Subcommittee for 

Dose Reconstruction Reviews

Meeting of the Advisory Board on Radiation and Worker Health

December 9, 2021

David Kotelchuck, Ph.D., M.P.H. (Chairperson); Josie Beach; 

Bradley P. Clawson; James E. Lockey, M.D., M.S.; 

David B. Richardson, Ph.D.; Loretta R. Valerio
Subcommittee Meetings

• Despite setbacks and delays since the onset of the COVID 

pandemic (March 2020) and later the Cybersecurity 

Modernization Initiative (May 2021), this Subcommittee has 

continued to hold at least two regular meetings per year 

since 2018.

• During 2021, the Subcommittee met on February 25 and 

September 29.

• The first meeting of 2022 will be January 19.

2
Blind Case Reviews

• With the onset of the Cybersecurity Modernization Initiative 

in May 2021, SC&A paused blind reviews until access to DR 

Tools is available again.

• The last group of blind case reviews the Subcommittee 

completed was at our February 25, 2021, meeting (Set 28), 

for a total of 44 blind case reviews since these were first 

initiated before our 2019 Report to the Secretary.

• Members will recall the next three slides, presented at the 

April 14, 2021, Advisory Board meeting.

3
Profile of Facilities for Which 

These 44 Blind Cases Were Reviewed 

Number of Blind Cases 

Reviewed for Facility

Facilities

7 Oak Ridge Y-12, Hanford

6 Rocky Flats

4 FMPC, SRS

3 Oak Ridge X-10, NTS, LANL

2 PNNL, Grand Junction, LLNL, Sandia, 

West Valley, Oak Ridge K25

1 14 others

4
Years Employed Among 44 Blind Cases

Years Employed Number (Percent)

Less than 10 years 8 (18%)

10–19.9 11 (25%)

20–29 10 (23%)

30–39.9 11 (25%)

40–49.9 4 (9%)

Total 44 (100%)

5
Gender of the 44 Blind Cases

• Of 44 blind cases reviewed,

• 11 cases (25%) were female.

• 33 cases (75%) were male.

• As of our last Secretary’s Report in 2019, 13.4% of claims 

involved a female energy employee.

6
Chronology of Our Blind Case Reviews

• Our previous Board Report to the Secretary of DHHS 

(12/2019) included an analysis of the first 32 blind cases 

reviewed and approved by the Subcommittee. These 32 

cases were drawn from the original contract, Set 17, Set 20, 

and Sets 22–24. 

• The next slides are the results for the next 12 blind cases: 

B33–B38 (Set 26) and B39–B44 (Set 28), completed by 

2/25/2021, followed by an analysis of the results for all 

44 cases, which had not been completed by the 4/14/2021 

Board meeting.

7
Set 26 Blind Cases

Blind Case No. POC by SC&A POC by NIOSH/ORAU

B33 50.16% 51.35%

B34 49.43% 50.06%

B35 50.35% 48.65%

B36 45.67% 48.45%

B37 42.31% 46.46%

B38 47.95% 48.44%

8
Set 28 Blind Cases

Blind Case No. POC by SC&A POC by NIOSH/ORAU

B39 50.45% 50.34%

B40 51.32% 51.34%

B41 49.07% 48.81%

B42 49.34% 47.87%

B43 38.33% 49.40%

B44 30.26% 48.25%

9
Selection Criteria for the First 44 Blind Cases

• The selection criteria for the earliest 14 choices of cases for 

blind reviews included best estimate cases with NIOSH POCs 

between 41 and 52 percent. Within these choices, significant 

attention was paid to assuring a broad representation of 

types of covered facilities (Slide 4).

• Starting with cases from Sets 22 on (30 blind cases), these 

selection criteria were tightened to best estimate cases 

between 45 and 52 percent.

10
Number of Blind Cases for which 

Compensation Decisions Differed

• For the 32 blind cases reported to the Secretary in 2019, only 

one, reviewed and approved by the Subcommittee, had a 

different compensation decision.

• With tightened selection criteria for the 12 cases in Sets 26 

and 28 (Slides 8 & 9), two more reviewed cases had different 

compensation decisions: B34 (NIOSH POC = 50.06%; SC&A 

POC = 49.43%) and B35 (NIOSH POC = 48.65%; 

SC&A POC = 50.35%).

11
Precision of Dose Reconstructions 

Based on Review of 44 Blind Cases

• Both of these cases in Set 26 had a NIOSH POC less than 

1.5% from the compensation determinant percentage of 

POC = 50.0%.

• Thus, out of a total of 44 blind cases reviewed and approved 

by the Subcommittee, a total of three cases (6.8%) had 

different compensation decisions.

• This establishes and confirms a solid basis of confidence in 

the precision of the instructions and established protocols 

for dose reconstruction, based on this group of 44 blind 

cases reviewed.

12
An Issue Related to Blind Case B44

• The calculated DRs by NIOSH and SC&A differed greatly. In seeking to understand this difference, the Subcommittee learned that after NIOSH 

received follow-up information from DOL on the dates when the claimed cancers were discovered, the DRs for the reported cancers with their 

corrected dates were accidentally run by NIOSH in addition to those initially reported – that is, the numbers of cancers used in the NIOSH DR were twice 

as many as those for SC&A’s. NIOSH’s internal procedures have since been 

changed to prevent such an error in the future. Since the compensation decisions were the same for both DRs, and would be so even after the NIOSH 

correction, the Subcommittee closed the review. 

• However, Subcommittee members are concerned that there should be a note 

in our records that the NIOSH POC here is elevated but was processed 

properly for blind review purposes. Grady Calhoun has agreed to suggest an 

appropriate site for placement of this note. 

13
Questions?

14