THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 

PUBLIC HEALTH SERVICE 

CENTERS FOR DISEASE CONTROL AND PREVENTION 

NATIONAL INSTITUTE FOR OCCUPATIONAL SAFETY AND HEALTH 

convenes the 

THIRTY-THIRD MEETING 

ADVISORY BOARD ON 

RADIATION AND WORKER HEALTH 

VOL. IV 

DAY THREE 

ABRWH BOARD MEETING
 

The verbatim transcript of the 

Meeting of the Advisory Board on Radiation and 

Worker Health held at the Knoxville Marriott, 

Knoxville, Tennessee, on October 19, 2005. 
 

 

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C O N T E N T S 

October 19, 2005 

WELCOME AND OPENING COMMENTS: 8 

DR. PAUL ZIEMER, CHAIR

DR. LEW WADE, EXECUTIVE SECRETARY 

NBS SEC: 9 

NIOSH PRESENTATION, DR. JIM NETON 13 

PETITIONER PRESENTATION, MRS. VIRGINIA BOND 27 

BOARD DISCUSSION AND DECISION 39 

83.14 SEC: 

NIOSH PRESENTATION, MR. STUART HINNEFELD 47 

BOARD DISCUSSION AND DECISION 55 

PUBLIC COMMENT 79 

GIBSON COMMENT 81 

SCIENCE ISSUES, DR. JIM NETON, NIOSH: 92 

CLL ACTIVITIES 93 

LYMPHOMA RISK MODEL 110 

AGE AT TIME OF EXPOSURE 142 

SMOKING RISK ADJUSTMENT 157 

SCIENCE ISSUES (CONTINUATION) 179 

DR. JIM NETON, NIOSH 

BOARD WORKING TIME, DR. PAUL ZIEMER, CHAIR 196 

FUTURE MEETINGS 202 

FUTURE ACTIVITIES 210 

CONFLICT OF INTEREST, HHS REPRESENTATIVE 246
 

APPROVAL OF MINUTES 263 

COURT REPORTER’S CERTIFICATE 280 
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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. 

-- (sic) denotes an incorrect usage or pronunciation 

of a word which is transcribed in its original form as 

reported. 

-- (phonetically) indicates a phonetic spelling of 

the word if no confirmation of the correct spelling is 

available. 

-- "uh-huh" represents an affirmative response, and 

"uh-uh" represents a negative response. 

-- "*" denotes a spelling based on phonetics, 

without reference available. 

-- (inaudible)/ (unintelligible) signifies speaker 

failure, usually failure to use a microphone. 
 

 

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

(By Group, in Alphabetical Order) 

BOARD MEMBERS 

CHAIR 

ZIEMER, Paul L., Ph.D.

Professor Emeritus 

School of Health Sciences 

Purdue University

Lafayette, Indiana 

EXECUTIVE SECRETARY 

WADE, Lewis, Ph.D.

Senior Science Advisor 

National Institute for Occupational Safety and Health

Centers for Disease Control and Prevention 

Washington, DC 

MEMBERSHIP 

ANDERSON, Henry A., M.D.

Chief Medical Officer 

Occupational and Environmental Health

Wisconsin Division of Public Health 

Madison, Wisconsin 

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

Director 

The Vanderbilt Center for Occupational and Environmental

Medicine 

Professor of Medicine 

Nashville, Tennessee 

ESPINOSA, Richard Lee

Sheet Metal Workers Union Local #49 

Johnson Controls 

Los Alamos National Laboratory

Espanola, New Mexico 
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GIBSON, Michael H.

President 

Paper, Allied-Industrial, Chemical, and Energy Union

Local 5-4200 

Miamisburg, Ohio 

GRIFFON, Mark A.

President 

Creative Pollution Solutions, Inc.

Salem, New Hampshire 

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

Director 

New York State Laborers' Health and Safety Trust Fund

Albany, New York 

MUNN, Wanda I.

Senior Nuclear Engineer (Retired)

Richland, Washington 

OWENS, Charles Leon

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 

STAFF/VENDORS 

LASHAWN SHIELDS, Committee Management Specialist, NIOSH

STEVEN RAY GREEN, Certified Merit Court Reporter 
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AUDIENCE PARTICIPANTS 

ADCOCK, DAVID, Y-12

ADKISSON, SUSAN, CLAIMANT

ANDERSON, LYNN, SRS

APOSTOAEI, A. IULIAN, SENES OAK RIDGE INC.

ARTHUR, PEGGY T., ORNL X10

BEATTY, EVERETT RAY, SR., FERNALD ATOMIC COUNCIL

BECKHAM, CLYDE E., K-25

BEHLING, HANS, SC&A

BEHLING, KATHY, SC&A

BOGARD, RHONDA, Y-12

BOND, JOLIN

BOND, VIRGINIA, NBS

BROEHM, JASON, CDC WASHINGTON OFFICE

BRYNESTAD, ASTRIS, Y-12

BUCKNER, MARY S.

CLELAND, REINA

CROWE, BILL, X-10

CROWE, ED, X-10

DANNLS, ROBERT, NIOSH

DEHART, JULIA

DEVANEY, JAMES, Y-12

DUNCAN, ASPASCIA, CLAIMANT SPOUSE

DUNCAN, THOMAS N., BWXT Y12

ELLIOTT, CHARLES C.

ELLIOTT, CONNIE, ENERGY RESERVE CENTER

ELLIOTT, LARRY, NIOSH/OCAS

FITZGERALD, JOSEPH, SC&A

FLOYD, SHERI, CLAIMANT

HALL, HUBERT T.

HALL, JO PAULETTE, LOCKHEED MARTIN

HALL, LAWRENCE R., X-10

HENSHAW, RUSS, NIOSH/OCAS

HINNEFELD, STUART, NIOSH

HOLLIFIELD, JAMES W., BWXT Y-12

HOMOKI-TITUS, LIZ, HHS

HOWELL, EMILY, HHS

HUMPHREYS, IDA, NIOSH

ISHAK, LAURIE, OCAS

JANNEY, PETE

JURKO, MARY LOU 
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KATZ, TED, NIOSH

KERR, ,GEORGE, KERR CONSULTING

KOTSCH, JEFF, DOL

LAWSON, J.H., BWXT-Y12/ATLC

LAYMAN, RANDY D., CLAIMANT

LINCOLN, DEARL

LINDSEY, HAZEL, ORNL

MAKHIJANI, ARJUN, SC&A

MAURO, JOHN, SC&A

MILLER, RELADA, NIOSH

PHELPS, JIM, DOE WATCH

PIERCE, WILLIAM, X10-Y12-K25 K33

PRESLEY, LOUISE S., WIFE OF ROBERT PRESLEY

ROBERTSON-DEMERS, KATHY, SC&A

RYAN, MAXINE, Y-12

SAMPSON, BOB, GAO

SCHAUER, DAVID, NCRP

SIMS, JOHN, IGUA

SMITH, KAREN D., Y-12

SNELLINGS, HOWARD

STRINGFIELD, MATTIE

THOMAS, BRIAN, SENES OAK RIDGE, INC.

TOOHEY, RICHARD, ORAU

WALKER, ED & JOYCE, BSAG

WOODY, RUTH, CLAIMANT

WORMSBY, PATSY E.

WRIGHT, BETTY R., Y-12

ZIEMER, MARILYN 
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P R O C E E D I N G S

 (8:30 a.m.) 

WELCOME AND OPENING COMMENTS 

DR. ZIEMER: Well, good morning, everyone. We come 

to day three of the Knoxville meeting of the 

Advisory Board on Radiation and Worker Health. 

We welcome all who are visiting here. And if 

you haven't already done so, I need to remind 

you to register your attendance in the booklet 

out in the foyer. 

This morning we're going to direct our 

attention to two Special Exposure Cohort 

petitions. 

Before we get underway with those, Mr. Wade 

will -- Dr. Wade will make a couple of 

comments. Lew. 

 DR. WADE: Yeah, just as the mood strikes me, 

I'll speak. I'd like to just pause and reflect 

on what a positive meeting we've had to this 

point, and I think some thanks are in order. 

think there are thanks due to the Board for its 

willingness to put in long hours of not only 

meeting time but preparation. I'd also like to 

thank NIOSH and SC&A for their willingness to 

engage in sometimes very difficult give and 

take on scientific issues. I think the level, 

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though, of professionalism that's been attained 

speaks well to the parties involved. I think 

it also serves the petitioners and the 

claimants very well. So I think there's an 

awful lot to feel good about, and I thank you 

all for that and look forward to today. 

 DR. ZIEMER: Okay. Thank you very much, Lew, 

for those comments. 

NBS SEC: 

As we get underway here we have two -- two SEC 

petitions, one involving what was then the 

National Bureau of Standards, an agency which 

does not exist under that name any longer; and 

then the other one is Linde Ceramics. And I 

think to begin with we'll call on Mr. Elliott 

from NIOSH to kind of kick off the discussion 

here for us and then we'll go directly into the 

petition. 

 MR. ELLIOTT: Thank you, Mr. Chairman. As a 

way of introduction for these two SEC petition 

evaluation reports, let me open with -- one of 

these is labeled as an 8314. Well, they're 

both 8314. In both cases, the National Bureau 

of Standards and the early years at Linde, 

we've identified that we could not do dose 
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reconstruction, and you'll hear that from Dr. 

Neton and Mr. Hinnefeld as they present those 

evaluation reports to you. 

With regard to the National Bureau of 

Standards, there are some deliberations going 

on about this particular site and its listing 

as a covered facility. So those deliberations 

are going on as you take this up in your 

deliberation in this forum. The Department of 

Labor and the Department of Energy are 

currently -- have evaluated whether it should 

be presented as a covered site on the list of 

covered facilities. It was inaccurately listed 

as an AWE, atomic weapons employer, facility. 

And as you can, I think, logically understand, 

it's a -- it was part of the Department of 

Commerce. It was a federal agency. It still 

is a federal agency with a different name, and 

the building that they worked in was a federal 

building. So DOE and DOL are working through 

trying to determine how this site either fits 

in or does not fit in as a covered facility. 

I was notified last week by the Department of 

Labor that this issue existed. The site has 

been listed from the very start as a covered 
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facility as an AWE. There's been an ongoing 

review of the covered facility lists by the 

Department of Energy in conjunction with 

(unintelligible) supporting interpretation and 

input by the Department of Labor for a number 

of sites, like arsenals, that are under review 

to either be de-listed or remain on the list. 

I can't answer any questions more than that. 

Mrs. Virginia Bond is here as the petitioner 

for the National Bureau of Standards, and 

you'll hear her presentation. Mr. Jeff Kotsch 

is here from the Department of Labor and he is 

here willing, I think and hope, to answer any 

questions you might have on the current status. 

There is a process of establishing this covered 

facility list. That is the responsibility of 

the Department of Energy. Department of Labor 

has some -- some interest in that and they also 

have some oversight and some responsibilities, 

as well, as far as the time frame of the 

covered periods. Right now it's my 

understanding there is -- a Federal Register 

notice has to be published by the Department of 

Energy to de-list a site. I understand and 

I've seen -- I understand that DOL has that 
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Federal Register notice draft from DOE and are 

reviewing it and preparing comments on it. 

It's not clear to me -- I do not have an 

understanding of when that will be published -- 

that Federal Register notice will be published 

and when the action -- and what the action will 

be in the end. So I would just encourage you 

to hear out the evaluation report, hear out the 

petitioner, have your deliberation and make 

your decision, and we'll take it from there. 

 DR. ZIEMER: Thank you, Larry, and I -- I think 

what -- then what you're telling us is that the 

status of this site we should in a sense not 

pay attention to in our deliberations. Right 

now it is a listed site and we can proceed on 

that basis to make a determination, that our 

determination probably should not be influenced 

by whether or not we think it will or will not 

remain on the list. Is that correct? 

 MR. ELLIOTT: That is correct. That's my 

understanding. We have no formal notification 

to provide you that this site has been delisted, so we --

 DR. ZIEMER: Right, so (unintelligible) is on 

the list, this is a valid petition -- 
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 MR. ELLIOTT: The advice that we have -- 

 DR. ZIEMER: -- and deserves the same treatment 

(unintelligible) --

 MR. ELLIOTT: The advice that we have is to 

proceed as -- in normal fashion and provide -- 

from your deliberation provide to the Secretary 

your recommendation --

 DR. ZIEMER: Thank you. 

 MR. ELLIOTT: -- and then it will be handled 

from that point on. 

 DR. ZIEMER: And Board members, any questions 

on that part of the issue? 

 (No responses) 

NIOSH PRESENTATION, DR. JIM NETON 

Okay, thank you. Then -- then we will proceed 

with the National Bureau of Standards SEC 

petition, and the NIOSH evaluation will be 

presented by Dr. Neton. 

THE COURT REPORTER: Do we have a handout for 

you? 

DR. NETON: Should be. I believe there are 

handouts available. 

 DR. WADE: I have one I can give you. 

THE COURT REPORTER: Oh, okay. 

DR. NETON: I admit they may have arrived here 
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on Saturday or such, but they are -- they are 

here. 

It's my pleasure to present to you NIOSH's 

evaluation of an SEC petition we received from 

the National Bureau of Standards. The Board 

has seen a number of these petition evaluation 

reports by now, so the format that you'll see 

has become somewhat standard, and you should be 

familiar with the flow of the information as I 

present it. 

 This petition was submitted to NIOSH on behalf 

of a class of employees. It was SEC petition 

number 0034. It was received for evaluation by 

NIOSH on May 9th of this year. The definition 

of the proposed class was all physicists that 

worked at the National Bureau of Standards 

which, as Dr. Ziemer pointed out, is now known 

as the National Institute of Standards and 

Technology -- all physicists who worked in the 

Radioactivity Lab in the East Building, and 

specifically the East Building is located on 

Van Ness Street in Washington, D.C. And the 

proposed covered employment period was from 

1943 through 1952. 

As you know, once a petition meets certain 
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criteria that are defined in our regulation, it 

has to be qualified. A petition, when it comes 

in, has to meet certain qualification 

parameters. And just in general, to remind 

you, those are -- a couple of those key 

parameters are the petitioner must be a member 

of the proposed class or they must -- it must 

be a labor organization representing that class 

or must be -- a person's authorized to speak on 

behalf of that class. And also the proposed 

class definition needs to be provided, and the 

basis for their belief that the records are 

inadequate to estimate dose. 

We looked at all those in the context of this 

petition, and it was qualified by NIOSH on June 

27th of this year. Again, in accordance with 

the flow and the regulations, this is sort of a 

process description of where we ended up, we're 

required to notify the petitioner and publish a 

notice in the Federal Register, which occurred 

on July 14th. 

NIOSH is required then to take that qualified 

petition and evaluate it against the guidelines 

in Part 83.13 and provide a summary report to 

the Advisory Board of our findings. That 
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report was sent to the petitioners on the 14th 

of September, and also provided to the Advisory 

Board on that same date. 

As part of the evaluation process, of course, 

you're all familiar with this so-called twopronged test now. There's two -- two tests 

that need to be passed for a petition to be 

granted. One is, is it feasible to estimate 

the level of radiation dose with sufficient 

accuracy, and that's to individual members of 

the class. And if we can't estimate with 

sufficient accuracy any cancer in that group, 

that says we can't do it with sufficient 

accuracy. And secondly, if that's true, is 

there a reasonable likelihood that the 

radiation dose may have endangered the health 

of the workers. 

Let me talk a little bit about the evaluation 

process, what did NIOSH look at when we were 

trying to determine if we could reconstruct 

dose with sufficient accuracy. We identified 

and reviewed all data sources available to us 

to look to see if we could come up with any 

means of bounding -- that is, put an upper 

limit on the dose received by any of these -- 
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member of this proposed class. And in 

particular we're looking for information such 

as personnel monitoring data, air monitoring 

data, radiation source material. That's 

consistent with our hierarchical approach for 

doing dose reconstructions. That is, we'll 

first preferentially look for personnel data. 

If we believe it to be valid monitoring data, 

we'll assume that that is the best data we have 

to reconstruct dose. But then -- our process 

allows us to look at air monitoring data, area 

monitoring, TLDs; and third, process; and then 

source term -- I mean how much material was 

there. 

So we search for all of those types of pieces 

of information in a number of various 

resources. We looked at the NIOSH dose 

reconstruction database. We looked at the ORAU 

research database. We went to the National 

Institute of Standards and Technology, 

requested information from their library. Not 

shown on this slide is we also went and 

contacted the health physics department that 

currently exists at the National Institute of 

Standards and Technology requesting records. 
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We spoke to the chief health physicist of the 

staff. And the bottom line is we could not 

find any monitoring records for any of these 

sources that would indicate the levels of -- 

potential levels of exposure to these workers. 

I have to qualify that a little bit. I'm 

getting ahead of myself a little bit. There --

there is some decontamination survey 

information I'll speak to later. 

I might say that the dose reconstruction 

database -- normally what we would do is look 

for individuals who have filed a claim, and 

then we have in our possession where we're 

attempting to do dose reconstruction. In this 

particular instance we only have one claim that 

fits this class definition. We've looked 

through the data in that claim, and again we 

could find no information that was informative 

about the types of radiation exposures incurred 

by members of this class. 

 The dose reconstruction database, again, I just 

mentioned that. We looked for evidence of 

internal/external records, any personal 

monitoring data, and none were found, so that 

was not useful to us. 
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Then we looked at a site research database. 

Site research databases, as the Board knows, we 

-- we travel -- ORAU and our -- we have travels 

around the country searching repositories for 

records -- known repositories of records for 

DOE exposure information. And in that context, 

we identified seven documents that were 

relevant to the National Bureau of Standards. 

But these documents were sparse. They had 

histories of activities performed. In other 

words, we could tell that there was an 

analytical laboratory. They analyzed samples, 

worked with radium, kind of got a feel for the 

types of materials they worked with, but no 

real evidence of any type of air samples or 

personnel monitoring devices or even the 

relative total magnitude of the source term 

that these folks could have been exposed to. 

Of note, though, and I just mentioned this 

briefly before, is that there were two surveys 

related to decontamination -- two documents 

related to decontamination of this particular 

facility. One was a 1952 document that spoke 

to a decontamination that was performed of the 

laboratory when the National Bureau of 
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Standards moved from Van Ness Street in 

Washington to Gaithersburg, Maryland. 

Unfortunately, there was no information related 

to the types of -- the amount of contamination 

found. It just alluded to the fact that there 

was a decontamination performed, so that was 

not informative other than the fact that there 

was some contamination present there. 

The facility was -- they moved out of that 

facility and four of the rooms were locked, and 

nothing happened at this facility that we could 

tell until 1968 when it was being transferred 

to the District of Columbia for another use. 

And the District of Columbia and the National 

Bureau of Standards combined to do a 

decontamination of the laboratory at that 

point, 1968. The surveys conducted at that 

point found evidence of significant 

contamination in these four rooms that were 

locked. In addition the contamination was 

found to have spread down the hallway. It was 

in the air ducts and the vent fans, and in an 

auditorium. 

The levels were fairly significant, as I 

mentioned. The data were not recorded in 
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disintegrations per minute, but counts per 

minute. But even at that, I believe that they 

were in the 100,000 to 200,000 counts per 

minute -- very, very significant levels of 

contamination. The exposure rates ranged as 

high as 20 MR per hour in some of these rooms, 

and radon levels were measured in the vicinity 

of around 8 picocuries per liter. 

Most of this -- although I don't think that the 

contamination surveys spoke to the contaminant 

itself, it's -- it can be inferred pretty 

easily that most of this is probably related to 

radium because of the high radon levels, the 

gamma doses and the high levels of alpha 

contamination. The National Bureau of 

Standards, during this time period, was 

responsible for handling medical sources of 

radium and -- and calibrating them and working 

with those sources. 

Again, we contacted this library and this one 

document that was found was applicable to the 

class, but again, it had no -- no information 

relative -- relevant to reconstructing doses or 

putting upper bounds on them. 

 The petitioner supplied a number of documents 
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and affidavits -- one affidavit and a number of 

documents, I believe. In total there were 55 

documents provided; 40 of these documents were 

mostly related to newspaper accounts, 

descriptions of processes, were not really 

necessarily informative about the site. 

Fourteen of them, though, spoke to process -- 

you know, what happened there, what type of 

materials. But again, nothing related to 

exposure information, nothing that could be 

used for -- nothing of exposure information 

that could be used to reconstruct doses. 

So based on the discussion we just had, the 

evaluation report was revised, because we felt 

that since this contamination was significant 

and had spread outside the laboratories where 

the physicists would be working, we revised the 

class definition to say -- to cover all atomic 

weapons employees who worked in the building 

number two at the NBS facility on Van Ness 

Street. We just felt that we couldn't parse 

the information sufficiently to make -- to 

determine whether it was physicists or anyone -

- because the hallway was contaminated, the 

laboratory was contaminated, the exhaust fans 
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were contaminated. 

This speaks a little more to the process 

description of what -- what the National Bureau 

of Standards worked with. A number of 

radiological activities were performed there in 

support of pilot studies for uranium 

processing; many measurements related to 

identifying, quantifying, purifying uranium. 

They were developing techniques for the thermal 

diffusion and separation of isotopes of 

uranium. There's evidence of thorium handling. 

We do have an indication that they were 

authorized to possess around five pounds of 

thorium, which is a significant source term of 

thorium, if any of you are familiar with the 

health physics practices of thorium. 

They developed a number of analytical 

procedures -- quality control measurements, 

that sort of thing. I had mentioned that these 

radium standards were probably responsible for 

the widespread contamination of the facility. 

These standards were shipped in ampules in the 

early days of development of sealed sources. 

There's an affidavit I think that discussed 

these sources' actual rupturing, the buildup of 
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the gas pressures. These are very hot medical 

type sources -- the sources' rupturing, and in 

fact there is one account of the physicist 

venting these sources outside the laboratory 

window, which could account for it being 

redistributed within the laboratory. 

The other thing of note is these activities 

were highly confidential and secret during 

their early days of the pre-war. Workers were 

not informed of the types of materials they 

were working with. It was sort of on a needto-know basis. And in fact, the streets around 

the NBS facility during this time period were 

completely cordoned off and blocked from public 

access. 

So our conclusion is that we lack sufficient 

monitoring, process or source information to 

estimate internal or external doses to this 

class of employees. We have no film badge 

data. 

I did mention -- I forgot to mention that there 

was a potential source term for neutron 

exposures. The NBS was involved in developing 

-- ironically enough -- guidance for protection 

against neutron exposures during this time 
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period. So if they're working with neutron 

exposures, we have no information as to what 

the levels may have been to these workers. So 

again, we lack monitoring, process or source 

information to do internal or external doses to 

the class. And again, we find substantial 

evidence that the contamination had spread 

beyond the radiological laboratories. 

 Regarding health endangerment, again, we cannot 

reconstruct dose. The key issue here then is 

were these acute, high level exposures that 

could have occurred such as in a nuclear 

criticality accident, or were these indeed 

chronic exposures to radiation over a period of 

time. Based on our review of what processes 

and what -- what the practices were with 

handling these sources, we believe they 

accumulated substantial chronic exposures to 

episodic intakes so that in fact the 250-day 

aggregate requirement for determining health 

endangerment would apply in this case. 

So again, the proposed class is all atomic 

weapons employees working in building two at 

the National Bureau of Standards on Van Ness 

Street for the period 1943 to '52. And our 
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final slide is it's infeasible for us to 

reconstruct doses at this facilities and health 

was endangered. 

And that's my -- end of my formal remarks. 

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

additional comments on --

 MR. ELLIOTT: I would, just before the Board 

starts its -- any questions about this, I'd go 

back to this last -- this slide on the proposed 

class definition. We're going to have to 

change our evaluation report, and I would 

suggest that anything that comes forward from 

the Board not use atomic weapons employer, use 

National Bureau of Standards employee, because 

this is obviously not an AWE, but we -- you 

know, you want to I think couch your definition 

correctly here. 

 DR. ZIEMER: So in that slide and in related 

documentation, instead of the words "atomic 

weapons employees who worked at building two" 

it would be "NBS employees who worked at 

building two" -- is that what you're -- 

everybody catch that one? Thank you. 

Let me ask, Board members, do you have any 

questions for Dr. Neton on this evaluation? 
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PETITIONER PRESENTATION, MRS. VIRGINIA BOND 

Thank you. Next we will hear from the 

petitioners. We're pleased to have Virginia 

and John Bond here today -- welcome. And 

Virginia, you may take the podium and make your 

presentation. 

 MS. BOND: Good morning, Dr. Ziemer and members 

of the Board. I want to thank you for allowing 

me to appear before you personally to request 

your approval of Special Exposure Cohort status 

for the National Bureau of Standards site. 

My name is Virginia Bond. My husband John and 

I have traveled from our home in Mill Creek, 

Washington so that I can speak as the personal 

representative of my mom, Elizabeth L. Brown. 

She is the surviving spouse of my dad, Burrell 

W. Brown, Sr. My brother Burrell W. Brown, Jr. 

would have joined us today, but since our 

mother is 91 we make a point not to ever be out 

of the area at the same time. He and my mother 

are listening by telephone this morning, as are 

many family members, friends and supporters. 

Thank you for making that service available. 

A little over a week ago I began drafting this 
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presentation. I understood that I needed to 

explain to you the history of the site, what my 

father did there, and why I felt NIOSH could 

not reconstruct the dose. I dragged out the 

many boxes I've collected over the years and 

started sorting through the papers. Which 

ones, I pondered, will convince the Board to 

agree with NIOSH's assessment and to recommend 

that the National Bureau of Standards become a 

member of the Special Exposure Cohort. 

I will get to that in a few minutes, but first 

I must address what I consider to be a 

completely despicable maneuver on the part of 

the Department of Energy and the Department of 

Labor. You've heard a little about this 

already. 

Last Wednesday Mr. Larry Elliott informed me 

that DOL had requested that this petition be 

taken off today's agenda. The reason they 

wanted it removed was the Department of Energy 

decided that the Bureau of Standards never 

should have been approved as a covered facility 

in the first place. 

The National Bureau of Standards has been on 

the list as a covered facility for over four 
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years. The Department of Labor accepted the 

claims four years ago and forwarded them to 

NIOSH for dose reconstruction. One week before 

your deliberations on this petition these two 

agencies decided to correct their mistake. 

This appears to be similar to what the 

Department of Energy did with the Iowa Army 

Ammunition Plant (IAAP) petition. 

Members of the Board, this action is cruel and 

unconscionable. The reason the Department of 

Energy has decided to de-list the Bureau of 

Standards is because it is a U.S. government 

agency, and the law exempts employees of 

certain U.S. governm-- government agencies from 

this compensation program. This does not seem 

quite fair or just. 

A compassionate Congress passed EEOICPA to 

correct the past wrongs of nuclear weapons 

production. My father, Burrell W. Brown, Sr., 

was involved in the development of the first 

atomic bomb. He died a horrible death as a 

result of working with radioactive materials 

without protective gear, let alone health 

monitoring. 

My dad worked in the Radioactivity Lab of the 
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National Bureau of Standards from 1931 until 

May of 1948. He was only 20 years old when he 

started his career with the Bureau of 

Standards. There are many records available 

that identify the National Bureau of Standards 

as being a crucial part of the Manhattan 

Project. As the documents I have submitted and 

the research done by NIOSH clearly proves, 

there is no doubt that the Bureau of Standards 

employees were exposed to high levels of AEC 

and DOE radioactive materials relevant to 

nuclear weapons production. 

The documents listing the levels of radiation 

found in the National Bureau of Standards 

buildings are in the packets I supplied today. 

I think you will be shocked at the levels. In 

addition to those records, included in my SEC 

petition is an affidavit from Dr. Rosalind 

Mendell, who worked in the Radioactivity Lab 

with my dad from 1944 until 1946. I quote Dr. 

Mendell (Reading) I was hired by Leon Curtiss 

of the National Bureau of Standards to do work 

on the alpha spectroscopy of "W metal". Such 

was the degree of secrecy or classification of 

the Manhattan Project in our area. In 
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principle, I was not kept informed about the 

nature of my research. I knew that I was 

working on a project involving artificiallyinduced fission of uranium only because I knew 

the energy of alpha particles for U-235 and U238, because I could see the occasional huge 

pulses from natural fission of uranium, and 

because I was measuring the gradual enrichment 

of U-235 alpha particles relative to those from 

U-238. 

You have a copy of her affidavit in her packet, 

also. 

I also have a document which I quote. 

(Reading) Mr. Burrell W. Brown of this section 

informs me that he holds a low number in the 

selective service lists and may receive a 

questionnaire at any time. Mr. Brown is 

engaged in research on problems in 

radioactivity concerned with national defense, 

of a confidential nature, which would be 

seriously delayed if he were called away for a 

year. This work involves studies of nuclear 

fission as a source of atomic energy, and 

requires the use of highly specialized 

equipment which he has developed and with which 
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he alone is familiar. It would be difficult to 

replace him, and it would require at least a 

year to train a man to attain the desired 

proficiency in the conduct of these 

investigations. It therefore appears that the 

national defense is best served by retaining 

him in his present work. 

You also have a copy of this letter in your 

packet. 

At the onset of World War II my dad felt called 

to join the Army. But he was told if he did so 

he would be stationed right back at the 

National Bureau of Standards, doing the exact 

same job, but reduced in rank from his P3 to 

PFC. Obviously he didn't join the Army. 

My mother tells of trips with my father to the 

Radioactivity Lab in the middle of the night to 

check on experiments. She said at one time he 

was checking on experiments being done with a 

garbage can-like container filled with water 

and positioned on -- there were several of 

them, positioned on their sides. My dad's 

responsibilities included being available 24 

hours a day, seven days a week, to monitor 

experiments being conducted in his lab. 
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Soon however the level of security was 

increased, and not only was my mom not allowed 

on these night trips, but even the streets 

around the Bureau of Standards were blocked off 

and traffic was no longer allowed into the 

secure area. Information on this change is 

readily available. 

 My father, Burrell W. Brown, Sr., meets the 

requirements set forth in the EEOICPA statutes. 

I believe I have proof, and the fact that NIOSH 

is recommending approval of my SEC proves that 

they believe, he worked on the Manhattan 

Project. My dad was exposed to radioactive 

materials during his work, developed 

myelofibrosis with myeloid metaplasia, a cancer 

verified by the Department of Labor as being an 

approved cancer. NIOSH has now come to the 

conclusion that they cannot do a dosage 

reconstruction. 

I've included many articles in your packet 

showing that the National Bureau of Standards 

was an important part of the Manhattan Project. 

My father's work was seen as so sacred and he 

was so valuable that he was not allowed to join 

the Army when the United States entered World 
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War II. Among his treasured memorabilia is a 

gold pin recognizing his distinguished service 

to the Department of Energy, DOE. Dr. Leon 

Curtiss, who was my dad's immediate supervisor 

and a prominent Manhattan Project leader, 

delivered the results of my father's work to 

other scientists in Chicago and Oak Ridge. 

Some things just don't add up here. It seems 

to me that there is more to this story that has 

been kept secret besides the development of the 

world's first atomic bomb. 

Additionally I received further information 

this weekend on the role of the National Bureau 

of Standards with the Manhattan Project. 

President Roosevelt approved the formation of a 

National Defense Research Committee in 1940. 

This committee was made up of a group of 

scientists responsible for researching nuclear 

capabilities for bombs, and thus was a 

predecessor agency of the Department of Energy. 

The head of the Uranium Committee was Lyman 

Briggs, Director of the National Bureau of 

Standards. In December of 1930 the National 

Defense Research Committee (NDRC) entered into 

an agreement with the National Bureau of 
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Standards for the research and development of 

proximity fuses and other related articles for 

rockets, bombs, and mortar shells. At the 

time, the National Bureau of Standards operated 

one of the premier scientific research 

facilities in the government on this campus in 

the District of Columbia. It can be argued 

that because of this contract the National 

Bureau of Standards was also a predecessor of 

the Department of Energy. I would like to 

elaborate on my father's collaboration over 

several years with Dr. Leon Curtiss and other 

well-known scientists. Burrell W. Brown, Sr. 

not only worked for Dr. Curtiss, he was also a 

colleague in the publication of scientific 

research articles related to radiation. 

Included among them are the following: 

Curtiss, L.F. and Brown, B.W. (1946). An 

arrangement with small solid angle for 

measurement of beta rays. Journal of Research 

of the National Bureau of Standards, Volume 37, 

August 1946. 

Brown, B.W. and Curtiss, L.F. (1945). Thinwalled aluminum beta-ray tube counters. 

Journal of Research of the National Bureau of 
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Standards, Volume 35, August 1945. 

Curtiss, L.F. and Brown, B.W. (1945). 

Frequency meter for use with Geiger-Muller 

Counter. Journal of Research of the National 

Bureau of Standards, Volume 34, January 1945. 

 Curtiss, L.F., Astin, A.V., Stockmann, L.L. and 

Brown, B.W. (1939). Cosmic-ray observations in 

the stratosphere with high-speed encounters. 

Journal of the National Bureau of Standards, 

Volume 23, January 1939. 

 Curtiss, L.F., Astin, A.V., Stockmann, L.L. and 

Brown, B.W. (1939). An improved radio 

meteorographic (sic) on the Olland principle. 

Journal of the National Bureau of Standards, 

Volume 22, January 1939. 

In addition there are pictures and newspaper 

articles that document my dad's collaboration 

with Dr. Curtiss. I am holding copies in my 

hand. If Dr. Curtiss, Astin and Stockmann were 

integral to the Department of Energy and the 

Manhattan Project, so indeed was Burrell W. 

Brown, Sr. 

These articles and pictures are also included 

in your packet. 

It is fitting that I am speaking to you this 
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week. My mom turned 91 yesterday, October 

18th. She has been a widow for the last 18 and 

a half years. My dad would have celebrated his 

95th birthday last Sunday, October 16th. His 

sisters lived well into their nineties. He 

should be here today to speak to you. He would 

have been able to answer your questions. But 

that is the reason we're here, isn't it? The 

important role he played in the Manhattan 

Project and the service he performed for our 

country cost him his life. Which department 

signed his paychecks should not be the focus. 

You, as Board members, have an opportunity and 

responsibility to help ensure that justice is 

served in this case. If this claim is not paid 

due to an oversight, it would be a glaring and 

inexcusable statement of inequity. 

I hadn't intended to ask you too many questions 

today, but I do have a couple that have 

surfaced because of the actions of the 

Department of Energy and Department of Labor 

employees this last week. 

What happens to my petition and my claim if the 

National Bureau of Standards is de-listed? 

What appeal mechanism do I have if my claim is 
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denied due to de-listing of the National Bureau 

of Standards? 

How will the DOL adjudicate my claim if the 

National Bureau of Standards is de-listed? 

 Members of the Board, I respectfully request 

that you accept NIOSH's recommendation and 

approve this petition and also recommend to the 

Secretary of Health and Human Services that the 

National Bureau of Standards become a member of 

the Special Exposure Cohort. I also 

respectfully request that you expedite your 

decision. Please do not delay your decision 

based on whether or not the National Bureau of 

Standards is a covered facility. It was 

covered four years ago. It was covered when 

DOL accepted my claim. And it was covered when 

NIOSH accepted and approved my petition. I ask 

that you deliberate the merits of this 

petition, not the eleventh-hour changes by the 

Department of Energy and the Department of 

Labor. Thank you. 

 DR. ZIEMER: Thank you very much, Virginia, for 

that presentation. 

Are there any others that are going to speak 

for your petition? For example, John, are you 
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-- you're not. Okay, I just wanted to give you 

that --

 MS. BOND: Oh, no. 

 DR. ZIEMER: -- opportunity. Okay, putting him 

on the spot. If you would remain there just a 

moment --

 MS. BOND: Oh, sure. 

BOARD DISCUSSION AND DECISION

 DR. ZIEMER: -- I want to ask if -- well, first 

on the three questions you asked -- 

 MS. BOND: Yes. 

 DR. ZIEMER: -- I don't think I know the answer 

to those. I doubt if our Board members do, but 

I'm wondering if either NIOSH or Department of 

Labor representatives know the answers to what 

happens to the petition if NBS is de-listed; 

what appeal mechanism do they have and how 

would DOE (sic) adjudicate the claim if it's 

de-listed. I don't know if we know the answers 

to those today. I think -- you'd certainly 

hope we don't have to ever know the answers to 

those, but do we know that information now? 

 MR. ELLIOTT: I think DOL has to answer those 

questions. NIOSH is not responsible for 

answering those questions in this regard, so I 
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don't --

 DR. ZIEMER: Jeff, you probably don't at this 

point know the answer, either, but... Jeff is 

here from DOL. 

 MR. KOTSCH: Yeah, Jeff Kotsch, Department of 

Labor. I -- first of all, I wouldn't know the 

answer to the first question 'cause I'm not a 

claims examiner for the case. There is an 

appeal process for all claimants that allows, 

at the recommended decision stage if it's 

denied -- or the -- the claimant has the -- the 

option to object, present additional evidence 

that they feel could be used by then the Final 

Adjudication Branch to review that and -- as 

they render their final decision, so that's 

the, you know, standard process for that. 

And even beyond --

 DR. ZIEMER: Would that apply in such a case as 

she defined here where -- 

 MR. KOTSCH: It would apply for all DOL 

decisions. 

 DR. ZIEMER: Okay. 

 MR. KOTSCH: So does that -- that at least 

answers the last two. 

 DR. ZIEMER: There is a formal appeal process, 
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though. 

 MR. KOTSCH: Yeah, even after the final 

decision there is a -- there are additional 

layers of what they call reconsideration or 

even reopening requests if -- if the claimant 

were to have additional evidence that they feel 

still was not addressed. They could bring that 

forward. 

 DR. ZIEMER: So in a sense, that answers two 

and three here, they both -- there -- there is 

a process then. 

 MR. KOTSCH: Yes. 

 DR. ZIEMER: Okay. Thank you. Now let me ask, 

Board members, do you have any questions for 

Virginia on this information that's been 

presented? And you should have in your packet 

all the documents that were referred to, 

including the -- the various publications, the 

newspaper articles and related materials are 

all there. And we thank you for providing all 

of that information. Thank you very much. 

 DR. WADE: I'd like to speak for the record 

very briefly, if I could. 

 DR. ZIEMER: Yes. 

 DR. WADE: Again, I -- I am not authorized to 
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speak for the Department of Labor. I would 

only offer the observation that, you know, 

based upon the discussions I've been privy to, 

I don't think there's any attempt to exclude 

this claim. I think the agencies, DOL and DOE, 

are just trying to get their procedures 

correct, and I'd like that on the record. I 

think we need to proceed according to the 

information in front of us, but I wouldn't want 

the record to -- to not contain at least my 

belief that this is not an attempt to exclude 

anyone. It's simply an attempt to make sure 

the procedures are right and correctly 

followed. 

 DR. ZIEMER: Okay. Thank you. Board members, 

this petition now is open for discussion or for 

action. 

 MR. PRESLEY: Mr. Chairman? 

 DR. ZIEMER: Yes. 

 MR. PRESLEY: I would like to take the action 

that we accept the NBSB (sic) employees who 

worked in Building 2 at the National Bureau of 

Standards, Van Ness Street in Washington, D.C. 

from 1942 through 1952 as an SEC site. 

 DR. ZIEMER: Okay --
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 MS. MUNN: I second that. 

 DR. MELIUS: Yeah, can --

 DR. ZIEMER: Motion made and seconded that the 

petition be recommended for approval. 

Discussion? Jim. 

 DR. MELIUS: I'd like to offer a friendly 

amendment --

 DR. ZIEMER: Friendly --

 DR. MELIUS: -- to be a complete -- a little 

bit more complete motion in the form of a 

letter in our usual style, if that's -- 

 DR. ZIEMER: I think this will --

 DR. MELIUS: Well, let me --

 DR. ZIEMER: -- (unintelligible). 

 DR. MELIUS: Obviously we can do that, and I 

was hoping to have copies made already. We had 

a little technical difficulties getting it 

transferred, but we should be able to shortly. 

But let me read this and a lot of this language 

will be familiar to the other members of the 

Board who've heard this... 

(Reading) The Board recommends that the 

following letter be transmitted to the 

Secretary of Health and Human Services within 

21 days. Should the Chair become aware of any 
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issue that, in his judgment, would preclude the 

transmittal of this letter within that time 

period, the Board requests that he promptly 

informs the Board of the delay and the reasons 

for this delay, and that he immediately works 

with NIOSH to schedule emergency meeting of the 

Board to discuss this issue. 

Letter. (Reading) The Advisory Board on 

Radiation and Worker Health (the Board) has 

evaluated SEC Petition 00034 concerning workers 

in Building Number 2 at the National Bureau of 

Standards in Washington, D.C. under the 

statutory requirements established by EEOICPA 

and incorporated into 42 CFR 83.13(c)(1) and 42 

CFR Section 83.13(c)(3). The Board 

respectfully recommends that a Special Exposure 

Cohort be accorded to all National Bureau of 

Standards employees who worked in Building 

Number 2 at this facility from 1943 to 1952 and 

who were employed for a number of work days 

aggregating at least 250 work days occurring 

under this employment or in combination with 

work days of employment occurring within the 

parameters, excluding aggregate work 

requirements established for other classes of 
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employees included in the SEC. 

This recommendation is based on the following 

factors: 

1. These workers were employed at a facility that 

handled substantial amounts of radioactive 

materials during the early time period for the 

production of nuclear weapons. 

2. NIOSH was unable to find any personal area 

monitoring data or other data that would be 

useful for individual dose reconstruction for 

these workers. However, available data 

indicate that these workers may have 

accumulated substantial chronic exposures 

through episodic intakes of radionucleides 

(sic), combined with external exposures to 

gamma, beta, and neutron radiation. 

Furthermore, radiological contamination in the 

building extended beyond the laboratories in 

which the physicists worked. 

3. NIOSH has determined that the health of 

employees at this facility may have been 

endangered by their radiation exposures. The 

Board concurs. 

Based on these considerations, the Board 

recommends that this Special Exposure Cohort 
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petition be granted. Enclosed is supporting 

documentation from the Advisory Board meeting 

held October 19th, 2005 in Knoxville, 

Tennessee. This documentation includes 

transcripts of public comments on the petition, 

copies of the petition and the NIOSH review 

thereof, and related documents distributed by 

NIOSH and the petitioners. 

 DR. ZIEMER: This proposed friendly amendment 

would put the motion in the form of the letter 

that we normally do transmit. Do you accept -- 

 MR. PRESLEY: I accept that. 

 DR. ZIEMER: Does the seconder accept that -- 

 MS. MUNN: Yes. 

 DR. ZIEMER: -- language as a friendly 

amendment? Then we have before us this motion 

as read by Jim. You all recognize the 

language, which is very similar in format to 

letters of -- SEC petitions that we have used 

in the past. 

Is there discussion on this motion? 

 (No responses) 

 Any speaking against the motion? 

 (No responses) 

 Any speaking for the motion? 
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 (No responses) 

 The Chair senses that there is sentiment to 

proceed. If so, all in favor of this motion 

please raise your right hand. 

 (Affirmative responses) 

 Any opposed? 

 (No responses) 

It appears to be unanimous. No abstentions? 

 (No responses) 

The motion carries. Thank you very much. 

Thank you, Virginia.

83.14 SEC: 

NIOSH PRESENTATION, MR. STUART HINNEFELD 

Next we have Linde Ceramics -- let's see, make 

sure we -- are we due for a break? 

 DR. WADE: No. I would criticize the Board, 

we're a minute off-schedule now, so work a 

little harder. 

 DR. ZIEMER: Stu Hinnefeld from NIOSH will 

present the petition evaluation for Linde 

Ceramics. You should have a hand-out, as well 

as the evaluation report. 

 MR. HINNEFELD: Good morning. At your last 

meeting in St. Louis I discussed very briefly 

and handed out a hand-out about procedures to 

follow when we determine that it's not feasible 
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to do a dose reconstruction. And I said that 

we hoped to bring a case like that to you at 

the next meeting, and this is the case. It did 

work out the way we had hoped, and so we have a 

case where -- a situation where we have 

determined that it's not feasible to do dose 

reconstruction and we've proceeded down the 

83.14 pathway for SEC determination. 

The site involved is the Linde Ceramics Plant, 

and it includes the Tonawanda laboratory. This 

is the site in Tonawanda, New York -- several 

buildings associated with that site. 

I think all of our SEC presentations have to 

have this two-pronged test slide in here, and I 

couldn't think of a good place to put it so I 

put it up front. Jim went through the twopronged test. We all -- I won't run back 

through that. We all know what the two-pronged 

test is. 

Linde Ceramics Plant refers to several 

buildings in Tonawanda, New York. They 

produced uranium materials for Manhattan 

Engineering District clearly from 1942 through 

1946. There was a stand-by period that started 

in the fall of 1946, and then production -- 
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some portion of that production resumed in the 

fall of 1947, around November of 1947. Clearly 

one of the early uranium production sites that 

assisted in the War effort. 

There were actually -- the-- referred to a 

three-step production process, so the 

production process is referred to in three 

steps. They're outlined on this slide. One 

was to take ore and ore-like feed materials to 

a U3O8 compound. Then to convert the U3O8 

compound to UO2, they had to go through UO3 to 

get to UO2. And then once they had the UO2, 

then they converted that to UF4. All three of 

these operations -- all three of these 

processes were in operation from '42 to '46, 

and research into these -- how to better do 

these were done at the Tonawanda laboratory 

during that period, as well. So this was a 

very -- a varied uranium production facility, 

and they did handle ore, including African ores 

which are relatively high in radium -- actually 

pretty high in radium. 

 Following the shut-down from '46 to '47, when 

production resumed in 1947 in November, only 

step three was resumed. So step three 
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continued from '47 to '49. There was a period 

of time when the plants were essentially 

cleaned and decontaminated -- that was a multiyear period of time -- for them to be turned 

over to Linde. These were actually MED-owned 

plants when they were built. Linde took 

ownership of them, because they were on their 

property, in the early '50's. And then there 

was future FUSRAP remediation in the '70's and 

'80's. So that's the period of time for the 

entire site, but we're really here to just talk 

about the '42 to '47 period. 

 The information available for performing dose 

reconstructions at Linde is we do have 

urinalysis on -- we have several samples on a 

number of workers. Those samples started in 

November of 1947. Prior to that time we don't 

find any radiological bioassay. 

There was an air monitoring program 

established. This is through HASL and the 

Environmental Measurements Laboratory -- again, 

in late 1947 -- where they do time motion 

studies, time-weighted average, the typical air 

-- air monitoring analysis that we see from 

HASL, but that again started in 1947. 
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There are some isolated samples from the 

earlier period that are -- they seem to be 

total airborne mass samples. The results are 

given in milligrams per cubic meter. They're 

collected on glass tubes. We have a very 

fragmentary description of the analytical 

technique, nothing that we're particularly 

familiar with, and there's not very many of 

them. And we don't have a lot of confidence 

that they reflect very well on what exposure 

may have been during that early period. 

The work activities that are described in the 

documents we have available to us, we did the 

typical document search in arriving at this 

conclusion that Jim described in his, the data 

that has been captured by our various datacapture activities and provided by the 

Department of Energy at the initiation. And 

whatever we can find, we've -- we've actually 

got a pretty decent store of information on 

what they did. We have quite a number of 

documents we reviewed. 

We have a pretty good description of 

activities. There are many, many manual 

activities. Ore arrived in burlap bags and was 
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stored on-site in burlap bags. People moved 

things by -- by hand, essentially -- handshoveled or hand-troweled or scooped materials 

into various vessels, hand-scooped materials 

into oven trays to be heated and in the 

fluorination furnaces, so there was a lot of 

manual handling and potential for significant 

internal exposure. 

We do have radiation surveys from quite early 

on, and we -- and they seem to be consistent 

with a plant of this type and the materials 

they had there. So we have radiation surveys 

of external radiation from early on, and then 

we have some film badge data that actually 

started later, in the post-'47 period. So we 

do have some information that we feel provides 

us some information about potential external 

exposures during this period. 

And we actually do have a pretty good 

description of the medical monitoring program 

which defined the frequency of -- of exam -- 

medical exam and type of medical exam that 

should be used to monitor the employees who are 

going to be working at this plant during the 

early period. 
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Our process on this was that we gathered this 

information in our data capture information and 

various sources in order to prepare a Linde 

site profile. That profile was completed 

earlier this year. And based upon the relative 

lack of information for these 1942 to 1947 

years, we marked as "reserved" the internal 

dose portions -- you know, how do you do -- how 

do you do an internal dose reconstruction for 

Linde. Those sections are reserved in this 

site profile, meaning that at the time of 

publication we didn't have a method to do it. 

And subsequently we've determined that we don't 

think we're going to find a way to do that. 

And so in our additional evaluation we've 

decided that the information for -- available 

to us in that period is insufficient to support 

reconstruction of internal doses from the '42 

to 1947 period, and the doses that result from 

that. 

So once we had reached that conclusion that it 

was infeasible to do dose reconstructions 

during this period, we -- we notified a 

particular claimant from this population who 

had worked in that period that we had 
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determined that dose reconstruction's 

unfeasible. This puts us on the 83.14 path for 

SEC. 

We sent the individual that letter, and we 

included a blank SEC petition Form A, which is 

a short-form petition, which is essentially 

sign here and send it back. And -- because 

they -- you know, we had essentially already 

arrived at the conclusion that it's infeasible 

for us to do the dose reconstruction. 

So that petition then was returned to us on 

September 29th, and we prepared a petition 

evaluation report, the basis for which we 

already determined, and presented it to -- and 

it was sent to the Board I believe about a week 

ago, about like that. 

Our conclusions on this is that we have 

determined that we lack sufficient monitoring, 

process or source information to provide -- to 

estimate the internal radiation doses to Linde 

Ceramic employees for the period of October 

1942 to October 1947. 

And we believe we do have sufficient 

information to estimate external and medical 

exposures during that period. 
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We did not identify a particular acute event, 

such as criticality, that would -- that might 

have occurred that would cause -- just presence 

to lead to health endangerment, but we clearly 

believe there is a potential for significant 

chronic exposure, internal exposure, that does 

lead to a potential health endangerment. So we 

believe the health endangerment is present for 

the site. 

And so for the period 1942 to 1947, we estimate 

that -- we find that it is not feasible for us 

to do dose reconstruction (unintelligible) that 

period, specifically the internal dose 

reconstruction during that period and that the 

health was endangered for the class of people 

that worked there. 

The class definition I neglected to bring up 

with me. I believe it's all AWE employees who 

worked at Linde Ceramics from October 1942 

through October 1947. 

BOARD DISCUSSION AND DECISION

 DR. ZIEMER: Okay. Thank you very much, Stu. 

Let me ask a couple of questions and we'll open 

the floor to other Board members, as well. 

Do I understand correctly that you were not 
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able to find any inventory information on 

amounts of material being processed there? You 

say there's no process or source information? 

 MR. HINNEFELD: Well, know what the mat-- we 

know what the material was. 

 DR. ZIEMER: Right. 

 MR. HINNEFELD: I don't know that we know 

definitively how much was there or -- 

 DR. ZIEMER: How much. 

 MR. HINNEFELD: -- production numbers. Even 

knowing the production numbers and having -- 

with the description of the processes that were 

involved, the manual nature of the processes, I 

think we'd be hard-pressed to provide a 

bounding estimate on what the exposures might 

have been. 

 DR. ZIEMER: And then my second question is, in 

-- in some cases, and perhaps Bethlehem Steel 

is an example, you have used another somewhat 

similar facility to infer things like air 

concentrations and so on, such as the Simonds 

Saw data. Are there any other -- I assume 

you've looked to see if there's other plants 

that were sufficiently similar to Linde 

Ceramics that might serve as a -- a substitute 
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or a model for -- for bounding the -- 

 MR. HINNEFELD: One -- one that the Board's 

fairly familiar with that would be fairly 

similar would be Mallinckrodt St. Louis site, 

'cause many of the same activities -- the 

handling of the African ores and the conversion 

of uranium compounds from one to another 

occurred at that site, as well. 

 DR. ZIEMER: Uh-huh. 

 MR. HINNEFELD: And we also reached a 

conclusion early on in response to a petition 

from Mallinckrodt that from '42 to '47 it was 

not feasible to do --

 DR. ZIEMER: Right. 

 MR. HINNEFELD: -- dose reconstruction there, 

as well. 

 DR. ZIEMER: So that is the one that is most 

like this facility is -- 

 MR. HINNEFELD: Certainly as far as the ones 

that have been discussed in front of the Board, 

that would be the one most like it. 

 DR. ZIEMER: Okay. Thank you. Other 

questions, Board members? Yes, Dr. Melius. 

 DR. MELIUS: I have -- it's more to do with the 

process. This would not -- this action would 
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not preclude the -- a petitioner from 

submitting a petition regarding later time 

periods. We're -- we're sort of focusing on 

what, you know, can't be done, not really 

coming to any sort of assessment of -- from '47 

on. 

 MR. HINNEFELD: That is correct. Our 

assessment at this date is that we -- we 

concluded it's not feasible to do it up to '47. 

There has not been a petition submitted from 

this site other than the one that was submitted 

in response to our letter that we can't do the 

-- your dose reconstruction. 

 DR. MELIUS: I guess -- does the petitioner 

understand that? I guess the -- and -- I 

assume he does 'cause I know him and I know he 

 MR. ELLIOTT: I hope he does. We worked really 

hard with this gentleman and his family, and I 

think he understands this -- this set of 

circumstances. And yes, the answer is -- to 

your earlier question is, as Stu answered it, 

this does not preclude a petition coming 

forward for the remaining years beyond '47. 

 DR. MELIUS: I just think that's important to 
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have on the record so, should we have to -- 

 MR. ELLIOTT: Right. 

 DR. MELIUS: -- encounter it, that's -- 

 DR. ZIEMER: Other comments or questions? 

Okay, then -- the -- for the petitioners, do we 

have a presentation? 

 MR. ELLIOTT: I believe they're on the line, 

but I don't believe they have anything they 

want to offer. 

 DR. ZIEMER: Okay. We do have the -- Board 

members I believe have the petition 

information. Board members, are there -- you 

have any questions on the material, as far as 

the petition itself is concerned? 

If not, this petition is open for discussion or 

for action. Wanda Munn. 

 MS. MUNN: Since NIOSH is unable to make any 

determination in this case, I move that we 

accept this petition as an SEC and I'm sure Dr. 

Melius has the appropriate words for that. 

 DR. ZIEMER: She's already ready for the 

friendly amendment, but is there a second to 

the motion? 

 MR. PRESLEY: I'll second. 

 DR. ZIEMER: And it's seconded. And Jim, are 
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you prepared to provide suitable wording for 

this? 

 DR. MELIUS: Yes, I am. I was -- I was going 

to hand my computer to Wanda and let her -- 

 DR. ZIEMER: If you would read the official 

motion then. 

 DR. MELIUS: Okay. And everyone will forgive 

me for getting this lengthy document onto the 

record again, which will sound repetitive. 

(Reading) The Board recommends that the 

following letter be transmitted to the 

Secretary of Health and Human Services within 

21 days. Should the Chair become aware of any 

issue that, in his judgment, would preclude the 

transmittal of this letter within that time 

period, the Board requests that he promptly 

informs the Board of the delay and the reasons 

for this delay, and that he immediately works 

with NIOSH to schedule an emergency meeting of 

the Board to discuss this issue. 

The letter. (Reading) The Advisory Board on 

Radiation and Worker Health (the Board) has 

evaluated SEC Petition 00044 concerning workers 

at the Linde Ceramics Plant in Niagara Falls, 

New York under the statutory requirements 
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established by EEOICPA and incorporated into 42 

CFR Section 83.13(c)(1) and 42 CFR Section 

83.13(c)(3). The Board respectfully recommends 

that a Special Exposure Cohort be accorded to 

all atomics weapons employees who worked at the 

Linde Ceramics Plant from October 1st, 1942 

through October 31st, 1947 and whom were 

employed for a number of work days aggregating 

at least 250 work days occurring under this 

employment or in combination with work days of 

employment occurring within the parameters 

(excluding the aggregate work requirements) 

established for other classes of employees 

included in the SEC. 

This recommendation is based on the following 

factors: 

1. These workers were employed at a facility that 

processed substantial amounts of radioactive 

materials during the early time period for the 

production of nuclear weapons. 

2. Monitoring for internal dosimetry was not 

implemented at this facility until November, 

1947. The other monitoring, process and source 

information available for this facility is not 

sufficient for estimating internal radiation 
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exposures in order to conduct individual dose 

reconstructions for workers at this facility 

during the earlier time period. 

3. NIOSH has determined that the health of 

employees at this facility may have been 

endangered by their radiation exposures. The 

Board concurs. 

Based on these considerations, the Board 

recommends that this Special Exposure Cohort 

petition be granted. Enclosed is the 

supporting documentation from the Advisory 

Board meeting held October 19th, 2005 in 

Knoxville, Tennessee. This documentation 

includes transcripts of public comments on the 

petition, copies of the petition and the NIOSH 

review thereof, and related documents 

distributed by NIOSH and the petitioners. 

If any of these item-- we don't need to -- 

that's it. 

 DR. ZIEMER: Thank you. And the seconder 

accepts that as the motion, I assume. 

Let me ask for clarification on the one 

statement about no monitoring being done until 

whatever date you specified. Is that accurate 

or do we need to modify that. I think I heard 
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you say there was some monitoring -- 

 MR. HINNEFELD: There were -- there were some 

isolated air samples, but there was no 

monitoring. It started in November... 

 DR. ZIEMER: I want to make sure we have an 

accurate statement on the monitoring. 

 DR. MELIUS: Yeah, I -- let me -- let me read 

it back and just make sure we're -- what you 

said is that monitoring for internal dosimetry 

was not implemented at this facility until 

November of 1947. The other monitoring, 

process and source information available for 

this facility is not sufficient. So I was 

trying to capture that issue, that there was -- 

 MR. HINNEFELD: I'm sure that's 

(unintelligible) --

 DR. MELIUS: I'm not saying there wasn't any 

other monitoring, but that it wasn't suffi-- 

that other -- I think I'm accurate about the 

internal dosimetry. 

 DR. ZIEMER: I wanted to make sure that date 

was correct and that -- okay. Any other 

comments on this motion? 

 DR. MELIUS: And I actually have also a legal 

question for Liz. Do we need to site any other 
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-- we've used the usual citation, and I'm not 

sure there isn't a separate part of the 

regulations or -- yeah, yeah. 

 DR. ZIEMER: And also I'm not sure we had a 

public comment on this petition. Did we have 

any? 

 MS. MUNN: I did not hear any. 

 DR. ZIEMER: There's a reference made to 

providing the public comment. 

 DR. MELIUS: Oh, okay, okay. We're --

 MS. MUNN: Public comment. A question was -- 

 MR. GRIFFON: (Unintelligible) a question. I 

don't know in the past if we've included a 

statement that indicates, as the recommendation 

does from NIOSH, that external doses can be 

calculated for this time period. Do we need to 

-- I mean I know you said that internal cannot 

be. Do -- we've -- we've remained silent on 

that or --

 DR. MELIUS: Yeah, my sense was that we would -

- you know... 

 DR. ZIEMER: It's kind of a moot point, I 

guess, if you can't --

 DR. MELIUS: Yeah, they still can't do internal 

dose reconstruction. I think that's covered, 
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yeah. 

 MR. GRIFFON: And we say that we accept NIOSH's 

recommendation, right, and so that -- that's 

defined that way. 

 DR. MELIUS: Yeah. 

 MR. GRIFFON: Okay. 

 DR. MELIUS: Yeah. 

 DR. ZIEMER: We could, if you want to consider 

including that, Mark, we could consider saying 

something like although external doses -- 

although it may be possible to -- to 

reconstruct external doses, the internal doses 

cannot be, or something to that -- 

 DR. MELIUS: Well, I thought I'd captured that 

indirectly, and let me read the whole sentence. 

(Reading) The other monitoring, process and 

source information available for this facility 

is not sufficient for estimating internal 

radiation exposures in order to conduct 

individual dose reconstructions. 

 MR. GRIFFON: Yeah, that's... 

 DR. MELIUS: So it brings it back to individual 

 MR. GRIFFON: Yeah, that's... 

 DR. MELIUS: It's just a little awkward to say 
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well, it is -- external's okay, you know -- 

 MR. GRIFFON: I agree, yeah. 

 DR. MELIUS: Yeah. 

 DR. ZIEMER: Okay. I guess maybe -- I don't 

know if counsel can help us. Do we need a 

statement in there about the public comment, 

since we had none on this -- 

 DR. MELIUS: Or just say transcripts are -- 

 DR. ZIEMER: -- or would you rather have it in 

there anyway, or just transcripts of the 

meeting would be sufficient. We don't have to 

say anything about the public comment. If it's 

agreeable, why don't we just delete that, since 

there wasn't any. 

 Any other comments? Are you ready to vote on 

this petition? 

 (No responses) 

Okay. All in favor of recommending approval of 

this SEC cohort, say aye? 

 (Affirmative responses) 

 Any opposed, no? 

 (No responses) 

 Any abstentions? 

 (No responses) 

It is so ordered, and the motion carries. 
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Thank you. And thank you, Stu. 

 DR. WADE: I'd ask Stu -- could you stay up for 

a minute, Stu? 

 DR. ZIEMER: Yeah. 

 DR. WADE: I mean while we have a few minutes, 

I wouldn't mind just talking about what we 

might expect to see relative to this process in 

the future, and get the Board to have a bit of 

a dialogue with you as to whether they'd like 

to see this done in a different way than we've 

done it or -- so Stu, I'd assume we will 

continue to -- to look to identify these 

targets of opportunity and bring them, as 

appropriate, to the Board? 

 MR. HINNEFELD: Yes. 

 DR. WADE: Any speculation as to volume or 

frequency or... 

 MR. HINNEFELD: Well, it would -- it would 

certainly be speculation. I think easily half 

-- half a dozen. 

 DR. ZIEMER: Of this type? 

 MR. HINNEFELD: Yeah. 

 DR. ZIEMER: Over the next year? 

 MR. HINNEFELD: It'll probably be a year or 

more, maybe, to get through that many. Maybe 
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many --

 DR. WADE: I'm not -- I'm not looking for -- 

 MR. HINNEFELD: -- sites with very limited 

information and a limited number of claims over 

the next year --

 DR. WADE: I just wanted to let the Board know 

that --

 MR. HINNEFELD: -- or about a year from now. 

 DR. WADE: -- this is a process. And again, I 

think we would -- NIOSH would intend to 

approach it the way we've done here. I don't 

know if the Board has any suggestions for us or 

-- it could become time-consuming, and yet I 

think we just have to do this. 

 DR. MELIUS: Well, I guess my question would be 

to what extent can we make it not time-consu-- 

as not time-consuming and is -- are we better 

sort of bundling them -- (unintelligible) hold 

up -- (unintelligible) keep it transparent. We 

don't want to hold up, you know, settlement of 

some of these claims. I mean would the Secre-- 

is it better to process these through in -- in 

a -- sort of in a bunch, you know, to the 

Secretary or --

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bundle --

 DR. MELIUS: A bundle, okay. 

 DR. ZIEMER: On the other hand --

 MR. HINNEFELD: -- (unintelligible). 

 DR. ZIEMER: -- you don't necessarily want to 

delay some waiting for others. And frankly, 

these types are not that time-consuming for us 

as a Board, as I see it. I mean this is not 

like Bethlehem or -- well, Bethlehem we didn't 

have an SEC, but certainly not like 

Mallinckrodt. The volume of paperwork for 

these two was relatively low compared to most 

things we get, and -- and certainly meeting 

time was not excessive. Larry? 

 MR. ELLIOTT: I just want to speak to bundling. 

We're certainly interested in that approach 

where it makes sense. But I think you need to 

recognize we -- we want to recognize, as you've 

seen in these two examples that have been 

before you today, they're different. And in 

one we say we can't reconstruct any dose 

whatsoever, and in this one we're saying we 

hope we would be able to attempt reconstructing 

external dose, perhaps for skin cancers. So 

you know, the bundling approach may be fine and 
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may provide an efficiency, but we need to be 

very careful in how we treat what we bundle. 

don't want to lose any opportunity here for -- 

for helping claimants with a non-presumptive 

case. 

 DR. MELIUS: Yeah. 

 DR. ZIEMER: Roy? 

 DR. DEHART: I think, as well, it's important 

for the record, and because of that we pretty 

well have to cover some of this material. But 

it's certainly an efficient way of doing it. 

We -- we give the claimant an opportunity to 

speak, we're hearing NIOSH's report, we've had 

an opportunity to review the document and 

events, and we move very quickly. 

 DR. ZIEMER: Wanda? 

 MS. MUNN: It's probably wise for us to be 

extremely sensitive to the individual nature of 

these claims, whether they are small and 

relatively direct or not. It appears, if we 

are to believe our own immediate past history, 

that as long as NIOSH indicates that it's not 

possible for them to do the dose 

reconstruction, that there is no dissention on 

the Board with accepting that. The only 
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dissention seems to appear when NIOSH says they 

can do so and members of the Board do not 

believe that's the case. 

Bundling cannot be perceived, in light of what 

we've seen today, as being an enormous timesaver. On the other hand, there's some merit 

to thinking about it. It just doesn't seem 

wise to break down the process in such a way 

that the individual case does not get at least 

the amount of hearing that each one got here 

today. 

 DR. ZIEMER: Thank you. Robert? 

 MR. PRESLEY: Stu, do we -- do you think are 

going to have any -- the time we have our 

telephone conference in December -- ready to 

go? 

 MR. HINNEFELD: No, I don't believe we'll have 

any more than these. 

 MR. PRESLEY: So we're looking at -- at the 

January meeting somewhere? 

 MR. HINNEFELD: If then, I --

 DR. ZIEMER: At the earliest. 

 MR. PRESLEY: At the earliest. 

 MR. HINNEFELD: The process -- you know, once 

we determine that we have a class of cases, or 
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a case, that we can't do dose reconstruction, 

that requires notification to the claimant -- 

you know, conversation with the claimant and a 

letter exchange, having them sign the Form A 

petition and send it back. So we're not at all 

down that pathway I think on any other 

population right now, so I don't think -- I 

don't know that we'll have any more in January. 

 MR. PRESLEY: Okay. 

 DR. ZIEMER: Well, Stu, it seems to me that one 

of the issues that NIOSH has had to deal with, 

and maybe -- and with your contractor, and I 

don't have a good feel for this, but one -- how 

do you decide in a case like Linde that you 

have come awfully close to exhausting the 

record search? Or -- or are you able to 

determine, from the records that exist, that in 

fact there are not any records out there? In 

other words, it's clear that they didn't do 

monitoring or it's obvious -- we don't have to 

search for monitoring records because we 

already know from other things that they didn't 

do in -- they didn't do urinalysis, for 

example. And maybe you can give us -- use 

Linde as an example. How did you decide that 
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for Linde and how would you decide it for other 

cases --

 MR. HINNEFELD: Well --

 DR. ZIEMER: -- 'cause that's sort of the -- 

sort of one of the issues, have you in fact 

exhausted the records search. 

 MR. HINNEFELD: I'll say this, with pretty good 

confidence, is that the records capture people, 

you know, that we have working for our 

contractor have reconnoitered, at least, very 

many -- very many repositories, and at least 

have some idea about what they're liable to 

find at various repositories, whether it's 

actually been retrieved yet or not. So we are 

-- we think that we are pretty well set in 

terms of knowing what might be out there. And 

if we have a site where we have no additional 

leads and we have collected a lot of 

information and no additional leads, and it 

leaves us with this -- this gap in the data, 

then we're pretty confident the -- you know, I 

guess theoretically if you look long enough and 

hard enough, you may actually find something 

archived, but we're at a point where we feel 

like it's time to stop and -- and do that. 
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There's a category -- you know, there's a 

population of sites that we would expect 

research to be done in a year, just because -- 

some contracting arrangements we have, we 

expect research to be done in a year on a broad 

category of sites with not very many claims 

from them. So when I was saying there is an 

opportunity for a bundle, that is I think the 

best opportunity for a bundle of these cases 

that -- research is done, you know, this -- 

based on this contractual arrangement, these -- 

research on these is done and we make the 

decision now on a number of these, so that is a 

good opportunity for a bundle, and that'll 

happen about a year from now probably. 

 DR. ZIEMER: Uh-huh. 

 DR. MELIUS: I have one other -- I have another 

question. 

 DR. ZIEMER: Fine, then we'll have -- Rich 

Toohey has a comment. Go ahead, Jim. 

 DR. MELIUS: Well, if you're speaking to Stu's, 

go ahead -- go ahead. I -- mine's sort of 

separate. 

 DR. TOOHEY: Are we on? 

UNIDENTIFIED: (Off microphone) Yeah. 
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 DR. TOOHEY: Okay. Dick Toohey, ORAU. I just 

want to mention one -- one of the key indexes 

or indicators we use that data might be 

available are actually the log books from 

Health and Safety Lab where all the air 

samples, many of the urine samples were 

actually analyzed. 

 DR. ZIEMER: Right. 

 DR. TOOHEY: So -- and we have all those 

records. So if, looking at that, we see 

there's data available from a site -- 

 DR. ZIEMER: Right. 

 DR. TOOHEY: -- we feel pretty good. If 

there's no record in the HASL records of 

measurements from the site, we haven't found it 

in any search effort, so we figure well, that's 

it. 

 DR. ZIEMER: Right. Okay, good. 

 DR. MELIUS: Yeah, I'd like to ask a sort of a 

different type of question, and that's related 

to how do you -- like, for example, with Linde 

-- intend to publicize this decision? We're 

pretty far away from Niagara Falls. There's 

people from -- representing workers at that 

facility have shown up at a number of our 
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public meetings on Bethlehem, actually, and -- 

and spoken, so there's some amount of interest. 

And I think -- I think there's -- be some 

benefit to some positive publicity on this to -

- for claimants that, you know, may be eligible 

and are not aware of it. I mean there -- it is 

also probably going to generate other claims 

and other time periods, but -- and you know, so 

be it, I think. I think it's good. But I 

think it would be good for the program, where 

you're being proactive, to go out and -- and 

make sure that -- that people know about that. 

 Now the National Bureau of Standards I think is 

a little bit different situation, but -- 

 MR. ELLIOTT: Yeah, there weren't that many 

people that worked at NBS, so -- 

 DR. MELIUS: Right, right, Linde -- 

 MR. ELLIOTT: Ten to 12, is our understanding, 

and we only had one claim -- 

 DR. MELIUS: Right. 

 MR. ELLIOTT: -- and that was Mrs. Bond's 

father's. But I appreciate your question and I 

agree wholeheartedly that we need to exert a 

coordinated campaign here to notify people. We 

will do that on an individual basis, of course, 
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as we do with all of the classes that are being 

added. We notify each of the claimants, for 

claims that we have in our hands, that their 

claim fits into the class and is being returned 

to the Department of Labor for a determination 

of eligibility and adjudication under that 

class definition. We will use our worker 

outreach program because the site profile, as 

you noticed, was developed back in -- earlier 

this year. 

We need to engage those folks and send them 

back out into the field with that site profile 

and use that opportunity to tell the -- tell 

the audience that we have established a class 

and our site profile covers the later years. 

We want your input, we want your comment about 

that. We want to hear your thoughts about our 

ability to do dose reconstruction or your 

thoughts about our inability to do dose 

reconstruction. 

We will notify the Congressional delegation, of 

course, about this class being added. I think 

-- I think we're going to have to work with 

DOL, as well, if they have another town hall 

meeting scheduled, or something like that. If 
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there's not, then we may need a town hall 

meeting, as well, to go up into that part of 

the country and -- and let people know that 

this class exists now and what we're doing in 

that regard. 

 DR. MELIUS: Okay, good. 

 DR. WADE: If I could have one final comment. 

I know this Board is painfully aware of the 

criticism that's been brought to the program of 

people waiting for years for their dose 

reconstructions to be completed. I think this 

is a very positive development, the mechanism 

that is now available to try and deal with this 

issue. So I applaud the NIOSH program bringing 

this forward and I think it was worth the Board 

spending some time talking about it and 

developing a little bit of an understanding and 

appreciation. But I think this is a very 

positive development, and thank you. 

 DR. ZIEMER: We're now scheduled for a break, 

so we'll recess till 10:30. Thank you very 

much. 

 (Whereupon, a recess was taken from 10:00 a.m. 

to 10:30 a.m.) 

 DR. ZIEMER: We're ready to call the session 
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back to order, if you'd please take your seats. 

 MR. ELLIOTT: Dr. Ziemer, if I -- if I might 

interrupt right now, there was a blue folder 

left on a chair here. It's got a BEIR VII 

report in the front. I just wanted to know 

hadn't claimed it for -- okay. Now I'm going 

to ask -- Jim, will you get this lady behind 

you a copy of this? Thank you. Sorry for 

interrupting. 

PUBLIC COMMENT

 DR. ZIEMER: Okay. Thank you. You may have 

noticed that we actually didn't schedule on 

today's schedule a public comment session. 

However, we have an individual who -- who drove 

up from North Carolina for today's meeting, 

anticipating participating in the public 

comment session. So we do want to accommodate 

that, and so without objection, I'd like to 

have a brief public comment time and allow 

Sherry Floyd from North Carolina to address the 

Board. And Sherry, if you would approach the 

mike, we'd be pleased to hear from you at this 

time. 

MS. FLOYD: Hello, Board. My name is Sherry 

Floyd. I'm from Murphy, North Carolina, and 
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this is my daddy, Clyde Floyd. He worked at 

Savannah River Plant for 35 years. He died of 

melanoma in May of 2001. And my situation's 

unique in that he was no longer married to the 

woman he lived with for 25 years while working 

there. He married a woman the last two years 

of his life. This woman took all the money 

that he had left for me in a trust fund. And I 

filed a claim as a dependent under my father. 

My claim was denied and (unintelligible). The 

unique part of my situation is I was never sent 

a letter with a final decision. It went to an 

old address. I missed out on all the appeals 

processes. And if it wasn't for Terry Berry, I 

wouldn't have gotten a hearing that's coming up 

next month. But I did want to thank y'all for 

approving his claim and trying to help the 

families. I know you have good intentions. But 

you need to know this is not the '50's. The 

men are not still married to the women for 20 

or 30 years. There's several wives probably in 

between. And one woman has ripped my heart 

out. But losing my daddy was the worst, but I 

did want to let y'all know. Thank you for 

letting me speak. 
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 DR. ZIEMER: Okay. Thank you very much for 

sharing that with the Board. 

While we're in an official public comment 

period, I do want to, if there are others who 

came today anticipating that opportunity, we do 

want to open that opportunity as well to any 

others who -- of the public who have comments 

for the Board today. Are there any others? 

 (No responses) 

GIBSON COMMENT 

If not, we will return to our agenda. Before 

we actually go into the scientific issues -- 

and Jim is already -- Jim Neton is on his way 

to the podium, but one of the Board members has 

requested the opportunity to make a comment 

before we begin this session. That's Mike 

Gibson. Mike, if you'll take the floor at this 

point and share with us the item you have. 

 MR. GIBSON: Yeah. Yesterday I -- during the 

program process -- status report I brought up 

the fact that I had heard that sometimes 

claimants and sometimes their survivors are 

asked to provide documentation and medical 

information about their claim. And I was able 

to get a copy of that letter last night, and I 
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just want to read some generic narrative out of 

the letter that I think will demonstrate why 

people are getting frustrated. And then after 

I read that, if counsel wants to make sure it's 

been redacted properly, we can make copies of 

it. But it is a letter from the Department of 

Labor and it says (Reading) This letter is to 

inform you that your husband's (blank) claimed 

under the Energy Employees Occupational Illness 

Compensation Program Act, Part B, has been 

forwarded to NIOSH. While we await the 

completion of your dose reconstruction, we will 

continue to develop your claim under E. 

It says (Reading) We have asked the Department 

of Energy to confirm the types of toxic 

substances that (blank) may have been exposed 

to at the facility. We ask that you provide 

additional evidence so we can make a decision 

on your claim. 

Then it says (Reading) Please list by name the 

toxic substances you believe caused or 

contributed to the claimed conditions. Please 

describe the nature, extent, frequency of 

harmful work exposures. You may also submit 

evidence to establish hazardous employment at 
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the exposures -- at the (blank) site. Please 

specify the exact nature of the claimed 

conditions, when the condition first was onset. 

Please submit a detailed report from (blank's) 

treating physician. The doctor should give an 

opinion with medical justification on the 

connection, if any, between the toxic 

employment exposures to the claimed conditions. 

The narrative medical report should contain a 

complex history, social, family, work, medical, 

exam findings, test results, diagnosis, date of 

diagnosis, course of treatment and a wellrationalized opinion as to whether, how and why 

the employment exposures caused or contributed 

to the claimed condition. The physician 

should discuss the nature and extent of causal 

relationship; i.e., direct causation, permanent 

or temporary aggravation between the claimed 

condition and the harmful work exposure you 

reported. 

Now I -- my question to the Department of 

Labor, I guess, is how -- well, you know, 

there's -- and then the last page, (Reading) 

When we need the information. Please provide 

the requested information within 30 days from 
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the date of this letter. As the claimant, it 

is your responsibility to submit the evidence 

needed to establish a claim under EEOICPA. 

I just personally feel that that is just 

unreasonable to -- to expect that of a survivor 

when, just as the lady spoke before, the 

survivor -- the surviving spouse may not even 

been the -- the spouse that the person was 

married to when they were employed there. And 

number two, as most of you know, with a Q 

clearance you shouldn't discuss what you've 

been working with. So how is this claimantfriendly? I think this shows why people get 

frustrated and -- and give up on their 

complaints. And I think this could really be 

reworked to be a lot more friendly to the 

claimants and/or survivors, and so if the 

Department of Labor would like to comment on -- 

 DR. ZIEMER: Is this a standard Part E letter? 

I -- Jeff, do you know if that's a standard 

letter that goes out under Part E? 

 MR. KOTSCH: Jeff Kotsch, Department of Labor. 

I have to admit that I'm not that intimately 

involved with Part E as I am with Part B as a 

health physicist. But I assume that this is a 
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standard letter. I'll take it back to my 

management that the -- I know that sometimes 

our wording of letters -- it seems like we -- 

you know, much beyond the scope of what people 

can provide, so I'll have to check with them 

and, you know, (unintelligible) -- 

 DR. ZIEMER: Yeah. In this case the issue of 

burden of -- who -- who does the burden rest 

on. Certainly in our part of the program we 

expect -- we don't expect the -- the claimant 

to come up with all that information. It 

appears here that the burden is placed on -- 

clearly on the claimant to -- 

 MR. KOTSCH: Well, even in Part B the burden 

for medical and employment is -- it at least 

starts initially with the claimant and then, 

you know, we provide or we attempt to provide 

assistance through the Resource Centers and 

through other mechanisms, the centers to 

protect workers rights and things like that. 

 DR. ZIEMER: Right, but certainly this listing 

of all the compounds and related things seems 

to go a bit beyond that --

 MR. KOTSCH: That may be -- that may not quite 

be reasonable for a survivor. Hopefully an 
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employee would have some recollection of what 

things he might have been exposed to. Plus we 

have a general feel for -- at the DOE 'cause 

this -- Part E is just DOE sites. We have a 

general feel for what toxic materials are at 

the sites. 

 MR. GIBSON: This -- this letter was to a 

survivor. 

 MR. KOTSCH: Yes, I mean it's probably -- it 

may not quite be appropriate for the survivor 

as persons, you know -- perhaps an employee 

who's still alive. 

 DR. ZIEMER: I don't know the extent to which 

this is directly in our purview, but certainly 

there is, insofar as there's a relationship 

between these programs, and we certainly end up 

getting coupled with the Part E activities 

frequently, it would seem that perhaps -- if -- 

if it's the sentiment of this Board, that it 

would be appropriate to ask that that be 

addressed in some way --

 MR. KOTSCH: I will take the comment back. 

 DR. ZIEMER: -- and perhaps you could report 

back to us --

 MR. KOTSCH: Okay. 
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 DR. ZIEMER: -- the nature of how this is 

handled, what the -- what the real burden is on 

the survivor to come up with information which, 

as Mike indicated, is often classified at the 

front end, anyway. 

 MR. KOTSCH: Right. 

 DR. ZIEMER: You know, I don't know if other 

Board members have comments on this issue or -- 

 DR. MELIUS: Yeah, I --

 DR. ZIEMER: -- suggestions, and -- yes, Jim. 

 DR. MELIUS: Can I -- can I -- well, one is I 

think it's important to realize that the 

Subtitle E program is a very traditional 

workers compensation program, and so it's sort 

of modeled on what's expected of someone in a -

- filing any other sort of workers compensation 

claim, and occupational disease claims have 

always been difficult to assemble the 

information for and so forth, for a variety of 

reasons. The Department of Labor is -- has -- 

my understanding, it has taken some steps to 

try to develop some of the background 

documentation that will facilitate the handling 

of claims and so forth and doing that. And I 

participated in a workshop -- can't remember if 
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you -- were you there, Mark, or -- now I can't 

remember -- with the Department of Energy, and 

I think Jim Neton -- you were part of that, 

also -- to try to develop sort of site profile 

kinds of information and so forth that would -- 

would facilitate this and -- and so forth. So 

I think recognize the problem. 

On the other hand, it's also the -- what's 

requested in the letter also goes back to 

what's in their interim final regulations, and 

(unintelligible) organization -- other 

organizations I know have submitted comments on 

those interim final regulations, pointing out 

the difficulty of assembling a lot of that 

information and the burden it'll put on both 

survivors, as well as people who -- who worked 

at these facilities to bring together all -- 

all -- be able to access and get -- get all 

that information. And so where they -- where 

the Department of Labor goes with this, I -- 

you know, where they draw the bounds, we'll 

have to wait and see. But it -- it --

certainly the points Mike brings -- brings up 

are -- are very appropriate, and I certainly do 

worry for what -- particularly people that 
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won't have -- be able to sort of take advantage 

of what's done under the OCAS part of the 

program where there are the site profiles and 

other information 'cause the site profiles 

don't cover the chemical exposures and so 

forth. And a lot of this will have to do -- 

and -- and again, what we talked about, you 

know, how do you determine disability for 

someone going back -- or an impairment going 

back 20 years. And so it's a lot of 

difficulties with this program. 

 DR. ZIEMER: And Roy, you've had some 

experience with this kind of thing. You have 

some comments for us? 

 DR. DEHART: When the original Part D was under 

the Department of Energy, I did serve as a -- 

as a consultant and early on an evaluator of 

the medical documentation. Jim's absolutely 

right. This is a worker compensation claim 

situation, and even in the best of 

circumstances it is often very, very difficult. 

We're not dealing, in this case, with a loss of 

limb or musculoskeletal problems which tend to 

be common worker compensation issues that are 

more definitive and defining. We're dealing 
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with heart attack, stroke, metabolic diseases 

such as diabetes, ulcer diseases, liver 

diseases. These are the general complaints 

that they're getting and they're trying to tie 

that to the kinds of exposures or the work 

stress that the worker sustained while 

employed. 

The more medical records that are available, 

the easier it is for an evaluator -- or in this 

case, generally not a physician, a claims 

manager -- to make a recommendation. I totally 

agree that it is beyond the capability of many 

of the people making the claims to be able to 

provide the information in detail. But I think 

it needs to be requested, if available. 

I would also suggest that possibly they would 

be willing to consider -- and I don't know that 

they do in Part E -- affidavits in lieu of 

medical records. That would ease the burden if 

that were possible, but I don't -- I don't know 

if that is currently allowed in that -- in that 

process. 

I can tell you that I reviewed documents on 

claims under Part D that would be 600 to 1,000 

pages, with all the medical records from 
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hospitals, et cetera, and this is -- this is 

what is happening. This is what they're 

requesting. And the medical records can be 

very comprehensive. But if a person died in 

the '50's and there was a worker compensation 

claim for someone who was in their fifties and 

theoretically had 15 more years of work to do, 

there could be substantial dollars involved, 

but yet unable to acquire the medical records 

because the records have been destroyed -- 

which is permissible after a period of time. 

The practitioners are no longer available -- 

retired, moved, dead. And it -- it is really a 

complicated situation and I -- I totally agree, 

if there's a way of easing that burden on the -

- on the claimants who may not have access to 

records, that would be helpful. 

 DR. ZIEMER: Yeah. Well, at least Department 

of Labor's been made aware of these concerns 

and perhaps Jeff will be able to come back with 

some positive report for us on that. Thank you 

very much, Mike. 

 DR. WADE: (Off microphone) Do you 

(unintelligible)? 

 DR. ZIEMER: I think we'll hold that till the 
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work session. 

SCIENCE ISSUES, DR. JIM NETON, NIOSH: 

It's been a while since we've addressed our 

list of what we've called "science issues," 

which are sort of the backbone of some of the 

dose reconstruction work. But we have a number 

of these back on the table for us today, and 

Jim Neton is going to present some of the 

breaking issues on -- on our science as far as 

dose reconstruction is concerned, and some 

possible upcoming changes to consider. 

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

You're absolutely correct, it's been a while 

since we've had a discussion about science 

issues, so I'm here to present to you a 

discussion on four issues that have appeared on 

the Board's priority listing in the past, and 

there -- there are four areas where we -- we've 

done some work, made some progress and, as Dr. 

Ziemer pointed out, are going to make some 

changes -- either proposed changes or in the 

process of making those changes at the current 

time. 

I'd like to acknowledge that, although I'm the 

spokesman standing up here, I certainly don't 
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purport to be the expert on all of these issues 

in depth, and I have a great support staff back 

there of the science team -- Russ Henshaw and 

Brant Ulsh, as well as our friends at SENES Oak 

Ridge who are responsible for some of this 

work. And in addition, the Health-related 

Energy Research Branch folks who are here who 

are engaged in some of this work, as well. 

CLL ACTIVITIES 

The four issues that we're talking about are 

chronic lymphocytic leukemia. As the Board is 

aware, this is the only cancer that is 

currently excluded from compensation. It's 

assigned a probability of causation of zero, 

and I'll get into the reasons for that and what 

we're going -- where we're going with what 

we've done so far in that area. 

I'd also like to talk a little bit about dose 

reconstructions for lymphomas -- not the risk 

model, but really what is the relevant target 

organ to reconstruct the dose -- where -- where 

is the relevant target organ for the dose to be 

reconstructed. 

And so the two -- the first two bullets deal 

with lymphocytes -- the lymph system in 
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general, and then the last two deal with the 

cancer risk models. That is the cancer risk 

adjustment for the age at exposure. There's 

been some evidence in the literature, as the 

Board is aware, that the age at which one is 

exposed to radiation may have an effect on the 

excess relative risk per Sievert, and also -- 

will finish up with the probability of 

causation for lung cancers. And more 

specifically, some adjustments that have been 

made by the National Cancer Institute related 

to smoking and -- and how we propose to 

incorporate their model into the NIOSH-IREP 

model. 

That said, this go on for a while. I know I 

tend to be long-winded, so we can stop at each 

point maybe and have a discussion if that's -- 

that's preferable. I think that probably is, 

so I'll proceed that way. 

As I mentioned, chronic lymphocytic leukemia is 

the only cancer that is excluded in 42 CFR 81 

from compensation. That regulation was issued 

in May of 2002. It was excluded for a number 

of reasons. Primarily, there were no published 

studies to support an association between 
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exposure and increased risk for chronic 

lymphocytic leukemia. We couldn't identify any 

at the time. It was also traditionally 

regarded as non-radiogenic by outside expert 

committees such as the BEIR committee and 

ANSCEER*. And on top of that, there was no 

risk model to apply. I mean no one -- no one 

had come up with a relevant risk model to use 

at that point. 

However, we did note in our evaluation that at 

a later time frame we would revisit this issue, 

and that's what I'm here to report on, our 

progress on where we are with this issue. 

So what -- what has been done. There's been a 

number of things going on that NIOSH has done 

some research in this area, and at this point I 

need to acknowledge the work of the Healthrelated Energy Research Branch, which was 

provided some money ear-marked by Congress for 

research into this area specifically. To that 

extent, HERB -- NIOSH/HERB convened a public 

meeting in Washington, D.C. in July of last 

year to have a panel discussion, a frank panel 

discussion about data gaps in chronic 

lymphocytic radio-- chronic lymphocytic 
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leukemia radiogenecity research -- that's a 

mouthful to say. 

 This panel discussion was -- included six 

invited experts. There was a public forum and 

discussed a wide-ranging array of issues in 

both molecular and epidemiologic CLL research. 

There were several written products produced as 

a result of that meeting. One was an annotated 

bibliography of the research that had been done 

in this area, and also the minutes -- or the -- 

a summary of that meeting has been published. 

And in fact, as of a week or so ago, that's 

been published as a NIOSH numbered document. 

believe the Board was e-mailed a copy of that. 

There are also copies available at the back 

table. It's a fairly extensive write-up -- I 

think it's about 100 pages long -- that just 

essentially paraphrases everything that was 

said by all the participants in that meeting. 

HERB -- based on the results of that meeting, 

NIOSH prioritized the CLL efforts under -- how 

they were going to approach -- you know, what 

they were going to do with CLL research, and 

one of the main thrusts of that research was to 

incorporate, where possible, CLL research into 

I 
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the ongoing epidemiologic studies that they had 

already had in place. They have done that. 

They've included that in two studies thus far 

that are completed, and redone the analysis to 

include CLL to see if any excess risk could be 

teased out of those studies. Thus far they've 

not been able to make any determin-- definitive 

determination as to how CLL could be used in an 

epidemiologic analysis. In fact, this is one 

of the key issues with CLL is it's very 

difficult. The number of cancers that are 

reported in the literature are difficult. 

Reporting is confusing over time, and it's -- 

it's just a difficult cancer to develop risk 

models for from an epidemiologic perspective. 

NIOSH has intended to produce, as a result of 

this meeting, a structured review of the 

literature that would be published in the peer 

review literature. It's a much-expanded 

version of the annotated bibliography that 

would essentially be a critique on the studies 

that have been done thus far and what the 

status is at the current time. 

 We've also worked with the International Agency 

for Research on Cancer to apply -- to do a 
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pooled analysis of the data that they had 

available, I believe it was for the U.S. 

cohorts, to look at CLL in their cohort to 

determine if any definitive association between 

CLL and radiation exposure could be determined, 

and the results of that are not yet available. 

So there's a number of areas that the Healthrelated Energy Research Branch is 

investigating, and those studies are ongoing. 

NIOSH activities related to the compensation 

program -- that is OCAS's mission on this -- 

have also been ongoing. We solicited opinions 

from five outside experts in 2004, and we asked 

them a question relevant in the context of a 

compensation program only. This was not a 

research question, but we asked them a specific 

question, and I provided you a quotation of 

what was in that packet that we mailed them, 

and essentially it says (Reading) In your 

expert evidence -- in your expert judgment, is 

there evidence between radiation exposure and 

the risk of developing CLL sufficient to 

continue to regard CLL as a non-radiogenic 

cancer and to continue to exclude it, a priori, 

from eligibility for compensation. 
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It's a fairly loaded question, but we wanted to 

get the question on the table and see -- see 

what we could elicit from these experts. So 

I'm just going to go through one by one -- and 

keep in mind when I'm talking, this is just a 

paraphrase, a snapshot, of what their -- their 

opinion was. The first -- and these are in 

alphabetical order so there's no significance 

to the order that I'm presenting these. 

 The first opinion was Dr. John Boice, who is 

the Scientific Director of the International 

Epidemiologic Institute and a professor of 

medicine at Vanderbilt University. And Dr. 

Boice's opinion was that the body of scientific 

evidence does indicate that CLL is not caused 

by exposure to ionizing radiation. That was a 

pretty definitive opinion from Dr. Boice. 

If one -- the next opinion that we solicited 

was from Dr. Mark Crowther, who is associate 

professor of medicine at McMaster University, 

and he is board certified in hematology and 

internal medicine. In Dr. Crowther's opinion, 

CLL is clearly not different from other forms 

of cancer. And in his opinion available 

evidence is insufficient to rule out an 
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association. 

 Next opinion, from Dr. David Ozonoff, who is a 

physician, a professor of environmental health 

at Boston University, states that the argument 

for continued exclusions are weak and lacking 

foundation. And he does support including CLL 

as a radiogenic cancer and against continuing 

to exclude it. Actually he believes the 

practice to be an arbitrary exclusion. 

 And finally, the opinion -- or next opinion of 

Dr. David Richardson, who many of you may be 

familiar with. We've used Dr. Richardson in 

the past for other -- other issues, such as the 

lung cancer risk model that we're going to talk 

about in a little bit. Dr. Richardson's 

opinion is the available evidence does not 

provide sufficient grounds for continuing to 

regard CLL as non-radiogenic. 

And finally, the fifth opinion, is from Dr. 

Lydia Zablotska, who's assistant professor of 

clinical epidemi-- did I go forward? I'm sorry 

-- is Dr. Zablotska's opinion. Her opinion is 

that from an epidemiologic perspective it is 

not possible to prove that there is no risk. 

It is only possible to say that we do not have 
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solid scientific evidence. 

So that's sort of in the middle of the -- of 

the opinions. 

So essentially what we have here is three of 

five outside experts recruited by OCAS argue 

against excluding CLL and one is sort of in the 

middle ground. 

This is a preliminary report. While we've got 

these expert opinions in-house, we've got the 

HERB ongoing research activities. So right now 

we're still in a pre-decisional status on this. 

We have not made a determination, but I would 

say that we are in parallel processing. We're 

not pre-deciding whether it should or should 

not be covered. But one also needs to have a 

risk model to use, so we're in parallel trying 

to develop a risk model, and that would have to 

be in place if we were to decide that CLL was a 

covered cancer. And we'd be happy to report 

more fully when we've made a decision on this 

issue. 

I think at that point I'll open up the question 

 DR. ZIEMER: Okay, so before we go on to 

lymphomas then, discussion on the CLL issue -- 
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again indicating it's essentially still open as 

far as the agency's concerned. Roy DeHart. 

 DR. DEHART: Jim, do you have any idea what the 

number is of -- of current claimants that would 

have chronic lymphocytic leukemia? 

DR. NETON: No, those are not forwarded to us 

by the Department of Labor. They're excluded 

from -- from coming over to us, so I really 

don't know. I --

 DR. DEHART: You don't even see them then. 

DR. NETON: No, we don't -- we did early on. 

There was a -- they were coming over there 

erroneously. I mean they were passing us on 

and we sent some back, but you know, there were 

-- there were not a large number at that point. 

But I really couldn't speculate as to what the 

total number is. 

 DR. DEHART: Is someone maintaining a log of 

those claimants in case there is a reversal? 

DR. NETON: I'm sure the Department of Labor 

would know which cases have been denied based 

on the fact that CLL is an uncovered condition. 

And if there were a reversal, we would -- we 

would be able to reconstruct that and notify 

claimants, I'm sure. 
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 DR. MELIUS: Yeah, I --

 DR. ZIEMER: Jim. 

 DR. MELIUS: Yeah. This -- this situation's a 

little bit different than some of the other 

issues we're considering 'cause CLL's excluded 

in the law, so it's not like a decision we can 

make and -- or recommendation that we can make 

and that it -- IREP gets changed. It would 

have to -- require a legislative change. 

 However, having said that, I would urge you to 

-- I think to take the same approach that you 

did in the lung cancer case. I thought the 

documentation that you sent us for that was 

very -- was excellent. It was very useful to -

- to have because it sort of laid out the 

options and what the implications were -- were 

of those options. 

I think in this case that whatever decision or 

-- you know, you make or however you want to 

frame that, I think it would be useful to have 

the background saying well, what -- what really 

would be the implication, what would be 

involved in adding CLL to the IREP risk model 

and what does it really mean, because I -- the 

risk's going to be low. I mean that -- in --
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no matter how you, you know, cut it and so, you 

know, what is the -- really the meaningfulness 

of that -- and it may not even be possible to 

add it, I mean in sort of a scientificallydefensible way given what's known. And then --

but I think laying that out and whether you 

want the Board to endorse that in some way or 

whatever is -- is fine, it's really up to you. 

This is a little different situation, as I 

said. 

But secondly, I -- but I also urge you in doing 

-- if you do do that is then also talk about -- 

lay out what you are doing to address the issue 

in terms of, you know, research and so forth, 

to the extent that's appropriate, really since 

Congress has already asked you to give some 

prior-- priority to that issue. But I think 

having that kind of document available would 

really be helpful 'cause claimants with CLL are 

going to continue to, you know, be concerned 

and -- and I think we really do need something 

that's -- lays out what -- what is -- how much 

-- what would it really mean, what effect would 

it have even if you, you know, decide to 

include it in the IREP model, or is it even 
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possible to do so. And then -- you know, and 

it's -- you know, first or -- or lastly, you 

know, is it really justifiable to do so and -- 

I also think that for the credibility of the 

program, it's also important because there are 

strong differences of opinion sort of expressed 

there and sort of, you know, just an assumption 

that it's not related and therefore you 

shouldn't even consider it. Well, I think you 

can lay out a good sound document, I think it 

would be helpful. 

DR. NETON: I definitely agree. The reason 

we're taking such a measured approach here is 

that this will require rule-making. It 

wouldn't be a -- it's not a legislative issue. 

It's in our rule. Liz maybe can speak -- speak 

to that. 

 DR. ZIEMER: Yeah, Liz, you want to address 

that? Is this legislative or rule -- 

MS. HOMOKI-TITUS: No, it's not in EEOICPA that 

CLL is excluded. It's actually in the dose 

reconstruction rule --

 DR. MELIUS: The rule --

MS. HOMOKI-TITUS: -- so it wouldn't require a 

change by Congress. It would require a rule-
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making by HHS. 

 DR. MELIUS: Oh, okay. 

DR. NETON: And certainly going through rulemaking we'll --

 DR. MELIUS: Yes. 

DR. NETON: -- this thing will be vetted very 

thoroughly before we make any changes. 

 DR. ZIEMER: But aside from that issue, if -- 

if you did go to rule-making, basically that 

allows consideration of it. But I think you 

kind of put your finger on the issue, that even 

so, the -- the risk value is going to be very 

slow -- very low. If it wasn't, you wouldn't 

have this issue to --

DR. NETON: Right. 

 DR. ZIEMER: -- start with. And the fact that 

in a sense the experts are split on this 

accentuates the fact that the risk is so low 

you can't really -- really ascertain whether it 

is there or not. So how would you go about 

actually establishing a risk number that could 

be used, for example, in IREP, if you took care 

of the a priori exclusion to start with? 

 MR. ELLIOTT: Well, that is the challenge for 

us right now, but -- and I appreciate the well-
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made points from Dr. Melius on this. But I 

would add this for your consideration. There 

are other cancers that we included in our -- in 

the IREP, like prostate, that's not recognized 

as a radiogenic cancer. But yet we were able 

to come up with a risk model, albeit it's -- 

the risk coefficients are very, very low there, 

so I would just posit that, that -- you know, 

if we can do that, there must be some way we 

can come up with some sort of risk model for 

CLL, and that's the challenge that I've placed 

before the science team. So that's what we're 

working on. 

 DR. ZIEMER: So they're -- even as we speak, 

they're looking at -- are they looking at at 

this point --

DR. NETON: Yes. 

 DR. ZIEMER: -- as to how -- how to construct 

that risk model and --

DR. NETON: Right. 

 DR. ZIEMER: -- are we going to hear about that 

at this point or --

DR. NETON: No. 

 DR. ZIEMER: -- no. There's not --

DR. NETON: We're not -- we're not far enough 
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down the line on that. 

 DR. WADE: Are you willing, Jim, to talk about 

a time frame when the Board would likely hear 

as to whether you're successful? I assume if 

you can't develop a risk model, then the 

question's moot. But if you can, then the 

question's open. 

DR. NETON: Right. I'm reluctant to give a 

time frame at this point. It is very 

preliminary. Chronic lymphocytic leukemia -- I 

feel like Stu, it would be very speculative on 

my part to -- to make a judgment there. CLL 

has characteristics of both leukemia and 

lymphoma, and the model is somehow going to 

have to address that. We are working with 

SENES/Oak Ridge, our friends over there, to 

help us in this endeavor. But I really 

couldn't speculate at this point. 

 DR. MELIUS: Yeah, but --

 DR. ZIEMER: Another comment, Jim? 

 DR. MELIUS: I would just elaborate that -- not 

to say not to take those steps or not to look 

into what extent you can do it, but as compared 

to prostate and some of the other cancers, I 

mean there is a fair amount of scientific 
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scrutiny that more scientists (unintelligible) 

put to the CLL issue in terms of studies 

because other leukemias are so radiogenic and 

just this one stands out. And so it's -- I 

think it's a different type of -- of issue in 

some ways and I think you have to be sensitive 

to that and, again, to maintain sort of the 

scientific credibility of what you do. Again, 

I think laying out sort of the options and not 

-- not to not pursue what you're doing, but I 

think it has to be thought about, you know, 

where's the scientific basis for that and is it 

feasible to do and then, you know, what are the 

-- what would be the implications of -- of 

that. 

DR. NETON: This would be -- a very good 

comment. I agree with that. This would be 

very precedent-setting. There -- to my 

knowledge, there's no other compensation 

program that considers CLL in a radiation 

compensation arena. 

 DR. ZIEMER: Other comments on CLL? 

 DR. WADE: Just before Jim goes on, one of the 

things that, you know, it would be good for the 

Board to speak to NIOSH on on science issue -- 
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science issues in general is priority. So I 

think when we finish these, we -- we could have 

a discussion giving some sense of priority to 

NIOSH on these issues. 

DR. NETON: Good point. I didn't bring with me 

the --

 DR. ZIEMER: There is an existing priority list 

DR. NETON: Right. 

 DR. ZIEMER: -- on scientific issues. Of 

course that could change as we learn more. 

DR. NETON: I'm sorry, I probably should have 

started off with that list, and I didn't. I 

apologize for that. That would have been 

instructive to do that. 

 DR. ZIEMER: Well, let's proceed then with 

lymphoma, Jim. 

LYMPHOMA RISK MODEL 

DR. NETON: Okay. Lymphoma is not -- was not 

really on the scientific issue radar screen. 

It's something that NIOSH self-identified in 

our continuing effort to use the best available 

science to do these dose reconstructions. And 

if I can get to the slide -- it has to do with 

the target organ selection. It has nothing to 
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do with the lymphoma risk model, it has to do 

with when one is presented with a case of 

lymphoma and a health physicist receives the 

packet, what is the relevant organ to 

reconstruct the dose for. I mean where -- 

where is that dose relevant. And it turns out 

that -- on the surface it seems like a very 

simple issue, and it has turned out, as most 

things in this program, to be much more complex 

than one could imagine. And I've learned more 

about lymphoma biology than I ever thought I 

would in going through this. And I give Brant 

Ulsh a lot of credit here. He is -- he has 

been the main driver behind researching this 

issue. 

So like I said, we initiated a re-examination 

of the internal and external dosimetry target 

organs for lymphatic/hematopoietic cancers. 

What -- what we had done in the past was if we 

were presented with a lymphoma and it was -- 

there was a diagnosis that -- a biopsy was 

taken, we would use that site of biopsy as the 

organ in which the lymphoma occurred. It turns 

out that's good in some cases, it's bad in 

other cases, and let me just tell you the 
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story. 

And our goal was to ensure target organ was 

correctly reflecting the best science. So we 

actually went out and obtained an expert 

opinion from a board-certified clinical 

hematologist on this, as well as an expert 

opinion from a dosimetrist who's on the ICRP 

committee, so we kind of have both issues 

covered, is this the right organ, and then are 

we doing the dosimetry right. 

So it turns out that there's two types of 

lymphomas. There is one that we call -- we 

will call structural lymphoma, and that really 

is a lymphoma that involves the cells that make 

up the lymph nodes themselves. These are just 

structural lymphocyte cells that make up the 

lymph system that develop a cancer, and it turn 

out that the site of occurrence of those organs 

-- of those cancers is instructive as to when -

- where the -- where the relevant radiation 

damage would have occurred. These types of 

lymphomas would be Hodgkin's Disease, reticular 

sarcoma and lymphosarcoma. So I have a listing 

here of the ICD-9 codes, international 

classification of disease, revision 9 codings 
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for these -- what we call structural lymphomas. 

And they're all the 200 series, and so when we 

have a diagnosis that said that this lymphoma 

was diagnosed in the abdomen or the pelvic area 

or the spleen, it gives us a clue as to where 

we should be dose -- organ we should be 

reconstructing. 

So for instance, in the -- if it was diagnosed 

in the spleen, we would do an internal dose 

reconstruction for the spleen. This HNMO 

stands for highest non-metabolic organ, and 

what that means is we have no idea that this 

material concentrates anywhere in particular, 

so we will assign it the dose of the highest 

organ that doesn't concentrate this radioactive 

material. In some locations, like the axilla, 

this would be the thoracic lymph nodes that are 

very near the axilla; thoracic lymph nodes 

again; in the head the extra-thoracic lymph 

nodes. So we have -- it gives us a clue as to 

where we should be reconstructing the dose for 

these structural lymph nodes -- structural 

lymphomas. 

 In the external area it's the same thing. We 

know in general the location of the origin of 
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the damage, and so we will assign an external 

dose accordingly. It's a little confusing when 

you see here why one would use -- let's say, 

for instance, a stomach for the spleen, and 

this actually happens to be a point of 

confusion among many claimants. This has to do 

with the fact that when we convert a badge 

dose, a film badge dose to an organ dose, the 

ICRP models do not give us the dose for every -

- the conversion factor for every single organ 

in the body, so we pick what we would call a 

surrogate organ that is the organ closest to 

that -- to that particular organ. So for 

instance, we would use the ICRP conversion 

factor from film badge dose to stomach to 

calculate the dose to the spleen. I hope I 

haven't confused everybody, but that -- that's 

been our practice and I -- and where -- where 

the organs don't match up perfectly, we try to 

pick one that would actually be a slight 

overestimate of the dose. 

Okay, the picture gets a little murkier when 

you start talking about B and T cell 

lymphocytes. These are lymphomas that involve 

these actual circulating lymphocytes 
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themselves. These circulating lymphocytes can 

become malignant and settle in the lymphatic 

system, and essentially develop tumors 

themselves. What'll happen oftentimes, as we 

found out, is a physician will go take a biopsy 

in a -- in a lymph node that is most 

convenient. And when they take the biopsy 

sample, they will use that to diagnose 

lymphoma. That in no way is informative about 

where the lymphoma started. Since these same -

- these lymphocytes are continually 

circulating, we really have no a priori 

knowledge as to where they were when the 

radiation damage occurred. This is most 

significant in the internal dose calculation, 

'cause if you have no knowledge, then you -- 

you know, you -- you have to speculate as to 

where -- where the damage may have occurred. 

So what we've done is we said if we don't know 

and one has a lymphoma that is a -- a cancer of 

a -- that started with a cancer of a 

circulating lymphocyte and we know that the 

lymphocytes reside predominantly in the lymph 

system -- I mean they are in peripheral blood, 

but most of them are in the lymph system -- we 
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will pick the highest lymph node. Well, it 

turns out we -- most -- in most cases, 

inhalation exposure is the route of entry that 

gives you the highest dose. And when you do 

that, there are the thoracic lymph nodes that 

drain the lung region, and those are the lymph 

nodes that become most heavily irradiated. 

So we are proposing a new procedure that I have 

on my desk that I'm ready to sign any minute to 

re-evaluate all lymphomas and use the thoracic 

lymph node as the organ to be reconstructed for 

internal dose. This will make a huge 

difference. I think we have about 500 

lymphomas that we've evaluated. As I indicated 

earlier, almost all those were done using the 

highest non-metabolic organ. The thoracic 

lymph nodes are a very small mass of tissue, 

maybe 30 grams of tissue, and they clear all of 

the radioactivity that's inhaled in the lungs. 

So the doses to these organs is -- is going to 

be pretty large, so the -- it's -- it's the 

first time I think that we're likely to change 

a -- change a dose reconstruction concept that 

will result in a large change in the number of 

compensable claims that have heretofore been 
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denied. 

 In the external region we'll pick the highest 

organ that is -- that -- the highest organ, 

whether it's the lung or the thymus. It has a 

difference between -- T cells and B cells stand 

for bone and thymus lymphocytes. The site of 

origin for those lymphocytes is relevant, so 

we'll just pick the -- whether it's the thymus 

or the lung. If it's a B cell -- let's see, if 

it's a T cell lymphocyte, we'll pick the 

thymus. If it's a bone lymphocyte we'll pick 

the lung. If it's indeterminate, we'll pick 

the thymus, which tends to give you the highest 

external dose. 

These are pretty trivial corrections compared 

to what we're doing over here in the internal 

arena. These -- these doses are going to go up 

orders of magnitude. This -- this is likely to 

change by percentage points. 

There's a couple of odds and ends that just 

didn't fit the model, and this is where the 

devil's in the details and Brant has done a lot 

of work in all these various ICD-9 codes. 

There's a disease called mycosis fungoides -- I 

hope I'm pronouncing that right, for our 
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medical folks that are here -- and it's 

actually a -- involves the skin and it's a 

lymphocytic and -- cancer that's associated 

with the skin. So in this particular ICD-9 

code we would use the skin dose from an 

internal dose calculation perspective, and use 

the external skin -- skin dose to the external 

-- the external dose to the skin, as well. 

While we were looking through this we decided 

well, let's just take a look at leukemia and 

multiple myeloma and make sure we're on the 

right page with that, and -- and fortunately we 

were. And the external and internal dose is 

relevant. We calculated the bone marrow, which 

has been our practice all along, and so we're 

still comfortable with that. We're just going 

to proceed that way. 

The final note here, hairy cell leukemia is 

listed as leukemia by nomenclature, but it is a 

lymphoma under the ICD-9 code, so that's 

another minor exception. 

So I think with this analysis we've got the 

waterfront covered now on lymphomas. We're 

eager to go back and start re-reviewing these 

cases. It becomes a little more complicated, 
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again, than you'd think because many of these 

lymphomas were -- were evaluated under the 

efficiency process. So we've given some very 

large doses and demonstrated the PC is less 

than 50 percent. So now it will require us to 

go back to the drawing board and do a more 

detailed dose reconstruction to determine what 

-- what the relevant dose is. It may not be as 

bad as we think, though, because of the -- it 

doesn't take much inhalation dose to get those 

30 grams of lymph tissue irradiated to a pretty 

large extent, particularly when you're dealing 

-- this is most relevant to alpha -- inhalation 

of alpha-emitting radionuclides. 

Okay. And -- and as I suggested, we're 

currently re-examining our past lymphoma cases 

and we'll be sending notices to the Department 

of Labor as -- as we process them. 

I've been a little long-winded on that, but I 

think I've got the message. Are there any 

questions? 

 DR. ZIEMER: Let's take some questions. Jim, 

do -- have you in the past and do you still 

distinguish between structural and B/T 

lymphomas? So is this only applied to the B/Ts 
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that --

DR. NETON: Yeah, it's the -- it's the 

circulating lymphomas. We've -- I think we've 

been -- and Brant, help me out here, I think 

we've been okay with the -- with the Hodgkin's 

lymphomas. We've been doing the right organ 

calculation for those. It's --

 DR. ZIEMER: So the --

DR. NETON: -- (unintelligible) practice to use 

the site --

 DR. ZIEMER: So the diagnoses do provide that 

level of distinction --

DR. NETON: Right. 

 DR. ZIEMER: -- in -- at the front end, so -- 

DR. NETON: Correct. 

 DR. ZIEMER: Okay. Okay, Wanda and Jim. 

 MS. MUNN: Actually Jim was first. 

 DR. ZIEMER: Jim and Wanda. 

(Pause) 

 MS. MUNN: I think I missed something. What 

was -- what's the rationale for changing from 

the highest non-metabolic organ to the 

lung/thymus? 

DR. NETON: Well, the highest non-metabolic 

organ was for the internal exposures. 
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 MS. MUNN: Right. 

DR. NETON: And we believe that the site of -- 

the site of diagnosis was relevant or the site 

of diagnosis was informative about where the 

lymphoma originated. And since the site of 

diagnosis was in the general lymph system, we 

just picked -- and the lymph system is not 

specifically modeled by the ICRP, we assigned 

it the dose -- the highest dose to what's 

typically called "other soft tissue" and just 

used that value in the calculation. Since --

since we believe that the site of diagnosis was 

not the thoracic lymph nodes. See, if we had a 

site of diagnosis that said that the lymphoma 

was diagnosed in the thoracic lymph nodes, we 

would have done that calculation. 

 MS. MUNN: Uh-huh. 

DR. NETON: But typically what they do is 

they'll take a biopsy punch of the axillary 

lymph nodes or some -- someplace else and say 

here's where we found the lymphoma. So we --

we believe that to be the site of origin. So 

we did not know what the dose to those lymph 

nodes were, but we knew that ICRP modeled all 

soft tissue, so we would just pick the highest 
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other soft tissue that we could find to assign 

that dose. Am I -- am I --

 MS. MUNN: That sounds reasonable to me, but 

what I think I hear you saying now is since the 

lymph system is so pervasive that you have no 

faith in which organ is the highest nonmetabolic organ, and therefore you're going to 

choose the highest of all potential internal 

organs; i.e., the lung. 

DR. NETON: No, it's a little bit different 

than that. What we're saying is that the -- 

the cancer of the circulating lymphocytes could 

have occurred -- the lymphocytes circulate 

throughout the body. 

 MS. MUNN: I understand. 

DR. NETON: So the radiation damage to that 

lymphocyte could have occurred anywhere where 

it was circulating. 

 MS. MUNN: Uh-huh. 

DR. NETON: Given that, we have no idea in what 

organ the lymphocyte was when the radiation 

damage happened. Given that, we will pick then 

the highest lymph node exposure and assume that 

that's where the damage occurred, which in -- 

in almost all cases will be the thoracic lymph 
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nodes. 

 MS. MUNN: Well, I can see that would certainly 

be claimant-friendly. My concern is always 

whether the claimant-friendly issue is 

overriding the known science. And what you're 

telling me is you -- the model that you're 

working from doesn't really give you that 

option. Right? 

DR. NETON: Right, well, we --

 MS. MUNN: Essentially. 

DR. NETON: We looked at a few options. One 

was to take a weighted average of where the 

lymphocytes reside on a time-weighted basis. 

mean we had -- believe it or not, the ICRP 

models get down to that level. 

 MS. MUNN: Uh-huh. 

DR. NETON: But the values were so uncertain, 

and by the time we would put uncertainties 

about those, I thought it was much more 

defensible just to pick the highest 

(unintelligible) the highest lymph node value 

itself. 

 MS. MUNN: When the bars get out there so far, 

there's no point --

DR. NETON: That's exactly right. 

I 
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 MS. MUNN: -- in dealing with it, yeah. 

 MR. ELLIOTT: I'd like to provide maybe a point 

of clarification that answers your question, if 

I could, from a simple lay person's 

interpretation here. What we're saying is that 

the -- the organ of diagnosis does not lead to 

-- to understanding of the organ of origin. 

 MS. MUNN: I understand that. 

 MR. ELLIOTT: Okay? And so we're picking what 

we think is the highest organ of origin to use 

in reconstructing the dose against that. 

 DR. ZIEMER: Since you can't otherwise 

(unintelligible) --

 MR. ELLIOTT: Since we can't otherwise, right. 

 MS. MUNN: Yeah. 

DR. NETON: That's exactly right. 

 DR. ZIEMER: Jim. 

 DR. MELIUS: Yeah, that's a good point. I have 

one caution and then a procedural question. 

The caution would be that the nomenclature and 

classification for lymphomas have changed over 

time, as well as the way that they are 

diagnosed -- the diagnostic information. And 

you may have difficulty with older cases in 

particular converting them to this scheme. 
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They -- they -- in terms of the available 

information and -- and the way that they're -- 

they're classified in the medical records. And 

you're going to have to give some thought to 

that. I -- I'm trying -- I'm trying to think 

in my mind, going back through the older 

classification systems for lymphoma, how it -- 

whether -- to what extent it will impact. But 

I think it will because I think some of the 

systemic lymphomas that you're referring to 

here are going to be classified anatomically in 

some of the older nomenclatures. And that's 

what you're -- you're going to see. And some 

of the newer methods now to determine that they 

are a certain systemic lymphoma just weren't -- 

the tests just weren't available 20 years ago 

or even, some of them, ten years ago. So I --

Roy may have some additional comments on that. 

My -- I don't think it's insurmountable, but 

there will be some uncertainty on that. 

 Procedurally, I'm a little concerned that we're 

making a -- you are, you know, offering up a 

very significant change, it's going to have 

significant impact, in terms of your dose 

reconstruction methods. And that we're being 
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asked to approve that based on a small number 

of slides -- presentation, without a document 

to refer to. And I would even question -- and 

this goes back since -- to our beginnings as a 

advisory board -- as to whether this shouldn't 

be federal -- noticed in the Federal Register. 

I recall, and I don't recall specifically, but 

we had talked about a -- that significant 

changes would be noticed and public would have 

an opportunity to -- to comment on them. I'm 

personally in favor -- by doing it. I think it 

is justified, but I am -- even I can say I'm 

not quite sure what I'm approving of because I 

don't -- you haven't even written out the 

classi-- all the classifications here and -- 

and looked at some of these issues, so I'd like 

some comment on the procedural issues. 

DR. NETON: Well, I'd like to address your 

first comment, which is that the uncertainty 

about classification of lymphomas. We -- I'm 

aware -- I've become aware of that, and it's 

certainly a big issue. However, that -- the 

responsibility for that codification lies with 

the Department of Labor. We take whatever ICD9 code is delivered and we'll use it. I'm not 
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saying that makes it better, I'm just saying 

that we need to make sure that the Department 

of Labor is very aware of this and -- 

 DR. MELIUS: Yeah, and I -- I think they may 

need some documentation that helps them do 

this, and I think you should have -- you have 

some responsibility getting that to them, 

parti-- particularly to these older cases, 

which a lot of these will be, from survivors 

and -- it's been significant change. I can't, 

from the top of my head, sort of -- I don't 

think it'll affect a lot of cases, but I think 

it -- there'll be a significant number that 

will be impacted -- there'll be some 

uncertainty about and how to fit them into the 

classification. I believe there are even 

regional differences, particularly before 

cancer registries became common, that you'll 

find in older medical records in terms of when 

-- like hematologists or whoever -- physicians 

were trained and where they were trained in 

terms of what -- what some of these tumors are 

called. 

 DR. ZIEMER: Roy, can you speak to that point? 

Roy DeHart, you want to speak to the point 
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there? 

 DR. DEHART: Jim, I was really surprised that 

you're getting significant anatomical location. 

In reviewing medical documentation over recent 

years where lymphoma was the issue, the 200 or 

the 202, usually the codings that I see are .00 

-- in other words, non-specific. And to find 

that we have them pretty well distributed bodywise is a surprise, particularly when you've 

got states that do not have cancer registries, 

where they really don't hassle the doctors to 

be very, very precise in their coding. Do you 

recall whether the majority of these lymphomas 

are in fact anatomically specified? 

DR. NETON: I don't know that, and I'm sorry if 

I meant -- I didn't mean to imply that we had 

that level of knowledge. If we do know, you 

know, beyond .00, we would apply it. But maybe 

Russ Henshaw is -- is slightly more familiar 

with what's been coded and he can help me out 

here. Russ, please? 

 MR. HENSHAW: Yes, Russ Henshaw. I don't -- I 

don't know the exact percentage, Dr. Melius, 

but some time ago we asked the Department of 

Labor to go back through all the lymphoma cases 
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and assign the fifth digits whenever possible. 

And they actually spent several days doing that 

for the coding, and so we have a fairly large 

percentage of cases with that degree of 

information. I don't know the percentage. 

 DR. MELIUS: I would be -- I'd be very cautious 

on this. I don't know what information the 

Department of Labor had, but this is not an 

easy task to do, particularly for these older -

- older cases, and -- I mean I've reviewed 

records also on -- series of lymphomas ranging 

over a time period, and sometimes it -- it's -- 

you have to go pretty deep into the medical 

records to -- to be able to understand what's 

happening. 

 DR. ZIEMER: Russ, are these cases that might 

originally have been specified as double-zeroes 

and you've asked them to go back and -- 

 MR. HENSHAW: Either --

 DR. ZIEMER: -- differentiate and --

 MR. HENSHAW: Yes, either double-zero or simply 

no digits beyond the first three. 

 DR. ZIEMER: In which case the physician 

involved wouldn't have made the 

differentiation; it's someone else that has 
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looked at the --

 MR. HENSHAW: Well, typically what -- the 

process that was followed was to review all the 

medical records, and in some cases that's 

several hundred pages per claim. And first 

look at the pathology report and see if the 

information can be derived from that or just 

really all the pages of medical information. 

But -- but again, the digit assigned was the 

site of the biopsy, not necessarily the site of 

origin, the site of radiation injury. 

DR. NETON: We tend to have a lot of medical 

records on these folks. I mean a couple of 

hundred pages, like Russ said, is not unusual. 

And Labor has gone back and we've spent, as you 

can tell, a lot of time looking through, trying 

to refine this. But I totally understand what 

you're saying --

 DR. MELIUS: Yeah, again, I'm not criticizing 

exactly what was done 'cause I don't know the 

detail, but I'm just saying it's not an easy 

task. And I'm sure if you have some cases from 

the '50's or something, I'd be surprised how 

much level of detail would be available. It's 

an issue we've talked about in terms of missing 
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records. But the way it was diagnosed in those 

days was very different. 

 DR. ZIEMER: But I'm confused then, if they are 

simply using that -- for example, if the -- if 

it's spleen, for example, do they still -- are 

they able to distinguish whether it's a 200 or 

a 202? 

DR. NETON: That's the crux of the issue. 

Really the site of diagnosis is not that 

important because we will default to -- well, 

for the circulating ones it's not important 

because we're going to always assume the 

thoracic lymph nodes, but for the non-Hodgkin's 

-- or for the Hodgkin's type lymphomas, that's 

going to be important and -- 

 DR. ZIEMER: Well, let me back up and ask it in 

a different way, maybe ask Roy, when you said 

they tended to use the double-zero or, you 

know, just generally unspecified, do they still 

distinguish between the 200 and 202 

classification or... 

 DR. DEHART: Normally they would, yes. 

 DR. ZIEMER: They would. So we -- if it's a 

202, then it doesn't matter. 

 MR. HENSHAW: Right, I just (unintelligible) in 
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many cases also the information is conflicting 

in these records, or just simply absent, so 

many of the claims are coded as diffuse, which 

is, you know, not helpful for this situation. 

DR. NETON: And we would certainly adopt a 

conservative default value in that case. 

 DR. ZIEMER: What is -- what -- is NIOSH asking 

for action at this point, or are you just 

reporting? 

DR. NETON: Well, that's -- that speaks to Dr. 

Melius's second point, which I was going to 

address. I'm not sure this requires rulemaking. I think -- I think, Dr. Melius, you're 

-- you're thinking about changes to the risk 

models, which is where, you know, rule-making 

may -- may be necessary. This is really a just 

-- not just, but it is a change to a dose 

reconstruction practice of selecting a target 

organ. 

 DR. MELIUS: I'm not talking about rule-making 

here. I'm talking about opportunity for public 

comment, public notification -- 

DR. NETON: Right. 

 DR. MELIUS: -- and, you know, presentation. 

That --
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DR. NETON: Right. 

 DR. MELIUS: -- I believe we had another 

option, short of rule-making, when we 

originally approved the regulations and we were 

concerned that the -- they were so general, and 

given the time frame and so forth, the need to 

get the program going, we -- I think we all 

agreed to that. But as things needed to be 

filled in, that if they would have a 

significant effect either in the -- dealing 

with the IREP model or in terms of the dose 

reconstruction, that we would provide some sort 

of public -- time for public comment, as well 

as -- you know, in the notification for that. 

Now my memory could be faulty. It's a number 

of years ago, but it's come up periodically and 

we have -- have discussed it here, and -- and -

-

 DR. ZIEMER: I know we've had the discussion on 

the IREP model itself. What we're hearing 

here, though, is the IREP doesn't change. It's 

just the -- you're using a different target 

organ. 

DR. NETON: Right. 

 MR. ELLIOTT: Well, we have to go back to our 
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rule-making effort in the early days and -- and 

this goes to Dr. Melius's point. In that rulemaking, we -- and I asked Liz to check on this 

-- what it says about -- my recollection in the 

language is we are to bring substantive changes 

to the Board for review and advice. Is this a 

substantive change. You know, I guess I -- you 

need to weigh in on that. We think it's a 

substantive change. We think it's a change in 

the right direction. We think it gives benefit 

of doubt and it just feels right, it's doing 

the right thing. Certainly if -- if you need 

more information about this, we're -- we're 

ready to do that. I'd hate to see us hold off 

on, you know, treating 500 claims, and a 

majority of those that have been denied, where 

they may be found to be compensable under this 

approach. So -- but appreciate your input. 

 DR. MELIUS: Yeah, it's not just a question of 

what we need to see or whatever. We can talk 

about that separately. But -- but as I recall, 

there -- there was an agreement to notice the 

public if, you know, substantial changes were 

being -- going to be made, if something would 

have a substantial effect on a num-- number of 
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claims, and so that then it would be on the 

agenda for the next meeting and there'd be an 

opportunity to talk about -- that was short of 

rule-making, but I think we need to look back 

at both what was in the rule and in the Board's 

discussions of the rule at that point in time 

and -- again, I'm not trying to -- I just think 

we need to stick by what we said we would 

originally do and -- and be consistent on that 

and not an issue whether it's a good change or 

a bad change or positive or negative that we -- 

we really need to follow that. 

 MR. ELLIOTT: And I agree, we do want to follow 

that, but -- and this is what the lawyers back 

in the office are checking on right now -- 

 DR. MELIUS: Okay. 

 MR. ELLIOTT: -- what does the language of the 

rule speak to. The POC rule, I'm pretty sure, 

specifies that substantive changes in the POC 

rule are to be brought before this -- this 

Board. I don't -- we're trying to figure out 

if this -- this is a dose reconstruction 

methodology, and if that is couched a similar 

and same way. 

I would also offer that we did not agree -- or 
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I don't think we covered in our agreement that 

we would put out a Federal Register notice. 

This could serve as public notice that we are 

interested in moving in this direction, but we 

welcome your input again. 

 DR. MELIUS: Yeah, let's -- let's check and we 

can --

 DR. ZIEMER: Anything that's outside of the 

rule-making issues, which are certainly 

binding, and irrespective of what this Board 

may or may not have done in the past, we can do 

as we wish on -- we can take action today that 

is even contrary to something we decided to do 

before, if we so wish. In other words, we can 

outline a procedure that we think should be 

followed in this case in terms of public notice 

and so on. I think those -- that prerogative 

is open to us, because we are not necessarily 

bound forever by any actions of the past. We 

may not have anticipated exactly this kind of 

thing in the past, or we had something else in 

mind. But it seems to me we still are not 

prevented from taking whatever action is 

appropriate. 

 DR. MELIUS: Well, I would strongly disagree 
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with that, Paul. I think we -- we have made a 

commitment -- if we did, and I'm not saying, 

you know, we did. But if we did make a 

commitment that if we were going to make 

substantial changes in dose reconstruction 

procedures or some other part of this program 

and told people that we would publicly notify 

them and so forth, then I think we do need to -

- to follow that. Now if we want to change 

that procedure and -- to what extent it was in 

the rule-making and to what extent it was a 

commitment that NIOSH made in terms of the 

meeting, we -- I have no problems with 

discussing that, but I -- I don't think we 

should just arbitrarily decide that we're going 

to change our approach or procedures because of 

some such issue --

 DR. ZIEMER: Well, actually we don't disagree. 

I was looking at it from completely the 

opposite point of view. It doesn't matter 

whether -- if we didn't do that in the past, we 

can still do it. 

 DR. MELIUS: Okay. 

 DR. ZIEMER: I was actually looking at it 

completely the opposite way -- 
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 DR. WADE: All right, let me --

 DR. ZIEMER: -- not dependent on whether we 

made a policy in the past on this. 

 DR. MELIUS: Okay. 

 DR. WADE: Given the sentiment of the Board, 

let me propose that we follow this course of 

action. We can have a rules check and see what 

the record shows, but I get the sense of this 

Board that they would like more information on 

this question, and they would like to see the 

public noticed of the fact that at the next 

meeting this item would be discussed. So I 

think we can follow that path. We can see what 

the lawyers produce in terms of what the record 

shows, but other than Larry's caution about 

wanting to do the right thing quickly, I see 

nothing wrong with providing this Board with 

the report that you said was on your desk, for 

example, Jim. You've got those materials. 

Provide them to the Board. When we put out the 

agenda for the next meeting, make it clear that 

this item's going to be discussed asking for 

the Board's concurrence, and let the public 

comment at that meeting if they would like. 

 DR. ZIEMER: And -- and indeed, we could also 
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identify previous commitments that we have -- 

 DR. WADE: Sure. 

 DR. ZIEMER: -- made along --

 DR. MELIUS: Yeah. 

 DR. ZIEMER: -- that line. That's certainly 

appropriate. 

Mark? 

 MR. GRIFFON: Just to -- just to follow on with 

what Lew said, the -- I was thinking the same 

thing. The procedure on your desk -- I don't 

know if it's a procedure or policy, and I don't 

know to what exten-- if you can describe that, 

maybe, if it has --

DR. NETON: This is a --

 MR. GRIFFON: -- enough background to help us -

- or is it just a --

DR. NETON: It's a procedure that really 

changes the target organ selection based on our 

input from our hematologist. 

 MR. GRIFFON: Does it include any of the basis 

for the change, or that's really extern-- 

DR. NETON: I think there is some basis in 

there about the discussions that took place, 

but --

 MR. GRIFFON: So that might be a -- a --
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DR. NETON: -- again, I mean this is not a 

giant rocket science sort of an issue. I mean 

if you don't know the target organ, then one 

has to default to something more conservative, 

and that's about the extent of the scientific 

debate, I think. 

 MR. GRIFFON: Yeah. 

DR. NETON: I mean there may be other opinions. 

Now maybe our one hematologist is not going to 

be sufficient evidence, I don't know. But --

 DR. MELIUS: But I -- I think there's some 

issues in the -- excuse me for interrupting, 

but in the details of it that -- about the 

classification and -- or maybe those can be 

dealt with on an individual basis, but I do get 

concerned that -- I mean I would certainly like 

to see the procedure and understand a little 

bit more about how it's communicated to the 

Department of Labor so that we -- 

DR. NETON: Sure. 

 DR. MELIUS: -- don't cause problems. 

DR. NETON: Again, classification is out of our 

hands. I mean we -- we have to assume we're 

getting the appropriate classification from 

them and they -- you know, that's their issue. 
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I'm a little concerned, though, because you 

know, with SC&A's reviews we're making -- we're 

in the process of -- there's numerous potential 

changes that could be made and tweaks to dose 

reconstruction. And if all these have to go 

through public process, it's going to be -- 

 DR. MELIUS: No, that --

DR. NETON: -- somewhat cumbersome. 

 DR. MELIUS: -- that was not the intent. This 

had to do with basic procedures and so forth, 

not individual dose reconstructions or site 

pro-- profile reviews. 

DR. NETON: Well, no, then there's other issues 

related to rotations and -- 

 DR. MELIUS: Well, then --

 DR. ZIEMER: There's a concern about -- aside 

from this particular situation, about setting a 

precedent on how we actually deal with changes 

of this type, and --

 DR. MELIUS: And again, may-- maybe we have to 

revisit the procedure or our procedure so that 

we facilitate this. I'm not trying to hold it 

up, but I do think we need to be, you know, 

sort of consistent with what we had decided at 

an earlier point in time. 
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DR. NETON: Okay. 

 DR. MELIUS: I also add that I think some of 

this is the -- some of the reaction is because 

-- we haven't talked about it yet, but what -- 

what an excellent job I thought you did with 

the lung cancer model. That document I 

thought, when you presented it to us, was 

excellent and very useful. And I guess when -- 

then when we don't see it on something else, 

then we're -- you know, it sort of raises 

expectations. 

DR. NETON: Appreciate that. 

 DR. ZIEMER: Okay, let's go ahead and -- we 

don't have to take a particular action right at 

this point. Let's go ahead with the rest of 

the presentation, so after lymphoma we're up to 

age at exposure. 

AGE AT TIME OF EXPOSURE 

DR. NETON: All right. This one is really just 

for information only, and we're not asking for 

any decision on the Board, although we 

certainly would appreciate any input that the 

Board might have -- we'll start with that -- 

on... 

 This issue was I believe a number two priority 
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on the Board's list of priority issues -- it 

was in the second tier of priorities, let's put 

it that way. It was not a first-tier priority. 

And this has been an issue for some time, that 

it's been in the literature that some 

researchers have suggested that the 

radiosensitivity to cancer increases with age. 

There -- there are studies out there that one 

can quote and cite that -- that demonstrate 

that there's some statistical effect relative 

to how old one is in the risk of developing 

cancer. 

We took a look at this and went back and 

reviewed the relevant major studies that we're 

aware of that we could find that demonstrated 

this effect, and just -- just to see where the 

science is falling on this issue at this 

particular time. Again, I suggest it's a 

priority research issue, but it was in the 

second -- priority. 

So what I have here really is sort of a summary 

of the papers that have been published relative 

to this, and there are a number of papers and 

I've cited here on this slide the Hanford 

study, Wing and Richardson, Gilbert et al, 
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Stewart and Kneale, the ORNL cohort and the 

Rocketdyne cohorts. Each of those studies have 

in some way made -- come to some conclusion 

that there may be an effect related to age at 

exposure. That is, older people when they're 

exposed have a higher risk of developing cancer 

per unit dose than -- than younger. 

They -- they all -- the stan-- this is not a 

standard analysis method, though, of how one 

does this. They all -- one can group these age 

bands differently and come to different 

conclusions, and that's one of the issues I 

think here is how one standardizes on this 

analysis. I think one of the studies actually, 

you know, picked a before-45 and after-45; one 

grouped them by decades, that sort of thing. 

So you can get different conclusions. 

So those studies have reported associations, 

and then on the bottom here we have studies for 

the Rocky Flats, Atomic Energy of Canada, the 

United Kingdom Atomic Energy Administration or 

Agency, and the UK Atomic Weapons Establishment 

and Sellafield. None of those studies, when 

they looked for this age of -- at -- issue have 

identified such an association. So again, you 
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have conflicting -- conflicting science on this 

issue. 

NIOSH -- HERB, that is, the Health-related 

Energy Research Branch -- had engaged in some 

research on this issue in collaboration with 

Oak Ridge Associated Universities in the past. 

And they looked at this effect in the ORNL -- 

the Oak Ridge National Laboratory cohort. And 

the conclusion of this analysis was that the 

observed trends may have been due to other 

factors than age at exposure. This is an issue 

of confounding within this -- this analysis, 

and that is these birth-cohort effects. That 

is, how you group these things from age at 

exposure, you end up with people who were born 

in different times. So then you may have 

confounding due to the fact that these people 

may have had different smoking habits, medical 

screening may have been applied differently in 

that time period. So there's -- there's other 

plausible issues that come into play here that 

tend to bring into question the robustness of 

this analysis. 

 Richardson and Ashmore just recently looked at 

this effect in Canadian workers, and their 
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conclusion was that there was an increase in 

radiosensitivity with age for lung and leukemia 

-- lung cancer and leukemia, but not for 

others. But again, you know, a more detailed 

analysis determined that this could have been 

the differences in smoking behavior over time. 

So again, not -- not conclusive. There's no 

conclusive determination made here. 

An interesting note here is, you know, NIOSHIREP actually has an age-at-exposure 

adjustment, and that is -- it's sort of the 

opposite of what we're talking about here. For 

most cancers the radiosensitivity decreased 

with age in the atomic bomb survivors, and that 

-- those corrections or adjustments are applied 

to a number of -- almost all of our cancer 

models with the exception of female genitalia, 

lung cancer and -- and leukemias and squamous 

cell carcinoma. So you know, right now we're 

doing something a little different than what -- 

if you hear age at exposure, this is different 

than the age at exposure that I was just 

talking about. 

So you know, just a brief summary on an arm's 

length view of this issue and -- and I 
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certainly have more experts here to help me, 

who can discuss this issue and flesh out the 

scientific details, but -- but the balance of 

the evidence right now is not conclusive as to 

whether or not, you know, we should engage in 

applying, you know, unilaterally an age-atexposure adjustment for occupational cohorts. 

There's certainly evidence out there. More 

research needs to be done, and we're going to 

continue to accrue these studies as they come 

out and -- and, you know, analyze them, keep 

our ear to the ground as to what the Healthrelated Energy Research Branch may be doing and 

see what happens in the future. Right now 

we're not -- we're not proposing to make any 

change based on that -- that effect. 

 DR. ZIEMER: Okay. Now let's open the floor 

for discussion on the age of -- age at exposure 

issue. Any questions or comments -- Dr. 

Melius. 

 DR. MELIUS: Yeah, would anybody -- Jim or you 

or any of the other staff here -- be aware of 

what other studies are currently underway that 

are likely to be completed shortly in terms of 

addressing this issue? And also I'd be curious 
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-- I don't recall what the current -- current 

BEIR report, most recent one, to what extent it 

tried to address this issue and what their 

conclusions were. 

DR. NETON: Right, I'm familiar with what -- 

the BEIR report had a very brief -- several 

sentences, and maybe Brant can speak to this; 

he's more familiar with the literature than I 

am. 

 DR. ULSH: The first part of your question 

about what major studies are underway right 

now, I think the biggest one on the horizon is 

probably the IARC 15-country study. 

Preliminary results of that study have been 

published, but we're still waiting for detailed 

results to come out and I think that's 

underway. 

 DR. MELIUS: Okay. 

 DR. ULSH: With regard to BEIR VII, it really 

didn't have a lot to say about this. As Jim 

indicated, there were a few paragraphs and 

basically they summarized what we said here in 

the slides, that some cohorts have some 

evidence of it and others have not, but they 

really didn't delve into it in much more detail 
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than that. 

 DR. MELIUS: Okay. Thank you, Brant. 

 DR. ZIEMER: Okay. Other comments or questions 

on that? 

Okay, if not, let's proceed then, Jim. 

DR. NETON: I think (unintelligible) more 

smoothly when we're not making major changes to 

models. 

 DR. ZIEMER: Counsel has an issue. 

 DR. WADE: There goes smooth. 

MS. HOMOKI-TITUS: No, I think this'll actually 

help smooth the last issue. 82.33, which is 

part of the dose reconstruction rule, how will 

NIOSH inform the public of changes to the 

scientific elements underlying the dose 

reconstruction process. NIOSH will publish a 

notice in the Federal Register informing the 

public of changes and the rationale for the 

changes. This notice will also provide a 

summary of the recommendations of comments 

received from the Advisory Board and the 

public, as well as responses to the comments. 

So therefore, we need to receive y'all's 

information before we put a Federal Register 

notice out. 
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DR. NETON: I guess, Liz, I'm not -- 

MS. HOMOKI-TITUS: Obviously, however you all 

decide to do that, whether it's hey, we need 

more information --

 DR. ZIEMER: And Liz, I don't know if you can 

help us on this, but I suppose one of the 

issues -- Jim kind of said, you know, we're -- 

we're always massaging the -- the things, it's 

-- it's, again, this threshold issue of at what 

point does a change become significant. Do we 

have any test of that internally, or is it the 

Board's judgment on these things? I mean this 

one looks significant insofar as it may cause 

re-examination and changes in a number of -- of 

what are now closed cases. Is that the test of 

significance, or -- I -- I'm -- that's sort of 

MS. HOMOKI-TITUS: I think I would have to -- 

 DR. ZIEMER: -- that's sort of a rhetorical 

question. 

MS. HOMOKI-TITUS: I was going to say, I don't 

think that we have a standard (unintelligible) 

 DR. ZIEMER: Don't have --

MS. HOMOKI-TITUS: -- that. 
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 DR. ZIEMER: -- a standard, it's a judgment 

call I think, perhaps both on the part of the 

agency -- in a sense, you've said it's 

significant because you brought it to us to -- 

to look at. That's sort of -- implies that you 

think it's -- has some level of significance. 

 DR. WADE: You know, I think there'd be two 

tests. One you just mentioned. If NI-- if the 

agency brings something to you and says it's 

significant, then I think we -- we live under 

this provision. The agency will also be making 

you aware of all the things that it's doing, 

and I think at any point the Board can say I 

consider that significant and would like to 

follow the procedures that Liz just read to us. 

 DR. ZIEMER: This could include changes that 

come about that we become aware of as part of 

the interaction with the contractor, for 

example. If something they do causes NIOSH to 

change a process or a methodology, one might 

identify that. Dr. Melius? 

 DR. MELIUS: Yeah, and I think if one would 

want to go back through the transcripts of all 

our previous meetings, I -- this actually -- 

issue has come up before and where we I think 
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have actually had discussions and decided that 

the proposed changes really weren't that 

significant and -- do that, and -- I mean the 

threshold is fairly -- I think this one does -- 

is significant, does meet that, you know, sort 

of arbitrary threshold we -- we've talked 

about. But we have discussed this before and 

have decided that it wasn't warranted so... 

 DR. ZIEMER: Okay, and it does appear that the 

rule itself is a governing thing over and above 

anything we might have done in our Board then, 

in terms of this notification process. 

 DR. WADE: Could I also ask the agency a 

question there? Given the fact that now we 

have significance defined in this term, do you 

bring this issue to the Board as a significant 

issue? 

DR. NETON: I -- I think I -- I certainly 

(unintelligible) call this a significant issue, 

I could not. But I think -- my take on this is 

this is a fundamental change to dose 

reconstruction, I don't know. It's a target 

selection. It's a lower-tier procedure that's 

being modified, not an implementation guide or 

an ICRP model. But it is significant, I will 
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grant you. 

 MR. ELLIOTT: Is the word "significant" or 

"substantial"? We don't know, but I would say 

it's a substantial change. 

 DR. WADE: So you're bringing it to the Board -

-

 MR. ELLIOTT: Yes. 

 DR. WADE: Well, the Board has every right to 

say in order for us to comment, we need certain 

information and we can proceed down that -- 

 DR. MELIUS: Yeah, and -- I mean I would also 

say, 'cause it -- something has to be commu-- 

Department of Labor has to -- I won't say 

endorse this, but implement this and -- in 

change and so forth, and -- and since it will -

- it does involve the recalculation of a number 

of completed dose reconstructions, I really 

think it's better to do it as -- a little bit 

more formally than we would do, you know, other 

-- deal with other issues. 

DR. NETON: No problem doing that. 

 DR. WADE: Let's also all pause to realize that 

we're doing the right thing. There is general 

agreement about it. We just want to make sure 

we do it the right way, so --
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 DR. ZIEMER: Mr. Presley I think has a comment, 

too. 

 MR. PRESLEY: Jim, I believe you said this 

could impact as many as 500 cases? 

DR. NETON: That's correct. 

 MR. PRESLEY: I believe that's a pretty 

significant number. 

DR. NETON: Well, I agree. 

 DR. ZIEMER: Mark. 

 MR. GRIFFON: I just wanted to go back one 

second for the age at exposure, just -- just to 

follow up on that. I mean the last slide you 

said evidence does not suggest modifying the 

NIOSH-IREP model. I guess -- I guess my only 

concern is the time frame on this because it 

seems the current model, as -- as you 

indicated, decreases the ER per sievert over 

time and some of these studies at least suggest 

an increase and yet, you know, you wonder if -- 

if the models should be made to say must at 

least be neutral over -- for age at exposure. 

And I guess you're saying there's just not 

enough evidence yet. I'm just wondering, you 

know -- 'cause that could significantly change 

models and results on the IREP outputs, and I 
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don't know if there's any kind of time frame 

expectation on resolving this. 

 DR. MELIUS: Well, that -- can I jump in --

'cause that was my really sort of my question I 

was trying to get at and -- and maybe to 

specify this a little bit more for your 

question, Mark, is to ask NIOSH to come back to 

us once this IARC analysis is done 'cause 

that's the sort of next big thing coming -- at 

least to inform us of -- of where that stands 

and then I think we can decide do we need to do 

a formal -- you know, more complete evaluation 

of this, given the conclusions of BEIR VII and 

then given the -- you know, what we -- what we 

see is coming. I think we -- I'm satisfied 

with waiting. I would like to know when that 

IARC report comes out and then when we can 

decide for --

 DR. ZIEMER: Did we -- did we hear that was on 

the street in a draft form or -- 

 DR. MELIUS: No, the early report of the -- I 

don't think they've done this kind of analysis 

yet, at least I'm -- I haven't heard of it. 

Now people more informed than I may have. 

 DR. ZIEMER: Okay, the good, the bad and the 
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ugly. Which one's the good and which one's the 

bad? 

 DR. MELIUS: Who's Clint Eastwood today? 

 MR. HENSHAW: I just want to make one 

clarification on the age at exposure issue. 

Dr. Melius, you raised this issue. In IREP a 

list of cancer decreases from ages 15 to 30, 

but then it remains constant from age 30 on, so 

it's not -- you know, after age 30 this would 

not be (unintelligible) with the current 

adjustments. 

 DR. MELIUS: Okay. 

DR. NETON: Thanks, Russ. 

 DR. ZIEMER: Do we have some SENES input on 

this or is that --

DR. NETON: I think that was the input. 

 DR. ZIEMER: All right. 

 DR. MELIUS: Can we go back to -- we're all 

over the place here -- can we just sort of get 

some closure on what we're doing with the 

lymphomas? 

 DR. ZIEMER: Actually I want to get the closure 

-- this topic's going to continue after lunch. 

We have some more to cover -- 

 DR. MELIUS: Oh, okay. 
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 DR. ZIEMER: -- and then we can sort of wrap up 

the whole thing. 

 DR. MELIUS: Okay, fine. 

 DR. ZIEMER: I think we'll go ahead -- it's -- 

it's 12:00, let's get our lunch break -- 

 DR. WADE: Could I impose upon --

 DR. ZIEMER: -- and continue after lunch. 

 DR. WADE: I'd like to impose upon my friend 

Jim -- Jim, would it be possible after lunch 

when we do the wrap-up for you to put up the 

list of priorities that the Board had had 

before? Can we get our hands on that and let's 

DR. NETON: I think I can. 

 DR. WADE: If we could just have that as 

background. 

 DR. ZIEMER: Okay, we'll recess till 1:30. 

 (Whereupon, a recess was taken from 12:00 p.m. 

to 1:30 p.m.) 

SMOKING RISK ADJUSTMENT

 DR. ZIEMER: Okay, we're ready to resume our 

deliberations. We're still on the topic of 

scientific issues, and I think we're ready to 

discuss the lung model aspect here, Jim, so 

let's proceed with that and then we'll have a 
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chance to discuss related things. And we also 

I think have the priority list that was 

requested prior to lunch so we'll have a chance 

to look at that. 

DR. NETON: Thank you, Dr. Ziemer. You should 

have a copy of our document labeled status of 

research topics as of June 2005. It's a 

summary of the Board's priority one and two 

issues that were identified by the Board. 

There may be some confusion, there is another 

longer, three-page -- two or three-page list 

that Dr. Melius I believe put together, so -- 

but I think this (unintelligible) reflects -- 

 DR. MELIUS: Yeah, that -- actually this does 

reflect that. I think we had a discussion and 

agreement of the Board that -- so from that 

longer list we culled it down to this shorter 

list. 

 DR. ZIEMER: The longer list was everything 

that we wanted to have before us, from which we 

selected the priority ones and twos. 

 DR. MELIUS: Correct, yeah. 

 DR. ZIEMER: So these are the important ones. 

DR. NETON: These are the ones that ended up 

being, you know, listed -- 
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 DR. MELIUS: And I also believe you convinced 

us to add some priorities of yours to our list 

so that it worked out. 

DR. NETON: Yeah, in fact target organ for 

lymphoma claims is there right on the bottom, 

isn't it? 

 DR. ZIEMER: And also CLL. 

DR. NETON: Right, so it's a little bit of a 

medley, but I think this does accurately 

reflect the current issues. And if we're going 

to have a discussion about those, we could use 

that as a sounding board. 

Okay, I want to move on with the final topic, 

which is the NIOSH-IREP lung cancer model. And 

in this case we're asking for advice from the 

Board, and as Dr. Melius pointed out -- input 

from the Board. As Dr. Melius pointed out, a 

fairly lengthy package was sent to the Board 

outlining all of the relevant documents that 

were reviewed and used in coming to this 

decision. 

I'll get right to the chase on this one, and 

the first bullet says this, that NIOSH proposes 

to modify the NIOSH-IREP lung cancer risk 

model. There are -- right now there are two 
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competing models out -- not competing, two 

distinct models. One that's owned by the 

National Cancer Institute, they developed it -- 

was developed by the National Cancer Institute 

and that is NIOSH-IREP. We are proposing, and 

I'll get into the details why we believe this -

- we're proposing to do lung cancer probability 

of causation calculations through a program, 

NIOSH-IREP, to run both our model and the 

National Cancer Institute's NIH-IREP model, and 

select the higher PC of the two runs and that 

we would use that to determine claim outcome. 

The decision is based on this NCI revision 

that's out there, and I'll talk a little bit 

about that, and solicitation from expert 

opinions -- and I'd like to acknowledge the 

fine assistance we had in reviewing this with 

our friends at the SENES/Oak Ridge, Owen 

Hoffman, John Trabalka and Iulian Apostoaei. 

I'm never sure if I quite pronounce that right, 

but I think that's a close approximation. 

I left my notes on my chair, so if you'll bear 

with me one second... 

(Pause) 

Okay. If we think back to the original Board 
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meetings that we had, NIOSH was required to 

come up with risk models for all cancers, and 

we worked very closely with the National Cancer 

Institute and have adopted much of what they 

put together in NIH-IREP, which was created to 

help adjudicate claims for radiogenic cancers 

in the Veterans Administration program that's 

administered by Defense Threat Reduction 

Agency. 

 Initially when we adopted the NCI model, they 

were identical. We had no differences between 

the two. But in late 2003 the National Cancer 

Institute modified their risk model based on a 

re-analysis of the Hiroshima/Nagasaki survivor 

data. There was a study put out by Pierce et 

al in Radiation Research in 2003 that included 

four years of additional follow-up of the 

Japanese cohort. So there was more data and 

there was also -- they incorporated a new 

interpretation between smoking and exposure to 

low level radiation. This new interpretation 

of smoking and low level radiation puts more 

weight on the additive interaction between 

smoking and cancer than in the multiplicative 

interaction. That is, both models acknowledge 
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that the interaction could be additive or 

multiplicative. But the new NCI interpretation 

using the Pierce data gave some more weight to 

the additive interaction. That is, these two 

agents acting independently, the synergism 

between the two is not as great as had previous 

been thought. 

So because of that, we end up with a different 

model out there that, you know, produces 

different PC results, given the same inputs. 

So you know, we're uncomfortable with that. 

These are both calculating the same type of 

parameters. So we undertook an analysis of 

this model to see (a), could we use it in toto. 

Was it just appropriate to adopt wholeheartedly 

into our program, or should we not adopt it 

because there are differences in our cohorts 

from the veterans; or should we do some 

combination of the two. 

Another factor that I forgot to mention is the 

new NIH model does factor in dependence upon 

age at exposure in the risk calculation, and 

it's -- it's similar to the other -- the other 

models we talked about. The risk -- risk 

changes up to about 30 years of age and then 
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it's a constant risk. So the dependency stops 

-- the dependency correction stops at around 

age 30. 

Okay, let me make sure I got all my points in 

here. 

Okay. We began evaluating this in -- in 2004 

we were looking at it. And during this 

evaluation the NCI actually changed their model 

again twice. They felt there was a need to 

change a couple of things. One was they 

recognized that the transfer factor that was 

used to go between the Hiroshima/Nagasaki 

survivors and the U.S. population was not 

applied in accordance with the actual document 

that they produced. It was a -- I wouldn't 

necessarily call it an error, but it was not 

consistent with what they thought was 

happening. The other factor had to do with -- 

I forget -- it was alpha particle-- weights 

given to alpha particles. So we had this issue 

of a -- of a changing model in the middle of 

when we were trying to evaluate whether the 

original NIOSH -- NCI change was appropriate. 

We did go out and to evaluate this model we had 

SENES do an analysis to see what -- what the 
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major differences were compared to the NIOSHIREP model and the NIH model. And the 

differences, we found out, could be 

significant. For instance, the NIH -- the 

NIOSH-IREP model would produce a -- these are 

generalities, nothing is -- nothing is cast in 

stone because there's so many parameters that 

are changing. But the NIOSH-IREP model would 

produce a greater probability of causation in 

general for non-smokers, whereas the NIH-IREP 

model would produce a greater probability of 

causation for smokers. And also the NIH-IREP 

model would have a greater probability of 

causation for females exposed at younger ages. 

There's other effects that are more difficult 

to generalize, but a lot of that has to do with 

this age at exposure adjustment that was added. 

So with that knowledge we went and solicited 

some expert opinions in late 2004 and received 

these comments in 2005. The outside experts 

are shown on this slide. They were each asked 

to independently evaluate the model -- in the 

context, again, of an OCAS compensation 

decision. Our goal was to recruit nationallyrecognized experts with as diverse a background 
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as possible, given that this is a fairly narrow 

-- narrow-focused field. So here we have the 

list of folks -- David Brenner, for those of 

you who have been around the risk analysis 

epidemiology business in radiation have, I'm 

sure, heard of Dr. Brenner at Columbia 

University; Faith Davis from the University of 

Illinois at Chicago; again, David Richardson, 

who we also used for the age at exposure -- the 

CLL, I'm sorry, I have been talking too much 

this week -- the CLL analysis; and Jonathan 

Samet at Johns Hopkins University. 

But we posed the same question to each of them, 

and that was: In your expert scientific 

judgment, should NIOSH adopt the NIH-IREP lung 

cancer risk model for exposures other than 

radon? 

 That's an important point; if you recall, we 

have a separate lung cancer/radon model, and 

this is not being called into question at all 

at this time. 

And if so, should the model be adopted intact 

or should we do something different? Should we 

modify it or should it be programmed to run 

both models? 
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So we left a wide-open issue here. We didn't -

- we didn't try to prejudge anybody to one side 

or the other. And we asked them to provide 

their rationale. 

Much like the chronic lymphocytic leukemia 

issue, we received a number of comments and I'm 

going to just mention these alphabetically 

again, and again paraphrase very succinctly 

here what we believe to be the main message we 

received from each of the reviewers. 

 Brenner suggested that we do a mixed model 

where we capture risk estimates from 

alternative distributions. Since he -- he 

didn't say run them both, he just said use a 

mixed model imbedded in the program, which 

effectively ends up being the same thing. He 

further went on to say that the overall weight 

of the evidence suggests an interaction between 

smoking and radiation is intermediate between 

these additive and multiplicative. 

 It's actually not really the same thing. This 

would be our own hybrid distribution of 

effects. 

Okay. Davis suggested that we adopt the NIHIREP model as the sole model, and primarily 
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because there was a new study that -- you know, 

for the reasons I mentioned; there's four more 

years of follow-up, there's age-specific 

effects; it seemed to her to be well-reasoned 

biologically and statistically and, you know, 

we're supposed to use the best available 

science, so -- so why not. She firmly believed 

that overall it was a substantial improvement 

over our -- our current model. 

Okay. David Richardson suggested that we 

program both models and used the higher 

probability of causation. And again, it was 

the current science provides an inadequate 

basis for determining which model is more 

appropriate. 

And Samet suggested that we, again, program 

both models and use the higher probability of 

causation. And he actually went on to say use 

of the NIH model alone would be a mistake, and 

he had some rationale for that about the 

possibly flawed understanding of the smoking 

adjustment profiles that were used, and 

specification may be inadequate. 

So we sort of received a mixed bag on this 

issue of comments, but -- but at the end of the 
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day not a single reviewer said just stay with 

NIOSH-IREP. I mean they all suggested one -- 

one side or the other, which led us to be-- led 

us to this position that we've been in a number 

of instances, particularly in the dose 

reconstruction business, where if you have a 

couple of equally plausible scientific 

explanations for something, and you can't pick 

one or the other and the science is not 

informative to allow you to do that, then we 

would pick the one that was more claimant 

favorable. And in this case, neither one was 

clearly claimant favorable over the other in 

all cases. So we have made a decision that we 

would just run both and use them that way. 

This would in no way reduce any PCs for any 

claims that have been processed thus far. We 

are proposing that we would go back and reevaluate lung cancers that have been -- been 

denied thus far with this new model, and then 

use it for future cases as they come available. 

The effect of this on our program we expect to 

be pretty small. If you recall our 

conversation yesterday, a large percentage of 

the lung cancers are already over 50 percent by 
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nature of our dose reconstruction efficiency 

process for inhalation of actinide elements. 

So the ones that have been denied, you know, 

we'll look at. And it certainly could change 

some, but it's nowhere near going to be the 

dramatic effect that we have seen with maybe 

the lymphoma -- the lymphoma change. 

So I think -- I think that's a brief synopsis 

of where we are with this, and I'm ready to 

entertain any questions. 

 DR. ZIEMER: Okay, this is open for discussion. 

 DR. MELIUS: Yeah, I have some --

 DR. ZIEMER: Jim. 

 DR. MELIUS: -- questions and -- and points. 

would just go a little bit further than you did 

in sort of describing what your experts said, 

'cause I thought what was especially important 

wasn't just, you know, counting up the votes, 

so to speak. There were good reason not to use 

the NCI model, and -- and it's the fact that 

smoking patterns are different in Japan and 

they took up heavy smoking later than we did in 

the United States, so it's just hard to judge 

since there's really a single time of exposure 

there to -- it just does -- isn't provide an 

I 
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adequate basis, so I think it give you, you 

know, sound justification for not just adopting 

their -- their model by itself and do that, 

even though it has some advantages over -- so 

to speak, over the -- the NIOSH model. So --

so I thought that was good. 

I have two questions. One is, I missed the -- 

what the September 2005 update was of the NCI 

IREP. I didn't see that referenced in there. 

I might have missed it 'cause I wasn't looking 

for it, but it just --

DR. NETON: Russ, can you help me out with 

that? 

 DR. MELIUS: I mean especially since your -- 

all your analysis preceded that. That's --

DR. NETON: That's a good point. 

 DR. MELIUS: Yeah. 

 MR. HENSHAW: Yes, the September 2005 -- 

DR. NETON: It's off, Russ; I think you -- 

 MR. HENSHAW: -- (unintelligible) NIH-IREP was 

THE COURT REPORTER: Russ --

 MR. HENSHAW: -- (unintelligible) correction -- 

 DR. ZIEMER: Turn your mike on, Russ. 

 MR. HENSHAW: Thanks. The September 2005 
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change was a modification of the computer code 

to make the -- to make NIH-IREP consistent with 

the documentation published in fall of 2003. 

It affected the -- the change affected the -- 

the transport function from the Japanese 

population to the U.S. 

 DR. MELIUS: Okay. 

 DR. ZIEMER: I think that was the discrepancy 

that --

DR. NETON: Right. 

 DR. ZIEMER: -- Jim referred to where the -- 

the program didn't follow what their actual -- 

DR. NETON: Right. 

 DR. ZIEMER: -- process said it was supposed to 

be doing. 

 DR. MELIUS: Right, and I just didn't see a 

reference to the Sep-- I was trying to make 

understood that was what the September 2005 

change was. That was the -- the content of it 

was referenced, not the date -- at least I 

missed it. 

My second question was that Brenner recommended 

a -- sort of a hybrid model. I don't know if 

that's the term he used. But he had actually 

made a very specific recommendation on how that 
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should be accomplished, and I think there was a 

-- you have a rationale for not adopting that, 

though it has some (unintelligible) advantages. 

You know, you just have to run two models and 

it's sort of -- you know, gives this a unified 

approach and so forth. I -- you know, I'm not 

sure we want to be in a position of adopting 

multiple model runs for every type of cancer 

and just pick out what's best. Not that I 

disagree with what you're recommending, but -- 

but if someone could sort of explain the 

rationale for not adopting his approach, I 

think that's -- I think it was in some of the 

comments where the -- I think it was in 

actually the -- the SENES review, but I want to 

make sure I understood it and (unintelligible) 

DR. NETON: I'm going to ask Russ to help me 

out again with that. I think I could explain 

it, but it would be better than -- than getting 

corrected. 

 DR. ZIEMER: And also as you comment on that, 

does his approach always give kind of an 

intermediate value, or is that -- I got the 

idea that it -- being a mixed model, it -- it 
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would end up somewhere between what you would 

get with the other two individual ones. 

 MR. HENSHAW: I think that's probably a fair 

characterization, but we asked SENES to 

evaluate the effect of Dr. Brenner's proposal. 

It actually turns out at the 99th percentile it 

was not that terribly different from what -- 

from some mixture of the NIH model and what 

we're actually proposing here. 

I might add that we received an e-mail from Dr. 

Brenner after making this decision, and he 

stated that he thinks we've made is extremely 

sensible. 

But the reason I think -- the rationale for not 

going with Dr. Brenner's suggestion would be 

that we're already -- we're already two years 

past the adoption of the NIH lung model. If we 

created a brand new hybrid model or mixed 

model, we would then need to vet that and 

obtain peer review on the model. We had no 

real consensus on -- on this proposal. Our --

our feeling was that if we went down that road 

it would be another year to two years and we'd 

be back essentially to where we started, back 

to square one. We felt it wouldn't be fair to 
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claimants to just basically postpone this whole 

process another couple of years. 

 DR. MELIUS: Yeah, but one could equally well 

argue that you could adopt the approach you're 

suggesting as an interim approach, and then, 

you know, adopt his suggestion -- you know, 

given that it takes two years to implement. 

I'm not -- at least as I read some of this 

documentation, I wasn't convinced that -- that 

his suggestion was necessarily the -- was 

feasible and appropriate to do, and I was just 

trying to make sure that was also other 

people's understanding, I wasn't reading too 

much in it, 'cause he had sort of -- he had 

different recommendations at sort of different 

points in time and I -- 

DR. NETON: You raise a very good point, Dr. 

Melius. I was concerned when we first looked 

at this that -- and -- and I was -- actually 

thought that the Brenner suggestion made a lot 

of sense to me. And for the reasons that Russ 

mentioned, he convincingly portrayed that, you 

know, that doesn't make sense from a time 

perspective. But then again, as you mentioned 

earlier, going with two models every time we 
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run up against a change is -- is a precedent 

sort of setting thing, and I didn't want to 

necessarily go there. But I think -- we've at 

least convinced ourselves that, what you 

suggested, is this is maybe an interim, and 

when the science is more informative and we can 

figure it out and make a better determination, 

we would be prepared then to go with one -- one 

universal model. 

 DR. MELIUS: Okay. 

DR. NETON: So that's -- that's sort of what -- 

how we ended up there. 

 DR. ZIEMER: Is the dual model approach -- will 

that cause you to have to review a number of 

closed cases --

DR. NETON: That's --

 DR. ZIEMER: -- and give us some idea of what 

the impact there is going to be. 

DR. NETON: Well, as I -- as I mentioned, it 

would -- many of the lung cancers are already 

compensable so we wouldn't have to look at 

those. So for the ones that are less than 50 

percent, we'll go back and look at every single 

one. The number shouldn't be that large. 

Russ, do you have a feel again? I don't -- I 
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don't know that we -- we don't feel it's a 

major effect and we don't feel that it is 

necessarily going to be a wholesale reversal in 

lung cancer compensation cases. 

 MR. HENSHAW: But bear in mind that we have a 

large number of lung claims, and the majority 

have been compensated. But that still leaves 

somewhere around 500 lung cancer claims that 

were not compensated, give or take 25 to 50. 

 DR. ZIEMER: Okay, that order of magnitude. 

DR. NETON: But the magnitude of the change is 

nowhere near what we were discussing with the 

lymphoma model. These are -- we've labeled 

them as significant changes, but they are -- 

they're percentage changes, you know. I think 

it's hard to predict exactly, but it's not an 

order of magnitude. 

 DR. ZIEMER: Gen -- Gen Roessler. 

DR. ROESSLER: I agree with Dr. Brenner in his 

most recent conclusion that this is a sensible 

way to go. For one thing, we don't have to 

discuss whether it's claimant friendly or not. 

I think this is kind of an obvious thing to do. 

It's claimant friendly and it ought to be 

looked into. 
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What I think we should expect, though, is down 

the road -- maybe six months or a year -- is a 

report back on what transpired using both 

models, going back in time, and then for any of 

the cases that -- that have come up up to that 

point, just out of scientific interest, if 

nothing else. 

DR. NETON: We'd be very happy to do that and 

maybe report if we still stand with this model, 

if the science is any better or not at that 

time. 

 DR. ZIEMER: Rich. 

MR. ESPINOSA: When running the two models 

together for a smoker, about what's -- what's 

the difference on the percentage and in running 

it for a non-smoker what's the difference on 

the percentage? 

DR. NETON: I hate to keep going to Russ here, 

but he's -- he's really the expert. It's --

it's percentage points. Again, I don't think 

it's --

 MR. HENSHAW: Richard, it's really -- I don't 

know that I can characterize that simply. It 

can range from a few percentage points to 20 

plus percentage points, depending upon the 
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exact claim scenario. 

DR. NETON: There's so many variables in these 

models that it -- you know, it's not easy to, a 

priori, come up and bracket what the magnitude 

of the change is, which is in fact one of the 

reasons that we've proposed both. 

 DR. ZIEMER: Jim, another comment? 

 DR. MELIUS: Yeah, can I ask what NCI's 

reaction was to this... 

DR. NETON: I think they -- they are supportive 

of what we're doing. I don't think there's any 

(unintelligible) --

 DR. MELIUS: Yeah, it seems to me there's also 

implications -- that there are deficiencies in 

their approach. I mean I think that's -- 

DR. NETON: Yeah, we -- we --

 DR. MELIUS: -- documented. I mean I'm sure, 

you know, you can argue which one's best, but 

it sort of depends who you are from the 

claimant's point of view. But also 

scientifically it's hard to -- to 

(unintelligible). 

DR. NETON: We've informed NCI where we're at 

and what we're doing with this, and we've 

received no negative feedback. 
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 DR. ZIEMER: Okay. Other comments? 

 (No responses) 

SCIENCE ISSUES (CONTINUATION) 

Okay. Then perhaps we can talk about the 

broader issues of both the -- well, you have 

the list before you --

 DR. MELIUS: Yeah, and actually I'd like to -- 

 DR. ZIEMER: -- of the priorities and related -

- yes? 

 DR. MELIUS: Before we drop this -- I mean I'd 

like to actually make a motion that the Board 

supports NIOSH adoption of this new approach. 

I think -- with the proviso that Gen mentioned 

earlier, that this issue be reviewed again in a 

year. Based on whether there's new science or 

other events, they may want to -- NIOSH may 

want to consider sort of a -- (unintelligible) 

we call it a unitarian approach to -- to this 

issue. 

 DR. ZIEMER: Yeah, that's actually -- the 

approach is how do we deal with each of these, 

so we'll start at that end, that's fine, the 

Chair will recognize that motion, and if 

there's a second --

MR. ESPINOSA: Second. 
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 DR. ZIEMER: -- and seconded. Now -- so the 

motion -- and that motion deals specifically 

with the lung model. 

 DR. MELIUS: Lung model, yeah. 

 DR. ZIEMER: And let me ask for discussion on 

that motion. If there is none, we'll -- did 

you have a comment, Rich, or not? 

MR. ESPINOSA: No. 

 DR. ZIEMER: Okay. Then let's proceed to vote 

on that motion. Do we -- everybody understand 

what the motion is? Can anyone help the Chair 

remember what it is? 

 DR. MELIUS: Yeah, the Board supports NIOSH's 

proposal to adopt this dual -- dual model 

approach to evaluating lung cancer cases, with 

the proviso that in approximately one year's 

time they sort of review what any new 

literature and sort of reconsider whether a 

unitarian model approach may be more 

appropriate. 

 DR. ZIEMER: Okay. 

 MS. MUNN: Is that a capital U? 

 DR. MELIUS: That's unitarian with a small u, 

not a large U. 

 DR. ZIEMER: Yeah, we're going to have a 
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Presbyterian approach on... 

Okay, all in favor of the motion, say aye? 

 (Affirmative responses) 

 Any opposed? 

 (No responses) 

 Any abstentions? 

 (No responses) 

And for the record, Dr. Anderson is not here. 

Let's -- now I'm going to ask that we return 

and ask if there's any actions the Board wishes 

to take on the CLL portion of the report. That 

was the chronic lymphocytic leukemia. 

(Pause) 

Roy. 

 DR. DEHART: Yes, we have discussed in part the 

possibility of getting additional information, 

and if so, would that be available in December 

when we have a phone conference? 

DR. NETON: Additional information on chronic 

lymphocytic leukemia? 

 DR. DEHART: On the -- on the proposal there. 

DR. NETON: Yes. Yeah, we can certainly update 

you on the status of where we are with it at 

that point --

 DR. ZIEMER: Yeah, and --
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DR. NETON: -- and if we've made any additional 

progress. 

 DR. ZIEMER: -- keep in mind on this one NIOSH 

is not recommending any change at this time, so 

we're looking for just update or -- 

DR. NETON: If we've made any progress on the 

risk model, I think that's what you're 

referring to. 

 DR. DEHART: Yes, that's correct. 

 DR. ZIEMER: Are you making a specific motion 

or just -- is this just a general -- 

 DR. DEHART: I was just clarifying information 

that we could get that information. 

 DR. ZIEMER: No action is otherwise required. 

Okay. 

Then on age at -- age at exposure. 

DR. NETON: Skip the lymphoma issue, possibly? 

 DR. ZIEMER: I'm sorry. I didn't intend to do 

that, but lymphoma. 

 DR. MELIUS: Yeah, on lymphoma can I -- I just 

want to understand -- I don't know what counsel 

or anybody's had -- change -- has the rules 

changed, first of all. I'm taking that meaning 

it hasn't. We didn't -- so my question would 

be sort of a logistical question, sort of how 
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to -- what's the best way of accomplishing this 

without, you know, unduly holding this up and 

so forth. And I think the consensus of the 

Board is we'd like to see a little bit more 

information. I think -- I think we could 

accomplish that with -- at the phone call 

meeting in November and -- and that would then 

fit, and then a Board action and then a Federal 

Register notice, is that the -- this question's 

for Larry or for Liz, is that the -- 

 DR. ZIEMER: I believe -- and Liz, you may want 

to help us again on this. I believe the 

Federal Register notice was to include 

something relating to Board's recommendation. 

Was that --

 DR. MELIUS: Yeah. 

 DR. ZIEMER: -- this, so we --

 DR. MELIUS: We need --

 DR. ZIEMER: -- need formal --

 MR. ELLIOTT: We need Board input on a -- on 

any substantive change of this sort 

(unintelligible) --

 DR. ZIEMER: Does that input appear in the 

notice itself or -- that was really the 

question I have. 
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 DR. MELIUS: Yeah. 

MS. HOMOKI-TITUS: For the Federal -- the 

Federal Register notice will include any 

comments that the Board makes, but you're not 

under a legal requirement to make comments if 

you don't want to. 

 DR. ZIEMER: Yes, okay. 

 DR. WADE: So the way this will happen, we'll 

put out an agenda for the meeting. We'll 

mention in that agenda we're going to discuss 

it. We'll come to that phone call and make a 

presentation to you. You'll react. We'll 

capture your comments, and then issue a Federal 

Register notice of the change and your 

comments. 

DR. NETON: I might add, though, prior to that 

meeting we'll provide the Board with some more 

documentation --

 DR. MELIUS: Yeah, now --

DR. NETON: -- (unintelligible) to this issue. 

 DR. MELIUS: -- what I think the documentation 

should include would be your new procedure. 

think --

DR. NETON: We can do that and we'll -- 

 DR. MELIUS: And some -- some of the background 

I 
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-- to the extent that background's not covered 

on lymphomas and sort of the science behind 

this, I think to the extent you could attach 

some of that, either a review article or 

whatever background documentation you have. 

don't think it needs to be, you know, an 

extensive report, but something that would be -

- be helpful for us to understand that would be 

useful. 

DR. NETON: That won't be a problem. 

 DR. ZIEMER: And let me ask, any of the other 

Board members have particular items you feel 

should be included in that report? I think to 

some extent we'll leave it to your judgment as 

to what that contains, but at least some 

background material so that we have a basis for 

making informed comments for the Federal 

Register. I -- I assume that the Board will at 

least want to have something on record in that 

-- in that Federal Register report. 

I don't -- since the procedure in the Federal 

Register is defined and we have conveyed the 

information desired, I don't think a formal 

motion is required here unless someone believes 

that you'd like to formalize it in some way. 

I 
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But I believe we understand how to proceed 

here, so without objection, we'll proceed on 

that basis. 

Then age at exposure -- 

 DR. MELIUS: Yeah, I... 

 DR. ZIEMER: Jim, do you have a comment there? 

 DR. MELIUS: Yeah, I think we had discussed 

briefly that -- again, the issue was for NIOSH 

to come back to us and -- particularly when the 

large IARC study has been analyzed and -- as to 

whether that sheds any further light on -- on 

this -- on the age at exposure issue and where 

there may be other -- other science at -- at 

the time and I think then make a decision if 

appropriate after that point in time on what 

way to go forward. But I think we generally 

agree that we need more science here. 

 DR. ZIEMER: Well, and keep in mind now that 

NIOSH is not recommending a change in this 

particular thing at this time. They have 

committed themselves to continue to monitor the 

research literature and keep us informed. So 

with that background and the comments you made, 

we --

 DR. MELIUS: Yeah, yeah, and the action may be 
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very well as sort of more formal evaluation of 

this in relationship to the IARC -- and to -- 

excuse me, to the IREP model. 

DR. NETON: It's been a long day. 

 DR. MELIUS: Whatever those are, one of those 

I-Rs. 

 DR. ZIEMER: Now in -- so thank you, Jim, on 

that. Why don't you stay put for just another 

moment. I'd like to make sure on the -- I have 

too many pieces of paper here, but on the list 

of priorities -- thank you, to the rescue -- on 

the risk -- or on the list of priorities to 

make sure that we have, number one, still 

retained the same priorities, or changed them; 

and are there other items that should be on 

this list now, as time has passed since the 

list was first generated. 

Gen Roessler, Jim Melius. 

DR. ROESSLER: I think it's referred to on this 

list, but under DDREF it mentions the imminent 

release of BEIR VII, and I'm wondering how that 

will impact on this particular topic and 

whether there are any other topics identified. 

I haven't read BEIR VII, maybe nobody else here 

has really read the whole thing, either, but -- 
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 DR. ZIEMER: Well --

DR. ROESSLER: -- I'm wondering if there's 

anything that --

 DR. ZIEMER: -- Owen claims to have read BEIR 

VII, and -- and since he's here from SENES and 

they're one of the key players here -- but 

please don't summarize BEIR VII for us, Owen. 

 DR. HOFFMAN: Well, I think the question has to 

do with the low dose, low dose rate 

effectiveness factor --

 DR. ZIEMER: Yeah, this is the dose rate 

effectiveness factor. 

 DR. HOFFMAN: -- and at the time that issue was 

discussed here, BEIR VII was not yet out. 

 DR. ZIEMER: Correct. 

 DR. HOFFMAN: It has since come out, and what 

you'll be interested to know is that what's in 

BEIR VII effectively is not much different than 

what's in IREP. The biggest difference is that 

they've chosen a continuous distribution to 

represent uncertainty, and that distribution 

conforms to a lognormal distribution instead of 

it being discrete -- a discrete distribution 

where weights are given at different points. 

The center of the distribution is at 1.5. They 
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did an evaluation just based on Japanese 

survivors' data at very low doses and came up 

with a geometric standard deviation at about 

1.24, but in committee said this intuitively is 

too tight of a distribution and inflated that 

to the equivalent of a geometric standard 

deviation of 1.35. And so when you look at a 

95 percent credibility interval on the DDREF 

itself, it's not markedly different from what's 

in IREP at present time. 

Now just to give you some insights, we have 

been tasked by NIOSH to look into the whole 

question of DDREF, and we're not ready to 

report to you on our results, but just to give 

you some preliminary insights as we still think 

there are some open questions having to do not 

so much with low dose acute exposure, but the 

whole question of chronic long-term exposures 

and whether or not the distribution adopted by 

BEIR VII is wide enough to account for our -- 

the uncertainty in our state of knowledge. 

 DR. ZIEMER: You're puzzled as to whether that 

answered your question or not, so -- 

DR. ROESSLER: I think what you are saying, at 

this time there is nothing from BEIR VII that 
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suggests that there's anything inconsistent 

with IREP. 

 DR. ZIEMER: There's no (unintelligible) -- 

 DR. HOFFMAN: No, no -- no, in terms of BEIR 

VII there is nothing that stands out. What 

stands out to us, there is some inconsistencies 

with the general literature. 

 DR. ZIEMER: Thank you. Jim. 

 DR. MELIUS: Just to follow up on that, maybe 

what's appropriate and -- is when you finish 

your report and there's sort of closure on it 

within NIOSH, maybe we could have a 

presentation, discussion of this issue then and 

sort of cover everything at that point in time. 

The other issue that I'd like to raise that's 

on there that's sort of listed as there's no 

action is the -- the issue of the interaction 

with chemical and other exposures in these 

facilities, which is something that, if I 

remember the law -- it's been a while -- it's 

sort of that NIOSH is tasked with evaluating in 

some way if -- at some point is -- you know, 

should worker populations be treated 

differently because of the worker populations 

and other issues. And I believe we discussed 
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this probably two years ago, may have been -- 

maybe longer, and at the time decided there 

just wasn't enough information to be able to 

adjust the IREP model to take that into 

account. I would think it's worth it at some 

point to sort of reopen that discussion, just 

to get updated. You know, what's new, what's -

- what's changed with that. And I think 

particularly because the Subtitle E program 

really raises that question again. Department 

of Labor's going to be going through and 

evaluating sort of mixed exposures -- 

radiation, chemical, asbestos, and so forth. 

And I think as we heard in the public comment 

period, it's -- and it's going to bring that 

more to the forefront in terms of people 

thinking about this program. And again, I'm 

not sure the science is ready to change the way 

we approach things, but -- but I think we do 

need to revisit the issue and at least get 

updated on -- on where we are 'cause I think 

it's still -- it still should be open at some 

point as to whether we -- we couldn't have a 

better approach that would take into account 

the other exposures at these facilities, at 
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least to the extent it interacts with the 

radiation exposure. 

 DR. ZIEMER: Is there someone in NIOSH that's 

currently tracking the literature on this? I -

- frankly, this is a vast, vast topic, I mean 

when you think of all the possible interacting 

agents and toxic agents that could be 

considered. Is anybody focusing on any 

particular subsets within the whole realm of 

toxic chemicals? And who's tracking the 

literature on this? 

DR. NETON: Thank you, Larry. 

 MR. ELLIOTT: Well, I would love to say that -- 

 DR. ZIEMER: I mean it's a --

 MR. ELLIOTT: It is a vast --

 DR. ZIEMER: Mind-boggling. 

 MR. ELLIOTT: -- vast, complex subject area, 

and I would like to say that somebody is 

tracking it with regard to radiation and 

effects associated with other exposures and 

radiation. We have a NORA committee on mixed 

exposures. They are probably the sole entity 

monitoring research and progress on determining 

synergistic, additive, multiplicative effects, 

interactions and these kind of things. But I 
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don't believe that they've included a specific 

focus on radiation and other chemicals in those 

interactions. 

 DR. ZIEMER: Are they -- are they looking at 

that as one of the things, though? Do they --

do they look at it at all, do you know? 

 MR. ELLIOTT: I don't -- I'll have to check 

into that, and it merits some follow-up, to see 

if -- if they have an interest in that and if 

they're following it. If not, I can express 

the concern that we want them to and see where 

that'll take us. There may be individual 

researchers, of course, at NIOSH who have, you 

know, a special interest in this and are doing 

what they can, but they're working at -- in 

their own vacuum in that regard and they need 

to seek those out, as well, so -- 

 DR. MELIUS: Who did the presentation two years 

ago? I -- 'cause we did have a presentation on 

this and decided -- I thought it was somebody 

from HERB that updated us as part of -- 

DR. NETON: I think that might have been Mary 

Schubauer-Berrigan, if I'm not mistaken -- 

who's in the audience right now, actually. 

 DR. ZIEMER: Was it? 
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 DR. MELIUS: (Unintelligible) that, and again, 

I don't want to say that we're ready to make 

changes or underestimate sort of the complexity 

of this. But at the same time, I think it is 

something that's going to be a recurrent issue 

among the claimants and I'd much rather have us 

take an -- affirmative steps to say -- at least 

stay on top of this issue. I really think 

Congress has charged you to -- to be at least, 

you know, monitoring what's going on. And 

again, it's not something that has to be at the 

next meeting, but at some point in the -- you 

know, next year or two, we need to be, you 

know, just updated on where this is. And if 

you -- the update is there's no new literature, 

nothing that's really helpful, then fine. At 

least we've -- we've said we've -- we've looked 

at it to that --

 DR. ZIEMER: I think it's a good suggestion, 

and let's make it -- two years is a little far 

out, I think, on the horizon. I'd like to 

suggest that we try to get this on the agenda 

this year, if we can -- simply a status report. 

It may be that there's someone else in the 

agency, maybe the NORA group has someone who 
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can at least give us a status report, if only 

to say nobody's funding such research. I'm 

also wondering if -- if there is any funding in 

either NIH or DOE, 'cause it's really these 

interactive or synergistic effects that often 

are synergistic, actually, and would be at 

least useful to identify what's going on in -- 

in that field. 

 DR. MELIUS: Just I would be happy to have Mary 

welcomed back or -- she did a good job last 

time. 

 DR. ZIEMER: That would be fine. However, if 

the agency has someone who's actively working 

on that --

 DR. MELIUS: I understand, I'm not -- that was 

just... 

 DR. ZIEMER: We'll have both. We'll have a 

synergistic presentation. 

 Yes, Roy? 

 DR. DEHART: As I recall, in the last several 

years there have been a number of publications 

coming out of Scandinavia and Europe regarding 

solvents and radiation exposure. One specific 

one is benzene. 

 DR. ZIEMER: Yes. 
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 DR. DEHART: So I know there's some current 

stuff out there. 

 DR. ZIEMER: And actually -- and I don't want 

to prolong this discussion -- but to move into 

that realm, it's going to have to be one step 

at a time. It's going to have to be something 

like radiation and benzene. And once you -- I 

think. And once you get experience with that, 

you can say okay, now it's radiation and 

benzene and you name some pesticide or whatever 

it may be and start to develop that. But this 

-- this has been a longstanding issue that is 

very difficult to come to grips with 'cause 

it's not easily analyzed epidemiologically, nor 

in the laboratory. 

 Okay, further items now on the priority list. 

Any additions or modifications? And that 

interaction is on the priority list and we will 

make sure we get it on the agenda, as well. 

Thank you, Jim. 

(Pause) 

BOARD WORKING TIME, DR. PAUL ZIEMER, CHAIR 

We have a number of items now that are sort of 

a Board working session. We're going to talk 

about future agendas and items, and maybe even 
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locations. We're also -- have maybe -- maybe 

one item can precede this pretty rapidly, but I 

want to point out to the Board that although we 

have desi-- or are recommending designating 

Linde Ceramics as a Special Exposure Cohort, 

our contractor also is, as we speak, in the 

process of reviewing the site profile for Linde 

Ceramics. And John Mauro has asked for some 

guidance from the Board as to how they proceed. 

In other words, does designating the early 

group as part of this Special Exposure Cohort 

affect how they review the site profile. 

Let me add to that, it would seem to me that 

for the early years where there still is a 

possibility for reconstructing external doses 

because there is monitoring data, and since 

there is the possibility that one could have 

skin cancer claims made in the -- outside the 

exposure cohort, that reviewing the site 

profile for the full scan of years may still be 

important, that we shouldn't necessarily 

exclude the early years simply because there's 

a Special Exposure Cohort. 

I'd like to get some feedback from the Board as 

-- so that we can give guidance to the 
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contractor on that issue. Jim? 

 DR. MELIUS: Yeah, another parameter that would 

be of use, 'cause I don't think we can predict 

whether we'll have another SEC petition 

relevant to other years, but this latest action 

may increase it -- that chances, but it -- it's 

hard to say. But -- but it would also be 

helpful to know where NIOSH is in terms of 

addressing -- obtaining the documentation, to 

what extent it's available, for later years and 

being able to have a comprehensive -- I don't 

know what the right term is -- site profile 

there, because -- you know, the question would 

be, as I looked at the site profile when we -- 

when I got the Linde evaluation, saw there was 

nothing there to review for -- for -- very 

little for '47 -- there wasn't much there in 

general. I mean it's a pretty sparse document, 

and I'd hate to have our contractor spend a lot 

of time rushing to get that done when there's 

really not much to review. And even if we got 

an SEC request there, we would end up having to 

spend --

 DR. ZIEMER: Yeah. 

 DR. MELIUS: -- you know, going back to it in 
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some way. I mean -- and some of the 

inefficiencies we've had are the fact that in 

addressing SEC petitions we end up then 

expanding or updating a site profile and it 

turns out our review wasn't really, you know -- 

 DR. ZIEMER: Wasn't needed. 

 DR. MELIUS: -- it goes -- isn't complete 

enough to address all the issues that have then 

come up, and I think it does tend to prolong 

the process, so it's -- I mean I think what 

we've been doing is appropriate in terms of 

action. So I guess my question be is -- you 

know, are there plans to fill in that more or 

is that -- are we -- all we have with Linde is 

what we've got now and that's it. So to the 

extent you can answer that in 30 seconds or... 

DR. NETON: I think that what we have right now 

is our best shot. It's unlikely to change 

substantially. 

 DR. MELIUS: Okay. Thanks. 

 DR. ZIEMER: Okay. And which means that what 

SC&A would review is what's there, which is 

sort of a minimal amount, but nonetheless, it 

is on their list. It's not -- it's -- they 

have some other priorities, but it is in the 
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list. And I think you've actually gotten 

underway. It's -- or at least somebody's 

started to review it, from what I understood 

from John. 

 MR. FITZGERALD: Yeah, we -- we have started 

reading and going through -- again, it's just -

- not too far, but just beginning to get into 

it. But certainly the same thought crosses our 

mind as far as the material to review. It 

might not be certainly as much on that 

particular one. 

 DR. ZIEMER: Okay. 

DR. NETON: I'd just like to add, I think in a 

case like Linde it's not exactly -- sort of 

like Bethlehem Steel. But where you have a 

paucity of data, we have constructed models to 

fill in the blanks, so to speak, and those are 

technical issues. You know, we certainly would 

welcome review comment by SC&A, you know, just 

because of the fact that we don't have a lot of 

-- of volumes of data, so it would be relevant 

I think to get some feedback on those 

approaches. 

 DR. ZIEMER: Now no particular action is 

required unless this Board wishes SC&A to 
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somehow modify what they are doing. Is -- I 

just simply wanted to make you aware that they 

have raised the question, does the action that 

we took affect them in terms of their review of 

Linde. Wanda? 

 MS. MUNN: No. 

 DR. ZIEMER: Okay. 

 DR. WADE: Could you be more specific? 

 DR. ZIEMER: Okay. Any other comments? 

 DR. MELIUS: Don't equivocate. 

 DR. ZIEMER: Okay. Thank you very much. We 

are going to talk about scheduling things, and 

then there are a couple of Board members who 

have some -- a variety of motions to make on 

dealing with a variety of issues, one having to 

do with -- there's been some consideration as 

to what we might do to define the parameters 

for quality of data for dose reconstructions, 

and perhaps a workgroup along that line, and 

we'll entertain a motion dealing with that. 

Also, some desire to make a formal response to 

the New York delegation, since they have 

written us some letters that were put on the 

record, and to reply to those, as well. But --

so we have several items there in addition to 
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the future meetings, future activities and so 

on. 

 DR. WADE: And the last item on the agenda, 

we'll just have a bit of a discussion of 

conflict of interest and get your sense -- the 

Board's sense as to the things they would like 

us and the Office of General Counsel to 

consider in any future analysis or review. 

FUTURE MEETINGS 

But let me try and tackle the topic of 

scheduling, and I'm going to do it in three 

pieces. 

 DR. ZIEMER: And everybody should have a copy 

of Lew's proposed schedule, I think. 

 DR. WADE: First I'm going to ask you to try 

and hold some dates for Board meetings. Then I 

would like to look at a proposed sort of 

future-looking agenda for Board activities. 

And then I'd like to take you back to some 

things you've been binning as potential topics 

for workgroups. 

So first the dates, and let me be very 

prescriptive, if I might, and then you can stop 

me, shout me silent, when it's appropriate. 

Right now we have a Board call scheduled for 
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November 28th. I would like you to mark on 

your calendars for a potential Board call on 

January 9th. 

 DR. ZIEMER: As well. 

 DR. WADE: As well. Again, I'm just trying to 

build some potential into the system for issues 

that might come up. 

 DR. ZIEMER: Do we have a time on the 28th 

Board call? 

 DR. WADE: Well, I think in deference to our 

friends on the west coast, I would say -- 

 DR. MELIUS: 7:00 a.m. 

 DR. WADE: -- 7:00 a.m. west coast time, which 

would be --

MR. ESPINOSA: 7:00 a.m. west coast time. 

 DR. ZIEMER: 10:00. 

 DR. WADE: -- 10:00 a.m. on the 28th, 10:00 

a.m. on the 9th. The 28th I think is a go. 

The 9th remains to be seen, but I'd like to get 

it on your calendar. 

We have a Board meeting scheduled for the 24th, 

25th and 26th. I'd like to come back and 

revisit that in a moment. 

I would like you to hold March 14th at 10:00 

a.m. for a Board call. And then I would like 
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you to hold April 25th, 26th and 27th for a 

Board face-to-face meeting. 

 MS. MUNN: April. 

 DR. ZIEMER: Give us the March date again. 

 DR. WADE: March 14th. And these are all open 

dates on all of your calendars. 

 MS. MUNN: The March 14th was... 

 DR. WADE: A call. 

 MS. MUNN: A call. 

 DR. WADE: And again, we might not need it. 

But I'm guessing -- the way we're doing 

business, I think there'd likely be a Board 

call between each face-to-face meeting to sort 

through some of these issues. 

 MR. GRIFFON: And the April date for... 

 DR. WADE: The April dates are the 25th, 26th 

and 27th. 

 DR. DEHART: And December again for the phone 

call? 

 DR. WADE: The phone call is November 28th. 

 DR. DEHART: Oh, I thought there was a phone 

call in December. 

 DR. WADE: December's phone call is November 

28th. 

 DR. ZIEMER: It was -- it was changed --
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 DR. WADE: We changed it yesterday. 

 DR. ZIEMER: It was on the 1st. 

 DR. DEHART: Okay. 

 DR. ZIEMER: It was originally on the 1st. 

 DR. WADE: We changed it to accommodate some 

schedules, so now I think everyone can 

participate in those dates. 

Okay, deep breath --

 DR. MELIUS: April date's 25th --

 DR. WADE: 25th, 26th and 27th, full Board 

meeting, likely Colorado. 

 DR. MELIUS: I'd better to play the lottery, it 

just fit my calendar perfectly. 

 DR. WADE: I understand. Now let me go to the 

knotty issue of -- we have long scheduled a 

face-to-face Board meeting for January 24th, 

25th and 26th. It has come to my attention 

that that is a conflict for some people, given 

the Health Physics Society meeting. There is 

an open period with one small exception. If we 

were to go to January 30th, 31st and February 

1st, that's open on everyone's calendar except 

Paul's on the 1st. I wonder, Paul, if there's 

any flexibility in that? 

 DR. ZIEMER: Yes, I can -- I can skip my other 
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meeting. 

DR. ROESSLER: I might be the only one with the 

conflict with the health physics meeting, and 

if that's the case it's not a problem because I 

think I can send a representative to the health 

physics meeting and be here. I don't want to 

throw everybody off, because that date has been 

there and I've thought about it and thought 

that that would work for me. 

MR. ESPINOSA: Where is your meeting at, Gen? 

DR. ROESSLER: Scottsdale. You want to switch? 

 DR. WADE: Paul, are you -- Paul, would you 

prefer to keep the dates originally or to 

switch one week? 

 DR. MELIUS: Let's switch our location. 

MR. ESPINOSA: (Off microphone) Let's switch 

our location, yeah. Let's piggyback on Gen's 

(unintelligible). 

 DR. MELIUS: We have an SEC petition from 

Scottsdale. 

MR. ESPINOSA: Yeah. 

 DR. ZIEMER: Yeah, my preference would be to 

keep it where it is, but I can switch my date, 

as well. 

DR. ROESSLER: No, I -- I think it'll work. 
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 DR. WADE: So let's keep it where it is, 

January 24th, 25th, 26th. I think it's going 

to be here in Oak Ridge. Not here in 

Knoxville, in Oak Ridge. And I think, LaShawn, 

we already have the hotel in Oak Ridge? Okay. 

So those are the dates. One more time, Board 

call at 10:00 a.m. Eastern Daylight Time on 

November 28th; a face-to-face Board meeting in 

Oak Ridge on January 24th, 25th, 26th; a 

tentative Board call at 10:00 a.m. on January 

9th; a tentative Board call at 10:00 a.m. on 

March 14th; and a face-to-face Board meeting on 

April 25th, 26th, and 27th, likely in Denver. 

Okay? That was okay. 

Next is this piece of paper that you've got 

that looks at starting to cobble together 

agendas for the Board meetings. For the 

November 28th call, we are likely to be looking 

at a Pacific Proving Grounds SEC that will 

likely be a recommendation to add the class. 

If that is the case, rather than to wait 

another month and a half, I would propose, 

again, if it's a simple recommendation we would 

do it on the November 28th call. Okay? 

We do want to deal with the Bethlehem Steel 
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Technical Basis Document, and we'll talk more 

about that in a moment as to what the issues 

are, but you asked that that be considered on 

the November 28th call. And we have the Y-12 

TBD that I think will be very important to 

address on the November 28th call. And you've 

asked that update on science issues CLL and 

lymphoma be on the November 28th call. 

 That's starting to make a busy call, but those 

are the tentative agenda items for the November 

28th call. Okay? 

 For the January meeting -- 

 DR. ZIEMER: Don't we have January 9th in 

between there? 

 DR. WADE: Well, we don't know what we'll do at 

that. That's, to me, held as a potential. 

 DR. ZIEMER: So we --

 MR. GRIFFON: Lew --

 DR. ZIEMER: -- if we can't cover all these, we 

would carry them over? Is that what you're 

suggesting? 

 DR. WADE: Possibly, and some of these other 

items that we're going to discuss I think might 

take some agreement before the Board meeting. 

 MR. GRIFFON: I -- I don't know if I'm getting 
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ahead of things here, but do we have some 

workgroup dates in between these, too, and -- 

 DR. ZIEMER: Right, yeah, we'll set those next. 

 MR. GRIFFON: Okay. The only reason I raise 

that is I'm wondering if -- on this conference 

all if -- if we would be ready and -- and it's 

probably not good to present this in a 

conference call format, anyway, but the 

procedures review of the internal dose. I'm 

not sure if -- that might want to wait until 

the face-to-face, but -- 

 DR. WADE: Okay. Jim? 

 DR. MELIUS: Yeah, I would just add that I get 

a little worried if we have a long agenda that 

involves a lot of public participation in a 

conference call. Just the sheer numbers of 

people on just cause problems. We've had 

problems with highway noise and other problems 

there, and I just think that -- we may just 

have to think through to the extent, again, if 

Pacific Proving Grounds is straightforward, 

that -- that may be okay. But some of these 

other -- both Bethlehem and Y-12 -- I don't 

know to what extent there'll be more people. 

And at the same time I think we have to be 
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available for the public so I don't want to say 

curtail it, but --

 DR. WADE: Yeah, I think -- I think we'll 

refine this as we go through the discussion. 

 DR. ZIEMER: Just --

 DR. MELIUS: Okay. 

 DR. ZIEMER: -- voiced a concern. Okay. 

FUTURE ACTIVITIES

 DR. WADE: Now in January we have a number of 

things that have been asked to be put on the 

agenda. Right now we're imagining that the Y12 SEC petition for '48 to '57 will be on the -

- and it'll be the centerpiece of the January 

face-to-face meeting agenda. 

We hold open the possibility, although it might 

not be great, that there'll be other 83.14 

NIOSH-identified SEC classes, although Stu 

indicated not likely. But I would like to hold 

that potential on the agenda. 

 You asked very specifically yesterday that the 

working group would report out on Bethlehem 

Steel, particularly the interview with Mr. 

Breslin and then the other issues. I put that 

on there. We'll talk about that in terms of a 

working group item. 
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I think we'll need to look at the Rocky Flats 

Technical Basis Document, the Savannah River 

Technical Basis Document, Hanford Technical 

Basis Document. We have the Mike Wright letter 

that was referred to last night that I think we 

need to put on the agenda of the next Board 

meeting. I'm open to the possibility of trying 

to do that in a telephone call but, again, that 

might be difficult. But I think we owe Mr. 

Wright an answer. 

We are looking at a re-write of the SEC rule 

that could well be through our department and 

ready for discussion with you in January. 

We owe a report on adding to the list of the 22 

covered cancers. We think tentatively we might 

be ready in January; we might not. 

 Depending upon what flows from the conflict of 

interest, we have the DR reviews that are 

continuing to -- to flow. 

And I imagine there'll be updates on science 

issues. 

Liz? 

MS. HOMOKI-TITUS: I'm not sure if that report 

that you just referred to regarding the 

updating of the SEC cancers list is something 
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that NIOSH is doing on their own, but as far as 

we know it has not been signed by the 

President. It's not a requirement yet. 

 DR. WADE: We understand. I'm just trying to 

make potential space available. 

MS. HOMOKI-TITUS: Okay. 

 MR. GRIFFON: It -- it seems to me that -- that 

this meeting may require a few more days. I 

also -- I also think procedures review belongs 

on there --

 DR. MELIUS: Yeah. 

 MR. GRIFFON: -- and -- and you know, this is 

getting full. I don't know that we're going to 

get to Savannah River or Hanford TBD, 

realistically. 

 DR. MELIUS: And I -- let me just add to that 

so -- I mean I'd much rather have us make 

significant progress on one of them than a 

little bit of progress on all three 'cause then 

we're -- you know, it just sort of prolongs it, 

at the same time recognizing that it may not be 

possible to have complete closure on one within 

a time period. So there may need to be some 

judgment on that based on some of the working 

groups. 
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I'm also a little confused, and it's probably 

my own fault 'cause I wasn't here when you were 

discussing Bethlehem, but -- but if Bethlehem's 

on both November and January, is -- I don't 

understand why it's on both. The idea, I 

thought, was to bring closure, and do we need 

to discuss it -- I think one or the other. I'm 

not sure --

 DR. WADE: Right, I'm not sure we do, either. 

When we talk about the working group -- 

 DR. MELIUS: Okay. 

 DR. WADE: -- I think that'll sort -- 

 DR. MELIUS: Okay. 

 DR. WADE: But what about this wonderful 

suggestion of meeting four days in Oak Ridge -- 

24, 25, 26 and 27? You've made the trip. 

 DR. MELIUS: How about a half a day on the 

(unintelligible) --

 DR. ZIEMER: It seems to me that that's really 

almost too long to be productive, both for us 

and for NIOSH staff, but that's my own feeling. 

These are -- I know we've made the trip, but 

there's a point of diminishing returns on these 

kind of activities. 

 DR. WADE: Okay, I understand. 
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 DR. ZIEMER: I don't know how the rest of you 

feel, but I think three days pushes -- 

certainly for me it does, but speak for 

yourselves. 

 DR. WADE: I understand. 

 DR. MELIUS: How about a half-day on Friday? 

Will we get anything done or -- 

 DR. ZIEMER: I don't know. 

 DR. WADE: Okay, let's keep the three days. 

I'll be shifting things -- things will -- the 

weight of this agenda will naturally cause it 

to flow down, but again, I wanted to get -- let 

you know the breadth of the kinds of things 

we're considering. 

Then when you get into the April meeting, we're 

likely looking at the Rocky Flats SEC petition. 

We're likely to be looking at the Ames 

University of Iowa -- or is it Iowa State? 

 DR. ZIEMER: It's Iowa State, Ames. 

MR. ESPINOSA: Would there be any possibility 

of having a face-to-face maybe for a day and a 

half to -- for the Oak Ridge SEC, late 

November, early December? 

 DR. WADE: I honestly don't think we'll be 

finished with the work on the -- 
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 MR. GRIFFON: No. 

 DR. WADE: -- the site profile. 

 MR. GRIFFON: Right. 

 DR. WADE: I think it's a good idea, Richard, 

but I don't think we'll be ready to have 

completed the site profile or... 

And you can see we've got the Nevada Test Site 

coming up. 

 MS. MUNN: Oh, yeah. 

 DR. WADE: You've -- I have an arrow up on the 

NIOSH status report on Task III external dose 

actions. Again, we've done -- no, we've done 

the external; this would be internal. Right? 

We've done the external? 

 MR. GRIFFON: Yeah. 

 DR. WADE: The internal is yet to be done. 

 MR. GRIFFON: It's procedures review, I think 

you can call that, yeah. 

 DR. WADE: Yeah, the Task III procedures review 

on the internal. It'd be nice to do that in 

January, but again, January is so full. 

So again, enough said on it. This gives you a 

sense of the kinds of things that we're 

juggling and we've -- we've identified some 

dates. 
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Now to the last issue, which is the working 

groups. I made notes and I've put it up on the 

screen of things that you said you wanted to 

deal with in working groups. And I know it's 

not a complete list, but on Bethlehem Steel 

there are the two issues. They are the 

discussions with Breslin relative to the GA 

versus BZ samples. And then there were trying 

to reach resolution on all the other issues 

that have been identified in Bethlehem Steel. 

Those are two separate things. I think we need 

to do them. Dr. Melius is correct, maybe we 

don't do them on the call. Maybe we do them 

when we sit down face to face in January. But 

again, there needs to be working group action 

taking us up to resolution on those two issues. 

We need the development and population of what 

I call the resolution matrices -- that's the 

start of the six-step process -- for Savannah 

River, Y-12 and for Rocky Flats. And I 

highlight Y-12 as the most important. 

We have the Task III, which again is the 

internal dose matrix and the CATI interview 

matrix. That needs to be done in working 

group. 
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And then I know there are other proposals going 

to be made to deal with working groups, so I'll 

end my comments to say once you hear the other 

motions, then we need to start to schedule 

these things. 

 MR. GRIFFON: I think -- I think there's the 

ongoing six-step process for the DR reviews, 

too, that we need to --

 DR. WADE: Okay. 

 MR. GRIFFON: -- need to add to that list. 

We've got the second set of 20 and the third 

set of 20 --

 DR. ZIEMER: We have DR calls coming up next 

week on the third set. 

 MR. GRIFFON: But we haven't resolved the 

second set, either. 

 DR. ZIEMER: And second set comments haven't 

been resolved yet. 

 MR. GRIFFON: Right. 

 DR. WADE: So you're correct, Mark. Thank you. 

Okay. Just to set the stage for your very 

productive discussions. 

 DR. ZIEMER: Any comments on these or any items 

that have been overlooked in terms of at least 

being out there before us so we know what's 
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coming down the pike? 

 DR. MELIUS: Yeah, I actually -- I'm -- 

 DR. ZIEMER: Yes, go ahead, Jim. 

 DR. MELIUS: Just also think about populating 

these January 9th calls and March 14th calls, 

'cause I -- I think it is possible to do a call 

with significant public participation, but it's 

a lot easier when it's public participation on 

one issue. 

 DR. WADE: Right. 

 DR. MELIUS: And so that way people can pay 

attention to that issue and they're not 

confused by discussing multiple things. 

 DR. ZIEMER: Well, actually multiple calls may 

be a better approach. 

 DR. MELIUS: A better -- yes, what I was 

thinking, and so we have those scheduled, but 

utilize them in that way and -- you know, maybe 

 DR. ZIEMER: In fact, it might be possible to -

- even on a given day -- to break it into two 

calls or three calls or something like that. 

 DR. MELIUS: Yeah. 

 DR. ZIEMER: And so if you're interested in the 

discussion on say Pacific Proving Grounds -- 
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 DR. MELIUS: Yeah. 

 DR. ZIEMER: -- that's when it's going to be 

discussed. We may even have a different callin number so we can --

 DR. MELIUS: Yeah. 

 DR. ZIEMER: -- keep those groups separate. 

But could we look into that -- 

 DR. WADE: Yes, we can --

 DR. ZIEMER: -- as a possibility. 

 DR. WADE: We need a quorum to --

 DR. ZIEMER: 'Cause that background noise issue 

and multiple people issue is very, very 

difficult to conduct business. 

 MS. MUNN: We could do from 10:00 to 12:00 and 

then --

 DR. ZIEMER: Roy? 

 DR. MELIUS: Yeah. 

 MS. MUNN: -- 2:00 to 4:00 or something. 

 DR. ZIEMER: Good suggestion, Wanda. 

 DR. DEHART: I don't want to overplay the 

obvious, but I'd just remind everyone that 

there's an enormous amount of paperwork -- 

reading reports, et cetera -- as part of our 

homework for each and every one of these calls 

and attendance at meetings, so... 
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 DR. MELIUS: Well, and the corollary to that is 

a plea to NIOSH to get them to us early -- fast 

and well and give us adequate time to review 

them. 

 DR. WADE: Certainly. 

 DR. ZIEMER: Well, this will serve as a kind of 

road map, but it may take some detours as we 

proceed. But certainly the idea of considering 

multiple calls, even -- all in one day or in 

successive days might be a possible way to 

handle some of these. 

Okay, the Chair's going to recognize Roy DeHart 

for purposes of a motion. This -- this motion 

would deal with responding to the letters from 

the New York delegation. 

 DR. DEHART: I want to apologize for the group 

-- to the group for not having written the 

letter. It wasn't the intent of the motion to 

do that, but to indicate a need for the letter. 

The motion basically is it is moved that the 

Board prepare a letter addressed to the -- to 

Senator Shreimer, to Congressman Higgins and to 

Congressman Slaughter, with the following: 

One, express our appreciation for their 

interest in the Board's deliberation regarding 
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Bethlehem Steel; 

Two, provide current information on the status 

of Bethlehem Steel claimants, to include the 

number of claimants, the number not qualified 

or disqualified, the number for whom dose 

reconstruction has been completed, the number 

who have a POC greater than -- equal to or 

greater than 50 percent, the number who failed 

to achieve 50 percent, the number awaiting dose 

reconstruction; 

Part three, address other information of value 

to the discussion; for example, payments made 

to the Bethlehem claimants. 

 DR. ZIEMER: That is your motion? 

 DR. DEHART: That is the motion. 

 DR. ZIEMER: And if it passed, the Chair would 

be instructed to prepare such a letter with 

that content. 

 DR. DEHART: I would hope so, (unintelligible) 

motion. 

 DR. ZIEMER: Seconded? 

 MR. PRESLEY: (Off microphone) (Unintelligible) 

 DR. ZIEMER: Okay. Discussion on this motion? 

I assume if it passed that NIOSH would provide 

the necessary statistical data and information 
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for the Chair. 

 MR. ELLIOTT: We would be happy to do so except 

for the one point on those cases that weren't 

qualified. We don't have that information and 

we'll try to get that from Department of Labor, 

but... 

 DR. ZIEMER: Okay. Comment, Jim? 

 DR. MELIUS: Yeah, again, I wasn't here for the 

discussion so I'm -- don't quite understand the 

context of -- complete context for this letter, 

but I think I would object to the letter as 

proposed, but would approve a letter than 

included then some description of what our 

follow-up actions would, you know, be -- what 

the process has been and where the process was 

going; i.e., what we plan -- 

 DR. ZIEMER: On the site profile. 

 DR. MELIUS: -- on the site profile that we 

plan to resolve, you know, 'cause I think 

that's some of the -- the questions. And I --

to some extent I'm -- I think talking about 

that in the context of what's already happened 

at the site which you lay out. I just thought 

your letter stopped a little bit short, and I'd 

like to not just respond and say this is the 
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situation there, but this is what the Board 

plans to do to, you know, sort of complete our 

part of the -- our responsibilities at that -- 

at that site. And that by whatever the date is 

that we intend to complete the review of the 

site profile and -- and so forth, and that it's 

gone -- undergone an extensive and very 

complete and comprehensive review. 

 DR. DEHART: My letter was intended to be brief 

and informative. The -- all three letters 

implied that nothing was being done for the 

workers, and that is incorrect. 

 DR. MELIUS: Yeah. 

 DR. DEHART: It was a misinformation. And my 

letter intends to simply provide that 

information. 

 DR. ZIEMER: Jim, I don't know if you're 

proposing an -- a friendly or semi-friendly 

amendment that there be point four to the 

letter to sort of give them a status report of 

where we are on the site profile. Is that what 

you were suggesting? 

 DR. MELIUS: That was what I was suggesting. 

And I was trying to suggest it as a friendly 

amendment, so --
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 DR. DEHART: As a friendly amendment I would 

accept that, but I would not want to see a date 

to hold us to it. And if you put a date in 

there, I'll guarantee you the Congress will 

hold us to it. 

 DR. MELIUS: Well, I -- I think we have to -- 

I'm comfortable with fudging or estimating a 

date that -- where we are and that we hope in 

the next few months to complete that 

(unintelligible) --

 DR. DEHART: I have an area in number three 

which -- for other information that's 

appropriate to the letter and so I can -- I 

would accept that. 

 DR. MELIUS: And I'm sure Paul can craft an 

appropriate... 

 DR. ZIEMER: I was hoping you guys would draft 

a (unintelligible) -- Wanda, you have a 

comment. Are you speaking for the motion or -- 

 MS. MUNN: Yes, I am, and I'm speaking -- 

 DR. ZIEMER: -- against the motion? 

 MS. MUNN: I am speaking for the abbreviated 

motion. It -- one -- of course I can count the 

votes now and see what the opportunity is for 

my passing that, but I know this won't go. 
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Nevertheless, that doesn't change the fact that 

the purpose of this letter, it seems, should be 

to correct the misinformation and obvious lack 

of knowledge that our lawmakers have with 

respect to where this particular claim is right 

now. They need to understand that there are 

not gross errors in what NIOSH has done, that 

no one is dragging their feet, that Bethlehem 

Steel has not been ignored and is not being 

unfairly treated, but that 45 percent of the 

claims that have been received so far from 

Bethlehem Steel have been paid and that most of 

them have actually been handled already. They 

don't -- they clearly do not know that. 

If we incorporate into this letter everything 

that we have done or plan to do, then it does 

not have either the impact nor does it meet the 

real purpose of responding to the issues that 

were raised in the letters to this Board. 

 DR. ZIEMER: Thank you. Now, other comments? 

It appears to the Chair that you were speaking 

against expanding -- adding the semi-friendly 

amendment. 

 DR. MELIUS: The friendly amendment -- 

 MS. MUNN: You are correct. 
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 DR. MELIUS: -- Roy had accepted where we are 

and (unintelligible). 

 DR. ZIEMER: That's all right. Okay, other 

comments pro or con? 

 DR. DEHART: To try to make room for everyone, 

let me suggest we leave this to our Chairman to 

prepare. He -- he has heard the comments from 

those of us around the table with regard to 

such a letter. 

 DR. ZIEMER: I think Bob has a comment. 

 MR. PRESLEY: As -- as second to the motion, I 

-- I agree to both parts. I think we do need 

to make it short and sweet as to what we plan 

on doing, but I do think that we need to 

address very strongly the three points that 

were made in that letter. Letters. 

 DR. ZIEMER: Letters, yes. Okay. Leon? 

MR. OWENS: Dr. Ziemer, I think that the Board 

has, over the past several months, responded in 

kind when we've had Congressional inquiries. 

We've also allowed our contractor to respond in 

kind to Congressional inquiries, and I would 

agree with Roy's motion. I'll speak in favor 

of it, but with the friendly amendment that Dr. 

Melius has suggested. I don't think the Board 
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in any way wants to chastise any member of the 

Congressional delegation. I think that what we 

would like to do, though, is to provide 

information and provide a status update when 

they have received information that was 

incorrect. I think that NIOSH, Mr. Elliott, 

provided us information yesterday in regard to 

the status of Bethlehem Steel, and I think it 

would be wise for the Board to include that 

information and also an update on the site 

profile, along with the points that Roy had 

made in his motion. 

 DR. ZIEMER: Okay, thank you. Other comments? 

Jim? 

 DR. MELIUS: Yeah, I was not necessarily trying 

to weaken what Roy was intending as much as 

just saying we need to add a fourth strong 

point and to -- to the letter. And I -- I just 

think it would both read better and I think it 

also conveys our efforts involved in that. 

 DR. ZIEMER: And the mover and seconder 

actually accepted that, so it does become part 

of the motion. The Chair will rule that the 

motion that's before us does include some brief 

-- brief comments about the status of -- of our 
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review of the site profile and is coming to 

closure on that. 

Further, if the Board so wishes, we could 

certainly distribute copies of a draft in 

advance to make sure there aren't levels of 

heartache, although I'm -- we can't really take 

any votes by mail, so -- and we can't do 

business by e-mail, so what -- what could 

happen is that if it took me long enough to 

draft this, it may almost take to the November 

28th conference call. 

 DR. WADE: Well, the other approach could be 

you could draft it and send it out, and if you 

heard from -- you pick the number, three Board 

members --

 DR. ZIEMER: We could call a meeting. 

 DR. WADE: -- concerned, then we -- 

 DR. ZIEMER: Right. 

 DR. WADE: -- could do it at --

 DR. ZIEMER: Right. 

 DR. WADE: -- the meeting. If not, we can send 

it out. 

 DR. ZIEMER: Right. Are you ready to vote on 

this motion? 

Okay. Then all in favor, say aye? 
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 (Affirmative responses) 

 Those opposed, say no? 

 (No responses) 

 And any abstentions? 

 DR. WADE: Henry Anderson's not here. 

 DR. ZIEMER: And Henry is not here. Motion 

carries, thank you very much. 

 DR. WADE: Just so -- for my understanding, you 

will draft a letter, send it out. If you hear 

from three Board members with a concern, you'll 

wait until the Board is next formally convened. 

 DR. ZIEMER: Right. 

 DR. WADE: If not, you'll send it on. 

 DR. ZIEMER: Right. 

 DR. WADE: Okay. 

 DR. ZIEMER: Now the Chair recognizes Jim 

Melius for purposes of making a motion relating 

to a potential workgroup for -- 

 DR. MELIUS: Yeah. 

 DR. ZIEMER: -- developing -- well, the motion 

will -- will --

 DR. MELIUS: Yeah. 

 DR. ZIEMER: -- I won't give your motion as 

part of the --

 DR. MELIUS: Yeah, let -- let me discuss the 
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context of this thing. It's certainly going to 

be popular in suggesting another workgroup and 

another meeting, but I -- I think this would be 

very helpful to the process. 

I think all of us have been frustrated by the 

difficulties we've had in addressing some of 

the -- both the SEC petitions, particularly the 

Mallinckrodt one and to a lesser extent the 

Iowa SEC petitions, and also in dealing with 

the site profiles, particularly the Bethlehem 

one where we have spent a long time wrestling 

with these issues. And part of the reasons for 

this are just sort of procedurally and us sort 

of learning how to deal with SEC petitions and 

so forth. But I also think that some of the 

problem is that -- that we really haven't 

defined the criteria for determining, you know, 

when has a SEC petition been adequately 

evaluated, what's a dose reconstruction that's 

been completed with sufficient accuracy, how do 

we -- what does it mean by sort of, you know, 

maximal feasible dose reconstructions and 

things like that that, while they may be 

difficult to define those precisely and 

mathematically in a regulation or whatever, I 
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do think that we could -- we need to try to 

come to grips with those issues and try to 

develop some guidance that NIOSH could follow 

in terms of dealing with SEC petitions, in 

terms of dealing with the evaluation of these 

site profiles, that the Board could utilize in 

having to make some assessment of those 

petitions and of the NIOSH evaluation reports, 

that it would also better instruct our 

contractor in terms of how to do some of these 

evaluations so that we focus on what is 

important to the process, not get sidetracked 

quite as often on -- on other issues which I 

think is sort of a -- in some ways it's just a 

natural result of a -- of how complicated these 

issues are and -- and the nature of the 

available -- available science. And I think 

we've -- could accomplish something by trying 

to develop -- and I think we could actually 

complete a set of guidelines that would help to 

inform the process and inform our work and 

NIOSH's work. I've had some discussions with 

NIOSH staff, including running into them in 

airports and so forth as we've traveled around 

the country, who I also think that they believe 
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this would be helpful also. So I would propose 

that we set up a small working group, that we 

hold, you know, sort of a one-day meeting with 

some of the NIOSH staff to discuss this and -- 

hopefully sometime in November in Cincinnati, 

that we try to, to some extent, meld this with 

what we're doing on the Y-12, but also go back 

and -- with a review of the site -- of the Y-12 

site profile, but also go back and sort of look 

at what happened with Mallinckrodt and Iowa and 

Bethlehem, and really see if we can come to 

grips with what our guidelines that would make 

this process work better for -- both for NIOSH, 

NIOSH staff, their contractor, ourselves as a 

Board having to make rulings on these and 

recommendations and also for our contractor -- 

do that. So that's my proposal, is another 

working group to look at this issue and I -- 

I'm optimistic that we could be successful with 

this, though. You know, we're never going to 

have all the answers. This is a complicated 

area and not a lot of external guidance for us 

to rely on. 

 DR. ZIEMER: For lack of a better term, the 

Chair will call this the workgroup on 
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sufficient accuracy and -- 

 DR. MELIUS: That is the motion then. 

DR. ROESSLER: I second. 

 DR. ZIEMER: -- it's not clear to me that that 

was a motion as a -- but I think, Jim, the 

motion is to establish a small working group to 

-- to evaluate possible criteria for sufficient 

accuracy. That's a concise way of saying it. 

Some of us have had some conversations about 

the makeup of the working group, and let me 

suggest -- well, first of all, the Chair would 

like to ask Dr. Melius to chair the working 

group. The Chair himself has agreed to 

participate in the group. I understand Mark is 

available to participate. We do want to keep 

the group small. I don't necessarily want to 

exclude others and -- but I think we -- we may 

want -- if there's say another person that 

would want to volunteer, that would be fine. 

But at least Mark and Jim and I would be 

willing to take a stab at this. Anyone else 

want to -- have an urgency -- and Roy would 

like to participate, so that -- that would give 

us a start. 

 DR. MELIUS: Yeah, we would hope that we could 
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report back by the November 28th -- we -- 

conference call for where things stand and then 

maybe --

 DR. ZIEMER: Well, as a minimum we could give a 

status report. And of course this may indeed 

not be something that can be resolved, but at 

least we could have a status report on where 

we're headed, whether we're making decent 

progress or not. It's a thorny issue, really, 

to say what are -- what are the criteria for 

really saying something is sufficiently -- I 

know that we tend to do this in an intuitive 

manner. We all do. 

 DR. MELIUS: Uh-huh. 

 DR. ZIEMER: You look at the Mallinckrodt data 

and we sort of all have our own internal 

criteria as to does it feel right, does it look 

right, do I trust the data. There's a whole 

gamut of issues. I think each of us approaches 

it somewhat differently. 

We may not be able to come up with criteria 

that are completely objective. One would like 

that. I don't think we'll ever completely 

remove some subjectivity -- and indeed, it 

would be the Board -- Board members' individual 
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rights to say, even beyond whatever criteria, I 

still don't like this dataset, or I do, for 

whatever reason it might be. We're not going 

to be able to cover every possible criteria, 

but we're hoping to have some guidelines that 

we can use as a -- kind of a measuring stick 

for sufficient accuracy and related issues, 

that we have some sort of guide as to how to go 

about evaluating. 

And Arjun, maybe you have some input. 

 DR. MELIUS: Well, can I just -- before Arjun, 

just to elaborate that a little bit. I mean it 

disturbed me that our vote on Mallinckrodt, 

that we were as split as we were. Not that it 

wasn't a difficult situation to evaluate and 

given the pressures and so forth, but it seems 

we've operated, up until then, pretty much on 

consensus. We've been able to craft some 

agreement on how to approach things. And 

again, it may not always be possible, and we've 

had other sort of close votes, but usually on 

more minor issues. 

And I also think that if you look back at the 

process and what NIOSH went through, what SC&A 

went through in terms of process, and the 
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amount of time we spent wrestling with some of 

these issues, and I don't think that's sort of 

fair to the whole process -- nor to the 

claimants to try to understand -- goes on, and 

it just reaches a point where everybody sort of 

-- sort of stops and then says well, let's just 

vote, let's just do it, and that's not a -- 

 DR. ZIEMER: Plus -- plus many issues are timeconsuming and yet have very little impact -- 

 DR. MELIUS: Yes. 

 DR. ZIEMER: -- on the bottom line, so that's 

another related thing. Arjun? 

 DR. MAKHIJANI: Dr. Ziemer, just as a reminder, 

at the last meeting you did ask SC&A to prepare 

two reports under Task V, one of which is an 

evaluation of the NIOSH procedures on SEC 

petitions. And the second report has two 

parts. One is suggested draft procedures for 

the Board itself to take up SEC evaluation -- 

petition evaluations, and the second part of 

that would be the SC&A procedures when you do 

ask us to evaluate an SEC petition evaluation. 

 DR. ZIEMER: Right. 

 DR. MAKHIJANI: And as you know, I'm tasked 

with -- with -- I'm the task manager for those 
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reports, and we have started work on that and 

expect to have, in about a month, by midNovember or so, so before -- before -- the 

second part, the SC&A procedures, as well as 

the -- perhaps to a lesser extent, the Board 

procedures will be more of a checklist, but the 

SC&A procedures will correspond to some extent 

with the list that Dr. Melius was talking about 

 DR. ZIEMER: Well --

 DR. MELIUS: -- and may be helpful to you. 

 DR. ZIEMER: Right, and in fact to the extent 

that your procedures would include criteria, 

obviously this would be very important input to 

that. We certainly don't want you to have to 

operate in a vacuum on that, so perhaps this 

will -- will inform that part of it, to some 

extent. 

 DR. WADE: I'll talk to you and John. Anything 

that would be available I think that could 

inform this process would be accepted and 

welcome. 

 DR. MAKHIJANI: Yeah, I --

 DR. ZIEMER: And I think the -- our procedures 

for evalua-- or our Board procedures that you 
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were going to help develop, as you say, are 

more along the lines of -- I think a little 

more mechanical than what we're talking about 

here, which is the -- sort of the underlying -- 

I don't want to call it philosophical so much, 

but the underlying criteria by which we make 

decisions. But that very well could end up -- 

and as you evaluate you've got to be looking -- 

or using such criteria, in any event. 

 DR. MAKHIJANI: Yeah, Dr. Ziemer, the second 

part of the report on procedures, which would 

be the SC&A procedures, for evaluation -- 

evaluating the NIOSH -- 

 DR. ZIEMER: Yeah. 

 DR. MAKHIJANI: -- petition evaluations, that 

would seem at least largely to overlap with 

what you're talking about. And I was -- if the 

working group members had some input to provide 

SC&A as they proceed -- 

 DR. ZIEMER: Oh, yes --

 DR. MAKHIJANI: -- and vice versa, so -- for -- 

I think it would be useful. 

 DR. ZIEMER: Oh, we would certainly keep you 

informed and -- and I think it's a two-way 

street because the Board doesn't have a corner 
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on ideas. We often like to think we do, but we 

realize that you guys occasionally have a good 

idea, too. 

 DR. WADE: Thank you, Arjun. 

 DR. ZIEMER: Thank you, Doctor. 

 DR. WADE: Let's -- Larry, you should be on the 

record as to reacting to this. Your reaction? 

 MR. ELLIOTT: I'm pleased that we're going to 

take this step. I think that we've heard loud 

and clear over the course of the last three 

face-to-face Board meetings concern among 

select Board members as to their understanding 

of what we mean by sufficient accuracy. It 

goes to what Dr. Ziemer was talking about 

earlier, we all bring something a little bit 

different to that, I think, on what level of 

subjective interpretation and trust we apply to 

this -- this bounding criteria for maximum 

plausible dose for the SEC evaluation reports 

and what we provide with regard to sufficient 

accuracy on dose reconstructions. These are 

both spoken about in our rules. You can find 

it in the preamble. You all worked with us on 

that. But it's still I think a somewhat 

confusing if not nebulous concept, and anything 
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that we can do to -- to bring clarity to that I 

think is only -- is welcome from my perspective 

and is going to aid us all in lowering the 

frustration levels and lowering the amount of 

effort and work we have to all go through to 

try to get to the -- the end posts, the goal 

posts here on these things. So I'll 

appreciate this. I'm supportive of it, and I'm 

looking forward to the day in Cincinnati when 

we sit down with the working group. 

 DR. WADE: How about November 2nd? 

 DR. ZIEMER: Okay, let's --

 MR. ELLIOTT: Did you say November 7th? 

 DR. WADE: 2nd. 

 MR. ELLIOTT: 2nd. 

 DR. ZIEMER: Let's -- have we voted yet on 

establishing this? We basically have a motion 

to establish the working group with membership 

as described. And I think it's been seconded 

or it's now seconded by Rich. 

MR. ESPINOSA: Gen seconded it. 

 DR. ZIEMER: Gen seconded it. 

 MR. ELLIOTT: We'll have to set a date later. 

 DR. ZIEMER: Okay. All in favor, say aye? 

 (Affirmative responses) 
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 And any opposed? 

 (No responses) 

 Any abstentions? 

 (No responses) 

Thank you. The motion carries. Now while 

we're talking about working groups, we still 

have some carryover activities relating to dose 

reconstruction and Task III matrix review -- 

 DR. WADE: Bethlehem. 

 DR. ZIEMER: -- and some Bethlehem things. We 

have a working group that has gotten underway 

on that, and I would hope that working group 

could continue that activity. We -- we know 

that working groups aren't supposed to go on 

indefinitely, but they were not able to finish 

that task. This was Mark and Wanda and Robert 

and -- and Mike, and then Rich was an alternate 

if someone couldn't come. And so we would ask 

them to continue those activities and have to 

make sure that they're on the schedule, too, to 

deal with those items. 

 DR. WADE: And I would ask again that Y-12 be 

prominent in those discussions. 

 DR. ZIEMER: So Mark, in that workgroup you 

have the internal dose par-- or the -- yes, the 
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internal dose part of the procedures matrix. 

You have the dose reconstruction matrix for the 

second round to work on, the Bethlehem Steel -- 

closure of Bethlehem Steel issues, and -- 

 DR. WADE: Y-12. 

 MS. MUNN: Y-12. 

 DR. WADE: Y-12 site profile. 

 DR. ZIEMER: -- Y-12 site profile. 

 DR. WADE: The resolution matrix. 

 DR. ZIEMER: Resolution matrix, so those four 

issues. Okay. 

 MS. MUNN: That's a lot. 

 DR. ZIEMER: Okay. Do we have other -- 

 DR. WADE: No. I don't know if you want to do 

anything with scheduling. You can work with 

LaShawn and I, both chairs, and we'll -- 

 DR. ZIEMER: I think the working groups can 

work out their schedules individually 'cause 

they're small groups. We don't have to do that 

as a -- as a whole. 

 DR. WADE: Now I assume that the -- that the 

Board would like us to follow the procedure 

that we would notice -- Federal Register notice 

about the working groups. We'll post a notice 

on the OCAS web site. Do you want us to make 
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these meetings available publicly or not? They 

don't have to be. 

 DR. ZIEMER: You're talking about open them up 

for the public to be physically at the 

meetings? Well, certainly we're committed on 

Bethlehem --

 MR. GRIFFON: (Off microphone) (Unintelligible) 

 DR. ZIEMER: -- but at least keep Ed Walker in 

the loop. 

 MR. GRIFFON: -- (unintelligible) for 

Bethlehem, so... 

 DR. ZIEMER: I don't know on the others if 

we're really going to be productive to do that. 

Jim, on yours I don't see any reason there, and 

as long as you have --

 MR. GRIFFON: I actually --

 DR. ZIEMER: -- Ed in the loop on the Bethlehem 

 MR. GRIFFON: On the non-Bethlehem stuff, I -- 

I -- I think we could actually be more 

productive if -- if we didn't have them open to 

the public, as long as they're transcribed. 

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I 
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 MR. GRIFFON: Yeah. 

 DR. WADE: -- we'll let people know that the 

meetings are going on. We'll promise then to 

deliver the transcripts on the web site, but we 

will not open the working groups to the public, 

except Ed Walker invited to Bethlehem. 

 DR. ZIEMER: Is that agreeable? It appears to 

be. 

Okay, we're ready to move on to conflict of -- 

 MR. PRESLEY: (Off microphone) Paul -- 

 DR. ZIEMER: Oh, I'm sorry, Bob, I missed you 

there. 

 MR. PRESLEY: Before we -- before we get into 

the conflict of interest, (unintelligible) been 

asked to come back to Washington two or three 

times. I was -- I was asked not too long ago 

by one of our representatives in the state of 

Tennessee as to when the Board was going to 

come back to Washington, and I think it's been 

what, four years since we've been up there 

again -- or since we've been up there. We 

might want to think about that down the road as 

to when the executive branches are going to be 

in session and schedule a meeting. I know it 

takes a long time to schedule rooms and meeting 
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places and things like that when they're in 

session, so you might want to start thinking 

about that down the road, if -- if the Board 

would like to go back to Washington. And with 

all the stuff that we've gotten here lately, it 

might be a good idea if we did hold a meeting 

up there where we can have some input. 

 DR. MELIUS: Yeah, I just -- point -- I mean I 

think I was one of the ones that suggested it, 

but -- but the other -- I mean we're always 

torn 'cause I also think it's important that we 

try to hold meetings near the sites and -- and 

now it seems we have more than -- that's even 

become impossible to address all of the sites 

that we need to, you know, address at a given 

meeting. We can't accommodate everybody, and I 

just worry that we go up to Washington, then 

we're just one less -- we're going to make a 

decision on something that's without the 

opportunity for the public to participate from 

at least one of the sites. Now some of it's 

unavoidable and I'm not sure what the solution 

is and... 

 DR. ZIEMER: Well, your -- your suggestion is 

so noted, and we'll look for an opportunity to 
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do that, certainly. 

CONFLICT OF INTEREST, HHS REPRESENTATIVE

 Lew, conflict of interest -- 

 DR. WADE: Yeah, let me --

 DR. ZIEMER: -- lead us in that discussion. 

 DR. WADE: Yes, it will be just a discussion. 

Let me introduce the -- the concept to you. 

There's been an awful lot of talk about 

conflict of interest. There's a lot of 

agitation over conflict of interest when it 

comes up here, and we've asked the Office of 

General Counsel to start to give sort of some 

holistic thought to this issue of conflict of 

interest. We -- we have many people involved 

in the program -- NIOSH employees, contractors 

of various types, this Board. The Office of 

General Counsel has been giving thought to it. 

We've also asked the Office of General Counsel 

possibly, when a plan emerges, to -- to be the 

implementer of that plan because it clearly 

can't be NIOSH. 

As that process is going on, I thought it would 

be worthwhile just to spend some time hearing 

from the Board things that it would want us to 

take into consideration as we imagine putting 
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together such a holistic plan. So I thought 

this was just an opportunity to talk a little 

bit. I know that there is some concern on the 

part of Board members, and I thought this might 

be an opportunity to get it out in the presence 

of the Office of General Counsel and NIOSH so 

we could hear these things and be sensitive to 

them as we move forward with putting together a 

plan of action. 

 DR. ZIEMER: Okay. So what we're looking for 

now is just comments relating to that that 

would provide input to your thinking. Jim. 

 DR. MELIUS: Yeah, first, I think it would be 

useful for the Board to have an update from 

someone knowledgeable and have some discussion 

of how our individual -- not our specific 

individual, but sort of the context and the 

criteria for how our individual conflicts of 

interest or potential conflicts are evaluated. 

You know, what is the -- the general rules for 

this and so forth, 'cause it's -- to me it's 

always been confusing, and I think -- we've had 

presentations before and I don't think they've 

really -- I've never understood. And I know 

when I think of what's in my letters and so 
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forth, it doesn't always fit with what I'm 

hearing and I then go out -- get individual 

explanation and it's helpful. But -- but I 

think having that sort of a background might be 

helpful, and also as it applies to -- in the 

general sense, to contracts 'cause some of the 

issues we've wrestled with is how to apply 

conflict of interest to contractors and -- I 

think it's a little bit different, at least 

operationally, and even going back to our own 

is -- is sort of -- it's always been confusing 

to me how we operation-wise -- dealing with our 

own, do we wait for Lew or do I -- does the 

Chair enforce that? Is somebody from Counsel's 

office informing us? Are we supposed to sort 

of self-identify when there is -- how -- how do 

we do that and particularly in these cases, 

'cause nearly all of us have some dealings with 

some of the sites in the past and -- or ongoing 

and we really need to understand this and this 

question of appearances. And at the same time, 

in order to function there's a lot of very 

general topics that we deal with that cover 

multiple sites, and what's appropriate there? 

And maybe there's a list of questions that we -
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- we want to put together to ask somebody and -

- to be addressed, but it -- I would certainly 

like to have a better understanding of what 

we're doing before we sort of offer too many 

opinions on what's good or -- or bad 'cause I 

don't quite understand the rules completely 

myself. 

 DR. ZIEMER: Right. And actually it's often 

difficult to ascertain the logic that is used. 

For example, if you worked at a site, are you -

- you end up being sort of banned from dealing 

with any of the years, even though -- for 

example, if -- let's take early years of Oak 

Ridge, maybe be-- before you were ever there, 

Bob, what vested interest would you have, pro 

or con, on what happened in the site when you 

weren't there? You couldn't be putting 

yourself into a cohort or something like that 

on the early years, so why would that matter? 

That sort of thing. And I'll take my own case 

where I'm excluded from Y-12 because I worked 

there a week as a student, not an employee, and 

yet actually probably had more direct dealings 

with sites when I worked for DOE when -- I mean 

when we were doing tiger teams and our group 
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was having more impact on what went on on sites 

than I ever had working at Oak Ridge or Y-12, 

but those aren't excluded, and if they were, it 

would be every site, I guess. 

 MR. PRESLEY: (Off microphone) (Unintelligible) 

 DR. ZIEMER: So it's those kind of -- there's a 

certain illogic to what goes on. Yeah. Who's 

next? 

 DR. MELIUS: I think Wanda was next. 

 DR. ZIEMER: Wanda. 

 MS. MUNN: Bob was going to say something. 

 MR. PRESLEY: Since -- since you -- since you 

mentioned me, that's one thing I want to -- had 

a problem with. You know, I've been out there 

at Y-12 for 40 years, and I can see where I 

shouldn't vote on something. But I am 

considered a site expert and think that I ought 

to be able to have some input to some of this 

stuff. I agree -- I agree about the voting, 

but it -- it really bothers me that I can't 

have input to some of the questions asked or -- 

or some of the things. 

 DR. ZIEMER: While sitting at the table. 

 MR. PRESLEY: That's correct. 

 DR. ZIEMER: Yeah. Okay. 
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 MR. PRESLEY: As a -- as a site expert. 

 DR. ZIEMER: Wanda. 

 MS. MUNN: Can we get the people who actually 

make these determinations -- that is to say the 

Ethics Office -- can we get a presentation from 

them? A 15-minute presentation, not a two-hour 

workshop, making it clear to us how those 

decisions are made so that we can ask our 

questions of the people who make those 

decisions. It seems difficult for us to have 

to place these questions, time and time again, 

in the hands of staff, who must interpret what 

they've been told from the Ethics Office. And 

so --

 DR. ZIEMER: Well, I don't know -- 

 MS. MUNN: -- why not --

 DR. ZIEMER: -- the answer to that, but -- 

 MS. MUNN: Why not go to the source? 

 DR. ZIEMER: -- right now we'll put that on the 

list of questions. Okay. Jim? 

 DR. MELIUS: Yeah, I would agree with that, 

that -- I think what we're looking for is a 

better understanding of the criteria and then 

how they apply sort of overall, and -- and how 

do we sort of operationalize tho-- I mean does 
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-- in Bob's example, should he -- when he is an 

expert on that site, some knowledgeable on that 

site, should he identify himself at the -- at 

the table's that -- should there be some -- or 

should he be -- have to go to the back 

microphone or, you know, what's re-- reality of 

the difference I think is there's some value to 

-- so that the people in the audience know how 

he's acknowledged some of the -- that he'll be 

speaking, but not, you know, voting on this 

situation and -- and so forth, and I think we 

need to know how that -- that works. And there 

are other situations for -- you said, Paul, and 

I think my own situation where there've been 

some sites I've been involved in on particular 

issues that -- you know, I think that if 

someone knew the details of those issues, then 

I -- that -- that it's very -- I should be 

conflicted, I should -- should avoid being 

involved in those issues. But you know, I -- 

understand what I'm saying, nobody here's going 

to know -- have the knowledge or very few 

people would ever have the knowledge of what I 

was involved in, so you sort of try to selfidentify those and maybe when, you know, you 
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were working for DOE there were certain things 

you're so vested in you really shouldn't be, 

you know, involved in if it comes before -- 

before the Board. Yet you know, I don't know 

everything you did at DOE or couldn't expect to 

and, you know -- so but does that mean every 

DOE issue and then, you know, to me what's 

ridiculous is if you spent a week as a student 

there at Y-12, I mean that makes -- you know, 

any sense at -- sense at all in that. 

 DR. ZIEMER: Other comment? Yes, Michael. 

 MR. GIBSON: There's also the issue that, you 

know, when NIOSH or our contractor goes out to 

the sites, they look for site experts to get 

their information, which obviously they have 

to. Those site experts could be just as much 

conflicted. They could hide their dirty 

laundry in one instance, or they might have a 

vested interest in -- in the future 

establishing a cohort for the site. So you 

know, I think that's why we were chosen, 

because of our vast backgrounds and in -- the 

expertise at different areas, so what's the 

difference in going to a site expert at the 

site as opposed to, you know, us being 
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conflicted? 

 DR. ZIEMER: Okay, good question. Others? 

Yeah, Jim. 

 DR. MELIUS: Just -- just along those -- those 

lines, and I think it also comes up even with 

the Board occasionally, is sort of the 

transparency of -- of that process and to the -

- to the public in -- in how that's -- that's 

dealt with, so that -- you know, to what extent 

is that expert consulted or does that expert 

control the process, did -- is there sort of a 

public process to it so it's happening in the 

open like our Board meetings, which are, you 

know -- most part all open and so forth, other 

than our working groups. Or is it happening, 

you know, out in the field someplace where no 

one's going to know what's going on until 

something's completed, and I -- and I think 

that's different. So again, we're -- we -- we 

have a situation where we've been involved in a 

site and are offering sort of our knowledge. 

That's happening in front of an audience and in 

public. There's a public record of that -- 

again, as opposed to something where there's -- 

you know, we do an off -- you know, writing a 
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report or doing something sort of behind closed 

doors. And I just don't understand how they're 

applying that and those criteria -- or even 

what they are all the time. 

 DR. WADE: Could I --

 DR. ZIEMER: Yeah, let me make one other 

comment. I think typically -- and maybe Liz 

can correct me if I'm wrong. Typically the 

test for conflict of interest sort of -- in all 

cases, not just the Board, but -- is whether or 

not you somehow would stand to gain from a 

decision that you make in terms of the 

relationship you've had or have -- an ongoing 

or a past relationship. For example, would you 

be in a position to put yourself on a -- in a 

Special Exposure Cohort or, you know, do you 

somehow enhance -- in many -- many kinds of 

boards it's do you gain -- will you profit 

personally from the action you take because of 

either your previous association or you have 

some insight or knowledge of some sort, and 

that often is the test of conflict of interest 

 DR. WADE: Yeah, but --

 DR. ZIEMER: -- where -- where your decision is 
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really colored by the fact that you are either 

going to personally gain from this or you have 

friends that are going to gain from this or 

whatever it may be. 

 DR. MELIUS: Yeah, but -- but it -- it's 

actually a little -- usually a little bit more 

-- would it appear --

 DR. ZIEMER: Or does it appear --

 DR. MELIUS: It's not just the actual conflict, 

it's would it appear, and it's a little more 

liberal --

 DR. ZIEMER: Yeah, it's a little more --

 DR. MELIUS: -- situation, though it doesn't 

always make it any easier. 

 DR. ZIEMER: Right. Roy. 

 DR. DEHART: There's also the other side, that 

-- the fact that you have worked at that plant 

and now sit on a decision process, are you 

protecting yourself or your decisions that you 

made while you were employed there, and I sense 

that is a very strong -- 

 DR. ZIEMER: Yeah. 

 DR. DEHART: -- part of the conflict. 

 DR. ZIEMER: Yeah, and that's why I say if it's 

a set of years that you weren't there and 
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weren't in either a decision-making process or 

any -- any part of that -- for example, earlier 

years, let's say in Presley's case. Suppose a 

cohort came before us that was -- long preceded 

him, unless it was his dad or something that 

worked there, how -- how does it -- why does it 

matter? That's what I'm having a little 

trouble with here. 

 DR. MELIUS: Yeah, while you were a student 

there for that one week, you've controlled 

everything that's ever happened or ever will 

happen at Y-12, Paul. We know that. 

 DR. ZIEMER: Well, unfortunately, the week I 

worked there at Y-12 was the week they had the 

criticality (unintelligible) -- 

 DR. MELIUS: See? 

 DR. ZIEMER: -- I don't want to take any credit 

for that. 

 MS. MUNN: Mystery solved. 

 DR. WADE: Not to -- not to bring this to 

closure or even to end the discussion, but let 

me sort of -- there are three issues that have 

emerged, and let's talk a little bit about 

them, each in turn. 

The first is the agency's rules for dealing 
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with issues like individual dose 

reconstruction, site profiles and SEC petition. 

And I can articulate those again and you can 

react to them and -- and we can hear your 

reaction and then possibly modify or -- or 

continue with them. 

There is this issue of transparency, who should 

know if there is a conflict; should we begin 

each discussion on a particular topic by 

identifying those people that have a conflict. 

I think we need to talk a little bit about 

that. 

And then the third and most vexing, as I listen 

to you, is by what logic were these conflicts 

identified. On the third, you know, I will use 

Liz's good offices to see what we might be able 

to do to get someone from the Ethics Office 

here to talk to you. That is easier said than 

done, but we think that's a reasonable 

suggestion and we would attempt to honor that. 

Liz has twice now during this week articulated 

what is the operative policy of the agency 

right now, and that is that for a discussion of 

a site profile someone with a conflict can be 

at the table and fully participate in the 
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discussion, completely participate in the 

discussion, but would not vote on a Board 

action relative to that site profile. 

MS. HOMOKI-TITUS: (Off microphone) Can I -- 

 DR. WADE: Okay? 

MS. HOMOKI-TITUS: And not make a motion. 

 DR. WADE: Not make a motion about the -- on 

issues of individual dose reconstruction 

reviews or SEC petitions, someone who's 

conflicted would not participate in the 

discussion at the table, but would be free to 

participate in the discussion as a site expert 

from the microphone -- that microphone -- but 

would again not make a motion and not vote. 

So those are the rules we're operating under. 

Again, we've heard some concerns about that. 

We'll consider those concerns. If you wish to 

speak to Liz or I after this meeting and 

articulate your concerns again, we'd be glad to 

hear them. But those are the positions we're 

operating from now. Liz? 

MS. HOMOKI-TITUS: I just wanted to let you 

know that I have heard from a number of members 

that they do have concerns with that policy, 

especially regarding the site profiles, so 
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we've made arrangements to have further 

discussions with the Ethics Office again and 

look forward to letting you know what we hear 

about that. 

 DR. WADE: Yes. And we -- we have heard your 

discussions and we are aware of your concerns. 

To the issue of transparency, intellectually I 

don't have my mind around that. I mean I could 

see some logic that would say if we were to 

dis-- start a discussion of Y-12 via a site 

profile or an SEC petition that we would 

identify all those people who were conflicted -

- for the record, for the public. On the other 

hand, I could see saying everyone knows of 

their conflicts and we ask them to self-police 

on those issues. Again, we have not taken the 

position of identifying at the start of every 

discussion. Again, if you have thoughts on 

that, you could let us know. We've heard some 

comment around the table now. 

And then the third one is, again, making the 

logic clear to you by which the decisions are 

made, and that we'll push to have someone from 

the Ethics Office come and speak to you about. 

 DR. ZIEMER: Thank you very much. You have an 
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additional comment, Mark? 

 MR. GRIFFON: Yeah, just -- just to follow up 

on Liz's comment and Lew, your last item, the 

logic for identifying. I guess that's where -- 

especially -- I think -- I don't know if 

there's any generic sort of way in which it was 

determined whether there was -- there was a 

conflict on participation in the site profile 

review process. I think it's probably specific 

to individuals around, depending on -- on our -

- our work histories or whatever. But I think 

that -- that's one item I think that I was kind 

of surprised the other day on and I would like 

some clarification on that, as Wanda stated. 

 DR. WADE: Thank you. 

 DR. MELIUS: Yeah --

 DR. ZIEMER: Jim. 

 DR. MELIUS: -- I'd like to maybe -- sort of go 

-- a little different issue, but one that's -- 

that's related. I think all of us received in 

the mail a report or -- I believe it was a 

draft report from Larry concerning the issue of 

the possible conflict or evaluation of possible 

conflict for some of the people involved at the 

Paducah site and -- and that thing. And the 
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only reason I wanted to -- my understanding is 

that that's getting further review and some 

input from the person that asked for the 

report. I don't think we need to discuss that 

portion of it, but -- but it struck me when 

reading through it -- 'cause I thought we were 

going to discuss it at this meeting, I was 

getting prepared -- was that, at least for the 

second part of that report which dealt with the 

site profile itself and some of the scientific 

issues that -- that -- one way of addressing 

that, if we feel it needs to be addressed, is 

having our contractor evaluate the site 

profile. My -- my recollection is that Paducah 

site profile is not on the list to be reviewed. 

And if we're going to take that step or -- and 

maybe we don't need to take it now, but to 

consider it, we -- it just -- there's a time 

frame involved and -- and at least like to get 

that out as something to -- to think about and 

-- as to whether we discuss that again. But 

maybe it's something NIOSH comes back to us as 

saying that yeah, that's what they also think 

is something -- makes sense to do, but -- but I 

at least wanted to mention that. 
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 DR. ZIEMER: Yeah. Larry, you have a -- 

 MR. ELLIOTT: I would like to react to that 

point, and I think it does make sense to -- to 

have the site profile reviewed. But I would 

suggest it makes more common sense to me to 

review it after it's revised, based upon the 

corrective action that has been identified in 

that -- that assessment report that you're 

speaking of. It wouldn't do any good, I don't 

think, at this juncture to review that rev. of 

that site profile. You need to review what's 

modified after this assessment is done. 

 DR. MELIUS: Okay. That makes sense. 

 DR. WADE: Thank you. 

 DR. ZIEMER: Thank you. 

 DR. WADE: I think we're done with this point. 

APPROVAL OF MINUTES

 DR. ZIEMER: Okay. We have one final item I 

believe on our agenda. This is a carryover 

from earlier in the meeting. We have the 

minutes for our July meeting to -- to act on, 

so I'm going to call now for any corrections or 

additions to the minutes. 

 Wanda, I know you have some. 

 MS. MUNN: Just a couple. They're minor. 
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Would you like me to go through them one by 

one? 

 DR. ZIEMER: Yes. Give us a page number and 

paragraph. 

 MS. MUNN: Page 13. 

 DR. ZIEMER: Page 13, paragraph? 

 MS. MUNN: The next to the last paragraph. 

 DR. ZIEMER: Uh-huh, in bold type? 

 MS. MUNN: Yes, uh-huh. Seems to me that it 

should tell us what provisions -- what those 

provisions were. If one's just simply reading 

through this quickly, we know that provisions 

were adopted governing communications and 

program direction, but it doesn't say what 

those --

 DR. ZIEMER: Now what we may need to do -- in 

the Executive Summary from which you're 

reading, many of these motions were abbreviated 

 MS. MUNN: Very much so, and I had no problem 

with any of the others and I agree with the 

idea of abbreviating. 

 DR. ZIEMER: I was looking to see whether -- 

 MS. MUNN: It just seemed to me this doesn't 

tell me anything. 
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 DR. ZIEMER: -- the motion, as it's discussed 

in the main minutes, covers that. 

 MS. MUNN: Well, I have rewording for the main 

minutes, but --

 DR. ZIEMER: For that same motion? 

 MS. MUNN: -- not for the motion itself. Not 

for the motion itself. 

 DR. ZIEMER: Oh. I believe this is a result of 

the condensation process there. 

 MS. MUNN: I think it is, too. The two 

preceding motions right on -- on that same 

page, on page 13, tell you what happened. 

 DR. ZIEMER: Uh-huh, and this one does not. 

 MS. MUNN: And this one really doesn't. It 

just says it had to do with this, but it 

doesn't tell us what happened. I think minor 

wording revision is in order and it doesn't 

have to be extensive. 

 DR. ZIEMER: Maybe we can -- Ray, did you 

prepare the Executive Summary or did NIOSH 

staff -- Ray Green? 

THE COURT REPORTER: I do. 

 DR. ZIEMER: Ray? 

 DR. WADE: Ray does the minutes. 

 DR. ZIEMER: Perhaps we can find a condensed 
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version of the provisions for that motion. 

 MS. MUNN: That would help a little. 

 DR. ZIEMER: Would that be agreeable. 

 MS. MUNN: That would be fine with me, yeah. 

 DR. ZIEMER: Okay. 

 MS. MUNN: On page 14, paragraph five that 

starts "Dr. John Mauro," perhaps I -- 

 DR. ZIEMER: What page is that? 

 MS. MUNN: Page 14 --

 DR. ZIEMER: Fourteen? 

 MS. MUNN: -- the next page. 

 DR. ZIEMER: Uh-huh. 

 MS. MUNN: Perhaps I'm just not reading that 

paragraph correctly, but the planned procedures 

did not seem to fit in there. 

 DR. ZIEMER: John Mauro commented that their 

conflict of interest planned procedures -- 

 MS. MUNN: And forms have been completed. 

 DR. ZIEMER: The procedures and forms, I -- I 

think the thrust is that the procedures and 

forms -- the conflict of interest procedures 

and forms that they plan to use, I believe is 

the thrust of it, so maybe the -- maybe the 

wording is awkward here. 

 MS. MUNN: Wasn't clear to me. 
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 DR. ZIEMER: I think you could leave out the 

words "planned" -- the word "planned" and it 

will read correctly -- their conflict of 

interest procedures and forms have been 

completed. It was -- it was forms that they 

planned to do. They now have been completed -- 

 MS. MUNN: Yes. 

 DR. ZIEMER: -- so --

 MS. MUNN: Yes, that's --

 DR. ZIEMER: -- take out the word "planned". 

 MS. MUNN: That's what I thought it meant, but 

I wasn't sure. 

 DR. ZIEMER: Okay. 

 MS. MUNN: There are many places in the -- in 

these minutes where there's a typo, which I'm 

assuming may just be -- 

 DR. ZIEMER: If you'll pass those on to Ray, 

we'll get --

 MS. MUNN: No, it's the same typo. 

 DR. ZIEMER: Oh, okay. 

 MS. MUNN: An equal mark appears instead of an 

apostrophe. 

 DR. ZIEMER: And actually I think it's probably 

the printout process. Many of the bullets 

showed up as -- in other forms, so -- 
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 DR. MELIUS: I think Ray did it. 

 DR. ZIEMER: -- Ray can take care of that. 

 MR. GRIFFON: I question that silver medal now. 

MS. MUNN: I literally meant typo. I meant 

that the printing process itself had done 

something strange there. 

 DR. ZIEMER: Thank you. 

 MS. MUNN: On page 26, the last of the marked -

- bulleted items there that have Ps in front of 

them, I was -- I think it's just language that 

doesn't read well. There seems to be a 

systematic overestimation error of the Barnes 

data due to the standard precipitating -- 

standard precipitating? -- which artificially 

jacked up the calibration curve. 

 DR. ZIEMER: Okay, I think their chemical 

standard precipitated out of the solution is 

what --

 MS. MUNN: That would have been precipitation. 

Right? Not precipitating. 

 DR. ZIEMER: Well --

 MS. MUNN: The standard having precipitated, 

which --

 DR. ZIEMER: I think that's the thrust of it. 

Maybe we can --
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 MS. MUNN: Which artificially jacked up the 

calibration curve back up to expectation. 

That's -- if that's clear to everyone else 

here, then I'll shut up. 

 DR. ZIEMER: It's a little bit awkward, but the 

thrust of it is there was a chemical 

precipitation --

MS. MUNN: That's fine. That's fine with me. 

 DR. MELIUS: Just to shut you up. 

 MS. MUNN: Yeah, I know. The only other one -- 

 DR. ZIEMER: If you -- if you could say due to 

the fact that the standard precipitated out of 

solution or something like that. How is that? 

Is that better? 

 MS. MUNN: Sounds fine to me. 

 DR. ZIEMER: Due to the fact that the standard 

precipitated out of solution, which 

artificially jacked up the calibration curve. 

 MS. MUNN: Uh-huh. 

 DR. WADE: Due to the fact that... 

 DR. ZIEMER: Well, then it still is awkward -- 

calibration curve back up to expectation. 

 MS. MUNN: Back to the expected level? 

 DR. ZIEMER: Yes. 

 MS. MUNN: Back to the expected level. 
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 DR. WADE: Page 26. 

 DR. ZIEMER: And Ray, I'll give you my marked 

up copy. Back to the expected level I think 

would handle that. Thank you. 

 Others, Wanda? 

 MS. MUNN: The last one, which I have written 

out, is page 43, line three, where it starts 

talking about my rant, and I have re-written it 

to say (Reading) Ms. Munn strongly protested 

the unexpected presentation of such a processchanging motion, previously unannounced in the 

agenda, at a time when several Board members 

could not be present. She indicated that in 

these circumstances she would not vote on the 

motion unless it was a vote to table. She then 

put forth a vote to table the motion. 

And then the last sentence would continue on as 

it was. Just replace the two sentences. 

 DR. ZIEMER: Can you provide that wording for 

Ray? 

 MS. MUNN: Yes. 

 DR. ZIEMER: Is that agreeable to everyone? 

Thank you. 

DR. ROESSLER: That's okay, but that's 

(unintelligible), we got --
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 MS. MUNN: (Off microphone) (Unintelligible) 

left out a great deal. 

DR. ROESSLER: -- we got the sense of it. 

 MS. MUNN: I left out a great deal. 

 DR. ZIEMER: Okay. Wanda, do you have 

additional ones? 

 MS. MUNN: No, that's the last --

 DR. ZIEMER: Okay. I'd like to call attention 

of the Board to page 4 in the middle of the 

page, the highlighted paragraph on the motion. 

It says the Board passed a motion granting an 

SEC petition. The Board does not grant SEC 

petitions. It should read -- we may have 

thought we did -- had really done that, but it 

should the Board passed a motion recommending 

the granting of an SEC petition. 

Also on page 2 under privacy issues, I'm going 

to suggest -- this talks about Board -- a Board 

member being required to recluse (sic) himself. 

I wasn't sure what we would do if the Board 

member was either Gen or Wanda since this only 

talks about reclusing (sic) himself. 

DR. ROESSLER: We're fellows. 

 DR. ZIEMER: You're fellows? 

 MS. MUNN: Both of us. 
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 DR. ZIEMER: My solution here would be under 

which Board members might be required to 

recluse (sic) themselves -- becomes -- just 

pluralize it and make it -- is that agreeable? 

And leave out the word "a" -- condition under 

which Board members might be required to 

recluse (sic) themselves. 

 MS. MUNN: Fine with me. 

 DR. ZIEMER: It just makes it neutral 

genetically -- genetically, generically. It's 

getting late in the day. 

I don't know what the Board's preference is on 

the use of data. My preference is to consider 

it plural. 

 MS. MUNN: Yes. 

 DR. ZIEMER: So in --

 MS. MUNN: It is. 

 DR. ZIEMER: -- on page 5 throughout the 

discussion of data -- and Ray, I'll mark this 

up -- we'll pluralize the use of the word 

"data" where it appears -- a number of places. 

If you have other minor changes -- are there 

any other major changes where there's incorrect 

information or incorrect concepts? If not, a 

motion to approve the minutes with these 
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suggested changes is in order. 

 MR. GIBSON: (Off microphone) (Unintelligible) 

 DR. ZIEMER: So moved? 

 MS. MUNN: Second. 

MR. ESPINOSA: Second. 

 DR. ZIEMER: Motion by Gibson, second by Rich, 

and any discussion? All in favor, aye? 

 (Affirmative responses) 

 Any opposed, no? 

 (No responses) 

 Motion carries, thank you. Any other business 

to come before us? Yes, Mark. 

 MR. GRIFFON: I know that Lew indicated that we 

can take care of workgroup dates outside of the 

Board. However, with -- with -- with our 

workgroup for -- covering Bethlehem, et cetera, 

I know we impact on NIOSH and SC&A, and I 

thought maybe while we have the key 

representatives here, we might -- 

 DR. ZIEMER: Check calendars? 

 MR. GRIFFON: -- check calendars. And -- and 

also I want to try to think out loud about if 

it's reasonable to expect certain things to be 

done by certain dates, otherwise we would push 

it back a little. I'm looking tentatively at 
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November 15th or 16th -- 

 DR. ZIEMER: So --

 MR. GRIFFON: -- November 15th or 16th, and 

hopefully by then having -- 

 DR. ZIEMER: This would be in Cincinnati. 

Correct? 

 MR. GRIFFON: Yes. 

 DR. ZIEMER: And how is that, Arjun, for you 

and --

UNIDENTIFIED: (Off microphone) What workgroup 

(unintelligible) --

 MR. GRIFFON: This will be the workgroup 

covering Bethlehem, procedures review, case 

review of Y-12, but I think we can decide which 

or all items -- I think it'll be -- at least 

Bethlehem I'd like to -- 

DR. NETON: This is separate apart -- separate 

and apart from the discussion with Breslin and 

(unintelligible). 

 MR. GRIFFON: Right, I'm assuming by then you 

would have the conversation with Breslin and -- 

DR. NETON: That's fine. 

 MR. GRIFFON: -- can report to our workgroup on 

that --

DR. NETON: Yes, that's okay with us. 
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 MR. GRIFFON: -- and then we can resolve the 

other findings. Okay. 

 DR. MAKHIJANI: (Off microphone) 

(Unintelligible) 

 MR. GRIFFON: Let's say the 15th. Is that --

 DR. MAKHIJANI: The 15th would be all right. 

just have a little bit of a conflict in the 

first part of November, so essentially John -- 

John and Jim and I would have to figure out a 

schedule with Mr. Breslin and then Mr. Breslin 

has to be available, so there's a -- otherwise 

the --

 DR. ZIEMER: If that doesn't work, then they'll 

have to find (unintelligible) -- 

 DR. MAKHIJANI: Yeah, the 15th otherwise is all 

right. 

 MR. GRIFFON: But tentatively it's -- it's an 

okay --

 DR. MAKHIJANI: Yes. Yes. 

 MR. GRIFFON: -- date to hold it? And I would 

say that at least Bethlehem -- I don't know if 

there's any chance that we might have the 

internal dose responses to the procedures 

review by then? 

DR. NETON: I'd have to rely on my colleague, 

I 
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Stu, to --

 MR. GRIFFON: Yeah -- yeah, I'm asking Stu to -

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DR. NETON: -- speak to that. 

 MR. GRIFFON: -- and/or the -- any -- any -- if 

it's too soon to work on Y-12 issues there, 

too, but --

 DR. WADE: It'd be nice to have the matrix on 

Y-12 put together with the SC&A comment and the 

NIOSH response. 

 MR. HINNEFELD: Okay. The matrix based on 

procedures --

 MR. GRIFFON: Procedures review. 

 MR. HINNEFELD: -- let's see, the internal 

procedures review, we can certainly be at the 

point on the internal and the CATI procedures 

on the 15th that we were on the 6th on the 

external. 

 MR. GRIFFON: That'd be great. 

 MR. HINNEFELD: We can have our initial 

responses --

 DR. WADE: Right, what about Y-12? 

 MR. HINNEFELD: -- (unintelligible) by that 

time. 

 MR. GRIFFON: And Y-12? 
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DR. NETON: First let me verify, that's the 

15th and 16th, Tuesday and Wednesday. 

 MR. GRIFFON: Or just the 15th, I'm saying. 

DR. NETON: Or -- well, just the 15th -- 

 DR. WADE: Jim has a conflict on the 15th. The 

16th? 

DR. NETON: No, I don't. 

 DR. MELIUS: Well, I was going to throw out 

let's further complicate this -- either the 

15th or the 17th would work for me for the -- 

the new workgroup if you're going to be out 

there and --

DR. NETON: I do have a conflict on -- 

 DR. WADE: I understand. What about the 16th 

for Mark's workgroup and the 17th for Dr. 

Melius's workgroup? 

DR. NETON: That seems okay. 

 DR. WADE: With the wisdom of Solomon. 

 DR. ZIEMER: Okay. 

 MR. GRIFFON: Okay. 

 DR. ZIEMER: Okay, Mark? 

 MR. GRIFFON: Yeah. 

 DR. MELIUS: The 17th? 

 DR. DEHART: The 17th? 

 DR. MELIUS: Yeah. 
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 DR. DEHART: Okay. 

 DR. WADE: The 16th for Mark's, the 17th for 

Jim's. I would really ask NIOSH if we can have 

the matrix on Y-12 put together by then. I 

think that would be very important, given the 

fact that we're likely to see a discussion of 

the SEC petition at the end of January. 

DR. NETON: We'll -- we'll try. 

 DR. WADE: Thank you. 

 DR. MAKHIJANI: Just a question, Dr. Melius, 

did you want any SC&A representative to be 

present at the 17th --

 DR. MELIUS: No. 

 DR. MAKHIJANI: -- just for planning purposes? 

 DR. MELIUS: No, not at this point. 

 DR. ZIEMER: I don't think we to on the initial 

meeting. 

Okay. Any other business to come before us? 

 MS. MUNN: We're talking the 16th? 

 DR. WADE: 16th for Mark, 17th for Jim. 

 DR. ZIEMER: Motion to adjourn? 

 MR. PRESLEY: So moved. 

 DR. ZIEMER: Second? 

MR. ESPINOSA: Second. 

 DR. ZIEMER: All in favor, leave. 
 

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 DR. WADE: Well done. 

 (Whereupon, the meeting was adjourned at 3:50 

p.m.) 
______________________________ 

280 

1 C E R T I F I C A T E OF COURT REPORTER 

STATE OF GEORGIA 

COUNTY OF FULTON 

 I, Steven Ray Green, Certified Merit Court 

Reporter, do hereby certify that I reported the 

above and foregoing on the day of October 19, 

2005; and it is a true and accurate transcript 

of the testimony captioned herein. 

 I further certify that I am neither kin 

nor counsel to any of the parties herein, nor 

have any interest in the cause named herein. 

 WITNESS my hand and official seal this the 

4th day of December, 2005. 

STEVEN RAY GREEN, CCR 

CERTIFIED MERIT COURT REPORTER 

CERTIFICATE NUMBER: A-2102