ORAU TEAM

Dose Reconstruction

Project for NIOSH

Oak Ridge Associated Universities I Dade Moeller & Associates I MJW Corporation

Page 1 of 19

Document Title:

Pantex Plant – Occupational Medical Dose

Document Number: ORAUT-TKBS-0013-3 

Revision: 01

Effective Date: 12/23/2005

Type of Document: TBD

Supersedes: Revision 00

Subject Expert: Jack J. Fix

Document Owner

Approval: Signature on File Approval Date: 12/08/2005

Dillard B. Shipler, TBD Team Leader

Approval: Signature on File Approval Date: 12/07/2005

Judson L. Kenoyer, Task 3 Manager

Concurrence: Signature on File Concurrence Date: 12/07/2005

Kate Kimpan, Project Director

Approval: Signature on File Approval Date: 12/23/2005

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-0013-3 Revision No. 01 Effective Date: 12/23/2005 Page 2 of 19

PUBLICATION RECORD

EFFECTIVE 

DATE

REVISION 

NUMBER DESCRIPTION

08/24/2004 00 New technical basis document for the Pantex Plant – Occupational 

Medical Dose. First approved issue. Initiated by Jerome B. Martin.

12/23/2005 01 Approved issue of Revision 01. Training required: As determined by 

the Task Manager. Initiated by Dillard B. Shipler.
Document No. ORAUT-TKBS-0013-3 Revision No. 01 Effective Date: 12/23/2005 Page 3 of 19

TABLE OF CONTENTS

SECTION TITLE

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

PAGE

5

3.1 Introduction ..............................................................................................................................6

3.2 Examination Types and Frequencies .......................................................................................7

3.3 Equipment and Techniques......................................................................................................7

 3.3.1 Photofluorography ........................................................................................................7

 3.3.2 X-Ray Machines ...........................................................................................................7

 3.3.3 Specific Technique Charts............................................................................................8

3.4 Organ Dose Calculations .........................................................................................................9

3.5 Uncertainty Analysis...............................................................................................................14

3.6 Instruction Guide for Dose Reconstructors .............................................................................15

References ........................................................................................................................................17

Glossary ............................................................................................................................................18
Document No. ORAUT-TKBS-0013-3 Revision No. 01 Effective Date: 12/23/2005 Page 4 of 19

LIST OF TABLES

TABLE TITLE PAGE

3-1 Pantex worker X-ray examinations............................................................................................

 

7

3-2 Technique factors for chest PA X-rays ......................................................................................8

3-3 Technique factors for lumbar spine AP X-rays...........................................................................9

3-4 Technique factors for lumbar spine lateral X-rays......................................................................9

3-5 Organ dose estimates for chest PA radiographs before 1967 assuming minimal 

 collimation ....................................................................................................................... ....10

3-6 Organ dose estimates for chest PA radiographs from 1967 through 1969................................11

3-7 Organ dose estimates for chest PA radiographs from 1970 through 1984...............................12

3-8 Organ dose estimates for chest PA radiographs from 1985 through 1994...............................13

3-9 Organ dose estimates for chest PA radiographs from 1995 through 2004...............................14

3-10 Organ dose estimates for lumbar spine AP and LAT radiographs prior to January 1,1982.......15

3-11 Summary of dose reconstruction recommendations ............................................................. ... 16
Document No. ORAUT-TKBS-0013-3 Revision No. 01 Effective Date: 12/23/2005 Page 5 of 19

ACRONYMS AND ABBREVIATIONS

AEC Atomic Energy Commission 

Al aluminum

AP anterior-posterior

cm centimeter

DCF dose conversion factor

EEOICPA Energy Employees Occupational Illness Compensation Program Act of 2000

ESE entrance skin exposure

GSD GEOMETRIC Standard Deviation 

Gy gray

HVL half-value layer

ICRP International Commission on Radiological Protection

IREP Interactive RadioEpidemiological Program

in inch

kV kilovolt

kVp kilovolt-peak

LAT lateral

mA milliampere

mAs milliampere-second

mC millicoulomb

mGy milligray

mm millimeter

mR milliroentgen

NCRP National Council on Radiation Protection and Measurements

NIOSH National Institute for Occupational Safety and Health

PA posterior-anterior

R roentgen

s second

SID source-to-image distance

SPD site profile document

SSD source-to-skin distance

TBD technical basis document

U.S.C. United States Code

yr year
Document No. ORAUT-TKBS-0013-3 Revision No. 01 Effective Date: 12/23/2005 Page 6 of 19

3.1 INTRODUCTION

Technical basis documents (TBDs) and Site Profile documents are general working documents that 

provide guidance concerning 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 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. § 73841(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. § 73841(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 [probability of causation] 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) define “performance of duty” for DOE employees with a covered cancer or 

restrict the “duty” to nuclear weapons work.

As noted above, the statute 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 contains an exclusion with respect to the Naval Nuclear Propulsion Program, 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 radiation exposures 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 dosimetry results are considered 

valid for use in dose reconstruction. No efforts are made to determine the eligibility of any fraction of 

total measured exposure for inclusion in dose reconstruction.

Diagnostic X-ray procedures contributed to the radiation exposure received by workers from their 

employment at the Pantex Plant. In general, doses from these medical procedures were not included 

as part of the occupational recorded dose, although they were clearly related to occupation. NIOSH, in 

its role to reconstruct occupational dose under the EEOICPA, has classified diagnostic medical X-rays 

administered in conjunction with routine or special physical examinations required for employment as 

occupational exposures (NIOSH 2002). This TBD describes recommended options to conduct dose 

reconstruction for Pantex workers from medical X-rays administered before, during, and at termination 

of employment as a condition of employment. Background information on X-ray doses can be found in 

Technical Information Bulletin: Dose Reconstruction from Occupationally Related Diagnostic X-ray 

Procedures (ORAU 2003). 
Document No. ORAUT-TKBS-0013-3 Revision No. 01 Effective Date: 12/23/2005 Page 7 of 19

3.2 EXAMINATION TYPES AND FREQUENCIES

Pantex required preemployment and routine physical examinations as part of its occupational health 

and safety program. The Medical Department maintains a log for each worker of what appears to be all 

X-ray examinations. An inspection of the logs for selected long-term workers showed that there was 

not a consistent pattern in the frequency of their examinations. Based on this inspection, practices 

apparently varied among workers, probably based on occupation and job responsibilities. Table 3-1 

summarizes general patterns and default dose reconstruction recommendations. 

Table 3-1. Pantex worker x-ray examinations. 

Period Examination Frequency Default dose reconstruction recommendation

1952-81 Chest PA For some workers, 

on employment and 

annual

Use log of X-ray examinations to identify 

occupation-related examinations for chest PA, 

lumbar spine AP, and lumbar spine LAT 

examinations. If log is not available in claim 

documentation, assume preemployment chest PA, 

lumbar spine AP, and lumber spine LAT 

examinations and annual chest PA examinations. 

Lumbar spine AP For some workers, 

men only,

preemployment

Lumbar spine LAT For some workers, 

men only, 

preemployment

1982 - 2004 Chest PA For some workers, 

on employment and 

every 5 years

Use log of X-ray examinations to identify 

occupation-related chest PA examinations. If log is 

not available in claim documentation, assume 

preemployment chest PA and an examination every 

5 years. 

3.3 EQUIPMENT AND TECHNIQUES

A complete history of Pantex X-ray equipment manufacturers, models, examination techniques, and 

exposure rates for these techniques has not been identified. Therefore, dose reconstruction must 

utilize claimant-favorable assumptions described in ORAU (2003). Section 3.6 summarizes the 

recommended approach for dose reconstructors. The following paragraphs summarize available 

historical information.

3.3.1

This TBD analysis examined X-ray film records for long-term Pantex workers who began work in the 

early 1950s to determine if the Plant used photofluorography techniques for chest X-rays. All the 

records showed full-size 14- by 17-in. films for all years, including 1952, 1954-1956, 1958-1959, 1962, 

1964-1966, 1968, 1970-1979, and 1982. These observations, along with conversations with Pantex 

employees, led to the conclusion that Pantex never used photofluorography.

Photofluorography

3.3.2

Historical records have been obtained for four X-ray machines at Pantex, as follows:

X-Ray Machines

• General Electric - The earliest record found of a specific X-ray machine at Pantex involved an 

inspection using U.S. Department of Health, Education and Welfare, Public Health Service, 

Form 4495-3 (PHS 1967) of diagnostic X-ray facilities on September 26, 1967. The inspector 

identified the “Control Panel Manufacturer” and “Tube Head Manufacturer and Model” as 

“General Electric,” and identified the film as “GAF Supreme” with “RADLIN T” intensifying 

screens. Another survey of the diagnostic X-ray facilities at Pantex occurred from August 13 to 

18, 1970; the inspector found a “General Electric” control panel and a “Profexray Model AZ 

Type 2” tube head (PHS 1970). 
Document No. ORAUT-TKBS-0013-3 Revision No. 01 Effective Date: 12/23/2005 Page 8 of 19

• Picker - From approximately July 11, 1972, through 1984, Pantex used a Picker X-Ray 

Pictronic 500 with a Picker X-Ray Style 2098 tube head. 

• Universal - A Universal X-Ray, Inc., control panel with a Eureka X-Ray Tube Company Model 

Sapphire 150 tube head was installed between March 19 and May 25, 1984. 

• Continental - A Continental TM-50 6626.235 X-ray machine was installed between November 

1, 1993, and November 6, 1995. On November 6, 1995, several measurements of x-ray 

exposure at 30 inches for selected kVps of 60 to 100 in increments of 10 were determined 

(Huddleston 1995). For chest films, the measured value of 0.913R for 100 MAS at 30 in for 80 

KVP was converted to the distance of 62 in for a PA Chest radiography. The calculated value is 

0.21 R for 100 MAS and this value is equivalent to 0.02 cGy for the typical 10 MAS PA chest 

examination. This machine uses photo-timing, which measures the incidence on the film 

directly, during irradiation, to determine the exposure time. This machine was in use as of June 

2004. 

There is evidence of ongoing Pantex reviews (Gidley 1970; Alexander 1972a,b) of the X-ray equipment 

and techniques but the information is difficult to evaluate, particularly with regard to the entrance skin 

exposure (ESE) for the different equipment and techniques.

3.3.3 

A table obtained from the Pantex Medical Department of suggested X-ray techniques in GE 1941 (GE 

1941) implies that Pantex probably used a General Electric CRT 1 or CRT 2 X-ray tube operated “on 

full wave rectification” in the early days, along with “fast” film. A 1967 table of desk instructions (Pantex 

1967) of X-ray examination steps shows close similarity to the 1941 table. Measurements of the 

entrance kerma for the Pantex X-ray equipment and techniques used have not been located prior to 

those in 1995 for the Continental X-ray machine. There is some kVp and filtration data for Pantex 

techniques, as listed in Tables 3-2 through 3-4, but not enough to estimate the beam quality. The 

measured beam output for the Continental system (Huddleston 1995) has been used in Table 3-2 and 

these values are consistent with NCRP 102, Table B.2 (1989). 

Specific Technique Charts

Table 3-2. Technique factors for chest PA x-rays. 

Period

Total filtration 

(mm Al)

Half-value 

layer (mm Al) Current (mA)

Voltage

(kVp)

Exposure 

time (s)

Entrance 

kerma

cGy

Pre-1967 Unknown Unknown Unknowna Unknowna Unknowna 0.2b

1967-1969 1.5 Unknown 100 Unknownc 0.1 0.2a

1970-1984 2.5 Unknown 100 Unknownc 0.1 0.1a

1985-1994 2.5 Unknown 100 Unknownc 0.1 0.05a

1995-2004 ~2.5 Unknown Unknown ~80 (d) 0.02e

a. Expected to have selected values closely similar to 1941 GE X-ray techniques. 

b. Default values from ORAU (2003): Pre-1970, 0.2; 1970-85, 0.1; after 1985, 0.05.

c. Operationally selected based on body size.

d. System has photo-timing. Used 0.1 sec and 100 MAS in calculations of entrance kerma.

e. Entrance kerma value calculated, at 80 kVp and 62 in TSD using measured output (Huddleston 1995). 
Document No. ORAUT-TKBS-0013-3 Revision No. 01 Effective Date: 12/23/2005 Page 9 of 19

Table 3-3. Technique factors for lumbar spine AP X-rays. 

Period

Total filtration 

(mm Al)

Half-value 

layer (mm Al) Current (mA)

Voltage

(kVp)

Exposure 

time (s)

Entrance 

kerma

mrad

Pre-1967 Unknown Unknown Unknowna Unknowna Unknowna 2,000b

1967-1969 1.5 Unknown 100 (c) 1 2,000a

1970-1981 2.5 Unknown 100 (c) 1 2,000a

1982-2004 Not Performed

a. Expected to have selected values closely similar to 1941 GE X-ray techniques. 

b. Default value from Lincoln and Gupton (1958, Table III, Facility F). 

c. Selected based on body size.

Table 3-4. Technique factors for lumbar spine lateral X-rays. 

Period

Total filtration 

(mm Al)

Half-value 

layer (mm Al) Current (mA)

Voltage

(kVp)

Exposure 

time (s)

Entrance 

kerma

mrad

Pre-1967 Unknown Unknown Unknowna Unknowna Unknowna 5,000b

1967-1969 1.5 Unknown 200 (c) 3 5,000a

1970-1981 2.5 Unknown 200 (c) 3 5,000a

1982-2004 Not Performed

a. Expected to have selected values closely similar to 1941 GE X-ray techniques. 

b. Default value from Lincoln and Gupton (1958, Table III, Facility F). 

c. Selected based on body size.

3.4 ORGAN DOSE CALCULATIONS 

Organ dose calculations for workers at Pantex from 1952 to the present involve three primary 

diagnostic medical radiographic procedures administered in connection with preemployment and

regular medical examinations: 

• PA 14- by 17-in. chest film (preemployment and annual through 1981 and approximately every 

5 years thereafter) 

• AP lumbar spine film (men only; preemployment only)

• Lateral lumbar spine film (men only; preemployment only)

The analysis for this TBD evaluated only doses from these three techniques. Other radiographic 

examinations of Pantex employees that could have occurred are likely to be nonoccupational in the 

sense that they were associated with illness or injury and were not part of a routine examination 

process. There is no indication in the examined records that the occupational medical program 

routinely administered other diagnostic radiographic examinations. Prior to 1995, the analysis used the 

default organ dose recommendations for PA chest examinations in ORAU (2003) (i.e., entrance kerma 

of 0.2 cGy prior to 1970, 0.1 cGy prior to 1985 and 0.05 cGy until 1995) because of the lack of detailed 

information on measurements of the ESE for the different Pantex X-ray equipment. The analysis used 

the measurements performed for the Continental X-ray and techniques in 1995 (Huddleston 1995). 

This analysis assumed that an exposure of 1 R is equivalent to a kerma of 1 rad, to 10 mGy or 1 rem

(ORAU 2003). Tables 3-5 through 3-9 summarize organ doses for PA chest examinations for the 

various periods.

There is no information from ORAU (2003) on an estimate of the organ dose from preemployment AP 

and LAT lumbar spine examinations performed prior to 1982. The purpose of these examinations was 
Document No. ORAUT-TKBS-0013-3 Revision No. 01 Effective Date: 12/23/2005 Page 10 of 19

to determine if individuals had preexisting back problems prior to hiring for certain occupations. Little 

information has been located pertaining to these examinations. For dose reconstruction purposes, and 

if there is not more specific information on the claim-specific log of worker X-ray examinations,

Table 3-5. Calculated organ dose for Default Entrance Kerma Values 

for PA chest radiographs before 1967 assuming minimal collimation. 

Organ

Dose conversion factor 

(mGy/Gy air kerma)(beam 

quality for 2.5 mm Al HVL)a

Organ dose 

(rem)

Thyroid 174 3.48E-02

Eye/brain 32 6.40E-03

Ovaries 168 3.36E-02

Urinary bladder 168 3.36E-02

Colon/rectum 168 3.36E-02

Testes 9.1 1.82E-03

Lungs 451 9.02E-02

Thymus 451 9.02E-02

Esophagus 451 9.02E-02

Stomach 451 9.02E-02

Bone surfaces 451 9.02E-02

Liver/gall bladder/spleen 451 9.02E-02

Remainder 451 9.02E-02

Female breast 49 9.80E-03

Uterus 149 2.98E-02

Bone marrow 92 1.84E-02

Skinb 2.72E-01

a. Dose conversion factors from ORAU (2003) and ICRP (1982, Tables A.2 to A.8).

b. Skin dose was determined by multiplying ESE by a backscatter of 1.36 for an HVL 

of 2.5 mm Al. From NCRP (1989, Table B-8). 
Document No. ORAUT-TKBS-0013-3 Revision No. 01 Effective Date: 12/23/2005 Page 11 of 19

Table 3-6. Calculated organ dose for Default Entrance Kerma Values 

for PA chest radiographs from 1967 through 1969. 

Organ

Dose conversion factor 

(mGy/Gy air kerma)(beam 

quality for 1.5 mm Al HVL)a

Organ dose 

(rem)

Thyroid 11 2.20E-03

Eye/brain 11 2.20E-03

Ovaries 0.2 4.00E-05

Urinary bladder 0.2 4.00E-05

Colon/rectum 0.2 4.00E-05

Testes 0.01 2.00E-06

Lungs 250 5.00E-02

Thymus 250 5.00E-02

Esophagus 250 5.00E-02

Stomach 250 5.00E-02

Bone surfaces 250 5.00E-02

Liver/gall bladder/spleen 250 5.00E-02

Remainder 250 5.00E-02

Female breast 18 3.60E-03

Uterus 0.3 6.00E-05

Bone marrow 49 9.80E-03

Skinb 2.56E-01

a. Dose conversion factors from ORAU (2003) and ICRP (1982, Tables A.2 to A.8). 

b. Skin dose was determined by multiplying ESE by a backscatter of 1.28 for an HVL 

of 1.5 mm Al. From NCRP (1989, Table B-8). 
Document No. ORAUT-TKBS-0013-3 Revision No. 01 Effective Date: 12/23/2005 Page 12 of 19

Table 3-7. Calculated organ doses for PA chest radiographs from 1970 

through 1984. 

Organ

Dose conversion factor 

(mGy/Gy air kerma)(beam 

quality for 2.5 mm Al HVL)a Organ dose (rem)

Thyroid 32 3.20E-03

Eye/brain 32 3.20E-03

Ovaries 1 1.00E-04

Urinary bladder 1 1.00E-04

Colon/rectum 1 1.00E-04

Testes 0.01 1.00E-06

Lungs 451 4.51E-02

Thymus 451 4.51E-02

Esophagus 451 4.51E-02

Stomach 451 4.51E-02

Bone surfaces 451 4.51E-02

Liver/gall bladder/spleen 451 4.51E-02

Remainder 451 4.51E-02

Female breast 49 4.90E-03

Uterus 1.3 1.30E-04

Bone marrow 92 9.20E-03

Skinb 1.32E-01

a. Dose conversion factors from ORAU (2003) and ICRP (1982, Tables A.2 to A.8). 

b. Skin dose was determined by multiplying ESE by a backscatter of 1.32 for an HVL

of 2.5 mm Al. From NCRP (1989, Table B-8). 
Document No. ORAUT-TKBS-0013-3 Revision No. 01 Effective Date: 12/23/2005 Page 13 of 19

Table 3-8. Calculated organ doses for PA chest radiographs from 1985 

through 1994. 

Organ

Dose conversion factor 

(mGy/Gy air kerma)(beam 

quality for 2.5 mm Al HVL)a Organ dose (rem)

Thyroid 32 1.60E-03

Eye/brain 32 1.60E-03 

Ovaries 1 5.00E-05

Urinary bladder 1 5.00E-05

Colon/rectum 1 5.00E-05

Testes 0.01 5.00E-07

Lungs 451 2.26E-02

Thymus 451 2.26E-02

Esophagus 451 2.26E-02

Stomach 451 2.26E-02

Bone surfaces 451 2.26E-02

Liver/gall bladder/spleen 451 2.26E-02

Remainder 451 2.26E-02

Female breast 49 2.45E-03

Uterus 1.3 6.50E-05

Bone marrow 92 4.60E-03

Skinb 6.60E-02

a. Dose conversion factors from ORAU (2003) and ICRP (1982, Tables A.2 to A.8). 

b. Skin dose was determined by multiplying ESE by a backscatter of 1.32 for an HVL 

of 2.5 mm Al. From NCRP (1989, Table B-8). 
Document No. ORAUT-TKBS-0013-3 Revision No. 01 Effective Date: 12/23/2005 Page 14 of 19

Table 3-9. Calculated organ doses for PA chest radiographs from 1995 

through 2004. 

Organ

Dose conversion factor 

(mGy/Gy air kerma)(beam 

quality for 2.5 mm Al HVL)a Organ dose (rem)

Thyroid 32 6.40E-04

Eye/brain 32 6.40E-04

Ovaries 1 2.00E-05

Urinary bladder 1 2.00E-05

Colon/rectum 1 2.00E-05

Testes 0.01 2.00E-07

Lungs 451 9.02E-03

Thymus 451 9.02E-03

Esophagus 451 9.02E-03

Stomach 451 9.02E-03

Bone surfaces 451 9.02E-03

Liver/gall bladder/spleen 451 9.02E-03

Remainder 451 9.02E-03

Female breast 49 9.80E-04

Uterus 1.3 2.60E-05

Bone marrow 92 1.84E-03

Skinb 2.64E-02

a. Dose conversion factors from ORAU (2003) and ICRP (1982, Tables A.2 to A.8). 

b. Skin dose was determined by multiplying ESE by a backscatter of 1.32 for an HVL 

of 2.5 mm Al (maximum value in NCRP, Table B-8).

dose reconstructors should use the assumption that AP and LAT lumbar spine examinations were 

conducted for each male worker, at preemployment only, employed prior to 1982. The dose to workers 

from these examinations is based on measurements of exposure by Lincoln and Gupton (1958) for 

several different X-ray examination techniques at eight Oak Ridge National Laboratory facilities. 

Exposures were measured using a phantom to simulate the patient, and both filtration and collimation 

varied by facility, reflecting different procedures employed at each facility at the time. This data was 

used to calculate (Lopez 2004) probability distributions for each organ of interest in ICRP (1982). Table 

3-10 lists the results of these analyses.

3.5 UNCERTAINTY ANALYSIS

The description of error and uncertainty in ORAU (2003) is directly applicable to the evaluation of 

medical X-ray doses to Pantex workers. Available historical documentation is insufficient to ensure 

claimant-favorable analysis of the dose. In particular, the apparent unavailability of measurements of 

the ESE for the specific X-ray equipment and diagnostic techniques used historically at Pantex provides 

little option but to utilize the default options from ORAU (2003). Dose reconstructors should use the 
Document No. ORAUT-TKBS-0013-3 Revision No. 01 Effective Date: 12/23/2005 Page 15 of 19

recommendation from ORAU (2003) to assume that errors are all positive (i.e., only +30% be used) for 

Pantex workers. 

Table 3-10. Organ dose estimates for lumbar spine AP and LAT radiographs prior to 

 January 1,1982.

a

Organ

Organ Dose, rem

AP lumbar spineb LAT lumbar spineb

Thyroid 5.00E-04 (2.96) 1.00E-04 (1.90)

Eye/brain 5.00E-04 (2.96) 1.00E-04 (1.90)

Ovaries 3.27E-01 (2.56) 2.25E-02 (2.10)

Urinary bladder 3.27E-01 (2.56) 2.25E-02 (2.10)

Colon/rectum 3.27E-01 (2.56) 2.25E-02 (2.10)

Testesc 2.55E-02 (3.10) 3.97E-02 (1.51)

Lungs 1.22E-01 (2.53) 6.36E-02 (2.00)

Thymus 1.22E-01 (2.53) 6.36E-02 (2.00)

Esophagus 1.22E-01 (2.53) 6.36E-02 (2.00)

Stomach 1.22E-01 (2.53) 6.36E-02 (2.00)

Bone surfaces 1.22E-01 (2.53) 6.36E-02 (2.00)

Liver/gall bladder/spleen 1.22E-01 (2.53) 6.36E-02 (2.00)

Remainder 1.22E-01 (2.53) 6.36E-02 (2.00)

Uterus 4.36E-01 (2.60) 1.51E-01 (2.10)

Bone marrow 5.75E-02 (2.60) 1.10E-01 (2.10)

Skinc 1.79E-00 (2.44) 5.79E-00 (1.84)

a. Doses are geometric means in rem and the values in parentheses are the 

corresponding geometric standard deviations.

b. Calculated by Lopez (2004) from the information in Lincoln and Gupton (1958).

c. Doses to the skin and testes represent measured (Lincoln and Gupton 1958) 

rather than calculated doses.

3.6 INSTRUCTION GUIDE FOR DOSE RECONSTRUCTORS

Pantex practice involved maintaining a log of the date and type of medical examination, and a historical 

record of the associated radiography films. DOE-provided medical X-ray dose information should 

include a copy or transcription of information from this log. Dose reconstructors should use the list of 

examinations in this log. In the event that DOE does not provide this log, dose reconstructors should 

use the default assumptions listed in Table 3-11 to ensure the use of claimant-favorable assumptions. 
Document No. ORAUT-TKBS-0013-3 Revision No. 01 Effective Date: 12/23/2005 Page 16 of 19

Table 3-11. Summary of dose reconstruction recommendations. 

Examination Period Default frequency Table

PA Chest Prior to 1/1/1967 Preemployment and annually thereafter Table 3-5

1/1/67 through 12/31/69 Table 3-6

1/1/70 through 12/3181 Table 3-7

1/1/82 through 12/31/84 Preemployment and every 5 years 

thereafter 

Table 3-7

1/1/85 through 12/21/94 Table 3-8

1/1/95 to 2004 Table 3-9

Lumbar spine AP Prior to 1/1/1982 Preemployment, men only Table 3-10

Lumbar spine LAT Preemployment, men only Table 3-10

For actual dose calculations, dose reconstructors should assume a normal distribution with an 

uncertainty of ±30% at the 99% confidence interval. However, to select claimant-favorable judgments, 

dose reconstructors should use only the positive uncertainty and multiply the doses listed in Tables 3-5 

through 3-10 by a factor of 1.3 to include uncertainty at the 99% confidence level (ORAU 2003). 
Document No. ORAUT-TKBS-0013-3 Revision No. 01 Effective Date: 12/23/2005 Page 17 of 19

REFERENCES

Alexander, R. E., 1972a, “X-ray Machine, 12-2 Medical,” internal memorandum to F. J. Kelly (Pantex 

Medical Director), February 10, Mason & Hanger-Silas Mason Co., Inc., Amarillo, Texas.

Alexander, R. E., 1972b, “X-ray Installation 12-2 Medical,” internal memorandum to F. J. Kelly (Pantex 

Medical Director), July 7, Mason & Hanger-Silas Mason Co., Inc., Amarillo, Texas.

GE (General Electric), 1941, “Technic Chart,” General Electric X-ray Corporation, Milwaukee, 

Wisconsin, copy obtained from Mason & Hanger-Silas Mason Co., Inc., Amarillo, Texas.

Gidley, M. D., 1970, internal memorandum to F. J. Kelley (Pantex Medical Director), Mason & HangerSilas Mason Co., Inc., Amarillo, Texas, August 19. 

Huddleston, A. L., 1995, letter to N. Bryson (Mason and Hanger-Silas Mason Co.), Texas Radiation 

Physics Associates, Inc., Dallas, Texas, December 12.

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

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

Lincoln, T. A., and E. D. Gupton, 1958, “Radiation Dose in Diagnostic X-Ray Procedure,” Radiology, 

71:2080215. 

Lopez, T., 2004, letter to R. Meyer, “Development of AP and LAT lumbar spine dose estimates for 

Rocky Flats TBD,” MJW Corporation, Inc., Buffalo, New York, October.

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 No. 102, Bethesda, Maryland.

NIOSH (National Institute for Occupational Safety and Health), 2002, External Dose Reconstruction 

Implementation Guidelines, OCAS-IG-001, Revision 1, Office of Compensation Analysis and 

Support, Cincinnati, Ohio.

ORAU (Oak Ridge Associated Universities), 2003, Technical Information Bulletin: Dose Reconstruction 

from Occupationally Related Diagnostic X-Ray Procedures, ORAUT-OTIB-0006, Revision 2, 

Oak Ridge, Tennessee.

Pantex, 1967, “X-Ray Procedures,” desk Instructions dated April 5 and April 10, initialed by CS 

(probably Colette Stoddard), Mason & Hanger-Silas Mason Co., Inc., Amarillo, Texas.

PHS (Public Health Service), 1967, “X-Ray Protection Survey Report, Pantex Medical Department, 

Building 12-36,” Form PHS-4495-3 (Rev. 7-65), Mason & Hanger-Silas Mason Co., Inc.,

Amarillo, Texas, September 26.

PHS (Public Health Service), 1970, “X-Ray Protection Survey Report, Pantex Medical Department, 

Building 12-2,” Form PHS-4495-3 (Rev. 7-65), Mason & Hanger-Silas Mason Co., Inc., Amarillo, 

Texas, August 18.
Document No. ORAUT-TKBS-0013-3 Revision No. 01 Effective Date: 12/23/2005 Page 18 of 19

GLOSSARY

absorbed dose

The energy imparted per unit mass by ionizing radiation to matter at a specified point. The 

International System unit of absorbed dose is joules per kilogram. The special name for this 

unit is the gray (Gy). The previously used special unit of absorbed dose, rad, is being replaced 

by the gray (1 rad = 0.01 Gy; 1 Gy = 100 rad). 

anterior-posterior (AP)

Irradiation geometry in which the radiation passes from the front of a person to the back.

entrance kerma

Air kerma without backscatter.

entrance skin exposure (ESE)

A value typically measured for various x-ray examinations used to estimate skin dose and to 

calculate organ doses (for organs that lie in the x-ray path) depending upon such parameters as 

x-ray unit voltage, current, filtration and collimation. The ESE is measured in units of Roentgen 

(R) or kerma (Gy).

filtration

Material in the useful beam that usually absorbs preferentially the less penetrating radiation.

fluorography

The production of a photographic record of the image formed on the output phosphor of an 

image intensifier by the action of X-rays transmitted through the patient.

half-value layer (HVL)

Thickness of a specified substance that, when introduced in the path of a given beam of 

radiation, reduces the kerma rate by one-half.

kerma

The sum of the kinetic energies of all charged ionizing particles liberated by uncharged ionizing 

particles per unit mass of a specified material. Kerma is measured in the same units as 

absorbed dose. The SI unit of kerma is joule per kilogram and its special name is gray (Gy). 

Kerma can be quoted for any specified material at a point in free space or in an absorbing 

medium.

lateral (LAT)

Irradiation geometry in which the radiation passes from one side of a person to the other.

posterior-anterior (PA)

Irradiation geometry in which the radiation passes from the back of a person to the front.

radiography

The production of images on film by the action of X-rays transmitted through the patient.

roentgen (R)

The previously used special unit of exposure. An exposure of 1 roentgen will produce 2.58 ×10-

4 coulomb per kilogram of air.

rem

Historical unit of dose equivalent. The word derives from roentgen equivalent (in) man.
Document No. ORAUT-TKBS-0013-3 Revision No. 01 Effective Date: 12/23/2005 Page 19 of 19

technique or technic

In diagnostic radiology, the combination of source-to-image distance (SID), accelerating 

potential (peak kilovoltage), tube current (milliampere), 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, expressed in milliampere-seconds or millicoulomb. Any combination of 

time and tube current that produces a given product in milliampere-seconds will produce the 

same exposure for a fixed peak kilovoltage. 

x-ray

 This refers to (1), scientifically, ionizing electromagnetic radiation of external nuclear 

origin, or (2) colloquially, an image generated by exposing a detector (e.g., film) to 

X-rays.