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ORRHES Meeting Minutes,
August 27, 2002
Pre-paid Box Meal ("working lunch")
Presentation and Discussion: ATSDR Radiation Screening
Process
Paul Charp - ATSDR
The presentation by Paul Charp entitled “The ATSDR Radiation Screening
Process” was cancelled because Paul Charp was unable to attend this
ORRHES meeting.
Presentation and Discussion: Chelation
Therapy
Videotape presentation:
The viewing of a videotape entitled “Chelation Therapy: A Prologue
to a Continuing Dialogue” was begun during the meal break and continued
afterward. After a portion of the videotape had been viewed the Subcommittee
heard discussion from members of the Subcommittee and the public regarding
their personal experiences with chelation therapy to remove contaminants
from their bodies.
Discussion:
Don Box discussed his personal experiences with chelation therapy for
plutonium intake that occurred approximately 20 years ago. Therapy with
DTPA (diethylenetriamine pentaacetic acid) as the chelating agent began
1.5 years after plutonium exposure. Three series of therapy are summarized
as follows:
Series One
- Treatments on Monday, Tuesday, Thursday and Friday occurred for one
week, 10 grams of DTPA by inhalation per treatment
- Increased plutonium excretion from 4 disintegrations per milliliter
(dis/mL) to 1,000 dis/mL (immediately), then decreased over a three
month period returning to 4 dis/mL
Series Two
- Treatments consisted of injections of DTPA on Monday, Tuesday, Thursday,
and Friday for one week.
- Increased plutonium excretion from 4 dis/mL to 600 dis/mL (immediately),
then decreased over a three month period, returning to approximately
4 dis/mL
Series Three
- Treatments consisted of inhalation of DTPA
- Increased plutonium excretion from approximately 4 dis/mL to 100
dis/mL (immediately), decreasing over a six month period, returning
to 2 dis/mL
- Over the last 20 years excretion rate has been approximately 1 dis/mL
Don Box commented that there had been virtually no side effects from
the DTPA treatment, and that it was effective in chelating much of the
plutonium from his body.
Peggy Adkins discussed her personal experiences with chelation
therapy for arsenic. She grew up between Kingston and Oak Ridge, and now
has symptoms of Lupus, MS, Lou Gherig’s, etc. (a total of 43 symptoms).
A doctor informed her that her symptoms could be from an environmental
source and suggested that she check with the women she grew up with in
the area to see if they have similar problems. At a meeting in Oak Ridge
Peggy Adkins encountered people who were familiar with her symptoms and
their similarity with the symptoms of Janice Johnson Stokes, who grew
up in same area (near the same spring-fed lakes). Peggy Adkins was referred
to the environmental and occupational health clinic in Atlanta by her
doctor for testing. The clinic refused to test her for metals due to the
controversial nature of potential contamination of people from Oak Ridge.
It was rumored that the clinic turns down people from Oak Ridge because
it is funded by a company that operates an incinerator in Oak Ridge. Peggy
Adkins summarized her chelation therapy as follows:
- Received chelation treatments every four months for one week
- Treatments were increased to three times per week at a local facility
due to high arsenic levels
- Arsenic levels have now decreased from approximately 446 to near
acceptable levels
Peggy Adkins stated that chelation therapy has helped immensely.
Barbara Sonnenburg asked Peggy Adkins whether the treatments were chelation
treatments and whether there were any side effects from those treatments.
Peggy Adkins responded that they were chelation treatments, initially
three times per week in Knoxville, now two times per week in Athens. No
side effects from the chelation were reported with the exception of feeling
ill immediately after the “BAL” shot. This effect lasted up
to two days in the beginning of treatment, but has lessened to dissipating
after half of an hour.
Charles Washington asked Don Box how he was exposed to plutonium and
over what period of time he received chelation therapy. Don Box explained
that he worked with plutonium in a glove box at ORNL. The glove box leaked,
releasing plutonium into the air. Thus, he was exposed via inhalation.
The chelation therapy began approximately a year and a half after exposure.
The first two series of treatments were three months in duration, and
the third was six months in duration (a total of nine months). Treatments
were administered four days per week. Ten grams of EDTA was inhaled per
treatment.
Charles Washington asked Don Box what the target organ is for plutonium?
Don Box replied that the target organ is initially the lungs, followed
by movement to the lymph nodes (plutonium is a bone seeking element).
Elmer Akin asked Don Box where the reduction is measured, in urine or
blood? Don Box responded that the measurements were in urine. There were
no blood samples taken. Kowetha Davidson explained that the chelating
agent moves the contaminant from a compartment in the body into the bloodstream
where it is available for excretion through the urine.
Herman Cember asked Don Box if any whole body counting was performed,
and if so, whether it showed that the chelation therapy was effective.
Don Box commented that over the years, until retirement, whole body counting
was performed annually (detection of plutonium daughter Am-241). Whole
body counts taken before chelation were used to determine the amount of
exposure (approximately ten body burdens). Whole body counts performed
after treatments confirmed the effectiveness of the chelation treatments.
Peggy Adkins asked if Don Box’s employer provided the treatments.
Don Box responded that treatments were suggested and carried out at ORNL
facilities. Peggy Adkins further commented that local residents do not
have access to such facilities.
Charles Washington asked Don Box what isotopes and heavy metals were
present in his body, commenting that different heavy metals affect different
organs of the body (e.g. mercury targets the kidneys). Don Box responded
that his intake was plutonium-238.
Kowetha Davidson commented that toxicity of heavy metals in a target
organ is distinct from the radioactive concern of heavy metal radionuclides.
Uranium has a toxic effect on the kidneys, and it is also radioactive.
The concern over plutonium is it’s radioactive properties. Don Box
added that the intake limit for plutonium-238 is very small (very restrictive).
Herman Cember clarified that the maximum body burden is 40 nanocuries
of activity, which would be a mass so small that it could not be detected
by chemical means.
Public Comment
Regarding the video entitled “Chelation Therapy: A Prologue to
a Continuing Dialogue”
Janet Michel commented that the presentations of case histories never
mentioned the medical history having a potential for exposure, a significant
omission.
Janet Michel discussed another chelator (DTPA) that has been used for
decades to chelate strontium-90, uranium, transuranics. This material
is owned by DOE, is in the possession of ORAU (Oak Ridge Associated Universities),
and REAC/TS (Radiation Emergency Assistance Center/Training Site), and
is unavailable to private physicians. Reportedly DTPA is available in
Canada and Europe. It has been used orally, in pill form, and helps protect
kidneys and bladder. In the past it was not used with an I.V. or monitoring
of vital organs. Consequently some kidney failures occurred. DTPA removes
isotopes from the blood stream and organs of deposition. Exposed persons
were given approximately three minutes to decide if they wanted the DTPA
treatment, without being advised of the advantages and disadvantages of
the treatment. This approach may have been followed to avoid providing
information, suggesting the possibility of accidental exposures. DOE did
not follow the proper protocols for chelation of lead. Janet Michel asked
Don Box why ORNL would have treated him with EDTA rather than DTPA.
Janet Michel reported that she has had chelation therapy for mercury
(DMPS chelating agent) and nickel. Chelation therapy was terminated due
to high out-of-pocket costs. Her symptoms were the same as she felt while
working at K-25, working in a building that has been risk mapped by the
union for high potential of exposure to nickel and mercury. Insufficient
chelation treatments were received to realize a health benefit.
Elmer Akin asked Janet Michel the cost per treatment. Janet Michel responded
that the cost was around $2,000. This cost included fluids received, monitoring,
and other lab work that was involved over a five day treatment period.
Don Box commented that, prior to his chelation treatments, the treating
doctor (head of the Medical Division at the time) at ORNL discussed the
treatment process, potential effects, and what they hoped to accomplish
with treatment. Janice Stokes asked Don Box his age when exposed, and
if he received free medical treatment since exposure. Don Box responded
that he was in his late 40’s when he was exposed. He has since had
some pulmonary problems, and received a lung wash at Baptist Hospital.
This treatment was administered approximately 4-5 years after exposure.
Janice Stokes mentioned Mr. Clark, the lone survivor of a criticality
accident, who was monitored by DOE, but did not receive free medical treatment,
nor was he told why he was being monitored.
Herman Cember noted that in 1943-44 twenty seven workers were overexposed
by inhalation of plutonium at Los Alamos. Since then, one person died
within a year of exposure from a heart attack, one other recently died
from cancer, and the others are still being monitored and have greater
than body burden amounts of plutonium in them.
Peggy Adkins noted that the cost of her chelation treatments ranged from
$115-125 per session.
Karen Galloway asked Don Box why his chelation treatments were not started
until a year and a half after his exposure. Don Box replied that it took
several months to determine the level of exposure (he was sent to a number
of national laboratories for whole body counts), and treatment had to
wait until the level of excretion stabilized. His excretion rate one month
from exposure initially was 50-60. After a year and a half, the excretion
rate stabilized for three to six months at 4. Then chelation therapy was
begun.
Janice Stokes mentioned that she received an offer in Atlanta for chelation
treatment at a cost of $12,000, and another offer from a local nurse.
People who need diagnosis and treatment need a local facility/clinic in
order to obtain these services.
Work Group Recommendations
AGENDA WORK GROUP
Barbara Sonnenburg reported that the Agenda Work Group has no recommendations.
GUIDELINES AND PROCEDURES WORK GROUP
Karen Galloway recommended from the Guidelines and Procedures Work Group
the following recommendation dated August 21, 2002 to the Subcommittee:
RECOMMENDATION ONE:
The Oak Ridge Reservation Health Effects Subcommittee (ORRHES) Guidelines
and Procedures Work Group is recommending adoption of “Suggestions
for Facilitating Effective Work Group Meetings,” as an aid to
all Work Group Chairs in the facilitation of more effective meetings.
In the event of a conflict of this document, “Suggestions for
Facilitating Effective Work Group Meetings” with the ORRHES By-Laws,
the By-Laws shall take precedence. The desired outcome is that each
Work Group Chair shall find ideas within this document to help him or
her:
- Focus on and clearly define for everyone the tasks assigned to
the Work Group;
- Put more work and forethought into the Meeting Agenda to better
manage the allotted time;
- Facilitate meaningful discussion of issues, drawing in opinions
and ideas from everyone who wishes to participate, while limiting
redundant expression of the same points of view;
- Summarize the key points made during a discussion for the benefit
of all participants, as well as for the record;
- Keep discussions on-topic;
- Ensure that invited speakers are made aware of the Work Group’s
particular concerns and issues in advance, so he or she has the opportunity
to fully address those concerns while structuring the presentation;
and
- Ensure that the meeting progresses appropriately.
It was moved and seconded that the Subcommittee adopt the recommendation.
Discussion:
There was no discussion.
A vote count was taken:
17 in favor
0 opposed
0 abstentions
The motion carried.
Karen Galloway recommended from the Guidelines and Procedures Work Group
the following recommendation dated August 21, 2002 to the Subcommittee:
RECOMMENDATION TWO:
The Guidelines and Procedures Work Group recommends to the Oak Ridge
Reservation Health Effects Subcommittee (ORRHES) that the three attached
documents (A – “Target characteristics for facilitator candidates,”
Michael Wilkinson; B – “What is a group facilitator,”
Sandor Schuman; C – “Transcript of ORR Public Health Working
Group” be sent to ATSDR for their consideration as one factor
in hiring a person for the Oak Ridge Field Office.
It was moved and seconded that the Subcommittee adopt the recommendation.
Discussion:
Kowetha Davidson asked about the origin of Attachment C to the recommendation.
James Lewis explained that it is a summary of a meeting of the Oak Ridge
Reservation Public Health Work Group on September 9, 1999, at the Oak
Ridge Mall.
Bob Craig asked for further explanation regarding the job description
and duties. The job description is for an administrative assistant rather
than a meeting facilitator. La Freta Dalton responded that the job description
is for a SEEP employee (Senior Environmental Employment Program). This
is consistent with the request from the Subcommittee. The information
concerning facilitation skills in the recommendation will be considered
in the hiring process. Karen Galloway commented that facilitation skills
are to be considered along with the requirements of the job description.
Herman Cember questioned the age requirement (minimum age is 55). La
Freta Dalton explained that SEEP is a program for those 55 and older.
Susan Kaplan commented that early in the public health assessment process
that the importance of having a facilitator has been stressed. James Lewis
concurred with Susan Kaplan’s comment and reiterated that a facilitator
is needed in Work Group meetings.
Jeff Hill stated that Attachment C is inconsistent with some of the ways
the Subcommittee functions, and asked whether it would be possible to
state that facilitation skills are needed, and remove Attachment C from
the recommendation. Susan Kaplan seconded Jeff Hill’s motion to
remove Attachment C, and include wording in the job description for facilitation
skills. Changes to the wording of the recommendation were discussed. Elmer
Akin commented that instead of requiring facilitation skills the job description
could specify that the person hired may be subject to facilitation training.
Kowetha Davidson asked for a vote count on the following amended wording
of the recommendation:
RECOMMENDATION TWO (amended):
The Guidelines and Procedures Work Group recommends to the Oak Ridge
Reservation Health Effects Subcommittee (ORRHES) that the two attached
documents (A – “Target characteristics for facilitator candidates,”
Michael Wilkinson; B – “What is a group facilitator,”
Sandor Schuman; be sent to ATSDR for their consideration of facilitation
skills as one factor in hiring a person for the Oak Ridge Field Office.
A vote count was taken.
16 In favor
0 Opposed
1 Abstention
The motion carried.
Donna Mosby expressed concern that the expectations of the new employee
will exceed the qualifications in the job description. Bob Craig suggested
hiring a professional facilitator rather than burdening an administrative
person with the responsibilities of a facilitator. James Lewis agreed
that often Work Group meetings need the skills of a facilitator. Tony
Malinauskas expressed concern that the ad is misleading, if facilitation
skills would be a deciding factor in hiring. If a facilitator is needed,
one should be hired.
Kowetha Davidson stated that the original request was for an administrative
assistant, who would assist committee members in preparing presentations,
take minutes, and maintain files.
A vote count was taken on the motion to approve Amended Recommendation
number 2:
8 in favor
9 opposed
0 abstentions
The motion did not carry.
COMMUNICATIONS AND OUTREACH WORK GROUP
The Communications and Outreach Work Group made no recommendations.
HEALTH EDUCATION NEEDS ASSESSMENT WORK GROUP
Donna Mosby recommended from the Health Needs Assessment Work
Group the following recommendation dated June 18, 2002:
RECOMMENDATION ONE (amended):
The Oak Ridge Reservation Health Effects Subcommittee (ORRHES) has
determined that discussion of public health activities related to the
establishment of a clinic, clinical evaluations, medical monitoring,
health surveillance, health studies, and/or biological monitoring is
premature to ATSDR’s Public Health Assessment (PHA) process.
Thus, the ORRHES recommends that formal consideration of these issues
be postponed until the ATSDR PHA process identifies and characterizes
an exposure of an off-site population at levels of health concern. If
this exposure warrants follow-up public health activities, the ORRHES
will then consider these issues in making its recommendations to ATSDR.
This recommendation is based on the ORRHES’s review, evaluation,
and understanding of the items listed in Attachment A.
It was moved and seconded that the Subcommittee adopt the recommendation.
Discussion:
Peggy Adkins proposed an alternative recommendation text to read:
The Oak Ridge Reservation Health Effect Subcommittee (ORRHES) has determined
that present policies and law restrict the establishment of a clinic by
ATSDR. Clinical evaluation, medical monitoring, health surveillance, health
studies and/or biological monitoring are, however, possible. Therefore,
ORRHES recommends that while waiting for the completion of ATSDR Public
Health Assessments that ORRHES create a task force or Work Group to aggressively
explore and encourage innovative alternative sources to check potentially
affected residents in the Oak Ridge area for toxicants and their affects,
and for tracking trends by location.
La Freta Dalton commented that ORRHES has had extensive discussions regarding
the tasks of the Subcommittee, and the available resources are committed
to the PHA process.
Jerry Pereira further commented that, with the exception of the health
clinic, other health activities listed in the recommendation could be
conducted by ATSDR, after completion of, and if warranted by, the PHA
process.
Susan Kaplan commented that she does not believe that it is inappropriate
for a Work Group of the Subcommittee to explore ways to track health trends
by location.
Bob Craig expressed that the Subcommittee should not get off task, and
should work through the PHA’s so that warranted public health actions
may then be taken. Barbara Sonnenburg stated that she supports the idea
of exploring resources for checking potentially affected residents while
the Subcommittee proceeds with the PHA process. The community has been
waiting for two years for something to be done. The PHA process would
not be hindered.
A vote count was taken on the motion to approve the alternativ amended
Recommendation One:
5 in favor
11 opposed
0 abstentions
The motion did not carry.
A vote count was taken on the motion to approve the original amended
Recommendation One:
RECOMMENDATION ONE (amended):
The Oak Ridge Reservation Health Effects Subcommittee (ORRHES) has
determined that discussion of public health activities related to the
establishment of a clinic, clinical evaluations, medical monitoring,
health surveillance, health studies, and/or biological monitoring is
premature to ATSDR’s Public Health Assessment (PHA) process.
Thus, the ORRHES recommends that formal consideration of these issues
be postponed until the ATSDR PHA process identifies and characterizes
an exposure of an off-site population at levels of health concern. If
this exposure warrants follow-up public health activities, the ORRHES
will then consider these issues in making its recommendations to ATSDR.
This recommendation is based on the ORRHES’s review, evaluation,
and understanding of the items listed in Attachment A.
12 in favor
5 opposed
0 abstentions
The motion carried.
Donna Mosby posed the possibility that, if the Subcommittee so directs,
a Work Group could try mapping the health concerns of members of the community
to track health trends by location. Kowetha Davidson responded that the
Health Needs Assessment Work Group should discuss that option
during its meetings.
Donna Mosby recommended from the Health Needs Assessment Work Group that
the Subcommittee adopt the fact sheet on environmental and occupational
medical resources:
RECOMMENDATION TWO:
The Oak Ridge Reservation Health Effects Subcommittee (ORRHES) adopts
the fact sheet entitled “Environmental and Occupational Medical
Resources” draft dated August 20, 2002. A statement should be
added to the reverse side of the fact sheet (medical resources for Oak
Ridge Reservation workers) directing workers to notify their employers
of their health concerns.
This recommendation received a motion, and was seconded.
17 in favor
0 opposed
0 abstentions
The motion carried.
PUBLIC HEALTH ASSESSMENT WORK GROUP
Bob Craig recommended from the Public Health Assessment Work Group the
following recommendation dated August 21, 2002:
RECOMMENDATION ONE:
ORRHES recommends that CDC/ATSDR present the public health implications
of I-131 thyroid doses (and risks, if feasible) due to releases from
the Department of Energy’s (DOE) Oak Ridge Reservation (ORR),
the Nevada Test Site (NTS), and the combined doses (and risks, if feasible)
from the ORR and NTS in its Public Health Assessment for I-131. ATSDR
should present the doses (and risks, if feasible), their ranges of uncertainty,
and an explanation of the level of uncertainty for public understanding.
It was moved and seconded that the Subcommittee adopt the recommendation.
Discussion:
LC Manley expressed reluctance about combining the I-131 doses from the
Oak Ridge RaLa program and doses from the NTS.
James Lewis asked how long it might take to combine the doses and risks
from Oak Ridge and the NTS and when the Subcommittee could expect to receive
that information, in light of ATSDR informing members of the Subcommittee
the previous evening that it could be six months before the evaluation
of the relevant data from ORNL can be performed.
Bob Craig responded that the six-month evaluation of data is independent
from the task of combining doses from Oak Ridge and the NTS because the
data that have yet to be evaluated were recently discovered monitoring
data (at Roger’s quarry). The evaluation will determine whether
those data bring greater credibility to the existing dose estimates from
the dose reconstruction.
Herman Cember commented that numerical dose estimates, whether combined
or not, will mean little and will be confusing to members of the public
and that it is the risk estimates that will be meaningful to people. Herman
Cember suggested that the recommendation be amended to propose estimating
only risks and not doses. Herman Cember also commented that combining
the doses involves the additional complicating issue of the dose rate
effectiveness factor (DREF), which affects the meaning of the dose estimates.
The National Academy of Sciences (NAS) recommended in the BEIR V report
(committee on the Biological Effectiveness of Ionizing Radiation) that
a DREF of 2.5 be used to adjust the dose estimates. This is an additional
aspect of dose estimates that will be confusing to the public. The dose
estimates are merely a step in the process of arriving at risk estimates,
which are the more meaningful endpoint to present to the public.
Herman Cember moved that the text of the recommendation be amended to
eliminate dose from the text and specify that only risks be estimated.
This motion received a second, with confirmation that the recommendation
does include combining the impacts from Oak Ridge and the NTS.
Tony Malinauskas suggested that combining doses from Oak Ridge and the
NTS would only be confusing and that fallout dose data should be used
as a baseline for comparison with the doses from Oak Ridge.
LC Manley commented that, from the perspective of a non-scientist, it
is desirable to receive information that is as easy to understand as possible.
Jeff Hill asked for clarification on the text of the amended recommendation.
George Gartseff suggested that the recommendation focus on the impact
of the Oak Ridge Reservation itself rather than complicating the issues
with added doses from the NTS or other DOE sites, which may also have
had impacts. These points at times confuse members of the Subcommittee
so they will likely confuse the public more.
Elmer Akin asked whether ATSDR makes qualitative risk statements rather
than quantitative risk estimates. Jack Hanley responded that ATSDR uses
dose estimates to make qualitative judgements about those doses based
on epidemiological information concerning the impact of the doses. ATSDR’s
conclusions are based on the dose estimates and their comparison to epidemiological
studies, health studies, toxicological studies, or animal studies. Typically,
ATSDR does not include quantitative risk estimates in their health assessments
because the public does not find those estimates helpful. The dose reconstruction
already presents quantitative risk estimates, which may not be helpful
to the public. ATSDR finds that the public is given a better understanding
of potential health impacts by presenting them with qualitative dose estimates
and recommended follow up action for each given level/range of dose. Qualitative
judgement is the focus of presentation to the public.
Susan Kaplan asked whether the public health assessment process is mandated
to only include consideration of impacts from the Oak Ridge Reservation.
Jack Hanley responded that the Superfund mandate for ATSDR public health
assessments requires that ATSDR conduct a public health assessment for
each Superfund site and where circumstances are such that other sources
of public health impact are present the ATSDR mentions those other sources.
Acknowledging that the uncertainties involved are large, James Lewis
posed the question that perhaps the Subcommittee should allow the NAS
to make a determination about combining doses from other sources rather
than proceeding with a recommendation to the ATSDR that doses from NTS
be combined with doses from Oak Ridge.
Herman Cember agreed with George Gartseff that the focus should be on
the impact of the Oak Ridge Reservation itself, leaving the potential
impacts from other sites to be addressed by the ATSDR. Herman Cember modified
his motion to eliminate combining exposures from NTS with those from Oak
Ridge.
Jeff Hill commented that the total health impact in the community from
various sources is the type of information that the public needs rather
than the isolated impact from a single source.
At this point Kowetha Davidson called for a vote on the first text amendment
proposed by Herman Cember:
ORRHES recommends that CDC/ATSDR present the public health implications
of the risks of I-131 thyroid exposures due to releases from the Department
of Energy’s (DOE) Oak Ridge Reservation (ORR), the Nevada Test
Site (NTS), and the combined risks of the exposures from the ORR and
NTS in its Public Health Assessment for I-131. ATSDR should present
the risks, their ranges of uncertainty, and an explanation of the level
of uncertainty for public understanding.
A vote count was taken on the motion to approve the amended recommendation
text moved by Herman Cember:
2 In favor
15 Opposed
0 Abstained
The motion did not carry.
A vote count was taken on the original recommendation text from the Public
Health Assessment Work Group:
RECOMMENDATION ONE:
ORRHES recommends that CDC/ATSDR present the public health implications
of I-131 thyroid doses (and risks, if feasible) due to releases from
the Department of Energy’s (DOE) Oak Ridge Reservation (ORR),
the Nevada Test Site (NTS), and the combined doses (and risks, if feasible)
from the ORR and NTS in its Public Health Assessment for I-131. ATSDR
should present the doses (and risks, if feasible), their ranges of uncertainty,
and an explanation of the level of uncertainty for public understanding.
10 In favor
6 Opposed
1 Abstained
The motion did not carry.
Kowetha Davidson asked the Subcommittee for specific direction on how
to proceed regarding the issue of combining doses.
Bob Craig commented that perhaps a recommendation on the issue of combining
doses is not necessary, and that the Public Health Assessment Work Group
has already expended much effort arriving at the recommendation brought
to the Subcommittee in this meeting.
Jack Hanley commented that, although the Subcommittee has not passed
a formal recommendation to ATSDR regarding the issue of combining I-131
doses, ATSDR has heard the importance of the issue and the discussion
of the Subcommittee on the issue. ATSDR will work with the Subcommittee
on the issue as it formulates the presentation of the results of the public
health assessment. The Subcommittee decided to wait for the input of Paul
Charp before proceeding on this issue.
Considering the first recommendation from the Public Health Assessment
Work Group did not pass, Bob Craig withdrew the second recommendation
from the Public Health Assessment Work Group dated August 21, 2002, because
it is an extension of the first recommendation.
RECOMMENDATION TWO:
ORRHES recommends that CDC/ATSDR establish an online calculator so
that individuals may obtain estimates of their thyroid doses (and risks,
if feasible) due to releases of I-131 from the Oak Ridge Department
of Energy Reservation and from the Nevada Test Site along with an option
for adding the doses (and risks, if feasible). CDC/ATSDR should provide
information to the public on interpretation, uncertainty, and credibility
of the results from the calculator and any follow-up action the individual
should take as a result of the estimate.
The motion was withdrawn by the Public Health Assessment Work Group.
Unfinished Business/New
Business/Issues/Concerns
Administrative Update:
La Freta Dalton reported on the budget status highlighting two documents:
- ORRHES FY2002 Approved Budget Mark, and
- ORRHES Project Obligation Status as of September 30, 2001.
La Freta Dalton reported that ATSDR has enough funds available to operate
ORRHES for the remainder of the fiscal year, ending September 30, 2002.
No budget information is available for the fiscal year beginning October
1, 2002.
La Freta Dalton distributed a letter to Ms. Beverly Cook (Assistant Secretary,
Office of Environment, Safety, and Health, DOE) from Peter McCumiskey
(ATSDR), Robert Delaney (National Center for Environmental Health), and
DeLon Hull (National Institute for Occupational Safety and Health), regarding
the impacts of DOE funding reductions on public health activities.
Donna Mosby asked about the Five Year Plan, noted as an enclosure to
the letter. Burt Cooper responded that DOE requires that a five-year plan
for public health activities at DOE sites be presented (Agenda for HHS
Public Health Activities, for Fiscal Years 2002-2007, at DOE Sites). Accompanying
the Agenda was a projected five-year budget. The most recent budget request
regarding funding for the next fiscal year (2003) depends upon Congressional
appropriations for DOE.
Jerry Pereira commented that he has recently discussed the issue of one
point of contact across ATSDR, and the project plan currently in draft
with Bob Williams, Director, Division of Health Assessment and Consultation.
Jerry Pereira reported that Bob Williams and Dr. Henry Falk, Assistant
Administrator, ATSDR, both support Jerry Pereira as the single project
manager/point of contact for Oak Ridge. Jerry Pereira reminded the Subcommittee
that he has no control over the budget allocated to ATSDR. The draft project
plan will be finalized and brought to the Subcommittee in the near future.
Community Health Concerns Database:
Jack Hanley presented an update on the Community Health Concerns Database
(beta version). An intern has been hired (July 1, 2002, Melissa Fish),
whose job is to enter concerns into the database. A handout was distributed
to the Subcommittee summarizing the concerns entered thus far. Melissa
will be here until the end of September. About 1300 concerns have been
entered into the database. Concerns have been captured from the minutes
of Subcommittee meetings, Work Group meetings, and video tapes of meetings.
Ongoing activities will include continuing to enter concerns from concern
sheets, written correspondence, Work Group meetings, and also developing
queries of the database. Additional information will be available at the
next Subcommittee meeting. The Subcommittee expressed great appreciation
for the effort on the Community Concerns Database.
Project Plan Work Group:
Kowetha Davidson proposed the establishment of a project Work Group composed
of the Work Group chairs, and two additional members, and a member of
the community for further development of the ATSDR project plan. Kowetha
Davidson proposed serving as lead of the Work Group, which would meet
with ATSDR once per month. Written progress reports would be prepared,
including:
- updates of expected completion dates
- accomplishments, milestones
- problems encountered
- delays
- what is going on within ATSDR as far as this project is concerned.
There was a motion to establish this Work Group. The motion was seconded.
James Lewis expressed disappointment in adopting Kowetha Davidson’s
proposal instead of an approach discussed at great length on the previous
evening among the Work Group Chairs. James Lewis asked for the opportunity
to make a presentation as noted in the agenda of the Subcommittee meeting.
A motion was received and seconded to table the discussion at this meeting.
A vote was taken by voice and the discussion was tabled until the next
Subcommittee meeting. The written presentation document from James Lewis
will be circulated to Subcommittee members for consideration before the
next Subcommittee meeting. The agenda for that meeting will include adequate
time to address the issue.
Identification of Action Items
La Freta Dalton discussed dates for future Subcommittee meetings. The
next two meetings of the ORRHES Subcommittee will be October 22, 2002
and December 3, 2002.
The action items are identified below.
ACTION 1: La Freta Dalton will arrange for the addition of a hyperlink
on the ORRHES web site to the “Roane County News” web site.
ACTION 2: La Freta Dalton will arrange for the addition of the ORRHES
action items chart/matrix to the ORRHES web site.
ACTION 3: La Freta Dalton will explore the possibility of adding the
ORRHES “Community Health Concerns Comment Sheet” to the
ORRHES web site.
ACTION 4: La Freta Dalton will arrange for the addition of a hyperlink
on the ORRHES web site to the ATSDR toxicity profiles on the ATSDR web
site.
Housekeeping Issues and Closing
Comments
Kowetha Davidson declared the meeting adjourned at 8:41 PM.
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