THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
 PUBLIC HEALTH SERVICE
 CENTERS FOR DISEASE CONTROL AND PREVENTION
 

NATIONAL INSTITUTE FOR OCCUPATIONAL SAFETY AND HEALTH
 

convenes the
 

SEVENTEENTH MEETING
 

ADVISORY BOARD ON
 

RADIATION AND WORKER HEALTH
 

VOLUME II
 

The verbatim transcript of the Meeting of the
 

Advisory Board on Radiation and Worker Health held
 

at The Westin Cincinnati, 21 East Fifth Street,
 

Cincinnati, Ohio, on August 19, 2003.
 

NANCY LEE & ASSOCIATES 

Certified Verbatim Reporters

P. O. Box 451196
 Atlanta, Georgia 31145-9196
 (404) 315-8305
 
2 

C O N T E N T S
 

August 19, 2003
 

REGISTRATION AND WELCOME
 

Dr. Paul Ziemer, Chair. . . . . . . . . . . . . . . . . 7
 

Mr. Larry Elliott, Executive Secretary . . . . . . . . .
 

ORAU CONTRACT SUPPORT STATUS 

Dr. Richard Toohey, ORAU. . . . . . . . . . . . . . . . 8
 

PRESENTATION 

Dr. John Till, RAC. . . . . . . . . . . . . . . . . . .48
 

STATUS OF TECHNICAL BASIS DOCUMENT/SITE PROFILE DEVELOPMENT 

Dr. Jim Neton, NIOSH. . . . . . . . . . . . . . . . . 108 

ADMINISTRATIVE HOUSEKEEPING AND BOARD WORK SCHEDULE 

Dr. Ziemer, Mr. Elliott, Ms. Homer. . . . . . . . .159,248
 

BOARD DISCUSSION/WORKING SESSION DEVELOPMENT OF TASK ORDER 

Mr. Mark Griffon. . . . . . . . . . . . . . . . . . . 164
 

PUBLIC COMMENT PERIOD. . . . . . . . . . . . . . . . . .262
 

ADJOURN. . . . . . . . . . . . . . . . . . . . . . . . .284
 

COURT REPORTER'S CERTIFICATION. . . . . . . . . . . . . 285
 
3 

TRANSCRIPT LEGEND
 

The following transcript contains quoted material. 

Such material is reproduced as read or spoken.
 

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

unintentional or purposeful interruption of a sentence. An
 

ellipsis (. . .) indicates halting speech or an unfinished
 

sentence in dialogue or omission(s) of word(s) when reading
 

written material.
 

In the following transcript (sic) denotes an incorrect
 

usage or pronunciation of a word which is transcribed in its
 

original form as reported.
 

In the following transcript (phonetically) indicates a
 

phonetic spelling of the word if no confirmation of the
 

correct spelling is available.
 

In the following transcript "uh-huh" represents an
 

affirmative response, and "uh-uh" represents a negative
 

response.
 

In the following transcript "*" denotes a spelling
 

based on phonetics, without reference available.
 

In the following transcript (inaudible) signifies
 

speaker failure, usually failure to use a microphone.
 
 

 

4 

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

(By Group, in Alphabetical Order)
 

BOARD MEMBERS
 

CHAIR
 

ZIEMER, Paul L., Ph.D.
 

Professor Emeritus
 

School of Health Sciences
 

Purdue University 

Lafayette, Indiana 

EXECUTIVE SECRETARY
 

ELLIOTT, Larry J.
 

Director, Office of Compensation Analysis and Support
 

National Institute for Occupational Safety and Health
 

Centers for Disease Control and Prevention
 

Cincinnati, Ohio
 

MEMBERSHIP
 

ANDERSON, Henry A., M.D.
 

Chief Medical Officer
 

Occupational and Environmental Health
 

Wisconsin Division of Public Health
 

Madison, Wisconsin 

ANDRADE, Antonio, Ph.D.
 

Group Leader 

Radiation Protection Services Group
 

Los Alamos National Laboratory
 

Los Alamos, New Mexico
 

DeHART, Roy Lynch, M.D., M.P.H. 

Director
 

The Vanderbilt Center for Occupational and Environmental
 

Medicine
 

Professor of Medicine
 

Nashville, Tennessee
 

ESPINOSA, Richard Lee 

Sheet Metal Workers Union Local #49
 Johnson Controls
 Los Alamos National Laboratory
 Espanola, New Mexico
 
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GIBSON, Michael H.
 

President
 

Paper, Allied-Industrial, Chemical, and Energy Union
 

Local 5-4200
 

Miamisburg, Ohio
 

GRIFFON, Mark A.
 

President
 

Creative Pollution Solutions, Inc. 

Salem, New Hampshire
 

MELIUS, James Malcom, M.D., Ph.D.
 

Director
 

New York State Laborers' Health and Safety Trust Fund
 

Albany, New York
 

MUNN, Wanda I. 

Senior Nuclear Engineer (Retired)
 

Richland, Washington
 

PRESLEY, Robert W. 

Special Projects Engineer
 

BWXT Y12 National Security Complex
 

Clinton, Tennessee
 

ROESSLER, Genevieve S., Ph.D.
 

Professor Emeritus
 

University of Florida 

Elysian, Minnesota
 

AGENDA SPEAKERS
 

Dr. John Till, RAC
 

Dr. Jim Neton, NIOSH
 

Dr. Richard Toohey, ORAU
 

Mr. Mark Griffon, Workgroup Leader
 

STAFF/VENDORS
 

CORI HOMER, Committee Management Specialist, NIOSH
 STEVEN RAY GREEN, Certified Merit Court Reporter
 
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AUDIENCE PARTICIPANTS
 

STEVEN AHRENHOLZ
 

JOHN ALEXANDER
 

EULA BINGHAM
 

DENISE BROCK
 

HELEN BUELIN
 

JULIA DEHART
 

JOHN DEMENT
 

LOU DOLL
 

JAMES EAST
 

RUSS HENSHAW
 

LIZ HOMOKI-TITUS
 

R. DELON HULL
 

JUDSON KENOYER
 

DAVID KOCHER
 

JEFF KOTSCH
 

MICHELE R. LANDIS
 

JAY MAISLER
 

PAULA MCCREARY
 

RICHARD MILLER
 

JOHN S. MORAWETZ
 

DAVID NAIMON
 

STEVE POWELL
 

LOUISE S. PRESLEY
 

HARRY RICHARDSON
 

D.M. SCHAEFFER
 

MARY SCHUBAUER-BERIGEN
 

BOB TABOR
 

RICHARD TOOHEY
 

BRANT ULSH
 

DAVID UTTERBACK
 
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P R O C E E D I N G S
 

REGISTRATION AND WELCOME
 

(8:30 a.m.)
 

DR. ZIEMER: Good morning, everyone. We're
 

going to reconvene at this time. Let me begin
 

with a couple of announcements and reminders.
 

Remind everyone who's here today to please
 

register your attendance in the notebook near the
 

entryway. Also members of the public who wish to
 

make public comment later in the meeting, please
 

so indicate at the sign-up sheet there at the
 

table, as well.
 

I would also again remind everyone that there
 

are copies of various handouts that are being
 

used today, as well as other documents that may
 

be of interest to you, on the table on my -- sort
 

of in the rear to my left side -- or the left
 

side of the room as you face the screen.
 

We have made an adjustment in the agenda for
 

this morning. Dr. Melius is not going to present
 

a report this morning, so we have moved Dr.
 

Toohey's report up so that we're going to begin
 

with the report on the ORAU contract support
 

status. Dr. Toohey's going to present that
 

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report and then we'll be back onto the
 

presentation by Dr. Till.
 

So let's begin then with Dr. Richard Toohey
 

from ORAU.
 

ORAU CONTRACT SUPPORT STATUS
 

DR. TOOHEY: Okay, are we on? Can you hear
 

me? Better? Okay, great. Thank you.
 

All right. Good morning. I'll go through my
 

presentation and try to answer all the questions
 

you asked Dave Sundin yesterday. As you know,
 

we're just about coming up on one year of the
 

ORAU team contract with NIOSH for dose
 

reconstruction support. And to refresh your
 

memory, our contract -- or our effort, I should
 

say, is organized into six different tasks.
 

Task one is database management, the computer
 

operations.
 

Task two is data collection for claims and
 

petitions. That's all been related to claims so
 

far. They receive the DOE submittals of
 

individual monitoring data, scan that in. Any
 

data that is captured to field trips to records
 

repositories and that, that group also scans in. 

We also have a number of health physicists in
 

that group who review claimant files, make a
 

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determination if they are in fact ready for dose
 

reconstruction, looking for things like gaps in
 

monitoring data. We also have some QA people
 

review files looking at the Department of Laborsupplied information to see if there are any
 

problems with that data that might hold things
 

up.
 

Task three is dose reconstruction research. 

That's headed by Judson Kenoyer with Dade Moeller
 

& Associates. Judson's here today. And their
 

primary effort right now is developing the
 

technical basis documents or the site profiles,
 

whatever you want to call them. And I'll talk a
 

little more about that effort, but the primary
 

presentation on that will be by Dr. Neton later
 

this morning.
 

We made a little change recently. You may
 

recall task four last time I showed this slide
 

was simply called CATI, Computer-Assisted
 

Telephone Interviews, with the claimants. We
 

have moved some other operations into that same
 

task and we now call it Claimant Contact. And
 

the things we moved in there were the dose
 

reconstruction assignment letters, the close-out
 

interviews with the claimant. Also mailing out
 

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the dose reconstructions and the OCAS-1 forms
 

which we're taking over from NIOSH and things
 

like that, and the 800 number operation we've
 

also moved into that task. So we've just
 

consolidated all the claimant contact into one
 

group. We have neither added nor deleted
 

anything we were doing. We just took those last
 

things I mentioned out of task five, dose
 

reconstruction; put them where they made more
 

sense and also we're having them done by people
 

who have better people skills than your average
 

health physicist.
 

Task five of course is the main operation,
 

the dose reconstruction generation itself.
 

And then task six, the technical and program
 

management support.
 

So how many folks have we got working on this
 

thing now? We've got -- these are full-time
 

equivalents. There's actually more people than
 

that. We have a number of part time people,
 

especially in task two, doing the claim review. 

Some are ORAU employees in our Colorado office,
 

and some are working on the beryllium project and
 

they had some time available and so we adopted
 

them, working on that. So we've got 29 FTEs on
 

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task two.
 

The big one is 102 on task three. And again,
 

Dr. Neton'll talk about that. We front-end
 

loaded this because we made the decision
 

generating these technical basis documents is
 

really the first thing we need to do, and the
 

light finally went on that it was going to take
 

us an awful long time to do this with our own
 

resources. So we decided to subcontract a lot of
 

it out, and we have now assembled I think 13 TBD,
 

technical basis document, teams, most of which
 

are subcontractor operations. And again, Dr.
 

Neton will show you that in detail, but it's
 

basically -- we've taken these subcontractors,
 

some of whom we had worked with before, some of
 

whom had been partnered with the SAIC Battelle
 

proposal -- I mean there aren't that many health
 

physics companies out there. But just giving a
 

given company the task to produce the technical
 

basis document for a given site.
 

Of course we have our own people overseeing
 

the task and working with them. We've also
 

involved OCAS staff early on in this process to
 

help expedite the eventual review process. If
 

we're heading down the wrong road early on, then
 

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there's no sense wasting a lot of time and effort
 

and not finding that out until it goes in for
 

final review.
 

And if a contractor -- or subcontractor, I
 

should say, does a good job on a document,
 

they'll get another one. If they don't, well,
 

thank you for your services and don't call us,
 

we'll call you. So we think it's an efficient
 

way to get this done, front-end load, and I would
 

expect a year from now that number of 102 will be
 

probably down to around 30 or so.
 

Task four on the -- well, this still shows
 

CATI, but it's all the claimant contact, is now
 

21 FTEs.
 

The majority of people in the health
 

physicists are the 98 folks actually doing dose
 

reconstruction. And then 18 on management
 

support, so it's a total of 285 FTEs, but it's
 

about 320 warm bodies or so when you could the
 

part-timers.
 

Okay. The facilities and equipment. We've
 

set up our Cincinnati Operations Center out in
 

Norwood, was five minutes away from the NIOSH
 

location until they moved last month, but now
 

it's only about 15 minutes away. We've got -- I
 

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went metric on this -- 1,400 square meters. And
 

we also set up a separate telephone interview
 

facility that's about a block away from that. 

Some of you did visit our facility some months
 

ago for the training effort for some of you, I
 

think the working group for the Board oversight
 

contractor has seen that.
 

We've got a computer network set up -­

actually it's more than 300 users now, but they
 

are spread all over the country. And of course
 

the big thing we've had on that is security
 

protection, so we've been very careful with antiviral software and firewalls and all that sort of
 

thing. And I am pleased to report to you that so
 

far we have not had any viruses or worms getting
 

into our system.
 

And we've also established telecommunications
 

and data transfer. We have a high-speed link to
 

NIOSH for data transfer back and forth. And we
 

also have a link to the Dade Moeller office in
 

Richland. They're doing a lot of the up front
 

data entry, inputting say monitoring records for
 

an individual worker into a spreadsheet from
 

whence they can then be copied and plugged into
 

the IREP spreadsheet, and it just expedites the
 

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actual physical production of the dose
 

reconstruction report. We're increasing the band
 

width on that, the -- we were thinking of putting
 

in a dedicated T-1 line out there but we found
 

out Dade Moeller & Associates, their internet
 

service provider can give them up to a megabyte
 

band width, so they're just going to expand that,
 

so that'll come in pretty quickly.
 

All right. Now, the thing everybody's
 

interested in, the performance plan or the
 

production plan. As you heard yesterday from
 

Pete Turcic, we were -- we were originally hoping
 

to do about 6,000 this year. And generally
 

that's not going to happen. Our current best
 

estimate, what we really think we can produce, is
 

about 4,000.

 As of last week we have completed and turned
 

in to NIOSH -- let me make sure I have the right
 

number here -- 850 dose reconstruction reports. 

Many of -- the vast majority of those have been
 

from Bethlehem Steel and Savannah River, but not
 

exclusively, and I'll talk a little bit more
 

about how we're doing those. We've been
 

averaging 75 a week for about the last month. 

We're ramping that up to -- oh, 100 to 125 a
 

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week. Next month, in September, we plan to be
 

doing 150 and in October get to about 200 a week
 

and just hold it there.
 

Now, the question came up yesterday about
 

clearing the backlog and how long that's going to
 

take. And the answer to that depends on your
 

definition of clearing the backlog. The first
 

definition is working through the 13,000 or so
 

claims that are already in the hopper. And at a
 

production rate of about 200 a week, we will
 

estimate we will be through those in November,
 

2004.
 

The operational definition of clearing the
 

backlog, which Larry Elliott and his staff have
 

put as a goal, is to have no claims in the hopper
 

that are over one year old. So I had to apply a
 

little calculus to work this out, and on the
 

assumption that we do 200 a week, but 100 new
 

ones come in a week, we get to the no claims over
 

one year old in April of 2005. At that point
 

we'll work through and then in the fall of 2005
 

we think the average age of a claim will be about
 

90 days. And we estimated if input continues,
 

new claims coming in at about 100 a week, we will
 

always have about a 90-day supply on hand, or
 

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about 1,200 to 1,500 claims in the hopper.
 

So our -- we should have actually a little
 

bit over 4,000 done this year. Right now we're
 

about a week behind. We got into a little more
 

detailed discussion with NIOSH on a revision to
 

the Savannah River document that was looking at
 

some aspects of internal dosimetry, but we got
 

their comment back last week. Our replies to the
 

comments are going back to NIOSH tomorrow. We
 

don't see any show-stoppers there, so we fully
 

expect to be able to process the rest of the
 

Savannah River claims.
 

Let me go on and discuss the sites we're
 

heading. As Dave -- or the sites we're aiming
 

at. As Dave Sundin mentioned yesterday, we've
 

decided to approach this in what we think is a
 

way that would do the most good for the most
 

number of people in the least amount of time, and
 

that is essentially batch processing. And once a
 

-- the site profile has been completed, the
 

technical basis document has been done, we're
 

just going to try to do all the claims -- or as
 

many as can be done -- from that site. And the
 

order in which we decided to attack the sites was
 

simply on the order of how many claims are from
 

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the site. Savannah River and Y-12 normally run
 

neck and neck. One month Savannah River will
 

have more, the next month Y-12 will have more. 

But in point of fact, there -- only about half of
 

the claims that show Y-12 as a work site, the
 

workers worked only at Y-12. About half of them
 

also worked at X-10 or K-25, and especially for
 

the trades because they would cover all three
 

sites. Many people who were assigned and had
 

offices at X-10, for example, actually had their
 

labs at Y-12 and so on and so forth. So we are
 

going ahead with Y-12 as an early on. But you'll
 

notice Oak Ridge National Lab and the Oak Ridge
 

gaseous diffusion plant are right there and we
 

hope to get all three of those done at the same
 

time.
 

The next major site we plan to have the
 

document done for is Hanford. The external
 

dosimetry and X-ray portions of that document
 

have been completed and we expect the rest of it
 

to be done and in for NIOSH review by the end of
 

this month.
 

We're also working on the Iowa ordinance
 

plant or the Iowa Army ammunition plant,
 

depending on which reference you look at. It's
 

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scheduled to be done by the end of this month. 

That may slip a week or two, but in point of
 

fact, we really can't process those claims until
 

the dosimetry data has been made available from
 

Defense Department. And we, together with NIOSH,
 

are actively pursuing capturing those records.
 

So then later on this fall, we will be
 

finishing up Rocky Flats and Los Alamos. Also
 

will get the technical basis documents done this
 

year for Idaho and a few other sites, but we
 

won't actually be processing claims this year.
 

I think Jim Neton may have mentioned
 

yesterday, once we've got the site profile done
 

and approved and everybody's happy with it,
 

there's about a one-month lag time before we can
 

actually start doing claims from that site. A
 

couple of things come into play there. One is
 

the dose reconstructor assignment letter, and we
 

give the claimant two weeks to offer any
 

objection they may have to the assigned dose
 

reconstructor. So far, out of over 1,200
 

assignments, we've only had two claimants raise
 

an issue about that.
 

The second thing of course is the telephone
 

interview, and that needs to be scheduled, and
 

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then also the claimant gets two weeks to turn
 

around the draft telephone interview report that
 

gets sent out. So there's some built-in lag time
 

in there.
 

The second thing is it also takes us about a
 

month to put some of the data in the site profile
 

into spreadsheets which then serve as templates
 

for the dose reconstruction. And we do go over
 

those spreadsheets with NIOSH and there's a
 

verification and validation procedure to make
 

sure the thing -- they are actually doing the
 

dose calculation that we think they are doing. 

But then that's an efficiency measure. With the
 

monitoring data entered up front and the
 

spreadsheet, the dose reconstructor has to put in
 

some of the personal specific information. Much
 

of it gets downloaded automatically from NIOSH's
 

NOCTS database. And there's relatively few
 

things in terms of data entry the health
 

physicist has to do. About the only thing they
 

still have to do by hand is enter some of the
 

bioassay data into the IMBA program to do the
 

internal dose calculation. So we've attempted to
 

streamline that as much as possible, but it does
 

take about a month to generate those spreadsheets
 

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and get them debugged and distributed, make sure
 

they're working.
 

On the AWE sites, of course Bethlehem Steel
 

was the first one we've gotten in, and we're
 

currently developing what we'll call Bethlehem
 

Steel clones, other rolling mills that also
 

rolled those billets down. Let's see, that's
 

Bridgeport Brass -- I'm drawing a blank on the
 

other ones, there's two or three -- Simonds Saw
 

and Steel, thank you. That's one of the other
 

ones.
 

The Blockson Chemical document was in. We're
 

on our second round of comments and review on
 

that. There's only -- there was one sticking
 

point on that, which we've resolved with NIOSH on
 

mutual agreement, which was dose rate from a
 

barrel of yellow cake. And we've actually found
 

some survey -- barrel survey data from Fernald on
 

uranium tetrafluoride, which is probably a little
 

bit higher than you get from yellow cake, but it
 

would certainly be claimant favorable to use
 

that. And then there are the Blockson clones,
 

the other phosphate processing plants that will
 

follow from that.
 

The Huntington Pilot plant, that one -- they
 

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recovered -- was primarily to recover nickel and
 

-- that had been contaminated with uranium. 

We've got a draft of that in for NIOSH review. 

The one sticking point on that we're still trying
 

to figure out is what was the efficiency of the
 

nickel recovery process, because what that tells
 

us is how much uranium by mass was left in the
 

slag or the by-product. If it was very high
 

efficiency recovery, then the by-product could be
 

fairly high uranium concentration. On the other
 

hand, if it was a low efficiency, then there
 

probably won't be much difference in that. So
 

that's something we have to try to chase down.
 

And also, as you heard yesterday, we have a
 

draft document on the Mallinckrodt Chemical Works
 

which is currently undergoing internal review by
 

the ORAU team and we hope to get that to NIOSH
 

for their review in another week or two. So
 

that's basically the plan on these things.
 

I should also mention that once we've got the
 

site profile done and approved, we do try to
 

process claims from the site roughly in the order
 

in which they were received. But the total
 

processing time for a given site's probably only
 

going to cover a few months, so that's not going
 

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to be a very big deal.
 

Let me also mention that we have what we call
 

supplemental dose reconstruction teams. We have
 

one assembled so far, which consists of four
 

senior health physicists, two external
 

dosimetrists and two internal dosimetrists. And
 

their assignment is start a claim, one, and start
 

going through and just work them through so that
 

people who have been in the queue for a long time
 

aren't totally neglected, waiting until we
 

finally get around to finishing their site
 

profile, so they're doing a number of items.
 

There are also some claims from other sites
 

we are doing under some efficiency protocols, and
 

let me talk about those next.
 

The first one is for potentially compensable
 

cases. And this would be workers at the
 

primarily Department of Energy facilities whose
 

records show positive bioassay results for
 

inhalation exposure to actinides or the
 

transuranics. So it would be uranium, plutonium,
 

americium, neptunium, curium, etcetrium*. Okay? 

And they have either lung cancer or a cancer of
 

what we call a metabolic organ -- of course all
 

organs are metabolic, but in this context, it
 

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means an organ which does tend to concentrate or
 

serve as a reservoir for that radionuclide. So
 

for uranium it would be kidney, primarily. For
 

the transuranics it's skeleton and liver.
 

So we will take their bioassay data, just do
 

an internal dose assessment using the IMBA
 

program, and if the probability of causation from
 

that is -- should be equal to or greater than 50
 

percent at the 99 percent confidence interval,
 

the case is likely compensable and we're finished
 

with the dose reconstruction. We're currently
 

processing Y-12 cases and there are probably
 

about 100 of those to date, and we've also done
 

some from Hanford, Rocky, Idaho and some of the
 

other sites. So that's going on and continuing.
 

So -- in fact, here's one example of that
 

protocol. Case was a Hanford engineer diagnosed
 

with lung cancer. His bioassay record had ten
 

positive plutonium urinalysis results in it -- by
 

positive we mean exceeding the MDA. The records
 

and an incident report showed a confirmed intake
 

of plutonium nitrate, so we took the bioassay
 

data, just ran IMBA. Took it back to that date
 

of the incident that was in the records and the
 

intake that came out from IMBA was 520
 

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nanocuries, which is actually an awful lot of
 

plutonium. But the lung dose equivalent
 

calculated from that, from the time of intake to
 

the date of diagnosis, was a total of 88 rem,
 

which produced a probability of causation of 66
 

percent at the 99 percent confidence interval. 

Case is finished.
 

The other efficiency protocols we're
 

developing are at the other end of the spectrum,
 

and that is a claim that is probably or
 

potentially non-compensable. So the criteria for
 

those cases are low exposure potential, a job
 

that in general did not involve hands-on work
 

with uncapsulated* radionuclides or working in
 

radiation areas, like a reactor operator you
 

would not do this way.
 

The exposure records show either zero or
 

fairly small internal and external doses, and the
 

cancer occurs in what we call a non-metabolic
 

organ, meaning an organ that does not concentrate
 

the radionuclides to which the claimant was
 

exposed. And prostate is our classic example of
 

that, but it's not the only one.
 

So we tried this at Savannah River and for
 

the internal dose side of it we looked through
 

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their records and incident reports and everything
 

on the site, and we dug out what were the maximum
 

intakes ever reported for all the workers at the
 

site of specific radionuclides. And we took the
 

top five of those and averaged them. Some of
 

them there were not five intakes, so we just used
 

what we had, and we assign that intake to the
 

first day of employment. Okay? Then for tritium
 

we assigned the maximum missed dose they could
 

get, we assigned the maximum missed external
 

dose, which is -- and the number of monitoring
 

intervals times the limit of detection, LOD, of
 

the badge. We also assigned the maximum medical
 

X-ray and environmental doses. So this is in
 

fact a maximum dose estimate.
 

So for Savannah River we wrote this up in
 

ORAU technical information bulletin number one,
 

and I think that is posted and on the OCAS web
 

page, was approved last month, and there's just a
 

laundry list of radionuclides that are included
 

in this.
 

For particle size and clearance type or
 

solubility, we made the claimant-favorable
 

assumptions, picking the ones that would produce
 

the maximum dose to those organs. And the other
 

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thing that to qualify for this procedure, if the
 

case was in fact monitored for internal exposure,
 

all the bioassay results must be below the
 

predicted bioassay results from this maximum
 

intake. So just assigning those -- all these
 

intakes to day one, we can calculate from IMBA
 

what should be in urine or whole body counting as
 

a function of time since exposure, and that's all
 

generated in the spreadsheet for one to 10,000
 

days post-exposure. And then what the dose
 

reconstructor has to do is look at the actual
 

monitoring data and make sure it always falls
 

below that as a function of time post-intake. Or
 

that the predicted results always exceeds the
 

MDA, minimum detectable activity, of the bioassay
 

method.
 

So as an example of that one for a Savannah
 

River claim was a claimant with male breast
 

cancer. The monitored external dose was a tenth
 

of a rem deep and .45 shallow. The missed dose,
 

which was the number of monitoring intervals
 

times the limit of detection, was .29 rem. The
 

maximum ambient environmental dose could have
 

gotten on the site was 2.2 rem. The maximum Xray dose from the annual X-rays was a tenth of a
 

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rem. The maximum internal doses, the maximum
 

missed dose from tritium was about a half a rem,
 

and the maximum dose from the assigned maximum
 

potential intake was .82. So adding all those
 

up, the -- was about four and a half rem,
 

producing a probability of causation of only
 

eight percent at the 99 percent confidence
 

interval. So we deemed this case to be complete
 

at this point and -- having assigned a maximum
 

dose and still it's very far from being
 

compensable. As an efficiency procedure, we
 

would stop dose reconstruction at that point.
 

So the next thing to do is extend this
 

efficiency procedure complex-wide and developing
 

a maximum intake scenario complex-wide. And I've
 

been doing some literature searches on that,
 

reviewing the REACTS -- Radiation Emergency
 

Assistance Center Training Site -- records for
 

accidents. Also the DTPA registry for
 

transuranic intakes who were treated with DTPA, a
 

chelating agent that removes those from the body,
 

and other data sources to come up with maximum
 

intakes for these.
 

For the external dose, for most sites and
 

most dosimeters, most doses are going to be very
 

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comparable to those for Savannah River 'cause all
 

the major DOE sites used very similar types of
 

dosimeters, so we're currently working on this. 

And of course we'll submit it to NIOSH for review
 

and approval. And then that opens up a lot of
 

cases or claims that can be processed, even
 

without the full technical basis document being
 

completed for that site.
 

We also want to extend this to the Atomic
 

Weapon Employer sites where it's primarily
 

uranium exposure. And what we decided to do
 

there is assign a maximum intake at the beginning
 

of exposure that would be high enough to cause
 

acute kidney failure from chemical toxicity of
 

uranium. And under the -- if you look in the old
 

Good Practice Guide for uranium facilities, it's
 

listed as about 300 milligrams of soluble
 

uranium. But that was based on the ICRP-30 long
 

model and the older biokinetic models. If you
 

use the new lung model, the ICRP-66 version and
 

the ICRP publication 78 metabolic models, it
 

actually comes out to be about 2,000 milligram or
 

a 2-gram intake of soluble uranium.
 

And just as an example, the resulting dose
 

from that for 50 years to the prostate gland is
 

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only one and a half rem.
 

So the external dose for a uranium facility
 

would be, depending on what the facility did,
 

either direct contact with a uranium slab, which
 

is about -- well, roughly 250 millirem an hour
 

shallow dose and about 10 millirem an hour deep
 

dose, or from uranium-containing barrels, and for
 

full-time exposure.
 

Now actually when I put this slide together,
 

I said whichever's higher. That's not correct. 

I should say whichever is appropriate, depending
 

on what the site did. So for the rolling mills
 

who were working with uranium billets, it would
 

be from the contact dose with a uranium billet or
 

slab. For places like Blockson that were
 

actually processing uranium ores or things, it
 

would be from the barrel of uranium-containing
 

material.
 

One thing we said we can't do this for is for
 

skin cancers. Not that they're metabolic, but
 

there's always a potential for a higher shallow
 

dose from uranium that has gone through a melting
 

process 'cause that brings the protactinium 234-M
 

daughter to the surface and it increases the beta
 

dose. Now we know from operations at Fernald,
 

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that was normally cut off of the billet before it
 

was sent out. But still, just to be claimantfavorable, make sure we haven't under-estimated a
 

potential dose, we're not going to use this for
 

skin or for the other two organs for which the
 

skin dose calculation becomes a surrogate in the
 

dose calculation procedure, which includes female
 

breast and testicular cancers.
 

Okay. So that's it. So that's a brief
 

synopsis of where we are and where we're going.
 

DR. ZIEMER: Thank you very much, Richard. 

Let's open the floor for some questions here. 

Okay, Jim Melius.
 

DR. MELIUS: Yeah, I've got a few questions. 

For the -- I think you referred to it as the
 

supplemental teams, you have two of them, and -­

DR. TOOHEY: Well, no, I have one team now. 

We're hoping to establish two more, but we're
 

running out of dosimetrists out there who need a
 

job.
 

DR. MELIUS: Okay. Well -­

DR. TOOHEY: We're competing with NIOSH to
 

hire the same people. I stole one from them,
 

they stole one from me, so we're even.
 

DR. MELIUS: Okay. What is the -- assume
 

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that's -- this program's just started?
 

DR. TOOHEY: Within the last couple of
 

months.
 

DR. MELIUS: Okay. Do we have any idea on
 

what the productivity of that group will be?
 

DR. TOOHEY: They do about one or two a week.
 

DR. MELIUS: Okay.
 

DR. TOOHEY: Simply because without the
 

technical basis document, they have to go do all
 

the records research independently. It hasn't
 

been done and digested for them, so it's not a
 

high volume.
 

DR. MELIUS: Okay. And second question I
 

have is -- to finish you was the efficiency
 

protocol -- the first one I believe it was, which
 

was -­

DR. TOOHEY: About likely compensable?
 

DR. MELIUS: Right. What happens to people
 

that don't fall -- that don't pass that, they go
 

back into the queue?
 

DR. TOOHEY: They go back into the regular
 

dose reconstruction pool.
 

DR. MELIUS: Okay, I was just curious on how
 

that worked.
 

Finally, at the last meeting I brought up the
 

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issue of posting the conflict of interest...
 

DR. TOOHEY: Yeah. 

DR. MELIUS: Where does that stand -­

DR. TOOHEY: Every -­

DR. MELIUS: -- in terms of that being done, 

and then secondly, what about for all these other
 

subcontractors and so forth, all this new
 

personnel you've added?
 

DR. TOOHEY: If I may coin a phrase, to the
 

best of my knowledge and belief, the bio sketches
 

and conflict of interest statements for everybody
 

involved in performing, reviewing or supervising
 

dose reconstructions and other key people -- you
 

know, the task managers, the team leaders -- are
 

posted on our web page.
 

DR. MELIUS: Okay.
 

DR. TOOHEY: Now as for everybody involved in
 

the project, we do not contemplate doing that.
 

DR. MELIUS: Okay. What about for the -- all
 

these subcontractors? I don't remember who are
 

key people or what the definitions were, so...
 

DR. TOOHEY: All right. Again, we hadn't
 

contemplated doing that.
 

DR. MELIUS: Had or had not?
 

DR. TOOHEY: Had not.
 

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DR. MELIUS: Why not? Is there a reason?
 

DR. TOOHEY: Because they're not directly
 

involved in dose reconstruction, which was the
 

essence of the conflict of interest requirement.
 

DR. MELIUS: Yeah, but don't you think that
 

-- seems to me that I -- we haven't heard the
 

full process. I guess Jim Neton's going to be
 

talking about it later, but it seems to me, from
 

the way you're describing it, that they -­

they're certainly very influential in doing dose
 

reconstructions, if not doing them directly.
 

DR. TOOHEY: Well, the data they produce
 

certainly is influential. But don't forget, it
 

goes through two independent reviews and -- one
 

internally by the ORAU team and externally by
 

NIOSH for approval.
 

DR. MELIUS: Uh-huh.
 

DR. TOOHEY: And we think that's an adequate
 

way of -- what's that word -- vetting that data
 

or what they come up with.
 

DR. MELIUS: So you're thinking that it -- I
 

still -- I guess -- my question would still be
 

why not make that information available so that
 

people would know?
 

DR. TOOHEY: But we did not propose that in
 

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the contract, so -- or the proposal, so that's
 

why we're not doing it. But -­

DR. MELIUS: You'd have no objection to -­

DR. TOOHEY: -- like everything else, it can
 

change. Well, like everything else, it'll take
 

time and cost money, but...
 

DR. MELIUS: NIOSH have any response on that
 

or -- Larry, or do we want to talk about it later
 

when Jim's presenting?
 

DR. ZIEMER: Larry?
 

MR. ELLIOTT: No, I have no response on that. 

We'll take it under consideration -- take your
 

comment under consideration. We are very adamant
 

that all of the dose reconstructors have their
 

bio sketches up on the web site. I'm not sure
 

that we see the need to go farther than that in
 

this case, so we'll take your comment under
 

consideration.
 

DR. MELIUS: Okay. Well, I'll have some more
 

questions then later. Thanks.
 

DR. ZIEMER: Thank you, Jim. Thank you,
 

Larry. Other -- Okay, Mike Gibson.
 

MR. GIBSON: So are you saying that there can
 

be people doing the site profiles that have a
 

past history at the site?
 

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DR. TOOHEY: Absolutely, that was in our
 

proposal. We have to use people who have
 

experience at the site 'cause they knew what was
 

going on there.
 

MR. GIBSON: But yet it's not necessary, in
 

your opinion, to give a background and their
 

potential conflict of interest.
 

DR. TOOHEY: Well, we didn't put that in the 

proposal. 

DR. ZIEMER: Okay. Robert Presley. 

MR. PRESLEY: Do you have a procedure for 

somebody that is terminally ill, say from one of
 

these other sites?
 

DR. TOOHEY: Oh, there is -- there is a -­

oh, what's the word -- compassionate processing
 

that NIOSH has. My understanding -- and maybe
 

the OCAS folks could reply to that. It pushes
 

them to the head of the queue to capture their
 

interview, primarily. It doesn't necessarily
 

mean the actual dose reconstruction itself is
 

accelerated, depending on the quality of the data
 

and if it can be done without the site profile
 

being completed. But let me also mention, the
 

supplemental dose reconstruction teams, they
 

would also have the task of doing a special
 

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processing as required by the client.
 

MR. PRESLEY: Thank you.
 

DR. ZIEMER: Okay. Mark?
 

MR. GRIFFON: I have some follow-up questions
 

also on the conflict of interest question, but I
 

think I'll hold that for after Jim presents.
 

Shifting gears a little bit, I'm interested
 

in this system you have with the 300 computer
 

users and is Privacy Act information exchanged
 

across that network -­

DR. TOOHEY: Yes, yes -­

MR. GRIFFON: -- and if so, can the Board -­

DR. TOOHEY: -- but not -- but not -­

MR. GRIFFON: -- possibly use the same 

network? 

DR. TOOHEY: -- but not by e-mail. Okay? 

It's -­

MR. GRIFFON: Right, right. 

DR. TOOHEY: -- you know, through dedicated 

lines using what are sort of standard security
 

protocols.
 

MR. GRIFFON: Right.
 

DR. TOOHEY: (text redacted - four lines - per
 

NIOSH, OCAS.) But basically -- well, yeah, we can
 

give anyone who needs it and, with NIOSH
 

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approval, make them a user on the network and
 

give you the -- what's called remote desktop
 

software that enables you to get in, if that's
 

something that NIOSH decides they want us to do.
 

MR. GRIFFON: All right.
 

DR. TOOHEY: Sorry about that -­

MR. GRIFFON: That's for a later discussion
 

for the working group discussion -­

DR. TOOHEY: Yeah.
 

MR. GRIFFON: -- but follow-up on the
 

efficiency process -­

DR. TOOHEY: Let me say one thing, though. 

The vast majority, if not all, of the data that's
 

out on our network is also on NIOSH's system. So
 

having access, if you get it, into their network
 

would give you essentially the same thing.
 

MR. GRIFFON: And a couple of questions on
 

the efficiency process or protocol. You -- I saw
 

maximum internal doses for these steps. Did you
 

consider maximum external doses in these cases? 

I noticed you talked about missed dose. There's
 

quite a bit of discussion about unmon-­

potentially unmonitored dose, and did you look at
 

using, as one of the efficiency protocols,
 

assigning maximum internal and maximum external
 

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and seeing how the cases fell out, as opposed to
 

just maximum internal plus -­

DR. TOOHEY: Uh-huh, well -­

MR. GRIFFON: -- missed dose.
 

DR. TOOHEY: But right now we're doing the
 

maximum missed dose. Now the question comes up,
 

what could the maximum unmonitored external dose
 

have been? Well, it could be almost anything up
 

to something that would cause acute radiation
 

syndrome, theoretically. So we haven't gone in
 

that direction yet. We're going on maximum
 

missed dose for monitored employees. For
 

unmonitored employees -- and that's a fairly
 

small fraction, say of the work force at DOE
 

sites. We haven't really nailed that down yet. 

But it's certainly possible and it's very similar
 

to the approach with uranium. A maximum uranium
 

intake that would put you in acute kidney
 

failure, we could give you -- I don't know -- 100
 

rem external would start causing blood dyscrasias
 

and -- and if it's still non-compensable. But
 

you know, if you get up to too high a dose, then
 

everything falls out because it then becomes
 

potentially compensable and -­

In fact, we -- just one story. There was a
 

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question at Savannah River about what point in
 

time they were using a mobile photofluorographic
 

unit in the 1950s for routine chest X-rays, and
 

that's one to one and a half R a shot, and that
 

was kicking a lot of these, if we assume maximum
 

dose from that, into a compensable range, which
 

knocks them out of the efficiency protocol.
 

MR. GRIFFON: Yeah, and there -- there's more
 

detailed questions -- I mean I understand that,
 

but also I think you could consider the -- the
 

monitoring records over time, the external
 

monitoring records over time -­

DR. TOOHEY: Well -­

MR. GRIFFON: -- to maximize your maximum.
 

DR. TOOHEY: Yeah.
 

MR. GRIFFON: You don't have to say, you
 

know -­

DR. TOOHEY: And we've got -­

MR. GRIFFON: -- lethal doses.
 

DR. TOOHEY: You know, we're getting into
 

area monitoring records and also, as we get more
 

and more claims done, then we can use coworker
 

data also to bracket that, I think.
 

MR. GRIFFON: All right, that's what I was
 

going -- and -- and for the maximum internal dose
 

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-- and maybe this is specific for Savannah River,
 

but how did you capture -- it talks about the
 

five maximums -- intakes for each radionuclide -­

or the primary radionuclides of interest. How
 

was that determined? What -- what resources,
 

what data did you use to determine that?
 

DR. TOOHEY: Basically it was Savannah
 

River's own monitoring records and incident
 

reports.
 

MR. GRIFFON: Okay. And -- and were those in
 

any way -- do -- does ORAU or the -- the site
 

profile teams, are you attempting to verify
 

those? I mean I imagine these are from bioassay
 

monitoring records or incident reports -­

DR. TOOHEY: Primarily they were from
 

incident re-- you know, the existence of a high
 

intake usually comes off an incident report.
 

MR. GRIFFON: Uh-huh.
 

DR. TOOHEY: You know, glove box blows or
 

something -­

MR. GRIFFON: Right.
 

DR. TOOHEY: -- so there's a potential. But
 

then the quantification of the intake comes from
 

the bioassay data. Now what we didn't do, though
 

-- again to be claimant-favorable -- was use the
 

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old lung and metabolic models to work back to the
 

intake, which is in fact claimant favorable. 

It's generally a higher estimate of the intake
 

than using the newer models. And comparison of
 

the models and the resulting predicted maximum
 

intakes are in that technical basis document -­

or technical information bulletin.
 

MR. GRIFFON: Okay. So these maximums would
 

have been based on reported incidents primarily ­

-

DR. TOOHEY: Right.
 

MR. GRIFFON: -- from the -- from the data
 

provided by the Department of Energy site.
 

DR. TOOHEY: Right.
 

DR. ZIEMER: Could you clarify for me the
 

types of individuals who worked on a site who may
 

now be involved in these site profile? For
 

example, is it conceivable that an individual who
 

at one time in the past was responsible for
 

generating some of the data which is now used in
 

the profile would be on a site -­

DR. TOOHEY: Yes.
 

DR. ZIEMER: -- team and -- and at least
 

perception-wise, be defending data that that
 

individual developed in the past? Do you
 

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understand the nature of the question I'm asking?
 

DR. TOOHEY: Yeah, sure, I do. And the short
 

answer is yes. I'll give you a couple of
 

examples. One of our key subcontractors looking
 

at external dosimetry data is Jack Fix, who
 

probably knows more about external dosimetry
 

across the DOE complex than anybody else. So did
 

-- was he responsible for generating some of the
 

data? Yes. Is he defending that data now? I'm
 

not sure if that's what he's doing. He's
 

providing it, and then it's subject to scientific
 

review and analysis by people who did not
 

generate it.
 

DR. ZIEMER: Give us an idea of the
 

composition of a typical team you're using, and
 

it's clear that we want to mine the information
 

from those who are very knowledgeable, and yet
 

questions might arise -- I think they've been
 

hinted at, that one might become defensive about
 

one's own past data.
 

DR. TOOHEY: Sure. 

DR. ZIEMER: So what -­

DR. TOOHEY: Well, the -­

DR. ZIEMER: What is the mix of sort of 

outside independence on a team?
 

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DR. TOOHEY: The typical team is about a half
 

a dozen people, would you say, Judson? Okay,
 

Judson Kenoyer's here, who is our task three team
 

leader, and will have some more input on that
 

later. In general the people on the team for the
 

site probably -- I would say -- it's fair to say
 

in general probably did not work themselves at
 

the site. The people who did or still do work at
 

the site are used as resources for the team. Now
 

Jack's one exception. He's -- he did the
 

external dosimetry part of the Savannah River
 

document and he's doing the one for the Hanford,
 

and of course he did work there. But for the
 

internal part of Savannah River, our primary
 

resource for that data was Tom Labone at Savannah
 

River. So he was -- I don't know, a consultant
 

may be too strong a word -- a data source for us
 

to use, but he was not actually on the team that
 

produced the document.
 

And Judson, do you want -- would you like to
 

comment on that?
 

MR. KENOYER: I'd like to add just a few
 

words to that. As we put together these teams,
 

we are trying to gather groups of people that
 

basically had experience working at those sites. 

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They may or may not have been employees of the
 

contractor on-site. Perhaps they were a
 

subcontractor that had done work. With the idea
 

that we needed to gather five or six people that
 

had different areas of expertise, also -­

internal dosimetry, external dosimetry, if they
 

knew anything about the X-ray systems used. So
 

it's a matter of trying to pull together a good
 

cohesive team that had experience, that perhaps
 

knew people that still worked on that site, or
 

people that had retired, so...
 

DR. NETON: I'd just like -­

DR. ZIEMER: Thank you. Jim Neton.
 

DR. NETON: I'd just like to add one extra
 

piece of information. Each one of these teams
 

has an assigned NIOSH health physicist who serves
 

as a technical monitor -­

DR. TOOHEY: Good point.
 

DR. NETON: -- of the technical basis
 

document or site profile for all 13 or whatever
 

currently ongoing. In fact, before it ever even
 

goes through formal review, I have a little slide
 

that'll demonstrate this, it is -- it is
 

essentially vetted by the NIOSH technical monitor
 

or worked with side-by-side until -- and then it
 

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comes to NIOSH for review, and it is a document
 

that is both reviewed by ORAU and reviewed and
 

signed by NIOSH, issued as a controlled document. 

So NIOSH ultimately approves the technical basis
 

document, not the person who may have worked at
 

that site.
 

DR. ZIEMER: Thank you for that
 

clarification. I think Mike Gibson has a
 

comment.
 

MR. GIBSON: How many of these teams has a
 

former field worker, such as a craftsman,
 

involved in them, or maybe a current field worker
 

such as a craftsman, that escorts them, that asks
 

them have you looked at this event, have you
 

looked at this potential event. That's one
 

question.
 

The second question is if an event happens
 

and it's found out about later and the report is
 

generated later to where bioassay data wouldn't
 

be adequate, how do you determine the dose to the
 

employee?
 

DR. TOOHEY: Okay. Well, first -- first
 

question, to my knowledge, we don't have any
 

crafts or trades people on these teams. They're
 

all health physicists.
 

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Second question, if incident occurred but was
 

realized later, when it's below say the limit of
 

detection of bioassay so you can't back-calculate
 

to what the intake may have been, then you would
 

have to work off any available data you do have ­

- air monitoring, surface contamination levels,
 

skin contamination, levels on workers present,
 

whatever you can get. And there are ways of
 

converting air monitoring data to release and
 

resuspension factors and all those sort of
 

things, so we can bracket what the potential
 

exposure could have been. And remember in this
 

case we're trying to determine what the maximum
 

could have been, not what the actual intake was. 

So all the way through that process in trying to
 

back-calculate, we make the claimant-favorable
 

assumptions to try to maximize the dose.
 

MR. GIBSON: And a third question, are you
 

going back and when you're looking at the MDA for
 

the different sites, are you also going back and
 

looking at whether the QC that they've used to
 

calibrate their systems and whether they've been
 

fined by Price-Anderson* for elevating the MDAs
 

to artificially high doses?
 

DR. TOOHEY: We certainly look at the
 

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historical MDA. And in fact that's one of the
 

things in this process, like many others, which
 

takes more time than we thought it would is going
 

back -- I think Dr. Neton's presentation will
 

talk about that. A lot of the notations in the
 

records are extremely cryptic. For instance, we
 

found whole-body counting records from Savannah
 

River where the activity designations are A, B,
 

C, D. It took us a while to find out what that
 

meant. It turned out it actually referred to
 

energy bands in the gamma ray spectrum. But
 

yeah, we do. We try to go back, look at the QA
 

records. And the calibration records, it's
 

especially important on the external dosimeters,
 

and we have had people looking at that. And part
 

of our uncertainty analysis team is also
 

specifically looking at that, also. Peter
 

Groher* from the University of Tennessee is
 

heading that effort up.
 

MR. GIBSON: And just one -- one thing for
 

the record is, you know, I'm not questioning
 

anyone's credibility here. I want to make the -­

this is a thorough and proper process. Let's not
 

forget we wouldn't be sitting here, this law
 

wouldn't be on the books if the Department of
 

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Energy had done its job right. I just want to
 

make sure that, now we're trying to correct the
 

problem, we do it fairly.
 

DR. ZIEMER: Thank you, Mike. We'll have one
 

more question and then Rich, if you would be
 

available later in the morning, obviously this is
 

of great interest and maybe when we get to your
 

regular time slot we can have an opportunity to
 

reopen things. But we do have a guest speaker
 

who will have to be leaving mid-morning and we
 

want to allow him to give his presentation before
 

the plane leaves. So I'll allow one more
 

question. Jim, and then we'll -­

DR. MELIUS: I believe this is a brief one. 

My understanding is at the last meeting -- I was
 

not present the second day -- that Larry Elliott
 

had talked to the Committee about relaxing the
 

conflict of interest rules for the people doing
 

the individual dose reconstructions. Has that
 

been done or what's -­

DR. TOOHEY: No. We felt the consensus of
 

the Advisory Board was that was not a good idea,
 

so we have not pursued it.
 

DR. MELIUS: Okay. Thank you.
 

PRESENTATION BY DR. JOHN TILL, RAC
 

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DR. ZIEMER: Thank you very much. Our next
 

agenda item is a guest speaker, Dr. John Till. 

Dr. Till is president of Risk Assessment
 

Corporation. I want to give a little bit of
 

biographical information. I'm not sure if -­

it's not in your book, so let me -- John, I'll
 

try not to use up too much of your time, but you
 

have such an important resumé I want to give a
 

little bit of that.
 

John is a graduate of the U.S. Naval Academy,
 

served in the U.S. nuclear Navy submarine
 

program. He retired from the Navy in '99 as a
 

Rear Admiral. He's a recipient of the
 

Distinguished Service Medal, Legion of Merit, a
 

couple of Navy Meritorious Service medals and
 

other commendations. Dr. Till is -- has been a
 

recipient of the Ernest Lawrence Award, which is
 

an award of the Department of Energy in the field
 

of environmental science and technology.
 

In 1977 he formed a company called the Risk
 

Assessment Corporation -- I think originally it
 

was called Radiological Assessment Corporation -­

and since its formation that group has played a
 

very key role in the evolution of methodologies
 

for environmental risk analysis.
 

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John served as Chairman of the Technical
 

Steering Panel for the Hanford Environmental Dose
 

Reconstruction Project. He's been principal
 

investigator in the successful completion of
 

Fernald Feed Materials Production Center
 

Historical Dose Reconstruction Project. He's
 

been involved in Phase II at the Rocky Flats
 

Plant Dose Reconstruction Process, Phases I and
 

II of the Savannah River Dose Reconstruction
 

Project, and there are a number of others, so you
 

get the point.
 

John's very well-published. He has over 175
 

publications. He edited the first book on
 

radiation dose analysis called Radiological
 

Assessment.
 

He's currently a member of the ICRP,
 

International Commission on Radiological
 

Protection. He's Chairman of the National
 

Academy of Sciences review committee that
 

reviewed the dose reconstruction program of the
 

Defense Nuclear Threat -- Defense Threat Nuclear
 

Agency, and we're going to hear about that
 

shortly.
 

DR. TILL: Paul, that's enough.
 

DR. ZIEMER: I left out the most -­

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DR. TILL: That's enough.
 

DR. ZIEMER: -- the most important thing,
 

John, to you. John is also a farmer. I think -­

DR. TILL: That's important.
 

DR. ZIEMER: -- originally was a dairy
 

farmer, still has that big farm and loves
 

farming, as well.
 

DR. TILL: That's -­

DR. ZIEMER: John, welcome.
 

DR. TILL: -- the most important thing, the
 

last. I am a farmer and I love it. And I am
 

very honored to be here and speak with you. I've
 

heard quite a bit about your work. Thank you
 

very much, Larry, for your gracious invitation. 

And Paul, what should I do, try to quit at 10:00
 

or do I have a bit more time? Well, I won't take
 

longer than you've allowed me, but maybe we
 

should set up a few ground rules.
 

I would encourage you to stop me at any time
 

if you have a question, and let's talk. And if
 

we see we're getting hung up too much and I'm not
 

getting through some of the key points I'd like
 

to make, then we'll change the course of action,
 

if that's all right.
 

A few things I need to say from the outset
 

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this morning is that I'm not speaking for the
 

National Academy. I'm speaking for myself. And
 

that's important because I think I want to say a
 

few things that probably are not in the Academy
 

report, and I may point those out to you as we
 

go.
 

The report itself will be published on
 

Friday, and I spoke with the Academy last week
 

and I asked them, Paul, to be sure and send you
 

copies. I said send Paul Ziemer as many copies
 

as you can. I think they're aware of your
 

committee and hopefully they'll do that, but it
 

should be published this Friday. It has been on
 

the web, as you know, and that's what I want to
 

focus on is the Academy report, but throwing in a
 

few other personal comments, if you don't mind.
 

The Academy report was a great privilege for
 

me. It was the first time I'd chaired an Academy
 

committee. I've served on many of them, but I'd
 

never chaired one before. We took two and a half
 

years to do the work.
 

I want to also make sure that you understand
 

that what I say this morning is not intended to
 

be critical of any individual, any organization,
 

whatsoever. And not that what I say is caustic
 

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in any way, but I think we sometimes forget how
 

science evolves and how we evolve as people and
 

what we do and what you're doing right now, for
 

example, is quite revolutionary. And I can
 

guarantee you one thing, and that is after you've
 

been here for a number of years -- and Dick,
 

after you've done this work for a number of
 

years, anybody can come in and tell you what you
 

did wrong from the beginning and what you're
 

doing wrong and how to make it better. And don't
 

forget that. And don't forget to convey that
 

message to the claimants, I guess that's the
 

proper term, that we're getting better at this
 

all the time. And right now, frankly, we're in
 

our infancy with regard to this science, and
 

probably with regard to what you're trying to do,
 

which is to administer a law that this country
 

saw fit to put into place.
 

I'm going to stop occasionally and look at my
 

notes to be sure I'm covering things 'cause I'm
 

sure I'm going to get off track here from time to
 

time. I have no presentation. I did that
 

deliberately. I'd rather you listen to what I
 

have to say. Much of what I have to say you can
 

read, and I really encourage you to read this
 

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report that is going to come out this week.
 

I want to say one thing in particular about
 

the Academy and the Academy's work, and it's
 

directed to Mike Schaeffer who's back there. 

Mike, I really commend you. And I have been
 

reviewed by the Academy -- in fact, almost all of
 

my work for 15 years has somehow gotten into the
 

channel of Academy review. And frankly, I've
 

found it downright annoying that you can bring in
 

this group of experts to sit around the table,
 

who suddenly -- after you've been doing the work
 

for three, four, five years and you've put
 

together this magnificent report, that these
 

experts who suddenly come in think they can pick
 

up in just a matter of meetings everything that
 

you've done and tell you what you've done wrong,
 

and very seldom compliment you on what you've
 

done right, I found very annoying.
 

On the other hand, it was also refreshing. 

also learned. I had the opportunity to look at
 

what they recommended and say you're right or
 

wrong, and in some cases, the Academy was
 

downright wrong about what they said, and we
 

challenged them on it. And at least I felt
 

better afterwards. But I think it is the
 

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character of how you accept the recommendations
 

of the Academy, or any other high and mighty -­

almighty group.
 

And Mike Schaeffer, you have done this
 

magnificently. I know that you've taken on many
 

of the recommendations already. I don't know
 

specifically, but I've heard incredibly good
 

things. Plus I think DTRA, SAIC, the VA, were at
 

an incredible disadvantage to what you have, and
 

that is they did not have this knowledge and they
 

had a program that was 20 years old. And it
 

really took about 20 years before some outside
 

group, like us, came in and looked at their
 

program in the depth and thoroughness that we
 

did. So I want to personally congratulate you,
 

Mike. But all the others at SAIC, at J-Corps and
 

the VA, as well. Tony Princippi has also been
 

very responsive to what we said.
 

It wouldn't be fair for me not to mention the
 

other committee members -- Harold Beck, Jay Brady
 

-- and if you don't know Jay Brady, he is quite a
 

character, a wonderful man to serve with, with
 

incredible experience -- first-hand experience at
 

the testing site -- Tom Giselle, David Hoyle,
 

Eric Kearsley, Dave Kocher -- Dave's here -­

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yeah, he's going to keep me on track here this
 

morning -- Jonathan Merino, who's a bioethicist,
 

and I'd never worked with a bioethicist before on
 

a scientific committee, but what a wonderful
 

contribution Jonathan made to our work; Clair
 

Weinberg, as well. And of course Evan Dupole and
 

Esoph at the Academy, just an incredible group of
 

people to work with.
 

As I accepted this job with the Academy to
 

chair this committee, I knew it was going to be a
 

difficult task because I had been involved in
 

dose reconstruction work for quite some time. I
 

know how tedious it is. I know how complex it
 

is. I know how much information is always
 

missing, usually far more than you have to work
 

with. And so it was with some bit of concern
 

that I accepted the job as Chair.
 

I was also a bit familiar with what DTRA was
 

doing, and the veterans' programs, but not in
 

great depth. And the reason I was somewhat
 

familiar with it is because I had an opportunity
 

to serve on one of the Academy reports, the five
 

series study. It was an epidemiological
 

analysis, looking at disease among some of the
 

atomic veterans in five different series to see
 

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if we could see an effect. When we started that
 

work we hoped to be able to assign specific doses
 

to the different cases. And I was asked to lead
 

a small task group in the work, and that was to
 

decide whether or not the dosimetry that had been
 

developed over the years by DTRA could be used in
 

fact in the epidemiological analysis. And the
 

conclusion of that small group was that we could
 

not, that this dosimetry was not suitable for
 

epidemiology. And that's the first point that
 

I'm going to make with you today that I hope
 

you'll remember, and it's not in the Academy
 

report.
 

I want to challenge you, I want to challenge
 

this panel, I want to challenge the scientists
 

who are working on this, and I'd like to
 

challenge NIOSH to make sure that what you're
 

doing in this study is not merely fulfilling the
 

law. But let's advance the science. Do not miss
 

an opportunity to let's push the science a notch
 

-- more than a notch.
 

I'll mention a couple of things as I talk
 

this morning where I think those opportunities
 

might exist. I know that you're open to this,
 

but let me encourage you that -- let me tell you,
 

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in my opinion as a scientist and as a taxpayer,
 

it is not sufficient to merely fulfill the law. 

We've got to raise the level of the science that
 

we're working with. As you get into this you're
 

going to realize how little we know about dose
 

reconstruction, how little we know about the
 

exposure situations that occurred, or even how
 

little we know about the validity of what you're
 

trying to do. That is, to compensate people
 

based on these calculations.
 

So the point there is I had some insight as
 

to what I was getting into before I started this,
 

but I had no idea how complicated it was
 

ultimately going to be.
 

You should know that this Academy report does
 

not deal at all with the idea of compensation. 

Whether it's good or whether it's bad and whether
 

you agree with it or don't agree with it, or
 

whether we agreed with it or did not agree with
 

it as scientists had nothing to do with the
 

report or what we did. We were there to decide
 

whether or not the science was being done and the
 

law was being fulfilled. So we could not and you
 

cannot allow personal feelings to get involved in
 

what you do.
 

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So the approach that we took to the work was
 

that we knew we were stepping into a situation of
 

volatility and a lot of visibility with the
 

Academy report. And I think this Academy -- I'm
 

not certain about this, but I think this Academy
 

committee did break some new ground with regard
 

to public involvement. I know they've been
 

working at this for a long time. If you work
 

with the Academy, you know it's a quite closed
 

organization. They have incredibly strict rules
 

for how they work.
 

But on the other hand, we thought it was
 

important to meet the veterans, to have the
 

veterans talk to us, to go to them on their turf
 

-- which we did. We wanted to be sure that what
 

we did was thorough and defensible. Did we
 

accomplish that? I don't know. Time will tell.
 

So in the beginning we set a course to do
 

several things. We were actually obligated with
 

our charge, which I'll come back to in a few
 

minutes, to develop a statistically significant
 

sample from which to work. At the time we began,
 

there were about 3,700 dose reconstructions that
 

had been performed. We decided to take a sample
 

of 99. We felt that was statistically
 

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significant. About two-thirds of those we wanted
 

in the higher dose category, so we said they had
 

to be a dose above one rem. But we were also
 

concerned that if we did that, we would neglect
 

one very important group and that were the
 

veterans from the Hiroshima/Nagasaki, either
 

prisoners of war or service men and women who
 

served in Japan following the A-bomb tests. So
 

we took a separate sample of those. That was
 

about ten. So we were working with about 110 of
 

our own selected -- randomly selected samples. 

But in addition, we encouraged veterans who
 

wanted to to send us their files. We got about
 

two dozen of these. And we did work a number of
 

these files and we found them quite interesting,
 

and some very supportive information for our
 

report.
 

So how did we do this? We set out, for about
 

the first year and a half, aggressively reviewing
 

these files. Every committee member looking at
 

every file, and that takes time -- a lot of time
 

-- to go through each file, to try in your own
 

mind to decide do you understand what's being
 

written here, do you agree with what's being
 

written here, what are your problems.
 

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So a few other things we wanted to do as we
 

drafted this report, we wanted it to be
 

understandable by Congress, by scientists and by
 

the veterans -- and by anyone else who might read
 

it. Now did we achieve that goal? Probably not,
 

but I do believe that a lot of what we did is
 

understandable. I mean I will tell you that when
 

you read a couple of the chapters, you may get
 

lost. I mean even we did, as we go through this
 

from time to time. We had some very bright
 

people who were working on this. However, I
 

think as a whole, when you look at the report,
 

everybody can get something out of this. And
 

there are parts of this report deliberately
 

written in the language where we hoped the
 

veterans would understand what we're saying.
 

We wanted to be detailed, very detailed, and
 

I challenged the members of the committee as we
 

drafted this report to be specific, to put case
 

numbers down so that anybody who wanted to go
 

back, these cases are available -- not the names,
 

but the cases. So anybody who wanted to go back
 

and see what we were talking about could
 

certainly do that.
 

We wanted not only to show what we thought
 

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was incorrect or weak, but the strengths of the
 

work. And where something could be done more
 

correctly, we wanted to show DTRA or the
 

scientists working on this how they could do it
 

better.
 

So just briefly, when you see the report
 

you'll see an introduction. You'll see a chapter
 

on the process of the committee that explains
 

basically what I just told you now. You'll see a
 

chapter on the process for claims, how does a
 

veteran file a claim and exactly what are the
 

steps that it goes through. Believe it or not,
 

that was very difficult to sort out. The
 

graphics that you see in this report, we
 

developed, because there was not a single graphic
 

that the VA could bring in, that DTRA could bring
 

in that showed the entire process -- at least not
 

clearly. I'm sure -- I'm sure we had some
 

examples to work with.
 

There's a chapter on the dose reconstruction
 

process and what that does. It focuses on how we
 

saw the process being done, without the critique. 

This is the way it was being done. These are the
 

steps being followed. These are the assumptions. 

These are the models being used.
 

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And then there's a chapter on findings, so if
 

you're doing it this way, what's good, what's
 

bad. Here's how we recommend solving problems
 

you might have.
 

And then a very key chapter, and I'll talk
 

about a few of these as we go through this this
 

morning, where we had other findings. Not
 

strictly dose reconstruction, but things related
 

to dose reconstructions. And I have to tell you
 

as I read the charge in a few minutes, you're
 

going to think wow, that's pretty restrictive. 

We were very broad in interpreting our charge. 

And I think this committee went as far as an
 

Academy committee can go to give -- to give DTRA,
 

to give the Congress, to give the veterans more
 

than what we were asked in the charge. And I
 

hope we did that. In fact, we probably -- we
 

tried to go a little farther in some cases and we
 

felt that it was inappropriate, but other
 

findings like communication with the veterans;
 

the bioassay program that DTRA had instituted
 

something called the low level dose screen, which
 

was a huge credibility issue; and what are the
 

implications to the veterans of what we're
 

saying. And then we had conclusions and
 

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recommendations. You'll see all of this when you
 

look at the report. If you have any trouble
 

getting these, Paul, give me a call, please.
 

We were also confronted, when we began the
 

work, with the fact that the Academy has looked
 

at the veterans before. Now that's interesting,
 

isn't it? In fact, in 1985 the first Academy
 

report on the mortality of nuclear test
 

participants, there were some problems in that
 

report with numbers and so forth in 1985, and
 

that work was ultimately redone. In 1985 there
 

was a report by -- that Merrill Eisenbud shared
 

on methods. That's interesting. 1989, a very
 

solid report that Frank Massey chaired on
 

external dosimetry. In 1996 an Institute of
 

Medicine mortality of participants, that was sort
 

of a repeat of the earlier work looking at -- it
 

was an epidemiological study. In 2000, the five
 

series study that I participated on. So what
 

happened? So why is what we're doing so new and
 

different?
 

Well, the problem is that the right questions
 

were not asked before. That's one problem. And
 

in great respect to Merrill Eisenbud, in 1985
 

when he looked at this, this science, this
 

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business of dose reconstruction, was really in
 

its infancy. And Merrill and his committee
 

pointed out some very serious issues that we
 

still found when we looked at this work.
 

But the point I'm making here, and it is
 

important because you need to challenge those who
 

are going to verify what's being done, be sure
 

you're asking the right questions, or you won't
 

get the answers that you're looking for.
 

I also believe that in the work that we did,
 

no other committee -- no other Academy committee,
 

aside from the fact that they didn't have the
 

explicit charge that we had -- and this may not
 

be a fair statement and I might have to qualify
 

it -- but did not look with the thoroughness and
 

aggressiveness that this committee looked into
 

with regard to these doses. And it's certainly
 

not fair to say that about the epidemiological
 

studies, but perhaps they never had an
 

opportunity.
 

You need to know something about the history,
 

and this is important, of the history of that
 

program because there's a point I want to make at
 

the end, and I'm not going to say much. But this
 

started a long time ago, this issue with atomic
 

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veterans and disease and the concern about
 

disease and the dose reconstruction program has
 

been in place for a long time, over 20 years this
 

has been going on -- 25 years when you look back.
 

In 1977 when there was reported an increase
 

in leukemias among participants at Shot Smoky*
 

and that was Glen Caldwell's work, and I think
 

that was the report that first elevated the
 

concern about exposures of veterans.
 

In 1998 Congress authorized the NTPR program,
 

and that was really to start pulling the
 

information together on the veterans. And thank
 

goodness at that time Congress did act, because a
 

lot of the records it's possible might not be
 

with us today, or might not have been retained.
 

And also in 1978 DTRA and -- well, it was DNA
 

at that time -- was responsible for determining
 

or looking into VA eligibility. In 19-- for
 

compensation.
 

In 1981 the first public law was passed. In
 

1984 the law was amended, and that's when we
 

really got into the dose reconstruction process,
 

about that time, so that doses had to be
 

calculated.
 

The law has been changed about 15 times. Now
 

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why is this important? It's very important to
 

keep in mind that the science is always changing. 

And so much -- in fact, I'm sure if you're in a
 

different field of science, you'll say that your
 

science has changed just as much as this whole
 

business of dose reconstruction. But by golly,
 

I've been in this for a while now, and I don't
 

know that I know of anything -- other than the
 

medicine field and the phenomenal advances we're
 

making there -- but I don't know of any other
 

area that's changed quite so much -- our ability
 

to grasp information, our ability to do something
 

with huge amounts of data. We couldn't do these
 

things 15 years ago -- ten years ago. And so
 

much even in the last five years.
 

And so as you're critical of what happened in
 

the DOE complex 20, 30, 40, 50 years ago, don't
 

forget that fact. And I think you have to keep
 

in mind that it very well may have been what
 

you're seeing as changes in the science, changes
 

in our expectations of scientists and data
 

management, and not the fact that somebody -- and
 

I heard the comment this morning, and I'm not
 

defending DOE. I -- believe me, I'm not. But on
 

the other hand, somebody said well, they didn't
 

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do their job. It's pretty difficult for us to -­

in my opinion, to make that statement because
 

we're not living in that time. So that's why the
 

history is so important. And it will change. In
 

the next five years and, Larry, by the time
 

you're finished with this task, I can guarantee
 

you what you see today, what you do today is
 

going to be so different.
 

So a question that this leads to, which is
 

also not in our report, so what do you do about
 

the changing science, and what is your policy
 

about changing science? Do you have one? Maybe
 

you do. If you don't, then think about it. What
 

is your position going to be that if you're using
 

ICRP dose coefficients, and I assume that perhaps
 

you are, when those dose coefficients are
 

upgraded over two years of time and maybe the
 

dose coefficient for plutonium inhalation goes up
 

or goes down, so what are you going to do? Are
 

you going to change the science as you go through
 

the process -- and I hope that you will, because
 

that's what my recommendation would be to you. 

But then what does that lead to? What do you do
 

about doses you've already calculated? What do
 

you do about people that you've already
 

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compensated? These are some serious thoughts
 

that I want to leave with you.
 

And I think that was one thing in our report
 

that we didn't feel was handled very well, at
 

least a clear policy on what you do about
 

changing -- changes in the science. And we felt
 

that for -- in a lot of the methods being used,
 

the most up-to-date, the most current information
 

was not being used to calculate doses.
 

Am I going too fast? Are we doing all right? 

I hope I'm saying something worthwhile to you. A
 

lot of this is off the cuff and not in the
 

report, but what I'm going to do now is shift to
 

the report itself just a little bit.
 

The first thing I want to do is just to
 

mention the charge of the committee. And this
 

was written -- I suspect it was written by
 

Congressional staffers 'cause let me just read
 

the first charge.
 

(Reading) Whether or not the dose
 

reconstruction of the sampled doses is accurate. 

Isn't that wonderful, the word "accurate"? Is
 

anything we do in this accurate? I don't think
 

so. And so, you know, here you are, the
 

committee, how do you respond to a question like
 

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that? Well, we interpreted that question -­

well, I'll come back to that in just a minute.
 

The second charge was (Reading) Whether or
 

not the reconstructed doses are accurately
 

reported to the VA.
 

The third charge, (Reading) Whether or not
 

the assumptions made about radiation exposure are
 

credible. What does that mean? Whether or not
 

the assumptions made about radiation exposure are
 

credible.
 

And fourth, (Reading) Whether or not the data
 

from nuclear tests used by DTRA as a part of the
 

reconstruction of sampled doses are, again,
 

accurate. Whether the data are accurate.
 

And then the committee was also asked to
 

recommend whether there should be a permanent
 

system of review for the dose reconstruction
 

program. Let me answer that now. Absolutely. 

Absolutely. And I think if the DTRA program has
 

suffered from anything over the years, it's the
 

fact that there's not been a group like you to
 

take responsibility for advising them on the
 

science and for challenging them, as you have
 

this morning on things like conflict of interest,
 

communication, quality assurance. And so we did
 

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recommend that a permanent system of oversight be
 

put into place.
 

Now I think it's important that I just go
 

ahead and hit right now the way we said that. If
 

you saw the report, when we responded to that
 

question we said if the program continues, yes,
 

we think there should be a permanent system of
 

oversight.
 

Now I'm going to go back into the John Till
 

mode and I'm going to tell you what that means. 

We struggled with value of what was being done,
 

and this is just me talking now, ladies and
 

gentlemen. But I think we have to look at the
 

value of what we are doing, as a country, as
 

taxpayers, some of you perhaps as claimants, the
 

value of what we are doing. What is this costing
 

us overall to administer a program that delivers
 

some benefit to these individuals -- quite
 

deservingly so, but what is it costing us? Now I
 

don't know the answer to what it costs DTRA, the
 

VA. I don't know the answer to that. But I
 

think the committee struggled with the question
 

of value and was what was being done, and the
 

cost of administering this program for 20 years,
 

and what was actually being paid out worth it.
 

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I'll give you an example of why this came up
 

-- or at least in my own mind why it came up. We
 

struggled on the committee trying to find out how
 

many individuals out of some 4,000 dose
 

reconstructions that had been performed -- and
 

I've missed talking about the law, and I hope
 

you'll forgive me for that.
 

There's a presumptive law and a nonpresumptive law for disease. The presumptive law
 

means that if you have a certain type of cancer
 

and there are about 21 cancers and you were there
 

at a test site, you're compensated. The nonpresumptive law accounts for those individuals
 

who don't have the presumptive disease who claim
 

they were there or who have some disease and want
 

to be compensated, and that's when you shift into
 

this mode of the dose reconstructions.
 

So over the time, there were about 4,000 dose
 

reconstructions. And we asked and were very
 

curious to know, well, how many of these claims
 

had been awarded. And so we went to the Veterans
 

Administration and we asked them, and the numbers
 

always came back a little bit different, but on
 

the order of I think 1,500 or 1,600 or something
 

like that. And we were really puzzled because
 

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the numbers didn't add up in our sample of 99. 

We just couldn't see it.
 

And so we did some more investigating into
 

this. It turns out -- and this is another point,
 

but I'm sure you've got this one resolved, Dick
 

and Larry, and that is we wanted to go into the
 

database and punch some buttons and do a query
 

that said out of these dose reconstructions, how
 

many successful claims have been awarded? You
 

couldn't do that. And when you did it, you came
 

up with the numbers that included a lot of other
 

categories and it just couldn't be sorted out.
 

And so what we did, and the VA worked with us
 

because they were really curious. The veterans
 

had been saying for years and years the number
 

was on the order of about 50. The VA was saying
 

on the order of about 1,500, 1,600. Big
 

difference there. Huge credibility issue for us,
 

to be able to sort this out. So we took a sample
 

of 300, looked at them individually. The answer
 

is about 50. And that's the best we can sort
 

this out, about 50.
 

Now whether or not that's good or bad to you
 

has nothing to do with this, but it does, in my
 

mind -- John Till speaking -- raise the issue of
 

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value of what we're doing. So I'll leave that
 

thought with you.
 

So what were the answers to our charge? With
 

regard to whether the dose reconstruction of
 

sample doses is accurate, the committee concluded
 

that credible upper bound doses from external
 

gamma, neutron and beta exposure are often
 

underestimated and sometimes considerably. And
 

that's what we reported in the press conference.
 

Now what that didn't say is that the average
 

doses that are calculated are pretty good,
 

especially the external gamma doses. The average
 

doses are pretty good. It was the upper bounds
 

we were concerned about, but the upper bound is
 

what's reported for compensation, and I know
 

you're doing the same thing. And we were looking
 

at a 95th percentile upper bound on the dose
 

calculations.
 

In response to question number two, whether
 

or not the reconstructed doses are accurately
 

reported, the committee concluded that as they
 

have been calculated by DTRA, they have been
 

accurately reported to the VA and the veterans. 

In other words, we're reporting the numbers that
 

we calculate, even though the numbers we're
 

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calculating may not be the correct upper bound,
 

but we are reporting. So the answer to that
 

charge is yes.
 

On the other hand, with regard to reporting
 

information -- and I want to come back to
 

communication before I finish; I'll have to get a
 

few words in about that -- we're doing a lousy
 

job of trying to explain to veterans what these
 

doses mean.
 

And I challenge you to do that to your
 

claimants. And it's tough. From what I know
 

about what you're doing -- what little I know
 

about what you're doing, I think you are making a
 

great effort at this and you are opening your
 

meetings and you are trying to explain to people,
 

for example on a probability of causation, what
 

it takes to get an award -- a successful award. 

So I congratulate you on that.
 

In response to question three, whether the
 

assumptions made regarding radiation exposure are
 

credible, the committee concluded that many key
 

assumptions and methods being used are not
 

appropriate and often lead to underestimation of
 

the upper bounds of doses to atomic veterans. 

That is a very difficult charge to respond to,
 

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because much of the information -- most of the
 

information is very good data to work with.
 

One key point there -- and I'll come back to
 

this and hopefully can read you a couple of these
 

cases -- is benefit of the doubt. And in that
 

area, we felt this charge -- they didn't meet
 

this charge, in particular because of following
 

with the responsibility of benefit of the doubt.
 

Regarding the fourth question, whether the
 

data used by DTRA to reconstruct the sample doses
 

are accurate, and we interpreted this to mean are
 

the data that we have to work with to reconstruct
 

these doses for atomic veterans, is there enough
 

information there to reconstruct the doses. And
 

if you haven't looked at some of that information
 

that was compiled early on in the NTPR program,
 

it is quite astonishing. It is a wealth of
 

information. And thank goodness Congress, DTRA,
 

took the time to put all of that together at the
 

beginning 'cause it's some good solid data to
 

work with. It's amazing how much information was
 

collected at these tests.
 

I honestly don't know how much you have to
 

work with. And Dick, one of these days we'll
 

have to have a little chat about that, 'cause I
 

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think you may be more in the dark -- far more in
 

the dark than DNA when they first started out
 

this work, the information they had to pull
 

together.
 

Okay. So just a few other key conclusions. 

Quality control was a real problem. A real
 

problem. And as we went through these records -­

and this is where I'm not trying to be critical
 

of DTRA or any of the contractors that worked on
 

this, but we had a very, very hard time following
 

the logic of the calculations, following the
 

documentation that was there. And in a lot of
 

cases it was -- we just couldn't do it. It was
 

impossible to do. Documentation is absolutely
 

crucial for what you are trying to do. In real
 

estate it's location, location, location. In
 

dose reconstruction it's documentation,
 

documentation, documentation.
 

And how would I address that if I were you? 

I would -- I would make sure that what you're
 

doing is checked. I heard this morning you're
 

having it checked by a couple of people, which is
 

certainly essential to do. But make sure
 

somebody coming in off the street who knows
 

something about the science, who has not been
 

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involved -- intimately involved in this process
 

you're doing, can take those records and follow
 

them. Every assumption that was made and how the
 

numbers were calculated.
 

So one of the other things in the report we
 

thought that this was very important to say, and
 

that is okay, so you read what we have done. You
 

read -- when you read this report you're going to
 

think there's a lot wrong -- perhaps you will -­

a lot wrong with how the doses were calculated
 

for the veterans. So what does that mean? What
 

are the implications of what we found?
 

We thought it was important to mention that
 

out of the thousands of dose reconstructions that
 

have been filed that if you were to go back and
 

redo all of these dose reconstructions, what
 

difference would it have made in terms of the
 

number of cases or claims that had been awarded. 

And the answer is, we think it would make very
 

little difference.
 

Now the reason for that is very apparent when
 

you look at the methods we're using, the methods
 

you are using, the probability of causation
 

approach -- which I do think is a very solid
 

approach for compensation. But the point is that
 

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in order to be compensated under this program -­

and remember, it's very -- very, very favorable
 

to the veterans because you're doing a 95 percent
 

confidence interval on your dosimetry. You're
 

doing a 50 percent PC with a 99 percent
 

confidence interval. I mean this is incredibly
 

favorable to the claimants. But most of the
 

veterans do not know and did not realize the
 

level of dose that it takes to be compensated. 

It's a huge communication problem, and I hope
 

that you, as I said, can solve that as you go.
 

So if you were to go back and recalculate all
 

these doses, what difference would it make? 

Probably not a lot. And I was talking to Tony
 

Princippi, the Secretary of the VA, about this. 

And of course you might say that in one sense and
 

think well, you know, it's probably not worth it. 

He is responsible for all of those veterans, and
 

he is listening to what you are saying and he's
 

said would it make a difference in some cases? 

Those are my guys out there. And yes, it would. 

And so he interprets this completely different
 

from what some of you might. And yes, it would
 

make a difference in some cases.
 

Okay. Other findings, and I've mentioned a
 

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few of these and I'll kind of try to wrap some
 

things up and I wanted to read you a couple of
 

things. Communication with the vets, I think
 

what was lost in that, it's not so much the idea
 

of telling the veterans here's your dose, here's
 

what it means. But it's also the idea of
 

listening to what the veterans have to say. That
 

was not done. The veterans have a lot to -- had
 

a lot to tell us about what they went through. 

And I want to read you a couple of things in a
 

few minutes, so communication very important.
 

Bioassay -- and Mike Schaeffer and his group
 

set out I think with something that was very,
 

very important, and if nothing else, it was huge
 

statement. And that was they tried to institute
 

a bioassay program looking at plutonium with
 

urinalysis, for which we have some very sensitive
 

methods, to see if there's some correlation and
 

to see if this method could be used to help
 

validate some of the dosimetry. I don't think
 

that they succeeded at this, and there are a lot
 

of reasons why and it's certainly not their fault
 

because I commend them for the statement of
 

trying to do this. But that's an example of an
 

area where we are making phenomenal progress in
 

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science is the bioassay. And one technique in
 

particular -- and that is not my field and so
 

don't ask me a question about it, but I try to
 

read about it -- is the work in this fluorescent
 

in situ hybridization method which, from what I
 

understand, could be very amenable to what you're
 

doing. And I don't suggest this as a part of the
 

compensation program, let me make that clear. I
 

don't know how it fits in. I do suggest it as a
 

part of the science.
 

Where I challenged you at the beginning of
 

this talk to further the science, I think there
 

may be some opportunity for you to look at high
 

dose situations and to see whether the
 

biodosimetry could correlate, not to back up a
 

dose in any sense, but to -- it's something I
 

think you should think about. We did look hard
 

at the tooth enamel biodosimetry and we had some
 

people coming into all of our meetings really
 

pushing this method. But I don't think the level
 

of sensitivity of that approach is quite where we
 

need it to be. But anyway, I want to leave you
 

with that thought.
 

I said I would mention the internal dose
 

screen, and this is interesting because it was a
 

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huge credibility problem that I think DTRA fought
 

for many years and just never could explain. 

Early in the process there was a method developed
 

where -- and if you know something about the
 

deposition of fallout on soil, then if you know
 

how much was in soil you can make some
 

calculation of what a person might have inhaled
 

through some resuspension back calculations, so
 

what they got in the body so you can calculate an
 

internal organ dose, basically. And so they came
 

up with this method called the internal dose
 

screen -- and the idea is not a bad idea -- that
 

you could, by knowing what's on the soil, sort of
 

decide whether or not there's some potential for
 

internal dose. It's a screening process where
 

it's either you're in or you're out, and it's not
 

a bad idea.
 

But this got picked up by the veterans and of
 

course they're very critical and concerned that a
 

lot of people were being eliminated and internal
 

dose was not being calculated because of the use
 

of this internal dose screen. And so we tried to
 

tell the veterans after we looked into this well,
 

they really aren't using it. But you go to the
 

records and here it is, internal dose screen,
 

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passed. Or internal dose screen, failed. And
 

you see why they were so confused.
 

And so we put -- and Dave Kocher wrote this
 

information that went into our report, trying to
 

explain to the veterans about the internal dose
 

screen. The bottom line is, it was not used.
 

So a message there is be careful with what
 

you say and be careful how you document
 

something, that it is going to be picked up by
 

these individuals. And if you're not using it,
 

make it clear why you're not using it.
 

Okay. And I think I'm getting through most
 

of this and I'm going to wrap it up in just a
 

moment, Paul. So let me just talk about three
 

issues and then I'll read you a few things from
 

the report that I think you'll find interesting.
 

The three things I'll mention now, and these
 

will be in the examples and that's why I wanted
 

to mention them -- benefit of the doubt, I've
 

mentioned that before. Let me read to you what
 

that means -- and I assume that you are
 

confronted with this, as well. Is that correct? 

And -- and the law, and this is written in the
 

law -- (Reading) When after careful consideration
 

of all procurable and assembled data, a
 

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reasonable doubt arises regarding service origin,
 

the degree of disability, or any other point,
 

such doubt will be resolved in favor of the
 

claimant.
 

Now I could read on, it's a fairly lengthy
 

paragraph that's legal language -- it's quite
 

legal language. But basically it means if you
 

don't know something and there's a chance that it
 

could have happened, then you have to assume in
 

favor of the claimant or in favor of the
 

assumption that makes the dose higher. Right? 

Okay. So benefit of the doubt was very
 

important.
 

Second point is consistency, and I think this
 

is absolutely critical for you to keep in mind,
 

over time, that you are consistent, that you are
 

dealing with claimants in exactly the same way
 

with exactly the same fairness, with exactly the
 

same assumptions where you have a choice. And
 

that you're also being consistent between your
 

claimants so that you can say well, look, we've
 

done it exactly the same way with this person and
 

this person as we are doing it with you. And we
 

had some problems with consistency.
 

And third point is uncertainty. And I don't
 

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want to get on -- get off track when I talk about
 

this, and I'm going to be very blunt with you,
 

and some of my friends will not like what I'm
 

about to say. But I'm concerned that we're
 

getting too far ahead of ourselves with
 

uncertainty. I think it's a great tangent to our
 

science. I think it's wonderful that we have the
 

calculating tools that we have today that ten
 

years ago you'd have to have a mainframe computer
 

to do. But I also worry sometime that we're
 

misleading people when we suggest that
 

uncertainty is accounting for all of our lack of
 

knowledge when it's a part of the lack of
 

knowledge. I don't know how to make that any
 

more clear. But I urge you to be careful here. 

And there may be some situations -- and it might
 

simplify your work, Dick and Larry, in
 

particular, when you think hard about going
 

through a mathematical calculation or a Monte
 

Carlo analysis when you can use a single number
 

that might take some upper bound into account. 

And I will be honest with you that over the last
 

couple of years as a scientist, I'm more and more
 

going back to the simple roots where I started
 

from, where deterministic calculations are not
 

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always bad. And by making a deterministic
 

calculation doesn't necessarily mean that we're
 

perceived to be ignoring all of this variability. 

I'm not trying to suggest to you in any way that
 

you don't do Monte Carlo calculations. I just
 

want you to be careful about what you can defend
 

and what you can't defend as scientists.
 

I'm on Committee IV of ICRP, and right now
 

one of the things that we're looking at -- and we
 

have a committee that probably -- that is trying
 

to take this on. ICRP has never clearly defined
 

-- and ICRP is the International Commission of
 

Radiological Protection, if you don't know, I'm
 

sorry -- and it makes recommendations to the
 

world about how we protect people in the
 

compliance area -- primarily in the compliance
 

area. We want to protect people. But for years
 

ICRP has gotten better and better at coming up
 

with dose conversion factors for the fetus, for
 

the six-month-old, for the one-year-old, for the
 

ten-year-old -- I mean we have really gotten to
 

where we can refine -- or I think we've refined
 

dose to all these individual age groups and
 

different sexes and so forth.
 

But as we look back on it in ICRP, we're
 

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concerned that these different categories are
 

being misused -- for the compliance purpose, now;
 

for the compliance purpose. And so one of the
 

things that we're looking at is how can you put
 

together and age-weighted dose coefficient that
 

takes into account an entire lifetime of an
 

individual, because really that's what limits are
 

based on is lifetime exposure. So that's
 

something that's being done.
 

And another thing that's being done is that
 

ICRP wants to make it very clear what is assumed
 

to be uncertain and what is not, in the realm of
 

radiation protection. A little different from
 

what you're doing now. But dose coefficients in
 

the ICRP system are assumed not to be -- are
 

assumed to be -- are assumed not to be uncertain. 

I want to be sure and say that right. In other
 

words, they're fixed, for radiation protection
 

purposes. I'm going to tell you again, that's
 

not the way you're using them, the way I
 

understand it.
 

On the other hand, my point is, just be
 

thinking, if there are some things in your
 

calculation that you really just don't have a
 

clue, and by coming up with a distribution of
 

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possibilities you're really stretching your
 

imagination, then why not use a fixed value and
 

just tell people that's the way it is.
 

Okay, I'm off that soap box. All right?
 

So let me just read you a couple of things
 

and then finish up here. I'm okay on time, just
 

a few more minutes? Okay.
 

I think just a few of these cases. We found
 

the records just absolutely fascinating, and I
 

think, as much as anything, what the veterans
 

were saying. It is amazing the effort that some
 

veterans went to to try to explain to these
 

dosimetrists what happened to them.
 

Let's see -- I'll also tell you that this
 

report -- I wanted it to be readable and I wanted
 

it to be interesting, and it's got photos all the
 

way through it, so you'll enjoy looking at some
 

of the photographs. You will be absolutely
 

amazed at some of these photographs where people
 

are leaning into this tank that was just a few
 

hundred yards from ground zero very soon after
 

the shot. The conditions -- the dust and so
 

forth -- under which they worked was amazing to
 

me, that's for sure.
 

Okay, here's a case, this is case number 22,
 

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and I'm just going to read this. It says
 

(Reading) The participant claimed that he was
 

present at Operation Ivy. His service records
 

have been damaged and his claim that he
 

participated in Ivy could not be verified. He
 

was not given the benefit of the doubt in
 

evaluating his claim for a non-presumptive
 

disease and no dose was calculated for
 

participation in Ivy, nor was the estimated upper
 

bound of his assigned dose from his participation
 

in other tests adjusted to reflect his possibly
 

participation in Ivy.
 

But he was never contacted to investigate
 

this matter further, so now there's a case where
 

the veteran says I was there, the records might
 

indicate you can't prove he was there, so what do
 

you do? Benefit of the doubt.
 

Case 53, this case provides a good example of
 

inconsistent -- remember consistency -­

inconsistent application of assumptions used in
 

estimating the external dose in the upper bound
 

from boarding target ships at Operation
 

Crossroads. The dose memorandum states that the
 

veteran was given the benefit of the doubt by
 

presuming that he participated in two-thirds of
 

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the target ship boardings by his unit. However,
 

the calculations in the case are based on only
 

one-third of the boardings. In other cases
 

involving target ship boarding -- and we give the
 

number of some of the other cases -- veterans
 

were usually given the benefit of the doubt by
 

assuming that they participated in all boardings.
 

Consistency, remember that.
 

I think I'll just do one more and let me just
 

tell you -- tell you this story. It's kind of -­

quite amazing, because the very first time we
 

went to DTRA to look at the records, we were sort
 

of given free rein of pulling out the files and
 

picking a file and then if we wanted to take one
 

back with us, they were going to take any
 

reference to name off, redact it. I happened to
 

go into a file -- and totally at random I pulled
 

this record out. It turned out to be possibly
 

the most interesting in the whole study. But
 

there was a veteran who was an aircraft crew
 

mechanic and he filed for a dose claim, and his
 

story was this; that there was a test in the
 

Pacific and these sample planes, as you know,
 

flew through the cloud. And the planes -- when
 

they did this, they were collecting samples, but
 

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they also became quite contaminated, just the
 

fuselage of the plane itself became very
 

contaminated. Two of these planes were flying
 

together. One of the planes had a serious
 

mechanical problem and went down in the ocean. 

The other plane, because he was trying to stay
 

with his fellow pilot, had to make an emergency
 

landing on Kwajalein, I think it was, the island. 

And when he came down, he really hit the runway
 

hard and it blew the tires on the plane. So he
 

was stuck there. He was also about out of fuel. 

And so this mechanic was flown in immediately to
 

repair the aircraft and to refuel the aircraft. 

And so he came in -- now think about this. This
 

is very, very soon after the plane had been
 

flying through the cloud. He came in and -­

we've got a picture of the aircraft, but he gets
 

down, he changes the tires. And the veteran said
 

he was there about four hours.
 

The analyst who did the dose reconstruction
 

said it took about one hour. But that's not the
 

key point. The key point is that in the initial
 

dose reconstruction he was assigned a dose of
 

zero. And the veteran just didn't buy this, and
 

he -- he also had pointed out it took more than
 

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92 

four hours to get decontaminated when he finally
 

got back.
 

So he complained and they reconstructed the
 

dose and the second dose reconstruction, what
 

they did was to start working with the -- an
 

exposure reading four inches from the pylon on
 

the aircraft, but it was four days later. Okay? 

Which theoretically that's not a bad idea because
 

if you can just extrapolate back in time, you
 

should be able to come up with a reasonable
 

estimate of what the reading was on the aircraft. 

Unfortunately they didn't take into account that
 

this plane was likely scrubbed -- washed. Okay? 

And we know that they were and we've seen the
 

data. And so the second dose that they came up
 

with was -- was not much better. I think it was
 

.8 rem.
 

Anyway, when we looked at this record, we
 

really took issue with almost every assumption
 

that they made. But I think that's a good case
 

where the veteran persisted and persisted and
 

persisted and finally the dose reconstruction was
 

raised enough -- I don't know whether or not this
 

veteran received compensation, but it's an
 

incredible story and the level of detail that you
 

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have to go into in these dose reconstructions, I
 

think that's just one of the best examples I've
 

ever seen.
 

I think I'll stop and if you want, we can
 

just chat a bit, Paul, or if there are any
 

questions. I am going to stick around for about
 

an hour before I have to leave.
 

I want to really commend you all for what
 

you're doing. There is no amount of money that's
 

going to pay you -- no amount of government
 

money, anyway -- that's going to pay you
 

appropriately for the time that you're putting in
 

to do this.
 

On the other hand -- wow, what I have learned
 

over the years from some of the work that I've
 

done is the importance that there is some kind of
 

oversight that represents the entire spectrum of
 

views, non-scientists and scientists, because
 

ladies and gentlemen, we don't have all the
 

answers. I was very intrigued by your -- Dick's
 

talk this morning, by the questions that you
 

asked him and how you challenged him on
 

credibility, on conflict of interest, on the
 

details of what they're doing. Stick to it. 

Thank you.
 

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94 

DR. ZIEMER: Thank you very much, John, for a
 

very challenging discussion. Let's take a few
 

minutes for some questions at this point, then
 

we're going to take a break. We'll start with
 

Roy here.
 

DR. DEHART: Thank you very much. It helps
 

place us in context, and we appreciate that. You
 

mentioned consistency, and one of the battles I
 

fight with myself is a legislative ruling which
 

indicates inconsistency, and this is the Special
 

Cohort area. And we have a Special Cohort of
 

atomic workers who has a listing of presumption
 

with cancer and there is no dose reconstruction. 

If they have the cancer, they're awarded a
 

disability or an impairment or a financial award. 

And everybody else who may have worked in similar
 

areas, these -- what I'm talking about is the
 

gaseous diffusion plants -- the other areas,
 

everybody else is having to go through a dose
 

reconstruction. And there is repeatedly in the
 

comments from the public this issue of
 

inconsistency in the management of those cases. 

And I just wondered how you would deal with
 

something like that.
 

DR. TILL: That's tough. That's tough. What
 

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95 

has generally happened over time, if you look at
 

the history I think with the veterans, is that
 

when we make a decision it's generally been in
 

favor of the claimant. Is that good? I mean
 

we've kept adding cancers to the presumptive
 

list. Okay? I think we can go too far with
 

that. I think -- I guess my answer is I think
 

that may be a -- I don't know why the decision
 

was made differently and I don't understand the
 

legal aspects of this, okay?, but you have -- but
 

I guess my answer is, you know, maybe that's a
 

case for inconsistency. I don't know that you
 

now say well, because you're doing this to a
 

smaller group for some reason -- and you've got
 

to look at why -- do you therefore go back and
 

bring everybody else into that category. That's
 

tough to say.
 

I mean remember what you're doing, without
 

that special case, has a good foundation. So -­

so is that a reason to change your method? You
 

really put me on the spot with that and I guess
 

my answer would be stick with your plan. There
 

are going to be cases for inconsistency. And I'm
 

-- I can't deal with the law. Okay? You're
 

going to let those guys deal with the law. I'm
 

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96 

talking about consistency in the science, in our
 

methods and in our assumptions. So you kind of
 

threw me a curve on that one, but that would be
 

my answer. Just recognize it exists and move
 

forward. If Congress wants to change it, let
 

them change it -- or whoever makes the law.
 

DR. ZIEMER: Gen?
 

DR. ROESSLER: John, you mentioned
 

communication a number of times in your talk and
 

you also said that -- of the veteran study -­

there was a lousy job. We've learned a lot over
 

time and I think you've learned a lot in the
 

projects you've been involved with. And I think
 

you know a little bit about what we're doing. We
 

have the open meetings. We have -- NIOSH has a
 

wonderful web site. I'm not sure people use web
 

sites -- I'm sure they don't, and so that might
 

be a problem. But what would you recommend to
 

our group that we could do better in the way of
 

communication?
 

DR. TILL: Well, certainly when we were
 

working on the veteran work -- again, Mike and
 

DTRA, I'm not trying to be critical of you guys ­

- but I think that's an area that we really fell
 

down in. We didn't do that much with the
 

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97 

Academy. We opened our meetings, which is a huge
 

step for the Academy in a lot of cases, but we
 

also went to the NAAV meeting -- we went to one
 

NAAV meeting. We invited the veterans to come in
 

and talk to us. So to answer your question, Gen,
 

I would be very aggressive about it. I would
 

look for new ways -- what you want to do is
 

establish a track record that says you've done
 

this. Whether it's successful or not, you tried. 

Okay?
 

I'm assuming that you have workers come and
 

talk to you, and I would try to do that
 

regularly. Okay? Just so that it's on your
 

agenda a lot. Okay? I would make an effort -­

and I know you meet in a lot of different places. 

Make sure that you have a record of trying to go
 

to the -- those exposed, as opposed to okay,
 

we're going to meet in your city; if you want to
 

come, come.
 

And I think, Gen, this is something I'm
 

learning more and more about with communication,
 

and I had always had this approach well, I'm a
 

scientist and I don't have to do it. That's how
 

I started. And then I shifted into the mode of
 

well, I'm a scientist. You come in and you can
 

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98 

tell me what you think is wrong or how to do it
 

better. That was my second phase of life. My
 

third phase of life, which is now, is I'm going
 

to the people and I'm making the effort to go to
 

the people because a lot of people don't want to
 

come to you. And that way you've got the track
 

record of having done it. But I think you'll
 

also be amazed at some of the things you'll hear
 

and the concerns you'll get.
 

So the idea is just be very aggressive about
 

this. Don't think it's sufficient to sit here as
 

a committee, open your doors and say come and
 

talk to us, we've got a public comment period. 

Try to do more.
 

Mary Lou Blasik*, who taught us a lot, Gen, I
 

think would have been happy to hear me say that,
 

but ten years ago I probably wouldn't have. Does
 

that help? Does that help or is that not
 

specific enough?
 

DR. ROESSLER: I know what you're getting at
 

and I can think of specific things -- things that
 

I don't think we're doing, but I wouldn't mind if
 

you mentioned some specific things. I think that
 

would help.
 

DR. TILL: Okay. Well, I assume you have a
 

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99 

newsletter -- do you? No? That's a good idea,
 

and you put things in a newsletter like
 

probability of causations, here's what it's going
 

to take you, here's what we know about the
 

science. Okay? A newsletter, I think, is a very
 

good thing.
 

The web -- does the web do that, Larry, or
 

not?
 

MR. ELLIOTT: It talks about it.
 

DR. TILL: I've seen your web site. Okay.
 

MR. ELLIOTT: We have brochures that we send
 

with our letters to the claimants that speak to
 

probability of causation and dose reconstruction.
 

DR. TILL: Okay.
 

MR. ELLIOTT: The web site also has topic
 

pages on both of those areas.
 

DR. TILL: Okay. Well, I know that -- I know
 

we're in the electronic age, but believe me, most
 

people out there and most people who are filing
 

claims with you don't look at the web, and they
 

won't. They don't know how. So a newsletter's
 

not a bad idea. And at some frequency where you
 

really put substantive stuff in there that tells
 

you what you're learning. Put out -- who -- how
 

many people are getting awarded claims, what's
 

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100 

the percentage, so people understand.
 

And I still think when you go into a city,
 

don't just have your meeting. Tell people you're
 

willing to sit with them one-on-one, small
 

groups, and -- you know, let's get together. 

We'll get together for dinner, whatever, and talk
 

about what we're doing. You will make more
 

ground with a small group like that -- if you
 

break up, in particular -- than you ever will
 

asking people to come in and talk to you.
 

And what I'll do, Gen, if I think of more
 

specifics, I'll tell you. But the web, too, is
 

very important and this information going on the
 

web, like a newsletter -- hard copy and web -- is
 

good.
 

DR. ZIEMER: Mark?
 

MR. GRIFFON: Yeah, John, I had a couple of
 

questions. One on the -- you mentioned
 

participant statements, and I -- looking through
 

the report quickly, I noticed that you had an
 

opportunity in a lot of your reviews -- maybe not
 

all of them, but the question is, were these
 

participant statements part of the file or did
 

your -- your board, in doing the review, elicit
 

participant statements or how did those come to
 

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101 

be in the file? That's the first question.
 

DR. TILL: Okay. We found far few statements
 

-- fewer statements in the file than we would
 

like to have seen. We think that was a serious
 

mistake not to go to the veterans. There were
 

forms, especially early on, where the veteran
 

could check off and answer questions. The best
 

information was information in the format of a
 

letter. You'll see some in this report. And
 

they will absolutely amaze you at the detail
 

these people could remember. I mean the detail. 

The best ones were probably in the files that the
 

veterans gave us, 'cause we just didn't discover
 

them in -- in our random search. Okay? But they
 

were probably there if you went to the file. So
 

it wasn't that we went out and asked the veterans
 

for the information. It was what we were looking
 

for in the record, and there was not enough of
 

it. And in a lot of cases, we felt the letters
 

were ignored -- some cases. Not a lot, some.
 

MR. GRIFFON: Right. And just the other -­

the other question was you mentioned these four
 

broad criteria, which we've sort of adopted in
 

some form or fashion. I wondered, for your
 

committee, whether you developed procedures on
 

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how you were going to evaluate against those
 

criteria for consistency on your board. And in
 

terms of -- I guess I'm looking at the nuts and
 

bolts of this since our working group is
 

constructing some of that and the approach you
 

took to how to evaluate against whether the dose
 

reconstruction was accurate. And if those
 

procedures were developed, are they available to
 

us?
 

DR. TILL: No, it's very interesting. The
 

answer to that is that when we started the case
 

reviews, when we finally got our first set of
 

cases to look at, we did have a list of criteria
 

that we were looking for. And I can't remember
 

exactly, maybe seven, eight, ten specific things
 

that -- I think we even formed a check sheet, you
 

know, and gave grades. I think this is correct.
 

We gave up on it, because it was so
 

difficult, the cases were so different, that we
 

found that those criteria we thought were so
 

wonderful, we never could apply to all the cases.
 

Now I think -- I think, Mark, in the back of
 

our heads that we were keeping those things in
 

mind. But the answer is we did not have some
 

specific list of criteria that every time we got
 

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together we said let's go through these.
 

On the other hand, I think what happened,
 

what evolved from this, is that as we went
 

through, you know, 50 or 60 cases, we were
 

evolving into several key issues. And I remember
 

a meeting -- you know, I mean I think that's just
 

-- this is the way any committee would work. You
 

know, after you've looked at a lot of specific
 

situations, you kind of involve to what you think
 

are the key points, and then that's what came out
 

of it. Does that answer your question? So I
 

don't think what we did will help you.
 

UNIDENTIFIED: (Inaudible)
 

DR. TILL: Okay, sorry.
 

DR. ZIEMER: Wanda, you have a question?
 

MS. MUNN: First a comment rather than a
 

question. Thank you so much, Dr. Till. I have
 

not had an opportunity to -- like many of our
 

claimants -- view what's on the web with respect
 

to the Academy's forthcoming publication, so I'm
 

looking forward to it eagerly.
 

Particularly want to thank you with regard to
 

your comments relative to staying flexible in
 

terms of changing science. I see a dilemma
 

there, however, and the dilemma is when do you
 

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decide to revisit this if the science changes and
 

when not? I don't know whether your committee
 

made any decisions in that regard or not. If
 

they have, it would be beneficial I think for us
 

to be aware of what they are.
 

And there's a second item that I wonder about
 

with regard to your experience. Clearly from the
 

claims that we are seeing now, we have a larger
 

number of claims that are being brought to us by
 

families, by heirs, rather than by the
 

individuals themselves. Therefore, first-hand
 

information is not as easily available to us as
 

perhaps it may have been in many of your cases. 

The claimants in those majority of cases express
 

great frustration with the fact that they know
 

very little about their loved ones' actual work
 

place and what transpired, what their real
 

experiences were. So we have a slightly
 

different struggle in that regard in an attempt
 

to try to reach a greater level of certainty
 

regarding what might have been missed in that
 

process.
 

I don't expect you to provide me any answer
 

to that, but I really would like to hear what
 

your experience was with regard to keeping up on
 

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105 

the science.
 

DR. TILL: With regard to the science, I
 

don't think we recommended what should be done. 

We just recommended that this -- some policy be
 

established to update -- or not update, but at
 

least to recognize that the science is changing. 

Because I think there were some changes in the
 

science, but it was sort of haphazard. I mean it
 

wasn't a deliberateness. All right? And there
 

also was no clear policy on if we change the
 

science, what does it do to the previous
 

calculations. And I think you need to address
 

that. So I think you have to make your own
 

decision about changes in the science. I think ­

- fortunately, hopefully -- what you are
 

undertaking is a shorter term deal, because
 

you're going after this pretty aggressively. You
 

want to respond to these people quickly.
 

So I'm not sure how much the science is going
 

to change in the five years or whatever time
 

you're going to be here. But what if it does? 

Okay? Maybe you don't want to change the
 

science. Maybe you want to fix it in time so
 

that everybody's treated the same. This is a
 

policy decision I think you have to make. And
 

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106 

then if you change it, do you go back and make -­

and recalculate those doses for awards? I think
 

my own personal opinion is that you wouldn't go
 

back and take anybody's claim away, but you might
 

go back and recalculate doses because it may
 

throw some people into a higher dose category and
 

entitle them to something. That is something we
 

pointed out in the report that somehow VA and
 

DTRA have to consider.
 

So did I answer that okay for you?
 

MS. MUNN: Consequently, it would behoove us
 

to be very cautious in the way we maintain our
 

database so that we -­

DR. TILL: Yeah. 

MS. MUNN: -- can pull only those cases that 

are relevant. 

DR. TILL: Oh, but I think it can be done. 

There's no question about it. I'm sure you're
 

keeping a database that will allow you to do
 

this. I am sure you can do this. I think it's
 

strictly a policy of this Committee, strictly.
 

All right. The other question, though, there
 

is an answer to the other question, I think,
 

because we did have situation where widows were
 

filing claims for veterans. I don't want to say
 

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107 

whether it was done well or not done well, but
 

there is a way to address that and you go to the
 

buddy system. You find some people who knew this
 

individual and who had similar work style of this
 

individual, and I think that's a perfectly
 

legitimate, defensible way of coming up with a
 

dose estimate. So it can be done. Yeah, okay.
 

DR. ZIEMER: Mike, let's make this the last
 

question. We do need to provide a comfort break
 

for people and there will be opportunities -- no,
 

you give your question, right. Right.
 

MR. GIBSON: Thanks for being here today. 

You mentioned consistency as being one of the
 

important factors, and just to follow up on Dr.
 

DeHart's question, let's just say hypothetically
 

a point in time came where people unknowingly got
 

exposed to radiation and a time subsequent to
 

that a law was passed. That's why they were put
 

in the Special Exposure Cohort.
 

Now as we go on down the path, if we find a
 

similar set of circumstances for another group of
 

workers that fits all the criteria that put those
 

workers at the gaseous diffusion plants in a
 

Special Exposure Cohort, in your opinion, would
 

that be consistent then for us to look at their
 

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108 

petition and consider putting them in the Special
 

Cohort?
 

DR. TILL: You guys are really stretching my
 

knowledge here today. If I were a member of the
 

Committee, I would say that's fair and that's a
 

part of my job that I would at least probe that. 

Okay? Because you're an advocate for -- some are
 

you are advocate for the claimants and some of
 

you are advocate for science or whatever. You're
 

all here with a responsible position, and I think
 

that's a part of your charge, yes. And then it's
 

up to whether or not the law gets changed to
 

invoke it, I guess. But yeah, I think that's why
 

you're sitting here.
 

That's not what I meant by inconsistency, at
 

all. I really was talking about science and
 

methods and doing the math the same way and
 

giving everybody the same benefit of the doubt. 

This is getting in -- more into the law.
 

MR. GIBSON: Then -- that's what I was trying
 

to do is leaving the legalese out of it and just
 

say -- let's just say hypothetically, if one
 

group meets the same criteria that the group met
 

that was included when the law was passed, then
 

when they bring that proof forward, it would be
 

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109 

consistent -­

DR. TILL: That's why you're here.
 

MR. GIBSON: -- it would be consistent -­

DR. TILL: I think that's why you're here is
 

to look out for those things.
 

MR. GIBSON: Thank you.
 

DR. TILL: Paul, thank you very much.
 

DR. ZIEMER: Thank you, John -­

DR. TILL: It's very good to see you again.
 

DR. ZIEMER: -- for being with us today and
 

if you're willing to stick around a little -­

DR. TILL: Yeah.
 

DR. ZIEMER: -- others may want to chat with
 

you individually during the break. Thank you.
 

We'll take a 15-minute break.
 

(Whereupon, a recess was taken.)
 

DR. ZIEMER: Before our next agenda item,
 

just a brief announcement. Larry?
 

MR. ELLIOTT: Just so you all know that at
 

your desk you'll -- or at your place here at the
 

table, you'll find the physician nomination
 

criteria that we have used in the appointment of
 

the 100-plus physicians for DOE. If you have any
 

questions about that or comments or concerns,
 

please let me or Dave Sundin know. We'll react
 

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110 

to those. Thanks.
 

DR. ZIEMER: Okay, thank you, Larry. Then
 

our next agenda item is Jim Neton's report on the
 

status of the technical basis documents. Jim.
 

STATUS OF TECHNICAL BASIS DOCUMENT/SITE
 

PROFILE DEVELOPMENT
 

DR. NETON: Okay. Thank you, Dr. Ziemer. 

This is a companion piece that goes with Dr.
 

Toohey's talk this morning and will tend to
 

describe to you some of the more inner details
 

and workings of how these technical basis
 

documents are put together. Since some of the
 

stuff was gone over briefly by Dr. Toohey this
 

morning, I probably won't take the full hour that
 

I was allotted, which you're probably glad about
 

since it's nearing the lunch hour, so I should be
 

able to probably get through this fairly quickly.
 

We recognized early on that we needed a
 

number of these site profiles. In fact, we need
 

essentially one for every site, at least the
 

major DOE sites, to be able to do our job of dose
 

reconstruction. These serve sort of as a road
 

map, I like to call them, as to how you do a dose
 

reconstruction for a particular site. And by
 

their very nature, they're limited in scope. 

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111 

They're not epidemiologic reviews. They're not
 

how-to guides for the dose reconstructor or
 

detailed responses to how you treat it, but
 

really it's just a summary used by the dose
 

reconstructor to provide him site-specific
 

information.
 

For example, if a claimant has worked in
 

1950, 1955 time frame, one should be able to find
 

some detail in that road map as to what detection
 

limits were for the badges that were worn, the
 

number of times it was exchanged on a -- how
 

frequently the badge was exchanged, that type of
 

information. It helps to minimize interpretation
 

of data because I think as you saw this morning,
 

we have -- I was surprised actually the number's
 

up to 300 people working on this project. These
 

dose reconstructors, by design, are distributed
 

around the country. It's the only way we could
 

get a critical mass of people sufficient to
 

complete these in a timely manner. So many of
 

them are working independently, without benefit
 

of interchange -- you know, sort of office
 

chatter. So it helps to minimize interpretation
 

of the date to ensure what we heard earlier is
 

consistency among these dose reconstructions. 

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112 

Again, it's used basically as a handbook.
 

And these are dynamic documents. Rev. zero,
 

when it comes out, is not the end of it. As
 

information is obtained further through either
 

site searches or from claimants, these things
 

will be amended as we go.
 

Okay, a little bit about the definition. I
 

know there's confusion along the -- the audience
 

and possibly the Board as to what we mean by a
 

site profile. It really is a compilation of
 

individual technical basis documents which covers
 

the five bullet items here -- facility/processes,
 

environmental dose, external dose, internal dose,
 

diagnostic X-ray information. So it's a series
 

of chapters that describe in some detail each of
 

these type of areas that are needed to do a dose
 

reconstruction.
 

Each section is intended to be a stand-alone
 

document, so we can develop these as we go. The
 

idea was that we wouldn't have to wait for the
 

entire site profile to be done to start moving
 

some claims forward. We're trying to -- always
 

looking toward optimizing the process and
 

maximizing our efficiency. So for example, if we
 

had a worker who was only -- who had only worked
 

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113 

exterior to the plant and had been exposed to
 

environmental dose, if the environmental dose
 

reports were available and we could reconstruct
 

their exposure, then we could do so without the
 

benefit of having to, you know, flesh out all the
 

internal dosimetry and external dosimetry
 

information.
 

I think we've talked about this enough at a
 

number of Board meetings, but there is a certain
 

hierarchy of data that are used to do these dose
 

reconstructions. Starting at the very top with
 

personal dosimetry and moving all the way down
 

through the bottom to source term and radiation
 

control limits, I think this is well-known by the
 

Board. We don't really need to go over these. 

But this is just up there to illustrate that the
 

site profiles tend to try to be true to that
 

concept so that they do follow, you know, what
 

was intended when the rule was written.
 

Okay, a little bit about timing of these
 

documents. This is a generic chart -- by the
 

way, I would like to acknowledge the help from
 

our contractor, ORAU, Dick Toohey and Judson
 

Kenoyer for helping put some of these slides
 

together. But this is a generic time line for
 

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114 

how long it takes to get a site profile together. 

As you can see, it ranges out to about 16 weeks. 

Some can be shorter, some can be longer, really
 

depends on the site. But in general, there's
 

some steps in here -- to review the available
 

data, and then to see if you have an update or
 

request additional information. That may require
 

going back to the site, talking to site contacts,
 

conference calls, any -- any way that we can get
 

information. In fact, sometimes looking through
 

the claimant files we've actually found some
 

leads of what the claimants have submitted with
 

their files to flesh out these dose -- these site
 

profiles a little better.
 

So given that these things can take a while,
 

up to three, four months to complete, the
 

decision was made a while ago that we would do
 

these in parallel. And as you heard Dr. Toohey
 

talk about earlier, there are 12 or 13 individual
 

teams out there right now working on these things
 

so that they can complete it and move the dose
 

reconstructions for those sites forward.
 

A little bit about the process. It's a
 

fairly formalized process to get these things out
 

the door. These are issued as controlled
 

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115 

documents, but what you see on the left-hand side
 

is the informal process. And what I mentioned a
 

little bit this morning during the discussion of
 

Dr. Toohey's presentation is we actually have a
 

NIOSH health physicist assigned on the dose re-­

on the technical basis document or site profile
 

team, so that all along there is sort of this
 

informal review process going on of the document
 

so there are no surprises. You know, we didn't
 

feel it was worth waiting three months, ORAU
 

would develop this document and we'd say no, you
 

know, that just doesn't really seem right to us. 

So in this informal process, NIOSH is involved in
 

resolving comments before it ever comes over here
 

for the official review.
 

These things are officially commented on,
 

once it comes over, by us. We provide written
 

comments. ORAU is required to respond. We have
 

what we call critical review comments and noncritical review comments. If it's critical
 

review, it must be addressed. So in that review
 

process it's an iterative process that occurs
 

where comments are considered, reviewed, and we
 

come to some consensus opinion as to how we're
 

going to proceed.
 

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116 

Once the document is completed with a NIOSH
 

official review, it goes into our document
 

control process. Well, this is an ORAU document. 

It goes into their document control process, but
 

it is signed both by NIOSH, that would be Dr.
 

Toohey and myself as the authorizer for the
 

document to be released for use. It has a
 

revision date and a revision number, and we will
 

always keep track of the revs. as we go so we
 

know which dose reconstructions were done with
 

which revs. of the technical basis documents.
 

Okay. What kind of resources do we use to
 

put these things together? And it comes from
 

just about any source, any source that we can get
 

reliable -- probably the best resources that we
 

have are some of these site technical basis
 

documents that the DOE sites themselves put
 

together. As DOE rad. control programs matured
 

in I guess probably the early to mid-1980s,
 

technical basis documents were required for the
 

external/internal programs. And these things not
 

only tend to document what's currently being
 

done, but also usually have some sort of
 

historical discussion at the beginning, and it's
 

a good starting point for us to branch out and to
 

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117 

obtain additional information.
 

Also useful are safety analysis reports that
 

were completed for certain projects 'cause those
 

tend to be all-encompassing, talking about
 

process descriptions, potential radiation
 

exposure environments, that type of information.
 

Work place environmental reports are very
 

useful. It's somewhat different than the site
 

environmental reports where you're talking about
 

fence-line dose. We really are not interested in
 

the dose at the fence-line. We're of course
 

interested in the dose to the workers who were
 

either in buildings or around buildings. So
 

where we can find those reports, they're used.
 

And facility data, which would be the area
 

monitoring results -- air samples, surface
 

smears, survey swipes, those type of pieces of
 

data, if we can obtain them -- internal memos,
 

correspondence sometimes are useful. Any
 

publication, particularly peer review
 

publications that may be available, we obtain. 

Most recently there's a very good publication
 

regarding the solubility class of materials at
 

the Y-12 facility that we've tried to use and
 

incorporate into some of our documents. Previous
 

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118 

dose reconstruction reports, whether they were
 

done hand-crafted basis by the supplemental team
 

or dose reconstructions that have been done -­

for instance, at the Mound site -- we would use
 

as a starting point. We wouldn't use them
 

necessarily, but we would evaluate them to see
 

how applicable they may be to our situation.
 

And I mentioned previously, sometimes
 

information submitted to NIOSH by claimants in
 

particular has been beneficial. That was the
 

case for the Bethlehem Steel technical basis
 

document. A claimant had some pretty rich sets
 

of data in there that led us to other sets of
 

data and helped us develop that document.
 

And there's other things here, other site
 

reports, web sites, conference calls, contacts
 

and visits. So anywhere we can get the
 

information is basically it.
 

Okay. The parameters of interest, as we
 

discussed earlier, medical X-ray dose is one of
 

the sections. Occupational dose for unmonitored
 

workers, which is a somewhat unique situation. I
 

mean if you've monitored, then we can flesh out
 

your dose a little bit by looking at the missed
 

dose for the monitoring program itself. But if
 

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119 

you're unmonitored, it's not that straightforward
 

to figuring out what the potential dose could
 

have been, and we'll talk about a little bit of
 

these as we go. Occupational internal dose for
 

monitored workers, and then occupational external
 

dose for monitored individuals. So these are the
 

areas that the site profile attempts to address.
 

Medical X-ray dose is addressed by year. Of
 

course the X-ray monitoring technology has
 

changed dramatically since the early '50s, so we
 

need to know what year the X-ray was taken and we
 

can try to determine what the dose may have been
 

by the type of the machine or the technique used
 

at the time. Dr. Toohey mentioned earlier about
 

this photofluorographic technique that was used
 

in the '50s. That's probably the extreme
 

example, but those doses can be very large. In
 

some cases we've noticed at the Savannah River
 

Site that the columnation* was wide open so that
 

all of the organs or most of the organs may have
 

been exposed versus just the narrow field of view
 

of the lung, which was the subject of interest of
 

the X-ray. So all these things are taken into
 

account and attempted to -- we attempt to address
 

them in the site profile.
 

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120 

By organ, of course, if it's a columnated*
 

field and one's taking an AP chest X-ray, then
 

the dose to the bladder is going to be somewhat
 

less than the dose directly delivered to the
 

lung, or typically the entrance skin exposure,
 

which is usually what's quoted for an X-ray
 

machine. And there is some attempt, to the
 

extent possible, to address uncertainties.
 

Okay. Occupational dose for unmonitored
 

workers, we'll first talk about internal dose. 

If a person was not monitored for internal
 

exposure -- you have no record of any bioassay
 

sample, no whole-body count, no urine sample, no
 

breath analysis, anything of that nature -- it
 

becomes a little bit tricky to figure out what
 

the upper limit of the person's exposure could
 

have been. So we attempt to address that by
 

looking at the inhalation based on air
 

monitoring. If the air monitoring data are
 

readily available -- that is, they're not in the
 

plants in 100 boxes distributed about there -­

about the plant, you know, they're fairly
 

consolidated -- I think the situation exists for
 

the Fernald site; we have some pretty good air
 

monitoring data -- that would be described in the
 

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121 

technical basis document and how that could be
 

used to assign some bracketing exposures for a
 

worker who was unmonitored for internal exposure.
 

If the information's not available -- or
 

readily available, and by readily I mean it
 

wouldn't be a million-dollar research project to
 

go retrieve these records and code them and that
 

sort of thing, we would have to default to the
 

source term analysis, which would be what type of
 

material was used at the site, what was the
 

process -- grinding, welding, that sort of -­

were performed on the -- at that facility. And
 

in certain circumstances, even if you know the
 

source term, we would use claimant-favorable
 

assumptions. For example, if we didn't know -­

if the person -- if the source term indicated
 

that there was a machine that would convert
 

billets into rods or something of that sort of
 

thing, and we didn't know where the person worked
 

relative to that instrument or machine, we would
 

use claimant-favorable assumptions and assume
 

they spent the majority of their time working
 

near that machine.
 

Internal exposure for outside facilities, if
 

a person is not in the facility where the
 

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equipment is being used to generate airborne
 

radioactivity, then we have a little bit more of
 

a problem. We have to know something about the
 

site ambient radionuclide activities, and that
 

takes a little bit of work. But as we talk about
 

-- I'll talk about shortly in the environmental
 

dose reconstruction area, there's some things we
 

can do there, and I think I have an example in
 

the Savannah River technical basis document.
 

Occupational dose for unmonitored workers in
 

the external area is also addressed in the
 

document. If the exposure probability is low, we
 

can use some sort of reasonable background dose ­

- maximum background dose that we can determine,
 

whether it's based on area that was out there or
 

if we had examples of what coworkers -- they
 

wouldn't necessarily be representative coworkers,
 

but maximum coworkers, people who were probably
 

exposed to higher levels, we could use that.
 

If the exposure probability is high, we would
 

use coworker data or claimant-favorable
 

assumptions. Again if -- an example of a
 

security guard who was not monitored who maybe
 

took -- you know, made a round through the
 

facility. If we knew what the maximum dose was
 

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123 

to any worker in each of the facilities that the
 

security guard visited, and we knew the amount of
 

time it would take to do the rounds through his
 

run, we could come up with some bracketing doses
 

for that particular person in the external area.
 

The document also, though, addresses the
 

release of any noble gases -- sometimes
 

submersion in a cloud of noble gas from an
 

external perspective, whether it's xenon or
 

krypton gas -- needs to be taken into
 

consideration. And of course, like all other
 

forms of exposure, uncertainties in the external
 

dose calculation is attempted -- we attempt to
 

address that in the technical basis document.
 

Occupational internal dose is probably the
 

most difficult thing to reconstruct. And as Dr.
 

Toohey mentioned earlier, these things are
 

difficult to decipher. You get bioassay cards
 

that are 50 years old with cryptic notations. 

Sometimes you get results that don't have units
 

of measurement, you just get a number -- five,
 

four -- I mean you really don't know. A lot of
 

research needs to go into determining what that
 

really means and deciphering these codes. You
 

know, I've seen cards -- as Dr. Toohey mentioned,
 

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A, B, C, D, or 1, 2, 3, 4. Sometimes they use
 

special notations for radioactive materials. 

Uranium was not always called uranium. I mean
 

they had special notations -- for security
 

reasons, I suspect -- back in the early days for
 

the types of materials that were -- that workers
 

were being exposed to.
 

The method of analysis needs to be taken into
 

consideration, whether it was a fluorometric
 

technique or whether it was a gas flow
 

proportional count or measure -- alpha
 

measurement of a deposit urine sample on a plant
 

check -- all needs to be taken into account. And
 

wherever there's a question, the technical basis
 

document will, again, err on the side of being
 

favorable to the claimant.
 

We've got some examples. For example, at the
 

Y-12 facility the detection limit appears to have
 

been listed as 40 disintegrations per minute for
 

an alpha measurement in urine in the 9150/60 time
 

frame. That's a pretty high detection limit. We
 

suspect that it's much better than that, but we
 

cannot find any evidence that there's a
 

statistical analysis that demonstrates it's any
 

better than that, so that's what the technical
 

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basis document indicates that we should use.
 

And again in the occupational internal area,
 

source term information by facility and process. 

You know, what were the nuclides that were at the
 

site, where were they, during what time frame and
 

what was being done with them. I mean that's
 

probably some of the more important types of
 

information to be described, if there were no
 

monitoring data available for the workers.
 

And again, uncertainty in the internal world. 

That's probably the most difficult thing to put
 

an uncertainty on. As Dr. Till mentioned
 

earlier, the ICRP has never come out with a
 

concrete statement as to what the uncertainties
 

are associated with internal dose. And we're
 

actually wrestling with that a bit right now. I
 

think we're getting close to putting some
 

brackets on it, but it's been the subject of some
 

discussion among our health physicists.
 

Okay. If you're monitored and you had a
 

badge, you know, you need to be able to interpret
 

that badge, so the site profile's going to have
 

the type of radiation energy -- the range of the
 

energies for photons and neutrons. You know, as
 

some of you are aware, we need to know the energy
 

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interval that you were exposed to for -- whether
 

photons or neutrons, because that will have a
 

direct result or effect on your probability of
 

causation calculation. By labor category, if we
 

know that, we'll tend to describe that in the
 

document, and exposure geometry's pretty
 

important. Whether, you know, you were facing
 

the reactor shield wall or whether you were
 

working in a rotational geometry, all those
 

factors we try to put in the document so that the
 

professional judgments exercised by the health
 

physicist in doing the dose reconstruction are
 

somewhat consistent.
 

Dose correction factors, we've heard talks
 

about those before, but those are in there. You
 

know, how we convert a dose that's measured on
 

the badge to a dose to the prostate or to the
 

bladder, that sort of thing.
 

Handling of missed dose, you know, the
 

detection limits are in there, the badge exchange
 

frequencies. Dosimeter correction factors,
 

sometimes the dosimeters couldn't measure what
 

they intended to measure -- 17 keV photons at
 

Hanford in the early days comes to mind. One
 

needs to know what to do with that, and how does
 

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one assign a dose to a worker? Well, hopefully,
 

you know, we're including that in there and -- as
 

is proper. Neutron dosimetry is another problem
 

area that we tend to flesh out in these
 

documents.
 

And again, putting the uncertainty with the
 

dose is -- to the extent possible, is included in
 

these documents.
 

Well, I mentioned that we're trying to do
 

these in parallel and get these out as fast as
 

possible. This slide is valid as of July 14th,
 

so it's changed somewhat, but these are the top
 

11 DOE sites and the number of claims from those
 

sites. And you see the bottom line is that if we
 

develop site profiles for 11 DOE sites, we
 

theoretically could produce dose reconstructions
 

-- or at least initiate them -- for over 10,000
 

claimants. So you know, it's not as daunting
 

maybe as it sounds. I mean we can do 10,000 with
 

11 site profiles, that's a pretty good number. 

It doesn't address the other ones yet, but
 

nonetheless, if we can get these documents out in
 

a short order, we could start moving these
 

forward.
 

One of the ones that we -- we've completed an
 

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128 

AWE site profile for Blockson Chemical, which -­

not Blockson Chemical, Bethlehem Steel, which the
 

Board heard about a couple of meetings ago.
 

Savannah River Site is the first DOE site
 

profile that's been completed, as of July 15th. 

It's out there on our web site, as we discussed. 

It covers operations from 1952 to the present at
 

29 separate facilities, all the major facilities
 

on-site are addressed in some way, shape or form. 

It's a fairly comprehensive document. Rev. zero
 

came out at 188 pages. It's very technically
 

detailed. It was not written from a layman's
 

perspective, although there is an executive
 

summary that is fairly readable.
 

Just a few of the highlights. It does cover
 

environmental dose on about any location on-site,
 

which was based on an adaptation of the CDC
 

studies of effluent releases by Dr. Till's
 

organization when they did the Savannah River
 

Site dose reconstruction. It's a little
 

different. You know, off-site -- fence-line and
 

off-site dose was reconstructed by Radiation -­

or Dr. Till's organization. We actually had to
 

adapt those releases and move in and do some
 

local area doses, based on their previous work. 

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129 

There was a discussion on that at the health
 

physics meeting in San Diego, if any of you saw,
 

I thought it was pretty impressive.
 

The document does describe photon/neutron
 

energy distributions and ratios by areas for all
 

those facilities over the entire operating
 

history of the plant. I guess I should be a
 

little clearer than that, though. There are a
 

few gaps. I mean we decided that we were not
 

going to have these things -- we're not going to
 

wait till every piece of information was complete
 

to move it out. But the idea was that where
 

there are some gaps in information that are
 

missing, we've identified in there and go back
 

and put it in later. So there are a few areas
 

that are maybe not covered at this point, but
 

we'll add them as we can.
 

And from the internal dosimetry perspective,
 

there's some documentation that contains the
 

isotopic activity fraction by area, what isotopes
 

were present, at which areas and when.
 

Just to give you a flavor, this is a
 

controlled document. This is the cover page of
 

the Savannah River site profile document. Again,
 

it is written by ORAU and signed by the task
 

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130 

manager for the project and then Dick Toohey and
 

I are involved in the approval process, once both
 

of our health physics staff have reviewed them.
 

You'll see that we do have -- there's an
 

executive summary that I think is fairly
 

readable. Then the rest of the document consists
 

of, as you see, Chapter 2, occupational medical
 

dose, occupational environmental dose, internal
 

dose and external dose. So it's a pretty good
 

compendium, I think, of what happened
 

radiologically -- occupational radiologically at
 

the Savannah River Site over time. And then
 

there's a number of appendixes that are there
 

that discuss things like facilities, processes
 

and that sort of thing.
 

These are controlled documents, as I
 

mentioned. Once they're issued, you know,
 

they're maintained. Only -- you know, the dose
 

reconstructor should only be working with the
 

latest revision of the controlled document, so
 

when ORAU distributes it, they make sure that,
 

you know, that document is in effect in the
 

field. And if it changes -- for example, we're ­

- I think revision one is being worked on
 

currently for the Savannah River technical basis
 

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131 

document. It's going to add another 50 pages of
 

data to help interpret internal doses. When rev.
 

1 comes out, then all dose reconstructors will be
 

made aware that, you know, as of this date, that
 

is the document that should be used to perform
 

dose reconstructions.
 

This is just a listing of the DOE site
 

profiles that are currently being developed, and
 

the contractor or subcontractor that's working on
 

them at this time, and the lead person who is
 

assigned to that dose reconstruction. Not shown
 

on here is the lead NIOSH person who works with
 

the lead ORAU person in getting these things
 

completed. But you can see that we've got all
 

these facilities covered. They're going in
 

parallel as we speak, so we will cover whatever I
 

showed on that first slide, something in excess
 

of 10,000 DOE claims -- DOE site claims could be
 

processed -- or at least initiated, given this.
 

The AWE sites are a smaller percentage of our
 

claims, I forgot what the statistic was, but 12
 

or 14 percent, something thereabouts. And so
 

this represents the number of claims from the top
 

ten Atomic Weapons Employer sites. You can see
 

the number totals about 1,200 or so. So you
 

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132 

know, not a tremendous number of claimants, but
 

that doesn't mean of course they're not important
 

to the individual claimant. They're just as
 

important as a DOE site. So we do have -- or
 

ORAU actually has in process a number of these
 

AWE sites right now. Bethlehem Steel of course
 

is done, so we have moved the majority of the
 

Bethlehem Steel claims through the process.
 

I think Dr. Toohey mentioned earlier Blockson
 

Chemical is in our hands for review, as well as
 

Huntington Pilot Plant. The other ones are in
 

various states of assemblage. They are trying to
 

take advantage of the process where these -- most
 

of the AWEs were uranium facilities and they did
 

sort of limited scope work, whether it was, you
 

know, making rods or producing uranium product,
 

uranium metal drums. They tend to fall into
 

similar categories, although they're not exactly
 

the same. One has to be careful about the level
 

of plutonium contamination that may be present in
 

the urine, or uranium, at the time the facility
 

was producing, the degree of enrichment, those
 

types of things need to be considered. But I
 

think there can be sort of a skeleton approach,
 

and then we can work out the details as to the
 

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133 

other factors that may contribute to the
 

claimant's dose.
 

This is a listing of currently the four AWE
 

sites that are under development, or one's done
 

and three more under development. And then just
 

a little slide showing the sites that are similar
 

to Blockson, that we feel we can use a similar
 

approach to dose reconstruction, and the sites
 

that we believe had similar operations to
 

Bethlehem Steel. So between the 10,000 DOE site
 

-- DOE claims and the 1,200 or so AWE claims,
 

we've got a good percentage of the claims
 

covered.
 

The good part of the story is these cover
 

that many claims, but then what Dr. Toohey talked
 

about earlier with the efficiency process is also
 

going to add some more claimants where we feel we
 

can move people through without actually having a
 

technical basis document or site profile. So
 

we've got the vast majority of the claims covered
 

with these things, although there's always going
 

to be these few that are going to be problematic
 

for us.
 

And I think that's the last slide, if I'm not
 

mistaken. Yeah. Well, I think I've kept us on
 

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134 

reasonable time for the lunch hour. If there's
 

any questions -­

DR. ZIEMER: Yeah, thank you, Jim, I think we
 

do have a little time for questions if we have
 

any.
 

Jim Melius.
 

DR. MELIUS: Just to back up a little bit, if
 

I recall correctly, the original plan was that
 

these site profiles would be done sort of
 

sequentially, not as a group like this. And that
 

they would sort of be built up from the
 

individual dose reconstructions and the
 

information and they would gradually come into
 

play. So I think that -- is that correct or -- I
 

mean this -- is this a change in plan? I'm just
 

trying to get a handle on -­

DR. NETON: Well, partially correct. I think
 

the concept of doing them sequentially was in the
 

plan, although we thought we might do a few at a
 

time, but with -- to step them up and to get them
 

all done in parallel is somewhat of a change in
 

direction. But you see we've added staff to do
 

that and we believe we need to do it to get the
 

numbers out the door.
 

To base them on the dose reconstruction and
 

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135 

the worker profiles, I think is what you're
 

alluding to, was really not the idea. The idea
 

was to have the site profiles in place so that we
 

could move claims, process claims, and as we got
 

experience with exposures from those workers who
 

were being processed using the site profiles, we
 

could start populating these worker databases or
 

worker profile databases. And in fact, we're
 

meeting next week with ORAU programmers to help
 

establish the overview of that database. We've
 

put some stuff in there, but we feel we have to
 

have a road map, you know, to get these things
 

completed.
 

Until you get a number of dose
 

reconstructions out the door and the data are
 

keyed in and entered, we can't really start doing
 

the worker profiles.
 

DR. MELIUS: But -- you can't start -­

DR. NETON: We can't establish worker profile
 

databases until we do dose reconstructions.
 

DR. MELIUS: Oh, okay, I understand now. 

Okay. Okay. I understand.
 

So then -- just so I understand then, these
 

site profiles are sort of a technical resource
 

document for the people doing individual dose
 

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136 

reconstructions, and then they will allow you to
 

-- based on that, to complete your individual
 

dose reconstruc-- to complete all the Y-12...
 

DR. NETON: That's the plan, although I have
 

to put a little bit of a proviso on there. There
 

may be some dose reconstructions that can't be
 

done even though the site profile is there. I
 

mean you've got all the information, but if the
 

person -- it may be more difficult to do -- you
 

may need more information than what's in the site
 

profile, let's put it that way. The person may
 

have had some very unusual incident that they
 

were involved with that we need to -- that might
 

not be in here. I mean this sort of covers the
 

standard operations at the facility and the
 

standard work practices. But if there's some
 

unusual circumstance, it may take a little longer
 

and a little more investigation to complete a
 

claim.
 

DR. MELIUS: And presumably also that once
 

the SEC reg comes out that that will -- you know,
 

there may be some numbers of people for whom a
 

individual dose reconstruction cannot be
 

completed.
 

DR. NETON: That's always a possibility.
 

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137 

DR. MELIUS: Yeah, and fall into -- to that. 

Okay.
 

Secondly I'd like to ask you about how the
 

information's being gathered for these? It seems
 

to me that it's -- appears to be, given the time
 

frame involved, mostly a what's available in
 

terms of summary reports. Is that true or -- I
 

don't -- I haven't had a chance to read in detail
 

the Savannah River -- but it appears to be mainly
 

a paper collecting -­

DR. NETON: Much of it's a paper review. We
 

have literally -- I'm not exaggerating when I
 

think I say tens of thousands of pages of
 

information in our database. But there are site
 

contacts or site conference calls set up with
 

current people at the facility to discuss -- I
 

know for Savannah River this is true. You know,
 

we had numerous discussions with them related to
 

their processes and that sort of thing. So it's
 

not merely a paper study, but it is primarily
 

based on paper -- paper data capture.
 

DR. MELIUS: Were any labor representatives
 

included in any of those -- that outreach effort?
 

DR. NETON: Not to my knowledge, no.
 

DR. MELIUS: Is there any plan to do that in
 

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138 

the other -- all the many others that you have
 

underway?
 

DR. NETON: No formal plans at this point,
 

but certainly if labor representatives had
 

information that were useful, we would -- we
 

would consider it.
 

DR. MELIUS: Well, it seems to me that from
 

your slide you were saying that you'd consider
 

information other people submitted, but it's a
 

passive process, so -- I guess I'm trying to
 

understand how -- how these -- how people get
 

into it, into this process. It seems to me it's
 

a very closed process. You have only an internal
 

review, though I -- I'm curious about this health
 

physics society review of the document that you
 

mentioned. But before -- talk about that, what ­

- I mean -- it's a closed process. True? I mean
 

it's -­

DR. NETON: I think -­

DR. MELIUS: -- between NIOSH and ORAU and
 

this -- you know, these contractors that you've ­

- ORAU's hired to do this.
 

DR. NETON: Yeah, I don't think I'd
 

characterize it as a closed process, but it is a
 

process that typically does involve health
 

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139 

physicists who are knowledgeable about the
 

exposure conditions at the facility. And it is
 

true that we have not gone out and solicited
 

labor's input on these documents.
 

DR. MELIUS: Do you think there might be some
 

value in soliciting input from not only labor
 

unions, but other people that are familiar with
 

the site that -- you know, retired technical
 

people, other people around a site that might be
 

-- provide useful information -­

DR. NETON: Oh, yeah, I -­

DR. MELIUS: -- particularly in what's not
 

available or what might not be readily available?
 

DR. NETON: I think that's useful. I think
 

we're -- it's a balancing act, you know, getting
 

these things completed and -- and using them. 

But they're dynamic documents, as well. And as
 

we have time to do that, I think it's a
 

reasonable -- reasonable idea.
 

DR. MELIUS: So it's going to depend on when
 

you have time to -- I'm just trying to understand
 

the process. I don't -­

MR. ELLIOTT: If I could add a comment here,
 

Bethlehem Steel we did use information that was
 

contributed by a worker.
 

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140 

DR. NETON: A claimant.
 

MR. ELLIOTT: A claimant. So it's not -- you
 

know, it's not fair to say that we don't accept
 

that and use it. We do. Jim mentioned that
 

earlier. Savannah River Site is not -- does not
 

have an organized labor group, per se, there. 

They're largely unorganized in their work force,
 

but we did not take advantage of the opportunity
 

to seek or solicit information from anyone other
 

than the people Jim's mentioned at that site.
 

However, once these documents are on the web
 

site or available to the public, we certainly
 

welcome any kind of comment or input that could
 

be garnered from those that we didn't touch.
 

DR. MELIUS: Well, Larry, I'd like to -­

there's nothing I saw in the beginning of the
 

document -- maybe it's buried on page 150 -- that
 

indicates you're soliciting input or interested
 

in input nor did I see it when it was posted on
 

the web site. It was post-- put up on the web
 

site as a completed document. In fact with this
 

-- I happen to know what a controlled document is
 

from my old bureaucratic days, but -- in the
 

government, but to me it looks like a very
 

official, final document and there's really no -­

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141 

not even a hint that you're looking for input
 

into that. And I think that needs to be
 

corrected.
 

I'd also like to add -- and again, I haven't
 

read Savannah River, but are there -- is there
 

any information in the document that indicates
 

what the sources of information were,
 

particularly the individuals that were talked to? 

You talked about some conference calls or some
 

attempt to reach out to the...
 

DR. NETON: Yes, I think that -- well, where
 

there are cital (sic) references, they're
 

certainly in there. I'd have to defer to Judson
 

Kenoyer on whether -- I forgot whether we've
 

cited contact information.
 

MR. KENOYER: I know in the original -­

DR. ZIEMER: Judson, you may need to use the
 

mike here, please.
 

MR. KENOYER: I'd have to check on the final
 

document as it was printed, but I know in the
 

original draft we referenced specific
 

conversations with people on site.
 

DR. NETON: I was pretty sure we did, but I
 

wanted to make sure.
 

MR. KENOYER: Some of the most valuable
 

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information we retrieve is from the direct
 

interaction with people that worked on-site in
 

the early years. Certainly that's our biggest
 

challenge, to get data describing -- or
 

information describing the systems that were used
 

in the early years. And we've gone to more and
 

more interviews, face-to-face interactions with
 

people that have since retired but are still
 

around.
 

One example is this week we are interviewing
 

Jan P. Lawrence at Los Alamos, a key individual
 

in the external and internal dosimetry programs.
 

DR. MELIUS: I guess what I'm concerned about
 

is that people don't know you're doing the
 

document, don't have any information on the
 

process or what's going on, how do they know to
 

even contact you or how do you know to contact
 

them? It's a very sort of hit and miss and I
 

agree, we're not going to find everybody that has
 

-- may have valuable information and you may have
 

people that end up with not very valuable
 

information. But if there's no attempt for
 

outreach or -- of this and -- and I think that
 

goes through -- right through from the start of
 

the document. Again, okay, these are dynamic
 

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documents. Why not make it -- tell people,
 

announce to people, get the information out that
 

you are soliciting further contributions to this
 

-- terms of information and -- and so forth. And
 

I don't know whether that's best -- you know, at
 

what step in the process it's best done. I'm
 

concerned when you're rushing through something
 

in, you know, three or four months, it doesn't
 

leave much time. And albeit there is -- you need
 

to get the program going, but that ought to be
 

balanced by how good and comprehensive the
 

information -- how complete the information is so
 

we don't make mistakes and leave out valuable
 

information that was -- you know, might have
 

changed somebody's dose reconstruction. And I
 

think some more active outreach would be useful
 

for that purpose.
 

DR. NETON: I think you make a good point and
 

we certainly will consider that. But I will say
 

that, you know, we would not release the document
 

unless we were very confident that we had
 

captured the essence of the exposure profile of
 

the site. But if information did come to light,
 

we are committed to going back and re-evaluating
 

the claims that were processed, with that new
 

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information, to make sure that someone was not
 

inappropriately, you know, characterized for
 

their exposure.
 

DR. MELIUS: Yeah, I'm not trying to
 

characterize your intent or whatever. I think
 

your intentions are good. But I think we have a
 

whole history of review documents being put out
 

about these sites that are -- been less than
 

complete, with a lot of missing information. So
 

I think having a public process to this and an
 

active outreach would be very helpful.
 

I'm also a little concerned about -- I
 

presume there's no external peer review, and I
 

think that's something that might be considered
 

as, again, a way of soliciting both technical
 

input in terms of what you're doing, as well as,
 

you know, soliciting more information from
 

people. You know, maybe we've used up all the
 

available health physicists and maybe peer review
 

would be hard to do, but -- I guess I was struck
 

by the fact that you went to the health physics
 

society, you mentioned that you had lively
 

debate. I don't know what that means, but that ­

- I assume it means you got some input in terms
 

of at least that particular calculation that you
 

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had done. And again, I don't know whether Dr.
 

Till's group or Dr. Till was contacted about what
 

you -- or you know, solicited about the way you
 

were using the original data and they with-- you
 

know, maybe some ideas they might have, but it
 

seems to me that there's some value to a
 

scientific peer input into this process at some
 

point.
 

DR. NETON: Well, at some point we have to
 

draw the line. I mean we are hiring a contractor
 

to do nothing but review these technical basis
 

documents in probably three months from now. So
 

to layer review upon review does sort of impede
 

the progress. But your point's well taken.
 

DR. MELIUS: If they're -- living documents. 

I was also -- my understanding was there was a
 

number of health physics society presentations
 

that were made by -­

DR. NETON: Yes.
 

DR. MELIUS: -- the NIOSH staff. Are those
 

available at all to those of us who didn't get a
 

chance to go to wherever?
 

DR. NETON: I don't believe they're on our
 

web site, although we can certainly do that and
 

make them -- are they out there, Dick?
 

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DR. TOOHEY: Let me just comment -- the ones
 

that were made by ORAU staff I think are on the
 

ORAU COC* web page. I know mine is. It's
 

certainly our intent to post them out there.
 

DR. NETON: We'll make sure that we put all
 

those on our OCAS web site for public viewing.
 

DR. ZIEMER: I might add, Jim, that the
 

health physics society doesn't publish
 

proceedings of their meeting, but they do publish
 

the abstracts of each of those papers. They are
 

basically individual submissions, and I don't
 

think the -- this was not a formal review by the
 

health physics society.
 

DR. NETON: No.
 

DR. ZIEMER: What you had was discussion at
 

an open meeting -­

DR. NETON: Exactly.
 

DR. ZIEMER: -- when a paper was presented.
 

DR. MELIUS: Yeah, but -- yeah, I understand. 

I understand. I just think -- thought I was
 

making the point that such a discussion is
 

valuable, as would additional peer review and
 

additional input into this process.
 

Finally I'd like to just go back to at least
 

this whole issue of conflict of interest and
 

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transparency of the process. I think all of
 

these things we've been talking about, the
 

questions I mentioned, are critical to the
 

credibility of this process. You're going to be
 

basing a lot on these documents, and that albeit
 

there's, you know, individual dose reconstruction
 

that'll go on and opportunity to question issues
 

and provide more information, but a lot of what
 

you do and a lot of the credibility of this
 

process is going to be dependent on the -- these
 

documents. And to have them done by -- without
 

people knowing who's involved and this whole
 

issue of potential conflict of interest, I think
 

is a serious mistake to be made, and I think
 

it'll cause serious issue-- serious questions to
 

be raised about the credibility of the whole
 

process, particularly if the wrong information,
 

wrong people are involved, or misinformation gets
 

out in a very selective way about who's involved
 

and then why has this been kept secret. And I
 

really think you need to seriously consider how
 

you open up this whole process, including the -­

how you solicit information, how you get the
 

review done, how you continue to solicit input,
 

as well as the transparency for the people
 

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involved in the process.
 

DR. NETON: Okay.
 

DR. ZIEMER: Thank you, Jim. Gen and then
 

Mark, and then we need to break for lunch. We
 

can return to this if there's others that want to
 

comment.
 

DR. ROESSLER: My question is about radon
 

doses. I assume some of these facilities do have
 

enhanced radon. How are you getting the
 

information to calculate those radon doses and
 

how are you taking into account what the non-work
 

place radon might have been, which to me should
 

not be a part of the radon dose attributed to the
 

work place.
 

DR. NETON: Right. Well, there are radon
 

monitoring data for a number of facilities. I
 

know Fernald has some -- minimal data, but at
 

least we know what -- what the upper limits were
 

in some facilities. I know Mallinckrodt has some
 

radon monitoring data. So to what -- to the
 

extent it's available, we'll use it to model what
 

the exposures were. I suspect if we didn't have
 

any radon information and we knew how much radium
 

was there, we could sort of back-calculate based
 

on emanation rate and equilibrium situation, what
 

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149 

could have been there at the upper limit. So we
 

do intend to use it. It's included in the
 

technical basis document if it's occupationallyderived.
 

The trick is, I think -- you know, your
 

second part of your question, which is what -­

what portion of the radon exposure at these
 

facilities is occupationally-derived. And in
 

fact, we're still wrestling with that concept. 

There are some areas where there are tunnels that
 

were drilled into the ground to do testing of
 

weapons. That's not technologically-enhanced
 

radon, but it is a tunnel, and is that an
 

occupational exposure or not. We are currently
 

formulating a policy on that position.
 

MR. GRIFFON: Just a quick one maybe, and
 

maybe if we need to we can continue after lunch
 

or whatever. But I'm seeing a new parenthetical
 

phrase in some of those overheads -- at least new
 

from my memory on some of your previous
 

presentations. "If readily available" keeps
 

cropping into many of these overheads now.
 

DR. NETON: Yeah.
 

MR. GRIFFON: And I'm wondering if you can
 

define for us -- sort of like sufficient
 

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accuracy, you know. Can you define "readily
 

available"?
 

DR. NETON: I can attempt to. The idea there
 

is that, you know, we have to produce these in a
 

reasonable time frame. And if the information
 

are somewhat consolidated and available, either
 

electronically or in one room as paper records,
 

we would consider using them in the technical
 

basis document themselves. But if the
 

information, as I mentioned, is distributed about
 

the site and available in 300 facilities that are
 

contaminated facilities, we just don't feel at
 

this point that it's beneficial to hold up the
 

technical basis document to retrieve all those
 

records.
 

Now as far as a dollar figure or time frame,
 

we really haven't established that. Fortunately
 

these things seem to sort of be dichotomous. 

They either have an electronic database or they
 

don't, and the records are not retrievable. So
 

we haven't had to really define what -- you know,
 

what that cut point is.
 

MR. GRIFFON: And is that something -- for
 

instance, if you identify a set of records that
 

may not be easily retrievable, where -- where is
 

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the responsibility drawn for -- for collecting
 

those rec-- does DOE have a role in this
 

collection process?
 

DR. NETON: DOE has a role -­

MR. GRIFFON: I'm sure they might want to be
 

reimbursed for their efforts or -- or -­

DR. NETON: Right.
 

MR. GRIFFON: How does that work?
 

DR. NETON: DOE has a role in making those
 

records available for us to capture. So they
 

would consolidate them to a certain point, but
 

then we would go to the site and do a data -­

what we call a data capture effort, which is to
 

scan all the records, if possible, and obtain
 

images of those records.
 

MR. GRIFFON: I guess -­

DR. NETON: Judson might have a slight
 

correction there, but I think that's fairly
 

accurate.
 

MR. KENOYER: That is accurate. What I'd
 

like to do is add to that, though. Remember we
 

talked about these being dynamic documents. 

Readily available really fits into the rev. zero
 

zero, because we're continuing the efforts to
 

search out additional data.
 

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DR. NETON: Yeah.
 

MR. KENOYER: Good example would be data on
 

Mallinckrodt. I know that there's some up in DOE
 

headquarters, but they're mixed in with
 

classified information. It's just going to take
 

time to retrieve it. We'll produce rev. zero
 

zero of the Mallinckrodt TBD, but we'll pursue
 

getting the other data and if it changes the TBD,
 

we'll -- that'll be in rev. zero one.
 

MR. GRIFFON: I guess, you know, just
 

referring back to some of what Jim said, you
 

know, some of the concerns early on in this
 

program that have been expressed is that past
 

reports and past DOE databases may -- may be at
 

least suspect or -- and part of the reason for
 

this independent effort would be that we, at the
 

very least, cross-reference or validate or
 

verify, if we're going to use those numbers for
 

determinations. And I guess some of what I -- at
 

least in this rev. zero of Savannah River, I
 

noticed that air monitoring -­

DR. NETON: Was not readily available.
 

MR. GRIFFON: -- was basically skipped over. 

I mean it seems that a lot of the records are
 

going to be difficult to get to, if in fact you
 

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153 

do attempt to get them. But I would argue that ­

- at least at some quality control level -- it
 

would be a valuable exercise to verify the
 

bioassay records.
 

DR. NETON: Oh, yeah, we certainly intend to
 

do that. I mean we'll go back and, as the
 

information becomes available, bounce it against
 

our TBD.
 

Let me say, though, one point -- it's been my
 

experience that when we -- if we construct a
 

technical basis document and we are lacking
 

information, we are claimant-favorable in our
 

approach. And at least in two instances now, I
 

know as additional data became available, it
 

would tend to reduce the doses or our estimated
 

exposures to the claimants rather than increase
 

them. So it's -- they tend to be more claimantfavorable the less data you have.
 

MR. GRIFFON: Last pre-lunch question. If -­

you know, I guess some of my concerns are -- and
 

you've heard these before -- is the notion of
 

missing the trees for the forest, and the fact
 

that -- this goes back to the question of
 

unmonitored workers, and you say when you don't
 

have other records, you may rely on source term
 

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data. When you define source term data, I would
 

imagine that this level, especially in rev. zero,
 

you're talking about building -- a building, or
 

as -- or -- or -- well, I -- well, I don't know,
 

but the question is, you know, at least my
 

experience is that sometimes within processes you
 

find different concentrations, different
 

accumulations of radionuclides so your source
 

term can vary over a process and over time and
 

how -­

DR. NETON: Right.
 

MR. GRIFFON: -- how do you define, you
 

know...
 

DR. NETON: Well, but I think, again, you'd
 

see that if we did -- if you did a dose
 

reconstruction based on source term data, it
 

would tend to be very claimant-favorable. If we
 

didn't know that the person worked near -- we
 

would come up with a maximum exposure scenario,
 

essentially, given that source term. And
 

essentially, if we couldn't prove otherwise,
 

assign it to the claimant and use that for -­

MR. GRIFFON: Yeah, my example -- being very
 

specific, if you assign a maximum, you know, for
 

some of the recycled fuel stuff, we know that
 

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155 

some of the transuranics will isolate in certain
 

areas and certain processes.
 

DR. NETON: Right.
 

MR. GRIFFON: If this individual worked
 

around some of those processes but you give them
 

the -- you assign them the -- you know, without
 

knowing that, you assign them the average, you're
 

potentially, you know, missing -­

DR. NETON: Well, that's an example where
 

it's a bad dose -- it's a bad profile. Right? I
 

mean we haven't done our job. And if we knew -­

if you know that material's there and -- for
 

instance, we didn't know that the worker didn't
 

work at one of -- if we couldn't establish he
 

worked at a trap or not, where maybe the
 

neptunium or whatever concentrations were
 

extremely high, we almost have no choice but to
 

then to say okay, that's -- that's a -­

potentially your exposure scenario, you know. I
 

mean there's just no way around that.
 

MR. GRIFFON: Okay. I guess it's -- it seems
 

to me that defining some of these source terms
 

can be a complex exercise 'cause some of these
 

facilities over time -­

DR. NETON: Sure.
 

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156 

MR. GRIFFON: -- very dynamic and...
 

DR. NETON: Yeah, absolutely. But I think if
 

you look through our dose reconstructions you'll
 

find that they tend to overestimate exposures in
 

general.
 

DR. ZIEMER: Let's now recess for lunch. I'd
 

like to ask if we could still shoot for 1:30
 

return time. It does shorten lunch period a
 

little bit, but try to keep us on schedule. 

Thank you.
 

(Whereupon, a luncheon recess was taken.)
 

DR. ZIEMER: I wanted to give an opportunity
 

for any additional questions for Jim. We were
 

pushing the lunch hour and needed to recess. But
 

are there any remaining questions for Jim Neton
 

and -- relative to his presentation -- comments
 

or questions? Yes, Jim Melius.
 

DR. MELIUS: I have one.
 

DR. ZIEMER: And -­

DR. MELIUS: I don't think -- Jim can stay
 

there, that's fine. Either one.
 

DR. ZIEMER: Either place, wherever you're
 

comfortable.
 

DR. MELIUS: It's sort of a follow-up to what
 

I asked before. I came to me over lunch. But I
 

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guess I get -- I get concerned, I think others of
 

us are concerned about sort of false negatives,
 

that we -- you'll miss important information
 

that might affect some proportion of the dose
 

reconstruct-- individual dose reconstructions
 

that are done at a particular site because the
 

information's not readily available, whatever. 

And I guess my question is have you thought about
 

some sort of a decision plan or approach that -­

for -- you finish the site profile with whatever
 

information's available. You're going through
 

doing the dose reconstructions and there's a
 

group of workers in a particular part of the
 

facility that there's a great deal of uncertainty
 

about their -- the available exposure information
 

for them, or that requires further work, or based
 

on individual dose reconstructions they're not in
 

the high category, those that are -- will be
 

compensated, or the low -- but they're sort of
 

closer to the decision point that you may -- you
 

might hold up their dose reconstructions until
 

you've done more work on the site profile? I
 

guess I'm worried about this, you know, sort of
 

steaming through, doing all X hundred cases from
 

some facility and then finding out that well, we
 

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later found, you know, information that for 50 of
 

them was -- really changed how we did it, or
 

maybe even for five. 'Cause I think to have to
 

go back and correct that kind of error would be
 

problematic, and I think it might be taken care
 

of up front as you're sort of developing your
 

document.
 

DR. NETON: I think I have your question. Is
 

it if we have a site profile done and we have a
 

group of workers that we're trying to move those
 

dose reconstructions through the process but we
 

feel that the site profile is not sufficient to
 

put them on one side of compensability or not,
 

what would we do with those claims?
 

DR. MELIUS: Yeah, I mean or that -­

DR. NETON: Yeah.
 

DR. MELIUS: -- might be built into the
 

process that we're not going to process these
 

because -­

DR. NETON: Right.
 

DR. MELIUS: -- there's a great deal of
 

uncertainty about a particular -- or availability
 

of records for a particular building or, you
 

know, particular type of exposure.
 

DR. NETON: Yeah, I think that's correct. We
 

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159 

would not move them through just for the sake of
 

moving them out the door and checking the box or
 

something to that effect. Those would be held up
 

until we had sufficient information to -- so that
 

Labor could make a decision, you know, one side
 

or the other for compensability. So you know,
 

I'm not sure what else to say on that.
 

DR. MELIUS: No, no, that's fine. I'm just
 

thinking that ought to be communicated as part of
 

this proc-- I'm just saying -­

DR. NETON: Okay.
 

DR. MELIUS: You're saying yeah, there are
 

limitations to these site profiles. They're not
 

final and we're continuing to seek information. 

We're not going to inappropriately use them until
 

we're -- we feel that the information is
 

adequate.
 

DR. NETON: Right. I thought I -- I tried to
 

allude to that a little bit in my presentation
 

when I pointed out that -- for instance, if we do
 

a claim that was involved in an incident or
 

several incidents and they weren't covered in the
 

profile, you know, there's just no way we would
 

be able to move that claim without, you know,
 

obtaining additional information.
 

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DR. MELIUS: Okay. Thanks then.
 

DR. ZIEMER: Henry Anderson.
 

DR. ANDERSON: Yeah, I just wanted to follow
 

up on that a little bit. I just quickly went
 

through the Savannah site review or base document
 

on -- and I had some difficulty identifying what
 

were the specific data gaps that you may have
 

identified. And I think, again, if it's going to
 

be a living document, it would be helpful, again,
 

from the standpoint of those individuals who
 

might, as we just talked about, not have their
 

claim finalized, it would be helpful -- almost
 

like a data call-in -- to say here's what we
 

currently have and here's some indications or we
 

believe there may be additional information that
 

we're looking for. I think that might be a more
 

-- trigger more people to send information in.
 

And then the second statement, I would just
 

ask is there have been quite a number of lawsuits
 

involved in the various sites, and as part of
 

that they typically have quite a bit of discovery
 

and documents are produced. And it would be ni-­

and usually they're listed by some type of a
 

name. It might be useful as readily available
 

information to look at those to see if that data
 

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161 

and information is included in your site profile. 

That's just a -- I would assume most of it is,
 

but there may well be some information there if
 

you have not mined those. I know in a lot of the
 

other litigation that's often turned out to be a
 

very useful source. It's very laborious to go
 

through, but it might be something to look at.
 

DR. ZIEMER: Okay. Thank you, Henry. Other
 

comments or questions?
 

(No responses)
 

ADMINISTRATIVE HOUSEKEEPING AND 

BOARD WORK SCHEDULE
 

Thank you. Let's move on in the agenda then. 

Our next item is some administrative issues. I
 

would like us to first turn to the charter, and
 

the reason I ask you to turn to the charter is to
 

make note of the fact that our charter, you know,
 

runs a two-year cycle. And if you look on page 3
 

of the charter, at least the version of the
 

charter that's in your book, you'll notice it's
 

dated August 1st, 2003, signed by Tommy Thompson. 

So this is the current charter.
 

Now if you read through that, I note many
 

things haven't changed. For example, I notice
 

your compensation has not increased by cost of
 

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living or any other factor, for whatever that's
 

worth, which apparently is not much.
 

What is different here in this charter is on
 

page 2 under the item called structure. And if
 

you read through structure, you will notice that
 

-- wait a minute, am I in structure?
 

MR. ELLIOTT: Second paragraph.
 

DR. ZIEMER: Second paragraph of structure,
 

yes. I was looking for something that is new in
 

our charter, and that has to do with specific
 

terms of the members. And Larry, could you speak
 

to that issue for us?
 

MR. ELLIOTT: Yes, thank you, Dr. Ziemer. 

The -- in renewal of the charter, the White House
 

and the Department incorporated term -­

membership terms for this body now. It wasn't
 

resident in the first charter. It is in this
 

renewal of the charter. We will be talking to
 

each individual Board member about the term of
 

membership that's been specified for you. This
 

is -- it's an HHS policy, as well as FACA, to
 

have term memberships. I think it perhaps is -­

is something that was attended to at this charter
 

renewal that was perhaps lost in the initiation
 

of the first one. So as we go forward, we will
 

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be contacting you individually and talking to you
 

about membership and term of membership.
 

DR. ZIEMER: Okay. And Henry, question or
 

comment?
 

DR. ANDERSON: Yeah, a question. Do you have
 

any thought as to how many terms one -- I mean
 

usually it's -- you know, I think a four-year
 

appointment. It's nice to know it's not an
 

endless appointment, from both sides. But
 

oftentimes they have -- but no more than two
 

consecutive terms, and I see they don't have any. 

Do you see that as a -- when you say a term, do
 

you mean that everybody will only serve four
 

years?
 

MR. ELLIOTT: Well, I would direct your
 

attention to the way that paragraph starts. You
 

are Presidentially appointed and you serve at the
 

pleasure of the President. And the White House
 

has designated terms. They are going to be
 

staggered terms so that each year there will be a
 

moderate turnover of the Board, perhaps. In some
 

cases maybe the White House will say they want to
 

keep someone in place in membership. I believe
 

FACA says that you can -- as you noted, that you
 

can serve up to a specified number of terms or a
 

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specified number of years.
 

DR. ANDERSON: Yeah.
 

MR. ELLIOTT: Also I would call your
 

attention to the last sentence in that paragraph
 

where it says terms of more than two years are
 

contingent upon the renewal of the charter, so
 

you know, there's a lot of factors that come to
 

play here in making these appointments happen. 

And so I just wanted to call your attention to
 

this fact that in this charter renewal this now
 

exists.
 

DR. ZIEMER: Larry, it would be my
 

understanding then that the current Board
 

membership would be assigned varying terms, so
 

the whole Board does not get replaced at one
 

time. Presumably what, a third of the Board
 

every two years or something like that. Can you
 

speak to the issue -- has the White House made
 

such a determination already or are -- will that
 

be made soon?
 

MR. ELLIOTT: Yes, that determination has
 

been made and the way it was made, the Board was
 

grouped into three categories on an alphabetical
 

order, A to Z. The first grouping of four would
 

go off a year from now, second grouping would go
 

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off two years from now -- with a possibility of
 

reappointment. This is up to the President, up
 

to the White House, so -- and the third grouping
 

would go off three years from now. So that's the
 

way this has been arranged in their appointment
 

cycle.
 

DR. ZIEMER: Thank you. Are there questions
 

or comments on the charter, or the terms?
 

(No responses)
 

Thank you. Now let me ask Cori if we have
 

additional -- or Larry, do we have additional
 

administrative matters at this time -- or
 

housekeeping matters?
 

MR. ELLIOTT: I don't believe that -- Cori's
 

standing back there shaking her head no, but I
 

would remind you all of our process of e-mailing
 

Cori or myself with your time of preparation. 

Cori says she'll remind you with an e-mail
 

tomorrow morning. It's important that we get
 

your travel voucher in for -- back as soon as
 

possible so that we can -- this is very
 

important, so please hear me out. We're
 

approaching end of year, fiscal year closeout,
 

and so if you don't want the hounds coming after
 

you for your voucher info, please submit that so
 

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that we can close the books on this fiscal year.
 

We do need -- perhaps not at this point, but
 

later before we depart today we need to figure
 

out what your next meeting schedule is, and I
 

think that may be dictated by perhaps the
 

discussion to ensue shortly.
 

DR. ZIEMER: Cori did ask all of us to send
 

her our schedules for the next -- I think for the
 

remainder of this calendar year. And if you
 

haven't already done that, you need to do that,
 

as well.
 

Do any of the Board members have any
 

questions on work schedule, administrative
 

procedures, housekeeping items?
 

(No responses)
 

If not, we'll proceed on the agenda and move
 

to the working session and -- on development of
 

the task order and I'll give the floor to Mark
 

Griffon. Mark.
 

BOARD DISCUSSION/WORKING SESSION
 

DEVELOPMENT OF TASK ORDER
 

MR. GRIFFON: Yeah, we -- we have several
 

items, including the homework assignment from
 

last night. But I thought -- I guess the way I
 

want to approach this is this morning the working
 

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group met again and we went through the two tasks
 

that were handed around the table yesterday
 

morning, which -- which are for dose
 

reconstruction review and for procedures and
 

methods review. And I thought -- I think -­

yeah, Cori's handing out -- we -- we worked and
 

edited those this morning and have them in more
 

final form. And my feeling is that I'd like, in
 

our time period that we have, to get as much -­

items completed as we can. I think we have some
 

open-ended discussions on some things, which I'll
 

hold off a little, if we can. So I'd like to
 

start with discussions on those two tasks. And
 

then talk a little about the process of how we're
 

going to review these tasks and what that will
 

involve, and that may impact some discussions on
 

future meetings, et cetera. And then the -­

there's a couple of other tasks that I've
 

developed real rough drafts of tracking tasks and
 

a site profile task, and then finally what -­

some -- I think we need some follow-up discussion
 

on the question on interviews, or follow-up
 

interviews.
 

So -- but to start with, something that I
 

think is hopefully nearing a final draft, these
 

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two tasks which just got circulated. I think I ­

- maybe we can open up a discussion on them, and
 

the language should look very familiar by now to
 

people in these things.
 

To start, the one -- the first one, dose
 

reconstruction procedure and methods review, the
 

shorter one of the two, we added -- and I left
 

the -- I didn't accept the changes on the track
 

changes mode. I left the changes there so you
 

could see where we really edited this morning. 

And Roy DeHart brought up a good point that, you
 

know, it seems like we should have asked the
 

contractor to, up front, establish a procedure by
 

which they're going to review all of NIOSH's and
 

ORAU's procedures and methods. And that
 

procedure would also be reviewed by the Board for
 

approval.
 

And in the bottom two sections you'll see
 

some editions on the period of performance and
 

the reporting and deliverable requirements. Give
 

you all a second to look at those.
 

(Pause)
 

DR. ZIEMER: Mark, while people are finishing
 

up reading that, I just want to ask a process
 

question here, and perhaps both to the working
 

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group and to NIOSH staff. And that is, in terms
 

of the content and the form, does this meet the
 

requirements for a work statement? I assume it
 

does since you've had Jim and others working with
 

you on that. So this would meet those
 

requirements, in terms of the specificity and
 

detail -- level of detail. And presumably the
 

contractor would then take this a develop the
 

cost document for final approval. Is that
 

correct?
 

MR. ELLIOTT: Yes, the -- you're -- the Board
 

would deliver this -- a task order to the
 

contractor, who would then be allowed an
 

opportunity of perhaps two weeks to prepare a
 

proposal on how they would conduct the work
 

specified in the task, describe what skill
 

categories would be employed in that effort and
 

provide a cost estimate. And that would -- that
 

proposal would come back to whoever the Board or
 

whatever your process is going to be -- how it's
 

going to be specified, who will take that
 

proposal, evaluate and, if necessary, negotiate
 

it.
 

DR. ZIEMER: And then my related question -­

again to staff and to Mark -- is that do we need
 

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today to have an approved statement of work for
 

that purpose, or are we still looking at this as
 

subject to some final polishing? Are you simply
 

looking for Board input and reaction today or are
 

you looking for closure today?
 

MR. GRIFFON: I was hoping that for these
 

two, since -- that we need closure on these
 

today. Yeah, and move these forward, at least in
 

the system.
 

DR. ZIEMER: So at some appropriate point
 

when we think we're ready to do so, then we could
 

have a formal motion to approve the document. 

Okay.
 

Mark, do you have any more comments on the
 

document, then we can put it on the floor for
 

formal discussion if you want to so move -­

MR. GRIFFON: Yeah, I'd like to -- I'd like
 

to -­

DR. ZIEMER: On behalf of the working group,
 

you move adoption of this statement of work?
 

MR. GRIFFON: Thank you for making -- yes.
 

DR. ZIEMER: That's what I thought you were
 

-- reading the body language.
 

MR. GRIFFON: Right.
 

DR. ZIEMER: And that basically is a motion
 

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from a working group. It doesn't require a
 

second in that case, so it's on the floor for
 

discussion. This is only on the first statement
 

of work -- I'm trying to identify it -- as -- I
 

guess it's dose reconstruction procedure and
 

methods review -­

MR. GRIFFON: Correct.
 

DR. ZIEMER: -- is the title of the statement
 

of work that we're considering now. And I think
 

we can both raise questions, you can ask for
 

clarifications, you can move for amendments to
 

this.
 

Robert Presley.
 

MR. PRESLEY: Where we have put in months, do
 

we need to go in and change that one month to 30
 

days, six months to so many days. Where you've
 

got two weeks -­

DR. ZIEMER: Robert, identify the item here
 

for all of us.
 

MR. PRESLEY: Okay, period of performance,
 

second page.
 

DR. ZIEMER: Okay.
 

MR. GRIFFON: I would say -- I mean I would
 

say, similar to the original contract language
 

that we did, I think we can allow NIOSH to make
 

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technical edits as long as they don't change the
 

-- you know, the nature of the -- and I think
 

that was done previously to tighten up some of
 

the language, so if that needs to be done, that's
 

fi-- you know, I would think that would be fine,
 

yeah.
 

DR. ZIEMER: Okay. Everybody understand the
 

question there? So you're not asking that this
 

language necessarily be changed, it's -- or are
 

you?
 

MR. PRESLEY: I think we need to ask legal
 

where we need to tie that down.
 

MR. ELLIOTT: I want to be clear on what
 

you're asking us to do here.
 

MR. PRESLEY: Where we have -- like one
 

month, do we want to tie that down to 30 days? 

Especially where you have in there within six
 

months, that can float quite a bit within a sixmonth period.
 

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

that once your task has been developed, we would
 

then put that in front of the procurement office,
 

and any kind of issues like that -- it's going to
 

come from them, not us. And so the procurement
 

office will drive those kind of edits. If they
 

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say hey, it needs to be so many working days
 

versus a calendar month, that'll come back from
 

them and we'll rely on them, if that's okay with
 

you all.
 

DR. ZIEMER: Right. So the intent is here
 

and they can polish that. Is that agreeable with
 

everyone? We can leave the language as it is for
 

the moment then. Okay.
 

Wanda.
 

MS. MUNN: This question may derive from my
 

lack of familiarity with the procurement process,
 

but I see no indication of establishing any
 

criteria for bidders here. Are we just going to
 

say anybody who thinks they can do this, do it? 

Or do we establish criteria?
 

MR. ELLIOTT: Well, this is the next phase of
 

procurement. The first phase was to put a
 

request for proposals on the street, which you
 

did, that provided a boundary, if you will, about
 

the scope of work. Now within that scope of
 

work, once your contract is awarded, you're going
 

to give the contractor task orders. That's what
 

this is. And so there's no need for -- you know,
 

you're not -- even if this -- if this contract is
 

awarded to multiple awardees, they're still given
 

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the same level playing field in one task. They
 

don't need that.
 

If I could also comment here on what I said
 

earlier about relying on procurement to help make
 

sure that we're following proper procurement
 

procedures, on the first page under purpose and
 

description paragraph, the second sentence -- The
 

task may be extended to be a periodic annual
 

review. I think we're going to have a little bit
 

of problem with that. You might want to think
 

about that 'cause you can't promise future work. 

You can only task under one task. Now you can
 

resurrect this same task later, say -- say a year
 

or 18 months later you want to have the
 

contractor conduct the same task, then you -- you
 

just issue a new task. But you can't promise
 

future work in a task. Okay?
 

MR. GRIFFON: I -- yeah, if they want to look
 

at it -- I mean the intent there was that -- in
 

"may" -- we put "may" because you said -- that's
 

what we heard, that you can't promise future work
 

in the task.
 

MR. ELLIOTT: I think what procurement will
 

say is that that sentence needs to come out. But
 

we'll leave it up to procurement if -­

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MR. GRIFFON: As long as we've established -­

DR. ZIEMER: In which case, the following
 

sentence would also come out because it explains
 

why the period -­

MR. ELLIOTT: Right.
 

DR. ZIEMER: -- periodic review, so -­

MR. ELLIOTT: Right, you can reissue a task
 

previously done -­

MR. GRIFFON: Right.
 

MR. ELLIOTT: -- at any point in time, but
 

you can't promise future work.
 

MR. GRIFFON: Okay. That may come -­

MR. ELLIOTT: It builds expectation -­

MR. GRIFFON: That may come up in the next 

one, too, so... 

DR. ZIEMER: And I think, Mark, you're saying 

the word -- the use of the word "may" doesn't
 

promise anything, but Larry's suggesting it may
 

nonetheless raise the -­

MR. GRIFFON: Well, I -­

DR. ZIEMER: -- anticipation level or -­

yeah. Or it could be left out. It doesn't
 

change the immediate task.
 

MR. GRIFFON: I actually -- you know, it was
 

in the original task order contract, too, so I
 

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don't know if we promised it in there. All this
 

language was lifted from that. And also for the
 

individual dose reconstruction reviews, it talked
 

about five years of reviews in the original
 

contract that we put out.
 

MR. ELLIOTT: But you're talking about RFP
 

versus an individual task.
 

MR. GRIFFON: All right, that's fine.
 

MR. ELLIOTT: And I think -- I think
 

procurement's going to say to us that each task
 

has to be a stand-alone and can't -­

MR. GRIFFON: That's fine.
 

MR. ELLIOTT: -- can't indicate that there's
 

going to be, you know, follow-on work on that
 

same task. There's a discrete -- these are
 

discrete tasks with discrete deliverables,
 

discrete endpoints, and that's what they're going
 

to -- I'm pretty sure they're going to preach
 

that to us, so...
 

MR. GRIFFON: Yeah. I have no problem with
 

that coming out if it has to come out.
 

DR. ZIEMER: Any objection to deleting those
 

two sentences since there is no promise of future
 

extensions in any event? Without objection,
 

we'll just delete the second and third sentence
 

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177 

of that paragraph then. That's the sentences
 

that say "This task may be extended to be a
 

periodic annual review of procedures since it is
 

likely that procedures will be modified as the
 

program evolves. The focus of the periodic
 

reviews will be to assure overall consistency of
 

the program from the earliest cases that were
 

completed." Those two sentences would then be
 

deleted. Thank you.
 

Other comments?
 

(No responses)
 

Is the Board then ready to take action on
 

this statement?
 

(No responses)
 

It appears that we're ready to vote. I'll
 

ask that all who favor this -- the statement of
 

work as modified, please say aye.
 

(Affirmative responses)
 

Any opposed, say no.
 

(No responses)
 

Any abstentions?
 

(No responses)
 

The motion carries.
 

MR. GRIFFON: Okay. The second task order
 

there is the lengthier one on individual dose
 

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reconstruction review. Again, I think -- just -­

just to pick up on the point we just discussed,
 

in the third paragraph, the last sentence, I
 

guess we should delete the sentence starting "The
 

Board anticipates that the next four years will
 

also involve a review of 2.5 percent of the total
 

cases." Is that correct, Larry? I think that
 

has to come out -- those last two sentences, also
 

the sentence saying "For purposes of this
 

proposal the contractor should only consider the
 

first year workload." So those last two
 

sentences will be removed.
 

MR. ELLIOTT: Yes, I think that would be
 

advisable. And here again, just so it's on the
 

record here and I'm clearly not trying to drive
 

you one way or another, this -- this is -- on the
 

previous one, the word that bothered me was
 

"extended", not "may". You know, you can't -­

it's got to be a discrete task, and you can just
 

reissue the task again once you have the
 

deliverables in your hand, and virtually have
 

them work the same task at a different time.
 

MR. GRIFFON: The only other thing I wanted
 

to note was on the last page -- really everything
 

in the middle is remain the same. The last page,
 

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179 

period of performance, is new. I'm sorry I
 

didn't leave these highlighted. I accepted the
 

changes. And reporting/deliverable requirements
 

is a new paragraph, as well. And I think in
 

there I reference this procedure that I gave to
 

everyone last night to look at, processing
 

individual dose reconstruction reviews. I was
 

going to give it a procedure number, but I think
 

we should just delete that at this point. We can
 

reference it by name.
 

DR. ZIEMER: Mark, are you suggesting that
 

where it says "Board number XX", that would just
 

be deleted from your document?
 

MR. GRIFFON: Yes. Yes.
 

DR. ZIEMER: In the very last paragraph.
 

MR. GRIFFON: Uh-huh.
 

DR. ZIEMER: It's just what would have been
 

an ID number. Right.
 

Okay. Questions or comments? Are you moving
 

adoption of this procedure -- or statement of
 

work?
 

MR. GRIFFON: Yeah, I think the working group
 

would make a motion to -­

DR. ZIEMER: On behalf of -­

MR. GRIFFON: -- to accept this -­

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180 

DR. ZIEMER: -- the working group -­

MR. GRIFFON: Yeah.
 

DR. ZIEMER: -- you're so moving. This
 

doesn't require a second. Comments, questions?
 

(No responses)
 

Mark, just for clarification because the
 

interview issue arose before, in this particular
 

document the interview item, which is on the
 

second page, it's item B, "Evaluate whether or
 

not NIOSH appropriately addressed the reported
 

work history" and so on, there's nothing in here
 

specifically that calls for post-claim
 

interviews, as such. This simply calls for a
 

review of the interview in terms of documentation
 

on hand. Is that not correct?
 

MR. GRIFFON: Yeah, that's correct. This
 

language was exactly as in the proposal.
 

DR. ZIEMER: Right.
 

MR. GRIFFON: So yes.
 

DR. ZIEMER: Okay. I raise that mainly so
 

that there's no question that -- the other issue
 

that we discussed can still arise later, but not
 

in the context of this document. This document
 

does not call for that particular procedure.
 

Yes, Roy DeHart.
 

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181 

DR. DEHART: Mark, isn't it correct that it's
 

only in the advanced review, which is on page 3,
 

advanced review -­

DR. ZIEMER: Use your mike there, Roy, if you 

would, please. 

DR. DEHART: My question addresses the 

advanced review. It is in this document item 2, 

page 3, that we first do the site profile. Is
 

that correct? That the basic does not do a site
 

profile, but this -- at this level, we do.
 

MR. GRIFFON: Yes, in the -- yes, this -- the
 

advanced looks at is the dose reconstruction
 

consistent with the site profile, so it sort of
 

ties those two together, right. The basic does
 

not go to that depth, that's correct.
 

DR. ZIEMER: Tony, another question or -- no? 

Okay.
 

DR. ANDRADE: Paul -­

DR. ZIEMER: Yes, Tony.
 

DR. ANDRADE: Perhaps I do have a question. 

With respect to the advanced review, on item B,
 

item 1 under B, it says "Evaluate the
 

effectiveness of the phone interview". As you
 

said, it really doesn't go into the specifics of
 

the procedure for doing so. However, this is
 

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kind of an -- what I would say an open-ended work
 

statement that's going to -- it's going to
 

require or probably going to get -- likelihood is
 

that the contractor will come back with a
 

question as to what -- a clarification of
 

effectiveness is, and I think we're going to get
 

back into the same discussion that we were
 

engaged in yesterday. So I just wanted to note
 

my concern with respect to this particular item
 

on the SOW.
 

DR. ZIEMER: Mark, do you want to respond to
 

that?
 

MR. GRIFFON: I mean just that it wouldn't
 

allow for the re-interviewing. They can do -­

they are required to evaluate the effectiveness
 

of it based on the documented phone interview
 

form, and that -- that's where it stops. They're
 

not allowed -- under this task they're not -­

they don't have the option of re-interviewing any
 

claimant. So you know, they -- they may have
 

some questions on what "effectiveness" means, but
 

you know, the option of re-interviewing is not
 

opened up there.
 

DR. ZIEMER: Tony, are you okay on that or
 

you feel it lacks clarity or...
 

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DR. ANDRADE: No, I'm satisfied with the
 

response. I do have a feeling we are going to be
 

handed requests for clarification, but that's
 

really the only point I had to make.
 

DR. ZIEMER: Okay. Roy DeHart.
 

DR. DEHART: There is one other way of
 

looking at the effectiveness. That is if the
 

interviewee responds, after reviewing what has
 

been documented from that interview, with a lot
 

of additional comments, and we see that
 

repeatedly, then something's faulty with the
 

interview process. So there's ways of looking at
 

that.
 

DR. ZIEMER: Jim?
 

DR. MELIUS: Another separate question. 

Regards the -- that -- the previous question
 

about site profile and the site profile only
 

coming up in the advanced review, did the task
 

group think -- I guess -- didn't really hear
 

about this in detail till after you met this
 

morning. Given that it appears that the site
 

profiles have become a sort of a basic procedural
 

document that are going to be used in all of -­

nearly all of the dose reconstructions, shouldn't
 

-- don't -- should we include that in the basic
 

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review, I guess is my question, since it's going
 

to be central to so many -- right now we sort of
 

evaluated against the procedures and other
 

procedures and so forth. To me, the site profile
 

is described -- has almost become a -- you know,
 

a standard procedure and that we ought to be
 

evaluating it and I think it would be relatively
 

straightforward to do that. I just can't see how
 

the -- how you can avoid doing it.
 

MR. GRIFFON: Yeah, I actually -- now that -­

I actually think it's going to happen, you know. 

I mean if -- if the site profile is working the
 

way we see the efficiency process working and
 

things like that, it's probably going to be
 

referenced in the bas-- in all the -- you know,
 

in all the dose reconstructions. And I guess -­

yeah, and we didn't know of this until, you know
 

-- so this is kind of new for us. But the other
 

thing is that for the -- for a more extensive
 

site profile review, we're going to have a
 

separate task, too. So we do have the chance to
 

review the site profile as a separate entity.
 

DR. ZIEMER: I might add a comment here, too,
 

Jim. I think that item A.2 of the basic review
 

opens the door for including the site profiles
 

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insofar as it tells the reviewer to review the
 

data used by NIOSH for that case. And indeed if
 

site profile was part of that, I think the door
 

is open for -- I don't think it's excluded, is
 

what I'm saying.
 

DR. MELIUS: Yeah, I think it actually fits
 

under several of these -­

DR. ZIEMER: Yes, right.
 

DR. MELIUS: -- as I'm reading through, and I
 

guess -­

DR. ZIEMER: It's not called out
 

specifically, but it certainly is -- if it's been
 

used, it's there.
 

DR. MELIUS: Yeah, okay. Right.
 

DR. ZIEMER: Yes, Larry.
 

MR. ELLIOTT: If I might make a suggestion on
 

page 4, item 3, blind dose reconstruction, I
 

think it would be beneficial if you would specify
 

who's going to select those ten. I know it's
 

implicit in page 1 down at the bottom there,
 

first -- or the last paragraph of page 1, but I ­

- it -- I think it should be clear that the Board
 

is going to make those selections, not your
 

contractor. You're going to -- somebody's going
 

to have to create these ten case files that are
 

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blind, and you don't want your contractor doing
 

that, I'm sure. And we're not going to do that,
 

I'm sure. See what I'm after?
 

DR. ZIEMER: You're talking about item 3 on
 

the last page, I believe.
 

MR. ELLIOTT: Item 3, page 4, blind dose
 

reconstruction. In that two or three-sentence
 

paragraph, I think you should be explicit as to
 

who makes those -- who selects those and prepares
 

them.
 

MR. GRIFFON: And it's not -- I mean we say
 

it up front, but you say we should restate it
 

especially for the blind -- the preparation of
 

the cases, as well.
 

MR. ELLIOTT: Well, I think it -­

MR. GRIFFON: Not only -- not only selection,
 

but preparation of the...
 

MR. ELLIOTT: I don't see it explicit up
 

front. I think it's implicit up front that the
 

Board is going to do it, but I -- you know.
 

MR. GRIFFON: Maybe it doesn't, okay.
 

DR. ZIEMER: Mark, I believe that certainly
 

was your intent.
 

MR. GRIFFON: Yes.
 

DR. ZIEMER: If it's not explicit here,
 

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perhaps a sentence could be added -­

MR. GRIFFON: Yeah, I think -­

DR. ZIEMER: -- to that.
 

MR. GRIFFON: -- we should add it, yeah.
 

DR. ZIEMER: Could we -­

MR. GRIFFON: I thought it was up front.
 

DR. ZIEMER: Yeah.
 

MR. GRIFFON: Re-reading...
 

DR. ZIEMER: Could we simply agree that an
 

appropriate explicit sentence would be added? I
 

don't know if it's to be up front or there. And
 

while you're thinking about that, Wanda, you have
 

another item?
 

MS. MUNN: Yes, I might address that one, as
 

well. Wouldn't it probably be cleaner to just
 

put it up front on the first page and say ten
 

blind review cases, specifically chosen by the
 

Board?
 

MR. GRIFFON: Actually even further than
 

that, I would say why don't we just add a
 

sentence at the end of that third paragraph on
 

the first page saying that the Board shall select
 

all cases for review, period. And that makes it
 

clear that the contractor's not.
 

MS. MUNN: All right.
 

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DR. ZIEMER: Is that agreeable? You're
 

adding that at the first paragraph on page 1?
 

MR. GRIFFON: Bottom of the third paragraph
 

on page 1, yes.
 

DR. ZIEMER: Give us the wording on that
 

again, Mark.
 

MR. GRIFFON: The Board shall select all
 

cases for review.
 

MS. MUNN: For this review or these reviews?
 

DR. ZIEMER: Okay? Wanda, do you want to
 

continue? Without objection, we're making that
 

modification. Okay.
 

You had another item then?
 

MS. MUNN: Yes. Originally I was back on
 

page 3, B.1 again, the concern that had been
 

expressed earlier with respect to what do we mean
 

by "effectiveness" and where we can go from
 

there. I might suggest a slight wording change
 

so that it would read -- since we can't expect
 

this contractor I think to actually verify
 

effectiveness, I don't know how you'd do that. 

Perhaps evaluate the completeness of the phone
 

interview and ascertaining that all relevant work
 

history information has been addressed. That's
 

really the best they can do, isn't it, to make
 

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189 

sure they cover the waterfront?
 

DR. ZIEMER: I suspect we're all a little
 

fuzzy on that. I'm not sure we know whether they
 

can evaluate the completeness, either. What -- I
 

guess it would come down to what do you mean by
 

the completeness of the phone interview.
 

MS. MUNN: We have the form identified. The
 

form is as complete as we can get it, in terms of
 

this is the material that needs to be covered
 

when you interview these folks. Now is the
 

material that's on the form that we've agreed is
 

going to be used adequately represented in the
 

report that NIOSH is submitting as its report of
 

this interview.
 

DR. ZIEMER: Well, anyone want to respond? 

It's -- maybe we need both words, "effectiveness"
 

and "completeness". Or maybe we just need
 

"evaluate the phone interview".
 

DR. MELIUS: I was going to say maybe we can
 

qualify it better by saying "based on the
 

available record of the phone interview and other
 

information in the case record, evaluate the
 

phone interview in ascertaining relevant work
 

history information". I think we -- I think if
 

we limit the -- what they're directed at rather
 

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than trying to describe the evaluation, I think ­

- I think it's easier.
 

DR. ZIEMER: What Jim is suggesting, I
 

believe, is that it would say "evaluate the phone
 

interview in ascertaining relevant work history
 

information".
 

DR. MELIUS: Based on -­

DR. ZIEMER: Do you want to add any
 

qualifiers or is that -­

DR. MELIUS: The qualifier I would add is
 

"based on the -- the record -- record of the -­

available record of the phone interview and other
 

information in the case record" -- 'cause they
 

would use other information from the case record,
 

so it's still a records-based review.
 

DR. ZIEMER: Without using words like
 

"completeness" or "effectiveness" or -­

DR. MELIUS: Completeness, right, or... 

DR. ZIEMER: -- which may have specific 

meanings. 

DR. MELIUS: And we're directing them at the 

ascertaining the relevant work history
 

information. That evaluation can include various
 

components, but I think if we circumscribe it to
 

just what's available in the record, I think
 

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we...
 

MS. MUNN: Then can we just simply say
 

"Evaluate the phone interview to ascertain that
 

all relevant work history information has been
 

addressed"? The simpler the better, I think.
 

DR. ZIEMER: Yes, that's a possibility. 

Tony?
 

DR. ANDRADE: As you'll probably see
 

tomorrow, you'll gather bits and pieces in
 

certain interviews, and especially when it's
 

survivors that are being interviewed. There may
 

be very little that has to do with the actual
 

claimant's work history. And so there's not
 

really going to be a validation or a vetting of
 

information in many instances on what the
 

interview -- what came out of the interview
 

versus other data that may be available, such as
 

a site profile.
 

MR. GRIFFON: Yeah, we do address the
 

survivor issue, as well, in the second bullet in
 

B, yeah. But I mean I think -- I think -- well,
 

actually I think the simpler the better. I'm not
 

sure I have a problem with the original language,
 

but if we have to say "evaluate the phone
 

interview in ascertaining relevant work history
 

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192 

information based on the phone interview record,
 

along with the relevant documents within the
 

administrative record", I think that'd be fine.
 

DR. ZIEMER: Well, I guess I would even
 

question whether we need all that -- how are you
 

going to evaluate the phone interview record if
 

you don't use the phone interview record? I mean
 

why do we have to say based on the phone
 

interview record?
 

MR. GRIFFON: I agree, you can stop -­

DR. MELIUS: I think we're -- we started this
 

out by questioning whether what -- a scope of
 

what we were doing, and so it -- try -- one issue
 

to try to circumscribe the scope, make sure that
 

it is on the record, and the second issue, which
 

is Wanda's, exactly what does the evaluation
 

entail.
 

DR. ZIEMER: Well, you know, in these other
 

evaluations, we're not spelling out in detail how
 

they're to be done. Part of what the
 

contractor's job is going to be is to develop
 

evaluation tools. Right? So why not let them do
 

that here, also? Eventually we will have to
 

approve those tools.
 

MR. GRIFFON: Yeah, the -- and I think your
 

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-- Paul, your suggestion, "evaluate the phone
 

interview", drop out "effectiveness of the".
 

DR. ZIEMER: Yeah, "evaluate the phone
 

interview in ascertaining relevant work history
 

information", boom.
 

MR. GRIFFON: Leave it at that, yeah.
 

DR. ZIEMER: Anyone object to the -- keep it
 

simple, as someone has suggested -- Wanda, I
 

guess -- and -- I mean we've not tried to tell
 

the contractor here how to develop all these
 

tools in the other stuff, so -- okay. Is that
 

agreeable?
 

(No responses)
 

Okay. So without objection, we will just
 

delete the words "the effectiveness of".
 

Now, are we making progress? Yes. Other
 

items?
 

(No responses)
 

Are we ready to take action?
 

(No responses)
 

It appears we may be ready to act on the
 

motion to approve the statement of work for
 

individual dose reconstruction reviews, with the
 

two minor modifications that -- one of which was
 

part of the original motion, the change in the
 

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last two sentences on page 1, and then this minor
 

change on the phone interview statement.
 

Okay. All who favor then this statement of
 

work -- oh, I'm sorry. Mike.
 

MR. GIBSON: We'd had some discussion earlier
 

on about the advanced review of the site
 

evaluations documents really wouldn't be an
 

advanced review, it'd be part of the process. Is
 

there -- do we want to delete "advanced review"
 

and add that into the basic scope on page 3, or
 

are we just considering the fact that that goes
 

along without saying?
 

DR. ZIEMER: Let me try to answer that, and
 

then maybe Mark can clarify. I think the
 

original question that was raised was sort of
 

along the lines of does the basic review exclude
 

site profiles, something like that. And I think
 

we agreed the answer was no, not necessarily. If
 

site profiles were used in those dose
 

reconstructions, that's open game for that
 

review. The advanced review is more specific in
 

calling for that site profile review, partially
 

because the advanced review in many ways is
 

looking at the administrative record in more
 

detail than the basics. But I think we believe
 

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that it's not excluded. Is that -- yeah. Are
 

you okay on that, Mike?
 

MR. GIBSON: Yeah, I just wanted to make sure
 

we're -­

DR. ZIEMER: Yeah, right. Right. Okay. Now
 

are we ready to vote then?
 

(No responses)
 

I think we are. All who favor the motion to
 

approve this statement of work on individual dose
 

reconstruction reviews, please say aye.
 

(Affirmative responses)
 

Any opposed say no.
 

(No responses)
 

And any abstentions?
 

(No responses)
 

Motion carries. Thank you very much.
 

Does the working group have any other items?
 

MR. GRIFFON: Yes.
 

DR. ZIEMER: Thank you. Please proceed.
 

MR. GRIFFON: Okay. The next item is really
 

a discussion item following up from yesterday's
 

discussion. And we -- this morning in our
 

working group meeting we asked NIOSH some
 

questions on the contracting process, and I had ­

- now that we have two tasks approved, this is -­

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you know, obviously we have to push these
 

forward. Larry answered one question, which is
 

that once the tasks are released to the
 

contractors, they'll probably have about two
 

weeks to respond -- didn't you say -- I'm not
 

trying to put words in your mouth.
 

Then the question, I guess -- we had some
 

questions, which I'm not sure if they were
 

procurement questions or FACA questions, I think
 

a little bit of both. What steps would be
 

involved from there on out and what would be the
 

time frame. And I think a discussion that we
 

have, which we couldn't really answer this
 

morning, was would the entire Board have to act
 

on any meetings with the contractor to resolve
 

scope or -- or to approve the task to move
 

forward, could a subcommittee take that role. 

And then further, could those -- would those
 

discussions require executive session. And so we
 

had some of those issues that we just didn't have
 

answers to but we think we need to raise them and
 

get answers fairly quickly so we can move ahead.
 

You have the answers?
 

MR. ELLIOTT: Okay. Well, I don't have the
 

answers, but we certainly captured, I believe,
 

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197 

between general counsel and staff this morning
 

that sat with you, the list of questions you
 

raised and we'll be pursuing the answers for
 

those very expeditiously.
 

MR. GRIFFON: I think what -- what we also
 

talked about this morning in our working group
 

was that we as a working group probably -- may
 

want to consider a meeting in Cincinnati, maybe
 

at -- for -- it probably wouldn't -- I mean if we
 

have one day to dedicate to this, we could iron
 

through the rest of -- some of this stuff and
 

then report back to the full Board and have, you
 

know, more final tasks like this to move through,
 

and also a clearer understanding of the process.
 

MR. ELLIOTT: Sure. 

MR. GRIFFON: I think that'd be a worthwhile 

endeavor. 

MR. ELLIOTT: We'll certainly support that 

and assist you in scheduling it. I also would -­

not to steer you in another direction, but I do
 

think it would be beneficial for you to come
 

forward with the task that speaks to the tracking
 

of your cases, but also this -- you know, I
 

hadn't thought of it until Dr. Ziemer mentioned
 

it, but the tools that you're going to -­

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evidently you want to review the tools and
 

approve the tools that are going to be used by
 

your contractor. And you may want to wrap that
 

up into one task, the tracking task, perhaps. I
 

don't know if it makes sense to do that or if you
 

need two tasks, but you're going to have to
 

specify at some point in time that you want to
 

see the tools and you want to approve the tools
 

and what those tools are to be, so maybe -- maybe
 

a full day -­

MR. GRIFFON: Yeah, we -- we -­

MR. ELLIOTT: -- you could get to all of
 

that, I don't know, but -­

MR. GRIFFON: Yeah, we -- I did take a stab
 

at an initial case tracking task, but in -- we
 

didn't even have time to discuss it in our
 

morning working group session. And part of what
 

I was thinking was the case -- the case tracking
 

task was going to do was I envisioned that -- and
 

I was looking at this along with the question of
 

case selection, and thought that a reasonable
 

task to ask the contractor to do up front would
 

be to work with NIOSH and establish a baseline
 

matrix of all the cases and laying out all the
 

parameters of interest for us -- the Board. Then
 

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once we have the baseline matrix, then we have
 

something to sample from, to get our cases from. 

And some of these things -- in informal
 

discussions I've noticed that some of these
 

things may not be simply there to pull off the
 

database -- there may be a little work involved
 

to get some of the parameters. You know, one
 

parameter we're considering is job group or first
 

decade employed is some other parameters we've
 

thrown out. So it may not be just something that
 

they can simply pull -- you know, so that would
 

be a sub-task for the contractor to develop would
 

be this matrix of cases versus -- versus the
 

various parameters, including site and all those
 

parameters we've discussed in the past.
 

MR. ELLIOTT: Did you also have a discussion
 

about the process of review itself? We need to
 

get a sense of how you see that running. And
 

maybe Jim's got this from your discussion, I
 

don't know. But you talk in the task orders
 

about selected Board members working with the
 

contractor in the review. Have you had
 

discussion about how that'll work and can you
 

share that with -­

MR. GRIFFON: Yeah, we -- the procedure that
 

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200 

we passed around last night was the first stab at
 

sort of outlining how that process is going to
 

work. You know, I think we -- we had further
 

discussions on that this morning involving the
 

question of -- of reports back to the full Board
 

and what they're -- you know, how we have to be
 

careful of Privacy Act issues on those public
 

reports. So that is -- and we could do that
 

next. I think we should do that next, you know,
 

but we did discuss that this morning.
 

DR. ZIEMER: Mark, I also want to make sure
 

that the Board goes into this with eyes open. If
 

you look at -- look at the last paragraph of what
 

you just approved on deliverables, and the -- 25
 

cases every two months is mentioned in here. I
 

looked at this in terms of Board panels. For
 

example, if we had three Board members per panel
 

plus a contractor, let's say, but -- and I don't
 

know what you're thinking in the working group,
 

but as an example, then each panel would have say
 

six cases every two months or about three cases
 

per month to review in detail. That would be
 

each Board member, four panels of three, for
 

example.
 

Or if you wanted a lighter load, you might
 

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have two Board members per panel with a
 

contractor. That means each panel would have
 

about four cases per month -- or per two months,
 

or about two cases per month, every Board member,
 

to review in detail. This is not a trivial task,
 

so what -­

MR. GRIFFON: No, and it's good to point that
 

out. I mean it's not a trivial task, it's -­

DR. ZIEMER: What were -­

MR. GRIFFON: -- it also is -­

DR. ZIEMER: What was the working -­

MR. GRIFFON: We're signing off -­

DR. ZIEMER: -- group thinking about?
 

MR. GRIFFON: -- on these, you know, so -­

DR. ZIEMER: The bigger the panel, the bigger
 

your workload. If you spread it out to smaller ­

- like two Board members per panel -- then you
 

lighten your workload.
 

MR. GRIFFON: Yeah, I mean we -- we can move
 

to that procedure. It does suggest -­

DR. ZIEMER: It's open-ended -­

MR. GRIFFON: -- two.
 

DR. ZIEMER: -- right now.
 

MR. GRIFFON: It does suggest two people per
 

-- it does suggest -­

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DR. ZIEMER: Right.
 

MR. GRIFFON: -- I think two members.
 

DR. ZIEMER: Right. Which I think gives you
 

about two cases per month that you would be
 

personally responsible for. Is that -- was that
 

your thinking? That's how it calculates out, as
 

far as I could see. Okay.
 

Tony, you had a comment or question and you
 

got cut off there, I think. Or did you?
 

DR. ANDRADE: Well, we were I think just
 

about to start discussing the process for case
 

selection, and I think we're -- we were focusing
 

in on the -- on the idea of developing a matrix
 

that would list the types of cases, basically,
 

that the contractor would be reviewing. I was
 

just going to suggest that, number one, I think
 

that a rough matrix has already been developed
 

and I think Mark actually took a stab at that. 

And indeed, given the dose reconstructions that
 

have taken place to date, you're not going to be
 

able to fill out that matrix in a way that really
 

starts to populate all of the areas. So I think
 

that -- in my judgment or in my opinion, in any
 

case -- it would perhaps be best to develop this
 

task, because we don't have to issue all the
 

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tasks at once, but develop this task over time,
 

perhaps developing this to a point where it can
 

really be released to the contractor, by the end
 

of the year when we expect to see several
 

facilities and site profiles developed and
 

thereby different types of dose reconstructions
 

done. So all I'm asking is that -- or what I'm
 

suggesting for consideration is that we might
 

think about this, defer discussion and develop
 

this task for issuance at a later date.
 

MR. GRIFFON: Can I take a stab at -- let me
 

just take a stab at first explaining the -- the
 

matrix I'm describing would be -- it wouldn't -­

there's two parts that I was suggesting, this
 

tracking and -- if it wasn't so raw I'd discuss
 

it here, but I didn't even circulate it to the
 

working group. Two parts, one would be develop
 

the matrix on the existing cases that -- that are
 

in NIOSH's system. And that doesn't mean just
 

approved cases, but all -- all the ones in the
 

hopper, sort of. And then the idea -- then the
 

second part of the contractor's requirement will
 

be to track -- so that -- and the intent here was
 

that we may have 300 or so coming from Savannah
 

River up front, and they may be the only ones in
 

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there. But we don't want to -- you know, we may
 

only want to sample certain ones of those, so
 

we'll only fill certain fields. And we may have
 

to slow down our review until we get other types
 

of cases. We don't want to over-populate in one
 

field or another. But I think it would be useful
 

up front to get a snapshot of what types of cases
 

are out there, and then we can refine our
 

stratified sampling strategy based on what -- you
 

know, what -- what the matrix looks like, the up
 

front 6,000 or so cases in the system look like. 

So that -- that -- it's kind of two levels of
 

that. And I thought they'd do the up front part
 

initially. And this tracking task is not ready
 

to -- you know, for the Board's approval now
 

anyway, so it would -- it would wait a little
 

here. 

DR. MELIUS: Yeah. 

DR. ZIEMER: Jim and then Roy. 

DR. MELIUS: Mark and I talked about this a 

bit last night, so -- the only place I'd differ
 

with what Tony was saying was I think that -­

it's not clear to me from looking at the database
 

getting my training yesterday morning that all
 

the elements that we may want to select on or
 

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track on are readily available for selection. 

And I think that -- I don't think -- I agree with
 

Tony, we're not going to be able to select until
 

the end of the year and we have everything -- you
 

know, enough cases completed out there to do
 

that. And I think Mark's right, given the way
 

they're being done in batches, it's not going to
 

be -- you know, we were sort of assuming it'd be
 

sort of a random group to be selecting from. 

They're not. They're going to be done in batches
 

and so that's going to complicate things even
 

further.
 

However, I think we may want to consider
 

either one of two things. Either one is an early
 

task for the contractor to go out and examine the
 

database, work with NIOSH and see how certain
 

information is available, what would be feasible
 

and easy to select on when we're choosing cases ­

- you know, what would be potential procedures,
 

so we don't develop a selection procedure that is
 

going to be very burdensome for -- to do, or
 

impossible. Or the alternative to that is the
 

task group, when you're meeting, if you have
 

time, is to do that 'cause I don't think it's
 

that complicated 'cause it's so much looking at
 

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the database structure, but -- seeing how it
 

might be done. But either one of those I think
 

would be helpful to do before the end of the year
 

so that when the end of the year we can then more
 

fully develop a way of selecting the cases. But
 

a lot of the information we want is contained in
 

documents within the database, so it's not easy ­

- necessarily easy to select from. There's also
 

problems with people with more than one type of
 

cancer and people that worked at multiple
 

facilities that complicate the -- some of these ­

- these issues. So you know, selecting someone
 

from Savannah River or whatever may not be as
 

easy as it may seem. And that may vary depending
 

on the site and so forth, so I think either of
 

those alternatives ought to be looked into. I
 

don't know whether we need to do it today or when
 

the work group meets, but I think it might be
 

helpful before we get going.
 

DR. ZIEMER: Roy and then Larry.
 

DR. DEHART: Trying to get a handle on when
 

the reality of having cases available for us
 

specifically to review, I think we need to
 

remember that these cases are cases that have
 

been finalized. I'm not sure whether that means
 

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finalized by Congress. Don't they have a period
 

of time to review, as well?
 

MR. ELLIOTT: Congress?
 

DR. ZIEMER: The cases may have a period of
 

time for appealing and there may be an issue
 

there. 

DR. DEHART: Somebody reviews -­

DR. ZIEMER: Is there -­

DR. DEHART: -- this case beyond us. 

DR. ZIEMER: Is there an appeal period after 

adjudication? 

DR. DEHART: So it -­

DR. ZIEMER: Sixty days after? 

MR. ELLIOTT: They can get actually to 60 

days. 

DR. DEHART: Yes. 

MR. ELLIOTT: But it's not -- Congress is not 

involved in this. You're confusing it with the
 

SEC process -­

DR. DEHART: Yes.
 

MR. ELLIOTT: -- I think.
 

DR. DEHART: So when would we anticipate
 

having cases ready to review then, for us, that
 

have gone through everything and the decision has
 

been made? First of the year, or is it even
 

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going into the winter?
 

MR. ELLIOTT: We're looking into that,
 

because there -­

DR. ANDERSON: First of the year is winter,
 

for many of us not from Tennessee.
 

MR. ELLIOTT: Recall that you're to re-- your
 

audit is to look at final adjudicated cases.
 

DR. DEHART: Right.
 

MR. ELLIOTT: Those that have achieved that
 

final status where either they've been deemed
 

compensable or non-compensable. And if they're
 

non-compensable, there's no -- evidently they're
 

-- you know, they're not in an appeal stage. If
 

they're in an appeal stage, that's still tied up.
 

DR. DEHART: That's correct.
 

MR. ELLIOTT: And there's -- there's some
 

issues associated with -- I'm just blanking on
 

the terminology, help me out here.
 

MR. NAIMON: Challenges in court?
 

MR. ELLIOTT: Well, challenges in court, but
 

there's the life of the claim, until it's no
 

longer -- what's -­

MR. NAIMON: Statute of limitations.
 

MR. ELLIOTT: Statute of limitations on the
 

claim, which is much too long, as we know it to
 

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be. Six years is too long for you to wait. 

Okay? So we've got to do a little homework and
 

we've got to coordinate with the Department of
 

Labor on this as to when a case has achieved a
 

point of adjudication that can be audited. Okay? 

So we're working that issue. I don't know if
 

that answers your question clearly or
 

confusingly, but we don't have a final answer
 

yet. We're working -­

DR. DEHART: It sounds like that we have
 

several months yet to -- before there's an issue
 

for us to -­

MR. ELLIOTT: Well, certainly we don't
 

anticipate compensable cases to be contested, and
 

so there are a number of -- you know, right now
 

we're -- I think we're around 45 to 47 percent
 

compensable in the number we have done. That
 

doesn't mean all those have reached that final
 

adjudication point. There's some of those still
 

in recommended decision. But by the end of the
 

year, yes, I think you'll have a goodly number to
 

look at.
 

DR. DEHART: Thank you.
 

MR. ELLIOTT: I would also like to comment
 

back on something Mark said a minute ago that -­

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what's in the hopper, not what's final, not -­

you know, let's take the number 13,500 that's in
 

the hopper right now to be done and -- to put a
 

matrix together. I don't believe that is your
 

contractor's work. That is our job. I think
 

that we have a robust data tracking system. Yes,
 

it does not right now drill down to some of the
 

things you want, and Dr. Melius knows this from
 

his training yesterday morning. This was a topic
 

of discussion we briefly had that right now we
 

can't produce a report from that system that says
 

how many lung cancer cases do we have for a given
 

site. I think -- well, we might be able to do
 

that, but it'll -- it takes a little bit of labor
 

right now, we -- so what I'm proposing is that
 

you come to grips with what you're matrix is
 

going to contain and tell us what those
 

parameters are that you want to see populated
 

eventually of what's in the hopper, and we'll
 

have our IT staff work to put that into place.
 

DR. ZIEMER: Thank you. Other comments? 

DR. MELIUS: Yeah. 

DR. ZIEMER: Jim. 

DR. MELIUS: I'll just follow up on that. I 

appreciate your offer to sort of change your
 

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database for our purposes, but I think it would
 

still work better if it were a little bit more of
 

an interactive process 'cause it may very well be
 

possible to select cases based on things that are
 

already in the database and not make extra work
 

for you in order to do that. At the same time, I
 

think if we did it sort of jointly in some way
 

rather -- that's -- may be things that would
 

serve your purposes, also. And it may turn out
 

that all these things would be helpful for you,
 

too, to have information on, so I still think we
 

should try to work together on it and coordinate
 

what we're -- what we're doing in that regard.
 

In regard to Roy's comment and so forth, I -­

we're going -- the work group may need to spend
 

some time on this, but I'm not sure we have to
 

wait until we get to 3,000 or 4,000 or whatever,
 

certainly for some of the early reviews and so
 

forth that -- you know, it may be a number
 

shorter than that that we're going to feel
 

comfortable sampling from. I think all of us
 

know that right now if we sampled randomly we'd
 

see a lot of Bethlehem Steel. And you know,
 

maybe it'll be -- next a lot of Savannah River
 

with Bethlehem Steel or whatever. But I still
 

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think there may be enough to certainly start a
 

review process short of having -- you know, maybe
 

it's a very small sample we'll take from that,
 

but I think we can get it going and I'm not -- I
 

worry that, given all the procurement and other
 

bureaucratic hurdles we have ahead of us that -­

I don't think we should count on we don't have to
 

do anything till next April, and I don't think
 

that's what you were suggesting, but that we, you
 

know, recognize that it -- we get the process
 

going and get things in place, it'll be easier.
 

DR. ZIEMER: Henry.
 

DR. ANDERSON: Yeah, I would suggest we have
 

a pilot phase and then we'll have a production
 

phase. In the pilot phase we don't need to worry
 

quite so much about the rigorous sampling
 

framework. I think with what we have, we ought
 

to get started as soon as we get the contractor
 

going and get some sense of -­

DR. ZIEMER: Right, some experience.
 

DR. ANDERSON: -- how we're going to do this
 

and what are the issues, because -- rather than
 

to try to spend a whole lot of up-front time
 

finalizing something that, once we start it, say
 

that this is unworkable. And then you're -- so
 

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let's start with some -- we may want to do a
 

batch of 25 or so and then have a month or two
 

delay while we process those.
 

DR. ZIEMER: Yeah, or even less. And I
 

think, Jim, what you were suggesting sounds very
 

much like a pilot program, anyway. Yeah. Other
 

comments?
 

MR. GRIFFON: Just to go back to that -- the
 

matr-- I mean we do have some draft parameters,
 

but I agree with Jim that when -- I would
 

volunteer the working group to come out soon, and
 

that could be one of the issues that we can take
 

up when we're sitting in front of the database
 

and thinking about this. You know, some
 

parameters -- it may get us to the same place,
 

I'm not sure, and if they're very difficult to
 

sort on, we could probably not -- necessarily
 

need to use, you know, those. So I think it
 

could be an interactive process.
 

DR. ZIEMER: Okay. Henry, did you put your
 

flag back up or is that -­

DR. ANDERSON: No.
 

DR. ZIEMER: -- just left over? Okay. Mark,
 

do you have other items then from the working
 

group to -­

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214 

MR. GRIFFON: Yeah, just to -- I think we've
 

sort of danced around it a little already, but
 

the procedure that went around last night, I
 

think it would be worthwhile to step through
 

that. This is the three -- three-page procedure
 

for processing individual dose reconstruction
 

reviews, which touches on some of the things
 

we've been talking about already, but -­

DR. ZIEMER: Do you have extra copies of
 

that?
 

MR. GRIFFON: No.
 

DR. ZIEMER: I had it 'cause I wrote my
 

comments on it -- that's all right. Does
 

everyone have a copy?
 

MR. GRIFFON: I can -- I can call out some
 

things from our discussion this morning that -­

you know, just -­

DR. ZIEMER: Sure.
 

MR. GRIFFON: And then give you more time to
 

read through it, but we -- if you look down at
 

the fourth bullet there, interface of Board and
 

contractors with relevant experts -- and I think
 

it goes on to say and individ-- or individual
 

claimants. I have a modified draft, so -- and
 

that interface with individual claimants, I think
 

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215 

that is something that -- that's still -- you
 

know, needs to be discussed and maybe it can be
 

deleted from this process and handled separately
 

and, you know -- so just to highlight you on
 

that, that's that re-interviewing question that
 

we have. If you -­

DR. ZIEMER: Did you say in your current
 

version you've actually deleted the individual
 

claimant state-­

MR. GRIFFON: I've highlighted it.
 

DR. ZIEMER: Oh, highlighted -­

MR. GRIFFON: I think from this process we
 

may, you know -- depending on how we want to
 

handle that -- that whole question, it may not be
 

part of -- you know, it's not part of the dose
 

review process right now, and this ties into the
 

dose review process.
 

DR. ZIEMER: Right.
 

MR. GRIFFON: So maybe it needs to be
 

deleted, yeah. Yeah. In section B we had a
 

fairly lengthy discussion on this. This brings
 

up the 25 cases every two months. I thought it
 

did say two, but apparently it does not say two
 

rotating members. It just says -­

DR. ZIEMER: There was no number there.
 

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216 

MR. GRIFFON: Right.
 

DR. ZIEMER: That's why I was trying
 

different combinations.
 

MR. GRIFFON: I guess it was in other
 

discussions that we said two, but -- I added on a
 

few sentences under this about some items that we
 

brought up in our working group discussion this
 

morning. One is that the Board needs a conflict
 

of interest plan related to our review work. And
 

the second thing was -- oh, that -- the second
 

thing was that -- this was the questions of the
 

privacy thing and the idea that these rotating
 

members could work with the contractor and have
 

in-depth discussions about individual cases. But
 

in the -- in the summary report that came to the
 

full Board meeting, we would have the -- Privacy
 

Act rules had to be adhered to and therefore
 

you'd only be presenting summary information and
 

nothing that could reveal the identity of an
 

individual claimant. So we highlighted that in
 

that section just to make sure.
 

We put -- we talked about a potential that if
 

-- you know, we said that it may go down this
 

path where other Board members that weren't the
 

designated two or three may start questioning,
 

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217 

and they may want more information about
 

individual cases, and we started discussing the
 

notion of, you know, would it be possible to go
 

into executive session for the full Board to
 

discuss individual cases where privacy -- you
 

know, where you were potentially talking about
 

identifiable information. So that -- that -- it
 

was sort of those items was the potential that we
 

could go into executive session to discuss
 

individual cases, as -- as -- as deemed necessary
 

by the Board. But generally the idea was that
 

the in-depth discussion would be between the
 

designated members for those cases and the
 

contractor. Then the summary report that came to
 

the full Board would be Privacy Act -- you know,
 

would only be general summary findings. It would
 

not reveal any privacy information.
 

DR. ZIEMER: Comment on that by Larry.
 

MR. ELLIOTT: Yes, I would like to comment on
 

that, just for your edification. It certainly
 

could happen that way, but to go into executive
 

session you'd have to have it announced in
 

advance. Certainly any Board member that wanted
 

to see any individual claimant's administrative
 

record, we could accommodate that, you know,
 

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218 

separately from the Board meeting. But to go
 

into executive session, there's -- we have to get
 

a waiver to do so and we have to announce it in
 

Federal Register notice in advance of such
 

happening.
 

DR. ZIEMER: Yeah -- and comment?
 

DR. MELIUS: That last, Larry, a question on
 

that, and maybe the attorneys can help, maybe
 

they can't. Can you have -- given the nature of
 

the work of the Board, have a provisional
 

executive session announced that it would be
 

included in the schedule and that for each
 

meeting we could have a hour set aside for -­

that would involve the review of confidential
 

information. We could specify what might be
 

entailed would be for this process.
 

MR. ELLIOTT: We're looking into that. It's
 

not only -- you know, it's FACA-related and also
 

legal-related, so we have to get some questions
 

answered, and we're working on that.
 

DR. MELIUS: I guess my ques-- I guess my
 

request is to look into that, that's all.
 

MR. ELLIOTT: And we are.
 

MR. GRIFFON: I guess that -- that was the
 

notion raised by that -- actually Roy brought up
 

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219 

that idea of having that standing -- having it be
 

a standing executive session, yeah.
 

DR. MELIUS: I didn't think I'd be original.
 

DR. ZIEMER: Proceed, Mark.
 

MR. GRIFFON: In section D, item D.3, again
 

this relates directly to the re-interviewing, and
 

I've highlighted it for potential deletion as it
 

applies to these dose reviews under this task
 

since we're not re-interviewing.
 

DR. ZIEMER: So item D.3 currently is being
 

deleted?
 

MR. GRIFFON: Yeah.
 

DR. ZIEMER: On item D, Mark, I wanted to
 

ask, where you say experts in item 1, and you
 

have, quote, experts.
 

MR. GRIFFON: Right. We don't define it, do 

we? 

DR. ZIEMER: Does that mean -- what does the 

quote mean here? For example, are workers 

considered experts in this context, 'cause that's
 

what you've listed, amongst other things. They
 

are experts in their own way -­

MR. GRIFFON: Yes, yeah, that was -­

DR. ZIEMER: -- was that the intent?
 

MR. GRIFFON: Right.
 

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DR. ZIEMER: That this is experts, considered
 

in a very broad sense.
 

MR. GRIFFON: Right.
 

DR. ZIEMER: People with -­

MR. GRIFFON: Shop floor, 30-year -­

DR. ZIEMER: -- special knowledge -­

MR. GRIFFON: -- experience and -- yes.
 

DR. ZIEMER: Okay, I just wanted to
 

understand the -­

MR. GRIFFON: Right.
 

DR. ZIEMER: Right.
 

MR. GRIFFON: In item E, number 4, I added a
 

similar line, but we also have to look into this
 

again, that the Board may consider a standing
 

executive session for more in-depth discussion of
 

individual cases, so that's item E.4.
 

DR. ZIEMER: I want to go back, though.
 

MR. GRIFFON: Okay.
 

DR. ZIEMER: And this may require legal
 

advice at some point, but can we legally go back
 

to any experts, whether it's workers or worker
 

representatives, and discuss any particular case
 

with them? And I just raise that in terms of
 

privacy issues. I can understand talking to
 

people about say site profiles. But if we're
 

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looking -- reviewing a case, John Doe, John Doe's
 

claim, in what way can we talk to a technical
 

expert -- or any expert -- on that claim?
 

MR. ELLIOTT: You can talk to them about the
 

generalities of the claim. You cannot speak to
 

them about the individual by name, Social
 

Security number. You could talk about
 

generalities like job title, years employed,
 

facilities worked in, those kinds of things. But
 

you can't reveal privacy information.
 

MR. GRIFFON: I think maybe we need to
 

clarify that, but that was the intent. It wasn't
 

about -- it wasn't intended to have meetings with
 

experts to discuss a particular case, but rather
 

background information related -- potentially
 

related to that case, without identifying the
 

individual.
 

MR. ELLIOTT: Right. When we go after
 

coworker interviews, we have to do so with a
 

waiver from the claimant.
 

DR. ZIEMER: Specific from the claimant.
 

MR. ELLIOTT: Right, and -­

DR. ZIEMER: But here you wouldn't be able to
 

do that.
 

MR. ELLIOTT: We wouldn't invoke that at this
 

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point.
 

DR. ZIEMER: So this would pretty well be
 

restricted to something that would look a little
 

more like site profile type of information -­

what kind of work was being done by -- you could
 

probably say by mill workers in some areas.
 

DR. MELIUS: (Off microphone) Target a site 

profile. 

DR. ZIEMER: Yeah, right. So it's in that 

context that -- if in fact you had to do this,
 

that it would be...
 

MR. GRIFFON: Just to continue -- is it all
 

right to continue on, Paul? Is -­

DR. ZIEMER: Sure.
 

MR. GRIFFON: E.6, I think it says on a
 

periodic basis, and to make that consistent with
 

the task that we just approved, I put on a semiannual basis.
 

Then on F.3, I modified that to say the full
 

Board, along with the contractor, will develop
 

semi-annual reports for HHS.
 

And then similar in G.3, corrective actions
 

in their semi-annual reports, the last sentence
 

in G.3.
 

DR. ZIEMER: Okay, are there other comments?
 

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MR. ELLIOTT: Could I make a suggestion on
 

the last one there where you're going to bring
 

recommendations to NIOSH? I would certainly hope
 

that if you find something in your audit that is
 

a deficiency that we could correct, you'd not
 

wait.
 

DR. ZIEMER: Right.
 

MR. ELLIOTT: You'd let us know. So maybe if
 

you could think about an edit to that sentence
 

that would allow you to report sooner than -- you
 

know, at whatever time information becomes
 

available or...
 

DR. ZIEMER: The intent particularly would be
 

for corrective action recommendations should be
 

made in a very timely fashion.
 

I want to ask again on this procedure, Mark,
 

it's probably not so critical that this
 

necessarily be approved today, but we at least
 

want some preliminary indication from the Board
 

that this is going in the right direction, that
 

it's covering what we want and so on.
 

I want to raise an idea for people to mull
 

over and cogitate with respect to the issue that
 

you've currently deleted here and that's the
 

issue of the interviews. It seems to me that -­

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well, I have had a personal objection to the idea
 

of going back and talking with people after cases
 

were closed, and tried to think about how we
 

might accomplish the evaluation of the interview
 

process that we talked about without having to go
 

back and interview people after the fact. And
 

recognizing at the same time that NIOSH would be
 

very concerned about taping all interviews and
 

that kind of thing, here's an idea to think
 

about.
 

What if NIOSH were to consider taping or
 

recording or transcribing a small fraction of the
 

interviews, perhaps two to three percent, on a
 

random or similar basis, so that, for their
 

purposes, there could be an internal quality
 

control and for our purposes there could be a
 

record for which -- against which the summary
 

interviews could be in fact compared. The idea
 

then would be that the burden of recording
 

everything would be decreased to a very small
 

level -- and again, NIOSH would have to consider
 

this and see whether it's feasible. We would
 

have a specific record of the interview against
 

which summaries could be compared.
 

Now it seems to me that this could meet our
 

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needs as well as being actually somewhat useful
 

to NIOSH in showing that they have in place an
 

additional quality review process. In fact, I
 

guess I would argue -- and I think we heard
 

counter-arguments before. I would argue that
 

this would help NIOSH in cases where appeals
 

occurred.
 

In any event, that's the idea I wanted to
 

float and to get -- kind of get a reaction from
 

people, both staff, Board members, as to whether
 

or not that would be a -- a way of coming at this
 

thing without having to open the cases in the
 

sense of going back to workers and reinterviewing them after the fact, which we said
 

was only for the purpose of validating or
 

evaluating the review -- or the interview
 

process, in any event.
 

So now that -- you all have stunned looks on
 

your faces, but I -- and maybe -- maybe you just
 

want to cogitate on that and think about it and
 

react next time. Henry?
 

DR. ANDERSON: I thought we'd talked about
 

that or made that as an option or a proposal
 

earlier and it was -­

DR. ZIEMER: I don't recall.
 

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DR. ANDERSON: Maybe it was in the work-­

maybe we just talked about it, but I -­

MR. GRIFFON: We talked about transcripts,
 

but not -- blanket, I guess, was really -­

DR. ZIEMER: I'm talking -­

DR. ANDERSON: Yeah, I mean I would -­

DR. ZIEMER: I'm talking about a very small
 

sample of approximately two percent, which could
 

serve our purposes as -­

DR. ANDERSON: I would think that would -­

DR. ZIEMER: In fact -­

DR. ANDERSON: -- that would work.
 

DR. ZIEMER: In fact, one could take that
 

sample and do a separate study -- audit the
 

interviews -- aside from the case audits.
 

DR. ANDERSON: Right, yeah, I mean that -­

DR. ZIEMER: 'Cause not ever case that we
 

audited would have -­

DR. ANDERSON: Right.
 

DR. ZIEMER: -- necessarily such an
 

interview, but one -- one could even do a
 

separate audit study.
 

DR. ANDERSON: Sure.
 

DR. ZIEMER: It's just an idea. Okay. Jim. 

Oh, Henry, you still on? Okay. Jim.
 

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DR. MELIUS: As you probably know, I feel
 

very adamant that we should be going back and reinterviewing. I think it's a valuable source of
 

information. But I also think -- I know other
 

people feel just the opposite and I think that we
 

ought to be exploring alternatives like that as
 

part of our -- my concern is the -- we need a
 

process to make sure that the interviews are
 

collecting the appropriate necessary information
 

and that there needs to be a -- both an internal
 

process within NIOSH for continuing to improve
 

those interviews and gather more information, as
 

well as our ability to review that. My position
 

that we need to go back and re-interview would
 

certainly be modified or could be modified,
 

depending on what NIOSH's own process was for
 

monitoring, as well as improving, you know -­

steps to improve the interview process. So I
 

think something like that certainly is worth
 

exploring, if it can be. As I said, following -­

I mentioned it before, it was sort of rejected
 

out of hand, so we really haven't explored that
 

and certainly be willing to do that.
 

I'd also think that maybe something that -- I
 

don't know whether it's part of Mark's group or
 

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whether we want to set up another working group
 

that might really focus in on this whole issue,
 

not just from the perspective of the -- of our
 

review of the process, but what could be done to
 

improve the interview process, and maybe have
 

that group report back to -- to the Board. There
 

may be altern-- if not -- strongly objects or
 

cannot do this recording, then maybe there are
 

other alternatives that ought to be looked into
 

and we ought to be -- I think if we had a work
 

group we might be able to, you know, explore
 

those, present those and have a more complete
 

discussion of this issue.
 

DR. ZIEMER: Okay. Wanda?
 

MS. MUNN: It occurs to me that such a record
 

might also be helpful to us early on in
 

determining whether there is some trend with
 

respect to the reaction of people who are being
 

interviewed relative to the completeness of the
 

questions that they're being asked. If, for
 

example, in the first half-dozen interviews you
 

have two or three people who say well, why didn't
 

you ask me about something, then that might, as
 

you said, serve as an additional quality
 

assurance flag for NIOSH and as an information
 

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item for us, as well. If we don't have negative
 

reactions from potential claimants to having that
 

done, it seems to me that it would -- would serve
 

multiple purposes and probably save a great deal
 

of time. Re-interviewing sounds like a very
 

tedious and very touchy item to me.
 

DR. ZIEMER: Incidentally, this could only be
 

done I think with the interviewee's knowledge. 

That is, they would have to be told that -- well,
 

as I would envision it, it would be one of those
 

things where both the interviewer and the
 

interviewee would be told that the interview may
 

be taped or recorded for quality purposes. But
 

it would be important that the interviewer not
 

know that it was that -- that specific interview
 

was being taped, and also that the interviewee
 

had the option of saying I do not wish my
 

interview to be taped. I think that would be
 

important.
 

MS. MUNN: Or conversely, if the interviewee
 

chose to record the conversation themselves, they
 

could -- they would be free to do so.
 

DR. ZIEMER: I think we heard yesterday that
 

that may already be happening. Okay. Yes,
 

Larry.
 

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MR. ELLIOTT: If I could, I'd like to offer
 

another option for your consideration, keeping in
 

mind that it's an audit that you're performing,
 

an audit of the process, an audit of the quality
 

control and quality assurance measures that we
 

have in place. We welcome that. I want that. I
 

want to know where we're deficient and I want to
 

improve. If you hear resistance in my voice, as
 

you've heard before, I'm not happy about going
 

back to claimants after the fact and interviewing
 

them. I have never said it's off the table, but
 

I've almost said that. I'm almost saying that
 

right now.
 

The offer I would make to you is, as part of
 

your audit, you and your contractor could observe
 

the interview process, follow it through to the
 

end. There's down sides to that, as well. 

There's perhaps advantages. So I just offer that
 

for your thinking.
 

I would also encourage staff and counsel to
 

speak their minds about this issue because there
 

has been considerable discussion, debate,
 

concern. And as the person who identified
 

interviews as something that I wanted in this
 

program, I am very much interested in seeing us
 

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do the best that we can with interviews. There's
 

no requirement in the statute for interviews. 

This came from me. And I'm not trying to toot my
 

own horn here, but as an industrial hygienist, I
 

believe that the experts on the shop floor should
 

be heard. I believe that a worker who worked
 

within a process, whether that's a reactor
 

operator or an electrician or a painter or
 

whatever, we should hear how they viewed their
 

work experience. And that's the interest that I
 

had in making sure that we had this interview
 

opportunity. People can make a lot out of it or
 

they can belittle it. We've had some gains and
 

some advantages and some benefits from the
 

interviews that we've conducted. In many cases,
 

we've not. But in those that we have, I think
 

it's beneficial that we do it and we do it right.
 

So I encourage you to think about this. I
 

encourage you to think of ways that we can do
 

this and perform your audit that will identify
 

ways that we can improve the process without
 

touching the claimants after the fact. I just
 

don't see any benefit or good to doing that.
 

So again I've spoken my mind. I wanted you
 

to hear that. I encourage staff to speak up. 

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Staff and counsel can identify issues that they
 

know of associated with not only going back to
 

claimants after the termination of the case is
 

made, but also with regard to taping everybody,
 

taping two percent, what have you -- whether it's
 

you observing. I'm sure there are issues they
 

can identify with that, as well as you can. So
 

thank you. I encourage you to consider the
 

options available here and keep pursuing this
 

because I want to hear where we can improve.
 

DR. ZIEMER: Mike Gibson.
 

MR. GIBSON: I appreciate Larry's position on
 

that, and if I understood Dr. Ziemer right, this
 

two or three percent would be all that our
 

contractor may be re-listening to after the fact. 

And if I understood Larry right, it would be
 

maybe a Board member and one of our auditors or
 

something would sit in on the conversation. And
 

it seems to me that, based on the reaction we've
 

heard from a lot of the public, that that may
 

intimidate them even more. I mean I've felt
 

reactions like they're up here blaming the Board
 

for what's going on instead of -- not the system
 

we're trying to implement. And it looks like to
 

me it may intimidate them even more in being
 

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forthcoming with information. It's just a -- my
 

thoughts.
 

DR. ZIEMER: Larry, you were talking about
 

having Board members there observing the phone
 

conversation. The presence of those Board
 

members would have to be made known to the
 

interviewee, as well, perhaps, I suppose.
 

MR. ELLIOTT: Well, you know, I -­

DR. ZIEMER: Well, we don't know -­

MR. ELLIOTT: I obviously haven't -- I
 

haven't thought through this myself, and we have
 

had Board members, as you know, some of you have
 

observed some of the interviews, overheard them,
 

sat with the interviewee and the interviewer. I
 

think it would take perhaps some legal review to
 

determine whether or not -- in order to prevent
 

bias of the interview process -- that you could
 

do this, you know, on line without the
 

interviewer or the interviewee knowing. I don't
 

know if that can be done or not as part of your
 

audit. Maybe it could be done with a simple
 

statement at the start of each interview that
 

this -- and we are -- we are -- in our process,
 

we are listening in to interviews for quality
 

purposes. So you know, we could look into that
 

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if that's an option that you want to pursue and
 

you think you're interested in. But it'd take a
 

little more work and thought I think to put into
 

play -- as any one of these options would.
 

DR. ZIEMER: Robert?
 

MR. PRESLEY: I really don't think that it
 

would -- that the people would be intimidated by
 

it. I actually think that some of them out there
 

might be glad to have a Board member listen to
 

where that they would know that we were taking an
 

interest in something that they were doing or
 

saying. I don't -- I don't think it would
 

intimidate people at all.
 

DR. ZIEMER: Thank you. Henry?
 

DR. ANDERSON: I guess what -- one thing that
 

would be helpful is when -- right now NIOSH is
 

already sitting in on some of them for quality
 

control. Are notes taken? Do you parallel fill
 

out the form? I mean going through the interview
 

form that's now kind of on line and the database,
 

clearly there's a lot more discussion that went
 

on between the interviewer and the interviewee
 

that gets converted into a check box. And I
 

guess one of our issues in the audit would be
 

that kind of winnowing process, was that done
 

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consistently and appropriately. One way to
 

evaluate it is if the individual writes back
 

saying gee, I told you about XYZ and you didn't
 

include it. That is easy -- you can easily see
 

that.
 

On the other hand, if somebody's listening in
 

and is parallel filling out the form or writ-­

taking notes, then if those notes were available,
 

you'd be able to make those comparisons versus
 

passively listening, which would be more is the
 

person's demeanor appropriate, are they
 

belittling the person or are they being
 

supportive and are they good interviewers. That
 

clearly is -- you know, a NIOSH activity more
 

than us, are they doing it -- but if there were
 

notes, that I guess is -- and does the
 

interviewer take notes besides just on the CATI
 

system or how -- how is that done? I mean it's ­

- I guess our concern or my concern is about
 

potentially information lost, that you're
 

listening to this interview and you're writing
 

down what you think is important and somebody
 

else might view -- that's information that, boy,
 

because you have special knowledge, is useful.
 

MR. ELLIOTT: Well, I think all of that would
 

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-- would be examined in your audit and would be
 

evaluated appropriately. And certainly, you
 

know, what -- whatever quality assurance process
 

that we have, as well as -- we look at quality
 

control being different than quality assurance. 

Quality control is as you're working through,
 

developing a product, you make efforts and take
 

steps to assure your quality is in control. At
 

the end of the process, you evaluate has your -­

is the quality that you wanted to achieve there,
 

you assure your quality at the end. And all of
 

that certainly would be fodder for your review
 

and the audit.
 

Let's be clear on one thing, though. The
 

claimant controls this. The claimant has the
 

opportunity to come back and say hey, I told you
 

about this and you didn't capture it in my
 

report. And you can see how many times those
 

edits have been made to make corrections based
 

upon claimant interest. I think it's there. I
 

think you need to go through the process of the
 

audit, the practice of the audit, figure out what
 

areas we can improve upon and where we're
 

deficient and certainly be very much welcome of
 

that.
 

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DR. ZIEMER: Tony?
 

DR. ANDRADE: Thank you. Larry, the first
 

order, I think you're absolutely correct. That
 

type of analysis is easily done and should be
 

done and should be part of the independent review
 

process here.
 

However, I really like your idea about
 

perhaps observing and/or sitting in on -­

listening in on conversations in which the
 

interviewee has agreed and would really like to
 

have a Board member sitting there. I think both
 

Bob and Mike are correct. There's going to be
 

some people that are just not going to be
 

comfortable speaking to two people. And in other
 

cases, there are folks that would just love to
 

tell their story to the world.
 

So if we could have two independent set of
 

note-takers, as the idea was raised, and have
 

those notes compared at the end, I think that
 

goes into the second order -- level of
 

information that would perhaps give us some
 

indication as to whether one person is biased in
 

taking down certain types of information rather
 

than -- as opposed to the other.
 

DR. ZIEMER: Yeah. Tony, let me make sure
 

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that I understand your comment with respect to
 

individuals welcoming a Board member being
 

present. It seems to me we do not want either
 

the interviewer or the interviewee to know
 

specifically that the conversation is being
 

audited. That has -- that can have the potential
 

of perturbing the system that you're trying to
 

check. An audit, to me, has to be blind to that. 

We don't want interviewers behaving differently
 

because a Board member's on line than they would
 

otherwise -- being nicer, being more thorough or
 

whatever it may be. So -- and so I thought I
 

heard you say that there would -- might be two
 

people asking questions. I think it would
 

perturb the system to have Board members asking ­

- or maybe I misunderstood.
 

DR. ANDRADE: I'm sorry, yes, let me clarify
 

that. First of all, the situation would be
 

presented to the interviewee as you might
 

possibly be -- or information might possibly be
 

taken by two people, and one being a Board
 

member. And then you go through the normal
 

interview process, but you have the second person
 

taking down their own set of responses. Okay?
 

DR. MELIUS: Two comments. One is back to
 

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the idea of parallel interviews or listening in,
 

whatever. I think when we discussed this before
 

at a meeting, the concern came up about this
 

issue that we were only going to be auditing
 

completed cases, and these would not be -­

obviously be completed, so it would involve a
 

change in that directive parameter in our audit
 

process, so we'd have to think through that.
 

And I don't want to cut off discussion of
 

this, but I do think we're going to need -- I
 

think setting up a work group to look into this,
 

look into what current practices are, look into
 

the alternatives and what would -- could be done
 

legally, what can be done programmatically and
 

what would satisfy everybody involved. I think
 

it would be helpful to get this moved along
 

'cause it's a contentious and it's a difficult
 

issue to resolve.
 

MR. NAIMON: I'm not here to give any instant
 

legal opinions, but -- no, there are no such
 

things as instant legal opinions. I just thought
 

I would mention to you some of the issues that
 

are involved in -- we looked -- at some point we
 

looked at taping in great detail. I think
 

listening in may have -- may all have some of the
 

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same issues. Dr. Ziemer mentioned that the
 

validity would be significantly helped by the
 

fact that someone was listening in not being
 

known to the interviewer or the interviewee. 

There would be a significant legal question in
 

some states as to whether that's possible. And I
 

think as a practical issue, when you're dealing
 

with these different laws in different states,
 

that you probably don't want to get into a
 

situation where you are picking at which places
 

you're listening in on and which places you're
 

taping, based on where the interviewee is
 

geographically located.
 

If we did have tapes for even a sample of the
 

interviews, they potentially would have to be
 

added to the administrative record for that
 

claim. You also would have the possibility the
 

claimants, when asked for their permission, would
 

ask for copies of those tapes and so there would
 

be an issue of providing those copies. There
 

will be, for some people, a chilling effect to
 

the idea that something is being recorded or
 

listened in. For other people, obviously, they
 

might like the idea that it's being recorded or
 

someone listening in. I think that varies a lot
 

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based on the individual person.
 

The states that have the most significant
 

requirements when it comes to taping, there's one
 

state in particular that has a requirement that
 

every party on the phone call give its consent
 

and give it on tape, so essentially what you
 

would have is you'd have to have each person who
 

participates say that it's okay with them, and
 

then you'd have to go turn the tape on and say it
 

again in order to verify that each person has in
 

fact -- has in fact said it. And I think that
 

would also be a protection for us in this case
 

that -- you know, the consent would be very
 

thoroughly noted so there's no issue later as to
 

-- as to what that is.
 

So Dr. Melius was correct that this is a -­

this is a very complicated question. I just
 

thought you'd want to hear what some of those
 

factors are.
 

DR. ZIEMER: Thank you very much. Other
 

comments? It wasn't my intent that we solve this
 

today, and in fact simply wanted to get some
 

ideas on the floor that at least get us thinking
 

about some options so that we -- otherwise we
 

were going to be very polarized. It was sort of
 

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an all or nothing kind of thing and there are
 

some options here that could be explored by a
 

subgroup or something like that. Jim.
 

DR. MELIUS: Can I formally propose that we 

do a subgroup? 

DR. ZIEMER: You certainly can do that. The 

Chair will recognize you for that purpose. The
 

Chair recognizes Jim has proposed a subgroup to
 

explore possible options for the purpose of
 

conducting the audit of the interview process.
 

Does that capture -- I think that -­

DR. MELIUS: Yeah.
 

DR. ZIEMER: -- that it -- are there any
 

objections to having such a work group? I'm just
 

-- 'cause the Chair's empowered to appoint work
 

groups. Richard?
 

MR. ESPINOSA: I'm in second on the motion.
 

DR. ZIEMER: Okay. It doesn't actually I
 

don't think require a motion, but if I have -­

the sense of the Board is that we should proceed
 

with a work group. And as I say, the Chair is
 

empowered to do that. I would be pleased to have
 

interested individuals volunteer to be part of
 

the work group. Rich is interested, Tony's
 

interested, Jim's interested, Wanda. There's
 

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four right there.
 

UNIDENTIFIED: How many can we have?
 

DR. ZIEMER: Five would be an upper limit -­

Mike is interested. Okay. Okay, that will
 

compose -- comprise the work group, and we can
 

ask the work group to report at the next meeting. 

We need some staff support on that probably, as
 

well, and -­

MR. ELLIOTT: Do you have a Chair for that?
 

DR. ZIEMER: I'm thinking about -- yes, we
 

definitely have a Chair, I just don't know who it
 

is at the moment. Does anyone want to volunteer
 

for that job or I am glad to appoint somebody?
 

DR. MELIUS: (Off microphone) I'd be glad to
 

volunteer for that (inaudible).
 

DR. ZIEMER: Okay, Jim has volunteered and
 

you have -- you have the names of the colleagues. 

And I would ask the work group to keep the Chair
 

of the Board in the loop on your deliberations. 

I also have an interest in this, but I'll let you
 

folks deliberate on your own, but I do want to be
 

kept in the loop on this.
 

Larry, is there a person on the staff that
 

can assist them? There may be -- or at least be
 

available to address legal/technical issues that
 

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might arise?
 

MR. ELLIOTT: Yes, we'll certainly make a
 

staff person available. I'm not sure yet -­

right now who that would be, but general
 

counsel's also at the ready to help this work
 

group, so David Naimon and Liz Homoki-Titus will
 

avail themselves of the work group.
 

DR. ZIEMER: Okay. Well, the formal charge
 

to the work group will be to explore potential
 

options that the Board can consider for the
 

purpose of auditing the interview process. And
 

I've expressed it that way because I think it
 

might be helpful if we had before us maybe more
 

than one possible option. You know, what are the
 

pros and cons of doing it this way versus doing
 

it this way and maybe a third way. But I think
 

it's important to be somewhat creative on this. 

We need to keep in mind -- I think we need to be
 

sensitive to all the issues. We sort -- you know
 

what issues we all have with each other and the
 

issues the staff have, and I think if we're
 

creative enough, we can find a solution that
 

satisfies all of our needs. The Board has
 

certain requirement. NIOSH has some certain
 

desires. We want to -- we want to be able to do
 

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this in a way that's helpful to both -- all
 

groups involved.
 

If we find a good process, I hope it's one
 

that will also be helpful to NIOSH that they can
 

use internally for whatever sort of improvement
 

and -- continuous improvement that they might
 

find useful as part of the process.
 

Now we -- let's see, we don't require any
 

formal action on that. The work group is
 

appointed and it has its charge and Henry and
 

then Richard.
 

DR. ANDERSON: I just had a question for
 

NIOSH. Since we heard that some of the claimants
 

are already recording, do they say anything on
 

the phone that they're going to record? Do they
 

ask or -- I mean do you know -- I'm just -- this
 

is just a point of information.
 

And then the other question is how many have
 

more than one person sitting with them to assist
 

them with their interview on the other end of -­

is that identified in any way?
 

MR. ELLIOTT: I can't answer either question
 

for you here today.
 

DR. ANDERSON: Yeah.
 

MR. ELLIOTT: It was news to me yesterday
 

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that the interview was taped. My first query to
 

folks -- to staff was go find out whether or not
 

it's recorded on the interview itself that it was
 

taped.
 

I can't honestly answer your second question,
 

either, sitting here today. I don't have those
 

details in front of me. We do know that a number
 

of people -- particularly on the survivor side -­

have people sit with them, people who are hard of
 

hearing, people who can't sit for longer than an
 

hour or who don't understand some of the
 

questions, there've been a goodly number,
 

perhaps, of those people having others sit in on
 

the interview. And we do take their names. We
 

know who -- you know, we identify who else is in
 

the room participating in the interview.
 

DR. ZIEMER: Rich?
 

MR. ESPINOSA: Yeah, over this issue, I'd
 

like to make the recommendation that labor unions
 

and advocacy groups be able to -- that we solicit
 

their comments, as well, on this phone interview.
 

DR. ZIEMER: I'm not sure -- and from a
 

practical point of view, how are you suggesting
 

this be done? I certainly glad -- we would
 

certainly be glad to have input, but are you
 

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suggesting a formal process of soliciting
 

comments or -­

MR. ESPINOSA: I think it could be done by
 

the working group over this issue, but groups
 

like the Los Alamos Project on Worker Safety, I'm
 

sure that they would have a big input on how the
 

phone interviews are going so far and what they'd
 

like to see done, whether they wouldn't mind
 

being recorded, as well as a lot of the other
 

labor unions like PACE -- sheet metal workers,
 

iron workers.
 

DR. ZIEMER: Okay, I understand what you're
 

saying. I'm trying to think of how practically
 

this could be done. It would seem to me that if
 

-- if it's to be done, you'd have to -- you
 

couldn't exclude -- you can't just do Los Alamos,
 

so it's kind of an all or nothing. And I guess ­

- I guess -- I'm concerned about the practicality
 

of this -- getting formal input from many groups. 

Those that are -- work more closely with labor -­

Jim, do you have a suggestion?
 

DR. MELIUS: Well, I guess I would just say
 

that maybe our working group, when we present
 

options to the Board, would -- one of the things
 

to be considered was did NIOSH or the Board go
 

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out and solicit more general input on this issue,
 

so that could -­

DR. ZIEMER: After you've -- after you've
 

developed some options?
 

DR. MELIUS: Options, and so when we come
 

back for discussion, maybe that's something we
 

could, you know, bring up in the appropriate
 

context -- may be something that NIOSH should be
 

doing or has done. You know, they may have
 

gotten comments and that may be -­

DR. ZIEMER: How does that sound to you, 

Rich? 

DR. MELIUS: -- and so we -- we consider it. 

I think that's fair.
 

MR. ESPINOSA: Yeah, that -- that hits right. 

That's fine.
 

DR. ZIEMER: At some point where we knew what
 

the options were -- I don't think at this point
 

we want the idea to float out there that we're
 

proposing to record all interviews again, 'cause
 

that wasn't what -- that's not at least what we
 

talked about here, so perhaps waiting till we see
 

what the options are might be helpful. Good. 

Thank you.
 

Wanda, you had a comment?
 

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MS. MUNN: (Off microphone) No, if we're
 

going to do it in task, that's fine.
 

DR. ZIEMER: Okay. Mark, I'm kind of back to
 

your original document here. I think what we
 

just discussed doesn't necessarily change what
 

you have here at this point. Depending on the
 

outcome from this other work group, you may have
 

some minor modifications, but that -- that could
 

be handled readily. Okay.
 

MR. GRIFFON: Yeah, I think we've separated
 

it out.
 

DR. MELIUS: Before we got talking about
 

interviews, my suggestion was going to be that we
 

give our -- I don't know if we want to call it
 

approval, but our general agreement with this
 

document as a sort of a structure for -- for what
 

it's intended to do and so forth, to the extent ­

- and sort of ask the working group to go on to
 

work with NIOSH and so forth, just sort of fill
 

in some of these issues. There are some privacy
 

issues, some FACA issues and so forth that need
 

to be dealt with and that -- that as long as
 

we're in general agreement with the -- what's in
 

here, that -- and that we have not identified any
 

other issues that we feel would -- that we ought
 

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to -- maybe we ought to have enough permission to
 

go back and start working with NIOSH with the
 

understanding that this would be not necessarily
 

fully approved yet -­

DR. ZIEMER: All right. How about a motion
 

for provisional approval of the draft document?
 

DR. MELIUS: Just what I was thinking.
 

DR. ZIEMER: I know this is a very unsanitary
 

way of speaking, and that's taking the words out
 

of other people's mouths, but we've done that,
 

have we? Okay. That's the motion.
 

Is there a second?
 

DR. DEHART: Second. 

DR. ZIEMER: Okay, seconded. Thank you. 

Discussion? 

(No responses)
 

All in favor of accepting the draft as a
 

provisional -- provisionally accepting the draft
 

on the procedure for processing individual dose
 

reconstruction reviews, please say aye.
 

(Affirmative response)
 

Any opposed?
 

(No responses)
 

And any abstentions?
 

(No responses)
 

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The motion carries. Thank you.
 

We have three sets of Board minutes to
 

approve. You were hoping I would forget that. 

Right?
 

MR. GRIFFON: I was just going to ask one -­

and this is sort of a process thing, too, but one
 

question for the working group. If I was
 

considering coming to Cincinnati September 1st,
 

2nd, 3rd, sometime in that time frame -- it's
 

only two weeks away, but I think we need to be -­

the contract's going to be awarded soon, we
 

think, I think we have to work with that in mind. 

And also whether any of those dates would work or
 

not work with NIOSH's staff.
 

UNIDENTIFIED: September 1st is Labor Day.
 

MR. GRIFFON: September 1st?
 

UNIDENTIFIED: Is Labor Day.
 

MR. GRIFFON: Is Labor Day, oh, I'm off by a
 

week. Oh.
 

DR. ZIEMER: Might I suggest that the work
 

group just work this out separately? Okay.
 

ADMINISTRATIVE HOUSEKEEPING AND BOARD WORK SCHEDULE
 

The Chair will now entertain a motion for
 

approval of the summary minutes of the 14th
 

meeting, which is the meeting of March 28th.
 

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MR. PRESLEY: So moved.
 

DR. ZIEMER: Is there a second?
 

UNIDENTIFIED: Second.
 

DR. ZIEMER: Are there any additions or
 

corrections to the minutes?
 

(No responses)
 

If not, all who favor approval say aye.
 

(Affirmative responses)
 

Any opposed, no?
 

(No responses)
 

Any abstentions?
 

(No responses)
 

Motion carried. The minutes of the 15th 

meeting on May 1st. This was a teleconference 

meeting. 

MR. PRESLEY: Move approval.
 

DR. ZIEMER: Move approval. Second?
 

MS. MUNN: Second.
 

DR. ZIEMER: Additions or corrections?
 

(No responses)
 

All in favor, aye?
 

(Affirmative responses)
 

Any opposed, no.
 

(No responses)
 

Abstentions?
 

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(No responses)
 

Motion carries. The minutes of the 16th
 

meeting held May 19th and 20th.
 

MS. MUNN: Move they be accepted. I've
 

provided a couple of typos -­

DR. ZIEMER: Yes, typos and so on, just pass
 

on to Cori. Motion to accept the summary minutes
 

for that meeting -­

UNIDENTIFIED: Second.
 

DR. ZIEMER: -- has been seconded and -- any
 

additions or corrections?
 

(No responses)
 

All in favor of accepting those minutes, say
 

aye.
 

(Affirmative responses)
 

Any opposed?
 

(No responses)
 

And abstentions?
 

(No responses)
 

The motion carries. Thank you. We are 15
 

minutes early on the public comment period -­

well, okay, next meeting, while Cori's getting me
 

the list.
 

(Pause)
 

MS. HOMER: Why don't you guys throw out some
 

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254 

dates and I'll tell you whether they're
 

available.
 

MS. MUNN: How about mid-October?
 

MS. HOMER: Mid-October?
 

DR. ZIEMER: Well, first of all, we -- we can
 

ask the question as to whether there is a need to
 

meet in September. The -- we're thinking that
 

the contract award may come around the first of
 

October, apparently. Is there a need for any
 

Board action prior to that, Mark?
 

MR. GRIFFON: I just can't see us being re-­

I mean the work group -- I'm going -- probably
 

going to have some other dates other than Labor
 

Day now, but I mean we're going to try to meet
 

early September, so I would say early October or
 

mid-October for the next Board meeting in case we
 

need full Board approval on tasks or whatever.
 

DR. ZIEMER: Okay.
 

MS. HOMER: There isn't a single week in
 

October that there's not at least two people
 

unavailable.
 

DR. ZIEMER: Okay. Did everybody hear that? 

There's no weeks in October where -- where at
 

least two people are out each -- each time. Is
 

that correct?
 

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MS. HOMER: That's correct.
 

DR. ZIEMER: How does early November? Is
 

that getting too late? We may have to go -­

MS. HOMER: Same thing.
 

DR. ANDERSON: What about 6th or 7th?
 

MS. HOMER: What dates?
 

DR. MELIUS: 6th or 7th.
 

MS. HOMER: 6th or 7th? Tony's not available
 

on the 7th.
 

MS. MUNN: I'm not available 6th or 7th.
 

DR. ANDRADE: What day is the 7th?
 

MS. HOMER: It's Friday.
 

DR. ANDRADE: I can make myself available.
 

MS. HOMER: Okay. And Wanda, you said you
 

weren't available -­

MS. MUNN: No.
 

MS. HOMER: -- on the 6th?
 

MS. MUNN: Neither the 6th nor the 7th.
 

MS. HOMER: Okay.
 

MR. GRIFFON: Can we look back at October, or
 

are people sure they can't switch -- I mean I
 

know we don't have a week free, but maybe people
 

can -­

MS. HOMER: The first week of October Jim and
 

Henry are unavailable the 1st and 2nd and Dr.
 

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DeHart is unavailable the whole week. The second
 

week of October Tony is unavailable on Friday,
 

Jim's unavailable all week, Roy is unavailable
 

all week and there are two staff unavailable on
 

the 6th.
 

DR. ZIEMER: How about the third -- how about
 

the week of the 12th?
 

MS. HOMER: That week is pretty much wiped
 

out. It looks like you guys are going to have to
 

rearrange your schedules.
 

MS. MUNN: The 20th?
 

DR. ZIEMER: Yeah, there's several people
 

unavailable that week, aren't there? What about
 

the week of the 19th?
 

MS. HOMER: Henry's unavailable the 22nd
 

through the 24th, Tony's unavailable the 24th and
 

Jim is unavailable the whole week. The last
 

week, Henry is unavailable all week, Gen is
 

unavailable the 27th and 28th. It looks like the
 

-- maybe the 29th through the 31st we could get
 

by.
 

DR. ANDERSON: (Off microphone) I'm wiped out
 

the 30th and 31st, that's (inaudible).
 

DR. MELIUS: I'm okay the 27th and 28th.
 

MS. HOMER: Okay.
 

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DR. MELIUS: Actually that whole week -- that
 

got canceled, so -­

MS. HOMER: Oh, it did? Okay.
 

DR. ZIEMER: So 27th and 28th, who's not
 

available?
 

MS. HOMER: Jim -­

DR. MELIUS: No, I am available.
 

MS. HOMER: He is available now. Henry's not
 

available the whole week.
 

DR. ZIEMER: Henry is not available the 27th
 

and 28th. Is -­

DR. MELIUS: Actually I'm not available the
 

27th. I'll be available the 28th and 29th.
 

DR. ZIEMER: 28th and 29th, but some -- Roy,
 

you're gone the 29th?
 

DR. DEHART: No, I'm good the 29th.
 

DR. ZIEMER: The 28th and 29th -- Henry,
 

you're -- you're not available at all that week.
 

DR. ANDERSON: Yeah, I'm on vacation in Italy
 

and I'm not giving that up.
 

DR. ZIEMER: Well, that's -­

DR. ANDERSON: I'll call in, though.
 

DR. ZIEMER: Okay -­

MR. ELLIOTT: Do we know Leon's availability? 

Did he contribute here?
 

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MS. HOMER: I did not get a response from
 

him.
 

MR. ELLIOTT: Okay.
 

DR. ZIEMER: First week in November again?
 

MS. HOMER: First week in November?
 

MR. ESPINOSA: What was wrong with the last
 

week in September?
 

DR. ZIEMER: Of September?
 

MS. HOMER: Jim's unavailable the 30th and
 

Roy's unavailable the whole week.
 

MR. GRIFFON: (Off microphone) And I'm not
 

available.
 

DR. ZIEMER: Mark's not available.
 

MS. HOMER: Oh, okay.
 

DR. ROESSLER: What about the week of the
 

22nd of September?
 

MS. HOMER: Henry's unavailable and Jim is
 

unavailable.
 

DR. ROESSLER: Are you in Italy then, too?
 

DR. ANDERSON: No, I'm fishing in Alaska.
 

DR. ZIEMER: What week was that, September -­

MS. HOMER: The last week of -- well, I have
 

the last week of September the 28th, 29th and
 

30th -- or the 29th and 30th.
 

DR. ROESSLER: But we were talking about the
 

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22nd.
 

MS. HOMER: Yeah, the 22nd, Henry's
 

unavailable, Tony's unavailable on Friday, Jim's
 

unavailable the whole week and Roy's unavailable
 

the whole week.
 

DR. ZIEMER: First week in November?
 

MS. HOMER: First week in November.
 

MR. ELLIOTT: I appreciate the Board's
 

interest to have all members present, but keep it
 

in mind that to conduct the business of the Board
 

you don't -- you only have to have a quorum.
 

MS. HOMER: Yeah. Okay, first week of
 

November, Henry's unavailable Monday and Tuesday,
 

Jim's unavailable Monday and Tuesday, so that
 

leaves the 5th, 6th, and 7th.
 

MS. MUNN: I'm unavailable the 7th.
 

MS. HOMER: That's right, Wanda's unavailable
 

the 7th.
 

MS. MUNN: 6th and 7th.
 

MS. HOMER: 6th and 7th.
 

DR. ZIEMER: It looks to me like we only lose
 

one person then October 28th and 9th. Right? 

Is that correct?
 

MS. HOMER: Uh-huh, that's correct.
 

DR. MELIUS: What if we just went the extra
 

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week and -- we're just delaying a week to do the
 

5th and 6th.
 

DR. ZIEMER: I thought the 5th and 6th we had
 

more people missing.
 

DR. MELIUS: No, just -­

MS. MUNN: We do have more missing. I'm not
 

here.
 

DR. MELIUS: Oh, I thought you just said the
 

7th.
 

MS. MUNN: No, I travel on the 5th.
 

DR. MELIUS: Oh, I'm sorry.
 

MS. MUNN: The 6th and 7th I -­

DR. MELIUS: I'm sorry.
 

MS. HOMER: For the 6th and 7th, Wanda would
 

be unavailable.
 

DR. ZIEMER: Is that the only one?
 

MS. HOMER: That's it.
 

DR. ZIEMER: So on the 28th and 29th one
 

person unavailable, 5th and 6th one person
 

unavailable. Any preferences? We could go
 

either.
 

DR. MELIUS: Figure out the location and then
 

just some logistics. Where are we going to have
 

the meeting?
 

MS. HOMER: Yeah, we need to know.
 

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DR. ZIEMER: We don't have to be in
 

Cincinnati for any reason at that point, do we?
 

DR. MELIUS: I'll propose St. Louis for the
 

location. We talked about that before and -­

continued interest and...
 

MR. ELLIOTT: Looks to me like, from my
 

perspective, the 28th and 29th would be best. I
 

-- the 6th and 7th -- and the next week is not
 

good, so...
 

DR. ZIEMER: Let's try 28th and 29th of
 

October. Any objection to St. Louis? Very
 

central location. Bob?
 

MR. PRESLEY: Do we need to be going back to
 

Washington any time?
 

DR. ZIEMER: D.C.?
 

MR. PRESLEY: Yes, sir.
 

DR. ZIEMER: Do we -­

MR. PRESLEY: That was discussed at our last
 

meeting. I mean...
 

MS. HOMER: It's up to the Board.
 

DR. ZIEMER: We don't need to, specifically. 

St. Louis is a potential site where we might have
 

some worker interaction, so I think that
 

certainly meets our intent. Any -- Cori, if you
 

would check on St. Louis and see if -- what's
 

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available on the 28th. Is that agreeable? Any ­

-

MR. ELLIOTT: Give us an alternate.
 

DR. ZIEMER: Alternate date or alternate
 

city?
 

MR. ELLIOTT: Alternate city.
 

DR. ZIEMER: Alternate city?
 

MS. HOMER: San Francisco? Santa Fe?
 

DR. ZIEMER: What about other locations near
 

sites? We've been to Oak Ridge, we've been down
 

to South Carolina. We haven't been to Richland.
 

DR. MELIUS: Yeah, Hanford's one we should go
 

to.
 

MR. ELLIOTT: Idaho.
 

DR. ZIEMER: What, Hanford in October?
 

MR. PRESLEY: We've talked about Texas.
 

MS. HOMER: I would suggest that the later in
 

the season we get, the bigger the city we want to
 

get into.
 

MS. MUNN: Yeah, but October's nice.
 

MS. HOMER: Is it?
 

DR. ZIEMER: In Hanford? Uh-huh. Hanford,
 

back-up site? Okay.
 

DR. MELIUS: Henry'll be disappointed. He
 

loves flying into Hanford.
 

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DR. ANDERSON: Boy, I gotta tell you, yeah. 

That makes it a four-day meeting, one day out,
 

one day back.
 

DR. ZIEMER: Thank you.
 

MS. MUNN: My heart bleeds for you.
 

DR. ZIEMER: Thank you.
 

MS. MUNN: It's easy to get to Richland from
 

there. The hotel will come get you.
 

DR. ZIEMER: Okay, we've agreed to St. Louis
 

on the 28th and 29th of October, with a fall-back
 

position at Hanford if St. Louis cannot
 

accommodate us in the manner to which we are
 

accustomed. Is that right? Okay.
 

DR. ANDERSON: Do you want to pick another
 

date -- I mean the next meeting?
 

DR. ZIEMER: The next meeting beyond that? 

Yeah, right. Well, we probably -- if we meet end
 

of October, we're probably talking about -­

MS. HOMER: Possibly early December?
 

DR. ZIEMER: -- early to mid-December. Most
 

people don't like to schedule meetings beyond the
 

middle of December.
 

MS. HOMER: The week of the 7th of December
 

looks great.
 

DR. ZIEMER: Let's get it scheduled then. 

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All days are open?
 

MS. HOMER: All days are open.
 

DR. ZIEMER: The week of the 7th -- 9th and
 

10th? 9th and 10th of December. Meeting
 

location? Something a little more southern than
 

Hanford? Amarillo near the Pantex site?
 

MS. HOMER: Amarillo? Okay?
 

MS. MUNN: Let's do Amarillo.
 

MS. HOMER: An alternate?
 

DR. MELIUS: San Francisco.
 

DR. ZIEMER: Let's see, have we been near
 

Rocky Flats? Oh, yeah, we went to Denver, right. 

Okay, we were in Denver. Are there other
 

locations that have... What did you write down?
 

MS. HOMER: Amarillo.
 

DR. ZIEMER: Okay. We had a lot of
 

alternatives kicking around for a fall-back
 

place, but...
 

MS. HOMER: Idaho Falls has jet service.
 

MR. ESPINOSA: Albuquerque.
 

DR. ZIEMER: Well, of course we were in Santa
 

Fe, so I'm not sure that -­

MS. HOMER: That's pretty close. I don't
 

know if you want to mix things up a little bit or
 

not.
 

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DR. ZIEMER: Anything in terms of Berkeley or
 

Lawrence Livermore? Berkeley and Livermore are
 

there. 

DR. MELIUS: Sizeable -- that's come up 

before. 

DR. ZIEMER: How many claims do we have out 

there, a lot? A small number.
 

MR. ELLIOTT: Over all the California sites,
 

not even 1,000.
 

DR. MELIUS: How many we have from Pantex?
 

MR. ELLIOTT: About 1,000.
 

MS. HOMER: Would you like me to use one of
 

the other identified cities as a fall-back? 

Wherever we don't have the meeting?
 

MS. MUNN: What about Nevada?
 

MR. ELLIOTT: Let me offer something here. 

The number of cases we have per site shouldn't
 

drive where we go. In fact, I would argue that
 

for a site like Pantex where we're worried about
 

the cases coming out of that site, or Hanford
 

where we can't seem to get people to sign up -­

or DOL can't get people to sign up -- it makes
 

some sense to go. So it could go the other way. 

I mean, you know -- you know.
 

MS. MUNN: Isn't Nevada a reasonable back-up
 

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for Amarillo?
 

MS. HOMER: That time of year it'd be nice in
 

Vegas.
 

MR. PRESLEY: You've got 400 and something
 

claims at the test site.
 

DR. ZIEMER: Okay, test site.
 

MS. HOMER: Okay?
 

DR. ZIEMER: Thank you. 

PUBLIC COMMENT
 

We're right on schedule for public comment
 

period. Our first commenter will be John
 

Alexander, Center for Worker Health and Safety
 

Education, I believe, in Cincinnati. And John?
 

MR. ALEXANDER: First off, I work at the
 

ICWUC Center for Worker Health and Safety
 

Education here in Cincinnati, and I'm the United
 

Steel Workers of America liaison there. I travel
 

all over the country teaching health and safety,
 

including many of the places that you had up on
 

the screen here yesterday and today.
 

And there was one item that I wanted to at
 

least give my opinion on. I don't know what
 

that's worth, but before I do that, I want to
 

thank you for all the work that you guys are
 

doing. I think it's wonderful that you are doing
 

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what you're doing and I believe it's something
 

that's certainly necessary, and it sounds like
 

it's an astronomical feat, but it's certainly
 

needed.
 

I hope I get these names right because I'm
 

going to comment on some of the things that were
 

said and what I think about those things. Dr.
 

Toohey -- is that right, the fella that was
 

sitting right over there? When he gave his
 

presentation he talked about the committee and
 

who's involved in the investigations, and I
 

believe Dr. Melius brought up the point about
 

conflict of interest. And then I think it went
 

over to -- I've got to put my glasses back on
 

here -- Brother Gibson and he brought up the fact
 

about there should be some craftsmen involved in
 

some of this discussion. And then it bounced
 

back around and then later on today -- this
 

afternoon Dr. Melius brought up about union
 

representation and then Richard brought up about
 

union representation again.
 

Now when Dr. Till gave his presentation -­

and actually last night after I watched yesterday
 

afternoon and listened to what was being said, I
 

had a lot of stuff I wanted to say today, but I
 

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think Dr. Till hit on a lot of the points that I
 

wanted to make and believe me, it was very
 

refreshing to hear him speak and the way he
 

eloquently covered the points. And I just -- and
 

I'm sure that he had just as much effect on you
 

folks as he had on me, and he certainly made some
 

very good points. And I think he identified a
 

few deficiencies that I was picking up yesterday,
 

just being here a half a day.
 

And one of them is who the committee is, and
 

Dr. Toohey -- I forget who exactly asked the
 

question, but they asked why the committee didn't
 

consist of -- with another representative -­

union representative or representative of the
 

employee or someone on the Committee, and his
 

answer was because of the cost.
 

Now, you know -- I mean what we're doing here
 

is we're trying to -- that was what he said, it
 

had to do with the cost. And you can check your
 

minutes on that. I was paying pretty strict
 

attention to this.
 

But anyway, this is an investigation for
 

people to be compensated who've been injured,
 

possibly been injured. I mean that's what all
 

this is about -- right? -- to determine whether
 

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or not they have.
 

Now just for your information, I found that
 

-- and I was trying to look for the right
 

adjective so I wouldn't insult anybody, so I'll
 

just stay I found it very unsettling that they
 

didn't have the union representatives of the
 

people involved in these committees where they're
 

doing these investigations 'cause I am a union
 

representative. I was the chairman of health and
 

safety for 15 different plants at one particular
 

time before I became a full-time instructor. And
 

believe you me, if you aren't investigating some
 

of the situations that took place in our
 

facilities, I know I could add a lot of
 

information to what actually happened as opposed
 

to what some of the people there would tell you
 

what happened. So -- so I'm certain that that's
 

the case in many of the situations of these -­

these incidents that you're checking into.
 

But just out of curiosity, at lunchtime today
 

I went to one of my colleagues who's retired from
 

the government 20 years and I asked him this
 

question. I said if -- if you found out that you
 

had been overexposed to something and you
 

possibly had a disease because of that, and a
 

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committee was going to be formed to determine if
 

in fact that exposure is what caused your disease
 

and you were to be compensated for it or not, who
 

would you want on that committee. And his first
 

answer -- he thought a little bit. He said well,
 

I'd sure want my union representative there. And
 

I started chuckling a little bit at that because
 

he had no clue what I'm attending here or, you
 

know, or what you guys are doing here.
 

And then I said well, who else would you want
 

on that committee? And he said well, the one
 

person I wouldn't want on there is my company's
 

safety representative. He says and then I would
 

want an outside source doing the investigation.
 

Now when you compare that to what Mr. Dewey
 

said -- or Toohey, who is on the committee, that
 

really makes you kind of wonder. And I went to
 

another colleague and I asked the same question. 

He said there's only one person I'd want to make
 

sure wasn't on there. And I said who is that? 

And he said the company health and safety
 

representative.
 

Now the reason I'm bringing this up is
 

because something that Dr. Till said. He said
 

that what you're doing here, you should try to
 

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have a program that can withstand the scrutiny of
 

certain people looking at it and when it's all
 

done to say whether or not it was done correctly,
 

or whether or not it can withstand scrutiny. Now
 

it would appear to me that you're missing a very
 

vital point here, and it was brought up by some
 

of the own people -- your own people on your
 

panel, and when I listened to when you went over
 

your work goals or statement of work or whatever,
 

nowhere in there does it say anything about
 

having the person's representative contacted or
 

discuss the incident, but it does say any
 

important information or whatever the exact
 

verbiage is on there, to reconstruct an exposure.
 

Now let me tell you, from my own personal
 

experience, that would include the union health
 

and safety representative, where in fact there
 

are unions. You did bring up the one point that
 

the one facility doesn't have -- but they do have
 

union personnel there, but not very many. But
 

even there I think I'd want to talk to the union
 

personnel.
 

Remember, cost -- if -- and I just -- cost
 

shouldn't be an issue here, very much. I mean
 

it's an issue in anything, but cost is probably
 

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one of the key issues that got us here in the
 

first place. And my job is to go out and prevent
 

from happening what has happened here in the past
 

today. And we still have the same battle going
 

on and cost is one of the key things that gets us
 

in these kind of predicaments. Everybody's
 

trying to figure out how to do the job the least
 

expensive way and not protect the workers the way
 

they should be. And so I don't think that cost
 

should prevent this committee from having a union
 

representative on the committee who's part of the
 

committee to figure out what actually happened in
 

some of these incidents.
 

So if you're going to have a program that's
 

going to withstand scrutiny, the one flaw that
 

I've seen -- and I'm not sure that there's not
 

other ones, I don't know. But the one flaw that
 

I've seen that sticks out sorely from yesterday
 

and today's conversations here is that, that's
 

what's lacking. So that's my opinion. You can
 

do whatever you want, but I really do think you
 

need to reconsider the verbiage that you have
 

here to -- to ensure that you're actually finding
 

out what did happen. And if you're really going
 

to give the benefit of the doubt to the worker,
 

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as Dr. Till said -- and he gave a perfect
 

example, the one -- the guy with the airplane,
 

the mechanic -- right? He said they were giving
 

the benefit of the doubt to the worker, but did
 

they really? I mean the first cut, they said he
 

wasn't exposed. And if it wasn't for his own
 

persistence, it doesn't sound like there would
 

have been a second reconstruction, would there? 

And on the second reconstruction, they determined
 

he still wasn't exposed because they really
 

wasn't giving him the benefit of the doubt. And
 

it wasn't till the third reconstruction that they
 

actually did figure out what did happen.
 

So you know, if it's going to be difficult on
 

some of these -- and I'm sure it is, on some of
 

them -- I would think if you're going to do an
 

investigation, you would want all parties
 

involved. And all parties who were involved in
 

maybe some of those incidents. Or otherwise
 

you're losing a very valuable asset. And that's
 

all I wanted to say. Thank you.
 

DR. ZIEMER: Thank you very much, John, for
 

those comments. Ask if any of the Board members
 

have questions for John?
 

(No responses)
 

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274 

Okay, thank you. Eula Bingham is here today. 

Dr. Bingham is from the University of Cincinnati
 

Medical Center. Dr. Bingham, pleased to have
 

you, as well.
 

DR. BINGHAM: Thank you. I have a couple of
 

points, some of them really are similar to what
 

Mr. Alexander said. The one is a point of
 

clarification, and I guess this slipped by
 

somebody, but I work with a group -- I'm a member
 

of a team and John Dement*'s a member of that
 

same team, and Knute Ringen* heads it up, and we
 

have examined over 2,000 workers at Savannah
 

River. They've been interviewed. They've had
 

medical exams. And they're all members of
 

unions, over a dozen unions at Savannah River. 

They are in that category of building trades. 

They're carpenters, they're operating engineers. 

We have an office there that brings in the people
 

to interview them for the worker history. The
 

office is run by Charles and Glenda Jernigan. 

Charles is an electrician by trade, still a
 

member of the union. And Glenda, I'm proud to
 

say, is an operating engineer. So I do think
 

that there are people there who know that
 

facility very well.
 

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Documentation was one of the issues that Dr.
 

Till brought up, and I would encourage -- for the
 

site profiles and anything else that's done -­

that you need documentation. It's really at the
 

heart of good science. And you're going to be
 

judged on that.
 

Interestingly enough, the example that I'm
 

going to give to you about documentation has to
 

do with Savannah River. I didn't plan it that
 

way, but that's what -- the first one that came
 

to mind. When we were doing our investigations
 

and coming up with a site history about three
 

years ago, we went to Savannah River and met with
 

some of the people there. I was not at that
 

particular meeting, but some of our -- the rest
 

of our group was there. And the issue of whether
 

or not -- how many LPTs, lymphocyte
 

transformation tests, we would do for beryllium
 

came up. They said well, you know, there's no
 

beryllium here, never was any beryllium here.
 

We had a meeting with individuals down there,
 

many of whom were -- had to do with health and
 

safety, actually occupational disease, as a
 

matter of fact. Some were DOE employees and some
 

were contractors. And they said oh, don't worry,
 

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there's no beryllium here.
 

We said well, you know, we've got five people
 

who are double positives on LPT tests. So they
 

allowed as how it was probably from the
 

fluorescent light bulbs. Somebody allowed to
 

them that we -- they thought Harriet Hardy had
 

done away with that 30 years ago or longer.
 

I will say that John Dement and I went back
 

to Savannah River and did a site visit, and they
 

still claimed that there was no beryllium there. 

We continue to have positive tests, positive
 

sensitizations, and the production workers have
 

them, also. So I hope that when NIOSH or the
 

contractor gets information from a site, they
 

will document the source, because some of your
 

sources will tell you whatever is convenient. 

And not just at Savannah River, all over. So to
 

CYA, you better document your sources or somebody
 

is going to find egg on your face in those site
 

profiles. Thank you.
 

DR. ZIEMER: Thank you very much, Dr.
 

Bingham. Any questions?
 

(No responses)
 

Okay. Our next person -­

MS. HOMER: It's Richard Miller.
 

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DR. ZIEMER: Oh, I couldn't read the -- it's
 

Richard Miller. Richard. No, I couldn't -- I
 

wasn't wanting to recognize him.
 

MR. MILLER: It's how I sign my checks. Take
 

note and put it on the web.
 

Good afternoon. I would just very briefly
 

like to underscore the question and discussion
 

that came up regarding conflict of interest. You
 

know, I sensed almost like the temperature went
 

up in the room slightly when the discussion was
 

raised about the -- just the mere disclosure or
 

providing transparency on the potential
 

professional conflicts of interest that might
 

arise from those performing site profiles. One
 

response was well, it's not in our contract. 

Another response was we didn't require it in our
 

contract. And you know, this is a program which
 

prides itself on transparency and openness and
 

making sure things are documented and having an
 

open process for folks to come in the room. And
 

this was the first time I had ever heard
 

resistance to transparency. And I puzzled over
 

it and I'm not sure I fully understand it, but
 

let me offer some observations.
 

The first is is that it appears from just
 

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these limited -- the technical basis team report
 

-- the report that Dr. Neton made which listed
 

those doing the 11 I guess site profiles, if you
 

go down the list you can kind of see why some of
 

these firms might readily be disqualified an
 

individuals from doing dose reconstructions under
 

the conflict of interest criteria that's in the
 

ORAU contract. In fact, they probably would be
 

disqualified because they are experts in
 

litigation defense and they would fall out on
 

that basis, at least with respect to certain
 

sites.
 

I had the pleasure of being on the other side
 

of one of these experts at a site -- Oak Ridge K25, Auxier & Associates -- and Auxier here is
 

listed as doing the K-25 technical basis
 

document. Now although it's a Special Cohort
 

site, obviously there's going to be a number of
 

claims that arise that are not SEC cancers. And
 

I puzzled to myself and I looked at the Fernald
 

site -- and of course Auxier was also the defense
 

expert in the Fernald litigation, which was -­

you know, led to the Fernald settlement. And I
 

remember when Auxier was brought in in the Joe
 

Harding* case. I mean they've got a lot of
 

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experience and they've -- they've been heavily
 

relied upon. I don't know about you, Dr. Ziemer,
 

but I imagine when you were there they were
 

heavily used by the general counsel's office for
 

a number of claims against the Department. And
 

so I can see why people are a little bit on edge. 

Mel Chew, a very reputable guy, but you know -­

great expert witness used in defense cases and
 

that -- and for his firm and was used -- is to
 

this day being retained, as I recall, in the
 

Marshall Islands defending the Fund. And I don't
 

know what all of the other activities are because
 

we don't have disclosure on it, but it would
 

seem, if the sensitivity is that there's
 

something that probably doesn't reflect well, the
 

answer to that is not to kind of do what DOE did
 

all these years was to put it in a drawer and
 

claim national security or it's in a -- you know,
 

critical proprietary information related to a
 

procurement or, you know, they have an array of
 

an excuses. And I don't know that that's the
 

right way to go about this.
 

Now there's really two issues that seem to -­

that tier from this. The first is transparency
 

and the second issue is what do you do if you
 

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find something really objectionable. And there's
 

probably a third one which I mentioned to Dr.
 

Neton earlier, which is as a manager managing
 

these site profiles, you should be able to at
 

least know that if you have contractors working
 

for you, you should know what filters they're
 

operating with, what -- either explicit or
 

unintentional, but you know, their basic
 

professional training. If you burrowed into the
 

Fernald case and spent all those years doing it,
 

well, maybe you view Fernald a certain way and
 

you don't have as open a mind as you might want
 

to have. It's not a -- it's not an explicit
 

thing. It may be just a -- you know, an
 

unconscious thing.
 

But it seems to me, as a program manager, you
 

all at NIOSH want to know what the professional
 

backgrounds of these individuals are because if,
 

to the degree and extent that these are cookie
 

cutters, or this is the dough out of which you
 

cut the cookie is what I should say, is if you
 

roll out the dough as your site profile and you
 

then lay in, you know, the cookie cutter -- and
 

I'm not sure it's going to be so simple at
 

Savannah River as it was at Bethlehem Steel -­

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but you know -- and Bethlehem Steel was -- there
 

-- that was the dough out of which each decision
 

was made. There wasn't much new information
 

needed other than the years of employment and the
 

age at exposure and the date of diagnosis.
 

And so it's worrisome, I think, not to have
 

that transparency and it's worrisome that the
 

program managers aren't at least having that as a
 

filter as they look at those working under them. 

And I think it's worrisome that Dr. Toohey
 

doesn't have that in his focal point. And so I
 

hope that this fine point about procurement
 

doesn't interfere with clear, open transparency
 

on the professionals doing the work on these
 

projects. That's -- that's my suggestion.
 

DR. ZIEMER: Thank you, Richard. Again let
 

me ask if there's any questions on the part of
 

the Board members here.
 

(No responses)
 

I have a kind of a question myself. Maybe
 

I'll address it to you, but maybe to the Board,
 

as well, because it came up before, and that was
 

the fact that the site profile teams seem to
 

consist exclusively of technical people. It's
 

hard -- it's probably hard to find any sort of
 

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unbiased person, whether it's a scientist or a
 

union person or whatever, on the site. But to
 

the extent to which one might include both,
 

wouldn't that be of benefit, for example, if the
 

union health and safety person from a site were
 

included? I don't know if maybe our first -­

maybe Mr. Alexander suggested that. Mike sort of
 

hinted at it earlier in the day.
 

MR. GIBSON: That's exactly what I was 

talking about. 

DR. ZIEMER: And I think I heard Jim Neton 

say maybe you would want to look at that as a
 

possibility. I don't -- it seems to me that that
 

would make a certain amount of sense, not only to
 

get some additional balance there, but maybe that
 

would help. I know it's very difficult in the
 

health physics community to find people that
 

don't at least have sort of appearance of
 

conflicts, even though they might not exist at
 

the time, that have baggage and so on, either -­

I mean I do myself, so -- except for mine,
 

everyone else's baggage is pretty bad, but -- I
 

don't know, I'm -- it just occurs to me, and
 

others can react. It seems to me it would make
 

sense for the NIOSH staff to perhaps consider how
 

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to address that issue.
 

And I guess I had always assumed that the
 

site profiles, the editors or the authors of
 

those would at least be identified. Are they not
 

being identified? I know they are on this list,
 

but in the reports themselves? No, I -- is there
 

a reason they're not?
 

MR. ELLIOTT: The benefit of having these
 

meetings are that we get this kind of input -­

and very good points, you know. And we walk away
 

from these meetings and we have a laundry list of
 

good comments that we have to take into
 

consideration, and we certainly will address
 

these comments. You know, the -- let me answer
 

your question. No, right now this is -- perhaps
 

as an oversight on our part -- we haven't been
 

including the authors as listed in the technical
 

basis documents. We're going to look at that. 

We're going to look at some of these other
 

issues, like how we engage -­

DR. ZIEMER: And perhaps not only
 

transparency, but I think as Board members, we
 

would like to know that, as well.
 

MR. ELLIOTT: Sure, sure, and you know, this
 

issue of a balanced perspective, we want to
 

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address that. We want to look at -- at how we
 

deliver the documents and, you know, make sure
 

everybody understands that this is a dynamic
 

document. The term "controlled document" I think
 

we take away from that our experience base in
 

government and know what that means, but on the
 

outside, we're now I think hearing a perspective
 

that that means something different to people on
 

the outside and it looks like it's a closed
 

system. Once you've got a controlled document,
 

it's done. Well, no. We want to make sure we
 

deliver the document in the appropriate context,
 

that it is a dynamic document where -- maybe we
 

got into a rush here to get the numbers done that
 

we all want to see done. But I'm not going to
 

make apologies for that. We're -- you know,
 

that's why we have these meetings. These
 

meetings are good for us in that regard. You
 

know, we do live in a glass house, and sometimes
 

we have to go to the toilet and I'm sure you
 

don't want to see us do that, but you know, we're
 

trying our level best and we do take this to
 

heart and we welcome the input, so -­

DR. ZIEMER: Appreciate those comments. 

Rich, do you have additional -­

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MR. ESPINOSA: Yeah. On the site profiles,
 

one of the things that I was kind of foreseeing
 

is having a union representative or worker
 

representative set up a worker forum for the
 

people that are doing the site profiles, such as
 

ORAU. That way they can -- you know, it could be
 

site by site, facility by facility, but they
 

could explain the -- the former workers could
 

explain the history and the current workers can
 

explain a lot of the history to current
 

situations now.
 

DR. ZIEMER: Mark?
 

MR. GRIFFON: Just to -- to offer -- from our
 

experience with the medical surveillance programs
 

that I work on, I can say that I've done risk
 

mapping sessions where we do group interviews. 

And I've had group interviews with all former
 

workers, which are great. But I have to honestly
 

admit, the best sessions I've ever had are the
 

sessions where I get former shop floor workers
 

along with some management or supervisory people
 

and maybe a former health physicist -­

DR. ZIEMER: Together.
 

MR. GRIFFON: -- and the dialogue usually -­

I mean it's very helpful because the workers know
 

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where things were, what they worked with. Often
 

they know code names, and then the technical
 

people can help me put radioisotopes with those
 

code names. And they also -- the supervisory
 

types -- at least when I first interview, when
 

the interview starts, they usually start off
 

presenting a picture of how it was on paper. And
 

then the workers will say come on, Joe, we're all
 

retired now, you know. You know it didn't work
 

that way. And then they'll kind of say well, it
 

was supposed to, but I got to admit, you know,
 

there were many occasions when we had to go
 

around this rule and that rule and here's sort of
 

how it was really. So they kind of check and
 

balance each other that way and it's very -­

usually the best results is when we have that
 

kind of dynamic, so -- so I think that kind of
 

mix would be beneficial.
 

DR. ZIEMER: Yeah, and it occurs to me that
 

there may be some counterparts around these sites
 

to the old retired health physicists -- many on
 

that list are in that category, I think. There
 

may be some old retired union health and safety
 

folks around those sites that have some
 

institutional memory that would be of value, as
 

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well.
 

Okay. Robert.
 

MR. PRESLEY: Yeah, I was going to say don't
 

-- don't leave out the retirees. They call us -­

they call us graybeards, but at Y-12 we have what
 

we call the retiree corps, and they -- they take
 

in not only our Ph.D.'s, but all the way down to
 

our hourly people that worked on the floor. One
 

of the good points is -- is going back and
 

talking to these hourly people. Your shop
 

foremen, things like that, these people came up
 

through the ranks. They started out as hourly
 

people. Our plant manager for many, many years
 

at Y-12 started out as a chemical operator and
 

went all the way up to vice president of the
 

corporation, so don't forget the retiree corps. 

They're there. I guarantee you that most of the
 

places have got them.
 

DR. ZIEMER: Roy DeHart.
 

DR. DEHART: I think the issue is not so much
 

whether it's union or not or management or not,
 

but the contribution they can make to the issue.
 

DR. ZIEMER: Right. Yeah, right on target. 

Well, I think, as Larry's indicated, they've
 

heard these expressions of both concern and
 

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interest and can take appropriate action.
 

Are there other matters that need to come
 

before us today?
 

(No responses)
 

Thank you very much. I think it was a
 

productive two days. We look forward to seeing
 

you all at the next meeting.
 

Oh, before you go, training session for -­

which people? -- Wanda, Gen, Roy and me. Is that
 

it? Okay -- Mike, okay. Five of us tomorrow
 

morning. Okay. Four tomorrow.
 

Okay, we're adjourned.
 

(Meeting adjourned 4:30 p.m.)
 

C E R T I F I C A T E
 

STATE OF GEORGIA )

 )
 

COUNTY OF FULTON )
 

I, STEVEN RAY GREEN, being a Certified Merit
 

Court Reporter in and for the State of Georgia, do
 

hereby certify that the foregoing transcript was
 

reduced to typewriting by me personally or under my
 

direct supervision, and is a true, complete, and
 
___________________________ 

289 

correct transcript of the aforesaid proceedings
 

reported by me.
 

I further certify that I am not related to,
 

employed by, counsel to, or attorney for any parties,
 

attorneys, or counsel involved herein; nor am I
 

financially interested in this matter.
 

WITNESS MY HAND AND OFFICIAL SEAL this _____ day
 

of September, 2003.
 

STEVEN RAY GREEN, CVR-CM
 

GA CCR No. A-2102