ORAU TEAM

Dose Reconstruction

Project for NIOSH

Oak Ridge Associated Universities I Dade Moeller I MJW Technical Services

Page 1 of 36

DOE Review Release 01/26/2010

Document Title:

Hanford Site – Occupational Medical Dose 

Document Number: ORAUT-TKBS-0006-3

Revision: 02

Effective Date: 01/07/2010

Type of Document: TBD

Supersedes: Revision 01

Subject Expert(s): Elyse M. Thomas, Fred Duncan, and Edward D. Scalsky

Site Expert(s): Ron Kathren and Vernon Shockley

Approval: Signature on File Approval Date: 01/04/2010

Fred Duncan, Document Owner

Concurrence: Signature on File Concurrence Date: 01/04/2010

Chris M. Tornes, Objective 1 Representative

Concurrence: Signature on File Concurrence Date: 01/04/2010

Scott R. Siebert, Objective 3 Representative

Concurrence: Signature on File Concurrence Date: 01/05/2010

James P. Griffin, Deputy Project Director

Approval: Signature on File Approval Date: 01/07/2010

James W. Neton, Associate Director for Science

New Total Rewrite Revision Page Change

FOR DOCUMENTS MARKED AS A TOTAL REWRITE, REVISION, OR PAGE CHANGE, REPLACE THE PRIOR 

REVISION AND DISCARD / DESTROY ALL COPIES OF THE PRIOR REVISION.
Document No. ORAUT-TKBS-0006-3 Revision No. 02 Effective Date: 01/07/2010 Page 2 of 36

PUBLICATION RECORD

EFFECTIVE 

DATE

REVISION 

NUMBER DESCRIPTION

09/16/2003 00 First approved issue of the technical basis document, Section 3, for 

the Hanford Site. Initiated by Edward D. Scalsky

04/11/2005 01 Approved issue of Revision 01. Incorporates numerical changes in 

tables and adds additional tables. Incorporates formal internal and 

NIOSH review comments. Initiated by Edward D. Scalsky.

01/07/2010 02 Revised to include the Oblique and Lordotic chest views; change in 

poor collimation assumption for early years x-ray dose data. 

Includes Attributions and Annotations section. Incorporates formal 

internal and NIOSH review comments. Changes some dose 

conversion factors for pre-1970 to conform to the project wide 

assumption of poor collimation for that time period. Adds organ dose 

for the Bucky PA chest performed at Hanford in the 1970s and 

1980s. Adds skin dose for all projections and time periods.

Constitutes a total rewrite of the document. Training required: As 

determined by the Objective Manager. Initiated by Edward D. 

Scalsky and Fred Duncan.
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TABLE OF CONTENTS

SECTION TITLE

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

PAGE

5

3.1 Introduction ..............................................................................................................................7

3.1.1 Purpose........................................................................................................................8

3.1.2 Scope...........................................................................................................................8

3.2 Technical Factors that Affect Medical X-Ray Dose................................................................... 8

3.2.1 Kilovoltage and Filtration ..............................................................................................8

3.2.2 Current and Exposure Time........................................................................................10

3.2.3 Distance .....................................................................................................................10

3.2.4 Collimation and Waveform Characteristics .................................................................10

3.2.5 Other Factors That Can Affect Worker Dose ..............................................................11

3.3 Type and Frequency of X-ray Screening at Hanford............................................................... 11

3.4 Equipment and Techniques.................................................................................................... 12

3.5 Organ Doses..........................................................................................................................12

3.5.1 Chest Photofluorography............................................................................................14

3.5.2 Radiography on 14- by 17-Inch Film...........................................................................16

3.5.2.1 PA Chest...................................................................................................... 16

3.5.2.2 Lateral Chest................................................................................................ 17

3.5.2.3 Bucky PA Chest ........................................................................................... 21

3.5.2.4 Oblique Chest .............................................................................................. 21

3.5.2.5 Lordotic Chest.............................................................................................. 21

3.5.3 Skin Doses .................................................................................................................22

3.6 Uncertainty Analysis for Hanford Radiography Doses ............................................................ 22

3.7 Attributions and Annotations .................................................................................................. 28

References ........................................................................................................................................30

Glossary ............................................................................................................................................ 33
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LIST OF TABLES

TABLE TITLE

3-1 Relationship of various technical factors to beam intensity.......................................................

PAGE

8

3-2 Standard body dimensions for dose reconstruction................................................................ 10

3-3 Frequency of occupational chest X-ray screening .................................................................. 12

3-4 Summary of beam parameters for 14- by 17-in. PA chest projections .................................... 13

3-5 General scheme for DCFs for IREP organs not included in ICRP Publication 34 ................... 14

3-6 Organ dose estimates for PFG until 1962 .............................................................................. 15

3-7 DCFs for various chest projections......................................................................................... 18

3-8 Organ doses for chest projections for all periods.................................................................... 19

3-9 Skin dose guidance for various chest projections and periods ............................................... 23

3-10 Skin dose from various chest projections, 1943 to 1982......................................................... 25

3-11 Skin dose from various chest projections, 1983 to present..................................................... 27
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ACRONYMS AND ABBREVIATIONS

AP anterior-posterior projection

CFR Code of Federal Regulations

cm centimeter

DCF dose conversion factor

DOE U.S. Department of Energy

DOL U.S. Department of Labor

EEOICPA Energy Employees Occupational Illness Compensation Program Act of 2000

EnSD entrance skin dose

ESE entrance skin exposure

Gy gray

HVL half-value layer

ICRP International Commission on Radiological Protection

in. inch

IREP Interactive RadioEpidemiological Program

keV kiloelectron-volt 

kVp peak kilovoltage 

LAT lateral projection

LPO left posterior oblique projection 

mA milliampere

mAs milliampere-second

mGy milligray

mm millimeter

mR milliroentgen

mrad millirad

mrem millirem

NCRP National Council on Radiation Protection and Measurements

NIOSH National Institute for Occupational Safety and Health

ORAU Oak Ridge Associated Universities

PA posterior-anterior projection

PFG photofluorography

POC probably of causation

R roentgen

RPO right posterior oblique

RSD remote skin dose

s second

SID source-to-image distance

SRDB Ref ID Site Research Database Reference Identification (number)
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SSD source-to-skin distance

TBD technical basis document

U.S.C. United States Code

§ section or sections
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3.1 INTRODUCTION

Technical basis documents and site profile documents are not official determinations made by the 

National Institute for Occupational Safety and Health (NIOSH) but are rather general working 

documents that provide historic background information and guidance to assist in the preparation of 

dose reconstructions at particular sites or categories of sites. They will be revised in the event 

additional relevant information is obtained about the affected site(s). These documents may be used 

to assist NIOSH staff in the completion of the individual work required for each dose reconstruction.

In this document the word “facility” is used as a general term for an area, building, or group of 

buildings that served a specific purpose at a site. It does not necessarily connote an “atomic 

weapons employer facility” or a “Department of Energy [DOE] facility” as defined in the Energy 

Employees Occupational Illness Compensation Program Act [EEOICPA; 42 U.S.C. § 7384l(5) and 

(12)]. EEOICPA defines a DOE facility as “any building, structure, or premise, including the grounds 

upon which such building, structure, or premise is located ... in which operations are, or have been, 

conducted by, or on behalf of, the Department of Energy (except for buildings, structures, premises, 

grounds, or operations ... pertaining to the Naval Nuclear Propulsion Program)” [42 U.S.C. § 

7384l(12)]. Accordingly, except for the exclusion for the Naval Nuclear Propulsion Program noted 

above, any facility that performs or performed DOE operations of any nature whatsoever is a DOE 

facility encompassed by EEOICPA.

For employees of DOE or its contractors with cancer, the DOE facility definition only determines 

eligibility for a dose reconstruction, which is a prerequisite to a compensation decision (except for 

members of the Special Exposure Cohort). The compensation decision for cancer claimants is based 

on a section of the statute entitled “Exposure in the Performance of Duty.” That provision [42 U.S.C. 

§ 7384n(b)] says that an individual with cancer “shall be determined to have sustained that cancer in 

the performance of duty for purposes of the compensation program if, and only if, the cancer ... was 

at least as likely as not related to employment at the facility [where the employee worked], as 

determined in accordance with the POC [probability of causation1

The statute also includes a definition of a DOE facility that excludes “buildings, structures, premises, 

grounds, or operations covered by Executive Order No. 12344, dated February 1, 1982 (42 U.S.C. 

7158 note), pertaining to the Naval Nuclear Propulsion Program” [42 U.S.C. § 7384l(12)]. While this 

definition excludes Naval Nuclear Propulsion Facilities from being covered under the Act, the section 

of EEOICPA that deals with the compensation decision for covered employees with cancer [i.e., 42 

U.S.C. § 7384n(b), entitled “Exposure in the Performance of Duty”] does not contain such an 

exclusion. Therefore, the statute requires NIOSH to include all occupationally-derived radiation 

exposures at covered facilities in its dose reconstructions for employees at DOE facilities, including 

radiation exposures related to the Naval Nuclear Propulsion Program. As a result, all internal and 

external occupational radiation exposures are considered valid for inclusion in a dose reconstruction. 

No efforts are made to determine the eligibility of any fraction of total measured exposure for inclusion 

in dose reconstruction. NIOSH, however, does not consider the following exposures to be 

occupationally derived (NIOSH 2007):

] guidelines established under 

subsection (c) ...” [42 U.S.C. § 7384n(b)]. Neither the statute nor the probability of causation 

guidelines (nor the dose reconstruction regulation, 42 C.F.R. Pt. 82) define “performance of duty” for 

DOE employees with a covered cancer or restrict the “duty” to nuclear weapons work (NIOSH 2007).

• Background radiation, including radiation from naturally occurring radon present in 

conventional structures

• Radiation from X-rays received in the diagnosis of injuries or illnesses or for therapeutic 

reasons

 1 The U.S. Department of Labor (DOL) is ultimately responsible under the EEOICPA for determining the POC.
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3.1.1 Purpose

The purpose of this TBD is to describe Hanford occupational medical X-ray procedures and practices. 

The Oak Ridge Associated Universities (ORAU) Team will use this information to reconstruct dose 

from occupational medical X-rays for EEOICPA claims for Hanford workers.

3.1.2 Scope

Under EEOICPA, medical X-rays that were administered in conjunction with preemployment, periodic, 

or termination physical examinations for screening for disease are recognized as a source of 

occupational exposure and eligible for inclusion in occupational dose reconstruction. Unlike 

occupational exposures that were incurred during normal work processes, individual medical X-ray 

exposures were not monitored, which necessitates establishment of a technical basis for these doses. 

This report describes the technical aspects of dose reconstruction for medical X-rays that were 

administered at Hanford for occupational health screening.

Attributions and annotations, indicated by bracketed callouts and used to identify the source, 

justification, or clarification of the associated information, are presented in Section 3.7.

3.2 TECHNICAL FACTORS THAT AFFECT MEDICAL X-RAY DOSE

A number of factors affect the dose to workers from a medical X-ray procedure. However, many of 

these factors do not need to be known when performing retrospective dose assessments that are 

based on actual X-ray beam measurements or on knowledge of several key technical factors. In the 

absence of direct measurements of the beam itself, dose to workers can be estimated with knowledge 

of basic machine parameters (peak kilovoltage, current, and time) and assumptions about filtration, 

collimation, and waveform characteristics. The implications of these factors to worker dose are 

discussed below, and summarized in Table 3-1.

Table 3-1. Relationship of various technical factors to beam intensity.

Factor Units Relationship to beam intensity

kilovoltage kV Intensity proportional to 1.7 power of the kVp.

Tube current mA Linear.

Exposure time s Linear.

Filtration mm Al Intensity decreases by ~40% for each additional mm Al.

Distance (d) cm or in. Approximately inverse square relations (1/d2).

3.2.1 Kilovoltage and Filtration

X-rays from a typical medical X-ray tube are mostly of bremsstrahlung origin, and as such are 

comprised of a spectrum of photon energies that range from zero to the peak kilovoltage, which refers 

to the accelerating potential between the anode and cathode of the X-ray tube. For a typical 

unfiltered, single-phase X-ray spectrum, the average energy is about one-third of the peak energy. 

Therefore, most of the X-rays that are produced are much lower in energy than those that correspond 

to the peak kilovoltage of the beam. The peak kilovoltage, however, determines the maximum energy 

of X-ray photons that are produced at that machine setting.

Filters, which are specific thicknesses of absorbing material (typically aluminum), are added to the 

beams of medical X-ray machines. The filters absorb the lowest energy X-rays from the spectrum 

that have too little energy to penetrate the body to the film and that contribute greatly to absorbed 

dose. A filtered X-ray spectrum therefore has a correspondingly higher average energy than an 

unfiltered one.
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The effective energy of the X-ray beam is determined primarily by the kilovoltage and the filtration, 

and is indirectly evaluated empirically using a quantity called the beam quality or half-value layer 

(HVL). Because the X-ray beam energy influences absorbed dose, an estimate of beam energy, 

inferred from the beam quality or HVL, is needed for dose reconstruction. HVL measurements can be 

used if they are available; if not, then information about the total filtration in the X-ray tube and kVp is 

needed.

Because adding filtration to medical X-ray machines has the potential to reduce absorbed dose to 

exposed individuals, radiation protection groups began making recommendations on added filtration 

as early as 1937 (ICRU 1937). The recommendations for filter thicknesses have increased over time. 

Typical added filtration in the 1940s ranged from zero to 1 mm Al. This was in line with the 1936 

recommendations of the U.S. Advisory Committee on X-Ray and Radium Protection [later the 

National Council on Radiation Protection and Measurements (NCRP)], which called for the equivalent 

of 0.5 mm Al for radiographic installations (NBS 1936). The NCRP recommended 1 mm Al filtration 

for radiography of thick parts of the body such as the chest in 1949 (NBS 1949), and this thickness 

was presumably used at Hanford. Recommended thicknesses were later increased. In 1961, the 

NCRP recommendation for medical X-ray units called for 2.5 mm total Al filtration (NCRP 1961). This 

was recommended again in 1968 for medical units operating above 70 kVp (NCRP 1968). These 

recommended filter thicknesses might not have been used widely for some time after the dates of the 

recommendations.

The relationship of beam intensity to kVp and filtration is complex and to some extent machinespecific. It is therefore best determined empirically. Beam intensity commonly refers to the radiation 

output of the machine in terms of air kerma in air. In the absence of empirical data for a specific 

machine, adequate contemporary empirical and theoretical data exist on which to base radiation 

output of machines with a reasonable degree of uncertainty. Additional filtration reduces the beam 

intensity in a generally exponential manner. For a typical single-phase, half-wave, full-wave, or selfrectified machine operating in the range of 50 to 130 kVp, each additional millimeter of aluminum 

filtration will effect a reduction of about 40% in the beam intensity (Trout, Kelley, and Cathey 1952). 

Therefore, the approximate intensity reduction that is afforded by any thickness of aluminum filtration 

can be determined by the following exponential equation:

I = Ioe-0.4t (3-1)

or

ln (I/Io) = -0.4 t (3-2) where

t = thickness of aluminum in millimeters

I = beam intensity with the filter

Io = beam intensity without the filter

In the absence of specific measurements or empirical data, this correction can be applied to 

determine the effect of filtration on beam intensity.

Increasing the kVp will increase the beam intensity. Many empirical studies of beam intensity as a 

function of voltage show that for a given amount of filtration, increasing the voltage increases the 

beam intensity according to the 1.7 power of the voltage (BRH 1970, p. 159; Newton and Heid 1976). 

In the absence of specific measurements or empirical data, this function can be applied to determine 

the effect of kVp on beam intensity.
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3.2.2 Current and Expos ure Time

Both the tube current in milliamperes and the exposure time in seconds directly affect the number of 

X-ray photons that are produced from the X-ray tube. The exposure is often described by the 

milliampere-seconds, which is the product of X-ray tube current and exposure time. All other factors 

being equal (e.g., kVp, filtration, development, and film/screen combination), and air kerma in air can 

be assumed to be proportional to the milliampere-seconds.

3.2.3 Dis tance

X-ray beam intensity (from the X-ray tube) varies inversely with the square of the distance from the 

X-ray tube target or focal spot (also known as the source) because the target is very small in 

comparison with the distances of interest from it. This relationship facilitates the conversion of 

measurement data that are taken at certain distances to the distances necessary for dose 

reconstruction.

X-ray procedures are performed at standard source-to-image distances (SIDs), which is the distance 

between the X-ray tube target and the imaging plane or film. Radiographic chest X-rays (on 14- by 

17-in. film) have been performed at a standard 72 in. (183 cm) since the earliest days of radiography 

including at Hanford (Rising and Soldat 1959). Photofluorography (PFG) of the chest and almost all 

other radiographic procedures are performed at 36 to 40 in. (92 to 102 cm) SID (Rising and Soldat 

1959); 40 in. is the most common.

X-ray dosimetry begins with knowledge of the entrance air kerma in air, which is the air kerma in air at 

the point where the X-ray beam enters the individual’s skin or at the source-to-skin distance (SSD) 

[formerly called the entrance skin exposure]. Body part thickness varies from one individual to 

another, and can vary over time in the same individual. This type of information has unfortunately not 

been recorded for workers at DOE facilities. Dose reconstructors should assume standard body part 

thicknesses identical to those in International Commission on Radiological Protection (ICRP) 

Publication 34 (ICRP 1982), national X-ray exposure studies (DHHS 1994), and contemporary 

literature (Cahoon 1961, pp. 106–107) which results in standard SSDs for dose reconstruction. 

These are listed in Table 3-2.

 Table 3-2. Standard body dimensions for dose reconstruction.

Projection Part thickness (cm) SID (cm/in.) SSD (cm)

PA chest 23 183/72 155

LAT chest 34 183/72 144

AP and AP spot lumbar spine 23 102/40 74

LAT and LAT spot lumbar spine 34 102/40 63

3.2.4 Collimation and Waveform Characteris tics

Two other factors that affect worker dose are collimation and waveform. The most common X-ray 

waveforms are from single-phase, three-phase, and high-frequency generators. Three-phase and 

high-frequency machines did not become commonplace until the 1980s and 1990s; therefore, singlephase machines are assumed to have been used at Hanford in the early years. The waveform is of 

no significance when actual radiation output data are available as is the case for Hanford.

Collimation refers to the restriction of the X-ray beam. Even though analysis of beam area data from 

the early X-ray machines at Kadlec Hospital in Richland where all early Hanford workers were 

X-rayed seems to indicate that beams were restricted to less than the area of the 14- by 17-in. film by 

the circular cones (Kirklin et al. 1969), poor collimation is assumed before 1970 for dose 

reconstruction.
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3.2.5 Other Factors That Can Affect Worker Dos e

A number of other factors affect the X-ray exposure that is required to obtain a usable radiographic 

image and therefore have the potential to affect the dose to the worker. Knowledge of these factors is 

unnecessary for dose reconstruction purposes if beam measurements are available or if the primary 

machine technical factors of kilovoltage, time, and current are known along with the amount of 

primary beam filtration. These factors are well documented at Hanford (Rising and Soldat 1959; 

Norwood et al. 1959).

3.3 TYPE AND FREQUENCY OF X-RAY SCREENING AT HANFORD

Review of the available historical documentation at Hanford from 1943 to the present and a sample of 

claim file records of Hanford workers reveals that chest X-rays were the most commonly used X-ray 

procedure for occupational health screening. While there are some lumbar spine examinations listed 

in the claim file records, they appear to have been clearly performed for on-the-job injuries and 

therefore should not be included in dose reconstruction (42 CFR Part 82). Chest X-rays at Hanford 

for which organ doses have been developed (Section 3.5) are:

• Photofluorographic (PFG) chest (4- by 5-in. film)

• Posterior-anterior (PA) chest (14- by 17-in. film)

• Lateral (LAT) chest (14- by 17-in. film)

• PA chest with Bucky (14- by 17-in. film)

• Oblique chests (14- by 17-in. film)

• Lordotic chest (14- by 17-in. film)

By far, the most commonly performed of these over all time periods was the PA chest projection on 

14- by 17-in. film. PFG was performed in the early years from 1943 to approximately 1962. The LAT 

chest projections appear to have been performed regularly for screening only after 2000, although 

there are a few included in the records before that time. A four-projection chest series that consisted 

of PA Chest, both oblique chests, and PA with Bucky (grid) projections, appears in the records for 

workers with asbestos exposure or radiographic findings of possible asbestosis during the 1970s and 

1980s. There is evidence that oblique projections increase the diagnostic accuracy of asbestosis and 

therefore could have been included as a standard screening projection for asbestos workers (Baker 

and Green 1982). Therefore, the dose from all of these projections should be included in dose 

reconstruction when they appear in the claim file records.

The lordotic chest projection was an additional projection that was requested by a physician, often to 

better visualize the apices of the lungs, which are a common location for tuberculosis (TB). It would 

not have been performed on all workers as a standard screening projection. This is evidenced by the 

fact that at Hanford, the number of lordotic chest projections is only 2% of the number of PA chest 

projections in the 10-year period from 1946 to 1956 (Kirklin et al. 1969). Because active TB was a 

cause for not hiring a potential worker (Cantril 1946), and the lordotic projection might have been 

necessary to diagnose active TB, the dose from lordotic X-rays in the preemployment examination 

should be included in dose reconstruction. Since it is not known from the historical evidence whether 

active TB would disqualify workers after hire, dose reconstructors should also include the dose from 

the lordotic projection in the periodic screening examinations. The lordotic chest projection is not 

seen in the claim file records after about 1990.

Table 3-3 shows the frequency of various X-ray procedures for the preemployment, periodic, and 

termination examinations from Hanford documents (Cantril 1946; Fuqua 1981; Kirklin et al. 1969; 

Vails 1990). In the early years at the site, periodic X-ray examinations were relatively frequent, and 

the groups of workers that were identified as at risk received medical examinations at more frequent

intervals than other workers (Cantril 1946). It is not clear from the historical records whether these 
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periodic physical examinations included X-ray screening more frequently than annually. In a few 

claim files, chest X-rays appear to have been taken more frequently than annually, and these should 

be included in dose reconstruction unless the records indicate a reason to preclude this, such as a 

notation with the words “first aid” or “dispensary.”

Table 3-3. Frequency of occupational chest X-ray screening.

Period Frequency Comment

Up to 1956 Preemploymenta All employees

Terminationa All employees

Annuallya All employees

1956–1980

(PFG until 1962)

Preemployment All employees

Termination All employees

Annuallya All employees

1981–1990 Preemploymentc All employees

Biennialb Age 45 and older

Every 5 years Age 45 or less

Termination All employees

1990 to present Physician’s discretionc All employees

a. Kirklin et al. (1969, p. 150).

b. Beginning January 4, 1981, protocol was biennial after age 45, and every 5 years for 

all others (Fuqua 1981).

c. Preemployment and termination X-rays were provided from 1941 to the mid-1990s 

(Vails 1990). These X-rays were not required after 1990 unless personnel were in a 

job class that required an X-ray or clinical needs were indicated.

3.4 EQUIPMENT AND TECHNIQUES

All of the X-rays on Hanford workers appear to have been taken at the Kadlec Hospital in Richland 

from the time it opened in 1944 until 1956 (Cantril 1946; Kirklin et al. 1969). This would have included 

construction workers because Kadlec Hospital was for many years the only place that could perform 

X-ray examinations (Norwood 1949, p. 18). While the specific equipment model and manufacturer do 

not appear to have been recorded in historical records, it is clear from the records that the original 

equipment was available for actual beam measurements as part of the Feasibility Study of the 

Correlation of Lifetime Health and Mortality Experience of AEC and AEC Contractor Employees with 

Occupational Radiation Exposure (Mancuso, Sanders, and Brodsky 1966). The technique factors, 

filter information, and actual beam measurements from this equipment are well documented in Rising 

and Soldat (1959). Table 3-4 summarizes information about the X-ray equipment, including 

information about equipment in the later years, which comes primarily from State of Washington X-ray 

machine registration and inspection records (WDOH 1990–1999). 

3.5 ORGAN DOSES

Conversion of entrance air kerma in air to organ dose is made in accordance with published dose 

conversion factors (DCFs) in Tables A2 to A8 of ICRP Publication 34 (ICRP 1982). The tables 

provide average absorbed organ doses for common radiographic projections relative to an entrance 

air kerma in air without backscatter of 1 Gy for various beam qualities in terms of HVL of aluminum. 

However, the tables do not include all organs that are identified in the Interactive 

RadioEpidemiological Program (IREP) for dose reconstruction. For organs other than the skin in 

IREP but without individual DCFs in Publication 34, the DCF for the anatomically closest organ is 

used in most cases. Therefore, the factor for the lung is applied to all other organs within the thoracic 

cavity (i.e., thymus, esophagus, liver, gall bladder, spleen, and stomach) as shown in Table 3-5. 
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7/2010 Page 13 of 36

Table 3-4. Summary of beam parameters for 14- by 17-in. PA chest projections.

Date 

range

Machine 

type

Voltage

(kVp)

Tube 

current 

(mA)

Exposure 

time 

(s) (mAs)

Added 

filtration 

(mm Al)

Assumed 

HVL 

(mm Al)

SID 

(in.)

Entrance 

skin 

exposure 

(mR) mR/mAs Reference

1943 -

1959

Unknown 80 500 1/20 25 1.5 2.5 72 79 3.2 Kirklin et al. (1969)

1959–

1982

Unknown 80 300 1/30 10 1.5 2.5 72 40 4 Rising and Soldat (1959)

1983–

1990

General 

Electric 

DXR 750

80 200 1/20 10 2.5 2.5 72 35 3.5 Kathren (1982,1983)

1991–

1997

Continental 

325

110 200 1/30 6.7 2.5 4.0 72 

with 

grid

21 

(assumed)

3.3 Measured at 11.7 mR by 

WDOH (1990–1999, p. 

55), but the 1993 value (p. 

20) is used because it was 

higher for the same 

settings and machine.

1998–

1999

Continental 

325

110 300 1/30 10 2.5 4.0 72 17 1.7 WDOH (1990–1999, p. 14)

2/1999–

present

XMA-360 110 300 1/60 5 2.5 4.0 72 11 2.2 WDOH (1990–1999, p. 4)
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Table 3-5. General scheme for DCFs for IREP organs not included in 

ICRP Publication 34 (ORAUT 2005).

Anatomical 

location

ICRP Publication 34 

DCF (ICRP 1982)

IREP organ without specific 

DCF

Thorax Lung Thymus

Esophagus

Stomach

Bone surface

Liver, gall bladder, spleen

Remainder organs

Abdomen Ovaries Urinary bladder

Colon/rectum

Head and neck Thyroida Eye/braina

a. For PFG, because of the shorter SID than conventional chest radiography, and 

as a result of assuming poor collimation in conventional 14- by 17-in. chest 

radiography before 1970, the thyroid dose is based on the DCF for the cervical 

spine, and the eye/brain dose is based on the DCF for the chest because it is 

larger than the DCF for the PA skull (ORAUT 2005).

Because an appreciable fraction of the skeleton, in particular the trabecular bone that has a large 

surface-to-volume ratio and the sternum that is a primary location of red marrow in the adult, lies 

within the trunk, the factor for the lung is also applied to the bone surfaces and remainder organs. For 

organs in the abdomen (i.e., urinary bladder, and colon/rectum) the DCF for the ovary is used. For 

the eye/brain, the DCF for the thyroid is used. There are a few exceptions to this general scheme in 

which the edge of the X-ray beam in relation to the organ might require the use of another DCF for the 

best dose estimate.

As mentioned above, selection of the appropriate DCF also depends on knowledge of the beam 

quality or HVL. Measured beam quality data for the X-ray machines before about 1990 at Hanford 

were not found. However, the kVp and filtration were known, and an estimate of beam quality for the 

X-ray machines at Hanford could be made from these data. Because for a given amount of filtration 

and exposure, absorbed organ dose increases as a function of HVL and for conservatism the upper 

limit on the likely beam quality is rounded to match the closest value in the tables in ICRP Publication 

34 (ICRP 1982). For the period before 1991, beam quality that was expressed as HVL was 

conservatively estimated to be 2.5 mm Al; after 1991, the estimate was 4.0 mm Al. These values are 

greater than the 1.75 and approximately 3.5 mm Al values that would be derived from Table A16 of 

Publication 34, and therefore are favorable to the claimant.

3.5.1 Ches t Photofluorography (PFG)

The organ dose values for PFG at Hanford are based on actual measurements of entrance air kerma 

in air that were made with a phantom. The potential for high exposure from this procedure was 

recognized by H. Parker, who cited studies in 1943 and 1945 and noted that the entrance exposure 

was about 1 R but could be as much as 2.5 R (Parker ca. 1947). The measured value for entrance 

exposure of 1.51 R for 4- by 5-in. PFG at Hanford (Kirklin et al. 1969) is essentially the same as the 

value of 1.53 R reported in Rising and Soldat (Rising and Soldat 1959), and is consistent with the 

range of values Parker (ca. 1947) observed. The higher value of 1.53 R was used for dose 

calculations. This value is assumed to be for a single PFG projection. Dose reconstructors should 

double the organ dose values in Table 3-6 when the records indicate that stereoscopic or stereo PFG 

was obtained on a worker. The stereo PFG was a technique in which two projections (i.e., two 

exposures) were obtained at slightly different X-ray tube angles. The physician then viewed the two 

projections with a stereoscope, which gave him a simulated three-dimensional view of the chest. The 

Hanford records have a blank line on the X-ray request form that indicates when stereo views were 

requested.
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Table 3-6. Organ dose estimates for PFG until 1962.

a

Organ

DCF

2.5 mm Al HVLb

(mGy/Gy air kerma) 

Organ dose 

(rem)c

Thyroid 174d 2.66E-01

Eye/brain 32e 4.90E-02

Ovariesf N/A 6.85E-03

Urinary bladderf N/A 6.85E-03

Colon/rectumf N/A 6.85E-03

Testesf N/A 4.80E-04

Lungs (male) 419 6.41E-01

Lungs (female) 451 6.90E-01

Thymus 451 6.90E-01

Esophagus 451 6.90E-01

Stomach 451 6.90E-01

Bone surface 451 6.90E-01

Liver/gall bladder/spleen 451 6.90E-01

Remainder 451 6.90E-01

Breast 49 7.50E-02

Uterus/embryo 1.3 1.99E-03

Bone marrow (male) 92 1.41E-01

Bone marrow (female) 86 1.32E-01

Entrance skin (EnSD)g N/A 2.06E00

a. Based on measured entrance exposure of 1.53 R (Rising and Soldat 1959)

b. Dose Conversion Factors from Tables A.2 through A.8, ICRP Publication 34 (1982).

c. Dose reconstructors should double these organ doses when the records indicate stereo 

PFG.

d. Based on DCF for AP C-spine corrected for depth by 0.2 (ORAUT 2005).

e. Based on the DCF for the thyroid for the PA chest (ORAUT 2005).

f. Ovaries, testes, and associated analogue doses are based on measurements of 6.85 mrad 

for ovaries and 0.48 mrad for testes (Rising and Soldat 1959).

g. Entrance skin dose was determined by multiplying the entrance air kerma in air by the 

backscatter factor of 1.35 (for HVL of 2.5 mm Al) from NCRP Report No. 102 (1997), Table 

B-8.

The organ doses were determined by multiplying the measured entrance exposure value of 1.53 R 

(Rising and Soldat 1959) by DCFs in Tables A2 through A8 of ICRP 34 (ICRP 1982). These tables 

list DCFs based on an SID of 183 cm for conventional chest radiography. An SID of 40 inches or 

102 cm was used for PFG (Rising and Soldat 1959). This difference in distance has a negligible 

effect on organ doses as discussed in ICRP Publication 34 (p. 23), and therefore, the values listed in 

Tables A2 to A8 are appropriate for PFG. An HVL of 2.5 mm Al was assumed for selection of the 

appropriate DCFs.

Because the SID for PFG is shorter than that for conventional radiography, the maximum size of the 

PFG beam is smaller than a poorly collimated beam at the 72 in. in conventional chest radiography. 

This affects the calculation of organ dose for several organs. For dose reconstruction, the PFG beam 

is assumed to include the thyroid, thoracic organs, and liver/gall bladder/spleen; the beam does not 

include the eye/brain, gonads, bladder, or colon/rectum. To ensure that the thyroid dose reflects the 

assumption that it is in the primary beam, the dose to the thyroid was determined using the DCF for 

the AP cervical spine (where the thyroid is definitely in the primary beam) and by correcting for the 

fact that the PFG chest projection was performed PA rather than AP (as is the case for the cervical 

spine projection). The correction consists of multiplying the DCF for the AP cervical spine by a depth 

dose correction factor of 20% (the approximate percentage depth dose at an assumed depth of the 

thyroid in the neck of 10 cm) (NCRP 1997; ORAUT 2005). The dose to the eye/brain is usually 

assumed to be the same as the dose to the thyroid (as shown in Table 3-5). However, as a result of 

the assumption that the PFG beam includes the thyroid but not the eye/brain, the dose to the 
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eye/brain is determined by using the larger of the DCFs for the thyroid for the PA skull or PA chest 

projections. The DCF for the thyroid dose from the PA chest projection is the larger of the two and 

was used to calculate the dose to the eye/brain for PFG.

The dose to the ovaries and testes are based not on the DCFs in ICRP Publication 34 (ICRP 1982), 

but on the measured doses in Rising and Soldat (1959), because these appear to be based on 

phantom measurements from the actual machine that was used in the screening of workers. The 

organ doses from PFG at Hanford are listed in Table 3-6. (Skin dose from all procedures are found in 

Tables 3-10 and 3-11 later in the document).

3.5.2 Radiography on 14- by 17-Inch Film

This section describes the calculation of organ doses for the various radiographic projections used at 

Hanford. Table 3-7 provides the organ DCFs for PA, LAT, and AP lordotic projections in three groups: 

(1) for 1944 to 1970 using 2.5 mm Al HVL, (2) for 1970 to 1990 using 2.5 mm Al HVL, and (3) for 1991 

to the present using 4.0 mm Al HVLs. 

3.5.2.1 PA Ches t

The organ doses for the 14- by 17-in. chest X-rays are based on actual beam measurements by 

Rising and Soldat (1959) and WDOH (1990–1999). The measurements consist of entrance exposure 

measurements using average technique factors for PA chest X-rays and phantom measurements of 

gonad doses in 1959. Table 3-4 summarizes salient data for 14- by 17-in. PA chest radiography. The 

measurements from the State of Washington were rounded to whole years for simplicity.

Poor collimation is assumed before 1970, even though there is evidence that the X-ray machine at 

Kadlec Hospital in Richland had a Videx cone (Rising and Soldat 1959). A Videx cone had square 

double diaphragms and a small light for centering (Cahoon 1961), and it therefore had better 

capability for beam restriction than a standard circular cone. The assumption of poor collimation 

before 1970 affects the organ doses and the selection of some of the DCFs. To ensure that the 

thyroid dose reflects the assumption that it is in the primary beam of a poorly collimated PA chest 

projection, the dose to the thyroid was determined using the DCF for the AP cervical spine (where the 

thyroid is definitely in the primary beam) and corrected for the fact that the 14- by 17-in. conventional 

chest X-ray is PA rather than AP. The correction consists of multiplying the DCF for the AP cervical 

spine by a depth dose correction factor of 20% (the approximate percentage depth dose at an 

assumed depth of the thyroid in the neck of 10 cm) (NCRP 1997; ORAUT 2005). The dose to the 

eye/brain is usually assumed to be the same as the dose to the thyroid when collimation is good and 

both organs can be assumed to be outside the primary beam (as displayed in Table 3-5). However, 

as a result of the assumption that the X-ray beam before 1970 was poorly collimated, the beam is 

assumed to include the thyroid but not the eye/brain. The dose to the eye/brain was determined by 

using the larger of the DCFs for the thyroid for the PA skull or PA chest. The DCF for the thyroid dose 

from the PA chest is the larger of the two and was used to calculate the dose to the eye/brain for 

poorly collimated PA chest X-rays before 1970.

Dose reconstructors should multiply the PA chest doses by two if the records indicate that stereo 

views (two exposures) were taken. The claim records from Hanford appear to be fairly clear about 

this scenario. Dose reconstructors should also be aware that the administrative form that Hanford 

used to request the X-ray exams lists only “Chest AP” (as opposed to PA) as possible selections. 

This must be interpreted as an error on the form itself, as almost all chest X-rays are performed PA 

whenever possible [1]. On many of these records, the physician’s interpretation will list the exam 

correctly as “PA chest”. 
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3.5.2.2 Lateral Ches t

The exposure necessary for a LAT 14- by 17-in. chest radiograph is greater than that for the more 

common PA chest projection. The entrance exposure must be increased because of the greater lateral 

body thickness in comparison to the PA thickness, which places the body closer to the X-ray tube. Few 

measurements are available for LAT 14- by 17-in. chest radiography at Hanford. Data indicate that the 

entrance air kerma in air from a LAT radiograph was 1.94 times the entrance air kerma in air from a PA 

chest radiograph (Kirklin et al. 1969). To ensure that exposure from this source was not 

underestimated, a moderately conservative factor of 2.5 was assumed for the ratio of entrance air 

kerma in air from LAT to PA chest radiographs for organ dose calculations.
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Table 3-7. DCFs (mGy/Gy entrance kerma in air) for various chest projections.

a

Organ Projection

DCF through 1970 

with 2.5 mm Al HVL

DCF 1971–1990 

with 2.5 mm Al HVL

DCF 1991–present with 

4.0 mm Al HVL

Thyroid PA 174b 32 78

LAT 137c 115 164

AP Lordotic 868d 317 414

Eye brain PA 32e 32 78

LAT 137c 115 164

AP Lordotic 868d 317 414

Ovaries PA N/Af 1.0 5.2

LAT N/Ag 0.6 2.5

AP Lordotic 233h 2.0 0.8

Testes PA N/Af 0.01 0.01

LAT N/Af 0.1 0.1

AP Lordotic 18h 0.01 0.01

Lungs (male) PA 419 419 628

LAT 193 193 313

AP Lordotic 473 473 685

Lungs (female) PA 451 451 674

LAT 220 220 351

AP Lordotic 353i 353 536

Breast PA 49 49 116

LAT 255 255 343

AP Lordotic 836 836 1004

Uterus PA N/Af 1.3 5.2

LAT N/Af 0.6 2.1

AP Lordotic 305 1.5 4.9

Bone marrow (male) PA 92 92 178

LAT 37 37 76

AP Lordotic 48 48 98

Bone marrow (female) PA 86 86 172

LAT 29 29 59

AP Lordotic 48 48 97

a. DCFs from ICRP (1982, Tables A.2 to A.8).

b. DCF for AP cervical spine corrected for depth by 0.2 (ORAUT 2005).

c. DCF for LAT skull (ORAUT 2005).

d. DCF for AP cervical spine.

e. DCF for PA chest (ORAUT 2005).

f. Ovaries, testes, and associated analogue doses for the PA chest are based on measurements of 0.867 mrad for ovaries 

and 0.0293 mrad for testes (Rising and Soldat 1959).

g. Ovaries, testes, and associated analogue doses for the LAT chest are based on measurements of 0.867 mrad for 

ovaries and 0.0293 mrad for testes for the PA chest (Rising and Soldat 1959) and on the ratio of gonad dose from LAT 

chest to PA chest of 3 (Webster and Merrill 1957).

h. DCF for AP abdomen.

i. Note that the male lung DCF is higher than the female lung DCF for the AP projection.

Doses to the gonads, as previously mentioned, are based initially on phantom measurements by 

Rising and Soldat (1959). Rising and Soldat measured gonad dose for the PA chest projection but 

not for the LAT or the lordotic chest projections. To determine gonad dose for the LAT chest, the

doses from Rising and Soldat were multiplied by 3, which is the ratio of the gonad dose from the LAT 

to the PA chest projection in Webster and Merrill (1957). Table 3-8 provides the organ doses for LAT 

14- by 17-in. chest radiography.
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Table 3-8. Organ doses (rem) for chest projections for all periods.

a,b

Organ Projection 1943-1959 1959–1970 1971–1982 1983–3/1990 1991–1997 1998–1999 1999–present

Thyroid PA 1.37E-02 6.96E-03 1.28E-03 1.12E-03 1.64E-03 1.33E-03 8.58E-04

Bucky PA 5.12E-03 4.48E-03

LAT/oblique 2.71E-02 1.37E-02 1.15E-02 1.01E-02 8.69E-03 7.05E-03 4.51E-03

AP lordotic 6.86E-02 3.47E-02 1.27E-02 1.11E-02 8.69E-03 7.04E-03 4.55E-03

Eye/brain PA 2.53E-03 1.28E-03 1.28E-03 1.12E-03 1.64E-03 1.33E-03 8.58E-04

Bucky PA 5.12E-03 4.48E-03

LAT/oblique 2.71E-02 1.37E-02 1.15E-02 1.01E-02 8.69E-03 7.05E-03 4.51E-03

AP lordotic 6.86E-02 3.47E-02 1.27E-02 1.11E-02 8.69E-03 7.04E-03 4.55E-03

Ovaries PA 8.67E-04 8.67E-04 4.00E-05 3.50E-05 1.09E-04 8.84E-05 5.72E-05

Bucky PA 1.60E-04 1.40E-04

LAT/oblique 2.06E-03 2.06E-03 6.00E-05 5.28E-05 1.33E-04 1.08E-04 6.88E-05

AP lordotic 1.84E-02 9.32E-03 8.00E-05 7.00E-05 1.68E-05 1.36E-05 8.80E-06

Urinary/bladder PA 8.67E-04 8.67E-04 4.00E-05 3.50E-05 1.09E-04 8.84E-05 5.72E-05

Bucky PA 1.60E-04 1.40E-04

LAT/oblique 2.06E-03 2.06E-03 6.00E-05 5.28E-05 1.33E-04 1.08E-04 6.88E-05

AP lordotic 1.84E-02 9.32E-03 8.00E-05 7.00E-05 1.68E-05 1.36E-05 8.80E-06

Colon/rectum PA 8.67E-04 8.67E-04 4.00E-05 3.50E-05 1.09E-04 8.84E-05 5.72E-05

Bucky PA 1.60E-04 1.40E-04

LAT/oblique 2.06E-03 2.06E-03 6.00E-05 5.28E-05 1.33E-04 1.08E-04 6.88E-05

AP lordotic 1.84E-02 9.32E-03 8.00E-05 7.00E-05 1.68E-05 1.36E-05 8.80E-06

Testes PA 2.93E-05 2.93E-05 4.00E-07 3.50E-07 2.10E-07 1.70E-07 1.10E-07

Bucky PA 1.60E-06 1.40E-06

LAT/oblique 8.79E-05 8.79E-05 1.00E-05 8.80E-06 5.30E-06 4.30E-06 2.75E-06

AP lordotic 1.42E-03 7.20E-04 4.00E-07 3.50E-07 2.10E-07 1.70E-07 1.10E-07

Lungs (male) PA 3.31E-02 1.68E-02 1.68E-02 1.47E-02 1.32E-02 1.07E-02 6.91E-03

Bucky PA 6.70E-02 5.87E-02

LAT/oblique 3.82E-02 1.93E-02 1.93E-02 1.70E-02 1.66E-02 1.35E-02 8.61E-03

AP lordotic 3.74E-02 1.89E-02 1.89E-02 1.66E-02 1.44E-02 1.16E-02 7.54E-03

Lungs (female) PA 3.56E-02 1.80E-02 1.80E-02 1.58E-02 1.42E-02 1.15E-02 7.41E-03

Bucky PA 7.22E-02 6.31E-02

LAT/oblique 4.36E-02 2.20E-02 2.20E-02 1.94E-02 1.86E-02 1.51E-02 9.65E-03

AP lordotic 2.79E-02 1.41E-02 1.41E-02 1.24E-02 1.13E-02 9.11E-03 5.90E-03

Thymus PA 3.56E-02 1.80E-02 1.80E-02 1.58E-02 1.42E-02 1.15E-02 7.41E-03

Bucky PA 7.22E-02 6.31E-02

LAT/oblique 4.36E-02 2.20E-02 2.20E-02 1.94E-02 1.86E-02 1.51E-02 9.65E-03

AP lordotic 3.74E-02 1.89E-02 1.41E-02 1.24E-02 1.44E-02 1.16E-02 7.54E-03

Stomach PA 3.56E-02 1.80E-02 1.80E-02 1.58E-02 1.42E-02 1.15E-02 7.41E-03

Bucky PA 7.22E-02 6.31E-02

LAT/oblique 4.36E-02 2.20E-02 2.20E-02 1.94E-02 1.86E-02 1.51E-02 9.65E-03

AP lordotic 3.74E-02 1.89E-02 1.41E-02 1.24E-02 1.44E-02 1.16E-02 7.54E-03
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Organ Projection 1943-1959 1959–1970 1971–1982 1983–3/1990 1991–1997 1998–1999 1999–present

Bone surface PA 3.56E-02 1.80E-02 1.80E-02 1.58E-02 1.42E-02 1.15E-02 7.41E-03

Bucky PA 7.22E-02 6.31E-02

LAT/oblique 4.36E-02 2.20E-02 2.20E-02 1.94E-02 1.86E-02 1.51E-02 9.65E-03

AP lordotic 3.74E-02 1.89E-02 1.41E-02 1.24E-02 1.44E-02 1.16E-02 7.54E-03

Liver/gall 

bladder/spleen

PA 3.56E-02 1.80E-02 1.80E-02 1.58E-02 1.42E-02 1.15E-02 7.41E-03

Bucky PA 7.22E-02 6.31E-02

LAT/oblique 4.36E-02 2.20E-02 2.20E-02 1.94E-02 1.86E-02 1.51E-02 9.65E-03

AP lordotic 3.74E-02 1.89E-02 1.41E-02 1.24E-02 1.44E-02 1.16E-02 7.54E-03

Remainder organs PA 3.56E-02 1.80E-02 1.80E-02 1.58E-02 1.42E-02 1.15E-02 7.41E-03

Bucky PA 7.22E-02 6.31E-02

LAT/oblique 4.36E-02 2.20E-02 2.20E-02 1.94E-02 1.86E-02 1.51E-02 9.65E-03

AP lordotic 3.74E-02 1.89E-02 1.41E-02 1.24E-02 1.44E-02 1.16E-02 7.54E-03

Breast PA 3.87E-03 1.96E-03 1.96E-03 1.72E-03 2.44E-03 1.97E-03 1.28E-03

Bucky PA 7.84E-03 6.86E-03

LAT/oblique 5.05E-02 2.55E-02 2.55E-02 2.24E-02 1.82E-02 1.47E-02 9.43E-03

AP lordotic 6.60E-02 3.34E-02 3.34E-02 2.93E-02 2.11E-02 1.71E-02 1.10E-02

Uterusa PA 8.67E-04 8.67E-04 5.20E-05 4.55E-05 1.09E-04 8.84E-05 5.72E-05

Bucky PA 2.08E-04 1.82E-04

LAT/oblique 2.06E-03 2.06E-03 6.00E-05 5.28E-05 1.11E-04 9.03E-05 5.78E-05

AP lordotic 2.41E-02 1.22E-02 6.00E-05 5.25E-05 1.03E-04 8.33E-05 5.39E-05

Bone marrow 

(male)

PA 7.27E-03 3.68E-03 3.68E-03 3.22E-03 3.74E-03 3.03E-03 1.96E-03

Bucky PA 1.47E-02 1.29E-02

LAT/oblique 7.33E-03 3.70E-03 3.70E-03 3.26E-03 4.03E-03 3.27E-03 2.09E-03

AP lordotic 3.79E-03 1.92E-03 1.92E-03 1.68E-03 2.06E-03 1.67E-03 1.08E-03

Bone marrow 

(female)

PA 6.79E-03 3.44E-03 3.44E-03 3.01E-03 3.61E-03 2.92E-03 1.89E-03

Bucky PA 1.38E-02 1.20E-02

LAT/oblique 5.74E-03 2.90E-03 2.90E-03 2.55E-03 3.13E-03 2.54E-03 1.62E-03

AP lordotic 3.79E-03 1.92E-03 1.92E-03 1.68E-03 2.04E-03 1.65E-03 1.07E-03

Entrance skinc PA/AP 1.07E-01 5.40E-02 5.40E-02 4.70E-02 2.98E-02 2.41E-02 1.56E-02

Bucky PA 2.16E-01 1.89E-01

LAT/oblique 2.67E-01 1.35E-01 1.35E-01 1.19E-01 7.53E-02 6.12E-02 3.90E-02

a. Doses before 1970 are based on measured values (Rising and Soldat 1959; Webster and Merrill 1957) for testes, ovaries, uterus, and analogues.

b. The LAT doses from this table can be used to determine the dose from oblique projections when claim file records show they were provided.

c. Entrance skin dose is determined by multiplying the entrance air kerma by the backscatter factors of 1.35 and 1.42 for HVL of 2.5 mm Al and 4.0 mm Al, respectively, from NCRP Report 

102 (NRCP 1997, Table B-8). Skin doses for all areas of skin are provided in Tables 3-10 and 3-11. 
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3.5.2.3 Bucky P A Ches t

Some of the claim file records from the 1970s and 1980s indicate that a special four-projection chest 

series, including the “Bucky PA Chest” projection was performed on some of the workers. It appears 

that this series was taken on workers who were suspected of having early signs of asbestosis or who 

worked with asbestos. Bucky is a term for a reciprocating grid, which consists of fine lead strips that 

are placed in front of the film that move back and forth during the exposure. The purpose of the grid 

is to absorb some of the scatter radiation that is emitted at large oblique angles from reaching the film. 

Such obliquely scattered radiation obscures detail in the image and detracts from it. The fact that a 

specific request is recorded for the grid to be used implies that the grid was not used for PA chest Xrays routinely during that period. After 1990, the State of Washington Department of Health 

measurements indicate that a grid was used for all PA chests (WDOH 1990–1999). Therefore, the 

Bucky PA doses are only provided for 1971 to 1990.

Because the grid itself consists of radiation absorbing material, the exposure factors must be 

increased when the grid is used. Table B-4 of NCRP Report 102, gives a bucky factor (the factor by 

which the exposure must be increased) of about 4.0 for 80 kVp and a 10:1 or 12:1 ratio grid (NCRP 

1997), while Cahoon (1961, p. 131) gives a factor of 3. The entrance air kerma in air values were 

therefore multiplied by 4 while using the same DCFs to obtain the organ doses for the Bucky PA 

projection. These organ doses are listed in Table 3-8.

3.5.2.4 Oblique Ches t

Part of the special four-projection chest series included two oblique projections of the chest. These are 

assumed to be the right posterior oblique (RPO) and the left posterior oblique (LPO) without evidence 

to the contrary. The position of the body for the oblique projection is similar but not identical to the 

position of the body for the LAT chest projection. The oblique chest projections would therefore have 

required similar technique factors of kVp, milliampere-seconds, and SID as the LAT projection because 

the chest thickness would be similar. For dose reconstruction, the organ doses from the LAT projection 

in Table 3-8 can be used for the oblique projection. Skin doses for the oblique projections are provided 

separately in Tables 3-10 and 3-11. It should be noted that the skin doses are not identical to the LAT 

chest skin doses because of the different position of the body relative to the direction of the X-ray 

beam. The doses in the tables are for the RPO and LPO. The Hanford claim records indicate that 

when oblique chest projections were done, both oblique projections were done, and so dose 

reconstructors should include the dose from both.

3.5.2.5 Lordotic Ches t

The lordotic projection was commonly performed as AP, in which the worker faced the X-ray tube and 

leaned back from the waist towards the cassette for the exposure (Ballinger 1982). Organ doses from 

the lordotic projection are in Table 3-8. Because the lordotic projection is performed as AP, the gonad 

doses were determined by using the DCFs for the AP abdomen and assuming that the X-ray beam 

was poorly collimated and the gonads were in the primary beam.

It is worth noting that in the PA chest projection the DCF for the female lung is higher than that for the 

male lung, but in the lordotic chest projection performed as AP the DCF is higher for the male lung. 

Therefore, the male lung dose value is used for the organs in IREP without specific ICRP Publication 

34 DCFs (such as the esophagus, stomach, etc.; ICRP 1982) when usually the female lung dose value 

is used for these organs (see Table 3-4). Organ doses for the lordotic projection are not provided after 

1990 because the records do not indicate that this projection was used after that date.
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3.5.3 Skin Dos es

The skin doses from all chest projections and all periods were developed in accordance with the 

general scheme in ORAUT-OTIB-0006 (ORAUT 2005), but have been expanded to include the chest 

projections in the Hanford claim files (i.e., AP lordotic, RPO, and LPO). The scheme defines areas of 

skin as belonging to one of the following categories for dose assignment: entrance skin dose (EnSD), 

exit skin dose (ExSD), outside but near the primary beam entrance (10% EnSD), outside but near the 

primary beam exit (10% ExSD), and remote skin dose (RSD). The skin dose categories are listed in 

Table 3-9. The category for a particular area of skin depends on the chest projection because of the 

different exposure geometries and on the size of the beam (poor collimation is assumed before 1970). 

The skin doses from all projections are provided in Tables 3-10 and 3-11.

3.6 UNCERTAINTY ANALYSIS FOR HANFORD RADIOGRAPHY DOSES

Error (deviation from the correct, true, or conventionally accepted value of a quantity) and uncertainty 

(potential range of a stated, measured, assumed, or otherwise determined value of a quantity) provide 

an indication of the confidence of the dose estimates. Error implies knowledge of what the correct or 

actual value is, which is of course not known. Therefore, the more appropriate factor is uncertainty, 

which is expressed in terms of the confidence level (e.g., a 99% confidence level indicates that the 

correct or true value, although not actually known, has a 99% probability of falling within the cited 

range). Uncertainty includes both precision (reproducibility of the measurement) and accuracy (how 

close the measurement or estimate of dose comes to the actual or correct value).

In theory, a large number of factors can introduce uncertainties or affect the X-ray machine output 

intensity and dose to the worker. However, because X-ray doses at Hanford were derived largely 

from actual beam intensity measurements, in practice only five variables can be reasonably 

considered to have an impact on dose uncertainty:

1. Measurement error

2. Variation in applied kilovoltage (kVp)

3. Variation in beam current (mA)

4. Variation in exposure time (s)

5. Distance from the worker to the source of the X-rays (SSD)

The influence of other factors such as use of screens, grids, reciprocity failure, film speed, and 

development, while potentially variable, are in a sense included among these five variables because 

the beam output intensity measurements at Hanford were based on the actual technique factors for 

the existing conditions.

The actual beam measurements at Hanford were made with R-meters or similar ionization chamber 

devices. If they were properly calibrated and used, they typically and historically had an uncertainty of 

±2% for photon energies below 400 keV (Kathren and Larson 1969). Although more recent versions 

of these instruments might provide a somewhat smaller uncertainty [perhaps on the order of ±1% 

(NBS 1985; Lamperti, Loftus, and Loevenger 1988)], for conservatism the uncertainty range of ±2% 

should be applied to measurements of X-ray intensity at Hanford.

For a given set of machine settings and parameters, X-ray output is theoretically constant. In general, 

for a given kVp setting, variation in kVp falls within ±5% of the machine setting (Seibert et al. 1991). 

As noted above, beam intensity is approximately proportional to the 1.7 power of the kilovoltage; this 

translates to an uncertainty of approximately ±8.6% in relation to output beam intensity in the 80 to 

100 kVp that was used for radiography at Hanford. For conservatism, this is rounded up to ±9%.
Document No. ORAUT-TKBS-0006-3 Revision No. 02 Effective Date: 01/0

7/2010 Page 23 of 36

Table 3-9. Skin dose guidance for various chest projections and periods.

Area of skin

PFG 

1943–

about 1962

PA 

before 

1970

LAT 

before 1970

AP lordotic 

before 

1970

RPO before 

1970

LPO 

before 

1970

PA 

after 1970

LAT 

after 1970

AP 

lordotic 

after 1970

RPO after 

1970

LPO after 

1970

Right front shoulder ExSD ExSD EnSD EnSD ExSD ExSD ExSD EnSD EnSD ExSD ExSD

Right back shoulder EnSD EnSD EnSD ExSD EnSD EnSD EnSD EnSD ExSD EnSD EnSD

Left front shoulder ExSD ExSD ExSD EnSD ExSD ExSD ExSD ExSD EnSD ExSD ExSD

Left back shoulder EnSD EnSD ExSD ExSD EnSD EnSD EnSD ExSD ExSD EnSD EnSD

Right upper arm to 

elbow

10% EnSD EnSD EnSD EnSD EnSD EnSD 10% EnSD EnSD EnSD 10% EnSD 10% EnSD

Left upper arm to elbow 10% EnSD EnSD ExSD EnSD EnSD EnSD 10% EnSD ExSD EnSD 10% EnSD 10% EnSD

Left hand EnSD EnSD 10% EnSD 10% EnSD 10% EnSD 10% EnSD 10% EnSD 10% EnSD 10% EnSD 10% EnSD 10% EnSD

Right hand EnSD EnSD 10% EnSD 10% EnSD 10% EnSD 10% EnSD 10% EnSD 10% EnSD 10% EnSD 10% EnSD 10% EnSD

Left elbow, forearm, 

wrist

10% EnSD EnSD 10% EnSD EnSD 10% EnSD 10% EnSD 10% EnSD 10% EnSD EnSD 10% EnSD 10% EnSD

Right elbow, forearm, 

wrist

10% EnSD EnSD 10% EnSD EnSD 10% EnSD 10% EnSD 10% EnSD 10% EnSD EnSD 10% EnSD 10% EnSD

Right side of head 

(including ear)

10% EnSD 10% EnSD Eye/brain 10% EnSD 10% ExSD 10% EnSD 10% EnSD 10% EnSD 10% EnSD 10% ExSD 10% EnSD

Left side of head 

including ear

10% EnSD 10% EnSD Eye/brain 10% EnSD 10% EnSD 10% ExSD 10% EnSD 10% EnSD 10% EnSD 10% EnSD 10% ExSD

Front left thigh RSD 

(0.52 m)

RSD 

(0.52 m)

RSD 

(0.52 m)

RSD 

(0.52 m)

RSD (0.52 m) RSD 

(0.52 m)

RSD 

(0.52 m)

RSD 

(0.52 m)

RSD 

(0.52 m)

RSD 

(0.52 m)

RSD 

(0.52 m)

Back left thigh RSD 

(0.52 m)

RSD 

(0.52 m)

RSD 

(0.52 m)

RSD 

(0.52 m)

RSD (0.52 m) RSD 

(0.52 m)

RSD 

(0.52 m)

RSD 

(0.52 m)

RSD 

(0.52 m)

RSD 

(0.52 m)

RSD 

(0.52 m)

Front right thigh RSD 

(0.52 m)

RSD 

(0.52 m)

RSD 

(0.52 m)

RSD 

(0.52 m)

RSD (0.52 m) RSD 

(0.52 m)

RSD 

(0.52 m)

RSD 

(0.52 m)

RSD 

(0.52 m)

RSD 

(0.52 m)

RSD 

(0.52 m)

Back right thigh RSD 

(0.52 m)

RSD 

(0.52 m)

RSD 

(0.52 m)

RSD 

(0.52 m)

RSD (0.52 m) RSD 

(0.52 m)

RSD 

(0.52 m)

RSD 

(0.52 m)

RSD 

(0.52 m)

RSD 

(0.52 m)

RSD 

(0.52 m)

Left knee and below RSD 

(0.86 m)

RSD 

(0.86 m)

RSD 

(0.86 m)

RSD 

(0.86 m)

RSD (0.86 m) RSD 

(0.86 m)

RSD 

(0.86 m)

RSD 

(0.86 m)

RSD 

(0.86 m)

RSD 

(0.86 m)

RSD 

(0.86 m)

Right knee and below RSD 

(0.86 m)

RSD 

(0.86 m)

RSD 

(0.86 m)

RSD 

(0.86 m)

RSD (0.86 m) RSD 

(0.86 m)

RSD 

(0.86 m)

RSD 

(0.86 m)

RSD 

(0.86 m)

RSD 

(0.86 m)

RSD 

(0.86 m)

Left side of face Eye/brain Eye/brain Eye/brain EnSD EnSD ExSD Eye/brain 10% EnSD EnSD 10% EnSD 10% ExSD

Right side of face Eye/brain Eye/brain Eye/brain EnSD ExSD EnSD Eye/brain 10% EnSD EnSD 10% ExSD 10% EnSD

Left side of neck 10% EnSD EnSD Eye/brain EnSD EnSD ExSD 10% EnSD 10% EnSD EnSD 10% EnSD 10% ExSD

Right side of neck 10% EnSD EnSD Eye/brain EnSD ExSD EnSD 10% EnSD 10% EnSD EnSD 10% ExSD 10% EnSD

Back of head 10% EnSD 10% EnSD Eye/brain ExSD 10% EnSD 10% EnSD 10% EnSD 10% EnSD ExSD 10% EnSD 10% EnSD

Front of neck Eye/brain Eye/brain Eye/brain EnSD Eye/brain Eye/brain Thyroid 10% EnSD EnSD Thyroid Thyroid

Back of neck 10% EnSD EnSD Eye/brain ExSD EnSD EnSD 10% EnSD 10% EnSD ExSD 10% EnSD 10% EnSD

Front torso: base of 

neck to end of sternum

ExSD ExSD Lung EnSD ExSD ExSD ExSD Lung EnSD ExSD ExSD

Front torso: end of 

sternum to lowest rib

ExSD ExSD Lung EnSD ExSD ExSD ExSD Lung EnSD ExSD ExSD

Front torso: lowest rib 

to iliac crest

ExSD ExSD Lung EnSD ExSD ExSD 10% ExSD 10% Lung EnSD 10% ExSD 10% ExSD

Front torso: iliac crest 

to pubis

10% ExSD 10% ExSD 10% Lung 10% EnSD 10% ExSD 10% ExSD 10% ExSD 10% Lung 10% EnSD 10% ExSD 10% ExSD
Document No. ORAUT-TKBS-0006-3 Revision No. 02 Effective Date: 01/07/2010 Page 24 of 36

Back torso: base of 

neck to mid-back

EnSD EnSD Lung ExSD EnSD EnSD EnSD Lung ExSD EnSD EnSD

Back torso: mid-back to 

lowest rib

EnSD EnSD Lung ExSD EnSD EnSD EnSD Lung ExSD EnSD EnSD

Back torso: lowest rib 

to iliac crest

EnSD EnSD Lung ExSD EnSD EnSD 10% EnSD 10% Lung ExSD 10% EnSD 10% EnSD

Back torso: buttocks 

(Iliac crest and below)

10% EnSD 10% EnSD 10% Lung 10% ExSD 10% EnSD 10% EnSD 10% EnSD 10% Lung 10% ExSD 10% EnSD 10% EnSD

Right torso: base of 

neck to end of sternum

EnSD EnSD EnSD EnSD ExSD EnSD EnSD EnSD EnSD ExSD EnSD

Right torso: end of 

sternum to lowest rib

EnSD EnSD EnSD EnSD ExSD EnSD EnSD EnSD EnSD ExSD EnSD

Right torso: lowest rib 

to iliac crest

EnSD EnSD EnSD EnSD ExSD EnSD 10% EnSD 10% EnSD EnSD 10% ExSD 10% EnSD

Right torso: iliac crest 

to pubis (right hip)

10% EnSD 10% EnSD 10% EnSD 10% EnSD 10% ExSD 10% EnSD 10% EnSD 10% EnSD 10% EnSD 10% ExSD 10% EnSD

Left torso: base of neck 

to end of sternum

EnSD EnSD ExSD EnSD EnSD ExSD EnSD ExSD EnSD EnSD ExSD

Left torso: end of 

sternum to lowest rib

EnSD EnSD ExSD EnSD EnSD ExSD EnSD ExSD EnSD EnSD ExSD

Left torso: lowest rib to 

iliac crest

EnSD EnSD ExSD EnSD EnSD ExSD 10% EnSD 10% ExSD EnSD 10% EnSD 10% ExSD

Left torso: iliac crest to 

pubis (left hip)

10% EnSD 10% EnSD 10% ExSD 10% EnSD 10% EnSD 10% ExSD 10% EnSD 10% ExSD 10% EnSD 10% EnSD 10% ExSD
Document No. ORAUT-TKBS-0006-3 Revision No. 02 Effective Date: 01/0

7/2010 Page 25 of 36

Table 3-10. Skin dose (rem) from various chest projections, 1943 to 1982.

a

Area of skin

PFG 

1943–

1962

1943-

1959

LAT 

Until 

1959

AP 

lordotic 

Until 

1959

PA 

1959–

1970

LAT 

1959–

1970

AP 

lordotic 

1959–

1970

PA 

1971–

1982

LAT 

1971–

1982

AP 

lordotic 

1971–

1982

Bucky 

PA 

1971–

1982

RPO 

1971–

1982

LPO 

1971–

1982

Right front shoulder 4.49E-02 2.3E-03 2.67E-01 1.07E-01 1.2E-03 1.35E-01 5.40E-02 1.2E-03 1.35E-01 5.40E-02 4.7E-03 6E-04 6E-04

Right back shoulder 2.06E+00 1.07E-01 2.67E-01 2.3E-03 5.40E-02 1.35E-01 1.2E-03 5.40E-02 1.35E-01 1.2E-03 2.16E-01 1.35E-01 1.35E-01

Left front shoulder 4.49E-02 2.3E-03 1.2E-03 1.07E-01 1.2E-03 6E-04 5.40E-02 1.2E-03 6E-04 5.40E-02 4.7E-03 6E-04 6E-04

Left back shoulder 2.06E+00 1.07E-01 1.2E-03 2.3E-03 5.40E-02 6E-04 1.2E-03 5.40E-02 6E-04 1.2E-03 2.16E-01 1.35E-01 1.35E-01

Right upper arm to elbow 2.06E-01 1.07E-01 2.67E-01 1.07E-01 5.40E-02 1.35E-01 5.40E-02 5.4E-03 1.35E-01 5.40E-02 2.16E-02 1.35E-01 1.35E-01

Left upper arm to elbow 2.06E-01 1.07E-01 1.2E-03 1.07E-01 5.40E-02 5.9E-04 5.40E-02 5.4E-03 6E-04 5.40E-02 2.16E-02 1.35E-01 1.35E-01

Left hand 2.06E+00 1.07E-01 2.67E-02 1.07E-02 5.40E-02 1.35E-02 5.4E-03 5.4E-03 1.35E-02 5.4E-03 2.16E-02 1.35E-02 1.35E-02

Right hand 2.06E+00 1.07E-01 2.67E-02 1.07E-02 5.40E-02 1.35E-02 5.4E-03 5.4E-03 1.35E-02 5.4E-03 2.16E-02 1.35E-02 1.35E-02

Left elbow, forearm, wrist 2.06E-01 1.07E-01 2.67E-02 1.07E-01 5.40E-02 1.35E-02 5.40E-02 5.4E-03 1.35E-02 5.40E-02 2.16E-02 1.35E-02 1.35E-02

Right elbow, forearm, wrist 2.06E-01 1.07E-01 2.67E-02 1.07E-01 5.40E-02 1.35E-02 5.40E-02 5.4E-03 1.35E-02 5.40E-02 2.16E-02 1.35E-02 1.35E-02

Right side of head including ear 2.06E-01 1.07E-02 2.71E-02 1.07E-02 5.4E-03 1.37E-02 5.4E-03 5.4E-03 1.35E-02 5.4E-03 2.16E-02 6E-05 1.35E-02

Left side of head including ear 2.06E-01 1.07E-02 2.71E-02 1.07E-02 5.4E-03 1.37E-02 5.4E-03 5.4E-03 1.35E-02 5.4E-03 2.16E-02 1.35E-02 6E-05

Front left thigh 5E-04 3E-05 4E-05 3E-05 2E-05 2E-05 2E-05 2E-05 2E-05 2E-05 6E-05 2E-05 2E-05

Back left thigh 5E-04 3E-05 4E-05 3E-05 2E-05 2E-05 2E-05 2E-05 2E-05 2E-05 6E-05 2E-05 2E-05

Front right thigh 5E-04 3E-05 4E-05 3E-05 2E-05 2E-05 2E-05 2E-05 2E-05 2E-05 6E-05 2E-05 2E-05

Back right thigh 5E-04 3E-05 4E-05 3E-05 2E-05 2E-05 2E-05 2E-05 2E-05 2E-05 6E-05 2E-05 2E-05

Left knee and below 2E-04 1E-05 1E-05 1E-05 6E-06 8E-06 6E-06 6E-06 8E-06 6E-06 2E-05 8E-06 8E-06

Right knee and below 2E-04 1E-05 1E-05 1E-05 6E-06 8E-06 6E-06 6E-06 8E-06 6E-06 2E-05 8E-06 8E-06

Left side of face 4.90E-02 2.5E-03 2.71E-02 1.07E-01 1.3E-03 1.37E-02 5.40E-02 1.3E-03 1.35E-02 5.40E-02 5.1E-03 1.35E-01 6E-04

Right side of face 4.90E-02 2.5E-03 2.71E-02 1.07E-01 1.3E-03 1.37E-02 5.40E-02 1.3E-03 1.35E-02 5.40E-02 5.1E-03 6E-04 1.35E-01

Left side of neck 2.06E-01 1.07E-01 2.71E-02 1.07E-01 5.40E-02 1.37E-02 5.40E-02 5.4E-03 1.35E-02 5.40E-02 2.16E-02 1.35E-01 6E-04

Right side of neck 2.06E-01 1.07E-01 2.71E-02 1.07E-01 5.40E-02 1.37E-02 5.40E-02 5.4E-03 1.35E-02 5.40E-02 2.16E-02 6E-04 1.35E-01

Back of head 2.06E-01 1.07E-02 2.71E-02 2.3E-03 5.4E-03 1.37E-02 1.2E-03 5.4E-03 1.35E-02 1.2E-03 2.16E-02 1.35E-02 1.35E-02

Front of neck 4.90E-02 2.5E-03 2.71E-02 1.07E-01 1.3E-03 1.37E-02 5.40E-02 1.3E-03 1.35E-02 5.40E-02 5.1E-03 1.15E-02 1.15E-02

Back of neck 2.06E-01 1.07E-01 2.71E-02 2.3E-03 5.40E-02 1.37E-02 1.2E-03 5.4E-03 1.35E-02 1.2E-03 2.16E-02 1.35E-01 1.35E-01

Front torso: base of neck to end 

of sternum

4.49E-02 2.3E-03 4.36E-02 1.07E-01 1.2E-03 2.20E-02 5.40E-02 1.2E-03 2.20E-02 5.40E-02 4.7E-03 6E-04 6E-04

Front torso: end of sternum to 

lowest rib

4.49E-02 2.3E-03 4.36E-02 1.07E-01 1.2E-03 2.20E-02 5.40E-02 1.2E-03 2.20E-02 5.40E-02 4.7E-03 6E-04 6E-04

Front torso: lowest rib to iliac 

crest

4.49E-02 2.3E-03 4.36E-02 1.07E-01 1.2E-03 2.20E-02 5.40E-02 1E-04 2.2E-03 5.40E-02 5E-04 6E-04 6E-04

Front torso: iliac crest to pubis 4.49E-03 2E-04 4.4E-03 1.07E-02 1E-04 2.2E-03 5.4E-03 1E-04 2.2E-03 5.4E-03 5E-04 6E-05 6E-05

Back torso: base of neck to midback2.06E+00 1.07E-01 4.36E-02 2.3E-03 5.40E-02 2.20E-02 1.2E-03 5.40E-02 2.20E-02 1.2E-03 2.16E-01 1.35E-01 1.35E-01

Back torso: mid-back to lowest 

rib

2.06E+00 1.07E-01 4.36E-02 2.3E-03 5.40E-02 2.20E-02 1.2E-03 5.40E-02 2.20E-02 1.2E-03 2.16E-01 1.35E-01 1.35E-01

Back torso: lowest rib to iliac 

crest

2.06E+00 1.07E-01 4.36E-02 2.3E-03 5.40E-02 2.20E-02 1.2E-03 5.4E-03 2.2E-03 1.2E-03 2.16E-02 1.35E-01 1.35E-01

Back torso: buttocks (Iliac crest 

and below)

2.06E-01 1.07E-02 4.4E-03 2.E-04 5.4E-03 2.2E-03 1E-04 5.4E-03 2.2E-03 1E-04 2.16E-02 1.35E-02 1.35E-02

Right torso: base of neck to end 

of sternum

2.06E+00 1.07E-01 2.67E-01 1.07E-01 5.40E-02 1.35E-01 5.40E-02 5.40E-02 1.35E-01 5.40E-02 2.16E-01 6E-04 1.35E-01
Document No. ORAUT-TKBS-0006-3 Revision No. 02 Effective Date: 01/0

7/2010 Page 26 of 36

Area of skin

PFG 

1943–

1962

1943-

1959

LAT 

Until 

1959

AP 

lordotic 

Until 

1959

PA 

1959–

1970

LAT 

1959–

1970

AP 

lordotic 

1959–

1970

PA 

1971–

1982

LAT 

1971–

1982

AP 

lordotic 

1971–

1982

Bucky 

PA 

1971–

1982

RPO 

1971–

1982

LPO 

1971–

1982

Right torso: end of sternum to 

lowest rib

2.06E+00 1.07E-01 2.67E-01 1.07E-01 5.40E-02 1.35E-01 5.40E-02 5.40E-02 1.35E-01 5.40E-02 2.16E-01 6E-04 1.35E-01

Right torso: lowest rib to iliac 

crest

2.06E+00 1.07E-01 2.67E-01 1.07E-01 5.40E-02 1.35E-01 5.40E-02 5.4E-03 1.35E-02 5.40E-02 2.16E-02 6E-04 1.35E-01

Right torso: iliac crest to pubis 

(right hip)

2.06E-01 1.07E-02 2.67E-02 1.07E-02 5.4E-03 1.35E-02 5.4E-03 5.4E-03 1.35E-02 5.4E-03 2.16E-02 6E-05 1.35E-02

Left torso: base of neck to end of 

sternum

2.06E+00 1.07E-01 1.2E-03 1.07E-01 5.40E-02 6E-04 5.40E-02 5.40E-02 6E-04 5.40E-02 2.16E-01 1.35E-01 6E-04

Left torso: end of sternum to 

lowest rib

2.06E+00 1.07E-01 1.2E-03 1.07E-01 5.40E-02 6E-04 5.40E-02 5.40E-02 6E-04 5.40E-02 2.16E-01 1.35E-01 6E-04

Left torso: lowest rib to iliac crest 2.06E+00 1.07E-01 1.2E-03 1.07E-01 5.40E-02 6E-04 5.40E-02 5.4E-03 6E-05 5.40E-02 2.16E-02 1.35E-01 6E-04

Left torso: iliac crest to pubis 

(Left hip)

2.06E-01 1.07E-02 1E-04 1.07E-02 5.4E-03 6E-05 5.4E-03 5.4E-03 6E-05 5.4E-03 2.16E-02 1.35E-02 6E-05

a. Values less than 1 mrem shown to one significant digit. 
Document No. ORAUT-TKBS-0006-3 Revision No. 02 Effective Date: 01/0

7/2010 Page 27 of 36

Table 3-11. Skin dose (rem) from various chest projections, 1983 to present.a

Area of skin

PA 

1983–

1990

LAT 

1983–

1990

AP 

Lordotic 

1983–

1990

Bucky 

PA 

1983–

1990

RPO 

1983–

1990

LPO 

1983–

1990

PA 

1991–

1997

LAT 

1991–

1997

PA 

1998–

1999

LAT 

1998–

1999

PA 

1999–

present

LAT 

1999–

present

Right front shoulder 1.0E-03 1.19E-01 4.70E-02 4.1E-03 5E-04 5E-04 1.0E-03 7.53E-02 8.E-04 6.12E-02 5E-04 3.90E-02

Right back shoulder 4.70E-02 1.19E-01 1.0E-03 1.89E-01 1.19E-01 1.19E-01 2.98E-02 7.53E-02 2.41E-02 6.12E-02 1.56E-02 3.90E-02

Left front shoulder 1.0E-03 5E-04 4.70E-02 4.1E-03 5E-04 5E-04 1.0E-03 6E-04 8E-04 5E-04 5E-04 3E-04

Left back shoulder 4.70E-02 5E-04 1.0E-03 1.89E-01 1.19E-01 1.19E-01 2.98E-02 6E-04 2.41E-02 5E-04 1.56E-02 3E-04

Right upper arm to elbow 4.7E-03 1.19E-01 4.70E-02 1.89E-02 1.19E-01 1.19E-01 3.0E-03 7.53E-02 2.4E-03 6.12E-02 1.6E-03 3.90E-02

Left upper arm to elbow 4.7E-03 5.2E-04 4.70E-02 1.89E-02 1.19E-01 1.19E-01 3.0E-03 6.E-04 2.4E-03 5E-04 1.6E-03 3E-04

Left hand 4.7E-03 1.19E-02 4.7E-03 1.89E-02 1.19E-02 1.19E-02 3.0E-03 7.5E-03 2.4E-03 6.1E-03 1.6E-03 3.9E-03

Right hand 4.7E-03 1.19E-02 4.7E-03 1.89E-02 1.19E-02 1.19E-02 3.0E-03 7.5E-03 2.4E-03 6.1E-03 1.6E-03 3.9E-03

Left elbow, forearm, wrist 4.7E-03 1.19E-02 4.70E-02 1.89E-02 1.19E-02 1.19E-02 3.0E-03 7.5E-03 2.4E-03 6.1E-03 1.6E-03 3.9E-03

Right elbow, forearm, wrist 4.7E-03 1.19E-02 4.70E-02 1.89E-02 1.19E-02 1.19E-02 3.0E-03 7.5E-03 2.4E-03 6.1E-03 1.6E-03 3.9E-03

Right side of head including ear 4.7E-03 1.19E-02 4.7E-03 1.89E-02 5E-05 1.19E-02 3.0E-03 7.5E-03 2.4E-03 6.1E-03 1.6E-03 3.9E-03

Left side of head including ear 4.7E-03 1.19E-02 4.7E-03 1.89E-02 1.19E-02 5E-05 3.0E-03 7.5E-03 2.4E-03 6.1E-03 1.6E-03 3.9E-03

Front left thigh 1E-05 2E-05 1E-05 5E-05 2E-05 2E-05 1E-05 2E-05 9E-06 1E-05 6E-06 8E-06

Back left thigh 1E-05 2E-05 1E-05 5E-05 2E-05 2E-05 1E-05 2E-05 9E-06 1E-05 6E-06 8E-06

Front right thigh 1E-05 2E-05 1E-05 5E-05 2E-05 2E-05 1E-05 2E-05 9E-06 1E-05 6E-06 8E-06

Back right thigh 1E-05 2E-05 1E-05 5E-05 2E-05 2E-05 1E-05 2E-05 9E-06 1E-05 6E-06 8E-06

Left knee and below 5E-06 7E-06 5E-06 2E-05 7E-06 7E-06 4E-06 6E-06 3E-06 5E-06 2E-06 3E-06

Right knee and below 5E-06 7E-06 5E-06 2E-05 7E-06 7E-06 4E-06 6E-06 3E-06 5E-06 2E-06 3E-06

Left side of face 1.01E-02 1.19E-02 4.70E-02 1.01E-02 1.19E-01 5E-04 1.6E-03 7.5E-03 1.3E-03 6.1E-03 9E-04 3.9E-03

Right side of face 1.01E-02 1.19E-02 4.70E-02 1.01E-02 5E-04 1.19E-01 1.6E-03 7.5E-03 1.3E-03 6.1E-03 9E-04 3.9E-03

Left side of neck 4.7E-03 1.19E-02 4.70E-02 1.89E-02 1.19E-01 5E-04 3.0E-03 7.5E-03 2.4E-03 6.1E-03 1.6E-03 3.9E-03

Right side of neck 4.7E-03 1.19E-02 4.70E-02 1.89E-02 5E-04 1.19E-01 3.0E-03 7.5E-03 2.4E-03 6.1E-03 1.6E-03 3.9E-03

Back of head 4.7E-03 1.19E-02 1.0E-03 1.89E-02 1.19E-02 1.19E-02 3.0E-03 7.5E-03 2.4E-03 6.1E-03 1.6E-03 3.9E-03

Front of neck 1.01E-02 1.19E-02 4.70E-02 1.01E-02 1.01E-02 1.01E-02 1.6E-03 7.5E-03 1.3E-03 6.1E-03 9E-04 3.9E-03

Back of neck 4.7E-03 1.19E-02 1.0E-03 1.89E-02 1.19E-01 1.19E-01 3.0E-03 7.5E-03 2.4E-03 6.1E-03 1.6E-03 3.9E-03

Front torso: base of neck to end of sternum 1.0E-03 1.94E-02 4.70E-02 4.1E-03 5E-04 5E-04 1.0E-03 1.86E-02 8E-04 1.51E-02 5E-04 9.7E-03

Front torso: end of sternum to lowest rib 1.0E-03 1.94E-02 4.70E-02 4.1E-03 5E-04 5E-04 1.0E-03 1.86E-02 8E-04 1.51E-02 5E-04 9.7E-03

Front torso: lowest Rib to iliac crest 1E-04 1.9E-03 4.70E-02 4E-04 5E-04 5E-04 1E-04 1.9E-03 8E-05 1.5E-03 5E-05 1E-03

Front torso: iliac crest to pubis 1E-04 1.9E-03 4.7E-03 4E-04 5E-05 5E-05 1E-04 1.9E-03 8E-05 1.5E-03 5E-05 1E-03

Back torso: base of neck to mid-back 4.70E-02 1.94E-02 1.0E-03 1.89E-01 1.19E-01 1.19E-01 2.98E-02 1.86E-02 2.41E-02 1.51E-02 1.56E-02 9.7E-03

Back torso: mid-back to lowest rib 4.70E-02 1.94E-02 1.0E-03 1.89E-01 1.19E-01 1.19E-01 2.98E-02 1.86E-02 2.41E-02 1.51E-02 1.56E-02 9.7E-03

Back torso: lowest rib to iliac crest 4.7E-03 1.9E-03 1.0E-03 1.89E-02 1.19E-01 1.19E-01 3.0E-03 1.9E-03 2.4E-03 1.5E-03 1.6E-03 1E-03

Back torso: buttocks (Iliac crest and below) 4.7E-03 1.9E-03 1E-04 1.89E-02 1.19E-02 1.19E-02 3.0E-03 1.9E-03 2.4E-03 1.5E-03 1.6E-03 1E-03

Right torso: base of neck to end of sternum 4.70E-02 1.19E-01 4.70E-02 1.89E-01 5E-04 1.19E-01 2.98E-02 7.53E-02 2.41E-02 6.12E-02 1.56E-02 3.90E-02

Right torso: end of sternum to lowest rib 4.70E-02 1.19E-01 4.70E-02 1.89E-01 5E-04 1.19E-01 2.98E-02 7.53E-02 2.41E-02 6.12E-02 1.56E-02 3.90E-02

Right torso: lowest rib to iliac crest 4.7E-03 1.19E-02 4.70E-02 1.89E-02 5E-04 1.19E-01 3.0E-03 7.5E-03 2.4E-03 6.1E-03 1.6E-03 3.9E-03

Right torso: iliac crest to pubis (right hip) 4.7E-03 1.19E-02 4.7E-03 1.89E-02 5E-05 1.19E-02 3.0E-03 7.5E-03 2.4E-03 6.1E-03 1.6E-03 3.9E-03

Left torso: base of neck to end of sternum 4.70E-02 5E-04 4.70E-02 1.89E-01 1.19E-01 5E-04 2.98E-02 6E-04 2.41E-02 5E-04 1.56E-02 3E-04

Left torso: end of sternum to lowest rib 4.70E-02 5E-04 4.70E-02 1.89E-01 1.19E-01 5E-04 2.98E-02 6E-04 2.41E-02 5E-04 1.56E-02 3E-04

Left torso: lowest rib to iliac crest 4.7E-03 5E-05 4.70E-02 1.89E-02 1.19E-01 5E-04 3.0E-03 6E-05 2.4E-03 5E-05 1.6E-03 3E-05

Left torso: iliac crest to pubis (left hip) 4.7E-03 5E-05 4.7E-03 1.89E-02 1.19E-02 5E-05 3.0E-03 6E-05 2.4E-03 5E-05 1.6E-03 3E-05

a. Values less than 1 mrem shown to one significant digit.
Document No. ORAUT-TKBS-0006-3 Revision No. 02 Effective Date: 01/07/2010 Page 28 of 36

Similarly, slight variations in tube current are normal; as a tube ages or heats up from use, current can 

change and typically drops. With all other factors constant, beam intensity reduces in direct 

proportion to the change in tube current. The reduction in beam output from current variation is 

typically not more than a few percent under normal operating conditions; large decreases are readily 

detectable and result in maintenance on the machine to restore the output or, as a temporary 

measure, an increase in the current or kilovoltage to provide the necessary intensity for proper film 

density. There is no evidence to suggest that such temporary measures were ever necessary or 

applied at Hanford. For a given kilovoltage setting, the output of the beam is a function of the tube 

current, which in turn is measured by a milliammeter, which measures average tube current. The 

measurement is subject to uncertainties; there might be minor changes in output as the tube heats 

from normal use. Because these variations are typically small, the estimated uncertainty in beam 

output attributable to current variation is ±5%.

Another parameter that has potential to affect the dose from radiography, perhaps significantly, 

relates to the time of exposure. A full-wave rectified machine produces 120 pulses per second of 

X-rays. In an exposure time of 1/20 of a second, only six pulses would result. A small error in the 

timer that resulted in a change of only ±1 pulse would correspondingly affect the output by ±17%. For 

an exposure time of 1/30 of a second, the change in output corresponding to a deviation of ±1 pulse is 

±25%. Early mechanical timers were notoriously inaccurate; accuracy improved significantly with the 

introduction of electronic timers. Other than measurements of reproducibility made in the late 1980s 

and beyond by the State of Washington, there are no data on which to base an evaluation of the 

accuracy and precision of the timers on Hanford X-ray machines. The measurements made by the 

State suggest that the timers, and indeed the entire X-ray output, were fairly constant (WDOH 1990–

1999). However, for conservatism, the assumed uncertainty in beam output attributable to timers has 

an upper limit of ±25%.

The final factor likely to affect worker dose relates to distance from the source of the X-rays, which is 

a determinant of the entrance air kerma in air. For a given individual, the SSD is determined largely 

by the body thickness of the worker and the accuracy of the positioning. Information on worker 

thickness is rarely available, even in the medical literature. However, at SRS entrance skin dose 

measurements were made on nine workers of varying chest thicknesses (builds) (Cooley, 1967). 

While Cooley does not report the measured chest thicknesses for these nine workers, the entrance 

skin doses are reported and reflect the increase in exposure needed to radiograph thicker body parts, 

in this case, chests. The standard uncertainty of the range of measurements is 5.6, resulting in an 

uncertainty of 21% from this source. 

There are two approaches to determine the combined uncertainty from the above five potential 

sources of uncertainty. The first, and most conservative in that it gives the greatest range, would be 

to assume that the uncertainties are additive, which would give an uncertainty range of 2 + 9 +5 + 25 

+ 21 = +62%. However, a more reasonable approach would be to assume that the uncertainties are 

in fact random, and therefore to compute the combined statistical uncertainty as the square root of the 

sum of the squares of all the various uncertainties, which is ±34.2%. Rounding this up to ±35% would 

seem to provide an adequate and suitably conservative indication of uncertainty. Therefore, for an 

individual derived organ dose, a total combined standard uncertainty of ±35% can be assumed; for 

further conservatism, dose reconstructors should assume that errors are all positive and use only 

+35%.

3.7 ATTRIBUTIONS AND ANNOTATIONS

Where appropriate in this document, bracketed callouts have been inserted to indicate information, 

conclusions, and recommendations provided to assist in the process of worker dose reconstruction. 

These callouts are listed here in the Attributions and Annotations section, with information to identify 

the source and justification for each associated item. Conventional References, which are provided in 
Document No. ORAUT-TKBS-0006-3 Revision No. 02 Effective Date: 01/07/2010 Page 29 of 36

the next section of this document, link data, quotations, and other information to documents available 

for review on the Project’s Site Research Database (SRDB).

Vernon E. Shockley served as one of the initial Subject Experts for this document. Mr. Shockley was 

previously employed at Hanford and his work involved management, direction or implementation of 

radiation protection and/or health physics program policies, procedures or practices related to atomic 

weapons activities at the site. This revision has been overseen by a Document Owner who is fully 

responsible for the content, including all findings and conclusions. In all cases where such 

information or prior studies or writings are included or relied upon by Mr. Shockley, those materials 

are fully attributed to the source. 

Ronald L. Kathren served as one of the initial Subject Experts for this document. Mr. Kathren was 

previously employed at Hanford and his work involved management, direction or implementation of 

radiation protection and/or health physics program policies, procedures or practices related to atomic 

weapons activities at the site. This revision has been overseen by a Document Owner who is fully 

responsible for the content, including all findings and conclusions. In all cases where such 

information or prior studies or writings are included or relied upon by Mr. Kathren, those materials are 

fully attributed to the source.

Fred Duncan assumed responsibility as Document Owner for this document in September, 2008. Mr. 

Duncan replaced Edward Scalsky when Mr. Scalsky’s employer declared a new corporate conflict of 

interest for the Hanford Site. Mr. Scalsky continues to participate on this document team in the 

appropriate role of Subject Expert in compliance with the NIOSH Conflict or Bias policy.

[1] Thomas, Elyse. ORAU Team. Principal Medical Dosimetrist. September 2009.

Review of claim file records from Hanford.
Document No. ORAUT-TKBS-0006-3 Revision No. 02 Effective Date: 01/07/2010 Page 30 of 36

REFERENCES

Baker, E. L., and R. Greene, 1982, “Incremental Value of Oblique Chest Radiographs in the Diagnosis 

of Asbestos-Induced Pleural Disease,” American Journal of Industrial Medicine, volume 3, pp. 

17–22. [SRDB Ref ID: 22751]

Ballinger, P. W., 1982, Merrill’s Atlas of Radiographic Positions and Radiologic Procedures, Fifth 

Edition, C.V. Mosby Company, St. Louis, Missouri. [SRDB Ref ID: 31426]

BRH (Bureau of Radiological Health), 1970, Radiological Health Handbook, Revised Edition, U.S. 

Department of Health, Education and Welfare, Public Health Service, Rockville, Maryland. 

[SRDB Ref ID: 75017]

Cahoon, J. B., 1961, Formulating X-Ray Technics, Fifth Edition, Duke University Press, Durham, 

North Carolina. [SRDB Ref ID: 38740]

Cantril, S. T., 1946, Industrial Medical Programs Hanford Engineer Works, Report MDDC-602, U. S. 

Atomic Energy Commission, Oak Ridge-Directed Operations, Oak Ridge, Tennessee, 

November 15. [SRDB Ref ID: 26814]

Cantril, S. T., 1951, “Industrial Medical Program—Hanford Engineer Works,” Part B, Paper 1, 

Industrial Medicine on the Plutonium Project, Survey and Collected Papers, R. S. Stone, 

editor, McGraw Hill Book Company, New York, New York. [SRDB Ref ID: 739, p. 311]

Cooley, R. C., 1967, “Personnel Radiation Exposures from Medical X-rays – Savannah River Plant –

Part II”. [SRDB Ref ID: 68124]

DHHS (U.S. Department of Health and Human Services), ca. 1994, Nationwide Evaluation of X-Ray 

Trends (NEXT), 1994 P/A Chest X-Ray Data, Public Health Service, Washington, D.C. [SRDB 

Ref ID: 21851]

Fuqua, P. A., 1981, “Chest X-rays to be Taken at the Time of Employment and Every Five Years 

Thereafter,” memorandum to physicians and physicians assistants, Hanford Environmental 

Health Foundation, Richland, Washington, December 22. [SRDB Ref ID: 26815]

ICRP (International Commission on Radiological Protection), 1982, Protection of the Patient in 

Diagnostic Radiology, Publication 34, Pergamon Press, Oxford, England.

ICRU (International Committee on Radiological Units), 1937, “Recommendations of the International 

Committee for Radiological Units (Chicago, 1937),” Radiology, volume 29, number 5, pp. 634–

636. [SRDB Ref ID: 73113]

Kathren, R. L., 1982, “Shielding for Diagnostic X-Ray Unit, HS-1,” memorandum to K. R. Heid, 

Battelle Memorial Institute, Pacific Northwest Laboratory, Richland, Washington, October 20. 

[SRDB Ref ID: 4901, p. 39]

Kathren, R. L., 1983, “Radiological Survey of HEHF Diagnostic X-Ray Facility,” memorandum to K. R. 

Heid, Battelle Memorial Institute, Pacific Northwest Laboratory, Richland, Washington, January 

28. [SRDB Ref ID: 4901, p. 43]

Kathren, R. L., and H. V. Larson, 1969, “Radiological Calibration and Standardization for Health 

Physics: A Program, a Plea, and a Proposal,” Health Physics, volume 16, pp. 778–782. 

[SRDB Ref ID: 13356]
Document No. ORAUT-TKBS-0006-3 Revision No. 02 Effective Date: 01/07/2010 Page 31 of 36

Kirklin, C. W., B. D. Nuss, K. R. Heid, F. L. Rising, F. E. Adley, and E. B. Lavelle, 1969, The AEC 

Health and Mortality Study: Its Purpose, Scope and Design and the Supporting Data Systems 

from the Hanford Operations: Retrospective and Continuing Phases of Data Acquisition, 

Hanford Environmental Health Foundation, Richland, Washington. [SRDB Ref ID: 12330]

Lamperti, P. J., T. P. Loftus, and R. Loevinger, 1988, NBS Measurement Services: Calibration of XRay and Gamma-Ray Measuring Instruments, Special Publication 250-16, U.S. Department of 

Commerce, National Bureau of Standards, Gaithersburg, Maryland. [SRDB Ref ID: 75020]

Mancuso, T. F., B. S. Sanders, and A. Brodsky, 1966, Feasibility Study of the Correlation of Lifetime 

Health and Mortality Experience of AEC and AEC Contractor Employees with Occupational 

Radiation Exposure, Progress Report No. 2, May 1965 - May 1966, NYO-3394-5, University of 

Pittsburgh, Graduate School of Public Health, Pittsburgh, Pennsylvania. [SRDB Ref ID: 

25758]

Mancuso, T. F., B. S. Sanders, and A. Brodsky, 1968, Feasibility Study of the Correlation of Lifetime 

Health and Mortality Experience of AEC and AEC Contractor Employees with Occupational

Radiation Exposure, Progress Report No. 4, June 3, 1967 - May 31, 1968, NYO-3394-9, 

University of Pittsburgh, Graduate School of Public Health, Pittsburgh, Pennsylvania. [SRDB 

Ref ID: 25759]

NBS (National Bureau of Standards), 1936, X-Ray Protection, Handbook 20, U.S. Department of 

Commerce, Washington, D.C., July 24. [SRDB Ref ID: 73165]

NBS (National Bureau of Standards), 1949, Medical X-Ray Protection up to Two Million Volts, 

Handbook 41, U.S. Department of Commerce, Washington, D.C., March 30. [SRDB Ref ID: 

73169]

NBS (National Bureau of Standards), 1955, X-Ray Protection, Handbook 60, U.S. Department of 

Commerce, Washington, D.C., December 1. [SRDB Ref ID: 73173]

NBS (National Bureau of Standards), 1961, Medical X-Ray Protection up to Three Million Volts, 

Handbook 76 (NCRP Report 26), U.S. Department of Commerce, Washington, D.C., February 

9. [SRDB Ref ID: 11113]

NCRP (National Council on Radiation Protection and Measurements), 1968, Medical X-Ray and 

Gamma-Ray Protection for Energies Up To 10 MeV: Equipment Design and Use: 

Recommendations of the National Council on Radiation Protection and Measurements, Report 

33, Washington, D.C.

NCRP (National Council on Radiation Protection and Measurements), 1985, SI Units in Radiation 

Protection and Measurement, Report 82, Bethesda, Maryland.

NCRP (National Council on Radiation Protection and Measurements), 1989, Medical X-Ray, Electron 

Beam and Gamma-Ray Protection for Energies up to 50 MeV (Equipment Design, 

Performance and Use), Report 102, Bethesda, Maryland, February 28.

Newton, C. E., 1976, “Kadlec Hospital Exposures," memorandum to K. R. Heid, Battelle Memorial 

Institute, Pacific Northwest Laboratory, Richland, Washington, April 28. [SRDB Ref ID: 

24016]

NIOSH (National Institute for Occupational Safety and Health), 2007, Radiation Exposures Covered 

for Dose Reconstructions Under Part B of the Energy Employees Occupational Illness 
Document No. ORAUT-TKBS-0006-3 Revision No. 02 Effective Date: 01/07/2010 Page 32 of 36

Compensation Program Act, OCAS-IG-003, Rev. 0, Office of Compensation Analysis and 

Support, Cincinnati, Ohio, November 5.

Norwood, W. D., 1949, History Present and Proposed Future Program, Hanford Works, Richland, 

Washington, September. [SRDB Ref ID: 455]

Norwood, W. D., J. W. Healy, E. E. Donaldson, W. C. Roesch, and C. W. Kirklin, 1959, “The Gonadal 

Radiation Dose Received by the People of a Small American City Due to the Diagnostic Use 

of Roentgen Rays,” American Journal of Roentgenology, Radium Therapy, and Nuclear 

Medicine, volume 82, number 6, pp. 1081–1097. [SRDB Ref ID: 13394]

ORAUT (Oak Ridge Associated Universities Team), 2005, Dose Reconstruction from Occupationally 

Related Diagnostic X-Ray Procedures, ORAUT-OTIB-0006, Rev. 03 PC-1, Oak Ridge, 

Tennessee, December 21.

Parker, H. M., ca. 1947, Health Physics Instrumentation and Radiation Protection, MDDC-783, 

Hanford Works, Richland, Washington. [SRDB Ref ID: 27283]

Rising, F. L., and J. K. Soldat, 1959, “Radiation Exposures During Diagnostic Radiographic 

Examinations at Kadlec Methodist Hospital,” letter to Dr. W. D. Norwood, April 30. [SRDB Ref 

ID: 13343]

Seibert, J. A., G. T. Barnes, and R. G. Gould, editors, 1991, Specification, Acceptance Testing and 

Quality Control of Diagnostic X-Ray Imaging Equipment, Medical Physics Monograph No. 20, 

American Association of Physicists in Medicine, American Institute of Physics, New York, New 

York. [SRDB Ref ID: 465]

Stanford, R. W., and J. Vance, 1955, “The Quantity of Radiation Received by the Reproductive 

Organs of Workers During Routine Diagnostic X-Ray Examinations,” British Journal of 

Radiology, volume 28, pp. 266–273. [SRDB Ref ID: 55763]

State of Washington, 1990–1999, “Radiographic Inspection Results,” Department of Health, March 

30, 1990, November 11, 1993, April 22, 1997, and October 18, 1999. [SRDB Ref ID: 4901, 

pp. 55, 20, 14, 4]

Trout, E. D., J. P. Kelley, and G. A. Cathey, 1952, “The Use of Filters to Control Radiation Exposure 

to the Patient in Diagnostic Roentgenology,” American Journal of Roentgenology, Radium 

Therapy, and Nuclear Medicine, volume 67, number 6, pp. 946–963. [SRDB Ref ID: 13358]

Vails, K. W, 1990, “Frequency of Diagnostic X-rays”, memorandum, Hanford Environmental Health 

Foundation, Richland, Washington, May 16. [SRDB Ref ID: 26816]

Webster, E. W., and O. E. Merrill, 1957, “Radiation Hazards, II. Measurements of Gonadal Dose in 

Radiographic Examinations,” New England Journal of Medicine, volume 257, number 17, pp. 

811–819. [SRDB Ref ID: 11100]
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GLOSSARY

air kerma in air

The sum of kinetic energy of all charged particles liberated per unit mass of air. The unit is the 

joule per kilogram (J kg-1

) and is given the special name gray (Gy).

anterior-posterior (AP)

Physical orientation of the body relative to a penetrating directional radiation such that the 

radiation passes through the body from the front to the back. See exposure geometry.

beam quality

Empirical measure of the ability of a polyenergetic X-ray beam to penetrate matter affected by 

the kilovoltage, anode material, voltage waveform, and filtration of an X-ray tube. The halfvalue layer in millimeters of aluminum is a typical measure of X-ray beam quality for the 

energy range used in radiography. Also called beam hardness. See filtration.

entrance skin exposure

Air kerma in air without backscatter at the point of entry into the body. Also called entrance 

kerma in air. See kerma.

exposure geometry

Orientation (physical positioning) of a person or object in relation to a radiation source. This 

geometry is a factor in the radiation dose to various parts of the body. See anterior-posterior, 

posterior-anterior, and lateral in relation to radiography.

film speed

Measure of the sensitivity of film to X-rays or light.

filtration

Process of selective absorption of an X-ray beam, usually with millimeter thicknesses of 

aluminum material between the X-ray source and the film. Usually measured in millimeters of 

aluminum. See beam quality and half-value layer.

focal spot

Apparent size of the area of the anode of an X-ray tube bombarded by accelerated electrons 

when viewed from the central axis of the useful radiation beam.

gray (Gy)

International System unit of absorbed radiation dose, which is the amount of energy from any 

type of ionizing radiation deposited in any medium; 1 gray equals 1 joule per kilogram or 

100 rads.

grid

Device that consists of a series of thin, closely spaced lead strips that is placed between the 

person being X-rayed and the X-ray film to reduce interaction of scattered radiation with the 

film.

half-value layer (HVL)

Thickness of a specified substance, usually in millimeters of aluminum, that filters an X-ray 

beam to reduce the kerma in air rate by one-half. See filtration.
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Interactive RadioEpidemiological Program (IREP)

Computer program that uses a person’s calculated annual organ doses and other information 

(e.g., gender, age at diagnosis, and age at exposure) to calculate the probability of causation 

of a specific cancer for a given pattern and level of radiation exposure.

International Commission on Radiological Protection (ICRP)

International private scientific organization established to advance the science of radiological 

protection in particular by providing recommendations and guidance on all aspects of 

protection against ionizing radiation.

inverse square law

Mathematical relationship between two quantities in which one quantity varies inversely as the 

square of the other (e.g., radiation exposure is four times larger at 5 feet from a source than at 

10 feet).

kerma

Measure in units of absorbed dose (usually grays but sometimes rads) of the energy released 

by radiation from a given amount of a substance. Kerma is the sum of the initial kinetic 

energies of all the charged ionizing particles liberated by uncharged ionizing particles 

(neutrons and photons) per unit mass of a specified material. The word derives from kinetic 

energy released per unit ma

kiloelectron-volt (keV)

ss.

Unit of particle energy equal to 1,000 (1 × 103

) electron-volts.

lateral (LAT)

Orientation of the body during an X-ray procedure in which the X-rays pass from one side of 

the body to the other. See exposure geometry.

milliammeter

Instrument for measuring electric current in milliamperes.

National Council on Radiation Protection and Measurements (NCRP)

Private U.S. public service organization chartered by the U.S. Congress to formulate and 

disseminate information, guidance, and recommendations on radiation protection and 

measurements.

organ dose

Dose to a given organ from an X-ray procedure.

photofluorography (PFG)

Historical radiographic technique used for chest images for screening a large number of 

people in a short period of time. The X-ray image produced on a fluorescent screen was 

photographed on 4- by 5-inch film. PFG was the primary method of screening large 

populations for tuberculosis before the advent of nonradiographic screening methods. Also 

called fluorography or mass miniature radiography.

photon

Quantum of electromagnetic energy generally regarded as a discrete particle having zero rest 

mass, no electric charge, and an indefinitely long lifetime. The entire range of electromagnetic 

radiation that extends in frequency from 1023 cycles per second (hertz) to 0 hertz.
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posterior-anterior (P/A)

Physical orientation of the body relative to a penetrating directional radiation field such that the 

radiation passes through the body from the back to the front. See exposure geometry.

preplacement X-ray, preemployment X-ray

An X-ray, usually of the chest, taken before hire or assignment to a specific job. The purpose 

of preplacement X-rays was to screen for active disease, such as tuberculosis.

probability of causation (POC)

For purposes of dose reconstruction for the Energy Employees Occupational Illness 

Compensation Act, the percent likelihood, at the 99th percentile, that a worker incurred a 

particular cancer from occupational exposure to radiation.

radiograph

Static images produced on radiographic film by gamma rays or X-rays after passing through 

matter. In the context of EEOICPA, radiographs are X-ray images of the various parts of the 

body used to screen for disease. See radiology.

radiology

Medical science and specialty of producing images on radiographic film or other media, which 

are used to identify, diagnose, and or treat diseases, injuries, or other conditions.

screen

Fluorescent material in X-ray film cassettes that absorbs X-rays and converts them into light to 

expose the X-ray film. Also called intensifying screens.

source-to-image distance (SID)

Distance from the X-ray machine target (anode) to the plane of the image receptor (film). This 

distance is standardized for typical radiographic procedures. Chest X-rays, for example, are 

performed at a 72-inch SID.

source-to-skin distance (SSD)

Distance from the X-ray machine target (anode) to the skin of the person being X-rayed. This 

distance varies with the size of the person being radiographed.

technique

Combination of X-ray machine settings used to produce radiographs, which consists of the 

applied kilovoltage, tube current (milliamperes), and exposure time (seconds). The last two 

parameters are often multiplied to yield the electric charge that has crossed the X-ray tube 

during the exposure in units of milliampere-seconds. Any combination of time and tube 

current that produces a given product in milliampere-seconds produces the same exposure for 

a fixed peak kilovoltage. Also called technic.

termination X-ray

X-ray, usually of the chest, taken when an employee separates from the company.

tube current

Average electrical current measured in milliamperes flowing from the cathode to the anode of 

an X-ray tube during operation of the tube.

variable

In a mathematical formula, a quantity or function that can assume any given value or set of 

values.
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X-ray

(1) See X-ray radiation. (2) See radiograph.

X-ray radiation

Electromagnetic radiation (photons) produced by bombardment of atoms by accelerated 

particles. X-rays are produced by various mechanisms including bremsstrahlung and electron 

shell transitions within atoms (characteristic X-rays). Once formed, there is no difference 

between X-rays and gamma rays, but gamma photons originate inside the nucleus of an atom.

X-ray tube

Evacuated electronic tube in which electrons accelerated by an applied voltage to strike an 

anode or target and produce X-rays.