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1

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

CENTERS FOR DISEASE CONTROL

NATIONAL INSTITUTE FOR OCCUPATIONAL

SAFETY AND HEALTH 

+ + + + +

ADVISORY BOARD ON RADIATION AND

WORKER HEALTH 

+ + + + +

WORK GROUP ON FERNALD

+ + + + +

THURSDAY

APRIL 19, 2012

+ + + + +

 The Work Group convened 

telephonically at 11:00 a.m., Bradley P. 

Clawson, Chairman, presiding.

PRESENT:

BRADLEY P. CLAWSON, Chairman

PAUL L. ZIEMER, Member
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ALSO PRESENT: 2

TED KATZ, Designated Federal Official

ISAF AL-NABULSI, DOE

SANDRA BALDRIDGE

BOB BARTON, SC&A

EVERETT "RAY" BEATTY, SR.

ELIZABETH BRACKETT, ORAU Team

MEL CHEW, ORAU

SAM GLOVER, DCAS

STU HINNEFELD, DCAS

KARIN JESSEN, ORAU Team

JENNY LIN, HHS

JOYCE LIPSZTEIN, SC&A

JOHN MAURO, SC&A

ROBERT MORRIS, ORAU Team

MARK ROLFES, DCAS

BILLY SMITH, ORAU Team

JOHN STIVER, SC&A
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3

 T-A-B-L-E O-F C-O-N-T-E-N-T-S 

Page

SC&A Response on In Vivo Thorium Bioassay 5 

Methods (White Paper)

by John Stiver

Work Group Plans for April 26 Board 103

Teleconference
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4 1 P-R-O-C-E-E-D-I-N-G-S 

2 (11:00 a.m.)

3 MR. KATZ: Let me get this 

4 started. This is the Advisory Board on 

5 Radiation and Worker Health, Fernald Work 

6 Group and we will begin roll call.

7 (Roll call.)

8 MR. KATZ: Let me just mention 

9 this for everyone involved. Some of the 

10 papers, I think, are already posted on the 

11 website for this meeting.

12 There are a couple papers from 

13 DCAS, they're not yet posted, they may be 

14 posted now, but they were sent, Sandra, to you 

15 directly by email by the program since they 

16 hadn't been posted yet, so I hope you have 

17 those, Sandra. One of those was a 

18 presentation, a PowerPoint presentation that I 

19 think DCAS will probably be using during this 

20 meeting, as well as, again, the agenda for 

21 this meeting is also on the website. It's a 
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5 1 pretty simple agenda.

2 Now, I drafted this agenda without 

3 input just by seeing the materials that were 

4 flowing back and forth between the parties, 

5 but the Chair and DCAS didn't have an 

6 opportunity, or didn't get around to 

7 commenting on the agenda, so I guess it's your 

8 agenda.

9 Brad, if you wish to admit 

10 revisions or solicit them from the program, 

11 that'd be the place to start, I think. And, 

12 everybody, please, other than the people who 

13 are speaking, mute your phones. If you don't 

14 have a mute button, use *6.

15 There's quite a lot of hiss in the 

16 background, which makes me think there are a 

17 lot of people that are not on mute. And then 

18 to take your phone off of mute, just press *6 

19 again. Okay, Brad, it's your meeting.

20 CHAIRMAN CLAWSON: Well, I 

21 appreciate that and I'm trying to find my 
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6 1 agenda that I just dialed in on. It's 

2 terrible when you do that, but I guess, 

3 basically, I'll turn it over to John Stiver. 

4 He's the SC&A person on this and we'll start 

5 out from there.

6 MR. STIVER: Okay. Thank you, 

7 Brad. My name is John Stiver from SC&A. I 

8 know most of you all. Today's topic is fairly 

9 focused. This is our issue 6b, which is the 

10 in vivo chest count data issue for the period 

11 of 1968 to 1978 when the data were reported in 

12 units of -- milligrams thorium.

13 So a bit of a recap. At our last 

14 meeting we had, kind of, come to a position 

15 where, this was on February 9th, SC&A had 

16 presented our kind of final position on this.

17 And that was that we felt that, 

18 because of uncertainties in the data set, 

19 which could, we felt, depending on how the 

20 milligram data were calculated, could give 

21 rise to underestimates up to possibly a factor 
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7 1 of 100 and also overestimates for the 

2 unexposed contingent, which could approach a 

3 factor of three orders of magnitude.

4 We felt that this data set was 

5 just not adequate for reconstructing doses 

6 with sufficient accuracy in an SEC context.

7 And shortly thereafter, NIOSH, 

8 right before the Board meeting in Oakland, 

9 they had posted some additional documents 

10 which were related to this issue, some of 

11 which, many of which we had already seen and I 

12 believe there were a couple that we hadn't 

13 seen.

14 And then, at the meeting, I 

15 presented kind of a summary of our position. 

16 I looked at two issues, really. One was the 

17 uncertainties inherent in the data themselves 

18 and we also looked at this, kind of, an 

19 overarching issue.

20 This idea of whether the system 

21 was adequate for the intended purpose under 
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8 1 EEOICPA, which was the issue of the stated 

2 detection limit being so high as to result in 

3 almost a de facto SEC-type situation where 

4 almost, virtually all metabolic cancers would 

5 likely be compensated.

6 And that's, really kind of an SEC 

7 Subcommittee issue. I tuned in to the meeting 

8 yesterday and the Board was taking a very 

9 deliberate approach on this issue of 

10 sufficient accuracy and what it really means 

11 and how it should be defined.

12 And that's probably, you know, the 

13 best way to approach this. And DCAS is in the 

14 process, evidently, of putting together a 

15 matrix of all SEC decisions and their bases, 

16 and then that's going to kind of serve as a 

17 starting point, kind of a gold standard.

18 And so that second aspect of 

19 sufficient accuracy regarding the system 

20 itself, I think, will be tabled today. I 

21 really don't intend to discuss that because it 
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9 1 really is more of a program-wide issue.

2 So what we're going to talk about, 

3 really, is this issue of the particular data 

4 set itself and the problems we have with it.

5 Since the Board meeting, Joyce 

6 Lipsztein put together kind of a summary of 

7 all the new NIOSH references as well as the 

8 previous White Papers going back until, I 

9 believe, August of 2011 and kind of laid out 

10 what we feel are the SEC issues and the 

11 technical bases for those.

12 And after that, I believe it was 

13 April 9th, DCAS submitted a presentation 

14 outlining their position in a nice spreadsheet 

15 with links to the different documents that 

16 kind of support the positions on the various 

17 slides.

18 And one thing that really jumped 

19 out on that list was an interview with L. Max 

20 Scott. He was the principal architect of the 

21 mobile system at Y-12 and evidently he's still 
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10 1 active and a professor at Louisiana State 

2 University, I believe.

3 And so they interviewed him and 

4 clarified some of the issues for us, but 

5 unfortunately, also crystallized some of the 

6 problems that we saw in the data set.

7 But Mark Rolfes also put together 

8 a presentation outlining their position, and I 

9 guess the best way to approach this would be 

10 to have Mark go ahead and give his 

11 presentation and then we can talk about the 

12 issues that we have with the derivations for 

13 the milligrams thorium as they stand now.

14 MR. ROLFES: Okay, this is Mark 

15 Rolfes. Thank you, John. Yes, I just put 

16 together a brief slide show on bounding 

17 thorium-232 intakes using the mobile in vivo 

18 radiation monitoring laboratory data.

19 NIOSH can bound thorium-232 

20 intakes -- I'm just going to go ahead and read 

21 through these slides for people who don't have 
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11 1 it in front of them.

2 NIOSH can bound thorium-232 

3 intakes. Sufficient data are available. A 

4 coworker model has been developed using more

5 than 5000 mobile in vivo radiation monitoring 

6 laboratory thorium chest count results.

7 Chronic thorium-232 intake 

8 retention fractions were derived, which 

9 account for the differential biokinetics of 

10 decay products. And sample intake and dose 

11 calculations have been completed to 

12 demonstrate the methodology and feasibility of 

13 the methodology.

14 NIOSH has investigated where, 

15 when, and why the mobile in vivo radiation 

16 monitoring laboratory technology was 

17 developed, how it was calibrated, and the 

18 operating procedures.

19 We did learn from Max Scott that 

20 the techniques in calibrations of the mobile 

21 in vivo lab were identical to the Y-12 
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12 1 stationary whole body counter.

2 We also learned who was selected 

3 for chest counting and why, and information 

4 regarding the reporting and interpretation of 

5 the mobile in vivo results.

6 The calibration of the mobile in 

7 vivo lab used a REMAB phantom. We learned 

8 information about the thorium calibration 

9 standard, which had a thorium-232 to thorium10 228 ratio of 1.27 and a thorium-232 to radium11 228 activity ratio of 1.67.

12 It was reported that for that 

13 material the limit of detection was 6 

14 milligrams of thorium. The thorium chest 

15 burdens were reported in milligrams rather 

16 than in nanocuries, and this was based solely 

17 upon an established protocol for reporting 

18 uranium at Y-12.

19 Rather than reporting activities 

20 of uranium at the Y-12 counter, they also did 

21 a similar reporting methodology, reporting 
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13 1 uranium mass. So to be consistent, they 

2 reported thorium in mass as well.

3 Thorium-232 chest burdens derived 

4 from measurements of deposited progeny are 

5 basically determined by the 240 keV gamma ray 

6 from lead-212, plus the 330 and 900 keV gamma 

7 rays from actinium-228.

8 These photopeaks were measured and 

9 allowed the mass of thorium to be determined 

10 using an established Y-12 technique of using 

11 ratios of the count rates from adjacent 

12 regions with the interests in the spectra.

13 Some of the adjustments that need 

14 to be applied to the measurements, for 

15 example, when NIOSH has a measurement from the 

16 mobile in vivo, we assume that the age of the 

17 thorium exposure material in this historical 

18 exposure scenario, we assume that that thorium 

19 material age is unknown.

20 The chemical separation and the 

21 purification of thorium disturbed the 
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14 1 equilibrium of the thorium-232 and progeny. 

2 And so in order to bound intakes under 

3 EEOICPA, we've assumed that three chemical 

4 separations of the thorium material occurred 

5 in order to produce the worst-case 

6 disequilibrium ratio of thorium-232 to 

7 thorium-228.

8 The ratio becomes, after three 

9 chemical separations of the thorium over 8.8 

10 years at specific times over those 8.8 years, 

11 you get the largest disequilibrium ratio for 

12 triple-separated thorium, which becomes a 

13 ratio of thorium-232 to 228 of about 1 to 

14 0.19.

15 So if you divide 1 by 0.19, that 

16 gives you a correction factor of 5.25, which 

17 we would apply to the measured results, but 

18 you also have to correct -- I'll get back to 

19 that in just a second with a specific example.

20 The next slide shows the algorithm 

21 that was used by Y-12 to estimate the quantity 
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15 1 of thorium in someone's chest. And we've got 

2 an equation here which basically shows the 

3 count rates in a particular region of 

4 interest.

5 And, for example, the region of 

6 interest from 0.208 to 0.248 is the count rate 

7 from the portion of the spectrum between 208 

8 keV and 248 keV, which was one of the 

9 photopeaks from lead-212.

10 There's a factor representing 

11 background data. It's basically from 

12 measurements of 1100 unexposed workers. This 

13 factor was determined to be 3.23. And then we 

14 have a thorium coefficient of 8.84 to convert 

15 to units of thorium mass.

16 In summary, the NIOSH and ORAU 

17 whole body count experts have reviewed and 

18 approved the approach to bound thorium intakes 

19 and doses to workers. We believe that the 

20 thorium mass reporting methodology is not an 

21 SEC issue and that the thorium intakes 
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16 1 estimated from the mobile in vivo radiation 

2 monitoring laboratory are plausible, claimant3 favorable and bounding.

4 And to get back to a brief example 

5 of our proposed approach, if we have 1 

6 milligram thorium chest burden of material 

7 identical to the calibration source, that 

8 would contain 0.086 nanocuries of lead-212.

9 So if this was actually triple10 separated thorium, we would then multiply this 

11 value by the triple-purified thorium 

12 correction factor of 5.25 to give us a value 

13 of 0.45 of correction factor.

14 If you divide this by the specific 

15 activity of thorium-232, 0.11 nanocuries, it 

16 gives you a value of 4.1 milligrams of 

17 thorium.

18 So by applying this triple19 separated thorium correction factor, the 1 

20 milligram of thorium measured in the chest we 

21 would interpret to be 4.1 milligrams. So 
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17 1 we're applying essentially a correction factor 

2 of 4.1.

3 Let's see. That basically sums up 

4 the approach that we have proposed to use the 

5 mobile in vivo radiation monitoring laboratory 

6 results to reconstruct thorium intakes.

7 The intake rates are actually 

8 going to be recalculated based upon this 

9 correction factor and we are working on a 

10 draft of that right now at this time. And 

11 with that, that's our summary of our proposed 

12 approach. If there are questions --

13 CHAIRMAN CLAWSON: Hey, John, 

14 before you jump in, this is Brad speaking. 

15 Mark, I was kind of taken a little bit back by 

16 not even knowing about this interview until 

17 all of a sudden it pops up in a report that 

18 you were putting out.

19 I was kind of under the 

20 understanding of when we did interviews like 

21 this that, you know, the other party that 
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18 1 would be involved was also to be notified and 

2 then to be able to find this out coming out 

3 into a report, it just kind of caught me off 

4 guard with this.

5 So, you know, this person's a 

6 valuable asset to be able to bring a lot of 

7 this to light and I'd just want to know that -

8 - I didn't see this -- just to tell you the 

9 truth, I'd probably would have wanted to be 

10 involved with it if they were performing 

11 interviews like this. There's a few questions 

12 that I had too.

13 MR. ROLFES: Well, we did hear 

14 back from Max Scott. This was, basically, a 

15 last-minute schedule, based upon our tight 

16 work schedule, to get results back to the 

17 Advisory Board Work Group.

18 And Mr. Scott is willing to speak 

19 with us again if you'd like to ask him some 

20 additional questions. I'm sure we probably 

21 have some clarification questions for him as 
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19 1 well.

2 CHAIRMAN CLAWSON: Well, you know, 

3 we've tried as a Board, and we've also tried 

4 as NIOSH, to be able to limit, especially to 

5 these sites and these individuals, six or 

6 seven different times.

7 Having to come back into this, I 

8 would just appreciate that if anything like 

9 this does come up, at least notify us. I 

10 realize that sometimes these individuals come 

11 up and it's a spur of the moment thing, but at 

12 least notify us of the interview and that a 

13 report is following, because I was somewhat 

14 blind-sided by this report.

15 All of a sudden I had to start 

16 asking, where did, you know, the interviews 

17 come from and so forth like that. So I just 

18 caution us to try to cooperate with each 

19 other's side just a little bit better on this 

20 and communicate it.

21 I know that these things come up. 
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20 1 It's just I personally would like to have 

2 been notified and know of it so that I knew 

3 what was coming. With that, I'll turn it over 

4 to John to have his response and we'll go from 

5 there.

6 MR. STIVER: Okay. Thank you, 

7 Brad. This is John. And thanks, Mark, for 

8 the presentation. I'm going to go back to our 

9 previous concerns before the Scott interview, 

10 clarify some of this, and we were concerned as 

11 to exactly how the milligram data were 

12 derived.

13 And we know that post-1978, the 

14 actual activities of lead-212 and actinium-228 

15 were calculated, which then allows the 

16 derivation of the age of the material, and 

17 based on the lead-212 then, using Tom LaBone's 

18 intake retention fraction White Paper and the 

19 triple-purification claimant-favorable-type 

20 assumptions, we feel that those techniques can 

21 yield a plausible upper bound for that period 
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21 1 during which the activities of the progeny are 

2 actually provided.

3 We never had a problem with that. 

4 What we have is that we also were not quite 

5 sure which nuclide was measured in order to 

6 get the milligram data for the '68 to '78. 

7 And the interview with Max Scott has clarified 

8 that, no, they did not actually measure the 

9 activity.

10 They had this empirical formula 

11 here which looks at ratios. And I'd like to 

12 draw everybody's attention to the paper, or 

13 actually, just a technical note that we sent 

14 out just a couple of days ago, April 17th. I 

15 hoper everybody has a copy of this.

16 It's entitled: SC&A Comments on 

17 Slide 7 of the NIOSH Presentation. And before 

18 I get started on that, I'd just like to take a 

19 look at, in Slide 6, where Mark had discussed 

20 the triple separation.

21 I think it's very important that 
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22 1 we don't conflate these two methodologies. We 

2 believe this is a perfectly adequate approach 

3 to take to the lead-212 measurements when 

4 they're reported actually in activity units.

5 However, this particular -- that 

6 would not apply to this empirical formula on 

7 Slide 7. So I'd just like to kind of discuss 

8 this equation a little bit and make sure 

9 everybody on the Work Group, and all the 

10 participants, really understand what this 

11 means.

12 As Mark said, you have three 

13 regions of interest. The first is for a 240 

14 keV emission from lead-212. The second is for 

15 the 330 keV emission from actinium-228. And 

16 the third, 900 keV emission from actinium-228.

17 And what they did, these ratios, 

18 really, they took the region of interest where 

19 the photopeak is, they divide that by the 

20 adjacent higher region, where there is no 

21 counting from the particular emissions, and 
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23 1 then this ration then gives you an idea in 

2 comparison to background, whether there is an 

3 elevation in those photopeaks relative to an 

4 unexposed population.

5 And I guess there's two empirical 

6 values here that I'd like to discuss and this 

7 really clarifies a lot to me. The first is 

8 this 3.23 and the other being the conversion 

9 factor to get from this dimensionless ratio to 

10 milligrams of thorium, this 8.84, which is 

11 contingent upon the calibration source used 

12 for the calculations. That's where this 8.8 

13 comes from.

14 If we take a look at the 3.23 

15 first, now, this represents the ratios in 

16 these three regions of interest. The summed 

17 ratios for these 1100 unexposed workers from 

18 the Y-12 plant.

19 And, really, this is a 3.23, 

20 basically, they're just a little over 1 and 

21 when you look at the spectra in the paper, I 
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24 1 believe it was the Scott paper for 1969, you 

2 see there's a little bit of elevation in 

3 there, but not a lot.

4 The uncertainty in that 

5 distribution of summed ratios for the 1100 was 

6 rather tight, as we'd expect for such a large 

7 sample size, and that is 0.7. And now, I 

8 understand where the 6 milligram stated 

9 detection limit for the system came from.

10 It's basically 0.7 times 8.84. It 

11 gives you 6 milligrams. So basically, it's 

12 the uncertainty in that background 

13 distribution. So if you had, essentially, no 

14 differentiation between your measured 

15 individual in this background distribution of 

16 summed ratios, the uncertainty in that 

17 empirical approach would correspond to 6 

18 milligrams.

19 So it's not a detection limit in a 

20 classical sense based on the accounting 

21 statistics of your system using the approach 
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25 1 of Currie's paper in 1968. It's really an 

2 empirical construct.

3 And so we note that there are 

4 also, if you take a look, I believe, on our 

5 little paper on Page 3, we had a discussion 

6 about this.

7 And so I guess the problem being 

8 is that this kind of solidifies our concerns 

9 regarding the detection limit and also its 

10 applicability to Fernald because I note that 

11 the mobile system did not have the same level 

12 of shielding.

13 The iron was not quite as thick 

14 and it wasn't quite as low background as the 

15 thick system at Y-12. So you'd expect a 

16 slightly different -- we really can't 

17 determine what the difference would be in this 

18 background distribution of summed ratios and 

19 we would also vary depending on the number of 

20 individuals who were measured.

21 I mean, obviously, if you only had 
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26 1 20 or 30, they'd have a much larger spread as 

2 you get more -- you know, it's just a known 

3 quantity of the central limit there and how 

4 that works.

5 So anyway, that really calls into 

6 question the whole issue of the 6 milligrams 

7 and I know Dr. Ziemer, Paul Ziemer, had a lot 

8 of questions regarding that in the last 

9 meeting.

10 And that was in relation to Table 

11 1, which, remember, this was this period of 

12 overlap where we had two groups of workers in 

13 1979, one from one plant for a short period of 

14 time, another from a separate plant for a 

15 short period of time.

16 And we had lead-212 measurements, 

17 all but one of which were above the detection 

18 limit based on that approach that we're taking 

19 post-1978. And they also had another column 

20 which gave, you know, milligrams of thorium.

21 And because you're looking, almost 
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27 1 certainly, at a single source for those two 

2 groups, and you have a range of lead-212 

3 measurements, all of which are above the 

4 detection limit, you would then have expected 

5 that the milligram thorium data would be 

6 proportional to those lead-212 measurements, 

7 if indeed, the milligram data were calculated 

8 off of the lead measurements.

9 And what we found instead was that 

10 every single one of those was listed as 2.1 

11 milligrams. Well, the real reason for that is 

12 because if you have a detection limit for 

13 lead-212 of 0.23 nanocuries and you assume 

14 secular equilibrium, that's going to correlate 

15 just based on the specific activity for 

16 thorium, it's going to be 2.09 milligrams. So 

17 that's where the 2.1 came from.

18 What they did is, they just 

19 assigned the MDL value of milligrams that 

20 would have corresponded to the detection limit 

21 for lead-212. And, you know, we brought that 
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28 1 up and we keep bringing it up at every 

2 meeting, practically.

3 Just illustrate that, here's the 

4 situation where you have a set of data, but 

5 you've got a comparison of the two. And it 

6 looks like the approach that had been declined 

7 by NIOSH really wasn't used. And so now, when 

8 we can step back, we can also look at this 

9 from another view is that, well, now we know 

10 what the 6 milligrams really means.

11 And it's a highly variable 

12 quantity that depends on the characteristics 

13 of the summed ratios for these unexposed 

14 workers.

15 The other aspect of this is this 

16 value 8.84, this conversion factor to get from 

17 this dimensionless ratio to milligrams of 

18 thorium.

19 And looking at the papers by Mr. 

20 Scott and Mr. West back in the mid-'60s where 

21 they were doing this system development, it 
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29 1 appears that what this really does is this is 

2 another empirical value which basically takes 

3 that calibration source they had at Y-12, 

4 which was at about 80 percent equilibrium for 

5 lead-212 and about 60 percent for radium.

6 And they used that, placed in 

7 their REMAB phantom in the lung tissue, I 

8 believe they used sponges to simulate lungs in 

9 this phantom, and put these little vials of 

10 material in there, and then they knew the mass 

11 that they were inserting, and they were able 

12 to determine that, you know, when you get a 

13 ratio increase of 1 compared to the unexposed 

14 group, this corresponds to about 8.84 

15 milligrams of thorium.

16 And so they indicate that they 

17 selected that source to be representative of 

18 the thorium that was being handled there at Y19 12.

20 Well, now you take this system, 

21 you got a mobile system now in a tractor 
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30 1 trailer rig, and you're moving it around to 

2 the different labs, but the real reason for 

3 using this was to measure U-235 and get 

4 maximum permissible body burdens.

5 The thorium measurements were kind 

6 of ancillary, but they had a technique and 

7 they could apply it. So, you know, they're 

8 here, we can measure them, let's go ahead and 

9 measure thorium too, but the real reason was 

10 to measure uranium and get these, you know, 

11 quantitative measures of the MPBD for that.

12 But when you're taking it to place 

13 like Fernald where, during a period of thorium 

14 production, you have all different types of 

15 sources.

16 You've got type M, you got type S, 

17 you've got freshly separated material from the 

18 refinery, you've got that feeding them and 

19 being converted to an oxide; very similar, 

20 almost exactly similar to the uranium 

21 processing approach.
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31 1 Then it's fluorinated to produce a 

2 tetrafluoride, which is then reduced to metal, 

3 and so forth, and then, I believe in thorium, 

4 they sent it offsite for extrusion into rods, 

5 but there was some machining done there as 

6 well.

7 And so you have this whole range 

8 of source terms; ages of the source. And so 

9 when you try to apply this value, we have a 

10 set of ratios to some of them.

11 And that's all you have, really, 

12 that summed ratios, and you've got this 

13 calibration factor which is dependent, 

14 entirely, on the characteristics of the 

15 calibration source and you hope that it's 

16 representative of the material you're actually 

17 trying to measure.

18 And in our little ditty here, we 

19 did some calculations, Joyce actually did 

20 these calculations, where she took an example, 

21 okay, we've got a type M thorium, the guy is 
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32 1 exposed for 60 days, and then he's monitored 

2 in the mobile laboratory.

3 We looked at several different 

4 contingencies. First, we looked at the middle 

5 of his exposure, 30 days from the onset of the 

6 intake, we looked at the last day of 

7 exposures, and then at 90, 120, 180, and 360 

8 days after the first day of exposure.

9 And what we did, we kind of 

10 finagled just a little bit, just for 

11 illustrative purposes, we used the detection 

12 limits that were in place post-1978 in units 

13 of nanocuries.

14 And when we took a look at this 

15 and we said, okay, let's look at three 

16 different contingencies. We've got a material 

17 that's essentially in equilibrium. And they 

18 looked at, okay, given this 10 -- oh, and, 

19 basically, what you wind up with is a 10 

20 milligram value at these different time 

21 periods.
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33 1 And so, you know, based on just 

2 the range of, we presented something similar 

3 to this at the meeting, but just bear with me, 

4 intakes over this period of time, 

5 corresponding it to 10 milligrams, it ranges 

6 over about from 17 to 140 becquerels, so it 

7 spans about an order of magnitude.

8 If the worker was exposed to 

9 material in equilibrium, it would be 

10 detectable. Then we took a look at, okay, 

11 let's take this triple-distilled thorium. 

12 Let's look at that.

13 And so we took a look at that, 

14 give it the same amount of material that would 

15 be in the lungs at the end of these exposures, 

16 and in those situations, the range of activity 

17 of lead-212, and of actinium, would not have 

18 been detected.

19 So here's a situation where you 

20 would have a 10 milligram burden which would 

21 be virtually undetected given this technique, 
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34 1 even if you had the conversions to get back to 

2 activity, which, in this case, we don't. All 

3 we have are milligram values and we don't even 

4 have the ratios or the count.

5 We finally looked at, okay, here's 

6 another situation. Let's look at a situation 

7 where you, instead of just having a triple 

8 purification, we just have one purification. 

9 And in that situation, you would have 

10 detectable counts in the lead-212 peak by 

11 virtue of the unsupported progeny of the 228 

12 thorium, which would be decaying away.

13 And the progeny build-in is 

14 governed by iridium-224, which builds in at, I 

15 believe, a 3.6 day half-life, so within about 

16 three weeks the progeny are in equilibrium 

17 with unsupported 228, but then the actinium 

18 ROIs, the two actinium ROIs, would detect 

19 nothing. And so this is illustrative of how 

20 you could have very large intakes that would 

21 be missed all together.
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35 1 And so I guess, at that point, 

2 really, I can say that our concerns aren't 

3 really alleviated. If anything, I think 

4 they're more crystallized here regarding the 

5 applicability of this data set without any way 

6 to get back to what an activity of lead-212 

7 might have been.

8 The only way I can see where you 

9 could get that is if you had the count data 

10 and the efficiency. And from that, you could 

11 apply the LaBone method to get back to a 

12 worst-case situation, you know, for triple 

13 distillation.

14 But as it is now, SC&A feels that 

15 this is just a really unstable foundation to 

16 build a coworker model on what is going to be 

17 the fundamental basis for making compensation 

18 decisions for hundreds, if not over a 

19 thousand, workers.

20 And that's, kind of, where we 

21 stand at this point. So if the Work Group or 
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36 1 DCAS want to resolve that. And I'd also like 

2 to, because we have Stu onboard, and he was, 

3 you know, working at Fernald during this 

4 period of time.

5 Maybe, Stu, could you tell us a 

6 little bit more about this 8.84, and what do 

7 these values really represent, and do you have 

8 any knowledge of the system and how it was 

9 used at Fernald?

10 MR. HINNEFELD: Well, this is Stu. 

11 I didn't start until 1981, so I wasn't there 

12 during the '68 to '78 time period, but the 

13 mobile in vivo counter was being used for 

14 several years after I started.

15 At the time that I was there, it 

16 was, really, a uranium counter. Thorium work, 

17 by the '80s, I don't recall any actual thorium 

18 processing or production. There was thorium 

19 in storage here and there, and there may have 

20 been some over-packing of containers that were 

21 corroding.
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37 1 MR. STIVER: Right.

2 MR. HINNEFELD: But thorium was 

3 largely just kind of left alone. It was in 

4 warehouses. It tended to be, for the most 

5 part sort of remote from the rest of the 

6 plant. That's not a 100 percent true. There 

7 was some thorium stored in relatively close 

8 proximity to some of the process areas.

9 So my recollection from my 

10 experience at having been there was: we didn't 

11 pay much attention to the thorium numbers 

12 because no one was really being exposed to 

13 thorium anyway.

14 I have spent quite a lot of time, 

15 since I've been authorized, and also in 

16 anticipation of being authorized to speak to 

17 the workers about this, and trying to follow 

18 the discussion here.

19 And I think it's pretty clear from 

20 everybody's work that, when the mobile counter 

21 was recording thorium milligram numbers, it 
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38 1 did not actually arrive at activities of lead2 212 and actinium-228 as an intermediate step 

3 and go from there.

4 John described really well that 

5 there was just a sum of the ratios approach. 

6 And so my question has always been, well, how 

7 is there a method to deconvolute a milligram 

8 of thorium number into lead-212 and actinium9 228 numbers that would give you a reliable 

10 bounding estimate, because I'm pretty clear 

11 you can't really deconvolute it and an amount 

12 of it gives you a precise estimate and then 

13 interpreting that milligram number, but can 

14 you do a bounding interpretation?

15 And so from that standpoint -- and 

16 some of my thoughts here just crystallized 

17 during John's presentation a minute ago. 

18 There are, from the calibration source that's 

19 described in either the West or the Scott 

20 paper, I forget which paper describes it, 

21 there is some knowledge that we have about how 
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39 1 the mobile in vivo counter interpreted a 

2 thorium source with those specific activity 

3 ratios; how it interpreted that into 

4 milligrams of thorium.

5 And so the question then is, well, 

6 if you don't have a mixture of thorium that is

7 the same as your calibration source, what are 

8 the possible combinations of lead-212 and 

9 actinium-228 that would be interpreted the 

10 same way as, say, 1 milligram of the 

11 calibration source?

12 And so having, you know, thought 

13 about that, it's not a simple issue to explain 

14 and the discussion that John talked about of 

15 the years when we have reports that were 

16 listed both ways, both with the activity of 

17 lead-212 and the actinium-228 and the same 

18 subject reported in milligrams of thorium, 

19 that, to me, kind of becomes more troubling as 

20 I think about it.

21 The issue there being that, you 
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40 1 know, if, in fact, the mobile counter 

2 interpreted -- if you have 1 milligram of 

3 thorium resulted to a source that had 0.086 

4 nanocuries of lead-212 and a somewhat less 

5 activity of actinium-228.

6 And if, in fact, the subject had 

7 freshly separated thorium in his lungs rather 

8 than the calibration source mixture, then the 

9 counter would see only lead-212 and it would 

10 require slightly more lead-212 than 0.086 

11 milligrams because the lead-212 ratio has to 

12 account for the entire sum of ratios.

13 He doesn't get any additional sum 

14 from the actinium piece. And so 1 milligram 

15 then, if it were strictly lead-212, should 

16 translate to something, you know, not a whole 

17 lot more than 0.086 nanocuries of lead-212.

18 The reason being that, the paper 

19 that describes the ratios and the one 

20 calibration we have that shows how much each 

21 region of interest contributes, shows that, at 
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41 1 least for that example, the lead-212 

2 contributed more to the excess ratio than the 

3 actinium-228 at, what I believe to be, the 

4 calibration source ratios.

5 So if we're counting only lead6 212, and we got 1 milligram, then we should 

7 see some value slightly above 0.086. And then 

8 when you look at the measurements from the 

9 year when you have both milligrams and 

10 activity, and John cited some of these, you 

11 have some measurements where the lead-212, I 

12 think it was in the 0.4 region, maybe higher 

13 than that, maybe higher then 0.4 in some 

14 cases, and the milligrams were at 2, then it 

15 seems to me that, just on the face of it, the 

16 2 milligram in vivo result shouldn't have been 

17 much higher than about 0.2 nanocuries because, 

18 you know, 0.086 and a little bit bigger than 

19 that, say, 1 nanocurie for 1 milligram, so 

20 then 2 milligrams would be about 2 nanocuries.

21 And so if you have 0.4 or higher 
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42 1 nanocuries of lead-212, why isn't that 

2 providing a sufficient boost to that sum of 

3 ratios that get a higher number than 2 

4 milligrams?

5 So there is a lot of stuff here. 

6 A lot of complications that SC&A has kind of 

7 pointed out, and there's some really sketchy 

8 available data on the actual calibration, at 

9 least that I've seen, calibration data.

10 So, to me, I'm really struggling 

11 with making a firm conclusion here that you 

12 can deconvolute that thorium number. So 

13 that's what I'm struggling with

14 MR. STIVER: Yes, I guess we've 

15 kind of come to the same place in that regard.

16 MR. ROLFES: This is Mark, and I 

17 know we had previously discussed a potential 

18 negative bias in some of the lead-212 results. 

19 I'd like to check, maybe, if Bob Morris might 

20 be able to possibly comment on that if that 

21 would play into this discussion here when they 
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43 1 switched over from reporting mass results to 

2 the activities of both actinium-228 and lead3 212.

4 I believe SC&A previously had a 

5 comment that the lead-212 activities appeared 

6 to have a negative bias to them. And so we 

7 had proposed adjusting the reported lead-212 

8 values upwards by this negative bias amount.

9 Bob, I don't know if you have any 

10 comments on this.

11 MR. MORRIS: No, you said it 

12 correctly.

13 MR. ROLFES: Okay.

14 MR. MORRIS: We did take note of 

15 the SC&A comment, which was made, well, 

16 probably a year and a half ago, pointing out 

17 that there was, obviously, too many negative 

18 values, too many values below, hovering around 

19 0 to be statistically appropriate, and we 

20 agreed with that.

21 Went through and made a process of 
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44 1 a bias adjustment to bring dose up as an 

2 additive value. So I think that that is in 

3 the plan for when we revise the coworker model 

4 for '78 to '88. It has no bearing on the 

5 coworker model for '68 to '78.

6 MR. HINNEFELD: This is Stu. I 

7 mean, you know, that's an adjustment that's 

8 made when the data are reported in activity 

9 and if you make that adjustment to the lead10 212 activity for the year when you have both, 

11 well, instead of having 0.4, then you've got 

12 0.6 nanocuries of lead-212, and you still have 

13 the same issue.

14 Why doesn't that much lead-212 

15 give a higher boost to the ratio than what 

16 turns into 2 milligrams? Am I right? Am I on 

17 somebody's speakerphone? I hear myself

18 echoing.

19 MR. STIVER: I'm hearing the echo 

20 too, Stu. This is John.

21 MR. HINNEFELD: I mean, I can deal 
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45 1 with it. It's not very loud.

2 CHAIRMAN CLAWSON: This is Brad. 

3 It happens to me too. Actually, I was having 

4 a little bit of a hard time hearing the one 

5 that just spoke before you, I believe it was 

6 Bob Morris or Robert Morris, because he was 

7 cutting out, but I think it's just a bad phone 

8 connection.

9 MR. KATZ: This is Ted. I think 

10 some people have not muted their phones and 

11 that's probably contributing to this 

12 background noise. Somehow it's feedback. So 

13 everyone who's not speaking, please mute your 

14 phones, and press *6 if you don't have a mute 

15 button.

16 MR. STIVER: Okay. This is John 

17 Stiver. I'd kind of like to add a little bit 

18 to this. Another thing that we had commented 

19 on in our previous papers is the milligram 

20 thorium data also don't appear to comport with 

21 biokinetic processes.
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46 1 And what this means, really, is 

2 that you've got very high values reported 

3 followed, not immediately, but within in a 

4 period of time where you should be able to 

5 predict, you know, within reason, a follow-on 

6 measurement would have been done.

7 And so we've got some pretty 

8 oddball situations where you've got, like, 

9 over 10 milligrams followed, about two months 

10 later, by 0.2 or it was 0.02. I know Bob 

11 Barton could probably give you the exact 

12 numbers on that.

13 So I guess the issue there is 

14 that, you know, we have kind of multiple 

15 snapshots of evidence here, all of which kind 

16 of tend to result in us questioning the 

17 veracity of this data set in terms of how it 

18 was actually developed, whether it was really 

19 done in a way that can be used to create a 

20 coworker model.

21 It would be nice if we had the 
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47 1 actual count data for these regions and you 

2 could kind of pick it apart and say, okay, 

3 yes, well, we got more lead counts here and so 

4 it's going to mean -- and once you get that, 

5 then you can kind of get back to activity and 

6 then you can put some bounding assumptions on 

7 it, but we're kind of adrift here.

8 We don't have that hook to get 

9 back to a reasonable milligram thorium value 

10 and so that's kind of where we are. We're 

11 just still struggling with this and I just 

12 don't see a reasonable way to put a bound on 

13 numbers.

14 John, we talked about this 

15 yesterday. Is there anything you'd like to 

16 add? John Mauro.

17 DR. MAURO: Yes. I'm here 

18 listening and yes, we did. My takeaway, and 

19 to really down to the bottom, I think, not 

20 withstanding some of the problems that were 

21 described post-`78, you may very well have a 
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48 1 tractable situation, because you do have the 

2 counts from lead.

3 But everything I'm hearing 

4 regarding '68 to '78 is impossible. And what 

5 really brought it home to me was the fact that 

6 the calibration source that was used to come 

7 up with this equation, I guess we'll call that 

8 Max's or Hap West's equation, it's only 

9 applicable to Y-12 for that particular 

10 calibration source and that particular 

11 background.

12 And it works as long as that, in 

13 fact, is what you were dealing with. And what 

14 I walked away from with is, but wait a minute, 

15 that only worked for that system at Y-12 and 

16 that calibration source.

17 And now you bring this on the 

18 road, which is a different shielding, 

19 different background, and who knows what the 

20 mix is of what people are actually 

21 experiencing. It certainly is not going to be 
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49 1 the mix of radionuclides that were used for 

2 the calibration source.

3 And I walk away from this saying, 

4 you cannot reconstruct those doses. You know, 

5 I just can't see a way of getting out of this. 

6 Now, there may be some folks on this who 

7 really have a very deep and rich understanding 

8 of these problems, and there may be ways of 

9 teasing things apart, and maybe making 

10 bounding assumptions, but I haven't heard it, 

11 or if I did hear it, I certainly did not 

12 understand it.

13 So right now, you know, in trying 

14 to watch this and stay close to it, I can't 

15 see a way out of having a tractable dose 

16 reconstruction coworker model from '68 to '78.

17 MEMBER ZIEMER: This is Ziemer, 

18 could I ask a question here? Hello.

19 MR. STIVER: Certainly.

20 MEMBER ZIEMER: Oh, okay. This is 

21 for Mark. Mark, when you talked to Dr. Scott, 
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50 1 did he indicate, when he said that they used 

2 the same procedures, anything about the 

3 counting times used for both the Fernald and 

4 the Oak Ridge cases?

5 I mean, there's been a lot of 

6 focus on this 3.23 factor which is associated 

7 with the background data for the Y-12 group, 

8 but, you know, if I were doing this, and I've 

9 done a lot of whole body counting work in the 

10 past, if I had different shielding and 

11 different background, I would just be 

12 adjusting my counting times.

13 I could get the same basic number 

14 there by adjusting counting times to get it. 

15 Basically, what you're after on these kind of 

16 counters is looking at a figure of merit, 

17 which, basically, turns out to be sample 

18 squared to background ratios.

19 And if you go from one background 

20 to another, you can make that adjustment 

21 through counting time, but is there any 
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51 1 indication that something like that was done?

2 MR. ROLFES: Dr. Ziemer, this is 

3 Mark, and as far as, from my recollection, I 

4 believe it was a 1000-second count. This is 

5 just from recollection. I'd like for someone 

6 from ORAU to --

7 MEMBER ZIEMER: I mean, is that 

8 what was used at both places?

9 MR. ROLFES: I'll get to that. I 

10 apologize. What we do know from Max Scott, we 

11 do know that, I can use another example, he 

12 had actually run what was the precursor to the 

13 mobile in vivo at the Weldon Spring plant to 

14 determine thorium exposures for workers in 

15 1966.

16 And we know that, at that time, he 

17 had adjusted due to the higher background of 

18 that system that he built. It wasn't the 

19 mobile in vivo unit yet per se, it was 

20 basically a room that he had constructed which 

21 had a much higher background than the Y-12 
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52 1 mobile counter.

2 And so in that case, at the Weldon 

3 Spring plant, instead of using the actinium4 228 and lead-212 photopeaks, he used a 

5 thallium-208 photopeak to quantify thorium 

6 exposures.

7 We do know that Max Scott was 

8 actually one of the first people to come to 

9 Fernald with the mobile in vivo counter that 

10 we're discussing today. And we know that 

11 background is somehow adjusted for in the 

12 counts.

13 We do know that the background was 

14 much lower at Fernald with the mobile in vivo 

15 than its precursor at the Weldon Spring plant 

16 because they were able to use the actinium-228 

17 and lead-212 photopeaks there.

18 So we do know that he was 

19 involved, and Y-12 was involved, in concerns 

20 about elevated background. We know that Max 

21 Scott trained the personnel at Fernald to 
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53 1 operate the mobile in vivo and was also called 

2 several times, as he indicated in his 

3 interview, to basically troubleshoot and come 

4 up to the site, to Fernald, when there were 

5 issues with elevated background.

6 He gave an example of one of the 

7 times in his interview that he had come up to 

8 the Fernald site due to elevated background.

9 MEMBER ZIEMER: Okay.

10 MR. ROLFES: As far as the 

11 counting times, I don't know the answer off 

12 the top of my head if the count times were the 

13 exact same or if they were adjusted based upon 

14 the background count rates.

15 That's something maybe ORAU might 

16 be able to answer, but I don't know the exact 

17 answer at this point.

18 MEMBER ZIEMER: Well, if you're 

19 going to have a follow-up interview with Max, 

20 maybe you could address that. I have more 

21 concerns about the other issues that John 
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54 1 Stiver raised than that 3.23 issue because I 

2 think, in principle, you can adjust the system 

3 to achieve that same level of -- it sort of 

4 looks like a detection limit, but it's, I 

5 think as you mentioned, 3.23 times 8.84, I 

6 guess; whatever that comes out.

7 MR. STIVER: This is Stiver, if I 

8 could jump in again. That 3.23, you got to 

9 remember, that's not based on the counting 

10 statistics of the system and it's based on the 

11 sum of ratios using this same approach, just 

12 taking the ratios of those three photopeaks to 

13 the adjacent area, the higher energy, and 

14 adding those up.

15 And also, the count time that I've 

16 seen is 1200 seconds, so it's a 20-minute 

17 count. I haven't seen any information on what 

18 the count times were at Fernald, but, you 

19 know, all the calibration information is for 

20 Y-12.

21 So it's not like you're actually, 
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55 1 you know, taking the background distribution 

2 of your counting system so you can count it 

3 longer and get more precision in this 

4 situation. It's really a --

5 MEMBER ZIEMER: Well, using the 

6 same calibration source in both cases, I 

7 assume.

8 MR. STIVER: Yes, it's a similar 

9 construct for that particular set. So if 

10 you've got the same counts, unexposed, and the 

11 same ROIs, you get 1100 of these people, they 

12 sum those up, they get an average value. 

13 That's what that 3.23 represents.

14 MEMBER ZIEMER: Right.

15 MR. STIVER: It's the average 

16 counts for 1100 unexposed people. And the 

17 spread in that is 0.7, and that's, then, where 

18 the 6 milligram MDA came from.

19 MEMBER ZIEMER: Yes. So you're 

20 talking about the three regions of interest in 

21 the background and suggesting then that if the 
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56 1 background is different, the regions of 

2 interest are probably different then.

3 I understand your point, yes.

4 DR. LIPSZTEIN: May I clarify 

5 something? When you look at those, 

6 supposedly, 3.23 is correct. And that dose is 

7 the same at Fernald and at Y-12. When we 

8 measured the people, the persons, it's 3.23, 

9 plus or minus 0.7.

10 Now, you have those three regions. 

11 In order to have the milligrams of thorium, 

12 you multiply it by 8.84. This is something 

13 that is only related to -- that's special for 

14 us that they used at Y-12. And I made the 

15 simulation of someone that really had 10 

16 milligrams of thorium in his lung.

17 Suppose he had 10 milligrams in 

18 his lung, and suppose that the force that they 

19 were dealing at Fernald had the three 

20 separation steps, so what happened is that, 

21 all of these three ratios that we see in the 
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57 1 equation, they will all be around the 3.23.

2 So the result we would have, minus 

3 3.23, would be between minus 0.7 and plus 0.7, 

4 or minus 6/plus 6, if you multiply it by 8.84. 

5 I don't know if I'm clear, but the three 

6 ratios that we see in the equation would not 

7 be different from the normal people, even if 

8 this person had 10 milligrams in his lung.

9 And we would get any number 

10 between minus 6 and 6 if we apply the 

11 equation. And in reality, he had 10 

12 milligrams, so we cannot determine which error 

13 was --

14 So depending on the mixture you 

15 had in the lung, it's impossible to determine 

16 what error, was the maximum error on this. 

17 Did I make myself clear? I don't know.

18 MEMBER ZIEMER: Yes. I agree with 

19 that. I think that would also happen if you 

20 had the same thing at Oak Ridge, though, would 

21 it not?
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58 1 DR. LIPSZTEIN: Yes. If you had 

2 another source, yes, exactly.

3 MEMBER ZIEMER: If the 

4 calibration's different from what you're 

5 counting, you're going to have that same 

6 issue.

7 No, I was just raising the issue 

8 of whether or not they wouldn't have adjusted 

9 this knowing what the background regions of 

10 interest were at Fernald versus those at Oak

11 Ridge, and using the standard calibration 

12 source, if they wouldn't have been able to 

13 adjust for the background part of this.

14 No, I agree with your other 

15 supposition that, in actual situations, if you 

16 have very different ratios in an actual 

17 person, your calibration is going to not be so 

18 useful.

19 So I'm a little bit like Stu in 

20 raising the question, can we bound from this 

21 or not? I think that's sort of the question, 
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59 1 realizing that you can get very different 

2 answers depending on what those ratios are. 

3 Well, I'm more concerned about those issues 

4 than I am the background issue.

5 I think that part, even as a 

6 starting point, could -- but we would need to 

7 talk to Max Scott to see how they did that I 

8 guess.

9 DR. MAURO: Paul, this is John. 

10 One of the things that crystallized my 

11 thinking was reading the minutes of the 

12 conversation with Max Scott and it certainly -

13 - oh, Scott Max, it certainly appeared that 

14 that equation that we're looking at right now, 

15 was what was used with that 8.84 and it really 

16 was the 8.84 that tipped me over.

17 That is, that 8.84, embedded in 

18 that is a certain ratio of, I believe it's 

19 radium-228 to thorium-232, and also a certain 

20 ratio, I guess, of thorium-228 to thorium-232.

21 There are certain ratios embedded 
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60 1 in that which reflect a mix of radionuclides 

2 in the calibration source that, in effect, was 

3 not even necessarily a certain age of thorium, 

4 but a thorium source that even had some other 

5 contaminations, if that's the right word, of, 

6 I want to say, radium-228.

7 So that was a very unique source. 

8 And in my mind, that was not only problematic 

9 as applied here in Fernald, but it may very 

10 well have been problematic as applied at Y-12 

11 if they did not take into consideration that 

12 the actual people that they were measuring had 

13 that mix.

14 And, quite frankly, how far you 

15 could be wrong. You're certainly going to get 

16 a bad answer if you're, you know, counting 

17 everybody on the assumption that that's the 

18 mix that these people have.

19 How far wrong you could be and 

20 whether you could somehow find an upper bound, 

21 that was my next question, and then I realize 
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61 1 that, if this was --

2 MEMBER ZIEMER: Now, John, I 

3 basically was asking the same question because 

4 my concern was with the 8.84, not what's 

5 inside the --

6 DR. MAURO: Me too. That was my 

7 first concern. I agree with you.

8 MR. STIVER: Yes. The 8.84, is 

9 really, that's what allows you to get to a 

10 milligram value. That's really your 

11 calibration factor and it is completely 

12 dependent on the characteristics of that 

13 source term that was being employed. 

14 DR. LIPSZTEIN: And the other 

15 problem, if I may, is that if someone had 

16 inhaled type S thorium in the lung, the radium 

17 would leave the lung faster than thorium-232 

18 and would behave more like a type M than a 

19 type S.

20 So if you had a type S material, 

21 you wouldn't have even a worse problem. If 
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62 1 you don't have, you know, the real number, you 

2 just know what the sums of the parcels minus 

3 3.23. So it's very difficult to go back.

4 MEMBER ZIEMER: Well, in fact, if 

5 you had type S, and some of that might account 

6 for what were described earlier as kind of 

7 strange biokinetics, at least if you were 

8 looking at these as being insolubles.

9 MR. STIVER: Well, actually, if it 

10 was type S, I think, you would probably just 

11 see a continuous amount. It wouldn't be any 

12 decrease to speak of in the lung.

13 DR. LIPSZTEIN: But you were 

14 seeing lead and actinium on both sums, and so 

15 if the radium leaves, so you see the daughters 

16 leaving too, so when you are measuring, this 

17 will also, depending on the time after 

18 inhaling that you are measuring the person.

19 MR. HINNEFELD: This is Stu 

20 Hinnefeld. I don't really want to get into 

21 this issue very much. I don't know that it 
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63 1 matters that much, but with respect to the 

2 differential dissolution in the lung, there 

3 has to be, for type S thorium, there has to be 

4 some sort of particle size consideration here, 

5 because only the radium that is available to 

6 the lung fluid would have any different 

7 ability to depart.

8 In other words, some portion of 

9 that radium would be within the particle and 

10 not available to be treated differently than 

11 the thorium particle itself. I mean, I don't 

12 know if we need to get into that very far 

13 because I don't know that that's a very big 

14 issue.

15 MR. STIVER: That is true, Stu. 

16 You're right.

17 CHAIRMAN CLAWSON: This is Brad 

18 speaking. You know, we get into a lot of this 

19 stuff all the time. Basically, there is so 

20 many uncertainties out there. I'm of the 

21 opinion, we've discussed this for how many 
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64 1 months now, that, you know, it'd really be 

2 hard to be able to come to a concluding point 

3 on this.

4 And, Paul, this is where it 

5 basically comes down to; as the Work Group, 

6 we need to make the decision on this. We can 

7 debate this, go back and forth, and we can 

8 make a real nice science project out of it, 

9 but the bottom line is, that isn't what I feel 

10 that we're here to try to do.

11 I think we've given it a good 

12 faith effort and, myself, I think that it just 

13 ought to come before the Board at the next 

14 Board Meeting and be presented this way.

15 I don't know about your feelings, 

16 Paul. I guess this is what I'm asking you.

17 MEMBER ZIEMER: What I haven't 

18 heard -- you know, we just saw this stuff in 

19 the last day, but what we haven't heard, I 

20 guess, is whether or not, given the wide range 

21 of potential doses, I mean, it has been 
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65 1 illustrated, depending on those ratios, does 

2 that mean you can't bound?

3 That's N/A, are you saying that 

4 you can't plausibly bound? I mean, you've 

5 indicated that --

6 MR. STIVER: That's our position, 

7 that you just can't put a plausible bound on 

8 these numbers because of the fact that there 

9 could be such a huge variability that you 

10 can't possibly quantify.

11 DR. MAURO: And Joyce made a very 

12 good point just now that, I was listening to 

13 it and she said that, you could actually have 

14 a person that you would say is below -- you'd 

15 go through this process, you would say he's 

16 below the lower limits of detection, and 

17 thereby assign one half the 6 milligram, when 

18 in fact, he could have had 10 milligrams.

19 MR. STIVER: Or typically a lot 

20 more than 10.

21 DR. MAURO: Or more. 
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66 1 MEMBER ZIEMER: How much more?

2 DR. MAURO: Yes. I can't say.

3 MEMBER ZIEMER: Well, that's sort 

4 of what I'm asking. What could it be and you 

5 could still miss it? I mean, is that a way of 

6 bounding? See what I'm saying?

7 MR. HINNEFELD: This is Stu 

8 Hinnefeld. I just want to comment on that. 

9 Recall, though, that our bounding approach 

10 calls for essentially a factor of five 

11 multiplier, on the indicated activity, based 

12 on lead-212 if you know what the lead-212.

13 So, in fact, if the person had, I 

14 haven't done all the math on this, but 10 

15 milligrams of thorium and being missed. In 

16 fact, if we were going to do that factor of 

17 five multiplier, it would seem to me, then, 

18 that the missed dose would not rely upon the 6 

19 milligram number or half of that, it would 

20 rely on five times that factor. If that was 

21 really during the day. So taking into 
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67 1 account, I mean, the fact that we said, well, 

2 we'll interpret these data as a triple 

3 separation of this worst case. Joyce has 

4 started from 10 milligrams and shown where you 

5 can't see that, but I don't think we would 

6 claim we would. If you say that's 6 

7 milligrams, then it would become 30.

8 We're talking about issues here 

9 that I don't think are the key issues, because 

10 the key issue is that lead-212 number.

11 MR. STIVER: Yes. If you don't 

12 have a lead-212 number, you're adrift. You 

13 have no way to get back to the true value.

14 DR. MAURO: Stu, I think our 

15 position is that post-'78, when you have the 

16 lead-212, and I think that this adjustment 

17 factor that you're referring to, and certainly 

18 correct me if I'm wrong, that all applies to 

19 the post-'78 lead-212 data that's available to 

20 us.

21 But when you go to the '68 to '78, 
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68 1 correct me if I'm wrong but that's not at 

2 play; these adjustment factors, et cetera, or 

3 what we have in this equation, and the 

4 inherent flaws in the equation, especially 

5 regarding the calibration factor that gives 

6 you that 8.8, whatever the number is.

7 See, that's the rock that equation 

8 stands on and I don't think that rock is 

9 necessarily very good and the effects of that 

10 being wrong are not applicable to a given 

11 worker at Fernald. I guess the question 

12 becomes: how wrong could you be?

13 And I don't think we've addressed 

14 that.

15 MR. HINNEFELD: Well, actually, 

16 and that's the part of your guy's argument 

17 that I really can't refute. That's what I 

18 tried to say a while ago in different --

19 DR. MAURO: And, Joyce, you looked 

20 at this pretty carefully. I mean, is there a 

21 way, you know, that someone could say, well, 
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69 1 let's assume this, this, and this, it could 

2 never be, under any circumstances, higher than 

3 some number?

4 Of course, when you start going 

5 that road, you're inventing a set of 

6 conditions that may or may not have ever 

7 existed, but, you know, everything I've heard 

8 is that, you know, it could be a hundred times 

9 higher.

10 Let's go to this triple-separation 

11 process that you folks make reference to. My 

12 understanding, under those circumstances, if 

13 you are counting a person relatively shortly 

14 after that process and he had a very large 

15 intake, you would not see anything, but he 

16 could have an extremely high body burden of 

17 thorium.

18 Now, I haven't heard what those 

19 numbers are, but that's a scenario that is not 

20 out of the question. Do we have a feel for 

21 how high? I mean, that would be a worst 
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70 1 circumstance, I presume, that is triple2 separated, which means you have minimal amount 

3 --

4 DR. LIPSZTEIN: Hello?

5 DR. MAURO: Yes, Joyce?

6 DR. LIPSZTEIN: Yes. Okay. Let 

7 me --

8 DR. MAURO: How bad could it get?

9 DR. LIPSZTEIN: Yes. That's the 

10 example that I did, was to take the 

11 separation. We accepted that this factor of 

12 five is valid when you have the lead-212 

13 measurement result. But when you have the 

14 milligrams, I did exactly this example because 

15 then you -- even if the person has 10 

16 milligrams in his lung, the results of 

17 applying this equation would be any place 

18 between minus 6 and 6, or even, I don't know, 

19 even this 0.7 that makes it go from minus 6 to 

20 6.

21 I don't even know if this is 95 
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71 1 percent of the mean, 99 percent of the mean, 

2 68 percent of the mean. I don't know. There 

3 is nothing about this 0.7 error, but it's 

4 3.23, plus or minus 0.7.

5 So when you have your result and 

6 take out 3.23, minus or plus 0.7, and multiply 

7 by 8.8 something, you get between minus 6 and 

8 6 with a mean of 0. That's what you would 

9 have for a person that would have 10 

10 milligrams.

11 But maybe it can even go below 

12 that, because I don't even know if this 0.7 is 

13 95 percent of the distribution, if it is 68 

14 percent of the distribution, if it is one 

15 standard deviation, two standard deviations,

16 three standard deviations, we don't even have 

17 this information.

18 So, you know, you can get from 

19 negative numbers to positive numbers because 

20 you are subtracting, you know, something that 

21 you don't see. It's similar to someone that 
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72 1 is not exposed. And in reality, he had 10 

2 milligrams.

3 So you can't apply this five times 

4 correction factor when you know the lead-212 

5 result. It doesn't apply here.

6 MR. HINNEFELD: Yes, Joyce. This 

7 is Stu Hinnefeld. I'm not arguing your point 

8 at all. Just a clarification, in the, I 

9 guess, West paper from '65. It's the paper 

10 from 1965. I think it's the West paper. Oh, 

11 I'm sorry. It's by Scott in 1965, sorry, 

12 1966, where he gives the tables of the ratios 

13 plus or minus 0.67 in the paper, it's 

14 described as 95 percent confidence interval. 

15 So that'd be the two-sided 95 percent 

16 confidence interval on that.

17 DR. LIPSZTEIN: Okay.

18 MR. STIVER: Yes. It's the Table 

19 1 on Page 102. That's right.

20 MR. HINNEFELD: I'm not arguing 

21 your point. I just wanted to point that out 
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73 1 to you.

2 DR. LIPSZTEIN: Okay.

3 DR. MAURO: I think that's a 

4 question that has been bothering me. Like, in 

5 that equation, with the 8.84, I think that was 

6 the number, the calibration factor. So there 

7 was a source that they put in a phantom that 

8 had a certain mix of radionuclides that 

9 basically said, you know, that was to have 

10 this source.

11 Now, let's say the source that was 

12 put in the calibration was freshly separated 

13 thorium without, basically, effectively, any 

14 progeny there, except the thorium was 232 and 

15 the thorium-228, that would be it. There'd be 

16 nothing else there for all intents and 

17 purposes.

18 And you put that in your phantom 

19 and it was a large source, you know, some 

20 large source, would you see anything in your 

21 regions of interest? Would it come back as 
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74 1 if, no, this guy's at background, and let's 

2 say it was a very large source that was put in 

3 there.

4 In other words, it'd be silly, of 

5 course, to do that. I'm not saying anyone has 

6 done that or should do that, but what I'm 

7 saying is: would you see anything in your 

8 regions of interest above controls, 

9 background?

10 MR. HINNEFELD: John, this is Stu. 

11 It depends on how quickly you count it after 

12 you separate it. What will go back in first 

13 is, it will look like the lead-212 number. 

14 It's actually one of the precursors to lead15 212, which is below thorium-228, and has about 

16 a three-day half-life.

17 And so that three-day half-life 

18 in-growth of the rest of the chain, then 

19 through the lead-212. So that's what you 

20 would count. If you count it the day after 

21 you got the separation, you probably wouldn't 
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75 1 see anything, and then the lead-212 would 

2 appear to grow in with, I think it's about a 

3 three-day half-life.

4 DR. MAURO: Okay. So within a 

5 relatively short period of time, you start to 

6 see a delta between your regions of interest 

7 because you start to get this in-growth that 

8 would be detectable.

9 So even if you did calibrate with 

10 some fresh source, you know, certainly not the 

11 minute it came out, but within a week or so, 

12 you know, there would be some in-growth.

13 See, what I'm trying to do is 

14 really help see if we could find a way to come 

15 out an upper bound, because we do know that 

16 people at Fernald could very well, some of 

17 them anyway, been exposed to fairly freshly 

18 separated material with a minimal in-growth of 

19 progeny. That's probably the exception.

20 Most of it may, especially, you 

21 know, have been of some age and I guess I 
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76 1 really haven't heard an explanation, to me, 

2 that I understood that said, you know, reality 

3 is, you could have a guy go in and be counted 

4 under this technique, and it's between '68 and 

5 '78, come back and say: we don't see anything.

6 Okay. We don't see anything. 

7 And, in fact, he could, in fact, have had as 

8 much as this. And I don't think it's 6 

9 milligrams. That's my problem. In other

10 words, you know, the 6 milligrams seems to me 

11 the one that works for that calibration 

12 source.

13 But, you know, in other words, 

14 when I say the calibration, if the person had 

15 that mix in him, then you would say, my MDL is 

16 6. But if, in fact, what the guy actually has 

17 in him is something that's relatively fresh 

18 and a lot different than the calibration 

19 source, how bad can it get?

20 And I think that's what we're all 

21 looking for. Is there a way to say, well --
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77 1 MEMBER ZIEMER: Well, that's the 

2 same question, John. That's the same question 

3 I'm asking. What's the worst case that you 

4 could miss?

5 DR. MAURO: Yes, right.

6 MEMBER ZIEMER: Or is there a 

7 plausible bounding based on this sort of great 

8 uncertainty? I guess NIOSH is still saying 

9 there is? Is that right, Mark or Stu? And 

10 SC&A is saying there isn't?

11 DR. MAURO: That's where it comes 

12 down to. I agree with you, Paul. We're 

13 fishing away to find that number.

14 MR. STIVER: Well, I guess, you 

15 know, depending on how early you're willing to 

16 go. I mean, if you were within a day or two, 

17 you would see nothing. If you waited three or 

18 four days you'd get one half-life of radium19 226 and the short-lived progeny build-in.

20 You'd start to see a little bit of 

21 a bump on the lead-212 peak.
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78 1 MEMBER ZIEMER: I guess you're 

2 saying, if it's nothing, then you can't bound 

3 it.

4 MR. STIVER: That's just it. So 

5 you have, in the extreme case, you have a guy 

6 working with freshly separated thorium in the 

7 refinery area, gets a snoot full of it, they 

8 happen to count him a couple of days later, 

9 very unlikely situation, but it could happen, 

10 and he might have gotten 50 milligrams and 

11 you're going to see nothing.

12 And then you've got a whole 

13 continuum up to the equilibrium situation that 

14 --

15 MEMBER ZIEMER: Well, a couple 

16 days later, I think there is, theoretically, a 

17 number in the region of interest and it may be 

18 lost in noise, but that's sort of the 

19 question: how big would that have to be before 

20 you could miss it?

21 MR. ROLFES: This is Mark Rolfes, 
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79 1 and this is something that we've considered. 

2 And we've agreed because if this exposure 

3 condition occurred, basically, someone working 

4 with thorium and then getting a chest count 

5 following that immediately, if they would only 

6 have one chest count, this would be an issue.

7 However, if they had a second one 

8 following that, it would be less of an issue. 

9 Anyway, to address this concern, we've 

10 proposed defaulting to the 50th percentile 

11 coworker intake rate for all employees; 

12 essentially.

13 So rather than use the 

14 individual's own exposure data as his own 

15 data, we've proposed that, collectively, the 

16 entire collection of data would be used for 

17 any individual potentially close to thorium.

18 MR. STIVER: But that's your 

19 basic, you know, missed dose model, but that 

20 really doesn't answer the question of what 

21 would be a plausible upper bound.
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80 1 DR. MAURO: And, John, let me also 

2 weigh in, but that presumes the database upon 

3 which you generate your 50 percent is sound. 

4 We're saying it isn't. You see the circular 

5 argument? You can't use --

6 MR. HINNEFELD: John, this is Stu 

7 and I think I would differ with that.

8 DR. MAURO: Go ahead.

9 MR. HINNEFELD: In order for this 

10 to be a critical problem with the entire 

11 population of results, then all the results 

12 would have to be taken within a day or two of 

13 the thorium separation. Seems kind of 

14 incredible.

15 If you have, on occasion, that 

16 happens to a person, on occasion, then you 

17 would have an issue with that person's in vivo 

18 count, and so don't give less than this amount 

19 to a monitored person.

20 But in order for the database to 

21 be really sullied, so to speak, by that issue 
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81 1 of accounting immediately after separation, 

2 you would have to have a pretty good chunk of 

3 the data counted in that fashion.

4 And, you know, it just seems to be 

5 too much coincidence, because remember, the 

6 mobile counter was there for campaigns, maybe 

7 once or twice a year, and they'd run as many 

8 people through as they could.

9 So to think that you were going to 

10 consistently count everybody within a couple 

11 days of a thorium separation just doesn't seem 

12 credible to me.

13 DR. MAURO: Yes. No, I understand 

14 what you're saying.

15 MR. ROLFES: Stu, this is Mark 

16 once again. And this fact was documented, 

17 actually, the concern about the in-growth of 

18 progeny. This is documented prior to the 

19 arrival of the mobile in vivo radiation 

20 measurement laboratory at Fernald.

21 It was documented in either the 
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82 1 Hap West article or in the Scott paper, either 

2 in 1965 or 1966, so they did consider this 

3 before they began counting Fernald workers.

4 MR. STIVER: I think they 

5 understood the problem at the time, yes. It 

6 could be a problem.

7 DR. LIPSZTEIN: May I go back to 

8 the equation again, because even if the lead9 212 was spilling and you could see something 

10 above that bound on the lead-212, you still 

11 have to two actinium fix that would be similar 

12 to the two actinium fix in the normal 

13 population, the non-exposed population, which 

14 is embed on this 3.23 here that you are 

15 subtracting.

16 So I don't know if, when you don't 

17 have the two parts of the two actinium fix 

18 being summed, and subtracting by 3.23, and 

19 multiplying by 8.84, if you really get what it 

20 was in milligrams in the lung of the person, 

21 you know, because they did this when they had 
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83 1 this equation, this value, when they have the 

2 three picks, the two from actinium and the one 

3 from lead.

4 MR. STIVER: I guess the question 

5 becomes, how distorted can this be and the 

6 worst-case situation, does that still yield a 

7 credible, or plausible, upper bound? That's 

8 kind of what we're struggling with at this 

9 point.

10 DR. MAURO: This is certainly the 

11 toughest brainteaser we've ever had. It's got 

12 to be. I have to tell you guys, to try to 

13 tease this apart and come to something that is 

14 understandable, with a clear path for setting 

15 an upper bound, you know, I have to say, I am 

16 struggling to try to find a way.

17 And I try hard to find a way, 

18 believe me, and this one has got me, anyways. 

19 It's beyond my ability to really tease out 

20 and say, well, if you do this, this, and this, 

21 and I'm always looking for that, you know, you 
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84 1 could find an upper bound, whether it's 

2 plausible, of course, that becomes your next 

3 question.

4 Well, I haven't even gotten to 

5 that place where I could say, I think you 

6 could place an upper bound because this 

7 equation doesn't apply to Fernald, or 

8 necessarily apply to Fernald. It's sort of 

9 like this construct that only applies to a 

10 very specific circumstance.

11 How do you take something like 

12 that and say, well, we could play with it and 

13 find a way to apply it to the worst-case 

14 condition that might have occurred at Fernald? 

15 I just can't imagine what you can do.

16 MR. HINNEFELD: I think, in my 

17 mind, it's talking about what's the worst-case 

18 condition, probably the question has to be 

19 that, you know, what (Phone interference) tell 

20 us? What milligram number would it spit out? 

21 (Phone interference) worst case, or most 
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85 1 favorable to the claimant.

2 (Phone interference) mixture --

3 MR. STIVER: Hey, Stu, you're kind 

4 of breaking up. I can't hear you. This is 

5 Stiver.

6 MR. HINNEFELD: I'm sorry. I'll 

7 try and get --

8 MR. STIVER: I don't know if 

9 anybody else is having that problem.

10 MR. HINNEFELD: If we say, okay, 

11 here is a worst-case mixture and maybe it's 

12 triple freshly separated and then all you have 

13 is the lead-212, you know, we're going to give 

14 it a few weeks or so to grow in. All you have 

15 is the lead-212 and maybe that's the highest 

16 dose intake, I don't know that, of the 

17 possible mixtures of stuff.

18 And then, you know, we kind of 

19 know what the intake would be in that 

20 situation, but do we know what the in vivo 

21 monitor would tell us? If we had X amount of 
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86 1 lead-212, do we know what the in vivo counter 

2 would tell us in terms of milligrams of 

3 thorium? To me, that's the question.

4 MR. STIVER: And that's where I 

5 get back to the proportionality issue that we 

6 were talking about earlier.

7 MR. HINNEFELD: Yes. I mean, what 

8 we've got now is, we've got a data point where 

9 if there's no thorium it'll tell you it's 0 if 

10 it's right on the -- or some distribution 

11 around 0. And if the ratio value for the 

12 specific mixture in the calibration source, if 

13 it's 1, then it's a little less than 9 

14 milligrams.

15 But if we only have lead-212, if 

16 that is the highest dose intake, and we don't 

17 have the additional contribution of the 

18 actinium, do we know what the in vivo monitor 

19 would tell us? 

20 And then, we have a data set to 

21 compare whether, in fact, it seems to tell us 
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87 1 that, at least we could -- and this is where I 

2 get back to the couple years where we had the 

3 paired measurements, both actinium and the 

4 math.

5 If, in fact, we believe that it 

6 takes so much, like, lead-212 to give us 1 

7 milligram of thorium readout in the mobile 

8 counter, and that would be in the absence of 

9 any actinium.

10 And then we have these 

11 measurements that have actinium and lead-212 

12 both, and an associated milligram number, then 

13 the milligram number in every case should be 

14 higher than what we believe the counter would 

15 tell us if it only had the amount of lead-212 

16 reported with that milligram number.

17 It's very hard to say in a 

18 comprehensible fashion, but there's a way to 

19 test whether the mobile counter gives results 

20 that we think it should give in a way. You 

21 can't test it completely, but you can prove 
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88 1 yourself wrong, you can't prove yourself 

2 right.

3 DR. GLOVER: So, Stu, this is Sam 

4 and I have done live in vivo. This is, 

5 perhaps, a modelable situation. The 

6 difficulty would be in determining background, 

7 efficiency, and how the counts in these 

8 different scenarios can be bottled in the 

9 human.

10 I mean, folks like John Hunt down 

11 at Brazil and Kramer, there's lots of human 

12 models you can put in the detectors. It has 

13 not been done to date, though, and it is not 

14 without some complexity.

15 MR. HINNEFELD: Yes. I don't 

16 know, Sam. You know, you're making a science 

17 project out of it. I'm not sure the answer --

18 DR. GLOVER: And I'm saying, the 

19 background may be an object that I couldn't 

20 overcome.

21 MR. HINNEFELD: And I'm not sure 
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89 1 that answers the question. You know, to me, 

2 I'm more concerned with what we know about 

3 what the counter actually tells us than doing 

4 a Monte Carlo calibration; something like 

5 that.

6 DR. GLOVER: By doing that, you're 

7 kind of implicitly accepting that the data are 

8 really not adequate.

9 MR. HINNEFELD: Well, my position 

10 here is that it's not really straightforward 

11 how you deconvolute that thorium-232, or it's 

12 that thorium mass number.

13 How you interpret that into a 

14 lead-212 activity and have that interpretation 

15 being consistent with the performance of the 

16 counter that we observe when we have both the 

17 activity measurement and the mass measurement, 

18 and how do you interpret that to a lead-212 in 

19 order to even start to apply all the bounding 

20 factors that we apply?

21 That's what I've struggled with 
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90 1 from the start, since I've been getting into 

2 this is, is how do I do that? So that's kind 

3 of where I'm at. And I think anything going 

4 forward, if there is more work to be done 

5 going forward, and I think it should be on 

6 that issue.

7 I can have a meeting with the team 

8 here, the ORAU and DCAS team working on this. 

9 I may refer to some tables and stuff, and 

10 explain how this is going to happen, but 

11 that's what I'm struggling with.

12 I believe that, yes, we have a 

13 bounding approach when we have the lead-212 

14 number. What I'm having trouble with is, how 

15 do I know what the lead-212 number is?

16 DR. GLOVER: Yes. How do you get 

17 from the milligram number based on the ratio 

18 method back to a plausible lead-212 number.

19 MR. HINNEFELD: Right. A bounding 

20 lead-212 number would be, you know, 

21 theoretically sufficient.
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91 1 DR. GLOVER: Yes. What's the 

2 worst it could have been given this counting 

3 system?

4 MR. HINNEFELD: And then you check 

5 and see, does the counter behave in accordance 

6 with that.

7 MEMBER ZIEMER: This is Ziemer, 

8 could you remind me again, is it being 

9 proposed that this be used as part of a 

10 coworker model or for individual dose 

11 reconstructions?

12 MR. HINNEFELD: Well, for people 

13 who have data and their data is above what the 

14 -- there will be a coworker model, but for 

15 people who have, actually, in vivo data and if 

16 their data indicates they would get an intake 

17 above what the coworker model would indicate, 

18 then they would get an intake based on their 

19 own data.

20 MEMBER ZIEMER: All right, but --

21 MR. HINNEFELD: People who have 
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92 1 data that's below what the coworker model is 

2 based on will get the coworker model.

3 MEMBER ZIEMER: In this case, for 

4 individuals who have data, this algorithm is 

5 what's being proposed and what's being pointed 

6 out is that it could, because of the ratios, 

7 miss a lot; possibly.

8 MR. HINNEFELD: Yes, it could miss 

9 a lot, but it could -- it's not clear to me 

10 there's even a way to get there, you know, 

11 knowing what we would miss or not.

12 MEMBER ZIEMER: Well, I guess 

13 that's sort of the question, isn't it?

14 MR. HINNEFELD: Yes. We could 

15 even get from the milligrams to the lead-212. 

16 That's easy.

17 MEMBER ZIEMER: Yes, right.

18 DR. GLOVER: This is the question 

19 we've been debating, now, for a year.

20 MEMBER ZIEMER: Right. And then 

21 if you can't do that, then it means you can't 
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93 1 bound the dose for every worker.

2 MR. HINNEFELD: That would seem 

3 that way to me.

4 DR. MAURO: And, Stu, let's say 

5 you have a worker where it's reported as 10, 

6 12, whatever, 18, milligrams. It's reported, 

7 but it's reported based on this equation.

8 And if this equation didn't really 

9 apply to his mix, you know, his background, 

10 and the mix that he had in his body was not 

11 the one for which this equation was developed, 

12 you know, with the calibration, there's even 

13 some question whether or not you can use that 

14 reported milligram number for that worker.

15 I'm not sure, you know, whether or 

16 not that worker could very well have been 

17 higher or lower than what was reported for him 

18 because of the problems inherent with using 

19 this equation to derive that number.

20 MR. HINNEFELD: That's kind of 

21 what I'm coming at here, is there a way that, 
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94 1 you know -- I think that's part of what I'm 

2 saying here too is that --

3 MR. STIVER: Well, you need to get 

4 out of the context of the coworker model all 

5 together, it'd be just for individual dose 

6 reconstruction? And is that number even --

7 MR. HINNEFELD: I mean, that 

8 thorium milligram number is true only for a 

9 mixture that is the same as the calibration 

10 source.

11 So the question is, do we know 

12 enough about how the calibrational source 

13 contributes to the ratio in the three regions 

14 of interest so that how much contribution do 

15 you get from lead-212? How much contribution 

16 to the excess ratio do you get from actinium 

17 first and actinium second?

18 What are the relatives and then, 

19 do we know enough to know that? And if we 

20 know enough to know that, then we might be 

21 able to surmise, you know, what different 
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95 1 combinations of actinium and lead-212 would 

2 contribute to the ratios.

3 And so at that point, then you 

4 would be able to come up with some alternative 

5 to that 8.8 whatever number in terms of 

6 interpreting, and maybe you wouldn't -- you 

7 know, we're kind of going backwards. You 

8 know, that 8.84 doesn't mean, really, 8.84 

9 milligrams of thorium, because we don't have 

10 the same mixture, but because with this other 

11 bounding mixture, the in vivo counter would 

12 tell you it was 8.84 when it really was this 

13 other mixture of lead-212 and actinium.

14 And based on that, and some 

15 conservative assumptions, then a high end -- I 

16 don't know if we can do it or not. I'm 

17 telling you that.

18 MR. STIVER: How many 

19 confirmations of those three ROIs could give 

20 you a ratio of 1; essentially? Yes. So 

21 there's so many unknowns in this and I'm 
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96 1 trying to grapple with --

2 MR. HINNEFELD: Yes. There may be 

3 too many unknowns for the number of equations. 

4 And so I'm not sure that it can be done, but 

5 to me, that's the thought is that, if there 

6 were a way to take the thorium milligram 

7 number, you know, and not automatically 

8 interpret it, you know, the fact that the 8.84 

9 only applies for the calibration source is 

10 part of what we know.

11 And so based on that knowledge, is 

12 there a way to figure out, if it were the 

13 bounding intake, what would 12 milligrams 

14 really mean, or 10 milligrams, you know, of 

15 thorium? What would that really mean in terms 

16 of this bounding intake ratio?

17 I don't know if we can do it or 

18 not. And that's just, you know, at least to 

19 this one issue. To me, that is fundamental. 

20 If we can't really get to this bounding ratio 

21 and what would the mobile counter tell us, you 
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97 1 know, how would it react to that, and what 

2 number do we get out, I don't know that we can 

3 do this or not.

4 But if there's anything else to 

5 do, it would be along those lines; I think.

6 MEMBER ZIEMER: Could I ask one 

7 other clarification? The denominators of the 

8 region of interest, are those all the valleys, 

9 which would be taken as background numbers?

10 MR. STIVER: No. Those are the 

11 adjacent --

12 MEMBER ZIEMER: Adjacent valleys, 

13 right?

14 MR. HINNEFELD: It's the higher 

15 energy adjacent region on the interest and 

16 it's --

17 MR. STIVER: Yes, so it's the 

18 adjacent higher energy region.

19 MR. HINNEFELD: Yes.

20 (Simultaneous speaking.)

21 MEMBER ZIEMER: If you put a 
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98 1 source in, it's the valley, right?

2 MR. HINNEFELD: Yes. It would be 

3 the valley to the high energy side.

4 MR. STIVER: Yes. It works out 

5 that way, yes.

6 MEMBER ZIEMER: Right. So the 

7 enumerator numbers out of the peak energy 

8 ranges and does anybody look at the ratios of 

9 those, because that tells you something about 

10 the mix?

11 MR. HINNEFELD: Well, if we have 

12 them.

13 MEMBER ZIEMER: Yes. That's what 

14 I'm asking.

15 MR. STIVER: All we have is the 

16 milligram number. If you have the counts, you 

17 could work your way back.

18 MEMBER ZIEMER: Yes. You've got 

19 the end result of what was plugged into this, 

20 in principle, the regions of interest tell you 

21 something about the mix.
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99 1 MR. STIVER: Yes. That's all 

2 you've got. And I think that's kind of where 

3 Sam was going if I can be so bold as to --

4 DR. MAURO: Absolutely, yes. If 

5 you knew that.

6 MR. STIVER: You would try to 

7 follow the model of the detectors.

8 MEMBER ZIEMER: No. I'm asking if 

9 that's part of the raw data set.

10 MR. STIVER: Unfortunately, there 

11 is no raw data set for this.

12 MEMBER ZIEMER: All we have is the 

13 output.

14 MR. STIVER: Milligram number.

15 MEMBER ZIEMER: Yes. Got you. 

16 Okay.

17 MR. ROLFES: This is Mark. There 

18 is some limited raw data, but for the majority 

19 of the cases, we do not have the mobile in 

20 vivo printout showing the number of counts 

21 under each region.
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100 1 MEMBER ZIEMER: Each region, 

2 because that would, sort of, answer the 

3 question pretty fast.

4 DR. MAURO: Yes.

5 MR. STIVER: Yes. If we had that, 

6 that would be our --

7 DR. MAURO: We'd be done.

8 MEMBER ZIEMER: So what we're 

9 really talking about is, what's the worst-case 

10 ratios? If there's something to be bounded, 

11 it would have to be, sort of, what Stu 

12 described there.

13 But I'm wondering, I know that 

14 we'd like to come to closure on this, if the 

15 NIOSH team would want to take a look at 

16 whether they think something like Stu 

17 described is feasible or not?

18 Can you actually get plausible 

19 bounding for these individual cases where 

20 you're going to reconstruct dose from a 

21 person's count?
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101 1 MR. STIVER: Given just the 

2 milligram value.

3 MEMBER ZIEMER: Yes. What's the 

4 worst it could be or can you not do it?

5 MR. HINNEFELD: Yes. I think we 

6 would owe that. I think if there's going to 

7 be further discussion, that's what we would 

8 have to provide not just to the Work Group, 

9 but if the Work Group wants to, the whole 

10 Board for further discussion when it's 

11 available.

12 That's not going to be something 

13 that can be done in a day or two, I don't 

14 think.

15 CHAIRMAN CLAWSON: This is Brad. 

16 I just wanted to throw out something too, and 

17 this is called timeliness. We've been playing 

18 with Fernald for how many years now? I think 

19 that we need to also put in something to 

20 prospective new -- but we owe the petitioners 

21 something.
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102 1 Gentlemen, I think that, if given 

2 enough time, we could battle through all of 

3 this stuff, but I want us to all remember that 

4 this is a compensation program and we owe it 

5 to the petitioners.

6 If we haven't got it by now, I 

7 really think that we have an obligation to be 

8 able to bring it before the Board and make 

9 this decision. We're talking this ten-year 

10 time frame here. We've been battling this for 

11 a very, very long time.

12 And my personal opinion is, in my 

13 opinion, this is just mine, time's up. You 

14 know, we can battle this and we can go on for 

15 years, but that isn't what we're here for. 

16 And we're all looking at this and I understand 

17 we all want the best, but the bottom-line is 

18 what it comes down to is, NIOSH feels that 

19 they can, SC&A feels that they can't.

20 I guess, in my opinion, that this 

21 ought to be brought before the Board. I've 
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103 1 been trying to bring this before the Board for 

2 the last two to three meetings. To me, 

3 personally, I'll just put it blunt; time's up. 

4 Let's proceed forward.

5 So with that, Paul, I understand 

6 you have something to say.

7 MEMBER ZIEMER: I'm certainly in 

8 favor of timeliness. I don't think that the 

9 Board doesn't actually have specific 

10 guidelines on that. We are charged with 

11 looking at whether there's a scientifically 

12 appropriate way to do these things.

13 I guess I'm certainly, Brad, 

14 willing that we propose to the Board. If 

15 NIOSH is not able to resolve this by the time 

16 of the Board Meeting, or, you know -- I think 

17 we've got several weeks here. Let's see, what 

18 do you we got time-wise?

19 MR. HINNEFELD: Well, if you're 

20 talking about the in-person Board Meeting, 

21 that's in --
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104 1 MR. STIVER: June 19th, isn't it?

2 CHAIRMAN CLAWSON: This is Brad. 

3 We have scheduled, on the 26th, to discuss 

4 Fernald for this time period. And this came 

5 from the full Board meeting last time. 

6 Basically, the following before that. Go 

7 ahead.

8 MR. KATZ: This is Ted. Yes. So 

9 it's on the Board Meeting schedule for next 

10 week and, yes, I think the sentiment at the 

11 last Board Meeting was that it would be 

12 possible to take action on the teleconference, 

13 not that it's a forgone conclusion.

14 But the full Board wanted the Work 

15 Group to flesh out its last materials. The 

16 full Board also wanted the Work Group to have 

17 an opportunity to engage DCAS on the question 

18 of, if there were to be a determination of 

19 non-feasibility for this period, whether there 

20 were any Class Definition issues that need to 

21 get sorted out in advance.
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105 1 You know, not prejudging the 

2 Board's final decision on that matter, but to 

3 prepare for that possibility.

4 MR. HINNEFELD: Yes, Ted, with 

5 respect to that issue, we have thought about 

6 what's available and we don't believe there is 

7 a Class Definition that's suitable, other than 

8 all workers.

9 MR. KATZ: Okay. So that settles 

10 that question. That's great.

11 MEMBER ZIEMER: Could you close my 

12 door.

13 MR. KATZ: What?

14 CHAIRMAN CLAWSON: Somebody's door 

15 is needing closed. So basically, to me, we're 

16 at a point where we're going to bring this 

17 before the Board next week. NIOSH and SC&A 

18 can present to the Board. My feeling, Paul, 

19 is that we bring this before the Board on the 

20 teleconference.

21 MEMBER ZIEMER: Oh, yes, okay. 
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106 1 The Board already decided they wanted to do 

2 that and that's what we do, yes.

3 CHAIRMAN CLAWSON: Right. I 

4 understand that. So not wanting to cut 

5 anybody off on this rousing discussion that we 

6 have here, I think that we need to move on. 

7 Is there anything else that we need?

8 We've got the in vivo bioassay

9 White Paper, the SC&A response, have you 

10 discussed that thoroughly, John?

11 MR. STIVER: Excuse me?

12 CHAIRMAN CLAWSON: I see on Ted's 

13 thing we've got an SC&A response to the in 

14 vivo thorium bioassay method. I think that's 

15 what we've been discussing.

16 MR. STIVER: That's what we've 

17 been talking about today, yes.

18 CHAIRMAN CLAWSON: Right. That's 

19 two of them right there and DCAS has performed 

20 theirs. You know, this bottom-line, to me, 

21 this is what we've been talking all day and 
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107 1 the only thing I see on the agenda is this 

2 part of it right now.

3 Paul, you know, you can weigh in, 

4 I don't know why we don't have all the Board 

5 Members here, and so forth, but I thought 

6 we've already discussed this and we'll just 

7 bring this before the Board on the 26th.

8 MEMBER ZIEMER: And that's fine, 

9 you know? See, I detect some uncertainty with 

10 NIOSH at the moment in terms of their 

11 position, but it may be that they'll have some 

12 additional information. It's not very far 

13 off, but if they have additional comments, 

14 that would be helpful.

15 I mean, I'm not confident at this 

16 point that we have a plausible upper bound, so 

17 if we were to vote today, I would have to 

18 favor going with a Class, but, you know, it 

19 seems that, in principle, one should be able 

20 to discover, in terms of some number that, 

21 once you pass that number, you could detect 
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108 1 it, number one, in the in vivo counter.

2 And that number would then be your 

3 upper bound, but we haven't reached that 

4 point. So here we are.

5 MR. KATZ: So this is Ted. Brad, 

6 I think I could use a little clarification 

7 just for preparing for next week. We have 

8 these various materials that have been 

9 exchanged, so I would suggest that if this 

10 seems right to you, that I'd circulate those 

11 materials to the full Board.

12 And then the other thing, if I 

13 could get clarification on is, it seems like 

14 it would be helpful for someone to give the 

15 Board -- we won't have any form of transcript 

16 soon enough.

17 So it would be helpful if someone 

18 could just give a summary presentation of this 

19 discussion today to bring the Board up to date 

20 beyond the papers that they would receive, 

21 because I think the papers, by themselves, 
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109 1 don't tell enough of the story of today.

2 And that would be a good way to 

3 start the Board, I think, discussion next 

4 week.

5 CHAIRMAN CLAWSON: Ted, I agree 

6 wholeheartedly with you on that. I appreciate 

7 you offering to send this out to the full 

8 Board. Basically, to me, it looks like Mark's 

9 already got his preparation to present to the 

10 Board put together in his slide show there.

11 And, to me, John Stiver will just 

12 have to bring us up to speed, but what I would 

13 offer out to him is that we kind of condense 

14 it a little bit and that we have not been able 

15 to come to a conclusion at this Work Group 

16 meeting, that there's too many uncertainties.

17 Basically, I'd suggest we allow 

18 both sides to air their side of it, and put it 

19 before the Board, and be able to proceed on 

20 from there.

21 MR. KATZ: So again, I just want 
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110 1 to get a little more clarification about this 

2 though. I think John's always done a good job 

3 at summarizing where we stand, but again --

4 MR. STIVER: Yes, I'll do it. I 

5 can tweak my slides from the last time and, 

6 kind of, update them to where we are now and -

7 - 

8 MR. KATZ: Right. I think, you 

9 know, John, given that, you know, we have 

10 these other materials I'll distribute, I think 

11 your summary really is to bring them up to 

12 date with the discussion today.

13 And then, you know, certainly Paul 

14 and Brad can chime in then with what they've 

15 concluded from today at that point, but 

16 somewhere in there I guess DCAS needs to have 

17 its last words because it's going to go back 

18 and think about some of the matters that it 

19 tangled with today.

20 CHAIRMAN CLAWSON: Now, I want to 

21 make a clarification on this because we're 
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111 1 only talking the time frame of '68 to '78, 

2 correct?

3 MR. KATZ: That's correct.

4 CHAIRMAN CLAWSON: Okay. And my 

5 suggestion would be to throw out, you know, 

6 we're just looking at this area right now. 

7 Fernald is a very, very big site. We've got 

8 27, 28 slides we can go through, but I guess, 

9 John, what I'm trying to get to the point of 

10 is, we just looked at the '68 to '78, the --

11 MR. STIVER: Yes. I'll keep it to 

12 that; focus to that time frame.

13 CHAIRMAN CLAWSON: Right.

14 MR. STIVER: I won't try to get 

15 into anything else at this point.

16 MEMBER ZIEMER: And this is going 

17 to really hinge on the thorium bioassay, 

18 right?

19 MR. STIVER: This is all related 

20 to the thorium bioassay.

21 MEMBER ZIEMER: Yes. So I think 
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112 1 that's the focus. If you get too much beyond 

2 that, it's going to be very difficult for the 

3 Board Members.

4 MR. STIVER: I won't try to do 

5 that.

6 CHAIRMAN CLAWSON: And, John, I 

7 can easily tell you that I cannot put anything 

8 before the Board at this time because, to tell 

9 you the truth, I don't got a clue where we're 

10 at, other than I don't think we can really do 

11 it.

12 So I appreciate you standing up 

13 and taking that. And I believe that we owe it 

14 to DCAS to be able to present their side of it 

15 and proceed on, but we do need to get this new 

16 material, Ted, out to the Board Members, 

17 especially Mark's presentation, and so forth.

18 MR. KATZ: Right. This is Ted. 

19 So I'll do that. And, John, if you want, I 

20 think it would be good for you to send out 

21 something in writing for the full Board. Send 
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113 1 it to me and I'll distribute it to everyone, 

2 also, please, to the petitioner.

3 And, you know, DCAS, Stu, whether 

4 you want to send out some conclusory memo in 

5 writing or just speak, but since you're 

6 dealing with, you know, very little time, if 

7 you wanted to speak to the Board, you know, in 

8 real time, I think either would work.

9 The last thing I just want to 

10 remind, we do have Sandra on the line, Brad, 

11 and I think it would be good to give Sandra an 

12 opportunity in case she has anything she wants 

13 to say now to the Work Group.

14 CHAIRMAN CLAWSON: I agree 

15 wholeheartedly. I appreciate that tip.

16 MS. BALDRIDGE: This is Sandra. 

17 It's been interesting. I certainly appreciate 

18 everybody's efforts, but, you know, some 

19 questions can't be answered and I think we've 

20 gotten to that point.

21 So I appreciate everybody's effort 
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114 1 on this on behalf of all those included in the 

2 petition. And I'd like to thank you.

3 MR. KATZ: Very good. Thank you, 

4 Sandra.

5 DR. MAURO: This is John. Just 

6 one thing because it's plaguing me a bit. 

7 Stu, it sounds like when we break, you're 

8 going to get together with your crew and say, 

9 is there a way we could wrestle this thing to 

10 the ground and, you know, you're going to give 

11 some thought to that.

12 I don't know whether you will be 

13 able to or whether you will be able to between 

14 now and next week, but is it possible that if 

15 you folks come up with an ah-ha moment and 

16 say, I think we got it. Is there any way, you 

17 know, we could hear about it?

18 A concept, you don't have to solve 

19 the whole thing. See, right now, I mean, I 

20 haven't heard a strategy that could wrestle 

21 this thing to the ground, but if you guys come 
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115 1 up with something, boy, we'd love to hear it.

2 MR. HINNEFELD: Yes, John. If we 

3 do have an ah-ha moment, we'll let you know.

4 MR. STIVER: Yes. Maybe we could 

5 have a technical call, or something, before 

6 the teleconference.

7 MR. HINNEFELD: Yes. That'll be a 

8 little problematic for me, but we'll see what 

9 we can do. I know next week is shot. I'm at 

10 Lead Team retreat, NIOSH Lead Team retreat 

11 next week, so I'll have to be working on this 

12 either this weekend or nights if I'm going to 

13 do anything on it.

14 But if we have something by then -

15 - 

16 MR. STIVER: Okay. We'll be on 

17 the lookout for it.

18 MR. HINNEFELD: -- we'll clue you 

19 guys in. I can step out and get on a phone 

20 call while I'm there. 

21 CHAIRMAN CLAWSON: This is Brad 
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116 1 speaking again. Also, too, I'd kind of like 

2 to preview both sides' response before the 

3 Work Group meeting so that we're not doing it 

4 -- or the Board Meeting.

5 I'd just like to see where we're 

6 at because, hey, I have a very hard time 

7 following some of this, but I'd still like to 

8 be able to read through it and try to get an 

9 understanding of where we're at on this.

10 So as the Work Group Chair, I 

11 would like to be able to see the two 

12 responses, at least a day or two before the 

13 Board, if possible.

14 MR. KATZ: Yes, Brad, you'll 

15 certainly have it from John Stiver, his 

16 summary, I think, which will help you a lot.

17 CHAIRMAN CLAWSON: Well, I'd also 

18 like to see DCAS' too because I'm just trying 

19 to get the feel. If anything does change to 

20 it, Mark. If it doesn't change, you know, 

21 that's fine too. So that I can try to digest 
This transcript of the Advisory Board on Radiation and Worker Health, Fernald Work Group, has 

been reviewed for concerns under the Privacy Act (5 U.S.C. § 552a) and personally identifiable 

information has been redacted as necessary. The transcript, however, has not been reviewed and 

certified by the Chair of the Fernald Work Group for accuracy at this time. The reader should be 

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

NEAL R. GROSS

COURT REPORTERS AND TRANSCRIBERS

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117 1 it.

2 It's probably not uncommon, but I 

3 talked to people that can help me understand 

4 it in a more basic form. It's been said, you 

5 know, I'm not the most scientific. I'd 

6 appreciate that. If something does change, 

7 that we're kept notified before the Board 

8 Meeting.

9 MR. HINNEFELD: Yes, we'll give it 

10 a shot.

11 CHAIRMAN CLAWSON: Okay. Thank 

12 you, Stu. I don't see anything else on the 

13 agenda so is there anything else that needs 

14 more to be said or that we need to discuss as 

15 a Work Group? I guess, Dr. Ziemer?

16 MEMBER ZIEMER: No. I think it's 

17 time to adjourn.

18 CHAIRMAN CLAWSON: Thank you. I 

19 appreciate that. Is there anybody else on 

20 here that has something that they need to say? 

21 I appreciate Sandra making her comments. I 
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been reviewed for concerns under the Privacy Act (5 U.S.C. § 552a) and personally identifiable 

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

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118 1 know Ray's on here too, but if there's anybody 

2 else that wants to have something clarified or 

3 say, I guess, at this time, I'd give that 

4 opportunity.

5 If not hearing anything, then, 

6 Ted, I guess I give a motion to adjourn this 

7 Work Group meeting.

8 MR. KATZ: And I think Paul 

9 seconds you, so we are adjourned.

10 CHAIRMAN CLAWSON: I'd like to 

11 thank everybody for the time they've spent on 

12 this. I know that it's been difficult. Thank 

13 you.

14 (Whereupon, the meeting in the 

15 above-entitled matter was concluded at 1:07 

16 p.m.)

17 

18 

19 

20 

21 
This transcript of the Advisory Board on Radiation and Worker Health, Fernald Work Group, has 

been reviewed for concerns under the Privacy Act (5 U.S.C. § 552a) and personally identifiable 

information has been redacted as necessary. The transcript, however, has not been reviewed and 

certified by the Chair of the Fernald Work Group for accuracy at this time. The reader should be 

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

NEAL R. GROSS

COURT REPORTERS AND TRANSCRIBERS

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119 1 

2 

3 

4 

5