DRAFT 

OCAS-PER-012, SUBTASK 4: 

REVIEW OF NINE ADVISORY BOARD SELECTED CASES 

REWORKED FOR THE EVALUATION OF HIGHLY 

INSOLUBLE PLUTONIUM COMPOUNDS 

Contract No. 200-2009-28555 

SCA-TR-PR2012-0012, Rev. 0

Kathleen Behling 

S. Cohen & Associates 

1608 Spring Hill Road, Suite 400 

Vienna, VA 22182

July 2012 

Disclaimer 

This document is made available in accordance with the unanimous desire of the Advisory Board on 

Radiation and Worker Health (ABRWH) to maintain all possible openness in its deliberations. However, 

the ABRWH and its contractor, SC&A, caution the reader that at the time of its release, this report is predecisional and has not been reviewed by the Board for factual accuracy or applicability within the 

requirements of 42 CFR 82. This implies that once reviewed by the ABRWH, the Board’s position may 

differ from the report’s conclusions. Thus, the reader should be cautioned that this report is for 

information only and that premature interpretations regarding its conclusions are unwarranted. 

 
Effective Date: 

July 20, 2012 

Revision No. 

0 (Draft) 

Document No. 

SCA-TR-PR2012-0012 

Page No. 

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

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Document No. 

SCA-TR-PR2012-0012, Rev. 0

S. Cohen & Associates: 

Technical Support for the Advisory Board on 

Radiation & Worker Health Review of 

NIOSH Dose Reconstruction Program 

Effective Date: 

Draft – July 20, 2012 

OCAS-PER-012, SUBTASK 4: 

REVIEW OF NINE ADVISORY BOARD 

CASES REWORKED FOR THE 

EVALUATION OF HIGHLY INSOLUBLE 

PLUTONIUM COMPOUNDS 

Page 2 of 46 

Task Manager: 

________________________ Date: ___________ 

U. Hans Behling, PhD 

Supersedes: 

N/A 

Project Manager: 

________________________ Date: ___________ 

John Stiver, MS, CHP 

Reviewers: 

 Douglas Farver 

 John Mauro 

 John Stiver 

Record of Revisions 

Revision 

Number Effective Date Description of Revision 

0 (Draft) 07/20/2012 Initial issued. 
Effective Date: 

July 20, 2012 

Revision No. 

0 (Draft) 

Document No. 

SCA-TR-PR2012-0012 

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

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TABLE OF CONTENTS 

List of Abbreviations and Acronyms.............................................................................................. 7 

1.0 Relevant Background Information...................................................................................... 9 

2.0 Review of OCAS-PER-012 Issues for Case #[Redacted]................................................. 12 

2.1 Background Information for Case #[Redacted].................................................... 12 

2.2 Comparison of NIOSH’s Original and Reworked Dose Reconstructions............ 12 

2.3 SC&A’s Review of OCAS-PER-012 Issues Related to Case #[Redacted] .......... 13 

3.0 Review of OCAS-PER-012 Issues for Case #[Redacted]................................................. 16 

3.1 Background Information for Case #[Redacted].................................................... 16 

3.2 Comparison of NIOSH’s Original and Reworked Dose Reconstructions............ 16 

3.3 SC&A’s Review of OCAS-PER-012 Issues Related to Case #[Redacted] .......... 17 

4.0 Review of OCAS-PER-012 Issues for Case #[Redacted]................................................. 20 

4.1 Background Information for Case #[Redacted].................................................... 20 

4.2 Comparison of NIOSH’s Original and Reworked Dose Reconstructions............ 20 

4.3 SC&A’s Review of OCAS-PER-012 Issues Related to Case #[Redacted] .......... 21 

5.0 Review of OCAS-PER-012 Issues for Case #[Redacted]................................................. 23 

5.1 Background Information for Case #[Redacted].................................................... 23 

5.2 Comparison of NIOSH’s Original and Reworked Dose Reconstructions............ 23 

5.3 SC&A’s Review of OCAS-PER-012 Issues Related to Case #[Redacted] .......... 24 

6.0 Review of OCAS-PER-012 Issues for Case #[Redacted]................................................. 27 

6.1 Background Information for Case #[Redacted].................................................... 27 

6.2 Comparison of NIOSH’s Original and Reworked Dose Reconstructions............ 27 

6.3 SC&A’s Review of OCAS-PER-012 Issues Related to Case #[Redacted] .......... 28 

7.0 Review of OCAS-PER-012 Issues for Case #[Redacted]................................................. 30 

7.1 Background Information for Case #[Redacted].................................................... 30 

7.2 Comparison of NIOSH’s Original and Reworked Dose Reconstructions............ 30 

7.3 SC&A’s Review of OCAS-PER-012 Issues Related to Case #[Redacted] .......... 31 

8.0 Review of OCAS-PER-012 Issues for Case #[Redacted]................................................. 33 

8.1 Background Information for Case #[Redacted].................................................... 33 

8.2 Comparison of NIOSH’s Original and Reworked Dose Reconstructions............ 33 

8.3 SC&A’s Review of OCAS-PER-012 Issues Related to Case #[Redacted] .......... 34 

9.0 Review of OCAS-PER-012 Issues for Case #[Redacted]................................................. 36 

9.1 Background Information for Case #[Redacted].................................................... 36 

9.2 Comparison of NIOSH’s Original and Reworked Dose Reconstructions............ 36 
Effective Date: 

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NOTICE:

9.3 SC&A’s Review of OCAS-PER-012 Issues Related to Case #[redacted] ........... 37 

10.0 Review of OCAS-PER-012 Issues for Case #[Redacted]................................................. 40 

10.1 Background Information for Case #[Redacted].................................................... 40 

10.2 Comparison of NIOSH’s Original and Reworked Dose Reconstructions............ 40 

10.3 SC&A’s Review of OCAS-PER-012 Issues Related to Case #016131................ 41 

11.0 Summary Conclusions ...................................................................................................... 43 

12.0 References......................................................................................................................... 45 
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LIST OF TABLES 

Table 1-1. Potential Categories of Dose Reconstructions ..................................................11 

Table 2-1. Comparison of NIOSH-Derived External/Internal Dose Estimates 

Assigned for the [Redacted] in the Original and Reworked Dose 

Reconstructions.................................................................................................13 

Table 2-2. Plutonium Intake Values Calculated for the Fitted and 

Coworker Periods of Exposure .........................................................................14 

Table 2-3. Comparison of Types S and SS Plutonium Doses for the [Redacted] and 

[Redacted] .........................................................................................................14 

Table 3-1. Comparison of NIOSH-Derived External/Internal Dose Estimates 

Assigned for the [Redacted] in the Original and Reworked Dose 

Reconstructions.................................................................................................17 

Table 3-2. Assumptions Used Calculating Internal Exposure to Plutonium......................18 

Table 4-1. Comparison of NIOSH-Derived External/Internal Dose Estimates 

Assigned to the [Redacted] System in the Original and Reworked Dose 

Reconstructions.................................................................................................20 

Table 5-1. Employment Periods .........................................................................................23 

Table 5-2. Comparison of NIOSH-Derived External/Internal Dose Estimates 

Assigned for the [Redacted] in the Original and Reworked Dose 

Reconstructions.................................................................................................24 

Table 5-3. Plutonium Intake Values...................................................................................25 

Table 6-1. Comparison of NIOSH-Derived External/Internal Dose Estimates 

Assigned for the [Redacted] in the Original and Reworked Dose 

Reconstructions.................................................................................................27 

Table 7-1. Comparison of NIOSH-Derived External/Internal Dose Estimates 

Assigned for the [rRedacted] in the Original and Reworked Dose 

Reconstructions.................................................................................................30 

Table 7-2. Summary of Intake............................................................................................31 

Table 8-1. Comparison of NIOSH-Derived External/Internal Dose Estimates 

Assigned for the [Redacted] in the Original and Reworked Dose 

Reconstructions.................................................................................................34 

Table 8-2. Plutonium Intake Values...................................................................................35 

Table 9-1. Comparison of NIOSH-Derived External/Internal Dose Estimates 

Assigned for the [Redacted] in the Original and Reworked Dose 

Reconstructions.................................................................................................36 

Table 9-2. Comparison of NIOSH-Derived External/Internal Dose Estimates 

Assigned for the [Redacted] in the Original and Reworked Dose 

Reconstructions.................................................................................................37 
Effective Date: 

July 20, 2012 

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NOTICE:

Table 9-3. Comparison of NIOSH-Derived External/Internal Dose Estimates 

Assigned for the [Redacted] in the Original and Reworked Dose 

Reconstructions.................................................................................................37 

Table 10-1. Employment Periods .........................................................................................40 

Table 10-2. Comparison of NIOSH-Derived External/Internal Dose Estimates 

Assigned for the [Redacted] in the Original and Reworked Dose 

Reconstructions.................................................................................................41 

Table 11-1. ORAUT-OTIB-0049 Dose Re-evaluation Criteria Used for the Nine 

Audited Dose Reconstructions..........................................................................43 
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LIST OF ABBREVIATIONS AND ACRONYMS 

Advisory Board 

or Board Advisory Board on Radiation and Worker Health 

Bq Becquerel 

CADW Chronic Annual Dose Workbook 

d day 

DOE U.S. Department of Energy 

DOL U.S. Department of Labor 

dpm disintegrations per minute 

DR Dose Reconstruction 

EE Energy Employee 

E&I Electric and Instrumentation 

ERR Excess Relative Risk 

FG fuel-grade 

g gram 

GI gastro-intestinal 

GSD geometric standard deviation 

ICD International Classification of Diseases 

ICRP International Commission on Radiological Protection 

IMBA Integrated Modules for Bioassay Analysis 

IREP Interactive RadioEpidemiological Program 

LLI lower large intestine 

LNET extrathoracic lymph nodes 

LNTH thoracic lymph nodes 

LOD limit of detection 

MDA minimum detectable activity 

MPBB Maximum Permissible Body Burden 

nCi nanocurie 

NIOSH National Institute for Occupational Safety and Health 

NTS Nevada Test Site 

OCAS Office of Compensation Analysis and Support [now the Division of 

Compensation and Analysis Support (DCAS)] 

ORAUT Oak Ridge Associated Universities Team 
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NOTICE:

PA Public Address 

pCi picocuries 

PER Program Evaluation Report 

POC Probability of Causation 

rem Roentgen equivalent man 

RFP Rocky Flats Plant 

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

SEC Special Exposure Cohort 

SRS Savannah River Site 

TBD Technical Basis Document 

TIB Technical Information Bulletin 

TTR Tonopah Test Range 

ULI upper large intestine 

WBC Whole-Body Count 

WG weapons-grade 

y year
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1.0 RELEVANT BACKGROUND INFORMATION 

During an Advisory Board meeting on October 22, 2009, SC&A was tasked by the Advisory 

Board on Radiation and Worker Health (Advisory Board or Board) to conduct a review of 

OCAS-PER-012, Evaluation of Highly Insoluble Plutonium Compounds. OCAS-PER-012 was 

initiated after the National Institute for Occupational Safety and Health (NIOSH) acknowledged 

the existence of highly insoluble plutonium at numerous Department of Energy (DOE) sites, 

which prompted an investigation into the potential impacts on organ doses to exposed workers. 

As a result of this investigation, NIOSH issued ORAUT-OTIB-0049, Rev. 00, Estimating Doses 

for Plutonium Strongly Retained in the Lung. This document provided guidance for reassessing 

organ doses for highly insoluble plutonium designated as Type Super S that have been shown to 

be retained in the lung longer than predicted by the International Commission on Radiological 

Protection (ICRP) Task Group Lung Model for Type S. Thereafter, OCAS-PER-012 was issued 

to determine which previously completed claims required re-evaluation for the affect of 

ORAUT-OTIB-0049. 

On March 18, 2010, SC&A submitted to the Procedures Subcommittee our review of NIOSH’s 

program evaluation report (PER) OCAS-PER-012 (SCA-TR-PR2010-0012, Rev. 0). In 

conducting a PER review, SC&A is committed to perform five subtasks, as specified below: 

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

on dose reconstruction (DR). Our 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 document(s) (e.g., white papers, technical 

information bulletins, 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 

selected for re-evaluation. The second step may have important implications in instances 

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

NIOSH’s re-evaluation 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 
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function(s) 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-stated 

subtasks, along with our review conclusions. 

This report fulfills the requirement defined in Subtask 4, “Conduct audits of DRs affected by the 

PER under review.” To determine the total population of claims that had the potential of being 

“affected” by ORAUT-OTIB-0049, NIOSH employed a set of criteria identified in Section 3.0 of 

OCAS-PER-012. Here, the word “affected” refers to all claims/DRs that (1) had been completed 

on or before February 6, 2007 (i.e., the date of issue for OTIB-0049), (2) involved facilities with 

potential exposure to Type SS plutonium, and (3) resulted in a probability of causation (POC) of 

less than 50%. Based on these criteria, NIOSH identified a total of 4,865 potential cases. 

Using two screening criteria identified in OCAS-PER-012, the number of potentially affected 

claims was reduced to 1,757. The first screening criterion that was applied to the 4,865 potential 

claims is defined by a threshold POC value of 45%. With the exception of the lung and thoracic 

lymph nodes (LNTH), the application of ORAUT-OTIB-0049 under the most conservative 

assumption (i.e., when the organ dose/POC was exclusively based on the internal exposure to 

Type SS plutonium) can be increased by a factor of 4. Thus, for the revised POC of 45% as a 

screening criterion, any of the 4,865 claims with POCs less than 16.97% (with the exception of 

lung and thoracic lymph node cancers noted above) can be eliminated from further consideration, 

as shown in Equation 1 below: 

POC

ERR

ERR  x 1 

100 Eq. 1 

For a revised POC to reach 45%, the Excess Relative Risk (ERR) must equal 0.81818, or 4 times 

the original ERR value of 0.20454, which corresponds to the original POC of 16.97%. 

A second screening criterion applied to the 4,865 total claims identified those claims for which 

either no plutonium dose (independent of solubility class) was assigned, or a plutonium intake 

was based on air monitoring data, but did not involve the lung or LNTH as target organs. 

When combined, the two screening criteria eliminated 3,108 cases from further consideration. 

Therefore, it was necessary for NIOSH to perform a dose re-evaluation for 1,757 claims from 

among the initial 4,865 total cases. 

In our review of OCAS-PER-012, SC&A concluded that the selection and screening criteria of 

claims described in Section 3.0 of OCAS-PER-012 are scientifically sound, inclusive of all 

potential variables affecting the original DR, and maximally conservative. To satisfy Subtask 4, 

SC&A indicated the need for dose re-evaluation for four groupings of target tissues that include 

(1) lungs and LNTH, (2) extrathoracic tissues of the respiratory tract, (3) tissues of the gastrointestinal (GI) tract, and (4) other systemic organs. The need for and the method for the reevaluation of dose in behalf of these four groupings is further dictated by the monitoring 

methods/data that were used in the original DR, which may have employed one of four possible 
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NOTICE:

options: (1) air sampling data, (2) urinalysis, (3) in-vivo lung counting, and (4) fecal analysis. 

Important to note is that for each of the four target organs/tissues, the prescribed method for dose 

re-evaluation differs. Thus, SC&A recommended that for OCAS-PER-012, a minimum of 10 

DRs are needed to assess at least 1 claim for each of the 10 permutations for dose re-evaluation, 

as shown in Table 1-1 below. However, this number could be reduced if there are no claims 

among the 1,757 cases of affected DRs that represent 1 or more of the 10 permutations. 

Table 1-1. Potential Categories of Dose Reconstructions 

Target Organ Urinalysis Lung Counts Fecal Sample Air Sampling 

Lung/LNTH Yes Yes Yes1 Yes 

Extrathoracic Yes No Yes2 No 

GI Tract Yes No Yes2 No 

Systemic Organs Yes No Yes2 No 1 Re-evaluation is required regardless of time interval between exposure and fecal sampling. 2 Re-evaluation is required only if time intervals are >2 months between end of exposure and fecal sampling. 

At the July 15, 2011, DR Subcommittee meeting, NIOSH provided the subcommittee members 

with a list of 50 cases from all potential categories specified in Table 1-1, with the exception of 

fecal sample monitoring for target organs extrathoracic and GI tract. From this list, 9 cases were 

selected for audit representing 8 of the 10 DR categories. 

It was determined by the Procedures Subcommittee that SC&A’s audit of selected DRs should be 

limited to evaluating those methods and corrective actions introduced in the reworked DRs that 

relate strictly to issues addressed in OCAS-PER-012. Presented in Section 2.0 through 

Section 10.0 below is SC&A focused review to determine whether reworked internal doses 

related to potential exposure to highly insoluble plutonium (Type Super S) were modified in 

accordance with OCAS-PER-012.
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2.0 REVIEW OF OCAS-PER-012 ISSUES FOR CASE #[REDACTED] 

2.1 BACKGROUND INFORMATION FOR CASE #[REDACTED] 

Case #[redacted] represents an energy employee (EE) who worked at the Oak Ridge National 

Laboratory (X-10) from [redacted], 1963, to [redacted], 1994. During this worker’s 

employment, the EE worked as a [redacted]. According to the telephone interview, the EE 

worked throughout the site, but primarily in the burial grounds and occasionally in hot cells, such 

as Building 3517. The EE was monitored for external photon, electron, and neutron exposures 

during employment. Internal exposure monitoring was also conducted by means of in-vitro 

urinalysis bioassays and one whole-body count (WBC). The EE was diagnosed with [redacted] 

cancer (ICD Code [redacted]) in [redacted] 1999. In May 2006, the EE was also diagnosed with 

[redacted] cancer (ICD Code [redacted]). 

2.2 COMPARISON OF NIOSH’S ORIGINAL AND REWORKED DOSE 

RECONSTRUCTIONS 

NIOSH performed the original DR of Case #[redacted] in April 2005. At that time, the EE had 

only been diagnosed with [redacted] cancer. The claim was reworked in November 2008 after 

the EE was also diagnosed with [redacted] cancer. Therefore, in addition to re-evaluating this 

case based on potential exposure to plutonium for Type Super S material, the case was also 

revised to evaluate the additional [redacted] cancer and utilized all current methods for DR. 

NIOSH indicated in both the original and revised DRs that the EE’s radiation dose was 

overestimated using claimant-favorable assumptions. External dose to the [redacted] was 

determined by using the dose calculated for the bladder. Internal dose to the [redacted] was 

determined by using the highest dose calculated for any non-metabolic organ. In the original 

DR, NIOSH calculated a dose of 43.59 rem to the [redacted]. Based on this assigned dose 

estimate, the Department of Labor (DOL) determined the POC to be 28.16% and the claim was 

denied. 

Using the most current technical guidance documents and considering Type Super S plutonium, 

a [redacted] dose of 18.244 rem was calculated in the revised DR. Table 2-1 provides a 

comparison of the original and revised external and internal organ dose estimates for the 

[redacted]. It should be noted that the values cited in Table 2-1 were extracted directly from 

NIOSH’s reworked DR. With the exception of internal doses from plutonium, SC&A has not 

assessed the accuracy/correctness of these doses, since performing such an assessment is beyond 

the scope of this Subtask 4 report. 
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Table 2-1. Comparison of NIOSH-Derived External/Internal Dose Estimates Assigned 

for the [Redacted] in the Original and Reworked Dose Reconstructions 

Dose Categories Previous Dose (rem) Revised Dose (rem)

External (photon) 3.994 3.379 

External (neutron) 21.081 11.498 

Missed photon (external) 0.838 0.620 

Missed neutron (external) 3.304 1.570 

Onsite Ambient 0.203 0.203 

Medical X-ray 0.015 0.015 

Internal 14.155 0.958 

Total 43.590 18.244 

In addition to the [redacted] doses cited in Table 2-1, external and internal doses to the 

[redacted] were also included in the reworked case. The internal dose was based on a 

comparison of doses calculated for the [redacted], [redacted], and the [redacted]. It was 

determined that the [redacted] provided the highest internal doses and was used for the DR. 

Using the EE’s DOE records and claimant-favorable assumptions, a dose of 19.508 rem was 

assigned to the [redacted]. The combined [redacted] doses of 37.752 rem resulted in a POC of 

34.71%, and the revised claim was denied. 

2.3 SC&A’S REVIEW OF OCAS-PER-012 ISSUES RELATED TO CASE 

#[REDACTED] 

As directed by the Procedures Subcommittee, SC&A’s review of Case #[redacted] strictly 

focused on internal doses calculated in behalf of exposure to plutonium. Case #[redacted] was 

included in the pool of claims that required the DR to be reworked for evaluation of potential 

exposure to Type Super S plutonium, since it met the OCAS-PER-012 criteria of (1) original DR 

was performed prior to February 6, 2007, (2) the EE worked at a site with the potential for a 

highly insoluble form of plutonium, and (3) the POC was less than 50%, but greater than 

16.97%. This case was selected by the DR Subcommittee because it represented an individual 

who was monitored via urinalyses for assessing doses to both a GI tract organ and a systemic 

organ. 

Internal dose monitoring records identified numerous urinalyses for strontium, plutonium, and 

uranium from 1963 through 1968 with results above the site detection level. However, even 

though there were positive bioassays, internal doses in the original DR ([redacted] cancer) were 

calculated based on a maximizing hypothetical internal dose using ORAUT-OTIB-0002. This 

hypothetical model assumes an intake of 28 radionuclides, which includes plutonium-238 and 

plutonium-239, on the first day of employment and is only used for non-compensable cases. The 

hypothetical inhalation intake is based on 10% of the Maximum Permissible Body Burden 

(MPBB). For both Pu-238 and Pu-239, the derived intake value that is used in Integrated 

Modules for Bioassay Analysis (IMBA) is 80 nCi with solubility Type M. 

In the reworked DR, NIOSH identified that the EE was monitored for plutonium on three 

occasions, once in [redacted] and twice in [redacted]. Using these data and the IMBA computer 

code, NIOSH calculated a fitted chronic intake of plutonium-239. For the period of 1969 

through the end of employment, coworker intakes were used to estimate plutonium dose, as 
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specified in the Technical Information Bulletin (TIB) Internal Dosimetry Coworker Data for X10 (ORAUT-OTIB-0034). For both the fitted and coworker periods, solubility class Types M 

and S were evaluated and compared. It was determined that the Type S plutonium provided the 

highest dose, which resulted in estimated daily intakes of plutonium for the two periods as shown 

in Table 2-2. In addition, Type Super S plutonium adjustment factors were applied in 

accordance with ORAUT-OTIB-0049. A comparison of the Type S dose and Type SS dose is 

shown in Table 2-3. 

Table 2-2. Plutonium Intake Values Calculated for the Fitted and 

Coworker Periods of Exposure 

Radionuclide Period Start End Intake Unit/Rate 

Plutonium-239 Fitted [redacted] [redacted] 352.94 dpm per day 

Plutonium-239 Coworker [redacted] [redacted] 138.1 dpm per day 

Table 2-3. Comparison of Types S and SS Plutonium Doses for the [Redacted] and 

[Redacted] 

Cancer Period Start End Type S Dose 

(rem) 

Type SS Dose 

(rem) 

[Redacted] Fitted [redacted] [redacted] 0.118 0.452 

[Redacted] Coworker [redacted] [redacted] 0.110 0.207 

[Redacted] ([redacted]) Fitted [redacted] [redacted] 0.174 0.588 

[Redacted] ([redacted]) Coworker [redacted] [redacted] 0.212 0.453 

The total internal dose assigned for potential exposure to plutonium was 0.659 rem to the 

[redacted] and 1.041 rem to the [redacted]. As identified in Table 2-3, the [redacted] dose was 

calculated using the [redacted] as a surrogate organ, since it resulted in the higher Type S and 

Type SS dose. It should also be noted that the significant reduction in total internal dose (see 

Table 2-1) is the result of using a 28-radionuclide hypothetical intake dose in the original DR 

versus determining dose based on fitted and missed (coworker) bioassay data in the reworked 

DR. 

In evaluating this case, SC&A reviewed the guidance provided in ORAUT-OTIB-0049 for 

assessing the fitted and coworker exposure to Type SS material specifically for systemic organs 

(i.e., [redacted]) using urinalyses as the monitoring method. For the convenience of the reader, 

this guidance is cited below: 

Systemic Organs 

Type SS material is absorbed into the blood stream at a slower rate than Type S 

material, which results in lower levels of material in the systemic organs and in 

the urine. Assuming that the doses to systemic organs are roughly proportional to 

the urinary excretion rate, organ doses determined from urine data are the same 

for Type S and Type SS materials during the period of time that urine data are 

available. However, for the period of time after the last urinalysis is available, 

the Type SS model would predict a much slower decrease in urine due to the 

continuing input to the bloodstream from the material contained in the [redacted]. 
Effective Date: 

July 20, 2012 

Revision No. 

0 (Draft) 

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Page No. 

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NOTICE:

Therefore, the predicted integrated urine content (and hence systemic organ dose) 

must be adjusted after the time of the last urine bioassay measurement. 

Unmonitored Individual (Coworker Data) 

Because the adjustment is based on intake rather than dose, the factor is applied 

to the time following the period used to determine the coworker intake rate rather 

than the worker’s exposure period. For example, given a set of site urinalysis 

data from 1974 through 1980 (7 years), and an individual who worked from Jan. 

1, 1975 to Dec. 31, 1979 (5 years), the adjustment would be applied beginning in 

year 7 (relative to the start of worker exposure). 

Along with reviewing the ORAUT-OTIB-0049 guidance, SC&A analyzed the bioassay records, 

the X-10 coworker dose guidance, all IMBA runs, and Chronic Annual Dose Workbook 

(CADW) worksheets for Case #[redacted]. It was also determined that NIOSH used the OTIB0049 Workbook for assessing the coworker portion of the dose. Based on our review, we were 

able to verify that NIOSH’s assumptions were appropriate and data were entered into IMBA and 

the OTIB-0049 Workbook correctly. We also verified the Interactive RadioEpidemiological 

Program (IREP) input, which was entered with the appropriate distribution and parameters. 

SC&A found that the rework was done in accordance with guidance provided in ORAUT-OTIB0049, and has no findings with NIOSH’s methodology for assessing the EE’s exposure to highly 

insoluble plutonium and the resulting estimated doses.
Effective Date: 

July 20, 2012 

Revision No. 

0 (Draft) 

Document No. 

SCA-TR-PR2012-0012 

Page No. 

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3.0 REVIEW OF OCAS-PER-012 ISSUES FOR CASE #[REDACTED] 

3.1 BACKGROUND INFORMATION FOR CASE #[REDACTED] 

Case #[redacted] represents an energy employee (EE) who worked at the Nevada Test Site 

(NTS) for [redacted], and again from [redacted]. During employment, the EE worked as a 

[redacted]. According to the telephone interview, the EE worked at the Tonopah Test Range 

(TTR) in the years 1989 through 1993, and was monitored for external photon and electron 

exposures for a portion of employment. Internal exposure monitoring was also conducted in 

1993 by means of one WBC and one fecal sample. The EE was diagnosed with [redacted] 

cancer (ICD Code [redacted]) in [redacted] 1997. In [redacted] 1998, the EE was also diagnosed 

with [redacted] cancer (ICD Code [redacted]). At the time of the [redacted] cancer diagnosis, the 

EE was reported to be a [redacted]). 

3.2 COMPARISON OF NIOSH’S ORIGINAL AND REWORKED DOSE 

RECONSTRUCTIONS 

NIOSH performed the original DR of Case #[redacted] in April 2005. The claim was reworked 

in September 2009. In addition to re-evaluating this case based on potential exposure to 

plutonium for Type Super S material, the case was also revised utilizing all current methods for 

DR, which included a revision to the NTS Technical Basis Document (TBD) and a TTR site 

profile that was not available during the initial DR. 

NIOSH indicated in both the original and revised DRs that the EE’s radiation dose was 

overestimated using efficiency measures and claimant-favorable assumptions. External dose to 

the [redacted] was determined by using the dose calculated for the bladder. Internal dose to the 

[redacted] was determined by using the highest dose calculated for any non-metabolic organ. In 

the original DR, NIOSH calculated a dose of 1.302 rem to the [redacted] and 4.444 rem to the 

[redacted]. Based on this assigned dose estimate, the DOL determined the POC to be 4.45% 

and the claim was denied. 

Using the most current technical guidance documents and considering Type Super S plutonium, 

a [redacted] dose of 0.384 rem and [redacted] dose of 2.340 was calculated in the revised DR. 

Table 3-1 provides a comparison the original and revised external and internal organ dose 

estimates for both organs of interest. It should be noted that the values cited in Table 3-1 were 

extracted directly from NIOSH’s reworked DR. With the exception of internal doses from 

plutonium, SC&A has not assessed the accuracy/correctness of these doses, since performing 

such an assessment is beyond the scope of this Subtask 4 report. 
Effective Date: 

July 20, 2012 

Revision No. 

0 (Draft) 

Document No. 

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Page No. 

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Table 3-1. Comparison of NIOSH-Derived External/Internal Dose Estimates Assigned 

for the [Redacted] in the Original and Reworked Dose Reconstructions 

Dose Categories External (includes dosimeter, 

missed, and unmonitored) 

Onsite 

Ambient

Medical 

X-Ray Internal Total

[redacted] Previous 0.496 0.692 0.002 0.112 1.302 

1997 Revised 0.200 0.170 0.001 0.012 0.384 

[redacted] Previous 0.452 0.692 0.562 2.737 4.444 

1998 Revised 0.197 0.170 0.391 1.582 2.340 

The combined [redacted] and [redacted] dose of 2.724 rem resulted in a POC of 1.50% and the 

revised claim was denied. 

3.3 SC&A’S REVIEW OF OCAS-PER-012 ISSUES RELATED TO CASE 

#[REDACTED] 

As directed by the Procedures Subcommittee, SC&A’s review of Case #[redacted] strictly 

focused on internal doses calculated in behalf of exposure to plutonium. Case #[redacted] was 

included in the pool of claims that required the DR to be reworked for evaluation of potential 

exposure to Type Super S plutonium, since it met the OCAS-PER-012 criteria of (1) original DR 

was performed prior to February 6, 2007, (2) the EE worked at NTS, which is a site with the 

potential for a highly insoluble form of plutonium, and (3) the POC was less than 50%. The DR 

Subcommittee selected this case because it represented an individual who was monitored via 

fecal sampling for assessing doses to both the [redacted] and a systemic organ. 

Internal dose monitoring records identified that the EE had two bioassay measurements 

throughout employment. One WBC was performed in September 1993 and one fecal sample 

was collected in November 1993, which coincide with the end of the EE’s work assignment at 

the TTR. The fecal sample was analyzed for Pu-239 and gamma, and the results were reported 

as ‘non detected.’ No internal dose was assigned from these bioassays, indicating that the results 

were insignificant. Therefore, in the original DR, internal dose was assigned based on 

environmental airborne radionuclide concentrations, as specified in the NTS TBD. This resulted 

in the assignment of a total internal dose of 0.112 rem and 2.737 rem to the [redacted] and 

[redacted], respectively. 

In the reworked DR, NIOSH accounted for the ‘non detect’ Pu-239 result from the fecal sample 

by calculating a missed dose using one-half the fecal detection limit of 0.004 pCi/g. This was 

adjusted to a standard fecal excretion rate of 135 g per day, which resulted in an assumed 

measurement rate of 0.27 pCi/day. Using IMBA, intake values for the [redacted] and [redacted] 

were calculated as shown in Table 3-2. Doses were calculated for both absorption Types M and 

S, with Type S resulting in the highest dose to the [redacted] and Type M resulting in the highest 

dose to the [redacted]. This resulted in a missed bioassay dose of 0.155 rem to the [redacted] and 

0.001 rem to the [redacted]. 

In addition, the rework assigned environmental intakes for employment at the NTS and TTR 

based on the NTS TBD (ORAUT-TKBS-0008-4), as shown in Table 3-2. To account for Type 

Super S plutonium, both the missed bioassay doses and the environmental doses were multiplied 
Effective Date: 

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by ORAUT-OTIB-0049 Attachment D [Redacted] Dose Adjustment Factors. The adjustments to 

dose were made using the OTIB-0049 workbook. 

Table 3-2. Assumptions Used Calculating Internal Exposure to Plutonium 

Radionuclide Source Intake Distribution applied

Plutonium-239 ([redacted]) fecal 5.77 × 10-1 pCi/day triangular 

Plutonium-239 ([redacted]) fecal 6.39 × 10-1 pCi/day triangular 

Plutonium-238 TTR Environmental 2 × 10-4 Bq/year Lognormal GSD of 2 

Plutonium-239/-240 TTR Environmental 1 × 10-4 Bq/year Lognormal GSD of 2 

Plutonium-238 NTS Environmental 3.47x10-1 Bq/year Constant 

Plutonium-239/-240 NTS Environmental 3.81x10-1 Bq/year Constant 

Based on these assumptions, NIOSH calculated a total missed plutonium dose of 0.959 rem to 

the [redacted] and 0.001 rem to the [redacted]. 

 

In evaluating this case, SC&A reviewed the guidance provided in ORAUT-OTIB-0049 for 

assessing exposure to Type SS material specifically for the 2 target organs (i.e., [redacted] and 

systemic organ) using fecal bioassay as the monitoring method. According to Section 4.1.4 of 

OTIB-0049, fecal samples collected less than 2 months after the end of a chronic intake should 

be evaluated using air monitoring data. For the convenience of the reader, this guidance is cited 

below: 

[Redacted] Dose 

In cases where the intake is derived from air monitoring, the intake is based on 

direct measurements. For Type SS material, the annual dose to the [redacted]

(including the [redacted]) will be underestimated if one assumes a Type S model 

because of the longer retention time. Therefore, annual [redacted] doses 

calculated with the Type S model are multiplied by dose adjustment factors. 

These factors are given in Attachment D for each year from 1 to 65 for 46 

different intake scenarios. The scenarios are based on the period of intake, 

specifically acute and chronic intake periods from 1 to 65 years in 1-year 

intervals. Because the dose adjustment factors decrease as the chronic exposure 

period increases, for chronic intakes for partial years, dose reconstructors should 

truncate the partial year and use the dose adjustment factor table for the full 

year; for instance, if the intake period is 4.5 years, use the dose adjustment 

factors for a 4-year chronic intake. 

Systemic Organs 

For a given intake, the dose to the systemic organs from a Type Super S material 

will be less than that from Types M or S because the material will be retained in 

the [redacted] longer; the material will be transported to the systemic organs 

more slowly. Therefore, the assumption that the dose from Type Super S is equal 

to that from Type S is favorable to the claimant. 
Effective Date: 

July 20, 2012 

Revision No. 

0 (Draft) 

Document No. 

SCA-TR-PR2012-0012 

Page No. 

19 of 46

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

NOTICE:

Along with reviewing the ORAUT-OTIB-0049 guidance, SC&A analyzed the EE’s bioassay 

records, all IMBA runs, and the CADW worksheets for Case #[redacted]. Based on our review, 

we were able to verify that NIOSH’s assumptions were appropriate, and data were entered into 

IMBA and the OTIB-0049 workbook correctly. We also verified the IREP input, which was 

entered with the appropriate distribution and parameters. SC&A found that the rework was done 

in accordance with guidance provided in ORAUT-OTIB-0049 and has no findings with 

NIOSH’s methodology for assessing the EE’s exposure to highly insoluble plutonium and the 

resulting estimated doses.
Effective Date: 

July 20, 2012 

Revision No. 

0 (Draft) 

Document No. 

SCA-TR-PR2012-0012 

Page No. 

20 of 46

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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. 

4.0 REVIEW OF OCAS-PER-012 ISSUES FOR CASE #[REDACTED] 

4.1 BACKGROUND INFORMATION FOR CASE #[REDACTED] 

Case #[redacted] represents an energy employee (EE) who worked at the Pantex Plant from 

[redacted], to the present. According to the telephone interview, the EE worked as a [redacted] 

throughout employment and worked throughout the site. The EE was monitored for external 

photon and neutron exposures starting in May 1989 and through the date of cancer diagnosis. 

Internal exposure monitoring was not conducted. The EE was diagnosed with [redacted] 

([redacted]) (ICD Code [redacted]) in [redacted]. 

4.2 COMPARISON OF NIOSH’S ORIGINAL AND REWORKED DOSE 

RECONSTRUCTIONS 

NIOSH performed the original DR of Case #[redacted] in November 2003. The claim was 

reworked in November 2007. This DR was reworked after it was determined that the internal 

and external dosimetry target organs used for several forms of [redacted] should be changed, as 

specified in OCAS-PER-009. During this revision, the case was also evaluated for exposure to 

plutonium for Type Super S material. 

NIOSH indicated in both the original and revised DRs that the EE’s radiation dose was 

overestimated using efficiency measures and claimant-favorable assumptions. External dose to 

the [redacted] system was determined by using the dose calculated for the thyroid. Internal dose 

was determined by using the [redacted]. In the original DR, NIOSH calculated a dose of 

12.607 rem to the [redacted] system. Based on this assigned dose estimate, the DOL determined 

the POC to be 1.97% and the claim was denied. 

Using the most current technical guidance documents and considering Type Super S plutonium, 

a total dose of 5.944 rem was calculated in the revised DR. Table 4-1 provides a comparison of 

the original and revised external and internal organ dose estimates for the [redacted] system. It 

should be noted that the values cited in Table 4-1 were extracted from NIOSH’s original and 

reworked DRs. With the exception of internal doses from plutonium, SC&A has not assessed 

the accuracy/correctness of these doses, since performing such an assessment is beyond the 

scope of this Subtask 4 report. 

Table 4-1. Comparison of NIOSH-Derived External/Internal Dose Estimates Assigned 

to the [Redacted] System in the Original and Reworked Dose Reconstructions 

Dose Categories Previous Dose (rem) Revised Dose (rem)

External (photon) 2.520 1.507 

External (neutron) – 3.864 

Medical X-ray 0.581 – 

Internal 8.966 0.573 

Total 12.067 5.944 

The revised dose of 5.944 rem resulted in a POC of 0.43% and the claim was denied. 
Effective Date: 

July 20, 2012 

Revision No. 

0 (Draft) 

Document No. 

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Page No. 

21 of 46

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

4.3 SC&A’S REVIEW OF OCAS-PER-012 ISSUES RELATED TO CASE 

#[REDACTED] 

As directed by the Procedures Subcommittee, SC&A’s review of Case #[redacted] strictly 

focused on internal doses calculated in behalf of exposure to plutonium. Case #[redacted] was 

included in the pool of claims that required the DR to be reworked for evaluation of potential 

exposure to Type Super S plutonium, since it met the OCAS-PER-012 criteria of (1) original DR 

was performed prior to February 6, 2007, (2) the EE worked at a site with the potential for a 

highly insoluble form of plutonium, and (3) the POC was less than 50%. This case was selected 

by the DR Subcommittee because it represented an individual whose doses were calculated for 

the [redacted] (including [redacted]). 

Internal dose records contained no bioassay monitoring results. In the original DR, internal 

doses were calculated based on a maximizing hypothetical internal dose using ORAUT-OTIB0002. This hypothetical model assumes an intake of 28 radionuclides on the first day of 

employment, which includes plutonium-238 and plutonium-239, and is only used for noncompensable cases. 

Since the EE did not participate in the bioassay monitoring program, the reworked DR assigned 

internal doses based on Table 5-19 of the Pantex Occupational Internal Dose TBD (ORAUTTKBS-0013-5), which assumes default intakes based on occupation and job description. 

Considering the EE’s job function of [redacted], the EE was assumed to be a category 2 worker. 

In accordance with the Pantex TBD, a plutonium-239 intake of 29 pCi/y, Type S absorption, was 

used as input to the IMBA computer code, which resulted in a dose to the [redacted] system of 

0.026 rem. In addition, Type Super S plutonium adjustment factors were applied in accordance 

with ORAUT-OTIB-0049, which resulted in a total Pu-239 dose of 0.070 rem. 

In evaluating this case, SC&A reviewed the guidance provided in ORAUT-OTIB-0049 for 

assessing exposure to Type SS material specifically for a target organ associated with the 

[redacted]. For the convenience of the reader, this guidance is cited below: 

[Redacted] Dose 

In cases where the intake is derived from air monitoring, the intake is based on 

direct measurements. For Type SS material, the annual dose to the [redacted]

(including [redacted]) will be underestimated if one assumes a Type S model 

because of the longer retention time. Therefore, annual [redacted] doses 

calculated with the Type S model are multiplied by dose adjustment factors. 

These factors are given in Attachment D for each year from 1 to 65 for 46 

different intake scenarios. The scenarios are based on the period of intake, 

specifically acute and chronic intake periods from 1 to 65 years in 1-year 

intervals. Because the dose adjustment factors decrease as the chronic exposure 

period increases, for chronic intakes for partial years, dose reconstructors should 

truncate the partial year and use the dose adjustment factor table for the full 

year; for instance, if the intake period is 4.5 years, use the dose adjustment 

factors for a 4-year chronic intake. 
Effective Date: 

July 20, 2012 

Revision No. 

0 (Draft) 

Document No. 

SCA-TR-PR2012-0012 

Page No. 

22 of 46

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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. 

NOTICE:

Along with reviewing the ORAUT-OTIB-0049 guidance, SC&A examined the IMBA run and 

CADW worksheet for Case #[redacted]. It was determined that NIOSH used the OTIB-0049 

workbook for assessing the Type SS dose. Based on our review, we were able to verify that 

NIOSH’s assumptions were appropriate and data were entered into IMBA and the OTIB-0049 

workbook correctly. We also verified the IREP input, which was entered with the appropriate 

distribution and parameters. SC&A found that the rework was done in accordance with guidance 

provided in ORAUT-OTIB-0049, and has no findings with NIOSH’s methodology for assessing 

the EE’s exposure to highly insoluble plutonium and the resulting estimated dose. 
Effective Date: 

July 20, 2012 

Revision No. 

0 (Draft) 

Document No. 

SCA-TR-PR2012-0012 

Page No. 

23 of 46

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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. 

5.0 REVIEW OF OCAS-PER-012 ISSUES FOR CASE #[REDACTED] 

5.1 BACKGROUND INFORMATION FOR CASE #[REDACTED] 

Case #006747 represents an energy employee (EE) who worked at the Savannah River Site 

(SRS) during [redacted] discrete employment periods that extended from [redacted], to 

[redacted], which are detailed below in Table 5-1. During this worker’s employment, the EE’s 

job function was a [redacted]. According to the telephone interview, the EE worked throughout 

the site in any areas requiring [redacted] pouring, including Areas 321M, 105, 100K, 100L, 

200F, and 200H. 

Table 5-1. Employment Periods 

Start End 

[Redacted], 1951 [Redacted], 1955 

[Redacted], 1965 [Redacted], 1965 

[Redacted], 1967 [Redacted], 1968 

[Redacted], 1968 [Redacted], 1969 

[Redacted], 1969 [Redacted], 1970 

[Redacted], 1970 [Redacted], 1971 

[Redacted], 1971 [Redacted], 1976 

The EE was monitored for external photon, electron, and neutron exposures during employment. 

Internal exposure monitoring was also conducted by means of in-vitro urinalysis bioassays. The 

EE was diagnosed with [redacted] cancer (ICD Code [redacted]) in [redacted] 1975. At the time 

of diagnosis, it was reported that the EE [redacted] per day. 

5.2 COMPARISON OF NIOSH’S ORIGINAL AND REWORKED DOSE 

RECONSTRUCTIONS 

NIOSH performed the original DR of Case #[redacted] in January 2006. The claim was 

reworked in December 2008 to re-evaluate this case based on potential exposure to plutonium for 

Type Super S material. Both the original and revised DRs stated that the EE’s radiation dose 

was overestimated using claimant-favorable assumptions. In the original DR, NIOSH calculated 

a dose of 69.000 rem to the [redacted]. Based on this assigned dose estimate, the DOL 

determined the POC to be 25.67% and the claim was denied. 

Using the most current technical guidance documents and considering Type Super S plutonium, 

a [redacted] dose of 340.801 rem was recalculated in the revised DR. Table 5-2 provides a 

comparison of the original and revised external and internal organ dose estimates for the 

[redacted]. It should be noted that the values cited in Table 5-2 were extracted directly from 

NIOSH’s reworked DR. With the exception of internal doses from plutonium, SC&A has not 

assessed the accuracy/correctness of these doses, since performing such an assessment is beyond 

the scope of this Subtask 4 report. 
Effective Date: 

July 20, 2012 

Revision No. 

0 (Draft) 

Document No. 

SCA-TR-PR2012-0012 

Page No. 

24 of 46

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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. 

Table 5-2. Comparison of NIOSH-Derived External/Internal Dose Estimates Assigned 

for the [Redacted] in the Original and Reworked Dose Reconstructions 

Dose Categories Previous Dose (rem) Revised Dose (rem)

External Measured/Missed 11.039 7.508 

Unmonitored 7.190 5.328 

Ambient External 1.314 1.183 

Medical X-ray 3.546 3.501 

Internal 45.911 323.282 

Total 69.000 340.801 

Using the EE’s DOE records and claimant-favorable assumptions, a [redacted] dose of 340.801 

rem resulted in a POC of 40.83% and on this basis, the revised claim was denied. 

5.3 SC&A’S REVIEW OF OCAS-PER-012 ISSUES RELATED TO CASE 

#[REDACTED] 

As directed by the Procedures Subcommittee, SC&A’s review of Case #[redacted] strictly 

focused on internal doses calculated in behalf of exposure to plutonium. Case #[redacted] was 

included in the pool of claims that required the DR to be reworked for evaluation of potential 

exposure to Type Super S plutonium, since it met the OCAS-PER-012 criteria of (1) original DR 

was performed prior to February 6, 2007, (2) the EE worked at a site with the potential for a 

highly insoluble form of plutonium, and (3) the POC was less than 50%, but greater than 

16.97%. This case was selected by the DR Subcommittee because it represented an individual 

who was monitored via urinalyses for assessing doses to the [redacted]. 

Internal dose monitoring records identified several urinalyses for tritium, plutonium, and fission 

products from 1968 through 1971, with results below their reporting levels. Even though there 

were no positive bioassays, the original DR made the claimant-favorable assumption that the EE 

was exposed to Type S weapons-grade (WG) plutonium from the time the EE returned to work 

in [redacted] until the date of cancer diagnosis. The intake of WG plutonium was determined 

using the reporting level limit of detection divided by 2 (LOD/2) specific to the each bioassay as 

found in the EE’s records. Using these data and the IMBA computer code, NIOSH calculated a 

missed chronic intake of plutonium-239. Once the plutonium alpha intake rate was determined, 

the plutonium-238, plutonium-239, plutonium-241, and americium-241 intake rates were 

calculated assuming the 10-year aged 12% (plutonium-240) plutonium mix ratios presented in 

the SRS TBD. Additionally, the original DR assigned environmental Pu-238 dose to the EE 

using the maximum 50th percentile site-wide annual intakes. 

In the reworked DR, NIOSH identified that the EE was monitored for plutonium on five 

occasions between 1968 and 1971. To account for doses associated with the negative urinalyses 

reported, NIOSH limited their missed dose assignment to a chronic intake beginning [redacted], 

through [redacted]. NIOSH began their dose calculation using the same assumptions and 

methodology as the original DR. Plutonium intake values for assessing missed dose and 

environmental dose (discussed below) are presented in Table 5-3. To account for Type Super S 

plutonium, the original annual doses were multiplied by ORAUT-OTIB-0049 Attachment D 

[Redacted] Dose Adjustment Factors, assuming a chronic 3-year intake. In addition, a urinalysis 

adjustment factor of 4 was applied to the annual dose calculations in accordance with ORAUT-
Effective Date: 

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OTIB-0049 recommendations. Both adjustments to dose were made in the OTIB-0049 

workbook. This resulted in a total missed plutonium dose of 320.941 rem. 

In addition, the reworked DR made adjustments to the assigned environmental dose assigned to 

the EE. NIOSH established the years that the EE was and was not employed at SRS, then used 

the SRS TBD Table C-17 to determine the 50th percentile maximum environmental intakes of 

Pu-238 during each period. Each of the intake periods were then adjusted using the ORAUTOTIB-0049 Attachment D [Redacted] Dose Adjustment Factors and the results were summed 

annually. No environmental dose was assigned to 1952 and 1953, because the SRS site profile 

indicated that the risk of plutonium exposure did not begin until 1954. This resulted in the 

environmental Type Super S plutonium dose of 0.907 rem. 

Table 5-3. Plutonium Intake Values 

Radionuclide Dose Type Start End Intake Unit/Rate

Pu-238 Missed [Redacted] [Redacted] 32.98 dpm per day 

Pu-239 Missed [Redacted] [Redacted] 166.59 dpm per day 

Pu-241 Missed [Redacted] [Redacted] 3987.2 dpm per day 

Am-241 Missed [Redacted] [Redacted] 81.21 dpm per day 

Pu-238 Environmental [Redacted] [Redacted]

a 24.6 Bq per yr 

Pu-238 Environmental [Redacted] [Redacted]

b 0.0419 Bq per yr 

Pu-238 Environmental [Redacted] [Redacted] 4.82 Bq per yr 

a [Redacted]–[Redacted] are excluded, because the EE had no employment periods during the time interval. 

b [Redacted] is excluded from environmental dose, because the EE had no employment periods during the 

year.

Based on these intake values, the total internal dose assigned for potential exposure to plutonium 

was 321.848 rem to the [redacted]. 

In evaluating this case, SC&A reviewed the guidance provided in ORAUT-OTIB-0049 for 

assessing exposure to Type SS material specifically for the target organ (i.e., [redacted]) using 

urinalyses as the monitoring method. For the convenience of the reader, this guidance is cited 

below: 

[Redacted] 

To calculate Type SS [redacted] doses from urinary excretion measurements, the 

annual dose to the [redacted] for the years of interest is first calculated from 

urinary excretion data using the standard Type S model. The urinary excretion 

data can consist of measured results and/or results less than the reporting level. 

The annual [redacted] doses calculated with the Type S model are then multiplied 

by the dose adjustment factors in Attachment D. This adjustment accounts for the 

longer retention of Type SS material in the [redacted], but it does not address the 

lower urinary excretion rate expected from Type SS material. 

To account for the lower excretion rate expected from Type SS material, the 

approach adopted here is to apply a single bounding correction factor of 4 (which 
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NOTICE:

is derived in Attachment C) to adjust the intake of Type S material upward to an 

intake of Type SS material. This “intake adjustment” increases the thoracic 

doses determined from urinalysis with the Type S model by a factor of 4 and is 

applied in addition to the Attachment D adjustment factors that account for 

increased retention in the [redacted]. 

Along with reviewing the ORAUT-OTIB-0049 guidance, SC&A analyzed the bioassay records, 

all IMBA runs, and the CADW worksheets for Case #[redacted]. SC&A was able to verify that 

NIOSH’s assumptions were appropriate and claimant favorable and data were entered into 

IMBA and the OTIB-0049 workbook correctly. SC&A also verified the IREP input, which 

indicated that the doses were entered with the appropriate distribution and uncertainty 

parameters. SC&A found that the rework was done in accordance with guidance provided in 

ORAUT-OTIB-0049, and has no findings with NIOSH’s methodology for assessing the EE’s 

exposure to highly insoluble plutonium and the resulting estimated doses. 

It should be noted that under the SRS Special Exposure Cohort (SEC), granted March 3, 

2012, this case would qualify for SEC status and thus be eligible for compensation. 
Effective Date: 

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6.0 REVIEW OF OCAS-PER-012 ISSUES FOR CASE #[REDACTED] 

6.1 BACKGROUND INFORMATION FOR CASE #[REDACTED] 

Case #[redacted] represents an energy employee (EE) who worked at the SRS during 2 discrete 

employment periods: [redacted], through [redacted], and [redacted], through [redacted]. The 

EE’s job function during the first employment period was [redacted] and [redacted] during the 

second employment period. According to the telephone interview, the EE worked throughout 

the site, including area T-1 while a [redacted], and the F and H areas, the canyons, tank farm, 

burial grounds and reactors 100P, 100L, and 100K while a [redacted]. 

The EE was monitored for external photon and electron exposures during employment. Internal 

exposure monitoring was also conducted by means of in-vitro urinalysis bioassays. The EE was 

diagnosed with [redacted] cancer (ICD Code [redacted]) on [redacted], 1996. At the time of 

diagnosis, it was reported that the EE was a former [redacted]. 

6.2 COMPARISON OF NIOSH’S ORIGINAL AND REWORKED DOSE 

RECONSTRUCTIONS 

NIOSH performed the original DR of Case #[redacted] in December 2005. The claim was 

reworked in October 2008 to re-evaluate this case based on potential exposure to plutonium for 

Type Super S material; both the original and revised DRs stated that the EE’s radiation dose was 

overestimated using claimant-favorable assumptions. In the original DR, NIOSH calculated a 

dose of 32.378 rem to the [redacted]. Based on this assigned dose estimate, the DOL 

determined the POC to be 44.36% and the claim was denied. 

Using the most current technical guidance documents and considering Type Super S plutonium, 

a [redacted] dose of 36.319 rem was recalculated in the revised DR. Table 6-1 provides a 

comparison of the original and revised external and internal organ dose estimates for the 

[redacted]. It should be noted that the values cited in Table 6-1 were extracted directly from 

NIOSH’s reworked DR. With the exception of internal doses from plutonium, SC&A has not 

assessed the accuracy/ correctness of these doses, since performing such an assessment is beyond 

the scope of this Subtask 4 report. 

Table 6-1. Comparison of NIOSH-Derived External/Internal Dose Estimates Assigned 

for the [Redacted] in the Original and Reworked Dose Reconstructions 

Dose Categories Previous Dose (rem) Revised Dose (rem)

External Measured 0.480 0.468 

External Missed 0.263 0.338 

Ambient External 0.697 0.697 

Medical X-ray 2.669 2.669 

Internal 28.270 32.148 

Total 32.378 36.319 

Using the EE’s DOE records and claimant-favorable assumptions, a [redacted] dose of 36.319 

rem resulted in a POC of 44.86% and on this basis, the revised claim was denied. 
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6.3 SC&A’S REVIEW OF OCAS-PER-012 ISSUES RELATED TO CASE 

#[REDACTED] 

As directed by the Procedures Subcommittee, SC&A’s review of Case #[redacted] strictly 

focused on internal doses calculated in behalf of exposure to plutonium. Case #[redacted] was 

included in the pool of claims that required the DR to be reworked for evaluation of potential 

exposure to Type Super S plutonium, since it met the OCAS-PER-012 criteria of (1) original DR 

was performed prior to February 6, 2007, (2) the EE worked at a site with the potential for a 

highly insoluble form of plutonium, and (3) the POC was less than 50%, but greater than 

16.97%. This case was selected by the DR Subcommittee because it represented an individual 

with a [redacted] cancer who was not monitored for plutonium exposure, but was assigned a 

potential incidental dose based on the SRS air monitoring program. 

The original DR estimated an internal dose based on environmental dose for all years of 

employment using guidance from ORAUT-TKBS-0003. Additionally, during the EE’s 

employment as a [redacted], internal dose was assigned based on SRS air sampling programs 

assuming that plutonium was the most restrictive radionuclide to [redacted] dose. 

In the reworked DR, NIOSH identified that the employment periods likely had different risks of 

exposure because the job functions had different requirements. During the time that the EE 

worked as a [redacted] ([redacted]), NIOSH assumed the EE had a potential for environmental 

levels of radionuclide intake. ORAUT-TKBS-0003, Table C-17, was used to assign the 50th

percentile maximum SRS site-wide environmental plutonium dose. To account for Type SS 

plutonium, this dose was then multiplied by the OTIB-0049 Attachment D [Redacted] Dose 

Adjustment factors, assuming 2 years of intake. No environmental dose was assigned to 

[redacted] and [redacted], because the SRS site profile indicated that the risk of plutonium 

exposure did not begin until [redacted]. This resulted in a total environmental plutonium dose of 

1.340 rem to the [redacted]. 

During the second employment period ([redacted]–[redacted]) while employed as a [redacted], 

NIOSH assumed that the EE had a potential to be exposed to greater than environmental levels 

on occasion. Dose was assigned during the [redacted] time period based on maximizing air 

monitoring programs. This dose was calculated in two ways. First, an intake was calculated 

using the default limiting alpha air concentration in the TIB Internal Dose Overestimates for 

Facilities with Air Sampling Programs, Table 4-1 (ORAUT-OTIB-0018). An adjustment was 

also made to account for potential ingestion. Both values were used as input to the OTIB-0018 

Annual Dose Summary Workbook to calculate total dose to the [redacted]. This resulted in a 

total alpha intake from inhalation and ingestion of 12.943 rem. 

In the second method, internal doses were overestimated by assigning 100% of the intake to the 

single radionuclide that produces the largest dose per unit intake to the [redacted], which was 

Type S Pu-239, in accordance with ORAUT-OTIB-0018. To account for Type Super S 

plutonium, this intake was then adjusted using the OTIB-0049 workbook by assuming an intake 

of 6 years and applying the Attachment D [Redacted] Dose Adjustment Factor. This resulted in 

a total Type SS plutonium dose of 9.191 rem. 
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Annual doses from the two methodologies were compared, and the larger annual dose for each 

year was used for calculating the POC. This resulted in the combined plutonium dose of 

15.994 rem for the second employment period. No environmental dose was assigned, because 

the air monitoring method already accounts for potential environmental levels of radionuclides. 

Based on these intake values, the total internal dose assigned for potential exposure to plutonium 

was 17.334 rem to the [redacted] from both employment periods. 

In evaluating this case, SC&A reviewed the guidance provided in ORAUT-OTIB-0049 for 

assessing exposure to Type SS material specifically for the target organ (i.e., [redacted]) using 

air monitoring as the monitoring method. For the convenience of the reader, this guidance is 

cited below: 

[Redacted] Dose 

In cases where the intake is derived from air monitoring, the intake is based on 

direct measurements. For Type SS material, the annual dose to the [redacted]

(including [redacted]) will be underestimated if one assumes a Type S model 

because of the longer retention time. Therefore, annual [redacted] doses 

calculated with the Type S model are multiplied by dose adjustment factors. 

These factors are given in Attachment D for each year from 1 to 65 for 46 

different intake scenarios. The scenarios are based on the period of intake, 

specifically acute and chronic intake periods from 1 to 65 years in 1-year 

intervals. Because the dose adjustment factors decrease as the chronic exposure 

period increases, for chronic intakes for partial years, dose reconstructors should 

truncate the partial year and use the dose adjustment factor table for the full 

year; for instance, if the intake period is 4.5 years, use the dose adjustment 

factors for a 4-year chronic intake. 

Along with reviewing the ORAUT-OTIB-0049 guidance, SC&A analyzed the CADW and 

OTIB-0049 worksheets for Case #[redacted]. SC&A was able to verify that NIOSH’s 

assumptions were appropriate and claimant favorable and data were entered into all workbooks 

correctly. SC&A also verified the IREP input, which indicated that the doses were entered with 

the appropriate distribution and uncertainty parameters. SC&A found that the rework was done 

in accordance with guidance provided in ORAUT-OTIB-0049, and has no findings with 

NIOSH’s methodology for assessing the EE’s exposure to highly insoluble plutonium and the 

resulting estimated doses.
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7.0 REVIEW OF OCAS-PER-012 ISSUES FOR CASE #[REDACTED] 

7.1 BACKGROUND INFORMATION FOR CASE #[REDACTED] 

Case #003036 represents an energy employee (EE) who worked at the SRS from [redacted], 

through at least [redacted], when the revised DR was completed. During this worker’s 

employment, the EE’s job function was in [redacted] in the F and H areas. 

The EE was monitored for external photon, electron, and neutron exposures during employment. 

Internal exposure monitoring was also conducted by means of in-vitro urinalysis bioassays. The 

EE was diagnosed with [redacted] cancer (ICD Code [redacted]) in [redacted] 1999. 

7.2 COMPARISON OF NIOSH’S ORIGINAL AND REWORKED DOSE 

RECONSTRUCTIONS 

NIOSH performed the original DR of Case #[redacted] in July 2004. The claim was reworked 

in June 2008 to re-evaluate this case based on potential exposure to plutonium for Type Super S 

material; both the original and revised DRs stated that the EE’s radiation dose was overestimated 

using claimant-favorable assumptions. In the original DR, NIOSH calculated a dose of 

18.440 rem to the [redacted]. Based on this assigned dose estimate, the DOL determined the 

POC to be 27.86% and the claim was denied. 

Using the most current technical guidance documents and considering Type Super S plutonium, 

a [redacted] dose of 15.036 rem was recalculated in the revised DR. Table 7-1 provides a 

comparison of the original and revised external and internal organ dose estimates for the 

[redacted]. It should be noted that the values cited in Table 7-1 were extracted from the original 

and reworked DRs. With the exception of internal doses from plutonium, SC&A has not 

assessed the accuracy/correctness of these doses, since performing such an assessment is beyond 

the scope of this Subtask 4 report. 

Table 7-1. Comparison of NIOSH-Derived External/Internal Dose Estimates Assigned 

for the [Redacted] in the Original and Reworked Dose Reconstructions 

Dose Categories Previous Dose (rem) Revised Dose (rem)

External Measured 8.939 9.068 

External Missed 5.766 8.304 

Ambient External 1.064 0.109 

Medical X-ray 0.146 0.070 

Internal 2.525 1.580 

Total 18.440 15.036 

Using the EE’s DOE records and claimant-favorable assumptions, a [redacted] dose of 

15.036 rem resulted in a POC of 21.05%, and on this basis, the revised claim was denied. 
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7.3 SC&A’S REVIEW OF OCAS-PER-012 ISSUES RELATED TO CASE 

#[REDACTED] 

As directed by the Procedures Subcommittee, SC&A’s review of Case #[redacted] strictly 

focused on internal doses calculated in behalf of exposure to plutonium. Case #[redacted] was 

included in the pool of claims that required the DR to be reworked for evaluation of potential 

exposure to Type Super S plutonium, since it met the OCAS-PER-012 criteria of (1) original DR 

was performed prior to February 6, 2007, (2) the EE worked at a site with the potential for a 

highly insoluble form of plutonium, and (3) the POC was less than 50%, but greater than 

16.97%. This case was presented to the DR Subcommittee as representing an individual who 

was monitored via fecal sampling for assessing doses to the [redacted] (systemic tissue). 

However, as discussed in more detail below, the internal dose was assigned using a hypothetical 

intake. 

Internal dose monitoring records identified several urinalyses for tritium, plutonium, and fission 

products done throughout employment. Several positive fecal plutonium samples were analyzed 

in the 1990s and a positive WBC done in 1981. In the original DR, citing efficiency measures, 

NIOSH used guidance from ORAUT-OTIB-0001 to assign plutonium dose to the [redacted] of 

the EE. Therefore, a hypothetical intake was assumed that NIOSH states “provides a greater 

dose than that would result from a detailed reconstruction.” SC&A contends that the use of 

OTIB-0001 in this instance was inappropriate, because the claimant does not meet the 

assumptions necessary for its applications. Specifically, the EE has multiple positive bioassays, 

which prohibit the use with OTIB-0001 guidance. 

In the reworked DR, NIOSH identified that the EE was monitored for plutonium and had 

several positive bioassays. SC&A’s review of DOE records showed the EE was routinely 

monitored for plutonium exposure between 1981 and 2002. Additionally, the EE received fecal 

bioassays, which are indicative of increased exposure potential. Four of these assays were 

positive for plutonium-239 and/or plutonium-238. SC&A identified one routine urinalysis done 

in [redacted] that was positive for plutonium; this positive bioassay was not listed in the DR 

report. The EE was also monitored occasionally by WBC and chest counts; one chest count 

detected Am-241 levels equal to the minimum detectable activity (MDA). In an attempt to 

calculate a fitted and missed internal dose based on bioassay samples, NIOSH used IMBA to 

model this chest count assuming an acute intake occurred on the EE’s first day of 1981, which 

corresponds to the start year of bioassay monitoring in the EE’s records. Type S Pu was found to 

best-fit the EE’s other bioassay records. No Type SS plutonium adjustment was necessary for 

fitted dose based on OTIB-0049 guidance. This intake is summarized in Table 7-2. 

Table 7-2. Summary of Intake 

Radionuclide Intake (dpm) Dose (rem) 

Pu-238 4,660 >0.001 

Pu-239 23,600 0.002 

Pu-241 564,000 0.001 

Am-241 11,500 0.001 

NIOSH also assumed that the EE likely received dose that was not captured by monitoring 

records. NIOSH modeled potential intake of the LOD/2 of plutonium and americium. NIOSH 
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found that Type M Pu-239 resulted in the largest missed dose in modeling. NIOSH adjusted this 

missed dose to account for a 10-year aged 12% plutonium mixture. No Type SS adjustment was 

necessary, because Type M dose was assigned. Using this methodology, NIOSH calculated a 

total missed plutonium dose of 0.002 rem to the EE. 

Based on these intake values, the total internal dose for potential exposure to plutonium was 

estimated at 0.006 rem to the [redacted]. However, after expending an extensive effort to 

calculate internal dose based on the EE’s actual bioassay samples, NIOSH chose to use a 

hypothetical acute intake method (ORAUT-OTIB-0001) for calculating and assigning internal 

dose, which resulted in an internal dose of 1.546 rem. The total internal dose of 1.580 rem 

shown in Table 7-2 also includes 0.979 rem estimated from exposure to tritium. Although 

NIOSH considered the potential for exposure to Type Super S plutonium, no additional dose was 

added, as justified in the DR report and cited below: 

Because workers at facilities with plutonium that were potentially exposed to 

insoluble plutonium compounds (i.e., compounds that have a Type S [redacted]

absorption type) may have also been exposed to plutonium compounds with a 

[redacted] retention exceeding that of Type S material, potential exposures to 

those plutonium compounds need to be evaluated in accordance with the 

recommendations in the Technical Information Bulletin: Estimating Doses for 

Plutonium Strongly Retained in the Lung. ... However, since the assigned internal 

doses used in this assessment were based on an overestimate of the soluble types 

of nuclides, no additional dose was added to account for a highly insoluble form 

of plutonium. 

In evaluating this case, SC&A questions the assignment of internal dose based on the SRS 

hypothetical intake model. Although this model results in a claimant-favorable dose, it is an 

inappropriate methodology, since the EE had positive bioassay samples. SC&A also identified 

this issue with regard to using the OTIB-0001 model in the original DR. 

With regard to NIOSH not adding any additional dose for potential exposure to highly insoluble 

plutonium, we consider this approach reasonable, since the hypothetical intake model results in a 

highly conservative dose. It should also be noted that if the assigned dose had been based on the 

chest count data, no Type Super S adjustment would have been made, in accordance with 

ORAUT-OTIB-0049 guidance.
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8.0 REVIEW OF OCAS-PER-012 ISSUES FOR CASE #[REDACTED] 

8.1 BACKGROUND INFORMATION FOR CASE #[REDACTED] 

Case #[redacted] represents an energy employee (EE) who worked at the SRS from [redacted], 

through [redacted]. During this worker’s employment, the EE’s job function was a [redacted] 

and a [redacted] in the Electric and Instrumentation (E&I) Department. 

The EE was monitored for external photon and electron exposures during employment. Internal 

exposure monitoring was also conducted by means of in-vitro urinalysis bioassays. The EE was 

diagnosed with [redacted] carcinoma at the [redacted] (ICD Code [redacted]), cancer of the 

[redacted] (ICD-9 Code [redacted]) and cancer of the [redacted] (ICD-9 Code [redacted]) during 

[redacted] 1981. 

8.2 COMPARISON OF NIOSH’S ORIGINAL AND REWORKED DOSE 

RECONSTRUCTIONS 

NIOSH performed the original DR of Case #[redacted] in January 2005. The claim was 

reworked in April 2009 to re-evaluate this case based on potential exposure to plutonium for 

Type Super S material. The original DR stated that the EE’s radiation dose was overestimated 

using claimant-favorable assumptions. As discussed in more detail below, the rework required 

only a partial DR, since the revised internal dose estimate for only one of the cancers was 

sufficient to result in a POC greater than 50%. In the original DR, NIOSH calculated a dose of 

8.318 rem to the [redacted] and [redacted]. Additionally, a dose of 85.284 rem to the 

[redacted] was calculated. Based on this assigned dose estimate, the DOL determined the POC 

to be 44.89% and the claim was denied. 

Using the most current technical guidance documents and considering Type Super S plutonium, 

a dose of 260.653 rem was recalculated for the [redacted] in the revised DR. This represents 

only a partial DR to the [redacted] and no dose was assigned to the [redacted] or [redacted]. 

NIOSH states: 

Only the dose to the [redacted] was necessary to complete this revised dose 

reconstruction. Per the provisions in 42 CFR § 82.10(k)(1), it was determined 

that the partially reconstructed dose was of sufficient magnitude to consider the 

dose reconstruction complete. That is, the partially reconstructed dose produced 

a probability of causation of 50% or greater. To expedite this claim, only a 

partial dose has been included in this dose reconstruction. The dose reported is a 

partial estimate of [the EE’s] total occupational radiation dose. 

Table 8-1 provides a comparison of the original and revised external and internal organ dose 

estimates for the [redacted]. It should be noted that the values cited in Table 8-1 were extracted 

directly from NIOSH’s reworked DR. With the exception of internal doses from plutonium, 

SC&A has not assessed the accuracy/correctness of these doses, since performing such an 

assessment is beyond the scope of this Subtask 4 report. Dose to the [redacted] and [redacted] 
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are not included in this table, because no dose was assigned to either organ as part of the revised 

DR. 

Table 8-1. Comparison of NIOSH-Derived External/Internal Dose Estimates Assigned 

for the [Redacted] in the Original and Reworked Dose Reconstructions 

Dose Categories Previous Dose (rem) Revised Dose (rem)

External Measured/ Missed 4.609 0 

Ambient External 1.022 0 

Medical X-ray 7.082 0 

Internal 72.569 260.653 

Total 85.282 260.653 

Using the EE’s DOE records and minimizing assumptions, an [redacted] dose of 260.653 rem 

resulted in a POC of 68.41%, and on this basis, the revised claim was granted. 

8.3 SC&A’S REVIEW OF OCAS-PER-012 ISSUES RELATED TO CASE 

#[REDACTED] 

As directed by the Procedures Subcommittee, SC&A’s review of Case #[redacted] strictly 

focused on internal doses calculated in behalf of exposure to plutonium. Case #[redacted] was 

included in the pool of claims that required the DR to be reworked for evaluation of potential 

exposure to Type Super S plutonium, since it met the OCAS-PER-012 criteria of (1) original DR 

was performed prior to February 6, 2007, (2) the EE worked at a site with the potential for a 

highly insoluble form of plutonium, and (3) the POC was less than 50%, but greater than 

16.97%. This case was selected by the DR Subcommittee because it represented an individual 

who was monitored via urinalyses for assessing doses to the extra-thoracic region. 

Internal dose monitoring records identified a single urinalysis for tritium and another for 

plutonium. Both samples were below the reporting level. Even though there were no positive 

bioassays, the original DR made the claimant-favorable assumption that the EE was exposed to 

10-year aged 12% Pu-240 material Type S chronically over the entire employment period. The 

plutonium intake was determined using the reporting level LOD/2 specific to the plutonium 

bioassay found in the EE’s records. Dose to each organ was modeled in IMBA assuming 100% 

Pu-239. Dose was then adjusted to account for 10-year aged 12% Pu-240 material and annual 

doses were calculated in the CADW. This resulted in a dose of 0.217 rem to both [redacted] and 

to the [redacted], and 72.569 rem to the [redacted]. 

In the reworked DR, NIOSH identified that the intake range established in the original DR was 

too broad. The revised DR assumed plutonium exposure only from January 1, 1954, through the 

date of the urinalysis, April 19, 1967. No plutonium intake was assumed during 1951–1953 

because the SRS site profile indicated that risk of plutonium exposure did not begin until 1954. 

The IMBA program was used to calculate intake rates for both Types M and S plutonium 

materials based on half the last urinalysis measurement’s MDA (0.1 dpm/1.5 liters) for 

plutonium, assuming 100% Pu-239. Type S gave a significantly higher dose to the [redacted] 

region. NIOSH elected to use minimizing assumptions and assumed an intake rate of 1 dpm/d to 

the isotopes associated with fresh fuel grade plutonium. To account for insoluble plutonium, 

NIOSH multiplied each annual dose by 4, which is consistent with the OTIB-0049 guidance for 
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NOTICE:

an extra-thoracic cancer that was monitored by urinalysis. Plutonium intake values for assessing 

missed dose are presented in Table 8-2. 

Table 8-2. Plutonium Intake Values 

Radionuclide Dose Type Start End Intake Unit/Rate

Pu-238 Missed 1/1/1954 4/19/1967 1 dpm per day 

Pu-239 Missed 1/1/1954 4/19/1967 1 dpm per day 

Pu-241 Missed 1/1/1954 4/19/1967 1 dpm per day 

Am-241 Missed 1/1/1954 4/19/1967 1 dpm per day 

Based on these intake values, the total internal dose assigned for potential exposure to plutonium 

was 260.653 rem to the [redacted]. 

In evaluating this case, SC&A reviewed the guidance provided in ORAUT-OTIB-0049 for 

assessing exposure to Type SS material specifically for the target organ (i.e., [redacted]) using 

urinalyses as the monitoring method. The [redacted] are part of the extra-thoracic region 

discussed in ORAUT-OTIB-0049. For the convenience of the reader, this guidance is cited 

below: 

Extra-thoracic 

Extra-thoracic doses should be calculated from urine bioassay data using the 

Type S model and then multiplied by a factor of 4 to account for the lower 

excretion rate of Type SS material compared to Type S material. 

Along with reviewing the ORAUT-OTIB-0049 guidance, SC&A analyzed the bioassay records, 

all IMBA runs, and the CADW worksheets for Case #[redacted]. SC&A was able to verify that 

NIOSH’s assumptions were appropriate, and data were entered into IMBA and the OTIB-0049 

workbook correctly. SC&A also verified the IREP input, which indicated that the doses were 

entered with the appropriate distribution and uncertainty parameters. SC&A found that the 

rework was done in accordance with guidance provided in ORAUT-OTIB-0049, and has no 

findings with NIOSH’s methodology for assessing the EE’s exposure to highly insoluble 

plutonium and the resulting estimated doses.
Effective Date: 

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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. 

9.0 REVIEW OF OCAS-PER-012 ISSUES FOR CASE #[REDACTED] 

9.1 BACKGROUND INFORMATION FOR CASE #[REDACTED] 

Case #013347 represents an energy employee (EE) who worked at the Rocky Flats Plant (RFP) 

during [redacted], through [redacted]. During this worker’s employment, the EE’s job function 

was as a [redacted]. According to the telephone interview, the EE worked on the site’s 

[redacted] and [redacted]. 

The EE was monitored for external photon, electron, and neutron exposures during employment. 

Internal exposure monitoring was also conducted by means of chest counting. The EE was 

diagnosed with [redacted] cancer (ICD-9 Code [redacted]) in [redacted] 1990, [redacted] cancer 

(ICD-9 Code [redacted]) in [redacted] 1991, and [redacted] carcinoma ([redacted] cancer) on the 

[redacted] (ICD-9 Code [redacted]) in [redacted] 2000. At the time of the [redacted] cancer 

diagnosis, it was reported that the EE [redacted] per day. 

 

9.2 COMPARISON OF NIOSH’S ORIGINAL AND REWORKED DOSE 

RECONSTRUCTIONS 

NIOSH performed the original DR of Case #[redacted] in March 2005. The claim was 

reworked in October 2007 to re-evaluate this case based on potential exposure to plutonium for 

Type Super S material; both the original and revised DRs stated that the EE’s radiation dose was 

overestimated using claimant-favorable assumptions. In the original DR, NIOSH calculated a 

dose of 23.152 rem to the [redacted], 20.368 rem to the [redacted], and 24.302 rem to the 

[redacted]. Based on this assigned dose estimate, the DOL determined the POC to be 28.14% 

and the claim was denied. 

Using the most current technical guidance documents and considering Type Super S plutonium, 

a [redacted] dose of 6.297 rem, a [redacted] dose of 2.057 rem, and a dose to the [redacted] to 

be 4.633 rem were recalculated in the revised DR. Tables 9-1 through 9-3 below provide a 

comparison of the original and revised external and internal organ dose estimates for the 

[redacted], [redacted], and [redacted], respectively. With the exception of internal doses from 

plutonium, SC&A has not assessed the accuracy/correctness of these doses, since performing 

such an assessment is beyond the scope of this Subtask 4 report. 

Table 9-1. Comparison of NIOSH-Derived External/Internal Dose Estimates Assigned 

for the [Redacted] in the Original and Reworked Dose Reconstructions 

Dose Categories Previous Dose (rem) Revised Dose (rem)

External Measured/Missed/Coworker 18.856 1.851 

Ambient External 0.437 0 

Medical X-ray 0.356 0.356 

Internal 3.476 4.090 

Total 23.125 6.297 
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Table 9-2. Comparison of NIOSH-Derived External/Internal Dose Estimates Assigned 

for the [Redacted] in the Original and Reworked Dose Reconstructions 

Dose Categories Previous Dose (rem) Revised Dose (rem)

External Measured/Missed/Coworker 19.888 2.047 

Ambient External 0.474 0 

Medical X-ray 0.002 0.002 

Internal 0.004 0.008 

Total 20.368 2.057 

Table 9-3. Comparison of NIOSH-Derived External/Internal Dose Estimates Assigned 

for the [Redacted] in the Original and Reworked Dose Reconstructions 

Dose Categories Previous Dose (rem) Revised Dose (rem)

External Measured/Missed/Coworker 22.345 4.250 

Ambient External 0.634 0 

Medical X-ray 1.310 0.356 

Internal 0.013 0.027 

Total 24.302 4.633 

Using the EE’s DOE records and claimant-favorable assumptions, a [redacted] dose of 6.297 

rem, a [redacted] dose of 2.057 rem, and a dose to the [redacted] to be 4.633 rem resulted in a 

POC of 1.83% and on this basis, the revised claim was denied. 

9.3 SC&A’S REVIEW OF OCAS-PER-012 ISSUES RELATED TO CASE 

#[REDACTED] 

As directed by the Procedures Subcommittee, SC&A’s review of Case #[redacted] strictly 

focused on internal doses calculated in behalf of exposure to plutonium. Case #[redacted] was 

included in the pool of claims that required the DR to be reworked for evaluation of potential 

exposure to Type Super S plutonium, since it met the OCAS-PER-012 criteria of (1) original DR 

was performed prior to February 6, 2007, (2) the EE worked at a site with the potential for a 

highly insoluble form of plutonium, and (3) the POC was less than 50%, but greater than 

16.97%. This case was selected by the DR Subcommittee because it represented an individual 

with in-vivo monitoring for assessing doses to the [redacted]. 

Internal dose monitoring records identified several urinalyses for uranium, plutonium, and 

americium products from 1981 through 1995, with results below their reporting levels. The 

original DR made the claimant-favorable assumption that the EE was exposed to plutonium 

during the entire time of employment. The intake of WG plutonium was determined using the 

reporting level LOD/2 specific to each bioassay found in the EE’s records. Using these data and 

the IMBA computer code, NIOSH calculated a missed chronic intake of plutonium-239. Once 

the plutonium alpha intake rate was determined, the plutonium-238, plutonium-239, plutonium241, and americium-241 intake rates were calculated assuming the fresh WG plutonium mixture 

ratio presented in the RFP TBD. 

In the reworked DR, NIOSH identified that the EE was monitored in vivo on 6 occasions 

between 1981 and 1995, and provided 6 urine samples that were assessed for plutonium 
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during the same time period. All measurement results showed activities less than MDAs. 

To account for doses associated with the negative monitoring results, NIOSH limited 

their missed dose assignment to a chronic intake beginning May 26, 1981, through June 

30, 1995. For this DR, each cancer was addressed independently to maximize dose. It 

was determined that, for the plutonium dose to the [redacted] and [redacted], the urine 

bioassay for solubility Type M was more claimant favorable. For the [redacted], missed 

plutonium dose was determined based on MDA levels of Am-241, as identified in the 

EE’s termination chest count. NIOSH compared solubility Types S and M while 

assessing dose based on the chest count, with Type S resulting in a more claimantfavorable dose.

NIOSH modeled missed dose from the urinalysis and missed dose from the chest count 

separately. To adequately address the modeling for each cancer, they are discussed separately 

below. 

[Redacted] 

NIOSH modeled missed dose in IMBA using half the MDA values of Am-241, using an intake 

rate of 0.097 dpm/d from the last negative chest count. Assuming a WG plutonium mixture as 

suggested in the RFP TBD, this resulted in a missed intake of Type S Pu-239 of 20.21 dpm/d. 

This intake was used as input to IMBA, resulting in a dose of 4.090 rem to the [redacted]. To 

account for Type SS plutonium, this dose was then multiplied by the OTIB-0049 Attachment D 

[Redacted] Dose Adjustment Factors, assuming 14 years of intake, and divided by the chest 

count adjustment factor of 4.7. Both adjustments to dose were made in the OTIB-0049 

workbook and were performed in accordance with the recommendations of OTIB-0049. This 

resulted in a Type SS dose of 2.478 rem. Since Type S plutonium resulted in a larger dose to the 

[redacted], this dose was assigned in order to be claimant favorable. 

[Redacted] 

To assign internal dose to the [redacted], NIOSH calculated Type M dose using the LOD/2 from 

the last urinalysis. NIOSH assumed the EE was chronically exposed to plutonium during the 

entire period of employment. NIOSH assigned dose based on the Type M urinalysis LOD/2 

results. This resulted in a total dose of 0.005 rem to the [redacted] using the [redacted] as a 

surrogate organ. Since Type M dose was assigned, no adjustment for Type SS plutonium was 

warranted. 

Although it is beyond the scope of this review, SC&A takes exception with NIOSH’s selection 

of the [redacted] as a surrogate organ to the [redacted]. The [redacted] is an organ already 

modeled in IMBA and thus does not require the use of a surrogate. In addition, all instances of 

using the [redacted] in modeling dose to the [redacted] yield a higher dose than using the 

[redacted] (i.e., 0.011 rem vs. 0.005 rem). This is obviously a small difference and would not 

have an impact on the POC of this case; however, it is difficult for SC&A to understand 

NIOSH’s rationale for this organ selection. 

[Redacted] 

To assign dose to the [redacted], NIOSH assumed that Type M yields the most claimantfavorable dose to the EE. NIOSH modeled this dose using half of the LOD of the final 
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NOTICE:

urinalysis. This resulted in an intake of 36.581 dpm/d Pu-239. NIOSH then adjusted to account 

for a mixture of WG plutonium that the EE was likely exposed to. This resulted in a total 

plutonium dose to the [redacted] of 0.011 rem. Since Type M dose was assigned, no adjustment 

for Type SS plutonium dose was necessary. 

Based on these intake values, the total internal dose assigned for potential exposure to plutonium 

was a [redacted] dose of 4.090 rem, a [redacted] dose of 0.005 rem, and a dose to the [redacted] 

of 0.011 rem. 

In evaluating this case, SC&A reviewed the guidance provided in ORAUT-OTIB-0049 for 

assessing exposure to Type SS material specifically for each target organ (i.e., [redacted], 

[redacted] and [redacted]) using the most limiting monitoring method. For the convenience of 

the reader, this guidance is cited below: 

[Redacted] [Chest Count] 

To calculate Type SS [redacted] doses from chest count measurements, the dose to 

the [redacted] is first calculated assuming that Type S material was inhaled. This 

dose is then adjusted upward with the factors given in Appendix D. However, the 

application of the adjustment factor will result in an implied Type SS [redacted]

content that is inconsistent with the original chest count. To make the observed 

and predicted chest counts agree, the Type SS [redacted] dose must be adjusted 

downward by applying the adjustment factor for the year of the chest count used 

to determine the intake. ... 

Systemic Organ [Monitored Individual Urinalysis]

...[T]he annual doses to systemic organs should be determined from urine data 

using the Type S assumption. Annual doses received during the period for which 

urine data are available should not be adjusted. Annual doses received after the 

year of the last urine sample used in the determination should be multiplied by a 

factor of 4. 

Along with reviewing the ORAUT-OTIB-0049 guidance, SC&A analyzed the bioassay records, 

all IMBA runs, and the Pu/Am Intake Calculation Workbook for Case #[redacted]. SC&A was 

able to verify that NIOSH’s assumptions were appropriate, with the exception of their organ 

selection for calculating internal dose to the [redacted], and data were entered into IMBA and the 

OTIB-0049 workbook correctly. SC&A also verified the IREP input, which indicated that the 

doses were entered with the appropriate distribution and uncertainty parameters. SC&A found 

that the rework was done in accordance with guidance provided in ORAUT-OTIB-0049, and has 

no findings with NIOSH’s methodology for assessing the EE’s exposure to highly insoluble 

plutonium and the resulting estimated doses.
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10.0 REVIEW OF OCAS-PER-012 ISSUES FOR CASE #[REDACTED] 

10.1 BACKGROUND INFORMATION FOR CASE #[REDACTED] 

Case #[redacted] represents an energy employee (EE) who worked at Hanford in Richland, 

Washington, during [redacted] discrete employment periods, as detailed in Table 10-1, which 

extended from [redacted], to [redacted]. Monitoring records identified during the original DR 

indicate that the EE may have also had employment periods during 1951 and 1952, though DOL 

could not confirm employment during this time; thus, no dose was assigned to these years in the 

revised DR. During this worker’s employment, the EE’s was a [redacted]. Records indicate that 

the employee [redacted] primarily in the 200 East/West and 100 D Areas. 

Table 10-1. Employment Periods 

Start End 

[Redacted] [Redacted] 

[Redacted] [Redacted] 

[Redacted] [Redacted] 

[Redacted] [Redacted] 

The EE was monitored for external exposures during employment. Internal exposure monitoring 

was not conducted. The EE was diagnosed with [redacted] cancer (ICD Code [redacted]) in 

[redacted] 1961. 

10.2 COMPARISON OF NIOSH’S ORIGINAL AND REWORKED DOSE 

RECONSTRUCTIONS 

NIOSH performed the original DR of Case #[redacted] in January 2006. The claim was 

reworked in December 2008 to re-evaluate this case based on potential exposure to plutonium for 

Type Super S material; both the original and revised DRs stated that the EE’s radiation dose was 

overestimated using claimant-favorable assumptions. In the original DR, NIOSH calculated a 

dose of 7.671 rem to the [redacted]. Based on this assigned dose estimate, the DOL determined 

the POC to be 37.39% and the claim was denied. 

Using the most current technical guidance documents and considering Type Super S plutonium, 

a [redacted] dose of 3.000 rem was recalculated in the revised DR. Table 10-2 below provides a 

comparison of the original and revised external and internal organ dose estimates for the 

[redacted]. It should be noted that the values cited in Table 10-2 were extracted directly from 

NIOSH’s reworked DR. With the exception of internal doses from plutonium, SC&A has not 

assessed the accuracy/correctness of these doses, since performing such an assessment is beyond 

the scope of this Subtask 4 report. 
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Table 10-2. Comparison of NIOSH-Derived External/Internal Dose Estimates Assigned 

for the [Redacted] in the Original and Reworked Dose Reconstructions 

Dose Categories Previous Dose (rem) Revised Dose (rem)

External Measured/Missed/Unmonitored 5.158 0.311 

Ambient External 0.966 0.328 

Medical X-ray 1.114 0.798 

Internal 0.433 1.563 

Total 7.671 3.000 

Using the EE’s DOE records and claimant-favorable assumptions, a [redacted] dose of 3.000 

rem resulted in a POC of 35.33%, and on this basis, the revised claim was denied. 

10.3 SC&A’S REVIEW OF OCAS-PER-012 ISSUES RELATED TO CASE #016131 

As directed by the Procedures Subcommittee, SC&A’s review of Case #[redacted] strictly 

focused on internal doses calculated in behalf of exposure to plutonium. Case #[redacted] was 

included in the pool of claims that required the DR to be reworked for evaluation of potential 

exposure to Type Super S plutonium, since it met the OCAS-PER-012 criteria of (1) original DR 

was performed prior to February 6, 2007, (2) the EE worked at a site with the potential for a 

highly insoluble form of plutonium, and (3) the POC was less than 50%, but greater than 

16.97%. This case was selected by the DR Subcommittee because it represented an individual 

who was not monitored for intake, but was assigned dose to a systemic organ using coworker 

urine bioassay data. 

The EE was not monitored for internal exposure to plutonium. Because there were no bioassays, 

the original DR assigned only environmental internal dose to the [redacted]. NIOSH assumes 

all environmental plutonium was Pu-239. Using guidance from ORAUT-TKBS-0006-4 and the 

CADW, NIOSH calculated a full year of environmental dose to each partial year of employment. 

This resulted in a dose of less than 0.001 rem to the [redacted]; therefore, no plutonium dose was 

assigned in the original DR. 

As a result of the SEC Class for Hanford (issued December 8, 2006), no internal plutonium dose 

could be reconstructed for the 1944 employment period. In the reworked DR, DR made the 

claimant-favorable assumption that the EE was exposed to fuel-grade (FG) plutonium (12% Pu) 

aged 10 years during the remaining [redacted] employment periods, based on the 50th percentile 

coworker models for Hanford. The intake of FG plutonium was determined using the Type S 

and Type M coworker plutonium intake values from ORAUT-TKBS-0006-5, Tables C-9 and C10. Using the “Hanford Pu and RU Mix Intake Rate Calculator 1.10,” NIOSH accounted for the 

radionuclide composition of FG Pu aged 10 years. Then, using the CADW, a dose beginning 

1958 through 1959 was calculated for a Type S and Type M mixture of FG Pu aged 10 years. 

Both Type S and Type M mixtures resulted in a total dose of less than 0.001 rem to the 

[redacted]. The potential for Type Super S plutonium exposure was also evaluated using 

guidance from OTIB-0049. Type Super S Plutonium was also found to contribute less than 

0.001 rem to the [redacted]. 

 

In addition, the reworked DR made adjustments to account for environmental dose to the EE. 

NIOSH first established the years that the EE was and was not employed at Hanford, then used 
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the Hanford TBD, Table 4-7, to determine the 50th percentile maximum environmental intakes of 

Pu-239 during 1944 and 1958–1959. No environmental dose was assigned for 1951 and 1952, 

because the DOL could not confirm the EE’s employment. A total environmental plutonium 

dose of less than 0.001 rem to the [redacted] was calculated. 

Based on these intake values, the total internal dose assigned for potential exposure to plutonium 

was less than 0.001 rem to the [redacted]. 

In evaluating this case, SC&A reviewed the guidance provided in ORAUT-OTIB-0049 for 

assessing exposure to Type SS material specifically for the target organ (i.e., [redacted]) using 

urinalyses as the monitoring method of the coworker model. For the convenience of the reader, 

this guidance is cited below: 

Systemic Organs 

Type SS material is absorbed into the blood stream at a slower rate than Type S 

material, which results in lower levels of material in the systemic organs and in 

the urine. Assuming that the doses to systemic organs are roughly proportional to 

the urinary excretion rate, organ doses determined from urine data are the same 

for Type S and Type SS materials during the period of time that urine data are 

available. However, for the period of time after the last urinalysis is available, 

the Type SS model would predict a much slower decrease in urine due to the 

continuing input to the bloodstream from the material contained in the [redacted]. 

Therefore, the predicted integrated urine content (and hence, systemic organ 

dose) must be adjusted after the time of the last urine bioassay measurement. 

Along with reviewing the ORAUT-OTIB-0049 guidance, SC&A analyzed the CADW and 

OTIB-0049 workbook for Case #[redacted]. SC&A was able to verify that NIOSH’s 

assumptions were appropriate and claimant favorable, and data were entered into CADW and the 

OTIB-0049 workbook correctly. SC&A also verified the IREP input, which indicated that the 

doses were entered with the appropriate distribution and uncertainty parameters. SC&A found 

that the rework was done in accordance with guidance provided in ORAUT-OTIB-0049, and has 

no findings with NIOSH’s methodology for assessing the EE’s exposure to highly insoluble 

plutonium and the resulting estimated doses.
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11.0 SUMMARY CONCLUSIONS 

Under SC&A’s A Protocol to Review NIOSH’s Program Evaluation Reports (PERs) (SCA-TRPR2009-0002, Rev. 1), Subtask 4 requires the audit of DR cases reworked as a result of the PER 

under review. In March 2010, SC&A submitted our review of NIOSH’s PER, Evaluation of 

Highly Insoluble Plutonium Compounds (OCAS-PER-012), to the Procedures Subcommittee. In 

that review, SC&A indicated that, based on guidance in ORAUT-OTIB-0049, Estimating Doses 

for Plutonium Strongly Retained in the Lung, which prompted the issuance of OCAS-PER-012, 

the prescribed method for dose re-evaluation differs (1) for each of four target organs/tissues 

(i.e., lung/LNTH, extrathoracic, GI tract, system organs) and (2) based on monitoring methods 

(i.e., urinalysis, lung count, fecal sample, air sampling) that were used in the original DR. 

Therefore, in order to satisfy Subtask 4, SC&A recommended selection of 1 case from each of 10 

potential permutations addressed in PER-012. 

In July 2011, the DR Subcommittee selected 9 cases for audit representing 8 of the 10 DR 

categories. Only 8 categories of reworked DRs were selected, since there were no cases 

available where fecal sample monitoring was performed for target organs extrathoracic and GI 

tract. Table 11-1 provides a listing of the OTIB-0049 criteria that were applied to each of the 

nine cases, identified in the table by case number. It should be noted that some DRs are listed in 

two categories, because the EE was diagnosed with more than one cancer. 

Table 11-1. ORAUT-OTIB-0049 Dose Re-evaluation Criteria Used for the Nine Audited 

Dose Reconstructions 

Target Organ Urinalysis Lung Counts Fecal Sample Air Sampling 

Lung/LNTH 6,747 13,347 2,614 2,767; 2,994 

Extrathoracic 3,871 NA No DR Available NA 

GI Tract 1938 NA No DR Available NA 

Systemic Organs 1938; 3036; 16131 NA 2614 NA 

For each of the nine cases, SC&A provided an overview of the case and a brief comparison of 

external and internal doses assigned in the original and revised DRs. Based on directives from 

the Procedure Subcommittee, SC&A’s audit of these cases focused strictly on those elements of 

the DR that were affected by the issuance of ORAUT-OTIB-0049 and OCAS-PER-012. 

Therefore, our audit only evaluated whether the internal doses associated with potential exposure 

to Type Super S plutonium were performed accurately and in accordance with guidance in 

ORAUT-OTIB-0049. For each case, we reviewed applicable IMBA files and workbooks 

employed for calculating the plutonium dose. In addition, we verified that all data were entered 

into IREP correctly. 

As discussed in Sections 2.0 through 10.0 above, SC&A concurs with the approach and 

assumptions used by NIOSH in calculating internal doses associated with potential exposure to 

highly insoluble plutonium for all nine cases. We also found that NIOSH re-evaluated each of 

these DRs using methodology consistent with the guidance in ORAUT-OTIB-0049. SC&A 

believes that the development of the OTIB-0049 workbook, which assists the dose reconstructor 

in entering appropriate data and then calculates fitted and missed organ doses, makes 
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comparisons of these data, and generates the IREP input, has been very instrumental in the 

successful implementation of OCAS-PER-012.
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12.0 REFERENCES 

42 CFR 82. Methods for Radiation Dose Reconstruction Under the Energy Employees 

Occupational Illness Compensation Program Act of 2000; Final Rule, Federal 

Register/Vol. 67, No. 85/Thursday, May 2, 2002, p. 22314. 

OCAS-PER-009, Rev. 0, Target Organs for Lymphoma, Office of Compensation Analysis and 

Support, Program Evaluation Plan, Cincinnati, Ohio, March 8, 2007. 

OCAS-PER-012, Rev. 0, Evaluation of Highly Insoluble Plutonium Compounds, Office of 

Compensation Analysis and Support, Program Evaluation Plan, Cincinnati, Ohio, August 7, 

2007. 

ORAUT-OTIB-0001, Rev. 00, Maximum Internal Dose Estimates for Savannah River Site (SRS) 

Claims, Oak Ridge Associated Universities, Cincinnati, Ohio, July 15, 2003. 

ORAUT-OTIB-0002, Rev. 01 PC-2, Technical Information Bulletin – Maximum Internal Dose 

Estimates for Certain DOE Complex Claims, Oak Ridge Associated Universities, Cincinnati, 

Ohio, May 7, 2004. 

ORAUT-OTIB-0018, Rev. 01, Technical Information Bulletin: Internal Dose Overestimates for 

Facilities with Air Sampling Programs, Oak Ridge Associated Universities, Cincinnati, Ohio, 

August 9, 2005. 

ORAUT-OTIB-0034, Rev. 00, Technical Information Bulletin: Internal Dosimetry Coworker 

Data for X-10, Oak Ridge Associated Universities, Cincinnati, Ohio, December 13, 2005. 

ORAUT-OTIB-0049, Rev. 00, Estimating Doses for Plutonium Strongly Retained in the Lung, 

Oak Ridge Associated Universities, Cincinnati, Ohio, February 6, 2007. 

ORAUT-TKBS-0003, Rev. 03, Savannah River Site, Oak Ridge Associated Universities, 

Cincinnati, Ohio, April 5, 2005. 

ORAUT-TKBS-0006-4, Rev. 02, Hanford Site – Occupational Environmental Dose, Oak Ridge 

Associated Universities, Cincinnati, Ohio, June 5, 2007. 

ORAUT-TKBS-0006-5, Rev. 02, Hanford Site – Occupational Internal Dose, Oak Ridge 

Associated Universities, Cincinnati, Ohio, June 22, 2007. 

ORAUT-TKBS-0008-4, Rev. 01, Nevada Test Site – Occupational Environmental Dose, Oak 

Ridge Associated Universities, Cincinnati, Ohio, May 27, 2008.

ORAUT-TKBS-0011-5, Rev. 02, Rocky Flats Plant – Occupational Internal Dose, Oak Ridge 

Associated Universities, Cincinnati, Ohio, August 17, 2007. 
Effective Date: 

July 20, 2012 

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0 (Draft) 

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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. 

NOTICE:

ORAUT-TKBS-0013-5, Rev. 01, Pantex Plant – Occupational Internal Dose, Oak Ridge 

Associated Universities, Cincinnati, Ohio, June 22, 2007. 

SCA-TR-PR2009-0002, Rev. 1, A Protocol to Review NIOSH’s Program Evaluation Reports 

(PERs), SC&A, Inc., Vienna, Virginia, December 1, 2009. 

SCA-TR-PR2010-00012, Rev. 0, A Review of NIOSH’s Program Evaluation Report OCAS-PER012, “Evaluation of Highly Insoluble Plutonium Compounds” SC&A, Inc., Vienna, Virginia, 

March 18, 2010.