Community Concerns and Communications Work Group

Community Concerns and Communications Work Group

July 19, 2005 - Meeting Minutes

Attendance

ORRHES Members attending:
George Gartseff (Chair), Kowetha Davidson, David Johnson, and James Lewis

ATSDR Staff attending:
Loretta Bush (phone), Jack Hanley (phone), Marilyn Horton (phone), Trent LeCoultre, and Maria Teran-MacIver

Public Members attending:
Lynne Roberson

TA Consulting, Inc. (contractor):
Amanda Bird

ERG Contractor:
Liz Bertelsen (phone)

Purpose

George Gartseff called the meeting to order at 5:30 p.m. During the meeting, the work group discussed approving past meeting minutes, establishing meeting agendas, lessons learned, an update on the L-tryptophan video request, the cancer incidence assessment (CIA) communications plan, the summary document for the Toxic Substances Control Act (TSCA) Incinerator Public Health Assessment (PHA), and the summary document for the White Oak Creek (WOC) Radionuclide Releases PHA.

Meeting Minutes

At the last meeting, Mr. Gartseff explained, the CCCWG passed a motion to not accept or approve any meeting minutes pending a resolution of the April 26 minutes and ATSDR's handling of those minutes. He noted that this had been discussed at the June 28 ORRHES meeting, and asked James Lewis if he felt as though he received an adequate response and was prepared to move forward with approving the minutes.

Mr. Lewis said that Dr. Bill Cibulas responded to him in a fair manner. In his opinion, he said, he had a problem with the way that Mr. Gartseff had presented the issue as regarding format when it was also about content. He said he wanted to compliment Liz Bertelsen for her excellent work on the last set of meeting minutes, and expressed his belief that Dr. Cibulas appeared to understand his comments about programmatic issues. According to Mr. Lewis, there are lingering issues that have had a generic impact on the effectiveness of their operations and activities. If the minutes provided the same amount of detail as the set of minutes he just read, then he would have no problems with them.

Regarding the past meeting minutes, Mr. Lewis said, he was willing to accept them based on the discussions with Dr. Cibulas. As a group, however, they reserved the right to ensure that the minutes followed the recommendations that were in place. In addition, he stated, this was also contingent upon Ms. Bertelsen continuing to do the same type of work, and as long as no major modifications were made to change the intent of something or to spin wording to put the agency into a better light than it should be in. Mr. Lewis indicated that there was an example of this in the newspaper this week, referring to an article written by Janet Michel. Mr. Lewis expressed his opinion that the article was interesting, adding that the meeting minutes reflect much of what is going on. In his opinion, he said, some sort of corrective action needed to be taken against these. Mr. Lewis indicated that he was prepared to accept the meeting minutes based on Dr. Cibulas's commitment to deal with these programmatic issues and to ensure that they are documented appropriately—not swept under the rug.

Mr. Gartseff made a point of clarification regarding Mr. Lewis taking exception to his use of the word "format." In his opinion, Mr. Gartseff said, the term format is inclusive of content. Thus, when using the word format, he was referring to detail versus lack of detail. He expressed his belief that this was a format issue, including the appearance of the minutes and their content. He indicated that his statements were not dismissive of Mr. Lewis's comments in anyway. Mr. Lewis said that he appreciated Mr. Gartseff's remarks, adding his opinion that Dr. Cibulas appeared to understand what he meant by content and noting that he had shared some specific examples with Dr. Cibulas. Mr. Lewis said he was willing to accept the minutes and move forward.

Mr. Gartseff explained that they still had an outstanding motion from the last meeting, which they needed to remove in order to go forward and accept the past minutes. The motion was to remove the restriction passed at the June 14 CCCWG meeting to not approve any meeting minutes from April 26 onward until this issue was addressed by ATSDR. David Johnson made a motion to approve, and Mr. Lewis seconded it. The motion passed. Mr. Gartseff said that the work group would resume review of approval of meeting minutes per further discussion of them.

Mr. Lewis indicated his acceptance of the April 26 meeting minutes as amended. There was no further discussion, and the meeting minutes were approved as previously revised. Mr. Gartseff stated that meeting minutes from May 10, May 24, and June 14 remained for approval. He asked whether they should be discussed individually or collectively. Mr. Johnson suggested going through the minutes individually. Mr. Gartseff asked for discussion on the May 10 meeting minutes. There was no discussion and the minutes were accepted. Regarding the May 24 meeting minutes, Mr. Gartseff stated that he personally had no issues with them. These were also approved by the CCCWG.

Mr. Gartseff stated that Dr. Owen Hoffman had provided revisions on June 30 for the June 14 meeting minutes. He asked whether the group had reviewed these, and if there was any further discussion. Kowetha Davidson asked if these comments would be incorporated directly into the meeting minutes or if they would be attached as an addendum. Mr. Gartseff replied that Bill Taylor's e-mail indicated that he had addressed the comments; although, he had not seen ATSDR's version with Dr. Hoffman's comments incorporated. Dr. Davidson suggested that they note whether these were incorporated directly or attached as an addendum. Mr. Lewis asked Ms. Bertelsen how she had addressed Dr. Hoffman's comments. Ms. Bertelsen replied that she had not received these comments, noting that Dr. Taylor makes the revisions. Marilyn Horton said she had not seen Dr. Hoffman's revisions in the minutes yet, but that they could certainly be included as an addendum.

Mr. Gartseff said that the only message he had from Dr. Taylor concerning the minutes was that he had received Dr. Hoffman's comments, though not Susan Robinson's, and to proceed as necessary. He expressed his belief that the comments had not been merged into the minutes. He indicated that they could either accept the draft minutes with Dr. Hoffman's comments included as an addendum or request that ATSDR combine them. Then, they could vote on them at a later date. Due to the sensitivity of the issue, Mr. Lewis said, the comments should be looked at and voted upon later. Therefore, he recommended waiting until Dr. Taylor returned.

Mr. Lewis made a motion to hold the discussion of the June 14 work group meeting minutes until Dr. Taylor had returned and combined Dr. Hoffman's comments into the June 14 record. Mr. Johnson seconded the motion, and the motion passed. Mr. Gartseff indicated that they would table the discussion of the June 14 minutes until the next meeting, but the minutes from April 26, May 10, and May 24 have now been accepted as final and could be posted to the Web site.

Meeting Agendas

Mr. Lewis asked how agendas were being established now, indicating that there used to be a standard way of developing them. Mr. Gartseff asked if this was for ORRHES or work groups. Mr. Lewis said both. Dr. Davidson explained that Ms. Horton attends the work group meetings, and based on those, prepares the ORRHES agenda. Mr. Lewis questioned if they established or distributed a draft agenda. Dr. Davidson said Ms. Horton does this. Mr. Gartseff said that this occurs for ORRHES meetings, but not for this work group. For the CCCWG, Mr. Gartseff stated, the discussion topics are sent via e-mail and announced at meetings. As far as setting the agenda, Mr. Gartseff said that any work group member could ask for a particular topic to be discussed, although typically, they have been tracking either deliverables or outstanding issues.

Lessons Learned

Mr. Lewis expressed concern that they never went back to address or discuss the lessons learned associated with the low turnout of the Dr. Robert Brent presentations, expressing his belief that Dr. Cibulas had agreed with this type of follow up. In his opinion, Mr. Lewis said, they should have gone back to discuss what he considered the root cause of this issue—the flyer distributed to promote the meeting. Although some people in the work group found that this was adequate, Mr. Lewis stated his view that many people did not find that it contained enough or appropriate detail to attract the community. When they have open issues such as this and plan to hold other meetings in the future, Mr. Lewis expressed his belief that some corrective action or response and a planned approach was needed from ATSDR in terms of lessons learned. In his opinion, Mr. Lewis said, this was not a single occurrence; it has taken place on two or three occasions where information used to spread a message was not well received or understood. Mr. Lewis recommended this topic as a potential agenda item for future discussion.

Mr. Gartseff said that this was a fair comment, noting that there is always an opportunity to bring up these types of issues under new business. Regarding this particular issue, Mr. Gartseff indicated that they would have an opportunity to comment on the communications plan for the CIA on August 8 or 9. He said that they needed to choose a preferred date for that meeting tonight, noting that the CCCWG would not have a meeting on July 26. He added that they have ample opportunity to suggest agenda items for the work groups at anytime.

Dr. Davidson said she was not sure whether Mr. Lewis was referring to ORRHES or work group meetings. He said he was talking about both. Dr. Davidson stated that ORRHES has not received a recommendation to bring this issue up again. Mr. Gartseff explained that they discussed this issue during several meetings, noting his personal preference was not to return to talking about Dr. Brent again tonight. He agreed that this was an outstanding issue, and that they had not received closure on the lessons learned aspect of it. Mr. Lewis expressed his belief that, when there is concern about an issue of this magnitude, ORRHES should accommodate these types of discussions even if a formal recommendation has not been made. Mr. Lewis expressed concern that they spend a lot of money to develop these things, but then they miss opportunities and end up with articles written in the newspaper. In his opinion, he said, someone needed to look at this issue and figure out how to address and improve the situation. He said that they could not say that they have failed and simply move on, expressing his belief that this was a significant issue. Mr. Gartseff replied that no one was saying that it was not.

If this was a significant issue, Dr. Davidson said, then something should have come out of this work group. She explained that initial discussions take place in the work groups, and any significant issues are then brought to ORRHES. Mr. Johnson expressed his belief that the issue goes beyond this, referring to what he identified as a scathing article written in The Oak Ridger today. In his opinion, he said, as written by Janet Michel, from her vantage point there is diminishing trust and respect from the community. In order to give their actions some validity, he said, it was vitally important to have trust with the community as they continued their activities. In his opinion, Mr. Johnson stated, if they did not continue needed community outreach, then their actions were essentially counterproductive and nil.

Jack Hanley explained that they have taken a lessons learned after each public meeting. He said that they have listened to the dialogue from the work group meetings, and even if specific recommendations are not developed, they note the comments and suggestions made. When they go to have another type of meeting, the agency will modify, adjust, and present the plan to the subcommittee. He said that ATSDR would be presenting the CIA plan to get their feedback, noting that modifications were already made to the plan based on their previous comments. According to Mr. Hanley, they are always trying to improve, learn, and make adjustments. He indicated that the work group has an opportunity to provide comments during these meetings or via a formal recommendation to ORRHES. Before the next meeting, such as for the CIA, ATSDR is putting out the communications plan and giving the work group an opportunity to provide suggestions and input. Mr. Hanley said that each time is a lessons learned, expressing his appreciation for their assistance and comments that they have been providing.

According to Mr. Lewis, ATSDR had a history of producing what he considered to be weak advertisements and publications. In his opinion, he said, oftentimes the agency would put out a plan that is very generic. He stated that they have had lapses in some cases that span a year or 2 years, and said that these things needed to be brought together, looked at, and refined. Mr. Lewis added that his suggestion of using Dr. Bob Overholt of the "Dr. Bob Show" was not followed up on. He expressed his belief that someone should have provided them with a response or a reason for why the show was not used, noting that he received no feedback in this area. In his opinion, Mr. Lewis said, using this type of show could assist them in bringing the community together.

Dr. Davidson said that if Mr. Lewis desired this type of feedback, then he needed to bring this issue to ORRHES. She stated that they were all aware that ATSDR would not and could not formally respond to work groups. Mr. Lewis replied that the agency could respond. Dr. Davidson said that ATSDR could not formally respond, adding that the agency had to be careful because this could interfere with regulations that had to be followed. Mr. Gartseff referred to Mr. Hanley's comments, noting that the agency is listening to their discussions. He said that ATSDR has not yet had the opportunity, however, to act on some of the specific suggestions, such as the "Dr. Bob Show," because this was brought up after Dr. Brent gave his presentations. In his opinion, Mr. Gartseff said, it was not fair to criticize the agency for not using something that was brought up after the fact. Mr. Lewis said that this was not true. However, Mr. Gartseff said, the CCCWG did hold discussions on the Dr. Brent presentations for three or four work group meetings. Although they did not develop a recommendation for ORRHES, and therefore nothing was formally recommended to ATSDR, there has been dialogue between the work group and ATSDR. They have been listened to by Mr. Hanley and Ms. Horton, and also received a response from Dr. Cibulas in person. Mr. Gartseff explained that they could not expect specific actions to occur until they made a recommendation identifying particular actions.

Mr. Lewis stated that he would say this again, and try to be as clear as possible. He indicated that there is a certain degree of professionalism and aggressiveness in preparing things to reach people. According to Mr. Lewis, in the past they have questioned and challenged some of the methods that were used to reach people. He stated that he recommended contacting the "Dr. Bob Show" before Dr. Brent's presentations, indicating that this could likely be found in the minutes.

Mr. Lewis expressed his belief that mindless compliance to the interpretations of the regulations does not always accomplish the job. Dr. Davidson answered that this is not an interpretation, but the regulation. In his opinion, Mr. Lewis said, the regulation and effectively taking action were two different things. Dr. Davidson expressed her belief that the regulations are in place and have to be followed, and although they might not agree with them or like them, Congress put them in place for a purpose. Mr. Lewis said that it was ATSDR's responsibility to tell them if they violated a regulation, and asked where they had violated one. Dr. Davidson said that expecting a formal response to a work group recommendation was violating this regulation. Mr. Lewis questioned how an expectation could be in violation of a regulation. According to Dr. Davidson, they have known since they started that ATSDR cannot formally respond to something from a work group. Mr. Lewis indicated that there was a difference between a formal response and corrective action. Dr. Davidson said that if the work group wanted to request Dr. Overholt, then the CCCWG would have had to first form a consensus; the request could not, however, come from an individual. Mr. Lewis added that requesting Dr. Overholt had been discussed before.

Ms. Horton said that she wanted the work group to know that Mr. Lewis had made this suggestion at an ORRHES meeting, while many ideas were being shouted out regarding the Dr. Brent flyer. Ms. Horton indicated that Mr. Lewis suggested the "Dr. Bob Show," someone else recommended a radio show, and a number of other suggestions were shouted out as well. Unfortunately, she stated, there was not sufficient time to follow up with the show. Even though no formal recommendation was made, Ms. Horton explained, the agency has heard all of the CCCWG's comments regarding the flyer. She suggested for the work group members to send her any sample flyer that they have liked. She stated that the flyer used for the Dr. Brent presentations was the new agency standard document that they are required to follow. However, if this work group had something that would work better for this community, she said she would be happy to take it through management to get it approved for any future meetings.

Mr. Hanley explained that once the work group has had a lot of discussion on an issue and reached a consensus, a recommendation to ORRHES is a means to clarify exactly what the work group is looking for. According to Mr. Hanley, the agency tries to do its best to address individual points of view, but it is difficult when there is no specific focal point or consensus for what the work group is recommending. Mr. Hanley stated that ATSDR listens to and tries to make adjustments based on individual suggestions too, but an ORRHES recommendation identifying the main issues is necessary for the agency to provide a formal response on why something was or was not carried out. Mr. Hanley indicated that responding to everyone during a group discussion was just not possible.

Mr. Gartseff indicated that they had tried to do this by having a work group meeting to discuss the flyer. He expressed his belief, however, that ATSDR discouraged them from having this meeting. According to Mr. Gartseff, comments submitted on time were not incorporated because the flyer had already gone to publication by the time the comments were received. He said that the comments were executed, and all they could say was that they were unhappy about it and ATSDR could say that it would try better next time. In his opinion, however, none of this lends itself to a recommendation because the event has passed. He indicated that the main message for the work group was that ATSDR is listening to their discussions, and they at least had the advantage of conveying their opinions without having to wait until they could vote in an ORRHES meeting. Although this was not ideal, he said, at least ATSDR was listening to them.

Mr. Gartseff asked if anyone was a graphic artist or community relations specialist. He said that he was not, but that he could identify what personally got his attention and what he disliked. Mr. Gartseff indicated that they could only speak in terms of generalities and make recommendations accordingly. Thus, if the time frame of the meetings is such that they cannot make formal recommendations in a timely manner, then they should at least be open to dialogue. His personal impression, he said, was that they were receiving a response over the phone; although, it was not timely to when the event occurred. He stated that he did not know how to turn back the clock. Mr. Johnson expressed his belief that they should not try to do turn it back. Referring to Mr. Hanley's comments on lessons learned, Mr. Johnson said that this issue has been closed and they needed to move forward. Mr. Gartseff expressed his belief that they would have an opportunity to apply their lessons learned to discussions on the CIA communications plan and future events. If there was a particular event that they would like Dr. Overholt for, then they needed to identify this and make a formal recommendation.

Mr. Johnson expressed his belief that the topic of cancer was a vitally important issue because it impacts everyone and is one of the leading causes of death. He said that, although there are many types of cancer, essentially there is one cancer. In his opinion, he stated, part of educating and outreaching to the community requires providing information about cancer and how it impacts communities via the family and individual using a tactful, tasteful, and layperson mindset.

Loretta Bush asked whether the "Dr. Bob Show" was live or taped. Mr. Lewis said it was taped and expressed his belief that it aired twice a week. According to Mr. Lewis, the show is customized to focus on health issues and designed to reach the lay and general public. Mr. Lewis stated that he was trying to point out that when they discuss health issues, people are looking for clinicians and people with a clinical background. Mr. Lewis expressed his belief that Ms. Horton had a copy of the program, and according to Mr. Lewis, she said she found it to be excellent.

Mr. Lewis indicated that the program was designed to address issues for rural communities and the lay public. He suggested contacting a professional to record the program so that they could review it. According to Mr. Lewis, there was not necessarily a lack of interest in the community, indicating that poor presentation skills could sometimes cause the messages to not reach the people. In his opinion, he stated, the program was excellent and others have agreed that someone like Dr. Overholt presenting information would be more meaningful for this community. Mr. Johnson expressed his belief that Dr. Overholt has a personality that is appealing to the culture of this area because he comes across as genuine, warm, friendly, and believable. Mr. Lewis said that Dr. Overholt phrases questions so that people can understand them and structures them in a way to relate to health issues. Mr. Gartseff suggested discussing this at the next meeting.

L-Tryptophan Video Request

Mr. Lewis asked whether they had received the video that Dr. Henry Falk was in. Ms. Horton asked whether the tapes had been brought to the office. Ms. Bertelsen said that the tapes were supposed to have been delivered to the office last week, but Amanda Bird stated that she had not seen them. Ms. Horton asked Ms. Bertelsen to follow up; she said she would do so tomorrow.

Mr. Gartseff asked for information about the video. Mr. Lewis stated that the video showed the process used when something goes wrong related to L-tryptophan, noting that Dr. Falk was involved in the process. Mr. Lewis explained that the video shows how the community is surveyed, indicating his belief that it would be educational for them to watch. Mr. Lewis said that they had been looking for this video for 2 ½ years and stated that he applauded ATSDR for finding it. In his opinion, Mr. Lewis said, this was the type of information they should be looking at and reviewing. He indicated that suggestions made by Jeff Hill and others regarding Dr. Brent's presentations, which would be in the meeting minutes, could be looked into further. Mr. Lewis said that they could not let these issues drop if they intended to reach the people.

Cancer Incidence Assessment Communications Plan

Mr. Gartseff asked Ms. Bush if she planned to present the communications plan at the next meeting. Ms. Bush said she planned to present it at the Monday, August 8 meeting. Mr. Gartseff explained that their usual meeting date would be August 9, but that they could choose between August 8 or 9.

Mr. Lewis asked whether they would see the plan without seeing the product, or if they would see the product in order to understand the plan. Ms. Bush indicated that they would see the plan before the meeting. Mr. Lewis replied that he was referring to the CIA document, not the plan itself. He questioned whether ATSDR intended to provide the CIA prior to discussing the plan. If they did not see the assessment in advance, then Mr. Lewis said he did not know how they could embrace the plan. Mr. Hanley explained that they would be provided with an informational flyer that explained basic information on a CIA, and also the plan. Mr. Hanley expressed his belief that Mr. Lewis already knew what a CIA was, and that they could be provided with a copy of the assessment conducted in Memphis. Therefore, Mr. Hanley said, the work group could see a similar type of document and the flyer, which would explain the assessment's limitations. These materials, as well as all of the key messages, will be given to them prior to the meeting. They would not, however, have the actual document with the data, conclusions, and results.

Mr. Lewis questioned that they would not see the assessment in advance. Mr. Hanley said that they would not, but they would have the communications plan and the fact sheet explaining the various aspects of the assessment, including information that it can provide as well as its limitations. In addition, Mr. Hanley said, he could give them an example of the assessment conducted by Dee Williamson in Memphis. Though this had been shared before with the Ad Hoc group, others might not be familiar with it. Mr. Hanley said that this was a good suggestion, and they could provide this example.

Mr. Lewis expressed concern about buying into a plan before they have seen the product. In his opinion, he said, this was similar to the PHAs, although they did see those in advance and help develop flyers and fact sheets. He expressed his belief that when they come to a sensitive issue, it appeared that the cards had been flipped on them. Dr. Davidson asked if Mr. Lewis wanted to wait and discuss the communications plan until after the assessment was completed, which could mean pushing this back 2 or 3 months. Mr. Gartseff said that, as Mr. Johnson mentioned, they know that the topic is cancer. Although they did not have the specific results or the data, they were still communicating information about cancer and this was no surprise to anyone. Therefore, Mr. Gartseff said, he expected that they could discuss the plan in fairly good detail.

Mr. Lewis asked Ms. Bush if she had seen the product. Ms. Bush responded that she had not received or reviewed the production, but has been in discussions with Ms. Williamson. She indicated that the information provided by Ms. Williamson is reflected in the communications plan and the flyer. Mr. Hanley clarified that Ms. Bush had seen last year's CIA draft, which was similar in content and structure. Ms. Bush stated that this was correct; she was talking about a more revised or updated version, which she had not seen. Mr. Gartseff reiterated that the topic is still cancer incidence. Regardless of the numbers or specific cancers, he said, the topic is still cancer and they could anticipate the results in that context.

Mr. Gartseff asked Ms. Bush if she would be presenting in person or over the phone. Ms. Bush said that she would be coming to Oak Ridge, and could come either Monday, August 8 or Tuesday, August 9. He asked if they would be provided with advance copies to allow preparation time. Ms. Bush replied that she would give them copies in advance, probably by Wednesday, August 3 or Thursday, August 4. Mr. Gartseff indicated that it would be helpful to receive them by August 3; Ms. Bush said that she would provide the plan to them by then. Mr. Gartseff suggested that they accommodate Dr. Pete Malmquist's request to meet on August 8.

Mr. Johnson requested a copy of the report conducted for Memphis. Mr. Lewis indicated that he had also requested a copy of information from the Paducah PHA, which he said he was interested in seeing. According to Mr. Lewis, Dr. Mark Evans indicated that something of this nature had been conducted for that area. Mr. Hanley asked if the information was in the PHA itself. Mr. Lewis stated that he did not know, but that Dr. Evans indicated that he would provide the information. He expressed his belief that the information was probably independent of the PHA. In his opinion, Mr. Lewis said, this should be reviewed by the CCCWG to see something that had been done at this level. Mr. Hanley asked Ms. Horton to follow up with Dr. Evans tomorrow; she said that she would. Mr. Hanley said he had thought that the information was included within the PHA and that Mr. Lewis had already seen it, but they could track it down if it is a separate document and give Mr. Lewis a copy. Mr. Lewis suggested giving a copy to Ms. Bush, expressing his opinion that it sounded similar to something that the community would be interested in. He added that he was not sure what they would be receiving as of this date. Mr. Hanley explained that they would be receiving something similar to the report done in Memphis, which Mr. Lewis had seen in the Ad Hoc group and was already familiar with.

TSCA Incinerator PHA Summary Document

Mr. Gartseff stated that he liked the updated version, including the increased level of detail and the improved graphic in the center. In his opinion, he said, it appeared that ATSDR had listened to and adopted many of the work group's suggestions. Mr. Hanley indicated that he initially had reservations about the middle graphic, but that it had developed nicely throughout the various drafts. He asked to go page by page to get their suggestions.

Mr. Johnson expressed his belief that the first page was very good; it was people friendly, easy to read, and provided a good overview. The only comment Mr. Gartseff had was in the middle of the paragraph under "What is ATSDR's main finding?" referring to the following statement: "Thus, there is no evidence that emissions from the TSCA Incinerator have harmed anyone." Though he said he understood the point and the message, Mr. Gartseff suggested re-phrasing this because there was probably at least one person who sincerely believed he or she had been harmed. Mr. Hanley asked for suggestions. Mr. Gartseff recommended something such as "no evidence that emissions have caused harm." Mr. Hanley asked about using the term "no harmful health effects." When it came to being dogmatic about not doing something, Dr. Davidson said that they needed to be simple, such as "don't expect any harm to come from this." In his opinion, Mr. Gartseff said, the language of the conclusion was appropriate, but this was oversimplifying it. Dr. Davidson expressed her belief that this sentence could be removed altogether. Mr. Gartseff added that a statement such as "has never harmed anybody" bothers him.

Under "What is the TSCA Incinerator?" on the first page, Mr. Lewis referred to the following sentence in the second paragraph: "The TSCA Incinerator began routine operations in 1991 and continues to operate today." Mr. Lewis expressed concern that it was now 2005—14 or 15 years after operations began, and asked for information on the history and reasons for waiting until now to address this issue. In his opinion, he said, this was a long time to wait to develop a response, and asked if they were saying that concerns still existed about the incinerator. Mr. Hanley said that the next paragraph under "Why is ATSDR evaluating the TSCA Incinerator?" says why ATSDR is evaluating it. He referred to the following sentences: "The Agency for Toxic Substances and Disease Registry (ATSDR) is working with the Oak Ridge Reservation Health Effect Subcommittee (ORRHES) to help answer questions that local residents have about environmental contamination. One specific issue of concern to many residents is airborne releases from the TSCA Incinerator." Mr. Hanley explained that other agencies have evaluated the incinerator in regulatory terms and issues, but ATSDR is addressing the issue because it has come to the forefront.

Mr. Lewis asked if there were outstanding issues. Mr. Hanley said he did not know if there were before or not, but that there are issues now so ATSDR is looking at them. Mr. Lewis said that his point was that these are outstanding issues remaining over a period of time. Referring to Mr. Lewis's comments, Dr. Davidson asked if she was missing something. Mr. Gartseff explained that this could be related to use of the present tense, such as "is airborne releases." Mr. Hanley suggested verbiage such as "what effect have historical releases from the incinerator had on an ongoing basis." He noted that the main point was not to imply that there is a new incidence of releases, and asked about possibly using "historical releases." Mr. Gartseff said that something like this would be appropriate, indicating that Mr. Lewis was nodding his head in agreement. Mr. Lewis suggested using "have releases from the TSCA incinerator" instead of "do releases from the TSCA incinerator." Dr. Davidson expressed her belief that "do" encompassed past and future. Mr. Hanley said that he would discuss this with the editors to see what would be most appropriate to cover past, present, and future. Mr. Gartseff said he was inclined to believe that "do" would work, questioning if changing this from present tense would eliminate the future.

Mr. Lewis expressed his belief that ATSDR was responsible for looking at the past and current, whereas the U.S. Environmental Protection Agency (EPA) was responsible for evaluating the future. Mr. Gartseff indicated that there was not a clear dividing line; it was not only up to EPA to evaluate future exposures. Mr. Gartseff asked Mr. Hanley to speak with the editors, stating that he did not disagree with Mr. Lewis. However, he said, this was an issue of semantics and determining the correct wording to ensure that this covered past, present, and future.

Dr. Davidson asked if the incinerator was located where the smokestack was in the center picture. Mr. Hanley said that this was correct, and asked whether it was appropriate to put a label on the bottom to identify the incinerator. In his opinion, Mr. Gartseff said, the picture was fine, but indicated that they had discussed cropping unnecessary buildings that are not part of the incinerator. Mr. Hanley said that they could move the blocks around and crop the picture. He asked if Mr. Gartseff was referring to the buildings on the right-hand side. Dr. Davidson expressed her belief that this showed the relation to the environment, unlike the picture on the first page that only showed the incinerator. For her, she said, this provided perspective; though, it might be too much for some people. Mr. Gartseff expressed concern that the eye goes straight to the largest picture, which was not the incinerator—it was storage for waste materials. Mr. Hanley said that this was an important building. Mr. Gartseff said that this was true, but indicated that some of the buildings on the right were office trailers—not support facilities. Mr. Hanley said that they would not cut too much, expressing his preference for showing the broader perspective. They could, however, trim some of the buildings, move the blocks over, and blow up the left side of the picture. In his opinion, Mr. Gartseff said, the main point is to center the eye on the incinerator itself as much as possible.

Mr. Lewis expressed concern that another outstanding issue was that, as a general rule, the plume coming out of the stack might comprise only steam. He stated that a good explanation of what is being released from the stack and where the emissions are going was needed. He indicated that he would have assumed that a simple process diagram, such as the one presented by ERG, would have been included. In his opinion, he said, this diagram effectively showed what was being released from the stack and what you were seeing in the picture. He explained that this would be helpful for people who did not know the specifics of the incinerator. Mr. Gartseff suggested that there might be room for another box beneath the picture, similar to a caption, to both identify the incinerator and state in descriptive terms what the incinerator emissions contain. Mr. Hanley summarized that they were looking for a diagram showing what goes in and comes out of the incinerator, including details about the organics being destroyed and where the metals come out.

According to Mr. Lewis, they had a detailed discussion on this at a past meeting, noting that this suggestion was made and cited in the minutes. Mr. Hanley indicated that there had also been a suggestion made to include this photograph. He added that the question at that time was whether they should expand this to another two pages or leave it as a four-page document. Mr. Gartseff stated that they did not need to expand the summary document, but suggested using descriptive terms in a caption or a diagram reduced to an inset box. He pointed out that the bottom of the picture had nothing to do with the incinerator, and that an inset of the process could be placed there. He said that they would still get a sense of the environment around the incinerator, while also having room to include an inset of the process.

Dr. Davidson asked how much information they needed regarding this because, as she reads through the summary, it already describes what could possibly be released. Mr. Gartseff said that he could see the balancing act between this and the last version, noting that this version included considerably more detail in these boxes that he stated was appropriate.

Mr. Hanley referred to the "Fate of Chemicals" section and read the following statement: "This process creates by-products that are mostly harmless (e.g., water, carbon dioxide)." Dr. Davidson indicated that the text under "Air Emissions" identified other things that could be released, but at very low levels. Mr. Hanley said that in the air section, they could also mention that emissions are primarily comprised of water, carbon dioxide, and these other contaminants.

Referring to the suggested diagram, Mr. Hanley clarified that the point was to show the materials that go in and come out at different points. According to Mr. Lewis, this had been said once before. Mr. Hanley explained that other points had also been made, such as showing where the after burner and stack were located. Mr. Lewis suggested using simplicity instead of providing this level of detail. Dr. Davidson recalled this conversation started because they indicated that people would wonder what was being released in the smoke coming out of the smoke stack. In her opinion, she said, other than the two primary by-products (carbon dioxide and water), it could be difficult to describe the others. Mr. Gartseff referred to the yellow box on the upper left-hand corner, and suggested putting the process in a box similar in size and fitting it along the bottom center. Mr. Hanley summarized that the point was to indicate what goes in and comes out of the incinerator, but not to identify all portions of the incinerator. Mr. Gartseff said that this was correct, noting that the emphasis should be on what is coming out.

Mr. Gartseff asked if there was any particular reason why they had backed away from quantifying how much waste has gone through the incinerator. He said that the past version had noted that the incinerator had treated more than 16,000 tons of waste since 1991. Mr. Hanley expressed his belief that they had received comments about this; Dr. Gartseff said he did not recall that. Dr. Davidson stated that she thought she saw that statement in this version, and added that the first blue box titled "Amounts and Types of Wastes Treated" did not discuss amounts. Mr. Hanley said that the amount could be put back into this paragraph. Mr. Gartseff said that it did not bother him either way, but noted that it would fit into this box. He stated that his recollection was that the incinerator operated much below its permitted capacity. Trent LeCoultre pointed out that this statement was included on the front page. Mr. Gartseff suggested putting it under the paragraph about amounts; Mr. Hanley said that this could be in both places.

In general, Mr. Gartseff said, the layout worked. He expressed his belief that the document provided more detail for those interested, and also provided a general idea of the incinerator for those who just wanted to glance at the document.

Mr. Lewis asked why they used the term "nearby" in the title. Mr. Hanley said he was not sure, but expressed his belief that it was because they had a title that was too long before, such as "people living near the Oak Ridge Reservation." He asked for suggestions. Mr. Gartseff asked if Mr. Lewis had strong feelings about it, questioning whether it was too vague. Mr. Lewis expressed his belief that it was. Mr. Gartseff noted that he personally had no problem with it. Dr. Davidson said that this is a term used in colloquial speech.

Mr. Gartseff said that it was not necessary to repeat the title on both inside pages. Mr. Hanley asked about using the title once across the middle. Dr. Davidson expressed her opinion that it appeared redundant to have the title on both inside pages. Mr. Gartseff also noted that the title itself should be written larger than the subheadings in the boxes, adding that he would leave it out. Mr. Hanley said that he would discuss it with the editors. Dr. Davidson indicated that it was common practice to have some type of header on each page. Mr. Johnson noted that this was basically universal and helps keep the layperson from getting lost.

Referring to the second paragraph on page four, Mr. Gartseff indicated that he still had issues with stating, "ATSDR has recommended that…" He explained that the regulatory agencies are already conducting this, and suggested diminishing ATSDR's initiative here. According to Mr. Lewis, they had an extensive discussion on this particular subject at a previous meeting because this implies that the agencies have been doing something wrong. Mr. Gartseff suggested saying "Most importantly, DOE [the U.S. Department of Energy], EPA, and TDEC [Tennessee Department of Environment and Conservation] will continue..." Dr. Davidson said that she was not sure of the use of "will." Mr. Lewis questioned why they could not say that these agencies would operate according to their regulatory commitments. Dr. Davidson replied that regulatory obligations can change, and thus, ATSDR could not say what these entities are going to do.

Mr. Gartseff asked if this was language from the PHA; Mr. Hanley said that it was similar. Dr. Davidson said that they needed to state that these actions were something that the agencies have done, but not as a binding recommendation. Mr. Gartseff indicated that to people who will only read this document once, it looks as though it was ATSDR's idea to begin this monitoring. Mr. Hanley read from the public health recommendations section of the PHA: "DOE, EPA, and TDEC should continue operating their routine ambient air monitoring networks at ETTP [East Tennessee Technology Park] to measure metals and radionuclides—two groups of contaminants that the TSCA Incinerator does not destroy."

Mr. Lewis indicated that this was discussed extensively before, and asked why ATSDR would make this type of recommendation when there was no indication that these agencies would discontinue their efforts. Mr. Gartseff said that Mr. Lewis was absolutely correct, noting that this statement reads as though the most important recommendation from the PHA is that ATSDR says that these agencies should continue their monitoring. Mr. Gartseff said, however, that this is not the way it really is. Dr. Davidson suggested saying that "DOE, EPA, and TDEC should continue..." because this would also tie into the next sentence indicating why these agencies should continue. She said if they did not change this sentence, then they would have to take out the next sentence too.

Mr. Lewis questioned why they would make a recommendation when nothing was wrong with the program in place. Mr. Hanley explained that ATSDR makes a recommendation to ensure that the agencies continue these efforts. Mr. Lewis asked what assurance they will get from making a recommendation. Mr. Hanley asked who would ensure that these agencies conduct this monitoring in the future. Mr. Lewis said that the law would make sure of this; Mr. Hanley indicated that this is not guaranteed.

Mr. Gartseff asked what happens to the recommendations that ATSDR makes in its PHAs under the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) mandate. Mr. Hanley said that the recommendations go to EPA. In this case, the recommendations go to EPA, TDEC, and DOE for consideration. Mr. Lewis questioned what there is to consider. Mr. Hanley agreed that this could be modified in the flyer and they would address it; he noted that the main point was that these efforts would continue.

Mr. Gartseff referred to the preceding sentence regarding existing safeguards: "...ATSDR has made several recommendations to be certain that these protective measures continue to be adequate." Mr. Hanley said that this would also be modified, and that they would indicate that recommendations were made in the PHA. Mr. Gartseff said that would be fine.

Dr. Davidson asked if they were going to remove the section about the agencies continuing these efforts because people might have questions about this. Mr. Gartseff explained that they were not suggesting weakening this statement, but were trying to emphasize the regulatory processes that were already in place. They were suggesting removing the part about ATSDR making the recommendation so as not to imply that these things were not already being done or might be discontinued. He said that they were removing the part about "Most importantly, ATSDR has recommended…" Dr. Davidson confirmed that they would be leaving in something about DOE, EPA, and TDEC; Mr. Gartseff replied that they were asking for this to be emphasized. Mr. Hanley said that he understood, noting that the emphasis would be that the agencies would continue sampling—not that ATSDR recommends that they continue.

Based on the comments made last time, Mr. Lewis said, he recalled that they emphasized that this was a state-of-the-art facility. They discussed giving credit to how the facility was set up to operate and to meet all of the required standards, thereby giving the community some assurance that this was a non-issue. He indicated that they could not say that the incinerator does not cause harmful exposures, but they could say that harmful releases would not occur as long as the incinerator is maintained and operated properly.

Mr. Hanley summarized that they were saying that the operations were fine, so the incineration is fine. Mr. Lewis indicated that he heard what Mr. Hanley was saying. However, he said, the language needed to indicate that this was a state-of-the-art facility, and it would meet the needs as long as it was operated according to the standards. Mr. Lewis stated that the work group had argued this point, noting that a technical writer from the laboratory had made many comments, which were reflected in the minutes. Mr. Hanley referred the group to "Incinerator Design and Operation" on page three and read the first sentence: "The TSCA Incinerator is designed to meet the strict requirements of multiple environmental regulations intended to protect human health and the environment." Dr. Davidson pointed out that the only way they know that this is occurring is by monitoring. Mr. Lewis asked whose job it was to monitor. Dr. Davidson explained that this is in the document, as well as saying that the studies should continue.

Mr. Gartseff stated that the following wording in the second paragraph on page four needed to be modified: "...and ATSDR has made several recommendations to be certain that these protective measures continue to be adequate. Most importantly, ATSDR has recommended that..." Mr. Gartseff explained that this should be changed to not incorrectly convey that these agencies have not done or will stop doing their jobs. In his opinion, he said, the problem is actually related to how the recommendation is worded in the PHA.

Mr. Lewis asked about the section on page four titled "Are there any general air quality concerns for the Knoxville metropolitan area?" He questioned how this related to the TSCA Incinerator. Mr. Hanley explained that this is a general public health message, indicating that there are problems with the air quality in Knoxville. These problems are general regional problems, however, and are not from the TSCA Incinerator. Mr. Hanley stated that they did not want to ignore these problems because they are legitimate public health issues of general air quality that occur at certain times of the year. Mr. Johnson asked if this was a comparison because of the closeness. Mr. Hanley said that it was not. Dr. Davidson added that this was addressing the general concern for the area. Mr. Hanley added that this was for parts of Anderson, Roane, and Loudon Counties, and asked whether Roane County is part of the metropolitan area. Mr. Johnson said that Roane County did comprise the metropolitan area. Mr. Hanley explained that these areas fall into what is referred to as "non-attainment areas" within the region for ozone and particulates for certain times of the year.

In his opinion, Mr. Lewis said, John Wilhelmi of ERG did an excellent job presenting information on the power plants, showing what the Tennessee Valley Authority (TVA) was releasing and comparing these amounts to what else was in the air. He expressed his belief that this information in the summary almost seemed irrelevant, adding that similar comments had been made before. Mr. Hanley asked if Mr. Lewis was suggesting that this be removed. Mr. Gartseff expressed his opinion that this was fine to include, but that the subheading question could possibly be reworded, such as "How does the TSCA Incinerator affect the general air quality in the Knoxville metropolitan area?" Mr. Gartseff said that this did not need to necessarily be a yes or no answer, and could possibly also make reference to residents nearby. Dr. Davidson indicated that they could only look at the air quality from the standpoint of the metropolitan area—not for little discrete areas. Mr. Gartseff clarified that he was referring to stating the subheading in a question that provides the message that Mr. Hanley was trying to get across, such as "Does the incinerator affect general air quality in the Knoxville metropolitan area?" He also suggested wording such as "has it ever" or "will it in the future."

Mr. Johnson suggested possibly explaining what the Knoxville metropolitan area encompasses for the layperson. Mr. Hanley indicated that this probably changed over time, and asked about re-phrasing the question to "Does the TSCA Incinerator affect the general air quality for the Knoxville metropolitan area?" Mr. Hanley said that the answer would be no; Dr. Davidson said that you did not have to put the "no" in the text.

In his opinion, Mr. Lewis said, the second paragraph on the first page basically indicated that this was not an issue. Mr. Gartseff explained that the point of including this section was in case people had this type of question. Although people living near the incinerator are not being affected, he said, people might have questions about impacts on the general area if the emissions are widespread. Mr. Gartseff expressed his belief that it was acceptable to have this section, but said they needed to ensure that the subheading was the question that they wanted to answer. Mr. Johnson indicated that this was important because someone might also read the last page first. Mr. Gartseff said not to begin the paragraph with a "yes" or "no" response to the question. Mr. Hanley replied that he liked this suggestion.

White Oak Creek PHA Summary Document

Mr. Gartseff asked Mr. Hanley to describe the intent for this document. Mr. Hanley explained that the intent for this summary was to be similar to an executive summary and it was modeled after the one developed for the Y-12 document. The document includes text boxes, pictures, and other elements to make it more readable. It gives the general message for the lay public, while also providing more detail for people who want additional information.

Mr. Gartseff asked if Mr. Hanley was referring to the four-page summary document prepared for the Y-12 PHA. Mr. Hanley said that he was referring to the 12-page summary document developed for Y-12; Mr. Gartseff indicated that he had looked at the wrong document. In general, Mr. Hanley said, it was easier to clarify the messages within the larger summary and then develop the smaller summary based on this.

Mr. Gartseff asked about the time schedule. Mr. Hanley expressed an interest in having the summary document ready at the end of September along with the responses to comments. He suggested that people review the document and send their comments to Mr. Gartseff. Then, at the next meeting sometime in August, they could go through the submitted comments as a work group. Mr. Gartseff agreed with this plan.

Mr. Hanley said that the Y-12 summary document was on the ORRHES Web site. He said to go to public health activities, then click on ATSDR current activities, and select Y-12 uranium releases. There were two fact sheets listed under selected resources: Y-12 basic information (four-page) and Y-12 technical summary (12-page).

Mr. Hanley explained that the technical summary was the model used to develop the WOC summary, which according to Mr. Hanley, people had liked. He said that Melissa Fish had taken a questionnaire and had people answer readability questions. Although they are not supposed to do this, she had not known at the time. The summary was modified based on these results. Mr. Hanley expressed his belief that many people got the take-home message and were also provided with more information. Mr. Hanley indicated that it would be helpful if an e-mail was sent out asking people, including those outside of the work groups who have shown an interest, to review the summary and provide comments.

Mr. Gartseff clarified that Mr. Hanley was asking them to send out copies of the draft document and solicit comments. Mr. Hanley indicated that this was correct, noting that there should be extra copies in the field office or more copies could be provided. He asked that an e-mail be sent out asking people to pick up copies of the document and provide comments. Mr. Hanley added that it would be easier to go through the document if people come in with their comments, particularly because this is a longer document.

Mr. Gartseff asked when Dr. Taylor would return. Mr. Hanley said he was scheduled to return the first week of August. After discussion, it was noted that Lieutenant LeCoultre would be in the field office this week, and Ms. Bird would be there the following week. Mr. Gartseff said that he would try to send a reminder e-mail to Dr. Taylor this week and copy Lieutenant LeCoultre, Ms. Horton, and Ms. Bird. Mr. Hanley suggested that the e-mail indicate that this was based on the Y-12 technical summary, and ask people to look at this document on the ORRHES Web site.

Mr. Gartseff asked if this summary was available electronically. Mr. Hanley said that the document is still in Word format so that changes could be made more easily to the text and graphics, but noted that they did not like to send documents out in this format. Mr. Gartseff reiterated that he would ask people to comment on the document and to come by the office to see a copy of it. Mr. Gartseff said that they could possibly discuss this at the August 8 meeting. Mr. Hanley replied that this would be possible if there was time.

Additional Comments

Mr. Hanley expressed his appreciation for their comments on the TSCA Incinerator summary, noting that it was a higher priority at this time; the WOC summary would be next. As soon as he received their comments on the WOC summary, Mr. Hanley said, the summary could be modified. Dr. Davidson noted that they needed the WOC summary comments before the next ORRHES meeting; Mr. Hanley said that they needed them by the end of August.

Mr. Gartseff asked if the next ORRHES meeting date had been set. Ms. Horton said that it had officially been changed to September 22. Mr. Gartseff indicated that there was no longer a quorum, and adjourned the meeting at 7:20 pm.