Public Health Assessment Work Group
Meeting Minutes
December 10, 2001

-cont-

Harry Williams: I’ve got a comment for you guys, and I’m sorry to put it in here, but I’m going to have to leave here in a minute. How do you all handle undocumented releases that have taken place? And one good source of information for you, if you’re looking for more current information and more current testimony from the public, would be the Employee Compensation Hearings that were held in Oak Ridge where several hundred people went to the microphone and talked. DOE does have those transcripts and videotapes. And DOE’s Safety Investigators that were in here interviewing workers, of which I was one, that could have information that could help you folks in looking for your releases. For instance, an undocumented release that took place was the purge of the cascades at K-25; it happened on a weekly basis. And it was undocumented in all of your Dose Reconstruction.

Karl Markiewicz: It was a purge of what?

Harry Williams: Purge of the Cascades Process.

Karl Markiewicz: . . . of the Cascades Process.

Harry Williams: And that has releases.

Walter Coin: That was in 1958.

Susan Kaplan: But right now, aren’t we dealing with soil samples where you actually go and pull samples and take data, where that was looking at the past, we’re now looking at the present, I believe . . .

Karl Markiewicz: Right.

Susan Kaplan: I mean we care about what’s in the soil - what are kids possibly eating.

Karl Markiewicz: If it were released in the past through that system and it’s still in the soil, we’re going to pick it up in our soil samples. But if you’re looking at an air pathway, say if it happened in1958 and there was a release . . . how to address that . . .

Harry Williams: Oh, no, this went on for decades. It didn’t just happen one or two times.

Karl Markiewicz: Right.

Harry Williams: Then in the 1980s, you had the K-29 Incident where there was a large release where, as best I can determine, was not documented. Those are the kind of things. If you’re going to have a credible study and a credible look, I think you need to look at more current avenues, and get away from all this document searching from 10 or 15 years back. But that’s my opinion. I do have to go, and I apologize.

James Lewis: Before you leave, I guess I’ve got a comment that’s associated with it. I think Linda sort of captured it talking about anecdotal information. I think ATSDR needs to have a process because when we look at anecdotal information that is presented to us - it may be separate from what you’re using - we need to have a way of collecting that information, outlining that, and set up a process for how you manage that. Somebody needs to get that developed.

Linda Gass: I would suggest that you start by going to the K-25 Legacy Interviews in which many people gave court-reported, transcribed testimony. And all of those reside with Department of Energy Headquarters. Headquarters came to town here about 2 years ago, and they did call it an Independent Investigation. And of course I asked, and many other people asked, what made this an independent investigation. The answer was that it was DOE Headquarters coming to a site, they configured it as being independent. But they did take a lot of transcribed information and that is in the DOE Database, in their hands. And I think that if ATSDR did not get that source of information, it would be a major oversight in trying to do a Public Health Assessment.

Harry Williams: I would like to encourage you to . . .

Paul Charp: They’re available on-line, I was looking at some other interviews a couple of days ago.

Linda Gass: I can’t hear.

Barbara Sonnenburg: Could you bring some of those out for us?

Karl Markiewicz: Paul was actually looking at some of those on-line the other day.

Paul Charp: If you go onto the OSTI Information System, and type in the word “interview” under the search, you’ll pull up a lot of interviews from all over the DOE Complex on history of . . . whatever they want to talk about, whether it’s Oak Ridge or . .

Barbara Sonnenburg: Could you get the ones from Oak Ridge for us?

Paul Charp: Yeah, I’ll try to get as many as I can.

Linda Gass: Who suggested the OSTI site? I can’t tell . . .

Karl Markiewicz: That was Paul Charp.

Paul Charp: Barbara Brooks of DOE Headquarters mentioned it at the Subcommittee meeting last week And that rang a bell because I had looked at some others from Livermore. And so I logged on and did “Oak Ridge interviews,” and a lot of files came up.

Al Brooks: How many of those gave quantitative information?

Paul Charp: I didn’t read through that many.

Bill Pardue: James, you’ve had your hand up.

James Lewis: Yes, I’d like to go back to the question that was raised earlier by Linda and the gentleman that was on the phone, Harry. My problem in my mind is that when this effort was going on with DOE, were these questions raised. We don’t get a list from DOE of concerns or issues. If there was something missed then, 5 or 10 years ago, and these issues were raised, then DOE or whoever was doing the sampling, should have captured those and gone back and started to dig that out. I’m not saying that we shun our responsibility, but what I am saying is, if we’re waiting 5 or 10 years to bring up an issue that was addressed and nobody followed up on it as a part of that effort, does that put us in a do-loop? And what do we do?

Kowetha Davidson: I think we all have to remember, too, that we’re talking about undocumented releases. It all depends on the chemical. There are some things, whether they’re documented or not, if they got into the soil, they will still be there. And you will pick them up. Volatiles you won’t find anymore. But there are some things that are going to be there - they’re not going anywhere. If it’s lead, once lead is there, lead is lead. It’s not going anywhere, so whether they’re undocumented, it depends on what the substances are. They will still be there is they do the soil sampling today, you are still going to detect them. I won’t say that’s true for all chemicals, but it’s true for a large number of chemicals.

Harry Williams: I don’t know, I guess UF₆ would react the same way. But the purge of the cascade and the K-29 Incident and stuff, those were large releases of UF₆. And, to the best I can determine, they are undocumented. And I got this directly from a Plant Shift Superintendent who should know. He said you may find references to them in the Plant Superintendent’s Log. Now if it stays in the soil and you can see it, that would be wonderful. But I hear a lot of talking, but I don’t hear . . . like the Burial Grounds that aren’t marked out of the Reservation and places like that . . . you treat the fenced-in areas as on-site and the rest of the Reservation as off-site, well that’s not true . . . there’s Burial Grounds stuck all over that place. That could have impact off-site. There’s just so many uncertainties in my mind that I think educated folks like yourselves and people that know how to do this need to take a look at (couldn’t hear). An undocumented release is just what is says - it’s undocumented. But for workers and people that witnessed it, then it’s not anecdotal! That’s direct testimony. If we have to go the Rules of Evidence, then I think maybe we ought to do that.

Barbara Sonnenburg: Harry, could you put some of this down in writing for us?

Harry Williams: Yes. Yes, sure can.

Barbara Sonnenburg: What you’re talking about that was seen and you know personally.

Harry Williams: Well, I know of purging the cascades and the K-29 Incident personally, and I know of a couple of places on the Reservation that are unmarked Burial Grounds . . various by-products of what Oak Ridge does. And I’m sure other folks will have them. DOE at one time supposedly had a database of all those sites.

Barbara Sonnenburg: Well, that may or may not have been kept. But if you write it down for us again, that would be very helpful.

Jack Hanley: Harry, regarding the K-25 releases of fluoride . . .

Harry Williams: Right, uranium hexafluoride?

Jack Hanley: Yes, that’s one contaminant that we will look at. In addition to the Dose Reconstruction studies that were done, we’re going to do our own analysis for fluoride and fluorine products that were released.

Al Brooks: Are you looking at fluorine releases via the UF₆ releases?

Harry Williams: Yeah, that’s the way it has to be looked at.

Karl Markiewicz: Yeah, we will be.

Jack Hanley: We did this in Paducah and we will do it here.

Harry Williams: I’ve got to go. See you folks later.

Bill Pardue: Thank you, Harry.

Bob Eklund: What is UF₆?

Al Brooks: UF₆ is the main process gas at K-25. . .

<TOO MANY CONVERSATIONS GOING ON TO HEAR>

Walter Coin: . . . trying to figure out whether they’re going to get rid of it or not . . .

Al Brooks: . process material, gas at nominal temperatures and pressures, liquid at room temperatures, . . .

Susan Kaplan: All those canisters . . .

Walter Coin: 500-gallon . . .

Bob Eklund: In other words, it was radioactive?

Paul Charp: They’re still radioactive, it’s just that . . .

Al Brooks: It’s not very radioactive . . . but uranium is a toxic ____, and there’s literally millions of tons out there.

Barbara Sonnenburg: Where? In barrels? Or just . . .

Al Brooks: In tanks. There are specially designed storage tanks for UF₆.

Barbara Sonnenburg: When you said “out there,” I didn’t know what you meant.

Paul Charp?: . . . 14 tons or more . . .

Karl Markiewicz: And when looking at UF₆, you need to look at acute hazards associated with hydrogen fluoride as well as the long-term-type hazards from uranium - the chemical toxicity from uranium. So you’re looking at both short- and long-term.

Susan Kaplan: The SSAB looked at this issue, and I think it will self-seal a hole of 1 inch . . . you have to have a pretty catastrophic event to release it, and even then I think . . .

Al Brook: Everybody got concerned about this. The standard thing was if a little hole occurred, and somebody put some duct tape over it . . .

Susan Kaplan: Even if you have a major release, it ?hydrolizes?, and it stays pretty . . .

Paul Charp: Somebody in Atlanta that was working on Paducah ran a NRC Model called RASCAL to see if you had a catastrophic release . ..

Linda Gass: Excuse me, I’m very interested. Could you speak just a little bit louder - I can’t hear.

Paul Charp: I can’t tell you all the details, but someone back in Atlanta ran a computer model called RASCAL 3.0 from the NRC. They were looking at the hydrogen fluoride impact from at least one ruptured canister at Paducah. And depending on the wind patterns, you could have some pretty significant exposure levels, perhaps a mile or so away.

Karl Markiewicz: Actually there were two accidents that we modeled for that site, and the levels were really high.

Paul Charp: One was a fire and explosion inside a building that blew out a wall.

Susan Kaplan: So it’s a _________, which is different than what they told us at SSAB.

Karl Markiewicz: This is a major, major release.

Bill Pardue: Susan, I think what they said at the SSAB that I listened to was that it would be unlikely that there would be any exposure to residents of the city because it’s 7 miles out there or something, but that there would be release from the site.

Al Brooks: It’s widely varied on that, probably by a factor of 1,000,000, on what you assume by the release. If you assume a 1-inch hole, which tends to seal, or you assume the total destruction of the facility. Those are two drastically different things.

Susan Kaplan: So is that what you guys modeled - the destruction of a facility?

Karl Markiewicz: Yes, the explosion that blew out the wall. Then there was another release - it was a process leak, wasn’t it. It was a smaller quantity that was released, but it was still substantial. I can’t remember what failed in the system.

Paul Charp: Probably a seal or something . . . they don’t tell you which building.

Jack Hanley: The point I wanted to bring up . . I wanted to let Harry know before he got off that we were going to look at fluorine and fluoride products. That’s just a point because we will be doing that and, as Karl said, we’ve done that in Paducah. Karl, do you have anything? How much longer do you have on this presentation?

Karl Markiewicz: Oh, I have a few more pages. OK, we had additional copies made. Three more pages. One had the 60-mg calculation for the EMEG. I think it may be the last one on this sheet. I think it may be in reverse order. The middle page . . .

Al Brooks: On this first page (average daily U.S. Dietary Intake), is that average over the whole public?

Karl Markiewicz: Yeah, that was a general survey that they had done over the United States. Go ahead.

Al Brooks: That could run a factor of ~20 higher than your intermediate oral MRL?

Karl Markiewicz: Yes, now remember that the intermediate oral MRL was based on a child eating 5000 mg of soil 365 days per year. That kind of puts it in perspective as to our MRL vs. the Average U.S. Dietary Intake. Linda and Jack, what I’m showing is what I call a thermometer graph. It’s a line graph that has doses in the center (mg/kg/day), and then off to either side, we show effects. I show the LOAEL for Animals, the NOAEL for Animals, the EPA Reference Dose, the ATSDR Intermediate Oral MRL, and the Average Daily U.S. Dietary Intake to try to put it in perspective. Then when we get into the Public Health Implication Phase, what I’ll do is put the dose for Oak Ridge on this bar graph, and you can look at the bar graph and see where it would fall and what the assumptions were.

Al Brooks: Please, let’s call it a screening level. Dose - that implies to most people that’s what the people in Oak Ridge . . .

Karl Markiewicz: Right, in the PHA, we called them Estimated Exposure Doses, but it’s based upon assumptions that we put into it and algorithms.

Al Brooks: But it’s based on very conservative assumptions.

Karl Markiewicz: Right, and those would be outlined in the Health Assessment. If we’re assuming that someone’s out there 250 days per year and they’re eating 5000 mg, that will be stated in there.

Al Brooks: I hope people read the . . .

Walter Coin: Can you also put in there how fast stuff gets out of the body?

Karl Markiewicz: Yeah, we can put that in the Health Implications side of it, the half-life in the body.

Susan Kaplan: Will you be showing a range? I think his point is that you’re going to put out a report that has this ultra, ultra conservative number. Will you also put a reference to a less conservative, more realistic number just as a comparison?

Karl Markiewicz: Definitely. That will be in there. But again, it’s just an estimate and it’s based upon assumptions. You assume . . .

Susan Kaplan: Giving us a range, I think, makes sense.

Karl Markiewicz: Yes. The initial screen again is that child who’s eating 5000. You know where that’s probably going to fall on this graph. And then if ___ is carried through the Public Health Implications, then we refine it even further. Like Mr. Manley had his tomatoes. Did he eat 70 lb. of tomatoes per year - does he eat that? If that’s not realistic, we would talk to the community and talk Mr. Manley - he may only eat 20 lb. per year. We use that in our dose calculation.

Al Brooks: I would point out that there is one facet to Mr. Manley’s analysis on tomatoes and other things. About half to all of the exposure is due to potassium-40. Potassium-40 is not used in any process on the ORR. Yet people will look at that and say “why does DOE give us all that radiation?”

Susan Kaplan: . . .can separate that out, don’t they?

Al Brooks: If people know that there is no potassium-40 in the processes, but they don’t know that.

Karl Markiewicz: That’s where we need to sharpen our pencils and communicate that. That falls on us for Risk Communication to say that in there - this is what it is and this is what it means. We can’t just throw a number down there.

Al Brooks: We need a footnote on the bottom of every table.

Susan Kaplan: . . . the ASER does that.

James Lewis: If I hear Al right, if we went to begin to clarify something, we’re in real trouble. If we use terms, we need to get those defined clearly-up front so we can agree on those so we can work to within this process, because they’re killing us . . .

Karl Markiewicz: On the middle page of the 3 that you just received, I calculated an EMEG based upon a Lowest Observed Adverse Effect Level in humans. It was an acute study. Sometimes, people would ask what if somebody would go out there and actually eat it - how much would they have to eat to have an acute effect - which means you would have an effect very rapidly - within 24 hours, typically. But if you look at that calculation, the LOAEL for the human/acute is 184 mg/kg/day, and I used a child at 10 kg consuming 5000 mg, and you could have percentage levels of boron in the soil before you would have an effect (368,000 ppm @ 36.8% boron). And the effect that they saw was diahrea.

Al Brooks: It could kill these babies.

Karl Markiewicz: And it can.

Al Brooks: That happened. Borox in some hospital maternity ward was mistaken once for some component of a formula. And it was very . . .

Karl Markiewicz: I remember reading that. Can we go into the real data - the color maps? I thought we would spend more time on that, but . . .

James Lewis: The little squares mean off-site, right? The background samples? So therefore, only the first two sheets have that on them. The rest of them, I didn’t find any indications on the other maps.

Karl Markiewicz: Right the very first sheet that we looked at, were all the detects and non-detects for boron in soil. And it’s just a big area map; it spans many, many miles; and it shows general locations of the background samples and the ORR samples. Now the second sheet, there’s a boron site and background samples over 20 ppm. The green squares that was detected at over 20 ppm. Remember the 20 ppm was our screening value using the child eating 5000 mg of soil per day. So if there was a child in Morgan County walking through the National Forest and sat down and starting eating some soil - based on that screening value, one could surmise that that would be a problem. That shows - that’s a natural background level of boron in the soil in that area. But if you look at Morgan County and Loudon County you see your backgrounds, you have samples that are above 20 ppm. There are actually 13 out of the 113 background samples that are above 20 ppm. So that’s roughly 10% of your background samples are above (20 ppm), and the highest background sample is 61 ppm. But when you’re sampling, if you end up getting a piece of rock or a small particle that had boron in it, you’re going to get a high level in your soil sample.

Al Brooks: Are you aware that East Tennessee is a surprisingly active mining territory - throughout East Tennessee. It would be interesting to know if there was any mining activity in the vicinity of these things.

Karl Markiewicz: I’m not sure, for Morgan County if I remember correctly, there’s National Forest up there where they took that sample.

James Lewis: Coal mining.

Karl Markiewicz: I know that doesn’t necessarily mean they didn’t mine it, . . . yeah, it would be interesting.

Al Brooks: DOE’s definition of disturbed land as it was used for agricultural purposes doesn’t . . .

Karl Markiewicz: Okay now the next page, what we did was show samples over 20 ppm, then I blew up for Y-12 and X-10. The reason I didn’t put K-25 was that out of the 480 samples that were collected around the K-25 area, only 7 were above 20 ppm.

Bob Eklund: I have a question. On the previous map, the green squares are above 20 ppm?

Karl Markiewicz: Yes. So I just blew up that area showing greater than 20 ppm for Y-12, for X-10. The next to the last page, we did the calculations for an adult (a 70-kg person was 7000 ppm; for a 60-kg person, it was 6000 ppm). This next one is boron samples greater than 500 ppm, and it’s only in the X-10 area that you have greater than 500 ppm. This is a process, when you’re walking through this, the initial screening is >20 ppm, but as we walk through this and refine the process, part of that refinement is also looking at the screening value we’re going to use. The first screen is 20 ppm, but subsequent screens may be between that and 7000 ppm - or if we’re looking at acute, it may be up to 100,000 ppm. I just put that on there to show you, as the screening process goes, if we were using 500 (and I’m not saying we are), the only samples >500 were in the X-10 area.

Al Brooks: When you extracted this data, did you looked at all samples for which boron was tested. Rights?

Karl Markiewicz: Correct.

Al Brooks: Otherwise, you wouldn’t have gotten any non-detects. Which says that the background samples which extend to NE and SW were not tested for boron.

Karl Markiewicz: They were tested for boron. You’re say the ones furthest to the north?

Al Brooks: I’m talking about NE and SW.

Karl Markiewicz: Well, for the soil samples, some of them - boron was not tested in all soil samples. Jack was talking about certain metals were tested, more of the RCRA-associated metals were tested. Boron was not tested in a lot of them. I shouldn’t say a lot - in some of the samples. Now we have sediment samples that have boron . . .

Al Brooks: I’m talking about soil samples. I was just surprised that boron wasn’t tested.

Kowetha Davidson: Boron was tested in these squares.

Al Brooks: Other background samples. This was supposed to be a comprehensive study. I’m just surprised they left boron out.

Karl Markiewicz: I’m still cross-checking to make sure that data set is in our electronic database.

Al Brooks: This is the BSCS Study?

Karl Markiewicz: That’s in there. It should be.

Bob Eklund: Even in Morgan County, they have some detects near this. What is non-detects? Further out, there’s a big space where, if they tested, there might be some detects. You’d think it would get less and less going out.

Al Brooks: No, I would not because boron is widely distributed in nature.

Bill Pardue: Excuse me, could we hold this to one conversation please?

Karl Markiewicz: There was a question on the number of detects vs. non-detects. I have the >20 ppm. I’d have to go back in and look at the data to see when were detects and non-detects.

Walter Coin: In 20 you don’t see that any more.

Karl Markiewicz: Right.

Kowetha Davidson: For non-detects, what is the detection level for boron?

Karl Markiewicz: Well, it varies depending upon the analysis. 0.04 ppm . . .

Al Brooks: It’s generally less than 1 ppm.

Karl Markiewicz: Yeah, I think almost all of them were. Some of these backgrounds detection limits were 4.8, 9.9, 10 ppm. It’s still half our screening level.

Kowetha Davidson: . . . up to 10 ppm?

Karl Markiewicz: Yeah. So most of them were below 1 ppm.

Walter Coin: For 500, the only place was X-10, right?

Karl Markiewicz: Yes, the higher sample there was 7000 ppm at X-10. I think you had a 5000, a 6000, a 7000, then you had other ones that were in the 600, 700, 800 range.

Walter Coin: There was nothing at K-25 or Y-12?

Karl Markiewicz: To try to pull this altogether, the focus and intent of this was to go through the screening process and to show that the first step of the screening process we’re looking at comparing the maximum concentration to a very low screening level, based upon very conservative assumptions. As you walk through that flow diagram, you refine that process further and further becoming more realistic in your assumptions until you get down to the Public Health Implications. Once it gets down to that point, if it goes through that whole process and you answer yes, yes, yes, you get into a more detailed discussion in the Public Health Implications portion of the document. I see that as being a very interactive process with this group. For the things that are going to screen out, a lot of them are going to be no-brainers where everything is below 20 - it’s not that big of a deal. So those are not contaminants of concern. But there may be something in there that - arsenic is a good example because of the comparison values that ATSDR and EPA use. They’re very, very low, and your natural values of arsenic in soil a lot of times will be above that. So, those kind of discussions will occur between the group.

Al Brooks: Let me assure you that it should be a no-brainer, but it won’t be. Somebody is going to bring out “what about the unknown synergistic effects?” I guarantee you!

Karl Markiewicz: Well, you’re right. As far as the mixtures and synergism and attitudes and antagonism, we’re going to talk about that - we’re going to address that. There’ll be a section in the document referring to that. Based upon the standard of science and the current literature, we’re going to go with it. ATSDR does not really have a written policy, some people think we do but we really don’t have a written policy that you can go on the web and look at and it says this is ATSDR’s policy on mixtures.

Linda Gass: Could you tell me where I could look that up on the web, please?

Karl Markiewicz: No, I’m saying it is not on the web. ATSDR does not have a written policy on mixtures.

Linda Gass: I thought you said you could go on the web.

Karl Markiewicz: No, I said you cannot - it does not exist. You cannot go on the web and find anything like that, but it will be addressed in the document.

Linda Gass: Well, if it’s not a written policy, what is your thinking on it? Is Mr. Markiewicz talking now - is that right?

Karl Markiewicz: Yes.

Linda Gass: Well, what is your thinking on that subject?

Karl Markiewicz: Well I had given you some of those articles from the Netherland Group, Sieden Ferone (sp?) and a group of European researchers. And what they’re looking at if you look at non-cancer or cancer effects, depending upon the dose. That thermometer graph is a really good representation of the type of site-specific of site-estimated doses that we would have. What they’re seeing is that when you have an exposure to a mixture of multiple compounds, if you are at or below the NOAEL in your exposures, you do not have any additivity or synergism (for non-carcinogenic). For carcinogenic exposures, if you’re 1/100 for the carcinogenic dose, the Cancer Effect Level of 1/100, you do not see any type of interaction between compounds for cancer. Typically, what we see in our site-related doses as well as these comparison values is you have factors of 100, 1000, or 1,000,000 - several orders of magnitude away from the Effect Levels that were seen. So if your exposure doses are within that range (1000, 10,000, 100,000, 1,000,000 away from those Effect Levels), you’re not going to see anything as far as a synergistic or additive effect, or even antagonistic.

Jack Hanley: Do you have those thermometer graphs up there right now?

Karl Markiewicz: Everyone has a copy of it.

Jack Hanley: Could you go through this very slowly and very carefully. This is very important.

Karl Markiewicz: There is a lot that goes on in this graph. It’s a line graph that goes from the top of the page to the bottom of the page, and doses along there are in mg/kg/day. I started the dose the dose at 1000 mg/kg/day. You can go even higher than that, depending on the compound. Some compounds, you’re going to have LOAELs and NOAELs higher than 1000 mg/kg/day. For boron, I started at 1000 because that was the LOAEL for animals; it ranged anywhere from about 20-30 mg/kg/day to 1000 mg/kg/day - that’s where you say Lowest Observed Adverse Effect Levels. Now we also have No Observed Adverse Effect Levels within that range of LOAELs; and again, when you’re looking at different end points, you may have a NOAEL in the range of 10?100 mg/kg/day. If you drop down 2 orders of magnitude for that NOAEL in animals, that’s where the Average Daily U.S. Dietary Intake falls. Then you go - not really an order of magnitude below that, but close to that - is where you have the ATSDR Oral MRL at 0.01.

Al Brooks: Rats will fall at the lower end of the bracket of the LOAEL. Right?

Karl Markiewicz: For that particular study, they did.

Al Brooks: The bottom of that is around . . .

Karl Markiewicz: 13.8, or whatever it was, yes - that particular study. Within our tox profiles, there’s a good summary in there and they actually have a table where it talks about animals and humans - what the LOAEL and NOAEL was. There’s a key at the bottom of that graph. So it’s really useful. These little symbols are numbered, and you can go back into the table. The key to Figure 40, it’s a rat study, 3 generations, the NOAEL was 17.5. It talks about the types of effects that were in there, and actually gives you the references. So there’s the compendium of animal and human studies that were used to derive the MRLs, and ultimately EMEGs, would be in the tox profiles.

Jack Hanley: Now Karl, when using the boron thermometer graph, we’re talking about additive and synergistic effects, if you could explain that - what type of dose you could have; where researchers say you may have a problem and you may not have, based on additive and synergistic effect.

Karl Markiewicz: Right. For the non-cancer, you’re looking range of the NOAELs and that’s for animals, so it’s between 10 and 100 mg/kg/day. The EPA Reference Dose is basically 0.1, so you’re several orders of magnitude lower than that. So you would have to have doses 2 orders of magnitude greater than EPA’s Comparison Value to even start approaching something where you MIGHT see synergistic, additive, or even antagonistic. Anytime you have a combination, it doesn’t mean they’re going to be synergistic or additive. They may cancel each other out as well. To emphasize that, doses need to be at a high enough level where you see that interaction.

Al Brooks: So as a rule of thumb, you would say that the interaction effects are in the range of the NOAEL?

Karl Markiewicz: Yes. You have to be above the NOAEL to see that type . . . from the recent research that’s been done, that’s what they’re finding . . .

Jack Hanley: So, we screen it out, based on our EMEGs, and it is unlikely to have any additive, synergistic, or antagonistic effects. If it doesn’t meet (at a minimum level) our EMEGs, there’s just no way that . . .

Linda Gass: That’s true. Thank you, Jack.

Karl Markiewicz: But now, some of the calculated doses - the estimated doses - the first time you’re going through, they may be above that EMEG. But again, that EMEG is based on a child @ 5000 mg/day. As you refine your dose estimates, you’re not going to jump 2 orders of magnitude, but you may be higher than the EMEG. But that still does not mean that you’re going to have interactive effects. Again, that’s 2 to 3 orders of magnitude and sometimes even more than that.

Susan Kaplan: What about the . . . carcinogenic compounds?

Karl Markiewicz: For carcinogenic compounds, the experimental design was such that it was 1/100th of the Cancer Effect Level (CEL). Once it was 1/100th of the CEL or less, they saw no interaction at all. I would have to go back into the literature if it was above 1/100th of the CEL. With certain things, you may see additivity, you may see antagonism, you may see synergism.

Kowetha Davidson: . . . you have to be concerned about the target.

Karl Markiewicz: A lot of the synergism and additivity that people have put into the research and the literature, they’re based on therapeutic doses - very, very high doses. For chemotherapeutic agents a lot of times, they use a combination of drugs, and those are at very, very high levels. You are definitely into the Adverse Effect Level range when you’re doing that. When you’re getting into environmental exposures, in a typical scenario, you don’t have that. Now when you have upset conditions, where you had an explosion or you had a stack that did not have any type of air pollution control devices and your house was 50 feet away and the stack blew right into your bedroom window, you might have some pretty high levels. But we typically don’t see that when we’re dealing with these type of sites.

Barbara Sonnenburg: When you give us a sample of all this further down the road, are you going to include samples taken in other parts of Oak Ridge and other surrounding counties?

Karl Markiewicz: Data from the samples?

Barbara Sonnenburg: Yes, if there are samples available. I asked you this question earlier. Will you include that data, not just the data you have thus far.

Karl Markiewicz: Definitely. Once it’s in the soil or the water or the sediment or the food, we don’t care where it came from.

Barbara Sonnenburg: Oh, but you are going to sample further from the actual plants?

Karl Markiewicz: We’re not going to sample . . .

Barbara Sonnenburg: Well, you’re going to take records to include those in your . . .

Karl Markiewicz: Yes.

Barbara Sonnenburg: Another question: other than soil, what else are you testing?

Karl Markiewicz: If you look at other types of exposure scenarios, you’re basically looking at air which would be inhalation, so you’re looking at air information. You’re looking at soil. Soil can be broken down into incidental ingestion of soil, it can be dermal contact with soil, or it can be root uptake or vegetable uptake from the soil. Then we can look at sediments - it’s fairly unrealistic - say it’s under the water, in the river, or in the creeks - you can look at incidental ingestion which may or may not happen (somebody may fall in and drink a little mouthful of muddy water); dermal exposure to sediments; but then you also have uptake from fish and other things - chemicals in the sediments which may bioconcentrate in the fish, so we’re looking at that. Then you have the whole gammit of biota, whether it’s apples or persimmons, or deer or turkeys . . .

Barbara Sonnenburg: How about the air - how do you test that?

Karl Markiewicz: Any air sampling that had been conducted - or, if we don’t have air sampling, a lot of times what we’ll do is model using a mathematical model from the source off-site. We can model it miles. We get an air concentration and we’ll look at that . . .

Barbara Sonnenburg: In other words, you figure out what you think was released, then you figure out what might have been in the air from that?

Karl Markiewicz: Right. Then again, when we do modeling, it’s very similar to our screening process. We use very conservative assumptions. So based on that model, it’s saying that the maximum amount would come off. And if that maximum amount is not a problem, because we use the maximum of release and meteorological conditions that we could get to that point at the highest concentrations . . . If all that comes back and it says there was not a problem. . .

Linda Gass: I would like to point out that you’re modeling using maximum release of what DOE tells you they released.

Karl Markiewicz: Sometimes, like for the Paducah Site, we knew there was an explosion, and we knew that a certain quantity (we assumed that the tank was full, and an X amount of UF was in there), and we assumed that maximum amount was released in one burst from that tank. Then we modeled that.

Linda Gass: How did you know about the explosion?

Karl Markiewicz: That was in the records, because people were killed.

Linda Gass: Okay, well, boy, that’s usually the way you find out.

Karl Markiewicz: But, if there were upset conditions at the facility, and if there is some suspect activity that occurred, and we had several accidents that workers had reported at the Paducah Facility, but because the release of that entire tank when the explosion occurred, that was far greater than any type of release that could have ever occurred from just a little process leak. So, if that one was okay, we would assume then that a smaller leak would be okay.

<SWITCHING TAPES AT 7:31 P.M.>

Walter Coin: . . . would be used for iodine releases for boron?

Karl Markiewicz: The type of mapping?

Walter Coin: Yeah. Cause, see, most of the . . .

Karl Markiewicz: I believe most of the Dose Reconstruction actually has _______ maps in it.

Walter Coin: Is that how they checked it? Is that the way they pretty well figured it - by using boron?

Karl Markiewicz: No, iodine is separate in and of itself. Boron is just a surrogate compound I picked to go through the screening process.

Walter Coin: That was one of the by-products from separation . . .

Paul Charp: This is not radioactive boron.

Walter Coin: Well, it is now.

Karl Markiewicz: The question was, was boron used as part of the iodine dose reconstruction process. My answer was that it was a separate procedure, and boron was not used as a surrogate to look at iodine.

Susan Kaplan: Al’s going to shoot me for asking this question, but I want it on record anyway, and you don’t have to answer it tonight. There’s been a lot of controversy about the TOSCA Incinerator. I’ve been on-site before. You facetiously made the comment before about the stack blowing into someone’s window. Well, that stack, on windy days, will blow directly into the trailers. Is that harmful?

Karl Markiewicz: I don’t know. If it’s a TOSCA Incinerator, it probably has a 99.9999 Destruction Removal Efficiency (DRE).

Linda Gass: It does. That is 99.9999 DRE. That is exactly what the regulations state. But the regulations do not require it to be monitored continuously, and the assumption is that when they do the test burns, that the same temperature, pressure, and feel material are the same things that are going in the rest of the time. So those are the assumptions in which the regulations are being met.

Karl Markiewicz: Right. And I’m not saying that it is, but if in fact, the DRE is 99.9999, most likely the air is cleaner coming out of that stack than it is in the ambient surrounding area.

Linda Gass: Assuming all those things that I said, and that’s what the regulation requires is 99.9999 DRE, but nobody’s checking. This is one example that was given: it’s like a Highway Patrol Officer standing on the interstate 1 hour out of the year using radar, and he assumes that all the cars go the same speed the rest of the year.

Karl Markiewicz: I understand what you’re saying. The one thing that EPA does do, and it’s not on a regular, routine basis, but will do stack testing where they just show up and say “we’re testing your stack today.” That gives kind of a snapshot in time of what’s going on.

Al Brooks: I believe you’ll find the stack is tested continuously.

Susan Kaplan: Sampled.

Karl Markiewicz: Yeah, it’s sampled by the operators. They have continuous monitoring equipment on there. Right.

Al Brooks: Every analysis system has a sampling time. I don’t care whether it’s microseconds or a week long. If you say it’s not continuously sampled, you are in error.

Karl Markiewicz: The TOSCA Incinerators - I probably shouldn’t say this, but they are very clean.

Walter Coin: When you start getting taste of metal in your mouth, you know it’s getting bad.

Barbara Sonnenburg: There’s only one problem. This is all based on the assumption that what is sent to them from other places is what the Bill of Lading says. It may not be, and if it’s not, then what comes out of the stack is not what they expect to be coming out of the stack. Nobody tests the material or verifies it before it goes into the incinerator.

Karl Markiewicz: Well actually, they do. They do sample it before it goes in, but it’s just a sample. There are requirements that if they’ve sent a truckload in and it does not meet TOSCA requirements, they can be fined for that. Now, I don’t know how they run their operation there. But I’ve worked with other TOSCA Incinerators, and they send people to Federal Prison if they screw this up, so they take it pretty seriously.

Susan Kaplan: Even contractor workers?

Karl Markiewicz: Yes.

Bill Pardue: Folks, excuse me. We’re getting way off the subject here. We’ve been going now for about 2 hours, still have lot to go through. I would suggest we try to get through it, then if we want to schedule another session to try to examine it in a lot more detail, then that’s appropriate. Either that, or we just write off the rest of the schedule tonight.

Linda Gass: I do think that all these things that have been brought up are important because, remember, boron - we are just walking through this as an example, and we have chosen the most innocuous example, the most non-controversial example. However, the same thing that happened with I-131 is that we walked through that and that’s establishing the precedent for everything else that’s going to come after it. And if you’re going to have 5 to 100 more Contaminants of Concern that we want run through at one time, I think we’re establishing a precedent and we’re asking some of the tough questions that need to be asked about sources and undocumented releases. This is very appropriate whether you choose PCB, mercury, I-131, or boron.

Bill Pardue: I would agree with that. My point was it’s a matter of when we do it - do we do it tonight, or do we schedule another session and go through it, Linda.

Linda Gass: I think we try to get it and head it off at the pass before we just walk through all of it and nobody ever raises these issues.

Bill Pardue: So you would propose to spend the rest of the evening talking on this topic?

Linda Gass: What topic?

Bill Pardue: Well, that’s a good question.

Linda Gass: I think the topic is boron, and we’re asking intelligent questions about boron among the other Contaminants of Concern.

Karl Markiewicz: I think the questions are more on the process. It’s not really on boron, specifically, but it’s the process that’s going to be used for all of the other compounds. I think they are all good and relevant questions because you’re asking not only about soil and metals, but you’re asking about air and other types of exposure media. That same process where we do comparisons with screening levels - we do that the whole way through. So they are very relevant questions.

L.C. Manley: Will we use this screening process that Karl and Jack have brought before us for the Subcommittee to use?

Bill Pardue: That’s a question that I think we need to address. It seems to me that we as a Work Group and as a Subcommittee should say, “Yes, we agree with these processes, or we don’t” before they go too far.

L.C. Manley: I feel like we need to make some kind of decision whether we’re going to use this or not.

Bill Pardue: Yes, I think we do.

James Lewis: I have a statement - I’m going to do the same thing as Susan - I want this on the record. These meetings and Work Group meetings are very beneficial to resolve these issues. Whatever they’re thinking about regarding Work Groups, I want to emphasize that we need these types of meetings in order to get some of these problems resolved so that when we go to the Subcommittee, we can come out with something that is meaningful.

Karl Markiewicz: Yeah, I agree. I would rather sit in the Work Group meeting and go through this and go through these than try to make an 8-hour presentation at a full Subcommittee meeting.

Bill Pardue: Well, I think what I’m hearing, unless there are other contradiction, is that we ought to just forego the other agenda items for tonight and continue this topic until quitting time.

James Lewis: I think you ought to scan it to see if there’s anything that’s critical that you need, then go back . . .

Kowetha Davidson: I have a question regarding that. We’re discussing the screening process for current exposures. The Work Group will make a recommendation to the Subcommittee as to whether it recommends that the Subcommittee accept the screening process. My question to Karl is: is there another type of screening process? Is it this process or no process?

Karl Markiewicz: This is the process that has been used for a number of years by ATSDR. It’s a very similar screening process to those used by other agencies where you screen environmental concentrations against conservative health protective screening values. And as far as that process goes, that’s just the basic screening process. I’m not sure there would be a better one or a different one in the sense that we wouldn’t do that type of comparison. So, the basic nuts and bolts of this thing would be the same unless it’s just an arbitrary kind of thing - is this a problem or isn’t it? This is just a scientific (semi-scientific) type of approach to this where we’re looking at environmental concentrations and comparing them with screening values.

Bill Pardue: Could I ask another very simple-minded question? Have you gone through this process? Have you identified a list of contaminants of concern for Oak Ridge yet?

Karl Markiewicz: The short answer is no. We do not have a completed list of contaminants of concern for current exposures.

Susan Kaplan: That’s not what he asked. We’re not asking if you have a completed list, we’re asking if you have any “hits.”

Karl Markiewicz: As I mentioned before, arsenic is one of those that almost always gets pulled into the public health implications portion of the document because of the comparison values and the fact that they’re so low. So there are certain ones that get pulled the process almost automatically, and those are the biggies that we’ve all talked about before. So we do have some that we know will be pulled into the PHI section, but a complete list - no.

Jack Hanley: In following up on what Karl said, there’s a few of them that <sound muffled> just fall into the furthest evaluation. The difference from what EPA would get in to is that when you get down to bottom of that process that Karl talked about - when you get to Health Implications - that is, once we get that initial list and go into Health Implications, that’s where we are different from other agencies and that’s where the Work Group is going to help us to identify realistic exposures. That’s going to be very crucial for the Work Group to have input into it. Up above it is the standard type of thing that other agencies use - it’s very common. When we get into Health Implications, that is where the rubber really meets the road, and that’s where the expertise - Karl should be able to explain and get input from you guys, and you will be able to help ATSDR and help this process tremendously.

Karl Markiewicz: That’s a good point. Basically, I only took it up to that Public Health Implication portion. For example, if we had boron off-site (and we do in the background samples above 20 ppm), if I were to come here tonight and said, “based upon 20-ppm screening level, this would get carried into the Public Health Implications; do you think that sounds reasonable?” I could have asked that. Given that whole presentation on how conservative those numbers are and what it actually means, I don’t know how many people would agree that we should use 20 ppm as a screening level, or 500 or 6000, or 7000, or 186,000.

Bob Eklund: Bill, before we continue with screening, there are some items on your agenda that had some time value like “schedule new meetings for coming year” and even this “letter to State regarding access to records of interviews.” Even earlier in this meeting, interviewing was a subject of concern.

Bill Pardue: Could I talk about the agenda for just a minute and we’ll make some decisions. That letter asking the State for interviews is something that came up at the last Subcommittee meeting. Linda brought it up and was very vocal in her statements that she had not been given access to interviews that she had requested, and the Subcommittee very strongly said that they wanted to support her in getting that information by ________ request. We were directed as an Action Item as a Work Group to draft a letter to Faulk, the Head of ATSDR, asking him to take action - Linda, help me with this please - of contacting the State, I believe, to get some of the interviews that you had not been able to get. During the meeting, Tim Joseph (the DOE person) was able to retrieve some of the interviews that Linda asked for, but there’s still a fairly substantial number (I’m not sure how many) that are still out there.

Linda Gass: Can I say something about that, please?

Bill Pardue: Yes, please do because I’m fumbling a little bit.

Linda Gass: I was very troubled from the fact that, after two days, I got up and said that I thought there was some hope here to see that things were moving in a more open direction after the discussion about the clinic and some discussion about trying to get these interviews. I felt that things were moving in a good direction - and I said that. But then when Timothy Joseph - he treated me in a manner very rude. And I hate to say that, but that’s the way it is. He stood there and would not even acknowledge my presence by his side when I was asking “may I see them?” And I stated “these are not the interviews I’m asking for.” I could see he had approximately 10 or 12 pieces of paper in his hand, and when he told where he got them, it’s where I had already been. I had uncovered every rock looking for those interviews for 6 months. And he would not speak to me, he did not hand me the papers. He very rudely said, “I’m not going to banty this about,” walked across the room. And everyone clapped I think at the mistaken impression that he had helped the process along by doing these. To me, that was a very good example of image vs. reality. The image was that something had been done to get those interviews. The reality was he would not even acknowledge my presence standing 1 foot away from him asking, “may I please see them?”

Bill Pardue: That was rude. But for clarification, Linda, I was under the impression that he did have some interviews there that you had not been able to access.

Linda Gass: That’s right. That’s exactly what I’m saying. There’s the image and the reality. The image was that he had done something helpful in the process. The reality was that it was very counterproductive. It was not what I had asked for. I had already seen that. And there was none of those, none of that was the material I was looking for. I have what he - in fact I went up and asked Kowetha for it, and it was not what I was needing. And so I felt that it counterproductive and, frankly, arrogant.

Jack Hanley: May I clarify something if I can? There was a list of documents that Linda asked for that came out of a Work Group meeting. In that whole list (the State’s looking up some, and ATSDR’s looking up others), there were 4 of those written down on the request that were interviews. DOE-HQ was having a hard time getting them, or whatever. And Tim was able to get those from SENES, from Owen Hoffman’s group because that’s who had them. And they called over there at SENES and got those. Those were the 4 interviews that were on there. Now Linda wants additional interviews - there’s a whole list of others. And I think they’re going to try to work to get those. But on the written request that was turned in, of all those on that written request, 4 were interviews, and those were the ones that Tim brought to the table. Now there’s a whole list of others that she would like, and we’re going to try and get those.

Bill Pardue: That was my understanding, but I thought we were assigned an Action Item to write a letter to Faulk to encourage him to expedite those efforts to get those for Linda.

Jack Hanley: Yes.

James Lewis: I think the way we’ve handled this whole thing in trying to be helpful, I think we’ve probably created more of a problem than was there in the beginning. We need to look at the process. Whoever’s in charge of these records, whether it’s DOE or the State, needs to come in and explain their process. If we don’t know exactly what you’re asking for and we don’t understand the process that’s out there, we need to get someone who is knowledgeable about this . . .

Linda Gass: It’s Tom Widener and it’s Patrick Lipford . . .

James Lewis: Then they need to be brought here to explain the process. Show them what you’ve given and put it in their hands. We can write a letter based on that. I don’t see how we can do anything if we keep . . .

Kowetha Davidson: We will write our letter - it was an Action Item from the Subcommittee. The Subcommittee Work Group will write our letter requesting Dr. Faulk to intervene in the process. That’s basically what it is, asking him to intervene . . .

Barbara Sonnenburg: Who is going to write the letter?

Bill Pardue: My approach to that was going to be to ask for volunteers to draft a letter as we usually do.

Kowetha Davidson: I’ll volunteer to draft the letter.

Susan Kaplan: Let Linda draft the letter. She knows what she wants.

Bill Pardue: That’s my point - Linda knows what she wants.

Linda Gass: Yeah, I’d like to check all the references in the 10 volumes. There are literally thousands of pieces of paper. All the references. Some of the interviews will say “interviews.” Some of the other things will say “repository,” and they’re documents, but they are not open-literature, scientific information. They are things that the Dose Reconstruction paid to investigate.

Bill Pardue: Can those things be identified in a fashion that . . .

Kowetha Davidson: I think our Action Item is, the way I read it - and there were no objections to this - is that we would request the interviews used in the Dose Reconstruction. That’s exactly what was read into the records, Linda.

Bill Pardue: That’s what I recall.

Al Brooks: I also spoke to this issue on two points. One is, I wanted to see the interviews of the operators regarding scrubber efficiency, both their first and their second interviews (in which they changed their mind about what they believed). But secondly, I registered a complaint of a public document that gives references which then turn out to be private references. If they can’t find them - their own records - then for all practical purposes, those records do not exist in terms of the normal usage of science reporting.

Linda Gass: They exist.

Al Brooks: Well, they do not exist for my purposes if I can’t see them!

Linda Gass: Well, I made an appointment, I went to OSTI (the Office of Scientific and Technical Information) in Oak Ridge, under DOE control. The State of Tennessee records are under DOE control. I made the appointment, I went there, and they would not let me see them even after an appointment. And they made a couple of phone calls, and then finally they came back and said “they’re in disarray” I believe was the words. “They’re not well organized.” And I said “may I see one box of them, please, just for 2 minutes” and they would not allow me to.

Al Brooks: Then for all practical purposes, they do not exist.

Kowetha Davidson: We can still send the letter.

Bill Pardue: Excuse me. We still have an Action Item that was assigned to us. I hear Kowetha volunteering to draft the letter.

Kowetha Davidson: I’ll draft the letter . . .

Bill Pardue: Linda, would you be willing to work with Kowetha and draft the letter?

Linda Gass: Yes.

Bill Pardue: If the two of you would come back to the Work Group with a draft, we’ll look at it our next meeting. I think that’s the way to start this process, unless someone objects.

James Lewis: I’ve got one question: define an interview. And I’m going to give an example because let me tell you, this is hard to understand. You get a summary, you get a sanitized version. What do we mean by the definition of interview?

Bill Pardue: Can you comment on that, Linda?

Al Brooks: It’s what THEY meant by interview. They used the word “interview.” Interviews with past experts. They used the term “interview.” What did they mean by interview?

Barbara Sonnenburg: Depends on what was written down.

James Lewis: Are we talking about a summary of that or are we talking about what was physically written down? And the reason I’m saying that is that’s where we may get into confusion. We need to define what is out there, then if that’s available, then define what it is and see what you can get.

Kowetha Davidson: James, it is my impression that there are interviews referenced in the document. Those are the interviews we are referring to.

Bill Pardue: Linda, can you comment? Linda?

Linda Gass: I think Al captured it. They used the word “interview.” I want to know what it means. When you use the word “repository,” that indicates that something is deposited somewhere. When you use the word “abstract,” that indicates that something has been summarized.

Susan Kaplan: During the ORRHES Meeting, the lady from DOE, the one who stood up and talked about the records, she told me that the CD that we received has some of the background materials on the CD. You can actually go in there, and she explained to me the process and I didn’t bring it. It would be helpful for everyone to hear what she told me. That lady needs to come back and explain where that material is because, evidently, some of it is on the CD-ROM.

Paul Charp: Are you talking about that Dose Construction CD-ROM? I’ve got that on my laptop.

Susan Kaplan: But she was telling me how to use it.

Bill Pardue: I’d like to bring this to some sort of closure. It seems to me that we have a volunteer and two persons who’ve volunteered to work with her to come back with a draft letter to come back to this Work Group. And until we have something on paper, I for one think we’re just going to continue to talk. And unless there’s objection - Kowetha, would you and Linda please attempt to develop a draft letter. There are a couple of other items on the agenda - one is that we do have Paul Charp here for our presentation. Since he’s taken the trouble to come up here, I think that’s something we might want to hear.

Barbara Sonnenburg: Can I bring up this thing about the statistics. I think it will only take 2 or 3 minutes. I know that the Subcommittee has a lot of reservations about Mr. Mangano and his work and his statistics. I’d like to ask Jack - based on the 3-page letter that he (Mangano) wrote on November 26 (copies of this are all over the place), if you could get the statistics for us with two slight changes. He compared 4 years to 5 years, and I think we ought to compare 4 most recent years to 4 earlier years starting in 1989 or 1990, so you have 4-to-4 rather than 5-to-4 because that was very confusing. I also think that it ought to be in counties that we have all agreed are the counties we’re interested in. I don’t think, for instance, Fentress is one - I don’t remember that name at all. I’m not sure how many of these counties are THE counties we’re focusing on. So Jack, if you could get the statistics from the U.S. Center for Disease Control (and he gives the URL), find this and get it for us. I, for one, would like to see it coming from you without any Mr. Mangano messing it up.

Jack Hanley: Can I make a suggestion here? In addition to that, what if we have the State folks that run the Cancer Registery and the Vital Statistics for the State to come in and present their database that they have on the Cancer Registry and Vital Statistics. We’ll give them the counties, and have them come in and present some of that data regarding what the rates are from the State, compared to other States, compared to the National (rates), just have them present their own dataIt will be coming from the State on the Cancer Registry and Vital Statistics.

Barbara Sonnenburg: I don’t know of those figures will be the same as the Center for Disease Control.

Bill Pardue: Does the State supply the data to the Center (for Disease Control)?

Jack Hanley: The death certificates?

Bill Pardue: No, I mean is the data that the State would talk to us about the same as in the CDC database?

Jack Hanley: No, it’s different data. The data that’s in the Mangano (report) is death certificates. And if you remember Lucy’s presentation about death certificates and the problems with death certificates . . .

Barbara Sonnenburg: Is there anything more accurate than that?

Jack Hanley: My contention is that Mangano and the issues that he gave, he just crunched additional numbers. He didn’t address any of the outside confounders, any of the issues regarding exposure in a separate analysis. He didn’t address all those.

Barbara Sonnenburg: I don’t want to clutter this up with where it comes from and who’s heard, or anything: just figures.

Kowetha Davidson: I think we have to think about what we’re going to get out of it. Are we going to get something out of it that we can use? I have doubts because it’s still not going to show a relationship with radiation and cancer. So there’s no other reason for us to look at it.

Barbara Sonnenburg: It may not, but when you look at the 8 counties between 1989 and 1993 and the last 4 years through 1998, suppose it doesn’t, but suppose it doubled.

Bob Eklund: We still wouldn’t know . . .

Barbara Sonnenburg: We wouldn’t know what caused it, but we’d open up our eyes.

Jack Hanley: This is all cancers, and remember what we learned about all cancers.

Barbara Sonnenburg: Well, he eliminates the lung cancers and does it with non-lung cancers.

Susan Kaplan: The State could come in with the data by the type, right?

Jack Hanley: The State could come in with Cancer Incidence - that’s not just dying from cancer, that’s all the cases of cancer, not just people dying of cancer. They could have it for the 8 (or 9) counties in the area, compare it to the rest of the State. And they can break it out by specific types of cancer, that’s what they normally do.

Barbara Sonnenburg: Can they do it for a period starting in 1989 for 4 years, and then the last 4 years?

Jack Hanley: In the 1990s, they have data. We can have them come in and present that data and talk about the limitations and proper interpretations of that data.

Bill Pardue: Barbara, do you want to make a motion to that effect?

Barbara Sonnenburg: Well, I want to make a motion that will pass. Is there anybody . . .

Barbara Sonnenburg: I’ll move that we ask the State to bring us cancer statistics for our counties that we’re interested in and compare the last 4 years of data to a slightly earlier 4 years of data.

Susan Kaplan: Second.

Bob Eklund: You don’t want it compared to anywhere else?

Barbara Sonnenburg: And it shows the rest of Tennessee and the United States.

Al Brooks: Why not look at all the years for which they have the Cancer Registry? ____ That just leads to confusion.

Susan Kaplan: They could do a plot, right? They could do a plot of what data they have.

Al Brooks: Yes.

<TOO MANY PEOPLE TALKING TO HEAR ANYONE>

Barbara Sonnenburg: Well, I don’t know how they’re going to do it. But if they can show us if there is growth, I guess.

Bill Pardue: See if there is increased or decreased or constant mortality from cancer in the area. Would that do it?

Barbara Sonnenburg: Compared to other parts of Tennessee and the whole United States.

Bill Pardue: I think that we ask our ATSDR friends to make the arrangements.

Susan Kaplan: When should it be on the Agenda?

Barbara Sonnenburg: Can we get these folks to come in at our next meeting?

Jack Hanley: My suggestion is that this Recommendation should be sent to the Agenda Committee, as coming from this Work Group to the other Work Group. We can work on trying to work with the State in trying to get them to one of the meetings coming up in the near future as soon as it’s convenient to get them there.

Bill Pardue: Jack, a question, and I guess it’s for the Group: Do we want to bring them to the full Subcommittee, or do we want to bring them to this Work Group first?

Jack Hanley: That’s up to you.

Bill Pardue: And if it’s just to the Work Group, I don’t think we really need a Recommendation. All you need then is just a request just like we’ve asked for Paul and for . . .

Jack Hanley: If it’s the Work Group, that may be the thing to do.

Barbara Sonnenburg: All right, I’ll accept that as a friendly amendment - that they come to the Work Group and bring us copies of their information so we don’t have to be writing . . .

Bill Pardue: Did everybody understand it?

Several People in Harmony: NO.

Linda Gass: Is this correct? I would like to ask a process question, if I’m understanding it. A Work Group can request someone to give a presentation without having to make a Recommendation, go through the entire Subcommittee, and come round the mountain, and then come back and get on it. Is that what was just said?

Bill Pardue: I believe so.

Kowetha Davidson: . . . this is in anticipation of making a Recommendation to the Subcommittee. And to make a Recommendation to the Subcommittee is not just to inform the Work Groups . . .

<TOO MANY PEOPLE TALKING TO HEAR ANYONE>

<SOMEONE MENTIONED LUCY PIEPINS>

James Lewis: She works for ATSDR. We’re going on the outside . . . I think Linda’s got a good point. We start reaching on the outside bringing people in to the Work Groups . .

Barbara Sonnenburg: Jack, is that a problem?

James Lewis: It could be.

Karl Markiewicz: Well I worked in the States. The Cancer Registry people will be more than happy (this is a different State, two different States) to go out and present this kind of stuff, because they want to get their faces out there and say “look at what we can give you.” Personally, I think it would be a good idea just to ask, then if they say no or hesitate, then do a written request.

James Lewis: If there’s a charge . . .

Al Brooks: The subject’s on their database with their software. I’m not certain, but I think it is. Anyone can construct this from their database.

Barbara Sonnenburg: Originally, that’s what I wanted Jack to do.

Jack Hanley: This is the reason I’d like for them to come in is because the issue of what data’s there, limitations of their database, interpreting their database - those things have come up in Subcommittee meetings. What years are good, what years are not? Dr. Bore(sp?) explained some of this in June, but I think it would be good to have the State people there that are in charge of the database to come in. As Karl said, many times they don’t mind coming out and doing this. I’ll see if they would be willing to come to the Work Group. If it’s a problem, I’ll bring it back to the Work Group. And then maybe - they might only want to come once, they might not want to have to come back twice. We’ll see - I’ll work with them.

Bill Pardue: Is that agreeable?

Barbara Sonnenburg: That’s fine. All of that is fine.

Susan Kaplan: Do we need to vote on that?

Bill Pardue: I don’t think we do if Jack’s agreed to do it. Does anyone object to that approach?

James Lewis: I’m concerned about what Linda just said. If there’s a charge with this? If this is a freebie, that’s one thing. If we get into a scenario that every time someone wants somebody to come in here, if we’ve got to pay for this, this is one thing. If this is something they give out of free gratus, that’s another.

Bob Eklund: Also, our time is worth something.

James Lewis: Yes, it is. So you need to think about that. Are we setting a precedent here, or is this a single . . .

Barbara Sonnenburg: Well, I had originally asked for some written pages.

Bob Eklund: To me, this borders on . . .

Al Brooks: This borders on the ridiculous.

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