ORRHES Meeting Minutes
June 28, 2005

Work Group Reports

Health Outcome Data Work Group
Dr. Malmquist asked Mr. Hanley for an update on the Cancer Incidence Assessment (CIA). Mr. Hanley provided the history of the request for this assessment, stating that a recommendation was made in April 2003. In August 2003, Dr. Malmquist reported what Dee Williamson of DHS had committed to looking at: cancer incidence data from the Tennessee Cancer Registry (TCR) from 1990 through 1996 for 26 different cancers. She was to evaluate the selected eight counties and 49 census tract geographic areas and compare them to state rates while adjusting for age and gender. Last year, ATSDR found that the state had data to 2000 and data on about 40 different cancers. Since this time, Ms. Williamson had received the new data, and there has also been transition within the registry.

As of 2005, Mr. Hanley said, Ms. Williamson has the cancer incidence data for the eight counties he presented a map outlining the areas that would be included. The data could be evaluated and a report could be completed for internal review by July 2005, with a public comment version probably released in the fall for these eight counties. For the rural counties within the census tract component of this geographic area of interest, however, there are problems with the census data. For example, 75% of the cancer cases in the registry only have a post office (P.O.) box number; there is no address (geolocator) to identify the census tract that the person lives in. Therefore, someone with a P.O. box in Ten Mile could actually live in another census tract. Because they do not know exactly where someone lives, Mr. Hanley said, misclassification would result–cases could be put into the wrong census tracts. According to Mr. Hanley, addresses with P.O. boxes represented about 9% of cancer cases in Loudon County, 9% in Knox County, and about 27% in Roane County.

Dr. Craig indicated that Roane County would not matter. Mr. Hanley said this was correct because all of Roane and Anderson Counties are included in the study; they do not need to be segmented because the study will include all of the cases. Mr. Hanley noted that Rhea and Morgan Counties are also rural and have a high number of P.O. boxes. It needs to be determined where these people live–there are hundreds of cases of this problem.

Dr. Craig expressed his belief that people were not likely to live too far from their P.O. boxes. He asked whether zip codes could be used. Mr. Hanley was not sure. Dr. Malmquist indicated that he has a P.O. box in Kingston, but lives outside Kingston. He explained that people could live in one census tract and have a P.O. box in a different tract. If someone had a P.O. box in Kingston, he said, he or she could live almost from Knox County to Rockwood because of the rural routes. In his opinion, he said, going by census tracts could cause a significant problem regarding the rural counties.

Mr. Lewis asked the percent of P.O. boxes versus those with full addresses within a tract. Mr. Lewis answered that 75% of the cases of cancer in Meigs County have P.O. boxes; only 25% of them have actual addresses.

Mr. Hanley explained that when Ms. Williamson committed to evaluating data by census tracts, she had been familiar with conducting this type of evaluation in Memphis, Tennessee. Though unlike these rural counties, Memphis is a metropolitan area with a high number of physical addresses. Mr. Hanley said that they could work with some of the numbers, such as those for Knox County (only had P.O. boxes for about 10% of its addresses). For the counties with large percentages of P.O. boxes, however, this would cause significant misclassification. Dr. Craig asked for the solution; Mr. Hanley said that it was to use the data for the eight counties. Dr. Malmquist clarified that it would be for each individual county and then the eight counties combined.

Mr. Lewis stated that he had a limited knowledge of the various P.O. boxes, but asked whether people typically had boxes closes to their residences. Mr. Hanley indicated that there are only three census tracts in Meigs County because of its small population. Mr. Lewis said he understood this, but asked whether the P.O. box areas would be covered with the tracts they included. Mr. Hill expressed his belief that Meigs County would be easy to decipher because there is only one P.O. box located in Ten Mile within Meigs County. Mr. Hanley referred to the map, asking how many people would use the P.O. box in Ten Mile but live below the census tract. Mr. Hill replied that it was only about 4 or 5 miles below the county line. Dr. Malmquist stated that there are people in Roane County with P.O. boxes listed in Ten Mile. Mr. Hill expressed his belief that they could correctly estimate the census tracts for about 90% of the P.O. boxes in Meigs County. Mr. Hanley asked about Rhea and Morgan Counties. Mr. Lewis expressed his belief that they could obtain an appropriate estimate if they determined where the post offices were located.

Dr. Evans said that because these were relatively rare cases, misclassifying cases might cause an astronomical relative increase in one area and decrease in another that would significantly confound the data. Ms. Galloway said that there were also complications in rural areas where people use a P.O. box across the county line.

Dr. Davidson asked if they could include all of Meigs, Rhea, and Morgan Counties. In his opinion, Mr. Hill said, this would dilute the data by including people they were not concerned about. Dr. Davidson expressed her belief that they had drawn such a fine line about areas they were and were not going to consider, but someone could live only 10 feet away. Mr. Hill indicated that they had selected the areas based on the river, including areas where the lake was not used for recreation or heavily fished. When they divided the boundaries in Meigs County, Dr. Malmquist said, they had looked for a natural boundary and took Highway 68 across the dam to Spring City. He noted that if they looked at the census boundary, they had not taken the boundary by census tract. Mr. Hanley recalled that they had not wanted to include Knox County because this would draw a large number of people who were not exposed.

Dr. Craig suggested using Meigs, Rhea, and Morgan Counties in their entirety, but using census tracts for the remaining areas. Dr. Malmquist said that this could work. Mr. Hanley asked about Blount County: not familiar with the area, he asked how to proceed if there was a high percent of P.O. boxes for that county as well. Mr. Hill indicated that Blount County was upstream, so contamination would not flow up to Knoxville. Dr. Malmquist explained that they had included Blount County because there was an air plume that could go down into that area. Mr. Hanley indicated that this was an iodine plume. He asked whether the group want to use the entire county or remove it altogether if there was a high percentage of P.O. boxes. Dr. Malmquist said he would rather cut it out. In her opinion, Dr. Davidson said, removing the county would cause less error than including it.

Mr. Hill asked about the number of cases in Meigs County. Mr. Hanley had not seen the pertinent data. He explained that statisticians and Ms. Williamson had presented the problem to him, and he was delegated to discuss the information with the ORRHES.

Ms. Vowell said there would be very small numbers of cancer cases in the smaller counties. Mr. Hanley indicated that Ms. Williamson has a limit of cases she will not analyze; Dr. Taylor said the limit was five or less. Dr. Malmquist asked Ms. Vowell if it made more sense to include the entirety of smaller counties such as Meigs and Rhea. In her opinion, Ms. Vowell said, this would be better because of such counties' small populations. She could speak for Morgan County, most of whose population she said would be covered from Oliver Springs to Wartburg. She said there were not many people after leaving Wartburg, so including the entire county would not be adding a large population.

According to Dr. Malmquist, Meigs County has a population of 9,500; Morgan County has a population of 18,000; and Rhea County has a population of 27,000. He expressed his belief that they were not referring to a large population, indicating that the number of cancer cases would be statistically small over the entire county. Ms. Vowell said this was true, particularly if there was a breakdown into gender and other categories.

In his opinion, Mr. Lewis said, this information should not be difficult to obtain. He explained that he had attended the meeting on the Loudon County report. Initially, he said, they had looked at entire counties; then the chair of that committee suggested delving deeper to determine what was occurring in various communities. Mr. Lewis said that the state's response on the videotape indicated that it could do a study in 5 or 6 months, using information similar to what they were trying to obtain. In his opinion, he said, Loudon County was taking its study to this level, but did not seem to have any problems associated with obtaining the same type of data. He said that they had talked about census tracts, voting precincts, and other types of information, but that the state had indicated that it could complete the study by looking at those areas.

In his opinion, Mr. Lewis said, Bonnie Bashor (TDOH's Director of Environmental Epidemiology) made an interesting statement, saying that she would meet the needs of the people. He said that available HRSA data on Loudon and Franklin Counties could have helped make this decision. Mr. Hanley expressed an interest in having a copy of this information. Mr. Lewis suggested reviewing it as a work group and making a call. Mr. Hanley said he would speak with the epidemiologist who worked on the Loudon County report. To his knowledge, he said, the Loudon County report used crude rates, whereas the CIA is adjusting for age and gender and using standardized incidence ratios. These are different types of analyses, but the differences would be explained within the CIA.

In his opinion, Mr. Lewis said, the Loudon County report was driven by health issues and responded to public requests, questions, and needs. He expressed his belief that this report would help their community. Mr. Hanley indicated that the CIA would compare rates of cancer for the eight counties to the state average, and also compare rates within the geographic area to the state averages. Mr. Lewis expressed his concern that the earlier meeting's minutes had not captured enough detail about the discussion of plumes and expectations for this recommendation. In his opinion, he said, they were trying to satisfy the needs of the public where it was practical. He expressed concern that ORRHES had not seen a formal program outlining the plans for this evaluation by plumes. He said he had read an e-mail from Mr. Hanley indicating that he would explain these details, but asked whether ATSDR planned to look at these data by plume, noting that they had drawn a map based on the plumes. If particular contamination was detected in a plume, he asked, did ATSDR plan to put these census tracts together–and if not, why not? In his opinion, doing so would provide a general idea of what is happening in these particular areas.

Dr. Davidson said she did not recall this being part of the recommendation. Mr. Lewis did not disagree with her, but noted that a discussion had been held on this topic. He expressed concern that they might not formulate the most detailed recommendations to convey their points, but said this had been discussed and suggested that they keep in mind the spirit in which the recommendation was prepared. Dr. Cibulas explained that he had had some discussions with Ms. Williamson and her Division Director, in which they indicated that they were still willing to do that work. However, he asked for the approval of the committee to move ahead with evaluating the eight counties–work which could be quickly turned around. According to Dr. Cibulas, DHS had identified problems with conducting a more focused plume analysis, some of them related to the geocoding of individuals. This would need to be worked out with the state, he said, but ATSDR is still willing to do this. He said he had heard one proposal about including the entire county for areas with geocoding issues, noting that they would discuss this with the state and epidemiologists to ensure its feasibility. He added that ATSDR was definitely willing to do what could be done.

Mr. Hanley presented the most recent diagram of the PHA process. Mr. Lewis said that he recalled this diagram very well and said he understood the latest figure, but asked about ATSDR grandfathering what had been started with them. Mr. Hanley noted that ATSDR is committed to complete what it promised as best it can. He explained that there are criteria regarding health outcome data for PHAs and went through the diagram showing why ATSDR will and will not conduct additional health outcome analysis. ATSDR evaluates the following exposure-driven criteria to make this determination: a) completed pathways, b) time of exposure, c) exposed population, d) sufficient exposure level, e) latency periods, f) geographic units, and other criteria that follow. This is documented in the PHAs.

Mr. Lewis was not in disagreement, but said he was not sure whether the Loudon County report was prepared according to the revised version of the Public Health Assessment Guidance Manual. According to Mr. Lewis, the Loudon County report also evaluated other diseases and captured health outcome data. He commented on two sections that he considered to be particularly good: a) a section addressing health outcome data related to various diseases associated with particular issues and b) a needs assessment section that included a survey of the community. He expressed his amazement that this could be accomplished under the ATSDR letterhead. Mr. Hanley said that this report was exposure driven, and expressed his belief that TDEC had identified areas for further evaluation. Based on these exposures, they looked at additional health outcome data.

Mr. Lewis indicated that the Loudon County group had a physician and nurse on board. According to Mr. Lewis, many health issues being raised were being placed on the top of their list. In his opinion, he said, their own leadership is not pushing health issues. He expressed his belief that health issues raised by the physician and nurse on the Loudon County board (from what he could surmise) carried a lot of weight, which focused their effort on health outcome data. In his opinion, he said, this is very helpful to people within the community regardless of whether something is statistically correct. He said people needed the information and ATSDR had to explain it. He expressed appreciation for Dr. Cibulas's comments, noting that they needed to ensure that their activities serve the needs of the community.

Dr. Malmquist had to leave, and moved to accept Dr. Cibulas's proposal to move forward with the cancer incidence data for the eight counties, while continuing to work on the census tracts and plumes, with ATSDR presenting the information to them as soon as possible.

Mr. Lewis agreed with moving forward, but suggested asking ATSDR for the following three reports:

• All counties individually and added together.



• All of Rhea, Meigs, and Morgan Counties; parts of Loudon County; all of Anderson County.



• All counties disregarding P.O. boxes.

Dr. Malmquist agreed to remove Blount County because it was a small area and difficult to do, but recommended coming back to look at plumes. He expressed concern that they have waited over 2 years for this report, and the report might not be published until 2007 if they wait for this additional information. In his opinion, Mr. Hill said, it appeared that ATSDR could provide these reports based on the information the agency already has. He expressed his belief that this would give ATSDR an opportunity to make and defend a decision.

Mr. Hanley asked Mr. Hill to repeat the third report he suggested. Mr. Hill said it would include all of the counties, but disregard the P.O. boxes that cannot be differentiated in Morgan, Rhea, Meigs, and Blount Counties. Given Ms. Vowell's comments, he said, he expected that this would provide results similar to the other reports requested. Dr. Malmquist said this was not necessarily true, providing the example of Meigs County where 75% of the cases had P.O. boxes. Mr. Hanley expressed concern that this would be excluding 75% of the data, which was a significant amount of data and not a preferential approach to use. Dr. Cibulas added that there are other counties with 25% to 30% P.O. boxes.

Dr. Craig recommended that they conduct the first two reports and work on something to address the issues to better geolocate cases. Mr. Hanley asked if he was referring to using the 49 census tracts; Dr. Craig said this was correct. Mr. Hill suggested doing something different if the third report shows large differences. Dr. Davidson pointed out that zip codes go along with P.O. boxes. In her opinion, Dr. Davidson said, the third report is a good proposal, but she was not sure it would provide the same results because it would involve eliminating a large portion of those particular census tracts. Mr. Hill asked about the difficulty involved in conducting that particular study; Dr. Hanley indicated that it would involve evaluating a significant amount of data. Dr. Cibulas expressed concern that it would not be a credible study, indicating that their epidemiologists would probably not let them do a study of that nature.

Dr. Davidson suggested applying the idea they have been discussing–using modified census tracts–that would exclude Blount County, but include all of Meigs, Rhea, and Roane Counties. Mr. Lewis asked if this was also including what Dr. Cibulas had said. Dr. Cibulas indicated that if they were comfortable with the modified plume area, then this type of analysis was feasible and they should definitely go forward with that.

After discussion among the ORRHES members, Dr. Davidson read the following motion: "The ORRHES recommends that the Cancer Incidence Review report should include an analysis of each of the eight counties individually; a modified census tract analysis that will include all of Meigs County, all of Rhea County, all of Morgan County, but exclude Blount County. Otherwise, remaining counties stay as they are in the census tract." The recommendation passed with 12 votes in favor, none opposed, and no abstentions.

Dr. Cember asked whether commonly occurring cancers, such as skin cancers, would be included in the total number of cancers. Dr. Davidson said she was not sure, but expressed her belief that skin cancer was not included. Dr. Craig explained that they had selected particular cancers that were somehow related to their areas of interest.

Though he said he trusted what Dr. Cibulas said, Mr. Lewis expressed an interest in having things in writing. He said that some plumes might go downstream, while others might go upstream. He asked whether ATSDR would evaluate the plumes in a segmented fashion by considering the different contaminants associated with different plumes or if they would homogenize them. He asked whether they would separate them in relation to how they had initially drawn the map.

According to Dr. Davidson, Ms. Williamson had said that this analysis should not be associated with any particular types of exposure (because it could not do that) and that they needed to be mindful of whether the analysis will convey to people that they can associate exposure with the outcome of these data when they cannot. In his opinion, Mr. Lewis said, they sometimes had to use this type of approach to get people to bring up their health issues. Mr. Lewis said he was not stating that there is a connection, but that was the way they looked at things. He questioned not following this logic when they had drawn a map based on the plumes.

Dr. Davidson said that they were looking at the entire map; Mr. Lewis was referring to particular small areas. ORRHES could make a decision on further investigations based on the findings; however, they did not want to give the impression that people can associate their cancers with a particular plume. Mr. Lewis asked how many times he needed to say this: they must address these types of things if they are going to meet the needs of the community. Dr. Davidson suggested that ORRHES make an additional recommendation to request that particular type of analysis, which was more specific than what had been voted upon. She said she was not indicating that they could not request that particular analysis; she stated that they had to put that particular recommendation on the table so there would be no mistakes as to what was being requested.

Mr. Lewis said he had been instrumental in identifying the census tracts, noting that they were originally only planning to deal with data at the county level. He said he had found information on a site in New York, which he had shared with the group. He stated that they held a discussion about subdividing their information and tying it into plumes. As a result, in his opinion, they ended up with a modified version of their original intent of evaluating the plumes. He expressed his belief that census tracts were not necessary if they were not going to look at the plumes, except for the purpose of separating Knox County. In his opinion, he said, subdividing by plumes would be helpful to people and give them an idea of what is going on in the area.

Dr. Davidson suggested that ORRHES make a specific recommendation for this type of report if the subcommittee had an interest in it. Mr. Lewis recommended that ATSDR look at the data by plumes. He indicated that he was not sure this would work, but said that ATSDR needed to look at the plumes, evaluate them, and present the findings to ORRHES. Ms. Adkins asked whether this would factor in the ridges and aerial pathways instead of only where contaminants were blown. Dr. Cember indicated that it was inherent that an airborne plume would follow those.

Mr. Lewis said he was not asking that information be so pinpointed that it removes anonymity; rather, he requested that information be general enough that people can make sense of it. In his opinion, he said, people would be interested in this type of information. Dr. Cibulas said that this would require a staged process. If ATSDR sees something in the county-level data, then the agency will (if it can) work to try to identify more specific plume-type areas. He said that they could make a recommendation now, but they would need to see if anything could even be identified.

Ms. Adkins said she also had a wind direction map that shows the direction at different times of the year, which could be helpful in this context. Mr. Hill asked about the difficulty of generating a map similar to Ms. Adkins' that would pinpoint where the actual cases have been identified, but not be specific enough to pinpoint people. In his opinion, he said, this could help them see areas of potential concern. Dr. Cibulas was not sure, but said it should not be too difficult via GIS technology. Dr. Evans indicated he had done something similar at Paducah Gaseous Diffusion Plant, stating that it was possible to rank cancer incidences in a census tract by frequency and incidence. Dr. Cember asked if Dr. Evans was referring to using a colored pit to designate that site of each cancer. Dr. Evans said this could not be done. Dr. Creasia questioned how they could possibly pinpoint cases when so many addresses were unknown.

Mr. Lewis asked Dr. Evans how he did this at Paducah. Dr. Evans explained that he used coded census tracts, not points. Mr. Hill said that zip codes would be helpful. Dr. Davidson suggested they ask Ms. Vowell if the TDOH would allow its data to be used in this manner. Ms. Vowell said she would have to speak with people at the registry, but–based on conversations she had with Toni Bounds (formerly with the registry)–you had to be careful when using small numbers because people could probably be identified.. In her opinion, she said, this would get into concerns associated with the Health Insurance Portability and Accountability Act of 1996.

Mr. Lewis asked why the Paducah information had never been presented as an example and expressed an interest in reviewing what was done at Paducah. He indicated he had not seen this in the PHA. Dr. Evans said it could possibly be included as an appendix.

Regarding Mr. Lewis's motion, Mr. Hill suggested asking for as much detail as possible. He asked if they had to wait until the next ORRHES meeting to obtain the information or if it could be provided to the work group as soon as it is available. If they see a pattern with an example, he said, then they can ask for more information. He did not want to wait and do nothing, he said, until the next ORRHES meeting. Mr. Hanley replied that the report could be drafted with an internal review started in July. The report would not be released, however, until the communications plan was ready. ATSDR's Community Involvement Branch will be presenting this plan to the Community Concerns and Communications Work Group (CCCWG) at the end of July. After this, ATSDR will take comments and present the plan to ORRHES at its following meeting. ATSDR will take their comments and implement them into the plan. Mr. Hanley indicated that Mr. Lewis and Dr. Malmquist have been working on this for a long time and continue to note the importance of effectively communicating the findings. The report will be presented to ORRHES, ATSDR will receive input from the subcommittee, and it will be released around October 2005.

Referring to Mr. Hill's comments, Mr. Lewis said, they were asking to talk to Ms. Williamson or someone else soon so that they could get an idea of the findings and the direction to determine whether or not to proceed with Dr. Cibulas's suggestion. He explained that they were not necessarily asking for a formal report: they wanted some input and general discussion at a work group meeting to guide the effort. Mr. Hill expressed concern with waiting until November to see any information in case it is not what they had expected. Mr. Hanley asked what specific information they were asking to speak with Ms. Williamson about. Mr. Lewis answered that they were asking to speak with her about the data and plumes to follow up on another level of detail. Dr. Davidson suggested that Dr. Malmquist contact Ms. Williamson to set up a work group meeting to look at the data.

Dr. Davidson indicated that there was a motion on the table to ask ATSDR to conduct a cancer incidence analysis by plume. Dr. Craig expressed his belief that this was going to be another level to evaluate if the data showed something. Dr. Davidson rephrased the motion: "ORRHES recommends that ATSDR conduct a cancer incidence analysis by plume if there are data indicating that it can be done." The motion passed with 11 in favor, none opposed, and one abstention.

Exposure Evaluation Work Group

Filling in for Dr. Malinauskas, Dr. Craig began by saying that (to his knowledge) the EEWG had met once since the last ORRHES meeting to discuss comments received on the White Oak Creek radionuclide releases PHA. The comments were compiled and evaluated. It is the recommendation of the work group that ORRHES recommend that ATSDR address and respond to the ORRHES comments on the PHA for Oak Ridge Reservation White Oak Creek radionuclide releases. Everyone has received copies of these comments, and the EEWG officially recommends that the comments be passed from ORRHES to ATSDR.

Dr. Davidson made a small modification to comment 38, regarding weighting factors. The comment asked for examples, but she was requesting that ATSDR also include the actual weighting factors used in the calculations and provide them in the document. Dr. Craig said that this correction would be included.

Mr. Lewis said that a visitor from a Coalition for a Healthy Environment had also attended the meeting. In Mr. Lewis's opinion, the visitor had done an excellent job of explaining his position regarding an article he had written in the newspaper. Mr. Lewis had invited him to the meeting, and said that it was refreshing to have him there. According to Mr. Lewis, the group embraced this new visitor and Dr. Malinauskas invited him back to provide input at additional meetings.

Ms. Adkins said she had learned many interesting details since this report was released. She said she had a list of 222 statements from people noting where things were dumped and buried. She referred to number 131 on her list, which was one of her examples: someone indicated that nerve gas was disposed along White Oak Creek. According to her source, Ms. Adkins said, phosgene was burned openly in an open fire by the creek. She said someone also told her about hexavalent chromium being dumped by the creek that, in her opinion, was never really addressed. She expressed her belief that there are a lot of these issues that are not discussed, but that people know about. Dr. Davidson asked whether Ms. Adkins was going to add her comments to those being submitted by ORRHES. Ms. Adkins said that she gathered so, adding that a source told her that thousands of tubes of picric acid were also dumped into the creek. Dr. Davidson asked if Ms. Adkins was trying to determine whether these chemicals were found in ATSDR's analysis. Ms. Adkins agreed that this would be appropriate.

Mr. Hanley asked if Ms. Adkins had timeframes for these disposals. According to Ms. Adkins, she had different timeframes and had been keeping notes. Dr. Craig said he believed she was referring to disposal in Rogers Quarry, where a lot of this took place. According to Dr. Craig, the waste was placed into tanks; the tanks were shot and then sunk. Dr. Craig said that these had all been cleaned up with underwater submarines at a cost of about 5 million dollars, and the areas sampled for many years. Based on her comments, Dr. Craig expressed his belief that Ms. Adkins was primarily referring to disposal that occurred in quarries. Ms. Adkins said she was referring to different disposal, but that she also had Rogers Quarry marked on her map.

According to Ms. Adkins, she also had locations where nerve gas was dumped and openly burned by DOE employees left over from World War II. Dr. Creasia expressed his belief that Oak Ridge had never had nerve gas; Ms. Adkins disagreed. Dr. Creasia explained that his expertise was in this field, and said she could believe there was never nerve gas in Oak Ridge. Dr. Davidson said it might be possible, but said she would be surprised. Dr. Craig expressed his belief that it would not have been coming out of White Oak Creek anyway.

Dr. Davidson said that they would ask ATSDR to check the monitoring records and recheck for the particular contaminants listed in Ms. Adkins' comments. She asked if there were any objections, noting that they were voting on the entire package with modifications and additions. The vote passed with 12 in favor, none opposed, and no abstentions. Dr. Davidson noted that the groundwater PHA is the next assignment for the EEWG, and asked Dr. Malinauskas set up a timeframe for having comments to him. Dr. Craig indicated the public comments are due August 19. Dr. Davidson noted that a meeting would need to be held before then.

Mr. Lewis noted that they had heard a lot of comments from Ms. Adkins on groundwater, asking how these comments would be addressed and where they would be presented (in the body of the document or somewhere else). Dr. Davidson said that they had asked earlier for ORRHES members to submit their comments to Dr. Malinauskas so they would be collated with the comments of the full subcommittee. Dr. Craig suggested that the analysis would be appropriate for the EEWG. Dr. Davidson said she would prefer to have all of Ms. Adkins's comments become part of their formal presentation of comments to ATSDR. Ms. Adkins said she would prefer to present her comments in total when she had received the data on the 300-foot-deep burial wells and present them to ORRHES at one time. Dr. Davidson asked if she would have them before they met to discuss the comments on the groundwater PHA before August 19.

To be honest, Ms. Adkins said, she was not sure what to do about her comments. She said she felt that nothing she says has any credibility and what she says is passed off as a joke. As a result, she said, she has no interest in saying anything to anyone. She indicated that she will continue to gather information, but she did not know what to do with the information or whom to give it to. In her opinion, she said, she had dozens of alarming quotes from people who did the burying and shooting of canisters, and were reportedly told by DOE officials that they could not record any conversations or report these activities. She expressed concern that she was not sure anyone here was sincere enough to hear these things and she was not sure how they could proceed without knowing what and where things were buried. In her opinion, she said, there are porous underground canals and aquifers, and learning this was the key to many issues. However, she said she felt that no one really wanted to hear about them. Several ORRHES members, including Drs. Creasia and Craig, responded that they had an interest in hearing these details from Ms. Adkins. Dr. Davidson said that this was the reason she asked Ms. Adkins to submit her comments along with those from ORRHES–because they are all taken and responded to.

Dr. Craig said that Dr. Joseph had asked Ms. Adkins for with more specific information, expressing his belief that Dr. Joseph would follow up on these issues. Dr. Davidson suggested that Ms. Adkins provide any comments on groundwater via the ORRHES to ensure that they are responded to. Mr. Lewis indicated that she could also send her comments to ATSDR. Dr. Davidson said that this was true, but in her opinion it was good to keep them together with the other ORRHES comments.

Ms. Adkins said that one person who has conducted research on groundwater for 4 years was not able to attend the meeting today. According to Ms. Adkins, this person has all kinds of information and had a PowerPoint presentation ready to show the ORRHES. In her opinion, Ms. Adkins said, there needs to be a way to incorporate this information also. Dr. Davidson asked if this individual had a copy of the document; Ms. Adkins said she did. Dr. Davidson indicated the individual could also submit her comments to ATSDR directly. Ms. Adkins expressed an interest in having the individual's report be sent directly to the groundwater staff because of her years of work in this field. Dr. Davidson said she could do this also and asked if the individual was on the e-mail list for meetings. Ms. Adkins said she was.

Community Concerns and Communications Work Group

George Gartseff said that his work group had met several times since the last ORRHES meeting, and that discussions during those meetings have had three main topics. First, the work group has discussed the updated ORRHES Web site and had a remote connection to go over the site enhancements. In addition, a usability test is planned for mid-July. Second, the work group spent a significant amount of time discussing Dr. Robert Brent's presentations. They talked about the effectiveness of these presentations, particularly at addressing community concerns. In general, the work group brought up questions about the perceptions of past failings of the community needs assessment and the effectiveness of communications with the public. According to Mr. Gartseff, the discussions on the presentations could be summed into very broad questions to ATSDR:

• What was the agency's impression of these presentations?



• Were the presentations effective?



• What measures does the agency use to gauge whether these types of outreach activities are effective?



• How are we capturing any lessons learned to bring forward for improving any future presentations involving community outreach?



• Are we publicizing these activities well enough to get the intended audience to attend?

As a work group, the CCCWG had expressed general disappointment in the fairly low attendance. Dr. Cember asked how long the attendee list was; Mr. Gartseff answered that ATSDR had given them a number of about 35 people who were characterized as those outside of ORRHES and ATSDR. Mr. Lewis indicated that the next question asked was how many people from the general public had attended. Mr. Gartseff said that the group had felt attendance was low and expressed concerns that it was not publicized well enough, which relates to questions of planning, lessons learned, and other issues.

Mr. Gartseff said that while discussing these presentations, the work group had issues related to the minutes. According to Mr. Gartseff, the minutes did not appropriately reflect some comments made during the discussions of Dr. Brent's presentations and community concerns. When these were modified, Mr. Gartseff said, they reportedly still did not reflect these concerns. Mr. Gartseff said that this led into a discovery that the format of the meeting minutes had differed from what ORRHES had become accustomed to seeing over the past few years; the work group passed a motion to not approve that set and any subsequent minutes that incorporated the different format. According to Mr. Gartseff, this also touched on administrative issues as to how the rest of the work groups and ORRHES do their business. Instead of creating a recommendation to discuss tonight, Dr. Cibulas was here to speak to this issue.

Mr. Lewis asked to make two clarifications. In his opinion, he said, if they had detailed minutes of the meeting, it would have been clear that they had broken down the full count of attendees to about 10 to 12 people in Oak Ridge and about 7 to 8 in Kingston. He expressed concern that they used the term "format" regarding the meeting minutes, but that the CCCWG had also discussed content. He expressed his belief that this was not an isolated issue, although the term "form" was being used when some of the content had been modified. In his opinion, he said, there would probably have been no issue if only the format was changed. He asked that this be recorded in the minutes.

Dr. Cibulas said that the minutes have been revised. ATSDR's Office of Communication recently looked at the minutes and made some subtle recommendations regarding them. He expressed his belief that minutes are very important as they serve as an important record for management and people who could not attend, and also are a good way to gather concerns that the agency needs to hear about, review, and respond to. He stated that detailed minutes are required under FACA. He said that he shared this concern that the minutes must accurately reflect the meetings and capture needed information in an appropriate fashion.

According to Dr. Cibulas, ATSDR had a sense that the tone of the meetings needed to be more objective. Therefore, the minutes were amended a little bit to reflect and put more emphasis on actions and decisions discussed during the meeting. He expressed his belief that the process and the content had not changed. In his opinion, he said, the change was not brought to the ORRHES because the sense was that the changes were minor. The videotapes and audiotapes are always available to back up the work group and ORRHES meetings if a closer examination of the minutes is necessary. He expressed his belief that the minutes accurately capture what the committee discusses, most importantly the actions and decisions, and that after looking at the last work group meeting minutes they would agree that they were acceptable to the ORRHES members. He indicated that if there were strong feelings that these changes were more than minor improvements, than this could be discussed further. Dr. Cibulas summarized that the changes were made after the Office of Communication expressed a strong sense that some of the minutes had tone issues and needed to be more objective.

Mr. Lewis thanked Dr. Cibulas for his comments, stating that he had raised most of the issues regarding the minutes. In his opinion, he said, there was a core issue pertaining to a particular set of minutes associated with the effort made by Dr. Cember to bring a qualified expert to assist them in discussing various issues, such as birth defects. Mr. Lewis explained that they had been trying to convey what they perceived as the root cause and weaknesses possibly associated with the low turnout at these presentations. He saw, he said, a programmatic breakdown between what they had seen advertised and the low turnout. He expressed his personal opinion that Dr. Brent was an excellent presenter, though he did not find that he had received necessary information in advance within a timely manner. In addition, he expressed his belief that Dr. Brent had not been familiar with the specific issues of the community and held conversations with him on this topic.

Mr. Lewis expressed frustration, saying that the person in charge of communications should have been reviewing this effort in order to improve the process and identify the weaknesses. In his opinion, he said, when he saw the meeting minutes, the detailed discussions in this area had appeared to be removed or sanitized. He expressed frustration that they had looked at the process and at the flyer to see its weaknesses, but expressed his belief that the level of detail regarding discussions on corrective actions to improve the process were not included in the minutes when they needed to be.

He said that the tone is conveyed when people are not representing things appropriately. He stated that he would become frustrated if someone indicated he was talking about format when his concerns were more related to content. He stated that the purpose of raising issues is sometimes not a result of a single issue, but an issue that has happened several times.

He said that he had conducted outreach, which was the reason for some of the large turnout at today's meeting. According to Mr. Lewis, when he chaired this work group he would reach out and bring people to meetings. He indicated that the effectiveness of their efforts is not only for them to understand, but also to spread the message to the public. He indicated that they needed to evaluate how they present things. He explained that they had found out Dr. Brent was giving different presentations in Oak Ridge and Kingston. The work group had also discussed how about 1,100 flyers and e-mails were distributed, and had evaluated the flyer. According to Mr. Lewis, work group members indicated that the flyer would not attract people to the meeting based on its content and appearance.

He continued that he sometimes uses a tone when he sees programmatic weaknesses or breakdowns regarding issues that have not been responded to. In his opinion, he said, the community deserves its best efforts, and said that they can do a better job of educating the public on what they are discussing to bring more people to the forefront. According to Mr. Lewis, comments made at the right time often help people, such as having Dr. Cember respond directly to questions from the public. In his opinion, Mr. Lewis said, because of his style and expertise Dr. Brent did an excellent job in dealing with some individuals who might not be considered friends of ATSDR or ORRHES. He expressed his belief that these individuals appeared to leave with a high degree of understanding and respect. Mr. Lewis expressed disappointment that there had not been a larger audience.

Mr. Lewis also expressed disappointment that key issues that have been raised in the public via newspapers and other sources were not presented to Dr. Brent so he could address them. According to Mr. Lewis, he had shown Dr. Brent an article from The Tennessean about grades in school and whether children were possibly suffering from birth defects, but Dr. Brent had not seen it beforehand. In his opinion, Mr. Lewis said, it would have been helpful to share this and other key concerns that have been expressed in the community over the last 10 years so that Dr. Brent could have addressed some of them during his presentations.

Mr. Lewis said that he had made another point–which was why he had pushed for the detail–regarding Dr. Brent's response to his question about what he would have used to advertise. He explained how Dr. Brent presented an example of what he did in Life magazine that Mr. Lewis considered beautiful, displaying information in a question-and-answer format. Mr. Lewis suggested looking at this article and comparing it to the flyer to see whether it would have helped attract a larger audience. It was a focus for him to help the community understand and bring them to the table. In his opinion, he said, there are some programmatic weaknesses that need to be improved with the advertisements and communications being developed at ATSDR, as well as some of the presentations.

He said that he applauded Dr. Cibulas for modifications made today to listening to the public at large and to their health issues. He stated that David Hackett had said that he did not know 10 people who were overly concerned about contamination issues, but most people he knew wanted to discuss health issues. He said he liked the Loudon County report because it evaluated health issues as part of its effort, stating his opinion that you gain credibility by knowing and focusing on health issues. He indicated that he would provide some of the questions and comments to Dr. Cibulas so he could see where their focus is, noting that in some cases people had some issues that would be categorized as anecdotal information. In his opinion, he said, Dr. Brent could have responded to some of these issues instead of saying that an answer would be provided later. Though some people might not consider anecdotal information, he expressed his belief that they still needed to listen to these concerns and try to address them.

Mr. Lewis said he spent about 10 years collecting and collating these types of concerns, expressing his opinion that he was not aware of how bad it was. He expressed his belief that they could make efforts to improve the situation, but was not sure that senior management was necessarily aware of what occurs at these different levels. According to Mr. Lewis, if Dr. Cibulas read some of these meeting minutes and examined the history of what has transpired with ATSDR's advertisements and other issues, he would see what they were attempting to accomplish. He expressed his hope that ATSDR took his comments as constructive criticism, saying they could work toward improvement. He recommended that Dr. Cibulas monitor what is going on so that they do not have more ATSDR staff from Atlanta sitting in the room, expressing his opinion that having too many staff attend these meetings is not effective.

Mr. Lewis also expressed concern about the fact that he had mentioned using the "Dr. Bob [Overholt] Show" and that there was no followup until afterwards. If ATSDR is going to address the public's issues, Mr. Lewis said, Dr. Cibulas should look at what is going on and see what adjustments can be made given the limited resources for that task. Mr. Lewis said that they work with Dr. Taylor, adding his view that some styles work more effectively in the community than others. In his opinion, he said, if certain things taking place were monitored closely with an objective view, then they might be able to improve operations and attract more people to come to meetings, which would benefit the community.

Dr. Cibulas thanked Mr. Lewis for his comments. They have 1 year left, he said, and ATSDR is willing to do what is necessary to make it the best year possible. He also expressed disappointment in the sparse attendance of Dr. Brent's presentation, stating he also finds him to be an excellent speaker. Since ATSDR was going into the larger CIA, it appeared logical to educate and provide some information the community on radiation, cancer, and birth defects. He said he believed that this was still a good idea, but agreed that lessons learned indicated that they had done something wrong. He said that they were all disappointed in this turnout. Over the next year, Dr. Cibulas said, they need to do better to ensure that they accomplish as much as feasible.

Dr. Cibulas said he understood Mr. Lewis's comments regarding the minutes, noting that he had given him a sense of why they had been changed. He expressed his belief that they were still minor changes, but said that he was willing to listen to a recommendation from ORRHES if the subcommittee found that the minutes were no longer consistent with what was agreed to as far as how the minutes would be captured. Although he was open to a recommendation, he noted that it was the agency's impression that the minutes capture the actions and decisions, and are what they consider to be a fair reflection of what transpires with the subcommittee.

Mr. Lewis complimented the minute-taker, Ms. Bertelsen, saying that she does an excellent job when left alone. He said he would reduce his comments as long as they are effective and do not repeat the same mistakes. In his opinion, he said, the problem is that issues raised are not being addressed, which is all he has ever asked for. He indicated that he has placed an emphasis on work group minutes so people can follow things that take place. He expressed his belief that the minutes needed to reflect when adjustments are discussed regarding programmatic issues. He indicated that he never asked for verbatim minutes, adding his opinion that continuity in the discussions is very important to those who cannot attend and as a tool to decipher what they are doing.

Dr. Cibulas stated that they would proceed with the minutes and ensure that all they fairly represent all programmatic issues. If there are comments indicating that programmatic content has not been captured, then they will ensure that it is accurately reflected. If the ORRHES leaves this responsibility to ATSDR, Dr. Cibulas said, ATSDR will make sure that the minutes are an accurate reflection of the discussion and are done correctly.

Mr. Hill said that he personally appreciates that the comments are modified, because in his opinion, they sound better than what he actually said. In his opinion, he said, they needed to be mindful that statements made by community members were captured accurately–either exactly what they said or extremely close to their actual words. He expressed concern that it really hurts community members when they find they have been misquoted or perceive that they have been misquoted, adding his belief that this has gotten them into trouble in the past.

Dr. Davidson expressed her belief that there are some instances when people say what they did not mean to say. In her opinion, she said, explanatory information can be placed into brackets and flagged as additional comments. However, she said, the minutes should accurately reflect the meeting tapes.

Mr. Hanley indicated that he has draft summary documents for two PHAs: White Oak Creek and the modified TSCA incinerator. He noted that they have discussed means of effective communication and asked for the ORRHES members to provide comments on these documents. He asked if he could receive the comments at one of the next two CCCWG meetings. He said that he looked forward to receiving the comments.

Dr. Davidson brought up the issue of public availability sessions, suggesting that the CCCWG should look into the logistics of holding these sessions–for example, how and where to hold them. In her opinion, she said, these were an effective means of communicating with the public and they needed to be established. She said that the format could be open discussion or something else; she suggested holding them outside Oak Ridge to reach people they normally do not target. Dr. Davidson asked the CCCWG to look into this as long as there were no objections. Mr. David Johnson did not object, adding his opinion that Ms. Hunter from Loudon County would be a good resource to tap into fresh ideas. He suggested that they make their process more inclusive of other personalities. Dr. Davidson checked to make sure they had Ms. Hunter's contact information, which they did.

Mr. Lewis asked Dr. Cibulas whether he found most of the comments from the public to relate to the technical issues of exposure evaluation or if most people he had heard from were interested in health issues. In his opinion, Mr. Lewis said, there was no point in having public availability sessions if they were going to be on topics that the community is not concerned about. Before going to the community, he recommended, they should find out the issues and advertise properly. Then, he said, they could go to the community and address the concerns. He indicated that he had proposed that the Health Outcome Data Work Group evaluate these types of issues, but no meeting has been held yet. He expressed his belief that they could say that the comments received today had disrupted their activities, but said this had happened because there has been no forum for these individuals to discuss these types of issues even after being here for 4 years. In his opinion, he said, this was another programmatic issue and they needed to set up something that could deal with responding to these issues, similar to how Dr. Cember responded to some of the public's questions today.

Mr. Lewis referred to a comment, from the Paducah PHA, in which a man asked about synergistic effects of an ordnance plant and the Tennessee Valley Authority (TVA) on the releases at Paducah. According to Mr. Lewis, some concerns were grouped together, and the response said that workers needed to report their problems to their companies. Mr. Lewis expressed his belief that this individual was dealing with issues outside the fence and was asking ATSDR to look at these; in his opinion, this showed an avoidance of issues and this had to be dealt with to help people understand. He indicated that some people are better than others at helping people understand these issues, and stated his opinion that they needed to lead with these people. He said that some simple actions get results, such as testing a well because someone asks for it. In his opinion, he said, this was what people want, adding that Dr. Brent did this in how he dealt with individuals and Dr. Henry Falk did this for the Scarboro community when he looked at children to address the community's health issues.

Dr. Davidson tasked the CCCWG to work with ATSDR to discuss the issues and concerns regarding the setup of availability sessions and to come to an agreement on how these should be conducted.

In her opinion, Ms. Galloway said, the continuing problem is that the public wants to discuss individual health concerns, but they are chartered to discuss public health concerns. She expressed her belief that the public feels their concerns are being homogenized, and she has not seen or heard a solution to address this issue–when the public has one expectation and ATSDR is chartered to do something quite different. She said that people are looking for answers to their particular health concerns, and recommended that they put a lot more consideration into how to address these people even though ATSDR is not here to address individual health concerns.

Dr. Cibulas said that this was very fair. He explained that ATSDR is a public health agency, and in his opinion, it is a disservice for people to feel that the agency is neglecting this issue. She said that he was pleased when he spoke with Ms. Stokes personally and she said she had been to two of ATSDR's AOECs. He said her concerns are still concerns for which she has not received satisfactory answers, but he was not sure what else they could do; they were talking about public availability sessions, and if they used this route to deliver PHAs and bring in the community, they would need to ensure that health is a significant part of these sessions. In his opinion, he said, it would be a complete disservice for ATSDR to neglect that it is a public health agency or for people to feel that the agency does not care about their health.

Mr. Gartseff indicated that ATSDR, via Dr. Cibulas, had responded to the main points on the work group meeting minutes issue. The CCCWG will address other issues as discussed during this meeting (such as public availability sessions) and will establish contacts with the agency if needed.

Ms. Robinson presented an update on the Oak Ridge Web site redesign project. She presented a project status diagram to show completed and upcoming activities. ATSDR was still making efforts to conduct the usability testing. At the March 22 meeting, the ORRHES members ranked a list of site enhancements, which ATSDR has been working on since that time. They had assumed that ORRHES members would have had more time to help ATSDR recruit people for the usability testing, but this has not occurred due to all of their busy schedules. She indicated that they needed to put some time into recruitment, and had asked the CCCWG whether it should conduct testing without enough subjects or postpone the testing. Based on discussions with the CCCWG, it was decided to postpone the testing. Ms. Robinson indicated that she spoke with Ms. Hunter and other meeting attendees, who expressed an interest in participating in the testing.

Ms. Robinson referred to a slide detailing the Web site enhancements and read through them in order from the highest- to the lowest-ranked item.

• Interactive map: show areas of projected contamination by year and community areas–show overlapping exposures.



• List of top issues (what people are asking about–questions and answers).



• Links to additional information on possible health effects by types of contaminant (could be cross-linked with interactive map).



• Add "Current Activities" section (list of Oak Ridge PHAs in progress) and add a "3-month look-ahead calendar."



• Add timeline to show the operating periods of the three main facilities (X-10, Y-12, and K-25).



• Best ORRHES and work group presentations.



• Search engine for minutes of ORRHES and work groups only.



• Open-ended feedback or comment input box.

ORRHES members also provided individual suggestions, but these were not discussed in detail. She indicated that Wilma López has been working on many of the site enhancements. One enhancement that is not easy to address is the interactive map. Ms. Robinson explained that they needed the PHAs completed to populate the map and to have the content programmed. She said she could go into details regarding the list of top issues and the actions that will be taken to address each one, but noted that the CCCWG had discussed them and recommended that everyone read these at their leisure. If anyone had questions, she asked that they send them to the work group–they will work on them together.

According to Ms. Robinson, nearly all of the enhancements have been addressed. That morning, she had spoken with Ms. LLópezpez, who indicated that most of the enhancements are not visible on the Web site because they are still undergoing QA/QC on the test server. They should be posted from the test server to the main site next week or the following week. ATSDR plans to come to Oak Ridge during the week of July 11. They have gone ahead and begun making enhancements instead of focusing on recruiting for usability testing. In her opinion, Ms. Robinson said, this would be beneficial because they could now test some of the enhancements.

Ms. Robinson referred to a slide summarizing the project issues. She explained that there have been what she considered to be good interactions and discussions with the CCCWG about the site. In addition to testing, in the next 6 months ATSDR is going to perform routes updates as possible, including minutes, calendar of events, training events, and PHAs as they are released. The next round of major enhancements will start in the last quarter of 2005. Over the next 3 months, ATSDR will maintain the site and conduct usability testing. Then, ATSDR will revisit the site enhancements. In her opinion, she said, the site is pretty rich, and now they needed to see what is and is not working.

Ms. Robinson emphasized the need for additional photos to make the site more interesting. Dr. Craig said that Ms. Krausse, who attended the meeting, is the head of publications at ORNL. He said that she would have access to thousands of photographs. Ms. Robinson indicated that community photographs, such as pictures of the Scarboro community, were needed. Ms. Robinson said she could try to schedule a meeting to obtain pictures during the week of July 11. Mr. Hanley stated that he would set this up with Dr. Joseph.

Ms. Robinson pointed out that if they could not recruit enough individuals for the usability testing, then they might have to delay it. By the next time Ms. Robinson reported to them, however, she intended to have the results of the usability testing. She indicated that there were some questions about the site enhancements, and apologized that she had forgotten to bring the Web site statistics with her.

Regarding an interactive map, Mr. Lewis provided Ms. Robinson with a figure titled "Timeline of Major Contaminant Releases" from one of the Oak Ridge Dose Reconstruction Reports. He expressed his belief that documents such as this could be obtained if they took the time to look on CD-ROMs. In his opinion, his said, people could follow this type of pictorial image showing dates of operations and releases at the ORR. According to Ms. Robinson, ATSDR has shown an interest from the beginning in doing this type of map and has begged them to help provide this type of information. She added that a tremendous amount of work has gone into the Web site. They still needed their help, however, and she asked the ORRHES members to look at their own records for information that could be used. Mr. Lewis expressed his belief that this type of information puts issues into perspective, such as where someone lives respective to where a plume is located, which people understand and can correlate their issues with. In his opinion, he said, most people questioned the releases that took place when they were living in a certain area during a particular time period. He suggested also having someone who can talk about these issues from a technical and clinical perspective, expressing his belief that these needed to be combined to reach people and in order to have some decent public availability sessions.

Ms. Robinson said that they could discuss some of the visual ideas that the work group has come up with and see if they can develop a strategy for completing some of them. This would be included in the next set of enhancements, which does require quite a bit of time. She said she completely agreed with Mr. Lewis about the strategy, but the question is having time to complete it. She requested that ORRHES members provide her with any additional information, such as the timeline brought in by Mr. Lewis.

Dr. Cember asked about the hit count. Ms. Robinson answered that the site had about 6,000 unique visits over a 4-month period. There was a 50% page reload, indicating that the site was receiving some repeat visitation. The site is able to tell if someone is reloading the page into the browser as well. Spikes have been observed as new stories appear (such as when the White Oak Creek PHA was released), suggesting that people are coming to the site. In her opinion, she said, this is not the most trafficked site, but it is receiving a significant amount of traffic from people who are probably generally interested and looking at the site. People are spending an average of 3 minutes per page, indicating that people are reading the content.

Mr. Hill asked how ATSDR would recruit for the usability testing. Ms. Robinson indicated that this was the labor-intensive portion, involving a snowball sample. She is working with Dr. Taylor and asking him to network in key groups in town and call people in Oak Ridge. Ms. Bird in the ATSDR Oak Ridge Field Office will be assisting with recruiting also. Mr. Hanley asked Mr. Hill if there were any union members who would be interested. Mr. Hill asked how they would draw people in. Ms. Robinson explained that they would conduct a convenient sample using a snowball technique. She expressed her hope that the ORRHES members would assist with the recruiting and call friends. She had gotten people from Loudon County to sign up today. They had to start making calls, and asked for their help.

Dr. Davidson asked if she was suggesting that they contact their friends, and questioned what time the testing would take place. Ms. Robinson answered that she should talk to their friends and e-mail their phone number to Ms. Horton. ATSDR will call the individuals to see if they can come during the week of July 11; however, the exact day and time are not available now. She asked them to explain that they are on the ORRHES, which recently updated its Web site, and that their participation would help improve the site. Dr. Davidson asked if they would indicate a range of times so people would know if they were available and when to be expected. Ms. Robinson explained that the testing would be during the week of July 11, and that the testing might occur on July 12 and 13 depending on responses from potential participants. People will be provided with a time range to be in the field office, and 1-hour (or possibly 30-minute) appointments will be booked. Participants will be given five tasks to perform and asked what they liked and did not like about the site.

Dr. Davidson asked if they wanted computer-savvy or naïve individuals. Ms. Robinson indicated that they were looking for novices and experts, but that people unacquainted with the site were the most preferred. Mr. Hill asked Ms. Horton to prepare an e-mail that they can forward to potential participants. Ms. Horton indicated she is out until July 5. Ms. Robinson said she would prepare an e-mail and forward it to Dr. Taylor.

Mr. Lewis suggested recruiting at high schools (particularly science teachers) and also among fellow church members. Mr. Gartseff asked how many people were needed. Ms. Robinson answered that they were looking to test about 16 people, and therefore would need to recruit 24.

Ms. Robinson summarized that she would send an e-mail for them to forward that recapped their conversation today. She asked that they send the e-mail and follow up with a phone call.

Vote on Work Group Recommendations

Dr. Craig stated that “ORRHES recommends that ATSDR address and respond to the ORRHES comments on the PHA for Oak Ridge Reservation White Oak Creek Radionuclide Releases.” This includes any modifications and additions made during the meeting. The vote passed with 12 in favor, none opposed, and no abstentions.

ORRHES Recommendations

The ORRHES recommends that the Cancer Incidence Review report should include an analysis of each of the eight counties individually; a modified census tract analysis that will include all of Meigs County, all of Rhea County, all of Morgan County, but exclude Blount County. Otherwise, remaining counties stay as they are in the census tract. The recommendation passed with 12 votes in favor, none opposed, and no abstentions.

The ORRHES recommends that ATSDR conduct a cancer incidence analysis by plume if there are data indicating that it can be done. The motion passed with 11 in favor, none opposed, and one abstention.

Schedule of Next Meetings

Dr. Davidson noted that Dr. Malinauskas needed to find a date for the next EEWG meeting prior to April 19 to discuss the off-site groundwater PHA. Dr. Davidson recommended that Dr. Malmquist contact Ms. Williamson to set up a time to present her preliminary information to the work group.

For the next ORRHES meeting, Ms. Horton asked about participants’ availability on September 8 or 20. After discussion, Ms. Horton indicated that Thursday, September 8, was the tentatively scheduled date for the next meeting. Dr. Taylor would send an e-mail to inform everyone of the date.

Additional Business

Ms. Horton said that she could present on DHAC collecting information around the ORR or present at a later time. There were no objections to Ms. Horton not presenting at tonight's meeting.

At a recent EEWG meeting, Mr. Hill said, they had discussed the fact that PCB levels in fish were not decreasing. He had asked for more information and had anticipated this information being presented today. He expressed concern that this was a new issue to him, and expressed his belief that this information would be interesting and beneficial to the subcommittee. He asked about the status of this request. Mr. Hanley indicated that ATSDR is still working on the PHA, and the agency would follow up on this concern in the document.

Dr. Cember indicated that coal is a main source of mercury contamination. He asked how much mercury is in coal in the steam plants (Bull Run and Kingston). Dr. Taylor said that this would be addressed in the mercury PHA. Mr. Hanley explained that the PHA would cover the years when major mercury releases occurred in the 1950s and 1960s. The Bull Run Steam Plant was not operating at that time, but the Kingston Steam Plant was. Thus, the PHA will include an evaluation of the Kingston Steam Plant.

Mr. Lewis asked if they were taking into account that about 70% of those units were supplying power to DOE. He asked them to be mindful that there were not many lights then, and to not assume that the power was going to the public. In his opinion, he said, a lot of emissions released from the stack and entering the valley were probably very bad, although they might not have been in the same wind direction. According to Mr. Lewis, today the Kingston Steam Plant is ranked as the twenty-third polluter. He said they might be surprised when they look at the location of the stacks and the coal being burned in the valley.

Dr. Davidson indicated that they were provided with a handout for recruiting of the Web site usability testing.

Action Items from This Meeting

• Dr. Malinauskas will schedule a meeting prior to April 19 to discuss comments on the off-site groundwater PHA.



• Dr. Malmquist will schedule a meeting for Ms. Williamson to present information to the Health Outcome Data Work Group.



• The next ORRHES meeting is tentatively scheduled for September 8.



• ORRHES members will review the TSCA and White Oak Creek summary documents and provide comments to the CCCWG at its next meeting (or the one following that) or to ATSDR.



• CCCWG will investigate the possibility of holding public availability sessions.



• Ms. Robinson will develop and send to Dr. Taylor an e-mail for ORRHES members to forward to potential Web site usability testing subjects.



• ORRHES members will recruit people for usability testing during the week of July 11.



• Mr. Hanley will set up an appointment via Dr. Joseph for Ms. Robinson to review photographs for the Web site.



• When available, hard copies of A Toxicology Curriculum for Communities will be provided to Dr. Creasia, Dr. Cember, Mr. Lewis, Mr. David Johnson, and Mr. Washington.

Meeting Adjourned

Dr. Davidson adjourned the meeting at 7:50 p.m.

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