SEC Petition Evaluation Report 

Petition SEC-00137 

Report Rev 0 Report Submittal Date: June 09, 2009 

Subject Expert(s): Lara Hughes 

Site Expert(s): N/A 

Petition Administrative Summary 

Petition Under Evaluation 

Petition # Petition 

Type 

Petition Qualification 

Date 

DOE/AWE Facility Name 

SEC-00137 83.13 February 17, 2009 Oak Ridge Hospital 

Petitioner Class Definition 

All workers who worked in any location at the Oak Ridge Hospital in Oak Ridge, Tennessee, from June 

30, 1958 through December 31, 1959 

Class Evaluated by NIOSH 

All employees who worked in any location at the Oak Ridge Hospital in Oak Ridge, Tennessee, from May 

15, 1950 through December 31, 1959 

NIOSH-Proposed Class(es) to be Added to the SEC 

All employees who worked in any location at the Oak Ridge Hospital in Oak Ridge Tennessee, for a 

number of work days aggregating at least 250 work days from May 15, 1950 through December 31, 1959, 

or in combination with work days within the parameters established for one or more other classes of 

employees in the SEC. 

Related Petition Summary Information 

SEC Petition Tracking #(s) Petition Type DOE/AWE Facility Name Petition Status 

SEC00033 83.13 Oak Ridge Institute for Science 

and Education 

Evaluation Completed 

Related Evaluation Report Information 

Report Title DOE/AWE Facility Name 

Revised Evaluation Report for Oak Ridge Institute for Nuclear Studies Oak Ridge Institute for 

Science and Education 

OCAS Health Physicist: Laura Hughes 

Peer Review Completed By: [Signature on File] 

Lara Hughes 

6/09/2009 

Date 

SEC Petition Evaluation Reviewed By: [Signature on File] 

J. W. Neton 

6/12/2009 

Date 

SEC Evaluation Approved By: [Signature on File] 

Larry Elliott 

6/15/2009 

Date 
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Evaluation Report Summary: SEC-00137, Oak Ridge Hospital 

This evaluation report by the National Institute for Occupational Safety and Health (NIOSH) 

addresses a class of employees proposed for addition to the Special Exposure Cohort (SEC) per the 

Energy Employees Occupational Illness Compensation Program Act of 2000, as amended, 42 U.S.C. 

§ 7384 et seq. (EEOICPA) and 42 C.F.R. pt. 83, Procedures for Designating Classes of Employees as 

Members of the Special Exposure Cohort under the Energy Employees Occupational Illness 

Compensation Program Act of 2000. 

Petitioner-Requested Class Definition

Petition SEC-00137, qualified on February 17, 2009, requested that NIOSH consider the following 

class: All workers who worked in any location at the Oak Ridge Hospital in Oak Ridge, Tennessee, 

from June 30, 1958 through December 31, 1959. 

Class Evaluated by NIOSH

Based on its preliminary research, NIOSH expanded the petitioner-requested class for evaluation. 

NIOSH evaluated the following class: All employees who worked in any location at the Oak Ridge 

Hospital in Oak Ridge, Tennessee, from May 15, 1950 through December 31, 1959. 

NIOSH-Proposed Class(es) to be Added to the SEC

Based on its full research of the class under evaluation, NIOSH has defined a single class of 

employees for which NIOSH cannot estimate radiation doses with sufficient accuracy. The NIOSHproposed class includes all employees who worked in any location at the Oak Ridge Hospital in Oak 

Ridge Tennessee, for a number of work days aggregating at least 250 work days from May 15, 1950 

through December 31, 1959, or in combination with work days within the parameters established for 

one or more other classes of employees in the SEC. The class under evaluation was expanded (see 

Section 3.0 below) because of the potential radiation exposures incurred by Oak Ridge Hospital 

personnel supporting the operations of the cancer hospital of the Oak Ridge Institute for Nuclear 

Studies (ORINS) Medical Division from 1950-1959. The NIOSH-proposed class dates correspond to 

the start of operations at the ORINS cancer hospital (May 15, 1950) and the end of the covered period 

for the Oak Ridge Hospital facility under EEOICPA. 

 

Feasibility of Dose Reconstruction

Per EEOICPA and 42 C.F.R. § 83.13(c)(1), NIOSH has established that it does not have access to 

sufficient information to: (1) estimate the maximum radiation dose, for every type of cancer for which 

radiation doses are reconstructed, that could have been incurred in plausible circumstances by any 

member of the class; or (2) estimate radiation doses of members of the class more precisely than an 

estimate of maximum dose. The information collected from all available resources is not sufficient to 

document or estimate the maximum internal and external potential exposure to members of the 

proposed class under plausible circumstances during the specified period. 
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Health Endangerment Determination

NIOSH did not identify any evidence supplied by the petitioners or from other resources that would 

establish that the proposed class was exposed to radiation during a discrete incident likely to have 

involved exceptionally high-level exposures. However, evidence indicates that some workers in the 

proposed class may have accumulated substantial chronic exposures through episodic intakes of 

radionuclides, combined with external exposures to gamma and beta radiation. Consequently, NIOSH 

has determined that health was endangered for those workers covered by this evaluation who were 

employed for at least 250 aggregated work days either solely under their employment or in 

combination with work days within the parameters established for other SEC classes (excluding 

aggregate work day requirements). 
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Table of Contents 

 

Evaluation Report Summary: SEC-00137, Oak Ridge Hospital............................................................. 3 

1.0 Purpose and Scope.......................................................................................................................... 7 

2.0 Introduction .................................................................................................................................... 7 

3.0 SEC-00137 Oak Ridge Hospital Class Definitions ........................................................................ 8 

3.1 Petitioner-Requested Class Definition and Basis.................................................................. 8 

3.2 Class Evaluated by NIOSH ................................................................................................... 9 

3.3 NIOSH-Proposed Class(es) to be Added to the SEC ............................................................ 9 

4.0 Data Sources Reviewed by NIOSH to Evaluate the Class........................................................... 10 

4.1 Site Profile Technical Basis Documents (TBDs) ................................................................ 10 

4.2 ORAU Technical Information Bulletins (OTIBs) and Procedures ..................................... 10 

4.3 Facility Employees and Experts .......................................................................................... 11 

4.4 Previous Dose Reconstructions ........................................................................................... 11 

4.5 NIOSH Site Research Database .......................................................................................... 12 

4.6 Other Technical Sources...................................................................................................... 12 

4.7 Documentation and/or Affidavits Provided by Petitioners ................................................. 12 

5.0 Radiological Operations Relevant to the Class Evaluated by NIOSH ......................................... 12 

5.1 Oak Ridge Hospital Operations Description ....................................................................... 13 

5.2 Radiological Exposure Sources from Oak Ridge Hospital Operations............................... 16 

5.2.1 Internal Radiological Exposure Sources from Oak Ridge Hospital Operations ..... 16 

5.2.1.1 Radioiodine (I-131) .................................................................................. 17 

5.2.1.2 Other Isotopes from Oak Ridge Hospital and ORINS operations............... 17 

5.2.2 External Radiological Exposure Sources from Oak Ridge Hospital Operations .... 18 

5.2.2.1 Photon....................................................................................................... 18 

5.2.2.2 Beta........................................................................................................... 21 

5.2.3 Incidents .................................................................................................................. 21 

6.0 Summary of Available Monitoring Data for the Class Evaluated by NIOSH ............................. 21 

6.1 Available Oak Ridge Hospital Internal Monitoring Data.................................................... 21 

6.2 Available Oak Ridge Hospital External Monitoring Data .................................................. 22 

6.3 Source Term Information ....................................................................................................... 23 

7.0 Feasibility of Dose Reconstruction for the Class Evaluated by NIOSH ...................................... 24 

7.1 Pedigree of Oak Ridge Hospital Data ................................................................................. 25 

7.2 Evaluation of Bounding Internal Radiation Doses at Oak Ridge Hospital ......................... 25 

7.3 Evaluation of Bounding External Radiation Doses at Oak Ridge Hospital ........................ 26 

7.3.1 Medical X-Ray Dose .................................................................................................. 27 

7.4 Evaluation of Petition Basis for SEC-00137 ....................................................................... 27 

7.4.1 Oak Ridge Hospital staff was not monitored for radiation exposure ...................... 27 

7.5 Summary of Feasibility Findings for Petition SEC-00137.................................................. 28 
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8.0 Evaluation of Health Endangerment for Petition SEC-00137...................................................... 29 

9.0 Class Conclusion for Petition SEC-00137 ................................................................................... 29 

10.0 References .................................................................................................................................... 32 

Tables 

Table 4-1: No. of Oak Ridge Hospital Claims Submitted Under the Dose Reconstruction Rule..Error! 

Bookmark not defined.

Table 5-1: Medical Isotopes used by Oak Ridge Hospital 1956-1959.. Error! Bookmark not defined.

Table 5-2: Major Activities of the ORINS Medical Division 1950-1959............Error! Bookmark not 

defined.

Table 5-3: Radioisotope Decay Characteristics .................................... Error! Bookmark not defined.

Table 5-4: Routine Film Badge Exposures of Selected ORINS Personnel (Dec. 1950 – Feb. 1951)

............................................................................................................... Error! Bookmark not defined.

Table 5-5: Exposures received during Surgical Procedure (mR/hr) ..... Error! Bookmark not defined.

Table 6-1: Summary of External Exposure Data at ORINS.................. Error! Bookmark not defined.

Table 6-2: Isotopes Used by the ORINS Medical Division .................. Error! Bookmark not defined.

Table 7-1: Summary of Feasibility Findings for SEC-00137 ............... Error! Bookmark not defined.

Table A1-1: Data Capture Synopsis for Oak Ridge Hospital................................................................ 37 

Table A1-2: Database Searches for Oak Ridge Hospital ...................... Error! Bookmark not defined.
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SEC Petition Evaluation Report for SEC-00137

ATTRIBUTION AND ANNOTATION: This is a single-author document. All conclusions drawn from 

the data presented in this evaluation were made by OCAS Health Physicist: Lara Hughes. These 

conclusions were peer-reviewed by the individuals listed on the cover page. The rationales for all 

conclusions in this document are explained in the associated text.

1.0 Purpose and Scope 

This report evaluates the feasibility of reconstructing doses for all employees who worked in any 

location at the Oak Ridge Hospital in Oak Ridge, Tennessee, from May 15, 1950 though December 

31, 1959. It provides information and analyses germane to considering a petition for adding a class of 

employees to the congressionally-created SEC. 

This report does not make any determinations concerning the feasibility of dose reconstruction that 

necessarily apply to any individual energy employee who might require a dose reconstruction from 

NIOSH. This report also does not contain the final determination as to whether the proposed class 

will be added to the SEC (see Section 2.0). 

This evaluation was conducted in accordance with the requirements of EEOICPA, 42 C.F.R. pt. 83, 

and the guidance contained in the Office of Compensation Analysis and Support’s (OCAS) Internal 

Procedures for the Evaluation of Special Exposure Cohort Petitions, OCAS-PR-004. 

2.0 Introduction 

Both EEOICPA and 42 C.F.R. pt. 83 require NIOSH to evaluate qualified petitions requesting that the 

Department of Health and Human Services (HHS) add a class of employees to the SEC. The 

evaluation is intended to provide a fair, science-based determination of whether it is feasible to 

estimate with sufficient accuracy the radiation doses of the class of employees through NIOSH dose 

reconstructions.1

 

42 C.F.R. § 83.13(c)(1) states: Radiation doses can be estimated with sufficient accuracy if NIOSH 

has established that it has access to sufficient information to estimate the maximum radiation dose, 

for every type of cancer for which radiation doses are reconstructed, that could have been incurred in 

plausible circumstances by any member of the class, or if NIOSH has established that it has access to 

sufficient information to estimate the radiation doses of members of the class more precisely than an 

estimate of the maximum radiation dose.

 

Under 42 C.F.R. § 83.13(c)(3), if it is not feasible to estimate with sufficient accuracy radiation doses 

for members of the class, then NIOSH must determine that there is a reasonable likelihood that such 

radiation doses may have endangered the health of members of the class The regulation requires 

NIOSH to assume that any duration of unprotected exposure may have endangered the health of 

members of a class when it has been established that the class may have been exposed to radiation 

 

1

 NIOSH dose reconstructions under EEOICPA are performed using the methods promulgated under 42 C.F.R. pt. 82 and 

the detailed implementation guidelines available at http://www.cdc.gov/niosh/ocas. 
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during a discrete incident likely to have involved levels of exposure similarly high to those occurring 

during nuclear criticality incidents. If the occurrence of such an exceptionally high-level exposure has 

not been established, then NIOSH is required to specify that health was endangered for those workers 

who were employed for at least 250 aggregated work days within the parameters established for the 

class or in combination with work days within the parameters established for other SEC classes 

(excluding aggregate work day requirements). 

NIOSH is required to document its evaluation in a report, and to do so, relies upon both its own dose 

reconstruction expertise as well as technical support from its contractor, Oak Ridge Associated 

Universities (ORAU). However, ORAU (formerly Oak Ridge Institute for Nuclear Studies, ORINS) 

has a conflict of interest for this site, since the former cancer research hospital operated by ORINS 

was closely affiliated with Oak Ridge Hospital. NIOSH therefore completed the evaluation itself, 

ORAU did not participate in this evaluation. Once completed, NIOSH provides the report to both the 

petitioner(s) and to the Advisory Board on Radiation and Worker Health (Board). The Board will 

consider the NIOSH evaluation report, together with the petition, petitioner(s) comments, and other 

information the Board considers appropriate, in order to make recommendations to the Secretary of 

HHS on whether or not to add one or more classes of employees to the SEC. Once NIOSH has 

received and considered the advice of the Board, the Director of NIOSH will propose a decision on 

behalf of HHS. The Secretary of HHS will make the final decision, taking into account the NIOSH 

evaluation, the advice of the Board, and the proposed decision issued by NIOSH. As part of this 

decision process, petitioners may seek a review of certain types of final decisions issued by the 

Secretary of HHS.2

 

3.0 SEC-00137 Oak Ridge Hospital Class Definitions 

The following subsections address the evolution of the class definition for SEC-00137, Oak Ridge 

Hospital. When a petition is submitted, the requested class definition is reviewed as submitted. Based 

on its review of the available site information and data, NIOSH will make a determination whether to 

qualify for full evaluation all, some, or no part of the petitioner-proposed class. If some portion of the 

petitioner-proposed class is qualified, NIOSH will specify that class along with a justification for any 

modification of petitioner’s class. After a full evaluation of the qualified class, NIOSH will determine 

whether to propose a class for addition to the SEC and will specify that proposed class definition. 

3.1 Petitioner-Requested Class Definition and Basis 

Petition SEC-00137, qualified on February 17, 2009, requested that NIOSH consider the following 

class for addition to the SEC: all workers who worked in any location at the Oak Ridge Hospital in 

Oak Ridge, Tennessee, from June 30, 1958 through December 31, 1959.

The petitioner provided information and statements in form of an affidavit in support of the 

petitioner’s belief that accurate dose reconstruction over time is impossible for the Oak Ridge Hospital 

workers in question. NIOSH deemed the following information and affidavit statements sufficient to 

qualify SEC-00137 for evaluation: 

2

 See 42 C.F.R. pt. 83 for a full description of the procedures summarized here. Additional internal procedures are 

available at http://www.cdc.gov/niosh/ocas. 
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As identified in item F.1 of the SEC00137 Form B and discussed in a February 4, 2009 

phone call, the petitioner asserted by affidavit that the energy employees who meet the 

proposed worker class at the Oak Ridge Hospital were not monitored for radiation 

exposure, despite working in the same work area where the Oak Ridge Institute for Nuclear 

Studies was located (Affidavit, 2009). 

Based on its research and data capture efforts related to Oak Ridge Hospital and the Oak Ridge 

Institute for Nuclear Studies, NIOSH determined that it has access to very limited personnel 

monitoring data and source term information for Oak Ridge Hospital workers during the time period 

under evaluation and that these personnel monitoring and source term information records are not 

complete either for all time periods or for all radionuclides. NIOSH therefore concluded that there is 

sufficient documentation to support the petition basis that internal/external radiation exposures and 

radiation doses were not adequately monitored at Oak Ridge Hospital, either through personal 

monitoring or area monitoring during the evaluated period. The information and statements provided 

by the petitioner qualified the petition for further consideration by NIOSH, the Board, and HHS. The 

details of the petition basis are addressed in Section 7.4. 

3.2 Class Evaluated by NIOSH 

Based on its preliminary research, NIOSH expanded the petitioner-proposed class. Although the 

petitioner requested an evaluation date from June 30, 1958 through December 31, 1959, NIOSH 

decided that the evaluation should encompass the entire period during which the Oak Ridge Hospital 

was connected to the ORINS cancer research hospital. This was based on the preliminary information 

that that no personal internal or external monitoring data were available to NIOSH for any employee 

of the Oak Ridge Hospital while potentially in close contact to operations from ORINS, which used a 

large variety of radionuclides for internal and external cancer treatments of patients. Therefore, 

NIOSH defined the following class for further evaluation: all employees who worked in any location 

at the Oak Ridge Hospital in Oak Ridge, Tennessee, from May 15, 1950 though December 31, 1959. 

The NIOSH-evaluated class dates correspond to the start of operations at the ORINS cancer hospital 

(the first patient was admitted for treatment on May 15, 1950) and the end of the covered period for 

the Oak Ridge Hospital facility under EEOICPA (December 31, 1959), after which the Oak Ridge 

Hospital moved to a facility that was separate from ORINS. 

3.3 NIOSH-Proposed Class(es) to be Added to the SEC 

Based on its research of the class under evaluation, NIOSH has defined a single class of employees for 

which NIOSH cannot estimate radiation doses with sufficient accuracy. The NIOSH-proposed class 

to be added to the SEC includes all employees who worked in any location at the Oak Ridge Hospital 

in Oak Ridge Tennessee, for a number of work days aggregating at least 250 work days from May 15, 

1950 through December 31, 1959, or in combination with work days within the parameters 

established for one or more other classes of employees in the SEC. 
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4.0 Data Sources Reviewed by NIOSH to Evaluate the Class 

As a standard practice, NIOSH completed an extensive database and Internet search for information 

regarding Oak Ridge Hospital. The databases searched included the DOE Legacy Management 

Considered Sites database, the DOE Office of Scientific and Technical Information (OSTI) database, 

the Energy Citations database, the Atomic Energy Technical Report database, and the Hanford 

Declassified Document Retrieval System. In addition to general Internet searches, the NIOSH 

Internet search included OSTI OpenNet Advanced searches, OSTI Information Bridge Fielded 

searches, Nuclear Regulatory Commission (NRC) Agency-wide Documents Access and Management 

(ADAMS) web searches, the DOE Office of Human Radiation Experiments website, and the DOENational Nuclear Security Administration-Nevada Site Office-search. Attachment One contains a 

summary of Oak Ridge Hospital documents. The summary specifically identifies data capture details 

and general descriptions of the documents retrieved. 

In addition to the database and Internet searches listed above, NIOSH identified and reviewed 

numerous data sources to determine information relevant to determining the feasibility of dose 

reconstruction for the class of employees under evaluation by determining the availability of 

information on personal monitoring, area monitoring, industrial processes, and radiation source 

materials. This included data requests to the present day Oak Ridge Hospital (Methodist Medical 

Center of Oak Ridge), the Oak Ridge Associated Universities, and the Tennessee Department for 

Environment and Conservation (TDEC). In addition, a records search was conducted at the National 

Archives and Records Administration in Atlanta, GA as well as a general search of the published 

scientific literature for worker exposures from handling of medical radioisotopes. The following 

subsections summarize the data sources identified and reviewed by NIOSH. 

4.1 Site Profile Technical Basis Documents (TBDs) 

NIOSH has not prepared a Site Profile to support dose reconstructions for the Oak Ridge Hospital site. 

4.2 ORAU Technical Information Bulletins (OTIBs) and Procedures 

An ORAU Technical Information Bulletin (OTIB) is a general working document that provides 

guidance for preparing dose reconstructions at particular sites or categories of sites. An ORAU 

Procedure provides specific requirements and guidance regarding EEOICPA project-level activities, 

including preparation of dose reconstructions at particular sites or categories of sites. NIOSH 

reviewed the following OTIBs and procedures as part of its evaluation: 

 ORAUT-OTIB-0006, Dose Reconstruction from Occupationally Related Diagnostic X-Ray 

Procedures, Rev. 03 PC-1; Oak Ridge Associated Universities, December 21, 2005; SRDB Ref 

ID: 20220

 ORAUT-PROC-0061, Occupational X-Ray Dose Reconstruction for DOE Sites; Rev. 02, January 

2, 2008, SRDB Ref ID: 39338
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4.3 Facility Employees and Experts 

To obtain additional information, NIOSH interviewed three individuals; one was a retired physician 

from Oak Ridge Hospital and two were former employees of ORINS who were employed during the 

time when the facility was closely affiliated with Oak Ridge Hospital. The interviews were conducted 

via telephone by an OCAS Health Physicist and each interview lasted approximately 20 minutes. One 

interview was completed on the spot; two were completed after an initial phone call to set up a time 

convenient for the interviewee. 

 Personal Communication, 2009, Personal Communication with Retired Oak Ridge Hospital 

Physician; Telephone Interview by NIOSH; February 17, 2009; SRDB Ref ID: 64061

 Personal Communication, 2009, Personal Communication with Retired ORINS Scientist; 

Telephone Interview by NIOSH; February 23, 2009; SRDB Ref ID: 64060

 Personal Communication, 2009, Personal Communication with Retired ORINS Technician; 

Telephone Interview by NIOSH; February 24, 2009; SRDB Ref ID: 64059

4.4 Previous Dose Reconstructions 

NIOSH reviewed its NIOSH OCAS Claims Tracking System (NOCTS) to locate EEOICPA-related 

dose reconstructions that might provide information relevant to the petition evaluation. Table 4-1 

summarizes the results of this review. (NOCTS data available as of May 12, 2009) 

Table 4-1: No. of Oak Ridge Hospital Claims Submitted Under the Dose Reconstruction Rule 

Description Totals 

Total number of claims submitted for dose reconstruction 17 

Total number of claims submitted for energy employees who meet the definition criteria for the 

class under evaluation (May 15, 1950 through December 31, 1959) 

12 

Number of dose reconstructions completed for energy employees who meet the definition criteria 

for the class under evaluation (i.e., the number of such claims completed by NIOSH and submitted 

to the Department of Labor for final approval). 

10 

Number of claims for which internal dosimetry records were obtained for the identified years in the 

evaluated class definition 

0 

Number of claims for which external dosimetry records were obtained for the identified years in the 

evaluated class definition 

0 

NIOSH reviewed each claim, as well as transcripts from the computer-assisted telephone interviews 

(CATIs), to determine whether internal and/or external personal monitoring records could be obtained 

for the employee. Of the 12 claims that are within the evaluated period of this report, all have received 

responses to requests for site data, but none contained personnel monitoring information related to 
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employment at Oak Ridge Hospital. Of the 10 claims where the associated individual dose 

reconstructions have been completed, all 10 cases have been submitted to the Department of Labor 

(DOL). 

4.5 NIOSH Site Research Database 

NIOSH also examined its Site Research Database (SRDB) to locate documents supporting the 

evaluation of the proposed class. Sixty-four documents in this database were identified as pertaining 

to the Oak Ridge Hospital and 72 documents in the SRDB were identified as pertaining to the Oak 

Ridge Institute for Nuclear Studies. These documents were evaluated for their relevance to this 

petition. The documents include historical background on facility operations, the relationship between 

Oak Ridge Hospital and ORINS, the types and quantities of radionuclides used for medical 

applications and the extent of the radiological control program and personnel monitoring. 

4.6 Other Technical Sources 

The Oak Ridge Hospital was closely affiliated with the ORINS cancer hospital. Radiological activities 

conducted at the ORINS Cancer Hospital were not typical of operations for the DOE weapons 

complex. The facility conducted research in nuclear medicine, particularly for the treatment of 

cancer. Therefore, NIOSH also searched published nuclear medicine literature for evaluations of 

occupational exposure hazards in nuclear medicine and radiology during the 1950’s. While there are 

numerous publications that would be relevant to the subject, NIOSH identified 8 documents that were 

used to evaluate the exposure potential encountered by Oak Ridge Hospital personnel. These included 

an article providing information concerning radioisotope hazards in medical applications from the 

ORINS cancer hospital. This report (Brucer, 1951), entitled Radioisotope Hazards and Protection in 

a Hospital, and published in the Journal of the American Medical Association, was authored by Dr. 

Marshall Brucer, head of the ORINS Medical Division at the time. 

4.7 Documentation and/or Affidavits Provided by Petitioners 

In qualifying and evaluating the petition, NIOSH reviewed the following documents submitted by the 

petitioners: 

 Petition Form B including affidavit from Survivor and employment record of energy employee, 

January 14, 2009; OSA Ref ID: 107870

5.0 Radiological Operations Relevant to the Class Evaluated by 

NIOSH 

The following subsections summarize both radiological operations at the Oak Ridge Hospital from 

May 1950 to December 1959 and the information available to NIOSH to characterize particular 

operations and radioactive source materials. From available sources NIOSH has gathered operational 

and source descriptions, information regarding the identity and quantities of each radionuclide of 

concern, and information describing processes through which radiation exposures may have occurred 
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and the physical environment in which they may have occurred. The information included within this 

evaluation report is intended only to be a summary of the available information. 

5.1 Oak Ridge Hospital Operations Description 

The Oak Ridge Hospital was a community hospital to provide medical services for the town of Oak 

Ridge, Tennessee. The original 50-bed hospital facility was completed in 1943 with the first patient 

being admitted in November of that year (Annual Report, 1951). Immediately upon completion, the 

hospital was expanded due to the rapidly increasing population of Oak Ridge, with the addition of 

three additional wings (two with 100 beds each, and one 60-bed wing), eventually reaching a capacity 

of 310 beds in 1945. Often up to 375 beds were simultaneously occupied as the facility operated 

above capacity. After the end of World War II, the hospital capacity was reduced to 250 beds due to 

the decreasing Oak Ridge population, and the 60-bed E-wing was placed in standby condition. The 

hospital staff was transferred from military to civilian status by January 1946 (Annual Report, 1951; 

MDH, 1946). 

When it opened in 1943, the hospital was operated by the University of Rochester for the Manhattan 

Engineer District (MED), but in December 1943 the Roane-Anderson Company took over operations 

until December 1948, when the facility became Oak Ridge Hospital Inc. (Annual Report, 1951-1955; 

Oak Ridge Hospital, 1944). Until March 31, 1959 the Oak Ridge Hospital operated under contract 

AT-40-1-gen-252 with the Atomic Energy Commission (AEC) (AEC contract, 1952; Ford, 1960). In 

1959 the hospital became privatized (i.e., operations ceased to be subsidized by the AEC), was moved 

to a new facility and was renamed the Oak Ridge Hospital of the Methodist Church. 

Radiological operations at the Oak Ridge hospital consisted of routine hospital X-ray diagnostics and 

treatments, medical radioisotope applications (starting around 1952), and the support of operations of 

the cancer hospital operated by the Medical Division of the Oak Ridge Institute for Nuclear Studies 

(ORINS) from 1950-1959. 

The radiology department of the Oak Ridge Hospital operated standard hospital X-ray equipment 

suitable for diagnostic radiography and fluoroscopy as well as for therapeutic applications. Based on 

the available annual reports, the number of treatments ranged from 11860 diagnostic and therapeutic 

treatments in 1951 to 13313 treatments in 1955, most of which were for diagnostic purposes (Annual 

Report, 1951, 1952, 1955). 

In 1952 the AEC authorized Oak Ridge Hospital to use radiophosphorus (P-32) and radioiodine (I131) for medical applications, and by 1954 a technician had been added to the staff to administer the 

radioisotope therapies (Annual Report 1952, 1954). The 1953 annual report also cites that studies 

using radium and Co-60 applicators were planned (Annual Report 1953). A radioactive materials 

license issued in 1956 permitted the Oak Ridge Hospital to use up to 10 mCi each of I-131 and P-32, 

and by 1959 the license had been expanded to the amounts listed in Table 5-1 (TDEC, 2009). No 

license information was located to indicate the quantities of medical isotopes that might have been in 

use before 1956. Table 5-1 lists the chemical forms and applications that were planned for medical 

isotopes at the Oak Ridge Hospital based on the information in the byproduct materials license. 
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Table 5-1: Medical Isotopes used by Oak Ridge Hospital 1956-1959 

Nuclide Max. Amount 

(mCi) 

Chemical Form Condition to be treated 

I-131 25 Iodide Thyroid function diagnosis and treatment of hyperthyroidism 

I-131 1 Iodinated human serum 

albumin 

Blood and plasma volume determination 

I-131 1 Triolein and/or Oleic 

acid 

Fat absorption studies 

Au-198 100 Colloidal Intercavity treatment of pleural effusions and/or ascites 

P-32 12 Soluble Phosphate Treatment of polycythemia vera, leukemia and 

lymphosarcoma 

Cr-51 1 Chromate Plasma volume and red cell mass determination. Labeling of 

erythrocytes 

Co-60 1 Labeled Vitamin B-12 Diagnosis of pernicious anemia 

I-192 200 Seeds encased in Nylon 

Ribbon 

Interstitial treatment of cancer 

The ORINS Medical division was established in 1948 to investigate new methods to treat cancer 

patients using internally and externally administered radioisotopes. For that purpose, the ORINS was 

assigned the unused E-wing of the Oak Ridge Hospital. An additional two-story expansion was added 

to one end of the E-wing, with the other end remaining connected to the Oak Ridge Hospital. By May 

15, 1950 the ORINS clinical facility admitted its first patient (Pollard, 1948, 1980). Ever since the 

start of operations, the 30-bed ORINS hospital relied heavily on basic services provided by the much 

larger Oak Ridge Hospital, which included hospital staff performing duties at the ORINS facility and 

ORINS using the facilities of the Oak Ridge Hospital as needed. Contract agreements existed between 

the two facilities from 1950 to 1959, based on which the Oak Ridge Hospital provided the following 

services to the ORINS facility (Pollard 1955, 1956; AEC Contract, 1951; AEC Contract 1959): 

 Physicians: provided services as needed; the pathologist and anesthesiologist each had a joint 

contract with both facilities. 

 Nurses: were required to be specially trained in handling patients who had been injected with 

radioactive isotopes. In 1952 employment of part of the routine nursing staff was taken over by 

ORINS, but additional nursing staff could be drawn from the hospital as needed (ORINS, 1952). 

 Housekeeping (maids, orderlies and janitorial staff): per contract agreement they were not to enter 

controlled areas at ORINS. 

 Morgue and pathology facilities: required deceased patients to be taken into Oak Ridge Hospital 

facility. ORINS-related autopsies counted about 3 per month, but were “more involved” than 

regular post-mortem examinations (Brucer, 1951) 

 Operating rooms: ORINS did not have its own operating room until 1955 

 Diagnostic and therapeutic X-rays: ORINS patients received these treatments in the Oak Ridge 

Hospital radiology department 

 Kitchen and dietary services: Oak Ridge Hospital kitchen was providing meals for ORINS patients 

 General Services: pharmacy, blood bank, general hospital supply and routine medical laboratory 

services were all provided by the Oak Ridge Hospital 

 Patient care if the patient could not suitably be cared for by ORINS facility, per contract 

stipulation the patient must not pose a radiological hazard. 
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In return, the Oak Ridge Hospital used the ORINS facility clinical chemical laboratory and the Co-60 

teletherapy unit as needed for patient treatment. The two facilities had separate laundry services; the 

ORINS laundry was sent to the Oak Ridge National Laboratory for contamination checking and 

washing, while Oak Ridge Hospital used a commercial service. 

Although the Oak Ridge Hospital’s own radiological operations were limited to the radiology 

department, the close affiliation with the ORINS cancer research facility clearly provided a 

radioactive exposure potential for the part of the hospital staff who either worked in locations of the 

Oak Ridge Hospital that supported ORINS operations, such as kitchen, operating rooms, morgue and 

the radiology department, or worked in the ORINS facility itself per contract agreement (such as 

physicians, nurses, maids, janitors, etc.). 

Beginning in 1950, the ORINS Medical Division employed a variety of experimental cancer treatment 

methods, either by internal administration of radioisotopes or by use of teletherapy devices (external 

application of radiation). During the first year of operations (1950-1951), a total of 18 different 

radioisotopes were used by ORINS, totaling almost 25 Ci of radioactivity (Brucer, 1951). Using the 

available data from ORINS annual and progress reports from 1950-1959 (ORISE, 1994, ORINS 1950-

1959), the following list of operations was developed by NIOSH. Due to the large variety and 

experimental nature, the list may not contain all isotopes that may have been used in a given year. 

Table 5-2: Major Activities of the ORINS Medical Division 1950-1959 

Year Activities (list may not be complete) 

1950  Radioiodine Treatment for thyroid cancer (I-131) 

 Gallium-72 administration for therapeutic uses and tracer studies, mainly for bone cancer 

 Administration of gold-198 for peritoneal and pleural metastases and bladder cancer 

 Therapeutic doses of radiophosphorus (P-32) for circulation studies and tumor uptake studies 

 Tracer studies using radiosulfur (S-35) 

 Studies with cobalt-56 and cobalt-57 labeled vitamin B-12 

 Use of sodium-24 and potassium-42 for investigative studies 

1951  Radioiodine Treatment for thyroid cancer (I-131) 

 Use of cobalt-60 for teletherapy (200 Ci source) 

 Gallium-72 administration for therapeutic uses and tracer studies, mainly for bone cancer 

 Administration of Au-198 for peritoneal and pleural metastases and treatment of pleural effusions and 

ascites 

 Therapeutic doses of radiophosphorus (P-32) for circulation studies and tumor uptake studies 

 Tracer studies using radiosulfur (S-35) 

 Studies with cobalt-56 and cobalt-57 labeled vitamin B-12 

 Use of sodium-24 and potassium-42 for investigative studies 

1952  Radioiodine treatment for thyroid cancer (I-131) 

 Use of cobalt-60 for teletherapy (200-curie source) 

 Gallium-67 and -72 ingestion for treatment of bone cancer 

 Administration of gold-198 for palliation of advanced neoplasms 

1953  Internal administration of a variety of radioisotopes, including: phosphorous-32, sulfur-35, potassium42, iron-59, gallium-67, rubidium-86, yttrium-90, antimony-122, antimony-124, iodine-131, leutecium177and gold-198 

 800-curie cobalt-60 Irradiator (modified from 200-curie to 800-curie in July, 1952) 
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Year Activities (list may not be complete) 

1954  Internal administration of a variety of radioisotopes, including: phosphorous-32, potassium-42, gallium67, rubidium-86, yttrium-90, yttrium-91 antimony-122, antimony-124, iodine-131, holmium-166, 

leutecium-177and gold-198 

 A 300-600 curie cobalt-60 Teletherapy unit and a kilo-curie cesium-137 moving beam unit were used for 

external delivery of radiation. 

1955  Internal administration of a variety of radioisotopes, including: phosphorous-32, chromium-51, iron-59, 

gallium-67,strontium-85, rubidium-86, yttrium-90, iodine-131, promethium-147, leutecium-177and 

gold-198 

 A 300-600 curie cobalt-60 Teletherapy unit and a kilo-curie cesium-137 moving beam unit were used for 

external delivery of radiation. 

 Thyroid uptake calibration program using barium-133 and cesium-137 

1956  Internal administration of a variety of radioisotopes, including: phosphorous-32, gallium-67, yttrium-90, 

iodine-131, leutecium-177, and gold-198. 

 A 300-600 curie cobalt-60 Teletherapy unit and a kilo-curie cesium-137 moving beam unit were used for 

external delivery of radiation. 

 Thyroid uptake calibration program continued using barium-133 and cesium-137 

 Portable strontium-barium X-ray source 

1957  Same as 1956 

1958  Internal administration of a variety of radioisotopes, including: phosphorous-32, chromium-51, iron-59, 

gallium-67 , yttrium-90, iodine-131, leutecium-177 and gold-198 

 A 300-600 curie cobalt-60 Teletherapy unit and a kilo-curie cesium-137 moving beam unit were used for 

external delivery of radiation 

 Thyroid uptake calibration program continued using barium-133 and cesium-137 

 Portable strontium-barium X-ray source 

 A leak occurred in the cobalt-60 Teletherapy unit 

 Design of a whole-body counter 

 Evaluation of the use of a radium source for treatment of carcinoma of the cervix 

1959  Internal administration of a variety of radioisotopes, including: phosphorous-32, calcium-47, chromium51, iron-59, copper-64, arsenic-74, yttrium-90, iodine-131, iodine-132, lanthanum-140, leutecium-177 

and gold-198 

 Thyroid uptake calibration program continued using barium-133 and cesium-137 

 Continued design of a whole-body counter 

 Construction and installation of a total body irradiator (The unit contained 8 – 500 curie cesium sources) 

5.2 Radiological Exposure Sources from Oak Ridge Hospital Operations 

The following subsections provide an overview of the internal and external exposure sources for the 

Oak Ridge Hospital class under evaluation. 

5.2.1 Internal Radiological Exposure Sources from Oak Ridge Hospital Operations 

No significant internal exposure potential existed at the Oak Ridge Hospital from the beginning of the 

covered period in 1943 to May 15, 1950, when ORINS operations started. Radioactive exposures 

during that time would have been external exposures to personnel involved with routine hospital 

radiology operations (diagnostic and therapeutic X-rays). With the startup of ORINS hospital 

operations in May 1950 and the start of a radioisotope laboratory in the Oak Ridge Hospital around 

1952, internal exposures were possible as a result of the preparation, administration and disposal of 

medical radioisotope materials as well as the collecting and analyzing of samples, cleaning up spills 

and caring for patients who had been treated with these isotopes. 
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5.2.1.1 Radioiodine (I-131)

Iodine -131 is a beta and gamma emitter that concentrates in the thyroid gland and is mainly used for 

diagnostic and therapeutic treatments of thyroid conditions. The major concern for internal exposures 

from the isotopes used at Oak Ridge Hospital and ORINS would have been internal exposure from 

volatile I-131 compounds, which were limited to diagnostic applications at the Oak Ridge Hospital, 

but included a variety of therapeutic and experimental applications at the ORINS hospital starting with 

the first ORINS patient (Annual report, 1955; ORISE, 1994; ORINS 1954). The Oak Ridge Hospital 

was licensed to use up to 25 mCi of I-131 by 1959 (TDEC, 2009). At the ORINS facility, up to 69.7 

mCi of I-131 were administered to a single patient in 1951 (ORISE, 1994; 1951 quarterly progress 

report, pg. 269) and the 1951 and 1958 ORINS annual reports (ORINS 1954, 1958) indicate that in 

those years the annual amounts of I-131 used were above 3000 mCi. 

The potential for intakes of staff of nuclear medicine departments who administered radioiodine to 

patients has only been studied since the mid-1970’s (Browning et al., 1978; Carey et al., 1979; 

Jönssen and Mattsson, 1998; Landon et al., 1980; Nishiyama et al., 1980). Since the article by Brucer 

(1951) clearly shows that ORINS was aware of some worker radiation exposures, the absence of 

thyroid counting for ORINS personnel indicates that the internal hazard to medical staff from volatile 

radioiodine must have been largely unknown at the time. As shown by Browning et al. (1978), the 

handling of I-131 preparations in mCi amounts can lead to significant airborne concentrations of I131, potentially leading to the accumulation of I-131 in the thyroid of the worker handling solutions. 

It is therefore likely that Oak Ridge Hospital and ORINS staff involved with the preparing, 

administering and disposing of liquids containing I-131, and also from activities such as collecting 

samples from patients and cleaning up spills, received internal radioiodine exposures. 

5.2.1.2 Other Isotopes from Oak Ridge Hospital and ORINS operations

By 1959, the Oak Ridge Hospital was licensed to use a small variety of internally and externally 

administered radioisotopes in the forms and quantities listed in Table 5-1 (TDEC 2009). The 1955 

Oak Ridge Hospital annual report indicates that the number of patients treated was fairly small and 

that therefore the internal exposure potential from in-house operations other than from the use of 

radioiodine was likely limited. 

The potential for internal exposures to the Oak Ridge Hospital personnel from ORINS operations was 

likely limited, but is impossible to quantify due to the large variety of isotopes in use and the 

experimental nature of their use in patient treatments. Most preparations used by ORINS were in 

liquid form, most radioisotopes used had short half-lives and the preparation of medicines containing 

radioisotopes for cancer treatment took place in fume hoods which were designed to prevent 

inhalation of fumes. However, the administration of medicines to patients orally or through injections; 

the control and disposal of biological waste (e.g., urine, feces, cancerous organs and other 

contaminated waste); and exposure to, and control of, airborne contaminants created during spills of 

radioactive medicines and biological waste could have created an internal exposure potential. Spills 

of radioactive fluids were not uncommon due to “unpredictable patient behavior” (Hayes, 1950). In 

addition, at least one incident is documented when a leak from the Co-60 teletherapy source caused 

significant surface contamination in the ORINS area (Brucer, 1960). The close association between 

ORINS and the Oak Ridge Hospital makes it impossible to conclude that only the ORINS staff could 
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have been exposed as a result of those activities. An example of specific concerns regarding 

exposures of personnel was described in a memorandum by Hayes (1950) that indicated the eating 

utensils used by ORINS patients left radioactive residues on the used dishes and utensils (which were 

subsequently returned to the kitchen at the Oak Ridge Hospital for cleaning). The use of operating 

rooms and morgue facilities by ORINS would have involved the handling and cleanup of a variety of 

fluids and solids from radioactive patients. 

5.2.2 External Radiological Exposure Sources from Oak Ridge Hospital Operations 

External exposures to personnel at Oak Ridge Hospital consisted of diagnostic and therapeutic X-Ray 

treatments of patients, the use of radioisotopes for medical treatments and the effect the ORINS 

operations had on the hospital facility by introducing radioactive patients or contaminated materials to 

the Oak Ridge Hospital facility. External exposures would have been due to photon and beta-emitting 

radionuclides only. There is no indication that any of the Oak Ridge Hospital or ORINS operations 

could have produced an exposure potential to neutrons; therefore neutron exposures are not 

considered in this evaluation. 

5.2.2.1 Photon

The Oak Ridge Hospital radiology department performed standard diagnostic and therapeutic X-ray 

procedures on patients, the majority of which were for diagnostic applications. Exposures to workers 

in radiology departments have long been recognized and a recent analysis of historical exposures to 

radiology technicians in the United States from 1916 to 1984 has been published by Simon et al. 

(2006), who estimated that the median exposure to a hospital radiology technician in the 1950-1959 

period was about 1.1 rem/year. 

 

An additional exposure potential to Oak Ridge Hospital personnel from gamma-emitting 

radionuclides was introduced around 1952 by the radionuclides used in the radioisotope laboratory, 

which by 1959 likely included most or all of the isotopes listed in Table 5-2. 

The ORINS facility used a large variety of beta and gamma-emitting radionuclides, almost all of 

which created an external exposure potential to workers and patients and some of which may have 

been introduced into the Oak Ridge Hospital facility over the course of routine operations. The major 

radioisotopes used by ORINS and the Oak Ridge Hospital and their respective decay energies are 

listed in Table 5-3 (Nuclides, 2009), with Ga-72, Au-198 and I-131 being the isotopes used in the 

largest quantities (Brucer, 1951; ORINS, 1954). 

Table 5-3: Radioisotope Decay Characteristics 

Isotopea Half-life Major Decay Type and Energy in MeV (decay fraction)b

P-32 14.26 d Beta: 1.71 (1.00) 

K-42 12.36 hr Beta: 2.00 (0.176), 3.52 (0.819) 

Gamma: 1.524 (0.181) 

Co-60 5.27 yr Beta: 0.318 (0.999) 

Gamma: 1.173 (0.999), 1.332 (1.00) 

Co-57 271.74 d Gamma: 0.122 (0.856), 0.136 (0.107) 

Ga-67 3.26 d Gamma: 0.933 (0.388), 0.185 (0.214), 0.300 (0.166) 

Ga-72 14.1 hr Beta: 0.659 (0.15), 0.676 (0.217), 0.966 (0.277), 3.167 (0.103) 

Gamma: 0.630 (0.248), 0.834 (0.956), 2.202 (0.259), 2.508 (0.128) 
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Isotopea Half-life Major Decay Type and Energy in MeV (decay fraction)b

Rb-86 18.64 d Beta: 1.77 (0.914) 

Gamma: 1.077 at < 10 % abundance 

Y-90 64.0 hr Beta: 2.280 (1.00) 

Sb-122 2.72 d Beta: 1.419 (0.667), 1.984 (0.261) 

Gamma: 0.564 (0.707) 

Sb-124 60.2 d Beta: 0.611 (0.512), 2.302 (0.232), 

Gamma: 0.603 (0.978), 0.723 (0.108), 1.691 (0.476), 

Cs-137 30.08 yr Beta: 0.513 (0.947) 

Gamma: 0.662 (0.851) 

I-131 8.025 d Beta: 0.606 (0.896) 

Gamma: 0.364 (0.815) 

Eu-152 13.54 yr, Gamma: 0.122 (0.287), 0.964 (0.147), 1.086 (0.102), 1.112 (0.137), 1.408 (0.211) 

Eu-154 8.59 yr Beta: 0.249 (0.286), 0.571 (0.363), 0.841 (0.168), 1.845 (0.100) 

Gamma: 0.123 (0.406), 0.723 (0.201), 0.873 (0.122), 0.996 (0.105), 1.004 (0.179), 

1.274 (0.35) 

Lu-177 6.65 d Beta: 0.177 (0.116), 0.498 (0.794) 

Gamma: 0.208 (0.103) 

Hf-183 1.07 hr Beta: 1.152 (0.680), 1.550 (0.250) 

Gamma: 0.073 (0.380), 0.459 (0.270), 0.784 (0.660) 

Ir-192 73.8 d Beta: 0.539 (0.414), 0.675 (0.48) 

Gamma: 0.296 (0.287), 0.308 (0.297), 0.317 (0.827), 0.468 (0.478) 

Au-198 2.695 d Beta: 0.315 (0.990) 

Gamma: 0.412 (0.956) a

 Includes isotopes used in quantities exceeding 100 mCi/year by ORINS based on ORINS (1954, 1958), Brucer 

(1951) 

b

 Includes decay energies with decay fractions greater than 10 % (Nuclides, 2009), beta energies are endpoint. 

In particular, the high-energy (> 2 MeV) gamma radiation of Ga-72 used in the early years of ORINS 

operation caused gamma exposure challenges at ORINS as discussed by Brucer (1951) and Hayes 

(1950). Both reported on Ga-72 gamma rays easily penetrating building walls, and Hayes (1950) 

reports on readily detectable radiation fields outside the hospital on the sidewalk resulting from 

patients treated with the isotope. Physicians and nurses who had to spend up to an hour per day near 

the patient were likely to exceed a weekly exposure limit of 300 mR (Brucer, 1951). The storage and 

disposal of patient urine samples also posed a problem because the samples were too radioactive for 

disposal in the sanitary sewer and had to be stored in a shielded space until some of the activity had 

decayed. The memorandum by Hayes (1950) also mentions that the Health Physics group at the 

ORNL voiced concerns about the occasionally “alarming” radiation intensities that were observed 

coming from the ORINS laundry. These contaminated items would have been handled by a nurse, 

maid or orderly before being sent to the laundry at ORNL, likely creating an external exposure 

potential to that worker. 

External exposures to ORINS personnel were measured and documented in personnel records and in 

technical publications (Brucer 1951). In that article, external exposures were outlined for a threemonth period from December 1950-February 1951 at the ORINS facility, as shown in Table 5-4 

below. 
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Table 5-4: Routine Film Badge Exposures of Selected ORINS Personnel (Dec. 1950 – Feb. 1951) 

Type of Employee No. with 

Blank Badge

No. Exposed Avg. mR/day Exposure Largest Avg. 

Exposure in 

Group (mR/day) 

Open Window Closed Window 

Staff (M.D. or Ph.D) 3 10 9.1 9.1 55.7 

Part-time Staff 1 3 2.0 3.9 10.9 

Technicians 2 9 10.3 11.9 28.5 

Nurses 0 12 4.9 3.9 10.6 

Nurse aides 0 6 4.1 3.7 5.9 

Orderlies 0 2 12.2 11.4 15.9 

Maids 0 2 1.8 1.8 3.1 

Maintenance Men 4 3 0.6 0.6 0.6 

Administrative 1 4 1.5 1.3 4.2 

Total Personnel 11 51 6.1 6.1 55.7 

Table 5-4 shows the dose levels measured for ORINS medical division personnel while working on 

ORINS projects. It is noteworthy that even the administrative personnel received non-zero external 

exposures. It is therefore likely that exposures would also be acquired by Oak Ridge Hospital staff 

who went to ORINS to provide services (such as the physicians, nurses and housekeeping staff), as 

well as by Oak Ridge Hospital staff supporting such activities as surgeries and post-mortem 

examinations of patients whom were brought into the Oak Ridge Hospital. Exposures during these 

procedures are also discussed by Brucer (1951) who lists the external exposures obtained by the 

surgeon and his support staff during several different types of surgeries and an autopsy on patients 

injected with various radioisotopes. These values are shown in Table 5-5 (adapted from reference). 

Since these data were acquired in 1950-1951, these procedures would have taken place in the Oak 

Ridge Hospital facility, since ORINS did not have an operating room until 1955 (Pollard, 1955). 

Table 5-5: Exposures received during Surgical Procedure (mR/hr) 

Operation Surgeon First Assistant Assistant/Anesthetist 

Left 

Hand 

Right 

Hand 

Total 

Body 

Left 

Hand 

Right 

Hand 

Total 

Body 

Left 

Hand 

Right 

Hand 

Total 

Body 

Laparotomy1, 5 mCi 72Ga, 0.5 hr 

n/a n/a 20 n/a n/a 20 n/a n/a 20 

Laparotomy, 100 mCi 

198Au, lesser omentum, 

2.5 hr 

62 30 16 14 14 4 20 n/a 4 

Laparotomy, 100 mCi, 

198Au, peritoneal cavity, 

2 hr 

245 90 40 145 300 40 15 n/a 5 

Implant Radium 

Needles, 45 mCi, 0.5 hr 

1400 860 180 720 940 180 n/a n/a n/a 

Autopsy 102 mCi 198Au, 

peritoneum, 1.3 hr 

115 107 46 n/a n/a 27 n/a n/a n/a 

Pneumonectomy1, 20 

mCi 72Ga , 2.5 hr 

160 160 12 16 

1

Laparotomy is a surgical procedure involving an incision through the abdominal wall to gain access to the 

abdominal cavity, pneumonectomy refers to the removal of the lung or part thereof. 
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5.2.2.2 Beta 

Exposure to beta-emitting radionuclides was a result of the diagnostic and therapeutic administration 

of various beta and gamma-emitting radionuclides to patients as described in the previous section. 

Several radioisotopes with strong beta energies were used by ORINS and the Oak Ridge Hospital and 

the handling of preparations or fluids from patients who have received doses of beta-emitters would 

also contribute to the beta dose to the hands and eyes of the personnel handling these solutions. 

According to Brucer (1951), ORINS was aware of the situation and supplied palm and finger badges, 

wrist and forehead chambers for procedures that would involve extremity exposure, such as surgeries, 

autopsies, and preparations of new compounds. This is evident from the extremity data presented in 

Table 5-5. 

5.2.3 Incidents 

NIOSH did not identify any documented accidents at the Oak Ridge Hospital that resulted in 

exceptionally high personnel exposure levels (such as a criticality event). However, in 1958 a leak 

developed in one of the ORINS Co-60 teletherapy units located in the E-wing, which resulted in 

widespread contamination of the room and adjacent hallways. It is possible that this contamination 

also spread to the Oak Ridge Hospital, since the ORINS teletherapy room and the contaminated 

hallway were close to the connecting doors between the two facilities (and the doors were not “closed 

and sealed” until 6 days after the leak was discovered). The hallway surface contamination on the 

ORINS side ranged from 0.05 to 0.1 Ci/ft2

. The report by Brucer (1960), which includes a floor plan 

of the area, details the efforts undertaken to clean a worker’s personal belongings (such as furniture) 

after it was found that the contamination had been tracked to the worker’s home. However there is no 

indication that contamination surveys were taken at the Oak Ridge Hospital side of the doors (which 

must have seen some foot traffic, based on the amount of services the Oak Ridge Hospital provided to 

ORINS). It is estimated that the leak started sometime between September 1-4 but was not discovered 

until September 8. The overall release in the form of Co-60 oxide was estimated to be less than 100 

mCi (Brucer, 1960). 

6.0 Summary of Available Monitoring Data for the Class Evaluated 

by NIOSH 

The following subsections provide an overview of the state of the available internal and external 

monitoring data for the Oak Ridge Hospital class under evaluation. 

6.1 Available Oak Ridge Hospital Internal Monitoring Data 

NIOSH has searched the data resources listed in Section 4.0 of this report and has not located any 

internal monitoring data for Oak Ridge Hospital employees for the evaluated period either in the form 

of bioassay or air monitoring. No claimant files contain internal monitoring data and no information 

listed in the claimant CATI interviews indicated that internal monitoring was done for employment at 

the Oak Ridge Hospital. This is in agreement with the findings published by NIOSH in its evaluation 

report for SEC00033 (OSA 101295) for the ORINS Cancer Research Hospital, for which no internal 

monitoring data were located either. A report published after the 1958 Co-60 leak incident has limited 
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internal data, but that was limited to four individuals who received nasal swipes, urine bioassay and 

whole-body counting (and intakes were measured between 0.003 Ci to 0.18 Ci) (Brucer, 1960). 

The lack of routine internal monitoring data is consistent with the reports of Oak Ridge Hospital and 

ORINS employees who have stated there was no internal monitoring program during this period 

(Personal Communication, 2009a, 2009b, 2009c; NIOSH 2006). 

6.2 Available Oak Ridge Hospital External Monitoring Data 

NIOSH has reviewed the data sources listed in Section 4.0 of this report and has located only a very 

limited amount of external monitoring data for Oak Ridge Hospital employees for the evaluated 

period. 

As early as 1946 the Manhattan Engineering District (MED) had ordered that the personnel of the 

radiology department should be monitored using 6 film badges supplied by ORNL, and that films 

should be exchanged and read weekly. The first distribution of these films to the hospital was to take 

place on April 29, 1946. The memorandum containing this information also stated that the resulting 

reports were to be sent to the MED, not to the Oak Ridge Hospital (Wirth, 1946). No reports on the 

results of these film badges have been located and it is not known for how long this practice was 

continued. 

With the acquisition of a radioactive materials license, the Oak Ridge Hospital may have been 

required by the AEC to monitor for radioactive exposure, but based on memos included with the 

radioactive materials license, film badge service was only obtained in 1958 from ORNL. Monitoring 

appeared to have been limited to the radiology department personnel (TDEC, 2009). Searches for any 

of this monitoring information proved unsuccessful. 

ORINS personnel were monitored for external radiation exposure as discussed in the SEC00033 

Evaluation Report and in the article by Brucer (1951). The data included in ORINS claimant files 

contain records of external radiation exposure monitoring in the form of dose cards listing penetrating 

dose. The majority of the records list only an annual summary of external exposure, with a few 

exceptions for whom monthly film badge information is available. During the records investigation 

for ORINS cancer hospital, ORAU provided NIOSH a spreadsheet with annual external monitoring 

summaries for ORINS employees from 1950-1961. The spreadsheet addressed external exposures to 

504 ORINS employees and contains only penetrating dose values. Those dose levels are shown in 

Table 6-1 for the 1950-1959 timeframe and indicate the exposure levels at ORINS. Limited wholebody and extremity exposure information is available from Brucer (1951), who discusses whole-body 

exposures as well as exposure to the hands of surgeons during a non-routine operation as outlined in 

Section 5. It appears that some of the Oak Ridge Hospital personnel were monitored under the ORINS 

program as well, based on name matching in the spreadsheet with information in the annual reports. 

As an example, ORINS and Oak Ridge Hospital shared the services of the pathologist and the 

anesthesiologist, and both were included in the ORINS external monitoring program. However, there 

are no external monitoring data for the general worker pool at the Oak Ridge Hospital who may have 

supported ORINS operations either in the Oak Ridge Hospital or the ORINS facility. This was 

corroborated in a telephone interview with a former Oak Ridge Hospital physician, who recalled that 

he routinely went to the ORINS facility to help out, but states that he was not monitored for radiation 

exposure (Personal Communication, 2009a). 
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Table 6-1: Summary of External Exposure Data at ORINS 

Year No. Employees 

Monitored 

Lowest dose recorded 

(mrem) 

Mean dose recorded 

(mrem) 

Highest dose recorded 

(mrem) 

1950 83 30 526 7051 

1951 144 30 554 7310 

1952 135 30 272 1090 

1953 116 30 280 2675 

1954 104 30 371 3901 

1955 114 30 350 2330 

1956 149 30 191 1210 

1957 138 30 256 2305 

1958 148 30 322 1360 

1959 158 30 295 2215 

Area monitoring of radiation fields was performed at ORINS on a routine basis to limit the radiation 

exposure from radioactive patients to workers, visitors and other patients. The nursing staff was 

specially trained in the use of the GM survey meter, which was calibrated to a 6.25 mR/hr “red” mark, 

above which limitations existed regarding access to patients. According to Brucer (1951) there were 

no restrictions to personnel working in areas below the 6.25 mR/hr limit. It is not clear if surveys of 

this nature were performed when patients or operations were transferred to the Oak Ridge Hospital. 

6.3 Source Term Information 

NIOSH reviewed available data sources for radiological source term information. Besides the Oak 

Ridge Hospital AEC license information (Table 5-2), the annual reports of the ORINS Medical 

Division contain listings of the radioisotopes used and the quantities handled in a given year. As an 

example, Table 6-1 identifies the isotopes and activities used by the Medical Division in 1951, 1954 

and 1958 (Brucer, 1951, ORINS 1954, 1958). Table 6-2 shows the large variety of different isotopes 

that was in use at ORINS and how the types and quantities of isotopes used by ORINS changed as 

time progressed, with new isotopes included in the experimental treatments while others were 

abandoned. The major isotopes in use at the ORINS facility were Au-198, Ga-72, I-131 and Co-60; 

the latter was used for teletherapy applications (external irradiation of tissues or whole body). 

Table 6-2: Isotopes Used by the ORINS Medical Division 

Isotope 1951 Activity 

(mCi) 

1954 Activity 

(mCi) 

1958 Activity (mCi) 

Antimony-121, 124 225 

Antimony-122 207 

Barium-133 8 

Calcium-45 7 1 

Carbon-14 5 

Cerium-presodymium-144 20 

Cesium-134 10 

Cesium-137 5 plus 1500 sealed 

source 

Chromium-51 8 19 

Cobalt-56-57 10 

Cobalt-60 2220 275 Milligrams plus 

450 Ci sealed source 

1.3x106
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Isotope 1951 Activity 

(mCi) 

1954 Activity 

(mCi) 

1958 Activity (mCi) 

Europium-152, 154 1.5 736 

Gallium-67 1 2587.4 

Gallium-72 10920 

Gold-198 6858 8275 2680 

Hafnium-183 100 

Holmium-166 64.3 

Indium-114 30 

Iron-59 3.65 6.25 

Iodine-131 3715 1350 3698 

Iodine-132 10 

Lutecium-177 192 

Manganese-54 10 

Nickel-63 3 

Niobium-95 2 

Phosphorus-32 110 472 289 

Potassium-42 123 390 20 

Promethium-147 20 

Rubidium-86 145 20 

Ruthenium-106 50 50 

Scandium-46 3 

Sodium-24 90 12 23 

Sulfur-35 114 2 63 

Thulium 1 

Yttrium-90 82.6 595 

Yttrium-91 40 75 

Zirconium-95 1 

7.0 Feasibility of Dose Reconstruction for the Class Evaluated by 

NIOSH 

The feasibility determination for the class of employees under evaluation in this report is governed by 

both EEOICPA and 42 C.F.R. § 83.13(c)(1). Under that Act and rule, NIOSH must establish whether 

or not it has access to sufficient information either to estimate the maximum radiation dose for every 

type of cancer for which radiation doses are reconstructed that could have been incurred under 

plausible circumstances by any member of the class, or to estimate the radiation doses to members of 

the class more precisely than a maximum dose estimate. If NIOSH has access to sufficient 

information for either case, NIOSH would then determine that it would be feasible to conduct dose 

reconstructions. 

In determining feasibility, NIOSH begins by evaluating whether current or completed NIOSH dose 

reconstructions demonstrate the feasibility of estimating with sufficient accuracy the potential 

radiation exposures of the class. If the conclusion is one of infeasibility, NIOSH systematically 

evaluates the sufficiency of different types of monitoring data, process and source or source term data, 

which together or individually might assure that NIOSH can estimate either the maximum doses that 

members of the class might have incurred, or more precise quantities that reflect the variability of 

exposures experienced by groups or individual members of the class as summarized in Section 7.5. 
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This approach is discussed in OCAS’s SEC Petition Evaluation Internal Procedures which are 

available at http://www.cdc.gov/niosh/ocas. The next four major subsections of this Evaluation 

Report examine: 

 The sufficiency and reliability of the available data. (Section 7.1) 

 The feasibility of reconstructing internal radiation doses. (Section 7.2) 

 The feasibility of reconstructing external radiation doses. (Section 7.3) 

 The bases for petition SEC-00137 as submitted by the petitioner. (Section 7.4) 

7.1 Pedigree of Oak Ridge Hospital Data 

This subsection answers questions that need to be asked before performing a feasibility evaluation. 

Data Pedigree addresses the background, history, and origin of the data. It requires looking at site 

methodologies that may have changed over time; primary versus secondary data sources and whether 

they match; and whether data are internally consistent. All these issues form the bedrock of the 

researcher’s confidence and later conclusions about the data’s quality, credibility, reliability, 

representativeness, and sufficiency for determining the feasibility of dose reconstruction. The 

feasibility evaluation presupposes that data pedigree issues have been settled. 

Performing internal and external dose reconstructions either requires worker monitoring data or 

sufficient source term and process information. It is possible to use coworker monitoring data as a 

means of calculating claimant-favorable and maximum potential radiation doses for class members 

who were unmonitored or have gaps in their monitoring records. 

However, in the case of this evaluation, NIOSH has found that the lack of internal and external 

monitoring data in combination with a highly complex and varied source term are insufficient for 

estimating internal radiation doses with sufficient accuracy for members of the proposed class. 

Therefore, further evaluations of the pedigree of any of the data were not performed. 

7.2 Evaluation of Bounding Internal Radiation Doses at Oak Ridge Hospital 

The principal sources of internal radiation doses for members of the class under evaluation were the 

potential inadvertent inhalation and ingestion of radioactive contaminants as a result of the operation 

of a medical radioisotope laboratory at the Oak Ridge Hospital as well as the support operations that 

were provided to the ORINS cancer research facility by the Oak Ridge Hospital. These operations 

may have involved the following activities that could have created airborne contamination (especially 

from solutions containing radioiodine): (1) preparation of medicines containing radioisotopes for 

diagnoses and treatment of illnesses; (2) administration of medicines to patients either orally or 

through injections; (3) collection, control and disposal of biological waste (e.g., urine, feces, 

cancerous organs and other contaminated waste); and (4) patient care and cleaning up spills of 

radioactive medicines. 
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 Any internal monitoring data would allow direct reconstruction of an individual claimant’s internal 

dose, but as shown in Section 6.1, no internal monitoring data are available and there are no 

indications that workers were monitored for internal exposure except after the Co-60 source leak, 

which was an isolated incident. Also, no air monitoring data are available that could be used for the 

development of an internal exposure model. Lacking these data, NIOSH considered the sufficiency of 

source term and process data for developing an internal exposure model for Oak Ridge Hospital 

employees covered by this evaluation. As indicated in Section 6.3, a number of source terms existed 

at the ORINS facility and some data are available for the isotopes used in the radioisotope laboratory 

located in the radiology department (Table 5-1). Even though NIOSH has these source term data for 

1950-1959, there is no information defining exactly how much activity of each isotope was used at 

what procedure and in what chemical forms the radioisotopes were present. There is no information 

that would allow estimating what types and quantities of radioisotopes could have been introduced 

into the Oak Ridge Hospital facility from ORINS activities. In lieu of bioassay data, this information 

is necessary to develop an exposure model with sufficient accuracy. 

As a result of these limitations, NIOSH cannot establish a maximum internal exposure scenario that 

addresses all of the internal exposure potential for the petitioning class, and therefore cannot estimate 

internal doses for members of this class with sufficient accuracy. 

7.3 Evaluation of Bounding External Radiation Doses at Oak Ridge Hospital 

The principal source of external radiation doses for members of the proposed class was photon and 

beta exposures from: (1) patient diagnostic and therapeutic X-rays; (2) radioactive medicines prepared 

and administered to patients; (3) removal and disposal of cancerous organs containing activities of 

radioisotopes; (4) care of patients containing activities of radioisotopes; and (5) radiation-generating 

devices used in cancer research. 

The available data indicate that there may have been some external monitoring of personnel in the 

radiology department at the Oak Ridge Hospital in 1946 and after 1958. No data have been located for 

the period under evaluation. All persons working at ORINS were monitored for external radiation 

exposure, as documented by Brucer (1951) and the summary data provided by ORAU. The latter 

included names and annual dose summaries from ~ 6 employees from the Oak Ridge Hospital (some 

last name match only) who went to the ORINS facility to provide services or treat patients, but these 

data are very limited and did not include all workers as indicated by the statements from an Oak Ridge 

Hospital physician (Personal Communication, 2009a). It is therefore not possible to conclude that all 

workers from the Oak Ridge Hospital who provided services to ORINS would have been included 

under the ORINS external monitoring program. 

NIOSH has concluded in its earlier SEC00033 evaluation report that external dose information 

available for ORINS employees is sufficient to reconstruct external doses for ORINS workers, based 

on individual claimant data that are available and the summary spreadsheet that was provided by 

ORAU, which contained external annual summaries for deep dose measurements. It is therefore 

possible that external doses could be reconstructed for an Oak Ridge Hospital worker if that worker 

was included in the ORINS external monitoring program. 
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Indications are that workers in the radiology department of the Oak Ridge Hospital might have been 

monitored for external radiation exposure but these data were not available for dose reconstruction, 

since no records have been located. In this case it is possible for NIOSH to estimate a worker’s dose 

based on available cohort data for X-ray technologists. External occupational doses to a cohort of 

radiologic technologists working in the United States from 1916 to 1984 have been estimated in a 

paper by Simon et al. (2006), who analyzed film badge data from hospitals over six decades. In this 

retrospective dose estimate, a radiology technician working during the period from 1950-1959 in a 

typical hospital radiology department was estimated to receive an annual median dose of 1.1 rem with 

a geometric standard deviation (GSD) of 0.39 rem. NIOSH can use this information to reconstruct 

doses to workers of the Oak Ridge Hospital radiology department. 

However, since Oak Ridge Hospital personnel were also potentially exposed to an unknown amount 

of external radiation as a result of operations of the ORINS facility, NIOSH has concluded that there 

is insufficient information available that would allow it to bound the external dose to all workers of 

the Oak Ridge Hospital. 

7.3.1 Medical X-Ray Dose 

In most industrial facilities associated with operations of the nuclear weapons complex, workers 

received regular medical X-rays to screen for lung disease and occupational problems, and NIOSH is 

required to include the dose resulting from occupationally-required X-rays in a worker’s dose 

reconstruction. Information about the type and frequency of such examinations is often included in the 

worker’s files or confirmed during the worker phone interview. NIOSH’s review of the current 

individual claims and additional information in the SRDB did not lead to the conclusion that workers 

at the Oak Ridge Hospital received routine annual X-ray examinations. Only one of the 17 claimants 

indicated that the deceased employee received occupational X-rays for employment related to the Oak 

Ridge Hospital. If such examinations took place, their frequency is unknown, but generally a hospital 

worker would not be expected to receive more than a single examination per year. In cases where 

available information exists that a worker received occupational X-rays, an upper bound for this 

exposure can be established using the procedure Occupational X-Ray Dose Reconstruction for DOE 

Sites (ORAUT-PROC-0061). NIOSH can reconstruct the medical X-ray dose for workers of the Oak 

Ridge Hospital with sufficient accuracy. 

7.4 Evaluation of Petition Basis for SEC-00137 

The following subsections evaluate the assertions made on behalf of petition SEC-00137 for the Oak 

Ridge Hospital. 

7.4.1 Oak Ridge Hospital staff was not monitored for radiation exposure 

SEC-000137: The petitioner made the assertion that workers employed at the Oak Ridge Hospital 

were not monitored for internal or external radiation exposure despite there being an exposure 

potential as a result of the operations at the ORINS facility, which was housed in the same work area 

as the Oak Ridge Hospital (OSA 107870).
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NIOSH concurs with the petitioner’s assertions that most Oak Ridge Hospital personnel were not 

monitored for radiation exposure. Although the Oak Ridge Hospital and the ORINS cancer hospital 

were separate organizations under separate contracts with the AEC, existing contract information 

indicates that the cooperation and sharing of facilities between the Oak Ridge Hospital and the ORINS 

facility were extensive and that based on the large quantity, variety and experimental nature of the 

ORINS operations there existed an exposure potential for some of the staff of the Oak Ridge Hospital, 

who were involved in support operations to ORINS. NIOSH has been unable to locate information 

that would allow it to bound the worker dose for workers of the Oak Ridge Hospital who worked from 

May 1950 to December 1959. 

7.5 Summary of Feasibility Findings for Petition SEC-00137 

This report evaluates the feasibility for completing dose reconstructions for employees at the Oak 

Ridge Hospital from May 1950 through December 1959. NIOSH found that the available monitoring 

records, process descriptions and source term data available are not sufficient to complete dose 

reconstructions for the evaluated class of employees. 

Table 7-1 summarizes the results of the feasibility findings at Oak Ridge Hospital for each exposure 

source during the time period May 1950 through December 1959. 

Table 7-1: Summary of Feasibility Findings for SEC-00137 

(May 1950 through December 1959)

Source of Exposure Reconstruction Feasible Reconstruction Not Feasible 

Internal1 X 

 - Radioiodine (I-131) X 

 - various other radionuclides X 

External2 X 

 - Gamma X (only X-ray technician) X (except X-ray technicians) 

 - Beta X 

 - Occupational Medical X-ray X 1

 Internal includes an evaluation of urinalysis (in vitro), airborne dust, and lung (in vivo) data (if available) 

PARTIAL DOSE RECONSTRUCTION INFORMATION: 

2

 EXTERNAL: Using the available ORINS external monitoring data for some of the Oak Ridge Hospital workers 

some external doses could be reconstructed in support of a partial DR for claims with non-presumptive cancers 

and those with less than 250-days of employment 

As of May 15, 2009, a total of 12 claims have been submitted to NIOSH for individuals who worked 

at the Oak Ridge Hospital and are covered by the class definition evaluated in this report. Dose 

reconstructions have been completed for 10 individuals (~83 %). 
SEC-00137 06-09-2009 Oak Ridge Hospital

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8.0 Evaluation of Health Endangerment for Petition SEC-00137 

The health endangerment determination for the class of employees covered by this evaluation report is 

governed by both EEOICPA and 42 C.F.R. § 83.13(c)(3). Under these requirements, if it is not 

feasible to estimate with sufficient accuracy radiation doses for members of the class, NIOSH must 

also determine that there is a reasonable likelihood that such radiation doses may have endangered the 

health of members of the class. Section 83.13 requires NIOSH to assume that any duration of 

unprotected exposure may have endangered the health of members of a class when it has been 

established that the class may have been exposed to radiation during a discrete incident likely to have 

involved levels of exposure similarly high to those occurring during nuclear criticality incidents. If 

the occurrence of such an exceptionally high-level exposure has not been established, then NIOSH is 

required to specify that health was endangered for those workers who were employed for a number of 

work days aggregating at least 250 work days within the parameters established for the class or in 

combination with work days within the parameters established for one or more other classes of 

employees in the SEC. 

NIOSH has located no internal or external monitoring data or sufficiently detailed source term 

information to bound worker exposures at the Oak Ridge Hospital. An exposure potential was created 

by the hospital’s radioisotope laboratory as well as the hospital’s cooperation with the ORINS cancer 

treatment facility. NIOSH’s evaluation determined that it is not feasible to estimate radiation dose for 

members of the NIOSH-evaluated class with sufficient accuracy based on the sum of information 

available from available resources. Modification of the class definition regarding health 

endangerment and minimum required employment periods therefore is not required. 

9.0 Class Conclusion for Petition SEC-00137 

Based on its full research of the class under evaluation, NIOSH has defined a single class of 

employees for which NIOSH cannot estimate radiation doses with sufficient accuracy. The NIOSHproposed class to be added to the SEC includes all employees who worked in any location at the Oak 

Ridge Hospital in Oak Ridge Tennessee, for a number of work days aggregating at least 250 work 

days from May 15, 1950 through December 31, 1959, or in combination with work days within the 

parameters established for one or more other classes of employees in the SEC.. The class under 

evaluation was expanded because NIOSH has determined that an exposure potential existed over the 

entire timeframe of the proposed class during which no monitoring data exist. 

NIOSH has carefully reviewed all material sent in by the petitioner, including the specific assertions 

stated in the petition, and has responded herein (see Section 7.4). NIOSH has also reviewed available 

technical resources and many other references, including the Site Research Database (SRDB), for 

information relevant to SEC-00137. In addition, NIOSH reviewed its NOCTS dose reconstruction 

database to identify EEOICPA-related dose reconstructions that might provide information relevant to 

the petition evaluation. 

These actions are based on existing, approved NIOSH processes used in dose reconstruction for 

claims under EEOICPA. NIOSH’s guiding principle in conducting these dose reconstructions is to 

ensure that the assumptions used are fair, consistent, and well-grounded in the best available science. 
SEC-00137 06-09-2009 Oak Ridge Hospital

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Simultaneously, uncertainties in the science and data must be handled to the advantage, rather than to 

the detriment, of the petitioners. When adequate personal dose monitoring information is not 

available, or is very limited, NIOSH may use the highest reasonably possible radiation dose, based on 

reliable science, documented experience, and relevant data to determine the feasibility of 

reconstructing the dose of an SEC petition class. NIOSH contends that it has complied with these 

standards of performance in determining the feasibility or infeasibility of reconstructing dose for the 

class under evaluation. 
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SEC-00137 06-09-2009 Oak Ridge Hospital

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10.0 References 

42 C.F.R. pt. 81, Guidelines for Determining the Probability of Causation Under the Energy 

Employees Occupational Illness Compensation Program Act of 2000; Final Rule, Federal 

Register/Vol. 67, No. 85/Thursday, p 22,296; May 2, 2002; SRDB Ref ID: 19391 

42 C.F.R. pt. 82, Methods for Radiation Dose Reconstruction Under the Energy Employees 

Occupational Illness Compensation Program Act of 2000; Final Rule; May 2, 2002; SRDB Ref ID: 

19392 

42 C.F.R. pt. 83, Procedures for Designating Classes of Employees as Members of the Special 

Exposure Cohort Under the Energy Employees Occupational Illness Compensation Program Act of 

2000; Final Rule; May 28, 2004; SRDB Ref ID: 22001 

42 U.S.C. §§ 7384-7385 [EEOICPA], Energy Employees Occupational Illness Compensation 

Program Act of 2000, as amended 

OCAS-PR-004, Internal Procedures for the Evaluation of Special Exposure Cohort Petitions, Rev. 0, 

National Institute for Occupational Safety and Health (NIOSH); Cincinnati, Ohio; September 23, 

2004; SRDB Ref ID: 32022 

ORAUT-OTIB-0006, Dose Reconstruction from Occupationally Related Diagnostic X-Ray 

Procedures; Rev. 3, PC1; December 21, 2005, SRDB Ref ID: 20220 

ORAUT-PROC-0061, Occupational X-Ray Dose Reconstruction for DOE Sites; Rev. 02, January 2, 

2008, SRDB Ref ID: 39338 

AEC Contract, 1951, Contract No. AT-40-1-Gen-33, Subcontract No. 3, Modification No. 2, June 28, 

1951, Subcontract between Oak Ridge Hospital and ORINS; SRDB Ref ID 64690 

AEC Contract, 1952, Contract No. AT-40-1-Gen-252, contract and contract modifications between 

AEC and Oak Ridge Hospital, 1949-1952, SRDB Ref ID: 64695 

AEC Contract, 1959, Subcontract No. 3 with Oak Ridge Hospital Inc under ORINS contract No. AT-

(40-1)-GEN-33, Feb 25, 1959, SRDB Ref ID: 64697 

Affidavit, 2009, Petition Form B and associated attached Affidavit submitted by petitioner for 

SEC00137, January 14, 2009, OSA Ref ID: 107870 

Annual report, 1951, Second Annual Report for the Year Ended June 30, 1951, Oak Ridge Hospital 

Inc.; SRDB Ref ID: 64546 

Annual Report, 1952, Third Annual Report for the Year Ended June 30, 1952, Oak Ridge Hospital 

Inc.; SRDB Ref ID 64541 

Annual Report, 1953, Fourth Annual Report for the Year Ended June 30, 1953, Oak Ridge Hospital 

Inc.; SRDB Ref ID: 64025 
SEC-00137 06-09-2009 Oak Ridge Hospital

33 of 46 

Annual Report, 1954, Fifth Annual Report for the Year Ended June 30, 1954, Oak Ridge Hospital 

Inc.; SRDB Ref ID: 64534 

Annual Report 1955, Sixth Annual Report for the Year Ended June 30, 1955, Oak Ridge Hospital Inc.; 

SRDB Ref ID 64529 

Browning et al., 1978, Airborne Concentration of I-131 in a Nuclear Medicine Laboratory, E. 

Browning, K. Bannerjee, W. Reisinger, Jr., The Journal of Nuclear Medicine, Vol. 19, pp. 1078-1081, 

September 1978. 

Brucer, 1951, Radioisotope Hazards and Protection in a Hospital, M. Brucer, Journal of the 

American Medical Association, Vol. 147, No. 18, pp 1745-1751, 1980. 

Brucer, 1960, Radiation Protection at the Medical Division, M. Brucer, E. Anderson, ORINS-37, Oak 

Ridge Associated Universities, Oak Ridge TN, SRDB Ref ID 25132. 

Carey et al., 1979, Thyroid Contamination from Airborne I-131, J. Carey Jr., D. Swanson, The Journal 

of Nuclear Medicine, Vol. 20, p. 362, April 1979. 

Ford, 1960, [no title], letter from F. W. Ford to The Renegotiation Board regarding closeout of 

contract of Oak Ridge Hospital with the Atomic Energy Commission, March 25, 1960; SRDB Ref ID: 

64698 

Hayden, 1950, ORINS Medical Center Radiation Problem, memorandum from R. E. Hayden to 

Edward McCrady, August 15, 1950; SRDB Ref ID: 6489 

Jönssen and Mattson, 1998, Thyroid Burdens of 125I in Hospital Laboratory Workers During a 20-

year Period, H. Jönssen, S. Mattsson, Health Physics, Vol. 75, No. 5, pp. 475-478; 1998. 

Landon et al., 1980, Advantages of Using Thin Sodium Iodide Detectors for Thyroid Monitoring of 

Personnel Working with 125I, S. Landon, P. Smith, S. Staniek, C. Webber, Clinical Chemistry, Vol. 26, 

No. 1, pp. 18-21, 1980. 

MDH, 1946, Manhattan District History, Book I – General, Volume 7, Medical Program, 31, [no 

author], December, 1946, pp. 139-147, SRDB Ref ID: 40434 

NIOSH, 2006, SEC Petition Evaluation Report, SEC-00033, Evaluation Report for the Oak Ridge 

Institute for Nuclear Studies, NIOSH, 20 July 2006, OSA Ref ID: 101295. 

Nishiyama et al., 1980, Internal Contamination of Laboratory Personnel by I-131, H. Nishiyama, S. 

Lukes, G, Mayfield, L. Grossman, Radiology, Vol. 137, pp. 767-771, December 1980. 

Nuclides, 2009, Chart of Nuclides, National Nuclear Data Center, Brookhaven National Laboratory, 

on-line data base of radionuclide properties at http://www.nndc.bnl.gov/chart/, accessed May 2009. 
SEC-00137 06-09-2009 Oak Ridge Hospital

34 of 46 

Oak Ridge Hospital, 1944, Operation of Oak Ridge Hospital, memorandum to Edward Diamond, 18 

January 1944; SRDB Ref ID: 30714 

ORINS, 1950, Fourth Annual Report of the Oak Ridge Institute for Nuclear Studies, June 30, 1950, 

Oak Ridge Associated Universities, Oak Ridge TN, SRDB Ref ID: 37994 

ORINS, 1951, Fifth Annual Report of the Oak Ridge Institute for Nuclear Studies, June 30, 1951, Oak 

Ridge Associated Universities, Oak Ridge TN, SRDB Ref ID: 37996 

ORINS, 1952, Sixth Annual Report of the Oak Ridge Institute for Nuclear Studies, June 30, 1952, Oak 

Ridge Associated Universities, Oak Ridge TN, SRDB Ref ID: 37997 

ORINS, 1953, Seventh Annual Report of the Oak Ridge Institute of Nuclear Studies; June 30, 1953; 

Oak Ridge Associated Universities; Oak Ridge, TN, SRDB Ref ID: 37998 

ORINS, 1954, Eighth Annual Report of the Oak Ridge Institute of Nuclear Studies; June 30, 1954; 

Oak Ridge Associated Universities; Oak Ridge, TN, SRDB Ref ID: 38001 

ORINS, 1955, Ninth Annual Report of the Oak Ridge Institute of Nuclear Studies, June 30, 1955; Oak 

Ridge Associated Universities; Oak Ridge, TN, SRDB Ref ID: 64032 

ORINS, 1956, Tenth Annual Report of the Oak Ridge Institute of Nuclear Studies; June 30, 1956; Oak 

Ridge Associated Universities; Oak Ridge, TN, SRDB Ref ID: 37961 

ORINS, 1957, Eleventh Annual Report of the Oak Ridge Institute of Nuclear Studies; June 30, 1957; 

Oak Ridge Associated Universities; Oak Ridge, TN, SRDB Ref ID: 37963 

ORINS, 1958, Twelfth Annual Report of the Oak Ridge Institute of Nuclear Studies; June 30, 1958; 

Oak Ridge Associated Universities; Oak Ridge, TN, SRDB Ref ID: 37964 

ORINS, 1959, Thirteenth Annual Report of the Oak Ridge Institute of Nuclear Studies; June 30, 1959; 

Oak Ridge Associated Universities; Oak Ridge, TN, SRDB Ref ID: 37965 

ORISE, 1994, ORINS and ORINS Medical Division Annual and Periodic Progress Reports, 1950-

1959, ORAU 30054, Oak Ridge Associated Universities, Oak Ridge, TN, SRDB Ref ID: 64052 

Personal Communication, 2009a, Personal Communication with Retired Oak Ridge Hospital 

Physician; Telephone Interview by NIOSH; February 17, 2009; SRDB Ref ID: 64061

Personal Communication, 2009b, Personal Communication with Retired ORINS Scientist; Telephone 

Interview by NIOSH; February 23, 2009; SRDB Ref ID: 64060

Personal Communication, 2009c, Personal Communication with Retired ORINS Technician; 

Telephone Interview by NIOSH; February 24, 2009; SRDB Ref ID: 64059

Pollard, 1948, Medical Division Budget for Fiscal Year 1948-1949, memorandum from W. G. Pollard 

to H. M. Roth, December 22, 1948; SRDB Ref ID: 64674 
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Pollard, 1955, Comments on Institute Hospital Operations as Related to Engineering Study for New 

Oak Ridge Hospital, letter by W. G. Pollard to H. M. Roth, October 11, 1955; SRDB Ref ID: 64516, 

pp. 9-12 

Pollard, 1956, [no title], memorandum from W. G. Pollard to H. M. Roth regarding agreement 

between the Oak Ridge Hospital and the Institute Regarding the Employment of Dr. C. Steffee, 

Pathologist, January 4, 1956; SRDB Ref ID: 64506 

Pollard, 1980, ORAU: From the Beginning, W. G. Pollard, ORAU-162, Oak Ridge Associated 

Universities, Oak Ridge Tennessee, 1980 

Simon et al., 2006, Estimating Historical Radiation Doses to a Cohort of U.S. Radiologic 

Technologists, S. Simon, R. Weinstock, M. Doody, J. Neton, T. Wenzel, P. Stewart, A. Mohan, R. 

Yoder, M. Hauptmann, D. Freedman, J. Cardarelli, H. Feng, A. Bouville, M. Linet, Radiation 

Research, Vol. 166, pp. 1974-192, 2006. 

TDEC, 2009, [no title], Folder with AEC license information and related documentation from 1956-

1963 from Tennessee Department of Environment and Conservation (TDEC); SRDB Ref ID: 63763 

Wirth, 1946, X-Ray Department Personnel – Oak Ridge Hospital, memorandum from J. E. Wirth to L. 

J. Deal, April 26, 1946; SRDB Ref ID: 64664 
SEC-00137 06-09-2009 Oak Ridge Hospital

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SEC-00137 06-09-2009 Oak Ridge Hospital

Table A1-1: Data Capture Synopsis for Oak Ridge Hospital 

Data Capture Information Data Captured Description Da

Comp

Primary Site/Company Name: Oak Ridge Hospital (Methodist Medical Center of Oak Ridge), DOE 1943-1959 Other names: Oak Ridge Hospital, 1943-1948 Oak Ridge Hospital Inc. (1948-1959) 

Negotiated with Ms. Lisa Hellard (Medical Records division) and Ms. Susan Hughes (HIM Director) of the Methodist Medical Center of Oak Ridge to determine the existence of personal monitoring data from Oak Ridge Hospital during the covered period. 

04/13/

State Agency: Tennessee Department of Environment and Conservation (TDEC) 

Entire folder with AEC radioactive materials license information for Oak Ridge Hospital from 1956-1963 

04/01/

Comprehensive Epidemiologic Data Resource (CEDR) 

No relevant data identified 03/10/

DOE Hanford Declassified Document Retrieval System (DDRS) 

No relevant data identified 03/11/

DOE Open Net Annual reports, contract information, operational 

history, radioisotope use and quantity (ORINS), facility details 

04/14/

DOE OSTI Energy Citations No relevant data identified 04/14/DOE OSTI Information Bridge No relevant data identified 04/14/Google Oak Ridge Hospital history information and current 

hospital newsletter. 

04/28/

37 of 46 
SEC-00137 06-09-2009 Oak Ridge Hospital

Table A1-1: Data Capture Synopsis for Oak Ridge Hospital 

Data Capture Information Data Captured Description Da

Comp

NARA Atlanta Contract information between Oak Ridge Hospital and 

ORINS, external monitoring memorandum, miscellaneous facility information, general operational history 

04/28/

National Academies Press (NAP) No relevant data identified 04/14/National Nuclear Security Administration (NNSA) – Nevada Site Office 

No relevant data identified 04/13/

NRC Agencywide Document Access and Management (ADAMS) 

No relevant data identified 04/12/

ORAU (formerly ORINS) ORINS annual reports 04/28/U.S. Transuranium and Uranium Registries 

No relevant data identified 04/15/

Unknown ORINS annual external data summaries 06/20/PubMed data base Various scientific articles regarding worker exposure 

from radiology and handling medical radioisotopes 

04/28/

TOTAL 

38 of 46 
SEC-00137 06-09-2009 Oak Ridge Hospital

Table A1-2: Database Searches for Oak Ridge Hospital 

Database/Source Keywords (Hits per keyword) Total H

DOE Open Net http://www.osti.gov/opennet/advancedsearch.jsp 

“Oak Ridge Hospital” (177), “Manhattan District Hospital (2)”,  US Army + Hospital (964),  “Oak Ridge Institute for Nuclear Studies” (1347), ORINS (354), AEC + hospital (1910),  “Oak Ridge Hospital” + ORINS (190),  “Oak Ridge Hospital”+ contract (830), “AT-40-1-gen-252” (0), “AT-40-1-gen-33” (5), Annual report + “Oak Ridge” (1166), Brucer (author) (54), Pollard (author) (51) ORAU* (Document number) (25), ORINS* (document number) (6) 

7081 

DOE Hanford Declassified Document Retrieval System (DDRS) 

“Oak Ridge Hospital” “Oak Ridge” “Oak Ridge Institute for Nuclear Studies” ORINS 

0 

39 of 46 
SEC-00137 06-09-2009 Oak Ridge Hospital

Database/Source Keywords (Hits per keyword) Total H

DOE OSTI Energy Citations http://www.osti.gov/energycitations/ 

“Oak Ridge Hospital” (1897), “Manhattan District Hospital” (212),  US Army + Hospital (1124),  “Oak Ridge Institute for Nuclear Studies” (13479), “Oak Ridge Institute for Nuclear Studies”+ 1943-1959 (267) “Oak Ridge Hospital” + ORINS (34),  “Oak Ridge Hospital”+ contract (1518),  “AT-40-1-gen-252” (0),  “AT-40-1-gen-33” (26), Annual report + “Oak Ridge”, + 1943-1959 (277), Brucer (author) (75), Pollard W. G. (author) (44) ORAU* (document number) (403), ORINS* (ID number) (34) 

> 10,00

DOE OSTI Information Bridge http://www.osti.gov/bridge/advancedsearch.jsp 

“Oak Ridge Hospital” (1790), “Manhattan District Hospital” (25),  US Army + Hospital (1049),  “Oak Ridge Institute for Nuclear Studies” (13130), “Oak Ridge Institute for Nuclear Studies”+1943-1959 (254) “Oak Ridge Hospital” + ORINS (32),  “Oak Ridge Hospital”+ contract (1510),  “AT-40-1-gen-252” (0),  “AT-40-1-gen-33” (0), Annual report + “Oak Ridge”+1943-1959 (207), Brucer (author) (0), Pollard W. G. (author) (1) ORAU* (Document number) (0), ORINS* (document number) (33) 

> 10,00

40 of 46 
SEC-00137 06-09-2009 Oak Ridge Hospital

Database/Source Keywords (Hits per keyword) Total H

americium OR Am241 OR Am-241 OR "AM 241" OR 241Am OR 241-Am OR "241 Am" AND "Oak Ridge Hospital" 

12 

ionium OR Th230 OR Th-230 OR "Th 230" OR 230Th OR 230-Th OR "230 Th" AND "Oak Ridge Hospital" 

2 

neptunium OR Np237 OR Np-237 OR "Np 237" OR 237Np OR 237-Np OR "237 Np" AND "Oak Ridge Hospital" 

7 

polonium OR Po210 OR Po-210 OR "Po 210" OR 210Po OR 210-Po OR "210 Po" AND "Oak Ridge Hospital" 

53 

thorium OR Th232 OR Th-232 OR "Th 232" OR 232Th OR 232-Th AND "Oak Ridge Hospital" 

22 

"232 Th" OR "Z metal" OR myrnalloy OR "chemical 10-66" OR "chemical 10-12" AND "Oak Ridge Hospital" 

0 

ionium OR UX1 OR UX2 OR Th-230 OR Th230 OR "Th 230" OR 230-Th OR "230 Th" AND "Oak Ridge Hospital" 

2 

230Th OR Th-234 OR Th234 OR "Th 234" OR 234-Th OR 234Th OR "234 Th" AND "Oak Ridge Hospital" 

1 

tritium OR H3 OR H-3 OR mint OR HTO AND "Oak Ridge Hospital" 

254 

uranium OR U233 OR U-233 OR "U 233" OR 233U OR 233-U OR "233 U" AND "Oak Ridge Hospital" 

469 

Google www.google.com Search based on standard list of keywords used for all data capture searches 

U234 OR "U 234" OR U-234 OR 234U OR 234-U OR "234 U" AND "Oak Ridge Hospital" 

3 

41 of 46 
SEC-00137 06-09-2009 Oak Ridge Hospital

Database/Source Keywords (Hits per keyword) Total H

U235 OR "U 235" OR U-235 OR 235-U OR 235U OR "235 U" OR U238 AND "Oak Ridge Hospital " 

18 

"U 238" OR U-238 OR 238-U OR 238U OR "238 U" AND "Oak Ridge Hospital" 

6 

U308 OR "U 308" OR U-308 OR 308-U OR 308U OR "308 U" OR "uranium extraction" OR "black oxide" OR "brown oxide" AND "Oak Ridge Hospital" 

3 

"green salt" OR "orange oxide" OR "yellow cake" OR UO2 OR UO3 AND "Oak Ridge Hospital" 

6 

UF4 OR UF6 OR C-216 OR C-616 OR C-65 OR C211 OR U3O8 AND "Oak Ridge Hospital" 6 plutonium OR Pu-238 OR Pu238 OR "Pu 238" OR 238Pu OR 238-Pu OR "238 Pu" AND "Oak Ridge Hospital " 

169 

Pu-239 OR Pu239 OR "Pu 239" OR 239Pu OR 239-Pu OR "239 Pu" AND "Oak Ridge Hospital" 

7 

Pu-240 OR Pu240 OR "Pu 240" OR 240Pu OR 240-Pu OR "240 Pu" AND "Oak Ridge Hospital" 

3 

Pu-241 OR Pu241 OR "Pu 241" OR 241Pu OR 241-Pu OR "241 Pu" AND "Oak Ridge Hospital" 

2 

radium OR Ra-226 OR Ra226 OR "Ra 226" OR 226-Ra OR 226Ra OR 226-Ra AND "Oak Ridge Hospital" 

359 

Ra-228 OR Ra228 OR "Ra 228" OR 228Ra OR 228-Ra OR "228 Ra" AND "Oak Ridge Hospital" 

2 

radon OR Rn-222 OR Rn222 OR "Rn 222" OR 222Rn OR 222-Rn OR "222 Rn" AND "Oak Ridge Hospital" 

329 

42 of 46 
SEC-00137 06-09-2009 Oak Ridge Hospital

Database/Source Keywords (Hits per keyword) Total H

thoron OR Rn-220 OR Rn220 OR "Rn 220" OR 220Rn OR 220-Rn OR "220 Rn" AND "Oak Ridge Hospital" 

3 

protactinium OR Pa-234m OR Pa234m OR "Pa 234m" OR 234mPa OR 234m-Pa OR "234m Pa" AND "Oak Ridge Hospital" 

2 

strontium OR Sr-90 OR Sr90 OR "Sr 90" OR 90-Sr OR 90Sr OR "90 Sr" AND "Oak Ridge Hospital" 

23 

oralloy OR postum OR tuballoy OR "uranyl nitrate hexahydrate" OR UNH OR K-65 OR "sump cake" AND "Oak Ridge Hospital" 

9 

"uranium dioxide" OR "uranium tetrafluoride" OR "uranium trioxide" AND "Oak Ridge Hospital" 

6 

"uranium hexafluoride" OR "air count" AND "Oak Ridge Hospital" 

9 

accident AND "Oak Ridge Hospital" 516 "air dust" OR "air filter" OR "airborne test" AND "Oak Ridge Hospital" 

2 

"alpha particle" OR "belgian congo ore" OR bioassay OR bio-assay AND "Oak Ridge Hospital" 

10 

breath OR "breathing zone" OR BZ OR calibration OR "chest count" OR collimation OR columnation AND "Oak Ridge Hospital" 

571 

contamination OR curie OR denitration OR "denitration pot" AND "Oak Ridge Hospital" 

103 

derby OR regulus OR dose OR dosimeter AND "Oak Ridge Hospital" 

491 

dosimetric OR dosimetry OR electron OR environment AND "Oak Ridge Hospital" 

452 

43 of 46 
SEC-00137 06-09-2009 Oak Ridge Hospital

Database/Source Keywords (Hits per keyword) Total H

"Ether-Water Project" OR exposure OR "exposure investigation" OR "radiation exposure" AND "Oak Ridge Hospital" 

350 

external OR "F machine" OR fecal OR "feed material" OR femptocurie OR film OR fission OR fluoroscopy AND "Oak Ridge Hospital" 

208 

"Formerly Utilized Sites Remedial Action Program" OR FUSRAP OR gamma-ray OR "gas proportional" OR "gaseous diffusion" AND "Oak Ridge Hospital" 

111 

Health OR "health instrument" OR "health physics" OR "H.I." OR HI OR HP OR "highly enriched uranium" OR HEU AND "Oak Ridge Hospital" 

68,60

hydrofluorination OR "in vitro" OR "in vivo" OR incident OR ingestion OR inhalation OR internal AND "Oak Ridge Hospital" 

517 

investigation OR isotope OR isotopic OR "isotopic enrichment" OR "JS Project" OR Landauer OR "liquid scintillation" AND "Oak Ridge Hospital" 

292 

log OR "log sheet" OR "log book" OR "low enriched uranium" OR LEU AND "Oak Ridge Hospital" 

158 

"maximum permissible concentration" OR MPC OR metallurgy OR microcurie OR millicurie AND "Oak Ridge Hospital" 

153 

"mixed fission product" OR MFP OR monitor OR "air monitoring" OR nanocurie OR "nasal wipe" OR neutron OR "nose wipe" AND "Oak Ridge Hospital" 

234 

nuclear OR Chicago-Nuclear OR "nuclear fuels" OR "nuclear track emulsion" OR "type A" AND "Oak Ridge Hospital" 

1490 

44 of 46 
SEC-00137 06-09-2009 Oak Ridge Hospital

Database/Source Keywords (Hits per keyword) Total H

NTA OR "occupational radiation exposure" OR occurrence OR "ore concentrate" OR "PC Project" AND “Oak Ridge Hospital” 

85 

permit OR "radiation work permit" OR "safe work permit" OR "special work permit" OR RWP OR SWP AND “Oak Ridge Hospital” 

165 

"phosphate research" OR photofluorography OR photon OR picocurie OR pitchblende OR "pocket ion chamber" OR PIC OR problem OR procedure AND “Oak Ridge Hospital” 

456 

radeco OR radiation OR radioactive OR radioactivity OR radiograph OR radiological AND “Oak Ridge Hospital” 

648 

"Radiological Survey Data Sheet" OR RSDS OR radionuclide OR raffinate OR reactor AND “Oak Ridge Hospital” 

575 

respiratory OR "retention schedules" OR roentgen AND “Oak Ridge Hospital” 

506 

sample OR "air sample" OR "dust sample" OR "general area air sample" AND “Oak Ridge Hospital” 

151 

"solvent extraction" OR source OR "sealed source" OR spectra OR spectrograph OR spectroscopy AND “Oak Ridge Hospital” 

580 

spectrum OR standard OR "operating standard" OR "processing standard" AND “Oak Ridge Hospital” 

993 

survey OR "building survey" OR "routine survey" OR "special survey" OR "technical basis" AND “Oak Ridge Hospital” 

304 

45 of 46 
SEC-00137 06-09-2009 Oak Ridge Hospital

46 of 46 

Database/Source Keywords (Hits per keyword) Total H

"thermal diffusion" OR "thermoluminescent dosimeter" OR TLD OR "Tiger Team" AND “Oak Ridge Hospital” 

19 

"tolerance dose" OR urinalysis OR urine OR "whole body count" OR WBC AND “Oak Ridge Hospital” 

1160 

"working level" OR WL OR X-ray OR "X ray" OR Xray OR "x-ray screening" AND “Oak Ridge Hospital” 

585 

National Academies Press (NAP) http://www.nap.edu 

“Oak Ridge Hospital” (253),  “Oak Ridge”+Hospital (6) 

259 

National Nuclear Security Administration (NNSA) – Nevada Site Office www.nv.doe.gov/main/search.htm 

“Oak Ridge Hospital” “Oak Ridge” + Hospital 

0 

NRC Agencywide Document Access and Management (ADAMS) http://www.nrc.gov/reading-rm/adams/webbased.html 

“Oak Ridge Hospital” (20) “Oak Ridge” (1000+) “Oak Ridge” + Hospital (0) “Oak Ridge” and contract (0) ORINS and contract (1000+) 

> 1,00

U.S. Transuranium and Uranium Registries http://www.ustur.wsu.edu/ 

“Oak Ridge Hospital” (0) “Oak Ridge” (19) 

19 

PubMed data base http://www.ncbi.nlm.nih.gov/pubmed/ 

Radioisotope + hospital + 1943-1959 Nuclear Medicine + I-131 + 1950-1980, Radioiodine + thyroid Radiology Radiologic technologist 

> 10,00