Executive Summary/Minutes August 25-26, 2005 
 

NIOSH/CDC Advisory Board on Radiation and Worker Health
 

The Advisory Board on Radiation and Worker Health 


National Institute for Occupational Safety and Health 


Centers for Disease Control and Prevention


 ________________________________________________________ 


Summary Minutes of the Thirty-second Meeting 


August 25-26, 2005 


________________________________________________________
 

The Thirty-second Meeting of the Advisory Board on Radiation and Worker 


Health (ABRWH or the Board) was held at the Westin St. Louis Hotel in 


St. Louis, Missouri on August 25 and 26, 2005. The meeting was called 


by the Centers for Disease Control and Prevention's (CDC’s) National 


Institute for Occupational Safety and Health (NIOSH), the agency 


charged with administering the ABRWH. These summary minutes, as well 


as a verbatim transcript certified by a court reporter, are available 


on the internet on the NIOSH/Office of Compensation Analysis and 


Support (OCAS) web site located at www.cdc.gov/niosh/ocas. Those 


present included the following: 


ABRWH Members: Dr. Paul Ziemer, Chair; Dr. Henry Anderson; Mr. Richard 


Espinosa; Mr. Mike Gibson; Mr. Mark Griffon; Dr. James Melius; Ms. 


Wanda Munn; Mr. Leon Owens; Mr. Robert Presley; and Dr. Genevieve 


Roessler. 


Designated Federal Official: Dr. Lewis Wade, Executive Secretary. 


Federal Agency Attendees:
 

Department of Health and Human Services: 


Mr. Fred Blosser, Ms. Chris Ellison, Mr. Stuart Hinnefeld, Ms. Liz 


Homoki-Titus, Ms. Emily Howell, Mr. Ted Katz, Dr. James Neton 


Department of Labor: 


Ms. Diane Case, Mr. Jeff Kotsch 


Government Accountability Office: 


Ms. Mary Nugent, Mr. Bob Sampson 


Contractors:
 

ORAU: Dr. Richard Toohey 


SC&A: Dr. Hans Behling, Mr. Joseph Fitzgerald, Dr. Joyce Lipsztein, 


Dr. Arjun Makhijani, Dr. John Mauro 


Public Attendees: See Registration 

Executive Summary/Minutes August 25-26, 2005 
 

NIOSH/CDC Advisory Board on Radiation and Worker Health


 Executive Summary
 

The Thirty-second Meeting of the Advisory Board on Radiation and Worker 


Health (ABRWH or the Board) was held at the Westin St. Louis Hotel in 


St. Louis, Missouri on August 25 and 26, 2005. All members were in 


attendance except Dr. Roy DeHart. Others in attendance included staff 


of various Federal agencies, as well as members of the public. The 


Summary Minutes of Meeting Thirty were approved without comment. 


* * * * *
 

Thursday, August 25, 2005
 

Selection of Fourth Round of 20 Dose Reconstruction Reviews
 

The Board completed the task of selecting 20 cases to comprise the 


fourth round of dose reconstruction reviews. The following cases were 


selected: 


Case No. POC %Cancer Site
 

105 44.45 Liver Savannah River 


108 63.25 Colon Nuclear Materials 


 & Equipment Corporation 


110 48.16 Colon Savannah River 


130 19.64 Pancreatic Hanford 


138 53.26 Colon Bridgeport Brass 


155 47.33 Male Genitalia Savannah River 


159 29.52 Stomach Chapman Valve 


176 50.29 Respiratory West Valley Demonstration 


Project 


201 50.81 Bladder Oak Ridge National 


 Laboratory, X-10 


204 23.02 Colon Oak Ridge, Y-12 


216 44.74 Thyroid Hanford 


234 19.65 Bladder Mound 


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Executive Summary/Minutes August 25-26, 2005 
 

NIOSH/CDC Advisory Board on Radiation and Worker Health


253 33.80 Esophagus Jessop Steel 


256 50.00 Melanoma skin, Hanford 


 Basal cell 


262 39.19 Acute Myeloid Heppenstall Company 


Leukemia 


264 27.85 Male Genitalia Oak Ridge, Y-12 


010 38.16 Nonmelanoma skin, Pinellas 


 Squamous cell 


011 32.78 Pancreas Feed Materials 


 Production Center 


017 50.55 Nonmelanoma skin, Nevada Test Site 


 Basal cell 


035 26.62 Breast Los Alamos 


The Board unanimously approved the selection of the 20 cases for 


review. The cases were divided among six two-member review teams. 


* * * * *
 

Candidate Site Profile Selection
 

The Board considered a recommendation by the subcommittee of site 


profiles for review. Recommended as priority sites were Fernald, Los 


Alamos, Mound, X-10, Bridgeport Brass and Pinellas. Included for 


consideration as alternates were Argonne West and Lawrence Livermore. 


A motion was made and seconded that the Pinellas site be replaced with 


Lawrence Livermore on the priority list. The motion failed. 


A motion was made and seconded that the Bridgeport Brass site be 


replaced with the Linde Ceramics site on the priority list. After 


discussion the six priority sites were unanimously approved, including 


the substitution of Linde Ceramics for Bridgeport Brass. 


* * * * *
 

Task III Procedural Review Report
 

The Board unanimously approved a recommendation by the subcommittee 


which directed NIOSH to proceed with their comments on the SC&A Task 


III Procedural Review report. 


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Executive Summary/Minutes August 25-26, 2005 
 

NIOSH/CDC Advisory Board on Radiation and Worker Health


Responding to a question on timing, Dr. John Mauro of SC&A indicated 


the matrix would be completed within two weeks. Mr. Stu Hinnefeld from 


NIOSH estimated their responses should be completed in four weeks. 


A workgroup comprised of Mr. Mark Griffon as Chair, Ms. Wanda Munn, Mr. 


Robert Presley and Mr. Mike Gibson was appointed to address the 


completion of the Task III review issue. Mr. Rich Espinosa was named 


alternate. It was agreed the workgroup's planned October meeting would 


be noticed on the NIOSH web site and open to the public. 


* * * * *
 

Bethlehem Steel Site Profile
 

Following a report from the subcommittee on the most recent draft 


Bethlehem Steel site profile revision, a motion was made and seconded 


that SC&A review the draft, paying particular attention to those items 


highlighted by the Board following SC&A's previous site profile review. 


* * * * *
 

Mallinckrodt Site Profile
 

Dr. Jim Neton from NIOSH and Dr. Arjun Makhijani from SC&A presented an 


update on the site profile's six identified priority issues. They 


included raffinate ratios, radon exposure, external dose correction 


factors, intermediate exposure, unmonitored workers' dose 


reconstructions, and specific dose reconstruction examples. Following 


the presentations a discussion ensued among members of the Board and 


representatives from NIOSH and SC&A. 


Discussions were suspended to accommodate a scheduled Executive 


Session. 


* * * * *
 

Results of Closed Executive Session
 

The Board met in a closed executive session to discuss future 


contractual issues. Upon reconvening the public session, Dr. Paul 


Ziemer reported the following decisions: 


#Approval of Task I scope, site profile reviews for the upcoming year, 

at a cost of $1,204,948. 

#Approval of Task III scope, procedural review, in the amount of 

$416,224. 


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Executive Summary/Minutes August 25-26, 2005 
 

NIOSH/CDC Advisory Board on Radiation and Worker Health


#Task IV scope was not approved, but would be further discussed in open 

session at the next meeting. 

#Approved Task V, contractor assistance in review of Special Exposure 

Cohort Petitions, in the amount of $917,341. 

#Approved Task VI, project management, at a cost of $217,801. 

Dr. Ziemer noted that during the closed session a conflict of interest 


had been discovered in one of the dose reconstruction review case 


assignments and had therefore been reassigned. 


* * * * *
 

The Board resumed discussion of the six Mallinckrodt site profile 


priority issues. The discussions primarily were directed toward 


concerns about illegible records and data discrepancies. 


* * * * *
 

In an effort to increase transparency in their deliberations, the Board 


continued discussion in open session on some of the issues surrounding 


the contractor's task proposals. 


 Task IV
 

The Board engaged in detailed discussion regarding the definition of a 


basic dose reconstruction review as compared to an advanced review. 


Proposals were advanced, and Dr. Ziemer suggested a motion could be 


made and acted on at tomorrow's meeting after refinement over the 


evening. 


 Task VI
 

Discussion was held on inclusion of SC&A trips to Washington for 


Congressional briefings on their work products as part of the project 


management task. 


* * * * *
 

Dr. Ziemer declared a recess until 7:00 p.m., at which time the public 


comment session would begin. 


* * * * *
 

Public Comment Period
 

Following is a list of members of the public who spoke. A full 


transcript of their comments is available on the OCAS web site, 


5
 
Executive Summary/Minutes August 25-26, 2005 
 

NIOSH/CDC Advisory Board on Radiation and Worker Health


www.cdc.gov/niosh/ocas. 


Mr. John Ransport, General Steel Industries; Ms. Christine Ransport;
 

Dr. Dan McKeel; Ms. Denise Brock, Mallinckrodt SEC petitioner; Ms. 


Louise McKeel; Father Jim Mitulski, survivor; Mr. Richard Miller, 


Government Accountability Project. 


Friday, August 26, 2005
 

The second day of the 32nd meeting was called to order by Chairman 


Ziemer, who reminded everyone present to register their attendance. 


Dr. Lew Wade, Designated Federal Official, stated that although NIOSH 


values timeliness and completeness, the time has come for the Board to 


make a recommendation on the Mallinckrodt SEC petition, which is on 


today's agenda for deliberation. 


* * * * *
 

Mallinckrodt SEC Petition
 

Ms. Denise Brock and Dr. Dan McKeel spoke on behalf of the petitioners 


for adding a class of Mallinckrodt employees to the Special Exposure 


Cohort. 


Ms. Brock cited federal acts and rules she believed called for timely, 


uniform and adequate compensation for employees made ill from various 


exposures at Mallinckrodt and other sites. She provided a 


chronological event of meetings regarding the Mallinckrodt facility, 


and reviewed the feasibility issue with respect to technical, cost, and 


time constraints. Ms. Brock remarked that NIOSH has far exceeded the 


time contemplated by Congress for SEC petition processing, noting it 


has taken 24 months to assess this petition. Ms. Brock concluded her 


comments by asking the Board to approve the SEC petition for 


Mallinckrodt workers in the period 1949 to 1957. 


Dr. McKeel declared that, based on 42 CFR 83, NIOSH lacked adequate 


data or information to accurately reconstruct doses. He stated the 


Board should recommend SEC status for the 1949 to 1957 class of 


Mallinckrodt uranium division workers. 


Following Board discussion, a motion was made and seconded that 


the Board recommend that a class of Mallinckrodt workers in 


the period 1949 to 1957 be included as part of the Special 


Exposure Cohort. The motion carried. 


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Executive Summary/Minutes August 25-26, 2005 
 

NIOSH/CDC Advisory Board on Radiation and Worker Health


* * * * *
 

Conflict of Interest Disclosure Statements
 

Ms. Liz Homoki-Titus of the Office of General Counsel for HHS addressed 


the Board relative to their conflict of interest disclosure statements. 


Ms. Homoki-Titus noted that the Board had expressed a desire to have 


their statements posted on the OCAS web site. She reported to the 


Board that she had discussed the matter with others in her office and, 


since that is contrary to HHS policy, they would like a formal Board 


motion to memorialize that request. 


Such a motion was made and seconded, and passed unanimously. 


* * * * *
 

Capitol Hill Policy
 

Dr. Ziemer referred the Board to a written motion titled "Advisory 


Board on Radiation and Worker Health Statement on Policy," already on 


the floor and preliminarily discussed at the previous day's meeting. 


Further discussion resulted in altering the motion to provide that 


presence of a Board member be requested at any meetings between 


Congressional staffers and SC&A, rather than that such presence be 


mandatory. The motion also covered proper protocol and procedures 


regarding notification of Congressional staff meetings. The motion 


carried. 


* * * * *
 

Site Profile Prioritization
 

Open for discussion was the issue of prioritization of the six sites 


previously identified for site profile review. 


A motion was made and seconded that SC&A work with NIOSH to 


establish a priority order for review of the site profiles 


for Fernald, Mound, Pinellas, Linde Ceramics, Los Alamos and 


K-10. The motion carried unanimously. 


It was agreed SC&A would report the priority list at the October 


meeting. 


* * * * *
 

Other Board Items
 

7
 
 

Executive Summary/Minutes August 25-26, 2005 
 

NIOSH/CDC Advisory Board on Radiation and Worker Health


The Board approved the minutes of the Thirtieth Meeting, held April 25­

27 in Cedar Rapids, Iowa. 


* * * * *
 

Dr. Wade reported to the Board on the question regarding the Department 


of Labor's position on non-covered cancers, should the Mallinckrodt SEC 


petition be approved. He stated DOL would reserve judgment on non-


covered cancers pending the Secretary's determination. 


* * * * *
 

A motion was made and seconded outlining the specifics of SC&A's Task 


IV scope of work dealing with upcoming dose reconstruction reviews. It 


included the numbers of each type of review, the contents of the review 


reports, and a description of their participation in the extended 


review cycle with NIOSH and the Board in the resolution process. The 


motion passed without further discussion. 


* * * * *
 

Mr. Hinnefeld reviewed the process by which NIOSH informs claimants 


when a determination has been made that there is insufficient 


information available to complete a dose reconstruction. He explained 


how that determination is a first step for an individual petitioning 


for inclusion as a class in the Special Exposure Cohort. 


* * * * *
 

Dr. Ziemer concluded the meeting with a reminder that the Advisory 


Board will be recommending the Secretary of Health and Human Services 


request Congressional approval of the Mallinckrodt uranium division 


workers for the period 1949 to 1957 as members of the Special Exposure 


Cohort. He emphasized the final determination is made by Congress. 


Ë Ë Ë 

End of Executive Summary 


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Executive Summary/Minutes August 25-26, 2005 
 

NIOSH/CDC Advisory Board on Radiation and Worker Health


The Advisory Board on Radiation and Worker Health 


National Institute for Occupational Safety and Health 


Centers for Disease Control and Prevention


 ________________________________________________________ 


Summary Minutes of the Thirty-second Meeting 


August 25-26, 2005 


________________________________________________________
 

Thursday, August 25, 2005
 

Dr. Paul Ziemer called the 32nd Meeting of the Advisory Board on 


Radiation and Worker Health to order, welcoming the attendees. He 


asked that everyone register their attendance, and discussed the sign-


up sheet for anyone desiring an opportunity to speak during the public 


comment session. 


Dr. Ziemer announced that NIOSH personnel are available to assist 


individuals who may have specific problems with individual claims. 


Noting the absence of Dr. Roy DeHart, Dr. Ziemer explained Dr. DeHart
 

was traveling out of the country. He announced the passing of Mr. 


Gibson's father, and expressed sympathy to the Gibson family. 


Dr. Lew Wade, Designated Federal Official, reminded the Board that 


while there would be other business addressed, the main purpose of this 


meeting was to resolve issues related to the Mallinckrodt Special 


Exposure Cohort petition. 


* * * * *
 

Selection of Fourth Round of 20 Dose Reconstruction Reviews
 

Dr. Ziemer reported that the subcommittee had compiled a list of 20 


dose reconstruction cases for recommendation to the Advisory Board for 


its fourth round of reviews. He noted 16 were chosen from the total 


list of completed dose estimate cases and four were from the random 


list. The subcommittee recommended the following cases: 


Case No. POC %Cancer	 Site
 

105 44.45 Liver 	 Savannah River 


108 63.25 Colon 	 Nuclear Materials 


 & Equipment Corporation 


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Executive Summary/Minutes August 25-26, 2005 
 

NIOSH/CDC Advisory Board on Radiation and Worker Health


110 48.16 Colon Savannah River 


130 19.64 Pancreatic Hanford 


138 53.26 Colon Bridgeport Brass 


155 47.33 Male Genitalia Savannah River 


159 29.52 Stomach Chapman Valve 


176 50.29 Respiratory West Valley Demonstration 


Project 


201 50.81 Bladder Oak Ridge National 


 Laboratory, X-10 


204 23.02 Colon Oak Ridge, Y-12 


216 44.74 Thyroid Hanford 


234 19.65 Bladder Mound 


253 33.80 Esophagus Jessop Steel 


256 50.00 Melanoma skin, Hanford 


 Basal cell 


262 39.19 Acute Myeloid Heppenstall Company 


Leukemia 


264 27.85 Male Genitalia Oak Ridge, Y-12 


010 38.16 Nonmelanoma skin, Pinellas 


 Squamous cell 


011 32.78 Pancreas Feed Materials 


 Production Center 


017 50.55 Nonmelanoma skin, Nevada Test Site 


 Basal cell 


035 26.62 Breast Los Alamos 


Dr. Ziemer called for comments or questions regarding the 


recommendation. 


Mr. Leon Owens expressed concern regarding the absence of any cases 


10
 
 

 

 

Executive Summary/Minutes August 25-26, 2005 
 

NIOSH/CDC Advisory Board on Radiation and Worker Health


from the Lawrence Livermore Site. He reminded the Board there had been 


considerable interest at their meeting in the Livermore area. Dr. 


Richard Toohey from ORAU noted the Livermore site profile had not 


received final approval for release. Therefore the only cases that had 


been completed were the min/max type cases, and SC&A had specifically 


requested a focus on best-estimate cases. 


Mr. Griffon commented that there had been two Livermore cases reviewed 


from the initial 60 cases, but they had indeed been min/max cases. 


The Board unanimously accepted the subcommittee recommendation of the 


20 cases to be included in the fourth round of dose reconstruction 


reviews. 


Dr. Ziemer led the Board in a discussion of team members, and assigned 


the 20 cases among the teams as follows: 


 Team No. Team Members Case Nos. Assigned

 1 Anderson and Presley 105, 108, 010 

2 Gibson and Ziemer 035, 130, 138, 155 

3 Roessler and DeHart 017, 159, 176, 201 

4 Owens and Munn 204, 234, 253 

5 Melius and Espinosa 011, 216, 256 

6 Griffon and Owens 264, 110, 262 

* * * * * 

Candidate Site Profiles
 

Dr. Ziemer reported that during yesterday's subcommittee meeting it was 


recommended the Board identify the next group of site profiles for 


SC&A's review. The nine site profile reviews already completed, or 


nearly completed, are Hanford, INEL, Nevada Test Site, Rocky Flats, 


Savannah River, Y-12 at Oak Ridge, Bethlehem Steel, Mallinckrodt and 


Iowa Army Ammunition Plant. 


The subcommittee recommended six site profiles for consideration as 


SC&A's next reviews. They were Fernald, Los Alamos, Mound, X-10 at Oak 


Ridge, Bridgeport Brass and Pinellas. An additional two sites as 


potential alternates were Argonne West and Lawrence Livermore. Dr. 


Ziemer suggested the Board select six of the sites as priorities and, 


should the opportunity present itself, two more could be added later. 


Mr. Richard Miller commented from the audience that consideration might 


be given to Linde Ceramics in place of Bridgeport Brass. He noted the 


Linde Ceramics plant was interesting and complex, while the Bridgeport 


11
 
Executive Summary/Minutes August 25-26, 2005 
 

NIOSH/CDC Advisory Board on Radiation and Worker Health


Brass facility was a traditional uranium processing plant. 


A motion was made and seconded to move Lawrence Livermore from the 


alternate list to the priority list and Pinellas from the 


priority list to the alternate list. After discussion 


elaborating on the reasons the sites were positioned as they 


were, the motion failed.
 

A motion was made and seconded to replace the Bridgeport Brass 


facility with Linde Ceramics on the priority list. The 


motion was open for discussion. Interest and numbers of 


claimants were two additional reasons given to exchange the 


facilities. The motion passed.
 

The amended list of Fernald, Los Alamos, Mound, X-10, Linde Ceramics 


and Pinellas as the six priorities for site profile review, with 


Argonne West and Lawrence Livermore as alternates, was unanimously 


approved. 


* * * * *
 

Task III Procedures Review Report
 

Dr. Ziemer reported to the Board on the Subcommittee's discussion and 


subsequent recommendation related to the SC&A report on their 


procedures review. Over the course of time, some of the original 


procedures have been modified or are no longer in use. SC&A has 


prepared a matrix of the procedures they have reviewed. They will add 


to that all other procedures. That revised matrix will be delivered to 


NIOSH. 


The subcommittee's recommendation is that NIOSH then review that total 


matrix and respond to SC&A's findings on those procedures still in 


effect, using the standard resolution process. They further recommend 


NIOSH identify any procedures no longer in use and report back to the 


Board on their plans for those procedures, either to revise them or 


officially cancel them. 


A subcommittee recommendation coming to the Board as a motion 


needing no second, a vote was called for and the motion 


carried unanimously. 


Dr. Wade inquired as to the expectations and timing of the task. Dr. 


Mauro opined the matrix would be completed in approximately two weeks. 


Speaking for NIOSH, Mr. Hinnefeld indicated their responses would be 


completed in roughly four weeks. Inasmuch as the Board desired 


participation in the resolution process, Dr. Ziemer appointed a 


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Executive Summary/Minutes August 25-26, 2005 
 

NIOSH/CDC Advisory Board on Radiation and Worker Health


workgroup to work with SC&A and NIOSH, naming Mr. Griffon Chair, with 


Ms. Munn, Mr. Presley, and Mr. Gibson rounding out the group. Mr. 


Espinosa was named alternate. It was agreed their October meeting will 


be posted on the NIOSH web site and open to the public. 


* * * * *
 

Bethlehem Steel Site Profile Review
 

Dr. James Melius reviewed the subcommittee's previous discussion 


relative to the latest NIOSH revision of the Bethlehem Steel site 


profile. While this revision is still in draft form, the subcommittee 


recommended SC&A review the draft, with particular emphasis on those 


items highlighted by the Board based on SC&A's review of the previous 


site profile. This is to be done for the purpose of confirming that 


the agreed-upon resolution of those issues between NIOSH and SC&A has 


translated accurately to the site profile document. 


A subcommittee recommendation coming to the Board as a motion 


needing no second, a vote was called for and the motion 


carried unanimously. 


Dr. Mauro responded to a timing query by stating SC&A could deliver a 


letter report in approximately three weeks. 


* * * * *
 

Mallinckrodt Site Profile Review
 

Dr. Ziemer reported that the subcommittee had made no recommendations 


on the six items designated as priority issues in the Mallinckrodt site 


profile. He noted SC&A and NIOSH were prepared to make presentations 


on those issues, after which the Board could proceed with further 


discussion. 


Ms. Denise Brock inquired from the audience as to whether dose 


reconstructions would be done on non-SEC cancers if the Mallinckrodt 


Special Exposure Cohort petition were approved. Dr. Ziemer indicated 


they would try to get an answer for her. 


Dr. James Neton, 


NIOSH
 

Dr. Neton reminded the Board NIOSH had been asked to evaluate six 


priority issues resulting from SC&A's third supplemental site profile 


review. Addressing each individually, Dr. Neton described the issue, 


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Executive Summary/Minutes August 25-26, 2005 
 

NIOSH/CDC Advisory Board on Radiation and Worker Health


what SC&A had found problematic, how NIOSH had approached it, and any 


resolution. 


The first, and perhaps the key issue, was the handling of raffinates or 


ore processing residues. Dr. Neton explained the ore processing that 


resulted in a different raffinate at each stage, their compositions and 


the ratios of various radionuclides. To address the issue NIOSH 


developed process-dependent ratios in which they bifurcated the 


processes and developed a method for looking at exposure to both 


radium-bearing residues and the airport case residues rich in thorium 


230. He provided a written description of how NIOSH arrived at the 


ratios. 


Dr. Neton discussed the questions raised on reliability of radon breath 


analyses and lost or not-analyzed data. He explained their research 


into the matter and the NIOSH conclusion that those data were likely 


lost to timing issues -- unavailability of analysts, sample shipping 


delays -- as a result of radon's short half-life. Their investigation 


revealed no indication of selective censoring. 


Also discussed was consistency of the distribution of worker types and 


use of analytical techniques. Dr. Neton observed there were a number 


of areas prone to make the values overestimates. In showing the 


sampling distribution by year, it reflected little substantial change 


in those worker categories over the years. 


Researching whether there might be additional data for those workers 


with missing samples, 98 percent had other samples within a year. 


Because the radon breath analyses measure the amount of radium in the 


skeleton, the picture doesn't change much within a few months or a 


year, so there is a way of looking at the intakes for those workers. 


Dr. Neton went on to discuss the handling of radon exposures, the 


sufficiency of samples available and whether there is a contribution of 


radon inhalation to systemic organs other than the lung, a point raised 


in the SC&A report. NIOSH considered SC&A's analysis, re-evaluated it 


using their own models, and concluded there is some dose and agreed a 


way to account for it was needed. 


A written analysis had been provided to the Board and reviewed by SC&A, 


and there is agreement in the way to address the radon issue. 


A third matter was the external dose correction factor. SC&A's report 


suggested in certain job categories a lapel badge would not adequately 


sample exposures in some scenarios -- grinding, milling, spills -- so 


those were modeled using the Attila software program. Based on those 


analyses, NIOSH agreed there were some exposure geometries where the 


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Executive Summary/Minutes August 25-26, 2005 
 

NIOSH/CDC Advisory Board on Radiation and Worker Health


film badge could underestimate the dose by about a factor of two. 


NIOSH has written a Technical Information Bulletin to address this. 


While still in draft form, SC&A has seen it and agrees the value is 


appropriate, so NIOSH will be multiplying doses for workers in those 


exposure geometries by a factor of 2.1. Dr. Neton indicated it appears 


this will apply to about 57 percent of current cases, being based on an 


analysis of where the people were working and what they were doing. 


The fourth priority item, assessment of intermittent exposures, 


resulted from SC&A's concern that the chronic exposure model NIOSH used 


as a default when they had bioassay data would not sufficiently bound 


the exposure scenarios of those workers. Dr. Neton reported NIOSH had 


gone through a number of scenarios which were discussed with SC&A 


during their meeting in Cincinnati. Without elaborating on details, he 


explained that if they fit a chronic exposure model through all the 


data points, it resulted in a higher intake than by inferring certain 


acute intakes. 


Noting that SC&A had looked at the model and was convinced in general 


that it's true, Dr. Neton added there may be unique incidents to which 


NIOSH will need to be sensitive and make corrections as appropriate. 


Priority topic number five related to dose reconstructions for 


unmonitored workers. Administrative workers have no exposure, but the 


question was raised about their environmental dose. NIOSH has agreed 


that unmonitored administrative workers will be assigned the full 


distribution of the monitored workers' environmental exposures. Dr. 


Neton remarked NIOSH has looked at the available environmental 


monitoring data and believes, from a routine exposure scenario, this is 


a claimant-favorable approach. 


Unmonitored workers in Plant One and Two decommissioning area and the 


airport storage site will be assigned the 95th percentile of the 


monitored worker environmental exposure. 


The final matter was a request that NIOSH present some examples of how 


these resolutions translate into what the doses look like. Dr. Neton 


presented examples of various scenarios using job descriptions with and 


without data, results for cancers to metabolic and non-metabolic 


organs, et cetera. 


Dr. Neton indicated he had been in discussion with Dr. Makhijani and 


others from SC&A about the difference between what is in ICRP and what 


is in the Federal Guidance Report. They agree it is an issue that 


needs to be resolved. But in general Dr. Neton opined the patterns 


would hold where cancers involving metabolic organs will easily exceed 


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Executive Summary/Minutes August 25-26, 2005 
 

NIOSH/CDC Advisory Board on Radiation and Worker Health


50 percent and non-metabolics will be high. Depending on the 


individual scenarios, they can go over. 


Discussion Points: 


#If a person's individual bioassay results in a lower dose than the 

95th percentile of the air concentration data, the highest value 

will be used. 

#Both will be checked in every dose reconstruction. 

#Have the two-page references to Sperry cake distributed during the 

subcommittee meeting been shared with SC&A and have they had an 

opportunity to review the information prior to the meeting. 

#Have the back-up calculations discussed yesterday been shared yet. 

#Has there been any other analysis of the missing radon breath data. 

#The site profile has had modest change. 

#The site profile information is intact, though it has been refined. 

The processes that have evolved are becoming the Mallinckrodt 

workbook. 

#A site profile gives you a lot of information. What you do with it 

when you're doing a dose reconstruction evolves over time. 

#Why was there a two-month urinalysis program and then suddenly just 

air sampling. 

Dr. Arjun Makhijani, 


Sanford Cohen & Associates
 

Dr. Makhijani commented the Board had requested SC&A conduct their 


review in real time as NIOSH was responding to the priority issues. He 


noted this third supplemental review, and agreed with Dr. Neton that 


the question of the trace radionuclides together with uranium 238 and 


U-235 were seen to be significant and the focus of the review effort. 


The Board had directed SC&A to keep track of how this review and 


resolution process was done, and it had been a fruitful and open 


collaboration with NIOSH. A record of communications, including the e-


mail record, was available in an attachment to the report. 


With the objective of tracking the six priority areas, the SC&A 


emphasis was on methodology. Dr. Makhijani noted they did not verify 


all the calculations. They did try to verify some of the work on 


ratios and radon breath and the radon dose issues, which were critical. 


They did not re-run IMBA. The review is also not a full SEC petition 


evaluation. He noted SC&A's overall conclusion is that NIOSH has 


developed an approach that can be applied to estimate maximum doses 


with plausible worst-case estimates. Dr. Makhijani added there is a 


16
 
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NIOSH/CDC Advisory Board on Radiation and Worker Health


checklist table in the report which looks at each sub-issue and its 


status. 


There are specific recommendations on major issues. In terms of the 


ratios associated with the radon breath data, Dr. Makhijani noted they 


seemed to be appropriate. They're well established, there's good 


measurements, and the measurements are internally consistent. 


The issue of non-equilibrium radionuclide exposures in regard to 


thorium 230-dominated areas is more difficult because there is less 


information. From a broad point of view is the question of job type, 


and the Board did ask to whom does this information apply. NIOSH has 


proposed that these high non-equilibrium ratios which produce high 


doses would be applied to most workers. Equilibrium ratios which 


produce lower doses would be applied only when it's clear a uranium 


worker labored in areas that did not involve these residues. Dr. 


Makhijani indicated SC&A is in agreement with that, with a caveat that 


because of the large difference in doses and potential outcome, 


assumption of equilibrium exposure should be carefully made and 

documented. 

An outstanding significant issue is the 95th percentile of air 

concentrations for high thorium areas. The NIOSH calculations have 


taken the 95th percentile of the daily weighted averages for all Plant 


6 where there was uranium processing, which SC&A doesn't feel is 


representative of the airport cake or AM-7 areas. Dr. Makhijani
 

admitted he had not reviewed the data personally, but accepting that it 


is double the daily weighted average of the thorium, it doesn't address 


the relation of the proposed number to the 95th percentile value of air 


concentration in the AM-7 areas. He suggested the air concentrations 


in the areas where thorium was dominant should be the reference point, 


and the 95th percentile of the value of the air concentration needs to 


be developed for that. SC&A believes some work needs to be done there. 


Dr. Makhijani observed that though there had been much discussion about 


illegible data, the point he would make is that the way the 


calculations are now set up, workers with radon breath data may be at 


some disadvantage because the full distribution is being used. And 


while SC&A understands that's in the nature of the process, the 


measurement uncertainties should be assessed somewhat differently. 


Perhaps some method to have 95th percentile values for missing data 


points should be developed to make it appropriately claimant-favorable, 


especially for workers who have just a few radon breath data points. 


On the question of Plant 7-E where thorium was extracted for parts of 


'55, '56 and '57, it wasn't clear how much bioassay data was available 


at the time the report was prepared. SC&A understands now there's 


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NIOSH/CDC Advisory Board on Radiation and Worker Health


quite a bit available for the two months. The air concentration data 


in the TBD and associated documents was clearly inadequate. The intake 


in the case study is 100 times bigger than was suggested in the TBD. 


The new information would help carry this forward. 


On the external dose issues, SC&A agrees with NIOSH regarding how they 


have handled the organ geometry versus the badge geometry. SC&A has 


reviewed the Attila results and are in agreement. 


Two remaining issues regarding dose conversion factors are the angle of 


incidence on the badge because the shielding absorbs some of the 


radiation, and the dose conversion factors need to be corrected. 


Although these are complex-wide issues, they need to be resolved to do 


Mallinckrodt dose reconstruction. Dr. Makhijani commented SC&A had 


raised them in this context because if there are issues to be resolved, 


these should be included. 


Dr. Makhijani noted there were several priority areas in which SC&A and 


NIOSH were in agreement such as radon exposures, unmonitored exposures, 


and routine environmental dose. He summarized the remaining critical 


issues as a need to develop ratios in the thorium areas; a need to 


develop air concentration measurements for the AM-7 areas; the dose 


correction factor for external dose needs to be completed. 


There is new information available which SC&A has not reviewed, 


although Dr. Makhijani indicated he had read it. The analysis of the 


residues contains very significant new information about process 


chemistry that could result in improved ratios. The air concentration 


data, underlying documents, and new production data presented is 


significant new technical information. 


Dr. Makhijani explained that between submittal of the report and coming 


to the meeting, he had tried to review the IMBA calculations to see if 


everything looked okay. That was when he had noted the discrepancy 


between dose conversion factors for actinium and protactinium, a 


significant issue which remains to be resolved as to which is 


appropriate. 


Discussion Points: 


#The discrepancy between the ICRP value and the Federal Guidance Report 

was on protactinium 231. 

#The Federal Guidance Report documents are EPA documents providing 50­

year doses. 

#The ICRP models are programmed to do annual dose increments for this 

program. 

#IMBA has programmed the most recent ICRP models, while the Federal 

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NIOSH/CDC Advisory Board on Radiation and Worker Health


Guidance Report was issued around 2002. 

#The question will probably be which metabolic model was used for 

actinium and protactinium. 

#It is suspected surrogate nuclide models were used, such as thorium 

for one and americium for another, but the issue needs to be 

settled. 

#The issue is whether it's a true difference in the model versus an 

error that's been introduced into one or the other. 

#NIOSH has committed to use current ICRP models in this program and 

have done so. The Federal Guidance Report has taken a different 

tack and a different approach to the dosimetry. If theirs is the 

most reasonable approach, NIOSH would look into it and adopt it. 

* * * * *
 

Closed Executive Session 


Review, Discussion and Finalization of Contractor Issues
 

Prior to adjournment for lunch and the closed session, Dr. Ziemer asked 


Dr. Wade to read into the record the parameters for the Executive 


Session scheduled from 1:00 to 3:00 p.m. 


Report on Executive Session
 

Dr. Ziemer reported the Board had approved the scope and cost for Task 


I, site profile reviews for the upcoming year, in the amount of 


$1,203,938; Task III, procedures review, in the amount of $416,224; 


Task V, contractor assistance in Board review of Special Exposure 


Cohort petitions, in the amount of $917,341; and Task VI, contractor 


program management, in the amount of $217,891. 


Task IV, dose reconstruction review, has not been approved. It will 


continue through the next four to six weeks on existing funds. There 


will be additional discussions on the scope of the task in open session 


and it is expected to be resolved at the next meeting. The discussions 


will revolve around the numbers of basic and advanced reviews. 


Dr. Ziemer also announced a conflict had been discovered in one of the 


case assignments for dose reconstruction review. It had been resolved 


by reassigning the case to a Board member without a conflict. 


Dr. Wade commented that the Board's action in closed session was based 


upon an assumed action on the part of Congress. It should be 


understood that appropriations and budgets will be factors, and if the 


numbers are different, adjustments may be necessary. 


* * * * *
 

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NIOSH/CDC Advisory Board on Radiation and Worker Health


Mallinckrodt Site Profile Review 


 Continued Discussion
 

Discussion Points: 


#NIOSH has a team at the Office of Worker Advocacy to recapture the 451 

pages of radon breath data in their possession. Those better 

copies will be made available to the Board and the contractor. 

#Some entries appeared to be high values and it wasn't clear whether 

the decimal point was missing or they were actually high. NIOSH 

will focus on those and make sure their understanding of them is 

correct. 

#The NIOSH team has been there for two days reviewing every image. 

Anything that can't be scanned properly will be captured in some 

form. The information gathered will be shared with SC&A. 

#There were at least three or four dates in 1955 where the whole day of 

data is missing. 

#In reviewing those dates, there were samples for 98 percent of those 

people at a later time. The measurements reflect a cumulative 

body burden, so no large intakes would have been missed. 

#The individuals' names are on the data sheets so identification is not 

an issue. 

#There are 16 or 17 data points on each of the missing days that are 

not in the CER database. 

#NIOSH will re-code the entire 451 pages and not rely on just the CER 

database. 

#Repeat the explanation of how the air sampling data was used and how 

the 95th percentile was established. 

#How much of the data is clearly identifiable as AM-7 air concentration 

data. 

#Approximately 500 air samples were collapsed into 40 or 50 job 

categories, approximately 11 of which were tied to an AM-7 area. 

#What is the impact on the dose to an organ of a one percent error in 

the protactinium to thorium ratio. 

#There had been an assumption that ICRP and the Federal Guidance Report 

were in agreement, and the discrepancy was found. 

* * * * *
 

Board Working Session
 

Task IV, Dose Reconstruction Reviews
 

Dr. Ziemer announced a carry-forward issue from the closed session is 


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NIOSH/CDC Advisory Board on Radiation and Worker Health


related to Task IV, the scope discussion in terms of basic and advanced 


dose reconstruction reviews. Scope discussions are appropriate in the 


open session, so it was reserved to this time. Dr. Ziemer suggested 


discussion as to what the Board might wish from SC&A next year with 


respect to advanced dose reconstruction reviews versus basic reviews. 


It was noted that in the task description provided by the contractor it 


was indicated that perhaps all of the dose reconstruction reviews to 


date are more advanced than basic, but less advanced than advanced. 


Dr. Wade added he would like to see from the Board what it would like 


to have the contractor prepare and submit before the next meeting so 


that the decision could be made in light of that information. 


Dr. Ziemer remarked closure was not reached on cost relative to this 


particular item because what the Board wants the contractor to do has 


not been defined in terms of advanced and basic reviews. 


Ms. Munn suggested that, allowing some judgment on the part of the 


contractor, the Board might consider looking at the upcoming 22 cases 


and identifying a range of percentage to be identified as advanced 


review cases. She reminded the Board SC&A had indicated it is 


sometimes difficult to identify what should be an advanced review case 


until there's been an opportunity to look at it. 


Some concern was expressed about leaving the choice to the contractor's 


judgment as opposed to assigning cases to receive basic or advanced 


reviews. 


Mr. Espinosa didn't want to tie the contractor's hands and was in favor 


of their having the ability to decide, but was concerned the cost could 


get out of hand. He was more comfortable with stipulating a 


percentage. 


Dr. Anderson questioned the purpose for doing the advanced reviews. He 


suggested the focus of advanced reviews might be the best-estimate 


cases. Conversely, an advanced review of min/max cases could show if 


there were any differences in the results. 


Mr. Presley remarked the original intent was an audit of cases. He 


proposed SC&A might do the next 22 cases as basic reviews, then come 


back with their suggestion for which ones might be ripe for an advanced 


review and why. He observed that was what he considered the audit, and 


the Board would then decide which ones would be advanced reviewed. 


Dr. Melius drew attention to SC&A's proposal in which they indicate two 


elements of the advanced review they have not pursued and are not 


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NIOSH/CDC Advisory Board on Radiation and Worker Health


intending to pursue. The first is to evaluate other relevant sources 


of data and the second is the issue of an adequate effort to research 


co-located workers and other records to characterize the individual's 


work history. He observed the first issue might be included in a site 


profile review, if a site profile has been done. If not, some level of 


effort should be made to address that objective. If a site profile is 


in development, perhaps the case review could be deferred. 


Continuing with the second element, Dr. Melius noted that evaluation of 


the effort to verify the characterization of an individual's work 


history should still be done on an advanced review. It was a component 


the Board wanted done from time to time. Survivor interviews are not 


going to provide much of that information. Dr. Melius reminded the 


Board that was the point of a lot of discussion about re-interviewing 


claimants, and this was their compromise. It's an important part of an 


advanced review and one he did not want to see dropped. 


Noting there are some practical limits needed in that SC&A can't spend 


months talking to everybody at a particular site, they are doing it on 


a modified scale when they talk to people during a site profile review. 


Those interviews are not in enough depth to deal with individual 


cases, however. 


Dr. Ziemer commented that SC&A had indicated they believe their dose 


reconstruction reviews are more thorough than what the Board had 


originally defined as basic, though not at the depth of an advanced. 


They used the term comprehensive. Since they've kept the Board 


informed all through their review process, the Board was aware they may 


have been a bit more thorough than anticipated, but continued along 


that path. For that reason, the contractor should not be faulted. But 


if it's the Board's desire that something less is wanted in a basic 


review, that should be defined. If there is uneasiness about the 


current level and its cost implications, that should be considered if 


the Board wants a sharp demarcation between basic and advanced reviews. 


Observing that what SC&A refers to as comprehensive comes very close to 


an advanced review with only a few components missing, he noted the 


contractor was bidding on the basis of 60 comprehensive reviews. Since 


the Board has no "comprehensive" category, the Board has to decide what 


it wants and in what numbers. 


The original breakdown was 40 basic reviews and 20 advanced, so the 


reviews currently underway are supposedly advanced. 


Mr. Griffon asked to hear the contractor's interpretation of the 


difference in advanced and basic. Indicating he was happy with the 


product received, Mr. Griffon observed that if one looked over the 


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NIOSH/CDC Advisory Board on Radiation and Worker Health


scope items in the original basic review definition, nothing has been 


added by SC&A. He acknowledged there had been a learning curve, 


particularly in the first 20 reviews, but felt the Board deserved some 


reviews done with the advanced scope in mind, with judgment reserved 


until they received the product. 


Dr. Wade announced the first set of 62 reviews was to be 40 basic, 20 


advanced and two blind. The 40 basic reviews had been delivered. The 

Board can tell SC&A it expects the next 22 to be advanced reviews. The 

Board can imagine what it would like to schedule for next year. He 

noted all options are open and it's a matter of deciding what to ask 


SC&A to do. 


Dr. Hans Behling explained SC&A's difficulty in doing an advanced 


review on an assigned case might be in a situation where there was full 


dosimetry data on a claimant. An advanced review would call for 


verification of coworker data, a last resort when there is an absence 


of primary data. What would be the point in such a case? Another 


situation would be a min/max case where only the most simplistic 


reconstruction was done because it was enough to go over 50 percent. 


What would be accomplished by pursuing a case where even partial dose 


reconstruction put the claimant over 50 percent? 


Dr. Melius suggested that it simply be reported as such if a particular 


element is not appropriate for a case. It's what SC&A bid on doing and 


what they're expected to do. 


Ms. Munn remarked if there is a case where it is appropriate for SC&A 


to search other records, the Board hasn't identified it for them yet. 


If that is going to be incorporated into the Board's view of an 


advanced audit, it probably needs to be done now. 


Dr. Anderson suggested the Board might want a checklist so that SC&A 


can say it wasn't appropriate in a particular case to look for coworker 


data or whatever the case may be. He added that if SC&A is saying the 


Board received more than what was called for in a basic review, what is 


that extra thing that would not be included? 


Mr. Griffon proposed that one answer to Dr. Behling's dilemma in 


pursuing coworker data might be to look at, for example, people the 


claimant mentioned working with to see if they had exposures much 


higher or lower than the claimant, or if they were monitored for 


something different, or any number of other things. 


Dr. Wade read the language from the original task, and commented the 


question was whether the Board agreed with it or if they wanted 


something else. 


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NIOSH/CDC Advisory Board on Radiation and Worker Health


Dr. Ziemer added that if Mr. Griffon's suggestion were followed, it 


would be hoped it would confirm everything to be in order. But if not 


and some pattern or discrepancies were found, SC&A might come back and 


say the dose reconstructors need to add something to the process. 


Dr. Melius discussed a proposal that would allow the reviews to 


continue, but still provide an opportunity for further evaluation and 


perhaps better decisions. He suggested the more complicated cases 


being reviewed in this round may raise new issues. 


Dr. Ziemer acknowledged Dr. Melius had probably intended his proposal 


as a motion, but suggested he refine the wording and provide it in 


written form for a vote the following day. A motion clarifying scope 


will enable the contractor to come back with a refined or revised cost 


estimate, if necessary. 


Mr. Gibson remarked that, regardless of how the Board defined the 


scope, there is nothing basic about reviewing dose reconstructions and 


trying to dig into all the information. 


Dr. Melius offered they should also thank SC&A for being so specific in 


laying out their scope this time; it had been helpful to the process. 


Dr. Wade reminded the Board that it had set a goal of two-and-a-half 


percent of dose reconstructions to be reviewed, and at some point the 


members should step back and evaluate what they're likely to do on 


that. 


Speaking on behalf of SC&A, Dr. Mauro noted they were in the midst of 


completion of the last 22 cases assigned for review, which were being 


done as comprehensive reviews. He noted they're in a position where 


they have in mind what will be delivered. But there may be some cases 


that the two items identified in their proposal might add more value, 


they might gain more out of their understanding of the strengths or 


limitations of a given dose reconstruction. Dr. Mauro called for Board 


guidance on whether SC&A should look at this last set more 


aggressively, that they exceed what they had been doing in the previous 


reviews. 


Dr. Ziemer commented that the instruction on the last set is that they 


are advanced reviews. He suggested SC&A might think about what it 


means to go into depth on something that appears to be straightforward. 


Mr. Griffon added that if SC&A feels strongly there's nowhere to take a 


certain case, that's all that can be done, just put not applicable. 


But the scope has to be considered; even if it looks simple, there may 


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NIOSH/CDC Advisory Board on Radiation and Worker Health


be something there. 


Explaining the Board's position, Dr. Ziemer remarked they are not 


judging whether or not SC&A can do an advanced review. He cautioned 


SC&A should not decide that if a thing looks simple, it's not subject 


to an advanced review. The idea is that SC&A should at least think 


about whether there are other things that should be looked at to 


confirm the data is correct -- or whatever the issue might be. 


Dr. Behling explained a question he had raised earlier with Dr. Wade as 


to what privileges SC&A is given. He noted there are certain issues 


that have not been addressed yet, such as who he was entitled to 


contact. 


Noting that it may have to be done on a case-by-case basis, Dr. Ziemer
 

inquired what the procedure would be if the contractor says it has to 


access certain information to complete the case in an advanced review. 


Dr. Wade agreed, commenting he had suggested Dr. Behling approach him 


with the particular issues and they would be handled on a case-by-case 


basis. 


Task VI, Project Management
 

Dr. Ziemer announced that an issue that emerged from the scope 


discussions was a matter of SC&A being asked to meet with various 


Congressional staffers to review the contractor's work product. SC&A 


has been instructed to proceed and make such briefings when asked. In 


some cases permission for Board presence has also been requested. At a 


minimum, SC&A has been asked to keep a record of such visits and the 


items discussed so that the Board has it on record. 


In the scope of the work product budget for this year those visits have 


been budgeted, so if Congress funds that, they will in fact be covering 


the cost of doing that. Nonetheless, it is not a big part of the 


budget. 


A related issue, however, is the ground rules under which the 


contractor makes those visits. Some members of the Board have 


expressed concern that a Board member should be present. Those on the 


Hill don't always want Board members present, preferring a candid 


discussion with the contractor. Dr. Ziemer indicated he was seeking a 


sense of what the Board feels should be the ground rules, keeping in 


mind that in the end the people on the Hill will have the final say. 


While Ms. Munn had drafted a written motion, Dr. Wade requested an 


opportunity to speak before the discussion begins. He commented that 


NIOSH very much respects the Board and looks for its advice, but is not 


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NIOSH/CDC Advisory Board on Radiation and Worker Health


prepared to create the impression it surrendered its right to make the 


decision on Hill visits by a government contractor. NIOSH will make 


the final decision, guided by the Board's information. Noting that to 


this point it had been his agency's position that the Hill would have 


unfettered access to SC&A, Dr. Wade indicated he assumed that would 


remain the position. 


Ms. Munn remarked the concern was not interaction with elected 


officials, nor the press, the public or other organizations. The 


concern is that the material being discussed might still be incomplete. 


She explained this had been the situation recently when the contractor 


was asked to provide a briefing on documentation that had not been 


through the vetting process of either NIOSH or the Board. That request 


had been coupled with a request that no member of the Board be present, 


raising a reasonable concern that misunderstanding and misinformation 


could derive from a draft document no one had seen. 


Acknowledging it could be anticipated that any elected official would 


be interested in staying abreast of what was transpiring with anything 


that affected their district, Ms. Munn indicated those were the 


thoughts in mind when the statement of policy was drafted. She 


reiterated the concern is that information provided not be partial or 


incomplete is the sense and spirit in which the statement of policy is 


written. 


Dr. Ziemer commented that in a majority of cases the requests are going 


to involve documents not yet finalized. He indicated his belief that 


SC&A had done a good job in making it clear that these are draft 


documents. In many cases the Board has not seen them yet so they don't 


represent the position of the Board. The other part, however, is that 


a Board member cannot speak for the Board. While a member may be 


present and hear what transpires, that member is not in a position to 


contradict, deny or agree on behalf of the Board. Dr. Ziemer suggested 


that should be kept in mind during this discussion. 


Noting that time was running short, Dr. Ziemer acknowledged the 


statement of policy comes as a motion and called for a second in order 


to get it on the floor in today's session. Having been duly seconded, 


Dr. Ziemer inquired if copies were available for the public. In the 


absence of copies, Dr. Ziemer read the formal motion into the record: 


(Reading) As an appointed body mandated by the Energy Employees 


Occupational Illness Compensation Program Act, EEOICPA, the Advisory 


Board on Radiation and Worker Health (the Board) works with multiple 


Federal agencies to fulfill the requirements laid down by the statute. 


The business of the Board is conducted with full transparency under 


the Federal Sunshine laws requiring open disclosure and public access 


to information. The Board routinely deals with matters that are 


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NIOSH/CDC Advisory Board on Radiation and Worker Health


complex, variable, frequently technical, and highly emotional. 


It is necessary that the Board contract for several technical or 


administrative services in order to completely address discrete issues 


within the Board's responsibilities. The resulting documents require 


extensive review, technical discussion and revision before the product 


can be released as properly vented (sic) and then authorized for 


distribution. Although draft documents are often widely distributed, 


they cannot be viewed as material yet ready for presentation or 


comment. 


Because of the incomplete and potentially misleading nature of 


information contained in draft documents, it is the policy of the 


Board to provide briefings, interviews or other informational 


exchanges from Board members, our subcontractor, affiliates and 


associates only when the final document has been accepted by the 


Board. It is our further policy that at least one member of the Board 


be present or in telephone contact at the time such a discussion takes 


place. 


Adopted this 26th day of August, 2005; St. Louis, Missouri. 


Dr. Ziemer suggested action be deferred until the following day. 


Dr. Melius remarked the Board had dealt with this issue in a slightly 


different form at the time of the Bethlehem Steel site profile. Dr. 


Ziemer noted the Board had taken specific action that future reports 


would not be withheld, with a suitable disclaimer first proposed by the 


late Dr. Antonio Andrade. 


Dr. Melius expressed his opposition to the motion, noting the 


contractor's relationship and credibility with Congressional staffers 


is of benefit to the program. He commented there was a lot to lose by 


trying to prohibit or limit this activity in some way. He reminded the 


Board that, given their record in getting some documents from draft to 


final stage, some meetings could be delayed years. 


Citing 36 years' experience in dealing with the Federal government, Mr. 


Presley agreed SC&A had done a wonderful job, but disagreed that their 


participation on the Hill was needed. He expressed a belief that any 


time there is a call for Board work on the Hill, the Board should ask 


to be allowed to participate. 


Dr. Anderson objected to the use of the term "all draft documents". 


That just forces a technical issue that once something has been adopted 


by the Board, it's too late for the public to comment on it. He 


clarified that he wouldn't want SC&A to share a document that was still 


their internal draft, but he didn't think they were doing that. 


Agreeing with Dr. Melius, Mr. Owens remarked the credibility of the 


Board is always on the line. He acknowledged all the Board members 


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NIOSH/CDC Advisory Board on Radiation and Worker Health


realize they serve at the pleasure of the President, and that this is a 


political process. Describing adoption of this language as a tragic 


move, Mr. Owens suggested it would send an incorrect message to 


Congress and a bad message to those who watch the workings of the 


Board. 


Dr. Melius commented there is a process in place that allows the Board 


to be informed about the Congressional visits, and he would have no 


objection to a policy that provides the Board may request permission to 


participate in the visit. But the Board's policy shouldn't be that 


they "will" attend because it is still the prerogative of the 


Congressional office who they want to invite into those offices. He 


suggested a process where the Board would be notified about the visits, 


members who want to participate can communicate that to appropriate 


staff setting up the meeting, then it's up to them to decide if they 


want that participation. 


Dr. Ziemer observed that a policy offering the opportunity for a Board 


member to be present would meet NIOSH's needs in that it wasn't a 


requirement but an offer, and it would allow the Hill the prerogative 


not to make the offer. The action on the motion was postponed until 

tomorrow. 

* * * * * 

The Chair declared a recess until 7:00 p.m. when public comment would 


be taken. He requested that any members of the public who wished to 


speak but had not yet signed up, do so at once. 


* * * * *
 

Public Comment Period
 

The following is a list of members of the public who spoke. A full 


transcript of their comments is available on the OCAS web site, 


www.cdc.gov/niosh/ocas. 


Mr. John Ransport, General Steel Industries; Ms. Christine Ransport; 


Dr. Dan McKeel; Ms. Denise Brock, Mallinckrodt Special Exposure Cohort 


petitioner; Ms. Louise McKeel; Father Jim Mitulski, survivor; Mr. 


Richard Miller, Government Accountability Project. 


* * * * *
 

Friday, August 26, 2005
 

The second day of the 32nd meeting of the Advisory Board on Radiation 


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Executive Summary/Minutes August 25-26, 2005 
 

NIOSH/CDC Advisory Board on Radiation and Worker Health


and Worker Health was called to order by Dr. Paul Ziemer, Chairman. He 


reminded everyone to register their attendance in the book provided. 


Dr. Ziemer extended the Board's welcome to Ms. Judith Dungan, who was 


in attendance as Senator Kit Bond's representative. 


Dr. Lew Wade, Designated Federal Official, spoke briefly to remind the 


Board they will be addressing the Mallinckrodt Special Exposure Cohort 


petition today. He observed there will always be tension between the 


passage of time, the need for timeliness and the need to be complete in 


their scientific deliberations, a tension the Board will face in 


everything it does. Speaking from his perspective as DFO, Dr. Wade
 

commented that he felt the Board should review the material today and 


move to making a decision. While the process has added value, it has 


been difficult for petitioners and claimants. 


* * * * *
 

Special Exposure Cohort Petition 


Mallinckrodt Chemical Works
 

Mr. Stu Hinnefeld, 


NIOSH/OCAS
 

Speaking on behalf of NIOSH, Mr. Hinnefeld indicated that his comments 


would be brief. Any presentations he would have made had already been 


made, and so he had not prepared a slide show. 


He observed that a lot of people had worked very hard to get the best 


science available regarding the questions raised. He added that's what 


NIOSH expected to do, and what should be expected of them. 


Mr. Hinnefeld expressed recognition of the difficulty of engaging in a 


site profile review at the same time as an SEC petition evaluation for 


that site. He proposed that NIOSH and the Board work together for a 


set of procedures to ensure a similar situation doesn't arise on other 


petitions at other times. 


Ms. Denise Brock, 


Petitioner
 

Ms. Brock cited the FY '05 Labor/HHS Appropriations Act and the Energy 


Employee's Compensation Act of 2000 as providing mechanisms for which 


timely, uniform and adequate compensation should be provided for 


employees made ill from radionuclide exposure. 


Thanking Senator Town, Congressman Akin and their staffs for their 


29
 
Executive Summary/Minutes August 25-26, 2005 
 

NIOSH/CDC Advisory Board on Radiation and Worker Health


continued support, Ms. Brock also welcomed and thanked Ms. Dungan for 


her presence, and passed along Senator Bond's comment that the former 


Mallinckrodt workers are part of an endless bureaucratic process. 


Ms. Brock provided a chronology of events from past meetings regarding 


the Mallinckrodt facility. She reviewed the feasibility issue with 


respect to technical, cost, and time constraints. Remarking that NIOSH 


has far exceeded the time contemplated by Congress for SEC petition 


processing, Ms. Brock noted it has taken 13 months to assess this 


petition filed in July of 2004. 


Ms. Brock concluded her comments by asking the Board to approve the SEC 


petition for the Mallinckrodt workers from 1949 to 1957. 


* * *
 

Opining that NIOSH lacked adequate data or information to accurately 


reconstruct doses based on his interpretation of 42 CFR 83, Dr. Dan 


McKeel offered the following reasons: 


#There are 107 Mallinckrodt EEOICPA claims from the 1949 to 1957 time 

period awaiting dose reconstruction, providing evidence that dose 


reconstructions cannot be performed in a timely manner. 


#The CER database is limited and biased. 

#The 20 percent sample of radon breath data NIOSH proposes to use is 


too small a sample and thus fails to meet the 42 CFR 83 test. 


#SC&A and NIOSH have significant differences with respect to the six 


priority Mallinckrodt issues. 


Dr. McKeel concluded by stating the Board should recommend SEC status 


for the 1949 to 1957 class of Mallinckrodt uranium division workers. 


* * * * *
 

Dr. Arjun Makhijani from SC&A spoke briefly on a correction to be made 


in the Mallinckrodt site profile review report with respect to 


calculated values for the AM-7 area air concentrations. He explained 


he and Dr. Neton had discussed a misunderstanding of a statement in the 


site profile and the issue had been clarified. Dr. Makhijani indicated 


a corrected replacement page to the report will be provided. 


* * * * *


 Board Discussion
 

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Executive Summary/Minutes August 25-26, 2005 
 

NIOSH/CDC Advisory Board on Radiation and Worker Health


Dr. Ziemer explained the options available to the Board relative to 


proceeding with the petition. 


A motion was made and seconded that the Board recommend a Special 


Exposure Cohort be accorded to all Department of Energy 


employees, contractor or subcontractor employees who worked 


at the uranium division of the Mallinckrodt facility from 


1949 to 1957 and whom were employed for a number of work days 


aggregating to at least 250 work days. 


This motion was read by Dr. Melius: The Board respectfully recommends 


a Special Exposure Cohort be accorded to all Department of 


Energy employees or its contractor or subcontractor employees 


who worked at the Uranium Division of the Mallinckrodt 


Destrehan facility from 1949 to 1957 and whom were employed for 


a number of work days aggregating at least 250 work days 


occurring under this employment, in combination with work days 


of employment occurring within the parameters (excluding 


aggregate work day requirements) established for other classes 


of employees included in the SEC. 


The floor was opened for discussion on the motion. Dr. Roessler 


commented on defining what is meant by adequate information to do 


sufficient dose reconstruction, and also to be uniform in decisions for 


the purpose of equity. 


Dr. Melius declared the Board needed to deal with the Mallinckrodt SEC 


petition today. To address those equity issues, however, Dr. Melius
 

suggested procedures and criteria should be developed for evaluating 


future SEC petitions. 


Ms. Munn observed NIOSH has shown that dose reconstructions can be done 


on this group of workers in the petition. Mr. Griffon argued that 


critical elements are missing for calculating accurate dose 


reconstructions. 


Following extensive Board discussion, Dr. Ziemer put the motion to a 


vote. The motion carried. 


Dr. Ziemer emphasized to the audience that the Board's recommendation 


to the Secretary, following the regular procedure of a letter to be 


generated for that purpose, will be to support the petitioners. This 


recommendation will accompany the NIOSH recommendation to the 


Secretary. The NIOSH recommendation is that dose reconstructions be 


done. The Secretary of Health and Human Services will take both 


recommendations into consideration as he makes his decision. Dr. 


Ziemer stressed it is the Secretary who makes the decision, not the 


Board. The Board simply makes a recommendation. 


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Executive Summary/Minutes August 25-26, 2005 
 

NIOSH/CDC Advisory Board on Radiation and Worker Health


* * * * *
 

Board Working Session
 

Conflict of Interest Disclosure Statements
 

Ms. Liz Homoki-Titus, 


Office of General Counsel
 

Ms. Homoki-Titus reminded the Board that at their last meeting members 


had expressed an interest in having their conflict of interest 


statements posted on the OCAS web site. Ms. Homoki-Titus explained 


that she had reported that interest to her office where it had been 


discussed. However, it is not HHS policy to allow such information to 


be posted. The compromise is to request a formal motion from the Board 


and approval by consensus in order to make such posting. 


Updated information for all the Board members was provided, formatted 


to include name, position, biographical information, the waiver 


statement, year issued and recusal sites. Ms. Homoki-Titus invited 


Board members to review their individual statements and report any 


changes needed to Dr. Wade, who will relay them to the Office of 


General Counsel. 


A motion was made and seconded expressing the Board's desire to 


allow individual conflict of interest disclosure statements 


for each member to be posted on the OCAS web site. The 


motion passed unanimously with minimal discussion.
 

* * * * *
 

Capitol Hill Policy
 

Dr. Ziemer referred the Board to a written motion, already on the floor 


and preliminarily discussed in yesterday's meeting. The floor was 


opened for additional discussion of the motion. 


Following a discussion regarding procedural issues, Dr. Melius read a 


motion he would propose, should the current motion fail. It was as 


follows: 


Recognizing that the credibility of the EEOICPA program and the 


work of this Advisory Board can be enhanced by communicating 


these efforts to Congressional staff, it is the policy of the 


Board to encourage such meetings when they are requested. 


The scheduling of such meetings should be communicated to all 


Board members. Board members who wish to participate in the 


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Executive Summary/Minutes August 25-26, 2005 
 

NIOSH/CDC Advisory Board on Radiation and Worker Health


meeting should inform the Board Chair and contractor, who 


will then communicate with the Congressional staff to 


determine whether the staff would like to also invite the 


Board member or members to attend the meeting. 


The Board also understands that our contractor must notify NIOSH 


about these official visits and should ensure that their 


staff takes appropriate precautions to properly characterize 


the status of the information being communicated. Further, 


Board members participating in such meetings will 


appropriately communicate any potential conflict of interest 


issues to the Congressional staff. 


Dr. Ziemer explained the issue could be handled by a motion to 


substitute what he called "the Melius motion" for "the Munn motion," at 


which time the motion on the floor for discussion would be the Melius 


motion. 


A motion was made and seconded that the Melius motion be 


substituted for the Munn motion. The motion carried.
 

Questions raised and issues discussed included the following: 


#Congressional inquiry should be made to the Board rather than to the 

Board's employee, their contractor. 

#The ultimate decision on how to handle Hill visits would be made by 

NIOSH, guided by the Board's policy. 

#Who would pay for travel expenses of any Board members attending such 

meetings. 

#Visits were not opportunities to espouse personal opinions. 

#Board members might attend in a different capacity than Board member, 

such as site expert. 

#It would have to be made clear that member was not representing the 

Board. 

The 	Chair put the motion to a vote and, with grammatical 


corrections, it carried unanimously. 


Dr. Wade reiterated that NIOSH accepts the motion and its intent and 


will make every effort to follow it. However, the contracting officer 


and the Secretary reserve the right to manage a government contractor, 


SC&A, as they see fit regarding Hill visits. 


* * * * *
 

Approval of Minutes
 

33
 
Executive Summary/Minutes August 25-26, 2005 
 

NIOSH/CDC Advisory Board on Radiation and Worker Health


Two sets of minutes were before the Board for approval, one being the 


minutes for the Subcommittee meeting on April 25, 2005; the other being 


the minutes for the meeting of the full Board on April 25, 26 and 27, 


2005, in Cedar Rapids, Iowa. 


A motion was made and seconded that the minutes of the 


Subcommittee meeting held April 25, 2005 in Cedar Rapids, 


Iowa be approved. The motion passed unanimously. 


A motion was made and seconded that the minutes of the Thirtieth 


meeting of the Advisory Board on Radiation and Worker Health, 


held April 25, 26 and 27, 2005 in Cedar Rapids, Iowa, be 


approved. The motion passed unanimously. 


* * * * *
 

Site Profile Prioritization
 

Opened for discussion was the issue of how to prioritize the six sites 


designated in yesterday's meeting as priorities for future site profile 


reviews. Dr. Wade confirmed those sites were Fernald, Los Alamos 


National Laboratory, Mound, X-10 at Oak Ridge, Pinellas, and Linde 


Ceramics, with Argonne West and Lawrence Livermore as alternative 


sites. 


Discussion centered around whether any of the sites had SEC petitions 


under NIOSH evaluation; pending site closings at Fernald, Mound, 


Pinellas and Linde Ceramics; numbers of claimants from various sites; 


and potential issues relative to classified data. 


A motion was made, seconded and amended that SC&A and NIOSH will 


review the issues surrounding the designated sites and 


present a proposed order of priority at the October Board 


meeting. The motion carried.
 

* * * * *
 

Other Board Items
 

The question had been raised by Mallinckrodt petitioners as to what the 


Department of Labor's position would be on non-covered cancers should 


the SEC petition be approved. Dr. Wade reported he had spoken with a 


representative from DOL in an effort to find an answer. It was now his 


understanding DOL would reserve judgment on non-covered cancers pending 


the Secretary's determination. He added that the Secretary's 


determination could be affected by the Board's recommendation. 


34
 
Executive Summary/Minutes August 25-26, 2005 
 

NIOSH/CDC Advisory Board on Radiation and Worker Health


* * *
 

A motion was made and seconded that the scope of work regarding 


the contractor's Task IV, individual dose reconstructions, 


include the following: 


No. 1, 40 basic and 20 advanced dose reconstruction reviews; 


No. 2, blind dose reconstruction reviews for two cases; 


No. 3, prepare and deliver a report for each set of Board-assigned 


cases that will contain (1) findings associated with 


individual case audits and (2) a summary of all case findings 


prepared in accordance with a format acceptable to the Board; 


No. 4, participate in extended review cycle, which includes 


working with NIOSH and the Board in resolving audit findings, 


and assist the Board in preparing an issues-tracking matrix 


which will be forwarded by the Board to the Secretary of HHS, 


and prepare a final audit report that reflects the results of 


the findings resolution process. 


The motion passed unanimously without discussion.
 

* * *
 

NIOSH Handling of Cases 


Lacking Sufficient Information 


to Complete a Dose Reconstruction
 

Mr. Hinnefeld announced he anticipated this issue would be on the 


agenda for the October meeting, but he wanted to speak to it very 


briefly and provide some background. He noted these are not cases for 


which an SEC petition has been received. 


Explaining that at the inception of the program NIOSH had built the 


tools and procedures for doing dose reconstruction, Mr. Hinnefeld
 

acknowledged that by the time those were ready to be used, a large 


backlog of cases had developed. First priority became getting the 


cases that could be done more quickly out of the way. The more 


difficult cases got older and remained undone. 


NIOSH has focused its efforts this year on clearing out those cases. 


As part of that process, they are reaching determinations that there 


are some cases where there is not enough information to do a dose 


reconstruction. And furthermore, Mr. Hinnefeld added, there doesn't 


35
 
Executive Summary/Minutes August 25-26, 2005 
 

NIOSH/CDC Advisory Board on Radiation and Worker Health


seem to be any likelihood the information will be discovered. 


The dose reconstruction regulation contained in 42 CFR Part 82 


describes the steps to be taken when NIOSH reaches that conclusion. 


Mr. Hinnefeld explained the process included notification of the 


claimant in writing that such was the case. With that notification is 


a short-form SEC petition form. This is then followed by a closeout 


phone call in which the process is explained to the claimant. That 


includes a conversation about the SEC petition form and a request that 


they sign it and send it back. Notification is sent to DOL and DOE 


that the dose cannot be reconstructed, and DOL issues a regulatory 


denial. NIOSH is at the point now where these "test cases" are being 


identified. 


While these petitions will be filed on behalf of the petitioner 


himself, the NIOSH evaluation will define the class in terms of all 


those cases that have similar characteristics. An example cited by Mr. 


Hinnefeld was a period of time at a particular site. NIOSH anticipates 


this will be a very streamlined process, but it will be presented then 


to the Board with a recommendation to the Board and the Secretary that 


the class be added because they have not located sufficient information 


to do dose reconstructions. 


Mr. Hinnefeld indicated they hoped the Board would see this in October, 


but because a portion of the process is outside NIOSH's control, they 


can't be certain. The claimants have to choose to participate by 


signing the form and returning it. While NIOSH hopes to make a 


presentation in October, Mr. Hinnefeld wanted the Board to be aware of 


what they could expect to see very shortly. 


Dr. Ziemer inquired if that meant a large number of petitions involving 


small numbers of individuals, or if there may be a methodology for 


combining groups, even from multiple facilities. 


Mr. Hinnefeld indicated that initially they are looking at one-site 


class descriptions. Ms. Homoki-Titus added that they will be addressed 


administratively as a group, citing one Federal Register notice for a 


group of sites coming to the Board. 


Mr. Owens inquired into the demographics of the relevant claimants, 


expressing a concern for elderly survivors who don't clearly understand 


the process under the best of circumstances. 


Mr. Hinnefeld explained NIOSH was selecting a test case for a 


particular site, making every effort to choose a claimant who was able 


to deal well with the process, and was in fact doing the closeout 


interview before the letter to be sure the claimant understood what was 


36
 
 

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Executive Summary/Minutes August 25-26, 2005 
 

NIOSH/CDC Advisory Board on Radiation and Worker Health


happening. If not, they would select another test case. In any event, 


once the test case was selected, that petition would bring along all 


the claimants who fit the class. Only that one test case would have to 


fill out a form and submit a petition. 


Dr. Ziemer observed that seemed to suggest NIOSH was going to do 


everything possible to shepherd them through the process, to which Mr. 


Hinnefeld agreed. 


In response to a query on potential sites, Mr. Hinnefeld declined, 


remarking that if things didn't proceed as NIOSH expected, they 


wouldn't want to raise expectations by discussing it prematurely. 


Mr. Hinnefeld was unable to attach numbers to affected cases, noting 


this is in the early stages. But most of the research is done before 


the claimants are contacted, and the regulation intends this to be a 


streamlined approach for adding classes to the SEC. 


* * * * *
 

With no further business to come before the Board, the meeting was 


adjourned.
 

Ë Ë Ë Ë Ë 

I hereby confirm these Summary Minutes are 


accurate, to the best of my knowledge. 


Paul L. Ziemer, Ph.D., Chair 


Date 


37