Defense Threat Reduction Agency

 8725 John J. Kingman Road, MS 

 6201 Fort Belvoir, VA 22060-6201 

TECHNICAL REPORT

DTRA-TR-10-29

A Technical Approach to Expedited 

Processing of NTPR Radiation Dose 

Assessments

Approved for public release; distribution is unlimited.

October 2011

HDTRA1-07-C-0015

Subcontract No. 06-792-SA

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1. REPORT DATE (DD-MM-YYYY)

17-10-2011 

2. REPORT TYPE

Technical report

3. DATES COVERED (From - To)

4. TITLE AND SUBTITLE

A Technical Approach to Expedited Processing of NTPR Radiation 

Dose Assessments

5a. CONTRACT NUMBER

HDTRA1-07-C-0015

5b. GRANT NUMBER

5c. PROGRAM ELEMENT NUMBER

6. AUTHOR(S)

Case, David R.; Chehata, Mondher; Dunavant, Jason D.; Egbert, 

Stephen D.; Mason, Carol L.; McKenzie-Carter, Michael A.; Singer, 

Harvey A.; and Weitz, Ronald L.

5d. PROJECT NUMBER

5e. TASK NUMBER

5f. WORK UNIT NUMBER

7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES)

 Science Applications International Corporation

 1710 SAIC Drive

 McLean, VA 22102

8. PERFORMING ORGANIZATION

REPORT NUMBER

9. SPONSORING/MONITORING AGENCY NAME(S) AND ADDRESS(ES)

Nuclear Technology Directorate, Attn: Dr. Blake 

Defense Threat Reduction Agency 

8725 John J. Kingman Road, Mail Stop 6201 

Fort Belvoir, VA 22060-6201

10. SPONSOR/MONITOR'S ACRONYM(S)

DTRA RD-NTSN

11. SPONSORING/MONITORING

AGENCY REPORT NUMBER

12. DISTRIBUTION AVAILABILITY STATEMENT

Approved for public release; distribution is unlimited.

13. SUPPLEMENTARY NOTES

14. ABSTRACT

This report describes the technical bases of an updated methodology that can be used in expedited processing of 

radiation dose assessments (RDA) for the Nuclear Test Personnel Review (NTPR) Program. The report defines the 

approach employed for selecting expedited processing groups (EPG), discusses the technical methods and 

assumptions used for estimating “maximized doses” and upper bound doses for each EPG, and summarizes the 

results of the dose assessment analyses. The detailed descriptions of each proposed EPG and its associated doses 

are contained in a separate volume—The Compendium of Expedited Processing Groups (DTRA-TR-11-01). The 

evaluation of the currently-used methods and technical basis of NTPR expedited processing of RDAs is documented 

in an interim report—Development of Radiation Doses to Support Expedited Processing of NTPR Dose 

Assessments, Pilot Phase Interim Report (NTPR-TM-10-03).

15. SUBJECT TERMS

Nuclear Test Personnel Review, Veterans, Atmospheric Nuclear Weapons Test, Dose Reconstruction, Radiation 

Dose Assessment

16. SECURITY CLASSIFICATION OF: 17. LIMITATION 

OF ABSTRACT

 U

18. NUMBER

OF PAGES

118 

19a. NAME OF RESPONSIBLE PERSON

Dr. Paul K. Blake

a. REPORT

 U

b. ABSTRACT

 

 U

c. THIS PAGE

 

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19b. TELEPONE NUMBER (Include area code )

 703 767-3384
CONVERSION TABLE 

Conversion Factors for U.S. Customary to metric (SI) units of measurement. 

MULTIPLY BY TO GET 

 TO GET BY DIVIDE 

meters (m) 

kilo pascal (kPa) 

kilo pascal (kPa) 

meter2

 (m2) 

joule (J) 

joule (J) 

mega joule/m2

 (MJ/m2) 

*giga bacquerel (GBq) 

radian (rad) 

degree kelvin (K) 

joule (J) 

joule (J) 

watt (W) 

meter (m) 

joule (J) 

meter3

 (m3) 

meter (m) 

joule (J) 

Gray (Gy) 

terajoules 

newton (N) 

kilo pascal (kPa) 

newton-second/m2

 (N-s/m2) 

meter (m) 

meter (m) 

meter (m) 

kilogram (kg) 

newton (N) 

newton-meter (N-m) 

newton/meter (N/m) 

kilo pascal (kPa) 

kilo pascal (kPa) 

kilogram (kg) 

kilogram-meter2

 (kg-m

2

) 

kilogram-meter3

 (kg/m3) 

**Gray (Gy) 

coulomb/kilogram (C/kg) 

second (s) 

kilogram (kg) 

kilo pascal (kPa)

1.000 000 x E -10 

1.013 25 x E +2 

1.000 000 x E +2 

1.000 000 x E -28 

1.054 350 x E +3 

4.184 000 

4.184 000 x E -2 

3.700 000 x E +1 

1.745 329 x E -2 

tk

 = (tof + 459.67)/1.8 

1.602 19 x E -19 

1.000 000 x E -7 

1.000 000 x E -7 

3.048 000 x E -1 

1.355 818 

3.785 412 x E -3 

2.540 000 x E -2 

1.000 000 x E +9 

1.000 000 

4.183 

4.448 222 x E +3 

6.894 757 x E +3 

1.000 000 x E +2 

1.000 000 x E -6 

2.540 000 x E -5 

1.609 344 x E +3 

2.834 952 x E -2 

4.448 222 

1.129 848 x E -1 

1.751 268 x E +2 

4.788 026 x E -2 

6.894 757 

4.535 924 x E -1 

4.214 011 x E -2 

1.601 846 x E +1 

1.000 000 x E -2 

2.579 760 x E -4 

1.000 000 x E -8 

1.459 390 x E +1 

1.333 22 x E -1

angstrom 

atmosphere (normal) 

bar 

barn 

British thermal unit (thermochemical) 

calorie (thermochemical) 

cal (thermochemical/cm2

)

curie 

degree (angle) 

degree Fahrenheit 

electron volt 

erg 

erg/second 

foot 

foot-pound-force 

gallon (U.S. liquid) 

inch 

jerk 

joule/kilogram (J/kg) radiation 

 absorbed dose 

kilotons 

kip (1000 lbf) 

kip/inch2

 (ksi) 

ktap 

micron 

mil 

mile (international) 

ounce 

pound-force (lbs avoirdupois) 

pound-force inch 

pound-force/inch 

pound-force/foot2

pound-force/inch2

 (psi) 

pound-mass (lbm avoirdupois) 

pound-mass-foot2

 (moment of inertia) 

pound-mass/foot3

rad (radiation dose absorbed) 

roentgen 

shake 

slug 

torr (mm Hg, 00

 C) 

 *The becquerel (Bq) is the SI unit of radioactivity; 1 Bq = 1 event/s.

**The gray (Gy) is the SI unit of absorbed dose. 
1

DTRA-TR-10-29: A Technical Approach to Expedited Processing of NTPR Radiation 

Dose Assessments

Table of Contents

List of Figures............................................................................................................................ 5

List of Tables............................................................................................................................. 7

1. Introduction............................................................................................................................ 9

1.1 Background ........................................................................................................ 10

1.1.1 Rationale for Expediting Radiation Dose Assessment Case ....................10

1.1.2 History of Current Process......................................................................10

1.1.3 Decision Criteria for Expediting Dose Assessment Cases.......................12

1.2 Purpose and Scope ............................................................................................. 13

1.3 Organization and Content of Report ................................................................... 14

2. Target Organs, Cancer Models, and Screening Doses for Claimed Medical Conditions.........15

2.1 Designation of Organs, Tissues and Diseases..................................................... 15

2.2 Relationship of NTPR NuTRIS Organ Codes and NTPR Standard Organs......... 16

2.3 Organs and Cancer Models Used for IREP/PC Screening................................... 16

2.4 Cross Reference between VA and DTRA Lists .................................................. 17

2.5 Screening Dose and Estimation of Probability of Causation ............................... 17

2.5.1 VA’s Estimation of Probability of Causation ..........................................17

2.5.2 Determination of Screening Doses..........................................................18

2.5.3 Variations in Screening Dose Values......................................................18

2.5.4 Definition of Doses well below a PC of 50 Percent.................................20

2.6 Role of Screening Doses for Non-Cancers.......................................................... 22
2

3. Methodology for Identifying Participant Groups and Maximizing Scenarios for Expedited 

Processing ............................................................................................................................25

3.1 Limitations of the Direct Use of Historical Doses from Previously Assessed Cases

.......................................................................................................................... 26

3.2 Expedited Processing Groups and Scenario-Based Dose Estimation................... 28

3.2.1 Definitions and Concepts........................................................................29

3.2.2 The “Highest-Dose Cohort” and Substitute Cohorts................................31

3.2.3 Maximizing the Doses............................................................................31

3.2.4 Identification of Excluded Cohorts and Activities...................................32

3.2.5 Combining EPGs....................................................................................33

3.3 Applicability of EPG Doses for Expedited Processing........................................ 33

3.3.1 Credibility of Assigned EPG Doses........................................................33

3.3.2 Suitability of EPG Doses........................................................................34

3.4 Initial Gamma and Neutron Exposures............................................................... 34

4. Rationale for the Makeup of the Proposed Expedited Processing Groups...............................37

4.1 Participants in the Oceanic Series....................................................................... 37

4.1.1 Land-Based Personnel ............................................................................41

4.1.2 Ship-Based Personnel.............................................................................42

4.1.3 Other Categories of Oceanic Series Personnel ........................................43

4.2 Participants in the NTS/CONUS Series.............................................................. 44

4.2.1 NTS Participants with Maneuver or Observer Activity ...........................45

4.2.2 NTS Participants with no Forward Area Activities..................................47

4.2.3 Task Force WARRIOR...........................................................................48

4.2.4 Second Marine Corps Provisional Atomic Exercise Brigade ...................49

5. Radiation Dose Assessment Results for Expedited Processing...............................................51

5.1 Development of Expedited Processing Groups................................................... 51

5.2 Dose Assessment Results................................................................................... 52
3

5.2.1 Summary of EPG Doses.........................................................................52

5.2.2 Alpha Doses for the ET Region and Lungs.............................................52

5.3 Expedited Processing Groups and Organ Combinations not Recommended for 

Expedited Processing ......................................................................................... 62

6. Summary and Conclusions....................................................................................................67

6.1 Pilot Phase ......................................................................................................... 67

6.2 Developmental Phase ......................................................................................... 68

6.3 Results of the Study ........................................................................................... 69

7. References.............................................................................................................................71

Appendix A. Cross Reference of NTPR NuTRIS Organ Codes, NTPR Standard Organs and 

NIOSH-IREP Cancer Risk Models.....................................................................75

Appendix B. Proposed NTPR Expedited Processing Groups.....................................................87

B-1 Highest-Dose Cohort .............................................................................. 87

B-2 Treatment of Exclusions......................................................................... 87

Glossary.................................................................................................................................. 107

Abbreviations, Acronyms, and Symbols.................................................................................. 113

DISTRIBUTION LIST ........................................................................................................... 117
4

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5

List of Figures

Figure 1. The Concept of Assessing Doses for Expedited Processing ....................................... 29

Figure 2. Map of the Pacific Proving Ground ........................................................................... 38

Figure 3. Map of Bikini Atoll during Operation CROSSROADS ............................................. 39

Figure 4. Map of Enewetak Atoll during Operation SANDSTONE .......................................... 40

Figure 5. Schematic of NTS 1951-1962 Indicating Approximate Locations of Forward Test 

Areas....................................................................................................................... 45
6

This page intentionally left blank.
7

List of Tables

Table 1. Categories of Cancer Risk Models Incorporated in NIOSH-IREP from Kocher and 

Apostoaei (2007) ..................................................................................................... 19

Table 2. Screening Doses for NIOSH-IREP Organ Categories (Kocher and Apostoaei, 2007) . 21

Table 3. Organ Doses Corresponding to the Limiting Dose (PC=40 percent) and Screening 

Dose (PC=50 percent) for Selected Cancers............................................................. 23

Table 4. Estimated Radiation Doses (rem) for Ship-Based Personnel at the Pacific Proving 

Ground* ................................................................................................................... 53

Table 5. Estimated Radiation Doses (rem) for Land-Based Personnel at the Pacific Proving 

Ground .................................................................................................................... 55

Table 6. Estimated Radiation Doses (rem) for Post-Operations Personnel at the Pacific Proving 

Ground* ................................................................................................................... 57

Table 7. Estimated Radiation Doses (rem) for Personnel at the Nevada Test Site* .................... 58

Table 8. Comparison of Alpha Particle and Total Doses for Type M and Type S...................... 59

Table 9. Dose Reconstruction Organs and Corresponding NIOSH-IREP Cancer Models Used in 

NTPR ...................................................................................................................... 63

Table 10. EPG and Organ Combinations not Recommended for Expedited Processing 

(Highlighted Cells) .................................................................................................. 64

Table A-1. Cross-Reference List of NTPR NuTRIS Codes, NTPR Standard Organs, and 

NIOSH-IREP Cancer Models .................................................................................. 76

Table B-1. General Exclusions Applicable to Pacific Proving Ground Ship-Based Personnel*.. 88

Table B-2. General Exclusions Applicable to Pacific Proving Ground Land-Based Personnel* . 89

Table B-3. General Exclusions Applicable to Participants during Testing at the Nevada Test 

Site*

......................................................................................................................... 90

Table B-4. Proposed Expedited Processing Groups for Operation CROSSROADS (1946) ....... 91

Table B-5. Proposed Expedited Processing Groups for Operation SANDSTONE (1948).......... 95

Table B-6. Proposed Expedited Processing Groups for Operation GREENHOUSE (1951)....... 96

Table B-7. Proposed Expedited Processing Groups for Operation IVY (1952).......................... 97

Table B-8. Proposed Expedited Processing Groups for Operation CASTLE (1954).................. 98
8

Table B-9. Proposed Expedited Processing Group for Operation WIGWAM (1955) ................ 99

Table B-10. Proposed Expedited Processing Groups for Operation REDWING (1956) .......... 100

Table B-11. Proposed Expedited Processing Groups for Operation HARDTACK I (1958)..... 101

Table B-12. Proposed Expedited Processing Groups for Operation ARGUS (1958) ............... 102

Table B-13. Proposed Expedited Processing Groups for Operation DOMINIC I (1962) ......... 103

Table B-14. Proposed Expedited Processing Groups for Nevada Test Site (NTS)................... 104

Table B-15. Proposed Expedited Processing Groups for PPG Post-Operations....................... 106
9

1. 

Introduction

This technical basis document describes the methods and approaches that were developed to 

support the expedited processing of some radiation dose assessments (RDAs) for Nuclear Test 

Personnel Review (NTPR) Program participants. It supports the Defense Threat Reduction 

Agency’s (DTRA’s) implementation of a recommendation of the Veterans' Advisory Board on 

Dose Reconstruction (VBDR) that “NTPR expand its technical bases and criteria for expedited 

case processing...” (VBDR, 2007c). 

The proposed approach to estimating equivalent doses for use in expedited processing of RDA 

cases involves evaluations for expedited processing groups (EPGs), which comprise large 

numbers of individuals with similar exposure circumstances and radiation environments. The 

goal of this approach is to calculate EPG doses, whose upper bounds at the 95th percentile are

demonstrably higher than the dose that any individual in the group could have received. The 

upper-bound doses are compared with cancer screening doses that likely would result in a 

Department of Veterans Affairs (VA) service-connected disability determination. If the EPG 

doses are well below the screening doses, no further refinement for accuracy is needed, and the 

EPG doses can be reported to the VA. This approach provides for the timely and cost-effective 

completion of RDAs to which it applies while giving full benefit of the doubt to claimants whose 

cases are being adjudicated by the VA. 

It is important to note that the assumptions made in calculating the EPG doses are even more 

conservative (i.e., they result in higher estimated doses) than the already high-sided assumptions 

documented in the NTPR Standard Operating Procedures (SOP) Manual and Standard Methods 

(SMs) for performing individual-specific, full RDAs (DTRA, 2008; DTRA, 2010a). In some 

instances, assumed input parameters meant to further increase the dose for the EPG would be 

impossible under the conditions that an individual veteran in the EPG actually experienced. For 

example, it is generally assumed that members of an EPG remained in the test area throughout a 

specified period of time; however a specific member of an EPG might have departed the test area 

early and therefore missed a major fallout event experienced by other members of the EPG. 

Nevertheless, he is given the same EPG dose that he would receive if he had been continuously 

present at the test site. Because of the inherent high-sidedness of EPG doses, expedited 

processing allows DTRA to provide more timely RDA results for the VA and ultimately for the 

veteran for cases in which doses are likely well below the level that would result in serviceconnected disability determinations. 

This report reviews the current state of NTPR’s expedited processing of RDA cases, describes 

the methods for defining EPGs, discusses the technical methods and assumptions for estimating 

“maximized doses” for the EPGs, and summarizes the results of initial analyses. Detailed 

descriptions of each proposed EPG and its associated doses are contained in a separate volume—
10

Compendium of Expedited Processing Groups (DTRA, 2011), hereinafter called the EPG 

Compendium. 

1.1 Background

In 2005, DTRA faced a backlog of almost 2,000 VA claims that required dose reconstructions 

and would have involved several years of effort at substantial cost to address with individual 

RDAs. Between January 2006 and December 2008, in response to VDBR recommendations, 

DTRA implemented expedited processing, first for cases involving skin cancer, prostate cancer, 

and posterior subcapsular cataracts; and subsequently for most other cancer cases when 

scientifically justified (Blake, 2009). This section presents the rationale for expediting RDA 

cases, reviews the historical development of the current process, discusses the criteria for 

expediting cases, and summarizes benefit-of-the-doubt considerations. 

1.1.1 Rationale for Expediting Radiation Dose Assessment Case

DTRA requires efficient methods for estimating radiation dose to participants in the U.S. 

atmospheric nuclear test program as well as personnel who were present in Japan at the end of 

World War II and the following occupation period. One approach to achieve this efficiency is to 

assign doses that are larger than the maximum dose the participants of a well-defined EPG could 

have received, based on the circumstances of their exposure scenarios. If such conservativelyestimated doses are known to be well below the dose that could result in a service-connected 

disability determination, VA could then make a determination with the confidence that claimants 

had received the full benefit of the doubt in determining their doses. 

Given a reconstructed dose to an organ with cancer (e.g. dose to the liver in cases involving 

liver cancer), an evaluation can be made of the likelihood that this dose caused the cancer. 

Service-connected determinations about whether a cancer is at least as likely as not associated 

with the given dose are based upon whether a probability of causation (PC) derived for that 

dose—determined at the upper 99th percentile, taking into account uncertainties in estimated 

risk—is equal to or greater than 50 percent. These evaluations of likelihood can have three 

possible outcomes: 1) the dose is well below the dose required to produce a PC of 50 percent, 2) 

the dose is well above the dose required to produce a PC of 50 percent, or 3) the dose is close to 

the dose required to produce a PC of 50 percent. 

1.1.2 History of Current Process

In late 2005, DTRA faced an enormous backlog of RDA cases with some case processing 

times approaching 4 years. Costs per case were also increasing, due to 1) the complex analyses 

and case-specific documentation of its “DTRA Dose Reconstruction Policy” in Title 32, Code of 

Federal Regulations, Part 218 (32 CFR 218) released in 1985, and 2) increased veteran or 

claimant involvement in providing and reviewing the full details of exposure scenarios as 
11

recommended in the 2003 review of DTRA’s dose reconstruction program by a Committee of 

the National Research Council of the National Academies of Science (NAS/NRC, 2003). 

Increased dose reconstruction resources failed to affect backlogs significantly. Consequently, 

DTRA considered two possible courses of action (Blake, 2009): 

• Revise 32 CFR 218—a challenging, time-consuming effort during a period of claimsprocessing delays and veteran frustration. 

• Obtain veteran buy-in to proposed changes through a VBDR recommendation to DTRA 

and/or VA. 

In January 2006, DTRA briefed the VBDR on a technical justification for an expedited 

approach to re-working RDA cases involving cancer of the prostate. DTRA subsequently 

released a point paper for public distribution and a restricted release technical basis document to 

the Subcommittee on DTRA Dose Reconstruction Procedures (SC-1) of the VBDR. These 

actions led to several VBDR recommendations for expedited processing, including:

• July 2006 recommendations to expedite prostate cancer and skin cancer cases (VBDR, 2006). 

- Implementation followed a review of substantial numbers of prostate cancer cases that 

showed a low upper-bound external dose, as well as a review of cases involving skin 

cancer that showed large uncertainties resulting in very high upper-bound doses to the 

skin. 

• March 2007 recommendation to develop an expedited process for posterior subcapsular 

cataracts (VBDR, 2007a).

- Implementation followed reviews showing large uncertainties in estimating dose to the 

eye lens and very high upper-bound doses; the results were similar to the situation

observed in skin cancer cases. 

• May 2007 recommendation to develop an expedited dose process for most other cancers, 

where scientifically justified (VBDR, 2007b). 

- Implementation followed review of a large number of cases that produced estimated 

doses from exposures to external and internal radiation sources, some of which were 

above and some of which were below the doses expected to result in a successful claim. 

Implementation of these “expedited process” recommendations allowed DTRA to reduce the

substantial case backlog and improve case processing time. Following implementation of these 

recommendations, an increase from 9 to 29 percent was observed in VA service-connected 

medical opinions for NTPR “expedited processing” cases, particularly for skin cancer and 

cataract cases. (Blake, 2009) 

Finally, VBDR recommended that DTRA “expand its technical bases for expedited 

processing” (VBDR, 2007c). To address this final recommendation, DTRA’s NTPR Program 

evaluated historical dose reconstruction cases, developed approaches to cost-effective methods 

for estimating doses in expedited processing, and produced this technical basis document on the 
12

expedited approach to NTPR RDAs for cases involving organs and tissues other than those for 

skin and prostate cancers and posterior subcapsular cataracts, which are currently processed 

using approaches with an acknowledged technical basis. This technical basis document

describes the methods that have been developed to expand the technical basis for expedited dose 

reconstruction cases of most other cancers, and are recommended for future implementation.

1.1.3 Decision Criteria for Expediting Dose Assessment Cases

In its recommendations to expand expedited processing to cases involving most other cancers, 

“where scientifically justified, and for which the doses are either well above or well below the 

level likely to result in a successful claim...1

• The expedited upper-bound (UB) dose estimates would be used by “VA in evaluating 

whether it is at least as likely as not, with 99 % confidence that the veteran’s cancer was 

caused by service-related radiation, while assuring the veteran receives full benefit of the 

doubt.” 

” VBDR (2007b) discussed features to be 

considered in developing the procedures for determining doses. These considerations include:

• The doses should be upper bounds based on dose reconstructions that are “more broadly 

generated and applied than those in previous single-case dose reconstructions.”

• The doses will “almost always be higher than doses that were estimated in previous RDAs

for the same condition, thus providing maximum benefit of the doubt to the veteran.” 

• The doses “will be high enough to ensure that the reported dose is not less than the veteran’s 

true upper bound (95th percentile) dose.”

• The reported doses are either well above or well below the dose that could result in serviceconnected disability determinations for the claimed medical condition, considering age at 

exposure and age at diagnosis. 

• The “assigned expedited UB doses should be based on worst-case (i.e., in the direction of 

overstating exposure) parameters and assumptions, not all of which the veteran may have 

actually encountered.”

The effort discussed in this report concentrated on the identification of the participants in each 

EPG and the development of their exposure parameters and assumptions with the purpose of 

satisfying the above considerations. Discussions are included concerning methods for assessing 

whether doses are well above or well below the dose that could result in service-connected

disability determinations. 

Development of an EPG involves careful application of these VBDR considerations as well as 

attempts to maximize the number of participants who are considered members of an EPG and 

 

1 The VA disability compensation program is based on a determination of whether a claimed condition is connected 

with military service, known as “service connection”. The VBDR phrase “result in a successful claim” is taken in 

this report to mean “service-connected disability determination” or similar term.
13

candidates for assignment of the EPG doses and their 95th percentile upper bounds. This 

additional consideration is crucial to providing timely, cost-effective dose reports. In an effort to 

include as many participants as reasonably feasible in a single EPG, implementation of the final

VBDR consideration listed above can be helpful. For example, a participant who departed a 

Pacific test site before the occurrence of a fallout event to which other members of the EPG were 

exposed may nonetheless be considered a member of that EPG and be assigned the EPG doses 

that include the contribution from the fallout event. This results in an apparent inconsistency 

between the veteran’s individual dose and his assigned EPG dose. However, because these 

assigned doses are not individualized but are derived from worst-case composite scenarios, they 

are acceptable for the purpose of providing high-sided estimates for all members of an EPG as 

long as they are well below the doses that could lead to service-connected determinations. This 

approach supports the conclusion that the EPG upper-bound dose is greater than the dose the 

veteran actually received.

The EPG upper-bound doses, thus derived with an approach that produces large and 

sometimes impossible overestimates of dose to certain organs and tissues, are not suitable for 

cases where these doses are near or greater than the minimum dose required for serviceconnected determinations (i.e., Outcomes 2 and 3 mentioned in Section 1.1.1). Doses that could 

lead to service-connected determinations should be calculated using information specific to the 

veteran’s circumstances of exposure while using parameters and assumptions that produce 95th

percentile upper-bound doses and that assure the veteran receives full benefit of the doubt.

1.2 Purpose and Scope

The purpose of this report is to document the technical basis for the NTPR expedited process 

for cases that are expected to produce EPG upper-bound doses that are well below the minimum 

doses required for service-connected determinations. This technical basis derives from a study 

that was designed and performed to: 

1. Review available NTPR data on veteran radiation exposures and reported doses to determine 

their suitability for serving as the basis for expedited doses. 

2. Apply a process for estimating the association between service-related radiation exposure 

and medical conditions that is consistent with the one used by the VA in adjudication of 

claims to assess whether proposed doses are well below those that could result in serviceconnected determinations. 

3. Develop standardized lists and lookup tables of diseased organs, organs with reported 

internal dose coefficients, and cancer risk models to ensure consistency in processing. 

4. Develop approaches to expediting cases based on the concepts of “highest-dose cohorts” 

augmented with maximizing exposure pathways and dose parameters for broadly defined 

exposure groups of participants. 
14

5. Carry out a pilot phase for proof of concept and to demonstrate the methodology using 

sample groups of participants, and provide preliminary results of the proposed methods in an 

interim report. 

6. Recommend a strategy for selecting groups of participants for expediting cases as well as the 

best approach to developing bounding scenarios of exposure. 

7. Complete EPG dose estimates for the broadest number of participants in expedited cases 

using the methods and approaches developed in this study. 

Doses for some tissues and organs were not included in these EPG dose assessments. 

Expedited doses to the skin and lens of the eye, developed following the VBDR 

recommendations of July 2006 (VBDR, 2006) and March 2007 (VBDR, 2007a) were already at 

a high level, reflecting the extreme uncertainty associated with their calculation. These 

previously calculated doses already are likely to result in a VA service-connected determination. 

Doses to the female breast, uterus, and ovaries were not evaluated because the participants in the 

VA disability program are overwhelmingly male, reflecting the military personnel practices of 

the post-World War II occupation of Japan and atmospheric nuclear weapons-testing eras. Doses 

from initial gamma and neutron radiation exposures also were not included in the EPG dose 

assessments, but are specifically addressed in Weitz and Egbert (2010).

This report includes discussions of the following: characterization and selection of groups of 

exposed participants to form EPGs; the need for and achievement of consistency among 

references to organs used in the dose reconstruction process and the cancer types (models) used 

in the National Institute of Occupational Safety and Health-Interactive RadioEpidemiological 

Program (NIOSH-IREP) software program, which is used by the VA in adjudicating claims for 

service-connected determinations for cancer; approaches to demonstrating that estimated EPG 

doses are credible and greater than those received by any member of the EPG; and details of an 

approach to evaluating whether the EPG doses are well below the dose that could result in a 

service-connected determination. The process and decision-making for using the EPG approach 

to expedited processing of NTPR RDAs is outside the scope of this report.

1.3 Organization and Content of Report

This report builds on the approaches, analyses, and results of pilot testing reported in an 

interim report (DTRA, 2010b). Section 2 addresses the relationships between claimed medical 

conditions, target organs, and NIOSH-IREP cancer risk models. Section 3 discusses 

methodologies for identifying participant groups and maximizing scenarios for expedited 

processing. Section 4 provides the rationale for the proposed EPGs. Section 5 provides 

summaries of the proposed EPGs that have been completed. Finally, Section 6 provides a 

summary and conclusions about the results obtained. This report is supplemented by a 

companion volume called the EPG Compendium (DTRA, 2011), which contains detailed 

discussions about each proposed EPG.
15

2. 

Target Organs, Cancer Models, and 

Screening Doses for Claimed Medical 

Conditions

A major goal of the dose reconstruction process is to apply sound, scientific methodologies to 

the calculation of dose estimates for organs associated with medical conditions identified in 

claims filed with the VA. Appropriate target organs must be identified that are associated with 

specific medical conditions in order to estimate organ doses. VA uses those target organ dose 

estimates to evaluate whether it is as least as likely as not that a medical condition was caused by 

a given radiation dose and to document the results in a medical opinion. 

VA’s assessment process differs for cancers and non-cancers. For cancers, VA uses the 

NIOSH-IREP software (NIOSH, 2002) to calculate a PC, which is the probability expressed as a 

percentage between 0 and 100 percent, that the radiation dose produced the diagnosed cancer in 

the veteran. In adjudicating claims for service-connection, VA uses the upper 99th percentile of 

PC, taking uncertainties in the estimated cancer risk to the individual into account. The NIOSHIREP software associates cancer risk models developed on the basis of radioepidemiological data 

with the dose, age at exposure and age at which the cancer was diagnosed. The 

radioepidemiological models used are those developed by a working group of the Centers for 

Disease Control and Prevention (CDC) and the National Cancer Institute (NCI) that was 

mandated by Congress to update the 1985 NIH Radioepidemiological Tables as described in 

Land, et al. (2003). 

For non-cancers, VA reviews the medical literature and consults with experts as needed to 

assess the potential that the radiation dose contributed to the medical condition.

2.1 Designation of Organs, Tissues and Diseases

A review of NTPR RDA records, documentation of the Fallout Inhalation Ingestion Dose to 

Organs (FIIDOS) internal radiation dosimetry computer code, and NIOSH-IREP documentation 

indicates that there are different sets of terminology used to describe:

• The claimed medical conditions and the associated tissues and organs in the NTPR Nuclear 

Test Review Information System (NuTRIS) Data Dictionary (DTRA, 2007a). 
16

• The organs with published, consensus values of radiation dose coefficients (ICRP, 1996; 

ICRP, 2002) used to generate dose conversion factors in NTPR dose reconstructions using 

the FIIDOS computer program (Raine et al., 2007). 

• The cancer types (models) used in the NIOSH-IREP software (NIOSH, 2009). 

The following sections discuss each of these terminology sets and their inter-relationships.

2.2 Relationship of NTPR NuTRIS Organ Codes and NTPR 

Standard Organs 

The NTPR NuTRIS Data Dictionary (DTRA, 2007a) contains 265 distinct entries in the 

“Organ Codes” field with an equal number in the corresponding “Description” field. 

Presumably, these entries have been developed to accommodate information contained in VA 

requests to DTRA for dose information. Of the 265 entries, 132 were related to skin sites, which 

are not within the scope of this study and are not discussed further. 

The calculation of radiation dose to organs and tissues from internally deposited radioactive 

materials requires dose conversion factors that relate a committed equivalent dose to an organ to 

the quantity of radioactive material that is taken into the body through inhalation, ingestion or 

other routes of entry. To accomplish this, NTPR calculates dose conversion factors for a 

consolidated inventory of radionuclides for 23 organs and tissues for which dose coefficient 

values have been published (ICRP, 1996 and 2002). These 23 organs are referred to as NTPR 

Standard Organs. For this report, three of the organs—ovaries, uterus, and skin—are not used, 

leaving 20 organs that must be related to 133 NTPR NuTRIS Organ Codes. Since there are 

many more NuTRIS Organ Codes than NTPR Standard Organs, choices are made to select the 

most appropriate NTPR Standard Organ to represent each NTPR NuTRIS Organ Code for which 

there is no corresponding NTPR Standard Organ (DTRA, 2010a). These representative NTPR 

Standard Organs are called NTPR Surrogates. Table A-1 of Appendix A lists the NTPR NuTRIS 

Organ Codes, with their NTPR Standard Organs, or Surrogates.

2.3 Organs and Cancer Models Used for IREP/PC Screening

NIOSH-IREP contains 32 cancer models designated by ICD-9 Code (NIOSH, 2009). Of 

these, five models for malignant melanoma of skin, basal cell carcinoma of skin, squamous cell 

carcinoma of skin, cancer of the ovary, and cancer of the female genitalia other than the ovary

are not considered in this report, leaving 27 cancer models that must be mapped to NTPR 

NuTRIS Organ Codes to estimate PC values for each NTPR NuTRIS Organ Code. This 

mapping was accomplished using the judgment of a radiation oncologist, who is certified in 

Therapeutic Radiology by the American Board of Radiology, to match cancer models with the 

most appropriate NTPR NuTRIS Organ Code. Table A-1 of Appendix A lists these crossreferences.
17

2.4 Cross Reference between VA and DTRA Lists

The NTPR NuTRIS Organ Codes reflect information provided in VA claims documents and 

possibly in personal inquiries for participation and dose information. Many of these NuTRIS 

Organ Codes use replicate terms for a particular diseased organ or tissue or are not specific 

enough to make reliable selections of the NTRP Standard Organ(s) and the NIOSH-IREP cancer 

model. In order to address replicates and non-specific codes Table A-1 of Appendix A lists both 

the “Current NTPR NuTRIS Organ Codes” and also “Proposed NuTRIS Organ Codes.” The 

latter provides a set of standardized NTPR NuTRIS Organ Codes for use in all RDAs—

expedited or full—that establishes the foundation for consistent recording of the information and 

selection of NTPR Standard Organs and NIOSH-IREP cancer models. Once adopted, this 

collection of codes could also form the basis for automated selection of the NTPR Standard 

Organs for dose reconstruction and selection of the appropriate NIOSH-IREP Cancer Model, 

based on medical diagnostic (ICD-9 Codes) (CDC-CMMS, 2010).

2.5 Screening Dose and Estimation of Probability of Causation

The PC values corresponding to the EPG doses can be useful in determining whether the 

proposed doses are appropriate for making service-connected determinations. A screening dose, 

which is a dose that produces a PC value of 50 percent at the upper 99th percentile, taking 

uncertainties in the cancer risk models into account, can serve as a benchmark to help assess the 

suitability of the assignment of doses through expedited processing. The following sections 

summarize the cancer risk models used in NIOSH-IREP, review VA’s use of radiation doses in 

reaching service-connection decisions, explain the meaning of a dose that is “well below the 

dose that could lead to a service-connected determination,” and discuss “screening dose” and its 

relevant parameters. 

2.5.1 VA’s Estimation of Probability of Causation

The VA’s Office of Public Health and Environmental Hazards (OPHEH), Veterans Health 

Administration, renders medical opinions about the association of cancers with radiation dose for 

claimant cases. Since April 2005, the medical staff of OPHEH has been using the latest version 

of NIOSH-IREP to evaluate PC. OPHEH uses doses reported by DTRA in evaluating cases 

related to NTPR participants. In so doing, it evaluates reported doses so that “when a range of 

dose estimates are provided, exposure at the highest level of the dose range will be presumed [38 

CFR 3.311(a)]” (Otchin, 2007). This means that when DTRA reports both a mean dose and an 

upper-bound dose, VA would use only the upper-bound dose (without uncertainty) as a point 

estimate of dose to calculate a PC using NIOSH-IREP.

Since NIOSH-IREP is designed to calculate PC using doses for each radiation type and DTRA 

reports doses in this format, OPHEH enters the highest dose for each radiation type, assumed to 

be the upper-bound doses reported by DTRA, as “constants” rather than as dose distributions and 

uses the following conventions for selecting radiation energy (designated as E): 
18

• External gamma doses are entered as acute photon doses of E > 250 keV.

• External neutron doses are entered as chronic neutron doses of E = 0.1–2 MeV.

• External beta doses are entered as acute electron doses of E > 15 keV.

• Internal gamma doses are entered as chronic photon doses of E > 250 keV.

• Internal beta doses are entered as chronic electron doses of E > 15 keV.

• Internal alpha doses are entered as chronic alpha doses.

• Combined internal beta/gamma doses are entered as chronic photon doses of E > 250 keV or 

chronic electron doses of E > 15 keV in separate NIOSH-IREP runs.

2.5.2 Determination of Screening Doses

One approach to evaluating the potential results of service-connected determinations for 

proposed EPG doses is to calculate the PC for each claimed organ with cancer and its associated 

dose. This approach would require substantial effort. An alternate approach is to use the socalled screening doses reported in Kocher and Apostoaei (2007), which DTRA employed during 

development of the currently used processes for expediting RDAs. The variation of PC with 

dose, age of the individual at exposure and the time between exposure and diagnosis of the 

disease is dependent on the cancer risk model included in the NIOSH-IREP software. 

Kocher and Apostoaei (2007) discussed the nature of the cancer risk models used in NIOSHIREP for four groups of cancer types and developed tables of screening doses at various ages at 

exposure and elapsed times between exposure and diagnosis of the disease for 34 cancers. 

Table 1 below lists the cancer types included in each group, and summarizes the model 

characteristics of each of the four cancer groups discussed in detail in Kocher and Apostoaei 

(2007). Cancers of the skin and cancers of female organs discussed in Kocher and Apostoaei 

(2007) are not included in Table 1 because currently used expedited processes for those cancers 

are established and are not part of the scope of this report.

2.5.3 Variations in Screening Dose Values

The risk of cancer to organs and tissues in Groups 1 and 2 vary with age at exposure and age at 

diagnosis of the cancer. Screening doses for these cancers also show a similar age-dependence. 

This allows screening doses to be calculated for various combinations of age at exposure and 

attained age at diagnosis—or equivalently the elapsed time between exposure and diagnosis. 

Although there may be many possible approaches to selecting values of these age-related 

parameters for use in calculating screening doses, two that seem reasonable for
19

Table 1. Categories of Cancer Risk Models Incorporated in NIOSH-IREP

from Kocher and Apostoaei (2007)

Category Cancer Types* Primary Risk Model 

Characteristics

Group 1 All digestive cancers other than stomach, 

colon and rectum; liver; breast*

Risk depends on age at 

exposure, attained age, and sex

Group 2 Oral cavity and pharynx; esophagus; stomach 

(male only); colon; rectum; gallbladder; 

pancreas; lung (including trachea and 

bronchus); respiratory other than lung (e.g. 

nasal cavity, larynx); bone; all connective 

tissue; all male genitalia (including prostate); 

bladder; kidney and other urinary organs 

except bladder; eye; nervous system 

(including brain); endocrine glands other than 

thyroid; other and ill-defined sites; lymphoma 

and multiple myeloma

Risk depends on age at 

exposure, attained age, and sex. 

Model dependencies on age 

parameters differ from Group 1, 

and lung cancer risk depends on 

smoking history.

Group 3 Lung (including trachea and bronchus) Risk is independent of age at 

exposure and attained age; risk 

of lung cancer depends on sex 

and smoking history. Lung 

cancer model differs from 

Group 2; both models are in 

current version of IREP used by 

VA

Group 4 Thyroid; leukemia (other than chronic 

lymphocytic leukemia, CLL), acute myeloid 

leukemia (AML), chronic myeloid leukemia 

(CML), and acute lymphocytic leukemia 

(ALL)

Unique risk model for each 

cancer type.

* Six cancer types included in Kocher and Apostoaei (2007) are not included in this study: stomach 

(female only) (Group 1); ovary (Group 2); all female genitalia except ovary (Group 3); malignant 

melanoma; non-melanoma skin cancers; and lung cancers due to radon exposure (Group 4).

determining screening doses for any cancer type (model) are as follows: 1) use the lowest dose 

for a given cancer for all combinations of age at exposure and attained age, or 2) use doses for a 

representative age at exposure and representative attained age. The lowest screening doses for 

many cancers are observed for exposures at age 18 and at times from exposure to diagnosis of 

the cancer that range from about 5 to 10 years, with a few exceptions (Kocher and Apostoaei, 

2007). Minimum doses for cancers in Groups 1 and 2 are typically observed at 10 years after 

exposure and increase thereafter. 
20

The risks and associated screening doses for cancers in Groups 3 and 4 have more varied time 

dependencies. For cancers in Group 3, screening doses decrease with elapsed times after 

exposure of 10–15 years. For all leukemias (Group 4), the lowest screening doses are observed 

at 5 years after exposure. For thyroid cancer (Group 4), the lowest screening dose occurs at 10 

years following exposure and remains constant thereafter. Many of these screening doses are 

within the range of the doses received by some NTPR participants, but correspond to ages at 

diagnosis that are well before any of the attained ages at diagnosis for participants who have filed 

claims. 

Kocher and Apostoaei (2007) calculated screening doses at ages at exposure ranging from 18 

to 40 or more years, as well as for times between exposure and diagnosis of disease ranging from 

5 to 30 or more years depending on the cancer type. Examples of the variations in the values of 

these screening doses are shown in Table 2, which lists the lowest screening doses and the 

screening doses at attained age 50 for exposure at age 18 for each of the 27 NIOSH-IREP 

organ/tissue/disease categories included in this report. These screening doses can be useful for 

assessing whether a given dose corresponds to a PC value of 50 percent at the 99th percentile. 

However, a dose that is slightly above or slightly below the screening dose may not provide a 

definitive answer about service-connection for several reasons. Exposures occurring over 

several years or involving significant doses from alpha particles or neutrons may produce 

different values of PC than those calculated under the assumption that the total dose was due to 

an acute exposure to photons with energy greater than 250 keV as was assumed in Kocher and 

Apostoaei (2007).

2.5.4 Definition of Doses well below a PC of 50 Percent

To determine whether an organ dose calculated using expedited procedures satisfies the 

condition that the dose is well below the organ dose that could result in a service-connected 

determination; the dose can be compared with a screening dose for the cancer that is the subject 

of a claim. Selection of a screening dose calculation for an age at exposure of 18 and elapsed 

times of 30 or 40 years represents a reasonable description of NTPR participants who were 

mostly exposed at young ages (18–22) during 1945 to 1962, and who began, or would begin 

experiencing cancers 30 to 50 years later (1992 to 2012) at attained ages of 48–72. 

In addition to taking into consideration the variation in screening dose with age at exposure 

and time elapsed between exposure and diagnosis of disease, evaluators must consider the 

inaccuracy in calculating PC related to the use of a finite sample size and changes in the random 

seed used to start the Monte Carlo process in NIOSH-IREP. One approach is to select a range of 

PC values around 50 percent. To be acceptable, a reportable dose from expedited procedures 

should be well below the dose that would not lead to a service-connected determination as 

represented by the dose corresponding to the lower value of the selected PC range for cancers. 

Cases with doses derived from expedited procedures that are greater than this lower value would 

be processed using full dose assessment procedures that take into account details of the 

individual exposure scenario, and use methods that mitigate the inaccuracies in calculating PC. 
21

Table 2. Screening Doses for NIOSH-IREP Organ Categories 

(Kocher and Apostoaei, 2007) 

Organ Categories Lowest Screening 

Dose (rem)* 

Screening Dose (rem)

at Age 50†

Oral cavity and Pharynx 32 98

Esophagus 12 35

Stomach 9.0 27

Colon 12 39

Rectum 36 110

All digestive (other than esophagus, 

stomach, colon, rectum/anus) 

22 66

Liver 4.0 11

Gallbladder 6.0 17

Pancreas 31 89

Lung (never smokers) 18 45

Other Respiratory 34 100

Bone 10 (5 years) 48

Connective tissue 16 50

Male breast 12 53

All male genitalia 21 60

Bladder 16 49

Urinary organs, excluding bladder 14 46

Eye 16 49

Nervous system 32 95

Thyroid 7.5 (≥ 10 years) 7.5 (≥ 10 years)

Other endocrine glands 14 45

Cancers of other and ill-defined sites 16 50

Lymphoma and multiple myeloma 22 61

Leukemia, excluding CLL 1.9 (5 years) 41 (30 years)

Acute Lymphocytic Leukemia 0.24 (5 years) 24 (30 years)

Acute myeloid leukemia (AML) 5.8 (5 years) 29 (30 years)

Chronic myeloid leukemia (CML) 1.4 (5 years) 57 (30 years) * Calculated for age of exposure of 18 and elapsed time of 10 years (or elapsed time shown).

† Calculated for exposure at age 18 and attained age of 50 (or elapsed time shown).

To be useful, doses that result from the EPG approach to expediting RDAs proposed in this 

report must be well below the dose that could result in service-connected determinations. To be 

credible, these doses should be based on specific criteria that are transparent and that veterans 

understand. Precedent exists in other federal compensation programs that can offer an example 

of such criteria. NIOSH uses efficiency methods for reducing efforts required to perform 

credible dose reconstructions performed under the Energy Employees’ Occupational Injury 

Compensation Program Act (EEOICPA). This program uses a PC range of 45 to 52 percent for 

determining whether dose reconstructions can be completed using efficiency methods or require 

full dose reconstructions (ORAU, 2007). The lower value (45 percent) could serve a similar 

purpose for NTPR RDAs. The doses associated with PC values of 45 percent for cancers of 
22

interest were found to be about 20 percent less than the doses that produced a PC value of 50 

percent. To provide an additional margin of error and to ensure benefit of the doubt to the 

veteran, this report defines “well below the dose that could result in compensation;” i.e., results 

in a service-connected disability determination as the dose that produces a PC value of less than 

40 percent for exposure at age 18 and diagnosis of cancer at either age 50 or after an appropriate 

elapsed time following exposure as shown in Table 3. This dose is defined as the “limiting dose. 

A comparison of screening doses and limiting doses for all organs considered in this report is 

presented in Table 3. 

2.6 Role of Screening Doses for Non-Cancers 

NIOSH-IREP does not address all medical conditions that could be the subject of claims filed 

with VA. For example, benign neoplasms and deterministic effects of radiation are not 

addressed. Therefore, screening doses are not available for claims involving non-cancer 

conditions.

For service-connected determination cases claiming disorders, for which that NIOISH-IREP

does apply, OPHEH uses sources such as the National Research Council (NRC) Biological 

Effects of Ionizing Radiation (BEIR) reports, the Agency for Toxic Substances and Disease 

Registry (ATSDR) Toxicological Profile for Ionizing Radiation, major textbooks, and key 

scientific papers to formulate medical opinions and make service-connected determinations. 

(Otchin, 2007) EPG doses could be reported in response to VA requests for dose information for 

cases involving non-cancers.
23

Table 3. Organ Doses Corresponding to the Limiting Dose (PC=40 percent) 

and Screening Dose (PC=50 percent) for Selected Cancers

Cancer of Organ

Limiting Dose 

(rem) at 40% 

PC* 

Screening Dose 

(rem) at 50% 

PC*†

Oral cavity and Pharynx 66 98

Esophagus 22 35

Stomach 18 27

Colon 26 39

Rectum 72 110

All digestive (other than esophagus, 

stomach, colon, rectum/anus) 

44 66

Liver 7.7 11

Gallbladder 11 17

Pancreas 61 89

Lung (never smokers) 30 45

Other Respiratory 67 100

Bone 32 48

Connective tissue 34 50

Male breast 36 53

All male genitalia 41 60

Bladder 33 49

Urinary organs, excluding bladder 31 46

Eye 32 49

Nervous system 64 95

Thyroid 5.1 7.5 (≥ 10 years)

Other endocrine glands 30 45

Cancers of other and ill-defined sites 34 51

Lymphoma and multiple myeloma 41 61

Leukemia, excluding CLL 29 41 (30 years)

Acute Lymphocytic Leukemia 14 24 (30 years)

Acute myeloid leukemia (AML) 20 29 (30 years)

Chronic myeloid leukemia (CML) 41 57 (30 years) * PC calculated for exposure at age 18 and attained age of 50 (or elapsed time shown).

† From Kocher and Apostoaei (2007).
24

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25

3. 

Methodology for Identifying Participant 

Groups and Maximizing Scenarios for 

Expedited Processing

Three approaches were evaluated during the initial phase of this study to update and document 

the technical basis for estimating organ radiation doses for expedited processing (DTRA, 2010b). 

The first approach relied on the direct use of historical RDA dose results without regard to the 

exposure scenarios of their associated cases. This approach established the expedited processing 

doses in use at the time this report was being written. These expedited processing doses will be 

referred to as “current” or “currently used,” to distinguish them from the proposed EPG doses 

discussed in this report and documented in its associated EPG Compendium (DTRA, 2011). 

These currently used doses are based mostly on the set of doses available in the NTPR NuTRIS 

database from fully developed RDAs completed between March 2004, following the publication 

of the 2003 NAS report (NAS/NRC, 2003), and March 2006. In the pilot phase of the present 

evaluation and update, dose data from non-expedited RDAs completed between April 2006 and 

March 2010 were added to the first data set, and the direct use of historical doses was 

reanalyzed. Review of the RDAs associated with currently used doses for expedited processing 

revealed that the methodology and dose assignments should be updated using information 

developed since this approach was established (DTRA, 2010b). The second approach evaluated 

uses of historical dose results to identify cases with the highest reported doses that are relevant to 

large groups of participants. This approach differs from the first approach in that it does not 

combine all historical doses into a single group. Rather, it identifies historical doses that can be 

assigned for groups of individuals with similar participation and exposure scenarios. The last 

approach, which was the one selected for further analysis as an alternative to the currently used 

method (first approach), develops doses for expedited processing based on maximizing exposure 

scenarios for large groups of participants. 

The selected scenario-based approach uses DTRA-approved dose reconstruction methods to 

determine group-specific external and internal doses. These doses are estimated using radiation 

survey data primarily and, where feasible, film badge records. The reasons for using exposure 

rate data or measurement-based estimates of such to calculate EPG doses, for the most part, are 

as follows: 

• Individual film badge doses are not representative of doses assignable to EPGs. 

• Personnel in a cohort with high film badge doses are considered likely outliers that were 

exposed to additional sources or higher levels of radiation than the generic group/cohorts for 

which expedited processing is designed. 
26

• Participants in a cohort with high film badge doses are likely to be excluded from expedited 

processing when their exposure information is reviewed. 

• Film badge dosimetry often does not cover the whole duration of participation of the entire 

membership of an EPG. 

• A quantification of exposure rate as a function of time is needed to reconstruct corresponding 

internal doses. This exposure rate function is more directly and accurately estimated from 

time-specific exposure rate measurements than from film badge data, the latter representing 

the integration of exposure rate over an often substantial period of time. 

3.1 Limitations of the Direct Use of Historical Doses from 

Previously Assessed Cases

The currently used doses, as derived from the first approach introduced above, were developed 

in 2007 using dose distributions from previously completed full RDAs. For the external gamma 

dose, the maximum dose from all previously-completed Nevada Test Site (NTS) or Pacific 

Proving Ground (PPG) cases was adopted for expedited processing as the dose to be assigned to 

an individual who participated at the relevant location (i.e., NTS or PPG). The selection of the 

initial neutron doses currently used in expedited processing was not clearly documented. The 

method adopted for internal doses consisted of sorting the historical dose estimates developed in 

full RDAs into groups of organs and tissues. The organs or tissues in each group were selected 

on the basis of cancer types or models used in the NIOSH-IREP software described in Section 2 

and hence would generate the same probability of causation for the same dose. The maximum 

historical internal doses for each group of organs or tissues were adopted as the doses to assign 

under expedited processing to any NTPR claimant with a relevant disease associated with the 

organs or tissues of that group (DTRA, 2007b). Because the number of completed cases for each 

group of organs and tissues was generally small except for prostate cancer, distinction was not 

made between NTS and PPG, and all available doses were analyzed in aggregate for each organ 

group. Exceptions were established where a case needed to undergo further review to address 

instances of special exposures that are based on a participant’s documented activities and 

statements that could result in higher doses. Participants at Hiroshima and Nagasaki, as well as 

those who participated in more than one test series were processed through a more in-depth 

review and/or full RDAs. 

However, as reported in DTRA (2010b), the direct use of previously-completed RDA dose 

estimates without regard to the scenario of activities results in doses that are unlikely to be 

representative of radiation exposures for the majority of participants. It is also important to note 

that maximum internal doses that are based solely on historical dose values without 

consideration of the associated exposure scenarios are inherently inconsistent across organs and 

participant groups; that is, the maximum internal doses do not reflect the relative magnitude of 

doses that would be expected from one organ group to another if the exposure scenario were the 

same for all groups. Furthermore, for cases where doses may potentially be greater than the 

respective maximum historical doses selected for use in expedited processing, current procedures 

require the preparation of full RDAs. If a more recent full RDA produces an external or internal 
27

dose that is higher than the existing historical maximum used for expedited processing, the latter

dose would need to be changed to the newer maximum value. Lastly, it is not obvious whether 

historical maximum mean doses, maximum upper-bound doses, or some other values should be 

used as the assigned external and internal doses under the current expedited processing

procedures. 

To illustrate the inconsistencies that could result from the direct use of historical dose results, 

consider two land-based participants from the same unit at the PPG who performed similar 

activities but submit claims of diseases to two different organs. Using current expedited 

processing procedures, the two cases would likely be assigned internal doses that are based on 

two different exposure scenarios, each of which differ from the participants’ scenarios and are

mutually inconsistent. Assume the first claim is for cancer of the oral cavity, for which the 

surrogate organ is “ET region,” and the second is for cancer of the kidney. For the claim 

involving the oral cavity, the maximum historical beta-plus-gamma internal dose is 7.4 rem. 

This dose is derived from a scenario involving inhalation of fallout that was resuspended from 

ship surfaces during decontamination activities after heavy fallout from Shot TEWA, Operation 

REDWING. For the claim involving the kidney, the maximum historical beta-plus-gamma dose 

is 0.004 rem. This dose is associated with the case of a veteran who served in a patrol squadron 

aircraft during REDWING and had minor radiation exposure and internal intake of contaminated 

materials while stationed at Kwajalein. Furthermore, the external gamma dose is 4.3 rem for the 

first case and 0.36 rem for the second. Additional inconsistency may occur for alpha doses 

because the highest alpha doses for the two organs would likely not be associated with the same 

cases as those for the highest beta-plus-gamma doses (DTRA, 2010b). 

The example above demonstrates how two claimants with similar potential exposure pathways 

are assigned doses that could be based on four widely varying scenarios of participation and 

radiation exposures. It is also clear that maximum doses from previously assessed cases are 

largely associated with special exposure scenarios for which expedited processing may not be

applicable. 

Moreover, current doses were selected based on an organ’s cancer model classification from 

the NIOSH-IREP software rather than the FIIDOS-derived Standard Organs list used in NTPR 

dose reconstructions (DTRA, 2010a). An example of a consequent discrepancy is the doses 

currently utilized in expedited processing for the organs rectum and colon. The maximum 

historical doses used in current expedited processing are 2 rem and 8 rem for beta-plus-gamma 

radiation to the colon and rectum, respectively. However, in full RDAs performed in the NTPR 

Program, internal doses to the colon and rectum are both estimated using lower large intestine as 

the surrogate FIIDOS organ. Therefore, an individual claiming disease for the rectum and colon 

would normally receive the same dose to both organs based on standard dose reconstruction 

methods for full RDAs that would calculate internal doses using FIIDOS dose conversion factors 

for the lower large intestine. 

Despite the limitations cited above for the direct use of historical RDA doses, such records can 

be useful in some situations to identify a large enough group of cases with comparable 

exposures. It is also appropriate to check the database of previously completed full RDAs to 

verify that the doses used in expedited processing are bounding for the defined group and ensure 

that cases with greater doses reflect special exposure scenarios that are excluded from 
28

consideration for expedited processing. Finally, historical dose results and individual RDAs are 

useful in providing the source for exposure scenarios and input parameter estimates, as well as 

pathway selection for EPGs. 

3.2 Expedited Processing Groups and Scenario-Based Dose

Estimation

Scenario-based EPG doses were developed using available information and publications on 

atmospheric testing and military participation from 1945 to 1962, film badge dosimetry records, 

and previously-completed RDAs. The process of developing doses for an EPG consists of the 

following steps:

• Identify EPG cohorts based on similarity of scenario activities and exposure pathways of 

their members.

• Select a “highest-dose cohort” that forms the generic basis for the scenario of participation 

and radiation exposure, potential exposure pathways, and related radiation environments.

• Modify dose components for specific exposure pathways using the scenario of exposure of 

the cohort(s) within the EPG that results in the highest dose for each specific dose 

component. 

• Use the limiting plausible values of input parameters that further overestimate each dose 

component. 

• Estimate the EPG’s external gamma dose and internal doses to 20 relevant organs using a 

single combination of the exposure pathways and input parameter values defined in the 

previous steps. The estimated doses are referred to as the “EPG doses.”

• Calculate upper-bound doses by multiplying the EPG doses by DTRA-approved uncertainty 

factors. In this calculation, it is also assumed that all dose components are dependent, which 

further increases upper-bound doses. This is done for all dose components whether based on 

radiation survey data or film badge dosimetry. 

The scenario-based EPG radiation assessment model for external doses is illustrated in

Figure 1, and the concepts and steps listed above are described in detail in the subsequent subsections. Using the above methodology guarantees that the doses assigned to an EPG bound the 

doses for each one of its members, even though not every exposure pathway or scenario of 

activities is applicable to all members of the EPG. 
29

Figure 1. The Concept of Assessing Doses for Expedited Processing

3.2.1 Definitions and Concepts

A scenario-based EPG radiation dose assessment provides results using documented cohort 

activities and exposures with additional high-siding adjustments that produce highly conservative 

doses for a group of cohorts. The highly conservative estimates can be assigned to large 

numbers of participants in the group of cohorts whose documented exposures are comparable to 

or smaller than those used to calculate the doses for the EPG. This means that the realistic doses 

of any member of an EPG, if calculated using a detailed assessment (full RDA), should be lower 

than the doses for that EPG. These groups can be as large as reasonable, with larger EPGs 

resulting in fewer doses to be estimated and maintained. 

An EPG consists of one or more cohorts that participated in atmospheric nuclear tests and 

performed activities that would have resulted in doses that are lower than the overall EPG doses. 

The aim is to use criteria so that all possible exposure pathways and radiation sources that are 

applicable to a cohort are combined to estimate the EPG doses. Therefore, to belong to an EPG, 

cohorts were selected based on the following criteria:

External Gamma 0 1 2 3 4

Dose (rem)

Cohort C1 d1

Cohort C2 d2

Cohort C3 d3

Cohort C4 d “Highest-Dose Cohort” 4 = dmax

Cohort C5 d5

EPG Dose (DEPG) = 

Maximized Scenario + 

Enhanced Parameters

DEPG > dms

The EPG external and internal doses are based on a maximized scenario of 

exposures and enhanced parameter values

EPG = C1 + C2 + C3 + C4 + C5 - Exclusions

Maximized 

Scenario (ms) dms ≥ dmax

C2 C4 C5C2

EPG UpperBound External 

Gamma Dose

NOTE: di is the external gamma 

dose for Cohort Ci

. Each dose 

component is represented by a 

different color/shade. Not all 

components apply to each 

cohort.

External Gamma 0 1 2 3 4

Dose (rem)

Cohort C1 d1

Cohort C2 d2

Cohort C3 d3

Cohort C4 d “Highest-Dose Cohort” 4 = dmax

Cohort C5 d5

EPG Dose (DEPG) = 

Maximized Scenario + 

Enhanced Parameters

DEPG > dms

The EPG external and internal doses are based on a maximized scenario of 

exposures and enhanced parameter values

EPG = C1 + C2 + C3 + C4 + C5 - Exclusions

Maximized 

Scenario (ms) dms ≥ dmax

C2 C4 C5C2

EPG UpperBound External 

Gamma Dose

NOTE: di is the external gamma 

dose for Cohort Ci

. Each dose 

component is represented by a 

different color/shade. Not all 

components apply to each 

cohort.
30

1. Commonality of activities and radiation environments.

2. Comparability of types of radiation (e.g., external gamma, internal alpha, and internal 

beta/gamma).

3. Similarity of exposure pathways.

4. Duration of participation and timing with respect to detonations.

5. Likelihood that doses are well below the screening doses for all or most non-presumptive 

cancers.

The satisfaction of Criterion (5) for large EPGs was verified based on a sequential process in 

which cohorts that were originally represented in separate EPGs were pooled together based on 

how the overall (external plus internal) doses of the higher doses EPG compared to the screening 

doses for most non-presumptive cancers. In another case, the compositions of two EPGs for 

Operation CASTLE ship-based personnel were re-evaluated, and cohorts were moved from the 

high-dose EPG to the low-dose EPG using Criterion (5) to better define the two groups. 

In relying on Criterion (5) to develop EPGs, attempts were made to minimize the number of 

EPG/organ combinations that would not satisfy the condition that the overall doses are well 

below the screening doses, as discussed in Section 2.5 and 3.3. Therefore, for an EPG/organ 

combination in which the overall dose is not well below the screening dose, the combination 

would not qualify for expedited processing. The results of these comparisons are discussed in 

Section 5. 

Based on these criteria, NTPR participants were grouped into compatible EPGs that are listed 

in Appendix B and described in detail in the EPG Compendium (DTRA, 2011) that accompanies 

this report, with the rationale for major groupings discussed in Section 4. Using scenario-based 

dose assessments guarantees adherence to the following principles:

• Representative scenarios are used as the basis for defining exposure pathways. 

• External doses incorporate maximized exposure scenarios and input parameter values. 

• Internal doses are based on an assumed concurrent accrual with external doses using 

maximized intakes where there is potential for internally-deposited contaminants. 

• Consistency exists between alpha and beta-plus-gamma internal doses, which are based on 

the same exposure scenario. 

• Internal doses among organs are in the correct relative magnitude given the same scenario of 

exposure. 

• Uniformity in the treatment of upper-bound doses is maintained. 

• Approved NTPR standard methods and procedures are used as the basic approach to estimate 

the doses. 
31

3.2.2 The “Highest-Dose Cohort” and Substitute Cohorts

The estimation of doses for an EPG requires identifying potential activities and the 

corresponding exposure pathways that bound the doses to all the members of the group. To 

develop such exposure pathways, a “highest-dose cohort” is first selected from all the cohorts 

that comprise the EPG based on the highest documented estimates of external gamma dose from 

residual radioactivity. These gamma radiation doses do not include initial gamma radiation, 

which is discussed later in this section. 

The scenario of participation and radiation exposure of the highest-dose cohort forms a starting 

point for estimating the EPG doses. To capture potentially higher doses for specific pathways, 

each component of both the external and internal doses is evaluated to determine if similar 

activities of participants from other cohorts of the EPG would have resulted in a higher dose than 

that of the highest-dose cohort. If a cohort dose is expected to be higher for any component of 

external or internal doses, that cohort becomes the basis for the specific exposure pathway and 

corresponding dose component for the entire EPG. Once all potential pathways are evaluated, 

components of the external and corresponding internal doses are assembled and modeled using 

the dose reconstruction methods described in DTRA (2008 and 2010a). These doses are further 

increased (see next section) to ensure that they are limiting for all EPG members. 

As explained above, the external and internal doses for the highest-dose cohort and any 

substitutions thereof are estimated based primarily on radiation survey data. In a few instances, 

film badge data are used to estimate some or all components of an EPG external gamma dose. 

This is suitable when members of the highest-dose cohort have been similarly exposed (i.e., 

reflected by a narrow film badge dose distribution) or when reliable radiation survey data are 

unavailable. The use of film badge dosimetry in estimating external doses is discussed for 

specific EPGs in the EPG Compendium (DTRA, 2011).

3.2.3 Maximizing the Doses

As described in the previous section, the external and internal doses derived for an EPG from 

the scenario of exposure of the highest-dose cohort can be maximized by substituting dose 

components for specific pathways. A substitute scenario of exposure is derived from another 

cohort that received a higher dose by a specific pathway than the corresponding dose component 

of the highest-dose cohort. This process results in higher doses from maximizing single 

exposure pathways and relevant dose components. 

For example, service observers who participated in a single shot at or after Shot BADGER 

during Operation UPSHOT-KNOTHOLE were exposed to residual radiation from Shot 

BADGER fallout at Camp Desert Rock (CDR) for a few days. The highest-dose cohort of an 

EPG consisting of all observer and maneuver troops of all operations carried out at the NTS is 

the Battalion Combat Team Able (BCT-A) at Shot SIMON during Operation UPSHOTKNOTHOLE. The dose for this highest-dose cohort would normally be estimated for this 

pathway based on the number of days the cohort remained at CDR after fallout from Shot 
32

BADGER was deposited. A more conservative dose can be estimated if the duration of exposure 

is extended to the end of the operational period of Operation UPSHOT-KNOTHOLE. This 

substituted scenario is valid for most CDR support personnel, many of whom participated as 

observers at one or two shots during Operation UPSHOT-KNOTHOLE. The dose can be further 

increased if the entire EPG is credited with exposure to fallout that was deposited from Shot 

POST during Operation TEAPOT rather than from Shot BADGER of Operation UPSHOTKNOTHOLE. Cohort substitutions of this type allow the formation of the EPG scenario which

results in the highest possible dose to any member for every exposure pathway. 

In addition to substituting cohort pathways and supplementing dose components for specific 

activities and exposure pathways to increase the overall EPG doses, input parameter values can 

be adjusted so as to increase the calculated doses. When selecting more conservative parameter 

values, it is imperative to use available published data or critical judgment to ensure that such 

dose-enhancing values are at or near the upper limit of the range of plausible estimates. For 

example, assuming a breathing rate of 2.0 m3 hr-1 instead of the default 1.2 m3 hr-1 results in an 

increase in the internal dose from inhalation. Another parameter that can be used to reasonably 

increase the doses is the exposure time for being outdoors or topside on a ship. 

It is important to recognize that the assignment of EPG doses and upper bounds may not be 

adequate for all cases. If statements from the veteran reveal an exposure scenario atypical for the 

EPG to which he was initially assigned, and a technical review indicates that consideration of 

this scenario could potentially increase his dose to a level comparable to or greater than the EPG 

dose, then a full RDA may be required. Conversely, if the total upper-bound dose for an EPG is 

at or above the limiting dose that produces a PC of 40 percent (see discussion in Section 2.5 and 

3.3), a full RDA based on an individual’s actual scenario of exposure may result in an individual 

dose that falls below the screening dose.

3.2.4 Identification of Excluded Cohorts and Activities

In general, exclusions consist of specific activities of an individual or one or more cohorts for 

which the documented scenario of participation demonstrates that the individual or members of 

the cohort had distinctly higher exposures than those used for the EPG due to special 

circumstances. These include cohorts for which there is insufficient information that ensures the 

EPG doses are appropriate. Conversely, certain cohorts that could be identified as members of 

an EPG may have carried out all of their activities in environments with no potential for radiation 

exposure, or where the exposures were much lower than for the other members of the EPG. 

They can be either organized into a separate EPG or processed individually. Cohorts in a 

participant group are organized into separate EPGs if, given well-documented special activities, 

their overall exposures are deemed quite distinct, either higher or lower by a significant margin, 

from the exposures experienced by other members of the EPG. Individual cases involving 

excluded cohorts or activities that have not been organized as a separate EPG should be referred 

for further review to determine one of two options:

1. The veteran’s likely doses are less than the doses used for the EPG, and therefore the EPG 

doses can be assigned. 
33

2. The veteran’s likely doses are close to or greater than the EPG doses and a detailed RDA 

should be carried out. 

Participants or cohorts excluded from an EPG based on operational activities that are specific 

to the EPG are listed in Appendix B, with detailed documentation provided in the EPG 

Compendium (DTRA, 2011). In addition to excluded participants or cohorts that are specific to 

an EPG, generally excluded activities that apply to multiple EPGs are provided in Table B-1 to 

Table B-3 of Appendix B of this report. 

3.2.5 Combining EPGs

Where warranted, it is also possible, after careful review and analysis, to combine small EPGs 

to form larger ones. This can be done as long as the doses of the most conservative EPG are well 

below the screening doses for all or most non-presumptive cancers. If this is not the case, then 

the combination of smaller EPGs would result in eliminating some cohorts from expedited 

processing. A possible situation for combining small EPGs into a larger one is the case in which 

cohorts with similar activities and exposures from one test series are grouped into one EPG and 

then EPGs for such similar participants from several series are combined into a larger one. As an 

example, observer and maneuver troop EPGs at each shot within an operation at the NTS were 

combined into an operation-specific EPG and then combined with observer and maneuver troop 

EPGs from all NTS operations into a single EPG. 

3.3 Applicability of EPG Doses for Expedited Processing

3.3.1 Credibility of Assigned EPG Doses

As described above, when using an expedited process for estimating doses to a group of 

exposed individuals, the process must clearly show that the dose is greater than the dose that any 

member of the group could have received. Achieving this goal depends on many factors such as 

the veteran’s specific activities that could have resulted in exposure, the characteristics of the 

radiation environment, and the uncertainties in the parameters used in the EPG dose calculations. 

The doses produced for expedited processing are only suitable for submission to VA when these 

doses are credibly maximized and are well below the screening doses. As stated in Section 2.5, 

to provide for an additional margin of credibility and be suitable for use in expedited processing, 

it is recommended that EPG doses produce estimated PCs that are lower than 40 percent. With 

this proposal, claimants whose doses are derived with expedited processes, and who do not 

receive favorable service connection decisions, can be assured that the assigned doses are higher 

than the veteran’s actual dose. 
34

3.3.2 Suitability of EPG Doses

During the development of the EPG approach, it was recognized that some EPG organ doses, 

which are maximized using the methodology described in this section, could be near or well 

above the screening doses as defined in Section 2. Such doses would not be suitable for use in 

support of VA’s claim decisions. Therefore, a review of EPG doses for suitability must be part 

of each individual EPG development, and organs with cancers associated with those doses must 

be identified. 

To identify which EPG doses for relevant organs and cancer models are credible, these were 

compared with the screening doses and the PC values were evaluated. To accomplish this task, 

the following suitability test of EPG/organ total upper-bound doses was applied: 

1. If the overall (upper-bound external plus internal) EPG dose for the relevant organ is higher 

than the screening dose of the corresponding NIOSH-IREP cancer model, listed in Table 3, 

the external and internal upper-bound doses estimated for the EPG/organ combination are 

deemed not suitable for expedited processing. 

2. If the overall EPG dose falls between the dose that produces a PC of 40 percent and the 

screening dose, the PC is calculated using the separate upper-bound doses from each 

radiation type, and if equal to or greater than 40 percent, the doses for the EPG/organ 

combination are deemed not suitable for expedited processing. 

3. If the PC calculated in step 2 is lower than 40 percent, the doses for the EPG/organ 

combination are deemed suitable and are proposed for use in expedited processing. 

A list of EPG/organ combinations that are recommended for exclusion from expedited 

processing is compiled for each EPG and are included in the EPG Compendium (DTRA, 2011) 

and summarized in Section 5. Cases involving an EPG/organ combination found to be 

unsuitable for expedited processing should be considered for a more comprehensive evaluation. 

3.4 Initial Gamma and Neutron Exposures

The initial gamma and neutron doses are to be treated separately from external and internal 

doses from residual radiations for each cohort or member of an EPG and are not taken into 

consideration when selecting a “highest-dose cohort” for an EPG. This approach was chosen 

due to the large variability of exposure to initial radiations by cohorts within some EPGs. 

Furthermore, these sources are not correlated with the scenario of exposure beyond the first 

minute after a shot and are not associated with the accrual of internal doses. Initial doses are 

based on actual scenarios of exposure of the particular cohorts or members of an EPG at the 

times of detonations. Giving the highest initial doses for any cohort to all members of an EPG 

would not be credible and would have the potential to cause several additional EPG/organ 

combinations to become excluded from expedited processing.
35

A large number of units or cohorts that received doses greater than 1 millirem are documented 

in Weitz and Egbert (2010). For many of the cohorts grouped into an EPG, the potential for 

initial radiation exposures did not exist or was insignificant given the locations of participants 

relative to the sites of the detonations. Conversely, cohorts that received substantial initial doses 

are likely to be excluded from EPG membership due to their specific types of activities and 

unique circumstances of exposure to radiation. For example, volunteer observers at some NTS 

shots and aircrews that were airborne and close to the detonation are excluded from expedited 

processing and a detailed review of participant cases is required. 

Moreover, where significant initial doses have been calculated previously for a cohort that was 

included in an EPG based on external and internal doses from residual radiation only, the impact 

of the initial dose upper bounds is evaluated using the overall EPG upper-bound organ doses. In 

these situations, the cohort’s initial upper-bound doses (i.e., gamma and neutron) are added to the 

EPG upper-bound doses (i.e., external and internal). The overall upper-bound dose, including 

initial doses, is then compared to the relevant cancer model dose, i.e. “limiting dose” at the 40-

percent PC level. The comparison allows determination of the impact of the additional initial 

doses and whether the overall dose, including initial doses, would still be well below the 

screening doses. Several high initial dose cohorts in the EPG for Observers and Maneuver 

Troops and the EPG for Task Force WARRIOR at the NTS were identified and are discussed in 

the EPG Compendium (DTRA, 2011). Organs with total upper-bound doses, including initial 

doses, which do not satisfy the well-below the screening dose criterion, are added to the list of 

organs not recommended for expedited processing for the relevant EPG. This evaluation of EPG 

doses using the initial doses of cohorts with highest exposure to initial radiation should cover all 

cohorts in these two EPGs that had some exposure to initial radiation. 
36

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37

4. 

Rationale for the Makeup of the Proposed 

Expedited Processing Groups

The method of identifying an EPG, as discussed in Section 3, relies heavily on the similarity of 

activities and exposure pathways among its members. The starting point in formulating EPGs is 

to combine elements that performed similar duties at the same location (e.g., on a ship, on a 

residence island at the PPG, or in the NTS forward area during a single test series). As a proof of 

concept, nine small sample EPGs were evaluated during the pilot phase of this study and are 

documented in an interim report (DTRA, 2010b). 

In the second phase, sample EPGs developed in the pilot phase were expanded by aggregating 

potentially similar cohort groups. The study team used its substantial experience in performing 

veteran-specific RDAs to develop a coherent membership for each EPG. For example, the crews 

of most ships in an oceanic test series experienced similar exposure scenarios and on that basis 

were incorporated into a single EPG (e.g., Operation GREENHOUSE Ship-Based Personnel). 

Care was taken to avoid mixing incompatible cohorts—(i.e., those with significantly different 

exposure scenarios that may have resulted in disparate doses). Each cohort of participants was 

individually assessed and either 1) incorporated into a compatible existing EPG, 2) made into a 

separate EPG, or 3) declared an exclusion. Exclusions were flagged for individualized dose 

assessments. 

The EPGs formed in this manner can be quite sizeable. The ship-based EPGs typically have 

memberships in the thousands to tens of thousands of participants. Similarly, all maneuver, 

observer and support troops whose participation included post-shot movement toward ground 

zero in the NTS forward area following one or two test shots were combined into one single EPG 

with a potential total membership of over 40,000 participants. 

4.1 Participants in the Oceanic Series

The United States conducted 106 nuclear weapon tests at locations in the Pacific Ocean during 

nine operations, and three high-altitude tests over the Atlantic Ocean during Operation ARGUS 

in 1958. These operations are collectively referred to as the “oceanic series.” The first nuclear 

test series was Operation CROSSROADS, conducted at Bikini Atoll in 1946. The following 

year, the Atomic Energy Commission established the Pacific Proving Ground (PPG) in the 

region of the Marshall Islands (Figure 2). The PPG initially consisted of the areas around Bikini 

and Enewetak Atolls (Figure 3 and Figure 4). It was subsequently renamed the Enewetak 

Proving Ground in 1958 and expanded to include Johnston and Christmas Islands (Figure 2). To 
38

avoid confusion in this report, the acronym “PPG” is used to designate this test area, regardless 

of time, and is considered to apply retroactively to CROSSROADS. 

Figure 2. Map of the Pacific Proving Ground
39

Figure 3. Map of Bikini Atoll during Operation CROSSROADS
40

Figure 4. Map of Enewetak Atoll during Operation SANDSTONE

Seven operations were conducted in the PPG after Operation CROSSROADS: SANDSTONE 

(1948), GREENHOUSE (1951), IVY (1952), CASTLE (1954), REDWING (1956), 

HARDTACK I (1958), and DOMINIC I (1962). Each was supported by personnel stationed on 

either ships (generally U.S. Navy ships), or on various “residence” islands. EPGs for 

participants of the PPG operations are typically broken out by operation and by residence base

(e.g., GREENHOUSE Land-Based Personnel and HARDTACK I Ship-Based Personnel). As 

needed, categories are subdivided to allow greater specificity of EPGs (e.g., the CROSSROADS 
41

Support Ship-Based Personnel and the CROSSROADS Target Ship-Based Personnel are distinct

EPGs, and the HARDTACK I Ship-Based Personnel EPG is separate from the HARDTACK I 

non-Exposed Ship-Based Personnel EPG). The EPGs of island-based and ship-based 

participants are discussed in the next two sub-sections, respectively. 

The remaining Pacific operation, Operation WIGWAM, was conducted in 1955 approximately

500 miles southwest of San Diego, CA, and thus outside the PPG. All the ship-based personnel 

at Operation WIGWAM are included in a single EPG. 

Some exposure scenarios involve activities that occurred after test operations had been 

formally terminated. Separate participant groups have been formulated in these cases and are 

addressed in the final sub-section.

4.1.1 Land-Based Personnel

Large numbers of operational and support personnel were billeted on “residence islands” 

during most oceanic series. These residence islands typically included Enewetak, Parry, and 

Japtan Islands of Enewetak Atoll and Eneu Island of Bikini Atoll, but varied somewhat from 

series to series. The residence islands for each operation are listed in the EPG Compendium 

(DTRA, 2011). The land-based personnel on the residence islands in the PPG during an oceanic 

test operation constitute a viable group for expedited assessment for the reasons discussed below. 

First, land-based personnel were stable and remained nearly stationary throughout an 

operation. They were stable because relatively few people transferred to or from the resident 

units during a test operation. They were stationary because most land-based personnel had little 

opportunity or incentive to participate in excursions away from the residence islands. 

Second, the radiation environments were similar for all groups of the land-based personnel. 

All residence islands were at distances from the detonation sites that precluded exposures to 

initial gamma and neutron radiations. Residual radiation from fallout on the residence islands 

was the primary source of both external and internal exposures for all land-based personnel. 

Nearly all fallout events on these islands occurred 10 or more hours after the times of detonation 

of the fallout-producing shots. At these times, the descending and deposited material to which 

land-based personnel were exposed consisted mostly of fine, inhalable particulates. The fallout 

deposition was fairly uniform over the inhabited area because by the time fallout arrived, the 

breadth of the radioactive fallout cloud was large compared to the dimensions of a residence 

island or the distance between such islands. As a result, most land-based personnel at a specific 

operation are likely to have encountered similar radiation exposure rates and consequently, 

accrued similar external doses.

Third, the pathways for internal exposures were common to all land-based personnel. These 

were inhalation of descending fallout, inhalation of resuspended fallout, and incidental ingestion 

of contaminated soil and dust. Because the sizes of the descending particles were generally 

small, all land-based residents who were outside during a fallout event inhaled the fallout with 

comparable efficiency. In addition, the fallout episodes on the residence islands were 

radiologically small enough that precautions were not taken to limit the exposure of the land-
42

based personnel to the descending fallout. Since the terrain and climate were generally similar 

throughout the occupied area, the resuspension of fallout particles from the ground and other 

surfaces would have been comparable. Thus, internal doses are expected to have been 

comparable across the population of land-based personnel present on the residence islands of the 

PPG.

4.1.2 Ship-Based Personnel

For reasons similar to those listed for land-based PPG participants, the ship-based personnel 

that supported oceanic testing also qualify as viable EPGs. Crews were stable and spatially 

constrained throughout an operation. Relatively few personnel transferred to or from a ship’s 

crew during an operation, and there were limited opportunities for crew members to participate 

in off-ship excursions. When substantive transfers occurred, as for the crews of targets ships at 

Operation CROSSROADS, the impact of such transfers on the doses was taken into 

consideration for those specific EPGs. 

The sources of exposure were similar across most ships in a given operation. All support ships 

were at distances from the detonations that precluded exposures of ship-based personnel to initial 

gamma and neutron radiations. The primary source of both internal and external exposure for 

most ship-based personnel was residual fallout on the deck. Secondary sources of external 

exposure included contaminated lagoon water and accumulations of fallout on the hulls and in 

the saltwater piping systems of the ships themselves. Similar to the case of the land-based 

groups, fallout events involving ship-based personnel generally occurred 10 or more hours after 

the time of detonation. Consequently, the deposited material to which shipboard personnel were 

exposed consisted mostly of fine particulates. 

Most ships participating in test operations were equipped with automated washdown systems 

that were fairly effective at removing fallout particles from topside locations, thereby limiting 

exposures to the crews. Those ships without automated systems usually resorted to manual 

methods to remove deposited material. Thus, the mitigating effects of decontamination are 

another common feature among support ships. 

Most crew members of a given ship are expected to have received generally comparable 

external and internal doses since the radiation environment experienced by individuals on that 

ship were similar. The consistency of external doses aboard individual ships is confirmed from 

film badge records. However, because a ship’s inherent mobility allowed the fleet of support 

ships to be widely dispersed during some fallout events, the amount of fallout deposition on 

these vessels varied significantly. This variability was probably reduced somewhat by 

decontamination—the more heavily contaminated ships are likely to have expended more effort 

in decontamination than marginally contaminated vessels. Nevertheless, the ship-to-ship 

variation in mean external dose is noticeably larger than the analogous variation seen among 

land-based units. One method of mitigating this condition for the purpose of expediting cases is 

to divide the population of ships into two or more tiers based on the crews’ average external 

doses, and treating each tier as a separate group. This is the case for ship-based personnel at 

Operation CASTLE, which has separate EPGs for “high-dose” and “low-dose” ships. The low-
43

dose EPG includes ships with resulting external and internal doses that produce a PC of less than 

40 percentfor all organs except thyroid, liver, gall bladder, and bile duct. These four organs are 

associated with low screening doses that are easily exceeded when attempting to make as many 

Operation CASTLE ships as possible eligible for expedited processing for all other organs. The 

selection of the two sets of ships was done primarily based on published external residual 

radiation doses and fine-tuned through an iterative process. 

A major pathway for internal exposure—the inhalation of resuspended fallout—was common 

to most shipboard personnel. Since the surface characteristics of weather decks and 

decontamination procedures were similar for most ship types, the subsequent resuspension of 

residual fallout particles would have been comparable. On the other hand, most ship-based 

personnel were not affected by descending fallout except for those few with duties that required 

their presence on weather decks during episodes of fallout. Material conditions (i.e., steps taken 

to increase the “tightness” of a ship) were set based on radiological safety considerations and 

stringently applied to prohibit non-essential personnel from being topside during fallout events. 

Personnel whose duties or temporary assignments required them to remain topside during 

documented or presumed episodes of descending fallout are classified as exclusions.

4.1.3 Other Categories of Oceanic Series Personnel

Other groupings of personnel who performed missions and/or conducted activities related to 

nuclear testing in the PPG also satisfy the criteria for expedited processing. Typically these 

groups are small, their exposure scenarios are unique, and the periods of their performance 

extended beyond the end of formal operations. These conditions inhibit the inclusion of these 

groups into the EPG categories discussed previously. These groups include the following:

• Inter-Operational Participants at Enewetak Atoll. Personnel were assigned to Enewetak Atoll 

following Operations SANDSTONE, GREENHOUSE, IVY, CASTLE, REDWING, and 

HARDTACK I. These participants served as a garrison force between operations to maintain 

the facilities on Enewetak Atoll and to prepare for the next operation. They generally 

departed the test site before any nuclear detonations of the next operation were conducted. 

The nature and timing of these missions are unique compared to Enewetak Atoll residents 

during test operations. 

• USS BRUSH Crew (February 25–27, 1947). The unique environment to which members of 

the BRUSH crew were exposed involves the handling and storage of contaminated souvenirs 

scavenged at Kwajalein from ships that had formerly served as target ships at 

CROSSROADS. There is little commonality between the exposure scenarios of this group 

and the crews of support and target ships that are the subject of Operation CROSSROADS 

EPGs.

• Bikini Resurveys (July–August, 1947). This small group performed or supported scientific 

activities (e.g., collecting fish, water, and soil samples in July and August 1947 at Bikini). 

The nature and timing of these activities are unique compared to those addressed in the more 

standard EPGs of ship-based and land-based personnel.
44

• Operations ARGUS, DOMINIC I, HARDTACK I non-exposed ships. Personnel in these 

three groups were assigned to ships that participated in high-altitude detonations that did not 

result in any doses from initial neutron or gamma radiation due to the distances between their 

locations and the detonations. In addition, no descending or residual fallout occurred due to 

the altitude and separation from the detonations.

The USS BRUSH crew and the Bikini resurvey personnel are not considered participants as 

defined by the Department of Veterans Affairs in Title 38, Code of Federal Regulations 

(38 CFR 3.309); these VA regulations supply the criteria that the NTPR Program applies in 

determining whether or not an individual is confirmed as a U.S. atmospheric nuclear test 

participant. However, these groups’ potentials for radiation exposure are being addressed in this 

report. (Note: some Bikini Resurvey personnel took part in eligible activities in other 

atmospheric tests and are therefore considered participants for those.) 

4.2 Participants in the NTS/CONUS Series

Atmospheric weapons tests in the continental United States (CONUS) were conducted almost 

exclusively at the NTS2, 3

Most NTS participants can be included in one of the four groupings described in this section. 

Grouping of participants for the purpose of expedited processing was based primarily on the type 

and extent of activities conducted in the forward NTS test areas, where most of the radiation 

doses for EPG members were received. Members of all NTS EPGs also received a dose from 

fallout contamination at the locations where they were housed. As used here, “forward NTS test 

areas” refers to areas north of News Nob near the Control Point and the Frenchman Flat area to 

the east of the Mercury Highway as illustrated in 

between 1951 and 1962 (USDOE, 2000). The personnel included in 

the NTS EPGs discussed in this report are limited to the military participants that formed a large 

portion of the roughly 75,000 Department of Defense (DoD) personnel who took part in those 

NTS detonations. Military personnel took part in three general types of activities during the NTS 

test series: scientific experiments, military technical and training projects, and support services. 

Troops from the latter two categories of participation compose the NTS EPGs. 

Figure 5. The NTS EPGs were grouped based 

on the overall similarity of activities, radiation environments encountered, and magnitude of the 

doses received, using the criteria described in Section 3 of this report. Details of each NTS EPG 

are contained in the EPG Compendium (DTRA, 2011), which is a companion document to this 

report. The rationale for grouping the cohorts in each of the proposed NTS EPGs is discussed in 

the following sections. 

 

2

 The Nevada Test Site was known as the Nevada Proving Ground prior to 1955. This report uses only the name 

Nevada Test Site (NTS) for simplicity. 

3

 One atmospheric detonation (TRINITY) was conducted at Alamogordo, New Mexico, in 1945. 
45

Figure 5. Schematic of NTS 1951-1962 Indicating Approximate 

Locations of Forward Test Areas

4.2.1 NTS Participants with Maneuver or Observer Activity

During all NTS test series, members of all services participated in official observer or tactical 

troop maneuver activities (DTRA, 2008, Appendix C-2 to C-9). Most of these personnel were 

Exercise Desert Rock (EDR) “service” troops who traveled from their home stations to Camp 

Desert Rock (CDR), located immediately south of the NTS, specifically to participate in an 

observer or maneuver training exercise. The activities of these service troops were usually 

limited to participation associated with a single nuclear test. Other observer and maneuver 

0 1 2 4 6 8 10

Approximate Scale (miles) 

Camp Desert Rock Camp Mercury 

(app. 2 miles south)

Frenchman Flat

Yucca Flat

Control Point News Nob

Mercury Highway

N

Frenchman

Lake

“Forward 

Test Area”

“Forward 

Test Area”

Approximate 

NTS 

Boundary
46

troops consisted of Camp Mercury and CDR support troops (i.e., troops who provided support 

functions for one of the camps or in support of Atomic Energy Commission (AEC) or EDR 

activities). Participants with activities at multiple operations are excluded from automatic 

expedited processing and their cases are referred for further review and assessment. 

One specific CDR support group has been evaluated and is included in the NTS Participants 

with Maneuver or Observer Activity EPG: personnel in the 505th Military Police Battalion (505 

MPB) that participated during Operation UPSHOT-KNOTHOLE (1953) or Operation TEAPOT 

(1955). Personnel from this unit provided routine military police duties at CDR and traffic 

control for military vehicular movement in forward areas of the NTS during EDR activities. 

They were exposed to residual radiation in NTS forward test areas during rehearsals and shotday activities (Frank, 1982). As CDR support personnel, these troops also participated in a 

maneuver and may have been observers at a detonation (Edwards et al., 1985). Activities, 

exposure sources, and dose ranges for 505 MPB personnel were evaluated separately and were 

found to be comparable to those of the NTS maneuver and observer troops discussed in this 

section and in the EPG Compendium (DTRA, 2011). Therefore, personnel in the 505 MPB who

participated during Operation UPSHOT-KNOTHOLE or Operation TEAPOT are included in 

this grouping of NTS participants with maneuver or observer activity. 

Another specific group that has been evaluated and is also included in the NTS Participants 

with Maneuver or Observer Activity EPG is Task Force BIG BANG (TFBB) personnel, who 

participated during Operation PLUMBBOB (Goetz et al., 1980). This task force was a 

provisional company from the 82nd Airborne Division that participated in rehearsals and 

conducted an exercise at the NTS in August and early September 1957. In general, TFBB 

personnel conducted activities similar to those of the NTS maneuver troops. They traveled from 

their home station to CDR specifically to participate in a maneuver exercise, and spent a period 

of 2 to 3 weeks at CDR. Their activities included training at CDR and rehearsals and testing in 

the forward test area. They observed one or more shots from News Nob, observed Shot 

GALILEO from Mercury Highway, and conducted specific military tasks following the 

GALILEO detonation. During their forward area activities, TFBB personnel were exposed to 

residual radiation from several earlier Operation PLUMBBOB shots. Their activities consisted 

primarily of walking or driving over open terrain, but also included crawling over terrain, during 

which they were exposed to resuspended fallout. Activities, exposure sources, and dose ranges 

for TFBB personnel were evaluated separately, and were found to be comparable to those of the 

NTS maneuver and observer troops discussed in this section and in the EPG Compendium 

(DTRA, 2011). Therefore personnel in TFBB are included in this grouping of participants with 

maneuver or observer activity. 

The majority of the maneuver and observer cohorts who participated over the years of the NTS 

test series can be consolidated into a single group for the purpose of expedited processing. This 

determination is based on the similarity in activities, exposure sources, and exposure pathways of 

participants, described as follows: 

• Housing, orientation and training at CDR or Camp Mercury for a period of about one week 

to several months, where there was the potential for exposure to no more than one fallout 

event. 
47

• Short periods of time (typically several hours) in NTS forward areas, conducting activities 

consisting primarily of walking or driving over open terrain. 

• No activities with potential high exposure such as radiation safety, retrieval of scientific 

instruments, excessive digging, or operation of heavy equipment in contaminated areas. 

• Comparable external exposures to deposited fallout or radionuclides in the soil that are 

produced by neutron activation from recent detonations at exposure rates limited by 

comparable exposure guidelines. 

• Internal exposures from inhalation of descending fallout, inhalation of fallout resuspended by 

typical troop activities (walking or driving over open terrain), and inhalation of fallout 

resuspended by detonation effects. 

• Sources of exposures only from initial radiation and residual radiation from fallout or 

radionuclides in the soil that are produced by neutron activation. 

Although participants did not experience exactly the same levels of exposure nor the same 

specific types of exposure (e.g., inhalation of fallout resuspended by detonation effects), NTS 

troops participating as maneuver or observer troops generally conducted similar activities that 

resulted in comparable exposure to residual radiation. Furthermore, the sources of residual 

radiation resulting in exposure of these troops were generally similar in type and duration. 

4.2.2 NTS Participants with no Forward Area Activities

Troops supporting AEC/DoD, EDR, and Air Force Special Weapons Center activities at NTS 

tests from 1951 to 1962 worked and lived at Camp Mercury, CDR, Indian Springs Air Force 

Base (AFB), or Nellis AFB. These support troops were assigned to one of these locations 

typically throughout a series (as long as five months in the case of Operation PLUMBBOB), 

although not all remained for the entire period. (DTRA, 2008, Appendices C-2 to C-9) 

NTS support personnel in this grouping are those who completed their assignments without 

entering the NTS forward. For these personnel, doses received resulted from exposure to fallout 

deposited at their housing/work location. Because fallout events and the types of activities 

resulting in exposures are comparable, the cohorts composing this overall group consist of all the 

support troops at billet locations mentioned above during all NTS test series from 1951 to 1962 

that did not carry out activities in the forward areas. These cohorts can be consolidated into a 

single exposure group for the purpose of expedited processing based on the following common 

features of activities and exposure sources and pathways shared by the support troops in this 

grouping: 

• Activities limited to general living and support tasks at billet location for a period of up to a 

few months where there was the potential for exposure to no more than three fallout events. 

These troops did not enter into any NTS forward areas, meaning that external exposure was 

from deposited fallout from recent detonations at the participant’s housing location. 
48

• Comparable external doses from residual radiation. 

• Internal exposure to descending fallout and recently-deposited fallout resuspended by typical 

troop activities such as walking or driving over roadways or graded ground. 

• Sources of exposures only from fallout or radionuclides in the soil that are produced by 

neutron activation. 

The above list demonstrates that NTS support troops who did not enter any NTS forward areas 

conducted similar activities that resulted in comparable exposure to residual radiation and that 

the sources of residual radiation resulting in exposure of these troops were similar in type and 

duration. 

4.2.3 Task Force WARRIOR

Task Force WARRIOR (TFW) was a reinforced infantry company from the 4th Infantry 

Division that was present at the NTS during Operation PLUMBBOB. This group participated in 

rehearsals, prepared defensive positions, and conducted an exercise at the NTS in August and 

early September 1957 (DTRA, 2008, Appendix C-7). The task force was excluded from the 

NTS Maneuver and Observer grouping because of TFW exposures to multiple previous fallout 

events that required further evaluation, and because questions have been raised regarding the 

shot-day exposure of this group (NAS/NRC, 2003).

In general, TFW personnel conducted activities similar to those of the other NTS maneuver 

troops: they traveled from their home station to CDR specifically to participate in a maneuver 

exercise. Their primary activity was conducted after observing Shot SMOKY. There are no 

clearly defined cohorts for TFW, and thus the high-dose cohort analysis for this group is based 

on the assumption that certain participants conducted a set of activities known to have been 

performed by specific TFW personnel. There are certain activities that not all subgroups of TFW 

personnel conducted; however, the makeup of performing subgroups and the extent to which 

TFW personnel were in multiple subgroups are unknown. Although not all TFW members 

participated in exactly the same manner, activities that may have resulted in exposures to 

residual radiation and the sources of such radiation were similar. These are described as follows:

• Housing, orientation, and training at CDR for a single period of 4 weeks. 

• Several hours in the NTS forward area, conducting activities consisting primarily of walking 

or driving over open terrain. 

• External exposure to deposited fallout and radionuclides in the soil that are produced by 

neutron activation from recent detonations at exposure rates limited by exposure guidelines. 

• Comparable external doses from residual radiation. 
49

• Internal exposure to recent fallout resuspended by typical troop activities such as walking or 

driving over open terrain. 

• Possible internal exposure to recent fallout resuspended by digging. 

• Internal exposure to a single descending fallout event at CDR, and for some members of the 

task force to descending SMOKY fallout in the shot area. 

• Sources of exposures only from initial radiation and residual radiation from fallout or 

radionuclides in the soil that are produced by neutron activation. 

The troops of TFW conducted similar activities that resulted in comparable exposure to 

residual radiation, and the sources of residual radiation resulting in exposure of these troops were 

similar in type and duration. Therefore, it is reasonable to include all TFW personnel in a single 

EPG for the purpose of expediting processing. 

4.2.4 Second Marine Corps Provisional Atomic Exercise Brigade

The 2nd Marine Corps Provisional Atomic Exercise Brigade (2MCPAEB) was a provisional 

unit comprising two Marine battalions with four companies each, a Marine air group comprising 

five squadrons, and a Headquarters unit. This unit of approximately 2,150 personnel conducted 

the largest DoD activity at Shot BADGER during Operation UPSHOT-KNOTHOLE in 1953 

(DTRA, 2008, Appendix C-5). The 2MCPAEB was excluded from the NTS Maneuver and 

Observer grouping because their activities resulted in higher exposures than those in the NTS 

Observer and Maneuver group. 

In general, 2MCPAEB personnel conducted activities similar to those of other NTS maneuver 

troops. They traveled from their home stations to CDR specifically to participate in a maneuver 

exercise. While some of the 2MCPAEB troops observed one or two shots from News Nob 

before the maneuver, the primary activities of this brigade consisted of a rehearsal and two days 

later the maneuver in conjunction with Shot BADGER (DTRA, 2008; Frank et al., 1982). The 

2MCPAEB group comprised several cohorts; each was a cohesive unit, and all members 

conducted similar activities. Representative film badge records are available for all cohorts 

(DTRA, 2010c), and the highest-dose cohort determination is based on a comparison of the 

average film badge readings of the cohorts. Differences in exposures between the 2MCPAEB 

cohorts exist. However, activities that may have resulted in exposures to residual radiation and 

the sources of such radiation were comparable, as described below:

• Housing, orientation, and training at CDR for a single period of about 2 weeks. 

• Two periods of time in NTS forward areas with activities consisting primarily of walking or 

driving over open terrain; some personnel were transported by helicopters. 

• Comparable external exposure to deposited fallout from recent detonations at exposure rates 

limited by the exposure guidelines. 
50

• Internal exposure to recent fallout resuspended by typical troop activities, such as walking or 

driving over open terrain, and by helicopter downwash during limited loading/unloading 

activities for some troops. 

• Possible internal exposure to aged fallout resuspended by detonation effects in the forward 

area. 

• Sources of exposures only from initial radiation and residual radiation from fallout or 

radionuclides in the soil that are produced by neutron activation.

The troops of the 2MCPAEB conducted similar activities that resulted in comparable exposure 

to residual radiation, and the sources of residual radiation resulting in exposure of these troops 

were similar in type and duration. Therefore, it is reasonable to include all 2MCPAEB personnel 

into a single EPG for the purpose of expedited processing. 
51

5. 

Radiation Dose Assessment Results

for Expedited Processing

During the developmental phase of the study, a total of 32 EPGs were identified that 

collectively address the majority of the PPG and NTS participants. Among these, the three EPGs 

for Operation ARGUS, Operation DOMINIC I, and Operation HARDTACK I non-exposed 

ships pertain to cohorts that had no potential for exposure to radiation during their participation. 

The 32 EPGs are listed in Appendix B and assessed individually in the accompanying EPG 

Compendium (DTRA, 2011). As important as identifying the participants that are covered by 

these EPGs is the explicit identification of those participants whose possible exposure scenarios 

are too complex or not sufficiently characterized to include in a general expedited process. The 

units and types of participant activities that are not recommended for expedited processing (i.e., 

exclusions) are identified in the EPG Compendium. To process an excluded case, further review 

and a more comprehensive RDA would be required. 

This section summarizes the EPG dose assessment results and discusses the applicability of 

expedited processing for the 32 EPGs based on the suitability test proposed in Section 3. 

5.1 Development of Expedited Processing Groups

The details of the dose assessments for the 32 EPGs are included in the EPG Compendium 

(DTRA, 2011). Each EPG dose assessment report specifies the composition of the EPG and 

provides detailed descriptions of the scenarios of exposure, exposure pathways, maximizing 

assumptions, and the dose parameter values employed in the dose calculations. In addition, the 

EPG Compendium identifies units, groups, individuals, and activities for which expedited 

processing methods are not recommended. 

Similarity of the exposure scenarios for many of the NTS participants allowed their 

consolidation into more broadly defined exposure groups consistent with the objectives of the 

study. Consequently, the 32 EPGs consist of only four EPGs for the NTS and 28 EPGs for the 

PPG. The PPG EPGs are further subdivided into 22 EPGs representing participation during 

actual test operations and six EPGs covering individuals whose activities occurred in time 

periods after or between test operations. The PPG EPGs are subdivided into land-based, shipbased, and other groups consisting of cohorts with unique exposure circumstances, as discussed 

in Section 4. 
52

5.2 Dose Assessment Results

Scenario-based external and internal doses were calculated for each EPG based on the 

methodology described in Section 3. These doses and their corresponding upper bounds are 

recommended for use in expedited processing of most NTPR cases. 

5.2.1 Summary of EPG Doses

The EPG doses consist of high-sided estimates calculated using exposure scenarios and input 

parameter values that maximize each dose component. The EPG doses are estimated for external 

gamma radiation, internal alpha radiation, and internal beta-plus-gamma radiation for the 20 

relevant NTPR Standard Organs; ovaries, uterus, and skin are not included. The resulting upperbound doses are generated from the EPG doses by applying DTRA-approved uncertainty factors, 

which are detailed in the EPG Compendium (DTRA, 2011). The EPG doses were calculated to 

meet the criteria recommended by the VBDR that these doses be based on worst-case parameter 

values and assumptions, and that their upper bounds be higher than any realistically calculated 

veteran’s upper-bound doses. Across all EPGs, the estimated upper-bound EPG external doses 

range from less than 0.1 to about 23 rem. Similar but wider ranges are observed for internal 

organ doses (DTRA, 2011). The EPG external doses, the external and internal upper bound 

doses, and the total doses for NTS, PPG-land based, and PPG ship-based personnel are provided 

in Table 4 to Table 7. The total (or the overall) upper-bound dose is the sum of the upper-bound 

external gamma dose and upper-bound alpha and beta-plus-gamma internal doses. 

5.2.2 Alpha Doses for the ET Region and Lungs

The doses due to alpha particles from inhalation of isotopes of the elements uranium, 

neptunium, plutonium, americium and curium were calculated assuming absorption type M4

 

4 Absorption type is a term defined in ICRP (1994) that characterizes the solubility of deposited radioactive 

materials in human organs and tissues. Three absorption types are used according to whether the absorption to 

blood is considered to be fast (F), moderate (M), or slow (S).

. 

This assumption was based on a determination that the oxides of these materials in fallout could 

be considered to have an indeterminate solubility and is the standard for the NTPR program 

(DTRA, 2010a). During the course of this study, reviewers noted that this assumption tended to 

maximize the doses from alpha particles to all FIIDOS organs except the ET region and lung, for 

which absorption type S results in higher doses. 
53

Table 4. Estimated Radiation Doses (rem) for Ship-Based Personnel at the Pacific Proving Ground*

EPG Name Radiation

Type†

AdrenalsBone SurfaceBrainBreastStomach wallSmall Intestine wall 

Upper Large Intestine WallLower Large Intestine WallKidneys LiverExtra-Thoracic Region Lung MusclePancreasRed MarrowSpleenTestesThymus Thyroid Urinary Bladder Wall

XRDS Target Ships UB α 0.09 47 0.09 0.09 0.09 0.09 0.09 0.09 0.2 11 0.5 1 0.09 0.09 3 0.09 0.7 0.09 0.09 0.09

Ext Dose Upper Bound UB β+γ 0.3 3 0.2 0.2 0.9 2 8 19 0.4 0.7 9 19 0.3 0.3 0.9 0.3 0.2 0.3 45 0.6

3 9 total 9 58 9 9 10 11 17 28 10 20 19 28 9 9 12 9 10 9 53 10

XRDS Support Ships UB α 0.003 2 0.003 0.003 0.003 0.003 0.003 0.003 0.006 0.3 0.02 0.03 0.003 0.003 0.07 0.003 0.02 0.003 0.003 0.003

Ext Dose Upper Bound UB β+γ 0.009 0.09 0.005 0.006 0.04 0.08 0.4 0.9 0.02 0.03 0.2 0.4 0.009 0.01 0.04 0.008 0.007 0.007 2 0.03

3 9 total 9 10 9 9 9 9 9 10 9 9 9 9 9 9 9 9 9 9 10 9

USS BRUSH UB α 0.09 51 0.09 0.09 0.1 0.1 0.2 0.2 0.3 11 0.5 1 0.09 0.09 3 0.09 0.7 0.09 0.09 0.09

Ext Dose Upper Bound UB β+γ 0.3 3 0.2 0.2 0.5 1 5 13 0.3 0.6 0.5 4 0.2 0.3 0.8 0.2 0.2 0.2 0.2 0.3

0.08 0.3 total 0.6 53 0.5 0.5 0.9 2 5 13 0.7 12 2 5 0.6 0.6 4 0.6 2 0.6 0.6 0.6

SANDSTONE Ships UB α <0.001 0.004 <0.001 <0.001 <0.001 <0.001 <0.001 <0.001 <0.001 <0.001 <0.001 <0.001 <0.001 <0.001 <0.001 <0.001 <0.001 <0.001 <0.001 <0.001

Ext Dose Upper Bound UB β+γ <0.001 0.002 <0.001 <0.001 <0.001 0.002 0.006 0.02 <0.001 <0.001 0.02 0.03 <0.001 <0.001 <0.001 <0.001 <0.001 <0.001 0.03 <0.001

0.09 0.3 total 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3

GREENHOUSE Ships UB α <0.001 0.1 <0.001 <0.001 <0.001 <0.001 <0.001 <0.001 <0.001 0.03 0.001 0.003 <0.001 <0.001 0.005 <0.001 0.002 <0.001 <0.001 <0.001

Ext Dose Upper Bound UB β+γ 0.02 0.2 0.01 0.02 0.1 0.2 0.7 2 0.02 0.03 2 3 0.02 0.02 0.06 0.02 0.009 0.02 3 0.06

3 7 total 7 7 7 7 7 7 7 8 7 7 9 9 7 7 7 7 7 7 9 7

IVY Ships UB α <0.001 0.03 <0.001 <0.001 <0.001 <0.001 <0.001 <0.001 <0.001 0.005 <0.001 <0.001 <0.001 <0.001 0.002 <0.001 <0.001 <0.001 <0.001 <0.001

Ext Dose Upper Bound UB β+γ <0.001 0.02 <0.001 <0.001 0.002 0.004 0.02 0.04 <0.001 0.004 0.05 0.08 <0.001 <0.001 0.002 <0.001 <0.001 <0.001 0.05 <0.001

0.07 0.2 total 0.2 0.3 0.2 0.2 0.2 0.2 0.3 0.3 0.2 0.2 0.3 0.3 0.2 0.2 0.2 0.2 0.2 0.2 0.3 0.2

CASTLE Ships (High) UB α 0.009 5 0.009 0.009 0.009 0.009 0.009 0.009 0.03 1 0.05 0.2 0.009 0.009 0.3 0.009 0.07 0.009 0.009 0.009

Ext Dose Upper Bound UB β+γ 0.2 5 0.08 0.2 1 2 7 13 0.3 0.8 21 24 0.2 0.2 0.5 0.2 0.2 0.2 16 0.5

8 23 total 23 32 23 23 24 25 30 36 23 25 43 47 23 23 24 23 23 23 38 23

CASTLE Ships (Low) UB α 0.02 7 0.02 0.02 0.02 0.02 0.02 0.02 0.03 2 0.07 0.2 0.02 0.02 0.4 0.02 0.1 0.02 0.02 0.02

Ext Dose Upper Bound UB β+γ 0.08 5 0.04 0.07 0.4 0.7 3 6 0.2 0.9 8 12 0.07 0.08 0.4 0.07 0.08 0.09 7 0.2

4 12 total 12 22 12 12 12 13 15 17 12 14 20 23 12 12 13 12 12 12 18 12
54

Table 4. Estimated Radiation Dose (rem) for Ship-Based Personnel at the Pacific Proving Ground* (cont.)

EPG Name Radiation

Type†

AdrenalsBone SurfaceBrainBreastStomach wallSmall Intestine wallUpper Large Intestine WallLower Large Intestine WallKidneys LiverExtra-Thoracic Region Lung MusclePancreasRed MarrowSpleenTestesThymus Thyroid Urinary Bladder Wall

WIGWAM Ships UB α <0.001 0.2 <0.001 <0.001 <0.001 <0.001 <0.001 <0.001 <0.001 0.03 0.002 0.003 <0.001 <0.001 0.006 <0.001 0.002 <0.001 <0.001 <0.001

Ext Dose Upper Bound UB β+γ 0.007 0.05 0.004 0.006 0.04 0.07 0.3 0.5 0.007 0.009 0.8 0.7 0.006 0.007 0.02 0.006 0.004 0.007 1 0.03

0.3 0.6 total 0.6 0.8 0.6 0.6 0.6 0.7 0.9 1 0.6 0.6 2 2 0.6 0.6 0.6 0.6 0.6 0.6 2 0.6

REDWING Ships UB α <0.001 0.09 <0.001 <0.001 <0.001 <0.001 <0.001 <0.001 <0.001 0.02 <0.001 0.002 <0.001 <0.001 0.005 <0.001 0.002 <0.001 <0.001 <0.001

Ext Dose Upper Bound UB β+γ 0.01 0.1 0.005 0.008 0.05 0.09 0.4 0.8 0.02 0.02 2 2 0.009 0.01 0.03 0.008 0.005 0.02 2 0.03

3 7 total 7 7 7 7 7 7 7 7 7 7 8 8 7 7 7 7 7 7 8 7

HARDTACK I Ships UB α 0.003 2 0.003 0.003 0.003 0.003 0.003 0.003 0.007 0.4 0.02 0.04 0.003 0.003 0.08 0.003 0.03 0.003 0.003 0.003

Ext Dose Upper Bound UB β+γ 0.03 0.4 0.02 0.03 0.08 0.2 0.8 2 0.2 0.09 3 3 0.03 0.03 0.09 0.2 0.02 0.03 3 0.2

2 6 total 6 8 6 6 6 6 7 8 6 7 9 9 6 6 6 6 6 6 9 6

HARDTACK I NonExposed Ships UB α No Potential for Exposure

Upper Bound UB β+γ No Potential for Exposure

NPE+ total No Potential for Exposure

ARGUS Ships UB α No Potential for Exposure

Ext Dose Upper Bound UB β+γ No Potential for Exposure

NPE+ NPE total No Potential for Exposure

DOMINIC I Ships UB α No Potential for Exposure

Ext Dose Upper Bound UB β+γ No Potential for Exposure

NPE+ NPE total No Potential for Exposure

* The total organ doses do not sum up to its components due to rounding. † UB means upper bound dose for the given radiation type. + NPE means No potential for Exposure
55

Table 5. Estimated Radiation Doses (rem) for Land-Based Personnel at the Pacific Proving Ground

EPG Name Radiation

Type†

Adrenals Bone SurfaceBrain Breast Stomach wallSmall Intestine wallUpper Large Intestine WallLower Large Intestine WallKidneys LiverExtra-Thoracic Region Lung MusclePancreasRed MarrowSpleenTestesThymus Thyroid Urinary Bladder Wall

CROSSROADS Land UB α 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Ext Dose UB β+γ UB β+γ 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

0.03 0.09 total 0.09 0.09 0.09 0.09 0.09 0.09 0.09 0.09 0.09 0.09 0.09 0.09 0.09 0.09 0.09 0.09 0.09 0.09 0.09 0.09

BIKINI Resurvey UB α 0.09 49 0.09 0.09 0.09 0.09 0.09 0.09 0.3 11 0.5 1 0.09 0.09 3 0.09 0.7 0.09 0.09 0.09

Ext Dose Upper Bound UB β+γ 0.02 1 0.007 0.01 0.02 0.03 0.1 0.3 0.01 0.3 0.2 3 0.008 0.01 0.08 0.01 0.02 0.02 0.008 0.008

0.8 3 total 3 52 3 3 3 3 3 3 3 14 3 6 3 3 5 3 4 3 3 3

SANDSTONE Land UB α <0.001 0.5 <0.001 <0.001 <0.001 <0.001 <0.001 <0.001 0.002 0.1 0.005 0.01 <0.001 0.002 0.03 0.003 0.006 <0.001 0.002 <0.001

Ext Dose Upper Bound UB β+γ 0.007 0.07 0.003 0.006 0.02 0.03 0.2 0.3 0.005 0.02 0.4 0.8 0.005 0.006 0.03 0.005 0.003 0.007 0.6 0.01

0.2 0.6 total 0.6 1 0.6 0.6 0.6 0.6 0.7 0.8 0.6 0.7 0.9 2 0.6 0.6 0.6 0.6 0.6 0.6 1 0.6

GREENHOUSE Land UB α 0.005 3 0.005 0.005 0.005 0.005 0.005 0.005 0.02 0.6 0.03 0.06 0.005 0.005 0.2 0.005 0.04 0.005 0.005 0.005

Ext Dose Upper Bound UB β+γ 0.2 2 0.08 0.2 0.9 2 5 8 0.2 0.3 12 15 0.2 0.2 0.5 0.2 0.06 0.2 16 0.4

7 21 total 21 25 21 21 22 23 26 29 21 22 33 36 21 21 22 21 21 21 36 22

IVY Land UB α 0.002 2 0.002 0.002 0.002 0.002 0.002 0.002 0.004 0.3 0.02 0.03 0.002 0.002 0.06 0.002 0.02 0.002 0.002 0.002

Ext Dose Upper Bound UB β+γ 0.02 0.7 0.007 0.02 0.04 0.08 0.4 0.7 0.02 0.2 1 3 0.02 0.02 0.08 0.02 0.009 0.02 0.8 0.02

0.2 0.4 total 0.4 3 0.4 0.4 0.4 0.5 0.7 1 0.4 0.7 2 3 0.4 0.4 0.5 0.4 0.4 0.4 2 0.4

CASTLE Land UB α 0.02 7 0.02 0.02 0.02 0.02 0.02 0.02 0.03 2 0.07 0.2 0.02 0.02 0.4 0.02 0.1 0.02 0.02 0.02

Ext Dose Upper Bound UB β+γ 0.1 5 0.05 0.08 0.5 0.9 4 7 0.2 0.9 11 15 0.08 0.09 0.4 0.08 0.08 0.1 8 0.2

2 5 total 5 16 5 5 6 6 8 12 5 7 16 20 5 5 6 5 5 5 13 5

REDWING Land UB α 0.02 9 0.02 0.02 0.02 0.02 0.02 0.02 0.04 2 0.09 0.2 0.02 0.02 0.5 0.02 0.2 0.02 0.02 0.02

Ext Dose Upper Bound UB β+γ 0.2 5 0.2 0.2 2 3 9 16 0.4 0.9 25 30 0.2 0.2 0.7 0.2 0.2 0.3 23 0.6

6 18 total 19 31 18 18 20 21 27 34 19 21 43 48 18 18 19 18 19 19 41 19
56

Table 5. Estimated Radiation Doses (rem) for Land-Based Personnel at the Pacific Proving Ground (cont.)

EPG Name Radiation

Type†

AdrenalsBone SurfaceBrainBreastStomach wallSmall Intestine wallUpper Large Intestine WallLower Large Intestine WallKidneysLiverExtra-Thoracic RegionLungMusclePancreasRed MarrowSpleenTestesThymusThyroidUrinary Bladder Wall

HARDTACK I Land UB α 0.02 12 0.02 0.02 0.02 0.02 0.02 0.02 0.06 3 0.2 0.3 0.02 0.02 0.6 0.02 0.2 0.02 0.02 0.02

Ext Dose Upper Bound UB β+γ 0.2 3 0.07 0.2 0.4 0.8 4 8 0.6 0.6 12 11 0.2 0.2 0.5 0.5 0.08 0.2 11 0.6

3 8 total 8 22 8 8 8 9 12 16 9 11 20 19 8 8 9 9 8 8 19 9

DOMINIC I Land UB α No Potential for Exposure 

Ext Dose Upper Bound UB β+γ No Potential for Exposure 

NPE+ NPE+ total No Potential for Exposure 

* The total organ doses do not sum up to its components due to rounding. † UB means upper bound dose for the given radiation type. + NPE means no potential for exposure from either external or internal radiation. If film badge dosimetry exists, assign film badge dose as the upper-bound external gamma dose. 
57

Table 6. Estimated Radiation Doses (rem) for Post-Operations Personnel at the Pacific Proving Ground*

EPG Name Radiation

Type†

AdrenalsBone SurfaceBrainBreastStomach wallSmall Intestine wallUpper Large Intestine WallLower Large Intestine WallKidneys LiverExtra-Thoracic Region Lung MusclePancreasRed MarrowSpleenTestesThymus Thyroid Urinary Bladder Wall

POST-SANDSTONE UB α <0.001 0.08 <0.001 <0.001 <0.001 <0.001 <0.001 <0.001 <0.001 0.02 <0.001 0.002 <0.001 <0.001 0.004 <0.001 0.002 <0.001 <0.001 <0.001

Ext Dose Upper Bound UB β+γ 0.002 0.02 <0.001 0.002 0.002 0.002 0.009 0.03 <0.001 0.003 0.03 0.2 <0.001 <0.001 0.005 <0.001 <0.001 0.002 0.009 <0.001

0.05 0.2 total 0.2 0.3 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.3 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2

POST-GREENHOUSE UB α 0.004 3 0.004 0.004 0.004 0.004 0.004 0.004 0.009 0.5 0.03 0.05 0.004 0.004 0.1 0.004 0.03 0.004 0.004 0.004

Ext Dose Upper Bound UB β+γ 0.06 0.6 0.02 0.05 0.07 0.2 0.5 2 0.04 0.1 2 7 0.04 0.05 0.3 0.04 0.02 0.06 2 0.04

3 8 total 8 10 8 8 8 8 8 9 8 8 9 14 8 8 8 8 8 8 9 8

POST-IVY UB α <0.001 0.2 <0.001 <0.001 <0.001 <0.001 <0.001 <0.001 <0.001 0.03 0.002 0.003 <0.001 <0.001 0.006 <0.001 0.002 <0.001 <0.001 <0.001

Ext Dose Upper Bound UB β+γ <0.001 0.07 <0.001 <0.001 <0.001 <0.001 0.004 0.009 <0.001 0.02 0.02 0.05 <0.001 <0.001 0.004 <0.001 <0.001 <0.001 0.01 <0.001

0.03 0.09 total 0.09 0.3 0.09 0.09 0.09 0.09 0.09 0.1 0.09 0.2 0.1 0.2 0.09 0.09 0.1 0.09 0.09 0.09 0.1 0.09

POST-CASTLE UB α 0.006 3 0.006 0.006 0.006 0.006 0.006 0.006 0.02 0.7 0.03 0.07 0.006 0.04 0.006 0.2 0.006 0.006 0.05 0.006

Ext Dose Upper Bound UB β+γ 0.008 2 0.005 0.008 0.008 0.02 0.04 0.1 0.008 0.4 0.2 0.8 0.006 0.03 0.007 0.08 0.005 0.007 0.03 0.009

0.3 0.8 total 0.8 6 0.8 0.8 0.8 0.8 0.8 0.9 0.8 2 0.9 2 0.8 0.8 0.8 1 0.8 0.8 0.8 0.8

POST-REDWING UB α 0.02 8 0.02 0.02 0.02 0.02 0.02 0.02 0.04 2 0.08 0.2 0.02 0.02 0.4 0.02 0.2 0.02 0.02 0.02

Ext Dose Upper Bound UB β+γ 0.05 3 0.02 0.05 0.06 0.09 0.4 1 0.04 0.5 2 7 0.03 0.04 0.3 0.04 0.04 0.06 0.8 0.03

2 6 total 6 16 6 6 6 6 7 7 6 8 7 12 6 6 7 6 6 6 7 6

POST-HARDTACK I UB α 0.006 4 0.006 0.006 0.006 0.006 0.006 0.006 0.02 0.7 0.04 0.08 0.006 0.006 0.2 0.006 0.05 0.006 0.006 0.006

Ext Dose Upper Bound UB β+γ 0.009 0.5 0.004 0.007 0.02 0.02 0.2 0.4 0.06 0.1 0.4 1 0.005 0.007 0.05 0.05 0.007 0.008 0.02 0.02

0.4 1 total 1 5 1 1 1 1 2 2 2 2 2 3 1 1 2 2 2 1 1 1

* The total organ doses do not sum up to its components due to rounding. † UB means upper bound dose for the given radiation type.
58

Table 7. Estimated Radiation Doses (rem) for Personnel at the Nevada Test Site*

EPG Name Radiation

Type†

AdrenalsBone SurfaceBrainBreastStomach wallSmall Intestine wallUpper Large Intestine WallLower Large Intestine WallKidneys LiverExtra-Thoracic Region Lung MusclePancreasRed MarrowSpleenTestesThymus Thyroid Urinary Bladder Wall

NTS OBS/Man UB α 0.008 5 0.008 0.008 0.008 0.008 0.008 0.008 0.02 1 0.05 0.1 0.008 0.008 0.3 0.008 0.06 0.008 0.008 0.008

Ext Dose Upper Bound UB β+γ 0.02 0.2 0.006 0.01 0.05 0.07 0.2 0.4 0.009 0.03 0.7 2 0.009 0.02 0.05 0.01 0.005 0.02 0.8 0.02

4 10 total 10 14 10 10 10 10 10 10 10 11 11 11 10 10 10 10 10 10 11 10

NTS Support Troops UB α 0.007 4 0.007 0.007 0.007 0.007 0.007 0.007 0.02 0.8 0.04 0.08 0.007 0.007 0.2 0.007 0.05 0.007 0.007 0.007

Ext Dose Upper Bound UB β+γ <0.001 0.05 <0.001 <0.001 0.006 0.009 0.03 0.05 <0.001 0.02 0.09 0.09 <0.001 <0.001 0.004 <0.001 0.001 0.001 0.2 0.003

0.04 0.1 total 0.2 4 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.9 0.3 0.3 0.2 0.2 0.3 0.2 0.2 0.2 0.3 0.2

2MCPAEB UB α 0.003 2 0.003 0.003 0.003 0.003 0.003 0.003 0.007 0.4 0.02 0.04 0.003 0.003 0.09 0.003 0.03 0.003 0.003 0.003

Ext Dose Upper Bound UB β+γ 0.03 0.3 0.02 0.02 0.2 0.2 0.6 2 0.02 0.04 2 3 0.02 0.02 0.08 0.02 0.009 0.03 2 0.05

6 17 total 17 19 17 17 17 17 17 18 17 17 19 20 17 17 17 17 17 17 19 17

TF WARRIOR UB α 0.02 10 0.02 0.02 0.02 0.02 0.02 0.02 0.05 2 0.2 0.4 0.02 0.02 0.5 0.02 0.2 0.02 0.02 0.02

Ext Dose Upper Bound UB β+γ 0.09 2 0.06 0.07 0.7 1 3 4 0.08 0.4 9 8 0.08 0.09 0.4 0.08 0.06 0.1 9 0.3

2 5 total 5 16 5 5 6 6 8 9 5 7 13 12 5 5 6 5 5 5 13 5 * The total organ doses do not sum up to its components due to rounding. † UB means upper bound dose for the given radiation type.
59

To evaluate the impact of using either absorption type, alpha particle doses for the isotopes of 

the elements mentioned above were calculated using an adjustment factor determined from the 

ratios of the ICRP dose coefficients for type S to the dose coefficients for type M for the ET 

region and lung for each alpha particle emitter (i.e. U-235, U-238, Np-237, Pu-238, Pu-239, Pu240, Am-241, and Cm-242). Those ratios were found to range from 2.1 to 6.0 for the ET region 

and from 1.4 to 3.0 for the lung. To maximize the estimates of alpha and therefore total doses, 

ratios of 6.0 and 3.0 were used for the ET region and the lung, respectively. The results of those 

calculations and a comparison of the alpha doses and total doses using absorption types M and S 

are listed in Table 8. 

Table 8. Comparison of Alpha Particle and Total Doses for Type M and Type S 

EPG

ET Region(Type M)ET Region(Type S) % diff(M-S)/SLung(Type M)Lun

g

(Type S)% diff(M-S)/S

Screening Dose (rem) 35 (Esophagus) 54 (Lung)

XRDS Target Ship alpha UB 0.465 2.79 -83% 1.03 3.09 -67%

Ext EPG Dose / UB b+g UB 8.95 8.95 18.3 18.3

2.88 8.65 total 18.1 20.4 -11% 28 30 -7%

XRDS Sup Ship alpha UB 0.0128 0.0768 -83% 0.0283 0.0849 -67%

Ext EPG Dose / UB b+g UB 0.108 0.108 0.321 0.321

2.72 8.15 total 8.27 8.33 -1% 8.5 8.56 -1%

USS BRUSH alpha UB 0.462 2.77 -83% 1.01 3.04 -67%

Ext EPG Dose / UB b+g UB 0.474 0.474 3.66 3.66

0.08 0.24 total 1.17 3.48 -66% 4.91 6.93 -29%

SANDSTONE Ship alpha UB 3.81E-05 0.000229 -83% 8.45E-05 0.000254 -67%

Ext EPG Dose / UB b+g UB 0.0182 0.0182 0.0262 0.0262

0.0862 0.258 total 0.277 0.277 0% 0.285 0.285 0%

GREENHOUSE Ship alpha UB 0.000932 0.00559 -83% 0.00207 0.0062 -67%

Ext EPG Dose / UB b+g UB 1.96 1.96 2.13 2.13

2.04 6.12 total 8.08 8.08 0% 8.25 8.25 0%

IVY 

Ship

alpha UB 0.000217 0.0013 -83% 0.000478 0.00143 -67%

Ext EPG Dose / UB b+g UB 0.0496 0.0496 0.0721 0.0721

0.0624 0.187 total 0.237 0.238 0% 0.26 0.261 0%

CASTLE (High) Ship alpha UB 0.0473 0.284 -83% 0.104 0.313 -67%

Ext EPG Dose / UB b+g UB 20.6 20.6 23.9 23.9

7.43 22.3 total 43.0 43.2 0% 46.3 46.5 0%

CASTLE (Low) Ship alpha UB 0.0647 0.388 -83% 0.142 0.427 -67%

Ext EPG Dose / UB b+g UB 7.91 7.91 11.2 11.2

3.81 11.4 total 19.4 19.7 -2% 22.7 23 -1%
60

EPG

ET Region(Type M)ET Region(Type S) % diff(M-S)/SLung(Type M)Lun

g

(Type S)% diff(M-S)/S

WIGWAM Ship alpha UB 0.00113 0.00679 -83% 0.00251 0.00753 -67%

Ext EPG Dose / UB b+g UB 0.737 0.737 0.686 0.686

0.230 0.557 total 1.3 1.3 0% 1.25 1.25 0%

REDWING Ship alpha UB 0.000829 0.00498 -83% 0.00183 0.0055 -67%

Ext EPG Dose / UB b+g UB 1.16 1.16 1.54 1.54

2.01 6.04 total 7.2 7.21 0% 7.58 7.59 0%

HARDTACK I Ship alpha UB 0.0151 0.0907 -83% 0.0351 0.105 -67%

Ext EPG Dose / UB b+g UB 2.52 2.52 2.2 2.2

1.94 5.81 total 8.34 8.42 -1% 8.04 8.11 -1%

CROSSROADS Land alpha UB 0.00 0.00 0% 0.00 0.00 0%

Ext EPG Dose / UB b+g UB 0.00 0.00 0.00 0.00

0.03 0.09 total 0.09 0.09 0% 0.09 0.09 0%

BIKINI Resurvey alpha UB 0.485 2.91 -83% 1.08 3.23 -67%

Ext EPG Dose / UB b+g UB 0.175 0.175 2.45 2.45

0.779 2.34 total 3 5.42 -45% 5.86 8.01 -27%

SANDSTONE Land alpha UB 0.00437 0.0262 -83% 0.00968 0.029 -67%

Ext EPG Dose / UB b+g UB 0.354 0.354 0.737 0.737

0.17 0.511 total 0.869 0.891 -2% 1.26 1.28 -2%

GREENHOUSE Land alpha UB 0.0268 0.161 -83% 0.0593 0.178 -67%

Ext EPG Dose / UB b+g UB 11.9 11.9 14.9 14.9

6.91 20.7 total 32.7 32.8 0% 35.7 36 -1%

IVY Land alpha UB 0.0144 0.0862 -83% 0.027 0.0809 -67%

Ext EPG Dose / UB b+g UB 0.974 0.974 2.22 2.22

0.109 0.326 total 1.31 1.39 -6% 2.58 2.63 -2%

CASTLE Land alpha UB 0.0672 0.403 -83% 0.144 0.431 -67%

Ext EPG Dose / UB b+g UB 10.4 10.4 14.9 14.9

1.55 4.66 total 15.2 15.5 -2% 19.7 20 -2%

REDWING Land alpha UB 0.0879 0.528 -83% 0.193 0.578 -67%

Ext EPG Dose / UB b+g UB 24.5 24.5 29.4 29.4

5.93 17.8 total 42.4 42.8 -1% 47.4 47.8 -1%

HARDTACK I Land alpha UB 0.116 0.697 -83% 0.268 0.805 -67%

Ext EPG Dose / UB b+g UB 11.4 11.4 10.6 10.6

2.52 7.56 total 19.1 19.7 -3% 18.4 18.9 -3%

POST-SANDSTONE alpha UB 0.000793 0.00476 -83% 0.00175 0.00525 -67%

Ext EPG Dose / UB b+g UB 0.0236 0.0236 0.14 0.14

0.05 0.14 total 0.16 0.164 -2% 0.277 0.281 -1%

Table 8. Comparison of Alpha Particle and Total Doses for Type M and Type S (cont.)
61

EPG

ET Region(Type M)ET Region(Type S) % diff(M-S)/SLung(Type M)Lun

g

(Type S)% diff(M-S)/S

POST-GREENHOUSE alpha UB 0.0203 0.122 -83% 0.0448 0.135 -67%

Ext EPG Dose / UB b+g UB 1.49 1.49 6.28 6.28

2.44 7.32 total 8.83 8.93 -1% 13.6 13.7 -1%

POST_IVY alpha UB 0.00106 0.00637 -83% 0.00234 0.00702 -67%

Ext EPG Dose / UB b+g UB 0.0104 0.0104 0.0476 0.0476

0.03 0.08 total 0.0949 0.11 -14% 0.133 0.138 -4%

POST-CASTLE alpha UB 0.0283 0.17 -83% 0.0623 0.187 -67%

Ext EPG Dose / UB b+g UB 0.104 0.104 0.796 0.796

0.25 0.74 total 0.867 1.01 -14% 1.59 1.72 -8%

POST-REDWING alpha UB 0.0736 0.441 -83% 0.162 0.486 -67%

Ext EPG Dose / UB b+g UB 1.16 1.16 6.07 6.07

1.91 5.73 total 6.96 7.4 -6% 12 12.3 -2%

POST-HARDTACK I alpha UB 0.0333 0.2 -83% 0.0772 0.232 -67%

Ext EPG Dose / UB b+g UB 0.302 0.302 0.995 0.995

0.36 1.07 total 1.41 1.57 -10% 2.14 2.3 -7%

NTS OBS/Man alpha UB 0.0418 0.251 -83% 0.0926 0.278 -67%

Ext EPG Dose / UB b+g UB 0.696 0.696 1.17 1.17

3.13 9.40 total 10.1 10.3 -2% 10.7 10.8 -1%

NTS Support Troops alpha UB 0.00823 0.0494 -83% 0.00847 0.0254 -67%

Ext EPG Dose / UB b+g UB 0.0822 0.0822 0.0847 0.0847

0.032 0.097 total 0.188 0.229 -18% 0.19 0.207 -8%

2MCPAEB alpha UB 0.0166 0.0993 -83% 0.0367 0.11 -67%

Ext EPG Dose / UB b+g UB 1.9 1.9 2.7 2.7

5.48 16.32 total 18.2 18.3 -1% 19.1 19.1 0%

TF WARRIOR alpha UB 0.122 0.731 -83% 0.331 0.993 -67%

Ext EPG Dose / UB b+g UB 8.05 8.05 7.12 7.12

1.51 4.53 total 12.7 13.3 -5% 12 12.6 -5%

The doses for ET region and lung calculated using the dose coefficients for type M are lower

than those using type S. The total doses are generally lower by no more than 20 percent except 

for the USS Brush, and Bikini Resurvey EPGs, which are both considered non-participants. The 

total doses for ET region exceed the screening dose calculated for the CASTLE (High) Ship EPG 

and the REDWING Land EPG. However, both of those total doses calculated for Type M also 

exceeded the screening dose. Therefore, using the doses based on absorption type S for alpha 

emitting radionuclides results in no changes to the overall utility of the doses for expedited 

processing. These alternate alpha doses should be considered during the implementation of the 

revised approach to expedited processing. 

Table 8. Comparison of Alpha Particle and Total Doses for Type M and Type S (cont.)
62

5.3 Expedited Processing Groups and Organ Combinations not 

Recommended for Expedited Processing 

The overall EPG upper-bound organ dose that results from combining external and internal 

upper-bound EPG doses for 20 organs and 29 EPGs—those EPGs for which there was potential 

for exposure to radiation—were compared with the organ/cancer screening doses listed in 

Section 2, Table 3. This evaluation process is discussed in detail in Section 3. If an EPG upperbound organ dose is higher than its respective screening dose, it is recommended that the 

EPG/organ combination be excluded from expedited processing. For those EPG/organ 

combinations where the overall EPG upper-bound dose falls between the doses listed in Table 3

that roughly correspond to the limiting dose (40-percent PC) and screening dose (50-percent PC), 

the NIOSH-IREP software is employed to calculate the PC using the EPG upper-bound doses for 

each type of radiation. If the PC is higher than or equal to 40 percent, the EPG/organ 

combination is added to the list of cases not suitable for expedited processing. Only the 

EPG/organ combinations for which the NIOSH-IREP estimated PC is lower than 40 percent are 

deemed eligible for expedited processing. 

The EPG upper-bound doses to 20 organs for the aforementioned 29 EPGs constitute 580 total 

upper-bound organ doses calculated. These doses were compared with the screening doses for 

27 NIOSH-IREP cancer models. Because 10 of the 20 organ doses were applicable to multiple 

cancer models, there were 37 dose/cancer model comparisons made for each EPG, resulting in a 

total of over 1,000 comparisons of EPG/organ doses to cancer model screening doses. The 

relationship of FIIDOS organs to relevant cancer models with the corresponding screening doses 

are shown in Table 9. 

Of these comparisons, only 68 EPG/organ combinations did not satisfy the criterion that the 

overall EPG upper-bound dose is well below the screening dose. About half of those situations 

occur for three relatively high-dose EPGs—Operation CASTLE high-dose ship-based personnel, 

Operation REDWING land-based personnel, and Operation GREENHOUSE land-based 

personnel—for about 10 cancer models each. Approximately two-thirds of the 68 EPG/organ 

sets are associated with cancers of the liver/gallbladder/bile duct (25 occurrences) and thyroid 

(20 occurrences). This large number of occurrences is due, in part, to cancers of the liver and 

thyroid having the lowest screening doses for the age at exposure and age at diagnosis of most 

NTPR claims. The remaining organs that did not satisfy the well-below criterion relate to the 

bone surface (six occurrences), red marrow (five occurrences), stomach (three occurrences), 

lower large intestine (three occurrences), extra-thoracic region (three occurrences), and lung 

(three occurrences). The chart in Table 10 shows all occurrences as EPG/organ combinations 

with the relevant cancer models. For the NTS Observers and Maneuver Troops EPG, the total 

upper bound doses relevant to the gall bladder, bile duct, and acute lymphocytic leukemia do not 

satisfy the well-below criterion when the initial doses (neutron and gamma) accrued by the 

Observers at Shot TESLA, Operation TEAPOT are added to the EPG upper-bound external plus 

internal doses from residual radiation. 
63 

Table 9. Dose Reconstruction Organs and Corresponding NIOSH-IREP Cancer Models Used in NTPR

NTPR Standard

Organ

IREP Cancer

SD*

(rem)

NTPR Standard

Organ

IREP Cancer

SD*

(rem)

NTPR Standard

Organ

IREP Cancer

SD*

(rem)

NTPR Standard

Organ

IREP Cancer

SD*

(rem)

NTPR Standard

Organ

IREP Cancer

SD*

(rem)

Adrenals

Other Endocrine 

Glands

45 

Bone Surface

Bone 48 

Brain

Other Endocrine 

Glands

Nervous system

Eye

Other Respiratory

45 

95 

49 

100

Breast

Breast 53 

Stomach Wall

Stomach 27 

Small Intestine 

Wall

All digestive 66 

Upper Large 

Intestine Wall

Colon 39 

Lower Large 

Intestine Wall

Colon

Rectum

39 

110

Kidneys

Urinary Organs 46 

Liver

Liver

Gallbladder

11 

17 

Extra-Thoracic 

Region

Esophagus 

Oral Cavity and 

Pharynx

Other 

Respiratory

35 

98 

100 

Lung

Lung

Other Respiratory

45 

100 

Muscle

Connective 

Tissue

Other and IllDefined Sites

All Digestive

Other Respiratory

50 

50 

66 

100 

Pancreas

Pancreas 89 

Red Marrow

Acute 

Lymphocytic 

Leukemia 

Acute Myeloid 

Leukemia 

Leukemia 

Bone

24 

29 

41 

48

Spleen

Lymphoma 61 

Testes

All Male 

Genitalia

60 

Thymus

Lymphoma

Other Respiratory

61 

100 

Thyroid

Thyroid

Other Endocrine 

Glands

7.5 

45 

Urinary Bladder 

Wall

Urinary Organs

Bladder

46 

49 * SD is the screening dose for age of exposure of 18 years and time elapsed of 32 years and for a probability of causation of 50 percent at the 

upper 99 percentile credibility limit (Kocher and Apostoaei, 2007).
64 

Table 10. EPG and Organ Combinations not Recommended for Expedited Processing (Highlighted Cells)

NTPR Standard

Organ

Adrenals Bone Brain Breast St WallSI WallULI WallLLI WallKidneys LiverET RegionLung MusclePancreasRed MarSpleenTestesThymus Thyroid Bladder 

NIOSH-IREP 

Cancer Model

Adrenals Bone Endocrine Nervous sysEye Other resp.Breast StomachAll DigestColon Colon Rectum Kidneys LiverGall Bladder, Bile DuctEsophagus Oral CavityOther resp.Lung Other Resp.Conn TissueIll-defined 

All digestOther resp.PancreasALL* 

AML†

LeukemiaBone Spleen

TestesLymphoma Other resp.Thyroid Other Endo.Urinary orgsBladder 

PPG, Ship-Based Personnel‡

XRD Support Ships 10 11

XRD Target Ships 59 21 21 55 55

USS BRUSH (1947) 49 11 11**

SS

IVY

GH 10

CSTL (High) 33 24 36 25 25 45 47 24 24 38 38

CSTL (Low) 14 14 14

REDWING 8

WIGWAM

HT I 9

ARGUS

HT I Ships Unexposed

DOM I

PPG, Land-Based Personnel‡

XRD

Bikini Resurvey (1947) 54 15 15**

SS

GH 29 29 22 22 33 36 22 37 37

IVY

CSTL 8 13

REDWING 32 20 34 21 21 44 49 20 41 41

HT-I 23 12 12 18
65 

NTPR Standard

Organ

Adrenals Bone Brain Breast St WallSI WallULI WallLLI WallKidneys LiverET RegionLung MusclePancreasRed MarSpleenTestesThymus Thyroid Bladder 

NIOSH-IREP 

Cancer Model

Adrenals Bone Endocrine Nervous sysEye Other resp.Breast StomachAll DigestColon Colon Rectum Kidneys LiverGall Bladder, Bile DuctEsophagus Oral CavityOther resp.Lung Other Resp.Conn TissueIll-defined 

All digestOther resp.PancreasALL* 

AML†

LeukemiaBone Spleen

TestesLymphoma Other resp.Thyroid Other Endo.Urinary orgsBladder 

PPG, Inter-Operation Personnel‡

Post-SS

Post-GH 9 10

Post-IVY

Post-CSTL

Post-RW 9 7

Post-HT-I

Nevada Test Site Personnel‡

Observers and Maneuver 11 11†† 16 11

NTS Support Troops

2MCPAEB 18 18 19

Task Force WARRIOR (PB) 8 14

*

 Acute Lymphocytic Leukemia. 

† Acute Myeloid Leukemia. ‡ PPG=Pacific Proving Ground, XRD=CROSSROADS, SS=SANDSTONE, GH=GREENHOUSE, CSTL=CASTLE, RW=REDWING, HTI=HARDTACK I, 

DOM I=DOMINIC I, PB=PLUMBBOB, 2MCPAEB=2nd Marine Corps Atomic Exercise Brigade. 

Table 10. EPG and Organ Combinations not recommended for Expedited Processing (Highlighted Cells) (cont.)
66 

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67 

6. 

Summary and Conclusions

The overall objectives of this study are to evaluate and update the technical approach for 

expediting NTPR cases and to use this approach to estimate doses for the broadest number of 

participants. Additionally, the effort required an evaluation of the association between those 

doses and specific cancers to assess if they are well below the respective screening doses that 

produce a PC of 50 percent at the upper 99th percentile. The study objectives have been met 

through the completion of a pilot phase and a subsequent developmental phase during which the 

proposed technical approach was researched, established, and applied successfully to estimate 

doses for expedited processing that are supported by sound technical methods.

The recommended approach is developed by first identifying large groups of NTPR 

participants who were exposed under similar conditions (the EPGs), and then for each EPG 

estimating doses on the basis of the “highest-dose cohort” concept that is further refined by 

substituting dose components and maximizing input parameters. This approach ensures that the 

doses assigned to an EPG bound any plausible doses actually accrued by any member. 

 

6.1 Pilot Phase

The pilot phase of this study was conducted to address several of the preliminary objectives. 

Early in this phase it was concluded that the use of historical RDA doses for expedited 

processing was not always adequate. The pilot phase was subsequently used to develop and test 

an approach for estimating doses for expedited processing through scenario-based dose 

assessments for large groups of NTPR participants and the “highest-dose cohort” concept. The 

pilot phase also resulted in proposing a set of standardized names and associations between a 

diseased organ, the corresponding organ for which doses are calculated, and the IREP cancer risk 

model used to estimate a probability of causation.

A thorough review of three sets of data elements—discussed below—used by DTRA, VA, and 

contractors to develop doses for claimed diseases resulted in a clearer understanding of the 

associations among these claimed diseases, the dose conversion factors appropriate to diseased 

organs, and the cancer models used to evaluate the probability of causation. This effort 

addressed two key objectives of the study involving the determination of the appropriateness of 

previously reported veteran doses for use in expedited processing, and the development of 

standardized and consistent organ dose processing tables. As a result, a proposed interrelationship of terms was prepared for the diseases specified in claims, called NTPR NuTRIS 

Organ Codes; the NTPR Standard Organs used to calculate doses from exposures to internally

deposited radioactive materials; and the cancer types, called NIOSH-IREP cancer models, used 
68 

to estimate the degree of association of a cancer with a given radiation dose to an organ or tissue. 

The proposed inter-relationships are included in Table A-1 (Appendix A). This table is proposed 

as the basis for implementation of future expedited processing as well as for other RDAs. The 

pilot phase successfully demonstrated the approach using sample groups of NTPR participants 

and resulted in the conclusion that the approach should be applied to the broader population of 

all NTPR participants.

6.2 Developmental Phase

 During the developmental phase of the study, a total of 32 EPGs were identified that 

collectively address the majority of PPG and NTS participants. Nine sample EPGs, evaluated 

and reported in the Interim Report of the Pilot Phase of this study, were expanded by aggregating 

similar cohort groups and by applying the experimental approach to other test operations. As 

important as identifying the participants that are covered by these EPGs is the explicit 

identification of those participants whose possible exposure scenarios are too complex or not 

sufficiently characterized to include in a general expedited process. The participants who are not 

recommended for expedited processing are identified and their cases recommended for further 

review and eventually a detailed assessment.

The rationale for the makeup of the proposed EPGs are discussed in Section 4 of this report 

with details of corresponding dose assessments included in the accompanying EPG Compendium 

(DTRA, 2011). The EPG RDA reports that make up the compendium describe the personnel 

who comprise each EPG and the details of their scenarios of exposure, maximizing assumptions, 

and input parameter values employed in the dose estimation. This information was used to

develop detailed calculation worksheets that fully document the dose estimates and support 

independent reviews. In addition to their use in developing the proposed EPG doses and upper 

bounds, the calculation tools would facilitate efficient evaluations of future individual NTPR 

RDA cases. Additionally, to help ensure appropriate implementation of expedited processing of 

NTPR RDA cases, the discussions for the 32 EPGs provide the detailed listings of units and 

cohorts that encompass the membership of each EPG (DTRA, 2011). 

Furthermore, the units, groups and activities that should be excluded from expedited 

processing are identified in DTRA (2011) and in Appendix B of this report. Some potential 

cohorts proposed for certain EPGs were found to be associated with special activities and 

exposures and were assigned to excluded categories that could not be processed using expedited 

procedures. The members of these cohorts were identified as having been involved in unique 

activities characterized by large variations in radiation sources, exposure rates, exposure 

durations, and timing of exposures. In addition, activities that could produce significantly higher 

doses for a participant than for most EPG members were identified as general exclusions 

requiring a case-specific review and eventually a detailed dose assessment. 

Similarity of the exposure scenarios for many of the NTS participants allowed their 

consolidation into more broadly defined exposure groups. Consequently, the 32 EPGs consist of 

only four EPGs for the NTS, and 28 EPGs for the PPG. The PPG EPGs are further subdivided 

into 22 EPGs representing participation during actual test operations and six EPGs covering 

individuals with activities that occurred in time periods after or between test operations. The 
69 

PPG EPGs for test operations are subdivided into land-based, ship-based, and other groups 

consisting of cohorts with unique exposure circumstances. 

6.3 Results of the Study

Scenario-based external and internal doses have been calculated for each EPG that are 

consistent across radiation types and affected organs and are proposed for assignment for 

expedited processing of NTPR cases. The EPG doses and their upper bounds consist of highsided estimates calculated using highly conservative scenarios of exposure and the highest 

plausible input parameter values. These doses are from exposure to external gamma radiation, 

internal alpha radiation, and internal beta-plus-gamma radiation for the 20 relevant NTPR 

Standard Organs; ovaries, uterus, and skin are not included. The upper-bound doses were 

calculated to meet the criteria recommended by the VBDR that they should be based on worst 

case parameters and assumptions and that they should be higher than any realistically-calculated 

veteran’s upper-bound doses. Across all EPGs, the estimated upper-bound external doses range 

from less than 0.1 to 23 rem. Similar but wider ranges are observed for internal organ doses 

(DTRA, 2011). 

The total organ doses that result from combining the external and internal upper-bound doses 

for each of the 20 organs in each of the 29 EPGs, for which there was the potential for radiation 

exposure, were compared with the organ/cancer screening doses discussed in Section 2. The 

comparison was performed to assess whether the total organ doses were well below the screening 

doses for each assessed cancer. This evaluation addressed the study objective related to 

estimating the association between radiation exposure and cancer disease. Of over 1,000 

comparisons of total EPG/organ upper-bound dose with the corresponding screening dose, only 

68 did not satisfy the criterion of being well below the screening doses. The 68 EPG/organ 

combinations are shown in Section 5 of this report and in the EPG Compendium (DTRA, 2011). 

Roughly half of those situations occurred for three EPGs—Operation CASTLE high-dose, 

ship-based personnel, Operation REDWING land-based personnel, and Operation 

GREENHOUSE land-based personnel—involving about 10 cancer models each. Approximately 

two-thirds of these 68 total organ upper-bound doses were associated with cancers of the liver 

and thyroid, which have the lowest screening doses for age at exposure and age at diagnosis of 

cancer for most NTPR claims. The remaining total organ upper-bound doses that did not satisfy 

the well-below criterion involve the bone surface, red marrow, stomach, lower large intestine, 

extra-thoracic region, and lung. This implies that the vast majority of NTPR cases should be 

suitable for expedited processing with this methodology.

The scenario-based approach for expedited processing has proven to be a valuable technique 

for identifying EPGs and producing upper-bound doses that are well below the screening doses

for most organs. However, this approach is not useful for identifying cases with upper-bound 

doses that are comparable to or above the screening dose because any one individual and any one 

cohort is likely to have an upper-bound dose below the total EPG upper-bound dose. For the 68 

EPG/organ combinations that do not satisfying the “well below” criterion, the estimated EPG 

doses are not suitable and relevant cases are not recommended for expedited processing. Rather, 
70 

a review of the veteran-specific information and eventually a detailed assessment should be 

performed. 
71 

7. 

References

Blake, P.K., 2009. Update on Nuclear Test Personnel Review (NTPR) Program; Brief for VBDR 

Plenary Meeting. June 10. 

http://www.vbdr.org/meetings/2009/presentations/Blake_2009.ppt (accessed on 

September 9, 2011)

CDC-CMMS (Centers for Disease Control and Prevention and the Centers for Medicare and 

Medicaid Services), 2010. The International Classification of Diseases, Ninth Revision, 

Clinical Modification (ICD-9-CM). October 1. 

DTRA (Defense Threat Reduction Agency), 2007a. NTPR NuTRIS Data Dictionary. 

DTRA (Defense Threat Reduction Agency), 2007b. NTPR Technical Basis Document: 

Expedited Radiation Dose Assessment of Non-Presumptive Medical Claims (other than 

Skin, Prostate, and Cataract), (FOUO), July 4. 

DTRA (Defense Threat Reduction Agency), 2008. NTPR Standard Operating Procedures 

Manual, Revision 1.2, October 31.

DTRA (Defense Threat Reduction Agency), 2010a. NTPR Standard Operating Procedures 

Manual, Revision 1.3/1.3a, March 31.

DTRA (Defense Threat Reduction Agency), 2010b. Development of Radiation Doses to Support 

Expedited Processing of NTPR Dose Assessments, Pilot Phase Interim Report. NTPRTM-10-03. Defense Threat Reduction Agency, Fort Belvoir, VA. June.

DTRA (Defense Threat Reduction Agency), 2010c. NuTRIS - Nuclear Test Research 

Information System, Defense Threat Reduction Agency, Fort Belvoir, VA.

DTRA (Defense Threat Reduction Agency), 2011. Compendium of Proposed Expedited 

Processing Groups. DTRA-TR-11-01. DTRA, Fort Belvoir, VA. November. 

Edwards, R., Goetz, J., and Klemm, J., 1985. Analysis of Radiation Exposure for Maneuver 

Troops, Exercise Desert Rock V, Operation UPSHOT-KNOTHOLE, DNA-TR-84-303, 

Defense Nuclear Agency, Washington, D.C. October 15

Frank, G., 1982. Radiation Dose for Personnel of the 505th Military Police (MP) Battalion, 

Exercise Desert Rock V, Operation UPSHOT-KNOTHOLE," SAIC Memo, February 15. 

Frank, G., Goetz, J., Schweizer, T., Weitz, R., and Klemm, J., 1982. Analysis of Radiation 

Exposure for 2nd Marine Corps Provisional Atomic Exercise Brigade, Exercise Desert 

Rock V, Operation UPSHOT-KNOTHOLE. DNA-TR-82-03, Defense Nuclear Agency, 

Washington, DC. February 5. 
72 

Goetz, J., Klemm, J., Kaul, D., and McGahan, J.T., 1979. Analysis of Radiation Exposure for 

Task Force Warrior-Shot Smoky-Exercise Desert Rock VII-VIII Operation PLUMBBOB. 

DNA 4747 F. Defense Nuclear Agency, Washington, D.C. May 31.

Goetz, J.L., McGahan, J. T., Kaul, D., McRaney, W.K., and Klemm, J., 1980. Analysis of 

Radiation Exposure for Task Force BIG BANG, Shot GALILEO, Exercise Desert Rock 

VII – VIII, Operation PLUMBBOB. DNA 4772F, Defense Nuclear Agency, Washington, 

DC. April 9. 

ICRP (International Commission on Radiation Protection), 1994. Human Respiratory Tract 

Model for Radiological Protection. ICRP Publication 66. Pergamon Press, Elmsford, 

NY.

ICRP (International Commission on Radiological Protection), 1996. Age-Dependent Doses to the 

Members of the Public from Intake of Radionuclides Part 5, Compilation of Ingestion and 

Inhalation Coefficients. ICRP Publication 72, Ann. ICRP 26/1, Pergamon Press, 

Elmsford, NY. 

ICRP (International Commission on Radiological Protection), 2002. The ICRP Database of Dose 

Coefficients: Workers and Members of the Public. Compact Disc Version 2.01, ICRP, 

Stockholm, Sweden.

Kocher, David C. and Apostoaei, Julian A., 2007. Screening Doses for Induction of Cancers 

Calculated with the Interactive RadioEpidemiological Program (IREP). DTRA-TR-07-4. 

Defense Threat Reduction Agency, Fort Belvoir, VA. March.

Land C.E., Gilbert E, Smith J., Hoffman F. O., Apostoaei I., Thomas B, and Kocher D., 2003 

Report of the NCI-CDC Working Group to revise the 1985 NIH Radioepidemiological 

Tables. NIH Publication No. 03-5387. 

Mason, C., 2009. Doses Accrued at the Residence Islands of Enewetak Atoll from Previous 

Operations. NTPR-TM-09-02. Defense Threat Reduction Agency, Fort Belvoir, VA. 

December 31.

NAS/NRC (National Academy of Sciences/National Research Council), 2003. A Review of the 

Dose Reconstruction Program of the Defense Threat Reduction Agency. (National 

Research Council, Washington, D.C.).

NIOSH (National Institute of Occupational Safety and Health), 2002. NIOSH-Interactive 

RadioEpidemiological Program (NIOSH-IREP), Technical Documentation, Final Report. 

77 pp. June 18.

NIOSH (National Institute of Occupational Safety and Health), 2009. User’s Guide for the 

Interactive RadioEpidemiological Program (NIOSH-IREP), Version 5.6. 22 pp. 

September. 

ORAU (Oak Ridge Associated Universities), 2007. Internal Dose Reconstruction, ORAUTOTIB-0060, Revision 00. Oak Ridge Associated Universities, Dade Moeller & 

Associates, and MJW Corporation. February 6.
73 

Otchin, N.S., 2007. The Use of the Interactive Radioepidemiological Program (IREP) by the

Department of Veterans Affairs (VA). Presentation to the Veterans Advisory Board on 

Dose Reconstruction (VBDR), Las Vegas, NV. March 7.

Raine, D.A. III, Egbert, S.D., Stiver, J.H., and Case, D.R., 2007. FIIDOS - A Computer Code for 

the Computation of Fallout Inhalation and Ingestion Dose to Organs, Computer User’s 

Guide (Revision 4). DTRA-TR-07-11, Defense Threat Reduction Agency, Fort Belvoir, 

VA. May.

USDOE (U.S. Department of Energy), 2000. United States Nuclear Tests, July 1945 through 

September 1992. DOE/NV-209 [Rev. 15] (U.S. Department of Energy, Nevada 

Operations Office, Las Vegas, NV). 

VBDR (Veterans’ Advisory Board on Dose Reconstruction), 2006. Letter to Director, Defense 

Threat Reduction Agency. July 5. 

http://docs.google.com/viewer?url=http://www.vbdr.org/recommendations/vbdrrecommendations-june06.pdf&embedded=true (accessed on September 9, 2011)

VBDR (Veterans’ Advisory Board on Dose Reconstruction), 2007a. Letter to Director, Defense 

Threat Reduction Agency. March 28. 

http://docs.google.com/viewer?url=http://www.vbdr.org/recommendations/VBDR_Reco

mmendations_March07Mtg.pdf&embedded=true ( accessed on September 9, 2011)

VBDR (Veterans’ Advisory Board on Dose Reconstruction), 2007b. Letter to Director, Defense 

Threat Reduction Agency. May 7. (NOT AVAILABLE on VBDR.ORG)

VBDR (Veterans’ Advisory Board on Dose Reconstruction), 2007c. Letter to Director, Defense 

Threat Reduction Agency. October 16. 

http://docs.google.com/viewer?url=http://www.vbdr.org/recommendations/VBDR_Reco

mmendations_Chicago.pdf&embedded=true (accessed on September 9, 2011)

Weary, S.E., Ozerroff, W.J., Sperling, J.L., Collins, B., Lowery, C.W., and Obermiller, S.K., 

1981. Operation WIGWAM, DNA 6000F, Defense Nuclear Agency, Washington, D.C. 

September 1.

Weitz, R., Thomas, C., Klemm, J., Stuart, J., Knowles, M., Goetz, J., Muller, E., and Landay, A.,

1982a. Analysis of Radiation Exposure for Naval Units of Operation CROSSROADS; 

Volume 1-Basic Report. DNA-TR-82-05-V1. Defense Nuclear Agency, Washington, 

D.C. March 3.

Weitz, R., Thomas, C., Klemm, J., Stuart, J., Knowles, M., Goetz, J., Muller, E., and Landay, A.,

1982b. Analysis of Radiation Exposure for Naval Units of Operation CROSSROADS; 

Volume II1-(Appendix B) Support Ships. DNA-TR-82-05V3. Defense Nuclear Agency, 

Washington, D.C. March 3.

Weitz, R. and Egbert, S., 2010. Compilation of Initial Radiation Doses to Atmospheric Test

Participants. NTPR-TM-09-01 (R1), Science Applications International Corporation, 

McLean, VA, December 31. 
74 

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75 

Appendix A.

Cross Reference of NTPR NuTRIS Organ

Codes, NTPR Standard Organs and NIOSHIREP Cancer Risk Models

This appendix provides a listing (Table A-1) of NTPR NuTRIS Organ Codes and their 

associated descriptions cross referenced to the NTPR Standard Organs used in FIIDOS internal 

dose calculations and the cancer risk models of NIOSH-IREP. Entries in the Surrogate Type 

column describe whether the assignment in the NTPR Standard Organ column is an actual NTPR 

Standard Organ used in FIIDOS calculations (FIIDOS), or an NTPR Standard Organ selected as 

a surrogate for the NTPR NuTRIS Organ Code (Surrogate).

The table contains entries in the “Current NTPR NuTris Code” and “Proposed NuTris Code” 

columns. The proposed codes are suggested for use in future dose reconstruction cases to 

provide improved consistency, eliminate duplicate organ entries, remove entries that are not 

organs or tissues, and provide the foundations for lookup of NTRP NuTris Codes and NTPR 

Standard Organs / Surrogates.

In addition, 16 new combinations, shown in italics, are included based on an assessment of 

cancer models and associated organs found in NIOSH-IREP documentation. These suggestions 

have been developed in the interest of possible future implementation to improve harmonization 

of references within the VA and DTRA processes. 

Comments are included for entries that require clarification or further study before the NTPR 

Standard Organ and NIOSH-IREP cancer risk model(s) can be selected. 
76 

Table A-1. Cross-Reference List of NTPR NuTRIS Codes, NTPR Standard Organs, and NIOSH-IREP Cancer Models

(Italicized rows are proposed additions)

Current 

NuTRIS 

Organ Code

Proposed 

NuTRIS 

Organ Code

Description

NTPR

Standard 

Organ

Surrogate 

Type†

NIOSH-IREP

Cancer Model 

(ICD-9)

Comments

ADR-GL ADR-GL Adrenal Gland Adrenals FIIDOS Other Endocrine 

Glands (194)

ANKLE BONANKLEBone (Ankle) Bone Surface Surrogate Bone (170)

ANT-COM ANT-COM Anterior Commissure Brain Surrogate Nervous system 

(191-192) 

None ANUS Anus (and Anal 

Canal)

LLI Wall+ Surrogate Rectum (154)

AORTA AORTA Aorta Muscle Surrogate Other Respiratory 

(160, 161, 163-165) 

APPENDX APPENDX Appendix ULI Wall+ Surrogate Colon (153)

ART-TIS ART-TIS Arthritic Tissue Bone Surface Surrogate Connective Tissue 

(171) 

ATRIAL ATRIAL Atrial Sarcoma Muscle Surrogate Other Respiratory 

(160, 161, 163-165) 

BILE-D BILE-D Bile Duct Liver Surrogate Gallbladder (156)

BLDR BLDR Bladder Urinary 

Bladder Wall

Surrogate Bladder (188)

BLOOD BLOOD Blood Red Marrow Surrogate Leukemia (204-208)

BON-MR BON-MR Bone Marrow Red Marrow FIIDOS Leukemia (204-208)

BON-P BON-P Bone (Pelvis) Bone Surface FIIDOS Bone (170)

BON-SR BON-SR Bone Surface Bone Surface FIIDOS Bone (170)
77 

Table A-1. Cross-Reference List of NTPR NuTRIS Codes, NTPR Standard Organs, and NIOSH-IREP Cancer Models (cont.) 

(Italicized rows are proposed additions)

Current 

NuTRIS 

Organ Code

Proposed 

NuTRIS 

Organ Code

Description

NTPR 

Standard 

Organ 

Surrogate 

Type†

NIOSH-IREP 

Cancer Model 

(ICD-9) 

Comments

BONE BONE Bone Bone Surface FIIDOS Bone (170)

ELBOW BON-EL Bone (Elbow) Bone Surface FIIDOS Bone (170)

BRAIN BRAIN Brain Brain FIIDOS Nervous System 

(191-192)

BREAST BREAST Breast Breast FIIDOS Breast (174-175)

BRN-ST BRN-ST Brain Stem Brain Surrogate Nervous system 

(191-192) 

None CECUM Cecum ULI Wall+ Surrogate Colon (153)

None CERVIX Cervis Uterus Surrogate Female Genitalia

(179-182, 184)

CHOROID CHOROID Choroid Brain Surrogate Eye (190)

CL-LLI CL-LLI Colon (LLI) LLI Wall+ Surrogate Colon (153)

CL-ULI CL-ULI Colon (ULI) ULI Wall+ Surrogate Colon (153)

COLON COLON Colon LLI Wall+ Surrogate Colon (153)

CONTISS CONTISS Connective Tissue Muscle Tentative Connective Tissue 

(171) 

CRNERV CRNERV Cranial Nerve Brain Surrogate Nervous System 

(191-192) 

DEUDNM DEUDNM Duodenum SI Wall+ Surrogate All Digestive (150-

159) 
78 

Table A-1. Cross-Reference List of NTPR NuTRIS Codes, NTPR Standard Organs, and NIOSH-IREP Cancer Models (cont.) 

(Italicized rows are proposed additions)

Current 

NuTRIS 

Organ Code

Proposed 

NuTRIS 

Organ Code

Description

NTPR 

Standard 

Organ 

Surrogate 

Type†

NIOSH-IREP 

Cancer Model 

(ICD-9) 

Comments

ENDOCR ENDOCR Endocrine Glands Specific 

diseased organ 

must be known.

Endocrine organs are hypothalamus, pituitary, thyroid, 

parathyroid, adrenals, pineal body, ovaries, and testes plus 

pancreas. Select the specific organ if listed elsewhere in 

table; otherwise select “endocrine organs other than thyroid 

(code 194).

ENDOS ENDOS Endosteum Bone Surface Surrogate Bone (170)

EPIG EPIG Epiglottis ET Region+ Surrogate Oral Cavity and 

Pharynx (140-149)

ESOPH ESOPH Esophagus ET Region+ FIIDOS Esophagus (150)

EYE EYE Eye Brain Surrogate Eye (190)

EYE-MUS EYE-MUS Eye (Muscle) Muscle Surrogate Cancers of other and 

ill-defined sites 

(195)

EYE-RET EYE-RET Eye (Retina) Brain Surrogate Eye (190)

EYELIDM EYELIDM Eyelid Muscle Muscle Surrogate Cancers of Other 

and Ill-Defined Sites 

(195)

FEMUR BON-FMR Bone (Femur) Bone Surface FIIDOS Bone (170)

GAL-BD GAL-BD Gallbladder Liver Surrogate Gallbladder (156)

GLOTTIS GLOTTIS Glottis ET Region+ Surrogate Other Respiratory 

(160, 161, 163-165) 

GUM GUM Gum ET Region+ Surrogate Oral Cavity and 

Pharynx (140-149)
79 

Table A-1. Cross-Reference List of NTPR NuTRIS Codes, NTPR Standard Organs, and NIOSH-IREP Cancer Models (cont.) 

(Italicized rows are proposed additions)

Current 

NuTRIS 

Organ Code

Proposed 

NuTRIS 

Organ Code

Description

NTPR 

Standard 

Organ 

Surrogate 

Type†

NIOSH-IREP 

Cancer Model 

(ICD-9) 

Comments

HEART HEART Heart Muscle Surrogate Other Respiratory 

(160, 161, 163-165) 

None HYPPHR Hypopharynx ET Region+ Surrogate Oral Cavity and 

Pharynx 

(140-149)

JAW BON-JAW Bone (Jaw) Bone Surface Surrogate Bone (170)

JOINTS JOINTS Joints Bone Surface Surrogate Bone (170)

KIDNEY KIDNEY Kidneys Kidney FIIDOS Urinary Organs, 

excluding Bladder 

(189)

None BON-HND Bone (Hand) Bone Surface Surrogate Bone (170)

L-INTES L-INTES Large Intestine LLI Wall+ FIIDOS Colon (153)

LARYNX LARYNX Larynx ET Region+ Surrogate Other Respiratory 

(160, 161, 163-165) 

LEUK LEUK Leukemia Red Marrow Surrogate Leukemia (204-208)

None LIP Lip ET Region+ Surrogate Oral Cavity and 

Pharynx 

(140-149)

LIPOMA LIPOMA Lipoma Muscle Surrogate N/A Not a malignant 

neoplasm

LIVER LIVER Liver Liver FIIDOS Liver (155)

LLI LLI Lower Large Intestine LLI Wall FIIDOS Colon (153)
80 

Table A-1. Cross-Reference List of NTPR NuTRIS Codes, NTPR Standard Organs, and NIOSH-IREP Cancer Models (cont.) 

(Italicized rows are proposed additions)

Current 

NuTRIS 

Organ Code

Proposed 

NuTRIS 

Organ Code

Description

NTPR 

Standard 

Organ 

Surrogate 

Type†

NIOSH-IREP 

Cancer Model 

(ICD-9) 

Comments

LUNG LUNG Lungs Lung FIIDOS Lung (162)

LYMP-G LYMP-G Lymph Gland Thymus Surrogate Lymphoma and 

Multiple Myeloma 

(200-203) 

If this is primary 

disease

LYMP-N LYMP-N Lymph Nodes Thymus Surrogate Lymphoma and 

Multiple Myeloma 

(200-203) 

If this is primary 

disease

LYMPHO LYMPHO Lymphoma Thymus Surrogate Lymphoma and 

Multiple Myeloma 

(200-203)

If this is primary 

disease

LYMPTS LYMPTS Lymphatic Tissue Thymus Surrogate Lymphoma and 

Multiple Myeloma 

(200-203)

If this is primary 

disease

LYMSYS LYMSYS Lymph System Thymus Surrogate Lymphoma and 

Multiple Myeloma 

(200-203)

If this is primary 

disease

None MIDEAR Middle Ear Brain Surrogate Other Respiratory 

(160, 161, 163-165) 

MOUTH MOUTH Mouth ET Region+ Surrogate Oral Cavity and 

Pharynx (140-149) 

MUS-PC MUS-PC Muscle Peritoneal 

Cavity

Muscle Surrogate All Digestive (150-

159)
81 

Table A-1. Cross-Reference List of NTPR NuTRIS Codes, NTPR Standard Organs, and NIOSH-IREP Cancer Models (cont.) 

(Italicized rows are proposed additions)

Current 

NuTRIS 

Organ Code

Proposed 

NuTRIS 

Organ Code

Description

NTPR 

Standard 

Organ 

Surrogate 

Type†

NIOSH-IREP 

Cancer Model 

(ICD-9) 

Comments

MUSCLE MUSCLE Muscle Muscle FIIDOS Cancers of Other 

and Ill-Defined Sites 

(195)

None NASCAV Nasal Cavities ET Region+ Surrogate Other Respiratory 

(160, 161, 163-165) 

NASALT NASALT Nasal Tip ET Region+ Surrogate Oral Cavity and 

Pharynx (140-149) 

Specific disease 

needed if not skin 

cancer

NASO-LF NASO-LF Nasolabial Fold ET Region+ Surrogate Oral Cavity and 

Pharynx (140-149) 

Specific disease 

needed if not skin 

cancer

NASOP NASOP Nasopharynx ET Region+ Surrogate Oral Cavity and 

Pharynx (140-149) 

NEROEND NEROEND Neuroendocrine 

System

Brain Surrogate Other Endocrine 

Glands (194)

NRV-MUS NRV-MUS Neuro-Muscular Muscle Surrogate Cancers of Other 

and Ill-Defined Sites 

(195) 

NRVSYS NRVSYS Nervous System Brain Surrogate Nervous System 

(191-192) 

ORALCAV ORALCAV Oral Cavity ET Region+ Surrogate Oral Cavity and 

Pharynx (140-149) 

OROPHAR OROPHAR Oropharynx ET Region+ Surrogate Oral Cavity and 

Pharynx (140-149) 
82 

Table A-1. Cross-Reference List of NTPR NuTRIS Codes, NTPR Standard Organs, and NIOSH-IREP Cancer Models (cont.) 

(Italicized rows are proposed additions)

Current 

NuTRIS 

Organ Code

Proposed 

NuTRIS 

Organ Code

Description

NTPR 

Standard 

Organ 

Surrogate 

Type†

NIOSH-IREP 

Cancer Model 

(ICD-9) 

Comments

None OVARY Ovary Ovary FIIDOS Ovary (183)

P-THYR P-THYR Parathyroid Thyroid Surrogate Other endocrine 

Glands (194)

PALATE PALATE Palate ET Region+ Surrogate Oral Cavity and 

Pharynx (140-149)

PANCRS PANCRS Pancreas Pancreas FIIDOS Pancreas (157)

PAROTID PAROTID Parotid Gland ET Region+ Surrogate Oral Cavity and 

Pharynx (140-149)

PENIS PENIS Penis Testes Surrogate All Male Genitalia 

(185-187)

PRTNM PRTNM Peritoneum Muscle Surrogate Cancers of Other 

and Ill-Defined Sites 

(195)

PHAR PHAR Pharynx ET Region+ Surrogate Oral Cavity and 

Pharynx (140-149)

None PNLGL Pineal Gland Brain Surrogate Other Endocrine 

Glands (194)

PITTGL PITTGL Pituitary Gland Brain Surrogate Other Endocrine 

Glands (194)

None PLEURA Pleura Lung Surrogate Other Respiratory 

(160, 161, 163-165) 

PROSTA PROSTA Prostate Testes Surrogate All Male Genitalia 

(185-187)
83 

Table A-1. Cross-Reference List of NTPR NuTRIS Codes, NTPR Standard Organs, and NIOSH-IREP Cancer Models (cont.) 

(Italicized rows are proposed additions)

Current 

NuTRIS 

Organ Code

Proposed 

NuTRIS 

Organ Code

Description

NTPR 

Standard 

Organ 

Surrogate 

Type†

NIOSH-IREP 

Cancer Model 

(ICD-9) 

Comments

RD-MRW RD-MRW Red Marrow Red Marrow FIIDOS Leukemia (204-208)

RECTUM RECTUM Rectum LLI Wall+ Surrogate Rectum (154)

RESPOTH RESPOTH Respiratory other than 

Lung

ET Region+ Surrogate Other Respiratory 

(160, 161, 163-165) 

SAL-GLS SAL-GLS Salivary Glands ET Region+ FIIDOS Oral Cavity and 

Pharynx (140-149)

SCROTUM SCROTUM Scrotum Testes Surrogate All Male genitalia 

(185-187)

SHLDR BONSHLDRBone (Shoulder) Bone Surface Surrogate Bone (170) If bone cancer

SINSMX SINSMX Sinus (Maxillary) ET Region+ Surrogate Other Respiratory 

(160, 161, 163-165) 

SINSNA SINSNA Sinus (Nasal) ET Region+ Surrogate Other Respiratory 

(160, 161, 163-165) 

SINUS SINUS Sinus ET Region+ Surrogate Other Respiratory 

(160, 161, 163-165) 

SMINST SMINST Small Intestine SI Wall+ FIIDOS All Digestive (150-

159)

SOFTH ST-TH Soft Tissue (Thigh) Muscle Surrogate Cancers of Other 

and Ill-Defined Sites 

(195)

SP-CRD SP-CRD Spinal Cord Brain Surrogate Nervous System 

(191-192)
84 

Table A-1. Cross-Reference List of NTPR NuTRIS Codes, NTPR Standard Organs, and NIOSH-IREP Cancer Models (cont.) 

(Italicized rows are proposed additions)

Current 

NuTRIS 

Organ Code

Proposed 

NuTRIS 

Organ Code

Description

NTPR 

Standard 

Organ 

Surrogate 

Type†

NIOSH-IREP 

Cancer Model 

(ICD-9) 

Comments

SPINE BON-SPINE Bone (Spine) Bone Surface Surrogate Bone (170) Cancer of vertebrae

SPLEEN SPLEEN Spleen Spleen FIIDOS Cancers of Other 

and Ill-Defined Sites 

(195) 

Use only if solid 

cancer of spleen is 

the primary disease

SPN-NV SPN-NV Spine Nerves Brain Surrogate Nervous System 

(191-192) 

ST-ARM ST-ARM Soft Tissue Upper 

Arm

Muscle Surrogate Cancers of Other 

and Ill-Defined Sites 

(195) 

ST-HIP ST-HIP Soft Tissue Hip Muscle Surrogate Cancers of Other 

and Ill-Defined Sites 

(195)

ST-SHLD ST-SHLD Soft Tissue Shoulder Muscle Surrogate Cancers of Other 

and Ill-Defined Sites 

(195)

STMACH STMACH Stomach Stomach Wall FIIDOS Stomach (151)

TESTES TESTES Testes Testes FIIDOS All Male Genitalia 

(185-187)

THROAT THROAT Throat ET Region+ Surrogate Oral Cavity and 

Pharynx (140-149)

THYMUS THYMUS Thymus Thymus FIIDOS Other Respiratory 

(160, 161, 163-165) 
85 

Table A-1. Cross-Reference List of NTPR NuTRIS Codes, NTPR Standard Organs, and NIOSH-IREP Cancer Models (cont.) 

(Italicized rows are proposed additions)

Current 

NuTRIS 

Organ Code

Proposed 

NuTRIS 

Organ Code

Description

NTPR 

Standard 

Organ 

Surrogate 

Type†

NIOSH-IREP 

Cancer Model 

(ICD-9) 

Comments

THYMUSC THYMUSC Thigh Muscle Muscle FIIDOS Cancers of Other 

and Ill-Defined Sites 

(195)

THYROD THYROD Thyroid Thyroid FIIDOS Thyroid (193)

TONGUE TONGUE Tongue ET Region+ Surrogate Oral Cavity and 

Pharynx (140-149) 

TONSILS TONSILS Tonsils ET Region+ Surrogate Oral Cavity and 

Pharynx (140-149) 

TRACHEA TRACHEA Trachea Lung Surrogate Lung (162)

U-BLDDR U-BLDDR Urinary Bladder Urinary 

Bladder Wall

FIIDOS Bladder (188)

U-TRCT U-TRCT Urinary Tract Urinary 

Bladder Wall

FIIDOS Urinary Organs, 

Excluding Bladder 

(189)

ULI ULI Upper Large Intestine ULI Wall+ FIIDOS Colon (153)

URTHRA URTHRA Urethra Urinary 

Bladder Wall

Surrogate Urinary Organs, 

Excluding Bladder 

(189)

None URTR Ureter Urinary 

Bladder Wall

Surrogate Urinary Organs, 

Excluding Bladder 

(189)
86 

Table A-1. Cross-Reference List of NTPR NuTRIS Codes, NTPR Standard Organs, and NIOSH-IREP Cancer Models (cont.) 

(Italicized rows are proposed additions)

Current 

NuTRIS 

Organ Code

Proposed 

NuTRIS 

Organ Code

Description

NTPR 

Standard 

Organ 

Surrogate 

Type†

NIOSH-IREP 

Cancer Model 

(ICD-9) 

Comments

None UVL Uvula ET Region+ Surrogate Oral Cavity and 

Pharynx 

(140-149)

VOCRD VOCRD Vocal Cords ET Region+ Surrogate Other Respiratory 

(160, 161, 163-165) 

YELMAR YL-MAR Yellow Marrow Red Marrow Surrogate Leukemia (204-208)

+ ET=extra-thoracic, LLI=lower large intestine, SI=small intestine, ULI = upper large intestine. † FIIDOS means that there is a dose conversion factor for the organ. Surrogate means that a dose conversion factor for the NTPR 

Standard organ is used for the diseased organ.
87 

Appendix B.

Proposed NTPR Expedited Processing 

Groups

B-1 Highest-Dose Cohort

Expedited Processing Groups (EPGs) are listed in Table B-4 to Table B-13 for participants in 

test operations conducted in the Pacific Proving Ground, in Table B-14 for participants in test 

operations conducted at the Nevada Test Site, and in Table B-15 for individuals who were 

residents of Enewetak Atoll during post-operational periods. In these tables, the column labeled 

“Highest-Dose Cohort External Residual Gamma Dose” includes doses previously assessed and 

documented in the publications referred to as NTPR White Books, Blue Books or other technical 

reports. These doses are not the proposed expedited doses. They do, however, help identify the 

cohort receiving the highest external gamma dose from residual radioactive material. The 

schedules and activities of the “highest-dose cohort” are used as a starting point for a scenario of 

participation and radiation exposure for an EPG. Refer to Section 3 of this report for a definition 

the “high-dose cohort.” 

B-2 Treatment of Exclusions

NTPR participants are excluded from an EPG if they had the potential for higher doses than 

the EPG or if there is insufficient information regarding their activities. One or more cohorts 

having well-characterized, common activities may be organized into a separate EPG. Cohorts

are organized into separate EPGs if their overall exposure is deemed distinct from the members 

of the EPG. 

Participants or cohorts excluded from EPGs based on operational activities that are specific to 

the group are shown in the column labeled “Exclusions (Units, cohorts, activities, etc.)” These 

exclusions are either organized as a separate EPG or identified for further case-specific review 

and, possibly a full RDA. Personnel and activities to be excluded are grouped into three general 

categories of participation as listed in Table B-1 to Table B-3. These exclusions apply unless 

otherwise stated for a specific EPG as described in the Compendium of EPGs (DTRA, 2011).
88 

Table B-1. General Exclusions Applicable to Pacific Proving Ground

Ship-Based Personnel* 

Activity or Cohort

Participation in more than one test series (operation)

Decontamination of any equipment (except for CROSSROADS target 

ship crews)

Personnel who performed maintenance or repair on contaminated 

equipment prior to decontamination

Personnel who were topside during one or more fallout events

Personnel whose regular assignment was to a small boat crew

Divers

Crews of cloud-tracking or cloud-sampling aircraft

Involvement in or near heliborne operations (crew members or 

passengers)

Radioactive sample recovery, handling, or preparation

Personnel who were assigned to support scientific projects 

(e.g., weapon development projects or effects experiments)

Personnel whose regular assignment was to a Radiological Safety (RadSafe) unit

Flight drone or sounding rocket operations

Personnel assigned to ships that experienced evaporator or potable 

water system failures that lead to contaminated drinking water

Shore excursion to any test island

Either consumption of meals while topside, or being topside during 

episodes of descending fallout

Individuals with film badge records and whose total film badge dose is 

greater than the EPG external dose determined for their respective EPG

* These exclusions apply unless otherwise stated for a specific EPG as 

described in the Compendium of Proposed EPGs (DTRA, 2011).
89 

Table B-2. General Exclusions Applicable to Pacific Proving Ground

Land-Based Personnel* 

Activity or Cohort

Participation in more than one testing series (operation)

Decontamination of aircraft, helicopters, vehicles, or equipment

Personnel who performed maintenance or repair on contaminated 

aircraft, helicopters, vehicles, or equipment prior to decontamination

Personnel whose regular assignment was to a small boat crew

Divers

Crews of cloud-tracking, cloud-sampling, or air delivery aircraft

Involvement in or near heliborne operations (crew members or 

passengers)

Radioactive sample recovery, handling, or preparation

Personnel who were assigned to support scientific projects, e.g., weapon 

development projects or effects experiments (except if participation was 

as Bikini Resurvey personnel in 1947) 

Personnel whose regular assignment was to a Radiological Safety (RadSafe) unit

Flight drone or sounding rocket operations 

Excursion to any test island

Consumption of meals while outside during episodes of descending 

fallout

Individuals with film badge records and whose total film badge dose is 

greater than the EPG external dose determined for their respective EPG 

* These exclusions apply unless otherwise stated for a specific EPG as 

described in the Compendium of Proposed EPGs (DTRA, 2011).
90 

Table B-3. General Exclusions Applicable to Participants

during Testing at the Nevada Test Site* 

Activity or Cohort

Participation in more than one testing series (operation)

Volunteer observers

Participation in decontamination of aircraft, helicopters, vehicles, or 

equipment

Personnel who performed maintenance or repair on contaminated 

aircraft, helicopters, vehicles, or equipment prior to decontamination

Crews of cloud-tracking, cloud-sampling, or air-delivery aircraft

Members of helicopter crews

Radioactive sample recovery, handling, or preparation

Personnel whose regular assignment was to a Radiological Safety (RadSafe) unit

Personnel who were assigned duties in the forward test area for any 

reason other than to observe a shot or participate in a maneuver 

(e.g., Instructor/Control, Signal, Transportation, Engineering, etc.)

Personnel who were assigned to support scientific projects 

(e.g., weapons development projects and military or civil effects 

projects) 

Consumption of meals while outside during episodes of descending 

fallout

Individuals with film badge records and whose total film badge dose is 

greater than the maximized external dose determined for their respective 

EPG

* These exclusions apply unless otherwise stated for a specific EPG as 

described in the Compendium of Proposed EPGs (DTRA, 2011).
91 

Table B-4. Proposed Expedited Processing Groups for Operation CROSSROADS (1946)

Proposed EPG* EPG Members

Exclusions

(Units, cohorts, activities, etc.)

HighestDose 

Cohort

Estimated External 

Residual Gamma 

Dose for the 

Highest-Dose 

Cohort

(rem)‡

Number of 

Participants

(Approx.)

CROSSROADS 

Support ShipBased Personnel

Crews of CROSSROADS support 

ships (those included in Weitz et 

al., 1982b ), and crews of the remanned target ships USS 

BLADEN, USS CORTLAND, 

USS FILLMORE, USS GENEVA, 

USS NIAGARA, and USS 

LCI(L)615. 

• Target ship boardings after 

BAKER (distinct EPG, see 

below). 

• Flight/drone operations aboard 

USS SHANGRI-LA and USS 

SAIDOR.

• USS BRUSH (distinct EPG, see 

below). 

• Ammunition Disposal Units at 

Kwajalein (Post-XRD).

• Bikini resurvey (distinct EPG, 

see below).

• Crew member of the USS 

ACHOMAWI, USS COUCAL, 

and USS O’BRIEN.

USS 

RECLAIMER†

 

1.7 

(Weitz et al., 1982a , 

Table 7-1) 

30,000 
92 

Table B-4. Proposed Expedited Processing Groups for Operation CROSSROADS (1946) (cont.)

Proposed EPG* EPG Members

Exclusions

(Units, cohorts, activities, etc.)

HighestDose 

Cohort

Estimated External 

Residual Gamma 

Dose for the 

Highest-Dose 

Cohort

(rem)‡

Number of 

Participants

(Approx.)

CROSSROADS 

Land-Based 

Personnel

Land-based personnel at Kwajalein 

and Enewetak Atolls and weather 

station islands (there were no landbased personnel at Bikini Atoll).

• Decontamination of target ships 

moored at Kwajalein Island.

• Towing of target ships to 

Kwajalein Island. 

• Small boat operations involving 

contaminated target or support 

ships moored at Kwajalein 

Island.

• Performing surveys, construction, 

or experiments on Bikini Atoll 

after Shot ABLE.

• Unloading, inspecting, handling, 

moving, and decontaminating 

ammunition on target ships 

moored at Kwajalein Island.

• Handling of contaminated 

clothing, waste, or equipment 

created during ammunition 

inspection and unloading 

operations at Kwajalein Island.

Army Air 

Group TG 1.5

0.1 

(DTRA, 2008, 

Appendix B-1, 

Operation 

CROSSROADS)

2,600 
93 

Table B-4. Proposed Expedited Processing Groups for Operation CROSSROADS (1946) (cont.)

Proposed EPG* EPG Members

Exclusions

(Units, cohorts, activities, etc.)

HighestDose 

Cohort

Estimated External 

Residual Gamma 

Dose for the 

Highest-Dose 

Cohort

(rem)‡

Number of 

Participants

(Approx.)

CROSSROADS 

Target Ship-Based 

Personnel

Crews that boarded contaminated 

target ships after Shot BAKER.

• Crews of six re-manned target 

ships that did not receive topside 

contamination from Shot 

BAKER: USS BLADEN, USS 

CORTLAND, USS FILLMORE, 

USS GENEVA, USS 

NIAGARA, and USS LCI(L) 

615. These personnel are 

included in the CROSSROADS 

Support Ship-Based Personnel 

EPG.

• Crew members of any target 

ships who did not participate in 

target ship boardings after Shot 

BAKER – these personnel are 

included in the CROSSROADS 

Support Ship Crew EPG.

• Crew members of any target 

ships who were subsequently 

assigned to Ammunition Disposal 

Units and participated in 

ammunition unloading at 

Kwajalein.

• Personnel who were crew 

members of target submarines.

USS 

CARTERET

2.9 (previous RDA) 8,000 
94 

Table B-4. Proposed Expedited Processing Groups for Operation CROSSROADS (1946) (cont.)

Proposed EPG* EPG Members

Exclusions

(Units, cohorts, activities, etc.)

HighestDose 

Cohort

Estimated External 

Residual Gamma 

Dose for the 

Highest-Dose 

Cohort

(rem)‡

Number of 

Participants

(Approx.)

USS BRUSH 

Crew (February 

25-27, 1947) 

Crew of USS BRUSH in Kwajalein 

Lagoon, February 1947.

• Personnel who transferred to 

USS BRUSH after the ship’s 

departure from Kwajalein Atoll 

on February 27, 1947.

Crew members 

who 

participated in 

excursions to 

target ships. 

0.07 (previous RDA) 250 

Bikini Resurvey 

Personnel JulyAugust 1947

Crew members of USS CHILTON, 

USS COUCAL and LCI(L) 615 

who participated as members of the 

Bikini Resurvey team in July and 

August 1947.

• None specific to this group. Navy 

Construction 

Battalion 

Detachment 

1800. 

0.8 (previous RDA) 700 

* Detailed descriptions with complete lists of ships, cohorts, excluded units, etc., are included in the EPG Compendium (DTRA, 2011).

† Crews of USS O’BRIEN received limited fallout after ABLE, in addition to BAKER’s. The corresponding external dose when added to that due to 

exposure to BAKER fallout is smaller than that for the USS RECLAIMER. USS ACHOMAWI and possibly other support ships had faulty evaporators 

that may have resulted in an additional internal dose due to ingestion of contaminated drinking water. 

‡ These are not assigned doses to members of EPGs (see introductory narrative of this appendix).
95 

Table B-5. Proposed Expedited Processing Groups for Operation SANDSTONE (1948)

Proposed EPG* EPG Members

Exclusions

(Units, cohorts, activities, etc.)

HighestDose 

Cohort

Estimated External

Residual Gamma 

Dose for the 

Highest-Dose 

Cohort

(rem)†

Number of 

Participants

(Approx.)

SANDSTONE 

Ship-Based 

Personnel

Personnel on ships during 

Operation SANDSTONE to 

include transient ships.

• Individuals who participated in 

Enewetak and Bikini Atoll resurveys 

(Post-SANDSTONE). 

• Individuals who Boarded Operation 

CROSSROADS target ships moored 

at Kwajalein.

• Individuals who participated in a 

special project known as Operation 

FITZWILLIAM that involved 

laboratory measurements of 

radioactive samples.

USS HENRY 

W. TUCKER

0.05 

(DTRA, 2008, 

Appendix B-2, 

Operation 

SANDSTONE)

6,400 

SANDSTONE 

Land-Based 

Personnel

Army, Navy, and Air Force 

personnel stationed at 

Enewetak and Kwajalein 

Atolls.

• Individuals who participated in 

Enewetak and Bikini Atoll resurveys 

(Post-SANDSTONE). 

• Individuals who boarded Operation 

CROSSROADS target ships moored 

at Kwajalein.

• Individuals who participated in a 

special project known as Operation 

FITZWILLIAM that involved 

laboratory measurements of 

radioactive samples.

• Individuals who were stationed at 

Majuro Atoll, Rongerik Atoll, or 

Wake Island.

TG 7.4 (Air 

Force) at 

Kwajalein 

Atoll

0.08 

(DTRA, 2008, 

Appendix B-2, 

Operation 

SANDSTONE)

5000 

* Detailed descriptions with complete lists of ships, cohorts, excluded units, etc., are included in the EPG Compendium (DTRA, 2011). 

† These are not assigned doses to members of EPGs (see the introductory narrative of this appendix).
96 

Table B-6. Proposed Expedited Processing Groups for Operation GREENHOUSE (1951)

Proposed EPG* EPG Members

Exclusions

(Units, cohorts, activities, etc.)

HighestDose 

Cohort

Estimated External 

Residual Gamma 

Dose for the 

Highest-Dose 

Cohort

(rem)†

Number of 

Participants

(Approx.)

GREENHOUSE 

Ship-Based 

Personnel

Personnel on ships during 

Operation GREENHOUSE 

including transient ships.

• No specific exclusions. USNS SGT. C. 

E. MOWER

0.68 

(DTRA, 2008, 

Appendix B-3, 

Operation 

GREENHOUSE)

4,700 

GREENHOUSE 

Land-Based 

Personnel

Army, Navy, and Air Force 

personnel stationed at Enewetak 

Atoll, Kwajalein Atoll, and weather 

station islands. 

• Individuals who participated in 

clothing contamination tests.

Headquarter, 

Joint Task 

Force-3 

3.1 

(DTRA, 2008, 

Appendix B-3, 

Operation 

GREENHOUSE)

4,700 

* Detailed descriptions with complete lists of ships, cohorts, excluded units, etc., are included in the EPG Compendium (DTRA, 2011). 

† These are not assigned doses to members of EPGs (see the introductory narrative of this appendix).
97 

Table B-7. Proposed Expedited Processing Groups for Operation IVY (1952)

Proposed EPG* EPG Members

Exclusions

(Units, cohorts, activities, etc.)

HighestDose 

Cohort

Estimated External 

Residual Gamma 

Dose for the 

Highest-Dose 

Cohort

(rem)†

Number of 

Participants

(Approx.)

IVY Ship-Based 

Personnel

Personnel on ships during 

Operation IVY including transient 

ships.

• None specific to this group. USS LIPAN 0.036 

(DTRA, 2008, 

Appendix B-4, 

Operation IVY)

4,700 

IVY Land-Based 

Personnel

Army, Navy, and Air Force 

personnel stationed at the residence 

islands of Enewetak Atoll, 

Kwajalein Atoll, and weather 

station islands. 

• None specific to this group. 7126th Army 

Unit on 

Enewetak 

Atoll.

0.059 

(DTRA, 2008, 

Appendix B-4, 

Operation IVY)

4,700 

* Detailed descriptions with complete lists of ships, cohorts, excluded units, etc., are included in the EPG Compendium (DTRA, 2011). 

† These are not assigned doses to members of EPGs (see the introductory narrative of this appendix).
98 

Table B-8. Proposed Expedited Processing Groups for Operation CASTLE (1954)

Proposed EPG* EPG Members

Exclusions

(Units, cohorts, activities, etc.)

HighestDose 

Cohort

Estimated External 

Residual Gamma 

Dose for the 

Highest-Dose 

Cohort

(rem)†

Number of 

Participants

(Approx.)

CASTLE HighDose Ship-Based 

Personnel

Personnel on Operation CASTLE 

ships that received heavier fallout.

• Personnel on Operation CASTLE 

ships that received light fallout to 

include transient ships (distinct 

EPG, see below).

• Shore excursions on Rongelap or 

Rongerik Atolls.

• Crew members of YAG 39 (USS 

GEORGE EASTMAN), USS 

PATAPSCO (AOG 1), or YAG 

40 (GRANVILLE S. HALL).

USS PHILIP 

(average crew)

3.56 

(DTRA, 2008, 

Appendix B-5, 

Operation CASTLE)

1350 

CASTLE LowDose Ship-Based 

Personnel

Personnel on ships at Operation 

CASTLE that received light fallout 

and transient ships. 

• Personnel on Operation CASTLE 

ships that received heavy fallout 

(distinct EPG, see above). 

• Shore excursions on Rongelap or 

Rongerik Atolls.

• Were crew members of YAG 39 

(USS GEORGE EASTMAN), 

USS PATAPSCO (AOG 1), or 

YAG 40 (GRANVILLE S. 

HALL).

USS ESTES 1.76 

(DTRA, 2008, 

Appendix B-5, 

Operation CASTLE)

4,300 

CASTLE LandBased PersonnelArmy, Navy, and Air Force 

personnel stationed at Enewetak 

Atoll, Kwajalein Atoll, and weather 

station islands. 

• Excursions on Rongelap or 

Rongerik Atolls.

7126th Army 

Unit stationed 

at Enewetak 

Island

1.09 

(DTRA, 2008, 

Appendix B-5, 

Operation CASTLE)

2,600 

* Detailed descriptions with complete lists of ships, cohorts, excluded units, etc., are included in the EPG Compendium (DTRA, 2011). 

† These are not assigned doses to members of EPGs (see the introductory narrative of this appendix). 
99 

Table B-9. Proposed Expedited Processing Group for Operation WIGWAM (1955)

Proposed EPG* EPG Members

Exclusions

(Units, cohorts, activities, 

etc.)

Highest-Dose 

Cohort

Estimated External 

Residual Gamma 

Dose for the 

Highest-Dose 

Cohort

(rem)†

Number of 

Participants

(Approx.)

WIGWAM ShipBased Personnel

All participants. • Individuals who performed 

large scale ship 

decontamination.

USS 

CHANTICLEER 

0.13 

 (DTRA, 2008, 

Appendix B-6 

Operation WIGWAM)

6,200 

* Detailed descriptions with complete lists of ships, cohorts, excluded units, etc., are included in the EPG Compendium (DTRA, 2011). 

† These are not assigned doses to members of EPGs (see the introductory narrative of this appendix).
100 

Table B-10. Proposed Expedited Processing Groups for Operation REDWING (1956)

Proposed EPG* EPG Members

Exclusions

(Units, cohorts, 

activities, etc.)

Highest-Dose 

Cohort

Estimated External 

Residual Gamma 

Dose for the 

Highest-Dose 

Cohort

(rem)†

Number of 

Participants

(Approx.)

REDWING ShipBased PersonnelMilitary personnel who were 

assigned to a ship that participated 

in Operation REDWING activities 

including transient ships.

• None specific to this 

group. 

USS SILVERSTEIN 1.4 

(DTRA, 2008, 

Appendix B-7, 

Operation 

REDWING)

est. 6,000

REDWING LandBased PersonnelMilitary personnel who supported 

Operation REDWING and resided 

on Enewetak Atoll, Kwajalein 

Atoll, or weather station islands 

during Operation REDWING.

• None specific to this 

group. 

7126th Army Unit 3.6 

(DTRA, 2008, 

Appendix B-7, 

Operation 

REDWING)

4,000 

* Detailed descriptions with complete lists of ships, cohorts, excluded units, etc., are included in the EPG Compendium (DTRA, 2011). 

† These are not assigned doses to members of EPGs (see the introductory narrative of this appendix).
101 

Table B-11. Proposed Expedited Processing Groups for Operation HARDTACK I (1958)

Proposed EPG* EPG Members

Exclusions

(Units, cohorts, activities, etc.)

HighestDose 

Cohort

Estimated External 

Residual Gamma 

Dose for the 

Highest-Dose 

Cohort

(rem)‡

Number of 

Participants

(Approx.)

HARDTACK I 

Ship-Based 

Personnel

Personnel on ships at 

Operation HARDTACK I 

including transient ships.

• Crew Members of ships that only 

participated in shots at Johnston Island 

(distinct EPG, see below). 

• Crew Members of ships that served as 

unmanned target vessels for the underwater 

shots WAHOO and UMBRELLA to include 

three destroyers (KILLEN, HOWORTH, 

and FULLAM), a liberty ship (SS 

MICHAEL MORAN), and a submarine 

(BONITA).

USS 

ARIKARA

0.8 

(DTRA, 2008, 

Appendix B-8, 

Operation 

HARDTACK I)

6,000 

HARDTACK I 

Non-exposed 

Ship-Based 

Personnel

All ships that only 

participated in Shots at 

Johnston Atoll.

• Individuals with non-zero film badge doses. USS 

EPPERSON

(DDE-719) 

NPE†

(DTRA, 2008, 

Appendix B-8, 

Operation 

HARDTACK I)

1,000 

HARDTACK I 

Land-Based 

Personnel

Personnel resident on Parry 

and Enewetak Islands of 

Enewetak Atoll and Eneu 

Island of Bikini Atoll.

• Personnel who resided on Japtan Island 

during the operation.

• Personnel assigned to Johnston Island.

TG 7.1

(Scientific 

Group 

stationed on 

Parry Island)

1.9 

(DTRA, 2008, 

Appendix B-8, 

Operation 

HARDTACK I)

3,500 

* Detailed descriptions with complete lists of ships, cohorts, excluded units, etc., are included in the EPG Compendium (DTRA, 2011). 

† NPE stands for no potential for exposure.

‡ These are not assigned doses to members of EPGs (see the introductory narrative of this appendix).
102 

Table B-12. Proposed Expedited Processing Groups for Operation ARGUS (1958)

Proposed EPG* EPG Members Exclusions

(Units, cohorts, activities, etc.)

HighestDose 

Cohort

Estimated External 

Residual Gamma 

Dose for the 

Highest-Dose 

Cohort

(rem)‡

Number of 

Participants

(Approx.)

ARGUS ShipBased Personnel

All participants in ARGUS. • None specific to this group. NPE†

(DTRA, 2008, 

Appendix B-9 

ARGUS)

4,369 

* Detailed descriptions with complete lists of ships, cohorts, excluded units, etc., are included in the EPG Compendium (DTRA, 2011). 

† NPE stands for no potential for exposure.

‡ These are not assigned doses to members of EPGs (see the introductory narrative of this appendix).
103 

Table B-13. Proposed Expedited Processing Groups for Operation DOMINIC I (1962)

Proposed EPG* EPG Members

Exclusions

(Units, cohorts, activities, etc.)

Highest-Dose 

Cohort

Estimated External 

Residual Gamma 

Dose for the 

Highest-Dose 

Cohort

(rem)‡

Number of 

Participants

(Approx.)

DOMINIC I 

Personnel

All participants in 

DOMINIC I. 

• Crewmembers of USS SIOUX (ATF 75), 

USC&GSS PIONEER (OSS-31), and USS 

MONTICELLO (LSD-35) during Shot 

SWORDFISH.

• Personnel involved in the recovery/handling of 

radioactively contaminated instrumented pods 

and rocket nose cones associated with 

successful THOR missile and rocket launches.

• Personnel involved in recovery and 

decontamination operations after any of the 

THOR missile incidents during Shots 

BLUEGILL, STARFISH, BLUEGILL PRIME.

• Personnel involved in recovery, servicing, or 

boarding of target rafts after airdrop shots. 

• Personnel involved in the recovery and handling 

of other contaminated with radioactive 

materials due to neutron activation.

N/A NPE†

(DTRA, 2008, 

Appendix B-10 

DOMINIC I)

25,000 

* Detailed descriptions with complete lists of ships, cohorts, excluded units, etc., are included in the EPG Compendium (DTRA, 2011).

† NPE stands for no potential for exposure.

‡ These are not assigned doses to members of EPGs (see the introductory narrative of this appendix).
104 

Table B-14. Proposed Expedited Processing Groups for Nevada Test Site (NTS)

Proposed EPG* EPG Members Exclusions

(Units, cohorts, activities, etc.)

HighestDose 

Cohort

Estimated External 

Residual Gamma 

Dose for the 

Highest-Dose 

Cohort

(rem)§

Number of 

Participants

(Approx.)

NTS Observer and 

Maneuver Troops, 

1951–1962 

Personnel that participated as a 

member of ground-based official 

EDR observer groups or maneuver 

groups during NTS shots from 

1951 through 1962, including 

Exercise IVY FLATS at 

DOMINIC II. Members of 505th 

Military Police Battalion that 

performed traffic control or march 

guide activities during UPSHOTKNOTHOLE (1953) or TEAPOT 

(1955). 

• Individuals who participated in 

one of the Volunteer Observer 

Programs conducted during some 

of the test series.

• Any individuals who participated 

in more than one maneuver group 

at more than one shot.

• The following maneuver groups 

are excluded and are each 

evaluated as a distinct EPG:

- The 2nd MCPAEB at 

Operation UPSHOTKNOTHOLE, Shot 

BADGER 

- Task Force WARRIOR at 

Operation PLUMBBOB, 

Shot SMOKY.

UPSHOTKNOTHOLE 

SIMON 

BCT-A 

3.2 

(DTRA, 2008, 

Appendices C-3 to 

C-7) 

42,600 

NTS Participants 

with no Forward 

Area Activities, 

1951–1962 

Support personnel stationed at 

Camp Desert Rock, Camp 

Mercury, Indian Springs Air Force 

Base, or Nellis Air Force Base 

during any single operation from 

1951 through 1962 who did not 

conduct any activities in any NTS 

forward area.

Inter-operational personnel at CDR, 

Camp Mercury, and Indian Springs 

Air Force Base.

• None specific for this group. UPSHOTKNOTHOLE 

CDR support 

troops

0.02 

(DTRA, 2008, 

Appendices C-3 to 

C-7; various NTPR 

technical memos)

Unknown
105 

Table B-14. Proposed Expedited Processing Groups for Nevada Test Site (NTS) (cont.)

Proposed EPG* EPG Members

Exclusions

(Units, cohorts, activities, etc.)

HighestDose 

Cohort

Estimated External 

Residual Gamma 

Dose for the 

Highest-Dose 

Cohort

(rem)§

Number of 

Participants

(Approx.)

Operation 

UPSHOTKNOTHOLE 

2nd Marine Corps 

Provisional 

Atomic Exercise 

Brigade 

(2MCPAEB) 

Marines that participated in the 

maneuver at UPSHOTKNOTHOLE Shot BADGER 

(1953). 

• Marine Helicopter Transport 

Group 16 that conducted air 

operations during the 2MCPAEB 

activities at Shot BADGER.

• Personnel in the 2MCPAEB 

Provisional Helicopter Atomic 

Test Unit that participated in the 

Operational Helicopter Test 

Program at several shots 

including Shot BADGER.

2nd MCPAEB 

HQ‡

3.7 

(DTRA, 2008, 

Appendix C-5) 

2,167 

Operation 

PLUMBBOB 

Task Force 

WARRIOR 

(TFW)

Army infantry troop test Task 

Force WARRIOR conducted at 

PLUMBBOB Shot SMOKY 

(1957). 

• Canadian Army Platoon 

(7th Platoon, Queen’s Own 

Rifles).

• 3rd Transportation Battalion 

(Helicopter). 

• Personnel not in an element of 

Company C, 1st Battle Group 

whose activities are not 

encompassed by the TFW 

highest-dose cohort scenario.

2nd Platoon 0.7 

(Goetz et al., 1979)) 

350 

* Detailed descriptions with complete lists of ships, cohorts, excluded units, etc., are included in the EPG Compendium (DTRA, 2011).

‡ Members of 1st Battalion 8th Marines of the 2nd MCPAEB received a higher total dose from external residual radiation (4.7 rem) than did the 2nd MCPAEB 

HQ personnel. However, no internal dose was accrued concurrently with approximately half of this total dose that was due to direct radiation from the 

BADGER stem as it passed the troops. Most of the dose to 2nd MCPAEB HQ personnel was from fallout, for which internal dose was concurrently 

accrued.

§ These are not assigned doses to members of EPGs (see the introductory narrative of this appendix).
106 

Table B-15. Proposed Expedited Processing Groups for PPG Post-Operations 

Proposed EPG* EPG Members Exclusions

(Units, cohorts, activities, etc.)

HighestDose 

Cohort

Estimated External 

Residual Gamma 

Dose for the 

Highest-Dose 

Cohort

(rem)†

Number of 

Participants

(Approx.)

PostSANDSTONE 

Enewetak Atoll

Residents of Enewetak Atoll on the 

islands of Enewetak, Parry and 

Japtan. 

• None specific for this group. Residents of 

Enewetak 

Island

0.05 

(Mason, 2009)

1,900 

PostGREENHOUSE 

Enewetak Atoll

Residents of Enewetak Atoll on the 

islands of Enewetak, Parry and 

Japtan. 

• None specific for this group. Residents of 

Parry Island

2.4 

(Mason, 2009)

2,600 

Post-IVY 

Enewetak Atoll

Residents of Enewetak Atoll on the 

islands of Enewetak, Parry and 

Japtan. 

• None specific for this group. Residents of 

Enewetak 

Island

0.028 

(Mason, 2009)

600 

Post-CASTLE 

Enewetak Atoll

Residents of Enewetak Atoll on the 

islands of Enewetak, Parry and 

Japtan. 

• None specific for this group. Residents of 

Enewetak 

Island

0.25 

(Mason, 2009) 

1,000 

Post-REDWING 

Enewetak Atoll

Residents of Enewetak Atoll on the 

islands of Enewetak, Parry and 

Japtan. 

• None specific for this group. Residents of 

Parry Island

1.9 

(Mason, 2009)

4,500 

PostHARDTACK I 

Enewetak Atoll

Residents of Enewetak Atoll on the 

islands of Enewetak and Parry.

• Individuals who resided on 

Japtan Island.

Residents of 

Enewetak 

Island

0.56 

(Mason, 2009)

973 

* Detailed descriptions with complete lists of ships, cohorts, excluded units, etc., are included in the EPG Compendium (DTRA, 2011). 

† These are not assigned doses to members of EPGs (see the introductory narrative of this appendix).
107 

Glossary 

absorption type A characterization of the rate at which material deposited in the 

respiratory tract is absorbed into the blood. Three material “types” 

to provide default absorption rates when empirically determined 

rates are unavailable. Types are defined for fast (F), moderate 

(M), and slow (S) absorption.

air delivery aircraft In atmospheric nuclear testing, an aircraft that releases a test 

nuclear device from a specified altitude above a designated point 

on the ground; sometimes called an air drop aircraft.

alpha particle A positively-charged particle ejected spontaneously from the 

nuclei of some radionuclides. It is identical to a helium nucleus 

(two protons and two neutrons) with a mass number of four and an 

electric charge of +2. It has low penetrating power and a short 

range (a few centimeters in air).

benefit of the doubt A principle applied by the VA in adjudicating veteran’s claims 

used to decide, all other conditions being equal, in favor of the 

claimant.

beta radiation Radiation consisting of energetic electrons or positrons (positively 

charged electrons) emitted spontaneously from nuclei in decay of 

some radionuclides. Its penetrating power is more than an alpha 

particle but less than a gamma ray.

breathing rate A parameter used in calculating a radiation dose from the 

inhalation of radioactive materials that represents the volume of air 

breathed in per unit of time; herein expressed as m3 hr-1. 

cancer risk model A mathematical model that relates the probability that a cancer 

will occur in an organ to the radiation dose delivered to the organ; 

used to estimate probability of causation.

cloud-sampling aircraft In atmospheric testing, aircraft that penetrate the cloud of debris 

generated by a nuclear detonation to monitor the radiation 

exposure rate at various locations in the cloud and to collect 

samples of the airborne material for further analysis.

cloud-tracking aircraft In atmospheric nuclear testing, aircraft that follow the cloud of 

debris generated by a nuclear detonation by alternately engaging 

and then retreating from the edge of the cloud, often by observing 

radiation exposure rates.

cohort A group of individuals having a common association or factor; for 

example, all members of a battalion combat team who did not 

perform any special duties.

dose coefficient An organ and radionuclide specific factor for calculating the dose 

to an organ from a unit intake of radioactive material as 

recommended by the ICRP.
108 

dose conversion factor An organ and test shot specific factor for calculating the radiation 

dose from alpha particles and beta particles plus gamma rays due 

to radioactive materials deposited in the body during nuclear 

testing.

dose reconstruction See radiation dose assessment.

dosimetry The science or technique of determining dose from exposure to 

radiation.

DTRA-approved 

uncertainty factors

Multiplying factors applied to the total external dose (3) and 

internal dose (10) in deterministic RDAs to calculate an upperbound dose for each.

equivalent dose Mean absorbed dose in a tissue or organ (DT,R ) weighted by the 

radiation weighting factor (wR) for the type and energy of 

radiation. For exposure from external sources, wR applies to the 

radiation type and energy incident on the body. The SI unit of 

equivalent dose is J kg–1 with the special name sievert (Sv). 1 Sv 

= 1 J kg–1. In legacy units as used in NTPR, 1 Sv = 100 rem.

exclusion An activity involving radiation exposure that is judged to involve 

situations and radiation environments, which are not suitable for 

expedited processing of groups with routine duties.

Exercise Desert Rock A series of activities conducted at the NTS to provide training for 

military personnel in the effects of nuclear detonations.

expedited processing An approach to determining the radiation dose for a claimant in 

the NTPR program using methods, which tend to overestimate 

actual doses to allow more timely and efficient completion of 

cases while providing benefit of the doubt.

expedited processing group A group of military participants in an atmospheric nuclear test or 

tests who performed similar types of activities, encountered 

similar radiation environments, and whose radiation doses were 

similar.

exposure A general term used to describe the act of being exposed to 

ionizing radiation. Exposure is also a defined ionizing radiation 

quantity that is a measure of the ionization produced in air. The 

unit of exposure is coulomb per kilogram (C kg-1). A special name 

for exposure is Roentgen (R), where 1 R = 2.58 × 10-4 C kg-1.

exposure parameter A variable of set of variables in a mathematical model or dose 

calculation method; such as exposure rate.

exposure rate The quantity of exposure produced per unit time (e.g., C kg-1 hr-1, 

R hr-1).

exposure scenario A description of the radiation environment at locations and times 

of exposure and the activities of individuals during that time.

fallout The radioactive material falling from the atmosphere to the ground 

after a nuclear event, such as a detonation.
109 

fallout deposition The process of fallout collecting on the ground.

film badge A device consisting of unexposed photographic film and various 

absorbing materials (filters) in a holder and worn by a person or 

placed in a location to measure ionizing radiation. When the film 

is developed the radiation dose and type of radiation may be 

determined.

flight drone operation Activities involving remotely controlled aircraft during nuclear 

test operations; for example in cloud sampling.

gamma radiation Electromagnetic radiation emitted by an atomic nucleus during the 

process of transition or radioactive decay. Gamma rays are much 

more penetrating than alpha and beta particles.

heliborne operations The collection of activities in and around operating helicopters, 

which can resuspend radioactive contamination on ground 

surfaces.

highest-dose cohort A cohort of participants at specific test operation that has the 

highest external dose from residual gamma radiation of all cohorts 

considered for inclusion in an EPG.

initial radiation Ionizing radiation emitted within the first minute following a 

nuclear detonation; primarily consists of neutrons and gamma 

radiation.

internally-deposited Radioactive material that remains in the body after entry by 

inhalation, ingestion, or through breaks in the skin and may be 

distributed to various bodily organs and tissues.

inter-operational personnel Participants who were present at the locations of atmospheric test 

operations during periods, which are not within the officially 

specified dates for the operation.

isotope One of several nuclides of a chemical element having the same 

number of protons in their nuclei, but different nuclear mass 

numbers due to different numbers of neutrons in the nucleus. An 

element may have numerous stable or unstable (radioactive) 

isotopes.

limiting dose A quantity of radiation dose that produces a PC of 40 percent for a 

specific cancer calculated assuming exposure at age 18 and 

diagnosis of disease generally at age 50.

maneuver troop A military participant in an atmospheric nuclear test or tests who 

was involved in post-shot, military-type maneuvers.

maximized In the context of this report, the modifications to a basic scenario 

of exposure and its dose calculation parameters that increase the 

estimated dose.

mean dose The arithmetic average of a set of dose values determined by 

dividing the sum of the values by the number of values.

neutron An uncharged elementary particle having a mass slightly greater 
110 

than a proton that is usually stable when inside a nucleus but 

unstable when outside

neutron activation The formation of a radionuclide produced by the absorption of a 

neutron by the nucleus of a given nuclide; e.g., the production of 

60Co through absorption of a neutron by 59Co.

non-exposed ships Ships that participated in an operation in the PPG whose personnel 

had no potential for exposure to radiation.

NTPR blue book One of a series of reports produced by the Defense Nuclear 

Agency (a predecessor of DTRA) that describes the general 

details, events, personnel participation, and radiation doses for a 

specific test operation or portion of one.

NTPR NuTris Organ Code An item in the data dictionary of the Nuclear Test Review

Information System used to code the organ or disease that is the 

basis of a claim to the VA.

NTPR Standard Organ A term used to refer to one of the 23 organs for which published 

ICRP dose coefficients are available for the calculation of 

radiation dose to organs and tissues from the intake of radioactive 

material.

NTPR Surrogate A term used to specify which of the 23 NTPR Standard Organs are 

chosen for calculation of the radiation dose for other organs; e.g. 

the testes is used as the NTPR Surrogate for the prostate in claims 

for cancer of the prostate.

NTPR White Book One of a series of reports produced by the Defense Nuclear 

Agency (a predecessor of DTRA) that documents the radiation 

dose assessment for a particular unit or collection of similar units 

who participated in the atmospheric nuclear test program.

observer troop A military member who was present as a member of a group to 

observe a specific atmospheric nuclear test but who did not 

perform any military maneuver-type activities (generally used only 

for NTS observers).

operation In the context of this report, a series of nuclear tests conducted at a 

specified location and within a specified time period, typically 

within a single calendar year; e.g. Operation CROSSROADS.

participant A veteran who was present at the location and within the defined 

time period of any atmospheric nuclear test series, or operation.

probability of causation The probability that a specific disease in a person was caused by 

their exposure to a hazardous agent, such as ionizing radiation. 

For purposes of this report, probability of causation is calculated 

for specific cancers using the NIOSH-IREP computer software.

radiation dose assessment An estimation of radiation doses received by a specified individual 

or individuals under specified exposure conditions. In NTPR, a 

full RDA includes consideration of all input received from the 
111 

participant.

rem The special name for the conventional unit of equivalent dose; 1 

rem = 0.01 Sv.

residence islands Islands in the Enewetak Atoll that were located at a distance from 

the test islands and generally served as the location where most 

participants were billeted and worked.

residual radiation Beta and gamma radiation other than initial radiation, which is 

emitted by fallout and neutron activation products following a 

nuclear detonation. This was a common source of exposure for 

NTPR program participants.

scenario of exposure See exposure scenario.

screening dose The quantity of radiation dose that produces a PC of 50 percent for 

a specific cancer calculated for this report assuming exposure at 

age 18 and diagnosis of disease generally at age 50.

service observer See observer troop.

service-connected 

disability

A term that VA uses to describe whether a veteran’s medical 

condition or disability is related to his active military service.

shore excursion Occasions when ship-board personnel may have gone ashore on 

islands for liberty or to support test operations.

sounding rocket operation Participants involved with the recovery of sounding rockets that 

may have penetrated the nuclear cloud during tests.

test series Synonymous with operation.

topside Aboard ship, this is the weather deck of topmost deck; as in the 

seaman was topside during observation of Shot BRAVO.

upper bound A property of a measured or calculated quantity that indicates the 

highest value of a range of values and represents a certain level of 

confidence or credibility that the value would not be exceeded by 

more than a certain percentage; e.g., the upper bound dose at 95 

percent.

volunteer observers Military participants at certain nuclear tests conducted at the NTS, 

who viewed detonations at distances from ground zero that were 

closer than other observers and that could involve significant dose.
112 

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113 

Abbreviations, Acronyms, and Symbols 

α Alpha (radiation)

β+γ Beta and Gamma (radiation)

2MCPAEB 2nd Marine Corps Provisional Atomic Exercise Brigade

AEC Atomic Energy Commission

AFB Air Force Base

ALL Acute Lymphocytic Leukemia

Am-241 Americium-241

AML Acute Myeloid Leukemia

ATSDR Agency for Toxic Substances and Disease Registry

BCT-A Battalion Combat Team Able 

BEIR Biological Effects of Ionizing Radiation

CDC Centers for Disease Control and Prevention

CDC-CMMS CDC and the Centers for Medicare and Medicaid Services 

CDR Camp Desert Rock 

CFR Code of Federal Regulations 

CLL Chronic Lymphocytic Leukemia

Cm-242 Curium-242

CML Chronic Myeloid Leukemia

CMMS Centers for Medicare and Medicaid Services 

CONUS Continental United States

DoD Department of Defense

DTRA Defense Threat Reduction Agency 

E Energy

EDR Exercise Desert Rock

EEOICPA Energy Employees’ Occupational Injury Compensation 

Program Act 

EPG Expedited Processing Group 

ET Extra Thoracic

Ext Dose External Dose

F Type F (Fast rate of absorption)

FIIDOS Fallout Inhalation and Ingestion Dose to Organs

ICD-9 International Statistical Classification of Diseases and 

Related Health Problems (9th Edition)

ICRP International Commission on Radiological Protection

IREP Interactive RadioEpidemiological Program

keV kiloelectron volt

LLI Lower Large Intestine
114 

m3 hr-1 cubic meters per hour

M Type M (moderate rate of absorption)

MeV megaelectron volt

MPB Military Police Battalion

N/A Not Applicable

NAS National Academy of Science

NCI National Cancer Institute 

NIH National Institutes of Health

NIOSH National Institute of Occupational Safety and Health

NIOSH-IREP National Institute of Occupational Safety and HealthInteractive RadioEpidemiological Program

Np-237 Neptunium-237

NPE No Potential for Exposure

NRC National Research Council

NTPR Nuclear Test Personnel Review 

NTS Nevada Test Site

NuTRIS Nuclear Test Review Information System 

OBS/Man Observer/Maneuver

OPHEH Office of Public Health and Environmental Hazards

ORAU Oak Ridge Associated Universities

PC Probability of Causation

PPG Pacific Proving Ground

Pu-238 Plutonium-238

Pu-239 Plutonium-239

Pu-240 Plutonium-240

Rad-Safe Radiological Safety

RDA Radiation Dose Assessment 

rem Roentgen Equivalent Man

S Type S (slow rate of absorption)

SC-1 VBDR Subcommittee 1 on DTRA Dose Reconstruction 

Procedures

SD Screening Dose

SI Small Intestine

SM Standard Method

SOP Standard Operating Procedure 

TFBB Task Force BIG BANG

TFW Task Force WARRIOR

TG Task Group

U-235 Uranium-235

U-238 Uranium-238

UB Upper Bound

ULI Upper Large Intestine
115 

USDOE United States Department of Energy

USNS United States Naval Ship

USS United States Ship

VA United States Department of Veterans Affairs

VBDR Veterans' Advisory Board on Dose Reconstruction

XRD, XRDS Operation CROSSROADS

YAG Yard Auxiliary, General (Miscellaneous Auxiliary Service 

Craft)
116 

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117 

DISTRIBUTION LIST

DTRA-TR-10-29 

DEPARTMENT OF DEFENSE

Defense Technical Information Center

Attn: DTIC/OCA

8725 John J. Kingman Road

Fort Belvoir, VA 22060-6201 

Defense Threat Reduction Agency

Attn: RD-NTSN

8725 John J. Kingman Road, 

Fort Belvoir, VA 22060-6201 

Defense Threat Reduction Information Analysis Center

Attn: OP-ONIUI 

8725 John J. Kingman Road

Fort Belvoir, VA 22060-6201 

DEPARTMENT OF VETERANS AFFAIRS

Department of Veterans Affairs

Veterans Health Administration

Director, Environmental Agents Service (10P3A)

810 Vermont Ave., NW

Washington, DC 20420

Department of Veterans Affairs

Veterans Benefits Administration 

Director, Compensation Service (211B)

810 Vermont Ave., NW

Washington, DC 20420

Department of Veterans Affairs

VA Regional Office

Attn: Director (21 - Radiation) 

1600 East Woodrow Wilson Ave.

Jackson, MS 39216
118 

FEDERAL AGENCY ADVISORY BOARDS 

Veterans’ Advisory Board on Dose Reconstruction

801 North Quincy Street, Suite 600

Arlington, VA 22203

Veterans’ Advisory Committee on Environmental Hazards

Department of Veterans Affairs

Compensation Service (211)

810 Vermont Ave., NW

Washington, DC 20420 

NON-FEDERAL ENTITIES

SAIC, Inc.

8301 Greensboro Drive, M/S E-5-5 

McLean, VA 22102

L-3 Services, Inc.

11410 Isaac Newton Square North, Suite 103

Reston, VA 20190-5005 

SENES Oak Ridge, Inc.

102 Donner Drive

Oak Ridge, TN 37830

Oak Ridge Associated Universities 

9950 W. 80th Ave., Ste 17

Arvada, CO 80005