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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

CENTERS FOR DISEASE CONTROL

NATIONAL INSTITUTE FOR OCCUPATIONAL

SAFETY AND HEALTH 

+ + + + +

ADVISORY BOARD ON RADIATION AND

WORKER HEALTH

+ + + + +

WORK GROUP ON SCIENTIFIC ISSUES

+ + + + +

FRIDAY

JANUARY 19, 2018

+ + + + +

The Work Group convened via 

teleconference, at 3:00 p.m. Eastern Time, David 

B. Richardson, Chair, presiding.

PRESENT:

DAVID B. RICHARDSON, Chair

R. WILLIAM FIELD, Member

JAMES E. LOCKEY, Member

WANDA I. MUNN, Member

GENEVIEVE S. ROESSLER, Member

PAUL L. ZIEMER, Member
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ALSO PRESENT:

TED KATZ, Designated Federal Official

STU HINNEFELD, DCAS

LARA HUGHES, DCAS

JOHN MAURO, SC&A

JIM NETON, DCAS

DANIEL STANCESCU, DCAS

TIM TAULBEE, DCAS
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Table of Contents

Welcome and Roll Call............................. 4

Work Group Discussion:............................ 5

Organize a review of "Dose and Dose-Rate.......... 5

Effectiveness Factors for Low-LET................. 5

Radiation for Application to NIOSH-IREP".......... 5

by Trabalka et al. (Oak Ridge Center for.......... 5

Risk Analysis Inc.)............................... 5

Adjourn.......................................... 78
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P-R-O-C-E-E-D-I-N-G-S 

(3:00 p.m.)

Welcome and Roll Call 

MR. KATZ: This is the Advisory Board 

on Radiation and Worker Health, the Scientific 

Issues Work Group. And today we are dealing with 

some scientific work that's recently been 

completed and published.

And we have the full report as well as 

-- I'm not sure, but I think just full report is 

posted on the NIOSH website, along with today's 

agenda, which doesn't tell you more than we're 

dealing with that report, really.

And the Members should also have a 

draft, a general summary of that. And so that 

takes care of it. And these things, on the NIOSH 

website, if you look at the NIOSH website, this 

is located in the Board's portion of the website 

under schedule of meetings, today's date. And so 

you can download that document.

All right, let's do roll call. We 
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have no issues with conflict of interest, you 

don't have to address that.

(Roll call.)

MR. KATZ: Okay, then, without further 

ado, everyone now knows the protocol about phones 

and meetings and so on. So, David, it's your 

meeting.

Work Group Discussion: 

Organize a review of "Dose and Dose-Rate 

Effectiveness Factors for Low-LET 

Radiation for Application to NIOSH-IREP" 

by Trabalka et al. (Oak Ridge Center for 

Risk Analysis Inc.) 

CHAIR RICHARDSON: Thank you. So this 

is the topic: dose and dose rate effectiveness 

factors. First let me check, can people hear me 

okay?

MEMBER MUNN: Sounds good.

CHAIR RICHARDSON: So this is a topic 

that's been on the table since 2012, I think, or 

2011. To remind you, we had meetings and a 
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briefing by the contractor back in 201 where we 

had an initial draft of the report.

What was discussed was what's called 

DDREF, which is, it's an adjustment factor. And 

unlike many of the other factors that are in use 

by the IREP program for calculating Probability 

of Causation, this is one that you divide by, as 

opposed to multiply by.

So there's an estimate of the risk 

based on analyses of the Life Span Study. And 

the DDREF is a divisor that you run through that 

based on hypothesized reduction of risk per unit 

dose for lower doses, or exposures that are 

received at lower dose rates. It's not applied 

for leukemia, but it is applied for other types 

of cancer.

And the topic for discussion in this 

report is dose and dose rate effectiveness 

factors for low-LET radiation. So we're not 

talking about dose rate effects that might be 

considered for alpha radiation exposure or 
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neutrons.

Currently, what's done, there are a 

range of values that have been used. I believe 

currently there's site-specific dose and dose 

rate effectiveness factors. And we'd been given 

a report, which has now been finalized by NIOSH 

and has had external review as well, discussing 

proposed new distribution values.

So, not a single value for the DDREF, 

but a probability distribution that would be used 

for all cancers other than leukemia. And as I 

understand it -- well, a couple issues.

One is Wanda noted prior to the start 

of the meeting that she had some questions that 

she would like to get cleared up before we move 

too far into the conversation. And I think that 

would be appropriate. And then we could briefly 

talk about what our task is.

So, Wanda, do you have some questions 

at the start?

MEMBER MUNN: Oh, yeah, I think they 
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are fairly straight forward, David. And I'm 

really glad that you're the person who is 

handling this. Clearly, your background and 

capability is reflected in papers that are 

referenced by this study itself. And thank you 

for being here.

My questions are fairly simplistic, I 

do believe. It's a matter of my not being 

familiar with analytical methods more than 

anything else. It's a couple of questions that 

I don't know about recent activities in the 

field.

One of them is, I am not clear whether 

-- I understand that, when we talk about DS02 

dosimetry, I think I understand what that 

collection of information does. But I understand 

that in recent years there's been an attempt to 

tighten that information up a little bit with 

older maps and things of that sort to try to place 

where people were.

But I guess my direct question to you 
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is, do we have more than just a reasonable method 

of estimating what the actual doses for these 

people, especially on the fringes? That clearly 

is the best set of data that we have with respect 

to exposures. But the fact that it has the 

additional problematic exposure from neutrons and 

other activating materials that you wouldn't get 

in ordinary exposures kind of complicates it from 

my point of view.

So, I guess my real bottom line 

question is whether you feel that we have better 

information now with respect to the source term 

for the LLS. Or LSS, pardon me.

CHAIR RICHARDSON: Yeah, that's a 

great question. And it impacts partly on this 

evaluation of dose and dose rate effectiveness 

factors because the approach that's taken here, 

and is often taken to estimate a change in the 

effectiveness per unit dose, is to get an 

estimate from the Life Span Study. And then 

compare it to an estimate from another population 
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that's either exposed environmentally, 

medically, or occupationally to lower doses or 

lower dose rates.

So we take a ratio of two values. And 

the validity of that ratio, that quantity, 

depends in part on each of those being well 

estimated, unbiased estimates.

And then from there we can also try 

and get some idea of the uncertainty. But we 

propagate that uncertainty because we have 

uncertainty in the numerator and the denominator 

of those two estimates.

MEMBER MUNN: Yeah, exactly.

CHAIR RICHARDSON: So that's why this 

is not a simple project. And then, further, we've 

got questions about the comparability of 

observations from 1950s Japan to populations in 

the Techa River cohort or nuclear worker cohorts.

Yeah, it's a difficult question. But 

specifically the dosimetry question, the recent 

updates have done a bit to refine information on 
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location by going back to maps. But a lot of 

what's gone in is trying to do improvements on 

modeling shielding through computationally 

intensive modeling.

And there have been attempts to 

validate dose estimates using other estimates of 

-- not of radiation deposition in human tissue, 

but, for example, in roof tiles. 

MEMBER MUNN: Right.

CHAIR RICHARDSON: In the end, 

though, the LLS's have some component which 

relies on self-supported information about 

location that was collected in the 1950s. So, 

anywhere from five to 12 years after the atomic 

bombings. So that's going to be one source of 

uncertainty. It's the accuracy and validity of 

the information that survivors provided.

And from that there's been fairly 

complicated, and I think strong, efforts at 

reconstruction of the radiation field. But it 

requires placing people in the right positions.
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But people on the fringes, if by that, 

you mean the people at good distances from the 

bombs?

MEMBER MUNN: Yes, correct.

CHAIR RICHARDSON: Actually what you 

get to, for a large group of those people, is 

sort of a default assumption that they're in the 

lowest dose groups.

MEMBER MUNN: Yeah.

CHAIR RICHARDSON: So, there was never 

as much information, detailed information about 

location and shielding collected. And it's sort 

of they're providing the reference rates for the 

rates in the lowest dose groups. 

MEMBER MUNN: As I said, at base, it's 

still the accuracy of the base of information. 

And I'm very interested in -- I have not seen 

your paper or any of the INWORKS statistics that 

came out of your work.

But I wanted to comment, I thought it 

was quite appropriate that, even though I'd love 
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to know what the Chelyabinsk findings were, but 

I agree that, as the authors here have said, there 

are too many potential variables to place much 

reliance on that information from that particular 

source.

It is still of interest, I think, to 

this paper to know what the other findings of 

your INWORKS study were that were used in this 

paper. Without going back to the references it's 

impossible to try to identify, in my mind, what 

the more trusted sources of information are that 

are being factored in to what [identifying 

information redacted] et al., did.

CHAIR RICHARDSON: I think that, for 

this program, I agree that there's a kind of 

natural -- there's some relevance, for sure, to 

the studies of the workers of the nuclear 

industry. And INWORKS has got some substantial 

fraction of the U.S. workers from DOE sites. And 

then workers that are at not entirely comparable 

facilities, but fairly similar to facilities in 
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the U.K. and France.

And that becomes the basis using the 

dosimetry records. And some attempts to evaluate 

the dosimetry programs in each of the facilities, 

reconstruct the dosimeters, put them on phantoms 

so that we could do some corrections for 

differences in response to different energies and 

geometries and exposures between the facilities.

And some of that early work on the 

dosimetry has been picked up and used by this 

compensation program as well. And that provides 

one set of risk estimates for this evaluation.

It is a question about whether the 

choices of the other studies, what they chose to 

include or exclude in making this probability 

distribution, I think those are influential 

decisions. I think they provided a rationale, 

but, you know, that's something that we could 

comment on, for sure.

MEMBER MUNN: Most of the time I think 

they did present some kind of rationale, but it 
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wasn't always clear to me, for example, when they 

refer to several of the potential data bodies 

that they had as being not statistically 

significant.

I was surprised that one study 

including the Canadians, they had made the 

statement that they didn't consider that 

particular body of knowledge to be statistically 

significant. And I do not know what that means 

in this context. Does that have any relationship 

with what the words "statistically significant" 

mean in the popular context? Or is that something 

else, that the judgement was made that the 

results were not going to be bearing on this? Or 

was it that the cohort was so small that it could 

not be used to influence the larger body of 

information?

Can you clarify for me what, in this 

paper, the words "not statistically significant" 

meant in choosing the representative information 

they were going to use?
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CHAIR RICHARDSON: I'm not -- maybe if 

you point me to a page, I could go back and look 

at that. I think most of the exclusions were not 

based on the significance of the point estimates, 

but rather concerned about data quality with some 

of the other recent studies which they looked at.

DR. NETON: David, this is Jim. I 

think he was talking about some of the earlier 

INWORKS results that came out, where the experts 

felt excess relative risk received was just not 

statistically significant. It was just a simple 

parroting of what the results of the study were.

CHAIR RICHARDSON: From the 15 

countries study?

DR. NETON: Yes.

CHAIR RICHARDSON: Okay.

DR. NETON: Some of the earlier 

results I remember were just not finding much. I 

think that's what they were talking about when 

they made that reference.

MEMBER MUNN: Yeah, and that's my 
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concern, whether it was because of the size of 

the population or it was another one of those 

things that happens in modeling when the 

researcher just simply determines that's not 

pertinent to what --

DR. NETON: Well, I think the 

researchers in those studies made those 

conclusions. They're just parroting what was 

stated in the findings.

CHAIR RICHARDSON: And I think, well, 

what they ended up doing in terms of 

implementation here is that study, the vast 

majority of the information from that study, was 

encompassed in the newer INWORKS study, which is 

an update of the oldest, mostly from the cohorts 

from the earlier analysis. So it's updated with 

the follow-up for the U.S., the U.K., the French 

cohorts. And they're going to rely on these 

updated data.

There are slight differences between 

that and the earlier 15 countries study. But the 
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cohorts that were not included were all cohorts 

which didn't provide much information previously. 

Lithuania. There were lots of other countries 

which had contributed that were older parts of 

the nuclear industry which had long term followup where you could study mortality.

MEMBER MUNN: I think when I first 

encountered the question, you asked for a page 

reference. On Page 14, the paragraph starts at 

"Exclusion from our analysis are all results from 

the 15 countries study of radiation workers by 

Cardis in 2007 was based mainly on two 

considerations. We judged the entire Canadian 

cohort should be excluded from the 15 countries 

study because of concerns about the reliability 

of estimated doses to the Atomic Energy of Canada 

limited workers who were monitored during the 

early period" -- they mean '64, I guess -- "and 

the significant impact of unusually high risk 

dose workers results from the 15 countries study. 

We excluded results from a 14 country study from 
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our analysis because the estimated risk was not 

statistically significant."

And, you know, I can understand 

eliminating some of that early information, but 

it surprised me that Canadian information later 

than 1964 somehow got excluded, if I'm reading 

this correctly.

CHAIR RICHARDSON: Yeah, it's because 

the Canadians themselves have expressed their 

concerns about the data. And so until they feel 

like they've understood what the issues of data 

quality are, for the purposes of combined 

analysis, the Canadians did not want to continue 

to include their data.

So, there has to be a representative 

from the country who would speak for the validity 

and ownership of the data. And currently in 

Canada there isn't one.

So, they had initially reported their 

results. The magnitude of the associations in 

the Canadian cohort were larger than in the other 
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cohorts. They felt like it was due to an issue 

of -- some problem with the recording of 

information in the dosimetry system.

So, they've gone back and done 

auditing on that. They've identified some 

issues, but they don't have a clear -- at least 

I've not seen a clear sort of explanation of what 

all those issues are yet. So they're currently 

withholding their information from these combined 

analyses.

MEMBER MUNN: I'm sorry to be asking 

these kind of questions, but my naturally 

questioning nature has a tendency to make me 

think why are these fairly large bodies of 

information not being used. It is partially 

because the result is not one that these authors 

particularly adhered to?

But this is the case also with respect 

to the colon data that was referenced in several 

-- obviously, some great emphasis was placed upon 

those particular studies. And it's not clear, at 
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least it wasn't clear to me from the text, what 

criteria made the choice of colon so obvious as 

the organ, target organ, for this report here 

that we're looking at. Do you have information 

on that?

CHAIR RICHARDSON: That's been a --

for estimates of doses to different target 

organs.

MEMBER MUNN: Yes.

CHAIR RICHARDSON: Is what you're 

referring to. And their use here for the analysis 

to solid cancers is to use the colon. They've 

taken the estimate of uncertain deep dose. So, 

estimates for many of the specific, to most of 

the tissues, there would be a good deal of 

correlation. You know, there's slight 

adjustments for estimates of the photons getting 

to different organs.

But the convention in the Life Span 

Study, when they're doing all solid cancers, or 

even all cancer analysis, is to take the colon as 
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a representative of what a deep dose would be.

And that's, more recently, with the 

nuclear workers studies, is where there's been an 

attempt to adjust the film badge reading to get 

an estimate of organ-specific doses as well.

They've followed that, in part, for 

comparability. I mean, partly for the logic of 

the argument that was made. But also to compare 

an estimate that was reported in one of the 

official all-year publications about, say, 

estimated dose.

You had to take some metric of the 

dose. So the coefficient reported was estimated 

dose to the colon in solid cancers. But we could 

get a comparable estimate in the worker 

population by making a slight correction to the 

film badge reading to get an estimate of what the 

deep dose would be just to the colon. And compare 

those.

So, it's partly that the literature 

now has some coefficients based on that metric 
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that allow you to compare, so that you could take 

the ratio from the numbers on the same scale.

MEMBER MUNN: So, it's partially a 

determination out of the RERF and similar 

references.

CHAIR RICHARDSON: Right. So, they 

weren't wearing badges. So, you know, their 

dosimetry system now reconstructs doses to a 

relatively short list of target organs. And 

that's the one they're taking.

But if you look within those, if you 

do like a correlation coefficient estimate of a 

dose to the liver versus a colon versus various 

organs you'll find it's not so different. Or the 

lung, being an important one.

MEMBER MUNN: Okay. I guess my last 

question is one of terminology. Again, as the 

statistically significant terminology was, I am 

not clear in my mind exactly what was referred to 

-- some of the tables refer to piecewise 

distribution versus discrete distribution. And 
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that's not clear to me. What is the difference 

in a piecewise distribution versus a discrete 

distribution? I'm just not familiar with the 

terms.

CHAIR RICHARDSON: Hello?

MEMBER MUNN: I'm here.

CHAIR RICHARDSON: Oh, I'm sorry. I 

was on --

MEMBER MUNN: Oh, were you talking 

away to some other air?

CHAIR RICHARDSON: Yes, I was.

MEMBER MUNN: I'm sorry about that.

CHAIR RICHARDSON: So, I think the key 

point in linear distribution -- in the footnotes 

example on Table 1. Where it's got a value, if 

you imagine a triangle with the peak of the 

triangle at 2. And the two bases of the triangle 

being at point 2 and 5. You could describe that 

distribution by two lines. One going from point 

2 to 2. And then a second line segment going 

from 2 to 5.
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MEMBER MUNN: Yes.

CHAIR RICHARDSON: So one's sloping 

up, and one's sloping down. I think that's what 

they're referring to. The footnotes see, so 

Footnote B in Table 1 is a uniform distribution. 

It's just flat with equal probability in the 

range 1 to 2. Footnote C is referring to a 

triangle that could be described by two lines 

with a joined point at 2.

And then the other one is like a 

histogram. I think discrete values at 1.5 and at 

2. Footnote E and F, I don't know if they have 

pictures of these distribution -- I don't think 

they do here. But if you imagine a histogram 

with its series of bars, when you say it's 20 

percent probability, it's 1.5. It's 25 percent 

probability, it's 2, and so on.

MEMBER MUNN: Okay. I can't see the 

figures but I can see the --

CHAIR RICHARDSON: You can imagine 

that.
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MEMBER MUNN: Yes, I can imagine that.

CHAIR RICHARDSON: There's basically 

like integrating up to 100 percent.

MEMBER MUNN: Right.

CHAIR RICHARDSON: Under a box, like 

a uniform distribution, under a triangle, or a 

series of histograms. But it always has to add 

up to the total.

MEMBER MUNN: Okay. I got it. And 

one last question and then I'll shut up. My last 

question is I'm never certain when I see the word 

kerma being used. Whether that description of 

kerma is the same for the user as it is for me 

and, because I always wonder why it's used. To 

me that's just a Gray. And is that incorrect?

(Simultaneous speaking.)

MEMBER MUNN: Should determine free in 

air.

CHAIR RICHARDSON: Yes, I mean it's 

the energy in air, but it's not all -- is that a 

gray? I --
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MEMBER MUNN: I thought it was the 

same as the SI unit. But, it's just an energy 

measurement, right?

CHAIR RICHARDSON: Yes. But now it 

doesn't have a volume does it, that it's 

deposited in? It's sort of an idea of the 

potential in the air. So -- I'd, yes, I'll defer 

to you, Wanda.

MR. HINNEFELD: Jim, this is Stu. Can 

I get a shot at this now?

DR. NETON: Yes, well kerma is an 

approximation. It's initial kinetic energy with 

charged particles that are released. And, you 

know, depending on whether or not those particles 

deposit all their energy in the volume under 

consideration or not, kerma is a pretty good 

approximation for the dose to an area. But I 

don't know exactly what usage there is in this 

document.

MEMBER MUNN: I think he's referred to 

kerma a couple of times in some of the footnotes.
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CHAIR RICHARDSON: Yes.

MEMBER MUNN: When I was trying to 

read you the footnotes to understand what the 

table said. But, okay, I just -- free in air, 

means there's no real target there. The energy's 

out there, free in air. Okay. I'll just accept 

that because I'm not at all sure it clarifies the 

table anymore for me or not. But it was a 

question that I puzzled over at the time I 

encountered it.

Now, I'm going to shut up and let 

people who know what they're doing with 

statistics talk about the paper.

CHAIR RICHARDSON: So, I had what I 

was imagining as a discussion, is we could have 

some open discussion about, you know, what's 

covered or not covered in the report.

I thought it would be useful to go 

back once again and consider whether there are 

implementation issues as you go from kind of our 

experience thinking about the types of 
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information we have for various types of claims. 

And how that gets implemented here.

This is sort of on the backhand side 

of what IREP's going to do. But I think some of 

the nuances are important to think about.

One of the major changes I think, from 

what was in the past relates to going from DREFs 

where there was some variation by types of 

cancers, to a kind of single distribution. And 

that might be worth us reflecting on. And --

MEMBER MUNN: I hope there's also some 

discussion about what I believe to be the 

conclusion of the paper. If I'm reading this, 

the conclusion is that there really isn't more 

than a ten percent difference in the risk at low 

dose rates, which I don't see clearly identified 

either in the papers what constitutes low dose. 

Everybody has a different idea about that I 

think.

And but that there's no more than a 

ten percent difference between the risk at low 
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dose as there is the high dose. And I'm, given 

the information that I've seen in other places, 

not sure I can buy that. So, I hope there's some 

discussion about that.

DR. NETON: Well, Wanda, this is Jim. 

There is the appendix in the Health Physics paper 

that has a discussion on what's considered to be 

low dose and a low dose rate. There's actually 

two factors considered in this paper.

There's the LDEF, they call it the low 

dose effectiveness factor, and then the dose rate 

effectiveness factor, DREF.

MEMBER MUNN: Yes. I saw that.

DR. NETON: Ultimately, they combine 

the two under one distribution. But a lot of 

that early discussion you had on the epi study 

was just one part of that analysis. That was for 

the dose rate effectiveness factor.

Well, low dose effectiveness factor 

was actually just looking at the non-linearity of 

the Hiroshima, the Life Span Study data. And 
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trying to come up with some estimates of low dose 

effectiveness factors based on just the Hiroshima 

data.

MEMBER MUNN: Yes, the final table, 

well not the final table, the final figure, I 

guess --

DR. NETON: Yes.

MEMBER MUNN: -- was very interesting 

to look at. What seems to be the conclusions, 

the outcome of the various studies that were 

listed. But the census risk studies were I think 

the most interesting of all from my point of view.

And one of the reasons that they were 

is they really seemed to identify what, at one, 

they seemed to identify where we are in terms of 

the various studies that try to look at 

everything.

And I note BEIR VII routinely stops at 

one. And I noted this report has potential all 

the way into below one, which is another issue in 

my personal attempts to try to understand exactly 
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what, not only DD is but also what the low dose 

effectiveness factor figures into it.

And I just, it's very difficult to try 

to identify in just simple numerals what that 

means. But this figure I think tells the whole 

story of what this very well annotated paper 

talks about. And I, you know, the assumptions 

that, even the time exposures that were 

considered, is I think fascinating.

And I don't know that I still feel 

that there's been any definition that I can hang 

my hat on. And say, okay, so exactly what are we 

going to use? There's a single chronic exposure, 

or sequence of acute exposures in five hours?

Based on what I know of recent cell 

studies, seems to be fairly reasonable but 

there's range in there of, in the non-homologous 

and joining that takes place in the secondary 

phase. Several hours, I don't know what several 

hours means.

And it's -- I guess what I'm trying to 
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say it's very hard to get a grip on which 

direction to expend your energies here. When the 

number of different aspects of really significant 

unknown is -- well, I don't have to tell you. 

You guys work with it all the time.

But it's hard still to accept the 

conclusion that there's no more of a difference 

given this type of approach than ten percent. 

That just does not seem, the concept is difficult 

given the information that's been available the 

last ten, twelve years, I guess.

DR. NETON: Yes, Wanda this is Jim. 

I'm not sure that ten percent, I really 

understand myself when they did this harmonic 

mean. I really have trouble getting my head 

around that.

The distribution that they've

developed or are recommending has a geometric 

mean of 1.3 which would be applied with a --

depends on whether you use discrete distribution 

or model it as a log normal, but have a GSD of 
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something like 1.8.

In reality that is going to be applied 

in our situation, to almost every case I can think 

of. Because it starts, DDREF starts being phased 

in at under 20 rem currently. And that's what 

they're recommending we stay with all the way 

down to 1 rem. Most of our exposures for workers 

in this program are well below the threshold 

where DDREF would kick in.

MEMBER MUNN: Yes.

DR. NETON: So, it is going to affect 

almost every case I can think of, and that has 

been analyzed to date, if we change this value.

DR. MAURO: Ted, this is John Mauro. 

Is it okay if I jump in a little bit too? I've 

been listening and I'm very interested in the 

subject. So, I just want to let you know I'm on 

the line. And if it's okay, I do have a question, 

observation, question. Just wanted to know at 

the appropriate time is it okay for me to join 

in? Or is it something I should just listen into?
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MR. KATZ: David's running the show. 

So, I think David is probably welcoming all 

comments.

DR. MAURO: Okay, well thank you. 

Well I'll make it with this one really quick. It 

relates to what you were just talking about. When 

I read that and the simplest -- and by the way, 

my takeaway of this is -- it's an undertaking.

The folks the people that are 

knowledgeable at a granular level are a very 

limited number in my mind. It's a very, I mean 

I've been in health physics certified for, I 

don't know, 40 years. And, you know, I read about 

this. I'm just going to give a little 

perspective, and there are different levels on 

which you could start to discuss this.

There's the level of granularity that 

unless you've lived with the Life Span Study and 

all of these epidemiological studies, and also 

these biochemical genetic studies, your whole 

life. You know, you really can't get into the 
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granularity of this and to say, you know, where 

there might be some problems or not.

So, my takeaway from this is that it's 

going to be hard for anyone unless they've lived 

with this their whole life to really get into the 

judgements that were made, what populations that 

were considered, epi work was considered or not.

So, I can't operate at that level, but 

I can operate at what I should say a more 

simplistic perspective of, what's really happened 

here? So and I think what you were just talking 

about, I did have one question is, one conclusion 

is that the DDREF that is being recommended has 

a range that goes from .047 to 3.6 with I guess, 

a 50th percentile median of 1.3.

And they do indicate when do you 

trigger this distribution? That you just 

answered my first question. Sounds like it's 

triggered when the doses are below, I guess the 

acute, the total dose is below 10 rem? I'm not 

sure. That was see, I was just trying to get a 
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practical sense. So there is a big range. It's 

.047 to 3.6. So it's not a --

DR. NETON: It's .47 John.

DR. MAURO: .0. Oh, it's .47?

DR. NETON: Yes, that's what I'm 

looking at.

DR. MAURO: Okay. You know, I took 

some notes and I obviously made a typo. Okay, so 

it's from .47 to 3.6. The spread is therefore 

about a factor of ten from top to bottom, with a 

geometric median of 1.3. Is that a log normal 

distribution that we're operating off? Or is I 

guess --

DR. NETON: Yes. They took the data 

and set it to a log normal distribution. I think 

that's in Figure 1 of the --

(Simultaneous speaking.)

DR. NETON: -- paper.

DR. MAURO: Okay.

DR. NETON: It's not clear to me 

whether they recommend using that fit or to do 
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the histogram method based on the one that 

generated that distribution. But either way 

that's essentially what would happen.

DR. MAURO: Yes.

DR. NETON: I'm thinking we'd end up 

putting a log normal distribution in. Seemed to 

be the simplest if we did this. If we agreed 

that this was appropriate to do that.

DR. MAURO: How does --

DR. NETON: It's a little different 

than what we're currently doing? If you look at 

IREP now, in the Health Physics Journal is a good 

paper that summarizes all that.

It's a histogram. I mean so many 

percent for, you know, at this value. So many 

percent at another value, and it's different. 

There's a separate histogram for DDREF for breast 

and thyroid versus all other solid cancers.

DR. MAURO: Yes. Represent the 

change. It's a method of change from what we're 

currently doing.
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DR. NETON: That's true. I think that 

the ultimate end point would be that the DDREF, 

it's a simple matter as suggested here would tend 

to raise the PC values for our cases.

DR. MAURO: Okay.

CHAIR RICHARDSON: The histogram that 

you had --

(Simultaneous speaking.)

DR. NETON: Yes.

CHAIR RICHARDSON: The histogram that 

you previously used goes from basically, because 

it's basically 0.5, and you had a small amount of 

weight there. And you, your histogram is 

distributed around the range 0.5 to 5 as well. 

It's going to shift your mass a little bit closer 

to 1, where it used to be centered around 1.8. 

So, it's just closer to, you know, 1. And the 

breast and thyroid were already shifted in that 

way. They were, most of their mass was around 1.

But most of your claims are not, 

breast and thyroid.
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MEMBER ZIEMER: Dave, can I raise some 

process questions? This is Paul.

CHAIR RICHARDSON: Yes.

MEMBER ZIEMER: First of all the 

original paper --

MEMBER MUNN: Did you go somewhere, 

Paul?

MR. KATZ: Yes, we lost Paul, I think.

CHAIR RICHARDSON: Paul, you need to 

go to your cell.

MEMBER MUNN: I hope you're not --

MR. KATZ: I'm sure he'll come back. 

I think he must realize we've --

MEMBER MUNN: He's probably talking 

away.

MR. KATZ: Yes, he's probably hung up 

on himself is what I'm thinking. But --

MEMBER MUNN: Yes, that's my guess.

MR. KATZ: Easy to do.

MEMBER MUNN: I'm glad he's asking 

process questions though, because that's on the 
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top of my mind too. What do we as a Work Group 

do? What are we responsible for?

CHAIR RICHARDSON: Yes, the previous 

product that the Science Issues Group provided to 

the full Board was a very brief memo that Paul 

actually drafted. I think I had gotten overly 

academic and verbose. And he did an excellent 

job of sort of trimming that back down to a few 

take home points.

He's offering some sentences about the 

issues. And I think sort of just offering a 

summarization that went to the Board. And then 

the Board made a decision about what our, Ted you 

can remind me, but basically sort of encouraging 

or discouraging moving forward with the report.

But we're sort of an oversight 

capacity. So we had some discussion about an 

issue, and then drafted a very brief memo about 

what we saw as points or issues.

MS. BEHLING: I looked for some 

transcripts and I couldn't find anything.
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MR. KATZ: That's sounds right. I 

mean this was in relation to CLL, that's you're 

saying, David.

CHAIR RICHARDSON: That's my 

recollection.

MEMBER MUNN: I think so. I mean I 

think this group has only had one meeting before. 

That was years ago.

MR. KATZ: We've had a couple, we've 

had a couple I think. But, yes. But it's been 

a long time it's true.

MEMBER MUNN: Yes, we were all --

MEMBER ZIEMER: Can you hear me now?

MEMBER MUNN: Yes.

MR. KATZ: There you are.

(Laughter)

MEMBER MUNN: Welcome back.

MEMBER ZIEMER: Yes, right. I 

switched phones here. Maybe this will help. What 

I was asking was whether or not we have access to 

the original reviewer's questions, or were their 
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comments already incorporated into the versions 

of the paper that we have?

DR. NETON: Their comments have been 

incorporated in the paper we have. I have both 

their comments and SENES', or Oak Ridge's Center 

for Risk Analysis' response to those comments.

MEMBER ZIEMER: So in your judgement 

whatever issues were raised by that group have 

been taken care of. Is that correct?

DR. NETON: Yes.

MEMBER ZIEMER: Okay, then my next 

question, for the benefit of our Work Group and 

the Board, it seems to me we need some assessment 

of some of these matters. Particularly, you 

know, Wanda raised a number of questions. But 

there's many more like that, particularly for 

those of us who are not heavily into this sort of 

bio-statistics of these things.

I wondered if we can have some review 

done now? As I looked at the main paper, that is 

the extended one, not the summary one. There's 
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a lot of it that is just review of -- for example 

review of the status of LNT models. Just 

reviewing works of others, the radiological 

studies to estimate DDREF.

There's detail on work that's been 

done by others. But there's some sections like 

Section 2 of the big report, Derivation of DDREF, 

which I think would need a detailed review by 

someone who's capable in that area.

Section 5 on the detailed analysis 

that this group did on the studies of others. 

And I think Section 6, which is the detailed 

description of the development of their 

probability distribution method for the DDREF. 

Seems to me we need some independent reviews of 

those.

I found in this paper an awful lot of 

assumptions and judgements that I'm wondering --

and they give some level of justification, but 

there's just an awful lot of judgements and 

assumptions made on how to develop this 
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distribution to give different parts of it.

And it seems to me we would benefit 

from having some independent review of that. I 

don't know if it's something that SC&A could do 

for the Board? Or whether our Chair, David 

Richardson could do that for us?

It might be somewhat awkward since 

he's an author of many of the papers that are 

cited, so I don't know if people would see that 

as unbiased or not?

You know, I like the methods, the 

uncertainty distribution approach. But there's 

just an awful lot of assumptions built in it, on 

the basis that it covers the uncertainties.

MEMBER ROESSLER: Paul, I like what 

you're saying. That was going through my mind 

too. This is Gen. When I got back to the early 

2000, I think it was around 2004, when our

Committee or our Work Group was responsible for 

reviewing the REF, the radiation effectiveness 

factor.
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MEMBER MUNN: Yes.

MEMBER ROESSLER: And at that time, 

and I tried to go back and find more information 

on how we handled that? How was our decision 

made? And one thing I did find is that we had a 

review panel at that time. And I jotted down a 

list of the people who did review that.

Similar in complexity, a different 

concept, and Dr. Richardson was on that panel, 

[identifying information redacted], who I think 

is no longer living if I'm right, [identifying 

information redacted], [identifying information 

redacted], and [identifying information 

redacted] were people we called on then, if I've 

got it right.

And I think we should probably take 

the same approach here as to try to find people, 

maybe as you're suggesting, Paul. It would take 

different people on different sections.

MEMBER ZIEMER: Well, it may be that 

that kind of review has already been done. That's 
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why I asked who reviewed it? Wasn't it Jim Neton 

got, I think, folks to review the document?

Maybe the review's already been done 

and I would, maybe we might be satisfied to -- I 

mean -- looked at these issues, and the 

judgements and the assumptions.

So maybe we would be satisfied in 

knowing what they have done and what their 

comments were, and how they were incorporated? I 

don't know. That's why I asked the question, 

because I --

(Simultaneous speaking)

DR. NETON: Well I'd like to --

MEMBER ROESSLER: Yes.

CHAIR RICHARDSON: I'm sorry, go 

ahead. Well, I think Paul's finished.

DR. NETON: I was going to say that 

we did get six independent subject matter expert 

reviews of the Rev 1, or Rev 0 of the document. 

Now, mind you, that was back in 2012.

The document sat for a while, and I 
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can't exactly remember why it sat for a long time. 

And SENES approached us and said, well, let's 

brush it up a little bit. Because it's 2000, I 

think they started a new in 2013.

MEMBER ZIEMER: Yes, one of the 

authors died, Jim. One of the authors died also, 

right?

DR. NETON: Well, yes. That's what 

happened, right guys. One of the authors passed 

away in the interim and then it sat for a long 

time. And so [identifying information redacted]

picked it up. It sat -- you're right.

But they suggested that when they 

picked it up in 2016 to, there was a few studies 

that came out in the interim that they added to 

the document. So, the original six reviewers did 

not review Rev 1, which they did incorporate 

their comments. But I think that they were 

largely, the same approaches were used between 

Rev 0 and Rev 1. Just updated with some more 

studies.
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So, I could provide the Work Group 

with those reviews. And SENES's response to 

those reviews. And maybe we could start there? 

I mean it's not a small undertaking to go out and 

try to find independent reviewers on a subject 

that's this narrowly focused.

DR. MAURO: Say Jim, this John. I'm 

listening to your concerns. And it's just really 

a coincidence. I recently read NCRP Report 

Commentary No. 24. I don't know if you folks 

are, it just came out I think in 2015, but it's 

right on target.

It's called Health Effects of Low 

Doses of Radiation, Perspectives on Integrating 

Radiation Biology and Epidemiology. And it all 

goes toward DDREF. And when you look inside at 

the authors -- so this is a relatively recent 

NCRP commentary. I read through it, it's 

spectacular. Just as is [identifying information 

redacted] report, you know, a lot of parity 

between the two.
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But what I'm getting at is that this 

work, that went into Commentary 24, is clearly at 

the cutting edge of all of these. Not only the 

epidemiology work which David drew upon and made 

certain judgements, but it also gets heavily into 

bio-indicators and bio-markers.

And I'm looking at all the different 

people that contributed to that. These are all 

really the top tier researchers in this area. 

And coincidentally, I only bring this up, one of 

them is [identifying information redacted]. You 

folks may know [identifying information 

redacted]. I know Jim, you probably know him.

MEMBER ZIEMER: Yes, we know Ray.

DR. MAURO: Yes, there you go, he was 

one of them. And I only bring it up because 

there's really no one at SC&A that operates in 

this domain. 

Except, when I looked at this, Ray, I signed 

him up as an associate for other purposes a while 

back. I just want to let you know that, you know, 
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certainly given that he was an author of this 

commentary. You know, he's available.

I stay in touch with him regularly. 

He is now semi-retired. And I get the sense that, 

you know, he's still very active in health 

physics. And I wanted to bring that up.

I've got one other thing I was hoping 

to throw into the mix here, if appropriate. As 

I said it was just a coincidence I happened to 

read Commentary No. 24.

And one of my takeaways after reading 

[identifying information redacted] report, and 

this Commentary No. 24 is that what's interesting 

is all of the DDREF distribution work that we've 

been talking about, all emerges from epi studies, 

appropriately so.

Where a selection was made on which 

epi studies, human epi studies, would be used and 

given different weights. One of the things that 

comes out of this Commentary 24 is very 

interesting.
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It said that, I think it's time that 

bio-indicators are used to help inform -- it's 

almost a quote -- help inform the construction of 

DDREF distributions.

So, I guess the only technical comment 

I'd like to just throw into the arena is, when 

you're in this process is, it's almost, it's 

coincidental that at this time this commentary 

would say that this in fact is an opportunity. 

This might be the first time. You may or may not 

want to do this.

Is that, is it time to see if you could 

inform these distributions, DDREF distributions, 

by factoring in the vast amount of new material 

that is available to us now regarding bioindicators, which is not related to 

epidemiologies really. It's really related to 

other studies, tissue studies.

I wanted to, that was one of the 

reasons I called in today is that I happened to 

have read this commentary, and I was able to have 
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some opinions that I just wanted to throw into 

the arena.

MEMBER MUNN: Thank you, John. This 

is Wanda. We should also be aware of the fact 

that this bears heavily on the topic that ANS and 

Health Physics joint meeting this coming 

September here in the Tri-Cities. It's going to 

be addressing the issue of the linear nonthreshold theory. And it's current information 

bearing directly on.

So, that request for papers is 

actually out on that. Anybody who is interested 

can find it at lowdosereg.org. And as I said, 

call for papers is out.

So anyone who is interested in being 

a part of that discussion which will hopefully 

bear in some way on this. Since this paper says, 

if LDEF based on analysis overdose ranges differ 

significantly, it's not clear which LDEF should 

be used to modify a dose response based on 

analysis over the full dose range?
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Especially when linear fits over both 

those ranges that are nearly the same. This 

particular meeting will bear specifically on low 

doses only, so.

CHAIR RICHARDSON: So, Paul had some 

suggestions in terms of the large document which 

we have. And a process for us as a committee to 

move forward with this given that we've had it 

for a long time. And the report has evolved 

somewhat over that period.

So, one had to do with some 

independent review. And Stu I believe had 

offered that he could share the responses. I've 

seen the Rev 0 comments on the report. And 

they're substantial as well. They maybe run to 

25 or 30 pages at least.

With kind of a general overview, it's 

comments from six different reviewers. And I 

agree that that would be a useful thing for us to 

take a look at. I agree also with the suggestion 

that -- well for two reasons.
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I don't think I would be -- either 

have the time, or necessarily be the appropriate 

person to offer a review of the work. In part it 

relates to my work. But sort of only tangentially 

drawing on it I would say, given that the goal of 

this report is to derive these distribution 

ratios. But I think that's going to be, for 

anybody that's going to be a really substantial 

undertaking to dig deeper into it.

But it would be, it might useful for 

us to delineate if we're going to be diligent in 

evaluating this. And given the impact that 

changing this distribution potentially could have 

on redoing calculations.

I think it would be useful for us to 

have somebody who can provide us with an 

oversight of that. So that would be my 

suggestion. Maybe that we all take a look at the 

independent reviews as a next step. Then 

consider whether those are sufficient, or whether 

we'd like to try and investigate the possibility 
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of having somebody else, whether it's through 

SC&A or otherwise take a review, take another 

look at this.

I don't know what the possibility of 

NIOSH is to go back and ask some of these 

reviewers to look again, given that the report 

has evolved a bit? That's another, a third 

approach possibly.

MEMBER ZIEMER: David, if it hasn't 

changed very much since Rev 0, I think I would be 

satisfied with the original reviews if we could 

sort of get an understanding of what they looked 

at and how it was resolved.

For example, on some of these 

assumptions I kind of wondered what the 

sensitivity would be to changing the assumption. 

For example if, you know, they would attribute a 

certain percent of the error to one thing and 

certain percent to another.

Did they do a sensitivity analysis and 

see what that would do to the distribution if 
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your assumption changed? But see they may have 

already looked at that. So, that's why I'm 

wondering what those early reviewers, 

[identifying information redacted]did? And maybe 

that would satisfy us if we saw that?

CHAIR RICHARDSON: Yes. You know, 

some of what changed between the revisions in my 

recollection, I think the new report is 

streamlined in a sense. They ended up reviewing 

a lot of radiobiologic literature. And yet in 

the end, these distributions are coming, you 

know, really largely informed on human studies.

Because you have more and more 

assumptions again, when you start to extrapolate 

from experimental evidence on, you know, a whole 

range of changes in plants, or cells, or impacts 

on specific molecules.

MEMBER ZIEMER: Which didn't seem to 

inform the cancer issue at all anyway, right?

CHAIR RICHARDSON: Right. So, it ends 

up that this report, you know, is a little bit 
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more focused on, at least on the epi literature, 

and they've streamlined that. I don't know that, 

yes, in the end that's probably not so big.

My recollection is the original 

distribution, you know, was also very subjective. 

So, that, you know, what's changed is the 

shifting of that distribution. But the basis for 

it was probably not so different than the basis 

for the distribution in this report.

MEMBER ROESSLER: David, this is Gen. 

I'd like to respond to some of this. I think it 

would be good for the Work Group to be able to 

look at the responses of those reviewers who have 

already done this.

But I think in a way, we might end up 

in the same position that those results, in that 

the Work Group really don't have the knowledge 

that they do. It might be a little difficult to 

do that. Although I think we should.

I like John Mauro's suggestion. I 

think we should consider it. Because often in 
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our field we look to NCRP for their studies. And 

I did too. I looked to see what NCRP has done on 

this. And I also found Report 24.

These people who worked on this have 

a lot of knowledge in the field. And they spend 

a lot of time doing exactly what we need. And I 

really like the idea of getting someone like 

[identifying information redacted] or there are 

others who are on that committee, who are 

knowledgeable, up to date on this, to see if we 

could have one or two of them do an independent 

review.

CHAIR RICHARDSON: If we can find 

somebody willing to do that, I think it would be 

useful.

MEMBER ZIEMER: You want to see these 

other reviews first, or do more simultaneous?

MEMBER ROESSLER: To move this along 

it would seem like if it's possible, that we 

should do them simultaneous.

DR. NETON: Well, I would like you 
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guys to maybe look at the reviews first. Because 

you might be surprised at the breadth of the 

reviews. And the subject matter experts, I guess 

I don't know, I guess with the Work Group I can 

release the names. Normally, we sort of redact 

that.

But these were high level people in 

this business that reviewed this document. One 

of them is close to with the NCRP, so to say.

MEMBER ROESSLER: Very closely 

probably.

MEMBER ZIEMER: Well I don't know if 

we need the names necessarily. I mean I would 

trust that you selected the appropriate people. 

I'm more interested in their comments at this 

point. But if --

(Simultaneous speaking)

MEMBER ZIEMER: -- and you may want to 

get the permission from them to release their 

names to the Work Group. But --

DR. NETON: Well, if we don't have to, 
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I think I have a generic version that has all the 

comments and SENES's response to those comments 

without the names.

MEMBER ZIEMER: Well, I wonder what do 

the others in the Work Group think, I mean?

DR. NETON: What I might be able to 

do is provide the names of the reviewers, but 

then not identify whose comments correspond to 

those --

MEMBER ZIEMER: That's fine.

DR. NETON: That would be okay. 

Because then you would know something about the 

pedigree of the reviewers.

MEMBER ZIEMER: Right, that's good.

MEMBER MUNN: Yes, it really doesn't 

matter to me where they came from. As has already 

been said, we certainly trust the judgement in 

selecting these folks. We know that they know 

what they're doing. Otherwise they wouldn't be 

cranking this kind of stuff out.

But I'm particularly interested in a 
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point that Paul brought up. Those of us who have 

ever worked with any kind of models at all know 

how sensitive one item can be in the way we put 

models together, which are, as we all know, also 

by definition, wrong.

But nevertheless if we can identify 

that someone actually has looked at sensitivity 

of these various assumptions, especially with 

respect to the weighting. You know, I have no 

feel for how one goes about weighting these 

things.

So, how one can decide, I'm assuming 

is background knowledge that folks who do this 

sort of thing put more faith in one set of data 

than another. But if that's been looked at, I'd 

certainly like to know it.

MR. KATZ: Wanda, one thing is 

typically modelers do their own sensitivity 

analysis too. I don't know that those were 

available from the original, from the authors. 

But it's a pretty common practice to run your own 
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sensitivity analysis on these kind of matters.

MEMBER MUNN: Yes, but for those of us 

who don't do it, we have no idea how deeply that 

--

MR. KATZ: No, no I'm just saying that 

the authors themselves may have those analyses 

available if you want to know.

MEMBER MUNN: Really like to see them. 

See what they've done. Whether they mention it 

in the comments.

MR. KATZ: Yes.

DR. NETON: And I'm not altogether 

sure, this is Jim, that they didn't discuss it in 

this 400 page tome.

MEMBER ZIEMER: I would have guessed 

they would have, Jim. But I guess we need to 

confirm it.

DR. NETON: I would agree. If you 

just look at the health physics summary paper, 

it's pretty breezy. The treatment of how they 

came up with these values. But I haven't read 
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the 400 page document in a while. But I recall 

that they did some good soul searching about how 

to approach it. And which values would be used, 

that sort of thing.

MEMBER ZIEMER: They certainly explain 

their thinking. But, you know, it's always good 

to have somebody independently either confirm 

that, or also to see how sensitive it is to a 

change in value. And they may have done that, 

but it wasn't clear that they did.

DR. NETON: I agree.

MR. KATZ: And the only other thing I 

just wanted to add just sort of along the lines 

of what, I think you mean, you were saying. Was 

that, I think it would be better for the -- as 

opposed to the parallel approach, it would be 

better to look at the peer reviewer's work first. 

Because I mean, they were well collected.

Now going and then adding, I mean they 

were independent in the first place. I mean NIOSH 

selected them, but they were independent of 
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NIOSH. And going and then finding another couple 

peer reviewers, it's just sort of adding a larger 

peer review. So, you're not necessarily any more 

independent simply because the Board would 

selecting them instead NIOSH.

MEMBER ZIEMER: Yes, that's why I 

thought we should get their comments. They're 

independent both from the authors and from NIOSH. 

So, I think it would be helpful to see them.

MEMBER MUNN: Let's do it and give us 

a month to think about it, to slog through them.

MEMBER ROESSLER: Sounds good to me.

CHAIR RICHARDSON: Yes, I think that 

sounds great. There's certainly, the people who 

provided the comments are engaged with this topic 

and with the literature. I mean they're very 

informed comments.

The only issue I really have is the 

fact the document has changed subsequent to that. 

But in part the changes, they are revisions in 

response to those initial comments. So, that's 
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not necessarily a bad thing.

And we'll get some sense from it. So, 

that sounds good to me as a way forward.

MEMBER ZIEMER: Dave, what happens 

after that? Let's say that we're, after we see 

that it gives us a good level of confidence in 

this document. Is it our job then to make a 

recommendation to the full Board to either go 

with the new model, or to not go with the new 

model, depending on our judgement? Or what 

happens after that? Or Ted, maybe you can tell 

me what happens?

CHAIR RICHARDSON: Yes, my 

recollection is that what we would do would be to 

provide some sort of short memo to the Board, 

basically of the issues. And maybe, yes, now 

don't the Board recommend to NIOSH the support 

for a report? Ted, what's the process?

MR. KATZ: Yes, I mean it's certainly 

within the Board purview to do it. It's within 

the Board's purview to consider any changes that 
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NIOSH makes based on evolving science. And if 

NIOSH proposes a change here, I mean then 

certainly it's the Board's role to make a 

recommendation that it believes that change is 

appropriate, or it has concerns about the change, 

or what have you, whatever you might find, yes. 

MEMBER ROESSLER: I think that's what 

our Work Group did on the REF decision, is the 

Work Group made a recommendation to the Board.

MR. KATZ: And the Board did this on 

CLL too. It concurred that it was appropriate to 

add CLL and so on. So, within changing science, 

when NIOSH decides it wants to make a change, 

it's certainly the Board's role and appropriate 

for it make a recommendation supporting that or 

suggest any changes it believes might be 

appropriate, whatever the case may be.

MEMBER ZIEMER: And as a practical 

matter. Let me ask Jim Neton or Stu, if this new 

model is adopted, are we obligated then to go 

back at every previous denial and recalculate?
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DR. NETON: Yes, this is Jim. We'd 

go back and we may attempt some sort of triage to 

see what the magnitude of the effect is.

MEMBER ZIEMER: Yes, in other words, 

yes.

DR. NETON: You're right. If we did 

that, we'd rerun ever case, it's not just denied.

MEMBER MUNN: Oh, holy cow.

MR. KATZ: You'd rerun every case that 

could possibly be changed, right?

MEMBER ZIEMER: Yes.

DR. NETON: Yes. I have a suggestion 

on one thing that we might want to do, on your 

term here, is that the Board meeting happens to 

be in Oak Ridge this time.

And SENES is based, or Oak Ridge 

Center for Risk Analysis is based out of Oak 

Ridge. And if it would be useful we could arrange 

to have them provide the Board a summary of their 

report if there's interest in that. I just 

thought I'd throw that out there.
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We did this with the radiation 

effectiveness factors. And I thought it was 

pretty helpful for the Board to hear an overview 

of the thought process and how this all came 

about.

MEMBER MUNN: That's a good idea.

CHAIR RICHARDSON: I think that's the 

best idea. I think if we're going to provide the 

Board with a memo. It would be great for them to 

have some context, so.

MEMBER MUNN: Well yes.

DR. NETON: I can't speak that their 

Oak Ridge Center for Risk Analysis is available 

during that time period, but I can certainly ask.

MEMBER MUNN: I don't know about 

Kocher, or Hoffman either one, but I think --

DR. NETON: Yes, I think David 

actually did a pretty good with the radiation 

effectiveness factor discussion. And he is now 

the principal author of this paper with the 

Health Physics Journal publication. 
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MEMBER MUNN: Yes, and --

DR. NETON: And also for us, you know, 

we're talking about independent reviews again. 

And the fact that this was in press in the Health 

Physic Journal, this paper also indicates that 

it's has yet another round of peer review.

MEMBER ZIEMER: Right, separately, 

yes.

DR. NETON: Yes, so I'm just 

questioning how many reviews we need, you know.

MEMBER ZIEMER: Yes, yes.

MEMBER ROESSLER: It's my 

understanding it has not been reviewed yet by --

DR. NETON: Oh, no it's been reviewed. 

It's at the galley proof stage.

MEMBER ROESSLER: Oh, it is. Okay 

that makes a big difference.

MEMBER ZIEMER: Yes.

MEMBER MUNN: It certainly does.

DR. NETON: Yes, this is a revised 

version that responded to all of the review 
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comments they received. And now it's -- I don't 

think they have the galley proofs yet, but it's 

at that stage.

MEMBER ROESSLER: Okay, you're right. 

It's a big thing.

MEMBER MUNN: Very good, yes I would 

like very much if we could get either Kocher or 

Hoffman. I think they're both in the Oak Ridge 

area still, aren't they, I think?

MEMBER ZIEMER: I know Owen is, I 

think Kocher is too, isn't he?

DR. NETON: [identifying information 

redacted] is still there. I just found out 

recently reading the Health Physics Newsletter, 

Owen Hoffman is now President Emeritus of Oak 

Ridge Center for Risk Analysis. He's still 

involved but Iulian Apostoaei is the President 

now.

MEMBER ROESSLER: Yes --

MEMBER ZIEMER: And he's there too, is 

he not in Oak Ridge?
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DR. NETON: Yes, they're all in Oak 

Ridge, all of them, [identifying information 

redacted]

MEMBER ZIEMER: Yes.

MEMBER ROESSLER: I'd like to voice my 

-- sending in [identifying information redacted]

if we can get him. As someone said he's very 

articulate. He did such a good job before. I 

would envision the fact that if he goes back to 

--

DR. NETON: Okay, well if I get a 

positive from you guys, I'll try to arrange that, 

work through Ted.

CHAIR RICHARDSON: So that meeting in 

April?

MR. KATZ: It's April 11th and 12th I 

think.

MEMBER MUNN: Just enough time to look 

at their comments, yes.

MEMBER ZIEMER: You know, let me add 

something else here. I think even if we weren't 
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ready to make a formal recommendation at that 

point. It still might be useful since we are 

down there to let them, you know, as kind of a 

status report, to have such a presentation.

MR. KATZ: Yes, this is Ted. And I 

was actually thinking that you would not be 

making recommendations at that point. This would 

be both useful for your interrogating the issues. 

And as I think David said, nice for sort of 

bringing the rest of the Board along at least in 

the general sense about what's going on.

Since this is going to be sort of a 

reach for some of the other Board Members, that 

you can, you know.

MEMBER ZIEMER: Yes, Ted. So we'll 

have to make sure that the presentation is user 

friendly for the Board.

MR. KATZ: Yes, to the extent it can 

be, right.

MEMBER MUNN: Now [identifying 

information redacted] does that.
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DR. NETON: Yes.

MEMBER MUNN: At the 8th grade level? 

Try it.

MEMBER ROESSLER: Well, to our level.

MR. KATZ: You know, I mean our Board 

Members have been around and are more 

sophisticated --

MEMBER MUNN: Well yes, but it's still 

an intellectual stretch to get around it.

MEMBER ZIEMER: Well, I'm not just 

talking about the other Board Members. I'm 

talking about us on the Work Group.

MEMBER MUNN: Me, talk about me.

MEMBER ZIEMER: I'm talking about me. 

Okay?

MEMBER ROESSLER: Wanda, don't sell 

yourself short.

MEMBER ZIEMER: No, no. I'm but, you 

know everybody thinks everybody else understands 

it and you know, you're the only one that doesn't. 

And it's not true, you know.
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MR. KATZ: I mean certainly we could 

have another Work Group teleconference closer to 

the Board meeting. And sort of check in on each 

other and see how far along we are with 

understanding and considering the issues.

If you want to do that and then you 

can decide at that point.

MEMBER MUNN: I would certainly love to 

get enough information to assure myself that what 

I think is the conclusion here, is not actually 

the conclusion. Because that's a very large pill 

for me to swallow. But, yes, let's do it.

CHAIR RICHARDSON: Great, so NIOSH 

will circulate via Ted, the six reviews on Rev 0 

of the report. And Ted, or somebody from NIOSH 

will ask [identifying information redacted] is he 

would be willing to present a summary to the 

Board. That would be great. And we will have a 

chance to look at those and hope to have a 

discussion maybe in March, after we've looked at 

the materials provided. And at least check in 
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prior to the meeting in Oak Ridge.

MEMBER ROESSLER: Should we pick a 

time now?

MR. KATZ: If your calendars are handy 

and want to now, we can do that. Or I can do 

that closer to the time. Whatever you want.

MEMBER MUNN: I'd prefer you do it 

closer to time, because I don't have any feel 

about how much time it's actually going to take 

to look at these.

MR. KATZ: Well, I mean I'd schedule 

the Work Group for, you know, later in March so 

it would be reasonably close to -- you'll have as 

much time as possible. But we can schedule it 

now or we can schedule it later.

CHAIR RICHARDSON: Do you want to send 

out an email Ted, and maybe we can --

MR. KATZ: Yes, I can do that, that's 

fine. It's easier that way, you can take your 

time on the material on this.

CHAIR RICHARDSON: Okay.
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MR. KATZ: I'll do that.

MEMBER ZIEMER: That sounds good.

CHAIR RICHARDSON: All right. Well, 

that's tremendous progress for how long it's 

taken us to get here.

(Laughter)

MEMBER MUNN: Well, thanks for the 

intellectual exercise, I think.

MR. KATZ: That's great. It keeps you 

young, Wanda.

MEMBER MUNN: Gees. It sure keeps me 

off the streets. And that's beneficial to my 

community. 

MEMBER ZIEMER: If that's what it takes 

to keep us young, I think I'm going grow old here.

(Off the record comment)

MEMBER MUNN: You're absolutely 

correct. So be it. All right, we'll hear from 

you, Ted?

MR. KATZ: Yes, I'll send you out a 

calendar next week, a calendar request.
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MEMBER MUNN: Super.

CHAIR RICHARDSON: That sounds great.

MR. KATZ: And yes, we'll send out the 

documents. And Jim will keep us updated on 

[identifying information redacted]

MEMBER MUNN: Thank you, okay.

MEMBER ZIEMER: Very good.

CHAIR RICHARDSON: Great, thank you.

Have a good weekend.

Adjourn 

MEMBER MUNN: Everybody have a great 

one. Bye, bye.

CHAIR RICHARDSON: Thanks everybody.

(Whereupon, the above-entitled matter 

went off the record at 4:24 p.m.)