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ORRHES Meeting Minutes,
January 18-19, 2001
January 19, 2001
The Subcommittee reconvened at 9:00 a.m. on the following
day. Dr. Davidson summarized the previous day's discussions.
ATSDR
Public Health Assessment Process
Mr. Jack Hanley, who leads the public health Assessment
at the Oak Ridge Reservation, described ATSDR's public health
assessment process. The public health assessment was delayed
pending the completion of Tennessee's dose reconstruction
to avoid duplicating its work.
A public health assessment is an analysis and statement
of the public health implications to off-site populations
from releases of hazardous substances, after which a triage
process determines the need for follow-up public health
actions or studies. The resulting document helps federal
and state agencies and citizens to decide the follow-up
public health activities needed. Of its seven steps in identifying
a completed exposure pathway, the third and fourth are potentially
the major drivers of the Oak Ridge assessment.
1. Evaluate site information: The Subcommittee
will help in developing site-specific information as ATSDR
collects data on: background information, community health
concerns demographics, uses of land and natural resources,
environmental data, and environmental pathways (the physical
characteristics that affect contaminant transport offsite).
2. Identify Community Health Concerns. ATSDR will
identify the community members actively involved in these
issues, as well as involve the overall community in the
public health assessment process. GWU's work and the input
of the Subcommittee will help this process. A section of
the public health assessment will list the concerns collected;
another section (Public Health Implications) will address
those concerns. Communications will be maintained with the
community and all involved parties throughout the process.
3. Determine Contaminants of Concern. This is
the first major screening assessment of the public health
assessment process. The contaminants used at the facilities
will be identified, and any which involved significant releases
which may have contributed significantly to off-site health
hazards. None of the contaminants are considered a health
hazard until the pathway analysis is complete.
4. Identify and Evaluate Exposure Pathways. The
Subcommittee's input on exposure pathways is expected to
be significantly helpful. Each site has unique characteristics
that affect the impact of the exposure pathway. This is
a complex process in which, first, each of the five elements
of an exposure pathway are identified (a. contaminant source,
b. environmental media that transports it to a human; c)
exposure point, the d) route of exposure [ingestion, inhalation,
etc.], and e) the receptor population). The pathways are
then categorized as completed or potential in either the
past, present, or future, which determines whether the pathway
can be eliminated. If any one of the five elements is missing,
a potential pathway is determined; if all are present it
is deemed complete. A toxicological investigation is then
done to assess the potential implications. Pathway analysis
enables the health assessor to focus on completed pathways.
5. Determine Public Health Implications. The pathway
analysis provides a systematic methodology with which to
identify receptors, and lays the foundation for evaluating
the public health implications. The latter is done in three
areas: toxicology, health outcome data, and community health
concerns.
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The toxicological evaluation estimates media-specific
exposures, compares exposure estimates with health guidelines;
determines exposure-related health effects; and evaluates
other factors that influence adverse health outcomes.
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Health outcome data is evaluated for all identified
plausible health outcomes associated with the contaminants
that are determined to be of public health concern.
- Community health concerns are evaluated using environmental
data, exposure pathways analysis, toxicological evaluation,
and health outcome data evaluation. These help determine
whether the outcome is plausible. If not, other data and
information are explored to explain the likelihood of
the outcome. Finally, other issues related to environmental
and other concerns are addressed.
6. Determine Conclusions. A public health hazard
category will be assigned to the site, the health implications
from completed exposure pathways identified, and plausible
community health concerns will be defined. Missing or insufficient
information will also be described to outline the study's
limitations. The public health hazard categories are: a)
urgent; b) present hazard; c) indeterminate; d) none apparent;
and e) no public health hazard.
The public health assessment document usually has three
types of recommendations: to protect public health, to list
follow-up public health activities, and to recommend on
further characterization of the site to gather additional
environmental information.
7. Develop a Public Health Action Plan. The public
health action plan identifies actions undertaken or planned,
and the agencies conducting/to conduct them. At Oak Ridge,
with the Subcommittee's assistance, ATSDR will analyze and
evaluate the information, data, and findings from previous
studies and investigations on the radiological and chemical
contaminants released from the Oak Ridge Reservation.(2)
The dose reconstruction feasibility study also will help
to identify contaminants of concern.
Mr. Hanley distributed time lines (Attachment
#7) outlining the major processes at the various Oak Ridge
facilities, the public health activities relating to them,
and the studies that ATSDR will examine to develop the public
health assessment. For example, the past environmental and
health assessments that addressed specific materials will
be reviewed by ATSDR to develop an overall picture.
Discussion.
The Subcommittee's discussion with Mr. Hanley included the
following:
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Has ATSDR done any work to address
the synergistic effects of multiple combinations of
chemicals? Oak Ridge uses all the 92 elements on the
periodic chart. An ATSDR toxicologist could attend
to discuss this. But synergism is very complex; involving
not only chemicals but their ratios and periods of exposure.
The pathway analysis will identify the chemicals that
people were exposed to off-site, and document those
effects. If there is insufficient information (including
the state of the science) to determine the latter, the
report will state that. As a toxicologist, Dr. Davidson
added that all chemicals do not act synergistically.
It depends on the chemical and the combination: some
are inhibitory, some are additive, some are not; and
some have no interaction.
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Only K-25 has medical screening,
not Y-12 or ORNL; can periodic screening be done here
as by Hanford's Medical Monitoring Program? That
could be an ORRHES recommendation subsequent to the
study, such as the Libby, MN, program discussed by Dr.
Falk. That was based on exposure to asbestos; the same
has been done for beryllium workers. Once the exposure
information is in place, it supports any recommendation
for follow-up work.
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Mr. Lewis thanked ATSDR for the time
lines provided, which gives the lay person a better
idea of what occurred at Oak Ridge. He stated that the
ORRHES should identify the public health impact on off-site
populations, including sick workers.
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What is the relationship between
assessing health education needs and the public health
assessment? The concerns documented in the needs
assessment will be included in the public health assessment.
ATSDR's public health assessment process focuses on
exposure; GWU's focuses on community needs and concerns.
ATSDR will use GWU's collected detailed demographic
information and needs assessment information to determine
how to channel the results of the public health assessment
out to the public.
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Once the pathways are identified,
can ATSDR do an independent test of the water from the
10 Mile Area's water supplier, about which there is
some community concern? Some testing can be done,
if indicated to demonstrate an identified exposure or
to fill a data gap. But that kind of testing is governed
by EPA and state regulations. The water utilities test
on their own, with state oversight.
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What if exposures cannot be linked
to health outcomes data? If information is insufficient
to identify an effect, that will be documented. But
if a concentration is found of a chemical linked to
effects (e.g., mercury to the kidney), ATSDR will look
for an information source to explore whether those effects
exist in the community (e.g., a cancer registry). This
is a sort of screening process. If a comparison of exposures
and outcomes indicates a link, doing an analytic epidemiologic
study (comparing outcomes of an exposed versus unexposed
group) could be recommended. Some advocate first identifying
illnesses in the community/workers, and then working
backwards to link that to a site contaminant source.
But Mr. Hanley compared this to drawing a bulls-eye
after the fact .
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Is there a way to get a baseline
of the community's health before beginning, since both
higher cancer incidence and better health than the national
average have been asserted for the area? This is
possible; there are some indicators to do that. Someone
could attend to explain for the Subcommittee that process
and its limitations, as well as describe what was done
at other sites and follow-up with those epidemiologists.
But Mr. Hanley cautioned that this raises people's expectations
despite its limitations. Both Anderson and Roane counties
have looked at those indicators already; ATSDR plans
to use and could present that information and others.
The problem is that one cannot just relate that information
to the site; it can only be stated what is found. Mr.
Pardue commented that publicly stating the latter could
be of value, since many such statements are circulating.
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A summary of the baseline and its
limitations is of interest. Is there a schedule for
the public health assessment process and its completion?
There is none written down yet, but this can be
developed with this Subcommittee and its Agenda Work
Group.
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Will ATSDR do exposure investigations
such as done at Watts Bar for the fish exposure pathway?
Where would that fit in the public health assessment
process? And how do existing environmental data fit
(e.g., the soil analyses done). Any indicated exposure
investigation would follow the public health assessment,
but if deemed critical, it would not be delayed. Some
of the soil information was used in the state screening
process that ATSDR will evaluate, and then again in
the more detailed pathway analyses. Dr. Brooks recommended
that ATSDR consult the state Health Department's Statistical
Profiles of Tennessee (SPOT) for its county-based health
data that can be variously delineated (e.g., age,
gender, etc.). He also advised caution in reviewing
the wording of material that may be provided (e.g.,
GWU's listed "health effects of brain/kidney damage,"
should instead state "potential" health effects).
-
A Subcommittee vote was taken on
the geography to be addressed in identifying and evaluating
exposure pathways. If that seems exceeded, is the process
flexible enough to follow it? Yes, but what was
voted upon is a reasonable starting point.
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There already are dose reconstruction
and health effects outcomes documents; what's wrong
with them? Why does ATSDR need to go beyond them to
do more? To review those and all the other material,
and to put all this in context before any further studies
are done, as well as for ATSDR to interpret those materials
and use them ourselves.
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Inevitably, the public health assessment
process won't satisfy everyone. For example, evaluating
health outcome data for "plausible" health outcomes
based on the scientific data will not match what some
community members perceive as plausible. That will need
to be addressed. Agreed. The report will not leave
that as an unanswered question. ATSDR will answer by
explaining that the data are insufficient. Mr. Pereira
suggested the Communications/Outreach Work Group work
with ATSDR to discuss how to convey to the community
from the beginning the uncertainties in all this work,
as early as possible and incrementally throughout the
work.
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Agreed! It is incredible, with
the amount of money spent and work done, that the lessons
learned have been so lacking that the understanding
of all this is still so low. Something is seriously
wrong with how study results are communicated.
This is the difference between doing research and public
health. For the latter, the information provided must
be adequate to allow a person to decide on subsequent
actions. This has to be checked on periodically.
Dr. Davidson suggested the Communications/Outreach
Work Group advise the Subcommittee on a communications strategy
that ATSDR can use to communicate to the public the results
of the assessments (needs and public health), and to evaluate
if that communication is effective.
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People hear what they want to hear.
Getting information out to the community is no easy
task, and doing both communications (ensuring information
is accurate and understandable) and outreach (to get
them to commit to the success of the program) is huge.
Re-thinking the process of combining both tasks (including
identifying the focus groups' topics) was suggested.
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Ms. Galloway asked what would happen
if a person were exposed to a material but evidenced
effects not known to be related to that material. Will
a database record be kept of that effect for comparison
to others at other places and times? Some of these materials
are new enough that all the effects may not be known.
Most of this process is "weight of evidence" decision
making. The public health assessment report will document
that concern and explain why/why not there is a plausible
link, and describe other plausible causes. If there
is a resource to address that, the person can be so
referred.
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Where does ATSDR get the numbers
regarding the materials' effect? The American
conference of Governmental Industrial Hygienists' (ACGIH)
standards can be converted to 24-hour exposures, and
estimated doses can be compared to EPA reference doses
as well as ATSDR's own minimum risk levels.
-
What is the reliability of estimated
synergistic effects, since only 10-15 have been examined?
Information can be provided on how ATSDR approaches
the toxicological issues related to synergism. Dr. Davidson
stated that not all chemicals have a large database
on their characteristics and effects; but some inferences
are possible from the data of other similar materials.
Public
Comment
Dr. Fay Martin was pleased to hear that
synergism would be discussed, but as a toxicologist, she
quoted the truism that "all substances are poisons... it
is the concentration which poses the effect."
Subcommittee
Discussion
Ms. Sonnenburg asked why, if Watts Bar
is safe for PCBs, the state had not taken down the warning
signs. Mr. Hanley acknowledged that it was probably poorly
communicated in the pre-meetings why PCBs and mercury, and
not other contaminants, were addressed. That should be explained
in the media.
Mr. Hill advised that the data collection
process should include the worker screening programs (PACE
and the Building Trades), and the database on prevalent
medical conditions. Mr. Hanley commented that presentations
on that material could be arranged. It provides perspective,
although not related to the public health assessment.
Mr. Pereira stated that the Oak Ridge ATSDR
office, staffed by Bill Murray, will have direct communication
to the logistical support in Atlanta for whatever is recommended
for communication/outreach (e.g., for publishing/layout
of a newsletter, etc.), as well as the use of a Website.
He encouraged the Subcommittee to "think out of the box"
beyond paper outreach (e.g., to perhaps have a public availability
session the day before the meeting).
Dr. Brooks commented that several groups
doing community outreach had found that there is no one
answer to doing that and building trust. In his experience,
outreach is a long-term intensive effort to present a point
to the public. He recommended letters to the editor as an
effective format of communication and outreach.
Mr. Kuhaida reported that a class-action
federal lawsuit was filed in the last week on the impacts
of the Oak Ridge Reservation on the public. He asked what
the legal implications this might entail to the Subcommittee's
work, the public health assessment, etc. (e.g., should the
members be cautious in their statements?). Mr. Pereira expected
none. As an independent government agency, ATSDR is often
at sites involving litigation, but stays clear of that in
its mandated work. Mr. Hanley added that, as the members
work as special government employees, their comments are
protected. The Justice Department would intervene to block
any use of that as evidence in a case.
Housekeeping
Issues
Mr. Malmquist moved to begin the
next meeting at noon on the morning of Monday, March 19th
and to end at 4 p.m. on Tuesday the 20th.
With all in favor, the motion passed, and
the members adjourned for lunch.
Unfinished
Business
Subcommittee Composition. Mr.
Hanley reviewed the steps taken to select the current Subcommittee
membership. In 1998, CDC, ATSDR, and DOE met in Oak Ridge
and other sites to discuss the launch of a process to set
a coherent, national research agenda across agencies. Based
on the information collected, the need for a Subcommittee
in Oak Ridge was identified, which ATSDR was charged to
lead. An Oak Ridge Reservation Public Health Work Group
was formed of seven federal and two state/local agencies.
Meetings were held in April, June, and September 1999 with
community members and stakeholders. The interest in having
a group with members representative of the community and
without conflicts of interest, to provide consensus advice
to the agencies, was expressed.
Subcommittee membership criteria were provided
by the community: 1) local health care providers, 2) organized
labor, 3) local government, 4) technical experts, 5) lay
community members, 6) Chamber of Commerce/business community;
7) Scarboro; and 8) surrounding communities; 9) community
health advocates; 10) workers with high risk of exposure;
11) workers or local citizens self-Identified as having
health concerns; 12) retirees, and 13) civic organizations.
Using these criteria, members were selected by ATSDR and
CDC from the nominees submitted, in a process observed by
community members. An additional criterion developed by
ATSDR addressed individuals with potential high risk of
off-site exposures based on the dose reconstruction reports.
One nominee was a worker with high risk
of exposure and who self-identified as having health outcomes,
who decided not to join (and reiterated that when asked
again recently), so one seat can be filled. Although other
present members fulfill that category, ATSDR decided to
try to fill this position one more time. ATSDR knows of
another candidate. Although not a worker, s/he meets
the additional criterion of being potentially at risk of
off-site exposures based on the dose reconstruction reports.
One consideration is that, although the FACA charter allows
up to 30 members, that is an unwieldy number for effective
committee function. Mr. Washington knew of a likely candidate,
and agreed to check on that person's interest and to advise
ATSDR. However, he also thought that adding other members
should re-open the process to other people. Mr. Pereira
recalled the last meeting's lengthy discussion about including
a sick worker, the one representation lacking on the Subcommittee.
If the ATSDR pool of nominees doesn't meet that criterion,
they could re-open the process, unless that is no longer
of interest to the present members. Dr. Brooks expanded
this from a "sick worker" to one who blames an illness on
their occupational exposure, and suggested ATSDR just fill
it by following the same process as previously used.
Mr. Pereira agreed to ask the CDC/ATSDR
committee management office if they would support an announcement
to seek a worker as a new member with health concerns attributable
to the Oak Ridge Reservation exposures. He will advise the
Subcommittee, and if so, when the nominations would formally
be opened.
New
Business
Health Effects Presentation. Dr.
Eklund asked for a presentation on health effects expected
to be seen among children as well as adults.
Activity
of the Communications/Outreach Work Group; focus group scope
decision. Dr. Brooks moved that the Subcommittee
reconsider the motion passed on the previous day, assigning
the work on focus groups to the Education and Outreach Work
Group. He suggested, instead, forming a long-standing
work group to follow the health assessment and the work
with GWU, since the focus groups leads naturally to the
next stage. Dr. Davidson allowed that, if subsequent work
is assigned to a different group, the work flow would be
discontinuous. Mr. Lewis agreed that outreach, education,
and communication entail different work and should not be
addressed by a single group. He thought the first effort
would be Outreach to draw the community in to the Subcommittee's
work.
Mr. Pereira distinguished between health
education and communication. Health education is product-driven
(e.g., children eating dirt that contains lead); but communication
is a process of conveying information. Optimally, they are
done in concert, but communication can be done alone. Education
would cover GWU's needs assessment for educational purposes.
Dr. Brooks agreed that, with tasks continually assigned,
the work group's burden will be too large. He advocated
a separate work group for the GWU effort and another for
the health assessment as well.
Ms. Kaplan reported her initially-considered
strategy of just sending some thoughts to the entire Subcommittee
and interested members of the public. She felt, though,
that this work should not be limited to just this small
Subcommittee. There is no way for four people to do all
that had been assigned, unless she could draft other people
to contribute. Additionally, all the work could not be done
in meetings; that would be too slow a process; but the initial
work could be done by e-mail. On Mr. Hill's question, Mr.
Pereira confirmed that a sit-down meeting is paid as a half-day
of FACA work, but 10 minutes to send an e-mail would not
be. He also reminded the members that an ATSDR staffer must
attend work group meetings.
Upon a vote to reconsider
assigning the focus groups to the Communications/Outreach
Work Group, 16 were in favor, none opposed, and one abstained.
The motion passed.
Dr. Brooks then moved to re-vote
on Mr. Hill's original motion. Ms. Mosby stated
that, as a member of the Work Group, she had voted against
it, favoring instead a separate work group to handle this
task. Mr. Lewis agreed. Upon a vote, none
were in favor; 14 were opposed. With no abstentions, the
original motion failed.
Mr. Malmquist then moved to form
a new work group to work on the health needs assessment,
with the first task be to address the composition of the
focus groups. The motion was seconded by Ms. Mosby.
The vote was 16 in favor and none opposed,
with one abstention. The motion passed.
The volunteers for the Health Needs Assessment
Work Group were: Brooks, Lewis, Mosby, Sonnenburg, Washington,
Lands, Craig, Vowell, and Johnson.
Clarification/Description of Focus
Groups Methodology. Upon a question, Dr. Parkin clarified
that the focus group methodologies would assemble 6-12 people
to discuss a topic of concern in qualitative (not quantitative)
research, guided by a list of questions, with a moderator
to ensure the questions are covered with in the time allotted,
and with a note-taker. Typically, the issues of concern
are identified that the group can address comfortably even
though in a disparate groups. Difficulty arises if the groups
are too mixed, so a random selection process is usually
used. Another issue identified on the previous day was the
ability of participants to attend the group. No record is
kept of who participated or who said what. Group characteristics
might be reported (e.g., general themes, concerns, perspectives,
etc.). In this project, the focus groups are intended to
collect a richer understanding of community concerns before
structuring the instrument for the phone survey. Seven work
groups will be formed for seven counties; for example, one
could have one nurse from each county if that could be managed
geographically. GWU will identify the individuals after
the Subcommittee identifies the groups of interest with
appropriate descriptors. But GWU will also need help to
know how to identify them (e.g., Scarboro or Watts Bar residents,
or sick workers). Dr. Parkin offered to meet with the Work
Group, ideally at its first meeting; and in future could
also meet by conference call.
Concern was expressed that the Work Group
be able to do this without delaying to the next meeting.
Dr. Davidson expected the work groups to meet and formulate
their recommendation and send it to ATSDR. The agency in
turn will send out the Subcommittee members and liaisons
for their review and comment. However, GWU cannot act on
anything until the Subcommittee approves it.
Public
Comment
After a short break, public comment was
solicited.
Ms. Romance Carrier, of the Oak
Ridge Health Liaison, was discomfited by the references
to a "self-identified sick worker." She asked what was different
about that category, thinking that it sounded as if it questioned
the legitimacy of the identification. Dr. Davidson responded
that ATSDR would respond in writing to the comments, which
Ms. Carrier appreciated. She continued that she was happy
to read that CDC will begin to track environmental illnesses,
something she suspected that many people assumed it had
done for years. She herself had participated in a CDC study
at Emory University with Dr. Frumpkin. She stressed the
difficulty of doing so; she could not have managed it if
not for her husband. Many physically disabled people cannot
do so; they are in wheelchairs and/or have lost everything.
Dr. Frome asked to read a comment
from the public, sent to the Environmental Quality Advisory
Board on September 2 from <andyh987@aol.com>.
Andy urged the board to "face the facts" that no one wants
to move to Oak Ridge because of the environmental problems;
he himself is ready to move. He stated that the real estate
values are too high, and that those moving in don't know
the problems. He charged that is DOE stalling any action
until the affected workers die. He challenged the EQAB to
address these issues within one month, or he would start
an Internet campaign to deter anyone from moving to Oak
Ridge. Dr. Frome e-mailed him back asking him to come to
this meeting and express those concerns, or offered to read
his message if he could not. Mr. Craig asked if the e-mail
could be distributed. Mr. Pereira was unsure, since it was
not sent directly to the ORRHES. However, Mr. Kuhaida thought
that possible, since Tennessee's open meeting law would
release the e-mail after being sent to the EQAB.
Dr. Davidson also read comments
received the previous day in writing from Ms. J. Shaakir-Ali.
She urged that Blount County be included in the study's
geographic area; the use of the Internet to deploy educational
materials; and the use of TV Access Channel 12 in Oak Ridge,
as many elderly people watch that.
Closing
Discussion
Outreach. Ms. Sonnenburg personally
thanked Ms. Carrier for coming to talk with the Subcommittee.
She hoped to find a way for the committee to be more welcoming
and responsive to those who take the trouble to come and
address it. Dr. Davidson noted the charge to the Outreach/Communication
Work Group to discuss how to be more responsive; and noted
that ATSDR will respond to each person's comments and that
the minutes will include a summary of each person's remarks.
Website. Mr. Pereira invited the
Subcommittee's recommendation to ATSDR as to how they would
like to use its Website. He offered to provide as a model
the site of the Hanford Health Effects Subcommittee. The
Outreach/Communication Work Group was asked to consider
this question.
Roberts Rules. Mr. Malmquist requested
that Dr. Brooks give a short presentation on Roberts Rules
at the next meeting, and provide that information before
the meeting.
Registries. Mr. Akin suggested
addressing the public misperception that ATSDR will track
everything as part of its disease registry. The latter's
cost and limited activity (diseases related to 3-4 contaminants)
should be made known. Mr. Hanley recalled media reports
that a commission funded by the Pew Charitable Trust (<health-track.org>)
recently recommended to President Bush that CDC set up a
tracking system.
Action Items. Dr. Connery summarized
the action items she had noted in the course of the meeting.
These are listed appended to this report in Attachment #8,
along with the meeting recorder's list of the meeting's
motions and action items.
Meeting Dates: In discussing future
meeting dates, the Subcommittee considered that the second
Tuesday is the CAB's meeting day; that two Monday nights
per month are City Council meetings; and that June 5 is
election day. The members agreed on the following
tentative schedule of meetings, on Mondays (noon to evening),
and Tuesdays (8-4:30 p.m.), on the following dates: June
11-12; September 10-11; and December 3-4.
Meeting Records: ATSDR will continue
the video- and audio-taping of meetings, and FACA requires
detailed minutes which will be available on the Website.
When asked about continuing the verbatim transcript, Mr.
Malmquist moved to discontinue the verbatim transcript.
Ms. Sonnenburg seconded the motion, which passed
unanimously.
Meeting Location: The Agenda Committee
and ATSDR are investigated other locations (e.g. the Mall)
for future meetings.
Finally, the members were asked to provide
changes to their biographies (which will be made public)
to Marilyn Palmer, and to sign the meeting roster before
leaving. With Dr. Davidson's thanks, the meeting then adjourned
at 3:50 p.m.
I hereby certify that, to the best of my knowledge, the
foregoing Minutes are accurate and complete.
Kowetha A. Davison, Ph.D., Chair
Date
ATTACHMENTS:
Review of AOEC document regarding Oak Ridge Reservation
and Reported Health Effects
Agenda Work Group report
Communications/Outreach Work Group report
Guidelines and Procedures Work Group report
DOE Information: Energy Employees Occupational Illness
Compensation Program Act of 2000
Memorandum from Save Our Cumberland Mountains, Roane County
Chapter/Oak Ridge Health Liaison
ATSDR information: time lines of Oak Ridge Reservation
facility histories
Motions passed and action items listed at the January meeting.
Attachment #8
Motions passed and Action Items Listed
by the Meeting Recorder
Motions passed during the January
2001 meeting:
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Include in the geographic scope for health effects
studies the Oversight Committee's represented 7-8 county
area: Anderson, Knox, Roane, Loudon, Meigs, Rhea, and
Morgan; and the city of Oak Ridge.
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The Communications/Outreach Work Group was asked explore
what issues the focus groups should address, and return
with a recommendation to the full committee.
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The Communications/Outreach Work Group will reword
its
-
draft report (e.g., to "attracting" or "advertising
for," rather than "identifying" new members). The balance
of the report was approved.
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The Procedures document's appendix was changed to become
Chapter 6.
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The Guidelines and Procedures Work Group will review
the issue of the Vice Chair after the CDC/ATSDR Legal
Department responds, and will discuss the relationship
of the process documents and by-laws.
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The Guidelines and Procedures Work Group will discuss
the use of Roberts Rules of Order, including which are
likely to be applied and how. The consensus process
will also be considered.
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The Guidelines and Procedures Work Group will include
the public comment period and adjournment in the agenda.
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A vote was taken to accept Figure 2, which was altered
to show all the non-voting liaison relationships with
the Subcommittee, including that of DOE. The vote was
11 in favor and 7 against. (See the next bullet)
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The Guidelines and Procedures document will not address
voting protocol until what constitutes an affirmative
vote is agreed upon by the Subcommittee.
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The liaison agencies and their nonvoting status will
be designated on their table name plates.
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The next meeting will begin at noon on the morning
of Tuesday, March 19th and to end at 4 p.m.
on Tuesday the 20th.
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The previous day's motion, assigning the work on focus
groups to the Education and Outreach Work Group was
withdrawn. A new work group to address the health needs
assessment was formed, with its first task to be addressing
the composition of the focus groups.
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The tentative schedule of meetings is to be held on
Mondays (noon to evening), and Tuesdays (8-4:30 p.m.),
on the following dates: June 11-12; September 10-11;
and December 3-4.
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The verbatim meeting transcript will be discontinued;
the audio and video taping and note taking to generate
Minutes documents will continue.
January 2001 Meeting Action Items, as noted by
the Meeting Recorder
Day 1:
1. ATSDR will make copies available of the 12/99 TDEC report
on the DOE Oversight Project.
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NIOSH/Mr. Elliott will convey to NIOSH's Acting Director,
Dr. Larry Fine, the committee's desire to have a NIOSH
representative at every meeting.
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ATSDR will provide comments on the Work Group's Program
of ORRHES Work.
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A progress report was requested on the interagency
meeting regarding the Scarboro soil sampling analysis
and a general sampling strategy.
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Ms. Vowell will provide a definition of what constitutes
a "medically under-served" population to ATSDR for distribution
to the Subcommittee.
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NIOSH will provide a listing of the accomplishments
for workers that stem from their research, as well as
the concerns expressed by the workers. A program booklet
and other information on present and past studies will
be provided.
Day 2:
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The Subcommittee requested a baseline report on the
community's health. ATSDR could present the results
of previous community health status reports (e.g., Anderson
and Roane counties) and on the implications of making
statements based on such information.
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The Communications/Outreach Work Group was asked to
develop advice to the Subcommittee on a communications
strategy that ATSDR can use to communicate the results
of the needs and public health assessments to the public,
and to evaluate if that communication is effective.
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ATSDR was asked to provide information on how they
approach the toxicological issues related to synergism.
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Mr. Pereira will ask ATSDR management, and should be
able to advise next week, if the agency will support
an announcement to seek a worker as a new member; and
if so, when the nominations will be formally opened.
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The Health Needs Assessment Work Group's first task
will be to address the descriptors with which to form
the GWU focus groups. Work Group volunteers were: Brooks,
Lewis, Mosby, Sonnenburg, Washington, Lands, Craig,
Vowell, Johnson.
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The Agenda Work Group will consider a short presentation
on Roberts Rules by Al Brooks at the next meeting.
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The Communications/Outreach Work Group was asked to
consider how best the ORRHES can use the ATSDR Website
as a resource.
ACTION ITEMS, "PARKING LOT" ISSUES,
AND DECISIONS [INCOMPLETE LIST]
As Noted by the Meeting Planner, Eastern
Research Group
OAK RIDGE RESERVATION SUBCOMMITTEE
JANUARY 18-19, 2001
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ATSDR will send a copy of the minutes of the first
meeting to Al Brooks.
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ATSDR will send copies of the 2000 TN Dept. of Environment
and Conservation DOE Oversight Division, Status
Report to the Public to the subcommittee members.
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GWU will provide a list of the documents they are reviewing
to all members of subcommittee via ATSDR. [DONE]
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ATSDR will get information on whether it is possible
under FACA to have a vice-chair to the G&P work
group within a week or so.
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ATSDR will distribute the letter from Save our Cumberland
Mountains to all members of the subcommittee and to
all panelists who were present on the first day.
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Brenda Vowell will get information on medically under-served
communities to subcommittee members via ATSDR.
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The Needs Assessment Work Group will develop recommendations
for the descriptors for the seven focus groups that
are not the general focus groups. ATSDR will distribute
these recommendations to all subcommittee members prior
to the next meeting.
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The Communications and Outreach Work Group will reconsider
and revise the first bullet of their purpose statement.
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The Procedures and By-Laws Work Group will consider
and recommendation a resolution of 1) the relationship
of the process document and by-laws, 2) vice chair (subject
to information from ATSDR).
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The P&G Work Group will determine and clarify what
aspects of Roberts Rules will apply to the subcommittee
and how they will be used.
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The P&G Work Group will add public comment period
and adjournment to the list of agenda items in the by-laws.
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ATSDR will check and get back to Bill Pardue/subcommittee
on work that has already been done on and limitations
of comparing health effects rate in people in the Oak
Ridge area to the general population.
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ATSDR will get copies of Community Diagnosis Status
Report for Anderson County etc. to subcommittee
members.
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ATSDR will look into developing a list of steps for
the needs assessment comparable to the seven steps for
the public health assessment process.
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ATSDR will work with the Agenda Work Group to develop
a schedule for the public health assessment.
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The Communication and Outreach Work Group will work
on: (1) a communication strategy for ATSDR and CDC to
communicate to subcommittee members and the public regarding
work on and results of the needs assessment and public
health assessment; and (2) a strategy for evaluating
whether communication by the subcommittee has been effective
within the community.
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Jerry Pereira will check with ATSDR management about
making an announcement of a vacancy on the subcommittee
for a member who is self-identified as having health
impacts as a result of exposure at work.
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ATSDR will respond in writing to questions asked by
public commenters (if the commenters have provided their
names and addresses).
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Al Brooks will give a brief presentation at the next
meeting on Roberts Rules of Order.
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ATSDR will information on the URL for the Hanford web
site to Al Brooks.
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ATSDR will create name tags and placards for the liaison
members that indicate the affiliation of the liaison
members and that there are liaison members (rather than
voting members).
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THREE ITEMS ADDED BY RECORDER RE NIOSH
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ATSDR will provide comments on the program of work
as soon as feasible.
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A progress report was requested for the next meeting
on the sampling strategy.
"PARKING LOT" ISSUES
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Al Brooks: wants clarification on issue of who will
decide what will be the scope of the focus groups.
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Al Brooks would like subcommittee to consider the issue
of how health effects are reported - issue that needs
assessment draft materials indicate certain things are
heath effects that are not.
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Split duties of outreach work group.
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Dr. Eklund's point.
DECISIONS [INCOMPLETE LIST]
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Decided to keep agenda as is rather than shift the
agency section to 3:30 p.m. from 4 p.m. 17 yes/1 abstention.
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For a new work group for the health needs assessment
and the first task will be to develop input to GWU regarding
the seven focus groups that are not the general focus
group. Members are Ron Lands, Barbara Sonnenburg, James
Lewis, Donna Mosby, Bob Craig, Brenda Vowell, Charles
Washington, Dave Johnson, Al Brooks.
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Decided to refer first bullet of communications and
outreach group statement back to the group for further
refinement. Approved the rest of the statement.
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Refer the issue of 1) the relationship of the process
document and by-laws, 2) vice chair (subject to information
from ATSDR) back to the Procedures and By-laws Work
Group.
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P&G work should further determine and clarify what
aspects of Roberts Rules will apply to the subcommittee
and how they will be used.
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Public comment period and adjournment should be included
items in the agenda items in the by-laws.
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Decision to table motion of adding DOE as a liaison
until by-laws are adopted.
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Placards of liaisons shall be displayed to indicate
agency affiliation and a designation that they are nonvoting.
2. At the
last meeting, a summary of the public health activities
at Oak Ridge in the last 15-20 years was distributed.
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