Public Health Assessment Work Group
Meeting Minutes
March 18, 2002
Agenda
- Review of minutes (10 min) - Bob Craig
- Update on PHA and ATSADR issues (10 min) - Jack Hanley
- Videotape on beryllium (30 min) - James Lewis
- Needs assessment for DOE worker medical surveillance
(10 min) - James
Lewis
- Screening maps (30 min) - Bob Craig
- New business (10 min) - Bob Craig
Attendees:
Gordon Blaylock
Bob Craig
Bob Eklund
Karen Galloway
George Gartseff
Jack Hanley, ATSDR (phone)
David Johnson
Timothy Joseph, DOE
James Lewis
Pete Malmquist
L.C. Manley
Bill Murray, ATSDR
Unfinished Business
Pete Malmquist made a motion to approve minutes of the PHAWG Meeting
on January 7, 2002. Bob Eklund seconded. All in favor, none opposed. Minutes
were approved.
David Johnson made a motion to approve minutes of the PHAWG Meeting on
February 4, 2002. Bob Eklund seconded. All in favor, none opposed. Minutes
were approved.
Bill Murray will submit draft minutes of the PHAWG Meeting on February
19, 2002, by our next PHAWG Meeting.
Update on Issues Regarding Public Health Assessment (Jack Hanley)
- We developed a Work Plan originally with Al Brooks. Jack thinks it
may be time that he takes another look at it and modify it now that
we’ve been around for a year.
- We have a flow diagram. We have made progress on the screening, contaminants
of concern, epidemiology.
- First year was about getting everybody “on board” and
familiar with ATSDR’s PHA process and the methodologies. This
took time, but the intended result is that, in the near future when
we’re it comes time to make these PHA decisions, the Subcommittee
and the Work Group members can help ATSDR make effective decisions for
this area.
- One great hurdle that we’ve already cleared: the Work Group
and Subcommittee reviewed, discussed, and adopted the use of the State
of Tennessee screening process to identify contaminants of concern (COC).
Now we need to make progress and move forward on each of the individual
COCs.
- Another thing that was instrumental was addressing issues/concerns
that were brought to the table in writing. We had to develop methods
of communicating what are findings were and also making sure that we
clearly addressed those concerns. We did that with the screening process.
He hopes that the Work Group will continue to develop and use the process
that James Lewis developed so that we continue to collect, document,
and address concerns. That will be the key to making progress.
- Thanks to Lucy Piepins, most of us now have some understanding of
the skills needed to review scientific reports. The critiquing exercise
was helpful. Jack would like to have those types of activities in the
near future with some of the outstanding issues.
- Came up with the initial list of COCs. There could be other issues
or specific contaminants that come up.
- Jack’s goal over the next 6-8 months is to go over iodine and
uranium and some of the individual COCs with the mapping that the PHAWG
is looking for. In future PHAWG meetings, we need to lay out a strategy
to cover outstanding issues on these.
- Regarding iodine: We’ve had a site visit, and some excellent
technical presentations that were comprehensive on the issues. We may
need to refamiliarize ourselves on some of these issues since it’s
been a while since we’ve heard them. One big issue is whether
we should combine iodine doses. Now that Paul Charp is on board, the
Work Group should look at this again. Jack needs to know the Work Group’s
position on combining doses. Jack and Paul are going to work together
to lay out the carcinogenic and non-carcinogenic effects of iodine.
Paul will be talking about the 5-rem issue. They will also be trying
to determine the geographic regions that need to be looked at more closely.
- The Work Group and Subcommittee did address the source term issues;
they’re almost finalized.
- Regarding uranium: Jack would like to lay out a strategy, maybe in
the next PHAWG meeting, to get uranium evaluated, get the concerns collected,
and make some headway on uranium. Bob Craig asked Jack to give PHAWG
an overview of what ATSDR’s conclusions are and what health effects
of uranium are, and of the different isotope concentrations of it. We
understand the relative threat or risk of depleted uranium vs enriched
uranium. That deals with K-25 and Y-12. They were really quite different.
Jack said we’ll likely have to take those in different meetings
and break them out, and Jack will develop a strategy for the Work Group.
Bob Craig stated that all uranium was just plastered as “uranium”
and it really is so completely different.
Bob Craig: Jack, you need us to make a decision for you on are we going
to combine the dose from the atmospheric testing? Is that right?
Jack Hanley: That was an outstanding issues for the Work Group last
year. The presentations we’ve had by Owen Hoffman, Tom Widner, and
Charles Miller lay out many of the issues. It may take someone sitting
down and reviewing those presentations, looking at the minutes, summarizing
it for the Work Group. The Work Group has to deal with that issue. That
issues still seems to be churning. We (ATSDR) would like to get your position
on it.
Pete Malmquist: After listening to all the speakers, to my mind, there
was an exposure. I can’t remember which speaker - when we asked
him if his daughter was exposed, what would you do? He said I would inform
her, and then tell her to go to her health professional and be sure and
be checked for that. In my mind, what difference does it make whether
the exposure was 2 or 10? If you’re exposed, that person should
be told, and go to their health professional and the health professional
does it. Doesn’t matter to me what the dose was. They were exposed
- whether it’s small or large - what difference does it make?
Jack Hanley: There are doses where you would say it is definitely not
a problem.
Pete Malmquist: I agree, but I’m talking about those people in
the area that have been exposed, and they are exposed, say, over here
in Bradbury.
Jack Hanley: In areas where we know they’re at levels of health
concern or at levels where we’re not quite sure. That’s what
we’d like to lay out - some kind of way geographically to show those
areas. There are other areas where dose was so low that you don’t
have any concerns, and we need to make that clear for those folks.
Pete Malmquist: I agree - if you go north from here to Wartburg, there’s
probably no concern. But I think we’d be spinning our wheels sitting
here talking about doses, rather than geographic areas where people would
be exposed.
Bob Craig: As I see it, you’re going to be able to delineate (using
quite conservative estimates) areas that could have received doses where
you might see an effect. Is that correct? You’re going to delineate
those geographical regions? (Jack’s response: Yes.) I think what
I’d like to see is what compounding factor does the atmospheric
testing put on that area as far as: what percent does that raise it, or
does it then raise some other areas that would not have been considered.
And from the way I understand Owen’s calculator, it’s a very
simple thing to do - you just plug in where you are and it tells you what
the atmospheric dose was. Right? It may be a simple thing to do. So that
you guys can be looking at what the impact is from the Reservation, and
we can turn the switch on and say “and here’s what the atmospheric
(testing) may have contributed over and above that.”
Jack Hanley: That’s something I’d have to talk with Paul
Charp, the health physicist, about. But that kind of discussion needs
to go on in the Work Group.
Bob Craig: Right, and that’s what I need to do. But the atmospheric
testing is not trivial as far as the iodine dose during that period.
James Lewis: The question is “should we combine doses?”
In last meeting we had (it wasn’t in this group), we even talked
about combining some of the TVA efforts. I think when we look at this,
even though we look at iodine, we need to look at some of the generic
logic that we’re talking about and where we’re going with
this. Are we vs should we combine doses. What does that
do to our program or charter?
Bob Craig: Yes, again, if we’re not just looking at the Reservation
. . .
Jack Hanley asked if there is someone who can take this issue on to relook
at videos, take notes, and refresh everyone on this issue as James did
in the past on other issues. Kowetha Davidson was thinking of doing it
last year, but not sure if that’s the case now. Someone will talk
to her and see if she still plans to do it.
Bob Eklund had a comment about combining doses. I agree that, in one
sense, we’re just looking at the Reservation. But what we’re
really doing is looking at health of public within the area of the Reservation,
or within the area that might have been affected by the Reservation. Since
we’re looking at the health of those people, we have to take into
account whatever affected their health, whether it was due to the Reservation
or not.
Bob Craig: This case is kind of a baseline dose that you’re getting
from atmospheric testing, and the dose added to that from RaLa processing
during those years. I do see your point, Bob. It would be kind of neat
to look at what we’re getting in excess now and then. Atmospheric
testing was a very short period of time, too; it was actually bursts.
Bob Eklund: But we need to distinguish between what is so small that
it’s insignificant and what is significant. And if atmospheric testing
is a significant thing to add in, we should add it in if we’re trying
to consider the effect on the health of the people.
Bill Murray: Just to make a point, from what I remember from Charlie
Miller’s talk, Charlie said that combining doses was not necessarily
a straightforward thing to do. He would it would require additional work,
and he would need some funding to address the problem because it just
wasn’t something you could do with an off-the-shelf type of approach.
Bob Craig: That’s where I was mistaken. I thought that Owen Hoffman
had an on-line calculator where you put in your specific location and
he read out your dose.
James Lewis: He demonstrated that I know in Scarboro - in the community
- he showed that. As far as Bob’s comment, I don’t know if
this thing has to be looked at in two phases. One is, what was the impact
of the Reservation. Then you may come back and say, if you combine these
things, what do they look at. But I think some kind of logic needs to
be laid out here to . . .
Jack Hanley asked Bill Murray if there was a report recently about all
these releases from weapons testing, etc, that Charlie Miller and all
were working on. Bill Murray responded saying that it was some testimony
that he say recently, and he doesn’t know that he saw anything more
than that. Jack said a number of things are going on now and it all needs
to be brought together.
James Lewis: CNN had a number of reports either last week or two weeks
ago in which they were talking about this issue and the number of deaths
that may have been created . . .
Bob Craig: Yeah, I saw that - 15,000 people killed by cancers . . .
James Lewis: . . . and they made reference to a report that was out,
and I remember that we went on the internet and chased one reference -
the New York Times had a spin on it, and I think they referenced Charlie
Miller’s name if I remember right. Some of the other papers didn’t.
But wherever this document is, I think it is something worthy of us getting
a copy and reviewing it.
Bob Craig said he downloaded the report and has it on his desk.
L.C. Manley: I don’t remember the details, but Senator Harkins
was giving a spill about same thing just a couple of days ago.
Bob Craig: Jack, you’re thinking that we should look for volunteers
among this group for someone to go back and pull the data together?
Jack Hanley: Yes, to look at what has been talked about (key points)
and bring them back to the table and summarize them. Just take it apart
like James has on a number of other issues. That method has been helpful
in the past. I’ll be glad to work with whoever this is.
James Lewis: I think Kowetha sort of gave the indication (we need to
find the minutes or tape) . . . we need to find out from her where she
stands and who wants to help her with it. If she doesn’t remember
that, . . .
Bob Craig: Shall I call Kowetha? James Lewis responded that would be
his recommendation.
ACTION ITEM FOR BOB CRAIG: E-mail Kowetha on review of additive doses
on iodine. This would involve looking at the tapes, looking at the new
report, talking to Paul Charp, and produce an overview/refresher for Work
Group.
James Lewis: In addition to this, we hear “synergistic effect.”
This is not a simple issue. We really need to look at this in light of
what are we chartered to do, what do we do if we do if we combine this
and we head toward the synergistic effect. These are three different steps.
Bob Craig: Synergism is a little bit of a different animal. We know a
lot more about additive doses than we do about synergism. Also, the work
we see on synergism seems to indicate that the dominant contaminants seem
to act almost independently - that there isn’t a whole lot of interactive
effect (or maybe additive). Additive doses in this case, where it’s
the same isotope, and we know where it hit and when it hit, and how much
of it decayed and that kind of thing . . . Okay, Jack, we’ll do
that.
Bob Craig: Jack, are you looking to have iodine and uranium finished
in the next 4-5 months?
Jack Hanley: Yes, I’m shooting to have them done by the end of
the fiscal year (end of September).
Bob Craig: We had talked about iodine in the December-January time period
for a draft. Do you have a timeline now for iodine?
Jack Hanley: I’ve been trying to bring Paul Charp up to speed and
get him involved. I’m thinking maybe at the next Work Group meeting,
we can lay out a time table and what his expectations are to get it done.
Bob Craig: So we’ll get this on the agenda of next PHAWG meeting,
Bill, to talk about a time table. Bill Murray responded yes.
Bob Craig agreed to keep the “Status Update” as a standard
topic on each PHAWG Meeting agenda so Jack can keep the Work Group apprized
of what is needed to proceed with the PHA.
Presentation on Beryllium (James Lewis)
This is a rehash of what was presented to Needs Assessment Work Group.
He’s primarily presenting the PACE Program which cares for the gaseous
diffusion workers here in Oak Ridge. The key here is that we’re
moving from what they define as the Phase I project to the Phase II (where
clinical intervention takes place). Right before you go to clinical intervention,
there is a Needs Assessment.
James basically compared the Needs Assessments of the PACE Program to
the one we’re working on, and highlights the similarities and differences
between the two. Both Needs Assessments utilize ChemRisk dose reconstruction
data. The PACE Program is able to utilize DOE’s actual dosimetry
data on individuals, whereas in the ORRHES effort, we would not have individual
dosimetry data. Both efforts have similar methods used. Both programs
employ exposure assessments. PACE uses “risk mapping;” we
utilize telephone surveys and focus groups from the communities to gather
concerns to complete a similar task.
PACE completed their evaluation of the releases and exposure assessments
prior to identifying what remedial actions and/or clinical actions
that should be taken. One key point: PACE emphasized the need to complete
the evaluations and exposure assessments RAPIDLY as people lose interest
very quickly. ORRHES/ATSDR now has the “clinic” issue on the
table and discussions are ongoing. Jack Hanley’s timeline should
help us keep on task.
PACE has actual recommendations, but we’re not there yet. We may
have potential recommended actions, but we really cannot decide that for
sure until all these other steps are completed (including whatever decision
we make regarding combining doses, whatever information we receive back
from Dr. Jackson, etc.).
Another point: The people who will be coming to give presentations at
the next Subcommittee meeting will focus on PACE, but will also give similar
rolldowns of other programs all over the country.
Mapping (Bob Craig)
Bill Murray passed around colored maps from OREIS indicating where sampling
has been done - one map for each type of sampling media (air, biota, water,
etc.). Bill said John Merkle put these maps together. Chudi Nwangwa (Tennessee
Department of Environment and Conservation (TDEC) - DOE Oversight Office)
generated them. The show locations of all sampling relative to the source
term (DOE Facilities).
Pete Malmquist: How far downstream did you do water sampling?
Bob Craig: Nobody here did it. I don’t think anybody knows. Tim
Joseph may be the only one to answer that. Oh, there are cesium samples
all the way down past Chattanooga.
Pete Malmquist: I know that they took milk samples all over the area.
James Lewis: Maybe you need to frame this regarding what happened in
the last meeting. Susan and John Merkle talked about this issue.
Bob Craig: And he stopped by their (TDEC’s) office, and they said
they could spin those off in nothing flat.
James Lewis: And they had a vote that they wanted to pull maps in the
Work Group, and he went to TDEC and I think this is what was extracted.
Bob Craig: Then I think we ought to postpone whatever we’re going
to do on this until Susan is here. She was certainly the most concerned.
And John Merkle is not here either.
James Lewis: But we don’t get a lot of people to visit the office,
so I think we ought to review this. The question I have is what is the
value-add of this. I had some experiences with DOE on another project
(Scarboro). Tim was so gracious to bring us copies of a report he put
out based on my request from Scarboro. I’m going to make this part
of the record, and put copies in this office. It tells the history of
an effort that went on in Scarboro in which certain maps were presented
and laid out, the reaction that we got associated with those maps. It
was very difficult for us to recover because when the public observed
the issue and saw the maps, they felt like they had been shortchanged
for some reason or another. Nobody was able to recover. There’s
a section in here that I think we could get a . . .
Bob Craig: But I don’t think these would cause any controversy
with folks. But it is kind of good to see where they have taken them.
Now as I understand it these are only the ones at ORNL, which means they
are since 1990. Obviously, there were a lot of samples taken prior to
that time.
James Lewis: You used the term “controversy.” We had a major
problem because somebody took a section of a map that had blocked out
Scarboro on a flyover. That was presented to the entire community. The
impression that they got from that was that they had been ignored. Then
the next thing we knew there was a whole lot of . . . Mr. Manley can explain
it better . . . we do have a videotape and if we can work it in, you can
see the history of what happened as associated with that. I asked Tim
to put together a history of it because we lost sight of what the man
that was there was presenting. He tried to explain to the people what
had gone on to give them a historical timeline. We lost all of that. Next
thing we knew, they were flying over again, we had people out there digging
soil samples up, and this has been 3 ½ years to the best of my
knowledge, and we still don’t have an answer. We may have other
communities requesting the same thing. My point to you is this: People
can do what they want to do, you can look at data. But I’d like
to share with you at next meeting a historical perspective of what happened
with something similar to this if it’s not presented in the right
context so everybody has an understanding. It may take a series of these
(maps). These don’t indicate what you found; they don’t know
when you did it.
Bob Eklund: What chemicals were tested for/found?
Bob Craig: They don’t know that yet. These are analyses by media.
We don’t have hits yet. I can see a lot of samples that I took that
aren’t on here - plutonium in crayfish in White Oak Lake. That was
back in the 1970s, and I don’t think we got into that.
Pete Malmquist: If you look at sampling locations, there’s a logical
thing all the way downstream to the dam. They took sediment samples all
the way across the lake - all the way down.
Bob Craig: Not core samples, but sediment samples? My recollection is
that they only took 5 or 6 core samples because those things are darned
expensive ($20K a pop).
James Lewis: Right behind you is a map that shows the various homes in
Scarboro. Take a look and see the where they sampled, as far as which
plots of land. On that wall is the arial photo of Scarboro. If I bring
you the videotape and you watch the responses to this, you’re going
to see responses like “you tested Ms. So-and-So’s yard, but
you didn’t get one from my yard. I’ve lived here for 15 years
and I live next to the fence . . .” Sometimes trying to explain
sampling to the community . . .
Bob Craig: This is for us, though, and we are a little bit different
than the community, I think. We’ve got a couple of upstream samples,
and quite a few downstream as I see it. We have soil, air, biota, water,
etc. Most were taken in the proximity of where source term is.
Bob Eklund: When you say source term, do you mean where the iodine was
coming from, or the uranium was coming from, or the mercury?
Bob Craig: Right. And it’s right here around the plants. This is
Bear Creek and straight down Bear Creek. Bear Creek was pretty contaminated
from those 3 ponds until they cleaned that up. You can also see that Bear
Creek’s a long way from getting offsite.
Pete Malmquist: The cesium burial was over in this area by Jones Island,
and here’s all the sampling down below it.
Bob Craig: Right. And it’s quite a bit. But that’s where
it’s coming from.
James Lewis: Are those maps comprehensive of (all testing): DOE, TDEC,
EPA, etc.?
Bob Craig: These are from OREIS, and I believe that these are only since
1990, and I’m not sure whether it’s . . .
Gordon Blaylock: Probably, some things go back further than others, but
I’d have to know exactly what you’re asking as far as what
sampling, but I think it goes back further than 1990.
Bob Craig: Gordon Blaylock was the guy who did the sampling. He was out
there every morning in his rubber boots.
James Lewis: Is this what Susan asked for?
Bob Eklund: This is part of it.
Bob Craig: I thought this was pretty much it.
Bob Eklund: It doesn’t tell what they were trying to find - what
did they test for?
Bob Craig: I thought that we kind of waved that off - that she just wanted
to see where the samples were taken by media.
Bill Murray: Her recommendation reads, “The PHAWG recommends to
ORRHES that they urge ATSDR to expedite the generation of maps, in color,
showing where all soil, water, and air sampling was done for each contaminant
of concern as soon as possible because of the importance to the credibility
of the Public Health Assessment.” It doesn’t say anything
about results, and I sent this to her, and these have her corrections
in it.
Bob Craig: I specifically remember discussing results, and she said no,
I just want to know where they were taken, by media.
Tim Joseph: They don’t have contaminants of concern as I heard
him say.
Bob Eklund: That’s a key element.
Bill Murray: She wanted them for each contaminant of concern.
Bob Craig: That could be a whole lot more data, a whole lot more information.
Bill Murray: We’d have to have maps for every one.
Pete Malmquist: If we take soil samples, and you have 15 different contaminants
you’re looking for, you’d have to have 15 different maps to
show what they did for each one.
Bill Murray: You’d have to have multiple maps for contaminants.
Bob Eklund: If you had a map of soil samples and they were all tested
for everything, you could say what they were tested for and use that one
set of maps when you talk about a particular contaminant.
Pete Malmquist: We don’t know how many contaminants did they check
per sample.
Bob Eklund: That’s the million dollar question.
Bob Craig: I don’t know. We can probably get that.
Pete Malmquist: When they took a soil sample, would they not have checked
for a whole spectrum of contaminants?
Bob Craig: I would bet that there would be certain things that they would
get a hit from almost all samples. There would be other things they would
get in very, very few samples.
In looking at the soil sampling map, Bob Eklund asked why they took samples
in Morgan County. Bob Craig said they were used as background samples.
Bob Craig: John Merkle thought this (maps) hit everything he wanted to
see.
James Lewis asked everyone to look at Table 1 (flyover information).
Where you see a “no” on this table, because of the community
reaction, we ended up doing another flyover and samples taken from those
sites.
Tim Joseph: The flyover in 1992 caused more problems because it looked
like they intentionally left off a chunk of Scarboro when it was intended
to be a focused survey. They hit 1/3 of Scarboro because they were doing
the creek.
New Business:
Bill Murray reminded everyone that two recommendations from the last
meeting will be going to ORRHES. We need to make sure we’re on the
same page about those.
The first one is about not sending the letter to Dr. Henry Falk regarding
the need for public availability of the references/interviews for the
Oak Ridge Dose Reconstruction in light what we have learned about the
availability of these references from Dr. Timothy Joseph. Everyone agreed
this one is okay.
The second one urges ATSDR to generate maps in color showing where all
soil, water, and air sampling was done for each COC. The difference between
what we now have and what we’re requesting is the wording “for
each COC” plus periodicity (when they were taken).
There was some discussion about briefing Chudi Nwangwa before the ORRHES
meeting so that he can be prepared to give more details.
James Lewis said the request is going to ATSDR, not TDEC. So he will
have to decide whether this will be a combination of maps from various
sources, etc. We need to keep a central focal point.
Bob Craig said they’re just trying to give Chudi a heads-up.
Bob Eklund said it’s not really Jack’s job until it goes
through ORRHES. If, before that, we find out that the information is already
here (like has already happened in Recommendation #1), we wouldn’t
need to ask.
Bill Murray will give Chudi a quick heads-up, and we’ll be ready
to respond.
Everyone finally agreed that the second recommendation is okay.
Jack talked about the beryllium video. He sent it for us to view because
it gives the historical context of beryllium, what the standards were
then and now, the DOE’s efforts that have gone into this program.
Beryllium is a contaminant where there was a clear source, pathway, exposures,
health effects, and DOE has taken action to protect the people.
BERYLLIUM VIDEOTAPE WAS SHOWN.
Bob Craig scheduled the next PHAWG meeting: April 1, 2002 @ 5:30 p.m.
in the Oak Ridge ATSDR Field Office.
Bob Craig adjourned the meeting at 7:20 p.m.
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