Review of One Advisory Board-Selected 

Case Reworked for the Evaluation of 

ORAUT-OTIB-0052 Revisions 

(DCAS-PER-062, Subtask 4)

Kathleen Behling, SC&A, Inc.

Advisory Board on Radiation and Worker Health, 

Subcommittee for Procedure Reviews

May 25, 2022
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ORAUT-OTIB-0052 revision history

 Addresses “Parameters to Consider when Processing Claims for 

Construction Trade Workers”

 Revision 00 issued August 2006

 SC&A review of revision 00 July 2007 (16 findings)

 Revision 00 PC-1 issued January 2007

 OCAS-PER-014 issued November 2007 to evaluate cases 

adjudicated before issuance of OTIB-0052

 Revision 01 issued February 2011

 SC&A review of revision 01 July 2011 (assess status of 16 findings)

 SC&A review of OCAS-PER-014 issued March 2012

 Revision 02 issued July 2014
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DCAS-PER-062, “ORAUT-OTIB-0052”

 Issued November 2017 to assess changes introduced in 

revisions 01 and 02 of OTIB-0052

 OTIB-0052 provides a correction factor that increases external 

dose if co-exposure data were used for construction trade 

workers (CTWs) 

 Population of potentially impacted cases included 20 total sites 

where co-exposure data had been developed 

 Only eight sites had no previous or forthcoming PER
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Cases reevaluated under DCAS-PER-062

 Total of 1,006 cases reevaluated: 

– 1 case with POC >52%

– 1 case with POC 45–50%

– 992 cases with POC <45%

– 12 cases returned to the U.S. Department of Labor (DOL) prior to 

issuance of PER-062
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SC&A’s review of DCAS-PER-062

 SC&A’s May 2018 review identified two observations

 Summary of observations:

– Observation 1: No documentation found that a co-exposure model is 

being developed or that a PER is forthcoming for Albany Research 

Center.

– Observation 2: To ensure that appropriate OTIB-0052 guidance is 

applied to all cases evaluated under planned PERs for the 20 sites 

listed in DCAS-PER-062, SC&A should (1) maintain a list of these sites, 

(2) be informed when the PER is issued, and (3) review the PER to 

assess whether the selection of reworked cases will adequately 

capture all potential CTWs.
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DCAS-PER-062 subtask 4 review of one 

reworked case

 ABRWH selected the one reworked case with a POC between 

45% and 50% for SC&A’s review

 SC&A evaluated the reworked case in December 2021 to 

determine if external doses were correctly assessed in 

accordance with DCAS-PER-062
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NIOSH’s reworked DR

 NIOSH’s rework of the case:

– Used applicable DR tools 

– Recalculated all annual doses 

– Re-ran IREP 30 times at 10,000 iterations

 Resulted in the reworked DR having a combined POC increase 

of ~19%

 Revised DR report not sent to DOL because the compensation 

decision did not change
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Case background

 Energy employee (EE) worked at Nevada Test Site (NTS) for 

~20 years and at one additional site

 Based the EE’s job title, the EE was classified as a CTW

 EE was periodically monitored for radiation exposure

 Diagnosed with two qualifying cancers nearly 30 years after 

employment termination
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Comparison of NIOSH’s reworked doses 

versus original doses

Dose categories Cancer 1 reworked vs. 

original dose 

percentage

Cancer 2 reworked vs. 

original dose 

percentage

External ~9% increase ~24% decrease

Occupational medical No change No change

Internal No change No change

Total ~9% increase ~24% decrease
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External dose components for this case

 Recorded photon dose

 Missed photon dose

 Unmonitored photon dose

 Unmonitored electron dose
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Original recorded photon dose calculations

 Based on guidance in NTS occupational external dose TBD, 

ORAUT-TKBS-0008-6, rev. 01 PC-1:

– a film badge correction factor of 1.25 was applied 

– an uncertainty factor of 1.3 was applied to the cancer 2 site 

– photon energies were assumed to be 25% 30–250 keV and 75% >250 keV

 Liver selected as surrogate organ for cancer 2

 For cancer 2, a DCF value from OCAS-IG-001, rev. 03, was applied 

for 30–250 keV photons and a claimant-favorable DCF of 1.0 was 

applied to >250 keV 

 Assigned dose to all cancer sites ~6.000 rem
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Reworked recorded photon dose calculations

 Based on guidance in NTS occupational external dose TBD, 

ORAUT-TKBS-0008-6, rev. 03:

– a film badge correction factor of 1.25 was applied 

– an uncertainty factor of 1.3 was applied to the cancer 2 site 

– photon energies were assumed to be 25% 30–250 keV and 75% >250 keV

 Liver selected as surrogate organ for cancer 2

 DCF values selected based on applicable guidance in ORAUTOTIB-0017, rev. 01, and OCAS-IG-001, rev. 03

 For cancer 2, DCF values applied using Monte Carlo methods 

 Assigned dose to cancer 1 of ~5.000 rem and cancer 2 of ~4.000 

rem
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SC&A’s conclusions on recorded photon dose 

calculations in the reworked DR

 Confirmed positive recorded doses were only found for 3 years of 

employment 

 Appropriate photon energies were used 

 Applied TBD-specified dosimeter biases and uncertainties 

 Verified appropriate anterior-posterior geometry exposure to organ DCF 

values were applied 

 Doses correctly entered in IREP input tables

 Reworked dose for cancer 2 decreased due to using IG-001 DCF value 

for >250 keV photons rather than claimant-favorable value of 1.0

 SC&A had no findings about reworked recorded external dose 

assignment
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Original missed photon dose calculations

 Calculated missed dose for 2 years of employment with zero badge 

readings

 Calculated missed dose for partial year of employment with no 

dosimetry records

 Assumed 13 zero badge exchanges

 Dose based on one-half the limit of detection of 0.040 rem

 Applied film badge correction factor of 1.25

 Photon energies 25% 30–250 keV and 75% >250 keV

 Applied same DCF values as recorded photon dose

 Assigned dose to both cancer sites ~0.300 rem
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Reworked missed photon dose calculations

 Counted 16 missed dose for years of employment with reported 

zero readings

 Counted 15 additional missed doses assuming a monthly exchange 

rate when unmonitored dose was assigned 

 Dose based on one-half the limit of detection of 0.040 rem

 Applied film badge correction factor of 1.25

 Photon energies 100% 30–250 keV for cancer 1

 Photon energies 25% 30–250 keV and 75% >250 keV for cancer 2

 DCF values selected from applicable guidance documents

 Assigned dose to cancer 1 ~0.700 rem and cancer 2 ~0.500 rem
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SC&A’s conclusions on missed photon dose 

calculations in the reworked DR

 Confirmed 16 badge exchanges reported a dose of zero

 TBD states that before 1957 missed dose should be assigned for each 

month employed during the years unmonitored dose evaluated

 Applied TBD-specified dosimeter bias

 Verified appropriate anterior-posterior geometry exposure-to-organ DCF 

values were applied 

 Doses correctly entered in IREP input tables

 Reworked doses increased due to counting 31 missed zero exchanges 

rather than 13 missed zero in original

 SC&A had no findings about reworked missed external dose assignment
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Original unmonitored photon dose calculations

 Unmonitored dose assessed for one year of employment

 50th percentile co-exposure dose assigned

 Applied film badge correction factor of 1.25

 Applied 1.3 uncertainty to cancer 2

 Photon energies 25% 30-250 keV and 75% >250 keV

 Applied same DCF values as recorded photon dose

 Modest dose assigned to both cancer sites
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Reworked unmonitored photon dose 

calculations

 EE not monitored before universal badging; therefore, unmonitored 

dose assigned for prior years of employment 

 50th percentile co-exposure dose used

 Applied film badge correction factor of 1.25

 Applied 1.3 uncertainty to cancer 2

 Applied CTW correction factor of 1.4

 Photon energies 25% 30–250 keV and 75% >250 keV for cancer 2

 DCF values based on applicable guidance

 Assigned dose to both cancer sites ~0.100 rem
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SC&A’s conclusions on unmonitored photon 

dose calculations in the reworked DR

 TBD guidance followed for:

– Assigning dose during appropriate years of unmonitored employment

– Use of 50th percentile co-exposure data

 Applied TBD-specified dosimeter bias and uncertainty

 Applied appropriate CTW correction factor

 Verified appropriate anterior-posterior geometry exposure-to-organ DCF 

values were applied 

 Doses correctly entered in IREP input tables

 Reworked doses increased due to number of years unmonitored dose 

assigned

 SC&A had no findings about reworked unmonitored photon dose 

assignment
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Original unmonitored electron dose 

calculations

 Nonpenetrating dose not recorded at NTS before 1966

 DR calculated unmonitored electron doses for years when the 

EE was monitored for photon dose 

 Dose based on photon-to-electron ratio of 1.0 

 Considering cancer location, attenuation factor of 0.855 was 

applied based on guidance in ORAUT-OTIB-0017, rev. 01

 Assigned total dose of ~4.000 rem

 Annual doses entered in IREP as >15 keV as constant values
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Reworked unmonitored electron dose 

calculations

 DR calculated unmonitored electron doses for years:

– prior to1966 when the EE was monitored for photon dose

– when photon co-exposure dose was assigned

 Dose based on photon-to-electron ratio of 1.04 to 1.0 

 Considering cancer location, attenuation factor of 0.855 was 

applied based on guidance in ORAUT-OTIB-0017, rev. 01

 Assigned total dose of ~4.500 rem

 Annual doses entered in IREP as >15 keV as lognormal values 

with GSD of 2.14
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SC&A’s conclusions on unmonitored electron 

dose calculations in the reworked DR

 TBD guidance followed for assigning electron dose:

– during years of employment prior to 1966

– when photon co-exposure dose was assigned

 Applied TBD-specified photon-to-electron ratio

 Attenuation factor justified and appropriate factor applied 

 Doses correctly entered in IREP input tables

 Reworked doses increased due to number of years 

unmonitored dose assigned

 SC&A had no findings about reworked unmonitored electron 

dose assignment
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Summary comparison of original and 

reworked external doses

External dose 

category

Cancer 1 rework 

vs. original

Cancer 2 rework 

vs. original

Comments

Recorded photon 0.4% decrease 32% decrease Cancer 2 rework decreased due to using 

IG-001 DCFs rather than claimant 

favorable

Missed photon 150% increase 95% increase Rework increase due to counting zeros 

for missed and unmonitored (31) vs. 

original counting missed only (13)

Unmonitored 

photon

717% increase 474% increase Rework increase due to assessing 

unmonitored for all years before 

universal badging rather than 1 year

Unmonitored 

electron

7% increase Not applicable Rework increase due to assessing dose 

prior to 1966, plus for years when photon 

co-exposure dose was assigned
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Questions?