[ BASIC INDIVIDUAL DOSE RECONSTRUCTION REVIEW CHECKLIST
i Audit Number: Claim Number: Date: Page of

Area of |Description of Technical Elements of Review | Yes/No/ Comments Initials
Review NA

D.2._ Internal Dose Calculations: Verify internal dose calculations are appropriate for purposes of determination
of POC. (Parenthetical number represents the section within the “Internal Dose Reconstruction Implementation

Guideline” (OCAS-IG-002) that provides detailed methodology for conducting the appropriate portion of the dose
reconstruction.)

Internal Estimate - Low Dose

D2.La Potential:
Are recalculations of bioassay values
appropriate and correct? (§6.1.2)

D2.1.b Are calculations for determining the highest
intake associated with each potential
solubility class that will produce a predicted
bioassay value equal to at least one of the
recalculated bioassay values from step
§6.1.2 appropriate and correct? (§6.1.4)

D.2.Le Are calculations for determining the highest
intake (using a constant chronic exposure
period) that will produce a predicted
bioassay value equal to at least one of the
recalculated bioassay values from step
§6.1.2 for each potential solubility class
appropriate and correct? (§6.1.5)

D2.1.d Are calculations for determining a scenario
(for each radionuclide for which the
claimant was monitored) that produces the
highest 50-year committed dose to the
organ of concern appropriate and correct?
(86.1.7)

D.2.1.e Are calculations for determining annual
doses to the organ of concern using the
scenario selected in step §6.1.7 (for each
radionuclide for which the claimant was
monitored) appropriate and correct?
(§6.1.8)



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DAZ
D.13.a

Preliminary Dose Estimate - High Dose
Potential:
‘Are assumptions for the selection of
radionuclides that will deliver the most dose
per unit intake or one with the highest
bioassay results appropriate? (§6.2.1)

D.1.3.b

Is the assumption used to determine the date
for an inhalation appropriate? (§6.2.2)

D.1.3.¢

Are assumptions associated with the
selection of all potential solubility classes
appropriate? (§6.2.3)

ee ee

D.1.3.d

‘Are assumptions used to determine the
highest intake for each potential solubility
class that will not exceed any of the
measured bioassay values appropriate?
(§6.2.4)

D.1.3.e

If the acute scenario does not produce a
realistic curve, are assumptions used in
finding a more reasonable scenario
appropriate? (§6.2.5)

DABL

Are assumptions used to determine the
scenario that produces the lowest 50-year
committed dose to the organ of concern
appropriate? (§6.2.7)

D13.g

Are assumptions used to determine the
annual doses to the organ of concern
appropriate? (§6.2.8)

D.1.3.h

When the PC calculation results in <50%,
are assumptions used in the refinement of
internal dose estimates appropriate?
(86.2.11 A-G and §6.5)

C-28


BASIC INDIVIDUAL DOSE RECONSTRUCTION REVIEW CHECKLIST

adequate for assessing internal exposure?

Claim Number Dat Page of
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Review NA
D.3 Consistency of Internal Dose Data: Evaluate whether data were consistent with site radiological monitoring
protocols of the time period and determine whether the protocols were adequate for monitoring the
internal exposure.
D3.1 Are internal bioassay measurement data (e.g.,
types of bioassay, detection limits, etc.)
consistent with site radiological monitoring
protocols/procedures of the time’?
D3.2 Were internal bioassay monitoring programs

| D33

‘Are the frequencies and types of workplace
sampling and surveys (e.g., air sampling,
contamination surveys) consistent with site
workplace monitoring practices/procedures of
the time?

D34 Were site workplace monitoring protocols
adequate for assessing internal exposure?
D35 Is the use of respirators consistent with

protocols defined in the respiratory protection
program of the time?



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C284

Are calculations of uncertainty associated
with incomplete/missed electron monitoring
dose appropriate and correct? (§2.3.2.3)

C28.

Are dose calculations of skin contamination
appropriate and correct? (§2.3.3.2.2)

C286

‘Are calculations of uncertainty associated
with the dose from skin contamination
appropriate and correct? (§2.3.3.3)

C29
C2.9.a

Electron Dose Reconstruction With NO

Monitoring Data:
Are calculations of reconstructed electron

dose using co-worker data appropriate and
correct? (§3.3.1)

C.2.9.b

Are calculations of uncertainty associated
with reconstructed electron dose using co-
worker data appropriate and correct?
(§2.2.1.3)

C.2.9.c

Are calculations of reconstructed electron
dose using survey data appropriate and
correct? (§$3.3.2)

C29.

Are calculations of uncertainty associated
with reconstructed electron dose using
survey data appropriate and correct?
(§3.3.2.3)

C29.

Are calculations of reconstructed electron
dose using source term data appropriate and
correct? (§3.3.3)

C-19


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| i. ADDITIONAL INTERNAL DOSE RECONSTRUCTION REVIEWS
11

results).

.1 Consistency of Data: Evalnate whether the inter dose estimate is consistent with relevant radiological
information within the NIOSH site profile (e.g., air monitoring, wipe data are consistent with bioassay

Lil Is there reasonable consistency between.
assumptions used to estimate internal dose and
process information (e.g., radionuclides and
quantities present and processed, production
processes) provided in the Site Profile?

11.2 Is there reasonable consistency between

y assumptions used to estimate internal dose and
routine radiation monitoring practices (¢.g., air
monitoring, contamination surveys, etc.)
identified in the Site Profile?

113 Is there reasonable consistency between
assumptions used to estimate internal dose and
routine protective measures (e.g., respirators,
ventilation, etc.) identified in the Site Profile?

with relevant co-worker case information and assumptions associated with internal dose for consistency.

2.4 Is there consistency between monitoring data
1 used to calculate internal dose for the covered
worker and monitoring data used to calculate
“| internal dose for a relevant co-worker case?

| 12 Comparison of Case Information: Compare case information and assumptions associated with internal dose
1

122 Ts there consistency between assumptions used
to reconstruct unmonitored internal dose for the
covered worker and assumptions used to
reconstruct unmonitored internal dose for a
relevant co-worker case?

cao



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D21f When the preliminary PC results in >50%,

are calculations used in the refinement of
internal estimates appropriate and correct?
(§6.1.14 A-D and §6.5)

D22 Preliminary Internal Dose Estimate - High Dose.
D22.a | Potent
Are calculations for determining the highest

intake for each potential solubility class that
will not exceed any of the measured
bioassay values appropriate and correct?
(86.2.4)

D2.2.b If the acute scenario does not produce a
realistic curve, are calculations used in
finding a more reasonable scenario

appropriate? (§6.2.5)

D2.2.¢ Are calculations for determining the
scenario that produces the lowest 50-year
committed dose to the organ of concern
appropriate and correct? (§6.2.7)

D224 Are calculations for determining the annual
internal doses to the organ of concern
appropriate and correct? (§6.2.8)

D2.2.e When the PC calculation results in <50%,
1 are calculations to refine internal dose
estimates appropriate and correct? (§6.2.11

| A-G and §6.5)
D23 Detailed Internal Dose Reconstruction:
| D23.a ‘Are calculations for determining the

quantity of each radionuclide for each

intake based on bioassay measurement data
appropriate and correct? (see example §8.5)



BASIC INDIVIDUAL DOSE RECONSTRUCTION REVIEW CHECKLIST
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=
Description of Technical Elements of Review | Yes/No/ Comments
NA

Are methods and/or statistical software used
for determining uncertainty distributions
surrounding external organ dose adequate
and appropriate?

Internal Dose Technical Basis
Documents/Methods:
Are the technical basis documents (e.g.,
ICRP reports, etc.) used in reconstructing
internal radiation doses adequate and
appropriate?

Are methods for estimating ‘missed,’
‘incomplete,’ and/or ‘unmonitored” internal
dose adequate and appropriate?

Are statistical approaches developed for
multiple internal dose reconstructions
appropriate?

Are procedures used for determining
whether data is sufficient to make a
reasonable internal dose estimate
appropriate?

Are methods/procedures used for
substituting internal exposure data for
unavailable or incomplete information
adequate and appropriate?

B.L2£ Are methods for estimating uncertainty in
dose associated with internal dose
reconstructions on a facility and time
specific basis appropriate?

WE.1.2¢ Are appropriate methodologies used to
resolve uncertainty estimates associated
with internal dose in favor of the claimant?

CAl


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D235

Ate calculations to determine the
concentration of each radionuclide in the
breathing zone using source term data (¢.g.,
dispersible quantity of material, .
resuspension factors, etc.) appropriate and
correct? (§5.3)

D23.k«

Are calculations to estimate internal dose

using workplace monitoring data
appropriate and correct?

D.2.3.1

Are uncertainty calculations associated with
the estimated intake quantity using
workplace monitoring data appropriate and
correct?

D.2.3.m

Are calculations to determine dose from

occupational radon exposure appropriate
and correct? (§7.4)

D23.0

Are uncertainty calculations associated with

occupational radon exposure appropriate
and correct? (§7.4)

D224

Are all internal dose calculations performed in
accordance with 42 CFR §82.18?

Le

C-37


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Comments

D.1.6.e

Are assumptions used to compare, confirm,
or validate internal dose estimates based on
workplace monitoring with any other
supporting information sources
appropriate? (§5.2)

D.1.6.£

Are assumptions used to estimate internal
dose using workplace monitoring data
conservative (claimant friendly)?

D.1.6.2

Are assumptions associated with uncertainty
surrounding the estimated intake quantity
using workplace monitoring data
conservative (claimant friendly)?

DAT

D.L7a

Internal Dose Reconstruction Considerations
Associated Source Term Dat
Are assumptions used to determine the
radionuclide(s) of concern for each intake

using source term data (e.g., type of
material in area or handled ) appropriate?
(85.3)

D17b

Are assumptions used to determine the
concentration of each radionuclide in the
breathing zone using source term data (e.g,
dispersible quantity of material,
resuspension factors, etc.) appropriate?
(85.3)

D.1.7.c

Are assumptions used to compare, confirm,
or validate internal dose estimates based
source term data with any other supporting
information sources appropriate? (§5.3)

D7

Are assumptions used to estimate internal
dose using workplace monitoring data
conservative (claimant friendly)?



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C3 Consistency of External Dose Data: Evaluate whether data were consistent with site radiological

the external exposure.

C3.1

Are external dosimetry data (e.g., monitoring
periods, detection limits, etc.) consistent with
site radiological monitoring
protocols/procedures?

monitoring protocols of the time period and determine whether the protocols were adequate for monte

Were external dosimetry monitoring protocols
adequate for assessing external exposure?

Are external dose estimates based on workplace
monitoring data (¢.g., surveys, air sampling,
fixed location dosimeters) consistent with site
workplace monitoring practices/procedures?

Were site workplace monitoring protocols
adequate for assessing external exposure?

Are assessments of environmental dose
consistent with area monitoring
procedures/protocols at the site?

Were environmental dose monitoring protocols
adequate for assessing the environmental
exposure?

C-24


ADVANCED INDIVIDUAL DOSE RECONSTRUCTION REVIEW CHECKLIST

Audit Number: Claim Number: Date: Page of
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Review NA

G.2 Adequacy of Research for Co-Workers/Historical Records: Evaluate whether, for the cases involving

survivors, there has been an adequate effort to research co-located workers and other historical records to

chai

acterize the individual’s work history.

G21

Does it appear that there was an adequate effort
to identify, locate, and contact co-worker,
supervisors, and/or any other individuals
identified by the claimant who could provide
data that would supplement/confirm the dose
reconstruction?

G.2.2

Does it appear that there was an adequate effort
to research historical records to characterize the
work history, radiation incidents, and other
relevant information provided by the claimant?

C47


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Coumments

F241

Are data in the Site Profile related to facility
operations and processes, which are applicable
to the claimant’s case, adequate and complete?

F22

Are data in the Site Profile related to
radiological source term characterization, which
are applicable to the claimant’s case, adequate
and complete?

Are data in the Site Profile related to workplace
conditions and monitoring practices, which are
applicable to the claimant’s case, adequate and
complete?

Are data in the Site Profile related to
incidents/accidents involving radiological
exposures, which are applicable to the
claimant’s case, adequate and complete?

Are relevant Site Profile data consistent with
information used to reconstruct external dose?

Are relevant Site Profile data consistent with
information used to reconstruct interna dose?

C-44


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Review

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NA

Comments

Tnitial

C2ALe

Are uncertainty calculations for annual
organ doses associated with photon energies
between 30 keV and 250 keV appropriate
and correct? (§5.1.2)

C2E

Has an appropriate total organ dose
distribution been determined (normal versus
lognormal distribution) for photon energies
between 30 keV and 250 keV? (§5.2)

C2.11g

Are annual organ dose calculations for
photon energies >250 keV appropriate and
correct? (§5.1.1)

C2.11b

Are uncertainty calculations for annual
organ doses associated with photon energies
>250 keV appropriate and correct? (§5.1.2)

C211

Has an appropriate total organ dose
distribution been determined (normal versus
lognormal distribution) for photon energies
>250 keV? (§5.2)

C2115

Are annual organ dose calculations for
neutron energies <10 keV appropriate and
correct? (§5.1.1)

yoo

Ave uncertainty calculations for annual
organ doses associated with neutron
energies <10 keV appropriate and correct?

(85.1.2)

C2411

Has an appropriate total organ dose
distribution been determined (normal versus
lognormal distribution) for neutron energies
<10 keV? (§5.2)

C-21


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wi)

C2945

Are calculations of uncertainty associated
with reconstructed electron dose using
source term data appropriate and correct?
(§3.3.3.3)

C298

Are calculations of reconstructed electron
dose to non-routine radiological workers
using radiological control limits appropriate
and correct? (§3.3.4)

C.2.9.h

‘Are calculations of uncertainty associated
with reconstructed electron dose using
radiological control limits appropriate and
correct?

C.2.10

Electron Dose Conversion to Organ Dose:
Are calculations for converting electron

dose to organ dose appropriate and correct?
(84.3)

C.2.11
C.2.11a

Annual Organ Dose and Distribution:

Are annual organ dose calculations for
photon energies <30 keV appropriate and
correct? (§5.1.1)

C.2.11.6

Are uncertainty distributions for annual
organ doses associated with photon energies
<30 keV appropriate and correct? (§5.1.2)

C.2.11.c

Has an appropriate total organ dose
distribution been determined (normal versus
lognormal distribution) for photon energies
<30 keV? (§5.2)

a

C2114

Are annual organ dose calculations for
photon energies between 30 and 250 keV
appropriate and correct? (§5.1.2)

C-20


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| Audit Number: Claim Number: Date: Page of
Set
Area of |Description of Technical Elements of Review | Yes/No/ Comments Tnitials
Review NA

Are assumptions associated with uncertainty
surrounding the estimated intake quantity
using workplace monitoring data
conservative (claimant friendly)?

Occupational Radon Exposure:

Are assumptions used to determine dose
from occupational radon exposure
appropriate?

Are assumptions associated with uncertainty
surrounding the radon dose estimate
appropriate?

‘Are assumptions used to determine dose
from occupational radon exposure
conservative (claimant friendly)?

Are assumptions used to assess the
uncertainty surrounding the occupational
radon dose conservative (claimant
friendly)?



BASIC INDIVIDUAL DOSE RECONSTRUCTION REVIEW CHECKLIST

Audit Number: Claim Number: Date: Page of
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Review NA

C2.11u Has an appropriate total organ dose

distribution been determined (normal versus
Jognormal distribution) for neutron energies
between 2.0 MeV and 20.0 MeV? (85.2)

C.21LY Are annual organ dose calculations for

neutron energies > 20.0 MeV appropriate
and correct? (§5.1.1)

C2.11.w ‘Are uncertainty calculations for organ doses

associated with neutron energies >20.0
MeV appropriate and correct? (§5.1.2)

C.2.1Lx Has an appropriate total organ dose
distribution been determined (normal versus
lognormal distribution) for neutron energies
>20.0 MeV? (§5.2)

C.2.41y Are organ/tissue dose calculations for
electron energies >14 keV appropriate and
correct? (85.1.1)

C2.11z Are uncertainty calculations for organ/tissue
dose associated with electron energies >14
keV appropriate and correct? (§5.1.2)

C.2.11.aa Has an appropriate total organ dose

lognormal distribution) for electron
energies >14 keV? (§5.2)

distribution been determined (normal versus

C-23


a

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Comments

Tnitial

D.4 Missing/Unmonitored Internal Dose: Evaluate the treatment of ‘missed internal dose’ and/or ‘unmonitored
|| _ internal dose’ if relevant to the case.

DAL Are ‘missed/unmonitored’ internal doses
reconstructed in accordance with 42 CFR
§82.16 and using guidelines established in
OCAS-IG-002?

D42 Are the types of information used to

substitute/supplement ‘missed/unmonitored’
internal doses reconstructed in accordance with
specifications in 42 CFR §82.17 and using
guidance in OCAS-IG-002?

D43

‘Were all relevant factors surrounding the
claimant’ s exposure scenario (e.g., distance
from source, work activities, etc.) properly
taken into account when evaluating
‘missed/unmonitored’ internal dose?

D44

Was the bioassay program at the time
considered when selecting the most appropriate
method for estimating ‘missed/unmonitored’
internal dose?

D45

Are data adequate for employing commonly
used practices/techniques/professional
judgments in estimating ‘missed/unmonitored’
intemal doses?

C39


| BASIC INDIVIDUAL DOSE RECONSTRUCTION REVIEW CHECKLIST

| ‘Audit Number: Claim Number: Date: Page of
Area of | Description of Technical Elements of Review | Yes/No/ ‘Comments Tnitials
Review NA
C224 ‘Are calculations of uncertainty associated

with incomplete/missed photon monitoring
dose appropriate and correct? (§2.1.2.4)

C.2.2.¢ Are calculations associated with the
occupational medical dose component of
photon dose appropriate and correct?
(§2.1.3)

C225 Are calculations of uncertainty associated
with the occupational medical dose
component of photon dose appropriate and
correct? (§2.1.3.3)

C222 Are calculations associated with the
environmental dose component of photon
dose appropriate and correct? (§2.1.4)

C2.2h Are calculations of uncertainty for the
environmental dose component of photon
dose appropriate and correct? (§2.1.4.3)

Photon Dose Reconstruction With NO
Monitoring Data:
Are calculations of reconstructed photon
dose using co-worker data appropriate and
correct? (§3.1.1)

C.2.3.b Are calculations of uncertainty associated.
with reconstructed photon dose using co-
worker data appropriate and correct?
(82.1.1.3)

C.2.3.¢ Are calculations of reconstructed photon
dose using survey data appropriaté and
correct? (§3.1.2)



BASIC INDIVIDUAL DOSE RECONSTRUCTION REVIEW CHECKLIST

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Review NA

D. INTERNAL DOSE REVIEW PROCESS

DA nal Dose Estimate Assumptions: Determine whether all assumptions used in the internal dose
determination are appropriate for a remedial compensation program and determine whether, if, and to
what extent the benefit of the doubt was resolved in favor of the claimant. (Parenthetical number represents
the section within the “Internal Dose Reconstruction Implementation Guideline” (OCAS-IG-002) that provides
detailed methodology for conducting the appropriate portion of the dose reconstruction.)

D.11 Preliminary Internal Dose Estimate Efficiency
Dilla Process:

‘Are assumptions. used in the preliminary
internal dose efficiency process for
determining whether the case falls into a
“clearly high’ or ‘clearly low’ category

| appropriate? (§6.0)

DA1b Are assumptions used to modify the
preliminary internal dose estimate
efficiency process appropriate for including
the case in a ‘clearly high’ or ‘clearly low’
category? (6.3 and $6.5)

D.1.1.c Are assumptions used in the preliminary
internal dose estimate efficiency process
conservative (claimant friendly)?

D2 inary Internal Dose Estimate - Low Dose
DA2a Potential:
‘Are assumptions used in the recalculation of
bioassay values for each radionuclide for
which the claimant was monitored
appropriate? (§6.1.2)

D.1.2.b Are assumptions used in the selection of all
potential solubility classes for each
radionuclide for which the claimant was
monitored appropriate? (§6.1.3)

C26


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Review

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NA

Comments Initials,

C4 Missing/Unmonitored External Dose: Evaluate the treatment
external dose’ if relevant to the case.

of ‘missed external dose’ and/or ‘unmonitored.

C41

[Are ‘missed/unmonitored’ external photon
doses reconstructed in accordance with 42 CFR
§82.16 and §82.17 and using guidelines and
hierarchy of data established in Section 3.1 of
OCAS-IG-001?

C42

Are data adequate for employing commonly
used practices/techniques/professional
judgments in estimating ‘missed/unmonitored’
external photon doses?

C43

Are ‘missed/unmonitored” neutron doses
reconstructed in accordance with 42 CFR
§82.16 and §82.17 and using guidelines and
hierarchy of data established in Section 3.2 of
OCAS-IG-001?

C44

‘Are data adequate for employing commonly
used practices/techniques/professional
judgments in estimating ‘missed/unmonitored’
neutron doses?

C45

Are ‘missed/unmonitored’ electron doses
reconstructed in accordance with 42 CFR
§82.16 and §82.17 and using guidelines and
hierarchy of data established in Section 3.3 of
OCAS-IG-001?

Ls

Are data adequate for employing commonly
used practices/techniques/professional
judgments in estimating ‘missed/unmonitored’
electron exposures?



ADVANCED INDIVIDUAL DOSE RECONSTRUCTION REVIEW CHECKLIST

Audit Number: Claim Number: Date: Page of
f Area of | Description of Technical Elements of Review | Yes/No/ Comments Initials
Review NA

G. ADDITIONAL INTERVIEW AND CLAIMANT DOCUMENTATION REVIEWS
G.1 Interview/Claimant Documentation Review: Evaluate the effectiveness of the phone interview in ascertaining

relevant work history information.

GAL Was the phone interview effective in confirming
applicable elements of the employment history
as included in the claims package provided by
DOL?

G12 Was the phone interview effective in identifying
any relevant information on employment history
that may have been omitted?

G13 Was the phone interview effective in confirming
or supplementing monitoring data provided in
the initial radiation exposure record?

G14 Was the phone interview effective in identifying
undocumented radiation exposures as a result of
work tasks, production processes, radiological
protection and monitoring practices, and/or
incidents?

GAS Was the phone interview effective in identifying
co-workers and/or other witnesses who could
potentially supplement or confirm radiation

‘| exposure information and/or work experiences
in behalf of the covered worker?

C46


ADVANCED INDIVIDUAL DOSE RECONSTRUCTION REVIEW CHECKLIST

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Review NA

F.3 Review of All Relevant Sources of Data: Evaluate whether, to the extent practicable, all relevant sources of

data (e.g., DOE, AWE, CDC, EML, NRC, EPA, External Health and Safety Regulators, GAO, DNFSB,
Congressional Hearing Records, other research program, research publications, publication regarding the
history of the DOE complex, or administrative/court records) were identified, evaluated and where
appropriate, included within the Site Profile database and, where appropriate, were used in the assessment of

the individual dose reconstruction case.

F31

Has a thorough search been conducted to
identify all potentially relevant sources of data
as they apply to the individual dose
reconstruction case? (Note: This may require
conducting interviews with employees,
employee representatives, site ‘experts,’ etc.)

F32

Have relevant data identified in the literature
search been evaluated and, where appropriate,
included in the Site Profile database?

B33

Have relevant data identified in the Jiterature
search been used in the assessment of the
individual dose reconstruction, where
appropriate?

C45


BASIC INDIVIDUAL DOSE RECONSTRUCTION REVIEW CHECKLIST

Audit Number:
———

Claim Number:

Date:

Page

Area of
Review

Description of Technical Elements of Review

Yes/No/
NA

Comments

forthe

Are annual organ dose calculations for
neutron energies between 10 and 100 keV
appropriate and correct? (§5.1.1)

C2.11a

Are uncertainty calculations for annual
organ doses associated with neutron
energies between 10 keV and 100 keV
appropriate and correct? ($5.1.2)

C.2.1L0

Has an appropriate total organ dose
distribution been determined (normal versus
Jognormal distribution) for neutron energies
between 10 keV and 100 keV? (§5.2)

C2.11p

Are annual organ dose calculations for
neutron energies between 0.1 and 2.0 MeV
appropriate and correct? (§5.1.1)

C.2.11.q

Are uncertainty calculations for annual
organ doses associated with neutron
energies between 0.1 and 2.0 MeV
appropriate and correct? (§5.1.2)

C2ALr

Has an appropriate total organ dose
distribution been determined (normal versus
lognormal distribution) for neutron energies
between 0.1 and 2.0 MeV? (§5.2)

C2.11s

Are annual organ dose calculations for
neutron energies between 2.0 and 20.0 MeV
appropriate and correct? (§5.1.1)

C2A1Lt

‘Are uncertainty distributions for annual
organ doses associated with neutron
energies between 2.0 MeV and 20.0 MeV
appropriate and correct? (§5.1.2)

C-22


ee

BASIC INDIVIDUAL DOSE RECONSTRUCTION REVIEW CHECKLIST

—<—= =

Audit Number:

Claim Number:

Date:

Page

of

Area of
Review

Description of Technical Elements of Review

Yes/Nof
NA

Comments

Initials

D2.3.b

Are uncertainty calculations associated with
the quantities of each radionuclide for each

intake based on bioassay measurement data
appropriate and correct? (§7.2 and §8.7)

D23.¢

Are calculations for determining missed
internal dose associated with bioassay
Measurements below detection limits
appropriate and correct? (§7.3)

D.2.3.d

Are calculations for estimating internal
dose when there are gaps in bioassay
measurements appropriate and correct?
(86.3)

D23.e

Are calculations for reconstructed internal

dose using co-worker data appropriate and
correct? (§5.1)

D234

Are uncertainty calculations associated with

worker data appropriate and correct?

the reconstruction of internal dose using co-

D2.3.g

Are calculations to estimate the
concentration of each radionuclide in the
breathing zone using workplace monitoring
data (e.g., air samples, contamination
surveys, etc.) appropriate and correct?

(85.2)

D23.h

Are calculations to estimate internal dose
using workplace monitoring data
appropriate and correct?

2

D234

monitoring data appropriate and correct?

Are uncertainty calculations associated with
estimating intake quantities using workplace

_——— a

C-36


BASIC INDIVIDUAL DOSE RECONSTRUCTION REVIEW CHECKLIST

Audit Number:

Claim Number:

Date:

Page

of

Area of
Review

Description of Technical Elements of Review

Yes/No/
NA

Comments

BA3
B.l3a

Work History Interview:

jew:
Are procedures used for work history phone
interview adequate and appropriate?

B.i3.b

Is the questionnaire used for the work
history phone interview adequate,
appropriate, and complete?

E14
B.i4a

Evaluation of Contractor:

Are NIOSH methods, procedures, and
performance analyses used to evaluate,
analyze and validate all steps of the
contractor’s dose reconstruction process
appropriate?

VE145

Are NIOSH methods, procedures, and
performance analyses for evaluating,
analyzing and validating the contractor's
tracking system for each step of the dose
reconstruction process appropriate?

B.l4c

Are NIOSH’s performance analyses
conducted on a frequency to adequately
monitoring contractor progress?

Bl4d-

Are NIOSH’s methods and procedures
adequate to ensure any data
inconsistencies/conflicts are resolved in an
appropriate manner?

C-42


BASIC INDIVIDUAL DOSE RECONSTRUCTION REVIEW CHECKLIST

Audit Number: Claim Number: Date: Page of
Area of | Description of Technical Elements of Review | Yes/No/ Comments Initials
Review NA

Are calculations of uncertainty associated
with reconstructed neutron dose using
survey data appropriate and correct?
(§3.2.2.3)

Are calculations of reconstructed neutron
dose using source term data appropriate and
correct? (§3.2.3)

Are calculations of uncertainty associated
with reconstructed neutron dose using
source term data appropriate and correct?
(§3.2.3.3)

Neutron Dose Conversion to Organ Dose:

Are calculations for converting area
monitoring data associated with neutron
dose to organ dose appropriate and correct?
(84.2.1)

C.2.7.b

Are calculations for converting personal
monitoring data associated with neutron
dose to organ dose appropriate and correct?
(84.2.2)

C28
C.28.a

Electron Dose Reconstruction Using
Monitoring Data:
Are calculations of electron dose using
dosimeters appropriate and correct?
(§2.3.1)

C.2.8.b

Are calculations of uncertainty for the beta
dosimetry results appropriate and correct?
(§2.3.1.3)

C.2.8.c

Are calculations of dose for incomplete/
missing electron monitoring records
appropriate and correct? (§2.3.2)

C-18



BASIC INDIVIDUAL DOSE RECONSTRUCTION REVIEW CHECKLIST

Audit Number: Claim Number: Date: Page of
Area of | Description of Technical Elements of Review | Yes/No/ Comments Initials
Review NA

DA3A Are all assumptions used in the ‘high dose’

preliminary internal dose estimate
conservative (claimant friendly)?

D4 Detailed Internal Dose Reconstruction - Key

Initial Considerations:

DlAa Are assumptions used to determine the date
of uptake(s) appropriate? ($7.1)

D.1.4.b Are assumptions used to determine the
route of entry of applicable radionuclides
into the body appropriate? (§4.1)

D.1.4.c Are assumptions used in the selection of
applicable solubility class(es) for each
radionuclide appropriate? (§4.3)

D.1.4.d Are assumptions used to determine whether
the exposure was chronic or acute
appropriate?

D.14¢e Are assumptions used to determine particle
size of all inhaled radionuclides
appropriate? (§4.4)

DAF Are assumptions used to select the
applicable ICRP biokinetic model for each
radionuclide appropriate? (§2.0)

D148 If more than one ICD code describes organs

associated with only one region calculated
by ICRP models, are assumptions in the
calculation of organ dose appropriate?
(§3.1.1)

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BASIC INDIVIDUAL DOSE RECONSTRUCTION REVIEW CHECKLIST

‘Audit Number: Claim Number: Date: Page of
[Area of | Description of Technical Elements of Review | Yes/No/ ‘Comments
Review NA
D.15.e Are assumptions used to determine missed

internal dose associated with bioassay
measurements below detection limits
appropriate? (§7.3 and §8.3)

DASA Are assumptions used to estimate internal
dose when there are gaps in bioassay
measurements appropriate? (§6.3)

DAi5.g Are assumptions used in the reconstruction
of internal dose using co-worker data
appropriate? (85.1)

D.1S.h Are assumptions used to reconstruct
internal dose using bioassay measurements
conservative (claimant friendly)?

D.1.6 Internal Dose Reconstruction Considerations
Associated with Workplace Mor 2. Data:
D.1.6.a Are assumptions used to determine the

radionuclide(s) of concern for each intake
using workplace monitoring data (¢.g., air
samples, contamination surveys, etc.)
appropriate? (§5.2)

E

D.1.6.b Are assumptions used to estimate the
concentration of each radionuclide in the
breathing zone using workplace monitoring
data (e.g., air samples, contamination
surveys, etc.) appropriate? (§5.2)

D.1.6.c Are assumptions regarding the use of
respirators and respiratory protection
factors appropriate? ($5.2)

D.1.6.d Ave assumptions regarding the effectiveness

of the respirator program (i.e., whether a
qualitative fit test was performed and
whether the respirator was worn during the
time of intake) appropriate? (§5.2)



| BASIC INDIVIDUAL DOSE RECONSTRUCTION REVIEW CHECKLIST

| Audit Number: Claim Number:
Area of |Description of Technical Elements of Review | Yes/No/ Comments Initials,
Review NA
C244 Are calculations of uncertainty associated

with the energy simplification process
appropriate and correct? (§4.5.1)

C25 Neutron

C.2.5.a  jMonitoring Data:
Are calculations of neutron dose using
personal monitoring data (dosimeters)
appropriate and correct? (§2.2.1)

C25.b Are calculations of uncertainty associated
with neutron personal monitoring data
appropriate and correct? (§2.2.1.3)

C.2.5.¢ Are calculations of dose associated with
incomplete/missing neutron monitoring data
appropriate and correct? (§2.2.2)

C25. Are calculations of uncertainty associated
with incomplete/missed neutron monitoring
dose appropriate and correct? (§2.2.2.4)

C.2.6 ‘Neutron Dose Reconstruction With NO
C.2.6.a | Monitoring Data:

Are calculations of reconstructed neutron
dose using co-worker data appropriate and
correct? (§3.2.1)

C.2.6.b Are calculations of uncertainty associated
with reconstructed neutron dose using co-
worker data appropriate and correct?
(§2.2.1.3)

I} C.2.6.c Are calculations of reconstructed neutron
dose using survey data appropriate and
correct? (§3.2.2)

C-17


BASIC INDIVIDUAL DOSE RECONSTRUCTION REVIEW CHECKLIST

Audit Number: Date: Page of
Area of | Description of Technical Elements of Review | Yes/No/ Comments Initials}
Review NA
E. NIOSH PROCEDURE/METHODOLOGY REVIEW PROCESS
E.1 Review of NIOSH Methods and/or Procedures: The review of each dose reconstruction shall include an

evaluation of all relevant portions of the methods and/or procedures used by NIOSH.

Ell
E.l.la

External Dose Technical Basis
Documents/Methods:
Are the technical basis documents used in
reconstructing external radiation doses
adequate and appropriate? .

E.l.1b

Are methods for estimating ‘missed,’
‘incomplete,’ and/or ‘unmonitored’ external
dose adequate and appropriate?

E.1.Lc

Are statistical approaches developed for
multiple external dose reconstructions
appropriate?

E.L.1d

‘Are procedures used for determining
whether data is sufficient to make a
reasonable external dose estimate
appropriate?

Elle

Are methods/procedures used for
substituting external exposure information
for unavailable or incomplete information
adequate and appropriate?

BLE

Are methods for estimating uncertainty in
dose associated with external dose
reconstructions on a facility and time
specific basis appropriate?

Elig

Are appropriate methodologies used to
resolve uncertainty estimates associated
with external dose in favor of the claimant?

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BASIC INDIVIDUAL DOSE RECONSTRUCTION REVIEW CHECKLIST }

Audit Number: Claim Number:

Date:

Page of |

Area of
Review

Description of Technical Elements of Review

Yes/No/
NA

Comments

Tnitial

C23.d

Are calculations of uncertainty associated
with reconstructed photon dose using
survey data appropriate and correct?
(§3.1.2.3)

C23.e

Are calculations of reconstructed photon
dose using source term data appropriate and
correct? (§3.1.3)

C236

Are calculations of uncertainty associated
with reconstructed photon dose using
source term data appropriate and correct?
(§3.1.3.3)

C23.g

Are calculations of reconstructed photon
dose using control limits appropriate and
correct? (§3.1.4)

C2.3.h

Are calculations of uncertainty associated
with reconstructed photon dose using
control limits appropriate and correct?
(§3.1.4.3)

C24
C242,

Photon Dose Conversion to ose:

Are calculations for converting monitored
photon dose to organ dose appropriate and
correct? (§4.1.1)

C2.4.b

Are calculations for converting
survey/source term data associated with
photon dose to organ dose appropriate and
correct? (§4.1.2)

C24.

Are calculations used in the energy
simplification of ICRP 74 dose conversion
factors for input into NIOSH-IREP
appropriate and correct? (§4.1.3)

C16


ADVANCED INDIVIDUAL DOSE RECONSTRUCTION REVIEW CHECKLIST

Audit Number: Claim Number: Date: Page of
Area of | Description of Technical Elements of Review { Yes/No/ Conments Initials
Review NA

H. ADDITIONAL EXTERNAL DOSE RECONSTRUCTION REVIEWS

H.1 Consistency of Data: Evaluate whether the external dose estimate is consistent with relevant radiological
information within the NIOSH site profile.

Had

Is there reasonable consistency between.
assumptions used to estimate external dose and
process information (e.g., radionuclides and
quantities present and processed) provided in
the Site Profile?

Ts there reasonable consistency between
assumptions used to estimate external dose and
routine radiation monitoring practices identified
in the Site Profile?

H.13

Is there reasonable consistency between
assumptions used to estimate external dose and
routine protective measures used at the site (e.g.,
glove boxes, shielding, etc.) identified in the
Site Profile?

H.2 Comparison of Case Information: Compare case information and assumptions associated with external dose
with relevant co-worker case information and assumptions associated with external dose for consistency.

H.2.1 Ts there consistency between monitoring data
used to calculate external dose for the covered
worker and monitoring data used to calculate
external dose for a relevant co-worker case?

H.2.2 Is there consistency between assumptions used

to reconstruct unmonitored external dose for the
covered worker and assumptions used to
reconstruct unmonitored external dose for a
relevant co-worker case?

C48



ADVANCED INDIVIDUAL DOSE RECONSTRUCTION
REVIEW CHECKLIST
(Note: The Basic Individual Dose Reconstruction Review checklist
should be completed prior to the Advanced Review)

‘Audit Number: Claim Number: Date: Page of

Auditor(s)/Area of Review:

Dose Reconstruction Analysts(s)/Area of Dose Reconstruction (External/Internal):

Area of | Description of Technical Elements of Review | Yes/No/ Comments Initials
Review NA
F. ADDITIONAL DATA GATHERING REVIEWS
F.1 Review of Entire Administrative Record: Review the entire administrative record to evaluate if relevant
information exists which was not considered by NIOSH.
Fl Does the administrative record contain data that

are relevant to the reconstruction of external
dose, which were not considered by NIOSH?

FA2 Does the administrative record contain data that
are relevant to the reconstruction of internal
dose, which were not considered by NIOSH?

P13 Does the administrative record contain data that
could be used to evaluate the completeness and
adequacy of individual monitoring data, which
were not considered by NIOSH?

Fld Does the administrative record contain data that
could be used to evaluate the completeness and
adequacy of monitoring programs, which were
not considered by NIOSH?

Fis Does the administrative record contain data that
could be used to reconcile discrepancies or
uncertainties associated with any aspect of the
dose reconstruction, which were not considered
by NIOSH?

F.2 Review of the Site Profile: Review the relevant aspects of the Site Profile as they apply to the individual case
and evaluate the adequacy and completeness of the site profile and evalnate whether the information from the
site profile is consistent with the information used for the individual dose estimate.

C43


a

BASIC INDIVIDUAL DOSE RECONSTRUCTION REVIEW CHECKLIST

Audit Number:

Claim Number:

Date:

Page

of

[Farea of
Review

Description of Technical Elements of Review

Yes/No/
NA

Comments

Initials|

D122.

‘Are assumptions for determining the highest
intake associated with each potential
solubility class that will produce a predicted
bioassay value equal to at least one of the
recalculated bioassay values from step
§6.1.2 appropriate? (§6.1.4)

tt
D.12d

Are assumptions used to determine the
highest intake (using a constant chronic
exposure period) that will produce a
predicted bioassay value equal to at least
one of the recalculated bioassay values from
step §6.1.2 for each potential solubility
class appropriate? (§6.1.5)

D.12e

Are assumptions used in the determination
of a scenario for each radionuclide for
which the claimant was monitored that
produces the highest 50-year committed
dose to the organ or concern appropriate?
(86.1.7)

D.1.2.£

Are assumptions used to determine annual
doses to the organ of concern using the
scenario selected in step §6.1.7 for each
radionuclide for which the claimant was
monitored appropriate? (§6.1.8)

D1.2.g

When the preliminary PC results in 250%,
are assumptions used in the refinement of
internal estimates appropriate? (§6.1.14 A-
Dand §6.5)

DA2h

Are all assumptions used in the ‘low dose’
preliminary internal dose estimate
conservative (claimant friendly)?

C-27



BASIC INDIVIDUAL DOSE RECONSTRUCTION REVIEW CHECKLIST

Audit Number:

Claim Number:

Date:

Page

of

Area of
Review

Description of Technical Elements of Review

Yes/No/
NA

Comments

Initials

D14h

If one ICD code describes organs
associated with more than one region
calculated by ICRP models, are
assumptions in the selection of ICRP region
and associated organ dose appropriate?
(83.1.1)

DAA

When an organ of interest is not included in
the ICRP metabolic model, are assumptions
for assigning dose to that organ
appropriate? (§3.1.1)

DAS

If an ICD code describes a type of
lymphatic cancer, are assumptions for
assigning organ dose appropriate? (§3.1.1)

DAS

D.i5.a

Internal Dose Reconstruction Considerations
Associated with Bioassay Measurements:
Are assumptions used to determine the
quantity of each radionuclide for each
intake based on bioassay measurement data
appropriate? (see example §8.5)

D.1.5.b

Are assumptions of uncertainty associated
with the quantities of each radionuclide for
each intake based on bioassay measurement
data appropriate? (§7.2)

D.1.5.c

‘Are assumptions regarding the capability of
the bioassay program in detecting all
potential radionuclides of concern
appropriate? (§5.1)

DAS

‘Are assumptions regarding the validity of
positive results (-e., determination of a
false positive result) appropriate? (§5.1)

C-30