ORAU Team

Dose Reconstruction Project for NIOSH

Technical Basis Document for the Argonne National 

Laboratory–West – Occupational Medical Dose

Document Number:

ORAUT-TKBS-0026-3

Effective Date: 05/16/2005

Revision No.: 00 PC-1

Controlled Copy No.: ______

Page 1 of 11

Subject Expert: Norman D. Rohrig

Document Owner

Approval: Signature on File Date: 09/09/2004

Norman D. Rohrig, TBD Team Leader

Approval: Signature on File Date: 09/09/2004

Judson L. Kenoyer, Task 3 Manager

Concurrence: Signature on File Date: 09/09/2004

Richard E. Toohey, Project Director

Approval: Signature on File Date: 09/09/2004

James W. Neton, Associate Director for Science

Supersedes:

None

TABLE OF CONTENTS

Section

Record of Issue/Revisions......................................................................................................................

Page

2

Acronyms and Abbreviations..................................................................................................................3

3.1 Introduction ....................................................................................................................................4

3.2 Examination Frequencies ..............................................................................................................4

3.3 Equipment and Techniques ...........................................................................................................5

3.4 Organ Doses..................................................................................................................................6

3.5 Uncertainty.....................................................................................................................................6

References .............................................................................................................................................8

Glossary..................................................................................................................................................9

Attachment 3A Occupational Medical Dose ....................................................................................... 10

LIST OF TABLES

3A-1 Organ doses from occupational medical exposures at the ANL-W ..........................................11
Effective Date: 05/16/2005 Revision No. 00 PC-1 Document No. ORAUT-TKBS-0026-3 Page 2 of 11

RECORD OF ISSUE/REVISIONS

ISSUE 

AUTHORIZATION 

DATE

EFFECTIVE 

DATE REV. NO. DESCRIPTION

Draft 05/26/2004 00-A New Technical Basis Document for the Argonne 

National Laboratory – West – Occupational 

Medical Dose. Initiated by Norman D. Rohrig.

Draft 07/23/2004 00-B Incorporates internal review comments. Initiated 

by Norman D. Rohrig.

Draft 08/20/2004 00-C Incorporates NIOSH review comments. Initiated 

by Norman D. Rohrig.

09/09/2004 09/09/2004 00 First approved issue. Initiated by Norman D. 

Rohrig

09/09/2004 01/14/2005 00 PC-1-A Replaces first paragraph of section 3.2 on page 4

and the associated table specifying x-ray /age 

requirements. Revises Table 3A-1 on page 11 to 

reflect these changes. Initiated by Norman D. 

Rohrig.

09/09/2004 03/31/2005 00 PC-1-B Formatted version sent to NIOSH for formal 

review. Initiated by Norman D. Rohrig.

09/09/2004 05/16/2005 00 PC-1 Approved page change revision. No changes 

were needed as a result of NIOSH formal review. 

No training required. Initiated by Norman D. 

Rohrig.

Approval:

Norman D. Rohrig, TBD Team Leader

Signature on File 05/10/2005

Judson L. Kenoyer, Task 3 Manager

Signature on File 05/09/2005

Richard E. Toohey, Project Director

Signature on File 05/10/2005

James W. Neton, Associate Director for Science

Signature on File 05/16/2005
Effective Date: 09/09/2004 Revision No. 00 Document No. ORAUT-TKBS-0026-3 Page 3 of 11

ACRONYMS AND ABBREVIATIONS

AEC U.S. Atomic Energy Commission

ANL-W Argonne National Laboratory - West

AP anterior-posterior

cm centimeter

EEOICPA Energy Employees Occupational Illness Compensation Program Act

ERDA Energy Research and Development Administration

ICRP International Commission on Radiological Protection

INEEL Idaho National Engineering and Environmental Laboratory

IREP Interactive RadioEpidemiological Program

kerma Kinetic Energy Released to Matter

kg kilogram

kV kilovolt

kVp kilovolt peak

LAT lateral

lb pound

mA milliampere

mm millimeter

mrad millirad

msec millisecond

PA posterior-anterior

U.S.C. United States Code
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3.1 INTRODUCTION

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

provide guidance concerning the preparation of dose reconstructions at particular sites or categories 

of sites. They will be revised in the event additional relevant information is obtained about the 

affected site(s). These documents may be used to assist the National Institute for Occupational 

Safety and Health in the completion of the individual work required for each dose reconstruction.

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

that served a specific purpose at a site. It does not necessarily mean an “atomic weapons employer 

facility” or a “Department of Energy facility” as defined in the Energy Employees Occupational Illness 

Compensation Program Act (EEOICPA; 42 U.S.C. 7384l (5) and (12)). 

This TBD discusses the occupational medical dose workers received during employment at the 

Argonne National Laboratory - West (ANL-W) which operated from February, 1951 to present. The 

site required pre-employment and periodic physical examinations as part of its occupational health 

and safety program. At first, the U.S. Atomic Energy Commission (AEC) provided these medical 

examinations for all onsite Federal and contractor personnel. Later, they became the responsibility of 

the site prime contractor. 

The examinations typically included diagnostic chest X-rays. The dose from these procedures 

depended not only on the characteristics of the X-ray machine and the procedure used, but also on 

the frequency of examinations. This document discusses various X-ray techniques and equipment 

used over the years at the Idaho National Engineering and Environmental Laboratory (INEEL). 

Attachment 3A contains tables for use by dose reconstructors in determining a worker’s occupational 

medical dose. The primary source of information on medical X-rays is a report by Collings and 

Creighton (2002) prepared at NIOSH request.

3.2 EXAMINATION FREQUENCIES

A review of the NIOSH OCAS Claimant (NOCTS) contents for ANL-W claimants shows that x-ray 

records are provided. From this I conclude that chest x-rays were given annually from 1959 to about 

1975. I assume they were also given annually before that time. This contradicts the practice at the 

INEEL even though these x-rays were given through the INEEL medical organization.

The Appendix to AEC Manual Chapter 0528 (AEC 1969) specified the following:

• A chest X-ray would be part of a medical examination.

• Workers under 40 would receive an exam at a frequency influenced by several factors.

• Workers over 40 would receive an exam at least every 2 years (approximately annually when 

indicated).
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The 1971 Annual Report (AEC 1972) states the schedule for examinations is “at time of hire, at ages 

25, 30, 34, 37, and 40, every two years until age 62 and then annually.” This is identical to that 

reported by Collings and Creighton (2002) and is assumed to apply from 1975 to 1976.

Beginning in 1976, physicals occurred every 2 years for workers under age 45 and every year for 

those over age 45 (Collings and Creighton 2002). On February 1, 1978, INEEL eliminated routine 

chest X-rays on periodic physicals with the exception of high-risk (as determined by the physician)

individuals, in which case they were performed every 4 years. Records from the exposures are 

reported in each worker’s medical file. 

3.3 EQUIPMENT AND TECHNIQUES

The standard distance from source to image was 72 inches (183 cm).

To the best of our knowledge, none of the INEEL exams used fluoroscopic techniques (Creighton 

2003). The 1971 Annual Report (AEC 1972) identifies a medical van as taking 22% of the 4,426 Xray examinations. In addition, this report mentions the Idaho Falls Navy dispensary for doing X-ray 

examinations. Both of these facilities performed standard chest X-rays and did not do 

photofluoroscopy. A key word search of the INEEL records system using the terms collimation, 

fluoroscopic, Health and Safety, Health and Safety Services, Medical X-ray, photofluorography, and xray resulted in nothing that indicated the use of fluoroscopic techniques (Vivian and Rockhold 2003).

From 1954 to February 1990, X-ray examinations were performed with a single-phase General 

Electric Model DXD350 machine. The voltage was 90 kVp, the current was 300 mA, and the duration 

of the exposure was 1/15 sec (67 msec). Added filtration of 2 mm Al was used, and a 10:1 grid was 

used to reduce scatter radiation (Collings and Creighton 2002). Tube window thickness is assumed 

to be about 0.5 mm. Based on Table A16 of International Commission on Radiological Protection 

(ICRP) Publication 34, Protection of the Patient in Diagnostic Radiology (ICRP 1982), the half-value 

layer at 90 kVp and 2.5-mm total aluminum filtration is 2.58 mm Al.

From February 1990 to the present, X-rays have been performed with a three-phase Gendex Model 

110-0030G2. The voltage is 100 kVp, the current is 300 mA, and the duration is 32 msec. Added 

filtration of 2 mm Al was used, and a 10:1 grid was used to reduce scatter radiation (Collings and 

Creighton 2002). Tube window thickness is assumed to be about 0.5 mm. Based on Table A17 of 

ICRP (1982), the half-value layer at 100 kVp and 2.5-mm total aluminum filtration is 3.3 mm Al.

Practices before 1954 are unclear. Offsite facilities might have been contracted to perform the 

examinations. The default value for entrance kerma of 200 mrad (Kathren 2003) is assumed for that 

period.

From 1954 to 1970, the chest X-ray consisted of a single posterior-anterior (PA; back to front) image. 

From 1970 to 1978, the procedure consisted of both PA and lateral (LAT) views. From 1978 to 1990, 

the LAT view was dropped and only a PA view was made. For the period from 1990 to the present, 

there were both PA and LAT views. For lateral views, the exposure time was about 1.25 times that of 

the PA view. In Collings and Creighton (2002), the terms PA and AP (anterior-posterior, front to back) 
Effective Date: 09/09/2004 Revision No. 00 Document No. ORAUT-TKBS-0026-3 Page 6 of 11

appear somewhat interchangeably. Creighton attributed this presumed interchangeable usage to a 

typographical error. The August 21, 1975, Energy Research and Development Administration 

(ERDA) requirement for occupational medical programs (replaced in 1982) specified the minimum 

requirements for chest X-rays and specified a PA view at least once every 5 years, as well as when 

transferring to a job with cardiorespiratory system stress (ERDA 1975).

Collimation and control of scatter for INEEL facilities generally followed the state of the medical art as 

it improved. However, in the absence of particular information about collimation, we will use the dose 

conversion factors in Table 4.0-1 of Kathren (2003) for the pre-1970 timeframe.

3.4 ORGAN DOSES 

The entrance air kerma for 100 mA sec can be determined from Table B3 of National Council on 

Radiation Protection and Measurements (NCRP) Report 102 (NCRP 1989) and the beam voltage, 

distance, and total filtration. Tables A2 to A9 of ICRP (1982) list Monte Carlo calculation results of the 

ratio of organ doses to air kerma, for a 70-kg (154-lb) male or female, for the thyroid, ovaries, testes, 

lungs, female breast, uterus (embryo), active bone marrow, and total body under different exposure 

conditions. For organs where there is a difference for males and females, the larger value is used. A 

linear interpolation, applicable to the pre-1990 and post-1990 years, was used between the dose 

ratios for half-value layers of 2.5, 3.0, and 3.5 mm Al to the values of 2.58 and 3.3 mm Al. The skin 

entrance surface was assumed to be 30 cm from the film for the PA view and 40 cm from the film for 

the LAT view. These distances account for body thickness and any other space between the person 

and the film. The dose to the skin is the product of the entrance skin exposure and a backscatter 

factor taken from NCRP 102 Table B-8.

The organ dose from a PA image is the product of the two table values, an inverse square correction, 

and the product of exposure current and time. Table 3A-1 in Attachment 3A lists these values. For 

LAT images, a similar calculation was performed and added to the PA result.

Cancers in several other organs, as listed in the Interactive RadioEpidemiological Program (IREP), 

are compensable. The ratio of doses for two organs is affected by the relative atomic numbers of the 

tissue (bone dose is higher than dose in nearby muscle), the relative positions of the organ and the 

X-ray beam, and the depth in the body. Attachment 3A lists these other organs and the organs from 

ICRP (1982), which were used to estimate the dose. Table 3A-1 lists these organs in the third row.

3.5 UNCERTAINTY

Uncertainties in the occupational medical dose result from uncertainties in the current, voltage, and 

time for exposures. In addition, organ doses are influenced by the size of the person. If an analog 

organ is used from the ICRP (1982) organs, the IREP organs are generally deeper in the body so the 

dose will be lower than the analog organ. No estimate is made of this one-sided uncertainty because 

it cannot lead to a larger dose.

The uncertainties assigned in the Savannah River Site (SRS) Technical Basis Document (ORAU 

2003) are generically valid for X-ray programs. The uncertainty at one sigma due to voltage was 9%, 

that due to current was 5%, and that due to time was 25%. The uncertainty for voltage assumes a 5% 

voltage uncertainty and, because the output has a V1.7 dependence, results in a 9% uncertainty.

Output is directly proportional to current, which is assumed to have a 5% uncertainty. The usually 

unfiltered voltage output from the voltage rectifier causes a pulsed character to the X-ray output at 

120 Hz (twice the supply frequency). For the short exposure times this results in only a few pulses 

and thus a fairly large uncertainty due to time.
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All Monte Carlo calculations have an uncertainty determined by the length of the run and the number 

of events scored for each calculation. For the organ dose calculations from ICRP (1982), this

uncertainty was not stated. Based on judgment, it is assumed to be 5% at 1 sigma, which would 

require at least 400 counts in each scoring unit.

The error due to patient thickness has two causes: (1) an increase for a larger person being closer to 

the source and (2) a decrease due to additional attenuation in the body. The Monte Carlo calculations 

in ICRP (1982) assumed 70-kg (154-lb) male and female geometries. The 10% uncertainty assigned 

in the SRS TBD (ORAU 2003) was due to the first cause; but, because the effects counteract, that 

value is appropriate for the combined effect. This should be taken as 1 sigma on a normal 

distribution. These sources of uncertainty added in quadrature result in a combined uncertainty of 

±30 % at 1 sigma or 84% confidence.
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REFERENCES

AEC (U.S. Atomic Energy Commission), 1961, Annual Report of the Health and Safety Division,

Report No. IDO-12019, Idaho Operations Office, Idaho Falls, Idaho

AEC (U.S. Atomic Energy Commission), 1969, AEC Manual Chapter 0528, Appendix, Occupational 

Health Program, December 5.

AEC (U.S. Atomic Energy Commission), 1972, 1971 Annual Report of the Health Services Laboratory,

Report No. IDO-12076, Idaho Operations Office, Idaho Falls, Idaho

Collings, L. H. and Creighton, P., 2002, Idaho National Engineering and Environmental Laboratory 

(INEEL) History of the Occupational Medical Program (OMP) X-Ray Process, April 8.

Creighton, P. N., 2003, “Transmittal of Medical X-ray Information for the INEEL,” letter to L. Johnson 

(Intrepid Technology and Resources), Idaho National Engineering and Environmental 

Laboratory, Idaho Falls, ID, June 24.

ERDA (Energy Research and Development Administration), 1975, Contractor Occupational Medical 

Program Handbook, ERDA Manual Appendix 0528-A, August 21.

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

Diagnostic Radiology, ICRP Publication 34, Pergamon Press. New York, New York.

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

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

Performance, and Use), Report No. 102, Bethesda, Maryland.

Kathren, R. L., 2003, Technical Information Bulletin: Dose Reconstruction from Occupationally 

Related Diagnostic X-Ray Projections, ORAU-OTIB-0006, Rev.00, Oak Ridge Associated 

Universities, Oak Ridge, Tennessee, November 14.

ORAU (Oak Ridge Associated Universities), 2003, Technical Basis Document for the Savannah River 

Site to be Used for EEOICPA Dose Reconstructions, Rev. 0, Oak Ridge, Tennessee, July 15.

Sommers, J. F., 1961, “Routine Blood Sampling Program at the MTR-ETR,” Som-165-61A-M, 

memorandum, December 15.

Spickard, J. (Physician and Medical Director at INEEL 1960-1988), Phone conversation of 11/12/03 

with Norman Rohrig.

Vivian, K. A. (DOE-ID) and Rockhold, L. E. (BBWI), 2003, “Transmittal of Medical Documents from the 

INEEL,” letter to Norman Rohrig (Intrepid), November 18.
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GLOSSARY

Atomic Energy Commission

Original agency established for nuclear weapons and power production; a predecessor 

to the U.S. Department of Energy.

anterior-posterior

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

back.

lateral 

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

other.

posterior-anterior 

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

front.

rad

The unit for absorbed dose, 1 rad = 100 erg gm-1

X-ray 

Ionizing electromagnetic radiation of external nuclear origin or an image generated by 

exposing a detector (e.g., film) to X-rays.
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ATTACHMENT 3A

OCCUPATIONAL MEDICAL DOSE

The following are analogs for IREP organs not included in ICRP (1982):

Anatomical 

location

ICRP (1982) 

reference organ

IREP organ 

analogs

Head Thyroid Eye

Brain

Thorax Lung Thymus

Esophagus

Bone surface 

Stomach /Spleen

Liver/gall bladder

Abdomen Ovaries Urinary bladder

Colon

Uterus

ANL-W conducted initial and periodic X-ray examinations as part of the medical examinations. The 

skin entrance air KERMA values in mrad are shown below.

Air kerma (mrad) PA LAT

Pre 1954 200 500

1954 to Jan 1990 52 74

Feb 1990 to present 53 76

Table 3A-1 lists the frequencies and doses. Table 3A-1, row 2 lists the organs identified in ICRP 

(1982) and row 3 lists the organs identified in IREP that are not listed in ICRP (1982). The 

uncertainties at the 84% confidence limit (1 sigma) are ±30%.
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Table 3A-1. Organ doses from occupational medical exposures at the ANL-W.

Period Frequency

ICRP 34 

organs

Organ doses (mrad) from ANL-W chest X-ray

Thyroid Testes Lungs Breast

Ovary 

Embryo Bone marrow

Other organs

Eye

Brain

Thymus

Esophagus

Stomach

Bone surface

Liver / Spleen

Gall bladder

Uterus

Bladder

Colon Skin

Geometry

Before 

1954

No information PA 69 1.8 93 10 34 19 272

Assume annual

1954 to 

1974

New hires PA 18 0.5 24 2.7 8 5 70

Annual

1975 to 

1976

New hires PA, 

Lat

10 0.008 41 22 0.1 8 171

25, 30, 34, 37, 40

Biennial 40 to 62

Annual >62

1977 to 

1978

New hires PA, 

Biennial <45 Lat

Annual >45

1979 to 

Jan 1990

New hires PA 1.8 0.001 24 2.7 0.1 5.0 70

4 years High risk

Feb 1990 

to present

only PA, 

Lat

14 0.008 53 27 0.3 11 180