Savannah River Site Health Effects Subcommittee (SRSHES) Meeting

Meeting Minutes
March 13, 2003

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Dr. Todd Crawford, an SRSHES member, explained that ABRWH is chartered to advise the HHS Secretary in three specific areas: guidelines for implementing the Energy Employees Occupational Illness Compensation Program (EEOICPA); the scientific validity and quality of dose reconstruction; and a class of employees exposed to radiation at DOE facilities for which a dose reconstruction would not be feasible and radiation exposure may have endangered health. EEOICPA was enacted by Public Law 106-398 in 2000. On December 7, 2000, Presidential Executive Order 13179 established responsibilities for DOE, ABRWH and the Department of Labor (DOL) to implement EEOICPA.

DOE is mandated to establish a panel of physicians to determine whether workplace toxic chemicals contributed to illness. Claimants with a positive diagnosis are to be referred to the state workers= compensation program. With assistance from the National Institute for Occupational Safety and Health (NIOSH), DOL is mandated to reconstruct doses of claimants and identify recipients for $150,000 in compensation. To fulfill its role in EEOICPA, NIOSH established the Office of Compensation Analysis and Support (OCAS) to interact with and serve as a point of contact for claimants. OCAS receives 80-100 telephone calls per day. As of January 31, 2003, 10,472 claims had been submitted and 14,017 telephone calls had been made. OCAS also conducts dose reconstructions.

During the claims process, the claimant receives an acknowledgment letter from OCAS, an introduction letter from Oak Ridge Associated Universities (ORAU), a letter and summary of the telephone interview, an ORAU dose reconstruction initiation letter, and draft and final dose reconstructions for the claimant’s signature. ORAU is contracted to perform the dose reconstructions. In an effort to obtain worker monitoring and workplace data from DOE sites, 6,825 requests were sent to DOE through December 31, 2002. Of 1,302 requests for worker monitoring and workplace data submitted by OCAS to SRS, 499 responses have been provided. As of January 2003, 18 dose reconstructions were completed, but no awards were made as of that time. For claims approved after a claimant’s death, compensation is made to survivors.

EEOICPA awards are made based on the following criteria. The dose reconstruction results in a probability distribution of exposure for each organ. Epidemiological data provide a probability distribution of cancer causation for different exposures to each organ. The two distributions are combined by random sample to yield an overall probability of cancer distribution. Compensation is made if the probability of cancer causation is >50% at a 99% confidence interval of the combined distributions. In February 2003, ABRWH held its 11th meeting since January 2002. At this time, ABRWH reviewed and approved an adjustment to the probability of cancer causation software.

ABRWH was involved with developing the claims process with NIOSH and DOL, but the members expressed concern about the lack of staff and delays in processing claims upon further review of the system. During its February 2003 meeting, ABRWH also reviewed and approved a request for proposals for a contractor to assist the members in performing quality reviews of dose reconstruction calculations. ABRWH identified several issues for further study: smoking adjustment for lung cancer; age and time of exposures; incorporation of background cancer risks and occupational studies; chronic lymphocytic and other leukemias; grouping of rare types of cancer; latency period for thyroid cancer and leukemia; dose rate effect factor and dose adjustments; risk transfer from the Japanese cohort; race/ethnicity adjustment for skin cancer; and interactions with other workplace exposures.

Dr. Umansky noted that the 99% probability level of cancer is extremely high, particularly in light of uncertainties. He indicated that perhaps this figure was established to limit the number of awards. He questioned whether an appeals process had been developed for denied claimants and survivors. Dr. Crawford clarified that the probability of cancer causation must be >50% with a 99% confidence interval. With these criteria, he was concerned some awards may be made in the absence of supporting epidemiological data. Mr. Hills reported that survivors of a deceased former worker with positive beryllium exposure from the Oak Ridge, Tennessee site received $150,000. Mr. Green announced that OCAS’s extensive web site contains all ABRWH meeting minutes, reports and recommendations. The information can be accessed at www.cdc.gov/niosh/ocas.