should be used with caution. And as you see, after 

we looked at the revisions of the TBD, we closed this 

finding out on February 1st, 2018.
34

The next Finding, February Finding of the 15, natural 

thorium-232 not always negligible. And we, as you 

see after looking at the revised TBDs, we closed this 

out on February the 1st in our meeting this year.

Finding 16, the use of external environmental dose 

from protracted Fernald estimated data. Again, 

looking at TBD-4, we used the Weldon Spring data 

instead of the Fernald data to resolve this issue and 

we closed it out in February of this year.

Finding 17, the episodic release. This issue was 

discussed in the September 13th, 2011, Working 

Group meeting. NIOSH then provided information 

and clarification to resolve this issue, which enabled 

us to close it out on February the 1st, 2018.

Finding 18, incomplete access of uranium decay 

products using TBD-5, which provided data to resolve 

this issue. We were able to close this out in our 

February Working Group meeting.

Finding 19, incomplete assessment of radon 

exposure. NIOSH changed to end or model with no 

ventilation with maximum process model intake. This 

was discussed in 2012 by the Working Group and the 

equilibrium factor of the 0.5 was a concern.

Sequentially, though, NIOSH increased it to a factor 

of 0.7 in order to be conservative. And, thus, the 

Working Group closed this out in February at our 

meeting this year.

Finding 20, different solubility classes listed for the 

same element. NIOSH stated that the most claimant 

favorable solution, solubility type, would be used. 

This was discussed in our Working Group meeting on 

January 25th of 2011 and was revised text in the 

TBD-5 on May the 21st, 2013.

Finding 21, missed data and coworker data not 

adequately addressed. The issue was discussed, 

resolved and closed at the May 9th, 2011, Working 

Group meeting.
35

Finding 22, the cost center codes may not be reliable 

for dose reconstruction. NIOSH stated at the January 

25th, 2011, Working Group meeting that the cost 

center code would not be used for dose 

reconstruction. This issue was resolved and closed in 

January of 2011 at our Working Group meeting.

And Finding 23, negative in-vivo results do not 

necessarily indicate lack of thorium uptake. NIOSH 

stated at the January 25th, 2011, Working Group 

meeting that these results would not be used for dose 

reconstruction. This issued was resolved and closed 

at the January, 2011, Working Group meeting.

Finding 24, enriched uranium, let's see, enriched 

uranium not sufficiently addressed. The use of the 

one percent enriched uranium has since been 

documented in the SRDB and TBD-5, and it uses the 

enriched uranium of one percent.

Therefore, the issue has been resolved. NIOSH 

recently increased the concentration from .783 to 

.973 picocuries per microgram. Therefore, a PER is in 

process. The Working Group closed this out in 

February of 2018.

Finding 25, shallow and extremity doses not 

sufficiently characterized. The revised TBD-6 of 

February 2013 added Section 6.3.11, which 

discusses geometric factors and references. And as a 

result, we were able to close this out on 2000, in 

February of this year.

Finding 26, the badging policy was not consistent. 

This issue was addressed and detailed on Page 17 of 

NIOSH's November the 9th, 2011 replied to the 

Weldon Spring Site Profile SEC issues and followed 

by revised text in the TBD-6 of February 6, 2013. The 

Working Group was able to close this out in our 

February meeting.

Finding 27, lack of sufficient coworker data developed 

for external dose. With TBD-6 of February 6, 2013, 

and later revised Table 6 and 7 and added Table 6 
36

and 8 to resolve the issue. And the Working Group 

closed this out in February of 2018.

Finding 28, the lack of documentation and detail for 

neutron doses. This was issued on September 13th, 

2007 to the Working Group and the SC&A evaluated 

results and other DOE sites, N/P values and found 

that the .1 was reasonable. Therefore, our Working 

Group closed this out in February of this year.

Any questions on the findings at this point?

(No audible response.)

Member Ziemer: And, Dick, we'll have opportunity 

after you finish the whole section here for additional 

questions and maybe hear from Ron Buchanan. But 

why don't you proceed with the observations and 

we'll complete this.

Member Lemen: Observation 1, lack of coverage of 

off-site activities. Resolution, exposures occurring 

off-site are not covered. So, as a result, we were able 

to resolve this in our February meeting this year.

Observation 2, TBD-3, Equation 3-1. Symbols and 

equation may be incorrect. Resolution, NIOSH 

removed Equation 3-1 from Revision 01 in January of 

2013 enabling the Working Group to resolve this 

issue.

Observation 3, application of environmental doses. 

Clarity needed with wording of when to assign 

environmental dose. The resolution was that TBD-4 

of May 2013 provides correct wording. So this was 

able to resolve this Observation 3 by the Working 

Group in February.

Observation 4, special uranium curie. The SC&A had 

questions concerning the equation. As a Resolution, 

SC&A analyzed this issue in view of the different TBDs 

and the associated wording and agrees with NIOSH 

and finds the observation resolved allowing the 

Working Group to resolve this issue.
37

Observation 5, corrections to text of TBD-4. Unit and 

working typos and the resolution to this was TBD-4 

of May 2013 corrected the typos allowing the 

Working Group to resolve this.

Observation 6, years of thorium use. TBD-5 needed 

clarification for years of use of thorium. And 

resolution to this was that details of thorium 

exposure had been addressed in other resolved 

Weldon Spring Site Profile findings. And the Working 

Group was able to resolve this then in our February 

meeting.

Observation 7 had three points and this changes in 

the text for TBD-5. First, the second paragraph on 

Page 10 seems out of place. Our resolution does not 

affect dose reconstruction. Therefore, we were able 

to resolve it.

Point 2, incorrect reference on Page 12. The 

resolution was corrected text in TBD-5 of May 2013 

enabled us to resolve this issue. And thirdly, there 

appears to be an incorrect statement concerning the 

MAC hour on Page 36 of TBD-5. The resolution was 

different method used in TBD-5 of May of 2013, 

therefore, no longer applicable. So, we were able to 

resolve this in 2018.

Observation 8 changes in the text of TBD-6 at two 

points. Table 6-6 contains incorrect symbol for 

gamma. Resolved. TBD-6 in the February 2013 

corrected this issue therefore allowing us to resolve 

this in our last meeting.

Point 2, Table 6-6 is not clear when referring to 

associated figures. Our resolution was this does not 

affect the dose reconstruction so we were able to 

resolve this issue.

Observation 9, missing data in the TBD-6. Two 

points, Table 6-2 contains some blanks were 

historical recorded dose practices. Our resolution, the 

dose does not affect the dose reconstruction so, 

therefore, we resolved this in our February meeting.
38

Point 2, Table 6-16, the data dose does not provide 

information for all years it concerns. Our resolution, 

missing data used LLD values will be used for the 

dose reconstruction. This does not affect dose 

reconstruction, therefore, we resolved this issue at 

our last meeting.

In summary, all 28 findings have been addressed, 

resolved and closed by the Working Group in our 

February the 1st meeting this year. The BRS Findings 

for Weldon Spring have been updated.

All nine observations have been addressed and 

resolved by our Working Group, again, in our 

February meeting. The BRS Observations for Weldon 

Spring have been updated.

So with that, I will turn it over, I guess, back to you 

Paul since you're the acting monitor or do you want 

to go directly to Ron Buchanan to have his 

presentation?

Member Ziemer: Well before we have Ron talk to us, 

let's see if there's any immediate questions right 

here. I think Josie has one, so let's go ahead. Josie.

Member Beach: I was just curious if the Work Group 

did any dose reconstruction, sample dose 

reconstructions on this?

Member Lemen: The answer to that, I think I no.

Mr. Katz: We do that with SECs. Right? This is a Site 

Profile review. Right?

Member Ziemer: So --

Member Lemen: Did you hear my answer?

Member Ziemer: Yes, Dr. Lemen has basically 

summarized eight years of Work Group work in 30 

minutes. And I know in 30 minutes you don't have a 

feel for the excitement that this Work Group has felt 

for eight years, but it really is there.
39

And a lot of that is a result of Ron Buchanan and 

SC&A which had a lot of Findings here to start with 

and they've been resolved. And you see that some of 

those resolutions go back and they're just now being 

reported.

Ron, do you have additional things to add at this 

moment? Well, let me point out before you say 

anything, Ron, Board Members, you all have 

available and this information is also on the website 

and I think a lot of it's in the back.

The current revisions of the Weldon Spring Site 

Profile, which includes all of the sections, the site 

description, occupational medical doses, 

environmental does, internal doses, external doses. 

Board Members have all of that back-up material.

We also have the findings matrix and the 

observations matrix. We have two matrices that 

explain actually in more detail the resolution of these 

findings and the matrices.

Dr. Lemen summarized them in a couple sentences, 

but more detail and, hopefully, Board Members, 

you've had a chance to look at that because I think 

where were going today is to indicate whether we 

agree that all the findings or observations have been 

closed appropriately.

So, let's see if there's additional questions, but, Ron, 

how about comments first? Ron, are you on the line?

Dr. Buchanan: Yes. This is Ron Buchanan, SC&A. Can 

you hear me okay?

Member Ziemer: Yes. Speak close to your phone.

Dr. Buchanan: Okay, can you hear me?

Member Ziemer: So you're as loud as you -- use your 

outdoor voice, as it were.

Dr. Buchanan: Yes, can you hear me okay?
40

Member Lemen: Yes.

Member Ziemer: You're good.

Dr. Buchanan: Okay. Yes, this is Ron Buchanan with 

SC&A and we've been working on the Weldon Spring 

Site for eight to ten years now. So some of this goes 

way back. Some of it goes back before some of the 

OTIBs and such were out and before any of the 

revisions were out to the Site Profile.

And we have made several visits to the site and we've 

interviewed the workers and we've worked with 

NIOSH. And working on this site, the resolutions, one 

thing that changed was that it got its material from 

Fernald. So when Fernald changed, well then this site 

changed.

So, it's been a work in progress for the last eight 

years or so. And so some of these things have been 

ironed out by other venues and some of them we've 

worked out at the site itself.

And so I feel that the Work Group, and I would like 

to thank them for their work and NIOSH's input into 

it and working with SC&A and three of us I think came 

to satisfactory resolution on these concerns.

And I think that Dr. Lemen did a good job of 

presenting it today. And I don't have any further 

comments, but I would like to thank the groups 

involved and feel that they have any questions and 

such have been resolved.

Member Lemen: I would just like to say thank you, 

Ron, for all the work you've done on this. It has been 

extremely beneficial to resolving these issues and we 

appreciate SC&A as a constant help when we have 

issues to help us deal with them.

And I would apologize for going through this so fast, 

but there's a lot of data and, as Ted said, we have 

provided other information that you can go back and 

look at. But as far as the Board or the Working Group 
41

is concerned, I think we feel that we resolved all the 

issues and are ready to put this to rest at this time.

Member Ziemer: So let me now ask if there are 

additional questions on any of the Findings or 

questions for clarification?

(No audible response.)

Member Ziemer: If there are not, although the Work 

Group didn't specifically present a motion, I think a 

motion would be in order for the Board to accept the, 

basically the, I'm going to call it recommendations of 

the Work Group, to close all of the issues and 

observations and findings.

Member Munn: Second, if necessary.

Member Ziemer: Wanda has made such a motion, is 

there a second?

(No audible response.)

Member Ziemer: Dave has made a second.

Member Anderson: I'll second it.

Member Ziemer: Okay, Dr. Lemen wishes to second 

it. Oh, that was Dr. Anderson. Okay.

Member Lemen: That was Dr. Anderson. I know we 

look alike and talk alike, but he made the second.

Member Ziemer: I should have recognized that. So, 

we have the motion before us. It would be 

appropriate to ask if there's any additional questions 

or comments, discussion on the motion to approve?

(No audible response.)

Member Ziemer: There appear to be none. We can 

do this by voice votes since it's not a 

recommendation on a site, on an SEC. All in favor of 

this motion will say aye.

(Chorus of ayes.)
42

Member Ziemer: Any opposed.

(No audible response.)

Member Ziemer: Abstentions?

(No audible response.)

Member Ziemer: So ordered. We turn it back to you, 

Mr. Federal Official.

Mr. Katz: So thank you, Paul. Is this mic working? 

Okay.

Member Lemen: We hear you.

Mr. Katz: Okay, great, thanks. It's 10:30 now and so 

the next session is on procedure reviews, which Paul 

will also serve as parliamentarian for. But we have a 

break in between and I think we probably will need 

some extra time for the procedure reviews.

So why don't we just take a break now instead of 

waiting until 11. And if you could all be back, so 15 

minutes, if you could all be back at 10:45 and we'll 

start the next session and that extra time will 

probably come in handy, 10:50.

Member Lemen: Ted?

Mr. Katz: Yes.

Member Lemen: You know that I have to leave at this 

time so I won't be there either.

Mr. Katz: That's fine. Thank you. Thank you very 

much for being able to make this session. So 10:50, 

let's say 10:50, I've been corrected.

Member Lemen: Thank you all. Bye, bye.

(Whereupon, the above-entitled matter went off the 

record at 10:34 a.m. and resumed at 10:54 a.m.)

Mr. Katz: Okay, well, I don't think we have Dr. 

Anderson yet, but I think we can get going. We still 
43

have our quorum.

And let me just note the agenda shows three 

procedures that the Board will be reviewing, sort of 

similar to the Weldon Springs, and Dr. Ziemer will be

doing the parliamentarian role for this. 

But before we get to that, at the last Board meeting 

in December, we dealt with another procedure, and 

Dr. Neton from NIOSH will address that. 

We had some questions from Dr. Richardson, I think 

primarily, during that session in December, and Dr. 

Neton followed up on those matters. So we want to 

bring that to you first, before we get into the new 

procedures. Thanks.

Dr. Neton: Here we go. All right, thanks, Ted.

As Ted mentioned, at the last Board meeting, there 

was a -- Wanda presented this presentation on OTIB20. The Procedures Work Group or Subcommittee 

undertook their review of that procedure a long time 

ago, like it was 2007. I mean that was when this all 

sort of came down. And the procedure is the use of 

coworker dosimetry data for external dose 

assignment. And I was asked by the Board to address 

a couple questions that came up by David 

Richardson, and these specifically related to closure 

of Findings 4 -- or no, Finding 5 and Finding 6.

Just a little bit about the review. Way back when in 

2007, SC&A reviews didn't contain findings, per se. 

They had narratives to discuss the issues, but there 

was no sort of dialogue that rolled up into a finding 

that you can point to. 

So to accommodate the way we currently do 

business, SC&A went back and extracted, they 

gleaned from those narratives what appeared to be 

findings, statements that you could identify as a 

finding. But in doing that, you sort of lose the context 

because there's not like a roll-up going to the finding.
44

With that as a prelude, I'll just go over these two 

findings. One, Finding 5 is SC&A considers the 50th 

percentile constant as one that was -- scientific basis 

and not claimant favorable. And 6, although it's a 

different finding, actually when I researched it, 

there's a 50-page transcript just on these two 

findings. They discuss this issue at depth back in --

when they reviewed this, way back when. And the 

second finding is there are multiple elements 

describing the guidance and use of the TIB that 

require dose reconstructors to make subjective 

decisions.

In reality, that all kind of boiled down to the same 

issue, which is the use of the 50th or 95th percentile 

of the external dosimetry coworker model. It was felt 

that the dosimetry -- there was too much burden 

placed on the dosimetrist, the dose reconstructor, to 

determine whether a person really merited the 50th 

or 95th percentile. And in reviewing the transcript of 

the discussion, what it came down to was the 50th 

percentile is really only used for people who typically 

had administrative assignments but could have 

entered the controlled areas of the plant, were not 

actively involved in work activities as such.

And so in the discussion, it came out that the -- what 

the dose reconstructor would look at would be the job 

title, the CATI, if there was any information on what 

the person actually did at the site, and any relevant 

information that might be in the Site Profile. And 

given that, a decision could be made as to whether it 

was environmental exposure, the 50th percentile, or 

the 95th percentile would be applied to these 

workers. And it was thought that the 50th percentile 

would be a reasonable upper limit for a worker who 

casually entered -- not casually -- occasionally 

entered work areas. It would be a bounding estimate. 

If anything, it would be a plausible upper bound, I 

would say, is the way it was treated.

Together with that, it was also discussed that these 

dose reconstructions undergo multiple reviews. A 
45

decision is not made by just a single dose 

reconstructor. There is an ORAU peer review that is 

done on those as well. And then NIOSH also reviews 

every dose reconstruction that goes out.

It was also discussed was there any evidence that 

NIOSH had inappropriately applied this 50th 

percentile. And the discussion centered around well 

we do dose reconstruction reviews. Has anybody 

seen any evidence that there has been inappropriate 

assignment of the percentiles? No one could recall, 

as such, but the Procedures Subcommittee took it 

upon themselves to say well, we'll pay attention to 

that, and as the dose reconstruction reviews go on, 

we'll see if anything of merit comes of that.

I'm trying to think of what else I had gleaned from 

those transcripts. I think that's essentially it.

It was the general agreement among the Procedures 

Subcommittee that they could think of no better way 

to accommodate this, other than just to look at it 

down the line and see if it's being applied 

appropriately. And that's been done, I'm sure. This 

50th percentile has been in play for, basically, the 

duration of this program. So it's nothing new.

So that's my brief summary of what occurred there. 

I'd be happy to answer any questions, if I could.

Member Richardson: Could I ask just one question? 

The procedure that you described, as I understood it, 

was that the -- one could restate it this way. The 

operating procedure is to use the 95th percentile. 

There are exceptional situations in which a lower 

percentile is used, and that's the 50th.

Now the question is, when one diverges from the 

typical operating procedure to a lower default 

situation, that's where you would like -- if that is the 

practice, that's where that would really be flagged 

and highlighted. We're diverging from the typical to -

- because I believe you said the 95th percentile is 

what you're using, except for these cases of let's say 
46

clerical workers who only occasionally would go into.

So it would seem like that would be highlighted. The 

claimant would understand that a different than 

typical assumption is being made and here's the 

rationale why.

Dr. Neton: I'm not sure that's the way it actually 

works in practice. I think a decision is made based on 

the CATI and the job title of the claim, not -- I think 

we would be claimant favorable and default to the 

95th percentile. If there was any doubt at all, we 

certainly would do that. But I wouldn't characterize it 

as the default is the 95th percentile. 

I say we have these options. There is three options. 

There is administrative dose, which was sparingly 

used for people, administrative people who clearly 

would not have entered the controlled area and may 

have stated as such in their CATI. But once you get 

the administrative personnel who you can't really tell, 

then that would be the default to the 50th percentile.

The 95th percentile is reserved for people who 

actually do hands-on work or appear to do hands-on 

work in radiation areas on a regular basis, operators, 

trades people, those types of folks, and whose 

coworkers were --

Ms. Lin: Hard to hear.

Dr. Neton: I'm sorry. So that's the way it works in 

practice.

Member Richardson: Okay, then I didn't understand 

the description that you described. But --

Dr. Neton: Okay, maybe I --

Member Richardson: No, I see where you're going. 

You think there's three categories. I was trying to 

simplify it so somebody would understand when 

there was a divergence. And I had understood that 

the, let's say the frequency distribution of these 
47

assumptions was that there was a mass at one point 

and there were a few cases in which the other 

assumption was made.

Dr. Neton: No, I have the procedure with me, and 

that's not the way that reads. The general approach 

of applying coworker -- I'm reading from the 

procedure -- is to assign either the 50th or 95th 

percentile with the intent -- assigned doses represent 

but do not underestimate the doses that would be 

assigned had the employee been monitored.

So it's pretty clear that the option is there at the 

beginning to use the 50th or 95th.

Ms. Lin: Dr. Neton, could you speak right into the 

microphone?

Dr. Neton: Okay, yes.

You know that would of course then be based on the 

job title, CATI, and any other information.

For instance at one site I think we found out -- you 

know, there are some sites where people who had 

what may have been administrative sounding titles 

actually were more exposed than we thought, and in 

those cases, we would have used the 95th percentile.

Member Ziemer: Dave, are you okay on that? I think 

what he's saying is that it's not automatically the 

95th by default, unless you can prove otherwise. I 

think they make the selection to start with, it sounds 

like. I believe that's the case, they determine which 

it should be at the front end.

Member Lockey: I guess it wasn't clear to me. When 

do you go to 50th percentile?

Dr. Neton: For people who have job titles that appear 

to be administrative in nature but we could not 

determine that they -- and that they may have 

entered intermittently controlled areas or radiation 

areas where radioactive material was handled or, you 
48

know, processed.

Member Kotelchuck: Dave Kotelchuck. Why not do 

that? Why not make that clarification? I realize the 

procedures are written, you're clear about that. But 

for eventually explaining to the claimants, it seems 

to me that some kind of clarification of where, 

apparently, the large majority of cases are decided, 

would be helpful.

Dr. Neton: Well, that would be in the dose 

reconstruction itself. The report, is that what you're 

speaking about?

Member Kotelchuck: Uh-huh.

Dr. Neton: Yes, I'm not exactly clear what language 

is in there right now. I think we do have an 

explanation in there that the coworker model was 

used and it was the 50th percentile but I don't know 

that we go to great lengths to explain the process 

behind that decision. We could certainly look at that.

Member Kotelchuck: It seems to me that the more 

that we can explain to the claimant after decisions 

are made, the better. And I think it would be worth a 

look.

Dr. Neton: Okay, yeah.

Member Ziemer: Now we have one, two, three, four 

TBDs that -- well, actually three TBDs and an OVER 

that we're going to be looking at. This particular one, 

most of it goes back to 20 -- the actual work by the 

Work -- it's not a Work Group, it's a Subcommittee in 

this case, goes back quite a few years.

But, Wanda, are you going to have additional 

comments on this TBD-20 or is this --

Dr. Neton: No, this was just clarification of questions 

that were raised. And I don't think the Board took 

any action on these findings, closure of these 

findings.
49

Member Ziemer: No, the Board did not. The 

Subcommittee closed the findings in 2012 on this 

particular one. So there's not been official Board 

action.

The document that the Board Members have includes 

all the findings, and they were all closed way back 

then. But there was clarification asked for this 

particular one for clarity, although it had been closed, 

I believe.

But do you have any additional comments on this 

one, Wanda?

Member Munn: No, I really do not. We just felt it was 

appropriate for Dr. Neton to be giving some response 

to the concerns that Dr. Richardson expressed at the 

time. But we have, as a Subcommittee, resolved all 

of the issues involved.

Member Ziemer: So what would be appropriate at 

this time would be a motion to close OTIB-20 -- it 

technically is 0020 -- ORAUT-OTIB-0020, Rev. 3. Is 

there a motion?

Oh, wait. I'm sorry. Brad had a comment first. Sorry, 

Brad.

Member Clawson: I just wanted to speak for a minute 

because of what David is talking about and also Mr. 

Kotelchuck. As a Dose Reconstruction Work Group, 

we have looked into this closer, and we have found 

some where they did not follow the CATI information, 

which changed things a little bit.

And so we are looking at this as a more in-depth 

process but also, too, as a dose reconstructor makes 

these decisions, we're trying to get them to why, kind 

of a more informational so that when we go through 

this, we'll understand why they did this and why they 

did not. 

Plus also, it goes back to the importance of the CATI 

interview and so forth.
50

Member Ziemer: And the reviewers will have that 

information as they review it, so that they know the 

basis of that decision, which is important.

Member Clawson: Yes.

Member Ziemer: So now I will entertain a motion to 

approve this OTIB.

Member Munn: Mr. Chair, I'm prepared to move that 

we consider that now.

Member Ziemer: Wanda Munn has moved that we 

approve the closing of all the findings on this OTIB. 

Is there a second?

Member Beach: I'll second.

Member Ziemer: Okay, that was a pretty noisy 

second, but we'll accept it.

Any further comments or discussion? 

(No audible response.)

Member Ziemer: If not, those in favor say aye.

(Chorus of aye.)

Member Ziemer: Those opposed, no.

(No audible response.)

Member Ziemer: Are there any abstentions?

(No audible response.)

Member Ziemer: Okay, as they say ayes above the 

noes.

Member Anderson: Aye is yes.

Member Ziemer: Okay, Andy, we heard that aye --

Member Anderson: Okay, thank you.

Member Ziemer: -- in some form.
51

Member Anderson: I'll go back on mute here.

Member Ziemer: Okay, thank you.

The motion carries.

Now Wanda is going to proceed, and I think the 

documents are also available to all of you. Are they 

all back on the table, too?

If those seated before the Board here, if you have 

need for having personal copies of all of these, there 

are copies on the back table.

Member Kotelchuck: Excuse me, which issue -- which 

OTIB are we starting with?

Member Munn: We'll start with 17.

Member Ziemer: I think we're on OTIB-17.

Member Kotelchuck: Thank you.

Procedure Reviews: OTIB-17, OVER-9, OTIB-34

Member Munn: Yes. And I thought, while Stu is 

bringing up the material here, I am going to rely on 

him to change it for me.

I need to let you know, as my enraptured audience, 

that I am coming out of a week of rather extensive 

laryngitis, which has been a terrible problem for me. 

The folks around me don't seem to mind, but, 

nevertheless, you may -- I'm not at all sure how well 

the vocal cords are going to hold out. I'm not really 

and truly this husky, normally, but we will do the best 

we can to see what we can get through here.

As you all know, the Subcommittee for reviewing 

procedures has been active since the inception of the 

Board's activities and, among the things that we've 

done most recently that we felt were applicable to 

what we're attempting to do in Oak Ridge today 

included OTIB-17, which is the Interpretation of 

Dosimetry for Assignment of Shallow Doses.
52

As you are undoubtedly aware, many of these things 

arise as a result of activities but turn out to be 

applicable quite often across the site. So we're trying 

to tie these all together for you, the things that might 

be most pertinent to what you're going to hear the 

rest of the day.

This is guidance for assigning shallow doses to the 

skin, testes, and breast from non-penetrating 

radiation. 

We have a great deal of information on these slides, 

and I'm going to try not to just read them back to 

you because you do have them in hard copy, if you 

would like to read them. But we like to, in cases of 

this sort, particularly, have slides that portray a fairly 

consistent view and a fairly detailed view of what we 

covered, simply because if people are going to use 

this as a reference in later years, we'd like them to 

have complete information on it.

We had Revision 1 issued back in 2005 and we had 

our first report from SC&A fairly soon after that in 

June of '06. They had 15 findings that went into our 

Board Review System, and those are the ones that 

we addressed throughout our activities with this 

particular OTIB.

We all worked on resolutions for it for the next couple 

of years. We wound up with 14 findings closed and 

one in abeyance.

I'll read the findings verbatim. It is suggested that 

the dose reconstructor check whether the site was 

reporting dose due to electrons or photons and 

whether the dosimetry system had been calibrated 

for that type of radiation.

SC&A wanted the OTIB to provide additional 

guidance on how to interpret film badge data because 

the beta versus low-energy photon exposure -- there 

are several different types of doses that are 

calculated here. The shallow dose for this type of beta 

is the one that is being under analysis at this 
53

moment.

NIOSH responded to that with the indication that 

OTIB is to be used together with the Site Profile. The 

Site Profile hopefully contains a significant amount of 

material that is necessary for interpretation of what 

the dose reconstructors must do. And it is one of 

those things that can only be done on a case-by-case 

basis. You can give general guidance but when the 

rubber hits the road, we have to take into 

consideration the specific conditions of that claim.

In 2007, we found that NIOSH's response was 

acceptable, SC&A agreed, and we closed the finding.

Finding 2, the protective clothing used for each case 

was known in the majority of cases. Clothing-specific 

transmission factors should be used.

NIOSH said that there is language in the OTIB, which 

there was, that allows the dose reconstructor to 

choose which of those factors was going to be 

applicable and whether that was going to require a 

maximizing, minimizing, or realistic data of the beta 

dose that was being looked at the moment.

Both parties agreed that this was appropriate, and 

we closed the finding on October -- at our October 

2nd meeting in 2007.

Finding 3, it is SC&A's opinion that individual 

monitoring for beta particles only works on a yes/no 

basis.

That position was disagreed with by both OCAS and 

ORAU. Talked about the geometry issues that are 

discussed in the OTIB under a different exposure 

geometry heading and we discussed the dose 

reconstruction reports on a case-by-case basis 

because that's the way we have to look at them.

SC&A's main concern was the potential for deposition 

of hot particles, which as you know, is a hot topic in 

this particular venue always. On a worker's skin if it's 
54

not -- or if it's localized and an undetected beta 

exposure.

NIOSH responded that whether such exposures 

might be occurring is determined primarily on the 

frisking data for hot particles, as people come out of 

the zones where they work, and the knowledge of 

what conditions were like in that specific facility for 

that particular claimant.

SC&A recommended that Finding 3 go ahead and be 

closed because OTIB-17, although they had some 

concerns with it technically, can't be improved much 

further than it already is. The work that could be done 

was done with respect to the verbiage and the 

presentation method.

So here was SC&A's suggestion. When the cancer site 

is on the hands, lower arm, or face, consider 

workplace monitoring data. When the cancer is on 

the thorax, use individual monitoring data. When the 

cancer site is on the lower legs or feet, you must 

consider both.

We closed that finding based on the assumptions that 

we had discussed and both parties being satisfied 

with addressing this further under overarching 

issues, which is the special corner in which we place 

issues that spread across more than one or two sites 

of the complex.

Finding 4, it is possible to state definitely where the 

cancer site is but not where the contamination was.

And the discussion that we just went through in the 

preceding on pretty much covered that. We thought 

about every aspect of it that we could during the 

discussion.

Finding 5, a skin dose due to hot particle exposure 

will not be detected because of the localized nature 

of the exposure.

Of course this is very much like the previous finding, 
55

which we closed along with Finding 3.

Finding 6, if dosimetry recorded detection of -- a limit 

of detection, then this value should be used as the 

basis for the missed dose calculation.

We had a subsequent White Paper prepared by SC&A 

on this particular OTIB, and it appears that the two 

agencies agree. Here is the verbiage. If it is known 

that the film badge dosimeter overstated the dose 

from low-energy photons and if it can be further 

ascertained that the limit of detection was expressed 

in terms of this overstated dose, rather than the 

corrected dose, then we agree that it's appropriate to 

supply a correction factor to the limit of detection in 

assigning a missed dose from low-energy photons.

So with that agreement on December 11th in 2007, 

we closed the finding.

Finding 7, it is not claimant favorable to consider that 

an employee had 4 millimeters of clothing thickness.

NIOSH took the position that, depending upon the 

location of the organ of concern, the 4-millimeter 

assumption had been made for pants and 

undergarments -- not a lab coat, which is more 

directly applicable in most cases that we encounter.

That was agreeable to SC&A, reasonable, and we 

closed the finding.

Finding 8, attachment A provides a correction factor 

for the breast, penis, and testicle using a source that 

was modeled as a 12 centimeter square infinitely thin 

disc source located two centimeters away from the 

skin. For the breast area, the film dosimeter would 

give a reasonable dose estimate. If the source was 

near the testicles, the film dosimeter would not 

measure anything.

So of course, these observations stimulated a great 

deal of discussion about the other documents that we 

had that addressed these issues in one way or 
56

another. The geometry of badge placement is not 

something limited to this discussion only.

NIOSH relies on quality assurance and training to 

ensure that everything that can be possibly 

addressed and documents are correctly used when 

individual doses are being calculated.

That response was accepted and we closed the issue 

in 2007.

Tables A-1 and A-2 list correction factors for nonpenetrating doses based on radionuclide. In nearly all 

real cases, it is not possible to state the radionuclides 

that are responsible for the beta dose was Finding 9.

NIOSH pointed out that the benchmark correction 

factors for a range of beta energies. We have Site 

Profile documents which typically provide additional 

information that will help the dose reconstructor 

determine for himself or herself whether the proper 

energy range is going to be used.

In addition, this particular document, this OTIB, 

provides guidance with respect to all of the uranium 

daughter products, which is most helpful, I'm sure, 

from the dose reconstructor's point of view.

The agency and the contractor agreed in that matter, 

and we, again, closed that finding.

Finding 10, for low-energy beta, the dosimeters were 

likely incapable of furnishing accurate doses.

As was pointed out, however, that the dose 

reconstruction staff would, of course, been 

considering that information before they began. The 

purpose of the OTIB is to provide generalized 

information known by all and sundry, including, most 

certainly, the dose reconstruction folks that they use 

all the resources at their disposal.

If necessary, the hierarchy of data sources listed in 

IG-001, that is one of our basic instructional 
57

documents and PROC-0006, which is shown in a table 

in this OTIB as well, includes the use of source term 

modeling.

That was an acceptable response. We closed the 

finding.

Finding 11, it is not clear why the two tables 

providing examples of skin dose assignments on 

pages 21 and 24 give the recommendation from 30-

250 keV for missed dose to the skin and zero for an 

OW reading and zero S reading.

Determining energy ranges for radiation types, in this 

case, are chosen because it is in fact the most 

claimant-favorable over and above the potential of 

assigning it as an electron dose.

Because it was claimant-favorable and the 

differences are known, it was an acceptable 

response, and we closed the finding.

Finding 12, the logical order of the information in 

Chapter 3, General Approach, could be improved.

And I think most of us who looked at it had a 

tendency to agree that that was, in fact, the case, 

and NIOSH agreed with it. They identified the need 

to revise it in the future and they did -- will. It is in 

abeyance awaiting exactly that. When the next 

revision is issued, that will occur.

Finding 13, the OTIB does not identify any cases 

where a possible -- Probability of Causation can be 

determined early in the investigation.

There is a different procedure, PROC-0006, which we 

mentioned earlier, that needs to be used in order to 

do this kind of triage in assessing whether or not a 

claim is likely for a high Probability of Causation.

If you're going to consider the use of 17 in the overall 

context, you have to be aware that this is a very 

important decision in making it. It does give guidance 
58

on the topic of high and low PoC. That potential is 

shown on a specific page, page 6 in several items.

Once that was observed a little more closely, we 

agreed with that response, and the Subcommittee 

closed the finding.

Number 14, the OTIB is not claimant-favorable in 

instances of unknown parameters that affect dose 

estimates. Ordinarily, the dosimeter location has no 

relationship to skin dose at the point of cancer 

incidence.

This was a thing on which there was no quick and 

easy agreement. Geometry issues are discussed in 

this OTIB and in specific OTIBs talking about 

geometry placement of your badge in relationship to 

the placement of cancer.

And the OTIB does make the recommendation of a 

dose conversion factor of 1 to accommodate potential 

inaccuracies that are caused by exposure geometry. 

So it's not an unknown, and it's not a matter which 

is addressed lightly. It is a primary concern for the 

DR.

The OTIB is claimant-favorable regarding the dose 

correction factors as well as the level of detection, 

attenuation, and radiation. So that's a very careful 

consideration.

And that was certainly an agreeable response. The 

Subcommittee closed the finding.

15, the OTIB does not employ scientifically valid 

protocols for reconstruction of doses regarding (a) 

assignment of non-penetration dose; (b) assumption 

of 4-millimeter clothing thickness; and (c) treatment 

of hot particles.

There was a disagreement with that position, and we 

had considerable discussion of SC&A's concerns.

The guidance is given in order to assign the non-
59

penetrating dose as electrons or low-energy photons 

-- as you will recall, we've already taken a look at 

that -- as necessary to complete a valid dose 

reconstruction using IREP. Dose is often given as OW 

and S or shallow and deep, not as beta and gamma.

Since the organ that was being under consideration 

in this particular section of the OTIB was the penis, 

the four-millimeter assumption was made for pants 

and an undergarment, which seems fairly obvious, 

not a lab coat, but you could add that, if you choose, 

but it's highly unlikely. That type of clothing is less 

common than the pants and underpants.

Non-uniform dose can be considered by the dose 

reconstructor using guidance in not only this OTIB 

but lots of other things that are available to them, 

including VARSKIN and guidance from Site Profile 

documents that are talking about hot particle 

exposures.

We agreed and closed the finding.

It was a long and very thorough review of the 

document itself and of the potential that it had to 

address.

Any questions?

Member Ziemer: Wanda, before we go to questions, 

since overarching values came up in this one as well, 

would it be helpful to go ahead and do the 

Overarching Issues 9 and then take the questions?

Member Munn: I, personally, would think that would 

be the best process because these overarching issues 

are not small things. They are issues that need indepth consideration and for which our technical folks 

have to spend a great deal of effort zeroing in on 

exactly what the root causes of the issues are and 

how to address them.

So yes, I would prefer to do overarching issue as well.
60

Member Ziemer: Okay, so why don't you go ahead 

with that? For the Board Members, it's another 

separate document, and you can pull that up, and 

we'll do that. And Stu can pull it up there, and then 

we can include those together.

This will be Overarching Issues 9 on skin exposure.

Member Munn: And I'm going to try to avoid 

coughing by trying to speak over Louise's very nicely 

offered cough drop. So prepare your ears for what 

you are likely to hear or not hear.

The first concern with this overarching issues paper 

addresses is the concern related to NIOSH's dose 

model for chronic deposition of fine particles on bare 

skin.

The concern that was expressed by NIOSH -- I mean 

by SC&A to NIOSH involves a derived dose of 16 

millirem a year to bare skin. It seems to be based 

from their position on unsupported and unrealistic 

assumptions, which included daily skin contamination 

for each of the 250 workdays per year that only 

persist for eight hours; an implication that after an 

eight-hour shift, each skin contamination is removed 

completely by a standard daily shower; and the 

assumption that only bare skin is subject to 

contamination and the radiation exposure that is 

likely to result from that.

NIOSH talked about its approach for addressing this 

particular issue, fine particle deposition, except that 

the assumptions regarding the ease with which 

uranium could be removed from skin and clothing.

This turned out to be more of a sticky issue than we 

had assumed. It is, of course, a fairly common 

occurrence and one that was going to recur. And so 

NIOSH spent some additional research time 

attempting to assure that they had covered all the 

known bases in that regard.

The did a White Paper that assessed all of the 
61

literature for quantitatively and qualitatively 

supporting the removal of 100 percent of uranium by 

soap and water wash, which, as you probably know, 

is accepted, common, and in most cases entirely 

satisfactory process that is used widely across the 

complex.

After reviewing that paper in-depth, we both found 

that the conclusions were acceptable, and we were 

able to close that concern.

The second concern was related to how IREP derives 

Probability of Causation and its relevance to how 

dose is assigned. Specifically, this involved the 

relationship between a derived dose and how IREP 

uses it to derive a PoC, given that the skin dose only 

occurs through a very small area.

The IREP issue was not an easy one either. We 

addressed it repeatedly, over the years of 2013 and 

2014, and we had a number of teleconferences, 

several of which were almost entirely on this issue.

NIOSH provided an explanation of the relationship 

between derived dose and IREP. They identified that 

specific guidance was given for dealing with nonuniform exposure to the skin, and it's been 

incorporated in the OTIB that we just talked about.

They consulted with SENES to confirm that that 

OTIB's guidance was appropriate and adequate. And 

we found that to be a quite adequate response. We 

closed the concern.

The third concern related to NIOSH's dose model for 

large uranium flakes on the skin. The same basic 

questions that we looked at earlier but for deriving 

the dose from large uranium flakes was discussed 

again in those 2013, and 2014 and later in 2016 

teleconferences.

SC&A recommended using the OTIB that we just 

looked at, where the skin exposure under a 

hypothetical flake is averaged over the entire surface 
62

area of the body, which is about as claimant-friendly 

as you could get I believe. 

That was accepted by the Subcommittee, and we 

closed Concern 3.

Now, questions?

Member Ziemer: I have one question, Wanda, not 

specifically on the actions here, but could you remind 

us on the Board -- what's the proper name for our 

big matrix -- the Board Review System, where we 

show a finding closed, do we distinguish between 

when the Subcommittee has closed it versus the full 

Board?

Mr. Katz: No, we don't. We don't.

Member Munn: No, we do not.

Member Ziemer: That was my thought. And it seems 

to me that at some point, we need to be able to 

designate or identify which of those closed findings in 

the Board -- oh, Ted's got an answer.

Mr. Katz: No, I mean I absolutely agree. I think that's 

an oversight. I don't believe we've been doing that, 

although it is possible it was occurring but I don't 

think so.

In any event, we can follow-up after this meeting 

because there have been many other procedures, 

too, that are in the Board Review System and they 

probably end with indicating that the Subcommittee 

closed them or the Work Group, but not necessarily 

that the Board did. And I think that's a good point.

Member Ziemer: Yes, and my point was so here's a 

group of things that I thought were all done with five 

years ago and we're just now acting on them as a full 

Board. And so -- and I had in the back of my mind 

that the Board may have even authorized the 

Subcommittee to be the final closure on those, but 

it's far enough back and I'm at the age where I don't 
63

remember that far back.

Mr. Katz: Yes, actually the Subcommittee isn't in a 

position to be authorized for that.

Member Ziemer: Well, that's helpful. Then we will 

find a way to designate in the documents themselves 

that when it is closed by the Subcommittee versus 

the full Board that we --

Member Munn: We can certainly talk about that at 

our next Subcommittee meeting --

Member Ziemer: Right.

Member Munn: -- and give NIOSH that charge 

because it would be a nice thing to add.

But I do have to point out that during the period of 

time we were discussing these things, especially as 

an overarching issue, the Board, itself, had this as a 

topic on more than one occasion.

So it isn't as though the Board was not kept briefed 

on our processes. We were moving through them.

Member Ziemer: Oh, yes, that is certainly very true. 

This is not a surprise to the Board. The overarching 

issues have come up under a number of other issues 

as well.

Member Munn: Yes, indeed.

Member Ziemer: Very good.

So we can do two things here. One is to separate 

these two vote-wise, but to open the floor for a 

discussion on either of these two documents, if there 

are questions.

Dr. Kotelchuck.

Member Kotelchuck: On Concern 1 on overarching, 

NIOSH did a study to say that removal of --

supported removal of uranium by washing with soap 
64

and water. But in Item 2, it said is 100 percent 

removed by a standard daily shower. Is that -- is 

there any data to show that there is in fact a standard 

daily shower winter and summer?

Member Munn: I believe that the term daily shower 

incorporated the soap and water process.

Member Kotelchuck: No, the question is I'm not sure 

people, all people do a standard daily shower and at 

different times of year, in winter, whether people do 

that. And I assume, in large facilities, people have to 

take a shower at the end of the work day. That's 

required I'm sure in some. On the other hand, for the 

AWE facilities, I'm not sure. 

I just wondered if there is data to say that that --

there's no question that it's removed if you do the 

standard daily shower. The question is, is there a 

standard daily shower? Is there evidence for that?

It's a little awkward. It's an awkward but, on the 

other hand, I'm not at all sure that everybody does a 

standard daily shower 12 months a year.

Member Munn: I'm at a loss to identify how we could 

possibly assure from every claimant that we have 

that has worked in an exposure area, that they -- I 

would think, and this is just a personal comment, 

certainly the radiation workers that I know personally 

want to shower when they come out of a zone, 

regardless of what the weather is.

Member Kotelchuck: Well I wondered whether there 

is data on this. And it is awkward. Obviously, we'll 

never know if people take a daily shower. I mean 

what are they going to do, fill out a form?

But if there is data on -- and it may relate to different 

facilities. As I say, some facilities, obviously, folks 

take a shower. It's required, and they do. I'm not 

worried about that.

But if we're really trying to figure out what the 
65

chronic -- the effect of the chronic deposition, it 

would help in my mind if there was some supporting 

data about that.

Member Ziemer: Several years ago, NIOSH did a 

White Paper for the Subcommittee on this issue. I 

don't recall the details but maybe -- Josie, do you 

recall that?

Member Beach: Well, I don't recall that particularly, 

but I do work in a rad facility. OSHA requires showers 

to be available. They do not, however, require people 

to take showers. So it is up to the individual.

Member Ziemer: But I thought -- I don't know if Jim 

Neton is still here.

Jim, didn't we have -- we had some data which 

formed a basis for a final decision on this particular 

issue, actually.

Dr. Neton: Yes -- testing.

I reviewed the literature and specifically, we were 

talking about time periods back in the 1950s. And in 

the facilities that we looked at, showers were 

required at that time. Now, I don't know that it was 

-- we didn't investigate all facilities but this was in 

the 1950s when uranium was being rolled and that 

sort of thing. And I found three papers relevant in the 

1950s, in that era, that looked at the efficacy of 

showering and removal of the uranium. 

And I don't think you're questioning that but there 

was some interesting studies. One was they made a 

-- they took some lanthanum-140 and mixed it with 

dirt of various particle sizes and rubbed it onto the 

arms of 45 volunteer workers and then used various 

treatments to try to remove it, one of which just used 

basic soap and water and it pretty quantitatively 

removed the contamination that was rubbed on their 

forearm. So we felt pretty comfortable that that was 

true from showering. 
66

But related to your question about how do we know 

that everyone took a daily shower, we really didn't 

look at that in tremendous detail. But it was our 

experience that many of these facilities that we were

familiar with, showering was part of their activity, 

especially when you're involved in these sort of 

messy operations, rolling and that sort of thing.

Member Kotelchuck: Well I mean I do appreciate 

what you're saying but, in fact, even to say, as you 

did appropriately, that these are studies in the '50s, 

when there was a lot more activity in the radiation 

field, we're now talking about almost 70 years later.

It might be worth taking a look at -- not the efficacy 

of the soap and water. No question about that, but 

the frequency with which people, just to sample 

perhaps a few facilities and find out, what is the 

frequency with which people really do take showers.

Member Ziemer: One related question would be 

whether or not showers are required in those cases 

where they actually detect activity through the 

portals when they're checking out or whatever their 

scan methods. It's one thing to say that everybody 

should shower every day, but it's another thing to say 

do those for whom we actually know got 

contaminated shower or if it's localized, wash their 

hands or whatever it is.

Certainly in my experience, if we detected something 

on somebody's skin, you didn't tell them to go home 

and wash. You took care of it right away.

Member Kotelchuck: Yes, good point.

Member Ziemer: But nonetheless, at some point, and 

I'm not sure how you would necessarily follow up, I'm 

not sure we want a big study on how frequently DOE 

people shower, but the point is, in the record, I don't 

know whether you have hesitation on closing this 

issue, but at least it's worth discussing, perhaps.

David you have --
67

Member Richardson: Well just first to close that out, 

I think Dr. Kotelchuck's observation was that 

currently the assumption is 100 percent showering 

with 100 percent efficacy, which gets back just to the 

basic question of that.

Just a clarification also on this first point, there's a 

distinction here between bare skin and covered skin. 

Is that correct?

I mean so there's -- because the other situation in 

some industrial settings is that when you have 

contamination on your clothing, as you take that 

clothing off in the workplace, the contamination gets 

onto your skin, at which point that distinction 

between covered and uncovered becomes a little 

more murky for me. And then if you say the person, 

it's questionable whether they took a shower when 

they left, then there's actually more skin that's been 

exposed. I mean that happens in other industries, 

certainly.

Could I ask one about, to work backwards just with 

these overarching concerns? Could you help me 

understand? Concern 3 you said is the same basic 

question as described in Concern 1. 

Concern 1 is what we've just been discussing about 

the efficacy of washing. Is that what you were talking 

about with Concern 3?

Member Munn: I think I was referring to the 

difference between small and large flakes.

Member Richardson: Because I was thinking that the 

issue was more about averaging over surface area, 

which I took to be Concern 2.

Member Munn: Joan, do you have any comment?

Kathy, are you with us?

Member Ziemer: Is Kathy Behling on the phone?

Member Munn: Kathy?
68

Ms. Behling: Yes, this is Kathy Behling. I'm on the 

phone.

Member Munn: Hey, good.

Ms. Behling: You're correct. It is a combination of 

Concern 1 and Concern 2. But you are correct, 

Concern 2 does come into play for the large uranium 

flakes, also, and averaging over the entire surface. 

And that was, ultimately, addressed in OTIB-17.

Member Richardson: And that -- so could you --

because I wanted to understand, it was stated that it 

was, that this issue of how IREP is going to handle 

this was resolved, but it wasn't -- we weren't told how 

it was resolved.

What is IREP -- how is this averaging being resolved 

by IREP?

Member Ziemer: I think you're asking Kathy but --

Ms. Behling: I'm still here. I have to go into IREP and 

-- I'm sorry -- OTIB-17 to recall how they go about 

doing this. And perhaps Dr. Neton can also help me 

here.

Member Ziemer: Yes, Dr. Neton is approaching the 

mic here.

Dr. Neton: There were some fundamental questions 

about how we would address various exposures, skin 

contamination scenarios of bare skin, not on the 

clothing.

And one issue was if you have a small particle, a 

small contamination area, how does that relate to 

risk, given that the risk models for skin exposure 

were based on a uniform exposure to the whole body, 

the Hiroshima/Nagasaki survivors.

And the answer to that was that it is true that the risk 

would be smaller because you have a smaller area of 

skin exposed but at least the way SENES or now Oak 

Ridge Center for Risk Analysis explained it to us is 
69

the baseline risk would also be lower. So they sort of 

cancel out each other.

So you can use the same excess relative risk per 

sievert for a small area as a large area. And that's 

how we handle it. That's how we were doing it 

anyways.

The other issue was if the contamination was not near 

where the skin cancer occurred and we knew that, 

then we would assign no dose -- no dose to that part 

of the skin.

Member Richardson: So maybe we could just start 

with --

Dr. Neton: There is a third scenario, though, which is 

if you don't know where the contamination occurred, 

then IREP -- this is not an IREP issue. It is an input 

into IREP issue. We assign a distribution, it's a lognormal distribution that accounts for the various 

possible scenarios of how large the area could have 

been contaminated as such. And I don't recall the 

exact parameters of that log-normal distribution right 

now, but it's in TIB-17, and if Kathy has it, she could 

probably --

Ms. Behling: I'm sorry, you were breaking up. I can't 

hear everything that was being said.

Dr. Neton: Oh, I'm sorry. Well, I was talking about 

how NIOSH or how we input into IREP the situation 

where we don't know where the skin contamination 

occurred. And I think there is a log-normal 

distribution in that procedure.

Ms. Behling: Yes -- excuse me. Yes, there is. The 

smaller the area of skin that is impacted, it starts with 

a GSD then of 6 and goes up to 14 for what they 

would consider a single hot particle exposure. So it is 

a log-normal distribution with a geometric standard 

deviation between 6 and 14, based on the area of 

skin that they feel is impacted.
70

Dr. Neton: You'd have to read the procedure. I have 

not read the procedure in a while but it's described in 

there. I don't know, Kathy, if we want to go through 

and read the whole thing, but there's a description in 

there why that's a valid approach, and that was 

vetted through this review process. And I'm at a loss 

right now to explain exactly how that works.

Member Richardson: But the basic issue is that we 

could imagine skinning an adult human and laying 

out a sheet of skin and it's got some defined area. 

And we could average the dose over that entire 

sheet, or we could look at subsets of that skin.

And one part of that subset, which isn't too large, is 

the bare skin. And you can help me, but I assume 

that is the face, the neck, the hands.

Dr. Neton: Yes, this is all related to bare skin we're 

talking about here, not --

Member Richardson: Well, but the issue of when we 

get to IREP is that now we're working on a model 

which, as you said, assumes whole body exposure, 

that whole sheet. And the suggestion was we could 

average over that because the baseline probability of 

the occurrence of skin cancers is also uniform over 

the whole sheet.

But I would ask somebody with experience, do skin 

cancers occur uniformly over the body or do they 

tend also to occur on the bare skin? Do we see the 

instances of skin cancer more often on the face, the 

neck, the hands than we do some of the covered 

flesh?

Dr. Neton: Yes, I don't know the answer to that.

Member Richardson: And I mean I guess the other 

part for the claimant is we're not blind to where the 

claimant's cancer occurred. Some of those cancers 

occurred on the bare skin and some of them occurred 

elsewhere.
71

And so we don't have to start from ignorance. We 

could start from --

Dr. Neton: This procedure deals specifically with a 

known skin contamination value, whether we know 

exactly where the skin contamination was measured 

or not.

Member Richardson: I was working the other way. 

We know where the cancer occurred or not.

Dr. Neton: Well, yes, that's what I'm saying. So if we 

know where the cancer occurred, and we have a 

survey that shows that the skin was contaminated at 

that location, then this is when we would assign the 

dose.

If the skin cancer occurred on the hand and the 

contamination occurred on the neck, we would assign 

zero dose to that skin cancer.

Member Richardson: One of the scenarios for this 

calculation of what the largest bare skin dose would 

be, for example, was just assuming some daily dust 

exposure, which is washed off 100 percent at the end 

of each day, and it assigns a dose to the bare skin.

And one of the questions with the implementation of 

IREP is do we take that estimate of the bare skin dose 

and then average it over the entire sheet of human 

skin or do we use a larger dose which is not averaged 

over the sheet.

As I understood that and it's the same thing with the 

flake --

Dr. Neton: No, we assign the dose as calculated to 

that area of the skin without any modifications.

Member Richardson: So this part here about 

averaging over the entire surface area of the body is 

a red herring.

Dr. Neton: No, I think I need to go back -- maybe I'll 

report out on this again. I need to go back and review 
72

that distribution that takes this into account. It's a 

log-normal distribution, and I'm at a loss right now 

to explain it, but I can certainly get back to you on 

that.

Member Ziemer: And you would only use that 

scenario if you didn't know -- if you had a skin cancer 

but didn't know where a contamination occurred.

Dr. Neton: That's correct.

Member Ziemer: Then you would do that averaging. 

Otherwise, it's right at the cancer, has a specific dose 

--

Dr. Neton: Right.

Member Ziemer: -- or it's zero if the contamination is 

known to be elsewhere. So there's three scenarios.

Dr. Neton: Correct.

Member Richardson: No, Paul, but I was working the 

other way. We know that a skin cancer --

Member Ziemer: We know where the cancer is, yes.

Member Richardson: -- occurred on the bare skin. We 

don't know where the contamination occurred, but 

we're generating a bare skin estimate and then 

averaging it over the entire body.

And is that claimant-favorable or not is my question. 

One could estimate just the dose that went to the 

bare skin --

Dr. Neton: But I think that is one piece of this lognormal distribution. It could be either distributed 

over the whole body or it could be a little piece 

directly under the thing. And that's what is accounted 

for in this distribution.

Member Richardson: I see that, I mean, under -- but 

the question is why would we use a distribution when 

we --
73

Dr. Neton: Because we don't know. All we have is a 

value. We know there was maybe 5,000 dpm per 100 

square centimeters. Where? We have no idea. And so 

we have to have some accommodation to account for 

the unknown nature of where the contamination 

occurred. Was it over the tumor? Was it not over the 

tumor? How large an area?

Member Richardson: And again, we could imagine 

that sheet and we could partition it into smaller and 

smaller pieces. The very smallest section of that 

sheet would be the site location of the tumor. A larger 

set but not still the whole sheet would be the bare 

skin. And the largest set would be the entire body, 

the entire surface of the body.

Dr. Neton: Yes, and that's basically what this lognormal distribution accounts for.

I mean if Kathy could maybe read the paragraph or I 

could report out, I don't know that we --

Member Ziemer: Well what I'm wondering here, this 

may, particularly on the overarching document, we 

may want to postpone action on that until we can 

clarify this. We could certainly do that.

Dr. Neton: I might ask is someone from NIOSH on 

the phone or ORAU? I think Tim Taulbee may be on 

the phone and/or Matt Smith. And if they have any 

better insight into how this log-normal distribution is 

generated, they could help at this point.

Dr. Taulbee: This is Tim Taulbee. I'm on the phone, 

but no, Jim, I don't have anything to add at this time 

about that log-normal distribution. I, like you, need 

to go back and reread all the assumptions associated 

with it. Sorry.

Maybe Matt Smith is on the phone. I'm not sure.

Member Ziemer: Well let me just suggest to the 

Board that a possible route here would be to defer 

action on the overarching issue document, and 
74

there's only the three concerns, and to take action on 

the OTIB with the possible exception of that part of 

the OTIB that also is related to this document. I think 

it was just one item. I forget which one it is.

Now, Loretta.

Member Valerio: So my question is on Finding 

number 12 of the OTIB, it appears that NIOSH, SC&A, 

and the Committee are all in agreeance with it, but 

the revision has been in abeyance since 2007. That's 

an awfully long time. So I'm wondering if there's any 

indication of when that will be revised.

Dr. Neton: Yes, this procedure is currently 

undergoing revision for other items and I made sure 

that this would be incorporated into that revision 

that's being worked on right now.

Ms. Lin: Loretta, can you please speak into the 

microphone?

Member Ziemer: Oh, were you asking about Jim 

Neton's remarks?

Ms. Lin: No, asking about Loretta's remarks.

Member Ziemer: Okay, Loretta, if you wanted to 

repeat that again.

Member Valerio: So my question was on the time 

frame for the revision of the OTIB-17.

Member Ziemer: Now what would be needed here, if 

you wish to pursue this in the manner I described, 

would be two things. One would be a motion -- well 

actually we don't need a motion to postpone. We 

don't have a motion to act at the moment.

So lacking a motion to act on OTIB -- or on OVER-9, 

Overarching 9, we could let it -- although, I think it 

would be helpful to have an action item where we 

instruct NIOSH, perhaps, to provide the information 

to the Board and then put this on the agenda again.
75

So perhaps a motion to that effect. I don't know if 

you want to use my words or some better ones. Does 

someone wish to make such a motion?

David is --

Member Richardson: I will.

Member Ziemer: Okay. Did I word that motion, 

though, in the proper way for you, David?

Member Richardson: Far better than I would have 

done.

Member Ziemer: Yeah, right.

Member Kotelchuck: And I'll second it.

Member Ziemer: And it's seconded.

So that motion is to defer action on Overaching-9 and 

to request that NIOSH provide further detail on the -

- I think it's on the IREP methodology and related 

information to help us resolve the issue raised by 

David's question.

Are you ready for a vote on that motion?

All in favor, aye.

(Chorus of aye.)

Member Ziemer: On the phone lines, any ayes?

(Chorus of aye.)

Member Ziemer: Okay, good. I think we have all 

ayes. 

Any noes?

(No audible response.)

Member Ziemer: Motion carries.

Now back to OTIB-17. What is your pleasure on that?
76

For clarity, help us remember which finding referred 

to OVER-9? Which finding was that?

Member Beach: I think it's 3. 

Member Munn: Let us get it back up for you.

Member Ziemer: Is it 3? Yes, Finding 3 recommends 

that it be closed. Well, let's see. No.

Oh, yes, number 3 does refer, at the bottom of the 

page to Overarching-9 --

Member Kotelchuck: 4 and 5 both mention.

Member Ziemer: Okay, 3, 4, and 5 also refer to that 

then. Is that correct?

I think what we may be looking for will be a motion 

to agree to the closure of Findings 1, 2, and then 6 

through 15.

Mr. Katz: Why don't you just defer it all?

Member Ziemer: We could defer it all.

Member Richardson: While we're here, could I ask a 

question about Finding 7?

Member Ziemer: Yes. Yes, go ahead.

Member Richardson: So Finding 7 relates to the 

assumption of four millimeters of clothing. And I 

understood it to be -- or maybe it's a question about 

how that's operationalized or what that means in 

terms of the shielding from four millimeters of 

clothing and what assumptions are implicit in that.

Member Ziemer: I suspect we may have to get Dr. 

Neton to address that as well.

Member Richardson: I can just give you a preview 

while he's coming up of what my question is. Is it that 

it's -- we've said one part of that clothing are the 

underpants.
77

And is the assumption that the worker is wearing an 

impermeable, non-absorbent underpant, or is there -

- is it possible, that given the fabric --

Dr. Neton: I don't know the answer to that question. 

I'd have to go back and research it. These things 

were done 11 years ago. And I thought I prepared 

adequately for this, but apparently, the level of depth 

at which --

Dr. Taulbee: Dr. Richardson, could you repeat that 

question, please?

Member Richardson: Sometimes when you 

incorporate clothing as an additional barrier, you 

view it -- there's various ways of implementing it. 

And one of them is that you assume it's impermeable 

or nonporous. And for the underpants, that would 

seem a stretch. I think they are designed to breathe.

Member Ziemer: A stretch so to speak.

Dr. Taulbee: I don't believe that's the case. The 

thicknesses were derived from the standpoint based 

upon the guidance within VARSKIN and clothing 

thicknesses. And so there was some compounding 

going on.

The whole issue was regarding the exposure to the 

testes --

Member Richardson: Right, but I believe, and 

somebody knows this far better than I do, that the 

recommendation with that VARSKIN algorithm was 

actually the best situation would be to measure inside 

the clothing. I mean that this issue of permeability 

was an important assumption in VARSKIN and one 

which is not clear.

And so if you're assuming like an impermeable work 

suit, that's one thing, but if we're saying half the 

thickness is underpants, then we may want to look at 

what the embedded assumption is, for example, in 

that VARSKIN, where this has been discussed before.
78

Member Ziemer: Okay, we're going to need a followup on that, too. 

So at this point, since there are several items in 

OTIB-17 that need follow-up, perhaps our best bet 

would be to defer action on the whole document until 

we have further clarification.

And, Josie, do you have an additional comment or 

question?

Member Beach: I just wanted to point out that 15, 

Finding 15 would also be included in that, in 17 -- not 

to miss 15.

Member Ziemer: Oh, Finding 15. Yes, correct. Thank 

you.

So we're going to ask for a motion to defer action on 

OTIB-17.

Mr. Katz: We don't have a motion.

Member Ziemer: I'm asking for a motion on OTIB-17 

to defer.

Mr. Katz: We don't have a motion to go forward.

Member Ziemer: No, we don't have a motion to go 

forward, but we need some action to be done, as we 

did on the Overarching 9.

Member Beach: I will be happy to make that motion.

Member Ziemer: I'm not certain what the follow-up 

is on this, however. I'm not sure what your motion 

covers follow-up wise, Josie. We've identified the 

items here.

Member Beach: Right. Just a report from NIOSH, is 

what I was assuming, clarifying those items in 

question.

Member Ziemer: Jim or Stu, are we sort of semi-clear 

on what's needed here? Okay.
79

Member Clawson: I second. 

Member Ziemer: We're not only semi-clear, we're 

completely clear. Correct?

Mr. Katz: Brad seconded.

Member Ziemer: Brad seconded. 

So the motion will be to defer action and to report 

back the clarification matters for those findings that 

deal with the skin dose and the undershorts and other 

garments.

Member Munn: So we're deferring --

Member Ziemer: Wanda?

Member Munn: So we're deferring? I'm not sure I 

understand.

Member Ziemer: I think we are deferring all of the 

action on --

Member Munn: We're deferring everything until we 

check on the underwear.

Mr. Katz: There were more items than that but 

anyway, we're --

Member Ziemer: There's a number of items here that 

have related parts of the skin dose issue. I think 

we've identified at least four of these, at this point.

And, Phil, did you have additional comment?

Member Schofield: I was just going to say that I don't 

think this one could be addressed because my 

experience has been that there is a wide variation in 

the weight of protective clothing, coveralls, 

underwear, tee shirts, whatever you wore. 

Sometimes they were very light. In the early days, 

they were all cotton. Then later on we went to 

coveralls -- cover the other coveralls.

So I don't know how they're going to formulate that. 
80

It's going to be a hard one for them.

Member Ziemer: Well, we'll see what information we 

gather, and we'll have claimant-favorable underwear. 

No Duluth Trading underwear.

Are you ready to vote then on the motion? Do you 

remember what it is? Okay.

All in favor aye.

(Chorus of aye.)

Member Ziemer: On the phone?

(Chorus of aye.)

Member Ziemer: Thank you.

Any noes?

(No audible response.)

Member Ziemer: The motion carries.

We're ready with OTIB-34 -- or are we ready?

Mr. Katz: We're actually out of time.

Member Ziemer: We're out of time.

Mr. Katz: Which is fine. I suspected that we might 

not get through all the agenda items, which is fine. 

We can also carry that agenda item, the last 

procedure forward to the next meeting.

But it's 12:15 now. In the session after lunch -- lunch 

break goes to 1:45 -- it's very important that we start 

on time because we have a lot to cover in that hour. 

It's going to be tough, again there, to make it within 

time. So let's try to break on time.

But thank you -- thanks, Board Members, for these 

questions because this is an important part of 

approving these procedures is getting clarification 
81

about these matters at the Board level.

So we are breaking, out of session until -- what did I 

say -- 1:45. And again, Board Members, please be 

seated and ready at 1:45 for the next presentation. 

Thank you.

(Whereupon, the above-entitled matter went off the 

record at 12:18 p.m. and resumed at 1:45 p.m.)

Dose and Dose-Rate Effectiveness for Low-LET 

Radiation

Mr. Katz: While we are waiting, let me just check on 

the line and see do we have back Dr. Anderson and 

Dr. Field? 

Bill, are you on the line, Bill? And Henry, Andy?

(No audible response.)

Mr. Katz: Okay well, we have a quorum in any event. 

We don't have Dr. Anderson or Dr. Field on at the 

moment. That's okay. And I don't think we have Dr. 

Lemen on either.

But, David, this is your session to lead.

Member Richardson: Well, thank you. So there is a 

Working Group on Scientific Issues and, for quite a 

long time now, we've been working through this topic 

of what's called dose and dose-rate effectiveness 

factors. A large report has been prepared that was 

commissioned by NIOSH. The group has gone 

through that report briefly. And also NIOSH solicited 

a number of external peer review comments on it, 

which have been circulated, and the Board has had 

an opportunity to circulate those and get to them.

But today what we're going to do is have a 

presentation on this topic. And just to orient people, 

we currently, we use the IREP system for relating 

dose to the risk of cancer for a claimant. Embedded 

within this computer system, which does a 

calculation, is an assumption about what the risk is 
82

per unit dose. And there's a set of risk coefficients 

which have been derived from studies of the 

Japanese survivors of the atomic bombings of the 

Hiroshima and Nagasaki. And for solid cancers, 

there's pretty much a straight line, which is drawn 

between on the x-axis, how much radiation exposure 

someone received and, on the y-axis, the risk or the 

probability that they got cancer.

This factor here, this dose and dose-response 

effectiveness factor for solid cancers is a number that 

they're going to divide that slope by when they start 

talking about lower doses and the typical doses that 

workers were receiving.

So we have assumptions that we use right now that 

are embedded. There's one set of assumptions for all 

cancers other than breast and thyroid, which is 

basically dividing that slope by two. So if it increases 

at a 45-degree angle, as risk -- as dose goes up, the 

risk goes up. It's going to be 22.5 degrees as an 

angle for that reduced slope at lower doses.

The exception is for breast cancer and thyroid cancer, 

where it's being divided more by a factor of 1.5 

instead of roughly a factor of 2.0.

These were subjective derived correction coefficients 

that came from Charles Land, who was at the NCI at 

the time. And my own reading of this is somewhat 

that this different slope factor for breast and thyroid 

versus the other solid cancers partly reflects Charles' 

subjective view of the world and his particular 

interests in breast cancer and thyroid cancer.

What NIOSH has done is now commissioned a report 

which is looking back at those assumptions that go 

all the way back to the start of this program about 

what risk per unit dose we should be using for making 

these decisions.

And I'm going to pass now over to Dave Kocher, who 

is going to talk about this report.
83

Dr. Kocher: So as David just said, we looked at this 

one parameter that's in the IREP program and we 

want to develop a probability distribution of this 

parameter. The idea of the probability distribution is 

to develop a distribution of possibly true values of 

this parameter. We're not interested in an 

uncertainty in the mean or anything else. We just 

kind of want to know the range and sort of what's the 

probability in-between that range.

But more generally, our interest was to develop a 

DDREF distribution that would be generally suitable 

for use in any modern-day cancer risk assessment 

that attempts to fully account for uncertainty.

As David just said, DDREF is basically an adjustment 

factor that's used in estimating cancer risks from lowLET radiation at low acute doses or low dose rates. 

And in our report and in the draft copy of a paper for 

health physics that I believe you have received, we 

do go into what constitutes a low dose and a low dose 

rate but I'm not going to talk about that today.

The basic idea of a DDREF, it is an assumption that 

the risk per unit dose, the risk per gray at low doses 

or low dose rates may differ from the risk at higher 

acute doses, which is observed in the Japanese 

atomic bomb survivors. The A-bomb survivors are 

still the gold standard in cancer risk assessment 

today.

DDREF is defined as the ration of the risk per unit 

dose at high acute doses to the risk per unit dose at 

low doses or low dose rates. This definition is 

arbitrary and I think it was done with the belief that 

DDREF would be greater than one. So they would like 

to have a nice number greater than one.

As David also said, this correction factor, this 

adjustment factor is used whenever a linear doseresponse for a cancer is assumed that risk is a linear 

function of dose, alpha is the coefficient, D is the 

dose. But when you use a DDREF, it means that this 

coefficient may depend on dose or dose rate. That's 
84

sort of what's implicit in here.

And the reason we like linear dose-responses, as 

David said, is that for all solid cancers and for most 

individual solid cancers, the dose-response in the Abomb survivors appears to be basically linear up to a 

fairly high dose, 2-3 gray.

Well, where did DDREF come from? I think it was 

invented about 40 years ago and it had certain 

arguments behind it. The main argument was that 

even though these dose-responses might be linear, 

that the true dose-response was really linear and 

quadratic in form. Okay -- that there was this 

quadratic term so the dose-response would curve 

upward. And I'll show you a picture of that in a 

moment.

So one assumption was that it may appear to be 

linear but it really was linear-quadratic underneath. 

And the other assumption was if you wanted to 

estimate the risk at low dose rates, it was determined 

by the linear term only. Only this term would occur 

when you were down in chronic exposure situations.

It turns out that the experimental basis for this 

linear-quadratic model was all artifacts. It had been 

proven later that these linear-quadratic doseresponses that they saw in cells, that was an artifact. 

And David Richardson was important in showing that 

the linear-quadratic dose-response for all leukemias 

in the A-bomb survivors was also an artifact. But this 

model lives on and people are still using it. But 

there's not a firm basis for its assumption. There's no 

doubt about that.

So here's a little picture that kind of -- and David tried 

to illustrate with his arms what's going on but this is 

basically what he said. Imagine we have four data 

points up here. And this is in the range where you 

really do see a response at a given dose. There is no 

doubt about that it's elevated. And for solid cancers, 

you can fit this dose-response with a nice linear curve 

that just goes a straight line down to zero. And the 
85

slope of that curve is the risk per unit dose. And that 

risk per unit dose is independent of dose. The slope 

is the same everywhere.

But if the true underlying dose-response is linearquadratic in form, like this solid line right here, it 

starts out with a small slope, increases, and then it 

rolls over here when you're doing a lot of cell-killing. 

If the true dose-response really is this, then the slope 

of this curve at low doses is this curve down here. It's 

a much lower slope.

So the idea is that DDREF is basically the ratio of this 

slope to this slope. In this cartoon, it's a number 

greater than one. But this is the basic idea behind the 

linear-quadratic model being the true dose-response.

When you have a linear-quadratic dose-response, the 

risk per gray, which is alpha plus beta D, it increases 

with increasing dose and DDREF is greater than one. 

And a DDREF is incorporated implicitly in this model 

and it depends on dose. The DDREF is 1 plus the 

ration of the beta coefficient to the alpha coefficient 

times the dose. And that is a dose-dependent 

quantity. 

And this beta over alpha is referred to as the 

curvature parameter. The higher the value of beta 

over alpha, the more distinct curvature you get in this 

linear-quadratic dose-response.

But since this linear-quadratic model doesn't have a 

firm basis, other kinds of dose-responses are not 

ruled out. One of particular interest is the doseresponse possibly super-linear, where the risk per 

dose at low doses and low dose rates is higher than 

at high acute doses, in which case, DDREF is less than 

one. And the question of whether DDREF can actually 

be less than one is of some controversy but it's not 

ruled out by anything that I'm aware of.

You have to distinguish, in this business, between 

solid cancers and leukemias. And again, David had a 

lot to do with this.
86

For solid cancers, you basically have linear doseresponses most of the time, adjusted by a possible 

DDREF. You don't know what it is but it's possibly 

adjusted by this factor. But it's clear that the doseresponse for leukemias combined in the A-bomb 

survivors is not linear. It is highly curve-linear. It 

looks like a linear-quadratic model with this dosedependent DDREF in it.

And this linear-quadratic model is an artifact because 

all leukemias consist of basically three different kinds 

of leukemias. The dose-response for none of those is 

linear-quadratic but, when you put it all together, it 

looks LQ. And that means that you can't use these 

dose-responses to inform a DDREF for solid cancers. 

It has nothing to do with solid cancers. Leukemias 

are just different. So you have to separate the two.

And so we're worried about a possible DDREF for solid 

cancers. Well, why do you we use it? This kind of 

reiteration. Okay, you get nice linear fits to doseresponses in the LSS cohort but that doesn't 

necessarily mean that it fits the data below limits of 

detection, which are typically about 0.1 to 0.2 gray. 

There may be small non-linearities that are concealed 

in there and they usually try to tease them out.

The other possibility is that the linear fits to the LLS 

may not describe the risk per unit dose at low dose 

rates, which is what you're interested in for your 

worker populations. So this is kind of why we need to 

use this parameter.

A DDREF really consists of two distinct concepts and 

I'm going to emphasize this throughout. The first we 

refer to as a low-dose effectiveness factor, LDEF. And 

this is basically the effect of dose from acute 

exposure on the risk per gray. As the dose from acute 

exposure goes down, does the risk per gray change?

And you analyze possible nonlinearities in the doseresponse from acute exposure and almost always it's 

done using linear-quadratic models fitted to data in 

the LLS cohort for all solid cancers combined.
87

So you attempt to tease out that there's some actual 

curvature, even though it looks linear and the 

response per unit dose is different at low acute doses.

The other concept is called a dose-rate effectiveness 

factor, DREF. It is concerned with the effect of dose 

rate on the risk per gray. When you go from acute 

exposure to a chronic exposure, what's the change in 

the risk per gray, if any?

And you, generally speaking, estimate this. You have 

some data in worker populations where you estimate 

risk to those workers and you compare those risks 

with comparable risks in the atomic bomb survivors, 

which is high acute doses. And you take the ratio of 

those two, a DREF is the risk per gray and the LSS at 

acute exposure divided by the risk per gray from 

chronic exposure in workers or members of the 

public.

Uncertainty is extremely important. IREP is all about 

uncertainty. Modern-day cancer risk assessment 

tools are all about uncertainty.

The goal of all of these programs is to obtain some 

kind of subjective confidence interval. These are not 

statistical confidence intervals that have any 

statistical rigor. They are subjective. There is always 

judgment involved.

These confidence intervals, in our view, are supposed 

to represent -- they represent uncertainty in 

estimated risks and we refer to this as state of 

knowledge. And I'll say this several times. It's a fuzzy 

concept. It took me a while to get used to it but state 

of knowledge does not mean statistical uncertainties 

from model fits the data.

And there are several analyses I have shown that the 

uncertainty in DDREF can be a very important source 

of uncertainty in estimating risks of solid cancers at 

low doses or low dose rates.

So to characterize the probability distribution of 
88

DDREF as best we can is extremely important for 

purposes of this compensation program and any 

other application where you are looking at 

uncertainties and estimated risks.

David mentioned the two probability distributions 

that are in IREP at the present time. These are what 

we call discrete probability distributions. Probability 

is assigned to discrete numbers. This is not a 

continuous function.

The one on the left is for all cancers other than breast 

and thyroid. It's set actually at about 1.8 or so. The 

90 percent confidence interval goes from one to 

three. And breast and thyroid has a slightly lower 

value. It's central value is about 1.3, somewhere in 

there.

And again, as David -- it's true that this was basically 

a wet your finger and put it in the air and see what 

you come up with. There wasn't any kind of formal 

analysis behind this. This was Charles Land abetted 

by Owen and others at our company about what this 

might look like. 

But this is what's in IREP at the present time and this 

is a fairly uncertain quantity. You know it can range 

from 0.5 to 4.0. Remember, anything less than one 

means that the risk per unit dose is considered to be 

higher at low doses and low dose rates than it is in 

the atomic bomb survivors at high acute doses.

Anybody that gets in this business -- this is an 

important slide for the panel. Anybody that gets into 

this business confronts two basic issues. Issue 1, 

what studies are relevant in developing at DDREF 

distribution for solid cancers? What are you going to 

choose? What data are you going to use? Are you 

going to use epidemiologic studies only or are you 

going to include this wealth of data on cells and 

animal systems, laboratory animal systems?

And if you include radiobiologic data, you have to 

answer the question can these data really be used to 
89

quantify or inform the uncertainty in DDREF in 

humans. We sort of believe that the answer to that 

question is pretty much no. You've got to show me 

that this is really relevant to quantifying uncertainty. 

They demonstrate, no doubt, that there is an 

effective dose and dose rate but to actually adjust 

some numbers, that's a stretch, in our view.

So even if you decide that you're going to use 

epidemiologic studies only, which ones are going to 

choose? There's a bunch of them out there. 

The second major issue is you're going to have each 

value that you choose is a distribution of some kind. 

It has uncertainty. And the question is, how are you 

going to combine those all different probability 

distributions of DDREFs that you have gleaned from 

the literature? How are you going to combine them? 

What weights are going to be given to them?

And we have done this differently from everybody 

else. So heads up about that.

So the basic idea of our study was to develop what 

we call a state-of-knowledge probability distribution 

of this parameter using data from epidemiologic 

studies only.

Our study is unique in the fact that we used four 

different data sets. We have low dose effectiveness 

factors for incidence and mortality from all solid 

cancers and we have dose-rate effectiveness factors 

for incidence and mortality for all solid cancers. Any 

other analysis of the literature includes only a subset 

of these data sets. We are the first one, to my 

knowledge, to use all four.

We also looked at data for specific solid cancers but 

we didn't use it in our analysis. We don't think it really 

informs anything that you don't get out of this.

And this distribution -- IREP doesn't calculate risks of 

all solid cancers combined. It calculates risks of 

specific solid cancers. And our intent would be that 
90

this distribution would apply to those cancers 

whenever linear dose-response is assumed. And 

that's an assumption.

We talked about the linear-quadratic model before. 

And you can actually use the linear-quadratic model 

in two different ways to estimate a low dose 

effectiveness factor in cases of acute exposure. The 

one that I showed you before is this take the ration 

of R sub-H over R sub-L. And I showed it before, it's 

1 plus the quadratic coefficient divided by the linear 

coefficient times the dose. And by convention, by 

convention only, it is evaluated a dose of 1 gray.

So in this approach, the LDEF is just 1 plus beta over 

alpha. Again, beta over alpha is this curvature 

parameter.

The other way to do this is the one that I showed in 

the cartoon before, where you take the ratio of two 

linear slopes. The numerator is the coefficient to the 

linear fit to the dose-response and the denominator 

is the coefficient of the linear term in the linearquadratic fit. Those are the two straight lines that I 

showed in the previous cartoon. You don't get the 

same answer. You get sort of the same answer but 

you don't get the same answer. It's just a different 

model for how to do this.

Okay, I'm going to describe qualitatively and then I'll 

show you some data here pretty soon. What studies 

did we use in our analysis to come up with a 

probability distribution of DDREF at the end of the 

day? And again, we used four data sets.

The first data set was data on low dose effectiveness 

factors from acute exposure for solid cancer 

incidence and solid cancer mortality. For solid cancer 

incidence, everything is based on DS02 dosimetry, 

for those of you who have been keeping score about 

that business. One estimate came from the study in 

2007 for the Radiation Effects Research Foundation. 

These are the experts at Hiroshima that have studied 

this problem since 1950. They came up -- Dale 
91

Preston published a single estimate of an LDEF and 

the BEIR VII Report from 2006 came up with two 

estimates, using the two different methods of LDEF 

that I showed you on the previous slide.

For solid cancer mortality in the LLS cohort, we 

actually have six different estimates. We get two 

estimates from a paper by Mark Little about ten years 

ago. This was done for the United Nations Scientific 

Committee on the Effects of Atomic Radiation. So this 

is an authoritative analysis. His approach was to use 

two different risk models, rather than the two 

different methods of applying a linear-quadratic 

model. He used an excess relative rate model, ERR, 

and an excess absolute rate model, EAR.

And the most recent paper from RERF on solid cancer 

mortality, you can tease out four different estimates 

of LDEF from that: the two different ways of 

evaluating linear-quadratic model that you showed 

you before; and the other dimension here, the other 

two come from the fact that this was evaluated over 

two different dose ranges in the dose-response. And 

amazingly enough, he got very different answers, 

depending upon the dose rate that was analyzed. And 

I'll show you that in a second. So we had, basically, 

three data points up here and we have six data points 

down here.

This is just an illustration of kind of what these data 

look like. This is the solid cancer incidence doseresponse from the BEIR VII report. Dose on this axis, 

excess relative rate really on this axis. And the solid 

curve is a nice linear fit and it basically fits the data 

pretty nicely.

What they tried to tease out is there any 

improvement in using a linear-quadratic fit. And the 

fit that they thought was best was this middle one, 

when the curvature parameter was 0.3, which means 

an LDEF of 1.3. And that's this curve in the middle.

And then they did one for a higher curvature that 

they thought gave a poorer fit. So their preferred 
92

best estimate for LDEF was 1.3, based on this.

But you know to the naked eye, it is basically close 

to linear. We are trying to tease out a pretty small 

effect here.

Well, we worked on this project for years. We finally 

reached a point in spring of 2017 when we said 

enough; no more papers. We're not going to consider 

anything else. And as sure as tomorrow's sunrise, 

here comes a flood of new papers. It was absolutely 

predictable.

RERF has updated the dosimetry system. It's now

DS02R1 and the paper is redoing the A-bomb 

survivor data with this new dosimetry system are 

starting to come out. We haven't accounted for any 

of this but I hope to talk about it at the end what the 

implications are for our work.

The first paper on solid cancer incidence by Grant, 

not only did it include a revised dosimetry for the 

survivors but a longer follow-up. The follow-up was 

extended from 2003 to 2009, I think, was the cutoff 

point. Anyway, a longer follow-up compared to the 

2007 paper that we used from Preston.

Filed shortly thereafter is another paper on solid 

cancer mortality by Harry Cullings, et al. This was a 

little different. He updated the dosimetry but he did 

not look at a longer follow-up to the cohort. So this 

is basically redoing the same data that we used in the 

2012 analysis with a new set of dose estimates for 

the survivors. But we didn't account for any of this 

but I'll try to show you what the potential implications 

are.

Okay, so now moving on to the second component of 

a DDREF, which is this dose-rate effectiveness factor 

and recall that you estimate by comparing risks in 

some population of workers or the public that receive 

chronic or protected exposures with risks in the Abomb survivors from the high acute exposure.
93

For solid cancer incidence, we used two different 

studies; one U.K. workers from Muirhead. The second 

was the Techa River cohort. This is a population --

this is members of the general public that live 

downstream from the Mayak production facility in 

Russia and they got zapped. This is an important 

cohort because it is a member -- a cohort of the 

public of all ages.

Now when you do this, of course, you have to pick a 

comparable risk in the LSS cohort and I've indicated 

where we got them. We got this one from a literature

and this one we calculated from the BEIR VII model. 

But one of the challenges is you have to match this 

risk in the LSS cohort by age at exposure, attained 

age, and male fraction with the distributions in these 

other cohorts and that's not a trivial job.

Solid cancer mortality, we used three studies to 

estimate DREFs for that. The paper by Muirhead 

included mortality as well as incidence. So we used 

it. The second was David Richardson's INWORKS 

study that I presume you've heard about something 

in the past. It's a pooled study of workers in three 

countries. And Techa River also has a study of solid 

cancer mortality.

So we had two DREFs incidence and three DREFs for 

mortality.

Now I mentioned there are many challenges in doing 

these DREFs so I think you kind of have to take the 

results with a grain of salt, with a healthy dose of 

skepticism. 

To select a particular age at exposure and attained 

age in the LLS cohort that matches the age 

distributions in these workers or public populations is 

not easy. Oftentimes, these exposures of workers, 

especially, you have neutrons and alpha particles 

that can complicate matters. Any of these groups 

could have non-uniform exposures from internal beta 

emitters. This really complicates your dose-response 

analysis and it's difficult to know how to do this.
94

Sometimes you have exposures to lower energy xrays. These workers all got x-rays on a routine basis 

to see if they had lung cancer. Some workers got 

treated with beta particle exposures. These things 

probably have an increased biological effectiveness. 

How are you going to account for that?

Risk transfer between populations of different 

nationalities. You're comparing risk in A-bomb 

survivors in the Japanese population with risks 

basically in Western populations. And it's not a given 

that the risks are the same because of differences in 

the baseline rates.

This is probably an unimportant problem for all solid 

cancers combined but it's not -- I would say it's not 

a zero effect.

These are challenges that are difficult to meet.

Well, as in the case of the LDEFs, there were a whole 

bunch of studies of workers and members of the 

public that we did not use in our analysis and I kind 

of wanted to outline those here.

The first study we did not use at all was the famous 

15-country study by Elizabeth Cardis that was done 

at -- let's see, this is International Agency for 

Research on Cancer I think is what that stands for. 

And this is a famous study. They pulled data from 

workers in 15 countries and they came up with a 

positive dose-response. My, that looks nice. The 

problem was, this positive dose-response was due 

entirely to an estimated risk in a sub-population of a 

Canadian cohort that is now believed to be totally 

invalid.

So when you take the Canadian cohort out and you're 

left with 14 countries, still 14 out of 15, that's still 

pretty good. The dose-response was non-significant. 

And furthermore, the dose-response was nonsignificant in workers in each of the 14 countries and 

some of those dose-responses had undefined lower 

bounds. So we, basically, parsed all this out.
95

Two recent studies we did not consider, a study about 

Mayak workers that I'm going to talk about a little bit 

later, and Chernobyl emergency workers. Our basic 

beef with those is reliability of dosimetry. There is a 

new dosimetry system for Mayak workers that we're 

still awaiting and the Chernobyl emergency workers 

have always had concerns about accuracies of their 

dose estimates.

And this is controversial. We basically omitted any 

other study in workers that had a statistically nonsignificant dose-response. Why? Because it's 

uninformative about uncertainty in DDREF. We are 

interested especially in the lower bound of a DDREF, 

the values that are going down kind of close to zero, 

maybe. But when you start getting negative 

numbers, you are in La -- La Land. These are 

basically -- in our view, these are basically 

uninformative estimates. That's controversial. Not 

everybody agrees with that.

We are dealing with -- we want to deal with 

probability distributions. We wanted to find a 

functional form of the probability distribution of each 

of these input LDEFs and DREFs but we have to make 

those up because the epidemiologists don't give you 

probability distributions. What they give you is a 

central value and a confidence interval.

While we assumed that all the central values, the 

parameters that they gave us, these are what are 

called maximum likelihood estimates. I think that is 

a good assumption. No problem with that.

And we fitted these reported maximum likelihood 

estimates and confidence intervals with Weibull 

distributions. We put the mode of the Weibull 

distributions, the MLE, and defined the bounds of the 

Weibull distribution by these confidence limits.

Weibull distributions are really handy. They are 

extremely flexible. And we needed this because some 

of these probability distributions in these parameters 

are highly skewed. The MLE is way close to one 
96

confidence limit and one way far away from another 

confidence limit. You can't describe that by normal 

distributions or lognormal distributions or anything 

like that. You need something that's flexible and 

Weibull fits the bill.

So what we come up with at the end of the day are 

50th percentiles, median values, and 90 percent CIs 

of these different quantities.

I don't expect you to look at this for very long but 

this is basically the data that we used. From here up 

to the top is the data for all solid cancers that we did 

include in our analysis. 

This solid line here, one, that's a DDREF of one. That 

basically means no effect. The risk per unit dose is 

the same under any condition. Going to the right is 

DDREF greater than one, which means the effect is 

reduced at low doses and low dose rates. Less than 

one means it's increased. DDREF less than one 

means an increase in the risk per unit dose.

The open figures are the incidence data. So here's 

your three LDEFs from the atomic bomb survivors. 

Here's our two DREFs from the worker studies. And 

here's our six DREFs for mortality.

And notice in the Ozasa analysis, there is one set for 

a dose range of 0-2 gray that gives these really high 

uncertainties and pretty high central values. This is a 

50th percentile of 3.2. This was a highly skewed 

distribution. His MLE is down here at 1.8. That is not 

a lognormal distribution by any means.

But if you just increase the dose range slightly, this 

is a kerma of 0-4 gray. So this is a colon dose, maybe 

going up to about 3-3.2 gray, something like that. 

But the answer is changed really tremendously, 

depending upon the dose range that you chose to do 

the analysis.

And here is our dose-rate effectiveness factors based 

on the worker in Techa River studies. And you notice 
97

right away that the greatest weight to the values less 

than one all comes from these studies of dose-rate 

effectiveness factors.

Part of the reason, I think, is that when you assume 

a linear-quadratic model in the LLS cohort, you are 

kind of biasing yourself toward a curvature greater 

than one.

Be that as it may, it is clear that the lower values are 

basically less than one or basically your dose-rate 

effectiveness factors, based on studies in workers 

and the public.

I just showed the organ-specific data down here. We 

didn't use any of this. Most of us, the old DS86 

dosimetry -- the only value that I think is relevant 

today is this one estimate for thyroid cancer from 

Veiga's paper in 2016.

The skin numbers are not relevant because this is not 

a linear dose response. This is a hockey stick dose 

response. Basically, piece-wise linear with different 

slopes and different ranges of dose.

So this is really important and I'm sorry that it will be 

confusing. 

Initially, we are different from everybody else in the 

way we chose the studies that we used in our 

analysis. And so we have developed probability 

distributions of all those parameters that I have 

shown. The way we combined these distributions is 

different from what other people have used and we 

think there is justification for this, even though 

epidemiologists look at me and say go away, you 

twit, you don't know what you're talking about.

Our whole approach to combining these different 

estimates is based on a concept called multi-model 

inference. It is basically model averaging. And this is 

a scheme -- it is a fairly new idea. It was first 

discussed in an UNSCEAR report in 2012. The basic 

idea in model averaging or multi-model inference is 
98

this: that each distribution of LDEF or DREF that we 

come up with is a distinct model. It is a distinctly 

different model of representing a DDREF. It is these 

different distributions. They do not represent 

repeated measurements of the same quantity. They 

are distinctly different models. And this is the new 

concept that I think we're the first people to try this 

in this arena.

The other thing that is different is how do we weight 

these different distributions? Well model -- yes, how 

do we weight them? We didn't assign our weights 

based on statistical uncertainties and the model fits 

to the data. We did it based on subjective judgment 

about the weights that should be given to each study 

to represent their relevance to estimating a DDREF. 

The relevance is different from statistical uncertainty. 

These weights account for the quality -- we can 

account for the quality of the underlying studies. 

This a very -- you're sitting there going this is a very 

squishy concept. It doesn't have any bedrock. That is 

true but I'm going to show you that it's really, really 

easy. It's really, really easy. And I'm also going to 

show you later that, no matter what you do, 

judgment is involved. And we're just admitting our 

judgments right up front.

The essential feature of this multi-model inference 

model averaging, you have a bunch of confidence 

intervals of the different estimates that you're going 

to combine. Some of them are narrow. Some of them 

are wide.

When you do multi-model inference or model 

averaging, the confidence interval of your answer is 

always wider than the narrowest distribution of the 

input distributions. And similarly, it's always 

narrower than the widest one. You're averaging. The 

confidence interval in its width well be somewhere in 

the middle. Very simple concept. And that's an 

essential feature of this model. It's always wider.

So here's where we part company from everybody 
99

else -- not everybody else. There are three papers in 

the literature that have done this method called 

inverse-variance weighting.

What this is about is instead of weighting each 

estimate by some kind of subjective squishy 

judgment about relevance and quality of the study, 

you just weight it by the statistical uncertainty. The 

variance is a measure of statistical uncertainty. And 

you weigh each one by one over the variance, the 

reciprocal of the variance. So if you have a very small 

uncertainty, that estimate gets a huge weight and if 

you have a large uncertainty, that estimate gets a 

very small weight.

So this is based on an assumption that all your 

uncertainties are purely random and that all these 

different distributions or measurements are the same 

thing. It's a very attractive way because it's a defined 

mathematical prescription for how to do this that 

everybody can understand.

What it produces is what we call a deflation of 

uncertainty. When you do this inverse-variance 

weighting based on statistical uncertainties only and 

assume they're all measuring the same thing, you get 

an uncertainty that is smaller than the uncertainty in 

the smallest input distribution that you put into the 

calculation, a deflation of uncertainty.

And this is the kind of thing you're used to from your 

college statistics classes, where you're doing random 

variability and that kind of thing. When you see that 

somebody has done a meta-analysis of epidemiologic 

studies, this is exactly what they're doing. That's a 

buzz word for this inverse-variance weighting but 

ours is different.

So, we have this squishy subjective weighting quality 

of studies baloney, you know no bedrock. It's really 

not that hard.

How did we combine our low dose effectiveness 

factors for solid cancer incidence? We have estimates 
100

from two expert groups, RERF and the National 

Academy of Sciences. They get equal weight. They 

both know what they're talking about. They get 

slightly different answers but so what? You give them 

equal weight. That's really easy. Now the BEIR VII 

report came up with two estimates so we give each 

of those 25 percent weight. 

They add to 100. So you just make a judgment. Both 

of these groups know what they're talking about. 

They just used different models, some different 

assumptions but the outcome is equally valid.

The same thing with the low dose effectiveness factor 

for solid cancer mortality. We have two expert 

groups, UNSCEAR up here, RERF down here. They 

get equal weight. They both know what they're 

talking about. They used different models. That's a 

matter of judgment. We say their judgment is equally 

valid.

Now we have two estimates from Little. We give each 

of those 25 percent weight.

Now, in the Ozasa LSS, the RERF analysis, we gave 

slightly higher weight to the lower dose range values 

than we did to the higher dose range values and this 

was only because Ozasa preferred an LDEF based on 

the narrower dose range. That was his preference. I 

think if I had to do it over again I'd reverse, to be 

honest with you.

Okay, how did we combine the estimates of DREF, 

the dose-rate effectiveness factors? We had two 

studies. Here we gave a much higher weight to the 

U.K. worker studies than we did to the Techa River 

cohort. 

We felt we had to include the Techa River cohort 

because it's the only public cohort I'm aware of in 

which risks of all solid cancers combined have been 

estimated, surprisingly enough. The lower weight of 

only 20 percent reflects the concerns about 

uncertainties in estimated doses. None of these 
101

people were monitored, obviously. The dose 

estimates are all based on modeling. There is a lot of 

uncertainty about it but we felt we had to include this 

to represent our state of knowledge, sort of the global 

what does the waterfront look like overall but we give 

it a low weight because the outcome may be less 

reliable than say a worker study.

In the solid cancer mortality, we had three studies to 

combine. Again, we gave a low weight to the Techa 

River cohort because of dosimetry issues. And this 

was probably something that we could reconsider for 

sure. 

We gave equal weight to the Muirhead study and to 

David Richardson's INWORKS study. Now the 

problem here is that the data from U.K. workers that 

David Richardson included is exactly the same data 

as in this paper up here. So we've kind of doublecounted this study. In effect, we've given a weight of 

like 50 to 60 percent to the Muirhead study and 30 

to 40 percent to the other two populations in David's 

study. But these are the kind of judgments that you 

have to make that people can argue about until the 

cows come home.

Okay, so at this point, we have four distributions. We 

have a low dose effectiveness factor for solid cancer 

incidence, based on LLS data. We have a low dose 

effectiveness factor for solid cancer mortality and we 

have DREFs for the two endpoints. 

We have four distributions. So how are we going to 

combine those? Well, the first judgment we made is 

we're going to give a relative weight of two-to-one to 

incidence over mortality. We're going to give the 

incidence-based distributions twice the weight of the 

mortality-based distributions. Why is this? Again, this 

is a judgment.

I think people today consider that the incidence data 

and the atomic bomb survivors really is the gold 

standard. One obvious reason for this is that IREP 

calculates incidence. It's not the least bit interested 
102

in mortality. 

But there are problems with mortality data in the LLS 

that don't arise in the incidence data. Disease 

ascertainment is a problem. Sometimes you know 

the cause of death is reported in such a way that you 

don't really know that it was a cancer. The other 

problem is that mortality risk clearly depends on the 

level and intensity of medical care; whereas, 

incidence does not. So for a variety of reasons, we 

give a higher weight by two-to-one to incidence 

versus mortality. 

So now we're down to distributions. We have an LDEF 

for incidence and mortality combined and a DREF for 

incidence and mortality combined. Well, we give 

them equal weight. We feel like in order to 

encompass the state of knowledge of what we know, 

both of these approaches to estimating a DDREF are 

equally valid. The data may not be so good in each 

one but the approaches themselves are equally valid.

So the result of all that, you do this in a Monte Carlo 

setting with a crystal ball and you all are probably 

familiar with this kind of thing. But you end up with 

a distribution that has some tails. So we truncated 

the distribution we got. We eliminated any value less 

than 0.2 and any value greater than 20. We just felt 

that there's no credible evidence of any kind that the 

true DDREF would lie outside this very broad range.

Well, we eliminated very few numbers, only about 

1.3 percent and removed them mostly at the low end.

So the answer that we came up with after doing all 

these machinations, we have a median value of 1.3, 

this is the 50th percentile, a 90 percent subjective 

confidence interval between about 0.5 and 3.6. The 

95 percent CI is broader. And just to kind of give you 

a sense of what this means, this distribution assigns 

a probability of 27 percent, more than one chance in 

four that the true value lies -- is less than one, that 

the effect is greater, that effective radiation is greater 

at low doses and low dose rates than it is in the 
103

atomic bomb survivors, and about 17 percent 

probability that it's greater than two. Two, of course, 

is the magic number in radiation protection today.

And again, it's a squishy concept but we are 

absolutely serious about it. This distribution is 

intended to represent our state of knowledge of 

DDREF. It's not any kind of statistical distribution. It 

is not necessarily what you could get if you could do 

a repeated measurement over and over again to get 

the true value. It's our state of knowledge.

As part of this study, we did a couple of comparisons 

with other estimates that had been in the literature. 

One was the BEIR VII report. Their 50th percentile 

was 1.5. I mentioned earlier that their maximum 

likelihood estimate was 1.3 but their distribution is 

lognormal with a median value of 1.5. This is 

basically an LDEF for solid cancer incidence only. So 

this is only kind of one-fourth of the kind of data that 

we used.

Peter Jacob, back in 2009, did a meta-analysis of a 

bunch of studies in workers and the public. His main 

result was obtained by combining seven studies on 

solid cancer mortality and he got a DREF with a 

central value less than one and a fairly tight 

confidence bound.

And another value for solid cancer incidence, this is 

not his main result, a central value of about one, 

fairly narrow confidence bound.

So this is a picture of kind of the way things look like. 

This is our data, again, up here at the top, our 

incidence data, mortality data, and the LDEF and the 

DREF. And below the line, the red is the result from 

our report. And here's Jacob's values and here's BEIR 

VII down here.

Now, I've been doing this for too long but I have got 

to tell you when I kind of stood back and looked at 

this, when I looked at our line down here and I looked 

at this data up here, I said that passes the eye test. 
104

That passes the eye test. This doesn't but they only 

did one data set so you can't fault them for that. But 

this kind is a representation of this stuff up here, this 

kind of passes the eye test to me.

I wanted to talk about this solid cancer mortality 

study in the LSS, where the low dose effectiveness 

factor depended very much -- let me go back. Here, 

again, in a narrow dose range you've got this high 

value, a large uncertainty. And if you went out to the 

full dose range, you got a value of nearly one with a 

small uncertainty. This is kind of surprising.

And basically what Ozasa found this curve L is the 

linear fit to the dose-response over the entire dose 

range. LQ is the linear-quadratic dose fit to the doseresponse over the entire dose range and it's virtually 

indistinguishable from the linear. LDEF is basically 

one. But if you restricted the fit of the linearquadratic model from 0-2 gray, he got a fairly 

substantial curvature. 

So really the question is, if you're going to estimate 

your risk per unit dose based on this curve up here 

over the full dose range, are you going to apply a 

DDREF based on a limited dose range or the full dose 

range? I think you apply this one but Ozasa thought 

this was the right one.

This is us just being cute. We're talking about 

distributions, probabilities, all kinds of things. If you 

want to look at a single estimate in a distribution that 

best represents what's going on, it's the arithmetic 

mean. The arithmetic mean is the expectation value 

of all the values in a distribution. It's the single most 

meaningful measure of central tendency.

So if you want to estimate the arithmetic mean of a 

risk at low doses and low dose rates, you might think 

well that's just one over -- that would be proportional 

to one over the arithmetic mean of DDREF. No, it's 

proportional to the reciprocal of the harmonic mean. 

This is a concept I was not that familiar with. If you 

want to punish yourself, you can stare at that 
105

equation. That's what it is.

But the point is that the harmonic mean is less than 

the arithmetic mean.

In our distribution, the harmonic mean is only 1.1, 

which means that our DDREF suggests that the 

reduction in average risks at low acute doses or low 

dose rates is only about 10 percent. Big whoop.

If you took the reciprocal of the arithmetic mean, you 

would get a reduction of about 40 percent but that's 

not the correct interpretation. It's the reciprocal of 

the harmonic mean that determines the arithmetic 

mean of the risk.

So do I have time to talk about the data that we didn't 

include? So let me go through this with some -- I 

know I put you all in La La Land.

These recent estimates that came down from the 

RERF, I'm going to show you MLEs and confidence 

intervals. For solid cancer incidence, this is the 

estimate that we used, the new paper by Grant, new 

dosimetry. Now, he only evaluated the curvature 

over the full dose range. He didn't do 0-2 gray to the 

colon. But basically his LDEF is the same and it's very 

close to one. So there's not really much change here.

Now here for solid cancer mortality in the LSS, here's 

the old Ozasa estimate. This is his preferred number. 

And you can see what I meant by this distribution 

being highly skewed. The MLE butts right up against 

the lower bound and is way far away from the upper 

bound. That's a funky distribution.

But this is his preferred value and when Cullings did 

it with DS02R1 dosimetry, he got basically the same 

central value. The uncertainty about double. The 

more you know, the worse it gets. This is life. This 

happens all the time. The more you know the worse 

it gets.

But he, again, found no significant curvature at the 
106

higher dose range. So if you did this over the full dose 

range, you would basically get an LDEF of one.

The real kind of new thing in the Grant paper on solid 

cancer incidence was the fact that LDEF may depend 

on sex. It appeared to be different in males than in 

females. A definite 2.3, that's a fairly high number 

for males; essentially 1.0 in females. Whether this is 

significant, it remains to be seen.

Well, if you look at the Cullings analysis for solid 

cancer mortality, there is no sex dependence over the 

same dose range. There is no sex dependence at 0-

2 gray to the colon in the mortality data, even though 

you still get a higher curvature.

If you go back and relook at the old 2012 data over 

the 0-4 gray kerma, nothing. But if you look at his 

data at 0-2 gray, he did see a big effect but it went 

away when you changed the dosimetry. So this is all 

a mystery.

In a personal communication, we asked Eric Grant 

what's going on here. And he sent us an email, a very 

nice email saying he's looking at data for specific solid 

cancers and he's not seeing anything yet. So the 

upstate returns are not in on this question of whether 

LDEF depends on sex.

So there are a number of issues with this recent data. 

They are not definitive. What we have done is not 

definitive. Nobody has done anything definitive. It's 

all information.

This dependence of LDEF for mortality on the dose 

range is very puzzling. It's not clear what to do about 

it. We think that you should use the same dose range 

to estimate LDEF in the risk per gray. That's the only 

thing that makes sense to us.

Now this effect on dose range appears to be small for 

solid cancer incidence. It's not been explicitly studied 

but the comparison with the Grant paper and the 

Preston paper indicates effect of dose range, if any, 
107

is probably small.

The other question is are LDEFs in males and females 

significantly different and are they different for solid 

cancer incidence versus mortality? It's hard to 

believe that this is really true.

I'm going to spend a minute talking about another 

study that came out in 2017 after our work was 

completed. The ICRP has a big Task Group that's 

looking at all issues of DREF. And one of their 

members, Roy Shore, published a paper recently 

looking at dose-rate effectiveness factors. And he 

looked at 19 studies of mortality, three studies of 

incidence, and he did this inverse-variance weighting 

that I talked about before.

His answer, when he included all 19 studies of 

mortality, he got a median value of 2.8, pretty high, 

with a range indicated here. If he included the 

incidence data, even a little higher. You know the 

probability that the value is less than two is very low 

in this distribution.

But here's one of the problems with the inversevariance method. The Mayak worker study had, by 

far, the smallest variance of any of the 22 studies. 

That one study alone contributed 91 percent of the 

weight to this answer. It contributed 80 percent of 

the weight to this answer. In fact, most of these 

studies contributed, basically, zero weight. So this is 

an issue.

If you took out the Mayak worker study, you get 

something that's kind of comparable to us because 

we didn't include Mayak workers. His value changed 

drastically. Instead of 2.8 for the central value, it's 

down to about 0.9 and the confidence interval gets 

way lower. Same thing for mortality plus incidence. 

Our value is here and, of course, we include low dose 

effectiveness factors, which are not in this analysis. 

But this one paper drove the whole thing. So Roy 

Shore, in his wisdom, and he's way smarter than I 
108

am, said I'm not going to recommend a value. Here's 

just a bunch of different values based on a different 

set of assumptions. You do with it what you want. 

That's smart.

He had another set of numbers where he restricted 

his studies with a mean dose less than 100 milligray. 

That excluded the Mayak workers. That was a fairly 

high-dose cohort. Again, he got numbers kind of like 

what we got, these really high values including the 

Mayak worker study were not there.

Well, I've been critical of this so-called meta-analysis 

approach. Let me just briefly summarize what our 

concerns are.

The approach is objective in the sense that it is a 

prescribed mathematical formalism that is 

understandable and everybody can do it but there are 

assumptions behind it. You make judgments when 

you do this. 

Judgment 1 is that each estimate of these things that 

you're combining represents a repeated 

measurement of the same quantity with the same 

instrument. Your risk estimate in German uranium 

millers has exactly the same meaning as your risk 

estimate in Japanese nuclear power plant workers. 

Sorry, I'm not buying that dog.

Even more important, this method assumes that 

every estimate that you're combining is totally free 

of bias. There is no systematic error in any of these 

risk estimates in workers of the LSS cohort. I would 

say good luck with that. Or the biases cancel out with 

no uncertainty. Good luck with that, again.

These assumptions, in our view, are not met and they 

result in confidence intervals that are too narrow to 

represent our state of knowledge.

After I gave this presentation in Charlotte about five 

months ago, an epidemiologist came up to me and 

said this is the way we do it, end of story.
109

Let me make some concluding remarks here. I hope 

I -- if you get nothing out of this, any way of 

estimating DDREF and its uncertainty always involves 

important subjective judgments. There is no right 

way. There's no objective way to do this. That's a 

flight of fancy.

You make judgments about the data to be included. 

You make judgments about how you are going to 

combine these different estimates. It's always there.

Our approach of subjective weighting based on 

relevance and this approach of model averaging, it 

differs from the more familiar inverse-variance 

weighting used in meta-analysis.

I want to make this point. Our analysis and every 

other analysis is a work in progress. It is a snapshot 

in time. The Upstate returns are not in yet. We hope 

we've contributed something to the dialogue.

I think it is clear that over time there is an increasing 

tendency toward a central estimate of DDREF of 

about one. ICRP is very unhappy about this, let me 

assure you about that. But we are not in the radiation 

protection business here.

There are lots of unresolved issues, even with the 

LSS data, this dependence on sex, different LDEFs for 

incidence and mortality, is that real? Dependence of 

LDEF on the dose range analyzed is an issue.

I summarized before that there are many important 

challenges in estimating DREFs, that I don't think any 

analysis, including ours has really overcome 

completely. And these uncertainties really matter.

To summarize our analysis again, our analysis is 

unique because we have four different data sets, low 

dose effectiveness factors and dose-rate 

effectiveness factors for the two different endpoints. 

Also unique is our approach to weighting the different 

estimates and using model averaging to combine 

them.
110

And our belief is that you have to do both of these 

things to come up with a distribution that represents 

a state of knowledge. And distributions of DDREF only 

don't represent the state of knowledge because you 

haven't accounted for this and vice-versa.

And again we believe that basing an answer on a 

statistical uncertainty is only -- does not really fully 

represent what we know, especially what we don't

know.

Now some of you know that we've put out a report of 

this. This is the website. We finally refer to this report 

as the mighty doorstop.

I'm done. Thank you.

Mr. Katz: Thank you. So I think we have -- I mean 

it's squishy. We have LaVon next and then we have 

a break. We have a little bit of elbow room here but 

I wouldn't think we could use more than five minutes 

or five or ten minutes at most.

And just a note for everybody. I mean this is really 

to welcome everybody to the subject, the point of this 

session today. NIOSH has not come out yet with what 

it proposes to do with this work so we are awaiting 

that for real Board dialogue. 

But with that said, then, David.

Member Richardson: Thank you, Ted, I was going to 

make a similar point, which the intention of the 

presentation today was for the Science Working 

Group to bring to the Board sort of the topic that 

we're dealing with. And thank you very much, David, 

for getting us oriented to it, to understanding sort of 

the history of one of these assumptions that goes into 

the IREP program that we've inherited and are using 

at this point, and to understand the report that you 

produced for NIOSH about an updated, again, 

proposed subjective distribution. And I think you've 

done a very good job of adding both documentation 

and clarity for the rationale for what a distribution 
111

would look like and how it's informed by different 

threads of evidence.

Dr. Kocher: I should say that a paper, a journal 

article describing our work in kind of summary form 

is scheduled to appear in Health Physics Journal in 

the June issue. So you don't have to read the mighty 

doorstop.

Mr. Katz: The Board actually already has that paper.

Dr. Kocher: Yes, I know. Okay. But I just wanted to 

let you know that it is going to be published soon.

And we'd be glad to answer questions from the Board 

at any time.

Member Richardson: So Ted, either we could stop 

there or if there's comments at this point.

Mr. Katz: Yes, I would just say if there is anything 

immediate someone to gets off their tongue about 

this at this point, that's super. You can do that for 

about five minutes but, otherwise, we'll carry on from 

there.

Member Beach: Ted, just a question for NIOSH. Is 

there any timeline for when they're going to come 

out with something on this?

Mr. Katz: I think -- I had spoke to Jim about this 

before the meeting. And I believe we'll have 

something well before the August Board meeting. So 

this will certainly be on the table again in August and 

you'll have the advantage of NIOSH being able to 

give some opinions about where to go with this.

David?

Member Kotelchuck: The presentation and the work 

is extremely interesting and intellectually 

challenging. How and whether it will ever be relevant 

to the task of this Board, I am certainly not sure. But 

we have to learn what we can learn and understand 

as best we can what we can learn.
112

Dr. Kocher: Our view is that NIOSH needs to do 

something about the DDREF and IREP. Our position 

would be that this one of many things that should be 

resolved when the entire Code is updated. To put 

Band-Aids on this thing at this point in time doesn't 

make a lot of sense to us. We would like to see this 

kind of thing judged and taken into account when 

new risk models are put into the code, that kind of 

thing, new data on biological effectiveness, all that 

kind of stuff.

And I would reiterate that ours is a work in progress. 

It's not the answer.

Member Richardson: Yes, I think we could separate 

issues of implementation from -- as far as the Science 

Work Group goes, we are sort of reflecting on the 

state of evidence, reflecting on what assumptions we 

have, and the input -- providing input on the report 

that NIOSH has given us.

Mr. Katz: Any questions from our Board Members on 

the phone?

Okay, then. Thank you very much.

Member Anderson: Hold on. Hey, wait. It's Andy.

Mr. Katz: Oh, go ahead, Andy.

Member Anderson: This is more a question for 

NIOSH. So what's next steps or what is going on 

NIOSH. 

Mr. Katz: So I've addressed that, Andy, already I 

think. But NIOSH is still digesting this and they will 

be coming out with a report of some sort to the Work 

Group suggesting how they would -- where they 

would go from here. 

So we'll get that and we'll get that sometime well 

enough before the August Board meeting.

Member Anderson: No, I was more wondering is 

NIOSH putting together external advisory group or 
113

are they going to be --

Mr. Katz: No, Andy. No. I mean this has already been 

peer reviewed.

Member Anderson: Okay.

Mr. Katz: So we don't need that but really the Board 

is the next step to consider what NIOSH will propose 

at that point.

Member Anderson: Okay, thank you.

Member Richardson: Just to follow-up on that, NIOSH 

got, in my opinion, got some really high-quality 

external review on this report already and that's been 

circulated to the Working Group. So we have those 

to digest.

Member Anderson: Okay.

Member Richardson: And then, as was mentioned, 

there's been a paper that has been peer reviewed as 

well.

Mr. Katz: Okay, then, move on. Carry on.

SEC Petitions Status Update

Mr. Rutherford: Okay, thanks, Ted. I'm LaVon 

Rutherford. I'm going to do the Special Exposure 

Cohort update. We do this update every Advisory 

Board meeting. It gives the Board a chance to 

prepare for Work Group meetings and future Board 

meetings.

I'm going to talk about petitions in qualification, 

under evaluation, currently under Board review, and 

potential 83.14s.

Okay, to date we've had 246 petitions. We actually 

have no petitions in the qualification process at this 

time. We have three petitions that are under 

evaluation. And we have nine reports with the 

Advisory Board.
114

Sandia National Lab, this is a petition under 

evaluation, SEC-188, it addresses the remaining 

years of an initial petition. We had hoped to present 

this evaluation at this Board meeting, however, we 

did not get data in time from Sandia. 

Right now, we're currently scheduled to have the 

report out the end of July. I think we've got enough 

information to complete that. We are still waiting for 

some things but I think we'll be okay.

Lawrence Livermore Nationals Labs, another 

addendum that addresses years 1990 to 2014. It's all 

employees and we do expect to have that report out 

in November.

De Soto is a new petition we received not long ago. 

It is under the 180 days. Currently, we are on 

schedule to have that report completed in July and 

do the presentation at the August Board meeting.

So you could expect Sandia and De Soto at the 

August Board meeting, as well as some additional 

work I'll discuss.

Under Advisory Board review, we have the Hanford 

petition. We're still working on resolving the issues of 

whether the prime contractors' bioassay program 

was meeting commitments.

Savannah River Site, I think Brad will update during 

the Work Group session where we stand there.

Los Alamos National Lab, we recently did some 

additional interviews, SC&A, Josie, the Board, and 

myself. And we also are working on a White Paper 

response to SC&A's review of our addendum. We 

expect that report out at the end of the month and 

for a future Work Group meeting.

Idaho National Labs with the Advisory Board still 

looking at the proposed Class Definition.

Argonne West, I think we have a paper that is in 
115

internal review right now. It will be discussed maybe 

during the Work Group sessions.

Area IV Santa Susanna, we are still working to 

resolve a couple of issues that were raised by SC&A.

Metals and Controls, we actually went back and did 

interviews with the Board back at this site. We have 

developed a new subsurface model. We expect that 

report on that model to be out sometime within the 

next week or so, in support of a May Work Group 

meeting.

We anticipate also presenting a revised Evaluation 

Report on Metals and Controls at the August Board 

meeting as well.

So, we have nine petitions that are with the Advisory 

Board. I went through each one of those.

And the only potential 83.14 we have on our plate 

right now is still the early years at LANL, which was 

a Z Division and have actually been changed to 

Sandia Albuquerque and that is 1945 to 1948.

We have not petitions or not litmus claims to move 

that one forward. At this time, Department of Labor 

is still processing those claims under LANL.

That's all I've got.

Mr. Katz: Thank you, Bomber.

And do we have questions from any of the Board 

Members or on the line?

Okay, much thanks, Bomber.

Okay, we are about at our break. And then we have 

probably a good bit to do on our Board Work Session 

and then Oak Ridge Facilities update after that. 

So, please try to be ready on time, 3:15. Thanks.

(Whereupon, the above-entitled matter went off the 
116

record at 2:59 p.m. and resumed at 3:15 p.m.)

Board Work Session

Mr. Katz: So, let me check on the line. Do I have Bill 

Field back and Henry Anderson back?

Member Field: Yes, I'm on for a little bit, but my 

wireless may be getting a little low. We're down to 

one bar, so --

Mr. Katz: Oh, dear, okay. Okay. Well, we'll try to 

make it before that blips out.

And, Henry Anderson, are you on?

(No response.)

Mr. Katz: Perhaps you're on mute, Andy.

(No response.)

Mr. Katz: Okay. Well, let's move on.

Board work session. We have a number of matters to 

get through, including the Work Group reports. But 

let me -- I think it's very important I get some 

scheduling done first quickly, if we can do that first 

thing.

So, the first matter is location for the next meeting. 

For Board Members, in your notes I gave you actually 

the wrong dates, of course, by a day. It's actually 

August 22nd-23rd that is our August Board meeting, 

not 23rd-24th, as I had it.

And it's sounding -- from what we've heard today --

like it might be quite a full -- a pretty full two-day 

Board meeting. So, plan on that.

What we have -- so we have the dates. What we need 

is a location for that. And I'm not sure we can settle 

the location now, but I want to raise the possible 

locations and get your thoughts about those at this 

point, and I'll communicate with you by email a little 
117

closer -- probably a month down the road or so, to 

firm up exactly what our location is. And that's 

probably as long as we can wait, but we have some 

uncertainties and it would be nice to get those 

resolved before we settle on a location.

Ms. Lin: Ted, can you repeat the dates for the 

upcoming Board meeting?

Mr. Katz: Yes. So, we're speaking of the next faceto-face Board meeting, not the teleconference. And 

that's August 22nd to 23rd.

Was that Jenny Lin?

Ms. Lin: Yes.

Mr. Katz: Yes, okay.

Ms. Lin: Thank you.

Mr. Katz: Yes, sure. You're welcome.

So, locations -- and this is based on where we have 

new SECs to present as well as important work to 

resolve on SECs. That looks like it may be ready for 

resolution at a Board meeting, and I have four 

locations for you to think about.

One, we've never been there, but Metals and 

Controls. That's a possibility. We haven't been there. 

There's some use in being there. That should be 

ready for discussion in front of the public.

Second, where -- we've been there several times 

recently, but we do have an SEC to complete there, 

Sandia. Now there's some work going on, and it 

should be -- as Bomber said, it should be ready at 

that point, but let's see how that goes.

De Soto is a third. As he talked about, they have a 

presentation for that -- for a new SEC on that. That 

should be ready.

And the fourth is INL. We have a couple of things 
118

relevant there. One, we have an SEC class 

recommendation still standing there. And I believe 

most of the work related to the Board's consideration 

of that is completed. So, there needs to be another 

Work Group meeting. SC&A may be still doing a little 

bit of work related to that, but, by August, we should 

be ready on that to resolve that. Or I'm hopeful of 

that.

And we also have at the same time possibly -- likely 

I think, but not certain -- an 83-14 on the burial 

grounds there, so a separate SEC matter. So, there's 

actually quite a lot that would be of interest relevant 

to the folks at INL.

So, those four locations. I haven't given 

consideration to other locations at this point because 

there's already quite a lot of options on our plate, but 

I'm happy for Board Members' thoughts about these. 

And then, like I said, we'll resolve this in about a 

month as to where we'll go.

Member Ziemer: Can you remind us where Metals 

and Controls is located?

Mr. Katz: I'm sorry?

Member Ziemer: Can you remind us where Metals 

and Controls is?

Mr. Katz: That's in Massachusetts.

Member Ziemer: Okay.

Mr. Katz: Yes.

Member Ziemer: Is it Boston?

Mr. Katz: Attleboro. No, it's not Boston, but it's 

actually closer, I think to -- what's the city below, the 

state below -- Rhode Island. Providence.

Mr. Rutherford: Yes, but, Ted, Burial Grounds will not 

be ready because there's some workers' interviews 

that are scheduled the first week of June. So, I do 
119

not expect that to be ready.

Mr. Katz: Okay. Well, that's good to know.

And then is there utility -- will there be utility in 

getting input at the Board meeting for Burial 

Grounds?

Mr. Rutherford: I think the worker interviews are 

already set up. So, I don't --

Mr. Katz: All right. All right. Thanks. That's helpful.

Josie?

Member Beach: I'll just vote for Metals and Controls 

now, simply because we haven't been there. We had 

quite a bit of petitioners that were very active at the 

last meeting, when the first report came out.

Mr. Katz: Thanks, Josie. Other thoughts?

Right, that's California. That's LA area. Sandia is New 

Mexico. Yes.

So, other thoughts from Board Members about these 

sites or another?

(No response.)

Mr. Katz: All right, then. So, the one place --the 

ardent request I've heard is Josie's for Metals and 

Controls in Massachusetts. So, that's a good 

possibility. Like I said, I'll communicate with you all 

by email as we go along with these.

Anything else?

(No response.)

Mr. Katz: Okay. Okay. Moving on, then, scheduling. 

We have to schedule -- this is for next year, but, 

believe it or not, this is time to do those.

We need a teleconference February of next year, and

the approximate right timeframe is the week of 
120

February 24th. So, if you can look at your calendars 

for that? That's a teleconference again. We usually 

do it in the middle of the week, but it doesn't have to 

be in the middle of the week.

So, that would be -- if we do the typical Wednesday, 

that's the 26th of February. Any conflicts there? Or, 

the 27th, okay. That's next year? Okay. Yes, the 27th 

-- I was corrected -- is Wednesday. Yes, that's the 

usual.

Is that good with everybody? It sounds like it. I 

haven't heard any objections. Okay. Let's settle that. 

So, February 27th, next year, teleconference.

And then, for a meeting, the approximate right 

timeframe is the week of April 15th, you know, give 

or take a week or two. It's better to add than to 

subtract on that.

First of all, how are we doing? I know Josie has a 

conflict. She'll be away. But the week of April 15th, 

how is that for others? Usually -- I mean, our first 

preference is Wednesday-Thursday probably. Well, 

you have to get them done by April 15th already. So 

-- yes, so you'll be okay with that, I hope? Right, well 

it is that week, and it wouldn't be the April 15th 

anyway. Anyway, the Wednesday-Thursday --

whatever numbers those are, 17-18 of April next 

year. Any problems with those dates?

(No response.)

Mr. Katz: Going once. Going twice. Sold. All right. 

Okay. So, April 17-18, 2019.

Okay, thank you. That was quick.

All right. Let's go to Work Group/Subcommittee 

reports. And we can just run these alphabetically. 

Some of these -- a lot of these will be very quick 

because there hasn't been work in the interim.

Ames?
121

Member Kotelchuck: Nothing.

Mr. Katz: Right. Argonne-East, Brad?

Member Clawson: We've got a little bit of an update. 

They've been working on some of the issues that 

they've been coming across. I had one paper that's 

come out on there from NIOSH. And we're just slowly 

working.

Mr. Katz: Thanks, Brad.

Blockson, Wanda?

Member Munn: We have nothing scheduled. We do 

anticipate meeting sometime in the next -- probably 

a month or so from now. We have new material to 

take a look at, but we haven't scheduled yet. So, 

you'll be hearing from us probably in the next couple 

of weeks --

Mr. Katz: Right.

Member Munn: -- with respect to a time certain.

Mr. Katz: Thank you. That sounds good.

Brookhaven, Josie?

Member Beach: No change. Just waiting for the 

external -- I believe it's the external TBD that's due 

in September.

Mr. Katz: Right. Carborundum is Gen. There's no 

update there. Okay.

The next is the Dose Reconstructions Review 

Methods. Dr. Melius was Chair of that. And that's 

going to wait, and there's been no action since the 

last meeting on that.

The next is Fernald. Brad?

Member Clawson: We've still got some outstanding 

issues. I believe there's some responses from SC&A. 

Is that correct, John?
122

Mr. Katz: Wait. They can't hear you. You're not at a 

microphone John.

Mr. Stiver: At our last Work Group meeting we had 

some concerns about one of the issues, which was 

the recycled uranium default values for the '61-to-'72 

timeframe. And we have prepared some preliminary 

numbers on that, but we didn't really have time to 

complete that memo. So, we need to get that finished 

up.

And, let's see, I think there was also the issue NIOSH 

had for looking into air sampling data. I think that's 

what it was. Yes, excuse me, yes, the raffinates. This 

will be the uranium poor and the uranium poor 

raffinates. And I believe that was about it, wasn't it? 

Yes.

Mr. Katz: Okay. So, yes, moving on from there --

thank you.

Grand Junction, Bill?

(No response.)

Mr. Katz: Bill Field was down to one bar when we 

heard from him last on his internet connection or his 

battery; I'm not sure which.

Grand Junction, there hasn't been any action, I can 

tell you that. So, we can move from there.

Hanford is another one. Dr. Melius was Chair of that. 

Brad's been on that Work Group a long time. I can, 

more or less, tell you I think the materials for that --

there's been a lot of work over a lot of time, and that 

work has been all organized well in terms of the 

issues that are needing to be resolved and the status 

of those. That was all done some time ago. So, I think 

we're probably pretty close to ready to a Work Group 

meeting to address all of that and get up-to-speed.

And then there is an SEC at Hanford still, and there's 

still some work to sort it out, as to finish that out. But 
123

it's largely finished out, the SEC matters at Hanford. 

I think there's a small window still to be addressed. 

Is that correct, Brad?

Member Clawson: Yes, that's correct. We also had a 

new NIOSH person come on, and they've kind of had 

to get up-to-speed and go on from there.

Mr. Katz: Right, a new NIOSH staff person lead for 

Hanford. 

So, we could see a Work Group meeting, I think, 

before August on Hanford, and we'll have a new 

Chair, too, for that Work Group.

INL -- we already heard from LaVon about INL 

matters.

Phil, is there anything you want to add?

Member Schofield: Yes. We're going to need a Work 

Group meeting before August.

Mr. Katz: Oh, absolutely, that makes sense. Okay, 

Work Group meeting there.

Lawrence Berkeley, Dr. Ziemer?

Member Ziemer: No action.

Mr. Katz: All right. And then, LANL, Josie?

Member Beach: So, you heard from LaVon we're 

expecting a paper talking about the post-1995 cutoff 

period, answering SC&A's memo. So, we expect that 

by the end of April.

And then, the Work Group, some of us did go out and 

do some interviews in March. We heard from a group 

of workers, the County workers that aren't 

consistently being represented for dose 

reconstruction. And so, we interviewed several of 

them.

LaVon might be able to add to this, but we're going -
124

- giving information to Denise, trying to sort out how 

that's going to be affected for those later years also.

Mr. Rutherford: Yes, I mean, it's a Labor issue. What 

we're trying to do is to provide the information that 

we get to Labor.

And also, I've gotten Denise onboard, and she's 

looking into the claims that have been accepted that 

were Los Alamos County workers and trying to 

understand what -- she's going to talk with the claims 

examiner to understand why some were accepted 

and some weren't.

We're also providing the interviews. Once we have 

finalized the interviews, we're going to provide those 

to Labor as well, and we'll go from there.

Member Beach: Thank you.

Mr. Katz: Thanks, LaVon and Josie.

Metals and Controls, we've heard from from Josie, 

and we have a Work Group meeting scheduled for --

Member Beach: May 3rd.

Mr. Katz: -- May 3rd. And then, we expect that to be 

on the agenda for August, and maybe we'll be out 

there.

Mound, Josie again.

Member Beach: Nothing to report there.

Mr. Katz: All right. And Nevada Test Site, Brad?

Member Clawson: There's nothing to report right 

there from the last time.

Mr. Katz: I think we -- SC&A should be about 

wrapping up, right? Or are we waiting on -- yes, are 

we waiting on something from DCAS as well? Okay. 

All right. Very good. So, we could have an NTS Work 

Group meeting then coming up.
125

Member Beach: Ted, sorry, I did forget. We are 

waiting for the external, which is due in September 

of 2018 for Mound.

Mr. Katz: Ah, okay. 2018, you said? Okay, very good.

ORNL, Gen?

Although we're going to be hearing extensively --

Member Roessler: You're stealing my line.

(Laughter.)

Mr. Katz: Go ahead.

Member Roessler: I was going to say, we have been 

hearing for some time, a number of meetings, that 

we would soon have an update. And in less than an 

hour, we're going to get that update.

Mr. Katz: Sorry about that, Gen, and thank you.

Pacific Proving Grounds, that's Jim Lockey.

Member Lockey: I mean, all the findings and 

observations are closed. We're waiting for NIOSH to 

look at that 95-percent confidence rule in relationship 

to the dosimetry. And that will be done by the end of 

this month, I understand.

Mr. Katz: Right. So, that is another Work Group 

meeting coming up. That will be another Work Group 

meeting coming up.

Member Lockey: We can probably handle that by 

phone.

Mr. Katz: Yes, absolutely.

Member Lockey: Yes, right.

Mr. Katz: Yes, yes, a teleconference.

Okay, Portsmouth, Paducah, K-25, Phil?
126

Member Schofield: Nothing.

Mr. Katz: Rocky Flats?

Member Kotelchuck: Nothing new. 

LaVon, though, you have been looking over some of 

the materials at LANL.

Mr. Katz: Thank you, Dave.

And Sandia we've already heard about.

Santa Susana Field Laboratory, Phil?

Member Schofield: With the new stuff coming out in 

De Soto and stuff, I don't know if we'll be ready to 

have one before August or not. And they kind of tie 

together, De Soto, and Santa Susana; there's a lot of 

intermesh between people there.

Mr. Katz: Well, NIOSH, do we have a sense for when 

-- aren't we producing some work for Santa Susana?

Dr. Hughes: So, yes, NIOSH -- it was the Work 

Group, some smaller reports on the issues that were 

remaining from the last Work Group meeting. I'm not 

sure if it's going to be with the Work Group before 

August. The effort has been slowed down a little bit 

because of other upcoming efforts, such as the De 

Soto SEC evaluation, which is on a tighter schedule 

at the moment. So, it's just we had to kind of reshuffle a little bit.

Mr. Katz: Thank you. Thank you, Lara and Phil.

Okay, let me just repeat that for her. For Santa 

Susana Field Laboratory, there is some work to be 

done by the NIOSH program. That's underway. It has 

been a little bit delayed because of the De Soto SEC 

petition, which is under a more rigorous timeframe. 

So, the same people working on both of those issues, 

so -- both of those facilities. So, that won't 

necessarily be ready before the August meeting, for 

our Work Group meeting.
127

Savannah River Site?

Member Clawson: We've been doing quite a bit with 

it. We've still got a -- we're still trying to work on 

coworker data. And as everybody remembers, we 

had -- Tim had found a bunch more documentation. 

We're trying to cover a certain area that we're trying 

to place. He's getting ready -- from the email that I 

got on Monday, that he's coming to us with a 

sampling plan for the 850 boxes, I guess, that they 

found. So, we're proceeding forward.

But I do have some issues from Savannah River of 

some items that we've kind of stepped over, the 

thorium. Can we task SC&A with that, to be able to 

finish up those reports?

Mr. Katz: We can. There are several reports there 

that Joe had indicated where really they could move 

forward on and that were relevant for the SEC 

petition. And absolutely.

Member Clawson: Okay. So, John, you've got -- you 

sent me that list. And also, we need to -- we kind of 

put those on the back burner -- we need to bring 

those up.

Mr. Katz: Thank you, Brad. That's good.

Science Issues, we heard from from Dr. Richardson. 

I don't think there's anything else to add. No? Thank 

you.

SEC Issues Work Group, that also was chaired by Dr. 

Melius. That Work Group has some work to do, but 

it's not pressing and I would prefer to wait until we 

have a Chair there before moving forward.

The Subcommittee on Dose Reconstruction, Dave?

Member Kotelchuck: Well, we started on the -- at our 

last meeting in March on the blind cases for Set 24. 

And at our next meeting, which is on July 24th, we're 

going to finish up the blinds for that set. And we're 
128

working actively on Sets 19 through 21. It's a little 

bit of a time span between our last meeting and our 

next one, but a lot of us are tied up in June and July. 

So, we can't meet until late July.

Mr. Katz: All right. Thanks, Dave.

And I will also add, in the meantime, SC&A is also 

working through a new set of dose reconstruction 

reviews to add to the work.

The Subcommittee on Procedure Reviews, Wanda 

just reported extensively out on some completed 

items, but, Wanda, do you have more to add about 

work ahead?

Member Munn: I am sorry, I was so busy with my 

cacophony over here that I'm not even sure where 

we are. Are we on Procedures?

Mr. Katz: We're on Procedures, yes.

Member Munn: We're on Procedures?

(Laughter.)

Member Munn: We have a few, but we do not have 

enough for us to schedule another meeting at this 

time. So, I have no activity since my last meeting, 

and we are uncertain yet of exactly when we're going 

to be scheduling. It will probably be before the 

August meeting, but not in the immediately 

foreseeable future.

Mr. Katz: Yes, that makes sense. Thank you, Wanda.

TBD-6000 Work Group?

Member Ziemer: The TBD-6000 Work Group has had 

no activity since our last meeting.

Mr. Katz: And I don't know if Andy -- Dr. Anderson is 

on the line, but the Uranium Refining AWEs Work 

Group.
129

(No response.)

Mr. Katz: Okay. I can tell you. There are some items 

for that Work Group and it probably will be having a 

Work Group meeting somewhere between now and 

August. There's some work that's ready to be 

discussed.

Okay. So, the next one is the Use of Surrogate Data. 

That's Dr. Melius. It does have one small item to 

address, but, again, that Work Group will need a 

Chair.

Weldon Spring, we heard them report out on the last 

of their work, and we know about the follow-up that's 

going to come on that.

And that's the list. So, that's it for the Work Groups 

and the Subcommittees.

So, finally, what we have is public comments from 

the December Board meeting to run through. Let's 

see how we're doing on time here.

Okay, I need to pull up those comments. One sec.

All right, then, I will run down these comments for 

everyone. And, please, Board Members, stop me 

wherever you would if you have questions. And I'll 

try to go through these fairly quickly. 

Okay. We had several comments on Sandia. And 

those were all responded to in real time by Dr. Melius. 

So, those are taken care of.

Let's see. Sorry, my computer is stopping on me.

Okay. We have a Los Alamos comment, and this has 

to do with the petitioner at Los Alamos being 

concerned about the use of a White Paper in dose

reconstruction. And NIOSH has gotten back to the 

petitioner on that matter. NIOSH isn't intending to 

use that White Paper in the way that the petitioner 

was concerned about. So, I think that sounds 

appropriate.
130

Okay. We had comments about CLL, and particularly 

about CLL being included on the list of specified 

cancers. And I addressed that, and I communicated 

with the Board about that matter as well. They're well 

familiar and agreed with the matter there, which is 

the specified cancers are set by statute, and they will 

only be changed by statute as a result. And I've 

communicated with the party who raised the issue as 

well.

Member Ziemer: A question, Ted, on that one.

Mr. Katz: Yes.

Member Ziemer: Is that information from that 

individual -- has that been sent forward to anyone in 

CDC or HHS that might have a role in updating the 

legislation?

Mr. Katz: Well, there isn't -- I mean, again, that's not 

an HHS issue. That's a legislative issue. And it's --

no, there's not going to be lobbying by -- at any point 

in the HHS structure on the legislation.

Member Ziemer: I'm not suggesting we lobby on it.

Mr. Katz: Yes, I know. I mean -- but yes. So, no, that 

hasn't gone forward beyond NIOSH to HHS, that 

matter.

Okay. And then, we have a comment on the 

Savannah River Site -- which LaVon has responded 

to -- related to the critical mass lab about 

characterization of waste. And LaVon basically 

explained that that matter had been thoroughly 

vetted already -- which is true -- by the Board.

Okay. There's a comment about Ames Lab, about the 

discussion we had in the December Board meeting 

about Ames. And this is a standard thing. The Board 

Members often ask about the number of claimants at 

a specific SEC site and, in particular, who might be 

included in a class. The Board is often interested in 

what the scope of that class might be.
131

And the commenter was commenting that the 

number is not -- shouldn't be relevant to the 

evaluation of an SEC petition. And it -- the number 

of claimants that could come with a class is not 

relevant for evaluating -- it doesn't affect how we 

evaluate those petitions. But it is relevant for the 

Board to know because the Board has to set priorities 

in how it does its work. It may have a class of 500 

and a class of 2,000 -- or what have you -- and a 

class of 10. And so it has to -- in terms of priorities 

of what comes first, it has to move the items that 

have a bigger impact, generally speaking. Of course, 

there are lots of other factors that matter too, how 

long something has been waiting, and so on. But it's 

not an irrelevant matter, and it's also just a matter 

of interest as to what kind of impact is the Board 

potentially having here, although it doesn't change 

how any SEC Class is evaluated.

Then, let's see, we have several comments about --

well, we have comments provided to someone's 

concern that NIOSH changes its dose reconstruction 

methodology without going through a regulatory 

notice and comment. And the person commenting is 

-- believes that that's not allowable, that it requires 

rulemaking, but this program was designed 

specifically to allow us to update our methods without 

having to go through rulemaking. You can imagine 

how that might work to update our dose 

reconstruction methodology.

Okay. We had questions about Sandia, what we were 

awaiting. Those were responded to in real time by 

LaVon. The question was about what documents 

were we awaiting to move on with the SEC. Anyway, 

that was covered.

Let's see. Okay. We have a question regarding 

General Steel about the PER-80 and SC&A's review. 

SC&A has that review underway. It should be 

completed fairly soon, I think.

Okay. We have several questions. We have questions 
132

related to Dow, Illinois, and Rocky Flats, a part about 

magnesium-thorium shipments potentially. And 

LaVon has responded to those. That all looks 

appropriate, and about the number of boxes of 

records were captured also been responded to.

Okay. For Santa Susana, we have a number of 

questions about americium and thorium, the 

reconstructability of those; about proving work 

location for people in Area IV; about Boeing's 

behavior related to claims and claiming, and verifying 

employment -- okay, about americium and thorium 

locations and about log records. All these, a whole 

series of questions, Lara Hughes has responded to 

these in March. These all look appropriate.

And that's it for public comments. Do I have any 

questions?

(No response.)

Mr. Katz: Okay, then, so we don't have any 

correspondence to discuss. That takes us up to the 

Oak Ridge facilities update, which begins at 4:15.

So, it's 3:54. So, you have another short break, a 

comfort break. Let's be ready, though, at 4:15, and 

we'll go into the Oak Ridge facility update and, then, 

follow with the public comment right away after that.

Thank you.

(Whereupon, the above-entitled matter went off the 

record at 3:53 p.m. and resumed at 4:16 p.m.)

Oak Ridge Facilities Update

Mr. Katz: Okay. Now we have an update on the Oak 

Ridge facilities, covering them all, by Dr. Lara 

Hughes. We will follow that by a public comment 

session. I'll have some brief remarks to make for the 

public before the public comment session. That will 

go really quickly. So, folks from the public, please 

hang in there and be ready following Lara's session. 
133

Thanks.

Dr. Hughes: Thank you, Ted and the Board.

Can you hear me okay? Okay.

This is the Oak Ridge facilities update. I'm going to 

try to update you on the status of all Oak Ridge 

facilities -- there are eight covered facilities -- in less 

than 45 minutes.

The currently active sites that I'm the lead for are 

ORNL and Y-12. There is some SEC-related work 

going on, and the work is -- currently the NIOSH 

contract overall person that's working both efforts is 

Joe Guido, and he has done a very good job at pulling 

a lot of information together. I would just like to 

acknowledge their contribution to all of the ORNL and 

Y-12-related information that is presented.

So, the current Oak Ridge ER facilities, let's start with 

ORNL/X-10. It is covered from 1943 through present. 

There's currently an SEC from 1943 through the 

middle of 1955, and there are a little over 3,600 

claims as of mid-March.

Y-12, also covered from the early '40s to the present, 

there's also an SEC from the beginning of nuclear 

operations through the end of 1957, and there are 

over 6,000 NOCTS claims in the NIOSH claims 

database currently.

K-25 is also covered from 1943. The operational 

period ended in 1987, and there is a remediation 

period from 1988 through the present. The SEC 

period is from '43 through February 1st, '92. This was 

a congressionally established SEC. There are close to 

4,000 claims at NIOSH for K-25.

CEW is Clinton Engineer Works. It's a covered site 

from 1943 through 1949, and there's an SEC period 

for that period. There are 64 claims at NIOSH.

The Oak Ridge Institute for Science and Education is 
134

covered from 1946 through the present, and there is 

an SEC from May 15, 1950 through December 31st, 

'63. There are 101 claims at NIOSH.

I will get a little bit more into detail on the SEC status 

of those sites.

Oak Ridge Hospital is covered from 1943 through 

1959, and it is an SEC from May 15, 1950 through 

December 31st, 1959. There are 51 claims.

Okay. Oak Ridge Hospital, there are 26 claims at 

NIOSH at the moment.

OSTI is covered from 1957 through the present, and 

there is currently no SEC period. There are 51 claims 

at NIOSH.

And lastly, S-50, the Thermal Diffusion Plant, covered 

from 1944 through 1951, and is also an SEC period 

for its entire operational period. And there are 43 

claims at NOCTS.

This is a map of the Clinton Engineer Works from the 

early 1940s. On it, you can see the entire Oak Ridge 

area that is covered under -- CEW is the outline that 

is presented here. And within this area you can see 

listed Y-12, X-10, K-25, S-50, as well as the City of 

Oak Ridge that is listed in the upper right corner. And 

in the City of Oak Ridge are several covered sites 

located, such as Oak Ridge Hospital, OSTI, and 

ORISE.

So, back to Clinton Engineer Works. That is a covered 

site that is essentially what I just showed you. 

Everything inside the fence is a 59,000-acre federal 

government area. This is a covered site. When we did 

an SEC evaluation, we determined that the exposure 

potential was limited to a warehouse area near the 

Elza Gate.

Now the Clinton Engineer Works is essentially 

everything in Oak Ridge but the plant. So, there isn't 

a lot of nuclear material or radiological operations 
135

going on. However, there was this storage area near 

the gate that was a collection of warehouses where 

they stored uranium ores and residues in barrels and 

that were handled there. So, this is the area that was 

added to the SEC -- or that was what caused the SEC 

evaluation. This evaluation was done in 2012, and 

the infeasibility is internal and external exposure to 

uranium-bearing ores.

K-25, the Oak Ridge Gaseous Diffusion Plant, did 

uranium-235 enrichment, processing, and recycling. 

The SEC is congressionally established.

The Oak Ridge Institute for Science and Education, 

ORISE, is a scientific research institute operated by 

ORAU. This was evaluated for an SEC, the ORINS 

Cancer Research Hospital. The evaluation percent 

was presented to the Board in 2006, and the 

infeasibility here is the internal dose from nuclear 

medicine handling. They developed -- they used the 

ORNL-produced isotopes to treat cancer and various 

other ailments at this hospital in Oak Ridge.

Oak Ridge Community Hospital is also a covered site. 

It is also an SEC. This was evaluated in 2009. And 

the infeasibility is the same as for the ORINS Cancer 

Research Hospital, internal/external exposure from 

nuclear medicine operations. These two facilities 

were essentially attached to each other. So, the 

ORINS Cancer Research Hospital used the Oak Ridge 

Hospital facilities such as kitchen, the morgue -- not 

the laundry, but various other facilities.

The Office of Scientific and Technical Information, 

OSTI, is a federal repository for DOE technical 

reports. There is no SEC Class. There was a petition 

submitted, but it did not qualify for evaluation. And 

this is the facility that was not associated with 

radiological work.

The Oak Ridge Liquid Thermal Diffusion Plant also 

was another version of the uranium enrichment 

facility. It was adjacent to K-25. It was shut down 

after the war and later did some work on nuclear 
136

energy for the propulsion of aircraft. There was an 

evaluation presented to the Board in 2006, and it has 

an infeasibility of internal/external exposure to 

uranium and other unknown radionuclides.

So, that leads us to the current effort. Oak Ridge 

National Laboratory, as I mentioned, currently is an 

SEC through the middle of 1955, and the infeasibility 

is based on internal exposure to uranium, mixed 

fission products, and thorium.

Y-12 also has currently an SEC ending in December 

1957, and the infeasibility is based on internal 

exposure to thorium and cyclotron-produced 

radionuclides. Ongoing work has identified a potential 

infeasibility to reconstruct doses from plutonium-241 

from calutron operations at Y-12. This was an ORNL 

effort at Y-12. So, there is a certain amount of 

overlap between the sites. And at Y-12, we are also 

working on evaluation of thorium exposures from 

thorium operations that started in the 1950s.

So, let's go back to SEC 189, the ORNL, the current 

-- or the evaluation that established the current 

ORNL Class. This is the summary slide or the 

summary table from this Evaluation Report. As you 

can see, so the top row is the year. And on the very 

left column, you have the internal sources. So, we 

identified the periods where there is no internal data 

available for uranium, thorium, and fission products. 

You can see that the infeasibility period ends in the 

middle of 1955. That's why the current SEC ends in 

1955. And at the bottom you see the yellow section 

of the table. It says, "Reserved for joint ORNL, X-10, 

and Y-12 for evaluation." And that is what we just 

last week presented to the Work Group in the form 

of ORAU Report 90.

Now this is listed for a time period from 1943 through 

1955. But, since we already have an established SEC 

Class from the middle of 1955, we start from there. 

We start in the middle of 1955 and go on after that.

So, a little bit to ORNL history. The photograph is the 
137

graphite reactor from a while back, I suppose. Those 

of you who went to the tour got to see it yesterday, 

which I thought was really cool. So, that was the 

graphite reactor that was used for -- that was a pilot 

plant used for initial plutonium production. After the 

war, ORNL supported the civilian nuclear power 

program development, different reactor 

configurations. They did nuclear fuel reprocessing, 

research and development that involved various 

methods of dissolving irradiated fuel and separating 

out the plutonium and uranium.

And another large part of ORNL history is the isotope 

production. They produced and sold radioisotopes for 

research and medical uses. Some of those were 

produced in the reactors. Some were produced at Y12 using calutrons. And there were numerous 

facilities doing separation, packing and shipping of 

those radioisotopes.

This photograph is a -- I think it's dated from the 

1940s, but it shows some workers removing some 

medical isotopes on this little cart from one of the 

reactor ports.

Additional ORNL history -- ORNL has just such a long 

history and so many different things they do, it's very 

difficult to give a brief overview. They are involved in 

fusion energy programs, development of renewable 

energy methods, fossil energy program, basic 

physical sciences research, biomedical and 

environmental programs, waste management, space 

and defense technologies, artificial intelligence, 

parallel computing, and education.

This is an aerial view of the ORNL campus. It seems 

to be fairly modern-day. I don't have a date for it.

So, let's go back. To value the -- what we call exotic 

radionuclides, that is the radionuclides that are 

produced in the isotope production program.

Ms. Lin: Dr. Hughes, hi. I'm sorry to interrupt, but 

the microphone really is not coming through. So is 
138

there any way that you can make sure that you're 

speaking directly into the microphone or get another 

one?

Dr. Hughes: Okay. I am right in front of the 

microphone. I can try to speak up a little bit.

Ms. Lin: Yes, this is perfect.

Dr. Hughes: Okay.

Ms. Lin: You're coming in loud and clear.

Dr. Hughes: All right. So on the left, this graphic is a 

schematic of the ORNL Isotope Production Division. 

There's X-10 and Y-12 involved. So the production 

part of this endeavor is at X-10 in the form of the 

graphite reactor and at Y-12 in the form of cyclotron 

calutrons.

Then on each side you have labs that do the chemical 

separations. And the end use is either onsite or 

offsite. You can see all these arrows going in 

between. So you have certain things that are 

produced at Y-12. They're separated at ORNL. They 

might have been used onsite or offsite. There's a 

fairly large overlap between the two sites for this 

program.

This graphic on the right is a cutout of an early ORNL 

map. The circled area, at the top the circle is the 

graphite reactor. At the oval, what's called the 

isotope circle, is a collection of smaller facilities that 

were used for chemical separation of the isotopes. 

And the reason they had several smaller buildings, 

they tried to keep things separate because you don't 

want any cross-contamination between those 

isotopes that you're selling.

As for the isotope production at Y-12, that was done 

in the beta calutrons. Those calutrons were initially 

used for uranium separation. They were not used for 

that anymore because that effort had shifted to K25. So they used some of the beta calutrons for 
139

plutonium separation starting in 1952. The 

separations were done in glove boxes in Building 

92043. And they used eight of those calutrons for 

various isotope separations starting in 1952, not '62.

So to evaluate the -- whether those exotic -- if there 

is a dose reconstruction infeasibility from exotic 

radionuclides, we started looking at the ORNL 

bioassay data. We have a database from ORNL that 

has over 100,000 results in it from the period of 1949 

through 1988. Almost 95,000 results from 7,500 

individuals are available from the period for 1955 

through 1988. There are 62 different analytes as well 

as a Code 000 for nonstandard methods.

We know that this database is incomplete, but we 

also know it's not inaccurate. So we know not 

everything is in there, but it has a large number of 

the bioassay records in it, and it's a good source to 

look for the various methods and what's available. 

We know that gross beta is missing from 1955 

through 1959.

We also have NOCTS bioassay data, over 20,000 

results from 1955 through 1988. This bioassay data 

has been extracted and tabulated for a potential 

coworker approach. And so a comparison of those 

two leads to a sample ratio average of 1.13. What 

that means is, for any given worker, we compared all 

available worker data. And it turns out that the 

NOCTS bioassay is a little more complete. So we 

already knew that the ORNL bioassay database is 

somewhat incomplete, but there's only a few samples 

missing.

There's also in vivo data from ORNL, whole body 

counts for gamma emitters. That program started in 

1960 and saw a slow ramp-up and program 

optimization. We think that routine operations 

started in 1963, such as baseline and recurring 

counts of potentially exposed persons. And they 

ended up with a system capacity of over 100 persons 

per month.
140

They had a selection criteria that are presented in the 

report on who got to have a bioassay or an in vivo 

count. This was determined by area health physics. 

So they did baseline, termination, quarterly, and 

semiannual counts.

So after doing a tabulation overview of the available 

bioassay data, we do a radioisotope inventory list. 

We look at isotope shipping and sales reports, all the 

operational and technical report series, logbooks, 

ORNL and Y-12 related holdings in the SRDB. There 

are currently over 15,000 documents.

And then what we did, we developed a table, and that 

is Table 6.3 in ORAU Report 90. That was presented 

to the Work Group last week. We ended up coming 

with a table, an inventory list of 213 radioisotopes. 

This does not include service irradiations. That means 

that we do not include -- there might have been other 

entities that brought radioisotopes to ORNL for 

irradiation and, then they took them back. They were 

not separated out on the site. So that's not included.

This table could not fit into this presentation. It 

essentially starts with, you know, hydrogen ends with 

fermium-257, and then the number of years in which 

this radionuclide was produced.

So after that, we compare annual production history 

of those 213 nuclides to the available bioassay 

methods for each year. We look at the characteristic 

radionuclide emissions, such as type and energy; the 

analytical method sensitivity. We did not reconcile 

the quantity of radionuclide with the frequency of 

monitoring method. This means we did not look at 

how much was produced per year and how many 

data-points do we have in the bioassay database. We 

also assumed that, once an adequate method was 

indicated, it was assumed to be available in the 

following years, whether or not we see any data 

available in the bioassay database. A gap is defined 

as no monitoring results for other years of interest.

So we come up with this table. This is also, again, 
141

this is an excerpt. This is a very large table spanning 

several pages.

At the top row, you have the years, 1955 onwards. 

At the very left column, you have the radionuclide. 

So the column -- each individual cell is color-coded. 

Green means the radionuclide was present, and the 

bioassay method is available, and we have sample 

results available. Yellow means the nuclide is 

present, a bioassay method is present, but we do not 

have any samples recorded in the database. N means 

this radionuclide was not present in the specified 

year. And red means the radionuclide is present, but 

no method was identified, and further analysis is 

needed.

So we did this for all 213 radionuclides on the 

inventory. So 34 radionuclides were identified to 

need additional research. Six of those are iodine 

radioisotopes for which we suggested a dose 

reconstruction method that I will talk to in just a 

minute. The remaining 28 have short half-lives; 22, 

less than a year and decay mostly by electron capture 

and isomeric transition.

So in order to assess the dosimetric significance of 

those, we estimated an intake of 10 to the minus 5 

of the listed inventory quantity for each. I'll try to 

explain that a little more simply. We assumed that 

any given person that would handle this could 

potentially inhale this fraction of the inventory. And 

then we calculated the 50-year committed organ 

dose to the highest organ from this radionuclide. We 

also compared this to the action levels of workplace 

monitoring and postulated that dosimetrically 

significant intakes were not likely.

This is what this table looks like. These are the 28 

radionuclides and the specified organ. ET stands for 

the extrathoracic region. BS stands for bone surface. 

As you can see, the doses are fairly small, relatively 

speaking.

So next, addressing the ORNL iodine production. 
142

Iodine was produced for commercial applications 

since 1946. Since 1958, this was done through 

separation from reactor fuel. The production years, 

1946 through 1964. The quantity of production 

ranged from 1.3 to 3,600 curies per year.

There was limited personnel monitoring data during 

that time. They did some thyroid monitoring from 

1944 through 1954. In addition to that, workplace 

controls were available. The separations area was 

3,000 -- 3026D, and 3028, but exposure is possible 

wherever reactor fuel was processed. They started 

whole body counting for iodine in 1961.

Looking at the available thyroid count data for 

chronic and acute exposures at ORNL, we developed 

this graph. The black line indicates the chronic 95th 

percentile data, developed from data from 1943 to 

1957. And this was done to address the gap starting 

in 1957 until the early 1960s. As you can see, 

whereas the acute doses are fairly high in the 1940s, 

the chronic 95th percentile can be used to bound 

doses for the later period from the mid-1950s on. 

This intake, this 95th percentile intake, from the 

1943 to 1957 data, is 5.4 times 10 to the 5th 

picocuries per day. And it is suggested as a dose 

reconstruction method to assign this intake to 

unmonitored workers from 1955 to the onset of full 

body counting for iodine.

Okay. That was the current effort for ORNL. This is 

basically the contents of Report 90.

So let's switch over to Y-12, a little bit of the history. 

Typically, we talk about different eras of the Y-12 

history. So the first period from 1943 to 1946, the 

focus was on uranium isotope separation using 

calutrons. The second era, from 1947 to 1992, 

manufacturing of Cold War nuclear weapon 

components, produce and testing key components of 

nuclear weapons, stockpiling highly enriched 

uranium, and technology development for new 

weapons designs. The third era, post-1992, consisted 
143

of multiple new missions such as storing highly 

enriched uranium, continued weapons parts 

production on a smaller scale, D&D, and 

environmental and waste management.

Our current focus is on the thorium operations at Y12. The thorium processing operations that are of 

concern for this effort started in the early 1960s. 

There was an arc-melting process of thorium 

electrodes. The metal from these meltings was pressrolled and machined. Radium and its progeny are 

volatilized during this process.

Process controls, air sampling, and in vivo counting 

were available. The detailed process information is 

classified.

Currently, we are researching the end date of this 

thorium processing information, and we're looking at 

the in vivo and air data for dose reconstruction.

This is an aerial photograph of the Y-12 campus. I 

think it's a little older.

So the issues we're looking at with Y-12 concerning 

the in vivo and air data. The in vivo data, the thorium 

results that we have for the in vivo are reported in 

units of milligram of thorium. In order to use this for 

dose reconstruction, we need calibration and 

count/channel data to assess intakes from these in 

vivo results. There's an issue with the thorium chain 

disequilibrium and whether or not inhaled thorium 

would have actually been picked up by the in vivo 

count.

As for the air data, we have general air, breathing 

zone, and operational data available. The majority is 

general air data. The Y-12 thorium air sample 

database has some issues with data pedigree and 

completeness. And the breathing zone data are not 

sufficient for intake, to develop an intake approach 

for all years.

So the path forward for ORNL and Y-12, we have not 
144

identified an obvious internal DR infeasibility from 

exotic radionuclides. However, the evaluation of that 

is sure to continue. The ORAU Report 90 was 

delivered to the ORNL Work Group, and I'm sure it 

will be discussed in detail in a Work Group meeting.

We're looking at a potential plutonium-241 

infeasibility. This is an ORNL effort that was done at 

Y-12. So we assumed there's an SEC evaluation for 

Y-12 moving forward. Since SECs are determined by 

site, not by operator, it would be an SEC for Y-12.

And we'll continue to look into the thorium DR 

feasibility. We'll continue with data capture to collect 

more information on thorium operations, and any 

potential thorium infeasibility would be an SEC issue.

And that's it. Questions?

Mr. Katz: Thank you. Thank you, Lara. That was a 

very rich presentation for the amount of time you had 

to work with.

Questions from Members here in the room? Gen?

Member Roessler: Mine is a comment. The report 

that Lara talked about that some of us got this week 

looks pretty formidable. It's very long, but I know the 

Work Group will read it, and I recommend everybody 

else reads it. It's very well-organized, and it's very 

well-written. So it certainly isn't as bad as it looks. 

Plus, most of it is tables. So I recommend you take a 

look at it.

Mr. Katz: Thanks, Gen.

Josie?

Member Beach: I just have a question. Is there a 

Work Group scheduled? I know you're probably going 

to report for Oak Ridge. Is there one coming up?

Member Roessler: No.

Mr. Katz: David?
145

Member Richardson: Thank you very much. I liked 

and appreciated the approach that you've taken with 

making this radioisotope inventory list, but I had a 

question about it.

My understanding, if I heard what you said correctly, 

was that the list was enumerated from sources such 

as isotope shipping and sales reports. I guess the 

clarification I'm looking for is, is this list intended to 

be a subset of those to which workers may be 

exposed? That is, those isotopes which were 

intentionally produced, those which are a product, as 

opposed to other isotopes which, when you begin 

working with reactor fuel, may occur, but were not 

the targets intended to be generated, and which 

would not appear on a shipping inventory list?

Dr. Hughes: No, it's my understanding that we looked 

at logbooks, and it's not solely shipping and 

production, but it's anything, separation from the 

fission product facility. So not necessarily only 

commercial radionuclides.

Member Richardson: So now the list would include 

those which were intentionally produced or those 

which were monitored for? And is there still a set of 

things which one might be exposed to which would 

not have been routinely monitored? I know that some 

of the things, which maybe on the bioassay program 

just have names like fission products.

Dr. Hughes: Yes, I'm not sure. I mean, this should 

cover most of it. So this is the produced, everything 

that was produced for this program as well as any 

other information that was available in logbooks or 

the various series of ORNL reports. This is in addition 

to the previously evaluated material that addressed 

mixed fission products, thorium, and uranium, and 

plutonium.

Mr. Katz: Other questions? Any questions from Board 

Members on the phone?

Oh, I'm sorry. Josie?
146

Member Beach: I don't see that report. Did that get 

sent out to the whole Board or just to the Work 

Group?

Dr. Hughes: It's also available on the NIOSH website 

now, yes.

Member Beach: And then is that something that has 

to be tasked for SC&A to report on that or is that too 

far ahead?

Mr. Katz: No, I -- well, I could just go ahead and say 

it. I mean, SC&A should be looking at that report, 

too, and I think they would have received it because 

they would have had their -- whoever is the lead 

person for SC&A would have received it.

I don't know, who is your lead? But, anyway, yes, 

they can go forward, SC&A, with reviewing that, if 

they haven't already.

Okay. So any other questions?

(No response.)

Public Comment

Mr. Katz: All right then. It's a little bit ahead of public 

comment session, but we're going to go into it. We'll 

perhaps still be at it, we'll certainly still be at it once 

the official public comment time, we hit that.

So let me, first, make a few remarks. Well, let me 

just see if we have any. Yes, we have some people 

who aren't necessarily familiar with our procedures 

about public comments. So let me give you that first.

Everything that you say in a public comment is 

recorded. Whether you know it or not, the Board's 

proceedings are transcribed verbatim, and then 

they're all published on the NIOSH website. So if you 

make public comments, everything you say will be 

reported there and attributed to you.

The one exception is if you discuss other parties other 
147

than yourself and you give private information about 

them, that information may be redacted because we 

protect the privacy of everyone else who's talked 

about. We don't necessarily know that they have 

given permission for their information to be given in 

a public sphere. So we do that under the Privacy Act 

to protect their privacy. So that takes care of what 

you need to understand about that.

We will begin with people who have public comments 

related to the sites here, and then we'll go from there 

to public comments about other sites and to people 

on the phone, although if we have people from the 

facilities here on the phone, we'll take those 

comments, too, before dealing with other sites.

So the first person I have, I believe, for this facility is 

Phillip Branson, who I believe has comments related 

to or worked at K-25. Is Phillip in the room?

(No response.)

Mr. Katz: Okay. And then I'm not entirely clear. We 

have a [identifying information redacted]. I 

don't know; is this related to -- oh, that's right, you 

talked to me earlier. Thanks.

I don't have any in the room, then, otherwise 

addressing the local facilities. But do I have anyone 

on the phone from these facilities here who has public 

comment?

Ms. Colley: Yes.

Mr. Katz: Okay. Would you please identify yourself? 

And then you can proceed.

Ms. Colley: Yes. My name is Vina Colley. I'm 

President of Portsmouth/Piketon Residents for 

Environmental Safety and Security.

Mr. Katz: I'm sorry. I'm sorry to interrupt, but, one, 

it was hard to understand even your name, and then, 

I don't know if you need to speak closer to your mic, 
148

but it's hard. You're hard to understand.

Ms. Colley: Is this any better?

Mr. Katz: That's much better. Thank you very much. 

Can you tell me your name again?

Ms. Colley: Okay. Vina, V-I-N-A, Colley, C-O-L-L-EY.

Mr. Katz: Thank you. Perfect. Go ahead.

Ms. Colley: And I'm President of a group called 

PRESS, Portsmouth/Piketon Residents for 

Environmental Safety and Security, and I co-chair 

National Nuclear Workers for Justice. And I'm a comember of Nuclear Whistleblower Alliance. I am from 

the Portsmouth Gaseous Diffusion Plant.

First off, we would like to invite you to hold one of 

your meetings here in Portsmouth, Ohio. We are the 

home of the Portsmouth Gaseous Diffusion Plant, one 

of the largest facilities in the world who enriched 

highly enriched uranium. We down-blended uranium 

from Russia. The contamination of plutonium is 

widespread. We are one of the facilities that broke 

the story in 1999 about plutonium being at the 

Portsmouth Gaseous Diffusion Plant and the Paducah 

Gaseous Diffusion Plant in Paducah, Kentucky.

My question is, we started out being one of the first 

special cohort sites, and for some reason, we seem 

to be left out of a lot of the process of these meetings. 

And we're not -- the workers here are still having tons 

of trouble trying to get through the NIOSH process 

and the dose reconstruction. We don't understand 

why. We don't know why they keep getting turned 

down, and we don't know why this facility, 

Portsmouth and Paducah, has been ignored.

We did highly enriched uranium. We also have had 

plutonium at the facility that was downgraded. And 

we've had it at the facility since 1953. We have 30-

some-thousand depleted uranium sitting out in the 
149

yard in the open that's giving off neutron exposures 

for anyone who walks around those cylinders.

And then I'm wondering why NIOSH, because a lot of 

these studies have all been inconclusive by design, 

and I am wondering how they have been able to 

come up with these studies when they're not talking 

to us, the workers, and what we really worked in. I 

know that our union (telephonic interference) of 

chemicals, the buildings, and they worked hours and 

hours and hours, and somehow everything got lost 

off of the process.

So being a sick worker myself, I've been fighting 

these issues since the late '80s. I am concerned 

about the special cohort sites, us being one of the 

first ones, and then still having to fight for our 

illnesses.

There is also a petition that [identifying 

information redacted] and myself worked on from 

the Hanford site. And it was one of the first petitions 

filed, and it had a number 00011. That petition 

somehow or another dropped through the cracks.

And I'm also aware that NIOSH has been used 

against the workers in court in litigation for the 

Department of Energy, and they fought against us. 

So I'm really concerned about how data is being put 

together, and when they don't have data, the 

government said they (telephonic interference) 

should get compensated, but we're still here. I'm still 

here fighting for compensation for consequential 

illnesses.

And they claim that they even had more exposures 

for neuropathy, and so far, I was told that I had more 

exposures and they were going to reevaluate me, but 

I haven't got that conclusion yet. But I do have 

another coworker that they opened up his case, and 

they turned him down, said he didn't have enough 

exposures.

So I'm really, really concerned about what is going 
150

on. Why are these workers having such a hard time 

fighting? I mean, we're all dying. They're dying, and 

their survivors are getting paid, and they laid -- they 

sent this since, what, 2002. It's 2018 now. Why are 

we still having to do re-dose?

So I guess that's my question. I'm just boggled about 

how we've been treated.

Mr. Katz: Thank you for that. Let me just quickly 

touch on some of what you said, though, if it's 

helpful.

The Board does have a Work Group that's actually 

dealing with your site. The Work Group was quite 

active a while ago. It's been a while. They're waiting 

for some additional work to be done by staff before 

they're ready to discuss it in Work Group meetings. 

But there is a Work Group.

And by all means, that's one good venue, I think, for 

you and other members there. If you have comments 

about how the dose reconstructions are being done 

or questions about what data is available and what 

isn't available, et cetera, next time we have a Work 

Group meeting -- these are noticed on the NIOSH 

website. But attending one of those, and you don't 

have to attend in person; those are mostly done by 

teleconference anyway. You can join by 

teleconference, and you or other people there can 

bring up comments. We usually have an opportunity 

for public members to comment. So that's one venue 

for you getting yourselves heard about concerns you 

might have with respect to how dose reconstructions 

are done.

And you can also go on the NIOSH website and look 

at the contact at NIOSH. You can both speak to 

NIOSH staff that are responsible for the dose 

reconstruction methods for your facility, and there is 

also, for individual claims where people are having 

trouble -- I don't know to the extent they've been 

taking advantage of this, but there's a NIOSH 

Ombudsman. Her name is Ms. Denise Brock, and 
151

she's very good. She's very good at dealing with all 

sorts of issues related to how the dose 

reconstructions are being done and getting 

misunderstandings sorted out, and so on. So I 

encourage you to use her, and her contact 

information is also on the NIOSH website.

So I hope those things are helpful to you. And thanks 

for your comment. We appreciate that.

Ms. Colley: I'd really appreciate if you would consider 

coming to our site with one of your meetings and put 

us down on your agenda.

Mr. Katz: Thanks. So we'll keep that in mind. Thank 

you.

Ms. Colley: I thank you.

Mr. Katz: Okay. Let's then, I don't -- do we have any 

folks from these Oak Ridge facilities on the phone 

who have comments about the Oak Ridge facilities?

(No response.)

Mr. Katz: Okay. Then let me go down the list of 

people here in the room who have comments.

I have John Sadler, related to Fernald. Please do go 

to a mic. Otherwise, we can't record you.

By all means, you know, there's a chair right there. 

Dr. Lockey is not using it, if that's comfortable.

Mr. Sadler: I'll be okay if I can hold onto something.

Mr. Katz: Okay. So then that mic is great.

Mr. Sadler: Here is stuff I need you to pass out to 

everybody on the Board.

Mr. Katz: Well, let's pass this out afterwards because 

they're not going to be able to read it and listen to 

you at the same time. But we'll pass this out after the 

fact.
152

Yes, there's a button right underneath the mic, and 

you have to hold it. You have to keep it down. You 

have to hold it down for it to work.

And, please, we have about five minutes. Thanks.

Mr. Sadler: My name is John Sadler. I'm from 

Fernald. And I passed out some things to the Board 

there to go into the record.

I appreciate the opportunity to speak and, hopefully, 

bring new topics to light that you may have never 

heard of or been aware of.

The Board may remember me from the Santa Fe 

meeting in August. I was the guy who said, if it wasn't 

for the nuclear workers in the country, we would all 

be speaking Russian or German.

I'm presenting some documents to the Board, and I 

recommend the books Behind the Fog, At Work in the 

Fields of the Bomb, and The Plutonium Files, and a 

research paper from Dr. Patricia Cianciolo, a 

professor at Northern Michigan University.

The paper is about the difficulties in navigating the 

claims process. She was involved with doing a claim 

for her father who worked at Fernald for some years, 

from '52 to '89, and it took her three years to do it, 

and he fell into an SEC and had to do dose 

reconstruction.

I'm also including a letter from Dr. Melius. He came 

up to me after the meeting in Santa Fe and told me 

not to get discouraged and keep on trying. He said

decisions are turned around all the time. This was 

after the no vote on the Petition 46 to extend SEC 

years for Fernald to 1989.

And it's my hope that the Board will be more 

informed for your decisionmaking in support of all the 

nuclear workers in our country, in support of the 

intent of Executive Order 13179, recognizing the 

sacrifices made for our country and that the workers 
153

deserve support to minimize the administrative 

burden on workers and their families.

You have a handout of uranium stack discharges by 

decade that happened at Fernald. This is a listing of 

what plants onsite were contaminating the 

environment and to what degree.

U3O8 is also called black oxide. When it gets into 

your lungs, it doesn't dissolve and is never coming 

out except on an autopsy.

During production years onsite, we would be 

breathing whatever was in the air, including black 

oxide, plutonium, thorium, technetium, neptunium, 

beryllium, and whatever other deadly and harmful 

elements were coming out of the dust collectors, and 

at what levels expressed in parts per billion.

I'll be one to donate my body to the government, so 

they can reclaim the black oxide in my lungs and 

whatever elements they could find useful. Some of 

us in this country are just a walking uranium mine, 

and some of the workers can't walk because they 

have passed into the phase of not being able to 

because they have become incapacitated by their 

sacrificial sickness, and many are gone.

There is strong reason to believe that the Fernald 

nuclear site, along with many others in the country, 

were part of the government's offensive radiological 

weapons program that secretly used workers and 

surrounding residents as experimental subjects.

In support of this reasoning, the sites being part of 

this program would contaminate the site and 

surrounding community. In personally hearing 

managers in Plant 5 and 9 tell workers not to shut 

down dust collectors because of major dust leaks, 

because we need to continue production and that we 

would shut down at our next holiday, which was often 

a month away, I thought that answer didn't make any 

sense at the time, since the whole countryside was 

being dumped on. And after finding out about the 
154

offensive radiological weapons program going on all 

over America, plus England and Canada, then it made 

perfect sense.

If checking on all the other sites in the country, you 

will find they all contaminated the environment in 

similar ways as Fernald, and some were doing a lot 

worse, such as Hanford. This weapons program 

lasted from the early 1950s into 1990. A GAO report 

came out in 1993 started mentioning about this 

program, the offensive radiological weapons 

program.

Secretary of Energy Hazel O'Leary stated in 1994 that 

the government continues to sponsor radiation 

experiments involving human subjects, but added 

that no tests in the 1990s were conducted in secret 

or without consent. And the person in charge of this 

program was General Leslie Groves, the same person 

that ran the Manhattan Project. He had run that 

program with the utmost secrecy, and it was 

expected that he could do the same with the 

offensive radiological weapons program.

Many other notable elites in the radiation sciences 

were also part of this secret project, to include Robert 

Oppenheimer. This group's title was the Radiological 

Weapons Experimentation Group. The Atomic Energy 

Commission was in charge of operating this project 

until 1977, when the Department of Energy took 

over.

And this refers to Fernald. The company was 

contaminating the environment purposely, and then 

say, we're protecting the workers at Fernald by way 

of monthly readings of the TLD badges. The company 

was either purposely protecting the workers or they 

were purposely not protecting the workers and the 

residents. The sad conclusion is they were not.

All the discharges from the dust collectors was a 

known health danger, and yet it went on for years. 

Public comments by management about health and 

safety at the plant had no way of accomplishing 
155

whatever their intended goal was. Nothing will hurt 

you at Fernald unless it falls on your head, and you 

can eat a teaspoon of what we process every day and 

it won't hurt you. All of those statements point to an 

uncaring and pointed disregard for the safety and 

health of workers at Fernald and the surrounding 

communities.

And with the government's high priority for the 

offensive radiological weapons program, there would 

have been no reason for Fernald and other sites not 

to participate. The government would have all the 

players in place and the logistics in place for an 

effective program. And all they would have to say is 

go.

All of the happenings of the past at Fernald causes 

me to wonder if this offensive radiological weapons 

program has some life left in it and what it would look 

like now. With all the government's efforts and 

money poured into this program, it would be hard 

believe that they would have given up without a final 

and effective offensive weapons product.

The sad and ironic part of all this narrative is that all 

of the taxpaying public were unknowingly bankrolling 

this program to be used as guinea pigs. What 

negative effects this would have on the nation's 

health is an unanswered and ongoing question. We 

were even making sick and killing off the nuclear 

workers we depended on to defend our country.

And there's a lot to be said for oversight to be a large 

part of how we operate our government. Most people 

working on the Manhattan Project didn't know what 

they were involved in until the bombs were dropped. 

The Vice President didn't know anything about the 

Manhattan Project until after the President died.

In 1945, the AEC put a limit on plutonium at 1 

microgram, 1 millionth of a gram, and they labeled it 

tolerable. And we operated on that in this country for 

over 22 years, and after 1977, DOE changes that 

amount as lethal. And how many workers and 
156

residents were lethaled?

In regards to the 5 rem per year dose, which I just 

found out was different from Stu a little while ago, 

that the rest of the world is 2, but the United States 

is still 5.

And a lady that's in a book, At Work in the Fields of 

the Bomb, [identifying information redacted], 

said 5 rems should be divided by 50 to get .1 rem a 

year. The physicists on the Manhattan Project set the 

limit, declared themselves the experts on safe limits, 

and we still use that limit today. It was set in 1951. 

Have we learned nothing in 67 years?

The ICRP, International Commission on Radiological 

Protection, was not set up as a professional society. 

It was set up as a secret club, a self-perpetuating 

committee right out of the military, never had a 

public health expert on it, no one in epidemiology on 

it, never anyone who would challenge the risk 

estimates. As of 1987, when At Work in the Fields of 

the Bomb came out, the Commission had only put 

out three publications, and all the people on the 

Commission were physicists.

And on page 151, At Work in the Fields of the Bomb, 

[identifying information redacted], a world 

authority on the health hazards of low-level radiation, 

relates that a key finding is that the lower the dose, 

the more cancer risk per unit dose. It does not make 

it safer to deliver radiation slowly and, in fact, it 

makes it more dangerous.

[identifying information redacted] from Rocky 

Flats died of a brain tumor at 32. In the final litigation 

on June 4th, 1987, the Colorado Court of Appeals 

ruled that [identifying information redacted] 

death was caused by on-the-job exposure to 

permissible levels of radiation. Rocky Flats did not 

appeal that ruling. Another guy from there named 

[identifying information redacted], he had the 

same findings in 1990.
157

There's a group called the Transuranium Registry, 

headquartered in the State of Washington. It's an 

arm of the government to collect cadavers for 

radiation contaminated studies. Someone from there 

came to the site to give a presentation and offered 

workers $500 for them to sign a release to give their 

bodies to the government after they died.

And this happened before I started working there in 

1982. The partner I worked with was there and asked 

what body parts they were interested in, and the 

presenter said both arms and both kidneys.

And the government uses this --

Mr. Katz: Mr. Sadler, you need to wrap up, please.

Mr. Sadler: I've got about a few seconds.

The government uses the Social Security retrieval 

process to get to workers that have died and to claim 

the bodies quickly.

After information came to light with the publication 

of Behind the Fog, three centers from the areas 

talked about were outraged and planned to further 

investigate the offensive radiological weapons 

program. One of the documents presented to the 

Board is a newspaper article that was in my local 

paper a few months back. After reading the article 

and the book Behind the Fog, the disconnects started 

connecting.

Mr. Katz: You need to speak into the mic, please.

Mr. Sadler: This is the first page of the Energy 

Employees Act, 35 pages long. Right down at the 

bottom where you see the highlighted areas, it said, 

furthermore, studies indicate that 98 percent of 

radiation-induced cancers within the nuclear 

weapons complex have occurred at dose levels below 

existing maximum safe thresholds, 5 rem.

Mr. Katz: Thank you, Mr. Sadler.
158

Okay. Next we have Susan Adkisson.

Ms. Adkisson: Thank you. My name is Susan 

Adkisson. I'm the Regional Director of Cold War 

Patriots here in Oak Ridge.

We just wanted to say that Cold War Patriots was 

deeply saddened when we learned of the loss of Dr. 

James Melius passing. He was a dedicated and longserving public servant not only to the stakeholders of 

this program, but to other workers in similar 

situations, such as those in the 9/11 first responders.

In appreciation, Cold War Patriots made a donation 

in Dr. Melius's name to the New York Committee for 

Occupational Safety and Health.

Dr. Melius will be missed by many.

Mr. Katz: Thank you very much, Ms. Adkisson.

Next we have Terry Barrie.

Ms. Barrie: Good evening. My name is Terry Barrie, 

and I'm with the Alliance of Nuclear Worker Advocacy 

Groups.

When I first started typing the draft of my public 

comments, I surprised myself and started 

automatically typing, good evening, Dr. Melius. I 

have always admired Dr. Melius. And while I did not 

always agree with his decisions, I know he carefully 

considered every aspect of the issue. I will miss his 

gentle humor, especially when he teased Stu or 

LaVon. ANWAG offers our condolences to Dr. Melius's 

family, friends, and especially to all of you here who 

worked so closely with him for years.

I am thankful that this Board can continue work until 

a Chair is appointed, unlike the situation with the 

Department of Labor Advisory Board. It's important 

that your work continue uninterrupted. The SECs that 

have been being debated for like 3, 5, 10 years would 

fall through the cracks if you weren't here to resolve 
159

them.

And now on to Rocky Flats, I'd like to give you an 

update on the petitioners' work on this issue. You 

know that NIOSH has reviewed 40 boxes down at Los 

Alamos, and they did find certain documents that are 

of interest to them, none of which were associated 

with the magnesium-thorium alloy.

I was disappointed, though, that they were only 

directed really to look for that specific issue, the 

magnesium-thorium, because in the thousands of 

records -- and I understand there's like maybe 1600 

boxes still of documents at Los Alamos that should 

be reviewed -- for one reason or another, probably 

resources and finances, they won't be able to take a 

look at them.

So the petitioners understood that. So we decided, 

okay, well, we'll make arrangements to go down and 

take a look, and Los Alamos said, no, we can't do 

that. So we're resorting to filing FOIA requests for 

documents from the indices of the 40 boxes. So that's 

where that stands right now.

It's very important that we resolve this. I mean, I 

honestly feel that there is one document in there that 

will allow SEC status for Rocky Flats.

And the last thing I would like to address is the issue 

of CLL. Dr. Ziemer had asked Ted about whether CDC 

or HHS can contact Congress or make Congress 

aware of this issue. And it dawned on me that 

Secretary Richardson did the exact same thing in 

order to get the EEOICPA legislated.

So I would like to ask Secretary Azar, I believe his 

name is, to reconsider and go to Congress and open 

a discussion about CLL and changing the legislation 

to let CLL be a covered, a specified cancer.

And that's all I have, and thank you very much.

Mr. Katz: Thank you, Terry.
160

That's it for the list in the room, but do I have other 

people on the line who want to comment?

Mr. Giron: Yes. My name is Eloi Giron from Sandia 

National Lab.

Mr. Katz: Hi. So before you start, I don't know 

whether you're on a speaker phone. You're very hard 

to hear.

Mr. Giron: Yes. Sorry about that.

Mr. Katz: That's much better. Thank you.

Mr. Giron: Can you hear me better? Okay. I had you 

on the speaker phone because I had a couple of 

people in here.

Mr. Katz: It's okay. Would you repeat your name, and 

then go ahead with your comments? Thanks.

Mr. Giron: Okay. My name is Eloi Giron. Chairman 

and Members of the Board, my name is Eloi Giron. 

I'm a member --

Mr. Katz: I'm sorry. I'm sorry, can you --

Mr. Giron: I'm an employee of Sandia National --

Mr. Katz: Excuse me. Just go ahead and spell out 

your name because it's still hard to decipher.

Mr. Giron: Okay.

Mr. Katz: Thanks.

Mr. Giron: The first name is Eloi, E-L-O-I; last name, 

Giron, G-I-R-O-N.

Mr. Katz: Thank you. That's perfect. Go ahead.

Mr. Giron: Okay. Thank you, Chairman and Members 

of the Board, for listening to me today. I'm an 

employee of Sandia National Labs. I'm a security 

police officer.
161

At this time, I'm addressing SEC 188. I addressed 

this Board in December 2016 in Santa Fe and 2017 

in Albuquerque. At those times, I brought up where 

and how we worked around SNM post 835.

At this time, I would like to be clear that nothing 

changed on the day-to-day operations on how we 

worked around SNM post 835 to prior to 835. It's 

been a few years, and a few of us, a group of us met 

with Sam Glover in a classified setting here at Sandia 

Labs. And we were able to ask questions directed at 

him on how we worked and where we worked in front 

of Sandia National Labs safety personnel. None of the

information that we gave to Sam Glover was 

challenged to be wrong.

I'm asking for an update on this. I asked this in 

December. The Board had told me -- I know there's 

been, you know, changes in the Board. I mean, 

things have happened now. And what I'm asking for 

is an update, and I asked in December. The response 

I received from the Board was the Board is waiting 

for information that Sandia was supposed to give.

Shortly after that, we had another one of our 

employees go before you guys, the Board, at the 

public input, and asked what information in writing 

from the committee are you waiting for from Sandia. 

The Board said, I think they referred it back to LaVon 

Rutherford, and he responded by saying that they're 

waiting for dosimetry. The question again at that 

time was, what type of dosimetry and what 

timeframe did Sandia request -- what was the 

timeframe that your Board requested this from 

Sandia and what type of dosimetry was LaVon 

Rutherford, what kind are they waiting for.

I know you guys are busy. I mean, we're just waiting 

patiently here and asking for these updates. But now 

it is mid-April 2018, and since our last meeting, there 

are four new cases of SNL employees that I know of, 

just me, with cancer. Three of them are Stage 4, and 

one of them has just passed. And all four of them are 
162

qualifying cancers under the program.

I would like to just find out again what the status is, 

if you received the information, or where are we at?

Thank you, Chairman.

Mr. Katz: Bomber, do you want to just give, remind 

-- we discussed this earlier, but you probably weren't 

on the line when we did. So LaVon is going to come 

up and just repeat what he said earlier.

Mr. Rutherford: Yes, this is LaVon Rutherford.

We have received most of the information from 

Sandia. We have gone back and forth with them on a 

couple of things, some discrepancies that we noted. 

But we fully intend to have the Evaluation Report 

completed at the end of July and presentation at the 

August Advisory Board meeting.

Mr. Katz: Thank you. Thank you, LaVon.

Mr. Giron: Chairman?

Mr. Katz: Yes? Do you have something else?

(No response.)

Mr. Katz: Okay. Well, thank you for your comment.

Mr. Giron: Sorry about that. I was able to hear your 

response. I was not able to hear LaVon Rutherford's 

at all. It was coming in broken.

Mr. Katz: Okay. Well, let me reiterate, basically, what 

LaVon said is they have had success receiving 

records that you've been discussing, and they are 

proceeding to work on that. They should be pretty far 

along a little early into the summer, and this should 

be ready for discussion by the Board at its August 

Board meeting.

So I think we thank everyone for pushing on this, and 

we have made good progress at this point. We will 
163

expect this to get addressed then in August.

Okay. Do I have any other --

Mr. Giron: Okay.

Mr. Katz: Any other public commenters on the line 

who want to speak to us?

Ms. Hand: Yes. Yes.

Mr. Katz: So would you please identify yourself and 

then proceed?

Ms. Hand: My name is Donna Hand.

And I would like to make a public comment regarding 

the overall process because the -- and today's 

meeting, Dr. Neton says, I think the decisions are 

made on the CATI and job title. It should never be 

done on the job title. Even the statute says it's in the 

performance of duty. So even an administrator, a 

secretary could be assigned to the reactor and 

everything. So she would get more than just the 

administration.

And the 50 percentile was told that it was just for 

administration people. That's not the case. Whenever 

we file for another cancer, they automatically use the 

50th percentile. The statute requires the 99th 

percentile. So you're only using the 95th percentile.

The methods and guidelines are in the regulations. 

What you're doing is a misapplication of the methods 

and guidelines to apply those. And to reduce it down 

to the 50th percentile, that's not what the law stated, 

nor the regulations.

And it is the duty of the Board to make sure that the 

dose reconstruction is scientifically valid. Back in 

December the 12th, 2017, I asked the Board to 

determine if there's a scientific validation of the metal 

tritide dose, and also, is it sufficient of data for the 

internal dose. The Board never responded. They sent 

it to Stu Hinnefeld.
164

That's great that Stu Hinnefeld responded. However, 

he does not have that authority. That authority is 

addressed and put into the statute for the Board to 

determine, not for Stu Hinnefeld or NIOSH to 

determine.

And the methodology is already into the law. So the 

Advisory Board, as well as the NIOSH, must comply 

within the parameters of the law.

As far as Pinellas group goes, we've been denied 

again on an SEC because it didn't qualify. 

Qualification is a policy. Policy is not binding. The 

statute and the regulations are binding. And the 

regulations, 42 CFR 83, we met that.

In fact, on March the 3rd, 2016, Peter Darnell did a 

response to Matrix Issue No. 6, which was the 

decontamination and decommissioning period, 

stating, we don't have those records. It's not there. 

And we're not going to look any more. But, yet, we 

were denied.

So if you don't have the data of the decontamination 

and decommissioning era, but, yet, you're saying we 

don't qualify, you're not having an equal application 

of the law.

And, again, I would request that the Advisory Board 

respond to my December 12th letter regarding the 

metal tritide dose, specifically at Pinellas, because 

you did not know which metal tritide was used when.

And also in that March 16th letter, Peter Darnell 

acknowledged that there were aged tritide uranium, 

uranium oxide, and uranium aluminum samples that 

was there in that information regarding Pinellas.

So the dose reconstruction for the external dose and 

internal dose was revised and renewed in 2016 for 

the internal dose and December of 2017 for the 

external dose. That's after you denied the SEC, but 

you still didn't add into those issues.
165

And, again, neither one of these have been approved 

by the Working Group, and definitely from the very 

first one until this recent one, have never been 

approved by the Board to be scientifically valid. So 

the Board has never done any of the Technical Basis 

Documents for Pinellas Plant saying that they were, 

yes, scientifically valid and voted on those. So they 

are still open, but, yet, you're denying us our SEC 

when there's not the information.

And the law demands and requires that you, that this 

program is to provide timely, uniform, and adequate 

compensation. When you're waiting even for your 

new Technical Basis Document 0017, you say, well, 

when we add on, we'll put in this new information. 

No, you should do it now because that's not timely 

then. If you wait, keep on waiting and waiting, that's 

not a timely decision, nor is it timely to be used.

And as the other people have stated, these people 

are dying, and it's not fair to them, whenever this 

program started in 2000. 2001, it was amended. 

2002, examples were going on, and the Board was 

up and ready. 2006, the Board started voting on 

certain things. So it's been over 10 years. So this is 

-- it's not in a timely -- so all I'm asking is that you 

follow the law and the regulations as implemented, 

and be fair and adequate to all of the sites, and to 

have equal application of the law to all the sites.

And, again, I would like to have an answer to my 

December 12th, 2017 letter.

Thank you.

Mr. Katz: Thank you, Ms. Hand.

I will just address the letter question because, in fact, 

the letter that was written by Stu was carefully 

reviewed by all the Members of the Board and 

concurred with by all the Members of the Board. So, 

that is, in fact, addressing the Board's view on the 

matter, not just the program's.
166

But thank you for your comments.

Do we have any other public commenters on the line?

Mr. Giron: Chairman? This is Eloi Giron again from 

Albuquerque, Sandia Labs.

Mr. Katz: Yes?

Mr. Giron: I want to be clear on this. When you 

responded to me saying that Sandia has provided 

some information, the question in December from 

[identifying information redacted], he had two 

questions. Have they, Sandia, are they providing all 

information or just portions of this, of his questions?

Mr. Katz: Okay. Well, this is not really the forum to 

get into nitty-gritty details about what exactly they're 

providing, and so on.

Mr. Giron: Okay.

Mr. Katz: But the general message is just that they're 

receiving the records that they require to address the 

SEC petition, and we will be considering that petition 

in August. I think those are the critical points.

Mr. Giron: Okay. Because the question that was 

posed in the December meeting, when Peter would 

ask those two questions, the Board or somebody on 

the Board was supposed to get back to him with 

answers to those two questions. And I met with Pete 

Irwin earlier, and he said he has received nothing 

since then.

Mr. Katz: Right. Well, the program would be 

communicating with you folks, not an individual from 

the Board. And I believe LaVon has been doing that. 

And if there needs to be more communication 

between LaVon and the questioners, by all means, 

get back in touch with him. There's plenty of time 

between now and then. Thanks.

Mr. Giron: Thank you, Chairman. Members of the 

Board, thank you.
167

Mr. Katz: Sure. You're welcome. Thanks for raising 

the issue.

Any other public commenters on the line?

Ms. Carroll: Yes, this is Stephanie Carroll.

Mr. Katz: I'm sorry, this is?

Ms. Carroll: Can you hear? Can you hear me okay?

Mr. Katz: Oh, yes, yes, there you go. Thanks.

Ms. Carroll: Hi. Stephanie Carroll. I'm an authorized 

rep here in Denver, Colorado.

And I would like to make a comment on the vote to 

deny the extension of the SEC for Rocky Flats. Prior 

to the vote, I had submitted via online submission a 

Manual of Good Practices at Uranium Facilities draft. 

And it was written by Bryce Rich, Stuart Hinnefeld, 

Clayton Lagerquist, Gary Mansfield, Leo Munson, and 

Edgar Wagner.

And that document did not show up online, nor did 

the Rocky Flats -- well, nor did the Board actually 

review the record prior to the vote. So I just wanted 

to make that be known, that there were two 

documents, actually, that were never reviewed

before the vote was put through to deny the SEC for 

Rocky Flats.

And that's all I have for you today.

Mr. Katz: Thank you, Stephanie.

Ms. Carroll: Thank you.

Mr. Katz: Do we have any other members of the 

public with comments?

(No response.)

Mr. Katz: Going once. Going twice.

All right. Thank you, everybody, for a productive 
168

Board meeting. We really appreciate it. All the public 

participation, we really appreciate it.

Ms. Colley: I would like to make another comment if 

I can.

Mr. Katz: And at this point we are adjourned.

(Whereupon, the above-entitled matter went off the 

record at 5:34 p.m. and resumed at 5:35 p.m.)

Ms. Colley: Hello? Hello? Can you hear me?

Mr. Katz: Hello.

Ms. Colley: Hello?

Mr. Katz: Hello. Is there someone trying to speak to 

us?

Ms. Colley: Yes, I said I'd like to make another small 

comment. This is Vina Colley.

Mr. Katz: Okay. Hold on a second because we already 

adjourned. And so there's a lot of noise in the room. 

And one second.

Ms. Colley: Okay. That's okay.

Mr. Katz: Hold one moment.

Everyone in the room, can we -- I know we tried to 

adjourn. I think there's another public commenter 

who wants to make comments. Can we, please, 

everyone, can we be quiet in here, so that we can 

hear the individual?

Sorry about that. So go ahead. Would you please 

identify yourself and go ahead?

Ms. Colley: Yes. This is Vina Colley.

And I just want to comment that I did --

Mr. Katz: Wait. Hold on one second.
169

Please, everyone in the room, please, we're trying to 

hear from someone who's calling in.

Okay. Go ahead again. This is Bonnie Clay?

Ms. Colley: Vina Colley.

Mr. Katz: Vina Colley.

Ms. Colley: From Portsmouth.

Mr. Katz: Okay. Go ahead.

Ms. Colley: I just wanted to make a comment that I 

did testify on behalf of the human experimentation, 

and I met many of the people that the government 

experimented on. And I was personally invited to 

Secretary Hazel O'Leary's Whistleblower Conference 

in '92 or '94; I'm not really sure right now because I 

don't have my papers here.

What's going on right now with the workers and the 

way they're letting them die, and keep re-dosing 

them, is a criminal act. All the workers that I worked 

with who started this process by getting it out to the 

public in the '80s have passed away.

[identifying information redacted] was 42. He 

died of a brain tumor. [identifying information 

redacted is still sick. [identifying information 

redacted] is sick. There's so many of us workers that 

started this process and they've all passed away.

And it seems like the government is just waiting for 

us all to pass away, where they continue to have 

meetings and try to figure out this dose 

reconstruction. It's just corrupted, and it's a criminal 

act against us workers who are already sick and have 

been experimented on by the government all these 

years.

And that's all I have to say for now.
170

Adjourn

Mr. Katz: Thank you for your comment.

And with that now, we will re-adjourn and remain 

adjourned, and thank you again, everybody.

(Whereupon, at 5:37 p.m., the meeting in the aboveentitled matter went off the record.)