WEBVTT

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Ladies and gentlemen , good afternoon .

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I'm Lieutenant Colonel John Severances ,

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and I'm the MC for today's town hall .

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Uh , as a quick reminder , uh ,

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everyone has the option of chatting

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right now , so if you have any

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questions at any time , please feel

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free to put your questions there . When

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we get to the Q&A session , or section

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of today's , uh , town hall , if you

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would like to ask your question out

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loud , simply raise your hand , uh ,

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using the raise hand option under

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reactions , and I will call on you to

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unmute yourself . With those remarks

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out of the way , uh , General Bier ,

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over to you , sir . Thanks , John . Um ,

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If , uh , if you don't mind , can I get

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somebody , anybody just come up on

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frequency to make sure that we are

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transmitting , you can hear us ? Copy

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so loud and clear . I put it from

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yourself , Sam . Thank you . So , uh ,

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again , thanks uh for everyone taking

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the time to dial in , um . Uh , it was ,

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it was that time in the , in the

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process of the study to uh . Uh , give

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everyone an update . Um , I'm guessing

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that some of you Uh , are joining this

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conversation for the first time and ,

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and many of you have been along for the

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last 20 months and uh in different

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forums , this is our 14th update to the

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uh community and to the command and to

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the Air Force on the efforts ongoing to

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address uh our cancer concerns in the

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missile uh career field . Um , so we're ,

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we're about 20 months into this effort ,

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um , and we will give you kind of , uh ,

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an update since the last . Uh , time we

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got together , but we're also gonna try

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to give you an overview of the entire ,

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uh , study . Um , we are going to leave

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plenty of time at the end . Of this

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briefing for folks to ask questions and

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I know there's folks out there that

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have questions , um , and , uh , and we

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will give you time to , to uh to do

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that . Um , I just , for the folks that

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are new or uh , uh , potentially

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haven't been tracking , uh , this

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effort , I just wanna kind of give you

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an overview , a macro-level overview of

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my intent . Uh , of initiating this

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study , uh back in 23 . So

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it's , it's , it's , it's multiple

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objectives . The , the initial

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objective uh within the the the the

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scope of the study was to understand .

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The as is in our current missile , uh ,

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um , fields . So the current conditions

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in our launch control centers and the

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Minuteman 3 missile wings and all three

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missile wings , to , to have an

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understanding of the , the risk that we

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were potentially taking or exposing our

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airmen to , the next priority was to

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mitigate those risks and come up with

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institutional processes while we ,

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while we are operating this uh uh

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system until we transition to the

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sentinel weapon system . To make sure

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our airmen understand those risks ,

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they're properly documented in their

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medical records , and they're given the

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proper opportunity to take care or see

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their professional medical uh providers ,

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uh , if desired . The initial focus was

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to to make sure we understood the

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environment and to make sure we took

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care of our airmen and their families .

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Uh , that accounts for our current

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force . The study also is intending

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on understanding the scope of the

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exposure since 1976 to

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today , and developing institutional

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processes that can account and record

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exposure . And provide that information

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to the extent we can based on the fact

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we only have 3 Minuteman 3 missile

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fields remaining . Uh , and provide

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that documented evidence to the

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communities in the Department of

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Defense , to our separated and retired

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military members and their families ,

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and probably most importantly to our VA

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partners in the Department of Veterans

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Affairs , so that we can document any

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potential exposure . So our airmen ,

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both current and uh ones that have

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separated or retired , uh , have the

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ability and access to care if required .

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So that's kind of the macro level piece .

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Uh , we've learned a lot in this

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process , and , uh , Greg and Shier are

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gonna , uh , give everyone an update

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and then again , we look forward uh to

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your questions . I have a few topics at

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the end that I'll bring up before we

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open up for uh questions too . So Greg ,

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over to you . Uh thank you , John Lucia .

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Uh , we can go to the next slide .

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Well , good afternoon . I'm Colonel

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Greg Coleman , command surgeon here at

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Global Goal strike . I wanna thank you

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all for joining us this afternoon . Uh ,

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as GeneralBu mentioned , many of you

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may be joining the town hall for the

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very first time . So we want to spend a

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little time going over , uh , and

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providing you a recap of that timeline .

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And then from there we will uh dive

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into , uh , the broader portions of

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today's discussion . So from the

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beginning , uh , as this important

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dialogue began , related to potential

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links of non-Hodgkin's lymphoma . At

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Maelstrom , we remain committed to

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being transparent in our process , uh ,

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and also prioritize the safety of our

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missileers in the missile community .

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The process and the progress that we've

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made over the last 20 months remains in

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line with that commitment . So really

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in addressing that questionnaire , the

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missileersers and the missile community

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have an increased cancer risk ? Uh ,

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Joe Busier directed this study to begin

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in February of 2023 . And this study is

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really one of the largest uh that we've

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ever uh uh set forth to do in

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discussions with the VA . This is the

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first study of its kind that combines

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both Air Force specialty code data with

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the base and location to operational

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activities , making it one of the

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largest um and most comprehensive

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studies being done . And so this is an

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amazing effort , great partnerships

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with the VA as well as the National

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Cancer Institute , um , that helps and

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assist in designing the study as we

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have it . So to get to that study

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design , we did conduct site visits ,

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um , and town halls to really

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understand the environment and to speak

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directly to the missile community , so

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we could design the , the study

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appropriately . And that study is

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broken out into two parts . One is the

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epidemiology review , and that looks at

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comparing the 14 common cancers in the

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general population to the

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missile-related career fields . The

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review looks at the incident rates of

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incidence of cancer rates , excuse me ,

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and requires an analysis of specific

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data sets to ensure that we're not only

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addressing uh the current population ,

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those currently serving , but also

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looking at the locations where we had

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previous missile wings , uh . So we can

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address the concerns of those who have

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served . The second part is the

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environmental sampling effort , which

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is divided into 3 seasonal rounds .

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That assessment was done by our

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aerospace medicine professionals , the

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bioenvironmental engineers , and public

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health , and it was informed again by

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the missile leaders in the community

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who work and live in those locations .

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The sampling effort includes industrial ,

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occupational , environmental , and

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local chemicals and hazards , and looks

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at them across three seasonal rounds to

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understand any seasonal variation . And

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so those initial site visits uh led to

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some changes immediately , and one was

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The halting of any burning material in

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our launch control centers , and the

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other was the update all the hazard

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signs and hazard locations uh

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throughout the missile alert facilities

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and launch control centers . Then

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moving forward in the summer of 23 ,

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the environmental sampling period began

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and being consistent again with

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transparency and prioritizing the

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safety of our , of our missiles and

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missile community . When the

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environmental sampling that was

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conducted , uh , came back , we had

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positive swipes for polychlorinated

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biphoils that were above the EPA's

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recommended standard , and those were 4

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out of 900 samples that were taken in 3

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of our missile alert facilities . All

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of the 90 air samples were

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non-detected . We immediately shared

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this information um at a town hall

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event , closed those 3 missile alert

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facilities , and shared that

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information with the community on our

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website as well as with the media .

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Those three me alert facilities have

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been have been then cleaned and

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mitigated and are now back at full

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operation . In the fall of 23 ,

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uh UAF then completed the second round

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of environmental sampling , finding all

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air , water , and soil samples to

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include radon to be below acceptable

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regulatory levels for any chemicals or

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hazards . That includes the efforts

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that were done at Vandenberg Space

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Force Base as well . And that brought

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us to the epidemiology arm of the study ,

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where Yusef Sam began working on the

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first phase of uh of the epidemiology

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review , phase one alpha . Phase one

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alpha analyzed the DOD electronic

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medical records and included

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individuals with um with cancer using

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the military healthcare system . And

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that was a very small data set . The

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team found no increased incidence of

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non-Hodgkin's lymphoma , but there was

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a potential trend for an increase in

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breast and prostate cancer . But again ,

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it was the first in a very small data

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set , and so the study continued on to

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phase one bravo . And that brings us to

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where we are today . Uh , we will

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discuss the round 3 environmental

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sampling , but also look at the results

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from phase 1 Bravo of the epidemiology

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review that looks at the VA electronic

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medical records , the DOD cancer

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registry , as well as the VA's cancer

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registry . Then the next time .

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So this slide provides us a , a

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snapshot of the actions taken today to

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include PCB cleaning and uh mitigation

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efforts . Environmental sampling

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completed at Hill Air Force Base

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strategic . Missile integration complex .

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We're also conducting PCB swipes and

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air sampling in the launch . A large

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facilities as well . And we expect to

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finalize those results for you , uh ,

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in the 3 whistle wings very soon .

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Sorry .

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And then for the epidemiology review ,

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uh , we will discuss the phase one

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Bravo today , but as you can see on the

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slide , uh , we're currently working on

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phase one Charlie , and then we'll

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begin analyzing data from phase two ,

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which is the virtual pool registry to

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allow us to capture data that's not in

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the DOD or the VA system . So phase one

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alpha and Bravo are within the federal

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system and then we're able to see uh

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the state data through the virtual pool

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registry because we know . That many uh

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receive their care outside of the

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federal system . As we continue to do

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this work , we want to remain

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transparent with the public , um ,

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whether that's on our public facing

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website or engagements with the VA and

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their military , uh , environmental

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exposure sub-council , and we continue

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to share information with them in order

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to uh expedite the , the process of

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getting the benefits to our , to our

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veterans . And that's also why we , we

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stay engaged with the veteran service

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organizations so that we may uh keep

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them apprised of all the activities

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that we have going on . So let's first

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couple of slides provide you with a

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great overview and a foundation for the

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rest of the brief , and then we can

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move on and to the environmental

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sampling results . So we go to the

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next slide , I think , uh , Colonel

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Waltrip , uh , you and your team , they

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will step us through the environmental

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sampling pieces of the study . OK ,

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thank you , Colonel Coleman . This is ,

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uh , currently Anthony Waldrop . I'm

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the chief Aerospace medicine for the 7

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of human performance wing and the

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senior Airspace and Operation medicine

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consultant here at the US Air Force

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School of Aerospace Medicine . Uh ,

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I'll also add that I have , uh ,

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subject matter experts from the , uh ,

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study teams , both the sampling arm and

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the epidemiologic , uh , study . Uh ,

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with regard to environmentally sampling

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results , uh , the three seasonal

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environmental sampling rounds of all 45

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operational missile alert facilities

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have been concluded with 8400 samples

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collected and analyzed . Additionally ,

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environmental sampling has been

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completed for Vandenberg Space Force

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Base and Hill Air Force Space strategic

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missile integration Complex . I'm happy

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to report that all air , water , and

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soil samples were below acceptable ,

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acceptable regulatory levels for any

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chemical or hazards . Additionally ,

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radon levels were low intervention

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thresholds for all five bases . As

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previously reported , of the 1,205

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samples , the surface swipe samples

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that were collected at all five bases ,

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there were 68 swipe samples that

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detected PCBs below the 40 CFR 761

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limit of 10 mcg per 100 square

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centimeters . There were 4 PCB swipe

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surface swipe samples that exceeded the

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40 CFR 761 threshold . The great effort

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has been taken to date to mitigate PCBs

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and prevent exposure . And I'll turn it

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back over to your current call and if

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you need any questions .

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All right , thank you , Carl for for

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stepping through that . I think it's a

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note that um there are over 100,000

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different data points that have been

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collected throughout uh the

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environmental sampling study , and as

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we continue to go through that , that

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will be uh very important as we talk

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later about hazard documentation and

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how we conduct our , our health risk

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assessment . We wanna move to next is

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really gonna discuss the ongoing

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efforts that we have , uh , in the

14:06.387 --> 14:08.553
missile community to kind of make sure

14:08.553 --> 14:10.331
that we are uh providing a safe

14:10.331 --> 14:12.498
environment , uh , for maintainers and

14:12.498 --> 14:14.890
our , our , our missiles . So , uh , Mr .

14:14.909 --> 14:18.659
Goner over to you next . Um , so , at

14:18.659 --> 14:20.603
the beginning of this , we started

14:20.603 --> 14:22.770
reviewing all of the , the maintenance

14:22.770 --> 14:24.826
technical orders , civil engineering

14:24.826 --> 14:28.099
manuals , looking for where we've had

14:28.099 --> 14:30.321
possible exposure in the past and where

14:30.321 --> 14:32.479
we could have exposure currently .

14:32.900 --> 14:34.900
We've identified all of . Locations

14:35.059 --> 14:37.330
standardized the , the way we warn our

14:37.330 --> 14:40.059
technicians , uh , provide cautions in

14:40.059 --> 14:42.539
the books and direct appropriate safety

14:42.539 --> 14:45.260
gear in all cases , in all locations

14:45.260 --> 14:48.580
where we currently have PCBs or have

14:48.580 --> 14:51.539
had PCBs in the past . So we have

14:51.539 --> 14:53.539
standardized the , the warnings and

14:53.539 --> 14:56.140
cautions and handling procedures for

14:56.140 --> 14:58.520
anything that that could have been at

14:58.520 --> 15:01.460
any point in time associated with PCBs .

15:01.940 --> 15:03.940
Uh , we're also walking through the

15:03.940 --> 15:06.162
final stages right now on standardizing

15:06.162 --> 15:08.780
the , the signage . To make sure not

15:08.780 --> 15:12.090
only current PCB containing components

15:12.090 --> 15:15.140
are clearly labeled , but any location

15:15.140 --> 15:17.251
where we know we have had PCBs in the

15:17.251 --> 15:20.200
past is also labeled . And

15:20.690 --> 15:23.770
including those signs in our periodic

15:23.770 --> 15:25.992
maintenance inspections to make sure if

15:25.992 --> 15:28.159
one gets knocked off , torn off , that

15:28.159 --> 15:30.530
at some point we pick that up and it

15:30.530 --> 15:33.489
remains part of what we do . It's not a

15:33.489 --> 15:36.630
one-time effort . Uh , we're working

15:36.630 --> 15:38.929
through with our depot field teams in ,

15:38.940 --> 15:41.330
you know , improvements in the math

15:41.330 --> 15:44.340
environmental . Environment , if you

15:44.340 --> 15:47.049
will , for , for the LCCs and LFs

15:47.380 --> 15:49.340
looking at where we can take ducks

15:49.340 --> 15:51.940
apart during our , our depot level

15:51.940 --> 15:53.662
maintenance , cleaning ducts ,

15:53.662 --> 15:56.659
providing , although no air samples

15:56.659 --> 15:58.659
tested bad , we have the ability to

15:58.659 --> 16:00.215
clean those ducks and we're

16:00.215 --> 16:02.650
implementing those steps right now . Um ,

16:02.770 --> 16:04.714
we have deep cleaning contracts in

16:04.714 --> 16:06.548
place from an industrial hygiene

16:06.548 --> 16:08.770
perspective at all three of the missile

16:08.770 --> 16:10.929
wings . That is not addressing PCB

16:10.929 --> 16:13.849
cleaning . Those contracts are

16:13.849 --> 16:16.520
addressing industrial cleanliness of

16:16.809 --> 16:19.479
the mass , the launch control center

16:19.479 --> 16:22.799
specifically . We also have a PCB

16:22.799 --> 16:24.688
cleaning contract with an outside

16:24.688 --> 16:27.640
agency that specializes in hazardous

16:27.640 --> 16:30.200
material cleanup . Uh , that contract

16:30.200 --> 16:33.880
is beginning in November 4 LCCs per

16:33.880 --> 16:36.229
wing on the first task order , and as

16:36.229 --> 16:38.451
we progress we can implement additional

16:38.451 --> 16:40.789
task orders and we will implement

16:41.159 --> 16:43.048
additional task orders as we move

16:43.048 --> 16:45.469
forward . Uh , launch facility testing ,

16:45.559 --> 16:48.659
the first round has been completed . Um ,

16:48.669 --> 16:51.070
sample size across all three of the

16:51.070 --> 16:53.181
operational missile wings , and we're

16:53.181 --> 16:55.126
waiting on , we're pending their ,

16:55.126 --> 16:57.181
their results being posted for , for

16:57.181 --> 17:00.880
that . Thank you , Mr . Miller , uh ,

17:00.890 --> 17:03.112
for that , uh , for that update on , on

17:03.112 --> 17:05.223
our ongoing activities . And so we'll

17:05.223 --> 17:07.380
move on to the next slide and , and

17:07.380 --> 17:10.089
bringing all this , uh , full circle .

17:10.380 --> 17:12.969
And so in conducting all of the Uh ,

17:13.109 --> 17:15.310
environmental sampling efforts really

17:15.310 --> 17:17.088
brings us to this stage and the

17:17.088 --> 17:19.143
question that we , we often get is ,

17:19.143 --> 17:22.109
how , how do we document , um , any

17:22.109 --> 17:24.276
potential exposure , get that into our

17:24.276 --> 17:26.498
medical records and so that's a concern

17:26.498 --> 17:28.720
for those that are serving but also for

17:28.720 --> 17:30.776
those who have served . And so we're

17:30.776 --> 17:33.109
trying to address that in multiple ways .

17:33.109 --> 17:35.569
One , Uh , we're sharing with everyone .

17:35.650 --> 17:37.539
If you have any health concerns ,

17:37.650 --> 17:39.428
please go see your primary care

17:39.428 --> 17:41.660
physician and get that documented in ,

17:41.729 --> 17:43.979
in your medical record . There's the

17:43.979 --> 17:45.701
second area for those that are

17:45.701 --> 17:47.812
surveying , getting ready to retire ,

17:47.812 --> 17:49.757
or separating , when you have your

17:49.757 --> 17:51.868
separation health and physical exam ,

17:51.868 --> 17:53.810
uh please make sure that that

17:53.810 --> 17:55.921
information is shared and exam during

17:55.921 --> 17:58.143
that exam so it can be added , uh , and

17:58.143 --> 18:00.310
included into your , into your medical

18:00.310 --> 18:02.119
record . We also published a uh

18:02.119 --> 18:05.369
polychlorinated bihool memo uh earlier

18:05.369 --> 18:07.425
this spring or earlier this summer ,

18:07.425 --> 18:09.091
excuse me , and in there , it

18:09.091 --> 18:11.040
references that the environmental

18:11.040 --> 18:12.880
sampling effort identified the

18:12.880 --> 18:14.800
continued presence of PCBs in the

18:14.800 --> 18:16.869
Minuteman missile alert facilities ,

18:17.160 --> 18:19.438
despite a comprehensive removal effort .

18:20.380 --> 18:22.491
While unable to sample decommissioned

18:22.491 --> 18:24.491
sites for the peacekeeper and titan

18:24.491 --> 18:26.658
weapon systems , a review of technical

18:26.658 --> 18:28.436
data showed that PCB containing

18:28.436 --> 18:30.491
components were likely used in those

18:30.491 --> 18:32.658
alert and control facilities given the

18:32.658 --> 18:34.880
construction time frame . So I want you

18:34.880 --> 18:36.936
to share that , uh , whether it's in

18:36.936 --> 18:38.824
your uh separation physical or if

18:38.824 --> 18:41.010
you're seeing your PCM in the civilian

18:41.010 --> 18:43.339
community and the VA , um , please ,

18:43.410 --> 18:46.189
please take that as a As evidence that

18:46.199 --> 18:48.310
that was an environment that you that

18:48.310 --> 18:50.477
you worked in , we've also shared that

18:50.477 --> 18:52.643
memo with the with the VA so that they

18:52.643 --> 18:54.866
have , they have a copy of that as well

18:54.866 --> 18:57.143
and that memos on our portal too , yes ,

18:57.143 --> 18:59.310
sir . And so that memo is available on

18:59.310 --> 19:01.366
the missile Community website so you

19:01.366 --> 19:03.477
can download that . Um , and so those

19:03.477 --> 19:05.699
are the most immediate ways to get , to

19:05.699 --> 19:07.866
get some documentation taken care of .

19:07.866 --> 19:09.477
Going forward in the defense

19:09.477 --> 19:11.366
occupational environmental health

19:11.366 --> 19:13.255
readiness system , where we track

19:13.255 --> 19:15.310
exposures , environmental monitoring

19:15.310 --> 19:17.532
data , and health risk assessments . We

19:17.532 --> 19:19.643
are standardizing the approach across

19:19.643 --> 19:21.699
all the missile wings . conducting a

19:21.699 --> 19:23.866
health risk assessment at each at each

19:23.866 --> 19:25.310
school this week . So the

19:25.310 --> 19:27.366
bioenvironmental engineers are doing

19:27.366 --> 19:29.310
that assessment and they are doing

19:29.310 --> 19:31.310
interviews with the supervisors and

19:31.310 --> 19:33.477
loading individuals into that system ,

19:33.477 --> 19:35.199
and that is on track as we had

19:35.199 --> 19:37.366
previously discussed to be complete by

19:37.366 --> 19:39.477
the end of the calendar year . And so

19:39.477 --> 19:41.199
all of that information , your

19:41.199 --> 19:43.310
individual information then connected

19:43.310 --> 19:45.477
to that door system will be visible in

19:45.477 --> 19:47.532
the individual longitudinal exposure

19:47.532 --> 19:50.800
record , um . Known as IRR . Uh , your ,

19:51.079 --> 19:53.412
that reflects the data indoors into the ,

19:53.412 --> 19:55.523
into your isler . It's visible by the

19:55.523 --> 19:58.359
VA as well as your DOD , uh ,

19:58.959 --> 20:01.369
providers at this time . And the

20:01.369 --> 20:03.400
information in there is somewhat

20:03.400 --> 20:05.680
location-based data for OO . For the

20:05.680 --> 20:08.609
KOU , um , we are working with the DOD

20:08.609 --> 20:11.369
Eyler Committee to connect data systems

20:11.369 --> 20:13.849
together so that you have the ability

20:13.849 --> 20:16.930
to not only see uh Oconis or deployed

20:16.930 --> 20:19.152
locations , but also to see in Garrison

20:19.152 --> 20:21.430
locations where their hazards would be .

20:21.430 --> 20:23.541
And , and that's important because we

20:23.541 --> 20:25.708
are loading the information from our 3

20:25.708 --> 20:27.874
missile wings into that system so that

20:27.874 --> 20:29.986
you'll have visibility for that . The

20:29.986 --> 20:32.152
other effort there is to expand access

20:32.152 --> 20:34.208
so that service members and veterans

20:34.208 --> 20:36.540
that have a common access card uh can

20:36.540 --> 20:38.540
access their own data and that's on

20:38.540 --> 20:41.540
track to uh for 2025 and that will grow

20:41.540 --> 20:43.596
to eventually for our veterans to be

20:43.596 --> 20:45.818
able to sign in without a CA card using

20:45.818 --> 20:47.859
a login uh in , in , in future

20:47.859 --> 20:51.680
iterations . And so the ability to To

20:51.680 --> 20:54.310
be able to connect and come full circle ,

20:54.520 --> 20:57.479
taking all of those um sampling effort ,

20:57.599 --> 20:59.599
those hundreds of thousands of data

20:59.599 --> 21:01.821
points to getting assessment to build a

21:01.821 --> 21:03.655
health risk exposure uh for each

21:03.655 --> 21:05.599
individual , uh where they work in

21:05.599 --> 21:07.655
their occupational shop . Um , we're

21:07.655 --> 21:09.877
doing that through this system and then

21:09.877 --> 21:12.043
connecting that to I so you've got a ,

21:12.043 --> 21:14.839
a long-term vision of uh of where

21:14.839 --> 21:16.395
potential exposures will be

21:16.395 --> 21:18.506
undocumented in your , in your health

21:18.506 --> 21:21.589
record . And so , uh , from there , um ,

21:21.760 --> 21:23.760
that would cover for those that are

21:23.760 --> 21:26.093
serving currently in those environments .

21:26.093 --> 21:28.204
Um , but we know that there are a lot

21:28.204 --> 21:30.482
of questions that come from those that ,

21:30.482 --> 21:32.538
that , uh , are no longer serving in

21:32.538 --> 21:34.593
those environments or have served in

21:34.593 --> 21:36.704
locations that are no longer active .

21:36.704 --> 21:38.816
And so the next way that we get after

21:38.816 --> 21:38.729
that to , to look into it is through

21:38.729 --> 21:41.040
the epidemiology review . And so we'll

21:41.040 --> 21:43.151
transition the epidemiology piece and

21:43.151 --> 21:45.373
all that Colonel Wrip and Youssef Sam ,

21:45.373 --> 21:47.040
and you know , the doctors of

21:47.040 --> 21:49.151
epidemiology kind of speak through uh

21:49.151 --> 21:51.262
the study and the efforts that they ,

21:51.262 --> 21:53.479
that they've done . Excellent . All

21:53.479 --> 21:55.590
right , thank you , Colonel Coleman .

21:55.590 --> 21:57.646
Uh , again , this is Colonel Anthony

21:57.646 --> 21:59.757
Waldrop at UAFA . Uh , today's update

21:59.757 --> 22:01.868
provides interim results of the phase

22:01.868 --> 22:03.923
one bravo of the epidemiologic study

22:03.923 --> 22:06.146
using a total of 4 data sources . These

22:06.146 --> 22:08.146
data sources are the DOD electronic

22:08.146 --> 22:10.312
medical records , which , by the way ,

22:10.312 --> 22:12.590
is what the analysis for phase 1 alpha ,

22:12.839 --> 22:15.439
uh , included . But uh phase one Bravo

22:15.439 --> 22:17.661
also includes the Department of Veteran

22:17.661 --> 22:19.828
Affairs , electronic medical records ,

22:19.828 --> 22:21.883
tumor registry data from the Veteran

22:21.883 --> 22:24.106
Affairs Administration , central Cancer

22:24.106 --> 22:26.328
Registry , and tumor registry data from

22:26.328 --> 22:28.161
the Department of Affairs Cancer

22:28.161 --> 22:30.383
Registry . The study protocol calls for

22:30.383 --> 22:32.550
a phased analysis with additional data

22:32.550 --> 22:34.772
sources being added until incidents and

22:34.772 --> 22:36.550
mortality rates are complete as

22:36.550 --> 22:38.606
possible . Next phase is incorporate

22:38.606 --> 22:40.828
additional data from the National Death

22:40.828 --> 22:43.729
Index in phase one Charlie . And we

22:43.729 --> 22:46.239
hope to um to soon to be able to report

22:46.239 --> 22:49.540
that uh and also the virtual pool

22:49.540 --> 22:53.030
registry in phase 2 alpha or phase two .

22:53.530 --> 22:55.752
The virtual pool registry is managed by

22:55.752 --> 22:57.641
the National , the North American

22:57.641 --> 22:59.650
Association for Central Cancer

22:59.650 --> 23:01.539
Registries and it's funded by the

23:01.539 --> 23:03.750
National Cancer Institute and is

23:03.750 --> 23:05.528
designed to efficiently connect

23:05.528 --> 23:07.528
researchers with multiple state and

23:07.528 --> 23:09.472
local registries . Since phase one

23:09.472 --> 23:11.583
alpha interim results were released ,

23:11.739 --> 23:13.850
study methodology was further refined

23:13.850 --> 23:15.683
in accordance with guidance from

23:15.683 --> 23:17.683
external partners . One significant

23:17.683 --> 23:19.979
adjustment required individuals to

23:19.979 --> 23:22.035
serve for a minimum of 1 year in the

23:22.035 --> 23:24.699
career field . Standard occupational

23:24.699 --> 23:26.643
cancer studies generally require a

23:26.643 --> 23:28.310
minimum of 1 year duration of

23:28.310 --> 23:30.143
employment to be included in the

23:30.143 --> 23:32.140
analysis , and this excluded

23:32.140 --> 23:36.050
205734 individuals from the analysis .

23:36.900 --> 23:39.260
Which approximately 19,000 were from

23:39.260 --> 23:41.859
this community cohort and approximately

23:41.859 --> 23:45.859
100 or 186,732 in the

23:45.859 --> 23:48.500
non-missile community cohort as we were

23:48.500 --> 23:50.722
unable to confirm that they contributed

23:50.939 --> 23:53.180
one full year of employment in the

23:53.180 --> 23:56.209
Department of the Air Force . Uh , next

23:56.209 --> 23:57.209
slide , please .

24:03.420 --> 24:05.642
Before we move on to the results of the

24:05.642 --> 24:08.540
uh of the interim results , a quick uh

24:08.540 --> 24:10.651
comment on interpreting the results .

24:11.180 --> 24:13.124
Internal comparison of the missile

24:13.124 --> 24:14.791
community and the active duty

24:14.791 --> 24:17.013
department of the Air Force non-missile

24:17.013 --> 24:19.180
community is directly comparable using

24:19.180 --> 24:21.347
a statistic known as the incident rate

24:21.347 --> 24:24.550
ratio . The incident rate ratio , also

24:24.550 --> 24:27.380
known as the IRR , is derived from

24:27.380 --> 24:29.213
dividing the incidence rate of a

24:29.213 --> 24:31.436
particular cancer and missile community

24:31.436 --> 24:33.436
cohort by the incidence rate of the

24:33.436 --> 24:35.436
same cancer type in the non-missile

24:35.436 --> 24:37.800
community cohort . However , because we

24:37.800 --> 24:39.967
cannot directly calculate the incident

24:39.967 --> 24:41.911
rate for the United States general

24:41.911 --> 24:44.078
population . The appropriate statistic

24:44.078 --> 24:46.133
is the standardized incident ratio ,

24:46.133 --> 24:48.589
also known as the SIR . The

24:48.589 --> 24:50.533
standardized incident ratio is the

24:50.533 --> 24:52.645
number of a particular cancer type in

24:52.645 --> 24:54.510
the missile community derived or

24:54.510 --> 24:57.119
divided by the expected number of cases

24:57.510 --> 25:00.199
of the same cancer type . The expected

25:00.199 --> 25:02.255
number of cases are derived from the

25:02.255 --> 25:04.310
National Cancer Institute SER data .

25:05.140 --> 25:08.050
Which is , which provides age , race ,

25:08.939 --> 25:10.661
specific cancer rates for each

25:10.661 --> 25:13.780
demographic slice for each year . The

25:13.780 --> 25:15.947
next step is calculating the amount of

25:15.947 --> 25:17.724
person time contributed by each

25:17.724 --> 25:19.613
demographic slice for each year .

25:19.613 --> 25:21.502
Person time is a measurement that

25:21.502 --> 25:23.724
estimates the total amount of time that

25:23.724 --> 25:25.947
participants are at risk for developing

25:25.947 --> 25:27.947
a disease or dying , in this case ,

25:27.947 --> 25:31.050
either cancer or dying . Once you have

25:31.050 --> 25:32.606
the annual age , race , and

25:32.606 --> 25:35.140
sex-specific cancer rate and the amount

25:35.140 --> 25:37.196
of annual person time contributed by

25:37.196 --> 25:39.029
that rate , the age , race , and

25:39.029 --> 25:41.140
sex-spec specific demographic slice .

25:41.449 --> 25:43.560
Then we multiply them together to get

25:43.560 --> 25:45.782
the expected count for that demographic

25:45.782 --> 25:47.829
for that year . We repeat those

25:47.829 --> 25:50.150
calculations for each demographic slice

25:50.150 --> 25:52.317
of the missile community for each year

25:52.317 --> 25:54.483
and add all the slices together to get

25:54.483 --> 25:56.706
a total expected number of cases in the

25:56.706 --> 25:59.270
missile community . Since there are 90

25:59.630 --> 26:02.150
possible demographic combination slices

26:02.150 --> 26:04.510
per year , it takes special statistical

26:04.510 --> 26:06.621
software to make these calculations .

26:07.300 --> 26:10.030
And uh sir , we can uh continue on the

26:10.030 --> 26:12.030
next slide or , or take questions .

26:15.650 --> 26:17.928
Uh , we're gonna continue the briefing .

26:17.928 --> 26:20.094
We'll take questions at the end . OK ,

26:20.094 --> 26:21.983
very good . Uh , so the basic Epi

26:21.983 --> 26:23.890
statistics continued , uh , we'll

26:23.890 --> 26:25.946
discuss a little bit about how the ,

26:25.946 --> 26:28.001
how do you interpret using the IR or

26:28.001 --> 26:30.168
the SIR . So once the calculations are

26:30.168 --> 26:32.168
for the incident rate ratio and the

26:32.168 --> 26:34.010
standardized incident ratio are

26:34.010 --> 26:36.290
completed , we can interpret similarly .

26:36.910 --> 26:38.854
If the incidence rate ratio or the

26:38.854 --> 26:40.854
standardized incident ratio is less

26:40.854 --> 26:42.966
than one , then it means the incident

26:42.966 --> 26:45.243
rate is lower in the missile community .

26:45.339 --> 26:47.283
If the incidence rate ratio or the

26:47.283 --> 26:49.506
standardized incident ratio is equal to

26:49.506 --> 26:51.617
one , then it means that the incident

26:51.617 --> 26:53.561
rate is the same in the comparison

26:53.561 --> 26:55.506
groups . And if the incidence rate

26:55.506 --> 26:57.450
ratio or the standardized incident

26:57.450 --> 26:59.506
ratio is greater than one , it means

26:59.506 --> 27:01.561
that the incidence rate is higher in

27:01.561 --> 27:03.728
the missile community . Additionally ,

27:03.728 --> 27:05.950
the calculation of confidence intervals

27:05.950 --> 27:08.006
and the P value statistics allow for

27:08.006 --> 27:09.839
the determination of statistical

27:09.839 --> 27:11.839
significance , which means a result

27:11.839 --> 27:13.839
that is unlikely to be explained by

27:13.839 --> 27:16.640
chance or random factors . If both the

27:16.640 --> 27:18.696
lower and upper confidence intervals

27:18.696 --> 27:20.880
are less than 1 , and the P-value

27:20.880 --> 27:23.839
statistic is less than 0.5 , the

27:23.839 --> 27:25.950
incident rate is lower in the missile

27:25.950 --> 27:27.617
community , and the result is

27:27.617 --> 27:31.099
statistically significant . Oh If both

27:31.099 --> 27:32.821
the lower and upper confidence

27:32.821 --> 27:34.988
intervals are greater than 1 , and the

27:34.988 --> 27:37.469
P value is less than 0.5 , then the

27:37.469 --> 27:39.636
incident rate is higher in the missile

27:39.636 --> 27:41.191
community and the result is

27:41.191 --> 27:44.459
statistically significant . And finally ,

27:44.609 --> 27:47.089
if the 95% confidence intervals cross

27:47.089 --> 27:49.810
one or the P value statistic is greater

27:49.810 --> 27:52.880
than 0.5 , the result is considered not

27:52.880 --> 27:55.047
statistically significant and in other

27:55.047 --> 27:57.880
words , uh , the incidence rates are ,

27:57.969 --> 28:00.410
are similar between the two , groups

28:00.410 --> 28:03.839
being compared . That's fine . OK .

28:06.270 --> 28:08.437
So this we'll uh we'll look at some of

28:08.437 --> 28:10.492
the results and in this case , as we

28:10.492 --> 28:12.659
move into phase one Bravo results , we

28:12.659 --> 28:14.826
want to emphasize again that these are

28:14.826 --> 28:17.130
interim results . And they are not

28:17.130 --> 28:19.630
final until we have um a lot more data

28:19.630 --> 28:21.463
to receive from the state cancer

28:21.463 --> 28:23.408
registries to incorporate into the

28:23.408 --> 28:26.160
phase two analysis . Table 3 here

28:26.160 --> 28:28.271
represents the number of cancer cases

28:28.271 --> 28:30.216
by cancer type for the missile and

28:30.216 --> 28:32.271
non-missile communities from January

28:32.271 --> 28:35.390
1st , 1976 to December 31st , 2020 ,

28:35.859 --> 28:39.579
and that resulted 55,224 cancer

28:39.579 --> 28:42.630
cases . You'll note that prostate

28:42.630 --> 28:44.741
cancer was the most common type among

28:44.741 --> 28:46.686
both the missile community and the

28:46.686 --> 28:48.619
non-missile community . Lung and

28:48.619 --> 28:50.459
bronchus cancer was the 2nd most

28:50.459 --> 28:52.979
frequent , frequently diagnosed in both

28:52.979 --> 28:55.739
groups , and colon and rectum cancers

28:55.739 --> 28:58.560
were also relatively common . An

28:58.560 --> 29:00.400
individual , uh , to know , an

29:00.400 --> 29:02.289
individual may have more than one

29:02.289 --> 29:04.359
cancer type , but not more than one

29:04.359 --> 29:06.189
case per type of cancer in this

29:06.189 --> 29:08.829
analysis . Next slide , please .

29:13.219 --> 29:15.930
The uh internal comparison , which is

29:15.930 --> 29:18.130
table 6 presents the incident incident

29:18.130 --> 29:22.050
rate ratios for aggregated and specific

29:22.050 --> 29:24.161
type of cancers comparing individuals

29:24.161 --> 29:27.170
in missile career fields to active duty

29:27.170 --> 29:29.003
servicemen , active duty service

29:29.003 --> 29:31.226
members and non-missile career fields .

29:31.270 --> 29:33.979
Which is adjusted for age , , race ,

29:34.050 --> 29:37.270
and rank . Cancer incidence rates

29:37.270 --> 29:39.437
occurs at different rates in different

29:39.437 --> 29:41.770
uh in different age , race , and groups ,

29:41.770 --> 29:43.770
so adjusting allows for an accurate

29:43.770 --> 29:46.000
comparison . The results suggest that

29:46.000 --> 29:48.660
there is no statistically significant

29:48.660 --> 29:50.660
difference in the incidence of most

29:50.660 --> 29:52.993
types of cancers between the two groups ,

29:53.079 --> 29:55.719
as indicated by IRR rates that are

29:55.719 --> 29:59.239
close to 1.00 and P values being above

29:59.239 --> 30:02.849
0.05 . Overall , the missile community

30:02.849 --> 30:04.689
has significant , has had a

30:04.689 --> 30:07.530
significantly lower IRR rate for all

30:07.530 --> 30:09.810
cancer types in both sexes compared to

30:09.810 --> 30:12.780
non-missile community . And

30:12.780 --> 30:14.836
specifically , the missile community

30:14.836 --> 30:16.780
shows statistically lower rates of

30:16.780 --> 30:18.669
urinary bladder cancer , lung and

30:18.669 --> 30:20.891
bronchus cancer , and prostate cancer .

30:21.750 --> 30:23.959
Among the male missile community

30:23.959 --> 30:26.015
population , overall cancer risk was

30:26.015 --> 30:28.015
significantly lower compared to the

30:28.015 --> 30:30.070
male non-missile cancer population .

30:30.589 --> 30:32.311
However , the overall relative

30:32.311 --> 30:34.367
difference in cancer incidence among

30:34.367 --> 30:36.478
the missile community and non-missile

30:36.478 --> 30:38.089
community , females were not

30:38.089 --> 30:40.256
statistically significant . There were

30:40.256 --> 30:41.867
no statistically significant

30:41.867 --> 30:43.922
differences in cancer rates for most

30:43.922 --> 30:45.811
other cancer types when comparing

30:45.811 --> 30:47.867
missile community versus non-missile

30:47.867 --> 30:50.449
community populations , uh , which is

30:50.449 --> 30:52.449
represented in this internal , uh ,

30:52.449 --> 30:54.780
comparison group . Nice slide please .

30:59.030 --> 31:02.329
The external comparison , uh , table

31:02.329 --> 31:04.770
5 presents the standardized instance

31:04.770 --> 31:06.881
ratios for different types of cancers

31:06.881 --> 31:08.937
in the missile community compared to

31:08.937 --> 31:11.810
the US civilian cases . Almost all the

31:11.810 --> 31:14.410
standardized ratios were less than 1.0 ,

31:14.640 --> 31:16.751
suggesting that the missile community

31:16.751 --> 31:18.918
had lower relative risk for developing

31:18.918 --> 31:21.140
these types of cancers than the general

31:21.140 --> 31:23.140
US population . Breast cancer had a

31:23.140 --> 31:25.251
standardized incidence ratio of 1.0 ,

31:25.469 --> 31:27.691
indicating that there was no difference

31:27.691 --> 31:30.390
in incidence rates . Moreover , ovarian

31:30.390 --> 31:32.390
cancer had a standardized incidence

31:32.390 --> 31:36.150
ratio of 1.32 , which is above 1 , but

31:36.150 --> 31:38.372
was not statistically significant given

31:38.372 --> 31:41.859
the fact the P value was 0.66 and

31:42.109 --> 31:44.189
likely because it relied on low case

31:44.189 --> 31:46.229
counts . There was only 5 observed

31:46.229 --> 31:49.060
cases and , and we had 4 expected cases ,

31:49.069 --> 31:51.959
so . Um , non-Hodge's homa was not

31:51.959 --> 31:53.959
found to be elevated in the missile

31:53.959 --> 31:56.015
community compared to the US general

31:56.015 --> 31:59.750
population with the SRR rate of 0.57

32:00.400 --> 32:02.760
and with a statistically significant P

32:02.760 --> 32:06.199
value of uh PE less than 0.01 .

32:07.069 --> 32:08.958
The incidence of urinary cancer ,

32:08.958 --> 32:11.180
bladder cancer among this community was

32:11.180 --> 32:14.430
70% , 71% lower than the general US

32:14.430 --> 32:16.479
population and was the lowest

32:16.479 --> 32:18.920
standardized incident uh ratio reported .

32:19.780 --> 32:21.459
For Hodgkin's lymphoma , the

32:21.459 --> 32:23.459
standardized incident ratio was not

32:23.459 --> 32:25.570
statistically different and was close

32:25.570 --> 32:28.819
to 1.0 . Uh , next slide , please .

32:32.630 --> 32:34.963
If you're paying really close attention ,

32:34.963 --> 32:37.074
you might have noticed that the dates

32:37.074 --> 32:39.297
and therefore the counts were different

32:39.297 --> 32:41.519
in tables 3 and tables 5 . The external

32:41.519 --> 32:45.390
comparison only considered uh 2001 to

32:45.390 --> 32:48.880
2020 in , in this phase of the MCCS .

32:49.810 --> 32:51.588
In order to allow more accurate

32:51.588 --> 32:54.349
comparison with the SER data , SE data

32:54.349 --> 32:56.182
forms the basis for the civilian

32:56.182 --> 32:58.920
comparison group . While SER data is

32:58.920 --> 33:01.150
available back to the 1970s , our data

33:01.150 --> 33:03.261
sources for the missile community are

33:03.261 --> 33:06.479
most complete starting in 2001 . The

33:06.479 --> 33:08.640
first year that all that all the

33:08.640 --> 33:10.640
databases including phase one Bravo

33:10.640 --> 33:14.560
analysis were available in 2001 . And

33:14.560 --> 33:17.510
so between 2001 and 2020 , our capture

33:17.510 --> 33:19.566
of cases is as complete as it can be

33:19.566 --> 33:23.500
for phase one Bravo . Um , data

33:23.500 --> 33:25.780
sources , and this includes 85% of

33:25.780 --> 33:28.709
cancers found in phase one Bravo . In

33:28.709 --> 33:30.820
phase one , Bravo , only the Veterans

33:30.820 --> 33:32.979
Administration Cancer Registry , uh ,

33:32.989 --> 33:36.810
actually goes back to 1976 . Analyzing

33:36.810 --> 33:39.099
the whole study time frame from 1976 to

33:39.099 --> 33:41.270
2020 would have added a lot of person

33:41.270 --> 33:43.479
time . Which is a factor in the

33:43.479 --> 33:45.800
analysis , but only added a

33:45.800 --> 33:47.744
disproportionately small number of

33:47.744 --> 33:50.140
cancer cases . The standardized

33:50.140 --> 33:53.119
incident ratios , which were mostly

33:53.119 --> 33:55.380
already lower than one would have been

33:55.380 --> 33:57.602
even lower due to this known data gap .

33:58.310 --> 34:01.130
Phase two analysis plans to include

34:01.130 --> 34:03.186
cancers from the entire study period

34:03.329 --> 34:05.496
for both the internal and the external

34:05.496 --> 34:07.273
comparisons since we still have

34:07.273 --> 34:10.010
additional data sources to cover this

34:10.010 --> 34:13.679
entire period of time . That's one .

34:17.789 --> 34:21.169
Thus The Missile Community Cancer team

34:21.169 --> 34:23.225
has sought collaboration and support

34:23.225 --> 34:24.947
from dozens of individuals and

34:24.947 --> 34:27.002
organizations in planning , design ,

34:27.002 --> 34:29.113
collection , and analysis of data and

34:29.113 --> 34:31.225
reporting . For Phase One Bravo , our

34:31.225 --> 34:33.447
external partners included experts from

34:33.447 --> 34:35.225
Wright State University and the

34:35.225 --> 34:37.225
National Institute for Occupational

34:37.225 --> 34:39.447
Safety and Health . I'll also point out

34:39.447 --> 34:41.447
our other partners included the Air

34:41.447 --> 34:43.502
Force Global Strike Command , Global

34:43.502 --> 34:45.613
Strike Command historians , Air Force

34:45.613 --> 34:47.836
Surgeon General Tumor registrar , Armed

34:47.836 --> 34:49.947
Forces Health Surveillance Division .

34:49.947 --> 34:52.002
The Association of Air Force Miles ,

34:52.002 --> 34:54.002
Defense Centers for Public Health ,

34:54.002 --> 34:55.947
Aberdeen , Defense Health Agency ,

34:55.947 --> 34:58.002
Privacy and Civil Liberties Office ,

34:58.002 --> 34:59.780
the Department of Defense Joint

34:59.780 --> 35:01.780
Pathology Center's tumor registry ,

35:01.780 --> 35:03.613
Department of Veterans Affairs ,

35:03.613 --> 35:05.725
hematology and oncology consultant of

35:05.725 --> 35:07.669
the Uniformed Service University ,

35:07.780 --> 35:09.780
Department of Defense Murtha Cancer

35:09.780 --> 35:12.058
Center , the National Cancer Institute ,

35:12.080 --> 35:14.247
the National Institute of Occupational

35:14.247 --> 35:16.469
Safety and Health , National Institutes

35:16.469 --> 35:18.469
of Health , the security of the Air

35:18.469 --> 35:20.636
Force's office . Montana Department of

35:20.636 --> 35:22.802
Public Health and Human Services state

35:22.802 --> 35:24.524
epidemiologists , North Dakota

35:24.524 --> 35:26.747
Department of Health and Human Services

35:26.747 --> 35:28.302
state epidemiologists , the

35:28.302 --> 35:30.191
surveillance epidemiology and end

35:30.191 --> 35:32.524
Results program , Torchlight Initiative ,

35:32.524 --> 35:34.580
United States Congress , the virtual

35:34.580 --> 35:36.691
poll registry , uh , the missile wing

35:36.691 --> 35:38.524
leadership and missile community

35:38.524 --> 35:40.610
members in those locations , and the

35:40.610 --> 35:42.221
Wyoming Department of Health

35:42.221 --> 35:46.159
epidemiologists . Phase 1

35:46.159 --> 35:48.699
Bravo included considerably more data

35:48.959 --> 35:51.080
capturing nearly 11 times more cancer

35:51.080 --> 35:53.939
cases compared to phase 1 alpha . Phase

35:53.939 --> 35:55.995
one alpha captured the Department of

35:55.995 --> 35:58.328
Defense's medical data only . Phase one ,

35:58.328 --> 36:00.550
Bravo added the Veterans Administration

36:00.550 --> 36:02.606
medical data and tumor registry data

36:02.606 --> 36:04.828
from both the Department of Defense and

36:04.828 --> 36:07.050
the Veterans Administration . The study

36:07.050 --> 36:09.219
team anticipates finding 2 to 3 times

36:09.219 --> 36:13.040
more cancers . In phase 2 using the

36:13.040 --> 36:15.560
virtual poll registry , and no

36:15.560 --> 36:17.709
definitive conclusion should be drawn

36:17.709 --> 36:19.879
until phase 2 is complete and all data

36:19.879 --> 36:22.459
sources have been incorporated . And uh

36:22.459 --> 36:24.403
I'll turn it back to you , Colonel

36:24.403 --> 36:26.737
Coleman , and if you have any questions .

36:26.737 --> 36:28.681
Thanks John . I just wanna kind of

36:28.681 --> 36:30.792
emphasize a few things that uh um and

36:30.792 --> 36:33.015
you guys can correct me 100% , but if ,

36:33.015 --> 36:35.126
but if uh phase one alpha , phase one

36:35.126 --> 36:37.870
bravo , and then phase two ,

36:39.439 --> 36:42.840
to your point , uh , we , the , the

36:42.840 --> 36:45.007
release of the preliminary information

36:45.007 --> 36:47.340
is just in an attempt to be transparent ,

36:47.340 --> 36:49.284
not , not , uh , definitive in the

36:49.284 --> 36:51.507
discovery journey yet . And we're about

36:51.530 --> 36:53.760
roughly 50% of the data that's out

36:53.760 --> 36:55.816
there . We still have another of the

36:55.816 --> 36:57.871
50% of the data to go through , so .

36:58.399 --> 37:01.770
The data is instructive , um , but I ,

37:01.860 --> 37:04.419
I just wanna caution folks to , that

37:04.419 --> 37:07.979
don't draw definitive con conclusions

37:07.979 --> 37:10.300
from the data yet until the report is

37:10.300 --> 37:12.578
done and all the data analysis is done .

37:12.899 --> 37:15.121
The other thing I'd like to highlight ,

37:15.121 --> 37:17.288
uh , Scheer , and again if , if , uh .

37:17.300 --> 37:20.520
Uh , and feel free to expand upon it is

37:20.520 --> 37:24.199
a part of this process from day one has

37:24.199 --> 37:27.320
been to include external peer review

37:27.320 --> 37:29.639
processes and , and you highlighted

37:29.639 --> 37:31.583
some of that in your first opening

37:31.583 --> 37:34.330
statement on this slide , but , uh , um ,

37:34.840 --> 37:37.062
part of it is just making sure that the

37:37.062 --> 37:39.550
Department of Defense . Uh , Department

37:39.550 --> 37:41.820
of the Air Force , uh , is a part of

37:41.820 --> 37:44.229
this analysis and this cancer study

37:44.570 --> 37:47.219
that we have , uh , external eyes and

37:47.219 --> 37:49.330
expertise to make sure that we , uh ,

37:49.330 --> 37:51.386
we aren't missing anything . If , if

37:51.386 --> 37:53.497
you or Greg could kind of expand upon

37:53.497 --> 37:55.441
that . Yes , sir , you're , you're

37:55.441 --> 37:57.497
absolutely right . I appreciate it ,

37:57.497 --> 37:59.552
General . Um , the , uh , especially

37:59.552 --> 38:01.552
the Wright State University and the

38:01.552 --> 38:03.497
National Institute of Occupational

38:03.497 --> 38:05.608
Health and Safety has given us , um ,

38:06.719 --> 38:09.510
huge support and made recommendations ,

38:09.600 --> 38:11.822
tangible recommendations to improve the

38:11.822 --> 38:14.156
study . Uh , again , I'll point out the ,

38:14.156 --> 38:17.629
uh , the , uh , recognition that , uh ,

38:18.520 --> 38:21.860
from the NIOSH that Stated cancer

38:21.860 --> 38:24.082
studies typically exclude folks if they

38:24.082 --> 38:26.193
haven't been employed for more than a

38:26.193 --> 38:29.229
year . And so that standard um

38:29.229 --> 38:31.451
expectation , this type of study and so

38:31.451 --> 38:33.618
we implemented that into the phase one

38:33.618 --> 38:35.896
Bravo analysis and so that , that , uh ,

38:35.896 --> 38:38.007
what we tried to explain why that was

38:38.007 --> 38:40.469
the case and so we are , we are relying

38:40.469 --> 38:43.620
on outside partners to help us to

38:43.989 --> 38:46.590
um improve and make sure that we do the

38:46.590 --> 38:48.701
best possible case we can for our mis

38:48.701 --> 38:50.889
leaders . Thanks , and if you don't

38:50.889 --> 38:52.722
mind , I know we've done this in

38:52.722 --> 38:54.889
previous town hall forms , but if , if

38:54.889 --> 38:56.722
you could briefly just kinda run

38:56.722 --> 38:59.649
through uh the expertise and , and the

38:59.649 --> 39:02.239
background of your teammates uh at your

39:02.239 --> 39:04.239
organization that have been part of

39:04.239 --> 39:06.350
this study . Yes sir , we have , uh ,

39:06.409 --> 39:08.850
for the , um , sampling and eventually

39:08.850 --> 39:10.969
the hazard risk analysis that will

39:10.969 --> 39:13.179
eventually be completed because on the

39:13.330 --> 39:15.689
on the uh on the hazard and sampling

39:15.689 --> 39:17.929
side of the house , um , our

39:17.929 --> 39:20.770
bioenvironmental bioenvironmental

39:20.770 --> 39:23.570
engineering occupational health and

39:23.570 --> 39:26.639
safety , um , teammates , uh .

39:27.250 --> 39:29.139
have done the analysis , done the

39:29.139 --> 39:31.439
collection of the sampling , and then

39:31.439 --> 39:33.520
they will use that to eventually

39:33.520 --> 39:35.550
develop a health risk analysis that

39:35.810 --> 39:38.989
hope we expect will inform us ,

39:39.719 --> 39:43.239
uh , oh yeah , and then I'll also add

39:43.239 --> 39:45.560
to NOS has been very instrumental with

39:45.560 --> 39:49.080
regard to the uh health risk assessment

39:49.080 --> 39:52.639
component of this as well . So ,

39:52.810 --> 39:55.032
uh , sort of our teammates on the bioen

39:55.032 --> 39:56.754
environmental engineering side

39:56.754 --> 39:58.977
including industrial hygiene as well as

39:58.977 --> 40:01.088
bioenvironmental engineers . Uh , for

40:01.088 --> 40:03.770
our epidemiology consult service , we

40:03.770 --> 40:05.659
have both pre preventive medicine

40:05.659 --> 40:08.209
physicians as well as epidemiologists

40:08.209 --> 40:10.540
that have been actively involved with

40:10.850 --> 40:13.639
the design and uh collection of data

40:13.639 --> 40:16.600
and the analysis of the data . And so ,

40:16.929 --> 40:19.360
um . So our , our teams here at your

40:19.360 --> 40:21.527
disposal as well as the uh community ,

40:21.639 --> 40:24.669
sir . So Colonel Waldrop , I think ,

40:24.719 --> 40:27.919
um , correct me 100% , but , but your

40:27.919 --> 40:30.086
team is made up of not only just the ,

40:30.086 --> 40:32.308
uh , active duty uniform , uh , members

40:32.308 --> 40:34.308
that also have doctorate degrees in

40:34.308 --> 40:36.389
epidemiology but of of civilians as

40:36.389 --> 40:38.611
well . So these are , these are experts

40:38.611 --> 40:40.722
in their field . They're scientists ,

40:40.722 --> 40:42.889
uh , that , uh , that are doing this ,

40:42.889 --> 40:44.889
this level of analysis of work . Is

40:44.889 --> 40:46.889
that , is that accurate ? Yes sir ,

40:46.889 --> 40:50.870
that is correct . We go to the

40:50.870 --> 40:54.270
next slide . So thank you for for

40:54.270 --> 40:56.326
walking us through all that . I know

40:56.326 --> 40:58.270
there's a lot of uh technical data

40:58.270 --> 41:00.437
there , but as we post this slide deck

41:00.437 --> 41:02.492
at the uh onto our missile Community

41:02.492 --> 41:04.492
website along with the epidemiology

41:04.492 --> 41:06.603
report from Phase One Bravo , we want

41:06.603 --> 41:08.770
you to be able to use the documents to

41:08.770 --> 41:10.881
reference one another so that you can

41:10.881 --> 41:12.992
uh look at the data yourself again in

41:12.992 --> 41:14.992
our effort to be transparent , uh .

41:14.992 --> 41:14.879
have that out on the website for you to

41:14.879 --> 41:17.157
look at . As we continue to go forward ,

41:17.157 --> 41:19.379
we will , um , and on the environmental

41:19.379 --> 41:21.268
sampling piece , there would be a

41:21.268 --> 41:23.323
comprehensive health risk assessment

41:23.323 --> 41:25.212
done and that will , as we talked

41:25.212 --> 41:27.323
through before uh be available to our

41:27.323 --> 41:29.679
uh to link with doors and assess the

41:29.679 --> 41:31.969
health risk exposure uh that our

41:31.969 --> 41:34.080
missileers and missile community work

41:34.080 --> 41:35.858
in . We'll close out the launch

41:35.858 --> 41:38.239
facility PCB sampling results and then

41:38.239 --> 41:40.540
we'll continue on to the next um

41:40.770 --> 41:42.826
portion of the epidemiology review ,

41:42.826 --> 41:44.909
the phase one Charlie data set , and

41:44.909 --> 41:48.020
then we will begin analyzing phase two .

41:49.360 --> 41:51.527
We have future engagements set up with

41:51.527 --> 41:53.471
um with the VA's Military exposure

41:53.471 --> 41:55.949
council briefing them uh next month and

41:55.949 --> 41:59.070
then again in December , um uh another

41:59.070 --> 42:01.126
working group that they have there .

42:01.126 --> 42:03.679
And then finally , we will , um , We

42:03.679 --> 42:05.959
have our site available . There's a QR

42:05.959 --> 42:07.792
code there , uh , for you to ask

42:07.792 --> 42:09.903
questions . We do , we're gonna run ,

42:09.903 --> 42:12.070
continue to run forensics to make sure

42:12.070 --> 42:14.237
that the answers that we are providing

42:14.237 --> 42:16.292
are getting back to you , um , and ,

42:16.292 --> 42:18.348
and close that loop so that we don't

42:18.348 --> 42:20.515
have any gaps in our communications to

42:20.515 --> 42:22.570
you , whether through this uh form ,

42:22.570 --> 42:24.792
the website , or directly as you ask us

42:24.792 --> 42:26.903
questions and so we're committed to ,

42:26.903 --> 42:29.126
to closing that loop with you as well .

42:29.126 --> 42:31.237
So so at this point I'll turn it back

42:31.237 --> 42:33.348
over to you . Thanks , Greg . Um , so

42:33.348 --> 42:35.515
either for you or or Siner can , can ,

42:35.515 --> 42:37.348
uh , either one of you talk to ,

42:37.348 --> 42:39.459
there's been , uh , some feedback and

42:39.459 --> 42:41.570
concern that there's been , uh , um ,

42:41.570 --> 42:44.250
uh . Significant , um , water

42:44.250 --> 42:46.194
contamination in the missile alert

42:46.194 --> 42:48.750
facilities . Have we discovered any in

42:48.750 --> 42:51.469
our , in our uh environmental testing

42:51.469 --> 42:53.636
so far have we found anything with the

42:53.636 --> 42:55.699
water in the mass or the LCCs either

42:55.790 --> 42:59.540
for Gregor or uh China ? So if you want

42:59.540 --> 43:01.979
to start first ? Yes , sir , and , and

43:01.979 --> 43:04.035
I'm gonna defer to my subject matter

43:04.035 --> 43:06.035
expert here , Lieutenant Colonel uh

43:06.035 --> 43:08.459
Scott Boyd . Uh , Scott , so , uh , out

43:08.459 --> 43:10.459
of the 3 rounds of this study we've

43:10.629 --> 43:13.090
collected about 810 drinking water

43:13.090 --> 43:15.860
samples which analyzed over 43,000

43:15.860 --> 43:18.060
total chemicals . All results were

43:18.060 --> 43:19.838
non-detected and or below their

43:19.838 --> 43:22.060
corresponding federal health limit , so

43:22.060 --> 43:24.060
we have detected no issues where we

43:24.060 --> 43:25.838
think there's an issue with the

43:25.838 --> 43:28.004
drinking water over . OK , thank you .

43:28.149 --> 43:30.038
That's what I thought , but I , I

43:30.038 --> 43:32.093
wanted to make sure I wasn't missing

43:32.093 --> 43:34.205
anything . Um , there's we we've also

43:34.205 --> 43:36.316
gotten feedback that , uh , um , from

43:36.316 --> 43:38.709
our last town hall meeting that

43:38.709 --> 43:41.760
questions that were submitted to , uh ,

43:41.770 --> 43:45.169
our portal have not been answered . Um ,

43:45.189 --> 43:47.169
we are gonna take that for action

43:47.169 --> 43:49.280
because they've all been received and

43:49.280 --> 43:51.469
replied to , so we don't know if uh if

43:51.469 --> 43:53.989
there's a uh a system on the far end or

43:53.989 --> 43:56.156
up in DC , but we'll , we'll take that

43:56.156 --> 43:58.045
for action . Uh , because all the

43:58.045 --> 44:00.378
questions that were submitted after the ,

44:00.378 --> 44:02.267
uh , the last town hall have been

44:02.267 --> 44:04.433
answered and , and responded to . So ,

44:04.433 --> 44:06.378
uh , obviously there's a technical

44:06.378 --> 44:08.600
issue somewhere in the system that we ,

44:08.600 --> 44:11.250
that we will pull the thread on , um ,

44:11.300 --> 44:14.110
and then , uh . The last thing I'll say

44:14.110 --> 44:16.332
before , John , if you can start teeing

44:16.332 --> 44:18.388
up uh the questions , the last thing

44:18.388 --> 44:20.554
I'll say is uh uh kind of end up where

44:20.554 --> 44:22.610
I started in the beginning is this ,

44:22.629 --> 44:25.719
this effort , um , is really focused on

44:25.719 --> 44:27.941
today , making sure we understand today

44:27.941 --> 44:29.997
and we can capture uh the historical

44:29.997 --> 44:32.750
data . Um , the way I would see it ,

44:32.909 --> 44:34.798
and we don't have this completely

44:34.798 --> 44:36.798
framed and codified yet , when this

44:36.798 --> 44:39.020
report is done . Uh , and we understand

44:39.020 --> 44:40.853
the environment that our missile

44:40.853 --> 44:43.020
operators have served in , in the , in

44:43.020 --> 44:45.409
the , in the last few decades that will

44:45.409 --> 44:48.399
provide the study , uh , our assessment

44:48.399 --> 44:51.120
of the exposure . Uh , and we'll put

44:51.120 --> 44:53.520
that out on our , uh , public facing

44:53.520 --> 44:56.169
website , and we'll work with the VA to

44:56.169 --> 44:58.290
make sure that , uh , any , uh ,

44:58.300 --> 45:01.250
exposure is documented , not only for

45:01.250 --> 45:03.250
our current , uh , members that are

45:03.250 --> 45:05.306
serving , but for those that have uh

45:05.306 --> 45:07.528
left the missile career field separated

45:07.528 --> 45:09.694
or retired , so that we can uh provide

45:09.694 --> 45:12.209
that information , uh , if they need uh

45:12.209 --> 45:15.320
documentation for service and benefits .

45:15.810 --> 45:17.643
So , John , over to you to start

45:17.643 --> 45:20.419
processing uh the questions . Copy ,

45:20.459 --> 45:22.292
sir . Thank you . Uh , just some

45:22.292 --> 45:24.515
station keeping announcements . Uh , we

45:24.515 --> 45:26.626
have gotten quite a few questions via

45:26.626 --> 45:28.403
chat , more than I think we can

45:28.403 --> 45:30.737
reasonably answer in the time remaining .

45:30.737 --> 45:30.379
So just a reminder , please keep

45:30.379 --> 45:32.601
submitting those questions , you can DM

45:32.601 --> 45:34.323
them to me . In the chat , I'm

45:34.323 --> 45:36.546
Lieutenant Colonel John Severance , and

45:36.546 --> 45:38.712
any questions we do not get to today ,

45:38.712 --> 45:40.823
our staff will work to answer and get

45:40.823 --> 45:40.639
posted on the Missile Community Cancer

45:40.639 --> 45:42.861
site website . In addition , because it

45:42.861 --> 45:44.750
is a common question , we will be

45:44.750 --> 45:46.949
posting these slides on the website

45:47.280 --> 45:49.391
after today's town hall . They should

45:49.391 --> 45:51.558
be up by tomorrow morning . Uh , sir ,

45:51.558 --> 45:53.558
with that , we'll go to some of the

45:53.558 --> 45:55.780
more common questions . Uh , one that's

45:55.780 --> 45:57.947
been asked several times , times , I'm

45:57.947 --> 45:57.489
gonna try to clue it together . Uh ,

45:57.949 --> 46:00.005
there have been several known , uh ,

46:00.005 --> 46:02.060
spills of various chemicals , either

46:02.060 --> 46:04.070
PCBs or various other hazardous

46:04.070 --> 46:06.292
materials at the missile sites over the

46:06.292 --> 46:08.237
years that have been documented by

46:08.237 --> 46:10.989
AFCAC and other agencies . Is the study

46:10.989 --> 46:12.830
doing anything to look at those

46:12.830 --> 46:15.629
specific spills and what personnel may

46:15.629 --> 46:17.550
have been exposed to them over ?

46:20.750 --> 46:22.750
So Colonel Lager , I'll , I'll give

46:22.750 --> 46:24.806
this a shot , um , or address it and

46:24.806 --> 46:26.861
then I'll leave it to you to add any

46:26.861 --> 46:29.028
specific details . But as we've got to

46:29.028 --> 46:31.194
walk through the study and what we can

46:31.194 --> 46:33.306
sample from the what we know today of

46:33.306 --> 46:35.194
the three missile wings as we can

46:35.194 --> 46:37.083
conduct sampling at those , those

46:37.083 --> 46:38.694
active sites . Um , we can't

46:38.694 --> 46:40.750
necessarily sample anything from the

46:40.750 --> 46:42.750
past . So in order to , in order to

46:42.750 --> 46:44.806
kind of assess what that environment

46:44.806 --> 46:46.972
was like in the past , we're using the

46:46.972 --> 46:49.028
retrospective epidemiology review to

46:49.028 --> 46:51.250
get that assessment . And that is those

46:51.250 --> 46:53.472
four distinct data sets that Through to

46:53.472 --> 46:55.417
see if we can , if there is any uh

46:55.417 --> 46:57.583
level of disease , uh , that we , that

46:57.583 --> 46:59.528
we pick up during the epidemiology

46:59.528 --> 47:02.209
review . We have heard that and uh this

47:02.209 --> 47:05.209
quite frequently about spills or other

47:05.209 --> 47:07.487
environments that are no longer active .

47:07.800 --> 47:10.022
And the epidemiology review is , is our

47:10.022 --> 47:12.979
most complete way of assessing , um ,

47:12.989 --> 47:14.933
assessing that time frame since we

47:14.933 --> 47:17.045
can't actively , actively sample that

47:17.045 --> 47:19.870
but so yeah , so Greg , I , um .

47:20.929 --> 47:23.629
I think the more efficient way of

47:23.629 --> 47:26.149
addressing that is what uh Matt briefed

47:26.149 --> 47:29.870
earlier is we , we have done and

47:29.870 --> 47:32.830
we understand based on the TCTOs of the

47:32.830 --> 47:36.070
previous systems , what chemicals or or

47:36.070 --> 47:38.820
contaminants might have been present in

47:38.820 --> 47:42.750
the LCCs and uh and to Greg's point

47:42.750 --> 47:44.917
earlier , we have some of that already

47:44.917 --> 47:47.083
on the portal . That's probably a more

47:47.083 --> 47:49.417
efficient way of understanding exposure .

47:49.417 --> 47:51.510
Um , and so if there's prior service

47:51.510 --> 47:54.260
members , um , I would recommend you go

47:54.260 --> 47:57.100
to our , our web our our website portal

47:57.100 --> 47:59.229
first and look at that VA letter that

47:59.229 --> 48:02.379
we have posted , um , and see if that ,

48:02.389 --> 48:04.550
uh , if your period of service is

48:04.550 --> 48:06.606
commensurate with what we know to be

48:06.606 --> 48:08.772
true based on the industrial standards

48:08.772 --> 48:10.760
at the time . Um , and , and that

48:10.760 --> 48:13.560
should be sufficient for exposure . I'm

48:13.560 --> 48:15.727
not sure we can go back in history and

48:15.727 --> 48:17.838
say AFCAC has a store report and then

48:17.838 --> 48:20.959
tie a a person's , uh , uh , missile

48:20.959 --> 48:23.126
duty to that for to that time period .

48:23.126 --> 48:26.489
I think that's probably um . Not

48:26.489 --> 48:28.433
necessarily a detail that's in the

48:28.433 --> 48:30.267
archives , but I'm not sure it's

48:30.267 --> 48:32.378
required either because we have the ,

48:32.378 --> 48:34.489
the data on what was in the system in

48:34.489 --> 48:36.711
previous decades and in previous weapon

48:36.711 --> 48:38.933
systems that should be sufficient to uh

48:38.933 --> 48:41.610
acknowledge exposure for prior service

48:41.610 --> 48:43.554
members . Uh , Shier , do you have

48:43.554 --> 48:46.010
anything to add to that ? Uh , general

48:46.010 --> 48:48.232
and , uh , Colonel Holman , know , know

48:48.232 --> 48:50.929
that a capsule , exactly . I , I don't

48:50.929 --> 48:52.818
have anything else to have done .

48:55.280 --> 48:57.502
All right , thank you , sir . Uh , next

48:57.502 --> 48:59.336
question , and this was one that

48:59.336 --> 49:01.336
several people asked as well , uh ,

49:01.336 --> 49:03.391
about the methodology of the study .

49:03.391 --> 49:05.447
Can you provide a bit of information

49:05.447 --> 49:07.780
about who the peer review , uh , is and ,

49:07.780 --> 49:09.836
uh , what , uh , you know , how they

49:09.836 --> 49:11.836
are basically checking our work and

49:11.836 --> 49:14.320
also for UAFA in particular , uh , can

49:14.320 --> 49:16.959
you describe , uh , just what the kind

49:16.959 --> 49:19.189
of expertise or experience there within

49:19.479 --> 49:21.312
that command is when it comes to

49:21.312 --> 49:23.201
epidemiological studies , uh , in

49:23.201 --> 49:26.850
general , over . OK , yes , uh , we can

49:26.850 --> 49:28.850
do that . And , in fact , I'm gonna

49:28.850 --> 49:30.906
have , I'm gonna defer to Lieutenant

49:30.906 --> 49:33.017
Colonel Keith Beam . Uh , he's on the

49:33.017 --> 49:35.128
study team and he can , uh , describe

49:35.128 --> 49:37.461
that for you . Good afternoon . So , uh ,

49:37.461 --> 49:36.889
let me just first uh introduce myself

49:36.889 --> 49:38.667
Keith Beam . Uh , I'm a prevMed

49:38.667 --> 49:40.778
physician , um , and , uh , we have a

49:40.778 --> 49:43.111
couple of premed physicians on the team .

49:43.111 --> 49:45.389
We have , um , a public health officer .

49:45.389 --> 49:45.330
We have a number of , uh , of

49:45.330 --> 49:48.080
epidemiologists , um , we have , uh ,

49:48.189 --> 49:51.040
uh , uh , folks who have a doctorate in ,

49:51.139 --> 49:53.306
in , uh , in public health . Um , so ,

49:53.306 --> 49:55.472
uh , so that , that kind is the makeup

49:55.472 --> 49:57.806
of our team , um , in terms of the , uh ,

49:57.806 --> 49:59.917
the external partnerships , uh , that

49:59.917 --> 50:01.972
we saw , uh , I think Colonel Walter

50:01.972 --> 50:04.139
read off a , uh , uh , a quite lengthy

50:04.139 --> 50:03.929
list of , of , uh , individuals that

50:03.929 --> 50:06.207
have been involved throughout the , uh ,

50:06.207 --> 50:08.373
the planning process of , uh , of , of

50:08.373 --> 50:11.060
study design , um . But uh during each

50:11.060 --> 50:13.171
phase , uh , you know , starting with

50:13.171 --> 50:15.338
phase one Bravo , we've really engaged

50:15.338 --> 50:17.504
uh even more with uh specific external

50:17.504 --> 50:19.782
partners on each phase . So the uh the ,

50:19.782 --> 50:22.004
the partner , excuse me , the , um , so

50:22.004 --> 50:24.116
for phase one Bravo we partnered with

50:24.116 --> 50:26.282
experts from the , uh , the , uh , the

50:26.282 --> 50:27.838
NAASH National Institute of

50:27.838 --> 50:30.171
Occupational Health and Safety and , um ,

50:30.171 --> 50:32.116
and with experts from Wright State

50:32.116 --> 50:34.060
University . Um , so those are the

50:34.060 --> 50:36.116
individuals that , uh , with whom we

50:36.116 --> 50:38.227
shared our , uh , our results , and ,

50:38.227 --> 50:40.282
um , and we , we've shared with them

50:40.282 --> 50:42.449
the , um , the , the memorandum that ,

50:42.449 --> 50:44.616
uh , that has been made available to ,

50:44.616 --> 50:46.838
to , uh , Air Force Global Stri Command

50:46.838 --> 50:48.949
and , uh , and , and they have helped

50:48.949 --> 50:51.116
us greatly with , um , you know , with

50:51.116 --> 50:53.282
our , our study methodology and , uh ,

50:53.282 --> 50:55.560
and with interpretation of the results .

50:55.560 --> 50:57.782
Also , our , um , we have a , uh , uh .

50:58.489 --> 51:00.409
Uh , Doctor of , of , uh , public

51:00.409 --> 51:03.959
health over at the , uh , uh , DCPH

51:03.959 --> 51:06.239
Aberdeen , um , who has been , uh ,

51:06.250 --> 51:08.417
just , you know , very instrumental as

51:08.417 --> 51:10.472
well in helping us to , uh , to , to

51:10.472 --> 51:12.361
really understand the , the , the

51:12.361 --> 51:14.417
military population as well . He's a

51:14.417 --> 51:16.583
one of the senior epidemiologists over

51:16.583 --> 51:20.389
there . For , uh , yeah ,

51:20.429 --> 51:22.429
go ahead . I was just gonna turn it

51:22.429 --> 51:24.540
back to you . All right , thank you .

51:24.540 --> 51:26.651
Uh , next question , and this one was

51:26.651 --> 51:29.229
submitted by uh . Let me expand upon

51:29.229 --> 51:32.989
that a little bit . So , um , I sense

51:32.989 --> 51:35.750
in the , in the , in the community writ

51:35.750 --> 51:38.820
large that there is uh some

51:38.820 --> 51:42.679
skepticism . Uh , based on the results

51:42.679 --> 51:45.360
of the 2001 and 2005 report .

51:46.729 --> 51:50.679
Um , uh . I share and

51:50.679 --> 51:53.679
I've been very vocal about my

51:53.679 --> 51:56.159
unsatisfaction with those two reports .

51:57.139 --> 52:00.379
Um , but this study , this effort , and

52:00.379 --> 52:03.300
this energy is significantly more

52:03.300 --> 52:06.820
focused and , uh , engaged in those two

52:06.820 --> 52:09.050
times , and some of it's because , uh ,

52:09.340 --> 52:12.370
you have a MACOM commander , uh ,

52:12.379 --> 52:15.219
pushing on this , but there is no

52:15.219 --> 52:17.330
organization in the department of the

52:17.330 --> 52:19.108
Air Force is better postured or

52:19.108 --> 52:20.941
prepared or has the professional

52:20.941 --> 52:23.689
competencies to do this . Then , uh ,

52:23.860 --> 52:26.570
uh . Yousaf Sam , there isn't .

52:27.719 --> 52:30.989
Um , and , uh , I would ask

52:31.560 --> 52:33.790
uh the collective group of , uh , uh ,

52:33.800 --> 52:36.000
operators out on the net and , and in

52:36.000 --> 52:39.310
your , uh , your close groups to , uh ,

52:40.280 --> 52:43.639
Trust that we have this uh at hand and

52:43.639 --> 52:46.790
have your , your interest in hand . Um ,

52:47.520 --> 52:49.687
To Greg's point , we have never done ,

52:49.687 --> 52:51.853
the department's never done a study to

52:51.853 --> 52:54.076
this level , scope and scale . Uh , you

52:54.076 --> 52:56.298
have our commitment that we're gonna do

52:56.298 --> 52:58.520
it right . You have our commitment that

52:58.520 --> 53:00.187
we're gonna make sure we have

53:00.187 --> 53:02.131
appropriate pure level review from

53:02.131 --> 53:04.353
outside agencies to make sure we didn't

53:04.353 --> 53:06.520
miss anything . Um , and our intent is

53:06.520 --> 53:09.729
to , uh , to document and , uh , make

53:09.729 --> 53:13.209
sure that we have the proper data that

53:13.209 --> 53:15.449
is respected both by the Veterans

53:15.449 --> 53:17.616
Affairs , as well as the Department of

53:17.616 --> 53:19.949
Defense and Department of the Air Force .

53:19.949 --> 53:22.060
So no one , no one's gonna question ,

53:22.060 --> 53:24.171
in my opinion , this report when it's

53:24.171 --> 53:26.282
done , similar to what was questioned

53:26.282 --> 53:28.699
in previous studies . Uh , so I , I

53:28.699 --> 53:31.860
acknowledge your skepticism , um , but

53:31.860 --> 53:33.971
I'd ask for both patience and trust ,

53:33.971 --> 53:36.027
uh , that we're , we're gonna get it

53:36.027 --> 53:39.590
done right this time . Uh thank you ,

53:39.610 --> 53:41.721
sir . Uh , another question that came

53:41.721 --> 53:43.888
up several times , what is the service

53:43.888 --> 53:45.832
doing to mitigate toxins and or to

53:45.832 --> 53:47.959
create a safe environment for , uh ,

53:47.969 --> 53:49.858
service members who are currently

53:49.858 --> 53:52.129
serving in facilities where uh toxins

53:52.129 --> 53:54.689
or hazards were identified in the

53:54.689 --> 53:56.245
environmental survey over .

54:00.580 --> 54:02.739
So , thank you for the question . And

54:02.739 --> 54:05.469
this is Colonel Coleman . The , as I

54:05.469 --> 54:07.699
walked through I was describing the ,

54:07.929 --> 54:10.040
the occupational shops that are being

54:10.040 --> 54:11.818
designed for the entire missile

54:11.818 --> 54:13.651
community , within those shops ,

54:13.651 --> 54:16.060
there's a level of periodic uh sampling

54:16.060 --> 54:18.171
that must be done , whether that's on

54:18.171 --> 54:21.020
the air sampling , uh , swipe samples

54:21.020 --> 54:23.399
that'll be uh conduct . As well as

54:23.399 --> 54:26.040
water sampling and , and uh and others .

54:26.360 --> 54:28.471
And so that will be periodically done

54:28.471 --> 54:30.138
to ensure that there's a safe

54:30.138 --> 54:32.249
environment , uh , and again all that

54:32.249 --> 54:34.304
information will be documented every

54:34.304 --> 54:36.304
time that those events occur into ,

54:36.304 --> 54:38.800
into that door system so that it will

54:38.800 --> 54:40.856
reflect in your medical record . And

54:40.856 --> 54:42.800
anytime that we're doing , I think

54:42.800 --> 54:44.911
we're also partnering uh with a force

54:44.911 --> 54:46.967
any time inspections are done within

54:46.967 --> 54:49.300
those facilities and the weapon systems ,

54:49.300 --> 54:51.356
another uh sampling effort will take

54:51.356 --> 54:53.467
place to ensure that we're continuing

54:53.467 --> 54:56.270
to provide a , a safe environment . So

54:56.270 --> 54:58.350
in short , really , the sampling

54:58.350 --> 55:00.239
efforts that we're doing now will

55:00.239 --> 55:02.429
become standard work as we go forward

55:02.429 --> 55:05.120
for those communities . Yeah , and so

55:05.120 --> 55:07.009
when we discover something that's

55:07.009 --> 55:09.064
outside the standard , we , we close

55:09.064 --> 55:11.179
the facility to access or mitigate to

55:11.179 --> 55:13.649
the point , uh , where we're satisfied

55:13.649 --> 55:15.649
of the safety and well-being of our

55:15.649 --> 55:18.689
airmen . Um , uh , is Stacey Joe on the

55:18.689 --> 55:19.060
net ?

55:24.989 --> 55:27.110
Sir , it would be difficult for me to

55:27.110 --> 55:29.443
find and bring her up at the moment . I ,

55:29.443 --> 55:31.969
if you give me a minute I can over . OK ,

55:32.219 --> 55:34.441
um , Matt , do you have anything to add

55:34.441 --> 55:36.663
to that ? Yeah , the only thing I would

55:36.663 --> 55:38.552
add to that , sir , is as we move

55:38.552 --> 55:40.719
forward , you know , we , we go , we ,

55:40.719 --> 55:42.775
when we implement something into the

55:42.775 --> 55:44.608
weapon system , we use the least

55:44.608 --> 55:47.604
hazardous material possible and PCBs

55:47.604 --> 55:49.604
specifically , you know , have been

55:49.604 --> 55:51.826
outlawed . We are installing nothing in

55:51.826 --> 55:53.660
the weapon system currently that

55:53.660 --> 55:55.844
contains PCBs , nor will we as we

55:55.844 --> 55:57.844
transition to the next generation .

55:57.844 --> 55:59.900
Yeah , so it was in the 70s when the

55:59.900 --> 56:01.733
government and the Environmental

56:01.733 --> 56:04.645
Protection Agency um outlawed the , the

56:04.645 --> 56:08.159
use of PCBs in industrial areas . Um ,

56:08.179 --> 56:10.100
and that's when the , the process

56:10.100 --> 56:12.267
started and I don't have the letter in

56:12.267 --> 56:14.433
front of me , but I believe it was the

56:14.433 --> 56:17.219
mid 90s , 9 , 1996 when the Department

56:17.219 --> 56:18.939
of the Air Force directed the

56:18.939 --> 56:22.780
mitigation steps um uh within specific

56:22.780 --> 56:26.770
to our uh um weapon systems . Um

56:27.020 --> 56:29.620
there are no uh reintroduction of those

56:29.620 --> 56:31.787
type of chemicals in , in the , in the

56:31.787 --> 56:34.669
workplace , uh now , and we're very

56:34.669 --> 56:38.129
cognizant of that . Um , so our , our

56:38.129 --> 56:41.919
sampling , our , uh , our cleaning ,

56:42.209 --> 56:45.129
and our contract , uh , mitigations for

56:45.129 --> 56:47.969
specific to PCB is our current steps

56:47.969 --> 56:50.209
and so and that's just specific to the

56:50.209 --> 56:52.729
PCB and the LCC even though we're doing

56:52.729 --> 56:55.399
our other samplings more routine , um ,

56:55.449 --> 56:58.020
and , uh , to Greg's point earlier with

56:58.020 --> 57:00.131
the environmental health linkage with

57:00.131 --> 57:03.449
the missile , um , operators uh is also

57:03.449 --> 57:05.227
gonna be another safety check .

57:09.649 --> 57:11.927
Yes , go ahead , Major General Hoosier .

57:11.927 --> 57:13.760
Hey , Stacey , Joe , do you have

57:13.760 --> 57:15.982
anything to add to that as the 20th Air

57:15.982 --> 57:18.093
Force commander ? Was it about the uh

57:18.093 --> 57:19.982
cleaning plan , sir , that you're

57:19.982 --> 57:22.260
referring to ? Uh , just specific , uh ,

57:22.260 --> 57:24.427
the question was how are we gonna make

57:24.427 --> 57:26.649
sure our airmen , uh , are operating in

57:26.649 --> 57:28.927
an environment that's safe ? Yes , sir .

57:28.927 --> 57:30.982
You , you nailed it . So not only um

57:30.982 --> 57:33.149
are we implementing the launch control

57:33.149 --> 57:35.149
center , deep cleaning specifically

57:35.149 --> 57:37.550
aimed at the PCBs , but then from now

57:37.550 --> 57:39.550
on , there's going to be continuing

57:39.550 --> 57:42.879
sampling that occurs , you know , until

57:42.879 --> 57:45.689
this system is replaced . So we will ,

57:45.770 --> 57:48.250
we will be continuously monitoring the

57:48.250 --> 57:50.194
environments in which not just our

57:50.194 --> 57:52.417
missileers but in which our maintainers

57:52.417 --> 57:54.194
and defenders , our chefs , our

57:54.194 --> 57:56.417
facility managers in which they work to

57:56.417 --> 57:58.361
ensure they're all safe . Thanks ,

57:58.361 --> 58:00.449
Stacey Joe . And , and uh you won't

58:00.449 --> 58:02.616
find somebody that's more passionate ,

58:02.616 --> 58:04.782
engaged on , on this topic than uh the

58:04.782 --> 58:07.005
person that's on the screen right now .

58:09.909 --> 58:12.242
All right , sir . Uh , next question is ,

58:12.242 --> 58:13.742
uh , again for the medical

58:13.742 --> 58:15.798
professionals , uh , and this is one

58:15.798 --> 58:17.965
that came up several times . Uh , many

58:17.965 --> 58:20.131
folks have asked if there is a way for

58:20.131 --> 58:22.131
them to confirm that their specific

58:22.131 --> 58:24.780
case of cancer or medical issue is

58:24.780 --> 58:27.100
included in the study . And also , is

58:27.100 --> 58:29.322
there a way that they should be talking

58:29.322 --> 58:31.580
to their providers about the potential

58:31.580 --> 58:33.659
enhanced risks for developing cancer

58:33.659 --> 58:36.100
that they may have as a result of

58:36.100 --> 58:38.580
working in these facilities ? Should

58:38.580 --> 58:41.459
they be asking for specific tests or

58:41.459 --> 58:43.739
should they be using the memo that we

58:43.739 --> 58:45.739
produced or any other method over ?

58:49.770 --> 58:51.826
Uh , this is Colonel Waldrop . I use

58:51.826 --> 58:53.937
that saying again . Uh , in general ,

58:53.937 --> 58:55.770
I'd say the results of the large

58:55.770 --> 58:57.826
epidemi studies such as this study ,

58:57.826 --> 59:00.270
the MCCS , are generally applicable to

59:00.270 --> 59:02.429
the entire population , meaning this

59:02.429 --> 59:04.639
whole cancer community , regardless of

59:04.639 --> 59:06.750
the individual's participation in the

59:06.750 --> 59:09.510
actual study . And the , the , the

59:09.510 --> 59:11.860
design of the study is to uh to really

59:11.860 --> 59:15.629
encapture in a scientifically valid

59:15.629 --> 59:18.120
way . Although some of the , the , the

59:18.120 --> 59:22.080
data may be de-identified um using

59:22.080 --> 59:24.239
the databases to the fullest extent ,

59:24.320 --> 59:27.000
we intend to capture everyone that we

59:27.000 --> 59:30.149
can , uh , in the analysis of the study .

59:30.560 --> 59:33.399
Um , now , there will be like for

59:33.399 --> 59:36.070
instance , Again , going back to the

59:36.070 --> 59:39.000
19,000 individuals that were excluded

59:39.000 --> 59:41.709
from the missile community cohort

59:42.080 --> 59:44.302
because we could not validate that they

59:44.302 --> 59:46.600
had one year of service or um

59:46.600 --> 59:48.919
employment within uh within that ,

59:49.080 --> 59:53.030
within that time frame , uh it was uh

59:53.399 --> 59:55.288
uh advised that we would , should

59:55.288 --> 59:58.120
exclude those folks to improve the

59:58.120 --> 01:00:01.590
potential for , for finding those ,

01:00:01.620 --> 01:00:04.709
uh , Potentially small signals and

01:00:04.709 --> 01:00:08.350
cancer rates . So , um , so in that

01:00:08.350 --> 01:00:11.530
regard , we think that the uh The study

01:00:11.530 --> 01:00:14.330
as such is the best , uh , the best

01:00:14.330 --> 01:00:16.219
possibly designed at this time to

01:00:16.219 --> 01:00:18.050
detect those increased rate or

01:00:18.050 --> 01:00:20.328
potentially increased rates of cancers .

01:00:20.689 --> 01:00:22.856
And if , if you don't mind , can , can

01:00:22.856 --> 01:00:25.022
I ask what was the second part of that

01:00:25.022 --> 01:00:26.800
question ? Uh , yes , sir . The

01:00:26.800 --> 01:00:29.022
question was how should individuals who

01:00:29.022 --> 01:00:31.245
are concerned talk with their providers

01:00:31.245 --> 01:00:33.409
uh about those concerns , uh , and is

01:00:33.409 --> 01:00:35.465
there any specific testing that they

01:00:35.465 --> 01:00:37.631
can or should ask for over ? Oh yeah ,

01:00:37.631 --> 01:00:40.209
so , so at this time , if , uh , if ,

01:00:40.360 --> 01:00:42.638
if somebody in the , or really anybody ,

01:00:42.638 --> 01:00:44.749
but if uh this whole community member

01:00:44.879 --> 01:00:47.090
uh has concerns , I would encourage

01:00:47.090 --> 01:00:50.000
them to seek out um counseling with

01:00:50.000 --> 01:00:53.659
their individual PCM . Now ,

01:00:54.030 --> 01:00:56.389
the letter that's uh the PCB letter

01:00:56.389 --> 01:00:59.949
that explains uh the fact that this uh

01:00:59.949 --> 01:01:01.782
potential hazard was in the work

01:01:01.782 --> 01:01:03.782
environment , certainly that can be

01:01:03.782 --> 01:01:05.893
provided to the healthcare provider .

01:01:05.893 --> 01:01:07.949
The healthcare provider can document

01:01:07.949 --> 01:01:10.060
that in the medical record as well as

01:01:10.060 --> 01:01:12.227
even upload a copy of that letter into

01:01:12.227 --> 01:01:14.171
their , um , into their um medical

01:01:14.171 --> 01:01:16.116
record , uh , for , for additional

01:01:16.116 --> 01:01:18.449
purposes , but if somebody has symptoms ,

01:01:18.629 --> 01:01:20.740
uh , and . Concerns , you know , that

01:01:20.740 --> 01:01:22.784
might be related to non-Hodgkin's

01:01:22.784 --> 01:01:25.006
lymphoma or some other type of cancer ,

01:01:25.006 --> 01:01:26.905
then certainly seeking out uh an

01:01:26.905 --> 01:01:28.738
evaluation by their primary care

01:01:28.738 --> 01:01:31.425
physician is appropriate . And at this

01:01:31.425 --> 01:01:33.895
point , what has been communicated to

01:01:33.895 --> 01:01:36.294
the medi the medics in the field is

01:01:36.544 --> 01:01:38.544
just be good doctors and healthcare

01:01:38.544 --> 01:01:41.104
providers . And so if that means doing

01:01:41.104 --> 01:01:43.048
an exam that's consistent with the

01:01:43.048 --> 01:01:45.375
symptomology , then they should do so .

01:01:46.060 --> 01:01:49.320
And such , uh , if it's a situation

01:01:49.320 --> 01:01:52.770
that maybe , uh , that , that , you

01:01:52.770 --> 01:01:54.992
know , this is a decision point between

01:01:54.992 --> 01:01:56.770
the healthcare provider and the

01:01:56.770 --> 01:01:59.209
individual person . We advise at this

01:01:59.209 --> 01:02:03.050
point to , um , with regard

01:02:03.050 --> 01:02:05.889
to developing standardized medical

01:02:05.889 --> 01:02:09.739
exams or um required . You know ,

01:02:09.780 --> 01:02:11.891
sampling of human tissue or this type

01:02:11.891 --> 01:02:14.899
of stuff to , uh , to be patient until

01:02:14.899 --> 01:02:17.066
the completion of phase two , until we

01:02:17.066 --> 01:02:19.066
really understand what phase two is

01:02:19.066 --> 01:02:21.780
actually going to inform us . um , and

01:02:21.780 --> 01:02:23.836
we are trying to do that analysis as

01:02:23.836 --> 01:02:27.010
quickly as we can . Uh , it's just , uh ,

01:02:27.260 --> 01:02:29.427
the timelines with regard to obtaining

01:02:29.427 --> 01:02:31.929
the data and then , um , um .

01:02:33.110 --> 01:02:35.110
Uh , there's a , there's a bunch of

01:02:35.110 --> 01:02:37.221
steps in terms of , uh , dealing with

01:02:37.221 --> 01:02:39.277
the data so that we can get it in an

01:02:39.277 --> 01:02:41.499
appropriate format to do the analysis .

01:02:41.499 --> 01:02:43.989
Uh , I wanna , yes , I wanna add , uh ,

01:02:44.000 --> 01:02:46.479
two things if I could , uh , one that

01:02:46.479 --> 01:02:48.535
you , you mentioned , uh , uh , very

01:02:48.535 --> 01:02:50.757
briefly , which is the information that

01:02:50.757 --> 01:02:52.965
we are , uh , that we find as . We go

01:02:52.965 --> 01:02:54.854
through the study itself , we are

01:02:54.854 --> 01:02:56.854
sharing with the providers not only

01:02:56.854 --> 01:02:59.076
within Global strike but across the Air

01:02:59.076 --> 01:03:01.021
Force so they understand they have

01:03:01.021 --> 01:03:03.076
knowledge of what's happening in the

01:03:03.076 --> 01:03:05.298
study and so when uh you as patients go

01:03:05.298 --> 01:03:07.465
to see your provider , they're also up

01:03:07.465 --> 01:03:09.465
to speed with what's going on . The

01:03:09.465 --> 01:03:11.632
other thing I would advise anyone that

01:03:11.632 --> 01:03:13.798
may have concerns to do is um . During

01:03:13.798 --> 01:03:15.965
your , uh , PHA , your physical health

01:03:15.965 --> 01:03:18.021
assessment , there's towards the end

01:03:18.021 --> 01:03:20.021
there's a text box where you can uh

01:03:20.021 --> 01:03:22.132
pretext any information . If you free

01:03:22.132 --> 01:03:24.187
text in there that you have concerns

01:03:24.187 --> 01:03:26.132
about your environment or specific

01:03:26.132 --> 01:03:28.354
things that automatically gets added to

01:03:28.354 --> 01:03:30.576
your record when you do that assessment

01:03:30.576 --> 01:03:32.576
so . Just two things we continue to

01:03:32.576 --> 01:03:34.854
want you to engage with your providers ,

01:03:34.854 --> 01:03:36.465
do a face to face , uh , PHA

01:03:36.465 --> 01:03:38.521
appointment if you desire to do so ,

01:03:38.521 --> 01:03:41.004
but , uh , manage that portion in just

01:03:41.004 --> 01:03:43.171
another way for you to document that .

01:03:43.245 --> 01:03:44.967
You have a record of it and it

01:03:44.967 --> 01:03:47.189
automatically feeds into your , to your

01:03:47.189 --> 01:03:50.850
medical records . All right , uh , and ,

01:03:50.860 --> 01:03:52.810
uh , a follow up to that , uh ,

01:03:52.830 --> 01:03:54.941
hopefully able to address quickly for

01:03:54.941 --> 01:03:57.108
separated members who no longer have a

01:03:57.108 --> 01:03:59.052
military PCM , what should they be

01:03:59.052 --> 01:04:01.219
saying to say Veterans Affairs members

01:04:01.219 --> 01:04:03.219
about their concerns and how should

01:04:03.219 --> 01:04:05.389
they , uh , use the memorandum over ?

01:04:08.800 --> 01:04:11.078
So , uh , again , this is Carl Coleman ,

01:04:11.078 --> 01:04:12.911
uh , and again thank you for the

01:04:12.911 --> 01:04:15.022
question we designed that , um , uh ,

01:04:15.022 --> 01:04:17.133
PCB memo for you to download and take

01:04:17.133 --> 01:04:19.300
to your provider to be able to explain

01:04:19.300 --> 01:04:21.244
them the environment that you were

01:04:21.244 --> 01:04:23.300
working in and that this was a known

01:04:23.300 --> 01:04:25.522
hazard in that environment . So again ,

01:04:25.522 --> 01:04:27.522
take that documentation , have that

01:04:27.522 --> 01:04:29.411
added to your , to your record as

01:04:29.411 --> 01:04:31.133
you're having those individual

01:04:31.133 --> 01:04:33.133
discussions uh with your uh primary

01:04:33.133 --> 01:04:35.500
care physician . Alright , thank you ,

01:04:35.540 --> 01:04:37.580
sir . Uh , next question is a

01:04:37.580 --> 01:04:40.139
methodology question and it's asking

01:04:40.139 --> 01:04:43.419
about the different AFSCs and how they

01:04:43.419 --> 01:04:45.641
were binned as part of this study . One

01:04:45.641 --> 01:04:47.752
of the slides showed the , the larger

01:04:47.752 --> 01:04:50.939
group of 65,000 or so missile related

01:04:50.939 --> 01:04:52.883
career fields and then the smaller

01:04:52.883 --> 01:04:54.939
group of actual missileers . Uh , is

01:04:54.939 --> 01:04:56.939
there a reason the study is binning

01:04:56.939 --> 01:04:59.106
them in that method , and is there any

01:04:59.106 --> 01:05:01.272
way of looking at particular exposures

01:05:01.272 --> 01:05:03.495
that certain career fields may have had

01:05:03.495 --> 01:05:05.699
over ? Thank you , this is , this is

01:05:05.699 --> 01:05:07.643
Doctor Beam again . Uh , that's an

01:05:07.643 --> 01:05:09.699
excellent question . Uh , so when we

01:05:09.699 --> 01:05:11.810
looked at the whole missile community

01:05:11.810 --> 01:05:13.643
as a , as a whole , we wanted to

01:05:13.643 --> 01:05:15.810
capture , uh , a , uh , or cast a very

01:05:15.810 --> 01:05:17.810
wide net and capture as many , uh ,

01:05:17.810 --> 01:05:19.921
personnel who might have been exposed

01:05:19.921 --> 01:05:22.143
to , to any of the locations , um , you

01:05:22.143 --> 01:05:24.088
know , associated with the missile

01:05:24.088 --> 01:05:26.421
community , so , um . So we , we have a ,

01:05:26.421 --> 01:05:28.366
uh , uh , uh , a list of 100 or so

01:05:28.366 --> 01:05:30.570
AFSCs , uh , that we have validated ,

01:05:30.679 --> 01:05:32.901
uh , through Global Strike Command 20th

01:05:32.901 --> 01:05:35.235
Air Force , uh , through the historians .

01:05:35.235 --> 01:05:37.457
You read through hundreds of pages of ,

01:05:37.457 --> 01:05:39.568
um , uh , position descriptions and ,

01:05:39.568 --> 01:05:41.401
and , uh , and , and , and other

01:05:41.401 --> 01:05:43.623
documents that helped us to refine this

01:05:43.623 --> 01:05:45.735
list , um . And then based on those ,

01:05:45.735 --> 01:05:48.320
uh , on , on those on that list of

01:05:48.320 --> 01:05:51.679
AFSCs we identified uh which locations ,

01:05:51.760 --> 01:05:54.280
which of the four exposure locations uh

01:05:54.280 --> 01:05:56.280
that that they would have come into

01:05:56.280 --> 01:05:58.224
contact with whether um you know ,

01:05:58.224 --> 01:06:00.447
isolated to the the uh the the the math

01:06:00.447 --> 01:06:03.294
or or the . CC or uh launch facility

01:06:03.294 --> 01:06:05.461
topside or launch facility underground

01:06:05.774 --> 01:06:07.718
and uh and and so that's how we've

01:06:07.718 --> 01:06:09.885
broken down those those uh or or bin I

01:06:09.885 --> 01:06:12.107
think that the word you used was that's

01:06:12.107 --> 01:06:14.330
how we've been those AFSCs for now just

01:06:14.330 --> 01:06:16.415
uh just the locations uh that they

01:06:16.415 --> 01:06:18.639
would have come into contact with . And

01:06:18.639 --> 01:06:20.870
um during this phase of the analysis we

01:06:20.870 --> 01:06:24.350
um we we went through those um those

01:06:24.360 --> 01:06:27.600
those various um various exposure

01:06:27.600 --> 01:06:30.000
groups we uh we , we performed those

01:06:30.000 --> 01:06:32.056
individual analysis on each exposure

01:06:32.056 --> 01:06:34.222
category uh comparing the instances of

01:06:34.222 --> 01:06:36.111
each cancer , uh , in each , uh ,

01:06:36.111 --> 01:06:38.222
missile community exposure category ,

01:06:38.222 --> 01:06:39.944
uh , to both their non-exposed

01:06:39.944 --> 01:06:41.889
counterparts and to the general US

01:06:41.889 --> 01:06:44.000
population . Uh , you're doing this ,

01:06:44.000 --> 01:06:46.167
this phase , the , uh , these analysis

01:06:46.167 --> 01:06:47.889
did not show any statistically

01:06:47.889 --> 01:06:50.000
significant increase in cancer in any

01:06:50.000 --> 01:06:49.989
of the missile community exposure

01:06:49.989 --> 01:06:52.100
groups . Uh , however , some of the ,

01:06:52.120 --> 01:06:54.453
those analyses were , were underpowered ,

01:06:54.453 --> 01:06:56.787
just meaning that more more data points ,

01:06:56.787 --> 01:06:58.676
uh , are still needed . So , uh ,

01:06:58.676 --> 01:07:00.676
additional data from phase two will

01:07:00.676 --> 01:07:02.898
help to solidify our understanding of ,

01:07:02.898 --> 01:07:04.898
uh , of cancer risk in those , uh ,

01:07:04.898 --> 01:07:06.842
exposure groups and in the missile

01:07:06.842 --> 01:07:09.064
community overall . I hope that answers

01:07:09.064 --> 01:07:11.330
the question . Thank you , sir . Uh ,

01:07:11.469 --> 01:07:13.802
next question relates to the facilities .

01:07:14.070 --> 01:07:17.149
Uh , they heard today that the PCBs and

01:07:17.149 --> 01:07:19.469
the LCCs are being mitigated and

01:07:19.469 --> 01:07:21.699
cleaned . Uh , those are two separate

01:07:21.699 --> 01:07:24.590
things . Uh , are PCBs being mitigated

01:07:24.590 --> 01:07:26.812
in the sense that their source is being

01:07:26.812 --> 01:07:29.709
removed from the equipment , or is the

01:07:29.709 --> 01:07:32.820
simple spillage being wiped up and , uh ,

01:07:32.830 --> 01:07:33.830
cleaned up over ?

01:07:37.340 --> 01:07:39.919
So this is Mr . Miller from a4 , in the

01:07:39.919 --> 01:07:42.340
instances where we have PCBs present ,

01:07:42.360 --> 01:07:45.080
the , the first step is to contain and

01:07:45.080 --> 01:07:48.070
clean , and then any component that is

01:07:48.070 --> 01:07:50.479
exposing , you know , PCBs to the

01:07:50.479 --> 01:07:52.320
environment would be removed and

01:07:52.320 --> 01:07:53.320
replaced .

01:07:58.229 --> 01:08:01.459
Thank you , sir . Uh , next question is ,

01:08:01.550 --> 01:08:03.590
uh , again , going back to some

01:08:03.590 --> 01:08:05.423
spillages that are known to have

01:08:05.423 --> 01:08:07.830
occurred in the past . Uh , there was a

01:08:07.830 --> 01:08:10.750
study that found , uh , what are said

01:08:10.750 --> 01:08:13.060
to be abnormally high levels of radon .

01:08:13.409 --> 01:08:15.810
In the facilities , uh , and that these

01:08:15.810 --> 01:08:17.643
results may have been discounted

01:08:17.643 --> 01:08:19.032
because they were , uh ,

01:08:19.032 --> 01:08:20.866
unrealistically high . Is anyone

01:08:20.866 --> 01:08:23.088
familiar with those studies , uh , what

01:08:23.088 --> 01:08:25.143
their outcome was , and if there are

01:08:25.143 --> 01:08:27.366
any new results regarding radon testing

01:08:27.366 --> 01:08:29.199
in the facilities as part of the

01:08:29.199 --> 01:08:32.229
current study over ? Uh ,

01:08:33.810 --> 01:08:36.589
I'm sorry , that , sir . No , uh , you ,

01:08:37.009 --> 01:08:39.819
this is in your area , so go ahead . OK ,

01:08:39.970 --> 01:08:42.529
so , um , as far as the radon sampling

01:08:42.529 --> 01:08:44.950
during these 3 rounds , uh , we did

01:08:44.950 --> 01:08:48.640
sample all 45 masks for over 270 days .

01:08:49.129 --> 01:08:51.390
We also uh sampled 4 facilities at

01:08:51.390 --> 01:08:54.569
Vandenberg with 5 facilities at uh Hill

01:08:54.569 --> 01:08:57.048
Air Force Base . Um , we did sample ,

01:08:57.219 --> 01:08:59.275
uh , a quite , um , a long period of

01:08:59.275 --> 01:09:01.449
time to get a very sufficient database

01:09:01.449 --> 01:09:03.560
as far as , uh , what radon exposures

01:09:03.560 --> 01:09:05.938
would go , and we , uh , the results of

01:09:05.938 --> 01:09:08.160
these have indicated that they are well

01:09:08.160 --> 01:09:10.327
below , uh , the annual exposure limit

01:09:10.327 --> 01:09:12.271
as well as the facility mitigation

01:09:12.271 --> 01:09:14.438
threshold in accordance with Chapter 9

01:09:14.438 --> 01:09:17.019
or chapter 7 of AFM 48 148 .

01:09:19.819 --> 01:09:22.419
Yeah , so , um , our current testing

01:09:22.419 --> 01:09:24.700
under this , under these protocols have

01:09:24.700 --> 01:09:27.819
not revealed any increased radon in any

01:09:27.819 --> 01:09:30.299
of our facilities . If somebody out

01:09:30.299 --> 01:09:33.899
there has information on

01:09:33.899 --> 01:09:36.169
a report somewhere , which we don't ,

01:09:36.740 --> 01:09:38.819
uh , we don't believe our historical

01:09:38.819 --> 01:09:42.089
records will , will capture that , um ,

01:09:42.100 --> 01:09:44.433
but if you , if you have a pointer that ,

01:09:44.433 --> 01:09:46.620
uh , there's a report from a specific

01:09:46.620 --> 01:09:49.299
year group at a specific location .

01:09:49.830 --> 01:09:51.886
Then we welcome that , but we're not

01:09:51.886 --> 01:09:53.052
tracking that here .

01:09:56.109 --> 01:09:58.276
Thank you , sir . Uh , we have another

01:09:58.276 --> 01:10:00.387
question on , uh , methodology . This

01:10:00.387 --> 01:10:03.160
one is about , uh , was there any

01:10:03.160 --> 01:10:05.750
attempt to uh examine the results

01:10:05.750 --> 01:10:07.917
within the missile career fields based

01:10:07.917 --> 01:10:10.430
on their location ? That is , were

01:10:10.430 --> 01:10:12.486
results from say Malmstrom different

01:10:12.486 --> 01:10:15.109
from results at FE Warren or Minot or

01:10:15.109 --> 01:10:18.549
some of the historical sites over ? Hey ,

01:10:18.589 --> 01:10:20.422
this is Doctor Beam again , um ,

01:10:20.422 --> 01:10:22.422
current physician on the EP consult

01:10:22.422 --> 01:10:24.533
service . So , uh , so that that is ,

01:10:24.533 --> 01:10:26.589
um , is planned , uh , to be done at

01:10:26.589 --> 01:10:28.811
the completion of , of , of phase two ,

01:10:28.811 --> 01:10:30.922
once we have a , a full data set that

01:10:30.922 --> 01:10:33.729
is as complete as we can make it , um ,

01:10:33.950 --> 01:10:36.172
you know , that includes the , the four

01:10:36.172 --> 01:10:38.172
databases that . We have already uh

01:10:38.172 --> 01:10:40.604
analyzed for uh for uh phase one Bravo

01:10:41.004 --> 01:10:43.171
and , uh , and then we will add uh all

01:10:43.171 --> 01:10:45.060
of the cancer registries from the

01:10:45.060 --> 01:10:47.226
participating states uh in the virtual

01:10:47.226 --> 01:10:49.448
cold registry that's like that's that's

01:10:49.448 --> 01:10:51.671
44 additional , um , you know , state ,

01:10:51.671 --> 01:10:53.893
uh state and regional cancer registries

01:10:53.893 --> 01:10:56.004
that will be added during phase two ,

01:10:56.004 --> 01:10:58.171
so once we have that complete data set

01:10:58.171 --> 01:10:58.084
then we , uh , we can kind of slice and

01:10:58.084 --> 01:11:00.165
dice , uh , different ways over .

01:11:02.310 --> 01:11:04.254
Yeah , but correct me , I'm saying

01:11:04.254 --> 01:11:06.477
we're not gonna be able to go to closed

01:11:06.477 --> 01:11:09.540
and and analyze any closed uh . Um ,

01:11:10.660 --> 01:11:13.020
Evaluate or analyze any closed missile

01:11:13.020 --> 01:11:16.060
wings or facilities , uh , because I'm

01:11:16.060 --> 01:11:18.004
pretty sure the cancer data is not

01:11:18.004 --> 01:11:21.259
gonna be specific to a wing or a

01:11:21.259 --> 01:11:22.870
location , is that correct ?

01:11:25.209 --> 01:11:27.376
We're , we're working through the AFPC

01:11:27.376 --> 01:11:29.209
data , uh , to see what level of

01:11:29.209 --> 01:11:31.320
granularity , uh , and , and all that

01:11:31.320 --> 01:11:32.987
we have on , uh , on , on the

01:11:32.987 --> 01:11:35.153
assignments , um , but , uh , but it ,

01:11:35.153 --> 01:11:37.209
it , it might be difficult for bases

01:11:37.209 --> 01:11:39.431
that , uh , that have been long close .

01:11:39.431 --> 01:11:41.487
OK , so TBD whether that level of uh

01:11:41.487 --> 01:11:43.870
data fidelity exists . Yes sir , uh ,

01:11:43.950 --> 01:11:46.172
and , and also with the , uh , with the

01:11:46.172 --> 01:11:48.117
rotation through the , the various

01:11:48.117 --> 01:11:50.283
spaces , um , you know , identifying ,

01:11:50.283 --> 01:11:52.172
um , you know , a particular base

01:11:52.172 --> 01:11:54.450
versus if , if there are multiple , um ,

01:11:54.450 --> 01:11:56.561
multi multiple bases that they were ,

01:11:56.561 --> 01:11:58.672
uh , stationed at , uh , makes that a

01:11:58.672 --> 01:12:01.006
little bit difficult , but , uh , we're ,

01:12:01.006 --> 01:12:00.160
we're gonna work with our , um , our ,

01:12:00.189 --> 01:12:02.300
our dedicated external partners for ,

01:12:02.310 --> 01:12:04.709
uh , for phase two to , , to , to , ,

01:12:05.390 --> 01:12:07.446
get the most scientifically rigorous

01:12:07.446 --> 01:12:09.612
way of working that out so that we can

01:12:09.612 --> 01:12:11.834
answer this question as that as best we

01:12:11.834 --> 01:12:14.939
can with the data that we have . All

01:12:14.939 --> 01:12:17.299
right , thank you , sir . Uh , next

01:12:17.299 --> 01:12:19.299
question is , and this is more of a

01:12:19.299 --> 01:12:21.410
recommendation than a question , it's

01:12:21.410 --> 01:12:23.689
asking , would it be possible to , uh ,

01:12:23.700 --> 01:12:25.589
publish a road , an environmental

01:12:25.589 --> 01:12:29.259
hazard roadmap or a repository listing

01:12:29.259 --> 01:12:31.426
all of the known environmental hazards

01:12:31.426 --> 01:12:34.009
such as uh major PCB spills , leaks ,

01:12:34.339 --> 01:12:36.450
contamination , underground storage ,

01:12:36.450 --> 01:12:38.561
plumes , etc . that are known to have

01:12:38.561 --> 01:12:40.970
occurred at the uh launch facilities

01:12:41.299 --> 01:12:42.743
over their history over .

01:12:48.779 --> 01:12:51.359
I don't know . I'm not sure we have

01:12:51.359 --> 01:12:54.810
that level of data , but we , we , we ,

01:12:55.319 --> 01:12:58.759
we'll , uh , ask the question , um .

01:13:00.720 --> 01:13:02.720
The way I understand the question ,

01:13:02.720 --> 01:13:05.299
John , is , is , is there kind of a , a

01:13:05.299 --> 01:13:07.299
historical record where there might

01:13:07.299 --> 01:13:10.850
have been a fuel spill or a uh

01:13:11.259 --> 01:13:14.500
uh uh previous PCP uh uh

01:13:14.500 --> 01:13:17.660
determination , um , or radon

01:13:17.660 --> 01:13:19.827
determination from uh either a current

01:13:19.827 --> 01:13:22.379
or previous uh missile wing . I'm not

01:13:22.379 --> 01:13:25.180
sure that data exists , but we will uh

01:13:25.180 --> 01:13:27.402
we will uh pull the thread on it over .

01:13:28.399 --> 01:13:30.640
Yes , sir , thank you . Uh , and I

01:13:30.640 --> 01:13:32.751
think this is the final question that

01:13:32.751 --> 01:13:34.973
we will have time for today , and again

01:13:34.973 --> 01:13:36.696
it kind of goes back to , uh ,

01:13:36.696 --> 01:13:38.918
remediation levels . Understanding that

01:13:38.918 --> 01:13:41.196
they are different for each of the sam ,

01:13:41.196 --> 01:13:43.529
the , uh , hazards that were tested for ,

01:13:43.529 --> 01:13:45.580
how are we deriving what the safe

01:13:45.580 --> 01:13:49.520
levels are , uh , and what are those uh

01:13:49.520 --> 01:13:51.464
safe levels if it can be described

01:13:51.464 --> 01:13:52.464
succinctly over .

01:13:56.509 --> 01:13:58.509
Um , during the reports we used the

01:13:58.509 --> 01:14:00.509
health screening value based on the

01:14:00.509 --> 01:14:02.231
occupational Safety and Health

01:14:02.231 --> 01:14:04.231
Administration permissible exposure

01:14:04.231 --> 01:14:06.120
limit for an 8 hour time weighted

01:14:06.120 --> 01:14:08.479
average . Um , we are now moving to ,

01:14:08.509 --> 01:14:10.342
uh , the final report which will

01:14:10.470 --> 01:14:12.581
incorporate health screening levels .

01:14:12.581 --> 01:14:14.637
What our plan on this is to find the

01:14:14.637 --> 01:14:16.803
most conservative , yet scientifically

01:14:16.803 --> 01:14:18.970
supported standard , uh , from federal

01:14:18.970 --> 01:14:21.026
and state levels , and those will be

01:14:21.026 --> 01:14:23.137
the levels that we adopt in the final

01:14:23.137 --> 01:14:26.680
health risk assessment over . So let me ,

01:14:26.799 --> 01:14:28.910
let me ask you a question , Mr . Carl

01:14:28.910 --> 01:14:31.188
Coleman , um , to what you just stated .

01:14:31.188 --> 01:14:33.355
I know that we look at often the eight

01:14:33.355 --> 01:14:36.120
hour time domain , uh , but when we

01:14:36.120 --> 01:14:38.549
look at that in the , as it's explained

01:14:38.839 --> 01:14:41.120
that also accounts for a 40 hour work

01:14:41.120 --> 01:14:43.640
week over the lifetime of somebody's

01:14:43.640 --> 01:14:45.918
working , uh , over a working lifetime .

01:14:46.080 --> 01:14:48.247
So as we've done the analysis , and we

01:14:48.247 --> 01:14:50.419
also not looked at on average the

01:14:50.419 --> 01:14:52.979
amount of hours that a uh maintainer or

01:14:52.979 --> 01:14:55.146
missileer would be in that environment

01:14:55.146 --> 01:14:57.090
and , and , and levels set against

01:14:57.090 --> 01:14:59.689
those to balance the exposure risk .

01:15:01.509 --> 01:15:03.787
Yes sir , we have , um , we've adopted ,

01:15:03.787 --> 01:15:05.620
uh , procedures from , uh , the

01:15:05.620 --> 01:15:07.509
American Conference of Government

01:15:07.509 --> 01:15:09.564
Industrial Hygienists as well as the

01:15:09.564 --> 01:15:09.299
Occupational Safety and Health

01:15:09.299 --> 01:15:11.521
Administration . Um , one thing to take

01:15:11.521 --> 01:15:13.299
note that these limits that are

01:15:13.299 --> 01:15:15.243
published by these agencies do not

01:15:15.243 --> 01:15:17.466
dictate what is , uh , acutely safe and

01:15:17.466 --> 01:15:19.790
hazardous or versus , uh , hazardous .

01:15:20.180 --> 01:15:21.958
um , these reports are based on

01:15:21.958 --> 01:15:24.069
exposure limits derived from national

01:15:24.069 --> 01:15:26.220
consensus standards and recognized

01:15:26.220 --> 01:15:29.069
federal standards , um . Although

01:15:29.069 --> 01:15:31.180
adjustment calculations are available

01:15:31.180 --> 01:15:33.439
to correlate an 8 hour exposure to

01:15:33.439 --> 01:15:35.750
extended work periods , OSHA only

01:15:35.750 --> 01:15:38.180
endorses this method under two ,

01:15:38.790 --> 01:15:40.901
specific , uh , standards , and those

01:15:40.901 --> 01:15:42.939
are both related to lead exposure .

01:15:43.629 --> 01:15:45.740
Whenever you're dealing with extended

01:15:45.740 --> 01:15:47.573
work periods , OSHA endorses two

01:15:47.573 --> 01:15:49.796
methods of evaluation . The first is to

01:15:49.796 --> 01:15:52.018
sample the worst continuous 8 hour work

01:15:52.018 --> 01:15:54.185
period of an entire work shift or of a

01:15:54.185 --> 01:15:56.018
work shift . And the other is to

01:15:56.018 --> 01:15:58.073
collect multiple uh samples over the

01:15:58.073 --> 01:16:00.240
entire work shift , which will include

01:16:00.240 --> 01:16:02.240
the entire work period . During the

01:16:02.240 --> 01:16:04.549
MCCS we employed uh sampling the first

01:16:04.549 --> 01:16:07.040
continuous eight hour work period . We

01:16:07.040 --> 01:16:08.873
only uh just we only found trace

01:16:08.873 --> 01:16:11.160
amounts of BOCs that were detected uh

01:16:11.160 --> 01:16:13.493
all below the uh health screening value .

01:16:14.290 --> 01:16:16.512
When comparing these uh detections to a

01:16:16.512 --> 01:16:18.568
respected 8 hour exposure limit , we

01:16:18.568 --> 01:16:20.679
observe these levels to be well below

01:16:20.679 --> 01:16:22.901
30% of the preliminary health screening

01:16:22.901 --> 01:16:25.123
values and and often many times lower .

01:16:25.123 --> 01:16:27.179
So under this standard of uh very uh

01:16:27.179 --> 01:16:29.089
minor levels , we've come to the

01:16:29.089 --> 01:16:31.256
conclusion that the conditions that we

01:16:31.256 --> 01:16:33.200
sample during an 8 hour period are

01:16:33.200 --> 01:16:35.033
actually conducive for a 24 hour

01:16:35.033 --> 01:16:36.311
extended work period .

01:16:38.939 --> 01:16:42.899
Thank you . All right , that brings

01:16:42.899 --> 01:16:46.259
us to 75 minutes , uh , as a reminder

01:16:46.259 --> 01:16:48.370
for anyone whose questions we did not

01:16:48.370 --> 01:16:50.537
get to , we will compile those as best

01:16:50.537 --> 01:16:52.426
we can and get them posted on the

01:16:52.426 --> 01:16:54.720
Missile Community Cancer website , uh ,

01:16:54.729 --> 01:16:56.562
just as soon as we can get those

01:16:56.562 --> 01:16:58.785
answers those questions answered . Uh ,

01:16:58.819 --> 01:17:01.089
these slides will also be posted on the

01:17:01.089 --> 01:17:03.200
website as of tomorrow morning . Uh ,

01:17:03.200 --> 01:17:05.311
General Bussier , over to you for any

01:17:05.311 --> 01:17:09.160
closing comments over . Thanks

01:17:09.160 --> 01:17:11.700
John . Um , Stacy Joe , do you have any

01:17:11.700 --> 01:17:13.922
uh comments you wanna make to the group

01:17:13.922 --> 01:17:14.922
before we close ?

01:17:17.950 --> 01:17:19.950
No , sorry , I don't . Thank you so

01:17:19.950 --> 01:17:22.172
much . Thanks to your team and the UEFA

01:17:22.172 --> 01:17:24.450
team . I really appreciate it . Thanks ,

01:17:24.450 --> 01:17:26.617
Stacey Joe . Um , to those that , uh ,

01:17:26.617 --> 01:17:28.728
again , I'll echo , uh , Stacey Joe's

01:17:28.728 --> 01:17:31.209
thanks to , uh , Yousaf Sam and , and ,

01:17:31.220 --> 01:17:33.870
uh , your continued , uh , efforts

01:17:33.879 --> 01:17:35.879
along the studies as well as , uh ,

01:17:35.979 --> 01:17:38.146
Greg Coleman's team in here , uh , and

01:17:38.146 --> 01:17:40.257
Matt's team and A for everyone that's

01:17:40.257 --> 01:17:42.257
working together , uh , to get this

01:17:42.257 --> 01:17:44.423
done . Uh , there's a lot more work to

01:17:44.423 --> 01:17:46.479
do . Uh , we will continue to , uh ,

01:17:46.479 --> 01:17:48.646
keep you informed . I would ask if you

01:17:48.646 --> 01:17:51.200
have a question or concern to send it

01:17:51.200 --> 01:17:53.311
in , and if you don't get an answer ,

01:17:53.439 --> 01:17:57.009
come up frequency . OK , if you're not

01:17:57.009 --> 01:17:59.930
getting an answer , call . Um , we're

01:17:59.930 --> 01:18:01.986
gonna go back and pull the questions

01:18:01.986 --> 01:18:03.986
from the last , uh , town hall that

01:18:03.986 --> 01:18:05.986
were , were pushed in , and then we

01:18:05.986 --> 01:18:08.009
will take those and , and obviously

01:18:08.009 --> 01:18:10.065
members that put them in did not get

01:18:10.065 --> 01:18:12.065
the their responses . So we'll just

01:18:12.065 --> 01:18:14.330
post those uh questions and responses

01:18:14.330 --> 01:18:16.640
onto our portal from the last town hall

01:18:16.970 --> 01:18:19.729
that somehow got lost in the , in the

01:18:19.729 --> 01:18:22.649
technology world , um . Again , thanks ,

01:18:22.770 --> 01:18:24.770
thanks for everyone's uh interest .

01:18:24.770 --> 01:18:26.970
Thanks for your efforts to uh uh keep

01:18:26.970 --> 01:18:29.192
this on the , on the front burner , and

01:18:29.192 --> 01:18:31.414
uh we'll keep you informed as the study

01:18:31.414 --> 01:18:34.779
continues . Thank you . Uh , sir , if ,

01:18:34.810 --> 01:18:37.669
uh , we have a moment , Dan Holmes is ,

01:18:37.750 --> 01:18:39.972
uh , on and has a question for us . I'm

01:18:39.972 --> 01:18:41.917
gonna go ahead and unmute him . Go

01:18:41.917 --> 01:18:41.549
ahead , Dan .

01:18:54.049 --> 01:18:56.105
Dan , you should be able to ask your

01:18:56.105 --> 01:18:57.105
question now .

01:19:03.439 --> 01:19:06.430
All right . No heard from Dan . OK , um ,

01:19:06.589 --> 01:19:10.100
Jean Busier , you know me , I . OK , OK ,

01:19:10.140 --> 01:19:12.362
I'm Dan Holmes . Uh , I was a messenger

01:19:12.362 --> 01:19:14.529
in Titan 2 weapons systems . Am I on ?

01:19:16.439 --> 01:19:19.740
Have you loud and clear , Dan . OK . I

01:19:19.740 --> 01:19:21.907
was a missileer in the Titan II weapon

01:19:21.907 --> 01:19:24.520
system at Little Rock back in the 70s ,

01:19:24.850 --> 01:19:26.569
and I retired as an Air Force

01:19:26.569 --> 01:19:29.209
lieutenant colonel after 20 years , and

01:19:29.209 --> 01:19:31.320
I'm the father of Mark Holmes , Major

01:19:31.320 --> 01:19:33.542
Mark Holmes , who died of non-Hodgkin's

01:19:33.542 --> 01:19:37.169
lymphoma in May of 2020 . And uh I had

01:19:37.169 --> 01:19:39.589
a series of questions , but I'll just

01:19:39.890 --> 01:19:43.890
cut right to the chase . Um A friend

01:19:43.890 --> 01:19:46.520
of Danny Se Becks , an Air Force major

01:19:46.520 --> 01:19:48.600
who's a lawyer stationed in Colorado

01:19:48.600 --> 01:19:50.649
Springs and is a member of the

01:19:50.649 --> 01:19:53.250
Torchlight Initiative , stepped up and

01:19:53.250 --> 01:19:55.220
came alongside Jenny , my

01:19:55.220 --> 01:19:57.770
daughter-in-law , to help her appeal

01:19:57.770 --> 01:20:00.970
her latest VA claim , which was denied

01:20:00.970 --> 01:20:04.009
back in March , and we were told that

01:20:04.009 --> 01:20:06.120
this appeal could take another year .

01:20:06.120 --> 01:20:08.231
It took already 15 months before they

01:20:08.490 --> 01:20:11.839
decided to uh deny that claim . While

01:20:11.839 --> 01:20:14.061
helping her with this paperwork for her

01:20:14.061 --> 01:20:16.540
appeal , Aaron had an aha moment , and

01:20:16.540 --> 01:20:18.759
he remembered that while an intern to

01:20:18.759 --> 01:20:20.926
become an Air Force lawyer , he worked

01:20:20.926 --> 01:20:22.703
on what's called a line of duty

01:20:22.703 --> 01:20:24.648
determination , where if a service

01:20:24.648 --> 01:20:26.759
member's death is determined to be in

01:20:26.759 --> 01:20:28.799
the line of duty that the deceased

01:20:28.799 --> 01:20:30.919
family members would be entitled to

01:20:30.919 --> 01:20:32.975
full benefits just as if the service

01:20:32.975 --> 01:20:35.270
member died on active duty . He

01:20:35.270 --> 01:20:36.937
wondered why the line of duty

01:20:36.937 --> 01:20:39.549
determination was never done by Mark's

01:20:39.549 --> 01:20:41.899
active reserve squadron at Schriever ,

01:20:42.310 --> 01:20:44.532
of which he was a member at the time of

01:20:44.532 --> 01:20:46.643
his death . So he initiated a line of

01:20:46.643 --> 01:20:48.870
duty determination , submitted it to

01:20:48.870 --> 01:20:51.092
the reserve squadron there at Schriever

01:20:51.092 --> 01:20:53.470
just a couple months ago . This was

01:20:53.470 --> 01:20:55.790
approved within days , probably less

01:20:55.790 --> 01:20:58.109
than a week , by medical , the group

01:20:58.109 --> 01:21:00.053
commander , and the wing commander

01:21:00.053 --> 01:21:02.109
there at Schriever . But then it was

01:21:02.109 --> 01:21:04.109
sent to the higher ups at Air Force

01:21:04.109 --> 01:21:06.331
Reserve headquarters at Warner Robins ,

01:21:06.331 --> 01:21:09.299
where it was denied . So after pulling

01:21:09.299 --> 01:21:12.950
over 300 alerts , which is over 7200

01:21:12.950 --> 01:21:15.750
hours below ground in the LCCs in a

01:21:15.750 --> 01:21:19.589
four-year period from 2007 to 2011

01:21:19.589 --> 01:21:22.109
at Malmstrom , my son's death was

01:21:22.109 --> 01:21:26.069
determined . To be not service related

01:21:26.069 --> 01:21:29.479
by the VA and not to be in the line of

01:21:29.479 --> 01:21:32.770
duty by the Air Force . Mark died in

01:21:32.770 --> 01:21:34.770
the service of his country , but in

01:21:34.770 --> 01:21:36.770
addition to fighting this gutless ,

01:21:36.770 --> 01:21:39.330
soulless , heartless bureaucracy that

01:21:39.330 --> 01:21:43.089
is the VA for 3 years now , now it

01:21:43.089 --> 01:21:45.370
appears to our family that the Air

01:21:45.370 --> 01:21:47.890
Force , my Air Force , doesn't care

01:21:47.890 --> 01:21:51.839
either . John Busier has commanded his

01:21:51.839 --> 01:21:53.919
leadership to treat , to treat their

01:21:53.919 --> 01:21:56.290
troops as if they were their own son or

01:21:56.290 --> 01:21:58.970
daughter . When is somebody sitting

01:21:58.970 --> 01:22:01.410
around that table there at Barksdale

01:22:01.410 --> 01:22:03.850
gonna treat Mark Holmes as if he were

01:22:03.850 --> 01:22:07.169
your son ? And have the balls enough to

01:22:07.169 --> 01:22:09.640
pick up the phone and contact the VA

01:22:09.640 --> 01:22:12.250
and find out who's evaluating and

01:22:12.250 --> 01:22:15.049
processing Jenny's claim . Any one of

01:22:15.049 --> 01:22:17.216
you can call me after this town hall ,

01:22:17.216 --> 01:22:18.993
and I'll give you Mark's social

01:22:18.993 --> 01:22:21.160
security number , which is the same as

01:22:21.160 --> 01:22:23.271
Jenny's VA claim number . You can get

01:22:23.271 --> 01:22:25.271
my phone number from General Busier

01:22:25.271 --> 01:22:27.549
like I said , I emailed him months ago ,

01:22:27.549 --> 01:22:29.729
and he immediately emailed me back and

01:22:29.729 --> 01:22:32.169
then Tom called me on the phone the

01:22:32.169 --> 01:22:34.225
next day , so he has my phone number

01:22:34.225 --> 01:22:36.750
and my email address . When is somebody

01:22:36.750 --> 01:22:38.972
gonna pick up the phone and call Warner

01:22:38.972 --> 01:22:41.149
Robins and find out why they denied

01:22:41.149 --> 01:22:43.950
Mark's line of duty determination ? I

01:22:43.950 --> 01:22:46.228
mean , I make these phone calls myself .

01:22:46.228 --> 01:22:48.450
I thought it would do any good . I'm 74

01:22:48.450 --> 01:22:50.740
years old . I don't care who I off

01:22:50.740 --> 01:22:54.020
anymore , but what do , do I have to do ?

01:22:54.310 --> 01:22:56.669
I mean , I've already lost , what ,

01:22:56.709 --> 01:22:58.931
what , what more do I have to lose that

01:22:58.931 --> 01:23:01.410
I haven't already lost ? I just like

01:23:01.410 --> 01:23:03.632
somebody to do the right thing to reach

01:23:03.632 --> 01:23:06.640
out to Jenny Holmes and her and Mark's

01:23:06.640 --> 01:23:09.399
3 children there in Colorado Springs

01:23:09.399 --> 01:23:11.930
and start treating them like an Air

01:23:11.930 --> 01:23:15.009
Force family . That's all I have to say .

01:23:15.049 --> 01:23:17.470
I'm done , thank you . Hey Dan , thank ,

01:23:17.509 --> 01:23:19.731
thanks for that . I wasn't tracking the

01:23:19.731 --> 01:23:22.430
uh the letter , um , so , uh , I'll ,

01:23:22.549 --> 01:23:25.259
I'll look into that and uh and get back

01:23:25.259 --> 01:23:27.790
to you . Um , I'm not sure if there's

01:23:27.790 --> 01:23:29.709
anybody from the VA that wants to

01:23:29.709 --> 01:23:31.376
respond , that's on the net .

01:23:35.140 --> 01:23:38.040
Uh , sir , I am showing , I believe

01:23:38.040 --> 01:23:39.318
it's Doctor Hastings .

01:23:42.500 --> 01:23:46.160
Doctor Hastings . Unmute .

01:23:48.870 --> 01:23:52.040
I am off mute . Um , OK , can't , it

01:23:52.040 --> 01:23:54.151
says I can't start my video , but are

01:23:54.151 --> 01:23:56.373
you able to hear me ? I , I do have you

01:23:56.373 --> 01:23:58.707
loud and clear , Doctor Hastings . Sure .

01:23:58.707 --> 01:24:00.540
Um , I was going to call Colonel

01:24:00.540 --> 01:24:02.707
Coleman after this . We've worked very

01:24:02.707 --> 01:24:06.120
closely and I can talk to VBA and see

01:24:06.120 --> 01:24:09.200
um what the determination was and uh

01:24:09.200 --> 01:24:11.256
how the determination was made , and

01:24:11.256 --> 01:24:13.033
I'd be happy to share that . In

01:24:13.033 --> 01:24:14.311
Moreland . Thank you .

01:24:19.850 --> 01:24:22.250
All right , sir , uh , I appreciate the

01:24:22.250 --> 01:24:24.361
extended time there . Uh , as noted ,

01:24:24.361 --> 01:24:26.361
we will post these slides online as

01:24:26.361 --> 01:24:28.194
well as additional questions and

01:24:28.194 --> 01:24:30.139
answers as we are able to get them

01:24:30.139 --> 01:24:32.472
answered . I appreciate everyone's time .

01:24:32.472 --> 01:24:34.639
Uh , I will stay in the chat for a few

01:24:34.639 --> 01:24:34.370
more minutes if anyone wants to direct

01:24:34.370 --> 01:24:36.609
message me additional questions . With

01:24:36.609 --> 01:24:38.720
that , we will call an end to today's

01:24:38.720 --> 01:24:40.887
town hall . Thank you very much , over

01:24:40.887 --> 01:24:39.930
and out .