Presidential Advisory Committee
 

Department of Health and Human Services
 

Centers for Disease Control and Prevention (CDC)
 

National Institute for Occupational Safety and Health 

(NIOSH)
 

Advisory Board on Radiation and Worker Health
 

VOLUME I
 

The verbatim transcript of the Meeting of the
 

Advisory Board on Radiation and Worker Health held at
 

the Inn at Loretto, 211 Old Santa Fe Trail, Santa Fe,
 

New Mexico, on October 15 and 16, 2002.
 

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
 

October 15, 2002
 

Registration and Welcome, Dr. Paul Ziemer, Chair. . 8
 

Review and Approval of Draft Minutes, Dr. Paul Ziemer,

Chair ..................... 13 
 

Program Status Report, Mr. Dave Sundin, NIOSH . . 15
 

Dose Reconstruction Contract Award Information, Dr. 

James Neton, NIOSH . . . . . . . . . . . .28
 

Dose Reconstruction Workgroup, Mr. Mark Griffon, 

Workgroup Chair . . . . . . . . . . . . . .72 

Examples of Completed Dose Reconstructions, Mr. 

Residual Contamination Study Progress Report, Mr. 

Grady Calhoun and Dr. James Neton, NIOSH 115 

Grady Calhoun, NIOSH . . . . . . . . . . 163
 

Department of Labor Activities Update, Mr. Shelby 

Hallmark, Director, OWCP, DOL . . . . . .184
 

Public Comment Period . . . . . . . . . . . . . .209
 

Adjourn . . . . . . . . . . . . . . . . . . . . .276
 

Court Reporter's Certification . . . . . . . . . 277
 
 

 

3 

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

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
 
4 

GADOLA, Sally L., M.S., R.N., COHN-S
 Occupational Health Nurse Specialist
 

Oak Ridge Associated Universities
 

Occupational Health
 

Oak Ridge, Tennessee
 

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
 

OWENS, Charles L. 

President
 

Paper, Allied-Industrial, Chemical, and Energy Union
 Local 5-550
 Paducah, Kentucky
 

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
 
5 

INVITED SPEAKERS
 

Mr. Dave Sundin, NIOSH
 

Dr. James Neton, NIOSH
 

Mr. Mark Griffon, Workgroup Chair
 

Mr. Grady Calhoun, NIOSH
 

Mr. Shelby Hallmark, Director, OWCP, DOL
 
6 

STAFF/VENDORS
 

CORI HOMER, Committee Management Specialist, NIOSH
 

NADINE RIVERA, Writer/Editor
 

STEVEN RAY GREEN, Certified Court Reporter
 

AUDIENCE PARTICIPANTS
 

Archuleta, Floyd
 

Arends, Joni
 

Bermudez, Joe
 

DeHart, Julia
 

Erins, Joanie
 

Garcia, Dolores
 

Gilbertson, Tracey
 

Green, Phil
 

Griffin, James
 

Hager, Rob
 

Harrison, Phil
 

Henshaw, Russ
 

Homoki-Titus, Liz
 

Howles, Ritchie
 

Jacquez, Epifania
 

Jacquez-Ortiz, Michele
 

Katz, Ted
 

Klemm, W. Jeffrey
 

Kotsch, Jeffrey L.
 

Lada, Jerry
 Malmgren, Peter
 Miller, Richard
 Naimon, David
 Ortiz, Ben F.
 Platner, James
 Presley, Louise S.
 Quintana, Frances G.
 Rankin, Adam
 Schaeffer, D. Michael
 Shinas, Betty Jean
 Shonka, Joseph J.
 Silver, Ken
 Tabor, Robert G. 

Toohey, R.E.
 

Toufexis, Rose
 

Trujillo, Gloria
 

Vazquez, Robert
 

Widner, Thomas
 
7 

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
 

mechanical failure or speaker failure.
 
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P R O C E E D I N G S 

(8:30 a.m.)
 

WELCOME
 

DR. ZIEMER: Good morning, everyone. I'd
 

like to call the eighth meeting of the Advisory
 

Board on Radiation and Worker Health to order. My
 

name is Paul Ziemer and I serve as Chair of the
 

Advisory Board.
 

I'm not going to introduce all the members
 

of the Board this morning. You do see their names
 

on the placards before them. I do, however, want to
 

introduce two members who were actually introduced
 

last time, new appointees to the Board, but who have
 

not yet been officially seated because of the
 

paperwork that is required to complete all the
 

requirements for officially being seated on the
 

Board. So we welcome now officially at the table
 

Leon Owens -- Leon's over here -- and Mike Gibson. 

Mike and -- Mike is from Miamisburg, Ohio. Leon is
 

from Paducah, Kentucky. Both of them, at their
 

respective facilities, are Presidents of their Local
 

Paper Allied Industrial Chemical and Energy Unions. 

I think that's the correct name. There's a lot of
 

words in there, but anyway, we welcome them to the
 

-- officially to the Board and look forward to their
 
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contributions.
 

I want to remind everyone -- Board members,
 

visitors, members of the public and staff members
 

from the various agencies -- to register your
 

attendance with us today. The registration book is
 

-- it is out in the corridor still? I guess it is. 

But if you have not registered, please do so.
 

And then also for members of the public who
 

wish to make a statement or to comment to the Board
 

at the appropriate time in the agenda, please sign
 

up on the sign-up sheet that is also out there. 

It's in the back of the room and Cori is in the back
 

and can direct you to that if you've not already
 

found it.
 

There are a number of handouts on the back
 

table you can avail yourself of. These are various
 

documents that have been generated over the past
 

several months, including the minutes of the
 

previous meetings of this body, the recommendations
 

of this body to the Secretary of Health and Human
 

Services, and other related documents that may be of
 

interest to you. I also would point out that all of
 

these documents, and others, as well, are on the web
 

site. You would go to the NIOSH web site and then
 

find the section on the worker's compensation
 
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program and you'll find all of these documents and
 

others there, as well.
 

I hope all of you have, if you haven't
 

already got it, will please get an agenda so you
 

know what's before us for the next two days. I know
 

the Board members have the current version of the
 

agenda in their packet. There's been several
 

revisions of this over the past several weeks. The
 

one on the web site last week has been revised
 

slightly, but there are copies -- hard copies in the
 

back of the agenda, as well.
 

We will follow that agenda, at least
 

topically. We may adjust the time somewhat,
 

depending on what questions and discussion the Board
 

may have, and we'll take those modifications as
 

necessary as we proceed.
 

I would point out to the Board members that
 

the mikes that are distributed around your tables
 

have no on/off buttons on them, so they're on all
 

the time. That means be careful of sidebar
 

conversations, but also when you do wish to speak,
 

pull one of the mikes toward you and avail yourself
 

of that. That will help our recorders here to
 

transcribe properly what you say.
 

Others who have comments later may use the
 
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back mike, or in some cases for members of the
 

public we may ask you to use the podium here so that
 

we can readily see you as you speak.
 

There will be some other housekeeping items
 

that come before us later in the meeting, but we
 

will proceed now with the agenda as it's presented,
 

and I'm going to call on Larry Elliott now to
 

officially welcome us. I would add my word of
 

welcome first -- I guess welcome myself as well as
 

others 'cause this isn't my place, but it's a
 

beautiful place to meet and we certainly are
 

enjoying the ambience of this location.
 

Larry Elliott serves both as Executive
 

Secretary of this Board and also as Director of the
 

Compensation Analysis Support Program for NIOSH. So 

Larry, if you want to speak from there or you're 

welcome to come up here. 

MR. ELLIOTT: I'll just speak from here. I 

have just a brief comment. I do welcome you all to
 

the -- I guess this is our eighth meeting. We had
 

seven meetings last fiscal year. We are preparing a
 

report for the Federal Advisory Committee Act,
 

Committee Management Office in the Department on the
 

activities of this Board, and that report will be --

a copy of that report will be available and shared
 
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with you, as well, but it's a standard process that
 

we go through in end-of-the-year effort to document
 

the accomplishments of this Board, the purpose of
 

the Board and how the Board does its work. So I
 

just wanted to give you an insight and an
 

understanding that that will be forthcoming for the
 

last fiscal year.
 

Additionally, I'm reminded by Committee
 

Management Office that at each meeting we need to
 

start the meeting with refreshing our memories as
 

Board members about the waivers that you have all
 

been provided. We have matters of general
 

discussion on this agenda, but as we proceed in our
 

next series of meetings I anticipate that we're
 

going to be moving toward matters that are more
 

specific in nature and you'll all have to take that
 

into account, so this is just a gentle reminder that
 

each Board member refresh your understanding of the
 

waivers that have been granted to you as a Board
 

member and what you need to do to recuse yourself
 

from certain discussions.
 

The agenda has been modified slightly over
 

the last few weeks, and I apologize for that. I
 

also apologize to you for the late distribution of
 

your minutes. This is the nature of this program. 
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We're still playing catch-up in a lot of ways and
 

I'm very sorry that we didn't get the minutes to you
 

earlier for your review in advance of this morning. 

We lost a whole box of information and minutes
 

happened to be in it, as I understand, and lost in
 

Albuquerque, but we did get them here this morning
 

for you.
 

Are there any questions of me at this point?
 

(No responses)
 

MR. ELLIOTT: That's it then. Thanks.
 

REVIEW AND APPROVAL OF DRAFT MINUTES
 

DR. ZIEMER: Thank you, Larry. The next
 

item on the agenda in fact is the review and
 

approval of the draft minutes. There are actually
 

two sets of minutes, one the minutes of the official
 

meeting that we held, the seventh meeting, and the
 

other the minutes for the telephone conference
 

meeting that was held. The seventh meeting was the
 

August 22nd meeting and the telephone conference
 

meeting -- wait, I may have that backwards. Right,
 

the telephone conference meeting was -- referred to
 

as the seventh meeting, was August 22nd. The
 

regular meeting was August 14th and 15th.
 

Now I'm a little concerned about the fact
 

that most of you haven't had a chance to go through
 
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those minutes in detail, so I may ask that we defer
 

action till tomorrow, if that's agreeable. Would
 

everyone feel more comfortable with deferring action
 

till tomorrow? I would point out to you that I got
 

the minutes about a week ago. I'm always given the
 

opportunity to go through them first and catch all
 

the dangling participles and things like that. But
 

that also hit me at a time when I was actually on
 

travel, so I was actually going through the minutes
 

-- I sat in a restaurant in Omaha last week doing
 

the minutes of the teleconference, so that tells you
 

how -- and who knows what the results of that might
 

have been. So in any event, I have already gone
 

through them and done some mark-ups, but I think in
 

fairness everyone should have a chance to do that. 

And then if it's agreeable without exception, we'll
 

actually take action first thing tomorrow morning.
 

Any objections?
 

(No responses)
 

DR. ZIEMER: Okay. Without objection we
 

will do that. We're basically looking for
 

substantive changes. If you have grammatical
 

changes -- you know, if you have your own dangling
 

participles you want to talk about -- we'll pass
 

those on separately, but we'll ask for substantive
 
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changes in the content.
 

Any questions or comments on that?
 

(No responses)
 

DR. ZIEMER: Then without objection, we'll
 

postpone action on those minutes until tomorrow
 

morning.
 

PROGRAM STATUS REPORT
 

Which moves us up automatically on the
 

agenda to Dave Sundin. Dave is involved in the
 

legal aspects of -- well, I'm sorry, I'm getting
 

ahead of myself. We've got the wrong guy here. 

Dave is the deputy director of the program, serving
 

under Larry Elliott, so Dave is going to give us his
 

regular program status report. Dave reported to us
 

last time, as well. So Dave, we welcome you back
 

for the program status report.
 

Dave, there's an on button there. Just push
 

that to the right and then -- and then clip that on
 

your --

MR. SUNDIN: How about now? Okay, that 

sounds fine. 

DR. ZIEMER: Can you hear me now? 

MR. SUNDIN: Can you hear me now? Well, 

good morning. This is really a fantastic place to
 

have a Board meeting, I've got to say that. So I'm
 
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privileged to be here with you this morning and I
 

thought I'd give you a brief overview of the program
 

status. I'll follow the basic approach we've used
 

in previous Board presentations. And as you know,
 

September 30th marks the end of our fiscal year
 

2002, so for a lot of these indicators you'll get a
 

year's worth of statistics to show trends over the
 

-- really the first full year that we've been
 

receiving claims for dose reconstruction.
 

The Department of Labor is currently working
 

on approximately 13,700 non-SEC cancer cases. There
 

are more claims than that, but that's the number of
 

actual cases. There can be multiple claims on a
 

case. DOL has transferred over 8,000 of these cases
 

to NIOSH for dose reconstruction. We actually began
 

receiving cases from the Department of Labor on
 

October 11th of 2001. And as you can see, the
 

number of cases referred to us has increased each
 

quarter of the fiscal year. We're currently
 

receiving approximately 200 cases per week from --

combined from the four district offices of the
 

Department of Labor.
 

As we receive referrals from the Department
 

of Labor we immediately send each claimant a letter
 

to let them know that we've received their claim for
 
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dose reconstruction. And in that letter we tell
 

them about the steps their claim will go through
 

while we have it and how they can contact us to
 

monitor their progress. We also log each case into
 

our computerized claims tracking system. We
 

electronically scan all the documents in each case
 

file and we also create and maintain a paper file
 

system.
 

You can see that the majority of the claims
 

involve employees who worked at DOE sites, but about
 

15 percent involve employment at atomic weapons
 

employer sites, or AWE's.
 

The DOL referral summary sheet which
 

accompanies each case when they refer it to us lists
 

the verified covered sites where the employee
 

worked, and this permits us to direct our requests
 

for radiation exposure information to the
 

appropriate DOE points of contact. We've sent
 

nearly 6,800 requests for personal radiation
 

exposure information to our 12 DOE points of
 

contact, and we've received responses to slightly
 

more than 50 percent of these requests.
 

We continue to work closely with the DOE
 

Office of Worker Advocacy and our designated points
 

of contact at the sites to ensure that we get the
 
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kind of exposure information that we need to conduct
 

dose reconstructions in a timely manner. We're
 

continuing also to explore ways to expedite the
 

fulfillment of our information requests.
 

We send each DOE point of contact periodic
 

status reports on the requests we've sent and the
 

responses we've received. These reports include a
 

listing of all requests which are 60 days or more
 

outstanding without a response.
 

DR. MELIUS: Yeah, Dave, just could you
 

clarify what you mean by a DOE response? Is that an
 

acknowledgement or is that sending records or
 

information back?
 

MR. SUNDIN: That's actually sending some
 

exposure information back.
 

DR. MELIUS: Okay.
 

MR. SUNDIN: And I'll get into it a little
 

bit later where that leaves us in terms of having
 

enough information to do a dose reconstruction. 

It's any response that contains exposure
 

information.
 

Our discussions with DOE on the terms of a
 

memorandum of understanding between HHS and DOE are
 

continuing. The purpose of this MOU is a limited
 

though important one. We want to achieve agreement
 
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between HHS and DOE on how we will carry out those
 

responsibilities in EEOICPA and the Executive Order
 

which require collaboration. The discussions have
 

been useful, and I hope an agreement will be reached
 

soon.
 

This chart just depicts how our caseload has
 

gone over the past several months and shows where we
 

are with our efforts to gather the exposure
 

information needed to proceed with claimant
 

interviews and dose reconstructions. The number of
 

requests for DOE information -- the number of
 

requests for DOE information is less than the number
 

of claims received because for some sites -- that is
 

principally the AWE's -- we've not yet identified a
 

point of contact that's able to provide exposure
 

information. Also, even in the cases where we have
 

received a response from DOE there may be a need for
 

follow-up requests to DOE as the information
 

provided in the initial response is more fully
 

analyzed.
 

Once we've assembled and reviewed all the
 

relevant information from NIOSH records and received
 

and examined the information from DOE, we schedule
 

an interview with the claimant. As of today we've
 

conducted interviews with 164 employees and
 
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survivors. We currently have 36 dose
 

reconstructions underway. This means we've
 

received, assembled, reviewed and evaluated the
 

readily available information pertinent to a claim,
 

completed the claimant interview and assigned the
 

case to the NIOSH health physicist. For 11 claims
 

we've completed the draft dose reconstruction report
 

called for in our rule, completed the closeout
 

interview with the claimant and received a completed
 

OCAS-1 form which closes the dose reconstruction
 

process. Nine of these cases have been transmitted
 

back to the Department of Labor, along with the
 

complete administrative record for final
 

adjudication. Of course that step includes a
 

determination of the probability of causation.
 

We intentionally make it very easy for
 

claimants to contact us, and they do so. The number
 

of phone calls received in OCAS has increased
 

substantially each quarter as we receive more and
 

more claims. We're currently receiving an average
 

of 60 phone calls per day, which keeps us connected
 

with claimant concerns and issues and motivates us
 

to continue our efforts on their behalf.
 

I hope most of you will agree that the OCAS
 

web site is an unusually rich source of information
 
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on this program. It also provides a channel through
 

which claimants can contact us. We received over
 

600 claim-related e-mails, and our goal is to
 

respond to each one of them within 24 hours.
 

You'll be hearing more about some recent
 

noteworthy developments and accomplishments later
 

today. We achieved one of our major goals, the
 

award of a five-year contract for much-needed
 

support to Oak Ridge Associated Universities on
 

September 11th. Dr. Jim Neton will provide more
 

details in his presentation, which immediately
 

follows this one.
 

As required by an amendment to EEOICPA which
 

was enacted on December 28th, 2002, NIOSH recently
 

completed a progress report on a study of residual
 

contamination of certain covered facilities under
 

the Act. Mr. Grady Calhoun will describe the study
 

findings to date and our plans for completing the
 

final report, as required by the amendment.
 

And finally, as you're aware, HHS published
 

a notice of proposed rule-making on procedures for
 

designating classes of employees as members of the
 

Special Exposure Cohort under EEOICPA on June 25th. 

The public comment period closed on August 26th, and
 

we received a wide variety of comments from 23
 
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individuals, labor and advocacy groups and
 

scientific organizations. All of these comments can
 

be viewed on our web site. Many comments focused on
 

feasibility of dose reconstructions, timeliness, and
 

the use of NIOSH-IREP for determining health
 

endangerment.
 

We're currently drafting solutions that we
 

believe will substantially improve the proposed
 

rule. If we receive support for these changes
 

during the review process, a determination will need
 

to be made concerning whether the revised rule can
 

be published as a final rule or must be issued for
 

public comment as a proposal. We believe that we
 

are on track for publishing a revised rule or, if
 

necessary, a second proposed rule in January.
 

Thanks for your attention. I'll try and
 

answer any questions you might have at this point.
 

DR. ZIEMER: Thank you. Henry?
 

DR. ANDERSON: Yeah, you've got a number of
 

phone calls. Are those individual calls or
 

individuals who called?
 

MR. SUNDIN: Those are individual calls. 

Some callers called multiple times.
 

DR. ANDERSON: Yeah, I was -- I mean it
 

could be 60 people 60 times each.
 
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MR. SUNDIN: We actually did a simple
 

analysis of that early on in the program and many
 

people haven't called at all. Most people call
 

once, but there's a handful of people that call many
 

times.
 

DR. ZIEMER: Jim?
 

DR. MELIUS: Yeah, a couple of related
 

questions. What's the status of the MOU with the
 

DOE?
 

MR. SUNDIN: We're still discussing that. 

It's -- right now it is with DOE. We're expecting
 

comments on our last draft to them.
 

DR. MELIUS: And that's what's holding up
 

the issue about some of the older atomic weapons
 

sites in terms of getting contact and getting
 

exposure information? It's a considerable number of
 

cases -- I mean it seems to be --

MR. SUNDIN: Certainly the issue of DOE
 

providing assistance to the degree that they can and
 

identifying contacts for some of these sites is an
 

element of the MOU. I will say that we're not
 

delaying going forward with activities in many areas
 

pending the resolution of the MOU, and we have
 

received some corporate contact information from DOE
 

on a number of these sites. Whether or not those
 
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corporate contacts are in a position to provide
 

exposure information is the other question. And we
 

have identified some contacts as some of the larger
 

AWE sites, but there's a number of them of course we
 

have not.
 

DR. MELIUS: Okay. So do you have -- I mean
 

is there a planned approach for dealing with those
 

workers then?
 

MR. SUNDIN: Well, one approach would be to
 

begin with the corporate contacts, obviously, and
 

burrow down and see whether or not -- and that's
 

likely to be a task that our contractor will take up
 

more vigorously than we've been able to at this
 

point.
 

DR. MELIUS: Okay. And then as another
 

related follow-up question, and this may be more --

better answered during Jim Neton's presentation, so
 

tell me if you can't answer, but have you done any
 

sort of projections on where this will take you in
 

terms of dealing with the numbers and so forth? It
 

seems to me that DOE is falling further behind
 

getting information to you. I mean the backlog's
 

getting -- at least numerically -- greater. And
 

then obviously in terms of completing dose
 

reconstruction -- is there some sort of a way of
 
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projecting out the workload and when some of these
 

claims will get handled in some way? Or should I
 

wait and ask that -- is it better answered in terms
 

of dealing with the contract and so forth?
 

MR. SUNDIN: I think probably Jim is going
 

to deal with the capacity issues of the contract,
 

unless you say -- unless you -- at least can tell
 

you what the scope of work calls for in terms of
 

capacity and where that might leave us a year from
 

now in terms of backlog.
 

DR. MELIUS: Okay.
 

DR. ZIEMER: We'll have Tony and then Roy. 

Before Tony starts, I just -- looking at your claims
 

processing chart, it looks like the volume coming
 

back from DOE has increased substantially, but
 

they're still falling behind further because the
 

other volume's going up.
 

DR. MELIUS: Exactly. Yeah, that's my...
 

DR. ZIEMER: So the further they get -- the
 

more they get the behinder they get or something.
 

Okay, Tony?
 

DR. ANDRADE: Dave, please refresh my memory
 

with respect to the number of claims in process at
 

the Department of Labor versus those that have been
 

forwarded on to NIOSH for dose reconstruction. 
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Currently -- or at least at the end of the fiscal
 

year -- there were some 5,000 cases still within the
 

Department of Labor. Do you expect all or most of
 

these to be forwarded on for dose reconstruction?
 

MR. SUNDIN: That's hard for me to say. The
 

Department of Labor of course basically has to
 

qualify or determine verified employment and disease
 

condition, so I'd have no idea how many of those
 

5,000 that we haven't seen may fail on either of
 

those two issues. I suppose the best way to say it
 

is the maximum number that might come over out of
 

those 5,000 would be 5,000. But of course their
 

caseload continues to increase with new
 

applications, so that's just a snapshot of what the
 

total number of -- or the total number of cases over
 

there is right now.
 

DR. ZIEMER: Roy DeHart.
 

DR. DEHART: Regarding the Special Exposure
 

Cohort public comment period, and reading that --

those comments -- there were several that were
 

frankly contradictory in terms of recommendations. 

Will NIOSH be responding to those independently? 

And if so, will the Board have access to that
 

information or are we waiting till January until a
 

decision's been made as to how you will handle --
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MR. SUNDIN: Typically the way this goes is
 

that the comments are responded to in the preamble
 

of the new proposed rule, and not always do you get
 

individual responses to individual comments. They
 

are grouped by subject area, more or less, and if
 

the agency has a response which covers several
 

comments, then that's the way it will be presented. 

So my sense is it would be -- the agency response to
 

public comments would be found in the preamble of
 

the next version of the rule.
 

DR. ZIEMER: Gen and then Jim.
 

DR. ROESSLER: You stated that nine dose
 

reconstructions have been completed by NIOSH and
 

that some others are underway. When will the
 

transition take place for the support contractor to
 

begin picking up? And if this is going to be
 

covered by Jim later, I'll just wait until then.
 

MR. SUNDIN: I think that probably would be
 

better addressed by Jim. The transition is
 

underway, let's put it that way, but in terms of
 

more specific information as to how that will affect
 

the rate of completed dose reconstructions coming
 

out, I think maybe Jim would be in a better
 

position.
 

DR. ZIEMER: Jim?
 
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DR. MELIUS: What's the current status of
 

adding -- any possibility of adding any additional
 

staff for your own program, aside from the outside
 

contractor?
 

MR. SUNDIN: We're adding contractor
 

personnel -- not only the main support contractor,
 

but additional on-site clerical and other staff. 

But in terms of additional government personnel,
 

we're essentially at our allocation right now.
 

DR. ZIEMER: Further comments or questions?
 

(No responses)
 

DR. ZIEMER: Okay. Thank you very much for
 

that presentation.
 

DOSE RECONSTRUCTION CONTRACT AWARD INFORMATION
 

Let's go ahead then and have Jim present the
 

information on dose reconstruction contract award.
 

DR. NETON: Good morning, everyone. It's
 

with some sense of relief, at least on my part, I'm
 

pleased to stand up here and discuss the dose
 

reconstruction contract award to help us perform our
 

task under EEOICPA.
 

The contract was awarded on September 11th
 

to a team that was led by Oak Ridge Associated
 

Universities, but with an award this size, you can
 

imagine there are a number of teaming partners and
 
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associated subcontractors with the team. The two
 

main ones as far as dose reconstruction activities
 

are concerned are Dade Moeller & Associates out of
 

Richland, Washington and MJW Corporation based out
 

of a suburb of Buffalo, New York. Dade Moeller &
 

Associates -- it's a little more complicated than
 

this, but essentially Dade Moeller & Associates is
 

going to be involved primarily with dose
 

reconstruction research issues and external
 

dosimetry, and MJW has a lot to do with the internal
 

dose reconstruction, although there are some other
 

areas of overlap that I'll talk about a little
 

later.
 

It is a five-year, incrementally-funded
 

contract, so it's a five-year contract, but the way
 

the government operates, money gets distributed or
 

allocated on an annual basis into the contract pot. 

And this addresses a little bit of the question
 

maybe that Dr. Melius was asking, is how are we
 

going to accomplish -- what are we going to
 

accomplish with this contractor? And the original
 

RFC, the request for contract, called for the
 

reconstruction of at least 8,000 doses per year. 

It's not constrained to that. That was a target
 

that was put into the contract so that we could have
 
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an equal footing to evaluate all the potential
 

bidders. But -- so the contractors were required to
 

propose 8,000 per year, and then provide provisions
 

for expansion and contraction, waxing and waning in
 

response to the demands -- the fluctuating demands
 

that are essentially unpredictable for a program of
 

this size and nature.
 

There are a number of personnel on there. I
 

believe the total, if we added them up, would exceed
 

100 individual personnel working on this contract,
 

so I've outlined a few of the key personnel on the
 

project. And a number of these I think some of you
 

will recognize. They've been involved in health
 

physics activities for quite some time.
 

With us today in the audience are Dick
 

Toohey, who's the project director at Oak Ridge
 

Associated Universities. Dick has had a number of
 

years of health physics experience, in dosimetry
 

particularly. And a little further down, Jim
 

Griffin is heading up the dose reconstruction
 

consolidation effort and he's -- he works with MJW
 

Corporation.
 

Other notable personnel on the project are
 

Phil Wallace from ORAU who will be heading up the
 

database management efforts. Phil will be working
 
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with not only ORAU personnel but staff from MJW
 

Corporation.
 

Bill Tankersley, who's got a long past
 

history involved in dose reconstruction research
 

activities from ORAU will be heading up that
 

activity.
 

Priscilla Campbell from ORAU will be
 

responsible for administration of the contract and
 

will serve as Dick Toohey's deputy director.
 

And heading up the individual internal dose
 

and external dose are Liz Brackett and Steve Merwin,
 

respectively. Liz is with MJW Corporation and Steve
 

Merwin is with Dade Moeller. Liz and Steve actually
 

report to Jim Griffin, who will consolidate all the
 

dose reconstruction activities as far as
 

coordinating the scheduling, planning day to day
 

activities, that sort of thing, and Jim reports to
 

Dick -- his organization.
 

The contract had six areas of support, so
 

it's a fairly broad-ranging contract. We didn't
 

want to limit ourselves just to do a dose
 

reconstruction, but we felt that we needed support
 

in a number of areas, and these are outlined here. 

Starting a little further down, dose estimation and
 

reporting, bullet item four (sic), is the most
 
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obvious task that we've asked our contractor to do. 

But also they're going to be responsible for
 

performing all the claimant interviews that we are
 

committed to in the rule.
 

But between interviewing and reporting, they
 

need to do a lot of dose reconstruction data
 

collection and research, so those are task two --

bullets two and three up there. They'll be tasked
 

with going out to the sites and essentially
 

establishing these site profiles that we've talked
 

about and I'm going to address tomorrow afternoon, I
 

think -- or morning. As far as establishing site
 

profiles, determining -- looking, evaluating, air
 

sampling, records, surveys, those sort of issues
 

will be under the responsibility of the contractor.
 

Once they collect all this information,
 

there will be dose reconstruction research
 

activities conducted, and that is to try to relate
 

certain work areas and work activities and job
 

descriptions with certain exposure profiles and that
 

sort of thing. So that all falls under the guise of
 

dose reconstruction research and that will be housed
 

in bullet item one, which is this database
 

management task that they've been asked to perform.
 

NIOSH ourselves will actually own, operate
 
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and control the database, but ORAU themselves will
 

have their own parallel and develop databases that
 

they're involved with claims tracking, profile
 

development, that sort of thing. So we'll be
 

running parallel systems here.
 

And last is sort of a catchall one,
 

technical and program management support issues as
 

they arise. We couldn't possibly envision all
 

activities that we may need to perform under this
 

contract.
 

I'd like to just take a little time to talk
 

about something that's been of key interest to NIOSH
 

and our stakeholders in letting this contract, and
 

that's conflict of interest. We asked all bidders
 

on the contract to propose -- provide a conflict of
 

interest plan to delineate how they would propose to
 

perform this, given that it's likely that many
 

people working for the contractor will have had ties
 

or employment histories with the Department of
 

Energy themselves or Department of Energy
 

contractors. So I've abstracted -- I think there's
 

nine areas in the ORAU plan -- and this is actually
 

on our web site, so I would encourage everyone who
 

has not looked at this to go out to the NIOSH OCAS
 

web site and read it. It's fairly short, but it's
 
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actually I think pretty good. It's about six pages
 

long.
 

I've taken out the main bullets, and the
 

first several deal with the fact that no contractor,
 

subcontractor or employee can actually do a dose
 

reconstruction or review one if they've actually
 

performed work at that site regarding the policies
 

and procedures at that site related to dosimetry, or
 

if they've actually done dose assessment at those
 

sites. Those are fairly obvious conflicts of
 

interest.
 

The next bullet item actually deals more
 

with the organizational level of conflict of
 

interest, which is no contractor element will review
 

or participate in a dose reconstruction if the
 

contractor itself was a prime contractor associated
 

with any of the teaming partners or associate
 

subcontractors at that site. So even if one of the
 

dose reconstructionists had not been involved at a
 

given time, if they now work for a contractor who
 

has done something there, they would be prohibited
 

from doing the dose reconstruction or reviewing it.
 

And the next bullet item talks -- addresses
 

the issue of conflict of interest when someone had
 

been -- performed expert witness, either testimony
 
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or a non-testifying expert analysis on behalf of DOE
 

or DOE contractor.
 

The next one addresses conflict of interest
 

related to if someone actually were performing dose
 

reconstructions for a co-worker. That would
 

certainly not be a good situation to be in, so he'd
 

be prohibited from doing that if any one that you're
 

reviewing had been a co-worker at that site.
 

And the next issue deals with another
 

organizational element, which contractor --

subcontractors or contractors cannot -- will be
 

prohibited from bidding on work related -- at other
 

DOE sites related to the dosimetry programs,
 

according to the terms of this contract.
 

And also key personnel of the ORAU team will
 

not have a conflict of interest with managing the
 

project. That's somewhat obvious. Or carrying out
 

or marketing related to activities in this area of
 

expertise.
 

The final two deal more with the
 

transparency issue, as we call it, or the -- which
 

is that each supervisor in dosimetry will be
 

required to complete and sign a form that
 

essentially outlines their employment history and
 

where there may be conflict of interest, and ORAU
 
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will maintain these forms as auditable records and
 

they will be scanned -- we're still working out with
 

ORAU whether it makes sense to post these on a web
 

page or have some abstracted database that contains
 

essentially the elements of what's on these forms. 

There's possibly some privacy issues associated with
 

this, but nonetheless, it will be transparent. It
 

will be out there to the public in some form as to
 

what potential conflicts of interest would be for
 

all supervisors, dosimetrists and reviewers working
 

on the program.
 

And the last one talks about identifying the
 

dosimetrist to the claimant as to who either
 

performed the dose reconstruction or reviewed it,
 

and that will be attached to each dose
 

reconstruction. And they have proposed, at least at
 

this point, along with a short biographical sketch
 

to be attached to dose reconstruction, so that's an
 

option at this point. They have not talked about
 

how that would work at this point, but that's in
 

their conflict of interest plan.
 

Okay. Well, were are we at so far to date? 

We've made some very good progress. We had a
 

kickoff meeting shortly after the contract was let,
 

within a week and a half, I believe it was, where we
 
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met with all the key -- the principals and -- of the
 

ORAU team at NIOSH and their information transfer. 

ORAU has had -- there's three short-term
 

deliverables that were listed in the request for
 

contract. It says that -- on this bullet that
 

they're on track to meet the early deliverables --

this was written prior to October 11th, which was
 

the due date for those deliverables, and they have
 

met all three of those deliverables thus far.
 

The 800 number is actually up and running
 

and they've hired a person who will answer it. I
 

will say that it's not out there actively taking
 

claimant calls yet, though. There are some start-up
 

issues associated with that, but they've met the
 

deliverable.
 

They've also been engaged in a design of a
 

claimant tracking database and dose reconstruction
 

research database. That's the data dictionary, the
 

data elements, the interface with the NIOSH
 

database. All that has been accomplished and
 

delivered to NIOSH as of last Friday, so it's in our
 

possession. We're reviewing it now to see how well
 

it will interface with our work activities.
 

They've also developed a data security plan
 

related to how they're going to handle privacy of
 
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claimant information over a distributed web-based
 

system. ORAU has proposed to work this system on a
 

nationwide basis with their dose reconstructionists
 

located about the country, and so there's some
 

issues related to security of that information, as
 

well as establishing a secure link between the NIOSH
 

facility in Cincinnati and the ORAU facility that's
 

based in Cincinnati, as well. A T-1 line it's
 

called.
 

Recruitment process is well underway for
 

CATI's -- computer-assisted telephone interviews. 

They've interviewed numbers of people. They've
 

actually -- there are people on-site now working in
 

our CATI office, ORAU representatives. As of last
 

week -- I didn't verify this, but there were some --

or yesterday, I believe, ORAU was to start doing
 

some dose -- computer-assisted telephone interviews
 

out of the office -- the area that we've established
 

in Cincinnati.
 

We've had several meetings with
 

representatives of both the internal and external
 

dosimetry staff related to procedures under
 

development. ORAU will develop procedures, but we
 

will be in the loop and review all procedures that
 

they develop that fall underneath our two
 
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implementation guides that are out there.
 

And we've also completed the initial dose
 

reconstruction training that was in our contract. 

Within 30 days we're to train up to six people from
 

ORAU in the operation of our internal dosimetry
 

software and go over the approach for internal dose
 

reconstructions. That was done last week sometime. 

I think Tuesday or Wednesday, I've forgotten
 

exactly, but we've accomplished that.
 

We've asked ORAU to -- as a priority issue,
 

one is to start getting the CATI interviews done
 

because we have a huge backlog of those, as you
 

could tell from Dave Sundin's presentation. We've
 

also asked them to go and review the DOE and DOL
 

submissions that are in our hands. I believe Dave
 

said that we had somewhere slightly less than 5,000
 

responses from the Department of Energy. The fact
 

is that NIOSH has not actually physically gone and
 

reviewed every one of those for completeness of the
 

data. We've pulled out and done samples from
 

different sites to make sure that what they're
 

sending fits our needs, but we just have not had the
 

staff at hand to go and review every single one. So
 

we've already had staff from ORAU in Cincinnati
 

going through the records and reviewing. And we've
 
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asked them to start with claimant one and go through
 

and review the DOE information for suitability to
 

conduct a dose reconstruction. And those that they
 

identify that are not suitable -- that do not have
 

sufficient information to do a dose reconstruction,
 

to assemble that and then we're going to start
 

issuing requests to the Department of Energy for
 

follow-up information on those dose reconstructions.
 

On the other hand, the ones that they do
 

identify that are -- have information that are
 

suitable to move forward, they will be flagged. I
 

don't -- they've flagged a number of these already. 

They're moving out into the ORAU files and they will
 

start performing dose reconstructions on those that
 

are ready to go.
 

As far as time frame goes on those, we've
 

had early discussions. We're hoping by the end of
 

the month or early November that ORAU will start
 

producing some dose reconstructions through the
 

pipeline. Of course, with something this large and
 

a transfer of this magnitude, it's going to take a
 

while to get up to speed. We're not going to be
 

performing 167 dose reconstructions a month on
 

average that we hope to get to right away, but I
 

would say within a couple of months there'll be a
 
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significant improvement and the dose reconstructions
 

will be getting there.
 

ORAU has done -- has taken claims managers
 

who will actually be -- have a health physics
 

background and they're going to be assigned to DOE
 

regions that parallel the NIOSH structure. NIOSH
 

has a claims specialist, or what we call a public
 

health advisor, that interfaces directly with each
 

of the four Department of Labor district offices. 

ORAU will have a health physics background person
 

that will be tied to the NIOSH person so that they
 

can manage a group of claims from each of those
 

district offices. It's a nice feature and in some
 

ways it makes a lot of sense. The district offices
 

themselves, although geographically-based, do sort
 

of fall around production operations activities. 

You have the -- Seattle, you have the
 

Richland/Hanford area, that sort of thing. 

Cleveland area handles a lot of AWE's. The
 

Jacksonville office has things like Savannah River,
 

Oak Ridge, so it makes some sense.
 

They have -- ORAU has rented a Cincinnati
 

office space. They've leased it. They're occupying
 

a temporary facility right now there while they
 

build out their permanent facility. That's going
 
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very well. I think by the middle of November they
 

will occupy their permanent leased space. And I've
 

forgotten the exact number, but there will probably
 

be somewhere in the vicinity of 30 to 40 ORAU
 

representatives or teaming partners based out of
 

that Cincinnati office.
 

So things are moving forward. We're making
 

progress. I'd be happy to answer any questions you
 

might have.
 

DR. ZIEMER: Before we get into the specific
 

questions, just for the benefit of the Board, Jim
 

has identified the fact that Richard Toohey is here
 

from ORAU and Richard, if you'd wave your hand or
 

something, we'd like to have the Board identify you.
 

DR. TOOHEY: Right here. 

DR. ZIEMER: We're glad to have Richard here 

this morning. 

DR. NETON: And Jim Griffin.
 

DR. ZIEMER: And Jim, okay, I didn't
 

realize. Good, thank you.
 

Let me start the questioning and then I
 

think Gen, you waved your hand? Okay. And Jim,
 

okay. We'll go down the line.
 

I'm concerned about security of the data,
 

and I'd like to ask if NIOSH has had any outside
 
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computer security experts look at the ORAU security
 

plan. Who's determined that that plan is adequate
 

is what my question is.
 

DR. NETON: We're working that in
 

conjunction with the CDC computer people that
 

represent, you know, CDC, their computer --

DR. ZIEMER: There are computer people and
 

there are security experts, and I'm asking
 

whether --

DR. NETON: Larry may be able to speak a
 

little more directly.
 

DR. ZIEMER: Do we have people who really
 

are computer security experts, 'cause there's a lot
 

of computer people who are not security people.
 

MR. ELLIOTT: Yes. Within the Centers for
 

Disease Control, which NIOSH is one -- an institute,
 

but it's one of the centers -- we're all required to
 

submit security plans on database management systems
 

that are reviewed, approved, modified, evaluated,
 

investigated even by individuals in what is called
 

IRMO -- I-R-M-O -- which is our Information Resource
 

and Management Office in CDC. And these people are
 

very well qualified to identify breaches in security
 

that might result from an improperly-established
 

database management system. They're very cognizant
 
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of new techniques to breach fire walls, techniques
 

that are used to create wormholes in fire walls and
 

this is taken very, very seriously because of the
 

very sensitive, personal, private information that
 

CDC has. Not only on this program, but a number of
 

other programs that you might be aware of -- HIV and
 

AIDS and -- you know, a number of these kind of
 

programs, so they do take this very -- exceedingly
 

seriously. And I think that their rigorous review
 

will put us in good stead here.
 

DR. ZIEMER: Thank you. Gen?
 

DR. ROESSLER: You mentioned providing short
 

bios for some of the personnel, and I think it would
 

be helpful, as soon as possible, to get short bios
 

for especially the key personnel you had listed on
 

the slide. That's one comment.
 

The second one I think you've already taken
 

care of, and that was to introduce the personnel
 

that you mentioned were here. But along with that,
 

Paul, don't you usually ask the audience to
 

introduce themselves at some point in the meeting?
 

DR. ZIEMER: Yes, I normally do that, and
 

I've found from past experience that to do that
 

first thing in the morning we miss a lot of people,
 

so I'm waiting till later in the morning when all
 
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the stragglers arrive. We will do that, though, in
 

a little bit.
 

Who was next?
 

DR. MELIUS: I think I was.
 

DR. ZIEMER: Jim?
 

DR. MELIUS: This might be -- I have some
 

questions on the conflict of interest policies, and
 

maybe you could click back through the slides. I
 

have a question on the second conflict of interest
 

slide.
 

DR. NETON: I'll get there.
 

DR. MELIUS: The first bullet there, that
 

applies only to where they are currently the prime
 

contractor, team member, et cetera, there. It does
 

not apply to their past work? Participate or review
 

for those DOE states (sic) where it is the prime
 

contractor --

DR. NETON: Right.
 

DR. MELIUS: -- or intends to -- well, first 

go back to "is" --

DR. NETON: Right.
 

DR. MELIUS: -- does not apply to their
 

past?
 

DR. NETON: That statement does not address
 

that. Maybe Dick could elucidate that a little bit.
 
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DR. TOOHEY: Well, certainly as the
 

statement exists, it says is currently. And the
 

only one we're aware of is of course ORAU operates
 

the Oak Ridge Institute for Science and Education
 

for DOE, so any claims -- and I think there's seven
 

or so -- from that in the pile, at least as of a
 

year ago, would have to be conducted directly by
 

NIOSH personnel. We won't even touch those.
 

I'm not aware that any of our partners have
 

-- Dade Moeller or MJW -- acted as primes or team
 

members to a prime managing dosimetry programs. And
 

we can certainly research that and if we -- if NIOSH
 

and the Board thinks it's advisable to make that
 

retroactive, we certainly would have no problem
 

doing that.
 

DR. MELIUS: And then related to that is how
 

do you determine -- intend to determine intent? 

Intends to be within 12 months. I mean I intend to
 

do a lot of things within 12 months -- lose 30
 

pounds, et cetera. How do you judge on --

DR. TOOHEY: I think an operational
 

definition of intent is submitting a proposal to do
 

so.
 

DR. MELIUS: Okay, that's -- I needed to
 

know.
 
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And then I don't know if we need the slides
 

for this, but I'm a little concerned that some of
 

what I've referred to as the transparency issues
 

seem to be up in the air, whether -- what
 

information or whether information would be put on
 

the web site and whether -- at least biographical
 

sketch information.
 

DR. NETON: The substance of what's on there
 

will be on the web site. Whether or not we post
 

forms that have a detailed employment history with a
 

person's signature on there on the web, we need to
 

-- there's some Privacy Act issues for protection of
 

the dose reconstructionists themself (sic) that I
 

think we need to address. I mean -- you know, they
 

have proposed to put the form out there. We need to
 

work out whether it makes sense to put the form or
 

some abstracted information from that form that
 

could be retrieved by someone who so desired. But
 

signatures out there on the web and stuff I'm not
 

sure makes sense.
 

DR. MELIUS: Well, I'm not sure of
 

signatures, either, but I think the type of
 

information to have out there is going to be
 

critical to the -- how people view the program and
 

the credibility of the program. So it worries me
 
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when I see you referring to a short biographical
 

sketch, which -- you know, was born in such and
 

such --

DR. NETON: No, no, no, I wish I had an
 

example of the form, but it would detail every
 

employment -- the employment history of the person
 

doing the dose reconstruction so that one could come
 

to their own conclusion whether or not they worked
 

at a site or had an affiliation with a site that met
 

one of the criteria that are outlined in these
 

conflict of interest statements.
 

DR. MELIUS: And then how does that differ
 

from the biographical sketch or abstract you're
 

sending to the claimant? 'Cause a lot of claimants
 

will not have access to the internet and I think --

how do you intend -- why not just give them that --

that same information to the claimant?
 

DR. NETON: It's quite possible we could do
 

that. Like I say, we've not quite fleshed out the
 

exact details of how we're going to address this
 

issue. I mean these are proposed in here, and I
 

think in substance we'll enact all of them, but the
 

exact forms they're going to take -- whether it's a
 

biographical sketch or just a bulletized work
 

history, or we could even have it so the claimant
 
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could request more detailed information if they so
 

desired, if the biographical sketch weren't
 

sufficient -- is still yet to be worked out.
 

DR. MELIUS: Well, I mean you're intending
 

to have this contract to go to work and start
 

submitting information within the next month or so.
 

DR. NETON: That's correct.
 

DR. MELIUS: So I think -- I certainly -- I
 

think that kind of information -- as a Board member,
 

I'd like to be able to review and look at. I think
 

the Board ought to comment on 'cause I think it's
 

going to be critical to the credibility of what this
 

contractor does and how their work is being --

DR. NETON: We certainly can do that. 

There's a lot of issues that we're working out right
 

now. The contract --

DR. MELIUS: You know, I understand those
 

logistics and I'm not telling you to delay having
 

them do the work until you do that, but at least
 

let's --

DR. NETON: Sure.
 

DR. TOOHEY: I would just comment on that
 

that I've instructed all our team members to start
 

collecting that information from all their sub-subcontractor personnel and get those forms completed
 
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and signed.
 

DR. MELIUS: Okay. Thank you. Finally I
 

have a question again related to conflict of
 

interest in terms of the supervision of both that,
 

as well as this overall contract. My understanding
 

is you have essentially yourself and three other
 

people working --

DR. NETON: That's correct.
 

DR. MELIUS: -- on oversight in this area
 

and I -- at least it's pretty clear to me that
 

you've got an impossible task to try to do well,
 

looking at 8,000 dose reconstructions coming in a
 

year, how do you do the kind of quality control,
 

conflict of interest oversight, all the other --

plus all the other program activities? And this
 

seems to be a -- I mean a growing -- growing problem
 

for you and for the -- for this program. And again,
 

there can be quality control within the contractor
 

and that was included in the contracts -- but I
 

think, again, you're -- NIOSH is going to be signing
 

off on these and ultimately responsible. You keep
 

telling us that. And I just don't see how you can
 

get it done and done effectively and --

DR. NETON: A good observation that's not
 

lost on me.
 
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DR. MELIUS: I know.
 

DR. NETON: I've spent a lot of sleepless
 

nights. As Dave Sundin did indicate that we are at
 

our approved staffing level of -- well, I think
 

we're 21 out of 22 FTE's and there's one position
 

out there for a paralegal I think that has not been
 

filled. But I have been asked by Larry to put
 

together a staffing plan or staffing requirements
 

plan that he could review and evaluate and determine
 

what our needs will be, and he could move that
 

forward to try to augment our staff, if he sees fit.
 

MR. ELLIOTT: If I could add to that, yes, I
 

-- Dr. Howard and Dr. Rest, the director of NIOSH
 

and deputy director of NIOSH, are expecting a
 

proposed plan from me to add additional staff to
 

OCAS and include -- that plan will have to address
 

not only the issues you brought forward, Dr. Melius,
 

about review of all these dose reconstructions that
 

will be forthcoming, but also it's going to have to
 

address our claims receipt, claims processing,
 

communications with claimants. There's a variety of
 

efforts that I feel personally that we need some
 

Federal position assistance on that we can't
 

accommodate right now with the staff of 22.
 

Also let me just add this, for the Board's
 
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understanding. It's my intention that in about six
 

to nine months we will commission a independent
 

review of conflict of interest, management and
 

control, not only concerning -- that review not only
 

concerning the contractor, but it will also address
 

how conflict of interest is managed and controlled
 

and addressed within this Board, and it will also
 

address the same within my staff. So we're going to
 

put together a commissioned review to evaluate that
 

across this whole program within NIOSH's
 

responsibilities. And I think that needs to be
 

done, and I would welcome any thoughts or comments
 

you might have on how to go about doing so, about
 

commissioning such an independent review.
 

DR. MELIUS: Yeah, I think -- at least I
 

personally would agree with a -- that that would be
 

helpful, but I think what's much more important at
 

this point is the perception of the program from the
 

point of view of the claimants as they're going
 

through the process. And as we all know, just one
 

mistake, one person -- you know, somebody not
 

revealing where they worked or something or -- you
 

know, something like that, one -- it may not even --

you know, it's a perceived conflict of interest, not
 

-- maybe not even be something very serious, can
 
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seriously undermine the credibility of the program,
 

as any conflict of interest -- so I think obviously
 

the attention is needed now, as well as a review
 

nine months from now, to this issue.
 

I'd also ask the Board to consider later on
 

in this meeting going on record in some way of
 

supporting -- I think what is, to me, becoming an
 

urgent need for better staffing for this program. I
 

think it's within our purview to do this. I know
 

we've commented on it at previous meetings -- first
 

meeting that we had -- but I really think that we
 

need -- ought to go on record again as to --

pertaining to that issue, as well as the issue of
 

the MOU with the DOE.
 

DR. ZIEMER: Let me comment, Jim. You may
 

recall at the last meeting, in fact, we in a sense
 

deferred doing that till we saw the extent to which
 

the contractor would be up to speed and perhaps
 

awaiting a little more definitive information on
 

what the staffing plan needs would be as seen by the
 

staff itself.
 

DR. MELIUS: Uh-huh.
 

DR. ZIEMER: It's becoming clear certainly
 

that additional manpower or person power is needed,
 

and at some point if it's important to even go as
 
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high as the Secretary, we may need to do that --

recognizing that we don't want Larry to end up in a
 

position of somebody viewing this Board as somehow
 

helping him leverage staff to the hierarchy. But on
 

the other hand, there are valid concerns about the
 

ability to get the work done, then we need to go on
 

record for that, so --

DR. MELIUS: Yeah.
 

DR. ZIEMER: And it may be that this is the
 

time to do that in some way, so --

DR. MELIUS: And just add to that, say -- I
 

don't remember the exact wording, but since this
 

Board is specifically charged with evaluating the
 

quality of the dose reconstructions being done, I
 

think --

DR. ZIEMER: Then that can be the --

DR. MELIUS: Yeah, that's the --

DR. ZIEMER: That can be the lever. 

DR. MELIUS: Yeah. 

DR. ZIEMER: Right. Okay. Roy DeHart has a 

comment or --

DR. DEHART: As people in the medical 

community are painfully aware, Federal legislation
 

passed several years ago becomes fully implemented
 

in April of '03. I'm referring to what is called
 
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HIPPA, Health Information Privacy and Portability
 

Act. Is this program going to in any way
 

incorporate the HIPPA guidelines for the privacy
 

transmission of data electronically, verbally, and
 

how are we going to protect that since the
 

government has taken a very active role in this
 

matter?
 

DR. NETON: I believe Dave Sundin has taken
 

a look at that and he might be able to comment on
 

that.
 

MR. SUNDIN: We have looked at this act, but
 

our sense right now is it applies primarily to
 

health care providers and is designed to eliminate
 

some of the misuses of privacy -- of medially
 

confidential information for marketing and other
 

purposes. At least as we currently read it, the set
 

of covered entities does not include the agencies
 

that are doing the kind of work that we're doing. 

So I mean the principles are certainly ones that we
 

subscribe to, but in terms of that Act actually
 

covering this program, our reading is it does not.
 

DR. ZIEMER: But Dave, you are at the same
 

time saying that we have the same level of
 

confidential protection that that --

MR. SUNDIN: Well, certainly the Privacy
 
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Act --

DR. ZIEMER: -- provides. 

MR. SUNDIN: -- itself is --

DR. ZIEMER: Right. 

MR. SUNDIN: -- has some very serious 

provisions about protecting that kind of
 

information. 

DR. ZIEMER: Roy, does that answer your
 

question?
 

DR. DEHART: The concept of the application
 

of the principles of security is the point that I
 

was making. I knew that it doesn't fit in terms of
 

health care communities, but I think the privacy
 

issue is applicable here.
 

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

we are working right now on a revision to our
 

routine use authority under the Privacy Act to
 

accommodate some disclosure needs that we need to
 

account for in order to provide information to
 

Congressional inquiries, to provide information to
 

DOE to request information on dose for these
 

claimants, and that will soon be published in the
 

Federal Register. And in that you will find the
 

description of security arrangements and
 

requirements that we have to meet under the Privacy
 
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Act, and I think it will be very informing for you. 

And we'll make sure when that gets published in the
 

Federal Register you're notified by e-mail and it'll
 

be also placed on our web site. Okay?
 

DR. ZIEMER: Let me ask either Larry or Jim,
 

what do you anticipate is needed for this Board to
 

make sure that we have full disclosure of conflicts
 

of interest ourselves as we look forward -- public
 

disclosures, disclosures here within our group and
 

so on? We -- at some point when we need to get
 

everything on the floor ourselves.
 

MR. ELLIOTT: As I mentioned in my opening
 

remarks earlier, as the Board's meetings proceed to
 

reviewing individual dose reconstructions and
 

reviewing SEC petitions, you all, as individual
 

Board members, know the financial disclosures that
 

you have made and the waivers that you have been
 

given. We will need at some point in time in the
 

next -- within the next meeting, perhaps, to
 

introduce yourself as a member of this Board, not to
 

talk about, in your introduction of yourself to the
 

public, what your financial disclosure statement
 

was, but to talk about your employment history and
 

perhaps explain in general details where you might
 

feel that you would need to recuse yourself, given
 
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your waiver, the information. That's pretty much
 

the limit of what we envision the Board would have
 

to do at one of the next -- future meetings. 

Certainly not to go into your financial disclosure
 

statement, not the OGE-451. We're not going to talk
 

about that. That is private for you and we need to
 

maintain your privacy in that regard. But we need
 

to have you introduce yourself, explain your
 

background and explain why you might find yourself
 

in a situation where you would have to recuse
 

yourself, just so the public would understand that.
 

DR. ZIEMER: And that might in fact be an
 

agenda item for say the next meeting so that we
 

don't get too far along before that actually is
 

done. 

Other comments or questions for Jim? Yes, 

Mark? 

MR. GRIFFON: Switching gears a little bit, 

I had a question on the -- I guess the priorities as
 

far as the scope of work for the subcontractor, the
 

site profile work. Are the -- ORAU task of working
 

on the site profile --

DR. NETON: Yes, yes.
 

MR. GRIFFON: -- database?
 

DR. NETON: Right. The priority --
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prioritization was essentially the big three. I
 

mentioned the two, getting the computer-assisted
 

telephone interviews done because without those no
 

dose reconstruction can move forward. The
 

collection -- or the review of the DOE submittals to
 

determine which ones we can move forward with at
 

this time, and then request additional information
 

for those that are lacking sufficient data. And a
 

third issue is the dose reconstruction data
 

collection and research, site profiling. Those are
 

all conducted by a different group within the
 

subcontract team -- the contract team, so none of
 

those issues will slow down at the expense of the
 

other. I mean clearly as the site profiles grow
 

better, more dose reconstructions can move. But
 

there's a separate dose reconstruction team, as I
 

indicated, led by Bill -- or dose collection data
 

research team led by Bill Tankersley, with a number
 

of other support people, primarily in both ORAU and
 

Dade Moeller. So they are already actively looking
 

through these things. We've asked them to go
 

through the ORAU database where they have
 

information that may be useful to us, as well. If
 

that information can be sufficiently pedigreed,
 

we'll start using it.
 
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To address some of Dr. Melius's earlier
 

concerns about the AWE's, we've made some pretty
 

good progress in those areas. We've identified and
 

we went down and did a data capture effort in a
 

vault at Oak Ridge and pulled out information on
 

about 15 or so -- I think we talked about this
 

before -- AWE's. We also picked up what I call a
 

spaghetti diagram or a flow map of where all the New
 

York operations AWE information ended up. It turns
 

out that most of those AWE's were uranium
 

facilities, which is a good thing. I mean they're
 

all mostly east coast operations and we believe that
 

-- there's a large degree of optimism on our part
 

that the Environmental Measurements Laboratory,
 

formerly the Health and Safety Laboratory, in New
 

York City has substantial holdings of those records. 

We're planning a data capture review effort there
 

later this month or early November with our ORAU
 

contractor to review those records.
 

I think that this is going to be --

nothing's going to be easy on this project, but I
 

think there's some light being seen here as far as
 

availability of bioassay monitoring records. Most
 

of the AWE's were not in the radiation monitoring
 

business. They were sort of coerced into it because
 
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of needs by the Department of Energy -- maybe
 

coerced is too strong a word, but brought into it
 

because of that. And they didn't have radiation
 

monitoring capabilities, so the EML, formerly HASL,
 

went out there and sort of served as the corporate
 

health physics organization for them to review their
 

program. So we feel fairly optimistic that we can
 

shed a lot of light on those issues in return.
 

MR. GRIFFON: I guess I was picking up on
 

something you said -- during your presentation you
 

said that ORAU -- you're bringing them in to start
 

to review some of those -- the data --

DR. NETON: That the DOE submitted.
 

MR. GRIFFON: -- you've got already to
 

determine the adequacy of it for --

DR. NETON: Correct.
 

MR. GRIFFON: -- your needs, and I just --

you know, I'll say this again -- I've said it at
 

every meeting, I might as well get it in early this
 

time. You know, just my fear of putting the cart
 

before the horse.
 

DR. NETON: Right.
 

MR. GRIFFON: If you -- you know, if you
 

start just taking the data you have from personnel
 

records and you don't have a good clear indication
 
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of the site profile --

DR. NETON: Yeah.
 

MR. GRIFFON: -- you'll be making wrong --

DR. NETON: Let me restate that, and I think
 

what I really meant to say was that they will go and
 

the ones that can move forward just based clearly on
 

the data of record that the DOE provided us, if they
 

appear to be compensable based on those large doses,
 

we're not going to hold those up. There's no reason
 

to go and collect environmental exposure information
 

or medical X-ray. We'll just move those forward,
 

and that -- those are sort of on a prioritized
 

basis. No one would be moved forward without the
 

complete picture of the site profile. As we
 

discussed earlier, it means you need all four pieces
 

of information -- environmental, medical X-rays,
 

internal exposure and external exposure. Without
 

the whole picture you can't make a real accurate
 

dose determination to move forward. Those are going
 

to be hard.
 

DR. ZIEMER: Larry?
 

MR. ELLIOTT: I'm glad Jim mentioned that --

what we're doing in regard to going out and doing
 

data review, data retrieval, capture efforts on AWE,
 

but I also would want you to know that -- you know,
 
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I have a number of staff here today, but a couple of
 

these folks are actually going to go up on the hill
 

to Los Alamos tomorrow and review records and
 

develop a data retrieval plan on some information we
 

think is very critical for the Los Alamos site, so
 

-- and this is just an example of one of the many
 

concurrent efforts that are going on as we're trying
 

to bring the contractor along. So we're not just
 

dealing with transferring information to the
 

contractor and telling them to go forward. We're
 

actually pursuing some of this ourselves at the same
 

time.
 

DR. NETON: Right. We're working hard at
 

this and we've actually -- until we get this
 

computer linkage up that has adequate security, we
 

have actually provided a hard drive that contains
 

ten gigabytes* of data to the ORAU contractor
 

they're loading on their own computers. So they 

right now have not necessarily real time, but fairly
 

real time access to the same information we have, so
 

we established that linkage already.
 

DR. MELIUS: Just one -- while we're talking
 

about AWE sites, I think it would be helpful -- at
 

least for me and maybe for the other Board members, 

to -- if for our next meeting or one of our next
 
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meetings for NIOSH to provide an update on those
 

sites and how you're handling them. I don't think
 

we've really discussed them very much here and I
 

think -- you're obviously making progress, but it
 

would be helpful to get a bigger picture of how
 

those are being handled, given the large number of
 

claims.
 

DR. ZIEMER: Jim, are you suggesting maybe
 

just a table or a matrix showing the site and where
 

it stands in terms of progress on -- with the site
 

characterization, or --

DR. MELIUS: Yeah, particularly relative to
 

claims coming in from different sites, what are some
 

of the problem sites. I think -- you make enough
 

progress, that may change -- the picture may change
 

in the next couple of months, but I think it would
 

be useful just for us to have a better handle on
 

what's happening.
 

DR. ZIEMER: Let me also ask -- and if this
 

goes beyond confidentiality things for the contract,
 

why you can decline it. I'd just like to get some
 

feel for either Jim or Rich (sic) Toohey, the degree
 

to which the contractor will be able to get up to
 

speed to where they need to be to handle this
 

contract. Is this going to happen in a week, a
 
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month? I'm not asking for a firm date, but some
 

kind of a feel for how that's going. It seems to me
 

there's going to be a lot of hiring that's going to
 

be done.
 

DR. NETON: I don't know how I can address
 

the specifics of that. It's an evolving process. 

We're just receiving our first monthly reports. I
 

think they'll be on my desk when I get back, but
 

maybe Dick can give us a glimpse of what he
 

perceives the future to be.
 

DR. TOOHEY: I'll try. Obviously, as you
 

all know, this thing is huge. We anticipate about a
 

dozen hires at ORAU, mostly health physicists on the
 

dose reconstruction research end of it. Our
 

partners maybe also another dozen full-time hires. 

The health physicists actually doing the dose
 

reconstructions are stringers, if you want to call
 

them that -- part-time employees who are already
 

under contract to our partners, and we have a
 

laundry list of about 90 of those people ready to
 

go.
 

Now, they have to be trained. And not just
 

in dose reconstruction, but also in Privacy Act and
 

conflict of interest and all these other equally, if
 

not even more, important considerations. The
 
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training has to be to procedures, so -- and the
 

procedures, as Jim mentioned, are under development
 

with NIOSH review and input.
 

The contract says that we cannot do any work
 

or any dose reconstructions, I should say, until
 

NIOSH has approved our quality assurance program
 

plan, which is a 90-day deliverable. I hope to have
 

that in between 45 and 60 days, so that's not a
 

hold-up. We have interpreted that to mean this
 

triaging of the records and things like that can go
 

ahead, even before that plan's been fully approved.
 

As was mentioned, we've already got staff in
 

doing telephone interviews. And in one of those
 

fortunate coincidences, some of our beryllium --

ORAU's beryllium staff in the Colorado office became
 

available because with the transition in fiscal
 

year, they were a little short on funding, so I've
 

got experienced telephone interviewers, already ORAU
 

employees, coming into Cincinnati to start reducing
 

some of the backlog of CATI interviewers while we
 

interview and train the permanent people doing that. 

So there's a lot of synergism going on here.
 

We expect to be able to actually start dose
 

reconstructions within a week or two, and some of
 

the ones that are the low-hanging fruit, clearly
 
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compensable, a case who -- you know, 40-year-old
 

developed leukemia with 30 rem external dose. I
 

mean that's an easy one. We'll get those knocked
 

out.
 

The ones that are clearly non-compensable,
 

as Mr. Griffon mentioned, that's a little harder to
 

do because unless you've got a good site profile,
 

you can't even estimate the maximum possible dose. 

But I would comment for some of the major sites, the
 

site profiles are pretty good. For instance, the
 

leukemia case controlled study that Health Effects
 

Research Branch funded between Hanford and Savannah
 

River, we got pretty good site characterization data
 

from that we can bring to bear. There's a whole
 

bunch of things on this.
 

My best guess is we will be fully ramped up
 

and hopefully cranking out at least 150 a week by
 

January 1st. We realize to clear the backlog we've
 

got to go beyond that, at least steady state from
 

the 8,000 that was part of the year, part of the
 

proposal would be 160 a week, roughly. We have to
 

get over 200 a week just to stay even, and to clear
 

the backlog it's got to be even more than that.
 

DR. ZIEMER: Is the clock ticking now?
 

DR. TOOHEY: There's a number of clocks
 
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working on this. Generally, the answer's yes. 

There's a 180-day clock from the time a claim is
 

received from DOL. There's a -- let's see, 30-day
 

clock once you've got all the information you need. 

There's a 14-day clock to do the CATI once the DOE
 

dose records have been received. So we've actually
 

got a whole bunch of clocks ticking simultaneously.
 

Part of the contract was to, together with
 

NIOSH, develop a plan and performance measures for
 

clearing the backlog, and that's currently in
 

development.
 

DR. ZIEMER: Thank you. Jim?
 

DR. MELIUS: Yeah. Again, tell me if you're
 

not able to answer this 'cause of the contract, but
 

it seems to me that all these clocks or many of
 

these clocks are dependent on receiving complete
 

dose information or exposure information from
 

Department of Energy. And I assume there's some
 

ability to adjust the clocks to take that into
 

account, also, 'cause it could very well be that you
 

could ramp up and be able to do 200 a week or
 

something, but you're not going to be able to do
 

that if you don't have complete information.
 

DR. NETON: That's correct. I think Dick
 

alluded to the fact that it's a 180-day -- 30 days
 
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after the -- all the information needed to do the --

once you've identified that there's sufficient
 

information, that's a 30-day clock.
 

DR. TOOHEY: Let me also mention that we do
 

have contractual obligation to inform NIOSH if we
 

are being delayed because of delays in getting the
 

data from DOE sites, and they're already tracking
 

this and we'll be taking that over and doing the
 

same thing, and advising NIOSH on the status of dose
 

requests site by site -- or I should say operations
 

office by operations office.
 

DR. NETON: As Dick mentioned, the backlog
 

of 8,000 is a somewhat different situation than once
 

they start taking the reins and moving forward with
 

the current plan instead of coming from Labor. We
 

can work all that out.
 

DR. ZIEMER: Other comments or questions?
 

(No responses)
 

DR. ZIEMER: If not, thank you, Jim, for the
 

presentation.
 

We are a little ahead of schedule and I'm 

now going to use this opportunity to follow up on
 

Dr. Roessler's suggestion, and that is to ask those
 

who are here as spectators and other support people
 

to identify themselves. And the way we'll do that,
 
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I think this is an open mike. Rather than do a Tom
 

Widner, come right up -- I'm not going to do that,
 

but I'm going to pass the mike around and ask, for
 

the record, identify yourself and who you represent,
 

if anyone other than yourself.
 

MR. BERMUDEZ: My name's Joe Bermudez and I
 

work with the Laborers Health and Safety Fund.
 

DR. ZIEMER: You've met Jim.
 

MR. CALHOUN: I'm Grady Calhoun. I'm a
 

health physicist with OCAS.
 

MR. HALLMARK: I'm Shelby Hallmark. I'm the
 

director of the energy program and worker's
 

compensation at Labor.
 

MR. SUNDIN: Dave Sundin with NIOSH/OCAS.
 

MR. PLATNER: Jim Platner with the Center to
 

Protect Workers Rights, which is the research
 

institute of the building trades department.
 

MR. KLEMM: Jeff Klemm, SAIC.
 

MR. NAIMON: David Naimon with the
 

Department of Health and Human Services.
 

MS. HOMOKI-TITUS: Liz Homoki-Titus with
 

HHS.
 

MR. WIDNER: I'm Tom Widner from ENSR
 

Corporation, the project director of the Los Alamos
 

Historical Document Retrieval and Assessment Project
 
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currently underway, working for CDC.
 

MR. GREEN: My name is Phil Green. I'm a
 

public health advisor with the radiation studies
 

branch at the National Center for Environmental
 

Health and I'm the project officer working with Tom
 

Widner on the LAHDRA project.
 

MR. SCHAEFFER: I'm Mike Schaeffer with
 

Department of Defense, Defense Threat Reduction
 

Agency, program manager of the nuclear test
 

personnel review.
 

MR. KOTSCH: Good morning, I'm Jeff Kotsch
 

with -- a health physicist with the energy
 

compensation group at the Department of Labor.
 

MS. TOUFEXIS: Rose Toufexis with the
 

Department of Labor.
 

MR. GRIFFIN: Jim Griffin, MJW.
 

DR. TOOHEY: Dick Toohey, ORAU.
 

MR. KATZ: Ted Katz with NIOSH.
 

MS. GILBERTSON: Tracy Gilbertson with
 

NIOSH.
 

MS. GARCIA: Dolores Garcia with Senator
 

Bingaman's office here in Santa Fe.
 

MS. HOMER: I'm Cori Homer and I'm with
 

NIOSH. I'm the committee management specialist.
 

MR. VAZQUEZ: Robert Vazquez with
 
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Congressman Tom Udall's office.
 

MS. ORTIZ: Michele Jacquez Ortiz, state
 

director, Congressman Tom Udall's office.
 

MR. SILVER: Ken Silver, environmental
 

consultant here in support of Los Alamos Project on
 

Worker Safety, LA POWS. We kept them out late last
 

night, but some of the workers will be here later.
 

MR. HENSHAW: Hi, Russ Henshaw,
 

epidemiologist with NIOSH.
 

MR. MILLER: I think that -- can we open the
 

comment period now? Richard Miller, Government
 

Accountability Project.
 

DR. ZIEMER: Thank you, everyone. Since we
 

do need a brief break before our next presentation,
 

I think -- is that correct, Mark? You need a little
 

setup time and so on, and so we are going to go
 

ahead and take our break at this time. It's
 

scheduled as a 15-minute break. We'll probably take
 

at least 20 minutes. Let's reconvene at 10:15, so
 

we're recessed for now.
 

(Whereupon, a recess was taken.)
 

DOSE RECONSTRUCTION WORKGROUP
 

DR. ZIEMER: I'll call us back to order. 

Earlier in the year we appointed a work group, a
 

subset of this Board, to serve as the dose
 
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reconstruction work group. Heading that work group
 

is Mark Griffon, and Mark, as you begin your
 

presentation if you would, for the benefit of the
 

record and all here, identify the members of the
 

work group, as well.
 

MR. GRIFFON: All right. Yes, the -- I'm
 

representing the work group for dose reconstruction
 

review, and we have our members Roy DeHart, Gen
 

Roessler, Rich Espinosa, Bob Presley and myself, and
 

Jim Neton has been -- a NIOSH representative -- a
 

regular member of our meetings to give us some
 

guidance.
 

Just for background, the statute requires
 

that the Advisory Board review a certain -- review,
 

as the -- I think these are from our charge in one
 

of our initial documents we created -- review the
 

scientific validity and quality of the NIOSH dose
 

estimation and dose reconstruction efforts. So with
 

that in mind, this work group has been working in
 

the past couple of meetings on the -- how will we go
 

about selecting the cases that this group will
 

review, how many cases should we review, what is the
 

scope of the review, and also do we need -- how can
 

we go about getting independent contractors to work
 

with the Board on reviewing -- on doing the case
 
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review.
 

And we met last night again to further flesh
 

out some of the -- in the last meeting we presented
 

a protocol which expanded on the scope of these
 

reviews a little further, and last night we met
 

again and we're now in the process of trying to take
 

what we've done as far as the scope and begin to
 

work it into an RFP where we can actually put it out
 

and get some bids in for contractors to assist the
 

Board in this audit function or review function. 

And last night the group met and we went through
 

some of this -- some of the major items in the RFP.
 

We have a draft which -- I hope we can finalize a
 

draft tonight and share it with the full Board
 

tomorrow. Right now it's in a little too raw a
 

form, but the presentation I have up here is going
 

to outline the basic things that we have included in
 

this draft RFP.
 

DR. ZIEMER: Mark, if we get into details on
 

the RFP, is that going to require an executive
 

session of this Board?
 

MR. GRIFFON: Well, that -- I'll defer that
 

question a little bit. I know in discussions we've
 

had we talked about any discussions of budget might
 

require an executive session, and to that extent I
 
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-- you know, like I said, we would have these drafts
 

ready tomorrow morning for the Board and maybe we
 

can consider that tomorrow morning as a...
 

DR. ZIEMER: Let me suggest the following. 

If -- discussions of this type have to be done in
 

executive session. We did not announce in the
 

Federal Register that there would be an executive
 

session at this meeting, so if there is one, number
 

one, we need to make that known today for the
 

members of the public who are here. And number two,
 

if there is an executive session, what I would plan
 

to do would be to put that at the end of tomorrow's
 

session so that folks who are here from the public
 

do not have to cool their heels out in the hallways
 

while we have an executive session. So if we do
 

need to do that to review details on an RFP for the
 

work group activities, then we will do that as the
 

very last item of business tomorrow rather than at
 

the front end, if that would be agreeable to the
 

Board.
 

I think in fairness to the members of the
 

public and others who are here, since this was not
 

announced in the Federal Register that there would
 

be an executive session at this meeting, we would
 

need to put it at the end of the session.
 
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MR. GRIFFON: I think that makes sense. I
 

don't know -- does any part of that have to be in or
 

only the budgetary discussion?
 

DR. ZIEMER: I believe only the budgetary
 

discussions. Let me defer to the staff here.
 

MR. ELLIOTT: Well, any monetary estimate
 

that you've derived and how you've derived it, such
 

as hours that you anticipate would be spent, those
 

kinds of informations are -- would be considered
 

proprietary at this point and would -- we would want
 

to protect it not to give unfair competitive
 

advantage, so yes, that kind of information would
 

have to be held separate from your presentation this
 

morning and held in executive session tomorrow
 

afternoon.
 

And I would add it's not only members of the
 

public, but we would restrict the attendance to that
 

executive session to the members of the Board and
 

Dr. Neton and myself, so the court recorder, the
 

writer/editor and the rest of the staff and the
 

public would have to recuse themselves outside this
 

meeting room.
 

DR. ZIEMER: So with that in mind, Mark,
 

please proceed then.
 

MR. GRIFFON: Sure. Okay. So just again to
 
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review, we've had a couple meetings here. After the
 

last Board meeting we did have a -- we met via
 

conference call on the 9th and we discussed some of
 

these same issues, the RFP and some budgetary items. 

The -- some of the discussion was that NIOSH
 

represent us on the role the Board would have in
 

the, quote, unquote, selection of contractors to
 

work with the Board, and I wondered if I couldn't
 

come up with a good word here. I mean NIOSH is
 

hiring this contractor and so the procurement
 

process is with NIOSH. We're trying to have a role
 

in defining the parameters, including the scope of
 

work, and how the bidders will be evaluated. And
 

this is coming -- this is the Board's input into
 

this process, if you will, I guess. So when I say
 

selection, we're not making a final decision on the
 

contractor.
 

On this conference call we did discuss
 

procurement processes, the options out there in
 

terms of sole source versus competitive bid process. 

Those sort of issues were discussed. We discussed
 

the work group's role in the development of the RFP
 

in that we would have a key role in this so we could
 

basically develop the scope of work entirely amongst
 

our work group and certainly reviewed by the Board. 
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We discussed the contractor technical requirements,
 

including the conflict of interest issues, so
 

technical requirements including personnel
 

requirements, but also -- we certainly had lengthy
 

discussions on the conflict of interest issues and
 

whether we would actually include language in the
 

RFP or in the evaluation plan or in both, possibly
 

outlining potential conflicts and conflict of
 

interest issues. And then we discussed the work
 

group developing an evaluation plan. 

The evaluation plan would basically be the
 

plan that was used to evaluate the bidders in this
 

sense, and the weights -- it would include -- we've
 

got some draft -- we've got one draft plan from a
 

previous contract, but it wasn't the dose
 

reconstruction contract -- another NIOSH contract --

where it outlined these sort of personnel,
 

technical, management, and we're adding in a field,
 

conflict of interest, and how those would be
 

weighted and how those would be -- certain weights
 

or points are assigned to each and then the bidders
 

are evaluated against that plan -- that evaluation -

- or with that evaluation plan in mind. And we're
 

redrafting something to that effect which also might
 

be ready tomorrow morning.
 
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79 

And then we also discussed Board
 

representation on the NIOSH review panel. NIOSH has
 

a review panel -- maybe Larry can describe this a
 

little better, the panel that reviews all the bids. 

And we had discussed the options of an external
 

reviewer being on that panel, and I think that was a
 

viable option. I don't know if it's gotten strict
 

approval from NIOSH yet, but I think that was
 

something that -- that a Board member could sit on
 

that panel was -- I think that conclusion was made.
 

MR. ELLIOTT: Did that come from Martha? 

Martha DiMuzio? 

MR. GRIFFON: Jim, can -- Jim --

DR. NETON: Martha DiMuzio of our office
 

checked with the Pittsburgh branch office and they
 

did indicate I think, at a minimum, one -- one
 

outside person could sit on the Board. We're not
 

clear at this point what level of training would be
 

required to participate in a Board meeting, though.
 

MR. GRIFFON: And a couple of questions were
 

just raised about that, too, as far as one -- one
 

Board representative or -- would it be one or more
 

Board representatives could be on it, I don't know. 

How would -- you know, could the Board select them
 

themselves and would that person be a voting member
 
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of that panel. I think those are some discussion
 

items at the end of this which I think we all should
 

discuss.
 

MR. ELLIOTT: Did you want me to speak about
 

the evaluation plan? I missed -- you asked me to --

just the panel.
 

MR. GRIFFON: Just the panel.
 

MR. ELLIOTT: Well, I'm glad to hear that
 

there's been some resolution that a Board member can
 

serve on that panel. There is training that would
 

be required, we know that. We talked about that
 

before, that NIOSH staff are required to take
 

training in procurement procedures and review. This
 

panel would be something we would set up. It's not
 

a standing panel, so within staff we'd identify
 

those technical staff members who would serve on the
 

panel along with the one Advisory Board member, and
 

they would use this evaluation plan that you all are
 

coming up with as the criteria to evaluate the
 

various proposals. So we've worked hard with Mark
 

and his group to try to identify ways to involve the
 

Board, get the Board integrated into this whole
 

process, and I'm pleased that I see some resolution
 

here toward that end.
 

MR. GRIFFON: So the RFP development is one
 
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thing -- one major focus of what we were discussing
 

last night. And this has sort of evolved into four
 

primary tasks for the RFP, and I think really at the
 

last meetings we were focusing on the first one,
 

which is review of a selection of individual dose
 

reconstructions. These next three have sort of
 

evolved from our conference call and also
 

discussions last night, and these include review of
 

selection of NIOSH site profiles, technical
 

assistance for SEC petition determination and review
 

-- that's a little awkward, but technical assistance
 

for the SEC petition determination. Another role
 

for this Advisory Board is we have to review all the
 

SEC petition determinations by NIOSH, and I think
 

there -- you know, down the line we may see a need
 

to call in for some expertise to assist the Board in
 

these reviews. I'll talk about each one of these a
 

little more in a second.
 

And then finally review of methods or
 

procedures used by NIOSH or the contractor for dose
 

reconstructions. And these are not -- as Jim
 

pointed out to me, these are not necessarily in
 

order. In fact, that last one we thought was
 

something that would probably be one of the initial
 

tasks for this contractor. Come on board, review
 
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the NIOSH and the contractor procedures and
 

protocols, methodologies right up front to make sure
 

everybody's on the same sort of sheet of music. It
 

seems to make a lot of sense to me, rather than
 

waiting till 600 or 1,000 cases are done and then
 

finding out through some review processes that we
 

have some real problems with the procedures, the
 

methods that ORAU and their team is using, so that
 

was something that was added on, too.
 

In addition to the RFP development, we've
 

been working on developing this evaluation plan. 

Part of that -- part of that certainly -- a big
 

piece that we're working with is the conflict of
 

interest component of that plan and how we will
 

evaluate conflict of interest. Wrestling with it is
 

the word I was looking for. That's the word. 

Certainly working on that.
 

And then the final thing, which I hadn't
 

included on my slides, I guess, but you'll be --

discuss more in the executive session tomorrow is
 

we've worked up some very preliminary draft sort of
 

budget numbers on what this might encompass.
 

Just to go through those tasks a little
 

more, the first one, review of the selection of
 

individual dose reconstructions. If you haven't
 
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been at some of these other meetings, we have -- I
 

might refer you back to the previous protocol we put
 

out which -- I don't know if it's available in the
 

back, but it's certainly on the web site. We talked
 

about selecting a certain percentage of cases and
 

for the first year we were looking at probably
 

around 200 cases. That was based on two to three
 

percent, which was a number similar to what the
 

veteran's program review ended up, around two and a
 

half percent, I think, of the cases.
 

Considering sort of three different levels
 

of review, a basic level, which would be much more
 

intensive; and advanced level, and then a blind
 

review. And a blind review would be where the
 

reviewing team wouldn't have the sort of input files
 

or any of the dose numbers that NIOSH or the
 

contractor generated. It would just go from the raw
 

data and reconstruct it from there.
 

The advanced review is above the basic
 

review in that the one example -- and I would refer
 

you back to the protocol 'cause it gives a lot of
 

little differences, but the one strongest part of
 

the difference is there's an administrative record
 

for each case, and I believe Jim -- make sure I get
 

this right -- at the top of the file, the data file,
 
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84 

will be the part that NIOSH or the contractor used
 

for the reconstruction. There may be other parts
 

that were not used to do the dose reconstruction. 

In the advanced review we would then ask the
 

contractor to review the entire administrative
 

record, whereas in the basic review we would only
 

look at the parts used by the contractor or NIOSH to
 

do the dose reconstruction. That's one example of,
 

you know, just the differences there.
 

Task two is the review of a selection of
 

NIOSH site profiles. And the reason we added this
 

task, and we think this is an important task, is --

just from my comments earlier today, that the
 

concern that if the site profiles are inadequate,
 

then -- we really think the Board has to have a role
 

in assuring that these site profiles are adequate
 

and complete -- this notion of completeness of data
 

-- to make sure that when the dose reconstruction --

you know, you could have a great deal of personnel
 

external and internal dose information and no site
 

profile, and then you get a site profile that just
 

doesn't match up and something's not in line with
 

the personnel records. So we think that at least a
 

selection of site profiles should be reviewed.
 

One part that we're having trouble with in
 
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defining the scope on this is just the issues on
 

access -- possible access to the DOE. We can see
 

already that we still -- we're still in negotiations
 

on the memorandum of understanding for NIOSH to get
 

access. Now we're asking for another contractor
 

potentially to come in and access DOE directly. I
 

personally think that's an important component of
 

this, just in terms of value added for this
 

independent review because if we're just going to --

to use the extreme example, if we're just going to
 

review the mathematics, I don't think we're going to
 

find great differences and we're just going to spend
 

a fair amount of money to do really -- not much
 

value added. Whereas if we have -- if we do -- we
 

can better check the adequacy and completeness of
 

the data being used for the dose reconstructions if
 

this contractor also has direct access, but
 

understanding that there's certainly some issues or
 

questions or hurdles to get over with that regard.
 

Another potential is that this contractor
 

would have access to site experts. And in the
 

contract for ORAU there's a section that talks about
 

the contractor working with site-identified experts
 

-- could be former workers, health physicists,
 

supervisors, line managers -- the gamut. And if
 
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those are identified by ORAU then that team could
 

probably be re-interviewed or -- you know, assessed
 

-- accessed by this contractor, as well, without
 

really having issues of going on the DOE sites. 

That may be another way to get at that. But that --

we're still wrestling with that and certainly would
 

ask for Board input on that.
 

I think there's one more slide and then we
 

can discuss some of these.
 

Task three is technical assistance for the
 

SEC petition determinations, and this is -- you
 

know, scope is undetermined at this time. You know,
 

part of the thing in wrestling with this is we don't
 

know how many SEC petitions might come in in the
 

first year. We don't know the breadth of these and
 

there's not even an SEC rule, so you know, this is
 

kind of up in the air, but we think that -- you
 

know, just looking down the line, I added this on in
 

and just thinking that at some point the Board may
 

need to call on these -- this expertise and it
 

certainly made sense. It's similar skills that
 

we're looking for so it certainly made sense as a
 

task to add into this -- into this work.
 

And the fourth one, review of methods,
 

procedures used by NIOSH and the contractor, and I
 
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think I mentioned that, just the preliminary review
 

of their protocols and procedures up front before a
 

lot of cases get done.
 

The next steps we're hoping to make this
 

evening, if my working group -- my working group is
 

available again, to complete a draft of this RFP to
 

share with the Board tomorrow morning, as I said. 

Also try to complete an evaluation plan -- a draft
 

evaluation plan. And I think we sort of -- we might
 

have resolved this representation on the review
 

panel issue already, but items for discussion now I
 

think are that, along with potential notification
 

lists. I was interested to hear Dick Toohey's
 

comment that there's some 90 -- I think he said 90
 

-- contractors, subcontractors, et cetera that are
 

already used up out of the pool of potential
 

contractors. And I think that -- this is why we
 

have this item on here. We're not -- I think if we
 

put an RFP out, we want to make sure that certain
 

people know about it.
 

And then finally discuss the budget. I
 

think that -- that will -- we've agreed we'll hold
 

till tomorrow's executive session.
 

And that's all we had unless anybody on the
 

working group -- did I miss anything?
 
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DR. DEHART: If I remember correctly, we
 

actually will not develop the RFP. That will be
 

done by procurement. But we will have input in the
 

formatting or the draft of the wording.
 

MR. ELLIOTT: You're drafting -- in this
 

complete the draft RFP Mark's talking about, you're
 

drafting the scope of work.
 

MR. GRIFFON: Scope, I should have said 

that, yes. 

MR. ELLIOTT: That's the piece that you're 

contributing to this bigger document called the RFP
 

which has a lot of boilerplate language.
 

MR. GRIFFON: And you're right, I should
 

have clarified that. Okay, and that's it, if any --

DR. ZIEMER: Okay, well --

MR. GRIFFON: -- discussions or questions.
 

DR. ZIEMER: -- why don't you go ahead and
 

sit down and you can answer from your chair. We
 

have questions or discussion. Let's start with
 

Henry over here.
 

DR. ANDERSON: Do you have any kind of a
 

tentative time line for accomplishing all of this? 

I saw -- I mean for tomorrow. The time line is
 

pretty clear for what you want to deliver tomorrow,
 

but for the rest of this as to how soon the process
 
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could move forward?
 

MR. GRIFFON: Well, I think we -- you know,
 

we know -- we're sort of working backwards, too. I
 

think we heard on our conference call that there is
 

probably going to be a 120-day period -- is that
 

right, 120 days after the bid goes out?
 

DR. NETON: Forty-five.
 

MR. GRIFFON: Oh, 45 -- a 45-day period?
 

DR. NETON: I'll have to clarify that.
 

MR. GRIFFON: Anyway, we need -- there is
 

quite a -- I mean even if it has to be posted, but
 

then -- then the time to actually get this
 

contractor on board, I think we're throwing around
 

120 days or so, but anyway, it's a fair length of
 

time. So we really see the urgency to get the RFP
 

out. And as I understood it, the critical
 

components that we need to finalize are this scope,
 

the evaluation plan and some sort of estimated
 

budget. And then I think we need to -- you know,
 

other -- other things which the working group can
 

continue to work on, like how we're going to select
 

cases and things like that, you know, that can sort
 

of be pushed aside for now -- unless it affects --

you know, unless it affects the scope. But I think
 

-- you know, unless it affects the scope, we're kind
 
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of pushing it aside. We're trying to get a draft
 

RFP and evaluation plan done, you know, in maybe the
 

next couple of days. It might need some more
 

massage work, but you know, at least within a week
 

or so I would say we could probably complete it --

complete that process.
 

DR. ZIEMER: Let me ask -- okay, Jim has a 

question. 

DR. MELIUS: Yeah. I think I -- I do like 

the idea of having the site profiles reviewed. 

However, I'm -- and I understand the dilemma of the
 

balance between -- how do you check that the
 

exposure information used for an individual case is
 

complete is a daunting task and could take up a lot
 

of time and effort. At the same time, the site
 

profiles are sort of a living document. They're
 

going to keep more information -- they're never
 

going to be complete. As NIOSH learns more as
 

they're going through and their contractor reviewing
 

individual cases, they're going to obtain more
 

information and put into the site profile. So I'm a
 

little concerned that the review of the individual
 

cases -- if I remember from the last meeting -- does
 

not include any attempt to go back and review the
 

amount of exposure information made avail-- was the
 
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91 

exposure information made available for that
 

particular case, was that complete. The check of
 

completeness will be what's available in the site
 

profile, what's available from the records that are
 

included in the dose reconstruction for that
 

particular case. And I would still like some
 

thought given to is there a way of -- at least on
 

some sort of a sub-sample of going back and checking
 

individual cases, also, to make certain that their
 

-- the information obtained for their dose
 

reconstruction was complete, since -- you know. At
 

the same time I don't necessarily think it can be
 

done for all cases, but at least for some.
 

Now we'll be discussing -- I think later
 

today or tomorrow -- the site profile process, I
 

believe that's on the agenda, and maybe that'll
 

become more clear there. But I still am -- I think
 

that the greatest concern that we're going to hear
 

from people about their individual dose
 

reconstructions is that the information was
 

incomplete, something was missed about my site,
 

about my exposure information and so forth. And I
 

think it behooves us to have a strong component of
 

our review focusing on that issue. Now whether we
 

have to do that as a separate -- last meeting we
 
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were talking about doing that almost as a separate
 

contract, a separate review given how much effort
 

would be required. I think that the approach you're
 

taking may allow us to do that as part of this
 

process by reviewing the site profiles. But at the
 

same time I'd like to see some individual case
 

review of that -- of that particular component. I
 

don't know where you are in terms of your
 

discussions, but it sounds like you've been
 

wrestling with this, also.
 

DR. ZIEMER: Well, Mark, aren't the blind
 

reviews intended in part to dig into that in more
 

depth and make sure that there's a completeness of
 

the dataset?
 

MR. GRIFFON: Yeah, that is part of the
 

intent with the blind reviews, and it was also
 

actually the advanced reviews we were trying to get
 

-- and I have the same questions that Jim has on
 

this. We were wrestling with where to draw that
 

line. But the advanced review also had a component
 

of comparing the site profile information against
 

the data used to do the dose reconstruction and, you
 

know, judging the adequacy of it for making a
 

determination. You know, I think we -- I'm not sure
 

how -- you know, we'll have to re-examine the scope
 
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93 

for the advanced review, but that's certainly
 

something that's been on my mind as we've tried to
 

wrestle with this scope language.
 

DR. MELIUS: I guess the example I'm
 

thinking of is the person who -- dose reconstruction
 

and then has questions about their particular work
 

process or task that they did for some period of
 

time that weren't included in the site profile. And
 

therefore what they believe to be their dose
 

reconstruction information wouldn't be in there.
 

Now presumably the NIOSH/contractor process
 

would be trying to get at that, also. But we're
 

supposed to be checking up on that part of the
 

process. So you know, we need to --

MR. GRIFFON: I think part -- I mean also my
 

hope on that was we are, in the advanced review --

or one of the reviews -- looking at the interview
 

process with the individual claimants. And you
 

know, I think if I were to review one of these cases
 

I'd say well, you know, this individual said they
 

were working on this process and had some concerns
 

about exposures to something and, you know, we don't
 

see that anywhere in the dose assessment. That
 

might raise a flag, you know, so we can ask if the
 

contractor was asking the right questions or looking
 
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94 

for the right information. That's an attempt anyway
 

to get where you -- you know, where you're talking
 

about.
 

DR. MELIUS: Yeah, but might that not be a
 

more -- a better check on the system and how it's
 

working than having another contractor review the
 

site profiles? 'Cause that's a huge task to do and
 

I think it would -- I'm not -- while it's tempting
 

in some ways, I'm not sure that you ever really get
 

your arms around it enough, given the amount of
 

effort that's available to be spent on doing that
 

and given the fact that those profiles are going to
 

be continually updated. So we're expecting them to
 

change. We never expect them to be finalized. If
 

something new or something that wasn't considered
 

important or people didn't think would come up now
 

comes up in terms of a number of cases and therefore
 

it has to be updated.
 

DR. ZIEMER: But nonetheless, I think we
 

could argue that you still have the responsibility
 

to review that. We cannot say we're going to wait
 

till the site profile is complete. So you have to
 

review what you have and say okay, have they made a
 

conscientious effort to get the information that's
 

needed to do an adequate dose reconstruction. Or
 
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are their obvious holes in the site profile. You
 

probably will never be able to say that you have
 

every piece of information, but you might be able to
 

say are there obvious gaps that need to be filled in
 

order to do a conscientious dose reconstruction. So
 

at some point we have to look at that and say have
 

they gotten the right information or are there these
 

gaps. I don't know what else you can do. We cannot
 

wait for completion.
 

DR. MELIUS: Yeah, I wasn't arguing for 

that. I'm just --

DR. ZIEMER: No, I understand you weren't, 

but --

DR. MELIUS: The question is the balance
 

between the amount of effort that goes into that
 

versus the amount of effort that we put into
 

checking individual cases as part of our review. 

'Cause again, I think the latter, the individual
 

cases are where these concerns are going to come up
 

from the claimants. That's where the complaints are
 

going to be or the --

MR. GRIFFON: Yeah, I guess I -- you know. 

I agree with that. I guess I was looking -- I was
 

looking to do both, and I agree with your concern
 

about scope. We certainly discussed this last night
 
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96 

that -- and to review a site profile, you know, boy,
 

that could be -- that could be wide open
 

potentially.
 

The concern I have with the -- you know, I
 

guess the concern about the -- just relying on the
 

questionnaires and interview process and things like
 

that, you might have process information, but the
 

questionnaires that have been developed talked about
 

potential exposures to radionuclides, and I've
 

interviewed a fair number of former workers at these
 

projects and I'm not sure we're going to get a lot
 

of information about specific radionuclide exposures
 

relayed on those questionnaires, so you may think,
 

looking at that, everything's fine. But you may do
 

a more in-depth site profile investigation and find
 

out that there were a lot more transuranics in a
 

certain process than anyone ever envisioned, you
 

know, as an example I've used before.
 

DR. ZIEMER: Mark, it occurs to me that you
 

were able to move ahead pretty well once you had a
 

feel for how the dose reconstruction process worked
 

and how the information was put together. I'm
 

wondering if we won't have a better feel for how to
 

evaluate the site profile when we see what that
 

looks like. I have only an intuitive feel for what
 
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that's going to look like, and Jim's going to help
 

us now.
 

DR. NETON: I just want to make a quick
 

comment to that effect. I think the development --

the degree of development of the site profile is
 

very dependent upon the individual case. You know,
 

some -- some -- so I think the Board really, in my
 

mind, would evaluate for that particular case was
 

the site profile sufficiently developed to make a
 

dose determination in light of the application of
 

our efficiency process. It's not that all cases
 

will be evaluated against all the data in the site
 

profile. Only those portions that are necessary to
 

be used to apply the efficiency process come into
 

play. So I sense we're going down a path where we
 

want to have this perfect site profile and apply it
 

to all the cases that come through it. I don't
 

think that's going to be the case. I think in
 

essence most of the cases will not necessarily
 

require the full-blown site profile development --

or a lot of the cases, anyway. So I think we need
 

to be a little bit careful about how much emphasis
 

is placed on the pedigree of the site profile versus
 

the extent that it was developed to actually
 

determine the dose for that individual claim. And
 
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maybe it'll become a little clearer when we do
 

discuss some of the dose reconstructions this
 

afternoon.
 

DR. ZIEMER: And it's conceivable that a
 

site profile might be adequate for one case on that
 

site and inadequate for another case on the same
 

site, I would presume.
 

Roy, you had a comment? No. Jim?
 

DR. MELIUS: I think Henry has. 

DR. ZIEMER: Henry, you're up. 

DR. MELIUS: Then I'll --

DR. ANDERSON: Yeah, I just wanted to kind
 

of -- I see the issues we're dealing with are kind
 

of two levels. One, the site profile issue, is
 

kind of an infrastructure -- data infrastructure
 

issue and is the Board -- do we want to get into are
 

we capturing for subsequent use all the information
 

available at a site, that over time information
 

erodes and is lost and the best time to capture
 

historic information is now, not ten years from now. 

That's one issue, and I think that's an
 

overwhelmingly large task, but we may want to look
 

at that. I think the individual reviews are going
 

to point out some of the holes, and as we go through
 

that I think that's going to be probably the way it
 
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will be easiest to investigate the site on specific
 

data information.
 

It seems to me that a critical factor's
 

going to be the case selections for review. And I
 

think as Jim pointed out to me, one of the issues we
 

may want to have as a criteria is we need to review
 

when a individual raises an issue on an exposure
 

that either is verified or not verified, we need to
 

review. So we've heard NIOSH will be addressing all
 

of those issues. We need to say -- look at is the
 

contractor and has NIOSH addressed that individual's
 

concern appropriate or if we're using, you know, a
 

group of experts on site, are they, you know, going
 

to be able to -- if we were to investigate that --

confirm what the individual said that might then
 

lead to a different conclusion. So seems to me a
 

key thing is how the contractor and NIOSH responds
 

to some of the exposure concerns raised by
 

individuals, and that will be part of the record and
 

that may be -- rather than randomly selecting cases,
 

we may want to look specifically at those kind of
 

issues 'cause I would say that's where you're going
 

to have the greatest potential conflict that a
 

worker's going to say well, I told them about this
 

and it never appeared. And we need to know was the
 
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decision made appropriate or not.
 

DR. ZIEMER: In fact I think you raise an
 

interesting part of the audit process and that is
 

how in fact does NIOSH or the contractor or both
 

respond to those issues that arise during the
 

personal interview process.
 

DR. ANDERSON: And see, those are the ones
 

that --

DR. ZIEMER: Not that we review the profile
 

itself, but how the profile was actually developed
 

tells you a lot.
 

DR. ANDERSON: I mean those are the things
 

that are going to build the profile.
 

DR. ZIEMER: I mean that's part of an audit
 

function anyway, is it not, to say how are they
 

developing the profile. Not just what's in the
 

profile, but how is it developed or what was
 

overlooked or what was the follow-up. Who else has
 

DR. ANDERSON: And maybe the assumptions
 

that were made --

DR. ZIEMER: Right.
 

DR. ANDERSON: -- will more than compensate
 

for the issue. So you know, how it was addressed --

DR. ZIEMER: Okay. Jim?
 
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101 

DR. ANDERSON: -- may well be fine.
 

DR. MELIUS: But there's also another group
 

of claimants that are going to be from claims made
 

from survivors that are going to have almost no
 

knowledge of the site or anything and are not going
 

to be able to raise these issues. So our audit
 

process also has to protect them and make sure that
 

every effort was being made to get complete dose
 

information, exposure information when they're able
 

to provide very little information to help NIOSH out
 

in being able to do so. And so I think that's
 

another part that we have to look at.
 

DR. ZIEMER: Yes, Mike?
 

MR. GIBSON: The Board's also still looking,
 

I think, at, you know, some potential -- how to deal
 

with conflict of interest issues with the dose
 

reconstruction contractor. What happens if a
 

claimant says I believe there's a conflict of
 

interest with this -- these people that's doing the
 

dose reconstruction process? Does their claim just
 

stay in limbo then or how is the -- how's that
 

question going to be answered?
 

DR. ZIEMER: Maybe Jim or one of the staff
 

people could answer that for us. Or Larry.
 

MR. ELLIOTT: He bounced it back to me. 
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Well, and Shelby Hallmark reminded me of this
 

earlier. I'm sure most of the Board remembers that
 

we talked about this at the last meeting, that there
 

is -- in the appeal process there's an opportunity
 

for DOL, in their adjudication of appeals, to --

claims through the appeal process, to remand those
 

back to us for further evaluation if new information
 

comes to light. Hopefully, in the example that
 

you're providing, Mike, we would recognize that
 

before it was sent out the door and we would deal
 

with it effectively. If the claimant -- before they
 

signed the OCAS-1 form they identified that I've got
 

an issue here with who did my dose reconstruction,
 

they make that aware -- make us aware of that, then
 

we would react to that and deal with that
 

effectively and remove that problem before it ever
 

got to an appeal.
 

DR. ZIEMER: Jim wants to add to that.
 

DR. NETON: I just was -- understood what
 

you were asking. As part of the -- we were talking
 

about the biographical sketches being attached to
 

the dose reconstructions so that a person would know
 

who performed it. Actually an option may be, and
 

we've discussed this, that at the time the dose
 

reconstruction is assigned to a dose
 
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reconstructionist, that would be forwarded to the
 

claimant so they would know up front who was
 

actually working on their case or claim and at that
 

time be able to raise an objection. It makes some
 

sense to be open up front, rather than after the
 

fact realize who did it and then cry foul or
 

something at that point. So that may be an option
 

to minimize that sort of a problem.
 

DR. ZIEMER: Yes, Rich.
 

MR. ESPINOSA: How transparent is that going
 

to be? I mean is the claimant going to be -- have
 

the access to the guy's resume?
 

DR. NETON: Well, as we talked about earlier
 

this morning, the final details of how that's
 

conveyed to the claimant are still being worked out,
 

but it would be something to the effect of either a
 

biographical sketch or a bulletized version of his
 

work history, that sort of thing, that would be
 

attached to possibly a letter sent to the claimant
 

saying your case is now in the dose reconstruction
 

phase and here are the credentials of the person and
 

their work history that is evaluating your claim. 

And at that point they could weigh in and make a
 

determination if that was a problem for them.
 

DR. ZIEMER: Okay. Other questions or
 
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comments? Let me ask the Board as a whole, do you
 

feel that the tasks that the work group has
 

enumerated, basically the four primary tasks, covers
 

what needs to be covered? And I'm not -- by asking
 

the question I'm not suggesting that I don't think
 

it does. I'm just giving you the opportunity to be
 

sure that the scope of what they've talked about --

and obviously one of the tasks, at least the one on
 

the Special Exposure Cohort, remains somewhat
 

undefined till the rule's in place. But in
 

general, do you feel the task is sufficiently
 

comprehensive or is it too comprehensive or what's
 

-- give us some feedback. I think -- I'm asking --

feedback to the work group.
 

MR. GRIFFON: I guess we would also, you
 

know, given Jim's comment on the site profiles and
 

the scope that that would involve -- I mean I think
 

if we get this draft document tomorrow, the Board
 

might have a better sense, then we can get some more
 

specific comments on where -- where those boundaries
 

should be and, you know, how the individual dose
 

reconstruction reviews are going to differ from
 

these site profile reviews and maybe which -- which
 

one is more the focus of the contractor. You know,
 

maybe one's a lesser focus than the other, you know. 
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So maybe they don't have enough details to give an
 

opinion on that right now, but...
 

DR. ZIEMER: Does the silence indicate
 

everybody's comfortable or everybody's
 

uncomfortable? 

DR. MELIUS: Yeah, I mean --

DR. ZIEMER: Jim. 

DR. MELIUS: I'll say it for myself, 

probably -- maybe for others, is that I think we are
 

comfortable and I thank the working group for
 

looking ahead a little bit and thinking about the
 

Special Exposure Cohort situation and other things,
 

rather than having us to scramble six months from
 

now or even a year from now to change the contract
 

around or whatever for doing that. I think maybe
 

after we've heard more about the site profiles today
 

and then when we see the document tomorrow, we can
 

wrestle some more with this issue of completeness of
 

records and how we include that in this process. 

But to me that seems to be the major issue in terms
 

of the scope of work that we need to discuss a
 

little bit more. But I'm certainly pleased with
 

what they -- the scope that's laid out so far.
 

DR. ZIEMER: Any other comments? Does Jim's
 

comment represent a minority report or is it...
 
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Well, let me ask it a different way. Does
 

anyone have a high level of angst with what the work
 

group is doing? If not, I think we'll proceed and
 

-- yes, Wanda. Okay, here we go.
 

MS. MUNN: I don't know if angst is the
 

right word. I'm having a little difficulty
 

determining where the level of detail and the level
 

of involvement of this particular Board ought to
 

fall. I see the items that the group identified and
 

think yes, those are good items, and how far into
 

that do we actually need to get. I hear Jim talking
 

about the level of concern the claimants are going
 

to have with respect to the oversight that we have
 

given. And I can't help but feel that we are always
 

in danger of trying to get too much detail into what
 

my perception of this Board's charge is. I hope
 

that we can keep in mind that we're trying to assist
 

both the claimant and NIOSH in their activities and
 

not be making things more difficult for either of
 

those in what we're doing. So I guess I feel a
 

little cautionary about how much detail we need to
 

be involving ourselves with.
 

DR. ZIEMER: Thank you for those comments,
 

Wanda. And if I might perhaps add to that that --

or perhaps comment on that, that -- and certainly
 
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it's been the intent I think of the work group and
 

of the Board as a whole that we are primarily
 

meeting to fulfill our responsibility for assuring
 

the quality of the work that's being done by the
 

contractor and by the agency, that we are not to do
 

the work of the contractor and the agency. The
 

primary task of gathering the information and doing
 

dose reconstruction lies in their hands, and we are
 

not established to micro-manage that.
 

We do want to have a way, I think, to assure
 

ourselves of the quality of the work that's being
 

done, the validity -- if I might use that word -- of
 

the work being done, so that there is in a sense an
 

independent look that those for whom the judgment
 

has been made can look with some degree of
 

confidence, whether they are compensated or not, and
 

feel that there was fair treatment, that it's not
 

some government agency that is simply trying to hurt
 

the little man, as it were, or the little woman. So
 

we have a role there to assure quality of the
 

process, and obviously we're walking a tight line
 

between what it takes to do that well and what it
 

takes to not do the work of the agency and the
 

contractor. And I think Mark and certainly the
 

working group's well aware of that, so -- but that's
 
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a good caution I think for us as we proceed to not
 

let this balloon -- a good word to use in this town
 

-- to balloon to the extent that we're doing the
 

work.
 

Yes, Leon.
 

MR. OWENS: I think it's important that we
 

keep in mind that credibility -- the credibility
 

that the workers have in this process, credibility
 

that they have that this Advisory Board is doing the
 

right thing, is maintained. There's a lot of
 

skepticism, as you all know -- skepticism based on
 

issues of the past. And I think that the more
 

transparent that we're able to make this process,
 

the better feeling that the public will have. I'd
 

like to commend the work group on what they have
 

done. I think that the scope of work is
 

appropriate. But again, I think that as we discuss
 

all these issues we have to keep in mind the
 

credibility of this Board. I think all of us would
 

want to have a product that we can be proud of,
 

whether a claimant is compensated or not. And I
 

think that we all would share in that. We want to
 

have this Board credible and we also want the
 

claimants to feel that their concerns have been
 

addressed and they've been addressed in a way that
 
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109 

is clear, that they can understand. It's not
 

confusing.
 

DR. ZIEMER: Thank you. And Mark, were you
 

about to say -- oh, okay. Next is Mike.
 

MR. GIBSON: I appreciate Ms. Munn's
 

comments, too, but I'd also just like to say that I
 

think if the government and the Department of Energy
 

had overseen their contractors correctly in the
 

beginning, there wouldn't be an Energy Employees
 

Occupational Comp Act, and I think that's why, once
 

it was established, it was important to remove the
 

dose reconstruction from the Department and to NIOSH
 

so that we can make sure that we have a true and as
 

close to valid dose reconstruction as we can.
 

DR. ZIEMER: Thank you. Any further
 

comments?
 

MR. GRIFFON: Can I just add -- before we
 

close out this session, there was one other thing --

discussion point there, and I don't know if it's
 

possible, but it might be worthwhile for us to get a
 

list of the 90 contractors that have already been
 

consumed by the dose reconstruction contractor. And
 

I mean this in all seriousness 'cause we've also
 

wrestled with the notion of availability of
 

appropriate expertise for this -- for this Board
 
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contractor. And then just -- I don't know if we
 

have individuals -- if we want to do it -- set up
 

the meeting here or -- or with -- in some way get a
 

list of individuals to notify that there should be
 

an RFP coming down the line on this issue.
 

DR. ZIEMER: I'd like to suggest that you
 

develop that list just as you work with the -- I
 

don't think we need to develop a list. In fact, I'd
 

be a little bit concerned about doing it in an open
 

meeting. It gets close to discussing personalities
 

'cause then you have to say well -- what we don't
 

want is the idea that Oak Ridge Associated
 

Universities got the 90 best people and so we're --

you know, they got the 90 draft choices and so we're
 

into the second team or something. There's many
 

other good people out there and I think you'll
 

readily be able to develop a list of qualified
 

people. But probably best done as you work with the
 

RFP. I don't know how the rest of you feel about
 

that.
 

MR. ELLIOTT: Let me react to that. I think
 

it's -- what I hear Mark asking for is who's
 

currently on board so that we can identify who's
 

not. We certainly can get that and we have time to
 

develop that and get it to the working group, to the
 
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111 

Board, before the RFP's issued. And as we talked
 

with Mark in the deliberations of this whole
 

procurement process -- we walked you through, Mark,
 

and for the benefit of the Board -- that if we can
 

identify who should be made aware that this RFP is
 

now available on the street and ready for proposal,
 

procurement will send that -- make sure that a
 

letter goes to those people. So that's what we're
 

after here. We can come up with that list. 

Procurement will send it out.
 

DR. ZIEMER: Okay. Have we completed the
 

discussion on this topic for now? And we will be
 

returning to it tomorrow. I'm just looking at
 

tomorrow's schedule for the moment to see where that
 

will go. I think -- huh?
 

UNIDENTIFIED: (Inaudible)
 

DR. ZIEMER: Right, but we have some fixed
 

presentations already tomorrow, and there is a Board
 

working -- Board discussion and working session
 

right after lunch, and that may be where it comes.
 

DR. MELIUS: Can I make one suggestion or
 

proposal? Not -- regarding another issue that I
 

think it would behoove us to find some time on the
 

agenda to speak about and that's this conflict of
 

interest issue. And given the time frame that NIOSH
 
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112 

has to work with this and given that some of these
 

issues are up in the air still, I think it might be
 

good if we spent a little bit of time tomorrow just
 

formulating some recommendations to NIOSH on some of
 

-- on what the Board would recommend in terms of
 

some of this transparency, what gets posted, what
 

kinds of information's available so that we've given
 

them a set of recommendations rather than reacting
 

to something they develop later and given time
 

frames and so forth. I think it'd be a better way
 

of doing it. So if we could set aside a half-hour
 

or something tomorrow to discuss that, I think it
 

would be good.
 

DR. ZIEMER: And again, Jim, let's plan to
 

do that during the working session and I'll ask you
 

to remind the Chair if the Chair is forgetful. 

Sometimes I do have senior moments -- not often, but
 

now and then.
 

I also have been informed by counsel that we
 

probably cannot have an executive session tomorrow
 

because of the requirements -- legal requirements of
 

the Sunshine Act and the requirement for prenotification in the Federal Register. So it appears
 

-- I don't know if that's a final --

UNIDENTIFIED: (Inaudible)
 
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113 

DR. ZIEMER: Yeah. We're still trying to
 

find some way to get this done, but we're cognizant
 

of the need to do things properly in terms of the
 

requirements of the Sunshine Act, so it may be that
 

we will not be able to have the -- an executive
 

session tomorrow since it was not announced in the
 

Federal Register. That could change, depending on
 

what we hear back from whoever's checking with the
 

right people. But in any event, we will have the
 

opportunity to discuss the other portions after the
 

work group has a chance to work further on this.
 

Let me ask Cori or others, do we have any
 

housekeeping items we need to take care of before
 

lunch -- before we break?
 

MS. HOMER: Let me check. Just a moment.
 

DR. ZIEMER: I'm sorry?
 

MS. HOMER: (Inaudible)
 

DR. ZIEMER: Remind, folks, for the public
 

comment period for this afternoon if you wish to
 

participate, please sign up. That's mainly so we
 

can plan for the time accordingly. I know there are
 

some who do wish to comment and we would simply ask
 

you to sign up so that we are aware of how many will
 

be involved in that.
 

Do we have -- we have no formal luncheon or
 
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114 

lunch plans. People are on their own for lunch. Is
 

there information available on where the good spots
 

are?
 

MS. HOMER: Well, there is a map --

DR. ZIEMER: They're all good in Santa Fe, I
 

know, but --

MS. HOMER: -- at the front desk. 

Unfortunately, there's no listing.
 

DR. ZIEMER: Okay. But there are many
 

places around the square here and close by,
 

including here in the hotel. I think many of you
 

have already scouted things out, so if you don't
 

know where to eat, you generally follow Bob Presley
 

or Roy. That's primary business when you get into
 

town.
 

In view of the fact that we're able to
 

recess a little early, let's plan to start up after
 

lunch a little earlier. Can we plan to be back at
 

1:00 o'clock? Shoot for 1:00 o'clock. Let's give
 

you 1:15. I know you're likely to get trapped by a
 

blanket trader in the square, so we'll give you --

let's say till 1:15, how's that? Okay, we stand in
 

recess till 1:15.
 

(Whereupon, a luncheon recess was taken.)
 

DR. ZIEMER: Let's begin the afternoon
 
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115 

session with one announcement, and that is that we
 

have definitely determined that we will not have an
 

executive session tomorrow, or today. There are
 

certain legal requirements that must be met in order
 

to go into executive session. We're not able to
 

meet those for this meeting, so we will give you an
 

update tomorrow on whether or not there's an actual
 

action required by the Board prior to even
 

scheduling a future executive session. So when we
 

get final word -- there's some e-mails going back
 

and forth with the proper authorities to find out
 

the rules of engagement for executive session, so we
 

definitely have to have one, but when and how has
 

yet to be determined.
 

EXAMPLES OF COMPLETED DOSE RECONSTRUCTIONS
 

So we're going to proceed with our agenda as
 

listed and we begin the afternoon with some examples
 

of completed dose reconstructions, and Grady Calhoun
 

and James Neton are going to lead us in that. Who's
 

going to start, Grady?
 

MR. CALHOUN: Jim's going to start.
 

DR. ZIEMER: Okay.
 

DR. NETON: Grady's name is first. There
 

was a tag-team effort. I'm going to start off the
 

discussion and then turn it over to Grady.
 
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116 

This is in response to -- I think at the
 

last Board meeting in Cincinnati -- a request that
 

we go over some examples of the completed dose
 

reconstructions, and I apologize to those who are on
 

the working group because we've taken a subset of
 

the ones that we've already discussed with the
 

working group, although these are of course deidentified and somewhat simplified in nature because
 

of that, so they won't look exactly as you saw them
 

before. But nonetheless, I think the messages that
 

we want to point out are still valid.
 

In looking at these things -- we've talked
 

about this at a number of different meetings, that
 

there are several different types of data that can
 

be used to perform a dose reconstruction, and those
 

include anything all the way from individual worker
 

monitoring data to -- which is what the DOE would
 

send us, their TLD badge results -- followed by
 

worker data with allowance for missed or actually
 

undetected dose, which we call missed dose. And
 

that would take the DOE record and supplement it
 

with dose that could have been received by the
 

person because of the detection limits of the badges
 

and frequency of the urine samples and those sort of
 

things. So that's sort of another stratum that we
 
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117 

would look at.
 

The third category would be the co-worker
 

monitoring data, where we had neither of those types
 

of information above available and we would just
 

rely on the worker's colleagues, as it were, engaged
 

in similar activities at the site.
 

And then followed by workplace environmental
 

data where none of the above existed, which would
 

consist of either air sample results, area
 

monitoring surveys, area TLD's, thermoluminescent
 

dosimeters, those sort of pieces of data.
 

And then finally followed by just source
 

term data, how much was there and what's the likely
 

range of doses a person could have received based on
 

just being there and working. Those are -- that of
 

course would be the most uncertain dose estimate.
 

What I have today to talk about is four
 

types of -- four dose reconstructions that address
 

the first four categories. We've done one -- at
 

least one of those dose reconstructions for each of
 

those categories. We have not yet done a dose
 

reconstruction where we have relied solely on source
 

term data, although I suspect that we will.
 

And just a little introduction before we get
 

into it about the report itself. I didn't
 
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118 

distribute copies of the reports to the Board. 

They're very -- fairly hard to de-identify and
 

redact all the information that would be required
 

for public dissemination because some of these are
 

fairly specific work activities. It'd be easy to
 

identify if we left some of this stuff in. But the
 

report itself has four pieces -- we tried to
 

standardize these reports, and the four categories
 

you see listed here are included in all reports,
 

which is an introduction, dose determination, the
 

information we actually used or didn't use, as the
 

case may be. And a summary of the dose
 

reconstruction itself.
 

We tried to keep these things reasonably
 

short, and by that I mean that in general we'd like
 

a dose reconstruction to be ten pages or less, if we
 

can. That's not been the case in some of these
 

things. I think the longest one we've written is
 

maybe 16 pages, but to give you a sense for how long
 

these things are, as far as volume. The idea was to
 

make it readable by the claimant and understandable
 

to the extent possible, but also to include enough
 

information that a health physicist knowledgeable in
 

these areas could go through and, with the
 

administrative record, determine if the dose
 
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119 

reconstruction makes sense and used valid concepts
 

and that sort of thing.
 

So the four cases that I'm going to go over
 

are somewhat going to follow this format that
 

follows the format of the dose reconstructions.
 

Okay. The first case we're going to talk
 

about is where we have the individual worker
 

monitoring data available, and Grady's going to
 

discuss that one.
 

MR. CALHOUN: Do the microphone shuffle 

here. Okay. Can you hear me? Can you hear me now? 

Good. 

This one is -- this one's based on 

information that we got purely from his individual
 

monitoring data provided to us from the Department
 

of Energy. This is going to be an underestimate of
 

the actual dose received to go along with our
 

efficiency process, and I'll try to highlight the
 

steps that we took in that effort.
 

Okay. Employment history, we -- like Jim
 

said, we took out all the sites, so he worked at a
 

reactor facility -- experimental reactor facility,
 

was a health and safety worker -- oh, I'm sorry, I
 

can do that here. This was a case where it was a
 

survivor, because the employee had passed. I did
 
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120 

the interview myself with the lady and found out
 

that his duties involved handling radioactive waste
 

and he was also involved in a clean-up after a
 

reactor accident and after several experiments.
 

The DOE reported dose was he had photon deep
 

dose of 22.6 rem. This is a whole-body dose as
 

reported by DOE. He had a shallow dose photon plus
 

beta of 28.1 rem. And his verified cancer --

verified through the Department of Labor -- was
 

chronic granulocytic leukemia. He was diagnosed at
 

40 years of age.
 

What I did first was just to run through the
 

process with just using the photon deep dose only. 

I didn't look at any internal dose. I just focused
 

on external initially.
 

Per our external dosimetry implementation
 

guide, there's three different ranges, energy
 

intervals of photons. And associated with each one
 

of those energy intervals are dose conversion
 

factors that are used to convert photon dose --

whole-body dose to organ-specific dose. I chose the
 

greater than 250 keV energy interval, knowing that
 

that would result in a lower POC than using the 30
 

to 250 keV energy interval because this was an
 

underestimate, so my starting point was to
 
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121 

underestimate, so that's why I picked that one. 

Chances are he was probably exposed to this, as well
 

as that other energy interval.
 

The dose conversion factors that I was
 

talking about vary, and so I used the very lowest
 

DCF so that multiplying that by the whole-body dose
 

resulted in the lowest dose to the red bone marrow,
 

and this again was an underestimate and that's why I
 

did that.
 

Okay. The information that we used was just
 

the reported deep dose recorded -- record from DOE,
 

employment dates from DOL, verified cancer from DOL
 

and a diagnosis date from the Department of Labor.
 

Based on the external dose alone, the
 

probability of causation was about 72 percent, so
 

I'm done. You know, we -- it didn't take a long
 

time, and what we do is to try to make this an
 

efficient process. And if we can get a case to be
 

greater than 50 percent in this little amount of
 

effort as we can, we're going to stop then because
 

there's no sense doing additional work to increase
 

that any further. Because once it's over 50
 

percent, it's in.
 

Now internal dose. There was internal dose
 

and there was records of internal dose. I didn't
 
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122 

use it, because just by going through the external
 

dose alone resulted in a POC high enough -- greater
 

than 50 percent, so I didn't even have to look at
 

the internal dosimetry implications of this
 

individual.
 

Any questions on that one before Jim goes
 

on? Yes, sir?
 

DR. MELIUS: Yeah. How will you keep your
 

records or a database on this particular dose
 

reconstruction? What would be -- for example, if
 

you were doing a fellow worker of that person and
 

were (inaudible), what sort of information would be
 

available -- and I think -- are you indicating that
 

well, yeah, you used a very conservative or an
 

underestimate of their dose so that if someone had
 

only worked there at a different time period or
 

whatever that -- I'm just curious how you're going
 

to --

MR. CALHOUN: Well, there's a couple of
 

different things that we can do. Now we are talking
 

about actually -- with the help of the contractor --

creating a nice table that can reference who worked
 

where, what kind of cancer they have. Even right
 

now, the way our database is set up, I can search --

like say this guy worked at ABC Company. Okay? And
 
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123 

I've got another guy who worked at ABC Company
 

roughly the same time period. I can search for ABC
 

Company. I can search by year, then I can look at
 

the sampling of those individuals who do have dose
 

information and we can do a co-worker comparison
 

based on that.
 

DR. MELIUS: Okay.
 

MR. CALHOUN: So we do have that capability
 

already. It could be better, but it's not bad right
 

now.
 

DR. MELIUS: Okay, that's what I was trying 

to get at. Thanks. 

MR. CALHOUN: Okay, and this is microphone 

shuffle. 

DR. NETON: Just to elaborate a little bit
 

on Grady's response, we have had discussions in our
 

early meetings with ORAU to establish what we
 

consider to be the research database, and that's one
 

vital component of it. 'Cause as Grady did
 

indicate, we can search now, but the reality is we
 

have very few cases. We intend -- without slowing
 

down dose reconstructions because dose
 

reconstructions need to move forward, we intend to
 

code all of the exposure information that we receive
 

from the Department of Energy, whether we use all of
 
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124 

it or not. It will be available in a database for
 

our use and potentially for future use as other
 

projects may need.
 

Okay. That was a fairly simple,
 

straightforward one. I have to say that's probably
 

about as simple as a dose reconstruction gets. You
 

just add up the record from the Department of
 

Energy, you don't even worry about missed dose or
 

potentially undetected dose, and the person appears
 

to be qualified for compensation. Yes?
 

MR. ELLIOTT: As you go through these, I'd
 

appreciate it if you'd tell the Board and the
 

audience an estimated number of hours spent
 

completing it. Just -- you know, if you can ball
 

park it.
 

DR. NETON: I'd like to couch that, though,
 

with a warning that we're on the learning curve here
 

and we expect that these things will go down, but
 

Grady?
 

MR. CALHOUN: I'd say with that first one it
 

probably took me -- once I had all the information
 

in front of me, not counting the CATI interview, it
 

probably only took 16 hours to get to the conclusion
 

that this was going to be a greater than 50 percent
 

POC. Now when you factor into it the amount of time
 
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required to write the report and send it through
 

some review and some iterations back and forth
 

through that, I would say it probably took a week. 

And that was a really, really easy one. I've done
 

several, and that one was very easy.
 

DR. NETON: I'd say 16 hours is a long
 

estimate. Now as we're going through them, I think
 

to actually take the data, enter it in and run the
 

PC calculation, I think it could be done in a couple
 

of hours or less and could get to that conclusion
 

very early on. And we're on the learning curve
 

here. It takes time to look at --

DR. MELIUS: Should we take the supervisor's
 

estimate and then the working guy's estimate --

DR. NETON: I'm going to switch gears to a
 

more complicated -- this is probably one of the more
 

complicated scenarios you're going to run against,
 

so you're going to see sort of a bracketing range
 

here of how complex these things can or cannot be.
 

This is a case where we actually had the
 

worker's data from the Department of Energy, but
 

they only provided us annual summary information,
 

the amount of external dose the person received
 

every year for a fairly long period of time.
 

In this particular case the claimant had --
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and actually this is a survivor claim, as well; the
 

person is deceased, I believe -- three primary
 

cancers. So the person developed prostate cancer in
 

1997, followed by lymphoma in 1998, followed by
 

basal cell carcinoma in 1999. These are all primary
 

cancers. These are not metastatic from some other
 

site. They're all verified by the Department of
 

Labor to be primary cancers and were treated as such
 

in the analysis.
 

The person had a fairly long employment
 

history at a DOE fuel and reactor -- in DOE fuel and
 

reactor operations. He started as a patrolman in
 

reactor operations between '48 and '52; switched
 

over to being an instrument technician, mostly
 

reactor operations, between '52 and '80; and then
 

became engaged in fuel fabrication -- a fuel
 

fabrication facility between '80 and '88, although
 

there was a little bit of uncertainty about exactly
 

when he shifted full-time from around the 1980 time
 

frame from reactor to fuel operations.
 

This person also has a relatively high gamma
 

dose record of 37.1 rem. This is just the annual
 

doses provided by the Department of Labor on record. 

The majority of the dose was from working in the
 

reactor area. And again, as in Grady's case, we
 
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started off by assuming that this person was exposed
 

to high energy photons that were greater than 250
 

keV. Again, that's the most that would result in an
 

underestimate if it were any lower than that in
 

energy.
 

I will say that in this particular case -- I
 

think I'll talk -- I'll get into this a little bit
 

later, but in this case DOE never did -- has not to
 

this day provided the individual monitoring records
 

for the badges, and so in this particular case these
 

records were supplemented with information that was
 

available in the NIOSH epidemiologic program that's
 

been going on for about nine years. The healthrelated energy research branch had some significant
 

-- most of the person's exposure information in
 

their archives, so that allowed us to move this case
 

forward.
 

There was a very low recorded neutron dose
 

on this individual. I think his total neutron dose
 

as reported by the Department of Energy was 80
 

millirem. And we need to discuss a little bit the
 

concept of unmonitored versus missed dose. Missed
 

dose is the badge -- the amount of exposure was
 

below the detection limit. In fact, after reviewing
 

the records at the facility that this person worked,
 
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it was determined that the badge itself could not
 

measure neutrons below the average neutron energy
 

that were present at that facility. So in a sense
 

it was essentially an unmonitored dose for that
 

fission spectrum of neutrons that range from I think
 

.1 to two -- .1 to two MeV, something like that. 

And even if they were detectable above the average
 

neutron energy, the detection limit of the badge
 

itself was stated in that time period to be around
 

50 millirem. So we've got a lot of potential here
 

for a person to have been exposed to neutrons and
 

not have been recorded.
 

So we went and did our homework and pulled
 

some data from the sites, trying to develop these
 

site profiles. It turns out Jack Fix* in 1996 did a
 

-- with others, did a study to evaluate the old --

monitoring capabilities of the old neutron films,
 

the -- what's known as the NTA films, Nuclear Track
 

emulsion type A films. He did estimate that even
 

when it was measured, it was under-reported by about
 

ten percent, which is not too bad. We could account
 

for that.
 

Also of significance is the relative
 

biological effectiveness that was used in this case
 

was ten. And if you remember way back from the
 
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David Coker presentation back at the Denver meeting,
 

our relative biological effectiveness that we're
 

assigning varies and it can be as high as 20 for
 

fission spectrum neutrons.
 

So applying this Fix -- the Fix evaluation,
 

the study that was done, we were -- we were looking
 

to apply -- we knew what the person's gamma
 

exposures were and we wanted to develop some kind of
 

a ratio of what the neutron to gamma exposure was. 

So, you know, based on so much gamma, what
 

percentage of that could have been a neutron
 

exposure. And the ratios of neutron to gamma ranged
 

anywhere from about .13 to .73, a fairly wide range,
 

depending on the area and the monitoring program and
 

a number of different factors. And the ratio also
 

was dependent upon the magnitude of the dose.
 

So what we adopted here was a distribution,
 

where we felt the best indication of the average
 

ratio of gamma -- neutron to gamma was .26, but we
 

assigned a distribution to that that ranged anywhere
 

from .13 to .73. So if you all remember that the
 

IREP program itself allows for a Monte Carlo
 

simulation to not just used a fixed point, so we
 

could sample the possible range of neutron exposures
 

this person may have experienced in his work
 
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environment.
 

There were a number of claimant-friendly
 

assumptions imbedded in this analysis, and one is
 

that -- remember, we're ratioing the whole body
 

exposure gamma -- the neutron to gamma ratios. In
 

this particular case, though, we added some missed
 

dose to the gamma dose because not all the badges
 

had measurable results on them so we increased the
 

person's dose. The neutron to gamma ratio that we
 

used was based on that total reconstructed dose, not
 

the dose of record from the Department of Energy.
 

We also used the gross track counts from the
 

badges without -- the method that Fix used was
 

method one where it was using the gross tracks. We
 

didn't know what the background subtraction was so
 

we just assumed the gross tracks were representative
 

of total neutron exposure. And a couple of other
 

indications here. We assumed continuous exposure
 

from '53 to 1980, even though there were some high
 

gamma exposures during -- obviously we couldn't
 

differentiate between the two so we assumed that
 

this neutron exposure occurred throughout this
 

entire time frame, and that same thing applies to
 

1980. We applied the same ratio.
 

The dose conversion factors are not really
 
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important in this study. I just want to point out
 

that we do -- we do use them in our analyses. And
 

as Grady indicated, there are certain dose
 

conversion factors that we use, depending upon the
 

exposure geometry of the person. So we've -- we're
 

sort of moving towards refining these dose
 

conversion factors, and for a patrolman we decided
 

that his exposure would be 25 percent from the front
 

to the back, 50 percent from -- rotationally around
 

the body, and 25 percent isotropic, meaning from all
 

directions. This is professional judgment that
 

we've applied in here, but we believe it to be -- at
 

least in our minds -- a fairly accurate depiction of
 

their exposure profiles.
 

In the instrument technician we've assume a
 

75 percent anterior-posterior exposure and a 25
 

percent rotational.
 

These factors affect -- make small
 

adjustments to the dose. These are not huge
 

adjustments that are made.
 

Okay. I don't want to belabor this too
 

much, but this is sort of a summary sheet that
 

describes what we did. We took the whole body dose
 

plus the missed dose and came up with a whole body
 

gamma dose to eventually come up with a total body
 
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gamma organ dose. Then we took that total body --

whole body gamma dose, used the gamma to neutron
 

ratio and then estimated what the total neutron was,
 

even though his total exposure to neutron was
 

estimated to be -- or measured to be 80 millirem by
 

the Department of Energy.
 

This is just a pretty picture that shows a
 

lot of the work we go through. We've generated 106
 

of these printouts so -- to give you a flavor for
 

how complicated some of these can be. I won't
 

bother going over any of those. If anybody has any
 

questions on those later, we could talk.
 

So we ended up with 68 inputs into IREP for
 

the prostate, two radiation types with 30-plus years
 

exposures. Another 68 inputs for the lymphoma
 

cancer and 106 inputs for the skin cancer because
 

there were four radiation types involved in his
 

exposure scenario. The beta exposure is not
 

included in internal organ exposure where it is for
 

skin cancer.
 

And this just goes over briefly the skin
 

dose determination. The badge actually was capable
 

of differentiating between beta exposure and photon
 

exposure with an open/closed window, so we looked at
 

that and calculated what the skin dose was directly
 
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off of the open window badge with some corrections,
 

and there was some indication in the person's file
 

that they did have a skin contamination incident at
 

one point, but it was not included in this analysis
 

because we felt that we had sufficient dose
 

information in the file to move forward and
 

determine probability of causation.
 

So we did at this point not proceed any
 

further with the additional dose information that we
 

could have, which would be to evaluate the person's
 

environmental dose, since there was a large fission
 

product release at this facility between 1945 and
 

1961. The person also had 44 individual
 

occupational X-rays during his employment history,
 

two of which were stereoscopic X-rays that tend to
 

be the large dose-givers, the ones that are
 

sometimes an order of magnitude higher than your
 

normal diagnostic chest X-ray. And he also, like in
 

Grady's case, had a positive urinalysis for some
 

transuranic materials, in this case plutonium and
 

uranium. And as I indicated earlier, the skin
 

contamination incident that he was involved with was
 

not included.
 

So we did end up using the annual dose
 

provided by the Department of Energy. However, we
 
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supplemented those with radiological records
 

provided by the NIOSH epidemiologic study group, and
 

we also used site-provided information on the
 

history of the dosimetry program to augment our dose
 

reconstruction, and this is essentially the start of
 

our site profile information at this particular
 

facility -- for external exposures, at least.
 

So in summary, these are what the PC --

these are what the organ doses were determined to be
 

for the individual, and you see the individual PC's
 

over here. Now one quick question, if you're sharp
 

after lunch here, why we just didn't do the skin
 

dose estimate because that exceeded 50 percent. And
 

the answer to that is -- I'll head off the question
 

-- is that we started doing this thing well before
 

the IREP models were finalized. And in the early
 

IREP, basal cell carcinoma, that model was -- we
 

knew it was being re-evaluated, but yet we were
 

trying to move forward, and under the old model this
 

person would have been below 50 percent. Under the
 

new model they were above 50 percent. So we had all
 

of these done anyway, so we ended up not discounting
 

them. We just included them in the final report.
 

It's interesting to note that even with a 60
 

rem lifetime dose estimated to the person to the
 
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prostate, the probability of causation is less than
 

50 percent, so this is an indication that prostate
 

cancer does require a fairly significant exposure
 

for compensation -- dependent upon age, of course. 

Lymphoma was 24.
 

So if one adds all these together using the
 

formula that is in our rule to combine the
 

individual probability to come up with a total
 

probability of causation, this claimant's overall
 

probability of causation ended up slightly over 74
 

percent.
 

So I know that was complicated and longwinded, but I wanted to give you a flavor for how
 

these things can go. And given that, we still
 

didn't even look at the person's internal exposures. 

We could have lengthened this dose reconstruction. 

I will say that several weeks at least were spent on
 

this dose reconstruction. A lot of that was
 

learning curves as obtaining the background
 

information, reading those profiles, that sort of
 

thing.
 

Are there any questions on this one in
 

particular? Or have I put you all to sleep with it? 

Dr. Melius?
 

DR. MELIUS: How are you capturing some of
 
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your sort of work rules or -- so for then getting
 

those to the contractor and in a way that allows
 

them to make an informed use of this information and
 

DR. NETON: That's a good point. We've
 

talked about that. We envision a series of
 

bulletins so that these things get disseminated to
 

the field rapidly so this cadre of 90 or whatever
 

people working in the field will have access to the
 

latest and greatest information. But those would be
 

assembled eventually and consolidated into technical
 

basis documents, white papers, positions papers, if
 

you will, that would document what those positions
 

are, and that's one of our big concerns is
 

consistency. That's one thing the NIOSH health
 

physicists will be looking for is consistency of
 

application of these concepts, you know, across the
 

board for the different work category. Good
 

question.
 

I believe we have a question from the
 

general audience. Is that -- do we entertain
 

questions from the audience at this point?
 

DR. ZIEMER: Yeah.
 

DR. NETON: Okay. Joe -- or --

UNIDENTIFIED: (Inaudible)
 
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137 

DR. ZIEMER: Would you go to your mike,
 

please, sir? And please state your name for the
 

record.
 

MR. SHONKA: My name's Joe Shonka. There
 

was an additional claimant-friendly assumption that
 

you didn't state, and that's ignoring the shielding
 

of anti-C's and other clothing for the skin dose.
 

DR. NETON: That's correct. I think in this
 

particular case the cancer was on either the neck or
 

the cheek, I can't remember the specifics, so we did
 

not include that. Although if it were on a location
 

that would have potentially been shielded, we would
 

have evaluated that. I'm glad -- thanks for
 

pointing that out.
 

MR. SCHAEFFER: Mike Schaeffer, Department
 

of Defense. What would you do with a particular
 

case where you arrived at a probability of causation
 

below 50 percent; however, the person had a history
 

of higher exposures, either through occupational
 

exposures in other industries or perhaps an atomic
 

test participant?
 

DR. NETON: Under -- the way the Act is
 

written, we would not include those exposures in his
 

dose reconstruction. The probability of causation
 

calculation only uses doses incurred at covered
 
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facilities -- DOE facilities or AWE's, so we would
 

not evaluate that case for those exposures.
 

MR. MILLER: Richard Miller from GAP. Let
 

me ask you what would have happened if your
 

probability of causation in this case again came out
 

below 50 percent? You made a set of assumptions
 

regarding your ratio of your neutron to gamma -- I
 

think it was a .26 and then you created a
 

distribution there. Assuming the neutrons in this
 

particular case had a much higher relative
 

biological effect than gamma, for example, would you
 

have re-run -- what policy or -- what would have
 

been your approach? Would you have then said okay,
 

well, let's make it .50 or .76? What would you have
 

done in a case like that?
 

DR. NETON: That's a good question. The
 

concept here is -- and we talked about this before
 

-- that we keep pulling the thread on this claim. I
 

mean you just keep trying to find dose until you can
 

find no more dose to add to the case, and at that
 

point if that ends up being below 50 percent, that's
 

what it is. So we would not -- if this case came
 

out 40 percent, then we would go back and say okay,
 

let's look at the environmental dose, let's look at
 

the internal dose from the transuranic out-take,
 
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let's look at the skin contamination incident. And
 

in fact if we had exhausted all those possibilities
 

and added in the medical X-rays and it came out to
 

be 40 percent, that's all we can do. There is no
 

more dose to find in that file. So your original
 

question about the neutron dose, we don't know any
 

more about that neutron energy spectrum, so in this
 

particular case I suspect that that distribution
 

would stand. If we don't know any better, we don't
 

know any more, so that particular distribution for
 

the neutrons, the gamma -- the neutron to gamma
 

ratio would be used.
 

MR. MILLER: Can you just explain -- where
 

did you get the .26 from?
 

DR. NETON: Okay. There was a -- Jack Fix,
 

et al had published an article -- it's actually a
 

report at their site -- that reviewed for gamma to
 

neutron ratio -- or neutron to gamma ratios at these
 

particular facilities that we're looking at, and
 

those ranged anywhere from I think .13 to .72. We
 

cannot make a judgment as to where that range fell,
 

other than the fact that -- and I didn't do this
 

dose reconstruction so I can't exactly pinpoint why
 

.26 was believed to be their best estimate -- there
 

is a reason behind it that is documented, but we
 
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decided that .26 was our best estimate, but we would
 

allow the range to vary between .13 and .72 on a
 

sampling basis. So all of those possible ratios
 

were sampled, given a triangular distribution.
 

MR. MILLER: But just to be clear, you're
 

not picking the upper confidence interval, you're
 

picking -- you're picking some mean around that
 

distribution.
 

DR. NETON: That's correct. That's correct. 

It's the best estimate of central tendency. It
 

might not necessarily be the mean, but that's
 

correct. We are -- we are using what we believe to
 

be a reasonable approach to this.
 

MR. PLATNER: Jim Platner, Center to Protect
 

Workers Rights. Oh, I'm sorry.
 

UNIDENTIFIED: Go ahead, Jim.
 

MR. PLATNER: I just wasn't clear whether
 

you're -- you were saying that you're trying to sort
 

of accelerate processing for ones with the -- with
 

high exposures. Is it simply accelerating the dose
 

reconstruction for those cases or is there some sort
 

of triage of claims so that you assess first the
 

high dose case?
 

DR. NETON: It's sort of both, actually. I
 

mean if we can -- if we find a claim that has --
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141 

appears to have a very high dose and looks like a
 

candidate where one can just add up the dose of
 

record and move it forward, we'll do that. So it --

we've been triaging at this point primarily because
 

we don't have -- we didn't have the resources and we
 

wanted to get some experience with these claims. 

But as ORAU goes through them, we've talked about
 

this where we need to get back to starting with
 

claimant one and moving through and looking at the
 

DOE data, evaluating it and seeing if we can do
 

something and requesting information. It's only
 

fair. Those claims have been sitting there longer. 

But also to be compassionate and fair, people that
 

can be moved through the system with -- I don't know
 

if it's a couple of hours or 16 hours, it depends on
 

-- a matter of debate between myself and Grady -- we
 

need to get those out the door, too, so it's really
 

a combination of both of those things.
 

DR. MELIUS: Any way of -- with respect to
 

estimating work time, if you had had to do the other
 

-- the internal dose, some of the other things you
 

didn't have to do for this particular case, about
 

how much longer would it have taken? Any idea?
 

DR. NETON: Of course that depends, but
 

internal doses can be difficult. Assuming we had
 
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the full record on the person for his internal
 

monitoring, I would say another week or two on that
 

case. But we will gain some efficiency in that once
 

the site profiles are there. The analysis itself is
 

not that difficult. It's actually gaining the
 

expertise and knowing what to do with the data,
 

which models to run, that sort of thing. So it's a
 

difficult determination.
 

Okay. Now I'm not sure which one is next
 

here.
 

MR. CALHOUN: Let's click it just to make
 

sure.
 

DR. NETON: Oh, that's mine.
 

MR. CALHOUN: Oh, that's you.
 

DR. NETON: I didn't think I was totally
 

inefficient in arranging this thing. This just
 

follows those three -- those four bullets that I
 

talked about earlier so it just sort of fell out
 

this way.
 

This is a dose reconstruction where we had
 

no monitoring information for the worker. In fact,
 

this is a dose reconstruction representative of an
 

Atomic Weapons Employer. It's one that we've
 

completed. This person was employed at an AWE, a
 

uranium facility, in fact, and again a fairly long
 
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143 

work history. This is a survivor claim, as well, I
 

should point out. The person worked there from 1940
 

to 1980. It was never really determined by Labor
 

through contact with the facility the person worked
 

there. Employment was actually verified via
 

affidavit, which is one means the Department of
 

Labor uses to verify eligibility in the program.
 

The person died of esophageal cancer in 1986
 

and upon interview with the survivors, they were
 

very unaware of the specific work activity of this
 

claimant. All they knew was the person went to work
 

at this facility and came home dirty, in coveralls
 

and apparently worked in a fairly messy operation,
 

which would rule out the fact that he worked in an
 

administrative area or something like that. He was
 

a production-type worker. So that's about all we
 

really knew starting this claim.
 

We of course asked the Department of Energy
 

to provide us some type of information on this and
 

we received very little. The Office of Worker
 

Advocacy provided some information, which consisted
 

of contracts and contract amendments with this
 

facility, which established that the employment
 

history for covered employment, at least at this
 

facility -- and some idea about what they were
 
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doing. We had some technical progress reports. 

There was a post-decontamination survey done on the
 

facility I believe in around 1960 time frame, and a
 

Former Utilized Site Remedial Action Program, the
 

FUSRAP program, actually became involved with this
 

site and did some fairly decent documentation about
 

what contamination levels were around -- I think it
 

was '60 or '61.
 

As I mentioned, we did conduct an interview
 

with the survivor, learned very little, could not
 

describe any of the work activities -- I essentially
 

went over these bullets -- and then also did believe
 

that all co-workers were deceased. We always ask
 

that question. It's the last question on our
 

interviews, can you give me names of any co-workers,
 

and they were unaware of any of this person's coworkers that we could talk to to find out more about
 

the process.
 

So we started a search for data. Again,
 

this is a co-worker data, so we tried to find
 

someplace where we could hang our hat on to at least
 

give a bracketing range for doses at this facility. 

The company was no longer in business. They no
 

longer exist. In fact, it had been turned into a
 

school, I believe, after it ceased operations. The
 
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company handling retirement accounts could not
 

describe what happened to the AWE. So our approach
 

was to go -- look at the DOE web site -- and again,
 

we talked about the progress reports, the contracts.
 

We did contact -- this was an extrusion
 

plant or at least purported to be an extrusion
 

plant. They were trying to take the uranium billets
 

or whatever and turn them into rods. So there was
 

only one existing AWE extrusion plant still in
 

existence and that is the RMI facility in Ashtabula,
 

Ohio. They're undergoing remediation at this point. 

We contacted them, hoping we could maybe get a range
 

for similar facilities. You know, what type of
 

activities went on there. But it turns out that
 

when we did the search at this Atomic Weapons
 

Employer, they had monitoring information for the
 

AWE we were looking for. Somehow that process was
 

transferred, through several other plants -- through
 

a Michigan facility -- and ended up in this
 

Ashtabula facility. So they actually had dosimetry
 

records for 1959 and 1960 for this particular
 

facility where the claimant worked. This was a
 

really good find for us. We were pretty happy about
 

that.
 

Also in reviewing these external dosimetry
 
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reports, we noticed that additional documentation in
 

the files indicated that the Department of Energy
 

Environmental Measurements Laboratory had taken some
 

bioassay samples. So we contacted the Department of
 

Energy Environmental Measurements Laboratory, and lo
 

and behold, they had about 200 pages of bioassay
 

samples for this facility, as well. So we felt like
 

we were onto something and, given that type of
 

information, we might be able to do a dose
 

reconstruction for this worker based on co-worker
 

data.
 

Above and beyond that, in looking at the
 

dosimetry reports, the reports were sent to the
 

radiation safety officer in 1959 and '60 and we
 

recognized that he's still an active member of the
 

Health Physicists Society, so we called him up and
 

asked him if he'd be willing to be interviewed to
 

discuss the operations in this time frame at this
 

facility, and he did.
 

So during this interview we learned a lot of
 

interesting things, and some of them are indicated
 

here. He indicated that it was an AEC project, that
 

the AWE employed about 12 technicians and
 

administrative personnel only at that facility, so
 

it was a fairly small operation, subset of the
 
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plant. It was actually a metallurgy laboratory only
 

and the general plant personnel did not migrate
 

through that operation. He did believe that all
 

technicians on this job site were monitored, and in
 

fact we did find monitoring results for 12
 

technicians for those couple of years. He did state
 

that all technicians wore coveralls and lab coats,
 

and that he did not think that in this particular
 

operation -- this was a fairly clean metallurgy
 

laboratory. They were looking at process and not
 

production. They weren't actually making these
 

rods. They were actually investigating the process,
 

and this was not typical for these people to become
 

dirty doing their work. There were other facilities
 

at the site that that was clearly the case, but not
 

in this laboratory.
 

Okay. A few more things that we learned was
 

all the extrusion, as I mentioned, took place at
 

different facilities, so they never really extruded
 

any rods at this facility. And in fact, that was
 

all done at this World War II Air Force aluminum
 

extrusion facility in Michigan at some point. The
 

AWE was sold in '61 and operations were moved to
 

other facilities, and I think this was the time
 

frame it became a school. It was -- a
 
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decontamination survey, though, was done at that
 

point and we have that data, so we felt pretty
 

comfortable we knew the whole story.
 

So in looking at the film badge results we
 

obtained from the records at the RMI facility, none
 

of the film badge records were assigned to the
 

claimant that we were looking for. Again, they were
 

only for a two-year period. So what we thought was
 

-- we realized that the process didn't change much. 

We knew the process didn't change much over the
 

whole period of operation that it ran those 12
 

years, so what we attempted to do was to find out
 

what was the highest external exposure at that
 

facility to the highest employee, so we took the
 

highest annual dose for any monitored employee over
 

those 11 years, which resulted in an upper estimate
 

of 550 millirem per year being assigned to the
 

worker -- or to the claimant.
 

And what this -- these two graphs show a
 

sort of before and after picture. These 24 numbers
 

here represent the 24 individual badge reads we had. 

This is -- there were 12 people monitored for two
 

years, so we had 24 annual doses. So this is the
 

highest annual dose of any particular year was
 

somewhere around 375 millirem, and you see a lot of
 
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people received nothing and much lower than that. 

So we went back in and added a missed dose into
 

these badges. These were annual summaries and we
 

knew the badge exchange frequency and the detection
 

limit, so we added back in a potential missed dose
 

and we determined that the highest monitored
 

individual for any given year was 550 millirem. So
 

what we did was we assigned that 550 millirem for
 

every year that the claimant worked at that
 

facility, even though we weren't sure or had any
 

evidence that that person received that exposure.
 

The internal dose -- again, we had a lot of
 

fairly complete -- we believed complete monitoring
 

records for that facility that were taken by the
 

Environmental Measurements Laboratory, which is a
 

pretty well -- pretty reputable laboratory within
 

the DOE system, and again no record of that employee
 

ever having been sampled at that facility.
 

The samples were not routine samples. They
 

were not on a routine program, but they did cover a
 

majority of the time period that these people were
 

working there. The first several years were fairly
 

consistent, indicative of a -- possibly like a
 

chronic, low level exposure, followed by a couple of
 

incidents in 1960 and 1961 time frame. So we did
 
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model the exposure as a chronic, followed by two
 

acute exposures, again using the highest individual
 

from each exposure scenario, so we took a composite
 

and took the worst case internal exposure we could
 

get from the highest individual in every particular
 

scenario. And in doing that, the maximum annual
 

esophageal dose was 16 millirem to the claimant's
 

esophagus. That is sort of indicative of the fact
 

that uranium does not concentrate in the esophagus,
 

so the metabolic model indicates that uranium
 

doesn't concentrate there so it's not surprising
 

that we assigned a fairly whopping intake to this
 

individual. I think we ended up assuming that the
 

person had inhaled seven grams of uranium during
 

their work history at that facility, which is almost
 

impossible to accomplish, but we did demonstrate
 

that even given that worst case assumption, the dose
 

is fairly small to the esophagus.
 

So, we took the exposure period to be from
 

the beginning of the first day of the award of the
 

AEC contract to the end of the date that the
 

facility was decontaminated, so we took that 550
 

millirem external, those 15 millirem internals and
 

used them -- applied them to the claimant from --

between these two time periods and ended up with an
 
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upper bound of what this person could have possibly
 

been exposed to as a result of his employment and
 

ended up resulting in a probability of causation
 

value of around 15 percent. So we're fairly
 

confident that this particular claimant, based on
 

co-worker data, did not receive anywhere near an
 

exposure that could have resulted in a 50 percent
 

PC. And in fact, even if his exposure were five
 

times what we estimated, the probability of
 

causation would be 48 percent. So this is an
 

example of how we can go about using co-worker data
 

-- in this particular case, a worst case assumption
 

-- move this claim forward without really having
 

individual monitoring data available.
 

I think that's it. Are there any questions
 

on that one? It's a fairly interesting one,
 

actually. We were very happy to find the AWE data
 

that we did. Richard?
 

MR. MILLER: When you did this particular
 

project -- this was an extrusion facility -- did you
 

assume that this was soluble or insoluble forms of
 

uranium? What was the assumption on that?
 

DR. NETON: I don't recall at this point,
 

but we took what would be the worst case exposure to
 

that organ, and I'm --
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MR. MILLER: But I mean it changes your dose
 

calculation significantly if it's -- right? If it's
 

an oxide or a -- versus a --

DR. NETON: Whatever would have been the
 

most claimant-beneficial approach to use, and I
 

don't recall whether it was soluble or insoluble
 

form at this point. It more than likely would make
 

very little difference because it just does not
 

concentrate in the esophagus itself. If this were a
 

kidney exposure, kidney dose or something, it would
 

make a difference, but the esophagus -- the only
 

dose that the esophagus receives is actually from
 

the uranium in the blood that travels through the
 

organ itself, so if it's soluble, the migration time
 

through there would be fairly quick and it would be
 

excreted or concentrated in the kidney, so -- I want
 

to -- I'm guessing that it was soluble, but I'd need
 

to check the dose reconstruction to confirm that.
 

MR. MILLER: Okay. And then secondly, just
 

out of curiosity, when you did your analysis of this
 

in terms of the materials that ran through this, did
 

you do any investigation about the origins of the
 

uranium that came into the facility?
 

DR. NETON: The origins of the uranium?
 

MR. MILLER: Yeah, I mean 'cause there's
 
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some of the uranium that came into these facilities
 

that ran through the recycle program and some of
 

them --

DR. NETON: That's correct.
 

MR. MILLER: -- did not run through recycle,
 

and that's why I'm asking.
 

DR. NETON: We did not do a detailed
 

investigation. We had no indication that any of
 

these things had been through the recycle program. 

But in reality, the doses are still going to be very
 

small to the esophagus from that half-life.
 

MR. MILLER: But -- but -- but in terms of
 

when you're doing the site profile for this AWE, it
 

would seem to me an awful lot of -- because the
 

recycle program began in roughly 1957, you know, and
 

there were hundreds of thousands of tons of material
 

that did run through this program because DOE didn't
 

want to waste the material, I just didn't know what
 

point you decide you're going to start entering that
 

kind of inquiry into your analysis.
 

DR. NETON: Right. I can say that we
 

discussed this on this particular case. We're well
 

aware of the issue that you raise. And I cannot
 

exactly recall, I'd have to go back to the paperwork
 

to determine what reason we used -- why this was not
 
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relevant in this particular case, but I know that we
 

talked about it in the dose reconstruction itself. 

I'd have to go back to the original records to look
 

at that to see what we actually decided. But again,
 

we -- this person had inhaled a theoretical seven
 

grams of uranium. If that material were
 

contaminated with a thousand parts per billion of
 

plutonium or something of that nature, it would make
 

it almost to the third decimal -- to the first
 

decimal point maybe in the dose. I'm not -- it
 

would be a very small contribution. And I think we
 

have those calculations somewhere. I'd need to go
 

back on that.
 

Any other questions? Okay, we need to move
 

on.
 

MR. CALHOUN: Okay, I'll try to do this one
 

quicker than 16 hours. This one's going to be
 

pretty much the opposite of what I did before. As
 

you saw before, I did an underestimate of the dose
 

received. This one's going to be an overestimate of
 

the dose received, and we're going to be using
 

primarily workplace monitoring data and
 

environmental data.
 

Okay, here's the deal. This is one that I
 

actually dealt with, too, from the beginning to the
 
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155 

end. This person worked as an accounting specialist
 

from 1992 to 1997. Primary duties were bookkeeping,
 

banking, billing, preparing financial statements,
 

things like that -- administrative completely. Work
 

location required no dosimetry. I actually did the
 

telephone interview with this person and there was
 

no entry into the radiologically controlled areas at
 

any time during her employment.
 

Okay, DOE reported dose, there is none. She
 

wasn't in the area where dosimetry was required,
 

therefore there was no dose report provided by the
 

Department of Energy.
 

Department of Labor verified chronic
 

myelogenous leukemia, and she was diagnosed at 53
 

years of age. This is prior to the end of her
 

employment period.
 

So I don't have any data to go by as far as
 

occupational exposure that would be monitored by
 

DOE, so I go to environmental report data. So what
 

I did is went back through the environmental reports
 

for these sites -- this site and looked at the TLD
 

doses, got the very highest TLD dose for the period
 

that she worked and assigned that to every year of
 

her employment at that facility up until the point
 

of diagnosis. The TLD station that I looked at was
 
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in between her work station and what would be
 

considered the source term of the radiation. I put
 

in here this is an overestimate.
 

Now you've seen before I used the greater
 

than 250 keV photons. In this case, since I'm doing
 

an overestimate, I used the 30 to 250 keV energy
 

interval because this would result in a higher
 

probability of causation, so all the external photon
 

dose that we applied I assumed was in this energy
 

interval.
 

Did not use a DCF at all. Dose conversion
 

factors in most cases, and especially for this one,
 

this would be to the red bone marrow, are going to
 

be less than one, so you're going to take your whole
 

body dose, multiply by a number that's less than one
 

and come up with even a smaller dose. In this case
 

did not use that because it's an overestimate.
 

Now as far as internal dose goes, there was
 

a whole series of perimeter air monitoring data that
 

was taken throughout this facility. Now this one
 

did take a long time because I ran through all
 

different kinds of scenarios, and specifically to a
 

question that Richard asked, I went through fast
 

solubility, slow solubility, went through several
 

different radionuclides to try to come up with the
 
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very highest dose to the red bone marrow. Turned
 

out that the activity that I used -- and those of us
 

who have been in monitoring situations before know
 

this is a very significant overestimate -- I used
 

gross alpha activity and assumed that all that was
 

due to plutonium 238. I assumed gross beta activity
 

and that was all due to strontium 90 and assigned
 

that dose.
 

The information that I used was site
 

environmental reports -- same old stuff, employment
 

dates, cancer -- type of cancer and diagnosis dates
 

from Department of Labor.
 

Based on the information that I have there,
 

the annual environmental dose, I normalized that to
 

a 2080 hour work year because she said she didn't
 

work overtime, and had she said she worked overtime,
 

we would have scaled it up. Total dose estimated
 

was 135 millirem over the entire period.
 

Internal dose, assume that the highest gross
 

alpha and gross beta concentrations were inhaled
 

throughout the employment to date of diagnosis, and
 

the total dose estimated was 36 millirem to the red
 

bone marrow. So I took the very highest airborne
 

concentrations, applied those throughout her
 

employment and came up with 36 millirem.
 
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The resulting POC here is four percent, so
 

this was, you know, another way of those efficiency
 

measures, and I overestimated the dose every
 

possible way that I could and still ended up with a
 

POC this low. So we were done. This one did take a
 

little bit longer -- 17 hours -- no, it did take a
 

while because I had to run through many, many
 

iterations to make sure that I was choosing the most
 

claimant-friendly solubility class and the most
 

claimant-friendly radionuclide to be applied in this
 

case.
 

Any questions on this one? Okay.
 

DR. ZIEMER: Okay, thank you. Let's ask
 

now, are there any further questions on any of the
 

cases that were presented or relating to the dose
 

reconstruction methodologies? Yes, Jim.
 

DR. MELIUS: I think these were helpful. I
 

appreciate you taking the time to do it. It
 

probably reflects my ongoing concerns about certain
 

issues, but the one thing that bothered me in terms
 

of what you're presenting is the third case, and as
 

you're presenting it I know you couldn't present all
 

the details and so forth, and I'm not questioning
 

what you did or the way you presented it or your
 

conclusions. But it's just that as you're
 
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presenting it I can think of other scenarios that
 

were part of that where you're relying on, you know,
 

a survivor who has very little information, data
 

that's passed through three companies to get to its
 

current storage place, the health safety officer
 

who's not even at the same facility and so forth
 

where facts can get lost and information can get
 

lost in that process. So I think that's probably
 

going to be the biggest challenge to sort of keep
 

track of all this and making sure that the right
 

amount of effort is put in 'cause I don't think it's
 

a question of how much -- I think it is going to
 

come down to a question of how much time and effort
 

do you have to put into particular cases, and my
 

related concern to that is how that information gets
 

recorded so that the next time a case comes in from
 

that same facility -- which happens to be the kidney
 

cancers -- someone doesn't look at that, says
 

there's not much exposure there, I'm not -- you
 

know, we're not going to spend the time on this one,
 

and how you sort of alert people that -- and keep
 

the records as you're processing thousands of cases
 

I think is also going to be a challenge.
 

DR. NETON: Yeah, we're very sensitive to
 

that. I mean that is a potential pitfall. I think
 
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the ORAU team is going to actually arrange their
 

dose reconstruction teams around facilities, which
 

makes some sense, so they develop a certain
 

expertise on certain areas and AWE's would likely be
 

one of those types of facilities. We do intend to
 

have these databases out there would contain all
 

this information that we obtain to be put in there.
 

MR. CALHOUN: And isn't it true now that you
 

can click on that facility and get that data that
 

we've got to use that?
 

DR. NETON: Yeah, that facility data that is
 

out there available for the dose reconstructionists,
 

wherever they may be, to evaluate and look at it
 

again.
 

DR. MELIUS: So that if there's another case
 

that has additional information or different type of
 

cancer, then it needs to be pursued further and
 

added.
 

DR. NETON: In fact if we recover additional
 

information beyond what's here, we would go back and
 

look at that case again as that information becomes
 

available.
 

DR. ZIEMER: Jim, in cases such as the one
 

Jim just described, is it not true that to some
 

extent that lack of information and the assumptions
 
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you used get also reflected in the uncertainty
 

values that are assigned and --

DR. NETON: No, on these particular cases
 

where we do these, what we believe the upper
 

bracketing estimates, we do not assign uncertainties
 

because we feel we are already at the upper end of
 

the distribution of the potential doses. We took in
 

every particular instance the highest exposure we
 

could find, so we took the highest worker in that
 

one year and assumed that that highest worker
 

received that exposure every year for 11 years. We
 

had no indication that was --

DR. ZIEMER: Okay, so that's the equivalent
 

to sampling the same point over and over at the high
 

end. That's like the 99th or 100th point.
 

DR. NETON: Exactly.
 

DR. ZIEMER: Okay.
 

DR. NETON: That makes the job --

DR. ZIEMER: So it's -- it's actually more
 

lenient than the uncertainty analysis approach.
 

DR. NETON: Exactly. If we assign that best
 

estimate, which would be the average worker dose,
 

and put this distribution about it, these -- the PC
 

would have been probably substantially less -- or
 

would have been substantially less.
 
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162 

DR. ZIEMER: Other questions? Any of the 

visitors have questions? 

MR. SILVER: Yes, Ken Silver. In the third 

case, let's say it was seven grams of insoluble
 

uranium, wouldn't the biokinetic models predict some
 

dose to the esophagus due to mucociliary clearance
 

and swallowing?
 

DR. NETON: Yes, and that is incorporated in
 

the ICRP-66 lung model itself.
 

MR. SILVER: So did I misunderstand? I
 

thought you said that the only dose to the esophagus
 

was through the bloodstream.
 

DR. NETON: That's correct. You're right,
 

there are mucociliary transport doses to the
 

esophagus, but even alpha emitter I suspect that
 

that dose would be extremely low. The mucous itself
 

has a blanket that exceeds more than likely the
 

range of the alpha particles.
 

MR. SILVER: So that biokinetic pathway was
 

or was not incorporated into this dose
 

reconstruction?
 

DR. NETON: It was. The models themselves
 

incorporate all the relevant ICRP information,
 

including -- the 66 lung model includes the
 

mucociliary transport, as well as the distribution
 
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163 

from the bloodstream into the individual organs,
 

including the esophagus.
 

MR. SILVER: Do you recall the relative
 

contributions of blood versus mucous?
 

DR. NETON: No, I do not.
 

MR. SILVER: Thank you.
 

DR. NETON: I don't have it handy.
 

DR. ZIEMER: Any other questions?
 

DR. NETON: I will just say one more thing,
 

that that is the advantage of using the current ICRP
 

models. The older models do not even allow one to
 

calculate a dose to the esophagus from the
 

biokinetic distribution in the body. It would have
 

been zero under the old model -- or uncalculable
 

(sic).
 

DR. ZIEMER: Thank you. We're already
 

scheduled for a break. We'll take a 15-minute break
 

and then we'll adjourn (sic). Thanks.
 

(Whereupon, a recess was taken.)
 

RESIDUAL CONTAMINATION STUDY PROGRESS REPORT
 

DR. ZIEMER: All right, we are ready to
 

reconvene. Under the National Defense Authorization
 

Act of 2002, NIOSH has a particular responsibility
 

that we're going to learn more about now, and Grady
 

Calhoun is going to make a presentation about this
 
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164 

activity called the residual contamination study. 

Grady?
 

MR. CALHOUN: Okay.
 

DR. ZIEMER: And Board members, there is a
 

packet in your -- or a copy of the presentation in
 

your notebooks.
 

MR. CALHOUN: All right. As you said,
 

National Defense Authorization Act tasked us to
 

undertake a study to evaluate the potential for
 

residual radioactive and beryllium contamination at
 

Atomic Weapons Employers and beryllium facilities
 

that processed these materials in support of nuclear
 

weapons production.
 

What we're supposed to do is to determine
 

whether or not significant contamination remained
 

after the facility discontinued activities related
 

to weapons production. And if it did, could such
 

contamination -- could it have caused or
 

substantially contributed to cancer or a covered
 

beryllium illness, as -- whatever the case may be.
 

So what we started out with is there was a
 

-- there is a list of AWE's and beryllium facilities
 

on a web site, the DOE Office of Worker Advocacy web
 

site. And along with that is a listed date, a
 

listed period that pretty much establishes the time
 
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165 

that people can -- would have had to have worked
 

there to start filing.
 

Now we've learned that this is somewhat of a
 

dynamic site and that these dates change, so we had
 

to go with a snapshot of the information because for
 

a study like this, we couldn't have a moving target
 

because we would never really be done with any
 

individual facility. So we used a snapshot of the
 

facility and that was a snapshot taken I believe
 

February 15th, and we used that throughout the
 

course of the study.
 

We had two tasks, and the first one was to
 

come up with a progress report, and then a final
 

report. And so for the first part what we thought
 

we would do was to look at all the available
 

documentation and try to make a judgment as to the
 

adequacy of the listed periods. And what I'm going
 

to do is I'm going to place each one of these
 

facilities in one of three categories, and I'll
 

explain a little bit about these categories.
 

And the three -- one -- the three
 

recommendations are that the documentation reviewed
 

indicates that there's little potential for
 

significant residual contamination outside of the
 

listed period. For something to get that
 
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designation, we had to have had either a documented
 

survey which shows that there was a decontamination
 

of the facility. If it's a facility that lists
 

present as the end period, then there's -- it's
 

still covered. It's still in the covered period, so
 

we didn't worry about that one. If the type of
 

operation performed in the document and was -- had
 

very little potential for residual contamination --

for example, there are facilities that may have
 

literally handled two rods, and it was done on two
 

days, you know, during one year, and I'm thinking of
 

a -- I don't remember the name of the facility, but
 

we have this one, and Fernald was the people who
 

commissioned that activity, and there's
 

documentation that they went in and did air sampling
 

and did surveys and took the material back after
 

that one or two-day test. So in a case like that,
 

there was little -- little potential for significant
 

residual contamination during the operation, so
 

there would also be little outside of that period.
 

Same goes with beryllium. We'd have to have
 

some kind of documentation that there was a
 

decontamination for us to say that there's little
 

potential for significant contamination.
 

The next category was documentation reviewed
 
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indicates there is a potential for significant
 

residual contamination outside the listed period. 

There were cases where we actually had surveys that
 

said okay, there's contamination here and it was two
 

or three years after the period that was listed on
 

the OWA web site. There's also some -- and I don't
 

know how many of you people have looked at this web
 

site, but there's a lot of operations where it's
 

listed as AWE for three years, then there may be a
 

six-year gap, and the DOE took over after that sixyear gap for remediation. Well, I don't have any
 

indication that there was a clean-up or
 

decontamination anywhere in that gap, therefore in
 

my mind the potential exists for significant
 

radioactive contamination.
 

And then the third category, which most of
 

them fell into, was that the site warrants further
 

investigation. And that was just that there wasn't
 

enough information there that could lead me to
 

believe one or -- one -- number one or number two,
 

and I'll show you a little bit how this played out.
 

With the radioactive contamination, the
 

yellow there is, like I said, additional information
 

required. And I think it's like 55 percent or
 

something roughly like that. And there just was
 
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very little to go on in these facilities, so we are
 

going to attack these -- I'm getting a slide ahead
 

of myself or two, but these are what we're going to
 

attack in the next phase of this report. Little
 

potential is in the green, and this is because there
 

-- you know, there's FUSRAP data in many cases gave
 

actual surveys of these facilities and in some cases
 

even maps, which is kind of interesting, so you
 

could actually look at the contamination levels that
 

were present. So FUSRAP studies and if, you know,
 

the current -- it's a -- current facilities, they
 

fell into that one. Significant potential, as I
 

said, was facilities where I definitely had
 

something that indicated there was contamination
 

outside that covered period -- listed period, and
 

only 27 of them fell into that. Now keep in mind
 

this is only the radioactive contamination section
 

of this report.
 

As far as beryllium contamination goes, it's
 

a little bit different. Most of these fell into
 

significant potential, and the reason is is that
 

with beryllium there was very -- we have found from
 

looking through the documents is there's very little
 

documented decontamination. And I think it's just
 

because it's -- you know, with radioactivity, we've
 
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169 

had programs in place ever since the Navy and before
 

with doing surveys, documenting, decontaminating. 

And with -- I'll say the industrial hygiene end of
 

things, the data is just now kind of catching up to
 

that and so it wasn't as well a documented
 

decontamination efforts and surveys, and so if a
 

facility had handled beryllium and there was no
 

documented survey or decontamination, we said that
 

there was significant potential at this point.
 

Little potential, you can see that there was
 

only five of the facilities there, and -- that we
 

felt that you could say there was little potential. 

And I believe that a couple of those are still
 

listed as current, and that's why. It's little
 

potential outside that listed period, because the
 

period is still current.
 

And eight was additional information was
 

required. And again, what we're going to do for the
 

path forward here is we're going to take another
 

snapshot of the OWA web site and actually we've got
 

the person -- the contractor doing this right now. 

And they're going to look for date changes. They're
 

going to go through and compare the current dates to
 

the previous dates listed, and their determination,
 

and some of them have changed already -- not as a
 
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170 

result of our report, but as a result of their
 

looking into the facilities, have changed to
 

actually match what we have found. So they found
 

the same thing, and not in a lot of cases, but in a
 

few.
 

After we do that we're going to focus on the
 

facilities for which more information was required. 

We've got a list of contacts gathered. That's
 

corporate contacts or even some health and safety
 

type management contacts. We'll contact them and
 

see if we can get any additional information to try
 

to nail down the time frame when the -- either a
 

clean-up was done or the facility was demolished, in
 

some cases.
 

We're going to look at additional document
 

searches. I believe somebody mentioned EML. That's
 

potentially a good source. The FUSRAP collection is
 

just enormous, so we plan on having a couple of
 

trips down there to do some searches for the
 

facilities that are listed as the yellow ones, and
 

contact with site reps. If we have to we'll do some
 

on-site visits. That may not do a whole lot of
 

good, unless the end point is relatively recent. So
 

that's where we're going with that as far as the
 

final report goes. And that's it for that slide.
 
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171 

Yes, sir?
 

DR. ZIEMER: Grady, I wanted to ask you
 

about the use of significant. Now you talk about
 

significant potential for contamination and you also
 

talked about significant contamination.
 

MR. CALHOUN: Uh-huh.
 

DR. ZIEMER: I'd like to ask about
 

significant contamination.
 

MR. CALHOUN: Well, what we're --

DR. ZIEMER: Do you have a number or a group
 

of numbers or --

MR. CALHOUN: Well, what we did with
 

radioactivity was we used the current DOE/NRC
 

standards for contamination. If we had some
 

indication that there was uranium 1,000 DPM loose in
 

a facility -- I'm just throwing uranium out 'cause
 

that's one of the ones that we all know -- we
 

considered that significant. For beryllium there's
 

really not a widely accepted number that I'm aware,
 

so if they handled beryllium and there's no
 

decontamination noted or documented, the potential
 

exists until we can come up with a better way -- err
 

on the claimant's side on this one.
 

DR. ZIEMER: At some point, though, you need
 

a working number, I presume, for beryllium, and
 
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maybe for other nuclides.
 

MR. CALHOUN: Well, you know, there's -- we
 

certainly do have those numbers for all the
 

radioactive constituents, you know. You know, for
 

plutonium you need 20 DPM alpha loose, and for the
 

uranium would be 1,000 loose. With the beryllium, I
 

don't know that. And we do have an industrial
 

hygienist working on this report for us and he's a
 

little bit smarter than I am about industrial
 

hygiene beryllium issues.
 

DR. ZIEMER: Other questions? Can you give
 

us an idea of how this program meshes with the
 

compensation program and -- to the extent to which
 

it doesn't mesh and impinges on it, in terms of
 

staff --

MR. CALHOUN: Well, it impinges on it only
 

because it takes our resources to some degree.
 

DR. ZIEMER: That's what I was asking.
 

MR. CALHOUN: But there will be some benefit
 

gained. From going through these reports, this will
 

help our site profile -- build the site profile of
 

many of these facilities, so the contractor is aware
 

of that and knows that when he finds any good data
 

like that that we need that so that we can organize
 

that in a way that will help us do dose
 
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173 

reconstructions later. So you know, ultimately I
 

think it's more of a benefit to us than a hurt
 

because I think it'll give us a lot of good
 

information from the radioactive standpoint, and
 

maybe somebody else can use it from the beryllium
 

standpoint -- physician review panel or whatever.
 

DR. ZIEMER: Other questions?
 

MR. MILLER: Can I try to answer that
 

question a little bit differently?
 

DR. ZIEMER: Sure.
 

MR. MILLER: There was a reason Congress put
 

that in the Defense Authorization Act, and it wasn't
 

to impinge on NIOSH's scarce resources. It was put
 

in the Defense Authorization Act because there were
 

clearly identified in a number of regions of the
 

country facilities which, after they terminated
 

their work -- atomic weapons facilities -- that
 

after they had terminated their work they were not
 

either decontaminated or the quality of the
 

decontamination was so poor and that when folks went
 

back to do, for example, the FUSRAP analysis, they
 

found a lot of contamination. There also had been a
 

number of compensation claims based on -- we'll call
 

it the hot facility syndrome that had been denied
 

under state compensation law, and so a number of
 
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174 

folks had approached members of Congress to see if
 

it would be -- if it was simply, you know, an
 

isolated circumstance where workers -- for example,
 

at Union Carbide in western New York at the Linde
 

facility, which was one of the facilities of
 

interest, which was very contaminated, even after
 

they stopped doing uranium work for the AEC, was
 

there any potential. Should, therefore, this be
 

studied with an eye towards Congress potentially
 

expanding the coverage dates for eligibility for
 

applying for compensation. So I don't think this
 

was an -- I just wanted to clarify the record that
 

this was not an activity done in a vacuum and that
 

there won't be a follow on response from Congress
 

once NIOSH has done the science.
 

DR. ZIEMER: Thank you, Richard, for that
 

clarification.
 

MR. HALLMARK: Chair, could I ask a
 

question, as well?
 

DR. ZIEMER: Yes.
 

MR. HALLMARK: Shelby Hallmark, Labor. 

Clarifying and following on Richard's comment, you
 

didn't really focus as much on the second part of
 

the question that was -- I thought, Grady, with
 

regard to having found that there is a significant
 
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175 

contamination, does it have a cause -- is it
 

potentially a cause of the disease. It seems to me
 

that in answering the question that Congress has
 

posed to you, which is should we expand the periods
 

of time for which individuals can successfully claim
 

covered employment, that NIOSH needs to look at
 

making a determination about is it -- is there
 

really sufficient -- I mean even if a facility has
 

contamination, is it sufficient to make a difference
 

in terms of real dose reconstructions. And for the
 

panel's purposes, I mean just explain that -- as
 

Grady suggested -- the -- finding this information
 

about the tail of contamination is already helpful
 

for dose reconstruction for employees who can
 

establish a covered employment period because if
 

they continued to work at that site, that time would
 

-- and the radiation is measured, that radiation
 

would be added to their current dose reconstruction. 

But an employee who comes to that site after the
 

period that is the covered period would now
 

currently not be able to file a claim successfully,
 

absent Congressional action based on this report.
 

So my question is, has the study been framed
 

in such a way that you'll be able to sort of answer
 

that question at AWE facility X it looks as if yes,
 
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176 

that residual contamination is sufficient that it
 

would -- that it should be looked at for expanding
 

the exposure -- the covered employment period.
 

MR. CALHOUN: And with the radioactivity I
 

believe that we did have that in our mind when we
 

were looking at that, because if I've got something
 

that would classify as a contamination area under
 

current regulations, I've got to consider that that
 

does have the potential to result in a cancer. 

Because as we all know here, there's -- depending on
 

the type of cancer that's out there, I could have
 

airborne radioactivity, and if I'm looking at
 

prostate cancer it's way different than lung cancer. 

So I think that we're certainly erring on the
 

claimant-friendly side to say that if it exceeds the
 

limits that would currently need controlling under
 

DOE, that it has the potential for significant --

for impacting a cancer or beryllium illness.
 

DR. ZIEMER: Well, I might comment that I
 

think that's a real stretch. First of all, going
 

from surface contamination limits to body doses is
 

not a trivial exercise, and I don't know how you're
 

going to do that in a very good manner that -- I
 

mean there's some pretty rough models you can use,
 

but that's a tough one. And if you use, for
 
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177 

example, the Brodsky* magic number, which is ten to
 

the sixth, which says that if you have -- huh? --

ten to the minus sixth -- it depends on which end
 

you're looking at. Six orders of magnitude, in
 

other words.
 

UNIDENTIFIED: (Inaudible)
 

DR. ZIEMER: No, it's six orders of
 

magnitude that the amount of, for example, uptake
 

you would get from a pretty sizeable surface
 

contamination turns out, in many cases, is virtually
 

trivial. So the stretch of saying that --

MR. CALHOUN: It is, but what you're
 

thinking of is what we're actually doing, is we're
 

going to end up having to do dose reconstructions. 

We're not saying -- we're not applying a dose
 

because there's surface contamination. What we're
 

doing is we're opening up a period that we could do
 

a dose reconstruction and based much more on just
 

surface contamination during that period.
 

DR. ZIEMER: Sure.
 

MR. ELLIOTT: I think the --

DR. ZIEMER: Larry.
 

MR. ELLIOTT: I'm sorry. I think the second
 

part of the question was -- to us -- and could that
 

contamination, that residual contamination, have
 
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178 

caused harm. That's the way it was phrased. Right?
 

MR. CALHOUN: I'd have to go back --

MR. ELLIOTT: And so your criteria that
 

you've set is the current regulatory limit.
 

MR. CALHOUN: Right. Well -- oh, well. 

MR. ELLIOTT: While Grady's looking for 

that, just let me --

MR. CALHOUN: I can find the actual words 

here 'cause I pulled them right out.
 

MR. ELLIOTT: I anticipated this question
 

but it hadn't come up yet -- where is this report
 

at? We're talking about a progress report. It's
 

not on our web site. It's not at the table at the
 

back. It is in the final throes of clearance within
 

the department and we're hoping that it'll be
 

released to the six subcommittees identified in the
 

Act -- or in the amendment language that we need to
 

deliver it to -- this week, I hope. We've been
 

trying to move that through for the last few weeks,
 

but it's very close, I understand. So as soon as it
 

is delivered to the committees on the Hill, it will
 

be placed on our web site and you'll be notified.
 

MR. CALHOUN: There's another question
 

behind you.
 

MR. SCHAEFFER: Mike Schaeffer, Department
 
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179 

of Defense. I have a question. Is the Iowa army
 

ammunition plant considered in your group of
 

facilities studied?
 

MR. CALHOUN: I don't know off the top of my
 

head but I can look. I've got the report back there
 

in my -- I think it is. I've got the report under
 

my chair right there.
 

MR. SCHAEFFER: My interest -- this is a
 

very unique situation where, although the Army is
 

the one that ran the plant, the AEC actually was
 

there co-operating it, side by side with the Army.
 

MR. CALHOUN: Yeah, I'll check. I have
 

that, like I say. I'll get back to you. I'll look.
 

MR. SCHAEFFER: Thanks.
 

DR. NETON: I think the answer to that
 

question is they're certainly covered under the Act
 

and I think they're listed as a DOE facility, not an
 

AWE.
 

MR. CALHOUN: Yeah, we wouldn't have looked
 

at DOE facilities. This study included only AWE's
 

and beryllium facilities. If they were listed as an
 

AWE and a DOE, we included them. If they were
 

listed just as a DOE facility, they weren't included
 

in this study.
 

DR. ZIEMER: I'd like to ask another
 
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180 

question. Maybe Richard Miller will have to answer
 

this, but I think -- I would be more concerned about
 

what the residual activity indicates about previous
 

work habits than saying I'm going to use those
 

activity levels to reconstruct the dose. Typically,
 

sloppy work habits result in surface contamination. 

And simply to reconstruct based on the numbers --

the contamination levels, seems to me misses the
 

point. The point is if those contamination levels
 

existed, there must have been some pretty sloppy
 

work habits, and what does that mean? Do we know --

you know, what's the intent here? Is it simply to
 

quantitate this or to identify where the practices
 

were pretty loose, or who knows the answer to that?
 

MR. CALHOUN: I would -- you know, I'm
 

guessing on this one, but like Richard said earlier,
 

the point is to see if those dates that are listed
 

are too restrictive. Were there contamination
 

levels at a point that we need to allow additional
 

people to file? That's my take on it, I --

DR. ZIEMER: Okay.
 

MR. MILLER: I agree with Grady. I mean --

MR. CALHOUN: Oooh!
 

MR. MILLER: Is that a problem? Let me
 

start over. For the record, this report was due to
 
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181 

Congress on June 28th of this year and it is now
 

three months late. We would like a clearer answer,
 

Mr. Calhoun. Is that better?
 

MR. CALHOUN: Yeah, thanks.
 

MR. MILLER: In answering your -- Dr.
 

Ziemer, just to give you an example of a case where
 

-- as a practical applied case. We have a green
 

salt storage facility in which an individual was
 

charged with going into and remove the concrete that
 

was contaminated that had sat with green salt in it
 

for many years. The -- and black oxide. And so the
 

question was, that individual who did that job was
 

breathing in cold war material in a facility that
 

went on to actually produce chemicals. Question: 

Should that individual have the ability, if they
 

were working in a, quote, hot facility and they got
 

lung cancer and they want to file a claim under this
 

program to be able to be -- able to apply and see if
 

it would be possible to do a dose reconstruction to
 

determine whether they would be compensable. And so
 

it's to deal with those types of remedial cases, I
 

think, that were motivating people and not did you
 

work at a facility because there were some
 

unremovable, you know, fixed contamination that
 

you're somehow automatically eligibly -- eligible or
 
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182 

compensable, and I don't know that that's where
 

anyone's heading on this.
 

DR. ZIEMER: Any other questions? Okay. 

Oh, here's one. Sally.
 

MS. GADOLA: I just had a comment. There
 

has been stories in literature, in Occupational
 

Health about accidental spills -- this gets to your
 

sloppy work habits -- and some of those were related
 

to beryllium that showed up on secretaries pages, on
 

reports. Also radioactive contamination on
 

materials that should not have been contaminated. 

And those are really hard to track down, and we do
 

hear about those stories every so often. And I was
 

wondering if any of that is a part of your
 

investigation?
 

MR. CALHOUN: I would say not those
 

individual kinds of cases, but I would imagine that
 

in the instance where let's say that the beryllium
 

contamination ended up on the page of a secretary's
 

desk or something, I think that we would have some
 

indication that that facility handled beryllium
 

during that period and therefore that would be a
 

covered period, unless there was a documented
 

decontamination. As you saw with the beryllium in
 

particular, there's very few documented
 
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183 

decontaminations at beryllium facilities that we've
 

been able to put our hands on. And the same thing
 

with the radioactive material. If -- I guess there
 

is a slight chance that something like that would
 

happen after a decontamination, but I don't think
 

it's as -- I don't think it's that likely.
 

MS. GADOLA: Thank you.
 

DR. ZIEMER: One question on -- are you
 

looking both at fixed and loose --

MR. CALHOUN: Yes.
 

DR. ZIEMER: -- contamination?
 

MR. CALHOUN: Yes.
 

DR. ZIEMER: Is there an analogous situation
 

for beryllium? I simply don't know. Is there --

are there cases where facilities may have tried to
 

fix beryllium by coating or something, where it
 

might later --

MR. CALHOUN: I'm going to answer that --

DR. ZIEMER: -- and if so is there a test
 

for surface beryllium?
 

MR. CALHOUN: Is there anybody --

DR. ZIEMER: But that's for loose --

MR. CALHOUN: Right, so I would -- you know,
 

I don't know that if in the industrial hygiene
 

world --
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184 

DR. ZIEMER: I would think there might --

MR. CALHOUN: -- a fixative --

DR. ZIEMER: -- be an X-ray fluorescence --

MR. CALHOUN: -- applying a fixative --

DR. ZIEMER: -- process --

MR. CALHOUN: -- would be okay. 

DR. ZIEMER: -- that somebody could use 

in --

MR. ELLIOTT: Well, I think they can do 

that. They can use X-ray fluorescence to pick it 

up, and they can use white tests, but I don't
 

believe that -- in my experience at NIOSH with
 

industrial hygiene and I don't believe there's any
 

process that I know of where they've fixed it in
 

place. They've tried to remove it. They do their
 

best to remove it and recover it, take it away, but
 

not fix it in place like we see with radiation.
 

DR. ZIEMER: Okay, no further questions on
 

this topic? Yes, Robert? No? Thank you. Let's
 

move on then.
 

DEPARTMENT OF LABOR ACTIVITIES UPDATE
 

Next we're going to have an update on the
 

Department of Labor activities and that presentation
 

will be given by Shelly (sic) Hallmark. Shelly's
 

the director of the Office of Workers Compensation
 
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185 

Programs at the Department of Labor. Shelly?
 

MR. ELLIOTT: Shelby.
 

DR. ZIEMER: Shelly, Shelby.
 

MR. HALLMARK: I'm going to try to follow
 

this on two different machines here, so Grady, this
 

will take 36 hours.
 

MR. CALHOUN: We'll report that to Jim.
 

MR. HALLMARK: I'm a graduate of the
 

University of Texas so I really would like to do
 

this presentation under the longhorns over here. If
 

longhorns were really that big we'd have won on
 

Saturday, obviously, but no such luck.
 

I just wanted to start out this morning --

this afternoon -- you left me till last here. This
 

is not fair, so I assume that energies may be
 

flagging. And if they are, I will attempt to be
 

silly from time to time. Don't consider that we
 

don't take this business seriously, but it is late
 

in the afternoon here.
 

I want to start off, however, by -- I want
 

to start by saying that we are proud of what the
 

Department of Labor's been able to do so far. It's
 

not a perfect program, as you'll see from my slides,
 

but we do think we've gotten a good start. But I
 

also wanted to really give my thanks and admiration
 
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to the NIOSH folks that are here with you. They
 

have really, in our view from the Department of
 

Labor, shouldered the task of getting this program
 

up and running. As some of you, Richard, may
 

remember, as this program was discussed early on,
 

before it was actually enacted, HHS was a little
 

leery, to say the least, about what its role was
 

going to be and what it should be. But all of that
 

history aside, when NIOSH got the call to do this
 

work in the Executive Order, they have taken it on. 

And from everything we've been able to see and in
 

our cooperative interactions, are doing a tremendous
 

job. And obviously your job is to validate that,
 

and I'm sure you'll do that, but I certainly would
 

say that from our perspective over at Labor, this
 

has been a really good effort, even though it takes
 

some of the employees a long time to do their dose
 

reconstructions.
 

Just a few highlights -- these are in your
 

book so I'm not going to dwell on them. We are
 

proud of the fact that we got started on time and
 

that we've gotten checks rolling, and we've absorbed
 

the amendments that took place this past December
 

and made the changes to the way that that process
 

works.
 
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And I can't do this, forget about it. I'll
 

just have to use one at a time. I had some
 

brilliant notes that are in here, but I can't find
 

them, so I'll just go through and see if they come
 

to me as we go through these slides.
 

We're doing a bunch of things to try to
 

expedite the process of getting claims pushed
 

through our system, as much as we can. We are
 

working with getting employment information from
 

DOE, especially on subcontractors. That's turned
 

out to be a really hard piece. We're working with
 

the Center to Protect Workers Rights on getting
 

employment information on construction workers. 

We've gotten on-line access from ORISE so we can
 

bypass the record centers in DOE to get straight to
 

the data that they have on 400,000 plus employees. 

We've worked with the National Cancer Institute on
 

defining what a cancer is and where those boundary
 

lines are with respect to the -- especially the SEC
 

cancer, the cancers that are on that list. And
 

we're working on our Department of Labor rule.
 

As you may recall, we published an interim
 

final rule back in May of 2001. That's what we've
 

been using to actually implement the program. We
 

expect to publish -- we hope to publish the final
 
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rule fairly shortly, taking into account the
 

comments that have been received.
 

We are in the Department of Labor moving
 

ahead with the staffing and we have what I consider
 

to be a fully functional operation now. We've got
 

about 200 total staff -- Federal, that is -- and
 

about 50 contractors who support us. We are adding
 

staff as we need it, and we may need to add
 

considerably more as time goes on, but we think we
 

have an adequate group now.
 

One of the things that we're doing right
 

now, and this is relevant, especially to folks from
 

New Mexico who are in the room, is we are trying to
 

balance out our workload. The work -- we expected
 

the workload to be organized differently than it is. 

Hanford and our Seattle office have not produced
 

nearly as many claims as we expected. Denver got
 

more than we expected. And as a result, even though
 

we've tried to balance staffing, we have an
 

imbalance in Denver and the claims processing has
 

not been as speedy as we would like to see it. So
 

right now we are working with Congressional
 

representatives to look at moving some of the cases
 

out of our Denver area and into Seattle's because
 

that will balance out the workload. We think that
 
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-- Iowa and Missouri are the two states that we're
 

thinking of moving, if that will take, we hope, only
 

a week or two for us to finalize and get moving. 

And we'll obviously communicate with the claimants
 

who are affected, but it'll -- it should speed
 

processing throughout the Denver region.
 

This is how our regions are split up
 

currently. And as you see, the two peach-colored
 

states in the middle there are the ones that we're
 

going to pull out of the Denver blue and move over
 

to the Seattle electric yellow. The other two
 

offices are Cleveland and Jacksonville.
 

We've gotten this many claims -- this is in
 

your books or the handouts, if you don't have it, so
 

you can run through this. This is as of about a
 

week ago, so these data don't necessarily track with
 

some that you may have seen earlier from our friends
 

in NIOSH, but it's usually just a timing issue. But
 

there's also -- these data are also captured on our
 

web site and we update data weekly. These are
 

claims, the 34,700 is claims. When that's reduced
 

to claims; i.e., individual workers, I think it's
 

down to about 27,000, so you see you can have
 

multiple claims for one case.
 

And this tells you something about the
 
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population, the yellow being survivor claims versus
 

living employee claims. That's an indicator of the
 

difficulty that NIOSH will have because we do have a
 

largely survivor population, so that makes dose
 

reconstruction more difficult.
 

I put these two slides in just to give some
 

information about one thing that I wanted to
 

particularly emphasize in my talk today, and that is
 

that we have a lot of claims coming in for the part
 

B part of EEOICPA, which is what the Department of
 

Labor administers, which are really part D claims. 

That is, they are not for radiation-induced cancer,
 

beryllium disease or silicosis for miners. They are
 

all these other things, and that's what this -- you
 

don't need to study this in any great detail, but
 

this is all claims which are for conditions which
 

are not covered under our part.
 

Unfortunately a lot of claims have come in
 

because people were not clear on which aspect of
 

this program to use. The DOE program has not been
 

-- up until recently wasn't up and running and
 

therefore I think a lot of people filed a claim
 

somewhere, but that has in fact slowed us down
 

because all we can do with claims for these kinds of
 

conditions is go through all the process and give
 
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the individual a denial and point them to the DOE
 

program, and that's what we've been doing. But
 

hopefully the information will go out that will show
 

-- that will advise people to go to the right place
 

in the first place.
 

This is just the same information, with the
 

most common circumstances. I think the next to the
 

last one, 18 percent, is other, and that consists of
 

a bunch of odds and ends which, again, are not at
 

all covered by the program. Some of which are not
 

covered by the DOE program, either. Hearing loss,
 

for example; occupational disease cases that are not
 

toxic conditions.
 

This gives you -- and this again is in your
 

data -- your packet so I don't need to go through it
 

all, but this gives you an idea of what we
 

accomplished. We have a two-stage decision process. 

There's a recommended decision in the district
 

offices, and then a final decision from our final
 

adjudication branch. And as you can see there,
 

about 9,000 cases have gone all the way through to
 

final decision. But of course a big chunk of cases,
 

this 8,400 as of last week sometime, have gone over
 

to NIOSH and they can't go to either recommended or
 

final decision until the dose reconstruction is
 
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completed.
 

One thing that I would point your attention
 

to is that although we've spent -- we've paid out
 

about $350 million so far, the medical benefit
 

payment so far is very low, and that's a piece of
 

information we would like people to get out to the
 

public who are affected. People should be filing
 

their medical bills with us so they can be paid by
 

the Department of Labor and not by whoever their
 

health carrier is or Medicare. It should come out
 

of this program. It would be to the benefit of the
 

injured worker and ultimately to the benefit of the
 

overall working of this program.
 

Final decisions have been mostly the green
 

kind that we paid cash for. The ratio of green to
 

yellow is going to change as dose reconstruction
 

occurs because I think everyone understands that
 

dose reconstruction is going to be a process that
 

finds some large percent of people do not in fact
 

meet the test, but this -- but we haven't gotten
 

there yet and so this doesn't really contain any
 

significant number of dose reconstruction cases.
 

This is a very interesting slide, again
 

going back to the comment I was making earlier about
 

other conditions. You see the approvals over there,
 
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5,400 approval cases. The breakout of the final
 

decisions that were denied shows that by far the
 

largest percent is that aqua bar, and that is the
 

other conditions that shouldn't have come to us in
 

the first place. So when you look at the ones that
 

we've actually denied because it wasn't an employee
 

or the survivor's not an eligible survivor or they
 

couldn't prove the case -- they claimed one of the
 

correct conditions but they couldn't prove it, the
 

red -- or the -- I think it's red bar, those are
 

fairly small compared to that big aqua bar which
 

says -- which is for the wrong kind of condition
 

altogether.
 

This is -- we have a goal in the program to
 

get our processing done within -- at the district
 

office level, this is the initial cut. We want to
 

get everything done within the first 180 days for
 

AWE and beryllium vendors, or within 120 days for
 

DOE facilities and RECA claims, RECA being the DOJ
 

program that we had a supplement to. We thought
 

that 120 days was plenty for those places like Oak
 

Ridge and Hanford where the data should be
 

relatively available. As I mentioned earlier, we've
 

run into a lot of problems that we didn't expect,
 

one of them being that there's so many subcontractor
 
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employees. That data's not readily available. So
 

as it turns out, this is not going to be an easy
 

task.
 

Our actual performance during the past
 

quarter that just ended in September was it took us
 

about 216 days to complete an AWE and beryllium case
 

and it took about 171 days for a DOE case, so
 

neither one of those are meeting the standard, and
 

that sounds like an indictment of the program. 

Actually that number went up this past quarter and
 

the reason for that is that we're working hard to
 

get rid of the backlog of cases, and that actually
 

causes the average to go down because you're
 

cleaning out the old dogs that have been sitting
 

around. But that number will go down with time. We
 

are moving -- we're going to move to get that
 

backlog of cases that we have resolved so that we're
 

down to just what is current, and that would be --

probably a current inventory for us would be about
 

5,000 or less cases. We have about 8,400 cases now
 

in inventory, so we've got about 3,000 that we need
 

to squeeze out of that system and we expect to do
 

that in the next two or three months, especially
 

with things like moving the cases from Missouri and
 

Iowa. And so at that point we'll be able to move
 
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cases I think through in 2003 on -- in terms of our
 

goal, meeting our goal.
 

And this just gives you an overall picture,
 

and the red cases are ones that are in process and
 

our district office hasn't reached it's initial
 

point on. And those are the ones I would say we
 

need to get down to about -- we need that to be down
 

to about 5,000 instead of 8,400. And when we get to
 

that, we'll be very current.
 

And again this is cases, 27,000 cases versus
 

34,000, 35,000 claims.
 

Just some information for you with regard to
 

the DOE work sites that are here in New Mexico. As
 

you can see here, we've received about 1,400 claims. 

Final decisions, only 125. That's relatively anemic
 

compared to the overall graph that I was at on the
 

previous page, but that's because almost all of
 

those cases have to go through the NIOSH process. 

And so because that's the case, because there's no
 

Special Exposure Cohort here, we haven't reached
 

nearly as many final decisions. And the ten cases
 

that are paid are probably all beryllium cases,
 

would be my guess.
 

And this tells you a little something about
 

the types of cases, overwhelmingly cancer. But if
 
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you notice again, other, the non-eligible cases, for
 

our part, 578, a very large number of those cases
 

which will be -- unless we go back in our -- in the
 

process of developing the case and discover that
 

there was a covered illness, those cases will end up
 

being denied and it's slowing down the process for
 

everyone else.
 

That's the same graph for New Mexico that I
 

showed for the country as a whole. And as you see,
 

the red bar is higher vis a vis the total claims
 

received, and that's bad. That's why we're moving
 

cases from Denver to Seattle. Seattle has almost no
 

red bar, and this will even that out and it will
 

allow Denver to catch up and Seattle will take care
 

of those other cases and we'll be -- I think
 

everyone will be better off.
 

This is just the same data for Los Alamos,
 

specifically. Again, this does not include --

neither of those slides includes RECA cases. And
 

here's RECA. This is primarily uranium miners out
 

in the northwest corner of New Mexico, and as you
 

see there we have a number of final decisions in
 

RECA because that process is very, very rapid and is
 

completely within our control once we get the
 

information from the Department of Justice. So you
 
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see there a lot of cases have been paid in New
 

Mexico under the RECA program.
 

And I think that's it. And I hope I have
 

kept you awake long enough to get through all of
 

this and be glad to answer any questions.
 

DR. ZIEMER: Let me start off the
 

questioning and ask about your staffing. We've been
 

concerned about NIOSH's staffing and ability to
 

handle the workloads. Give us an assessment of your
 

Federal and contracting staffing for this effort. 

Are you where you want to be or...
 

MR. HALLMARK: As I said, I think we're
 

pretty close to where we want to be. We have some
 

additional hiring that we're doing right now will
 

probably take us up another ten percent or so. We
 

have authorization to hire more, but it's my -- as I
 

explained, I believe we're going to be current with
 

our workload in the next two to three months. We
 

have that initial hump of cases that we got. I
 

think we're going to have those cleared out, and we
 

don't want to bring on a bunch of additional staff
 

that would -- with our workload actually trending
 

down right now, would not -- you know, we'd end up
 

not having an efficient operation. We're receiving
 

roughly 250 new claims per week right now in the
 
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part B program, and that's been gradually declining. 

It was up 500 or more per week earlier.
 

Now we expect -- you know, I frankly
 

acknowledge that when the NIOSH process begins to
 

roll cases back to us in volume -- we've gotten only
 

nine cases back so far, so that's only a -- you
 

know, just a test group, really.
 

But when the volume of cases start coming
 

back, it may very well be that individuals out there
 

in the sites will reconsider their situation and
 

we'll receive more claims. That's something we'll
 

obviously look at, and we're in a position now where
 

we have a well-framed operation. We have training
 

materials available. We can bring new people on and
 

bring them up to speed very rapidly, as needed. And
 

that's what we'll do obviously if the workload
 

arises.
 

DR. ZIEMER: Any questions?
 

DR. MELIUS: Yeah. This issue with the
 

other disease cases that are inappropriate for DOL,
 

how are you handling -- I mean do you think it's
 

just people don't know where to go or is there some
 

outreach efforts or informational efforts, or do you
 

think that DOE -- developing a process and will take
 

care of that by itself?
 
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MR. HALLMARK: I think it's probably all of
 

the above. I mean I -- clearly I think we got a lot
 

of claims in the early going because the program was
 

announced. There was not a lot of information and
 

DOE's part of the program was not in place. Their
 

final reg wasn't actually published until I guess a 

month or so ago. And so I think some people just
 

came to us because we were the only game in town. 

There may have been outreach efforts to sort of drum
 

up support, I don't know. But we've tried to get
 

the word out about where you should go. And now
 

that there is a DOE program, I'm hopeful that we
 

will sort that out and people will be headed in the
 

direction that they need to be headed and we won't
 

waste people's time. But as I said, when we get
 

those kinds of claims, we do provide -- we worked
 

with DOE and we do provide in the -- when the
 

decision goes out saying we're sorry, you're not
 

eligible under this program, we do provide them with
 

information about where to go to file the part D
 

plan.
 

DR. MELIUS: Secondly, on the medical claims
 

issue, that number surprised me also because one of
 

the things -- I mean your office has been using and
 

certainly we've been using in terms of getting --
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reaching out to members is one of the benefits of
 

filing a claim is to get your medical care covered,
 

and it's obviously a big issue for many people, yet
 

people don't seem to be following up, and is that
 

true in your -- some of your other compensation
 

programs you handle or is it something unique to
 

this program because of the -- some of the time
 

frames involved, survivors applying, things like
 

that?
 

MR. HALLMARK: Well, obviously survivors are
 

not eligible so that's off the table.
 

DR. MELIUS: Yeah.
 

MR. HALLMARK: And in -- I think it's unique
 

to this program in that a lot of the population here
 

has coverage under a health package from their
 

employment. I think people don't -- and there's a
 

concern, and we've done some outreach on this. 

There's a concern that physicians are uncomfortable
 

with filing with us and that they will have to fill
 

out voluminous workers comp type reports and so on,
 

which is not the case. I mean we take exactly the
 

same form that Medicare and everybody else takes,
 

and it's just a matter of getting it routed to the
 

right place. But we need to do that outreach to
 

make sure that people get it. But people do need to
 
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know that they're paying out of pocket and co-pays
 

and co-insurance now for these services that would
 

be paid 100 percent, first dollar, by us. That's
 

what the program is supposed to deliver, and it will
 

be to everybody's advantage to get that started as
 

early as possible, and we would like that
 

information out.
 

DR. MELIUS: I mean I thought your process
 

was very claimant-friendly when I heard it explained
 

and so forth. I was impressed.
 

I'd also like to say I think -- you know,
 

I've been very impressed with the good job that your
 

agency's been doing on this program, 'cause I
 

remember you were a little bit reluctant to take
 

this on a long time ago.
 

MR. HALLMARK: There was reluctance all
 

around the table, you know, at a certain point. No,
 

that's right. One of the things that's been very
 

positive about this is that we do have the
 

sufficient support from Congress and funding to do
 

the job the right way, and I'm sure that as the
 

program changes and there are fluctuations and
 

there's need for adjustments in the budgets, that
 

that can be done. And we've been very pleased with
 

that. We think we're providing the service that was
 
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supposed to be provided in this program. And as I
 

say, I think NIOSH has done the same with what is
 

really the harder part of this whole operation. I
 

would not want to trade places with Larry as far as
 

the two pieces of work that have to be done.
 

DR. MELIUS: Of the three agencies, you're
 

the only one without the advisory committee, though,
 

so it may explain --

MR. HALLMARK: That explains how quickly we
 

begin to operate.
 

DR. ZIEMER: That's why your work is so
 

easy, I know.
 

Roy DeHart has a comment.
 

DR. DEHART: While I have you here, a couple
 

of questions that affect the way I deal with some
 

patients. It's my understanding, and I just need
 

your confirmation, that not only is it first dollar
 

pay, it's first dollar on medication, which Medicaid
 

does not cover.
 

MR. HALLMARK: Absolutely. We cover any
 

prescriptions, the whole gamut of services, hospital
 

right on through.
 

DR. DEHART: And that's what I've advised
 

some patients about. The next concern that they
 

have, do they have to trade physicians, or is any 
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physician eligible to participate as a recipient for
 

their billing?
 

MR. HALLMARK: Folks need to get us the
 

information. One of the things that we do when we
 

approve a case is we try to have a personal
 

conversation and identify who the providers are so
 

that we can register them. And those providers are
 

then put in our database and then that's who the
 

individual -- they would continue to use their
 

treating physician and that's -- that's the whole
 

outreach problem that we have. We do have some
 

individuals where we just don't know who their
 

treating physicians are, but that's part of what
 

we're --

DR. DEHART: Those are the two major
 

concerns that I've repeatedly heard about that
 

because patients don't know that, apparently, very
 

well. And that needs to really be amplified, that
 

you are not changing physicians and your
 

medication's covered.
 

MR. HALLMARK: Now there is one complicated
 

area that probably is depressing bill submission and
 

that has to do with the beryllium program, the
 

monitoring program that DOE has run through ORISE. 

And I think there has -- we are working with DOE to
 
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create a -- to move that process over because we
 

actually -- those services ought to be being
 

delivered by the Department of Labor now. On the
 

other hand, when we make -- when we handle medical
 

payments in that context, we do it differently than
 

DOE and ORISE have done in their former worker
 

program. So we're trying to work with DOE to make a
 

seamless transition to make that process work, and
 

that has -- we haven't quite nailed that down. But
 

that's only with respect to the group of people who
 

are beryllium sensitive and being monitored by the
 

DOE program.
 

With respect to anyone who is accepted for
 

any other condition or for beryllium sensitivity,
 

for that matter, if they're not in the ORISE
 

program, we want to get started. We want to get
 

them registered. We want to give them our medical
 

card and get them in the process as quickly as
 

possible.
 

Where's Richard? I figured he'd want to
 

give me some kind of help. Oh, this Richard.
 

MR. ESPINOSA: There's quite a bit higher
 

survivor claims. About what percentage of survivor
 

claims get forwarded to NIOSH?
 

MR. HALLMARK: I don't have it broken out
 
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for that particular categorization. I don't know
 

that there's a reason to believe that the cases that
 

are going to NIOSH would differ from that percentage
 

that I've shown here. But don't forget, the
 

percentage that was shown here was for both DOE
 

employee claims and RECA claims, and so that could
 

affect -- obviously only DOE cases are going to
 

NIOSH.
 

DR. NETON: I think I can address that.
 

DR. ZIEMER: Jim?
 

DR. NETON: The last time we looked at it,
 

about 50 percent of our claimants were survivors.
 

MR. HALLMARK: So it's half and half. So
 

RECA --

DR. NETON: It's fairly consistent with what
 

you've seen.
 

MR. HALLMARK: RECA has a very high survivor
 

population because a lot of these individuals who
 

were exposed a long, long time ago.
 

DR. ZIEMER: No further comments? 

MR. SILVER: A member of the public, Ken 

Silver. 

DR. ZIEMER: Ken. 

MR. SILVER: A question about beryllium 

sensitivity and ORISE.
 
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MR. HALLMARK: Sure.
 

MR. SILVER: Folks around here have been
 

diagnosed with beryllium sensitivity are generally
 

interested in getting their long-term medical
 

monitoring up the road in Denver. Is that likely to
 

be available for the foreseeable future?
 

MR. HALLMARK: I don't know the particular
 

circumstances here in New Mexico. You know, it's --

we have a process of trying to figure a -- you know,
 

create a rational process whereby individuals
 

receive treatment in a locale that's as close as
 

possible. Whether there's any beryllium facilities
 

in New Mexico that we would point injured workers
 

to, I just don't know. It may be that National
 

Jewish is still the closest and most appropriate
 

spot for here in New Mexico. I just don't know the
 

answer to that question.
 

MR. SILVER: Just for the record, there've
 

been some horror stories of people getting referred
 

to general practitioners or lung specialists in the
 

greater Santa Fe area and getting nothing. So
 

that's why there's such a high comfort level with
 

Denver because there's real expertise and it's not
 

too far away.
 

Another question. When you send out your
 
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rejection letter to people with non-covered
 

conditions, is there a sentence or paragraph in
 

there about the subtitle D program?
 

MR. HALLMARK: There was -- we worked with
 

DOE. Some of the early letters may have gone out
 

without that, but -- my goodness, several -- at
 

least six or eight or ten months ago we started
 

including -- or at least supposedly -- there should
 

be included in each such letter a paragraph that
 

points the individual to the DOE program.
 

MR. SILVER: I want to commend you if you're
 

really doing that.
 

MR. HALLMARK: We're trying to do that. 

That's the policy.
 

MR. SILVER: Folks in northern New Mexico --

I'm relatively new here, but you learn pretty quick
 

that the interactions with the Federal government
 

over the centuries haven't always been good. And
 

you know, be careful what you advocate for or you
 

just might get it. Those of us who got active when
 

this was a twinkle in Senator Bingaman's eye and a
 

lot of other people have tried to follow through and
 

make sure the interaction with the Federal agencies
 

is not too hurtful to folks. In that vein, would
 

you be friendly to an increase in your
 
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appropriations for hiring more people to break that
 

backlog of cases?
 

MR. HALLMARK: As I said earlier, we have
 

authority right now to hire more people. I don't
 

think we need it at this point. I think we have the
 

capacity to do what needs to be done with the
 

resources that are in place. If that turns out to
 

be not correct, we can remedy that and take care of
 

the additional workload. As I said, Denver was a
 

special case. We had -- because of the large number
 

of RECA cases, we did get a -- behind. And as I
 

say, I would want to say to the folks in New Mexico
 

that the screens, the slides that I showed of the
 

workload and the backlog here, were not, as far as
 

I'm concerned, acceptable. And that's the reason
 

why we're taking action to move cases. I think,
 

though, that once we do that, the Denver office --

which is, by the way, just reorganized itself
 

internally a couple of weeks ago -- will be able to
 

take care of the backlog and move on and keep cases
 

current. We'll be meeting the timeliness goals that
 

I showed in Denver as well as the other sites this
 

-- in this year.
 

DR. ZIEMER: Any further questions?
 

(No responses)
 
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PUBLIC COMMENT PERIOD
 

DR. ZIEMER: Thank you very much. Let's
 

move on now to the public comment period. We have a
 

number of individuals who have requested time, and
 

I'll take them in the order that they signed up and
 

we'll begin with Jonathan Garcia from Fairview, New
 

Mexico.
 

Let me ask all the speakers to -- if they
 

are affiliated with any particular organization, to
 

identify that for the record, as well, and then you
 

may use either this mike or the podium, whichever
 

you're more comfortable with. So Jonathan, are you
 

here?
 

MR. GARCIA: My name is Jonathan Garcia. I
 

was a heavy equipment operator in Los Alamos. I
 

buried radioactive material. I came down with
 

leukemia and had a bone marrow transplant done in
 

Denver, Colorado. I did an interview, the telephone
 

interview, and I got my papers back just last week,
 

and some of the stuff I told them on the interview
 

didn't come back in my papers. I don't know -- was
 

it recorded or how are they going to make the
 

evaluation -- you know, reconstruction?
 

MR. ELLIOTT: If I can answer -- respond to
 

this. The interviews that are being conducted to
 
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date are not being recorded. We're working with our
 

contractor about doing recordings for quality
 

purposes, and that's not in place yet. But the
 

process that is in place has a designed ability for
 

you to comment back to the interviewer and say you
 

missed this or you didn't account for what we talked
 

about here and I would like to see that incorporated
 

into this interview. And so that's why you get a
 

copy of it, and it's not a final. It's a draft and
 

we ask for your input and your corrections, your
 

edits.
 

MR. GARCIA: So I can send it back and --

MR. ELLIOTT: You can send it back. That
 

should have been made clear. I'm sorry, it must not
 

have been made clear.
 

MR. GARCIA: Yeah, it wasn't.
 

MR. ELLIOTT: You should send that back. 

You can -- we'll call you back and talk to you about
 

those and make sure that they are all accounted for
 

in the interview.
 

MR. GARCIA: All right.
 

MR. ELLIOTT: The recorded interview -- the
 

documented interview.
 

MR. GARCIA: 'Cause I didn't give them a
 

phone numbers 'cause I didn't have them, you know,
 
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of people that could verify what, you know, we did
 

over there and what spills we had and stuff like
 

that. So can I still send them that, too?
 

MR. ELLIOTT: Yes, you can still add to the
 

record at this point, sure.
 

MR. GARCIA: All right. Thank you.
 

MR. ELLIOTT: Uh-huh.
 

DR. ZIEMER: Next is -- if I can read the
 

writing, I believe it's Ben Ortez. Is that correct? 

Ortiz, I believe it's Ben Ortiz. Okay.
 

MR. ORTIZ: Yes, my name is Ben Ortiz and I
 

worked at LANL since '69 till about '89 and I have
 

an occupational illness I acquired at work. Okay? 

I was exposed to many toxic substances for 20 years
 

and without any safety equipment or anything like
 

that. The way you see me today is the way I worked. 

Okay? I took my clothing home. It was done -- the
 

laundry, with the one from my family and everything. 

Okay?
 

While going to the doctors at LANL, you
 

know, I was treated for these symptoms that I had,
 

and they said most of my symptoms were imaginary. 

Okay? And other things that you said, but
 

nevertheless, they treated the symptoms, like
 

respiratory -- upper respiratory symptoms. So I
 
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also went to many private doctors with the same
 

condition. It was very chronic. Okay? I couldn't
 

understand why I would get so sick. I was always a
 

healthy person, always very active in many things. 

Okay? Sports and stuff like that. I could not
 

understand why, when I would go home with a severe
 

sinus infection or bronchial asthma or flu-type
 

symptoms -- okay? -- and I'd stay home like three
 

days, four days, I would improve. Okay? When I
 

went back to work, again, the thing was just
 

repeated, repeated over and over. And I continued
 

to go to doctors and no one ever asked me what type
 

of work I was doing, what I was working with or
 

anything like that. I had no knowledge myself. I
 

could not understand that these materials that I
 

worked with were actually making me sick. I didn't
 

know that.
 

And actually in the later years, as I
 

progressed on, you know, with different jobs and so
 

forth, my symptoms increased to where I was dizzy, I
 

was nauseated. I developed a chronic insomnia like
 

in the early eighties which one of the lab doctors
 

said the reason I had the insomnia -- his diagnosis
 

was that I was too old. Does anyone agree with
 

that? Are there any doctors here today that perhaps
 
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can answer, that a chronic insomnia can come from
 

old age? I was like 49, I believe. Today the
 

insomnia continues with me.
 

DR. ZIEMER: Well, I can interject that 49
 

is not old age. That's the only thing I can --

MR. ORTIZ: And he was the head -- he was
 

the head -- he was the head of the occupational
 

medicine up at Los Alamos. Okay?
 

As I went on, you know, I began to get
 

sicker and sicker. Okay? Until finally I had to
 

leave. They placed me on medical leave back in 1988
 

and one of the doctors that -- when I went for a
 

work history -- it was done at the University of New
 

Mexico -- they sent me to San Francisco to see a Dr.
 

James Cone*, who's a leading doctor at the San
 

Francisco General Hospital, I believe. And he
 

diagnosed me with solvent encephalopathy. Okay? 

And restricted airways. And then I was sent to
 

another doctor at Berkeley, like in a couple of days
 

after I saw Dr. James Cone. That one -- doctor,
 

after the exam and the whatever, you know, said I
 

was intoxicated, and I didn't like the word
 

intoxicated. I thought he meant that I was
 

intoxicated, but he said no, industrial
 

intoxication. And I'm asking you people here today,
 
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who would like to work eight, 12 hours a day
 

intoxicated the way I was? Would any people like to
 

work under those conditions?
 

Anyway, it was 24 hours with me 'cause it
 

never would get away from me. But finally when I
 

was placed on medical leave by the doctors --

doctors, management -- it took me seven months for
 

the intoxication to get out of my system, but the
 

damage is there. Okay? The liver, the kidneys, my
 

eyes, you know. The damage is done. Okay? Where I
 

continue to feel lousy.
 

So I think a lot of people like me with a
 

toxic substances illness -- okay? -- I believe that
 

we should also be recognized like the special cohort
 

like they did in Paducah or the gaseous people and
 

so on and so on. We had no idea what we worked
 

with. Okay? No one told us. No safety meetings at
 

all. I was there 20 years. I never had a safety
 

meeting on the hazards of chemicals. No safety
 

clothing or anything like that.
 

Another question I have is someone mentioned
 

about medical expenses. My expense is like $100 a
 

month that I have to pay out of my pocket. Even my
 

insurance will not pay for it, so how do I do it, to
 

get reimbursed? Who's going to assist me on that? 
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215 

Someone from the Texas Longhorns talking about it?
 

MR. HALLMARK: It sounds like you have a
 

proper claim to take to the Department of Energy's
 

worker assistance --

MR. ORTIZ: Okay, you mentioned doctors. I
 

don't go to a medical doctor. I go to a natural
 

path doctor. Is that covered?
 

MR. HALLMARK: Well, that -- the part of the
 

program I'm talking about is run by the Department
 

of Energy and put your -- would put your claim
 

through a physician panel to determine whether it's
 

-- whether your condition is work-related. If so,
 

then your -- then the case would be -- you'd be
 

given assistance in going to I suppose the New
 

Mexico workers compensation program and an attempt
 

would be made to get you benefits through that
 

program. I can't speak to what the rules are in
 

terms of New Mexico, the state system, but that
 

would be how (inaudible).
 

MR. ORTIZ: The routing I would take. Okay. 

I guess -- what does safer healthier people mean
 

through CDC, what does that mean?
 

DR. ZIEMER: Where are you reading from?
 

MR. ORTIZ: From there (indicating).
 

DR. ZIEMER: Oh, CDC, okay.
 
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MR. ORTIZ: Yeah, CDC. What does that mean?
 

MR. ELLIOTT: That's part of the CDC on a
 

logo that they're trying to achieve in their mission
 

vision statements, so that's why it's on that cover.
 

MR. ORTIZ: Okay, I was thinking it might
 

date it back to the -- when LANL began. Okay, what
 

happened way back then to safety and health? Who
 

was supposed to oversee LANL's safety and health
 

programs? Apparently not you. OSHA, I think.
 

MR. ELLIOTT: No, that would have been the
 

Department of Energy.
 

MR. ORTIZ: Well, what happened that -- they
 

were not wise.
 

DR. ZIEMER: Certainly the early days it was
 

the U.S. Atomic Energy Commission and the agency now
 

that carries on that mission is the Department of
 

Energy. And I'm not sure -- you've raised some
 

questions here that I'm not sure this -- this panel
 

can answer, but certainly there are some people in
 

the room and perhaps the rep from the Department of
 

Labor can get you on the track here. It might
 

appear that some of the medical conditions you
 

describe which you suggest might be related to
 

chemical exposures, and of course we're well-focused
 

here on the radiological issues, and you may have
 
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had some radiation exposures, as well. But it
 

sounds like maybe the chemical issues -- but perhaps
 

there is -- are folks here that can help on an
 

individual basis, where the panel may not be able to
 

directly deal with your case but there are folks who
 

probably could.
 

MR. ORTIZ: Well, actually when I called you
 

people at NIOSH -- okay? -- there was a fellow who
 

sent me a booklet -- okay? -- with the orange cover
 

on it and he said there was no reason for me or
 

others to have gotten sick then 'cause you people
 

had a handle as to what the solvents would do to a
 

person, and that's I guess what I'm asking also. I
 

mean how could things like this be allowed for an
 

employer not to care?
 

DR. ZIEMER: This group probably doesn't
 

know the answer to that,and in fact we're trying to
 

address -- trying to address some remedies for some
 

things that occurred in the past that unfortunately
 

have had some adverse effects. And the object is to
 

try to fairly address those. Certainly on an
 

individual basis we want to make sure you're pointed
 

in the direction --

MR. ORTIZ: All right.
 

DR. ZIEMER: -- where that can be done.
 
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218 

MR. ORTIZ: I would like to talk to someone
 

that --

DR. ZIEMER: I don't know if -- Shelby, if
 

you can --

MR. HALLMARK: Somebody's just given me a
 

card.
 

DR. ZIEMER: Okay, so we'll try to help this
 

gentleman get underway in the right direction. 

Thank you very much.
 

MR. ORTIZ: Okay, thank you.
 

DR. ZIEMER: Thank you, Ben. Then Ken
 

Silver, and Ken, you can introduce yourself
 

background-wise.
 

MR. SILVER: Yeah, I met Mr. Ortiz in the
 

spring of '99 and we decided we'd try to get folks
 

together around this issue since Bill Richardson got
 

most of his education on these issues around here. 

Mr. Ortiz and many others have already been through
 

the New Mexico workers comp program and the local
 

Congressional offices are well aware that that's an
 

issue. Would the Department of Labor be friendly to
 

an increased appropriation to manage a single payer
 

system for other toxic chemical claims?
 

MR. HALLMARK: I'm sorry, I was --

MR. SILVER: Would the Department of Labor
 
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be friendly towards a major increase in their
 

appropriations to manage a single payer system for
 

subtitle D claims?
 

MR. HALLMARK: I think you're referring to
 

the legislation that's been submitted by Senator
 

Bingaman, among others, to alter the part D program
 

and the Department of Labor I don't think is in any
 

position to make comments on that legislation.
 

MR. SILVER: All right. Well, I hope you'll
 

take the strong message back to Washington that it's
 

really the only thing that's going to help Ben Ortiz
 

and many other people here in New Mexico. They've
 

already been through the New Mexico workers comp
 

mill.
 

For the purpose of this Advisory Board,
 

though, you're doing these site profiles, and we
 

understand your mandate is really just radiation
 

exposure. But as long as you're in the record
 

series, interviewing people, doing one-of-a-kind
 

work that's never been done before, our
 

recommendation is that you keep a little
 

bibliography of useful sources of information about
 

toxic chemical exposures at Los Alamos and other
 

places, and make it public; don't just send it to
 

NIOSH, append it as a bibliography to your site
 
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profile. And others will come along and build on it
 

as the subtitle D part of the legislation is
 

improved.
 

Another point that a person who's here today
 

asked me to raise is many people at Los Alamos also
 

had exposures in the test program in the Pacific and
 

the Nevada test site, and we understand that the
 

legislation is not very favorable towards combining
 

the doses. But for the record, a lot of people went
 

to work at Los Alamos. They incurred those
 

exposures in the Pacific, on the hill at the Nevada
 

test site, and you know, for another day the only
 

way those people are going to be able to get justice
 

if the doses can be added together.
 

When it comes to conflict of interest, one
 

of the reasons these problems have been insoluble
 

around here is that -- you've heard the expression
 

company town. Well, welcome to the company state. 

A lot of the professionals who had the credentials
 

and training to help were essentially bought and
 

paid for already, and we are a little -- we are
 

quite concerned that Oak Ridge Associated
 

Universities is a major DOE contractor. And by
 

their own admission, they have major conflicts of
 

interest. There's a lot of knowledge and expertise
 
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among former LANL workers that isn't reflected in
 

the formal models that health physicists use, so
 

we're going to be watching the dose reconstruction
 

process very carefully and make sure that the
 

workers, who are the real experts when it comes to
 

their work environment, are respected.
 

And if you set up an auditing system, as has
 

been proposed, John Till's* group and (inaudible)
 

are known quantities around here. They're known to
 

be people of integrity who already have
 

relationships and enjoy a high level of confidence
 

with the public, so I'd urge you to include them as
 

auditors in some part of the work that you're doing.
 

And finally, documentation of exposures in
 

work processes has been a huge bugaboo for everyone
 

bringing claims, especially the survivors. The
 

occurrence reports collection at Los Alamos is one
 

of the largest, most informative series. 

Unfortunately it hasn't been available to the public
 

over the years. Dr. Andrade, I want to thank you
 

for the limited access I had a few years ago. I'm
 

wondering if you've had a -- if the lab has had a
 

chance to digitize that collection yet.
 

DR. ANDRADE: I believe it is digitized.
 

MR. SILVER: Well, that's good news. We
 
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filed a Freedom of Information Act request this
 

morning for the entire collection, and we're going
 

to put it in the public domain and work with people
 

to add their own recollections to what has been
 

documented on the hill over the years and help
 

people pull together documentation for their claims. 

Thank you for your time.
 

DR. ZIEMER: Thank you, Ken. I might
 

mention that in the past we have actually -- I
 

neglected to do this, to ask if any of the Board
 

members have questions to direct to those who make
 

public comment, so let me back up a minute and ask
 

if anyone has any questions for Jonathan or for Ben 

or for Ken. I didn't mean to neglect to do that.
 

(No responses)
 

DR. ZIEMER: If not, then we'll proceed. 

Next is Richard Miller. Richard? Now you may
 

publicly comment, Richard.
 

MR. MILLER: I feel unconstrained, Dr. 

Ziemer. 

DR. ZIEMER: Oh, no. 

MR. MILLER: I knew you didn't want to 

invite that. 

This is probably going to be redundant with
 

your deliberations, but I'm also going to just put
 
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it on the record because we happen to be blessed
 

with Senator -- I hope -- yes, Senator Bingaman's
 

staff is still here, and I think Congressman Udall's
 

staff is here or was here -- yeah, there we go,
 

great. And that is that if this Advisory Board is
 

not able to, shall we say, appropriately assist
 

NIOSH in getting additional FTE's, particularly to
 

help in the dose reconstruction process, maybe some
 

of those in the Congressional delegation could nudge
 

CDC to give you another 25 or so FTE's. Would that
 

be a good round number? Okay. With no objection --

without objection, so ordered. But it is -- it is
 

painfully -- just from being in the audience, it is
 

so painfully clear that with what at least was
 

represented at the last Advisory Board meeting that
 

there were four health physicists, I believe -- is
 

that correct? That you have on the NIOSH staff?
 

MR. ELLIOTT: Right.
 

MR. MILLER: That's an accurate number. And
 

you know, you look at 8,000 dose reconstructions,
 

the conflict of interest reviews -- I would actually
 

lose sleep if I were the director of OCAS with that
 

circumstance. I know you don't, Larry, but -- would
 

you care to comment?
 

MR. ELLIOTT: (Inaudible)
 
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224 

MR. MILLER: All right. In any event, to
 

the extent that this is really a huge issue that has
 

to be dealt with appropriately, and I guess we would
 

really defer to you on the best way to do it. 

Congress did put some language in the Labor/HHS
 

bill. Probably -- who knows when we'll have a
 

Labor/HHS bill? It may not be for some time and so
 

it's not timely to solve your problem. How soon do
 

you need additional staff -- no, this is a serious
 

question. How soon? Like is this like something
 

you need to start hiring immediately or is this
 

something by January? How quickly does this need to
 

happen?
 

MR. ELLIOTT: I think the answer to your
 

question is very obvious, that as soon as the ORAU
 

team starts churning out dose reconstruction reports
 

on the order of 150 a week or more, we're going to
 

need help. I don't believe that Jim and the three
 

health physicists that we have on staff will be able
 

to accommodate a full-fledged review. So yes --

MR. MILLER: Great. The second question I
 

wanted to raise had to do a little bit with how
 

NIOSH will go about the implementation. We've heard
 

some discussion from Jim and others today about the
 

COI disclosures. How -- how will this work? The
 
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conflict of interest statement in the contract says
 

sunshine is the best disinfectant, and yet we hear
 

competing concerns about Privacy Act considerations. 

I don't know that anybody's asking for anybody's
 

home address or phone number, or their written
 

signature. But I guess getting around sort of those
 

obvious issues where we really don't think that's in
 

dispute and there are constantly public documents
 

with Federal officials' names on them. Here you've
 

got contractor employees carrying out the
 

activities, in effect, of the Federal government
 

because you don't have enough FTE's to do your -- to
 

do the mission that you've been tasked. And so I
 

would like I guess for the Advisory Board, when it
 

thinks about its work with NIOSH, to try to provide
 

for a level of transparency that is most simple for
 

claimants, that is as in-depth and as thorough as
 

possible, because I think at some level the right to
 

know by claimants outweighs the privacy rights of
 

the individuals not to have their resumes known when
 

they're doing the public's work.
 

Having said that, it'll ultimately become
 

public if these cases ever get litigated. And it
 

just sort of seems silly, you know, later for that
 

stuff to -- it would seem silly to withhold
 
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information that ultimately becomes public later and
 

then suspicions rise and so -- you know, you've done
 

a good job on your web site. You've got a lot of
 

information out and I would just like to encourage
 

you all, because it is -- there's nothing in the
 

contract today that orders ORAU to make these
 

disclosures. The slides you put up today said if
 

NIOSH tells us to, we'll make this information
 

public -- if. And so it's conditional on you all's
 

action.
 

I think earlier today we heard a question
 

about what happens if there's a conflict of interest
 

challenge, and you would like it brought to your
 

attention so you could try to resolve it before
 

perhaps it might be appealed to the Labor
 

Department. What if -- do you have a procedure in
 

mind about how people would seek recourse? In other
 

words, if somebody thinks they've got a problem with
 

who's doing their dose reconstruction and they
 

actually do get this information, is there going to
 

be a phone number and a procedure of someone they
 

can call up, or are you going to have some process
 

for evaluating whether they're raising a credible or
 

a non-credible conflict concern? And then lastly,
 

are you going to give them the choice to -- if
 
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they're still uncomfortable, even after they've
 

heard your explanation, and under what circumstances
 

would you give them choice to select perhaps
 

somebody else to do their work if it would raise
 

their comfort level?
 

MR. ELLIOTT: It's a three-part question.
 

MR. MILLER: You had a lot of sleep lately.
 

MR. ELLIOTT: Three-part answer. Yes, there
 

will be -- there will be a NIOSH point of contact
 

assigned to each claimant for each case file who
 

will be able to respond to concerns and questions
 

regarding how a claim is moving forward -- not only
 

conflict of interest, but where's my -- where's the
 

status of my claim, where's the DOE-submitted
 

information, how long has it been -- a variety of
 

things that the NIOSH point of contact, that's the
 

claims specialist that Jim mentioned before that we
 

call public health advisors.
 

As well, the ORAU team will have their
 

person who is also a mirror image of that. And so
 

they're going to have both of those points of
 

contact, the NIOSH point of contact, the ORAU team
 

point of contact. We will be working with ORAU and
 

their team to establish a policy procedure and
 

process that will be implemented to alert the
 
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claimants that if you have a question about -- or
 

have a concern or have an issue regarding conflict
 

of interest, here's how you go about registering
 

that, and providing what your concern is to us so
 

that we can take some action to review and evaluate.
 

Now I've lost sleep 'cause I've lost the
 

third part of your question --

MR. MILLER: Which is what's the recourse? 

I mean once they notify you, are they going to have
 

the option of being able to select somebody as an
 

alternative?
 

MR. ELLIOTT: No, the claimants do not have
 

an option to select their dose reconstructionist. 

That's not on the table. And the reason for that is
 

is because we need to assign a dose
 

reconstructionist who has the skill and the
 

expertise to do that work, and we can't rely on a
 

claimant to understand, you know, from the pool of
 

available dose reconstructionists who might fit that
 

scheme, so that's not on the table.
 

What is on the table, though, is that we can
 

hear what the concerns and the issues are regarding
 

the dose reconstructionist who has been assigned,
 

and if we feel that that's a valid concern, we'll
 

reassign -- make a new assignment and put a new
 
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person on top of it. I don't think there's going to
 

be any argument or quibbling about the validity of
 

that concern that's registered. We're just going to
 

take it and go with it and make a change.
 

MR. MILLER: Okay, so it's a no-quibble
 

policy. All right.
 

And then with respect to the disclosure that
 

came up today, that there are approximately -- it's
 

either 90 firms or 90 individuals that have been
 

retained by ORAU to do dose reconstruction?
 

MR. ELLIOTT: There's 90 individuals. There
 

are not 90 firms. Ninety indivi--

MR. MILLER: That was a bit confusing
 

earlier.
 

MR. ELLIOTT: Ninety individuals. I
 

believe, am I right, Mr. Toohey? Yeah, Dick -- Dr.
 

Toohey?
 

So there are 90 individuals who have been
 

identified to date that are ready to serve as a dose
 

reconstructionist, not 90 firms.
 

MR. MILLER: Okay. And how many firms are
 

there? Are there just the three?
 

MR. ELLIOTT: Dick, you want to --

MR. MILLER: Dade Moeller and MJW and
 

yourselves?
 
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DR. TOOHEY: No, we have three or four other
 

what we call resource subcontractors -- ENSR,
 

Research Associates, maybe one -- and another one
 

that I just can't think of. I know we did submit
 

with the proposal that NIOSH has what was a measles
 

chart listing of names, education, experience and
 

qualifications (inaudible).
 

MR. MILLER: Well, since Larry's
 

anticipating my next question, which is disclosure,
 

one of the things that was included in the NIOSH
 

contract was it incorporated the bid proposal by
 

reference. Is that -- is there a plan at some point
 

to make that public in some form?
 

MR. ELLIOTT: Yes, we're working toward that
 

end. However, there's been a -- we have to go back
 

to the ORAU team. They're being asked to review
 

their proposal for proprietary information that
 

would give an unfair competitive advantage for
 

future bidders on a similar statement of work that
 

we might let in the future. So once we have that
 

established through our legal process to remove
 

those kind of things, it will be put out.
 

MR. MILLER: So -- and with respect to the
 

posting of the other subcontractors, is that going
 

to be posted on your web site, as well? Or how will
 
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that be made known outside this room?
 

MR. ELLIOTT: Well, it's in the proposal,
 

but it -- once we come up with how we're going to
 

place -- I think on ORAU's web site -- who the dose
 

reconstructionists are, it'll be very apparent what
 

their work histories have been and who they've been
 

-- who they're currently affiliated with, who
 

they've been affiliated with in the past.
 

MR. MILLER: All right. And I just -- my
 

last comment has to do with your Section 3152
 

report. I heard Grady say that he's planning on
 

contacting corporate enterprises and I guess other
 

DOE sources of information. Can we just make a
 

small suggestion, which is if you're going to try to
 

fill in the gaps on the data, there are a bunch of
 

other sources, including workers. There's been no
 

community outreach on this up to this interim
 

report. It would be helpful if there was some
 

outreach to try to capture knowledge. There are
 

Congressional offices with file drawers of
 

information, some of whom are leaving Congress this
 

year, who -- on some of these facilities, which is a
 

rich mother lode. You have some people on this
 

committee who have actually worked on individual
 

facilities that need additional data that could be
 
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your data source. And there's the state regulatory
 

agencies. And so I don't know if it's going to be
 

doable if you have a report due to Congress on the
 

28th of December to do all that, but I would just
 

encourage some outreach.
 

MR. ELLIOTT: Your suggestion has been
 

provided before. It's been well taken. We
 

understand what you propose to us in that
 

suggestion. It's not a -- in Grady's list of where
 

we're going to go next in further investigation. It
 

was perhaps an oversight, but we do intend, once we
 

get down to a specific site where we need more
 

information, we're going to focus and target where
 

we can get that, and that's when we'll engage those
 

other kinds of sources of information.
 

MR. MILLER: Thank you for clarifying that.
 

DR. ZIEMER: Let's see, I have next -- I
 

think it's Jerry Lada -- is that -- do I pronounce
 

that correctly, Jerry? From Espanola, New Mexico. 

Jerry.
 

MR. LADA: Good afternoon, ladies and
 

gentlemen. I want to welcome all the CD to Santa
 

Fe, New Mexico where I was born and raised. Welcome
 

to the state of the Land of Enchantment.
 

I worked as a RCT, radiological control
 
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tech, for the Los Alamos National Laboratory for a
 

number of years, worked with plutonium 238, 239,
 

americium 241, cobalt 60, cesium 137, and I'm now in
 

the process of going through medical evaluation,
 

hopefully with the National Jewish Hospital in
 

Colorado.
 

The three issues that I want to address to
 

you is, one, the IREP model. I don't understand why
 

you're taking atomic data that we used in Japan when
 

we did the bombing for Hiroshima and Nagasaki
 

because a lot of the scientific data does not really
 

apply to nuclear workers around the United States. 

And I think they should use the data that is used at
 

nuclear facilities around the country, the 12
 

nuclear facilities that under Department of Energy.
 

The second issue is the conflict of interest
 

with Oak Ridge. I think, as Ken and Richard
 

expressed, that there is a conflict of interest and
 

they admitted it themselves, also. And for auditing
 

purposes I would like to know, as a taxpayer, my
 

money going -- when the claimant should have the
 

right when the caseworkers assigned to him or her
 

that they should know through the whole process what
 

is going on with their -- the dose reconstruction.
 

The third issue that I want to address is
 
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Los Alamos National Laboratory becoming a special
 

cohort exposure (sic). What are the guidelines,
 

what's going to be the petition for Los Alamos
 

National Laboratory for it to become a special
 

cohort exposure (sic)?
 

I feel, as a representative of the union at
 

Los Alamos National Laboratory -- we don't have a
 

contract yet, but we're UPTE, University
 

Professional Technical Employees, TWA 9119 out of
 

California for Berkeley, Santa Cruz, a lot of the
 

different -- there's 10,000 strong members and right
 

now we're organizing at Los Alamos National
 

Laboratory.
 

And I feel that -- when I talked to the guys
 

who worked at TA-55, they're intimidated by
 

management. I asked them how come you guys haven't
 

filed a claim? Oh, Jerry, we can't do that. Why
 

can't you? I'm afraid to lose my job.
 

Director John Brown came out with a memo to
 

all the employees that no employee will be
 

retaliated if they file a claim for the energy
 

illness compensation act. But still a lot of these
 

guys are scared. And I see them -- people like
 

custodians, staff members, technicians, security
 

guards -- 28 people that I know that have died. One
 
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of my neighbors, Mariano (inaudible), he was an RCT. 

He died from cancer. One of my friends father,
 

Senor Antonio Garcia, I know worked at Los Alamos
 

National Laboratory for many years and has cancer. 

He goes to John (sic) Hopkins University School --

the medicine where they take the physical at
 

Espanol. They tell him nothing's wrong with him. 

Nothing's wrong with him. He's not the first case. 

So I think John (sic) Hopkins is losing credibility
 

here.
 

Also the Department of Energy, the brochure
 

I received to go get a medical review or a medical
 

exam, but not both of them because of budget
 

constraints. Well, what good is the study for if
 

they're just going to refer you to another primary
 

physician? Right now I'm trying to get my HMO, Blue
 

Cross-Blue Shield, to approve this visit to the
 

National Jewish Hospital in Denver. It's only been
 

five weeks. I still can't get an approval.
 

So I'm asking NIOSH -- there's a lot of work
 

that you guys still have to do because, as a
 

Hispanic person who was born and raised here, a lot
 

of my cousins, uncles, aunts, grandpas and grandmas
 

who have worked on Los Alamos National Laboratory to
 

do the dirty work from glow boxes and cleaning pipes
 
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that are leaking with plutonium 238 and have gotten
 

sick.
 

This is a program for the people. The money
 

was set aside for the people to be compensated. The
 

burden of proof is upon the claimant. Once they
 

have one of the 22 known cancers, then they have to
 

go through all the hard work, all the paperwork, all
 

the medical work and then just to get shut down. I
 

think this is b.s., Larry.
 

And it hurts me that I see my family, my
 

Hispanic people, Anglo people, Native Americans and
 

black people who have died from cancer and are
 

suffering now. $150,000 is nothing for a human
 

life, nothing. It is your duty, 'cause these people
 

gave their duty to their country. They fought for
 

freedom. It's time for you guys to help these
 

Americans out.
 

It's a shame that we can give hundreds of
 

millions of dollars to other countries around the
 

world, but we can't pay our own American people who
 

have gotten sick, who have cancer, working for
 

nuclear facilities. Thank you.
 

DR. ZIEMER: Thank you, Jerry, and let me
 

ask again if any of the Board members have questions
 

for Jerry. Your comments will be on the record,
 
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Jerry.
 

MR. LADA: Thank you.
 

DR. ZIEMER: Let's see, I've got another
 

sheet here. I think we've had some additional folks
 

come in. I'm having a little trouble reading this. 

Is it Epifamia?
 

UNIDENTIFIED: (Inaudible)
 

DR. ZIEMER: Yes. Would you like to speak? 

You need to use the microphone. You need to
 

identify yourself and --

MS. SHINUS: I'm sorry, my name's Bettie
 

Jean Shinus. I'm a survivor and my father worked
 

for (inaudible) company and he worked there for 35
 

years. He's deceased. And my sister couldn't be
 

here and she asked that I ask something of the
 

panel.
 

There's a questionnaire on the internet
 

right now that's going to be asked of the survivors. 

Are you aware of that questionnaire that I'm
 

speaking of? It relates -- doesn't relate to
 

anything that we can answer. Absolutely there is
 

not one question I could, as a survivor, answer. 

And the question my sister had is are you going to
 

revise that for the survivors or what? Because
 

there's not one question on that that -- as a
 
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survivor, that I could answer. And she wanted to
 

know that.
 

DR. NETON: The questionnaire was crafted
 

with the idea that all the questions were related to
 

helping us to determine what the exposures were to
 

the workers, and so that's why they tend to be
 

somewhat technical in nature, and we do expect that
 

many of the survivors will not be able to answer
 

them. But we felt it necessary to have them on
 

there in case that information would be available.
 

That being said, we do ask at the end of the
 

questionnaire for any information on co-workers who
 

would be knowledgeable or others to shed some light
 

on the exposure scenarios or profiles or experiences
 

that the person would have underwent at that
 

facility. So they're really just there as an
 

attempt to gather sufficient information for us to
 

do some type of a dose reconstruction. And by that
 

nature, they're somewhat technical. And I don't
 

know that we can craft another questionnaire that
 

would provide us the same type of information that's
 

somewhat simpler, although we are definitely open to
 

feedback on that questionnaire.
 

MS. SHINUS: I don't think it's because it's
 

technical that we can't answer it. We can't answer
 
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for my dad. We don't work there. We didn't know
 

who he worked with. How can we answer that. It's
 

been -- how many years, Epi? It's been 20 years
 

since he died. There's no way.
 

There was something said about dose
 

reconstruction. Does anybody here -- has anybody
 

here worked at Los Alamos? Well, I can tell you,
 

you've been exposed. I mean, to me, there is no
 

question in my mind. I have a brother that works
 

there. I have a nephew that works there. And I
 

know that they've been exposed. I know my father
 

was exposed. Doesn't -- I don't have to be a
 

physicist to figure that out because I know the
 

safety -- what needed to be in place was not there
 

when my father worked there. My father was a sheet
 

metal worker. He worked -- contracted to the labs
 

and we have pictures of my dad working there at the
 

labs, working with all that piping, with no safety
 

gear at all. I know my dad was exposed. He died of
 

cancer -- died of throat cancer.
 

I guess my question is to you can you prove
 

that he wasn't exposed? Not that he was exposed,
 

that he wasn't? 'Cause I know that -- you cannot
 

convince me that everything was in place to make it
 

safe for my dad to work there. My dad had six kids
 
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to support. He didn't question whether it was safe
 

or not. He put that faith in the labs and where he
 

worked. And what I'm hearing now is he put his
 

faith in the wrong place. My dad was very -- the
 

type of person that lived for his work and gave
 

everything to his job. But he had a family to
 

support and he did it with love, never complained a
 

day in his life, never retired. He worked for 35
 

years for (inaudible) company. And I feel like
 

we're put -- being put in a place to defend that and
 

to prove what, that my dad didn't work at Los
 

Alamos? He worked there for 35 years. Prove to me
 

that he wasn't exposed.
 

I've read some of my dad's records and I can
 

tell you he was. But what -- I mean to have to put
 

that into your hands to determine just how much
 

exposure really counts. To me, if he had cancer and
 

he worked there, that's a given to me, and that's
 

all I have to say as his daughter.
 

DR. ZIEMER: Thank you, and -- is it a 

sister or --

MS. SHINUS: We're all siblings. 

DR. ZIEMER: Siblings, okay. Thank you. 

MS. JACQUEZ: My name is Epifania Jacquez 

and I am Bettie Jean Shinus's sister and there's
 
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(inaudible) siblings and we are the survivors. We
 

were the people that was -- that were I guess
 

eliminated from the program the first time around,
 

and we're very pleased that Jeff Bingaman and Ken
 

Silver and Tom Udall and a lot of people worked on
 

our behalf. My sister and I also, we hung in there
 

and didn't give up because we knew about my dad and
 

we are survivors.
 

I have a couple of questions that I want to
 

ask -- I didn't come here -- I understand you had
 

your meeting and then it was open for public comment
 

for about an hour, so -- but I guess we weren't
 

allowed at the -- you know, while you guys were
 

having your meeting, the scientists. And not being
 

scientists --

DR. ZIEMER: No, let me -- the meetings are 

all open, yes. 

MS. JACQUEZ: Okay. Well, the notice that I 

got, it said that the public -- it was open to the
 

public from 3:45 on but that your meeting started at
 

8:30. I got --

DR. ZIEMER: I'm sorry you --

MS. JACQUEZ: That's how I was informed.
 

DR. ZIEMER: All of the meetings are
 

completely open to the public. This period is open
 
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for public comment, but --

MS. JACQUEZ: Oh, I didn't know that. I
 

would have been there.
 

DR. ZIEMER: These are not closed meetings. 

I'm sorry that that was not communicated to you.
 

MS. JACQUEZ: That's how I understood it. 

But as --

DR. ZIEMER: And the meeting tomorrow is
 

also open. You're certainly welcome to attend.
 

MS. JACQUEZ: I do have a question for all
 

these scientists that are here, and I'm going to ask
 

you -- I want to ask, should any individual or any
 

person be exposed to high levels of contamination? 

Should anyone be exposed? Should anyone be exposed? 

I'd like an answer for that.
 

DR. ZIEMER: No.
 

MS. JACQUEZ: Good, okay. And if the answer
 

is no, so if a person is exposed about seven to nine
 

times, is that a bit too much? If someone is --

DR. ZIEMER: Well, you're asking a technical
 

question that does not have one single answer. Many
 

of us have worked with radiation all our lives,
 

including me, so --

MS. JACQUEZ: But have you been exposed?
 

DR. ZIEMER: Oh, of course.
 
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MS. JACQUEZ: You've been exposed to --

DR. ZIEMER: Of course.
 

MS. JACQUEZ: -- high levels of radiation?
 

DR. ZIEMER: Of course.
 

MS. JACQUEZ: Do you have cancer?
 

DR. ZIEMER: No, I don't.
 

MS. JACQUEZ: You're lucky. Anyway --

DR. ZIEMER: But you know, one of the things
 

-- let me just comment that we're charged by
 

Congress to do is try to establish how much exposure
 

an individual's received. You used numbers -- one,
 

two, three, nine. We use some dose numbers, but
 

they relate to the numbers of times exposed. And
 

you know, the law's written in a certain way that
 

does provide compensation at certain levels. And
 

our Congressmen have established that law. We may
 

not agree with its complete provisions -- you know,
 

is the money enough, is the level at which
 

compensation is given the right one -- but currently
 

it's the law and this Board is charged with trying
 

to assure that that law gets carried out by the
 

agencies in a fair way, and that's what we want to
 

do. So -- and we're certainly sympathetic. There
 

are so many individual cases, each one's a little
 

different. But the effort is to treat them fairly,
 
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try to establish the extent to which that exposure
 

makes them eligible under the Congressional mandate
 

that we have received. And this Board nor the
 

agencies can operate differently from what our U.S.
 

Congress has charged us to do. So you appreciate
 

that.
 

MS. JACQUEZ: I do. And I'm also aware that
 

there was a rating, you know, as you go from a low
 

to a high and next to a high is a moderate, and I
 

think moderate is high. What is your opinion, as a
 

scientist, if you get moderate exposure repeatedly? 

I think that's pretty high.
 

DR. ZIEMER: It may be in some cases.
 

MS. JACQUEZ: It may be in some cases? I
 

think it is actually. I can't imagine how you would
 

imagine that it wouldn't be in all cases, but that's
 

just my opinion.
 

And I'm wondering, I don't -- there's a lot
 

of times that these workers were not monitored, you
 

know. You have a worker that worked in all -- you
 

know, in all the buildings, and in some of the hot
 

spots in Los Alamos. My dad worked there, and not
 

always were they protected or were they monitored. 

And so I have also -- it is my understanding that
 

the r-e-m has been set at five. Am I correct? 
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That's what you're using?
 

UNIDENTIFIED: (Inaudible)
 

MS. JACQUEZ: So if a worker has 4.4
 

something, do you take that into consideration,
 

considering that they weren't always monitored? Are
 

you -- you know, being as to how you're going to be
 

very fair and very compassionate towards these
 

workers, and you're looking at a worker that has
 

worked for 35 years?
 

DR. ZIEMER: We don't want to get into a
 

long dialogue, but let me say -- and I'm sorry that
 

you missed the earlier part of the meeting because
 

in fact the NIOSH staff has shared with us a number
 

of cases that they've already processed where they
 

have situations very similar to what you're
 

describing. One of the jobs NIOSH does in the dose
 

reconstruction is in fact to identify missing dose
 

and they are very -- let me call it worker-friendly
 

in assigning numbers based on related data,
 

monitoring data where there's missing information. 

But -- and perhaps that can be shared with you
 

later, but you're quite right. There are many cases
 

that will come before this group where there are
 

pieces of information missing. And the question is,
 

how do you treat that, and we're trying to do that
 
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in an equitable and fair manner.
 

MS. JACQUEZ: Okay. And we do have
 

documentation of my dad's exposure, so I'm very much
 

aware --

DR. ZIEMER: That would be very helpful.
 

MS. JACQUEZ: And we have already filed our
 

claim. I have one more question before I ask you my
 

final question, and that's -- just curious. Let's
 

say a scientist that worked in Los Alamos, how
 

protected were they when they were working, compared
 

to other workers? Because we've heard horror
 

stories. Did they wear suits? I know that they
 

were extremely well-educated, especially -- that's
 

going back 21 years. You had your craftsmen and
 

then you had your scientists. My guess that there'd
 

be a large amount of those scientists that knew the
 

dangers that probably were protected or knew how to
 

protect themselves. And also the fact that in Los
 

Alamos -- and this is stuff that I've heard or
 

information that I've heard -- they were shredding
 

evidence -- evidence that -- you know, they were
 

shredding papers and records and everything. And at
 

the beginning you were told that there weren't any
 

records to be found. So Los Alamos is one of those
 

labs where that was going on, and I don't believe
 
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that the workers -- this is my opinion, that the
 

workers at that time worked in Los Alamos didn't
 

share that much with their families and felt very
 

fortunate that they had a job in Los Alamos. At
 

that time Los Alamos paid good salaries, but I don't
 

think that they were very well informed about the
 

dangers of working out there. You know, this has
 

only happened in say, what, the last five years,
 

that we've become so aware of the dangers that were
 

out there?
 

For my dad, who was very dedicated in his
 

job, extremely dedicated in his job, we're going to
 

hang in there because my dad believed in his country
 

and this compensation act is a compensation act. 

And like someone said, what's $150,000, you know,
 

for a life? My dad died fairly young. That is not
 

a lot of money. It doesn't replace a person that
 

you've lost.
 

And so one final question or comment and
 

that would be the timetable. Okay? What is the
 

timetable? Let's say if you filed a claim and it's
 

been six or seven months that you filed your claim
 

and they have all the paperwork. Your father's
 

dead. He's deceased. Is there a timetable? Are
 

you putting any kind of timetable for this program
 
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to come to fruition? I mean even a guess? I know
 

that the government has money to pay for this. 

We've been told that money is not an issue. I have
 

that as a quote from one of your top officials. So
 

supposedly it's not the money. Then why is it
 

taking so long? If we can in a moment turn around
 

and finance a war to eliminate Hussein -- and I'm
 

just going to use that as an example -- and it
 

probably -- happen within two weeks, why something
 

like this that affects American citizens, people
 

that have given up their lives, that have worked for
 

something they believe in, their government, why is
 

it taking so long? Why should it continue to take
 

so long? And as far as a timetable, could you
 

answer that for me?
 

DR. ZIEMER: Great question. I think we all
 

wonder some of these -- philosophically about where
 

priorities are in our government sometimes.
 

Specifically on the timetable, there are a
 

couple and Department of Labor has some specific
 

timetables which in fact they shared with us this
 

morning to make us aware, and NIOSH had some
 

timetables, and perhaps the staff can comment on
 

that.
 

DR. NETON: Yes, this morning we went over
 
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some of the -- we just brought on board on September
 

11th a dose reconstruction contractor to assist us
 

in performing these dose reconstructions. The
 

provisions of the contract call for up -- at least
 

8,000 dose reconstructions to be conducted per year. 

So assuming that your father's claim is less than
 

8,000, it would be processed hopefully in the next
 

year. Do you happen to know the claim number?
 

MS. JACQUEZ: I have it at home.
 

DR. NETON: That also being said, the -- it
 

does depend on us having a complete record from the
 

Department of Energy to complete the dose
 

reconstruction, or at least sufficient for us to use
 

our process on that claim. You know, not knowing
 

your father's specific claim, I don't know that we
 

actually have all of the information at hand. We
 

do? Well, if that's the case, we've asked our dose
 

reconstruction contractor to go through all the
 

claims starting with number one and identify those
 

claims where sufficient information exists and to
 

make them a priority to process. So not knowing
 

where your claim is in the system, I'm fairly
 

optimistic that if we can meet our goal of 8,000, it
 

will be accomplished in the next -- within the next
 

year. But it could be much sooner than that. I
 
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don't want to give you the impression that it could
 

be a year.
 

MS. JACQUEZ: Okay. So then I can say that
 

perhaps -- me being a survivor and I'm 63 years old
 

-- that it won't go on to my children, another --

another set of survivors.
 

DR. NETON: I hope not.
 

MS. JACQUEZ: Thank you for listening to me.
 

DR. ZIEMER: Thank you very much. Are there
 

any other members of the public -- another comment? 

Sure. 

MS. SHINUS: I'm sorry. 

DR. ZIEMER: No, that's fine. Please. 

MS. SHINUS: And I only come up here because 

I'm speaking for my sister and myself, so I figure
 

that's two people. When I asked that question about
 

the questionnaire, I didn't get an answer back, I
 

don't think. My sister wanting to know -- this --

you know, it's an assessment tool. I mean this is
 

an assessment tool, what -- this questionnaire. We
 

can't answer -- I'm not kidding you, we cannot
 

answer one of these questions. So I'm saying if
 

it's an assessment tool, that may be negative
 

towards our --

DR. ZIEMER: Again, I think we can have the
 
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staff answer that. Note that there are some
 

survivors that have that information, and where they
 

do, they want to make sure to get it. But I think
 

it's understood that many will not. But you're
 

quite right, and particularly in the early days,
 

much of this work was sort of secret and the workers
 

weren't supposed to talk about it at home, so you
 

didn't know about it. Plus a lot of men just don't
 

talk about their work. You know, wives are kind of
 

-- what are you doing; they don't tell them. Who
 

wants it -- Larry?
 

MR. ELLIOTT: I think Jim answered your
 

question, but maybe you didn't hear it or you -- it
 

was misunderstood. We fully expected that that
 

survivor questionnaire would not be beneficial for
 

all survivors. But hearing you talk and hearing
 

your sister talk, you have pictures, you have
 

photos, you have dose records, you have information
 

about what your dad did. You knew he was a sheet
 

metal worker. You knew he worked on duct work and
 

where he worked, perhaps. That's information that
 

is beneficial to our dose reconstruction process. 

It's information that would come out in the
 

interview. Maybe it's not a question specific in
 

that questionnaire, but it's information that will
 
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be elicited or obtained during the conversation with
 

the interview person that would conduct the
 

interview with you all.
 

The questionnaires have to go through a
 

approval process that is very rigorous for the
 

Paperwork Reduction Act with the Office of
 

Management and Budget, and it takes a good deal of
 

effort and time and resources to modify those
 

questionnaires. As Jim said, if you have -- we
 

welcome input on the content of the questionnaires
 

or the difficulty in understanding them, recognizing
 

that this whole process has a technical basis to it.
 

And unfortunately, they do have to speak to
 

technical things and so -- Jim I think wants to add
 

MS. SHINUS: Again, I want to say it's not
 

the technical piece of it. I've read it. I've got
 

it right here. It's very straightforward. It isn't
 

about that. It doesn't relate to survivors. It
 

relates to a person that's living, not to a
 

survivor. My dad's been dead for --

DR. NETON: I would say that we do accept
 

and encourage any of this additional information to
 

be provided at the time of the interview to us. A
 

number of people have done that where if they feel
 
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the dose reconstruction interview does not
 

adequately capture their situation or their father's
 

situation, they will provide us in writing a
 

detailed description of what they believe to be the
 

case, and that will be added and stapled right to
 

the back of that interview form and considered at
 

dose reconstruction time. So that is not the only
 

piece of information that is used for the dose
 

reconstruction. There is numerous other pieces and
 

claimant-provided or survivor-provided input is
 

encouraged, and we will consider that. If you have
 

that information, please sent it to us.
 

MS. SHINUS: Okay. So the answer to my
 

sister is no, there is not a separate questionnaire
 

for survivors. It's --

UNIDENTIFIED: Yes, there is.
 

MS. SHINUS: Oh, there is?
 

UNIDENTIFIED: (Inaudible) right version. 

There are two versions.
 

DR. NETON: Well, there is a separate
 

questionnaire, but in reality they are very similar
 

in their lines of inquiry.
 

MS. SHINUS: This is what I have. You can
 

-- whoever can tell me if this is it. And also is
 

there a Richard from the sheet metal workers here? 
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Richard? You work for the sheet metal workers? 

This is a question from my sister. It asks -- oh,
 

go ahead.
 

DR. NETON: In looking at this, this appears
 

not to be a survivor interview. It talks about
 

reviewing of records of jobs you have held, so this
 

is specific to a claimant. However, I will --

UNIDENTIFIED: An Energy employee.
 

DR. NETON: An Energy employee, rather. I
 

will say, though, that the script is not -- there
 

are differences tailored to the survivor, but there
 

are similar questions on here because they are still
 

trying to elicit something about the dose, the type
 

of work.
 

MS. SHINUS: So there is a different one? 

There is a different one?
 

UNIDENTIFIED: Yes.
 

MS. SHINUS: And she can access it through
 

the internet. Is that correct?
 

DR. NETON: I don't know that the
 

survivor --

MS. SHINUS: 'Cause that's where she got
 

this.
 

DR. NETON: -- is on the internet.
 

DR. ZIEMER: I'd like to ask -- particularly
 
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since you may be asking questions specific to your
 

case and you want to ask Richard something --

MS. SHINUS: Yes.
 

DR. ZIEMER: -- I wonder if it would be
 

appropriate if you did that privately, since we
 

don't generally --

MS. SHINUS: Well, the thing is, it isn't
 

private because everything that I'm saying today --

DR. ZIEMER: It has a general --

MS. SHINUS: -- it isn't just for my dad. 

DR. ZIEMER: Okay. 

MS. SHINUS: I feel that I am speaking for 

those people that can't be here, and those are the
 

people that are dead that have worked at the labs. 

I feel I am one of those children, one of the family
 

members that is speaking for these families that are
 

out there and I have -- from the very beginning have
 

said that if we don't get a penny for me, the
 

important is for speaking for these families that
 

don't have a voice. I am a voice for some of those
 

families.
 

Richard, my question to you is this. ...
 

asking if we know of any people -- I'll read you
 

what my -- 'cause she wanted this specifically for
 

you. She said if you talk to Richard from the sheet
 
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metal workers, ask if there's any way we could
 

contact or get a list of living workers to help in
 

the application process. Let him know that we have 

charter listing workers. In other words, we have 

access to that. 

MR. ESPINOSA: Yes, in the back there's a
 

(inaudible) of sheet metal workers, Local 49 in the
 

-- to answer your question, yes. In the time period
 

that your father worked in Los Alamos we still have
 

a -- keep their Local senior that's still alive that
 

could probably help answer a lot of your questions,
 

and a few other workers that are in the Espanola
 

area and Santa Fe area, the Romero family and quite
 

a bit of other people that will be able to help you.
 

MS. SHINUS: So there is a few still living.
 

MR. ESPINOSA: Yeah, there's a few still
 

living.
 

DR. NETON: I would like to point out that
 

NIOSH is not asking you to contact those people and
 

provide that information to us. It would be
 

sufficient if you just provided the names of those
 

people and we would contact them and conduct those
 

interviews. However, you're free to do that
 

yourself, as well, but it's not -- the burden is not
 

on the claimant to contact the co-workers and obtain
 
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the information. We will do that for you if you
 

desire.
 

MS. SHINUS: I have only one more comment,
 

and thank you for your time. I think many of the
 

people -- employees that are still working in Los
 

Alamos do not have a voice. I know my dad would not
 

be here today if his job depended on supporting his
 

family, so it is not that easy to come forward when
 

you're an employee, and I have family that works
 

there right now. So I want to thank you for your
 

time and I really appreciate your time and your
 

effort. Thank you so much.
 

DR. ZIEMER: Thank you. Maybe your sister
 

has another comment.
 

MS. JACQUEZ: I have a comment to make. If
 

I have submitted a claim and you have the dosometry
 

(sic) readings and you have exposure records, I'm a
 

survivor, my dad was the employee, why are you
 

asking me questions that you have answers to?
 

DR. ZIEMER: I'll let the staff answer that,
 

but in part it's because we believe there may be an
 

incomplete record in many cases that we want to fill
 

in the gaps, and you've already alluded to that, so
 

there are the dosimetry records, but we're really
 

saying is there additional information that we don't
 
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know about and --

MS. JACQUEZ: But if you have enough in
 

front of you, I can't imagine -- I mean, you know,
 

let's say --

DR. ZIEMER: Oh, we had such a case this
 

morning. If there's enough information that
 

demonstrates that the claim requirements have been
 

met without the additional, then the claim is
 

approved without all that. Jim, you --

DR. NETON: Well, Dr. Ziemer's exactly
 

correct. However, we are committed in our rule to
 

interview every individual claimant, and so we do
 

contact them once we receive the Department of
 

Energy information, just as Dr. Ziemer indicated, to
 

ensure that the record accurately reflects the work
 

conditions. A person, however, does not have to
 

have an interview. One merely has to state that I'm
 

not interested in being interviewed, and that's the
 

end of it. So it's not a requirement to move the
 

claim forward.
 

MS. JACQUEZ: Okay. I cannot see, and I
 

think I'm a fairly intelligent person -- and I'm not
 

a scientist, but I'm a fairly intelligent person,
 

but as a scientist or as a doctor, if I had
 

documents giving me dosometry (sic) readings, I
 
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would think that that'd be enough for me to
 

determine it, since you have a certain scale that
 

you're using. And for the claimants, to expect
 

answers from them, and I mean how can you answer for
 

that worker that wasn't there. You weren't -- you
 

weren't in -- you didn't walk in his shoes. They
 

didn't come home and tell you exactly what happened
 

at work. And we know of instances where he was
 

exposed, but my dad was not one to come in and
 

discuss his job with you. So I'm saying I have to
 

tell my sister, the one that asked this sister to
 

ask this question, my God, if that's -- if I get
 

called and I get thrown these questions -- which I
 

thought they were -- they didn't pertain to me. I
 

couldn't answer them. She kept saying well, these
 

are the questions that are going to be asked of you. 

I said I'm not my dad. I can't answer them. So
 

these cannot be questions that are going to be asked
 

of us because that is silly. We weren't there. We
 

were not at his job. So to me, that's just
 

complicating an issue more, and I always say hey,
 

look at the simplicity. Get down to simple facts,
 

you know what I mean? A person is working in Los
 

Alamos. A person is exposed, is working in hot
 

spots, has a certain amount of exposure repeatedly,
 
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what else do you want from the family when it's
 

documented right in front of you? And thank
 

goodness we have those documents.
 

DR. ZIEMER: Thank you very much. Are there
 

any other members of the public who have comments? 

Okay, we have one lady here and then --

MS. TRUJILLO: My name is Gloria Trujillo
 

and I'm the oldest sister of my dad's family. I
 

don't have very many comments, but you did mention a
 

while ago that the workers were not supposed to talk
 

to their families. I'm the oldest and I was old
 

enough at that time that when my dad did come home
 

after exposure, he would tell my mom. They had to
 

do a complete change of clothing and all these
 

different procedures that they had to do on him, and
 

this was very often. I don't know how much -- how
 

many reports we actually have that have -- prove
 

that. You know, they may not all have been
 

documented. I don't know.
 

I have one question for you on -- 'cause
 

that's not clear in my mind. You have a certain --

I think it's five rems of exposure that you're
 

basing the -- your determinations on, more or less. 

Will you have -- or is there a cumulative effect of
 

nuclear exposure?
 
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DR. NETON: Okay, I think this was alluded
 

to in a previous commenter, the five rem of exposure
 

is the current regulatory limit -- annual regulatory
 

limit for a worker in a Department of Energy. We
 

don't -- that is not what we use to determine a
 

person's dose or their probability of cancer or
 

anything like that. We are totally independent of
 

that and use this model, this -- it's called an IREP
 

model -- to take the person's exposure as we
 

calculate it the best we can, given input from the
 

claimant and the Department of Energy to determine
 

the probability that the cancer was caused by an
 

exposure.
 

The second part of your question is yes,
 

cumulative exposure -- the larger the exposure, the
 

larger the probability the cancer was caused by that
 

exposure.
 

MS. TRUJILLO: I have one more question and
 

it's medical. There are certain types of cancer
 

that are, you know -- that are rare in the whole
 

population. My father had cancer of the esophagus,
 

which is, you know -- are you basing it on the types
 

of cancer? Say someone had lung cancer, someone had
 

cancer of the esophagus, are you taking that into
 

consideration, the type of -- where it's at, the
 
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organ that it's affected?
 

DR. NETON: Yes, absolutely. Not only -- we
 

calculate the dose, the specific organ that
 

developed cancer, and as well use a model that was
 

specifically modeled for that type of cancer, so
 

that is taken into account.
 

MS. TRUJILLO: Thank you for your time.
 

MR. ELLIOTT: And now I think -- Dr. Ziemer
 

had to step out, so I get the mike and Bob Tabor
 

would like to speak.
 

MR. TABOR: For the record, my name's Bob
 

Tabor or Robert G. Tabor. I'm from the Fernald
 

site. I'm a member of the Fernald Atomic Trades and
 

Labor Council, a 22-year veteran of that site. On
 

the issue of credibility, I guess the issue would be
 

-- this in my mind is how do you maintain
 

credibility if the contractor supporting the
 

Advisory Board had DOE and/or NIOSH business? To me
 

this is kind of like the Arthur Andersen syndrome or
 

issue. You know, you can't do both. You can't do
 

both audit and consult work -- so to speak, serve
 

two masters. When you have someone in to support
 

the audit process, they will need to only serve one
 

master in my mind and that is strictly audit. That
 

should be their business. They can't be anybody
 
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that's beyond -- or they can't be -- you know,
 

nobody can ever doubt their integrity is what I'm
 

really saying here. We need to have somebody that's
 

knowledgeable, somebody that's credible, somebody
 

that's recognized to do this business because the
 

credibility of the Advisory Board and credibility of
 

this process is absolutely -- you know, it's very
 

important. And that basically is my comment.
 

DR. ZIEMER: Thank you very much. Any
 

questions for this commenter? Thank you.
 

Shelby, did you have a comment?
 

MR. HALLMARK: I just wanted to say since
 

several individuals spoke about difficulties in
 

filing claims or that there were workers at Los
 

Alamos who have felt pressured not to file, my
 

comments earlier were with respect to people filing
 

with the right program, with the DOL program if you
 

had one of the three conditions that we cover, or
 

with the DOE, their worker assistance program if you
 

have other kind of toxic illness. But I wanted to
 

make clear to you, to everyone and then hopefully
 

you will pass the word along to anyone you know,
 

that it is certainly the Department of Labor's
 

position, and I believe the Department of Energy's
 

position, that anyone who has one of those
 
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conditions ought to be able to feel free to come
 

forward and file that claim without any reprisal and
 

without any other negative impact.
 

Floyd Archuleta, who is the resource center
 

chief here in Espanola, is charged with helping
 

people file claims, both for the Department of Labor
 

program and the Department of Energy program which
 

is now getting started. And insofar as there are
 

individuals out there who have those conditions who
 

have not come forward, they certainly should utilize
 

those services and make use of this program, which
 

was intended for individuals in those two
 

categories. I just wanted to make that clear
 

because I do think it's important that people have
 

that chance.
 

DR. ZIEMER: Thank you. Are there any
 

other --

MR. LADA: Can I ask you a question, please? 

Floyd Archuleta of the --

UNIDENTIFIED: Come to the mike, sir.
 

DR. ZIEMER: Please use the mike so the
 

recorders can record your comments.
 

MR. LADA: Sir, I understand in this nearly
 

1172 cases have been filed and only nine people have
 

been compensated. Nine people.
 
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MR. HALLMARK: Ten.
 

MR. LADA: Ten people out of 1172. That's a
 

very low number, don't you think?
 

MR. HALLMARK: I think it's quite low. I
 

mentioned this in my comments. The reason -- the
 

reason for that is that virtually all the population
 

here at Los Alamos would need to go through -- who
 

would be eligible for the Department of Labor
 

program would need to go through the NIOSH dose
 

reconstruction program, which is what's being
 

discussed here today. That process is just now
 

getting started. Until it's completed for all those
 

individuals who have filed of that 1100 or more, it
 

won't -- 1400, I believe -- it won't -- we won't, at
 

the Department of Labor, be able to complete the
 

work on those cases. So by definition, those cases
 

are still in process.
 

And as I indicated, our office in Denver has
 

had a backlog and we are working to try to reduce
 

that backlog, but the major issue for most of the
 

people here in New Mexico is going to be the NIOSH
 

process and having that process work all the way
 

through.
 

MR. LADA: It'll work if NIOSH does not
 

raise the bar. The bar is 15 R. Is this correct,
 
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NIOSH?
 

DR. ZIEMER: No. In fact, the legislation
 

is not based on a dose number. It's based on
 

whether it's more likely than not that the cancer
 

was caused by radiation, and that actually is a
 

little more complex calculation. It's conceivable
 

that somebody below the dose limit could get
 

compensated.
 

MR. LADA: So if somebody -- if it's 50 R --

or 50, and it's 49.9, is there going to be bias in
 

that?
 

DR. ZIEMER: It's not -- these cases are not
 

decided based on where they are relative to the DOE
 

numbers because the NIOSH folks go back and they add
 

some additional things in. For example, they will
 

add back in if there's dose missing that can't be
 

accounted for, they will add that back in. If there
 

are medical X-rays that were required as part of the
 

work employment that -- and those won't appear on
 

those dose records, those are added back in. So the
 

NIOSH number may be very different from the DOE
 

dose. And the reason for that is the DOE numbers
 

are used to simply control the workplace on an
 

administrative level. These numbers are used in a
 

specific way to compensate people based on the law,
 
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where -- so in fact, you simply don't take the DOE
 

dose number and say okay, they're 49.9 so they don't
 

make it and 50 does. It doesn't -- that's not how
 

it works, really. Well, let -- Jim's the expert on
 

this here. I'm answering for you, Jim.
 

DR. NETON: I think you've answered the
 

question, really.
 

MR. LADA: Well, you know, 'cause a lot of
 

the guys that I talk to say why go for -- through
 

all this, Jerry, you know. And then there is no
 

compensation. And I tell them look, who's going to
 

take care of your family? The cancer's not going to
 

show up till five, ten, 15, 20 years down the road. 

In fact I just had a friend that just passed away
 

Saturday, Mr. Ernesto Serrano, who was a custodian. 

He had cancer since '91. So I'm encouraging his
 

family, his wife, to file a claim.
 

DR. ZIEMER: And you're quite right in doing
 

that.
 

MR. LADA: Yeah. Thank you.
 

MR. ELLIOTT: Jerry, I would like to one
 

statement you said about NIOSH raising the bar, and
 

I wish you had -- if you weren't here earlier when
 

we went through some examples of dose
 

reconstruction, I would think if you saw those
 
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examples we displayed for the Board today you would
 

see how -- where science takes us and science ends,
 

we start from that point and we're claimant-friendly
 

in every regard that we have. Every step that we
 

take past where science -- the basis of science is
 

used to support the merit of the claim. Anything
 

further -- beyond that, we use a claimant-friendly
 

approach. We're not raising the bar.
 

MR. LADA: Okay.
 

MR. ELLIOTT: The bar, if anything, is being
 

lowered because where science fails us, we become
 

claimant-friendly.
 

MR. LADA: Okay.
 

MR. ELLIOTT: Okay. So I thank you for your
 

comments, as always.
 

MR. LADA: Well, I know that Ted Katz is the
 

one that came up with the numbers. Right?
 

MR. ELLIOTT: Ted Katz?
 

MR. LADA: I know he was part of the --

MR. ELLIOTT: Grady is a health physicist
 

who has done some of the dose reconstructions that
 

were displayed today, yes, but the numbers that
 

you're talking about are dose estimation numbers in
 

the dose reconstruction process -- I assume.
 

MR. LADA: Right. What I was talking about,
 
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Larry, is that I knew for a military G.I. they used
 

to use five R.
 

MR. ELLIOTT: Yeah.
 

MR. LADA: So --

UNIDENTIFIED: Different purpose.
 

DR. ZIEMER: Yeah, the five R or the five
 

rem, which is still used today as a working annual
 

limit for workers for external exposure -- well,
 

external plus internal. But that is not the only
 

piece of information that these folks are using. So
 

as a health physicist, which is my background, I
 

would say this is very worker-friendly.
 

MR. LADA: Well, as long as you take into
 

consideration all the alpha, the beta gamma, the
 

neutrons --

DR. ZIEMER: And they do.
 

MR. LADA: -- the things they did at 55 and
 

the glow box, the glove changes, you know, all these
 

barrels that went down to over at CMR, 40, THE,
 

lance, take a very good close look.
 

DR. ZIEMER: Thank you.
 

DR. NETON: Just one last thing. The dose
 

reconstruction itself is issued in draft form to the
 

claimant to review and comment on. Until the person
 

actually reviews it and signs off that we've
 
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incorporated anything that they brought to bear on
 

the claim or we have explained sufficiently why we
 

didn't use it, then it won't go forward. So it's
 

not that we will do this thing, this dose
 

reconstruction, and then send it directly to
 

Department of Labor without the claimant's input. 

There is that safeguard built into the process.
 

MS. JACQUEZ: (Inaudible)
 

DR. ZIEMER: Sure, you bet.
 

MS. JACQUEZ: (Inaudible)
 

DR. ZIEMER: No, but we may all leave for
 

dinner. Please proceed.
 

MS. JACQUEZ: Can I act as your appetizer
 

then? My dad had readings -- a lot of readings of
 

tritium, plutonium -- and I don't know how to
 

pronounce this, is it americium or --

DR. ZIEMER: Americium.
 

MS. JACQUEZ: Americium?
 

DR. ZIEMER: Right.
 

MS. JACQUEZ: -- among others, but many
 

times he was close to this tritium and I'm to ask
 

you as a scientist, was this used to build atomic
 

bombs or is it...
 

DR. ZIEMER: Tritium -- I guess -- since I
 

don't know any of the secret stuff, I'll just tell
 
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you -- well, it's certainly a well-known fact that
 

what we called the hydrogen bomb -- tritium is
 

hydrogen 3 and the hydrogen bomb, as a component,
 

has tritium in it. If you want details on how to
 

make one of those bombs, you can read the -- yeah, a
 

web site -- no, the novel by -- huh? Well, Howard
 

Moreland, but -- I am having a senior moment on the
 

writer that -- the Hunt for Red October guy --

Clancy. Read Clancy's book, you know. It has more
 

detail than anyone wants to know. Thank you.
 

MS. JACQUEZ: But anyway, those are the --

that's what he --

DR. ZIEMER: Sure.
 

MS. JACQUEZ: -- had high readings in and,
 

to me, that's -- that's -- I mean plutonium?
 

DR. ZIEMER: Hopefully that should show up
 

in his records and --

MS. JACQUEZ: It is. It's written down
 

several times.
 

DR. ZIEMER: Do we have any further comments
 

from the public? Yes, ma'am -- and identify
 

yourself again for the record.
 

MS. ERINS: Good afternoon. My name is
 

Joanie Erins. I'm the waste programs director for
 

Concerned Citizens for Nuclear Safety here in Santa
 
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Fe, New Mexico. And in May of 2002 we commissioned
 

a report by Steve Wing and David Richardson, who are
 

epidemiologists from the University of North
 

Carolina, entitled Occupational Health Studies at
 

Los Alamos National Laboratory, and I would -- I
 

don't know if I have enough copies for everybody,
 

but I thought I would provide this as an example of
 

a review that was done of the occupational health
 

studies at LANL, obviously. But also it talks about
 

the -- most of the people that were studied were the
 

white UC workers, the University of California
 

workers, as opposed to (inaudible) workers, and this
 

may help move this process along further. So thank 

you. 

DR. ZIEMER: Thank you very much. Any 

further comments? Yes? 

MR. ARCHULETA: If I may, I'd just like to
 

take a minute to introduce --

DR. ZIEMER: Please identify your--

MR. ARCHULETA: -- myself.
 

DR. ZIEMER: Oh, you were --

MR. ARCHULETA: Yes, my name is Floyd
 

Archuleta. As Shelby mentioned, I'm the manager at
 

the resource center in Espanola, and we also -- you
 

know, we have three large facilities that we're
 
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responsible to, the Sandia National Laboratories, as
 

well as Los Alamos and also PanTex in Amarillo, and
 

other smaller facilities in New Mexico. And we try
 

to be a true resource to our claimants. We assist
 

them with our staff of caseworkers in taking their
 

claims. But also there's plenty of follow-up work
 

that needs to be done after the claims are followed
 

-- or are filed, and so we're there to be, like I
 

said, a true resource to them. We try to become as
 

involved as we can, even in the NIOSH process. 

We've had requests to serve even as translators or
 

interpreters through the interviews because a lot of
 

our people don't speak Spanish -- or English
 

fluently, and so we -- our caseworkers do. And so
 

again I'd like to make that offer to you.
 

We have an office in Los Alamos at the
 

Laboratory that we're staffing twice a week. Los
 

Alamos has been very cooperative with our office in
 

sharing facilities with us, and so we're taking them
 

up on that and also we're using the facilities at
 

Sandia in Albuquerque to -- again, to make ourselves
 

available to potential claimants there, as well.
 

So again, welcome to New Mexico, and we're
 

there to do -- try to promote the program and make
 

it available to as many workers as can benefit from
 
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it. Thank you.
 

DR. ZIEMER: Thank you very much. Okay --

yes?
 

MR. HAGER: My name is Rob Hager and I'm an
 

attorney and I've litigated -- well, both the Karen
 

Silkwood case and the Harding case in Paducah, and
 

I'm going to be very brief. I'm not going to make
 

an opening argument here. In the Harding case we
 

had an opportunity to put into evidence Steve Wing's
 

study at Oak Ridge, and I heard earlier some talk
 

about using the bomb data for doing dose
 

reconstruction. I strongly urge taking a close look
 

at Steve Wing's work. That's all I have to say.
 

DR. ZIEMER: Thank you very much. Any
 

further comments? If not, we're -- oh, yes, Larry.
 

MR. ELLIOTT: I feel that it's important for
 

everyone's understanding for me to say something
 

about the dose reconstruction contract award and
 

this -- the many things that have been said about
 

conflict of interest here today. I want you to
 

understand that there are two types of conflict of
 

interest that we're dealing with here.
 

One is an apparent, obvious conflict of
 

interest. That would be where someone serving in
 

the position, through their own influence and self-
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motivation, commits an act that influences the
 

outcome adversely. Our goal is to have zero of
 

those. No obvious adverse outcomes due to conflicts
 

of interest.
 

The second type of conflict of interest that
 

you need to understand and be aware of is one called
 

perceived conflict of interest, and that is I think
 

what everyone is talking about here today. And that
 

is where an individual, by former affiliation, has a
 

perception -- gives a perception to the general
 

public that they could -- they could -- commit an
 

act that would be a conflict of interest, just
 

because they have served or they have been involved
 

or they have been affiliated in some shape or form
 

that would allow them to do that.
 

And so I want you to understand what we're
 

trying to do here is to control for no apparent
 

conflicts of interest that are distinct. We're
 

dealing and controlling as best we can with our ORAU
 

team perceptions about conflicts of interest, and I
 

think that's -- the latter is what everybody seems
 

to be talking about and I want you to be aware that
 

there are two here and we're trying very hard to
 

deal with both and we have goals set for both.
 

DR. ZIEMER: It's now time to recess until
 
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tomorrow. Our session tomorrow -- the technical
 

session -- formal session begins actually at 8:30. 

The schedule shows us as convening at 8:00 o'clock. 

That's a time to chat informally, get a cup of
 

coffee and get squared away and ready for the day's
 

activities, which will kick off at 8:30.
 

Let me emphasize, in case it was
 

misunderstood, these are open meetings. No one is
 

excluded. Everyone is free to attend as much as
 

they can stomach of the Board's deliberations --

that wasn't a good word to say, but you understand. 

It's getting that time of day where -- but please do
 

not feel excluded. Everyone is welcome to attend
 

and we do value input from all.
 

So with that, we will recess for the day. 

Thank you very much.
 

(Meeting adjourned 5:15 p.m.)
 
 

 

 

 

277 

 

1 C E R T I F I C A T E 

2 

3 STATE OF GEORGIA : 

4 : 

5 COUNTY OF FULTON : 

6 

7 I, Steven Ray Green, Certified Merit Court 

8 Reporter, do hereby certify that I reported the 

9 above and foregoing on the 15th day of October, 

10 2002; and it is a true and accurate transcript of 

11 the proceedings captioned herein. 

12 I further certify that I am neither kin nor 

13 counsel to any of the parties herein, nor have any 

14 interest in the cause named herein. 

15 WITNESS my hand and official seal this the 

16 17th day of November, 2002. 

17 

18 

19 

20 ___________________________ 

21 STEVEN RAY GREEN, 

22 CERTIFIED MERIT COURT REPORTER 

23 CERTIFICATE NUMBER: A-2102 

24 

25