DRAFT 

REPORT TO THE ADVISORY BOARD 

ON RADIATION AND WORKER HEALTH

National Institute for Occupational Safety and Health 

COMPARISON OF SC&A’S BLIND DOSE RECONSTRUCTION 

TO NIOSH’S DOSE RECONSTRUCTION OF CASE #[REDACT] 

FROM THE NATIONAL SECURITY COMPLEX (Y-12) 

Contract No. 211-2014-58081 

SCA-TR-DRC2015-CN[Redact]

Prepared by 

Ron Buchanan, PhD, CHP 

S. Cohen & Associates 

1608 Spring Hill Road, Suite 400 

Vienna, Virginia 22182 

March 2015 

NOTICE: This report has been reviewed for Privacy Act information and has been cleared for distribution. 

However, this report is pre-decisional and has not been reviewed by the Advisory Board on Radiation and Worker 

Health for factual accuracy or applicability within the requirements of 42 CFR 82.
Effective Date:

March 25, 2015

Revision No.

0 (Draft)

Document No. 

SCA-TR-DRC2015-CN[Redact]

Page No.

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S. Cohen & Associates:

Technical Support for the Advisory Board on

Radiation & Worker Health Review of

NIOSH Dose Reconstruction Program

Document No. 

SCA-TR-DRC2015-CN[Redact]

Effective Date: 

Draft – March 25, 2015

Comparison of SC&A’s Blind Dose 

Reconstruction to NIOSH’s Dose 

Reconstruction of Case #[Redact] from the 

National Security Complex (Y-12)

Page 2 of 12

Task Manager:

________________________ Date: ___________

Douglas Farver, CHP

Supersedes:

N/A

Project Manager:

________________________ Date: ___________

John Stiver, MS, CHP

Reviewer:

 Kathleen Behling

 Douglas Farver

 Rose Gogliotti

Record of Revisions

Revision 

Number Effective Date Description of Revision

0 (Draft) 03/25/2015 Initial issued.
Effective Date:

March 25, 2015

Revision No.

0 (Draft)

Document No. 

SCA-TR-DRC2015-CN[Redact]

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TABLE OF CONTENTS

Abbreviations and Acronyms ..........................................................................................................4

1.0 Relevant Background Information .......................................................................................5

2.0 Comparison of Methodology/Doses used by NIOSH and SC&A for Case #[Redact] ........7

2.1 Occupational External Dose Calculations ...............................................................8

2.1.1 Recorded/Missed/Unmonitored External Doses ..........................................8

2.1.2 Occupational Medical Doses .......................................................................8

2.2 Occupational Internal Doses ....................................................................................9

2.2.1 Recorded/Missed/Unmonitored Internal Doses ...........................................9

3.0 Summary Conclusions .......................................................................................................10

References ......................................................................................................................................11

Addendum A: SC&A’s Blind Dose Reconstruction Report of Case #[REDACT] ......................12

LIST OF TABLES

Table 1-1. Comparison of NIOSH’s Assigned Doses to SC&A’s Blind DR Doses ......................6

Table 2-1. Comparison of Data and Assumptions Used by NIOSH and SC&A ............................7

Table 2-2. Secondary Cancers and Their Related Primary Cancer Sites for Medical X-rays ........9

Table 2-3. Comparison of Occupational Medical Doses ................................................................9

Table 3-1. Comparison of Total External and Internal Doses Estimated .....................................10
Effective Date:

March 25, 2015

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ABBREVIATIONS AND ACRONYMS 

Advisory Board Advisory Board on Radiation and Worker Health 

CATI Computer-Assisted Telephone Interview 

DCF dose conversion factor

DOE (U.S.) Department of Energy 

DOL (U.S.) Department of Labor 

DR dose reconstruction 

EE Energy Employee 

EEOICPA Energy Employees Occupational Illness Compensation Program Act of 

2000

ICD International Classification of Diseases 

IREP Interactive RadioEpidemiological Program 

keV kiloelectron volts 

NIOSH National Institute for Occupational Safety and Health 

ORAUT Oak Ridge Associated Universities Team 

PFG photofluorography 

POC probability of causation 

rem Roentgen equivalent man 

SC&A S. Cohen and Associates (SC&A, Inc.) 

SD standard deviation 

SEC Special Exposure Cohort 

TBD technical basis document 

TIB technical information bulletin
Effective Date:

March 25, 2015

Revision No.

0 (Draft)

Document No. 

SCA-TR-DRC2015-CN[Redact]

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1.0 RELEVANT BACKGROUND INFORMATION 

Under Contract No. 211-2014-58081, SC&A was tasked by the Advisory Board on Radiation 

and Worker Health (Advisory Board) to perform six blind dose reconstructions (DRs) at the July 

2014, DR Subcommittee meeting. SC&A was provided all of the Department of Energy (DOE) 

dosimetry records; the Department of Labor (DOL) correspondence, forms, and medical records; 

and the Computer-Assisted Telephone Interview (CATI) Reports that were made available to the 

National Institute for Occupational Safety and Health (NIOSH) for constructing doses in behalf 

of these cases. SC&A used an independent approach to reconstruct occupational external and 

internal doses for the cases using the available dosimetry records and current guidance from 

NIOSH, including the spreadsheets and other tools developed by NIOSH to calculate the doses. 

On February 12, 2015, SC&A submitted to the Advisory Board and NIOSH, a memorandum 

containing the summary results of our blind DR in behalf of Case #[Redact]. The complete DR 

report entitled, Blind Dose Reconstruction of Case #[Redact] from the Y-12 National Security 

Complex (SCA-TR-BDR2015-CN[Redact]), which provides the assumptions and methodologies 

used to derived occupational radiation doses and resultant probability of causation (POC), is 

included herein as Addendum A. In this report, SC&A presents a comparison between NIOSH’s 

and SC&A’s DR methodologies, doses, and resultant POC values for Case #[Redact]. Table 1-1 

summarizes the external and internal occupational doses calculated by SC&A and the NIOSHassigned doses for the lung, bone, and metastatic carcinoma cancers diagnosed in behalf of 

Case #[Redact]. A detailed comparison of the two methodologies used to calculate doses in 

behalf of this case is presented in Section 2. Section 3 of this report provides Summary 

Conclusions. 

It should be noted that where appropriate, an explanation is provided regarding the differences in 

doses and why they occurred; however, SC&A does not make any value judgments regarding 

which among them may be the more preferred approach. It is our position that further 

discussions are best addressed by the DR Subcommittee. 
Effective Date:

March 25, 2015

Revision No.

0 (Draft)

Document No. 

SCA-TR-DRC2015-CN[Redact]

Page No.

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Table 1-1. Comparison of NIOSH’s Assigned Doses to SC&A’s Blind DR Doses

NIOSH

Lung Doses 

(rem)

NIOSH

Carcinoma 

Doses (rem)

NIOSH

Bone Doses 

(rem)

SC&A Lung 

Doses 

(rem)

SC&A Bone 

Doses 

(rem)

SC&A

Carcinoma 

Doses (rem)

External Dose (Occupational):

 ▪ Recorded Dose

 - Photons <30 keV NA NA NA NA NA NA

 - Photons 30–250 keV NA NA NA NA NA NA

 - Neutrons NA NA NA NA NA NA

 ▪ Missed Dose

 - Photons <30 keV NA NA NA NA NA NA

 - Photons 30–250 keV NA NA NA NA NA NA

 - Neutrons NA NA NA NA NA NA

 ▪ Unmonitored Dose

 - Photons <30 keV NA NA NA NA NA NA

 - Photons 30–250 keV NA NA NA NA NA NA

 - Neutrons NA NA NA NA NA NA

 ▪ Occupational Medical Dose

 - Photons 30–250 keV 12.150 4.050 3.780 12.150 3.780 4.050

Internal Dose: NA NA NA NA NA NA

Total Cancer Dose 12.150 4.050 3.780 12.150 3.780 4.050

Cancer POC 27.67 11.22 22.29 27.71 21.29 11.22

Combined POC 49.46% 49.48%

NA = not applicable or not analyzed. 
Effective Date:

March 25, 2015

Revision No.

0 (Draft)

Document No. 

SCA-TR-DRC2015-CN[Redact]

Page No.

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2.0 COMPARISON OF METHODOLOGY/DOSES USED BY NIOSH 

AND SC&A FOR CASE #[REDACT] 

Case #[Redact] represents an energy employee (EE) who worked at the National Security 

Complex (Y-12) from [Redact], through [Redact]. According to the DOE records, the majority 

of the EE’s radiation exposure was received while working as a [Redact] at Y-12.

The EE was not monitored for external or internal exposures. In [Redact], the EE was 

diagnosed with secondary lung cancer (ICD-9 Code 197.0), secondary bone cancer (ICD-9

Code 198.5), and unknown primary metastatic carcinoma (ICD-9 Code 199).

For calculating radiation doses from employment at Y-12, both DR methods primarily relied on 

guidance in the Technical Basis Document (TBD) for Y-12 (issued as six separate documents 

numbered ORAUT-TKBS-0014-1 through ORAUT-TKBS-0014-06) and ORAUT-OTIB-0005, 

Technical Information Bulletin: Internal Dosimetry Organ, External Dosimetry Organ, and 

IREP Model Selection by ICD-9 Code. Using the guidance provided in the relevant documents, 

along with the EE’s records, NIOSH and SC&A employed a best-estimate approach for 

calculating annual organ doses.

A summary of the documents, assumptions, and dose parameters used by each DR method is 

provided in Table 2-1: 

Table 2-1. Comparison of Data and Assumptions Used by NIOSH and SC&A 

Parameters NIOSH SC&A

External Dose

Recorded/Missed/Unmonitored:

 Records/Guidance Documents DOE records, Y-12 TBD-6. DOE records, Y-12 TBD-6.

 Work Locations Freight facilities at Y-12. Freight facilities at Y-12.

 Energy Range/DCF NA NA

 Dosimeter Uncertainty Factor NA NA

 Dose Distribution NA NA

External Medical X-rays:

 Guidance Documents Y-12 TBD-3, OTIB-0005, 

OTIB-0006, OTIB-0079. Y-12 TBD-3 and OTIB-0005.

 Frequency Annual x-ray exam and 

termination x-ray exam.

Annual and termination x-ray exams, 

based on Table 3-1 of Y-12 TBD-3.

 Dose Data Y-12 TBD-3 Y-12 TBD-3 (Table A-2)

 Dose Distribution Normal; SD = 30%. Normal; SD = 30%.

Internal Dose

Recorded/Missed/unmonitored:

 Records/Guidance Documents DOE records, Y-12 TBD-5. DOE records, Y-12 TBD-5.

 Dose Determination Approach NA NA

 Solubility Type NA NA

POC Program:

NIOSH-IREP POC Ver. 5.7 Ver. 5.7.1
Effective Date:

March 25, 2015

Revision No.

0 (Draft)

Document No. 

SCA-TR-DRC2015-CN[Redact]

Page No.

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2.1 OCCUPATIONAL EXTERNAL DOSE CALCULATIONS 

2.1.1 Recorded/Missed/Unmonitored External Doses 

The DOE records show that the EE was not monitored for external exposures. According to 

ORAUT-TKBS-0014-6, page 12, external doses, except occupational medical dose, cannot be 

reconstructed during the EE’s employment time period of [redact]–[redact], as per the Y-12 

Special Exposure Cohort (SEC). Therefore, neither NIOSH nor SC&A could assign 

recorded/missed/ unmonitored dose in this case. The EE failed to qualify as a member of the 

SEC class since the EE did not work for a total of 250 days during the SEC period. 

2.1.2 Occupational Medical Doses 

Both DR methods calculated an occupational medical dose from diagnostic x-ray procedures 

required as a condition of employment. NIOSH indicated that they followed guidance cited in 

the following four guidance documents in order to calculate their occupational medical doses: 

1. ORAUT-TKBS-0014-3, Technical Basis Document for the National Security Complex –

Occupational Medical Dose, Rev. 01.

2. ORAUT-OTIB-0005. Technical Information Bulletin: Internal Dosimetry Organ, 

External Dosimetry Organ, and IREP Model Selection by ICD-9 Code, Rev 05.

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

Occupational Medical X-Ray Dose Procedures, Rev. 04.

4. ORAUT-OTIB-0079, Technical Information Bulletin: Guidance on Assigning 

Occupational X-Ray Dose under EEOICPA for X-Rays Administered Off Site, Rev 00.

SC&A used guidance provided in the Y-12 TBD (ORAUT-TKBS-0014-3) and ORAUT-OTIB0005. 

Both NIOSH and SC&A assigned dose for a pre-employment x-ray exam in [redact] (the EE’s 

starting date was [redact]; therefore, another x-ray exam would most likely not be conducted in 

[redact]), an annual exam in [redact], and a termination exam in [redact], for a total of three 

exams. SC&A used the recommended exam frequency in Table 3-1, page 9, and the 

recommended organ doses in Table A-2, page 22, of ORAUT-TKBS-0014-3.

This EE had secondary cancers with unknown primaries. According to ORAUT-OTIB-0005, 

Table 3-2, page 41, in this case, the dose reconstructor is to evaluate the potential primary 

cancers and use the primary cancer site that provides for the greater dose for each of the 

secondary cancers. Table 2-2 of this report provides a summary of the three secondary cancer 

sites and their respective primary sites. 
Effective Date:

March 25, 2015

Revision No.

0 (Draft)

Document No. 

SCA-TR-DRC2015-CN[Redact]

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Table 2-2. Secondary Cancers and Their Related Primary Cancer Sites for Medical X-rays 

Secondary Cancer

ICD-9 Code Secondary Cancer Potential PrimaryCancer ICD-9 Code

Potential Primary

Cancer Site*

197.0 Lung 153 Colon

162 Lung

172 Skin

185 Bladder

188 Bladder

189 Liver

198.5 Bone 162 Lung

185 Bladder

199 Metastatic Carcinoma 199 Remainder

*Organ that produced the greater dose is shown in bold font.

The medical x-ray doses for a photofluorography (PFG) exam for each of these potential primary 

organs were obtained from Table A-2, page 22, of ORAUT-TKBS-0014-3. The greater of the 

primary dose was assigned for the secondary cancer site, i.e., for the lung, the skin dose 

(4.050 rem) represented the most claimant-favorable dose; for the bone, the lung dose 

(1.260 rem) was highest; and for the carcinoma, the remainder dose (1.350 rem) was the most 

claimant favorable. These organs are in bold text in Table 2-2.

From the Interactive RadioEpidemiological Program (IREP) Input tables in NIOSH’s DR 

Report, it appears that NIOSH used the same methods and assigned the same doses that SC&A 

derived. Table 2-3 summarizes NIOSH’s and SC&A’s dose assignments.

Table 2-3. Comparison of Occupational Medical Doses 

Cancer NIOSH

(rem)

SC&A

(rem)

Lung 12.150 12.150

Bone 3.780 3.780

Metastatic carcinoma 4.050 4.050

Each DR method entered the annual doses into the IREP Input tables with a normal distribution 

and a standard deviation (SD) of 30%. 

2.2 OCCUPATIONAL INTERNAL DOSES 

2.2.1 Recorded/Missed/Unmonitored Internal Doses 

The DOE records show that the EE was not monitored for internal intakes. According to 

ORAUT-TKBS-0014-5, page 11, internal doses cannot be reconstructed during the EE’s 

employment time period of [redact]–[redact]. Therefore, neither NIOSH nor SC&A could 

assign recorded/missed/unmonitored internal doses in this case. 
Effective Date:

March 25, 2015

Revision No.

0 (Draft)

Document No. 

SCA-TR-DRC2015-CN[Redact]

Page No.

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3.0 SUMMARY CONCLUSIONS 

Total external and internal doses and resultant POCs calculated by NIOSH and SC&A in behalf 

of Case #[Redact] are presented in Table 3-1 for comparison. 

Table 3-1. Comparison of Total External and Internal Doses Estimated 

Total Dose

NIOSH

Lung

(rem)

SC&A

Lung

(rem)

NIOSH

Bone

(rem)

SC&A

Bone

(rem)

NIOSH

Carcinoma

(rem)

SC&A

Carcinoma

(rem)

External Dose: NA NA NA NA NA NA

Occupational Medical Dose 12.105 12.105 3.780 3.780 4.050 4.050

Internal Dose: NA NA NA NA NA NA

Total Dose 12.105 12.105 3.780 3.780 4.050 4.050

POC 27.67% 27.71% 21.29% 21.29% 11.22% 11.22%

As shown in Table 3-1, NIOSH’s and SC&A’s methods resulted in individual cancer POCs, and 

a combined total POC, that were nearly identical; NIOSH derived a total combined POC of 

49.46% compared to 49.48% for SC&A. The slight difference between NIOSH’s and SC&A’s 

POC value for the lung cancer may be due to the version of the NIOSH IREP POC program 

used; i.e., NIOSH used Ver. 5.7 and SC&A used Ver. 5.7.1. 

The following summarizes/compares the methods used by NIOSH and SC&A to assign doses in 

this case: 

 Dose Reconstruction Methodology 

 – Both NIOSH and SC&A employed a best-estimate approach to dose reconstruction. 

 Assignment of Unmonitored External Dose

 – Neither NIOSH nor SC&A could assign unmonitored external dose because of the 

 Y-12 SEC during the EE’s employment period, and the EE did not qualify as a 

member of the class due to not having worked at least 250 days.

 Assignment of Occupational Medical Dose 

 – NIOSH and SC&A used the same methodology in assigning medical doses. 

 Assignment of Internal Doses 

 – Neither NIOSH nor SC&A could assign unmonitored internal dose because of the 

 Y-12 SEC during the EE’s employment period.

 Dose Uncertainty Entered into IREP 

– Both NIOSH and SC&A assigned the occupational medical dose as a normal 

distribution with an uncertainty of 30%. 
Effective Date:

March 25, 2015

Revision No.

0 (Draft)

Document No. 

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Page No.

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REFERENCES 

ORAUT-OTIB-0005. 2012. Technical Information Bulletin: Internal Dosimetry Organ, 

External Dosimetry Organ, and IREP Model Selection by ICD-9 Code, Rev. 05, Oak Ridge 

Associated Universities Team, Cincinnati, Ohio. December 20, 2012. 

ORAUT-OTIB-0006. 2011. Technical Information Bulletin: Dose Reconstruction from 

Occupationally Related Diagnostic X-Ray Procedures, Rev. 04, Oak Ridge Associated 

Universities, Cincinnati, Ohio. June 20, 2011. 

ORAUT-OTIB-0079. 2011. Technical Information Bulletin: Guidance on Assigning 

Occupational X-Ray Dose under EEOICPA for X-Rays Administered Off Site, Rev. 00, Oak 

Ridge Associated Universities Team, Cincinnati, Ohio. January 3, 2011. 

ORAUT-TKBS-0014-3. 2007. Technical Basis Document for the Y-12 National Security 

Complex – Occupational Medical Dose, Rev. 01, Oak Ridge Associated Universities Team, 

Cincinnati, Ohio. June 18, 2007. 

ORAUT-TKBS-0014-5. 2012. Technical Basis Document for the Y-12 National Security 

Complex – Occupational Internal Dose, Rev. 03, Oak Ridge Associated Universities Team, 

Cincinnati, Ohio. March 12, 2012. 

ORAUT-TKBS-0014-6. 2009. Technical Basis Document for the Y-12 National Security 

Complex – Occupational External Dose, Rev. 02, Oak Ridge Associated Universities Team, 

Cincinnati, Ohio. December 18, 2009. 
Effective Date:

March 25, 2015

Revision No.

0 (Draft)

Document No. 

SCA-TR-DRC2015-CN[Redact]

Page No.

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ADDENDUM A: SC&A’S BLIND DOSE RECONSTRUCTION 

REPORT OF CASE #[REDACT] 
Draft

REPORT TO THE ADVISORY BOARD 

ON RADIATION AND WORKER HEALTH

National Institute for Occupational Safety and Health 

BLIND DOSE RECONSTRUCTION OF CASE #[REDACT]

FROM THE Y-12 NATIONAL SECURITY COMPLEX 

Contract No. 211-2014-58081

SCA-TR-BDR2015-CN[Redact]

Prepared by 

Ron Buchanan, PhD, CHP 

S. Cohen & Associates 

1608 Spring Hill Road, Suite 400 

Vienna, Virginia 22182 

February 2015 

NOTICE: This report has been reviewed for Privacy Act information and has been cleared for distribution. 

However, this report is pre-decisional and has not been reviewed by the Advisory Board on Radiation and Worker 

Health for factual accuracy or applicability within the requirements of 42 CFR 82.
Effective Date:

February 12, 2015

Revision No.

0 (Draft)

Document No. 

SCA-TR-BDR2015-CN[Redact]

Page No.

2 of 12

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S. Cohen & Associates:

Technical Support for the Advisory Board on

Radiation & Worker Health Review of

NIOSH Dose Reconstruction Program

Document No. 

SCA-TR-BDR2015-CN[Redact]

Effective Date: 

Draft – February 12, 2015

Revision No.

0 (Draft)

BLIND DOSE RECONSTRUCTION 

OF CASE #[REDACT] FROM THE Y-12 

NATIONAL SECURITY COMPLEX 

Page 2 of 12

Task Manager:

________________________ Date: ___________

Douglas Farver, CHP

Supersedes:

N/A

Project Manager:

________________________ Date: ___________

John Stiver, MS, CHP

Reviewers:

 Kathleen Behling

 Douglas Farver

 Rose Gogliotti

Record of Revisions

Revision 

Number Effective Date Description of Revision

0 (Draft) 02/12/2015 Document finalized. This document will be distributed as an addendum to the

blind dose reconstruction comparison for this case review.
Effective Date:

February 12, 2015

Revision No.

0 (Draft)

Document No. 

SCA-TR-BDR2015-CN[Redact]

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TABLE OF CONTENTS 

1.0 Summary Background Information .................................................................................... 4

1.1 SC&A Blind Dose Reconstruction Approach ......................................................... 4

2.0 External Doses .................................................................................................................... 5

2.1 Occupational Medical Dose .................................................................................... 5

3.0 Internal Doses ..................................................................................................................... 6

4.0 CATI Report and Radiological Incidents ........................................................................... 7

5.0 Summary Conclusions ........................................................................................................ 8

References ....................................................................................................................................... 9

Appendix A-1: IREP Input – Lung .............................................................................................. 10

Appendix A-2: IREP Input – Bone .............................................................................................. 11

Appendix A-3: IREP Input – Carcinoma ..................................................................................... 12
Effective Date:

February 12, 2015

Revision No.

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Document No. 

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1.0 SUMMARY BACKGROUND INFORMATION 

This report presents the results of an independent blind dose reconstruction (DR) performed by 

S. Cohen & Associates (SC&A, Inc.) for an energy employee (EE) who worked at the National 

Security Complex (Y-12) from [redact] through [redact].

In [redact], the EE was diagnosed with secondary lung cancer (ICD-9 Code 197.0), secondary 

bone cancer (ICD-9 Code 198.5), and unknown primary metastatic carcinoma (ICD-9 Code 

199).

According to Department of Labor (DOL) and Computer-Assisted Telephone Interview (CATI) 

Report, the EE was a [redact] at Y-12. The EE was not monitored for external or internal 

exposures. 

1.1 SC&A BLIND DOSE RECONSTRUCTION APPROACH 

SC&A reviewed all of the Department of Energy (DOE) records provided on behalf of this EE

and the National Institute for Occupational Safety and Health (NIOSH) procedures relevant to 

this case, which included the Technical Basis Documents (TBDs) for Y-12 (issued as six 

separate documents numbered ORAUT-TKBS-0014-1 through ORAUT-TKBS-0014-6). 

According to the Y-12 Special Exposure Cohort (SEC), the external doses (ORAUT-TKBS0014-6, page 12), internal doses (ORAUT-TKBS-0014-5, page 11), and environmental doses 

(ORAUT-TKBS-0014-4, page 9) for workers at the Y-12 facility cannot be reconstructed prior to 

1948, except for occupational medical. Additionally, according to the DOL records, the EE only 

worked for a total of 242 days; therefore, the cancers would not be covered by the SEC. 

SC&A derived the appropriate occupational medical x-ray doses as summarized in Table 1. 

Since the EE was diagnosed with three cancers, three sets of doses were entered into the 

Interactive RadioEpidemiological Program (IREP), one set for each cancer. SC&A determined 

the probability of causation (POC) for this case using the annual doses listed in the three IREP 

Input tables, as shown in Appendices A-1 through A-3 of this report. The total dose shown in 

Table 1 produced a POC of 49.48%. 

Table 1. Summary of SC&A-Derived External/Internal Dose Estimates 

#1 Lung

IREP Entry

Dose

(rem)

#2 Bone

IREP Entry

Dose

(rem)

#3 Carcinoma

IREP Entry

Dose

(rem)

External Dose (Occupational):

 ▪ Recorded Photon Dose 

 30–250 keV Photons NA – NA – NA –

 ▪ Missed Photon Dose 

 30–250 keV Photons NA – NA – NA –

 ▪ Recorded Shallow Dose

 e

-

>15 keV NA – NA – NA –

 ▪ Occupational Medical Dose: 1–2 12.150 1–2 3.780 1–2 4.050

 ▪ Occupational Envir. Dose: NA – NA – NA –

Internal Dose (Occupational): NA – NA – NA –

Total 12.150 3.780 4.050
Effective Date:

February 12, 2015

Revision No.

0 (Draft)

Document No. 

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Health for factual accuracy or applicability within the requirements of 42 CFR 82. 

2.0 EXTERNAL DOSES 

According to the Y-12 SEC, the external doses (ORAUT-TKBS-0014-6, page 12) and

environmental external doses (ORAUT-TKBS-0014-4, page 9) for workers at the Y-12 facility 

cannot be reconstructed prior to 1948, except for occupational medical. 

2.1 OCCUPATIONAL MEDICAL DOSE 

This EE had two secondary cancers with unknown primaries. According to ORAUT-OTIB0005, Table 3-2, page 29, in this case the dose reconstructor is to evaluate the potential primary 

cancers and use the primary cancer site that provides for the greater dose for each of the 

secondary cancers. Table 2 provides a summary of the three secondary cancer sites and their 

respective primary sites. 

Table 2. Secondary Cancers and their Related Primary Cancer Sites for Medical X-rays 

Secondary Cancer

ICD-9 Code Secondary Cancer Potential PrimaryCancer ICD-9 Code

Potential Primary

Cancer Site*

197.0 Lung 153 Colon

162 Lung

172 Skin

185 Bladder

188 Bladder

189 Liver

198.5 Bone 162 Lung

185 Bladder

199 Metastatic Carcinoma 199 Remainder

*Organ that produced the greater dose is shown in bold font.

The medical x-ray doses for a photofluorography (PFG) exam for each of these potential primary 

organs were obtained from Table A-2, page 22, of ORAUT-TKBS-0014-3. The greater of the 

primary dose was assigned for the secondary cancer site. This resulted in assigning the skin dose 

of 4.050 rem for the lung; for the bone, the lung dose of 1.260 rem was the most claimant 

favorable; and for the carcinoma, the remainder dose of 1.350 rem represented the highest dose. 

These organs are shown in bold text in Table 2. 

Using the recommendations in Table 3-1, page 9, of ORAUT-TKBS-0014-3, SC&A assigned a 

PFG medical x-ray exam for 1944 (EE’s start date was December 6, 1944; therefore, most likely 

the EE would not have received a pre-placement and an annual exam in [redact]). SC&A 

assigned an annual and termination x-ray ([redact]) for [redact], since the EE worked most of 

that year. This resulted in the doses listed in the IREP Input tables, as shown in Appendices A-1 

through A-3 of this report. 
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3.0 INTERNAL DOSES 

According to the Y-12 SEC, internal doses (ORAUT-TKBS-0014-5, page 11) and environmental 

internal doses (ORAUT-TKBS-0014-4, page 9) for workers at the Y-12 facility cannot be 

reconstructed prior to 1948.
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4.0 CATI REPORT AND RADIOLOGICAL INCIDENTS 

SC&A reviewed the EE’s DOE records and CATI Report (provided by the survivor) to 

determine if the EE was involved in any radiological incidents. SC&A did not find any 

documentation of radiological incidents that would impact the radiation doses assigned in this 

case. 
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5.0 SUMMARY CONCLUSIONS 

This DR used best-estimate methods to obtain reasonable external occupational medical x-ray 

dose assignments. The derived doses resulted in a POC <50%.

The total POC for the three cancers was calculated using the NIOSH-IREP (v.5.7) and was

determined to be 49.48%.
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REFERENCES 

ORAUT-OTIB-0005. 2012. Dosimetry Organ, External Dosimetry Organ, and IREP Model 

Selection by ICD-9 Code, Rev. 05, Oak Ridge Associated Universities Team, Cincinnati, Ohio. 

December 20, 2012. 

ORAUT-TKBS-0014-3. 2007. Technical Basis Document for the Y-12 National Security 

Complex – Occupational Medical Dose, Rev. 01, Oak Ridge Associated Universities Team, 

Cincinnati, Ohio. June 18, 2007. 

ORAUT-TKBS-0014-4. 2006. Technical Basis Document for the Y-12 National Security 

Complex – Occupational Environmental Dose, Rev. 01, Oak Ridge Associated Universities 

Team, Cincinnati, Ohio. July 20, 2006. 

ORAUT-TKBS-0014-5. 2012. Technical Basis Document for the Y-12 National Security 

Complex – Occupational Internal Dose, Rev. 03, Oak Ridge Associated Universities Team, 

Cincinnati, Ohio. March 12, 2012. 

ORAUT-TKBS-0014-6. 2009. Technical Basis Document for the Y-12 National Security 

Complex – Occupational External Dose, Rev. 02, Oak Ridge Associated Universities Team, 

Cincinnati, Ohio. December 18, 2009. 
Effective Date:

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APPENDIX A-1: IREP INPUT – LUNG 

(Lung secondary => Max primary external dose organ = skin, IREP model = Melanoma) 

CLAIMANT CANCER 

DIAGNOSES

Primary 

Cancer #1

Primary 

Cancer #2

Primary Cancer 

#3

Secondary 

Cancer #1

Secondary 

Cancer #2

Secondary 

Cancer #3

Cancer Type N/A N/A N/A Lung Cancer N/A N/A

Date of Diagnosis N/A N/A N/A [redact] N/A N/A

EXPOSURE INFORMATION

Number of exposures

2

Exposure #

Exposure 

Year

Exposure 

Rate Radiation Type

Dose 

Distribution 

Type Parameter 1 Parameter 2 Parameter 3

1 [redact] acute photons E=30–250keV Normal 4.050 1.215 0.000

2 [redact] acute photons E=30–250keV Normal 8.100 2.430 0.000
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APPENDIX A-2: IREP INPUT – BONE 

(Bone secondary => Max primary external dose organ = lung, IREP model = Lung) 

CLAIMANT CANCER 

DIAGNOSES

Primary 

Cancer #1

Primary 

Cancer #2 Primary Cancer #3

Secondary 

Cancer #1

Secondary 

Cancer #2

Secondary 

Cancer #3

Cancer Type N/A N/A N/A Bone Cancer N/A N/A

Date of Diagnosis N/A N/A N/A [redact] N/A N/A

EXPOSURE INFORMATION

Number of exposures

2

Exposure #

Exposure 

Year

Exposure 

Rate Radiation Type

Dose 

Distribution 

Type Parameter 1 Parameter 2 Parameter 3

1 [redact] acute photons E=30–250keV Normal 1.260 0.378 0.000

2 [redact] acute photons E=30–250keV Normal 2.520 0.756 0.000
Effective Date:

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APPENDIX A-3: IREP INPUT – CARCINOMA 

(Metastatic carcinoma, unknown primary => Max primary external dose organ = remainder, 

IREP model = Other & ill defined sites) 

CLAIMANT CANCER 

DIAGNOSES

Primary 

Cancer #1

Primary 

Cancer #2

Primary Cancer 

#3

Secondary 

Cancer #1

Secondary 

Cancer #2

Secondary 

Cancer #3

Cancer Type

Metastatic 

carcinoma, 

unknown primary N/A N/A N/A N/A N/A

Date of Diagnosis N/A N/A N/A N/A N/A N/A

EXPOSURE INFORMATION

Number of exposures

2

Exposure #

Exposure 

Year

Exposure 

Rate Radiation Type

Dose 

Distribution 

Type Parameter 1 Parameter 2 Parameter 3

1 [redact] acute photons E=30–250keV Normal 1.350 0.405 0.000

2 [redact] acute photons E=30–250keV Normal 2.700 0.810 0.000