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 


WORKING GROUP MEETING 


ADVISORY BOARD ON 


RADIATION AND WORKER HEALTH 


SEC ISSUES
 

The verbatim transcript of the Working Group 


Meeting of the Advisory Board on Radiation and 


Worker Health held at the Holiday Inn Airport, 


Erlanger, Kentucky, on November 17, 2006. 

 

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C O N T E N T S 

November 17, 2006 

WELCOME AND OPENING COMMENTS 

DR. LEW WADE, DFO 

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“PARSING HEALTH ENDANGERMENT CRITERIA” 12 

“HEALTH ENDANGER ASSESSMENT FOR NEVADA TEST SITE 

SPECIAL EXPOSURE COHORT” 124 

COURT REPORTER’S CERTIFICATE 187 
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TRANSCRIPT LEGEND
 

The following transcript contains quoted material. Such 


material is reproduced as read or spoken. 


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


an unintentional or purposeful interruption of a 


sentence. An ellipsis (. . .) indicates halting speech 


or an unfinished sentence in dialogue or omission(s) of 


word(s) when reading written material. 


-- (sic) denotes an incorrect usage or pronunciation 


of a word which is transcribed in its original form as 


reported. 


-- (phonetically) indicates a phonetic spelling of 


the word if no confirmation of the correct spelling is 


available. 


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


"uh-uh" represents a negative response. 


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


without reference available. 


-- (inaudible)/ (unintelligible) signifies speaker 


failure, usually failure to use a microphone. 

 

 

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


(By Group, in Alphabetical Order) 


BOARD MEMBERS
 

CHAIR
 

ZIEMER, Paul L., Ph.D. 


Professor Emeritus 


School of Health Sciences 


Purdue University 


Lafayette, Indiana 


EXECUTIVE SECRETARY
 

WADE, Lewis, Ph.D. 


Senior Science Advisor 


National Institute for Occupational Safety and Health 


Centers for Disease Control and Prevention 


Washington, DC 


MEMBERSHIP
 

GRIFFON, Mark A. 


President 


Creative Pollution Solutions, Inc. 


Salem, New Hampshire 


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


Director 


New York State Laborers' Health and Safety Trust Fund 


Albany, New York 


MUNN, Wanda I. 


Senior Nuclear Engineer (Retired) 


Richland, Washington 


PRESLEY, Robert W. 


Special Projects Engineer 


BWXT Y12 National Security Complex 


Clinton, Tennessee 

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ROESSLER, Genevieve S., Ph.D. 


Professor Emeritus 


University of Florida 


Elysian, Minnesota 

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ANNOUNCED PARTICIPANTS
 

BARRIE, TERRIE, ANWAG 


BEHLING, HANS, SC&A 


ELLIOTT, LARRY, NIOSH 


HOMOKI-TITUS, LIZ, HHS 


HOWELL, EMILY, HHS 


KATZ, TED, NIOSH 


KOTSCH, JEFF, DOL 


MAKHIJANI, ARJUN, SC&A 


MAURO, JOHN, SC&A 


MCFEE, MATT, ORAUT 


NETON, JIM, NIOSH 


ROBERTSON-DEMERS, KATHY, SC&A 


RUTHERFORD, LAVON, NIOSH 

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P R O C E E D I N G S
 

(8:00 a.m.) 


WELCOME AND OPENING COMMENTS
 

DR. LEW WADE, DFO
 

DR. WADE: Okay. Good morning, all. This is Lew 


Wade, and I have the privilege of serving as 


the Designated Federal Official for the 


Advisory Board, and I welcome you to a meeting 


of the working group on SEC issues. That group 


is ably chaired by Dr. Melius. Members include 


Dr. Ziemer, Gen Roessler and Mark Griffon. 


Drs. Melius and Ziemer and Gen Roessler are 


here in the room. Mark, are you on the phone ­

- Mark Griffon? 


 (No response) 


I think Mark intends to join us, so we'll ask 


Mark when he gets on line to mention that. 


 Again what I'll do is we'll go around the table 


here and identify individuals, and then we'll 


go out onto the telephone and identify 


individuals. I'll start by asking, are there 


any Board members on the call at this point? 


Any Board members? 


 (No response) 

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Okay. This is Lew Wade, I work with NIOSH and 


serve the Advisory Board. 


 MS. HOWELL: Emily Howell with HHS. 


 DR. BEHLING: Hans Behling, SC&A. 


DR. NETON: Jim Neton with NIOSH. 


 DR. MAKHIJANI: Arjun Makhijani, SC&A. 


 DR. MELIUS: Jim Melius, the Advisory Board. 


DR. ROESSLER: Gen Roessler, Advisory Board. 


 DR. ZIEMER: Paul Ziemer, Advisory Board. 


 DR. WADE: Now let's go out to the telephone 


and I'll ask any members of the NIOSH or ORAU 


team to identify themselves. 


 MR. RUTHERFORD: LaVon Rutherford, NIOSH. 


 DR. WADE: Good morning, LaVon. 


 MS. ROBERTSON-DEMERS: This is Kathy Robertson-


Demers, SC&A. 


 DR. WADE: Thank you, Kathy. 


DR. MAURO: John Mauro, SC&A. 


 DR. WADE: Welcome, John. Any other NIOSH, 


ORAU or SC&A people on the line? 


MR. MCFEE: Matt McFee with the ORAU team. 


 DR. WADE: Good morning, Matt. Any -- anyone 

else? 

 (No responses) 

 Any government employees who are on this call 

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by virtue of their employment? 


 MR. (UNINTELLIGIBLE): Steve (Unintelligible), 


CDC. 


 DR. WADE: Morning. 


 MR. KOTSCH: Jeff Kotsch, Department of Labor. 


 DR. WADE: Morning, Jeff. Anyone else? 


 (No responses) 


Is Mark Griffon with us yet? 


 (No response) 


Is there anyone on -- on the telephone who 


would like to be identified, would like to be 


on the record? 


 MS. BARRIE: Terrie Barrie with ANWAG. 


 DR. WADE: Good morning. 


 MS. BARRIE: Morning. 


THE COURT REPORTER: I'm sorry, who was that? 


 DR. WADE: Could you repeat your name and 


affiliation, please? 


 MS. BARRIE: Terrie Barrie with ANWAG. 


 DR. WADE: Thank you. Now I'd like members of 


the NIOSH/ORAU team, and I'll ask members of 


the SC&A team, to identify if they have any 


conflict. This meeting is really going to 


focus on Nevada Test Site and Pacific Proving 


Grounds. So if there are any conflicts in 

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those areas, I'd like members of the NIOSH/ORAU 


team and then SC&A to identify. 


 Are there any NIOSH/ORAU team members on this 


call who are conflicted at NTS or Pacific 


Proving Grounds? 


MR. MCFEE: Matt McFee. I'm corporately 


conflicted through MJW and their work at NTS. 


 DR. WADE: Thank you. Anyone else on the 


NIOSH/ORAU team? 


 (No responses) 


Anyone on the SC&A team conflicted? 


DR. MAURO: John Mauro, no conflict. However, 


as -- as you folks know, there -- we have put 


up a firewall to separate work that SC&A is 


doing on support of the Advisory Board and a 


contract that SC&A is currently performing for 


the Defense Threat Reduction Agency, so we are 


operating under the special firewall. I just 


wanted to inform the working group of that 


situation. 


 DR. WADE: And that firewall is in place and 


functioning, and there's no prohibition on the 


people representing SC&A on this call in 


participating fully. 


I don't think there's anything else that we 

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need to do. I'd ask one more time, is Mark 


Griffon on the phone? 


 (No response) 


THE COURT REPORTER: Dr. Wade, could I get the 


name of the person, Steve somebody, I couldn't 


hear his last name -- on the phone? 


 MS. HOWELL: From CDC. 


 DR. WADE: Steve from CDC, could you identify 


yourself again, please? 


 (No response) 


You might be on mute. 


 (No response) 


You might have decided you were on the wrong 


call and gone away. 


THE COURT REPORTER: He was right before Jeff 


Kotsch. 


 DR. WADE: There was a gentleman, first name 


Steve, with CDC who identified themself. 


 (No response) 


Anyone who identified themself as being an 


employee of CDC? 


 (No response) 


THE COURT REPORTER: Well... 


 DR. WADE: Okay. It wasn't a familiar name to 


me. 

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 DR. MELIUS: Maybe he was on the wrong call. 


 DR. WADE: Could have been the wrong call, but 


we welcome even wrong-callers. 


Okay. Dr. Melius. 


 DR. MAKHIJANI: John, did you get the report? 


DR. MAURO: I'm sorry, I was on mute. Not yet, 


but I'll be fine. Don't worry. I'll get it 


eventually. 


DR. ROESSLER: It didn't come through? It said 


it went out. 


 DR. WADE: Okay, we're all -- the preliminaries 


are done. 


“PARSING HEALTH ENDANGERMENT CRITERIA”


 DR. MELIUS: Okay. This working group is set 


up to review the -- particularly the issue of 


the people that were exposed during Nevada Test 


Site, Pacific Proving Ground for less than 250 


days and hence didn't qualify for the Special 


Exposure Designation for those two sites. In 


order to work in this area, we've had 


discussions and had SC&A do some work, and we 


have two reports from them that we will be 


discussing this morning. The first one is 


called "Parsing Health Endangerment," which I 


think everybody here got earlier in the week -- 

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past couple of days, Arjun sent out. 


The second one is called "Health Endanger 


Assessment for Nevada Test Site Special 


Exposure Cohort," which is a -- sort of a draft 


of a paper that Arjun and -- and others at SC&A 


have been working on and was sent to us last 


night and most of us got it as a hard copy this 


morning for the first time to -- to look at. 


 DR. ZIEMER: Could I ask a question? Was that 


distributed also to the Nevada petitioners? 


For example, did Terrie Barrie get a copy of 


that? 


 DR. MAKHIJANI: No, I -- I did not have their 


e-mails on the distribution list. I guess I 


should have thought of that. 


 DR. ZIEMER: Well, we probably should get a 


copy of that to the petitioners, should we not? 


 DR. WADE: Did you send a copy to Jason Broehm? 


You would not have done that. 


 DR. MAKHIJANI: No, I just sent it to the 


working group and to Larry and Jim, Stu 


Hinnefeld, and I believe to you, Dr. Wade. 


 DR. WADE: Yes, I have it. Okay, let me --


 DR. ZIEMER: Well, Terrie is on the line. We 


can probably get her e-mail address -- 

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DR. ROESSLER: Get her e-mail address and I'll 


send it. 

 DR. ZIEMER: We can send it, Terrie, if that's 

agreeable. 

 MS. BARRIE: Yes, Doctor. 

 DR. WADE: Terrie is willing to put it on the 


line? 


 MS. BARRIE: (Unintelligible) 


 DR. WADE: Terrie, would you be willing to give 


your e-mail address to us so we could send you 


a copy of this? 


 MS. BARRIE: Sure, it's T-as-in-Tom B-as-in-boy 


a-r-r-i-e@yahoo.com. 


DR. ROESSLER: I'll try to send it as an 


attachment. 


 MS. BARRIE: Okay, that would be perfect. 


 DR. ZIEMER: It's 60-some pages -- 67 pages, so 


it's fairly lengthy. 


 DR. WADE: Now does Terrie have the first of 


the two documents, the "Parsing Health 


Endangerment Criteria"? 


 MS. BARRIE: No, I don't. 


 DR. WADE: So, Gen, if we could impose? 


DR. ROESSLER: I'll send them in two separate 


e-mails because they're both rather large. 

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 DR. WADE: Uh-huh. It's on its way, Terrie. 


It might take time because it's big and it's 


cold here. 


 MS. BARRIE: Okay, thank you. 


 DR. MELIUS: I thought how we would proceed 


would -- is to first have Arjun sort of walk us 


through the first paper, the "Parsing Health 


Endangerment Criteria," 'cause it was -- and my 


plan was that -- what I wanted to -- hoped we 


could -- is to have some discussion of sort of 


the general approaches that might be used for 


addressing this issue and how we might make 


decisions, and then move into talking about 


individual sites. But it's not clear that 


we'll have time this morning to deal with 


individual sites. And some extent, how we deal 


with individual sites will depend on how we 


look at criteria and how -- how we approach the 


problem. So I think most of the focus will be 


sort of more in a general sense and seeing what 


we can accomplish there. So I thought that 


Arjun did a good -- very good job of putting 


together sort of a background for how to think 


about that and focus based on -- on the -- on 


the current regulation that NIOSH has for 

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health endangerment. 


So Arjun, if you don't mind -- 


 DR. MAKHIJANI: Sure. 


 DR. MELIUS: -- you want to take over and walk 


us through that? 


 DR. MAKHIJANI: Well, I -- what I did was I 


started with -- with the paragraph in 42 CFR 83 


that -- that deals with health endangerment, or 


two paragraphs, but there's one specifically 


that deals with those who have worked less than 


250 days. And I broke that up into -- the 


reason I called it parsing is I broke that up 


into -- one, two, three, four, five -- five 


bullets, five separate items for analysis. 


And the five items that I looked at in that 


paragraph that might make people that worked 


less than 250 days eligible for inclusion in 


the Special Exposure Cohort were that they 


would have exposure to radiation during 


discrete incidents. 


The other one was they were likely to have 


involved exceptionally high exposures, such as 


nuclear criticality incidents or other events 


involving similarly high levels of exposures. 


Then there was a question of that the exposures 

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would result from the failure of radiation 


protection controls. 


And the rule also says that any duration of 


unprotected exposure could cause a specified 


cancer. 


And then the criterion for whether an 


individual should be included was not a dose 


criterion 'cause you're already past that stage 


where NIOSH has said they cannot calculate a 


dose, and health endangerment is the second 


step to that, was presence during the incidents 


where the potential exposures could have 


happened. 


So the accent is not on exposures, but on 


potential exposures, and I tried to indicate 


that throughout by -- by italicizing potential 


exposures --


 DR. ZIEMER: Can I ask a question here? 


 DR. MAKHIJANI: Yeah. 


 DR. ZIEMER: When you're separating this out -- 


for example, the fourth bullet, "any duration" 


-- but are -- you're not suggesting, are you, 


that that be taken by itself? It's linked in 


the regulation to the discrete event part, so ­

-

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 DR. MAKHIJANI: Yes, it is. Yeah, yeah. 


 DR. ZIEMER: -- so when we talk about these we 


-- we need -- yeah, we can't talk about them 


exclusively of the other. I just want to make 


sure that. 


 DR. MAKHIJANI: You have to put Humpty Dumpty 


back together in that kind of -- 


 DR. ZIEMER: Taken by itself, the statement 


"any duration of unprotected exposure" is very 


different than any duration in a -- in a 


discrete event. 


 DR. MAKHIJANI: Right. Right. I think -- I 


think you have to -- you have to take them 


together. The "any duration" -- well -- 


 DR. ZIEMER: But we'll get a chance -- we'll 


get a chance to discuss --


 DR. MAKHIJANI: -- Jim might elaborate on that 


more, but I think any duration within the 


context of the exposure. 


 DR. ZIEMER: Yeah. Yeah, obviously. 


 DR. MAKHIJANI: If there's no exposure, then 


there's no eligibility. 


So the first thing I tried to do was to 


interpret the term "exposures," and -- and so I 


tried to separate the question of exposure from 

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probability of causation, because once you pass 


the stage of not being able to calculate dose, 


then you're past the stage of talking about 


probability of causation. So mainly what I did 


in that section was to argue that what we're 


talking about is potential for exposure, and 


then that would be linked to the other clauses, 


potential for exceptionally high exposures such 


as during criticality accidents. But so far as 


individuals are concerned, you're talking about 


whether they -- they had a potential to be 


exposed to those kinds of incidents or not. 


And I suggested that the 250-day problem -- 


exposure potential might be considered in two 


categories: Exposure potential that arises 


from facilities where sources -- sources are 


present during the entire work day and 


throughout the year without incidents. So 


here, if -- if there are no incidents, then 


presumably you would not fall within the rule. 


You're just in a uniform radiation working 


environment where there might be a source, and 


your working there is a normal part of your 


employment. And then there's a question of 


exposure potential that arises from incidents, 

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and what I suggested is that health 


endangerment within the context of the rule is 


really only in that second context, within the 


context of incidents. 


We -- I think we had handed out previously a 


paper by Mike Thorne which drew on a Los Alamos 


summary of criticality accidents throughout the 


world. That paper is appended in full, but I 


had Bob Barton in the SC&A office reorganize 


all that information into tables that would be 


more directly applicable to the way the rule is 


written, and those tables are shown in Table 2, 


U.S. criticality accidents and Russian 


criticality accidents and accidents in other 


countries. 


I did this to be able to get a sense of what is 


the range of doses. You know, what does it 


mean, exceptionally high exposures such as 


those during criticality accidents? It turned 


out that this actually, in my opinion -- in our 


opinion -- we discussed this in SC&A quite a 


bit. It didn't seem as useful as it might be 


at first sight. You think criticality 


accidents always had very high exposures, but 


they don't. They might be exposures from less 

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than a rem to 10,000 rem, so you've got 


exposures all over the map. So then you're 


left with a significant problem of how to 


define exceptionally high exposures, since 


that's the only example that's given in the 


rule and everything else is similar to 


criticality exposures. And I think I made a 


table -- Table 1 on page 4 is a very brief 


summary. It talks about the duration of the 


incident. 


Now the duration of the accident itself is 


usually longer than the duration of the 


exposure, because workers would usually 


evacuate. And so the -- the ranges of doses in 


U.S., Soviet and incidents in other countries ­

- again you can see it's -- it's -- typically 


the ranges have been similar, independent of 


geographic location or whether it's here or in 


some other -- other nuclear establishment. And 


the duration of the accidents are from very 


brief to over 30 hours, so nearly a -- a 


working week. 


So that gives some idea of the range. Now --


so you're left with the problem of then 


discovering what high exposure might mean, and 

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then exceptionally high exposure. And so I 


argued that you eliminate less than one rem or 


less than a few rem as high exposures, because 


the ICRP standards for workers are two rem per 


year. They've not been adopted here in the 


United States. The then-prevailing standards 


were three rem per quarter and five rem per 


year. 


So I think -- part of the suggestion for 


discussion is is that the kind of frame of 


reference that should be suitable for high 


exposures. At the time, for instance, at the 


Nevada Test Site when people exceeded three rem 


per quarter, they asked for special permission 


to exceed that dose. So whether a few rem, 


five rem or something more than that ought to 


be considered as high exposures -- well, we 


question -- it certainly is within the range of 


criticality. Then there's a question of what 


does "exceptionally" mean. And in the context 


of the nuclear weapons context, certainly I 


think most people were not exposed to five rem 


or more, and so it would be exceptional in that 


sense. But whether it's exceptional in the 


context of high exposures, I don't know. So 

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it's kind of -- it's -- it's really -- 


 DR. ZIEMER: At what point do you want to 


discuss that? 


 DR. MELIUS: Let's -- yeah. 


 DR. ZIEMER: Well, whether you're talking about 


the two rem or the five or the three per 


quarter, those are in the context of 


controlling lifetime exposures. 


 DR. MAKHIJANI: Right. 


 DR. ZIEMER: For example, the three rem per 


quarter, typically you could get that as long 


as your lifetime exposure -- they used to use 


the five times n minus 18. So a single 


exposure of three rem -- at least in the health 


physics field -- you'd -- I'd be hard-pressed 


to find anyone who would consider that high 


exposure. It would be the issue of if you got 


that three rem every quarter for a certain 


number of years and -- and there the concept 


was you don't want to do that every quarter, 


which would be 12 rem a year, for years. But 


you could do it until you reach that point 


where you caught up with the five times n minus 


18 curve, and then that dropped you back. 


But -- and now I think probably -- we've become 

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more conservative, obviously, on this. And now 


the two rem per year and now some people use 


your age as a lifetime limit. You don't want 


to -- which really, in a sense, comes down to 


one rem per year. But whatever it is -- but -- 


but exceeding it for one year, I think -- to 


me, conceptually, you'd be -- it would be hard 


to argue that that's a high dose in terms of 


contribution to a probability of some health 


effect. It's -- it's -- if a person's getting 


two per year for lifetime, certainly compared 


to old standards that still is awfully low. 


mean -- what, used to be 15 a year and people ­

- I don't know if we argue. Now very few 


people reach that, but in the early days a lot 


of them did. And I think by today's standards 


we would say that 15 a year for ten years is 


high. 


The other part of it is that, talking to 


radiobiologists, I think they still -- most of 


them argue that in any event, to show health 


effects below about ten rem is pretty 


speculative. 


DR. ROESSLER: In fact, the Health Physics 


Society has a position statement out stating 


I 
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that below five rem there is no evidence in any 


scientific studies of any health effects. And 


I think that's a general consensus among 


scientists in the field is that there -- 


there's no evidence below five rem of any 


health effects. 


 DR. MAKHIJANI: Well --


 DR. ZIEMER: Five or ten, but it's ball park, 


it's --


DR. ROESSLER: Yeah. 


 DR. MAKHIJANI: I have a question about that. 


This is -- this is the first controversy that 


spans the decades, and the question that's been 


examined by the ICRP, by the NCRP and the 


National Academy in the last five years. I 


think NCRP in 2002, ICRP a little bit after 


that -- I don't know if that rep-- the draft 


was finalized or not, I don't remember -- and 


the BEIR VII report of course came out in 2005, 


last year, and -- and was published actually 


this year. So this -- this position of the 


Health Physics Society is really at variance 


with -- with those findings. 


When -- when people say "evidence" in the 


Health Physics Society context, I think they 

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mean epidemiological evidence. And when I talk 


to epidemiologists who are frank about their 


profession and tell you that you can't be sure 


in epidemiology until people are dropping like 


flies and -- otherwise it's a statistical art. 


And the way I understand BEIR VII is they've 


taken into account cellular level evidence that 


-- there's a lot of evidence. Now -- so it 


depends on -- then you're -- you're not into 


the what's a high exposure; then you're into 


the meaning of what's evidence. And for me, I 


think -- I find it surprising that industry and 


Health Physics Society would consistently 


reject what have been the most thorough 


international investigations into the health 


risks -- cancer risks of radiation, which all 


adopt a linear -- it's not that it's certain 


there's a linear no-threshold, but it's 


regarded as the best working hypothesis under 


the circumstances. So I -- I find it -- I find 


it kind of --


 DR. ZIEMER: Well --


 DR. MAKHIJANI: -- difficult to put this 


discussion in that context. 


 DR. ZIEMER: Right. The linear hypothesis 

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really is a practical thing to use for 


radiation protection work. And I think it's 


quite true in epidemiology -- you know, they 


say that a biological catastrophe is one that's 


so bad that even an epidemiologist can see it. 


And epi studies don't answer either the -- the 


linear no-threshold question. And I think the 


ten or five rem, whatever it is -- 


DR. ROESSLER: It is ten, I just looked at 


that. 


 DR. ZIEMER: -- yeah, it's very -- it's very 


hard -- it's very hard to see that, even in epi 


studies. And you -- you really end up saying 


are there effects, can -- even in biological 


experiments, and special sensitive groups and 


so on. And yeah, there are some special cases 


where you can actually observe them, but if you 


can't observe the effect in a human population 


-- if you can't observe it, then it's pretty 


hard to argue -- it's pretty hard to argue that 


it's -- that it's there. And there -- you 


know, even -- even with the linear no-threshold 


thing -- with the linear no-threshold thing, it 


-- there's some point at which you -- you 


simply can't observe it. I mean otherwise you 

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get into the one gamma ray issue business, you 


know, if you want to carry it all the way -- 


DR. MAURO: This is John Mauro. I'd like to 


sort of step in a little here also. 


 DR. ZIEMER: Yeah. 


DR. MAURO: I notice we're -- we're thinking 


about this criteria within the context of what 


levels of exposure where there's clear and 


unambiguous evidence of some adverse effect. 


certainly agree that's one line of -- of attack 


on how do you develop criteria. And certainly 


five, ten rem is in the appropriate area, not 


only for the acute effects of radiation where 


you start to see drop in white blood cell 


count, but also in terms of the chronic effects 


where you start to see a statistically 


significant increase. But the other side -- I 


mean another tack, and I don't know whether or 


not it is an appropriate tack, but is asking 


the question if an individual were exposed -- 


let's use the number ten rem -- is it -- is it 


possible that that type of exposure could 


result in a probability of causation in excess 


of .5 for a given exposure -- condi-- condition 


-- a given scenario and cancer. So I mean that 


I 
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-- that's sort of like another way to come at 


this; that is, thinking in terms of well, what 


-- what types of doses does it take to end up 


with a PC of .5 -- and that seems to be the one 


that is, in my mind, at play here, only because 


of parity issues. That is -- the way I'm 


looking at it is if you have an individual 


that's exposed to a level over the course of 


greater than 250 days and -- and you 


compensate, why would you discriminate against 


the person who gets the same dose in less than 


250 days and not compensate? That -- that's 


another tack that I think is worthy of 


discussion. 


 DR. ZIEMER: And I agree with that issue, and I 


was simply making the argument that if -- if 


we're trying to isolate a number and sort of 


argue from that point of view that there's 


inherently some effects and therefore we should 


use that as a criteria, I think it may make a 


lot of sense to take a number and see what you 


get in the probability of causation 


calculation. Now -- keeping in mind that when 


you do that and -- and I don't know, when you 


assume this theoretical number, what you do 

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about -- are you going to take a point value 


and what are you going to do about a 


distribution --


DR. NETON: There's the problem. 


 DR. ZIEMER: -- because in -- in the -- in the 


case of those individual workers who are put 


through the system with a dose reconstruction, 


we're typically saying, in effect, their dose 


may have been as high as some number which is 


very much above whatever that value is because 


of the distribution of uncertainty. 


DR. MAURO: Right. 


 DR. ZIEMER: I mean their official number may 


be ten rem, but if you go out to the tail, that 


POC that we look at probably is associated with 


-- who knows, 40, 50 rem probably. 


 DR. WADE: Jim. 


 DR. ZIEMER: So what do we do on the point 


values. 


DR. NETON: I think the -- we hit right exactly 


very quickly on the basic issue here. We 


debated early on in this regulation as to is 


there a number, is there ten rem, 15, 20, what 


is it. And you quickly run into an issue that 


is what number do you use to -- to bracket that 

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50 -- if you use 50 percent as a PC. And the 


way the regulation is structured, if you cannot 


reconstruct dose for any particular cancer, 


then they're all in. That's the way it's 


worked. 


 DR. ZIEMER: Yeah. 


DR. NETON: So essentially what you end up 


having to do is establish a three-dimensional 


matrix where all cancers or all the variables 


in the probability of causation calculation 


against all variable of dose to try to find 


what the lowest possible dose one could arrive 


at to get to 50 percent. Well, then you've got 


variables in the probability of causation 


calculation -- latency, date of diagnosis, you 


know, sex, all these other variables -- and 


then the variables in the dose calculation. 


And it's -- it's, in my mind, a very -- it's 


not practical. It cannot be practically 


implemented in that way. You just -- I don't 


know that you can solve it. You can't say like 


leukemia you would think a priori is probably 


one of the lower ones. You can -- we've 


compensated people in this program for two, 


three rem exposures to leukemia. On the other 

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hand, solid tumors are in the multiple tens -- 


50, 60 rem, 100 rem for lung cancer. But what 


combination of age and sex and exposure and -- 


and solubility type -- you know, I don't know 


how you could optimize that to come out with 


the answer on a particular case, but -- and 


then you run into the issue of now -- now you 


know I've got the dose. 


Say we could even solve that, now you've got 


the exposure time. If you take a chronic 


exposure like an internal dose, am I going to 


make the cut point one hour of exposure, two 


hours, five hours? I mean I -- it's a very 


difficult problem. 


So what we ended up with in the regulation was 


sort of a dichotomous situation; 250, which 


very much parallels the original SEC. And then 


the intent was that you could identify -- it 


was fairly obvious, if these large exposures 


were so far out of the realm of this chronic, 


250-day type situation, that we would treat 


them separately. And that would be a -- a 


criticality, say, for example; and 


exceptionally high, where radiologic controls 


failed, were -- were meant to be fairly 

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obvious, that even anyone looking at that would 


say the PC is clearly over 50 percent without 


even running a calculation. That was sort of 


the way it was structured. 


So we're back to where we were three or four 


years ago now, trying to figure out possibly a 


way to come up with a finite number that one 


can use as a litmus test. And I -- I'm all 


ears. It's a -- it's a difficult problem. 


 DR. MELIUS: But -- but I'm not sure we can -- 


can do that, partly because, number -- the test 


for getting in here, the first step is that you 


can't reconstruct dose. So even if we come up 


with a number, how close are we going to be 


able to, you know, calculate that we're at that 


number or above that number or below that 


number for a particular individual? And we're 


going to -- and some of the variables about how 


they were exposed and how long they were 


exposed and so forth is going to be also very 


unknown, or we're going to be -- you know, 


have very limited information on that. And I 


think some of the situations that we've heard 


about at Nevada Test Site and other places is 


just there's a lot of uncertainty -- how much 

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time did they spend there, exactly where they 


were in relationship to -- to exposures and so 


forth. We're not going to have either and -- 


and you know, I just wonder if we're better off 


trying to come up with some sort of qualitative 


way of -- of making those assessments. But 


even that's going to be difficult because, you 


know -- well, does that only apply to people 


that, you know, were there for a certain time 


period or, you know, two days, five days, what 


-- whatever. I mean it's very (unintelligible) 


a real mix and we may not have the records to 


even support that kind of distinction. 


But -- but I do think what Arjun's getting at 


is helpful in the sense that we need to figure 


out what do we mean by "exceptionally high 


exposures" and -- and maybe in retrospect, did 


we mean all criticality incidents, in which 


case we're talking about a -- 


DR. NETON: This -- this was intended to be a 


qualitative definition. 


 DR. MELIUS: Yeah. 


DR. NETON: I mean, you know, exceptionally 


high is sort of qualitative. It 


(unintelligible) --

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DR. MAURO: This is John Mauro. Let's say for 


the moment we agree that it's a qualitative -- 


and to pi-- to try to pick a -- a specific 


number is -- is difficult, and perhaps not what 


we would li-- are really trying to do. Then 


the alternative would be is -- well, then let's 


-- in this particular case, well, let's look at 


what exposures did occur and -- I mean it's 


almost as if rather than look-- it's almost an 


iterative way to look at it, say well, you 


know, we'll -- we'll just -- we -- we -- we're 


starting to understand the challenges of trying 


to pick some numerical criteria. And then we ­

- then you go back to well, in this particular 


case, Nevada Test Site, what are the kinds of 


potential doses that were experienced? For 


example, are we talking about situations where, 


by and large, no one got much more than one rem 


in a short period of time, ten rem, 15 rem? 


guess what I'm getting at is I'm not sure if -- 


if -- if we do move into a qualitative 


approach, then it really becomes a matter of a 


collective judgment for this particular site 


under these particular conditions, does it meet 


the qualitative standard. So I just throw that 


I 
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in as a way to not find ourselves gridlocked to 


try to come up with a number. 


DR. NETON: But you still end up with having to 


-- having to pick a number, John. That's the 


problem. I mean you can look at the population 


and say their doses were as high as 50 rem, but 


then at some point a judgment has to be made, 


is that the number, is that a number that -- 


you know. 


DR. MAURO: Well, the reason I say this is 


because, as Arjun pointed out, it's really the 


combination of five criteria. I mean it's the 


con-- it's all of those elements that together 


-- only one of which would be this dose -- that 


together, when you view that particular site 


and it -- what transpired there within the 


context of all of the different facets of the 


definition, is the judgment made, not -- not 


based solely on one dimension, namely let's say 


some dose. So -- so I'm just trying to find a 


way to come to grips with the problem in a way 


that is not so -- with -- with such bright 


lines, because I don't think this is a bright-


line prob-- problem that can be solve with 


bright lines. 

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 DR. MELIUS: But could -- could I just add one 


thing, though. I -- I think we might actually 


take and look at a particular site and say that 


that would have a -- sort of a, you know, a 


range of exposures. And say again, let's -- 


Nevada Test Site situations with the above-


ground testing that -- that would qualify as 


exceptionally high. 'Cause remember, we're not 


going to have the kind of records that are 


going to, you know, pinpoint that John Smith 


was there for two hours in a certain spot on a 


certain day. We're going to have, you know, a 


range of -- of, you know, poor and -- to, you 


know, sort of mixed -- you know, very -- not 


very good information always and -- and so 


we're just I think trying to put people into 


categories as best we can, trying to be fair to 


them and -- and recognize that they -- they 


were at risk from this -- as much the same way 


that we're doing with everybody else in this 


program. I mean we're -- you know, we're not 


making very, you know, precise estimates, just 


based on the amount of information that we have 


and the nature of the situation. And so -- I 


mean one other approach would be, you know -- 

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again, rather than take it incident by 


incident, focus -- look, we have this group of 


people that -- or groups of people that worked 


at Nevada Test Site or Pacific Proving Ground, 


whatever; they had -- they were in these 


situations, do -- do these sort of qualify as 


exceptionally high exposures and can we somehow 


group people in a -- in a way that, you know, 


we think is fair and do -- I think that would 


make -- take a fair amount of work of trying to 


understand the nature of the different work 


groups and what people did at the site and -- 


and how their employment's described. But --


but I -- but I think we -- I suspect we could 


come up with a sort of collective judgment that 


we'd all be fairly comfortable with, much like 


we do with -- with regular SECs. 


DR. NETON: I think we'd have to be a little 


careful that -- that the class definition that 


applies the 250-day group might be quite 


different for a discrete group then. 


 DR. MELIUS: Yeah. 


DR. NETON: I mean if you start narrowing -- 


you know, the requirement for a discrete is to 


have this exceptionally high exposure, and you 

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can't take that and then apply it to the -- the 


class that was defined for a 250-day exposure 


'cause that -- that's essentially anybody who 


was on site that should have been monitored. 


 DR. MELIUS: Right. 


DR. NETON: Now if one can identify -- and I 


see there's been some attempt here in the SC&A 


documents -- to identify these discrete 


incidents that might have occurred, I think we 


could maybe agree at some point that there was 


a discrete incident that occurred and that -- 


those people involved in that discrete incident 


may be a member of a class based on discrete 


exposure. That's what we have to be careful to 


do. We can't make the whole site a -- 


everybody involved in a discrete incident. I 


mean it's --


 DR. MELIUS: Oh, yeah, yeah. No. 


DR. NETON: -- not the way it works. 


 DR. MAKHIJANI: If I might say, what I was 


trying to do and -- well, I'm very glad of the 


discussion because -- I mean all of the numbers 


-- I -- I put them out really to be shot down 


or discussed or --


DR. NETON: Yeah. 

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 DR. MAKHIJANI: -- changed in some way. That's 


why when I discussed it with John and Joe we 


thought better to call it working papers 


because they're going to undoubtedly going to 


be changed as a result of this discussion, so 


just -- that was the spirit in which they were 


offered, not as the normal kind of a report 


that we present to you intended to be discussed 


in a Board meeting, because this is more 


difficult. 


The thing that I was trying to do in thinking 


about this was not in terms of actual exposures 


of people who were in incidents. The -- what I 


did -- when I -- when Kathy and -- and Bob 


Barton and I were looking at this, what we 


tried to do is to take those incidents and show 


the radiological conditions, were there 


failures of radiological control, did somebody 


do something out of the ordinary that resulted 


in a high exposure -- like this person that 


wound up at ground zero and refused to leave 


and got 39 rem and then two people went after 


him and they got more than ten rem. Well, 


clearly that didn't happen to everybody. That 


happened to a few people. 

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DR. NETON: That's a discrete incident. 


 DR. MAKHIJANI: It's a discrete incident. But 


the idea of exploring those kinds of things in 


this con-- context was to examine whether there 


were incidents and whether there was a 


potential for exposure. Say you're in a 


situation where you've said we don't know how 


to calculate dose, or you take the plutonium 


exposure example that -- that we have in the 


Nevada paper. There were these shots in 


Project 56. People got -- some people got 


significant plutonium intakes, and some of 


those doses were pretty high. Well, they're 


committed doses. 


DR. NETON: Uh-huh, military or civilian? 


 DR. MAKHIJANI: I -- I'm not sure. I'd have to 


-- I'll have to check. 


DR. MAURO: Yeah, Arjun, we -- we gave the -- 


the num-- we did not convert them to doses. 


think right now we just have the exposure 


levels in terms of -- 


 DR. MAKHIJANI: There are -- you haven't -- you 


haven't seen the -- maybe I don't have the 


latest report. You know, Joyce cal-- 


calculated the -- the exposures for the 


I 
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plutonium --


DR. MAURO: Oh, okay, my version ha-- didn't go 


that far. Okay. 


 DR. MAKHIJANI: It doesn't have that, but -- 


but I have the calcu-- yeah, I put them all 


together day before yesterday, I think. 


And -- and so the idea was not to identify 


groups of individuals, and that's part of the 


reason at this stage we didn't separate 


military and civilian a lot. We know they were 


together and -- in many circumstances, but the 


idea was to identify is this not a radiological 


environment in which there were incidents, in 


which case the problem is solved. There's no 


less-than-250-day SEC. Or is this a 


radiological environment in which there were 


incidents and some doses that could be 


considered, by some criteria, high. And that's 


why (unintelligible) compiled as much as we 


could so you could take a look at the range of 


what's there. 


 DR. BEHLING: Can I make a comment here? I'm 


looking at your tables, the one on page 7, and 


I've also looked at it from -- in this book 


here, the NIC book, and if you look at 

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Operation HARDTACK, there were 37 tests during 


that period. 


 DR. MAKHIJANI: Table 1 in the Nevada paper? 


 DR. BEHLING: Yeah. And the -- the operation 


started September 12th and finished on October 


of '58, so you have less than a two-month 


period. And let's assume a person started 


there and was there for the full duration of 37 


tests, and basically stayed for let's say four 


months, at which time basically the external 


exposure dose rate would have ceased to exist. 


And if he terminated at that point, you would 


have obviously considerably less than 250 days 


of work time. 


At the same time, there were no additional 


tests thereafter until the next one, Operation 


NOUGAT, which didn't commence until 1961. So 


you have a long time interval between Operation 


HARDTACK II and the next event. And if you had 


a person who was there, two people, one stayed 


for a year plus and the other one terminated 


after four months, after Operation HARDTACK II, 


you can reasonably conclude that -- assuming 


they were standing next to each other 


throughout the whole time period -- that they 

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received essentially identical doses based on 


the rapid decay rate. And you would obviously 


say if this person had a dose that was 


compensable and qualified him for SEC based on 


the 250-day criteria, you would say fine, 


you're in, but the other guy is out. And it 


(unintelligible) reasonable to, at this point, 


exclude that other person who failed to meet 


the 250-day criteria based on just simple, 


intuitive logic that the two would have 


received the same dose. 


 DR. MAKHIJANI: It's actually a little worse 


than that because --


DR. NETON: (Unintelligible) say the same dose 


because there's resuspension issues that were 


there --


 DR. BEHLING: Well, I know, but 


(unintelligible) --


DR. NETON: -- (unintelligible) -- 


 DR. BEHLING: -- (unintelligible) talk about 


two external exposure and realizing that 


(unintelligible) equation which basically say ­

-


DR. NETON: Well, external exposure is not the 


basis for the SEC at Nevada Test Site. 

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Internal exposure is the basis for qualifying 


for the SEC. We are reconstructing external 


exposures at Nevada. In fact I'll point out, 


of the 61 people from Nevada Test Site that 


have less than 250 days exposures and at least 


one presumptive cancer, we have dosimetry data 


for most of them. There are some gaps, but -- 


but by and large, these are people who visited 


the site once, twice, five, ten, 15 times, and 


we have that full -- we have external data for 


-- for many of those people. 


 DR. BEHLING: But even for internal, you 


(unintelligible) short-lived fission products 


that are obviously not in there 


(unintelligible) previous time, and -- 


DR. NETON: Right, but the long-term fission 


products and resuspension of plutonium and 


those type of things are still -- 


 DR. MELIUS: Let's get away from Nevada Test 


Site --


DR. MAURO: Jim, you -- you brought up -- bring 


up a very, very important point in terms of 


defining the problem that we're trying to 


solve. What I'm hearing is that when we look 


at the 250 workday issue, are we saying that we 

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should only be looking at internal exposure? 


DR. NETON: Internal exposure -- the inability 


to reconstruct internal exposure was the basis 


for granting SEC for this time period. 


DR. MAURO: Well, I understand, and I think 


it's important that we discuss this because, 


see, what we did -- up until this point -- is 


emphasize external exposure -- 


DR. NETON: Right, and I was --


DR. MAURO: -- whether or not there were 


incidents whereby the doses could be considered 


somewhat uncontrolled over a relatively short 


period of time, and we -- we started at about 


one rem and up as being -- to -- to try to -- 


as a compendium of what transpired. But what 


I'm hearing is maybe we're looking in the wrong 


place, and I'm -- you know, I'm prepared to 


accept that since -- since the -- and this is 


unique to this site, because the basis for 


granting SEC was not based on external, it was 


based on not being able to reconstruct 


internal. So is it possible that we have just 


been looking in the wrong place and our 


attention should have been entirely on internal 


and short-term, and not on external? 

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DR. NETON: I would -- I think so. I mean I --


I guess one -- there is an argument one could 


make whether the 250-day should have included 


external, but we did not. We -- we felt that 


we had sufficient monitoring data to 


reconstruct external dose. And in fact, if you 


look at the records we have for the claimants 


that we're supposed to be applying this class 


to, the ex-- internal exp-- external exposures 


are fairly small, on a -- well, it's all 


relative, but the collective dose for all the 


cases combined, for all 61 cases, is 21 rem. 


That's combined for everybody. The highest 


recorded dose we have for anybody in this pool 


of 61 people is 4.7 rem. So -- external-wise. 


So -- you know, I was urging all along that we 


should be looking at the records of the 


claimants that we have and seeing how those 


apply to this class, as opposed to going out 


and looking at these military personnel who 


were standing at the blast. And yeah, there 


may have been some commingled civilian 


exposures, but we have data in our files for 


these people. And in fact, if you look through 


the records, they'll refer to the shots and 

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where a person was a civilian involved in a 


military shot, we have pretty good 


documentation of that and what they were doing. 


So --


DR. MAURO: Jim, I think that this is really 


getting to the -- a deeper perspective that we 


need to discuss. It's important, because in 


effect what I'm hearing is that this -- our 


concern here is with the -- the claimants as 


opposed to the scenarios that may have 


occurred. 


DR. NETON: Right. 


DR. MAURO: See, we came at this in a way that 


said -- asked the question what may have -- 


what -- what transpired at these -- during 


these tests 'cause -- to create a -- basically 


a compendium of information, and we did not -- 


and -- and ask ourselves the question -- and we 


zeroed in initially heavily on the external, 


but what I'm hearing is that we may have come 


at this thing incorrectly, and -- and I'm 


willing to accept that, but I think we need to 


talk about this. Namely, what I'm hearing is 


that we -- we -- the issue has nothing to do 


with external. The fact that -- let's say for 

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a second, just for a moment, that we're able to 


show that there were some incidents where some 


people -- we're not saying who they are, but 


they could have experienced an external dose, 


let's say in excess of 100 rem. Okay? Let's 


just say -- I -- I'm mak-- that didn't happen, 


by the way, but --


DR. NETON: Right. 


(Whereupon, Mr. Larry Elliott joined the 


group.) 


DR. MAURO: -- but let me just say it now. 


What I'm hearing, and you correct me if I'm 


wrong, is it doesn't matter. That is not the 


basis upon which we would make a judgment. You 


can -- you --your position is that that's not ­

- that question is not at play here. 


DR. NETON: Right. 


DR. MAURO: Because you would say that no, we ­

- we can reconstruct those people's doses and 


therefore the -- the whole -- so it's not 


really part of what we're concerned with here. 


You will reconstruct those doses and you will 


compensate because you can do a partial dose 


reconstruction and take care of that problem. 


 The problem we're worried about, I'm hearing, 

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is those people who may have gotten a very high 


exposure that was internal and -- and should be 


included. So I have to say I'm struggling 


right now with defining the boundaries of our 


problem, and I'm not quite sure whether or not 


we -- you know, I -- I think we need to talk a 


little bit, maybe for my sake. How does 


everyone else see this? 


 DR. WADE: Well, let me -- let me speak -- 


DR. MAURO: 'Cause all of a sudden I have a 


different vision of this. 


 DR. MELIUS: Well, John, let me say that I 


think you're off-track here 'cause I think we ­

- first we -- what we ought to focus on is how 


are we going to deal with the issue of these 


short-term ex-- discrete incidents. And then I 


think there's a separate issue of how it 


applies at -- at different sites. And I think 


what you and Hans have brought up -- you're 


sort of -- you're jumping ahead and -- and I 


don't particularly think that's something we 


should be discussing right now. I think --


DR. MAURO: Okay. 


 DR. MELIUS: It may be very relevant when we go 


to apply -- look at issues such as Nevada Test 

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Site and specific sites, but -- but I think we 


need to first go back and look at how are we 


going to approach this overall. I think that's 


the intent of -- of our discussion today and 


the initial steps for the -- for this 


workgroup. 


DR. MAURO: Okay, good, I -- I think that 


needed to be said, though, so that we could get 


back to where -- I guess we -- where we were. 


 DR. WADE: Yeah, let me -- this is Lew Wade. 


Let me talk a little bit about sort of a number 


of issues, and I'll try and do it very briefly, 


starting with the last one that Dr. Melius 


discussed. 


I mean the working group can define what it 


wishes to look at. The working group really 


was born of the issue to look at SE-- SEC-


related issue, and the working group, through 


its chair or the Board can advise the working 


group, can decide upon what issue it wants to 


look at, what issues it wants to look at. 


That's perfectly reasonable and that 


intellectual direction can -- can go anywhere 


that they choose to take it. 


As it relates to the issue of making a 

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recommendation for the Nevada Test Site or 


Pacific Proving Ground on the issue of less 


than 250 days, I would also point out that the 


working group will bring a recommendation to 


the Board, the Board can make a recommendation 


to the Secretary, the Secretary will eventually 


have to decide this issue. I would encourage 


the working group to make its records as 


complete as possible to advise the Secretary, 


and I know that the working group will do that. 


I will also say on the record that if the 


Secretary wishes in any way to inform the 


working group as to the Secretary's thoughts or 


needs, then that needs to happen as well. But 


again, the -- the discussion can go where the 


working group wishes to take it. The issues 


need to be explored as the working group wishes 


to explore them, and I think that's all that 


needs to be said. 


 MS. ROBERTSON-DEMERS: This is Kathy Demers. 


have a question for Jim. You said that in your 


pool of 61 individuals, the highest dose was 


4.7 rem? 


DR. NETON: External, yes. 


 MS. ROBERTSON-DEMERS: Okay. In -- in your 


I 
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pool of 61 individuals, did you include 


individuals from the laboratories which came up 


to the site and participated in the tests? 


DR. NETON: This is the pool of actual 


claimants that we have. 


 MS. ROBERTSON-DEMERS: Okay. 


DR. NETON: Not a sampling of -- across the 


site. I just took the people who would have to 


be adjudicated based on this SEC class -- 


 MS. ROBERTSON-DEMERS: Okay. 


DR. NETON: -- the people who were not elig-- 


currently eligible for the class based on the 


250-day requirement and -- but they do have a 


presumptive cancer. 


 MS. ROBERTSON-DEMERS: Okay. Just to let you 


know, we have run across an external dose of 


18.5 rem, and this was actually a Los Alamos 


employee who participated in a shot at NTS. He 


later went to work for NTS, but at the time he 


received this exposure he was a LANL employee. 


So when we talk about those individuals who are 


exposed to high doses at the test site, we need 


to bring in those laboratory people. 


DR. NETON: Yeah, that's fine, Kathy. I wasn't 


trying to, you know, cover the universe of 

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potential exposure. In fact, he may be in one 


of these 444 cases that already meet the 


definition of exposures since he was there 


possibly more than 250 days. But -- but 


nonetheless, my original statement was that we 


believe we can reconstruct these external 


exposures. And a lot of the data I'm hearing 


around the table tends to support that, that we 


do know what these levels were. 


 DR. WADE: But again, the lead will come from 


the working group as to the direction that we 


take. 


 DR. MAKHIJANI: May I go -- may I go through 


the other --


 DR. MELIUS: Yeah --


 DR. MAKHIJANI: -- things that went into the -- 


 DR. MELIUS: -- please. 

 DR. ZIEMER: I have one additional -- 

 DR. MELIUS: Oh, yeah. 

 DR. ZIEMER: -- question or comment. I think 

it's very helpful to get some idea of what 


numbers come out of these incidents, and I 


found it very helpful. One thing that occurs 


to me as I look through the data, I think on 


all of these what they tend to do is they 

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select out the top end -- the few people who 


got the highest exposures. For example, if you 


look at the Y-12 data, those -- those five 


people are the ones who were right there -- 


 DR. MELIUS: Right. 


 DR. ZIEMER: -- when -- when the impromptu 


barrel reactor had its excursion. But there 


are hundreds of people who got exposed from 


this. But they were all -- I was in the next 


building and I got exposed to that. But it is 


sort of insignificant when you get out very -- 


you don't have to be very far away from any of 


these when your exposure gets down to normal -- 


almost normal working exposures in a facility. 


So all of these are -- in their reports I think 


get truncated simply by who are the high 


people. And maybe inherently they pick people 


who are above some sort of management level in 


that facility, whether it's one or two or a few 


rem and up. They don't report the rest of the 


folks in all of these that got maybe some 


elevated exposure. Do you think that's -- 


would you agree that that's probably the case, 


that most of these are the folks who were right 


close in, and in almost every case where 

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there's a -- an incident like this, 


criticality, it's a known incident, is it not? 


Are we -- are we postulating that some of these 


could have occurred without people knowing it, 


or do you know whether it -- 


 DR. MAKHIJANI: Well, they -- they would have 


at least had to know it post facto to have 


documented it, but -- the unknown unknown, as 


Mr. (unintelligible) would say. 


 DR. ZIEMER: Is that a quote? 


 DR. MAKHIJANI: But -- but I think, as I -- as 


I read the criticality data, I think you're 


right in the sense I don't think they're 


excluding some tail of the distribution. I 


think they're taking to account only the people 


who are nearby or involved with the accident or 


in the control room or in the room where the 


vessel exis-- you know, where the reaction 


occurred. 


 DR. ZIEMER: Right. 


 DR. MAKHIJANI: At least that's my impression, 


from reading over the data. 


 DR. ZIEMER: Right. 


 DR. MAKHIJANI: I don't think they're taking 


next-building people. 

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 DR. ZIEMER: Right, that's exactly right. And 


so automatically sort of an administrative 


truncation where you're picking the high end 


here, but even that has a big distribution. 


And I'm not sure -- if one were arguing that 


something like this could have occurred without 


our knowledge -- you know, breakdown of 


radiologic controls -- could -- could -- is 


that an argument that anyone is making? 


DR. NETON: There have been claimants who made 


-- made those arguments, that criticalities 


occurred that were undetected by the -- by the 


facility. That's been an argument in a couple 


of cases. 


 DR. MAKHIJANI: It's not something that I -- 


UNIDENTIFIED: Small level. 


DR. NETON: Small level. 


 DR. MAKHIJANI: -- factored into our report. 


 DR. ZIEMER: No, I understand, but I -- what 


I'm -- what I'm getting at is that basically 


what this does is give us some handle on what 


kind of doses could occur if that in fact were 


the case and individuals -- and I would -- I 


would tend to look at the upper end of these, 


the people in close. Those are the numbers of 

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concern. 


But the other part of that is, in many of these 


those doses are high enough that you would 


expect to see the non-stochastic effects -- 


 DR. MAKHIJANI: Right. 


 DR. ZIEMER: -- which is a different endpoint. 


You have, for example -- well, certainly in the 


Japanese case, the guy was -- 


DR. NETON: Well, two of the workers 


(unintelligible) --


 DR. ZIEMER: Right. So -- and I think even -- 


even in the Oak Ridge case, they -- they saw -- 


they weren't lethal doses, but they saw blood 


effects early on, so --


DR. NETON: In fact in our -- in the petition, 


if you're -- if you're petitioning as a 


discrete incident, one of the proofs that you 


could submit is, in our regulation, medical 


evidence that one or more members of the class 


may have incurred a high-level radiation dose 


from the incident such as depressed white blood 


counts associated with radiation exposure or 


the application of chelation therapy in terms 


of an internal high incident. So we -- you 


know, we envisioned that. You know, if you're 

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proposing a class based on an incident, then 


you'd like to see, you know, medical evidence 


of some type --


 DR. ZIEMER: And that --


DR. NETON: -- and that, I think, kind of 


speaks --


 DR. ZIEMER: -- and that's clearly high, no 


argument. 


DR. NETON: And I think that statement actually 


speaks to the level that we intended these to 


be in the range for (unintelligible) -- 


 DR. ZIEMER: The problem --


DR. NETON: -- blood cells --


 DR. ZIEMER: -- I'm having with getting away 


from stochastic -- or non-stochastic effects 


such as blood count and so on, where are we on 


this? At what point is it still high or at 


what point is it the folks in the next building 


and that's just routine stuff? That's --


DR. NETON: Right. 


 DR. ZIEMER: -- sort of the issue that I'm 


struggling with. 


 DR. MAKHIJANI: Well, that's partly what I was 


trying to put before you to (unintelligible) 


out. 

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60

 DR. ZIEMER: Yeah, so we can think about -- 


 DR. MAKHIJANI: White blood cell counts might 


not be a bad (unintelligible) rem. 


DR. MAURO: Yeah, coincidentally, ten rem is 


sort of the number that gives you not only the 


threshold where you see the acute effects, but 


also -- about -- but also the threshold where 


you start to see stochastic effects. 


DR. NETON: Well, we have to be careful when we 


start talking about stochastic effects now 


because the techniques are so sensitive, one -- 


some people -- I've been to conferences where 


they'll say (unintelligible) down to one rem 


now. 


DR. MAURO: Yeah, they're all -- I agree with 


you, there are places where they bring it down 


to one. 


DR. NETON: But traditionally I think, you know 


-- at least when I was growing up in health 


physics, 25 to 50 rem was sort of the ball park 


of where you could pretty easily see 


circulating, you know, effects in white blood 


cell depression. I mean just talking about 


decline in the count itself, and without 


special -- special techniques. But that was 

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sort of the intent and that got to the 


qualitative issue as -- you're saying -- to a 


health physicist looking at data, you start 


seeing blood cell depression, you start seeing 


administration of chelation therapy, those are 


the kind of evidence points that we would be 


looking for to say well, this was a discrete 


incident that was high enough where you don't 


need to start applying these PC calculations 


where you're refining your estimates down to, 


you know, the class. So that -- that was 


clearly the intent of the way this was put 


together. 


 DR. MELIUS: But -- but I would question 


whether that really matches up with sort of the 


equity argument with the 250 day -- what we 


talked about earlier. 


DR. NETON: Well, the 250 --


 DR. MELIUS: I mean I think (unintelligible) 


have to be careful about, you know, what kind 


of test you put on -- on the -- the criteria 


for health endangerment for, you know, a 


discrete incident not to be something that, you 


know --


DR. NETON: Agreed. 

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62

 DR. MELIUS: -- yeah, a great deal different 


than that. 


 DR. MAKHIJANI: Could I put two other points on 


the table for discussion, because I think it 


would help. 


 DR. MELIUS: If they're -- if they're from your 


first paper. 


 DR. MAKHIJANI: Yeah, okay. Only from -- I'm 


with you -- I'm with you, Jim. 


The -- the two other things that seem important 


for this discussion that are in the paper were 


the legislative record -- I could find only one 


-- one piece in the legislative record that 


actually talked about Amchitka and doses. I --


so I put the whole thing in so people could 


see. 


DR. ROESSLER: What page are you on in what 


document? 


 DR. MAKHIJANI: On -- on the health 


endangerment paper --


 DR. ZIEMER: Page 19. 


 DR. MAKHIJANI: Yes, with a statement by 


Senator Frank Murkowski, and he actually quoted 


dose reconstruction done by Dr. Bertell that -- 


I talked with Dr. Bertell subsequent to seeing 

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this, just a few days ago and I made a few 


notes from that conversation and sent them to 


her. I actually think the 669 to 7,240 (sic) 


millirems for a year -- I don't think they're 


for a year, I think that's cumulative doses -- 


they are internal and external combined. And 


the way she did the calculation, if I 


understand it, is she took job categories and 


assumed that somebody just did one category of 


job and that was the low end, and somebody else 


may have done all of the categories of job 


serially and participated in everything, 


including the cleanup, and that would be high 


end. I have not seen the paper itself. I have 


requested Dr. Bertell to send it to me. 


But I thought this particular thing was 


important, not for its technical content but 


for what -- what Congress saw when they -- 


technically, when they passed the legislation 


containing Amchitka without the 250-day 


restriction. And I made a list of six factors 


that I -- you could actually relate to the 


rule. 


The statement indicates that those are the 


difficult to quantify. The dose records are 

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partial since they are dose -- I'm just saying 


what's in the statement, not my opinion; I 


haven't (unintelligible) -- dose records are 


lost or improperly maintained. They gave a 


range of doses under one rem to just over 17 


rem. And potential for episodic exposure. And 


then it talks about quarterly and annual dose 


limits, and that the workers were not properly 


informed. 


 And there's some broad general sense in which 


you could relate this to 42 CFR 83, and I tried 


to do that. And you can argue the merits of it 


or -- or demerits of -- of how I tried to do 


it, but I just wanted to sort of call attention 


to there is a range of doses in the legislative 


record from Amchitka which doesn't have -- and 


the other -- the other thing that I -- I -- the 


other two things, actually, are the reduction 


of 250 days to 83 just because people were 


present is an announced policy of the 


Department of Labor in how it's going to treat 


Pacific Proving Grounds and Nevada Test Site, 


as I understand it. 


DR. NETON: Portions of the Nevada Test Site. 


 DR. MAKHIJANI: Portions of the Nevada Test 

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Site, thank you. And I think that that applies 


in the absence of the Advisory Board or the 


Secretary of Health and Human Services having 


made a decision of health endangerment. But if 


presence at the site -- you know, sleeping in a 


trailer -- is -- is considered sufficient to 


reduce the time from 250 days to 83 days, then 


it does raise the question of -- what does it 


imply for -- and the last factor -- the last 


factor -- let me just put all -- all the issues 


on the table, then I'll -- then I'll stop. 


The last thing that -- that -- and actually 


based on Hans's calculations that were 


presented to the Board in June, I believe, at 


the D.C. Board meeting, and they related to 


internal dose from thorium at Ames from a 


single day's intake with committed -- 50-year 


committed doses. They turned out to be quite 


high for certain organs and they are there in 


Table 5 of the paper. And the -- the issue 


here is that if -- for instance, at Nevada Test 


Site -- somebody worked for 251 days and had a 


plutonium intake which you can't properly 


characterize and you're giving them an SEC, 


they would also be getting -- getting the dose 

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over a long period of time, and so the question 


of whether internal doses should be considered 


within this framework -- today I'm hearing that 


they should be considered. But in the past, 


informally, I've heard expressed that maybe, 


because it's committed doses over a long period 


of time, they shouldn't be considered there. 


The argument I think that I've made, at least 


for people to shoot at, is that it seems that 


internal doses should be considered if there 


was a failure of radiological controls and 


incidents of exposures in a relatively short 


period of time. So those -- those are sort of 


the other complicating issues. 


MS. HOMOKI-TITUS: Liz Homoki-Titus. I just 


want to be clear and make sure that everyone 


understands, under the regulation you have to 


either pick the 250-day requirement or presence 


(unintelligible) if they want to decide how to 


count the work days. So I just want to be sure 


that we're not going in a direction where the 


Board might recommend 83 work days or something 


like that, unless you want to make the 


recommendation to the Secretary to change the 


rule. 

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 DR. ZIEMER: No, I think --

 DR. MELIUS: We understand that. 

 DR. ZIEMER: -- we understand that. That --

that's how Labor -- we understand Labor is 


interpreting it --


MS. HOMOKI-TITUS: Right. 


 DR. ZIEMER: -- is they're doing a weighting, 


and I think we have sort of indicated that we 


think that's reasonable. It weights the amount 


of time there. 


MS. HOMOKI-TITUS: Okay, I just wanted to make 


sure that we're all on the same page. Thank 


you. 


DR. NETON: A couple of issues Arjun raised, 


one is -- the regulation never intended to 


discount internal exposures for less than 250 


days. In fact, that statement I just read 


about chela-- administration of chelation 


therapy would support that, that -- 


 DR. MAKHIJANI: Right. 


DR. NETON: -- you were involved in a -- for 


instance, a glove -- a ion exchange column 


explosion at Hanford and were administered 


chelation therapy for your intakes and we 


couldn't reconstruction your dose, we'd 

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certainly consider something less than 250 days 


in that case. 


 Secondly, the reduction of exposure time from 


250 to 83 by Labor I think is very consistent 


with the reason the class was granted, which 


was based on our inability to reconstruct 


internal exposures, not external. So if for 


instance these people were living there, 


swimming in lagoons, eating local vegetation, 


that sort of thing, it makes sense to me that 


presence of less than 250 days because of the 


24/7 exposures, it makes sense to reduce it. 


 DR. MAKHIJANI: No, I agree with that. I'm not 


arguing that it doesn't make sense. I am just 


putting the question before the group that if 


you're doing that, then what does it -- and I 


don't have a clear, clean answer to this 


question -- is what does it imply if you 


consider that in the context of health 


endangerment? I don't have an answer to this 


question. I think it does raise the question. 


 DR. WADE: Just to be open -- Jeff Kotsch, are 


you still on the line? Jeff Kotsch? 


 MR. KOTSCH: Yeah, still here. 


 DR. WADE: Is there anything you would like to 

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say, Jeff, at this point -- since we're talking 


about DOL and decisions they've taken or -- 


I'll give you an opportunity to speak if you'd 


like. 


 MR. KOTSCH: Unfortunately I've only been 


listening with half an ear, but basically, you 


know, we're -- our interpretation of -- at like 


Nevada Test Site or even PPG, if we determine 


that a person is there continuously, that's the 


reason we use that -- you know, the 83-day or 


whatever the value is -- 


 DR. WADE: Thank you. 


 MR. KOTSCH: -- as an interpretation of the 


250-day standard. 


 DR. WADE: Thank you. 


 DR. MELIUS: Yeah, Paul. 


 DR. ZIEMER: Yeah, I had just a comment on the 


congressional intent issue here. I think it's 


very helpful to know that and I appreciate 


Arjun putting that information in. It's 


interesting to me that point five says that 


exceedance of the quarterly limit and that five 


rem is considered significant. I don't know, 


Arjun, if you're saying if -- if you are -- I ­

- I don't know that the fact that that argument 

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was used, I don't know if that necessarily 


means that Congress says that particular 


argument was significant. You're -- you're 


pointing out that was part of the argument. 


 DR. MAKHIJANI: Right, that's all I'm saying. 


 DR. ZIEMER: Yeah. 

 DR. MELIUS: It was -- it was Senator 

Murkowski. 

 DR. ZIEMER: It was one of the points Murkowski 

made. 

 DR. MAKHIJANI: Right. 


 DR. ZIEMER: To me, the important one is the 


third point, that -- where he's saying that at 


least they're estimating that the doses to the 


people might be as high as 17,000, and they're 


also saying we don't know what they are, but 


certainly the upper --


DR. ROESSLER: 17,000 millirem. 


 DR. ZIEMER: -- millirem, a 17-rem per year, 


certainly the upper end of this seems to me to 


be the most significant thing. 


Now obviously if you're making the argument to 


Congress, you would want to point out that 


people are exceeding the legal limit. Whether 


or not Congress thought that was significant I 

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think is speculative. That's the only point I 


-- I would make here. 


 DR. MAKHIJANI: I agree. 


 DR. ZIEMER: You know what I'm saying? 


 DR. MAKHIJANI: No, no, I completely --


 DR. ZIEMER: And I would make the same argument 


if I was standing before Congress. I'd say and 


these guys are exceeding the legal limit. 


 DR. MAKHIJANI: Right. 


 DR. ZIEMER: But is that what swayed the day, 


or is it the fact that there are doses as high 


as some number, number one, and number two, 


there are these uncertainties and we don't know 


what they're getting. So -- and it's probably 


a preponderance of all of those things taken 


together. 


 DR. MAKHIJANI: Right. 


 DR. ZIEMER: I just -- I was uncomfortable with 


the idea of putting too much weight in the 


fifth point, and that's what I was talking 


about earlier. A quarterly limit is -- it's a 


-- it's a management limit, in my mind. And 


not everybody agrees with that, but if a person 


-- if all they ever got in their life was three 


rem, except for some unusual situation where 

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you had the combination of age and -- and other 


factors and the right cancer, maybe it would 


come out and, you know, we'd go with our POC 


stuff. But otherwise, I -- I'm more concerned 


about these incidents that can indeed cause 


what I would sort of intuitively feel is 


higher. 


 DR. MAKHIJANI: Right. 


 DR. ZIEMER: On the upper end of that, you 


know. I'm not comfortable with people getting 


17 rem per year. 


DR. MAURO: Dr. Ziemer, I completely agree. 


also would like to add that probably one of the 


considerations is establish precedent. That 


is, when we move forward -- you folks move 


forward, taking into consideration the 


precedent established by the decision-making 


that supports Amchitka should be part of the 


argument when we -- when we come out of the 


back end of this process. Collectively the -- 


the arguments made that obviously were 


convincing to Congress needs to be part of the 


milieu of our thinking. So I think it's 


important, Arjun, that you did put that out. 


 DR. ZIEMER: Well, and see, I think it's a good 


I 
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argument from a different perspective. I don't 


look at that number as a -- as a health issue. 


To me, it indicates lack of rad controls and 


therefore you don't have a good -- you're -- 


the site's not being management -- managed 


well. That's -- that's the kind of argument 


that would -- to me is more important in the 


long run. They're not managing their workers 


well and therefore there's reason to think 


there could be problems. That's -- that's just 


a point I would make here. 


 DR. MAKHIJANI: I -- I agree with you. I mean 


I would -- I just tried to look at that 


statement and say what are the points that were 


made. 


 DR. ZIEMER: And those were the points they 


made, yeah. 


 DR. MAKHIJANI: In my personal opinion, I think 


the failure of radiological controls is -- is 


clearly -- well, it's there in the regulation ­

-


 DR. ZIEMER: Yeah. 


 DR. MAKHIJANI: -- it's clearly and important 


thing and how -- how you define failure of 


radiological controls obviously, to some extent 

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 DR. ZIEMER: Well, there's the starting point 


right there. 


 DR. MAKHIJANI: -- might be a legal -- legal 


idea to what controls were expected. 


 DR. MELIUS: So can we come up with a way that 


would -- an approach that would allow us to -- 


what are discrete, high exposure incidents? 


 DR. ZIEMER: Well, I have another question -- 

 DR. MELIUS: Okay, go ahead. 

 DR. ZIEMER: -- that could -- maybe Jim can 

help me with this, too. On Table 5 -- and 


Arjun, I'm just trying to make sure I 


understand Table 5. 


 DR. MAKHIJANI: The Ames table? 


 DR. ZIEMER: Yeah, it's page 24 of the -- of 


the "Parsing" paper. 


 DR. MAKHIJANI: Yeah. 


DR. NETON: What page is that on? 


 DR. WADE: 24. 


 DR. ZIEMER: Page 24, Table 5, 50-year 


committed dose. 


Your final column, it's 50-year committed dose, 


rems per day of intake -- is this -- let me see 


if I understand this right. Are you saying, 

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for example, if the person were there under the 


-- under the prescribed scenario for one day, 


inhaled I guess maybe eight hours of continuous 


inhalation, then their committed dose for lung 


would be ten rem for one day of intake -- 


 DR. MAKHIJANI: Let's call the man who did the 


calculation. 


 DR. ZIEMER: -- and five for red marrow and 145 


for bone surface? 


 DR. BEHLING: Yes, and the assumptions are 


actually nine hours. I think they were 


specified in the --


 DR. ZIEMER: Oh, okay. 


 DR. BEHLING: -- the report, and there was some 


discussion that Jim and I had that the 


methodology by which this was calculated was 


perhaps a factor of up to three too high, based 


on the crude method by which alpha detection 


(unintelligible). 


DR. NETON: These are gross alpha measurements. 


 DR. BEHLING: However, that is more than 


compensated by the fact that this only includes 


thorium and it does not include radium-228, 


actinium-228, thorium-228, and radon-220. So 


when you add that back into the calculation, 

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those numbers will go up -- way up. 


DR. NETON: I'll have to look at it, but -- 


 DR. BEHLING: Yeah, they will. 


DR. NETON: -- I do -- I do remember John Pos-- 


Dr. Poston asked the question. This was 


actually 50-year committed dose -- 


 DR. BEHLING: Dose per day of --


DR. NETON: -- per -- per one day of intake, 


yeah. 


 DR. ZIEMER: So if a person was there for a 


week -- for -- for five days, for example, 


they'd get a 50 -- a 50-rem lung dose. 


 DR. MAKHIJANI: And this was a daily weighted 


average intake, so -- the way they used to do 


those surveys. You know, so many minutes in 


the lunch room, so many minutes in this kind of 


job and so (unintelligible). 


 DR. ZIEMER: When I saw these numbers, Jim, I 


was wondering if one could, for example, take 


lung cancer and some typical scenario and say 


how many days of such exposure would it take to 


get --


DR. NETON: Oh, you could. Yes, you could. 


But see, that gets to the issue of these 


cancer-specific SECs (unintelligible) -- 

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 DR. ZIEMER: I know, I know, I know. 


DR. NETON: -- didn't want to have. The Board 


actually recommended they didn't want -- 


 MR. ELLIOTT: Well, through public comment in 


the regulatory process we arrived at that. 


DR. NETON: But I would -- I would suggest -- 


we may be getting ahead of ourselves again 


here, but these are doses per organ and then, 


as I mentioned before, then we would have to 


have this three-by-three matrix 


(unintelligible) --


 DR. ZIEMER: I -- I know. 


DR. NETON: -- for is it leukemia that drives 


this as the lowest possible -- and then to come 


down to the lowest possible exposure time that 


would get you to 50 percent, we'd have to come 


up with some --


 DR. ZIEMER: Well, see, that's what I was 


thinking about when I saw these numbers, but -- 


but it's a multi-factorial array -- 


DR. NETON: I think it would be pretty easy to 


convince someone that ten days' exposures to 


thorium, if these numbers are correct, would 


more than likely get everybody over 50 percent 


for lung cancer. But that doesn't do anything 

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for the person who has leukemia or who has some 


other cancer that should be in here -- you 


know, should be lower based on some other 


combination of cancers, latencies and -- and 


risk factors. And that -- that-- I don't know 


how we would approach that. (Unintelligible) 


practical issue is how we ended up how we did, 


I think. We couldn't solve this problem 


(unintelligible). 


 DR. ZIEMER: But do you -- do you have to be 


able to show that there -- that's -- that an 


incident occurred, then, that could have led to 


high intakes like this, just -- 


 DR. MAKHIJANI: This would be a failure of 


radiological control, I would say, because you 


have -- you have dust that is very consistently 


and very largely over the established control 


limits. But this --


 DR. ZIEMER: Well, I don't know what the 


scenario was here, but I -- 


 DR. BEHLING: The issue -- no, but I just want 


to get back to what Jim was saying, the 


complexity, because when we talk about external 


dose it's an easy one to deal with because one 


external dose pretty much defines exposures to 

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all tissues that might become cancerous and 


therefore compensable. But when we talk about 


internal dose, the selection of the same dose 


becomes very critical based on the potential 


that the tissue of question is very limited 


when -- let's talk about iodine as an example. 


The dose is -- be pretty much driven -- or the 


issue will be driven by thyroid exposures and ­

- and we know that dose to the thyroid has to 


be very high in order to reach a 50 percent 


compensability level. And so there is no such 


thing as a single dose that you could point to 


and say this will be sufficient, because it's 


driven by the radionuclide when we talk about 


internal and the specific cancer that that 


radionuclide would potentially put that person 


at risk. 


DR. NETON: I'm more worried about bounding the 


low end, though. The high end, I think we can 


say -- we could get one cancer and let's say 


(unintelligible) you have a lung cancer that 


they'd be compensated. But then to bound the 


low end to give you the lowest possible 


exposure so that -- for the cancer that -- that 


-- you know, the absolutely one cancer you 

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can't reconstruct, and if you get down real low 


-- for leukemia, polycythemia (unintelligible), 


one of those type things -- I don't know that 


we can actually calculate that. You're going 


to have to take a hypotheti-- I hate to use the 


word hypothetical in front of Dr. Melius, but a 


hypothetical claimant who -- who was maybe 18 


years of age at exposure and developed leukemia 


at age 22 and was -- was exposed to very 


soluble mater-- you know, you get to all these 


machinations where you're always going to be -- 


can be challenged on that low end, what is the 


lowest level of discrete exposure that would 


bring that class in. So --


DR. MAURO: Jim, let's try to simplify. Let me 


ask a simpler question. Let's say for the 


moment we all agree that at Ames there 


certainly were -- situations existed whereby, 


over relatively short periods of time, people ­

- some people could have experienced exposures 


which could easily have been responsible for 


particular cancers. And let's say we all agree 


that that's true -- and I think we do, given 


the numbers that Hans reported there. 


 Now the ladder then becomes -- okay, let's say 

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we all agree on that. What form does the 


finding come out? In other words, let's say 


we're about to say something about Ames and 


about the 250-day. Is it -- is it something 


that we say well, yes, there certainly is a -- 


a potential for endangerment for people who 


worked there for less than 250 days. But now 


we also know something more. We know --


however, the endangerment is only limited to 


let's say certain people that were in certain 


places at certain times, and also endangered -- 


the reality is, if it was this cancer and this 


cancer and this cancer, absolutely. But in the 


case of these other cancers, not a chance. But 


I know that there's a problem with parsing to 


that level. I know from -- I guess from other 


-- from other discussions we've had, it seems 


that we all could agree very readily regarding 


let's say bone cancer and lung cancer. But in 


regard to some other cancers, we could probably 


even make a case that it's virtually impossible 


that these levels of exposures could have -- 


could have been a -- been a problem. So is 


that why you're going to the low end, so that 


you could say something about all cancers? 

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DR. NETON: You have to -- you have to be fair 


to the class. You have to -- you have to pick 


the lowest dose for the cancer that can't be 


reconstructed. I mean that's -- 


DR. MAURO: Yeah. 


DR. NETON: -- the way it works, so you have to 


-- you have to drive it to the lowest level. 


Otherwise you're not being equitable to the 


entire class. 


DR. MAURO: And as you pointed out, to do that 


is an in-- dimensional problem that -- 


DR. NETON: It's a -- it's a three-dimensional 


matrix. It's huge. 


 DR. MAKHIJANI: Maybe in some way this is 


backwards in that a problem in practice may be 


simpler than this very complicated case. So if 


we -- if we take this particular example of 


Ames, and the way the rule is written, that you 


have to be able to reconstruct for all this -- 


for now, let's just say the SEC cancers -- and 


that we cannot do it for any cancer, then 


you're in. If you apply that to the idea, not 


of the doses people got but for the potential 


for exposure and you have this one big exposure 


-- one-day intakes leading to committed doses 

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that are this high -- then you know there are 


some cancers in the -- in the SEC list of 


cancers that -- that could have been caused by 


this level of exposure. And so I think then 


you have to include everybody who was not in 


the -- if you have conditions like that, then 


people exposed (unintelligible) -- 


DR. NETON: But Arjun, the point is that the 


dose -- for internal exposures, the dose is 


directly related to the exposure duration, the 


length of a discrete incident -- 


 DR. MAKHIJANI: Right. 


DR. NETON: -- you're going to define. So if 


you define the discrete incident as one day and 


I can -- there's potentially some less exposure 


that could occur -- I'm not sure I can find it, 


but there could be a smaller length of time 


exposure that could have been -- caused some 


other cancer that should be the driver to make 


that an SEC. You don't say -- you can't -- you 


can't brack-- you can't come -- bound with a 


lower bound on that discrete exposure. 


 DR. MAKHIJANI: For practical purposes, if 


you're talking of somebody who was there for a 


few days -- I mean what's the -- in a way, 

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what's the universe of people that we're 


talking about? We're not talking about 


somebody who popped in for a few minutes and 


then went away. 


DR. NETON: Oh, I don't --


 DR. MAKHIJANI: We're talking about people who 


are employees. 


DR. NETON: When you have a thousand people in 


a class or whatever, you have that walk through 


an area for ten minutes that have -- be -- have 


to be adjudicated somehow. It's going to 


happen, and so you have to really define the 


lower bound very scientifically. Otherwise I 


don't think the case can be adjudicated 


properly. We're going to be challenged -- we 


see this all the time. I walked through the 


area to deliver the paychecks. I was there 


maybe 15, 20 minutes. So how do you --


 DR. MELIUS: But -- but I disagree with that, 


Jim, 'cause I think -- remember, these are -- 


by definition, you can't do the dose 


reconstruction. You don't have sufficient 


accuracy and so forth, so that mean-- I mean 


it's not dissimilar to the kind of decisions 


that are being made -- probably by Department 

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of Labor, in effect -- for determining who 


qualifies for the SEC at the 250-day level. 


DR. NETON: But that -- that is the level, they 


have to demonstrate 250 days exposure. I mean 


that's (unintelligible) -- 


 DR. MELIUS: Yeah, but -- but -- but -- 


DR. NETON: -- in the regulation. 


 DR. MELIUS: -- the job class-- there's job 


classification issues and -- 


DR. NETON: Sure. 


 DR. MELIUS: -- so forth and -- that probably ­

- I mean I'm not -- I think if we try to find ­

- search for too much precision here, we're 


fooling ourselves in terms of the nature of the 


information and it -- it -- 


DR. NETON: Well --


 DR. MELIUS: -- I mean I understand your 


theoretical point, but -- but you know, mak-- 


making a cutoff, whether it's a week or a month 


or -- or a day is something that just ha-- you 


know, nature of the way it has to be done. 


DR. NETON: Oh, I know. I agree. I think it 


has to be solved technically because 250 days 


is cast in concrete. That's not debatable. 


That's part of the rule so Labor can -- Labor 

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can use that. When we define the length of 


duration that would allow you to be a member of 


the class, then it has to be based on some sort 


of scientific analysis that would, you know -- 


 MR. KATZ: Can I --


DR. NETON: -- well, if you want to change the 


rule. Right now it's a qualitative thing. 


It's really either very high, like a 


criticality, or it's 250. 


 DR. MELIUS: Yeah, but we're --


DR. NETON: Now we're trying to go to the other 


extreme to -- well, let's define the time. 


What is the duration? 


 DR. MELIUS: Yeah. 


 MR. KATZ: I'm sorry, this is Ted Katz from -- 


from Atlanta. I just -- it -- it's sounding a 


little confusing to me where you're going with 


this, Jim, because if it's not 250 days, you're 


not defining a period of time whatsoever except 


for the period of time over which the incident 


occurred. 


DR. NETON: Exactly. 


 MR. KATZ: That's it. 


DR. NETON: That's what I'm saying, though, 


with the de-- if the incident occurred -- if it 

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was a chronic exposure situation like we're 


talking about at Ames -- I mean this was a 


airborne cloud over a period of days -- the 


question is, what is the lowest period of time 


of that incident that would get someone in the 


class. 


 MR. KATZ: No, I think the question is what is 


the period of time over which that cloud 


existed. 


DR. NETON: Well, it could be anywhere from 


five minutes to five days, say. 


 MR. KATZ: Well, if it was five days, then -- 


then the class would be defined as anyone who 


was present for any amount of time within those 


five days during which the cloud existed. 


DR. NETON: Any period of time. 


 MR. KATZ: Any period, 'cause -- because the 


standard is presence, not -- not a duration. 


So anyone who walked through or who was there 


the entire period during which the incident 


occurred would be part of that class. 


 DR. ZIEMER: But you have to know when that 


incident occurred. 


 MR. KATZ: Exactly. 


 DR. ZIEMER: Now, what about a site at which 

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unknown incident have occurred and we don't 


know when or where? I think is -- is part of 


what we're trying to grapple with here, aren't 


we? 


 DR. MELIUS: I think we're more like the other 


end. We're going to have known incidents and 


not know where people were or -- or -- in rela­

- I mean so I think it's going to be the 


location issue that's going to be the -- the -- 


the thing and the... 


 DR. ZIEMER: Seems to me that's a little 


easier. I mean if -- 


 DR. MELIUS: Yeah. No, I mean I agree. I 


think that can be dealt with. 


 DR. ZIEMER: -- (unintelligible) prove that 


they were somewhere else, then you assume maybe 


they were in it. 


 DR. MELIUS: Yeah, and you may have to define 


it within -- yeah. 


 DR. ZIEMER: Is that really going to be the 


driver, known incidents but we don't know where 


the people are? 


DR. NETON: Well --


 DR. MAKHIJANI: Well, that's why you can't 


calculate the dose. Right? If you say you 

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can't calculate the dose -- 


DR. NETON: Yeah. 


 DR. MAKHIJANI: -- then -- that's how I 


understood --


 DR. ZIEMER: Well, I thought we were talking 


about the possibility of unknown incidents 


occurring. 


DR. NETON: No, at least --


 DR. MAKHIJANI: I'm not. 


DR. NETON: We'd have to establish an incident. 


DR. MAURO: I think -- this is John Mauro. I 


think something important just happened now, 


though. Namely, with the help of Ted, what 


we're saying is we've almost solved the Ames 


question. I hate to leap like this, but what 


I'm hearing is we all agree that there were 


conditions at Ames where the airborne dust 


loadings over some period of time were clearly 


and unambiguously at levels that endangered the 


health of the workers, and that this period of 


time was relatively short. So in effect --


DR. NETON: I don't know if we've agreed to 


that yet, John. 


DR. MAURO: Okay, that's --


 DR. ZIEMER: (Unintelligible) suppose that were 

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the case. 


DR. NETON: (Unintelligible) 


DR. MAURO: -- why I didn't want to leave that 


'cause I thought we were close to something 


here and I (unintelligible) walk away from it. 


 DR. MELIUS: Don't leap yet, John. 


DR. MAURO: Okay. 


 DR. WADE: (Unintelligible) discussion 


continue. 


 DR. MELIUS: Either that or go to the first 


story. 


DR. MAURO: No, I actually wasn't leaping, 


that's why I was doing this. I felt as if we 


were making -- we -- something important 


happened on Ames in terms of trying to come to 


grips with -- see, Ames turns out to be a lot 


simpler problem and -- and to allow us to 


explore the philosophy and strategy that we're 


-- we're engaged in here and -- and we were 


making -- and some important things were said 


and I was hoping that we could keep it going 


that way to see if we could start to achieve 


some consensus. Ted said something very 


important. It was the fir-- that is, the time 


-- once you've established that such conditions 

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exist over some time period -- let's say it's 


five days and that -- that -- the fact that a 


person was there for a very short period of 


time is really not one of the criteria. If he 


was there and the conditions existed, then what 


we have is a person that would fall into that 


class. Now that's what I was hearing. 


DR. NETON: I don't necessarily agree with 


that, and maybe --


DR. MAURO: Okay. 


DR. NETON: -- maybe we need to talk, you know, 


among our NIOSH folks here on the side 


eventually, but mere presence alone, just 


walking through this incident, would not give 


you a dose that was exceptionally high, similar 


to a criticality. That -- I guess that's where 


I was going with that. You -- there's got to 


be some minimal duration of exposure that would 


be considered to be exceptionally high. But --


that's what I'm trying to say, you -- 


DR. MAURO: That's why I'd like to stay with 


this a little longer because it's -- we're -- 


we're -- we've got a very well-bounded issue 


that has very real implications, at least for 


Ames --

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DR. NETON: Yeah. 


 DR. MAKHIJANI: -- and -- and if we -- if we 


could -- see, if we can't deal with this one, 


if -- you know, essentially this is a -- this 


is about a simple issue that we can -- can 


engage in in terms of trying to come to grips. 


It's much simpler than let's say some of the 


issues that we're going to encounter on Nevada 


Test Site, so that's why I guess I -- I'm 


feeling enthusiastic about continuing with the 


Ames discussion, with some hope of getting some 


-- at least tentative consensus on, you know, 


what -- what is the right way to come at this 


problem. 


DR. ROESSLER: It seems to me, though, we're 


right back at the beginning, because now we're 


going to have to define an incident. 


 MR. GRIFFON: Yeah, I agree. 


DR. ROESSLER: Wasn't that -- wasn't that our 


original problem? 


 DR. MELIUS: And I think that's the crux of it 


DR. ROESSLER: Yes. 


 MR. GRIFFON: I agree. 


 DR. MELIUS: -- that there -- what -- what kind 

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of an incident fits the definition we have in 


the --


 DR. BEHLING: I think that Ames really -- John 


-- for John's sake, Ames really has two 


components to it. There's the particular bombs 


that went off, which are discrete and very -- 


and have a very finite duration for exposure. 


And if you look at the report again, there was 


cartoons about the five secretaries that were 


ushered back in and encouraged to resume their 


job as secretaries -- who were potentially 


exposed during those explosions. That's one 


event. 


The other is where -- where we talk about air 


concentrations. Those were assumedly steady-


state conditions because there were air -- 


random air samples taken at various job 


locations and they have no finite period. When 


we talked about it, we did effective dose for 


one day of exposure. That essentially can be 


assumed to have continued for long, long 


periods of time so if a person reported for 


that job day after day after day, that exposure 


would have been continuous. 


DR. NETON: That's why it's an SEC class. 

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 DR. BEHLING: It's a sample. It was done --


the AEC came down and said here we are, we're 


going to do some spot samplings, and they 


weighted it. It wasn't even for eight hours, 


it was for the duration that a worker worked 


that location. 


DR. NETON: But then --


 DR. BEHLING: And so these are reasonable 


assumptions. 


DR. NETON: -- to make the leap that this went 


on for months. We don't know that. That's the 


point, we don't know the upper bound 


(unintelligible) --


 DR. BEHLING: Well, (unintelligible) can 


certainly conclude that based on the production 


quantity and assuming that the potential work 


that was done at a given location was basically 


one that was in a steady state mode. 


 DR. MAKHIJANI: I -- I think one -- one maybe ­

- one point might be discussed is the -- the 


idea -- the concept is excessive, which is that 


-- essentially argument between Hans and Jim is 


how many days (unintelligible), and the concept 


I'm holding forward is the potential for 


exposure, not actually getting into what the 

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exposure was 'cause you already decided you 


can't calculate the exposure. I agree with Jim 


there. So you don't know what the radiological 


conditions were from a three-day survey in 


March, 1952. But you know from the 


descriptions of the events that those kinds of 


conditions existed, even though we can't put a 


number on it. You can't calculate individual 


dose, but you can infer whether the conditions 


were similarly dangerous, and so -- or risky or 


the potential existed for similar doses so you 


can actually arrive at an endangerment decision 


based on presence during incidents or presence 


during those workdays. And I think this is an 


important distinction because we keep going 


back and forth between can we arrive at a dose 


number. And the way I thought about this in 


parsing the rule is really the focus should be 


on potential for exposure for those who worked 


for less than 250 days. 


DR. ROESSLER: Is there a -- Jim talks about 


there is external dose or there are external 


measurements. 


DR. NETON: For which site? 


DR. ROESSLER: Well, I don't know. Is this --

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is this --


DR. NETON: Oh, at NTS we have considerable 


(unintelligible). 


DR. ROESSLER: -- is this true acro-- if this 


is true across the board, is that a measure 


then? And it wouldn't be very exact, but is 


that some sort of measure of what the total 


dose would be? 

UNIDENTIFIED: Not combined with the internal. 

DR. ROESSLER: Yeah. 

UNIDENTIFIED: That's the problem. 

DR. NETON: I think we've identified an issue 


here with what I would call chronic exposure 


for internal and trying to fit that into the 


definition of a discrete incident that's in the 


regulation, and there seems to be a disconnect 


here because, you know, if the -- if a chronic 


exposure occurred over three days 


(unintelligible) say just walking through the ­

- through that area is enough to get a -- an 


exceptionally high level exposure. That's the 


problem I'm having -- an issue. 


DR. MAURO: But Jim, what happens if you say -- 


if you describe it in a different way. Say 


listen, we know that there was a time period 

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which could have lasted many months, maybe even 


many years, where the concentration in the air 


spiked to very high levels for some relatively 


short periods of time because of these bombs. 


So we know that at this facility, let's say 


this particular building, over this time period 


-- which could be many years -- that there were 


scenar-- situations where people could have 


been exposed to very high levels for relatively 


short periods of time. We don't know who those 


people were. We don't know what their exposure 


durations were. But one thing we do know is 


the scenario's very real. So anyone that -- 


who worked in that facility, that building, no 


matter what time period -- duration -- but they 


were there and did go into that building meet 


the criteria of endangerment. So in a way, 


what I just described is something that avoids 


all of these -- what I would call more precise 


issues that we'd like to address, but there's 


no doubt what I just said is probably true. 


That is, if there -- that you -- if you -- if 


you worked in that building doing your job 


during this time period, it's -- there is a 


very real possibility that you were exposed to 

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an uncontrolled high level of airborne thorium 


for some period of time that would be 


considered endangerment. 


Notice I just said that without even saying 


what the doses were, what the time periods were 


or who the people were. All I said was that -- 


that certainly that scenario existed. Is that 


enough -- is that enough for -- for a decision 


to be made on how to deal and grant let's say 


the petitioners' request for compensation of 


people who were at Ames less than 250 days? 


DR. NETON: I don't know. I mean we'd have to 


look at the definition of the class. 


DR. MAURO: But did you see what I ju-- did I ­

- see, in -- in effect, I just did that. I 


threw -- I'm throwing sort of like the gauntlet 


down. 

DR. NETON: Well, I don't know what you did. 

DR. MAURO: Why -- why couldn't that be it? 

DR. NETON: The way you described that, to me, 

is anybody who ever worked there, walked 


through the plant, is in the class. 


DR. MAURO: That -- during that time per-- 


during a given time period and a given 


building. 

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DR. NETON: Right. 


DR. MAURO: Yeah, that -- that -- I'm putting 


that down as something to shoot at. 


DR. NETON: Yeah. 


DR. MAURO: Why couldn't -- why wouldn't that 


make sense, to define it in those terms? 


DR. NETON: Well, as a health physicist, would 


you believe that someone who walked through a 


building for five minutes had an exceptionally 


high level of exposure or even had a reasonable 


potential to get 50 percent POC? I mean --


DR. MAURO: I agree with that. I would say 


you're absolutely right, because if it's only 


five minutes -- but the -- the problem -- to 


get to the level you'd like to get at -- let's 


say you did say well, we know it's five 


minutes. Well, that's just equally impractical 


because how do you determine if a person was 


there -- you know --


DR. NETON: I agree with that. 


DR. MAURO: -- for less than five minutes, you 


know. So I think that the -- even if we knew ­

- even if we were to solve for that time, it 


doesn't help us make good decisions. 


DR. NETON: Well, I think at some point, 

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though, you would have to refine the class 


definition for the -- and this is what I 


started off the day with -- for those less than 


250 days, you'd have to somehow, if possible, 


more narrowly define that class. If it is only 


workers who worked in the thorium area that had 


these exceptionally high -- 40, 50, 100 -- MAC 


air samples. Now whether that can be carried 


out by the Department of Labor is another issue 


because we always have to be sensitive to them 


being able to administer that class. 


 DR. MELIUS: Well, but on the Nevada Test Site, 


I think what I hear you're saying, Jim, is that 


you can -- we can do external dose, but for 


internal dose, we can't. And so you're saying 


then for -- if the internal dose is only for a 


day, you can't calculate it, so theoretically 


you could have somebody in -- you know, their 


external dose gets them to 49.99 percent -- you 


know, that increment of internal dose could put 


them over --


DR. NETON: That's another issue when you start 


adding the internal back to the external -- 


 DR. MELIUS: No, I know, that's --


DR. NETON: I don't know how to deal with that. 

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 DR. MELIUS: -- that's another complication to 


this, and yet it seems to me that, you know -- 


now if we could -- if you can say you can 


estimate it 'cause it's a shorter time period 


or there's some way of bounding it that you 


couldn't do for a longer time per-- I mean I 


don't know what -- how you -- 


DR. NETON: I don't know. I mean once you 


start adding the external plus the internal, 


that adds another dimension. 


 DR. WADE: Just for a moment -- has Mark 


identified himself as being on the line? Mark, 


are you --


 MR. GRIFFON: Yeah, yeah, I'm here. I -- I 


just -- and I'm -- I'm listening. I -- I also 


feel that -- I -- I was sort of leaning toward 


Ted's -- you know, the -- the notion of 


presence because I'm -- I'm grappling with this 


-- this is really deja vu, though, this whole 


discussion, but --


DR. NETON: It really is. 


 MR. GRIFFON: -- I'm grappling with this -- 


this notion of -- you know, if you try to 


define that time frame, Jim, I think you're -- 


you know, you're -- you're down to -- I -- I'm 

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drawing out your 3-D matrix here on my scrap 


paper, but you know, we're back to -- 


 DR. ZIEMER: I think it's actually 4-D. 


 MR. GRIFFON: -- well, if you can do all that, 


then you can -- you can calculate a plausible 


upper bound. I mean you can estimate -- you 


can quantify intakes. And the point of all 


this is that we can't quantify the intakes so 


that sheer presence -- but I would say that 


presence of a -- then, you know, we've got to 


define -- then we're back to defining discrete 


incident. 


DR. NETON: Exactly. 


 MR. GRIFFON: And how do you define discrete 


incident? It's got to be sort of a qualitative 


definition, I guess, because -- 


DR. NETON: Right. 


 MR. GRIFFON: -- you know, we can't give it a 


rem -- you know, we can't -- because of the 


points you made earlier, we can't quantify 


that. 


 DR. ZIEMER: Currently the way -- the way the 


reg is written, it already talks about discrete 


incidents and presence, doesn't it -- presence 


during a discrete incident? 

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DR. NETON: Yeah. 


 DR. ZIEMER: That's already in the reg. 


 MR. GRIFFON: Right. 


 DR. ZIEMER: So you don't have to sort of re-- 


we don't have to come up really with a new 


definition, as long as we're not dealing with 


this steady-state thing and trying to change 


those days. 


So then it -- then it boils down to two things. 


One is, can -- how well can you define the time 


frame for the incident, 'cause then presence 


becomes pretty clear-cut. And I thought I 


heard you saying you -- somebody's got to 


establish that the incident occurred, either 


through affidavits or something. Right? Or --


or external evidence of some sort. And -- and 


if an incident is defined -- I mean if it's 


agreed that it has occurred, you usually put a 


boundary on it probably occurred between this 


day and this day? 


DR. NETON: Right. But the problem with that 


is, though, when you get to places like Ames, 


we're not talking about discrete incidents 


anymore. We're talking about -- 


 DR. ZIEMER: A steady state. 

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DR. NETON: -- chronic operations, steady 


state. 


 DR. BEHLING: Well, we have two things. We 


have --


DR. NETON: Well, you've got the bombs, but 


let's -- let's -- that aside, 'cause that's 


more easy to deal with, I think. But when 


you've got a --


 DR. ZIEMER: I mean if -- if it's a -- if it's 


a steady-state thing, you're into the other 


category. If it's a discrete incident -- 


DR. NETON: Well, not necessarily, because Hans 


is pointing out here that you've got a 145-rem 


bone dose for one-day exposure of a -- of a 


chronic situation that could have persisted for 


months. 


 DR. MAKHIJANI: And most of that exposure would 


come from maybe half an hour or an hour 


exposure. 


DR. NETON: It's not really an incident at this 


point; it's a chronic plant condition that 


we're (unintelligible) define at what point is 


it less than 250 days to grant a status 


(unintelligible) --


DR. MAURO: But Jim, this is John, let's think 

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about if -- I'm a worker. I worked -- I worked 


at Ames. Okay? And I developed lung cancer. 


And -- and I -- and I say to mys-- I tell you, 


tell everybody there before the Board, listen, 


you know, I was there -- I don't know how long 


I was there, but it was certainly less than 250 


days. I wasn't there for -- but it was 


actually -- but I did spend time. I don't even 


know how much time, but I could demonstrate 


that I spent some time in this building, this 


building that we have data for that says the 


concentrations at some times for some unknown 


duration were very, very high, such that it's 


plausible that I could have experienced a dose 


to my lungs that was more than sufficient to 


give me a PC of .5. I mean let's say that's 


all I could say, and I'm a worker now. I'm 


thinking of myself. And then you come along 


and you tell me well, I'm sorry, there -- you 


know, we're not going to compensate you because 


we -- you know -- the answer is no, of course 


you have to compensate that person. I mean for 


a practical, common-sense point of view, that 


person who could demonstrate to you that he was 


there for some time period, even though it was 

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uncertain, but you know -- we know that the -- 


that there were time periods, whether due to 


bombs or due to chronic, were very, very high, 


where thousand -- where it's not impossible a 


thousand rem to the lung could have occurred. 


It's very plausible. What happens if you -- if 


you folks all agree that it would on-- that it 


would be fair to compensate this guy, don't -- 


what we have here is it -- is we -- we avoid so 


much of trying to over-analyze, we -- we could 


-- we know that there were scenarios that -- 


where the exposures for less than 250 days for 


people who were present there could very well 


have resulted in endangerment. Once we know 


that, aren't -- are-- and don't we then know 


that there are people, at least some people, 


who should be compensated even though they were 


there for less than 250 days? Doesn't that 


greatly simplify what we're trying to do here? 


Isn't that the only question we have to ask 


ourselves: Are we being fair to the people who 


were there for less than 250 days and have come 


down with a specified cancer? And we have to ­

- and -- and we have to just make that judgment 


on a site-by-site basis whether or not we 

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believe for this site there were conditions 


such that -- and I think that Ames clearly, in 


my mind, falls -- that's why I keep sticking to 


the Ames case, because Ames brings us to a 


place where there is no argument that potential 


existed. And once -- once you have that, that 


the potential existed and there are very real 


scenarios that could have occurred that we all 


agree to, then I think that would solve the 


Ames problem. 


Now that sort of gives us a path -- if we 


accept that, if you buy my premise that I just 


said, then -- then we have a path, can we do 


the same thing at more difficult sites where -- 


where we don't have as good information 


regarding the magnitude of the doses. You 


know, for example, now we're at -- then we move 


off to Nevada and we say well, wait a minute, 


you know, Nevada may -- the problem there is we 


don't have scenarios where the doses were a 


thousand rem to the lung, could have been a 


thousand rem to the lung or the -- or to the 


bone marrow. We have doses that are on the 


order of tens at -- at top end. So all of a 


sudden we're asking ourselves questions that 

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are more semi-quantitative, more qualitative, 


on a case-by-case basis, which becomes a 


manageable problem. I think, Jim, you would 


like to come up with some formulization which 


is quantitative, bright lines. I don't think 


that's -- I don't think that's going to work. 


I think the line of argument that -- and what 


triggered this in my mind was when -- when Ted 


mentioned this -- it became clear to me in the 


case of Ames. I'm -- listen, I'm just putting 


this on the table for consideration, but it's ­

- that is the -- that sheds a lot of light on 


how do you deal with this problem, and it 


becomes one of these common-sense arguments 


that you deal with on a case-by-case basis when 


you look collectively at that facility and the 


scenarios that you believe are real and that 


real people may have been put in that position. 


DR. NETON: Well, John, I think you just 


basically restated what our regulation says. 


mean that's how it sounded. 


DR. MAURO: I -- I -- but I mean -- but -- 


DR. NETON: And I wasn't trying to force us 


into some complicated formula. What I was 


trying to point out was the difficulty in 


I 
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picking -- picking these limits, these values 


like 100 rem, 50 rem -- you know, we're 


throwing out all kinds of values, and I said 


you've got to be careful when you do that 


because --


DR. MAURO: What -- what I'm saying -- don't -- 


don't -- well, maybe we don't have to pick 


those -- a dose. 


DR. NETON: No, I (unintelligible) -- 


DR. MAURO: All we have to do is say do we 


think that the situation existed. Now the 


answer is yes at Ames. 


DR. NETON: But here's -- here's the scenario, 


though. Now you've got a regulation that says 


we have to determine that an exposure occurred 


that was an exceptionally high exposure, 


similar to criticality. That's the -- that's 


the test. That's the qualitative test that we 


have to apply here. 


 DR. BEHLING: You -- you only -- however, 


that's an incomplete statement. If you look at 


the regulation, it does say -- involves 


exceptionally high levels of exposure, such as 


nuclear criticality incidents or events 


involving similarly high levels of exposure 

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resulting from the failure of radiation 


protection controls. 


DR. NETON: Right. 


 DR. BEHLING: That's the second half. 


DR. NETON: Right. 


 DR. BEHLING: And at Ames, you have both of 


them. You have the explosions, which are 


similar to a criticality accident; and you have 


a failure of radiological controls. 


DR. NETON: I agree, so the only test to apply 


then is are those exposures -- do those 


exposures at Ames meet that test. 


 DR. BEHLING: I think they meet --


DR. NETON: That's the question. 


 DR. BEHLING: -- both criteria. 


DR. NETON: (Unintelligible) 


 DR. BEHLING: (Unintelligible) the criticality 


criteria and the failure of radiological 


controls is clearly evident by not meeting the 


70 MACs. You had 3,100 dpm per cubic meter and 


those two criteria are clearly met. 


DR. MAURO: And I -- and I'll go a step 


further. Notice we didn't have to talk about 


what's the lowest dose they got at Ames. What 


we had to do is ask ourselves is it plausible 

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that someone could have gotten a dose that was 


-- that reads what we believe to be an 


endangerment. Now we're -- we're sort of lucky 


in a way here because we didn't have to specify 


what that threshold is. All we had to do is 


take a look at what happened at Ames and 


everyone says oh, my God, yes, of course that ­

- that existed at Ames. Notice a decision 


could be made regarding Ames without talking 


about the threshold dose that triggered it. 


DR. ROESSLER: But you're only talking about 


one place, and aren't we here to set some sort 


of criteria, some sort of definition of a -- an 


incident so that when we look at everything, 


it's done with fairness? I think that's our 


objective. 


DR. MAURO: But I -- but I think that using 


Ames is a stepping stone now. I mean it -- I ­

- I -- it -- if the scenario that I just 


described, the definition of -- that I just 


described is found to be something that -- that 


intuitively you feel is -- is the fair way to 


deal with Ames, then the question becomes to 


what degree can we now use that as a stepping 


stone in the way we think about it to apply to 

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Nevada Test Site. And -- and now of course 


we're going to have to struggle with it and ask 


ourselves the same questions that we asked 


ourselves to get to where we got to on Ames 


where we ask ourselves now okay, how do we use 


that experience that we all -- if we do agree 


on it, now let's try to apply it to Nevada Test 


Site. And where is the challenge in trying to 


do that? Can we do it? That's why I kept 


trying to stick to Ames and maybe if we could 


solve Ames, we -- we have a step -- a stepladder upon which to move on to solve the more 


difficult ones. 


 DR. ZIEMER: John, this is Ziemer. You -- you 


did put some parameters on there, though, maybe 


unknowingly. But you specified although it was 


less than 250 days, that it was a fair number 


of days. Like it wasn't one day. 


DR. MAURO: Yeah, I -- I -- I -- well -- 


 DR. ZIEMER: But see, if we use the current 


definition, it's got to be -- you -- you can't 


-- you can't have it both ways. It's presence 


-- how does it state, presence -- 


DR. NETON: Presence --


 DR. ZIEMER: I want to use Ted Katz's --

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 DR. MAKHIJANI: The presence of potential 


exposure during discrete incidents -- 


 DR. ZIEMER: Yeah, presence during discrete 


incidents --


 DR. MAKHIJANI: -- rather than --


 DR. ZIEMER: -- would allow --


 DR. MAKHIJANI: -- qualified duration of a 


potential --


 DR. ZIEMER: You -- you can't really say well, 


I've got to have worked there a certain number 


of days, then. Right? 


 DR. BEHLING: But doses for discrete incidents, 


and I think we have to separate discrete 


incidents as in the case of Ames, with the 


second have, the failure of (unintelligible) -- 


 DR. ZIEMER: That's what -- that's what I was 


getting at, is Ames simply a chronic thing with 


high exposures where you can actually do dose 


reconstructions or isn't it? See? It -- we 


either know it or we don't know what those 


levels are. 


 DR. BEHLING: Well, we know for one moment in 


time when the air samples were taken -- well, 


actually three days that the AEC conducted 


their survey measurements, but certainly it 

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would suggest one thing: If you do do it, then 


a person with even a week's period of -- of 


exposure at these work stations would have 


accrued a dose that would clearly be 


compensable for at least three cancers that we 


know of. 


 DR. MAKHIJANI: I have -- I have a question 


about this long sentence in the rule and what 


it means suddenly, from the way that Hans read 


it. It says (Reading) Exceptionally high 


exposures, comma, such as nuclear criticality 


accidents --


DR. NETON: Incidents. 


 DR. MAKHIJANI: -- incidents or other events 


involving similarly high levels of exposures 


resulting from a failure of radiation 


protection controls. 


Now I have to admit, the way I read it, I read 


those two things as separate -- 


 DR. MELIUS: No --


 DR. MAKHIJANI: -- examples. 


 DR. MELIUS: -- they're not. They're not. 


 DR. MAKHIJANI: High levels of exposure, so 


high levels -- exceptionally high exposures 


would apply to both of them. 

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DR. NETON: Yes. Yes. 


 DR. MAKHIJANI: Yes, but -- no, no, I agree to 


that because that's where the comma is. 


 DR. MELIUS: They have to be discrete. 


 DR. MAKHIJANI: (Unintelligible) exposures 


apply to both of them. But the second part I 


read as being applicable to the kind of 


situation described at Ames because it did-- 


high levels of exposure occurring from a 


failure of radiological protection controls. 


 DR. BEHLING: I don't see why discrete is 


(unintelligible) --


 DR. MAKHIJANI: I didn't think that both things 


were necessary to be present, but if high level 


-- exceptional exposures for a failure of 


radiological controls or from an incident. 


DR. NETON: No, no, no, no, no, no, it's not -- 


 MR. ELLIOTT: It's descriptive --


 DR. ZIEMER: It is the incident. 


 MR. ELLIOTT: It's descriptive of the incident. 


 DR. MELIUS: It has to be a discrete incident. 


DR. NETON: A discrete incident with high level 


of exposure from loss of radiologic controls. 


When you had a nuclear criticality incident, 


you also had loss of radiologic controls -- 

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failure of radiologic controls. 


 DR. BEHLING: Well, the fact that we're talking 


about -- again here, we're talking about 


discrete inci-- or events. We're already 


talking about multiple things. An event is a 


discrete issue, but events is plural. I just 


can't understand why the issue of a discrete 


element has to be part of the failure of 


radiologic controls. If it's a chronic, 


serious problem that renders a person exposed 


to high levels -- I'm not talking about 


minutes, seconds, like a pulse of 


(unintelligible) neutron gamma ray exposure 


from a nuclear criticality accident. We're 


talking about a short period of time, but 


certainly more than seconds, minutes, or even 


hours and -- and I read that second sentence 


for the -- to -- to apply to that kind of 


condition, failure of radiological controls. 


DR. NETON: But it would have to be a defined 


incident. 


 DR. BEHLING: Well, if it's a chronic problem ­

-


DR. MAURO: Let's -- let's -- let's talk about 


that a little bit --

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 DR. MELIUS: No, let's not. 


DR. MAURO: -- it seems very important -- 


 DR. MELIUS: John -- John, let's not talk about 


it. We're going to take a ten-minute break. 


DR. MAURO: Okay. 


 DR. WADE: Can I just -- going into the break, 


again, remember the Secretary will make 


decisions based upon the regulation, based upon 


the rules. The Board needs to think about that 


as it makes its recommendations. Now the Board 


could also say to the Secretary we think the 


rule needs to be modified in some way. And 


again, all those options are available to you, 


but again, the Secretary will make his 


decisions based upon the rule as it's written. 


 (Whereupon, a recess was taken from 10:03 a.m. 


to 10:21 a.m.) 


 DR. MAKHIJANI: (Unintelligible) you on, Kathy 


DeMers? 


 MS. ROBERTSON-DEMERS: Yeah, yeah, I am. 


 DR. MAKHIJANI: What document did you read to 


me on the phone? 


 MS. ROBERTSON-DEMERS: It was the test managers 


authority letter for Project Nougat. 


 DR. MAKHIJANI: Jim, could you have -- I'm not 

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sure I wrote all the words down accurately 


'cause I had the phone (unintelligible) like 


that. Could you have -- would it be 


appropriate to have Kathy read that definition 


(unintelligible) --


 DR. MELIUS: Yeah, let me just get -- we need 


to go back on the record and -- 


 DR. WADE: Yeah, we need to go back on the rec­

- now again, I would ask for Board members 


present on the call to identify themselves. 


 (No responses) 


Mark, are you with us? 


 (No responses) 


 DR. MELIUS: He has (unintelligible). 


 DR. WADE: He will be again. 


 DR. MELIUS: Yeah. 


 DR. WADE: Mark, I don't know if you're muted. 


Are there any other Board members on the line? 


We do have Wanda Munn in the room with us. We 


are still under quorum so we can continue our 


business. You can stay, Wanda. We want you to 


stay. 


Okay, we're back on the record then. 


 DR. MELIUS: And Arjun was -- Kathy, do you 


want to read that -- identify the document and 

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read that phrase or whatever. 


 MS. ROBERTSON-DEMERS: Okay. Just let me kind 


of give you some background. 


 DR. MELIUS: Yeah. 


 MS. ROBERTSON-DEMERS: When we go to each site, 


over time they've established limits or action 


levels where they will consider something an 


incident, and those action levels in the early 


days are quite large compared to what we would 


tolerate right now, so you need to consider, at 


each facility, what they defined as an 


incident, because anything below that will not 


be called an incident. However, we may call it 


an incident in the perspective of today. 


And what I had found was the test managers 


authority report from Operation Nougat, and it 


was dated 1961. And this is how Nevada defined 


an incident. 


 (Reading) The term "incident" has been 


understood by NTS organizations to cover those 


situations of unexpected or accidental types of 


overexposure and not situations where minor 


exposures in excess of normal working levels 


have been required to accomplish the necessary 


required objective when considered justified by 

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the project or test manager. 


So anything that isn't called by -- by the 


Nevada Test Site an unexpected or accidental 


overexposure would not meet their threshold for 


incidents. And when we go and we examine 


records, we normally have them pull the 


incidents. But we have to keep that in mind 


because there may have been incidents that were 


not documented because they didn't reach the 


criteria of the site at the time, which was 


quite high. And I just wanted to bring this up 


and have you guys keep that in the back of your 


mind as you're having this discussion. Each 


site tends to have different incident 


thresholds, and I think it's important in the 


consideration of incidents that potentially 


were not identified. When you have a large 


incident at a DOE site, it's typically 


documented. However, something right below 


that threshold will -- will not be documented. 


 DR. MELIUS: Okay, thank you, Kathy. I thought 


that rather than continuing our Ames debate 


that we try to go back and sort of think about 


an approach -- and Arjun and I talked a little 


bit at the break and so forth and -- that -- 

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that maybe one ap-- I think the critical thing 


is how do we sort of come up with some way of 


categorizing or recognizing what are discrete 


incidents that -- that sort of fits the 


definition and the -- the regulation. And if 


there may not be sort of a single criteria for 


that, you know, number of rems or whatever, but 


-- but rather than maybe a set of criteria that 


we would want to look at in evaluating those -- 


tho-- those situations that may include a -- a 


number of -- of different factors and, you 


know, dose rate, the nature of the incident, 


absence of radi-- normal radiation controls and 


so forth and that what we could do is sort of 


develop a series of sort of those general 


criteria as the way of -- of evalua-- of 


evaluating the incidents that we would 


encounter at -- at particular sites, but it 


would still be a judgment on that particular 


in-- incident. And I was just wondering what 


people's reaction was to that sort of an 


approach, that -- that if we -- that that will 


give us a place to start from, and then -- then 


there would be, you know, the issue of how that 


-- how that would qualify and then how you 

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actually implement -- implement that in terms 


of health endangerment and so forth. Paul? 


 DR. ZIEMER: I like the concept of doing that, 


and I would suggest that maybe it would be 


useful if we got a number of ideas on the 


table, without necessarily have to agree or 


disagree to them right now, but get some 


different perspectives on this and -- and 


starting with the fact that what DOE defines as 


an incident now is not what we're talking 


about. DOE typically will define anything as 


an incident where it's outside of a management 


control. 


 DR. MELIUS: Yeah. 


 DR. ZIEMER: If you exceed a dose limit without 


going -- I mean there are -- there are ways you 


can exceed dose limits in DOE, and even with 


NRC, if you do certain management things. But 


in any event, it -- it's not the same 


definition anyway that DOE uses so -- 


 DR. MELIUS: Right. 


 DR. ZIEMER: -- again, this is more like an 


event or something. 


 DR. MELIUS: Yeah, I think -- yeah, I -- 


 DR. ZIEMER: It's a -- it's a high-dose event, 

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but I like the idea of getting the parameters 


down and then we can look at those and see if 


they make sense. 


 DR. MELIUS: This'll be sort -- how do we judge 


if it's a discrete incident likely to have 


involved exceptionally high exposures, and then 


-- you know, there's some other qualifications 


there, but I think it was -- sort of -- how the 


working group would -- would approach this is 


let's do what Paul suggested, you know, talk 


about -- about different things, put some ideas 


out there, then ask SC&A to sort of take those 


ideas and -- and suggestions and come back to 


us with a -- you know, a -- maybe it's a one-


page or -- I don't know, how long it -- it 


wouldn't be very long, that would try to 


capture those in some sort of coherent way that 


would -- that could be operationalized for 


look-- looking at -- looking at such incidents, 


and then -- then as we progress through -- you 


know, two ways. One, can we come to an 


agreement on that, and then secondly, how do we 


apply that in -- in some of the situations in 


front of us such as, you know, Nevada Test Site 


and so forth -- makes sense. Is that -- Jim 

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and Larry, does that make -- helpful from your 


point of -- point of view? 


 DR. WADE: Administrative detail -- on the 


phone we're getting an awful lot of background 


noise from people clanging dishes to blowing 


their nose, so if you could mute. 


 MR. ELLIOTT: Yeah, that sounds... 


 DR. MELIUS: Okay. 


 MR. ELLIOTT: (Unintelligible) 


 DR. MELIUS: Actually try to give someone an 


excuse not to do the dishes, so -- okay, who 


wants to start? Go ahead, Paul. 


“HEALTH ENDANGER ASSESSMENT FOR NEVADA TEST SITE
 

SPECIAL EXPOSURE COHORT”
 

 DR. ZIEMER: Let me start with one I think 


probably won't be very controversial, but any 


incident that results in non-stochastic or 


deterministic effects; i.e., clear blood 


changes or -- it's basically the standard 


radiation high-dose effects. 


 DR. MELIUS: Yeah. 


 DR. WADE: Others? 


 DR. MELIUS: Arjun, you rattled off a... 


 DR. MAKHIJANI: Well, I was thinking of some of 


the data from Nevada Test Site where there were 


situations with quite high dose rates, and we 

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know that there were people in those 


environments that -- 25 rads per hour or 50 


rads per hour -- flying through the cloud, 


sampling emissions -- 100 rads per hour. I'm 


wondering -- I was wondering in that context 


whether dose rates that were very high -- say 


on a per hour basis that could produce 


deterministic effects and we know there were 


people involved, but that might be -- sometimes 


you cannot -- sometimes you can actually 


determine how long people were there because 


you have -- you have documentation for what the 


operation was planned to be, but sometimes you 


can't -- at least sometimes you don't know how 


long people -- sometimes you have a dose so you 


can infer how (unintelligible). 


 DR. ZIEMER: High dose rate situations are 


fairly common, both in the labs and in -- in 


private sector where you determine in advance 


work times which may be as -- as short as one 


minute. I've had cases where we sent 


electricians in to do something for one minute, 


then the next guy comes out -- or gal -- and 


does the next step. And you -- you -- you're ­

- you can be talking about ten, 20 to 30 rads 

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per hour working in -- close to reactors and so 


on, but you can -- and so you control doses by 


-- by time. So the presence of a high dose 


rate, per se -- now if you're talking about 


hundreds of rads per hour, then it becomes very 


difficult to control, so -- 


 DR. MAKHIJANI: No, what I was thinking was -- 


 DR. ZIEMER: -- but if -- but if you can show 


those exist and you're not controlling entries 


or something, then it's -- 


 DR. MELIUS: Yeah, I don't think these are, you 


know, separate criteria. They're going to -- 


 DR. ZIEMER: (Unintelligible) 


 DR. MELIUS: Yeah, in some way, 'cause I'm not 


sure we can come up with -- or it'd get very 


complicated if we did. 


 DR. MAKHIJANI: No, I agree that -- that -- I 


mean obviously the failure of radiological 


controls along -- along with -- 


 DR. ZIEMER: But we should -- we should get the 


ideas down here --


 DR. MELIUS: Yeah, yeah. 

 DR. ZIEMER: -- and then we can -- so it's high 

dose rate? 

DR. NETON: (Unintelligible) define high dose 
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rate as .5 to 50 rem -- rem per hour, is that 


what you said? 


 DR. MAKHIJANI: Well, I was thinking if -- if 


there's a level -- if there's a level you 


decide is a non-stochastic or deterministic 


effect, then perhaps it's a suggestion that 


that dose rate per hour might be an important 


thing to factor in as one -- one consideration. 


DR. NETON: (Unintelligible) can offer up 


what's in the regulation already, which is an 


incident which involves the administration of 


chelation therapy. 


 DR. MELIUS: Uh-huh. 


DR. NETON: That would, in my mind, qualify as 


something that at least had the potential to be 


a very high dose. 


 DR. ZIEMER: Maybe we can define what high dose 


rate is later. The point is to get the ideas 


down. 


DR. NETON: At least fall in the category of 


"this might be a high dose rate if". 


 DR. MELIUS: No, I think it's -- there are 


always going to be -- not by themselves a, you 


know, sole criterion, but it would be in -- you 


know, in combination with failure of radia-- 

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you know. 


 DR. ZIEMER: I mean you can argue that a 


medical X-ray's a high dose rate event; it is. 


I mean you -- a tenth of a second and you get 


some of these -- you know, in the early medical 


ones -- a rad. Those are high dose rate 


things. 


DR. NETON: An example might fall in the line 


of deterministic effects but I was thinking in 


terms of some evidence of some renal toxicity 


from uranium exposure or something on that 


line, kidney toxicity. 


THE COURT REPORTER: I'm sorry? 


DR. NETON: Medical evidence of kidney 


toxicity. 


THE COURT REPORTER: Kidney. 


DR. NETON: We have to be careful with that 


'cause some-- sometimes you can have fairly low 


doses from very soluble uranium and you have 


kidney toxicity. Those were soluble materials 


 DR. ZIEMER: Well, yeah, in fact the chemical 


toxicity is overriding for uranium in some 


cases. 


DR. NETON: Right, but I was -- what I was 

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thinking is you had fairly moderate to 


insoluble uranium and had evidence of kidney 


toxicity, that would clearly support -- in my 


mind -- a very high exposure. 


 DR. MAKHIJANI: But now you're into the high 


exposure realm, and then add -- that would be 


combined with incidents in some way? 


DR. NETON: Right, well, that's what I was 


thinking. I thought we were trying to bracket 


some high exposure criteria that would define ­

-


 DR. ZIEMER: Verify that an incident occurred. 


 DR. MELIUS: Discrete incident likely to 


involve exceptionally high exposures, how do we 


 DR. MAKHIJANI: This is what I --


 DR. MELIUS: Yeah, how do we put parameters on 


that some way or make some evaluation. 


 DR. ZIEMER: Can you separate that, do you 


think, from chronic uranium uptake? 


DR. NETON: That's a good question. You really 


can't. But a discrete incident could result in 


this effect, as well a chronic -- 


 DR. ZIEMER: Right. 


DR. NETON: -- as well. 

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 DR. BEHLING: As you know, in the Ames 


situation there was evidence of renal problems. 


DR. NETON: Early on, yeah. 


 DR. BEHLING: But of course it has to be likely 


that it obviously was chronic exposure that led 


to that, rather than a single discrete event. 


DR. NETON: I don't think it has to be. 


 DR. BEHLING: You couldn't differentiate. 


DR. NETON: You couldn't, but I'm just throwing 


these out. I mean --


 DR. WADE: Okay, just making a list. 


DR. NETON: -- these are not --


 DR. ZIEMER: Do you know what -- what the -- 


Hans, the time is for renal effects on uranium 


vers-- I mean --


DR. NETON: I think it can be fairly quick if 


the --


 DR. ZIEMER: A week or two? 


DR. NETON: Yeah, very short. We used to test 


fairly quickly after an incident or a -- 


protein albumin urea for a gross test, but... 


And then this would have to be bracketed in 


terms of the types of tests. There are now 


some real very sensitive tests that can measure 


deterministic effects for extremely low levels 

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of exposure. I was thinking in terms of the 


classic tests they were apt to use. 


 MS. ROBERTSON-DEMERS: This is Kathy DeMers. 

 DR. MELIUS: Yeah. 

 MS. ROBERTSON-DEMERS: Can I propose, in terms 

of iodine-131, 132 and 135, that you look at 


detriment to the thyroid in (unintelligible)? 


 DR. MELIUS: Uh-huh. 


DR. NETON: These, so far, have been sort of 


indirect indicators of high exposure, but would 


-- would something such as -- you know, I'm 


thinking of an explosion of an ion exchange 


column like at the Hanford facility. That, to 


me, is a... 


 DR. MELIUS: (Unintelligible) 


DR. NETON: There's very concentrated amounts 


of transuranic materials present in these 


columns when they're extracting them. 


 DR. MELIUS: No, I'm just trying -- how do we 


turn into a more general criteria so it's not ­

- you know --


DR. NETON: I agree, yeah, that --


 MS. ROBERTSON-DEMERS: Actually, Jim, wouldn't 


that kind of fall under the chelation category? 


DR. NETON: It would, it would. See, that's 

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what I was trying to -- I didn't know whether 


we wanted to go with just these sort of 


indirect medical indicators and deterministic 


effects, or whether we wanted to really cite 


examples of activities that could have happened 


or, you know, scenarios that could result in a 


high exposure. Certainly you would have a 


chelation indication at that point, but -- 


 DR. ZIEMER: I mean these are -- these are 


items -- you wouldn't necessarily take any one 


of them by itself, but it would be an 


indicator. 


 DR. MELIUS: Uh-huh. 


 DR. ZIEMER: So what -- what would be the 


general thing to -- an explosion, a laboratory 


explosion? 


 MS. ROBERTSON-DEMERS: What about a situation 


that resulted in significant medical treatment? 


In that case he lived at the hospital. 


DR. NETON: Yeah. 


 MS. ROBERTSON-DEMERS: But you might get a 


situation where -- for example, at Rocky Flats 


one of the individuals was involved in an 


explosion and he actually lost part of his 


hand, but he had a substantial potential for 

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intake through his rather substantial wound, 


and he received extensive medical treatment 


also. 


DR. MAURO: Would you want to leave -- limit 


that to medical intervention because of concern 


over radiological exposures? 


DR. NETON: Yeah, that would be a 


(unintelligible) --


 MS. ROBERTSON-DEMERS: Yeah. 


DR. NETON: -- general category. 


 MS. ROBERTSON-DEMERS: Yeah. 


 DR. MELIUS: And then you'd have a whole subset 


(unintelligible). 


DR. NETON: That would apply to internal and 


external. 


 DR. MELIUS: Yeah, right. 


 MS. ROBERTSON-DEMERS: What I'm trying to avoid 


is treatment for minor wounds. 


 DR. MELIUS: Yeah. 


 DR. MAKHIJANI: What about these -- when you're 


talking about explosions and Hans -- Hans 


brought up the question of bombs and how do you 


-- how do you consider the -- the -- the 


explosions of the bomb, for uranium and thorium 


especially, and (unintelligible) -- 

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134 

DR. NETON: Yeah, we -- we talked about that. 


I mean this -- this sort of falls -- Hans and I 


had a little sidebar conversation on this. 


This falls into these acute incidents that 


we've always talked about -- you know, in the 


plant. Often normal things happen and puffs 


occur. The question is to decide do they rise 


to this exceptionally high level. And 


certainly we would welcome an analysis of -- of 


an explosion due to one of these uranium bombs 


or the thorium bombs. But our opinion on this 


so far has been that when those occur there's 


usually an immediate evacuation of the area. 


People don't hang around very long so that you 


have a high exposure for a very brief period of 


time that doesn't end up, like at the end of 


the day, resulting in a -- in a dose that is 


that high -- exceptionally high, at least. And 


in fact, most of these are covered by what we 


believe to be the routine bioassay program 


where we can demonstrate that even -- even 


given those, the bioassay results don't 


indicate these high levels of exposures. But I 


think in general some -- some analysis of -- I 


think any time there was a potential for an 

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explosion involving large quantities of 


radioactive materials, it certainly would at 


least raise the flag in my mind that there was 


a potential for a... 


 MS. ROBERTSON-DEMERS: This is Kathy DeMers 


again. With respect to explosions, could we 


add substantial fires to that, on the order of 


the 1969 fire at Rocky Flats? 


 DR. MAKHIJANI: When we're talking about fires, 


they had some pretty intense fires in the 


thorium drums at Fernald. They had all kinds 


of fires. You know, you have small chip fires 


and you have large -- you have fires across the 


scale of -- and some fires are -- what could 


really be considered as routine, where they're 


small and you treat them as routine exposures 


in your (unintelligible), but there are some 


that are clearly exceptional. 


DR. NETON: Right, I would agree, there are 


fires that would occur that were large, for 


example, that we were not able to reconstruct 


using bioassay or -- there's a lot of these 


that we've been talking about. I think there 


are tools that we have available to bound 


exposures. You know, you have to have this as 

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a precondition, plus an inability to 


(unintelligible) air samples or bioassay or any 


of those other (unintelligible). 


 DR. MELIUS: Yeah. No, I think it's assumed 


that -- this is not assuming that you can't 


reconstruct --


DR. NETON: This is to get you in the analysis. 


 DR. MELIUS: Yeah, how do we -- how do we -- 


for an actual individual to get in here, they 


would -- for these purposes, they -- not be 


able to reconstruct their dose, also. And I 


also think this is sort of the failure of 


radiological controls or routi-- you know, is 


sort of going to be fundamental to a lot of 


these kinds of incidents 'cause, you know, if 


everybody's sort of evacuated immediately, it's 


not... 


 DR. MAKHIJANI: (Unintelligible) let me bring 


up my favorite example from Fernald, the one 


that shocked me the first time I saw it and 


still shocks me when I think about it, is that 


famous 97,000 times MAC cleanout where it was 


averaged over some time -- you know, I mean 


trying to fix it -- and the second year it was 


18,000 times MAC. But -- and that kind of 

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cleanout happened only once in a long while, so 


it wasn't part of a routine job, so it's not 


like the Ames situation we're talking about but 


-- where they went in and shut down the 


equipment and cleaned out this place, and it 


was a very intense, few-hour operation. It was 


clearly --


DR. NETON: But it was a planned event. 


 DR. MAKHIJANI: It was a pla-- it was planned, 


but the -- there were -- there was clearly 


failures of radiological controls and very 


extreme exposures. I don't know 


(unintelligible) --


 DR. ZIEMER: Now are those cases where the 


exposures were or were not monitored? 


 DR. MAKHIJANI: Well, I don't know. I mean --


 DR. ZIEMER: I mean you had similar situation 


with the SL-1 recovery. 


 DR. MAKHIJANI: Right. 


 DR. ZIEMER: Pretty high exposures, some of 


those folks who went in to rescue and so on, 


but they were also monitored pretty closely, so 


I mean in general one would have been able to 


reconstruct those doses. On -- on the case 


you're talking about, were those -- do we have 

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-- would there have been data? It sounds like 


you --


 DR. MAKHIJANI: Yeah. 


 DR. ZIEMER: -- they knew pretty well what they 


 DR. MAKHIJANI: Yeah, they may have monitored 


them. I'm not -- I'm not using this as an 


example of -- I'm just saying if -- if that 


kind of situation occurred in the context of an 


SEC, I wasn't saying of, I know of an 


(unintelligible) --


 DR. ZIEMER: As an indicator of an incident. 


DR. NETON: I would agree if you had 18,000 MAC 


air unmonitored, that would qualify as a 


discrete incident. That's up there so high 


that I can't imagine you can generate air that 


high, but --


 DR. MAKHIJANI: Well --


DR. NETON: -- apparently they did. 


 DR. MAKHIJANI: -- it's -- it's what the 


document said. 


 MS. ROBERTSON-DEMERS: This is Kathy. I think 


when you're talking about failure of 


radiological controls, you need to define what 


type of failure you have in mind, because in 

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today's world if you spread contamination 


outside a contamination area, that's failure of 


radiological control. And I don't think you 


mean at that level. 


 DR. ZIEMER: No. 


 DR. MELIUS: I think it -- that's always going 


to be a subsidiary or a secondary way -- it's a 


way of evaluating the initial incident, and it 


would be a failure of the controls that should 


have been in place relevant to that particular 


type of exposure and incident. You know, not 


simply, you know, any failure of radia-- you 


know, radiological controls. I mean I can't 


think of an example where you just base it on 


that alone, you -- it would be failure to 


evacuate people in some of the incidents Paul 


was talking about, failure to monitor -- 


 MR. ELLIOTT: Failure to adequately monitor -- 


 DR. MELIUS: Yeah, right. 


 MR. ELLIOTT: -- knowing full well that -- 


 DR. MELIUS: Yeah. 


 MR. ELLIOTT: -- it's gone beyond the radiation 


control area. 


 DR. MELIUS: Yeah, exactly. 


 MR. ELLIOTT: Failure to clean up, and still 

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send people in to work there. 


 DR. MELIUS: Yeah, yeah. And like what Paul 


said, you know, the -- you used a -- was it a 


Fernald incident or what that -- where people 


away from the -- I mean other people were 


exposed, but they were monitored and so forth 


so they wouldn't be part of the -- 


 DR. MAKHIJANI: No, no, I just used that number 


 DR. MELIUS: No, no, I'm just trying to -- 


 DR. MAKHIJANI: -- (unintelligible) my mind. 


 DR. MELIUS: -- make sure we have an 


understanding of how we're applying this -- or 


would apply this. 


DR. NETON: The external area -- the failure of 


any interlock systems that were in place for 


protection of high dose rate exposures, there's 


a number of those that have occurred. We've 


actually dealt with a few of them. The famous 


one down at Oak Ridge I remember, wasn't it the 


agricultural facility? 


 DR. ZIEMER: The U of Tennessee Ag and -- where 


the guys bypassed the interlocks and went in, 


yeah, that -- that's a good example. And of 


course they had separate monitoring. They 

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pretty well --


DR. NETON: Yeah, if they're unmonitored -- 


 DR. ZIEMER: And those are easy to reconstruct 


anyway 'cause you have discrete sources, but -- 


DR. NETON: Yeah. 


 DR. ZIEMER: -- but what would be the indicator 


there, the first... 


 MS. ROBERTSON-DEMERS: Along that line --


 DR. ZIEMER: And those are -- yeah, those are 


oft--


DR. NETON: Well, we'll reconstruct it later -- 


after the fact. 


 MR. ELLIOTT: Along the line of we'll 


reconstruct it, we're having workshops across 


the street for DOL's FAB and claims examiners, 


and today their resource center folks. One of 


the questions that came out of that is why 


isn't the SL-1 incident already established as 


a class, and -- and to this discussion, 


certainly the cleanup activities that occurred 


after SL-1, to go in and retrieve the bodies 


and, you know, do all that cleanup, while it 


was well monitored, it was certainly a huge 


exposure that those individuals got, you know. 


So if there was a failure somewhere there -- 

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you know, I don't know if that goes to the 


incident that we're trying to define, but it 


certainly is an exposure incident. It's --


it's a unique set of circumstances that people 


encountered. And if we couldn't -- you know, 


if there was some component there that was 


missing in the monitoring and we couldn't 


reconstruct dose, how would we define, you 


know, the time period around that. 


 DR. ZIEMER: Well, in that one, you know very 


specifically what dates it occurred on, who the 


people are --


 MR. ELLIOTT: But under our current rule -- 


 DR. ZIEMER: Yeah. 


 MR. ELLIOTT: Yeah, on that one you clearly 


know when -- when the ex-- the doses started 


going down on the people that they were 


monitoring after the cleanup and we can define 


the time limits, but it wouldn't meet our, you 


know, current definitions, you know -- 


 DR. MELIUS: Why not? 


 MR. ELLIOTT: 'Cause it wasn't 250 days. It 


was only like --


 DR. MELIUS: Yeah, but --


 MR. ELLIOTT: -- I believe 60-some --

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 DR. MELIUS: No, I thought you were talking 


about it would be a discrete incident -- 


UNIDENTIFIED: High dose. 


 DR. MELIUS: -- yeah, high dose. 


 MR. ELLIOTT: High dose. 


 DR. MELIUS: Yeah -- okay. I thought you then 


(unintelligible) --


 DR. MAKHIJANI: Let me understand. Would 


cleanup for 60 days be a discrete incident? 


 MR. ELLIOTT: I'm just saying it could be 


considered that. I mean it could -- as you're 


talking about these things, I -- 


 DR. MELIUS: Yeah. 


 MR. ELLIOTT: -- it occurs to me that, you know 


 DR. ZIEMER: Well, the -- but to me, the 


cleanup -- see, those -- those folks were 


working under -- at least under dose limits. 


For -- for rescuing they're allowed much higher 


values, although they didn't really have to 


rescue, the people were already dead from the 


explosion, but they had to remove the bodies. 


I think Ed Valleria* was the guy who got the 


high dose and --


DR. NETON: I do agree that a discrete incident 

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could be a 60-day event. 


 DR. MELIUS: Yeah. 


DR. NETON: I don't think there was any 


intention to -- to limit a discrete incident 


to, you know, a day, an hour, a second. 


 DR. MELIUS: Yeah. 


DR. NETON: But it would have to be -- it'd be 


hard to envision those scenarios like -- like 


Dr. Ziemer's pointing out, and the cleanup 


really was a planned event. Now they were 


monitored. Maybe there was some failure of 


radiologic controls there, but -- 


 DR. WADE: But at this point you're trying to 


look at --


DR. NETON: Yeah, we're not trying to -- 


 DR. MELIUS: Yeah, yeah, yeah, yeah -- 


 MR. ELLIOTT: Such an event might have been in 


the time period where they didn't have the 


monitoring practices (unintelligible) certain 


constituent of the exposure. 


 DR. WADE: Yeah, it should be on the list. 


 MR. ELLIOTT: I guess that's my only point 


there that I'm trying to make. 


 MS. ROBERTSON-DEMERS: What about if we looked 


at people who were allowed to exceed the dose 

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limit in an emergency situation? In other 


words, they were authorized to receive the 


emergency dose --


DR. NETON: Authorized and monitored or 


unmonitored, I guess? 


 MS. ROBERTSON-DEMERS: Well, I would hope that 


DR. NETON: Monitored? 


 MS. ROBERTSON-DEMERS: -- monitored, if they 


had to request that type of dose. However, 


there may be some situations in which they 


weren't. 


DR. NETON: Well, I think -- yeah, I think that 


would qualify if there was a life-saving -- 


some guys just ran into an area without any 


dosimetry and pulled a guy out and -- sure. 


 DR. MELIUS: I mean some of the incidents that 


are described here --


 DR. MAKHIJANI: I think there's one -- there's 


a couple of incidents -- 


 DR. MELIUS: There's a couple of them, too, 


where that appears to have happened, at least 


from the work description. 


 DR. MAKHIJANI: At Nevada I think there were 


two. 

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DR. NETON: Okay, I'm kind of running out of -- 


 DR. ZIEMER: If we're looking at indicators 


that something has occurred, one of the 


indicators often is the contamination shows up 


at some other location, either a home or 


something like that, and you can use that as an 


indicator that there's been some kind of loss 


of control. I don't know if that's a practical 


thing 'cause you don't end up getting that 


information necessarily, though. 


DR. NETON: Sometimes we do. There's an 


interesting one where -- followed a guy out to 


his baseball game and -- I won't give the 


details, but he had contamination -- various 


parts of his body. And I don't know about that 


one. I don't know if that gets to the level of 


significant -- you know, I guess 


(unintelligible) --


 DR. ZIEMER: No, as an indicator that something 


has occurred. Only as an indicator, as a 


potential indicator that there's been loss of 


control. I'm trying to think of specific 


cases. 


 MS. ROBERTSON-DEMERS: That's a hard one to 


deal with 'cause routine -- 

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 DR. ZIEMER: Yeah, in terms of the information 


that we're able to get ahold of, it is. 


 MS. ROBERTSON-DEMERS: With the -- the early 


contamination control measures, especially for 


uranium, they may have been taking it home on a 


daily basis --


 DR. ZIEMER: Right. 


 MS. ROBERTSON-DEMERS: -- and nobody would have 


thought to monitor them, or monitor their home. 


 DR. ZIEMER: Right. 


 MS. ROBERTSON-DEMERS: And they didn't have 


personnel contamination monitors to indicate 


that they had that contamination on them. 


 DR. ZIEMER: Good point. 


 MS. ROBERTSON-DEMERS: This would especially be 


relevant to AWEs. 


 DR. ZIEMER: Uh-huh. 


 DR. MELIUS: Do you think from this list you -- 


 DR. MAKHIJANI: Yeah, I think --


 DR. MELIUS: Yeah. 


 DR. MAKHIJANI: I've made notes and I'll -- 


I'll work with Ray maybe to get a piece -- this 


piece of the transcript roughly early. But I 


had a question. When you compile some -- 


compile this list of criteria -- 

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 DR. MELIUS: Yeah. 


 DR. MAKHIJANI: -- and then you try to apply it 


to the less-than-250-day, who do you apply it 


to? Do you apply it to everybody who worked 


that -- who's qualified as an employee by DOL 


and worked there, so then presence -- once you 


go through these criteria, then presence is 


enough during those 250 days or employment at 


another time or how do you translate these? 


 DR. ZIEMER: Currently. 


DR. NETON: I -- I think you need -- you need 


to define the class based on that. If you 


define the incident well enough, you'll define 


the class. It will be those workers involved 


in this incident in this particular building at 


this -- I mean ideally it would be that. 


 DR. MAKHIJANI: Yes. 


DR. NETON: Now whether in reality one can tie 


people -- bodies to those -- that incident is 


another story, but you at least have to start 


there. Say here's what I'm talking about, this 


-- this bomb incident occurred on December 


15th, whatever. And -- and then you narrow the 


class to as small as it needs to be without 


engaging, you know, the entire plant population 

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(unintelligible) --


 DR. MAKHIJANI: But then we've shifted the 


question. These are different -- sorry. 


 DR. WADE: It will be different for different 


discrete incidents. Once you define them, then 


how you go about defining the class will depend 


upon that definition. 


 DR. MAKHIJANI: But this is a different 


question than the one we started the meeting 


with, as I see it. Maybe I'm mistaken, because 


where we started the meeting with, there was 


this SEC that's been granted -- say at Nevada 


Test Site or Ames or someplace -- 


 DR. MELIUS: Uh-huh. 


 DR. MAKHIJANI: -- where there was a group of 


employees that was defined in a certain way who 


worked with uranium or thorium or were employed 


at Ames or people who -- there during 


atmospheric testing. And then everybody who 


was there at least 250 days is in. And I 


thought the question on the table when we 


started the meeting was: In that group of 


people, what about everybody with less than 250 


days? 


And now I guess what we're saying is we're not 

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going to consider that whole group as one group 


but we're going to split it apart. Is that 


what we're saying? 


 DR. MELIUS: We could. I think we're just -- 


 MR. ELLIOTT: If you applied -- if you applied 


this against our rule right now, and we said 


that there was a unique incident here that 


contributed to high dose but it wasn't really 


truly presence, and whatever the -- let's 


forget the day issue --


 DR. MELIUS: Uh-huh. 


 MR. ELLIOTT: -- then -- and we know that -- 


what that incident was and -- and where it was, 


at least, then the class definition would be 


bounded by that. 


 DR. MELIUS: Uh-huh. Yeah. 


 MR. ELLIOTT: And so that's a lot narrower 


definition of a class than what you have before 


you now with -- with saying all who worked at 


Nevada Test Site under those years. 


DR. NETON: It doesn't mean that you couldn't 


end up at the same place, but I think you've 


got to start with a narrow definition of -- of 


a discrete incident, investigate it and -- and 


work around. Now if you can't bracket the -- 

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any smaller than the entire site and it looks 


like anyone on the site could have been 


involved in this incident, then that's a 


different story. 


 DR. BEHLING: Let me give you an example of 


that because Ames -- there were fires and 


because of the --


DR. NETON: Yeah. 


 DR. BEHLING: -- issues involving national 


security, firefighters -- as you see in the 


cartoon -- were told you can't come in here, we 


fight our own fires. So now it's employees 


fighting a fire and, as we just mentioned here, 


fire may be one of those discrete events that 


may lead to high exposure. But we don't have a 


clue who the people were who may have fought 


those fires within the ranks of employees. So 


do we then identify the entire cohort as lessthan-250 eligible? We don't know who the 


firefighters were who were (unintelligible) -- 


DR. NETON: Well, that -- that's where we need 


to work, you know, with the Department of Labor 


in defining the class so you know it can be 


administered. 


 DR. WADE: But one thing at a time. I mean --

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 DR. MELIUS: Yeah, but I think the difference 


that -- back to what Larry was saying, in the 


250-day situation we -- we (unintelligible) the 


relationship to exposure or some threat of 


exposure. Here we're defining a -- a different 


class or a new class in relationship to 


incidents. And so I think we are sort of going 


through -- we know what it -- now we have to 


develop some inci-- you know, definition of 


what an incident is, and then -- then I think 


we have to go through the steps, well, can you 


reconstruct people and exposure 


(unintelligible) so you can't, then -- then 


it's defining it -- we define the class in 


relationship to that incident. 


 DR. MAKHIJANI: So we are defin-- we are, in -- 


in a way, embarked on defining a different 


class --


 DR. MELIUS: Right, right. 


 DR. MAKHIJANI: -- because of the way the 


regulation is written. 


 DR. MELIUS: Right. 


DR. NETON: I think so. 


 DR. MELIUS: Yeah. 


 DR. WADE: And the step there would be to 

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define did an incident take place at the Nevada 


Test Site; here are the beginning 


characteristics to look for to see if an 


incident took place. If one did, then you need 


to go into more detail as to how you would 


define the class associated with it. 


 MR. ELLIOTT: Say the petition comes to us and 


the starting point was there was an incident 


and there's no data about that incident. 


 DR. MELIUS: Uh-huh. 


 MR. ELLIOTT: Then that sets up boundaries of 


the proposed class itself, and then we have to 


use the two-pronged test. Can we reconstruct 


dose based upon what's presented to us as an 


incident we can't reconstruct. 


 DR. MELIUS: Yeah. 


DR. NETON: A good example of this is I went 


through and looked at the Nevada Test Site, the 


61 who don't currently qualify, and if we were 


to say, based on the criticality as it 


happened, the individual tests that would 


qualify -- many of these people were not there 


on the days the criticality occurred, and so -- 


 DR. MELIUS: Yeah. 


DR. NETON: -- you need to look at that and 

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define that class. 


 DR. MELIUS: Oh, no, no -- yeah, sort of how do 


you operationalize that, the group, and it may 


-- may end up not being very many people or 


whatever, we don't know, you know -- you know ­

- do that. 


What I would propose for sort of next steps is 


-- 'cause I think we do have to figure out how 


we've been defining these classes so we -- do 


that -- is -- is to write up these criteria and 


then let's take and -- take Nevada Test Site 


and apply it, see if we can, you know, define 


classes there. 


 DR. WADE: Define discrete incidents -- 


 DR. MELIUS: Identify the incidents and then 


define class and --


 DR. WADE: Very logical approach. 


 DR. MELIUS: Yeah. 


 DR. ZIEMER: And one kind of additional 


question. It just occurred to me that in many 


incidences, and I think about the Y-12, the 


reason we -- we know that that incident 


occurred, the first indication is an alarm. 


Now do -- are -- is there any indication that 


on these sites like Nevada Test Site that 

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alarms were bypassed or not working, or 


something like that, in terms of things that -- 


or were unexpected outside the -- the testing 


of the devices themselves? I mean obviously 


the testing of the device is a criticality, but 


that's -- that's what you're doing. 


 DR. MELIUS: Uh-huh. 


 DR. ZIEMER: But were there inadvertent -- or 


are there claims that there were unexpected 


criticalities in the handling of the materials? 


DR. NETON: I think there were. 


 DR. ZIEMER: And did they have criticality 


monitors that would -- would be -- 


DR. NETON: (Unintelligible) would know better 


than (unintelligible) -- 


 DR. MAKHIJANI: In at least one case -- 


 DR. ZIEMER: I mean if you have an area monitor 


of any sort, air sample or whatever, it'll get 


set off by a criticality if it's in the work 


area. 


 DR. MAKHIJANI: I think in at least one of 


these safety tests they did have a criticality 


and that was one of the incidents I was 


referring to. We're pretty sure we -- I didn't 


say inadvertent in the paper because I didn't 

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have a reference, but I think -- I'm pretty 


sure that it was inadvertent, but not 100 


percent. 


DR. NETON: But -- are you wanting to get into 


specifics? 


 DR. MAKHIJANI: Sure. 


DR. NETON: The Nevada Test Site -- I think by 


and large anyone who was positioned near these 


planned events or even the inadvertent events 


were monitored for external exposure. I'm 


pretty sure we've got pretty good data on 


those. But then the question for Nevada comes 


as was there an incident with -- involving 


internal exposure that -- exceptionally high 


and we have to apply it to the appropriate 


metric. 


 DR. MAKHIJANI: Now I think that Nevada -- 


 DR. MELIUS: The -- does the internal exposure 


have to be exceptionally high? 


DR. NETON: That's what the definition is in 


the regulation. 


 DR. MELIUS: But -- no, but is it -- now it's 


back to that issue of parsing out between 


external and --


DR. NETON: Oh, no, I think the intent was that 

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it would have to be -- qualify as a discrete 


incident. For less than 250 days it had to be 


exceptionally high exposure. 


 DR. MELIUS: Yeah. 


DR. NETON: It was only on failure of 


radiologic control that whole thing goes 


together. It has to be an exceptionally high 


exposure --


 DR. MELIUS: I -- I agree to that, but I'm 


saying does it have to be an exceptionally high 


-- that's that whole issue you and I talked 


about earlier, does it -- did it have to be an 


exceptionally high internal exposure. 


DR. NETON: Yeah. 


 MR. ELLIOTT: It wasn't speci-- the language 


doesn't specify internal versus external. 


 DR. MELIUS: Exactly, that's my point. 


 MR. ELLIOTT: It just specifies exceptionally 


high. 


 DR. MELIUS: The point -- I mean this whole 


point -- you can -- if you can -- you know, you 


have somebody and you can -- 49.99 percent 


probability of causation. You have this little 


DR. NETON: Oh, I see what you're -- you can 

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get to 45 percent based on your external dose 


and then --


 DR. MELIUS: But you can't -- you know. 


 DR. MAKHIJANI: Need to think about that. 


 DR. MELIUS: Yeah, yeah, I (unintelligible) -- 


 MR. ELLIOTT: (Unintelligible) partial dose 


reconstruction. 


DR. NETON: I won't comment at this point. 


 DR. MELIUS: Yeah, no, it --


 MR. ELLIOTT: Partial dose reconstructions for 


those who do not have a presumptive cancer. 


 DR. MELIUS: Yeah, no, it's -- it's a -- 


 MR. ELLIOTT: It is a problem. 


 DR. MELIUS: And it may be if -- define what 


you can and cannot do very precisely -- 


 MR. ELLIOTT: (Unintelligible) 


 DR. MELIUS: -- much more precisely than we've 


done -- done -- done --


 MR. ELLIOTT: We have to, because it leaves the 


individual claimant with no remedy on what we 


can't reconstruct. 


 DR. MELIUS: Exactly. 


 MR. ELLIOTT: And we just hate that. 


 DR. MELIUS: Yeah, yeah. 


 DR. MAKHIJANI: Okay, so within -- within this 

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universe of incidents, just thinking about how 


one would write up Nevada, which is looking -- 


the criteria look fairly straightforward, but 


writing up Nevada looks quite complex because 


now if you're into defining what all incidents 


there were, then you really have to get into 


being fairly exhaustive because you're -- 


you're telling people -- and then you also 


raise the question of was entry into ground 


zero shortly after a test an incident? I guess 


if it was planned, you would say it was not an 


incident, or people were monitored -- 


DR. NETON: (Unintelligible) monitored or -- 


 DR. MAKHIJANI: -- if they were not monitored ­

- they weren't monitored for internal. 


DR. NETON: Yeah, we've got some pretty good 


radiation safety reports for almost all of 


those (unintelligible) -- 


 DR. MAKHIJANI: Right. 


DR. NETON: -- sure you've looked at that and ­

-


 DR. MAKHIJANI: Right. 


DR. NETON: -- they're very detailed, 200, 300 


pages long reports, I -- very planned. Now 


whether something happened outside of that plan 

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that was an incident that -- I think Dr. Ziemer 


was alluding to was were there things that went 


awry that --


 DR. MAKHIJANI: No, no, what I'm asking is -- 


as you said, during those planned activities, 


there were external exposures that were 


monitored. But there were also internal 


exposures, on the basis of which you granted an 


SEC. These were short -- so I don't know -- 


are those -- are we talking about those as 


incidents for the test sites, because the test 


sites are pretty unique in that -- in that 


respect. 


 MR. ELLIOTT: Talking about what as incidents? 


I just don't know what -- 


 DR. MAKHIJANI: Internal exposures --


 MR. ELLIOTT: Oh. 


 DR. MAKHIJANI: -- that were not -- because 


early on we said, you know, if there were 


18,000 MAC that was monitored, then 


(unintelligible) planned activity, then it's 


not an incident. But if were not monitored, 


then it becomes an incident. So I think that 


monitoring -- I -- I just want to be clear 


whether monitoring is a factor in how an 

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incident is defined. That's where we kind of 


wound up in that example. 


DR. NETON: I think an incident is an incident. 


If you have monitoring, you can do something 


about it, so... 


 DR. MELIUS: I don't think it would necessarily 


affect -- it could, but it wouldn't necessarily 


-- just because there was monitoring, would 


indicate that it's not an incident; it's still 


an incident. 


DR. NETON: Right. 


 DR. MELIUS: I think there's sort of this 


intersection between sort of how we look at an 


incident and radiation -- failure of radiologic 


controls and being able to reconstruct dose. 


And -- and I don't know how to proceed on this 


'cause, given the complexities of the site, is 


-- do we just take a few incidents and then try 


to figure out how that -- how to apply it in 


those incidents, sort of make this operational 


in, you know, three or four incidents? I don't 


know what the number is, but... 


DR. ROESSLER: You know, beyond that -- I think 


beyond this particular site, my question would 


be on any site where does the list of potential 

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incidents come from? I mean there will be a 


list which are going to be evaluated and who or 


how is that list generated? 


 DR. MELIUS: Well --


 MS. ROBERTSON-DEMERS: That's where the 


incident criteria comes into play. 


DR. NETON: Well, the petitioner certainly has 


the -- in the beginning the petitioner can cite 


all the incidents they would like 


(unintelligible) --


DR. ROESSLER: But there may be potential -- 


DR. NETON: -- you know, we need to run them to 


ground, but we also take, you know, proactive 


approach and start to try to find evidence of 


any other incident (unintelligible) -- 


 DR. ZIEMER: Is one of the characteristics of 


an incident the fact that it is not planned? 


mean as an a priori part of the definition. 


DR. NETON: I think we need to be careful 


there, though, because in my mind -- 


 DR. ZIEMER: Well, I'm trying to distinguish 


between the planned events of testing weapons, 


for example, and even -- I guess you could even 


argue about planned releases such as those -- 


planned releases from Hanford, but what -- in 


I 
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terms of when we say "incident" is -- are we 


inherently talking about something that occurs 


that's outside the planned parameter of the 


planned test or whatever it is? 


DR. NETON: I don't think necessarily, because 


 DR. WADE: But possibly. 


DR. NETON: But in this case, Nevada Test Site 


-- I mean they planned to explode the weapon. 


 DR. ZIEMER: Right. No, I --


DR. NETON: But the incident we're looking at 


in this case, in my mind, is the internal 


exposures that were unmonitored. Right? I 


mean it was an unmonitored event that was 


planned, they just didn't have the -- I don't 


want to say foresight, but (unintelligible) -- 


UNIDENTIFIED: (Unintelligible) 


DR. NETON: -- internal exposures were 


(unintelligible) --


 DR. ZIEMER: They didn't know (unintelligible). 


DR. NETON: -- so in that mind it kind of rises 


to the incident level because it was unforeseen 


exposure pathway that -- 


 DR. ZIEMER: Uh-huh. 


DR. NETON: -- wasn't documented or something. 

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164

 DR. WADE: But as I understand the task -- I 


mean what you're trying to do is to determine 


if there are discrete incidents that will 


likely have exceptionally high exposures and on 


and on, so what the working group has said are 


-- these are things you might find present at 


those situations. They're not meant to be all-


inclusive or all-exclusive. So now with this 


list, then what has to happen with this list is 


that someone -- SC&A, the working group, NIOSH, 


a combination -- needs to go through the 


evidence and see what they can pull out that 


sort of meets some of these criteria. Then you 


get this -- this list of things and then you 


need to start to do the hard analysis as to 


whether any of these rise to the bar that -- 


that will be defined. 


Now who does it, as Gen asks, right now the 


working group chair is asking SC&A to begin the 


process. That's quite reasonable, but -- but 


not easy, because how -- how many data streams, 


how deep you mine the data to develop this 


candidate list is really an art at this point. 


And you know -- but you have to start it to see 


what happens. 

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 DR. MELIUS: And what I would propose is that 


we take some sampling and bring it back for -- 


to the workgroup for discussion, and that way ­

- then maybe we come up with another set of 


criteria how we would apply -- you know, figure 


out what the incidents are and whether they -- 


incidents are important to us evalua-- relative 


to the SEC, 'cause there may be a whole host of 


incidents. I mean that's sort of what you were 


getting at, Paul, that -- that may be, you 


know, not SEC level 'cause we'll be able to 


reconstruct dose or whatever and -- 'cause -- 


'cause of monitoring, so -- and that's also 


what I think you're getting at, so I -- I don't 


think we define an incident by whether it's 


monitored or not, but I think in terms of its 


relevance to a Special Exposure Cohort it is 


going to -- the fact of whether the explosions 


were monitored so -- or not, it's going to be ­

- will be important criteria. 


DR. NETON: I guess doing -- doing this 


analysis -- in doing this analysis, I think it 


would be good if the emphasis was placed on, if 


possible, looking at the civilian population 


exposures. I know that's not always going to 

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be easy, but rather than -- you know, the bulk 


of the data are going to be military -- 


military personnel, but -- they are commingled, 


but they are identified in these exposure 


reports separately, to a large degree. So --


so that we -- we can compare apples and apples. 


 DR. MELIUS: Uh-huh. 


DR. NETON: It'd be good to look at that. 


 DR. MELIUS: So -- so if the step was a sample 


of the incidents of, you know -- potential 


incidents at Nevada Test Site and then focus of 


not only on, you know, will they meet criteria 


and so forth, but then focus on trying to just 


pinpoint some that are relevant where there was 


a significant number of civilians there -- 


DR. NETON: Right. 


 DR. MELIUS: -- so we start to figure out how 


this is operationalized 'cause we -- I think we 


know that there's a problem with internal 


exposures. 


DR. NETON: Some of the NTS specific case files 


have some interesting descriptions in them. 


 DR. MELIUS: Okay. 


DR. NETON: Some of the so-called old-timers 


have written down some notes and pages on this. 

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They might be able to provide good access to... 


 DR. MAKHIJANI: And these are -- these are 


where? 


DR. NETON: These would be in the case files. 


I know that's a sensitive issue these days, but 


I think we can work through that. 


 DR. WADE: And I think SC&A has access to the 


case files. 


 DR. MAKHIJANI: I -- I believe -- I haven't 


tried it, but I got that e-mail yesterday. 


DR. NETON: But I would -- I would -- if you're 


going to, there's the 61 that have less than 


250 days exposure that -- I've gone through a 


number of them and I've found some interesting 


anecdotal information from the CATI interviews 


or supplemental information. I mean some 


people took the time to write a two, three-page 


summary of -- of their activities, to the 


extent of, you know, after an operation they 


were -- there was a bulldozer running back and 


forth to bury the material -- that sort of 


thing, so I think there's some useful 


information in there that could 


(unintelligible) --


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partial basis for choosing the -- you know, 


list the sample of incidents or whatever we're 


going to call that that we're going to be 


looking at. I just want everyone to understand 


that up front so that we're not -- 


DR. NETON: Yeah, I think that'll -- I don't 


know -- I'm not saying that they're -- all have 


(unintelligible) --


 DR. MELIUS: Yeah -- no, no. 


DR. NETON: -- but I've run across at least two 


or three in my casual -- 


 DR. MELIUS: Uh-huh. 


DR. NETON: -- trying to put together -- 


prepare for this meeting that there are some 


writeups in there that might be useful -- 


civilian experience. 


 DR. MAKHIJANI: Jim and maybe one or two other 


people at NIOSH might have this list, so if you 


could --


DR. NETON: I could (unintelligible). 


 DR. MAKHIJANI: -- make the list and provide it 


to us and save duplication work 'cause -- 


DR. NETON: Yeah. 


 DR. MAKHIJANI: -- I'm a little bit afraid of 


the schedule between now and December. I feel 

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the first piece of the charter would be very 


doable. The second piece -- 


 DR. MELIUS: I'm not sure is -- I'm not sure is 


doable. 


 DR. MAKHIJANI: -- is very complicated and I'm 


not sure it is doable, but we -- especially if 


you want to see it before and if you want to be 


in decision-making mode, that may be a little 


(unintelligible) --


 DR. ZIEMER: No, I think if you get the first 


piece by December that'll be fine. 


 DR. WADE: Clearly not, and this is terribly 


important, not only to Nevada Test Site but to 


other sites, so I think it's important that 


this be done carefully and done right. 


 DR. MAKHIJANI: Well, that's why I just -- it's 


my kind of gut reaction that if we try to rush 


this, we might --


 DR. MELIUS: No, no. 


 DR. MAKHIJANI: -- wind up at a place that -- 


start arguing about it after the fact, which 


would not be so good. 


 DR. MELIUS: No, no, my -- what I would see is 


if we could have the criteria -- 


 DR. MAKHIJANI: Right. 

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 DR. MELIUS: -- present -- present our plan for 


going forward at the next -- next meeting and 


then be scheduling another workgroup meeting 


prior to the -- what do we have, a February 


meeting? -- prior to that to try to, you know, 


meet and accurately (unintelligible) -- 


 DR. WADE: But I do think this criteria, one by 


the working group, refined and presented along 


with a plan, would be a tremendous 


accomplishment for December. 


 DR. MAKHIJANI: I think that -- Hans, do you 


think -- I think we can do the criteria. 


 DR. BEHLING: Are you looking at me to do it? 


 DR. MAKHIJANI: No, I'm not looking to you to 


do it, I'm looking -- I'm looking to you for an 


opinion of somebody who's experienced on our 


team. I'm not -- I'm not going to ask you to 


do it. I know you're a busy man. 


 DR. BEHLING: Well, I'll -- I'll help. 


 DR. MAKHIJANI: Okay. 


 DR. MELIUS: (Unintelligible) knows, I -- we 


haven't heard from John Mauro in two hours, 


(unintelligible) about work. 


 DR. MAKHIJANI: John, is that a fair 


commitment? 

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DR. MAURO: Could I -- before we go there, 


'cause I'm trying to sort this out, the idea of 


incidents and defining them and finding them 


and -- but at the same time I'm looking at your 


draft report and I do now have the updated 


version --


 DR. MAKHIJANI: Oh, great. 


DR. MAURO: -- that you -- and I'm looking -- 


just for a moment, if you'd bear with me, could 


you -- could you folks go to page 13, table -- 


DR. ROESSLER: (Unintelligible) 


 DR. MAKHIJANI: Which one, the Nevada one? 


DR. MAURO: This is the "Health Endangerment 


Assessment for the Nevada Test Site Special 


Exposure Cohort," this is not the criteria 


document. This is the Nevada Test Site 

document. 

 DR. WADE: Page 13, did you say, John? 

DR. MAURO: Page 13, and it's cal-- and it's 

Table 3. 

(Pause) 

 DR. MELIUS: Okay. 


DR. MAURO: Okay. Now, what we have here is 


information that says that there were a number 


of individuals that experienced doses above 

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five rem. We know the categories -- Army, Navy 


-- and we know one category -- scientific 


personnel, contractors and affiliates. 
I 


assume that last column applies -- I'll ask you 


all -- applies to civilians. The question I 


have is, given these data -- you see, I'm 


trying to juxtapose incidents with records of 


information on magnitudes of exposures that 


have occurred. And let -- let's say we go 


through the process you have just described 


whereby we are able to define and list and 


describe a number of incidents that are -- the 


criteria for the incidents, what constitutes a 


trigger that -- all -- well, this might be 


something we need to look at. And I'm not sure 


what we do with this information -- for 


example, the Table 3 information -- that tells 


us well, yes, we do have some people that 


experienced doses that were above five rem and 


this -- for this -- we actually picked this 


case because apparently this is one where we 


felt the external exposures anyway were -- were 


high. How -- how do we combine this 


information now? I'm -- I guess I'm sort -- if 


we know we have an incident, but we have -- and 

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we -- but we don't know very much about the -- 


the magnitude of the exposures that might or 


might not have occurred or be associated with 


that incident, does that get us where we need 


to go or are we just -- be -- would it be just 


good enough to know that well, we can get a 


handle on -- that yes, there were incidents, 


but we -- but we really can't say much about 


the magnitude of the exposures? 


See, I -- I -- what I'm saying is I think we 


could do what you're asking in terms of 


identifying all the different categories of 


incidents that might have occurred in the 


records. I'm not quite sure what we do with 


that information once we have it. 


DR. NETON: Well, you have these incident and 


criteria that were developed to bounce against. 


Right? I mean that was the idea. 


 DR. MELIUS: So you --


DR. MAURO: Let -- let's say we have that and 


we --


 DR. MELIUS: -- you have that --


DR. MAURO: -- and we do say yes, there were -- 


these many incidents occurred over this time 


period at this facility. Let's say we're 

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talking Nevada Test Site, whatever criteria we 


come up with. When we have that, we have a 


piece of the -- I guess -- a piece -- one of 


the criteria is yes, we do have incidents. Are 


we going to do -- would -- what -- and I think 


that -- that's doable and, as you had 


mentioned, depending on how rigorous and how 


complete you'd like it will determine the level 


of effort, the time it might take. And as 


Kathy pointed out, we of course have to 


struggle with the issue of what the def-- you 


know, the -- of the -- I guess the variable 


nature of what -- what the definition of an 


incident is, according to the different record-


keeping practices. But let -- let's assume we 


go through that process. I guess I'm looking 


forward, beyond that a little bit, and say the 


-- you know, once we have that information, is 


that going to put us into a position that will 


get us to where we are going to be able to come 


to grips with -- unless we could do something 


about dose, I guess that's where I'm getting 


with -- associated with these incidents, or 


somehow place -- place some kind of order of 


magnitude exposure, you know, on what the doses 

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might have been to people who were involved in 


those incidents. Is that where we're headed in 


the next step after we get our hands around the 


definition and what incidents have occurred? 


 DR. MELIUS: I think the next step is we want 


some description of who was at that incident 


and what the -- what -- what their nature of 


their work was at the site and parameters like 


that. So that would be -- kind of information 


would be used to -- to -- you know, potentially 


to establish a class. 


DR. MAURO: Notwithstanding what the doses 


might or might not have been. 


 DR. WADE: Well, if the working group feels, 


based upon its criteria, that an incident 


occurred that meets the intent of the law, then 


the next step would be to attempt to define a 


class --


 DR. MELIUS: Right, but -- but --


 DR. WADE: -- surrounding that --


 DR. ZIEMER: An incident for which we cannot 


reconstruct doses. 


 DR. MELIUS: Right, yeah. But -- but fir-- 


first we want you do is to -- take a sample of 


the, you know, possible incidents that -- at 

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Nevada Site, how -- how would we apply the 


criteria to those. And then secondly, among 


those -- for -- for those, what are the -- you 


know, give us some information on who was 


present and the nature of their -- their work, 


durations, things like that that I think -- as 


Jim was pointing out -- are, you know, based on 


some of the documentation about the tests and 


so forth. And then let us come -- then let us 


go back and talk about it and it may be that 


then -- then there's -- I don't think we want 


to just select out those that qualify for the 


class or whatever at this point in time. I 


think we need to sort of figure out first one ­

- one can -- do we have criteria that we -- are 


useful for classifying incidents, and then 


secondly, how are we then going to work on 


defining the class. And we need to understand 


that information a little bit better in terms 


of what approaches might be used for defining 


it -- you know, appropriately defining a class. 


DR. MAURO: Okay. 

 DR. ZIEMER: Comment. 

 DR. MELIUS: Yeah, Paul. 

 DR. ZIEMER: And I know this has taken a little 
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bit different direction maybe than you 


expected, Arjun, but -- 


 DR. MAKHIJANI: (Unintelligible) these were 


(unintelligible) pieces. 


 DR. ZIEMER: -- I just wanted to say to you and 


to SC&A that I found the document very helpful 


in thinking about this whole problem, so I 


appreciate the work that's gone into -- well, 


actually both the documents, and they do help 


us think about the parameters and try to come 


to grips with the issue, so -- 


 DR. MAKHIJANI: Yeah. No, I have no -- no 


investment (unintelligible) -- 


 DR. ZIEMER: No, I understand that, but -- 


 DR. MAKHIJANI: -- any of the (unintelligible). 


 DR. ZIEMER: -- I did want -- I did want you to 


understand that it's -- it's been helpful. 


 DR. MAKHIJANI: I appreciate that. 


 DR. ZIEMER: A helpful document. 


DR. ROESSLER: Jim, you mentioned that -- okay, 


the workgroup is going to present this plan at 


the December Board meeting and that you hope 


the workgroup could get together before the 


February meeting. I suggest that we -- while 


we're all here, pick a date if we're going to 

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do that. 


 DR. MELIUS: Okay. 


DR. ROESSLER: We have a January 11th 


conference call and the February meeting is the 


7th through the 9th. 


 DR. ZIEMER: At the December meeting the 


subcommittee will probably meet at what, 11:00 


o'clock, Lew? 


 DR. WADE: 11:00 o'clock. The morning of 


Monday will be available for workgroup meeting 


time. 


DR. MAURO: I've got a question regarding this 


mission. Are we going to be focusing in on I 


guess the Nevada Test Site and the definition 


of incidents and classes within the context of 


the Nevada Test Site, or are we talking a 


little more broadly than that? 


 DR. MELIUS: Nevada Test Site. 


DR. MAURO: Okay. Thank you. 


 MS. MUNN: Jim, may I make a comment? 


 DR. MELIUS: Yes, you may, Wanda. 


 MS. MUNN: It occurs to me that since there's 


so much focus on the Nevada Test Site, it would 


be very helpful for the workgroup which has 


that responsibility for NTS to be brought up to 

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date on what's transpiring here -- 


 DR. MELIUS: Yeah. 


 MS. MUNN: -- and to have access to these 


documents. It would be -- I think there's so 


much cross-fertilization here that to have one 


group working on one segment of the issue and 


another workgroup working on another segment, 


without clear cross lines of communication, may 


confuse us all and cause more of a time delay 


in coming to fruition than we really want. 


 DR. MELIUS: That's a -- I agree. 


DR. MAURO: It's interesting to know, by the 


way, that when talking about the Nevada Test 


Site site profile, in general -- and correct me 


if I'm wrong -- those documents usually are 


concerned with the chronic exposures people 


routinely experienced as part of their work, 


and incidents are not usually part of that. 


And in fact, that was very often one of our 


comments. So I certainly agree that marrying 


the knowledge base that the Nevada Test Site 


folks have, but I think that we're probably 


going into an area that is not the primary 


focus of what we've been doing at Nevada Test 


Site -- and Arjun, please correct me if I'm 

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wrong. 


 DR. MAKHIJANI: Well, but I think -- I think 


that simply adding -- adding that working group 


to -- to the document, forwarding this, it 


would be a good thing. 


DR. MAURO: Yeah. From a practical standpoint, 


Arjun, when I read your report -- the version 


everyone has -- it looks like you've got a good 


start. That is, those -- very -- you have 


described. In effect, in the process of trying 


to characterize the magnitude of the exposures 


that are on the record that individuals have 


experienced that were above one rem and then 


you've binned them -- you know, from one to I 


guess three, above five, and so forth. In the 


process of doing that, apparently you have 


uncovered records that you would attribute 


these exposures to what would be called an 


incident. Now from my -- for the ben-- from 


the practical standpoint, do you see this as 


tractable? That is, Kathy DeMers, you -- you ­

- you helped Arjun build these tables and these 


documents, as I understand, came out of 


incident reports or -- is that correct? 


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pick some dates here and -- 


 DR. MAKHIJANI: Let's talk about that off -- 


off --


 DR. MELIUS: Off-line, yeah. 


DR. MAURO: Okay. 


 DR. MELIUS: Were you -- somebody was prop-- I 


thought proposing that we try to meet just 


before the December meeting? 


DR. ROESSLER: Oh, no, I wasn't suggesting 


that. 


 DR. ZIEMER: I was just pointing out that there 


is a possibility. 


 DR. MELIUS: Oh, okay. 


 DR. WADE: If you wanted to meet with the 


Nevada Test Site site profile workgroup, you 


could do it that Monday morning. 


DR. ROESSLER: Oh, oh, oh, oh --


 DR. MELIUS: I -- I see, I -- I don't think 


that --


DR. ROESSLER: -- maybe that's not enough time 


for --


 DR. MELIUS: I don't think that -- no. 


DR. ROESSLER: -- all these things to --


 DR. MELIUS: Yeah, right. 


DR. ROESSLER: -- develop. 

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 DR. WADE: So then we go into January. 


 DR. MELIUS: Yeah, and I think -- I want to 


give you enough time. 


 DR. MAKHIJANI: Yeah, so -- like the work-- at 


the Board meeting, you -- you're expecting one 


document, which is the criteria document. 


 DR. MELIUS: Right. 


 DR. MAKHIJANI: And then at the working -- 


prior to the working group meeting, you will 


expect the next document, which will relate to 


incidents at Nevada Test Site. 


 DR. MELIUS: Correct. 


 DR. MAKHIJANI: Okay. 


 DR. MELIUS: And -- and so I'm thinking that's 


something that -- that meeting should be toward 


the end of January? Since we're meeting the 


7th, 8th and 9th is the February meeting. 


DR. ROESSLER: There's a mid-year health 


physics meeting from about the 20th of January 


to about the 25th and I'm -- I'm certainly 


going to be there. I don't know how many other 


people would be. 


 DR. MELIUS: Minneapolis? 


DR. ROESSLER: Knoxville. 


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before that. 


 DR. MELIUS: Yeah. Around the 19th? 


 DR. WADE: Sure. 


 DR. MELIUS: Or --


DR. ROESSLER: Let's give a few days in 


between, like maybe the 15th? 


 DR. WADE: 17th? 


DR. ROESSLER: 17? Yeah, 17th would be good. 


 DR. WADE: Okay. 


 DR. MELIUS: Actually the beginning of that 


week's better for me. 


DR. ROESSLER: I like it better, too. 


 DR. WADE: 16th? 15th is a government holiday 


-- 16th? 


 DR. MELIUS: 16th? 


DR. ROESSLER: Sounds good to me. 


 DR. WADE: Face-to-face or telephone? 


 DR. MELIUS: What do people think? 


DR. ROESSLER: I think face-to-face is better. 


 DR. MELIUS: Face-to-face might be better, 


simply because it's a lot of paperwork. Okay. 


 DR. WADE: So working group meeting -- 


 DR. MELIUS: 16th. 


 DR. WADE: -- Cincinnati? 


 DR. MELIUS: Cincinnati on the 16th. 

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 DR. WADE: You want to start at 10:00, give 


people the opportunity to fly in, or... 


 DR. MELIUS: How do people feel, do they -- the 


night before works best for me. 


DR. ROESSLER: Start at 8:00 and see if we can 


get done --


 DR. MELIUS: Yeah, getting out earlier. 


 DR. MAKHIJANI: From that point of view, could 


we do it on the 17th so we don't have to be 


flying out on a holiday, 'cause the -- the 


airline things may get kind of crazy on 


holidays in terms of just getting reservations 


and --


 DR. WADE: (Unintelligible) proposal for the 


17th? 


DR. NETON: I think that is somehow 


(unintelligible) school breaks or something 


like that. Last year had a problem. 


 DR. BEHLING: It's always a problem 


(unintelligible) it's a combination with a 


weekend. 


 DR. WADE: Is that okay with you, Dr. Melius? 


 DR. MELIUS: I'm going to need to check on 


(unintelligible) --


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that's fine. I'm open on the 16th. That's 


fine. I was just suggesting -- 


DR. ROESSLER: Either one is fine. 


 DR. WADE: We could also do it the afternoon of 


the 16th so people could travel in the morning. 


 DR. MELIUS: Yeah, that's fine. 


 DR. WADE: You don't want to cut into people's 


holiday, which --


 DR. MAKHIJANI: I like both days --


DR. ROESSLER: Keep both days... 


 DR. MELIUS: Yeah, okay -- yeah, I'll figure 


out -- I've got a conflict on the 17th, but I 


can check and find out. 


 DR. WADE: Here in Cincinnati. 


DR. ROESSLER: At the airport. 


 DR. WADE: Maybe this (unintelligible). 


THE COURT REPORTER: On the 17th then? 


DR. ROESSLER: He's waiting --


 DR. WADE: Either the 16th or 17th -- afternoon 


of the 16th or the morning of the 17th. 


 DR. MELIUS: Okay. Any other comments or 


questions? 


 DR. WADE: I compliment the workgroup on taking 


on such a knotty issue. I think it's an issue 


that needs to be addressed and I applaud the 

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approach. 


 DR. MELIUS: Good, and I would like to thank 


the -- SC&A and also NIOSH. Larry -- I guess 


Larry left, but Jim, thank you. It was helpful 


and it --


 DR. WADE: And it's always good to have Jim 


Neton at the table. 


 DR. ZIEMER: You bet. 


 DR. MELIUS: Yeah. 


 MS. MUNN: It is indeed. 


 DR. MAKHIJANI: And Jim, can I thank our young 


people who helped here --


 DR. MELIUS: Yeah. 


 DR. MAKHIJANI: -- Bob Barton and Kathy DeMers 


really put in a lot of work. 


 DR. WADE: Okay. Well, we are then adjourned. 


 (Whereupon, the meeting concluded at 11:34 


a.m.) 

______________________________ 

187 

1 CERTIFICATE OF COURT REPORTER 


STATE OF GEORGIA 


COUNTY OF FULTON 


 I, Steven Ray Green, Certified Merit Court 


Reporter, do hereby certify that I reported the 


above and foregoing on the day of November 17, 


2006; and it is a true and accurate transcript 


of the testimony captioned herein. 


 I further certify that I am neither kin 


nor counsel to any of the parties herein, nor 


have any interest in the cause named herein. 


 WITNESS my hand and official seal this the 


24th day of November, 2006. 


STEVEN RAY GREEN, CCR 


CERTIFIED MERIT COURT REPORTER 


CERTIFICATE NUMBER: A-2102