ORRHES Meeting Minutes
June 3, 2003

Update on the NIOSH Occupational Energy Research Program

Dr. Ahrenholz explained that ATSDR, NCEH and NIOSH are the three agencies conducting site activities under the DOE/HHS memorandum of understanding (MOU). In terms of NIOSH’s organization, the Health-Related Energy Research Branch (HERB) is housed within the Division of Surveillance, Hazard Evaluations and Field Studies. Dr. Ahrenholz extended apologies on behalf of Dr. David Utterback, the HERB Chief, who was unable to attend the meeting.

HERB’s role and function are often confused with another NIOSH program. HERB conducts intramural and extramural studies of the DOE workforce and has served in this capacity since 1991. After a project is finalized, HERB develops a one-page synopsis outlining the context of the project, study results, contact information for principal investigators and instructions to obtain additional information. The findings are first communicated to DOE, site managers, and former and current DOE workers and then released to the general public. The Office of Compensation Analysis and Support was established in 2000 to process dose reconstruction claims submitted under the Energy Employees Occupational Illness Compensation Program Act.

HERB recently completed several intramural and extramural studies. The Portsmouth Gaseous Diffusion Plant project was an update of a mortality study NIOSH conducted in the 1980s. In the more recent activity completed in October 2001, HERB assessed exposures to several chemical contaminants found at the site; analyzed internal and external ionizing radiation exposures; and used a nested case control group to examine cancers of interest identified in the first study. Eight DOE grants and cooperative agreements administered by NIOSH were communicated to workers in the summer of 2002. Most of these activities were methodological and did not involve data from a specific site.

A lung fibrosis study among plutonium-exposed workers at Rocky Flats was completed in November 2002 and an epidemiologic evaluation of cancer and occupational exposures among Rocky Flats workers was completed in April 2003. For both extramural and intramural projects, HERB attempts to analyze ionizing radiation and non-radiological exposures. Similar to other federal agencies, NIOSH is also experiencing budget constraints and other resource limitations. As a result, several criteria were used to prioritize projects for FY’04. For example, the study has been underway for some time, is close to completion, is being implemented with a full project team, or will influence another activity.

NIOSH’s intramural project priorities are cohort mortality studies at the Idaho National Engineering and Environmental Laboratory (INEEL) and the Portsmouth Naval Shipyard (PNS); a study of chemical laboratory workers; an internal epidemiological data system; a multiple myeloma study at the K25 facility in Oak Ridge; a leukemia case control study; and a leukemia study among PNS workers. Additional details about these projects are outlined below.

INEEL is the largest DOE facility for which no study has ever been conducted; the cohort will include 64,000 workers. The PNS site is not a part of the DOE complex, but many workers were exposed to external ionizing radiation. Health physics and industrial hygiene data are being incorporated into HERB’s epidemiologic data system. The database is being designed in a uniform format and will then be used to conduct cross-site studies, update study populations or select certain criteria among workers to increase statistical power. The new system will also allow HERB to develop a more complete occupational profile, such as whether the worker has records at multiple DOE sites, if the worker is living or deceased, or the date the employee’s work history was completed. In addition to the multiple myeloma study at the K25 facility, Oak Ridge cohorts will be included in the chemical laboratory worker study and the leukemia case control.

NIOSH does not have sufficient funds to release a request for grant applications in FY’03, but three new grants were awarded in 2002. The University of Louisville will study health effects of occupational exposures among Paducah Gaseous Diffusion Plant workers. The University of Washington will develop stochastic models for radiation carcinogenesis to identify temporal factors and dose-rate effects. Existing data on workers from Canada and DOE sites will be collected and included in the research project, but actual workers will not be followed.

The University of North Carolina will analyze susceptibility and occupational radiation risks. Differences in cancer and other health effects based on an individual’s age at the time of radiation exposure will be examined in a cohort of ~22,000 Savannah River Site workers. The study is being conducted because some studies have suggested that older workers with exposures to ionizing radiation may be at greater risk. One hypothesis is that this may be because the capacity of repair mechanisms is thought to decrease as a person ages. As a result, individuals who receive radiation doses at an older age may be at greater risk than younger persons.

Despite decreases in HERB funding, staff and other resources, several research projects are still expected to be completed and communicated to workers in 2003:

• An assessment of radon and cigarette smoking exposure among Fernald workers.
• Cohort mortality studies among INEEL, PNS and Pantex Plant workers.
• Follow-up case control studies on leukemia and lung cancer among PNS workers.
• A study of beryllium disease natural history and exposure response.
• A study of chronic beryllium disease among exposed workers.
• A study of sensitization and disease caused by beryllium dose.
• Epidemiological studies to evaluate health effects of uranium milling.
• An analysis of corrections in measurement errors of radiation exposure.
• An uncertainty analysis to characterize plutonium exposure and improve lung cancer risk estimates among Rocky Flats workers.
• A dose reconstruction of Chernobyl liquidators.
• An evaluation of time-related variables in occupational epidemiologic studies.

Manuscripts for many of the FY’03 studies have already been submitted for publication. With respect to the future direction of NIOSH’s research agenda, CDC has modified its policy for peer-reviewed studies. Each intramural project will be reviewed at least once every five years in addition to the usual peer review of protocols and final reports. Dr. Ahrenholz encouraged ORRHES to visit the HERB web site at www.cdc.gov/niosh/ 2001-133.html to access completed and ongoing research projects of workers at Oak Ridge and all other DOE sites. The Occupational Energy Research Program book contains study results, one-page summaries and full reports. Grantees, award periods and project summaries for studies are listed as well.

Dr. Akin noted that the ability of HERB’s epidemiological data system to pool data from multiple sites can ultimately change conclusions about exposures. Dr. Ahrenholz agreed with this comment, but he pointed out that the Fernald, Hanford and Rocky Flats sites are currently being remediated. As other facilities are dismantled, the epidemiological data system will allow HERB to access dosimetry records, industrial hygiene data, work histories and other employee records after DOE sites cease to exist.

Mr. Lewis inquired about the trigger for NIOSH to conduct occupational studies and the funding mechanism for these types of projects. He mentioned that problems are created when federal agencies conduct activities in one area, but a nearby site in the community is ignored. For example, NIOSH may implement a study at a DOE facility, but an investigation in the surrounding community is not being performed. Dr. Ahrenholz explained that NIOSH’s decision to conduct an occupational study is based on several research issues and questions.

For example, potential factors that may contribute to adverse health effects among workers are considered, such as handling radiological materials or working near certain chemicals. The decision is also based on occupational exposure criteria extracted from existing data, including studies on atomic bomb survivors and investigations of lung cancer and other health effects in the workforce. Requests for proposals are an additional mechanism for NIOSH to conduct occupational research projects of interest, i.e., retrospective exposure assessments; studies on radiation- and chemical-related diseases; and evaluations of differences and errors in techniques used to define worker exposures.

Dr. Ahrenholz conveyed that although DOE funds HERB research projects, NIOSH selects occupational studies to conduct. Dr. Falk added that Dr. Ahrenholz’s presentation was limited to the CDC/NIOSH occupational research program for workers; the CDC/NCEH environmental health research program focuses on communities. Under its research agenda, NCEH has conducted dose reconstructions, a thyroid disease case control study and other activities in communities near DOE sites.

Dr. Cember acknowledged that radiation and chemical doses cannot be combined. He asked about HERB’s methodology to consolidate data on health effects from both radiation and chemicals. Dr. Ahrenholz replied that HERB performed this type of investigation at the Portsmouth plant. External and internal radiation exposures of workers were analyzed along with exposures to nickel, uranium and fluorides due to a possible association with lung cancer and kidney problems. At PNS, HERB is conducting a nested case control study of exposures to both external ionizing radiation and asbestos among workers.

In both of these projects, NIOSH assembled chemical and radiation data to characterize worker exposures that could be used to evaluate dose response analyses. This may use logistic regression analysis or other types of analytical models to characterize worker exposures and identify associated health outcomes. At sites with chemicals and ionizing radiation, exposures are assigned to specific groups. Mr. Washington inquired about actions ORRHES can take to increase HERB’s involvement in Oak Ridge. Lead, beryllium, cadmium, uranium and many other chemicals may be related to kidney dysfunction, heart disease, tumors and other health conditions that have been identified at the site. He indicated that further investigation at Oak Ridge may provide HERB with more conclusive findings.

Dr. Ahrenholz clarified that many of HERB’s projects include Oak Ridge cohorts. For example, exposures from the K25 and X10 facilities are being examined in the multiple myeloma and chemical laboratory worker studies, respectively. NIOSH needs additional funding, personnel and other resources to conduct more occupational studies at Oak Ridge. Most notably, NIOSH is scheduled to receive another budget cut of 15%-20% in FY’03. Dr. Timothy Joseph of DOE recalled that in 2000, ATSDR led a multi-agency effort in developing a compendium of all health-related research studies at Oak Ridge. He raised the possibility of HERB updating the document with more recent projects. Dr. Ahrenholz was not aware of the compendium, but he explained that the NIOSH web site contains all completed and ongoing worker studies for Oak Ridge since HERB’s involvement with DOE sites in 1991.

Mr. Gartseff noticed that the PNS and Rocky Flats cohort mortality studies both refer to the healthy worker effect. He questioned whether HERB would anticipate the same outcome in a mortality study of Oak Ridge workers. He also asked if investigations of populations at other sites would be relevant to the Oak Ridge workforce. Dr. Ahrenholz replied that the workforce is generally healthier than comparison populations. HERB always expects this outcome because certain individuals in the general public are not included in the workforce, such as persons who are elderly, ill or disabled. As a result, attempts are made to further define the general U.S. population before a comparison is made to the workforce, such as stratifications by age, gender and other factors.

In addition to national comparisons, smaller breakdowns are made by state or region to stratify by race/ethnicity, job transfers to other DOE sites and other variables. Despite these efforts, however, concerns have still been raised about the appropriateness of populations that are used as comparison groups for the workforce. With respect to DOE sites, HERB has found that workers are generally healthier than those in other industries. Employment at DOE facilities typically requires a clearance that prohibits abuse of alcohol or illegal drugs. Many DOE workers are also highly skilled or educated, enrolled in ongoing medical surveillance programs, and receive higher pay.

Dr. Cember reported that based on his review of the literature, education is the most significant contributor to good health. Low mortality ratios among atomic energy workers are most likely attributed to high education levels in this workforce rather than the healthy worker effect. Mr. Hill announced that he and other Oak Ridge union health and safety representatives recently participated in a conference call with HERB senior management. The workers were asked to provide HERB with suggestions on areas to study in Oak Ridge because the HHS/DOE MOU will soon expire. Mr. Hill encouraged ORRHES to now consider recommendations for Oak Ridge occupational research projects that can be submitted to HERB.

Dr. Ahrenholz confirmed that HERB is interested in feedback from workers on the NIOSH research agenda. Any recommendations should be submitted to Dr. Utterback for consideration. Ms. Adkins questioned whether HERB has conducted studies on spouses and children of workers at atomic energy or nuclear plants. Dr. Ahrenholz responded that one project examined an increase in leukemia among children of nuclear weapons facilities workers. Another NIOSH program conducts research on take-home exposures of asbestos, beryllium, lead, pharmacological agents and other contaminants to identify health effects among family members of workers.

Public Comment Period

The Chair called for public comments; no attendees responded.

ATSDR Chemical Screening of Surface Water and Ground Water

Dr. Karl Markiewicz of ATSDR conveyed that he would use Scarboro data to review and illustrate ATSDR’s chemical screening process since this data set is smaller and more manageable than those for other media. Data collected for current and future screening of various media include 131,592 records for soil, 142,748 records for sediment, 585,770 records for surface water and 1.1 million records for groundwater. Sampling by EPA and Florida A&M University (FAMU) in the Scarboro community resulted in the collection of 5,940 records for surface soil, sediments and surface water.

Of the chemicals analyzed in Scarboro, 40 were detected in soil, 32 in sediment and 23 in surface water. Several chemicals identified in Scarboro media were above comparison values: four in soil, two in sediment and two in surface water. To identify chemicals with completed or exposure pathways, an exposure dose was estimated and compared to a health guideline. No chemicals above cancer screening guidelines were detected in Scarboro soil, sediment or surface water. No chemicals of concern were found in sediment, surface water, air or biota.

Arsenic, heptachlor epoxide and iron in soil were identified above non-cancer screening guidelines and will be included in the public health implication section of the PHA. These three chemicals are of concern due to exposure to children or children with pica behavior. Pica is an abnormal appetite for soil, starch or other non-food items. ATSDR used default assumptions for pica established by EPA in the screening process. To determine the likelihood of adverse health effects from arsenic, heptachlor epoxide and iron, exposure doses in soil were reviewed. A child with soil pica behavior will have an exposure dose above ATSDR’s chronic oral minimum risk level of 0.0003.

Health effects from ingesting arsenic have been determined by calculating lowest observed adverse effect levels (LOAELs) and no-observed adverse effect levels in animals; lethality in humans; and LOAELs in humans as recognized by EPA. This level is also in the range of the human body’s capacity to detoxify arsenic. Using these data, the dose was estimated to be below the LOAEL in humans. During the screening process of a child with soil pica behavior, ATSDR made a number of conservative assumptions. The child was assumed to absorb 100% of arsenic, but bioavailability of the chemical in soil will actually be less than 100%.

The child’s weight was assumed to remain at 10 kg for three years, but the body weight will actually increase and the exposure dose will decrease. The child’s soil ingestion rate was assumed to be 2,000 mg/day for 291.2 days/year, but the rate will actually be much lower. Although arsenic was detected above the health screening value in Scarboro soil, the chemical was not found to pose a public health hazard. For heptachlor epoxide in soil, data extrapolated from a rat study demonstrated that exposure doses were 833 and 66 times below effect levels for a child and a child with soil pica behavior, respectively.

For iron in soil, a child with soil pica behavior receives five times the Food and Drug Administration recommended daily dose of 10 mg. However, only low levels of iron in soil are absorbed by the human body. ATSDR’s highest assumption of 51 mg for a child with soil pica behavior is still well below the dose of 200 mg/event required to cause toxicity. ATSDR’s estimate also assumed 100% iron absorption from the gut and an ingestion rate of 2,000 mg/day for 291.2 days/year.

As with arsenic, both iron and heptachlor epoxide were placed in the “no apparent public health hazard” conclusion category based on the bioavailability of the chemicals in soil and ATSDR’s exposure assumptions. This finding means that exposure is now occurring and will occur in the future in Scarboro, but the chemicals are not expected to result in adverse health effects to adults, children or children with soil pica behavior. For groundwater screening of current and future exposures, 379 different chemicals were sampled; 302 were detected offsite; and 353 were found onsite. Maximum concentrations above the comparison value were identified in 52 offsite chemicals and 101 onsite chemicals.

Benzene will be used as a surrogate compound for 7 offsite chemicals and 56 onsite chemicals that did not have a comparison value. Exposure doses were calculated for carcinogenic and non-carcinogenic effects to identify chemicals of concern. Over 1.1 million data points were collected for mercury in groundwater from 1990 to February 2003. Samples taken in the 1980s will not be included in the chemical screening process; these data will used in the analysis of historic exposures. ATSDR used a screening level of 1 ppb for mercury in groundwater.

For surface water screening of current and future exposures, 370 different chemicals were sampled; 321 were detected offsite; and 313 were found onsite. Maximum concentrations above the comparison value were identified in 33 offsite chemicals and 85 onsite chemicals; 26 chemicals did not have a comparison value. Over 585,000 data points were collected for mercury in surface water; ATSDR used a screening level of 1 ppb for this pathway as well.

ATSDR is still attempting to obtain data from the Bull Run and Kingston plants to review and consider for inclusion in the chemical screening process for mercury. The Tennessee Valley Authority and other agencies have been contacted in this effort because the information is not available electronically. Dr. Markiewicz confirmed that the chemical screening data will be peer reviewed by ATSDR staff and will also be submitted to ORRHES for review and comment. The chemical screening process for air and biota will be presented to ORRHES at future meetings.

Several ORRHES members asked questions and made comments about past exposures in Scarboro. Ms. Sonnenburg questioned whether ATSDR’s public health conclusions would apply to children who lived in the community in the past due to changes in soil and water composition over time. Ms. Adkins believes past exposures from groundwater is the source of the high arsenic level of 469.6 Fg/l detected in her body. She suggested that ATSDR overlay the chemical screening data with limestone slabs in the area. For example, springs and wells in her community shared the same limestone slabs with the K25 facility and East Poplar Creek area. Moreover, crevices and sinkholes are present in the underground limestone formation.

Mr. Lewis asked whether the EPA and FAMU data can be used to determine if historical contamination was more than ATSDR anticipated. Dr. Markiewicz made some clarifying remarks to ORRHES’s comments and questions. The public health conclusion from the chemical screening process only applies to current and future exposures from 1990 and thereafter. To obtain answers about past exposures, historical sampling data can be reviewed or modeling can be conducted. However, a much higher degree of uncertainty is associated with reconstructing past exposures and determining risk.

Seafood in the diet is the primary source of arsenic rather than groundwater or soil. The level of concern for urinary arsenic is ~200 ug/l. Arsenic levels in Scarboro groundwater were not found to be abnormal for the area, but individual wells in the community may have elevated concentrations. Identifying the migration of contaminated water and particles through underground crevices is extremely difficult. Nevertheless, ATSDR will attempt to examine this pathway in Oak Ridge and determine potential health impacts. Data collected from multiple media in Scarboro do not indicate historical contamination was a public health hazard.

Dr. Akin noted that the chemical screening process focuses on current and future onsite exposure pathways for contaminants detected in the EPA and FAMU sampling data. However, some ORRHES members are attempting to use these findings to clarify dose reconstruction. The chemical screening process was not designed to identify exposures in Scarboro prior to 1990. Dose reconstructions should be revisited when ORRHES has the appropriate data to discuss this issue. Questions about the chemical screening process should focus on the ability of sampling data to characterize the community; the capacity of the risk assessment process to determine health concerns; and the appropriateness of ATSDR’s conservative assumptions to calculate exposure doses and pathways.

Dr. Joseph pointed out that a dose reconstruction may not be necessary initially. DOE has been collecting groundwater data for the past 15-20 years. The data include offsite and domestic well samples. He offered to provide this information to ORRHES to review. Dr. Davidson mentioned that current arsenic levels in the body are due to current exposures. The chemical does not remain in the body for a long time and could not be attributed to past exposures. Dr. Markiewicz added that arsenic remains in blood for less than two days and in tissue for 7-14 days; the chemical does not bind to bone. Alternatively, dioxin and lead remain in the body for ~9 and 20 years, respectively.

Ms. Adkins asked if studies have been conducted on cumulative exposures from chemicals. Dr. Markiewicz acknowledged that this area of scientific study is limited, but research on synergistic effects is emerging. No studies have shown additive effects from exposures to multiple chemicals that are below the LOAEL for non-carcinogenic effects. Data released in 2001 demonstrated that some chemicals will cancel others when multiple exposures are involved. Mr. Washington mentioned that when samples were taken, the Oak Ridge plant was not at full capacity compared to its 90%-100% operation prior to 1990. As a result, contamination levels in Scarboro media may be higher than those reported in ATSDR’s chemical screening data. For example, uranium levels were found to be five to ten times higher in Scarboro than other areas.

Dr. Craig was not aware of any evidence demonstrating that uranium concentrations were five to ten times higher in Scarboro than other areas. He requested that the reference for these data be cited. Mr. Washington clarified that this rate is documented in a report and was previously accepted by ORRHES. He acknowledged that the elevated uranium levels in Scarboro still did not result in adverse health effects.

Dr. Cember inquired about ATSDR’s safety factors that were incorporated into the comparative values. Dr. Markiewicz explained that safety factors are based on either human studies or animal data. Safety factors of 10 are added for extrapolations from animal data; studies with a LOAEL for a total of 100; and sensitive sub-populations for a total of up to 1,000. Unlike a regulatory assessment, ATSDR reviews assumptions, toxicological profiles and epidemiological data when determining public health implications of calculated doses.

Public Comment Period

The Chair called for public comments; no attendees responded.

Work Group Reports

Public Health Assessment Work Group (PHAWG). Dr. Craig reported that a meeting was not held on the previous day. Instead, PHAWG members interacted with the public during ATSDR’s public availability session on the Y-12 uranium releases draft PHA. During PHAWG’s three meetings convened after the April 2003 ORRHES meeting, the members discussed the WOC PHA, radiation terms and issues, ATSDR’s chemical screening process, and administrative matters. PHAWG emphasized the need to continue to provide ATSDR with solid guidance to ensure the PHAs are completed on schedule.

Mr. Lewis encouraged ORRHES members to attend PHAWG meetings. For example, some of the confusion about historical versus current and future exposures in the chemical screening process may have been eliminated if more ORRHES members were in attendance when Dr. Markiewicz presented these data to PHAWG. He also pointed out that PHAWG’s critique of the chemical screening data was not known to other members because minutes are not posted on the ORRHES web site in a timely fashion.

Dr. Craig added that PHAWG meets on the first and third Monday of each month. The members and ATSDR staff extensively discuss the technical aspects of ATSDR activities at Oak Ridge as well as mechanisms to clearly communicate scientific data to the lay public. He joined Mr. Lewis in extending an invitation for ORRHES members to attend PHAWG meetings. Dr. Davidson clarified that even if PHAWG resolves an issue or concern during its meetings, these topics should still be presented to the full ORRHES.

Several members commented on the article in the Knoxville News Sentinel on Y-12 uranium releases. Mr. Washington asked for the source of the information because any information published about the study should be known by the full ORRHES due to its role as an advisory group chartered under the Federal Advisory Committee Act (FACA). Minority opinions that some ORRHES members may have should be reported as well. Ms. Spencer replied that the source of the article was the newspaper reporter’s interview with Dr. Charp and Mr. Hanley.

Dr. Davidson conveyed that Dr. Charp and Mr. Hanley were the appropriate persons to address the media’s questions about ATSDR’s draft PHA of Y-12 uranium releases. ORRHES had previously provided its comments on the document; ATSDR is now gathering comments from the public. Dr. Davidson added that ORRHES was informed about ATSDR’s public availability session and encouraged to attend, but only a few members were present.

Dr. Akin mentioned that the article quotes a former Oak Ridge worker who disagrees with ATSDR’s conclusions on the PHA. Her position is that she was exposed during her employment at the plant. Some members of the public may be confused about the fact that ATSDR assesses risks to the community rather than workers. He urged the members to continue to reinforce the distinct roles and functions of ORRHES and the different agencies involved in Oak Ridge site activities. This approach will ensure that ORRHES maintains trust and credibility with the public. Dr. Craig clarified that the PHA is an ATSDR product rather than a FACA document. ORRHES has no authority or influence in ATSDR’s responses to the media, comments made by the public or the publication of the article.

Communications and Outreach Work Group (COWG): Mr. Lewis reported that COWG’s meetings focused on efforts to ensure information is being properly distributed to appropriate groups. Assistance provided by Mr. Hanley and Ms. Spencer in developing the briefing packets is greatly appreciated, but improvements still need to be made in ORRHES’s communications and outreach activities. The ORRHES web site should be operational and documents should be posted on the site in a timely fashion. The web site should be viewed as a legacy of ORRHES’s activities and a tool to maintain public involvement. Agendas should be more detailed to inform the public about presentations and discussions as well as to increase attendance. Consideration should be given to reducing the length of meetings, particularly since a local television station may broadcast videotapes of ORRHES meetings.

Ms. Dalton clarified that the ORRHES web site has been in operation for more than one year and is updated after each meeting. Minutes are posted on the web site after being approved by the members. ATSDR acknowledges that the web site is a work in progress and will continue to make improvements. However, expenditures for all aspects of Oak Ridge site activities must be considered, including contractor costs to maintain the ORRHES web site. Dr. Davidson specified that many individuals do not use the Internet as an information resource. As a result, COWG should focus on other mechanisms to communicate with the public. She recalled that the members were charged with developing a briefing book targeted to community-based activist organizations and other groups.

Ms. Spencer announced that the briefing books were developed and circulated to several organizations. Further distribution will now be facilitated by Oak Ridge Field Office staff. Dr. Akin noticed that public attendance at ORRHES meetings continues to decrease. The absence of the public is inconsistent with ORRHES’s role to obtain feedback from the community on its deliberations. The members will be viewed with skepticism if the public is separated from the ORRHES process. Several members suggested potential reasons for the lack of public involvement.

First, an eight-hour meeting may not be the appropriate format to engage the public. The public comment periods do not provide the community with an opportunity to interact with ORRHES. Second, public concern about potential exposures and adverse health effects in Oak Ridge may have decreased since the PHA on Y-12 uranium releases found no apparent health hazards at the site. Third, many individuals may define a “health assessment” as a clinical examination rather than an evaluation of a site. Public interest in ORRHES activities may decrease after this issue is clarified. Fourth, many members of the public have no knowledge of ORRHES’s existence, role, purpose and activities. Several members made recommendations to increase public participation in ORRHES meetings.

• Convene a one-hour session during ORRHES meetings that is focused on a particular issue for the public.
• Hold ORRHES meetings in other counties and place items on the agenda that are of specific interest to the community. PHAWG could make recommendations on locations where future ORRHES meetings should be held in relation to a particular PHA. For example, ORRHES and PHAWG meetings on the WOC PHA could be convened in the Kingston area.
• Publish a comprehensive press release to announce upcoming PHAs and other major documents.
• Clearly outline the public’s role in the ORRHES process by obtaining input on specific areas of interest to the community, such as iodine, mercury, PCBs and health outcome data.
• Stimulate public interest by informing the community of ORRHES’s activities.

Agenda Work Group (AWG). Mr. Hill reported that AWG discussed ORRHES’s adherence to meeting agendas. With the exception of reconvening after breaks, the members generally follow agendas. During the next AWG meeting, Ms. Sonnenburg plans to suggest that public comment periods be increased from 10 to 20 minutes. Two ten-minute public comment periods does not convey to community members that their attendance is desired at ORRHES meetings. If no one is scheduled to make a public comment during a meeting, the presentation or discussion on the floor can continue. Dr. Davidson confirmed that public comment periods can be increased to 20 minutes, but ORRHES’s deliberations will be limited.

Guidelines and Procedures Work Group. Ms. Galloway reported that the members have not met since the last ORRHES meeting. Dr. Davidson explained that GPWG only convenes when charged by ORRHES to perform a specific task.

Health Education and Needs Assessment Work Group (HENAWG). Ms. Mosby reported that the draft needs assessment report was sent to HENAWG members by FedEx; a copy of the document will also be given to Dr. Davidson. HENAWG will convene its next meeting on June 12, 2003 from 6:00-7:30 p.m. to provide members with an opportunity to comment on the draft report and formulate recommendations. HENAWG is proposing that a follow-up meeting be held on June 16, 2003 from 6:00-7:30 p.m. Dr. Rebecca Parkin, of George Washington University, will participate by conference call. HENAWG plans to present formal recommendations on the draft needs assessment to ORRHES at the next meeting. Due to scheduling conflicts of some members, HENAWG agreed to change the time of the June 12 meeting to 7:00-8:30 p.m.

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