Draft

ADVISORY BOARD ON

RADIATION AND WORKER HEALTH

National Institute for Occupational Safety and Health

DCAS-PER-066, SUBTASK 4

REVIEW OF IMPACTED CASES REWORKED FOR THE 

EVALUATION OF INTERNAL INTAKES FROM THE 

HUNTINGTON PILOT PLANT

Contract No. 211-2014-58081 

SCA-TR-2016-PER066-ST4, Revision 0

Prepared by

Ron Buchanan, PhD, CHP 

SC&A, Inc.

1608 Spring Hill Road, Suite 400 

Vienna, Virginia 22182 

Saliant, Inc.

5579 Catholic Church Road 

Jefferson, Maryland 21755 

October 2016 

DISCLAIMER

This is a working document provided by the Centers for Disease Control and Prevention (CDC) technical 

support contractor, SC&A for use in discussions with the National Institute for Occupational Safety and 

Health (NIOSH) and the Advisory Board on Radiation and Worker Health (ABRWH), including its 

Working Groups or Subcommittees. Documents produced by SC&A, such as memorandum, white paper, 

draft or working documents are not final NIOSH or ABRWH products or positions, unless specifically 

marked as such. This document prepared by SC&A represents its preliminary evaluation on technical 

issues.

NOTICE: This report has been reviewed to identify and redact any information that is protected by the 

Privacy Act 5 U.S.C. § 552a and has been cleared for distribution.
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SC&A, INC.: Technical Support for the Advisory Board on Radiation and Worker 

Health Review of NIOSH Dose Reconstruction Program

DOCUMENT TITLE: Review of Impacted Cases Reworked for the Evaluation of Internal 

Intakes from the Huntington Pilot Plant

DOCUMENT NUMBER/

DESCRIPTION:

SCA-TR-2016-PER066-ST4

REVISION NO.: 0 (Draft)

SUPERSEDES: N/A

EFFECTIVE DATE: October 11, 2016

TASK MANAGER: Kathleen Behling [signature on file]

PROJECT MANAGER: John Stiver, MS, CHP [signature on file]

DOCUMENT 

REVIEWER(S):

Kathleen Behling [signature on file]

John Stiver, MS, CHP [signatures on file]

Record of Revisions

Revision 

Number

Effective 

Date Description of Revision

0 (Draft) 10/11/2016 Initial issue
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TABLE OF CONTENTS 

Abbreviations and Acronyms ......................................................................................................... 5

1.0 Relevant Background Information ...................................................................................... 6

1.1 Finding 1: Incorrect Values Cited in DCAS-TKBS-0004, Table 5 ........................ 7

2.0 Review of DCAS-PER-066 Issue for Case # (HPP) ............................................... 9

2.1 Background Information for this Case .................................................................... 9

2.2 Comparison of NIOSH’s Original and Reworked Dose Reconstructions .............. 9

2.3 SC&A’s Review of DCAS-PER-066 Issue Related to this Case ........................... 9

2.3.1 Original Dose Reconstruction ................................................................... 10

2.3.2 Reworked Dose Reconstruction ................................................................ 10

2.3.3 SC&A’s Evaluation ................................................................................... 10

3.0 Review of DCAS-PER-066 Issue for Case # (HPP) ............................................. 11

3.1 Background Information for this Case .................................................................. 11

3.2 Comparison of NIOSH’s Original and Reworked Dose Reconstructions ............ 11

3.3 SC&A’s Review of DCAS-PER-066 Issue Related to this Case ......................... 11

3.3.1 Original Dose Reconstruction ................................................................... 12

3.3.2 Reworked Dose Reconstruction ................................................................ 12

3.3.3 SC&A’s Evaluation ................................................................................... 12

4.0 Summary Conclusions ...................................................................................................... 13

5.0 References ......................................................................................................................... 14
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LIST OF TABLES

Table 1. Original and Reworked Results for Case # ........................................................... 9

Table 2. Original and Reworked Results for Case # ......................................................... 11
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ABBREVIATIONS AND ACRONYMS

Advisory Board Advisory Board on Radiation and Worker Health 

Am americium

CADW chronic annual dose workbook 

CATI computer-assisted telephone interview

DCAS Division of Compensation Analysis and Support 

DR dose reconstruction 

EE energy employee

HPP Huntington Pilot Plant 

ICD International Classification of Diseases

IREP Interactive RadioEpidemiological Program

NIOSH National Institute for Occupational Safety and Health

Np neptunium 

OCAS Office of Compensation Analysis and Support 

ORAU Oak Ridge Associated Universities

ORAUT Oak Ridge Associated Universities Team

OTIB ORAUT technical information bulletin

pCi/day picocuries per day 

pCi/yr picocuries per year

PER program evaluation report 

POC probability of causation 

PRSC Procedures Review Subcommittee 

Pu plutonium 

TBD technical basis document

Tc technetium

Th thorium 

TIB technical information bulletin
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1.0 RELEVANT BACKGROUND INFORMATION

On May 16, 2016, the Procedures Review Subcommittee (PRSC) of the Advisory Board on 

Radiation and Worker Health (Advisory Board) tasked SC&A, Inc. to conduct a Subtask 4 

(i.e., review of a sample set of impacted cases) review of DCAS-PER-066, Huntington Pilot 

Plant Program Evaluation Report (DCAS 2015). The terms “Huntington Pilot Plant” and 

“Reduction Pilot Plant” are often used interchangeably; Huntington Pilot Plant (HPP) will be 

used in this report. The National Institute for Occupational Safety and Health (NIOSH) issued 

DCAS-PER-066 to determine the number of claims affected by the revisions to the HPP 

technical basis document (TBD) made in DCAS-TKBS-0004, Technical Basis Document for the 

Huntington Pilot Plant, Huntington, West Virginia, Revision 01 (DCAS 2013). This revised 

TBD added internal intake values for americium-241 (Am-241), thorium-230 (Th-230), and 

technetium-99 (Tc-99) for the periods 1956–1963 and 1978–1979. These changes could increase 

internal dose assignments in some previous dose reconstructions (DRs), as stated in Section 2.0 

of DCAS-PER-066: 

Revision 1 of DCAS-TKBS-0004 added intakes for Am-241, Th-230 and Tc-99. 

That results in an increased internal dose estimate for all claims that were 

completed using an earlier version. Therefore, it was not necessary to itemize any 

other increases in dose or further breakdown the time periods affected. 

The previous TBDs—ORAUT-TKBS-0004, Technical Basis Document: Basis for Development 

of an Exposure Matrix for Huntington Pilot Plant, Revision 00 (ORAUT 2003); ORAUT-TKBS0004, Technical Basis Document: Basis for Development of an Exposure Matrix for Huntington 

Pilot Plant, Revision 01 (ORAUT 2004); and OCAS-TKBS-0004, Technical Basis Document 

for the Huntington Pilot Plant, Huntington, West Virginia, Revision 00 (OCAS 2008)— 

provided recommended intakes for total uranium, plutonium-239 (Pu-239), and neptunium-237 

(Np-237), but not for Am-241, Th-230, and Tc-99. 

In conducting a review of a program evaluation report (PER), SC&A is typically committed to

perform five subtasks, as specified below (SC&A 2009): 

Subtask 1. Assess NIOSH’s evaluation/characterization of the “issue” and its potential impacts 

on DR. SC&A’s assessment intends to ensure that the “issue” was fully understood and 

characterized in the PER.

Subtask 2. Assess NIOSH’s specific methods for corrective action. In instances where the PER 

involves a technical issue that is supported by documents (e.g., white papers, technical 

information bulletins [TIBs], procedures) that have not yet been subjected to a formal 

SC&A review, Subtask 2 will include a review of the scientific basis and/or sources of 

information to ensure the credibility of the corrective action and its consistency with 

current/consensus science. Conversely, if such technical documentation has been 

formalized and previously subjected to a review by SC&A, Subtask 2 will simply provide 

a brief summary/conclusion of this review process. 

Subtask 3. Evaluate the PER’s stated approach for identifying the universe of potentially 

affected DRs and assess the criteria by which a subset of potentially affected DRs was 
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selected for reevaluation. This third step may have important implications in instances 

where the universe of previously denied DRs is very large and, for reasons of practicality, 

NIOSH’s reevaluation is confined to a subset of DRs that, based on their scientific 

judgment, have the potential to be significantly affected by the PER. In behalf of 

Subtask 3, SC&A will also evaluate the timeliness for the completion of the PER.

Subtask 4. Conduct audits of DRs affected by the PER under review. The number of DRs 

selected for audit for a given PER will vary, based on important elements such as (1) the 

number of target organs/tissues that may be impacted by a PER, (2) the method/data that 

were employed in the original DR, and (3) the time period, work location, and job 

functions that characterize the DR of a claim. (It is assumed that the selection of the DRs 

and the total number of DR audits per PER will be made by the Advisory Board.) 

Subtask 5. Prepare a comprehensive written report that contains the results of the above 

subtasks, along with SC&A’s review conclusions.

Because SC&A has reviewed all previous HPP TBDs and NIOSH has committed to review all 

HPP DRs that previously had a probability of causation (POC) less than 50%, as stated in 

Section 3.0 of DCAS-PER-066, the PRSC determined that SC&A did not need to perform 

Subtasks 1, 2, and 3. Therefore, this report fulfills the requirement defined in Subtask 4, 

“Conduct audits of DRs affected by the PER under review.” 

In Section 3.0 of DCAS-PER-066, NIOSH identified two reworked cases that had POCs between 

45% and 50%. These cases were selected for review under Subtask 4 and provided to SC&A on 

May 18, 2016. Based on the PRSC’s guidance, SC&A’s review of these cases is limited to 

evaluating only those methods and corrective actions introduced in the reevaluated dose that 

relate strictly to issues addressed in DCAS-PER-066. Sections 2 and 3 below present SC&A’s 

focused review to determine whether the internal doses associated with the two selected cases 

were correctly assigned per the recommendations in DCAS-PER-066. 

1.1 FINDING 1: INCORRECT VALUES CITED IN DCAS-TKBS-0004, TABLE 5 

In reviewing the two cases, SC&A used Tables 4 and 5 of DCAS-TKBS-0004 (DCAS 2013) and 

found that Table 5, with units of picocuries per day (pCi/day), had several errors in the 

Administrative Workers’ section (the Production Workers’ section was correct). The errors 

were as follows:

• Th-230 Ingestion – Table 5 lists an ingestion intake value of 6.3E-1 pCi/day, which is 

the same numerical value listed in Table 4 as 6.3E-1 picocuries per year (pCi/yr). The 

value of 6.3E-1 pCi/yr in Table 4 should have been divided by 365 day/yr to obtain the 

correct value of 1.7E-3 pCi/day for Table 5. 

• Tc-99 Inhalation – Table 5 lists an inhalation intake value of 1.9E-1 pCi/day, which is 

the same numerical value listed in Table 4 as 1.9E-1 pCi/yr. The value of 1.9E-1 pCi/yr 

in Table 4 should have been divided by 365 day/yr to obtain the correct value of 5.2E-4 

pCi/day for Table 5. 
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• Tc-99 Ingestion – Table 5 lists an ingestion intake value of 4.0E-3 pCi/day, which is the 

same numerical value listed in Table 4 as 4.0E-3 pCi/yr. The value of 4.0E-3 pCi/yr in 

Table 4 should have been divided by 365 day/yr to obtain the correct value of 

1.1E-5 pCi/day for Table 5. 

These errors would result in a slight overestimate of internal doses but did not impact the dose or 

POC determinations for the two cases reviewed, because the two EEs were production workers, 

not administrative workers.
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2.0 REVIEW OF DCAS-PER-066 ISSUE FOR CASE # (HPP)

2.1 BACKGROUND INFORMATION FOR THIS CASE

Case # represents an energy employee (EE) who worked at HPP from 1952, 

through 1982. During this worker’s employment, the EE worked as a Maintenance 

Worker in the according to the computer-assisted telephone interview (CATI). The 

EE was diagnosed with cancer (International Classification of Diseases [ICD] Code ) 

in December 2000. No records of external or internal monitoring were available for this EE; 

therefore, external doses and internal intakes and doses were assigned according to the HPP TBD 

(DCAS 2013). Production Worker values recommended in TBD Table 6 were used for external 

doses, and Production Worker values in Table 5 were used in determining internal intakes and 

doses. ORAUT-OTIB-0006, Technical Information Bulletin: Dose Reconstruction from 

Occupationally Related Diagnostic X-ray Procedures, Revision 04 (NIOSH 2011), was used for 

assigning medical x-ray doses.

2.2 COMPARISON OF NIOSH’S ORIGINAL AND REWORKED DOSE 

RECONSTRUCTIONS

NIOSH performed the original DR of Case # in February 2003. The claim was reworked 

in September 2015, as per DCAS-PER-066. Table 1 summarizes the results for this case as 

reworked by NIOSH.

Table 1. Original and Reworked Results for Case # 

Dose Type

Original Dose

(rem)

Rework as per 

DCAS-PER-066 

(rem)

External 2.330 0.724

Medical X-ray 1.210 1.173

Internal 0.022 8.885

Total Dose 3.562 10.782

POC 33.94% 49.87%

Revisions in the HPP TBD (DCAS 2013) after the original DR was performed resulted in 

decreases in some of the external doses and medical x-ray doses for the reworked case in 2015. 

The application of DCAS-PER-066 resulted in an increase in internal dose, with an overall 

increase in the resulting POC. SC&A was tasked with only evaluating the application of DCASPER-066 to this case (addition of Am-241, Th-230, and Tc-99 intakes and doses); therefore, 

SC&A did not review the other aspects of the DR rework. 

2.3 SC&A’S REVIEW OF DCAS-PER-066 ISSUE RELATED TO THIS CASE

As directed by the PRSC, SC&A’s review of Case # focused on revised internal dose, as 

specified by the criteria in DCAS-PER-066. Case # required the internal doses to be 

reworked because the EE worked at HPP during the periods and . 
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2.3.1 Original Dose Reconstruction

The original DR, performed in 2003, assigned internal intakes using the recommended intake

values from Table 5, page 8, of ORAUT 2003 in the chronic annual workbook (CADW) and 

entered the resulting doses in the Interactive RadioEpidemiological Program (IREP) Input table. 

The radionuclide intake values given in the Table 5 of ORAUT 2003 were for total uranium, 

Pu-239, and Np-237. 

2.3.2 Reworked Dose Reconstruction

In the reworked DR performed in 2015, NIOSH used the recommended internal intake values

from Table 5, page 17, of DCAS 2013 (which included Am-241, Th-230, and Tc-99) in the 

CADW and entered the resulting doses in the IREP Input table. The new IREP Input table 

(which contained other revised doses according to DCAS 2013 recommendations) was used to 

determine the revised POC.

2.3.3 SC&A’s Evaluation 

SC&A ran the appropriate CADW using the intake values for total uranium, Pu-239, and Np-237 

plus the additional intake values for Am-241, Th-230, and Tc-99. SC&A then evaluated the 

recent dose rework and concurs that NIOSH used the correct intake values and assigned the 

greater dose considering the potential solubility types (Type M and Type S). The resulting dose 

values were entered correctly in the IREP Input table (along with other revised dose values 

according to DCAS-PER-066). SC&A calculated the POC using the IREP Input table and 

derived approximately the same POC value as NIOSH did for the reworked case. (SC&A found 

that the NIOSH-IREP v.5.8 on the website will not run IREPs with random seed generators; 

therefore, SC&A used a random seed of 99 to run the program and obtain similar POC values.) 

SC&A had no findings concerning this case in view of DCAS-PER-066.
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3.0 REVIEW OF DCAS-PER-066 ISSUE FOR CASE # (HPP)

3.1 BACKGROUND INFORMATION FOR THIS CASE

Case # represents an EE who worked at HPP from 1951, through 1968. 

During this worker’s employment, the EE worked as an Operator according to the CATI. The 

EE was diagnosed with cancer (ICD Code ) in March 1975 and recurrent cancer

(ICD Code ) in May 1985. No records of external or internal monitoring were available for 

this EE; therefore, external doses and internal intakes and doses were assigned according to the 

HPP TBD (DCAS 2013). Production Worker values recommended in TBD (DCAS 2013) 

Table 6 were used for external doses, and Production Worker values in Table 5 were used in

determining internal intakes and doses. ORAUT-OTIB-0006 (NIOSH 2011) was used for 

assigning medical x-ray doses.

3.2 COMPARISON OF NIOSH’S ORIGINAL AND REWORKED DOSE 

RECONSTRUCTIONS 

NIOSH performed the original DR of Case # in February 2004. The claim was reworked 

in September 2015, as per DCAS-PER-066. Table 2 summarizes the results for this case as 

reworked by NIOSH.

Table 2. Original and Reworked Results for Case # 

Dose Type

 1975 

Original Dose

(rem)

 1975

Rework as per

DCAS-PER-066 

(rem)

 1985 

Original Dose

(rem)

 1985

Rework as per 

DCAS-PER-066 

(rem)

External 1.962 0.552 1.962 0.552

Medical X-ray 1.729 1.089 1.729 1.089

Internal 2.588 21.171 2.693 22.110

Total Dose 6.278 22.812 6.384 23.751

POC 24.38% 30.39% 26.64% 28.93%

The original DR’s combined POC was 29.79%; the reworked DR’s combined POC was 47.86%. 

Revisions in the HPP TBD (DCAS 2013) after the original DR was performed resulted in 

decreases in some of the external doses and medical x-ray doses for the reworked case in 2015. 

The application of DCAS-PER-066 resulted in an increase in internal dose, with an overall 

increase in the resulting POC. SC&A was tasked with only evaluating the application of DCASPER-066 to this case (addition of Am-241, Th-230, and Tc-99 intakes and doses); therefore, 

SC&A did not review the other aspects of the DR rework. 

3.3 SC&A’S REVIEW OF DCAS-PER-066 ISSUE RELATED TO THIS CASE

As directed by the PRSC, SC&A’s review of Case # focused on revised internal dose, as 

specified by the criteria in DCAS-PER-066. Case # required the internal doses to be 

reworked because the EE worked at HPP during the period . 
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3.3.1 Original Dose Reconstruction

The original DR, performed in 2004, assigned internal intakes using the recommended intake 

values from Table 5, page 8, of ORAUT 2004 in the CADW and entered the resulting doses in 

the IREP Input table. The radionuclide intake values provided in Table 5 of ORAUT 2004 were 

for total uranium, Pu-239, and Np-237.

3.3.2 Reworked Dose Reconstruction

In the reworked DR performed in 2015, NIOSH used the recommended internal intake values

from Table 5, page 17, of DCAS 2013 (which included Am-241, Th-230, and Tc-99) in the 

CADW and entered the resulting doses in the IREP Input tables. The new IREP Input tables

(which contained other revised doses according to DCAS 2013 recommendations) were used to 

determine the revised POC.

3.3.3 SC&A’s Evaluation

SC&A ran the appropriate CADWs using the intake values for total uranium, Pu-239, and 

Np-237 plus the additional intakes values for Am-241, Th-230, and Tc-99. SC&A then evaluated 

the recent dose rework and concurs that NIOSH used the correct intake values and assigned the 

greater dose considering the potential solubility types (Type M and Type S). The resulting dose 

values were entered correctly in the IREP Input tables (along with other revised dose values 

according to DCAS-PER-066). SC&A calculated the POCs using IREP Input tables and derived 

the same POC values and combined POC. (SC&A found that the NIOSH-IREP v.5.8 on the 

website will not run IREPs with random seed generators; therefore, SC&A used a random seed 

of 99 to run the program and obtain similar POC values.) SC&A had no findings concerning this 

case in view of DCAS-PER-066.
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4.0 SUMMARY CONCLUSIONS

Under SC&A-TR-PR2009-0002, A Protocol to Review NIOSH’s Program Evaluation Reports 

(PERs), Revision 01 (SC&A 2009), Subtask 4 requires the audit of DR cases reworked as a 

result of the PER under review. For DCAS-PER-066, 57 cases met the applicable criteria.

During the May 16, 2016, PRSC meeting, SC&A was tasked with evaluating the appropriate 

cases concerning the application of DCAS-PER-066.

This current report satisfies the Subtask 4 requirement. For the two cases selected from the 

57 cases impacted by DCAS-PER-066, SC&A provided an overview of the case and a brief 

comparison of doses assigned in the original DRs and the revised dose estimates. Based on 

directives from the PRSC, SC&A’s audit of the two cases focused on those elements of the DR

that were affected by the issuance of DCAS-PER-066. Therefore, the audit determined if internal 

doses were appropriate for these cases, and, if so, whether they were assigned correctly.

As discussed in Sections 2 and 3, SC&A found that NIOSH did correctly derive the appropriate

doses as recommended by DCAS-PER-066. SC&A had no findings in the two cases reviewed 

concerning the reworked doses as per DCAS-PER-066, but did have a finding concerning errors 

in Table 5 of the current TBD (DCAS 2013) for Administrative Workers that need to be

corrected as outlined in Section 1.1 of this report.
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5.0 REFERENCES

DCAS 2015. Huntington Pilot Plant Program Evaluation Report, DCAS-PER-066, Revision 0, 

National Institute for Occupational Safety and Health, Office of Compensation Analysis and 

Support, Cincinnati, Ohio. November 30, 2015.

DCAS 2013. Technical Basis Document for the Huntington Pilot Plant, Huntington, West 

Virginia, DCAS-TKBS-0004, Revision 01, Oak Ridge Associated Universities Team, Cincinnati, 

Ohio. December 12, 2013.

OCAS 2008. Technical Basis Document for the Huntington Pilot Plant, Huntington, West 

Virginia, OCAS-TKBS-0004, Revision 00, Oak Ridge Associated Universities Team, Cincinnati, 

Ohio. August 13, 2008.

NIOSH 2011, Technical Information Bulletin: Dose Reconstruction from Occupationally Related 

Diagnostic X-ray Procedures, ORAUT-OTIB-0006, Revision 04, Oak Ridge Associated 

Universities Team, Cincinnati, Ohio. June 20, 2011.

ORAUT 2003. Technical Basis Document: Basis for Development of an Exposure Matrix for 

Huntington Pilot Plant, ORAUT-TKBS-0004, Revision 00, Oak Ridge Associated Universities 

Team, Cincinnati, Ohio. October 31, 2003.

ORAUT 2004. Technical Basis Document: Basis for Development of an Exposure Matrix for 

Huntington Pilot Plant, ORAUT-TKBS-0004, Revision 01, Oak Ridge Associated Universities 

Team, Cincinnati, Ohio. January 16, 2004.

SC&A 2009. A Protocol to Review NIOSH’s Program Evaluation Reports (PERs), SCA-TRPR2009-0002, Revision 01, SC&A, Inc., Vienna, Virginia, and Saliant, Inc., Maryland.

December 2009.