ORRHES Meeting Minutes
April 24, 2001

Minutes of the Conference Call Held on April 24, 2001

The Agency for Toxic Substances and Disease Registry (ATSDR) sponsored a conference call of the Oak Ridge Reservation National Laboratory Health Effects Subcommittee (ORRHES) on April 24, 2001. The call, which had been advertised in the Federal Register to allow public input, was convened at 11:33 a.m. by the ORRHES Chair, Dr. Kowetha Davidson. She stated the purposes of the conference call as: to discuss key resources for the Oak Ridge needs assessment, the planned focus groups, and the demographic areas of study. Related materials had been sent to the Subcommittee members prior to the call.

Members participating were:
Donald Creasia
Kowetha Davidson
Robert Eklund
Edward Frome
Karen Galloway
Jeff Hill
David Johnson
Susan Kaplan
James Lewis
L.C. Manley
Peter Malmquist
Donna Mosby
Barbara Sonnenburg

Member Al Brooks, who was in another meeting, joined the discussion at 11:59, but quickly disconnected since a quorum was in place. Members absent were William Pardue, Andrew Kuhaida, and Charles Washington, Sr.

Liaisons participating included Tim Joseph (Department of Energy), Chudi Nwangwa (Tennessee Department of Environment and Conservation) and Brenda Vowell (Tennessee Department of Health).

ATSDR staff participating were: William Carter, Lafreta Dalton (ORRHES Executive Secretary), Michael Grayson, Jack Hanley, Yahya Mohamed, William Murray, Teresa NeSmith, and Marilyn Palmer.

Also participating were Rebecca Parkin and Teresa Regan, George Washington University (GWU); and Marie Murray, recorder.

I. Key Resources.

Ms. Donna Mosby, Co-Chair of the Health Needs Assessment Work Group, reported their development of four categories and sub-categories with which to identify individuals to serve as key resources of information for GWU: 1) health care providers and health researchers; 2) community organizations, 3) health officials, 4) other. Each had sub-categories. Ms. Sonnenburg moved to adopt the key resource categories, and was seconded by Ms. Kaplan.

Subcommittee response:

• Mr. Hill moved to amend the document to delete the listing of Plumber/Steam Fitter Union Local #102. Since there are 18 locals at the ORR, he advised instead listing the umbrella organizations. Dr. Eklund seconded the motion. With no dissent, the motion carried unanimously.
  
• Ms. Vowell suggested that the page 5 text read "Regional Health Officer and Director," not "Health Department;" and under "County", refer to the "retired Director of the Anderson County Health Council."
  
• Ms .Galloway moved to add, under health studies (page 2), the University of Tennessee's Developmental and Genetic Center (formerly the Birth Defects Center), if it is found to not be part of the UT Health Science Center. They have birth defects information on a wide-area basis. With no dissent, the motion passed.
  
• Dr. Frome suggested adding, to the list of institutions with individuals who were involved in Oak Ridge health studies, the Emory University School of Public Health, which was involved in mercury worker study.
  
• Mr. Manley was unsure that the listed Scarboro Community Environmental Justice Council and Oak Ridge Empowerment were representative of the township proper. Dr. Davidson asked him to provide other names, which she added need not be within the stipulated categories

Public comment was solicited, to no response.

Ms. Mosby called the question. The vote on adopting the key research categories list, with the two additions and one deletion, was as follows:
In favor: Malmquist, Eklund, Frome, Sonnenburg, Creasia, Lewis, Mosby, Hanley, Johnson, Hill, Galloway, and Kaplan. None were opposed, and the motion passed.

II Health Needs Assessment Procedures

Ms. Mosby called the members' attention to the list of Health Needs Assessment Procedures in their meeting packet. The Subcommittee members or members of the public was invited to suggest those who should participate in the assessment. The suggestions should describe what the person would add as a key resource and provide their contact information. Each Subcommittee member will collect those names and provide the list to GWU when called upon to do so.

• Dr. Malmquist stressed the need to ensure to the participants the confidentiality of the names submitted to GWU.
  
• Dr. Parkin requested that "e-mail, fax, or U.S. mail" replace "phone" as a response option, to avoid swamping her voice mail.

Public comment was again requested, again to no response.

III. ORR Needs Assessment: Proposed and Alternative Focus Groups.

Mr. James Lewis drew the members' attention to the packet materials dated April 19 and April 20, on the ORR Needs Assessment's proposed focus groups and alternative focus groups. The April 19 document summarized the Work Group's brainstorming, which developed focus group characteristics, rationale and sources of group members. This process produced 17 groups, more than GWU's suggested 8-9. The alternate proposal (April 20) combined groups as was possible to have better representation on fewer focus groups. Mr. Lewis moved to adopt the alternate proposed focus groups list (April 20, 2001).

• Dr. Frome asked if 8-12 people would be in a group. Dr. Parkin confirmed that 6-8 people are best to enable discussion of all the issues in a 1½-2 hour meeting. Involving as many as 12 is likely to limit the input. Doing the phone survey before the focus groups is hoped to help sharpen the latter's definition.
  
• Dr. Davidson asked if the phone survey information would be provided to the Subcommittee so that they could refine the focus groups they submitted to GWU. Dr. Parkin responded that the groups may not be formed exactly as advised by the ORRHES, and that it would be inappropriate for GWU to share input that was gained from one part of the study to prepare for the next part. GWU will use their best judgement, and any big change will be discussed with the Work Group. However, she expected that what they find will match what's been provided by the ORRHES.
  
• Ms. Kaplan suggested splitting #6, health care providers and researchers, and combining #8 and #10 as a control group, on the April 20 list. Dr. Parkin thought #6 to be an unnecessary focus group, as those persons will likely have been identified and interviewed in the key resources phase. Additionally, their schedule almost always precludes participation in such groups. The intent of the focus groups is to obtain the residents' input.
  
• Dr. Davidson suggested a separate focus group of those with thyroid disease, sine I-131 exposure is one of the concerns. It has a potential link to thyroid disease and there is a high area incidence of thyroid disease. She proposed adding those with thyroid disease as a separate category. Dr. Parkin agreed that the groups of those exposed/believing they were exposed should be separated from those with a disease, due to their different perspectives, but pointed out that a reported 30% of the population has some sort of thyroid disorder. Mr. Lewis suggested adding those with thyroid disease to group #9, those who believe their health may have been affected.

Ms. Mosby moved for the adoption of the alternate April 20 focus group list, with the changes of eliminating #6 (health care providers/researchers) and adding people with thyroid disease. Ms. Sonnenburg seconded the motion.

Ms. Kaplan thought the vote premature and that more work was needed (e.g., to explore kidney disease, chelation therapy, heavy metal exposures). Dr. Davidson responded that those links are not clear-cut, while iodine appears to be so, and that this list is initial. No one expects to answer all the questions, and GWU may do some tweaking based on information from the phone survey.

A vote was taken. Those in favor were: Frome, Sonnenburg, Creasia, Galloway, Mosby, Lewis, Manley, Johnson, Kaplan, and Eklund. Mr. Hill opposed the motion, which carried.

IV Telephone Survey: Demographic Areas

Mr. Lewis drew attention to the map provided in the members' packet, and the written representation of the telephone survey area agreed upon by the Work Group. While the map indicates the direction to Spring City, it does not show it; but it is included in the written description.

Ms. Sonnenburg moved to approve the written description of the demographic map of the phone survey area. The motion was seconded. In discussion, Ms. Kaplan requested that a paragraph be added to explain on what basis these lines were decided. Dr. Davidson amended the motion to note that if the map/description are discrepant, the map takes precedence. Ms. NeSmith suggested that the title be changed from "demographic" to "geographic" area. With no dissent, the description of the geographic area was approved. Ms. Palmer agreed to e-mail/fax the geographic area description to Ms. Murray to be appended to this report.

With no further comment, Ms. Sonnenburg moved to adjourn. Dr. Eklund seconded the motion and the meeting adjourned at 12:26 p.m..

Attachment #1

RESIDENTIAL TELEPHONE SURVEY
DEMOGRAPHIC AREA

The telephone survey demographic will include the following boundaries:

• Anderson County – all residential phone numbers.
  
• Knox County – all residences west of TN 131, starting at the Anderson/Knox County border south to the Tennessee River.
  
• Blount County – From the Pellissipi Parkway over the Tennessee River to US 129S (Alcoa Highway) to US 321W at Alcoa/Maryville; US 321 W to Loudon County line.
  
• Loudon County – follow US 321W to US 11S at Lenoir City; follow US 11S to Loudon/Monroe County border; follow Loudon/Monroe county border to TN 68W; TN 68W through McMinn County (not included in survey) to Meigs County.
  
• Meigs County – all residences north TN 68W.
  
• Rhea County – follow TN 68W across Watts Bar Dam into Rhea County; TN 68W to US 27N through Spring City (the intersection of TN68 and US 27 in Spring City is not shown on the map) into Roane County; only phone numbers with a ‘365' exchange.
  
• Roane County – all residences.
  
• Morgan County – south and east of Nemo Rd., starting at the Cumberland County border to Catoosa Rd. to Wartburg; from Wartburg, south of the Gobey-Macedonia Rd. to the Anderson County border.

These boundaries were established by the Needs Assessment Work Group from a map by Superior Mapping (ISBN 1-57263-049-3), Ó2000) that included Knoxville and a 50-mile radius around Knoxville. A copy of the portion of that map showing the boundaries is enclosed.

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