Public Health Assessment Work Group
Meeting Minutes
August 20, 2001

Agenda

1. Discussion on an approach to reaching a consensus on the I-131. (Bill would like everyone to come prepared with ideas on how handle the outstanding questions, issues, concerns, and recommendations regarding I-131).

Attendance

ORRHES Members attending:

William Pardue (Work Group Chair), Alfred Brooks, Kowetha Davidson, Robert Eklund, Karen Galloway, David Johnson, Susan Kaplan, James Lewis, Barbara Sonnenburg (conference phone)

Public Members attending:

Gordon Blaylock, Linda Gass, Margaret Herring, Timothy Joseph, Bob Peele, Suzanne Baktash

Press attending:

Paul Parson

ATSDR staff attending:

Michael Grayson, Bill Murray, Jack Hanley (conference phone)

The meeting assembled at 5:30 pm and was called to order.

Agenda:

Pardue presented two agenda items.

Item #1. Issues that need to be resolved in regard to iodine-131. Lewis and Brooks have developed a system for sorting out these issues and organizing them so that they can be addressed in a defensible manner. Similar techniques will be used for the other Contaminants of Concern (COCs) under review.

Item #2. Discussion of Lucy Peipins' review of the "Mangano" Report. Peipins will present on either August 28 or 30. There is a need to decide how this discussion will be conducted. The Work Group is planning to deliver a report on the Mangano paper to the full Subcommittee.

Eklund proposes an additional agenda item.

Item #3. Discuss "Statements of Clarification" being entered into the minutes.

Pardue proposed that Item #3 be expanded to include the whole process of taking minutes. At a previous meeting, there was uncertainty among members of the Work Group about how and why minutes are taken and approved.

Issue #1:

Lewis presented an organizational scheme (developed with Brooks) whereby PHAWG will first collate technical information about each COC near the Oak Ridge Reservation (ORR) and then will summarize this information for use by the public (Attachment I). Each COC will be considered separately. It was proposed that information dealing with each COC be divided into the following categories:

• A generic toxicology profile


• Site-specific source data


• Off-site exposure scenarios


• Off-site estimated concentrations


• Off-site human exposure estimates, and


• State and local government health data (e.g., cancer registries).

There was discussion of how to respond to other comments and concerns that the public sends to ORRHES.

It was moved that the document presented by Lewis be adopted as a working document. All voting members but Gass voted in favor.

Members of the Work Group identified issues that they want to address at a later date:

• Combining I-131 doses to thyroid from Nevada Test Site (NTS) with those from releases at the Oak Ridge National Laboratory [ORNL] (X-10). Later, this issue was expanded to include doses from weapons testing at the Marshall Islands, Chernobyl, etc.


• Should the central value of the dose value be used in the public health assessment (PHA)? This was later expanded to include which central value would be used.


• Are children more sensitive to I-131? What model will be used? Standard child? Standard man (70 kg)?


• Propagation of errors using Monte Carlo techniques.


• Range of limits on the uncertainty vs. central values.


• Other sources of I-131 at X-10, other sources at the Oak Ridge Reservation (ORR).


• Use of thyroid dose vs. total body dose from I-131.


• Have all releases been estimated to the best of ability and included in the Oak Ridge Dose Reconstruction (ORDR)?


• Understanding what uncertainty means and how it affects ORDR conclusions.


• Non-cancer thyroid effects, hypothyroidism, non-malignant nodules.


• Conservative efforts in source term.


• Is this an issue for workers at ORR, or just the public?

The Work Group agreed that it will prioritize these issues and assign someone to report on the top priority issues, subsequent to the September ORRHES meeting (at which a presentation will be given on I-131).

Issue #2:

Hanley reported that Peipins is offering to present to the Work Group a review of the Mangano Report on the 28^th or 30^th of August. PHAWG will conduct a review under her guidance. She plans to mail her review worksheet to the Work Group in advance. Following this meeting, Peipins will come to the next subcommittee meeting. Everyone will go over the findings of the PHAWG regarding the Mangano Report. Work Group members should read the review and fill out a review evaluation form before going to Peipins' presentation. The group decided on August 28 as a date for this meeting.

The Work Group considered the idea of notifying the entire Subcommittee, or even the general public, of Peipins' upcoming presentation, and decided to give it wide publicity. The Communications and Outreach Work Group will prepare a press release for the meeting. The meeting date was set for Tuesday, August 28, 2001, at 5:30 p.m.

Issue #3:

The Work Group discussed the procedures for taking minutes at meetings. What are they for? How can they be corrected? How should they be maintained? Pardue distributed a draft document describing a possible minute-taking process for the Work Group. The purpose of minutes is to provide an accurate historical record of the meeting that will last longer than the individual members of the group. The question arose of whether or not people should be allowed to correct statements made in error by appending "statements of clarification" to existing minutes that have already been approved. This issue is in specific reference to the wishes of Owen Hoffman to clarify a statement which he was recorded as making in a previous meeting. There was debate about whether or not speakers have an absolute right to clarify a statement which has been subject to question or whether or not speakers must receive a positive vote from the Work Group to add new statements to the Work Group's minutes.

A motion was proposed that:

If an issue arises about a statement made in a meeting, the speaker in question can make a statement of clarification at a subsequent meeting. If the speaker cannot be at the next meeting, he or she can submit a statement of clarification to the chair of the Work Group. This will be read into the minutes of the current meeting. Minutes will not be changed, they can only have a new statement of clarification appended to them.

Votes in favor of this motion were unanimous among voting members. A revised writeup of the minute-taking process, reflecting this change, is attached (Attachment II).

A motion was proposed that:

The previous motion be made retroactive to the meeting of August 6 so that Owen Hoffman could submit a statement of clarification in regard to his previous remarks.

Votes in favor of this motion were unanimous among voting members.

At 9:15pm, the meeting adjourned.

Attachment I:

OAK RIDGE RESERVATION HEALTH EFFECTS SUBCOMMITTEE (ORRHES)
Public Health Assessment Work Group (PHAWG)
Proposed Procedure for Reviewing Issues/Concerns Related to the
Public Health Assessment (PHA) for Each Contaminant of Concern (COC)
at the Oak Ridge Reservation

• Compiling Contaminant Files


• Collect, organize, and assemble all of the pertinent technical health information supplied by the Agency for Toxic Substances and Disease Registry (ATSDR) and other individuals, groups, and sources for each contaminant of concern (COC). The proposed categories for the files are:


• Generic toxicological profile for each COC.
• Site-specific source data.
• Off-site exposure pathways.
• Off-site measured or estimated concentrations.
• Off-site human exposure estimates or calculations.
• State and local government health data (e.g., cancer registry).


• Once the file is assembled for each COC, a Public Health Assessment Work Group (PHAWG) team will be assigned the task to review and summarize the file. The primary goal of the team is to generate a lay summary of the findings identified in the technical health information file for each COC.


• When the file and summaries are completed, the PHAWG will begin its review. All information will be evaluated for technical merit before it is incorporated into the technical health information file. All items that are not deemed to be appropriate for the technical health information file will be transmitted to ATSDR or ORRHES for disposition.


• Case History File


• The Needs Assessment Work Group (NAWG) is responsible for identifying, compiling, and categorizing all of the public health issues and concerns. The concerns file is not limited to off-site issues because it is difficult to separate on-site and off-site issues.


• Categorization of Concerns


• The NAWG categorizes all of the concerns/issues based on the following:


• Relationship to the specific contaminant under investigation.
• The generic implication of the concern to the specific concern under review.
• Documented public health concerns from ATSDR and the Communications and Outreach Work Group and the NAWG.
• Identification of concerns that should be directed to other health agencies for review.


• The NAWG Summarizes the concerns into a specific issue list for evaluation and review by the PHAWG to determine what recommendations are required.


• Final Report and Recommendations

Attachment II:

Process for Developing PHAWG Minutes

Background: Quality minutes of meetings are absolutely critical to the operation of any organization. In the case of the PHAWG of the ORRHES, this is especially true. The Work Group deals with complex technical issues, many of which have a high emotional content and are of interest to a widely diverse and geographically scattered audience. Further, the results of the PHAWG deliberations will result in a major portion of the ORRHES recommendation to ATSDR. Participation in the PHAWG will likely vary over a time frame that may be measured in years, and attendance may not be uniform by the ORRHES members and members of the public. Finally, these minutes must be maintained with a high degree of integrity to permit anyone who has an interest in the meetings to satisfy that need.

Purpose: It is the purpose of this document to define the PHAWG policy on minutes of their meetings.

Details: Minutes must have the following characteristics:

• actual account of what happened


• sufficient detail to allow understanding of the proceedings


• action items, major conclusions, and recommendations developed shall be recorded verbatim and read back by the note-taker prior to voting


• include the vote count (by individual) on each vote taken


• be backed up by some electronic recording (audio or visual) which will be a permanent part of the PHAWG files, as will be approved copies of the minutes


• be approved by the PHAWG membership

Process: The minutes will be prepared by a party who is not an ATSDR staff member and who will be present at the meeting. All notes, etc. used in the preparation of the minutes will be supplied to ATSDR for the record, along with the electronic record. Draft minutes will be reviewed by the PHAWG chairperson and supplied to the PHAWG distribution list via e-mail one week in advance of the next meeting for review.

Approval: At the following meeting, the chair will entertain a motion for approval of the draft minutes. Discussion of any proposed changes will be held. Proposed changes can be made by any member of the PHAWG, including members of the public, who were present at the meeting for which the minutes were taken. Comments may be submitted in writing to the PHAWG distribution list prior to the meeting or raised orally at the meeting during the discussion of the minutes. After reasonable discussion, the chair will call the questions and the minutes will be approved as written, or as modified.

If an issue arises about a statement made at a meeting, the speaker in question can make a statement of clarification at a subsequent meeting. If the speaker cannot be at the next meeting, he or she can submit a statement of clarification to the Chair of the Work Group. This will be read into an addendum to the minutes. Minutes will not be changed. They can only have a new statement of clarification appended to them.

If questions of fact arise, the minute taker will be instructed to check the accuracy of the minutes against the electronic record and report such at the next meeting. Action on approval of the minutes will be postponed until that report is received.