Savannah River Site Health Effects Subcommittee (SRSHES) Meeting

Meeting Summary

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List of Acronyms
	ACPM  American College of Preventive Medicine  ATSDR  Agency for Toxic Substances and Disease Registry  CDC  Centers for Disease Control and Prevention  DOE  Department of Energy HESs  Health Effects Subcommittees HHS Department of Health and Human Services NCEH National Center for Environmental Health NIOSH National Institute for Occupational Safety and Health OICP  Occupational Illness Compensation Program  SRSHES  Savannah River Site Health Effects Subcommittee

HHS and CDC convened an SRSHES meeting on June 6, 2002 at the Radisson Riverfront Conference Center in Augusta, Georgia. The January 10-11, 2002 meeting minutes were unanimously approved with the amendment as noted in the record. Current action items were completed by scheduling agenda items or disseminating information.

SRSHES agreed to clarify and clearly define the mission of each workgroup in writing before making structural changes. Agreement was reached that the collective SRSHES rather than individual workgroups would continue to serve as the official outreach mechanism to the public. Assignments for each workgroup were noted for the record. The Epidemiologic Data Workgroup is awaiting guidance from NCEH in identifying the most useful and effective information to collect for Phase III of the dose reconstruction project.

Technical assistance from NCEH epidemiologists is also needed to define the workgroup’s future direction in terms of accessing available resources and existing data. The workgroup will only focus on data from SRS releases, but may expand to other sites in the future. SRSHES was interested in consulting with a non-CDC epidemiologist to assist the workgroup in collecting data. The Agenda Workgroup will identify agenda items that were previously recommended and report outstanding issues to SRSHES.

The former Outreach Workgroup chair will be contacted to obtain comments from former and current members on the SRSHES brochure. The Community Summary Workgroup will receive final comments on the Phase II community summary, call for a vote, and then ask CDC to revise and distribute the document. The proposed draft charter for HESs has not yet been approved by the agencies; the current SRSHES charter expires on July 7, 2002. The revised charter will be distributed to SRSHES immediately after the draft is cleared for release to HESs.

OICP provides compensation to persons who become ill as a result of work at DOE facilities and certain of its vendors, contractors and subcontractors. The program was implemented in July 2001 and is divided into federal and state components. Under the federal program, employees and survivors can submit claims for cancer, chronic beryllium disease, beryllium sensitivity and silicosis. NIOSH performs a dose reconstruction to determine cause and effect of cancer claims for any worker not involved with gaseous diffusion processes.

Employees and survivors receive compensation for covered medical costs and a lump-sum payment of $150,000. Ten resource centers have been established in areas with major DOE facilities to assist workers in filing claims. As of May 2, 2002, $190.4 million has been paid. Under the state program, DOE assists contractors and survivors in filing claims for state workers’ compensation benefits. Covered illnesses caused by exposure to a toxic substance in the course of employment at a DOE facility include heavy-metal poisoning, asbestosis, liver disease, nervous system disorders, non-cancerous respiratory problems, kidney disease and certain reproductive disorders.

Hearing loss, primary depression, carpal tunnel syndrome and lower back pain are not considered. HHS appoints panels of independent physicians with expertise in occupational illnesses to review medical and exposure records of claimants. SRSHES noted that OICP criteria for doses are large compared to existing epidemiological studies of DOE workers. A recent newspaper article reported that most SRS claimants have not received compensation.

In Phase III of the SRS dose reconstruction study, radionuclides released from the site that were of highest significance relative to human health effects will be determined. A report by the International Atomic Energy Agency is being considered as the data source for default values. The basic screening model will calculate the activity released as well as factors for environmental dispersion, food transfer, human usage and dose. The study area for the SRS dose reconstruction project has been defined as 50 miles around the perimeter of the site.

The Phase II source terms and demographics on the exposed human population will be incorporated into the screening scenarios, such as age; location of residence, work, school and food sources; breathing rate; and percent of time spent outdoors. Milk will be particularly emphasized as a food source in the screening scenarios. The screening scenarios currently being considered include the rural family, urban/suburban family, migrant worker family, houseboat family, delivery person and outdoors person. CDC has hired a contractor to conduct the screening analysis and collaborate with the Scenario Workgroup.

ATSDR has entered into a five-year cooperative agreement with ACPM to implement a capacity-building program with environmental health education activities related to I-131. ACPM is a national medical specialty society with more than 2,000 physicians who are Board-certified in preventive medicine and other specialties. Under the I-131 education project, ACPM will establish a central data source; facilitate exchange of information among affected sites; and design and disseminate materials to health care providers, community-based groups and other target audiences at the SRS, Hanford and Oak Ridge sites. During the implementation of the I-131 education project, ACPM will seek input from HESs and integrate new activities with existing community-based initiatives.

ATSDR distributed the pilot test of the draft Case Studies in Environmental Medicine. These documents serve as valuable tools for ATSDR to educate physicians, nurses and other health care professionals. An evaluation form asks health care providers to record the amount of time to complete the activity and rate the usefulness of the case studies. The draft document can be distributed only to health care providers at this time.

ATSDR circulated the draft report on the SRS environmental health education needs assessment. Data collected for the project will be used to develop tools and training for outreach activities and health education and promotion initiatives. During 18 focus groups with 110 community leaders in ten SRS counties, recommendations were made to SRSHES and agencies participating in the needs assessment.

The suggestions related to modifying SRS environmental health materials to make them easier to read; revising current SRS communication channels to reach broader audiences; and collaborating with community leaders, schools, health care providers and other local organizations. These approaches will improve message delivery, enhance knowledge about SRS and provide science-based education. ATSDR requested assistance from SRSHES in assigning a member to the project and engaging SRS health care professionals in the needs assessment.

SRSHES reviewed new action and agenda items raised during the meeting and properly voted on consensus recommendations. The Chair opened the floor for public comment at all times as designated on the agenda. The next SRSHES meeting is tentatively scheduled for September 12-13, 2002; September 5-6, 2002 was selected as the alternate date. Suggestions were made to hold the meeting in Hilton Head or Columbia, South Carolina or Atlanta or Savannah, Georgia.