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-FIRST MEETING 

ADVISORY BOARD ON 

RADIATION AND WORKER HEALTH 

DAY THREE 

The verbatim transcript of the Meeting of the 

Advisory Board on Radiation and Worker Health held 

at the Chase Park Plaza Hotel, St. Louis, Missouri, 

on July 7, 2005. 
 

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C O N T E N T S 

July 7, 2005 

WELCOME AND OPENING COMMENTS 10 

DR. PAUL ZIEMER, CHAIR

DR. LEW WADE, EXECUTIVE SECRETARY 

SC&A TASK III/WORKBOOK ISSUES

DR. HANS BEHLING, SC&A 10 

REPORT ON THE REVIEW OF THE FIRST 20 DOSE RECONSTRUCTIONS 

DR. PAUL ZIEMER, CHAIR

MR. MARK GRIFFON, ABRWH 59 

BOARD DISCUSSION 

DR. PAUL ZIEMER, CHAIR 142 

REPORT ON THE REVIEW OF THE SECOND 18 DOSE 

RECONSTRUCTIONS 

MS. KATHY BEHLING, SC&A 233 

SC&A CONTRACT ISSUES 271 

DR. LEW WADE, NIOSH

DR. JOHN MAURO, SC&A 

GENERAL PUBLIC COMMENT 299 

COURT REPORTER’S CERTIFICATE 328 
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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. 

In the following transcript refers to microphone 

malfunction or speaker's neglect to depress "on" 

button. 
 

 

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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 
 

 

6 

AGENDA SPEAKERS
 

(in order of appearance) 

DR. HANS BEHLING, SC&A

DR. PAUL ZIEMER, CHAIR

MR. MARK GRIFFON, ABRWH

DR. PAUL ZIEMER, CHAIR

MS. KATHY BEHLING, SC&A

DR. LEW WADE, NIOSH

DR. JOHN MAURO, SC&A 

STAFF/VENDORS 

CORI HOMER, Committee Management Specialist, NIOSH

LASHAWN SHIELDS, Committee Management Specialist, NIOSH

STEVEN RAY GREEN, Certified Merit Court Reporter 
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AUDIENCE PARTICIPANTS 

ADAMS, EILEEN, NIOSH

ADAMS, NANCY, UNWW

AL-NABULSI, ISAF, NCRP

ALGERT, DAVE, DOD/DTRA

ALLEN, M. GEORGE

BAFASI, MARILYN, MALLINCKRODT

BEATTY, EVERETT RAY, SR., FERNALD ATOMIC COUNCIL

BEHLING, HANS, SC&A

BEHLING, KATHY, SC&A

BERRY, CHARLENE, MALLINCKRODT

BIEST, JOAN, MALLINCKRODT

BLAND, ROGER

BLOSSER, FRED, NIOSH

BLUE, GEORGE, MALLINCKRODT

BROCK, DENISE, UNWW/MALLINCKRODT

BRUENING, MARK, MCW

BUHR, LORRAINE

BULYAK, HAROLD A.

CAPPIELLO, ROBERT, ATTNY FOR WIFE/MALLINCKRODT

CASE, DIANE L., DEPT. OF LABOR

CHEFITZ, SANDRA, GAO

COWPER, ANN, SPOUSE OF MCW WORKER

DEEP, HEIDI, NIOSH

DEHART, JULIA

DOWNS, DEB

DORNFELD, DEBBIE, U.S. SENATOR JIM TALENT

DREY, KAY, NUCLEAR INFO & RESOURCE

DUGAN, PAUL, MALLINCKRODT WORKER

EHLMANN, PAT, UNWW

ESPY, RICHARD, MALLINCKRODT WIDOWER

EPPE, STEVEN

FITZGERALD, JOSEPH, SC&A

FRISCHMAN, BILL, MCW

GARNER, DON, ST. LOUIS

GASSEI, LARRY

GENERI, MARY, MCW

GILLEYLEN, HERSHELL, NIOSH

HAPPELL, CARL C., NIOSH

HEARL, FRANK, NIOSH

HEISTER, MELANIE, NCRP/VBDR

HERBST, ALVERA, MALLINCKRODT WIFE 
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HICKAM, JOHN

HINNEFELD, STUART, NIOSH

HOLTBAUS, RICHARD A.

HOMOKI-TITUS, LIZ, HHS

HOWELL, EMILY, HHS

JOHNSON, SHEILA, DAUGHTER OF MCW WORKER

KOENEMAN, BARB & TANYA, UNWW

LAMZIK, ED, RETIREE MCW

LEACH, ANN, MALLINCKRODT

LEACH, BOB, MALLINCKRODT

LICAVOLI, JOSEPHINE, MALLINCKRODT SURVIVOR

LOVETT, BRICE, UNWW

MAKARA, MEL, SELF

MAKHIJANI, ARJUN, SC&A

MALDENHAVER, RUBY, MALLINCKRODT

MAURO, JOHN, SC&A

MCBRIDE, MOLLY

MCGRUEN, JAMES

MCKEEL, DAN & LOUISE, VILLAGE IMAGE NEWS

MEYER, STEVEN

MILLER, RICHARD, GAP

MITAS, JIM, OFFICE OF CONGRESSMAN AKIN

MUECKE, EDWARD

MULEHOUR, BOB, SON OF (RICHARD)

NAGLE, KATHLEEN, DAUGHTER

NITCHMAN, JOHN

NOVAK, JUSTINE, MALLINCKRODT

PEDERSEN, ELAINE

POTTER, HERMAN, USW INT UNION

PRESLEY, LOUISE S., WIFE OF ROBERT PRESLEY

PUDLOWSKI, CAROL, MALLINCKRODT

RAFKY, MICHAEL, HHS

RAMSPOTT, CHRISTINE

RAMSPOTT, JOHN, MCW

ROSENETT, JAMES, MALLINCKRODT

SAMPSON, ROBERT, GAO

SCANENSEN, CLARENCE, UNWW

SCHAEFFER, D. MICHAEL, SAIC

SCHISLER, ELAINE, DAUGHTER OF MALLINCKRODT WORKER

SCHNEIDER, MARILYN, UNWW

SCRANEE, DARRELL, MALLINCKRODT

SCRANEE, E E

SCRANEE, RON, MALLINCKRODT 
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SHAW, SHIRLEY, MALLINCKRODT

STACAOWITZ, RAINER

STEFFEN, CAROLE, MALLINCKRODT

STEGER, RON, MALLINCKRODT

STUCKENSCHNEIDER, DOLORES, MALLINCKRODT

SUERMANN, ZELDA, MCW

TAYLOR, GEORGE EDWIN, VBDR

TOOHEY, RICHARD, ORAU

TUCKER, EVELYN

TUCKER, RICHARD

VERNOFF, GWENDOLYN

WALKER, EDWIN A., BETHLEHEM STEEL

WALKER, JOYCE, BETHLEHEM STEEL

WELLMAKER, SHIRLEY, NIOSH

WHITE, GARY, DOD

WILDHABER, SANDRA, MALLINCKRODT

WINDISCH, ANTHONY J., MALLINCKRODT WORKER

WIPFLER, ED, WELDON SPRING

YOUNG, OBIE, NIOSH

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

 (9:30 a.m.) 

WELCOME AND OPENING COMMENTS

 DR. ZIEMER: We're going to convene the full 

Board at this time, please. Let me begin our 

session this morning with the usual reminder 

that, if you haven't done so, please register 

your attendance in the registration book. 

We also have later today a public comment 

period and those members of the public who wish 

to participate in the public comment period, 

please sign up in the book there at the 

registration desk. 

One of the carryover items that we've not acted 

on from our contractor's deliverables is task 

three, which has to do with the review of 

procedures. So we are going to have the formal 

presentation on the task three review this 

morning. Hans Behling from our contractor, 

SC&A, will make that presentation. Hans, we'll 

be pleased to hear from you now if you'll take 

the podium. 

SC&A TASK III/WORKBOOK ISSUES

 DR. BEHLING: Good morning. My name is Hans 

Behling. I'm with SC&A and I'm here to briefly 

discuss task three, which is an overview of the 
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procedures and methods used by NIOSH to do dose 

reconstruction. As you can see, the people who 

were involved in this project were several 

people, and we divided our -- our task three 

among the different subject matters. I 

personally looked at the procedures that deal 

with external dosimetry and we had Joyce 

Lipsztein look at internal dosimetry. Arjun, 

that you've heard early this morning, and Kathy 

DeMers were involved in reviewing procedures 

that deal with the CATI interview procedures. 

And also there were several procedures 

involving quality assurance that were reviewed 

by Steve Ostrow, and Kathy Behling looked at 

documentation and records management. 

And just to give you a brief overview of the 

genesis of this project, under the energy 

employee act and under 42 CFR Part 82 the 

Advisory Board on Radiation and Worker Health 

is mandated to conduct an independent review of 

the methods and procedures used by NIOSH for 

dose reconstruction. And of course as 

contractors to the Board, we were asked to look 

at these procedures. 

In total NIOSH identified 33 procedures to us 
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for review. At least 33 procedures represent a 

sizeable body of written text that encompasses 

a wide array of complex subjects. Moreover, 

some of these documents are very, very detailed 

in defining how dose reconstructions should be 

done. For instance, Implementation Guides 1 

and Implementation Guide 2 are very critical 

and provide a foundation for external and 

internal dose reconstruction. 

Also, among the 33 procedures that were 

identified to us, some of them are somewhat 

generic in nature. In other words, they 

represent procedures that are to be used for 

all DOE sites. On the other hand, there were 

also several procedures, including OCAS-TIB 6 

and 7 and OCAS-PER 1 and 2, that are highly 

site-specific. These particular four 

procedures are directive to the dose 

reconstruction involving Savannah River Site 

claims. 

On the first slide you will see all of the 

procedures that represent those produced by 

NIOSH or OCAS, and there are a total of 13 and 

they cover a wide range of spectrum from, as I 

said, actual things that are directly involved 
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in dose reconstruction to things that are more 

peripheral in dose reconstruction. Some of 

them are also selective in particular areas. 

For instance, CATI reports or CATI procedures 

are driven by only a handful of procedures, and 

some of the issues that they contain are 

confined strictly to those procedures and not 

to any of the other procedures. As I said, the 

OCAS procedures are 13 in number and -- I'm 

sorry. 

The second half of the procedures are those 

that were produced by ORAU, and there are a 

total number of 20 of these procedures. All 

but two of those procedures are generic. 

Again, generic meaning that they apply 

essentially to all the different sites, as well 

as AWEs. 

Not included, and this is very important for 

you to understand in -- under task three for 

our procedural methods review are TBDs. They 

were re-- they are being reviewed under task 

one, but using different criteria. So I will 

remind you that our review of procedures 

involving dose reconstruction do not include 

TBDs and we'll come back to that a little 
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later. 

 Again, this is probably a busy slide, but if 

you have the handout in front of you, the ORAU 

procedure cover a wide range of issues. On top 

are QA procedures, there are documentation and 

records procedures. Again, the record 

procedure for internal and external dosimetry 

and CATI reports and others, so again, the 

procedures have a wide range of topics that we 

needed to address and therefore we had divided 

our task group three people into various areas 

for -- for review. 

 As contractors to the Advisory Board we were 

first asked to develop a method by which we 

would conduct this review, and so the task 

three was broken into two phases. Phase one 

was to divide (sic) a method by which we would 

systematically review and standardize the 

review process. And phase two was then 

actually to conduct a review. Phase A -- that 

is developing a protocol that would essentially 

define for the Board how we were planning on 

doing our review -- was -- that report was 

finished on September, 2004, almost a year ago, 

and was handed to the Advisory Board for review 
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and approval. The second phase, that is the 

actual review of the NIOSH and ORAU procedures, 

came in a report that was given to the Advisory 

Board in January of this past (sic) year. 

In reviewing the procedures and in drafting a 

protocol, we realized that central to that 

protocol would essentially have to address 

technical issues. These are key, and it's 

almost a given that we would have to look at 

all of the procedures in terms of their 

technical accuracy. And for that, NIOSH had 

given us, under task three, a list of technical 

issues that they needed for us to evaluate, and 

there were a total of ten of these. And I 

won't go through all of them, but I'll just 

cite a few of them as a representative. 

We needed to identify the technical basis for 

performing internal and external dose 

reconstruction. That is, critically review the 

Implementation Guide 1 and 2. And we needed to 

assess not only how to do the dose 

reconstruction in terms of recorded dose, but 

to identify how do we deal with missed doses, 

or the uncertainty of doses. So these were key 

technical issues that were part of our protocol 
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for -- for evaluation. 

But in addition to these technical issues we 

were clearly also asked to look at nontechnical issues. And these non-technical 

issues are very well specified in both the Act 

and the Federal regulations. And in reviewing 

the Federal regulations and saying what do we 

need to look at besides the technical issues, 

certain key words kept coming out of the pages. 

Things such as the dose reconstruction has to 

be fair, it has to be consistent, it has to be 

reasonable, it has to be claimant-favorable. 

And over and over again the word "timeliness" 

comes up. 

For example, in Section 73.84 of the Act, the 

statement -- the following statement is 

presented. (Reading) One of the purposes of 

the compensation program is to provide for a 

timely compensation. 

Section (e) of 42 CFR 82 in the final rule 

states that an additional critical fact 

affecting how doses are reconstructed is the 

amount of time available. In compensation 

programs a balance must be struck between 

efficiency and precision, and that is a very 
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important element. 

So according to these directives then, SC&A 

evaluated all of these 33 procedures. And not 

only in looking at, for instance, things as the 

ICR bio-- the ICRP biokinetic models, the 

accuracy of those conversion factors, how were 

they developed, the (unintelligible) risk 

coefficients, computer codes and all of the 

science that went behind it, but in addition we 

also had to address perhaps something that was 

even more difficult and subjective in terms of 

striking the proper balance between efficiency 

and precision. And these are subjective 

things. I will basically give you warning here 

that many of our findings have a very 

subjective element. They express in essence 

our opinion as to whether or not something is 

ambiguous or whether it's properly stated, 

whether it's formatted properly. And -- and I 

will fully admit to you that there's not always 

consensus amongst even the group that's 

represented, the task three group, as to what 

was to be given as a score. 

But in this slide we identified, as a result of 

our directives, seven basic objectives as their 
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fin-- objective one basically, again, dealt 

with the issue of timeliness. Objective two 

was is there -- is the procedure written in a 

way in which it will be used in infective (sic) 

manner, in an efficient manner. 

Objective three, the key issue is, is the 

procedure, written as it stands, complete. In 

other words, is it sufficient to allow the dose 

reconstructor to do what he's expected to do 

without having to consult with outside 

documents. In other words, a procedure would 

be very inefficient and perhaps missing if it 

simply made reference to a host of other 

documents that you needed to get in order to 

fulfill the objective of that procedure. 

Objective five addresses fairness and benefit 

of doubt to the claimant. You've heard that 

over and over again, whenever there is an issue 

here that we cannot fully understand or we do 

not have the necessary data, that we have to at 

least be fair and give the benefit of doubt to 

the claimant under those circumstances. 

Objective number six has to deal with 

uncertainty. We know very well that not 

everything -- we don't live in a perfect world 
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where all dosimeters and all bioassay can be 

taken at their face value. But oftentimes 

there is a need to look at the limitation of 

these assays and say what is the uncertainty 

regarding a film or TLD dosimeter reading or a 

bioassay. And clearly when you deal with 

uncertainty, we have to understand the science 

behind those -- those particular measurements, 

whether it's a film badge or -- or a internal 

bioassay or in vitro or vivo bioassay, et 

cetera. 

 And lastly, the issue that I've already brought 

out comes into play. That is where do we 

strike the proper balance. And I'm sure you've 

heard the discussion over the last three days 

and -- and we realize oftentimes there are 

opposing forces. We need more precision in 

order to be sure that you're not going to 

shortchange anybody in terms of reconstructing 

dose. At the same time, time is of the 

essence. We cannot spend an infinite amount of 

time in order to get to the last decimal point 

of accuracy. So we need to understand the 

importance of striking that balance. 

So for each of the seven objectives that you 
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see listed here, we decided to derive secondary 

questions in the form of a checklist, and a 

rating system by which we would then say is 

this in essence a procedure that fully fulfills 

the objectives that it's intended to do, or are 

there pers-- portions of it that we feel may be 

missing. And so we decided to aid the 

evaluation of these procedures by means of a 

checklist. And again this is a busy slide. 

I'm not sure to what extent you can see from 

the back, but on the very bottom you will see 

the rating system. So under rating, in the 

third column, we have a rating system of one 

through five. And one represents a rating that 

says no, it's -- it's not likely or this 

completely misses the point or the word never. 

In other words, in the first category of 

objective number one, determine the degree to 

which a procedure supports a process that is 

expeditious and timely for dose reconstruction. 

Under that heading we have five separate 

secondary questions. Is the procedure written 

in a style that is clear and unambiguous? In 

other words, the dose reconstructor has to be 

able to read this and say I know what I'm 
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supposed to do, and is it written clearly 

enough for him to follow that procedure. 

The second one, is the procedure written in a 

manner that represents -- oh, presents the data 

in a logical sequence? In other words, there 

are a sequence of steps that need to be 

followed. Is the procedure written where step 

one truly is defined as step one and not as 

step three where you end up, again, causing an 

awful lot of confusion and loss of time. 

And so forth and so forth. And so under 

category one or objective one, determine the 

degree to which the procedure supports a 

process that is expeditious and timely for dose 

reconstruction, we have a series of questions 

that have to be answered after each of the 

procedures was reviewed and given a rating that 

says no, never -- meaning that it's very bad; 

or it's perfect, it's a five; or in many cases 

we found that many of these procedures, as I 

already pointed out to you, are extremely 

selective. In other words, they're sitespecific for Savannah River, or the procedure 

deals strictly with the CATI interview so that 

the other 30 procedures really do not have any 
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need to even address these questions. 

Also, for instance, under heading two or 

objective two, determine whether the procedure 

provides adequate guidance to be efficient in 

instance where a more detailed approach to dose 

reconstruction would not affect the outcome. 

For those of you who may not be familiar with 

that question, it's really directed in terms of 

the efficiency process. In other words, we 

know that claims fall into one of three general 

categories and we'll briefly explain those. 

And under category one it's basically a process 

by which we can easily eliminate a claim by 

doing a partial dose reconstruction, and so 

this particular section or question addresses 

that. If you're going to do a -- an 

abbreviated dose reconstruction, which we call 

category one claims, is the procedure 

sufficient to guide you in that direction and 

saying, for efficiency purposes, do as 

minimumly (sic) as you need to in order to say 

yes, this guy has a claim by which the 

probability of causation exceeds the 50 percent 

value and you need to go no further. It's an 

incomplete procedure. 
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And again, section 2.2, the claims with 

suspected cumulative low doses, does the 

procedure provide clear guidance in defining 

worse-case assumption. These are the maximized 

category, and we need to understand how to 

maximize it, and there are -- many of the 

procedures that I showed you, especially the 

ORAU procedures, that are specifically geared 

towards maximizing doses. Don't worry about 

the uncertainty because uncertainty is a very 

difficult element to define in some cases. And 

so by maximizing doses we say it couldn't 

possibly any bigger than this or higher than 

this. We eliminate the time-consuming aspect 

of identifying, for instance, the geometric 

standard deviation or the standard deviation 

which at times can be a very time-consuming 

issue. So again, review objective two 

addresses those particular comment -- classes 

of -- of claims. 

Objective three at the bottom here is, again, 

pretty much confined to the CATI interview and 

-- and we'll briefly discuss some of those 

issues later on. 

This is the second page of our review and it 
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addresses section -- review objective four, 

five, six and seven, and I'll just briefly 

mention it. Review objective four is the issue 

of consistency, are we consistent so that a 

claim that's being submitted from one DOE site 

versus another are not treated significantly 

different. We do recognize that there are 

site-specific issues which certainly has -- 

have to be considered, but in general when we 

have certain generic components of a claim, 

each of the site should comply with a 

standardized protocol so as to be fair to all 

of the claimants. 

Five is the issue of fairness give -- benefit 

of doubt given to the claimant. And again, six 

are the issues that -- questions that focus on 

the concern about the uncertainty by which 

certain dose reconstruction have to be 

evaluated. And they're mostly category three. 

When we talk about the need to be highly 

definitive in our understanding of uncertainty, 

that also may include the Monte Carlo analysis. 

We're really dealing with category three 

claims. 

 And lastly, again, are the issues of -- of the 
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balance between technical precision and process 

efficiency. 

For each of the ratings other than five, which 

is a perfect score, and the NA which means it's 

not applicable, you -- you see a column over 

here called comments. And so our report, which 

is a close to 300-page document, has -- for 

each of the 33 procedures that we were asked to 

review -- this particular checklist and the 

rating. And in all cases other than in the 

cate-- rating number five, which is a perfect 

score, or NA, we would submit comments. And 

here -- this is not the section for actually 

describing the comments. It only gives the 

reader an understanding where those comments 

will be found in the text. And so for that 

reason we have a fairly lengthy document and it 

is close to 300 pages in -- in full text. And 

clearly it's a text that I cannot even hope to 

summarize in the brief period that has been 

allotted this morning to me. 

So what I've done in order to try to at least 

give you an overview is to -- I collated 

comments in a checklist that makes use of this 

one. And in a couple of minutes here I'm going 
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to show you what we modified. 

Where you see, for instance, the rating one 

through five, I have expanded it in order to 

give you the actual numbers one through five, 

as well as NA, and eliminated the comments, and 

then collated all of the 33 procedures and said 

how many of the 33 procedures have comments in 

section 1.1 that would fall into one of those 

categories. And let's go take a look at this 

and we will simply look at the numbers. 

As you can see -- and I hope, again, you can 

see from the back -- in review objective one 

there were five questions and question 1.1 says 

(reading) Is the procedure written in a style 

that's clear and unambiguous? As you can see, 

there were no ratings of one, but of the 33 

procedures there were four that had a two 

rating, and a two rating is infrequently. 

There were nine of the 33 procedures that had a 

value of three, which is sometimes; and seven 

that had a frequent -- had a rating of four, 

which is very frequently or essentially always 

-- near -- near perfect, and of the 33 

procedures 13 had a five rating, meaning that 

they were excellent procedures. And of course 
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there were some that had the NA, didn't really 

apply here. 

So for each of the 33 procedures we went 

through the checklist and what you're seeing 

here is a collation of numbers. 

Let me go and I'll -- in addition to this I'm 

also going to give you examples of each of 

these categories because, like I said, I can't 

go through all of them, time wouldn't permit 

me. So I will first show you the summation 

slide, and then I will give you some discrete 

examples that fall into each of those 

categories. So let me go to the next page. 

And so this continues, our checklist continues 

here, and it continues with question 3.2.3 and 

again you see the different ratings. Again, 

they probably don't mean anything, but one of 

the things you will see, that for certain 

review objectives you see an awful lot of NAs. 

In other words, it simply didn't apply to that 

procedure. 

But what I did want to point out to you is the 

very bottom row, which is now the total of the 

-- our evaluation. What you see therefore is 

in total. Of the 33 procedures that we 
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reviewed, seven -- there were seven ratings 

that had the rating of one, meaning that they 

were lacking significantly in clarity. Thirtyseven had a rating of two; 87 of three, 55 of 

four and 114 of five. In other words, that was 

a perfect score. But the largest number of -- 

of ratings was the NA column of 525. So that 

gives you essentially an overview of how these 

33 procedures were evaluated. 

So let me now go back to the actual ratings and 

give you some examples. I mention again that 

under review objective one, is the procedure 

written in a style that's clear and 

unambiguous. And for an example, I will give 

you implementation guide one. I found 

implementation guide to be extremely definitive 

and technically reasonably sound. But I found 

it to be extremely fragmented. 

And what do I mean by fragmented. If you look 

at the external dosimetry section you have a 

discussion that involves photons, neutrons and 

electrons. And for each of those three major 

categories that are critical for external dose 

reconstruction you had subsections in terms of 

photons that involve real recorded dosimeter 
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data. You have a section on missing data and 

uncertainty. But if I were doing a dose 

reconstruction and I needed to consult that 

particular document and I said I'm right now 

dealing with photon exposures as measured by 

film or TLD, I would have to go through a whole 

series of cycles. 

In other words, photons are discussed in terms 

of the dosimeter data, and then comes in the 

same section neutrons, which I'm not interested 

in. And then comes electron. And so for me to 

go from the recorded photon dose to the missing 

photon dose, I'd have to cycle over -- on over 

each of these three different categories, and 

it's a very inefficient process. 

And I was very -- almost -- you know, it was 

ecstatic when I realized that my finding had 

been corrected in ORAU Procedure PROC 6 where 

they did exactly what I would have said, take 

all of the three components of photon doses, 

whether it's recorded dose, missing dose, 

uncertainty, and put it into one package so 

that when a person has to consult it, he 

doesn't have to go through and cycle each and 

each over. So this is, again, a subjective 
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issue. I just simply categorize this as the 

procedure being fragmented. It may not require 

any resolution other than the fact that it's 

not written in an efficient style. 

The second objective is (reading) Is the data 

presented in a clear and logical way? And --

and again here I ran into -- and this is 

consistent throughout all the procedures. I --

at times I was frustrated. I would read these 

very complex procedures where they give you a 

lot of history up front and they give you all 

the kinds of data from previous studies, and it 

almost reads like health physics 101 course, 

and it only in the last page do you realize 

that the guidance they want you to follow is 

sequestered to the last page, or to an 

attachment. And in the meantime, you know, I'm 

looking at some of these re-- procedures and 

I'm saying is this how I'm supposed to dose 

reconstruct if I had to do a dose 

reconstruction? And it turns out no, no, 

you're just given an awful lot of information, 

background information, and sometimes it's only 

through -- at the end of the -- the procedure 

in a -- in a single attachment that's two or 
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three pages do you actually get to understand 

that this is the procedure you're supposed to 

follow. In fact, one time I didn't even know 

it existed. I thought I was done because I 

looked at the end of the procedure and there's 

the references and I said I must be done. And 

then I just turned one more page and I said 

well, here's now the procedure for me to 

follow. 

And I personally think this is a poor 

efficiency because I would like to see the nuts 

and bolts in the front saying this is what I 

want you to do, and this are the steps, one 

through ten, one through 20. And if you don't 

have a full, comfortable feeling about what 

these steps represent in terms of technical 

merit, please consult appendix A, B, C and D to 

verify, to -- to somehow or other give you that 

warm and fuzzy feeling that what we're telling 

you to do has technical merit. 

As it turns out, just about every procedure 

suffers from that problem in terms of the 

reverse order. You get an awful lot of 

historical background data and it's only in the 

last page or two that you understand what 
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you're really supposed to do. 

For technical -- for the review item 1.3, is 

the procedure complete in terms of required 

data, this was a critical issue, too. And I'll 

give you an example. In some instances -- and 

this procedure in particular suffers from 

multiple elements of deficiency, including the 

first and second one I just mentioned, and 

that's the occupational medical exposure. You 

get an awful lot of history about X-rays and 

how they're produced and so forth, and then you 

get an awful lot of information that says, you 

know, it's important for us to really include 

this in dose reconstruction. And 

unfortunately, some of the data is not going to 

be available to you in terms of dose because 

when people had a occupational X-ray for the 

chest, they would oftentimes just do it and -- 

and that's all you have in the record, this 

person was exposed to a chest X-ray in 1957. 

Okay. You don't have a clue what the doses 

were to specific organs. And so the procedure 

gives you a long list of how to do this. And 

again, I was initially puzzled when I read this 

and I said how am I supposed to do this, and it 
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tells you. You can do this from first 

principles if you understand -- if you know the 

kilovoltage potential of the tube, if you 

understand the milliamperage, if you understand 

the milliseconds of exposure, if you know the 

distance between the source and the body or the 

organ, you can reconstruct it. And I looked at 

this -- is this efficient? 

And then of course, again, there's appendix -- 

of -- an appendix that has a clear-cut series 

of tables that says from '45 to '57 or whatever 

it is, use these. 

My gut feeling is it should have been up front 

that says if you have any doubt as to how these 

numbers were derived, please consult the 

appendix and we'll explain it to you. So a lot 

of information that I consider useless was 

introduced, but only to demonstrate that we 

know what we're talking about. 

Let me go to issue number two here and that is 

determine whether the procedure provides 

adequate guidance to be efficient in instance 

where a more detailed approach to dose 

reconstruction would not affect the outcome. 

That is, again, the efficiency process that 
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affects category one and two. And I'd say in 

most instances these were fairly readily 

discernible. They were very few instance where 

we felt that there was anything missing, and -- 

and as you can see in the column over here 

under 2.1 and 2, most of these became NAs 

anyway. 

The only thing that I sometimes had a problem 

with in looking at this is the definition of 

worst case, and I think we have two different 

definitions of worst case. Some instances 

worst case is really a maximized approach and 

other times it's best estimate. Maximized 

meaning that we don't want to deal with 

uncertainty; just multiply by two and we'll 

cover the issue and that's fine. In other 

instance the worst case has also been used and 

very sometimes difficult to discern under 

conditions where we simply don't know. 

For instance, under maximized, we do know but 

we just don't want to go through the exercise 

of -- of -- of finding out what the uncertainty 

is, so efficiency -- for efficiency purpose we 

will maximize and use worst case assumption. 

In other instance we simply merely don't know 
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the answer, such as what is the solubility of 

the material, and you're not maximizing you're 

just giving the -- the benefit of doubt to the 

claimant. And sometimes that was not necessary 

always clear how to differentiate worst case 

for maximized dose reconstruction versus, for 

instance, where you really don't know and 

applicable to best estimate approaches. 

Let me give you examples of category three. 

Again, these are the CATI procedures under 2.1 

and 3.1 1, 2, 3. And again, you've already 

heard earlier this -- from -- this morning from 

Arjun, there were some problems here, and I 

won't go through all of them, but the problems 

center around the failure on the part of the 

CATI interviewer to be necessary familiar with 

the particular site in question. And it would 

certainly be helpful if the CATI interviewer 

had an understanding of the complexity of a 

given site and then asked the directive 

questions that would be potentially very 

relevant to the response that you might solicit 

from an interviewee. 

 The other issue that already was mentioned this 

morning by Dr. Makhijani was the issue of bias, 
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and we realize that, for instance, there's a 

distinct disadvantage when we interview a 

survivor who frequently, as we heard yesterday 

as part of the testimony on the part of one of 

the people here who -- who gave his -- his 

understanding of how the interview process went 

along where all the answers are I don't know, I 

don't know. And so the -- the -- there's a 

distinct bias in the way of -- of the interview 

process where we're not talking about the 

claimant himself, but a survivor who simply 

doesn't have the answer because in too many 

instances the -- the secrecy surrounding these 

facilities mandated that people did not talk 

openly, including to family members. 

Let me briefly go to category 3.2. These --

this particular category we had a bunch of 

deficiencies, but I think they were all, by and 

large, centered around a -- a single procedure 

that is OCAS-PR-3, performing and reporting 

dose reconstruction. To the best of my 

knowledge when looking at that procedure, it's 

a procedure that was written early on and, 

quite frankly, I don't believe there's much use 

to this procedure. At this point I've looked 
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at 38 dose reconstructions and none of them 

have referenced this particular procedure. So 

the bottom line is OCAS-PR-03 may be a limit-- 

of limited use and -- and therefore limited 

concern at this point as part of our review. 

Let me go to review objective number four. 

Again, I don't want to spell -- spend too much 

time here, but we didn't really see too many 

inconsistencies among the procedures. There 

were a few, but sometimes one of the problems I 

had, when there were multiple procedures, is to 

determine which procedure should I be using. 

For instance, I think there are three different 

procedures one could make use of in defining 

the tritium exposure at Savannah River Site, 

and they parallel each other to some extent but 

they're not totally superimposable, and it was 

always a difficult thing for me to say which 

one should I really be using. And in an 

instance where there are multiple protocols 

that one can follow, especially when you talk 

about complex-wide issues, the question of 

hierarchy comes into play, which ones are 

really the ones that have precedent over the 

other procedures. So that was one of the 
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issues that involved category -- or -- or 

review object-- number four. 

 Review objective five is the issue of fairness 

and benefit of doubt. If I look at these 

procedures, most of these procedures were 

generic procedures. They are geared towards 

maximizing doses and admittedly the maximized 

doses are very, very claimant-favorable. They 

tend to over-estimate, as is their charter, and 

so we found very little to -- to be critical 

of. 

There were a couple of instance, however, when 

I felt that a -- a bias was given to the 

unmonitored workers, which may be inevitable, 

but we -- I came to the conclusion that it be -

- it almost behooves you to be an unmonitored 

worker because oftentimes he would get up -- 

end up with a much larger dose than any person 

who had truly internal exposures that were in 

the form of a urinalysis or in the form of a -- 

of a whole body count. And all of a sudden we 

get all these assigned doses to the worker who 

was not monitored. And even there there were 

multiple options at times that says well, for 

instance, if a person was monitored but there 
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was a period of time during which he is not 

monitored, you could, for instance, use an 

extrapolation/interpolation use and say well, 

what was -- how much dose did he get before 

this gap in information and how much did he get 

afterwards and side of -- kind of interpolate a 

little bit here and come up with what's 

reasonable. 

 You could also choose coworker data, if you 

wanted to, to fill in the gap. Or we could, 

for instance, use the maximum recorded doses 

for that particular facility during that time 

frame. Or we could even default to 

administrative dose limits or regulatory dose 

limits, as I've seen in some cases. So again, 

there were multiple options. Not all of them 

were consistent. Some were claimant favorable 

than others and at times it was difficult to 

assess basically what is it that you should 

really do, and there was a lot of subjective 

selection here available to the dose 

reconstructor in how he wanted to deal with 

this. 

Let me go on to item number six, which is the 

issue of uncertainty. And as I've mentioned, 
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this is a very, very important issue, but not 

necessary important when we talk about category 

one or two -- certainly not category one, 

because we don't even address uncertainty under 

category one where we do minimized doses where 

we say no, you're going to get exactly what the 

dosimeter read, and in fact we may even shave 

it. We're not going to address missed dose, et 

cetera, et cetera. So uncertainty doesn't 

address the issue of the category one claim. 

It is marginally used in category two claims 

where oftentimes uncertainty is swipe-- wiped 

off the table by saying we'll multiply 

everything by two, and that's a maximized dose 

which then give you the 95th percentile value 

that exempts you from uncertainty. 

But clearly for the last and third case, 

category three, where best estimates have to be 

evaluated, uncertainty becomes a critical, 

critical issue to be sure that we're not doing 

anything that is less than -- than claimantfavorable. And let me give you a couple of 

examples of some of the problems here. 

 In looking at implementation guide one, there 

is an uncertainty discussion that requires the 
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dose reconstructor, if you're doing best 

estimate, to establish a sigma value or 

standard deviation for film. And if -- I 

looked at that. I said my God, for people who 

were monitored by film in the early periods, 

like in the '50s, they may have been given a 

weekly film dosimeter that -- for which they 

have to establish a sigma value. And then 

through propagation of error for one year, do 

that 52 times and collate it. And the 

methodology that's described -- I mean I'm 

scratching my head and saying I'm a reasonable 

health physicist. I think I know what I'm 

doing. I've been doing this for 30-some-odd 

years and I have to say I wouldn't know how to 

do this. 

They tell you, for instance, that to -- there's 

a formula in the -- in the implementation guide 

that says if you expose in roentgens you must 

have a sigma value that's defined as a 

densitometer* reading uncertainty typically of 

0.015 density unit. Well, that's a typical 

value. Should I use it? Is there another 

value that should be using? Part of that 

equation also says that it's saturation density 
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of film and it's based on Dupont 502 film which 

was commonly used, has a saturation density of 

2.8. But what if in some other instances, as 

we already know, other film was used? So --

and -- and to do this 52 times and then use a 

propagation for one year? I sort of looked at 

this and saying my God, this is not something 

that anyone can easily do in an efficient 

manner. 

The worst is the TLD uncertainty where the -- 

the uncertainty is defined in terms of an air 

kerma dose, and I'm not sure we even have that 

kind of data. And there are questions here 

that in the equation that is to be used there 

is a sigma sub one, which is the standard 

deviation of the total air kerma. I don't know 

what that means and the standard deviation of 

the no readings, I don't have a clue what those 

numbers mean. Then it basically tells you that 

for those sigma sub-N and sigma sub-Mu, which 

are part of an equation, you should have that 

data readily available from the -- for most 

DOE-lab accredited programs. In other words, 

call up the guy who was the DOE lab accreditor 

(sic) and get these numbers in order for you to 
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do a sigma value. 

I find these things very difficult and -- and 

questionable in terms of their usefulness in 

doing dose reconstruction. I think there is a 

better way to doing this. 

So again, the uncertainty issue needs to be 

resolved and I think it may very well have 

already been resolved because ORAUT-OTIB-12 may 

address that issue. 

Also crystal ball has been used. According to 

some information that we got when we went to 

Cincinnati about a month ago, we were shown 

computer codes that do this for you. So again, 

some of the criticism may simply fall by the 

wayside. This -- these documents were drafted 

early on and of course since that time much has 

been done to rectify these problems. And I 

will also tell you that -- I will jump ahead 

and Kathy will probably verify this -- at -- to 

date I've reviewed 38 dose reconstructions and 

not one instance were of dose reconstructions 

where recorded doses were part of the dose 

reconstruction with anyone ever developed a 

sigma value for the recorded dose. And it's 

clearly an understandable issue. I didn't know 
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how to do this. And even if you did know, you 

could spend weeks trying to chase down these 

numbers. So some deficiencies that Kathy will 

be talking to later on is clearly a reflection 

of the difficulties that I've identified in 

these procedures. 

Let's go to lastly category seven, and that is, 

again, the issue of does the procedure require 

a level of detail that can reasonably accounted 

for by the dose reconstructor. And I've 

already mentioned to you a classic case of the 

occupational medical dose where they tell you 

up front well, you can reconstruct it if you 

have the KDP, the MA, the milliseconds and the 

distance, and of course we don't have that. If 

you don't have the dose, you sure as -- not 

going to have those values. So again, we 

categorized some of these procedures in that 

fashion saying this is -- this is a request 

here that cannot be achieved. So we -- we 

obviously took notice of that. 

 On -- on the issue of 7.2, does the procedure 

avoid levels of detail that have only limited 

significance in final dose estimate and its 

POC, there were instances where I felt that we 
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went far beyond the call of duty and introduced 

levels of detail that I think are suggestive of 

a level of precision that really doesn't exist. 

Again, in the case of some of the tables that 

I've found in the occupational medical, we 

found organ doses to the -- E to the minus 

sixth rem. We're talking about a microrem. Is 

this significant or should we even have these 

numbers in here? I mean it's reasonable to say 

it's less than one millirem and be done with 

it. And so oftentimes some of these procedures 

would essentially project a level of precision 

that simply doesn't exist. It's a -- it's a 

false sense of security here in assuming that 

you know something that you in fact don't know. 

Another example is the external exposure 

geometry. We have in table 4.2 common exposure 

geometry for various jobs and facilities, and 

they give you uranium facility, reactor and 

chemical separation facilities, and they have 

by job category -- general labor, machinist, 

supervisor, fuel handlers, reactor operators -- 

and they will tell you that if you have a -- an 

exposure dose from a TLD you should consider 

certain geometries -- isotopic, anterior, 
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posterior, rotational -- and in fractions. I -

- I'm reasonably certain these numbers have no 

real scientific basis. Or if they do, they 

probably don't apply to most of the 

individuals. And the question is, is it really 

necessary to get that level of detail? Not to 

mention that some of the dose conversion 

factors -- if you look at appendix B, I -- I -- 

I scratch my head. Appendix B offers you all 

the DCFs after, of course, a lengthy discussion 

on how they were derived. But among the four 

categories of DCFs are DCFs that are defined in 

terms of the ambient dose equivalent, and I 

question if I've ever heard of anyone using 

ambient dose equivalent for recording film or 

TLD -- or air kerma doses, to my -- best of my 

knowledge. All doses that have ever been used 

for -- for monitoring personnel for external 

exp-- (unintelligible) defined in the Roentgen 

or in -- in HP-10 in shallow dose, but I've 

never heard -- I -- I -- in fact, I had to look 

up the definition of ambient dose equivalent 

and I kept scratching my head even harder 

'cause I didn't know what the definition really 

totally were, so there's a lot of data here 
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that seems superfluous, takes away from the 

efficiency and the clarity of a procedure. 

So let me just briefly summarize. We -- we 

obviously had a -- a tally here in -- in one of 

the earlier procedures -- no. Well, I'm lost 

here. Where I am? 

Here. These are the numbers. As I said, 

again, the majority of ratings were not 

applicable, 525. A good number were perfect 

scores, and there were shades of deficiencies 

that ranged from the -- never to -- to most of 

the time, and so forth. 

What I did not want to discuss this morning are 

technical issues. I didn't know that, for 

instance, Mark Griffon was going to introduce a 

matrix, unbeknownst to me. He said he did it 

on the 4th of July. He didn't inform me about 

it. And I really clearly wanted to avoid the 

issue of technical issues because, out of 

fairness to NIOSH and ORAU, I did not want to 

address specific technical issues without 

having to go through an iterative process by 

which we could say well, you know, I cited you 

here as a deficiency. You've clarified it. 

I've -- see things now in a different light and 
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I'll walk away from it. I didn't want to be in 

that position. I believe that there are 

technical issues that need to be looked at very 

carefully, including DCFs. But at this point I 

would refrain from identifying and discussing 

those particular issues until SC&A has had a 

face-to-face communication with NIOSH people. 

And some of these issues may very well be 

resolved in their favor. We may realize we 

were wrong in identifying them and some will 

have to require resolution because we're right. 

But that day hasn't come yet and we'll 

obviously look forward to the time when we will 

meet with NIOSH and -- and discuss some of our 

technical findings. 

The non-technical findings I'm not sure what to 

do about them. As I said, they will have 

probably been reviewed in -- in the past and 

they have -- numerous revisions have been made 

to take care of some of the problems that we 

have may -- may have identified. There are 

many new TIBs which we have not looked at that 

have come out and they keep coming out. There 

have been revisions to -- to those documents 

and including new TBDs that will be used in 
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category three and so forth. So I want to be 

sure that -- this review has not been a 

comprehensive and exhaustive review for those 

very reasons. This set of 33 documents pretty 

much focused on generic documents, complex-wide 

documents. Part of our review was not to look 

at TBDs, which are very, very critical and 

instrumental in doing the best estimates, which 

are likely to be something that I -- ORAU and 

NIOSH hasn't even really entered into yet 

because the low-hanging fruit have been the 

first in line and prioritized in terms of 

adjudication. So at this point in time our 

findings may have limited impacts from all 

those factors. 

And -- and I just want to for -- for -- as a 

way of leading into -- into Kathy's 

presentation, as I'd already mentioned, you're 

all familiar with the three categories of 

partial -- category one we call a partial 

and/or minimized dose reconstruction. A 

category two, which is really the focus of most 

of these procedures, are the maximized dose 

reconstruction. And of course category three 

are the best-estimate, which will obviously be 
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the -- those -- claims that require an 

incredible amount of work. Category one, just 

again here, they are really used to ensure that 

a person's going to be compensated, where even 

a partial dose reconstruction, very incomplete, 

already puts you over the 50 percent mark and 

we don't need to really worry too much about 

uncertainty and others, so these -- these 

category of claims are least affected by the 

quality of the dose -- of dose reconstruction 

procedures because they almost -- in some 

instance don't even have to bother with it if 

you're, for instance, dealing with strictly an 

issue of external dose that puts you over the 

50 percent mark. 

In terms of category two, the maximized dose, 

again, they're somewhat insensitive to 

precision because we build in so much fat in 

overestimating doses. We give hypothetical 

internal, even though there's no evidence that 

the person was even monitored, let alone been 

exposed. And errors here simply don't mean 

anything. They're used to basically say no to 

a claimant. And even when you maximize doses, 

the POC's less than 50 percent, so the need for 
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precision is simply not there when we do 

maximized doses. The only thing we need to do 

is to be sure that we have not overlooked 

anything, that all pathways, all exposures to 

different radionuclides have been properly 

addressed, but precision is clearly not an 

issue here. 

And lastly of course is the category three, 

which is the best estimate approach and we've 

talked, again, in terms of Mallinckrodt, these 

are the ones that will be very difficult 

because they require a thorough understanding 

of how to interpret the bioassay data, how to 

interpret the -- the external doses, the missed 

doses, et cetera. And there are likely to be 

those cases where a marginal error could easily 

trigger a non-compensable to a compensable 

claim, and this is where we need to be very 

sure that we understand what we're doing and 

how to do the dose reconstruction properly. 

And as I said, I think Kathy will talk more 

about what kinds of claims that we have looked 

at in the dose reconstruction in a discussion 

that she'll have this morning yet. So I'll 

close with that statement and if there's any 
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questions I'll be happy to answer those. 

 DR. ZIEMER: Thank you, Hans. Let me open the 

floor for questions from the Board members on 

the presentation. We do need to -- 

 MR. PRESLEY: Gen has one. 

 DR. ZIEMER: Oh, sorry, Gen Roessler. Sorry, I 

didn't see you there. 

DR. ROESSLER: I just have a comment. This was 

a huge amount of work for your team to do, and 

it also impresses me that this whole set of 

procedures for NIOSH and ORAU was very much a 

learning procedure, starting from the very 

beginning going on through all the improvements 

and recognizing where things could be redone. 

And it kind of reminds me of supervising a 

master's or Ph.D. work where the student, in 

learning what they're doing, has to put all 

that information there. And then later on you 

realize it's not necessary and you move it to 

an appendix. 

I guess I'm wondering, is there anything that 

really needs to be done with these deficiencies 

that you see in the procedures, or -- or is -- 

is this being taken care of by the later 

procedures that -- that sort of correct the 
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deficient --

 DR. BEHLING: Yeah, if you look at the bottom 

line tally among the categories, other than 

five and NA, I believe they come up to 154. So 

in essence we had 154 comments and -- and 

statements regarding deficiencies. And I will 

tell you, many of them are subjective. Many of 

them are things that may not have to be 

corrected, it's just a -- if we talk about a 

poor formatting of a procedure, what do you do? 

Rewrite the procedure if you want to, but at 

this point it may be unnecessary in lieu (sic) 

of the fact that many of these procedures have 

been replaced by spreadsheets and work books. 

And so the question is, do we need to do that. 

Now I will tell you that there are some 

procedures that are used that are very poorly 

written and very ambiguous, and I think Kathy's 

going to get into it. And I will cite to you 

two procedures in particular, TIB 8 and 10. 

For all the 38 dose reconstruction we've done 

to date, I've seen just about every one of them 

fail to understand what the intentions were of 

TIB 8 and 10 and understanding how to maximize 

doses. And even when -- as I said, maximized 
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doses are not necessarily affected by 

precision, but there was a consistent misin-- 

misunderstanding on the part of the dose 

reconstructor in their interpretation of those 

procedures. 

Again, you want -- you may want to just rewrite 

these in order to clarify these -- if these 

complex-wide procedures are used in the future. 

Just for the record, I think some of the work 

books may illuminate that because the option 

for doing a redundant approach may no long 

exist when a person then clicks on -- on -- on 

an icon or something and says this is what I 

want to do, so the misinterpretation has been 

eliminated. 

There are, however, a couple of issues that I 

will say are very important issues that need to 

be looked at in terms of technical 

incorrectness. And I think -- we briefly 

mentioned, I don't want to get into it because, 

as I said, I wasn't even going to bring those 

up because we have not had a face-to-face with 

-- with NIOSH in discussing our concerns, some 

of these technical issues. 

And so yeah, I think -- to answer your 
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question, the majority these 154 items and 

comments will probably not amount to a 

significant issue at this point, but there are 

some technical issues that I would hope will be 

resolved because they're so important, not just 

for the claims that have been done, but for 

future claims, as well. And they cross all 

categories. 

 DR. ZIEMER: Thank you. Mark has a question or 

comment. 

 MR. GRIFFON: I guess I was going to offer a 

response to Gen's question, as well. We don't 

know, you know, and that's -- I think we 

discussed it in the subcommittee yesterday that 

we're starting to set up a resolution process, 

and I took a first shot at -- at sort of what 

Hans was talking about, taking out some of the 

more technical issues and -- and putting them 

into that -- that preliminary matrix and saying 

these are ones that I think are more overarching. But I think yesterday -- I -- I don't 

know if we -- we need to -- 

 DR. ZIEMER: During our working session we are 

going to come back and take a first crack at 

what are next steps now, what do we do with 
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this report. If there are issues that need 

sort of a common resolution process, we need to 

get the ball rolling on that and we will 

address that during our working session later 

today. 

 MR. GRIFFON: Yeah, I guess I was going to -- I 

think we -- we discussed that at the 

subcommittee. I don't think we brought it back 

to the full Board yet, but we need to to bring 

that --

 DR. ZIEMER: Right. 

 MR. GRIFFON: -- proposal back to the full 

Board, yeah. 

 DR. ZIEMER: And we have a -- we have a 

starting matrix for that purpose that we'll use 

in that discussion. 

 MR. GRIFFON: Can I ask -- can I ask one other 

 DR. ZIEMER: You bet. 

 MR. GRIFFON: -- item of Hans? It -- it -- I -

- I -- I glance at this summary sheet and it 

strikes me that 525 of your -- of your matrix 

items or whatever that high number was, are NA. 

And it raises the question in my mind as to 

whether we have the right evaluation objectives 
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up there. If everything's not applicable, are 

we measuring -- are we looking at the right 

metrics? Just -- just something I was 

thinking, Hans. 

 DR. BEHLING: That's due to the diversity of 

the procedures. For instance, when we look at 

a host of QA, they have nothing to do with 

external or internal dosimetry -- 

 MR. GRIFFON: Right. 

 DR. BEHLING: -- and clearly -- or the CATI 

interview. You know, they -- they were select 

questions that were geared towards only select 

procedures. And we knew from the beginning 

that not all of these review objectives will 

apply. In fact, most of them would not, to a 

given procedure. But in order to keep things 

consistent, we wanted to keep a -- a -- sort of 

a review checklist that would be used for each 

and every single procedure, even if the 

majority of -- of our objectives were NA to 

that procedure. 

 MR. GRIFFON: Okay. 

 DR. BEHLING: And of course one of the -- the 

shortcomings was that we reviewed these 

procedures before we had a chance to look at 
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the dose reconstruction audits. And I liken 

that to a situation where you walk into the 

showroom and say gee, I'm interested in looking 

at a car but, you know, the -- the -- the 

salesman says well, here are the technical 

specifications. And you sort of say well, they 

sound great, but you know, I really want to 

take it out for a test drive, and he says no, 

not -- not now. And so right now we're -- when 

we reviewed these -- these procedures, we only 

had the tech specs to look at. We didn't have 

the benefit of a test drive. And the test 

drive comes with the review that Kathy's going 

to give you from the audits, which will verify 

some of our findings in many instance. In some 

instances we identified, as a result of our 

review of the dose reconstructions, things that 

we should have picked up but didn't because now 

we are seeing it through the eyes of the dose 

reconstructor. What did he do? He didn't 

understand the procedure. But we didn't have 

that benefit when we first looked at the 

procedures themselves, so some of the findings 

that I would have introduced here in our -- our 

procedure review came only -- that wisdom only 
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came with us doing the audits themselves. 

 DR. ZIEMER: Good. Thank you. Other 

questions? 

Okay. Thank you, Hans. We're going to move on 

then to the next presentation -- this is the 

test drive, I guess -- report on the -- oh, 

wait a minute. 

 MR. GRIFFON: Where are we on the agenda, yeah. 

 DR. ZIEMER: Where are we on the agenda? 

 MR. GRIFFON: I think we're doing the first 20 

cases. 

 DR. WADE: Well, we could reverse the order if 

you wanted to do that. 

 MR. GRIFFON: I -- I --

REPORT ON THE REVIEW OF THE FIRST 20 DOSE 

RECONSTRUCTIONS

 DR. ZIEMER: Yeah, actually what -- what is 

next on the agenda is the first 20 cases. The 

second 18 comes a little later, sorry. I was -

- after Hans's remarks, I was so ready to see 

the outcome there that I skipped ahead. 

On the first 20 cases we had the report from 

SC&A. We went through what became known as the 

six-step process where there was some dialogue 

back and forth with NIOSH. And ultimately we 
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ended up with a matrix, the latest version of 

which -- I'm looking for a date on it. Did it 

have a date on it? 

 MR. GRIFFON: Probably not. No, there's no 

date. 

 DR. ZIEMER: Which will contain today's date, 

which you will write in. Anyway, you should 

all have it there at your place. As the matrix 

has developed, each of the findings of SC&A has 

been identified and cross-walked to the 

original document. There's a finding number 

that also includes with it the particular 

portion from the original report, so the 

finding number 1.1 also references item C.2.1, 

which I believe is where it rises in the 

original report from SC&A. There's a brief 

phrase or sentence which summarizes the 

finding, a brief summary of NIOSH's response. 

There's a ranking -- let's see, what is the 

next -- case rank. This was a high, medium, 

low ranking in terms of level of importance, if 

we want to call it that. In some cases a 

ranking in terms of whether this was -- I'm 

trying to remember now -- program-wide or 

simply --
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 MR. GRIFFON: Case-specific. 

 DR. ZIEMER: -- case-specific. And 

identification of whether it was a technical 

issue versus a -- what were the other ones -- 

procedural or quality issue. Identification of 

external, internal -- was there another 

category in there -- or a CATI issue -- 

internal dose, external dose, CATI. And 

ultimately the resolution -- the NIOSH 

resolution. In other words, did NIOSH accept 

it or agree with it or -- or is there some 

other resolution, and then finally a proposed 

Board action, and it's the proposed Board 

action that we have to take actual action on. 

 Now these proposed actions are categorized as 1 

to 7, and what we will need to add for your 

assistance here comes from an earlier document, 

and that is what do the numbers 1 through 7 

mean. 

 MR. GRIFFON: Right. 

 DR. ZIEMER: And Mark, if you have that before 

you, I'll let you read that. I have it here, 

if you don't. 

 MR. GRIFFON: Yeah. 

 DR. ZIEMER: Go ahead. 
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 MR. GRIFFON: And I -- I think it needs to be 

added as a footnote on the matrix itself -- 

 DR. ZIEMER: And I might add that --

 MR. GRIFFON: -- but I didn't get around to 

that. 

 DR. ZIEMER: -- I think initially we had 1 to 

6, when this Board last met. 

 MR. GRIFFON: That's right. 

 DR. ZIEMER: But we determined in the working 

group at Cincinnati about a month ago, as -- I 

think Mark and I went over this, we realized 

that there was an additional category we needed 

to add, and that's what the 7 is, and Mark'll 

tell you what that is. 

 MR. GRIFFON: Right, number -- number 1 is 

NIOSH agrees and accepts the finding; 2, NIOSH 

disagrees but will comply -- 

 MS. MUNN: Go slowly. 

 DR. ZIEMER: Go slower. 

 MR. GRIFFON: Three, NIOSH disagrees -- 

 MS. MUNN: Hold on, hold on. 

 DR. MELIUS: Start all over again, Mark. 

 MR. GRIFFON: Do we want just copies of this 

made? Is that --

 MR. PRESLEY: That's what you need to do is 
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make a copy. 

 MR. GRIFFON: That'd be a lot easier and I -- 

and I don't have another copy, so... 

 DR. ZIEMER: The first six categories actually 

we had agreed on earlier. 

 MR. GRIFFON: Right. 

 DR. ZIEMER: Unfortunately, they didn't get 

carried across onto the matrix, but why don't 

you go ahead and read them slowly, even -- 

we'll get the hard copy here, but -- 

 MR. GRIFFON: I don't have --

 DR. ZIEMER: -- number one --

 MR. PRESLEY: He's got --

 DR. ZIEMER: Oh, okay. 

 DR. WADE: As quickly as she can walk to the 

copy machine. 

(Pause) 

 DR. ZIEMER: I thought I was going to pull them 

right -- here -- here they are. And actually, 

Board members, you had a hard copy of this 

before, but I'm not scolding you. You wouldn't 

necessarily have brought it. 

 NIOSH -- 

 DR. MELIUS: We need a moving van every time to 

haul the paper. 
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 DR. ZIEMER: That's literally true. I had some 

boxes this time. 

NIOSH agrees and accepts the finding, that's 

number one. 

 Number two, NIOSH disagrees, but will comply. 

The third one is similar but a little more 

reluctant on NIOSH's part, it's NIOSH disagrees 

and will not implement unless the Board 

recommends action through HHS. It requires a 

letter to the Secretary. 

 Number four, NIOSH disagrees and the Board and 

NIOSH reach a compromise. This would be an 

intermediate step if we were to agree outside 

of a mandated solution to some sort of 

compromise. 

 Number five, NIOSH disagrees and the Board 

concurs. We -- in other words, we say we agree 

that NIOSH -- we are basically agreeing with 

NIOSH on the outcome rather than the 

contractor. 

Number -- am I going too fast? 

 MS. MUNN: It's fine. 

 DR. ZIEMER: Okay. Number six, the issue is 

deferred to -- to the site profile, the TBD or 

procedures review process. And -- and I -- in 
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other words, it's not resolved here. The Board 

in essence is saying we are deferring this 

because it's going to be handled in the site 

profile. Let me read it again. 

The issue is deferred to the site profile or to 

a site profile, TBD or procedures review 

process. And there will be a number of these. 

You will see more specifically how that 

applies. 

And then seven, which we hadn't allowed for, 

was SCA concurs with NIOSH's view. In other 

words, if NIOSH disagrees and SC-- and SCA says 

we concur. 

 MR. GRIFFON: 

 DR. MELIUS: 

that? 

Right. 

 And there are no gradations in 

 DR. ZIEMER: 

 DR. MELIUS: 

 DR. ZIEMER: 

dinner. 

Well, SCA reluctantly concurs. 

 John Mauro agrees, but... 

But it's going to cost you a steak 

Okay, those are the seven current categories. 

You'll have hard copy before you here 

momentarily. And what -- what we actually need 

to do, and there's a lot of pages here, but I 

think once we're under way, we can speed 
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through this pretty rapidly. And actually if 

it's a category 1 or a category 2, it would be 

my sense of it that that closes the issue and 

we don't have to actually do anything -- we 

would accept it, but if it's a 1 or a 2, it 

means that NIOSH agrees with the finding and 

accepts it, or will comply with it. 

 MR. GRIFFON: As long as NIOSH agrees with my 

interpretation that it was a 1 or 2, yeah. 

Yeah. 

 DR. ZIEMER: Right. Now --

 MR. GRIFFON: I mean I -- sometimes that was me 

trying to understand what was written in the 

NIOSH resolutions, so -- 

 DR. ZIEMER: In some of these, yes, it's where 

Mark thinks that --

 MR. GRIFFON: Right. Right. 

 DR. ZIEMER: -- NIOSH -- maybe that's another 

category, Mark thinks. 

 MR. GRIFFON: Yeah. 

 DR. ZIEMER: Also if -- if there are ones where 

we think SC&A concurs with NIOSH's response, 

then -- and --

 MR. GRIFFON: We see Stu moved up closer to -- 

to take care of those 1s and 2s. Yeah. 
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 DR. ZIEMER: Okay. Do we need to pause until 

we get the hard copy or... 

We -- we can proceed. Okay, the first one is 

an example where there was a finding, NIOSH 

gave a response and you notice on the 

resolution NIOSH and SC&A agree with the way 

the exposure time was handled in the site 

profile. Basically that's a 7. SC&A is 

concurring then. 

 MR. GRIFFON: That's an easy one. 

 DR. ZIEMER: Okay. And if -- if NIOSH and SC&A 

agree with the -- with the 7, unless there's an 

objection, I'm going to take it that the Board 

concurs that this resolves that issue and the 7 

would be our action -- Is that agreed? -- and 

we'll proceed through these in that manner. 

 MR. GRIFFON: If we -- I -- Paul, just for 

processing, I think if -- if we don't hear an 

objection -- you know, SC&A or NIOSH, if you 

have an objection, just step to the mike as 

we're --

 DR. ZIEMER: Sure. 

 MR. GRIFFON: -- you know. We won't have to 

ask each time, maybe. 

 DR. ZIEMER: We'll make sure that -- right. 
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Stu? 

 MR. HINNEFELD: Why don't I just suggest that 

I'll speak up if I feel like we haven't been 

characterized --

 DR. ZIEMER: Thank you. 

 MR. GRIFFON: That's what I was trying to say. 

 DR. ZIEMER: And you likewise, John, for... 

okay. The next item, finding 1.1(b), this is 

an issue that is to be addressed in the review 

of the Blockston (sic) Chemical site profile, 

so this would be a 6, and in essence the 

finding is not resolved here and awaits the 

resolution in that -- was this a Blockson -- 

let's see --

 MS. MUNN: It doesn't look like it, the way 

it's stated. The summary finding looks like 

it's more general than that. 

 MR. GRIFFON: Yeah, it -- the inter--

 DR. ZIEMER: Mark, do you recall? 

 MR. GRIFFON: -- the interesting -- the 

interesting dilemma we face here is that we 

haven't tasked our contractor with doing the 

review of the site profile for Blockson, so -- 

but the NIOSH resolution that was given to -- 

provided to me said, you know, that this is 
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pending the review of the Blockson profile, so 

I think that -- that would necessitate us to 

take up that profile as -- on a review basis. 

DR. ANDERSON: To see how it was addressed? 

 MR. GRIFFON: Right. 

 DR. ZIEMER: Stu? 

 MR. HINNEFELD: I think at the time we revisit 

these in -- in the Blockson profile, say 

revision or reconsideration of Blockson 

profile, whatever's determined at that time we 

can, you know, address with SC&A and -- and 

bring back to the Board. 

 MR. GRIFFON: Okay. 

 MR. HINNEFELD: You know, the language that's 

chosen here does sort of imply that there will 

be a review of the Blockson Chemical site 

profile, which I don't think is on the agenda 

at the moment -- or at the moment, and -- and 

it may not be what you want to do to force that 

to happen because of this particular response. 

 MR. GRIFFON: That's fine. 

 DR. ZIEMER: Right now this does not require an 

SC&A -- this says that NIOSH will address the 

issue in the profile, and the implication here 

is that the Board then would see how it's 
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addressed in the profile. In a sense, it 

delays us taking action on this till we see 

what NIOSH has come up with. 

 MR. HINNEFELD: Yeah. And I just want to make 

sure that -- I don't think you -- 

 DR. ZIEMER: It doesn't necessarily task SC&A 

at --

 MR. HINNEFELD: SC&A to do --

 DR. ZIEMER: -- this point to do anything. 

 MR. HINNEFELD: Okay. I think it can be 

resolved --

 MR. GRIFFON: Yeah. 

 MR. HINNEFELD: -- without obliga-- obligating 

ourselves today --

 DR. ZIEMER: Yes. 

 MR. HINNEFELD: -- for review of the site 

profile. Right. 

 DR. WADE: Right, but -- but in essence NIOSH 

agrees and accepts this recommendation and 

intends to act upon it. 

 MR. HINNEFELD: Yes, it -- it's -- we need to 

do things in response to this -- 

 DR. ZIEMER: Right. 

 DR. WADE: Right. 

 MR. HINNEFELD: -- this item, this 
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recommendation. 

 DR. ZIEMER: In essence, this -- if the Board 

accepts item 6 as our -- our action, it -- the 

item remains open. That's all I'm saying. 

 MR. GRIFFON: Yeah. 

 DR. ZIEMER: You understand what I -- the point 

here? So it doesn't close out the item. That 

-- our action is that this will be addressed in 

the site profile. The item --

 MR. GRIFFON: Right, and --

 DR. ZIEMER: -- therefore remains open. 

 MR. GRIFFON: -- it doesn't necessarily -- what 

I hear them saying is it doesn't necessarily 

commit to the Board reviewing Blockson site 

profile, but what -- it's just NIOSH, as 

they're finishing that site profile, they'll 

come back with these answers. Right? Yeah. 

 DR. ZIEMER: So I'm -- I'm just saying it 

remains an open item. At some later point we -

-

 MR. GRIFFON: Yeah, deferred. 

 DR. ZIEMER: -- have to address it again. 

Wanda, do you have a question on that? 

 MS. MUNN: As we're going through these, I'm 

assuming that 7s and probably 1s will just fall 
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off the -- the list. 

 DR. ZIEMER: Right. 

 MS. MUNN: We will no longer carry the -- 

 DR. ZIEMER: And now you will notice that 

there's a series here of -- of 6s in a row that 

 MR. GRIFFON: Right, no further tracking, you 

mean, yeah, right, right. 

 DR. ZIEMER: There's seven 6s in a row here; 

all of these are Blockson issues. 

 MR. GRIFFON: Right. 

 DR. ZIEMER: Okay. Any -- any questions on 

those? Those would remain open items. Okay. 

 Then we're ready for item -- this may be a 

little hard to read. This is item 2.1 and 

NIOSH agrees and accepts. 

 MR. GRIFFON: Thi-- this -- Stu, there's a 

couple here that don't have a NIOSH resolution 

listed, and I think these are ones that SC&A 

had in their original text but it wasn't in 

that Cincinnati meeting we had, so you might 

want to pay close attention to these ones that 

don't have a... 

 MR. HINNEFELD: Well, I think it -- it's 

certainly true that -- of these three that I 
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see, that we agreed to some reconsideration of 

the question. 

 DR. ZIEMER: Yeah, it was an eval-- agreed to 

evaluate something, and apparently went ahead 

and did that, as -- perhaps. I don't recall. 

Or --

 MR. HINNEFELD: Well, I don't know that we've 

actually completed it yet. 

 DR. ZIEMER: Oh, okay, but --

 MR. HINNEFELD: Yeah, I'd say that -- 

 DR. ZIEMER: -- apparently agreed to do it or 

something. 

 MR. HINNEFELD: -- we -- we agree that we need 

to reconsider the -- the question raised here, 

and -- but I don't know that we have 

determined, you know, concurrence with the 

comment as made. I don't know that we 

particularly dispute it, either, but -- I just 

don't know that we've finished evaluating it 

yet. 

For instance, one of these is a MCNP run that's 

discrepant. We have an MCNP run, they have an 

MCNP run; they don't agree. And so we're -- we 

have not yet been able to chase down the 

discrepancy. You know, that's one. That's 
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that five-fold birdcage, right? 

 DR. MELIUS: Is that for another category 

then? 

 DR. ZIEMER: I'm -- I'm wondering if this 

doesn't cause the item to be open then. 

DR. ANDERSON: Become 6. 

 MR. HINNEFELD: Maybe it's a --

 DR. ZIEMER: This -- this is one -- the only 

agreement here is that you would follow up on 

this. 

 MR. HINNEFELD: Yes. 

 DR. ZIEMER: And that has not yet been done -- 

 MR. GRIFFON: (Unintelligible) 6s --

 DR. ZIEMER: -- so maybe -- maybe this is a 

category -- this is not necessarily a 6, is it? 

 MR. HINNEFELD: I believe this is also dose 

model dose reconstruction, isn't it? Which --

which site's this from? I don't remember right 

now. 

 MS. MUNN: Seems like the same thing. 

 MR. HINNEFELD: Which case is -- is this 

Huntington? 

 MR. GRIFFON: Yeah. 

 MR. HINNEFELD: Huntington? It would be the 

same type of thing. We would have to re-
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evaluate the information in the Huntington site 

profile --

 MR. GRIFFON: Yeah. 

 MR. HINNEFELD: -- in order to -- and -- and 

any revision we would make in response would be 

in a revision of the Huntington site profile, 

so it'd be really analogous to the Blockson 

cases. 

 DR. ZIEMER: Okay, so this would be addressed 

in the Huntington site profile, so we should 

change this then to a 6 and put that comment on 

-- under resolution. 

 MR. GRIFFON: Yeah. 

 DR. ZIEMER: Is that true for all three of 

these --

 MR. GRIFFON: Four of those maybe. 

 DR. ZIEMER: -- the C -- 2.1, .2 and .3? 

 MR. HINNEFELD: Yes. 

 MS. MUNN: So they're all Huntington. 

 DR. ZIEMER: And then the next one after that 

is also Huntington. It's also a 6. 

 MS. MUNN: Yeah. 

 DR. ZIEMER: Is that agreed? 

 MS. MUNN: Yeah. 

 DR. ZIEMER: Okay. On -- then we're at item 
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2.5, this is a re-evaluation also. What -- is 

this a Huntington issue? 

UNIDENTIFIED: Right. 

 DR. ZIEMER: This then I believe becomes a 6, 

also. 

 MR. HINNEFELD: Well, no, actually we -- we 

agreed with 2.5 that that was an error. It was 

an error that was made and it substantially -- 

it resulted in a dose that's substantially 

higher than what it should have been had the 

IMBA run been done correctly, and so we agree 

that it's an error. 

 MS. MUNN: It was a data entry thing. 

 MR. HINNEFELD: But we didn't -- you know, I 

don't know if you have a category -- we agree 

it's an error, but it doesn't warrant 

correction because it was a significant 

overestimate of dose of a case that had a POC 

less than 50 percent. 

 MS. MUNN: They just put in the wrong values. 

 DR. ZIEMER: So it's not -- the re-evaluation -

- it says NIOSH agrees to re-evaluation. 

That's --

 MR. HINNEFELD: (Unintelligible) wrong one? 

 DR. ZIEMER: -- not quite correct, then. 
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 MR. HINNEFELD: Which -- maybe I'm looking at 

the wrong one. 

 MR. GRIFFON: 2.5 (unintelligible) --

 MR. HINNEFELD: 2.5-G.4. 

DR. ANDERSON: It was an error, but it didn't 

change the... 

 DR. ZIEMER: So --

 MR. HINNEFELD: Okay, well --

 DR. ZIEMER: So the resolution is that NIOSH 

acknowledges the error -- 

 MR. HINNEFELD: We acknowledge the error. 

 DR. ZIEMER: -- but no -- it had no effect on 

the outcome? 

 MR. HINNEFELD: Right, the error was on -- 

 MR. GRIFFON: No correction required. 

 MR. HINNEFELD: -- on the high side. It was --

the error significantly overestimated what the 

internal dose would have been from the exposure 

situation, and so the case ended up, even as it 

was done, ended up with a probability of 

causation of less than 50 percent. So if we 

would correct this error it would just go lower 

-- farther below 50 percent. 

 DR. ZIEMER: Yes. 

 MR. HINNEFELD: So we don't propose to actually 
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do anything. 

 MR. GRIFFON: I -- I put in the NIOSH 

resolution NIOSH agrees, comma, no correction 

required since error resulted in overestimate. 

 MR. HINNEFELD: Right. Right. 

 DR. ZIEMER: So basically you're accepting the 

finding and --

 MR. HINNEFELD: Yes. 

 DR. ZIEMER: -- thus a 1 is correct there. 

 MR. HINNEFELD: Yes, we agree that the finding 

is correct. 

 DR. ZIEMER: Okay, 2.6, this is a re-evaluation 

issue again. 

 MR. GRIFFON: Yeah, thi-- this was the work 

period question. 

 MR. HINNEFELD: Well, I recall the -- I can 

recall the issue, and I'm trying to decide how 

best to phrase the -- what the resolution would 

be. I think 1's probably the best response 

there, we agree and will -- will modify it to 

adjust. Because this was a question of what 

was the covered employment and therefore 

potential exposure period. And it had to do 

with sort of an idiosyncrasy that really only 

occurred with Huntington where there was a 
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verified employment period that ended before 

the end of the employee's total employment at 

that plant. Huntington Pilot Plant, one 

portion of the Huntington plant was shut down 

at a particular year and therefore the verified 

employment reported to us by labor terminated 

with the shut-down of the Huntington Pilot 

Plant. Okay. The Huntington Pilot Plant 

wasn't necessarily forbidden property after 

that day, and so a worker who continued to work 

at Huntington could have entered and then had 

some residual contamination exposure. 

 DR. ZIEMER: Well, did -- did this have to go 

back to Labor to get the time period changed or 

-- or --

 MR. HINNEFELD: No. 

 DR. ZIEMER: -- were you authorized to change 

it? 

 MR. HINNEFELD: We're -- we are allowed to 

include residual contamination -- 

 DR. ZIEMER: So --

 MR. HINNEFELD: -- exposure to someone who has 

covered employment and then continues 

employment in a residual contamination period. 

We can do that without having to go back to 
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Labor --

 MR. GRIFFON: So NI--

 MR. HINNEFELD: -- so we agreed --

 MR. GRIFFON: -- NIOSH agrees and will modify -

-

 MR. HINNEFELD: Yes. 

 MR. GRIFFON: -- is that okay? 

 MR. HINNEFELD: Sure. Or we will at least 

consider the impact of the change. For 

instance, if -- if the change -- 

 MR. GRIFFON: Okay. 

 MR. HINNEFELD: -- represents -- you know, this 

-- this case has a very low probability of 

causation, even with the IMBA error already 

built in. 

 DR. ZIEMER: Right, it may not affect the 

outcome, but you -- you are -- 

 MR. HINNEFELD: I don't think it's going to 

affect the outcome --

 DR. ZIEMER: -- going to go --

 MR. HINNEFELD: -- but we will evaluate how 

this affects the outcome of the case. 

 DR. ZIEMER: Okay. 

 MR. HINNEFELD: I suspect it won't actually -- 

 DR. ZIEMER: Yeah. 
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 MR. HINNEFELD: -- affect the outcome of the 

case, in which case we wouldn't necessarily 

submit a new one back to Labor. 

 DR. ZIEMER: Right. 

UNIDENTIFIED: Agreed. 

 DR. ZIEMER: This is -- the action -- the 1 is 

then correct. 

 MR. HINNEFELD: Yes. 

 DR. ZIEMER: Yes. The next one is 3.1, and 

this -- actually the next -- there's six in a 

row here, all of which involve the Bethlehem 

site profile, so those would be deferred by 

indicating that the issue's deferred to the 

site profile. Any comments from NIOSH on that? 

No. Board members, okay on that? Okay. 

 Item 4 -- 

 MR. GRIFFON: I guess I should put NA for Board 

action on those. 

 DR. ZIEMER: Clarify item -- items 4 and 5 for 

us, Mark, could you -- or Stu? 

 MR. HINNEFELD: Well, it -- they're case number 

4 and case number 5, and they're both Bethlehem 

Steel cases and so the findings from those 

cases are characteristic -- like case 3 was, 

they flow directly from the site profile and so 
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 MR. GRIFFON: Except --

 MR. HINNEFELD: -- and so resolution of the 

site profile --

 MR. GRIFFON: I guess the one distinction is I 

think the two -- 4 and 5 were both lung 

maximizing situations -- 

 MR. HINNEFELD: Oh, okay. 

 MR. GRIFFON: -- so -- so the findings were 

more for the one that was denied rather than 

the two that were overestimates or -- 

 MR. HINNEFELD: Oh, okay. Sorry. 

 MR. GRIFFON: -- or -- or --

 MR. HINNEFELD: Sorry. 

 MR. GRIFFON: Right. The two were over 50 

percent lungs so the result in these findings 

wouldn't -- wouldn't necessarily -- they 

weren't findings, they -- they weren't 

comfortable with that, but where they could 

have been important in -- in resolving is the 

case that was denied, so that why they're 

findings on case 3 but not 4 and 5 for 

Bethlehem Steel. 

 DR. ZIEMER: So there's no -- but should there 

be a response, though, explaining, or... It 
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actually says no findings -- 

 MR. GRIFFON: Right --

 DR. ZIEMER: -- specific to case so -- 

 MR. GRIFFON: -- no findings, yeah. 

 DR. ZIEMER: -- maybe that's suitable, and no 

action therefore needs to be taken. 

 MR. GRIFFON: Right. 

 DR. ZIEMER: Okay, 6.1, the preliminary closure 

is NIOSH agrees and accepts. This says NIOSH 

will investigate. 

 MR. HINNEFELD: Well, the issue --

 DR. ZIEMER: Well, yeah, okay. 

 MR. HINNEFELD: We will determine whether the 

addition of the uncertainty affects the outcome 

of the case. We agree that -- with the finding 

they made that we should consider uncertainty 

in this issue or evaluate whether the approach 

suitably addresses it. 

 DR. ZIEMER: Right. 

 MR. GRIFFON: And -- right. And you'll modify 

if it affects --

 MR. HINNEFELD: If it affects the outcome of 

the case, we --

 MR. GRIFFON: Outcome, right. 

 MR. HINNEFELD: -- will then modify. 
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 MR. GRIFFON: But otherwise (unintelligible). 

 DR. ZIEMER: So that is a -- that is an 

agreement then. 

 MR. HINNEFELD: Yeah, that -- I believe it's 

characterized appropriately or properly. 

 DR. ZIEMER: Okay. Thank you. 

 MR. GRIFFON: We're getting there. 

 DR. ZIEMER: 6.2 is disagree but comply. Any 

comments on that one, Stu? Do you want to... 

All dose of record was accounted for. Some 

details were missing. Revised dose 

reconstruction --

 MR. GRIFFON: Surprised myself here. 

 MR. HINNEFELD: Yes, this --

 DR. ZIEMER: -- drafted. 

 MR. HINNEFELD: -- this case, 6 -- case number 

6, there were a number of errors identified 

that we've evaluated to -- and reworked, 

correcting those errors. They were errors. 

They were, for instance, a misunderstanding of 

the number of zeroes that should have been 

included in the -- in the missed dose 

calculation, seems like there were a couple of 

others, as well. Part of it was based on the 

fact that there seemed to be a page -- a page 
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or two missing from the DOE response that -- 

 MR. GRIFFON: Should those be --

 MR. HINNEFELD: -- wasn't picked up on. 

 MR. GRIFFON: Should those be 1s, did I make a 

mistake? 

 DR. ZIEMER: Yeah, this says you disagree with 

the finding but you're -- 

 MR. HINNEFELD: No, that --

 DR. ZIEMER: -- it sounds like you probably 

agreed --

 MR. HINNEFELD: -- probably a 1. Probably a 1. 

 MR. GRIFFON: So that's my mistake, I'm sorry. 

 DR. ZIEMER: Okay. Is that also true then with 

 MS. MUNN: All the way down. 

DR. ANDERSON: Yeah. 

 DR. ZIEMER: -- down through the rest of that 

page? Okay. So down through item 6.5(a) and 

(b) everything would be a 1 then. 

 MR. GRIFFON: Right, and 6.6 also? 

UNIDENTIFIED: It's already a 1. 

 MR. GRIFFON: Oh, yeah, that's a 1 already, 

yeah. I'm sorry, I'm looking at -- 

 MS. MUNN: Is that reconstruction 

(unintelligible) --
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 MR. GRIFFON: -- computer... 

 MS. MUNN: -- or is it still in draft form? 

 DR. ZIEMER: Well, hang on. Are we okay 

through 6.5 completing that page, (a) and (b), 

Stu? 

 MR. HINNEFELD: Yeah, we're -- we're okay 

making them all 1s. In response to the 

question about is it complete, we still need to 

do --

 DR. ZIEMER: 6.5(c) on the next page also is a 

1, improper cited reference to occupational 

medical exposure? 

 MR. GRIFFON: Did we answer Wanda's question? 

Wanda, didn't you have a question about a 

drafted, is that --

 MS. MUNN: My question was whether it's still 

in draft -- whether the reconstruction is still 

in draft form or has it been completed. 

 MR. GRIFFON: And that's what --

 MR. HINNEFELD: We still need to add the 

uncertainty issue from earlier on. 

 MR. GRIFFON: Okay. 

 MR. HINNEFELD: Now bear in mind that this -- 

this is -- these -- these errors all affect the 

external dose -- dose on this dose 
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reconstruction and this -- internal dose on 

this dose reconstruction was done with an 

intentional overestimating approach, maximizing 

approach, so there's -- there's very little 

likelihood that the outcome of the case will 

change once we correct all these things. 

 DR. ZIEMER: 6.7, the potential dose from an 

incident. Currently this says NIOSH disagrees? 

 MS. MUNN: It says no change is needed. 

 DR. ZIEMER: It also says SC&A's February 

report agrees with the conclusion regarding the 

incident. 

 MS. MUNN: So it is a 4. 

 DR. ZIEMER: So that sounds like SCA is 

accepting NIOSH response. Is that correct? 

UNIDENTIFIED: Or is it a -- have we reached a 

compromise? 

 MR. HINNEFELD: I think that -- I'd like to 

offer an explanation on how that sentence ended 

up in our response is that we started -- the 

matrix originally was prepared with the 

original version of the procedure or the first 

20 reviewed. And subsequent to some 

conversations, you know, in our conversion 

process, another matrix was prepared from the 
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first version -- the listing, the findings. 

And so we tried to deduce from the second one 

whether an issue had gone away. We may have 

made a mistake and we certainly didn't mean to 

speak for SC&A and characterize their response. 

It may be fair -- to be fair to them, we may 

want to allow them the opportunity to see if 

they -- if we did in fact accurately 

characterize their response. 

 DR. ZIEMER: Okay. NIOSH -- this is the NIOSH 

response. It says that SCA's February report 

agrees with the conclusion, so Stu is asking if 

he has correctly characterized your conclusion. 

Kathy, can you answer? 

 MS. BEHLING: Yeah. Yes, in that -- in this 

particular case we did feel that NIOSH could 

have looked a little bit harder at the 

radiological incident that was identified in 

the CATI. However, we do agree with the fact 

that NIOSH used the hypothetical internal dose 

in calculating the internal dose portion, that 

that should take care of, you know, any 

radiological incident that may have happened. 

So I guess we are saying that we do agree, 

although --
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 MR. GRIFFON: I think I can -- I mean maybe my 

-- I -- I wrote the number 4, so I'll try to 

explain it. I think what I'm getting at here 

was the -- the last sentence in the NIOSH 

response -- NIOSH also agreed that this is -- 

this needed to be explained in the DR report. 

We had a lengthy discussion at the workbook -- 

the workgroup level that -- that basically if -

- if incidents were brought up in the CATI 

reports it was important to convey in the DR 

report that the dose reconstructors considered 

that information, even if it -- even if it was 

by saying we've looked into what you've 

described in your incident scenario. We don't 

have data for that particular incident, however 

we've used over-arching -- overcompensating 

mechanisms or assumptions to apply an internal 

dose and therefore we still think we've -- 

we've given you a claimant-favorable 

assessment. You know, that wasn't done in the 

DR report, so I think the compromise was that 

they -- they agreed to modify language in the 

DR report. So it -- it was -- I guess it was 

kind of a split finding almost there. You 

know, they -- they -- I think we are all in 
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agreement that that incident likely wouldn't 

have affected the outcome of the -- of the -- 

the case, but the second part was the -- where 

I -- I guess -- that's why I put a 4 there. 

I'm not sure if that number's the right action. 

 MS. MUNN: But now that the -- now that 

another draft is out, now that a second DR is 

out, doesn't that become a 7 then? 

 MR. GRIFFON: Well, there's no -- there's no 

second DR out, I don't think, on this. They --

they've agreed to modify for future DR 

reports... 

 MR. HINNEFELD: Right, I mean the only way we 

would -- if we were to modify this dose 

reconstruction for wording, we would be sending 

a new dose reconstruction report to a claimant 

who has received a decision that does nothing 

different than change the wording. So we would 

not expect to send a new dose reconstruction on 

this -- for this case, but to pursue the idea 

in future ones that have similar issues. 

 MS. MUNN: Okay. 

 MR. HINNEFELD: That's -- that's what we agreed 

to. 

 MR. GRIFFON: Right. 
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 DR. ZIEMER: Right. It sounds to me that this 

is not a -- a 4 where NIOSH is disagreeing and 

we're trying to reach a compromise. It sounds 

like SC&A's accepted NIOSH's -- is that right? 

 MR. GRIFFON: I don't know. 

 DR. ZIEMER: No? 

 MR. GRIFFON: I -- I -- I don't think NIOSH 

disagrees. I think you're right. I... 

 DR. ZIEMER: NIOSH has made a response. It 

sounds like SC&A --

 MR. GRIFFON: SC&A accepts and NIOSH accepts, 

number 8 -- I mean it's -- that's -- 

UNIDENTIFIED: A 1-7. 

 MR. GRIFFON: Yeah. I think the complicating 

part is it was kind of a split issue -- 

 DR. ZIEMER: Oh, I see. 

 MR. GRIFFON: -- you know. 

 MS. MUNN: A 4. 

 MR. GRIFFON: Halfway, I know. 

 DR. ZIEMER: That's why -- yeah, but -- 

But -- but the 4 has an implication that NIOSH 

still doesn't agree with this, but we're 

finally going to close it out anyway. I would 

-- I think -- this is not overly critical, but 

I would suggest we just go with a 7 here and it 
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would say that there's closure on it and 

agreement. 

Henry? 

DR. ANDERSON: Well, I mean it isn't -- 

 MR. GRIFFON: Yeah. 

DR. ANDERSON: -- that SCA concurs with NIOSH. 

In other words, SCA's comment was wrong and -- 

and now they agree that -- so I don't think 

it's a 7. If anything it would be a -- a 1. 

 MR. GRIFFON: See, I -- I -- I --

DR. ANDERSON: I mean that's what's a compro-- 

 MR. GRIFFON: -- I think this is -- this is a 

problem. 

DR. ANDERSON: -- a compromise (unintelligible) 

address. 

 MR. GRIFFON: I'm trying to find a way of doing 

this without creating a new finding. 

DR. ANDERSON: Yeah. 

 MR. GRIFFON: But I think it's a 1 and a 7. 

mean --

DR. ANDERSON: Yeah. 

 MR. GRIFFON: -- the one part -- SC&A agrees 

that the incident wouldn't have affected the 

outcome. The second part, NIOSH accepts that 

they need to modify their DR reports, you know. 

I 
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 DR. ZIEMER: Okay, 1 and 7, that's 

(unintelligible). 

 (Simultaneous comments) 

 MR. GRIFFON: 1 comma 7. That's going to look 

interesting. 

 DR. ZIEMER: Okay, item 7.1 --

 MR. GRIFFON: Yeah. 

 DR. ZIEMER: -- read it here, suggested 

category is NIOSH does not accept. This is a 

missed dose issue. 

 MR. HINNEFELD: Well, if you'd like to know the 

-- the specifics of the issue are that this -- 

for this employee -- there were a number of 

sites that badged people with a combination 

badge that would measure photons and neutrons 

both. And so they would generally process 

those badges, and this is usually a TLD, a 

combination TLD badge. So there would be zero 

neutron reading in this person's record, 

regardless of what their exposure potential 

was. You know, whether they had a potential to 

be exposed to neutrons or not didn't matter, 

there would be a zero dose in their dose 

record. So in this case the dose reconstructor 

evaluated this person's exposure history, which 
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was relatively well-known where they worked and 

determined these -- these areas there is no 

appreciable neutron dose potential and 

therefore we won't apply the neutron dose 

methodology to these zeroes because there was 

no neutron exposure potential in these jobs. 

And that was the -- that was the decision of 

the dose reconstructor. It seems to be -- you 

know, in our view it's fairly well supported by 

the quality information we had about where he 

worked and the information we had about the 

buildings and, you know, about the radiological 

fields in those buildings. 

 Now this occurs relatively -- I mean not often, 

but it's not uncommon to have sites that hang 

one of these combination badges on people 

because that's their dosimeter. They don't 

make a judgment when they hang that dosimeter 

on people that there's a likelihood for neutron 

exposure. And so that's how we treat those 

kinds of situations, and we do -- that's our 

general practice and what we think is 

appropriate in those cases. 

The missed dose calculation is appropriate when 

there's a potential for exposure to that kind 
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of radiation. But without that potential for 

exposure to the radiation, you wouldn't -- we 

don't think it's appropriate to be adding in 

the missed dose numbers. So that's the 

specifics of the -- the finding. 

 DR. ZIEMER: Okay. 

 MR. GRIFFON: And I -- I guess this was a -- 

and -- and I think 3 -- you know, it might 

look different or bad, but it's -- I would 

agree that no Board action's required, so I 

think, you know -- I guess the point here, if -

- if -- and SC&A may help me out, but the point 

here was that -- a procedural question, and -- 

and if they were strictly doing a maxim-- 

following their maximizing procedures, I think 

we -- SC&A found that they -- they didn't 

strictly follow them, and that might have -- go 

ahead. 

 MS. BEHLING: Excuse me. I think in this 

particular case it's a combination of the 

procedural -- maximizing the dose, and also 

just a judgment, a difference in judgment. 

When we looked at the records and we looked at 

the potential locations that the worker -- 

 MR. GRIFFON: Right. 
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 MS. BEHLING: -- may have worked, we felt there 

was a potential for neutron dose. So it's just 

a difference of opinion. 

 MR. GRIFFON: I think there -- I think there 

was general agreement that even if that had 

built -- been built in it wouldn't have 

affected the outcome on -- I don't know about 

that, though. This is a -- this may be the... 

 MS. BEHLING: Again, in this particular case, 

this is a maximizing dose and so even if it was 

a significant amount of neutron dose, on this 

particular case I know they assigned a 

hypothetical internal dose which was -- excee-- 

-- is a very high dose, and even if we 

incorporated the neutron dose and it went over 

the 50 percent, they would go back and refine 

this. So it has no impact on changing the 

compensability of the case. 

 DR. ZIEMER: If we agree with the 3, it does 

close the issue. It simply says the two have 

disagreed and we're not asking that anything be 

done. 

 MR. GRIFFON: Right. 

 DR. ZIEMER: The issue is closed. Is -- so 

that's --
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 MR. GRIFFON: Yeah. 

 DR. ZIEMER: Anyone objecting to a 3? 

 MS. MUNN: No (unintelligible) -- 

 DR. ZIEMER: No --

 MS. MUNN: -- (unintelligible) scientifics. 

 DR. ZIEMER: No objection. Is this the same -- 

let's see --

 MS. MUNN: Same case. 

 DR. ZIEMER: -- 7.2, the same case, on on the 

X-ray dose. 

 MR. GRIFFON: I think these are -- are similar 

answers. Right, Kathy, on these next three? 

Similar reasons for -- for... 

 DR. ZIEMER: Is 7.2, 7.3 and 7.4 all the same 

issue, in essence? 

 MR. HINNEFELD: I think -- I think my 

recollection is 2 and 3 are similar issue. I 

mean there was a medical dose chosen that is -- 

was higher than what these references cited by 

SC&A would prescribe. I believe that was -- I 

believe that was the issue. Okay. 

And then the 7 -- 7.4 has to do with the -- 

what's the appropriate target organ for a 

lymphoma. And SC&A did not have available to 

them at the time they reviewed the dose 
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reconstruction the medical opinion that had 

been rendered by ORAU's medical expert on what 

target organ to use for this case. So that's -

- that's the origin, I believe, of 7.4. 

 DR. ZIEMER: Okay. Again, this one would 

identify that the disagreement remains, but 

that no action is being taken. 

 MR. GRIFFON: Is that true? Okay. 

 DR. ZIEMER: Is that agreeable? 

 MR. GRIFFON: The only thing I would say 

possibly for 7.2 -- you know, in looking at 

that, I don't know if -- if PROC-6 is one of 

the procedures under our procedures review, but 

we might consider taking that up under -- 

deferring that under number 6 -- assigning a 6 

to the Board action to say deferred to the 

procedures review 'cause it is -- PROC-6 is the 

question. But I don't know if that was under a 

list of procedures that we reviewed -- it was. 

 MS. BEHLING: Yes. 

 MR. GRIFFON: That might be a way to make sure 

we don't lose track of that one. I would argue 

to change that to a 6. 

 DR. ZIEMER: The 7.2? 

 MR. GRIFFON: Yeah. 
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 MS. MUNN: 'Cause that is a procedure issue. 

 MR. GRIFFON: It's -- it's still def-- you 

know, it's... 

 MS. MUNN: Something needs to be done with the 

procedure. It's the procedure, not the DR, 

that's at issue. 

 MR. GRIFFON: Right. 

 DR. ZIEMER: You're suggesting that 7.2 be 

categorized as a 6. A 6 currently talks about 

site profiles, not --

 MR. GRIFFON: No, it --

 DR. WADE: Or procedures --

 DR. ZIEMER: -- or procedures, okay. Yes. Is 

that general agreement we'll go to a 6 then? 

Okay. 

Then down to 8.1, this, Stu, says that NIOSH 

agrees with the finding and accepts. 

Apparently didn't change the outcome, but -- 

okay on that? Okay. 

8.2, this is a disagreement category. Well, 

last column suggests there is agreement, but 

the categorization says that there's a 

disagreement. 

 MR. GRIFFON: 8.2? 

 MR. HINNEFELD: I think for consistency this 
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might be better called a 1. I mean we agree 

that -- we agree that the dose was higher than 

the reference cited, but since it was higher on 

a less-than-50- percent case -- 

 MR. GRIFFON: I think so, yeah. 

 MR. HINNEFELD: -- so, you know -- am I right? 

 DR. ZIEMER: Okay. That will be changed to a 1 

then, NIOSH agrees. I wonder if the -- well, 

in fact it says in the original response NIOSH 

agrees. 

 MR. GRIFFON: Right. 

 DR. ZIEMER: 8.3 and -- 8.3(a) and (b), defer 

to the Savannah River site profile. Any 

objection? 

 MR. GRIFFON: Here we go again. 

 DR. ZIEMER: 8.4? 

 MR. GRIFFON: This is the same, the 1 -- 

DR. ANDERSON: 1 and 7, yeah. 

 MR. GRIFFON: -- 1 and 7 issue, I think -- 1 

comma 7. 

 DR. ZIEMER: 1 comma 7. There is ultimate -- 

yeah, both sides have sort of agreed. We'll 

change that one. 

9.1, Stu, that one says NIOSH agrees -- 

 MR. GRIFFON: I think this is your issue that 
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you won't -- you'll investigate it. If it 

requires a change, you'll make it, but 

otherwise you'll leave it. Right? 

 MR. HINNEFELD: That's correct, we agree to 

evaluate the impact of the -- of the finding. 

 DR. ZIEMER: Okay. 9.2. 

 MR. GRIFFON: Is dropped. Right? 

UNIDENTIFIED: Yeah. 

 DR. ZIEMER: It was what? 

 MS. BEHLING: SC&A concedes this issue. We are 

in agreement. 

 DR. ZIEMER: So this is a 7? That's correct. 

9.3, listed as a NIOSH disagrees. 

 MS. MUNN: Agreed (unintelligible) procedure. 

 DR. ZIEMER: Okay. 9.4? 

DR. ROESSLER: It says it agrees and then it 

says --

DR. ANDERSON: No, it's not a... 

DR. ROESSLER: It's not 3, is it? 

DR. ANDERSON: Isn't that just a 1? 

 DR. ZIEMER: Well, the initial column says 

NIOSH agreed with the issue. 

 MR. GRIFFON: And as a result modified the 

procedure, yeah. 

 MS. MUNN: And modified --
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 DR. ZIEMER: So is the -- the correct one for 

9.3 is a 1? 

 MR. GRIFFON: Maybe, yeah. 

 DR. ZIEMER: Yes. 

 MR. GRIFFON: It's a 1, sorry. 

 DR. ZIEMER: 9.4, this says NIOSH disagrees. 

 MR. GRIFFON: I think this was a -- a question 

of the imp-- application of procedures. Right, 

Hans? If -- previously --

 DR. BEHLING: Yeah, I believe there are two 

options for assigning tritium doses in the 

absence of data. One procedure would allow you 

to assign 71 millirem for a given year and 

that's based on one microcurie per liter, and 

the other one would allow you five-fold times 

higher, 355 millirem. And it's not clear which 

one really applies in -- in the absence of -- 

of data. Because I think in some instance they 

did not record tritium doses that were less 

than five microcuries per liter for some period 

of time. 

 MR. GRIFFON: So -- so there's still a little 

disagree-- you know. I think it remains a 3 in 

this case. 

 DR. ZIEMER: Yeah, sounds like it remains a 3, 
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unless the Board decides it wants something 

done on it. Okay? 9.4 and -- 9.4(b), rather, 

and (c) are referred to the site profile, so 

they get deferred. 

We're up to 10.1, making good progress. We're 

halfway through this, folks. Feels like we 

should be further, doesn't it? 

 MR. GRIFFON: Should go quicker. 

 DR. ZIEMER: This is a 1. Any ob-- Stu, are -- 

NIOSH okay with a 1 on that? You've concurred 

and accepted? 

 MR. GRIFFON: We have a group of Savannah River 

Sites here -- cases here together. They should 

go quickly. 

 MR. HINNEFELD: I don't dispute anything on the 

page. I -- I guess it's... 

 DR. ZIEMER: It sounds like the -- the response 

basically sounds to me like you disagreed with 

the fin--

 MR. HINNEFELD: Sounds like we disagreed -- 

 DR. ZIEMER: -- the finding was that -- 

 MR. HINNEFELD: -- with the original finding. 

 DR. ZIEMER: -- they didn't -- they didn't use 

photofluorographic, and you said yes, because 

we had actual information on what was used and 
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that overrides --

 MR. HINNEFELD: A default. 

 DR. ZIEMER: -- the default assumption -- 

 MR. HINNEFELD: Yeah. 

 DR. ZIEMER: -- that if you don't know what was 

used, you --

 MR. HINNEFELD: Right. 

 DR. ZIEMER: -- assume... 

 MR. HINNEFELD: That seems to be what -- how we 

responded. 

 MS. BEHLING: Actually this one should be a 7 

because we did concede on this one, Mark. 

 DR. ZIEMER: Yes. 

 MR. GRIFFON: Yeah. 

 DR. ZIEMER: Thank you, Kathy. 10.2 and --

10.2(a) and (b) deferred to the site profile? 

Okay. Any objection? 

 MS. MUNN: No. 

 DR. ZIEMER: 10.3, this says NIOSH agrees, but 

from the response I'm not sure that that is 

correct then. 

 MR. GRIFFON: I think they --

 MS. MUNN: (Unintelligible) insignificant. 

 MR. GRIFFON: I think they agreed, but there's 

no --
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 DR. ZIEMER: They agreed, but it wouldn't 

change anything? 

 MR. GRIFFON: -- (unintelligible) facts, 

right. Agreed, but no significant effect in 

this case. 

 MR. HINNEFELD: I think we both agree it 

doesn't have any significant effect. I mean 

there's -- the information wasn't available at 

the time the dose reconstruction was written 

because it came out in the closeout interview, 

so the dose reconstruction was written the way 

it was because the information led -- you know, 

the -- the claimant provided information that 

came in the closeout interview and the 

determination was essentially made that it 

wouldn't affect the dose reconstruction, so it 

went as -- as it was. 

 DR. ZIEMER: So you agree with the finding, 

however, with --

 MR. HINNEFELD: Sure, we agree that the 

information mentioned in the closeout interview 

wasn't described in the --

 DR. ZIEMER: Right. 

 MR. HINNEFELD: -- dose reconstruction, you 

bet. 
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 DR. ZIEMER: Okay. Up to 11(a). 

 MR. GRIFFON: NIOSH agrees and I have a 3, so 

maybe this (unintelligible). 

 DR. ZIEMER: This should be a 1, it appears. 

 MR. GRIFFON: Right. 

 DR. ZIEMER: Likewise in 11.1(b), which is 

already a 1. 

 MR. GRIFFON: I was just trying to keep you 

guys on your toes. 

 DR. ZIEMER: 11.2 is shown here as a 7, that 

SC&A accepts NIOSH response. Kathy's saying 

yes. 

11.3 is deferred to site profile -- 

 MR. GRIFFON: Right. 

 DR. ZIEMER: -- as -- that's 3(a) and 3(b). 

Okay, we'll keep going. 

11.4 is --

DR. ANDERSON: It's a 1-7 again. 

 MR. GRIFFON: Right. 

 DR. ZIEMER: What's that? 

DR. ANDERSON: It's a 1-7. 

 DR. ZIEMER: It's a 1-7? 

 MR. GRIFFON: I think so. 

 DR. ZIEMER: Where both sides have come 

together. 
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Then we're up to 12.1, is this one -- 

 MR. GRIFFON: Same thing. Right? 

 DR. ZIEMER: -- where NIOSH agrees but it -- 

 MR. HINNEFELD: Yeah, this issue has been 

identified in a couple of other cases. 

 DR. ZIEMER: Thank you. Item 12.2 identified 

as SC&A accepting. That is correct. Okay. 

12.3 --

 MR. GRIFFON: Yeah, I think they... 

 DR. ZIEMER: This is NIOSH disagrees -- 

 MR. GRIFFON: Right. 

 DR. ZIEMER: -- but unless we require action, 

it stands. Okay. 

12.4, currently identified as SC&A accepting. 

 MR. GRIFFON: And 12.5(a) and (b) are the same 

again. 

 DR. ZIEMER: Well, I'm waiting to hear -- 

 MR. GRIFFON: Oh. 

 DR. ZIEMER: -- from Kathy or Hans on --

 DR. BEHLING: Yeah, it just seems that it's 

strange where you have a badge that 

concurrently monitors gamma and neutrons 

concurrently from probably a common source, and 

one is considered chronic and one is acute, and 

the justification is that it's claimant-
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favorable to do so. It just doesn't make 

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exposed concurrently to a source that both 

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claimant-favorable and that may be a 

justifiable reason for doing so, but it's 

scientifically questionable. That's -- that's 

the only reason I raised the issue. 

 DR. ZIEMER: This is more of a 3, I think, than 

 MR. GRIFFON: Right. 

 DR. ZIEMER: Yes, thank you. 

 MR. GRIFFON: And -- and under the NIOSH 

resolution box there, just to be complete, I 

should say that you would contend that it would 

not affect the -- Stu, can you -- can you help 

me with the resolution there? 

 MR. HINNEFELD: Well, the -- making the change 

suggested on either of the photon or the 

neutron delivery rates would lower the 

probability of causation number from what we 

arrived at the way we did it. 
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 DR. ZIEMER: Yeah, Hans --

 MR. HINNEFELD: So we would (unintelligible) -- 

 DR. ZIEMER: -- Hans's argument is from a 

scientific --

 MR. HINNEFELD: Right. 

 DR. ZIEMER: -- point of view, not -- 

 MR. HINNEFELD: Right. 

 DR. ZIEMER: -- from the outcome point of view, 

I guess. 

 MR. HINNEFELD: Right. 

 DR. ZIEMER: Understood. So the -- you could 

add in the resolution that -- 

UNIDENTIFIED: It's claimant -- claimantfavorable. 

 MR. GRIFFON: Right, low-- it would actually 

lower the dose estimate. 

 DR. ZIEMER: Yeah. I mean that's -- the 

original response basically is -- is the 

response. It stands. The original response 

really stands. They've -- they've already said 

that. 

 MR. GRIFFON: Yeah. 

 DR. ZIEMER: Okay, 12.5(a) and (b) are deferred 

to site profile. 

12.6 is indicated as a disagreement, but no -- 
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 MR. HINNEFELD: I think we've called these a 1 

comma 7 in the past. 

 DR. ZIEMER: 1-7? 

 MR. HINNEFELD: Right, that's what I -- we 

agree that the wording could have been better 

in the dose reconstruction and SC&A agrees that 

if we had -- you know, it wouldn't change the 

outcome of it. 

 DR. ZIEMER: Okay. Is that agreeable? 

13.1(a) and (b) are both deferred to site 

profile. 

13.2 currently indicated as NIOSH disagrees. 

Is this a 1-7? 

DR. ANDERSON: Yeah, that's another 1-7. 

 DR. ZIEMER: Appears to be a 1-7. 

 DR. WADE: 13.2. 

 DR. ZIEMER: NIOSH and SEC (sic) agree that 

that's correct? 

Up to case 16.1(a) and (b), both indicated as 

NIOSH accepting. The NIOSH response here says 

that it wasn't discussed. I -- so --

 MR. GRIFFON: Yeah. 

 DR. ZIEMER: -- I'm not clear, I --

 MR. GRIFFON: So waiting for resolution here. 
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Yeah. 

 DR. ZIEMER: Where do we actually stand on this 

one? 

 MR. HINNEFELD: I think -- I think we'll need 

to find some open category to put this in so 

that we can go look at it because I -- I don't 

recall right now. Is there any of these 

categories that means it's open for future 

evaluation? 

 DR. ZIEMER: That's category 8. 

 MR. HINNEFELD: I'm sorry to do that. 

DR. ANDERSON: That's okay. 

 DR. ZIEMER: Actually it's --

 MR. HINNEFELD: I just don't recall this. 

 DR. ZIEMER: Is this a procedural... 

 DR. MELIUS: I think you could modify category 

6 and just use it as the general -- 

DR. ANDERSON: Yeah. 

 DR. ZIEMER: Category 6, it could be deferred 

to site profile, TBD, procedures or other 

issues. 

 MR. GRIFFON: Yeah. Or further investigate -- 

 DR. ZIEMER: Or other -- or further 

investigation. It's a deferment, in any event. 

 DR. BEHLING: Dr. Ziemer, the -- the issue of 
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.277 and .240 is possibly an error that was 

introduced by the DOE records where you have 

yearly doses as opposed to a breakdown, and I 

think if you look at the yearly doses, they 

showed .240. If you look at the individual 

monthly records and tally them up, they're 

.277. So it's one of those issues that -- it 

involves an error perhaps on the DOE records 

themselves and the dose reconstructor chose to 

use one as opposed to the other and perhaps the 

prudent thing would have been to go to the 

higher dose, but you know, it's really an error 

on the part of the DOE records that identified 

both -- both values. 

 DR. ZIEMER: Right. In any event, it appears 

that NIOSH has to look at this and -- 

 MR. GRIFFON: Yeah, I should say we -- I 

probably could have coordinated this better 

ahead of time 'cause I think these ones with 

blanks were actually non-issues when we had the 

first workgroup meeting, so they were -- they 

were -- it was my understanding that they were 

-- weren't even questions raised by NIOSH. 

They were kind of accepted in the original 

report, but -- but anyway, we'll put a 6 for -- 
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for now. Move on. Right? 

 DR. ZIEMER: The 16.2 would be in the same 

category then, I gather. Right? 

DR. ANDERSON: Yeah. 

 MR. GRIFFON: Three of those, yeah. 

 DR. ZIEMER: 16.3, currently indicated as a 

NIOSH disagrees, and no action would be taken. 

Does that still stand? It appears to be. 

 MR. HINNEFELD: Like a 1-7. 

 DR. ZIEMER: Hans? 

 DR. BEHLING: Yeah, this is -- this is one of 

those examples that I alluded to earlier in my 

presentation. I think it involves TIB 8 and 

10, which are consistently being misinterpreted 

where you have a maximized dose reconstruction 

using either 8 or 10, and then they refer back 

to the implementation guide 1 and they combine 

two -- two mutually exclusive procedures, one 

using LOD over two, which is the implementation 

guide procedure for best estimate, versus LOD 

times N, and it's a repeated problem and it's a 

misinterpretation of -- of those two 

procedures. 

 DR. ZIEMER: Okay. 

 MR. GRIFFON: How about we defer that to 
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procedures review, number 6? 

 DR. ZIEMER: Yeah. 

 MR. HINNEFELD: Well, we can do that 'cause I 

think there's a -- it will come up in the 

procedure review anyway. I mean can do that. 

I was going to just offer it could be a 1 

because I -- I think --

 MR. GRIFFON: Oh, 1? 

 MR. HINNEFELD: -- I think that I agree with 

the SC&A position on this. Okay? 

 DR. ZIEMER: Okay. You agree with -- 

 MR. HINNEFELD: I think it's probably a 1. 

 MR. GRIFFON: All right. 

 DR. ZIEMER: Okay. 

 MR. HINNEFELD: That what they have pointed out 

is correct. 

 DR. ZIEMER: Okay. 

 MR. HINNEFELD: It is in fact and we should do 

the -- we should proceed in the way they say we 

should proceed on these issues. It comes up 

repeatedly in the second 18 DR reviews, the 

same issue. 

 DR. ZIEMER: That -- that means that the 

resolution as described here needs to be 

altered, Mark, the narration. 
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 MR. GRIFFON: Well, do -- do -- can you help me 

with that, Stu? Do you -- do you say you're -- 

accept the -- procedures will be modified or 

what -- what's -- what -- what is the 

resolution then? I don't think it affects the 

claim, does it? 

 MR. HINNEFELD: It doesn't affect these claims 

because the error consistently overestimates 

the dose, and these --

 MR. GRIFFON: Right. 

 MR. HINNEFELD: -- claims had less than 50 

percent POC. 

 MR. GRIFFON: But --

 MR. HINNEFELD: The procedure is in fact hard 

to interpret. It -- it is -- in fact, it's 

downright misleading in terms of what you 

should appropriately be doing on this 

particular aspect of missed dose. So --

 MR. GRIFFON: So will NIOSH modify -- 

 MR. HINNEFELD: Yeah. So we expect to modify 

that procedure. 

 MR. GRIFFON: Which procedure is it again? 

 MR. HINNEFELD: 8 and 10 -- it's two of them. 

Right? 

 DR. BEHLING: Yes. 
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 MR. HINNEFELD: TIB? O--

 DR. BEHLING: (Unintelligible) 

 MR. HINNEFELD: Yeah, OTIB 8 and OTIB 10. 

 DR. ZIEMER: Okay, so I think the resolution is 

no change in the dose reconstruction is needed, 

but NIOSH will modify the procedure, and they -

-

 MR. GRIFFON: (Unintelligible) listed the two 

procedures. 

 DR. ZIEMER: -- procedures, and this becomes a 

1. Thank you. 

 MR. GRIFFON: Thanks. 

 DR. ZIEMER: 16.4 -- is this the same issue? 

 MS. BEHLING: Yes. 

 DR. BEHLING: Yeah, it is. 

 DR. ZIEMER: It is. Same resolution then? 

 DR. BEHLING: Yeah, again, there are a 

multiplicity of errors that associate -- are 

associated with those two procedures, and when 

you use, for instance, a maximized dose that 

uses LOD over two, you're dealing with the 95th 

percentile and therefore exempts you from the 

use of a -- of a -- the sigma value or -- or 

GSD value, and -- and they usually in 

combination. With those two procedures there 
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are three errors, the first two cancel each 

other out and you're left with a value that 

should not have an uncertainty associated with 

it. 

 DR. ZIEMER: All right. This is the same 

resolution then. It doesn't affect this 

particular -- but the procedure will be 

changed, so NIOSH accepts that. Yes. 

16.5 is currently --

 MR. GRIFFON: Is this -- is this a -- a 1 but 

no change necessary or is this a 3? I don't... 

 DR. ZIEMER: It -- it -- it looks like -- like 

there was an agreement that too much dose was 

assigned, so it doesn't change the outcome, but 

 MR. GRIFFON: A 1, but no change in the 

outcome. 

 DR. BEHLING: 'Cause there's sometimes when 

we've reviewed the DOE records we realize the 

person was monitored on a quarterly basis, but 

the dose reconstructor chooses to give a 12-

cycle -- a missed dose assignment for every 

year of employment, so you're basically 

overestimating it by a factor of four. 

 DR. ZIEMER: Right. Okay, 16.6 -- 
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 MR. GRIFFON: What -- what --

 DR. ZIEMER: I'm sorry, am I ahead of you here? 

DR. ANDERSON: (Unintelligible) a 1. 

 MS. MUNN: He gave him (unintelligible). 

 DR. ZIEMER: 16.5 became a 1, NIOSH agreed with 

the finding. 

16.6, this says --

 MS. MUNN: It's a 1-7. 

 DR. ZIEMER: Yeah, the response says NIOSH 

agreed, but the -- category 4 says they 

disagreed, so we need to resolve that. 

 MR. GRIFFON: Disagreed, however... 

 DR. ZIEMER: They agreed, however. 

 MS. MUNN: It's a 1-7. 

 MR. GRIFFON: Okay, yeah, it's... 

 DR. ZIEMER: Is this a 1 or a 1-7? 

 MS. MUNN: Yeah, it's a 1-7. 

 DR. ZIEMER: 1-7? 

 MR. GRIFFON: Okay. 

 DR. ZIEMER: 16.7, again it said NIOSH agreed 

with the finding. NIOSH also agreed that 

tables and data are available in the TBDs to 

select organ-specific doses which would be more 

accurate. 

 MR. GRIFFON: So it's not a 3. Right? 
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 MS. MUNN: It's not a 3. 

 DR. ZIEMER: It appears not to be a 3. Is this 

a 1? 

 DR. BEHLING: Again, we find a lot of maximized 

doses where the dose reconstructor was overly 

enthusiastic and, for instance, if you have a 

cancer involving specific tissue that is 

clearly identified in -- in one of the tables 

for occupational medical, and let's assume the 

-- the organ in question turns out to be colon 

or rectum or something --

 DR. ZIEMER: Yeah. 

 DR. BEHLING: -- he chooses to put the lung 

dose. 

 DR. ZIEMER: Right. 

 DR. BEHLING: And of course, you know, it 

doesn't make sense to use a different organ 

that is not related to the cancer of concern. 

And -- and for effeciency's sake, those cannot 

be justified as surrogate because the same 

table contains the very tissue that you're -- 

of concern. 

 DR. ZIEMER: Yeah. 

 DR. BEHLING: It's easy to say okay for a 

surrogate, if one of the tissues is not 
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involved, to maybe default to a comparable or 

higher one. But clearly when the table 

identifies the organ that involves the cancer, 

why not use it? And efficiency cannot be 

justified. 

 DR. ZIEMER: Yeah. This says that NIOSH agrees 

with the finding already. 

 MR. GRIFFON: Yeah. 

 DR. ZIEMER: Rich, do you have some additional 

comments on this? 

 DR. TOOHEY: Well, I just want to make one 

comment on that because it relates to the issue 

of assuming you've got a well-collimated beam. 

And if the colon could have been in the primary 

beam of an AP chest, I think it is appropriate, 

if we're doing a claimant-favorable assumption, 

to give the maximum lung dose. 

 DR. ZIEMER: Okay. 

 MR. GRIFFON: I knew we'd get side-- 

 DR. BEHLING: That's the reason why we have 

multiple tables. There are some tables that 

have a specific date associated with them where 

the collimation was not there and -- and if you 

look at the tables in the medical exposure 

procedure, you will see different doses as a 
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function of time. And for earlier years, yes, 

the collimation wasn't there and therefore 

tissues that were, in subsequent years, out of 

the primary field are -- are -- are included 

and the doses are significant. But over time 

those -- those doses are diminished because the 

collimation was introduced. And so I will take 

exception to that. When the -- the organs are 

cited by time period, they take into 

consideration the issue of collimation. 

 DR. ZIEMER: Okay. Well, this says in fact 

that NIOSH agreed with the finding, so -- 

 MR. HINNEFELD: Yeah, if we're on 16.7, we -- 

that's a 1, so --

 DR. ZIEMER: That's a 1, yeah. 

Okay, 16.8, this --

DR. ANDERSON: This is a 1, too. 

 MR. GRIFFON: Yeah, I think it's a 1. 

 DR. ZIEMER: It says NIOSH concedes that in 

this case this would have been appropriate, so 

 MR. HINNEFELD: This was a -- an intentional 

overestimate maximizing internal exposure, and 

it was a matter of fact the first way we did 

that was to choose colon as the highest non-
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metabolic, because in virtually all cases it 

is. Okay. And so colon was selected. This 

particular cancer calls for a target origin -- 

of lower large intestine, which is marginally 

higher than the colon 'cause the colon is a 

weighted average of the lower and upper large 

intestine, but it's marginally different. The 

intake was vastly overestimated. So it's --

it's a case where -- yeah, it doesn't matter. 

I don't know if there's a -- that number 8, it 

doesn't matter or not, but that's -- 

 MS. MUNN: A 1-7. 

 MR. HINNEFELD: -- however -- 1-7? 

 DR. ZIEMER: Well, I think it's a 1-7, which 

coincidentally adds up to eight. 

 MR. GRIFFON: And averages 4. 

 DR. ZIEMER: Okay, we're getting there, folks -

- 17.1. It says that NIOSH agrees but defends 

their method by indicating that it was a 

reasonable approximating method. So again, 

this is one where they agree with the finding, 

I believe. Is that correct, Stu? 

 MR. HINNEFELD: I -- I don't necessarily think 

we agreed with it. Again, it doesn't -- it 

doesn't matter. It was a compensable case. 
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 DR. ZIEMER: Oh -- yeah. 

 MR. HINNEFELD: It was an underestimating 

approach to a skin dose, and so -- 

 DR. ZIEMER: So maybe the word "agree" should 

be deleted, just says NIOSH defends the method 

by indicating... 

 DR. BEHLING: That -- that just -- I -- I don't 

disagree with Stu, but the issue here was one 

of a skin cancer, and when you have a shallow 

dose which incorporates obviously the 

combination of deep dose and shallow dose, what 

they did was subtract the shielded component of 

the shallow dose, which is a whole different 

new step and it's time consuming, and the skin 

dose is in fact the shallow dose, so why 

wouldn't you have assigned it. So for -- from 

a proficiency point of view, going through that 

extra step of subtracting each of -- each cycle 

the shielded component from the open window is 

-- is obviously going to minimize the dose, but 

it's an extra step that certainly wasn't 

warranted from the viewpoint of efficiency. 

 DR. ZIEMER: Okay. 

 MR. GRIFFON: I think it might be a 3, I don't 

know. I mean --
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 DR. ZIEMER: Well, it's currently -- 

 MR. GRIFFON: -- (unintelligible) --

 DR. ZIEMER: -- currently listed as a 3. 

 MR. GRIFFON: Right. 

 DR. ZIEMER: And I'm going to suggest, for 

clarity, that NIOSH responds be changed 

slightly to read "NIOSH defends the method" -- 

DR. ANDERSON: Yeah. 

 DR. ZIEMER: -- "by indicating"... So --

Okay, 17.1 also is -- this is one where there 

is also disagreement. 

 MR. GRIFFON: Stays as a 3? 

DR. ANDERSON: Yeah. 

 MR. HINNEFELD: I think we should leave it as a 

3. Again, this was an underesti-- an 

underestimating dose we don't necessarily apply 

uncertainty because we say it is at least that 

high, so we don't include uncertainty value on 

 DR. ZIEMER: Right. 

 MR. HINNEFELD: -- on an uncertain... 

 DR. ZIEMER: Okay. 18.1, this says SC&A 

agreed. 

 MS. BEHLING: Yes. 

 DR. ZIEMER: Yes. This is a 7. Okay. 18.2 is 
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similar, SC&A agreed, no revision? 

 MS. BEHLING: We agree. 

 DR. ZIEMER: Yes. Okay. 19.1 and 19.2 both 

NIOSH agreed with the findings. 

 MR. GRIFFON: I might ask Stu to -- to look at 

these. 

 DR. ZIEMER: Has this been res... 

 MR. GRIFFON: (Unintelligible) case. 

 MR. HINNEFELD: Okay, these are the TIB-8 and 

10 issues, apparently. 

 MR. GRIFFON: TIB-8 and 10 for both of those? 

 MR. HINNEFELD: Is it -- yeah, it's 19.1 and 

19.2, I'm sure. Is it -- is it 3(a) and (b), 

as well? All the way through to the bottom of 

the page. 

DR. ANDERSON: It's all 1s. 

 MR. HINNEFELD: Right? We -- we think that 

everything -- 19.1 through 19.3(b) -- are the 

TIB-8 and TIB-10 issue. That's what we -- is 

that... 

 DR. ZIEMER: Are what? 

 MR. HINNEFELD: The -- the issue with TIB-8 and 

TIB-10 that I tal-- we talked about earlier 

that was mis-- that is misleading. I use the 

word misleading --
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 MR. GRIFFON: And NIOSH agrees to modify -- 

 MR. HINNEFELD: Yeah, uh-huh. 

 MR. GRIFFON: -- TIB-8 and --

 MR. HINNEFELD: Yeah. 

 MR. GRIFFON: -- TIB-10. Right? 

 MR. HINNEFELD: I believe all of these fall 

into that, if I'm not mistaken. 

 DR. ZIEMER: So 19.1, 19.2, 19.3(a) and (b), 

19--

 MR. GRIFFON: And 3(a) should be changed from a 

3 to a 1, also. Right. 

 DR. ZIEMER: Yes, 3(a) should be a 1. And --

 MS. MUNN: TIB-8 and 10 -- TIB-10 modifications 

will resolve it. 

 DR. ZIEMER: Did it go beyond 19.3? Just -- is 

it through 19.3 that we're talking about there, 

Stu? 

DR. ANDERSON: Yeah. 

 MR. GRIFFON: Yeah. (Unintelligible) close. 

 MR. HINNEFELD: Certainly through 3(a), we're 

trying to decide 3(b) right now. We can't 

remember for sure. I think it's along that 

line, though, of an issue we've already 

addressed in one of the others. 

 DR. ZIEMER: Can we move on ahead or -- yeah. 
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 MR. GRIFFON: Yeah. 

 DR. ZIEMER: 19.4 is currently listed as NIOSH 

disagrees, although the initial response says 

NIOSH agrees. I -- this is a 1, I guess, is 

it? 

 MR. GRIFFON: I guess the reason I started 

putting these 3s and 4s is 'cause they agreed, 

but defended. Or agreed, but pointed out. So 

there was howevers in them so I was 

(unintelligible). 

 DR. ZIEMER: I think we can interpret that as 

they're not going to change that particular 

dose reconstruction, but they agree with the 

finding. Is that not correct? 

 MR. HINNEFELD: Right, I think the difference 

probably between a 1 and a 3 would be that a 3 

would say boy, we should do that different in 

the future. 

 DR. ZIEMER: Yeah. 

 MR. HINNEFELD: On a case like this where we 

say this is an overestimate, it's not a 

compensable case, we won't necessarily do that 

different in the future. Okay. This would be 

-- you know, I -- I -- you know, there's that 

qualitative difference. You know, there's -- 
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in some cases we'll say yes, we'll do something 

different in the future. I guess that'd be a 

1. And then in a case where we say yeah, we 

agree that this is an overestimate, but an 

overestimate on a -- on a non-- on a less-than50-percent case we do routinely and we don't 

necessarily intend to go change that overtly. 

 MR. GRIFFON: That would be a 3 then. 

 MR. HINNEFELD: If that's -- that would be a 3 

probably. 

 DR. ZIEMER: Okay, 19.5, cur-- it says SC&A 

accepts. 

DR. ANDERSON: It's a 1. 

 DR. ZIEMER: Yes, okay. 19 -- or 20, now we're 

up to the last case. 

 MR. GRIFFON: Wait, so 19.4 should be a 1 or 3? 

 DR. ZIEMER: 1. 

 MS. MUNN: A 1. 

 MR. GRIFFON: A 1. 

 MR. HINNEFELD: Based on what I just said, I 

think it would be a 3 because we agree that the 

dose was an overestimate, but we wouldn't 

intend to behave differently if we got -- you 

know, today, necessarily. 

 DR. ZIEMER: Okay, so it's a 3. 19.5 is a 7. 
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20.1, this is currently listed as a 3, NIOSH 

disagrees and they would not change unless the 

Board mandated. 

 MR. HINNEFELD: Number 20.1 is the -- is the 

TIB-8 and 10 issue. I believe that's probably 

a 1. Okay, so 20.1, 20.2 and 20.3 are all in 

that category. 

 DR. ZIEMER: Where you agree with the finding. 

 MR. HINNEFELD: We agree that the procedure 

should be changed -- well, the procedure really 

needs to be changed so it's clear. 

 MR. GRIFFON: So it's 6 or 7? 

 MR. HINNEFELD: We agree, it's a 1. We agree. 

 DR. ZIEMER: Okay, so 20.1 through 4s are all -

-

 MR. GRIFFON: Through 3. 

 DR. ZIEMER: Through 3? 

 MS. MUNN: Through 3. 

 DR. ZIEMER: Through 3 are all 1s. 

 MR. GRIFFON: And they're -- and they're the 

OTIB-8 and 10 modification? 

DR. ANDERSON: Yeah. 

 MR. GRIFFON: Is that the resolution? Yeah, 

okay. 

 MR. HINNEFELD: Yes, it is. 
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 MR. GRIFFON: Sorry. 

 MR. HINNEFELD: And 20.4 would be a 3 because, 

again, it's an overestimate. We agree it's an 

overestimate. We don't necessarily agree that 

we should do it differently. 

 DR. ZIEMER: Okay. 20.5 is listed as a 7, that 

SC&A concurs or accepts NIOSH's response. 

And then a few final things. 

 MR. GRIFFON: Can we go -- Paul, can I ask you 

just to go back --

 DR. ZIEMER: Yes. 

 MR. GRIFFON: 20.1, 2 and 3 turn into 1s then -

- right? -- 'cause they're agreeing to modify -

- just a minute. 

DR. ANDERSON: Yes. 

 MR. GRIFFON: I fell behind a little here. 

 DR. ZIEMER: All right. 

 MR. GRIFFON: And can I just go back to 19.4, 

just for my own clarification, in the NIOSH 

response I'd suggest to change it maybe NIOSH 

disagrees, pointing out that it was an 

overestimate? I'm just a little worried about 

having a ranking of 3 where we say the ranking 

of 3 means that NIOSH disagrees and then the 

first sentence in here is NIOSH agrees. I mean 
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I think we -- we understand the explanation 

that you -- it's an overestimate so you don't 

have to change anything, and you're not going 

to change anything in the future. I just want 

-- the -- the language in the response to look 

consistent with our ranking system, you know. 

 DR. ZIEMER: I would suggest we word it as 

NIOSH defends this method -- 

 MR. GRIFFON: Oh, okay. 

 DR. ZIEMER: -- of overestimating dose. 

 MR. GRIFFON: That's better. 

DR. ANDERSON: Yeah. 

 DR. ZIEMER: Then we have some final items. 

The -- the next one here covers all cases and 

it has to do with the report itself, and this 

says NIOSH agrees with the comments on changing 

the format of the report. Is that correct, 

Stu? 

 MR. HINNEFELD: Yes. Yes, we don't dispute 

that finding. 

 MR. GRIFFON: Can I just back up for one second 

-- 20.4 remained a 3. Right? 

 MS. MUNN: Correct. 

 MR. HINNEFELD: Yeah. 

DR. ANDERSON: You use the same --
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 MR. GRIFFON: Same language in the response. 

DR. ANDERSON: -- same language as 19.4. 

 MR. GRIFFON: Right. 

 DR. ZIEMER: Okay? 

 MR. GRIFFON: Okay. 

 DR. ZIEMER: Stu, did you have a comment on the 

dose -- on the report that -- 

 MR. HINNEFELD: Actually I was reading the 

final three, and I think they're appropriately 

characterized and that our resolution is 

presented appropriately, as well. 

 DR. ZIEMER: As 1s? 

 MR. HINNEFELD: Well --

 MS. MUNN: 3. 

 MR. HINNEFELD: -- one is a 1 -- two of them 

are 1s and then next to last one is a 3. 

 DR. ZIEMER: Oh, the second -- the second -- 

the one called "several"? 

 MR. HINNEFELD: Well, I would con-- I'm sorry, 

I'm -- I would characterize the last one as a 

3. The one that says -- where the finding 

number is "all," third one from the end -- 

 DR. ZIEMER: Yes. 

 MR. HINNEFELD: -- that I believe is 

characterized as a -- well, a 1 I believe is -- 
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 DR. ZIEMER: Correctly? 

 MR. HINNEFELD: -- correct on that. Yes. 

 DR. ZIEMER: Yes, you agree. Okay. 

 MR. HINNEFELD: The second one is them 

questioning the application of conservative or 

overestimating when -- when more specific 

information is available. You know, we 

understand that approach, but we tend -- you 

know, we don't necessarily feel like we're 

going to stop doing overestimates on -- on 

less-that-50-percent cases. 

 MR. GRIFFON: Right. 

 MR. HINNEFELD: And then on the final one -- 

 DR. ZIEMER: So that would be a 3 on the second 

one. 

 MR. HINNEFELD: Second to last one, right. 

 DR. ZIEMER: So it shouldn't say NIOSH accepts. 

 MR. HINNEFELD: No, it doesn't accept -- we 

don't accept the comment. What that means to 

say is we accept and approve dose 

reconstructions that are overestimates for non-

- for non-compensable claims, meaning we accept 

them from the contractor. Okay. So that's 

what's implied there. We don't -- it's not 

that we accept the comment. We accept them 
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from the contractor, overestimating dose 

reconstruction. 

 DR. ZIEMER: Oh, okay. 

 MR. HINNEFELD: That's what -- that's what that 

means there. 

 DR. ZIEMER: I -- I think we need a different 

word there. It sounds like you're accepting 

the finding. 

 MR. HINNEFELD: Okay. 

DR. ANDERSON: No, that's agreed. 

 MS. MUNN: Or NIOSH defends reconstructions. 

 DR. ZIEMER: Well, I think we can word that, 

Mark, so it expresses what Stu said. You're --

you're --

 MR. GRIFFON: Well, I think the --

 DR. ZIEMER: This sounds like they're accepting 

the finding. 

 MR. GRIFFON: I think what -- what the 

resolution is, you're saying no action 

required, and then in the next sentence, NIOSH 

accepts and approves DRs that are 

overestimates. Right? You're saying NIOSH -- 

 MR. HINNEFELD: It's a matter of practice. 

It's just a matter of practice -- 

 MR. GRIFFON: Right, no --
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 MR. HINNEFELD: -- that we will perform -- 

 MR. GRIFFON: NIOSH says no action required -- 

 MR. HINNEFELD: -- or approve --

 MR. GRIFFON: -- and then the next sentence 

explains why, 'cause they're saying that they -

- that you accept and approve -- right? 

 MR. HINNEFELD: Well, or we -- or we --

 MS. MUNN: You can say --

 MR. HINNEFELD: -- prepare --

 MS. MUNN: -- NIOSH defends and continues to 

approve --

 DR. ZIEMER: Well, I don't think they have to 

say accepts. They can just say they approve 

dose reconstructions that are overestimates. 

 MR. HINNEFELD: Right. 

 DR. ZIEMER: I just want to get the word 

"accepts" out of there so it doesn't sound like 

you're accepting the finding -- 

 MR. HINNEFELD: Okay. 

 DR. ZIEMER: -- 'cause you aren't. 

 MR. HINNEFELD: All right. 

 DR. ZIEMER: And then, Stu, the last one on 

that page, did you say that that -- you agreed 

with that finding? 

 MR. HINNEFELD: Well, certainly we understand 
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that the use of an efficiency method and an 

intentional overestimate on a case that may 

subsequently be returned when information -- 

additional information is provided by 

Department of Labor which may require more 

detailed rework of that dose reconstruction, 

that can lead to confusion and we understand 

that. But we still feel that the importance of 

getting the dose reconstructions done in a 

timely fashion is such that we intend to 

continue to behave in this fashion. 

 MR. GRIFFON: So it's a 3. 

 MR. HINNEFELD: Yes. 

 DR. ZIEMER: And then the final one on the very 

last page, again it's a general one, procedures 

complicated and seemed as though the individual 

dose reconstructors had difficulty applying the 

procedures. Is this --

 MR. HINNEFELD: That's a 1. 

 DR. ZIEMER: -- a 1. 

 MR. HINNEFELD: That's a 1. 

 DR. ZIEMER: Oh, you understand -- okay. 

 MR. GRIFFON: The resolution, though, is worded 

the same as the one before it. Should --

should we modify that in any way? 
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 DR. ZIEMER: I think, Stu, you indicated 

there's already some efforts to modify some of 

those procedures. 

 MR. GRIFFON: Right. 

 DR. ZIEMER: NIOSH intends to modify procedures 

as appropriate. 

Now I'd like -- I'd like to ask for a motion to 

accept this summary finding as -- as the 

Board's findings for the first 20 cases. 

 MR. GRIFFON: Can I -- can I just ask -- I 

don't want to just let that last one go. I 

mean can we be more -- I think that's pretty -- 

pretty broad. We've identified OTIB-8 and 10. 

 MR. HINNEFELD: Well, do you want to make it a 

-- you could make it a 6. I mean there's a 

whole procedure review effort under way -- 

 MR. GRIFFON: We could make it a 6, yeah. 

 MR. HINNEFELD: -- and you could address it 

through that. 

 MR. GRIFFON: Okay, we -- so we can say that, 

and then -- and then maybe defer it to 6 -- 

 MR. HINNEFELD: Yeah. 

 MR. GRIFFON: -- where you'll consider further 

 DR. ZIEMER: It could be a 1-6, even. 
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 MR. HINNEFELD: Sure. 

 MR. GRIFFON: Yeah, okay. Right. 

 DR. ZIEMER: A 1-6, meaning it remains open to 

the procedures review. 

 MR. GRIFFON: Okay, that's -- thanks. 

 DR. ZIEMER: Now I'd like to call for a motion 

to accept the summary of findings matrix as 

modified, together with -- well, let's -- let's 

just do this. There actually is a preamble 

that goes with this, Mark. 

 MR. GRIFFON: Right. 

 DR. ZIEMER: And I don't know if the folks have 

that today, but we might be able to get that 

out this afternoon. Let's accept this document 

as --

 MR. GRIFFON: I think we've actually accepted 

the other one, but I -- I think we also -- 

 DR. ZIEMER: Yeah, we'll -- we'll check on 

that. 

 MR. GRIFFON: -- we have to change some numbers 

in there and --

 DR. ZIEMER: A motion to accept the summary of 

findings matrix --

 MS. MUNN: So moved. 

 DR. ZIEMER: -- as -- as -- as part of the 
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Board's report on the first sum-- first 20 

cases. So moved, and seconded? 

DR. ROESSLER: Second. 

 DR. ZIEMER: Okay. Any discussion? 

 DR. MELIUS: Could Mark read that back for us 

so... 

 DR. ZIEMER: The Chair declares that request 

out of order. 

DR. ANDERSON: Table it. 

 DR. ZIEMER: All in favor of the motion, say 

aye. 

 (Affirmative responses) 

Those opposed, no? 

 (No responses) 

 Any abstentions? 

 (No responses) 

The motion carries. I didn't ask if -- if Mike 

was on the line today. Mike is not able to be 

with us today, okay. Thank you very much. 

Roy? 

 DR. DEHART: Just one question, and that deals 

with any generic findings that have come up 

that might improve a -- a claimant's 

favorability. Do you know whether that has in 

fact occurred? I couldn't keep track of the -- 
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 MR. HINNEFELD: On any of these 20 cases? 

 DR. DEHART: Yes. 

 MR. HINNEFELD: No, we've evaluated them all 

and I don't -- there won't be a change in the -

-

 DR. DEHART: My point --

 MR. HINNEFELD: -- decision. 

 DR. DEHART: -- would have been, had they been, 

are we going back and look at -- 

 MR. HINNEFELD: Oh, certainly. If we identify 

at any time, through this process or any other 

process, that kind of a -- a mistake, we would 

go back and reopen that and revisit that. 

 DR. DEHART: Thank you. 

 MR. HINNEFELD: Sure. 

 DR. ZIEMER: I think we need to break for 

lunch. 

 MS. MUNN: I think so. 

 DR. ZIEMER: We need a break, in any event, and 

if we're -- if we're going to take a break, 

we'd better grab some lunch and we'll proceed 

with -- with the report on the second 18 cases 

right after lunch. 

 MR. GRIFFON: The only thing I would ask, Paul, 

is -- is -- it would be nice to close this 
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whole thing out. We have -- we have voted and 

accepted the letter, I believe the front end. 

There's only -- there's only a few edits and 

I've been working on them today -- 

 DR. ZIEMER: Yeah, if we can get a 

confirmation, we'll check our minutes, make 

sure it's been approved -- 

 MR. GRIFFON: Okay, I think it'd be good to -- 

 DR. WADE: Or if you have the modified letter, 

we can print it out and give it to people or 

have it when they come back. 

 DR. ZIEMER: Okay, we'll do that. 

 DR. WADE: I just need to be sure that -- is 

everyone who's sitting around the table 

intending to be here through the full 

afternoon? I want to make sure we have a quo-- 

 DR. ZIEMER: No, some have to leave -- Presley 

had to leave. 

DR. ROESSLER: I have to leave about 3:30. 

DR. ANDERSON: I have to leave about 2:00. 

 DR. ZIEMER: I think Leon at 2:00. 

MR. OWENS: Dr. Ziemer, I can leave at 3:30. 

 DR. ZIEMER: 3:30. 

 DR. WADE: 3:30. 

 DR. ZIEMER: Okay, we're --
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 DR. WADE: How many at 2:00? 

 DR. ZIEMER: We're good for a little bit. 

 DR. WADE: Five until 3:30, we'll -- 

 DR. ZIEMER: Try to get back as soon after 1:00 

as you can. Let's try to get rolling. Thank 

you. 

 (Whereupon, a recess was taken from 12:00 p.m. 

to 1:20 p.m.) 

BOARD DISCUSSION

 DR. ZIEMER: We do have Mike Gibson with us by 

phone, also, this afternoon. And Mike, we are 

going to try to modify the agenda somewhat so 

that we address issues that -- particularly 

that require votes by -- by the Board. One of 

those is a continuation of business that we 

conducted just prior to lunch, and that 

business was the -- the Board's summary of the 

first 20 dose reconstruction cases. We had 

gone through the matrix that had been 

developed, primarily by Mark Griffith, and -- 

Griffon, and taking the findings of SC&A, the 

NIOSH responses and finally addressing how the 

Board would close out each of those items. We 

have completed that. 

I want to make sure that Mike gets copied on 
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this latest version of the matrix. Can we be 

sure that Mike gets that? 

 DR. WADE: We’ll make sure of that. 

 DR. ZIEMER: And -- and the other part of this 

action is the -- the narration, which is 

basically a narration to the Secretary of 

Health and Human Services. It would constitute 

our first report on dose reconstruction 

findings to the Secretary, and this you've seen 

in several versions at earlier meetings. It's 

been modified over time, and we've distributed 

the current version which includes all the 

updates to date to this memo to the Secretary. 

The memo, as we have it currently, is a fourpage memo. It includes the -- an introductory 

two paragraphs discussing the review process. 

It has several paragraphs talking about the 

findings and referring to the matrix. 

 MR. GIBSON: (Via telephone) Uh-huh. 

 DR. ZIEMER: It identifies several specific 

items that we're calling attention to, one 

being concerns about the dose reconstruction 

final report, and that's reports I believe that 

go to the claimants, as I recall, asking for 

some improvement in those reports so that 
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they're more sort of user-friendly. There's 

some comments about internal quality control, 

procedural issues, and then concerns about the 

telephone interviews, validation and 

verification procedures and consistency of 

cases and concerns relating to the efficiency 

approach. 

I think -- Mike, particularly -- you should 

have at least a version of this that came 

before the Board at the last meeting, the April 

meeting. There was a version of this. 

 MR. GIBSON: Correct, yes. 

 DR. ZIEMER: The changes I think are very minor 

-- if indeed there were any. Mark, can you 

tell us if there were any substantive changes 

since we last saw this? 

 MR. GRIFFON: The on-- the only changes I made 

were just this morning while we're all sitting 

here, and I just totaled again the case 

rankings and the site/program-wide rankings and 

reflected that and --

 DR. ZIEMER: Just updated from --

 MR. GRIFFON: -- updated those numbers so the 

numbers were --

 DR. ZIEMER: Right. 
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 MR. GRIFFON: -- consistent with what we had -- 

 DR. ZIEMER: With what we had just done. 

 MR. GRIFFON: Right. 

 DR. ZIEMER: Otherwise, the -- the narration 

remains the same. 

 MR. GRIFFON: Yeah. The only other -- the only 

other slight difference was in -- in several of 

the examples, like -- like for -- for example, 

in number two on page 3 I give example -- 

examples where this -- this particular thing, 

internal quality control, was an issue. And 

before I had -- have -- I wanted to reference 

the individual finding. I just settled on 

referencing the case number. 

 DR. ZIEMER: Yes. 

 MR. GIBSON: Okay. 

 MR. GRIFFON: But I (unintelligible) -- 

 DR. ZIEMER: Otherwise it remains substantially 

as it was before, but it has been modified very 

slightly and I think to handle this the Chair 

would entertain a motion to approve this 

document, and it would be accompanied by the 

matrix, as our report to -- to the Secretary. 

 MR. GIBSON: Okay. 

 DR. ZIEMER: Okay? Yes, Dr. Melius. 
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 DR. MELIUS: I so move. 

 DR. ZIEMER: Okay. Dr. Melius has made a 

motion that we accept this report -- 

 DR. DEHART: Second. 

 DR. ZIEMER: -- and seconded by Roy DeHart. 

Now it's open for discussion. Questions, 

amendments? 

 MR. GRIFFON: There are a few slight changes, 

and I think Stu has already -- I forget if you 

provided this to me or not, but there's a table 

that we reference in here summarizing the cases 

and -- and the -- the POC, the site -- 

remember, the --

 DR. ZIEMER: Yes, there was a table that was to 

accompany this. 

 MR. GRIFFON: To -- yeah. 

 MR. HINNEFELD: That -- yeah, that table 

essentially reproduced the table you saw at 

selection time. 

 MS. MUNN: Uh-huh. 

 MR. HINNEFELD: Case number, site number, POC 

result, employment decade, things like that. 

 MR. GRIFFON: I've yet -- I've yet to insert 

that, so I don't know if I got it 

electronically or -- or you may -- you may -- 
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 MR. HINNEFELD: I believe I did send it to you 

electronically. 

 MR. GRIFFON: Okay. 

 DR. ZIEMER: We'll double-check and make sure 

we have it, but it's understood -- 

 MR. HINNEFELD: Oh, yeah. 

 DR. ZIEMER: -- that that would be part of this 

report. 

 MR. GRIFFON: That would be part of it. 

 DR. ZIEMER: And in approving this we're 

indicating inclusion of that particular table. 

 MR. GRIFFON: And then just -- just to finalize 

this thing, I think there's -- on the first 

page there's a few Xs that you'll see as placeholders where I didn't -- I just didn't know -- 

the first one comes in the second paragraph 

there where it says at the time of the case 

selection for this initial audit, only XXX 

cases had been... And I just wanted to -- we 

need --

 DR. ZIEMER: We have to go back and get the 

exact number. 

 MR. GRIFFON: Or -- or even -- we can even put 

appro-- only approx-- or approximately so many 

cases were available. I'm -- I mean -- we need 
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a number there, one way or the other. 

 DR. ZIEMER: And actually --

 MR. GRIFFON: Can we get that number, is the 

question. 

 DR. ZIEMER: We -- and we actually need the 

date for that. You referred to August XX, 2004 

in the -- in the -- is that the second or third 

paragraph? 

 MR. GRIFFON: Right. 

 DR. ZIEMER: So we need the date that 

corresponds to that, as well. 

Larry? 

 MR. ELLIOTT: We'll certainly get that for you, 

the date and the -- the --

 MR. GRIFFON: Right, the date and the number -- 

 MR. ELLIOTT: -- approximate number. 

 MR. GRIFFON: Right. 

 MR. ELLIOTT: I don't know --

 MR. GRIFFON: That -- that's fine, that's -- 

 MR. ELLIOTT: It'll be in the 1,000, probably -

- ball park. 

 DR. ZIEMER: Okay. 

 MR. GRIFFON: That's it. 

 DR. ZIEMER: Okay. Wanda? 

 MS. MUNN: It's only a clerical thing, but I'm 
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wondering, since I was sort of sensitized this 

morning to how important the order of things 

can be when you're making sense of something 

trying to read it, in the second paragraph, as 

I was reading through it and getting past the -

- getting down to the set of Xs there, I was 

stopped when I saw the word "unrepresentative". 

The following sentences clarify what that 

means, but having that particular word in that 

spot seems to cause the reader to stop and try 

to identify what does unrepresentative mean. 

 DR. ZIEMER: What sentence are you in on this 

second paragraph? 

 MS. MUNN: The second paragraph, third line. 

 MR. GRIFFON: Yeah, I agree. 

 MS. MUNN: The 20 cases covered in this report 

were selected from an unrepresentative pool, 

and one thinks why is it unrepresentative and 

why did they choose those. And as I said, the 

following sentences clarify that, but -- 

 MR. GRIFFON: Can we flip them? 

 MS. MUNN: Yeah, could -- could you put the 

word somewhere else, is really what I'm asking. 

 DR. ZIEMER: Is it important that we have that 

word in there at this time? I think -- I think 
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the -- the impli-- or the intent was to -- was 

related to the fact that those early cases 

adjudicated early don't really represent a 

cross-section of the kinds of cases. This is 

the -- the low -- low-hanging fruit cases. 

Right? 

 MS. MUNN: Yes. 

 DR. ZIEMER: Is that -- that was the issue. 

 MS. MUNN: And that's what we say -- that's 

what we say in the next few sentences. 

 DR. ZIEMER: So I'm -- I'm wondering --

 MS. MUNN: I'm just questioning -- 

 DR. ZIEMER: -- if -- if we can just say 

selected from a pool of those cases available 

for audit. 

 DR. MELIUS: Or the pool --

 MR. GRIFFON: Yeah. 

 DR. MELIUS: -- really is --

 MR. GRIFFON: That's fine. 

 DR. MELIUS: -- it's not like there's more than 

one pool. There was the pool. 

 DR. ZIEMER: From -- is that -- would that be 

agreeable and --

 DR. MELIUS: Yeah. 

 DR. ZIEMER: -- to the mover and the seconder, 
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a friendly amendment, so it's selected from the 

pool of cases which had been adjudicated. And 

then it goes on to describe that anyway, so -- 

okay. Thank you, Wanda. 

 Other comments? 

 MR. GRIFFON: Can --

 DR. ZIEMER: Mark? 

 MR. GRIFFON: Can -- I just want to ask one -- 

one process question. Can I, at this point, 

turn this document over electronically and let 

you guys insert that table and do the final -- 

not that I'm sick -- I've got like Rev. 8 on 

it, you know -- revision eight on my computer, 

so... 

 DR. ZIEMER: If they can do that and then I -- 

they need to get it to me so I can prepare the 

letter to the Secretary, but would that work, 

Larry or Stu, if he gave you a copy and you 

just inserted the numbers and sent them on to 

me? Okay. Thank you. 

Okay, any other comments or questions? 

 (No responses) 

Are you ready to vote then? Mike, do you have 

any questions? 

 MR. GIBSON: No. 
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 DR. ZIEMER: Okay. Thank you. 

 MR. GRIFFON: Just one -- one --

 DR. ZIEMER: Another comment from -- 

 MR. GRIFFON: -- one final --

 DR. ZIEMER: -- Mark. 

 MR. GRIFFON: -- thing. Are we -- we're voting 

on the -- the letter at this point or -- 

 DR. ZIEMER: Right, with the understanding that 

that letter, together with the table that NIOSH 

will supply and the matrix -- 

 MR. GRIFFON: And --

 DR. ZIEMER: -- will become --

 MR. GRIFFON: -- and --

 DR. ZIEMER: -- the re--

 MR. GRIFFON: -- and also SC&A's matrix and -- 

and --

 DR. ZIEMER: The items --

 MR. GRIFFON: -- the methodology --

 DR. ZIEMER: -- that we've referred to here -- 

 MR. GRIFFON: All the attachments. 

 DR. ZIEMER: -- all the attachments -- 

 MR. GRIFFON: Yeah, which we've --

 DR. ZIEMER: -- referred to in the document -- 

 MR. GRIFFON: -- gone through. 

 DR. ZIEMER: -- become -- become the report to 
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the Secretary. Understood, for the movers? 

Yes. 

Okay, all in favor, aye? 

 (Affirmative responses) 

 Any opposed? 

 (No responses) 

 Any abstentions? 

 (No responses) 

The motion carries. Thank you very much. It 

is so ordered. 

 MR. GRIFFON: It's good to complete something. 

 DR. ZIEMER: And especially thank Mark for his 

work, both on the main document and the matrix, 

as well. It's very helpful to the Board and 

that's been ongoing and laborious effort, 

actually. 

 DR. MELIUS: Yes, and -- and just to clarify or 

follow up, we just make sure that when it is 

transmitted to the Secretary that we all 

receive the --

 DR. ZIEMER: Oh, yes. 

 DR. MELIUS: -- final copy so we have --

 DR. ZIEMER: Yes, right. 

 DR. MELIUS: And Mark can erase his hard disk, 

all eight versions or whatever. 
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 MR. GRIFFON: And I'll send -- Paul, do you 

want me to forward electronically the matrix, 

the methodology -- that's slightly revised 

'cause I've got a number 7 item on there. 

 DR. ZIEMER: Yes. 

 MR. GRIFFON: Along with the letter. 

 DR. ZIEMER: Right, thank you. 

 MR. GRIFFON: To -- to you or to --

 DR. ZIEMER: Just send that part to me, that's 

fine. 

 MR. GRIFFON: Okay. 

 DR. ZIEMER: In the interest of addressing 

issues that need votes, and while we have Mike 

Gibson on the line, I would like to have us 

address a recommendation from the subcommittee 

pertaining to issues and tasks that have been 

identified with relation to the Mallinckrodt 

site profile and the Mallinckrodt petition. 

The subcommittee is recommending to the full 

Board, and actually most of you were present, 

but the adoption of a document which is 

entitled "Priority Issues for Demonstrating 

Feasibility of Dose Reconstruction for MCW 

Destrehan Street Workers for the Time Period 

1949 to 1957, List of Tasks". Again, are we 
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able to get Mike a copy of this list of tasks? 

 DR. WADE: You want me to do it immediately or 

 DR. ZIEMER: Mike, do you have quick access to 

your e-mail if this is e-mailed to you? 

 MR. GIBSON: Yes. Yes, I do. 

 DR. ZIEMER: Do we have an electronic version 

we can send, or does it have to be FAXed? 

 DR. WADE: I would like -- Mark, do you have 

an electronic version? 

 MR. GRIFFON: Of -- of Mallinckrodt, yeah. 

 DR. ZIEMER: If -- if there is an electronic 

version -- yes, we have it on a flash strip or 

 DR. WADE: We'll do it on --

 DR. ZIEMER: -- memory strip and -- Mike, we're 

going to try to get that to you shortly. 

 MR. GIBSON: Okay, I'll be watching for it 

here. 

 DR. ZIEMER: Now Board members, if you have 

your copy, I want to identify for you the 

modifications recommended by the subcommittee 

in the printed copy. I know many of you 

already have these from the session this 

morning, and so the recommendation from the 
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subcommittee will be this document, as amended. 

And the first -- the first part of the document 

includes a timetable as to -- it's really a 

milestone type of thing as to when certain 

things will be completed or accomplished or 

take place, and there are specific dates that 

we want to make sure that we're all in 

agreement on those dates. 

The first of these, and I -- I'm simply going 

to identify the recommended changes. We will 

act on the document as a whole in a moment. 

And it's the first bulletin -- bulletin -- 

first bullet after the first paragraph, work 

group conference call for status report and 

task clarification by July 26, so you should 

change the number that is on the original 

number to 26. 

 MR. GRIFFON: Paul, did we get printouts of -- 

I -- I revised this, and I thought they printed 

it off --

 DR. ZIEMER: Oh, is there a revised -- 

 MR. GRIFFON: -- for me and I don't think I 

handed it around, though. 

 DR. ZIEMER: Maybe they're already -- 

 MR. GRIFFON: I made all those changes. I 
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don't know if it got printed off, though. 

 DR. ZIEMER: I don't think I've seen it, and -- 

and I think these changes are -- 

 MR. GRIFFON: Fairly --

 DR. ZIEMER: -- minor enough I think we can 

catch them by handwriting, if it's not already 

out. 

The next date is in the second bullet where 

NIOSH completes the following tasks in 

consultation with SCA by August 7. And the 

third bullet, those dates remain unchange, 

workgroup meeting between July 31st and August 

7th. 

Fourth bullet remains unchanged, SCA to review 

NIOSH response by August 16. And the last 

bullet, workgroup conference call between 

August 16th and August 22nd, remain the same. 

But in relation to all of that and not on -- as 

part of the document, I would like to insert 

here for information the fact that there's a 

likelihood now that the Board meeting will be 

rescheduled or delayed by a couple of days to 

August 25 and 6 perhaps, instead of 3 and 4? 

 DR. WADE: That's what I believe. Let me just 

double-check. 
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 DR. ZIEMER: Double-check that. And Mike, I 

don't know if you had those dates down, in any 

event, but we had talked yesterday about 

scheduling the next meeting for August 23rd and 

4th. We're looking for a little breathing 

space there and now looking at 25th and 6th, 

and I believe Cori just checked with you on 

those dates a moment ago. 

 MR. GIBSON: Yes, she did. 

 DR. ZIEMER: Thank you. 

DR. ROESSLER: If -- if we change that, you'll 

have to change, I would assume, the first 

paragraph. There's a date there. We had 

August 23rd. We'd go to August 25th then, I 

would guess. 

 DR. ZIEMER: That's correct. 

 MR. GRIFFON: That's fine. 

 DR. ZIEMER: That's correct. 

 MR. GRIFFON: Yeah. 

 DR. ZIEMER: Thank you. So that -- that's 

where that change would show up -- 

 MR. GRIFFON: Right. 

 DR. ZIEMER: -- in this document. Thank you, 

Gen. 

 DR. WADE: They said they could. 
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 DR. ZIEMER: Okay. 

 MS. MUNN: And also, did I misunderstand? On 

the third bullet, I thought we had sort of 

tentatively chosen August 8th rather than 

August 7th. 

 DR. ZIEMER: I think the 7th was the one that 

turned out to be a Sunday? 

 MS. MUNN: Yes. 

 DR. ZIEMER: I think there's no harm in 

changing that to the 8th. Mark, did you have 

any objection to that? 

 MR. GRIFFON: On the third bullet it was 

between -- what does it read, between July 31st 

and August 7th? I mean it --

 MS. MUNN: Yeah, but we had talked about the 

possibility of making it August 8th, but... 

 MR. GRIFFON: That's fine, I don't 

(unintelligible) --

 DR. ZIEMER: One -- one day is okay -- 

 MR. GRIFFON: -- it's between, it's -- yeah. 

 DR. ZIEMER: Then on the list of tasks, under 

task one, handling of raffinate exposures, 

under item (d), after the words "estimating 

intake when," insert the words "any combination 

of urine, air sampling and breath radon data" -
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- "any combination" are the words -- "any 

combination of," those words should be 

inserted. 

In item two, item -- subheading (b), item 2(b), 

NIOSH must specify their approach -- wait a 

minute, let me see. There's something missing 

here on my -- their approach to -- 

DR. ROESSLER: Handling. 

 MR. PRESLEY: For handling. 

DR. ROESSLER: For handling. 

 DR. ZIEMER: Approach for handling -- 

 MR. GRIFFON: Approach for handling, yeah. 

 DR. ZIEMER: -- for handling job-related radon 

ex-- job-specific radon values. 

Item (c) would read NIOSH/SCA must further 

discuss and, if possible, resolve -- add the 

words "further discuss and, if possible,". 

DR. ROESSLER: Professor Ziemer? 

 DR. ZIEMER: Yes. 

DR. ROESSLER: NIOSH should be its, rather than 

their. 

 DR. ZIEMER: Which item is this, by the way? 

 MR. GRIFFON: I just -- I actually put it NIOSH 

must specify approach for handling -- 

DR. ROESSLER: That gets away from it. 
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 MR. GRIFFON: -- instead of its or their. 

DR. ROESSLER: Yeah. 

 DR. ZIEMER: Well --

 MR. GRIFFON: It's --

 DR. ZIEMER: -- it is an entity. It's also 

kind of a collective noun, isn't -- 

DR. ROESSLER: It's not a dangling participle. 

 DR. ZIEMER: It's not a dangling participle, 

that we know. Even though it collects lowhanging fruit. 

 Okay, item three, 3(a), NIOSH must specify the 

approached used to determine, insert "the 

approach used to determine". 

In item four, line two, this is 4(a), line two, 

delete the word "bounding," so it reads "what 

the approach to estimating cumulative intake 

will be". 

 Item five, specification of dose reconstruction 

methodology -- no, that's not the problem. 

 MR. GRIFFON: Scientifically (unintelligible) -

-

 DR. ZIEMER: That's the next line, 5(a), NIOSH 

needs to outline scientifically defensible, add 

"l-y" (sic) to the word "scientific". And then 

in the next line after "unmonitored," add the 
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word "workers," just ahead of the parentheses 

sign. 

Item six, instead of "detailed dose 

reconstructions" it will now read "example" or 

"sample" -- "example"? 

 MR. GRIFFON: Example. 

 DR. ZIEMER: -- "example" dose reconstructions 

-- I think DRs -- D-R-s, dose reconstructions -

-

 MR. GRIFFON: I just spelled out dose 

reconstructions instead, yeah. 

 DR. ZIEMER: Yeah, dose reconstructions. Item 

(a), "Example" internal dose reconstruction. 

Item (b), "Example" internal dose 

reconstruction -- I'm sorry, item (a), at the 

end of the sentence delete the words "for all 

organs associated with the 22 SEC listed 

cancers" and replace it with the word "for 

selected metabolic and non-metabolic organs". 

 MR. GRIFFON: Right. 

 DR. ZIEMER: Likewise in (b), "Example" 

internal dose reconstruction, and then delete 

the last phrase "for all organs" and replace it 

with "for selected metabolic and non-metabolic 

organs". 
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Item (c) is deleted. 

Item (d) becomes item (c) and is "Example" 

internal dose "intake estimates for selected 

organs for Plant 7". In other words, deleting 

the word "reconstruction" in this case, so as 

to read "Example internal dose intake estimates 

for selected organs for Plant 7", and then 

delete the phrase that follows the parentheses 

relating to the 22 selected organs (sic). 

 Now did everybody get those changes, if I need 

to repeat any? 

 MR. GRIFFON: I --

 DR. ZIEMER: Mark? 

 MR. GRIFFON: Actually I don't even think we 

needed "for selected organs" on that last 

point. We're just asking for intake estimates. 

 DR. ZIEMER: That's correct, once -- that -- 

that is correct. We don't -- once you have the 

intake estimate, we agreed it doesn't matter 

for --

 MR. GRIFFON: (Unintelligible). 

 DR. ZIEMER: -- yeah. So the last one would 

read "Example internal dose intake estimates 

for Plant 7 thorium extraction workers." Thank 

you. 
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Adoption of this protocol, if I can call it 

that, comes as a recommendation from the 

subcommittee. It therefore has the force of a 

motion. It does not require a second. It is 

open for discussion. Wanda? 

 MS. MUNN: Did we catch the misspelled ruptures 

in the first line? 

 DR. ZIEMER: We probably didn't. 

 MS. MUNN: First line on the second page, dust 

bag ruptures. 

 DR. ZIEMER: Well, these are rupters (sic) 

here. 

 MS. MUNN: Yeah. 

DR. ANDERSON: Did we mean raptors? 

DR. ROESSLER: While we're doing that sort of 

thing, in the heading ABWRH should be ABRWH. 

 MR. GRIFFON: AB-- yes, yes, it should be, huh? 

 DR. ZIEMER: Yes, thank you. With those 

additional changes -- which are friendly 

amendments --

DR. ROESSLER: I -- I would like to comment 

that while the rest of us are doing normal 

things like eating dinner and sleeping that 

Mark is working hard to develop this sort of 

thing, and I think the Board owes a great deal 
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of gratitude toward him for -- 

 DR. ZIEMER: Exactly. 

DR. ROESSLER: -- doing it. 

 DR. ZIEMER: Thank you, Mark. Arjun, a 

comment? 

 DR. MAKHIJANI: Excuse me, Dr. Ziemer. Jim and 

I were just talking here, the second bullet now 

says NIOSH complete the following tasks in 

consultation with SCA by July 31st. That still 

is that way, and the workgroup meeting is 

between July --

 DR. ZIEMER: No, it was changed to August 7th. 

 MS. MUNN: 8th. 

 MR. GRIFFON: Or August 8th now, I guess. 

 DR. ZIEMER: Or August 8. We -- we had changed 

 DR. MAKHIJANI: I thought -- oh, I -- 

 DR. ZIEMER: We had changed that. The working 

group could still meet ahead of that, just to 

discuss issues. 

 DR. MAKHIJANI: Oh, I see. 

 DR. ZIEMER: I think that was the concept, was 

it not? 

 MR. GRIFFON: Yeah. 

 DR. MAKHIJANI: A point of clarification then 
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for us is it would be important for us to have 

something in hand from NIOSH before the 

meeting. Otherwise -- you all know the 

experience, I guess. You walk into a meeting 

and you're confronted -- 

 DR. ZIEMER: Yeah, that --

 DR. MELIUS: -- something collects. 

 DR. ZIEMER: That is a very good point that if 

SC&A doesn't have anything from NIOSH -- for 

example, if we met on July 31st, they don't 

have anything, what -- is the phone call simply 

going to be how are you doing, NIOSH; great, 

glad to hear it -- or what? 

 DR. MAKHIJANI: Yeah, so I -- I would request 

that -- that -- I had interpreted the second -- 

before we had five bullets and the second 

bullet was NIOSH complete the following tasks 

in consultation with SCA by July 31st, followed 

by a workgroup meeting. I didn't interpret 

that second bullet as having any resolution or 

anything, but that NIOSH would finish a kind of 

a rough draft and deliver it to us so we could 

look it over be-- and then talk about things at 

the working group meeting and the Board members 

and the working group could also similarly look 
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it over. But I'm afraid if we don't have 

anything in hand it'll be very -- 

 DR. ZIEMER: That's a very good point. Let me 

ask --

 MR. GRIFFON: Well, what -- what if we then 

said workgroup meeting on August 9th? I mean I 

just had -- I was trying to give us a range 

with that workgroup meeting 'cause I knew -- 

but I -- I also wanted time between the 

workgroup meeting and the time that SC&A had to 

provide a -- a report back, so... 

 DR. MAKHIJANI: Yeah, Mark, I -- you know, the 

August 8 or 9 --

 MR. GRIFFON: Yeah. 

 DR. MAKHIJANI: -- doesn't bother me, one way 

or another. It -- it's much more important I 

think for us to have a document several days 

before, a very rough draft document that'll be 

on the table during the workgroup meeting -- 

 MR. GRIFFON: Oh, yeah, I see what you're 

(unintelligible). 

 DR. ZIEMER: Yeah. 

 DR. MAKHIJANI: -- so that we can actually talk 

about something that we've reflected on, had a 

chance to go to the documents, our own report, 
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and we're not scrambling on the airplane or 

something. 

 DR. ZIEMER: I think it's a valid point and we 

need to either move the NIOSH completion date 

up or move the working group back a little bit. 

 DR. WADE: Possibly those issues could be 

resolved on the July 26th call. 

 MR. GRIFFON: Yeah. 

 DR. ZIEMER: Well, I think, though, if -- if 

we're going to put this thing in motion, we 

need to be specific so it's clear that there is 

time for SC&A to have something in their hands. 

 MR. GRIFFON: Well --

 DR. ZIEMER: We could have that -- you see, if 

we get too much after August 8th for this, then 

we're starting to encroach on SC&A's deadline. 

 DR. MAKHIJANI: Thank you, Dr. ... 

 MR. GRIFFON: Right. 

 DR. ZIEMER: Now is -- it'd be possible that we 

could move the -- find a date between August 

3rd and -- or July 31st and August 8th that -- 

since we modified some of these other things so 

DR. NETON: I think I'd just like a little 

clarification on what means complete. I mean 
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if we have to have this completed -- I mean 

complete-complete -- by July 31st, then -- you 

know, that's a -- that's a tough order to fill. 

I mean I think we're going to have substantial 

progress and be able to discuss all of our 

approaches and that sort of thing. But you 

know, if we're required to complete this -- 

what, several weeks before the August 16th 

deadline for SC&A --

DR. ROESSLER: (Unintelligible) August 8 

(unintelligible). 

DR. ANDERSON: It's now August 8th. 

DR. NETON: What's this -- July 31st is the 

date that's on here to have -- complete the 

following tasks. 

 MULTIPLE SIMULTANEOUS SPEAKERS: We just 

changed it. 

DR. NETON: But now we're talking about moving 

it back --

 MR. GRIFFON: (Unintelligible) talking about 

moving it back --

 DR. ZIEMER: August 8th is where it is now. 

DR. NETON: Right, and I was totally fine with 

that, but I understand SC&A's issues -- 

 MR. GRIFFON: Right. 
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DR. NETON: -- with getting a --

 MR. GRIFFON: But I see the dilemma there. I 

think -- but I was really thinking July 31st 

because then that gives us time before the 

workgroup meets to have a -- a look at it, you 

know. I don't think we can show up cold to the 

workgroup, so --

DR. NETON: Right, and I guess that's my -- 

question I have is complete the following 

tasks, I mean --

 DR. ZIEMER: We might be able to slip the SC-- 

SC&A date a couple of days since we've moved 

the -- the Board meeting. 

 DR. MAKHIJANI: I think, Jim, we might be in 

agreement if we change the word "complete" 

because I'm not looking for something complete, 

and I imagine Dr. Mauro also would not be. If 

we got a rough draft, as Jim as just said -- 

 MR. GRIFFON: How about NIOSH report on the 

following tasks? 

 DR. MELIUS: Yeah. 

 DR. MAKHIJANI: A NIOSH draft report on the 

following tasks by July 31st, then we could 

have a meeting a few days after that. We'd 

have some flexibility in the meeting date. 
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It's not going to take a long time to look it 

over, but it'll take a few days. 

 DR. ZIEMER: How would this sound for bullet 

two? NIOSH complete -- or NIOSH provide a 

draft report on the following tasks in 

consultation -- by August 8th. 

UNIDENTIFIED: July 31st. 

 DR. ZIEMER: Oh, 31st? I -- I thought I heard 

Jim say --

DR. NETON: Yeah. Well, it depends on what a 

draft report -- I mean I think we are going to 

substantially have the approaches outlined, but 

I don't know that we're going to have all the -

-

 DR. ZIEMER: By July 31st? 

DR. NETON: Right, all the --

 MR. GRIFFON: All right, let's --

DR. NETON: -- organ documentation included by 

-- I think we'll be able to discuss in some 

depth the approaches and issues that would be 

surrounding those proposed approaches, but -- 

but to have them complete just sounded a little 

too final. 

 MR. GRIFFON: Let's just -- all right. Yeah. 

DR. NETON: Okay. 
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 MR. GRIFFON: Provide draft report on, and 

we'll stay with July 31st, though, and then 

we'll be able to have that workgroup meeting 

(unintelligible) --

DR. NETON: Right, 'cause I think it'd be -- 

it's worthwhile, it has merit. 

 MR. GRIFFON: Yeah. 

DR. NETON: But to meet on July 31st, I totally 

agree, I just don't want people to show up with 

the expectation that NIOSH is going to have 

everything finalized by then. 

 DR. ZIEMER: So you're okay with July 31st in 

that case? 

DR. NETON: I think so. I think if we've 

agreed that this is a -- a work in progress and 

-- and will be substantially -- 

 DR. ZIEMER: Yeah, now --

DR. NETON: -- you know, fleshed out -- 

 DR. ZIEMER: -- I believe what you're saying is 

that will be the point at which SC&A will see 

your draft initially so that the words that 

you're going to have this draft in consultation 

with them may not be quite correct. 

DR. NETON: I think that -- that's okay. I --

I think we're going to discuss at this meeting 
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the draft approaches that we have and there 

will be a report available, but they're not -- 

 MR. GRIFFON: Well, I -- I guess the reason I 

put "in consultation with" there was that I was 

trying to allow for flexibility so that if you 

needed to call Arjun and check on a -- on 

certain issues that they -- have been raised 

through this whole process, we didn't -- we 

didn't want to restrict you from doing that -- 

DR. NETON: I think that's --

 MR. GRIFFON: -- on certain things. 

DR. NETON: That's --

 MR. GRIFFON: So in consul-- that's all "in 

consultation with" meant. 

DR. NETON: That's fine then. 

 MR. GRIFFON: Yeah. 

 DR. MAKHIJANI: Yeah, I'm happy to do that, 

provided the Board explicitly authorizes these 

conversations -- informal conversations because 

up to now things have been -- and -- been very 

formal. If you direct us to have that, I think 

it'll be useful. I don't know if you want us 

to keep any notes or minutes or keep it 

completely informal. 

 DR. WADE: I can deal with that. 
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 DR. MAKHIJANI: That's fine. 

 DR. ZIEMER: Probably important that there is a 

record of when such exchanges take place. It 

doesn't have to be transcribed, but there 

should be a record of whatever the exchange is. 

 MR. GRIFFON: Yeah. 

 DR. ZIEMER: So what's being proposed is to 

change the second bullet to read "NIOSH will 

provide a draft report on the following tasks, 

in consultation with SC&A, by July 31st." Is 

that agreeable? Can we take that as a friendly 

amendment or do you want to formal -- formally 

vote? It appears to be agreeable. 

And then -- and then the workgroup would still 

meet then the -- sometime that following week, 

and so on. 

Okay, thank you for helping clarify that. 

Other -- other points of discussion on this 

document? 

 (No responses) 

Okay. Are we -- Mike, did you get a copy yet 

or do you know? 

 MR. GIBSON: Yes, I did. I'm --

 DR. ZIEMER: Okay. Any comments? Are you 

okay? 
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 MR. GIBSON: Yeah. 

 DR. ZIEMER: Great. Are we ready to vote on 

this then? 

Okay, all who favor proceeding with this 

document as amended, please say aye. 

 (Affirmative responses) 

And any opposed, no. 

 (No responses) 

 Any abstentions? 

 (No responses) 

The motion carries. 

 DR. WADE: Could I speak a bit to the -- just 

the engagement and -- let me talk a little bit 

about how these engagements should take place, 

from my perspective, and then the Board could -

- could modify that as it would. 

We're going to do this work largely as working 

group activity. That would represent members 

of NIOSH, representatives of SC&A and members 

of the Board would be present. What we'll 

agree to do is we will -- we will issue a 

Federal Register notice in advance of any 

working group meeting. We would invite the 

public to the working group meeting. We would 

keep a transcript of the working group meeting. 
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We would be sure that the petitioners were not 

only made aware of the meeting but were 

available to attend as they would, and they 

could participate in those discussions. 

I would also ask that if SC&A and NIOSH find it 

appropriate to have telephone discussions 

toward the goal of clarifying issues prior to 

or after a working group meeting, we allow 

those interactions to take place and we would 

ask both parties to keep a record of those 

calls and make those records available to the 

Board, should the Board request them. I 

wouldn't say those interactions need to be 

working group meetings because I don't want to 

limit your ability to have interchanges. But 

we will issue Federal Register notices of the 

working group meetings. We'll make it 

available for the public to attend and we will 

keep transcripts of the working group meetings. 

Of the interactions we only ask that the 

parties keep records of those calls. 

 DR. ZIEMER: Okay. Thank you very much. 

Denise? 

MS. BROCK: I just was curious if it's possible 

for the communication to be open between SC&A 
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and myself, as well, through any of these 

proceedings with NIOSH. 

 DR. WADE: Sure. 

MS. BROCK: Phone conversations --

 DR. WADE: Yeah. 

MS. BROCK: -- besides the meetings. 

 DR. WADE: Certainly. 

MS. BROCK: Great, thank you. 

 DR. WADE: I would ask both parties to be sure 

to -- to see that the petitioner is aware of 

potential calls and can join those calls. 

 DR. ZIEMER: Wanda? 

 MS. MUNN: Dr. Wade, I had been under the 

impression that the significant difference 

between a subcommittee and a working group 

meeting was that the working group would not be 

required to have a Federal Register notice and 

therefore give us the flexibility to -- to be 

able to call such a meeting quickly if -- if 

that was possible. Am I uninformed? 

 DR. WADE: No, you're correct. We're not 

required to do it. I'm proposing in this case 

that we do it, given the -- 

 DR. ZIEMER: Go through a Register notice? 

 DR. WADE: -- yeah, that we notice these 
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working group meetings, given the -- the 

various -- the very obvious interest in our 

deliberations on this matter. So I'm proposing 

that we notice these working group meetings. 

We are not required to do that. 

 DR. ZIEMER: Yes, Arjun and Jim. 

 DR. MAKHIJANI: Dr. Wade, by "record of the 

calls," you mean the time of the call, who we 

spoke to and the topic of the call? Would that 

be sufficient? 

 DR. WADE: It would be, yes. 

 DR. MAKHIJANI: Thank you. 

DR. NETON: Sorry I'm being somewhat dense this 

afternoon, but could we go over the dates for 

the five bullet items that have been agreed 

upon? I just --

 DR. ZIEMER: Yes. 

DR. NETON: -- want to make sure we got 

those... 

 DR. ZIEMER: We'll make sure that everybody 

agrees with what they are. 

 DR. WADE: And if I could ask Denise if you'd 

pay particular attention to these dates. Go 

ahead. 

 MR. GRIFFON: (Unintelligible) get a clean 
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copy. 

 DR. ZIEMER: The date in the first bullet is 

July 26. The date in the second bullet now, as 

I understand it, is July 31. The third bullet, 

the dates are July 31 to August 8. Fourth 

bullet remains at August 16. The last bullet, 

August 16 to 22nd. Is that --

 MR. GRIFFON: Yeah. 

 DR. ZIEMER: Yes, NIOSH agreed to do that. 

Does that coincide with what you have, Jim? 

DR. NETON: The working group meeting is still 

a range between July 31st and August 7th? I 

thought at one point we -- 

 MR. GRIFFON: August 8th, yeah. 

DR. NETON: -- decided to have it on August 

8th. Is that not --

 MR. GRIFFON: Oh, no, I -- I was --

 DR. ZIEMER: It could be. It could be. 

 MR. GRIFFON: Between then. I think we slide 

it away from the July 31st -- 

DR. NETON: July 31st through August 8th is the 

current... 

 DR. ZIEMER: Time window, uh-huh. 

 MR. GRIFFON: Yeah. I was giving us 

flexibility, but logically I think it would 
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tend to be toward August 8th more than toward 

July 31st 'cause we've just gotten the reports. 

DR. NETON: And then the meeting to finalize 

this all was schedule the end of August. 

 DR. ZIEMER: 25 and 6 now for the Board -- 

DR. NETON: 25 and 6, right. Okay, thank you. 

 DR. WADE: Denise, for your purposes, the only 

scheduled working group meeting at this point 

is on July 26th, and I'm going to propose that 

that meeting take place at 11:00 a.m. Eastern 

time. Okay? 

MS. BROCK: That's fine. 

 DR. WADE: Now we'll notice you again on that, 

but just to give you a -- a preliminary 

warning. There will be another meeting 

scheduled sometime between July 31st and August 

8. That has yet to be determined. Possibly 

the time will be set on that first working 

group call. 

MS. BROCK: That's fine. 

 DR. WADE: Thank you. 

 DR. ZIEMER: The Chair recognizes -- who do I 

recognize? Oh, Wanda Munn has her 

(unintelligible) --

 MS. MUNN: I'm sorry, leftover from 
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(unintelligible). 

 DR. ZIEMER: Okay. Roy, did you have a 

comment? 

 DR. DEHART: Just a question. Since it will be 

a working group, we're limited to what number 

of participants before we cross -- 

 DR. ZIEMER: Less than --

 DR. DEHART: -- over --

 DR. ZIEMER: -- a quorum. 

 DR. DEHART: So --

 DR. ZIEMER: Less than a quorum and -- 

 DR. DEHART: Right, do those need to be -- 

 DR. ZIEMER: -- I think in general we're 

talking three or four individuals and we'll -- 

 DR. WADE: Do you know who the working group 

members will be now? 

 DR. ZIEMER: Well, let's identify who would be 

available and interested for that date or that 

-- during that week. We'll get the names --

okay, Wanda Munn. 

 MR. GRIFFON: If -- it would be nice if whoever 

volunteers for that first call can also make 

the meeting during the July 31st to August 8th 

-- probably July (sic) 4th, 5th, that time 

frame -- in Cincinnati I think is the -- 
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 DR. ZIEMER: Okay. Rich is interested. 

MR. ESPINOSA: I'm available but would prefer 

to be an alternate. 

 DR. ZIEMER: Okay. 

 DR. MELIUS: What date are we -- I'm sorry. 

What date are you looking for availability on? 

 DR. ZIEMER: We have a conference call for July 

26, 11:00 o'clock, and then a workgroup meeting 

sometime between July 31st and August 8th. 

 DR. MELIUS: And I am available for the 

conference call and I'm also available that 

week, except for the July -- for August 4th. 

 DR. ZIEMER: Okay. 

 MR. GRIFFON: Okay. 

 DR. ZIEMER: Mike, are you -- do you have an 

interest in this? 

 MR. GIBSON: Yes, and I believe -- I believe 

I'll be available for those dates, barring my 

situation. But I believe I'll be available for 

those. 

 DR. ZIEMER: Okay. Mark? 

 MR. GRIFFON: Yeah. 

 DR. ZIEMER: We have four names and an 

alternate right now. Anyone else? Then I 

would -- I'll specify Mark, Wanda, Jim and Mike 
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as being the working group, with Rich as an 

alternate. And Mark, if you would serve as 

Chair then. 

If for any reason any of you cannot come -- 

there are a variety of things, sometimes 

hurricanes interfere or illness or whatever -- 

there are others available and simply let me 

know or let Lew know and we'll -- we'll -- we 

have a -- one alternate. If we need more, we 

can get others, but this, let us say, will 

constitute the working group. 

 DR. WADE: Thank you. 

 DR. ZIEMER: And I know that general counsel 

likes to make sure that we have specified the 

task for the working group. I think the task 

is spelled out in the document and -- and they 

will be following the -- the dictates of this 

document in their work, so that will be the 

task. 

Now the Chair recognizes Dr. Melius for 

purposes of making a motion. 

 DR. MELIUS: Yeah, actually two issues I'd like 

to raise. One actually is a -- references some 

of the things we've already discussed, but I 

think we've been, up until this meeting, a 
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little bit unclear about what our communication 

has been with our audit contractor and who does 

the communication and about keeping everybody 

informed about it. And it's not to fault 

anybody 'cause I think we've been sort of 

laboring under some tight deadlines and some 

dif-- difficult issues, so I'd like to offer a 

motion -- consists of three parts. It's 

actually fairly consistent with the procedures 

we just adopted for the Mallinckrodt workgroup 

and -- and follow-up. And let me read the -- 

the motion and then we can offer -- if we get a 

second, we can discuss it. 

So the motion is the Advisory Board, Radiation 

and Worker Health adopts the following 

provisions governing communication and program 

direction for the Bo-- with the Board's audit 

contractor. 

Number one, all communications initiated or 

received by the Chair, NIOSH and/or the audit 

contractor regarding the scope, performance or 

activities of the audit contractor will be 

copied to the entire Board. The audit 

contractor shall prepare and disseminate to the 

Board a written summary of all telephone calls 
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and meetings with NIOSH regarding issues 

related to -- to contact-- contracting scope or 

performance. 

 Number two, no approvals, changes or directives 

related to task orders or procedures may be 

provided by the Chair and/or NIOSH to the audit 

contractor without first securing concurrence 

from the Board for these approvals, changes or 

directives in ad-- and directives in advance to 

the entire Board. If three or more Board 

members raise concerns or objections about the 

proposed changes, then the Chair shall convene 

a meeting of the Board forthwith to review the 

proposed changes. 

Number three, all working groups and 

subcommittee meetings, including conference 

calls, involving NIOSH and the audit contractor 

to review findings of the audit contractor will 

include the participation of at least two Board 

members. All Board members will be notified 

about the meetings at least two weeks prior to 

the meeting, and the Chair will ensure that 

adequate Board representation will be present 

at the meeting. Such meeting shall be noticed 

in advance to the public through the e-mail 
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list and on the NIOSH web site and open to the 

public, consistent with the Open Governments 

Act. Such meetings, including those by 

teleconference, shall be transcribed. 

 And I think it gives -- 

 DR. ZIEMER: That was your motion. 

 DR. MELIUS: Huh? 

 DR. ZIEMER: Is there a second to the motion? 

 MR. GIBSON: Dr. Ziemer, I would second that 

motion. 

 DR. ZIEMER: The motion's been seconded. I'm 

wondering if we can easily get -- that's fairly 

extensive. We may want to see the words. The 

motion is on the floor for discussion. I want 

to ask for clarification. There -- there's a 

whole set of things that I get from the 

contractor's office, which are the -- the 

monthly progress reports which include the 

financials and so on. Those are -- are you 

asking that those be included in this so that 

everyone gets a copy? This can be done, but 

the practice has not -- has been to not 

distribute those widely, but -- 

 DR. MELIUS: Yeah, I -- we actually voted at 

one point not to have those distributed -- 
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 DR. ZIEMER: That's exactly right. 

 DR. MELIUS: -- but I think it would be better 

actually I think --

 DR. ZIEMER: I just want to make sure 

everybody's aware of the all-encompassing 

nature of this. There -- there -- you will get 

a lot of stuff. 

 MR. GRIFFON: We already -- we get a lot of 

stuff. 

 MS. MUNN: Yeah. 

 DR. ZIEMER: Liz? 

MS. HOMOKI-TITUS: I may have missed what you 

said. Could you re-read number two? 

 DR. MELIUS: Well, why -- I think we're going 

to get this printed out, so -- 

MS. HOMOKI-TITUS: You are? 

 DR. MELIUS: -- I would prefer --

 DR. ZIEMER: Yeah --

MS. HOMOKI-TITUS: Okay. 

 DR. ZIEMER: -- we'll get it printed out before 

we act on it. Wanda? 

 MS. MUNN: I always thought Dr. Melius was a 

physician. I didn't understand that he was an 

attorney. I'm sure he's had benefit of same, 

but nevertheless, I have such strong 
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reservations about bringing such a complex 

motion to this Board at -- after 2:00 o'clock 

on an afternoon when we've already had a 

discussion indicating that Board members will 

be gone by 2:00 p.m., that I would not under 

any circumstances vote on this today. I would 

strongly object to it and I feel quite sure 

that I surely am not alone. 

 DR. ZIEMER: So are you making any particular 

motion? 

 MS. MUNN: I'm protesting the presentation of 

this motion to us in this manner at this time, 

and am stating categorically that I feel it is 

improper, that it is rude and I won't vote on 

it. If it's going to be voted on, it will have 

to be tabled. It will have to be provided to 

me in written format and I may even choose to 

have counsel before I decide whether to vote on 

it. 

 DR. ZIEMER: You are certainly in order if you 

wish to move to table the motion. 

 MS. MUNN: I so move. 

 DR. ZIEMER: I thought that's what -- where you 

were -- I'm not trying to influence you. 

 MS. MUNN: No, no. 
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 DR. ZIEMER: Is there a second? 

 DR. DEHART: I would second. 

 DR. ZIEMER: Seconded tabling the motion. This 

is not a debatable motion, requires an 

immediate vote. A two-thirds vote will table 

the motion. I might indicate to you that if it 

is tabled you will have the written copy 

available to study. I think it's being run now 

and those will, in any event, be made 

available. 

Yes, Leon -- again, you may not speak to the 

motion, but as a point of information. 

MR. OWENS: Yes, sir. Dr. Ziemer, are we sure 

that a two-thirds vote is required to table? 

 DR. ZIEMER: Yes, I'm quite sure it is, unless 

-- I -- I've worked with Robert's Rules quite a 

bit. 

MS. HOMOKI-TITUS: (Unintelligible) a table 

requires half. 

 DR. ZIEMER: Half? 

MS. HOMOKI-TITUS: Half, yes. 

 DR. ZIEMER: Okay. Well, that's nearly twothirds for this group. Thank you. Well, I 

stand corrected. Okay. 

 MR. GIBSON: Dr. Ziemer, unfortunately I'm not 
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there, but could I ask, is part -- other than 

me, is there some other Board members that are 

not in attendance? I'm just not aware of -- of 

the --

 DR. ZIEMER: Actually --

 MS. MUNN: Henry's gone. 

 DR. ZIEMER: -- Robert Presley had to leave. 

 DR. DEHART: Dr. Anderson. 

 DR. ZIEMER: And has Dr. Anderson left? 

 DR. DEHART: Well, he took a bag with him 

(unintelligible) material (unintelligible) 

there. I don't know where he is. 

 DR. ZIEMER: There are -- there are seven Board 

members here plus you, Mike, makes eight. 

 MR. GIBSON: Okay. 

 DR. ZIEMER: So this would require five votes 

to table. 

DR. ROESSLER: Eight (unintelligible). 

 MR. GIBSON: Thanks for the clarification. 

 DR. ZIEMER: Actually there's nine. I didn't 

count myself, nine. 

 DR. MELIUS: It still takes five. 

 DR. ZIEMER: It still requires five, yeah. 

Okay, voting on the motion to table, all in 

favor raise your right hand. One, two, three, 
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the Chair votes, four, that's -- one, two, 

three, four -- and Mike, you vote -- 

 MR. GIBSON: Not to table the motion. 

 DR. ZIEMER: -- not to table. That's -- so let 

me get the no’s. One -- one, two, three, four 

UNIDENTIFIED: Mike's five. 

 DR. ZIEMER: -- and Mike is five. Okay, so the 

motion to table fails, so the original motion 

comes back to us. We do want to have the 

written copy, however. What's the status of 

that? 

 DR. MELIUS: I can get Cori -- I can give 

her... 

 MR. GRIFFON: Can we take up something else 

while we wait? 

 DR. ZIEMER: Yes --

 DR. MELIUS: Can I make a comment, just in 

response to Wanda? I -- you know, Board 

meetings are scheduled for two and a half days. 

This was the first opportunity we've had to 

take up motions. I specifically talked to the 

Board Chair about doing this and what the time 

period should be and, you know, it's part of 

doing Board business. I don't -- it's not 
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meant to be rude or unfair to anybody, but it's 

-- we have to have some time to take up 

business and we are scheduled to do business 

through 4:00 o'clock today or 4:30, and... 

 MS. MUNN: I'm here (unintelligible). 

 MR. GRIFFON: That's -- yeah. 

 DR. MELIUS: So I mean it wasn't deliberately 

put aside until somebody left or whatever. 

 DR. ZIEMER: No, indeed, Dr. Melius asked me if 

-- if he could make a motion pertaining to the 

interactions with the contractor at the meeting 

this afternoon. 

Do any of -- while we're waiting for that, you 

have a general sense of the motion, do any of 

you wish to speak for or against the motion at 

this point? 

 MR. GIBSON: Dr. Ziemer? 

 DR. ZIEMER: Yes, Mike? 

 MR. GIBSON: I would just like to say that Dr. 

Ziemer's -- or, sorry -- Dr. Melius's motion 

has a lot of issues that I know I for one have 

brought up at other meetings, and so have other 

Board members, concerning the way the Board is 

kept involved. And so I don't think this is a 

new issue. I think it's something that -- it's 
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been brought up before and it's, at least in my 

opinion, something that -- that's what we've 

all been charged to do is take care of the 

Board's business and -- and I think he has -- 

he's outlined our duties and it's -- you know, 

it's the business of the Board and I -- I just 

think the motion's completely in order. 

 DR. ZIEMER: Thank you. Anyone wish to speak 

for or against the motion? Roy. 

 DR. DEHART: We will be seeing the motion in 

writing and that'll perhaps be a clarification 

for me, but there were several things in there 

in terms of timing, et cetera, that tended to 

bind the Board rather tightly and avoid the 

possibility of flexibility. And that was one 

of the concerns that I had. In addition, I get 

enough mail as it is. I don't need other mail 

that isn't important for me to review and -- 

and go through. Perhaps there's a way that one 

can put themselves on a mailing list, if that's 

what some want, to receive all the 

correspondence that's generated that -- by the 

actions of this Board and its contractors well 

beyond what we normally already receive, that 

might be an option, rather than to imply that 
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it would go snowflake to everyone. 

 DR. WADE: I would like to speak, if I could. 

 DR. ZIEMER: Yes. 

 DR. WADE: As Dr. Melius read the motion, I 

didn't have any problem with it as it related 

to NIOSH. I do have to point out to you that 

the contract with SC&A is with CDC. The 

contracting officer is a CDC employee. I don't 

think that in any way the Board can limit 

communications between the contracting officer 

and the contractor, and -- and I point that out 

to you as a clarification. 

 DR. MELIUS: And that's why the motion 

specified NIOSH --

 DR. WADE: Right. 

 DR. MELIUS: -- understanding that, and... 

 DR. ZIEMER: I would like to suggest that if 

the motion carries, if there are Board members 

who actually don't want all of the 

correspondence, this wouldn't exclude them from 

opting out of the e-mail list. And I -- I 

don't believe there -- typically that there's 

anything -- the most sensitive things are 

probably those monthly reports which include 

time and effort information -- 
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 DR. WADE: Uh-huh. 

 DR. ZIEMER: -- and so you would have to agree 

to keep all of that confidential -- 

 DR. WADE: Right. 

 DR. ZIEMER: -- because -- other than that, the 

e-mails are similar to things that you have 

seen. They are exchanges or questions about 

when meeting times -- when we can get together 

and so on, or -- or John may say how much time 

do I have on the agenda for the next meeting to 

present this and so on. They are generally 

pretty innocuous. 

MS. HOMOKI-TITUS: I probably need to see the 

written motion before I make this comment, but 

I'm a little concerned about getting Board 

approval and if three Board members are 

concerned, 'cause the Board is only supposed to 

act when you're -- have been called together or 

you're having an Advisory Board meeting that's 

been announced in the Federal Register. I 

don't know if that's language that you want to 

try to rework, but to try to get a majority or 

what would end up being a majority if three 

Board members are concerned -- consensus on 

something, is in violation of FACA. 
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 DR. MELIUS: What -- well --

MS. HOMOKI-TITUS: And like I said, I need to 

see the written because I'm not -- didn't catch 

everything that you said. 

 DR. ZIEMER: I -- I think he -- the -- the 

three-member thing was -- was an issue of if 

three members raise a concern about something, 

I guess that arose in the -- 

 DR. MELIUS: That is communicated from the 

Chair. 

MS. HOMOKI-TITUS: So you're not looking for 

agreement for everyone and if three people say 

no, that's not what you're looking for. Right? 

 DR. MELIUS: If three people raise concerns and 

it may be then we need a -- 

MS. HOMOKI-TITUS: A meeting. 

 DR. MELIUS: -- mechanism for the Chair to -- 

so this is instructing the Chair that in that 

situation that he should call a meeting of the 

Board. 

MS. HOMOKI-TITUS: Okay. Thanks for 

clarifying. 

 DR. MELIUS: I think that's -- and -- and 

again, that was I think trying to address the 

flexibility issue and so forth that there are 
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times when we need to move in other ways and it 

-- this kind of communication will do it. It 

also that -- this doesn't override actions we 

just took in terms of setting up a schedule and 

procedures for dealing with -- with 

Mallinckrodt. I just do think we have to be 

sensitive to the fact that we want to make -- 

we want to have transparency in terms of our 

dealings with the contractor and to -- 

transparency in assurances to the public and to 

the claimants that the contractor is working -- 

is not being unduly influenced by NIOSH in the 

technical is-- issues as taken. It's an 

awkward arrangement to have CDC/NIOSH running 

the contract that is auditing the work that 

NIOSH is doing, and I think we need to take -- 

I think it will -- some extra steps to try to 

make sure. And I think -- I don't think this 

changes a great deal from what we've done or 

it's not reflecting anything that anybody's 

done wrong, but rather let's try to have some 

rules in terms of governing this situation so 

that we all understand them and Paul's not put 

in a spot where he's not sure what to do and 

we're not put in a spot of do we second-guess 
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what Paul did because it's -- he's trying to 

react and do this, you know, under -- in not 

always easy circumstances, either. 

 MR. GIBSON: Dr. --

 DR. ZIEMER: Also --

 MR. GIBSON: -- (unintelligible) comment? 

 DR. ZIEMER: Yes, Mike? 

 MR. GIBSON: With all due respect to Dr. DeHart 

and his comments, you know, and people opting 

out of the list, you know, I think Jim's motion 

is important and I think that the obligation 

that we all accepted when we took the positions 

on the Board -- I know we get a lot of mail, 

and I know it takes -- it's very timeconsuming. I know we have other things to do 

in our life. But we took the obligation to 

take this business at hand and, as Jim said, 

you know, it's an awkward situation and 

sometimes, Dr. Ziemer, you're put in a position 

that, you know, you may need to react or think 

you need to react and it's -- really should 

fall on the Board's shoulders on how to react 

and not put you in the awkward position that 

that -- these unfortunate time situations may 

do. So I -- you know, I'm not sure that all 
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Board members shouldn't be included in all 

these e-mails and whether they choose to read 

them or act upon them, I guess that's their 

prerogative. But this is an obligation that we 

accepted when the President appointed us. 

 DR. ZIEMER: Okay. Thank you for those 

comments. 

I think we may have the document itself. 

 DR. WADE: Could you just pass them around? 

 MS. SHIELDS: Sure. 

 MR. GIBSON: But -- Dr. Ziemer? 

 DR. ZIEMER: Yes, Mike? 

 MR. GIBSON: I'm sorry, if I could make one 

more comment. You know, I -- I do want to 

apologize, but I think this is the first Board 

meeting I haven't been able to attend due to 

some unfortunate circumstances, and so I -- you 

know, I don't want to sit here on a conference 

call trying to act like I'm, you know, so 

involved. But you know, I have tried to be at 

every --

 DR. ZIEMER: No, we understand that, Mike, and 

you're quite right. Mike has an exemplary 

record of attendance at the meetings and 

unfortunately his father is very ill and he's 
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had to help attend to him, but we appreciate 

your being on the call, Mike. 

 MR. GIBSON: Thank you. 

 DR. ZIEMER: I don't know if we can -- Mike, if 

you need a copy of this motion, you have 

already indicated support for it so maybe 

you're comfortable with just the sense of it, 

but the Board members now have a copy of the 

motion and the Chair is going to step us 

through each item. There's three parts to it. 

I'd like to ask first if any of the Board 

members have any comments or changes or 

concerns on item one. 

 DR. WADE: Can I ask a -- a clarifying 

question? 

 DR. ZIEMER: Uh-huh. 

 DR. WADE: I would understand then, Jim, that 

if I was to have a discussion with the audit 

contractor, it would be the audit contractor's 

responsibility to notify the Board. 

 DR. MELIUS: Correct. 

 DR. WADE: Okay. 

 DR. DEHART: Paul, you may want to read that 

for Mike. He doesn't have -- 

 DR. ZIEMER: Okay, here's the item, and I'll 
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read it, Mike. (Reading) All communications 

initiated or received by the Chair, NIOSH 

and/or the audit contractor regarding the 

scope, performance or activities of the audit 

contractor will be copied to the entire Board. 

The audit contractor shall prepare and 

disseminate to the Board a written summary of 

all telephone calls and meetings with NIOSH 

regarding issues relating to contracting, scope 

or performance. 

 DR. WADE: I do need to ask another question. 

There are certain activities that I, as 

technical officer on the contract, undertake 

relative to rating the contractor's 

performance. 

 DR. MELIUS: Uh-huh. 

 DR. WADE: I'm not sure if I can share those 

with the Board. I -- I mean I need a 

determination from the contracting officer as 

to --

 DR. MELIUS: Fine. I mean obviously we're not 

trying to violate contracting rules. 

 DR. WADE: Okay. 

 DR. MELIUS: To the extent that information can 

be shared, I mean I think that the fact that 
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you had such a call could be shared. To what 

extent the content of that discussion can be 

shared I think would be governed by, you know, 

the rules of -- that govern contracting. 

 DR. ZIEMER: Perhaps a phrase could be added to 

this first paragraph that would specifically 

mention that those -- those activities which 

are permitted by law -- because performance is 

mentioned here, and in fact -- 

 DR. WADE: I don't know if that's the same 

performance as the performance I pass judgment 

on. 

 DR. ZIEMER: Right. Right. Perhaps Liz can 

assist us on item one here. Any issues there 

from a legal point of view? 

MS. HOMOKI-TITUS: No, I'm sorry, I was going 

to comment on number two. 

 DR. ZIEMER: Okay. Let's get number one first. 

MS. HOMOKI-TITUS: Okay. 

 DR. WADE: Arjun has a com... 

 DR. ZIEMER: Arjun? 

 DR. MAKHIJANI: Yeah, we were having a little 

caucus here, Dr. Ziemer. I wondered if the 

word "performance" would impact the 

conversations that you earlier authorized 
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between SCA and --

 DR. ZIEMER: No, I think anything --

 DR. MAKHIJANI: -- NIOSH. 

 DR. ZIEMER: -- anything specifically 

authorized by action is already authorized. 

This would be -- I believe -- aside from those 

items. 

 DR. MAKHIJANI: Thank you. Okay, no issues on 

item one. 

Item two, (reading) No approvals, changes or 

directives related to task orders or procedures 

may be provided by the Chair and NIOSH to the 

audit contractor without first securing 

concurrence from the Board for these approvals, 

changes or directives in advance to the entire 

Board. If three or more Board members raise 

concerns or objections about the proposed 

changes, then the Chairman shall convene a 

meeting of the Board forthwith to review the 

proposed changes. 

So in this case we're talking about, for 

example, if -- based on some circumstance -- 

the Chair said I believe the task order should 

be modified in some way -- 

 DR. MELIUS: Right. 
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 DR. ZIEMER: -- or something of that sort -- 

 DR. MELIUS: We have -- there've been 

circumstances where the order -- priority has 

been changed for particular tasks or parts of 

particular tasks and so forth, really without 

knowledge of the Board, and it -- I'm -- I'm 

not sure to what extent -- 

 DR. ZIEMER: Yeah. 

 DR. MELIUS: -- you were involved in those, Dr. 

Ziemer, but --

 DR. ZIEMER: No, I --

 DR. MELIUS: -- but again, it was not -- again, 

we're not objecting to what was done -- 

 DR. ZIEMER: No. 

 DR. MELIUS: -- but just saying procedurally we 

should be notified, and then if -- 

 DR. ZIEMER: Right. 

 DR. MELIUS: -- a number of us raise -- 

 DR. ZIEMER: Right. 

 DR. MELIUS: -- sort of --

 DR. ZIEMER: In essence, this was the case in 

Iowa, and in fact the Chair notified the Board 

that day when -- when the decision was made to 

make the change. So -- but there was not a 

mechanism to say -- well, we did -- we did then 
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try to set up a telephone conference to -- 

 DR. MELIUS: Uh-huh. 

 DR. ZIEMER: -- which took a couple of weeks. 

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

 DR. ZIEMER: And that still could be the case 

here. Forthwith, you know -- 

 DR. MELIUS: Uh-huh. 

 DR. ZIEMER: -- when is forthwith? 

 DR. MELIUS: Yeah. 

 DR. ZIEMER: 'Cause we have to notify -- but 

the intent is clear and I have no personal 

problem with it. I think it's quite fine. 

 DR. DEHART: The question I had is how -- how 

are we defining concurrence? Can that be done 

with e-mail? 

 DR. MELIUS: Yeah. 

 DR. DEHART: Can we avoid all of us getting on 

a telephone call? Can it be done quickly or is 

-- or is it --

 DR. ZIEMER: Well, we -- we cannot -- 

 DR. DEHART: -- going to have to be 

(unintelligible) Federal Register? 

 DR. ZIEMER: -- concur on things by e-mail, is 

my understanding. We can't take actions 

outside the public frame-- I believe that's 
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correct. Liz? So if -- if there were 

something -- see, I don't know how we -- how we 

obtain the concurrence without meeting. 

 DR. MELIUS: Well, what if we modify this and 

take out "first securing concurrence" and just 

say without first communicating these to the 

Board? 

 DR. DEHART: I have no problem --

 DR. MELIUS: And then -- and then if -- then 

the thing would -- if three or four or more 

Board members raise issues about -- in 

relationship with the communication, it would 

be in effect asking Paul to take the steps to 

convene a meeting. 

 DR. ZIEMER: I think that -- and Liz is nodding 

as -- she has --

 DR. WADE: She's --

 DR. ZIEMER: That was her issue, as well. 

 DR. WADE: Could I speak also to this one? And 

this is to the -- to the spirit of the motion. 

The actual instructions to the contractor would 

come from the contracting officer. That's the 

only person who can instruct the contractor as 

to change in scope. I understand the Board's 

intention that in my position you would not 
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want to see me initiate any action, and I 

understand the spirit of it, just as you 

understand that the actual instructions would 

come from the contracting officer. 

 DR. ZIEMER: That's correct, approvals, changes 

or directives -- I can't do any of those in any 

event, but the -- so we need to change the 

wording a little bit. I mean in essence I 

think we talked about having -- let me use the 

Iowa case where -- where we did ask SC&A to -- 

to begin work on that Rev. 1 -- was it the Iowa 

case? I guess it was -- site profile. I 

didn't direct them to do that. We asked the 

contracting officer to do that on behalf of the 

Board, so in essence yeah, it sort of becomes 

our directive, but it's -- 

 DR. WADE: Yeah, we understand the spirit of 

it. 

 DR. ZIEMER: -- the spirit of it is... And 

may-- maybe you can change the wording there a 

little bit. 

 Other comments on item two? 

 (No responses) 

Let me alert the -- let me alert the Board 

members to one other kind of activity that 
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occurs -- or has occurred on a semi-regular 

basis. Our contractor gets calls to the Hill 

on a fairly regular basis to give reports to 

staffers on the Hill of various things. John 

has always contacted Wade and contacted me to 

let me know of those requests, and has 

basically said should I do this. And the 

turnaround times are usually a day or two. Now 

we would probably be better to have a formal 

policy on this in the future. What I've done 

in the past is said yes, do this. I mean it's 

hard to turn those down. But I have raised the 

question with Wade and asked him to raise it 

with the contracting officer, these are outside 

the scope of the tasks, and the question is 

who's paying for that time for our contractor 

to brief people on the Hill. Now yes, it's -- 

it's Federal money that's paying for the 

program and so on, but in reality, those 

resources that are used to do that come out of 

the program. So -- and -- and frankly, you -- 

you will probably start to see some of these 

requests 'cause they seem to come on a fairly 

regular basis. In fact, there was one this 

past week. People on the Hill want -- want a 
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briefing on -- on everything that they produce, 

really. 

 DR. WADE: Now is it the sense of this motion 

that we would bring those requests to the 

Board? 

 DR. MELIUS: No, I think the sense would be 

that those would be communicated to let -- 

there'd be a communication on it. 

 DR. ZIEMER: Right. And in general there's 

very little response time -- 

 DR. MELIUS: Right. 

 DR. ZIEMER: -- even if -- if I said yes, go, 

and three Board members said I don't think you 

should go, it's going to be too late. 

 DR. MELIUS: Yeah, right, and -- and -- 

 DR. ZIEMER: So we'll -- we'll have to have a 

policy --

 DR. MELIUS: No, no, that's a communi-- 

 DR. ZIEMER: -- in the future. 

 DR. MELIUS: To me it's a communication issue. 

It's something that we have a policy of 

allowing, I would think --

 DR. WADE: Right. 

 DR. MELIUS: -- and --

 DR. WADE: And I don't know the contracting 
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officer is going to -- is going to surrender 

that prerogative anyway. 

 DR. MELIUS: No, I -- yeah. 

 MR. GRIFFON: Right. 

 DR. ZIEMER: Anything else? Jim, did you 

revise item two in any way that -- 

 DR. MELIUS: Yeah, I have -- and -- and let me 

-- I have a question whether this first part's 

right, that no approvals, changes or directives 

related to task orders or procedures may be 

provided through the contracting officer -- 

excuse me, let me do this right -- may be 

provided by the Chair and/or NIOSH through the 

contracting officer to the audit contractor? 

Is that -- Lew, is that -- you think -- 

 DR. WADE: It's okay. I mean it doesn't rule 

out the contracting officer. 

 DR. MELIUS: No, no, I --

 DR. WADE: That's fine. 

 DR. MELIUS: I think it covers the -- okay, 

through -- without first communicating these 

approvals, changes, directives in advance to 

the entire Board. 

So we've taken out concurrence there, and then 

the second sentence there reads the same. 
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 DR. ZIEMER: So after the words "audit 

contractor" -- what follows that? 

 DR. MELIUS: Okay. No approvals, changes, 

directives related to task orders, procedures 

may be provided by the Chair and/or NIOSH 

through the contracting officer to the audit 

contractor without first communicating these 

approvals, changes or direction -- directives 

in advance to the entire Board. 

 DR. ZIEMER: Thank you. Any objections to 

those -- that change? I'm not going to take a 

formal motion on it. If there's no objections, 

we'll consider that change a friendly 

amendment. 

Ready for item three? (Reading) All working 

group and subcommittee members (sic), including 

conference calls, involving NIOSH and the audit 

contractor to review findings of the audit 

contractor will include the participation of at 

least two Board members. All Board members 

will be notified about the meeting at least two 

weeks prior to the meeting, and the Chair will 

ensure that adequate representation is present 

at the -- at the meetings. Such meetings shall 

be noticed in advance to the public through the 
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e-mail list and on the web site and -- and open 

-- to the public? 

 DR. MELIUS: Yeah, open to the public. 

 DR. ZIEMER: -- to the public, consistent with 

the Government in the Sunshine Act. Such 

meetings, including those by teleconference, 

shall be transcribed. 

Okay, any discussion on that, there -- it seems 

to me that the two-week thing is pretty 

limiting in some cases. 

 DR. DEHART: I was going to ask if NIOSH and 

the contractor could comment whether or not, in 

their experience, would two weeks have been 

limiting. 

 DR. ZIEMER: In other words, if -- if you -- if 

there -- if an issue arose and let's say that -

- that Hans needed to speak to someone at 

NIOSH, does he have to wait two weeks or can he 

say, you know, I need -- I need to discuss this 

issue, we're working on something, if I can -- 

if I can schedule it and get some Board members 

and get a notice out, is the two weeks that 

critical? 

 DR. MELIUS: Well, I think we have to have 

adequate time to notify the public and people 
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that have an interest in the -- in the 

particular issue, so I think there needs to be 

some time -- if I recall correctly when we were 

dealing with some of the security issues, then 

some of those meetings took place in pretty 

short -- much shorter time frame because I 

think Mark -- I was talking to Mark one day and 

he suddenly got called the next day to go down 

to Washington area, but in general I think we 

should -- I mean if two weeks -- anybody feels 

is too long, if one week is fine, but I think 

we should at least strive for some time period 

-- again recognizing that we may -- hopefully 

would have some understanding ahead of time 

that there would be situations -- like with the 

security clearance issue and so forth where we 

need to move faster and in general I think the 

Board would be aware of that and 

(unintelligible) but at the same time we don't 

want to have the appearance that we're trying 

to exclude, you know, the public from 

participating or knowing about this and -- and 

Board members. So if -- would prefer to change 

it to one week, that's fine with me. 

 DR. WADE: But two weeks, if possible. I mean 
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-- you know. 

 DR. MELIUS: Okay, how about that? 

 DR. ZIEMER: At least two weeks, if possible? 

 DR. MELIUS: Yeah. 

 DR. ZIEMER: Which opens the door for a special 

situation. 

 DR. MELIUS: Yeah. 

 DR. ZIEMER: Is that -- anyone object to that? 

I -- I think flexibility there is important. 

 DR. WADE: I would like to ask a clarifying 

question about this, as well. As we did on the 

Mallinckrodt issue, there -- there -- it seems 

to me there are times that there could be 

telephone calls between NIOSH and the 

contractor that wouldn't represent a working 

group or a subcommittee meeting. Are we going 

to rule out all such phone calls? 

 DR. MELIUS: No, I think we've not. At the 

same time I think we do have to be careful 

that, to the extent possible, we know about 

those in general ahead of time. Like -- which 

we did with Mallinckrodt. We authorized those 

calls, but --

 DR. ZIEMER: This is not a -- this only 

pertains to official workgroup or -- 
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 DR. MELIUS: Correct, and --

 DR. WADE: That's right. 

 DR. MELIUS: -- and we have to be careful that 

these other types of calls don't -- 

 DR. ZIEMER: And that they are recorded and -- 

 DR. MELIUS: Right, right, and do that. But --

 DR. ZIEMER: Okay, so it doesn't exclude those 

exchanges --

 DR. MELIUS: No. 

 DR. ZIEMER: -- if needed. If there's a 

question on some point, what did you mean by 

this phrase --

 DR. MELIUS: Yeah, I -- I would think there'd 

be --

 DR. ZIEMER: Yeah. 

 DR. MELIUS: -- that kind of call or --

 DR. ZIEMER: Okay. 

 MR. GRIFFON: I guess the --

 DR. MELIUS: Or where is this proc-- you know, 

I don't understand --

 DR. ZIEMER: Or -- or how do we get this 

document --

 DR. MELIUS: -- this particular procedure, you 

re-- you refer to, you know -- 

 DR. ZIEMER: Right. 
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 DR. MELIUS: -- 2(a) and I don't see this 

listed --

 DR. ZIEMER: Right. 

 DR. MELIUS: -- in 2(a), it's -- you know, 

maybe it's in 3(b) or something, that kind of 

thing is kind of --

 MR. GRIFFON: I certainly understand the 

intent, in two weeks where possible I think 

would be good. I don't want to fall into a 

situation where we're violating that all the 

time. I don't know if we need to -- to parse 

out -- because I think that the workgroup 

conference calls can -- can -- we may not need 

as much time for those. I mean I think -- I 

think where possible is a good addition, and I 

think it's much more important when people have 

to physically go to Cincinnati or -- you know, 

if they can dial in or be on a call, maybe less 

notice is required, but I -- I'm just also 

thinking about the flexibility of being able to 

meet our deadlines. So -- but I guess where 

possible covers us there. 

 DR. WADE: There is another clarification. The 

meetings will be open to the public, and I 

think that's fine. It doesn't necessarily mean 
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that there'll be public participation in the 

meetings. 

 DR. ZIEMER: Doesn't have to be a public 

comment period. 

 DR. WADE: Do we have -- did we have to have a 

public comment period? 

 DR. MELIUS: No, I -- no. 

 DR. WADE: Okay. 

 DR. MELIUS: Open to the public I think is -- 

 DR. WADE: Okay. And that's what I tried to 

say when I --

 DR. MELIUS: Yeah. 

 DR. WADE: -- we spoke before. 

 DR. ZIEMER: Okay. Now let me ask if you are 

ready to vote on this motion, as amended -- 

with the amendments that have been identified? 

 (No responses) 

It appears that we're ready -- comment first, 

John? 

DR. MAURO: I appreciate the opportunity. I 

did not -- but at -- one question I did have 

that did not -- was not clarified I think in 

discussion is -- the word "performance" in 

here, does that mean the performance of any 

work or -- or can I call EVA* up to get a 
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document? I guess that's my question. Very 

often -- or can I call up someone at NIOSH? 

EVA's -- is a contact point we have to get 

documents. Very often we'll need help in -- in 

arranging for meetings with site experts where 

we are required to coordinate with NIOSH 

whenever we do that. Is this -- fall within 

this -- the term "performance"? 

 DR. ZIEMER: I don't think this --

 DR. MELIUS: Not at all, no. 

 DR. ZIEMER: -- is the intent, no. 

DR. MAURO: Thank you. 

 DR. MELIUS: That's... 

DR. MAURO: Thank you. 

 DR. ZIEMER: Yeah. Okay, let's then vote. All 

in favor of this motion, as amended, please say 

aye. 

 (Affirmative responses) 

Those opposed say no. 

 (No responses) 

 And those abstaining? 

 MS. MUNN: Aye. 

 DR. ZIEMER: One. The motion carries. I'd 

like to determine whether Cori is here. 

 DR. WADE: I'm sure she's available. 
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 DR. ZIEMER: Could we get Cori out here 

briefly? Roy? 

 DR. MELIUS: I have one other issue, also, 

which you --

 DR. ZIEMER: Yeah, I'm going to delay you just 

a moment if Cori's here. 

 DR. MELIUS: It's just informational. I hope 

it's not... 

(Pause) 

 DR. ZIEMER: Cori, could you just be available 

just for a moment while we handle our next item 

of business? 

MS. HOMER: Okay. 

 DR. ZIEMER: The Chair recognizes Roy DeHart. 

 DR. DEHART: I have a motion to propose for the 

Board. 

The Advisory Board on Radiation and Workers 

Health, at the 31st meeting, held in St. Louis, 

Missouri, on the 7th day of July in the year 

2005, on the occasion of Ms. Cori Homer's final 

presence in the support of the Board's 

performance and activities, this resolution is 

prepared. 

In the year 1998, or approximately, on the 

Board's formation, Ms. Homer received the 
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charge to provide much of the administrative 

support, a task that she has accomplished with 

efficiency and effectiveness; and 

Further, her efforts have been accomplished 

with flexibility, warmth, humor and dedication 

to the mission; and 

Further, she has been available to advise and, 

when possible, resolve issues to the members 

who must travel with special needs and unusual 

requirements; and 

Further, during the meeting her presence has 

been a source of assurance that even unexpected 

events can be addressed toward the meeting's 

success. 

Therefore, be it resolved that the Board fully 

assembled recognizes Ms. Cori Homer for her 

superior administrative support and assistance 

to individuals and the Board. 

 DR. ZIEMER: Is there a second to the motion? 

MR. ESPINOSA: Second. 

 MR. GIBSON: I would -- I would second that 

motion. 

 DR. ZIEMER: All in favor, aye. 

 (Affirmative responses) 

(Applause) 
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 DR. ZIEMER: (Unintelligible) work. 

 MR. GRIFFON: A few words, I think. 

MS. HOMER: Oh, no --

 DR. ZIEMER: Cori, if you want to say 

something, you'll have to approach the mike. 

Ray wants to record it. 

MS. HOMER: Okay. 

(Pause) 

I'm going to try really hard not to cry. 

Working with you folks the last three years has 

-- has really been, as I indicated before, a 

real experience -- in very many ways. I'm 

going to miss every single one of you. I will 

miss the work, as well, but it is time for me 

to move on, and it will in some ways be 

difficult to move on, in some ways not. I have 

left the Board in the capable hands of LaShawn 

Shields and I believe she will care for you as 

well as I tried to. Thank you very much for 

the last three years. 

MULTIPLE SPEAKERS: Thank you, Cori. 

Good luck, Cori. 

(Applause) 

 DR. ZIEMER: We actually have -- I'm looking 

for items -- do we have any other items that 
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are going to require a vote on, for Mike's 

benefit? 

 DR. MELIUS: I have one that may, but I'm 

hoping --

 DR. ZIEMER: Okay. You may proceed. 

 DR. MELIUS: -- it doesn't. 

 DR. ZIEMER: Proceed. 

 MR. GRIFFON: SEC task order, too. 

 DR. ZIEMER: Oh, SEC task order. 

 DR. MELIUS: Yeah. I would just -- in -- one 

of the issues that came up in the public 

comment period was issues related to conflict 

of interest. And while not commenting directly 

on that -- particular issues that were raised, 

but it did remind me about some issues where I 

don't think we've been quite as vigilant about 

dealing with this as (unintelligible) and 

that's the issue of transparency. And I 

believe it was about a month ago that I tried 

to find SC&A's conflict of interest statements 

on the web site and was unable to find it. And 

I thought we've dealt with this before and I 

don't know if it's been taken care of, but I 

think we should try to make sure that it does 

get taken care of so that those are available -
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- so forth. 

Related to that, I do wish that ORAU would make 

theirs a little less difficult to find. Every 

time I go to look at it -- which is not very 

often -- and I have to hunt around quite a 

while and it'd be nice if there was a link or 

if NIOSH could consider, on their web page, 

having some direct link -- statement where 

people could go and find conflict of interest 

statements. 

 And finally, something I think the Board should 

consider is having our own conflict of interest 

statements, also, up there. Not our financial 

statements, but the conflict of interest 

things, just -- again, for consistency and 

transparency. I -- I think it would -- would 

be helpful to have those available. 

 DR. ZIEMER: Ours can certainly be added, can 

they not, to the web site on -- 

 DR. WADE: I believe so. 

 DR. ZIEMER: I actually thought they were, but 

where do we stand on SC&A and -- are we -- are 

we talking about their web site or our web 

site? 

 DR. WADE: Do you want the SC&A materials on 
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the NIOSH web site? 

 DR. MELIUS: I would just like some place where 

it's easy to find, for people -- for claimants. 

I mean, again, I was unable to find it. Now 

maybe it's available on theirs and I -- 

 DR. WADE: I don't know that John -- I don't 

know, do you have such materials available on 

your web site? 

DR. MAURO: Our conflict of interest plan and 

procedures of course has been delivered and you 

folks have it and it has been finalized. 

 DR. WADE: Right. 

DR. MAURO: That plan and procedure requires 

certain forms to be filled out by everyone on 

the project, and all those forms have been 

filled out and are on file in hard copy at our 

headquarters office. Certainly those could all 

-- I do not believe you folks have copies of 

those forms. That is the forms individually 

signed by everybody on the project. And so --

but certainly if you require that, also, we -- 

provide you with that and that material could 

be put on the -- provided electronically and, 

if you care to, be placed on your web sites. 

 DR. WADE: Is it your suggestion that it be 
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placed on the NIOSH web site? 

 DR. MELIUS: Actually I think the Board had 

requested that some time ago and maybe we -- it 

was miscommunicated, but I certainly think 

that's -- needs to be done in terms of 

consistency and... 

 DR. ZIEMER: It could either be a link to our 

web site to yours, if it's on the SC&A web 

site, or it can be put on ours directly, I 

suppose. 

DR. MAURO: The actual forms, the hard copy 

signed forms, and dated, by every participant 

is in hard copy. 

 DR. ZIEMER: Yeah, okay. 

DR. MAURO: We could of course get it into 

electronic form and deliver -- deliver it to 

you, or put it on our web site -- 

 DR. ZIEMER: I don't know that we need the 

signed forms on a web site. I think it's the 

information --

 DR. MELIUS: The information on the... 

 DR. ZIEMER: -- what are the -- the conflicts 

or --

DR. MAURO: Well, we have a proc-- we have a 

procedure that requires certain forms to be 
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filled out by each individual that would be in 

effect testifying that they -- regarding all -- 

the conflict of interest requirements that 

pertain to our contract, so it flows down from 

our contract. For example, the main -- the 

main provisions are that the individual has not 

in the pa-- has -- does not -- the comp-- 

whether a subcontractor -- or there are several 

 DR. ZIEMER: Right. 

DR. MAURO: -- but the big ones are did not 

defend the government against claims in the 

past. The other one is if the person's working 

as a lead, let's say on the site -- the site 

profile review, that they were not an employee 

of that -- Savannah River, so they could work 

on it as an expert, technical support expert, 

but they cannot provide lead, so there are 

several criteria --

 DR. ZIEMER: Right. 

DR. MAURO: -- and we -- those forms are filled 

out, signed by the individual and they're on 

file. And we keep a record of those -- actual 

a separate form that says who has restrictions 

and what their restrictions are regarding 
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working on the project. All this material is 

on file in hard copy, and it certainly can be 

made available to you folks in any form you 

care to have it. 

 DR. MELIUS: Yeah, I -- I think the format that 

ORAU follows and has used is -- was appropriate 

in terms of what information -- the type of 

information and level of detail and so forth. 

 DR. ZIEMER: Rich. 

 DR. TOOHEY: I'd just like to mention all the 

ORAU forms are posted on our project web page, 

which is www.oraucoc.org. 

 DR. MELIUS: Yeah. No, I -- I realize that. I 

think the -- the issue I was raising was 

getting to them -- understanding where to find 

them, particularly for the site profile reviews 

from the NIOSH web site, is not straightforward 

and I -- so it's -- criticism wasn't of you, it 

was of -- essentially asking NIOSH to -- to 

make all this -- and I think we had something 

saying, you know, here's the Board members, 

here's how you find the -- the forms for ORAU 

and here's how you find the forms for SC&A. I 

think then we -- everybody's -- we're all 

consistent, it's all available, that's all. 
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 DR. ZIEMER: I don't think this requires a 

formal action. 

 DR. MELIUS: Okay. 

 DR. ZIEMER: I think it's understood that we 

all want the information out there. We'll make 

sure it's pub-- publicly available. And if --

we can work with SC&A to make sure it's... 

 Let's see, the -- well, help the Chair out. 

It's getting late in the day. What -- what did 

I overlook? 

 DR. WADE: We want to do the SC&A task order -- 

 DR. ZIEMER: Oh, SC&A task order, yes. 

 DR. WADE: The SC&A SEC task order. Let me 

give you just a very brief report. You have at 

your place a task order that was developed by 

the Board. I transmitted that -- the 

contracting officer has transmitted that to 

SC&A and asked for a proposal from SC&A on this 

material. It was sent on Monday, John. My 

hope is that by the -- by the Board meeting in 

August we should have the SC&A proposal, and I 

would ask the Board to consider that proposal 

at that time. 

 That would require us going into closed session 

to look at the specific costs that will come 
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back to us, and I guess I just alert the Board 

to that. And if there are any concerns the 

Board has, let me know. It would require a 

closed session that I would intend to schedule 

for the August meeting. 

 DR. ZIEMER: Right. And this -- this task 

order -- did we approve the content of this at 

a prior meeting. Is this verbatim? 

 DR. WADE: Yes, it's the mat-- it's the 

material that was provided to me. 

 DR. MELIUS: I have a question on that, and it 

may be that -- it is late and maybe -- I don't 

recall, but item number two, did we ask the 

contractor to develop and draft Board 

procedures? Or proced-- I mean for them to 

develop draft procedures for the review, but 

are they -- I mean the -- implies here they're 

-- they're developing our -- the Board's 

procedures. 

 DR. DEHART: I guess we did. 

 DR. MELIUS: We're asking them to do our own -- 

I mean it... 

 MR. GRIFFON: Well, I guess -- I guess the 

intent was to draft procedures that -- that we, 

along with our contractor, would use to review, 
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but ultimately we have to approve those 

procedures. So I -- I know it's kind of funny 

wording, I think, but -- 

 DR. MELIUS: That -- that's the intent, fine. 

I just --

 MR. GRIFFON: Yeah. Yeah. 

 DR. MELIUS: -- it sort of looks -- it struck 

me when I read this that -- 

 MR. GRIFFON: I mean --

 DR. MELIUS: -- sort of --

MR. GRIFFON: And I think draft implies that 

they supply it to us and then we -- we can 

change the lang-- you know. 

 DR. MELIUS: That's sort of like telling us 

what to do to tell them what to do. I mean it 

just looks a little... Okay, I understand. 

 DR. WADE: But to complete the --

 DR. ZIEMER: This is verbatim from what we 

approved? I -- I honestly don't remember that 

part of it, either. 

 DR. WADE: Well, yes, in my -- it's my hope 

that it's verbatim. I mean Mark wrote it, 

so... I, on your instruction, have developed 

an independent government cost estimate that 

I've provided to the contracting officer. But 
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again, you'll see the proposal and we'll 

discuss the proposal in closed session. 

 DR. ZIEMER: And actually I think we'll have 

the opportunity to -- we -- we can reword this 

slightly if it's not what we want, or -- or we 

can say we're not actually going to task you to 

actually do our procedures. 

 DR. MELIUS: I think my concern was somebody on 

the outside looking at this is going to say 

what is this Board doing, you know, telling the 

-- you know, again, asking a contractor to tell 

us what to do to tell them what to do. This 

whole -- something's not -- 

 MR. GRIFFON: Yeah, you --

 DR. MELIUS: -- quite right there. 

 MR. GRIFFON: -- (unintelligible) you know the 

intent (unintelligible). 

 DR. MELIUS: Yeah, I don't (unintelligible). 

 DR. ZIEMER: Yeah, I -- I think I thought the 

intent was they would draft procedures on how 

they would review the petitions on behalf of 

the Board. 

 DR. MELIUS: Yeah. Yeah. 

 DR. WADE: Okay. So that's the status of 

the... 
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 DR. ZIEMER: Okay, this requires no action 

today, however. 

 DR. WADE: Right. There is one other item that 

I -- I brought to you last time and that is to 

get a sense of the work you would like to task 

SC&A with next year. 

 MR. GRIFFON: Can -- can we -- I'm sorry, just 

to go back to the last item, but one question 

on a closed session. Is there any way -- I 

know we've brought this up before, but I don't 

even know if we'll have any of this information 

beforehand, but I think this is critical to get 

this moving. I mean it's -- in my mind, I 

thought we would have been having a closed 

session by now to approve the proposal, but is 

there any way to expedite this by having a 

phone session? I know we've asked this before, 

and I don't -- I think the answer is that we 

cannot have a closed session on phone. 

 MS. MUNN: That's what we were told. 

 DR. ZIEMER: There was a -- the issue of -- of 

assuring the privacy of the... 

 DR. WADE: SC&A has recently received this. 

They have a month to prepare, so it -- 

 MR. GRIFFON: Oh, okay. 
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 DR. WADE: -- it sort of coincides with our 

August meeting. 

 MR. GRIFFON: So (unintelligible) doesn't 

matter anyway, yeah. 

 DR. ZIEMER: Very good. Thank you. 

 MR. GRIFFON: It's moot. 

 DR. ZIEMER: Lew, I don't -- I -- I think we 

still need to hear from Kathy -- 

 DR. WADE: Okay. 

 DR. ZIEMER: -- and we need to do this, and I 

know she's been waiting patiently. I think we 

should go ahead with the report on the second 

20 -- actually 18 -- cases. Let's do that. 

UNIDENTIFIED: (Unintelligible) 

 DR. ZIEMER: Oh -- then we'll -- we're going to 

come back to this. I think we need to hear 

from Kathy. 

REPORT ON THE REVIEW OF THE SECOND 18 DOSE 

RECONSTRUCTIONS

 MS. BEHLING: Can you hear me? 

 DR. ZIEMER: Make sure it's on. Is the light 

on? 

 MR. GRIFFON: (Unintelligible) hearing it on 

the... 

(Pause) 
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 MS. BEHLING: Okay. Can you hear me? 

 DR. ZIEMER: Yes. 

 MS. BEHLING: All right. So good afternoon. 

I'm Kathy Behling with SC&A and I appreciate 

having an opportunity to present an overview of 

our findings of the second set of 18 cases -- 

case reviews. 

 Since submitting our report to the Board on May 

9th of this year, we've conducted and we've 

held discussions with the two-member Advisory 

Board teams regarding findings associated with 

their assigned cases. I think we've contacted 

most everyone on the Board. 

We've also met with NIOSH on May 31st in 

Cincinnati to discuss their findings -- to 

discuss our findings of these cases, and we, 

during that meeting, attended a -- attended a 

two-day familiarization training on the work 

books at the ORAU facility. And I'll get into 

that discussion a little bit further -- a 

little bit later. 

We also or I also initiated generating the 

matrix for the second set of 18 cases, which I 

have submitted to Mark and I'm sure Mark and I 

will be working over the next few weeks to 
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compile the matrix and submit that to the Board 

within a few weeks. 

I'd like to start by just explaining to you 

SC&A's approach to doing dose reconstruction 

reviews, and this approach parallels what the -

- the Board-approved statement of work to SC&A 

when we started this project. 

 And there's three key elements that we look at. 

First of all we review all of the data that's 

collected for the case and we assess those 

records for the completeness and adequacy for 

use in estimating doses. 

 Second we look at internal and external doses, 

and we first of all take the IREP input sheets 

and we attempt to reproduce all of the doses 

assigned by the dose reconstructor. As you 

heard earlier as we were going through the 

matrix for the 20 cases, I'm sure there were 

times you questioned why we cited certain 

issues, but one of the things we do try to do 

is reproduce each of those doses. Even if 

there's only minor chan-- or differences in 

what we reproduce and what the dose 

reconstructor reproduces, we do cite that or 

bring that to the attention of NIOSH. 
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We assess whether the dose reconstructor 

estimated those doses based on the appropriate 

procedures and guidance documents, and whether 

that dose reconstructor understood and complied 

with the applicable procedures. We also 

lastly, under the dose estimate review, 

evaluate whether the assumptions used in the 

dose reconstruction to estimate doses are fair, 

consistent and well grounded in the best 

available science, as stated in the 

regulations. 

And then lastly, we look at the ComputerAssisted Telephone Interview to evaluate 

whether NIOSH has addressed all of the work 

histories, the monitoring and work practices, 

and incidents and events that were discussed or 

that were addressed or discussed by the 

claimant. If there's any other documentation 

that's available from the claimant, we also 

look at that information and review -- or 

determine whether NIOSH did address anything 

else that the claimant may have provided. 

Now this next slide, here's something you have 

seen quite a few times. This has become a 

reoccurring theme during this meeting, but 
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because of the importance of understanding 

NIOSH and ORAU's approach to the dose 

reconstruction process, I'm going to repeat it 

one more time. 

Initially when NIOSH sits down and starts to 

look at a case they have a group of individuals 

that screen these cases and prejudge or 

categorize them into one of these three -- 

these three categories. And this is important 

to the dose reconstructor because she or he 

will use different procedures or different 

steps in the procedure based on what category 

that case falls under. 

Specifically -- and I won't belabor this 

because, as I said, I know you've heard this 

many times over the last two days -- but the 

minimizing approach is an approach that is used 

when it's determined that there's most likely 

enough data available that the dose 

reconstructor does not need to possibly 

complete the entire dose reconstruction. It's 

considered an underestimating asses-- 

assessment because the -- even with the partial 

data, the POC will be greater than 50 percent. 

And once they've determined that the POC is 
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greater than 50 percent, they can stop the dose 

reconstruction process. 

The second case, the category two, is the 

maximizing or overestimating -- yeah, 

overestimating approach which, again, uses very 

conservative and overestimating claimantfavorable -- sometimes excessively claimantfavorable -- approaches to the dose 

reconstruction. 

And in the third category is the best-estimate 

approach, which obviously is going to look at 

more site-specific data and attempt to use 

information that's as scientifically defensible 

as -- as the information will allow. 

Now this table provides you a list of 18 cases. 

And as you can see, these 18 cases are 

represented by 13 sites, by eight types of 

cancers and a range of POC values. Typically 

they're a little bit higher range of values. 

And I'm going to once again explain to you, in 

each of these cases I looked at that particular 

case -- and you can review these in your tabs, 

and I make examples of the tabs as we go along. 

The -- when you see maximizing external, that 

means that in this particular case on tab 21 
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the dose reconstructor used maximizing 

assumptions. And if I can give you an example 

in tab 21, it just so happens that they in that 

case used -- they took the reported and missed 

annual doses and they multiplied it by a 

standard correction conversion factor of two, 

implementing the ORAU-TIB 8 guidance document, 

and they also took an organ dose correction 

factor of -- they also multiplied organ dose 

correction factor of 1.244 and applied that to 

a 30 to 250 keV photon dose for all years of 

employment. So it gives you an idea of the 

type of overestimating assumptions that are 

applied in these maximizing external dose 

cases. 

And I indicate here also the hypothetical 

internal dose. The -- ORAU has a procedure, 

OTIB 2, which is the maximizing internal dose 

estimates for certain DOE complex claims. And 

this is often used by the dose reconstructor or 

typically used by a dose reconstructor in a 

maximizing case. And what this procedure 

allows the dose reconstructor to do is he has a 

maximum -- a maximum internal dose calculation 

work book, and he can select whether that 
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worker was -- worked at a facility that had a 

reactor, and in that case this work book will 

automatically generate the internal dose 

associated with 28 radionuclides and that's 

what gets entered into IREP. 

 The dose reconstructor can also select a model 

that is a non-reactor site, and that looks -- 

that then takes into account 12 radionuclides. 

This approach of using a hypothetical internal 

dose is only used in maximizing cases where 

you're not going to compensate because it is a 

very ov-- very conservative assumptions built 

in. 

One of the other things I'll point out here, I 

think tab 26 I mention, rather than a 

hypothetical internal, it's an overestimated 

internal. In that particular case that was an 

Iowa case that we had looked at a ways back and 

that case they used -- the technical -- the 

Technical Basis Document which specifies how to 

-- how to calculate internal dose using an 

overestimating approach, so that's why I 

differentiated between hypothetical internal 

because in that particular case they did not 

use the TIB 2 guidance document. 
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Tab 34 (sic) you'll see a partial dose 

reconstruction which was based on external 

dose, and that's the category one, which is the 

minimizing or underestimating dose. They could 

utilize -- in that particular case the dose 

reconstructor was able to reach a POC value of 

greater than 50 percent by just estimating the 

external dose, and so that particular case was 

compensated, both tab 33 and 38. 

Now the only one I haven't touched on is tab 

27, 28 and 30 where you see a best-estimate 

external dose. In this particular case -- this 

is a very good example of a case where the dose 

reconstructor started using a maximizing 

approach for this dose reconstruction. He or 

she must have realized that using that 

maximizing approach and using a hypothetical 

internal dose assessment the dose 

reconstruction -- dose reconstruction resulted 

in a POC value of greater than 50, and the 

procedures that are used in these maximizing 

exposure scenarios and approaches cannot be 

used to compensate. And so therefore this -- 

those three cases had to be reclassified and 

re-- and reworked. The external dose had to be 
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reworked using external -- using a bestestimate. And once they calculated the 

external dose using a best-estimate approach, 

the POC was below 40 percent. 

Okay. Now the next slide, I've taken these 18 

cases and I've -- using the criteria -- the 

approach that SC&A uses in evaluating each of 

the cases, I identified the number of findings 

for each of those different categories by case. 

And as you can see, the external dose is the 

overwhelming majority of -- area where we have 

findings, actually represents about 83 percent 

of the total findings of 113 findings. 

Within that -- that column of external dose, 

the -- over 50 percent of that dose is 

represented by the tabs 27, 28 and 30, which as 

I mentioned in the previous slide were the dose 

reconstructions that were conducted using the 

best-estimate approach. The reason there are 

so many findings under external dose for the 

best-estimate approach because as we began 

working on reviewing these case, we realized 

that the dose reconstructor had used a work 

book. And at the time, SC&A was not aware of 

the use of these best-estimate work books that 
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employ Monte Carlo methods. And so we sat down 

with the procedures and we could not reproduce 

the numbers that the Monte Carlo methods had 

produced. We couldn't reproduce the 

uncertainties using the procedures, although I 

will tell you we got close in some instances. 

So that is why there are so many findings 

associated with those three tabs. It had to do 

with us not being aware of the work books. 

Since then we have -- as I mentioned earlier, 

we have had a two-day familiarization training 

on the work books, and I'll discuss those a 

little bit later. 

 Okay, this chart took those 18 cases and the 

113 findings and I broke down those findings 

based on -- categorized those findings to give 

you an understanding of what those findings 

really represent. And I'm going to start with 

the top, the review -- reviewer could not 

reproduce assigned dose, which is what I just 

discussed. The reason we couldn't reproduce a 

lot of the assigned dose was the use of these 

work books, and I'm going to go 

counterclockwise (sic) and try to give you some 

examples of each of these cases -- of each of 
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these categories. 

The second category is the procedure used to 

estimate doses was not referenced. Again, this 

goes back to the -- a lot of the cases that 

fell under this category goes back to the three 

cases, tab 27, 28 and 30, because based on what 

the dose reconstruction report told us as to 

how that dose was reproduced, we could not -- 

we could not reproduce that dose and therefore 

we had to assume that there was -- that these 

procedures were not properly referenced and 

because the work books are not referenced in 

the dose reconstruction report. 

The next category is procedures error -- 

procedural errors and inconsistencies, which 

represents four percent. And I won't belabor 

this one because I think Hans spoke to this 

issue earlier today and had -- gave you quite a 

few examples. I can point out tab 37 and 

various tabs that do have some procedural 

inconsistencies. If you want to go to those 

tabs and look specifically at those findings, 

tab 37 would be one example. 

 The only other issue I will bring up under the 

inconsistency -- it just happened we had two -- 
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we were -- we were working on an Iowa case and 

we were also working on a Paducah case, and in 

both instances this -- this points out a con-- 

an inconsistency that Hans didn't necessarily 

discuss earlier, but we took notice that in the 

Iowa Technical Basis Document there was a dose 

estimate for the lumbar spine, which 

recommended a dose of 330 millirem to the 

colon. And when we compared that to the dose 

that is recommended for the -- in the TBD for 

the Paducah site, they recommended 2.9 rem for 

that same lumbar spine dose estimate to the 

colon and there's an area of inconsistency that 

is rather significant and -- and we could not -

- you know, could not come to an understanding 

on why that was. 

The next area is unresolved CATI issues. As I 

said, one of our areas of review is looking at 

the CATI report and trying to determine if 

NIOSH looked at all the data provided in that 

report and attempted to resolve any incidents 

and include any -- any of that information in 

the dose reconstruction. In this particular 

case we have a fairly low -- fairly low 

incidence of unresolved CATI issues at six 
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percent. 

The next item is the data collection issues and 

here is also a very small incidence of 

findings. And typically this again will go 

back to a CATI issue. An example is tab 36, 

which the -- the finding is associated with the 

data collection relative to the -- a CATI 

issue. In this case NIOSH -- DOE's reply to 

NIOSH's initial request for an incident 

investigation record -- report failed to 

acknowledge whether the data -- there's a form 

that the -- NIOSH includes with any 

documentation it sends back, and it must 

indicate on that form whether the data was not 

readily available or if the data did not exist. 

And in this particular case, NIOSH had 

requested an incident report from DOE. 

However, they didn't send any information back 

and they didn't indicate whether the data was 

actually available or if it did not exist. So 

it just raised a red flag in our mind as to 

whether the -- all the data was actually 

collected. 

Now this next category is misinterpretation of 

procedures or procedural noncompliance. And 
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again, I won't belabor this issue because Hans 

addressed this earlier. Misinterpretation of 

procedure goes back to these two procedures 

that we routinely see the dose reconstructor 

being confused by, and that's the TIB-8 and 

TIB-10 procedures, which -- the TIB -- these 

are both standard complex-wide conversion 

correction factors for overestimating external 

dose, either associated with TLDs or with film 

badge dosimeters. 

An example of procedural noncompliance is -- a 

good example is one we talked about earlier, 

also, and that was the issue of rarely or if -- 

I don't think we've ever seen a case where the 

dose reconstructor has recorded dose and has 

actually attempted to determine what that 

uncertainty is based on the guidance provided 

in the Implementation Guide 001. It's just, as 

Hans indicated, too complex. And so I 

considered that a procedural noncompliance 

issue. 

Moving on, the inappropriate procedure, method 

or assumption used, there 14 percent of our 

cases -- of our findings fell under that 

category. An example of that would be tab 22. 
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In fact, tab 22 has three findings that fall 

under this category. The first one is -- there 

was what we considered an inappropriate 

assumption used for calculating missed doses 

where -- again, I think this is something we 

talked about during the matrix. In this case 

the dose reconstructor assumed 12 cycles per 

year rather than a quarterly -- quarterly badge 

exchange. And as we noted when we went through 

the matrix on the first 20 cases, we cite 

issues that are not only underes-- overestimate 

-- or underestimates but also overestimates 

because we're trying to look at issues that -- 

we're trying to ensure that these dose 

reconstructions are done in a consistent manner 

and also done in a scientifically sound manner. 

In fact, that leads to the next category -- oh, 

let me finish the -- let me go back to tab 22 

and finish the other two findings associated 

with the inappropriate procedures, methods and 

assumptions. 

The second finding under tab 22 was the use of 

an inappropriate procedure for estimating 

electron doses, at least based on our 

understanding of the procedures. And the third 
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issue was that the dose reconstructor selected 

an LOD value that we could not verify based on 

the Technical Basis Document, based on complexwide procedures. We don't -- we were not con-- 

we could not convince ourselves where he -- he 

or she got that LOD value, so that particular 

tab identifies three findings that fall under 

that type of category. 

The next category is model or assumption 

selection is not scientifically sound. And 

here again at tabs 36 and 37 are good examples 

where the findings that fall under this 

category are typically obviously excessive 

overestimations of dose that cannot be 

justified based on efficiency, and they lack 

scientific merit. For example, the 

hypothetical internal dose model that we were 

talking about, when the dose reconstructor 

selects a model for the hypothetical internal, 

they'll often select that highest non-metabolic 

organ, which was the colon, and in some cases 

they will -- even though the -- the actual 

organ of interest would be available for them 

to select, as opposed to selecting the highest 

non-metabolic, which is the colon. 
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And in addition, they'll often select the 28 

radionuclides, which are associated with 

facilities that have reactors, as opposed to 

when the individual actually worked at a nonreactor facility they could have selected the 

12 radionuclides, which will give a lower dose. 

And so we do cite that as a finding. 

Then the last category is the dose 

reconstructor did not consider all potential 

sources of exposure or the exposure was not 

properly accounted for. And as is obvious 

based on the title of this, in most cases these 

are generally underestimations of dose and 

they're due to judgments typically by the dose 

reconstructor. An example would be in tab 23 

of our report. In that particular tab the dose 

reconstructor did not assign any missed neutron 

dose for that particular case. And based on 

the work locations that the individual worked, 

we felt that it would have been appropriate to 

assign neutron doses. 

 (Unintelligible) see a -- oh, okay, an example 

of exposure not properly accounted for is al-- 

can also be seen in tab 21 where the dose 

reconstructor considered occupational medical 
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exposure. However, he only -- he or she only 

considered it for one year of employment rather 

than an annual X-ray throughout the employment 

period. And so that -- in tab 21 gives you 

another example of exposures not properly 

accounted for. 

 Then finally, to give you a complete picture of 

the breakdown of these findings for the first 

38 cases that we've reviewed, I've compiled -- 

I've added to the second set of 18 cases the 

findings from the first set of 20 cases and 

reproduced this chart. And as you can see, 

there's really very little difference. There 

was one category added, which is a 

calculational error category where I think we 

discussed that this morning in the 20-case 

matrix where there was an input value into IREP 

that was an error -- calculational error that 

was put in there. But as you can see 

throughout these first 38 cases, most of the 

types of findings are very consistent. 

So in summary, I believe that the root cause of 

a lot of these findings have to do with 

procedural issues. The -- as Hans discussed 

this morning, the procedures are somewhat 
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ambiguous. It's obvious that the dose 

reconstructors in some cases are having 

difficulty following them. There are 

overlapping procedures and sort of competing 

procedures. It gives the dose reconstructor 

numerous options as to how they want to go 

about calculating the dose. 

 A good example -- well, an example of various 

options that can be used is -- can be seen in 

our tab 27. The -- in that particular case I 

believe we've included a table that indicated 

the variations of calculating the on-site 

ambient doses and the -- the Technical Basis 

Document gives you about three or four options, 

plus you have other procedural options. And 

when you get right down to it, the dose 

associated with those options -- there's very 

little difference in the dose and, again, this 

is one of those issues that does not seem to 

comply with an efficiency or timeliness 

process. 

The third root cause finding under the 

procedures is procedure inconsistencies and 

errors which, again, Hans discussed this 

morning and I won't belabor that. 
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Another category of what we consider root cause 

findings are judgments or assumptions that are 

made by the dose reconstructors. As I pointed 

out, there are -- failure to consider all 

potential sources of exposure -- it's typically 

a judgment issue. The dose reconstructor reads 

-- or looks at all of the documentation and 

where the individual works, and in a lot of 

cases we feel he -- he or she should have 

considered neutron doses when maybe they 

didn't, or should have considered additional 

missed photon dose. It's -- it's just an issue 

of -- of a -- of a judgment call by the dose 

reconstructor which differs from what we think 

would be a more appropriate judgment. 

Again, failure to properly account for all 

doses. I gave you an example of that. 

Selection of model and parameters that are not 

scientifically sound. In this particular case 

it results typically in an un-- an 

overestimation of dose, but we still feel that 

based on what is required under the regulations 

that the dose reconstructor should be 

consistent and scientifically sound in making 

their judgments when it doesn't necessarily 
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impact efficiency. And many of the procedures 

do have tables and appendices that allow that 

dose reconstructor to select line items such as 

the example that I use, as opposed to -- when 

they're calculating an internal dose as opposed 

to using the colon, they do have the option of 

using a prostate or a breast as the organ of 

interest, which may be the actual -- they 

should select the actual organ of interest for 

that particular case in -- in our way of 

thinking, even if that is a less claimantfavorable dose that results. 

And lastly, the selection of inappropriate 

procedures or methods for assigning doses, and 

I believe this speaks back to the procedural 

issues. And once we go through our iterative 

process of trying to identify inconsistencies 

and clarifying the procedures, this may be an 

item that will -- where we'll see a reduction 

in the findings. 

Now I -- one of the things I wanted to point 

out throughout this is -- to date, the impact 

of the dose reconstruction audits that we have 

done -- the majority of these dose 

reconstructions, in fact the large majority, 
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have been maximizing approaches to dose 

reconstructions. And therefore, even if we 

find areas where we feel there was missed 

photon dose, a missed neutron dose that wasn't 

accounted for, it has very little impact on the 

potential for affecting a change in 

compensability because this approach cannot be 

used for compensation. If that dose were to be 

considered, if -- if NIOSH agrees, as in one 

particular case we -- they did agree that there 

may have been some neutron dose that wasn't 

accounted for. However, if that would have put 

that dose reconstruction over 50 percent, the 

dose reconstructor would have had to go back 

and reclassify that particular case as a bestestimate approach and they would have attempted 

to -- usually they'll start to go into -- 

they'll first of all go into the external dose 

because it's a little bit easier to refine that 

dose. And if that gets that particular case 

below the 50 percent -- to 50 percent, then 

that -- that will be adequate for that dose 

reconstructor. He can stop at that point. But 

it's important for you to understand that 

currently the impact that our audits have had, 
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although they have not changed -- they have not 

impacted changes in compensability, I think 

they have still pointed out areas where the 

procedures need to be clarified and there is 

some room for the -- for improvement. 

Now when we start getting into cases that are 

much -- that -- that -- where the do-- the dose 

reconstruction is being -- is -- is being done 

using best-estimate approaches, then I believe 

that our findings may be more significant. 

Now with that being said, we have had 

familiarization training on the work books and, 

based on our understanding of those work books, 

it appears that NIOSH is preparing for doing 

more of the best-estimate doses. And the work 

books utilize a lot of the information in the 

site profiles and allow that dose reconstructor 

to take a work book and the -- a lot of the 

site-specific information that comes from the -

- from the Technical Basis Document is part of 

that work book and will possibly help to 

eliminate a lot of the misinterpretation of 

procedures that we're seeing in our -- in a lot 

of our findings. 

 However, it's important to note that SC&A or -- 
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or -- there's only 2.5 percent of the dose 

reconstructions are expected to be audited as a 

part of this task four, so therefore it is 

important that we take corrective actions in 

behalf of the other 97.5 percent of the claims. 

And I believe that sum-- that summarizes my -- 

and if you have any questions, I'd be happy to 

answer them or if Hans wants to -- I don't know 

if Hans wants to add anything to my 

presentation. Okay. 

 DR. BEHLING: Yeah, just as a comment, I think 

Kathy just summarized it in a final slide, the 

impact of our findings -- and of course they 

were quite a few -- seem substantial, but right 

now we all know that the maximized doses are 

very much immune to -- to errors because 

there's so much fat built in there. I think 

Kathy tried to summarize this in one of the 

particular cases where we feel that in one 

instance the missed neutron dose may have 

amounted to about 12 rem, possibly, if you were 

to collate all of the missed neutron doses, et 

cetera. 

On the other hand, that particular case had a 

hypothetical internal dose of about 15 rem, and 
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of course this person had no indication of 

having been exposed. There was no data on 

internal exposure from bioassay data. So had 

that additional neutron dose pushed him over 

the limit, the first thing that would have 

happened is that -- well, I guess we're going 

to have to take away your hypothetical, so we 

would have ended up with the same dose as we 

would have without the correction. And this is 

the -- the immunity of maximized doses from any 

findings. The -- the real test of dose 

reconstruction in terms of precision and 

accuracy will come when we deal with bestestimate doses. 

 DR. ZIEMER: Thank you. Thank you, Kathy. 

 DR. WADE: Yes. 

 DR. ZIEMER: I -- thank you very much. One 

comment, in the future -- it might be helpful 

if we do some of these pie charts in the future 

to be consistent both with color and location. 

It would be much easier to -- it's a little bit 

 MS. BEHLING: I meant to apologize for that. 

realized that afterwards, I -- 

 DR. ZIEMER: You're aware of it then. Thank 

I 
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you. 

 MS. BEHLING: I do apologize. I should have 

kept them consistent. 

 DR. ZIEMER: They're very colorful, however. 

Gen Roessler. 

DR. ROESSLER: I have a comment and then a 

question. My comment is that I attended the 

subcommittee meeting in Cincinnati recently 

when these cases were presented, and I was 

really impressed with the procedure. I think 

this is a very effective way of looking at the 

audit summary of the dose reconstructions, and 

then hearing NIOSH's interaction, it just seems 

very effective and I think a lot can be learned 

from this. 

My question I think is directed toward Mark. 

As I sat there at the meeting and went through 

the big notebook and saw the amount of detail 

that went into the review of these dose 

reconstructions, I kept thinking what's going 

to happen with the advanced dose 

reconstructions? What more is going to be 

done? And I went back to when this was all 

defined and I think one of the things that will 

happen with the advanced is that the contractor 
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will do more searching for data to see if 

there's any data that's missing. But then what 

else is going to happen? Can -- can you 

enlighten me, Mark? 

 MR. GRIFFON: I'm -- I'm not sure. I mean one 

-- one cri-- I think one part of it -- I'd have 

to look back at the scope myself, but one part 

I think is the -- the data question. Verifying 

the source data I think was -- was one area 

where we expected that. I -- I think -- you 

know, we -- we've -- some of that is happening 

in site profile reviews, so there might be some 

overlap there, too. But I -- I think that's 

one area. I think the -- I think the best 

estimates, as Kathy described, will be the more 

extensive reviews, just by their nature 'cause 

they're more detailed assessments. But I'm not 

sure ex--

 DR. BEHLING: Yeah, let me --

 MR. GRIFFON: -- how much we're going to add 

onto an advanced review in reality, you know. 

 DR. BEHLING: I think the real test for the 

auditor will come in looking at the internal 

doses. Right now most of the internal doses 

have been relegated to the hypothetical 12 or 
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28 radionuclides, which is a simple code that 

we run. We look at the numbers, we say yes, 

these are -- and the only findings we had up to 

this point in time is the use of a surrogate 

colon organ when in fact they should have used 

let's say the rectal tissue, which is the issue 

-- the tissue of interest and so forth. But in 

the future when best estimates will have to 

address internal exposure, we're going to have 

our work cut out, as well as of course NIOSH 

will. When you look at urine data, when you 

look at chest counts, when you look at whole 

body counts and you have a guy who's worked 

there for ten, 20 years and you're trying to 

assemble his bioassay data and make sense of 

it, there's going to be a lot of subjective 

thinking here. And -- and the IMBA code is not 

as prescriptive as might be. There's a lot of 

room for judgment here, and of course we'll 

have to look at this and saying is this a 

claimant-favorable judgment, how do you 

interpret your bioassay data, is it done in a 

claimant-favorable way. This is going to 

escalate by orders of magnitude in terms of 

sophistication, both for the dose 
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reconstructors as well as for the auditor. 

 MR. GRIFFON: I -- I guess another way -- I'm -

- I'm just reflecting on Kathy's presentation 

and one possible example where the advanced 

review might differ in this case is that that 

form that they found where they -- it was a 

data request to DOE about an incident report, 

and there was no indication as to whether it -- 

you know, they didn't get the document, but it 

wasn't clear whether it was available and not 

provided by DOE or it wasn't available. And I 

think on that kind of -- that might -- in an 

advanced review we might ask SC&A to say -- 

follow through on that and see -- you know, 

what -- was it one or the other, what happened 

to that and is it available and would it have 

impacted the case. So I guess if I had to draw 

an example -- but I think Hans is right, too, 

on the -- on the best estimates I think we're 

going to get into more of the internal dose 

questions where you have to... 

 MS. BEHLING: And if I can just interject, yes, 

these first 38 cases have been basic reviews. 

But as I started out by saying, we do try to 

reproduce all the doses and we sit down 
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initially with the IREP input forms. And to 

reproduce the dose, you need to go through this 

extensive process. 

I believe that in addition to -- in the 

advanced reviews, which is our next set of 22 

cases, as Mark indicated, we have a little bit 

more latitude to possibly go to or contact the 

DOE facility to try to get documentation that 

NIOSH maybe did not get. 

I also believe there's a little bit more 

latitude with regard to information that we may 

find in the CATI reports. I believe we can 

possibly contact coworkers or if there's a 

discrepancy there we -- we can go a little bit 

further with the CATI reports, based on the 

guidance that was provided to us for the 

advanced reviews. 

 DR. ZIEMER: Jim. 

 DR. MELIUS: Yeah, I'm not a member of the 

subcommittee, but maybe somebody could help me 

out a little bit in terms of this issue of, you 

know, where's the appropriate place for us to 

put our resources in terms of this review. 

Seems to me that this work book concept, which 

I now understand a little bit better and I 
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understand why NIOSH and their contractor is 

taking that approach, but at the same time it 

certainly raises the possibility that an error 

in a site profile gets carried over to a work 

book, which can then have a very significant 

effect on a whole series of dose 

reconstructions with, in some ways, less 

opportunity for the dose reconstructor to catch 

that error 'cause it will not be as transparent 

or involved a process. Now it's good 'cause it 

-- it's much more efficient for them and I 

think we want that. At the same time I think 

it -- it does raise issues regarding potential 

for -- for errors and sort of where we go if -- 

if a problem is undiscovered from a site 

profile it's going to get carried through this 

process and could potentially affect very 

significantly a number of these, you know, 

best-estimate dose reconstructions and 

therefore affecting some of the outcomes. So 

have -- has the subcommittee discussed where we 

go in terms of resources and priority? 

 DR. ZIEMER: Jim, excellent question, and let 

me in a sense postpone the answer for a few 

moments 'cause we're going to hear from John 
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Mauro in just a few minutes and this will 

relate to particularly the topic of note books 

and some tasking that we might have before us 

for our contractor that would address that very 

question. But it certainly is a pertinent 

question to -- to follow up now, not only on 

the dose reconstructions but on the procedures 

review itself. 

Let me see if there's other questions for 

Kathy. 

 DR. WADE: Kathy, where are we in terms of the 

next round of reviews? Just could you fill us 

in on status? 

 MS. BEHLING: Actually we have just really 

started doing the next round of -- I think 

we've looked at about two of them. 

 DR. BEHLING: We are -- I -- I had hoped to 

have been well into the next 22 cases, but due 

to the changes in -- in -- in interests 

regarding some of the TBDs I was drafted into, 

I've had to forego some of my time and -- and 

not dedicating too much to those cases -- 

 DR. ZIEMER: Understood. 

 DR. BEHLING: -- but I hope to, as soon as -- 

in fact, starting tomorrow we'll get back into 
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the next 22 cases. And unless there's some 

recommendation that perhaps we may not want to 

even do that, but I think that's a topic for 

discussion by the Board. 

 MS. BEHLING: If I can also just expand on the 

work books, one of the things I intended to say 

on the tab 27, 28 and 30 that I talked about at 

length that indicated that it was a best 

estimate for the external dose, there were 

quite a few findings that SC&A had because we 

couldn't reproduce all of those doses. And 

once we have an opportunity to take a more 

thorough look at that particular work book, 

which happens to be the Savannah River Site 

case, many of those findings may be withdrawn. 

But to us I think it's very important that we 

have a -- a full understanding of the work 

books. And as you indicated, Dr. Melius, if 

the Technical Basis -- the work books seem to 

be being developed as the Technical Basis 

Documents are developed, and it is -- it's 

actually a very good approach for the dose 

reconstructor to -- for consistency purposes 

and ensuring that the site-specific information 

is incorporated into one -- one work book, 
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which would -- certainly helps them. But right 

now we don't fully understand those work books 

and I do think that's an important aspect and 

we will contin-- we will, at least in these 18 

cases, look at the work book associated with 

the Savannah River Site to get a much better 

understanding of that. 

 DR. ZIEMER: Thank you. Other questions for 

Kathy? Okay, thank you very much. 

Now let me just point out where we are in the 

scheme of things here. We have a task three 

follow-up document, I think, to act on, do we 

not, from out of the subcommittee? Am I 

correct? 

 MR. GRIFFON: Talking about the matrix? 

 DR. ZIEMER: Help me remember what -- yeah. 

 MR. GRIFFON: I mean I think we wanted -- I 

think we wanted to just discuss the process for 

going forward with --

 DR. ZIEMER: Right, for task three. 

 MR. GRIFFON: -- accord-- to -- yeah. 

 DR. ZIEMER: We have -- we -- we need to hear 

from Larry Elliott yet on the status report. 

That can -- Larry can make that pretty brief, I 

know. Right? We have --
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 DR. WADE: Well, we can also forego that. 

 DR. ZIEMER: It's a program update. 

 DR. WADE: Right. 

 DR. ZIEMER: Also --

 DR. MELIUS: Can I e-mail my usual questions to 

Larry? 

 DR. ZIEMER: Also I -- I guess there's tacit 

understanding, but we need to make clear what 

the next steps are on the -- the 18 cases that 

Kathy just reported on. I think there's an 

assumption that we would proceed in a process 

parallel to what was done in the first 20 cases 

where we get the NIOSH responses and -- and -- 

and go through the matrix and basically I think 

that's the expectation of both NIOSH and SC&A. 

Does that require any specific Board action for 

that to proceed or can we take it by consent 

that that process will move forward as it was 

done previously? 

 MS. MUNN: I thought we'd established that at 

our -- at our second round, that that's -- 

 DR. ZIEMER: I believe that's been put -- 

 MS. MUNN: -- the way we were going to proceed. 

 DR. ZIEMER: -- in pace -- place. I just want 

to make sure everybody's comfortable that 
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that's what will happen and that -- 

 MS. MUNN: Unless --

 DR. ZIEMER: -- we will move forward in -- 

 MS. MUNN: -- we decided we were going to 

change our procedure. 

 DR. ZIEMER: Was that the understanding of both 

the contractor and NIOSH, that we would proceed 

on the second 18 cases in a manner similar to 

what we did with the first 20 in terms of going 

through the matrix process, the NIOSH responses 

and --

 MR. GRIFFON: We -- we started already but, you 

know --

 MR. HINNEFELD: Well, we -- we can certainly -- 

 DR. ZIEMER: Yeah, under way already, yes. 

 MR. HINNEFELD: We expect that we would do 

that, I think. 

 DR. ZIEMER: Right, thank you. 

 MS. BEHLING: And in fact I believe that 

process --

 DR. BEHLING: (Unintelligible) pretty far 

along. 

 MS. BEHLING: -- has been started, our meeting 

in Cincinnati on the 31st of May. 

 DR. ZIEMER: Yeah. Just make sure that the 
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Board is aware that this -- 

 MS. BEHLING: Yes. 

 DR. ZIEMER: -- will continue and will come to 

a closure time similar to what we did earlier 

today on the second 18. 

Does the group wish to have a break, or do you 

want to plow ahead? 

 DR. WADE: Well, I wonder about John's 

availability, though. I... 

DR. MAURO: Yes, I have a relatively brief 

presentation that it would be helpful to me if 

we can take care of that now, if that's okay 

with... 

 MR. GRIFFON: You know, I -- I do have one 

question, though. I -- I'm worried that you've 

got public comment on the agenda and I -- 

 DR. WADE: At 4:15. 

 MR. GRIFFON: -- I fear that we're not going to 

have a quorum 'cause a lot of us have -- I know 

that I have a 7:00 o'clock flight and so I 

don't know if -- if there's people that are 

signed up, maybe we should -- 

 DR. WADE: I think --

 MR. GRIFFON: -- instead of --

 DR. WADE: -- we should hear John while he's 
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here. 

 MR. GRIFFON: Okay. All right. 

SC&A CONTRACT ISSUES

 DR. ZIEMER: Okay, John Mauro. I think John 

just has like one slide. 

(Pause) 

DR. MAURO: My slide is not here. Unless I'm -

- I don't see it. 

 DR. WADE: Well, it has been handed out, John. 

(Pause) 

 DR. ZIEMER: John's slide is a -- what would 

look like an organizational chart. It was I 

believe e-mailed to the Board members earlier. 

UNIDENTIFIED: Correct, nobody's got it. 

DR. MAURO: Okay. Well, we'll -- we'll make do 

with the -- if everyone has a -- 

 DR. ZIEMER: We have copies, John. 

DR. MAURO: You have a hard copy and I think we 

can work with the hard copy. What -- what this 

-- everyone should have in front of them this 

one -- this little chart. What -- what -- what 

this represents is -- as a result of the work 

we've done over the past year and a half, we 

all know -- and we're -- we're in the home 

stretch. That is, we're going to be through 
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with the period of performance for all our 

work, for the four tasks, by the end of 

September. And what we really have is 22 

additional cases to do. We've got three more 

site profiles, and we will have accomplished 

fulfilling our mission for the first four 

tasks. 

What this chart is is over this year and a half 

we asked ourselves -- we regrouped about two 

weeks ago and said listen, can we be doing our 

work in a better way, are there other things 

that we should be doing or do things in a 

different way than we did over the past year 

and a half. You know, we have our four tasks. 

And the question becomes do we need to change 

anything to -- to help the Board accomplish its 

mission in a more efficient and effective way. 

Well, what I did is I asked myself the question 

well, is -- is NIOSH's dose reconstruction 

process changing, and if it is changing in a 

way that -- does that mean that we need to 

change the way we go about our business of 

auditing and reviewing their work. And the 

answer to that is yes. And this chart is my 

attempt to capture the changing nature of the 
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activity -- the dose reconstruction process 

that NIOSH has employed in the past and how 

it's changing and it's going into a new 

direction. 

Let -- let me explain this chart. You'll 

notice on the top half of the chart is a box 

that's -- where I make reference to minimal use 

of site profiles, and a box right beneath that 

that says original sets of procedures, and the 

to the right is arrows pointing to primarily 

min/max dose reconstructions. What that says 

is in the past -- and based on our review of 

the cases that we've just heard, the 38 cases, 

what's been -- what we see is that the -- the 

cases we've been looking at have been primarily 

min/max type analyses as opposed to these 

realistical (sic) best estimates. And -- and 

in order to perform those dose re-- dose 

reconstructions, the -- NIOSH has made -- 

basically has made use of, of course, its site 

profiles, but made minimal use because using 

the min/max approach you don't really have to 

get into the nuts and bolts of the details. 

And in addition, they have their sets of 

procedures. 
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Now -- so our work has been to review this -- a 

selected number of site profiles, review their 

procedures -- and you heard about that today -- 

and of course review the dose reconstructions 

themselves. And what we found is that yes, 

there -- we find a long list of findings in 

regard to the -- the site profiles themselves, 

a long list of findings related to the 

procedures that were used, and of course -- 

this is re-- we all saw how -- are making 

certain findings related to the actual dose 

reconstructions. Now -- and -- and you have 

all our reports and everything's before you and 

now we're actually in the process now of trying 

to achieve some closure. So to me, 

everything's proceeding as planned. 

But then I asked myself where -- where were we 

falling short or where may-- may be some 

weaknesses in -- in what we've been doing, and 

-- and maybe we should think about a new way of 

doing things. And one of the first things that 

comes to mind is that when we review a dose 

reconstruction, as described by Hans and Kathy, 

we -- we really emphasize the procedures that 

are being used, the written procedures, trying 
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to understand what those procedures say. We 

don't -- when we review the case -- the actual 

cases, we read the site profile and the 

supporting TBDs, but to the extent we can, we -

- we get a feel for whether or not it looks 

like they've got a good scientific basis for 

their -- for the -- to base their dose 

reconstruction. But most of the time, the on-- 

there's only one set of actual cases where -- 

that we reviewed where we benefited from the -- 

the site profile review and that was Bethlehem 

Steel. So that -- in fact, one -- one of the 

first sets of cases -- and in fact I reviewed 

those cases -- had to do with Bethlehem Steel 

and I was fortunate enough to be able to stand 

on the shoulders of all the folks that did the 

review of Bethlehem Steel. We were -- now 

that's not the case for just about any of the 

others. That is, most of the other studies 

that -- dose reconstructions that was reviewed 

were being done about at the same time that 

some of the site profiles were reviewed. So 

what happens is our commentaries and findings 

certainly reflect the deficiencies or issues 

that we raised as described by Hans and Kathy 
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really don't fully reflect perhaps some 

problems might -- that might exist in many of 

the site profiles that -- that are being 

described and discussed at these meetings, 

also. 

See, there's a -- we have a disconnect. That 

is, we could probably do a better job if we had 

more of the site profiles under our belt. And 

as we do more and more site profile reviews, 

we're going to be in a better position to -- to 

do a more thorough review of the actual cases. 

Now -- now what's happening, though, is we -- 

we have all these findings, 103 findings on the 

last 18 cases, but what we found out is none of 

them really -- as Kathy pointed out, though we 

have these findings, the -- and the root cause 

of many of these findings go back to the 

procedures. Well -- and some problems that 

we're finding with the procedures, but they 

really have no -- have not had a profound 

effect on the outcome of what we've reviewed so 

far because the min/max cases are really pretty 

robust. They -- you -- it's really hard to 

flip any of those, so -- so -- but, now here's 

what -- now we're going to move to the bottom 
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half of my little chart here. Okay? 

 What's happening now is NIOSH is moving out of 

a mode of min/max and they're moving into a 

mode of doing realistic cases. Okay? The 

tough ones. Okay? The low-hanging -- they're 

getting away from the low-hanging fruit. But -

- and -- and -- and what's happening now is -- 

so NIOSH is moving away -- now what's happening 

is in order to support that, lot -- lots more 

Technical Information Bulletins are being 

prepared to supplement the -- the -- the site 

profiles because they have to address more and 

more sophisticated issues. More procedures are 

being written and the whole methodology for 

doing dose reconstructions get -- are -- are 

maturing and getting more and more 

sophisticated, to the point where -- to make 

sure that they're being done correctly, 

quickly, efficiently, to do realistic estimates 

they need work books. So the work books are in 

-- are moving in place. And so all of a sudden 

the mode of operation, as I see it -- and you 

know, our -- our view of the world is now -- 

NIOSH is shifting away from let's say just 

using the simple site profiles, the simple sets 
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of procedures to do min/max calculations. Now 

they're moving into much more sophisticated 

work books, spreadsheets, you -- more advanced 

Technical Information Bulletins in order to do 

best estimates or realistic analyses. 

Now, so what -- what does that mean? Okay. If 

-- if they're moving into that mode of 

operation, we have to move into that mode of -- 

mode of operation. And what does that mean 

regarding our tasks? The tasks, as we've 

crafted them to date, are inadequate to meet 

that demand. And what I see is -- in the 

future to -- is tweaking task one and tweaking 

task four, and let me explain what I mean by 

that. 

I see -- let's say we -- we're going to move on 

and do a review of another site profile. I 

think that -- and -- I think that in the 

process of reviewing the site profile we should 

also review not only all the TIBs that go with 

it 'cause they have all these supplements that 

are always being added, but we should also be 

reviewing the work books that implement that 

site profile because the work books really come 

in two types. There are generic work books 
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that sort of cut across the board, but there 

are also work books that are primarily sitespecific. There are INEEL work books, there 

are Savannah River work books. And so what I 

see is -- in the future as being very important 

is review your TBD or site profile reviews and 

their supporting Technical Information 

Bulletins, but simultaneously review the work 

books to see the degree to which the work books 

faithfully capture the guidance contained in 

the TBDs, so this -- because the work books, as 

far as I'm concerned -- the site-specific work 

books -- are really part and parcel of a TBD. 

They're part of the instructions and guidance. 

In fact, the work books appear to me to be 

coming where the rubber meets the road. 

This is how they're going to -- how dose 

reconstructions are going to be implemented. 

So it seems to me that when we're reviewing a 

site profile we should also be reviewing these 

work books and spreadsheets. But I'll take it 

a step further. 

 When we're reviewing the work books, I think we 

should also be reviewing some cases. Now this 

is a difficult problem, but you see, it's 
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really a three-step process. You -- you come 

up with the -- detect the science, the approach 

in the work book and TIBs. You convert that 

into a work book. Then the next step is they 

take the work book and they implement it and 

they do some -- they do some ca-- some 

realistic cases. And they say we're not doing 

min/max now. It was on with the real thing 

now. And in my mind, we have to integrate. We 

have to cut across the -- the three separate 

tasks that we have now where we're separately 

looking at procedures, separately looking at 

TIBs -- Technical Information Bulletins, and 

separately looking at dose reconstructions. I 

think that is -- I think that it -- we would 

benefit greatly and it -- and I'll tell you why 

-- what the great benefit is. It's going to 

make these much more -- we're going to come to 

closure much more quickly. 

So we have this long list of findings. Right? 

I mean list of findings go on forever on -- on 

whether we're reviewing TIBs or reviewing 

procedures or reviewing dose reconstructions. 

If we integrate the three, we're going to find 

out what's important and what's not important, 
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because we're going to be -- in fact, in a way, 

this happen -- it's happening on Mallinckrodt. 

That's exactly what we're going to be doing on 

Mallinckrodt. We're looking at some real cases 

'cause we -- we have to validate that the 

procedure that's been laid out -- whatever that 

procedure is that's being developed -- is in 

fact implementable and works. So it seems to 

me that that -- that is -- that just emerged 

out of this process we're in. I mean it wasn't 

by design. We sort of came to that consensus, 

this is how we're going to get through the -- 

the Mallinckrodt issue and this -- of course 

that was for an SEC, but I see that -- in a 

similar way, we need to cut across. 

So my first recommendation is, in light of the 

new -- to shift toward work books. I -- I 

think that whenever we do review of a site 

profile under task one, it should also include 

work books and it should also include at least 

a selected handful of cases which are 

deliberately selected because they're best 

estimates so we could -- so we could find out 

whether the -- the process from cradle to grave 

is working, and whether or not it's an 
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efficient process and what -- and what issues 

are important. So that -- that's one of my 

first recommendations on how to do things 

differently, and it's all triggered because of 

moving from min/max to best estimates, and 

we're moving away from let's say just hand 

calculations or follow procedures and be -- and 

using these spreadsheets and work books. So I 

would tweak task one to do this full -- this 

flow I just described. 

With regard to task four, which is our site -- 

I -- I think if we continue to do our two and a 

half percent, but I think we've got to get away 

from the min/max cases. You see, we've done -- 

we've done 38 cases. We're coming back with 

the same results over and over again, over and 

over again. So I mean it's almost like we -- 

we can do them, but are we really adding value 

now. 

It seems to me that an effort -- when -- when -

- when the cases are selected, when you go 

through your case selection process and you 

have your criteria -- you have all your 

criteria -- well, I think one of the criteria 

has to be is it a best-estimate. In fact, when 
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I was talking to Paul the other day and Paul 

said well -- well, doesn't -- well, if it's a 

45 percentile POC, 'cause that's one of your 

criteria, POC, wouldn't that automatically make 

it one that's probably realistic. The answer 

is no, not necessarily. In fact, most of the 

times no. So part of your selection process 

should be specifically make sure we get some 

realistic ones in there 'cause I don't think 

we're going to get -- that we're going to get 

very much more out of our audits of min/maxes. 

We're going to start to really get -- we're 

getting a lot more out of reviewing the -- the 

-- the best estimate cases. 

So my second recommendation is that we -- when 

-- when the cases are selected for task four, 

the next round, that an effort be made to get 

some realistic cases in there so we could 

really test it, you know, as opposed to just 

these min/max. So I mean I -- that really is 

the essence of the point I wanted to make and 

some of my thoughts on looking to the future 

and perhaps changing the way we're doing things 

a little bit. Thank you. 

 DR. ZIEMER: Thank you very much, John. And it 
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immediately poses a question. In fact I asked 

John this, also, and I'm not sure we knew the 

answer to it, but perhaps Stu or Jim could 

answer this. Do we have a way, a priori, on -- 

on closed cases of determining -- you know, we 

know what sites they're from and we know POCs 

and so on. Can we tell in advance whether it's 

a best-estimate case, or can we readily tell 

whether it's been a min/max versus a best 

estimate as a sorting tool? 

 MR. HINNEFELD: We -- we have a way to select 

that choice, but it's a -- the field is 

populated by the approving HP at the time he 

approves the dose reconstruction. He -- he 

decides is this an internal overestimate, 

internal both, internal -- you know, 

overestimate, both internal and external. And 

so they choose in that fashion. And probably a 

best-estimate is chosen fairly reliably. Now 

the reason I say that is we can pull up cases 

from that field -- you know, final cases with 

that field that's saying best estimate, but it 

may require a manual look to determine if a 

work book was really utilized in that approach. 

Okay? 
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 DR. ZIEMER: Yeah. 

 MR. HINNEFELD: So it would be sort of a twostep selection. 

 DR. ZIEMER: And we don't have to come to 

closure on that today, but I wanted to find out 

if it's at least feasible to have that as a 

selection criteria, and I think you're saying 

it probably is feasible. 

 MR. HINNEFELD: It might be a two-step, and 

there's some Board working group members would 

probably want to look and see -- I would see -- 

I don't want us to do it because then we would 

potentially censor it -- 

 DR. ZIEMER: Right. 

 MR. HINNEFELD: -- so -- so a working group 

member perhaps look at the -- 

 DR. ZIEMER: Right. 

 MR. HINNEFELD: -- pulled on the -- you know. 

 DR. ZIEMER: Right. And --

 DR. BEHLING: Actually, Dr. Ziemer, if I can 

add something. 

 DR. ZIEMER: Sure. 

 DR. BEHLING: In principle we should have been 

able to do that on the basis of POC. But as we 

now know, that has not been a successful 
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criteria. If you look at -- 

 DR. ZIEMER: Right, that's why I'd asked -- 

 DR. BEHLING: Yeah. 

 DR. ZIEMER: -- John that originally 'cause I 

think we thought that --

 DR. BEHLING: Yes. 

 DR. ZIEMER: -- would capture these when we 

selected that -- the area -- 

 MR. GRIFFON: Or I think --

 DR. BEHLING: Yes. 

 DR. ZIEMER: -- just below 50 percent. 

 MR. GRIFFON: I think we had asked before 

whether we could --

 DR. BEHLING: Well, let me -- let me --

 MR. GRIFFON: -- come up with some criteria -- 

 DR. BEHLING: -- explain something -- 

 MR. GRIFFON: -- for efficiency, but I think 

we're asking the better question now, you can 

sort by --

 DR. BEHLING: Well, and let me explain 

something. If you look at Procedure 6, ORAU 

Procedure 6, it does in fact state that if a 

best estimate exceeds 30 percent POC, it should 

be converted into -- a maximized procedure 

exceeds 30 percent it should be redone as best 
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estimate, which is not currently being done. 

So the procedure that exists currently is not 

being used. So any time you maximize a dose 

and the POC exceeds 30 percent, the procedure 

calls for revising that estimate and turning it 

into a best estimate. And so I'm sure in the 

past when we have selected -- when the Board 

has selected these cases and looked at -- oh, 

here's a case that's 42 percent, the -- the 

illusion is that it must be a best-estimate, 

otherwise --

 DR. ZIEMER: Right. 

 DR. BEHLING: -- you wouldn't have gotten 

there. 

 DR. ZIEMER: Right. 

 DR. BEHLING: But the truth is, that 42 percent 

should have never occurred to a maximized dose 

reconstruction based on the procedure 

requirement that says any time you exceed 30 

percent you convert it to a best estimate. And 

there's -- there's multiple benefits to that. 

One, you don't obviously give the false 

illusion to the claimant that oh, my God, I got 

very close. I think there's a multitude of 

benefits from doing --
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 DR. ZIEMER: Right. 

 DR. BEHLING: -- exactly that, but it's not 

being used. 

 DR. ZIEMER: Right. So the -- the tweaking of 

task four is more realistically a change in our 

selection criteria rather than a change in the 

task. 

DR. MAURO: Exactly. 

 DR. ZIEMER: Whereas the tweaking of task one 

may be more than a tweak. 

 MS. MUNN: Sounds like it. 

 DR. ZIEMER: May be a double-tweak, but it -- 

it -- it is a -- a modification, at least, of 

task one, if -- if we were to do this. Again, 

Lew, I don't know what it would take for us to 

move into that mode if we -- if we want to 

begin to think about this further or to do 

something more concrete very soon, but we -- we 

certainly need to consider that because that's 

the issue of the use of the work books and the 

review of those and how that fits in with the 

site profile. So it would seem that we have to 

move in that direction fairly soon, get -- 

 DR. WADE: Right, with some --

 DR. ZIEMER: -- something under --
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 DR. WADE: -- dispatch. I mean relative to 

task four, we could at our next meeting, in the 

subcommittee, undertake the selection of the 

next 20 cases with this information in mind and 

-- and accomplish what John has asked for. And 

I think we can do that within the original task 

structure. 

On task one, we would need to modify task one, 

if the Board agrees, to include what John has 

asked, which is when they review a site 

profile, have them review the work books and 

include as part of that review package several 

specific best-estimate cases. If the Board 

wants to move in that direction it can go in 

one of two directions. It can prepare the task 

order or it can ask me to prepare the task 

order. But I think we want to move with some 

dispatch on this. 

 DR. ZIEMER: Okay. 

 DR. MELIUS: Can I --

 DR. ZIEMER: Jim and then --

 DR. MELIUS: -- can I com--

 DR. ZIEMER: -- Mark. 

 DR. MELIUS: Yeah, I -- I have some concerns 

about including actual cases in the procedures 
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review -- in task one. I think there's going 

to be some delays involved in those cases 

getting adjudicated, and I think that I would 

rather keep case review part of -- of task 

four. I think we have to keep in mind, you 

know, in terms of our sampling and so forth, 

that -- that we want these best-estimate cases 

and so forth --

 DR. ZIEMER: We could keep in mind what site 

profiles are being reviewed -- 

 DR. MELIUS: Right. 

 DR. ZIEMER: -- and select accordingly -- 

 DR. MELIUS: Yeah. 

 DR. ZIEMER: -- but keep the tasks separate, 

would be a good point. 

 DR. MELIUS: Yeah, I think so. But -- so we 

include work books, these technical 

(unintelligible). I think the first step we 

need to take, though, is -- is to inventory 

those, if that hasn't been done already to -- 

so -- that -- I think we ask our contractor 

maybe to -- I think this is appropriate, to do 

an inventory I think of sort of the matrix, 

what's -- okay, there's the Savannah River site 

profile and there's these eight, ten, 12 or 
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whatever kind of -- you know, whatever the 

number is of work books and so forth that are 

currently there or currently -- hopefully we'd 

include --

 DR. ZIEMER: Or does this inventory already 

exist or readily --

 DR. MELIUS: Well --

 DR. BEHLING: Can I ask -- or -- or make a 

comment here? 

 DR. ZIEMER: Sure. 

 DR. BEHLING: I think the benefit -- I fully 

understand what Dr. Melius's concern is, but 

there's also benefit that John I think brought 

out but maybe needs to be re-emphasized. When 

I for instance do a dose audit, a dose 

reconstruction audit -- and let's assume we do 

get best estimates and it -- they do in fact 

make use of a TBD, my assessment will be very 

limited. It will be a stage one review in a 

sense where my evaluation of that audit -- as 

an auditor will be looking at the -- the dose 

reconstruction and saying did you comply with 

the TBD, which is the first step. The second 

step, is the TBD correct. And what John is 

proposing is to integrate the task one and task 
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four so that the audit under those conditions 

would not only say did he comply with the TBD, 

but is the TBD correct, which may even be a 

much more important issue, which would be lost 

if we segregate task one from task four. 

 DR. WADE: Is Michael Gibson still on the 

phone? 

 (No responses) 

 DR. WADE: Okay. If Mike is not, when Gwen 

(sic) leaves we lose a quorum, by my count, so 

it means we just can't conduct any formal 

business. We can continue to have a 

discussion, but we lose a quorum. 

The issue I'd like to get a sense of the Board 

on is the modification of task one to include 

work books. Is that something that you want to 

pursue? 

 MR. GRIFFON: I --

 DR. ZIEMER: Mark. 

 MR. GRIFFON: You know, I -- I suppose that's a 

modification. I mean I -- it -- it -- it 

strikes me that this is such a revelation. 

These work books have been used forever. They 

continue to add some, I know that continues to 

evolve. But I mean I've been looking at and -- 
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and -- and I haven't had the training, so I've 

stumbled through some of these work books. I 

admit they're comp-- there's a level of 

complication there that maybe wasn't expected 

or anticipated. But for instance, the Savannah 

River site profile, the findings in the dose 

review were deferred to the site profile 

review, and one of the big issues is the high 

five, which we all know is in the -- is in this 

spreadsheet that they've been using. So isn't 

that under the scope already there? I --

that's a question -- part of my question. I 

understand that as -- as -- I think part of 

what John's saying is that as we've learned 

what these work books are and -- and the level 

of complication, programming, they do have 

Monte Carlo techniques integrated into some of 

the work books -- I mean maybe there is 

additional scope there -- 

 DR. WADE: Let me expl--

 MR. GRIFFON: -- but I --

 DR. WADE: Let me explore with the contracting 

officer the --

 MR. GRIFFON: Yeah. 

 DR. WADE: -- the premise that the review of 
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the work books is -- should already have been 

included or is already included in the scope of 

our task one, and see what -- what answer I get 

from the contracting officer. 

 DR. MELIUS: And then parallel to that, if we 

can develop this inventory, if it hasn't been 

done already -- at least -- or make it 

available to the Board so that we understand. 

 DR. WADE: Yes, we’ll keep the work going. 

When we meet in August we can have the 

subcommittee meeting that can pick the next 20 

cases and we can try and consider the things 

that John has spoken to us about, about 

increasing the number of best-estimate cases. 

 DR. ZIEMER: If -- if in fact the -- the 

contracting official believes that the work 

books are somewhat apart from the defined task, 

then we need to be in a position to tell him 

that the sense of the Board, if it is indeed 

the sense of the Board, is that -- if necessary 

-- they should be explicitly identified as 

being part of the task. 

 DR. WADE: Okay. 

 DR. ZIEMER: And I think -- well, we don't have 

a quorum anymore so we can't formalize that, 
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but at least we can explore the question with 

the contracting officer and -- and at the next 

meeting, if we need to take action, we can take 

that action and move ahead on it. 

 DR. WADE: Explore the question. 

 MR. GRIFFON: I mean I -- I think this -- this 

also came up in procedures review. You know, 

there is -- I mean one of the first procedures 

I looked at was -- and I can't remember the 

document number or the complete title, but it 

was the atomic weapons overes-- maximizing 

models, and ri-- you know, you read through it 

and right in there it references a work book. 

So my first question a couple of years ago was 

-- to Jim Neton, you know, where is this work 

book and that's how we started down this path 

of actually getting access to the O drive and 

finding these things. So I -- I think, you 

know, in my mind, part and parcel to reviewing 

that procedure -- I've got to look at that work 

book, you know. 

 DR. ZIEMER: Right, right. 

 DR. WADE: I understand. And I feel --

 MR. GRIFFON: Yeah. 

 DR. WADE: -- I feel comfortable pursuing this. 
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Thank you. 

 DR. ZIEMER: All right. So thank you, John, 

we'll follow up on that. 

Wanda? 

 MS. MUNN: Just a comment. It seems only 

reasonable and efficient to try to move in the 

direction that our subcontractor has suggested. 

Certainly if I were doing those cases I would 

want to do precisely as John has suggested, 

look at all of it at one time. And I can't 

imagine any way that we could streamline it any 

more obviously than that. 

The other thing -- Dr. Wade suggested that 

perhaps the subcommittee could be choosing the 

next 20 cases that we would be looking at. 

That is not what our process has been in the 

past, but I -- I can't speak for the rest of 

the subcommittee, but I -- I assume that if 

that's what the Board wants us to do, we can do 

that. But in the past --

 DR. ZIEMER: The subcommittee made the 

preliminary cut and brought it to the Board for 

final -- the Board has to make the selection. 

 DR. WADE: That's what I meant, I'm sorry. 

 DR. ZIEMER: The subcommittee did the initial 
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sort of screening of those. 

 MS. MUNN: We had more than 20 before the whole 

Board to choose from, though. 

UNIDENTIFIED: Right, we did. 

 DR. ZIEMER: Yes, we did. We selected -- in 

fact, we selected the second 20 and found out 

two of them had -- had been removed from 

finalization and had them sent back for review 

or something, so ended up with 18. But -- but 

we had a longer list from which we chose. 

 MS. MUNN: Much longer. 

 DR. WADE: I'm sorry, Wanda, I misspoke. I 

would just suggest the same process be followed 

by the subcommittee and the Board to arrive at 

the next 20, with this consideration in mind. 

 DR. MELIUS: Can -- can I just speak to what I 

think is a competing concern the Board should 

have. And while I understand the efficiency of 

doing it the way John and Hans have suggested, 

I also worry that that gets our whole review 

process focused on a few sites. And I think we 

have some duty to all of the claimants from all 

-- many different sites that we continue to 

have some process that reviews other claims. 

And I -- I'm not convinced yet that -- that by 
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moving individual dose reconstruction reviews 

into task one that we don't sacrifice too much 

of our need to keep some breadth to that -- 

that process. So it -- it's probably an issue 

of finding the right balance and so forth -- 

 DR. ZIEMER: Right. 

 DR. MELIUS: -- and the right approach, but I 

think we have to keep that other-- 

 DR. ZIEMER: Right. 

 DR. MELIUS: -- issue in mind. 

 DR. ZIEMER: And at present, if we maintain the 

separate tasks, it would be up to the Board to 

select them appropriately so that if they 

indeed need some samples from that site that 

they are available for them to use. 

Mark, you had another comment? 

 MR. GRIFFON: Yeah, I just wanted 

clarification. I -- I notice we don't even 

have enough --

 DR. WADE: Right, I think we --

 MR. GRIFFON: -- Board members now, but the 

last 22 that -- that Hans just mentioned that 

he's just begun to -- to work on, is there any 

sense that -- that we should continue with 

that? And I don't know that we have a quorum 
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here now that we could even consider halting 

that work --

 MS. MUNN: No point in talking about it. 

 DR. WADE: Yeah --

 DR. MELIUS: E-mail. 

 DR. WADE: -- I really don't think we could. 

don't think we have a quorum. I think we need 

to -- to stop. I mean we can talk off-line and 

if you feel strongly we can try and get a phone 

meeting of the Board together, but I think 

we're past our quorum now so I think we need to 

be done. 

GENERAL PUBLIC COMMENT

 DR. ZIEMER: I want to move to the public 

comment period since it is that time to do so. 

Let me -- I'm going to introduce first a 

gentleman who's been here for our session all -

- all week -- that is all during the meeting 

time. He is here as an observer. He's a board 

member for the newly-formed advisory board -- 

and I don't know their full correct title, but 

it's the parallel group that is going to be 

handling the veteran's cases. They are going 

to be -- it's going to be administered through 

the National Council on Radiation Protection 

I 
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and Measurements. The President has now 

selected those board members and they are 

underway. We have -- one of their staff 

members has -- actually a couple of their staff 

members have been with us in the meeting, but 

one of the board members is Colonel Ed Taylor, 

and there he is at the mike. And Ed, welcome, 

just to -- he wanted to bring greetings to us. 

COLONEL TAYLOR: Thank you. I only planned to 

use two minutes and you just used one of them, 

so we're (unintelligible). You told who I am 

and where I'm from and what I'm doing, and I 

wanted to thank this Board particularly. There 

are actually four or five staff members from 

DTRA here. I happen to be the only board 

member, and I can assure you that Admiral 

Zimble would like to have been here and sends 

his regards. 

We're having our first meeting down in August -

- mid-August in Tampa, co-located with the 

National Association of Atomic Veterans, of 

which I'm also a member. But I just sat here 

for three days now and you have done a 

tremendous job of broadening the perspective of 

somebody that's going to have to do part of 
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what you do. Our restriction will be basically 

to veterans and to people with atomic. It will 

not be the industrial side of it that you've 

had, so our challenges will be a little bit 

different. Our reports will be -- but the 

system you are using is what we were really 

here to look at. And I wanted to thank you 

individually and collectively for that and say 

that you've had 31 meetings, we have yet to 

have our first one. So wish us well and we 

want to thank you for your help. Thank you. 

 DR. ZIEMER: Thank you, Ed, for being with us 

today and -- yes. 

(Applause) 

COLONEL TAYLOR: Incidentally, I'm limping 

because the day this thing was done was the day 

the Mayo Clinic people decided to take four 

sections of my lumbar region and completely 

clean them out and they said I could never get 

out to do this. Four of the five doctors said 

yeah, you can go. The other one said hell, I'm 

not going to tell you no; you'll go anyway. So 

the end result of it was, it was interesting 

and I wanted to leave one last message with 

Mike. 
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Fri-- Thursday night I got out of the hospital 

and spent Friday -- all day Friday on a similar 

thing with my board, and it was a fascinating 

experience, and now I get to see it from the 

other side. And I got a cauliflower ear out of 

mine, I don't know what Mike got out of his. 

Thank you. 

 MS. MUNN: Welcome, Colonel. 

 DR. ZIEMER: Thank you, Colonel Taylor, for 

being with us today. 

Dan McKeel has asked to have the floor. Dan, 

welcome back to the mike. 

 DR. MCKEEL: Okay. Thank you. It's been a 

long meeting. I'll try to be rather brief. 

I'd really like to address the Board this 

afternoon on several issues related to the past 

three days, and I want you to excuse me for 

being blunt, but I really have to take this 

position which I feel pretty strongly about, 

both as a medical scientist and as a concerned 

citizen and a taxpayer. 

First point is concerning scientific rigor. As 

I understood the Advisory Board's charge from 

you, Dr. Ziemer, Tuesday night, one of the 

three main responsibilities under the EEOICPA 
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is to oversee NIOSH and their performance as 

the prime contractor to perform radiation dose 

reconstructions. 

I was rather dismayed yesterday at the Board's 

and SC&A's ready acceptance of data that Jim 

Neton presented on four of his slides, on pages 

7, 8 and 9. The slides all showed data he 

construed as validating CER data on the MCW 

dust study, air intakes and the urinary -- 

uranium median levels of Plant 6 workers. The 

striking point to me was the very small end 

values of only four ether house workers, three 

cloth operators, five pot room workers and 

three packagers, and that's out of a total work 

force at that total uranium division of about 

3,600 people. 

No member of SC&A or the Board commented on 

this fact, nor did they ask whether NIOSH had 

performed any power analyses to detect 

differences, which is a fundamental statistical 

practice. 

If NIOSH has air and dust urine data on 78 

percent of the Mallinckrodt Destrehan workers, 

as NIOSH states they have, why weren't the ends 

much higher? And I ask, was this data in any 
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way representative of the total number of 

workers in these crucial job categories? No 

clear reason was stated as to why these 

particular workers were used in the analyses to 

demonstrate data integrity in the CER database. 

The representative sampling nature of the data 

went unquestioned by any Board member. 

As a scientist, seeing this data raised more 

questions for me than it answered. It 

certainly did not convince me about the extent, 

the scalability (sic) or the quality of the CER 

MCW data. It really showed me there was a 

large -- huge unexplained individual 

variability and that good data might be 

extremely limited. 

Point number two, I was stunned by the Board's 

tabling of Wanda Munn's motion to deny the MCW 

SEC 0012-2 petition. This action effectively 

delayed a final decision, probably until 

November. In my opinion, this action was not 

consistent with the Board's Congressional 

mandate to decide about dose reconstruction 

feasibility in a timely manner. In fact, the 

tabling motion guaranteed another long delay. 

In doing so the Board ignored the position of 
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SC&A, its own auditors, which found that 

accurate dose reconstruction based on the Rev. 

1 Mallinckrodt TBD was not possible, and that's 

a quote, and may never be possible, even when 

changes are made to correct multiple 

deficiencies. The Board decided once more to 

simply trust NIOSH's claim that they would 

perform in three months dose reconstructions on 

107 workers. Yet NIOSH, by their own 

admission, had accomplished no -- that is zero 

-- full dose reconstructions on MCW workers 

thus far in almost five years of the program. 

This is not a reasonable assumption to trust. 

Why is this unconditional level of trust in 

NIOSH merited by the President's oversight 

board? I say it is not. The facts presented 

should have had the opposite effect. That is, 

they should make the Advisory Board 

increasingly skeptical of NIOSH claims 

regarding the agency's ability to do timely 

dose reconstructions. 

Also, is this unwarranted trust imparted to 

NIOSH a responsible implementation of the 

Board's primary responsibility? With all due 

respect to Wanda Munn and those on the Board 
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who side with her, I do not believe it was. 

Contracts are canceled in other arenas when 

prime contractors fail to perform this way. 

Ms. Munn's basic argument that we should trust 

the Federal agency to be able to do what they 

say they will do, and to discount past 

performance or lack thereof, is not 

historically appropriate. That is not what 

this Board is charged to do. 

Third point. There has been the repeated 

implication that doing dose reconstructions on 

MCW Destrehan Street workers was somehow a 

uniquely difficult challenge. I believe NIOSH 

stated that they had already performed 8,000 

dose reconstructions, and I see from Larry 

Elliott's figures the number's actually 8,230. 

How are these MCW workers unique? The job 

categories at many atomic weapons sites 

overlap. Workers at other covered facilities 

worked with pitchblende ore, were exposed to 

radium and thorium, and handled K-65 type 

raffinate waste. Yet zero MCW workers have 

been fully dose reconstructed by NIOSH. Why is 

this? 

My opinion is that a Federal agency such as the 
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Government Accounting Office, the GAO, should 

look anew at the EEOICPA claimants who have 

been denied compensation and those whose dose 

reconstructions are now in limbo. The root 

causes of this failure by NIOSH to perform dose 

reconstructions in a timely manner need to be 

exposed and corrected, by legislation if 

necessary. EEOICPA can and should be amended 

further. 

My fourth and last point is to remind the Board 

that I brought FOIA evidence to them on Tuesday 

night which showed that, at a minimum, several 

hundred Mallinckrodt records from the 1949-'57 

time period remain in the DOE CER classified 

vaults at Oak Ridge. This remained -- this 

retained classified status of MCW-related 

records is possibly in violation of a 1999 

internal DOE-wide directive. Many of those 

classified records have titles which indicate 

that they're MCW production process data. This 

data, if known, could facilitate the Board 

making a more informed decision on the MCW 

special cohort -- Special Exposure Cohort 12-2. 

Why is this information on MCW production 

processes still classified 48 years after the 
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downtown site uranium operations ceased? 

I asked three Federal agencies and ORAU for 

this information in my March 10th, 2005 Freedom 

of Information Act request, but an answer was 

not forthcoming. I didn't mention this 

situation merely as a curiosity. These 

classified records need to be examined and 

captured by the Board, SC&A and NIOSH, if that 

has not already been done. If the data has 

already been captured in Rev. 0 and 1 of the 

MCD TBD, then NIOSH should document this fact 

for the Board and SCA. I urge the Board to 

examine this new information. 

In closing, I'd say although I strongly endorse 

the basic mandates of the Board, I cannot 

adequately express my profound sense of the 

magnitude of a disservice that has been done 

once again to deserving Mallinckrodt claimants 

and survivors in St. Louis during these past 

three days. The least the Board needs to do is 

schedule the August meeting here in St. Louis. 

The needs of the Board for making direct 

flights must be a secondary consideration. To 

me, and I have to add, sadly, the net effect of 

this meeting has been to significantly 
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undermine the scientific credibility and 

objectivity of this Advisory Board on Radiation 

and Worker Health. Thank you. 

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

And I must admit, I'm a little dismayed about 

the FOIA request, also. I'm wondering what is 

there and why there has not been some response. 

The request went to which agencies? I know you 

mentioned it yesterday, but just remind me, 

what agencies? 

 DR. MCKEEL: (Unintelligible) so I -- because 

the -- one of the issues was the content of the 

six boxes and getting more understanding of 

that. 

 DR. ZIEMER: Right. 

 DR. MCKEEL: I sent it to DOE Oak Ridge, to 

ORAU, to CDC/NIOSH and to the OCAS office, just 

to make sure that everybody got a copy, and I 

asked that the folks at ORAU coordinated that, 

not knowing -- as I learned from the -- the 

general counsel and Pam Bonet*, who's actually 

helped me in the past, that they don't answer 

FOIA requests, that they're answered by DOE Oak 

Ridge. So -- so I did get a -- finally got an 

answer from DOE Oak Ridge on -- it -- it was 
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dated on the 30 -- on June the 28th and I got 

it on June the 30th. I'd gotten a three-line 

answer from CDC, interestingly. It's just 

marked CDA ATSDR FOIA Officer in Atlanta, three 

lines. I showed it to Larry Elliott. Didn't 

mention NIOSH, didn't mention that it -- they 

had corresponded with NIOSH. They said we got 

your FOIA request of March 10th. Here's some 

information that's partly responsive. We're 

waiving the fees because, you know, your bill 

isn't high enough. And what they included -- 

what CDC included was some information that you 

all had already been -- handed out at one of 

the -- I think at the Cedar Rapids meeting, 

maybe even the St. Louis meeting, that 

supplement to SEC 001-12 that had the list of 

contents of the six boxes. So I already had 

that actually about the time we sent in the 

FOIA request. So that was -- that was all that 

was in the CDC response. 

Then from Oak Ridge what I got was this 205 

pages of information, and the -- the most 

interesting -- I mean a bunch of the pages, 70 

pages were last names, first names, with 

basically no information except that Amy 
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Rothrock's* letter -- cover letter said that 

they were records that still resided in the 

classified CER vaults at Oak Ridge. Now that's 

not exactly the same as saying what we asked 

about, were these records still classified. 

But presumably if they're in the classified 

vaults, then they have to be declassified for 

anybody to read them. 

But the most interesting thing was this 35 

pages of additional listing of documents, and 

what was nice about that was that the dates of 

all those documents were provided so you could 

see that at least -- I think the number was 230 

or so -- directly pertained to 1949-'57 

Mallinckrodt. 

Now, I don't have any way to know -- and -- and 

-- oh, items two and three of our request were 

specifically to find out which documents had 

had to be declassified to get into those six 

boxes that NIOSH came to have and that SC&A has 

now examined, but also to find out a question 

that I have never heard anybody address here or 

been asked by anybody, and that is how many 

documents that pertain to MCW remain still 

classified. And I tried to draw the difference 
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with Amy Rothrock on the telephone in an hour's 

conversation I had with her at the end of May 

that I didn't consider that records that were 

kept under the Privacy Act as classified. I 

said I was after -- she called me to clarify 

exactly what I wanted from them. I said I 

don't -- that that's a different thing. I want 

to know what records are classified, withheld 

from a FOIA request by that exemption at your 

place. And so, you know, it looked to me like 

28 pages of those records were still 

classified. And -- and then I simply took 

those 28 pages and -- so the classified ones -- 

and -- and there were eight pages of 

unclassified data, saw how many of them 

pertained to that period of time that we were 

all interested in, and again it was -- you 

know, it was over 200 documents. And what 

interested me is that the -- all that was 

listed about them besides date was a title, but 

a bunch of them had to do with uranium process 

operations. 

Now I thought that might be very interesting. 

I don't know exactly what they have. All I 

asked for was an index, hoping that it would 
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save some time to get that material. Well, it 

actually took three and a half months to get 

it, but in any case, I didn't ask for the 

records themselves, so I don't know what's in 

those bo-- I can't really see those. But we do 

have people on your Board, we have people 

obviously at NIOSH and we have people at SC&A 

who have Q clearances who could get in to see 

those records. 

Now if they've all been captured, well, then 

you know, that's not really relevant. If they 

have not been captured into the Technical Basis 

Documents, that might be highly relevant. And 

it -- it's really late in the course, so I 

don't know how it could happen. I can't do it, 

but somebody should go and look at those 

records, and -- you know, so -- so in any case, 

that's kind of the way I feel about it. I -- I 

do not think that FOIA request response was 

completely responsive to what I asked about. 

It didn't say specifically that they were 

classified. There was no information about why 

they were still classified. So I -- I'm going 

to pursue that farther, but I'm really trying 

to do something that will help get this SEC 
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petition moved along and -- and brought to 

closure. 

 DR. ZIEMER: Yeah. 

 DR. MCKEEL: And that's really the spirit. I -

- I appreciate everybody's work. 

 DR. ZIEMER: Yeah. 

 DR. MCKEEL: But I -- I really am very upset 

about what's happened about Mallinckrodt and I 

just want to help move it along. 

 DR. ZIEMER: Thank you very much. I -- I don't 

know if this -- if this is something NIOSH is 

in a position to pursue or if we think we have 

captured the essence of those, but perhaps 

that's something I'd ask Lew if maybe he can 

follow up on that. I think if there's records 

out there that need to be captured, certainly 

NIOSH would have an interest and certainly this 

Board would, so appreciate that -- or maybe 

we'll know something more by -- 

 MR. HINNEFELD: I really don't know any 

specifics 'cause, you know, I haven't seen the 

list. I know that for most of the period of 

this work that Oak Ridge ORAU team has had 

people working in the classified vault -- 

 DR. ZIEMER: Uh-huh. 
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 MR. HINNEFELD: -- reviewing information that 

may be helpful and then having it -- selecting 

what would be helpful and then having it 

reviewed for classification to be removed. I 

know that's been sort of an ongoing process 

down there for months and months, maybe longer, 

so I don't know, though, whether those specific 

things have been seen or not. I -- I don't 

know that, and Dr. Toohey's no longer here, so 

-- I doubt he would know specifically, either. 

 DR. ZIEMER: Right. Thank you, Stu. Let's 

continue with comment. Hershell Gilley --

Gilleylen, is it? 

UNIDENTIFIED: (Unintelligible) 

 DR. ZIEMER: Oh, okay. Larry Gassei -- Larry? 

Did I pronounce that correctly? 

 MR. GASSEI: It's Gassei. 

 DR. ZIEMER: Gassei? 

 MR. GASSEI: Uh-huh. Denise asked me to bring 

up my little situation that I have. My father 

worked for Mallinckrodt from 1936 to 1969. 

That's 33 years. And he passed away on 

September 1, '69. He died of pancreatic 

cancer. So I had filed a claim and haven't 

received anything yet, so when notice was 
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brought out about the SEC, approval for that 

period of '42 to '48, I seen that in the paper 

and I contacted Denise and she told me -- she 

says things look very favorable. You should 

receive some notification and a payment process 

should start. She said there'll be some other 

forms that you have to fill out. 

Well, that's been a while. So earlier this 

week I decided to try to find out myself what 

the status was and I called NIOSH and they told 

me it was -- my claim was now transferred to 

the Department of Labor in Denver and I should 

call this number, speak to this individual. I 

did, and he informed me yeah, you meet all the 

particulars except we're waiting for a call 

that (unintelligible) -- a verification of 

employment as to where my father worked and if 

he was on Destrehan or the uranium division or 

what product line. And I said well, you know, 

I'm -- have already given everything. And he 

said well, we have -- waiting for notification. 

And I said well, where does that leave me? I 

said, you know, I got some records here and I 

went through it -- he said well, does it state 

that he worked on Destrehan? I said as far as 
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I know he -- that's the same Mallinckrodt that 

we've been talking about all along. I said I 

know there's different buildings in that, but 

whether it's -- I didn't know exactly what he 

was getting at. And maybe I misunderstood. 

So I -- I looked through my papers and -- see 

if I could have something specific, and I 

didn't. And I asked -- and I told him what I 

had. I called him back and told him what I had 

and -- and I said well, don't you have all 

this? And he said well, we're in the process 

of -- of inquiring and trying to get this 

resolved so we can process your claim. I said 

well, what happens if -- if you don't hear 

anything or get this clari-- he said well, 

it'll go back to NIOSH for dose reconstruction. 

With that I got a little bit ticked off because 

I thought everything was in order and I 

contacted Denise. And she said no, that's 

entirely wrong because everything has been 

appr-- if it got past NI-- NIOSH and they went 

to the Department of Labor, everything should 

be in order. And I'm here to say it's a little 

bit frustrating. When you get misled, you get 

going down the road and you're expecting 
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something favorable to happen. I've been 

waiting for this for quite some time and -- and 

everything that's being told to me is that 

everything is in order for me to receive 

compensation on that claim, and that's all I -- 

I wanted to point out and I don't know... 

 DR. ZIEMER: Thank you very much. I -- I don't 

know if any of the folks that were here earlier 

assisting with claims are here now that could 

assist on this, but is there some way to -- it 

sounds like a -- that Labor is trying to 

confirm work location. Is -- is that --

MS. BROCK: I -- I took care of it, but that's 

just an example of what goes on. 

 DR. ZIEMER: Oh, yeah, the frustration of -- 

MS. BROCK: Well, exactly. I mean it made it -

- it qualified the first time to even make it 

to NIOSH for dose reconstruction, and there's 

some confusion -- for whatever reason -- 

sometimes between the Destrehan Street plant 

and Second and Broadway and the ether house or 

certain terminology that's in these claims. 

And so, again, it's very frustrating, but the 

people that were here were very helpful and 

then I called Labor, but just for the record, 
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we'd like to have it noted because it does 

raise complications when situations arise such 

as that and -- and people are asked to give 

things that they've already sent. And if they 

qualify for the 250 days, they're in the cohort 

years and they've got one of the 22 cancers, 

this should not be a big thing, made it past 

the hump. 

 DR. ZIEMER: You're exactly right, and I think 

to the extent that the folks here can help with 

whatever verification -- 

MS. BROCK: And they were --

 DR. ZIEMER: -- is needed --

MS. BROCK: -- wonderful. They made calls, 

they did a wonderful job. 

 DR. ZIEMER: Okay. 

 DR. WADE: Thank you. 

 DR. ZIEMER: Denise, while you're at the 

microphone, I think you did ask for comment 

time. You want to proceed? 

MS. BROCK: Certainly, sure. 

 DR. ZIEMER: We have one other person, Roni 

Steiger -- Steger that was going to speak, but 

MS. BROCK: Oh, there you are. 
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 DR. ZIEMER: -- we'll take it in either order. 

MS. BROCK: Did you want -- do you want to go 

first? 

 MR. STEGER: Go right ahead. 

MS. BROCK: Okay. And I'll try to be brief. 

think the first thing I wanted to state that -- 

was that I would appreciate maybe next time we 

do a meeting like this that we try to do -- or 

whoever does the agenda, try to make the public 

comment period where all the Board members are 

available. And the reason for that is because 

thank goodness we do not have a lot of people 

here, but many times the claimants feel like 

this is falling on deaf ears anyway, and so 

actually people's feelings get hurt. You feel 

like you're talking to a wall. What they have 

to say is very important and it is very 

relevant and they need to say that. And I 

think that's the reason for public comment and 

it would be greatly appreciated if whoever does 

the agenda could make sure to squeeze that in 

when all the Board members are here to actually 

hear that. 

 DR. ZIEMER: Right. Good point, and in fact 

that's one of the reasons we have the -- the 

I 
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evening one so that we have some early -- 

earlier in the week that we had when we have 

assurance of both opportunities for more 

members of the public, as well as the full 

Board. I don't think we anticipated this 

situation --

MS. BROCK: Oh, I'm --

 DR. ZIEMER: -- but -- but --

MS. BROCK: -- sure it's nobody's fault. I 

mean --

 DR. ZIEMER: Yes, well --

MS. BROCK: -- people have flights to make, but 

I --

 DR. ZIEMER: -- but we appreciate --

MS. BROCK: -- think it will be easier if you 

do it always --

 DR. ZIEMER: -- appreciate and understand -- 

MS. BROCK: -- to where Board members are here. 

 DR. ZIEMER: -- the comment. Yeah. 

MS. BROCK: And the other thing I wanted to 

state for the record was I appreciate 

everybody's hard work. It is not easy 

decisions that you have to make. I don't agree 

with everybody's opinions or statements, but I 

respect everybody, and everybody's entitled to 
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their opinion. But what I would like to state 

for the record was I -- beyond anything I could 

imagine happened yesterday. I thought we had a 

-- a good case. SC&A to me did a wonderful job 

and they stated, in my understanding, that at 

this point NIOSH cannot dose reconstruct these 

claims. And to me, that was the intent. We 

needed to see what the auditors felt, not could 

NIOSH fix it or can we go through all this time 

and all this extra process to dig through all 

this stuff that could take years and then at 

the end of it never even know if they're still 

going to be able to do a dose reconstruction. 

And I would like that on the record that I am 

very disappointed and just completely 

flabbergasted because maybe I don't understand 

the law. Maybe I didn't understand feasibility 

meant just scientific technical things. And 

even at that, at this point NIOSH cannot dose 

reconstruct. They haven't been done yet. So I 

just want that on the record and thank you very 

much --

 DR. ZIEMER: Thank you. 

MS. BROCK: -- and I will see you in August. 

 DR. ZIEMER: And that will certainly be on the 
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record. And Roni Steger. 

 MS. STEGER: I had to work all week so I really 

didn't get to come down here to catch any of 

the meetings, but I understood from my dad and 

obviously from the comments tonight that the 

special cohort exemption was tabled, I 

understand. And my mom worked at Destrehan. 

My name is Roni Steger and my mom was Norma 

Duvall Steger and she worked at the 

Mallinckrodt Destrehan facility in a uranium 

lab. My dad and I attended together one of the 

days at the meetings at the Adams Mark a couple 

of months ago. I sat in awe of the people that 

stood up and related their stories to you. 

Those stories moved me beyond words, and it 

drove home to me the importance of this and how 

it's affected some people, because I can't tell 

you a story like that. 

My mom died. I was a teenager and I lost her. 

But my dad's great, and he married a great 

woman and we were all taken care of very well. 

So there's no horror story there. We didn't 

lose our income, but I lost my mom. And it 

really hasn't even been determined yet because 

obviously the dose reconstruction can't be 
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done, so we don't know if it actually -- the 

cancer she had came from that or not. We're 

just sitting here for years wondering. And for 

me and my brother and sister, it really never 

occurred to us that maybe this was a result of 

this employment. And it came as a shock to us 

that possibly, you know, the government and the 

company let these people work in this lab and 

these diseases and these deaths and these 

sicknesses came as a result of that. 

And so now for five or six years we've been 

sitting and waiting, and filling out paperwork, 

talking to people and going to meetings. And I 

understand there's been like 30-some-odd of 

these meetings and still nothing's happened for 

any of these people here. And I can't imagine 

that we're alone, with all the people that are 

affected by this. I just know that it's 

personal here. 

I would like to mention that I noticed that 

both of these meetings that we attended were at 

very premium hotels in the city. I can't help 

but notice all the handouts and the paperwork, 

and I've listened to all these committees and 

subcontractors, and I can't help but think the 
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cost involved with just determining whether or 

not any of these people are going to receive 

$150,000. And I know for a lot of people that 

worked there and are older and are sick and are 

dying, this $150,000 might make a lot of 

difference in their lives. For us personally, 

it probably wouldn't. It's just going to be 

the satisfaction of knowing one way or another 

what actually happened. And it's a revisiting 

that we really didn't want to do. And I wonder 

if the government, in their -- I don't know 

what you want to call it, but if they would 

have just said obviously they had some 

culpability, there was some wrongdoing, maybe a 

little deceit or whatever you want to call it, 

if they would have just decided all these 

people were due this money and paid it, if it 

would have cost less than to determine who was 

actually going to get it. And that frustrates 

me 'cause I -- you know, I look around and I 

think well, what's it costing to do all this? 

And if everybody would have just got this 

money, it could have helped so many people at a 

time where maybe they needed it 'cause they're 

not young anymore, you know. I think about the 
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people that worked there that are still 

suffering or still sick, and are still coping 

with these diseases and what you could do to 

help them. And why it's taking so long is just 

beyond me. Hell, give them a loan, you know. 

I don't know. It's just -- I find it very 

difficult that the government makes it 

necessary for each one of us to discover, maybe 

by chance, that the existence of this 

compensation act even existed. And then we 

have to prove to the government that we even 

deserve it, that it wasn't enough that we 

worked there, blindly trusting the employer 

that we were safe. I just think it's -- what 

about these people, you know. I'm just 

frustrated. I'm sorry that I had to say all 

that. 

 DR. ZIEMER: Okay. Thank you, Roni, for 

sharing with us today. And we're quite aware 

of the levels of frustration. I recognize 

that. 

That completes our public comment period. I 

want to ask -- Board members, do you want to 

hear from Larry or can you just view the -- you 

have his update materials. 
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10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

327

 DR. WADE: You have to view his materials. 

 DR. ZIEMER: Okay. 

 DR. WADE: We're well below a quorum now. We 

 DR. ZIEMER: Right. 

 DR. WADE: -- (unintelligible) stop. 

 DR. ZIEMER: I just want to point out a couple 

of pieces of information. The list of science 

issues -- that was distributed, was it not? 

 DR. WADE: Yes. 

 DR. ZIEMER: So you have that before you. 

 DR. WADE: I'll -- I'll be providing e-mail on 

times and dates of meetings to all of you and -

-

 DR. ZIEMER: Okay. Is there any other item 

that needs to come before us today? 

 (No responses) 

There appears to be none. If not, I declare 

this meeting adjourned. Thank you very much. 

(Whereupon, the meeting was adjourned at 5:00 

p.m.) 
_____________________ 

328 

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 July 7, 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 

7th day of August, 2005. 

STEVEN RAY GREEN, CCR 

CERTIFIED MERIT COURT REPORTER 

CERTIFICATE NUMBER: A-2102