Susan Robinson (ATSDR) provided the ORRHES members with a folder containing handouts for the presentation. She thanked the ORRHES members who contributed their time and thoughts for the Web site redesign and the ATSDR team members who worked on the redesign, including the NCEH/ATSDR Office of Communication and the Oak Ridge Reservation Site Team. Ms. Robinson noted that it was requested for ATSDR to redesign the site to better meet the information needs of the community and to better support the communication and educational goals of reaching multiple audiences.
Susan Robinson referred to Oak Ridge Reservation Web Site Creative Brief handout that she had provided, which summarized the ideas about what the new site will accomplish. Ms. Robinson identified the goals of the new site: a) assist the ORR community in understanding findings of the PHAs, b) build capacity in the community to respond to issues related to the PHAs,
c) increase community's interest and participation in providing input on PHAs, and d) collect and address community's needs and concerns.
Susan Robinson explained that the process has taken a phased approach. Phase 1, which was now completed, included the initial "migration" of old content into the new formats. Ms. Robinson noted that this was a straight conversion from the old to new site, but it has been completely updated. Phase 2 includes site enhancements based on input from the former Communications and Outreach Work Group (COWG), now the CCCWG. She referred to the project status handout, which showed the deliverables and the time line.
Susan Robinson wanted to walk through the new site with the group. She referred to a handout that showed the old and new home page side-by-side so that the ORRHES members could see how it has changed. After a brief introduction on the history of the ORR, the home page also includes a block that allows visitors to select public-friendly resources and a block for education and training.
Bob Craig referred to the picture on the home page that only shows the Y-12 Plant. In relation to health effects, Dr. Craig thought that the size of the ORR was important to show. He wanted to see a picture that had all of the three plants in relation to the city of Oak Ridge. Susan Robinson thought that this was a good idea and asked Dr. Craig where she could find such a picture. Tim Joseph said that he could locate a picture. Ms. Robinson asked Dr. Joseph to e-mail her the picture at sjr2@cdc.gov.
Susan Robinson went through different portions of the Web site with the group. She pointed to the calendar of meetings listed under events on the front page. She noted that there was a drop down box that they could use to find minutes from various meetings. According to Ms. Robinson, the Web site has been updated with all of the minutes through December 2004 (pending approval of any minutes that they could not obtain).
Susan Robinson showed the next item under the home page called "Public Health Activities." She said that this section includes overview text that could be changed. She pointed to where the current activities would be placed and noted that this will include public comment versions of the PHAs as they are released. In addition, past activities, other agencies' public health activities, and resources on Oak Ridge Reservation health effects are available under this section. She noted that all finished products would be listed here when they are completed.
Bob Craig asked if there would be a hyperlink to the actual documents; Susan Robinson said this was correct. Susan Kaplan asked about 1985 CDC worker studies that she was unable to locate on the Internet and wondered if these would be found on this portion of the Web site. She added that the studies had included urine and hair samples. Jack Hanley said that a summary of these studies is available in the Compendium of Public Health Activities, but that the full document is not on the site. Ms. Kaplan asked if the complete document could be made available on the site. Ms. Robinson said that they could look into this further. Mr. Hanley has the pilot study, but it is not in electronic format.
Susan Robinson showed the group that "Public Participation" was the next item under public health activities. She explained that one of the goals has been to enable the public to provide more comments because this section was difficult to find on the old site. On the new site, however, providing public input is incorporated into its own section. Ms. Robinson showed the group that the community health concerns comment sheet is now in this section and the site enables people to send their comments directly from the page. She told the group that there is also a link to EPA's National Priorities List (NPL) site as Susan Kaplan had requested. Ms. Robinson added that the contact names and links have been updated under the "contact us" section.
Susan Robinson showed the group the next section named "Community Resources." She explained that this is a new section and that the overview block is a place to incorporate general information that could be augmented during the second phase. She said that the CCCWG had mentioned having links to the presentation on thyroid cancer, which has been added, as well as additional information. Ms. Robinson noted that new presentations could be incorporated onto the site as they are completed. She stated that useful links from the old site have also been added under the community resources section.
Jack Hanley asked if the presentation on the site included the overheads and transcripts. Susan Robinson said that these items could be included if they are available.
Susan Robinson went to the next link named "ORRHES Subcommittee." She pointed to the link for obtaining ORRHES and work group meeting minutes and explained that minutes could be accessed through this method or via the calendar as previously shown.
James Lewis asked about formal recommendations and ATSDR's responses. Susan
Robinson said that there is not a place for these per say,
but that she had provided directions in their handouts on
how to search through the minutes using www.google.com.
Susan Kaplan questioned that there is no search engine on
the site. Ms. Robinson explained that this is not available
on the site yet because the person working on it left ATSDR,
but noted that this is at the top of her priority list.
In the meantime, however, people could use www.google.com
to search the minutes.
James Lewis thought that Ed Frome had raised a good point when he noted that (as a minimum) people should be able to find all formal recommendations and responses in one location. Mr. Lewis believed this would be helpful. Susan Robinson explained that Marilyn Horton had a list of all of the formal recommendations and responses, which could be added to the site.
Susan Robinson continued reviewing the site with the group. She said that the wording was a straight conversion and that people might want to look at changing some of the text. She presented the "Contact Us" section, which contained ATSDR contact names, addresses, phone numbers, and e-mail addresses. "Site Map" is the next heading, which essentially outlines the form of the Web site so people can scroll up and down to see the resources available on the site (e.g., calendar of meetings).
Susan Robinson referred the group to "Oak Ridge Current Activities" under the "Public Health Activities" section, which now reads the "Y-12 Uranium Web Page". She said that this would be expanded as new studies are added (e.g., Iodine 131). She would like to have pictures for each of the main sections.
Susan Robinson stated that phase 1 has been completed. She said that the initial "migration" of old content to new formats was finished. They have also: a) added all minutes for 2003 through 2004, b) added "Community Resources" and "Public Participation" sections, and c) added/ checked the new suggested links.
Susan Robinson noted that they are now in Phase 2 of the process, which includes site enhancements. She discussed the CCCWG's suggestions (listed below) that are now pending and asked the ORRHES to rank these in order of preference.
- Search engine for minutes only
- Best ORRHES and work group presentations or links to other presentations (e.g., link to the Hanford Web site for a presentation on thyroid and iodine 131)
- List of "top issues" that they hear through the Web site, via the database at the office, and through other channels
- Open-ended feedback or comment input box for any public member to send in comments
- Interactive map
- Show areas of projected contamination by year and community areas (show overlapping exposures)
- Interactive map
- Provide links to additional information regarding possible health effects by types of contaminants
- Add "Current Activities" section
- List of Oak Ridge PHAs in progress
- Add a "3-month look ahead" calendar
- Add time line to show the operating periods of the three main facilities (X-10, Y-12, and K-25)
- Post 1997 articles from the Nashville Tennessean
- Not possible because of copyright and endorsement issues
Susan Robinson noted that Jack Hanley has the time lines for the three main facilities and they can be incorporated into the site. She also stated that Mr. Hanley mentioned that the interactive map would not be completed until the PHAs are finished. Mr. Hanley asked if DOE had an interactive map link. Tim Joseph said that DOE has this link and that the site could link to it.
Kowetha Davidson asked if the group should rank the items and turn them in during the meeting today. The ORRHES members agreed that this would be best.
James Lewis said they are looking to interact with the public and believed it is important to have a tool that they are comfortable using. He thought that Susan Robinson had done an excellent job in the information she pulled from the work group and the community.
Kowetha Davidson said that the CCCWG has been working on this issue and that additional recommendations should be taken to the work group. Based on the suggestions among the work group, the items could be taken back to ORRHES or ATSDR will act upon them. Dr. Davidson reminded the group that they have a very diverse group of people and that they needed to keep this in mind when looking at these suggestions. She wanted them to rank these items as a member of the community, instead of solely as a member of ORRHES.
James Lewis asked Kowetha Davidson if she wanted public participation. She responded that she did and commented that they needed to keep in mind that these enhancements should be presented in a public-friendly manner. She pointed out that the ORRHES members are also representatives of the surrounding areas. She thought that if every ORRHES member invited someone from his or her community, they could possibly have twice as many attendees at the meetings as they do now.
Susan Robinson suggested that the ORRHES members go through the Web site with a friend to see if he or she has any questions. If so, Ms. Robinson asked that the questions be sent to her.
Herman Cember asked if there is any information on the "hit rate" of the site. Susan Robinson said that they have information on "unique visits," but that these data are not indicative of the potential of the channel because it has not been promoted. If the site is promoted in upcoming events, she stated that a spike in traffic would occur. She could provide this information to Dr. Cember if he wanted it.
Bob Craig asked about the requirement to shut off the pop-up blockers because he was unable to get on the site. Susan Robinson replied that this was probably on the old remote usability site, but that these will be removed from the new site that is now face-to-face.
Presentation/Discussion: DHAC Proposed Plan for Collecting Information About the ORR Community
Bill Cibulas introduced this topic by saying that he has heard "loud and clearly" since his involvement that members of ORRHES and others feel that ATSDR has not done an adequate job of reaching out to the public and understanding their concerns. He noted that ATSDR is taking this issue seriously and shared the following recommendation that ATSDR received from ORRHES on February 3, 2004: "ATSDR adopt the Proposed Plan for Collecting Information about the ORR Community Suggested Timeline that is outlined as a process to fill the gaps that were left behind after the George Washington University study. This will be an opportunity for ORRHES members to sign up and participate themselves and/or identify individuals in the community who might be willing to help carry out the plan."
Bill Cibulas thought that it was "high time" to share this plan with ORRHES. He said that Jerry Pereira had informed the group that the responsibility of this plan had shifted from the Division of Health Education and Promotion (DHEP) to DHAC. Dr. Cibulas stated that ATSDR will address the concerns found during this follow-up process (hopefully within the appropriate PHAs). He noted that the overall goal and commitment of ATSDR is to ensure that the identified community concerns are addressed and answered.
Jack Hanley explained that the Oak Ridge Site Team has worked over the last few months to try and identify ways to address the gaps from the needs assessment and the ORRHES recommendation. They have heard that the agency needs to reach beyond the work groups and ORRHES to obtain comments from the community and incorporate them into the PHAs. Mr. Hanley presented a handout to the group entitled "Collecting Information About Communities Surrounding the ORR." He explained that DHEP had proposed four actions for collecting information, which have been modified to focus on how the information will help the agency address these issues.
Jack Hanley stated that the literature review, review of existing reports, and key resource interviews have been combined into three steps. The literature review would be conducted to identify specific concerns and issues (e.g., community health and environmental hazards). DHAC will review previous community surveys, newspaper articles, and reports (a handout was provided with the list of materials to be reviewed) to capture community health concerns and issues related to the ORR. The concerns will be identified and entered into ATSDR's Community Concerns Database. Mr. Hanley explained how these would be extracted based on key words related to particular PHAs and placed into the documents with corresponding responses. He said that the agency is now trying to reach beyond the work group and ORRHES meetings because they have heard numerous times that the database generally contains concerns from meeting minutes. They do have concerns from a few surveys conducted in Scarboro and comment sheets that have been sent in, but they would like to outreach to more people.
Jack Hanley explained the next step in DHAC's plan for collecting information that included identifying health programs and medical resources. In addition, ATSDR will interview key representatives in TDOH, county health councils, health promotion programs, and screening programs. During these interviews, ATSDR will outline its activities and learn about the other agencies' activities to see how they can coordinate their efforts.
Brenda Vowell told Jack Hanley that the list of representatives to be interviewed contained several errors and asked if she should note them for him. Mr. Hanley would appreciate it if Ms. Vowell could provide the errors to him so that these could be corrected.
Jack Hanley continued speaking about the interviews with the key representatives, and provided an example of when the agency releases its Cancer Incidence Review. He said that because the review will be reporting cancer incidence in different counties, ATSDR would like to have partners come to the table when the findings are presented. He explained that if increases are seen in particular counties, ATSDR can work with these representatives to see if their agencies have activities that can be used for follow up, such as providing cancer prevention information and offering cancer screenings. Through this partnering, ATSDR hopes to direct people to one of these other programs when ATSDR is unable to help with a particular issue (e.g., cancer screening). Mr. Hanley added that DHEP also indicated that demographic information should be collected; however, this information is incorporated into the specific study areas in each PHA.
David Johnson asked if the intention was for ATSDR to partner with these groups in "collaborative partnerships." Jack Hanley said that the agency would do this as appropriate. He explained that the purpose was for ATSDR to be able to direct people to appropriate programs available at the local level. Mr. Johnson asked if ATSDR would also be willing to work with these other agencies. Mr. Hanley responded that if ATSDR had something that could help the other agencies (e.g., findings of the Cancer Incidence Review), then this information would definitely be shared.
Jack Hanley referred to focus groups listed under DHEP's proposed actions for collecting information. Mr. Hanley said that this had been a recommendation proposed in the initial needs assessment with a follow-up action. According to Mr. Hanley, no focus groups have been conducted thus far. He has heard from the work groups and ORRHES that the agency's perception of a focus group (i.e., about 12 people) differs from the subcommittee's view of a focus group (i.e., larger groups of people asking questions and documenting concerns and possibly providing answers). As a result, ATSDR is modifying its concept of a focus group to meet the needs of this community.
Jack Hanley said that ATSDR would be holding community education sessions in Oak Ridge and Kingston, and directed the group to the draft flyer handout. He explained that the forums would be open to the public and would cover topics on radiation, cancer, and birth defects. ATSDR had an expert, Dr. Robert Brent, coming to discuss and give a presentation on these topics. In addition, there would be time for public members to present their comments, concerns, and questions within a specified time period. Mr. Hanley said that Dr. Brent would answer all of the questions to the best of his abilities.
Barbara Sonnenburg asked if Dr. Robert Brent is familiar with this particular area. Jack Hanley explained that Dr. Brent is an expert who was recommended by Herman Cember; Dr. Cember has heard Dr. Brent speak a number of times. Ms. Sonnenburg asked if Dr. Brent would be able to speak in general terms, but not specifically to their area. Mr. Hanley replied that Ms. Sonnenburg was correct, and explained that Dr. Brent will be able to help people have a better understanding of radiation, cancer, and birth defects.
Jack Hanley said that Dr. Robert Brent would be able to answer people's questions directly, an aspect that worked well at the past presentation on thyroid cancer by Dr. Jerome Hershman. Mr. Hanley stated that the format for these community sessions would be modeled after Dr. Hershman's presentation, but ATSDR would be modifying its outreach efforts to contact many more public members than it has for past events.
Susan Kaplan asked if chemicals would be covered in the presentations. Jack Hanley said that Dr. Robert Brent would be able to answer questions related to birth defects and chemicals if they arise. Mr. Hanley continued that there have been presentations on chemicals in ORRHES and work group meetings, but noted that the original needs assessment focus group identified radiation, cancer, and birth defects as high importance for the community. He added that the open forums would not only occur one time; additional topics could be covered in future public forums. Ms. Kaplan explained that the public is also very interested in chemicals, and if the forums only focus on radiation they will miss an opportunity to reach the broader public audience. Herman Cember said that Dr. Brent would be able to respond to questions on chemicals. Ms. Kaplan thought that ATSDR should include this in its promotional materials; Mr. Hanley thought that Ms. Kaplan brought up a good point.
Kowetha Davidson asked Herman Cember if Dr. Robert Brent was an expert on specific chemicals because there are a number of chemicals related to cancer. Dr. Cember responded that Dr. Brent is an expert in embryology and the development of the embryo and fetus. Dr. Cember said that he can discuss the factors that affect the embryo and the fetus, any causes for interruption and damage, and the time that exposures take place. Dr. Cember noted that he has heard Dr. Brent speak several times and that he is "very understandable." Jack Hanley said that Dr. Brent is also an expert in radiation and health physics, and therefore can answer questions about cancer and radiation issues as well.
James Lewis commented on the indication that ATSDR has heard their issues about addressing concerns. He read the following section from Section 3.1.2 Community Health Concerns of the PHAGM: "Understanding community health concerns related to a site or environmental release is an important component of the public health assessment process and ATSDR's overall mission. Community health concerns, therefore, need to be investigated and understood to the greatest extent practical. It is important to gather this information early in the process."
James Lewis next read a title from an article in the Nashville Tennessean from October 26, 1997, entitled, "Study the People Not the Poisons Sick Oak Ridge Residents Urge Officials." Mr. Lewis said the outstanding issues have still not been addressed even after the efforts in Scarboro and the concerns raised by the residents there. He stated that ATSDR should read these articles because they contain information that the agency should use to guide its efforts for developing responses that reach the needs of the public. He noted that the article discusses various chemicals and how they relate to cancer. He stated that this article has been published and is the knowledge within the community. He believed that ATSDR should be reviewing these types of articles to adjust the agency's products in order to meet the needs of the community. He thought that they could move forward if these types of things were factored into ATSDR's efforts.
Jack Hanley told James Lewis that he had brought up a number of good issues. James Lewis replied that Dr. Robert Brent needed to be familiar with these issues when speaking with the community. Mr. Lewis thought that ATSDR should show that it has heard these concerns because it will be the "driving effort on how you close the gap." Mr. Hanley continued to reply to Mr. Lewis's comments. Regarding the community concerns citation from the PHAGM, Mr. Hanley said that the key is to address the community concerns, which is one of the main purposes of ATSDR. Mr. Hanley added that this is also the reason why ATSDR created the community concerns database in Oak Ridge to capture the community's concerns; he noted that ATSDR had never developed this type of database before. Mr. Hanley explained that through work group and ORRHES meetings, ATSDR learned that it has not been reaching the broader audience. As a result, the agency is making modifications to reach the broader public. In addition to obtaining people's concerns, ATSDR will also be providing answers to individuals by placing concerns and corresponding responses in the appropriate PHAs.
Regarding the Y-12 concerns expressed by James Lewis, Jack Hanley said that the Y-12 PHA included key concerns extracted from the Oak Ridge Environmental Justice Committee, ATSDR's Community Concerns Database, CDC's door-to-door survey, and the Scarboro Community Assessment Report by the Joint Center for Political and Economic Studies. Mr. Hanley noted that these key concerns, as well as corresponding responses, were provided in the PHA. Mr. Hanley agreed that the PHA is a large document, but it includes an index to the areas where concerns are detailed and answered. Mr. Hanley thought they could work on how to communicate the agency's responses to concerns, and stated that they needed to find an effective method for directing people to these areas of the PHAs.
Bill Cibulas spoke to the issue about studying people instead of the toxics. Dr. Cibulas explained that epidemiology is a difficult science and practice to effectively use and show cause and effect. He said that when they review literature and look at exposures to low-level effects, there is a scarcity of literature that demonstrates any cause and effect. He explained that through the PHA process, a health assessor makes recommendations based on the knowledge of health effects associated with the COCs and exposures. Dr. Cibulas believed that the PHA is the appropriate place to make recommendations on the need to further study any particular population. He stated that when ATSDR can make a case that there are significant exposures and adequate knowledge of substances, which suggest that a biologically plausible link exists between that substance and a health effect, DHAC would refer this to ATSDR's Division of Health Studies because it is experienced with working to identify whether links exist between health effects and exposures.
Bill Cibulas continued that it is unlikely that they could link low-level exposure with health effects. He said that the PHA is a necessary step before studying people. He stated that they might not be doing an adequate job in their recommendations and conclusions to demonstrate why it is not sensible to conduct a health study. James Lewis appreciated Dr. Cibulas's comments. Mr. Lewis said that many people felt as though millions of dollars were spent on the Oak Ridge Dose Reconstruction, and that this argument should have been made up-front to the community so that disconnects do not result. He noted that "timing is everything" and that disconnects will not occur if everything is presented in an organized and easily understood format. To not lose the trust of the community, he thought they needed to look at the sequence of activities and disseminating messages to the public before making a health call.
Kowetha Davidson said that they have discussed (on several occasions) that they would need to have a PHA that shows an exposure, a linkage, and a pathway to continue to look at specific health effects associated with those contaminants. If no link is identified, then Dr. Davidson stated it would be "misleading to the public to imply that there is a link" between exposures, contaminants, and health effects.
To demonstrate how the PHA process has directed further evaluation, Jack Hanley noted how biological sampling was conducted in the Oak Ridge area in the early 1980s when information suggested that mercury was in the floodplain. As a result, CDC conducted a pilot study to evaluate whether people were being exposed to mercury (of all the contaminants that passed through Watts Bar). Mr. Hanley noted that DOE, EPA, TDEC, and ATSDR conducted separate analyses and all identified people who consumed large quantities of certain fish as those likely to have an increased risk of developing health effects. ATSDR then followed up with an exposure investigation, which was directed by previous studies suggesting to look for people who consumed a significant quantity of fish; ATSDR looked specifically for PCBs.
Peggy Adkins commented on the list of representatives to be interviewed. She had about 20 agencies that she thought needed to be added to the list, such as the March of Dimes, mental health organizations for each community, birth defects registries, and special education departments from area schools. Jack Hanley noted that the birth defects registry was not fully developed at this time. He explained that the purpose of interviewing these representatives was to identify resources and programs that are available within these communities so ATSDR can direct people with questions to these other agencies.
Peggy Adkins thought if ATSDR is collecting information about communities surrounding the ORR, then it would be good to know this type of information to assess how these communities compare to other areas. Jack Hanley explained that they will be comparing data for the eight counties to the state of Tennessee in the Cancer Incidence Review. He said that ATSDR could provide information on these counties to these agencies and then could forward people to these programs depending on their needs and available local resources.
Peggy Adkins asked about specific diseases (e.g., lupus and multiple sclerosis). Mr. Hanley replied that for the community education sessions, ATSDR wants to reach out to other organizations, such as those on her list. Mr. Hanley suggested that ATSDR add these organizations to its mailing list so that they could be invited to the public forums. Mr. Hanley said that Dr. Robert Brent can give these agencies his thoughts on their questions and concerns that fall within his areas of expertise.
Karen Galloway thanked ATSDR for "finally" planning community outreach efforts as she believed this was an important step. She said that people needed the opportunity to ask questions and receive answers from an expert.
Jack Hanley said that the key is to outreach and meet various groups. He stated that ATSDR will take input from ORRHES to ensure that the word reaches the public. He noted that the handout flyer is only a draft document for the public forums. Also, the flyer would be used to reach groups to obtain their concerns and inform them of the sessions. He added that if questions are not answered during the sessions, then they could hopefully be answered in appropriate PHAs.
Barbara Sonnenburg asked when the Cancer Incidence Review would be released. Jack Hanley had spoken with Dee Williamson before coming to Oak Ridge. He explained that Ms. Williamson had obtained data from the state and had to go back to validate some of the data for a few counties. However, there was turnover at the state agency, and Ms. Williamson's contact had left. She has now identified and been in contact with a state representative who is in the process of checking and validating the data. Ms. Sonnenburg asked if they could receive the report for the counties that do not need additional data validation. Mr. Hanley said that this would not be possible because the document still had to undergo internal review once the data issues were resolved with the state. In response, Ms. Sonnenburg said that it would "be about another year." Mr. Hanley reassured her that it would not take this long.
James Lewis thought people needed a map that shows the areas of contamination so that people could relate this to where they live. He said that people want to know about health effects in their communities. He added that people want to know, "What happened to me?" "What did I receive?" and "What are the health issues in that community?" Jack Hanley responded that they might be able to fold this into the summary document once they have completed all of the PHAs. However, Mr. Hanley explained that this type of map could not be created until the areas have all been identified in the various PHAs. Mr. Lewis thought that since the toxins have been studied rather extensively that they should have a good idea of where they are and capture that in a map.
Kowetha Davidson thought that John Wilhelmi discussed the areas potentially impacted by the TSCA Incinerator and explained the links that have been made for sources and potentially impacted areas. Dr. Davidson noted that this was also done in the Y-12 and White Oak Creek PHAs. In addition, LT Trent LeCoultre showed the areas potentially impacted by groundwater at the previous night's EEWG meeting. She added that they are obtaining information regarding impacted areas by contamination via discussions in the PHAs.
Presentation/Discussion: Community Health Education
Marilyn Horton directed the group to the handout for the "Public Outreach Plan for Community Education Sessions on April 18 and 19, 2005." She said that they wanted the subcommittee's feedback on this plan and referred back to the sample flyer that they previously discussed. Ms. Horton noted that Susan Kaplan had made a great comment about including chemicals in the flyer and she stated that they needed to work on the wording to reach a broader audience. Regarding the flyers, Ms. Horton explained that ATSDR wanted to go beyond its normal efforts to reach the community because they have heard that comments are normally only collected form the work group and ORRHES meeting minutes. She added that Jeff Hill had provided a good contact for BWX Technologies, Inc. (BWXT) to identify current and former workers.
Marilyn Horton explained that ATSDR had already conducted research for this outreach plan. Over 800 physicians and 52 cancer centers in the area have been identified that could be targeted with outreach efforts. She said that Don Box has offered to outreach to his church. In addition, ATSDR already has a mailing list with about 300 people as well as an extensive e-mail list. The flyer will also be e-mailed to people on the ORRHES and Local Oversight Committee (LOC) normal mailing lists. ATSDR's goal is to reach as many people as possible through these outreach efforts.
From the handout, Marilyn Horton read the following objectives: a) inform the public about the community education sessions, b) gather questions and concerns, and c) provide a resource for additional information. She noted that they are asking people to send in their questions in advance of the sessions so that Dr. Robert Brent can frame his presentation around people's issues and concerns. Ms. Horton explained that there will be someone present to take minutes at the public forums to capture and document people's concerns.
Pete Malmquist suggested a few things to reach a broader audience. He said that ATSDR could send materials to the Roane County Chamber of Commerce and the Oak Ridge Chamber of Commerce, which could probably send the information to their members. He noted that the Kingston City Council, and probably the Oak Ridge City Council, are on local cable; an ATSDR representative could provide the information during the public comment period and the word would spread quickly. However, Dr. Malmquist pointed out that they have to go out and talk to people for these efforts to work effectively.
Tony Malinauskas suggested arranging media interviews with Knoxville's top talk radio show with Hallerin Hilton Hill. He thought that Mr. Hill was receptive to things of this nature.
James Lewis questioned the timing of these presentations. He wondered if there would be a disconnect by having these sessions before the Cancer Incidence Review is released. Jack Hanley responded that this was discussed in work group meetings and within ATSDR. Based on these discussions, it was decided that they should move forward to obtain concerns so that ATSDR can respond to them in the PHAs. Mr. Hanley believed that these sessions will help put issues regarding cancer, radiation, and birth defects in perspective prior to releasing the Cancer Incidence Review. If a need for follow-up is identified, then ATSDR hopes that the agencies they anticipate partnering with can help provide answers and guide any follow-up activities.
Marilyn Horton pointed out that the Cancer Incidence Review and the Public Outreach Plan for the Community Education Sessions are two separate issues. She explained that the review compares the eight-county area to the state, whereas this outreach plan is specifically related to the educational sessions on birth defects, cancer, and radiation; they will also add chemicals.
James Lewis thought it was a good approach to be upfront, but stated that ATSDR would need to be in a position to return with something similar once the Cancer Incidence Review is released.
Kowetha Davidson had asked in a work group meeting if they should put off these sessions and no one responded. Based on this, according to Dr. Davidson there was no reason for ATSDR not to continue.
Jack Hanley said that ATSDR will also videotape Dr. Robert Brent's presentation with his overheads and make a CD, which can be presented later if needed.
James Lewis asked if Dr. Robert Brent had data on incidence for areas that he has studied because he needs to "relate to something real." Herman Cember said that Dr. Brent has these data.
David Johnson recommended adding the Knoxville Academy of Medicine and local community colleges to the mailing list for the flyers.
Marilyn Horton read the days and times of the education sessions to see if the ORRHES members had any suggestions or comments. She said that Dr. Robert Brent will be making a formal presentation, which will be filmed and could be provided later on a DVD to interested individuals. She said that Roane State has a room available that they had reserved in case the group preferred it to the Kingston Community Center. When she noted that the auditorium was booked all that week, Pete Malmquist replied that the community center would be better than a classroom.
Jeff Hill said that the times were fine because people who want to attend will go to the sessions.
George Gartseff suggested having a CCCWG meeting on March 29, 2005, to discuss any specific comments and procedural issues.
Herman Cember asked if the flyer had already been distributed. Marilyn Horton replied that this was a draft flyer and had not been distributed yet.
Marilyn Horton provided more details on the identified possible contacts for the flyers, including 24 public officials; more than 1,200 churches; 52 community, recreation, and senior centers, 66 environmental and health groups, and 51 retiree groups. She noted that they also have other civic groups and will incorporate the organizations listed on Peggy Adkins's list. For the physicians mentioned previously, Ms. Horton said that ATSDR will target those physicians in radiation, cancer, birth defects, and other specialties related to the topics of interest at the public forums.
James Lewis recommended contacting the "Dr. Bob program" because it reaches a broad audience and he is connected to physicians. Peggy Adkins said that there are shows on Channel 10 at 4:00 p.m. and 5:00 p.m. that deal with community events. Ms. Adkins also mentioned that Senator Frist's assistant, Carolyn Jensen, has a community show on cable television.
Kowetha Davidson suggested providing additional suggestions for contacts to Bill Taylor or Marilyn Horton.
Work Group Reports
EEWG
Tony Malinauskas said that the EEWG had four meetings. In the first and second meeting, the EEWG heard presentations by John Wilhelmi on the TSCA Incinerator PHA. Dr. Malinauskas indicated that many comments and suggestions were made to Mr. Wilhelmi during the first meeting, and Dr. Malinauskas was pleased that most (if not all) of the work group's comments and suggestions were incorporated into the document. He noted that the second meeting was primarily a follow-up to comments and suggestions made during the first meeting. During the third EEWG meeting, Dr. Mark Evans of ATSDR presented the PHA on air releases from K-25 and S-50. In the fourth meeting, LT Trent LeCoultre of ATSDR gave a report on the off-site groundwater PHA. The potentially affected areas were identified during these presentations.
Regarding comments on the TSCA PHA, Tony Malinauskas said that the EEWG will be receiving and collating these comments for presentation to ORRHES. Dr. Malinauskas requested that all of the comments be e-mailed to him no later than April 5, 2005. On April 11, 2005, the EEWG will meet to form and collate comments and prepare them in formal recommendations for ORRHES.
James Lewis asked Tony Malinauskas about the level of public participation received by the EEWG and asked what the work group members were doing to bring people into the meetings. Dr. Malinauskas responded that the public participation has been "disappointingly sparse." He said that when they do get public participation, the individuals are usually concerned about particular issues and they make "significant contributions." He asked if there were advertisements for the work group meetings. Marilyn Horton said that advertisements are not placed for work group meetings. He added that Ellen Rogers from The Oak Ridger attended the meeting held last night.
Kowetha Davidson admitted that she has been lax in conveying their activities to people in the public, but said she would announce the meetings in her church. She recommended that each ORRHES member make efforts to get the public more involved.
James Lewis wanted to get feedback from the technical people who no longer attended the meetings. He suggested interviewing these individuals to see what they would need to come back.
CCCWG
George Gartseff said that the CCCWG had met eight times since October 2004. He stated that during this time, the work group covered a variety of topics. Many of these topics were discussed during today's agenda, including the communications plan, Y-12 video, Web site redesign, and summary flyer for the TSCA Incinerator PHA. Mr. Gartseff recommended that the CCCWG meet on March 29, 2005, to discuss preparations for Dr. Robert Brent's public forums. He would send Bill Taylor a meeting announcement and asked the subcommittee members to send their comments on the flyer to him or Bill Taylor.
Health Outcome Data Work Group (HODWG)
Pete Malmquist explained that this work group has not met on the Cancer Incidence Review. As he understood it, once Dee Williamson obtains the validated data from the state, the document will have to undergo an internal review similar to the PHAs. Dr. Malmquist thought that they were looking at several months before they could obtain a copy of the document. They also have not met because the PHAs to date have not dealt with health outcome data. Dr. Malmquist said that the work group will meet as any relevant topics arise.
James Lewis thought that the original design of the work group was not only to discuss health outcome, but also because people had many health issues to discuss. Mr. Lewis explained that this group was developed so that the public could come and share their concerns with this work group. Pete Malmquist said that he could "solve the problem" and appointed Mr. Lewis as the Vice Chairman of Health Issues so he could call a meeting when he so desires.
Presentation/Discussion: Y-12 Uranium PHA Video
Bob Safay explained that this is the first site-specific video prepared by ATSDR related to health. Mr. Safay said that the process began in September 2004. Since this time, he has received comments from many individuals and groups, including the CCCWG, EPA, DOE, and ATSDR/ CDC. He said that EPA and DOE have signed off on the document and it has passed through ATSDR/CDC clearance.
Bob Safay thanked the subcommittee members for their comments on the script and their suggestions for individuals to interview. He noted that he had a few changes to make: a) add credits, b) replace Tim Joseph's reference to mercury with silver, and c) re-shoot the community member gardening scene.
Bob Safay wanted to hear their comments on this most recent version of the video. He noted that this will be menu-driven and emphasized that the community is the audience. The video is divided into three parts, with the first two parts mainly for the public and the last part for the more technical audience. Mr. Safay noted that the video measures 8.6 gigabytes (GB).
Bob Safay is currently in the process of developing a DVD jacket. After the jacket is completed and he adds the credits to the end, he will send it out for publication. Mr. Safay started the video at 4:35 p.m.
Following the video, Herman Cember commented on the comparison of doses. He said that when you say 2/10 of a millirem (mrem) for lifetime, this would be about 10 minutes in an airplane. Dr. Cember said that you would get more in about an hour during a flight on a commercial jet aircraft.
Tony Malinauskas said that the PHA should indicate the libraries (e.g., Oak Ridge Public Library) where the PHA is available for public review.
Jeff Hill commented on the video. He noted that when the video discusses exposures and comparisons, the narration says that DOE restricts workers to 100 mrem per year; however, this is untrue. Herman Cember said that this is 5,000 mrem at the DOE level. Mr. Hill said that if they wanted to say that DOE has guidelines of 100 mrem for the public as the standard, then that would be a true statement. Jack Hanley said that this should be public instead of worker. Tim Joseph suggested saying that the regulation is 5,000 mrem, but that every year the highest maximum exposure for workers is usually less than 100 mrem. Mr. Hill suggested removing this unless they were going to conduct research to validate that statement. Bob Safay thought it would be easier to leave off.
Jeff Hill stated that the kidney and liver are each noted as target organs in different parts of the video. Herman Cember said that this should be kidney.
Jon Richards stated that the narration says that the Nuclear Regulatory Commission (NRC) and DOE have 100 mrem, but that the graphics still had federal government. Mr. Richards said that this is not a federal government number and that it would be better to put DOE and NRC on the graphic.
Tony Malinauskas said that the video mentions background radiation due to generally ground level activities and then says it is because of elevation when discussing radiation in Denver. However, Dr. Malinauskas noted that this is actually cosmic radiation. Bob Safay said that the original video mentioned location and geography, but EPA asked him to change it to say this was due to elevation. Dr. Malinauskas added that the video says that the general background radiation is due to radiation from rocks and water, which does not make sense because elevation has nothing to do with radiation in rocks and water. Jon Richards clarified the term "elevation" in that Dr. Malinauskas was saying people are getting more cosmic radiation. Mr. Safay reminded the group that they are trying to keep this video in terms that are understandable for the general public. He thought they might not want to use terms such as "cosmic radiation," but noted that they could work on the language.
Charles Washington stated that minimum risk levels (MRLs) in vegetables are discussed in the video, but the video does not mention that the data are for 1995–2003 when the facilities were not operating at capacity. He suggested interjecting a clarification statement to show that risks are not expected even when the capacity is much greater than today. Jack Hanley responded that when the state estimated doses for soil in the Dose Reconstruction, assumptions were made for consuming vegetables based on the past analysis for 1944–1995, and estimates were made for uranium exposure posed from the vegetable pathways. He noted that measured data were available for the current exposure.
Charles Washington asked if Jack Hanley had emissions data from 1944; Mr. Hanley said that he did have these data. He had emissions rate and deposition rate data and used the highest level of uranium in the soil in the floodplain for the evaluation. Mr. Washington stated that no filters were present back then and now there is equipment to keep the emissions from being airborne. Mr. Hanley said that the past estimates were based on emissions released from Y-12 during 1944–1995, and all assumptions were included in those estimated emission releases. Mr. Washington said that many questions came to his mind while he watched the video and explained that there are many people in the area who know about these past activities. His concern was not to raise more questions than they solve.
James Lewis thought that Karen Galloway had brought up some comments that were made about the Dose Reconstruction by people at the Oak Ridge National Laboratory (ORNL). He recalled that the responses were that some of this information was not necessarily believable. He asked if the people familiar with these topics and those who had made these comments reviewed this video. He wanted to know the identities of these people and their comments. He also thought it had been mentioned that data in the Reports of the Oak Ridge Dose Reconstruction, Uranium Releases From the Oak Ridge Reservation—a Review of the Quality of Historical Effluent Monitoring Data and a Screening Evaluation of Potential Off-Site Exposures (referred to as the Task 6 report) had underestimated a particular amount. He wanted to know if the author of the report was in agreement with ATSDR's findings because he wanted to hear from technical experts familiar with the Task 6 to see if it is as good a document as it seems.
Kowetha Davidson did not want them to discuss the document because this was the group's opportunity to talk about the video. She said that they do not need to discuss the PHA because it has already been released to the public. She either wanted the group to endorse the video or suggest that ATSDR not prepare additional videos.
James Lewis wanted to know if ATSDR has received input on the video from principal scientists who prepared these documents. Jack Hanley explained that ATSDR hired independent technical experts to review the Task 6 report, and one of the reviewers also peer reviewed the Y-12 PHA. He noted that all of this information was provided to ORRHES last year and that no substantive comments were received on the document by any of the three independent peer reviewers. In addition, ATSDR addressed comments from EPA, which were included in the PHA, and EPA has also reviewed the video. Tim Joseph added that DOE had an independent review of the Task 6 report via Auxier & Associates. Mr. Lewis wanted to know if the principal author or other technical experts who have questioned the document (e.g., Bob Peele) reviewed the video. Kowetha Davidson said that there was no new material in the video and these individuals have seen the PHA. Mr. Hanley added that everything in the video is also in the document.
Bob Craig said that ORNL is only called X-10 by "insider clubbers" and that it is known worldwide as ORNL. Kowetha Davidson cautioned Dr. Craig to remember that ORNL has also been located at Y-12. Jack Hanley thought that it would have been X-10 when discussing iodine and other products depending on the time period. Dr. Craig said that iodine would have come from ORNL because it was around 1954/1955.
Jeff Hill said that the video mentions exposures to the community as 150 mrem over lifetime (70 years) only one time. He found it confusing that this comparison was used and the comparison to the 100 mrem annual dose was also mentioned. He suggested possibly removing this from the video because he did not think it added anything. Mr. Hill thanked Bob Safay for producing the video. Tony Malinauskas thought this was a very good product.
Tim Joseph believed that the public is unable to visually perceive log graphs. He suggested not using log graphs in future videos because they are difficult for the public to understand and they do not visually show what you are trying to indicate. Bob Safay explained that recommendations were made several times to remove them, and then to include them. ATSDR's contractors told him that the line would be almost invisible because it would be so far down on the graphs. Dr. Joseph replied, "That's the point."
Kowetha Davidson asked ORRHES members to send all of their comments on the video to George Gartseff, Jack Hanley, or Marilyn Horton.
Bob Safay summarized the comments received on the video regarding: a) cosmic radiation,
b) removing the word worker when discussing 100 mrem, and c) changing liver to kidney. He would also look into Jeff Hill's comment on changing the dose to annual instead of lifetime. Bob Craig commented that the whole basis for the 5,000 mrem is to compare it to lifetime. Dr. Craig did not see how they could not compare the dose to lifetime. Jack Hanley said that there are comparisons for annual and lifetime in the PHA, but that this would be too much for the video.
Discussion of Next Meeting
Kowetha Davidson said that they needed to choose a date for the next ORRHES meeting. She suggested the first Tuesday in May 2005. During the meeting, the EEWG will bring forward its recommendations and comments to ORRHES, and the subcommittee will provide recommendations to ATSDR based on the EEWG's comments and the discussion during the ORRHES meeting. The tentative meeting date was scheduled for May 3, 2005.
Action Items From Today's Meeting
Marilyn Horton went over the action items from today's ORRHES meeting:
- Provide James Lewis with a hard copy version of PHAGM.
- Add DVD onto the old schedule of PHAs.
- Add a column to show the final PHA at the end of the schedule table.
- ATSDR is currently working on the four-page summary document for the TSCA Incinerator PHA.
- Discussed (not recommendation or vote) on having a draft summary document available at the time that the PHAs are mailed out.
- Add overheads and transcripts to presentations on the Web site.
- Post recommendations and responses from each meeting on the Web site.
- Post the Draft TSCA Incinerator PHA on the Web site.
- Discussed the Y-12 Uranium PHA video and the subcommittee's suggestions.
- Next CCCWG meeting is scheduled for March 29, 2005.
- Send comments on the TSCA Incinerator PHA to Tony Malinauskas by April 5, 2005.
- Next EEWG meeting is scheduled for April 11, 2005.
- Next ORRHES meeting is scheduled for May 3, 2005.
Additional Items
Jeff Hill asked if they needed to make a vote or motion to have the draft summary document released. Kowetha Davidson replied that the work group decided that it did not want this summary document released at this time. Mr. Hill said that they had wanted the draft available at this ORRHES meeting. Dr. Davidson responded that the current process is to have the summary document released at the same time as the PHA; however, this summary document was not released at that time because the CCCWG did not want it released. Jack Hanley explained that this is a problem with the new process. Mr. Hill confirmed that the summary and the PHA would be released at the same time in the future; Mr. Hanley said that this was correct.
Tony Malinauskas reminded the group that comments on the TSCA Incinerator PHA are due to him by April 5, 2005, and will be discussed at the April 11, 2005, EEWG meeting. Kowetha Davidson would also ask Bill Taylor and Marilyn Horton to send comments to Dr. Malinauskas no later than April 15, 2005.
Meeting Adjourned
Kowetha Davidson adjourned the meeting at 5:45 p.m.
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