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 

ADVISORY BOARD ON 

RADIATION AND WORKER HEALTH 

The verbatim transcript of the Meeting of the 

Advisory Board on Radiation and Worker Health held 

at The Garden Plaza Hotel, 215 South Illinois 

Avenue, Oak Ridge, Tennessee, on May 20, 2003. 

 VOLUME II 
 

 

 

 266 

C O N T E N T S
 

May 20, 2003 

REGISTRATION AND WELCOME 

Dr. Paul Ziemer, Chair. . . . . . . . . . . . . . . . 271 

Mr. Larry Elliott, Executive Secretary 

ETHICS FOR SPECIAL GOVERNMENT EMPLOYEES 

Ms. Paula Kocher, HHS, OGC. . . . . . . . . . . . . . 272 

EPIDEMIOLOGICAL RESEARCH OF DOE WORKERS - STATUS 

Dr. David Utterback, NIOSH. . . . . . . . . . . . . . 293 

Dr. Mary Schubauer-Berigan, NIOSH . . . . . . . . . . 305 

BOARD DISCUSSION/WORKING SESSION 

REVIEW PROCESS OF COMPLETED DOSE RECONSTRUCTIONS . . .363 

PUBLIC COMMENT PERIOD. . . . . . . . . . . . . . . . . .386 

REVIEW/APPROVAL OF MINUTES, BOARD WORK SCHEDULE & 

 ADMINISTRATIVE HOUSEKEEPING 

Ms. Cori Homer, NIOSH; Dr. Paul Ziemer, Chair; Mr. Larry 

Elliott, Executive Secretary . . . . . . . . . . . . .427 

ADJOURN . . . . . . . . . . . . . . . . . . . . . . . . 453 

COURT REPORTER'S CERTIFICATE . . . . . . . . . . . . . .454 
 

 

 

 

 

 

 

 267 

 TRANSCRIPT LEGEND
 

The following transcript contains quoted material. 

Such material is reproduced as read or spoken. 

In the following transcript a dash (--) indicates an 

unintentional or purposeful interruption of a sentence. An 

ellipsis (. . .) indicates halting speech or an unfinished 

sentence in dialogue or omission(s) of word(s) when reading 

written material. 

In the following transcript (sic) denotes an incorrect 

usage or pronunciation of a word which is transcribed in its 

original form as reported. 

In the following transcript (phonetically) indicates a 

phonetic spelling of the word if no confirmation of the 

correct spelling is available. 

In the following transcript "uh-huh" represents an 

affirmative response, and "uh-uh" represents a negative 

response. 

In the following transcript "*" denotes a spelling 

based on phonetics, without reference available. 

In the following transcript (inaudible) signifies 

speaker failure, usually failure to use a microphone. 
 

 

 

 268 

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
 

ELLIOTT, Larry J.
 

Director, Office of Compensation Analysis and Support 

National Institute for Occupational Safety and Health 

Centers for Disease Control and Prevention
 

Cincinnati, Ohio 

MEMBERSHIP
 

ANDERSON, Henry A., M.D. 

Chief Medical Officer 

Occupational and Environmental Health 

Wisconsin Division of Public Health 

Madison, Wisconsin 

ANDRADE, Antonio, Ph.D. 

Group Leader 

Radiation Protection Services Group 

Los Alamos National Laboratory 

Los Alamos, New Mexico 

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

Director 

The Vanderbilt Center for Occupational and Environmental 

Medicine 

Professor of Medicine 

Nashville, Tennessee 

ESPINOSA, Richard Lee 

Sheet Metal Workers Union Local #49 

Johnson Controls 

Los Alamos National Laboratory 

Espanola, New Mexico 
 

 269 

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 

MUNN, Wanda I. 

Senior Nuclear Engineer (Retired) 

Richland, Washington 

OWENS, Charles L. 

President 

Paper, Allied-Industrial, Chemical, and Energy Union 

Local 5-550 

Paducah, Kentucky 

PRESLEY, Robert W. 

Special Projects Engineer 

BWXT Y12 National Security Complex 

Clinton, Tennessee 

ROESSLER, Genevieve S., Ph.D. 

Professor Emeritus 

University of Florida 

Elysian, Minnesota 

STAFF/VENDORS
 

CORI HOMER, Committee Management Specialist, NIOSH 

STEVEN RAY GREEN, Certified Merit Court Reporter 
 270 

 AUDIENCE PARTICIPANTS
 

ADLER, TIM 

AHRENHOG, STEVEN 

APOSTOAEI, A. IULIAN 

AYERS, R.L. 

BELL, GLENN 

BILLARD, JOHN 

BROCK, DENISE 

DEHART, JULIA 

HENSHAW, RUSS 

HILL, JEFF 

HINNEFELD, STU 

HOFFMAN, OWEN 

HOMOKI-TITUS, LIZ 

HOWARD, JOHN 

HOFF, JENNIFER 

JESSEN, KARIN 

KATZ, TED 

KOCHER, DAVID 

LAWSON, JACOB HOWARD 

LEWIS, MICHAEL 

MILLER, RICHARD 

NAIMON, DAVID 

NETON, JIM 

POTTER, HERMAN 

POWELL, STEVE 

PRESLEY, LOUISE 

SCARBROUGH, CARL 

SCHAEFFER, D.M. 

SLOVAK, ANDY 

STEWART, JOHN 

SUNDIN, DAVE 

TABOR, BOB 

TANKERSLEY, BILL 

THOMAS, BRIAN 

TURCIC, PETE 

UTTERBACK, DAVID 

WILEY, ALBERT 

YIIN, JAMES 

ZIEMER, MARILYN 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 271 

P R O C E E D I N G S

 (8:00 a.m.) 

REGISTRATION AND WELCOME

 CHAIR
 

DR. ZIEMER: Good morning, everyone. While the Board 

members are finding their seats -- and I'm taking a 

quick count to make sure we have a quorum -- wandering 

around here a bit, but we're going to follow our agenda 

fairly closely, if we can, to try to stay on schedule. 

I do want to make a brief announcement, remind everyone 

if you have not done it to register attendance. Even 

if you did that yesterday, you should do it again 

today. We register the attendance for each day, so 

please do that. 

Also members of the public who wish to address the 

Board during the public comment period, please sign up 

for that in the book that's back on the table. 

We begin our session today with a presentation by Paula 

Kocher, who's Deputy Legal Adviser in the Office of 

General Counsel for Centers for Disease Control, and 

she also serves in a similar capacity for the Agency 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 272 

for Toxic Substances and Disease Registry, ATSDR. I 

think the most interesting thing about Paula, other 

than being Deputy Legal Adviser, she has to oversee the 

work of 18 attorneys, and that's the -- that's the 

biggest challenge in the job, I think. 

Paula, we're glad to have you here today, and she's 

going to address us on ethics for Special Government 

Employees. Which means ethics for members of this 

Board, is what that translates to. And this is -- if 

you want to call it training. It's required by FACA 

for people in our capacity, so we have to do this on a 

periodic basis. 

ETHICS FOR SPECIAL GOVERNMENT EMPLOYEES
 

MS. KOCHER: Good morning. First I just wanted to say 

that I had the privilege of meeting David Kocher 

yesterday. It's highly unusual to come to a meeting 

with my last name and meet someone else who's speaking 

with the same last name, but he is not my long-lost 

second cousin, so... 

I'm actually here today to both congratulate and thank 

you for agreeing to be and being selected for 

membership on the Advisory Committee on Radiation and 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 273 

Worker Health. As is stated in the Committee charter, 

you are charged with advising the Secretary of Health 

and Human Services on the probability of causation 

guidelines, the dose reconstruction and Special 

Exposure Cohort rules, and review of SEC petitions. 

But with these responsibilities come two sets of rules, 

and that is what I will be primarily talking to you 

about this morning. 

In a nutshell, you are required to follow a standard of 

conduct as a Special Government Employee. For 

instance, you must not, generally speaking, accept 

gifts because of your official position, or share nonpublic information with outside sources. 

For those of you with a financial interest in the 

matters that come before this Committee, you must take 

certain steps to avoid a conflict of interest. And as 

a Special Government Employee you must act impartially 

towards members of the public, and there are limits on 

your representing others before the Department of 

Health and Human Services or the Department of Labor 

relating to radiation compensation claims. 

The second set of rules is derived from the Federal 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 274 

Advisory Committee Act. My understanding is that you 

all received a copy of a videotape. Did any of you 

have a chance to look at it? Wonderful. You might 

recognize somebody. Another attorney and I put that 

tape together -- oh, I guess it's probably about six or 

seven years ago, and I do recommend it because not only 

does it review some of the rules that we'll go over 

this morning, but I think it gives a very nice 

historical perspective about the Federal Advisory 

Committee Act, and the importance of Federal advisory 

committees in general. 

FACA's overriding purpose is to make consensus advice 

to the Federal government from people outside the 

government as transparent as possible. That is why 

your meeting today was announced in the Federal 

Register. It's why minutes of the proceedings are 

being kept, why a Federal official such as Larry 

Elliott is present, and why this meeting is open to the 

public. As a member, you have a responsibility to 

ensure that your deliberations comply with FACA. 

You can certainly communicate with each other outside 

this public forum, for instance, to exchange factual 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 275 

information. But you should avoid even the appearance 

that you are conducting Committee business, 

deliberating and reaching consensus when you're not 

seated at this table with a Federal official present. 

I'll go into more detail about those obligations in a 

minute. 

So let's begin reviewing these two sets of rules. I 

will finish up by also talking about -- a little bit 

about the Privacy Act and the Freedom of Information 

Act. And we're going turn to the Power Point now, and 

I wish to thank Liz Homoki-Titus for putting the Power 

Point together for me. 

Can you still hear me okay? Sort of? I'll try to 

speak up. Almost have to be out here to see this. 

DR. ZIEMER: That's fine, you're good. Stay there. 

MS. KOCHER: Stay right here? 

DR. ZIEMER: Uh-huh. 

MS. KOCHER: Okay. Let's define what a Special 

Government Employee is. Well, it's an officer, an 

employee in the Executive Branch of the Federal 

government, and you're appointed to perform temporary 

duties, with or without compensation, for a period not 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 276 

to exceed 130 days during the previous year. All the 

Board members here are Special Government Employees. 

One of the most important rules has to do with 

conflicting financial interests. And under Title 18 of 

the United States Code, Section 208, a Special 

Government Employee may not act in certain matters that 

would affect the financial interests of the Special 

Government Employee or their spouse, minor children, 

general partner or an entity they serve as officer, 

trustee or employee. And just as an aside, the rules 

have set $15,000 or less as the amount that's not 

considered a conflict if you own stock from one source. 

So how do we deal with a conflicting financial 

interest? Well, as most of you know, you are able to 

get a waiver, and many of you here at this table 

probably have a waiver memo, and that's available if 

the Department determines that the need for your 

service is actually greater than the conflict. And 

what that waiver basically does, it allows you to deal 

with matters of general applicability. Now there may 

be situations where you would actually have to 

disqualify or recuse yourself from deliberations of the 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 277 

committee when there is a specific matter -- excuse me, 

a particular matter between specific parties that's 

being deliberated that would affect your financial 

interest. 

Let's look at the example here. If a Board member 

owned $30,000 of Oak Ridge Associated Universities 

stock, he would either have to get a waiver or divest 

that stock in order to serve on the Board. Well, 

obviously divesture is probably the least attractive 

option, and that's something that we'll rarely ever 

even have to think about. 

What's an appearance of a conflict of interest? Well, 

the standard is if the circumstances would cause a 

reasonable person to question the Special Government 

Employee's impartiality, then there is an appearance of 

a conflict of interest. 

The example that's given here, if four members of the 

Board were to meet with a member of the public for 

lunch during a Board meeting, there could be an 

appearance of a conflict of interest to other members 

of the public who do not receive such personal special 

access to the members of the Board. And we look to the 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 278 

standards of conduct found at Title 5 of the Code of 

Federal Regulations, this handy little book right here 

-- this is not all the rules. Okay? Just a small 

portion of this deals with these rules today. But this 

one says that an employee shall act impartially and not 

give preferential treatment to any private organization 

or individual. 

Gifts, illegal gratuities and bribes. Well, may you 

accept a gift? In most instances not. Certainly when 

the gift is given because of your official position, 

and we look to see whether or not the giver of the gift 

has a connection with the agency seeking action, 

seeking to do business, already conducts business 

regulated by the agency or has interests affected by 

how you perform your duties. But it is okay to accept 

occasional gifts, as long as they're valued under $20 

and the aggregate does not exceed $50 from one source 

in a year. 

There are other exceptions that are listed in the 

standards of conduct that I won't go into -- fairly 

common sense sort of things, where you have a personal 

relationship with someone. 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 279 

Here's our example. Mr. A, who's president of XYZ 

Corporation, offers the Advisory Board member a new set 

of golf clubs, if -- if -- if the Advisory Board member 

will support XYZ's bid for the contract to assist the 

Board in its work. Now obviously Dr. B cannot accept 

the gift, and this is an easy one. 

But sometimes there are situations that come up that 

are not quite as clear as that, and so what I would do 

is I would urge you to contact Larry or David or Liz 

and talk some of these issues over with them. We also 

have an attorney in Washington D.C. who only deals with 

ethics issues, and sometimes we'll -- I mean we'll be 

able to consult with him, as well. Of course what this 

is all about is a criminal matter found in Title 18. 

Use of non-public information. This is an important 

one. Information that's learned due to your government 

position that is not publicly available may not be used 

to further your, or anyone else's, financial interests, 

or be shared with outside sources for any reason. 

Here's our example. The Board is told that, once 

again, XYZ Corporation has been selected for a contract 

to review dose reconstructions, but the public 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 280 

announcement will not be made for a couple of weeks. 

Board members may not use this information for anyone's 

financial gain, nor tell non-members this information 

for any reason, and the authority for this is found in 

the Code of Federal Regulations, Title 5, which states 

that employees shall not allow the improper use of nonpublic information to further his own private interests 

or that of another, whether through advice, 

recommendation or by knowing, unauthorized disclosure. 

(Pause) 

All right, moving right along. Outside activities. 

This really just means that you cannot accept 

compensation for being a Board member here today. Of 

course you're -- may of you are employed. You will 

continue to receive that salary. You will do so while 

you serve as a Special Government Employee for the 

government. There's an exception that's made for 

Special Government Employees who do serve on advisory 

committees. But the only compensation that you can 

receive for serving as a Board member is from the 

Federal government. 

Now in the second bullet it talks about compensation 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 281 

being allowed for activities that are related to your 

Board service, and you can of course continue to write 

or make speeches where you have a brief discussion of 

the work that you do here on the Board. 

Let's look at the example. Dr. C on the Board is asked 

to speak at the annual meeting of a private 

organization. He cannot get paid to discuss his work 

on the Board, but he can speak, for a fee, if he is 

discussing his own private research and only briefly 

discusses the publicly available information about the 

Board's work. And we look for authority again to Title 

5 of the Code of Federal Regulations where it states 

that an employee shall not use his public office for 

his own private gain, or for the private gain of 

friends, relatives or persons with whom the employee is 

affiliated in a non-governmental capacity. 

There are some employment restrictions placed on 

Special Government Employees as to their work on the 

Board, so a Special Government Employee cannot work on 

matters that would affect the financial interests of a 

current or future employer. And this goes back to what 

I was saying before dealing with conflicts of interest 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 282 

and seeking a waiver. But there are instances where 

you literally cannot get a waiver and again you have to 

recuse yourself from the discussion that was going on. 

And what I would suggest everyone do is, prior to 

coming to a Committee meeting, check the agenda, look 

it over, see if there's anything on there that would 

make you believe that there's going to be something 

that will definitely affect your financial interests. 

And again, seek counsel from Larry, who can then talk 

with David and Liz, and we can figure out how best for 

you to approach the situation. 

Post-employment. So you leave the Board and you think 

well, that's it; I'm done, I don't have to worry about 

these silly standards of conduct anymore. Well, that's 

not entirely true. There are still restrictions on 

your being able to represent another person -- not 

yourself, but another person or entity back to the 

Federal government. But it's in a -- it's in a very 

narrow area where there's a particular matter involving 

a specific party in which you participated personally 

and substantially while you were serving the 

government. 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 283 

There are a couple of other rules related to limits on 

representation, and this one has to do with when the 

United States is a party or has a direct and 

substantial interest. And again you will have had to 

have participated personally and substantially. You 

are also once again urged to contact the Department. 

If you have any kinds of questions we'll be happy to 

help you through this. Many of these issues are very 

fact-specific. We really need to understand the facts 

in order to be able to advise you. 

But the example that's given here, a Board member may 

not represent a petitioner for the Special Exposure 

Cohort, even on an unpaid basis. 

This is yet another one that basically just points out 

that -- here the example is that not even the business 

partner may represent a petitioner when compensation is 

being offered. 

Okay. Let's move from the standards of conduct to the 

Federal Advisory Committee Act. And again, the most 

important thing to remember about FACA is that it 

promotes open and public meetings. And as you know, 

each advisory committee meeting shall be open to the 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 284 

public. 

Now there are instances where meetings have to be 

closed because there will be deliberation about nonpublic information. But even so, that still has to be 

announced in the Federal Register. The public has to 

be notified that that meeting is going to take place. 

And as you well know, interested persons -- or noninterested, for that matter -- shall be permitted to 

attend, appear or file statements with any advisory 

committee. And it seems to me that what's happening 

here is that there's a public comment period every day 

of a Committee meeting, which is wonderful. 

Also the documents that were made available or prepared 

for by each advisory committee shall be available for 

public inspection and copy. And as I learned 

yesterday, many of the things are being placed on a web 

site, so it's really made available to the public. You 

don't even have to file a Freedom of Information Act 

request. 

Minutes of each meeting of the advisory committee shall 

be kept, and one thing many people don't realize is 

that the Chair must review those minutes for their 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 285 

accuracy and certify that they are in fact accurate. 

And very importantly, advisory committees shall not 

hold any meetings except at the call of or with the 

advance approval of the committee's designated Federal 

official, Larry Elliott in this case. 

I'm going to talk a little bit about the Privacy Act 

because it will be implicated in the work that you all 

do here. The Privacy Act prohibits disclosure of 

personally-identifiable information to any third party 

without the written consent of the individual to whom 

the record pertains, unless one of several statutory 

exceptions applies. I won't get into those other than 

to say they're things like audits that are being done 

by the Inspector General, if there is actually a court 

order issued -- a court that has what's considered 

competent jurisdiction over the matter, but otherwise 

you've got to have consent. 

It is the policy of the Department to protect the 

privacy of individuals to the fullest extent possible, 

while at the same time permitting the exchange of 

records so that you all can do your business. And it's 

also the policy that the Department be as open as 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 286 

possible and fully comply with the Freedom of 

Information Act and the requests that are made under 

that Federal statute. 

Here's the bottom line rule for the Privacy Act. Do 

not discuss individual claims with any non-government 

employees or with government employees who do not have 

a need to know the Privacy Act-protected materials. 

And please understand that there are both civil and 

criminal penalties that apply to this Federal law for 

any knowing violations. 

Let's look at a couple of -- I thought we had an 

example. I guess we don't here. 

Privacy Act rules. These are not just rules for the 

Privacy Act, but these are also, just generally 

speaking, good rules for Special Government Employees. 

Don't speak for the agency or the Board. Avoid 

discussing or disclosing the merits of individual 

claims -- and I cannot emphasize that enough, and let 

me just say also, you need to be very careful when you 

do have claims information that's personallyidentifiable to make sure that it's locked up at all 

times, that it's -- it's not something that you should 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 287 

carry around casually. I wouldn't put any of that 

information in an e-mail -- e-mails are not secure. So 

you really do need to be vigilant when it comes to 

handling Privacy Act records. Stick to public 

information and refer requests to OCAS. Avoid 

speculating about the identity of a claimant. Avoid 

speculation about dose reconstruction issues. Don't 

try to predict future agency or Board actions. You 

need to avoid assisting with individual claims, but you 

-- under the standards of conduct, you are able to 

serve as a fact witness for some of these claims if you 

happen to have been an employee at the time with this 

coworker who's filing a claim. 

Here are my examples. So here's two. So we have two 

Board members who are talking about someone's dose 

reconstruction and the gentleman's office is open. His 

coworkers can overhear his conversations. This would 

be considered a violation of the Privacy Act because 

that information may not be shared with non-government 

employees. 

Another example is where an Advisory Board member has 

been reviewing information on the computer tracking 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 288 

system and he goes ahead to print some files to review 

later. He leaves them on his desk. Again, this is a 

violation of the Privacy Act because the information 

must be protected to ensure that only government 

employees with a need to know have access to that 

information. That would be easy to take care of. Just 

put it in a file drawer and lock it or lock the door 

when you leave. 

Just a short statement or two about the Freedom of 

Information Act. It is a disclosure statute. It is a 

way that people are able to get access to government 

documents. There are some statutory exemptions. One 

of the ones that we're finding to use more and more at 

CDC now has to do with security issues, which you can 

understand. But records are available to the public 

under the Freedom of Information Act. Again, what I --

what's happening more and more is that the government 

is putting things on the web site and making things 

much more accessible to people so they don't have to go 

ahead and file that FOIA request. But the Department 

does answer all written requests for records. 

With regard to media and Congressional inquiries, here 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 289 

are just some guidelines to be thinking about. You can 

always refer media inquiries to Fred Blosser, who is 

with NIOSH. And Congressional inquiries -- I mean 

Larry loves to get them, don't you, Larry? Yeah, he 

lives for those Congressionals. You know, if you do 

choose to speak to the media, you know, make clear that 

you're speaking as an individual and not for the agency 

or the Board. And please limit yourself to public 

information. Remember the standard of conduct I talked 

about, not disclosing non-public information. And it's 

always a good idea to say that's what you're doing. 

You know, I'm telling you what is already publicly 

known, this is it, so it's very clear to the media that 

that's what you're doing. And again, you know, Fred --

this is what he does for a living. And Larry, I think 

this is what he does for a living, so you know, feel 

free to contact them and see if you can coordinate any 

response you're going to make -- be making with the 

agency. And here's some contact information that I 

think you all have as part of the Power Point slides 

that were given to you. 

I think that's it. Thank you very much for your time. 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 290 

DR. ZIEMER: Thank you very much, Paula. I suspect 

there might be some questions. 

MS. KOCHER: Sure. 

DR. ZIEMER: Let's see if there are. I'm going to ask 

one. Let me ask it in the form of a hypothetical 

situation. Let's suppose that the Florida chapter of 

the Health Physics Society invites Dr. Roessler to come 

down there and give a talk to their chapter about the 

work of this Board. She can't accept any payment for 

this. Can they cover her travel expenses? 

MS. KOCHER: We have what are called travel 

regulations. I would have to look at those, and I 

would be happy to do that because they're very 

specific. So without having the rules with me, I 

wouldn't want to, you know, guess --

DR. ZIEMER: Well, it would seem to me that that's a 

fairly likely scenario for some members of this Board, 

as opposed to a payment or honorarium --

MS. KOCHER: Well, let me ask you this. Are you going 

down to do things other than just talk about your Board 

membership and --

DR. ZIEMER: If she were invited to Florida, she would, 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 291 

but --

DR. ROESSLER: This actually hasn't happened, but it is 

-- it's a really likely scenario, and I -- I would ask 

you to look at it from the point of view that there is 

nothing else. It would just be to attend the meeting, 

because I think it's a reasonable --

MS. KOCHER: No, what I mean is your attendance at the 

meeting, are you being invited because you're an 

Advisory Board member and you're expected only to 

address issues --

DR. ZIEMER: That -- yes. 

MS. KOCHER: -- related to the Advisory Board, or 

because of your other expertise or other research or 

writing that you've been doing? 

DR. ROESSLER: Let's assume that it's just as an 

Advisory Board, and let's also assume that if I 

couldn't go, Dr. Ziemer would go. 

MS. KOCHER: Okay. 

(Laughter) 

DR. ZIEMER: And if I couldn't go, Wanda would go. No, 

I think it's -- I think it's --

MS. KOCHER: Yeah. 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 292 

DR. ZIEMER: -- a fairly likely expectation that 

members of this Board might be asked to tell what the 

Board's doing -- it would be analogous to our 

colleagues from Great Britain coming here to talk to 

this group. Maybe not analogous 'cause I don't know if 

they're -- who paid for their transportation, but --

but an invitation of that sort, tell us about what the 

Board does. 

MS. KOCHER: It's a great question --

DR. ZIEMER: We could always say Larry will come and 

tell you. 

MS. KOCHER: It's a great question, and what I'd like 

to be able to do is talk with David and Liz and we'll 

get an answer back to you. And we can do that so it's 

for the entire Board then. 

DR. ZIEMER: Thank you, that would be helpful. Other -

- other questions or comments? 

MS. KOCHER: And if you have any individual questions 

that you don't want to raise now, you know, you can ask 

me on the break, as well. Okay. Thank you. 

DR. ZIEMER: Hold on, Paula, just a second. 

MR. ELLIOTT: I'm just going to let the Board know that 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 293 

because the overhead -- or the slides that were placed 

in your booklet are a little hard to read, some of the 

fonts small, we will send this by e-mail to you all so 

that you have a copy that you can read from. 

DR. ZIEMER: Good, thank you. Thank you again, Paula. 

MS. KOCHER: Uh-huh. 

EPIDEMIOLOGICAL RESEARCH OF DOE WORKERS - STATUS
 

DR. ZIEMER: Okay, we're going to move ahead on the 

schedule. We're pleased to have two individuals 

actually, and Dr. Utterback is going first, I 

understand. Mary Schubauer-Berigan has been with us 

before, but who -- who's going first? 

DR. SCHUBAUER-BERIGAN: Dr. Utterback. 

DR. ZIEMER: Okay. Well, Dr. Utterback is Chief of the 

Health-related Energy Research Branch at National 

Institutes for Occupational Safety and Health in 

Cincinnati. He really originally was an industrial 

hygienist, and maybe still is in that regard, but he 

has responsibilities on the U.S. Department of Energy 

Occupational Epidemiology studies at Idaho National 

Engineering Laboratory and other DOE sites, and he also 

has been involved in a number of these epidemiological 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 294 

studies that have been funded through DOE to Health and 

Human Services. 

He has been very active in a number of professional 

activities related to this, and I'm not going to read 

his whole biographical sketch, but there is a copy of 

it on the table and you can avail yourself of that. 

We're pleased to have Dr. Utterback with us today to 

speak on the epidemiological research of DOE workers. 

Dr. Utterback. 

DR. DAVID UTTERBACK, NIOSH
 

DR. UTTERBACK: Thank you for the introduction, and 

thank you for the invitation to be here. It's truly a 

pleasure to be here and talk about our research program 

at the National Institute for Occupational Safety and 

Health that evaluates the health of workers who have 

been employed at Department of Energy sites. 

With me today is Mary Schubauer-Berigan, and we've 

divided this presentation up. Mary's presentation will 

follow mine and I'll try to set the stage for her, and 

she is to go through our research program and describe 

it in such a way that it addresses some questions that 

we understand that this Board had concerning the way 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 295 

that the NIOSH research program addresses the issues 

related to compensation of workers. 

The NIOSH program on the health-related energy research 

came into existence in 1991, and our group -- at that 

point in time a core group was on board, beginning to 

get things organized, and in 1992 they were able to 

hire a number of additional scientific staff to get a 

number of things underway. We are a group that 

conducts analytical epidemiologic studies of workers at 

Department of Energy sites. And we also get involved 

in a number of other activities related to these sites 

from time to time. The core of our mission is to 

conduct the analytic epidemiologic studies. 

We do this both through intramural and in extramural 

research program. The balance between the two 

historically -- it varies from year to year and it's 

certainly at one end of the spectrum right now, but 

about one-third of our dollars have gone out for 

extramural research grants and contracts and 

cooperative agreements. So we try to emphasize 

extramural research because we think it's a very 

important way to allow the broadest range of intellects 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 296 

to address these very complicated problems. 

Our average funding over the years has been about $5 

million. We're once again kind of at a low point here, 

substantially below that $5 million right now and have 

been for the last couple of years. And currently we 

have 27 FTEs available to us within the Branch to, you 

know, do the things that are necessary to have a 

program of this nature. 

We came into existence -- actually the responsibilities 

for this type of research were transferred to HHS and 

the CDC as the result of a secretarial panel for DOE. 

This is the so-called SPEERA panel. You may have heard 

of this in the past; maybe this is a new acronym. It's 

the Secretarial Panel for Evaluation of Epidemiologic 

Research Activities at the Department of Energy. And 

at that point in time, in the late 1980's, there was 

quite a bit of concern about these studies that was 

coming out and the Secretary of Energy, Admiral Watkins 

at that time, convened this panel to try to address 

this issue. And they made a number of recommendations. 

One is that the epidemiologic program -- studies needed 

to be made independent of the Department. There is 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 297 

some -- questions that were coming out about the 

credibility of these studies given that they were 

conducted by contractors to the Department of Energy, 

and there was a group at that time, the Physicians for 

Social Responsibility, that published a very thorough 

analysis, if you will, of these studies -- programs 

called Dead Reckoning. So the decision was made to 

transfer the responsibility for the epidemiologic 

program to the Department of Health and Human Services, 

and through that process it came to CDC, and NIOSH does 

the occupational studies. National Center for 

Environmental Health has been involved in the studies 

of populations around these sites. 

They believed that by doing this they could restore 

public trust in the studies, and that it was the means 

to try to assure the highest scientific credibility or 

quality of these studies to put them into a research 

program, a research-oriented program where, you know, 

there was opportunities for peer review, thorough 

analysis of proposals that were written and those types 

of activities associated with research programs and 

HHS. And they were especially trying to ensure the 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 298 

independence of the investigators, that these people 

could have the ability to request information and get 

the information necessary to do these studies and not 

be subject to some of the limitations perhaps that a 

contractor directly to the Department of Energy would 

have to prevail. 

And we considered all these to be very important 

issues. Public trust, scientific quality, independence 

of investigators, stakeholder input, we want this to be 

an open process, and it is an open process. And you 

know, our studies go through peer review. CDC has 

recently instituted a policy now that every five years 

the research projects have to go through another round 

of peer review if they have not been completed in that 

period of time. So these are things that we take very, 

very seriously in the way that we organize and conduct 

our research program. 

Here is our staff, and our scientific staff is on the 

left, the information technology staff in the upper 

right, and then our support staff in the lower right. 

Now we have a number of industrial hygienists, health 

physicists, epidemiologists that work with our program 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 299 

and conduct a lot of the science that gets done within 

this group of studies. In the upper right is our 

information technologists, and again, these people are 

vitally important to us and our success. We are very, 

very information system rich. It takes a tremendous 

amount of data and data manipulation and testing and 

evaluation in order for these studies to be successful, 

and so we have an excellent staff of information 

technologists that are really at the leading edge in a 

lot of this kind of research and putting together 

information systems necessary to conduct it. And of 

course our support staff, we wouldn't be here without 

them, so this is a great group of people that I work 

with. I'm truly very honored to be associated with 

them. 

The research purpose is -- I've kind of paraphrased a 

few things here to make them fit on a slide, but this 

was something that we did together under Larry 

Elliott's leadership when he was the Branch Chief of 

this group, and we went into a strategic planning 

process and developed a mission statement, purpose and 

some research goals associated with that, and these 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 300 

have been very helpful to us in trying to keep us on 

beam, keep us focused on what's important. 

And overall we're primarily interested in understanding 

the risk of radiation in the occupational setting on 

worker health. How is it that the various forms of 

radiation that exist within the occupational 

environment, how do those impact a worker's health over 

their lifetime. And of course cancer is a primary 

response that we were concerned about, given the types 

of impact that it has on a person that suffers from one 

of these various types of disease. Grouped together 

they're called cancer. So we're interested in 

evaluating the significance of the health effects in 

the radiation-exposed workers. And by significance 

we're not just talking about, you know, the number of 

incident cases to the number of prevalence -- you know, 

the prevalence of the disease. We're interested in the 

impact it has on the individual and the worker's life 

and how that -- change is brought about in that 

individual's life as a result of that health effect. 

And we think it's very important that we have an 

informed public and an informed group of workers that 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 301 

understand our studies. We work very hard with the 

communication effort to get our word out to the workers 

so that they can understand what the study is saying 

about their health and how their health may be affected 

in the future. 

And it's important to recognize that it's not only 

radiation that we study, but also chemical and other 

stressors within the work environment. And we look --

as you'll hear more about today, that there are a 

variety of studies that try to look at multiple 

exposures, not just radiation. 

Research goals. Again paraphrasing, trying to collapse 

these down into some succinct statements here. Again, 

to evaluate the relationships between work place 

exposures and diseases. And we wish to use and we try 

to use and we do apply the best available analytical 

methods with this. In order to apply the best 

analytical methods, you've got to have a top quality 

staff. And you know, we have many, many people in our 

group -- although it's a very, very small group, we 

have many, many people in our group that are very high 

quality scientists and we feel that, you know, we've 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 302 

got the intellect necessary to try to determine which 

path to follow and how to get there, but it is 

something that requires, you know, input from our staff 

and their discussions that they have with colleagues in 

the scientific community and the like to try to build 

towards that goal. 

We do want to analyze combined populations for rare 

cancers where, you know, one single population -- this 

is something I heard mentioned yesterday in one of the 

discussions about trying to get populations large 

enough for statistical analysis to be meaningful. And 

one of the ways that we've gone about this is to 

combine studies across sites so that we look at 

different populations, bring them together in order to 

have sufficient numbers to try to determine if there is 

an effect associated with an occupational exposure. 

And we've really become specialists at this. 

This is no simple task. When you talk about, you know, 

eight or ten data systems from each site that you're 

trying to bring in to apply to a study, and then you 

multiply that times the number of sites, all that 

linking and matching and testing and evaluation, it all 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 303 

gets very, very complex and difficult to achieve. But 

we've really become specialists. This is our -- this 

is our cup of tea. This is the way that we try to 

address studies and try to bring meaningful results out 

of the research that we do conduct. 

Again, we want to examine the relationships --

exposures and worker health. I mean anybody that's 

worked in this field of environmental/occupational 

health for a period of time realizes that this has been 

an issue at the top of the agenda for decades. You 

know, I hate to speak like I have that much experience 

in this, but I'm afraid to admit that I do now, having 

been in this field for 25 years. But the question has 

always been toxicologically epidemiologically well, 

this is what one compound does, but nobody gets exposed 

to one compound. So we're working trying to address 

that, look at multiple exposures, radiation in 

combination with other chemicals, chemicals in 

combination with other factors and stressors in the 

work place. But it takes very large datasets and 

systems and a good deal of time to get this 

accomplished. 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 304 

And again, our bottom line is that we want to complete 

the epidemiologic research, which increases our 

understanding of the effects of low levels of exposure 

in the work place to ionizing radiation to DOE workers 

and others. There are -- research does have impact, 

meaning for other workers beyond the DOE sites, and we 

want that to be very clear, as well. There's a large 

impact that we feel we can have within the occupational 

health community because of the types of records that 

are available to us and the investment that's being 

made in this, and has been made in this program. 

There are a number of previous occupational radiation 

studies that have been completed. We've assembled a 

bibliography, an annotated bibliography, if you will, 

of studies that we feel are directly pertinent to the 

work that we do. You know, the previous studies at the 

weapons sites that go back, you know, into the sixties 

with Mancuso* and his colleagues at University of 

Pittsburgh, the DOD studies of shipyard, the nuclear 

Navy studies that are out there. And again, we heard 

some comments yesterday about the atomic veterans 

studies and compensation program. There's 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 305 

international studies. There's a lot of attention and 

effort being focused on workers at Mayak, the plutonium 

facility in the former USSR. There's a very large 

multi-national studies being conducted by the 

International Agency for Research on Cancer under the 

leadership of Elizabeth Cardis*. Both Mary and I, you 

know, serve on subcommittees within that study and we 

are contributing data to that study. And then also 

there's been various studies of medical workers -- Xray technologists, radiologists and various physician 

specialties within the health care setting. 

Our purpose here today is, you know, to talk about the 

status of the HERB research program and to talk about 

how it fits into the questions that you've raised as a 

Board for us to address. And you know, basically what 

we're going to be driving towards is discussing the 

uncertainty in the current knowledge and how that has 

an impact on the models that are driven, trying to 

understand probability of causation for compensation of 

workers at these sites. So we want to further identify 

any research areas that you may have related to the 

compensation of these workers. 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 306 

And I think all of us kind of join together in 

realizing that, you know, the work is not done here. 

There's a lot of current workers in the audience out 

here I believe, and I think all of us want to join 

together and work as hard as we can to try to protect 

the health of those current workers, and there's even a 

few current workers on the Board here. So I mean it 

really is a commitment that NIOSH has to try to protect 

the health of the American work force, and the DOE 

workers are a very important part of that and we 

consider that part of our mission, as well. 

So with that, I'll turn it over to Mary SchubauerBerigan and she will begin to discuss -- present the 

status of our research program and talk about how it's 

related to the questions that you raised. Thank you. 

DR. MARY SCHUBAUER-BERIGAN, NIOSH
 

DR. ZIEMER: While Mary is coming up -- she's there 

already, but let me just mention that she is the lead 

epidemiologist with the Health-related Energy Research 

Branch, division of surveillance, hazard evaluation and 

field studies within NIOSH. And she's been involved in 

conducting epidemiological studies of cancer and other 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 307 

health effects among U.S. nuclear workers for a number 

of years now. So Mary, we're glad to have you back 

with us today. 

DR. SCHUBAUER-BERIGAN: Thank you very much, Dr. 

Ziemer. I'd like to reintroduce myself to the Board. 

It's been about a year since I've been up here speaking 

before you, and now I'm wearing a different hat. I've 

been back for the last year or so working with the 

Health-related Energy Research Branch, continuing to 

conduct epidemiologic research on DOE cohorts. 

What I'm going to do, as Dr. Utterback mentioned, is to 

talk about our current epidemiologic research program 

and to try to place it into the context of what we 

understand to be the main issues that were raised by 

this Board in your last meeting in February. I'll 

start with a discussion of some of our current studies. 

And the first slide illustrates several studies that 

are ongoing that are being conducted by our 

cooperators, either through contracts, grants or 

cooperative agreements. And these are listed primarily 

in the order in which we expect them to be completed. 

The first study that I'll mention is a study of Rocky 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 308 

Flats workers. This is a cohort study conducted 

through a cooperative agreement with the Colorado 

Department of Public Health, Welfare and Environment, 

and through a grant that they have to Dr. James 

Ruttenber as lead investigator. Several studies have 

been completed and are near completion to date. 

We recently attended a communication of Dr. Ruttenber's 

results for a cohort mortality study and a lung cancer 

case-control study in Denver. And several of you may 

have heard some of the initial findings of that study. 

The report is available or shortly will be available 

on our internet web site. This also includes dose 

assessment of plutonium doses to lung, using the most 

current ICRP-60 methodology, and we're eagerly 

anticipating the findings of that study, as well. That 

is not quite as near to completion, according to our 

understanding. 

There's also currently a grant through the University 

of North Carolina, Dr. Steve Wing, to study -- to 

further study the Hanford cohort mortality experience. 

As many of you know, this is a very important cohort 

that's been studied quite extensively over a period of 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 309 

decades. And Dr. Wing and colleagues anticipate their 

update to be completed and a report available sometime 

we believe this summer. 

We also have a grant with the University of Cincinnati. 

Dr. Susan Pinney and Richard Hornung, who many of you 

are familiar with as well, are studying additionally 

radon, cigarette smoking and their interaction on lung 

cancer risk among workers at the Fernald facility in 

Ohio. We anticipate -- we've been in contact with 

these researchers fairly recently and we do anticipate 

a study report sometime before the end of this fiscal 

year. We believe this will be a very important study 

as it uses new techniques to try to address missed 

information on cigarette smoking that could help 

address issues of the interaction between radon 

exposures and smoking in producing lung cancer risk. 

We have a contract through ORAU with Janice Watkins, 

who is subcontracting with Ed Frome, to further 

evaluate time-related factors that are of importance in 

evaluating cancer risk. Right now this is primarily 

restricted to the Oak Ridge National Lab cohort. We 

anticipate the final report will be finalized sometime 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 310 

before the end of this fiscal year, as well. And this 

contract is looking further into some of the issues 

regarding age at exposure, time since exposure and just 

how one models complex epidemiologic data to 

disentangle the various effects of time-related 

factors. 

We have a new grants program, as well, that has funded 

two studies, one of which is listed here, a grant with 

Dr. David Richardson, also of the University of North 

Carolina. And this is looking at susceptibility, timerelated risk factors and occupational radiation risks 

at the Savannah River site cohort. This was just 

recently funded and data has begun to be processed, we 

understand, by these researchers. We anticipate the 

completion date therefore will be sometime within the 

next several years. 

Not on this slide but of great importance to us are 

several other projects that I just wanted to mention. 

There's a very large ongoing study now of the Paducah 

workers, and this is being conducted by the University 

of Kentucky and the University of Louisville. Also 

recently funded through our grants program was a grant 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 311 

to researchers at the University of Washington, who are 

looking at multi-stage modeling for lung and colorectal 

cancer in the Canadian National Dose Registry workers, 

and they also anticipate using data from CEDR, as well. 

We also have a grant that is closer to completion on 

dosimetry errors with Roy Schorr* and colleagues at the 

University -- or at New York University. 

Next I'd like to talk about some of our current 

internal studies that are being conducted by the 

researchers that Dave mentioned on one of his slides. 

First we'll try to illustrate some of the cohort-based 

studies, what they're trying to evaluate and when we 

expect them to be completed. And again, these are 

listed approximately in the their order of expected 

completion. 

We have several studies ongoing at the Portsmouth Naval 

Shipyard, and although this is not a DOE facility, it 

is of historic importance and of great current 

importance for several reasons. It's primarily a group 

of workers who were exposed to high energy photons, and 

so it's a great cohort to study issues related to that 

particular exposure. We don't tend to see a lot of 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 312 

internal exposures and tritium and other factors, so it 

does provide -- in terms of radiation risk -- a fairly 

singular exposure, but yet it's a classic occupational 

setting in which exposures are received in a chronic 

rather than in an acute basis. 

We have several reports soon to be issued for this 

cohort. I'd like to mention that several of the -- my 

colleagues, in addition to Dr. Utterback, are with us 

today in the audience, and if you have questions about 

them, I may defer to some of the investigators 

themselves who are with us, but I did want to 

acknowledge they're here, too. 

We also -- I'll mention a couple of other studies that 

are of real importance in answering some of the key 

questions that we believe the Board has, and some of 

them pertain to this PNS facility, so please keep that 

study in mind. 

We also have a large cohort study for a group of 

workers that we believe to be very important. It's a 

group of more than 60,000 workers at the Idaho National 

Engineering and Environmental Laboratory, and as Dr. 

Ziemer mentioned, both Dr. Utterback and I are 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 313 

investigators, as well as Greg Macievic, in this study. 

These worker -- this work force is a very diverse work 

force consisting not only of radiation workers, but of 

workers who may have had more incidental access to the 

site, such as ranchers or farmers. We have workers who 

were involved in the construction of the facility, as 

well as processors and researchers, so it is a very 

diverse cohort. Approximately a half to a third of 

them do have radiation monitoring data, so we will be 

able to conduct dose response analyses. These analyses 

are underway and we expect to have a final report 

before the end of September for this cohort, as well. 

A third cohort-based study that I'd like to mention is 

a study of the chemical laboratory workers at four 

facilities within the DOE complex. These are the three 

facilities in Oak Ridge and workers at the Savannah 

River site. As your briefing document mentioned, very 

few studies have been conducted of workers in chemical 

laboratories, and this study we hope will address some 

very important issues with regard to interactions 

between chemical exposures. And the chemical exposures 

of primary concern here are workers who were employed 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 314 

in inorganic, organic and organic mist labs, and Dr. 

Utterback is a primary author of that study, as well, 

and will be able to address any questions you have 

about that. This study is a little farther behind and 

we expect that to be completed sometime before the end 

of this calendar year, or perhaps in late winter. 

Lastly we have a cohort study of Fernald workers, and 

this has been driven by questions related to uranium 

exposures across the complex. We do expect this study 

to address issues related to radon and lung cancer, as 

well. Dr. James Yiin, who is with us today, is the 

lead epidemiologist on that study. That is really in 

its early phases and we don't expect that to be 

completed for several years. 

In addition we have several case-control studies, and 

for those of you who are not epidemiologists, in 

occupational settings we typically study cohorts, and 

we also study -- use a study design that is designed to 

be very efficient and yet very thorough in studying 

specific diseases. These are conducted in a casecontrol setting in which you take all of the cases that 

you see in a cohort and you select randomly from 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 315 

eligible workers who didn't have the disease to study 

exposures in those two groups to determine if there's a 

difference between those with disease and without. 

It's a very efficient design because instead of 

studying 60,000 people, you can address the same issues 

by studying 1,000 or 2,000, which makes the exposure 

assessment much more thorough and much more costeffective. 

Several case-control studies are currently ongoing to 

address specific important questions. We have a 

leukemia case-control study in the Portsmouth Naval 

Shipyard which is being conducted by Travis Kubale as 

part of his dissertation program, and he is with us 

today. We do expect this to be fairly close to 

completion, sometime before the end of this calendar 

year, and I know Travis would be very happy to have 

that sooner rather than later. 

We have a second case-control study at the PNS facility 

which is looking at lung cancer risk. This was driven 

by observations in the first studies that had been 

conducted in this cohort in which excess risks of lung 

cancer were observed, but because of the rather high 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 316 

asbestos exposures, and perhaps exposures to welding 

fumes that occurred at the facility, we anticipated the 

need to do a lung cancer case-control study to evaluate 

those three factors in addition to smoking. 

This study is approximately a year and a half away from 

completion, and several of the researchers on the PNS 

team are also involved in that case-control study. 

My second study is a multi-site leukemia case-control 

study. We've had this ongoing for several years now, 

and it combines workers from six different cohorts at 

five different DOE and DOD facilities, including 

Hanford, Savannah River site, Los Alamos -- including 

ZIA* workers, the Oak Ridge National Laboratory and the 

Portsmouth Naval Shipyard. This study has almost 260 

cases of leukemia, which makes it one of the largest 

studies of its type ever conducted. But as you can 

imagine, conducting an exposure assessment at six -- or 

five different facilities is quite complex, given the 

number of potential confounding exposures to things 

like benzene that we need to address. We're also 

looking at the potential to evaluate plutonium dose to 

the bone marrow for workers, particularly at Oak Ridge, 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 317 

Savannah River site, Hanford and Los Alamos. 

A fourth case-control study is a study of K-25 workers 

who have multiple myeloma. Again, this is a very large 

study, one of the largest of its kind, and it follows 

Steve Wing and colleagues in their investigation of 

multiple myeloma across the DOE complex, and hopes to 

explore further some of the important exposures, 

particularly to internally-deposited uranium and 

multiple myeloma risk. 

Lastly we have a multi-site lung cancer case-control 

study that is right now pretty much on hold because of 

all the other higher priority studies that had been 

currently underway. We don't yet have a health 

physicist assigned to this project, but Sharon Silver 

and Dennis Zaebst are working on this from an 

epidemiologic and industrial hygiene perspective. This 

study is also quite complex in that it's studying a 

number of different facilities across the complex, and 

it's attempting to get around the issue of confounding 

by other exposures like asbestos by restricting itself 

to workers in the reactor areas, and it's hoped that 

the exposure assessment for that group of workers would 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 318 

be simplified. 

Now I didn't mention it in each case, but as Dave 

mentioned, virtually all of these studies have to take 

into account not only the radiation exposures, but also 

exposures to other factors that could be either 

confounders that somehow are obscuring the relationship 

between radiation risk and cancer, or they could be 

effect modifiers, in which they're changing somehow. 

Different levels of exposure to those factors change 

your sensitivity to radiation or change the risk of 

actually getting cancer. And so in many of these 

studies, we're looking not only at evidence of 

confounding, but also for effect modification or 

interaction, which I'd like you to have a grasp on 

because it really is the heart of many of the questions 

-- the complex questions that this Board has asked and 

will continue to ask, in our opinion. 

I also wanted to mention a few other key projects that 

are really instrumental in telling us where we're going 

to be heading in the future. The first -- well, really 

the sole one on this slide is the systems which we call 

HEDS, which stands for the HERB Epidemiological Data 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 319 

management System. It's a complex database of 

Department of Energy and Department of Defense workers, 

all of which have been studied by HERB in some way or 

another. 

This study is linked by -- well, it contains 

demographic and work history data for Department of 

Energy workers. It also contains radiological exposure 

data, as well as non-radiological exposure data such as 

chemical exposures, physical hazards other than 

radiation. It could contain noise exposure or anything 

that we measure that isn't related to radiation. 

The data, very importantly, are linked by something we 

call a master roster, and every time we put a new 

cohort into HEDS, we have to match it against everyone 

else that's already in there so that we can find 

workers who went from facility to facility. And this 

linkage is what allows us to do multi-site studies and 

to carefully take into account exposures that occurred 

across the complex, because we do know that workers did 

move from site to site. 

The key staff on this project are clearly our IT 

specialists, but we do have input as well from 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 320 

epidemiologists, exposure assessors and others. 

I wanted to touch briefly on some of our high priority 

future research projects. These include -- and really 

are based in some degree on our success in putting 

together the HEDS system. We would like to be able to 

conduct more multi-site studies because we really 

believe that they allow us sufficient power to overcome 

the problem we have in doing these low-dose chronic 

radiation epidemiology studies. 

Some of the cohort-based studies we've considered are, 

for example, studies of the neutron-exposed workers 

across the complex. As I learned several years ago in 

sitting on a panel that IARC put together that was 

evaluating risks of exposure to gamma and neutron 

radiation, there really are no cohort -- human cohort 

studies of neutron exposures and risks directly from 

neutrons. We do believe that the DOE work force offers 

an opportunity to evaluate neutron risks directly 

instead of relying on animal studies or on studies of 

chromosomal aberrations or other lab-based studies. 

We're also very interested in studying plutonium as a 

hazard across the DOE complex. We've -- I've told you 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 321 

about a number of studies that involve plutonium 

exposures, and the most effective way we believe to 

study them is to combine them through our epidemiologic 

database system and to be able to evaluate, complexwide, the hazards faced -- or brought by plutonium 

exposures. 

A few of the other exposures that have received 

slightly lesser priority, just because of the primacy 

given to plutonium and neutron, are perhaps uraniumexposed workers. A number of researchers -- and you'll 

see discussions of this in your briefing packet -- have 

looked across the complex at uranium exposures, and we 

believe the exposure assessments could be improved in 

that assessment and would like the opportunity to study 

that. We've also discussed conducting tritium and 

polonium exposure-based cohort studies. 

As you may have noticed as you've gone through the 

briefing book, most of our studies are studies of 

cancer mortality, simply because those -- mortality 

data systems are well established for epidemiologic 

research and we know how to use them on a national 

basis. However, we do understand that these are not as 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 322 

efficient for studying cancer incidence for disease 

that have low mortality rates, like skin cancer, 

prostate cancer or breast cancer. Now this is not to 

say that these aren't serious, deadly diseases, but 

compared to other cancers, it's -- you tend to see 

fewer of them if you only study mortality, and we 

believe it is important to study cancer incidence for 

these types of diseases. The problem, though, is that 

the U.S. doesn't have a good system for monitoring 

cancer incidence on a nationwide basis, and so it's 

difficult to find comparison statistics across a 

population. And it's even difficult to find incident 

cancer cases in a defined population, so we do view 

this as a high priority to develop and to evaluate such 

an incidence study system, but we're in the process of 

looking into that right now. 

And for many reasons we believe that it's important to 

start assessing the information that we already have 

about occupational cohorts with respect to radiation 

exposure. One way to do this, if we can't combine 

cohorts using the raw data that's in our system, we 

would have to use information from studies that are 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 323 

published in the literature. This is a common thing to 

do epidemiologically, and it's a way that 

epidemiologists can make sense of data from studies 

that give you conflicting information. It's a 

formalized research process called meta-analysis, and 

it allows you to incorporate results of studies when 

perhaps all you may have is the study design 

information, information about the risks and confidence 

intervals about them. And we believe that it is 

possible to begin doing these types of analysis, given 

the information we already have about DOE cohorts and 

that which we're about to get from these studies that 

I've mentioned recently. 

Lastly, and very importantly, we believe that current 

worker exposures and health effects are of great 

interest from a public health standpoint. We have 

primarily been studying workers who were formerly 

involved in DOE production -- the era of DOE 

production. As you know, most DOE facilities have 

moved into a decommissioning and decontamination era, 

and we believe that studies of hazards of health 

effects faced by these workers is a very important 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 324 

direction for us in the future. 

Now I'd like to turn to what we learned from reading 

transcripts. Unfortunately, none of us were attending 

your February meeting, but due to the excellent minutetaking, we were able to understand what you discussed 

and agreed on as priorities in terms of research needs. 

And these are in no particular order. Russ Henshaw 

really helped us try to distill your discussion into a 

couple of different priority levels. The first I 

called level one and the second level two. 

The first is the incorporation of occupational studies 

into risk models, which you expressed as a level one 

priority. The smoking adjustment for lung cancer, 

which we've already heard discussed over the last day, 

was expressed as well as a level one concern or 

research priority. The incorporation of background 

cancer risks into the risk models was identified as a 

high priority item, as well as the grouping of rare 

types of cancer and prostate cancer, which isn't 

necessarily a rare cancer, but which -- of which little 

is known about risks from radiation exposures. 

Some of the lesser priority levels -- items were age at 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 325 

exposure issues and the interaction of radiation with 

other workplace exposures. Now I don't know if this 

reflects your current thinking. This is what we were 

able to glean from, again, what we read from the 

February meeting. 

So I'd like to go through, if I have time, our current 

research agenda and how we believe that it addresses 

several of your most important priority areas, as well 

as a few others that we thought of ourselves or that we 

learned through discussions with many of you in other 

settings. 

First is the incorporation of occupational studies into 

risk models. And to us, this is a simple thing to say, 

but when you try to identify how a study fits into it, 

you really need to break it apart into its component 

parts. Because as you know, IREP itself is very 

complicated and doesn't have just a single model that's 

used to evaluate risk. 

The first issue that we felt really touched on one of 

the major concerns is that we feel it's important to 

establish -- just as the atomic bomb survivor data is 

considered a gold standard of exposures that occur 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 326 

instantaneously, we believe it's important to establish 

an occupational gold standard against which risk 

coefficients could be based and evaluated. 

Because of the different flavors of radiation and the 

different effects that they may have on tissue and on 

cancer risk, it's simplest to break this up into 

exposure types. So starting with high energy photon 

exposures, we have several studies that have either 

been completed or are soon to be completed that are 

looking primarily at high energy photon exposures and 

don't have a lot of other exposures that make the 

picture much more complex. These include the cohort 

mortality study of Portsmouth Naval Shipyard workers, 

the study of INEEL workers, the cohort mortality study 

-- we believe the best study of that will be the most 

current study since it takes into account more recent 

cancer mortality. And this, as I said, is a grant that 

we expect to be completed sometime this summer. 

The new grant that we've just funded with Dr. 

Richardson to look at cohort mortality among Savannah 

River site workers we believe will also answer some key 

questions with respect to high energy photon exposures. 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 327 

And yet it's important to remember that each of these 

studies could give us very different estimates of risk 

on an individual basis. This is why we believe the 

combined cohort studies that allow you to not just pool 

results from a risk estimate basis, but also combine 

the basic data that's used to derive risk coefficients 

could be very important. 

As Dave mentioned, though, there are many researchers 

who are also doing important research on this area. 

For example, studies of X-ray technologists that are 

being conducted by the National Cancer Institute are 

also occupationally-based and also are concerned with 

relatively low, chronically-received doses. They're 

not instantaneous high-dose exposures. So it's 

unlikely that we'll get raw data with which to pool DOE 

data. However, we could conduct meta-analyses that 

incorporate not just DOE and DOD cohorts, but also 

other occupational cohorts that could give us very 

valuable information on higher energy photon risks. 

Another obvious one is the study of cancer among the 

international nuclear workers, which is one of the 

largest studies ever to be conducted I think of 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 328 

anything epidemiologically. It has over half a million 

people in it. 

A second question that we feel is extremely important 

is not only to look at high energy photons as a gold 

standard, but to directly assess the risks of exposures 

to internal emitters and to neutrons. As I've 

mentioned, several of our studies, including the Rocky 

Flats cohort study as well as the Rocky Flats lung 

cancer case-control study, the Fernald lung cancer 

study looking at radon exposures, the Savannah River 

cohort mortality study which is looking not only at 

photons but at tritium exposures, the study of multiple 

myeloma among K-25 workers, neutron-exposed cohort 

study which has yet to begin, and again combined cohort 

studies like the plutonium, uranium workers and other 

studies based on radionuclide exposures. Again, we 

also need to consider incorporating, through hopefully 

meta-analysis or some other technique, data from nonDOE cohorts such as Mayak worker studies, although the 

dose ranges for that study are far greater than most 

DOE workers have experienced, so the relevance is not 

quite as good as it is studying this in the population 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 329 

of DOE workers themselves. 

We've identified a few other issues related to exposure 

assessment, and you may ask why this is being 

considered in the HERB setting rather than in the dose 

reconstruction setting of OCAS. We also think it's 

very important in producing accurate risk estimates to 

work with the best exposure data possible. And to do 

this, we need to address key errors that may exist in 

dosimetry in conducting our epidemiologic studies. One 

of these is the direct assessment of organ doses from 

internal radiation exposures. As we know, commissions 

like the ICRP and other international and national 

bodies continually update and improve their dose 

assessment models, and we would like to be able to 

incorporate these as much as possible into our 

epidemiologic studies. We're doing this in a grant 

setting through the Rocky Flats lung dose assessment 

project. We're also looking, as I mentioned, at 

plutonium bone marrow doses in the multi-site leukemia 

study, which could help us address the issue of RBE in 

leukemia for alpha emitters. As you saw, that is a key 

question that still remains in the IREP program. 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 330 

The multiple myeloma K-25 case-control study is looking 

at direct organ doses to uranium -- enriched uranium 

exposures. And we're also looking at radon and -- lung 

doses to radon in the Fernald cohort mortality study 

and in the lung cancer case-control study being 

conducted by our grantees. 

In addition to internal emitters, we're also concerned 

about organ dose characterization for neutron 

exposures, and so as we move into the phase of studying 

neutron work-- exposed cohorts across the complex, a 

very important aspect of that is the exposure 

assessment and neutron dose assessment. As Dr. 

Kocher's presentation explained yesterday, there are 

still key questions about transferring organ doses from 

animal studies into human studies, and that is a 

question that we're very concerned about, as well. 

Oh, I skipped one, which is the additional sources of 

uncertainty in the dosimetry in epidemiologic studies. 

This is a well-studied phenomenon that continues to 

advance as researchers prove their uncertainty analysis 

techniques and dosimetry analysis techniques. Several 

of our studies are well-suited to study these 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 331 

particular issues, particularly the Portsmouth Naval 

Shipyard cohort studies. 

A second priority that received some discussion 

yesterday was the issue of a smoking adjustment for 

lung cancer. And as epidemiologists, the way that I 

like to view this is in a question that can be either 

confirmed or refuted. One of these is exactly what is 

the interaction between smoking and radiation 

exposures, for not only lung cancer, but for other 

cancers as well. As poor as the data may be for lung 

cancer, it's far better than for any other smokingrelated cancer, and there are many of them. We just 

don't have a lot of information epidemiologically about 

how smoking interacts with other exposures, including 

radiation. 

The Rocky Flats lung cancer case-control study, as I 

mentioned, is specifically evaluating this and I'd urge 

you to read that report if you're interested in this 

topic. Several of the studies that we have underway 

that address -- directly address this in nuclear 

workers is the Fernald lung cancer study, the 

Portsmouth Naval Shipyard lung cancer case-control 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 332 

study, our multi-site lung cancer case-control study, 

our multi-site leukemia case-control study -- which is 

an example of another disease in addition to lung 

cancer, and we believe it's important to conduct a 

careful structured review of these and other studies 

that have been conducted looking at this issue in the 

past. 

This is -- does pose a great challenge in DOE cohorts, 

however, because most of our studies, as you see, are 

case-control studies in which the case has already 

died. And so in some cases it is difficult to get 

smoking information. We've made great use of medical 

records within the DOE complex in order to obtain 

smoking information that's unbiased because it was 

collected in advance of the person becoming a lung 

cancer case or entering into our study. 

The issue of incorporation of background cancer risks 

we split into two different topic areas. One is the 

use of adjustments for racial, ethnic and other group 

differences, and also temporal changes, changes over 

time. As you know, the IREP model is based on 

background rates that are fixed at one point in time. 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 333 

However, cancer rates have changed over time and in 

some cases increased, in some decreased. Workers who 

may be claimants could have become sick many, many 

years ago, and the issue of which rate one uses to 

adjust for background risk is of some interest. 

Now this isn't necessarily a research question for 

HERB. However, we do believe that the use of direct 

risk estimates from DOE worker populations would to 

some degree obviate the need to use a risk transfer 

function in the IREP models, which we believe to be of 

great importance in -- to this Board. 

A second question is the use of adjustments for 

radiosensitive subpopulations. Now it's been a while 

since I read the actual enabling legislation for the 

program, but I think I recall something about looking 

into radiosensitive subpopulations. That's something 

that doesn't currently exist in the IREP modeling. 

However, we are interested in looking at risks by 

gender, by race if we have sufficient numbers, and 

perhaps other factors. And some of the other studies 

that are already looking into this are listed here. 

This is something that we note is of great interest 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 334 

across the entire scientific community and is something 

that may grow in interest and importance in the coming 

years. 

You identified another fairly high priority item which 

is how the different rare cancer types are grouped, and 

issues about prostate cancer. We view this as looking 

into developing risk models for some of the more rare 

cancer sites, or for cancer sites for which the 

radiation risks are not well known, such as prostate. 

Now breast cancer is well known; however, one -- male 

breast is of concern. However, very few studies have 

evaluated breast cancer risk in men and what the risk 

factors are for that. 

In order to address some of these -- we do have some 

proposed studies. As I mentioned, it is difficult to 

do incidence studies in the DOE work force and really 

in any large U.S. population that's mobile, like the 

DOE work force is. However, we've evaluated conducting 

a skin cancer incidence study, a prostate cancer 

incidence study. We also believe that evaluating some 

of the rare cancers could be more feasible if we use a 

combined cohort approach that combines data from many 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 335 

facilities in order to increase the statistical power 

to evaluate risk. Again, a meta-analysis or structured 

review of not only HERB studies but of other 

occupationally-exposed cohorts could help us address 

this issue. 

The issue of age at exposure is one that we've been 

keenly interested in, as has the Board. This, we feel, 

breaks into two different questions. One is how does 

radiation risk depend on the age at which a person 

receives exposure. 

The other is really an epidemiologic problem, which is 

that it's very difficult to study complex exposures 

that occurred continuously over time because there are 

so many factors that could weigh into what the risks 

are from. One of these is age at exposure. As we 

heard from Owen, the issue of attained age, how old one 

is when one gets cancer, is an important potential risk 

factor. The duration of time that occurs between when 

exposure occurred and when disease might occur is 

another factor. All three of these are very difficult 

to study independently. And depending on how one 

chooses a model, you could get very different results 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 336 

about age at exposure if you look at these other 

factors in -- concurrently or separately. So it is 

epidemiologically a very -- that's, in my opinion, why 

it's so difficult to get a firm answer on this, is that 

there are so many other factors that are co-occurring 

along with age at exposure. 

As I mentioned, we have a contract and several grants 

that are looking specifically at age at exposure 

issues. The Rocky Flats lung cancer case-control study 

did evaluate age at exposure, as well as several 

cohorts, including Hanford, Savannah River site. I 

believe the PNS cohort mortality study can address this 

to some degree, as well as the Idaho cohort. The 

International Nuclear Workers study is looking into age 

at exposure, as well, combined across a large group of 

workers. And again, to increase the statistical power 

to detect small differences or changes that are 

affecting other risks, as well, we believe the combined 

cohort analysis and perhaps meta-analysis is a good way 

to approach this problem. 

The interaction of radiation and other workplace 

exposures was identified as an issue of some importance 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 337 

to this group, and as you know, IREP assumes that the 

interaction is multiplicative. That is, it doesn't 

matter what your other exposures were, your risk from 

radiation is the same whether you were exposed to no 

other chemical -- or no chemical exposures, a moderate 

level of chemical exposure or a very high level of 

chemical exposure. The relative increase in your risk, 

which is what directly affects your probability of 

causation, is the determining factor. And that's 

assumed to be equal across categories. 

So the question then boils down to is there evidence 

for a departure from a multiplicative interaction, and 

if so, which direction does it go. In some cases that 

change could be less favorable to the claimant, and in 

some cases more. 

As Dave indicated, several of our studies do address 

mixed exposures. However, no study addresses all kinds 

of mixed exposures. It would just be too difficult to 

study and probably not possible, given the range of 

activities that occurred across the complex. However, 

some of the studies that I've already mentioned are 

looking at interactions with chemical exposures, with 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 338 

benzene and carbon tetrachloride in the case of 

leukemia risk, with asbestos and welding fume exposures 

in the case of lung cancer, with -- let's see, uranium 

with external exposures, including work-related X-rays 

and chemical exposures in the multiple myeloma study, 

and on and on. We really -- every study has to 

consider how the radiation exposure interacts with 

other co-occurring workplace exposures. 

Some other issues that weren't raised at your February 

meeting but which I recall being raised in the past and 

which certainly have come up already at this meeting 

are important, in our opinion, and we have studies 

that will be addressing these issues. A couple of 

these are risk models for radiation exposures in 

chronic lymphocytic leukemia. Although the Department 

of Labor is returning letters that say there is zero 

probability of causation, the scientific evidence for 

that is not that strong. And many of our studies are 

addressing CLL risks directly. These include the 

multi-site leukemia case-control study, the PNS 

leukemia study, and we believe we're seeing enough 

leukemias in other cohorts as well that some combined 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 339 

investigations of -- across the DOE complex could 

address this. CLL, as you know, is rare in the 

Japanese population. However, it is fairly common in 

western populations. And so not only are DOE studies 

important, but meta-analysis or structured review of 

additional western populations like the Canadian 

workers, the British workers and several others will be 

of some importance. And I should add that the IARC 

study will also be looking into risk of exposure for 

CLL, as well. 

The adjustments for latency for radiogenic leukemia we 

know you addressed in an administrative setting or 

policy setting in your last meeting. However, there 

are still important scientific issues related to this. 

The time period that elapsed between the exposure that 

occurred in Japan, the atomic bomb blasts, and the 

initiation of the studies is such that they can't 

answer that question using the Japanese data. It's 

really incumbent on other research studies to look into 

this issue. The standard thinking is that two years is 

sort of the standard latency adjustment one applies for 

leukemia risks. However, that has not been empirically 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 340 

determined to be the best or the most accurate latency. 

And so several of our leukemia studies are looking 

into this issue, as well. 

Two more issues are the direct evidence for a dose and 

dose rate adjustment factor that occurs in occupational 

studies. Now that -- you've mentioned some potential 

adjustments that could occur from IREP, but this really 

is a central topic of great concern in conducting any 

occupational cohort study because it's inherent in the 

design of the study that we're dealing with populations 

that are exposed at a lower dose rate to lower levels. 

And so any -- generally any study that evaluates risks 

compares the findings for risk coefficients for a low 

dose rate, low dose exposure to studies like the 

Japanese atomic bomb survivor study. And those kinds 

of comparisons have been done in the past and will 

continue to be done. We think that there really needs 

to be a careful look at this, not only in a combined 

study basis, but reviewing what other studies have 

found to address this issue to help us, using the 

existing human data, to answer the question, without 

relying on either theory or animal studies. 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 341 

And lastly there is a minor issue related to the cut 

points that the NCI program uses to determine what an 

acute dose is versus a chronic dose. I don't know how 

or if this is really applied in IREP, but it is 

something that piqued our interests as researchers and 

we believe we can attempt to evaluate this, to some 

degree. 

I wanted to leave you with a few issues regarding 

current workers. As Dave mentioned, public health 

issues related to current workers and the health 

hazards that they face are of great interest to us 

because we know that problems didn't end with the end 

of the production era. A few of the issues that we 

have identified and that have been outlined in some of 

our documents that you'll see in the annotated 

bibliography include the fact that D and D era workers 

could face not only different hazards in the workplace, 

but also health effects that could differ from those of 

concern to current workers. And we have been in 

contact -- Travis Kubale in particular has been in --

done an outstanding job of reaching out to current 

workers to try to identify issues of concern to them. 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 342 

And we are gathering this information to help us 

develop future research and other activities that could 

help address the hazards and health effects of concern 

to these workers. 

One of our very important findings is that for these 

current workers the -- well, we're hearing concerns 

right now about the adequacy of radiation monitoring 

and health monitoring, even in current workers, 

particularly in subcontractors who may have -- not have 

access to the same level of monitoring as prime 

contractors at a facility. 

And lastly, we've identified the fact that information 

quality that could support future epidemiologic studies 

and also compensation practice is of some concern to 

us, and we've identified this in a document published a 

couple of years ago. We hope that DOE will be helpful 

in responding to these concerns, but we do feel that 

the documentation that could support future studies is 

of great concern and something we're hoping to address. 

For further information about this you can reach us via 

many mechanisms. Talk to us here, call us at this 

number. We have an excellent web site that contains 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 343 

full reports of many of the things that you've seen 

annotated in the listing. 

We also encourage you to, if you'd like us to come back 

and talk to you, we'd be happy to do so at some point 

in the future. And with that, I'll open it up for 

questions. 

DR. ZIEMER: Thank you very much, both of you, and -- I 

get a little amused at all the acronyms, particularly 

when acronyms include other acronyms as part -- but I 

am looking for the day when every letter of an acronym 

is another one. But -- and we use that to shorten 

things, so I'm going to call you Dr. MS-B. Dr. MS-B --

DR. SCHUBAUER-BERIGAN: That's fine. 

DR. ZIEMER: -- would you identify for our group -- I 

know you have a number of your colleagues from the 

group from HERB here today. Could you identify for the 

Board the other HERB individuals? I've met some of 

them but not everybody has. 

DR. SCHUBAUER-BERIGAN: Sure, I'd be happy to do so. 

Perhaps they'd be willing to stand as I say their name. 

The assistant branch chief, Dr. Steven Ehrenholtz* is 

with us and he's been in HERB for quite a long time and 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 344 

I'm sure is familiar to many of you. Next to him we 

have Dr. James Yiin, who is an epidemiologist who's 

fairly new to our branch and who's got expertise in 

statistical analysis of epidemiologic studies and in 

risk assessment, as well. Travis Kubale, who is not 

only our help communicator and a doctoral student, but 

a tremendous outreach asset to our group, as well. 

Scott Hind* who is at the end is a contractor with us. 

He's an industrial hygienist and he's helping us to 

get these studies done and get them out the door. And 

Dr. Greg Macievic, who I almost missed here, is a 

health physicist who's been with us about a year and a 

half now, who is conducting -- health physicists are in 

very short supply in our group so we spread them rather 

thin across the projects. He's on three of our very 

important cohort case-control studies. Did I miss 

anyone? Okay. 

DR. ZIEMER: Thank you very much. I suspect there are 

a number of questions and I would like to ask you to do 

two other things before we get into general questions. 

Early in your presentation I think you -- maybe it was 

Dr. Utterback -- mentioned analytical epidemiological 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 345 

studies, and would you define for the Board and for the 

public the difference between analytical 

epidemiological studies and descriptive epidemiological 

studies? This is a test. Maybe we should ask the PhD. 

candidate to do this. 

DR. SCHUBAUER-BERIGAN: He's hiding and he's shaking 

and -- no, I'd be happy to do that. It's a very 

important question, and it is raised frequently. 

A descriptive epidemiological study is one that 

attempts to define disease in terms of where it occurs, 

when it occurs. It's really defining its occurrence in 

time and place and among people -- who is getting the 

disease, what are the rates of disease. It also 

includes studies that are not necessarily done on an 

individual basis. And in the radiation community you 

frequently see published things like what we call 

ecologic studies that are conducted at the level of a 

population rather than at the level of an individual 

person. And so you might see someone comparing rates 

of cancer in India in a low altitude environment where 

radiation doses are low with people in Colorado who 

might get higher doses and look at cancer. It's 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 346 

considered non-analytic because it doesn't take into 

account what's happening on a personal level. 

In contrast, an analytic epidemiology study looks at 

the level of the individual and it also tries to 

evaluate associations between disease and some kind of 

exposure, in this case radiation exposure. And the 

most common designs are cohort studies, case-control 

studies and the like, and that's -- that is what we 

conduct. 

DR. ZIEMER: And then one other item that was 

mentioned, sort of in passing, but -- and might have 

escaped notice was the use of CEDR, and would you 

describe for the Board and for the public the 

Comprehensive Epidemiological Data Resource? 

DR. SCHUBAUER-BERIGAN: Surely. You've already defined 

the acronym and for the record, again, it's the 

Comprehensive Epidemiological Data Resource. It 

operates by the DOE. They are the keepers of CEDR, and 

they've contracted with -- is it Lawrence Livermoor? 

UNIDENTIFIED: Lawrence Berkeley. 

DR. SCHUBAUER-BERIGAN: -- Lawrence Berkeley Laboratory 

to actually operate CEDR on their own storage systems. 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 347 

 CEDR contains de-identified information containing 

analytic files that were used to conduct epidemiologic 

studies. So as you go through the annotated 

bibliography and see a study listed in there, if it's 

been completed and it has been conducted among DOE 

workers, the Department of Energy wants the deidentified data from that study, including mortality or 

incidence information, any other extraneous factors 

that were used to conduct the study, and also exposure 

assessment information in the files of CEDR. And any 

qualified researcher who would like to have access to 

the data to study it is eligible to apply and to 

receive permission to use the data. 

DR. ZIEMER: Thank you. Dr. DeHart has a question. 

DR. DEHART: Currently there are a number of clinical 

evaluations that are ongoing with non-DOE workers who 

were contractor workers at some point in time at DOE 

facilities. For example, construction workers, an 

organization that's working with them, a unionsupported research activity there. What kind of 

interface is going on between you and those -- that 

clinical data? 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 348 

DR. UTTERBACK: Just to clarify, I believe you're 

referring to what collectively at DOE is known as the 

former worker program of providing medical screening 

for workers at Department of Energy sites, and there 

are a number of these that have been underway. I think 

the number right now is 15, maybe 16 of these programs, 

and some sites have multiple activities. 

We do interact with this group. We try to keep abreast 

of changes that are going on with that group of 

investigators and clinicians, and we are trying to work 

with the Department of Energy in evaluating the value 

of that information for protecting worker health, not 

just site by site, but collectively across the sites. 

So very recently, just this spring, we were able to get 

copies of the questionnaires that are administered to 

these workers as they are introduced into the programs 

to try to determine what kind of information is 

collected, how consistent it is across the site and 

what the capabilities may be of collapsing the data --

that's a term that we use for kind of bringing 

everything together. And just this past week we did 

get a report from our investigator, Dave Peterson, and 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 349 

a contractor that he's working with, Phil Beirbaum*, in 

analyzing the content of the questionnaires. And of 

course any time you go through that sort of a process 

of trying to look across a variety of different 

information sources, you know, the first result that 

comes out of that is a whole list of additional 

questions that you now have. So we are -- we want to 

try to work with the program, try to evaluate the value 

of that information for protecting not only former 

workers, but also current workers and some of the 

individual investigators. I know Mark Griffon's 

involved in a program, as well. You are looking at 

this, you know, within a site, trying to identify where 

hazards that maybe were not recognized by the current 

staff who, you know, people go to for information about 

historical exposures are trying to utilize this 

information they're getting from the workers, you know, 

from the sites and trying to identify where hazards may 

have exist over the lifetime of the facility. So we 

believe that potentially it's a very useful set of 

data. 

Unfortunately, just like, you know, data systems vary 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 350 

from site to site. If you look at Los Alamos versus 

Hanford, you know, run by two different contractors, 

they've got different data systems, different 

organizations, different ways of running things. The 

same occurred with these former worker medical 

screening programs. Each site basically developed 

their own data systems, their own set of questionnaires 

and the like, and so it will be challenge to try to 

bring that information together and try to analyze it 

appropriately. 

Thank you for the question. I think it is a very 

valuable -- potentially very valuable resource. 

DR. ZIEMER: Let me ask a question regarding plutonium 

workers. In that -- in those studies do you have 

access or do you use any of the database from the U.S. 

Transuranic Registry in the... 

DR. UTTERBACK: The work with plutonium workers that 

was recently completed with, you know, Jim Ruttenber at 

the University of Colorado Health Sciences Center and 

the Colorado Department of Public Health and 

Environment is -- well, as a matter of fact, I think 

one of Owen's colleagues that was here yesterday is 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 351 

working with that group and trying to develop a model 

for doing lung dose estimates for the lung cancer cases 

and controls within that study. And then they want to 

compare -- this is based on a conversation I had with 

Dr. Ruttenber last month, that they want to compare 

their predicted lung doses with what they are getting 

from autopsy tissues -- or from the tissue samples that 

come from plutonium-exposed workers that are maintained 

by the Transuranic Registry. So I mean we have not 

used any of that information directly within our 

studies, but the link is going on, you know, through an 

external investigator. 

DR. ZIEMER: I'd also like to ask about Chernobyl 

workers, such as the liquidators. Are there any -- do 

you have any collaborations going on? I notice you're 

looking at Russia and the Mayak people. What about the 

Ukraine and any of the Chernobyl-related workers? 

DR. UTTERBACK: Once again, we have an extramural grant 

that is addressing that issue. It is by Dr. Elizabeth 

Cardis at the International Agency for Research on 

Cancer, IARC, in Lyon, France. And she's doing the 

dose reconstruction for the Chernobyl liquidators, as 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 352 

they're called. It's a very large population of 

workers who responded to the incident and over the 

succeeding months had relatively -- well, very high 

doses of both external -- and many of them had internal 

exposures, as well. And we do anticipate a report on 

that study within the next six to 12 months, I would 

add. 

DR. ZIEMER: Leon? 

MR. OWENS: In regard to the study that was initiated 

at Paducah by the University of Kentucky and University 

of Louisville, I know that study got off to a very good 

start. There appeared to be -- have been some 

setbacks. Do you have an expected date on when that 

study will be completed? 

DR. SCHUBAUER-BERIGAN: I have not recently seen a 

projected end date, you know, for that study. They are 

preparing right now for a site visit to begin the 

collection of the records necessary to complete the 

study. This is a study that involves University of 

Louisville, University of Kentucky, as well as some of 

the staff at the University of Cincinnati who will be 

involved in getting that work done. And they are 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 353 

preparing, I believe within the next couple of months, 

you know, to get to the site and begin to collect the 

records and -- you know, initiating a cohort study like 

this, they're doing a study of a group of workers 

that's never been studied before. It's a large 

undertaking. We've learned this lesson the hard way, 

you know, doing a Denovo* cohort analysis on a working 

population is a huge undertaking. The INEEL study is 

one that we began early on in our group and we are just 

now wrapping it up, you know, some ten years later. 

That's a very large cohort. We're hoping that the 

Paducah worker cohort is going to be -- you know, given 

it's a much smaller work force, Idaho is a national 

lab, have people moving in and out a lot. Hopefully 

the work force at Paducah is more stable. 

MR. OWENS: We were -- we were concerned because the 

union was directly involved in the initial meeting that 

was held at Paducah. We had a small group of former 

and current workers who were assembled together to 

assist in the information collection, and since that 

date -- which has been about six or seven months ago --

we just haven't had any additional follow-up, so that's 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 354 

why I wanted to at least find out the status. 

DR. UTTERBACK: Well, I know they are working through 

some of the business aspects of, you know, getting 

contractors in there so that they can collect the 

information, and that's the most recent activity that 

I've seen there. They're just trying to get those 

things worked out. 

You know, there is a process of getting access to these 

sites that oftentimes is -- is problematic. I mean you 

wind up investing a lot of time in finding out what the 

rules are, what the limitations are on access to 

various things you want to look at, and then trying to 

put together some sort of a solution for addressing 

that particular problem at that site. So I -- you 

know, I'm very optimistic -- an eternal optimist -- and 

I'm very hopeful that they're going to be in there 

very, very shortly and begin to collect the records. 

And some of those are electronic. Some of them are 

microfilm, microfiche and some of them are paper, and 

that can be a very difficult problem. 

One of the problems there is that there's pertinent 

records to that study that are in the vault, and the 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 355 

vault is a secure area because it also contains, you 

know, information that's restricted for national 

security reasons. So getting people in there requires 

people who are cleared, and getting a clearance is 

something that takes time, especially these days. 

Thank you for your question, though. 

MR. GRIFFON: Yeah, I was just looking in the 

attachments and -- that you provided on summaries of 

all the studies, current and past. And I was -- I was 

thinking that it might be a valuable tool -- going on 

the discussion we had yesterday, it might be a valuable 

tool to take the matrix that you developed, Mary, 

showing the items of interest to the Board and lining 

up current studies that might be also useful to 

integrate the past studies of relevance for those 

certain factors, like the gold standard photon studies, 

and group them by historical -- that might be a 

starting point for us to look at how we might use some 

of those past studies to modify uncertainty estimates 

in the IREP model or something -- you know, at least 

initiate discussions on that topic. I know, you know, 

we have questions of how quickly or when we can do 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 356 

that, but -- is that something that can possibly be 

provided? 

DR. UTTERBACK: Well, I mean I really kind of see that 

as an initial step in pursuing some of the research 

goals that we talked about, trying to figure out, you 

know, what is there and where it fits into this kind of 

matrix of -- of questions and issues that have been, 

you know, brought to our attention by the Board and by 

the people working with the Board. It really is an 

analytical process to do that. It's not a matter of 

just well, they did external exposures here and they 

did external exposures there, because it's never clear 

cut, and you have to be very careful about beginning to 

sort these things out. But I do believe that it's a 

very worthwhile analytical process, and I do believe 

that the stage that we're at now with the occupational 

studies presents this opportunity to us finally, that 

we are getting cohort analyses done on these very large 

populations in such a way -- and we've worked very hard 

over the years to try to do these studies in such a way 

-- that they can be combined for future analysis. And 

it's not -- as Mary pointed out -- you know, based on 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 357 

exposures, but also on the cohorts and looking at, you 

know, some of the larger questions of external -- the 

effects of external radiation, you know, particularly 

gamma radiation in these occupational cohorts. You 

know, it's something that we are looking at addressing 

in the future. You know, it's something that would 

require some change in the strategies and the way that 

we've done studies in the past. 

And frankly, you know, it's going to be easiest to do 

if we are able to identify, you know, additional 

resources to make that possible, not only, you know, 

financial resources, but also the intellectual 

resources, the people, you know, the most important 

part of our program. We need to find the people that 

have skills in this area that can bring them to bear in 

the most efficient way. If we have to retrain, retool 

our people, then that, you know, stretches out the 

timeline a little bit. 

Yeah, we believe that the stage is set and we'd like 

very much to -- you know, to pursue that line of 

reasoning within these studies. 

DR. ZIEMER: I'd like to ask a question that, in a 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 358 

sense, cuts across many of these studies and to 

parallel this question with what's done on individual 

dose reconstructions. In your studies of various 

sorts, whether they're case-control or otherwise, 

somebody is having to take some dose data -- DOE dose 

data. Now in our case, there's a lot of massaging 

done. We take the dosimetry data, there's some 

corrections made for missing dose, there's corrections 

made for certain medical exposures that were required 

as part of the job and -- you're all aware of this --

and there's a distribution that's associated with that, 

not just a point value. Now I'm trying to get a feel -

- we have a number of investigators doing these other 

studies, these analytical epidemiological studies, and 

I'd like to get a feel for to what extent is there a 

somewhat common protocol in establishing what the dose 

values -- 'cause obviously you have -- you're looking 

at dose versus effect in a population type of 

situation. Can you talk a little bit about the 

uncertainties in those that are used there -- I think 

in many studies they bin these doses; they take groups 

of people that have doses between some lower and upper 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 359 

value and there's a variety of bins. Right? But give 

us a feel for what's required -- how -- how the 

investigators are using the DOE dose data, which 

everyone is saying is inadequate, and if it's 

inadequate, what are they -- and we do things to make 

it adequate for compensation decisions. How are the 

epidemiologists making it adequate for their studies so 

that we have confidence that the final result is 

useful, even for our use? 

DR. UTTERBACK: I mean you -- you mentioned several 

things that are -- that are used, including, you know, 

utilizing dose ranges instead of individual values, you 

know, doing the categorical analysis instead of 

analyzing continuous variables. That -- you know, I --

that is -- is a -- I mean how much time do I have? I 

mean --

DR. ZIEMER: Well, I think --

DR. UTTERBACK: We could bring out some health 

physicists --

DR. ZIEMER: I think if you could give us kind of an 

overview of how -- I don't want to get into all the 

detail here, but it seems to me, even if you're going 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 360 

to do meta-analysis, you have to have some idea of 

whether the investigators are approaching this in a 

sort of somewhat similar way, or how do you put this 

all together? 

DR. UTTERBACK: Actually --

DR. ZIEMER: And remember you're speaking to largely 

non-epidemiologists here. 

DR. UTTERBACK: You know, we would like to come back 

and bring, you know -- we do have a health physicist 

here with us who could come up and talk a lot about 

this. We would like to come back and maybe address 

that at some point in the future, but all those things 

you mentioned are areas that over the past decade of 

conducting this research that we've discovered as being 

important issues. The role that medical exposures and, 

you know, occupationally-required medical evaluations 

and the X-rays that are associated with that and how 

that affects the dose estimate for the workers as 

missed dose is something that early on was recognized 

as an issue due to censoring within the data limits of 

detection on dosimetry, a variety of other things, and 

in some populations only portions of the populations 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 361 

being monitored, and internal dosimetry presents this 

whole sundry of uncertainties as we go through this 

process. So you know, it is different because, you 

know, it's not sufficient within the epi study -- and 

I'll defer to Mary very shortly on this, but you know, 

to do the distribution of uncertainty and assign that 

to each individual worker. You know, instead we want 

to come up with some estimate of the central tendency, 

you know, what is the best estimate of exposure for 

this worker, and then, you know, run that through the 

analysis. So you know, these are all things that we 

work very, very hard on. We've got some very talented 

individuals and some very detail-oriented individuals 

who really dig into this and find out what the records 

will support, what is possible to do and what are the 

best estimates that we can derive. 

DR. SCHUBAUER-BERIGAN: I would only add to that in a 

couple of sentences. One is that most -- or many 

epidemiologic studies, not just worker studies, put 

exposures into bins. The lung cancer study done by Dr. 

Pierce Owen Hoffman referred to yesterday is one such 

study of the Japanese survivors that did classify 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 362 

workers according to the bin of radiation dose. It's 

of course imperative that you put workers into the 

proper bin in order to have an accurate study. And as 

Dr. Utterback indicated, there are many methods that we 

incorporate to try to do that. 

We may end up not being able to entirely determine 

which is the best estimate. And in that case, we would 

frequently conduct what's known as a sensitivity 

analysis to use a range of possible alternative doses 

that could have been applied to that population and to 

determine how risk estimates might change. And that's 

part of the analysis one would have to do in order to 

incorporate different cohorts into a single analysis. 

DR. ZIEMER: Thank you. 

MR. GRIFFON: Yeah, you know, Paul's question triggered 

a question for me. Just -- just fro-- does the HERB 

branch have access to OCAS records? I imagine there's 

some privacy issues or -- or some -- but does the HERB 

branch have access to -- specifically, instead of the 

broader question, I was thinking of the case-control 

studies that you have ongoing where it might be very 

advantageous to look to some of the extensive health 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 363 

physics work that's going on in the OCAS branch for 

particular cases that are in your case-control study --

or controls that are in your case-control study. 

DR. SCHUBAUER-BERIGAN: I think at many levels there is 

a lot of interchange between HERB and the work that 

OCAS is doing. They've discovered a tremendous amount 

of information that's been very useful to the conduct 

of our epidemiologic studies. So far, to my knowledge, 

we haven't received any individual level exposure data 

that would contribute to our studies, but the data 

discoveries and data sources that OCAS has made to date 

have been very useful to us. 

MR. GRIFFON: But do you intend on -- on looking for 

that data? I mean -- or would you do a parallel 

process where you would reconstruct your doses 

independently of OCAS or... 

DR. SCHUBAUER-BERIGAN: It gets tricky in an 

epidemiologic setting because you end up, in some 

cases, having a different exposure assessment for your 

cases than you would for the non-cases because clearly 

every claimant -- the claimants who come in are most 

likely to be cases in our studies, and so that leads to 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 364 

problems epidemiologically in doing analysis. But we 

would certainly take any higher level information that 

could be useful that would help us further refine our 

exposure estimates. 

MR. ELLIOTT: Let me add to the first question that you 

asked. There's one system of records under the Privacy 

Act at NIOSH that -- that both the HERB research 

studies are added to the system of records which OCAS 

has access to, and we've utilized that information as 

best we can. And the information that OCAS receives 

from claimants and from our dose reconstruction effort, 

from our interviews, all of that is under the same 

Privacy Act system of records and HERB, in a 

institutional review board-approved protocol study, 

could have access to that if the study design called 

for it and was approved for that. 

DR. ZIEMER: But of course keep in mind that many of 

the dose reconstruction values only go far enough to 

determine probability of causation, and then you can 

stop. So that may not be the dose. If you have enough 

dose to get compensated, this -- the analysis is 

carried no further. That's not the value you need for 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 365 

an epi study, so there are two different endpoints that 

are of interest. 

Again, thank you very much. We appreciate a very 

informative input to the Board on this topic. 

DR. UTTERBACK: Thank you for having us here. It's 

been a pleasure. We always love talking about our 

research program and would welcome the opportunity to 

come back at any time. 

DR. ZIEMER: And we appreciate meeting your colleagues, 

as well. 

We're going to take a 15-minute break, and then we'll 

return for working -- Board working session. 

(Whereupon, a recess was taken.) 

BOARD DISCUSSION/WORKING SESSION 

REVIEW PROCESS OF COMPLETED DOSE RECONSTRUCTIONS
 

DR. ZIEMER: I'm going to call the Board back to order. 

We have a number of items to take care of yet, so if 

you'll take your seats we'll proceed. 

We're going to move now to a work session on dose 

reconstruction review process. I believe, Board 

members, you should now have some handouts from the 

dose reconstruction work group. There are I believe 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 366 

three documents. One is called procedure for 

processing individual dose reconstruction reviews; one 

is task order, dose reconstruction procedure and 

methods review; and the third is task, individual dose 

reconstruction review. 

Mark, is that correct? Those are the items? 

MR. GRIFFON: Yeah, and then --

UNIDENTIFIED: (Off microphone) And then there are 

some others. 

MR. GRIFFON: Yeah, there's three more that I think are 

being cop-- oh, that are -- have been handed out. 

Right? Three more from yesterday. 

DR. ZIEMER: Okay. The other items, there's a copy of 

yesterday's slides and I see a copy of a summary review 

for a basic review and advanced review. 

UNIDENTIFIED: Correct. 

DR. ZIEMER: All right. So there are six documents. 

Make sure you have those. 

So let me -- let me turn this over to Mark -- Mark, if 

you would, what I'd like to do if we can do this is try 

to limit this to 30 minutes, because we have an 

additional item we want to discuss before the public 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 367 

comment period. 

Wait a minute. Are we behind schedule? 

Okay. Well, yeah, try to limit this to --

MR. GRIFFON: I'll try -- I'll try to pick out the --

the big items. 

DR. ZIEMER: Let's move ahead, yeah. 

MR. GRIFFON: And let -- and -- yeah. What I -- what I 

can probably do is just tell you what we did as a 

working group last night and this morning. We -- we --

the three document -- the first three documents that 

Paul mentioned to you here, the first one is a 

procedure -- a draft, I should say, procedure for 

processing individual dose reconstruction reviews, and 

then the other two are separate tasks -- draft tasks 

that we sort of extracted from the task order contract 

itself. A lot of the language in the two tasks you'll 

recognize. I -- we did do some additions to those, but 

a lot of it's similar -- you know, sort of cut and 

pasted from the original task order contract. 

And I think what -- the process here, I think the --

that -- that I think might be appropriate is we -- we 

would like -- we would like these certainly available 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 368 

when the contract is awarded, some of this stuff to be 

all in place. And the notion was to get some drafts 

out today, as rough as they may be, and then by the 

time we have our next Board meeting we would -- we 

would get full comments from all Board members and 

draft a final document at that point. 

So, you know, I think -- 'cause there's a lot just to 

throw on you for a 30-minute discussion to review and 

give all comments, so I think the real intent is to 

take these back with you and have more -- a full 

discussion and -- and come up with a final draft at the 

next meeting. 

Having said that, I should point out some things in the 

-- in -- I'll start with the procedure and processing 

the individual dose reconstruction reviews 'cause I 

think it builds on some of the points from my overheads 

yesterday, some of the discussion items that I -- I 

threw out at the end of that presentation yesterday. 

You can see there are several parts of this --

selections of the cases for review -- I don't know, are 

copies available for the public? I see -- okay. All 

right. Selection of the cases for review, designation 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 369 

of Board members to the individual dose reconstruction 

case review. Section B there, we made some assumptions 

in this draft about how many cases would be done, and 

that was from the original -- the original task order 

contract, and then I -- you know, we made a estimate 

here that we would -- we would do 25 cases every two 

months, just to sort of give us something to think 

about in terms of how are these things going to be 

processed and what is the burden going to be on the 

contractor, as well as on the Board members that are 

going to be involved. I note that Board members, on a 

voluntary, rotating basis -- I -- I think that a lot of 

people -- a lot of individuals on the Board are -- are 

interested in participating in this, but I think 

everybody wants a little better definition of what 

participate means, what -- you know, what extent each 

individual Board member will have to be involved in 

this. So it would be -- you know, 25 cases every two 

months, cycling through at least for the initial year, 

based on the estimate of cases we did in the task order 

contract. 

The distribution of data -- this question -- Section C 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 370 

is the distribution of data to the contractor and 

designated Board members. I note in here something 

that -- that I think we need -- as a discussion, 

something that came up in the discussion items 

yesterday, which is -- NIOSH will provide data -- all 

data related to the individual case, which --

parentheses, the entire administrative record -- to 

both the contractor and designated Board members. And 

I've had some discussions with Larry on -- on just, you 

know, whether this can be done, given Privacy Act 

concerns, and I think we might want to ask NIOSH if 

there's any more word on that -- where we stand on 

that. I guess we should do it as we go, as... 

DR. ZIEMER: Yeah, I don't know that we need the 

answers to all of these necessarily --

MR. GRIFFON: Just to point out --

DR. ZIEMER: -- today if they don't have it, but at 

least they need to explore that and -- and while I have 

the mike, let me suggest that everybody on the Board 

and those members of the public, as well, just mark all 

of these copies as draft -- all this whole packet of 

stuff -- none of this has been approved by the Board. 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 371 

These are working drafts, so I think it would be 

appropriate to label them as such, and that way you 

will not later mistakenly think that these are 

procedures as they will be used 'cause they're subject 

to change. 

Additional comment, Tony? 

DR. ANDRADE: A quick question. Mark, item number one 

on C, just so that I can go home and think about it 

correctly, it says case numbers will be provided to 

NIOSH. Who is supposed to provide these case numbers? 

MR. GRIFFON: Right, in the -- Section A, the idea is 

that the Board is -- is going to do the random 

selection of the case numbers --

DR. ANDRADE: Okay. 

MR. GRIFFON: -- based on a random stratified approach, 

and then we give those numbers for them to pull the 

records -- the language might not have been great 

there, but that's the idea, yeah. 

DR. ANDRADE: That's fine. Okay. 

MR. ELLIOTT: Let me speak to the Privacy Act question. 

I don't have an answer today. We need to understand 

what you were proposing to do, what the process that 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 372 

you're proposing to engage in looked like here before 

we could get you answers about how we're going to 

control Privacy Act-related information and maintain 

the confidentiality of that. I think there's several 

ways we -- we might achieve that, but we need to have a 

better understanding of how you envision the process to 

be before we can then come to -- come into that and 

play the role that we need to play to support you, as 

well as to make sure that we do protect the 

confidential information, as we're all very much 

interested in doing that. So... 

MR. GRIFFON: The -- and the next item, C-3, talks 

about requests for additional documents. I know that 

at the pre-bidder meeting the question was asked on the 

records, and I think primarily what -- what we've been 

envisioning happening -- what NIOSH has been 

envisioning happening is the -- for an individual case 

the -- the administrative record will be on a CD and 

distributed, if it's -- meets Privacy Act concerns. 

The other question would be additional documents 

relevant to the review of the case, and I believe 

Larry's said in the past that's -- many of these 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 373 

documents may be available on the web site or by other 

means, or published papers that are readily available 

through other means, then the contractor would have to 

get them themselves. But there's -- there's questions 

-- and this is worth highlighting because it comes up 

in the -- in the individual task, also. There's 

questions about the site profiles, the worker profiles, 

those databases, if -- if they can be remotely accessed 

or if the contractors will actually have to make 

provisions for traveling and working at the ORAU or 

NIOSH offices to do some of those activities where 

they're required to compare a case against a site 

profile, for instance. So we -- we just want -- wanted 

some clarification on what -- what means might be 

available for that. 

Going on to the next page, D is the interface of the 

Board and the contractors with relevant experts and to 

the individual claimant. And I -- and understanding 

that last issue is certainly something that we need 

more discussion on, the access of the Board or this --

or our contractor, the contractor assisting us, to the 

individual claimant to do follow-up interviewing. 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 374 

That's something that we removed from the task order 

contract initially until we had more time to discuss 

it, but I think that -- that many of us on the Board do 

want to discuss that further, and many of us are 

interested in it, so I just highlight that. Maybe we 

won't get to it today, but I think we need more 

discussion on whether -- whether we want access to 

individual claimants for the Board and the contractor, 

and if so, how we can possibly go about that. And if 

there is -- I don't know if there is legal restrictions 

or --

DR. DEHART: You may recall that we had discussed at 

what point in the system will we actually have access 

to the record, when will we want to review this record 

with the contractor. And it's my understanding we've 

agreed that it would be post-adjudication. So the case 

has been --

MR. GRIFFON: Right. 

DR. DEHART: -- resolved, and now do we have access. 

MR. GRIFFON: Right, that's a --

MR. ELLIOTT: Yes, for the record, let's just make sure 

that we're all on the same page, that your review of 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 375 

completed dose reconstructions is actually review of 

the pool of cases that have reached final adjudication. 

So that means if there is a case that goes to appeal, 

it's not in that pool yet. And we have also talked at 

length about interacting with the claimants, and you 

know my feelings about that, so I think we're probably 

going to end up in more discussion about that, it 

sounds like. 

MR. GRIFFON: Yeah, I think we will. So those are just 

laid out. The other -- the other portion of D is 

interface of the Board and contractors with relevant 

experts, and -- experts in quotes, which may include 

technical experts from the sites, former workers, 

worker representatives, and we discussed that. Also --

you know, this -- this comes into play in the task 

contractors, I -- these interviews may be conducted 

over the phone, but they also may want to meet with 

these people in person. We did talk about -- these 

would probably be -- it may be like at the Garden Plaza 

and not on the Oak Ridge site, necessarily. Although 

Bob Presley did raise a question during our discussions 

this morning that in the event that we wanted to 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 376 

follow-up and it needed to be done in a classified 

room, then we would have those issues to -- to attend 

to, so -- and to get a classified room, obviously we 

have to be on a DOE facility. 

MR. ELLIOTT: And with a classified member of the 

Board, which right now I think we only have one -- two. 

Two, maybe -- three? Okay. Don't know who all's got 

a clearance. We're not supposed to know that. Right? 

But we do have to make sure that we don't send people 

in who do not have a clearance. 

MR. GRIFFON: Or, you know, a contr-- we -- we've had a 

proviso in the contract language that the contractor 

would have cleared people, so it may be that the Board 

members cannot attend that portion, you know, but the 

contractor may be able to do that. 

Going on to Section E, inter-- interaction between 

contractor and designated Board members and the Board, 

this was a sort of an attempt to walk through how we 

saw this -- these cases being processed. So the first 

step is that the designated Board members and the --

and a contractor will work on a group of cases and --

and then -- the way we saw this sort of cycling through 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 377 

possibly, and this is really, you know, preliminary I 

think, and maybe best-case, but the idea would be to 

select a group of cases -- and we said 25. Those go to 

one contractor, possibly more than -- multiple 

contractors, but a contractor and two designated Board 

members, which is also open for discussion, would then 

start a review process of those -- of those 25 cases 

say, for sake of argument, in two months or at the next 

Board meeting -- approximately two months was an 

estimate -- then this -- the designated Board members 

and the contractor would meet and discuss those 

individual reports, which we brought up yesterday the -

- the individual dose reconstruction reports versus the 

summary reports, so they'd go through all 25 reports 

with the designated Board members. And possibly we 

said that this could be done like the day before the 

actual Board meeting. Then they would -- would -- and 

they may have this compiled beforehand, obviously, but 

they might have a summary report, also, and once the 

designated Board members and contractor are in 

agreement, then they would bring that summary report to 

the full Board. And the summary report would be a deNANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 378 

identified version and would look more at aggregate 

results than the individual cases. So that -- that was 

sort of the way -- and then the final step would be --

I think this covers E and F, too. They overlap a 

little, as I looked at it this morning. The final step 

would be that then the Board, on a periodic basis, 

would report out on -- on our findings to HHS, and that 

would also be obviously in a de-identified form. And I 

think that sort of steps through E and F. 

And then G is -- finally the Board recommendations --

this also overlaps a little. The Board recommendations 

to NIOSH regarding the individual case or aggregate 

findings was another one of my discussion items 

yesterday, and we -- we did say that there may be cases 

where the Board makes recommendations to NIOSH 

regarding a single case, and that may be -- most likely 

limited to a case where it would -- it would affect the 

outcome of that -- of that determination -- or affect 

the final outcome. On the most -- for the most part, I 

think the Board is going to provide NIOSH with 

recommendations on the aggregate findings and trends 

and things like that. I also say in here the Board 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 379 

will track the recommendations to NIOSH and NIOSH's 

subsequent actions or responses to the recommendations, 

and the Board will include a summary of findings, 

recommendations and corrective actions within their 

report to HHS. So this was sort of a way -- we 

discussed a lot of these things in the past. It was 

sort of a way to lay out a real rough preliminary draft 

of how we see it maybe processing through. 

DR. ZIEMER: And this requires no action today, but are 

there additional questions for clarification purposes 

that any of the Board members wish to ask of the 

subcommittee -- it's not a subcommittee, it's a working 

group. I've got to get my terminology correct. 

Okay. Thank you, Mark. The two drafts of review forms 

we probably don't need to go through 'cause they are --

they are supportive of this. They're simply a --

MR. GRIFFON: Right. 

DR. ZIEMER: -- step-by-step sort of identification of 

the issues and the findings and observations. It's 

simply a form that would be generated in the process of 

doing the reviews. And then what about the two -- the 

task order --

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 380 

MR. GRIFFON: The -- yeah, the task --

DR. ZIEMER: -- items? 

MR. GRIFFON: -- the tasks that I've laid out here, 

they -- they will look very similar to the language 

we've already discussed and which was in the original 

task order contract. On the first one, the individual 

dose reconstruction review, at the very end of it I put 

just a few items for us to think about, whether --

whether and how we have to build it into the individual 

tasks for the purposes of the contractor being able to 

make a bid on this. You know, their required travel, 

access to data -- some of these same questions, you 

know, to the extent that some of these answers would 

affect how the contractor could bid on this task, we 

need to flesh them out a little more. 

Also I said -- as next steps, I think before the next 

meeting, I would hope that we could take these two --

two tasks at least and work with NIOSH to -- to draft 

them -- you know, to put the other language that we 

need to make them an actual task -- all the other 

contract language that needs to be included within 

this. So that was the -- the hope was that at the next 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 381 

meeting we could present a more formal task. 

The other task is the dose reconstructions procedures 

and methods review. The A through -- A through H or so 

-- let me just say, most of these, the list of 

procedures were in the original contracts -- task order 

contract. There were some additions to this. The 

additions I don't think contradict the original task 

order contract, but someone might want to examine that, 

too. The additions primarily were made by comparing a 

list provided by ORAU to the working group of the 

existing procedures that they're either -- that they've 

either developed or they are developing, so it gave us 

a sense of what -- you know, to -- a different level of 

specificity, I guess, that we could add to this task. 

And so that's -- that's about it. And I think --

DR. ZIEMER: Okay. 

MR. GRIFFON: Like you said, we don't expect --

DR. ZIEMER: Now does --

MR. GRIFFON: -- action today. 

DR. ZIEMER: Does the working group wish to have 

comments from Board members and -- before our next 

meeting, either questions or comments so they could 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 382 

feed them to Mark? 

MR. GRIFFON: Yeah, that would be --

DR. ZIEMER: We have a question here. Tony? 

DR. ANDRADE: More of a comment, perhaps suggestion. I 

looked over both of the draft task orders. It's pretty 

standard. We've been over this stuff often enough. 

It's procedures and methods review and then basically a 

-- the first level -- a description of the different 

types of reviews that might take place. I was going to 

suggest that perhaps we turn it over either to the 

project officer or to the contracting officer and maybe 

get out a draft so that we can look at what one of 

these -- or both task orders may look like in near 

final form and that we then proceed to comment and work 

on them during the next meeting. 

DR. ZIEMER: This is -- this is a good suggestion, and 

we -- we can probably have both things happening. If 

there's something that jumps out at you on this draft 

that you think should be addressed, you can let Mark 

know. But as Mark has already suggested, he's going to 

work -- I guess with Jim Neton or the staff people to 

get whatever language is necessary for the final task 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 383 

order in terms of the Federal requirements. It seems 

to me some of the issues -- particularly this issue of 

the interviews -- is one that we may want to think 

about dealing with that in some way that would not hold 

this up. I have a hard time envisioning us getting 

into any interviews early on in this review process, 

but I'm -- I'm suggest-- I'm asking whether it would be 

possible to -- well, at least in the initial task order 

-- I guess you don't have any interviews involved in 

the initial task orders, do you, or --

MR. GRIFFON: It doesn't necessarily mean I don't want 

any. 

DR. ZIEMER: I understand --

MR. GRIFFON: It's just that we're --

DR. ZIEMER: I understand that. But -- but I think we 

have to think very seriously about cases that are 

closed in terms of what that means even to a claimant, 

whether the claimant is successful or unsuccessful, if 

-- if -- we already know that interviewing claimants 

has been, in some cases, rather traumatic anyway. And 

I'm not -- it's not obvious to me what we gain by this 

at this point. But you know, I'm certainly open to --

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 384 

if there's something in the record that makes it 

awfully clear that we just need to get back and find 

out --

MR. GRIFFON: Well --

DR. ZIEMER: -- you know, or say that something doesn't 

look right, that's -- but I'm a little nervous about 

the idea of -- of going back to a claimant whose case 

is closed --

MR. ELLIOTT: Let me comment on that. 

DR. ZIEMER: -- 'cause there's -- there's a lot of 

personal things involved in this in terms of people 

coming to closure, whether it's -- whether it's pro or 

con, coming to closure with something that gets 

reopened, that's a very -- you know, it involves 

sickness, in some cases deaths and so on, so we need to 

be sensitive to that part of it, as well. 

MR. ELLIOTT: I'm going to jump in here again. You've 

heard me speak about this before. I fully agree with 

what Dr. Ziemer just said. I firmly believe that you 

should conduct your audit looking at the informational 

materials that support the decision. In that process 

of your review, if you identify issues associated with 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 385 

the interview process, that then may trigger the need. 

You can establish perhaps the need to interact with 

claimants. But frankly, I'm -- I'm not -- I'm not in a 

position to say that you're going to be able to 

interact with claimants. There are -- as I related to 

you in the past, there are a host of issues associated 

with that after the decision. There are materials. 

There is -- there are documentations that support the 

interview interaction with claimants that you'll need 

to avail yourselves of in your review, examine those 

materials, the way the interviews were set up, the way 

they were conducted, the reports that were generated 

from the interviews. All of this is information that 

is supporting of the decision. That, in our opinion, 

is what you should be reviewing and evaluating for 

quality and credibility. 

DR. ZIEMER: Okay. 

MR. GRIFFON: Can I --

DR. ZIEMER: I don't know that we want to have an 

extended debate on this issue today because we're going 

to revisit these documents at our next meeting, but --

yeah, Mark. 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 386 

MR. GRIFFON: Just one thing to think about. I know 

it's a longer debate, but -- I mean I think there were 

other alternatives offered on a way to maybe get at 

this issue. And one, which is not being -- certainly 

is not being done right now, but it would be to 

transcribe or tape the interviews that NIOSH is doing 

and then the contractor and the Board would have 

something to turn to to review that -- you know, other 

than just the final written, you know, questionnaire 

form, so that may be one way to get a more in-depth 

review of the actual interview itself. But I -- I 

understand the issues, but I also -- I also reflect on 

some of the findings in the NAS report. And 

notwithstanding Larry's -- you know, and I understand 

the intent of NIOSH to involve and to get information 

from the workers, but I think we also have to keep our 

eye on that, that that -- you know, that's one of our 

roles is to make sure that that's being done in an 

adequate fashion. 

DR. ZIEMER: Tony? 

DR. ANDRADE: Quick comment. I think in the spirit in 

which we first decided to go forth with this auditing 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 387 

contract that if it truly is going to be a quality 

audit on -- on what -- on the procedures and methods 

that we were using, then let's not forget about the 

fact that our findings really and truly should be used 

to continuously improve our processes. And in that 

sense, it's a forward-looking type of audit. If we 

find deficiencies, then those deficiencies should be 

pointed out to NIOSH for improvement in the future. 

And again, going -- I think going back retrospectively 

is a mistake, so that's just something to think about. 

DR. ZIEMER: Robert. 

MR. PRESLEY: Bob Presley. I go along with Tony, and 

you just go back and don't forget this. To us it's a 

very important thing. Maybe between Larry's group and 

the lawyers, that they can come up with some wording 

that this would be left open, with the fact that we 

come and, as a Board, ask if we do see fit to interview 

somebody, but leave this as an open -- open-ended 

thing, don't close the door. 

DR. ZIEMER: Any other comments? Yeah, Roy. 

DR. DEHART: A different topic. Larry, do we need to 

have any kind of training, since we're going to be 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 388 

working directly with the contractor? As we sit and 

work over that, we're going to have the contractor 

there. Do we need any precautionary instruction or 

whatever? That -- just keep in mind that -- that 

question. I don't know. 

MR. ELLIOTT: I will keep in mind that question. At 

this point I'm lost with what -- you've had Privacy Act 

training, you've had -- you've had that. You've signed 

-- you know what you're committed to in that regard, 

and the contractor will be held accountable to that, as 

well. But yeah, if you think of something that you 

think merits training or you're curious about do we 

need training to interact with the contractor, let me 

know and we'll --

DR. DEHART: Don't misunderstand. I'm not asking for 

training. And secondly, we did talk last time about 

the fact that we, as a group, will need training on the 

data access systems, and we need to keep that in mind. 

DR. ZIEMER: Okay. Again, we're not taking specific 

actions. You've heard the comments. We'll work 

further to develop documents that we'll act on formally 

at our next meeting, which we'll be talking about a 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 389 

little later in terms of when that will be. 

PUBLIC COMMENT PERIOD
 

Now I'd like to move on. We're just a little bit 

behind schedule, but we have our public comment period. 

I have several individuals who've requested to speak. 

We're going to begin with Carl -- Carl Scarbrough, I 

think, if I'm reading this correctly, Carl, Atomic 

Trades Labor Council -- president of Atomic Trades 

Labor Council, and if you'll approach the mike, please. 

So Carl, if you'll approach the mike, we'll be pleased 

to hear from you at this time. 

MR. SCARBROUGH: For one thing, I'd like to welcome you 

to Oak Ridge, and we appreciate having such a honorable 

group here. What I'd like to appeal to you -- for 

fairness on this thing. And we're dealing with people 

that are sick. Some of them are dead. Some of it's 

real personal. We've got people dying that, you know, 

there's no compensation. I personally think $150,000 

is kind of cheap for a person's life. Of course that's 

something to talk about later on. But what I -- like I 

said, I'd like to appeal for fairness from you. And 

some of the decision-making -- for instance, I 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 390 

represent X-10 and Y-12, everybody except the guards. 

There's different unions. And right now probably less 

than five fingers'll be the ones that's got 

compensation, and there's 10,000 people working --

current workers, and there's got to be that -- that 

many or more retirees. And so something you can count 

on one hand that's been going on for quite a while 

means we're not doing a whole lot very fast. I mean 

NIOSH, you know, is making some of these 

recommendations on data, and then they turn around and 

they really say they don't have complete data. And 

then the individual has to come up with data that he 

has no control. I mean I can't go anywhere unless 

somebody comes up to me and says how am I going to do 

this? Like I run into a guy last night, 11:00 o'clock. 

Hey, he said, I know you. I didn't know him from 

Adam, but he's -- he said I put in for this 

compensation program, and they tell me that -- it's for 

his father, and they tell me that I've got to find my 

father's -- somebody he worked with, and I've got to 

have all this information, and I don't know who my 

father worked with. And of course obviously wherever 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 391 

you go to ask this, they don't know who they worked 

with. Of course I recommended he go to his father's 

local union and maybe they can come up with something. 

But we're really loading these people up. 

I think one of the hardest things we're doing is the 

expectation they're going to get paid. Other words, 

you've got -- I don't know how many thousand people out 

here. Do y'all know how many from Oak Ridge that's 

signed up? It's a pretty big number. Right? You've 

got 3,000 people, every one of them thinks they're 

going to get $150,000, for whatever reason, justifiable 

or not. And at X and Y right now, that's what I'm 

asking for the fairness, you know, they don't work in a 

gaseous diffusion plant. What's the odds of them 

getting -- under -- under the criteria you have now, of 

them getting the compensation? You know, if it was 

you, could you prove everything you need to to do all 

this compensation program? Now if you worked at K-25 

or a gas diffusion plant, if you got lung cancer, you 

pretty well got -- you don't have to prove that. But 

you see where we're coming from, and there's a lot of 

contradictions in this data that's out here. But like 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 392 

I said, I'd like to appeal to you all for some 

fairness. I know you've got a big job. You've got a 

great big ol' boy over here on the end here, and I know 

he's going to take care of all of our business. We can 

count on you, can't we, Bob? Okay. He said he didn't 

have but one vote, but he had all of you in the palm of 

his hand. But anyhow, I appreciate it and give these -

- play like these people are your -- might be --

consider it's you, your brother, sister, mother or 

daddy and that -- take it to heart where we're just not 

a bunch of numbers out here. Appreciate it, thank you. 

DR. ZIEMER: Thank you very much, Carl. Next we'll 

hear -- let me ask, any of the Board members have any 

questions for Carl? Bob, I think Carl just wants some 

barbecue ribs is what he was after. 

Next we'll hear from Bob Tabor. Bob's been with us 

before. He's from Harrison, Ohio. Bob, welcome. 

MR. TABOR: Yeah, for the record, Bob Tabor, Fernald 

Atomic Trades and Labor Council, and I'm pleased to be 

here once again. I want to reiterate some comments 

that I've made a number of times in the past, but it 

seems like the urgency again is before us and possibly 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 393 

it may have some bearing on an issue that Mary 

Schubauer-Berigan -- I think that's how she pronounces 

her name -- Mary, okay. She brought up an interesting 

thing in one of her slides here was the issues 

regarding current workers, decommissioning and 

decontamination era workers may face different hazards 

and health effects, and I definitely agree with that 

because Fernald is a closure site that is definitely in 

full blown closure. I mean we're just right around the 

corner from, you know, having it done. 

There will be some tasks that will continue into what 

we define as completion, which is a little different 

than closure. And there will be some post-closure 

activities. But just about all the work that's being 

done out there really is cleanup and totally, you know, 

true environmental remediation and decommissioning and 

decontamination of these facilities is something that's 

ongoing on a regular basis. 

Now the regular work force -- as the regular work 

force, I'm referring to the Fernald Atomic Trades and 

Labor Council represented folks -- those folks are not 

highly engaged in the final decommissioning and 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 394 

decontamination aspect of these buildings in these 

facilities. The contractors bring in other workers and 

other work forces to do that work, and they are shorttimers, as we put it, and I can't speak to possibly the 

adequacy of the radiation and health monitoring of 

those particular facilities. But obviously, as she 

pointed out, this is something of great importance. 

When it comes to facilities that my workers are 

involved in, we're somewhat of a work force that's a 

little bit more astute to the processes and have a 

little bit more insight and knowledge of on-site 

monitoring and surveillance and so, you know, we are 

always looking at those aspects of the project to be 

sure that they are adequate. 

But the whole thing here, and this gets to my point, is 

the information -- the information that may be needed 

in the future to -- to look at the issues regarding the 

current workers and regarding things with 

decommissioning and decontaminating of these buildings, 

that information -- I'm not certain, with respect to 

how available that it will be. And I know there's only 

so much that you folks can do as far as in the past I 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 395 

have asked you to look into whatever avenues we have to 

-- to have our government reissue some assurance that 

the necessary information can be retained, and I -- and 

this Board I believe did write a letter to that effect, 

as I recall, and I appreciate that. But most recently 

at my site -- and I do not have it with me, 

unfortunately -- we had a memo that was put out that 

concerned the retention of information and the 

responsibility of who needs to retain what. This very 

specifically alluded to the things that the DOE would 

be responsible for retaining. But the interesting 

point of that communication and that I want to tell you 

about is that it alluded to the fact that the current 

contractor and all the stuff that pertains to his 

ongoings, and that may -- I don't know if that includes 

medical surveillance and things like that; it probably 

would not, but most of the project activities, all 

those type of records, he is fully in charge of. 

Now that brings me to the point of well, what is the 

retention time, how may they dispose of those, are 

those records going to go with the contractor, what 

information will that contractor still have concerning 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 396 

the processes of decommissioning and decontaminating of 

these buildings and other things and operations in the 

downsizing of the project overall and things that might 

allude to, you know, the physical ongoings that might 

have a bearing on profiling this particular site or 

have a bearing on, you know, any information in the 

future that would be pertinent, not just in the 

development of what you may need as far as future 

claimants, but in the development of studies that they 

alluded to here. I just wanted to raise the issue to 

put you on notice again that these are serious issues 

at these sites that are -- have a short life now and --

you know, and if there's going to be -- if you 

anticipate there's going to be information that you may 

need in the future, there may be some avenues that you 

may want to pursue or look at to assure that the kind 

of information you may need in the future will be 

attainable. So there's a major concern here. I thank 

you. 

DR. ZIEMER: Thank you, Bob, for raising that point. 

Again let me ask if any of the Board members have 

questions to address to Bob? 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 397 

Thank you, then we'll move on. Owen Hoffman has a 

comment. Owen addressed the Board yesterday as part of 

the formal presentation. Owen, from -- with SENES Oak 

Ridge. 

DR. HOFFMAN: Hello again. The comment I have to make 

is rather inspired by the excellent presentations by 

David Utterback and Mary Schubauer-Berigan on the 

worker epidemiological programs, both those completed 

and underway. Several of us are intimately involved 

with the beginnings of this. Paul, you as former 

Undersecretary of DOE for environment safety and 

health, and I think you presided over the transfer of 

authority from DOE to HHS in this matter, and I think 

it was at that time that you were engaged in the 

distinction between analytical epidemiological research 

and descriptive epidemiological research. Gen, you 

served, as I did, on the advisory committee for energyrelated epidemiological research to the HHS to oversee 

progress in both the environmental off-site and for 

worker studies. And of course Larry, you and I go back 

almost to the beginning of those days when I -- when I 

would ask for the -- informing workers of the risk of 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 398 

their exposure, even when those risks were below limits 

of epidemiological detection or below regulatory 

standards. 

My concern is this, is that there is a organizational 

disconnect between the occupational safety program and 

the needs for epidemiological research. You're 

Congressionally mandated in your work, but I don't know 

the extent to which this Congressional mandate supports 

-- has a support mechanism to ensure the right 

epidemiological research gets conducted. The Advisory 

Committee for Energy-Related Epidemiological Research, 

under your initial program, no longer exists. As far 

as I understand, David Utterback and his group, which 

is known -- I don't like using acronyms so I -- it's 

known as the epidemiological branch -- all that funding 

comes from the Department of Energy, and the mechanism 

for that funding is still under this Memorandum of 

Understanding, but there is no constituency, there is 

no advisory board overseeing whether or not the 

funding's adequate or whether or not the spirit of the 

Memorandum of Understanding is being honored, whether 

or not there are incentives put in place to go slow in 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 399 

these areas. And so given this legacy that we all 

share, I thought I would take this opportunity to just 

sort of publicly state my concerns that there is this 

disconnect, and my concern is that these studies --

although they're answering the -- their attempt is to 

answer the right questions -- whether or not they're 

sufficiently funded to ensure that the answers come 

forward in a timely manner. 

Now I'll make one last comment. Paul, Gen and I, we go 

back a long ways. The three of us are members of the 

Health Physics Society. Gen, you gave a presentation 

about two years ago -- two years ago this month to 

Congress, informing Congress there is no 

epidemiological evidence to support risk below about 10 

rem effective dose. There are a few people who have 

benchmarked off that information. Now in the 

epidemiological evidence coming forward under NIOSH, is 

there support for this, or is there new information 

that would draw into question whether or not the limit 

of epidemiological detection is at 10 rem. So I start 

with more of an urge -- a plea for ensured support for 

your programs, and with the next question, which is a 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 400 

technical question, as to whether or not our state of 

knowledge has improved from that of let's say two years 

ago. 

DR. ZIEMER: We may have to consider those rhetorical 

questions, 'cause I'm not sure anyone has the answer to 

that. They're very thought-provoking remarks, Owen. 

We appreciate that. Again let me ask if any -- okay, 

Gen Roessler wishes to respond or --

DR. ROESSLER: I'll respond in this way, Owen, to your 

second comment. If I were making that presentation 

next week, I would do research, as I did at that time, 

and find out what the appropriate number is. 

MR. GRIFFON: I would also ask if -- if Owen had an 

answer to his own question. 

DR. HOFFMAN: In -- in terms of a constituency or 

mechanism to ensure the Memorandum of Understanding is 

preserved, the answer to that is no, I don't think that 

mechanism exists. It needs to be rebuilt. 

The question in terms of evidence for risk below 10 

rem, I believe it exists, and I believe the -- in fact 

-- in fact, from the NCRP review of low-dose studies, 

we know that in utero exposure at one rem will induce 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 401 

cancer in later life, and so the lowest that I 

currently know about is about a one rem limit to -- as 

a limit to epidemiological detection. But I -- but 

maybe this question goes to Mary or David as to whether 

in their studies they are seeing evidence for effects 

at doses substantially below an effective dose of 10 

rem. 

DR. ZIEMER: Well, I'm not sure they are zooming to the 

mike to answer that, either. But the debate's going to 

go on. I'm going to answer for them in the sense that 

it's -- it's going to be a long time before 

epidemiology answers the question, for example, is 

there a linear no-threshold response, which is a big 

debate nowadays. In fact, I'm -- I'm a little 

pessimistic about whether epidemiologists can answer 

that, and during the break I reminded some of my 

epidemiology colleagues here -- I call them colleagues. 

I'm not an epidemiologist, but a colleague who was 

told me that an environmental catastrophe is one that 

is so great that even an epidemiologist can detect it, 

which is to say that epidemiology has a much easier 

time at higher dose -- looking at dose effects at 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 402 

higher incidence -- or higher doses. 

MR. GRIFFON: Must be a good health physics joke. 

DR. SCHUBAUER-BERIGAN: That's right. You can laugh at 

our expense. We're tough, we can take it. 

You're addressing very important questions, and those 

are precisely what drives our research program. And 

although I didn't make it explicit enough, that's 

exactly why we feel it's important to design studies 

carefully and to combine cohorts to increase the 

statistical power to see low effects that might be 

expected at doses in the range of one to, you know, 10 

rem. Individual studies have shown suggestions of 

effects below 10 rem, in my opinion, but in terms of a 

consensus in the general public, you've -- you know, 

that you've clearly touched on an issue that is of 

great importance and one that we feel we can be better 

equipped to address as we complete our research 

program. 

DR. ZIEMER: Thank you very much. That's all I have 

for members of the public. Let me give the opportunity 

-- is there anyone else who didn't sign up that --

thank you. 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 403 

MR. STEWART: How do, I'm John Stewart. I'm PACE 

safety rep at ETTP. I've heard enough technical, can I 

just ramble on for a little bit? I remember back in 

the early nineties, I guess maybe even early eighties, 

talking to a fellow worker -- I'll use his name, Jimmy 

Walls -- and he described in building 1131, the feed 

plant, where the system messed up and started backing 

up and spitting product in the floor. Of course he was 

on evening shift and they rushed them in there with 

buckets and shovels, no protection, shoveling this 

product in the buckets and hauling out. The next day 

they asked for some safety equipment. They went to a 

sporting goods store and bought them hip waders, still 

buckets and shovels. 

Now I've looked and I can't find any records of that 

except for talking to Jimmy Walls, said he was there 

and he did it. But interestingly enough, 1131 was one 

of the first buildings DOE tore down. It's got a 

asphalt cap on it now where it used to be. 

Another bit of rambling, a friend of mine -- another 

friend of mine named Don Arp came to my office I guess 

October two years ago, said he needed my help. I knew 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 404 

he'd been to the company physical about two months 

before and they'd said he -- perfect health, a little 

overweight, maybe some onset of diabetes because of 

that. Other than that, no problem. I said what can I 

help you with, Don? He said well, I just came back 

from my doctor, and he said I've got three months to 

live. He had lung cancer, stomach cancer, colon 

cancer, intestine cancer, just ate up with cancer. And 

we started -- he said now if I take the chemo, which 

I'm not going to do, I can -- they say I'll have nine 

to -- nine months to a year. So we started and, you 

know, you can -- if you have a letter from your doctor, 

you can get half your life insurance in advance and we 

set up an annuity. He was worried that his wife, which 

had never handled the money, would be left penniless. 

We set up an annuity where she was almost guaranteed 

she couldn't go through the money and waste it. But I 

guess my point with Don is -- I said what we need to do 

after everything -- this is over with, we need to go 

ahead and file this for this compensation, get that in 

the works, so we did. The letter came back from DOE 

says -- remember, he'd been there 27 years, and when 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 405 

the letter came back he was on short-term disability 

for cancer, said we cannot find any proof to verify 

your claim that you've ever worked at a DOE facility. 

A fellow worker, still had his badge, his badge number, 

no proof. Of course we got that -- his widow 

subsequently got the money. We worked through that. 

That doesn't say too much for DOE, in my opinion. For 

dose reconstruction, if they can't find your employment 

records for someone that's there now, how are they 

going to go back 40 years ago, Larry, and find 

something? You know, we feel like -- almost like the 

Israelites that have left Egypt and now we're out in 

the desert trying to find the promised land and don't 

know -- we have meetings and meetings and more 

meetings. And we're using -- being used for guinea 

pigs and they're doing studies and all kind of results, 

all kind of studies, still got people dying. 

I noticed in yesterday's paper Frank -- he's not here 

now -- over in Iraq. I think President Bush said that 

fighting war was over about two weeks ago. Set up a 

program we're paying out pension benefits to Iraqis, 

what -- said two crisp $20 bills. So in two weeks we 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 406 

can pay the foreigners, and how long has this been 

going on? We can't have a program to where the 

workers, they're sick and their families that are 

suffering financial loss cannot get any compensation 

from the government. I'm like Bubba, I think the 

$150,000 -- almost a slap in the face. So again, as 

I've said at every meeting, you know, we need to get 

off square one and get moving and get some kind of a --

something for the workers so they can have some kind of 

a benefit that it won't destroy their families 

financially 'cause they're -- when I worked at the 

Resource Center when we first started, had such 

overflow they had some of us up there working, I had 

people that came in, put in for benefits, helped fill 

out their form that I had worked with, younger than me, 

that were so ate up with cancer I didn't recognize 

them, didn't -- till they told me their name, didn't 

even know them. You know, we're -- we're -- all the 

epidemiological studies, all the meetings we're having, 

this is all great. But the workers feel like we're 

being guinea pigged to death. You're studying our 

records. You're studying our health. You're studying 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 407 

how much doses of radiation it takes to cause our 

cancers, and meanwhile we're there dying and not 

getting compensated for it. Thank you. 

DR. ZIEMER: Okay. Thank you very much. Those are 

sobering words, indeed. 

 Commenter here? 

MS. AYERS: Good morning. I --

MR. ELLIOTT: Can you state your name for the record, 

please? 

MS. AYERS: My name is R. L. Ayers, initials only, R. 

L., and I'm here just to ask you all a question. I 

didn't have a prepared speech or anything, didn't even 

know this meeting was going on until I went by the 

union hall and he told me over there. He said you --

maybe you should go down there. 

What I want to know if -- my husband worked at K-25 

plant. He worked there from 1971 until he retired in 

1985, and of course he died last year in November, and 

he died of silicosis. I've never heard anybody even 

mention any compensation or anything for silicosis, but 

that is a deadly disease. There is no cure for it. 

And that's what he died of. I called Ms. Yvette Waters 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 408 

down in Jacksonville, Florida and she told me that if 

he worked in Alaska or Nevada that is the only way that 

they would pay for that disease. I wonder if it will 

ever be added to the state of Tennessee compensation 

plan for these plants here, because he had never been 

to either one of the places, never. And since 1943 

he'd worked in this area. When he went to K-25 in '71 

-- of course my husband was a concrete finisher and he 

worked at Y-12 and X-10, helped them build it, but when 

he went to K-25 in the plants in '71, he didn't have 

silicosis at that time, or it didn't show up at that 

time because they would have never hired him. They was 

kind of strict then on hiring people, because I worked 

down there. And now they tell me that they won't pay 

for it. And I just wonder if anything could ever be 

done about that. Thank you. 

DR. ZIEMER: One of the Department of Labor individuals 

may be able to address that. 

MR. TURCIC: Yeah, that's correct, silicosis is only --

DR. ZIEMER: Please identify for the record --

MR. TURCIC: Pete Turcic, Department of Labor. 

Silicosis is only covered for individuals who worked 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 409 

mining the tunnels for the underground test sites at 

Amchitka in Alaska or Nevada Test Site. However, and 

Shelby had mentioned yesterday about subpart D of 

EEOICPA, which is a -- it's administered by the 

Department of Energy to provide assistance to claimants 

for other toxic diseases, which would include 

silicosis, to get State Worker's Comp. 

MR. STEWART: Can I follow up? This lady's husband I 

worked with. During the centrifuge program, when we 

manufactured the tubes, we used silicon sand when we 

sandblasted the inside of those tubes, every one of 

them -- hundreds of them. No telling -- I would say 

most everyone at K-25 was exposed to silicon sand at 

some time 'cause it was -- from when you blast with it, 

it made a dust. It went all over the site. Sure, we 

can do part D. What we've got, 16,000 waiting for the 

doctor's panel and there's I think what, 14 of them 

gone so far? Yeah, but there's -- probably 20 years 

from now they'll get to you. 

DR. ZIEMER: Any further public comments? Okay. 

Before we break for lunch I'm going to turn the mike 

over to Larry Elliott to raise an issue related --

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 410 

actually related to yesterday's public comments and the 

issue relating to when site characterizations might be 

completed and some related issues. Larry, if you would 

raise this point to the Board. 

MR. ELLIOTT: Thank you, before I jump in on that, I 

would like to make an announcement for the Board and 

for the public, at the behest of Michael Schaeffer from 

the Defense Threat Reduction Agency so you'll all know 

that the Department of Veterans Affairs Committee on 

Environmental Hazards will meet in June 3rd and 4th, 

next month, at -- let me get my cheaters on here -- at 

811 Vermont Avenue, N.W. in Washington, D.C. The 

meeting starts at 9:00 a.m. on both days. For further 

information or to obtain the agenda for that, please 

call Dr. Neil Ochin, M.D. at 202/273-8452. That's the 

Department of Veterans Affairs Committee on 

Environmental Hazards. I'll be attending that meeting 

as a liaison from this Board to that Board in case they 

have any questions. We will also have on our web site 

a link that'll link up for this particular meeting and 

agenda. 

Now I wanted to raise an issue with the Board to get a 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 411 

sense of where the Board stood. And this goes at the 

heart of appearance of conflict. We're fortunate 

enough in our contracting team with ORAU to have 

several individuals who were instrumental in -- and 

integral in development of dose reconstructions for the 

Mound site. These dose reconstructions were conducted 

for a different purpose than our dose reconstructions 

for compensation, but they're very much of interest to 

us and very applicable and these individuals are very 

knowledgeable about the Mound site. 

In the spirit of good management practice, good 

management control and efficiencies that we're trying 

to achieve in finishing claims and moving cases over to 

DOL for final adjudication, and in our effort to try to 

achieve 6,000 against our backlog by the end of this 

year, I would like to be able to ask the ORAU team to 

task those individuals with direct effort on individual 

dose reconstructions, and still maintain the process 

that we have put in place with the help of this Board 

whereby the claimant still has the opportunity to speak 

up about who is assigned to do their dose 

reconstruction. It just seems to me that without 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 412 

utilizing these experts, we do ourselves a disservice. 

It goes beyond just the Mound plant. I have on my 

staff experts from Fernald. I would like to be able to 

see those experts be assigned to do Fernald cases. I 

would like to be able to rely on the claimant to say 

wait a minute, I got a problem, and according to the 

way your operating procedures are characterized, I have 

the opportunity here to take exception to that 

individual and request another individual be assigned. 

I think that gives us enough control and protection 

about appearances of conflict of interest, and would 

allow me to make sure that we utilize our resources 

effectively. Right now we're a little bit concerned 

about whether or not the Board's perception of this or 

how you view this would survive in your audit, whether 

or not if you saw a number of health physicists, dose 

reconstructionists who are assigned to individual dose 

reconstructions, working on those, and whether or not 

that appearance of conflict is too heavy in the 

balance. So I'd just appreciate hearing a little bit 

of discussion from the Board in trying to get a sense -

- a sense from the Board as to what your views are in 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 413 

this regard. Thank you. 

DR. ZIEMER: Let's start with Tony here. 

DR. ANDRADE: I really think that, for all the reasons 

that you mentioned, especially efficiency, but more so 

than even that, because of their -- because of the 

expertise that they've built up having worked doing 

dose reconstruction in the past, it would be -- it 

would be a sad waste in not using those folks to go 

back and help us get going and moving at a faster rate 

in completing dose reconstructions. 

Having said that, let me also remind the Board and the 

public that the auditing that Mark and his colleagues 

in the dose reconstruction working group have put 

together are those folks who may not ever have had work 

associated with sites previously, and so that helps in 

going back to check fairness. It helps to go back to 

see if there could be any -- any instance in which some 

sort of favoritism is being placed. So I think that we 

have checks and balances in place or that we are just 

about to put in place that would help us out in this 

regard, and so I really feel it's an excellent 

suggestion to go forward with. 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 414 

DR. ZIEMER: Wanda. 

MS. MUNN: Failure to take advantage of known expertise 

with respect to activities on any site can only have 

the effect of lengthening the process, which I do not 

feel is the desired outcome by either this Board nor 

the claimants. If there is a perceived concern with 

respect to the trustworthiness of the reviewers to 

recuse themselves in cases where they may have had any 

personal contact or even knowledge of the individual 

case, then it appears to me that it could be -- that 

particular concern probably could be met with a 

statement of -- of recusement, essentially, by the 

individual. Otherwise, there is an issue of 

institutional knowledge that simply cannot be rapidly 

accumulated by other individuals. It would be a shame 

to lose that professional capability. 

DR. ANDERSON: I guess it's hard to really comment 

without looking at the specific review. I think there 

were -- there's a set of conflicts of interest and bias 

sorts of things set up that I think it's important for 

us to apply uniformly across the board and not say 

well, we're running behind. Now let's, you know, scrap 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 415 

the procedures and we think in this case it's okay and 

in that case it's not okay, so -- and I guess I 

wouldn't want to rely solely on the challenge that an 

individual can have because they may not know the 

individual and have had no experience, and I would 

expect there'll be very few challenges to that, so 

they're to expect that now we put the burden on them to 

say do you want this person or not, I think is somewhat 

problematic. So I would say it's somewhat of a 

slippery slope as to when does it become a significant 

conflict and when does it not. And without knowing 

what the work the individual did and I think that there 

is some subjectivity to deciding should they be 

excluded or not. I thought at one point we'd talked 

about these individuals. We wouldn't lose their 

expertise, but they wouldn't be the lead reviewer, that 

they'd be available as a consultant, that if you had 

questions about it, that individual, they'd be there, 

they'd be available just as, you know, a set of experts 

who, you know, aren't -- haven't been hired or are 

workers that could be consulted as opposed to be the 

lead constructionists. So I think we'd need -- you 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 416 

know, I think having some flexibility in it might be 

helpful, but I think we really do have to stick to 

criteria that have been developed. And if NIOSH feels 

that there isn't a conflict, just as dealing with Board 

issues, you make that determination and I think, you 

know, whether we would do that and then subsequently 

through an audit disagree, that would be a thing. But 

I think it's really up to NIOSH to decide. Do you 

think there's -- is the balance here greater one way or 

the other. Now if the dose reconstructions they were 

doing, not part of this, were part of a lawsuit, you 

know, then I think that might be something that people 

might find suspicious. So if it was part of a research 

project, that might be something totally different. 

DR. ZIEMER: Larry, can you clarify or maybe give some 

more concrete examples? Are we talking about 

individuals who, for example, did dose reconstructions 

as part of a research project from outside, as opposed 

to individuals who were workers on that site, or do you 

have a specific --

MR. ELLIOTT: Well, it covers --

DR. ZIEMER: Or both. 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 417 

MR. ELLIOTT: -- the waterfront, and certainly at the 

Mound site, that set of dose reconstructions, over 

2,000, were done as part of a settlement, I believe, in 

a litigation. We're -- I'm not proposing that we 

change the conflict of interest plan that the ORAU team 

developed and was part of their proposal, and then 

further developed as the Board reviewed it and got 

engaged in all of this, still holding up the claimant 

opportunity and ability to take exception to that 

individual assigned to do the dose reconstruction. But 

we're so limited, so limited in the number of qualified 

health physicists that we can bring to bear on this, 

the way the site profiles will -- we're proposing to 

get developed, I can just see a need to have the 

ability to say -- unless it's -- the assignment is 

challenged by the claimant, it's a good utilization of 

resources. It's not only the individual dose 

reconstructor, it is the reviewer who reviews on top of 

that person's work who reconstructed the dose. It goes 

to my staff, who some -- you know, have -- some of my 

staff have backgrounds within the DOE system at certain 

sites, some don't. I'm just trying to get a sense here 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 418 

of the Board as to how best to utilize the limited 

resources that we have and get the job done effectively 

as possible. 

And let's remember that what we talked about earlier is 

zero tolerance for actual conflict of interest, where 

somebody intentionally does something. We have no 

tolerance for that. We're monitoring that very 

closely. What I'm getting at is the appearance of 

conflict. You heard about this in Paula Kocher's 

slides to you this morning about appearance of 

conflict. It is different than actual conflict of 

interest. 

DR. ZIEMER: Mark, did you have --

MR. GRIFFON: Really I think Henry hit most of my 

points. I -- I just -- you know, the slippery slope 

thought was going through my head as Larry was 

presenting the Mound example, and then he -- you know, 

I was thinking could this be a slippery slope, and then 

I think he answered it by adding on Fernald. I mean 

I'd be concerned that -- and I was under the 

understanding that Henry was, that -- that these people 

could still be used as resources, as tech-- so -- so 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 419 

the team would not lose their expertise from the sites, 

but that they would not -- I think having them 

available as the lead dose assessor would be 

problematic. And even -- even from the standpoint that 

if they've done dose reconstructions already, I think 

human nature might make it difficult for them to find a 

very different result the next time through, so they 

might not be so critical of their own past work, so I 

think another reviewer to come in -- that's part of the 

concern from -- from past activities, past studies that 

have been done. You know, there's always been at least 

some of the public concern about the adequacy of those 

dose assessments that were done, exposure assessments 

that were done, and if you have the same people doing 

them again, I think there'd be -- that -- that 

perception would be even stronger, so... 

DR. ZIEMER: Rich, you had a comment? 

MR. ESPINOSA: Well, Mark and Henry are saying that --

yeah, I agree with. As long as the dose 

reconstructionist has the avenue to access somebody 

with the expert, but I guess one of the things I don't 

understand is the site profile. You know, somebody 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 420 

that's from the site -- we're talking about Mound right 

here. I guess I don't understand if they can or can't 

do the site profile. 

MR. ELLIOTT: We think they can do the site profile. 

We didn't think that was off the table. They are 

working on the site profile. That's how to apply their 

expertise. And that is going forward, whether it's the 

MJW folks working on the Mound site where they've done 

dose reconstructions for a different purpose before, or 

whether it's ORAU folks specifically who may be working 

on the Mallinckrodt site profile or technical basis 

document, but they have a -- you know, they have a vast 

experience and expertise with the data that's been 

collected on Mallinckrodt workers. We've felt from 

the very start that we could utilize that expertise 

that way. The crunch comes where we try to get 200 

plus out the door a week, and we're limited in a -- you 

know, we have a site profile put on the table, 

technical basis document put on the table for Mound and 

we're limited in the number of dose reconstructors that 

we can assign, we're limited in the number of reviewers 

that we can assign to get those cases processed. 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 421 

I spoke earlier about our monitoring for conflict of 

interest. Every one of these things that is finished 

gets reviewed by my staff. We're very careful about 

who we assign to review those. They cross Jim Neton's 

desk and I personally read every one of these and sign 

every one of these, and looking for a laundry list of 

things that we're checking for. So I think the 

controls are in place. I would like to be able to use 

the experts that I have at my disposal, not only to 

develop site profiles, but to engage in individual dose 

reconstructions using those site profiles. 

DR. ZIEMER: Roy? 

DR. NETON: I'd just like to comment specifically on 

the MJW issue at Mound. The situation is such that MJW 

possesses almost -- most of the internal dosimetry 

expertise on the project. It's divided between Dade 

Moeller doing external dosimetry and MJW doing 

internal. MJW did the bulk of the dose -- almost all -

- did all the dose reconstructions at Mound, and ORAU 

has taken the very conservative approach in implying 

that since MJW did the dose reconstructions at Mound, 

they are organizationally conflicted, meaning no one on 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 422 

their corporate staff or employed by MJW could do a 

dose reconstruction at Mound. So that -- that severely 

handcuffs us from moving dose reconstructions forward 

at the Mound site in particular. And that's just one 

example of a situation that I think may be an 

interpretation that they're not organizationally 

conflicted might help us out there. 

DR. ZIEMER: And they're talking about cases where 

there may be individuals who were not involved in the 

Mound site, but it's a -- they're raising the issue of 

corporate conflict, simply because the person is 

working for them and they had other people involved in 

that dose reconstruction, so that's a very broad, as it 

were, interpretation of conflict. 

Okay. Mike? 

MR. GIBSON: With all due respect to the claimants that 

are not being paid and the system being bogged down, 

with all due respect to NIOSH and Larry and everyone 

else, I am adamantly opposed to this in any way, in any 

shape, in any form. MJW was brought in -- there was 

two different dose reconstructions. One of them had to 

do with a lawsuit, one of them had to do with a Price 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 423 

Anderson violation where they were not monitoring 

workers correctly. The data that they took to do this 

dose reconstruction was old, was limited. They made 

assumptions that it was based on gross alpha. They 

didn't go back and do a site profile to see if it was 

plutonium, to see if it was uranium, to see if it was 

any other isotope. I questioned the results of these 

dose reconstructions at the time. I had to FOIA over -

- we brought this to bear. Our union was the one that 

had Senator John Glenn get a commitment out of DOE to 

come in and do this dose reconstruction, and it took 

them probably six or seven years to do it. They went 

on limited data. I -- they didn't do a site profile. 

I question -- I'm adamantly opposed to this in any way. 

I had to go through the -- an interview in the office 

of the President's general counsel to get a waiver of 

conflict for any issue to deal with Mound that I'd have 

to recuse myself from from this Board, and yet the same 

people that's made millions of dollars at Mound, we're 

going to let them try to do dose reconstruct-- redo 

dose reconstructions they've already done? How much 

extra emphasis are they going to put into that, and how 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 424 

much are they really going to look at people who 

deserve compensation? Or are they going to look back 

to what they got paid to do, and that was to make it 

look like that they had repaired bad dose assessments. 

I'm adamantly opposed to this. 

DR. ZIEMER: Okay. Thank you, Mike. Let's see who 

else had a comment. 

MR. ESPINOSA: Actually it's not so much a comment, but 

you know, I kind of get the feeling of where the 

Board's at with this. I'm kind of interested in what 

the public is thinking on this issue, as well. So 

maybe we can get a little bit of public comment on 

this, I'd appreciate it. 

DR. ZIEMER: I don't object to getting public comment. 

We have gone into our lunch hour. We -- and we can --

we can take this up again after lunch, if you wish. 

Let me -- and Larry, you've seen there's a crosssection of views here. It's obviously not clear --

clear cut. Well, it's -- there does not appear to be a 

clear consensus one way or the other. I think -- I 

think we have to, in this case, give a fair amount of 

weight to some experiences that Mike has raised it 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 425 

seems to me are pertinent here. I -- on the surface of 

it, I would have not personally objected to individuals 

simply because they worked for the company, if they had 

never worked on the site. But there is, I think, that 

sensitivity could be important that Mike has raised, 

so... 

MR. GIBSON: I believe most all the people at MJW 

drafted to do this dose reconstruction did work on the 

Mound site. 

DR. ZIEMER: I was speaking in generalities, if there 

had been -- the issue is corporate versus individual, 

but -- well, it may or may not, but you've heard the 

comments. 

Let's -- let's recess for lunch, and let me tell you 

that this is an abbreviated lunch hour. Remember, we 

have a tour of Oak Ridge scheduled for 2:00 o'clock. 

What we have after lunch -- we have Board review of the 

minutes, which we can get through very rapidly. I'm --

let me -- let me ask if there are members of the public 

who are -- who want to address this issue that we've 

just -- are there -- is there -- is there anyone in 

addition to Richard Miller? 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 426 

Let us hear from Richard. Okay, Richard, why don't you 

go ahead and --

MR. MILLER: Hello. 

DR. ZIEMER: -- if you promise not to take too much of 

our lunch hour -- no, we can do it after lunch if --

MR. MILLER: Look, this got brought up after the public 

comment period. Okay? I don't know why Larry brought 

it up then, but he should have brought it up, 'cause 

this is such a significant question in terms of the 

management and the tensions that the program is 

grappling with. I don't think this is something that 

should be hushed. I think this ought to be put on the 

agenda for the next meeting. I think alternatives, in 

the spirit of NEPA*, ought to be explored here. I know 

that, just to reflect on my very first conversation 

with Larry Elliott about this program, I was on a 

conference call with Larry with Kathy Rest in her 

office in November of 2000, just after the law had 

passed. And I apologized to Larry for having worked so 

hard to make sure that NIOSH was going to get this 

responsibility because they didn't volunteer for it. 

But we had a commitment, and the commitment was that 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 427 

for those of us who were advocates of this program who 

had specified and had convinced Congress that it was 

completely inappropriate to have the Energy Department 

do dose reconstruction, and there is specific 

proscription in the statute that says neither DOE nor 

any DOE official can do this. It was with some 

reservation that we saw a major DOE contractor wind up 

getting the contract to do dose reconstruction. It 

didn't violate the law, but it sure tempted one to 

think that this was getting awfully darned close to the 

edge. 

But back to this conversation, because this very 

conflict was -- we were aware of for those of us who 

were advocates for this program, even while we were 

legislating. And the first suggestion that we made to 

NIOSH was please take some of the money that the 

Department of Labor is going to give you and put them 

into some ERCs or ERC-like institutions -- Education 

Resource Centers -- that NIOSH has for training 

physicians and go find a couple of institutions that do 

a good job training health physicists so that the 

Department wasn't -- Health and Human Services was not 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 428 

dependent on such a shallow pool of expertise to fish 

from in terms of the conflict of interest problem. And 

I repeated this suggestion to Kathy Rest when she came 

here to visit us, and I've repeated it to Larry and 

NIOSH on countless occasions because this very moment 

was foreseen where we would be told that claimants 

would not get their claims processed because they 

couldn't manage the conflict of interest because the 

pool of expertise was too shallow. 

This is not a newly-discovered problem which NIOSH has 

just encountered and now wants to try to swim through 

these very difficult waters by saying well, let's bring 

down the walls on conflict of interest. How many 

people on your staff worked at Fernald, Larry? How 

many have come to work to you from Mound because it 

looks like brighter and bluer skies? How many of the 

individuals who have been on your team here at Oak --

with Oak Ridge Associated Universities, who brings 

terrific expertise in the DOE, nonetheless is going to 

have to go back and render judgment on work that they 

or their colleagues will have done in the past? Even 

in site assessments, Oak Ridge Associated Universities 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 429 

faces an extraordinary conflict. They did -- Betsy 

DuPree* did the study on Mallinckrodt, just to use the 

example you brought up, and Oak Ridge Associated 

Universities had Bill Tankersley* working on this 

project, as well. And here you have individuals who 

are going to be doing site profiles which ultimately 

are going to contradict the external dosimetry 

potentially that were published in the Oak Ridge 

Associated Universities studies. And we've said site 

profiles are off the table, we're only going to look at 

individual dose reconstructions. 

I'm not sure, actually going the other way, that your 

conflict of interest screening is adequate. I think 

the question of putting it onto the claimants, who 

don't remember names, who don't know who did dosimetry, 

who worked in large institutions, is the wrong place. 

They are the check and balance on the system in case 

your conflict of interest system fails. That's why 

you're sending them the conflict of interest reviews. 

Conflict of interest reviews which, I would add for the 

Board's benefit, are not even fully published on the 

OCAS web site as we sit here today, nine months after 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 430 

the Oak Ridge Associated University contract was 

awarded. We don't even have all the conflict of 

interest disclosures on the dosimetrists posted on the 

web site, and now they want to start to tear down even 

the public disclosure. 

I have to say this, there is a solution. There's a 

NEPA-like solution if we want to step back from this 

problem, because I'm very sympathetic with the delay 

issue. The solution is to expand the pool of people 

who you want to invite in, whether it's to issue task 

order contracts to supplement the work ORAU is doing, 

authorize ORAU to bring in others who don't have 

conflicts of interest, let's allocate more funds if 

there wasn't enough money budgeted from our friends to 

come over from the Labor Department to you all to solve 

that problem. But let's not tear down the conflict of 

interest wall. Let's apply the resources where they're 

needed so that at the end of the day there is no 

question about the integrity of the product you put 

out. And if you start to tank the integrity of your 

product at the outset, what a shame this program is 

going to turn into. 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 431 

DR. ZIEMER: Okay. Thank you, Richard, certainly good 

food for thought for us. 

Now are there any other members of the public who wish 

to comment? Again, we're eating -- my mind must be --

we're eating into our -- into our lunch hour. 

Okay. We will take -- let's try to be back here by 

1:15, because we have to finish up by 2:00. Okay? 

(Whereupon, a luncheon recess was taken.) 

REVIEW/APPROVAL OF MINUTES, BOARD WORK SCHEDULE 

& ADMINISTRATIVE HOUSEKEEPING
 

DR. ZIEMER: If you haven't already done so, Board 

members, there is a green slip that you need to fill 

out if you're going on the tour to Oak Ridge facilities 

today. Where it says estimated dose for the year, I 

had all kinds of thoughts about how you might figure 

that out -- put in a -- you know, a mean value with --

tell them whether it's a lognormal distribution and --

and the error bars. Anyway, fill everything in that's 

highlighted there and pass that over to these young 

ladies who are here from the Lab to help with the 

logistics. 

We have -- let's see, who's missing? Mike? Mike told 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 432 

me he had to leave, and Jim isn't here anyway. Let's 

see, Tony is -- okay. Well, I think we'll sort of go 

ahead here anyway. 

We have two immediate things to take care of. We need 

to take action on the minutes of the previous meetings, 

or some of the previous meetings, and then we also need 

to identify some dates for our next meeting, and there 

may be some other housekeeping things. But let's first 

address the minutes, the first set of which are the 

minutes for February 5 and 6. They are stamped draft, 

5/19/03, which means they were the draft for this 

packet, but they are the minutes for February 5th and 

6th. Now there are -- there was a previous set in your 

packet that is not stamped draft. That's not the set 

we're focusing on, unless somebody wishes to revert to 

that earlier version. But the Chair would entertain a 

motion to approve these minutes. Is there a second? 

DR. DEHART: Second. 

DR. ZIEMER: Let me ask for any corrections or 

additions, with the exclusion of minor spelling and 

other editorial things which you can pass on separately 

to Cori. But are there any substantive changes in the 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 433 

minutes that anyone wishes to point out? 

If there are none, are you ready to vote on the 

acceptance of these minutes or what we're calling 

summary minutes? 

UNIDENTIFIED: Yes. Yes. 

DR. ZIEMER: Okay. All in favor of accepting these 

minutes say aye. 

 (Affirmative responses) 

DR. ZIEMER: Any opposed say no. 

(No negative responses) 

DR. ZIEMER: Any abstentions? 

 (No responses) 

DR. ZIEMER: Thank you. We have approved those 

minutes. 

We also have in the packet summary minutes -- this one 

happens to be labeled summary report, for some reason; 

I'm not sure if there's a difference -- for the March 

7th meeting. This would be the meeting in Cincinnati 

March 7th, and likewise the Chair would entertain a 

motion to accept these minutes. 

UNIDENTIFIED: So moved. 

MR. PRESLEY: Second. 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 -- 

20 

21 

22 

 434 

DR. ANDERSON: The only thing I would say is it's 

helpful to have the pages numbered. 

DR. ZIEMER: Yes, I noticed that myself. In fact, it 

was my recollection that the version that I saw on my 

computer had them numbered, you know, with the 

header/footer business. But they somehow either didn't 

show up in the printing or in the transmission, but we 

will make sure that the copy that I -- I have to sign 

off on these, and I'll make sure that those are. 

DR. ANDERSON: And single-spaced, too. 

DR. ZIEMER: That's why these were so long. 

DR. ANDERSON: Yeah, I was going to say that looks 

awful long, but it isn't. It's just that --

DR. ZIEMER: Actually we've already had a discussion on 

single versus double space on future minutes and they 

are going to be single-spaced. I had arbitrarily made 

that decision already, so -- but the final form will be 

single-spaced. The draft -- doesn't matter to me, but 

DR. ANDERSON: I think it's helpful if it's doublespaced 'cause you can write on it then -- for the 

draft. And that can also help us distinguish between 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 435 

final and draft. 

DR. ZIEMER: Oh, you mean for the draft that comes to 

you? 

DR. ANDERSON: Yeah. 

DR. ZIEMER: Okay, that would be fine. We'll -- we'll 

do -- and our editor/writer is nodding because he's 

going to help us with that, so we'll have the drafts in 

double-space and the final form will go to single. 

Are there corrections or additions to the March 7th 

minutes? Apparently not. 

All in favor of accepting these minutes will say aye. 

 (Affirmative responses) 

DR. ZIEMER: Any opposed say no. 

(No negative responses) 

DR. ZIEMER: The minutes -- any abstentions? 

 (No responses) 

DR. ZIEMER: The minutes are approved. Thank you very 

much. 

We actually have two additional sets that will be 

coming to you, and we can handle them at our next 

meeting, but those are the minutes of our two telephone 

conferences which were I think March 14th and 28th, 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 436 

something like that. 

Okay. Administrative housekeeping, one of the things 

we need to do is talk about dates for next meeting. To 

sort of kick that off, let me identify one of the 

issues that -- the most immediate issue I think that 

has to come before us for action will be the materials 

that were presented to us earlier by Mark, and that is 

the various documents relating to the task orders and 

the work group procedures. It would be useful if we 

had the task orders ready to go at the time that the 

final contract is awarded, and it's anticipated that 

that would actually occur perhaps in September. So 

that would suggest that we ought to meet no later than 

perhaps August. We could meet in July. I see no need 

to meet in June. I'm not sure we would need to meet in 

July, but it's going to depend somewhat on schedules. 

I know that August starts to get busy in a variety of 

ways in terms of people's family commitments and school 

and things like that, but -- or last minute vacations, 

whatever it may be. But let me ask -- let me start 

with the staff, because I think we also need to 

recognize as the staff pushes forward in terms of their 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 437 

activities and other commitments, what does it look 

like from staff point of view? Is July probably not a 

good time? 

MR. ELLIOTT: Probably not a good time in July, and 

there's at least -- I have Dr. Melius's availability, 

as well, and I'm looking at that. And Mike Gibson told 

me that whenever you set the meeting, he'll be there 

since he's now enjoying his non-retir-- non-employment, 

I guess. I don't think he's retired, per se, but 

there's one week in August I can point to, August 11th 

through the 15th, that would not be good. August 20th 

through the 22nd would not be good for Dr. Melius. I 

think Cori's got a week in there in August. 

MS. HOMER: Late July/early August, yes. 

DR. ANDERSON: How about the week of the 25th of 

August? 

MR. ESPINOSA: The 26th is out for me, that week. 

MR. GRIFFON: I would rather have it earlier in August, 

just so we can finalize these things. We might need... 

DR. ZIEMER: Well, let's go back and just check dates 

in August. Let's begin with the first week in August, 

which is the week of August 4, I guess. 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 438 

DR. DEHART: I'm out 3, 4, 5. 

DR. ZIEMER: Three, 4, 5 is out. 

DR. ANDERSON: And I'm out 7 and 8. 

DR. ZIEMER: I'm out 8 and 9. 

DR. ANDERSON: How about the week before? 

DR. ZIEMER: Last week of July? 

UNIDENTIFIED: Cori's out. 

DR. ANDERSON: Oh, that's yours, yeah. 

DR. ZIEMER: Cori's out the last week of July. 

MR. ESPINOSA: What about the 21st of July? 

DR. ROESSLER: That's the Health Physics --

DR. ZIEMER: Health Physics meeting. 

DR. ROESSLER: There are a lot of health physicists on 

the staff that are going. 

DR. ZIEMER: Yeah, I'm involved there and couldn't make 

it. You're probably involved. 

MR. ESPINOSA: Is the 14th getting a little bit too 

soon? 

DR. DEHART: Week of the 11th sometime? 

MR. ESPINOSA: July or August? 

DR. DEHART: August. 

MR. ELLIOTT: August 11th is out. That week is out. 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 439 

DR. ZIEMER: August 11th, that whole week is out? 

MR. ELLIOTT: Yes. 

DR. ZIEMER: Okay. 

MS. HOMER: What about the 18th and 19th of August? So 

far I haven't heard any no's to that. 

DR. ANDERSON: That's good for me. 

MR. ESPINOSA: I thought that was bad for --

MR. GRIFFON: What was that date? 

DR. ZIEMER: 18th or 19th. 

MR. GRIFFON: Of August? 

DR. ANDERSON: Monday/Tuesday. 

MR. ESPINOSA: That's a little bit bad for me, but I 

might be able to rearrange it. 

DR. ZIEMER: I have a cryptic notation. I'm going to 

ask if Mrs. Ziemer has returned from lunch. We're 

okay? Okay. 

UNIDENTIFIED: What's it say? 

DR. ZIEMER: Something like check with wife before you 

do anything. Not quite that. No, I had -- I had an 

item which was only tentative and my wife has signaled 

that it's clear that week. 

MR. ELLIOTT: Could we -- instead of Monday, could we 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 440 

look at Tuesday/Wednesday or --

DR. ZIEMER: 19/20? 

MR. ELLIOTT: Yeah. 

MS. HOMER: 20th through the 22nd is out. 

DR. ZIEMER: Who has a conflict on the 20th? 

MS. HOMER: I thought Dr. Melius might have. 

MR. ESPINOSA: I think Dr. Melius did and --

MR. ELLIOTT: Yes, he has a conflict on the 20th, 21st 

and 22nd. 

MR. ESPINOSA: It's getting up to July --

DR. ZIEMER: Is the 18th bad, also? 

MR. ESPINOSA: 18th and -- it's not bad, but the 19th 

is kind of bad for me. 

DR. ZIEMER: Okay. 

UNIDENTIFIED: But is it possible? 

MR. ESPINOSA: With this much notice, it's possible. 

I'll just have to bring her along. 

DR. ANDERSON: That's fine. 

DR. ZIEMER: There you go. 

DR. ANDERSON: Where would you like to meet? 

DR. ZIEMER: Okay, 18th and 19th are possible. Let's -

- what happened on the week of the 25th? Is that --

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 441 

MR. GRIFFON: I just thought that was kind of late, 

given that I have -- you know... 

DR. ZIEMER: But poss--

MR. GRIFFON: But possible for me. 

DR. ANDERSON: Yeah, it's okay for me. 

DR. ZIEMER: In terms of actual meeting time, is it --

25, 6, 7, any conflicts that week? 

MR. ELLIOTT: 26th and 27th? 

MR. ESPINOSA: 26th and 27th are out for me. 

DR. ZIEMER: Are... 

MR. ESPINOSA: The 26th and -- 26th and 27th I'm not 

available. 

DR. ZIEMER: Okay. So that means if we did it that 

week it would have to be the 28th or 9th. Okay. So 

the possibilities then, it appears, are the 18th and 

19th or the 28th and 9th. 

DR. ANDERSON: That's just before Labor Day? 

DR. ZIEMER: Yes, that is just before Labor Day. 

DR. DEHART: Let's go for 18th/19th. 

DR. ANDERSON: 18/19. 

DR. ZIEMER: 18/19? 

DR. ANDERSON: We'll just squeeze Richard here. 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 442 

DR. ZIEMER: Okay, 18th and 19th is where we have 

settled. Cori --

MS. HOMER: I'm okay on the 18th and 19th. 

DR. ANDRADE: Is there anything wrong with the week of 

July 14th? 

MR. ESPINOSA: Yeah, I was just going to say the same -

-

DR. ZIEMER: I have a conflict on the 14th, 15th and 

16th. 

MR. GRIFFON: I'm out the 14 --

MR. ESPINOSA: What about --

MR. GRIFFON: -- 14 through 17. 

MR. ESPINOSA: -- the 17th and 18th? 

DR. ZIEMER: You're out the whole week through the 

17th. 

DR. DEHART: I'm out the next. 

DR. ZIEMER: Okay. 

DR. ANDRADE: Of July or --

DR. ZIEMER: That was July we were looking at. So it 

looks like we're back to August 18th and 19th. 

MR. ESPINOSA: Getting into the 7th would probably be 

too -- too close. 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 443 

MR. GRIFFON: July 7th, you mean? 

MR. ESPINOSA: Yeah. 

MS. HOMER: That's not much more than a month away. 

DR. ZIEMER: Let's shoot for August 18/19. We need to 

then also decide where we should meet. 

MR. GRIFFON: St. Louis? St. Louis is an option. 

Hanford is an option. 

MR. ESPINOSA: Hey, I thought it was my decision. Oh, 

I'm sorry. 

DR. ROESSLER: Las Vegas. 

MR. ESPINOSA: There you go, Las Vegas. No, no, that's 

-- that'd get me in trouble. 

DR. ZIEMER: Let me ask -- I want to ask Mark, in terms 

of the working group, is there any need for us to be in 

Cincinnati for this meeting in terms of logistically --

in terms of what the work group is going to be doing, 

to prepare or... 

MR. GRIFFON: I -- I don't know. I guess there could 

be some advantages to it. I'm not sure we need to get 

access to the database systems or anything like that at 

this point. 

MR. ELLIOTT: It would certainly be easier on staff, I 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 444 

can tell you that. 

MR. ESPINOSA: St. Louis? 

MR. PRESLEY: No, Cincinnati. 

MR. ESPINOSA: Oh, Cincinnati? 

MR. ELLIOTT: But I serve at your pleasure, so... 

DR. ZIEMER: Other suggestions? 

DR. ANDERSON: Where would you like to go, Cori? 

MS. HOMER: Me? 

DR. ANDERSON: Yeah, where would you like to go? 

MS. HOMER: I like Santa Fe. 

MR. ESPINOSA: Yeah, how about Santa Fe? 

MS. HOMER: That works for me. 

MR. GRIFFON: St. Louis is great in the summer. 

MR. ELLIOTT: So's Cincinnati. 

DR. ANDERSON: Or maybe Atlanta. 

MR. GRIFFON: Warm and humid. Right? 

DR. ANDERSON: Savannah. Savannah, right. 

DR. ZIEMER: Well --

MR. ESPINOSA: Before we commit, does anybody have a 

baseball schedule? 

DR. ZIEMER: Let me suggest a couple of considerations. 

The one was whether or not there is a logistical 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 445 

reason to meet in Cincinnati. There could be some 

staff considerations, that is one. Another possibility 

was to go back to the D.C. area, and then the other 

possibility would be to try to hit a city that is in 

fact co-located with one of the sites, which would 

argue for either one of the DOE sites or one of the 

other sites, such as -- such as Mallinckrodt. 

MR. ESPINOSA: With a -- reading some of the public 

comments on the SEC, you know, from a year ago and the 

stakeholders meetings and stuff like that, I would like 

to see the Board at some time go to the Hanford area, 

and I don't know if it's -- you know, and also a 

consideration, Ms. Wanda Munn, she's traveled through 

all the time zones and we haven't gone to hers. 

MS. MUNN: Honey, you're welcome to come on down any 

time. In the middle of August we are hot to trot. 

It's -- I would --

MR. ESPINOSA: Maybe -- how is it in October there, 

Wanda? 

MS. MUNN: I really, genuinely would love to have you 

there, but I am concerned about the overall cost of 

transporting everybody across country like that. It's 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 446 

bad enough transporting me across. Every time I look 

at my ticket, I blanch. But the concept of bringing 

this entire Board and the staff out there is -- you 

know, I think we need to go out there at some juncture, 

but it really is going to cost us a lot. 

MR. ELLIOTT: If I might add this, I think it would be 

appropriate when we have the technical basis document, 

site profile for Hanford, that's when we probably ought 

to go out there and --

MR. ESPINOSA: Yeah, that's a good --

MR. ELLIOTT: -- talk about that, deliver that, you 

know, get the Board's input on that once we have it in 

a state where we're ready to present it to you. 

DR. ANDRADE: I would think that would be a good --

DR. ZIEMER: Are there any other locations where we're 

approaching that, where it would be appropriate to go 

to such a location? Any other DOE sites or other major 

facilities? 

DR. ANDRADE: Based on public comment, I think there's 

a --

UNIDENTIFIED: Microphone. 

MR. ELLIOTT: Microphone, please. 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 447 

DR. ANDRADE: Based on public comment, I think there's 

a lot of interest in St. Louis, what's going on at 

Mallinckrodt -- the former Mallinckrodt facilities. 

It's centrally located. It would probably be easy for 

all of us to get to, so I -- I'd suggest that as a --

as a potential place for the 18th. 

MR. ESPINOSA: Make it a motion. 

DR. ZIEMER: Any other suggestions? 

DR. ROESSLER: I'll say that since there's no place 

that's good to go in August that we might as well go to 

Cincinnati and save St. Louis for when we can do a 

little sight-seeing and Hanford when it's -- the 

weather's better. That's just my... 

MR. ESPINOSA: What about Lawrence -- is it Lawrence 

Livermoor? 

UNIDENTIFIED: California. 

MR. ESPINOSA: Yeah, what about California this time of 

year? The Giants are playing. 

DR. ZIEMER: Robert? 

MR. PRESLEY: Larry, would it help if we came to your 

place in August to straighten up some of our problems 

that it looks like that we're going to be perceived 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 448 

with our audit? That way we'll get more of the staff. 

MR. ELLIOTT: I think if you could meet in Cincinnati 

in August, it would be of benefit to everybody. It 

would allow my staff to do the work that they need to 

be doing in the office. It will allow us to support 

your needs if you've got information needs on 

developing your process or, you know, checking out the 

technical basis documents that we might have at the 

ready at that point. We need to figure out in this 

process how we can get the information on these 

administrative records to you and -- it'll travel less 

staff if we can do it right there, but... 

MR. PRESLEY: Can I make a motion we go to August -- go 

to Cincinnati in August? 

DR. ZIEMER: Sure. Hang on, we'll hear from Richard 

and then you can make a motion. 

MR. ESPINOSA: In the March meeting it was also 

suggested -- if I'm not mistaken, it was suggested by 

Mr. Presley here, that the rest of the Board go through 

the -- ORAU's office, the training, and NIOSH offices, 

as well, so we might want to make it a three-day trip 

for the people that aren't on the working group, the 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 449 

people that are alternates on the working group. So 

that's something that might want to be considered now. 

MR. PRESLEY: Might want to do it all for everybody 

'cause things have changed. Everybody hears the same 

thing at one time. 

MR. ESPINOSA: And I think it -- yeah, just like --

everybody hear the same thing at one time. I know 

that's a problem with (inaudible) and stuff like that, 

but even if we broke it into two groups, one group in a 

half-day in the morning and a half-day in the 

afternoon, it's -- you know, this meeting might want to 

be turned into three days instead of just the general 

two. 

DR. ZIEMER: That's a good suggestion. I think we 

could work out the logistics on that. You want to make 

your motion now, Mr. Presley? 

MR. PRESLEY: I make a motion we go the 18th, 19th, 

possibly the 20th to Cincinnati in August. 

DR. DEHART: Second. 

DR. ZIEMER: And seconded. Further discussion? 

MR. ELLIOTT: Just so you know, Dr. Melius would not be 

available on the 20th, so if you target the meeting for 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 450 

the 18th and 19th and then the training -- the working 

session for those who could stay on the 20th --

MR. ESPINOSA: Are you seeing a full two-day schedule, 

Larry? 

MR. ELLIOTT: Well, I was going to ask, what -- you 

know, what other agenda items you want to see on that 

meeting date. You know, we could certainly approach 

Dr. Till and see if he is available those two days to 

come in and talk to you all about the NAS report. 

That's one thing --

DR. ZIEMER: We'd want to hear that. We need to 

finalize these documents. Those are --

MR. ELLIOTT: This is the primary work. 

DR. ZIEMER: -- the two main issues, and it may be that 

we'd have a day and a half meeting plus the training. 

DR. ANDRADE: I think beyond -- beyond the agenda 

items, I know that there are four of us that still 

require the training -- we're alternates -- and that 

does include Jim, Leon, Wanda and myself. 

MR. ESPINOSA: You're on there, too. Right, Henry? 

DR. ANDERSON: Yeah. Well, I mean eventually 

everybody, so it would be nice if we kind of put it 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 451 

together, we all go through. 

DR. ZIEMER: Let me suggest that we plan the following 

-- we'll plan it to be a day and a half meeting, plus 

the training. But if the agenda fills up, we have the 

option of going over the extra day. Is that --

MR. ELLIOTT: Yes, you would. But I would offer this 

for your consideration, that to have the whole Board 

there to go through what the working group has seen --

DR. ZIEMER: Oh, we'd need to --

MR. ELLIOTT: -- constitutes a quorum, constitutes --

we'd have to have a closed session because you're going 

to deal with Privacy Act information and we'll have to 

get that put in play to have a closed session of the 

Board. 

MR. ESPINOSA: Just another suggestion --

MR. ELLIOTT: Or you could split the group and split 

the days. That's the other way to get at it. 

MR. ESPINOSA: Yeah, just another suggestion, you know, 

some people won't be leaving until that Wednesday the 

20th, so maybe we could have a half-day on the 20th and 

some people get here early enough to where you can have 

a later half-day on the 18th or something -- or in the 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 452 

morning of the 18th and, you know, however that works 

out. 

DR. ZIEMER: And start mid-day on the 18th, yeah. 

Yeah, we can work out the logistics. I think we 

understand the -- so did we vote on this? I lost track 

here. 

MR. PRESLEY: Yes. 

DR. ZIEMER: We did. Did we? We didn't vote. 

DR. ANDRADE: No, I don't think so. 

DR. ZIEMER: Must be time to end. All in favor of 

meeting on the 18th through the 20th, if necessary, in 

Cincinnati say aye. 

 (Affirmative responses) 

DR. ZIEMER: Any opposed? 

(No negative responses) 

DR. ZIEMER: So ordered. Thank you very much. 

DR. DEHART: One other question, Paul. 

DR. ZIEMER: A question. 

DR. DEHART: When will the final rule be out? Do we 

have any idea? 

MR. ELLIOTT: Good question. We are addressing the 

comments that we received and we're working that rule 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 453 

back together, and it's our hope that before the end of 

the year we'll have a final rule out and people can --

DR. DEHART: Okay, so August is too -- it's premature. 

MR. ELLIOTT: Yes, yes. The number of comments that 

we've got and the number of issues we have to deal 

with, I don't think we're going to have a final rule by 

August. 

DR. ZIEMER: Mark, did you have a --

MR. GRIFFON: Yeah, just another proposed agenda item. 

I'd like to see the site profile -- you know, status 

report on site profiles --

MR. ELLIOTT: Sure. 

MR. GRIFFON: -- at the meeting if we can, and if 

possible maybe a presentation on sample ones that have 

been completed. I know Bethlehem Steel's one -- I 

guess you're calling it an exposure profile more than a 

site profile, but --

DR. ZIEMER: Did you have another comment, Rich? 

MR. ESPINOSA: Oh, I just -- you know, I was 

(inaudible). 

DR. ZIEMER: Okay. Any other items pertaining to the 

next meeting? 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 454 

Okay, housekeeping items. Cori? 

MS. HOMER: Yes. Instead of filling out that little 

slip of paper we usually ask you to hand to Larry and 

have him sign to approve your time, what I'd like for 

you to do from now on and in the future, to send an email to Larry identifying very specifically the time 

you've spent preparing, time you've spent on the work 

group and of course our meeting time we already know, 

you know, what days you were here. That way when I'm 

accounting for your time, I can separate the work group 

and prep time, as well as meeting time. But go ahead 

and send it to Larry. He'll approve it and send it to 

me. You'll have to do that the day that you get back 

or the day after or I may not be able to get you on 

that pay cycle. 

MR. ESPINOSA: You want the meeting time, also? 

MS. HOMER: No, I do not need the meeting time. 

DR. ROESSLER: So you need it -- two categories, the 

preparing for the meeting and doing the normal things, 

and then the other one is --

MS. HOMER: Work group. 

DR. ROESSLER: -- work group. Okay. 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 455 

MS. HOMER: Anything work group-related is entirely 

separate from preparation time. 

MR. ELLIOTT: And if you've already given me this on a 

piece of paper, don't send an e-mail at this time, but 

for the future that's the way we'd like to have this 

transaction occur. 

DR. ZIEMER: Cori, for clarification, the work group 

time, you're -- you're talking about the actual time 

that the work group meets. 

MS. HOMER: Meets, as well as whatever time you spend 

preparing for the work group, 'cause it's entirely 

different. 

MR. GRIFFON: Entirely. 

DR. ZIEMER: It's separate from the committee time. 

MS. HOMER: I know, it's -- the way I have to account 

for it on annual reports, it's just really helpful for 

me to have it as specific as possible. 

MR. GRIFFON: Just a clarification, Cori, on the prebid meeting that a bunch of us attended, were we 

supposed to submit ours or was --

MS. HOMER: Yes. 

MR. GRIFFON: Okay, I never did --

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 -- 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 456 

DR. ZIEMER: For prep time --

MS. HOMER: Uh-huh. 

DR. ZIEMER: -- and the meeting time? 

MS. HOMER: Uh-huh. No, meeting time you never have to 

DR. ZIEMER: Okay. 

MS. HOMER: -- but if you have attended a work group 

meeting, and I may not necessarily be aware of that, 

you need to tell me. 

MR. ESPINOSA: Yeah, the bidder's conference was 

considered a work group meeting. Right? 

MS. HOMER: Okay, so identify that under work group. 

MR. ESPINOSA: Okay. 

MS. HOMER: Even if I was there, just go ahead and --

DR. ZIEMER: Thank you. Other items --

MS. HOMER: 'Cause that helps. 

DR. ZIEMER: -- Cori? 

MS. HOMER: I think that's about it. Can you think of 

anything else? 

DR. ZIEMER: Henry -- or Jim -- Henry. 

DR. ANDERSON: It might be helpful if, just seeing the 

difficulty picking a date for the -- for this next 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

 457 

meeting, when we get into the fall season, when I look 

at my calendar it's already filling, so I'm wondering 

if we want to start to think about anyway what -- when 

would the next meeting potentially be and -- something 

like that 'cause, for instance, my October -- that's 

always the busiest month, so... 

MS. HOMER: I can pull them by e-mail. 

DR. ZIEMER: Cori, why don't you ask each person to 

send in their schedule --

MS. HOMER: Yeah. 

DR. ZIEMER: -- of bad times --

MS. HOMER: Through October and November, is that 

helpful? Okay. So if you could send your schedule to 

me through November. 

DR. ZIEMER: Now -- you have a calendar in your packet 

now -- right? -- if you know what it is. 

MS. HOMER: That's right. 

DR. ZIEMER: Otherwise e-mail it? 

MS. HOMER: Uh-huh. 

DR. ZIEMER: Any other items to come before us today? 

Okay. Does anyone have any other issue that needs to 

be raised? I have some instructions on the tour. 

NANCY LEE & ASSOCIATES 
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

 458 

Robert? 

MR. PRESLEY: People that are going on the tour please 

just stay in place here in the room and Steve White 

will come in and we will get our instructions on 

badging and then we'll head out and get on the bus. 

Has everybody got a blue TLD that's going on the tour? 

DR. ZIEMER: Okay, very good. And again for the 

record, I want to announce that the tour is simply an 

effort to allow Board members to see the site and learn 

more about the Oak Ridge site. There will be no 

official business conducted by this Board on the tour. 

We stand adjourned. 

(Meeting adjourned 1:50 P.M.) 

NANCY LEE & ASSOCIATES 
 459 

1 

2 C E R T I F I C 

3 A T E
 

STATE OF GEORGIA ) 

) 

COUNTY OF FULTON ) 

I, STEVEN RAY GREEN, being a Certified Merit Court 

Reporter in and for the State of Georgia, do hereby certify 

that the foregoing transcript was reduced to typewriting by 

me personally or under my direct supervision, and is a true, 

complete, and correct transcript of the aforesaid 

proceedings reported by me. 

I further certify that I am not related to, employed 

by, counsel to, or attorney for any parties, attorneys, or 

counsel involved herein; nor am I financially interested in 

this matter. 

WITNESS MY HAND AND OFFICIAL SEAL this _____ day of 

June, 2003. 

___________________________ 

 STEVEN RAY GREEN, CVR-CM 

 GA CCR No. A-2102 

NANCY LEE & ASSOCIATES 
 

 460