Summary Minutes February 7, 2007 
 

NIOSH/CDC Advisory Board on Radiation and Worker Health 


Subcommittee for Dose Reconstruction Review
 

THE SUBCOMMITTEE FOR DOSE RECONSTRUCTION REVIEW


 OF THE
 

ADVISORY BOARD ON RADIATION AND WORKER HEALTH 


NATIONAL INSTITUTE FOR OCCUPATIONAL SAFETY AND HEALTH 


CENTERS FOR DISEASE CONTROL AND PREVENTION


 _______________________________________________________ 


Summary Minutes of the Second Meeting 


February 7, 2007


 _______________________________________________________ 


The Second Meeting of the Subcommittee for Dose Reconstruction Review 


(the subcommittee) of the Advisory Board on Radiation and Worker Health 


(ABRWH or the Board) was held at the Cincinnati Marriott Northwest in 


Mason, Ohio on February 7, 2007. The meeting was called to order by 


Dr. Lewis Wade, the Designated Federal Official, Centers for Disease 


Control and Prevention's (CDC) National Institute for Occupational 


Safety and Health (NIOSH), the agency charted with administering the 


ABRWH. These summary minutes, as well as a verbatim transcript 


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


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


located at www.cdc.gov/niosh/ocas. 


Those present included the following: 


Subcommittee Members: 


Mr. Mark Griffon, Chair; Mr. Bradley Clawson (Alternate); Mr. Michael 


Gibson (telephonically); Dr. John Poston (joining late); Mr. Robert 


Presley (Alternate); Ms. Wanda Munn. 


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


Federal Agency Attendees: 


Department of Health and Human Services: 


Mr. Larry Elliott, Mr. Stuart Hinnefeld (NIOSH). 


Contractors:
 

Dr. Hans Behling, Ms. Kathy Behling (telephonically); Dr. John Mauro, 


Sanford Cohen & Associates. 


Other Participants:
 

Dr. Paul Ziemer, Chairman of ABRWH. 


* * * * *
 
Summary Minutes February 7, 2007 
 

NIOSH/CDC Advisory Board on Radiation and Worker Health 


Subcommittee for Dose Reconstruction Review


 Opening Remarks
 

Dr. Lewis Wade, 


NIOSH
 

Dr. Wade called to order the second meeting of the Subcommittee for 


Dose Reconstruction. Mr. Mark Griffon was introduced as Chair, with 


membership including Mr. Michael Gibson, attending telephonically; Dr. 


John Poston, who would be arriving late; and Ms. Wanda Munn. 


Alternates are Mr. Brad Clawson, who was asked to participate in Dr. 


Poston's absence, and Mr. Robert Presley.
 

* * * * *


 Agenda Outline
 

Mr. Mark Griffon, Chair 


Mr. Griffon outlined his agenda for the meeting to include refining the 


selection of cases for the seventh round of dose reconstruction 


reviews; updates on the fourth set matrix and status of the fifth and 


sixth set reviews, and a discussion of establishing protocol for blind 


case reviews. 


* * * 


Mr. Griffon reminded the members of the additional information they had 


requested NIOSH provide on cases available for selection, in an effort 


to refine that selection and avoid repeatedly reviewing cases with the 


same or similar issues. NIOSH had been provided with a preliminary set 


of cases and had searched the claimant files for additional information 


on methods for internal and external dose reconstruction, work area, et 


cetera. 


A matrix reflective of that additional information was provided, and 


Mr. Griffon noted in the second part of the document were some cases he 


had added from the pool. A discussion with Mr. Stu Hinnefeld from 


NIOSH had indicated the current selection could fall short of the 20 


cases desired as a result of the expanded parameters. 


Mr. Griffon presented his recommendation from the first pre-selected 


set identified in December, 2006 as follows: 


No. 079, Nervous system; Los Alamos National Laboratory 


No. 063, Liver; Oak Ridge National Laboratory (X-10) 


No. 455, Other respiratory; Savannah River Site 


2

Summary Minutes February 7, 2007 
 

NIOSH/CDC Advisory Board on Radiation and Worker Health 


Subcommittee for Dose Reconstruction Review


No. 335, Urinary organs, excluding bladder; Mound Plant 


No. 337, Lung, Bladder; Lawrence Livermore National Laboratory 


No. 322, Stomach; Kansas City Plant 


No. 375, Non-melanoma skin, Squamous and Basal cells; Pinellas 


No. 017, Lung; Pacific Northwest National Laboratory 


No. 306, Lung; Mound Plant 


From the second pre-selected set in January, 2007: 


No. 428, Lung, Savannah River Site 


No. 377, All male genitalia, urinary organs (excl. bl.); Y-12, K-25 


No. 379, Urinary organs (excl. bl.), breast; Savannah River Site 


No. 470, All male genitalia, pancreas; Savannah River Site 


No. 370, Lung; Hanford 


No. 352, Lung, Hanford 


No. 340, Breast; Hanford, Pacific Northwest National Laboratory 


No. 360, Nervous system; Simonds Saw & Steel Co. 


No. 058, Lung; Rocky Flats Plant 


No. 421, Lymphoma & multiple myeloma; Savannah River Site 


No. 001, All male genitalia; Portsmouth Gaseous Diffusion Plant 


A discussion ensued related to job titles, work areas, methodologies 


used, and type of work done in more unfamiliar sites. There was 


general agreement the choice of cases comprising the first 20 was 


satisfactory. 


Mr. Griffon indicated he had noted some potentially additional cases, 


and subcommittee members discussed and suggested possible selections, 


which included: 


No. 028, All male genitalia; Oak Ridge (K-25 and X-10)* 


No. 076, Lung, esophagus; Pinellas Plant 


No. 099, All male genitalia; Project Gnome nuclear explosion site 


No. 056, All male genitalia, Los Alamos National Laboratory 


No. 302, Non-melanoma skin, Basal cell & other resp.; Huntington PP* 


No. 354, Lung; Aliquippa Forge 


No. 013, Pancreas; Brookhaven National Laboratory 


No. 315, Urinary organs (excl. bl.), acute myeloid leukemia; SRS* 


No. 342, Lung; Savannah River Site* 


No. 060, Non-melanoma skin, Basal cell; Paducah Gaseous Diffusion Pl. 


No. 174, All male genitalia, Oak Ridge Y-12 Plant* 


No. 344, Urinary organs, excluding bladder; Hanford 


No. 166, Eye; Oak Ridge Gaseous Diffusion Plant (K-25) 


No. 100, All digestive; Hanford, Idaho National Laboratory 


3
 
Summary Minutes February 7, 2007 
 

NIOSH/CDC Advisory Board on Radiation and Worker Health 


Subcommittee for Dose Reconstruction Review


Discussion among the members resulted in elimination of Nos. 028, 302, 


315, 342 and 174. 


It was agreed the remaining cases would be presented to the Board as 


the subcommittee's recommendation of cases for the seventh round of 


dose reconstruction reviews. 


* * * * *
 

Status of Ongoing Reviews
 

Mr. Griffon reported he had updated the matrix on the fourth set of 


reviews, adding a resolution column. He intended to meet with Mr. 


Hinnefeld to resolve a couple of questions, and would distribute that 


document to the subcommittee members afterward. He planned to schedule 


another subcommittee meeting before the next full Board meeting so they 


could have a full day to work through a resolution of the findings. 


Ms. Kathy Behling from SC&A confirmed she had provided Mr. Griffon with 


a matrix on the fifth set of reviews, but had not yet provided it to 


NIOSH as she was awaiting direction from Mr. Griffon. 


Mr. Griffon agreed to review that quickly and get in touch with her so 


that it can be provided to NIOSH for their responses. The goal would 


be to bring the fourth set to closure at the next meeting, and begin 


the resolution process on the fifth set. 


Ms. Behling reported she was planning to conduct the conference calls 


with the two-member Board teams to address the sixth set of reviews by 


the week of February 18th. A draft report will be provided thereafter. 


* * * * *
 

Blind Review Protocol
 

Mr. Griffon remarked that over the past year many comments have been 


made about the need to do the blind reviews called for in the original 


scope of work. The issue of figuring out how to go about that still 


remained. 


He observed that it would make sense for the subcommittee to work with 


NIOSH to select a case for such a review. However, the subcommittee 


operates in a public forum and the case should go to SC&A in a de-


identified state. 


4
 
Summary Minutes February 7, 2007 
 

NIOSH/CDC Advisory Board on Radiation and Worker Health 


Subcommittee for Dose Reconstruction Review


Discussion followed addressing exactly what is wanted from a blind 


review, how to go about it, et cetera. 


Discussion Points:
 

#There are two approaches to be considered, depending on what 

information is sought. 

#One approach would be to have SC&A reconstruct dose, using their 

sensibilities, skill sets and resources, based on the raw data 

provided. 

#An alternative approach is to reconstruct dose using NIOSH workbooks, 

tools and procedures. 

#A third option would be to do both. 

#It is highly unlikely the precise result would be achieved, no matter 

the method. 

#Recognizing there are differences in the approaches, what is an 

acceptable difference in results. 

#If the NIOSH approach is used, the result should be very close. 

#There are options available in the NIOSH approaches, so there will be 

variables based on subjective selection of guidance documents. 

#Some of the NIOSH tools are quite sophisticated and could mean 

additional training will be required for SC&A personnel. 

#NIOSH offered their help in providing whatever information SC&A needs, 

noting either approach brings useful information. 

#A blind reconstruction starting with raw data and using professional 

judgment, et cetera goes more toward whether there's another way 

of doing the work, which would be of interest to NIOSH. 

#Perhaps some time should be spent in deciding exactly what is wanted 

from a blind review. 

#The Board's function, as defined by the Charter, was read into the 

record. 

#SC&A will also have the opportunity to come back to the Board if they 

feel a case selected for blind review is not appropriate for that 

purpose. 

#The Board's own resolution process is available to determine whether 

differing results are really so different, given tools used and 

options available. 

#Blind review of AWE sites should not be ruled out simply because the 

level of exposure information available is not the same. 

#The underlying premise in the development of NIOSH's tools and 

approaches used is to provide consistency in how they go about 

their business. 

5
 
Summary Minutes February 7, 2007 
 

NIOSH/CDC Advisory Board on Radiation and Worker Health 


Subcommittee for Dose Reconstruction Review


#The degree to which the process of engaging in a blind review will 

help bring closure to some of the many technical issues currently 

under discussion related to site profiles and/or SECs is another 

facet to be considered. 

#There will have to be some baseline information provided, probably the 

claimant file without the NIOSH DR report. 

#It should be remembered a claimant may appeal a decision based on 

application of methodology, but they cannot question the 

methodology itself, which was developed from the law and the 

regulations that have been commented on and reviewed. 

#While NIOSH is interested in whether there may be another way of going 

about the work, trying to prove the established methodology wrong 

will cause some legal issues. 

Dr. Paul Ziemer, Chairman of the ABRWH, remarked that the parameters 


must be identified so that a list of cases may be provided to select 


from that gives no specifics other than those parameters. He also 


noted that, regardless of how the blind review is done, the resulting 


number will be different. The ultimate criteria is whether the number 


would change the compensation decision. If it does, what's being done 


has to be examined. If not, that's the ultimate focal point. 


Mr. Griffon explained his goal is to develop a written protocol for the 


blind review. Based on today's discussion, he indicated he would draft 


something he would bring to the next meeting for further discussion. 


Dr. Wade offered it would also be valid to ask if the blind review 


result raised concerns relative to scientific validity or quality of 


the dose reconstruction. 


Ms. Wanda Munn opined that cases previously reviewed were not 


necessarily taken out of the pool of availability for blind review. 


* * *
 

Mr. Griffon suggested another issue for subcommittee discussion is the 


difference in the scope of work for basic and advanced reviews. He 


commented he believed some components of the advanced review had not 


been addressed in reviews to date. Conversely, there may be some 


detail in the reviews which can be eliminated, such as line by line 


calculations by SC&A of the NIOSH-prepared IREP input sheets. 


Dr. Wade agreed to capture the issue as an agenda item for the next 


subcommittee meeting. 


6
 
 

_______________________________________ 

_______________________________________ 

Summary Minutes February 7, 2007 
 

NIOSH/CDC Advisory Board on Radiation and Worker Health 


Subcommittee for Dose Reconstruction Review


* * * * *
 

With no further business to come before the subcommittee, the 


meeting was adjourned at 11:24 a.m. 


End of Summary Minutes 


Ë Ë Ë Ë Ë 

I hereby confirm these Summary Minutes are 


accurate, to the best of my knowledge. 


Mark Griffon, Chair 


Date 


7