Centers for Disease Control and Prevention 

National Institute for Occupational Safety and Health
 

Summary Minutes
 

Eleventh Meeting of the 

Advisory Board on Radiation and Worker Health
 

February 5-6, 2003
 

Meeting Held at the DoubleTree Guest Suites 

Charleston, South Carolina
 
 

TABLE OF CONTENTS
 

Executive Summary .......................................................................................................................1 

Minutes of the Eleventh Meeting..................................................................................................6 

Wednesday, February 5, 2003 ........................................................................................................7 

Opening Remarks.............................................................................................................................7 

Approval of Summary of Closed Session, Meeting 10........................................................7 

 Announcements ...................................................................................................................7 

Program Status Report .........................................................................................................7 

Update on IREP Latency Adjustment Functions for Leukemia and Thyroid................................11 

IREP & Scientific Issues Workgroup Report ................................................................................13 

Savannah River Site Health Effects Subcommittee Activities ......................................................14 

Board Discussion/Working Session...............................................................................................15 

Contract Procurement Agency Issues ................................................................................15 

Workgroup Versus Subcommittee: Organizational Issues ................................................16 

Dose Reconstruction Workgroup Update ..........................................................................17 

Public Comment Period .................................................................................................................17 

Thursday, February 6, 2003 .........................................................................................................19 

Board Discussion/Working Session...............................................................................................19 

Review and Approval of Draft Minutes, Meeting 10 ........................................................19 

Dose Reconstruction Review Process................................................................................20 

Basic Review Report..........................................................................................................20
 

................................................................................................................................20 

Procurement Administration Decision 

Statement of Work Amendments .......................................................................................21 

Federal Register Changes Workgroup ...............................................................................21 

ABRWH Schedule and Future Agenda Items ...................................................................21 

Housekeeping and Miscellaneous......................................................................................22 

Public Comment Period .................................................................................................................22 
 

 

 

 

NIOSH/CDC Advisory Board on Radiation and Worker Health (ABRWH) Executive Summary/Minutes Febr uary 5-6, 2003

Executive Summary 

The Eleventh Meeting of the Advisory Board of Radiation Worker Health (ABRWH, or the Board) was 

held at the DoubleTree Guest Suites in Charleston, South Carolina on February 5-6, 2003. All but one 

member was in attendance, with one joining later in the day. Others in attendance included staff of 

various federal agencies as well as members of the public. A list of those in attendance is included in the 

Summary Minutes of this Eleventh Meeting. The Summary of the Closed Session of Meeting 10 was 

approved with no changes. 

Wednesday, February 5, 2003 

OCAS Program Status Report 

Ms. Martha DiMuzio reported on NIOSH’s Office of Compensation Analysis and Support (OCAS) 

Program through the end of January 2003. To date, approximately 10,472 cases have been transferred 

(~150-200/week) from the Department of Labor (DOL). The majority of the claims are from Department 

of Energy (DOE) workers, with approximately 16% from Atomic Weapons Employer (AWE) workers. 

In January 2003, Oak Ridge Associated Universities (ORAU) assumed responsibility for carrying out 

dose reconstructions. Ms. DiMuzio shared response statistics, as of December 31, 2002, for seven larger 

sites and indicated that if a claim response takes over 150 days, the DOE will be contacted for a status 

report. To date, approximately 726 telephone interviews with claimants have been conducted. 

Currently, 144 dose reconstructions are underway 

On January 24, 2003, 35 physicians were appointed to the DOE Physician Panel. OCAS is working to fill 

an additional 22 positions, and 6 new health physicists and 5 public health advisors will be joining the 

program soon. Dr. James Neton and Dr. Richard Toohey updated the Board on the status of claimant 

correspondence and how ORAU would incorporate its correspondence into OCAS’s process. Dr. Toohey 

distributed the latest personnel chart for ORAU and indicated that ORAU’s webpage may be accessed 

live at www.oraucoc.org. 

Update on IREP Latency Adjustment Functions for Leukemia and Thyroid 

Mr. Russell Henshaw updated the Board on recent changes to the proposed leukemia and thyroid cancer 

latency adjustment models, and distributed tables of Comparison of Probability of Causation Results at 

the 99th Percentile for both leukemia and thyroid cancer. Using hypothetical claimant inputs, the tables 

compared three latency adjustment models: the model currently in use, a model developed in October 

2002, and a newer model which NIOSH intends to adopt. Also presented were changes in the NIOSHIREP User’s Guide and in the NIOSH-IREP software, that have been made since April, 2002. 

Mr. Henshaw also presented a list of proposed research needs for NIOSH-IREP. 

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NIOSH/CDC Advisory Board on Radiation and Worker Health (ABRWH) Executive Summary/Minutes Febr uary 5-6, 2003

IREP and Scientific Issues Workgroup Report 

Dr. James Melius presented the Workgroup’s ideas regarding reasons for possible review of IREP, 

proposed a list of possible research topics, which looked very similar to Mr. Henshaw’s list of topics, and 

proposed a topic review process. A motion to utilize the Workgroup’s recommended topic review 

process was seconded and unanimously passed. The Board then organized the workgroup’s possible 

research topics into priority areas. 

Savannah River Site Health Effects Subcommittee (SRSHES) Activities 

Dr. Sergio Bustos, Chair of the SRSHES, explained the purpose, membership, and past and present 

activities of the SRSHES. He distributed and explained a map of the Savannah River Site (SRS), 

reminding the Board that SRS occupies 310 square miles in the boundary between Georgia and South 

Carolina. 

Board Discussion/Working Session 

Contract Procurement Office Issues 

Mr. Elliott asked the Board whether it wanted to switch contract procurement over to the DOL. Both Mr. 

Elliott and Mr. Pete Turcic of DOL described to the Board how each agency might handle contract 

procurement. Advantages and disadvantages were discussed. The Board deferred decision on this issue 

until later in the meeting. 

Workgroup and Subcommittee Issues 

The Board discussed how to best organize itself to handle dose reconstruction review. The advantages 

and disadvantages of subcommittees and workgroups were discussed. Processes involving both types of 

groups were discussed. No decision was made regarding which type would be used for the dose 

reconstruction review process. 

Dose Reconstruction Workgroup Update 

Mr. Griffon indicated that a decision needed to be made on how dose reconstruction cases would be 

reviewed. Mr. Griffon presented possible steps for the process. Members agreed that the Board should 

select the cases for review and that a stratified sampling of the cases would be necessary. It was also 

decided that the sample of the overall caseload should not be greater than 2.5%. The Board agreed that 

some type of checklist might be used to review all cases and that a fatal error process needed to be 

developed. 

Public Comment Period 

Public comment was solicited on both the first and second day of the deliberations. There were no 

comments on the second day. Public input on the first day included the following: 

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NIOSH/CDC Advisory Board on Radiation and Worker Health (ABRWH) Executive Summary/Minutes Febr uary 5-6, 2003

‘	 Issues related to NIOSH-IREP dose measures regarding internal and external exposures to the 

thyroid and how iodine intake was measured. 

‘	 Quality of the telephone interview reports was questioned. 

‘	 Concerns were expressed over the time it is going to take to process claims. 

‘	 Concerns were raised regarding the smoking adjustment. 

‘	 The Board was asked what would happen if adjudicated claims were found to contain errors. 

Thursday, February 6, 2003 

Board Discussion/Working Session 

Review and Approval of Draft Minutes, Meeting 10 

A motion to approve the executive summary and the minutes of the tenth meeting (with discussed edits) 

was seconded and unanimously passed. 

Dose Reconstruction Review Process 

The Board decided to establish a Workgroup to develop a Dose Reconstruction Review Process. The 

Dose Reconstruction Workgroup was charged with developing the procedures for identifying available 

dose reconstruction cases; developing the dose reconstruction case selection process; and developing the 

procedures for the selection of dose reconstruction cases. In parallel, the workgroup was tasked to 

develop task orders and task order process and procedures for the reviewer contractor soon to be hired. If 

time permits, the workgroup will also develop procedures for the review of dose reconstruction cases. 

Basic Review Report 

The Board discussed what a basic review report might look like. Items to be included in the report 

include adequacy and consistency of site and personnel data; adequacy of interview; adequacy of dose 

reconstruction and probability of causation determination. The report should identify strengths and 

weaknesses and eventually be part of a possible annual report that will be sent to the Secretary of the 

Department of Health and Human Services (DHHS). 

Procurement Administration Decision 

Dr. Ziemer asked the Board if anyone wished to make a motion to move the procurement administration 

to the DOL. Hearing no motion, Dr. Ziemer declared that the procurement would stay with CDC/NIOSH. 

Statement of Work Amendments 

The Dose Reconstruction Workgroup submitted a rewrite of Attachment A, Section E, Pages 9-10, 

Conflict of Interest. The section was revised to be more inclusive of prospective bidders. 

A motion to approve the rewrite of Attachment A, Section E, Conflict of Interest was seconded and 

unanimously passed. 

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NIOSH/CDC Advisory Board on Radiation and Worker Health (ABRWH) Executive Summary/Minutes Febr uary 5-6, 2003

Federal Register Changes Workgroup 

A Workgroup was appointed and charged with drafting discussion points concerning changes in the 

federal register regarding the Special Exposure Cohort (SEC) rulemaking. The group plans to meet via 

telephone or e-mail sometime before the next Board meeting to prepare points to discuss at the full Board 

meeting in March. 

ABRWH Schedule and Future Agenda Items 

The ABRWH’s next two meetings are scheduled for March 7, 2003, in Cincinnati, Ohio; and May 19-20, 

2003, in Oak Ridge, Tennessee. The Dose Reconstruction Workgroup plans to meet on March 6, 2003, 

and will present a progress report to the full Board in March. The back-up meeting date for the next 

ABRWH meeting is planned for March 18, 2003, with the Dose Reconstruction Workgroup meeting on 

March 17, 2003, in Cincinnati, Ohio. 

Housekeeping and Miscellaneous 

‘ Mr. Presley has forwarded concerns to the DOL regarding a DOL pamphlet that was causing 

confusion with regard to whether certain claims were to be handled through Workers 

Compensation or through the Sick Workers’ Bill. 

‘ Ms. Homer verified which action items on the list had been covered by this ABRWH meeting. 

‘ Mr. Presley offered to set up an ABRWH tour of parts of the Oak Ridge facility for the May 

19-20 meeting. 

Public Comment Period 

No members of the public signed up to address the Board during this second public comment period. 

With no further business posed, the meeting was officially adjourned at 1:51 p.m. 

End of Executive Summary 

ËËË

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NIOSH/CDC Advisory Board on Radiation and Worker Health (ABRWH) Executive Summary/Minutes Febr uary 5-6, 2003

The Advisory Board on Radiation and Worker Health 

National Institute for Occupational Safety and Health 

Centers for Disease Control and Prevention
 

Summary Minutes of the Eleventh Meeting
 

February 5-6, 2003
 

The Eleventh Meeting of the Advisory Board on Radiation and Worker Health (ABRWH, or the Board) 

was held at the DoubleTree Guest Suites in Charleston, South Carolina on February 5-6, 2003. The 

meeting was called by the Centers for Disease Control and Prevention’s (CDC’s) National Institute for 

Occupational Safety and Health (NIOSH), the agency charged with administering the ABRWH. These 

summary minutes, as well as a verbatim transcript certified by a court reporter, are available on the 

Internet on the NIOSH/Office of Compensation Analysis and Support (OCAS) Website located at 

(www.cdc.gov/niosh/ocas). Those present included the following: 

ABRWH Members: Dr. Paul Ziemer, Chair; Dr. Henry Anderson; Dr. Antonio Andrade; 

Dr. Roy DeHart; Mr. Richard Espinosa; Mr. Michael Gibson; Mr. Mark Griffon; Dr. James Melius; 

Ms. Wanda Munn; Mr. Robert Presley; and Dr. Genevieve Roessler. 

Designated Federal Official: Mr. Larry Elliott, Executive Secretary 

Federal Agency Attendees: 

Department of Health and Human Services: 

Ms. Martha DiMuozi, Mr. Russell Henshaw, Ms. Cori Homer, Ms. Liz Homoki-Titus, Mr. Ted Katz, 

Mr. David Naimon, and Dr. James Neton
 

Department of Labor: 

Mr. Jeffrey Kotsch and Mr. Peter Turcic 

Guests and Members of the Public: Ms. Rose Marie Andrade (Los Alamos, NM); Dr. Hans Behling (S. 

Cohen & Associates, Edenton, NC); Ms. Kathleen Behling (S. Cohen & Associates, Edenton, NC); Ms. 

Denise Brock (United Nuclear Weapons Workers of St. Louis, MO); Dr. Sergio E. Bustos (SRSHES, 

Augusta, GA); Mr. Todd V. Crawford (SRSHES, New Ellenton, SC); Ms. Julia DeHart (Nashville, TN); 

Donald Elisburg (CPWR); James Griffin (MJW Corporation, Olean, NY); Mr. Charles Jernigan (August 

Old Trades Medical Screening Program, Augusta, GA); Mr. W. Jeffrey Kleem (Science Applications 

International Corporation); Mr. Richard Miller (Government Accountability Project); Ms. Louise Presley
 

(Clinton, TN); Dr. Knut Ringen (CPRW, Seattle, WA); Mr. Richard G. Tabor (Fernald Atomic Trades 

and Labor Council); Ms. Teresa Robinson (Writer/Editor, Cambridge Communications, Atlanta, GA); 

Mr. D. Michael Schaeffer (DTRA); Dr. Richard Toohey (Oak Ridge Associated Universities); Ms. 

Debbie G. Williams, CVR (Certified Court Reporter, Cumming, GA); Ms. Marilyn Ziemer (Lafayette, 

IN). 

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NIOSH/CDC Advisory Board on Radiation and Worker Health (ABRWH) Executive Summary/Minutes Febr uary 5-6, 2003

Wednesday, February 5, 2003 

Opening Remarks 

Call to Order/Welcome 

Dr. Paul Ziemer called the meeting to order at 8:35 a.m., welcoming the attendees. He reminded 

everyone to register their attendance each day at the registration table located in the back of the room, and 

instructed members of the public to sign up if they wished to address the Board during the public 

comment periods. 

Announcements 

Mr. Larry Elliott, Executive Secretary, explained that the Notice of Proposed Rulemaking on Additions to 

the Special Exposure Cohort was not complete. Therefore, that discussion did not appear on the agenda. 

Approval of Summary of Closed Session, Meeting 10 

Dr. Ziemer deferred approval of the full draft of the tenth meeting minutes until the next morning because 

the Board had not had a chance to review them. He then asked the Board to enter in a formal motion to 

approve the Summary of the Closed Session of the January 8, 2003 meeting. 

Motion 

Dr. Antonio Andrade moved to approve the January 8, 2002 Summary of the Closed Session minutes as 

written. Mr. Robert Presley seconded. The motion received unanimous approval. 

Program Status Report 

Ms. Martha DiMuzio 

Program Analyst , NIOSH/OCAS 

Ms. DiMuzio presented the Office of Compensation Analysis and Support (OCAS) Program Report for 

February 2003, as Mr. David Sundin was unable to attend. Ms. DiMuzio provided statistics for the 

number of cases received for dose reconstruction as of January 31, 2003. She indicated that the National 

Institute for Occupational Safety and Health (NIOSH) has moved to a new SQL system used by both 

NIOSH and ORAU, and numbers in her presentation might not be exact. As of January 2003, OCAS has 

received approximately 10,472 cases from the Department of Labor (DOL) for dose reconstruction, 

receiving, on average, 150 to 200 cases per week. The majority of the claims are from Department of 

Energy (DOE) sites. Approximately 16% are from Atomic Weapons Employer (AWE) workers. 

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NIOSH/CDC Advisory Board on Radiation and Worker Health (ABRWH) Executive Summary/Minutes Febr uary 5-6, 2003

In January 2003, Oak Ridge Associated Universities (ORAU) took over responsibility for conducting 

dose reconstructions. Ms. DiMuzio shared DOE response statistics as of December 31, 2002 for the 

seven larger sites (Idaho, Nevada, Oak Ridge, Ohio Field, Richland, Rocky Flats, Savannah River [SRS]) 

which represented 81% of the total information requests that OCAS has made to the DOE. If a claim 

response takes over 150 days, the DOE is contacted for a status report. Response numbers are not 

indicative of the quality of the data received from the sites. In many cases, sites that have taken the 

longest to respond have provided OCAS with the most complete claimant information. 

To date, approximately 726 telephone interviews with claimants have been conducted and more than 389 

interview reports have been sent to claimants for review and comment. Currently, 144 dose 

reconstructions are underway. Over the past month, OCAS staff have focused on reviewing the initial 62 

dose reconstructions received from ORAU to ensure compliance and to establish procedures. ORAU is 

currently updating those 62 dose reconstructions to incorporate NIOSH comments and continues to work 

on an additional 82. OCAS has completed 18 draft dose reconstruction reports. Of the 18 cases, 14 have 

been transmitted back to DOL for completion of administrative records and for final adjudication. On 

January 24, 2003, letters were sent to 35 physicians appointing them to the DOE Physician Panel. OCAS 

also has been working to fill an additional 22 positions. Six new health physicists and five public health 

advisors will be joining the program soon. 

Discussion Points: 

‘	 Ms. DiMuzio indicated that OCAS is not tracking website hits. 

‘	 Dr. Melius asked why Idaho and SRS took so long to respond to requests for information, and 

whether these were initial responses. Dr. Jim Neton replied that OCAS has recently received 

approximately 100 additional completed responses from SRS, but not all of them have been 

entered into the new system. Both sites had to add personnel for the increased workload. He 

reiterated that the information received from sites that took longer to respond were good quality 

responses, and often better than those who responded more quickly. He indicated that all 

responses, initial, secondary, and other, will be tracked and that all information will go into the 

claimant’s file. 

‘	 Mr. Elliott pointed out that the numbers in the program would soon become more fluid and that 

cases would be handled on a first-come-first-served basis, with the older claims being handled 

first. 

‘ Dr. Melius asked about the status of the Memorandum of Understanding (MOU) with DOE. 

Mr. Elliott replied that the MOU is now being reviewed by NIOSH’s general counsel. 

‘ Dr. Melius suggested posting the timeline for pending claims on the website for accountability 

purposes. 

Status of Claimant Correspondence 

Dr. Jim Neton Dr. Richard Toohey 

NIOSH/OCAS Oak Ridge Associated Universities (ORAU)
 

Dr. Neton indicated that during the current claims process, OCAS sends the following communications to 

claimants: 

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NIOSH/CDC Advisory Board on Radiation and Worker Health (ABRWH) Executive Summary/Minutes Febr uary 5-6, 2003

Communication Purpose 

Acknowledgment Letter Informs claimant that OCAS has received claim and has issued a request to the DOL for 

exposure information. In the current process, file transferred to ORAU for receipt of DOE 

information. 

Telephone Interview Letter Asks claimant to schedule a telephone interview. The package includes a summary of the 

line of inquiry allowing claimant to gather their information and prepare responses. 

Telephone Interview 

Summary Report 

Gives claimant an opportunity to either correct or provide supplemental information. 

Draft Dose Reconstruction 

and OCAS-1 form 

Informs claimant that dose reconstruction has been assigned and completed. Provides 

claimant with opportunity to provide feedback on the dose reconstruction. (If claimant 

agrees dose reconstruction adequately addresses concerns, the claimant signs the OCAS-1 

form and returns it to OCAS). 

Final Dose Reconstruction Once OCAS receives the signed OCAS-1 form, the final dose reconstruction is issued and 

copies are forwarded to the DOL and the claimant. 

ORAU is attempting to integrate into this process. Dr. Richard Toohey highlighted the ORAU claimant 

correspondence process as follows: 

Communication Purpose 

ORAU Introduction Letter Briefly describes the roles and responsibilities of the ORAU team, making it clear that 

ORAU is a support contractor to NIOSH, which retains responsibility for the claims process. 

Four teams will cover the claimants; includes information about ORAU and its principles 

and partners (tri-fold brochure); includes a brief corporate history; assigns a claims manager 

(health physicist) and a claims specialist (support staff) who will be the claimant’s main 

point of contact (POC); includes the toll-free number to ORAU; includes Telephone 

Interview Letter (From OCAS process). 

Telephone Interview 

Summary Report 

From OCAS process 

Status Report Informs the claimant that claim is moving into the process of dose reconstruction. Claimant 

will receive information on the health physicist assigned to do their dose reconstruction. At 

this point, claimant has opportunity to object to the health physicist. If no objections, then 

the actual dose reconstruction will proceed. 

After the dose construction is completed, ORAU will send the dose reconstruction to NIOSH for review 

and approval. Then the claimant is sent the Draft Dose Reconstruction and OCAS-1 form and the Final 

Dose Reconstruction (from OCAS process). Dr. Toohey distributed the latest chart, which lists the 

ORAU personnel to date. He also indicated that the ORAU webpage was live at www.oraucoc.org. 

Currently, the website displays biographical sketches of several ORAU health physicists, and more will 

follow. 

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NIOSH/CDC Advisory Board on Radiation and Worker Health (ABRWH) Executive Summary/Minutes Febr uary 5-6, 2003

Discussion Points: 

‘	 Dr. Ziemer wondered what the parameters were on requesting a different dose reconstructor. 

Dr. Toohey responded that requests would be considered on an individual basis, and that ORAU 

anticipated that most requests will center around conflicts of interest. All valid and reasonable 

requests will be considered. 

‘	 A discussion ensued regarding the anticipated number of calls to the toll-free line and whether 

ORAU had adequate staff to handle those calls. Dr. Toohey and others explained that the claim 

specialist’s job is to interact with the claimant and retrieve data. Also, both NIOSH and ORAU 

will be assigning staff to each claimant. All POCs will be able to access the NIOSH-OCAS 

Claims Tracking System (NOCTS). 

‘	 Concerns were raised regarding the adequacies of the telephone interview program and report. 

Dr. Neton pointed out that changes were being made in the computer system to allow the 

telephone interviewer more response space on the computer form. Claimants are given the 

opportunity to make changes to and provide feedback on that report. Dr. Toohey clarified that 

there were two opportunities for claimant recourse: first, when the claimant receives the Draft 

Dose Reconstruction Report, and second, after claimant receives the final dose reconstruction. 

Once the DOL receives the final dose reconstruction and the full administrative record, the DOL 

will render a decision. At that point, the claimant may contest that decision. 

‘	 Mr. Elliott noted that in the next few weeks, assignments for dose reconstruction will occur. A 

number of Computer Assisted Telephone Interviews (CATI) have been completed. He stressed 

that it was important to integrate the ORAU communications into the process soon. He explained 

that the process for the initial 62 claims would be different from the rest of the claims because of 

the integration of the ORAU process. The first 62 were test dose reconstructions to ensure proper 

procedures were in place. 

‘	 Some Board members expressed an interest in seeing samples of the letters that were going to be 

used by ORAU. E-mailing them or posting them on the web-site was suggested. Dr. Toohey 

indicated that they would be distributed to the Board members in some fashion. 

‘	 Mr. Griffon asked if there was a list of ORAU procedures available. Dr. Toohey responded that 

ORAU supplies a list of documents, including procedures, with their monthly report to NIOSH. 

He stated that he could provide a draft external dose reconstruction procedure, but that the 

internal dose reconstruction procedure had not been approved. 

‘	 Mr. Gibson expressed concern regarding the shallow pool of internal dosimetrists and wondered 

whether enough of them would remain at the sites to do their current work. Dr. Toohey explained 

that most of the health physicists were recruited from closing sites, and the majority are part-time 

staff who are acting as independent consultants to ORAU. Dr. Andrade pointed out that 

normally, those responding to requests for facility information are usually document specialists 

and not necessarily health physicists, so they would not be competing with this pool of health 

physicists. 

‘	 Mr. Elliott stated that NIOSH is very aware of the obligation to protect information vital to 

national security. He indicated that NIOSH has conducted five secure interviews, and secure 

interviews are always available for claimants who feel they need them. 

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NIOSH/CDC Advisory Board on Radiation and Worker Health (ABRWH) Executive Summary/Minutes Febr uary 5-6, 2003

IREP Update 

Mr. Russell Henshaw 

NIOSH/OCAS 

Mr. Henshaw noted that NIOSH was concerned that the NIOSH-Interactive RadioEpidemiological 

Program (NIOSH-IREP) assigned no risk, no probability of causation, for radiation exposures that 

occurred within two years of diagnosis for leukemia and within three years of diagnosis for thyroid 

cancer. The feeling at NIOSH was that science did not support such a severe and absolute adjustment 

function for these two cancer models. SENES Oak Ridge, Inc. (SENES) was tasked to develop new 

adjustment models that factored in nonzero risk for short latency periods. Those models were presented 

to the Board in October. Upon evaluation of the new models, NIOSH found that, even though they did 

not factor in probability at short exposure periods, they actually reduced probability of causation at some 

times since exposure. NIOSH was uncomfortable with this unanticipated effect. 

SENES was asked to revisit these cancer adjustments, specifying that any developed model should not 

have the effect of reducing probability of causation at any time since exposure when compared to the 

current models, and yet still factor in some nonzero risk, as appropriate, at all times since exposure. In 

December, SENES developed the new models. Mr. Henshaw presented tables of Comparison of 

Probability of Causation Results at the 99th Percentile for both leukemia and thyroid cancer. Using 

hypothetical claimant inputs, the tables compared three latency adjustment models: the model currently in 

use, the model presented to the Board in October 2002, and a newer model which NIOSH intends to 

adopt. 

Regarding other NIOSH-IREP issues, Mr. Henshaw indicated that a new NIOSH-IREP User’s Guide had 

been distributed and that copies had been FedExed to the Board. The new guide was redesigned 

specifically for the DOL for use by their claims examiners. The guide includes changes to software since 

April 2002; a revised and expanded glossary; file-naming conventions for input files; expanded coverage 

of claims needing extra calculations; and new screenshots (log-on screen, summary report, “Multiple 

Primary Cancers” online calculator, input file template). The new User’s Guide will be placed on the 

website. 

Since April 2002, several improvements have been made to the NIOSH-IREP software. Changes include: 

new opening screen allowing choice of manual data entry or use of input file; default simulation sample 

size increased to 2000; random seed number generator; multiple primary cancer calculator; online direct 

links to cancer model tables in NIOSH-IREP Technical Documentation (work in progress). 

Regarding scientific issues and IREP research needs, Mr. Henshaw noted that the current version of IREP 

was created under time constraints imposed by EEOICPA and was never intended to be a stationary 

product. It has been recognized from the beginning that more research would be needed and that changes 

should be made whenever appropriate. The changes in the leukemia and thyroid latency models are the 

beginning, but there are other issues that are just as or even more important. Mr. Henshaw compiled a list 

of research topics for the Board to consider. This list, which is not all-inclusive, is as follows: Evaluation 

of DOE workforce data; review of risk transfer from the Japanese cohort; review of time-dependent 

factors, such as age at exposure and time since exposure; update of cancer incidence background rates; 

review of “minimum latency” adjustments, of various smoking/lung cancer issues, of race/ethnicity 

adjustment for skin cancers, of DDREF and other dosimetry issues; re-evaluation of chronic lymphocytic 

leukemia (CLL); and review of interactions with other workplace exposures. 

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NIOSH/CDC Advisory Board on Radiation and Worker Health (ABRWH) Executive Summary/Minutes Febr uary 5-6, 2003

Discussion Points: 

‘	 Dr. Ziemer asked how the National Cancer Institute (NCI) planned to utilize the new model. Mr. 

Henshaw responded that at first NCI was planning to adopt the old model, but now they are 

leaning toward adopting the new model. 

‘	 Mr. Henshaw noted that latency is the most difficult aspect of modeling, especially in regard to 

leukemia and that it is NIOSH’s mission to be claimant-friendly where science fails. 

‘	 Dr. Melius asked what the status was of NCI finishing IREP. Mr. Henshaw responded that 

another draft of the working report had been sent for internal peer review by NCI in early 

December, 2002. Mr. Elliott added that the changes that NIOSH has sponsored have triggered a 

revision of NCI’s working document. Those revisions must be cleared through the Department of 

Health and Human Services (DHHS). 

‘	 Dr. Melius inquired about the National Academy of Sciences (NAS) review report. Mr. Elliott 

responded that the NAS review was completed and addressed all the National Academy of 

Science’s comments. The NIOSH-IREP is standalone and has been approved by DHHS for use. 

Regulations allow for substantial modifications through a formal process. 

‘	 Dr. Ziemer asked the Board if they wished to show support for the current fixes in the NIOSHIREP leukemia and thyroid cancer latency models. Board members agreed to the fixes, but 

cautioned that any support should be qualified with some statement to the effect that science does 

not necessarily support either model, and that this is a claimant-friendly approach. Dr. Neton 

indicated that the documentation includes a discussion about cancer models, their adoption to 

IREP, and the science supporting them. He stated that modifications could be made to the 

leukemia and thyroid cancer model discussions regarding the claimant-friendly approach in 

adopting the new models. 

‘	 Dr. Roessler asked for a status update on BIER-VII and whether it would cover some of the 

above research issues. Dr. Ziemer noted that BIER-VII was not yet published. The release 

would be dependent upon the National Academy of Science’s (NAS) review process. 

IREP & Scientific Issues Workgroup Report 

Dr. James Melius 

IREP & Scientific Issues Workgroup 

Dr. Melius indicated that the IREP and Scientific Issues Workgroup was charged with setting up a review 

process for IREP and other scientific issues that might be raised during the overall claims and dose 

reconstruction processes. Reasons for possible review include: limitations of IREP or other science-based 

models used for dose reconstruction; limitations usually related to applicability of model for DOE 

workers; limitations related to assumptions used for model; possible need to review science to improve 

IREP or other models for use in this application; and review may be triggered by alternate approaches 

used in other programs using IREP or perceived problems with application. 

The group compiled a list of possible research topics based on past discussion, communications, and 

public comments that the Workgroup felt were of importance. Dr. Melius pointed out that the Workgroup 

list looked quite similar to NIOSH’s research needs list, even though the two groups did not collaborate 

on this issue. The list includes the following: 

• Smoking adjustment for lung cancer 

• Age at exposure/survivor population 

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NIOSH/CDC Advisory Board on Radiation and Worker Health (ABRWH) Executive Summary/Minutes Febr uary 5-6, 2003

• Incorporation of occupational studies 

• CLL and other leukemias 

• Incorporation of background cancer risks 

• Grouping of rare types of cancer; DDREF adjustments 

• Latency for thyroid cancer and leukemia 

The workgroup proposed the following process regarding these topics: Prioritize the topics; NIOSH 

prepares a background briefing (report) on each of these topics that might include recommended changes 

or policy issues; Peer review consultation on background briefing (could include agencies like NCI and 

other outside scientists); Presentation of report and review to Board by NIOSH and consultants (as 

necessary); Board would make recommendations based on report, review, and presentation; If change in 

IREP or other dose reconstruction is needed, NIOSH would proceed with Federal Register notice, etc.; 

and Board reviews changes, comments, and makes final recommendations. 

Discussion Points: 

‘	 Mr. Elliott reminded the Board that the regulation which speaks to modification of IREP, Section 

81.12b, allows the Board and other sources to recommend revisions to the NIOSH-IREP for 

NIOSH consideration. Section 81.12c requires that before NIOSH implements any revisions to 

the NIOSH-IREP that would substantially affect estimates of probability of causation, NIOSH 

must obtain a review of the Board and address any Board recommendations arising from such 

review. Section 81.12d requires NIOSH to notify the public, through the relevant Board meeting 

notice, of any substantial change. Fixes are different and require no such process. 

‘	 Dr. Andrade and others felt that prioritization of the topics needed to be done first. He also liked 

the proposed process and felt it increased transparency. Mr. Elliott stressed that some of the 

suggested topics would take more time to accomplish than others, and asked that timeline be 

considered when prioritizing. 

Motion 

Dr. Ziemer interpreted the IREP and Scientific Workgroup’s report as a motion that the Board utilize the 

workgroup’s recommended topic review process. There were no objections from the Board, and a vote 

was taken. The motion received unanimous approval. 

The Board then grouped the possible research topics into the following order: 

Priority One Topics 

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NIOSH/CDC Advisory Board on Radiation and Worker Health (ABRWH) Executive Summary/Minutes February 5 -6, 2003

‘ Incorporation of occupational studies 

‘ Smoking adjustment for lung cancer/incorporation of background cancer risks 

‘ Grouping of rare and miscellaneous cancers (including prostate cancer) 

Priority Two Topics 

‘ Age at exposure/survivor population 

‘ Interaction with other workplace exposures. 

Regarding all topics, the Board should consider consistency with other compensation programs. This 

list is not all inclusive and may be amended from time to time. 

Savannah River Site Health Effects Subcommittee Activities 

Dr. Sergio Bustos, Chair 

Savannah River Site Health Effects Subcommittee (SRSHES)
 

Dr. Bustos indicated that the SRSHES was established to identify the needs of exposed and 

potentially exposed populations around the SRS; make recommendations to the CDC; and advise 

NCEH, NIOSH, and Agency for Toxic Substances and Disease Registry (ATSDR). The 

Subcommittee also evaluates the adequacy of the agencies’ health research and public health 

activities at SRS. SRSHES membership, which currently stands at 18, includes knowledgeable 

persons selected by federal agencies who bring experience and/or scientific and technical 

expertise to the group, as well as representatives of concerned or affected communities. The 

vision of the SRSHES is to study the potential health effects of releases of radioactive and 

hazardous materials from SRS on offsite populations and SRS workers. Since 1995, the 

Subcommittee has: considered presentations, summaries and proposals by agencies; 

recommended changes in the peer review protocols used by agencies; advised RAC on Phase I 

procedures of the dose reconstruction procedures; developed a brochure describing purpose and 

functions of SRSHES; instituted a toll-free phone line; provided input to the Advisory Committee 

for Energy-Related Epidemiological Research (ACERER); and participated in Phases I and II of 

the Dose Reconstruction Project. 

The SRSHES is currently assisting in developing scenarios for radionuclide screening analysis, 

which includes defining types and locations of those families who may have been exposed to 

harmful substances. Dr. Bustos reminded the Board that SRS occupies 310 square miles in the 

boundary between Georgia and South Carolina, and small creeks and rivers inside the SRS drain 

into the Savannah River. 

Discussion Points: 

During the discussion, Dr. Bustos provided the Board with the following information: 

‘ There is sufficient evidence for investigating whether effects are multiplicative or 

cumulative. 

‘ No anomalies were found during dose reconstruction except that inventory was kept 

better at some points than at other points. This anomaly was corrected by interviews with 

the past workers who provided missing information. 

‘ Mr. Elliott pointed out that one of the SRSHES’s greatest accomplishments was to effect 

change across the three agencies, ATSDR, NCEH and NIOSH, regarding how the peer 

review process was handled on individual research projects. 

13
 
NIOSH/CDC Advisory Board on Radiation and Worker Health (ABRWH) Executive Summary/Minutes February 5 -6, 2003

Board Discussion/Working Session 

Contract Procurement Agency Issues 

Dr. Ziemer directed the Board’s attention to the Request for Contract developed by the Board’s 

Dose Reconstruction Workgroup. He asked Mr. Elliott for an update on the procurement process. 

Mr. Elliott indicated that the document labeled Draft 01/31/03 was the document that NIOSH 

understood the Board had reached a consensus on at their January meeting. Also, at previous 

meetings, some concerns were expressed regarding NIOSH acting as the contracting office for 

procurement of the Board’s dose reconstruction auditor. After discussions at NIOSH, it was 

decided that the DOL might, under existing regulations, alternatively serve as the contracting 

office for this purpose. Mr. Elliott asked the Board whether they would prefer NIOSH or the 

DOL to act as the contracting agency. 

Mr. Pete Turcic presented the DOL’s perspective on how they would handle the contract’s award 

and administration, a process similar to NIOSH’s process. No matter which agency was chosen, 

either would be working in an administrative capacity only, and neither felt there that there were 

any conflict of interest issues. If the change is made, a MOU might be in order between involved 

parties. The Board discussed choosing one agency over the other, and ultimately deferred the 

decision until after salient points of the dose reconstruction review process could be considered. 

Workgroup Versus Subcommittee: Organizational Issues 

A discussion ensued regarding the differences between a workgroup and a subcommittee. 

Agency staff explained that a workgroup is a short-term group charged with specific tasks. Once 

those tasks are completed, the workgroup is dissolved. A Subcommittee handles longer, ongoing 

tasks that need to be performed on a more regular basis. A Subcommittee must be formally 

established, and the same rules that apply to the Advisory Board would apply to a Subcommittee. 

In regard to the Board, a Subcommittee would not necessarily be doing the reviews of individual 

dose reconstructions, but instead would oversee the flow of work, deciding the numbers of the 

different categories of dose reconstructions that will be reviewed by the Board, and assigning 

tasks of the review process to Board members and consultants. 

It was pointed out that a Subcommittee does not have to be a majority of the Board members and 

that outside consultants may participate on the Subcommittee. Neither a Subcommittee nor a 

workgroup may act on behalf of the Board. Any decisions or work done by Subcommittees or 

workgroups must be brought to the full review of the Board. 

The Board asked for clarification on the dose reconstruction process so that they could think 

about group organization relative to that timeline. Ms. DiMuzio presented a handout on how the 

entire task order contract award processing worked at NIOSH. If the procurement is complete, 

the task order process could take 2 months to go from the Board to the contractor. The main 

procurement, under optimal conditions, takes 3 to 4 months. Ultimately, the entire process could 

take up to six months. 

Mr. Elliott asked whether there would need to be two executive sessions on any individual task 

order, one to prepare the task order and the IGE, and another to examine the contractor’s 

proposal, deliberate on the proposals, and estimate and provide any negotiation points back to the 

contracting officer. It was decided that an IGE must be developed during a full Board meeting in 

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NIOSH/CDC Advisory Board on Radiation and Worker Health (ABRWH) Executive Summary/Minutes February 5-6, 2003

a closed session. Ms. DiMuzio indicated that if the Board receives a proposal back from the 

contractor and approves the estimate, there would be no need for a second executive session. 

Dose Reconstruction Workgroup Update 

Mr. Griffon explained the Dose Reconstruction Workgroup’s review process model. He called 

the Board’s attention to the workgroup’s slides from July presentation and indicated decisions 

needed to be made on how dose reconstruction cases would be reviewed. The Board discussed 

the completed dose reconstruction case selection process, including the projection of possible 

numbers of cases and the types of cases that might be available at any given time. The Board 

agreed with the workgroup that the Board should select the cases for review. A stratified 

sampling of the cases is necessary, considering at least the following parameters: site, exposure 

type, cancer type, time period (50s, 60s, etc.). The sample of the overall caseload should not be 

greater than 2.5%. Discussion included the idea of an audit report form or a checklist with which 

the Board or workgroup might review all cases. It was pointed out that although the contractor 

will provide the expertise required to do case reviews, ultimately, oversight of these reviews is 

the Board’s responsibility. A fatal error process also needs to be developed. 

Public Comment Period 

Dr. Hans Behling 

S. Cohen and Associates 

Dr. Behling raised a question about whether the IREP thyroid cancer model addresses the effects 

of internal and external exposure to the thyroid. In response, Dr. Neton indicated that internal and 

external exposures are treated independently and that NIOSH-IREP used the standard default 

ICRP values for uptake of iodine. 

Ms. Denise Brock 

United Nuclear Weapons Workers of St. Louis, Missouri 

Ms. Brock raised a number of issues on behalf of all the Missouri claimants. Ms. Brock has 

gathered a tremendous amount of information regarding the Mallinckrodt Downtown Destrehan 

facility, where her father worked for 16 years before his death. She raised questions about the 

review process, about a DOL standard letter to claimants stating that reconstrucetion may take 

months or years, and about the adjustment in the risk models for smoking. 

Mr. Richard Miller 

Government Accountability Project 

Mr. Miller inquired as to what the Board would do if they looked at a case and found 

questionable assumptions that might affect an individual’s case or several cases Mr. Elliott 

responded that regulations allow dose reconstructions that have been completed to be revisited. If 

credible evidence of errors is provided by a review, those errors will be addressed. 

Regarding the idea of DOL becoming the contracting authority for the Board, Mr. Miller 

commented on the advantages or disadvantages of one agency over the other. 

With no further comments, the Board officially recessed at 5:05 p.m., until the following morning. 

15
 
 

 

NIOSH/CDC Advisory Board on Radiation and Worker Health (ABRWH) Executive Summary/Minutes February 5-6, 2003

Thursday, February 6, 2003 

Board Discussion/Working Session 

Dr. Paul Ziemer called the meeting to order at 8:35 a.m. 

Review and Approval of Draft Minutes, Meeting 10 

The Board reviewed the minutes of their tenth meeting, held on January 7-8, 2003, and approved 

the following changes: 

‘ Executive Summary, Page 7, Board Housekeeping, Sentence #1: Corrected to read: 

“Board housekeeping included an added agenda item (update on implementation of the 

conflict of interest policies) at the February meeting in Charleston, SC; a likely need for a 

conference call on February 19 or 20, for 2-3 hours to discuss the expected SEC 

rulemaking if it is issued on the week of January 20 for a 30-day comment period that 

ends February 21.” 

‘ Main Minutes, Page 21, Board Housekeeping, Paragraph 2, Sentence #1: Corrected 

to read: “Dr Ziemer noted that the SEC rulemaking may be issued on the week of 

January 20, and the 30-day comment period ends February 21.” 

Motion 

Mr. Presley moved to approve the executive summary and the minutes of the tenth meeting with 

noted changes. Dr. Andrade seconded. The motion received unanimous approval. 

Dose Reconstruction Review Process 

The Board decided to establish a workgroup to develop a Dose Reconstruction Review Process. 

Following an in-depth discussion regarding possible workgroups tasks, Dr. Ziemer appointed a 

Dose Reconstruction Workgroup comprised of the following Board members: Mark Griffon 

(Workgroup Chair), Roy DeHart, Robert Presley, Genevieve Roessler, and Richard Espinosa. 

Alternate members include: Jim Melius, Mike Gibson, Tony Andrade, Wanda Munn, and Henry 

Anderson. 

The Dose Reconstruction Workgroup was charged with the following tasks: 1) Develop the 

procedures for identification of available dose reconstruction cases; 2) Develop the dose 

reconstruction case selection process; and 3) Develop the procedures for the selection of dose 

reconstruction cases. In parallel, the Dose Reconstruction Workgroup was tasked to: Develop the 

task orders and task order processes and procedures for the dose reconstruction reviewer 

contractor soon to be hired. Time permitting, the Dose Reconstruction Workgroup also will: 

Develop the procedures for the review of dose reconstruction cases. 

Basic Review Report 

The Board then discussed what a basic review report might look like. Following their 

deliberations regarding this issue, the Board decided that the proposed report might be or include 

the following: 

1) Adequacy and consistency of the site and personnel data; 2) Adequacy of the interview; 3) 

Adequacy of the dose reconstruction and the probability of causation determination; 4) Individual 

16
 
 

 

NIOSH/CDC Advisory Board on Radiation and Worker Health (ABRWH) Executive Summary/Minutes February 5-6, 2003

reports and group reports, compiled into a composite annual report that identifies strengths and 

weaknesses; and 5) Annual report sent to the Secretary of DHHS. The Report was passed on to 

the workgroup for further development. 

Procurement Administration Decision 

Dr. Ziemer asked the Board if anyone wished to make a motion to move the procurement 

administration to the DOL. Hearing no motion, Dr. Ziemer declared that the procurement would 

proceed through the CDC/NIOSH, and instructed Mr. Elliott to proceed with the procurement. 

Statement of Work Amendments 

Dr. Ziemer asked the Dose Reconstruction Workgroup if they recommended any changes to the 

Request for Contract document. The Workgroup asked that the Board consider the changes in the 

newly drafted Workgroup Request of Contract document labeled “Draft - 02/06/03.” Mr. Griffon 

explained revisions to Attachment A, Section E, Page 9-10, Conflict of Interest. This section was 

completely redrafted and the language was amended to be more inclusive of prospective bidders. 

The amendments were discussed in detail. 

Motion 

Mr. Griffon moved to accept the amendments made to Attachment A. Dr. Roessler seconded. 

The motion received unanimous approval. 

Federal Register Changes Workgroup 

A second workgroup was established and charged with drafting discussion points concerning 

changes in the Federal Register regarding the Special Exposure Cohort rulemaking. Jim Melius, 

Mike Gibson, and Paul Ziemer volunteered for this task. The group plans to meet via telephone or 

e-mail sometime before the March 7, 2003 ABRWH meeting to prepare points to discuss at the 

full Board meeting. Ted Katz also plans to attend the meeting and will assist the group by 

providing a crosswalk analysis of changes made in the federal register language regarding the 

SEC. 

ABRWH Schedule and Future Agenda Items 

The ABRWH’s next meeting will be held on March 7, 2003, in Cincinnati, Ohio. Proposed 

agenda items include: 

‘ If published, review the Special Exposure Cohort rulemaking under the guidance of the 

Federal Register Workgroup. 

‘ Review the Dose Reconstruction Workgroup’s progress regarding procedures and 

processes of case selection and task orders. 

‘ Discuss IREP and other scientific issues. Suggested priority topics include: 

Priority One Topics Priority Two Topics 

Incorporation of occupational studies Age at exposure/survivor population 

Smoking adjustments for lung 

cancer/incorporation of background 

cancer risks 

Interaction with other work place exposures 

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NIOSH/CDC Advi.ron1 Board 011 RDdJDtiOll mill WorD,. Health fABRWHJ E8t:IIJive SWIfmanI/MbnIw F.hrIIDrv 5-6. 2063

The Dose Reconstruction Workgroup plans to meet on March 6, 2003, in Cincinnati, Ohio, and

will present a progress report to the full ABR WH meeting on March 7, 2003. The Workgroup

requested that a staff representative ofNIOSH also attend the meeting. The back-up meeting date

for the next ABRWH meeting is planned for March 18,2003, with the Dose Reconstruction

Workgroup meeting on March 17,2003, in Cincinnati, Ohio. The following ABRWH meeting is

planned for May 19-20,2003, in Oak Ridge, Tennessee.

Housekeeoin2 and Miscellaneous

Mr. Presley reported that he has forwarded concerns to the DOL regarding a DOL pamphlet

which was causing confusion with regard to whether certain claims were to be handled through

Workers Compensation or through the Sick Workers' Bill. DOL will be addressing those

concerns.

Ms. Homer reviewed the current action item list, verifying which items were covered during this

meeting. She asked Board members to check the roster to make sure their contact information

was correct. Ms. Homer also asked members to record time spent (other than meeting time),

noting they should be specific when identifying meeting preparation time and workgroup time, and forward for approval. .

Mr. Presley offered to set up an Advisory Board tour of parts of the Oak Ridge facility for the

May 19-20 meeting, in Oak Ridge, Tennessee. Approximately twenty people indicated that they

would be interested in the tour. Mr. Presley will make the necessary arrangements.

Public Comment Period

No members of the public signed up to address the Board during the public comment period.

Dr. Ziemer thanked the Board/or their hard work. With no further business posed; the meeting

was officially adjourned at 1:51 p. m.

End of Summary Minutes

'i"i"i'

I hereby confirm that these Summary Minutes are accurate to the best of my knowledge:

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Date

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