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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