Oak Ridge Reservation: Public Health Assessment Work Group
Public Health Assessment Work Group
April 1, 2002 - Meeting Minutes
- Review of minutes (10 min) - Bob Craig
- Radiation screening (60 min) - Paul Charp
- Cumulative doses for I-131 (ORNL and NTS) (30 min) - Bob Craig
- Recommendation for screening maps (10 min) - Bob Craig
- Old business (10 min) - Bob Craig
- New business (10 min) - Bob Craig
Paul Charp, ATSDR
Jack Hanley, ATSDR (phone)
Timothy Joseph, DOE
Mike Knapp (phone)
Bill Murray, ATSDR
1. Minutes of the 3/4/2002 Meeting: James Lewis wanted some handouts he provided at the 3/4/2002 meeting included as attachments to the minutes. Also in the minutes of the 3/4/2002 meeting, on page 3, ‘Mike Knapp remarked that they are also looking at medical records of workers for individual diseases, but this is not being done in the general public.’ Mr. Lewis initially thought that was a true statement; but ATSDR is in the business of doing public health assessments, not looking at individuals. Mr. Lewis stated that when we get issues like this, whether they’re right or wrong, we need to capture them into the concerns database. He emphasized the need to develop a procedure for taking minutes of these meetings to make sure to capture issues and respond to them so the same unresolved issues don’t come back and bite us later. Mr. Lewis will review the tapes of the 3/4/2002 meeting to make sure the issues raised and conversations during that meeting on various topics are captured in the minutes. Bob Craig said approval the minutes of the 3/4/2002 PHAWG Meeting should be tabled until a later time. James Lewis said we should also make sure we have answers to the questions raised in the 3/4/2002 meeting as it relates to Queens College and the people that gave presentations in the last Subcommittee Meeting. It is important to link issues with answers given to us. Bob Craig said James Lewis has the action on that and also to make sure appropriate addendums/attachments are included; anyone else with amendments to the minutes of the 3/4/2002 meeting should get their changes to Bill Murray, and James will get them from Bill and work up another version by the next PHAWG Meeting.
2. Minutes of the 3/18/2002 Meeting: James Lewis moved to accept the minutes of the 3/18/2002 meeting. Pete Malmquist seconded.
Page 3 (bottom): “recorder not sure she heard correctly” not “true” should be changed to not “trivial.”
Bob Peele: On page 4, in a discussion between various people about whether it was trivial or understandable how to combine doses from the Test Site and ORR iodine doses, you (Bob Craig) say that it seems to me that Owen Hoffman has done this on the on-line calculator, but Charlie Miller mentioned that it wasn’t trivial. Well, I’m sure it’s not trivial, but I think (Owen) probably did solve that problem by making that calculator.
Bob Craig: In that case, I say that getting the estimated dose is a pretty easy thing to do using Owen’s calculator.
Bob Peele: Once you’ve done the work to make the calculator. I’m not sure that calculator is available.
Bob Craig: According to Gordon Blaylock who works for SENES, it was.
Susan Kaplan: I think it’s available as a public service . . .
Bob Craig: All you have to do is put in your location or county or something.
Bob Peele: That has a big advantage over the ORHASP Report. There are big uncertainty margins in the ORHASP Report because that uncertainty includes the uncertainty in how much dose you got at the different locations. If you know a lot about where you were and can insert that with precision, it shrinks the error quite a bit.
Susan Kaplan: I’m pretty sure Owen’s calculator is based on the National Cancer Institute data - it’s a big, thick book.
Bob Peele: He pointed out that’s not absolutely secure, right?
Bob Craig: Right, but it’s the best we have. It’s county . . . (dose calculated per county)
Bob Peele: As you walk across the county line, your dose changes quite a bit.
Bob Craig: Every time . . . every time I go from Roane to Anderson (counties), it just drops like crazy! But, it’s better than nothing.
Vote on accepting minutes of the 3/18/2002 meeting: 4 voted yes, 4 abstained. Vote passed.
<Bill Murray reported that David Johnson called in to say he had prior commitments.>
<Bill Murray dialed in Mike Knapp. Mike requested in future, if possible, to forward the minutes and handouts to him in advance of the meetings.>
Radiation Screening Presentation (Paul Charp)
Paul Charp: This topic was raised at March 11 ORRHES meeting by Jeff Hill and others on how ATSDR picked their No Apparent Concern screening value. He’s going to go through the reasoning used. First slide - graph published by the General Accounting Office in their report on standards and the controversy associated with standards. We have a disk of it in the office. Figure 2 shows that above a dose of 10 rem, everybody agrees about what effects are from ionizing radiation. Between 5?10 rem, effects are varied. Controversy arises below 5 rem (or 500 mrem). Linear threshold model shows a completely straight line from zero exposure all the way up to 10 rem or higher. There are folks that say that at lower doses, risk is higher than we believe (that’s called the Higher Risk Model). One proponent of that model is Alice Stewart. Some say a little radiation is good for you (Threshold Hormesis Model). A Lower-Risk Model says when area breaks down, at lower doses you’re somewhat protected, but still at risk. Paul is going to go through information he used on initial screening he showed at the March 2002 ORRHES Meeting; and talk about one other issue also addressed in that meeting - use of dose 100 mrem above/below background.
Timothy Joseph: Is there much written on Higher Risk Model?
Paul Charp: Mostly Alice Stewart and her coworkers. Most of that was based on exposure to abdomen of pregnant women and what she thought those results meant..
Timothy Joseph: What kind of exposure?
Paul Charp: X-Rays. What’s interesting about all the risk models is there is a lot of human/animal exposure to radiation. Everybody sees the same data, but for every 4 people, you get 6 different ways of interpreting the same data.
Charles Washington: There appears to be contaminant calculation on the curve, but below that curve, you’re saying that paper is divided; I’m saying that paper that came out - there were so many questions until it was not really accepted by scientific community.
Paul Charp: It depends on which scientific community you talk to. There’s a large number in the scientific community who say the Linear Model is correct; there’s a large portion of the radiation community who say it’s the Lower Risk Model that’s correct; then there’s another set of the community who say there’s a Higher Risk. I don’t want to say which one is correct. Again, it’s how you look at the numbers, and what your biases are. For all practical purposes, the regulatory community says the Linear Model is good for setting regulatory limits.
Bob Peele: Everywhere, every country all over the world. There are significant groups that don’t want to think about that - the Health Physics Society does not. The reason, I guess, if you look directly at data of people in trouble from radiation, there is absolutely no accuracy. It’s impossible. Asking what the observed risk is in that region down there is what Alvin Weinberg once called “transcience.” It’s a technical question, but you can’t answer it scientifically. It’s just not feasible.
Paul Charp: Some people have said that in order to answer that question, you’d have to have more study participants than the population of the planet.
Bob Peele: Yeah, it’s really not doable, so you have to get there by some other process. There is one more comment I want to make. This is the access risk = everybody has some dose which is partway up in that curve, so that the excess from anything added, I think most likely taken as linear because we don’t have enough data to say anything else. People on the other side say you don’t have enough data. It takes extra data to add parameters - you have to add all those parameters for every type of cancer, for everything - it’s just impossible. There will never be enough data.
Paul Charp: So that’s the low-dose radiation controversy in science. Below 5 rem, nobody knows what the correct answer is; between 5 and 10 rem, we think we know what it is; and above 10 rem, we know for sure.
Bill Murray: These are total lifetime doses, right?
Paul Charp: Right. This is the issue that was raised at the 3/26/2002 ORRHES meeting. I presented screening levels and dose levels for radiation exposure. I mentioned that we’re going to use a dose limit of 5 rem, and assign anything below that a category of “No Apparent Concern.” Portions of that evaluation were based on shipyard studies, so Paul was asked by Jeff Hill to present something about the shipyard studies. Paul didn’t want to circumvent PHAWG before bringing it to the full ORRHES.
Paul Charp: On what dose should ATSDR base its screening? I’m going to give you a review of the nuclear shipyard worker studies. There have been two major studies. First, there are 8 shipyards in Navy complex with about 700,000 workers, not all of which are considered nuclear workers.
Bill Murray: There’s another one in Pascagula, Mississippi. There are 9 altogether. Some don’t exist anymore.
James Lewis: Is this associated with the refueling efforts at the shipyards? They built submarines, built carriers, is this only associated with that portion?
Paul Charp, Bill Murray, Bob Craig: No, it’s construction, refueling and overhaul, and drydocks. Not just submarines, it’s aircraft carriers as well. Also welding, pipe joints, etc.
Bob Craig: Pascagula may not be nuclear.
Paul Charp: Two types of studies: case control and cohort. Case control studies compare groups of people with a disease such as leukemia, etc, to a similar group of people without the disease. Cohort studies study levels of exposure each group has before the appearance of that disease. Conversely, in cohort studies, there’s a very large group of people identified by a common characteristic (cohort), and they’re studied over a long period of time. They look for disease/mortality rates and try to calculate that for the two members with different exposures. Standard mortality ratio is the ratio of number of deaths in a study group compared to the number of deaths in a similar population. The 1981 NIOSH study was a cohort study of workers only at the Portsmouth Naval Shipyard. They found no significant excess mortality cases from any cause at that shipyard. That means they could find no connection between radiation exposure and leukemia. However, the results were questioned by NIOSH itself because majority of workers who took part in that study had less than 15 years of exposure to radiation. There is some latency regarding induction of cancer after radiation exposure (5-20+ years).
Bob Peele: Leukemia is supposed to be fairly low.
Paul Charp: Yes, some people say leukemia runs in waves of 5 years (5, 10, etc., years).
Bill Murray: For leukemia, you start looking in 2-3 years.
Paul Charp: In the case control studies NIOSH also did, they tried to find excess cancer mortalities associated with different doses for radiation workers. These doses were from 1-5 rem. The big problem with this was that same workers potentially exposed to radiation were also potentially exposed to ends from welding torches and also asbestos. These other insults could also cause lung cancer. Also confounding this was that welders and electricians who were not exposed to any type of radiation also were found to have excess leukemia .
Charles Washington: When did they start keeping the data? Was it like Oak Ridge which only recently began to keep data for cancer? What happened before that?
Paul Charp: I think some of the studies were over a 10-year period.
Bill Murray: They had dosimetry data there, they used a roster for employees working there, then went and got the death certificates for those who died.
Charles Washington: Do you conclude that that’s a valid study? Looking at the death certificates?
Bill Murray: Yes. Absolutely.
Charles Washington: It couldn’t be a valid study. If a person who had cancer suddenly has a heart attack, what will they put on the death certificate? - Heart attack.
Bill Murray: That’s true for people who aren’t radiation exposed as well. There’s always that problem with death certificates.
Charles Washington: But it was predominantly the case here. We had just begun keeping that kind of data in this community.
Kowetha Davidson: I think you’re looking at the difference between diagnosis of cancer and mortality from cancer. This is a mortality study.
Charles Washington: Earlier those people who had been exposed might have had cancer, but that’s not what they died from.
Kowetha Davidson: Then you’d have to look at a different type of study.
Mike Knapp: Between morbidity and mortality, correct?
Bob Craig: Yes.
Mike Knapp: These studies focus primarily on mortality data. They are cooberating whatever type of exposure methodology they had for workers from badge or whatever. They’re looking at how they died and what was on their death certificate vs somebody who might have had any number of cancers who got cured for it. That’s not going to show up in overall incidence be it either sickness and morbidity or death and mortality.
Paul Charp: In essence, the 1981 NIOSH study listed several causes of death. The standard mortality ratio was listed. In this case, the standard mortality ratio of 100 would mean that the rate of mortality in workers would be identical to a non-worker population. Also, it gives confidence intervals. Remember that confidence intervals goes through the value of 100, that means it’s a good chance that the cause of death is not significant. In this case, all causes of death for the workers was less than normal population because the standard mortality ratio was 80, and the confidence intervals were from 86 to 91. However, on other types of neoplasms (leukemia, lymphatic, and blood cancers), they were not significant because confidence intervals go through the value of 100.
Bob Peele: The first line must have an error because 80 is not between 86 and 91. It must be 90.
Bob Craig: Maybe it’s 88.
Paul Charp: Thanks for pointing that out.
Barbara Sonnenburg: Would age have anything to do with rate?
Paul Charp: I think when they do a standard mortality ratio, they look at age-adjusted rates.
Bill Murray: Yes, and compare them to the U.S. population.
Bob Peele: Which is not a trivial process.
Barbara Sonnenburg: That takes care of it if the Oak Ridge people died at an average age of 50 and other people died at an average age of 75. Somehow it would be taken care of in . . .
Bob Craig: No the averages would be the same. Age adjusted.
Paul Charp: If Oak Ridge people died at an average age of 50, they would compare that to the population of the U.S. who died at the same age.
Barbara Sonnenburg: Got ya. Thank you.
Paul Charp: Here’s the actual results from NIOSH study in 1981. On the top we have the dose in rem (½-1 rem, 1-5 rem, 5-14 rem, 15+ rem). Totals are given for each. Observed number of deaths is indicated by O; expected number of deaths are indicated by E. For example, for Hodgskins Disease over this entire range of doses, they observed 3 cases, and they expected 2.9.
Bob Peele: That’s expected if there is no radiation, based on general popoulation?
Bill Murray: Based on the general popoulation.
Charles Washington: Key thing up there is this is for white males.
Bill Murray: The majority of shipyard workers at that time were white males. There were very few women or black male radiation workers. There were some Native Americans. You’re talking about time period of 1958 on. Not enough in the other categories to make meaningful comparisons, so they kept it to white males.
Paul Charp: Remember the NIOSH study only looked at the Portsmouth Naval Shipyard, so the government decided to look at all the shipyards combined. This study ran from 1980 to 1988, and they contracted with Johns Hopkins University School of Public Health to look at all the naval shipyard workers across the country. So in this case, they go to 28,000 workers with the largest doses, and they compared them to 32,000 workers of same ages and same jobs who had lower or no doses of radiation.
Bob Craig: So we’re not observing a healthy worker phenomenon? Workers will be healthier than the general population. They’re all workers?
Paul Charp: I couldn’t have said that before, because all causes of death in this one (NIOSH), whether it’s 80 or 90 or whatever, it’s still because . . . you could have said this is healthy worker. You could not have said that in this one because the confidence only goes to 100.
Bill Murray: You only do healthy worker effect on all causes, anyway.
Bob Craig: But it’s not going to show up on this one (Johns Hopkins), because it’s all workers, both the control group and the experimental group are workers.
Paul Charp: Johns Hopkins found high levels of mesothelioma which is associated with asbestos, but could not find any association between ionizing radiation and the risk of death from leukemia or any other form of cancer.
Bob Craig: These are all low doses - below 5 rem?
Paul Charp: Yes.
Bob Peele: If you use regulatory linear thing, how many cases would you have expected?
Paul Charp: You expect to see a few. I can’t remember the numbers off the top of my head, but for leukemia, it’s pretty high.
Bill Murray: They focused on leukemia for a very specific reason: Around 1978, there was a hematologist in with the Veteran’s Administration in Boston who said he had found a lot of cases in veterans that worked at the naval shipyard in Portsmouth. He got Congress’s attention, so Congress mandated NIOSH to do that study, and it focused on leukemia because that’s what he said the problem was. That’s why they focused on leukemia in both studies.
L.C. Manley: Are you saying that these are occasional doses or daily doses?
Paul Charp: Daily. So the death rates (these are unadjusted death rates for the workers in those categories), those workers who had a dose of 500 mrem or 0.5 rem had a death rate on the order of 6.5/100,000. In the non-nuclear workers, that unadjusted death rate was about 7.5/100,000. For those workers who had a dose less than 0.5 rem, their death rate was about 3/100,000.
Barbara Sonnenburg: How do they explain why non-nuclear folks die twice as much?
Paul Charp: How do they determine the table?
Bob Craig: A little radiation is good for you.
Paul Charp: I’m not going to try to explain why the non-nuclear folks die more. These are unadjusted rates, too, so after you adjust, they could be different.
Susan Kaplan: Adjusted for what?
Paul Charp: They would adjust them for age, sex, etc. These are raw numbers. I’ve asked Lucy Piepins to take a look at this study, but she hasn’t finished looking at it yet. This report is about 600 pages.
Bob Peele: I presume that 3.07 means about 3.
Paul Charp: Here we have the standard mortality ratios, and they are age-adjusted. Again you can see that due to confidence intervals, none of these are really significant because they all go through the value of 1. Whether their dose is greater than or less than 0.5 rem for the non-nuclear folks. For lymphatic and other blood cancers, for dose greater than 0.5 rem, it’s not significant.
Bob Peele: I can’t do it in my head, but it seems to me that really need to know what linear model would give you.
Paul Charp: The authors of some of these reports say there doesn’t appear to be any dose-response effect for leukemia.
Bob Peele: But you really wouldn’t expect to find dose-response at that dose.
Bob Craig: It would be very difficult to show.
Bob Peele: There’s no way to see it; that’s why we don’t see it.
Bill Murray: If they wanted to look for a dose-response, they should have had several dose categories. The reason it may be higher in the >5 rem category - there may be some very highly exposed people there.
Bob Peele: The ranges do pretty much . . . That suggests already that you don’t have enough _____ to prove anything (because the ranges are so big).
Bill Murray: I would think in all the workers they looked at, they had enough.
Bob Peele: Then why are the ranges so big?
Paul Charp: To my knowledge, this report (Johns Hopkins) never was finalized.
Bill Murray: It was never published in a peer-reviewed journal.
Susan Kaplan: Then why are you using it to come up with 5-rem limits? Is this the basis for your 5-rem limits?
Paul Charp: Not all of this. You’ll see that there are some changes. I was going through the shipyards while depicted. Now as I go along, you’ll see that this is their logic behind it, and then it’s changed. We’re a little bit ahead of the story. For asbestos exposure, everything is highly significant - significantly elevated above the standard folks.
Bob Craig?: But it does seem to be dependent on radiation?
Paul Charp: No, no.
Bob Craig?: Maybe synergistic?
Barbara Sonnenburg: Where would they have gotten it?
Bob Craig: Pipes, insulation.
Paul Charp: For lung cancer, there apparently is no significance in any type of lung cancer between exposed and unexposed populations. Our conclusion at that time for the industrial 5 rem was the average health effect you’re looking for (leukemia) was not very strong (whichever report). Plus exposure of less than 10 years, some of these studies may have missed the first wave.
Susan Kaplan: Explain to me again what the 5 rem is. Does that include your background dose, or is that just extra?
Paul Charp: Five rems - you’re talking about 15,000 above background, so you can always exclude background in that 5 rem.
Bob Peele: 5 rem per day or 5 rem lifetime?
Paul Charp: We’re talking about 5 rem per year. This is where we’re going to propose to changing of the flowcharts, and I think it will solve some of this issue. It was pointed out that 5 rem is kind of high after reading dose numbers. Five rem per year over a 70-year lifetime would be a 1-in-5 risk of developing cancer, based on the ____ risk models. After some discussion, we decided that’s a little bit too high. So what we did is we went back to ATSDR pulled tox profiles on ionizing radiation. These tox profiles are a compendium of a lot of research - not the sum knowledge of everything known about ionizing radiation, but tries to cover as much as they can without being too much. Tox profiles are available for ORRHES members and PHAWG members. ATSDR MRL for external chronic exposure to ionizing radiation is (on flowchart) 1 mSv or 100 mrem per year. The way they developed that was they said it’s very difficult to find any type of adverse effect from someone who’s exposed to background levels of radiation. In the U.S., average exposure is on the order of 3.6 mSv or 360 mrem per year, including radon. Not every person responds to radiation or disease like anyone else. When you through in a little bit of variability (uncertainty factor of 3), divide 3.6 by 3 and it gives you a value of 1.2. So the MRL risk is 1/3 the risk of being associated with being exposed to background radiation, so you round it off to - instead 1.2 mSv, you round it off to 1 mSv to be a little more conservative. So if you’re exposed to 1 mSv per year, that risk cannot be measured precisely, therefore, you would not expect to see any adverse effect.
Kowetha Davidson: How can you set a screening level below background?
Paul Charp: What we’re doing is - it would be background plus 100.
Susan Kaplan: Background plus 100, so would be 400.
Paul Charp: Let’s say somebody has an exposure of 500 mrem, you have to find out what their background exposure is. At the lab, background is subtracted (dosimeters). If you have a net exposure of 1 mSv/y above background, you would not expect to see that. There are plenty of places in the country - if you move from Oak Ridge to Denver, your background will almost double.
Paul Charp: What you’ve done is to drop from 50 mSv to 1 mSv, or from 5 rem to 100 mrem. If you do the risk on that, that 1 mSv is something like 3.5% chance or something like that. I can’t do that math in my head, but it’s really low (screening level). If you have 1000 exposures, instead of doing 1000 calculations to see what somebody’s risk is, we set an MRL (Minimal Risk Level), and anything above the MRL requires us to do some extra steps.
Susan Kaplan: Could you explain why this hasn’t been set before. We’ve pointed out that we thought the ?product? was way too high, and now we’re coming to this. I’m just curious why ATSDR has never set this before now?
Paul Charp: ATSDR, until a few years ago, did not have any radiation expertise in the division that does the tox profiles. Since that time (the publication date on this is 1999, so they set this in 1999), and it’s my fault for not looking through the document more carefully before . . .
Susan Kaplan: So this 5 rem was . . .
Paul Charp: The 5 rem was based on an inappropriate methodology for looking the results, and that’s my mistake - I’ll take the blame for that one.
Susan Kaplan: But it came from the tox profile?
Paul Charp: No, the tox profile didn’t mention the 5 rem. The 5 rem was based on how we initially reviewed the worker studies in shipyards, then we went back and looked at the risk associated with the 5 rem/year exposure. That’s when we realized it was 17% chance of getting cancer if you get 5 rem/year over a long lifetime (70 years).
Barbara Sonnenburg: What’s this business of getting it every year for 70 years or something? Why do they pick that?
Bob Peele: It could be 50 years, 40 years.
Barbara Sonnenburg: Nobody does the same thing for 70 years.
Paul Charp: As Mr. Hill pointed out, very rarely in the DOE facilities now-a-days do you have somebody who gets a 1-year dose of 5 rem. In that past, they might get 10 or 15 rem, or even more.
Bob Craig: The highest occupational dose is for a flight attendant.
Susan Kaplan: Frequent fliers are considered radiation workers.
Bob Craig: They’re not badged, though. In theory they would be, but in actuality, they’re not.
Susan Kaplan: That was in the paper this week. What about medical procedures because that’s all on top. I just had a bone scan, so you get some significant radiation exposure from that.
Bob Craig: That’s in the 3.6.
Bill Murray: No, it’s not.
Paul Charp: A whole-body CT scan can give 2 or 3 rem. Some of those medical doses are quite high.
Timothy Joseph: An upper GI can give 1400 mrem; a CT scan gives 1100 mrem; radon in the average home is 200 mrem; a mammogram: 30 mrem.
Paul Charp: Generally, the thoughts are that the benefits from a medical procedure far outweigh the risks from radiation. If you don’t have the procedure and you have some type of medical problem they can’t detect, there’s a better chance of dying from not having the procedure than there would be from the procedure itself.
Kowetha Davidson: This lifetime exposure, when you multiply by 70, you get 7 rem.
Bob Peele: About 4/10 of 1 percent lifetime risk.
Paul Charp: According to this, medical exposures account for 15% of average exposures.
Susan: So it is built into the 3.5.
Kowetha Davidson: I don’t understand why you didn’t apply uncertainty factor to shipyard workers instead of to background. This doesn’t make sense to me. It just seems like it’s excessively conservative.
Paul Charp: Again, it’s a screening factor.
Kowetha Davidson: But in a screening, what about the levels that are above this. That will be associated with something else, right?
Paul Charp: Right.
Kowetha Davidson: So, I still think it’s excessively conservative.
Bill Murray: What value would you choose for a risk number for chemicals in the environment - for cancer induction? Don’t they normally look at 1 in 10,000?
Kowetha Davidson: You mean for risk level?
Bill Murray: Yes.
Kowetha Davidson: Yeah, I’d say so for risk level. But, this isn’t a risk level he has here. This is exposure.
Bill Murray: I know, but 1 mSv/y for a lifetime is equal to a risk factor of 3.5 in 1000, right? Not 1 in 10,000.
Kowetha Davidson: Where did that come from?
Bill Murray: From some generally accepted ICRP (International Commission on Radiological Protection) and NCRP (National Council on Radiation Protection and Measurements) risk analyses that have been done based on all the studies.
Paul Charp: That 100 mSv/year comes out to a risk of about 35 in 10,000. The upper limit for EPA is 1 in 10,000.
Bob Peele: I want to tell a short story. For myself as a nuclear worker, I used this kind of a guideline, so it’s not unreasonable (100 mrem/year, I’m doing fine). Now, for the point of working with the public, we’ve got quite a different answer. We are looking not for an acceptable risk, or an unimportant risk, or a no-consequence risk, we didn’t want that. We found we needed needed a minimum level for continuing our study. It had many, many branches for possible pathways. So in order to do it in a finite time (5 years), we had to throw away low-priority cases so that we could keep and elevate the high-priority cases. So we were looking for a decision threshold. So we said if risk was a certain level or below, we would, let’s say, put them off for 10 years because we had to do the more important ones. So we weren’t really looking for an acceptable risk, we were looking for a decision threshold. We published some notes, and called a meeting in Oak Ridge, and about 30 people came (which are the same constituents of this committee here). Paul Block was the chairman, and he presented this nicely. He pointed out that the 100 mrem (same number that Bill Murray just pointed out) corresponds to 3/10 of 1 percent over lifetime in regulatory approaches. The group was about evenly split, until the last four. When it came to ORHASP itself, we barely got a majority for setting a decision threshold at 10-4 instead of 10-5 (10-4 is 1/30, if you assume a lifetime, of what we’re talking about). Our experience with the public said we had to be concerned about pretty low risk. There were some that wanted 1 in 1,000,000. It turned out it’s a good thing we didn’t - we would have never have finished because there were too many calculations. A decision threshold of 10-4 shortened the job just barely enough to get it done. We had to be careful not to say that smaller doses were acceptable, or we got hammered. We had to say, “well, we just couldn’t get to it - we were doing the more important ones.”
Paul Charp: Also in answer to a rationale Kowetha raised on tox profiles, no individual studies were identified that could be used to base a chronic-duration external exposure that do not results in cancer-producing endpoint. However 2 sources of information were identified that did provide doses of ionizing radiation that has not been reported to be associated with detrimental effects (that’s No Observed Adverse Health Effects). We’ll go through some of those, and other sources of information used to support the MRL (they include the ICRP and NCRP reports). We also have set an acute external MRL for exposure to ionizing radiation. Acute level is set at 4 mSv (a one-time acute, or less than a 2-week exposure). The rationale for that is also defined in here, and for the external acute MRL, it’s based on studies done from atomic bomb survivors and based on IQ reduction.
Charles Washington: Reductions where?
Paul Charp: Atomic bomb survivors.
Bill Murray: In their children.
Paul Charp: Some of the Atomic Bomb Casualty Commission of the Radiation Effects Research Foundation folks evaluated the quantitative effects of exposure to ionizing radiation on the developing fetal and embryonic brain. Going through their math, etc., they found out there’s a 0.3 IQ point reduction in identical twins, and those were raised apart. That was a No Observed Adverse Health Effect, so by the time you do the math, it comes out to be an acute exposure of 4 mSv (not a year, but 4 mSv total).
Kowetha Davidson: Did you say 0.3 reduction in IQ? How can you measure that with any accuracy?
Paul Charp: I think it was dose response.
Bill Murray: Yeah, 0.3 for so many rem or something?
Paul Charp: A 1-Sv dose results in a 25 IQ point reduction (range of 21 to 29). The mean was 25. And it provides a 1 Sv to 1 Sv, so for 1000 mSv . . ., and provides a conversion factor from IQ prediction to radiation dose. Assume that radiation dose and the subsequent reduction of IQ is a linear relationship. So you do the math, and 25/1000 mSv, that would be 0.3.
Kowetha Davidson: Sometimes the math . . . significance.
Paul Charp: Yeah, when I first came up here, someone in this room asked me what I thought about whole-body vs thyroid dose, and I said mathematically you can do whatever you want to do - that doesn’t necessarily mean it’s right. So we have an acute of 4 mSv, and we have a chronic of 1 mSv/y.
Bob Peele: The IQ reduction is for fetal exposure?
Paul Charp: Yes. Again the rationale for all that is listed in the back of the tox profile, in Appendix A. It tells you what the MRL is, etc. So when we say No Apparent Health Concern, what we’re saying is that these are levels, when applied to the sites of exposure, that are not expected to cause adverse health effects. So we have an MRL (chronic) less than 100 mrem/y, and you wouldn’t expect to see any adverse health effects. If we see someone who says they have a one-time exposure (if we did do whole-body to thyroid, which we’re not), if their one-time whole-body exposure was less than 400 mrem, you would not expect to see any adverse health effects. So this was our initial thoughts (needs to be changed), based on our evaluation of ________ threshold, which we didn’t discuss, and based on epidemiological reviews which we now know to be a little questionable, and based on finding more MRL data, we’re going to lower that initial screen of No Apparent Health Effect from 5 rem to 200 mrem/year and 400 mrem one-time). That’s what we want to propose to PHAWG. I know it’s a lot to digest because of the language, no matter how much you work around Oak Ridge.
Bob Craig: Acute is 4 on top of the 1 background - is that right?
Paul Charp: Acute is 4 on top of 3.6 background.
Mike Knapp: I wasn’t able to catch the last part. The gentleman mentioned something about expectations of the Work Group. I just wanted to ask a few questions regarding what the expectations are and what exactly - I can’t remember the rationale for interfacing with worker health in regard to radiation screening. I just want to make sure that I’m up to speed on what the rationale for that was. And if anyone can tell me what the proposal is for the Work Group?
Paul Charp: The proposal is that we’re going to set a ‘No Apparent’ for chronic exposure at 200 mrem above background (2 mSv per year), and for an acute exposure, we’re going to set it at 400 mrem or 4 mSv per year. Doesn’t make any difference worker or member of public. It applies to both of them. These are screening levels.
Bill Murray: But they’re off-site exposures.
Paul Charp: So that’s the ATSDR MRL. Anything below that, they don’t expect to see anything. I’ll go line up something for distribution to Work Group clarifying the rationale for that.
Mike Knapp: You guys are going to go ahead and set thresholds for workers and non-workers?
Paul Charp: No, this is only for off-site. This committee does not deal with workers.
Mike Knapp: Correct. So we’re looking at what thresholds will be for offsite non-workers?
Paul Charp: No, not thresholds. These will be screening values. Anything below these screening values, we will say that’s going to be a No Apparent Health Concern, and we’ll not go any further. Anything above this (remember now, this is whole body, not thyroid), we will do more dose calculations or look more into some potential adverse health effects.
Mike Knapp: Can you give me those values again, please?
Paul Charp: 200 mrem/year or 2 mSv chronic exposure above background, and for an acute one-time exposure, it will be 4 mSv or 400 mrem (SCREENING VALUES).
Paul Charp: Again, I’ll write something up and submit it to the Work Group for your review before you profess your blessing to present it to the entire Subcommittee.
Bob Craig: Will that be in our next meeting?
Paul Charp: No, I will be out of town 3 times in next 2 weeks. I’ll be working on it, but I won’t promise you anything I can’t keep.
Bill Murray: Will it be available for next Subcommittee meeting (May 6)?
Bob Craig: Bottom Line - At the next PHAWG meeting, we will review and talk about Paul’s presentation to us today, and hash out some of these related issues, but Paul will not be able to have the written recommendations together by then. It will probably be mid-May before he has it written up.
Bob Peele: Would this threshold apply to affected exposure for large populations because then you’d almost predict there would be several people involved in cancers. You ought not do a health concern to 1 person - you wouldn’t be able to measure it. But if you had enough people, then that dose per time (10, 20, 30, 40 years), . . .
Paul Charp: You’d probably have to have 100,000 people or so before you start to see a . . .
Bob Peele: You’ll start to see it - it may not be a reality. But if the people are dead, it’s important. I’m looking at it from that point of view. That’s why, people in Oak Ridge, typically when asked, come up with a relatively small risk.
Bob Craig: You’re talking about a collective dose.
Bob Peele: If you have a dose of 200 mrem for 100 different people, . . . people at the screening level. I’m not saying what answers you’d use, but maybe from the point of view of getting a job done, may need this to succeed sort of like we had our decision threshold, which was considerably lower. The Working Group should take a look at it.
Kowetha Davidson: Are you asking whether they should use individual risk or population risk? I can’t explain what the difference is right now, but there is a difference.
Bob Peele: This doesn’t come up in this conversation, because in this case, the population risk is as high as the number in the population times the individual risk. Whole body doses - there will be very few. There may be nobody in Oak Ridge on whole body dose that achieves that screening level.
Bill Murray: If you had 10,000 people, you’re talking about all cancers (not a specific cancer), you’re talking about a 0.2 mSv or 200 mrem, you’re talking maybe 70 extra cancers over people’s whole lifetime.
Bob Peele: For lifetime, will have ½ percent of the people exposed will die from any kind of cancer. So, if you have 200 people, you’ll lose 1. Already 60 people in that group who have cancer, half of them will die, and you’ll have one more. Can’t prove with calculator. In fact, screening value is high enough that no population in Oak Ridge will achieve it on whole body radiation.
Paul Charp: That may be true, but at least, we’ve now lowered it.
Bob Craig: This will be continued at the next meeting, and we will get a written report from Paul in May.
James Lewis: I’d like to say I appreciate Bob Peele’s comments. We need to get more of that.
Paul Charp: If it’s alright with this Work Group, I’d like to talk with Bob Peele on the phone later on.
Kowetha Davidson: Could Paul provide us with hard copy of presentation?
Paul Charp: I’ll correct it and send to Bill Murray.
Susan Kaplan: Before we move on, there’s one more iodine issue that I think we dropped and never put to bed: whether we’re going to look at other releases besides RaLa.
Bob Craig: That’s the whole point - to look at what the cumulative dose is - RaLa on top of NTS and Russia. That’s the point. Kowetha will review tapes - Charlie Miller’s presentation (September), and give us a technical review.
Mike Knapp: Did we ever come to conclusion on discussions regarding efficacy of the scrubbers?
Bob Craig: On RaLa itself, I thought we came to a consensus on the dose. Go back and look at the minutes, but I thought we looked at ORNL releases (we settled on those), now just a matter of whether we’re taking those doses in dose reconstruction. There were hours and hours of discussion, and I thought we came to a consensus.
Susan Kaplan: Was there ever a resolution or anything documenting a consensus? I think it got dropped after September 11.
Mike Knapp: I think it did too. I appreciate that there was definitely a lot of discussion. I was also moving to Chattanooga once we started taking a bite out of that, so if there’s a way for Bill or somebody to check out minutes. I don’t know whether we came to resolution one way or the other on efficacy of scrubbers - what kind of values.
Bob Craig: Jack, I thought we did.
Jack Hanley: This is what I remember. ChemRisk presented Dose Reconstruction last June. Owen also presented. Owen was saying they could be looked at a little more. Al Brooks thought they were too efficient. One thought releases were overly conservative; one thought they were not. Check and see if there’s a formal vote - Jack doesn’t think so. Bottom line: There is no data to say either one is right or wrong. Estimates that Chem Risk came up with were down the middle. ChemRisk estimates were reasonable and appropriate because there is no data to prove otherwise.
Bob Peele: There were a number of bad runs.
Susan Kaplan: What I remember being left out was that it depends what ATSDR’s goal is in doing this. Are we trying to get a hard number (what someone’s dose is), or are we just going to come back to the people who were exposed who could potentially be impacted (mainly women born during a certain timeframe) - that’s what we need to know - are we trying to get an accurate number?
Jack Hanley: That’s a different discussion that came up, but very important. Owen mentioned it in June meeting: if we’re going to use it to make public health decisions, if people lived in geographic area, estimates of Task 1 were appropriate to do that. However, if we were going to do probability of causation analyses, Owen thought that we’d have to pull out our pens again and sharpen them up a little bit, and look at other possible sources and look at scrubbers. ATSDR does not get into probability of causation (more of a legal issue). ATSDR is in public health arena, making public health decisions to determine if someone was exposed, what should we do to help them regarding that exposure. We deal with the larger public, not on an individual basis. In regards to looking at it in the public health context, the doses were appropriate and can be used for making pubic health decisions. In Owen’s view, he’s going to go back and decide probability of causation - who’s responsible, who’s going to pay, and who’s going to get compensated - that’s a different issue than what ATSDR’s mandate is.
Susan Kaplan: There’s one issue he did bring up and it is important - the other ORNL event besides RaLa could expand time period during which people were impacted. Where RaLa occurred in a certain period of time, evidently thorax or some others were from a different timeframe.
Bob Peele: There were a couple of other smaller programs. They were not included in ORHASP, perhaps in error. The reason the weren’t is they were much smaller. If Owen is right about the scrubbers, the changes might be a factor of 2. The only problem would be if the estimate given way back in the Phase I report where they looked at different programs and tried to make rough estimates, if those are important, it’s a . . .
Bob Craig: When you look at iodine releases without scrubbing, and they screened it, then came back and looked at the scrubbing, then RaLa was much less (it raises importance of the others), but they’re still down in what we consider “noise.”
Susan Kaplan: We kept asking for spreadsheet showing us the possible impact of these other incidents.
Bob Peele: We didn’t produce a nice description of that problem.
Susan Kaplan: It would be nice to see one.
Jack Hanley: One reason Owen thought it would be important to go back
and look at the other releases was they were small and of shorter timeframe
and much lower releases. RaLa was over an extended period of time. Others
are important if you’re going to look at probability of causation.
For that end, every little bit counts.
Susan Kaplan: But if you don’t go in a logical, rational and documented manner, it will never be put to bed and it will continue to haunt you. All we every asked for was a spreadsheet or something to show us the rationale.
Jack Hanley: That’s fair. I don’t remember anybody asking, but we could present this, and as Bob mentioned, a lot of this is covered in Phase I.
Bob Peele: There are numbers in Phase I, if I recall correctly, which could . . . But we’re talking about dancing around on the fringes. The scrubber a big deal.
Bob Craig: The scrubber is huge. The scrubber overwhelms everything else.
Jack Hanley: The problem with that, Susan, and this is a little technical problem - Phase I is a screening. Task 1 is much more in-depth, detailed analysis. With RaLa and screening, they estimated a certain number of curies of iodine that got out, they thought it was a real large number, but when they came back and did a more detailed analysis, that number dropped down.
Susan Kaplan: Which raised the significance of ones they screened out.
Jack Hanley: Well, no, because it’s assumed that they were all screening very rough numbers and they were all overestimates in the first screening.
Mike Knapp: Where does this leave us? Obviously, I’ve raised an issue that seems to have some pretty substantive questions and assumptions about it. What I hear Jack saying is that there’s a separate issue between public health vs individuals, but if you asked some individual who has had thyroid disease all their lives (who grew up in Oak Ridge) whether or not they would care if we only look at RaLa and the efficacy of its scrubbers and tossed out the other ________, they might care quite a bit about that. To me, that’s an issue in and of itself.
Jack Hanley: We do look at individuals and follow up with individuals. However, we do not get into probability of causation issues (those types of calculates and estimates). Those are outside our mandate. We do look at individuals and are interested in individuals.
Mike Knapp: I understand that, but I have to ask you the questions, though. What is difference between . . . I’m just trying to get a handle on what it is ATSDR’s role is. I don’t understand, if I’m looking at it purely from a large ______ public health situation, what you and Peele are saying (if I understand you correctly) is we really want to look at the large releases and perhaps the efficacy of the scrubbers, but when it comes to the additional later releases, you guys insist they are at later timeframes and lower levels, so for a public health perspective, those really aren’t a cause for concern. Do I understand that correctly?
Jack Hanley: No, you have to put resources where they count. Going on the fringes and trying to estimate doses you know are very small and adding onto RaLa totals (much greater), then you have to . . . Where are you going to spend your time, resources, and effort? On the fringes, or primarily on the main operation where the releases were?
Bob Peele: There’s another side to it (I can argue both sides, of course): Suppose you were born in 1980 and lived just across river from ORNL. You were absolutely unaffected by RaLa, but you may have been affected by the later release. During that later release, Owen was out there measuring milk and radiation on the ground and various other things. There’s a smaller effect on that person, but let’s say there are people in that area that might have gotten their ______ irradiated to a serious level. You decide to send them a postcard to say go see your doctor. You may have gotten a level that makes you a little more likely to have trouble than the average. That would be the typical response. So if you’re trying to decide who to send postcards to, you would send to that individual.
Susan Kaplan: I think we need to deal with all those releases. If all we’re going to do is a card or fliers or whatever, there’s no reason why those people shouldn’t be included.
Kowetha Davidson: You need to look at drivers for whole thing. To me, RaLa is the driver. In toxicology, when looking at different exposures, if you have large exposure then little one, this large exposure will overwhelm anything that happened with the little one. So that large exposure is your driver.
Bob Craig: You’ve also got uncertainty here. What are your significant numbers? You’re out there, you have some little releases here, but uncertainty in that big number overwhelms these other things.
Mike Knapp: I don’t buy that argument. I understand what Kowetha’s saying. But I can give the converse of that: The driver might be the larger lead, but for whatever physiological reason, you didn’t get sick then. It was a later release, if you stay around here long enough, that pushed you over the edge. There is an additive effect there. If you’re going to have credibility in this process, you’re going to have to look at all the releases. Not only that, you’ll have to look at other releases. Not only that, you’re going to have to look at NTS, mercury from sites other than Oak Ridge, etc. Eklund had a good point that he was talking about with me on the phone: if you’re a doctor and you’re only telling your patient about that one release that might have hurt them but you’re not telling them about other risks involved, you can get sued for malpractice. It seems only fair to people who have been having to deal with these health problems, to tell them about the added ones - especially if you got hit by the big bomb and that didn’t get you sick, and you stuck around here, and it turns out that the stuff released later on might have pushed you over the edge. Maybe it didn’t give you total thyroid dysfunction, maybe it only gave you cancer or something like that.
Bob Peele: Mike, you’re both right.
Kowetha Davidson: I think that second population is not going (the same as) that first one, because you have years in between. There are fairly specific age groups. If you’re talking about the 1950s and then the 1980, those are totally different populations.
Bob Craig: Iodine has such a short half-life, it’s gone.
Susan Kaplan: Iodine mainly impacts up to what - 5 years?
Bob Craig: Five-year-olds.
Bob Peele: Less than 15-year-olds have some sensitivity.
Susan Kaplan: It’s mainly young people, so they’re going to grow up and they’re not the ones who get that second blast. But there will be a new generation there who did get it. All I’m asking is put together a table to show me, and show me the years, and show me the relative doses or something.
Bob Craig: Jack’s going to do that table, right?
Jack Hanley: You can’t just look at a spreadsheet. It will take explanation, but we can possibly do that and explain that out for you.
Bob Peele: I’d like to see it, because I’ve never seen it either.
Mike Knapp: Mr. Chair, in regards to our next meeting and work items between now and then, I would like to suggest that we go through minutes of previous meetings and see whether or not there was actually a vote or determination one way or the other regarding the scrubber.
Bob Craig: We can ask Bill if he can go back and see if there was ever a motion made on that.
Mike Knapp: I want to know whether or not the Working Group has made a decision as to what we’ll be dealing with - have we made the determination about efficacy and efficiency of the scrubbers?
Bob Craig: I thought we made an overall decision to use ORHASP Dose Reconstruction dose calculation. They used 95% efficiency with a range. That’s what we concluded was to use the ORHASP Dose Reconstruction. Isn’t that right, Jack?
Jack Hanley: I’m not sure there was a formal vote. There were a few discussions on it. I think what they determined was that there is no was to determine exactly because there’s a lack of data, so they should use the range that ChemRisk used in the task force. One group thought it was too high, one thought it was too low. Our technical reviewers, especially Dr. Jeffrey Eicholtz (the one book that has been written on dose reconstruction - he wrote the chapter on source term and he’s an expert in that area), thought assumptions they made were practical and reasonable.
Mike Knapp: Is Eicholtz a chemical engineer?
Bill Murray: Are we looking for what went on in the Work Group or the Subcommittee?
James Lewis: Generic implications as this rolls down through the project, we really need to take time to evaluate what we’re doing here. As we move to other contaminants, if we get these types of challenges, is there enough money in the budget to handle challenges like this? I am concerned. We can put certain things in phases, get them fixed up out of the way. But somebody needs to look at this. If not, you may just as well shut down now because you might not be able to finish it. We always talk about this. We need to get together in a room, led by our leader, and get together and decide what we’re going to do.
Bob Craig: We’ve already had technical discussions on scrubbers.
Susan Kaplan: Let’s finalize what we’ve decided as an entity. Things just started drifting on.
James Lewis: Al left, some other things happened, so we need to revisit it, and make a decision.
Mike Knapp: I agree that we need to make a decision. Obviously I raised a question that doesn’t have a correct answer right now, but it can be quickly answered by looking at the minutes. The other concern I have will be addressed by Kowetha - whether or not we’re going to use smaller short timeframe releases in connection with what Jack pointed out about public health implications or non-implications of using other releases from Oak Ridge in the overall assessment of how iodine has impacted people here in the area. We obviously haven’t covered that one yet, but I want to make sure that concern is identified, and that this Work Group will tackle it.
Bob Craig: Yes, and Kowetha will take that on.
James Lewis: I’d like to see Mr. Knapp and Susan document their issues. In addition to that, how are we going to address issues similar to that. Then send it to Jack.
Jack Hanley: That would help me if this is in writing.
Bob Craig: Me too.
Cumulative Doses for I-131 (Kowetha Davidson)
We’re not ready for this conversation yet. Kowetha will review and give us a synopsis maybe at next meeting.
Recommendation Regarding Screening Maps (Bob Craig)
The recommendation got sent back to the Work Group. We have color screening maps, by media but not by contaminant of concern. The Subcommittee Chair asked for a rationale stating why it’s necessary. PHAWG members all agree they want color screening maps, by media and by contaminant of concern. The question is WHEN do we need them.
Susan Kaplan: Well, it looks like we’re going with uranium next, right? Someone needs to generate the uranium maps.
James Lewis: We haven’t got through the ones we’ve started first. Why are we jumping to uranium?
Susan Kaplan: Because who knows how long it’s going to take.
James Lewis: Then, why don’t we just open up the floor, have a meeting and draw it out. I brought some things to show you. I guess as we start looking at these maps (I’ve asked this question 2 or 3 times), we need to look at data, how to present data, what are we doing with that, what is the reason for that, and how is it subject to be used? Let’s discuss it openly. You all allow somebody to throw something on the table; we don’t take it down, dissect it, figure out what we want, and then send it to Jack and say “can you produce it?” Then we argue about what was said. Just like I got through asking about this. Let’s write it down, define it, and put it on the table and figure out what we need to do.
Bob Craig: Maybe we can ask Susan to draft the rationale too.
Susan Kaplan: The rationale, I told you I feel like it impacts the credibility. Is that a technical rationale? Give me a break.
Bob Craig: I think we’re all in agreement that we do want to see where these contaminants of concern were sampled. It’s a matter of, from my point of view, when do we want them, how much work is involved. Jack has committed he’s going to have it for every one of the contaminants.
Susan Kaplan: Right, but if it takes us another 3 years to get through those contaminants, we don’t want to get two years from now before we get the final one.
Paul Charp: I don’t know anything about how the mapper folks do it, but think about the logistics. If you have 6 media, and 1000 contaminants of concern, you want 6000 maps?
Susan Kaplan: There are not 1000 contaminants of concern.
Paul Charp: It depends on how you define contaminants of concern.
James Lewis: I have a tape - I had a presentation that I wanted to give
at the last meeting as to how information gets put on the table, and sometimes
when it’s put out in a piece-meal basis, what happens. What I wanted
to do was to show you, with a map, what happened in Scarboro.
Susan Kaplan: I know what happened.
James Lewis: Well, if you do, some people may not. Why don’t I slide it in. We can show you. We have a timeline here, we can show you the reactions we had, we can show you how much money was spent, we can show you what drove that issue. And it was because, rather than having all the things in one place, they took one thing out of context, threw it up, we got a reaction, and we spent an ungodly amount of time and money chasing something because we did not get the story together. I requested Tim (Joseph) to put together this (attached) after the reaction we got in Scarboro. If this type of thing had been laid out, along with the matrix in here, showing the various flyovers and what was done, if we’d had things like that with everything in place at one time, there’s a possibility that we wouldn’t have been chasing this throughout Scarboro for the last 3-4 years with almost zero results. That’s why I’m saying - take the time to look at what we’ve done. Mr. Manley and I voted against it. From a minority position, we want to give a presentation as it relates to that and then let the group vote and they decide.
Timothy Joseph: A question to Susan that needs to be asked - you know kind of what you want - but a question that needs to be addressed is “what value is a map of a location of a sample when you don’t know anything about the level or anything else?” What is the value to be gained by a seeing a map and saying something was collected.
Susan Kaplan: People’s confidence in what you were studying, and are you studying the right places.
James Lewis: We’ll show you some confidence.
<James Lewis showed videotape of a news report done for the NBC News detailing children’s sicknesses in Scarboro, and Scarboro citizens’ suspicions about DOE not protecting its residents based on a map of a flyover which had a portion of Scarboro blacked out - charges of environmental racism.>
James Lewis: What I brought was an evaluation and what we had was a map. Whole basis of this was a map with an area being blocked out. We asked Tim to go back and generate a report, and he graciously did. Tim produced a matrix of the various flyovers that had gone on prior to and actually after the one on the map that caused the trouble. He also defined why certain things were blacked out and certain things were not blacked out. When we got through reading this and looking at this, we had sent for Falk and the crew from the CDC to come in a do a whole thing on asthma, then we sent from somebody from the Joint Center, then we go get the EPA. What I’m trying to say is if you look at the sequence and what is truly needed and put it all together, then you present something, then I think you have a tendency to get an overview. But just to take a map and throw it out - it kills us.
L.C. Manley: That information was given to the public by voice, but they had to go back and put together hard copy. People don’t want to listen when they’re told things. This is what seems to be happening right here in this Work Group - you’ve been told certain things, but you don’t want to listen.
James Lewis: In addition to that, I brought another one which we may not have enough time to see which will show you the detailed discussions. This is really what gets to be interesting. You’re going to watch the people from the various communities when they’re talking about the map, and you’ll see who’s listening.
<Tape was played.>
James Lewis: My point to you is if you take something out of context and don’t have whole story, rethink your position make sure what you’re asking for.
Susan Kaplan: You’re making an important point that I believe strengthens what I feel because if some group had held a committee meeting and looked at this before they got to that public phase, I would hope. I don’t want that to happen 4 years from now or 3 years from now, because we didn’t look at where the samples are.
Timothy Joseph: You’re going to be producing a map, let’s say of uranium, not showing levels, and public or press picks up a map with a million dots of uranium. How will that be interpreted?
James Lewis: Timing of presentation with maps and explanations, then is the time for the presentation when you have the whole story.
Susan Kaplan: Fine, then they need to go and think it through. But my point is I don’t want it 2 years from now. It doesn’t say anything about screening or results.
Timothy Joseph: I don’t know what value that would be. It’s a piece of information that doesn’t tell you anything except raise questions.
Bob Craig: As part of what Jack will do for each PHA, he’ll take us along and somewhere before it’s released he’ll share the sampling map. Looking at specific contaminant of concern. Plus rationale. That’s what he plans to do. Before it gets to the Subcommittee, we’ll see it.
Susan Kaplan: I would like to make minority statement - I think that is the wrong approach. I can be overruled by this group, obviously, but I think it is the wrong approach.
Timothy Joseph: Just for my clarification, let’s say you have a map of Oak Ridge. You do a uranium map just like the boron map, so you see some here and some here but none here. Are we going to have to explain why?
Susan Kaplan: Sure, what’s your rationale for sampling?
Timothy Joseph: That’s the problem with putting out a map with just sampling locations. Every inch of Oak Ridge doesn’t need to be sampled. Every community doesn’t need sampling. But we’ll have to explain every sample collection and why we didn’t sample where we didn’t sample, that is going to take a lot of effort.
Bill Murray: One thing - when whole issue came up with maps John Merkle went down to TDEC. There is a whole database of these maps. Two big groups are doing this: one is TDEC (primarily since 1993). It’s not on OREIS. That’s the group that has all the data way back and recently. TDEC does not. I’d suggest that the whole Subcommittee might need to hear someone from these groups talk about what sampling has been done, what data they have and for what dates.
L.C. Manley: James, didn’t Jean mention something about that?
James Lewis: Yes, Jean Shakir Ali.
L.C. Manley: She worked with that about 15-20 years.
James Lewis: Yeah. I guess one of the things we’re saying though, even with that, it still goes back to the heart of the matter. When you’re ready to present [and he (Jack) is willing to share with you in advance, and I think he does need a schedule for each one of these things], it should be put out to the public in advance when you’ve got responses to anticipated questions, because issues will be raised when somebody says, “justify with your random sampling why you didn’t look in my yard.”
Bob Craig: First thing, James, it’s just going to be for this Working Group and then ORRHES. So these are fairly well educated folks. As far as this issue, they’re going to be knowledgeable about it.
James Lewis: Let me add this, Bob. When we walked into that room, there were some people who understood this. But by the time we got off Dateline, you don’t know what the world was dealing with. When we got through showing this and identifying this because, if you’d seen where they presented it, it looked like they had intentionally left it out.
Mike Knapp: I want to understand exactly what Susan’s thinking is in regards to her request. So can we quickly revisit her thinking. I just couldn’t understand what her thinking is and her demand for having maps.
Susan Kaplan: I have asked them to generate color maps that show us where the sampling to date has been conducted. I’m not asking them to imply any results, or levels, or hits. I just want to see the rationale by contaminant of concern for sampling. And I think the issue of sampling needs to be dealt with before as a comprehensive plan and strategy, rather than dragging it out over the next 3 years and dealing with it as a contaminant of concern issue.
Mike Knapp: Let me see if I can restate it. Your request is to have maps, and the primary goal for those maps is for you to see where sampling has been conducted, regardless of whether or not there were hits. You just want a spatial representation of where the sampling has been conducted per contaminant of concern. Right?
Susan Kaplan: Yes.
Mike Knapp: My understanding of that (and I agree with that) is that you’re trying to make sure we tackle the question of where sampling has been done, where it hasn’t been done, and why it hasn’t been done there. We’ve had meetings with EPA about this very issue. Some of our members live in Roane County (e.g., Dyllis, back behind K-25, etc.). We’ve had to meet with EPA because when it comes to off-site sampling, not a lot of sampling has been done. One of our concerns is that this Work Group and this Subcommittee is making assessments on public health without even having what we consider to be a decent set of off-site sampling data to indicate what the historical contamination levels are in areas off-site in soil, for example. I’m going to agree with Susan. I think when it gets down to actual logistics of generating maps and stuff - I don’t know whether we want to generate a map for every one of the thousands of contaminants that could have possibly been tested for.
Bob Craig: No, there aren’t that many contaminants.
Mike Knapp: Right. So I would suggest I and whoever else come up with a list that narrows it down somewhat.
Bob Craig: No, Mike, we have a list. We have a screening process that gives us contaminants of concern.
Susan Kaplan: The question is do we do it now or do we drag it out forever so that we’re ineffective at the end.
Timothy Joseph: A question on the maps: By default, if an area has not been sampled (e.g., a residential community or a forest somewhere), by definition should that automatically have been sampled; and since it hasn’t, will DOE or the contractor have to answer why every square mile or quarter of a square mile hasn’t been sampled?
Susan Kaplan: Wind direction and water flow - that’s all we care about.
Timothy Joseph: I don’t think you understand what you’re asking for.
Bob Craig: Well then, let me suggest that we pick up on something James or L.C. said. Why don’t we have somebody who manages OREIS come in here and tell us what’s in it and how it was done.
Timothy Joseph: OREIS has hundreds of thousands of sampling data points, locations, parameters. It’s reclamation data, it’s health data, it’s environmental monitoring data. It’s a combination of QA data so that the State or anybody can get access. But they all have different geneses as far as for what program, what reason. And to put that on a map is almost impossible and say “okay here’s why we didn’t sample in an area that you’re going to see no uranium samples - because there was no need to sample, there was no program need, there was no emission thought to go there, there was nothing that ever drove uranium samples into this community. What more can we say?
Susan Kaplan: From a DOE mission standpoint, that’s a whole different thing than a public health standpoint.
Timothy Joseph: We know wind roses. Everything should be sampled in those wind rose? We need to get you on to the OREIS - let you fool with it an see how extensive it is. Then get on to the State data. There is no State data on our system. Cannot take State data that we can’t validate.
Susan Kaplan: What about ATSDR data?
Timothy Joseph: ATSDR data is from ours.
Susan Kaplan: It’s from yours, but doesn’t it have TDEC data on it?
Mike Knapp: You guys haven’t sampled that much offsite, and you know it.
James Lewis: So, do they need to?
Timothy Joseph: We have sampled a great deal offsite.
Mike Knapp: Is that why EPA tells us that they feel like there needs to be extensive off-site sampling done? Has sampling been done to the same extent off-site as on-site?
Bob Craig: Of course not.
Mike Knapp: I think it gets back to Susan’s original request. Susan, let’s ask the guys from DOE, from Environmental Sciences, TDEC, along with some people from EPA to come in and hammer out the extent to which sampling has or has not been done.
Timothy Joseph: Off-site sampling is extensive.
Bob Craig: We need to cut this off and move on. We’re going to define this issue for the maps. We know we’re going to be getting maps as each one of these public health assessments is going to be done, and we’re going to have a better technical explanation at that time. If folks need to see it ahead of time, they’re going to have to make that case. I don’t get the sense of the committee that we need to have that.
Mike Knapp: Is it possible for us to go with original recommendation, just to have a couple of people to give a general overview of sampling that has been done and the decision-making matrix.
Bob Craig: We can request someone from Environmental Sciences Division to give us an overview of the OREIS.
James Lewis: Everything needs to come together in ATSDR - whoever that focal point is that’s pulling both sides together probably needs to look at that and speak to the issue.
Bob Craig: Maybe Jack - is that what you’re saying?
James Lewis: Yes, if he’s getting stuff from TDEC, stuff from everywhere . . . Near end of April, EPA is coming up, need to figure out that date.
Timothy Joseph: When we met in Chattanooga about 1 ½ years ago, we decided that EPA was going to get on our OREIS (they asked for it) to find where EPA thought data gaps were. We got them on it; they were working on it; and we haven’t heard a thing. That was a long time ago. Until EPA looked at DOE’s sampling scenario, they felt they wouldn’t be able to identify data gaps.
Susan Kaplan indicated that just identifying total number of samples without identifying the location could possibly be misleading to the public. Wouldn’t you rather have this group hash this issue out here before it Dateline or 20/20 comes back and slams us with it in 5 years?
ATSDR and DOE countered by saying that there could be logical reasons for having more samples in one area than there are in another.
Timothy Joseph summarized James Lewis’ concern by saying that we need to present the entire story to the public at once, rather than provide piece-meal information. To just provide sampling data points without the logic could create a lot of confusion and questions about why they didn’t sample in a particular area or community.
ATSDR and DOE reassured Susan that the information she is requesting will be presented to her far enough in advance that it can be studied and reviewed prior to the formal presentation by ATSDR.
The meeting was adjourned at 8:20 p.m. Next meeting in 2 weeks.