Oak Ridge Reservation
Environmental Health Archives
Current as of 10FEB99
Compiled by
Captain John R. Stockwell, M.D., M.P.H
U.S. Public Health Service
Proceedings of the Oak Ridge Workshop on Energy-
Related Public Health Activities Held at the
Ramada Inn in Oak Ridge, Tennessee on October 30
-31,1997
04DEC97
Oak Ridge Reservation
Environmental Health Archives
(ORREHA)

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4
DEPARTMENT OF HEALTH & HUMAN SERVICES
Public Health Service
Centers for Disease Control
and Prevention (CDC)
Atlanta GA 30341-3724
December 4, 11997
Dear Participant:
Enclosed is a draft copy of the proceedings from the Oak
Ridge Workshop on Energy-Related Public Health Activities held at
the Ramada Inn in Oak Ridge, Tennessee on October 30-31, 1997.
Please send any comments or changes you may have to me at the
address listed below. If the changes are more than editorial,
they will be added as an attachment at the back of the
proceedings.
Thank you for your participation and help in making this Workshop
a success.
Sincerely yours,
Nadine Dickerson
Program Analyst
Radiation Studies Branch
Division of Environmental Hazards
and Health Effects
National Center for Environmental Health
Centers for Disease Control
and Prevention
4770 Buford Highway, N.E., MS-F35
Atlanta, Georgia 30341-3724
Enclosure
SvTHST^fW

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DRAFT COPt DRAFT
Oak Ridge Workshop on Energy-Related
Public Health Activities
PROCEEDINGS
October 30-31, 1997
Ramada Inn Oak Ridge
420 South Illinois Avenue

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Table of Contents
Agenda
1	Pw-pose/Goals/Approach
Government Participant Roster
Workshop Attendee Roster
4
Proceedings  October 30, 1997
October 30, 1997
Speakers' Hard Copies: Talks/Slides
October 30, 1997
Participants' Hard Copies: Talks
October 30, 1997
Charge to the Breakout Groups
8
October 30, 1997 -- Breakout 1
Community Health Studies
October 30, 1997  Breakout H
Worker Health Studies
10
Proceedings  October 31, 1997
11
October 31,1997
Speakers' Hard Copies: Talks/Slides
12
Miscellaneous
AVERY

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Development of an Agenda for Public Health Activities
at the Oak Ridge Reservation
* * * Workshop Agenda * * *
October 30.1997
1 00 pm Introduction and Welcome
Background and Workshop GoaJs
1  10 pm Introduction and Welcome
1:20 pm Introduction and Welcome
Presentations on Community Studies and Other Public
1:30 pm Tennessee Department of Health
Presentation
1:5G pm Questions and Answers
2:00 pm ATSDR Presentation
2:20 pm Questions and Answers
2:30 pm Break
Department of Energy (DOE)
Paul Seligman, Deputy Assistant Secretary
for Health Studies
James Hall, Manager, Oak Ridge Operations Office
Centers for Disease Control and Prevention
William Parra, Deputy Director, National Center
for Environmental Health
Agency for Toxic Substances and Disease
Registry (ATSDR)
Peter McGtmiiskey, Dcpuh Assistaiit Adrn'uiisUatui
Health Activities:
Doris Spain, Assistant Commissioner
William Moore, State Epidemiologist
Jack Hanley, Lead Health Assessor

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Presentations on Worker Studies:
3:00 pm National Institute for Occupational Safety
and Health (NIOSH) Presentation-
Past Studies
Donna Cragle, Oak Ridge Institute for Science
and Education
3:20 pm Questions and Answers
3:30 pm NIOSH Presentation-Current Studies
Larry Elliott, Chief, Health-Related Energy
Research Branch
3.50 pm Questions and Answers
4.00 pm DOE Presentation
Paul Seligman, Deputy Assistant Secretary
Secretary for Health Studies
4 20 pm Questions and Answers
Public Comment:
4:30 pm Public Comments and Questions
5.30 pm Session Concluded; Break for Dinner
Breakout Sessions.
6.30 pm Breakout Session on Community Health
Studies and Other Public Health Activities
Breakout Session on Worker Health Studies
9:30 pm Breakout Sessions Concluded;

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October 31.1997
\
Wrap-Up Sessions:
9:00 am Facilitators Report on Breakout Session
Results
9:30 am General Discussion on Breakout Session
Results
10.00 am Development of List of Public Health
Priorities for Site
11:45 am Closing Comments	Paul Seligman, Deputy Assistant Secretary
for Health Studies
N

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Oak Ridge Workshop on Energy-Related
Public Health Activities
Government Participant Roster
October 30-31, 1997
Ramada Inn Oak Ridge
420 South Illinois Avenue
Oak Ridge, Tennessee 37830
(423) 483-5972
Department of Energy
~ Paul Seligman, Deputy Assistant Secretary-
Office of Health Studies
U.S. Department of Energy
19901 Germantown Road
DOE, MS-EH-6
Germantown, Maryland 20874-1290
(301) 903-5926
~ Heather Stockwell, Director
Office of Health Studies
U.S. Department of Energy
19901 Germantown Road
DOE, MS-EH-6
Germantown, Maryland 20874-1290
(301) 903-5926

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Oak Ridge Workshop
Government Participant Roster
October 30-31, 1997
Department of Energy (continued)
~ Andv Lawrence
Office of Health Studies
U.S. Department of Energy
19901 Germantown Road
DOE, MS-EH-6
Germantown, Mi viand 20874-1290
(301)903-5926 '
~ Barbara Brooks
Office of Health Studies
U.S. Department of Energy
19901 Germantown Road
DOE, MS-EH-6
Germantown, Marvland 20874-1290
(301) 903-5926
~ Timothy Joseph, Senior Environmental Scientist
U.S. Department of Energy
P.O. Box 2001
200 Administration Road
Oak Ridge, Tennessee 37831
(615) 576-1582

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Oak Ridge Workshop
Government Participant Roster
October 30-31, 1997
Centers for Disease Control and Prevention
~ Tim Smith
Radiation Studies Branch
National Center for Environmental Health
Centers for Disease Control and Prevention
4770 T.uford Highway, MS-F-35
Atlanta, Georgia 30341
(770) 488-7040
~ Mike Sage
Radiation Studies Branch
National Center for Environmental Health
Centers for Disease Control and Prevention
4770 Buford Highway, MS-F-35
Atlanta, Georgia 30341
(770) 488-7040
~ Art Robinson
Radiation Studies Branch
National Center for Environmental Health
Centers for Disease Control and Prevention
4770 Buford Highway, MS-F-35
Atlanta, Georgia 30341
(770) 488-7040

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Oak Ridge Workshop
Government Participant Roster
October 30-31, 1997
National Institute for Occupational Safety and Health
~ Larry Elliott
NIOSH, MS-R-44
4676 Columbia Parkway
Cincinnati, Ohio 45226
(513) 841-4400
~ Bill Murray
NIOSH, MS-R-44
467 6 Columbia Parkwav
Cincinnati, Ohio 45226
(513) 841-4400
~ Steve Ahrenholz
NIOSH, MS-R-44
4676 Columbia Parkway
Cincinnati, Ohio 45226
(513) 841-4400

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Oak Ridge Workshop
Government Participant Roster
October 30-31, 1997
Agency for Toxic Substance and Disease Registry
~ Jack Hanley
ATSDR
1600 Clifton Road
Mail Stop E-56
Atlanta, Georgia 30333
(404) 639-6042
~ Robert Spengler
ATSDR
1600 Clifton Road
Mail Stop E-56
Atlanta, Georgia 30333
(404) 639-6200

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OAK RIDGE WORICSH N ENERGY-RELATED
PUBLIC HEALiri ACTIVITIES
Attendee Roster
OCTOBER 30-31, 1997
Ramada Inn Oak Ridge
420 South Illinois Avenue
Oak Ridge, Tennessee 37830
^ -S::' ^ ;
Address
_AhfeiThT5Jz7~St:even
NIOSH
4676 Columbia Parkway, R-44
Cincinnati, Ohio 45226
x1
-Andersen", James D:
2936 Braithwood Court, NE
Atlanta, Georgia 30345
Armstrong, Paul
1321 Aroumouth Road
ICnoxville, Tennessee 37914
Barncord, David
2309 Highland Drive
ICnoxville, Tennessee 37918

J&askeiyBermre-
Tennessee Department of Health
Nashville, Tennessee 37247

v J?
&





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Oak Ridge Workshop
Atteiulce Roster
October 30 - 31, 1997
Name
Bell, Glenn
Address
504 Michigan Avenue
Oak Ridge, Tennessee 37830
Bertram, Jeanie
141 E. Broad Street
Clinton, Tennessee 37716
Bierbaum, Phil
4129 Ascot Court
Cincinnati, Ohio 45251
Black, Sheree
SSAB/125 Broadway Avenue
Oak Ridge, Tennessee 37830
Blackman, Betty
2759 Sunset Avenue
Knoxville, Tennessee 37914
Blankenship, Jim
133 Hillside Court
Clinton, Tennessee 37716
Brooks, Alfred
100 Wiltshire Drive
Oak Ridge, Tennessee 37830
Brothers, Robin
P.O. Box 2003
831JCB, MS7606
Oak Ridge, Tennessee 37831
JBiirns, JonatharrA:
No Address Given

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Oak Ridge Workshop	Attendee Roster	October 30 - 31, 1997

Address
Carrier, Romance (?)
*- 	
14 Ashbury Lane
Oak Ridge, Tennessee 37830
Carson, Joe
10953 Turn Harbor Drive
ICnoxville, Tennessee 37922
XMdtessrfiill
TDEEC
Oak Ridge, Tennessee
Coin, Walter
209 Talley Lane
Clinton, Tennessee 37716
Cragle, Donna L.
ORAU/P.O. Box 117
Oak Ridge, Tennessee 37831
Dominguez, Nicolas
100 Greenbriar Lane
Oak Ridge, Tennessee 37830
Dyer, Cheryll
1120 Melton Hill Circle
Clinton, Tennessee 37716
Elliottrtanrty
NIOSH
Cincinnati, Ohio 45226
Farver, Sherrie
106 Gordon Road
Oak Ridge, Tennessee 37830

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Oak Ridge Workshop
Attendee Roster
October 30 - 31, 1997
'-'/''Name v':'v.
Address
Fay, R.J. Michael &. Shirley
209 Brechett (?)
Oak Ridge, Tennessee 37830
Fudge, DR
ll,h Arwick Lane (?)
Oak Ridge, Tennessee 37831
-Gawarecki, Susan
136 S. Illinois Avenue, Suite 208
Oak Ridge, Tennessee 37830
Gilbertson, Mark
U.S. DOE 1000 Ind. Ave. SW, EM-52
Washington, DC 20585
Glenn, Floyd
811 Vinson Lane
Knoxville, Tennessee 37923
Gragg, Richard
Florida A & M University
Tallahassee, Florida 32307
Hall, Jim
P.O. Box 2001
Oak Ridge, Tennessee 37830
Hill, Donzettia
429 Hidden Valley Road
Clinton, Tennessee 37716
Hill, Jeff
7501 Shallow Brook
Knoxville, Tennessee 37531

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Oak Ridge Workshop	Attendee Roster		October 30 - 31, 1997
/Name
Address
Holloway, Jacqueline
102 Artesia Drive
Oak Ridge, Tennessee 37830
Honicker, Cliff
422 South Gay Street
ICnoxville, Tennessee 37902
Hughart, Faye &. Husband
*
308 Dyllis Road
Harrison, Tennessee 37748
Hutchison, Roger (?)
100 Tulsa road, Suite 4A
Oak Ridge, Tennessee 37830
Jackman, Robbie
Office of Minority Health/Cordell Hall
426 5th Avenue North
Nashville, Tennessee 37247
Johnson, Darryl E.
2444 Bishops Bridge Road
Knoxville, Tennessee 37922
Johnson, Josh
918 W. Outer Drive (?)
Oak Ridge, Tennessee 37830
_^O^oires7Ti
sTTodd
DOE Headquarters
Germantown, MD

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Oak Ridge Workshop
Attendee Roster
October 30-31, 1997
 "3:	Name
Address
Joseph, Timothy
11458 R. Couch Mill
Knoxville, Tennessee 37931
Kelly, Sid (?)
118 Copeland Road
Powell, Tennessee 37849
Kittrell, Jackie
6328 Straw Plains Park
Knoxville, Tennessee 37914
Kopp, Steve
1215 Harper
Knoxville, Tennessee 37922
Kornegay, Frank
143 Tanasi Trail
Kingston, Tennessee 37763
Lai mil ig, EaTi~(?7"
DOE Oversight Division  TDEC
Oak Ridge, Tennessee

rd, Patrick
1522 Cherokee Trail, #240
Knoxville, Tennessee 37923
Marciante, Gabe
U.S. DOE
Oak Ridge, Tennessee 37831
Margulies, Imelda G.
7308 Willette Court
Knoxville, Tennessee 37909

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Oak Ridge Workshop
Attendee Roster
October 30 -31, 1997

v.'/:V:x'v;Name:
Address
Martin, Fay
108 Meadow Road
Oak Ridge, Tennessee 37830
McCoy, Doug
2325 Robinson Road
Knoxville, Tennessee 37923
Meadows, Elese P.
116 E. Price Road
Oak Ridge, Tennessee 37830
Michel, Janet -
-?
2106 Holderwood Lane
Knoxville, Tennessee 37922
Mila, David (?)
701 SCA Lines (?)
Oak Ridge, Tennessee 37831
		

Mims, Telicia
P.O. Box 2001, SE-312
Oak Ridge, Tennessee 37831
Jvleore, Jr.T-WiUiaHt	
425 5,h Avenue North
Nashville, Tennessee 37247-4911
Moser, Tom
101 Meadow Drive
Lenoir City, Tennessee 37772

OR
Mugart, G.F. (?) -

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Oak Ridge Workshop
Attendee Roster
October 30-3J, 1997

. .Name . .
Address

Mynatt, Fred
1800 Thoreau Lane
Knoxville, Tennessee 37922

Neal, Mark W.
P.O. Box 3446
Oak Ridge, Tennessee 37831
t-
-Parduc, William	
222 Connors Circle (?)
Oak Ridge, Tennessee 37830
*
JEaj^ar-Wrttrarn ~~
CDC
Atlanta, Georgia 30333

Peelle, Bob
130 Oak Ridge
Oak Ridge, Tennessee 37830

-Peny, Waller	-
DOE Public Affairs
P.O. Box 2001, M-4
Oak Ridge, Tennessee 37831-8502

-Peny, Teresa 
413 Triple Crown
Knoxville, Tennessee 37922

Phelps, Jim
1600 Buttercup Circle
Knoxville, Tennessee 37921

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Oak Ridge Workshop
At ten/Ice Roster
October 30 - 31, 1997

' Address "*
. JReerftobert
U.S. DOE
Oak Ridge, Tennessee 37831
Ramirez, Jean
224 Sawmill Circle
Jacksboro, Tennessee 37757
Rector, Dale
13 Clark Place
Oak Ridge, Tennessee 37830
Reed, Sandra
#S^12 Ashbury Lane
Oak Ridge, Tennessee 37830
Rogge, Mary
1406 Southgate Road
Knoxville, Tennessee 37819
Rothrock, John
417 Sugarwood Drive
Knoxville, Tennessee 37922
Ryan, Pat
162 W. Wadsworth
Oak Ridge, Tennessee 37830
Shaffer, Peery
164 Rainbow Circle
LaFollette, Tennessee 37766
Sonnenenburg, Barbara
Route 2, Box 125
Ten Mile, Tennessee 37880

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Oak Ridge Workshop
Attendee Roster
October 30 - 31, 1997

Address
-SpaktT^Duiis
426 5th Avenue North v
Nashville, Tennessee 37247
_SpeglerrRobei L
ATSDR
Atlanta, Georgia
Stoclcwell, Heather
DOE
Washington, DC
Stokes, Janice
465 Miller Road
Clinton, Tennessee 37716
Talboy, Phillip
4770 Buford Highway, F-28
Atlanta, Georgia 30341
Thomas, Hardil
235 Tusculum Drive
Oak Ridge, Tennessee 37830
Thomas, Susan
177 Bell Road
Nashville, Tennessee 37217
Totten, John R.
360 Laboratory Road
Oak Ridge, Tennessee 37830
Travis, Curtis
795 Main Street
Oak Ridge, Tennessee 37830

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Oak Ridge Workshop
Attendee Roster
October 30 - 31, 1997
'  Name' 
Address
"TumTPat
TDH/525 5,h Avenue North
Nashville, Tennessee 37247
Walton, Barbara A.
85 Claymore Lane
Oak Ridge, Tennessee 37830
Webb, Holly
504 Bridgewater Road
ICnoxville, Tennessee
-AVidnci, Tom
ChemRisk
1135 Atlantic Avenue
Alameda, California 94501
Wiggins, Mattie L.
5408 Holston Drive
Knoxville, Tennessee 37914
Wiley, Steve
106 Marion Road
Oak Ridge, Tennessee 37830
Williams, Leo
790 N. Cedar Bluff Road, No. 1118
ICnoxville, Tennessee 37923
Williams, Harry L.
12410 Buttermilk Road
Knoxville, Tennessee 37932

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Oak Ridge Workshop on Energy-Related
Public Health Activities
October 30-31, 1997
Ramada Inn Oak Ridge
420 South Illinois Avenue
Oak Ridge, Tennessee 37830
WORKSHOP INTRODUCTION/WELCOME
10130/97
Paul Seligman, Deputy Assistant Secretary for Health Studies at the Department of
Energy called the meeting to order, asking everyone to make certain they signed in in
order to receive further information. He discussed the steps for making public
comment and/or filling out or sending in written comment statements.
He indicated that he was in the Department of Energy's Office of Health Studies in
Washington, D.C. which provided support for research and Public Health activities
both nationally and for Tennessee.
He then introduced Mr. James Hall, Manager of the Oak Ridge Operations Office of
the Department of Energy. Mr. Hall added words of welcome from his department,
thanking the community members for talcing time to participate in the workshop. He
also welcomed Dr. Seligman, thanking him for making Oak Ridge a priority. In
addition, he welcomed William Parra, Peter McCumiskey, Larry Elliott, and Doris
Spain, thanking them for their participation.

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Oak Ridge Workshop
Plenary Session
October 30, 1997
In the event that some people in the room were not familiar with the Public Health
and Worker Health Issues, he briefly covered the history of Oak Ridge, indicating
that much of its long history was related to war and the Cold War. He pointed out
that although that history had left Oak Ridge with an environmental legacy, it did
not change their responsibility to deal with it. He stated that protecting the workers
and the surrounding environment was their priority, with more attention being
focused on health concerns than ever before.
He referred to their compilation of thousands of documents from working groups,
many of which were alleging that the DOE had harmed their health. He pointed out
that the causes for varied/unique Public Health and Worker Health problems were
not always directly evident. He stated that they used many methods, and that the
workshop was a move toward more and better science  that the public was their
customer and they needed to listen to and serve them better.
He suggested that the workshop was a momentous occasion, and that the input
would surely be a credible start toward establishing a Department of Energy Agenda
forcaring for Public Health. He indicated that they wanted to have a clear
understanding of the community and worker needs.
He then turned the meeting back over to Paul Seligman who gave some background
on how the workshop came to be. He mentioned that Tara O'Toole had called on
her colleagues to work with the Department of Energy in working toward a clear
Public Health-Agenda  one which would provide a forum for all parties interested in

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Oak Ridge Workshop
Plenary Session
October 30, 1997
that he was there to listen, not to announce, make excuses or make promises he could
not keep. The goal was to deliver credible, coherent responses to community/worker
concerns.
He then commented on the agenda, explaining how the remainder of the afternoon
would work.
Dr. Seligman introduced the following, each of whom spent a few moments
welcoming the participants and speaking of their agency/division's
history/involvement in the Oak Ridge community:
~ William Parra, Deputy Director
Centers for Disease Control & Prevention
National Center for Environmental Health
~	PeterJvteGttmiskey, Deputy Assistant Administrator
Centers for Disease Control & Prevention
Agency for Toxic Substances and Disease Registry
~	William Moore, State Epidemiologist
State of Tennessee--
Tom Widner of ChemRisk spent a few moments discussing the Oak Ridge Dose
Reconstruction project, discussing the history of, and the cloak of secrecy surrounding
Y-12, K-25, and S-50. He went on to give details of the reconstruction.
r	3

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Oak Ridoe Workshop
Plenary Session
October 30, 1997
(Hie opening speakers talked from hard copies, some utilizing slides and/or overheads.
In order to reduce duplication, they are contained in Tab 5 of the main proceedings).
PUBLIC COMMENT
	if
Questions, Answers, Comments
1:50 PM  Following Opening Talks
Q: How many people have you studied in any study whatsoever?
A: The Health Department is not involved in any study of people at all. A
number of physicians in this community, and one at Emory have been doing ^-WHO ,
HOWA#
studies.	<	i&AurtPt-'M.
i
C: That's not quite accurate. We've studied the poisons, not the people. The
research done here should have been called a toxic study. It has been limited
and without enough document search. There has not been very good or
enough data. One of my concerns is that March of Dimes says that less than
19% of birth defects will be identified with a document search, but if you look
at people, the recorded number goes up to 80%.

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Oak Ridge Workshop
Plenary Session
October 30, 1997
Q: Why are we spending money cmxelrospective dose reconstruction when we
have an active NPL site under remediation? We do not look at the people.
Any number of people up and down the creek are engaged in these high risk
activities, yet there has been a limited effort to look at actual exposures. We
should be concentrating on current exposures.
A: The appropriate way to address studies is to develop a data base to which
sound epidemiologic principles can be applied. I agree we must look at both
the epidemiology and the people.
Q: Do you consider blood levels of people involved as a component?
A: Yes, they would be a component.
Q: Then why did we do retrospective dose reconstruction?
C: Because the DOE does not want to know the truth.
A: I do not accept that answer. I think they prefer to go by the data base in a
proper manner.
(Jack Hanley, Lead Health Assessor for Oak Ridge, Agency for Toxic Substance and
Disease Registry, discussed past activities as well as future plans. His talk and slides
are included in their entirety under Tab 5).

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Oak Ridge Workshop
Plenary Session
October 30, 1997
Questions, Answers, Comments
2:20 PM  Following Tack Hartley's Talk
Q: You were talking about PCB exposure. What are the diseases caused by
exposure to PCBs?
A: On the acute side, and in the workers, there have been documented cases of
chloracne. Then there are the chronic long-term questions. Based on animal
studies available at this point, there is indication of cancer, though the
particular cancer I don't remember. (Probable liver cancer, stomach cancer,
and melanoma). Worker studies have been inconclusive.
C:	By design.
A:	PCBs are considered a probable carcinogen.
Q:	How are you evaluating the medical effects of exposure in the workers?
A:	Our agency evaluates mostly off-site. NIOSH is involved in worker situations.
Q:	How would you evaluate in persons then?
A:	Based on historical releases at Oak Ridge, we have determined the only way
people can be exposed to PCBs out there is eating fish. We assume based on

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Oak Ridge Workshop
Plenary Session
October 30, 1997
our risk assessments, if we try to document people being exposed to elevated
levels of PCB, as far as dose reconstruction, that will give us an indication and
direction for finding who and to what levels they may have been exposed.
Based on the answer to that, we will decide on follow-up.
Q: So at present, a physician has not evaluated a person for PCB exposures?
A: Some people, workers have been evaluated at K-25 sites, others by
environmental clinics in regional areas, particularly Emory.
Q: Do you know the physicians at Emory?
A: Dr. Howard Frumpkin and his staff.
Q: I heard your presentation before. You were looking for people eating bottom
fish like catfish.
A: Others were striped bass due to elevated levels ~ they are predatory fish.
Q: When we came to this area, we were told not to eat bottom fish. That seems
to be what most people pay attention to. How many people have you found to
study who have done it anyway?
A: We identified 117 in Kingston recently looking at catfish, striped bass and
turtles.

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Oak RiAge Workshop
Plenary Session
October 30, 1997
Q: Why are you spending so much time on examining people who have been
instructed not do certain things when there are people with much more serious
A: Watts Barr had a tremendous concern when we first came into the community,
as we have more information based on risk assessment and dose reconstruction,
it indicated that people eating fish and turtles could be_exposed. Some of them ^
were not familiar with the advisory, and that's why we have developed a
brochure to promote understanding.
C: I just wonder, after you complete this study, what more will you know than
before this expensive study?
A: Many have mentioned to us that if we show their levels are high, they will stop
eating fish. From a general population perspective, we did not know how
many people ate fish. We will use the information to determine whether we
need more education, more study, we really don't know until all studies are in.
Q When you measure what you do in people's blood, you measure mercury and
PCBs. That does not measure anything deposed in body tissue. I am
concerned about organics and the deposition in fat of some of these
substances. What you are measuring is something I would call acute level -
still circulating in blood rather than stored.
A: Let me clarify. PCB in blood is an indicator of how much one has been
problems?

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Oak Ridge Workshop
Plenary Session
October 30, 1997
exposed to in the last to 5 to 7 years. It's half life is about 7 years. If you stop
eating fish, within 7 years you will have half as much. We were looking for
low level intake, not chronic.
Q: Is your answer the same for mercury?
A: No, mercury in the blood reflects exposure over the last 60 to 90 days. In our
final report we will have all caveats. We picked PCBs because all other
screening criteria have shown it to be a risk factor. Some fish have low levels.
While drawing blood for PCBs, we went ahead and drew for mercury as well.
In looking at fish data of almost 10 years, the contaminant that came up that
was of concern to us as possible and probable was PCB. All others screened
out.
Q: When you have tested people, what is the reference dose you are using and
what is data that you are using and is it controversial?
A: We don't use reference dose. For levels of PCB at this point, there is no
indication that certain levels in blood will cause certain outcomes. We
compare levels we get to ranges CDC developed to see if someone has elevated
levels as compared with a reference population with those of known exposure.
If they are elevated, then we go to the individual for a complete history to
determine exposure.
Q: I am a citizen and a worker. In your presentation, you said your agency

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Oak Ridge Workshop
Plenary Session
October 30, 1997
determined mercury was not bioavailable. What process did you use to
determine this?
A: We did not determine that it was not bioavailable - in terms of other forms
out there  our determination differed from EPA or DOE. Our determination
was that it's a relatively insoluble form of mercury out there based on types of
studies conducted by DOE. We brought in other folks from sites with lead
and arsenic out west, and we asked them help us identify ways we can evaluate
bioavailability at ours and/or other sites. Our conclusion was it's a relatively
insoluble form of mercury.
Q Those were only studies done by DOE and you took that data -- no
independent analysis was done by ATSDR?
A: We don't do analyses of that type.
Q: What group of people were you looking at, and what was the criteria?
A: No people -- air, soil, and water.
(Donna Cragle, Oak Ridge Institute for Science and Education, National Institute of
Occupational Safely & Health, spoke on past studies of Oak Ridge workers, already
completed and reported, which she indicated could be used as the base for future
studies. She showed further details of past studies on leukemia rates, mercury,
beryllium, solvents, etc. Her talk and slides/overheads can be seen in their entirety

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Oak Ridge Workshop
Plenary Session
October 30, 1997
under Tab 5.
Questions, Answers, Comments
3:20 PM  Following Dow?a Crude's Talk
No questions were posed and no comments were made.
(Larty Elliott, Chief, Health-Related Energy Research Branch of the National
Institute of Occupational Safety & Health discussed their adveise health outcomes
studies of workers. His talk and slides may be seen in their entirety under Tab 5.)
Questions, Answers, Comments
3:50 PM  Following Larn; Elliott's Talk
Q: You said that you were going to do a clean up worker study to characterize the
workforce. Do you have any plans to involve those people most directly
affected and bring them to the table to design studies and gain access to the
studies?
A: We are collecting information now on defining them. The next phase will be
study design and at that time we will engage those folks, bring them to the
table to know their needs. Our mandate is typically generated from looking at
historical reconstruction. In Phase II, we might have to pass off to DOE on
health and safety issues, etc. Those are the kind of things we see coming out

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of this feasibility study. We have several other studies - Chemical Lab Study
of laboratory chemists and technicians who have worked at all 3 Oak Ridge
sites, as well those of the Savannah River workforce. We are looking at those
involved with organic ionizing in the laboratory setting. We feel there is a
large population. We also have a mortality study of construction workers --
historical retrospective.
Q: I did not hear an answer to my question --1 really want to know if you have
thought about and planned to bring those people most directly affected by
outcome of your study to the table to characterize what's happen, what they
might have been exposed to, the nuts and bolts.
Q: Once we identify who they are, and categorize them properly - yes we plan to
bring people into the process. We're not there yet.
Q: That's wonderful that you're dealing with that, but I suggest you bring people
to the table ahead of time rather than have them troubleshoot. The people I
know are the true authorities on what you're studying.
A: When we prepare a protocol, we come to the site and engage everyone who
wants to be involved. We have had 2 such meetings for multiple myeloma case
studies.
Q: You have to remember that there are a lot of people who are not working
because of sickness. You can't forget them.

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Oak Ridge Workshop
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Q: On mortality among female nuclear workers, you stated that the conclusions
from the dosimeter readings were ....
Q: It is based on dosimeter readings that were presented to in some form. Were
there any variances in dosimeter readings? I know of one incident in many
where a worker purposely put his reading to a ridiculously high level ~ they
never even called him to find out why his dose was way up there. Yet, when he
got his reading it was zero.
A: We are aware of that, and we have the ability to talk individually with workers.
We at NIOSH have a large effort in each of our studies to validate dose by
going back to original records to look at zeros. Was a film batch done on
weekly basis so as there was not enough opportunity to show a dose on a
badge? If there were high results, what can we say about that? We've held
worker interviews to find out how widespread a problem they think this is.
When we look at this, we look at population studies, we look to see whether
there is a contributing factor that would influence outcome of that study. If
there are 15 to 25 of these cases every year, we need to know.
Q: I want to ask about nickel studies arid also the possible of melanoma in the
nose. There are several cases of that developing in the general population.
Whole faces are eaten away. Why do you see a rise in this? Will you examine
each individual toxin? How long will this take? You take one -- you took
cyanide ~ you examined that and found nothing. You study one thing for
years and years. I am seeing we have multiple toxins that have been released

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Oak Ridge Workshop	Plenary Session	October 30, 1997
and we know that. So my encouragement to all of you in this room is that you
don't take one toxin -- you already know what nickel does, you know what the
mercury does in people. You take too long looking at all this. I don't think
this epidemiologic route you're taking is going to help anybody. Why can't we
take care of people and give them some solutions? You don't diagnose this and
then not given people a way out. How are we going to be helped by NIOSH,
CDC, the Health Department? Everybody wants to get scientifically funded
so you can all have a job  but we want to have a life.
A: I did not know about melanoma, we are studying myeloma.
Q: This is in the public, not necessarily workers.
A: I study workers. If we see that in the workforce, we will study that. In
NIOSH, we were not looking at one toxicant per se. We identified what we
call chemicals of concern. Those are hazards that have been or that we suspect
are associated with certain health outcomes - it is a mixed soup of those.
Q: I am poisoned with nickel and have high levels of mercury. I live down stream
in Kingston. The symptoms are devastating, the outcome is cancer. Who can
tell me if this nickel is radioactive? Nobody but the DOE. Who will allow the
physicians to treat me? Nobody. We need to be allowed to get treatment for
these things. For those who are not affected, count yourself lucky. Some
people with metals get sick some don't.

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Q: I worked at IC-25 for 8 years until somebody finally heard my cries for help and
my fear of permanent damage. Someone finally moved me. I'm now at 12. I
suffer from heavy metal toxicity. My question, why when NIOSH came into
K-25 and I was one of workers, did our site managers refuse to do it? We did
it -- the workers. Why did you not do an anonymous paper survey to
ascertain how many workers had problems?
A: The response is done out of another branch in NIOSH. I know those two
researchers, but I don't know why they chose not to do that.
Q: They sleep in the same bed with Lockheed. There are layoffs going on,
without an anonymous survey, workers will not come forward. My second
question is that I thought the cyanide study was in your realm of NIOSH.
A: I did speak to Branch Chief Dave Sundid. Give him a call.
Q: My opinion was that it was nothing but junk science. It does not take a rocket
scientist to know the health problems out there. No biological samples were
taken of workers. I have extensive data on me and my toxicity. To date, my
company Lockheed, or DOE, have taken no samples. I've got blood and urine,
take it please someone. They will not do it. They are failing miserably. I hold
them accountable. I hope we see some criminal prosecution out of this. I feel
deeply they know very well what's going on, management. This is not your
scope, but thanks for listening.

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A: I'm sure Dave Sundid will be happy to hear your comments.
Q: Hydrogen cyanide. You can check 2000 times for it, but if you don't look at
other compounds, then you are failing. There is a massive cover up here and
someone must answer.
A: We've been following this for many years. I want to get some things out.
There is inherent conflict in this room between the government officials, the
experts, the scientists, and the affected individuals who are exposed and want
answers. When they get metal studies back, they believe that they have been
injured. They want answers now. There is inherent conflict in the way science
has been done for 50 years, on how science is conducted on the people but not
by the people and with the people. There is a political shift in that. The
people want an integral part in decision-making on how science is created,
those who conduct it, how the results will be used, and whose benefit that
information will be for. Will it be for the government so they can say, "there is
no way you individuals can be harmed?" Whereas, what may really be going
on is that a combination of all these substances may be causing an effect that
may not be causing a certain cancer, but may manifest differently in
individuals. That's the message that's hard to grasp by these scientific studies.
Specifically 1-131. It took 14 years and over 10 million to study one
radionuclide? That comprised only 2% fallout from nuclear weapons. We
don't have till the year 4000 for these folks who are affected now. It's
critically important for NCI to be very sensitive to bringing in the affected
people when you sit down to do the study. Science will be done airtight and

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valid, but we all come to the table as equals.
I was fascinated with Cragle's study because the Manhattan Project scientists
were predicting all these symptoms and diseases. I don't think those studies
did one bit of good. Of all those mortality studies where you found excess
cancers with positive dose response ~ did the government notify a single
survivor or family member to let them know they were a part of this group?
A: I cannot speak to those prior studies.
Q: Donna Cragle, is she still here?
A: Yes. No, no one was notified for the mortality studies.
Q: We used the Freedom of Information Act to ask how much money was spent
between 1947 and 1994, and the cost was over 500 million in health studies.
Yet, not a single worker has been notified. That methodology helps no one.
We only pray and hope that the studies that you do help the affected people.
We have to make that shift happen.
Q: For multiple myeloma, what about the cut off date if you did not die before
1987?
A: In 1990 there was a follow up, we are still collecting data and follow-up to
determine whether to take this study to 1995 for 4 more years of follow-up.

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October 30, 1997
Then we might see additional cases of myeloma.
Q: In my communications with researchers, there've been others who have called
who said they did not meet time of death, and question whether they should
be included in study.
A: That's part of why we axe here today and why we are considering taking it up
through 1995. We are debating that at NIOSH right now.
Q: It's my understanding that workers who work with hazardous materials are
subject to annual medical monitoring. Do you have access to this information
with more recent studies, with the cleanup workers?
A: We have access to all medical records under our Memoranda of Agreement
with DOE. In the clean up study, we have not yet looked at individual
workers. We are defining and categorizing them, and we can look at those
when we get to that stage.
Q: You should look at them and make a determination for DOE as to whether the
appropriate tests are being done.
A: That is absolutely one thing we want to do in Phase II of this feasibility study.
Q: The second thing is that we've heard some this afternoon about workers who
feel they have sensitivities to specific metals or compounds, that there are

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October 30, 1997
individual sensitivities, maybe combination effects, lots of anecdotal evidence
about health effects. This is the sort of evidence that takes it out of the realm
of scientific investigation. NIOSH and other agencies need to recognize this.
While the scientific investigation should proceed as scientifically sound, at the
same time these workers health concerns should be addressed. They are 2
separate issues. There is a health care crisis in this area, workers may lose
insurance, pre-existing conditions may be denied when they transition to other
contractors. I've heard a variety of concerns and reasons why people are not
getting the follow-up they feel they desperately need for their conditions. This
is something this community needs. It would be much cheaper for DOE to
just go ahead and pay for medical care for sick people instead of lawyers when
sick people have to litigate.
(Dr. Seligman spoke on several studies undertaken by the DOE, discussed the Former
Workers Program, and discussed research of health at 43 sites in all of their facilities.
He indicated that DOE presented unique hazards to workers and communities. He
then reviewed the challenges, specific aims, and detailed the Former Worker Project.
His talk and slides/overheads may be seen in their entirety under Tab 5).
Questions, Answers, Comments
3:50 PM  Following Dr. Seligman's Talk
Q: In one of your slides, you said you determined the groups of workers subject to
risk. It seems to me that's the root of one our problems here in Oak Ridge. As

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October 30, 1997
you go through your list., and you identify workers subject to these, you come
up with set of people to examine. Probably here you have a set of people who
are ill and most of them are biologically not subject to known categories. You
need another group of people, those who experience illness and the nature of
that group is, while not exposed to some known substances, they should be
studied. We study what we know, but we don't tend to study groups who are
affected by some things, but we don't know what it is. How you determine
this is subject to development, but without it you'll still have all kinds of
responses. This is a vast and complex problem. Comment please.
A: You are correct in stating that as part of this program, we have not indicated
this as criteria. If you feel we should expand into such program, what criteria
would vou use?
Q: You'd have to identify some kind of cluster, a commonality shown in a site.
The K-25 group is a good example. There were subject to exams every 2 to 3
years. People don't come up with answers, if there are answers then public
doesn't know. Most information is anecdotal, which makes it difficult for the
public to be informed in a manner that they can make good recommendations.
I hear the same from state, that they don't have other information besides
anecdotal. This goes beyond medical implications. We have doubts about the
management and the integrity of our medical system.
A: Back to the original point, the eligibility criteria is still the subject of intense
debate among those conducting this work. Monday, we are having our annual

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meeting. One of the first items we will cover is how we should determine who
should be eligible. I am willing to put before this group alternate ways.
Q: One thing I'd like to address is that we might also want to consider present
workers. One thing I have not heard addressed is the DOE subcontractors who
are not covered under the MOA like Lockheed. I've been allowed to tag on
-vdth Lockheed. There's got to be some way to make this go faster. I don't
think anybody wants to cause harm. I think it's time we put the federal dollar
back into this community. We have the technology here. We have to move
past who is responsible. We have all the appropriate agencies, federal and
state, who can deal with this situation and make it better. You have that
ability within this room  so help me figure out how to get better.
A: This is precisely why we are here.
Q: I am from MSRE where people were locked out, and many of us have not
spoken out. I will read this. I know that you're aware of this situation and I
was surprised by slides you had that you do address workers - I filled out an
employee complaint form after I had retired. This is the reactor building. I
was in a complex of two office buildings occupied by a lot of people after the
project was shut down. The Friday before, they were going to put in an alarm.
When I asked what to do if it went off, the answer was to stay in place. The
following Monday we were all locked out due to criticality. I had access to the
Freedom of Information Act. A colleague of mine and I wrote a document
about the situation. In the early eighties, it was known that something was

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Pleaniy Session
October 30, 1997
wrong with exhaust and flooring monitoring. We had lots of sick people there.
1	was poisoned. Many things lead me to believe we should not have been in
that building. After we submitted our document, we asked for a clinical
evaluation from R L. But only 3 of us had the courage to say anything.
Everyone is in line waiting to be dismissed, afraid they'll be laid off. The
clinical evaluation was promised in 1996 in January. I wrote a letter and now
2	people are going to be sent out. I think the entire group should be included
in some kind of clinical evaluation.
Q: As a result of your beryllium tests, have changes taken place in the workplace
to change exposure level?
A: Is someone with Oak Ridge here who can answer that?
A: Yes we are in the process of upgrading and improving controls. We are
working with headquarters in deciding what needs to be done.
A: The department is engaged in developing a new rule about controlling
beryllium exposure. The Beryllium Advisory Committee is discussing the fact
that beryllium has a unique situations because we can cause people to become
sensitized at lower levels. We are considering how best to protect workers at
levels far below the levels accepted for half a century.
Q: Does it concern you that beryllium is being disposed of in the incinerator?

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Oak Ridge Workshop
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A: Of course.
Q: What is happening to improve the 6 people you have found?
A: Individuals who have been diagnosed can have whole range of symptoms, some
may be asymptomatic and may need to be followed, some have more severe
lung disease and suffer impairment in lung function.
Q: Can they get that therapy that is needed?
A: Yes, the treatment for individuals who have lung disease that is symptomatic is
treatable with prednisone.
Q: Can beryllium be taken out of their bodies?
A: No, at best is what we think will slow progression, it cannot be reversed.

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Oak Ridge Workshop
Plenary Session
October 30, 1997
PUBLIC PRESENTATIONS
Jackie Kittrell:
I'm going to talk about l\\z past, it is an important aspect of what we do in the future.
Institutional memories fade. No one in this room from agencies or elsewhere were
involved in some of what I am going to talk about. I am a Public Interest Lawyer. I
have been dealing with nonprofit public interest issues with the American
Environmental Health Studies Project, which engages primarily in research, but has
done work in public interest.
The first thing I am going to talk about is dirty linen. It's important to talk about,
although it is not pleasant to hear. Keep in mind 3 points as I talk:
1.	Acknowledge how litigation or an agency's wish to avoid liability impacts the
way we talk about public health, and the way agencies arc allowed to talk
about Public Health.
2.	The need for a complete classification review of documents that are in the
DOE's care as classified documents in order to bring out every shred of
information that would help people study current health problems or come to
terms with past health problems. DOD and DOE have lots of classified studies
on toxicology, etc.

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3. A need to involve those most directly affected -- to not exclude those who are
involved in litigation with any agency. Most people who sue the government
don't want to, but they have to. Sick workers have to because it's an insurance
issue. They have to get under the right plan. In Tennessee the whole Workers
Compensation process is court driven. They have to sue and have a short time
to do so. A lot of times when people are involved in litigation, they are forced
to have dialog in litigation rather than across the table. DOE should not
exclude people from constructive discussion because they are litigating against
the agency.
To cover dirty linen, I think of my father. I think of a time when, in my father's
adult lifetime, there was trust between the government and those not in the
government - there was more of a sense of common goals and efforts. My father was
born in the 20s, raised during the Depression, and went into the military at 16
because he wanted to serve his country. He stayed in to get a better life. He rose in
rank because of his involvement in the Nuclear Navy. If the government had been
able to tell him when he served in the military that he would be exposed in order to
win the war, if they had said, "We don't know what will happen to you, will you do
it? He would have said "yes."
I think of that time. The government did not tell him because of secrecy ~ when the
government could have and did not tell. Part of that raising of my father's hand was
coupled with an expectation that he had, he expected and deserved -- that if he got
sick, the government would take care of him. If there could be a cure, he would

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Oak Ridge Workshop
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October 30, 1997
expect the government to do that, and or provide compensation for him and/or his
family. There was a time the government could have done that and did not. That's
where the dirty laundry happened.
What the government did was not tell people what they knew about how these
substances caused illness and death. Instead they started studying people. The very
first studies were clinical. The government was great at doing clinical studies. But,
they were a litde ethically challenged  they forgot to tell people they were studying
them. We have found out a lot about this because of DOE's honesty about its past.
Nonetheless, a lot of early studies were on workers, clinical studies, etc. At some
point, a move was made to statistical. I'm poking at DOE, but almost every agency
has this history of studying populations (Department of Justice-Lawyers of the
Government) I have personally seen the Department of Justice stop any discussion
about settling or helping victims of exposure because they wanted to litigate and play
hardball. I think they are present in decisions about any health study,
When the government decided to create its dirty linen and study people, it developed
a legal strategy to withhold diagnosis from people and to refrain from treating people.
They tried to manage medical diagnosis outcome.
There is an article called "The Hidden Files," which details this policy by virtue of
one case of study without the knowledge of the person. The DOE, under Hodel,
never said a word, never refuted. The fact checking was done.

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The second thing is another set of documents dated in the early 40s which talks
about the diseases that they were going to be looking for and expected to find in
terms of special hazard insurance. They wanted to make sure they had some fund of
money for some of these illnesses. Here are some of the speculations:
~	Abnormal white blood cell levels
~	Leukemia and lymphoma
~	Skin damage with hyperkeratosis formations
~	Skin cancer
~	Lung cancer
~	Thyroid destruction
~	Nephritis
They were also concerned about some of these things we see in workers today:
~	Coproporphyrin
O Urine pigment uranium
In 1943, there were improved techniques in testing, why are they not used today?
Pigment tests, what these people were looking for were simple bio-markers -- these
were classified secret, not now, but there is no data that tells us what the data were or
how the tests were done. There needs to be a complete evaluation of any
toxicological data, etc. To a certain extent, just because of the volume of data, we
would have to look for just human experiments. They did not de-classify the
toxicology and bio-marker stuff. We could find good information there.

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The Records Holding Tasks Group in Oak Ridge is nothing but classified documents.
There is schizophrenia within DOE about people who want to hold everything
secret, and others who think they can be de-classified so as not impose on national
security.
We want DOE to prioritize, to have independent auditors, trustworthy people who
would be able to say they'd seen it and that was all there was. That would help
tremendously with the data base they are working with.
Janet Michelle:
I was born and raised in Oak Ridge. 1 lived right across the street from Cross Creek.
Yet, no one from ATSDR has ever contacted me. I have been out of work almost a
year due to nickel and mercury. I have a suppressed immune system.
I was an office worker. If I were a deer, oak tree or dead  you'd care more about
me. I was a certified kayak instructor. The pigment in my skin is going bad. With
all the studies we have heard today, and all the money out there, we might as well go
home. I suggest we change the direction of what these activities have been. We have
new people here who have never heard.
Health concerns were first reported to Lockheed Martin in March, 1995 related to
cyanide exposure. A NIOSH review was denied. In January of 1986, NIOSH
conducted a limited study, and claimed that it was a conclusive study. That nullified

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us from getting any benefits. There are lots of applications sitting there that should
be worker compensation claims. Lockheed Martin conducted air sampling only.
Industrial Hygiene said they'd come into my workplace  that never happened. The
University of Alabama came in 1996 and in 1997. We have sent hundreds,
thousands of letters, faxes, articles.
In response to these medical incidence reports, we were sent to Vanderbilt. We were
given no choice of 3 physicians like workers compensation law requires. There was
only one man, and he concluded that there had been no occupational exposure.
We then addressed Lockheed management. Before the NIOSH study was done,
Lockheed said they would establish reference ranges from cyanide. The documents
from Vanderbilt, who said spot samples were no good, now wanted to do them.
Lockheed would not sample children and spouses, local physicians refused to treat
employees or run tests. One employee was refused a company physician or
documentation. If you request the employee files, you aren't getting it all.
Lockheed finally brought in an outside physician, that was October 1996. So far, 3
employees have received reports and they have danced all around occupational
reports. Exams included no testing. It was a review of medical records mostly. Many
sick workers have not even filed medical incident reports because even if they are
secure in their jobs, they are afraid of being retaliated against. One employee was
retaliated against. Another employee filed a heavy metal document 50 weeks ago and
we have heard nothing. Anybody here from DOE? I would like to give you this
Medical Incident Report and I would like for somebody to act on this report. 50

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Plenary Session
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weeks is long enough. Anybody from Lockheed want to take on this tasks for this
worker? We have extra copies.
We've had over 180 people contact our group. Most of them are ill, some are not.
Some are DOE or Lockheed employees. Interestingly, when employees have left the
sites, elevated levels have dropped to near zero.
Symptoms include immune, auto-immune, cardio pulmonary, neurological, chronic
fatigue syndrome, reproductive problems, all body systems. When people's
symptoms are viewed individually ~ some have said they are vague, nonspecific,
unexplainable, this coming typically from physicians with no toxicology training. You
see amazing consistencies and similarities. The only unifying factor we have is
working or living in the same place.
Other metals are cadmium, lead, and mercury which are harming the surrounding
population, which are usually omitted as oxide aerosols in the flame.
We don't see rigorous clinical studies that need to be done. When they are done,
they are often run by engineers. Few physicians in the Knoxville area have any
toxicology background, and none have any in the Lockheed network. We have been
forced to do litigation. Most of us don't want to do this. We've had Lockheed
insurance providers refuse to honor referrals to those with toxicology expertise, which
renders our insurance useless. The documents recently de-classified significantly
change the parameters.

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Plenary Session
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One man's medical records had portions blacked out pertaining to materials he was
exposed to. Residents have never been contacted and tested, spouses and families
have not been tested. ATSDR studies are about fish and turtles. I wonder how many
other people also work in Oak Ridge who are afraid to come forward and be tested.
We don't need anymore dose reconstruction, epidemiological studies, government
panels, or doctors who are afraid. We do not need any more studies. We need real
symptom surveys, treatment/testing by independent experts -- we need this attitude
fixed now. We need all health and medical records de-classified now. When
someone is raped, and alive, the victim is not required to personally find the
perpetrator themselves. When someone has cancer or a knee operation, we -- imagine
fighting this every day.
We need independent medical monitoring treatment free, now. We deserve it every
bit as much as veterans themselves. We need an environmental health clinic. We
have put together a proposal and petition.
Janice Stokes:
This is the first time I've seen Janet Michel. She's a hard act to follow. She said
everything I wanted to say. We've been saying the same things since 1991. No
health care, denial in the community, denial of medical care, no ability to receive any
adequate medical care for our concerns. I will focus on medical care.

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When I first learned that I was sick, and learned that I had multiple metals in my
body. I did not know the doctor who tested me. I just heard about him. I went to
my private doctor of 12 years, and asked him to retest me to make sure. He said,
"Absolutely, I will test you and give back your results on Thursday." 3 Thursdays
came and went. I had to take medication which had made me fuzzy. So I spoke my
thoughts in a tape recorder. When I finally talked to my doctor, got on the phone
stating he would no longer be my doctor if I pursued the metal poisoning. He was
associate with a local hospital. I was devastated, furious.
Determined to find what was really wrong with me --1 found a toxicologist. He
found nickel. I saw Dr. Frumpkin. They found, I've only swam in river, I breath the
air from the toxic incinerator. I have never worked in the plant. This has caused
tremendous personal problems for me. I cannot even clean house half the time.
I'm going to ask you, that all the agencies come in and teach doctors -- teach, train,
and treat -- tell them what is here and what it causes, treat the people showing
symptoms, give them an avenue of hope, give them trust, they cannot trust you. You
have to prove it, you lost my trust 5 years ago. It is vital that you give humane
treatment to your own people. I should not still have to be here saying this again.
Treat the people right, at least like we treated the Japanese after we bombed them ~
we gave them free medical care for their lifetime -- yet, you refuse to give it to your

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Oak Ridge Environmental Peace Alliance:
We feel the federal agencies should listen to the sick people and their advocates.
There should be community control over health benefits, who does studies, who
makes decisions. Observers from other communities are welcomed. We question the
capacity of those here to address those issues. We would like to know what is
planned for this community after today.
Jim Phelps:
You look at this whole situation at a much higher level, constitutional rights, the
Manhattan Project. This community can start a whole new way of doing things.
That needs to be done. Right now, national security is more like national
debauchery. The Gulf War things are handled like Oak Ridge. The Pentagon, Bush,
Powell went after -1000 mile plume. Gulf War soldiers' reports are missing from the
national labs which identified the nature of the toxics. The forgetful memories of
Pentagon generals. It's a model of what's gone on in Oak Ridge. We've had only
limited knowledge. We need to get beyond that because the country, its morality,
how well it functions are based on trust of our government. We aren't doing a good
job on that matter. We know there's been health impacts, there are denials of those
health impacts, we have more than enough evidence of harm, we need new way of, we
need a new definition of national security. I think we can handle health for nuclear
workers 1000 times better than what we've done.

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Plenaiy Sessio)!
October 30, 1997
We have Hepa filters now days, we have lots of stuff coming out less than 3 microns
in size, we monitor with black paper filters. How can we say the community is OK
when we don't monitor, or monitor how it should be done. Strontium, blood cells
and immune problems, we see a lot of that in Oak Ridge. The technology is here to
do a better job.
The people are best dosimeters of what's going on. We need a turnaround of our
government. People should not have to become whistle blowers or be called
terrorists. Oak Ridge was the beginning of the Manhattan Project and the beginning
of secrecy. Thank you.
Sondra Reed:
I'm married to Dr. William Reed. His clinic here in Oak Ridge was shut down. Six
weeks after I arrived in Oak Ridge, my husband was reported as a drug addict. That
was first idea we had that doctors were not supposed to treat illnesses. He was told
he would fit in this community.
His patients told him what to look for. He was very interested in the lands of
diseases he was seeing in this community. He was using information from those
patients who were scientists. He called Dr. Dan Conrad at Lockheed. When he did
blood samples, they were not coming back at reference dose, yet he could see
pathology. Conrad told him it had been extensively studied, and there was no need
to study it further.

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Oak Ridt>e Workshop
Plenaiy Session
October 30, 1997
They started investigating my husband and telling him to move out of town. He met
with Dr. Dodd in Nashville, and after an extensive evaluation of my husband, he was
cleared of any drug use at all. Then the hospital said he was mentally incompetent.
I'm the mouth. My husband is shy. He is a very good man. He was bewildered by
what was happening here. 28 of his records were pulled up. After a Duke peer
review, and $250,000 in legal fees, we saw regular news releases seen by my children,
I hated this community. I could not believe the scientists were not speaking out.
I researched the history. I couldn't find out why people could not get help here. We
were trying to see patients in our home. No doctor within 200 miles of this
community were prepared to risk what happened to my husband who thought he was
helping his patients and practicing good medicine. I am a nurse, I am an Emergency
Room Intensive Care Nurse. When I see a problem, I identify it and I take care of
your patients. I do not see the problems identified, diagnosed or treated here. I
started trying to find doctors to bring to the community to help these people.
I tell you with reluctance, I am fond of you and I love this place. It's beautiful. I
want us to see some way of dealing with the problems that wc have here. I am from
South Africa and I tell you this is a form of Apartheid.
We have developed a strategy with a number of others such as Hanford and Los
Alamos. Those communities support us in developing a clinical research program. I
don't trust data, and I don't know that my children are safe. I don't know how to sell
my house, we cannot afford to leave. Do I tell people when I try to sell my house
about the contamination? We were not informed about that when we moved here. I

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Oitk Ridge Workshop
Plenary Session
October 30, 1997
would not have risked my children's lives here. Dr. Herbert Needleman was also
harassed.
(She then read from her notes a document which is included Tab 6).
With that, the meeting was adjourned for dinner. The participants were asked to go
to their respective breakout sessions at 6:30 i'M.

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Oak Rhine Workshop
Plainly Ssit>Ji
October 31, 1997
certificates of those long gone, DOE asserts privacy rights in that data. As I
understand it, in some states with nothing to do with us, there is no such
privacy right stipulation. People here should be able to look at death
certificates. When is DOE going to stop controlling the data?
Also, we've got a situation with the Records Holding Task Group in Oak
Ridge. There are nearly 100 classified chemicals used in Oak Ridge that you
can't tell us the name of. Workers have been exposed to way more than that.
Are there additional elements on the periodic table that are classified out
there? What are they and what are their effects? The community's right to
know is meaningless if we can't know the name of it.
DOE Headquarters, in order to penetrate the Oak Ridge Operations, needs a
new manager of Oak Ridge. When Jim Hall retires, you need to replace that
incestuous bunch in the Oak Ridge Operations Building with someone outside
and independent of the past. Get rid of bad managers who retaliate and cover
up. The days of DOE telling people what they need to know about their
health are over. We have the very bad notes of the dose reconstruction
contractors. Get us someone new who will meet with the National
Tennessean. Ms. Garrity is laughing, I'd like the record to reflect that. How
dare Jim Hall refuse to answer questions. He's a federal employee and should
be fired on the spot.
Linking health care. For years the hospital in Oak Ridge has been very closely
tied in a small community of interest. There has never been a worker or union

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HARD COPIES OF
TALK/SLIDES
FROM:
DONNA CRAGLE
PLENARY SESSION

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REFERENCES
Albers JW. Kallenbach LR. Fine U. I.angolf GD, Wolfe RA, Donofno PD. Alessi AC, Stolp-Sm.lh KA.
Bromberg MO, and the Meicury WorVers Study Croup
Neurologies/ Abnormalities associated with remote occupational elemental mercury exposure
Annals of Neurology 1988; 24-651-659
Cacdit E, Gilbert ES, Carpenter L, Howe G, Kato I, Armstrong BK, Berat V, C'owper 
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RKFKRENCF.S
Albers JW, Kallcnbach LR. Fine LJ. Langolf GD, Wolfe RA, Donofrio PD, Alcssi AG. Slolp-Snmli IO\.
Urombcrg MH, and the Mercury Workers Study Group
Neurological abnormalities Associated with remote occupational elemental mercury exposure
Annals of Neurology 1988. 24 651-659
Ca/dij E, Gilbeil F-.S. Carpenter L, Howe G. Kato I. Armstrong RK. Ilcral V. Cowper G. Douglas A. I'ix J.
Fry SA, KildorJ. |jve C, Salmon L, Smith PG. Voelz Gl., and Wiggs LD
Effects of low doses and low dose races of external ionirinj radiation. Cancer mortality among miclcai
industry workers in tliree countries
Radiation Research 1995, 142:117-132
Carpenter A V, Flanders WD, Frome EL. Cole P. and Fry SA
Brain cancer and nonoccupational risk facturs' A case-control study among woikers at (wo nuclear
facilities
American Journal of Public Health 77:1180-1182. 1987
Carpenter AV, Flanders WD. Frome EL. Crawford-Brown DJ. and Fry SA
CNS cancers and radiation exposure: A ease-control study among workers at two nuclear facilities
Joumif of Occupational Medicine 29:601-604, 1987
Carpenter A V, Flanders WD. Frome Kl., Tankersley WG, and Fry SA
Chemical exposures and central nervous system cancers A case-control study among workers at two
nuclear facilities
American Journal of Industrial Medicine 13351-362, 1988
ChecVoway II, Mathew RM, Shy CM. Watson JR. Tankersley WG. Wolf S) I. Smith JC, and Try SA
Radiation, work experience, and cause specific mortality among workers at an energy research laboratory
British Journal of Industrial Medicine 42.525-533. 1985
Checkoway, H, Pearce NE, Crawford-Brown DJ, and Cragle DL
Radiation doses and cause*specific mortality among workers at a nuclear materials fabrication plant
American Journal of Epidemiology 127:255*266, 19&8
Cragle DL, Mollis DR. Qualters JR. Tankersley WG, and Fry SA
A mortality study of men exposed to elemental mercury
Journal of Occupational Medicine 26.817-B2I,1984
Cragle DL. Wells SM, and Tankersley WG
An occupational morbidity study of a population potentially exposed to cpoxy resins, hardeners and
solvents
Applied Occupational and Environmental Hygiene 7.&26-&31, 1992
Dupree EA, Watklns JP, Ingle JN, Wallace PW. Wes[ CM, and Tankersley WG
Lung wnccr risk and uranium dust exposure in four uranium processing operations
Epidemiology 6.370-375, 1995
Gilbert TS, Cragle DI-. and Wiggs I.D
L'pdakd analyses ol combined mortality data on workers at the Hanford Site, Oak Ridge National
I abnratory, and Rocky Mais Weapons I'lant
Radiation Research 136 408-421, 1991
Tinal report for NIOSII Contract 200 93-2fi29.HI!U91 181
Departments of Behavioral Sciences and Health Education and of l-'nvironmental and Occupational
Health. Rollins School of Public Healili of Kmory University and Center for Epidemiologic Research
rnvtronmeni.il and Health Sciences Division. Oak Ridge Assoualed Universities
A study of ihe health effects of exposure to elemental mercury A follow-up of mercury exposed workers
fit the Y-12 pl.ini in Oak Ridge, 'I ennesscc. January 1997
Frame 1 1., Cragle 1)1.. Walking JP. \Vmg S. Shy CM. Tankersley WG. and West CM
A mortality study of employees of ilic nuclear industry in Oak Ridge, Tennessee
Radiation Research 118 64-80, 1997
Gilbert ES. Fry SA, Wiggs l.D. Voeb GL. Cragle DL. and Petersen GR
Methods for analyzing combined data from studies of workers exposed to low doses of radiation
Amcnian Journal of rpidemiology 131 917-927, 1990
Godbold JM and Tompkins EA
A long-term mortality study of workers occupational!/ exposed to metallic nickel at the Oak Ridge
Gaseous Diffusion Plant
Journal of Occupational Medicine 2 I 799-X06, 1979
Polednak AP
Mortality among men occupauonally exposed to phosgene in 1943-1945
Environmental Research 22 357-367. 1980
Polednak AP
Mortality among welders. including a group e posed to nickel oxides
ArO lives of Environmental Health 36235211, 1981
Polednak AP and Tromc l'l.
Mortality among men employed between 1943 and 1947 at a uranium-processing plant
Journal of Occupatiun.il Medicine 23 169-178, 1981
Polednak AP and 1 lolli> DR
Mortality anJ causes of death among workers exposed to phosgene in 1943-1945
Toxicology and Industrial Health 1 137-147, 1985
Wing, S. Shy CM. Wood JIWolfS, Cragle DL, and Frome EL
Mortality among workers at Oak Ridge national Laboratory. Evidence of radalion effects in follow-up
through 1984
Journal of Ihe American Medical Association 265 1397-1402. 1991
Wing S. Shy DM, Wood JL, Wolf S, Crnglc DL, Tankcrjlcy W, find V'romc EL
Job factors, radiation and cancer mortality at Oak Ridge National Laboratory l'ollow-up through I9S4

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HARD COPIES OF
TALK/SLIDES
FROM:
LARRY ELLIOTT
PLENARY SESSION

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HARD COPIES OF
TALK/SLIDES
FROM:
JAMES HALL
PLENARY SESSION

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HARD COPIES OF
TALK/SLIDES
FROM:
JACK HANLEY
PLENARY SESSION

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The goal of our respective agencies is to develop a credible, coherent DHHS/DOE
public health agenda at and surrounding DOE sites. This agenda should be based on
a set of priorities that responds to worker an community concerns, that recognizes
budgetary limitations, and most importantly, leads to a clearer understanding of the
health impacts of DOE operations and improved health protection and prevention
programs for workers and communities.
The format of the workshop starts with a series of presentations on community studies
and other public health activities by the Tennessee Department of Health and the
ATSDR and on worker health studies by NTOSH and die DOE. Each presentation will
be followed by a period for questions and answers. After the presentations will a
period for more general public comments, followed by a break for dinner. At 6:30
pm, we will reconvene for three hours of breakout sessions on community and worker
health studies and other public health activities. During these sessions, we are seeking
input from you on three general topics:
1. Are there concerns/health issues at Oak Ridge that are not being addressed by

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2.	What types of studies or public health programs should the DOE/DHHS
consider to address these outstanding concerns and which of the these activities should
have the highest priority?
3.	Finally, how should workers and the public be involved in the design,
implementation and communication of results of these studies and activities?
I know that those of you here with us today have given many of these issues a lot of
thought and have real concerns about the health and environmental impacts of the over
50 years of operations of the different facilities here at Oak Ridge. I am committed
to hearing all of those concerns and issues. But, we are also committed to giving
everyone an opportunity to have their say. This workshop is the beginning of a
process to redefine how resources are spent by the DOE on health activities at each
of its sites. In addition to participating today and tomorrow, I and my colleagues at
the CDC encourage you and others who may not have been able to attend to put your
concerns and ideas in writing to myself, Mike Sage from the NCEH, Larry Elliott

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HARD COPIES OF
TALK/SLIDES
FROM:
PETER MCCUMISKEY
PLENARY SESSION

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HARD COPIES OF
TALK/SLIDES
FROM:
WILLIAM PARRA
PLENARY SESSION

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HARD COPIES OF
TALK/SLIDES
FROM:
PAUL SELIGMAN
PLENARY SESSION

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Remarks
I'd like to give you a little background on how this meeting came to be. On July 23,
1997, in a letter addressed the heads of both NIOSH and NCEH, then Assistant
Secretary Tara O'Toole called upon her colleagues to work with the DOE to "develop
a clear research agenda, project priorities, and a budget that is linked to these
priorities." This workshop is a direct outgrowth of that letter and the favorable
response from the CDC and ATSDR to her request.
The purpose of this meeting is to provide an open forum for all parties interested in
and concerned about the health and well being of workers at the Oak Ridge facilities,
past, present, and future, and the citizens of the communities surrounding these
facilities. We are seeking advice on host of issues, advice that the our agencies can
use in crafting a research and public health agenda that will be responsive to and
recognize the diversity of interests and needs at the Oak Ridge site, in particular, and
for the Department of Energy as a whole.
I am here to listen. I am not here to announce, to defend, to advocate, to prosletize,

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With that I look forward to a veiy interesting two days and turn the microphone over
to Bill Parra from the CDC for his introduction and welcome.
Thanks.

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Paul J. Seligman, M.D., M.P.H.
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Public Law 102-484, Section 3162

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Former Workers Project
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l Nevada Test Site (Shaft Re-entry Workers)
PI: Lewis Pepper, M.D., Boston University
I Oak Ridge (Construction Workers)
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Challenges
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Former Workers Program
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HARD COPIES OF
TALK/SLIDES
FROM:
DORIS SPAIN/WILLIAM MOORE
PLENARY SESSION

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KARB COPIES OF'
Participant Presentations
A! Brooks
PLENARY SESSION

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Alfred A. Brooks *100 Wiltshire Drive  Oak Ridge, TN 37830-4505
Phone (& fax): 423 482-1559  E-mail: brooks@icx.net; Web Page: http://eser.icx.net/~brooks/
October 30,1997
To: OR Health Research Workshop
Re: Comments on the Worker Illness problem
There is little dispute that the K-25 workers are ill or that DOE/LMES should be concerned. The area of
disagreement is what is the cause of the illness and what should be the preferred approach to the problem. To
date, the approach has been to use the traditional health care services augmented by assistance by various
outside agencies and clinics. Recently DOE/LMES has engaged the services of outside physicians to review and
pursue the problem. Unfortunately to date, the efforts have been misunderstood and have fallen short of providing
answers to either the workers or the concerned public.
This approach has produced a paucity of publicly available data on which the public can base a sound decision
about the legitimate public concerns described below.
During the several years that the problem has extended beyond the immediate concerns for ill workers, it was
escalated by a series of inflammatory newspaper articles into a challenge of:
	the quality of life in the Oak Ridge Community and surrounding counties,
	the safety of the incinerator technology to dispose of waste and the nuclear technology in general,
	the sincerity and honesty of the DOE/LMES management and the OR medical establishment,
	the role of ORR in the National waste management program
	the acceptable methodology to be used in OR on-site waste management
	the very nature of exposure to and management of industrial contaminants beyond the ORR
The problem now extends to the State legislature and to the Governor's office. In spite of the data and experience
to the contrary, these accusations have become so widespread that they discourage newcomers from living in Oak
Ridge and have an adverse effect upon its economic future The problem is now in litigation and appears to be
spreading to other ORR sites.
This is a problem that cries out for resolution and yet, in spite of sincere efforts, it remains unsolved.
Whatever the causes of these illnesses and the associated spin-off effects, a technological society must
understand them If the cause is pollutants, they must be more rigidly controlled. If the cause is not pollutants,
society needs to understand and manage them.
For these reasons, many citizens in Oak Ridge after much observation and discussion have concluded that Oak
Ridge provides a real life setting both for the study of affected workers as well as other populations exposed to
environmental pollutants. The presence of the analytical capabilities of the ORNL and its environmental sciences
program will provide a support foundation for such an effort. Further, it is felt that groups of workers, such as, the K-
25 group, offer an opportunity to conduct a clinically oriented research program to further understand this
phenomenon and provide insight into matters of occupational health. Similarly, there are opportunities to examine
the body burdens associated with occupational exposures as well as environmental exposures. Such data would
remove some of the assumptions, which are necessarily made in risk assessment models. Limited activities of this
nature are ongoing but more applications of the experimental approach are needed. The results of such work could
be made available in research papers and thus would guide public actions.
I strongly urge you to consider such a research program.
Addendum: The use of the term "clinical" above does not imply the establishment of a clinic for continuing care but
rather the approach to ill workers to determine the contributing environmental causes, if any, and the counsel the
traditional care-giving services.
The terms "public control" and "public design" have been applied frequently to both the concept of a clinic and to
epidemiological studies. While I strongly endorse strong public participation, early input in the setting of goals and
scope, review and overview, I do not endorse public control to mean the power to administer (or to shut down as
some have suggested of TSCA). There is ample evidence that public advisory groups may or may not ensure
public access In some cases, they are less accessible than DOE itself. To ensure effective public access, the

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HARD COPIES OF
Participant Presentations
Romance Carrier
PLENARY SESSION

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RATIONALE FOR CLINICAL HEALTH EVALUATION OF FORMER MSRE OCCUPANTS
Approximately 65 employees occupying the Molten Salt Reactor (MSRE) office buildings at Oak Ridge
Motional Laboratory were locked out on a Monday in July 1994 due to the fact that a potential criticality
condition.
The uranium hexafluoride fuel had undergone radiolysis over the years since shutdown of the reactor in
1965 and was found to have migiated from the fuel storage tanks through the reactor pipe system out into a
ground surface charcoal bed that had (not incidentally) become flooded with water.
In view of the fact that:
1) repeated requests from ORNL MSRE facility managers other the years since shutdown failed to result
in funds to install a fluorine monitor and other badly needed upgiades to the reactor facility, and that
(2)	it had been discovered earlier that spring through a routine bioassay program that an employee had
suffered an acute inhalation exposure attributed (by ORNL) to MSRE fuel, and that
(3)	unexplained problems such as higher radiation levels in unexpected areas had been noted by at least
the middle 19S0s with no corrective action taken, and that
(4)	many emplovees had been strangely ill while occupying offices and ancillary spaces in the MSRE
(5) a query came directly through ORNL to one of us from the DOE Inspector General concerning
alleged violations of CERCLA.
document was completed and submitted to the DOE-1G in November, 1995, detailing the histoiy of the
v.ciliiy and documenting support for the allegations.
A. request was then submitted to ORNL management (hat clinical evaluations be performed to determine
"my potential health, effects that may accrue to the occupants of the buildings. This was promised soon after the
document submission. [The basis for the information contained in the document (now published and available
from ORNL Technic,"! Publications as ORNL/M-5458) was material obtained from a Freedom of Information
Act iequesi.] The promise, however, was extended only to the employees who voiced their concerns - all others
.r.re very afraid of reprisal and felt their jobs to be in jeopardy if they raised their voices. We perceived that
retribution had occurred to some individuals.
Airangonien-'u leading to the clinical evaluations continued favorably (for the three people) until April,
!99o Tiny were to vnakc arrangements. There was no further mention of proceeding or contact to us from that
date rj'i:)] prompted by a letter from me in April 1997.
At that ti:;:c, the evaluation was offered to the three, including myself. Two have accepted and I have refused for
two reasons: 1) I have been properly treated and am doing very well and (2) I will not do so until the others have
been informed that they may join in the effort.
The concerns about the condition of the MSRE have led to extensive funding to remediate the facility -
-1.5 million dollars a month for the last 1 or 2 years. The difficulties have grown since they have found that the
fuel migrated to a much greater extent than had been realized and the chemistry of the situation is extremely
complicated and, previously unknown. It seems to me that a mere fraction of the remediation funds would have
more th;\n provided for extensive evaluations AND treatment of all the individuals who had occupied the
building since 3 980 or so and who desired it.
We feel strongly that negligence has occurred, that the situation been virtually ignored with regard to the
ile who, we believe, were more than likely exposed to harmful gases, and that our request should be honored
mediately.
complex, and
Romance F. Carrier

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HARD COPIES OF
Participant Presentations
Sondra Reed
PLENARY SESSION

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We would like to develop a pilot project to address the clinical
diagnosis and management of environmentally induced illnesses. In
the past, attempts to address this difficult issue have concentrated on
epidemiology, risk assessment, and dose reconstruction. These forms
of science, some of which are in their early stages of development,
dehumanize the real effects of toxic exposure. A single unnecessary
death in our community is a tragedy. In epidemiology, it is a statistic.
The reduction of a human being to a number is dehumanizing. The
science of dose reconstruction and/or risk assessment is based on
inaccurate, industry-driven data which use improper tools to measure
health effects from toxins in impacted populations. In order to avoid
any accusation of human experimentation or Tuskegee-type
experiments, the research project we are proposing must be care driven
with a direct benefit to the people participating in the program. The
benefit should be in the form of diagnosis, management, treatment,
referral, and education. The first rule of order is "treat the cause." We
need to take small but intelligent steps such as the following:
We recommend that a process be developed to establish a full-
scale clinical research project that will include data collection, medical
intervention, and the development of treatment modalities. We also
recommend implementation of this project by a multi disciplinary team
of technical and clinical experts working in close collaboration with
the affected population to evaluate the actual health affects caused by
exposure to toxins in the environment.
	establish a community-designed and directed symptom survey,
	develop an advisory board of similarly affected communities to
help develop a strategy for a clinical research program,
	develop an advisory board of physicians who are experts in their

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physician leading this as there are many instances where
physicians are attacked, and their credibility and ability to take
care of their patients is interfered with; e.g. Dr. Needleman's
research on lead (Pb).
	develop a coordinating, board of environmental scientists,
biomedical researchers, biologists, etc. to collaborate in
understanding the complexities of the science as to how the
toxins affect human health and the environment, especially when
exposures involve multiple contaminants, and
	provide an opportunity for field training for medical students and
physicians as this is an area of medicine that is in its infancy.
The expertise available at the Oak Ridge facilities already includes
adequate analytical and environmental and research resources. We
believe that the research obtained through this research projects will be
valuable for many other communities. Oak Ridge has the scientific
and technical skills to support the development of this new approach.
There are recurring occasions where workers and residents
manifest symptoms of illness not readily treatable by their current
medical care. There is increasing public apprehension that our health
care system is not well prepared to address hazardous substances in the
workplace or general environment. Most individuals with occupational
or environmental illnesses must obtain their health care from primary
physicians who are not specialists in either occupational or

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pressed to keep up with current information and treatment methods
used for occupational and environmental conditions. Precise incidence
and prevalence data are unavailable, and estimates have been the focus
of considerable debate. The inadequacy of the data has long been
recognized and a concern about substantial under reporting exists.
Even available reported data is difficult to obtain because of the
following.
1.	There is a long latency period between exposure and disease
manifestation;
2.	the etiology of chronic disease is multifactorial in nature;
3.	recognition and diagnoses of environmental and occupational
diseases are lacking; and,
4.	these types of problems are historically under-reported.
There are virtually no reporting requirements for suspected
occupational and environmentally caused diseases, and further
recognition and diagnosis is rendered difficult by a paucity of defined
clinical symptoms. More precise estimates are needed to target and
evaluate the health affects to develop prevention and treatment
modalities.
Research designed to answer the complex questions posed by
these issues is avoided as it is perceived to be prematurely difficult.
Disease and impairment problems attributable to occupational and
environmental exposure present unusual complexities in clinical
medicine. There is a need to develop a rigorous research and

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'XI v; "r
v   ?-^- :. > v--i---   . s. tt.-a^Yy.rCi^'VOty.*-;^&.-*&&.***&?.
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 "  rrlW.
i i>vfVSn ;:
sembly weal supercritical Slotin stepped the rhain reaction by knodang
the sptoerc apart. But in less than a millisecood. deadly gamma and neu-
tron radiaben had burst from the assembly. The blue glow lighted
room as the air become momentarily ionized.
The eight men rushed out 0fthe laboratory and ailed the authorities in
Los Alamos. Then they sat down in the aiieroocn sun, aod. as calmly as
they could. began to assess Uve levels ol their exposure. They made a dia-
gram of the room, noting where each had been standing None of them
had been wearing radiation badges, wtiich would have helped register the
extent of the exposure. Slotin asked the scientist who had been farthest
from the accident to go back and retrieve the film badces out of the lead
box where they were stored, and throw them onto the a obly.
Those who had been standing at the table (area . - worst. Klin:,
who had been three or four feet away from Slotin, received what he
calculated to be between 90 and 110 rads of neutron radiation.
Graves, standing a foot closer, received an estimated 166. For Slotin.
the exposure was nearly'l.000 rads, a lethal dose twice over.
The men drove themselves to Los
Alamos Hospital, where tbey were sur-
rounded by teams of specialists who
had been preparing for their arrival.
There was not much they could do for
the injured men. The doctors closely
monitored their bodily functions. They
took radiation counts on their blood and
borxs. They toolc readings from the gold
fillings in their teeth, from silver belt
buckles, from a gold Sheaffer pen that
Slotin had been carrying and from a coin
Kline had had in his pocket
The doctors knew the next two weeks
would provide them a unique opportunity.
From a civil-defense standpoint, the
knowledge gleaned from these cases
could prove invaluable in the event Of a
nudear war. For the first time, doctors
and scientists would have a chance to
view the effect of measurable levels of
Deutron radiation on humans without the
complicating factor erf other damages from a bomb. Before the week was
over, experts from ail over the country had been flown in.
For Kline, the next days were hard. According to notes made by nurses
on the hospital records, he suffered nausea and vomiting on the first day.
fainting spells and complete loss of appetite for the next five days, and
rapid weight loss. The men knew Skxin was dying, but despite their anxi-
ety they tried to keep their spirits up. Kline told the curses his vomiting
was due to nervousness and nring hot dogs rather than to rndiarior.
The men's bodily Cuids and excretions were gathered day and
night and tested for radiation. Doctors watched the steady concurrent
rise and fall of the victims' blood counts, blood pressure and tempera-
ture as the radiation ran its course through their bodies.
Fearing that the gold inlays in Kline's teeth were radiating damag-
ing rays into his jawbone, constituting a threat of future cancer, the
scientists decided to shield them with a mouthpiece made of gold foil.
It was not thick enough to absorb the radiation. A second mouthpiece
was made of heavy solid gokL Kline wore it for five days, until the
radiation in his inlays subsided.
On the ninth day, Louis Skxm died.
ALLAN KLINE. THOUGH STILL WEAK, WAS RELEASED FROM
the hospital two weeks after the May 1946 accident. Then he was fired.
The dose of radiation that he had received precluded him from work-
ing around or being exposed to radiation for at least 25 years.
Kline knew he faced the prospect of cancer. After the initial re-
curcfOT KKxtn
'	""N  f 
J.	^ 
iS.. "Vt'r'n'-^'.Vi
Far left, 1380: John
Smtthernun, on* o{
220,000 servicemen
exposed to nuciejr
radation kj the postwar
years, developed
lymphedema, than
cancer. He (fed In 1383.
Left, circa 13SO; Hen
Levy, president
of the Nevada Test
SJts Radbtion

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Y7 Uxi* Slop's ID
halo* Alamos
_. On May 21,1546,
b experiment cna
omb core wentwrsnc.
br days Liter, he tJod.
etc* left, 19S6: Aljn
In Sjr Francisco.
Sne spent yean
yinj h vaii to jet hb
fflclaf medcal record*,
ow, he ts sient.
i HAT&VL iaSOSaIORT
jht, May 1955: AJvkl
ivrv, shown Sere et
tevada nuclear
it, stayed wttfc the
S. atomic program.
>(Sedinl96.


DAVE OCflOA*,VBEr7Uw< KWSPH0TC3
very from acute radiation sickness, a person may lead a healthy
e, with the real damage manifesti-is Itself only years or decades
ter. Leukemia, testicular cancer cr other radiogenic maladies
ight appear-
The director of the Los Alamos Laba-atcry wrote a letter to Kline's
3ther informing her that her son was "iat seriously affected." and
it he had "only minimal symptoms." Yet the final note on Kline's
spital chart stated, "The depression o" the lymphocytes and leu-
penia which developed makes it obvous that this man's exposure
is significant Final Diagnosis: Radiauor Sickness."
From Los Alamos. Kline returned to his hometown of Chicago. At
t time of his discharge from the haspital, one of his physicians,
mis R. Hempelmann. advised him to itay out of the sun for at least
t> years and to wear a sombrero. long; underwear and women's long
3 gloves whenever he went outdoors. KUne took these precautions
-ring the summer of 1946. (The .	_ .
ir on the front of his head was '* "	.
Hing out. and he rarely had the
ergy to leave his apartment.) In
letter to another of his doctors,
said he looked quite the specta-
; down the street In his
IpucflL
been referred by the
! Hospital to the Univer-
licago Metallurgical Labo-
~y. which took 22 blood samples
tween June 10 and Nov. 22.
3n Dec 8. Kline went Into BU1-
2s Hospital In Chicago, for what
*s to be an extended battery of
its. He ouicklv decided he was
i
OJf:CflOt.HONCX
Left, 1946: Stafford Warren,
at left, an A.E.C. safety
official, soujht charges In polcy
In order to avoid powUa
tovemmeiTt embarrassment
Above, 1387: Or. Lois
Hempcfcnam, who says Ns A**
on the 1346 Incident have
been destroyed. Why was Kin*

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RADIATION
Continued from Page 41
studied  not treated. On
Dec. 10, angry that he was
being used as a guinea pig. he
left, cutting short the hospital
stay.
Two months later, Kline
began a campaign to gather
his medical files, which he
would need to receive com-
pensation for the accident. On
Feb. 24, 1947, a law firm he
had retained wrote to the ad-
ministrator in charge of the
Los Alamos operations to say
that Kline intended to seek
compensation.
The letter an-
nouncing Kline's inten-
tions was probably not
unexpected. As early as Dec.
3, 1946, Norris E. Bradbury,
who had succeeded J. Robert
Oppenheimer as director of
the Los Alamos Scientific
Laboratory, issued a direc-
tive that no Los Alamos per-
sonnel were to make any
statements or commitments
involving Kline, because of
the possibility thai Kline
might file a lawsuit.
A week later, on Dec. 10, the
same day Kline walked out of
Billings Hospital, Louis Hcra-
pelmann, the Los Alamos
physician, wrote to Kline's
Chicago physician, James J.
Nickson, medical director of
the Argonne Medical Labora-
tory, that the prospect of a
lawsuit from Kline was giv-
ing everyone "a most re-
markable case of Jitters."
The letter also said. This
case is being handled In a
most unusual manner. We...
have been instructed not to
contact Kline directly nor to
commit the project in any
way."
That same month, Stafford
L. Warren became involved.
Chief of the medical section
for the J2 billion Manhattan
Project, Warren had headed
the American team assessing
the damage at Hiroshima
and was chief of the radiolog-
ical safety section for Opera-
tion Crossroads. He advised
that a situation existed "re-
quiring a clarification of
policy in order to save possi-
ble embarrassment of the
Government by medical legal
suits." The case of Allan
Kline, he wrote, had been
handled in such a way as to
leave the Government in a
bad light. Kline had been
treated as a "research case,"
medical investigations ot
people claiming injury from
radiation.
In April 1947, Warren wrote
a similar letter to the general
manager of the Dewly formed
Atomic Energy Commission,
which that year officially re-
placed the Manhattan
Project, calling for a proce-
dure to deal with former em-
ployees who claimed they
were injured in the course of
their work. For most people,
he wrote, a simple letter from
a leading medical represent-
ative from the commission
would suffice, ^ssurui^ them
that they had not been sub-
jected to anything that would
affect their health. For
others, more detailed investi-
gations needed to be made. In
both letters, the handling of
the Kline case was singled
out as the example of the
need for such a policy.
That June, Allan Kline en-
tered Yale Law School. All
that year, letters went back
and forth between Kline and
the A.E.C., culminating, on
Aug. 16, 1943, with an offer
from the commission of a
cash senlement of $3,333, in
exchange for an agreement
that Kline would drop all
claims. The evidence indi-
cates he turned it down.
Almost a year later, in July
1949, following Warren's sug-
gestion. the A.E.C. issued
guidelines on Investigating
radiation and chemical in-
jury cases that fell under the
"special hazards" category.
As Warren bad recommend-
ed, when the commission
heard that a former em-
ployee was claiming injury
from exposure to radiation or
other toxins used in the pro-
duction of nuclear weapons, it
was to initiate an investiga-
tion to determine the validity
of the claim. The directive
spelled out what information
was to be gathered and who
in the A.E.C. was to receive
the information. There was
no indication that the claim-
ant was to be given the infor-
mation.
MEANWHILE. ALLAN
Kline persisted in his at-
tempts .to get his medical
records. On Aug. 15,1949, his
attorney, Paul Stickler, wrote
to Senator Brien McMahon,
Democrat of Connecticut,
who had sponsored the Sen-
ate bill establishing the

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the "shabby" treatment Klne had re-
ceived and asked McMahcra to con-
sider legislation to rectify the case.
He included a six-page, detailed as-
sessment written by Kline of the in-
juries he had sustained.
Three months later, on Nov. n, a
top official of the A.E.C. denied that
Kline's medical records had been
withheld from him by either the com-
mission or the University of Califor-
nia, which operated the Los Alamos
laboratory for the Government. In a
letter to McMahon's committee, the
deputy general manager of the A.E.C.
said Kline had not even requested the
information: "Neither the files of the
Commission nor the University dis-
close any request by Mr. Kline for
such information nor any indication
of any refusal by the University or
the Commission to furnish such infor-
mation to him." Furthermore, the let-
ter stated, "With respect to the extent
of the injuries sustained by Mr. Kline,
the statements contained in Mr.
Stickler's letter and attachment ap-
pear inconsistent with available
medical reports."
On March 17,1950, another lop offi-
cial commented on the Kline case,
this ume linking the A-E.C's re-
sponse to it to future similar claims.
Carroll I_ Tyler, manager of the com-
mission's Santa Fe operations
(where the administrative work for
the Los Alamos projects was done),
wrote to a colleague instructing him
on how to respond to Senator
McMahon's continuing inquiries
about the Kline case.
Tyler's advice was to stress that
Kline was a difficult man to deal with.
It should be painted out, Tyler wrote,
that Kline had broken medical ap-
pointments and turned down settle-
ments offered him Tyler advised
that "McMahon should consider the
fact that there may be many other in-
dividuals not now known who have
been exposed to radioactive emis-
sions at this or other installations and
the preparation of such specific legis-
lation might lead to a deluge of re-
quests for individual legislative
acts."
Twelve months later, on March 21,
1951, Tyler wrote Kline that specific
studies on his contamination were un-
available. "There are certain data
which you request such as calcula-
tions of radiation emitted from ob-
jects on your person which are appar-
ently non-existent and we ran only
presume that if any count was taken
on these objects it was primarily as a
matter of curiosity and no record was
made."
That was an outright lie.
IN 1984. QUITE BY CHANCE. I
discovered a 270-page-dossier,
most of it legal and medical evi-
dence pertaining to Allan Kline's ex-
posure and his subsequent medical
problems. It had been compiled by
the A.E.C. and stored in cardboard
twwc in th rarfinioeical archives at
about radiation issues. I knew im-
mediately that this particular file
was significant.
The files were those of Stafford
Warren, who had died in 1981. They
contained the records of more than
two dozen people who had formally or
informally claimed injury from expo-
sure to radiation. In nearly every in-
stance, Warren had been asked by the
Atomic Energy Commission how to
handle the case.
Of the two dozen, mostly service-
men and workers at nuclear-weapons
plants, none had been treated or com-
pensated for radiation injury, despite
the fact that some of the records re-
vealed well-documented overexpo-
sures. In none of the cases did the
A.E.C. acknowledge to the claimant a
diagnosis of radiation injury.
Most of the files were very brief, in-
dicating a 4uick settlement of the
case (and never to the claimant's ad-
vantage). Of the two dozen claimants,
only one, Allan Kline, had apparently
persisted through years of docu-
mented stonewalling. Kline's file in-
cluded medical records, radiological
exposure records, telexes, lecters and
conference reports. Ail were related
to the Los Alamos accident at the
Omega Site on May 21,1946.
For six weeks, I pored over the
records that Kline himself had been
denied. By the end of that time, I had
written an 80-page paper on the case,
which I decided to submit as my mas-
ter's thesis.
In the summer following the acci-
dent, I read, KLine had suffered se-
vere lassitude, sleeping 16 hours a
day. He couldn't walk up a flight of
steps without resting; he couldn't
swim more than few strokes; he
couldn't read a newspaper for more
than a few minutes. He was sterile for
more than two years. The level of ex-
posure had been so high, and he had
had such immediate debilitating ef-
fects, that I was almost certain that
now, 38 years later, he must be dead.
On the day I finished my thesis, my
wife, a health and safety adviser to
nuclear-weapons workers at Oak
Ridge, brought me a book that in-
cluded a follow-up of the survivors of
the 1946 accident. "Case Five"  a
designation that clearly referred to
Kline  had refused to cooperate
with the study, but a note Indicated
that in 1978, when the article was re-
searched. he was still alive.
I knew he bad gone on to Yale Law
SchooL I called the alumni office and
was told that the man whose files I
had practically memorized was liv-
ing in California. I had no trouble get-
ting Kline's phone number.
My first call met with a brusque re-
buff.
"No comment," he said when I iden-
tified myself and said I wanted to talk
about the criticality accident.
What?" 1 said.
"No comment." He hung up.
I called again, this time barely giv-
ing him a chance to say hello. I

ART am
adyerti:
are offere
evei
The NewYoi
Here are some impc
Jan. 28 
Apr. 8  New
Apr. 22 I
June 10  The
Sept. 9 
Oct. 14 I
Nov. 11 C
Nov. 18  Nei

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ployed three different law
firms in an effon to get his
records. And that finally he
had been told by the director
of the Los Alamos laboratory
that the files simply no longer
existed, that in fact those
records ought have never
been collected in the first
place.
"I have in my hands the
files that are not supposed to
exist." I told him. For a few
seconds there was silence on
the line. But this time, he did
not hang up.
Three weeks
later, we met at his
home near San Fran-
cisco. From 9 P.M. until mid-
night, we went over the let-
ters, reports, '-jlegrams and
medical records in the file.
Then Kline wiped a tear from
his eyes and said, "What they
did to me... lies, all lies."
But when I asked permis-
sion to use his case as ray
master's thesis, he turned me
down.
The former physicist was
now a successful business-
man, the founder of a number
of companies including Xicor
Inc., which manufactures
computer chips that have
potential defense applica-
tions. He insisted that he did
not want his story to affect in
any way the nuclear-weapons
testing and development pro-
grams in this country. Even
though the accident had left
him with debilitating and life-
threatening conditions  and
he detailed a list of longterm
effects, which he refused me
permission to mention in
print  he wanted to keep his
story a secret. He blamed the
stonewalling on the work of &
few misguided, overzealous
officials within the Atomic
Energy Commission.
TWO MONTHS AFTER
my session with Kline,
I met with staff mem-
bers of the House Energy
Conservation and Power Sub-
committee in Washington.
The subcommittee, then
chaired by Representative
Richard L. Ottinger, Demo-
crat of New York, had over-
sight and investigative man-
dates over the Department of
Energy, which had replaced
the A.E.C. in the 1970's. After
I briefed the subcommittee
members on what I had found
in the Warren files, they
drafted a letter to Energy
Secretary Donald P. Hodel,
signed by Ottinger. initiating
a Congressional investigation
on the medical and radiologi-
and the two dozen other files I
had seen in the archives at
KnoxvUle. But I also sus-
pected that a repository ex-
isted that would show that
hundreds of other people had
been treated in the same way.
We requested all the files of
the commission's division of
biology and medicine from
1946 through 1962. It was the
same division that 40 years
earlier had blocked IGine's
request for his own files. We
were told the request would
take time to process, so in the
meantime I decided to look
into A.E.C. policy directives.
Among the stack of direc-
tives delivered to me was
Chapter 0521, from the A.E.C.
Manual entitled "Medical In-
vestigation of Alleged Dis-
abilities From Special Haz-
ards." Issued in 1954. it dealt
with "radiation exposure or
exposures to tojac materials
peculiar in kind or degree to
acomic energy operations."
The "medical investiga-
tion" referred to in the title
was not, the policy stated, one
that would be made after a
routine claim of injuries. It
was, rather, a policy to col-
lect information, "to the ex-
tent permitted by law, and to
the extent consistent with the
best interests of the Atomic
Energy Commission," when-
ever it heard about any alle-
gation made by a former
commission employee of in-
Jury from "special hazards"
 radiation or any toxins
used in the production of nu-
clear weapons.
The policy spelled out in de-
tail which commission offi-
cials would be informed of an
investigation. Conspicuously
absent was any mention of
whether the radiation survi-
vor himself would be in-
formed.
Chapter 0521 was very simi-
lar to the directive issued, at
Stafford Warren's suggestion,
by the A.E.C. in 1949. The title
was identical. The similarities
seemed to go beyond the possi-
bility of coincidence. The 1949
directive, which came out in
the heat of dealing with Kline,
seemed a direct forerunner of
Chapter 0521.
TWO WEEKS AFTER
our request, I was al-
lowed to see the divi-
sion of biology and medicine
files. From the first, I sus-
pected they were incomplete.
Brand-new legal-brief fasten-
ers were in place on 30-year-
old file folders. Folders la-
beled "Case Histories. 1953,"
and "Claims, 1954" consisted
Over the next three weeks,
other boxes of files arrived,
in similar condition. Toward
the end of that time, a De-
partment of Energy em-
ployee supplied me with an
index listing of additional de-
partmental liles, stored
separately. The list referred
to more than a hundred other
special cases stored in four
boxes, two of them contain-
ing classified material. Ten
days after ] asked for those
four boxes, they were de-
livered. A subcommittee
staffer with a top-secret se-
curity clearance went
through the two boxes
marked classified and made
notes, which the D.O.E.
cleared for me to see* A for-
mal request to declassify
these files, which dealtonly
with scientific and medical
issues, was not only refused
but in some cases resulted in
the files being reclassified
from secret to top secret.
I was allowed to study the
two boxes thaL were unclassi-
fied. These included the Kline
file and 50 others. Allan Kline's
file was identical to the legal-
medical We kept on hrni by
Stafford Warren  except that
90 percent of it was missing.
It contained only 27 pages of
the 270 that I had seen in Ten-
nessee. (According to the De-
partment of Energy's official
version of the Kline case, the
Government had acted rapidly
to provide Kline with all the
records he wanted.) It was
clear that material had also
been removed from the other
50.
As the files came in, I'd
gone back several times to
the D.O.E. Congressional liai-
son with whom I'd been work-
ing to ask if the material was
complete. After I got the last
batch, including Kline's file, I
asked once again. He denied
that the files had been
tampered with in any way.
Staff members of the sub-
committee were not hopeful
about their ability to investi-
gate further. There's no way
to prove it unless you can find
a whistleblower in D.O.E. who
will admit that the files have
been tampered with and de-
stroyed," one of them told me.
"Hang in there: document
what you think is missing, and
find us a whistleblower."
Sensing that my very pres-
ence in the repository was
causing a large-scale de-
struction of the Tiles, I de-
cided to go back to Tennes- 
see.
ON AND OFF OVER THE
t rri#H fn
when.
t
is.
There are many ser
there is only one C,.
The Cupola sets a i
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Under the very caa;
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Every Sund

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America's Radiation Victims
The
Hidden
Files
IN 1946. A NUCLEAR ACCIDENT KILLED
ONE SCIENTIST AND INJURED
SEVERAL OTHERS. THE GOVERNMENT
RESPONSE TO THAT TRAGEDY
ESTABLISHED A PATTERN
OF SECRECY THAT STILL PERSISTS.
B T C LI F F 0 I D T. B 0 N [ C K E R
A BLUE GLOW SHROUDED THE ROOM FOR AN INSTANT. THEN
was gone. In that moment, Louis Slotin knew he had received a lethal
dose of radiation from the core of the plutoniuro bomb he was testing.
Eight men had been working in the secret laboratory that day.
Called the Omega Site, it was nestled in Pajarito Canyon, four miles
from the main compound of the Los Alamos Scientific Laboratory in
New Mexico. Slotin was preparing Alvin C. Graves to take over his
duties at the Omega Site. The two stood together at a table with the
core of the bomb in front of them. A third man, a Junior-level physicist
named S. Allan Kline, > 26-year-old graduate of the University of Chi-
cago, had been called over only a moment before the experiment
began. Five others stood behind them as Slotin gently brought to-
gether the two halves of the beryllium sphere that would convert the
Plutonium to a critical state. The date was May 21,1M.
Although it was a potentially deadly experiment, Slotin had per-
formed the "cm lest" more than two dozen times before. The physi-
cists involved that afternoon had bees part of the team that designed
the atomic bombs that annihilated Hiroshima and Nagasaki This lest
was being done in anticipation of the Operation Crossroads test, which
would take place at Bikini AloU in the Marshall Islands a month later.
Slotin lowered the upper hemisphere onto the larger lower one, his
thumb lodged in a bole in the top. In his other hand was a screwdriver,
which he wedged between the two halves to keep them from touching as
he attempted to bring the plutonium to a critical state. The men held then-

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had divulged at thai first
sting. (All the facts about
ine's case m this arucie
rom the public
Finally, it became
'if it were up to him.
lake it with him to
; grave.
vleanwhile, I had recerved
lumber of grants to pursue
/estimations into cases of
illation contamination,
jch of my work focused on
mlar instances of suppres-
in of information by the
ivemment, in atomic vet-
ui and downwinder cases,
il I couldn't let the Kline
s go. In April of this year,
vent to Los Alamos, deter-
ned to review the technical
cuments connected with
: accident. In particular, 1
j interested in a report I
d seen referred to in the
'8 follow-up study. It had
:n labeled simply "Los
itnos document LA-687"
d its authors were sclen-
ts 1 knew had been in-
.ved in the Kline case from
: start.
_A-687 turned out to be a for-
rrty secret report called
adiation Doses in the Pa-
lto Accident of May 21,
16." Written by Joseph G.
ffman. U was completed
3 years alter the accident,
he bile page as coo-
the secoon oc
^^^Bere Louts Hempd-
^BHq Philip Morrison.
e report indicated that
s experts (many of whom
d also examined the men at
; hospital following the ac-
lent) had gone as far as to
ike bollow life-sue models,
lied "phantoms." filled
th simulated blood. The ac-
lent was then recreated
tie and again using the
me guts of the atom bomb,
ly now by remote controL
impansoos were made
th the phantoms' expo-
res and those recorded
radioactive blood
^^^Aken from the men
^^^Hcideni.
1.ST SUMMER, I WENT
ick to Washington with ihn
w information. My first
sit was to Senator Paul
Simon of Illinois, who had
worked for seven years to
pac* a compensation bill for
atomic veterans who have
developed commonly ac-
cepted radiation-related can-
cers. Tbe bill was enacted in
1988.
It took about 30 minutes to
brief Simon on my findings.
When 1 was finished, be stood
up and began pacing the floor
in agitation. This is an in-
credible story," he said.
"What can 1 do lo belp you?"
I had interviewed Louis
Hempelmann, the chief medi-
cal doctor at Los Alamos dur-
ing the cnucaliry accident, in
1387 at his summer home in
Rochester, N.Y, but be had
been reluctant to speak of
specifics. He had also been at
Los Alamos last spring, but
had refused comment alto-
gether. I asked the Senator to
intervene for me.
He called Hempelmann as I
stood by in his office, and
urged him to meet with me.
"For the good of the country,"
he said. Hempelmann
sounded startled, Simon told
me, but he agreed.
To his knowledge, Simon
told me. this kind of withhold-
ing of files in a case of nu-
clear exposure had never
been documented before. He
fell, as I did, that Kline's case
set the stage for a policy that
has been applied in hundreds
of other similar cases.
"There have been things to
cover up, just for an individu-
al," he commented to me in
August. "I don't know of any
cover-up that is this exten-
sive, that could aifect the
lives of so many people."
TWO WEEKS AFTER
Simon's call. Hempel-
mann met with me at
Strong Memorial Hospital in
Rochester, where he had
been the head of radiology for
more than a decade. Among
his first words were, "Tbe
records have all been de-
stroyed since 1 retired from
this place in 1979."
Noting my surprise, be ex-
plained that be had seen no
reason to keep his notes after
his report was published. "As
far as I was concerned, I was
finished with it."
I outlined to Hempelmann
what I knew about Allan
Kline's experiences. I men-
tioned his own letter, dated
Dec. 10, 1946. which said
"everyone" was getting a
"most remarkable case of jit-
ters" over the possibility of a
lawsuit from Kline.
Hempelmann said he knew
of the difficulty that Kline
had had getting his records,
but that Kline had never
come to him. Kline's request
would have had u go through
the proper channels. he said.
He would have needed ap-
proval from Norris Brad-
bury. then director of the Los
Alamos laboratory. It was
Bradbury who issued Lhe di-
rective on Dec 3. 1946, that
Los Alamos personnel were
to make no commitments or
statements involving Kline.
I reminded Hempelmann
that Kline had gone through
the proper channels. The
proper authorities were the
very people denying him ac-
cess to the records.
"That was aot my responsi-
bility," Hempelmann replied.
Hempelmann had been the
principal doctor of record for
the patients after the acci-
dent. as well as a participant
m the "phantom" study. His
correspondence makes it
clear that he was aware that
Kline wis being stonewalled
m his attempts to retrieve his
records, even unclassified
documents.
Hempelmann listened as I
recited all Uus. He turned his
head away and said nothing.
Finally, he softly repeated.
That was not my responsi-
bility."
Philip morrison. 74,
is a professor emeritus
in the physics depart-
ment at tbe Massachusetts
Institute of Technology. He
had been a colleague and
close personal friend of Louis
Slotin, and had worked with
him, and with Kline, in the
laboratory at the Pajanto
site. Slotin had called Morn-
son after the accident, and he
was the first to arrive on the
scene. It was Morrison who
insisted that an announce-
ment be made that the acci-
dent had occurred Reports of
a similar accident nine
months earlier had been
squelched by project offi-
cials. The military director of
the Manhattan Project, Maj.
Gen. Leslie R. Groves, was
known for his passion for se-
crecy, and officials wanted to
keep a lid on this accident,
too. But Momson insisted.
Like Kline, Morrison had
come to Los Alamos from
Chicago. For the test explo-
sion of the first atom bomb,
Momson bad ridden to the
Trinity Site at Alamogordo,
N.M, with the bomb core be-
side him in the back seat of
an automobile. Three weeks
after Trinity, on Tinian Is-
land in the Pacific Ocean.
Momson participated in the
assembly of tbe bomb that
destroyed Nagasaki.
Following'the cnucality ac-
cident, it was Momson who
coordinated a team of physi-
cists to monitor the radiation
emanating from the men and
the objects they'd been carry-
41 don't know of
any cover-up
that is this
extensive,' said
Senator Paul
Simon, 'that
could affect
the lives of so
many people.'
ing A memo, written by him
in the week after the acci-
dent, detailing the radiation
levels found in Kline's body,
was among the documents I
had found is Stafford War-
ren's file. After Sloan's death.
Momson Tiled a detailed se-
cret report with Los Alamos.
When, last summer, I
showed Momson the secret
study I had found in Los
Alamos  LK-6S7  which
listed him on the title page as
a contributor to the section on
Theory," be denied having
ever seen it before. He said
he had been "furiously con-
cerned" with the case and
had prepared a report, but
that this was not it. (At Los
Alamos. I had requested a
1946 report by Momsoa and
a co-author, which may have
been the one he was now
referring to: I was not al-
lowed to see iL)
I asked Morrison about the
0521 policy, commenting that
its recommendations as to
bow the Government should
respond to radiation injury
claims seemed very similar
to those made in tbe Klioe
case. Was Kline's case part ot
an orchestrated response?
"It probably was a policy. I
don't think they would deny it,
would they?" Morrison re-
plied. "I think the Govern-
ment was very scared about
this litigation. Tbe Govern-
ment ..." he paused. "I dont
know who the Government'
is, but somebody was. Some
lawyers."
The policy of
tightly restricting the
information the
United Slates Government is
willing to give people who
fear they have been exposed
to radiation goes far beyond
the Kline case.
Some 220,000 American
servicemen were exposed to
radiation at Hiroshima and
Nagasaki or witnessed the at-
mospheric nuclear tests per-
formed between 1343 and
1962. Of the more than 9,600
veterans ho have ,'ilec
radiauon injury ciams with
the Veterans Administration,
only 812 have been compen-
sated for disability, the vast
majority in the last couple of
years.
One wbc was not compen-
sated was John Snutherman.
who, like 42,000 other service-
men, witnessed the two
Operation Crossroads explo-
sions in the Marshall Islands
m 1946. Although he became a
double amputee and suffered
multiple cancers, he died in
1983 without ever having re-
ceived compensation for his
injuries. The Veterans Ad-
ministration admits that he
suffered from six radiation-
related cancers, as well as
several others, but says that
thi* cancer that killed him
was aot radiogenic
Huhdreds, if not thousands,
of people townwmd from nu-
clear weapons tests were ex-
posed to potentially damag-
ing levels of radiauon.
Elma Karoett witnessed
the cloud trom the nuclear-
weapons test code-named
Grable as she was watering
her grazing sheep in Hambhn
Valley, Utah, on May 25, 1953.
She developed nausea and
vomiting and rashes over her
body; her :kin began to scale
off her body, her hair fell out,
and her weight dropped from
130 to 100 pounds. Atomic
Energy Commission doctors
diagnosed hypothyroidism.
Eight and half months after
the incident, a Geiger counter
passed over her body failed
to detect radiauon m her
body, and on that basis, doc-
tors working under Stafford
Warren at the Los Angeles
Atomic Project reiterated
their diagnosis that radiauon
was not the cause of her prob-
lems.
More than 600,000 people
have worked in nuclear-
weapons facilities across
America since 1943. Untold
millions of pounds of radioac-
tive and chemical waste have
been released into the envi-
ronment Estimates range
from S50 billion to 3200 billion
and more to clean it up.
Countless workers have un-
doubtedly been exposed to
the wastes.
The Three Mile Island Pub-
lic Health Fund, established
after the accident in 1979 at
the TJd.L reactor, has spent
the last three years in legal
battles trying to get the
D.O.E. to release records it
compiled on 300,000 workers
at the nation's principal
weapons facilities; many of
them are believed to have
been exposed to radiauon.
Dr.Thomas F. Mancuso was
hired by the Government in

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DISCUSSION QUESTIONS FOR WORKSHOP BREAKOUT SESSIONS
Breakout Session #1: Community Health Studies and Other Public Health Activities
Breakout Session #2: Worker Health Studies
Format: Each breakout session will be held in a separate meeting room and
will be led by a professional facilitator. The facilitators will lead
their respective groups through the questions below, which will be
provided to invited attendees in advance of the workshop.
As part of the discussion surrounding these questions, the facilitator will attempt to
establish a framework by which the current and future health activity agenda can
be prioritized. In establishing this framework, it mav be appropriate to categorize
activities as focusing on either exposures/hazards or health outcomes (both cancer
and non-cancer) associated with either past operation:;, cuiient operations, or
future operations (including cleanup and D&D [decontamination and
decommissioning]). This categorization may assist the breakout sessions in
identifying what thev perceive as gaps in the public health agenda and prioritizing
the kinds of health activities the audience believes should be pursued in the future.
Questions'
	Are there any additional questions/comments about the presentations made concerning
ongoing and completed worker/community studies or other public health activities at the site?
	What type of worker/ccmmunity'health studies or other public health activities should
Department of Energy (DOE)/Department of Health and Human Services (DHHS) be
considering to address outstanding concerns?
- Which of these health activities are of highest priority? Why?
	How should workers and the public be involved in determining which health-related issues
should be studied in the future?
	How should workers and the public be involved in determining the kind of health study to be
undertaken?
	How should workers and the public be involved iri the design and implementation of a health .

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oJ-
	What is the best way to communicate final results of a public health activity to workers and
the public?
-	What types of interpretation of results are needed?
	How should workers and the public be involved in determining whether followup studies are
warranted?
-	How can the need for followup studies be weighed against the need for new
studies on other topics?
	How should the State and local public health community be involved with respect to

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BPEAKOUT GROUP #1
Deliberations
COMMUNITY HEALTH STUDIES AND

-------
Oak Ridge Workshop on Energy-Related
Public Health Activities
October 30-31,1997
Ramada Inn Oak Ridge
420 South Illinois Avenue
Oak Ridge, Tennessee 37830
li	=
|	Breakout Session #1:
Community Health and Other Public Health Activities
Deliberations
Mike Sage called the meeting to order, explaining the purpose of the breakout. He
indicated that they should express their specific concerns about Community Health
and Other Public Health Activities, as well as making comments/suggestions regarding
the process and building programs to address concerns. He then turned the program
over to Jim Andersen, the facilitator.
Jim Andersen pointed out that he was not associated with CDC or any other agency,
but was retired. He said he brought 35 years of Public Health experience to the floor
and had worked with community groups and community health issues for a long
time. He indicated that he had come out of retirement to help with the process of
identifying community needs, and expressed his hope that they would engage in an
open dialog process. He stated that he did not have any background in Oak Ridge,
Atomic Energy or Radiation, but that there were experts present to answer questions
and address those issues if necessary.

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Oak Ridge Workshop
Breakout I  Deliberations
October 30, 1997
For those who had not attended the earlier afternoon session, he briefly discussed
what had been covered, telling them that the afternoon session had given them an
overview of the nature of problems and issues. He then reviewed the charge to the
group, reading the questions which they were to consider in the breakout session.
(See Tab 7 for Charge to the Breakouts).
He asked the participants to follow some simple ground rules which were:
~	Be brief.
~	Direct comments to future action.
~	Everyone should have an opportunity to speak or voice an
opinion. If you do not wish to speak, write down your comments.
Mr. Andersen pointed out that he had made the assumption that everyone was from
the Oak Ridge Community, and therefore had a fair understanding of the issues.
However, he asked for those who were not residents of the community to clarify what
brought them to meeting.
~	We are with the State of Tennessee, Division of Oversight. We are here for
support and to answer questions.
~	Is that a public function?
~ Yes, state government.

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Oak Ridge Workshop
Breakout 1  Deliberations
October 30, J 997
~	The State Epidemiologist is also here.
~	I am with Oak Ridge National Lab which has done a lot of risk assessment.
~	We are from the University of Tennessee College of Social Work. We are
students researching this community for a project.
~	I am a faculty member from the School of Environmental Science at Florida A
& M University, working with Oak Ridge Operations to assess some of the
exposures and their affects on surrounding communities.
With that, Mr. Andersen opened the floor for comments.
Questions, Ansivers, Continents:
~	I wanted to comment on dose reconstruction work here at Oak Ridge. When I
hear comments that we don't need dose reconstruction, I take that message
seriously. There is a commonality, and they do not see these studies we are
engaged in as addressing their personal situations. Our studies are scientific,
we axe addressing levels of exposures. I don't think there is a direct connection
between those two. There is a gap between what currently is going on and
what the needs are. What is the bridge?
~	I'd like to be given the chance to try harder to communicate the benefits of

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Oak Ridge Workshop
Breakout 1  Deliberations
October 30, 1997
dose reconstruction once we complete the studies and have results to show.
On the other hand, there needs to be a much more aggressive and concerted
effort to address the concerns numerous people are articulating. No one is
funding the community to be involved. They are talcing time out of their
personal lives. A meeting like this is major step forward. Step one is to hear
what's being said. The next step is coming up with an action plan.
~	I would add that not only do we need an action plan, but also the participants
who are most directly affected need to be involved in making that action plan.
~	ATSDR, having worked with them, I am familiar with their phases and
sequences of investigations. The community might not know what you can do.
For instance, no one has taken blood. That is one thing that ATSDR can do.
~	We don't want ATSDR doing this work. They do not address the health needs
of the community. We have asked ATSDR to leave us alone. They have not
been successful in their clinics. I worked on the Superfund Rc-authorization.
ATSDR has elected not to intervene. Part of it is that they don't want to be
involved due to litigation. When people are ill, they need to know how they
are ill -- they need clinical studies. ATSDR is not in the business of doing that.
~	ATSDR's mandate was to go into communities and change things, but they
have gone to Congress and tried to change that. We do not want more
inconclusive studies  they are a waste of our time and lives.

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Oak Ridge Workshop
Breakout 1  Deliberations
October 30, 1997
Q So who might address that? How would you design such a program?
~	(Bob Spangler) I am here to listen and leam. I am dismayed with comments
about the agency. I don't take that personally. I want to communicate to you
that the agency addressed the issues of "inconclusive by design." We have
tried to change that. Whether ATSDR is the right agency to get involved in
this is to be decided later. We should be given a chance. We have worked
hard at Hanford and have several activities about to get underway there which
will address many of their health outcome complaints. This is not being
addressed anywhere else. We are also putting into place a Medical Monitoring
program for thyroid for radioactive iodine (contaminated milk downwind from

that facility). The exposure information we are seeking helps define the
services we can provide these people.
~	I didn't hear you mention that what you are doing at Hanford or here would
include biological measurements.
~	If we are talking about current on-going, we have done such testing, and for
biomarkers. We do it for renal, immune and liver. That can be applied in
certain situations. It does not help to test for VOCs if we don't know they've
been exposed.
~	At Hanford, we do have a Citizens' Advisory Board. I want to comment about
ATSDR. The agency has been dinged a lot tonight. I urge you to submit your
concerns in writing, we want to hear it. Also, I totally agree that there is a

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Oak Ridge Workshop
Breakout 1  Deliberations
October 30, 1997
competing dilemma between clean-up and health issues which should not be
your concern.
~	I think Oak Ridgers in general are flexible as to what is being done. But it
needs to be clinically based. Health based. Personal care level.
~	We also want control with a bias toward sick people and their advocates.
We've been on the NPL for years. Some want ATSDR to come on. All
agencies should have heard what all these coalitions are saying -- we do not
have confidence in ATSDR. If you send them in here to do any work, you will
not be doing what this community wants. Hear that and take it home.
~	(ATSDR Representative) My purpose is not to be defensive but to be helpful.
ATSDR is not doing those dose reconstructions. We rely on other experts.
The dose reconstructions in Hanford identified that 99% of the cumulative
dose came from iodine, that did not come from ATSDR. You're right, iodine is
not the only agent concerning Hanford. There's lots going into the Columbia
river. Similar scenario here. Lots of potential contaminants, workers,
community, former workers to be concerned about. I wanted to add the
interest in trying to network and bring to the table other agencies who can
assist you. One is HERSA (Health Resources and Services Administration).
~	There is a Memorandum of Agreement between the DOE and ATSDR. I'd like
to put that out for discussion and get feedback on it. I clearly heard concerns
of lack of trust, confidence. My comments are directed to the comments about

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Oak Ridge Workshop
Breakout I Deliberations
October 30, 1997
ATSDR's lack of direct services for clinical evaluations, and the comments
about not wanting ATSDR in the community. The dilemma is in CERCLA.
The way the law is written Congressionally mandates the things ATSDR is to
perform and DOE is to provide resources for. Following that set of mandates,
based on exposure pathways. Until the law is changed, DOE is responsible for
following that mandate and providing the resources. That competes with
resources to do on the ground clean up and restoration work -- either to
remove contaminants or put treatment methodologies in place.
~ People want remediation for their problems. Some of these people are not
working anymore and some of these compounds are residual. They are
currently being exposed based on emissions as well. Work on dose
reconstruction is important, but more important is to know body burden.
~	Health and Human Services should be involved. Dr. Satcher thought there
was a way for such a program through HHS National Institute Of
Environmental Health Services which would balance the needs of science and
the citizens. Also, the Medicare Program where care could be given to the
public -- it is there to address communities particularly for areas like
Scarborough which historically or until recently have not been part of the
process. With ATSDR, there was never any meeting held in that community.
~	Downstream of Kingston, they need a water source other than what they have,
for drinking water. Fish lolls happen often. When the dam is shut down on
the Tennessee River, but Mt. Hill is generating, there is a backflow up the

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Oak Ridge Workshop
Breakout 1  Deliberations
October 30, 1997
Tennessee River. When you use Kingston water day in and out, you're
drinking arsenic, manganese, and radioneuclides.
~	Are you suggesting an environmental study of that part of the river?
~	Yes". And we have a whole problem with all the science being done here, it's
not addressing us. We need a pilot project here in Oak Ridge. It will benefit
other sites around here who have the same types of substances. We transport
tons of benzene, etc. Tennessee is a watershed for the whole southeast - the
whole country could benefit from it.
~	I've met ATSDR in here for a decade. They've had a long shot at getting
things done and have not. You talk about Hanford with a one item problem.
This is the green run. Strontium-90 is a bigger problem than what ATSDR is
looking at. This is organ-specific to the bone, plus cell damage that can cause
all these problems. Maybe ATSDR is incapacitated, perhaps due to national
security. We need to get beyond the institutional incapacity. Part of it is
you've had ten years to do this. Involve the community, get on with more
effective treatments. Use X-ray fluorescence to figure out what the body
retention is. Whole body counting is very inaccurate. There are better ways
and better sciences. Deal with the people who have problems. There's more
than just iodine here. It's not that simple here.
~	Lead all happened with the Center for Environmental Health. It fit well with .
the local Health Department, and all CDC had to do was enhance what was

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Oak Ridge Workshop
Breakout J  De!ibertitio)is
October 30, 1997
there already. We identified a problem and then enhanced the system already
in place.
~	There also needs to be a system for X-fluorescence. You need to know the
isotope. But do we have that set up in any way here?
~	Hie capability is there, we do it on deer at the reservation. They take bone,
liver, and analyze it to see if it's too contaminated to take home and eat.
~	One reason for the sudden success of the lead program is because it dealt with
lead, levels that were easy to test, they knew what they were dealing with. But
that was on heavy metal with lots of basic information. The complexity here
overwhelms any sort of system to sort out. Chronic low level multiple
chemical exposure is a new concept.
~	Even with lead, we were on the verge of doing away with lead in 1979. In
1980, during the Reagan Administration, the program that was about to
eliminate lead was stopped for 12 years. That is a complicated story that has
politics associated with it.
~	The thing is, I looked at lead because it and uranium have similarities, when oil
industry talked about putting lead in gasoline, Public Health officials told them
that because they did not know the health effects of lead, they advised against
doing it. They had 2 diametrically opposing points of view - I hope with
technology and openness we don't have this discussion going on.

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Oak Ridge Workshop
Breakout 1  Deliberations
October 30. 1997
~	1592, lead goes back that far. Then, if you put lead in wine you were
executed. If you knew someone who was doing it, you also got executed.
~	I could summarize what I heard, that some of the issues are actual chemical
and physical measurements, there are Public Health studies that could be used
to address those issues, the pilot study with actual chemical measurements
could be base.
~	You also need independent doctors, not one who is to serve the worker as well
as the master who pays the doctors paycheck. We need occupational doctors.
~	I think it's ridiculous that people in this community cannot find health care
here in this community. Someone needs to say there will be no threat against
any doctor in this community. Doctors are fearful to have it on record that
they treated someone for strontium, mercury or whatever.
~	It's true, people have had difficulty getting treatment. Special blood tests
have been done at Lockheed though they've covered up everything. I can't get
blood tests. The system doesn't function they way it ought to. Someone
needs to look out for workers' best interest
~	As a nurse, when I have patients come in to be treated, I don't compare them
to another patient to decide whether to treat them. I don't wait. I was a triage
nurse. This hits the issue of how one diagnoses these problems. These are
often misdiagnosed because training has not been there to train health care

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Oak Ridoe Workshop
Breakout I Deliberations
October 30, 1997
workers. We need a system where patients' symptoms are being addressed.
This has been missed. We need to examine the people. In the legal system
they call an anecdote an eye witness. Thyroid cancer is less worrisome than
hypothyroidism in young people.
~	You've scienced it down to where you're going to let us die.
~	For follow-up it would be useful to see a mechanism for who will be in charge
of follow-up, who will take the lead and the accountability.
~	One other issue is what we are going to compare this to. What is our
background? One of the doctors I read in '91 or '92 was one that came out of
NCI which studied cancer around nuclear facilities. They used neighboring
and adjoining counties. We raised concern that the issue here is what is a good
reference community for Oak Ridge given the education and economic status?
To go to an adjoining county is not a reference community. Plus you have
contaminants blowing and flowing down there.
~	On Public Health programs and studies to address those issues and concerns --
they are not looking at blood levels of the people, we're not allowing the
doctors to test because of political pressure, and if they do test, who is looking
at the results? There is also the synergistic question of multiple metals in the
body. This is not being addressed, nor are multiple pathways - air, water,
food, clothes hanging on line, daycares and on playgrounds.

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Oak Ridge Workshop
Breakout 1  Deliberations
October 30, 1997
~	We need to be looking at other things besides just thyroid cancer. We should
look at the genetic/geno response, immuno response, rate of infectious diseases,
and opportunistic diseases.
~	If we allow the doctors in the area to test without crucifixion, then my family
could get tested, and if they showed problems, we could get help.
~	I want to address the openness issue. For health studies alone, I have
personally approved 30 things. There is a lot of information that is classified,
that will probably never be available to the public. It is available to the State
of Tennessee. The information is available to health studies and (could not
hear the remainder of his discussion due to simultaneous talking in the room).
~	That's not true, they have not been adequately addressed. ChemRisk
themselves have admitted that those documents are huge. They looked at
them as engineers, we are talking health issues.
~	We will give access.
~	Access continues to be an issue at all sites.
~	For EPA you can pull up maps that designate the NPL and hazardous waste
sites arid demographics around sites, but none of the national labs or fed
government sites are up on that data base. That might be a vehicle that's sort
of related here.

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Oak Ridge Workshop
Breakout 1  Deliberations
October 30, 1997
~	They are supposed to provide us with a sheet on the site and EPA or DOE
have not responded -- it was to find out whether we could get an idea of
present day data.
~	I recommended that to be approved, and it would give us an idea of the
chemical loading of this community -- they either cannot do it because they
don't have the expertise or they are being politically kept from doing it. I
don't know how to get any action.
~	In the Risk Analysis Section, we have an extensive data base -- and the
Environmental Science Division also has a data base. We have point and click
maps that show what contaminants are involved. It's a controlled web-site
right now. It's a committee who has access. It's not EMA, it's ORIS (Oak
Ridge Information System). The one specific aspect is the Risk Assessment
Access System. There are moves here with DOE fellow at headquarters to
develop a public website that can link to these things. The decisions to make
these public are DOE issues.
~	Are they not subject to the Freedom of Information act, though?
~	I can bring this before this committee, if there are people who want access to
these. There are sophisticated tools. EPA uses ours more than they use theirs.
~	There's one thing I don't think we've addressed. The Local Oversight
Committee, made up of local citizens who advise the state and DOE regarding

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Oak Ridge Workshop
Breakout 1  Deliberations
October 30, 1997
environmental issues, has a political accountability because 7 County
Commissioners are on there. I have not heard here about the need for open
access to DOE data. DOE has been closed for so long it's starting to fog.
There are contaminants and chemicals used in some processes that are still not
open for public knowledge. We should have some guarantee of open access of
data of information regarding chemicals used on site, and that have been, are
and will be leaving the site.
~	There is a decreasing number of things that are classified. However, much of it
is not understandable.
~	Lots of activity has gone on in this community over the last 40 years
addressing these concerns. It appears to me that since lots of assets are
dedicated already to providing a comprehensive data base, there needs to be an
authority that can operate and coordinate these activities.
~	Who would you recommend be in charge?
~	Not me.
~	I just wanted to add some information. The Department of Education has
recently done a review of learning disabilities in this area. You should look to
them for further information. Talk to Assistant Commissioner Joe Fisher. You
should include him, he?s in Nashville in the Department of Education.

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Oak Ridge Works)iop
Breakout 1  Deliberations
October 30, 1997
~	I've been involved in the Manhattan project not knowing what we were doing.
I think the start of this process was 1956 or '59. We don't tell. In 1982,
under pressure, they had to tell. They started a process which has continued of
increasing openness. Over the last 40 years, there has been a tremendous
amount of progress and it continues to increase. The mistake is to beat these
people up for something their ancestors did.
Q DOE needs to send a representative to go stand next to the ministers making it
clear that DOE will not interfere with people's lives or ability to work. That
would help the community recognize this is a safe issue to bring up. People are
reluctant to speak up because of fear of reprisals. Lives have been destroyed.
~	I'd like to talk about the issue of paying to serve on advisory committee. I
argued against paying people at one time, but I see what it takes to serve. I
think there should be a stipend, not too high, but high enough to make people
want to serve. We have a beast in our community of DOE handpicked
members, it's an evil creature. Use it for good. DOE has creaited a scam outfit
made up with people from EM. They are reusing a highly contaminated
facility. DOE needs to think about how they can do something good.
~	Let's do a "lessons learned" plan  what have we done wrong and right?
Political control in this community has gone on excessively.
~	How would you formulate such a group, knowing the environment?

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Oak Ridge Workshop
Breakout 1  Deliberations
October 30. 199/
~	Admit what the industry has done, treat people more humanely, change how
you do work. It's ridiculous that the press here is so politically driven. The
press needs to be told to do what a normal journalist would do. The industry
is too controlled and tied to politics.
~	There is no ability of the community to hire expertise, they don't have funding
for an advocate. We don't need to be paid as professional  gas money, hotel
bill, babysitters, etc. would be nice.
~	There are medicines that can chelate these metals off of us. Nobody's pulling
it together. Have a roadmap and a deadline to bring the fragments together.
~	The scope of clinic services must be defined first if you're going to have this.
~	Just as a reminder, this is brainstorming of ideas of what we need to go forward
with. Nothing has to be set in stone or have consensus.
~	I am a student. I agree about the roadmap and decline. I write my best when I
have a deadline and a heightened sense of urgency. These are lives which have
completely changed -- in essence people who will be spending the rest of their
lives on earth dying. That calls for a heightened sense of urgency. Intelligent
people should be able to push forward with this. Without cleanup, we're going
to get more and more sick. There are 30,000 people on campus of UT and
only 3 of us are here. We are not aware of it, I have not sensed that
heightened sense of urgency that I feel to help my fellow human beings. I've

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Oak Ridge Workshop
Breakout I  Deliberations
October 30, 199/
heard a lot about plans and pushing forward. Is seeing these people going to
help you help them?
~	Really, this whole meeting is driven by the fact that there is a sense of urgency
and compassion of what's going on in this community. And the community
has been left out in the past. People are pushing us to be more conscious of
what's going on in the world.
~	The increase in a sense of urgency is quite apparent.
~	Looking over the history of these kinds of things, a tremendous transition is
taking place here.
~	I am pleased with this process and that you're here to listen. I wanted it done
5 years ago, though. When I see younger and newer people getting sick at 30
years old, children, etc., I can't accept that. When you sit in an office, it's
easy to forget there's a world out there. It's frustrating when you know there is
help arid you are prevented from being treated. Doctors who live here don't
know how to help or they are afraid.
~	I predict no matter which way this system goes, if there's any work done, those
reports should be valuable no matter what is done. Way back, a decision was
made, the work was done, let's make it as useful as possible.
Q
Oak Ridge reservation is different from Operations budgetarily which includes

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Onk Ridge Workshop
Breakout 1  Deliberations
October 30, 199/
Portsmouth and Paduka. What is the overall DOE budget for Oak Ridge
Reservation and how much is spent on human health? Has anyone with any
agency done a cost analysis of this proposed plan?
~	The answer to how much is spent on health is "none."
~	There was an agency that did it, we met with Satcher in 1993 to see if it was
feasible to Superfund. Health demonstration was then $20 million from one
and $50 million from another for 5 sites. It was within Congress, but it was
blocked by Dole and got dropped.
~	Part of creativity is ensuring that there are sufficient resources to do this.
~	What are the agencies willing to do? Are they willing to step back and re-assess
this issue, start over again? Or are we going to end up in a constant adversarial
situation?
~	I'm Andy Lawrence, Deputy at DOE. That's the heart of why we're here.
There is a minor bureaucratic miracle going on here today ~ all agencies are
here today together in one room. There have to be creative ways to do things.
There is no statutory driver for this meeting. We are here because of the
issues, because of what you just stated. This issue is repeated in other DOE
sites. The fundamental issue we're dealing with is that we do business in a
certain way and we want to examine that and look at ways of working to try to
get programs better coordinated, and make them easy to sell to folks who

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Oak Ridge Workshop
Breakout 1  Deliberations
October 30, J 997
appropriate money to us. Budget is part of our problem -- but we need
feedback to do this. This is the first step. One thing we're doing is learning as
we go.
~	I want to close my comments by saying first and foremost that I am a Public
Health Official and Public Servant. What I want to see come out of this
process is that your heath concerns are met.
~	There seems to be a plethora of groups here, but we do want to lenow how to
follow up from this meeting. An ad hoc group could be formed.
~	It seems we are talking about community involvement. We want everyone in
the community involved. I hate to suggest forming another group, but
shouldn't we form that here in Oak Ridge?
~	We need to level the playing field, I put in 60 volunteer hours per week. We
need to bring our experts in too.
~	You have to define who would want to be on this group.
~	Was there not a petition mentioned earlier that had 5 to 8 groups already?
~	Yes.
~	Regardless, the community must be involved. That brings us back to

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Oak Ridge Workshop
Breakout 1  Deliberations
October 30, 1997
community involvement.
~	There are ways to get around bureaucratic tape. DOE did this with a tribe who
had a huge problem with uranium mined on their property. DOE said they
would clean up, but the tribe petitioned DOE to let them clean it up. DOE
trained the people of the tribe, the tribe formed a municipal organization  a
corporation & DOE gave them the clean-up money. Because the tribe took
control, they generated revenue and increased the base and knowledge level of
the members. A community can own the solution to the problem.
~	This is as much about process, how ever decisions will be made, it is crucial
that there is heavy community involvement ~ even in dose reconstruction.
~	ATSDR has addressed the Local Oversight Committee, and is getting advise
from them. But there are others who represent the community. Scarborough
has absolutely been excluded. They know nothing and that must be addressed.
There's been one meeting in 5 years.
~	The last meeting was held there Sondra.
~	No, there have never been more.
~	Only 1 to 3% of the community even knows when there are meetings.
~	Censorship of media here is also a problem. Oak Ridge is just Oak Ridge. The

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Oak Ridge Workshop
Breakout 1  Deliberations
October 30. 1997
Tennessean National Newspaper has run article after article. I show those to
Knoxville and others who have not heard about it because DOE and its
contractors put pressure on them. They advertise with the media and then
threaten to pull their advertising dollars. Articles get buried. Everything is so
controlled here it's like the military is still occupying us. I'm repeating what I
hear from the public. They get no news.
~	What we're trying to do here is get at the needs and issues regardless of who
does them.
~	Typically, ATSDR gets involved in DOE sites and states don't get funding.
Oak Ridge is different. ATSDR decided not to duplicate that activity, deciding
to let the state go forward with that past study. We plan to use those studies
to identify exposures.
~	What is the circle of law with ATSDR resolving issues? Maybe we could
receive special designation in terms of addressing these issues of clean up and
health which might provide opportunities or avenues for other agencies to get
involved. I don't think CERCLA law prevents ATSDR from contracting out
other local agencies. Maybe this site could serve as a model to help resolve
issues around the country.
~	Oak Ridge would be excellent for a pilot. Epidemiological studies are too
limited. Our population is too small. If ATSDR does it, who has responsibility
of bringing it back to us?

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Oak Ridge Workshop	Breakout 1Deliberations	October 30, 199/
~	I handle public focus for DOE. What seems to be lacking here is a road map.
How do these pieces and parts all fit together to reach the destination of
healthy people? This is a people issue. It's not like clean-up with 3 foot
documents.
~	What we're talking about has a national background level with nuclear ideas,
address this and the localized effects. It's not just workers, it's the whole
community. We're the highest pocket for ALS. Look at DOE's clean-up -- it's
like Keystone Cops on parade. Oversight and QA is next to none. If you look
at K-25, $200 million dollars have been spent there. This is easy to get junk
out of a pond, yet it's the last thing on the DOE slate to do it right. Another
problem is companies who realize they can make more money on screw ups.
~	I'd like to add to doing things right. There are some other models of
expanding scientific process - models of a participatory nature that the
Department of Housing has utilized. It brings together, through
empowerment zones, participatory teams.
~	There are some other initiatives also. It's difficult enough to get an idea of the
kinds of exposure and risks. You have to look simultaneously at mental health
and economic effects because they all add to physical health. I also want to
bring up children. I know agencies are having more focus on children in many
arenas.
~	CDC and HIV is that land of model.

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Onk Ridge Workshop
Breakout I  Deliberations
October 30, 1997
~	I wanted to say something about the remark earlier about changing CERCLA
provisions. If we're going to have flexibility to integrate other agencies and
find creative ways to involve the community -- then we need regulatory relief.
That's a function of hands being tied by the way statute is now.
~	Are you saying that is going to have to come out of your EM budget?
~	Yes. That interferes with our milestones. On the other side are stakeholders
who say they want medical monitoring. We're looking at stakeholders who say
don't use EM clean up funds for non-CERCLA activities. There is conflict
here. That needs to be worked out. We had $90 mil, now we're down to $7
million. Oak Ridge has taken on their fair share. If you have answers, give
them to me.
~	We have a proposal asking for this to be done. We don't want the
environmental clean up to fund this. We have to have that to clean up. We
should not stop because you're worried about money coming out of your
budget. That's budget driven health care and science and that should not
apply.
Explain to me why I have to trade clean-up for health care or health care for
clean-up. That's not our job to solve the problems of the government. We
should not have to do that. Don't make excuses of the controlling factors ~
what the controlling factor should be is what the people here say they need.

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Oak Ridge Workshop
Breakout 1  Deliberations
October 30, 1997
~ State laws and pulling money from clean-up to medical care sounds like same
games with school funds. You're running out of funds so you vote taxes in, but
the funds go elsewhere. It seems to be the same with taking care of the sick
people in this town.
Q I think there's a wide interest in knowing what causes illness, so let's be
creative in finding ways to involve the community in treating people and in
clean-up. Do not let budget drive health care.
With that, the meeting was adjourned for the evening.

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Oak Ridge Workshop
Plenary Session
October 31, 1997
Breakout Session #i:
Community Health Studies and Other Public Health Activities
The Community Health Studies and Other Public Health Activities Breakout
Group discussed issues of concern in terms of the following parameters:
1. Concerns/Health Issues Currently Not Being Addressed:
~	Community wants Environmental Health Services in Oak Ridge -- Pilot
Project
~	Community designed symptoms survey that will identify whether
pathology appears to be elevated
~	Look at other than cancer endpoints for thyroid such as
hypothyroidism, especially since it's being seen in such young people in
this area. System should shift to one where patients' symptoms are
addressed
~	Look at whether there is an infectious disease increase
~	Explore alternate avenues for health care and community clean-up,
including community-run service

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Oak Ridge Workshop
Plenary Sessio>t
October 31, 1997
I. Concerns/Health Issues Ciurently Not Being Addressed: (continued)
~ Focus on children needs to be a priority
~	Alternate drinking resources
~	Clinch River Environmental Analysis
~	Explore psycho social issues
~ Address censorship in the media
~	Explore daycare services along creek
~	Engage the medical community on health issues at Oak Ridge

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Oak Ridge Workshop
Plenary Session
October 31, 1997
2. Public Health Programs/Studies to Address Those Health Issues and Concerns:
~	Current studies do not allow for biologic testing
~	Multiple pathways and chemical/toxic sensitivity need to be addressed
~	Different or better analytical method (the technology is available)
~	Actual biological measurements for exposure
Q	Explore participatory research models
~	Study design:
- look to new methods
who is the cohort
-* participatoiy research
~	Rx physicians should be independent, especially for workers
~	Strontium-90 needs to be addressed (top on the list) organ specific

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Oak Ridge Workshop	Plenaiy Session	October 31, 1997
3. How Public Should be Involved:
-> Design
Implementation
4 Communication of Results
~	Form a working group here in Oak Ridge and discuss who we would put
on a group to work on these problems and follow up of these meetings
~	Community involvement means negotiate planning and conduct of all
health work with the community
~	Creative solutions like funding NGO locally to address problems and
build capacity for the future
~	Citizen involvement in action plan. Community involvement means
local control with bias toward sick people on any board
~	Identify focal point for coordination
~	Diversity of viewpoints necessary
~	Support ombudsman to address health care concerns, especially workers
~ Community wants ownership

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Oak Ridge Workshop
Plenary Session
October 31, 1997
3. How Public Should be Involved: (continued)
~ Don't schedule meetings during work day, nights or weekends are better
~	Level the playing field by paying people who are involved in planning
~	Concern from local people should drive process

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Oak Ridge Workshop
Plenary Session
October 31, 1997,
Breakout Session #2:
Worker Health Studies
The following represents the bulleted items from Breakout #2 on October
30, 1997 as presented by the Rapporteur in the Plenaiy Session on
October 31, 1997.
CONCERNS:
~ In the past, concerns of well workers and ill workers were different
-* Employed workers are concerned about their jobs
-4 Community seemed less concerned about illness than keeping
jobs
-* The Community is developing support
~	This support is in the beginning stages
~	This is turning into a broad spectrum of support

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Oak Riil^e Workshop
Plcnar\> Session
October 31, 1997
CONCERNS: (continued)
~	Only people at high risk are being studied
Need to broaden selection of those surveyed not concentrate
on high risk
4 Example is office worker
4 Study clusters such as workers at K-25
4 Occupational verses non-occupational survey
4 Need to change HMO's attitude
-4 Study non-workers as well
~	Disproportionate number of people with allergies at Oak Ridge
-4 Speaker felt health records would show commonalities
between worker illnesses

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Oak Ridge Workshop
Plenar\' Session
October 31, 1997
CONCERNS: (continued)
~ Suggestion to study medical records!exposures of deceased workers
4 Since workers are still exposed to same things
-4 Would show what the current workers are getting sick from
4 So apply mortality studies to morbidity studies to help
current workers
-4 Several workers echoed need for morbidity verses mortality
studies
-4 Workers were shifted between all 3 plants to complicate
matters
-4 Most workers were administered physicals periodically
4 Reminder that wouldn't be the case for office workers or
people in community
4 Also physicals wouldn't apply to DOE contractors
~	We're losing institutional memory at K-25 due to
deaths

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Oiik Rhine Workshop
Plenary Session
October 31, 1997
CONCERNS: (continued)
~	Call for an independent clinic
4 Might be used for triage purposes, to get proper treatment for
people
~	Concern that Lockheed Martin Doctors on staff are biased against
ill workers
~	Exposures from one generation to the next
-4 Concern about which current illnesses might be
caused/effected by a parents exposure
How is the exposure from parents working at Oak Ridge now
affecting offspring
~	Mention of genetic predisposition towards some of these illnesses
The predisposition is aggravated by exposures
Concern of Government/Company interpretation of a
predisposition

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Oak Ridge \Vorhliop
Pleit/ir]' Session
October 31, 1997
CONCERNS: (continued)
~	Concerns voiced about pregnant women exposures
~	Concern about increasingly transient work base
4 How to study or track down exposure outcome
4 Private companies leasing buildings on contaminated sites
~	Concern about workers/community being informed properly
4 DOE isn't sharing information on studies it's doing with other
similar communities
4 Need to disseminate risks/results openly
4 Need to declassify medical documents
4 How to do a worker evaluation when his exposure is classified
4 Need worker involvement/input
4 Need to know cumulative effect of being exposed to
"acceptable" levels of 10 or 20 different chemicals

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Oak Ridge Workshop
Plenary Session
October 31, 1997
CONCERNS: (continued)
~ In environment of downsizing, workers seemed more concerned about
job than their fellow ill workers
When threatened with lay-offs, workers are less safety
conscious
4 Feels that stress caused by job worries is definitely an exposure

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Otik Ridge Workshop
Pleittiry Session
October 31, 199/
NEEDS;
~	Need a safe workplace, where work can be done in a safe manner
~	Need good science
~	Need a broader selection of individuals selected to be studied
~	Need morbidity studies incorporating knowledge gained from
mortality studies
~	Need surveillance for routine collection and dissemination of
information
~	Need education of medical community
-4 DOE should reimburse physicians who perform tests

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Otik Ridge Workshop
Plamn' Session
October 3], 1997
NEEDS: (continued)
~	Need the planning process to address distrust, fear, reprisals and
retaliation
4 Need independent health treatment for screening of
symptoms
4 Independent means outside of the politics of the area
-~ The independent health facility must be staffed by
knowledgeable physicians
4 There has to be a mechanism for assessing exposures of
workers
- QA
4 Characterization of workplace tasks
4 Declassification of medical documents
~	Need state of the art monitors
-4 Need trained personnel to operate/maintain those monitors

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Oak Ritlge Workshop
Plenary Session
October 31, 1997
NEEDS: (continued)
~	Need history of plant
-4 What work was done where and when
What chemicals were used
4 What possible exposures were present
-4 What are effects of multiple exposures
~	Need infonned workers
-4 Treat workers with honesty
-4 Give workers knowledge
~	Need an approach to symptom surveys that involves talking to people
~	Need studies of women reproductive health and exposure outcomes
4 Removal of pregnant women from the site

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Oak Ritl^e Workshop
Plenary Session
October 31, 1997
PRIORITIES:
1.	Help the people who are sick now.
2.	Involve the affected community or employees in the process.
3.	Do a morbidity study.
Requires good registries, medical exams or other ways of
obtaining information
Require physicians to do the reporting
Need creativity to obtain the information, since this is
company town
4.	Treatment/prevention and intervention.
5.	Better monitoring & control of exposure - state of the art devices.
6.	Speeding up declassification of documents.

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Otik Ridae Workshop
Plenary Session
October 31, 199/
PRIORITIES: (continued)
7.	Better education for area physicians, and the freedom to exercise
their knowledge.
8.	Instead of doing partial decontamination, do decontamination to
safe levels at the work place and in the community.
9.	Conduct clinical studies and conduct a symptom survey to improve
lives, in a care driven study.
Information would be from residential/family/doctors/and
medical history
Empowering the people or shared ownership was suggested
For instance something like a pigmentation change symptom,
might signal the onset of some worse disease
Might use sets of symptoms
Surveys consisting of family, work and medical history
At first might do pilot survey for testing purposes
10.	Independent Health Clinic.

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Oak Riil^e W'orkslwp
Plenary Session
October 31, 1997
Questions, Answers, Comments:
Following the Breakout Presentations
C: One thing you left out, or I missed you saying, is in process of creating
whatever survey or whatever health outreach that the people be involved in
that.
A: Yes that is very important and I'm sorry I left that out.
Q: Was there anv discussion of a more thorough use of routine plant physical
exams?
A: There was some conversation on that, a lot of the information I recall is that
some people get yearly exams, but other workers, like office or contractors
don't get exams.
Q: Have they ever been looked at from this point of view?
A: I don't know.
C: In our group, I recommended they consider setting up an independent clinic
for physicians who were not beholding to companies to examine patients.
C: One reason why we didn't delve into the physicals at the plant is that not
everyone is required to have a physicals. There have been a few instances

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Oak Ridge Workshop
Plenaiy Session
October 31, 1997
where problems have been noticed within individuals, but the patient has not
been told about it. If they had been they could have sought medical treatment
from their own doctors. There have been many who were not getting proper
care through the plant doctor.
A: An outside independent clinic would deal with patient problems.
C: The community here is the best and most informed community I've ever
encountered.
C: (A1 Brooks) I'd like to say that we started slow, but last night compensated for
it. I think both sessions were very good. One thing disturbs me in this process.
I'm a member of 4 or 5 organizations that worry about these problems, but
don't agree on all details. This process leads to recording the statements of one
person. I assure you the community does not believe all these things. If you
went out to the community at large, I don't believe they would endorse some
of these things. They will support workers who are ill and need help. A lot of
these are not communitv concerns.
A: (Mike Sage) You raise a good point. In the proceedings, the clarification will
be that this has been a workshop where we tried to bring in anyone in the
community who wished to be here. That's fair to reflect in the proceedings.
C:
I think that is not a shared opinion of the community. These efforts prove to
disprove the concerns of the few that did have them. We should go forward

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Otik Ritli>e I Vorkshop
Plamn' Session
October 31, 1997
and investigate and either prove or disprove the things that are on the table
now. It would help other sites as well.
C: (A1 Brooks) It's the statement that it's the community view that's not right.
C: I'm moving into year 3. I'm Jso in that group that Al's in and I keep hearing
this come up. Both the community and the sick workers need to come to a
bridge.
C: Also, federal agencies bridging their gaps was part of the discussion in
Breakout 1. There was discussion of the roadmap, some of that bridging will
occur there. How can we create a roadmap?
C: I'm not looking for a blame, I'm loolcing for a cure and a help. I need the next
3 years of a pleasant life instead of miserable one.
C: (Mike Sage) Another point here that would help, that's secondary to this
meeting, is that we'd appreciate comments because we are going Lo replicate
this in the future.
C: People addressed problems that people in the other group would not recognize
would happen. Problems came up between apparent conflicts between what
people believe is local law and what actually is. It sounds like what is desired
might not be within realm of public administration. Can you explain that
more thoroughly? That's fairly complex, but a possibly important point.

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Oak Ridge Workshop
Plainiy Session
October 31, 1997
A: They surfaced in the dynamics of concerns about agencies and their
incapacities to do anything. The discussion was about how to follow the
mandate of the congressional acts that govern the Superfund and other issues,
and make choices between Public Health and cleanup activities. Some actions
are dictated by the laws that were written. The community would have none
of that. They said that if we looked at Oak Ridge in special way, we could get
around this. That I thought was the issue at hand.
C: (Mike Sage) There were 2 sub-issues in that:
1)	The one around budget, and
2)	The issues in clean-up and health activities, and legal/mandate issues
It was suggested that could we be creative in dealing with those  that's what
I heard. The individuals in the room did not find it acceptable to say, "We
can't do that" or "We're going to juggle money around." They said find
creative ways of addressing both issues.
C: On questions of budgets, mandates and laws do not always read the same. If
one reads the law and then reads the EPA guidelines, it's hard to believe they
came from same source. Laws can be changed. They are written by man and
they can be changed by him.
C: (Mike Sage) There are many interpretations of the law, and there is a lot of
debate over what a laws say and their interpretations in many arenas.

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Oak Ruhe Workshop
Plenary1 Session
October 31. 1997
C: I would like to say what I'm hearing are laws and budgets. Who is the
government? We are voting taxpayers. We need to move out of Washington.
Tennessee needs funding for both clean up and heath needs. Do not rob one
pot to pay the other. I have this to say to the people of this community and
the workers -- you all have a mouth and a hand -- dial the phone. Call your
Congressmen. We do not need to mess with the budgets. But candidates are
driven by their constituents, speak up.
C: (Mike Sage) That was also a message in Breakout 1. It's not just up to the
federal agencies to do this, You need to exercise your rights.
C: The suggestion was to perhaps seek special designation for the Oak Ridge site.
Still, there must be commitment from DOE and/or other agencies -- they do
recognize they have special problems here as it centers around people's health.
DOE needs to analyze and assess what's been done. Exercising political rights
is one thing, but DOE has to change the way of looking at things toward
people's health.
C: (Mike Sage) That was a general theme. We need to examine and re-examine
"business as usual" and see how to do things differently. That focus is a
difference between addressing technical, scientific, and bureaucratic issues. We
all have to spend a lot of time in refocusing on people's human concerns. That
was the general theme out of yesterday's meetings. Any other discussion on
last night? Anybody that wasn't here last night who would like to add
anything you didn't hear? Or new thoughts. The process isn't over here. Let's

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Oak Riil^c Workshop
Pleiian' Session
October 31, 1997
add as much as we can to the pot.
C: In thinking over the discussions of last night, I'd like to offer a caveat. Much
of this thinking outside the box is not considered state-of-the-art, it does not
satisfy the contemporary stuff. It is research and needs protocols, review
boards, etc. At agencies, we're talking about not funding research for the m^st
part of this nature (outside the box). So when a community begins to look at
pursuing this, legitimate resources for funding research from foundations, etc.
need to be sought and initiatives need to be carefully designed. If you ask the
wrong questions, you get the wrong answers.
C: (Mike Sage) We did not get into a next-step discussion around what any of
this wall look like. These were just conceptually put on the table and would
require extensive dialogue and planning. You touch on an issue we did not
touch at all, and that is all the ethical issues around conducting community or
worker studies. I sit on a group for the CDC Presidential Apology on
Tuskegee. We have our own dirty linen and are engaged in addressing these
issues of ethics in research. It's a piece often missing in community
involvement.
C: It was said earlier that we need to think of first steps instead of big leaps into
the unknown. There are many opportunities for pilot programs that the
agencies could be thinking about  something similar to the idea of the
charter schools that test out whether something will work before dumping in
the money to all schools. I recommend picking a small community like Oak

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Oak Riilge Wurkshtni
Plt'unn' Session
October 31, 1997
Ridge, where people really know intuitively and through understanding from
the history of this community, that the community is going to show some risk
from pollution. There is no litigation around Scarborough right now. It
might be good first step for a Pilot Symptom Survey that the community
would design, asking questions based on technical input.
My second point, and DOE knows this very well, is that if you don't become
proactive and help with these ways of addressing this problem now, what is
going to happen is what has happened to you many times over -- you'll get
sued. A lot of their health studies are litigation drive. Many people who are
affected are being studied by doctors who DOE lawyers hire. That's bad
science.
C: I have approached universities on my own about getting into medical research
programs. Because of where I am located and what I am associated with, they
don't want to take me on  they are afraid to damage their grants and
funding.
C: I think that speaks to the need for interagency coordination. One agency who
is not here is NCEH. It seems to me Oak Ridge would be ideal for one of their
projects. The funds are out there. NIEHS is taking a different view of how
they do things, and one way is working with other federal agencies in these
projects. They would be very good group, and we should have involved them
here.

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Oak Ri/lt>i' Workshop
Pltauuy Session
October 31, 1997
C: (Mike Sage) In Breakout 1, NIEHS was mentioned, and so was HERSA  The
Health Resources Service Administration.
C: The other thing is that one main problem needing to be addressed is the
notion of risk communication. The communication which this meeting
allowed was a -good start. In a broader sense, communication between agency,
scientist, and community and immunity perception of what's going on about
agency, science, and lay people -- have to come to common ground and respect
for each other . This is an overriding issue that needs addressing also.
C: I shared some of my comments with representatives from ATSDR last night. I
have had the opportunity to come in and serve as an independent observer at
other facilities that have had the community take the initiative to do surveys.
Independent surveyors -- some of them have been treated horrendously.
Because of it, I saw the tendency for the community to throw the baby out
with the bath water. There are agencies un-doing things. There are ways to do
these that are acceptable.' The situation I shared, their symptom survey was
3000 questions and took 3 hours to complete. They had everything from
toenail fungus to other issues. They were serious. I don't mean to downgrade,
there are ways to accomplish this. There needs to be discussion of how you
train your surveyors, how you do whatever. The community was not treated as
equal members of scientific communities. Use resources of these agencies as
best you can, to bring appropriate information to table, do it in a way that will
be acceptable to the agencies.

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Oak Ridge Workshop	Plea an' Session	October 31, 1997
C: (Mike Sage) You hit a lot of design issues. Bill Moore spoke to them also.
Anything helps in focusing the purpose of that survey. Most of the time it
isn't really science you're trying to gain. It's a needs assessment, documenting
concerns, pointing to a hypothesis that needs to be developed further. You
have to ask what it is you're trying to get at. Working with agencies who have
done this a lot is necessary.
C: I would endorse comments of last speaker. Several years back I was at odds
with every agency who came into this town. I am no longer. If this
community wants this help, there's a great deal of it. This community needs to
open the door for them. Some said they did not want these agencies in here.
If this community can't learn how to deal with them, we won't get very far.
We need to bring these groups together in a constructive way. This
community is asking a lot  individual citizens must realize that a letter to a
Congressman carries a lot more weight from a voter. EPA listens to political
pressures. I'm not saying they should compromise technical points. The
budget is a political process and without it, you're not going to do very much.
C: 14.5 years ago, we got DOE to declassify mercury. A1 Gore held a hearing
relating to mercury losses. At the time, they thought it was 2.4 million
pounds, it was actually 4 million. I called for CDC to investigate based on my
testimony. We appreciate that you're here, but 14 years is too long. Many
people have died, many are sick. The fact that you don't meet on weekends
and nights -you ought to stay the weekend, meet workers, etc. This is a
community where retaliation is alive and well. A man appeared on the CBS

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Oak Rieh^e Workshop
Plenary Session
October 31, 1997
news and he was given an office contaminated with radiation and then moved
to one contaminated with mercury. 900 PhDs are intolerant about workers
raising concerns. Even for mild reports workers are harassed, intimated, put in
harms way.
This community helped to win the Cold War, World War II. But as far as the
ability as management to assist your efforts, don't trust them. We've got
Frank who said he destroyed all his e-mail, and his Franklin Planner every
month got destroyed. DOE and Lockheed are not going to give you answers.
They have destroyed lives for years. Trust is earned. I disagree with Mr.
Brooks. The people here have a right not to trust DOE. Everybody who
comes in here -- look at DOE knowing they have committed horrible crimes
here. The truth is just coming out, people here need to know the truth.
C: After having been involved in this process half century, I don't agree with last
speaker.
With that, Mike Sage called a 15 minute break. Upon re-convening, he indicated
that Paid Seliginan would make the closing remarks:
Paul Seliginan
Deputy Assistant Secretary for Health Studies
Department of Energy
Prior to making his closing remarks, Paul Seligman pointed out that meetings don't
happen spontaneously. He thanked everyone responsible for putting the meeting

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Onk Ritle Workshop
Plenary Session
October 31, 1997
together and making certain that it ran smoothly. He indicated that a list of federal
employees and their addresses would be provided for anyone who wished to make
additional comments.
He indicated that it was now his job is to put together what had been a very
interesting and enlightening day of sessions and comments. He pointed out that he
had been with DOE for 3 years in the Office of Health Studies.
He reminded them that they could not get anywhere without knowing where they
were going. He indicated that DOE sponsors a Health Studies Program in Oak Ridge
and throughout the department, and that at any given time, there were hundreds of
studies going on in his office and the Office of Environmental Management. He said
it was difficult to describe the incredible sene of where those programs were going,
that all of the activities had been started at one point or other for good reason, and in
a scientific manner. He said he liked the idea of small steps, but he wanted to look at
the big picture as well, indicating that he viewed the Health Studies Workshop as one
part a series of very important steps in developing a Public Health Agenda.
He showed the following slide indicating that it represented what he saw as the future

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Otik Ritlne Workshop
Pleiitir)' Session
October 31, 1997
~	Develop a credible, coherent Health Research and Public Health Activities
Agenda.
~	Address the needs and concerns of the community and workers.
~	Maintain coordinated, coherent local input in all aspects of programs:
	Workers
*	Community
>	DOE operations people responsible for conduct of work
-	Contractors hired to perform the work
~	State &. Local Health Departments
	>	All federal agencies (are the right agencies at the table?)	
He pointed out that if thev were to have a clear agenda, everyone had to be at the
table. As thev had mentioned earlier, many were represented at the workshop, and
there were many others like NIEHS, EPA and others who should be there.
He said that A1 Brooks had made a good point in asking, "Who do you go to with a
research agenda to make sure it meets the broadest needs of the community?" It had
to address eveiyone's needs. He reminded them that it was quite a challenge to do
those things and get input into doing those things.
He then discussed some of his reflections on the workshop, apologizing for not being
able to address all the issues, comments and concerns that were raised individually.
He said instead, he wanted to tell the participants the things that stuck in his mind
and that he had learned as a result of the workshop. He showed the following slide:

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Oak Ritlge Workshop
Plenary Session
October 31, 1997
leader on the board of that hospital ever. That hospital controls 30 doctor
practices, and 3 Lockheed Martin employees sit on that board. It all ties in
with the contractor and DOE. They've told patients they weren't getting tests.
Medical care and clinical studies must be done by somebody else. Release
doctors.
Michael Dukakis once said the fish rots from the head. Jim Hall is way over
his head. He needs to be run off. The manager of Oak Ridge ought to come
from EPA who knows how to manage and find his way out of paper bag.
C: In the spirit of openness, I represent only myself. How will you get a forum
where you can get a consensus of Oak Ridge people.? There are large numbers
of groups, almost like a group of lawyers. A group of 3 of us have at least 5
opinions. I think the only way to go is collect as much wisdom as you can, and
then your responsibility in your office is to distill it in your wisdom. You'll
have to pick the intellectual way to whatever it is, then take your research
agenda and distribute it widely and get comments. Also, you must remember
that there are a number of people who don't belong to any group, and they too
deserve representation.
The last remark that I want to make is that after the initial presentations,
there's been almost no discussion about the work your office is doing from
there. The Oak Ridge Health Agreement Steering Panel --1 was not on the
panel at the time the decision was made to do the study that we're trying to
complete -- but I'm trying to help make it worthwhile. It may not be the right
38
C 3z- 37

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Oak Ridge Workshop	Pleiuvy Session	October 31, 1997
study to do, it may. Whatever is done in the clinic setting, epidemiological
setting, whatever, offsite effects, we'll have to make use of what is known.
That may not be all that turns out to be important in the passage of time.
Reviewers for those reports are still needed.
C: Paul, I think you've done a good job in capturing the concerns and giving an
outline of what's gone on here and outside these meetings. Getting a
representative group is a problem. My advise would be to require whatever
group is established to have open participation in it's discussion, then the
public can take care of themselves by speaking up at the meetings.
Q: If you believe that there are sick people in the community, why don't you
come in and check us out now and not wait more months to figure out the
agenda? Do some immediate spot checks and take action. Is that a possibility
or reality that we could look forward to?
A: (Paul Seligman) That's a tough question. In that context, many in my office
and myself have been engaged with group of individuals who have come before
my office and the Secretary of Energy with health complaints. The name of the
group is "The Exposed." We have tried to ensure that they are provided with
appropriate medical evaluations. It's my understanding from comments made
at this meeting, that our 3 doctors we placed here many not have addressed
those needs. Is that right? It's not meant to be an excuse, it's a reality. We
have not had the means or mechanisms in the past to provide direct health
care. That's why, when we talked about clinical studies, I want to say that I

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ik Ritlvc Workshop
Plenary Session
October 31, 1997
hear you and recognize that people need these things the most now. In my
capacity, I am not in position to provide that. I am willing to think about how
we can work down the road to ensure that our program helps to address those
needs.
C: One thing mentioned last night in the Community Session was the sense of
urgency and understanding that that sense might be applied to the situation.
DOE must come forth honestly.
C: I'd like to offer a different perspective from last few minutes. I have worked in
hazardous waste individually locally for 10 years, and the last 10 months as
paid staff for the Local Oversight Committee. I've worked with many DOE
technical subcontractors. For 7 years I worked with League of Women Voters.
In my experience here, I have found the vast majority of the DOE people and
their contractors to be technically competent, concerned about the
environmental issues, frustrated by the bureaucracy they have to work within,
and on a progressive basis being more willing to listen to public input.
Mr. Slaven is looking at issues 14 years old and has not been active in this
community since then. I can see that, as a whistle blower lawyer, he would
like to keep antagonistic relationship. But we need DOE's cooperation,
technical support and data to address these health problems.
Similarly I've heard ATSDR criticized at this meeting. In my capacity with the
Local Oversight Committee, we've had many local meetings with the Fish

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Otik Riilge Workshop
Plea/in' Session
October 31, 1997
Advisory - they have been responsive, have accepted our suggestions, the ones
they disagreed with they justified and subsequently negotiated other
agreements. ATSDR would be an asset to contributing to health studies in this
community. The agencies involved and others need to form a working group.
There needs to be a champion for type of work desired here. There has to be a
designated person as point of contact - a career person, not a political person.
We don't want a loss of driving force between or for these issues which need
ongoing committee input. I urge you to look at who might be tasked as being
the person to push this initiative through, to ensure other agencies are on
board so that each one can provide as their input based on their specialty.
Look at your budget to see who you can task this with.
Whatever public policy that comes out of this does need to be based on good
science, not superstition, not bad science. You need to listen to and educate
the community so that what research takes place meets professional standards
or it's worthless. Science and health care issues are separate and need to be
addressed.
Thank you very much for having this meeting, bringing these agencies
together, and listening to others. Hopefully this won't be the end of it. We
will have ongoing and progressively more useful work occur here with respect
to the health issues.
C: I understand that some of what we're asking requires big shift in paradigm. If
it ain't broke don't fix if it is sometimes thought to be better. The health

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Oak Ridge Workshop
Plenary Session
October 31, 1997
system in Oak Ridge is extensive, but it somehow has not worked. I have a
glimmer here and there of why it hasn't. You could do a studv to find out
why it doesn't work. In trying to resolve some of these issues, maybe there is a
straightforward fix that would help. Is it within your purview to do that study?
A: (Paul Seligman) I think so.
C: I agree with A1. I respect him and have learned to share the floor. The group
you referred to, The Exposed is now known as The Coalition For a Healthy
Environment. Thank you. The 3 doctors you brought in are doing an
excellent job. But it's still a year later. I want to kick the snail. The mechanic
can work only one day out of the month. You've got a Cadillac and a
mechanic but he only works one day. Give me 3 hours in the room with those
doctors and I'll get information. Being DOE's subcontractor is another major
problem, testing is not authorized. Your office can deal with that.
A: (Paul Seligman) We'll work with our colleagues in Oak Ridge.
C: I strongly agree. Amend your contract and require all subcontractors to
provide for patient autonomy to go to any doctor in the country they want to.
Let them see a specialist, stop letting Lockheed Martin tell them they can't see
such doctors. They told 30 practices here in Oak Ridge they could not order
certain tests. What about antitrust? Sign here, make a contract modification.
Patients have the right to autonomy. If you do that by Christmas, you will
have trust from this community. That will resolve concern here. Let them

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Oak Ridge Workshop
Pleiuin' Session
October 31, 1997
pick their doctors.
C: Thank you very much for coming here. I agree with Susan. We need good
science and new science. A lot of work is based on classical toxicology and
outdated methods. We have methods now that we can look at immunological
data, and ways of impairment we didn't know before. I think engineering
designs have been done and no health effects were known when writing
designs. When asked where data comes from, it's not from clinical health
studies. It's simulated acute exposure to healthy white males for 8 hours using
computer models. It was a tool, but it needs to be dealt with if health and
safety is going to be the driver for remediation. This is not a welfare program,
not entitlement for people who are ill in community. People who live in and
have worked in an environment that is contaminated deserve care. They may
not have known what they were exposed to. That's where research needs to
come. The City Council also' needs to be here. This also impacts the economic
development for this community.
Q: If your agency doesn't have the power to help sick workers, who can we turn
to?
A (Paul Seligman) As far as the contract modification idea, that's out of my
realm.
C: I represent myself. You've been beat up on Paul. I'd like to say that I spent
22 years in the military. When my government called I came. When you

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Oak Ridge Workshop
Plenary Session
October 31, 1997
leave here, I'd like you to have same thing in mind. When the government
called, this community came. You have dedicated citizens, true blooded
Americans. We're not a mean-spirited people, though we get riled. Lives are
at stake. Everybody's doing the best you can do, but we can do better. Thank
you for what you've done. But I warn you, it is dangerous to raise the
expectation of the people and then not deliver. We're looking forward to
receiving these proceedings. We appreciate what you're doing.
C: We've talked about community, understanding that employees are part of
community. We have a number of employees who reside elsewhere, or are
retired who may be hard to find. Now we have a number of unemployed
workers living where ever they can find a job. So when you look at the
mechanism for finding all these people, it's going to be hard. Something good
is going to come out of this and that's the treat, or nothing is going to happen
and that's a trick. I wonder if it's significant that this meeting is on
Halloween?
With that, the meeting was adjourned.

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BREAKOUT GROUP ?1
PLENARY SESSION
ACTION ITEM
REPORT
COMMUNITY HEALTH STUDIES AND

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Oak Ridge Workshop on Energy-Related
Public Health Activities
October 30-31, 1997
Ramada Inn Oak Ridge
420 South Illinois Avenue
Oak Ridge, Tennessee 37830
(423) 483-5972
Breakout Session #1:
Community Health Studies and Other Public Health Activities
The Community Health Studies and Other Public Health Activities Breakout
Group discussed issues of concern in terms of the following parameters:
I. Concerns/Health Issues Cwrently Not Being Addressed:
~	Community wants Environmental Health Services in Oak Ridge -- Pilot
Project
~	Community designed symptoms survey that will identify whether
pathology appears to be elevated
~	Look at other than cancer endpoints for thyroid such as
hypothyroidism, especially since it's being seen in such young people in
this area. System should shift to one where patients' symptoms are
addressed
~	Look at whether there is an infectious disease increase
~	Explore alternate avenues for health care and community clean-up,
including community-run service
~	Focus on children needs to be a priority

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Oak Ridge Workshop
Breakout #1 Report
October 31, 199/
1.	Concenis/Health Issues Cuirently Not Being Addressed: (continued)
~	Alternate drinking resources
~	Clinch River Environmental Analysis
~	Explore psycho social issues
~	Address censorship in the media
~	Explore daycare services along creek
~	Engage the medical community on health issues at Oak Ridge
2.	Public Health Programs/Studies to Address Those Health Issues and Concerns:
~	Current studies do not allow for biologic testing
~	Multiple pathways and chemical/toxic sensitivity need to be addressed
~	Different or better analytical method (the technology is available)
~	Actual biological measurements for exposure
~	Explore participatory research models
~	Study design:
-* look to new methods
4 who is the cohort
participatory research
~	Rx physicians should be independent, especially for workers

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Oak Ridge Workshop
Breakout #i Report
October 31, 1997
2.	Public Health Programs/SIit dies to Address Those Health Issues and Concerns:
(continued)
~ Strontium-90 needs to be addressed (top on the list) organ specific nature
3.	How Public Should be Involved:
Design
-> Implementation
Communication of Results
~	Form a working group here in Oak Ridge and discuss who we would put
on a group to work on these problems and follow up of these meetings
~	Community involvement means negotiate planning and conduct of all
health work with the communitv
j
~	Creative solutions like funded NGO locally to address problems and
build capacity for the future
~	Citizen involvement in action plan. Community involvement means
local control bias to sick people on any board
~	Identify focal point for coordination
~	Diversity of viewpoints necessary
~	Support ombudsman to address health care concerns, especially workers
~	Community wants ownership
~	Don't schedule meetings during work day, nights or weekends are better
~	Level the playing field by paying people who are involved in planning

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Oak Ridge Resen'ation Workshop
Breakout Group #i
October 30, 1997
~	Concern from local people should drive process
4. Official Agency Conduct:
~	Have a deadline, have a forum to develop the roadmap
~	Come up with a roadmap for winding up with healthy people
~	Establish who is accountable for follow-up
~	Agency dedication to creative problem solving
~	Lessons learned plans should be developed
~	Officials of authority in Oak Ridge should publicly speak to the need to address
health issues
~	Department of Education should be involved (Approach Joe Fisher in
Nashville)
~	Provide user friendly and open access to information
~	Direct money where it's intended to be and will do the most good to
people
~	Wide interest in knowing what has happened, health relationships
~	Agencies should look to best mechanisms to address the concerns
~	Oak Ridge could receive special classification or designation to allow
other agencies to be involved
~	Address censorship of the media
~	Go beyond institutional incapacity

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Oak Ridge Reservation Workshop
Breakout Group #1
October 30, 1997
4. Official Agency Conduct:
~	Have a deadline, have a forum to develop the roadmap
~	Come up with a roadmap for winding up with healthy people
~	Establish who is accountable for follow-up
~	Agency dedication to creative problem solving
~	Lessons learned plans should be developed
~	Officials of authority in Oak Ridge should publicly speak to the need to address
health issues
~	Department of Education should be involved (Approach Joe Fisher in
Nashville)
~	Provide user friendly and open access to information
~	Direct money where it's intended to be and will do the most good to
people
~	Wide interest in knowing what has happened, health relationships
Of'
7	?rcCOfY -n

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Oak Ridge Reservation Workshop
Breakout Group #1
October 30, 1997
4. Official Agency Conduct: (continued)
~ Agencies should look to best mechanisms to address the concerns
~ Oak Ridge could receive special classification or designation to allow
other agencies to be involved
~ Address censorship of the media
~ Go beyond institutional incapacity

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BREAKOUT GROUP #2
Deliberations

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Oak Ridge Workshop on Energy-Related
Public Health Activities
October 30-31, 1997
Ramada Inn Oak Ridge
420 South Illinois Avenue
Oak Ridge, Tennessee 37830
Worker Health Studies
Paul Seligman called the session to order, making a few opening remarks, before
turning the floor over to Phillip Talboy, a Public Health Advisor for CDC, who served
as the facilitator evening's session.
Mr. Talboy referred the participants to a list which he had determined from listening
to the earlier session seemed to be the main problems that the community felt needed
to be addressed. They were:
1.	Health concerns are not being addressed.
2.	There was discussion about kinds of health programs that should be
supported.
3.	Input from the workers, on how the workers should give input, is
needed.

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Oak Ridge Workshop	Breakout #2 Deliberations	October 30, 1997
He then opened the floor for comments, requesting that the participants give their
input freely.
Questions, Answers, Comments;
C: In the past, the concerns from workers and ill workers might be different.
Workers who are still employed at the facility are concerned about their jobs.
Since this is a one business town, I feel that the community in general isn't too
concerned with the problems of the ill workers, because if the business went
away, most of the money would also.
C: I disagree with the last speaker, I have seen a lot of support in the community
for the ill workers.
C: I disagree. I have heard people refer to these as phantom illnesses. The
community is too complacent, but if they understood the incineration that's
going on, maybe they wouldn't be so complacent. The size of some of the
particulates is so small, that even with filters there is no way that they are
trapping all the particulates when they do the incineration.
C: I disagree with that. I believe that the community, that support from the
community for the ill workers is in an infantile state.
C: If they would do a study on the mortality records of the dead workers,
detailing what kinds of exposures/diseases they had experienced, it would be a

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Oak Ridge Workshop	Breakout #2 Deliberations	October 30, 1997
good indicator of what the current workers were being exposed to and the
diseases they are experiencing, or will eventually experience. Institutional
memory of the site is being lost due to the rate of deaths and lay-offs.
C: I am a retired worker. I worked in the different sites on the reservation all my
adult working life, but am relatively healthy. In addition to the ill workers
where it's known what illness they have, there is yet another class of people
who show evidence of illness from some unknown cause. The people who
have been studied up to this point, for the most part, are workers who worked
in some of the worst exposure areas and are already ill. What's needed is a
broader selection of people to study.
C: I am a good example of the types of worker who are not being studied. I
worked in ari office and didn't go into the places where it's expected that
someone might be exposed to chemicals or radiation, and yet I have very bad
symptoms. I used to be a kayak instructor and enjoyed the outdoors, but due
to my illnesses am unable to enjoy an active outdoor life.
C: I suggest that you study risk and clusters, like occupational and non-
occupational exposures. It would go a long way to allay current workers
suspicions and mistrust if there is a change in the attitude/conduct at the
HMO's, and with how managers reacted to employees who complain of illness.
These people should not feel neglected.
C: There is a disproportionate number of people with allergies in Oak Ridge. If all

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Oak Ridge Workshop
Breakout #2 Deliberations
October 30, 1997
the health records of the people of Oak Ridge were looked at, there would be
some strong commonalities.
C: An independent clinic should be established that would act like a triage center.
Workers or people in the community could be examined by medical personnel
who were trained in spotting toxicology and radiation symptoms, who would
then send these people to a hospital or medical facility where they could get
qualified treatment for their illnesses.
Q: Will there be a survey of the general population? There should be a survey of
people working at K-25 noting what their jobs were and what the effects were
on both the well and the sick people.
C; It would be very hard to do such a study because the workers were frequently
shifted between all three plants over the years.
C: Maybe we should back up a step and figure out what the risks are. Most of the
metals the workers were exposed to are non-standardized, except lead, as to
what they do to the human body, so we wouldn't know what outcome to
expect. So a symptom survey might be a logical first step. This survey would
take into account work, medical history, lifestyles, etc.
Q: Would we identify clusters from such a survey?
C: There is no clear answer to that question. Maybe we should administer a pilot

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Oak Ridge Workshop
Breakout #2 Deliberations
October 30, 1997
survey.
C: A lot of the workers were administered routine physicals, so there should be a
sizable amount of data that could be studied immediately.
C: An office worker reminded everyone that not all workers were given these
physicals, such as the office workers.
C: One comment that I have heard over and over is that we need to get the
morbidity studies. But I would rather have the mortality studies, and then
apply that information to the people who are still working there.
C: If you use the mortality studies from previous workers, along with the
morbidity studies, it would be even better for helping the current workers.
C: A symptom survey would look at a broader range of symptoms, not just cancer,
but also something like a change in pigmentation that might be the start of
some worse disease.
C: I'm the second generation in my family working at the Oak Ridge Reservation.
I am wondering if some of my health problems were caused by my father's
exposure, and whether my exposure is affecting my children.
C: I feel strongly that if it can be determined that exposure is causing health
problems, then what's needed is to shut down the plant. The doctors on staff

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Oak Ridge Workshop
Breakout #2 Deliberations
October 30, 1997
are biased against ill workers. Lockheed-Martin doctors have treated people
poorly.
C: The workers at Lockheed Martin and the community aren't being informed
properly. Tidbits of both sides of the debate are heard, exposures then
rebuttals. The community needs to be better educated as to the hazards of a
technical society. This is not a unique phenomenon to this community. So
there has to be more openness about risks and results. Information is not
getting out in a meaningful way.
C: The information needed is more than what's happening at Oak Ridge. There
are many such communities in the world and occurrences of exposures such as
the survivors of Hiroshima and Chernobyl. The DOE is doing research on
most of these communities. So there is a feeling that there is a lot of money
being spent on this research without the public being informed about what
patterns or results are being determined, if any.
C: There is an inherent flaw when looking at morbidity studies. That is, although
the person might have been suffering from bladder cancer, the cause of death
may be listed as a massive coronary. So there needs to be a determination of
what is really causing those deaths. Over the course of working at the Oak
Ridge Reservation, a worker could be exposed to "acceptable" levels of 10 to
20 chemicals. So even if the exposure has only been to an acceptable level,
with a multiple exposure like that what is the combined effect? There is a lack
of knowledge about this.

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Oak Ridge Workshop
Breakout #2 Deliberations
October 30, 1997
C: There are several auto-immune diseases, and if a person's medical history was
known, there might be a weak link that would make that person more at risk
for developing an auto-immune disease if they experienced certain exposures.
So it would help to know if a person had a genetic pre-disposition which could
be aggravated by exposures.
C: I wouldn't want the government or the company to say that because of a
predisposition someone couldn't be in the work force.
C: Life is a risk taking affair. We already exclude some people from certain
industries, such as pregnant women and children. There is no way to make the
workplace or the environment risk free. What is needed is a balance of risks.
C: In an environment of downsizing, the current workers seem to be more
concerned about keeping their job than about their fellow ill workers.
C: Currently, workers are constantly being threatened with layoffs and job
closure, so they are not talcing all the safety precautions they could when doing
the job. This job stress is definitely an exposure.
C: I know a fellow employee who is side from the workplace and is not reporting
it because of fears of losing his job.
C: I have a concern for women who worked in the same area as I did who are
having children.

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Oak Ridge Workshop
Breakout #2 Deliberations
October 30, 1997
C: DOE contractors or employees don't have the regular medical reports like the
LockheedMartin Employees.
C: Classified exposures are another concern. How can a worker be treated for
exposure to an unknown substance? There is a need for full access to medical
documents or classified substances. When people are sick, that should override
that something might be classified.
C: Over the next few years, as the work force at the reservation changes from one
company to a number of companies, and to a transient work force, it is going
to be even harder to track down these people to find out about exposures and
outcomes, etc.
C: Workers must have involvement in their own health and safety.
C: I don't agree that the older workers would be the easiest to follow up on,
because even when the facilities were being built, there were a lot of
subcontractors working on the project. The permanent workers from the
earlier years that had been exposed would also be hard to trade down.
C: There is indeed some concern about how to track down some of these people.
Also, it is sometimes hard to understand from a job title where these people
worked, what they were doing, and what they may have been exposed to.

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Oak Ridge Workshop
Breakout #2 Deliberations
October 30, 1997
Phillip Talboy then introduced Doug Farver who had been unable to attend the Public
Comment Session earliei in the day.
Doug Fai-ver:
Mr. Farver discussed chemical exposures in the vicinity of the K-25 site, stating that
he has been working with ill workers from K-25 for the last two years. Since at least
1995, the workers from K-25 and the nearby residents have shown symptoms
indicative of chemical exposure.
In addition, he's noted these symptoms among others: fatigue, headache, muscle
aches, depression, sleeplessness, and muscle tremors. He advised that when studied
apart there didn't seem to be many similarities in the symptoms, but when put
together, along with the disproportionate numbers of individuals working in the site,
there were many similarities.
Mr. Farver indicated that he had biological data from workers and residents from
numerous biological samples submitted to him by them. Fie has been working with
28 individuals ranging in age from 12 years to 54 years old.
He stated that during the last two years that he has been doing his study, Lockheed
Martin and the DOE have done zero urine samples, zero hair samples, and zero blood
samples of the workers. However, he pointed out that he had found thiocyanate in
the urine of workers and residents. He also did a hair analysis on some workers and

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Oak Ridge Workshop
Breakout #2 Deliberations
October 30, 1997
residents and found elevated levels of arsenic, beryllium, cadmium, lead, nickel, and
mercury. In response to a question, Mr. Farver advised that in this case elevated
meant one standard deviation above the mean.
He then described a test he had done on a walling worker, his spouse. The worker
had blood drawn before going to work on Monday, and then again after worldng aU
day on Friday. On Monday, there was no cyanide detected. But that Friday after
work, her blood sample showed a level of 0.4 ug/ml of cyanide. According to Saxs'
Dangerous Properties of Industrial Materials, a blood cyanide level of >0.2 ug/rrd is
considered toxic.
Mr. Farver then cited some sources of organic cyanide such as acetonitrile which is an
organic solvent, a by-product of plastic production. He pointed out that cyanide
could have many names such as cyanomethane, ethnenitrile, nitrile of acetic acid,
methyl cyanide, ethyl nitrile, and methanecarbonitrile. Hence, it was sometimes hard
to detect all the places a worker might have been exposed to cyanide.
He referenced some information on acetonitrile in Oak Ridge wherein 10,000 gallons
had been burned in TSCAI. He also said that it was still being shipped to K-25. He
mentioned that at Uhe Hanford Site, acetonitrile was prominent in tank waste.
Where could it come from? In Oak Ridge, Y-12 engaged in solvent extraction and
metal recovery process. He mentioned building 9206, 9204, and 9202. Also, it
could come from lithium operations and precious metal recovery operations. In
addition, there were the 9201-5N Cyanide Treatment Facility, and 9404-11
acetonitrile.

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CM Ri/lge Workshop
Breakout #2 Deliberations
October 30, 1997
He then mentioned other problem areas for exposure, and what they were doing in
those areas:
K-25 - Solvent extraction and metal recovery processes
K-1004-J -- Laboratory
IC-1410 -- Plating Facility
K-1413  R&D Facility
K-1420 -- Decontamination Facility
He summarized his findings pertaining to similarities in symptoms, explaining that he
had, indeed, observed toxins in people, and he was continuing to try to find the
sources of the exposures.
Questions, Answers, Comments:
Resumed After Mr. Faiver's Talk
C: The workers who are being brought into the plant under the leasing program
are advised that DOE and Lockheed Martin are not responsible for them, they
can only be helped by their own companies. That's a big problem because
these other companies don't know about these facilities. So these people who
have leased some of the buildings under individual companies will be at even
greater risk of exposure.
C: Industrial hygiene workers are being laid off though they are actually in short
supply already.

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Oak Ridge Workshop
Breakout #2 Deliberations
October 30, 1997
C: For a number of years, there were monitors in place for the protection of the
workers and surrounding community. But when the incinerator was installed,
the responsibility for repairing and maintaining the monitors was taken away
from people who had been doing that job for 15 years, and that responsibility
was given to workers unfamiliar with those devices.
At this point, the facilitator asked the participants to arrive at a list of needs that
they thought should be addressed.
C: There is a need for a safe workplace. Part of this need includes informing
workers of the risks they face in performing certain jobs, and honesty on the
part of management as to where there are hazards instead of covering up
exposures.
C: There is a need in the planning process to address the distrust, fear, reprisals
and retaliation that are taking place in the workplace.
C: Morbidity studies are needed, for which good registries or ways of obtaining
information are required. Physicians should be required to do the reporting.
There is a need for better dissemination of information, and a speeding up of
de-classification. There have been a lot of studies and more information
should be passed on to the workers. There is also a need for creativity in
obtaining that information since this is a company town.
C: The medical community needs to be educated on symptoms associated with

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Oak Ridge Workshop
Breakout #2 Deliberations
October 30, 1997
the exposure risks the workers are facing at the Oak Ridge Reservation. Since
Lockheed Martin can refuse to pay for medical tests it deems undesirable, DOE
needs to reimburse physicians who do tests for exposure symptoms.
C: An independent treatment facility that would screen for symptoms related to
exposures should be established which would fall outside of the politics of the
area, and that is staffed by knowledgeable physicians. This facility should also
provide coverage for people outside of Lockheed Martin, such as DOE
employees and the community.
C: We need a mechanism for assessing exposures of workers, QA, and
characterization of the workplace tasks, including de-classification. A
surveillance system needs to be in place for routine collection of information,
and dissemination of that information.
C: We also need a symptoms survey, with information gathered by talking to the
actual people, which DOE has not done. Some of the information could come
out of residential factors, lifestyles, family doctors, and medical histories. This
would be a comprehensive survey with input from the population. The
information could come from a questionnaire.
C: A doctor from Emory wanted to do exactly this, but his grant was turned
down.
C: We need to broaden the selection criteria for who will be included in surveys.

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Oak Ridge Workshop
Breakout #2 Deliberations
October 30, 1997
Traditionally the people who have been studied are people who are already at
high risk for outcomes, so there's a need to broaden the risk categories beyond
those who are already sick. The surrounding community should be included in
any survey.
C: Pregnant women should be removed from the site, and there should be
reproductive health studies on the women who have worked at the plant.
C: We need to gather and document the institutional memory of the site, and see
if there are lessons that can be learned from that, and then apply those lessons.
C: We need to study how generations of exposure might compound problems
associated with exposure.
C: The negative as well as the positive outcomes of any research or studies that
are done should be published.
The facilitator thai asked the participants to arrive at a list of priorities for the
government agencies involved to help them proceed. They arrived at the following
priorities:
1.	Help the people who are sick now.
2.	Involve the affected community and employees in the process.
3.	Do a morbidity study.
4.	Treatment/prevention and intervention.

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Oak Ridge Workshop	Breakout #2 Deliberations	October 30, 1997
5.	Better monitoring and control using state of the art devices.
6.	Speeding the declassification of documents.
7.	Better education for area physicians, and the freedom for those
physicians to exercise their knowledge.
8.	Instead of a partial decontamination, perform decontamination to a safe
level at both the work place and the surrounding area.
9.	Conduct clinical studies from the symptom survey to improve lives in a
care driven study.
With that, the breakout session was adjourned.

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BREAKOUT GROUP #2
PLENARY SESSION
ACTION ITEM
REPORT

-------
Oak Ridge Workshop on Energy-Related
Public Health Activities
October 30-31,1997
Ramada Inn Oak Ridge
420 South Illinois Avenue
Oak Ridge, Tennessee 37830
Breakout Session #2:
	Worker Health Studies	
The following represents the bulleted items from Breakout #2 on October 30,
1997 as presented by the Rapporteur in the Plenary Session on October 31,1997.
CONCERNS:
~ In the past, concerns of well workers and ill workers were different
Employed workers are concerned about their jobs
Community seemed less concerned about illness than keeping
jobs
4 The Community is developing support
~	This support is in the beginning stages
~	This is turning into a broad spectrum of support

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Oak Ridge Workshop
Breakout #2 Report
October 31, 1997
CONCERNS: (continued)
~	Only people at high lisk are being studied
4	Need to broaden selection of those surveyed not concentrate
on high risk
-4	Example is office worker
->	Study clusters such as workers at K-25
-4	Occupational verses non-occupational survey
-4	Need to change HMO's attitude
-4	Studv non-workers as well
~	Disproportionate number of people with allergies at Oak Ridge
-4 Speaker felt health records would show commonalities
between worker illnesses

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Oak Ridge Workshop
Breakout #2 Report
October 31, 1997
CONCERNS: (continued)
~ Suggestion to study medical records!exposures of deceased workers
Since workers are still exposed to same things
Would show what the current workers are getting sick from
-4 So apply mortality studies to morbidity studies to help
current workers
Several workers echoed need for morbidity verses mortality
studies
Workers were shifted between all 3 plants to complicate
matters
-4 Most workers were administered physicals periodically
Reminder that wouldn't be the case for office workers or
people in community
-4 Also physicals wouldn't apply to DOE contractors
~	We're losing institutional memory at K-25 due to
deaths

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Oak Ridge Workshop	Breakout #2 Report	October 31, 1997
CONCERNS: (continued)
~	Call for an independent clinic
Might be used for triage purposes, to get proper treatment for
people
~	Concern that Lockheed Martin Doctors on staff are biased against
ill workers
~	Exposures from one generation to the next
Concern about which current illnesses might be
caused/effected by a parents exposure
How is the exposure from parents working at Oak Ridge now
affecting offspring
~	Mention of genetic predisposition towards some of these illnesses
The predisposition is aggravated by exposures
-4 Concern of Government/Company interpretation of a
predisposition

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Oak Ridge Workshop
Breakout #2 Report
October 31, 199/
CONCERNS: (continued)
~	Concents voiced about pregnant women exposures
~	Concern about increasingly transient work base
-4 How to study or track down exposure outcome
-4 Private companies leasing buildings on contaminated sites
~	Concent about workers!community being informed properly
-4 DOE isn't sharing information on studies it's doing with other
similar communities
4 Need to disseminate risks/results openly
-4 Need to declassify medical documents
-4 How to do a worker evaluation when his exposure is classified
-4 Need worker involvement/input
-4 Need to know cumulative effect of being exposed to
"acceptable" levels of 10 or 20 different chemicals

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Oak Ridge Workshop	Breakout #2 Report	October 31, 1997
CONCERNS: (continued)
~ In environment of downsizing, workers seemed more concerned about
job than their fellow ill workers
When threatened with lay-offs, workers are less safety
conscious
Feels that stress caused by job worries is definitely an exposure

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Oak Ridge Workshop
Breakout #2 Report
October 31, 1997
NEEDS:
~	Need a safe workplace, where work can be done in a safe manner
~	Need good science
~	Need a broader selection of individuals selected to be studied
~	Need morbidity studies incorporating knowledge gained from
moi~tality studies
~	Need surveillance for routine collection and dissemination of
infonnation
~	Need education of medical community
-* DOE should reimburse physicians who perform tests

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Oiik Ridge Workshop	Breakout #2 Report	October 31, 1997
NEEDS: (continued)
~	Need the planning process to address distnist, fear, reprisals and
retaliation
-4 Need independent health treatment for screening of
symptoms
Independent means outside of the politics of the area
-4 The independent health facility must be staffed by
knowledgeable physicians
-4 There has to be a mechanism for assessing exposures of
workers
QA
-4 Characterization of workplace tasks
Declassification of medical documents
~	Need state of the art monitors
Need trained personnel to operate/maintain those monitors

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Oak Ridge Workshop
Breakout rr 2 Report
October 31, 1997
NEEDS: (continued)
~	Need history of plant
What work was done where and when
What chemicals were used
-4 What possible exposures were present
What are effects of multiple exposures
~	Need infonned workers
Treat workers with honestv
~
Give workers knowledge
~	Need an approach to symptom swveys that involves talking to people
~	Need studies of women reproductive health and exposure outcomes
Removal of pregnant women from the site

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Oak Ridge Workshop
Breakout #2 Report
October 31, 1997
PRIORITIES:
1.	Help the people who are sick now.
2.	Involve the affected community or employees in the process.
3.	Do a morbidity study.
Requires good registries, medical exams or other ways of
obtaining information
-4 Require physicians to do the reporting
-4 Need creativity to obtain the information, since this is
company town
4.	Treatment/prevention and intervention.
5.	Better monitoring & control of exposure -- state of the art devices.
6.	Speeding up declassification of documents.

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Oak Ridge Workshop	Breakout #2 Report	October 31, 1997
PRIORITIES: (continued)
7.	Better education for area physicians, and the freedom to exercise
their knowledge.
8.	Instead of doing partial decontamination, do decontamination to
safe levels at the work place and in the community.
9.	Conduct clinical studies and conduct a symptom survey to improve
lives, in a care driven study.
4 Information would be from residential/family/doctors/and
medical history
4 Empowering the people or shared ownership was suggested
4 For instance something like a pigmentation change symptom,
might signal the onset of some worse disease
4 Might use sets of symptoms
4 Surveys consisting of family, work and medical history
~ At first might do pilot survey for testing purposes
10.	Independent Health Clinic.

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HARD COPIES OF
TALK/SLIDES
FROM:
PAUL SELIGMAN
PLENARY SESSION

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E
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Department of Energy
Paul J. Seligman, M.D., M.P.H.
Deputy Assistant Secretary
for Health Studies




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WORKER
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Oak Ridge Workshop on Energy-Related
Public Health Activities
October 30-31,1997
Ramada Inn Oak Ridge
420 South Illinois Avenue
Oak Ridge, Tennessee 37830
(423) 483-5972
Q: How many people have you studied in any study whatsoever?
A: The Health Department is not involved in any study of people at all. A
number of physicians in this community, and one at Emory have been doing
C: That's not quite accurate. We've studied the poisons, not the people. The
research done here should have been called a toxic study. It has been limited
and without enough document search. There has not been very good or
enough data. One of my concerns is that March of Dimes says that less than
19% of birth defects will be identified with a document search, but if you look
at people, the recorded number goes up to 80%.
Q: Why are we spending money on retrospective dose reconstruction when we
have an active NPL site under remediation? We do not look at the people.
Any number of people up and down the creek are engaged in these high risk
activities, yet there has been a limited effort to look at actual exposures. We
should be concentrating on current exposures.
A: The appropriate way to address studies is to develop a data base to which
PUBLIC COMMENT
Questions, Answers, Comments:
1:50 PM
studies.

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Oak Ridge Workshop
Questions, Answers, Comments
October 30, 1997
sound epidemiologic principles can be applied. I agree we must look at both
the epidemiology and the people.
Q: Do you consider blood levels of people involved as a component?
A: Yes, they would be a component.
Q: Then why did we do retrospective dose reconstruction?
C: Because the DOE does not want to know' the truth.
A: I do not accept that answer. I think they prefer to go by the data base in a
proper manner.
2:20 PM
Q: You were talking about PCB exposure. What are the diseases caused by
exposure to PCBs?
A: On the acute side, and in the workers, there have been documented cases of
chloracne. Then there are the chronic long-term questions. Based on animal
studies available at this point, there is indication of cancer, though the
particular cancer I don't remember. (Probable liver cancer, stomach cancer,
and melanoma). Worker studies have been inconclusive.
C:	By design.
A:	PCBs are considered a probable carcinogen.
Q:	How are you evaluating the medical effects of exposure in the workers?
A:	Our agency evaluates mostly off-site. NIOSH is involved in worker situations.
Q:	How would you evaluate in persons then?

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Ridge Workshop
Questions, Answers, Comments
October 30, 1997
A: Based on historical releases at Oak Ridge, we have determined the only way
people can be exposed to PCBs out there is eating fish. We assume based on
our risk assessments, if we try to document people being exposed to elevated
levels of PCB, as far as dose reconstruction/that will give us an indication and
direction for finding who and to what levels they may have been exposed.
Based on the answer to that, we will decide on follow-up.
Q: So at present, a physician has not evaluated a person for PCB exposures?
A: Some people, workers have been evaluated at IC-25 sites, others by
environmental clinics in regional areas, particularly Emory.
Q: Do you know the physicians at Emory?
A: Dr. Howard Frumpkin and his staff.
C I heard your presentation before. You were looking for people eating bottom
fish like catfish.
A: Others were striped bass due to elevated levels - they are predator)' fish.
Q: When we came to this area, we were told not to eat bottom fish. That seems
to be what most people pay attention to. How many people have vou found to
study who have done it anyway?
A: We identified 117 in Kingston recently looking at catfish, striped bass and
turtles.
Q: Why are you spending so much time on examining people who have been
instructed not do certain things when there are people with much more serious
problems?
A: Watts Barr had a tremendous concern when we first came into the community,
as we have more based on risk assessment and dose reconstruction, it indicated
that people eating that could be exposed. Some of them were not familiar with
advisory, that's why we developed brochure to promote understanding.

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Oak Ridge Workshop
Questions, Answers, Comments
October 30, 1997
C: I just wonder, after you complete this study, what more will you know than
before this expensive study?
A: Many have mentioned to us that if we show their levels are high, they will stop
eating fish. From a general population perspective, we did not know how
many people ate fish. We will use information to determine whether we need
more education, more study, we really don't know until all studies are in.
Q When you measure what you do in people's blood, you measure mercury and
PCP. That does not measure anything deposed in body tissue. I am concerned
about organics and the deposition in fat of some of these substances. What
you are measuring is something I would call acute level - still circulating in
blood rather than stored.
A: Let me clarify. PCB in blood is an indicator of how much one has been
exposed to in the last to 5 to 7 years. It's half life is about 7 years. If you stop
eating fish, within 7 years you will have half as much. We were looking for low
level intake, not chronic.
Q: Is your answer same for mercury?
A: No, mercury in the blood reflects exposure over the last 60 to 90 days. In our
final report we will have all caveats. We picked PCBs because all other
screening criteria have shown it to be a risk factor. Some fish have low levels.
While drawing blood for PCB, we went ahead and drew for mercury as well. In
looking at fish data of almost 10 years, the contaminant that came up of
concern to us as possible probable was PCB. All others screened out.
Q: When you have tested people, what is the reference dose you are using and
what is data that you are using and is it controversial?
A: We don't use reference dose. For levels of PCB at this point, there is no
indication that certain levels in blood will cause certain outcomes. We
compare levels we get to ranges CDC developed to see if someone has elevated
levels as compared with a reference population with those of known exposure.
If they are elevated, then we go to the individual for a complete history to
determine exposure.

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Oak Ridge Workshop
Questions, Answers, Comments
October 30, 1997
Q: I am citizen and worker. In your presentation, you said your agency
determined mercury was not bioavailable. What process did you use to
determine this?
A: We did not determine that it was not bioavailable -- in terms of other forms
out there -- our determination differed from EPA or DOE. Our determination
was that it's a relatively insoluble form of mercury out there based on types of
studies conducted by DOE. We brought in other folks from sites with lead
and arsenic out west, and we asked them help us identify ways we can evaluate
bioavailability at ours and/or other sites. Our conclusion was it's a relatively
insoluble form of mercury.
Q Those were only studies done by DOE and you took that data -- no
independent analysis was done by ATSDR?
A: We don't do analyses of that type.
Q: What group of people were you looking at, and what was the criteria?
A: No people -- air, soil, and water.
3:20 PM
Q: You said that you were going to do a clean up worker study to characterize the
workforce. Do you have any plans to involve those people most directly
affected and bring them to the table to design studies and gain access to the
studies?
A: We are collecting information now on defining them. The next phase will be
study design and at that time we will engage those folks, bring them to the
table to know their needs. Our mandate is typically generated from looking at
historical reconstruction. In Phase II, we might have to pass off to DOE on
health and safety issues, etc. Those are the kind of things we see coming out
of this feasibility study. We have several other studies -- Chemical Lab Study
of laboratory chemists and technicians who have worked at all 3 Oak Ridge

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Oak Ridge Workshop
Questions, Answers, Comments
October 30, 1997
sites, as well those of the Savannah River workforce. We are looking at those
involved with organic ionizing in the laboratory setting. We feel there is a
large population. We also have a mortality study of construction workers --
historical retrospective.
Q: I did not hear an answer to my question --1 really want to know if you have
thought about and planned to bring those people most directly affected by
outcome of your study to the table to characterize what's happen, witat they
might have been exposed to, the nuts and bolts.
Q: Once we identify who they are, and categorize them properly - yes we plan to
bring people into the process. We're not there yet.
Q: That's wonderful that you're dealing with that, but I suggest you bring people
to the table ahead of time rather than have them troubleshoot. The people I
know are the true authorities on what you're studying.
A: When we prepare a protocol, we come to the site and engage everyone who
wants to be involved. We have had 2 such meetings for multiple myeloma case
studies.
Q: You have to remember that there are a lot of people who are not wo riding
because of sickness. You can't forget them.
Q: On mortality among female nuclear workers, you stated that the conclusions
from the dosimeter readings were ....
Q: It is based on dosimeter readings that were presented to in some form. Were
there any variances in dosimeter readings? I know of one incident in many
where a worker purposely put his reading -- they never even called him to find
out why his dose was way up there. Yet, when he got his reading it was zero.
A: We are aware of that, and we have the ability to talk individually with workers.
We at NIOSH have a large effort in each of our studies to validate dose by
going back to original records to look at zeros. Was a film batch done on
weekly basis so as there was not enough opportunity to show a dose on a

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Oak Ridge Workshop
Questions, Answers, Comments
October 30, 1997
badge? If there were high results, what can we say about that? We've held
worker interviews to find out how widespread a problem they think this is.
When we look at this, we look at population studies, we look to see whether
there is a contributing factor that would influence outcome of that study. If
there are 15 to 25 of these cases every year, we need to know.
Q: I want to ask about nickel studies and also the possible of melanoma in the
nose. There are several cases of that are developing in the general population.
Whole faces are eaten away. Why do you see a rise in this? Will you examine
each individual toxin? How long will this take? You take one ~ you took
cyanide -- you examined that and found nothing. You study one thing for
years and years. I am seeing we have multiple toxins that have been released
and we know that. So my encouragement to all of you in this room is that you
don't take one toxin ~ you already know what nickel does, you know what the
mercury does in people. You take too long looking at all this. I don't think
this epidemiologic route you're taking is going to help anybody. Why can't we
take care of people and give them some solutions? You don't diagnose this and
then not given people a way out. How are we going to be helped by NIOSH,
CDC, the Health Department? Everybody wants to get scientifically funded so
you can all have a job -- but we want to have a life.
A: I did not know about melanoma, we are studying myeloma.
Q: This is in the public, not necessarily workers.
A: I study workers. If we see that in the workforce, we will study that. In
NIOSH, we were not looking at one toxicant per se. We identified what we
call chemicals of concern. Those are hazards that have been or that we suspect
are associated with certain health outcomes ~ it is a mixed soup of those.
Q: I am poisoned with nickel and have high levels of mercury. I live down stream
in Kingston. The symptoms are devastating, the outcome is cancer. Who can
tell me if this nickel is radioactive? Nobody but the DOE. Who will allow the
physicians to treat me? Nobody. We need to be allowed to get treatment for
these things. For those who are not affected, count yourself lucky. Some
people with metals get sick some don't.

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Oak Ridge Workshop
Questions, Answers, Comments
October 30, 1997
Q: I worked at K-25 for 8 years until somebody finally heard my cries for help and
my fear of permanent damage. Someone finally moved me. I'm now at 12. I
suffer from heavy metal toxicity. My question, why when NIOSH came into
IC-25 and I was one of workers, did our site managers refuse to do it? We did
it-- the workers. Why did you not do an anonymous paper survey to
ascertain how many workers had problems?
A: The response is done out of another brc ich in NIOSH. I know those two
researchers, but I don't know why they chose not to do that.
Q: They sleep in the same be with Lockheed. There are layoffs going on, without
an anonymous survey, workers will not come forward. My second question is
that I thought the cyanide study was in your realm of NIOSH.
A: I did speak to Branch Chief Dave Sundid. Give him a call.
Q: My opinion was that it was nothing but junk science. It does not take a rocket
scientist to know the health problems out there. No biological samples were
taken of workers. I have extensive data on me and my toxicity. To date, my
company Lockheed, or DOE, have taken no samples. I've got blood and urine,
take it please someone. They will not do it. They are failing miserably. I hold
them accountable. I hope we see some criminal prosecution out of this. I feel
deeply they know very well what's going on, management. This is not your
scope, but thanks for listening.
A: I'm sure Dave Sundid wall be happy to hear your comments.
Q: Hydrogen cyanide. You can check 2000 times for it, but if you don't look at
other compounds, then you are failing. There is a massive cover up here and
someone must answer.
A: We've been following this many years. I want to get some things out. There is
inherent conflict in this room between the government officials, the experts,
the scientists, and the affected individuals who are exposed and want answers.
When they get metal studies back, they believe that they have been injured.
They want answers now. There is inherent conflict in the way science has been
done for 50 years, on how science is conducted on the people but not by the

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Oak Ridge Workshop
Questions, Answers, Comments
October 30, 1997
people and with the people. There is a political shift in that. The people want
an integral part in decision-making on how science is created, those who
conduct it, how the results wall be used, and whose benefit that information
will be for. Will it be for the government so they can say, "there is no way you
individuals can be harmed?" Whereas, what may really be going on is that a
combination of all these substances may be causing an effect that mav not be
causing a certain cancer, but may manifest differently in individuals. That's
the message that's hard to grasp by these scientific studies. Specifically 1-131.
It took 14 years and over 10 million to study one radionuclide? That
comprised only 2% fallout from nuclear weapons fallout. We don't have till
the year 4000 for these folks who are affected now. It's critically important for
NCI to be very sensitive to bringing in the affected people when you sit down
to do the study. Science will be done airtight and valid, but we all come to
table as equals.
I was fascinated with Cragle's study because the Manhattan Project scientists
were predicting all these symptoms and diseases. I don't think those studies
did one bit of good. Of all those mortality studies where you found excess
cancers with positive dose response - did the government notify a single
survivor or family member to let them know they were a part of this group?
A: I cannot speak to those prior studies.
Q: Donna Cragle, is she still here?
A: Yes. No, no one was notified for the mortality studies.
Q: We did the Freedom of Information Act to ask how much money was spent
on the part of 1947 and 1994, the cost was over 500 million in health studies.
Yet, not a single worker has been notified. That methodology helps no one.
We only pray and hope that the studies that you do help the affected people.
We have to make that shift happen.
Q: For multiple myeloma, what about the cut off date if you did not die before
1987?
A: In 1990 there was a follow up, we are still collecting data and follow-up to

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Oak Ridge Workshop
Questions, Answers, Comments
October 30, I997
determine whether to take this study to 1995 for 4 more years of follow-up.
Then we might see additional cases of myeloma.
Q: In my communications with researchers, there've been others who have called
who said they did not meet time of death, and question whether they should
be included in study.
A: That's part cc why we are here today and why we are considering talcing it up
through 1995. We are debating that at NIOSH right now.
Q: It's my understanding that workers who work with hazardous materials are
subject to annual medical monitoring. Do you have access to this information
with more recent studies, with the cleanup workers?
A: We have access to all medical records under our Memoranda of Agreement
with DOE. In the clean up study, we have not yet looked at individual
workers. We are defining and categorizing them, and we can look at those
when we get to that stage.
Q: You should look at them and make a determination for DOE as to whether the
appropriate tests are being done.
A: That is absolutely one thing we want to do in Phase II of this feasibility study.
Q: The second thing is that we've heard some this afternoon about workers who
feel they have sensitivities to specific metals or compounds, that there are
individual sensitivities, maybe combination effects, lots of anecdotal evidence
about health effects. This is the sort of evidence that takes it out of the realm
of scientific investigation. NIOSH and other agencies need to recognize this.
While the scientific investigation should proceed as scientifically sound, at the
same time these workers health concerns should be addressed. They are 2
separate issues. There is a health care crisis in this area, workers may lose
insurance, pre-existing conditions may be denied when they transition to other
contractors. I've heard a variety of concerns and reasons why people are not
getting the follow-up they feel they desperately need for their conditions. This
is something this community needs. It would be much cheaper for DOE to
just go ahead and pay for medical care for sick people instead of lawyers when

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Oak Ridge Workshop
Questions, Answers, Comments
October 30, 1997
sick people have to litigate.
3:50 PM
Q: In one of your slides, you said you determined the groups of workers subject to
risk. It seems to me that's the root of one our problems here in Oak Ridge. As
you go through your list, and you identify workers subject to these, you come
up with set of people to examine. Probably here you have set of people who
are ill and most of them are biologically not subject to known categories. You
need another group of people, those who experience illness and the nature of
that group is, while not exposed to some known substances, they should be
studied. We study what we know, but we don't tend to study groups who are
affected by some things, but we don't know what it is. How you determine
this is subject to development, but without it you'll still have all kinds of
responses. This is vast and complex problem. Comment please.
A: You are correct in stating that as part of this program, we have not indicated
this as criteria. If you feel we should expand into such program, what criteria
would you use?
Q: You'd have to identify some kind of cluster, a commonality shown in a site.
The IC-25 group is good example. There were subject to exams every 2 to 3
years. People don't come up with answers, if there are answers then public
doesn't know. Most information is anecdotal, which makes it difficult for the
public to be informed in a manner they can make good recommendations. I
hear the same from state, that they don't have other than anecdotal. This goes
beyond medical implications. We have doubts about the management and the
integrity of our medical system.
A: Back to the original point, the eligibility criteria is still the subject of intense
debate among those conducting this work. Monday, we are having our annual
meeting. One of the first items we wall cover is how we should determine who
should be eligible. I am willing to put before this group alternate ways.
Q: One thing I'd like to address is that we might also want to consider present

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Oak Ridge Workshop
Questions, Answers, Comments
October 30, 1997
workers. One thing I have not heard addressed is the DOE subcontractors who
are not covered under the MOA like Lockheed. I've been allowed to tag on
with Lockheed. There's got to be some way to make this go faster. I don't
think anybody wants to cause harm. I think it's time we put the federal dollar
back into this community. We have the technology here. We have to move
past who is responsible. We have all the appropriate agencies, federal and
state, who can deal with this situation and make it better. You have that
ability within this room -- so help me figure out how to geL better.
A: This is precisely why we are here.
Q: I am from MSRE where people were locked out, and many of us have not
spoken out. I will read this. I know that you're aware of this situation and I
was surprised by slides you had that you do address workers --1 filled out an
employee complaint form after I had retired. This is the reactor building. I
was in a complex of two office buildings occupied by a lot of people after the
project was shut down. The Friday before, they were going to put in an alarm.
When I asked what to do if it went off, the answer was to stay in place. The
following Monday we were all locked out due to criticality. I had access to the
Freedom of Information Act. A colleague of mine and I wrote a document
about the situation. In the early eighties, it was known that something was
wrong with exhaust and flooring monitoring. We had lots of sick people there.
1	was poisoned. Another person externally inhaled just from wandering around
in the building. Many things lead me to believe we should not have been in
that building. After we submitted our document, we asked for a clinical
evaluation from R &. L. But only 3 of us had the courage to say anything.
Everyone is in line waiting to be dismissed, afraid they'll be laid off. The
clinical evaluation was promised in 1996 in January. I wrote a letter and now
2	people are going to be sent out. I think the entire group should be included
in some kind of clinical evaluation.
Q: As a result of your beryllium tests, have changes taken place in the workplace
to change exposure level?
A: Is someone with Oak Ridge here who can answer that?
A: Yes we are in the process of upgrading and improving controls. We are

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Oak Ridge Workshop
Questions, Answers, Comments
October 30, 1997
worlcing with headquarters in deciding what needs to be done.
A: The department is engaged in developing a new rule about controlling
beryllium exposure. The Beryllium Advisory Committee is discussing the fact
that beryllium has a unique situations because we can cause people to become
sensitized at lower levels. We are considering how best to protect workers at
levels far below the levels accepted for half a century.
Q: Does it concern you that beryllium is being disposed of in the incinerator?
A: Of course.
Q: What is happening to improve the 6 people you have found?
A: Individuals who have been diagnosed can have whole range of symptoms, some
may be asymptomatic and may need to be followed, some have more severe
lung disease and suffer impairment in lung function.
Q: Can they get that therapy that is needed?
A: Yes, the treatment for individuals who have lung disease that is symptomatic is
treatable with prednisone.
Q: Can beryllium be taken out of their bodies?
A: No, at best is what we think will slow progression, it cannot be reversed.

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Oak Ridge Workshop
Questions, Answers, Comments
October 30, 1997
Closing Public Comments
Major themes from the final public presentations were:
~	Three major things need to happen:
1.	Acknowledgment of how litigation or an agency's wish to avoid liability
impact the way we talk about public health, and the way agencies are
allowed to talk about public health;
2.	There is a need for a complete classification review of documents that
are in DOE's care as classified documents in order to bring out every
shred of information that would help people study current health
problems, or come to terms with past health problems; and
3.	There is a need to involve those people most directly affected and not to
not exclude those who are involved in litigation with an agency. Most
people who sue the government don't want to, but they have to.
~	The secrecy must stop. We have to change the direction of activities. The
people must be fully informed about what is going on.
~	The community must have medical care -- it's cheaper for DOE to pav for that
than litigation.
~	Workers should not have to fear retribution and/or loss of employment for
speaking their minds.
~	We deserve and Environmental Health Clinic just as much as the veterans
themselves.
~	All the agencies need to get together on teaching, training, and treating

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Oak Ridge Workshop
Questions, Answers, Comments
October 30, 1997
physicians in environmental health issues. One group has put together a
proposal and petition for that.
~	Agencies need to listen to sick people and their advocates.
~	The community should have control over health benefits, who does the studies,
who makes the decisions, etc.
~	We need a new definition of national security.
~	This is a for of apartheid, but we can deal with it with integrity.
~	In manv children in this community, there is intellectual impairment and
hypertension.

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